bid_id	contract_year	version	cs_b0056	cs_b0057	cs_b0058	cs_b0059	cs_b0060	cs_b0061	cs_b0062	cs_b0063	cs_b0064	cs_b0065	cs_c0056	cs_c0057	cs_c0058	cs_c0059	cs_c0060	cs_c0061	cs_c0062	cs_c0063	cs_c0064	cs_c0065	cs_d0012	cs_d0056	cs_d0057	cs_d0058	cs_d0059	cs_d0060	cs_d0061	cs_d0062	cs_d0063	cs_d0064	cs_d0065	cs_e0025	cs_e0026	cs_e0027	cs_e0028	cs_e0029	cs_e0030	cs_e0031	cs_e0032	cs_e0033	cs_e0034	cs_e0035	cs_e0036	cs_e0037	cs_e0038	cs_e0039	cs_e0040	cs_e0041	cs_e0042	cs_e0043	cs_e0044	cs_e0045	cs_e0046	cs_e0047	cs_e0048	cs_e0049	cs_e0050	cs_e0051	cs_e0052	cs_e0053	cs_e0054	cs_e0055	cs_e0056	cs_e0057	cs_e0058	cs_e0059	cs_e0060	cs_e0061	cs_e0062	cs_e0063	cs_e0064	cs_e0065	cs_f0025	cs_f0026	cs_f0027	cs_f0028	cs_f0029	cs_f0030	cs_f0031	cs_f0032	cs_f0033	cs_f0034	cs_f0035	cs_f0036	cs_f0037	cs_f0038	cs_f0039	cs_f0040	cs_f0041	cs_f0042	cs_f0043	cs_f0044	cs_f0045	cs_f0046	cs_f0047	cs_f0048	cs_f0049	cs_f0050	cs_f0051	cs_f0052	cs_f0053	cs_f0054	cs_f0055	cs_f0056	cs_f0057	cs_f0058	cs_f0059	cs_f0060	cs_f0061	cs_f0062	cs_f0063	cs_f0064	cs_f0065	cs_f0066	cs_g0012	cs_g0025	cs_g0026	cs_g0027	cs_g0028	cs_g0029	cs_g0030	cs_g0031	cs_g0032	cs_g0033	cs_g0034	cs_g0035	cs_g0036	cs_g0037	cs_g0038	cs_g0039	cs_g0040	cs_g0041	cs_g0042	cs_g0043	cs_g0044	cs_g0045	cs_g0046	cs_g0047	cs_g0048	cs_g0049	cs_g0050	cs_g0051	cs_g0052	cs_g0053	cs_g0054	cs_g0055	cs_g0056	cs_g0057	cs_g0058	cs_g0059	cs_g0060	cs_g0061	cs_g0062	cs_g0063	cs_g0064	cs_g0065	cs_h0025	cs_h0026	cs_h0027	cs_h0028	cs_h0029	cs_h0030	cs_h0031	cs_h0032	cs_h0033	cs_h0034	cs_h0035	cs_h0036	cs_h0037	cs_h0038	cs_h0039	cs_h0040	cs_h0041	cs_h0042	cs_h0043	cs_h0044	cs_h0045	cs_h0046	cs_h0047	cs_h0048	cs_h0049	cs_h0050	cs_h0051	cs_h0052	cs_h0053	cs_h0054	cs_h0055	cs_h0056	cs_h0057	cs_h0058	cs_h0059	cs_h0060	cs_h0061	cs_h0062	cs_h0063	cs_h0064	cs_h0065	cs_i0025	cs_i0026	cs_i0027	cs_i0028	cs_i0029	cs_i0030	cs_i0031	cs_i0032	cs_i0033	cs_i0034	cs_i0035	cs_i0036	cs_i0037	cs_i0038	cs_i0039	cs_i0040	cs_i0041	cs_i0042	cs_i0043	cs_i0044	cs_i0045	cs_i0046	cs_i0047	cs_i0048	cs_i0049	cs_i0050	cs_i0051	cs_i0052	cs_i0053	cs_i0054	cs_i0055	cs_i0056	cs_i0057	cs_i0058	cs_i0059	cs_i0060	cs_i0061	cs_i0062	cs_i0063	cs_i0064	cs_i0065	cs_j0025	cs_j0026	cs_j0027	cs_j0028	cs_j0029	cs_j0030	cs_j0031	cs_j0032	cs_j0033	cs_j0034	cs_j0035	cs_j0036	cs_j0037	cs_j0038	cs_j0039	cs_j0040	cs_j0041	cs_j0042	cs_j0043	cs_j0044	cs_j0045	cs_j0046	cs_j0047	cs_j0048	cs_j0049	cs_j0050	cs_j0051	cs_j0052	cs_j0053	cs_j0054	cs_j0055	cs_j0056	cs_j0057	cs_j0058	cs_j0059	cs_j0060	cs_j0061	cs_j0062	cs_j0063	cs_j0064	cs_j0065	cs_j0066	cs_j0067	cs_j0068	cs_k0025	cs_k0026	cs_k0027	cs_k0028	cs_k0029	cs_k0030	cs_k0031	cs_k0032	cs_k0033	cs_k0034	cs_k0035	cs_k0036	cs_k0037	cs_k0038	cs_k0039	cs_k0040	cs_k0041	cs_k0042	cs_k0043	cs_k0044	cs_k0045	cs_k0046	cs_k0047	cs_k0048	cs_k0049	cs_k0050	cs_k0051	cs_k0052	cs_k0053	cs_k0054	cs_k0055	cs_k0056	cs_k0057	cs_k0058	cs_k0059	cs_k0060	cs_k0061	cs_k0062	cs_k0063	cs_k0064	cs_k0065	cs_k0066	cs_l0012	cs_l0025	cs_l0026	cs_l0027	cs_l0028	cs_l0029	cs_l0030	cs_l0031	cs_l0032	cs_l0033	cs_l0034	cs_l0035	cs_l0036	cs_l0037	cs_l0038	cs_l0039	cs_l0040	cs_l0041	cs_l0042	cs_l0043	cs_l0044	cs_l0045	cs_l0046	cs_l0047	cs_l0048	cs_l0049	cs_l0050	cs_l0051	cs_l0052	cs_l0053	cs_l0054	cs_l0055	cs_l0056	cs_l0057	cs_l0058	cs_l0059	cs_l0060	cs_l0061	cs_l0062	cs_l0063	cs_l0064	cs_l0065	cs_m0025	cs_m0026	cs_m0027	cs_m0028	cs_m0029	cs_m0030	cs_m0031	cs_m0032	cs_m0033	cs_m0034	cs_m0035	cs_m0036	cs_m0037	cs_m0038	cs_m0039	cs_m0040	cs_m0041	cs_m0042	cs_m0043	cs_m0044	cs_m0045	cs_m0046	cs_m0047	cs_m0048	cs_m0049	cs_m0050	cs_m0051	cs_m0052	cs_m0053	cs_m0054	cs_m0055	cs_m0056	cs_m0057	cs_m0058	cs_m0059	cs_m0060	cs_m0061	cs_m0062	cs_m0063	cs_m0064	cs_m0065	cs_m0066	cs_m0067	cs_m0068	cs_n0025	cs_n0026	cs_n0027	cs_n0028	cs_n0029	cs_n0030	cs_n0031	cs_n0032	cs_n0033	cs_n0034	cs_n0035	cs_n0036	cs_n0037	cs_n0038	cs_n0039	cs_n0040	cs_n0041	cs_n0042	cs_n0043	cs_n0044	cs_n0045	cs_n0046	cs_n0047	cs_n0048	cs_n0049	cs_n0050	cs_n0051	cs_n0052	cs_n0053	cs_n0054	cs_n0055	cs_n0056	cs_n0057	cs_n0058	cs_n0059	cs_n0060	cs_n0061	cs_n0062	cs_n0063	cs_n0064	cs_n0065	cs_n0066
E5088_801_0	2008	5	e.3.	h.6.	h.7.								DME/Prosthetics/Supplies	OP Facility - Other	OP Facility - Other								2000	Diabetic Mon Supplies	Urgent Care	PT/OT/ST/CORF/Cardiac Rehab/Pain Clinic								A		D	V	T	Coin	Coin	V	V	Coin	V	Coin	Coin		V	V	V	V		V	Coin	P			V		V			V		Coin	V	V																																																	0		193		813	614	93	21.36	0.76	255	311		600.4				3210	2899	92	883		576	29.29	19			333					1		3.4	79	155								"$400/admit, reduced to $300/admit if pre-notify (PBP #1A/1B)"		$100/admit (waived if pre-notify); $0/day for 1st 20 days; $75/day for days 21 - 100 (#2)	"$15/visit, reduced to $10/visit if pre-notify (#6)"	$25 copay (#10A)	10% coinsurance if under $750 or pre-notified; 20% otherwise (#11A)	Prosthetics: 10% coinsurance if under $750 or pre-notified; 20% otherwise; Medical Supplies: 0% coinsurance; Diabetes Monitoring Supplies: see below (e.3.) (#11B)	$50/visit (#4A)	$75/visit (#9B)	0% coinsurance (#8A)	"$25 copay/day for MRI, MRA, PET, & SPECT; all other diagnostic radiology $0 copay; Therapeutic Radiology $15 copay (#8B)"	0% coinsurance	0% coinsurance (#12)		$5/visit (#7A/14C)	$15/visit (#7D/7F/7G/14C)	$15/visit (#7E/7H)	$15/visit (#7C/7I)		Chiropractic Services: $15/visit (#7B)	10% coinsurance (#15)	eyewear after cataract surgery: $15 copay (#17B)			$15/visit (#17A)		$0 copay (#18A)			$15 copay (#14A)		"Glucose monitors: 0% coinsurance for Bayer glucometer, 50% for all others; Test strips: 10% coinsurance for Bayer test strips, 50% for all others; 10% coinsurance for lancets and all other supplies (#11C)"	$25 copay (#4B)	$15 copay (#3/9D/13D)								311.2087912		41.34055998	10.6978022	24.31318681	0.10017033	0.10017033	48.62637363	72.93956044		3.520549451				4.862637363	14.58791209	14.58791209	14.58791209		14.58791209	0.097252747	14.58791209			14.58791209					14.58791209		0.17310989	24.31318681	14.58791209								5.0053	0	2.800822938	0.547370879	0.188427198	2.139638242	0.076129451	1.03331044	1.890350275	0	0.176144824	0	0	0	1.300755495	3.524196429	0.111840659	1.073427198	0	0.70021978	2.848532967	0.023097527	0	0	0.40481456	0	0	0	0	0.001215659	0	0.588573626	0.160061813	0.188427198	0	0	0	0	0	0	0	24.7826		0.7	5.0053	0	2.800822938	0.547370879	0.188427198	2.139638242	0.076129451	1.03331044	1.890350275	0	0.176144824	0	0	0	1.300755495	3.524196429	0.111840659	1.073427198	0	0.70021978	2.848532967	0.023097527	0	0	0.40481456	0	0	0	0	0.001215659	0	0.588573626	0.160061813	0.188427198	0	0	0	0	0	0	0	24.7826																																																																																				0			5.0053	0	2.800822938	0.547370879	0.188427198	2.139638242	0.076129451	1.03331044	1.890350275	0	0.176144824	0	0	0	1.300755495	3.524196429	0.111840659	1.073427198	0	0.70021978	2.848532967	0.023097527	0	0	0.40481456	0	0	0	0	0.001215659	0	0.588573626	0.160061813	0.188427198	0	0	0	0	0	0	0	24.7826
E6036_801_0	2008	2																																Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	Coin	P	P	P	P	P	P	P																																																				0																									10																		#1A $0	#1B $0	#2 $0	#6 $0	#10A $0	#11A $0	"#11B $0, #11C $0"	"#4A $0, #4B $0"	"#9A $0, #9B $0"	#8A $0	#8B $0	$0 (incl. in h.5)	#12 $0	"#3 $0, #5 $0, #9C $0, #9D $0"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $0, #7D $0, #7F $0"	"#7E $0, #7H $0"	"#7C $0, #7I $0"	$0 (incl. in h.2)	"#7G $0, #14I $0, #14J $0"	#15 $0	#13A $0	#10B $0	"#16A 20%, #16B 20% ER/Diag, 30% Restor/Endo, 50% Prostho, $10 Deduct"	#17A $0	#17B $0	#18A $0	#18B $0	#19 $0 n/c	#14A $0	#13B $0																																		0.266084																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.66084	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.6608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.66084	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.6608																																																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.66084	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.6608
H0087_801_0	2008	3																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	201.6006165	1.05035567	37.94064013	0	4.285251731	0.345275794	11.98600256	22.25271218	42.02751954	4.259266106	4.341459696	0	0	27.91903652	29.26172724	107.6109069	0.405222776	0.162314124	0	90.02181334	27.27060643	0.589680964	0	0	0	0	0	0	0	0	0											"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"20.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"0.0%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											0.087429324	0.087429324	0.20726814	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											17.6258	0.091831887	7.863885919	0	1.002748905	0.080794536	2.8047246	5.20713465	9.834439571	0.996668269	1.015901569	0	0	6.533054546	6.847244173	25.18095222	0.09482213	0.037981505	0	21.06510432	6.381321904	0.137985346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8024	0	0	17.6258	0.091831887	7.863885919	0	1.002748905	0.080794536	2.8047246	5.20713465	9.834439571	0.996668269	1.015901569	0	0	6.533054546	6.847244173	25.18095222	0.09482213	0.037981505	0	21.06510432	6.381321904	0.137985346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8024	0																																																																																			0	0	0	17.6258	0.091831887	7.863885919	0	1.002748905	0.080794536	2.8047246	5.20713465	9.834439571	0.996668269	1.015901569	0	0	6.533054546	6.847244173	25.18095222	0.09482213	0.037981505	0	21.06510432	6.381321904	0.137985346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8024
H0087_802_0	2008	3																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	201.6006165	1.05035567	37.94064013	0	4.285251731	0.345275794	11.98600256	22.25271218	42.02751954	4.259266106	4.341459696	0	0	27.91903652	29.26172724	107.6109069	0.405222776	0.162314124	0	90.02181334	27.27060643	0.589680964	0	0	0	0	0	0	0	0	0											"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"20.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"0.0%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											0.087429324	0.087429324	0.20726814	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											17.6258	0.091831887	7.863885919	0	1.002748905	0.080794536	2.8047246	5.20713465	9.834439571	0.996668269	1.015901569	0	0	6.533054546	6.847244173	25.18095222	0.09482213	0.037981505	0	21.06510432	6.381321904	0.137985346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8024	0	0	17.6258	0.091831887	7.863885919	0	1.002748905	0.080794536	2.8047246	5.20713465	9.834439571	0.996668269	1.015901569	0	0	6.533054546	6.847244173	25.18095222	0.09482213	0.037981505	0	21.06510432	6.381321904	0.137985346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8024	0																																																																																			0	0	0	17.6258	0.091831887	7.863885919	0	1.002748905	0.080794536	2.8047246	5.20713465	9.834439571	0.996668269	1.015901569	0	0	6.533054546	6.847244173	25.18095222	0.09482213	0.037981505	0	21.06510432	6.381321904	0.137985346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8024
H0087_803_0	2008	3																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	201.6006165	1.05035567	37.94064013	0	4.285251731	0.345275794	11.98600256	22.25271218	42.02751954	4.259266106	4.341459696	0	0	27.91903652	29.26172724	107.6109069	0.405222776	0.162314124	0	90.02181334	27.27060643	0.589680964	0	0	0	0	0	0	0	0	0											"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"20.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"0.0%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											0.087429324	0.087429324	0.20726814	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											17.6258	0.091831887	7.863885919	0	1.002748905	0.080794536	2.8047246	5.20713465	9.834439571	0.996668269	1.015901569	0	0	6.533054546	6.847244173	25.18095222	0.09482213	0.037981505	0	21.06510432	6.381321904	0.137985346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8024	0	0	17.6258	0.091831887	7.863885919	0	1.002748905	0.080794536	2.8047246	5.20713465	9.834439571	0.996668269	1.015901569	0	0	6.533054546	6.847244173	25.18095222	0.09482213	0.037981505	0	21.06510432	6.381321904	0.137985346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8024	0																																																																																			0	0	0	17.6258	0.091831887	7.863885919	0	1.002748905	0.080794536	2.8047246	5.20713465	9.834439571	0.996668269	1.015901569	0	0	6.533054546	6.847244173	25.18095222	0.09482213	0.037981505	0	21.06510432	6.381321904	0.137985346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8024
H0097_001_0	2008	6																																d	d	d		t	coin	coin	v	v		v			v		v	v	v	v	v	s				v		v																																																								0		748.0168931	15.36768206	451.6492502		174.9329044	7.3701	14.613	198.8413865	432.7679148		856.4728808			396.6210087		6575.861866	174.1525471	854.1937314	192.2236918	355.1984287	2.951056387				165.26899		0.0001															"$150/day, 10 day max (PBP Cat 1a)"	"$150/day, 10 day max (PBP Cat 1b)"	"$25/day, days 1-100 (PBP category 2)"	$0 copay	$100 copay (PBP category 10a)	20% coinsurance (PBP cat. 11a)	"20% coinsurance (PBP cat. 11b, 11c)"	"$50 per visit (PBP category 4A), 0-15 per Visit (PBP category 4B)"	"$100/visit (PBP category 9a, 9b)"	$0 copay	$15/visit (PBP category 8b)	$0 copay	$0 copay	"$15 per visit (PBP categories 3, 5, 9C, and 9D)"	$0 copay	"$15 per visit (PBP categories 4B, 7B, 7D, and 7F)"	"$15 per visit (PBP categories 7E, 7H and 9C)"	$15 per visit (PBP categories 7C and 7I)	$15 per visit (per note in PBP category 8B)	"$15 per visit (PBP category 17A - Medicare covered vision exams, PBP category 18A - Medicare Covered Hearing Exams) and 7D"	$50/script for certain covered injectibles (PBP category 15)	$0 copay			$15/visit (PBP category 17a)	$0 copay	$15/visit (PBP category 18a)	$0 copay														150	150	25		100	0.2	0.2	50	100		15			15		15	15	15	15	15	50				15		15															9.3502	0.192096026	0.940935938	0	1.457774203	1.474013141	2.922591104	0.828505777	3.60639929	0	1.070591101	0	0	0.495776261	0	8.219827333	0.217690684	1.067742164	0.240279615	0.443998036	0.012296068	0	0	0	0.206586238	0	0.000000125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7473			9.3502	0.192096026	0.940935938	0	1.457774203	1.474013141	2.922591104	0.828505777	3.60639929	0	1.070591101	0	0	0.495776261	0	8.219827333	0.217690684	1.067742164	0.240279615	0.443998036	0.012296068	0	0	0	0.206586238	0	0.000000125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7473																																																																																				0			9.3502	0.192096026	0.940935938	0	1.457774203	1.474013141	2.922591104	0.828505777	3.60639929	0	1.070591101	0	0	0.495776261	0	8.219827333	0.217690684	1.067742164	0.240279615	0.443998036	0.012296068	0	0	0	0.206586238	0	0.000000125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7473
H0097_002_0	2008	9																																d	d	d		t	coin	coin	v	v		v			v		v	v	v	v	v	s				v		v																																																								0		748.0168931	15.36768206	451.6492502		174.9329044	7.3701	14.613	198.8413865	432.7679148		856.4728808			396.6210087		6575.861866	174.1525471	854.1937314	192.2236918	355.1984287	2.951056387				165.26899		0.0001															"$150/day, 10 day max (PBP Cat 1a)"	"$150/day, 10 day max (PBP Cat 1b)"	"$25/day, days 1-100 (PBP category 2)"	$0 copay	$100 copay (PBP category 10a)	20% coinsurance (PBP cat. 11a)	"20% coinsurance (PBP cat. 11b, 11c)"	"$50 per visit (PBP category 4A), 0-15 per Visit (PBP category 4B)"	"$100/visit (PBP category 9a, 9b)"	$0 copay	$15/visit (PBP category 8b)	$0 copay	$0 copay	"$15 per visit (PBP categories 3, 5, 9C, and 9D)"	$0 copay	"$15 per visit (PBP categories 4B, 7B, 7D, and 7F)"	"$15 per visit (PBP categories 7E, 7H and 9C)"	$15 per visit (PBP categories 7C and 7I)	$15 per visit (per note in PBP category 8B)	"$15 per visit (PBP category 17A - Medicare covered vision exams, PBP category 18A - Medicare Covered Hearing Exams) and 7D"	$50/script for certain covered injectibles (PBP category 15)	$0 copay			$15/visit (PBP category 17a)	$0 copay	$15/visit (PBP category 18a)	$0 copay														150	150	25		100	0.2	0.2	50	100		15			15		15	15	15	15	15	50				15		15															9.3502	0.192096026	0.940935938	0	1.457774203	1.474013141	2.922591104	0.828505777	3.60639929	0	1.070591101	0	0	0.495776261	0	8.219827333	0.217690684	1.067742164	0.240279615	0.443998036	0.012296068	0	0	0	0.206586238	0	0.000000125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7473			9.3502	0.192096026	0.940935938	0	1.457774203	1.474013141	2.922591104	0.828505777	3.60639929	0	1.070591101	0	0	0.495776261	0	8.219827333	0.217690684	1.067742164	0.240279615	0.443998036	0.012296068	0	0	0	0.206586238	0	0.000000125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7473																																																																																				0			9.3502	0.192096026	0.940935938	0	1.457774203	1.474013141	2.922591104	0.828505777	3.60639929	0	1.070591101	0	0	0.495776261	0	8.219827333	0.217690684	1.067742164	0.240279615	0.443998036	0.012296068	0	0	0	0.206586238	0	0.000000125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7473
H0097_003_0	2008	6																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H0097_004_0	2008	8																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H0097_801_0	2008	4																																coin		coin	coin	coin	coin		coin	coin	coin					coin						coin	coin																																																													0		285.3630245		17.03765482	7.803900803	5.569287491	15.40533134		4.362465336	66.97486828	120.8893192					376.037416						4.508534994	2.482785467																				Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS					Medicare FFS						Medicare FFS	Medicare FFS																				0.073		0.1705	0	0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				20.8315	0	2.904920147	0	1.303213273	3.604847533	0	1.020816889	15.67211918	28.28810069	0	0	0	0	87.99275533	0	0	0	0	0	1.054997189	0.580971799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	163.2542			20.8315	0	2.904920147	0	1.303213273	3.604847533	0	1.020816889	15.67211918	28.28810069	0	0	0	0	87.99275533	0	0	0	0	0	1.054997189	0.580971799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	163.2542																																																																																				0			20.8315	0	2.904920147	0	1.303213273	3.604847533	0	1.020816889	15.67211918	28.28810069	0	0	0	0	87.99275533	0	0	0	0	0	1.054997189	0.580971799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	163.2542
H0097_802_0	2008	4																																coin		coin	coin	coin	coin		coin	coin	coin					coin						coin	coin																																																													0		285.3630245		17.03765482	7.803900803	5.569287491	15.40533134		4.362465336	66.97486828	120.8893192					376.037416						4.508534994	2.482785467																				Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS					Medicare FFS						Medicare FFS	Medicare FFS																				0.073		0.1705	0	0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				20.8315	0	2.904920147	0	1.303213273	3.604847533	0	1.020816889	15.67211918	28.28810069	0	0	0	0	87.99275533	0	0	0	0	0	1.054997189	0.580971799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	163.2542			20.8315	0	2.904920147	0	1.303213273	3.604847533	0	1.020816889	15.67211918	28.28810069	0	0	0	0	87.99275533	0	0	0	0	0	1.054997189	0.580971799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	163.2542																																																																																				0			20.8315	0	2.904920147	0	1.303213273	3.604847533	0	1.020816889	15.67211918	28.28810069	0	0	0	0	87.99275533	0	0	0	0	0	1.054997189	0.580971799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	163.2542
H0104_002_0	2008	4																					4500											A	A	D	V	T	coin	coin	V	V	V	V	O	coin	P	V	V	V	V	V	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	170.4193277	1.686879965	254.9441584	0	181.5495278	16.83119513	0.80167991	257.8865666	363.4636554	0	0	0	0.11021431	740.6550512	2657.608685	3400.786064	99.41780331	320.7136506	0	70.48634239	2.836303231	147.0101859	0	0	250.5346021	0	149.2825597	0	0	121.8702058	0											$600 per benefit period	$600 per benefit period	$75 days 1-30	$0 per visit	$150 per trip	20%	20%	"ER:  $50 per visit, UC:  $30 per visit"	$225 per visit	$0 per visit	$0 per visit	$0 per visit	20% coinsurance	OP PT/ST/OT:  $30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$0 per visit	"Medicare Hearing Exams:  $30 per visit, OPSA:  $30 per visit"	20% coinsurance	Medicare Vision Exams:  $30 per visit	$0 per trip	$0 per visit	$30 per visit	$0 	$30 per visit	$0 	0	0	0											569.872353	569.8729609	67.9378375	0	139.7343992	0.186463558	0.186463558	40.72492037	217.5329815	0	0	0	0.185423148	28.70283043	28.3167777	28.31971106	28.31526635	28.3154524	0	28.25582845	0.183062388	24.88438561	0	0	30	0	30	0	0	30	0											8.0931	0.08010894	1.4433629	0	2.114059516	3.138404535	0.149484089	0.875200824	6.588777719	0	0	0	0.020436284	1.771574695	6.271242863	8.025773227	0.234586798	0.756762676	0	0.165970833	0.519220444	0.304854846	0	0	0.626336505	0	0.373206399	0	0	0.304675514	0	0	0	0	0	0	0	0	0	0	0	41.8571	0	2.356	8.0931	0.08010894	1.4433629	0	2.114059516	3.138404535	0.149484089	0.875200824	6.588777719	0	0	0	0.020436284	1.771574695	6.271242863	8.025773227	0.234586798	0.756762676	0	0.165970833	0.519220444	0.304854846	0	0	0.626336505	0	0.373206399	0	0	0.304675514	0	0	0	0	0	0	0	0	0	0	0	41.8571	none	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance											4.3716	0.0334	0.4621	0.3011	0.1044	0.347	0.016	0.0837	0.7116	0.1437	0.392	0	0.0034	0.3793	0.7434	2.0227	0.0231	0.0776	0.5103	0.6516	0.0986	0.0559	0	0	0.0487	0.0175	0.0169	0.0023	0	0.0373	0											11.6552	2000	0	12.4647	0.113520831	1.905444482	0.301108064	2.218449129	3.485452699	0.165483576	0.958886736	7.300385134	0.143691395	0.391998776	0	0.023840385	2.150827879	7.014634182	10.04850469	0.257657472	0.834412295	0.510259694	0.817521486	0.617825059	0.360777861	0	0	0.67505624	0.017486051	0.390088604	0.002325755	0	0.341976126	0	0	0	0	0	0	0	0	0	0	0	53.5124
H0104_004_0	2008	3																					2500											A	A	D	V	T	coin	coin	V	V	V	V	O	coin	P	V	V	V	V	V	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	189.6098471	1.877267658	353.184173	0	202.6072833	18.69300798	0.890443258	291.5699233	405.5626347	0	0	0	0.121402728	828.3357577	3098.098216	3947.967521	115.3572657	372.1823511	0	82.12713131	3.182183585	173.8034848	0	200.6875	289.0314495	0	169.1965354	0	0	136.0169641	0											$150 per benefit period	$150 per benefit period	$50 days 1-50	$0 per visit	$150 per trip	20%	20%	"ER:  $50 per visit, UC:  $15 per visit"	$100 per visit	$0 per visit	$0 per visit	$0 per visit	20% coinsurance	OP PT/ST/OT:  $15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$0 per visit	"Medicare Hearing Exams:  $15 per visit, OPSA:  $15 per visit"	20% coinsurance	Medicare Vision Exams:  $15 per visit	$0 per trip	$0 per visit	$15 per visit	$0 	$15 per visit	0	0	0	0											138.7329766	138.7333503	43.01866557	0	134.9326419	0.180120695	0.180120695	33.98735266	95.01369011	0	0	0	0.178414671	14.02772786	13.74693326	13.74810671	13.74475333	13.74505822	0	13.75365157	0.17490913	11.24154351	0	0	15	0	15	0	0	15	0											2.1921	0.021703303	1.266125985	0	2.278194666	3.366997591	0.160387259	0.825807484	3.211166874	0	0	0	0.021660028	0.968305716	3.54911245	4.523089898	0.132129763	0.426305674	0	0.094128996	0.556592962	0.162818286	0	0	0.361289312	0	0.211495669	0	0	0.170021205	0	0	0	0	0	0	0	0	0	0	0	24.4994	0	2.261	2.1921	0.021703303	1.266125985	0	2.278194666	3.366997591	0.160387259	0.825807484	3.211166874	0	0	0	0.021660028	0.968305716	3.54911245	4.523089898	0.132129763	0.426305674	0	0.094128996	0.556592962	0.162818286	0	0	0.361289312	0	0.211495669	0	0	0.170021205	0	0	0	0	0	0	0	0	0	0	0	24.4994	none	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance											4.6436	0.0355	0.5269	0.3172	0.1111	0.3701	0.0171	0.0873	0.7609	0.1524	0.4157	0	0.0036	0.4022	0.7906	2.1511	0.0245	0.0826	0.5426	0.6929	0.1043	0.0588	0	0	0.0514	0.036	0.0176	0.0048	0	0.0387	0											12.4397	2000	0	6.8357	0.057193562	1.793054455	0.317245615	2.389318223	3.737110541	0.177450071	0.913152348	3.972109867	0.152389217	0.41572696	0	0.025270183	1.370515576	4.33967385	6.674168847	0.156664331	0.50888236	0.542636978	0.787022205	0.660925269	0.221613872	0	0	0.412662027	0.036014865	0.2291407	0.004790204	0	0.208738355	0	0	0	0	0	0	0	0	0	0	0	36.9391
H0104_006_0	2008	5																					none											coin	coin	coin	V	T	coin	coin	V	coin	V	V	O	coin	P	V	V	coin	coin	V	V	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	237.6811679	1.757109259	23.17831916	0	268.5293795	25.03616265	1.190785631	344.3633255	43.51226516	0	0	0	0.115502273	0	0	0	1.349034376	4.114189115	0	0	3.839922365	1.724271977	0	0	0	0	0	0	0	0	0											$0 per benefit period	$0 per benefit period	$0 days 1-1	$0 per visit	$50 per trip	0%	0%	"ER:  $50 per visit, UC:  $50 per visit"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	0% coinsurance	OP PT/ST/OT:  $0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	"Medicare Hearing Exams:  $0 per visit, OPSA:  $0 per visit"	0% coinsurance	Medicare Vision Exams:  $0 per visit	$0 per trip	$0 per visit	$0 per visit	$0 	$0 per visit	0	0	0	0											-4.68E-20	0	0	0	50	0	0	50	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	1.118872415	0	0	1.43484719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.5537	0	0	0	0	0	0	1.118872415	0	0	1.43484719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.5537	none	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance											4.354	0.0333	0.3516	0.4393	0.1641	0.5463	0.0252	0.075	0.6416	0.1245	0.3396	0	0.0026	0.3286	0.6479	1.7628	0.0201	0.0677	0.4447	0.5678	0.0849	0.0428	0	0	0	0	0	0	0	0.0331	0											11.0975	2000	0	4.354	0.033277038	0.351599445	0.439333494	1.28298487	0.546263565	0.025183643	1.50984289	0.641647302	0.124481492	0.339593004	0	0.002639895	0.328551352	0.647875896	1.762838663	0.020106414	0.067672725	0.444698436	0.567835475	0.084855602	0.042791171	0	0	0	0	0	0	0	0.033121594	0	0	0	0	0	0	0	0	0	0	0	13.6512
H0104_008_0	2008	3																					2500											coin	coin	coin	V	coin	coin	coin	V	coin	V	V	O	coin	P	V	V	coin	coin	V	V	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	219.2746547	1.618837027	14.1383823	0	6.947990421	20.98019399	0.999467733	197.4029145	39.88103427	0	0	0	0.137178891	0	0	0	1.313005752	4.004311583	0	0	3.568067715	1.97078939	0	200.6875	0	0	0	0	0	151.4096942	0											$0 per benefit period	$0 per benefit period	$0 days 1-1	$0 per visit	$0 per trip	20%	20%	"ER:  $50 per visit, UC:  $0 per visit"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	20% coinsurance	OP PT/ST/OT:  $0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	"Medicare Hearing Exams:  $0 per visit, OPSA:  $0 per visit"	20% coinsurance	Medicare Vision Exams:  $0 per visit	$0 per trip	$0 per visit	$0 per visit	$0 	$0 per visit	0	0	0	0											5.40E-19	0	0	0	0	0.199038847	0.199038847	49.82190352	0	0	0	0	0.19896404	0	0	0	0	0	0	0	0.198794212	0	0	0	0	0	0	0	0	15	0											0	0	0	0	0	4.175873618	0.198932905	0.819582413	0	0	0	0	0.027293666	0	0	0	0	0	0	0	0.709311208	0	0	0	0	0	0	0	0	0.189262118	0	0	0	0	0	0	0	0	0	0	0	6.1203	0	0.0285	0	0	0	0	0	4.175873618	0.198932905	0.819582413	0	0	0	0	0.027293666	0	0	0	0	0	0	0	0.709311208	0	0	0	0	0	0	0	0	0.189262118	0	0	0	0	0	0	0	0	0	0	0	6.1203	none	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance											4.9721	0.038	0.3239	0.3371	0.1193	0.3949	0.0182	0.0924	0.8237	0.1631	0.4449	0	0.0039	0.4305	0.828	2.253	0.0257	0.0865	0.5684	0.7257	0.1114	0.0621	0	0	0.0534	0.0374	0.0178	0.005	0	0.042	0											12.9784	2000	0	4.9721	0.038000895	0.323898742	0.337051308	0.119336896	4.570798008	0.217139565	0.911989662	0.82373577	0.163095346	0.444933923	0	0.031157454	0.430467178	0.82803569	2.253044661	0.025697558	0.086490997	0.568359123	0.725737819	0.820667226	0.06209879	0	0	0.053366035	0.037418975	0.017838138	0.004976959	0	0.231235786	0	0	0	0	0	0	0	0	0	0	0	19.0986
H0104_801_0	2008	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	238.914465	1.772774807	26.13794982	36.26260776	8.961576014	28.43191669	1.354739024	4.096848492	20.88277846	8.15288439	22.2415595	0	0.195151059	21.51838925	38.14424864	101.5929448	1.03762733	3.484613267	25.52822544	30.85744972	6.026183827	5.176016223	0	0	0	0	0	0	0	0	0											Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	0	0	0	0	0	0	0	0	0											0.090167201	0.090167201	0.2155528	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.5422	0.159846143	5.634108259	0	2.097008787	6.653068506	0.317008932	0.958662547	4.88657016	1.907774947	5.204524923	0	0.045665348	5.035303083	8.925754182	23.77274908	0.242804795	0.815399505	5.973604753	7.220643234	1.410127016	1.211187796	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.0141	0	0	21.5422	0.159846143	5.634108259	0	2.097008787	6.653068506	0.317008932	0.958662547	4.88657016	1.907774947	5.204524923	0	0.045665348	5.035303083	8.925754182	23.77274908	0.242804795	0.815399505	5.973604753	7.220643234	1.410127016	1.211187796	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.0141	none	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare											1.204	0.0092	0.4609	0	0.0814	0.2783	0.0128	0.0594	0.3068	0.1198	0.3268	0	0.0028	0.3161	0.4855	1.3087	0.0151	0.0506	0.3305	0.4232	0.0885	0.0655	0	0	0	0	0	0	0	0	0											5.9459	0	0	22.7463	0.169075159	6.09500447	0	2.178412638	6.931368721	0.329839027	1.018046564	5.193365631	2.027551538	5.531282674	0	0.048502898	5.351436513	9.411250227	25.08146401	0.257858115	0.866001297	6.304075978	7.643851857	1.498659579	1.276648297	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.96
H0104_802_0	2008	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	238.914465	1.772774807	26.13794982	36.26260776	8.961576014	28.43191669	1.354739024	4.096848492	20.88277846	8.15288439	22.2415595	0	0.195151059	21.51838925	38.14424864	101.5929448	1.03762733	3.484613267	25.52822544	30.85744972	6.026183827	5.176016223	0	0	0	0	0	0	0	0	0											Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	0	0	0	0	0	0	0	0	0											0.090167201	0.090167201	0.2155528	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.5422	0.159846143	5.634108259	0	2.097008787	6.653068506	0.317008932	0.958662547	4.88657016	1.907774947	5.204524923	0	0.045665348	5.035303083	8.925754182	23.77274908	0.242804795	0.815399505	5.973604753	7.220643234	1.410127016	1.211187796	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.0141	0	0	21.5422	0.159846143	5.634108259	0	2.097008787	6.653068506	0.317008932	0.958662547	4.88657016	1.907774947	5.204524923	0	0.045665348	5.035303083	8.925754182	23.77274908	0.242804795	0.815399505	5.973604753	7.220643234	1.410127016	1.211187796	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.0141	none	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare											1.204	0.0092	0.4609	0	0.0814	0.2783	0.0128	0.0594	0.3068	0.1198	0.3268	0	0.0028	0.3161	0.4855	1.3087	0.0151	0.0506	0.3305	0.4232	0.0885	0.0655	0	0	0	0	0	0	0	0	0											5.9459	0	0	22.7463	0.169075159	6.09500447	0	2.178412638	6.931368721	0.329839027	1.018046564	5.193365631	2.027551538	5.531282674	0	0.048502898	5.351436513	9.411250227	25.08146401	0.257858115	0.866001297	6.304075978	7.643851857	1.498659579	1.276648297	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.96
H0104_804_0	2008	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	238.914465	1.772774807	26.13794982	36.26260776	8.961576014	28.43191669	1.354739024	4.096848492	20.88277846	8.15288439	22.2415595	0	0.195151059	21.51838925	38.14424864	101.5929448	1.03762733	3.484613267	25.52822544	30.85744972	6.026183827	5.176016223	0	0	0	0	0	0	0	0	0											Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	0	0	0	0	0	0	0	0	0											0.090167201	0.090167201	0.2155528	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.5422	0.159846143	5.634108259	0	2.097008787	6.653068506	0.317008932	0.958662547	4.88657016	1.907774947	5.204524923	0	0.045665348	5.035303083	8.925754182	23.77274908	0.242804795	0.815399505	5.973604753	7.220643234	1.410127016	1.211187796	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.0141	0	0	21.5422	0.159846143	5.634108259	0	2.097008787	6.653068506	0.317008932	0.958662547	4.88657016	1.907774947	5.204524923	0	0.045665348	5.035303083	8.925754182	23.77274908	0.242804795	0.815399505	5.973604753	7.220643234	1.410127016	1.211187796	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.0141	none	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare	Similar with FFS Medicare											1.204	0.0092	0.4609	0	0.0814	0.2783	0.0128	0.0594	0.3068	0.1198	0.3268	0	0.0028	0.3161	0.4855	1.3087	0.0151	0.0506	0.3305	0.4232	0.0885	0.0655	0	0	0	0	0	0	0	0	0											5.9459	0	0	22.7463	0.169075159	6.09500447	0	2.178412638	6.931368721	0.329839027	1.018046564	5.193365631	2.027551538	5.531282674	0	0.048502898	5.351436513	9.411250227	25.08146401	0.257858115	0.866001297	6.304075978	7.643851857	1.498659579	1.276648297	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.96
H0117_001_0	2008	6																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1859.547903	111.8239412	1939.946949	2284.669375	739.1647603	14.90344437	4.14401678	1671.085541	333.6382383	9378.078848	1565.103764	80.09721726	0.087672189	697.3698297	7624.691984	18198.15026	399.4578408	3659.301722	4668.600491	864.3773003	39.88933654	42.27855229	0	434.6666667	379.2	262.5230769	46.8	17.82857143	0	0	3600											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$150.00 copayment	20% coinsurance	Copay between $15.00 and $100.00	Copay between $0.00 and $10.00	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $10.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											66.96830445	36.82226348	27.7471374	0	33.20224567	0.183391523	0.183391523	16.92899952	76.83982512	0	14.55060681	99.51050132	0.183391523	19.93840767	3.786389225	6.861881384	18.08173684	8.314212362	3.986368799	0	0.183391523	0	0	45.8478807	9.16957614	9.16957614	18.33915228	0	0	0	0											10.3776	0.343134219	4.485664545	0	2.045160831	2.733165359	0.759977548	2.35748386	2.13639199	0	1.897767457	0.66420952	0.016078336	1.158703663	2.405837631	10.40612904	0.60190763	2.535350968	1.550896945	0	7.315366172	0	0	1.660712123	0.289758606	0.200602112	0.071522694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0134	0	5.072737388	10.3776	0.343134219	4.485664545	0	2.045160831	2.733165359	0.759977548	2.35748386	2.13639199	0	1.897767457	0.66420952	0.016078336	1.158703663	2.405837631	10.40612904	0.60190763	2.535350968	1.550896945	0	7.315366172	0	0	1.660712123	0.289758606	0.200602112	0.071522694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0134	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	10.3776	0.343134219	4.485664545	0	2.045160831	2.733165359	0.759977548	2.35748386	2.13639199	0	1.897767457	0.66420952	0.016078336	1.158703663	2.405837631	10.40612904	0.60190763	2.535350968	1.550896945	0	7.315366172	0	0	1.660712123	0.289758606	0.200602112	0.071522694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0134
H0117_002_0	2008	6																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1740.871672	57.45782509	1694.009277	2155.892804	736.0091323	15.48707115	3.78361291	1213.826393	233.2203946	8771.92631	1517.901875	125.1831792	0.127095695	690.4275626	9991.468001	17201.02584	288.3938898	3795.251856	4460.247526	869.8300095	31.0183552	32.27352338	0	434.6666667	379.2	262.5230769	46.8	17.82857143	0	0	3600											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 10, $100 days 11 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $20.00 and $75.00	Copay between $0.00 and $5.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											44.3350864	31.7562448	46.93882837	0	32.81644796	0.186450162	0.186450162	17.54968385	56.91632808	0	13.51531433	67.44677123	0.186450162	16.43072094	1.75061949	7.86486376	23.27873792	10.43912684	4.307063522	0	0.186450162	0	0	46.61254059	9.322508117	9.322508117	18.64501623	0	0	0	0											6.4318	0.15205373	6.626234227	0	2.012767116	2.88756693	0.705455241	1.775189121	1.106170708	0	1.709576747	0.703600104	0.023697013	0.945351884	1.457604884	11.27364373	0.559453815	3.301592959	1.600880785	0	5.783377363	0	0	1.688409803	0.294591257	0.203947793	0.072715563	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.3157	0	3.729249914	6.4318	0.15205373	6.626234227	0	2.012767116	2.88756693	0.705455241	1.775189121	1.106170708	0	1.709576747	0.703600104	0.023697013	0.945351884	1.457604884	11.27364373	0.559453815	3.301592959	1.600880785	0	5.783377363	0	0	1.688409803	0.294591257	0.203947793	0.072715563	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.3157	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	6.4318	0.15205373	6.626234227	0	2.012767116	2.88756693	0.705455241	1.775189121	1.106170708	0	1.709576747	0.703600104	0.023697013	0.945351884	1.457604884	11.27364373	0.559453815	3.301592959	1.600880785	0	5.783377363	0	0	1.688409803	0.294591257	0.203947793	0.072715563	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.3157
H0117_003_0	2008	7																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1644.767823	54.2712166	1554.414038	2044.212453	728.6336847	15.26446932	3.658073788	1180.912376	225.6755304	8486.042566	1468.37771	121.1086383	0.122562088	668.617817	9639.065215	16624.30515	280.0959347	3679.200844	4320.866084	842.8239195	29.86723857	31.21840161	0	935.4545455	379.2	262.5230769	46.8	17.82857143	0	0	3600											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 10, $100 days 11 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $20.00 and $75.00	Copay between $0.00 and $5.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											44.77881427	32.0731965	47.40687789	0	33.14309878	0.188309346	0.188309346	17.72802908	57.47887663	0	13.65018783	68.11931527	0.188309346	16.59247188	1.779269888	7.978462969	23.51390766	10.54410611	4.349669005	0	0.188309346	0	0	0	9.415467307	9.415467307	18.83093461	0	0	0	0											6.1376	0.145054283	6.140826375	0	2.012431515	2.874442237	0.688849483	1.744604078	1.080964664	0	1.67030263	0.687486459	0.023079587	0.924501861	1.429208207	11.05303358	0.548845829	3.232823675	1.566194773	0	5.624280167	0	0	0	0.297528767	0.205981454	0.073440645	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.1614	0	2.989967152	6.1376	0.145054283	6.140826375	0	2.012431515	2.874442237	0.688849483	1.744604078	1.080964664	0	1.67030263	0.687486459	0.023079587	0.924501861	1.429208207	11.05303358	0.548845829	3.232823675	1.566194773	0	5.624280167	0	0	0	0.297528767	0.205981454	0.073440645	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.1614	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	6.1376	0.145054283	6.140826375	0	2.012431515	2.874442237	0.688849483	1.744604078	1.080964664	0	1.67030263	0.687486459	0.023079587	0.924501861	1.429208207	11.05303358	0.548845829	3.232823675	1.566194773	0	5.624280167	0	0	0	0.297528767	0.205981454	0.073440645	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.1614
H0117_004_0	2008	6																					2500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1870.75956	117.2301854	1943.983932	2362.295987	734.2390093	14.92822864	4.134410695	1695.765017	331.0693685	9277.313918	1575.709491	80.76107738	0.08778995	702.1673435	7751.635881	18129.68294	411.3311554	3674.793662	4643.341908	845.5895439	40.09655231	43.38756715	0	434.6666667	379.2	262.5230769	46.8	17.82857143	0	0	3600											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $15.00 and $75.00	Copay between $0.00 and $5.00	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											44.11099971	24.17165434	27.43037086	0	33.00459741	0.181297891	0.181297891	16.64316342	57.68934164	0	11.2755439	65.58298049	0.181297891	15.46123023	1.902311014	6.762471978	17.84383798	8.226301806	3.904373249	0	0.181297891	0	0	45.32447268	9.064894535	9.064894535	18.12978907	0	0	0	0											6.8768	0.236137293	4.44368335	0	2.019438575	2.706456365	0.749559938	2.351907858	1.591597826	0	1.480581796	0.441379347	0.015916133	0.90469758	1.228835192	10.2167894	0.611643874	2.519163478	1.510778328	0	7.269420359	0	0	1.641753121	0.286450667	0.198312	0.070706177	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.372	0	5.093053644	6.8768	0.236137293	4.44368335	0	2.019438575	2.706456365	0.749559938	2.351907858	1.591597826	0	1.480581796	0.441379347	0.015916133	0.90469758	1.228835192	10.2167894	0.611643874	2.519163478	1.510778328	0	7.269420359	0	0	1.641753121	0.286450667	0.198312	0.070706177	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.372	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	6.8768	0.236137293	4.44368335	0	2.019438575	2.706456365	0.749559938	2.351907858	1.591597826	0	1.480581796	0.441379347	0.015916133	0.90469758	1.228835192	10.2167894	0.611643874	2.519163478	1.510778328	0	7.269420359	0	0	1.641753121	0.286450667	0.198312	0.070706177	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.372
H0117_005_0	2008	6																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1733.385225	57.17011865	1683.02189	2141.200527	730.9869772	15.33535087	3.748108076	1206.938107	232.5831316	8712.15573	1534.370549	124.784338	0.125880036	708.8074663	9930.502269	17239.43931	292.2287332	3820.453631	4447.254908	864.1831632	30.70992131	32.19998601	0	434.6666667	379.2	262.5230769	46.8	17.82857143	0	0	3600											"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 10, $100 days 11 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$50.00 copayment	20% coinsurance	Copay between $15.00 and $25.00	Copay between $0.00 and $5.00	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											22.65099323	16.22383905	47.96159753	0	33.53110216	0.1905128	0.1905128	17.93276851	19.78861988	0	9.615576808	34.45819813	0.1905128	7.321227122	1.788769007	6.75603409	19.79671405	8.891048898	4.06910651	0	0.1905128	0	0	47.62820012	9.525640025	9.525640025	19.05128005	0	0	0	0											3.2719	0.077293234	6.726701543	0	2.042566584	2.921580641	0.714062566	1.80364514	0.383541598	0	1.229488156	0.358320287	0.023981758	0.432445037	1.480281224	9.705853306	0.482097389	2.830653337	1.508029491	0	5.850633113	0	0	1.725199249	0.301010225	0.208391694	0.074299992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.152	0	2.198690461	3.2719	0.077293234	6.726701543	0	2.042566584	2.921580641	0.714062566	1.80364514	0.383541598	0	1.229488156	0.358320287	0.023981758	0.432445037	1.480281224	9.705853306	0.482097389	2.830653337	1.508029491	0	5.850633113	0	0	1.725199249	0.301010225	0.208391694	0.074299992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.152	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	3.2719	0.077293234	6.726701543	0	2.042566584	2.921580641	0.714062566	1.80364514	0.383541598	0	1.229488156	0.358320287	0.023981758	0.432445037	1.480281224	9.705853306	0.482097389	2.830653337	1.508029491	0	5.850633113	0	0	1.725199249	0.301010225	0.208391694	0.074299992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.152
H0117_006_0	2008	9																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1778.832961	111.4994868	1799.192301	2262.499464	733.4647609	14.90668758	4.046572085	1662.099513	322.539065	9056.085692	1524.513069	78.51650507	0.08571142	680.1576844	7366.709502	17660.86335	402.5875429	3593.272799	4536.758672	826.3392817	39.1209464	42.25263287	0	935.4545455	379.2	262.5230769	46.8	17.82857143	0	0	3600											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$150.00 copayment	20% coinsurance	Copay between $15.00 and $100.00	Copay between $0.00 and $10.00	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $10.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											67.57149471	37.02722785	28.01303002	0	33.70552837	0.18514891	0.18514891	17.00012029	77.56322804	0	14.64976753	100.4640811	0.18514891	20.0482583	3.845170954	6.934594935	18.22737834	8.401636038	4.004504204	0	0.18514891	0	0	0	9.25744548	9.25744548	18.51489096	0	0	0	0											10.0165	0.344043075	4.200068996	0	2.060151442	2.759956952	0.749218409	2.354657637	2.084764254	0	1.861146838	0.657340711	0.015869376	1.136331412	2.36052145	10.20591113	0.611509622	2.515780853	1.513955765	0	7.243200569	0	0	0	0.292535277	0.202524423	0.072208075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.2582	0	4.271927858	10.0165	0.344043075	4.200068996	0	2.060151442	2.759956952	0.749218409	2.354657637	2.084764254	0	1.861146838	0.657340711	0.015869376	1.136331412	2.36052145	10.20591113	0.611509622	2.515780853	1.513955765	0	7.243200569	0	0	0	0.292535277	0.202524423	0.072208075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.2582	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	10.0165	0.344043075	4.200068996	0	2.060151442	2.759956952	0.749218409	2.354657637	2.084764254	0	1.861146838	0.657340711	0.015869376	1.136331412	2.36052145	10.20591113	0.611509622	2.515780853	1.513955765	0	7.243200569	0	0	0	0.292535277	0.202524423	0.072208075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.2582
H0117_007_0	2008	8																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		452.1012004	64.17321064	4100.835765	61.77279344	27.79104578	32.81590451	5.342549155	31.99577598	16.4309091	10.97536244	19.27476698	112.1033405	2.140688933	8.249212213	9127.424248	85.00063103	11.34493913	46.76684848	16.98091232	3.99078519	20.73029267	0.297943169	0	909.3333333	0	0	0	0	0	0	8.25											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.4	708.4	30.26	0.056990607	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.198265651	0.017471936	0.2	0.2	0	20	0	0	0	0	0	0	0											26.689	3.788358535	10.34094086	3.520468979	5.558209156	6.563180902	1.068509831	6.399155197	3.28618182	2.195072487	3.854953396	0	0.428137787	1.649842443	0	17.00012621	2.268987826	9.353369695	3.366731643	0.069726742	4.146058534	0.059588634	0	1.515555556	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.1222	0	0	26.689	3.788358535	10.34094086	3.520468979	5.558209156	6.563180902	1.068509831	6.399155197	3.28618182	2.195072487	3.854953396	0	0.428137787	1.649842443	0	17.00012621	2.268987826	9.353369695	3.366731643	0.069726742	4.146058534	0.059588634	0	1.515555556	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.1222	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	26.689	3.788358535	10.34094086	3.520468979	5.558209156	6.563180902	1.068509831	6.399155197	3.28618182	2.195072487	3.854953396	0	0.428137787	1.649842443	0	17.00012621	2.268987826	9.353369695	3.366731643	0.069726742	4.146058534	0.059588634	0	1.515555556	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.1222
H0117_008_0	2008	7																					1000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2610.930106	544.336324	4088.369142	5867.913428	3664.268216	28.0644566	4.260170083	3324.854448	289.7785361	10569.74867	1561.453202	102.921094	0.393644623	704.0038609	7994.621515	20701.44068	1619.009727	10849.58975	5040.911675	592.9369064	20.73571249	16.06075276	0	434.6666667	379.2	262.5230769	46.8	17.82857143	0	1600	3600											"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$75 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $10.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $25.00 and $50.00	$0.00 copayment	Copay between $0.00 and $50.00	$75.00 copayment	20% coinsurance	Copay between $5.00 and $50.00	$0.00 copayment	$10.00 copayment	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											22.52658858	16.06574171	20.59548579	0	18.19384855	0.136123502	0.136123502	12.80286804	28.23933777	0	4.963689696	36.93114511	0.136123502	6.626715592	0	1.40593488	5.262919959	2.631257301	1.056915071	0	0.136123502	0	0	34.03087539	6.806175078	6.806175078	13.61235016	0	0	0	0											4.9013	0.728763899	7.016829046	0	5.55559508	3.820232102	0.579909269	3.547306062	0.681929497	0	0.645880764	0.316749488	0.053584284	0.388769447	0	2.425406461	0.710059884	2.379005187	0.443984627	0	2.822617791	0	0	1.232673931	0.215075132	0.148898169	0.053088166	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.6676	0	18.14494371	4.9013	0.728763899	7.016829046	0	5.55559508	3.820232102	0.579909269	3.547306062	0.681929497	0	0.645880764	0.316749488	0.053584284	0.388769447	0	2.425406461	0.710059884	2.379005187	0.443984627	0	2.822617791	0	0	1.232673931	0.215075132	0.148898169	0.053088166	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.6676	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	4.9013	0.728763899	7.016829046	0	5.55559508	3.820232102	0.579909269	3.547306062	0.681929497	0	0.645880764	0.316749488	0.053584284	0.388769447	0	2.425406461	0.710059884	2.379005187	0.443984627	0	2.822617791	0	0	1.232673931	0.215075132	0.148898169	0.053088166	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.6676
H0117_009_0	2008	7																					1000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2505.35472	473.079366	4074.534585	5353.222149	3559.784025	33.67442602	5.397720587	3117.732922	207.541039	12938.64794	1648.22001	99.62951226	3.029421465	761.0506032	9275.857905	20066.1346	1767.15297	9388.096275	5407.164962	611.34347	16.64318833	24.8697692	0	434.6666667	379.2	262.5230769	46.8	17.82857143	0	1600	3600											"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 20, $100 days 21 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$25.00 copayment	20% coinsurance	Copay between $15.00 and $25.00	Copay between $0.00 and $5.00	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											7.413987828	4.845505927	15.597882	0	17.59380305	0.130909627	0.130909627	13.35222267	13.57597977	0	5.459380185	11.83886289	0.130909627	5.15811255	1.065364544	3.282135952	13.89202018	6.246072781	1.650323618	0	0.130909627	0	0	32.72740663	6.545481325	6.545481325	13.09096265	0	0	0	0											1.5479	0.191025739	5.296175804	0	5.219178252	4.408306533	0.706613586	3.46905535	0.234797746	0	0.749854972	0.098291678	0.396580432	0.327132056	0.823514177	5.488315151	2.045777059	4.886561051	0.743631004	0	2.178753568	0	0	1.185459396	0.20683721	0.143194991	0.051054754	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.398	0	21.32091396	1.5479	0.191025739	5.296175804	0	5.219178252	4.408306533	0.706613586	3.46905535	0.234797746	0	0.749854972	0.098291678	0.396580432	0.327132056	0.823514177	5.488315151	2.045777059	4.886561051	0.743631004	0	2.178753568	0	0	1.185459396	0.20683721	0.143194991	0.051054754	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.398	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	1.5479	0.191025739	5.296175804	0	5.219178252	4.408306533	0.706613586	3.46905535	0.234797746	0	0.749854972	0.098291678	0.396580432	0.327132056	0.823514177	5.488315151	2.045777059	4.886561051	0.743631004	0	2.178753568	0	0	1.185459396	0.20683721	0.143194991	0.051054754	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.398
H0141_001_0	2008	6																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		324.4346542	33.06038198	52.09320709	0	13.96978049	30.64733188	22.8750961	12.37750462	25.55608869	12.96006001	25.46300583	0	4.002055368	44.48261515	56.82727023	109.1380811	11.6650318	4.0069825	26.46426681	34.61593339	10.85240029	0.744772558	0	0	0	0	0	0	0	0	0											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing																				0.070892848	0.070892848	0.19926424	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											23.0001	2.343744624	10.38031334	0	3.268928634	7.17147566	5.352772487	2.896336081	5.980124754	3.032654042	5.958343363	0	0.936480956	10.40893195	13.29758123	25.53831097	2.729617442	0.937633905	6.192638434	8.100128413	2.539461668	0.174276779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2399	0	0	23.0001	2.343744624	10.38031334	0	3.268928634	7.17147566	5.352772487	2.896336081	5.980124754	3.032654042	5.958343363	0	0.936480956	10.40893195	13.29758123	25.53831097	2.729617442	0.937633905	6.192638434	8.100128413	2.539461668	0.174276779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2399																																																																																				0	0		23.0001	2.343744624	10.38031334	0	3.268928634	7.17147566	5.352772487	2.896336081	5.980124754	3.032654042	5.958343363	0	0.936480956	10.40893195	13.29758123	25.53831097	2.729617442	0.937633905	6.192638434	8.100128413	2.539461668	0.174276779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2399
H0150_001_0	2008	7																																D	D	D	V	T	COIN	COIN	P	P	P	P	P	P	P	V	V	V	V	V	V	COIN	COIN	T	V	V	V				O	V																																																				0		1567.585976		190.1919805		193.4686313	7.323178983		370.7355637	378.3115066		539.5690161				5407.882302	7612.613096	201.2148351	66.30033267	1633.480008		15.5239813					369																$150 per day for 1st 10 days		$95 for days 1 - 100		$150 per trip	20% Coinsurance		$50 per visit	$265 per visit		$20 per visit				$5 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit		20% Script					$100 limit on eyewear																150		95		150	0.2		50	265		20				5	20	20	20	20		0.2					100																19.5948	0	1.505686512	0	2.418357892	1.464635797	0	1.544731516	8.354379104	0	0.899281693	0	0	0	2.253284293	12.68768849	0.335358059	0.110500554	2.72246668	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.071			19.5948	0	1.505686512	0	2.418357892	1.464635797	0	1.544731516	8.354379104	0	0.899281693	0	0	0	2.253284293	12.68768849	0.335358059	0.110500554	2.72246668	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.071																																																																																				0			19.5948	0	1.505686512	0	2.418357892	1.464635797	0	1.544731516	8.354379104	0	0.899281693	0	0	0	2.253284293	12.68768849	0.335358059	0.110500554	2.72246668	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.071
H0150_007_0	2008	3																																D		D		T	Coin	Coin	P	P	P	P	P	P	P	V	V	V	V	V	V	Coin	Coin	T	V	V					O	V																																																				0		0		0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																	$0 Copay		$0 Copay		$0 Per Trip	0% Coin	0% Coin	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	0% Coin	0% Coin	$0 Per Trip	$0 Copay	$0 Copay					$0 Copay	$0 Copay											0		0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0					0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H0150_010_0	2008	3																																D	D	D	V	T	Coin	Coin	P	P	O	V	O	V	O	V	V	V	V	V	V	Coin	Coin	T	V	V	V				O	V																																																				0		1406.538845		210.5390175		201.1006578	7.404780687		14.45040963	311.914042		539.8836539				5379.745762	7559.859884	200.8910141	65.32898715	1633.137106		15.36825533					369																$225 per day for 1st 10 days		$150 for days 1 to 100		$150 per trip	20% coinsurance		$50 per visit	$315 per visit		$20 per visit				$10 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit		20% per Script					$100 limit on eyewear																225		150		150	0.2		50	315		20				10	20	20	20	20		0.2					100																26.3726	0	2.631737718	0	2.513758223	1.480956137	0	0.06021004	8.187743602	0	0.89980609	0	0	0	4.483121468	12.59976647	0.334818357	0.108881645	2.721895177	0	3.073651066	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5439			26.3726	0	2.631737718	0	2.513758223	1.480956137	0	0.06021004	8.187743602	0	0.89980609	0	0	0	4.483121468	12.59976647	0.334818357	0.108881645	2.721895177	0	3.073651066	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5439																																																																																				0			26.3726	0	2.631737718	0	2.513758223	1.480956137	0	0.06021004	8.187743602	0	0.89980609	0	0	0	4.483121468	12.59976647	0.334818357	0.108881645	2.721895177	0	3.073651066	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5439
H0150_012_0	2008	2																																D	D	D	V	T	Coin	Coin	P	P	O	V	O	V	O	V	V	V	V	V	V	Coin	Coin	T	V	V	V				O	V																																																				0		1462.484845	46.78744086	181.1657237		167.8036338	7.404780687		299.7614005	370.6938639		539.8836539				5379.745762	7559.859884	200.8910141	65.32898715	1633.137106		15.36825533					369																$150 per day for 1st 10 days	$125 per day for 1st 10days	$95 for days 1 to 100		$150 per trip	20% coinsurance		$50 per visit	$200 per visit		$20 per visit				$5 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit		20% per Script					$100 limit on eyewear																150	125	95		150	0.2		50	200		20				5	20	20	20	20		0.2					100																18.2811	0.487369176	1.434228646	0	2.097545422	1.480956137	0	1.249005836	6.178231065	0	0.89980609	0	0	0	2.241560734	12.59976647	0.334818357	0.108881645	2.721895177	0	3.073651066	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.2638			18.2811	0.487369176	1.434228646	0	2.097545422	1.480956137	0	1.249005836	6.178231065	0	0.89980609	0	0	0	2.241560734	12.59976647	0.334818357	0.108881645	2.721895177	0	3.073651066	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.2638																																																																																				0			18.2811	0.487369176	1.434228646	0	2.097545422	1.480956137	0	1.249005836	6.178231065	0	0.89980609	0	0	0	2.241560734	12.59976647	0.334818357	0.108881645	2.721895177	0	3.073651066	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.2638
H0150_015_0	2008	4																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H0150_017_0	2008	4																																D	D	D	V	T	Coin	Coin	P	P	P	P	P	P	P	V	V	V	V	V	V	Coin	Coin	T	V	V	V																																																									0		1518.990811	48.59516525	190.1919805		193.4686313	7.323178983		370.7355637	378.3115066		539.5690161				5407.882302	7612.613096	201.2148351	66.30033267	1633.480008		15.5239813					369																$290 per day for 1st 10 days	$290 per day for 1st 10 days	$150 for days 1 to 100		$150 per trip	20% coinsurance		$50 per visit	$250 per visit		$25 per visit				$5 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit		20% per Script					$100 limit on eyewear																290	290	150		150	0.2		50	250		25				5	25	25	25	25		0.2					100																36.7089	1.17438316	2.377399756	0	2.418357892	1.464635797	0	1.544731516	7.881489721	0	1.124102117	0	0	0	2.253284293	15.85961062	0.419197573	0.138125693	3.40308335	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9471			36.7089	1.17438316	2.377399756	0	2.418357892	1.464635797	0	1.544731516	7.881489721	0	1.124102117	0	0	0	2.253284293	15.85961062	0.419197573	0.138125693	3.40308335	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9471																																																																																				0			36.7089	1.17438316	2.377399756	0	2.418357892	1.464635797	0	1.544731516	7.881489721	0	1.124102117	0	0	0	2.253284293	15.85961062	0.419197573	0.138125693	3.40308335	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9471
H0150_019_0	2008	4																																D	D	D	V	T	Coin	Coin	P	P	O	V	O	V	O	V	V	V	V	V	V	Coin	Coin	T	V	V	V				O	V																																																				0		1567.585976		190.1919805		193.4686313	7.323178983		370.7355637	378.3115066		539.5690161				5407.882302	7612.613096	201.2148351	66.30033267	1633.480008		15.5239813					369																$290 per day for 1st 10 days		$150 for days 1 to 100		$150 per trip	20% coinsurance		$50 per visit	$250 per visit		$25 per visit				$5 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit		20% per Script					$100 limit on eyewear																290		150		150	0.2		50	250		25				5	25	25	25	25		0.2					100																37.8833	0	2.377399756	0	2.418357892	1.464635797	0	1.544731516	7.881489721	0	1.124102117	0	0	0	2.253284293	15.85961062	0.419197573	0.138125693	3.40308335	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9471			37.8833	0	2.377399756	0	2.418357892	1.464635797	0	1.544731516	7.881489721	0	1.124102117	0	0	0	2.253284293	15.85961062	0.419197573	0.138125693	3.40308335	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9471																																																																																				0			37.8833	0	2.377399756	0	2.418357892	1.464635797	0	1.544731516	7.881489721	0	1.124102117	0	0	0	2.253284293	15.85961062	0.419197573	0.138125693	3.40308335	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9471
H0150_802_0	2008	2																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																				18.5939	0.3366	5.7462	0	0.2727	0.291	0.0737	0.4198	1.1905	0.4885	0.1933	0.0058	0.0041	0.5252	2.7099	4.2421	0.0978	0.0063	0.9838	0	1.2056																					37.3867		1651.875929	29.9	434.9427285	0	8.021842345	8.614603266	2.211857595	12.34758456	35.01586931	14.36744236	5.685140783	0.170364929	0.119886432	15.44642024	79.70370122	124.7671247	2.876143953	0.184073213	28.93400816	0	36.84																					Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																			10.15088008	10.15088008	12.07417683	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0	0																	1.3973	0.02529261	0.437631285	0	1.604368469	1.722920653	0.442371519	2.469516913	7.003173861	2.873488471	1.137028157	0.034072986	0.023977286	3.089284048	15.94074024	24.95342493	0.575228791	0.036814643	5.786801633	0	7.368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9215	37.38669088		19.9913	0.361854729	6.18379683	0	1.877111109	2.01388	0.51612	2.889334788	8.193713417	3.361981511	1.330322943	0.039865393	0.028053425	3.614462336	18.65066608	29.19550717	0.673017685	0.043073132	6.77055791	0	8.573566966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.3082																																																																																				0			19.9913	0.361854729	6.18379683	0	1.877111109	2.01388	0.51612	2.889334788	8.193713417	3.361981511	1.330322943	0.039865393	0.028053425	3.614462336	18.65066608	29.19550717	0.673017685	0.043073132	6.77055791	0	8.573566966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.3082
H0150_804_0	2008	2																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																				18.59394195	0.33656212	5.746165545		0.27274264	0.290959347	0.073748481	0.419817875	1.190539556	0.48849304	0.193294787	0.005792408	0.004076139	0.525178288	2.709925841	4.242082239	0.097788894	0.006258489	0.983756278		1.205566966																					37.3867		1651.875929	29.9	434.9427285		8.021842345	8.6146	2.2119	12.3476	35.0159	14.3674	5.6851	0.1704	0.1199	15.4464	79.7037	124.7671	2.8761	0.1841	28.934	0	36.84	0																				Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																				10.1509	10.1509	12.0742	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2																				1.3973	0.02529261	0.437631285	0	1.604368469	1.722920653	0.442371519	2.469516913	7.003173861	2.873488471	1.137028157	0.034072986	0.023977286	3.089284048	15.94074024	24.95342493	0.575228791	0.036814643	5.786801633	0	7.368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9215	37.38669088		19.9913	0.361854729	6.18379683	0	1.877111109	2.01388	0.51612	2.889334788	8.193713417	3.361981511	1.330322943	0.039865393	0.028053425	3.614462336	18.65066608	29.19550717	0.673017685	0.043073132	6.77055791	0	8.573566966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.3082																																																																																				0			19.9913	0.361854729	6.18379683	0	1.877111109	2.01388	0.51612	2.889334788	8.193713417	3.361981511	1.330322943	0.039865393	0.028053425	3.614462336	18.65066608	29.19550717	0.673017685	0.043073132	6.77055791	0	8.573566966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.3082
H0150_805_0	2008	2																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																					18.5939	0.3366	5.7462	0	0.2727	0.291	0.0737	0.4198	1.1905	0.4885	0.1933	0.0058	0.0041	0.5252	2.7099	4.2421	0.0978	0.0063	0.9838	0	1.2056																					37.3867		1651.875929	29.9	434.9427285	0	8.021842345	8.614603266	2.211857595	12.34758456	35.01586931	14.36744236	5.685140783	0.170364929	0.119886432	15.44642024	79.70370122	124.7671247	2.876143953	0.184073213	28.93400816	0	36.84																					Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																					10.15088008	10.15088008	12.07417683	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2																					1.3973	0.02529261	0.437631285	0	1.604368469	1.722920653	0.442371519	2.469516913	7.003173861	2.873488471	1.137028157	0.034072986	0.023977286	3.089284048	15.94074024	24.95342493	0.575228791	0.036814643	5.786801633	0	7.368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9215	37.38669088		19.9913	0.361854729	6.18379683	0	1.877111109	2.01388	0.51612	2.889334788	8.193713417	3.361981511	1.330322943	0.039865393	0.028053425	3.614462336	18.65066608	29.19550717	0.673017685	0.043073132	6.77055791	0	8.573566966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.3082																																																																																				0			19.9913	0.361854729	6.18379683	0	1.877111109	2.01388	0.51612	2.889334788	8.193713417	3.361981511	1.330322943	0.039865393	0.028053425	3.614462336	18.65066608	29.19550717	0.673017685	0.043073132	6.77055791	0	8.573566966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.3082
H0150_806_0	2008	4																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																				18.59394195	0.33656212	5.746165545		0.27274264	0.290959347	0.073748481	0.419817875	1.190539556	0.48849304	0.193294787	0.005792408	0.004076139	0.525178288	2.709925841	4.242082239	0.097788894	0.006258489	0.983756278		1.205566966																					37.3867		1651.875929	29.9	434.9427285		8.021842345	8.6146	2.2119	12.3476	35.0159	14.3674	5.6851	0.1704	0.1199	15.4464	79.7037	124.7671	2.8761	0.1841	28.934	0	36.84	0																				Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																				10.1509	10.1509	12.0742	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2																				1.3973	0.02529261	0.437631285	0	1.604368469	1.722920653	0.442371519	2.469516913	7.003173861	2.873488471	1.137028157	0.034072986	0.023977286	3.089284048	15.94074024	24.95342493	0.575228791	0.036814643	5.786801633	0	7.368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9215	37.38669088		19.9913	0.361854729	6.18379683	0	1.877111109	2.01388	0.51612	2.889334788	8.193713417	3.361981511	1.330322943	0.039865393	0.028053425	3.614462336	18.65066608	29.19550717	0.673017685	0.043073132	6.77055791	0	8.573566966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.3082																																																																																				0			19.9913	0.361854729	6.18379683	0	1.877111109	2.01388	0.51612	2.889334788	8.193713417	3.361981511	1.330322943	0.039865393	0.028053425	3.614462336	18.65066608	29.19550717	0.673017685	0.043073132	6.77055791	0	8.573566966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.3082
H0151_001_0	2008	7																					3400											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2380.098785	122.3558974	898.1029693		239.1303877	21.54288059	4.493154481	617.359542	33.08217779	10731.86954	48.7266979		0.336887743	17.65984114	6317.81507	4797.815574	435.2380934	2.714678032			44.53582574	776.4485575			253.2614413		19.8604858															$250 (1a); $0 (1a1)	$250 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	15% (9b)	15% (8a1); $0/$25 (8a2)	"$25 (8b1); 15% (8b2, 8b3)"	15% (incl in h5)	20% (12)	"15% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"15% (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 (10b)	$0 n/c (16)	$20 (17a1)	$0; $0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											151.5794	151.5794	90.9477		106.1056	0.121263539	0.192537693	30.3159	0.090947654	6.0632	0.061773386		0.121263539	0.090795158	10	20	37.5	0.090947654			0.121263539	20			20		20															30.0645	1.545553035	6.80669653	0	2.114422706	2.612365942	0.865101597	1.559650061	3.008746468	5.422435336	3.010013103	0	0.0408522	1.603428071	5.264845891	7.996359289	1.360119042	0.246893599	0	0	5.400571844	1.294080929	0	0	0.422102402	0	0.03310081	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6718	0	41.22170069	30.0645	1.545553035	6.80669653	0	2.114422706	2.612365942	0.865101597	1.559650061	3.008746468	5.422435336	3.010013103	0	0.0408522	1.603428071	5.264845891	7.996359289	1.360119042	0.246893599	0	0	5.400571844	1.294080929	0	0	0.422102402	0	0.03310081	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6718																																																																																				0			30.0645	1.545553035	6.80669653	0	2.114422706	2.612365942	0.865101597	1.559650061	3.008746468	5.422435336	3.010013103	0	0.0408522	1.603428071	5.264845891	7.996359289	1.360119042	0.246893599	0	0	5.400571844	1.294080929	0	0	0.422102402	0	0.03310081	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6718
H0151_015_0	2008	5																																D	D	D	V	T	O	O	V	V	O	O	O	O	O	V	V	V	V	P	P	S	O	T	V	P	Coin	P	P	O	O	O																																																				0																																											"$0 (1a, 1a1)"	$0 (1b)	"$0 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$0 (10a)	$0 (11a)	"$0 (11b, 11c)"	"$0 (4a, 4a1, 4b)"	$0 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	$0 (incl in h5)	$0 (12)	"$0 (3, 5, 9d, 9a); $0/$0 (9c)"	"$0/$0 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1)"	"$0 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$0/$0 (7e, 7h)"	"$0 (7c, 7i)"	$0 (incl in h2)		"$0 (15, 15a1)"	"$0 (13a, 17a, 17b, 18a, 16b, 13a1)"	$0 (10b)	$0 n/c (16)	$0 (17a1)	$0; $0 n/c (17b)	$0 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H0151_017_0	2008	5	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)							Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						Coin	Coin	D	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V		Coin	Coin	Coin	T				Coin					Coin	Coin	Coin	V																																																0		305.0328711	4.665873518	9510.308217	229.9648939	30.28677112	32.02185665	0.287847449	193.7713789	14.10060967	55.43687042	50.7632387	2.586410835	0.62726444	8.338222934	137.0463316	130.2228105	13.52739417	26.73904482		13.10713078	3.949013999	6.575447835	1912.9									1.053684246	0.007813433		247.1							(1a) 8.6% coins	(1b) 8.6% coins	(2a) $0/day	(6a) $0/proc	(10a) 20% coins	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) 20% coins	(8a) 10% coins	(8b) 19.2% coins	(9a) 20% coins	(12) 20% coins	(9a) 20% coins	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) 20% coins	(7e/7h) 20% coins	(7c/7i) $0/visit		(7g) 20% coins	(15) 20% coins	(Misc. PBP Cats) 20% coins	(10b) $0/trip				(18a) 20% coins					(4b) 20% coins	(9c) 20% coins	(9d) 20% coins	(7f1) $0/visit							0.085643884	0.085643884			0.2	0.2	0.2	50	0.2	0.1	0.192	0.2	0.2	0.2		0.2	0.2			0.2	0.2	0.2										0.2	0.2									26.1242	0.399603528	0	0	6.057354223	6.404371329	0.05756949	0.807380745	2.820121933	5.543687042	9.746541831	0.517282167	0.125452888	1.667644587	0	26.04456209	2.705478833	0	0	2.621426155	0.7898028	1.315089567	0	0	0	0	0	0	0	0	0	0.210736849	0.001562687	0	0	0	0	0	0	0	0	93.9599		0	26.1242	0.399603528	0	0	6.057354223	6.404371329	0.05756949	0.807380745	2.820121933	5.543687042	9.746541831	0.517282167	0.125452888	1.667644587	0	26.04456209	2.705478833	0	0	2.621426155	0.7898028	1.315089567	0	0	0	0	0	0	0	0	0	0.210736849	0.001562687	0	0	0	0	0	0	0	0	93.9599																																																																																				0		0	26.1242	0.399603528	0	0	6.057354223	6.404371329	0.05756949	0.807380745	2.820121933	5.543687042	9.746541831	0.517282167	0.125452888	1.667644587	0	26.04456209	2.705478833	0	0	2.621426155	0.7898028	1.315089567	0	0	0	0	0	0	0	0	0	0.210736849	0.001562687	0	0	0	0	0	0	0	0	93.9599
H0151_019_0	2008	3																					3100											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2282.157835	121.6379866	895.2302344		227.8998607	23.31398991	4.250713663	562.4727756	36.77379586	10813.06173	50.77817666		0.26266474	18.12188841	6257.974831	4884.972712	434.3731586	3.523105143			38.69290744	840.0102509			158.063668		17.24688363															$295 (1a); $0 (1a1)	$295 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	15% (9b)	15% (8a1); $0/$15 (8a2)	"$15 (8b1); 15% (8b2, 8b3)"	15% (incl in h5)	20% (12)	"15% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"15% (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 (10b)	$0 n/c (16)	$20 (17a1)	$0; $0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											169.5677	169.5677	86.2209		100.591	0.114961143	0.186080058	28.7403	0.086220857	3.4488	0.054005146		0.114961143	0.08611291	10	19.9692	37.5	0.086220857			0.114961143	20			20		20															32.2484	1.718822654	6.432293168	0	1.910389571	2.68020292	0.790973047	1.347135688	3.170668194	3.107704832	2.742282823	0	0.030196239	1.56052855	5.214979026	8.129074325	1.35741612	0.303765145	0	0	4.448180853	1.400017085	0	0	0.263439447	0	0.028744806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.8852	0	45.69911466	32.2484	1.718822654	6.432293168	0	1.910389571	2.68020292	0.790973047	1.347135688	3.170668194	3.107704832	2.742282823	0	0.030196239	1.56052855	5.214979026	8.129074325	1.35741612	0.303765145	0	0	4.448180853	1.400017085	0	0	0.263439447	0	0.028744806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.8852																																																																																				0			32.2484	1.718822654	6.432293168	0	1.910389571	2.68020292	0.790973047	1.347135688	3.170668194	3.107704832	2.742282823	0	0.030196239	1.56052855	5.214979026	8.129074325	1.35741612	0.303765145	0	0	4.448180853	1.400017085	0	0	0.263439447	0	0.028744806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.8852
H0151_023_0	2008	4																					2650											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2380.098785	122.3558974	898.1029693		239.1303877	21.54288059	4.493154481	617.1909164	33.08217779	10731.86954	48.7266979		0.336887743	17.65984114	6439.318219	4816.749669	435.2380934	2.714678032			44.53582574	776.4485575			144		16.8541424															$170 (1a); $0 (1a1)	$170 (1b)	"$125 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$15 (4b)"	20% (9b)	20% (8a1); $0/$25 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 (10b)	$0 n/c (16)	$30 (17a1)	$0; $0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											95.6952	95.6952	70.3641		98.5098	0.168873934	0.287572428	28.1457	0.112582623	5.6291	0.0677817		0.168873934	0.112370651	15	29.9206	37.5	0.112582623			0.168873934	30			30		30															18.9803	0.975739639	5.266186867	0	1.963057122	3.638031	1.292107345	1.447603586	3.724478344	5.034258418	3.302778423	0	0.056891559	1.98444785	8.049147773	12.01001751	1.360119042	0.305625573	0	0	7.520940107	1.941121394	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.255	0	42.13986257	18.9803	0.975739639	5.266186867	0	1.963057122	3.638031	1.292107345	1.447603586	3.724478344	5.034258418	3.302778423	0	0.056891559	1.98444785	8.049147773	12.01001751	1.360119042	0.305625573	0	0	7.520940107	1.941121394	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.255																																																																																				0			18.9803	0.975739639	5.266186867	0	1.963057122	3.638031	1.292107345	1.447603586	3.724478344	5.034258418	3.302778423	0	0.056891559	1.98444785	8.049147773	12.01001751	1.360119042	0.305625573	0	0	7.520940107	1.941121394	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.255
H0151_801_0	2008	3																					4800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2671.458466	133.1017481	902.690081		259.947137	21.37257806	4.085216986	560.5866451	36.90650383	11961.87935	52.44730558		0.27472123	19.3021538	6536.979218	5116.543458	449.5120111	2.604549246			35.72749225	934.211104			182.3515755		17.59257869															$475 (1a); $0 (1a1)	$475 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$20/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											268.3403	268.3403	84.739		98.8622	0.141231749	0.237423182	28.2463	0.141231749	3.3896	0.084260374		0.169478099	0.141030387	20	29.9558	37.5	0.141231749			0.169478099	30			30		30															59.7383	2.976380516	6.374424966	0	2.141579353	3.018486589	0.969925218	1.319543877	5.212370101	3.378794294	4.419229597	0	0.046559232	2.722190218	10.89496536	12.77249747	1.404725035	0.367845046	0	0	6.05502748	2.33552776	0	0	0.455878939	0	0.043981447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.6483	0	75.34743824	59.7383	2.976380516	6.374424966	0	2.141579353	3.018486589	0.969925218	1.319543877	5.212370101	3.378794294	4.419229597	0	0.046559232	2.722190218	10.89496536	12.77249747	1.404725035	0.367845046	0	0	6.05502748	2.33552776	0	0	0.455878939	0	0.043981447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.6483																																																																																				0			59.7383	2.976380516	6.374424966	0	2.141579353	3.018486589	0.969925218	1.319543877	5.212370101	3.378794294	4.419229597	0	0.046559232	2.722190218	10.89496536	12.77249747	1.404725035	0.367845046	0	0	6.05502748	2.33552776	0	0	0.455878939	0	0.043981447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.6483
H0154_001_0	2008	4																																A	A	D	V	T	Coin	Coin	V	V	P	P	O	V	V	V	V	V	V	P	V	Coin	P	T	P	V	P	V			Coin																																																					0		233.7240098	1.968612352	1349.012436	0	161.8341986	9.454346598	9.454346598	631.2954132	373.7193135	0	75.38731833	4.297894786	10.52335406	309.8948326	6261.510795	8556.586126	152.2002937	634.665933	0	1396.588254	17.18044804	0	0	0	78.2217312	0	49.26427303			0												Avg copay per admit of $3000 for transplants and $200 for other IP admissions	$200 per admit	"$95/day for days 8-28 with $1,995 annual out-of-pocket max (est. as avg $41.66 per day copay)"	No member cost sharing	$125 copay per one-way trip	20% coinsurance	20% coinsurance	$50 emergency room copay and $50 urgent care facility copay	"$175 per visit, $1,050 out-of-pocket maximum"	No member cost sharing	$40 radiation therapy copay	$30 per day	$50 per visit	$25 rehab. services (CORF) copay and $30 outpatient substance abuse svcs copay	$10 per visit	$15 per visit	$30 per visit	$25 per visit	No member cost sharing	"$15 chiropractic copay, $15 podiatry copay, and $30 other health care services copay"	"20% coinsurance and $2,500 OOP max on Medicare covered chemotherapy drugs"	No member cost sharing	0	0	$15 per visit	0	Avg copay of $13 assumes 2/3 of svcs delivered by contracted specialist at $15 copay and 1/3 by PCP at $10 copay			0												210.0592106	200	41.65909671	0	125	0.2	0.2	50	175	0	40	30	50	25.25286825	10	15	30	25	0	15.04705768	0.181956233	0	0	0	15	0	13.33333333			0												4.0913	0.032810206	4.683219962	0	1.685772903	1.89086932	1.89086932	2.630397555	5.450073322	0	0.251291061	0.010744737	0.043847309	0.652144448	5.217925662	10.69573266	0.380500734	1.322220694	0	1.751212001	3.126089609	0	0	0	0.097777164	0	0.054738081	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9596			4.0913	0.032810206	4.683219962	0	1.685772903	1.89086932	1.89086932	2.630397555	5.450073322	0	0.251291061	0.010744737	0.043847309	0.652144448	5.217925662	10.69573266	0.380500734	1.322220694	0	1.751212001	3.126089609	0	0	0	0.097777164	0	0.054738081	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9596																																																																																				0			4.0913	0.032810206	4.683219962	0	1.685772903	1.89086932	1.89086932	2.630397555	5.450073322	0	0.251291061	0.010744737	0.043847309	0.652144448	5.217925662	10.69573266	0.380500734	1.322220694	0	1.751212001	3.126089609	0	0	0	0.097777164	0	0.054738081	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9596
H0154_008_0	2008	2																																A	A	D	V	T	Coin	Coin	V	V	P	P	O	V	V	V	V	V	V	P	V	Coin	P	T	P	V	P	V			Coin																																																					0		220.0570267	1.853497984	1270.129098	0	152.3709635	8.90150483	8.90150483	594.3804907	351.8661221	0	70.97905405	4.04657591	9.908002209	291.7737699	5895.369712	8056.240792	143.3004	597.5539197	0	1314.922926	16.17582343	0	0	0	73.64772498	0	46.38355065			0												Avg copay per admit of $3000 for transplants and $150 for other IP admissions	$150 per admit	"$95/day for days 8-28 with $1,995 annual out-of-pocket max (est. as avg $41.66 per day copay)"	No member cost sharing	$125 copay per one-way trip	20% coinsurance	20% coinsurance	$50 emergency room copay and $20 urgent care facility copay	"$125 per visit, $1,000 out-of-pocket maximum"	No member cost sharing	$40 radiation therapy copay	$25 per day	$50 per visit	$25 per visit	$5 per visit	$10 per visit	$25 per visit	$25 per visit	No member cost sharing	"$10 chiropractic copay, $10 podiatry copay, and $25 other health care services copay"	"20% coinsurance and $2,500 OOP max on Medicare covered chemotherapy drugs"	No member cost sharing	0	No member cost sharing	$10 per visit	0	Avg copay of $8.33 assumes 2/3 of svcs delivered by contracted specialist at $10 copay and 1/3 by PCP at $5 copay			0												160.2388394	150	41.65909671	0	125	0.2	0.2	40	125	0	40	25	50	25	5	10	25	25	0	10.05643381	0.181956233	0	0	0	10	0	8.333333333			0												2.9385	0.023168725	4.409369244	0	1.587197537	1.780300966	1.780300966	1.981268302	3.665272105	0	0.236596847	0.008430366	0.041283343	0.607862021	2.456404047	6.713533994	0.2985425	1.244903999	0	1.101952947	2.943291899	0	0	0	0.061373104	0	0.032210799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.9117			2.9385	0.023168725	4.409369244	0	1.587197537	1.780300966	1.780300966	1.981268302	3.665272105	0	0.236596847	0.008430366	0.041283343	0.607862021	2.456404047	6.713533994	0.2985425	1.244903999	0	1.101952947	2.943291899	0	0	0	0.061373104	0	0.032210799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.9117																																																																																				0			2.9385	0.023168725	4.409369244	0	1.587197537	1.780300966	1.780300966	1.981268302	3.665272105	0	0.236596847	0.008430366	0.041283343	0.607862021	2.456404047	6.713533994	0.2985425	1.244903999	0	1.101952947	2.943291899	0	0	0	0.061373104	0	0.032210799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.9117
H0154_009_0	2008	4																																A	A	D	V	T	Coin	Coin	V	V	P	P	O	V	V	V	V	V	V	P	V	Coin	P	T	P	V	P	V			Coin																																																					0		256.3190738	2.158926227	1479.427032	0	177.4793781	10.36833728	10.36833728	692.3253444	409.8483008	0	82.6753213	4.71339	11.5406901	339.8536442	6866.836867	9383.786596	166.9141238	696.0217063	0	1531.6022	18.84135281	0	0	0	85.78374856	0	54.02685348			0												Avg copay per admit of $3000 for transplants and $200 for other IP admissions	$200 per admit	"$95/day for days 8-28 with $1,995 annual out-of-pocket max (est. as avg $41.66 per day copay)"	No member cost sharing	$125 copay per one-way trip	20% coinsurance	20% coinsurance	$50 emergency room copay and $50 urgent care facility copay	"$175 per visit, $1,050 out-of-pocket maximum"	No member cost sharing	$40 radiation therapy copay	$30 per day	$50 per visit	$25 rehab. services (CORF) copay and $30 outpatient substance abuse svcs copay	$10 per visit	$15 per visit	$30 per visit	$25 per visit	No member cost sharing	"$15 chiropractic copay, $15 podiatry copay, and $30 other health care services copay"	"20% coinsurance and $2,500 OOP max on Medicare covered chemotherapy drugs"	No member cost sharing	0	0	$15 per visit	0	Avg copay of $13 assumes 2/3 of svcs delivered by contracted specialist at $15 copay and 1/3 by PCP at $10 copay			No member cost sharing												210.0592106	200	41.65909671	0	125	0.2	0.2	50	175	0	40	30	50	25.25286825	10	15	30	25	0	15.04705768	0.181956233	0	0	0	15	0	13.33333333			0												4.4868	0.035982104	5.13596615	0	1.848743521	2.073667455	2.073667455	2.884688935	5.976954387	0	0.275584404	0.011783475	0.048086209	0.715189942	5.722364056	11.72973325	0.417285309	1.450045221	0	1.920508888	3.428301584	0	0	0	0.107229686	0	0.060029837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4027			4.4868	0.035982104	5.13596615	0	1.848743521	2.073667455	2.073667455	2.884688935	5.976954387	0	0.275584404	0.011783475	0.048086209	0.715189942	5.722364056	11.72973325	0.417285309	1.450045221	0	1.920508888	3.428301584	0	0	0	0.107229686	0	0.060029837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4027																																																																																				0			4.4868	0.035982104	5.13596615	0	1.848743521	2.073667455	2.073667455	2.884688935	5.976954387	0	0.275584404	0.011783475	0.048086209	0.715189942	5.722364056	11.72973325	0.417285309	1.450045221	0	1.920508888	3.428301584	0	0	0	0.107229686	0	0.060029837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4027
H0154_010_0	2008	4																																A	A	D	V	T	Coin	Coin	V	V	P	P	O	V	V	V	V	V	V	P	V	Coin	P	T	P	V	P	V			Coin																																																					0		274.1287826	28.69121736	1911.789047	0	322.269248	14.59361732	14.59361732	1002.729395	395.2750019	0	79.17031957	4.93672294	31.40335915	460.4453798	7198.526917	8886.121093	1479.273736	1039.21561	0	1789.030561	23.93411044	0	0	0	105.088386	0	50.72215966			0												Avg copay per admit of $3000 for transplants and $150 for other IP admissions	$150 per admit	"$50/day for days 8-28 with $1,050 annual out-of-pocket max (est. as avg $21.93 per day copay)"	No member cost sharing	$125 copay per one-way trip	20% coinsurance	20% coinsurance	$20 emergency room copay and $20 urgent care facility copay	"$100 per visit, $600 out-of-pocket maximum"	No member cost sharing	$30 radiation therapy copay	$30 per day	$40 per visit	$25 rehab. services (CORF) copay and $30 outpatient substance abuse svcs copay	No member cost sharing	No member cost sharing	No member cost sharing	No member cost sharing	No member cost sharing	No member cost sharing	No member cost sharing	No member cost sharing	No member cost sharing	No member cost sharing	No member cost sharing	No member cost sharing	No member cost sharing			0												158.7033076	150	21.92584037	0	125	0.2	0.2	20	100	0	30	30	40	26.65410691	0	0	0	0	0	0	0	0	0	0	0	0	0			0												3.6254	0.358640217	3.49313179	0	3.356971333	2.918723464	2.918723464	1.671215658	3.293958349	0	0.197925799	0.012341807	0.104677864	1.022730032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.9745			3.6254	0.358640217	3.49313179	0	3.356971333	2.918723464	2.918723464	1.671215658	3.293958349	0	0.197925799	0.012341807	0.104677864	1.022730032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.9745																																																																																				0			3.6254	0.358640217	3.49313179	0	3.356971333	2.918723464	2.918723464	1.671215658	3.293958349	0	0.197925799	0.012341807	0.104677864	1.022730032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.9745
H0154_801_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	P	P	O	V	V	V	V	V	V	P	V	Coin	P	T	P	V	P	V			Coin																																																					0		212.5506016	1.790272809	1226.803379	0	147.1733961	8.597863175	8.597863175	574.1054159	339.863521	0	68.55786821	3.908542058	9.570027647	281.8209954	5694.27115	7781.432169	138.412241	577.1705952	0	1270.069232	15.62404551	0	0	0	0	0	0			0												$250 per admit	$250 per admit	$75 per day	No member cost sharing	$125 copay per one-way trip	20% coinsurance	20% coinsurance	$50 per visit	"$175 per visit, $1,050 out-of-pocket maximum"	No member cost sharing	$40 radiation therapy copay	$30 per day	$50 per visit	$30 rehab. services (CORF) copay and $30 outpatient substance abuse svcs copay	$25 per visit	$25 per visit	$30 per visit	$25 per visit	No member cost sharing	"$25 chiropractic copay, $25 podiatry copay, and $30 other health care services copay"	"20% coinsurance and $2,500 OOP max on Medicare covered chemotherapy drugs"	No member cost sharing	0	0	0	0	0			0												250	250	75	0	125	0.2	0.2	50	175	0	40	30	50	30	25	25	30	25	0	25.01568589	0.181956233	0	0	0	0	0	0			0												4.4281	0.03729735	7.667521116	0	1.53305621	1.719572635	1.719572635	2.3921059	4.956343014	0	0.228526227	0.009771355	0.039875115	0.704552489	11.8630649	16.21131702	0.346030603	1.20243874	0	2.647637747	2.842892467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5497			4.4281	0.03729735	7.667521116	0	1.53305621	1.719572635	1.719572635	2.3921059	4.956343014	0	0.228526227	0.009771355	0.039875115	0.704552489	11.8630649	16.21131702	0.346030603	1.20243874	0	2.647637747	2.842892467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5497																																																																																				0			4.4281	0.03729735	7.667521116	0	1.53305621	1.719572635	1.719572635	2.3921059	4.956343014	0	0.228526227	0.009771355	0.039875115	0.704552489	11.8630649	16.21131702	0.346030603	1.20243874	0	2.647637747	2.842892467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5497
H0154_802_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	P	P	O	V	V	V	V	V	V	P	V	Coin	P	T	P	V	P	V			Coin																																																					0		212.5506016	1.790272809	1226.803379	0	147.1733961	8.597863175	8.597863175	574.1054159	339.863521	0	68.55786821	3.908542058	9.570027647	281.8209954	5694.27115	7781.432169	138.412241	577.1705952	0	1270.069232	15.62404551	0	0	0	0	0	0			0												$250 per admit	$250 per admit	$75 per day	No member cost sharing	$125 copay per one-way trip	20% coinsurance	20% coinsurance	$50 per visit	"$175 per visit, $1,050 out-of-pocket maximum"	No member cost sharing	$40 radiation therapy copay	$30 per day	$50 per visit	$30 rehab. services (CORF) copay and $30 outpatient substance abuse svcs copay	$25 per visit	$25 per visit	$30 per visit	$25 per visit	No member cost sharing	"$25 chiropractic copay, $25 podiatry copay, and $30 other health care services copay"	"20% coinsurance and $2,500 OOP max on Medicare covered chemotherapy drugs"	No member cost sharing	0	0	0	0	0			0												250	250	75	0	125	0.2	0.2	50	175	0	40	30	50	30	25	25	30	25	0	25.01568589	0.181956233	0	0	0	0	0	0			0												4.4281	0.03729735	7.667521116	0	1.53305621	1.719572635	1.719572635	2.3921059	4.956343014	0	0.228526227	0.009771355	0.039875115	0.704552489	11.8630649	16.21131702	0.346030603	1.20243874	0	2.647637747	2.842892467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5497			4.4281	0.03729735	7.667521116	0	1.53305621	1.719572635	1.719572635	2.3921059	4.956343014	0	0.228526227	0.009771355	0.039875115	0.704552489	11.8630649	16.21131702	0.346030603	1.20243874	0	2.647637747	2.842892467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5497																																																																																				0			4.4281	0.03729735	7.667521116	0	1.53305621	1.719572635	1.719572635	2.3921059	4.956343014	0	0.228526227	0.009771355	0.039875115	0.704552489	11.8630649	16.21131702	0.346030603	1.20243874	0	2.647637747	2.842892467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5497
H0154_803_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	P	P	O	V	V	V	V	V	V	P	V	Coin	P	T	P	V	P	V			Coin																																																					0		212.5506016	1.790272809	1226.803379	0	147.1733961	8.597863175	8.597863175	574.1054159	339.863521	0	68.55786821	3.908542058	9.570027647	281.8209954	5694.27115	7781.432169	138.412241	577.1705952	0	1270.069232	15.62404551	0	0	0	0	0	0			0												$250 per admit	$250 per admit	$75 per day	No member cost sharing	$125 copay per one-way trip	20% coinsurance	20% coinsurance	$50 per visit	"$175 per visit, $1,050 out-of-pocket maximum"	No member cost sharing	$40 radiation therapy copay	$30 per day	$50 per visit	$30 rehab. services (CORF) copay and $30 outpatient substance abuse svcs copay	$25 per visit	$25 per visit	$30 per visit	$25 per visit	No member cost sharing	"$25 chiropractic copay, $25 podiatry copay, and $30 other health care services copay"	"20% coinsurance and $2,500 OOP max on Medicare covered chemotherapy drugs"	No member cost sharing	0	0	0	0	0			0												250	250	75	0	125	0.2	0.2	50	175	0	40	30	50	30	25	25	30	25	0	25.01568589	0.181956233	0	0	0	0	0	0			0												4.4281	0.03729735	7.667521116	0	1.53305621	1.719572635	1.719572635	2.3921059	4.956343014	0	0.228526227	0.009771355	0.039875115	0.704552489	11.8630649	16.21131702	0.346030603	1.20243874	0	2.647637747	2.842892467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5497			4.4281	0.03729735	7.667521116	0	1.53305621	1.719572635	1.719572635	2.3921059	4.956343014	0	0.228526227	0.009771355	0.039875115	0.704552489	11.8630649	16.21131702	0.346030603	1.20243874	0	2.647637747	2.842892467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5497																																																																																				0			4.4281	0.03729735	7.667521116	0	1.53305621	1.719572635	1.719572635	2.3921059	4.956343014	0	0.228526227	0.009771355	0.039875115	0.704552489	11.8630649	16.21131702	0.346030603	1.20243874	0	2.647637747	2.842892467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5497
H0154_804_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	P	P	O	V	V	V	V	V	V	P	V	Coin	P	T	P	V	P	V			Coin																																																					0		212.5506016	1.790272809	1226.803379	0	147.1733961	8.597863175	8.597863175	574.1054159	339.863521	0	68.55786821	3.908542058	9.570027647	281.8209954	5694.27115	7781.432169	138.412241	577.1705952	0	1270.069232	15.62404551	0	0	0	0	0	0			0												$250 per admit	$250 per admit	$75 per day	No member cost sharing	$125 copay per one-way trip	20% coinsurance	20% coinsurance	$50 per visit	"$175 per visit, $1,050 out-of-pocket maximum"	No member cost sharing	$40 radiation therapy copay	$30 per day	$50 per visit	$30 rehab. services (CORF) copay and $30 outpatient substance abuse svcs copay	$25 per visit	$25 per visit	$30 per visit	$25 per visit	No member cost sharing	"$25 chiropractic copay, $25 podiatry copay, and $30 other health care services copay"	"20% coinsurance and $2,500 OOP max on Medicare covered chemotherapy drugs"	No member cost sharing	0	0	0	0	0			0												250	250	75	0	125	0.2	0.2	50	175	0	40	30	50	30	25	25	30	25	0	25.01568589	0.181956233	0	0	0	0	0	0			0												4.4281	0.03729735	7.667521116	0	1.53305621	1.719572635	1.719572635	2.3921059	4.956343014	0	0.228526227	0.009771355	0.039875115	0.704552489	11.8630649	16.21131702	0.346030603	1.20243874	0	2.647637747	2.842892467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5497			4.4281	0.03729735	7.667521116	0	1.53305621	1.719572635	1.719572635	2.3921059	4.956343014	0	0.228526227	0.009771355	0.039875115	0.704552489	11.8630649	16.21131702	0.346030603	1.20243874	0	2.647637747	2.842892467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5497																																																																																				0			4.4281	0.03729735	7.667521116	0	1.53305621	1.719572635	1.719572635	2.3921059	4.956343014	0	0.228526227	0.009771355	0.039875115	0.704552489	11.8630649	16.21131702	0.346030603	1.20243874	0	2.647637747	2.842892467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5497
H0245_001_0	2008	3																																D	D	D	V	P	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	Coin	V	V	V	V	V	V	V	Coin																																																				0		1177.240206	297.2624891	1043.38387	313.4298271	283.4158171	15.40993335	4.957540858	854.948818	2943.51259	2859.885275	893.1652732	0	12.97138129	147.6092744	3671.543118	6051.919275	855.4803386	188.548424	1816.584209	0	16.19369751	9.690961788	0	1630.659814	240.819947	339.0432384	20.39969491	94.77302646	0	1.90021064	41.34197238											$100/day - 1st 10 days	$100/day - 1st 10 days	$50/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $30 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$30/visit	$10/visit	$30/visit	$30/visit	$30/visit	$30/visit	Zero Cost Sharing	20% Coinsurance	10% Blood	100% Coinsurance	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											70.03328531	70.03328531	40.52480559	0	126.3157895	0.2	0.121870541	44.1609844	65.85289683	0	0	0	0	0	8.552971576	9.764057143	30	30	0.344827586	0	0.2	0	0	9.795348837	0	0	0	0	0	0	0											6.8705	1.734855726	3.523577375	0	2.983324391	3.08198667	0.604178187	3.146281785	16.15323591	0	0	0	0	0	2.616883661	4.924273802	2.138700847	0.47137106	0.052200696	0	3.238739501	0	0	1.331073476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8712			6.8705	1.734855726	3.523577375	0	2.983324391	3.08198667	0.604178187	3.146281785	16.15323591	0	0	0	0	0	2.616883661	4.924273802	2.138700847	0.47137106	0.052200696	0	3.238739501	0	0	1.331073476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8712		$100/day - 1st 10 days	$100/day - 1st 10 days	$50/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $30 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$30/visit	$10/visit	$30/visit	$30/visit	$30/visit	$30/visit	Zero Cost Sharing	20% Coinsurance	10% Blood	100% Coinsurance	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.7771	0.1962	0.1232	0	4.5663	0.0016	0.0562	0.3663	1.5775	0	0	0	0	0	0.7522	1.4154	0.6148	0.1355	0.015	0	0.8652	0	0	0.1637	0	0	0	0	0	0	0											11.6262			7.6476	1.931080102	3.64674247	0	7.549616121	3.083566458	0.660378054	3.512553873	17.73075732	0	0	0	0	0	3.369083294	6.339711945	2.753451138	0.606862425	0.067205315	0	4.103976235	0	0	1.494817024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4974
H0245_002_0	2008	2																																D	D	D	V	P	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin																																																				0		1439.508552	363.4873268	1275.831387	383.2564623	346.5558606	18.8429946	6.061993489	1045.41633	3599.275259	3497.017253	1092.146737	0	15.86117617	180.4940163	4489.498144	7400.180109	1046.066264	230.5536861	2221.287118	0	19.80136759	11.84993709	0	1893.051714	294.4703822	414.5760898	24.944387	94.77302646	0	2.323544043	50.55223438											$95/day - 1st 10 days	$95/day - 1st 10 days	$75/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $20 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	Zero Cost Sharing	20% Coinsurance	10% Blood	100% Coinsurance	$10/visit Preventative; $10/Visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											35.01664265	35.01664265	60.78720838	0	126.3157895	0.2	0.121870541	44.1609844	65.85289683	0	0	0	0	0	4.276485788	6.509371429	20	20	0.229885057	0	0.2	0	0	9.795348837	0	0	0	0	0	0	0											4.2006	1.060675486	6.462852365	0	3.647956427	3.768598921	0.738778427	3.847217853	19.75189186	0	0	0	0	0	1.599939584	4.01421008	1.743443773	0.384256143	0.042553393	0	3.960273517	0	0	1.545258492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.7685			4.2006	1.060675486	6.462852365	0	3.647956427	3.768598921	0.738778427	3.847217853	19.75189186	0	0	0	0	0	1.599939584	4.01421008	1.743443773	0.384256143	0.042553393	0	3.960273517	0	0	1.545258492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.7685		$95/day - 1st 10 days	$95/day - 1st 10 days	$75/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $20 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	Zero Cost Sharing	20% Coinsurance	10% Blood	100% Coinsurance	$10/visit Preventative; $10/Visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.4751	0.12	0.2259	0	5.5836	0.0019	0.0687	0.4479	1.929	0	0	0	0	0	0.4599	1.1538	0.5011	0.1105	0.0122	0	1.058	0	0	0.1901	0	0	0	0	0	0	0											12.3377			4.6757	1.180645338	6.688758522	0	9.231537386	3.770530657	0.807498632	4.295088899	21.68085721	0	0	0	0	0	2.059827804	5.168058605	2.244580979	0.49470711	0.054784983	0	5.018269728	0	0	1.735350258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1062
H0245_003_0	2008	5																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0.281	0.5989	0.1927	0.9441	5.5468	0.3937	0.5909	0	0.0285	0.042	0.8244	2.3334	0.2052	0.0564	0.3156	0	0.6294	0.0115	0	0	0	0	0	0	0	0	0											12.9945		271.1764838	137.2164596	1192.673541	15.9622476	8.263308391	17.61482068	5.666876762	27.76886285	163.1420651	11.578513	17.38044518	0	0.837851514	1.235238995	24.24797323	68.63011048	6.035983466	1.657556068	9.283108501	0	18.51072754	0.33860937	0	25.67809962	1.146442876	2.089143664	0.068346933	2.491593593	0	23.35585018	0.356556642											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	100% Coinsurance	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											520.0080469	92.94484945	59.64569891	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0	0	0	0	0	0	0	0											11.7512	1.062796932	5.92815391	0	1.652661678	3.522964135	1.133375352	5.553772571	32.62841303	2.3157026	3.476089036	0	0.167570303	0.247047799	4.849594645	13.7260221	1.207196693	0.331511214	1.8566217	0	3.702145508	0.067721874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.1805	135		11.7512	1.062796932	5.92815391	0	1.933614164	4.121868038	1.326049162	6.497913908	38.17524324	2.709372042	4.067024172	0	0.196057254	0.289045925	5.674025735	16.05944585	1.412420131	0.38786812	2.172247389	0	4.331510244	0.079234593	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.1751		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	100% Coinsurance	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											1.3291	0.1202	0.2072	0	2.9596	0.3834	0.1233	0.7564	3.7282	0.3129	0.4698	0	0.0226	0.0334	1.6309	4.6161	0.406	0.1115	0.6244	0	1.1572	0.0142	0	0	0	0	0	0	0	0	0											19.0066	135		13.0803	1.183006735	6.135369918	0	4.893213995	4.505278826	1.449396526	7.254363792	41.90342899	3.022312408	4.536777315	0	0.218702438	0.322431572	7.304973316	20.67558889	1.818407574	0.499357317	2.796640332	0	5.488683204	0.093429459	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.1817
H0245_004_0	2008	2																																D	D	D	V	P	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	Coin	V	V	V	V	V	V	V	V																																																				0		1177.240206	297.2624891	1043.38387	313.4298271	283.4158171	15.40993335	4.957540858	854.948818	2943.51259	2859.885275	893.1652732	0	12.97138129	147.6092744	3671.543118	6051.919275	855.4803386	188.548424	1816.584209	0	16.19369751	9.690961788	0	1630.659814	240.819947	339.0432384	20.39969491	94.77302646	0	1.90021064	41.34197238											$50/day - 1st 10 days	$50/day - 1st 10 days	$50/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $20 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	Zero Cost Sharing	20% Coinsurance	10% Blood	100% Coinsurance	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											35.01664265	35.01664265	40.52480559	0	126.3157895	0.2	0.121870541	44.1609844	65.85289683	0	0	0	0	0	4.276485788	6.509371429	20	20	0.229885057	0	0.2	0	0	9.795348837	0	0	0	0	0	0	0											3.4352	0.867427863	3.523577375	0	2.983324391	3.08198667	0.604178187	3.146281785	16.15323591	0	0	0	0	0	1.30844183	3.282849202	1.425800564	0.314247373	0.034800464	0	3.238739501	0	0	1.331073476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7312			3.4352	0.867427863	3.523577375	0	2.983324391	3.08198667	0.604178187	3.146281785	16.15323591	0	0	0	0	0	1.30844183	3.282849202	1.425800564	0.314247373	0.034800464	0	3.238739501	0	0	1.331073476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7312		$50/day - 1st 10 days	$50/day - 1st 10 days	$50/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $20 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	Zero Cost Sharing	20% Coinsurance	10% Blood	100% Coinsurance	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.3886	0.0981	0.1232	0	4.5663	0.0016	0.0562	0.3663	1.5775	0	0	0	0	0	0.3761	0.9436	0.4098	0.0903	0.01	0	0.8652	0	0	0.1637	0	0	0	0	0	0	0											10.0366			3.8238	0.965540051	3.64674247	0	7.549616121	3.083566458	0.660378054	3.512553873	17.73075732	0	0	0	0	0	1.684541647	4.22647463	1.835634092	0.40457495	0.044803544	0	4.103976235	0	0	1.494817024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7678
H0251_001_0	2008	7																																Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	P	P															0.0001	0.0001	0.0001		0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001																				0.0017		363.1840043	23.81213621	58.92449426		18.8750968	31.58310336	31.85661092	692.5709921	39.2997677	19.22345097	42.71551753	1.750278218	3.680734241	24.04113952	29.75657988	101.2682043	5.80755543	2.151871678			21.58733407	0.405725754																				ffs medicare (1a)	ffs medicare (1b)	$0 1-20 days; $130 21-100 days (2)	0% (6a)	20% (FFS) (10a)	20% (FFS) (11a)	"20% (FFS) (11b, 11c)"	"$50 (4a), 20% (4b)"	20% (FFS) (9b)	20% (FFS) (8a)	20% (FFS) (8b)	20% (FFS) (incl in h.5)	20% (FFS) (12)	"20% (FFS) (3, 5, 9a, 9c, 9d)"	"20% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i)"	"20% (FFS) (7b, 7d, 7f)"	"20% (FFS) (7e, 7h)"	"20% (FFS) (7c, 7i)"	20% (FFS) (incl in h.2)	20% (FFS) (7g)	20% (FFS) (15)	"20% (FFS) (13a, 14j, 16b, 17a, 18a)"	$0 n/c (10b)	$0 (16a)	$0 (17a)	$0 (17b)	$0 n/c (18a)	$0 n/c (18b)	$0 n/c	$0 (14a)	$0 (13c)											0.083085982	0.083085982	0.220587974		0.234	0.234	0.234	50.0017	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.5	0.234			0.234	0.233999986																				30.1755	1.978454726	12.99803481	0	4.416772651	7.390446187	7.454446955	2.885811463	9.196145641	4.498287527	9.995431102	0.409565103	0.861291812	5.625626649	6.963039692	23.69675981	2.903777715	0.503537973	0	0	5.051436173	0.094939821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.0993	135	0	30.1755	1.978454726	12.99803481	0	4.416872651	7.390546187	7.454546955	2.885811463	9.196245641	4.498387527	9.995531102	0.409665103	0.861391812	5.625726649	6.963139692	23.69685981	2.903877715	0.503637973	0.0001	0.0001	5.051536173	0.095039821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.101																																																																																				0	0	0	30.1755	1.978454726	12.99803481	0	4.416872651	7.390546187	7.454546955	2.885811463	9.196245641	4.498387527	9.995531102	0.409665103	0.861391812	5.625726649	6.963139692	23.69685981	2.903877715	0.503637973	0.0001	0.0001	5.051536173	0.095039821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.101
H0302_001_0	2008	8																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	Coin	V	P	V	P	V																																																				0	0	1414.683336	111.6473696	965.0493934		169.47405	15.11613993	3.376236557	296.2228003	119.2109049	7.999974677	363.6863935		52.96968919	564.8547955	4522.729734	5872.754747	234.1024854	46.73661085		232.6591347	13.89167002	0.056566772			92.15500959		235.8361937			1.244468992	152.1052893											1a: $125 days 1-4	"1b: $125 days 1-8, $175 days 31+"	"2: $0 days 1-20, $50 days 21-100"		10a: $100/15%	11a: 0%-20%	"11b: 0%-20%, 11c: $0-$12"	"4a: $50, 4b: $25"	9b: $150	8a: $0-$75	8b: $0-$300		12: $10/$30	"3, 5, 9c: $0, 9a: $0-$150"	"7a: $10 14c: $20, 14: $0-$25, 14d, 14e, 14f, 14h:  $0; 14g: $25"	"7b, 7f: $30, 16b: 20%, 18a: $20; 7d, 17a: $20/$30"	"7e, 7h: $20"	7i: $10	$0 (incl in i.2.)	7g: $10-$50	15: 20%	17b: $20			17a: $20		18a: $20			14j:  $10	13c:  $15											82.1943	78.0876	14.1722		101.6314	0.037	0.031122344	48.3985	150	75	76.4121		10.7865	13.0606	11.8736	20.0641	20	10		6.34	0.240807515	20			20		20			10	18.8526											9.6899	0.726522935	1.139737766	0	1.435324245	0.559297177	0.105076397	1.194728429	1.490136311	0.049999842	2.315835296	0	0.047613204	0.614778242	4.4750837	9.819282047	0.390170809	0.038947176	0	0.122921576	3.345218537	9.43E-05	0	0	0.153591683	0	0.393060323	0	0	0.001037057	0.238964417	0	0	0	0	0	0	0	0	0	0	38.3473	0	0	9.6899	0.726522935	1.139737766	0	1.435324245	0.559297177	0.105076397	1.194728429	1.490136311	0.049999842	2.315835296	0	0.047613204	0.614778242	4.4750837	9.819282047	0.390170809	0.038947176	0	0.122921576	3.345218537	9.43E-05	0	0	0.153591683	0	0.393060323	0	0	0.001037057	0.238964417	0	0	0	0	0	0	0	0	0	0	38.3473																																																																																				0	0	0	9.6899	0.726522935	1.139737766	0	1.435324245	0.559297177	0.105076397	1.194728429	1.490136311	0.049999842	2.315835296	0	0.047613204	0.614778242	4.4750837	9.819282047	0.390170809	0.038947176	0	0.122921576	3.345218537	9.43E-05	0	0	0.153591683	0	0.393060323	0	0	0.001037057	0.238964417	0	0	0	0	0	0	0	0	0	0	38.3473
H0302_004_0	2008	5																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	P	T	P	P	P	P	P	P	P	P																																																				0		1842.572484	57.42752095	1402.990736		410.3564274	22.7010354	28.32738893	352.6491494	342.1790189	8.234052875	132.0001263		22.24284958	41.49894097	6559.199327	9234.328615	282.7553236	1218.008279			48.1441929	459.9962919			144		249				50											1a: $125 days 1-4	"1b: $125 days 1-8, $175 days 31+"	"2: $0 days 1-20, $50 days 21-100"		10a: $100/15%	11a: 0%-20%	"11b: 0%-20%, 11c: $0-$12"	"4a: $50, 4b: $25"	9b: $0-$150	8a: $0-$75	8b: $0-$300/ 20%		12: $10/$30	"3: $10, 5, 9c: $20, 9a: $0-$150"	"7a: $10 14c: $20, 14b: $0-$25, 14d, 14e, 14h: $0; 14f:$0-$150 14g: $25"	"7b, 7f: $30; 18a: $20; 7d, 17a: $20/$30"	"7e, 7h: $20"	7i: $10	$0 (incl in i.2.)	7g: $10-$50	15: 20%	13a: $0; 14j: $10; 16b: 20%; 17b: $20			17a: $20/$30		18a: $20				13c:  $15											66.855	95.7824	14.4611		125	0.036680648	0.048909715	50	150	75	90.401		10	21.0205	10.5215	19.4899	20	10			0.2	19.8082			20		20				15											10.2654	0.458378916	1.69073743	0	4.274546119	0.832688679	1.385484518	1.469371456	4.277237736	0.05146283	0.994412117	0	0.018535708	0.07269392	5.75106885	14.99804851	0.471258873	1.015006899	0	0	9.62883858	0.759307052	0	0	0.24	0	0.415	0	0	0	0.0625	0	0	0	0	0	0	0	0	0	0	59.132	0	0	10.2654	0.458378916	1.69073743	0	4.274546119	0.832688679	1.385484518	1.469371456	4.277237736	0.05146283	0.994412117	0	0.018535708	0.07269392	5.75106885	14.99804851	0.471258873	1.015006899	0	0	9.62883858	0.759307052	0	0	0.24	0	0.415	0	0	0	0.0625	0	0	0	0	0	0	0	0	0	0	59.132																																																																																				0	0	0	10.2654	0.458378916	1.69073743	0	4.274546119	0.832688679	1.385484518	1.469371456	4.277237736	0.05146283	0.994412117	0	0.018535708	0.07269392	5.75106885	14.99804851	0.471258873	1.015006899	0	0	9.62883858	0.759307052	0	0	0.24	0	0.415	0	0	0	0.0625	0	0	0	0	0	0	0	0	0	0	59.132
H0303_013_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1594.194498	10.08648197	1121.005587		184.190676	11.14612394	17.82342418	395.2342771	341.0139327	8056.029167	50.51741605			528.6050641	4523.514506	3438.742293	299.5921787	163.3770211			27.01692278	1673.883759			177.8687922	2.613039023																$200 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$200 (9b)	$0 (8a1); $0/$14 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $10/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											85.6739	912	69.5467		100	0.2	0.2	48.7101	200	5.6	0.13736741			5.6893	10	30	30	7.9579			0.2	30			30	0.411104632																11.3817	0.76657263	6.496849511	0	1.5349223	2.229224788	3.564684836	1.604326448	5.683565544	3.759480278	6.939446585	0	0	0.250616024	3.769595422	8.596855023	0.748980447	0.108344968	0	0	5.403384556	4.184709398	0	0	0.44467198	1.074232446	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5422	0	0	11.3817	0.76657263	6.496849511	0	1.5349223	2.229224788	3.564684836	1.604326448	5.683565544	3.759480278	6.939446585	0	0	0.250616024	3.769595422	8.596855023	0.748980447	0.108344968	0	0	5.403384556	4.184709398	0	0	0.44467198	1.074232446	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5422																																																																																				0			11.3817	0.76657263	6.496849511	0	1.5349223	2.229224788	3.564684836	1.604326448	5.683565544	3.759480278	6.939446585	0	0	0.250616024	3.769595422	8.596855023	0.748980447	0.108344968	0	0	5.403384556	4.184709398	0	0	0.44467198	1.074232446	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5422
H0303_015_0	2008	6																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1563.578173	9.418732151	1301.068455		529.0949578	14.10281393	18.45864763	405.6894239	222.0928962	5391.566982	58.10620246			368.1065572	4873.26206	3887.333435	296.9317861	588.6776659			32.56384449	1654.909257			176.9868598	2.612980728																$150 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$150 (9b)	$0 (8a1); $0/$20 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$150 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5, 9a); $30/$30 (9c)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"											64.2555	912	69.5467		100	0.2	0.2	49.082	150	8	0.139008289			5.7357	15	30	30	7.9579			0.2	30			30	0.411069113																8.3724	0.715823643	7.54041376	0	4.409124648	2.820562785	3.691729525	1.659338817	2.776161202	3.594377988	8.07724381	0	0	0.175945155	6.091577574	9.718327149	0.742329465	0.390386985	0	0	6.512768897	4.137273143	0	0	0.44246715	1.07411567	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9423	0	0	8.3724	0.715823643	7.54041376	0	4.409124648	2.820562785	3.691729525	1.659338817	2.776161202	3.594377988	8.07724381	0	0	0.175945155	6.091577574	9.718327149	0.742329465	0.390386985	0	0	6.512768897	4.137273143	0	0	0.44246715	1.07411567	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9423																																																																																				0			8.3724	0.715823643	7.54041376	0	4.409124648	2.820562785	3.691729525	1.659338817	2.776161202	3.594377988	8.07724381	0	0	0.175945155	6.091577574	9.718327149	0.742329465	0.390386985	0	0	6.512768897	4.137273143	0	0	0.44246715	1.07411567	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9423
H0303_034_0	2008	7	F2	H5a	H5b	I2a	O1a	E2b					OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)	DME					700	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests	Diabetes Monitoring Supplies					D	D	D	P	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V		V	Coin	V	T	P	V	P	V	P				V	P	V	V	V																																															0		1881.733278	9.585884389	1441.65029	377.5712437	1.642590449	9.956381022	21.0069866	396.3948104	310.4372129	1641.679007	1247.872598		6.450224828	52.73391936	3992.013122	3835.898877	5.290618706	516.4294567			1451.606496	34.23564161	816.08		239.9590361							66.29674183		22.58185084	78.6							(1a) $75/day	(1b) $75/day	(2a) $140/day days 21-100	(6a) $0/proc	(10a) $75/trip	(11a) 20% coins	(11b/11c) 20%/0% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $25/visit	(8a) $10/visit	(8b) $10/visit		(12) 20% coins	(9a) $25/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $10/visit	(7e/7h) $0/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $10/visit			(15) $0/proc	(16b/17a) $10/visit (13a/13a1/14a10/17b N/A $0 Copay)	(10b) $0/trip		(17a1) $0/visit							(4b) $10/visit (waived if admitted)		(9d) $25/visit	(7f1) $0/visit							56.5045	56.5045	31.6425		56.5045	0.150678689	0.150678689	37.6697	18.8348	7.5339	7.5339		0.150678689	18.8348		7.5339		7.5339				7.5339										7.5339		18.8348								8.8605	0.04513714	3.801454568	0	0.00773448	1.500214437	3.165305194	1.244338547	0.487252835	1.030691833	0.783449195	0	0.971911419	0.082769561	0	2.40828422	0	0.324228806	0	0	0	0.02149409	0	0	0	0	0	0	0	0	0	0.041622942	0	0.035443788	0	0	0	0	0	0	0	24.8119		8.121611969	8.8605	0.04513714	3.801454568	0	0.00773448	1.500214437	3.165305194	1.244338547	0.487252835	1.030691833	0.783449195	0	0.971911419	0.082769561	0	2.40828422	0	0.324228806	0	0	0	0.02149409	0	0	0	0	0	0	0	0	0	0.041622942	0	0.035443788	0	0	0	0	0	0	0	24.8119																																																																																				0		0	8.8605	0.04513714	3.801454568	0	0.00773448	1.500214437	3.165305194	1.244338547	0.487252835	1.030691833	0.783449195	0	0.971911419	0.082769561	0	2.40828422	0	0.324228806	0	0	0	0.02149409	0	0	0	0	0	0	0	0	0	0.041622942	0	0.035443788	0	0	0	0	0	0	0	24.8119
H0303_035_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1478.490373	9.824058458	795.501412		457.9822057	16.4555479	22.73865579	417.5212401	341.0848434	5433.637374	67.17088884			653.2910072	4825.521484	3890.346469	297.5128127	450.578478			28.73126905	2024.818218			173.4125315	2.44056248																$150 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$150 (9b)	$0 (8a1); $0/$19 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$150 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5, 9a); $30/$30 (9c)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											64.2555	912	69.5467		100	0.2	0.2	47.9056	150	7.6	0.147576569			4.5827	15	30	30	7.9579			0.2	30			30	0.413819041																7.9168	0.746628443	4.610372169	0	3.81651838	3.29110958	4.547731159	1.666801499	4.263560542	3.44130367	9.91284929	0	0	0.249484098	6.031901855	9.725865745	0.743782032	0.298805244	0	0	5.74625381	5.062045544	0	0	0.433531329	1.009951226	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.5153	0	0	7.9168	0.746628443	4.610372169	0	3.81651838	3.29110958	4.547731159	1.666801499	4.263560542	3.44130367	9.91284929	0	0	0.249484098	6.031901855	9.725865745	0.743782032	0.298805244	0	0	5.74625381	5.062045544	0	0	0.433531329	1.009951226	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.5153																																																																																				0			7.9168	0.746628443	4.610372169	0	3.81651838	3.29110958	4.547731159	1.666801499	4.263560542	3.44130367	9.91284929	0	0	0.249484098	6.031901855	9.725865745	0.743782032	0.298805244	0	0	5.74625381	5.062045544	0	0	0.433531329	1.009951226	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.5153
H0303_039_0	2008	6																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1594.849736	9.607106794	1327.089824		539.676857	14.31370704	18.70215765	413.6232144	226.5347541	5499.398321	58.82546014			375.4686884		3965.080103	302.8704218	600.4512192			32.99731003	1688.007442			144	1.8025																$200 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$0 (4b)"	$200 (9b)	$0 (8a1); $0/$18 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$0/$50/$30 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$35 (7b, 7d); $0 n/c (7b1, 7f1); $0/$35( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $0/$35 (17a); $35( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"											125.8558	912	69.5467		100	0.2	0.2	49.0816	200	7.2	0.139080035			6.8962		35	30	7.9579			0.2	35			30	0.428571429																16.7268	0.730140116	7.691222035	0	4.497307141	2.862741408	3.74043153	1.691775602	3.775579235	3.299638993	8.181447063	0	0	0.215776182	0	11.56480165	0.757176055	0.398194725	0	0	6.599462007	4.92335504	0	0	0.36	0.7725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7883	0	0	16.7268	0.730140116	7.691222035	0	4.497307141	2.862741408	3.74043153	1.691775602	3.775579235	3.299638993	8.181447063	0	0	0.215776182	0	11.56480165	0.757176055	0.398194725	0	0	6.599462007	4.92335504	0	0	0.36	0.7725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7883																																																																																				0			16.7268	0.730140116	7.691222035	0	4.497307141	2.862741408	3.74043153	1.691775602	3.775579235	3.299638993	8.181447063	0	0	0.215776182	0	11.56480165	0.757176055	0.398194725	0	0	6.599462007	4.92335504	0	0	0.36	0.7725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7883
H0303_040_0	2008	3																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1566.15627	9.434262173	1303.213714		529.967353	14.07936088	18.39596312	406.1887795	222.4590927		57.86236089			368.7135076	4727.388384	3893.743042	297.4213804	589.6483036			32.45707313	1657.637945			144	1.8025																$150 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$150 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$150 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5, 9a); $30/$30 (9c)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"											64.2555	912	63.2242		100	0.2	0.2	49.0817	150		0.139065754			5.7359	15	30	30	7.9579			0.2	30			30	0.428571429																8.3862	0.717003925	6.866224298	0	4.416394608	2.815872176	3.679192625	1.661368296	2.780738659	0	8.046672868	0	0	0.176242943	5.90923548	9.734351157	0.743553451	0.391030673	0	0	6.491414626	4.144094862	0	0	0.36	0.7725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.0921	0	0	8.3862	0.717003925	6.866224298	0	4.416394608	2.815872176	3.679192625	1.661368296	2.780738659	0	8.046672868	0	0	0.176242943	5.90923548	9.734351157	0.743553451	0.391030673	0	0	6.491414626	4.144094862	0	0	0.36	0.7725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.0921																																																																																				0			8.3862	0.717003925	6.866224298	0	4.416394608	2.815872176	3.679192625	1.661368296	2.780738659	0	8.046672868	0	0	0.176242943	5.90923548	9.734351157	0.743553451	0.391030673	0	0	6.491414626	4.144094862	0	0	0.36	0.7725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.0921
H0303_801_0	2008	4																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1325.678961	76.33265241	888.9362848		8.176814173	14.98122063	15.73053569	358.0633791	340.1494411		65.28469305		1.573984625	495.8791681	4492.8541	4089.677021	2.664828298	801.0964959			50.25203812	1697.039716			154.6008387																	$400 (1a); $0 (1a1)	$400 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											251.7116	265.8188	159.1696		0.3	0.3	0.3	48.9726	300		0.220227555		0.3	7.5201	20	40	0.391607276	40			0.3	40			40																	27.8074	1.690887584	11.79096657	0	2.453044252	4.494366189	4.719160707	1.461274207	8.503736027	0	14.37748831	0	0.472195387	0.31075582	7.488090167	13.63225674	1.043566151	2.670321653	0	0	15.07561144	5.656799053	0	0	0.515336129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.1633	0	0	27.8074	1.690887584	11.79096657	0	2.453044252	4.494366189	4.719160707	1.461274207	8.503736027	0	14.37748831	0	0.472195387	0.31075582	7.488090167	13.63225674	1.043566151	2.670321653	0	0	15.07561144	5.656799053	0	0	0.515336129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.1633																																																																																				0			27.8074	1.690887584	11.79096657	0	2.453044252	4.494366189	4.719160707	1.461274207	8.503736027	0	14.37748831	0	0.472195387	0.31075582	7.488090167	13.63225674	1.043566151	2.670321653	0	0	15.07561144	5.656799053	0	0	0.515336129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.1633
H0303_803_0	2008	3																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1324.708359	76.27878467	888.2592469		8.165424665	14.95963771	15.70964323	357.8085688	339.9207054		65.19766525		1.572418434	495.536225	4489.670632	4086.67466	2.661066765	800.5627415			50.18250087	1695.861056			154.6008387																	$400 (1a); $0 (1a1)	$400 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											251.7116	265.8188	159.1696		0.3	0.3	0.3	48.9726	300		0.220228197		0.3	7.5201	20	40	0.391743362	40			0.3	40			40																	27.787	1.689694329	11.78198626	0	2.4496274	4.487891313	4.71289297	1.460234611	8.498017636	0	14.35836425	0	0.47172553	0.310540901	7.482784387	13.62224887	1.042455241	2.668542472	0	0	15.05475026	5.652870185	0	0	0.515336129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.047	0	0	27.787	1.689694329	11.78198626	0	2.4496274	4.487891313	4.71289297	1.460234611	8.498017636	0	14.35836425	0	0.47172553	0.310540901	7.482784387	13.62224887	1.042455241	2.668542472	0	0	15.05475026	5.652870185	0	0	0.515336129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.047																																																																																				0			27.787	1.689694329	11.78198626	0	2.4496274	4.487891313	4.71289297	1.460234611	8.498017636	0	14.35836425	0	0.47172553	0.310540901	7.482784387	13.62224887	1.042455241	2.668542472	0	0	15.05475026	5.652870185	0	0	0.515336129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.047
H0303_804_0	2008	5																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1391.228151	77.21225706	970.4440303		8.152526934	16.18232537	16.21477877	365.805389	327.8621864		66.01477101		1.485244249	491.5635073	4960.300062	4303.486837	2.696377944	765.066271			51.80154882	1689.453163			181.3898644																	$300 (1a); $0 (1a1)	$300 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											188.7837	199.3641	159.1696		0.3	0.3	0.3	48.9602	300		0.21987979		0.3	7.5203	20	40	0.391190664	40			0.3	40			40																	21.8868	1.282779152	12.87209592	0	2.44575808	4.85469761	4.86443363	1.49249099	8.196554659	0	14.51531397	0	0.445573275	0.308057393	8.267166771	14.34495612	1.054797877	2.550220903	0	0	15.54046465	5.631510542	0	0	0.604632881	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.1583	0	0	21.8868	1.282779152	12.87209592	0	2.44575808	4.85469761	4.86443363	1.49249099	8.196554659	0	14.51531397	0	0.445573275	0.308057393	8.267166771	14.34495612	1.054797877	2.550220903	0	0	15.54046465	5.631510542	0	0	0.604632881	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.1583																																																																																				0			21.8868	1.282779152	12.87209592	0	2.44575808	4.85469761	4.86443363	1.49249099	8.196554659	0	14.51531397	0	0.445573275	0.308057393	8.267166771	14.34495612	1.054797877	2.550220903	0	0	15.54046465	5.631510542	0	0	0.604632881	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.1583
H0303_805_0	2008	4																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1391.228151	77.21225706	970.4440303		8.152526934	16.18232537	16.21477877	365.805389	327.8621864		66.01477101		1.485244249	491.5635073	4960.300062	4303.486837	2.696377944	765.066271			51.80154882	1689.453163			181.3898644																	$300 (1a); $0 (1a1)	$300 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											188.7837	199.3641	159.1696		0.3	0.3	0.3	48.9602	300		0.21987979		0.3	7.5203	20	40	0.391190664	40			0.3	40			40																	21.8868	1.282779152	12.87209592	0	2.44575808	4.85469761	4.86443363	1.49249099	8.196554659	0	14.51531397	0	0.445573275	0.308057393	8.267166771	14.34495612	1.054797877	2.550220903	0	0	15.54046465	5.631510542	0	0	0.604632881	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.1583	0	0	21.8868	1.282779152	12.87209592	0	2.44575808	4.85469761	4.86443363	1.49249099	8.196554659	0	14.51531397	0	0.445573275	0.308057393	8.267166771	14.34495612	1.054797877	2.550220903	0	0	15.54046465	5.631510542	0	0	0.604632881	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.1583																																																																																				0			21.8868	1.282779152	12.87209592	0	2.44575808	4.85469761	4.86443363	1.49249099	8.196554659	0	14.51531397	0	0.445573275	0.308057393	8.267166771	14.34495612	1.054797877	2.550220903	0	0	15.54046465	5.631510542	0	0	0.604632881	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.1583
H0307_008_0	2008	6	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)																				D	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0	0	0	0									0		1982.08	2	821.4	24.7	229.51	3.39	0.96	354.8	200.7	11857.31	1426.06		134.1	267.47	5226.46	2582.82	13.49	259.94			16.7									0.08	0.18	0.02	2.5									$165/Day(Days 1-5)	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	0%-20% Coins	$50/Visit	$150/Visit	$0-$150/Visit	$25-$150/Visit		$0-$100/Proc	$15-$150/Visit	$10/Visit	$30/Visit	$30-$150/Visit	$50/Visit			20% Coins									Active Outlook Newsletter	Meals on Wheels	QUIT NET	Silver & Fit									107.256268	950.002474	28.944132	0	100.000002	0.199999	0.054761	49.999995	149.999989	4.166605	107.279842		19.319836	114.598364	9.999999	29.999995	150.000344	49.999999			0.199999									0	0	0	0									17.7159	0.158333746	1.981225835	0	1.912583372	0.67799661	0.05257056	1.478333186	2.508749816	4.117060594	12.74895762	0	0.215899167	2.554302035	4.355382898	6.457048924	0.168625387	1.083083312	0	0	3.3399833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.526	0	0	17.7159	0.158333746	1.981225835	0	1.912583372	0.67799661	0.05257056	1.478333186	2.508749816	4.117060594	12.74895762	0	0.215899167	2.554302035	4.355382898	6.457048924	0.168625387	1.083083312	0	0	3.3399833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.526																																																																																				0	0	0	17.7159	0.158333746	1.981225835	0	1.912583372	0.67799661	0.05257056	1.478333186	2.508749816	4.117060594	12.74895762	0	0.215899167	2.554302035	4.355382898	6.457048924	0.168625387	1.083083312	0	0	3.3399833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.526
H0307_009_0	2008	4	s.	t.	u.								Other Non-Covered	Other Non-Covered	Other Non-Covered																			D	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V		Coin	O		O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0		0	0	0								0		1873.471925	1.891162	776.394375	23.342438	216.931297	3.027743	0.862137	335.358485	189.701808	11207.57581	1347.919576		126.755248	252.815336	4940.067289	2441.292729	12.74646	245.696197			14.922213			3.16	2.72		0.15		1.77	0.08		0.02	0.18	4.75								$175/Day(Days 1-5)	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	0%-20% Coins	$50/Visit	$150/Visit	$0-$150/Visit	$25-$150/Visit		$0-$100/Proc	$15-$150/Visit	$5/Visit	$30/Visit	$30-$150/Visit	$50/Visit			20% Coins			Coin:  0%	Vision		Hearing		IP 225(1-5) with OP at 15%	Active Outlook Newsletter		Quit Net	See PBP	Forever Fit								113.756651	950	28.94412	0	100.00001	0.2	0.054761	49.999999	150.000025	4.166606	107.279839		19.319815	114.598316	4.999999	30	150.000235	49.999992			0.2			0	0		0		1	0		0	0	0								17.76	0.149716992	1.872670996	0	1.807760989	0.6055486	0.047211484	1.397326993	2.371272995	3.891462716	12.05038292	0	0.204073995	2.41435098	2.058360959	6.103231823	0.159331	1.02373399	0	0	2.9844426	0	0	0	0	0	0	0	1.77	0	0	0	0	0	0	0	0	0	0	0	0	58.6709	0	0	17.76	0.149716992	1.872670996	0	1.807760989	0.6055486	0.047211484	1.397326993	2.371272995	3.891462716	12.05038292	0	0.204073995	2.41435098	2.058360959	6.103231823	0.159331	1.02373399	0	0	2.9844426	0	0	0	0	0	0	0	1.77	0	0	0	0	0	0	0	0	0	0	0	0	58.6709																																																																																				0	0	0	17.76	0.149716992	1.872670996	0	1.807760989	0.6055486	0.047211484	1.397326993	2.371272995	3.891462716	12.05038292	0	0.204073995	2.41435098	2.058360959	6.103231823	0.159331	1.02373399	0	0	2.9844426	0	0	0	0	0	0	0	1.77	0	0	0	0	0	0	0	0	0	0	0	0	58.6709
H0307_801_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		318.561078	2.000799	821.404213	24.695666	229.507435	3.388971	0.964995	354.800191	200.699374	11857.31154	1426.062391		134.103619	267.471776	5226.457344	2582.821563	13.485409	259.939921			16.702522																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214493	177.217201	28.944132	0	100.000002	0.199999	0.2	49.999995	200.000025	35.416661	84.505267		19.319836	87.723693	19.999999	29.999995	99.999636	99.999999			0.199999																					4.7045	0.029548	1.981235997	0	1.912561997	0.677790811	0.192999	1.478333981	3.344989985	34.99553194	10.04248193	0	0.215904994	1.955300997	8.710761804	6.457052831	0.112377999	2.166165987	0	0	3.340487697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.318	0	0	4.7045	0.029548	1.981235997	0	1.912561997	0.677790811	0.192999	1.478333981	3.344989985	34.99553194	10.04248193	0	0.215904994	1.955300997	8.710761804	6.457052831	0.112377999	2.166165987	0	0	3.340487697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.318																																																																																				0	0	0	4.7045	0.029548	1.981235997	0	1.912561997	0.677790811	0.192999	1.478333981	3.344989985	34.99553194	10.04248193	0	0.215904994	1.955300997	8.710761804	6.457052831	0.112377999	2.166165987	0	0	3.340487697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.318
H0307_802_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		318.561078	2.000799	821.404213	24.695666	229.507435	3.388971	0.964995	354.800191	200.699374	11857.31154	1426.062391		134.103619	267.471776	5226.457344	2582.821563	13.485409	259.939921			16.702522																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214493	177.217201	28.944132	0	100.000002	0.199999	0.2	49.999995	200.000025	35.416661	84.505267		19.319836	87.723693	19.999999	29.999995	99.999636	99.999999			0.199999																					4.7045	0.029548	1.981235997	0	1.912561997	0.677790811	0.192999	1.478333981	3.344989985	34.99553194	10.04248193	0	0.215904994	1.955300997	8.710761804	6.457052831	0.112377999	2.166165987	0	0	3.340487697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.318	0	0	4.7045	0.029548	1.981235997	0	1.912561997	0.677790811	0.192999	1.478333981	3.344989985	34.99553194	10.04248193	0	0.215904994	1.955300997	8.710761804	6.457052831	0.112377999	2.166165987	0	0	3.340487697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.318																																																																																				0	0	0	4.7045	0.029548	1.981235997	0	1.912561997	0.677790811	0.192999	1.478333981	3.344989985	34.99553194	10.04248193	0	0.215904994	1.955300997	8.710761804	6.457052831	0.112377999	2.166165987	0	0	3.340487697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.318
H0307_803_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		318.561078	2.000799	821.404213	24.695666	229.507435	3.388971	0.964995	354.800191	200.699374	11857.31154	1426.062391		134.103619	267.471776	5226.457344	2582.821563	13.485409	259.939921			16.702522																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214493	177.217201	28.944132	0	100.000002	0.199999	0.2	49.999995	200.000025	35.416661	84.505267		19.319836	87.723693	19.999999	29.999995	99.999636	99.999999			0.199999																					4.7045	0.029548	1.981235997	0	1.912561997	0.677790811	0.192999	1.478333981	3.344989985	34.99553194	10.04248193	0	0.215904994	1.955300997	8.710761804	6.457052831	0.112377999	2.166165987	0	0	3.340487697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.318	0	0	4.7045	0.029548	1.981235997	0	1.912561997	0.677790811	0.192999	1.478333981	3.344989985	34.99553194	10.04248193	0	0.215904994	1.955300997	8.710761804	6.457052831	0.112377999	2.166165987	0	0	3.340487697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.318																																																																																				0	0	0	4.7045	0.029548	1.981235997	0	1.912561997	0.677790811	0.192999	1.478333981	3.344989985	34.99553194	10.04248193	0	0.215904994	1.955300997	8.710761804	6.457052831	0.112377999	2.166165987	0	0	3.340487697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.318
H0307_804_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		318.561078	2.000799	821.404213	24.695666	229.507435	3.388971	0.964995	354.800191	200.699374	11857.31154	1426.062391		134.103619	267.471776	5226.457344	2582.821563	13.485409	259.939921			16.702522																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214493	177.217201	28.944132	0	100.000002	0.199999	0.2	49.999995	200.000025	35.416661	84.505267		19.319836	87.723693	19.999999	29.999995	99.999636	99.999999			0.199999																					4.7045	0.029548	1.981235997	0	1.912561997	0.677790811	0.192999	1.478333981	3.344989985	34.99553194	10.04248193	0	0.215904994	1.955300997	8.710761804	6.457052831	0.112377999	2.166165987	0	0	3.340487697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.318	0	0	4.7045	0.029548	1.981235997	0	1.912561997	0.677790811	0.192999	1.478333981	3.344989985	34.99553194	10.04248193	0	0.215904994	1.955300997	8.710761804	6.457052831	0.112377999	2.166165987	0	0	3.340487697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.318																																																																																				0	0	0	4.7045	0.029548	1.981235997	0	1.912561997	0.677790811	0.192999	1.478333981	3.344989985	34.99553194	10.04248193	0	0.215904994	1.955300997	8.710761804	6.457052831	0.112377999	2.166165987	0	0	3.340487697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.318
H0316_002_0	2008	5																					3600											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1446.429954	171.6520925	404.5102638		273.6068888	7.65463878	3.191274215	359.1705908	27.83118129	11179.06539	54.67306706		0.169994184	12.92257689	4956.075489	4723.101346	555.3974384	2.811908595			44.60557666	1121.445008			142.1629659		21.06166942															$295 (1a); $0 (1a1)	$295 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	25% (9b)	25% (8a1); $0/$25 (8a2)	"$25 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											192.2477	192.2477	97.7531		114.0453	0.195506157	0.246956561	32.5844	0.162921797	6.5169	0.074213978		0.195506157	0.162728749	10	30	37.5	0.162921797			0.195506157	30			30		30															23.1727	2.74997696	3.295176957	0	2.600297352	1.496529008	0.788106104	0.975278636	4.534306072	6.071044744	4.057505808	0	0.03323491	2.102874776	4.130062907	11.80775337	1.735616995	0.458121202	0	0	8.720664853	2.80361252	0	0	0.355407415	0	0.052654174	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.941	0	32.38020587	23.1727	2.74997696	3.295176957	0	2.600297352	1.496529008	0.788106104	0.975278636	4.534306072	6.071044744	4.057505808	0	0.03323491	2.102874776	4.130062907	11.80775337	1.735616995	0.458121202	0	0	8.720664853	2.80361252	0	0	0.355407415	0	0.052654174	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.941																																																																																				0			23.1727	2.74997696	3.295176957	0	2.600297352	1.496529008	0.788106104	0.975278636	4.534306072	6.071044744	4.057505808	0	0.03323491	2.102874776	4.130062907	11.80775337	1.735616995	0.458121202	0	0	8.720664853	2.80361252	0	0	0.355407415	0	0.052654174	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.941
H0316_012_0	2008	5																					730											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	S	P	T	V	V	P	V	P																																																							0		2120.337739	245.9170424	893.5952994		627.6097894	28.21947259	12.25045072	744.2313004	330.6398695	7855.282225	653.6531875	45.18793643	3.170943343	2397.564366		2193.874302		565.325682				594.8823114																				1(a) $75 per Day	1(b) $75 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $10 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per procedure; other $0 per procedure	8(b) X-rays $10 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a)/(d) $25 Copay Per Visit; 9(c) $0 Copay per Visit"	7(a) PCP $0 per visit; Urgent Care $10 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15 $0 per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $10 per procedure"	10(b) $0 Copay	16(a)/16(b) $0 copay per visit	17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a/18a1 $10/$0 per visit	18(b) $0 copay per procedure														37.0453	37.0453	20.7454		37.0453	0.098787465	0.098787465	17.7817	12.3484	4.9394	4.9394	12.3484	0.098787465	12.3484		4.9394		4.9394				4.9394																				6.5457	0.759172541	1.544830256	0	1.937499385	2.78773017	1.210190975	1.102810857	0.340240361	3.233347585	0.26905309	0.046500018	0.313249456	2.467180277	0	0.90303034	0	0.232696213	0	0	0	0.244862149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.9381	0	24.52574691	6.5457	0.759172541	1.544830256	0	1.937499385	2.78773017	1.210190975	1.102810857	0.340240361	3.233347585	0.26905309	0.046500018	0.313249456	2.467180277	0	0.90303034	0	0.232696213	0	0	0	0.244862149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.9381																																																																																				0	0	0	6.5457	0.759172541	1.544830256	0	1.937499385	2.78773017	1.210190975	1.102810857	0.340240361	3.233347585	0.26905309	0.046500018	0.313249456	2.467180277	0	0.90303034	0	0.232696213	0	0	0	0.244862149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.9381
H0316_013_0	2008	7																					2500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2052.778651	140.7813361	927.5160109		267.7381984	9.804928592	17.0281726	410.9890314	388.4639194	3256.818036	428.0038239	65.22598717	15.49936352	2737.057581		4031.020039	396.0537792	579.5365156				721.7411603					0.071647377															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															131.8088	131.8088	31.6341		56.4895	0.150638672	0.150638672	31.0692	56.4895	15.0639	49.1564	56.4895	102.2798	54.6109		18.8298	15.0639	15.0639				18.8298					18.8298															22.5479	1.546352031	2.445096159	0	1.260366461	1.477001426	2.565101315	1.064092598	1.828677784	4.08835621	1.753261102	0.307048629	0.13210603	12.45610843	0	6.325286533	0.497175129	0.727505094	0	0	0	1.13252219	0	0	0	0	0.000112426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.154	0	20.36665331	22.5479	1.546352031	2.445096159	0	1.260366461	1.477001426	2.565101315	1.064092598	1.828677784	4.08835621	1.753261102	0.307048629	0.13210603	12.45610843	0	6.325286533	0.497175129	0.727505094	0	0	0	1.13252219	0	0	0	0	0.000112426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.154																																																																																				0	0	0	22.5479	1.546352031	2.445096159	0	1.260366461	1.477001426	2.565101315	1.064092598	1.828677784	4.08835621	1.753261102	0.307048629	0.13210603	12.45610843	0	6.325286533	0.497175129	0.727505094	0	0	0	1.13252219	0	0	0	0	0.000112426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.154
H0316_801_0	2008	4																					6000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1518.751452	180.2346971	424.735777		287.2872333	8.037370719	3.350837925	377.1291204	29.22274036	11738.01866	57.40672041		0.178493893	13.56870573	5203.879263	4959.256413	583.1673103	2.952504025			46.83585549	1177.517258			149.2711142		22.1147529															$525 (1a); $0 (1a1)	$525 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											370.4709	370.4709	105.8488		123.4903	0.176414723	0.212646449	35.2829	0.176414723	4.234	0.075856057		0.211697668	0.176195032	10	35	37.5	0.176414723			0.211697668	35			35		35															46.8878	5.564309492	3.746482231	0	2.956432371	1.417910532	0.712543784	1.108852158	5.155321657	4.141518629	4.354647455	0	0.037786741	2.390738539	4.336566053	14.46449787	1.822397845	0.520865181	0	0	9.915041389	3.434425337	0	0	0.435374083	0	0.064501363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.468	0	36.91303611	46.8878	5.564309492	3.746482231	0	2.956432371	1.417910532	0.712543784	1.108852158	5.155321657	4.141518629	4.354647455	0	0.037786741	2.390738539	4.336566053	14.46449787	1.822397845	0.520865181	0	0	9.915041389	3.434425337	0	0	0.435374083	0	0.064501363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.468																																																																																				0			46.8878	5.564309492	3.746482231	0	2.956432371	1.417910532	0.712543784	1.108852158	5.155321657	4.141518629	4.354647455	0	0.037786741	2.390738539	4.336566053	14.46449787	1.822397845	0.520865181	0	0	9.915041389	3.434425337	0	0	0.435374083	0	0.064501363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.468
H0316_803_0	2008	4																					6000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1518.751452	180.2346971	424.735777		287.2872333	8.037370719	3.350837925	377.1291204	29.22274036	11738.01866	57.40672041		0.178493893	13.56870573	5203.879263	4959.256413	583.1673103	2.952504025			46.83585549	1177.517258			149.2711142		22.1147529															$525 (1a); $0 (1a1)	$525 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											370.4709	370.4709	105.8488		123.4903	0.176414723	0.212646449	35.2829	0.176414723	4.234	0.075856057		0.211697668	0.176195032	10	35	37.5	0.176414723			0.211697668	35			35		35															46.8878	5.564309492	3.746482231	0	2.956432371	1.417910532	0.712543784	1.108852158	5.155321657	4.141518629	4.354647455	0	0.037786741	2.390738539	4.336566053	14.46449787	1.822397845	0.520865181	0	0	9.915041389	3.434425337	0	0	0.435374083	0	0.064501363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.468	0	36.91303611	46.8878	5.564309492	3.746482231	0	2.956432371	1.417910532	0.712543784	1.108852158	5.155321657	4.141518629	4.354647455	0	0.037786741	2.390738539	4.336566053	14.46449787	1.822397845	0.520865181	0	0	9.915041389	3.434425337	0	0	0.435374083	0	0.064501363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.468																																																																																				0			46.8878	5.564309492	3.746482231	0	2.956432371	1.417910532	0.712543784	1.108852158	5.155321657	4.141518629	4.354647455	0	0.037786741	2.390738539	4.336566053	14.46449787	1.822397845	0.520865181	0	0	9.915041389	3.434425337	0	0	0.435374083	0	0.064501363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.468
H0317_001_0	2008	7	s.	t.	u.								OP Facility - Other	Other Non-Covered	Other Non-Covered									Renal Dialysis										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin			V			O	O	P	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0			0			0	0	0	0	0								0		313.871413	6.744461	536.718595	224.807031	75.196419	5.458645	1.868013	355.788637	420.174058	6608.584824	1548.911613		2.944586	563.233477	5106.10948	3857.217427	50.327793	320.198524			19.595023			6.47			0.15			0.08	0.02	5.880112	0.18	3.4								$300/Admit	$300/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$150/Visit	$0-$150/Visit	$25-$150/Visit		$100/Proc	$15-$150/Visit	$5/Visit	$25/Visit	$25-$150/Visit	$50/Visit			20% Coins			Dental			Hearing			Active Outlook Newsletter	Quit Net	$0/Proc	Meals on Wheels	Silver Sneakers								299.999987	300.000845	28.94	0	100.000027	0.2	0.2	50.000011	149.999979	25.517693	91.858966		99.999117	87.009018	5	24.999998	77.262835	50.000018			0.2			0.355486862			0			0	0	0	0	0								7.8468	0.168612	1.294386345	0	0.626636994	1.091729	0.3736026	1.48245298	5.25217499	14.05298656	11.85678493	0	0.024538	4.083865978	2.127545617	8.035868997	0.324038997	1.334160997	0	0	3.9190046	0	0	2.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1952	0	0	7.8468	0.168612	1.294386345	0	0.626636994	1.091729	0.3736026	1.48245298	5.25217499	14.05298656	11.85678493	0	0.024538	4.083865978	2.127545617	8.035868997	0.324038997	1.334160997	0	0	3.9190046	0	0	2.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1952		$600/Admit	$600/Admit	40% Coins(Days 1-20) $0(Days 21-100)	40% Coins	$100/Trip	50% Coins	50% Coins	$50/Visit	15% Coins	15% Coins	15% Coins		15% Coins	15% Coins	20% Coins	20% Coins	15%-20% Coins	15% Coins			20% Coins			Dental			Hearing			Active Outlook Newsletter	Quit Net	$25/Proc	See PBP	Silver Sneakers								2.7695	0.0595	0.8134	1.2707	0.6266	3.0166	1.0323	0.2616	2.0225	0.5014	1.3523		0.0031	0.6761	2.7882	2.2938	0.0712	0.1825			0.7326			1.7			0			0	0	0.0022	0	0								22.176	0	0	10.6162	0.228122	2.107772345	1.270652	1.253273994	4.108348	1.4059256	1.74406198	7.27464799	14.55436956	13.20912093	0	0.027615	4.759950978	4.915747617	10.329663	0.395204997	1.516698997	0	0	4.6516376	0	0	4	0	0	0	0	0	0	0	0.002162	0	0	0	0	0	0	0	0	0	88.3712
H0317_002_0	2008	6	s.	t.	u.								OP Facility - Other	Health & Education (Non-Covered)	Health & Education (Non-Covered)									Renal Dialysis										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O	O	P	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0	0	0	0	0								0		297.311301	6.388618	508.400883	212.946029	71.228994	4.897841	1.676099	337.016937	398.005332	6259.9105	1467.189771		2.789226	533.51682	4836.706981	3653.707492	47.672459	303.304589			17.581894									0.08	0.18	5.569872	0.02	3.4								$550/Admit	$550/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$150/Visit	$0-$150/Visit	$25-$150/Visit		$100/Proc	$15-$150/Visit	$10/Visit	$30/Visit	$30-$150/Visit	$50/Visit			20% Coins									Active Outlook Newsletter	See PBP	$0/Proc	QUIT NET	Silver Sneakers								550.000001	550.000642	28.94	0	100.000008	0.199999	0.199999	49.999991	149.99998	25.517693	84.683564		100.001936	87.00902	9.999999	30	80.172327	49.999995			0.2									0	0	0	0	0								13.6268	0.292812	1.226093463	0	0.593574997	0.979563302	0.335218124	1.404236985	4.975065987	13.31153953	10.35390491	0	0.023244	3.868397972	4.030588748	9.13426873	0.318500998	1.263768994	0	0	3.5163788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.2539	0	0	13.6268	0.292812	1.226093463	0	0.593574997	0.979563302	0.335218124	1.404236985	4.975065987	13.31153953	10.35390491	0	0.023244	3.868397972	4.030588748	9.13426873	0.318500998	1.263768994	0	0	3.5163788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.2539		$750/Admit	$750/Admit	40% Coins(Days 1-20) $0(Days 21-100)	40% Coins	$100/Trip	50% Coins	50% Coins	$50/Visit	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter	See PBP	$25/Proc	QUIT NET	Silver Sneakers								4.2707	0.0918	0.9505	1.4848	0.7731	3.5251	1.2063	0.3227	3.1512	0.7812	2.1071		0.0048	1.0534	3.2582	2.6805	0.0923	0.2844			0.8561									0	0	0.0027	0	0								26.8968	500		17.8975	0.384580757	2.176590281	1.484841478	1.366628083	4.504685372	1.541556019	1.726972892	8.126257366	14.09273893	12.46096312	0	0.028038017	4.921798793	7.288789194	11.8147218	0.410784189	1.548180118	0	0	4.37250994	0	0	0	0	0	0	0	0	0	0	0.00266725	0	0	0	0	0	0	0	0	0	96.1508
H0317_004_0	2008	7	s.	t.	u.								OP Facility - Other	Other Non-Covered	Other Non-Covered									Renal Dialysis										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin			V			O	O	P	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0			0			0	0	0	0	0								0		305.02666	6.554406	521.594112	218.472072	73.077418	5.155343	1.764218	345.762677	408.333747	6422.357958	1505.264		2.861609	547.361819	4962.221675	3748.522822	48.909578	311.175478			18.506254			6.47			0.15			0.08	0.02	5.714414	0.18	3.4								$300/Admit	$300/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$25/Visit	$15-$100/Visit	$0-$100/Visit		$100/Proc	$15-$100/Visit	$10/Visit	$25/Visit	$25-$100/Visit	$25/Visit			20% Coins			Dental			Hearing			Active Outlook Newsletter	Quit Net	$0/Proc	Meals on Wheels	Silver Sneakers								299.99998	299.999725	28.94	0	99.99992	0.2	0.2	50.000006	24.999991	29.460026	49.899478		100.001083	60.001159	10	24.999998	56.35755	24.99999			0.2			0.355486862			0			0	0	0	0	0								7.6257	0.16386	1.257911133	0	0.608977996	1.0310686	0.3528436	1.440677994	0.850695	15.7669027	6.259323988	0	0.023847	2.736861961	4.135184729	7.809421921	0.229701999	0.648281987	0	0	3.7012508	0	0	2.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9425	0	0	7.6257	0.16386	1.257911133	0	0.608977996	1.0310686	0.3528436	1.440677994	0.850695	15.7669027	6.259323988	0	0.023847	2.736861961	4.135184729	7.809421921	0.229701999	0.648281987	0	0	3.7012508	0	0	2.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9425		$600/Admit	$600/Admit	40% Coins(Days 1-20) $0(Days 21-100)	40% Coins	$100/Trip	50% Coins	50% Coins	$50/Visit	15% Coins	15% Coins	15% Coins		15% Coins	15% Coins	20% Coins	20% Coins	15%-20% Coins	15% Coins			20% Coins			Dental			Hearing			Active Outlook Newsletter	Quit Net	$25/Proc	See PBP	Silver Sneakers								2.6914	0.0578	0.7682	1.2001	0.609	2.849	0.975	0.2542	1.9101	0.4735	1.2772		0.0029	0.6385	2.6333	2.1663	0.0672	0.1724			0.6919			1.7			0			0	0	0.0021	0	0								21.1402	0	0	10.3171	0.221693	2.026103133	1.20005	1.217955996	3.8800736	1.3278066	1.694914994	2.760792	16.2404267	7.536518988	0	0.026753	3.375380961	6.768463729	9.975765921	0.296912999	0.820677987	0	0	4.3931768	0	0	4	0	0	0	0	0	0	0	0.002101	0	0	0	0	0	0	0	0	0	78.0826
H0317_801_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		297.311301	6.388618	508.400883	212.946029	71.228994	4.897841	1.676099	337.016937	398.005332	6259.9105	1467.189771		8.359098	533.51682	4836.706981	3653.707492	47.672459	303.304589			17.581894																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214494	177.213913	28.944119	0	100.000008	0.199999	0.199999	49.999991	200.000024	37.551768	90.505003		33.368193	87.838647	19.999999	30	59.267175	99.99999			0.2																					4.3907	0.094346	1.226267971	0	0.593574997	0.979563302	0.335218124	1.404236985	6.633422996	19.58922557	11.06566789	0	0.023244	3.905282968	8.061177899	9.13426873	0.235450998	2.527537989	0	0	3.5163788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7155	0	0	4.3907	0.094346	1.226267971	0	0.593574997	0.979563302	0.335218124	1.404236985	6.633422996	19.58922557	11.06566789	0	0.023244	3.905282968	8.061177899	9.13426873	0.235450998	2.527537989	0	0	3.5163788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7155		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.2652	0.1047	0.4561	0.7126	0.7032	1.3534	0.4631	0.7941	3.0245	0.7498	2.0223		0.0138	1.011	3.1272	2.5727	0.0886	0.273			0.8217																					27.5569	0	0	13.6559	0.199042	1.682406971	0.712568	1.296759997	2.332914302	0.798350124	2.198338985	9.657906996	20.33901357	13.08800189	0	0.037015	4.916326968	11.1883669	11.70694073	0.324022998	2.800512989	0	0	4.3380848	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.2725
H0317_802_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		297.311301	6.388618	508.400883	212.946029	71.228994	4.897841	1.676099	337.016937	398.005332	6259.9105	1467.189771		8.359098	533.51682	4836.706981	3653.707492	47.672459	303.304589			17.581894																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214494	177.213913	28.944119	0	100.000008	0.199999	0.199999	49.999991	200.000024	37.551768	90.505003		33.368193	87.838647	19.999999	30	59.267175	99.99999			0.2																					4.3907	0.094346	1.226267971	0	0.593574997	0.979563302	0.335218124	1.404236985	6.633422996	19.58922557	11.06566789	0	0.023244	3.905282968	8.061177899	9.13426873	0.235450998	2.527537989	0	0	3.5163788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7155	0	0	4.3907	0.094346	1.226267971	0	0.593574997	0.979563302	0.335218124	1.404236985	6.633422996	19.58922557	11.06566789	0	0.023244	3.905282968	8.061177899	9.13426873	0.235450998	2.527537989	0	0	3.5163788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7155		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.2652	0.1047	0.4561	0.7126	0.7032	1.3534	0.4631	0.7941	3.0245	0.7498	2.0223		0.0138	1.011	3.1272	2.5727	0.0886	0.273			0.8217																					27.5569	0	0	13.6559	0.199042	1.682406971	0.712568	1.296759997	2.332914302	0.798350124	2.198338985	9.657906996	20.33901357	13.08800189	0	0.037015	4.916326968	11.1883669	11.70694073	0.324022998	2.800512989	0	0	4.3380848	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.2725
H0317_803_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		297.311301	6.388618	508.400883	212.946029	71.228994	4.897841	1.676099	337.016937	398.005332	6259.9105	1467.189771		8.359098	533.51682	4836.706981	3653.707492	47.672459	303.304589			17.581894																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214494	177.213913	28.944119	0	100.000008	0.199999	0.199999	49.999991	200.000024	37.551768	90.505003		33.368193	87.838647	19.999999	30	59.267175	99.99999			0.2																					4.3907	0.094346	1.226267971	0	0.593574997	0.979563302	0.335218124	1.404236985	6.633422996	19.58922557	11.06566789	0	0.023244	3.905282968	8.061177899	9.13426873	0.235450998	2.527537989	0	0	3.5163788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7155	0	0	4.3907	0.094346	1.226267971	0	0.593574997	0.979563302	0.335218124	1.404236985	6.633422996	19.58922557	11.06566789	0	0.023244	3.905282968	8.061177899	9.13426873	0.235450998	2.527537989	0	0	3.5163788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7155		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.2652	0.1047	0.4561	0.7126	0.7032	1.3534	0.4631	0.7941	3.0245	0.7498	2.0223		0.0138	1.011	3.1272	2.5727	0.0886	0.273			0.8217																					27.5569	0	0	13.6559	0.199042	1.682406971	0.712568	1.296759997	2.332914302	0.798350124	2.198338985	9.657906996	20.33901357	13.08800189	0	0.037015	4.916326968	11.1883669	11.70694073	0.324022998	2.800512989	0	0	4.3380848	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.2725
H0317_804_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		297.311301	6.388618	508.400883	212.946029	71.228994	4.897841	1.676099	337.016937	398.005332	6259.9105	1467.189771		8.359098	533.51682	4836.706981	3653.707492	47.672459	303.304589			17.581894																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214494	177.213913	28.944119	0	100.000008	0.199999	0.199999	49.999991	200.000024	37.551768	90.505003		33.368193	87.838647	19.999999	30	59.267175	99.99999			0.2																					4.3907	0.094346	1.226267971	0	0.593574997	0.979563302	0.335218124	1.404236985	6.633422996	19.58922557	11.06566789	0	0.023244	3.905282968	8.061177899	9.13426873	0.235450998	2.527537989	0	0	3.5163788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7155	0	0	4.3907	0.094346	1.226267971	0	0.593574997	0.979563302	0.335218124	1.404236985	6.633422996	19.58922557	11.06566789	0	0.023244	3.905282968	8.061177899	9.13426873	0.235450998	2.527537989	0	0	3.5163788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7155		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.2652	0.1047	0.4561	0.7126	0.7032	1.3534	0.4631	0.7941	3.0245	0.7498	2.0223		0.0138	1.011	3.1272	2.5727	0.0886	0.273			0.8217																					27.5569	0	0	13.6559	0.199042	1.682406971	0.712568	1.296759997	2.332914302	0.798350124	2.198338985	9.657906996	20.33901357	13.08800189	0	0.037015	4.916326968	11.1883669	11.70694073	0.324022998	2.800512989	0	0	4.3380848	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.2725
H0318_001_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0	0	0	0	0											$100/day 1-5	$100/day 1-5	"$0/d 1-20, $100/d 21-100"	0	100	20%	20%	$50 ER; $30 UC	100	$0 	"$0 X-ray; $100 CAT, PET, MRI"	30	30	30	$10 	30	30	30	30	30	45	0	0	0	$0 	Not Covered	$0 	$500 Every 3 Yrs	N/A	Not Covered	0											61.28	61.28	41.2	0	100	0.2	0.2	47.4	100	0	18	30	30	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0	0											8.1069	0.157932208	4.452090201	0	1.957621255	3.143561179	0.200659672	1.682966016	2.925180284	0	1.720425682	0	0	0	4.613623101	17.1038632	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0785			8.1069	0.157932208	4.452090201	0	1.957621255	3.143561179	0.200659672	1.682966016	2.925180284	0	1.720425682	0	0	0	4.613623101	17.1038632	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0785																																																																																				0			8.1069	0.157932208	4.452090201	0	1.957621255	3.143561179	0.200659672	1.682966016	2.925180284	0	1.720425682	0	0	0	4.613623101	17.1038632	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0785
H0318_002_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0	0	0	0	0											$200/day 1-5	$200/day 1-5	"$0/d 1-20, $100/d 21-100"	0	90	20%	20%	$50 ER; $35 UC	200	$0 	"$0 X-ray; $150 CAT, PET, MRI"	35	30	35	$10 	35	35	35	35	35	45	0	0	0	$0 	Not Covered	$0 	$500 Every 3 Yrs	N/A	Fitness	0											122.57	122.57	41.2	0	90	0.2	0.2	48	200	0	27	35	30	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0	0											16.2151	0.315890189	4.452090201	0	1.76185913	3.143561179	0.200659672	1.704269383	5.850360569	0	2.580638523	0	0	0	4.613623101	19.95450706	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1348			16.2151	0.315890189	4.452090201	0	1.76185913	3.143561179	0.200659672	1.704269383	5.850360569	0	2.580638523	0	0	0	4.613623101	19.95450706	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1348																																																																																				0			16.2151	0.315890189	4.452090201	0	1.76185913	3.143561179	0.200659672	1.704269383	5.850360569	0	2.580638523	0	0	0	4.613623101	19.95450706	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1348
H0318_801_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1403.234861	27.33675297	1146.203462	1881.554753	207.6460381	15.71780589	1.003298358	376.6101166	310.2755935	1972.668358	1013.814245	0	0	0	4893.697162	6208.051603	178.2619179	1031.528894	1409.798725	2556.992056	18.07125295	0	0	0	0	0	0	0	0	0	0											200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance	0	N/A	Not Covered	$0 per visit	Not Covered	$0 per visit	Not Covered	N/A	Not Covered	0											144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665
H0318_802_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1403.234861	27.33675297	1146.203462	1881.554753	207.6460381	15.71780589	1.003298358	376.6101166	310.2755935	1972.668358	1013.814245	0	0	0	4893.697162	6208.051603	178.2619179	1031.528894	1409.798725	2556.992056	18.07125295	0	0	0	0	0	0	0	0	0	0											200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance	0	N/A	Not Covered	$0 per visit	Not Covered	$0 per visit	Not Covered	N/A	Not Covered	0											144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665
H0319_001_0	2008	6	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						800	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	P	P	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T	P	V	P	V	P				V	P	V	V	V																																															0		1440.291547	222.9253032	6493.363369	111.9435759	487.6457507	564.7852215	203.7771272	133.2449135	162.7926367	1876.666823	136.202301	30.5801933	42.2053335	427.6201564	30941.91841	968.994113	413.8819086	89.8381462		188.0094346	247.2885425	725.0749156	1341.182079	1347.86	70.97586219	278.16		95.475				85.28307758	1.58320184	2.794332756	234.745	287.945						(1a) $75/day	(1b) $75/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) $0/proc	(11a/11c) $0/proc	(4a) $50/visit (waived if admitted)	(9a/9b) $25/visit	(8a) $0/visit	(8b) $0/visit	(9a) $25/visit	(12) $0/proc	(9a) $25/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $0/visit	(7e/7h) $0/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $0/visit	(15) $0/proc	(Misc. PBP Cats) $0/visit	(10b) $0/trip	(16a) $0/proc	(17a1) $0/visit	(17b2) $0/proc	(18a) $0/visit	(18b) $0/proc				(4b) $10/visit (waived if admitted)	(9c) $0/proc 75%/25% Ind/Grp Blended Copay	(9d) $0/visit	(7f1) $0/visit	(18a1) $0/visit						67.3367	67.3367			67.3367			44.8911	22.4456			22.4456		22.4456																		8.9782										8.082	1.250920998	0	0	2.736370885	0	0	0.498459522	0.304497702	0	0	0.057199139	0	0.799847939	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.063807557	0	0	0	0	0	0	0	0	0	13.7931		1.569740519	8.082	1.250920998	0	0	2.736370885	0	0	0.498459522	0.304497702	0	0	0.057199139	0	0.799847939	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.063807557	0	0	0	0	0	0	0	0	0	13.7931		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					10	0.3	0.3	0.3	0.3						1.8708	0.0834	0.7591	0.0254	0.2979	0.1823	0.0106	0.0292	0.2822	0.4585	0.5868	0.0212	0.0467	0.1791	0.0153	1.5035	0.0491	0.0129		0.0892		0.1289	0.0714		0.0043							0.0037	0.0002	0.001	0.0131	0.0185						6.7443		0	9.9528	1.334318571	0.759090378	0.025392369	3.034231801	0.182289878	0.010624374	0.527679898	0.586733996	0.458468169	0.586830144	0.07840913	0.046651614	0.978976206	0.015340826	1.503457082	0.049062777	0.012924495	0	0.089236054	0	0.128925716	0.071393211	0	0.004256396	0	0	0	0	0	0	0.067548043	0.000222793	0.00100409	0.01305	0.01845	0	0	0	0	0	20.5374
H0319_002_0	2008	4																					2800											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		3274.019634	456.710849	2551.757771		3524.757727	47.85434173	3.301406141	1439.136866	236.6155873	8227.170107	271.2181453	17.59305674	5.042442917	990.8479816		471.8270056	1421.463691	112.3798566			12.52149891	373.6110877																				1(a) $200 per Day	1(b) $200 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $100 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $35 per Visit	8(a) Diagnostic: $25 per preocedure; other $0 per procedure	8(b) X-rays $25 per visit; other: $25 per visit	9(a) $35 per Visit	12  20% Coinsurance	3 $50 per visit; 5 $25 per visit; 9(a) $35 per Visit; 9(c) $25/$35 per Visit; 9(d) $35 per Visit	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $25 per Visit	7(e)/7(h) $25/35 per Visit	7(c)/7(i) $25 per Visit		7(g) $25 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $25 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															108.8951	108.8951	22.868		54.4475	0.108895089	0.108895089	24.3653	19.0566	13.6119	13.6119	19.0566	0.108895089	19.0785		13.6119	17.6955	13.6119			0.108895089	13.6119																				29.7104	4.144464064	4.86279309	0	15.992867	5.211102825	0.359506917	2.922080611	0.375758185	9.332275261	0.30764921	0.027938713	0.549097273	1.57532566	0	0.535204625	2.096120214	0.127475151	0	0	1.363529745	0.423795967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9174	0	66.86128038	29.7104	4.144464064	4.86279309	0	15.992867	5.211102825	0.359506917	2.922080611	0.375758185	9.332275261	0.30764921	0.027938713	0.549097273	1.57532566	0	0.535204625	2.096120214	0.127475151	0	0	1.363529745	0.423795967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9174		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"4(a)$50 per Visit, 4(b) $35 per Visit"	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															2.9463	0.0924	0.8723	0.124	0.2122	0.293	0.0262	0.133	0.2038	0.1651	0.2661	0.0159	0.0309	0.2707	0.0439	0.1728	0.0302	0.0112			0.0767	0.0279	0.0077		0.0007																	6.023	0	0	32.6567	4.236844397	5.735089305	0.124010243	16.20504503	5.504088591	0.385728795	3.05509755	0.579569304	9.497367184	0.573723377	0.04383824	0.579969372	1.846005244	0.043919938	0.708018641	2.126360427	0.138711177	0	0	1.440191983	0.451675793	0.00774	0	0.000733774	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.9404
H0319_004_0	2008	8																					2500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		1989.881438	136.4840712	927.3042769		287.1228583	11.37830319	19.76064474	449.7218304	425.0738865	3563.750019	468.3401463	71.37307349	15.95332486	2994.669041		4054.726921	399.8208498	584.7181897				721.6319904					0.076406423															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															129.037	129.037	30.9689		55.3016	0.147470913	0.147470913	30.4159	55.3016	14.7471	48.1227	55.3016	114.7684	53.4673		18.4339	14.7471	14.7471				18.4339					18.4339															21.3974	1.467625151	2.393132152	0	1.323195943	1.677968764	2.914120329	1.139890281	1.958938572	4.379578919	1.878149791	0.328920386	0.152578107	13.34307433	0	6.228690442	0.491349549	0.718574379	0	0	0	1.108538841	0	0	0	0	0.000117372	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9018	0	22.40560309	21.3974	1.467625151	2.393132152	0	1.323195943	1.677968764	2.914120329	1.139890281	1.958938572	4.379578919	1.878149791	0.328920386	0.152578107	13.34307433	0	6.228690442	0.491349549	0.718574379	0	0	0	1.108538841	0	0	0	0	0.000117372	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9018		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.306	0.0659	0.2839	0.2833	0.0728	0.1393	0.121	0.0324	0.2945	0.0462	0.1202	0.0241	0.0056	0.2102	0.021	0.2031	0.0305	0.033			0.1821	0.0431			0.0051																	4.5233	0	0	23.7034	1.533517965	2.676996377	0.28332066	1.395966519	1.817294925	3.035103868	1.172298461	2.253431704	4.425810026	1.998322638	0.353033142	0.158138752	13.55329278	0.021012048	6.431823968	0.521868552	0.751545432	0	0	0.182143077	1.151605599	0	0	0.005058988	0	0.000117372	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.4251
H0319_005_0	2008	7																					2500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	P	V	P	V	P	P	V	V																																																				0		3813.095098	463.3590454	3385.605449		844.8121362	14.69818778	17.23365305	781.4249455	321.4508442	3821.187466	448.14699	68.461941	22.45275122	2977.74091		3856.259364	908.0574817	780.7384672				663.2992147					0.017215289															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	"(6a)0;(6a2) $50/day, $300 ann max"	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"	(10b)0				(18a)$25/visit				(13c)0											107.3308	107.3308	25.7594		45.9989	0.122663783	0.122663783	25.2994	45.9989	12.2664	40.9867	45.9989	128.7969	45.5436		15.333	12.2664	12.2664				15.333					15.333															34.1052	4.14439182	7.267595529	0	3.2383704	1.80293532	2.113945084	1.647465534	1.232199272	3.906010927	1.530672171	0.262431272	0.240986996	11.30142919	0	4.927326697	0.928214718	0.798069451	0	0	0	0.847529074	0	0	0	0	2.20E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.2948	0	50.62371908	34.1052	4.14439182	7.267595529	0	3.2383704	1.80293532	2.113945084	1.647465534	1.232199272	3.906010927	1.530672171	0.262431272	0.240986996	11.30142919	0	4.927326697	0.928214718	0.798069451	0	0	0	0.847529074	0	0	0	0	2.20E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.2948		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"	0.3				0.3															3.3696	0.2161	1.0395	0.8991	0.1951	0.18	0.1055	0.0568	0.1998	0.0489	0.0976	0.0176	0.0106	0.2556	0.0166	0.2108	0.0773	0.0407			0.1377	0.0394																				7.2144	0	0	37.4748	4.360513274	8.307113276	0.899137934	3.433426565	1.98291313	2.219457245	1.70425844	1.432028003	3.954945201	1.628313079	0.280050243	0.251561877	11.5569997	0.016578339	5.138119369	1.005557571	0.83879818	0	0	0.137655985	0.886923544	0	0	0	0	2.20E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.5092
H0319_006_0	2008	4																					730											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	S	P	T	V	V	P	V	P																																																							0		3063.410184	442.5788786	2387.609611		3298.018926	44.77599226	3.089034986	1346.56081	221.3947016	7697.936942	253.7713641	16.46133964	4.718075244	911.3330992		441.4755608		105.150743				349.577626																				1(a) $75 per Day	1(b) $75 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $10 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per procedure; other $0 per procedure	8(b) X-rays $10 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a)/(d) $25 Copay Per Visit; 9(c) $0 Copay per Visit"	7(a) PCP $0 per visit; Urgent Care $10 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15 $0 per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $10 per procedure"	10(b) $0 Copay	16(a)/16(b) $0 copay per visit	17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a/18a1 $10/$0 per visit	18(b) $0 copay per procedure														29.242	29.242	16.3755		29.242	0.077978655	0.077978655	14.0362	9.7473	3.8989	3.8989	9.7473	0.077978655	9.7473		3.8989		3.8989				3.8989																				7.465	1.078490796	3.258195238	0	8.036721203	3.491571632	0.240878792	1.575045004	0.179833968	2.501144856	0.082453123	0.013371178	0.36790916	0.74025551	0	0.143440293	0	0.034164639	0	0	0	0.113581637	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.3221	0	45.88331482	7.465	1.078490796	3.258195238	0	8.036721203	3.491571632	0.240878792	1.575045004	0.179833968	2.501144856	0.082453123	0.013371178	0.36790916	0.74025551	0	0.143440293	0	0.034164639	0	0	0	0.113581637	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.3221		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"4(a)$50 per Visit, 4(b) $10 per Visit"	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															2.7567	0.0864	0.8162	0.116	0.1985	0.2741	0.0245	0.1245	0.1907	0.1545	0.249	0.0149	0.0289	0.2533	0.0405	0.1617	0.0283	0.0105			0.0717	0.026	0.0077		0.0007		0.006															5.6414	0	0	10.2218	1.164928535	4.07437883	0.116032976	8.235250347	3.76571036	0.265413883	1.699505297	0.37053443	2.655616831	0.331411408	0.028247928	0.396795335	0.993522956	0.040524951	0.305137617	0.028294936	0.04467788	0	0	0.071730749	0.139613828	0.00774	0	0.000686572	0	0.00598221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.9635
H0320_001_0	2008	5																					5100											d	d	d	v	t	coin	coin	v	v	coin	coin	coin	coin	coin	v	v	v	v	coin	coin	coin	v	v	v	v	p	v	p	v	v	v	v	v	v	v	v	v	v	v	v	v																																										0		1407.524989	58.64687453	57.88378696	196.7820206	282.4837289	6.287852673	5.804171699	288.628157	597.2081702	15.87693389	10.85982278	0.269907876	0.333415612	0.381046413	5150.156518	4630.856642	29.21061801	732.8619497	13.68110177	27.2225923	1.472015074	1136.540347	0	1000	544.4566984	544.4566984																"$200/day, days 1-5 only"	"$260/day, days 1-7 only"	"$45/day, days 11-100 only"	$15/visit	$200/trip	20% coins	35% coins / 10% supplies	"$50/visit, waived if admitted"	"$470(hosp), 225(ASC)"	no copay	"15% radiolog, 20% radiation therapy"	20% coins	20% coins	20% coins	$15 per office visit/$15 routine physical	$35 per office visit	"$55/visit, $55/visit Outpat S/A"	$25 per visit	15% coins	"10% coins card testing, 20% nutrition therapy, $30/visit med cov chiro"	20% coins	$35/visit vision and hearing			$25 per visit	$70 max/2 years																139.0349711	195.156	25.515	15.4765	204.42	0.2	0.3	50	347.3964585		0.1962	0.2	0.2	0.2	15.3315	35.7735	54.165	25	0.15	0.15	0.2	35			25																	16.3079	0.95377412	0.123075402	0.253791412	4.812110323	1.257570535	1.74125151	1.202617321	17.28900028	0	2.130697229	0.053981575	0.066683122	0.076209283	6.579968721	13.80516251	0.131849427	1.526795729	2.052165266	4.083388845	0.294403015	3.314909347	0	0	1.134284788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.1916		4.56	16.3079	0.95377412	0.123075402	0.253791412	4.812110323	1.257570535	1.74125151	1.202617321	17.28900028	0	2.130697229	0.053981575	0.066683122	0.076209283	6.579968721	13.80516251	0.131849427	1.526795729	2.052165266	4.083388845	0.294403015	3.314909347	0	0	1.134284788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.1916																																																																																				0			16.3079	0.95377412	0.123075402	0.253791412	4.812110323	1.257570535	1.74125151	1.202617321	17.28900028	0	2.130697229	0.053981575	0.066683122	0.076209283	6.579968721	13.80516251	0.131849427	1.526795729	2.052165266	4.083388845	0.294403015	3.314909347	0	0	1.134284788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.1916
H0321_002_0	2008	8																																Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	P	P	P	P															0.0001	0.0001	0.0001		0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001																				0.0017		336.691417	16.82623825	27.41233432		21.07077483	0.040781867	0.417121901	878.1018271	36.99980774	5.451104916	49.87719223	3.219995439	8.0891764	15.86409151	0.013991881	107.5833703				1.586915539	21.12980362	3.151291054																				#1A ffs medicare	#1B ffs medicare	#2 ffs medicare	#6 $0	#10A 20%	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B 20%"	#9B 20%	#8A 20%	#8B 20%	#9A 20%	#12 20%	"#3 20%, #5 20%,#9a 20%, #9c $0, #9D 20%"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0, #14I 20%"	"#7B $0, #7D 20%, #7F $0"	"#7E $0, #7H $0"	"#7C $0, #7I $0"	20% (incl in h2)	#7G 20%	#15 20%	"#13A 20% #14J 20% #16B 20%, #17a 20%, #14A $0, #17B $0, #18A 20%"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	$0 n/c	$0 n/c	$0 n/c	$0 n/c	$0 n/c											0.073510315	0.073510315	0.167911922		0.234	0.234	0.234	49.7332	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.237413088				0.234	0.234	0.234																				24.7503	1.236902078	4.602857752	0	4.930561311	0.009542957	0.097606525	3.639237416	8.65795501	1.27555855	11.67126298	0.753478933	1.892867278	3.712197413	0.0032741	25.54170016	0	0	0	0.371338236	4.944374046	0.737402107	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.8284	135	0	24.7503	1.236902078	4.602857752	0	4.930661311	0.009642957	0.097706525	3.639237416	8.65805501	1.27565855	11.67136298	0.753578933	1.892967278	3.712297413	0.0033741	25.54180016	0.0001	0.0001	0.0001	0.371438236	4.944474046	0.737502107	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.8301																																																																																				0	0	0	24.7503	1.236902078	4.602857752	0	4.930661311	0.009642957	0.097706525	3.639237416	8.65805501	1.27565855	11.67136298	0.753578933	1.892967278	3.712297413	0.0033741	25.54180016	0.0001	0.0001	0.0001	0.371438236	4.944474046	0.737502107	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.8301
H0322_001_0	2008	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	1397	27.2	1141.1	1873.2	206.7	13.8	0.9	374.9	308.9	1963.9	1009.3	0	0	0	4872	6020.6	177.5	513.5	842.1	1272.8	948.6	0	0	0	0	284.8	0	19.9	0	0	0											$200/day 1-5	$200/day 1-5	"$0/d 1-20, $100/d 21-100"	0	100	0.2	0.2	$50 ER; $35 UC	200	0	"0 X-ray; 100 CAT, PET, MRI"	35	30	35	20	35	35	35	35	35	45	0	0	0	0	Not Covered	0	$300 Every 3 Yrs	0	Not Covered	0											122.57	122.57	41.2	0	100	0.2	0.2	48	200	0	18	35	30	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0	0											14.2692	0.277825333	3.917776667	0	1.7225	2.76	0.18	1.4996	5.148333333	0	1.51395	0	0	0	8.12	17.56008333	0.517708333	1.497708333	2.456125	3.712333333	3.55725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7104			14.2692	0.277825333	3.917776667	0	1.7225	2.76	0.18	1.4996	5.148333333	0	1.51395	0	0	0	8.12	17.56008333	0.517708333	1.497708333	2.456125	3.712333333	3.55725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7104		20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	$100 per trip	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	$50 ER; $35 UC	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	0	0	0	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	$300 Every 3 Yrs	0	0	0											3.6638	0.0284	0.5941	0.5322	0.1628	0.3032	0.0194	0.1462	0.3752	0.1302	0.3656	0	0.1199	0.4039	0.476	0.5947	0.0225	0.063	0.4423	1.6029	0.3486	0.0106	0	0	0.0619	0.0432	0.0175	0.0174	0	0	0											10.5455	500	9.202287476	17.933	0.306225333	4.511876667	0.5322	1.8853	3.0632	0.1994	1.6458	5.523533333	0.1302	1.87955	0	0.1199	0.4039	8.596	18.15478333	0.540208333	1.560708333	2.898425	5.315233333	3.90585	0.0106	0	0	0.0619	0.0432	0.0175	0.0174	0	0	0	0	0	0	0	0	0	0	0	0	0	79.2559
H0322_002_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	1397	27.2	1141.1	1873.2	206.7	13.8	0.9	374.9	308.9	1963.9	1009.3	0	0	0	4872	6020.6	177.5	513.5	842.1	1272.8	948.6	0	0	0	0	284.8	0	19.9	0	0	0											$100/day 1-5	$100/day 1-5	"$0/d 1-20, $100/d 21-100"	0	100	0.2	0.2	$50 ER; $35 UC	100	0	"0 X-ray; 100 CAT, PET, MRI"	30	30	30	10	30	30	30	30	30	45	0	0	0	0	Not Covered	0	$300 Every 3 Yrs	0	Not Covered	0											61.28	61.28	41.2	0	100	0.2	0.2	48	100	0	18	30	30	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0	0											7.134	0.138901333	3.917776667	0	1.7225	2.76	0.18	1.4996	2.574166667	0	1.51395	0	0	0	4.06	15.0515	0.44375	1.28375	2.10525	3.182	3.55725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1244			7.134	0.138901333	3.917776667	0	1.7225	2.76	0.18	1.4996	2.574166667	0	1.51395	0	0	0	4.06	15.0515	0.44375	1.28375	2.10525	3.182	3.55725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1244		20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	$100 per trip	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	$50 ER; $35 UC	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	0	0	0	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	$300 Every 3 Yrs	0	0	0											3.6638	0.0284	0.5941	0.5322	0.1628	0.3032	0.0194	0.1462	0.3752	0.1302	0.3656	0	0.1199	0.4039	0.476	0.5947	0.0225	0.063	0.4423	1.6029	0.3486	0.0106	0	0	0.0619	0.0432	0.0175	0.0174	0	0	0											10.5455	500	9.202287476	10.7978	0.167301333	4.511876667	0.5322	1.8853	3.0632	0.1994	1.6458	2.949366667	0.1302	1.87955	0	0.1199	0.4039	4.536	15.6462	0.46625	1.34675	2.54755	4.7849	3.90585	0.0106	0	0	0.0619	0.0432	0.0175	0.0174	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6699
H0322_006_0	2008	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	1397	27.2	1141.1	1873.2	206.7	13.8	0.9	374.9	308.9	1963.9	1009.3	0	0	0	4872	6020.6	177.5	513.5	842.1	1272.8	948.6	0	0	0	0	284.8	0	19.9	0	0	0											$200/day 1-5	$200/day 1-5	"$0/d 1-20, $100/d 21-100"	0	100	0.2	0.2	$50 ER; $35 UC	200	0	"0 X-ray; 100 CAT, PET, MRI"	35	30	35	20	35	35	35	35	35	45	0	0	0	0	Not Covered	0	$300 Every 3 Yrs	0	Not Covered	0											122.57	122.57	41.2	0	100	0.2	0.2	48	200	0	18	35	30	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0	0											14.2692	0.277825333	3.917776667	0	1.7225	2.76	0.18	1.4996	5.148333333	0	1.51395	0	0	0	8.12	17.56008333	0.517708333	1.497708333	2.456125	3.712333333	3.55725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7104			14.2692	0.277825333	3.917776667	0	1.7225	2.76	0.18	1.4996	5.148333333	0	1.51395	0	0	0	8.12	17.56008333	0.517708333	1.497708333	2.456125	3.712333333	3.55725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7104		20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	$100 per trip	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	$50 ER; $35 UC	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	0	0	0	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	$300 Every 3 Yrs	0	0	0											3.6638	0.0284	0.5941	0.5322	0.1628	0.3032	0.0194	0.1462	0.3752	0.1302	0.3656	0	0.1199	0.4039	0.476	0.5947	0.0225	0.063	0.4423	1.6029	0.3486	0.0106	0	0	0.0619	0.0432	0.0175	0.0174	0	0	0											10.5455	500	9.202287476	17.933	0.306225333	4.511876667	0.5322	1.8853	3.0632	0.1994	1.6458	5.523533333	0.1302	1.87955	0	0.1199	0.4039	8.596	18.15478333	0.540208333	1.560708333	2.898425	5.315233333	3.90585	0.0106	0	0	0.0619	0.0432	0.0175	0.0174	0	0	0	0	0	0	0	0	0	0	0	0	0	79.2559
H0322_801_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1234.846677	24.05634262	1008.659047	1655.768182	182.7285135	13.83166919	0.882902555	331.4169026	273.0425222	1735.948155	892.1565356	0	0	0	4306.453503	5463.08541	156.8704877	907.7454267	1240.622878	2250.153009	15.90270259	0	0	0	0	0	0	0	0	0	0											200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance	0	N/A	Not Covered	$0 per visit	Not Covered	$0 per visit	Not Covered	N/A	Not Covered	0											144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065			14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065		"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	0	$50 ER/UC	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	0	0	0	"30% coins; $500ded; ""Unlimited OOP"	0	"30% coins; $500ded; ""Unlimited OOP"	0	0	0	0											7.922	0	1.2845	1.1508	0.2023	0.6555	0	0.2118	0.8113	0.2815	0.7904	0	0.2592	0.8734	1.0292	1.2859	0.0486	0.1361	0.9564	3.4659	0.7537	0	0	0	0.1338	0	0.0378	0	0	0	0											22.2902	500	0	22.7988	0.289818788	9.690032461	6.669992775	2.486439732	4.805029776	0.264870766	1.592750556	5.362014101	6.068034846	4.875000015	0	0.259194098	0.873417564	11.79529122	19.26857794	0.571469634	3.161956187	5.09182229	10.96639979	3.934222733	0	0	0	0.133775323	0	0.037769123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.9967
H0322_802_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1234.846677	24.05634262	1008.659047	1655.768182	182.7285135	13.83166919	0.882902555	331.4169026	273.0425222	1735.948155	892.1565356	0	0	0	4306.453503	5463.08541	156.8704877	907.7454267	1240.622878	2250.153009	15.90270259	0	0	0	0	0	0	0	0	0	0											200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance	0	N/A	Not Covered	$0 per visit	Not Covered	$0 per visit	Not Covered	N/A	Not Covered	0											144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065			14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065		"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	0	$50 ER/UC	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	0	0	0	"30% coins; $500ded; ""Unlimited OOP"	0	"30% coins; $500ded; ""Unlimited OOP"	0	0	0	0											7.922	0	1.2845	1.1508	0.2023	0.6555	0	0.2118	0.8113	0.2815	0.7904	0	0.2592	0.8734	1.0292	1.2859	0.0486	0.1361	0.9564	3.4659	0.7537	0	0	0	0.1338	0	0.0378	0	0	0	0											22.2902	500	0	22.7988	0.289818788	9.690032461	6.669992775	2.486439732	4.805029776	0.264870766	1.592750556	5.362014101	6.068034846	4.875000015	0	0.259194098	0.873417564	11.79529122	19.26857794	0.571469634	3.161956187	5.09182229	10.96639979	3.934222733	0	0	0	0.133775323	0	0.037769123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.9967
H0332_001_0	2008	4																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		936.3422518	17.97975952	589.2630492	1391.142588	182.1561293	13241.03102	16757.03218	175.9763024	185.7940157	1389.402646	569.3995977	0	39.75403437	396.7488988	6644.362323	9720.679428	139.1319819	404.7780426	3784.587294	10281.54604	267.3769036	738.1090638	0	0	351.5549872	223.90776	150.6664231	19.29722741	0	0	2745.354068											"$100 copay, days 1-7"	"$100 copay, days 1-7"	"$100 copay per day, days 21-100"	$0 copay	$100 copay	10% copay	20% copay	$50 copay	$100 to $150 copay	$0 copay	$25 to $100 copay	$0 copay	$25 copay	$10 copay	$0 copay	$10 copay	$20 or $35 copay	$10 copay	$0 copay	$10 to $25 copay	10% copay	10% copay			$10 copay	$0 copay	$10 copay	$0 copay			$0 to $50 copay											19.04462231	19.04462231	47.46157989	0	100	0.54126704	1.23599855	45	133.3333333	0	10.34809132	0	25	12.82143374	0.468001038	6.839156291	33.5	10	0	2.967792637	26.3766285	8.2158043	0	0	10	0	10	1	0	0	0.015280336											1.486	0.028534811	2.33061294	0	1.517967744	0.597244472	1.72597229	0.659911134	2.064377953	0	0.491016586	0	0.082820905	0.423907476	0.259130705	5.540103822	0.388410116	0.337315036	0	2.542791386	0.587708438	0.505346635	0	0	0.292962489	0	0.125555353	0.001608102	0	0	0.003495828	0	0	0	0	0	0	0	0	0	0	21.9928			1.486	0.028534811	2.33061294	0	1.517967744	0.597244472	1.72597229	0.659911134	2.064377953	0	0.491016586	0	0.082820905	0.423907476	0.259130705	5.540103822	0.388410116	0.337315036	0	2.542791386	0.587708438	0.505346635	0	0	0.292962489	0	0.125555353	0.001608102	0	0	0.003495828	0	0	0	0	0	0	0	0	0	0	21.9928																																																																																				0			1.486	0.028534811	2.33061294	0	1.517967744	0.597244472	1.72597229	0.659911134	2.064377953	0	0.491016586	0	0.082820905	0.423907476	0.259130705	5.540103822	0.388410116	0.337315036	0	2.542791386	0.587708438	0.505346635	0	0	0.292962489	0	0.125555353	0.001608102	0	0	0.003495828	0	0	0	0	0	0	0	0	0	0	21.9928
H0332_002_0	2008	6																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		934.2862093	17.92831507	589.2614503	1391.138813	182.1556351	13240.99509	16756.98671	175.9758249	185.7935116	1375.790284	562.0737784	0	39.75392651	396.7478222	6564.455982	9620.412176	139.1316044	387.0407155	3722.902935	10137.75349	267.3761781	714.5886872	0	0	338.4287922	223.9071525	0	0	0	0	2744.103775											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$100 copay per day, days 21-100"	$0 copay	$100 copay	10% copay	20% copay	$50 copay	$100 to $150 copay	$0 copay	$25 to $100 copay	$0 copay	$25 copay	$25 copay	$0 copay	$25 copay	$20 to $35 copay	$25 copay	$0 copay	$25 copay	10% copay	10% copay			$25 copay	$0 copay					$0 to $50 copay											57.13386694	57.13386694	47.46157989	0	100	0.541265571	1.235995196	45	133.3333333	0	10.36376014	0	25	20.34630448	0.77279364	16.18286798	33.5	25	0	3.779433818	26.37655693	20.39270818	0	0	25	0	0	0	0	0	0.015287256											4.4483	0.085359497	2.330606616	0	1.517963626	0.597241231	1.725962923	0.659909343	2.064372351	0	0.485433152	0	0.08282068	0.672695999	0.422747486	12.97382168	0.388409062	0.806334824	0	3.19291403	0.587705249	1.214366547	0	0	0.705059984	0	0	0	0	0	0.003495818	0	0	0	0	0	0	0	0	0	0	34.9655			4.4483	0.085359497	2.330606616	0	1.517963626	0.597241231	1.725962923	0.659909343	2.064372351	0	0.485433152	0	0.08282068	0.672695999	0.422747486	12.97382168	0.388409062	0.806334824	0	3.19291403	0.587705249	1.214366547	0	0	0.705059984	0	0	0	0	0	0.003495818	0	0	0	0	0	0	0	0	0	0	34.9655																																																																																				0			4.4483	0.085359497	2.330606616	0	1.517963626	0.597241231	1.725962923	0.659909343	2.064372351	0	0.485433152	0	0.08282068	0.672695999	0.422747486	12.97382168	0.388409062	0.806334824	0	3.19291403	0.587705249	1.214366547	0	0	0.705059984	0	0	0	0	0	0.003495818	0	0	0	0	0	0	0	0	0	0	34.9655
H0332_801_0	2008	6																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		936.3422518	17.97975952	589.2630492	1391.142588	182.1561293	13241.03102	16757.03218	175.9763024	185.7940157	1389.402646	569.3995977	0	39.75403437	396.7488988	6644.362323	9720.679428	139.1319819	404.7780426	3784.587294	10281.54604	267.3769036	738.1090638	0	0	351.5549872	223.90776	150.6664231	19.29722741	0	0	2745.354068											"$100 copay, days 1-7"	"$100 copay, days 1-7"	"$100 copay per day, days 21-100"	$0 copay	$100 copay	10% copay	20% copay	$50 copay	$100 to $150 copay	$0 copay	$25 to $100 copay	$0 copay	$50 copay	$10 copay	$0 copay	$10 copay	$20 or $35 copay	$10 copay	$0 copay	$10 to $25 copay	10% copay	10% copay			$10 copay	$0 copay	$10 copay	$0 copay			$0 to $50 copay											19.04462231	19.04462231	47.46157989	0	100	0.54126704	1.23599855	45	133.3333333	0	10.34809132	0	50	12.82143374	0.468001038	6.839156291	33.5	10	0	2.967792637	26.3766285	8.2158043	0	0	10	0	10	1	0	0	0.015280336											1.486	0.028534811	2.33061294	0	1.517967744	0.597244472	1.72597229	0.659911134	2.064377953	0	0.491016586	0	0.16564181	0.423907476	0.259130705	5.540103822	0.388410116	0.337315036	0	2.542791386	0.587708438	0.505346635	0	0	0.292962489	0	0.125555353	0.001608102	0	0	0.003495828	0	0	0	0	0	0	0	0	0	0	22.0756			1.486	0.028534811	2.33061294	0	1.517967744	0.597244472	1.72597229	0.659911134	2.064377953	0	0.491016586	0	0.16564181	0.423907476	0.259130705	5.540103822	0.388410116	0.337315036	0	2.542791386	0.587708438	0.505346635	0	0	0.292962489	0	0.125555353	0.001608102	0	0	0.003495828	0	0	0	0	0	0	0	0	0	0	22.0756																																																																																				0			1.486	0.028534811	2.33061294	0	1.517967744	0.597244472	1.72597229	0.659911134	2.064377953	0	0.491016586	0	0.16564181	0.423907476	0.259130705	5.540103822	0.388410116	0.337315036	0	2.542791386	0.587708438	0.505346635	0	0	0.292962489	0	0.125555353	0.001608102	0	0	0.003495828	0	0	0	0	0	0	0	0	0	0	22.0756
H0332_803_0	2008	5																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		934.2862093	17.92831507	589.2614503	1391.138813	182.1556351	13240.99509	16756.98671	175.9758249	185.7935116	1375.790284	562.0737784	0	39.75392651	396.7478222	6564.455982	9620.412176	139.1316044	387.0407155	3722.902935	10137.75349	267.3761781	714.5886872	0	0	338.4287922	223.9071525	0	0	0	0	2744.103775											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$100 copay per day, days 21-100"	$0 copay	$100 copay	10% copay	20% copay	$50 copay	$100 to $150 copay	$0 copay	$25 to $100 copay	$0 copay	$50 copay	$25 copay	$0 copay	$25 copay	$20 to $35 copay	$25 copay	$0 copay	$25 copay	10% copay	10% copay			$25 copay	$0 copay					$0 to $50 copay											57.13386694	57.13386694	47.46157989	0	100	0.541265571	1.235995196	45	133.3333333	0	10.36376014	0	50	20.34630448	0.77279364	16.18286798	33.5	25	0	3.779433818	26.37655693	20.39270818	0	0	25	0	0	0	0	0	0.015287256											4.4483	0.085359497	2.330606616	0	1.517963626	0.597241231	1.725962923	0.659909343	2.064372351	0	0.485433152	0	0.16564136	0.672695999	0.422747486	12.97382168	0.388409062	0.806334824	0	3.19291403	0.587705249	1.214366547	0	0	0.705059984	0	0	0	0	0	0.003495818	0	0	0	0	0	0	0	0	0	0	35.0483			4.4483	0.085359497	2.330606616	0	1.517963626	0.597241231	1.725962923	0.659909343	2.064372351	0	0.485433152	0	0.16564136	0.672695999	0.422747486	12.97382168	0.388409062	0.806334824	0	3.19291403	0.587705249	1.214366547	0	0	0.705059984	0	0	0	0	0	0.003495818	0	0	0	0	0	0	0	0	0	0	35.0483																																																																																				0			4.4483	0.085359497	2.330606616	0	1.517963626	0.597241231	1.725962923	0.659909343	2.064372351	0	0.485433152	0	0.16564136	0.672695999	0.422747486	12.97382168	0.388409062	0.806334824	0	3.19291403	0.587705249	1.214366547	0	0	0.705059984	0	0	0	0	0	0.003495818	0	0	0	0	0	0	0	0	0	0	35.0483
H0351_014_0	2008	2																					none											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	266.871572	4.213402883	124.9979569	12.12201651	261.3723113	4.014275338	1.185047755	439.9881076	430.7561278	5.302766538	12.89438009	0	0.140806226	328.9546777	0	4386.793454	275.6122589	314.913218	31.8262165	85.75163105	27.37129522	829.2124302	0	0	0	0	0	0	0	10400	0											$200/admit	"$950/admit + $225 / day, days 61-90"	"$100/day, days 21-100"		$100 copay	30% DME / 0% Diabetes Monitoring Supplies	30% coinsurance	$50 ER / $35 UC	$150 ASC / $150 OP		"20% Rad Ther, $25 - $200 copay others"	0	20% coinsurance	$35 Cardiac Rehab; $35 PT/OT/ST	$0 PCP	$35 SCP / $35 Chiro / $35 Podiatrist	$35 MH	$35 Therapy	$0 copay	$35 Hearing / $35 OPSA	30% coinsurance	$35 Vision					0				0											200	950	100	0	100	0.246012	0.3	44.67427768	150	0	0.194467986	0	0.2	35	0	35	35	35	0	35	0.3	35	0	0	0	0	0	0	0	0	0											4.4479	0.333561062	1.041649641	0	2.178102594	0.987559905	0.355514326	1.638012574	5.384451597	0	2.507544128	0	0.028161245	0.959451143	0	12.79481424	0.803869089	0.918496886	0	0.250108924	8.211388565	2.418536255	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2591	0	0	4.4479	0.333561062	1.041649641	0	2.178102594	0.987559905	0.355514326	1.638012574	5.384451597	0	2.507544128	0	0.028161245	0.959451143	0	12.79481424	0.803869089	0.918496886	0	0.250108924	8.211388565	2.418536255	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2591	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.4479	0.333561062	1.041649641	0	2.178102594	0.987559905	0.355514326	1.638012574	5.384451597	0	2.507544128	0	0.028161245	0.959451143	0	12.79481424	0.803869089	0.918496886	0	0.250108924	8.211388565	2.418536255	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2591
H0351_029_0	2008	3																					none											coin	D	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	coin	coin	V	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	298.2194574	36.77272458	314.2381348	51.02199424	655.866817	9.889964118	2.919600372	392.8237256	33.2123409	4.69665914	11.42054957	0	0.133387029	0	0	0	278.7487805	1.384277484	32.71921535	29.26092171	24.24275007	6.230390479	1320	2616.974016	735	0	0	0	0	10400	0											$0/day	1-14: $0/day; 15-90: $203/day	"$50/day, days 21-100"		$25 copay	25% DME / 0% Diabetes Monitoring Supplies	25% coinsurance	$50 ER / $25 UC	$0 ASC / $0 OP		"20% Rad Ther, $0 - $100 copay others"	0	20% coinsurance		$0 PCP	$0 SCP / $0 Chiro / $0 Podiatrist	$10 MH	$0 Therapy	$0 copay	$0 Hearing / $10 OPSA	20% coinsurance	$0 Vision		Prev/Diag/Restor 100% IN / 80% OON; Other Major 80% IN / 50% OON	"$10 copay exams, $0 copay glasses"		0				0											0	48.55170984	50	0	25	0.20501	0.25	40.84023084	0	0	0.084151159	0	0.2	0	0	0	10	0	0	10	0.2	0	0	2.240220716	5.714285714	0	0	0	0	0	0											0	0.148781555	1.309325562	0	1.366389202	2.027541544	0.729900093	1.336917636	0	0	0.961052479	0	0.026677406	0	0	0	0.23229065	0	0	0.024384101	4.848550014	0	0	0.48854995	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.8504	0	0	0	0.148781555	1.309325562	0	1.366389202	2.027541544	0.729900093	1.336917636	0	0	0.961052479	0	0.026677406	0	0	0	0.23229065	0	0	0.024384101	4.848550014	0	0	0.48854995	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.8504	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0.148781555	1.309325562	0	1.366389202	2.027541544	0.729900093	1.336917636	0	0	0.961052479	0	0.026677406	0	0	0	0.23229065	0	0	0.024384101	4.848550014	0	0	0.48854995	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.8504
H0351_030_0	2008	4																					none											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	259.9708318	4.096602764	126.9452565	11.57279541	254.0714515	3.83239762	1.131355927	423.0843445	406.9224866	5.004623931	12.1694068	0	0.135479448	310.7536882	0	4226.202565	265.5226985	303.3849357	30.57291426	82.61245189	25.83237223	798.8567816	0	0	0	0	0	0	0	10400	0											$100/admit	"$950/admit + $225 / day, days 61-90"	"$100/day, days 21-100"		$100 copay	30% DME / 0% Diabetes Monitoring Supplies	30% coinsurance	$50 ER / $25 UC	$100 ASC / $100 OP		"20% Rad Ther, $25 - $200 copay others"	0	20% coinsurance	$25 Cardiac Rehab; $25 PT/OT/ST	$0 PCP	$25 SCP / $25 Chiro / $25 Podiatrist	$25 MH	$25 Therapy	$0 copay	$25 Hearing / $25 OPSA	30% coinsurance	$25 Vision					0				0											100	950	100	0	100	0.246012	0.3	40.84023084	100	0	0.194625814	0	0.2	25	0	25	25	25	0	25	0.3	25	0	0	0	0	0	0	0	0	0											2.1664	0.324314385	1.057877138	0	2.117262096	0.942815803	0.339406778	1.439905191	3.391020722	0	2.368480705	0	0.02709589	0.647403517	0	8.804588678	0.553172289	0.632051949	0	0.172109275	7.74971167	1.664284962	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3979	0	0	2.1664	0.324314385	1.057877138	0	2.117262096	0.942815803	0.339406778	1.439905191	3.391020722	0	2.368480705	0	0.02709589	0.647403517	0	8.804588678	0.553172289	0.632051949	0	0.172109275	7.74971167	1.664284962	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3979	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.1664	0.324314385	1.057877138	0	2.117262096	0.942815803	0.339406778	1.439905191	3.391020722	0	2.368480705	0	0.02709589	0.647403517	0	8.804588678	0.553172289	0.632051949	0	0.172109275	7.74971167	1.664284962	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3979
H0351_032_0	2008	3																					none											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	283.7002465	4.479096173	136.4031898	13.14611855	289.6585503	4.353412606	1.285163921	471.9199589	462.0179741	5.760371358	14.0071069	0	0.150438824	352.8283499	0	4719.129814	296.4921969	338.7705329	34.08802371	92.24803561	29.73331447	892.0322197	0	0	0	0	0	0	0	10400	0											$200/admit	"$950/admit + $225 / day, days 61-90"	"$100/day, days 21-100"		$100 copay	30% DME / 0% Diabetes Monitoring Supplies	30% coinsurance	$50 ER / $35 UC	$150 ASC / $150 OP		"20% Rad Ther, $25 - $200 copay others"	0	20% coinsurance	$30 Cardiac Rehab; $30 PT/OT/ST	$0 PCP	$30 SCP / $30 Chiro / $30 Podiatrist	$30 MH	$30 Therapy	$0 copay	$30 Hearing / $30 OPSA	30% coinsurance	$30 Vision					0				0											200	950	100	0	100	0.246012	0.3	44.67427768	150	0	0.192363906	0	0.2	30	0	30	30	30	0	30	0.3	30	0	0	0	0	0	0	0	0	0											4.7283	0.354595114	1.136693249	0	2.413821252	1.070991742	0.385549176	1.756890274	5.775224677	0	2.694461789	0	0.030087765	0.882070875	0	11.79782454	0.741230492	0.846926332	0	0.230620089	8.91999434	2.230080549	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9954	0	0	4.7283	0.354595114	1.136693249	0	2.413821252	1.070991742	0.385549176	1.756890274	5.775224677	0	2.694461789	0	0.030087765	0.882070875	0	11.79782454	0.741230492	0.846926332	0	0.230620089	8.91999434	2.230080549	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9954	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.7283	0.354595114	1.136693249	0	2.413821252	1.070991742	0.385549176	1.756890274	5.775224677	0	2.694461789	0	0.030087765	0.882070875	0	11.79782454	0.741230492	0.846926332	0	0.230620089	8.91999434	2.230080549	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9954
H0351_033_0	2008	3																					4500											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	264.880807	4.181972428	124.911513	12.14934216	263.8812322	4.023324384	1.187719109	439.4015634	430.1818906	5.322522313	12.94241888	0	0.140170066	328.5161511	0	4378.855242	275.1135192	314.3433604	31.71831775	85.59645744	27.47326862	827.711912	0	0	0	0	0	0	0	10400	0											$200/admit	"$950/admit + $225 / day, days 61-90"	"$100/day, days 21-100"		$100 copay	30% DME / 0% Diabetes Monitoring Supplies	30% coinsurance	$50 ER / $35 UC	$150 ASC / $150 OP		"20% Rad Ther, $15 - $200 copay others"	0	20% coinsurance	$25 Cardiac Rehab; $25 PT/OT/ST	$0 PCP	$25 SCP / $25 Chiro / $25 Podiatrist	$25 MH	$25 Therapy	$0 copay	$25 Hearing / $25 OPSA	30% coinsurance	$25 Vision					0				0											191.0156095	907.3241453	95.50780477	0	95.50780477	0.234960661	0.286523414	42.66742191	143.2617072	0	0.169298512	0	0.19101561	23.87695119	0	23.87695119	23.87695119	23.87695119	0	23.87695119	0.286523414	23.87695119	0	0	0	0	0	0	0	0	0											4.2164	0.31620038	0.9941687	0	2.100226434	0.945322955	0.340309334	1.562344324	5.135716003	0	2.19113226	0	0.026774671	0.653663676	0	8.712809408	0.547406006	0.625463423	0	0.170315203	7.871734728	1.64693641	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0569	0	1.79	4.2164	0.31620038	0.9941687	0	2.100226434	0.945322955	0.340309334	1.562344324	5.135716003	0	2.19113226	0	0.026774671	0.653663676	0	8.712809408	0.547406006	0.625463423	0	0.170315203	7.871734728	1.64693641	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0569	4500																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.2164	0.31620038	0.9941687	0	2.100226434	0.945322955	0.340309334	1.562344324	5.135716003	0	2.19113226	0	0.026774671	0.653663676	0	8.712809408	0.547406006	0.625463423	0	0.170315203	7.871734728	1.64693641	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0569
H0351_801_0	2008	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	240.1852366	2.865346716	20.65302019	9.781923761	10.75037859	2.604622221	0.104883232	12.51192368	54.45064062	3.222133128	11.07827836	0	0.052588346	16.87667031	50.80697265	112.5077945	2.912242098	3.009114622	35.57706207	24.23869385	40.29523116	4.277682149	0	0	0	0	0	0	0	0	0											Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits											0.075152155	0.075152155	0.162913948	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											18.0504	0.21533698	3.364665059	0	2.51558859	0.6094816	0.024542676	2.927790141	12.74144991	0.753979152	2.592317136	0	0.012305673	3.949140853	11.8888316	26.32682391	0.681464651	0.704132822	8.325032525	5.67185436	9.429084092	1.000977623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.7852	0	0	18.0504	0.21533698	3.364665059	0	2.51558859	0.6094816	0.024542676	2.927790141	12.74144991	0.753979152	2.592317136	0	0.012305673	3.949140853	11.8888316	26.32682391	0.681464651	0.704132822	8.325032525	5.67185436	9.429084092	1.000977623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.7852	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.0504	0.21533698	3.364665059	0	2.51558859	0.6094816	0.024542676	2.927790141	12.74144991	0.753979152	2.592317136	0	0.012305673	3.949140853	11.8888316	26.32682391	0.681464651	0.704132822	8.325032525	5.67185436	9.429084092	1.000977623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.7852
H0351_803_0	2008	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	240.1852366	2.865346716	20.65302019	9.781923761	10.75037859	2.604622221	0.104883232	12.51192368	54.45064062	3.222133128	11.07827836	0	0.052588346	16.87667031	50.80697265	112.5077945	2.912242098	3.009114622	35.57706207	24.23869385	40.29523116	4.277682149	0	0	0	0	0	0	0	0	0											Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits											0.075152155	0.075152155	0.162913948	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											18.0504	0.21533698	3.364665059	0	2.51558859	0.6094816	0.024542676	2.927790141	12.74144991	0.753979152	2.592317136	0	0.012305673	3.949140853	11.8888316	26.32682391	0.681464651	0.704132822	8.325032525	5.67185436	9.429084092	1.000977623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.7852	0	0	18.0504	0.21533698	3.364665059	0	2.51558859	0.6094816	0.024542676	2.927790141	12.74144991	0.753979152	2.592317136	0	0.012305673	3.949140853	11.8888316	26.32682391	0.681464651	0.704132822	8.325032525	5.67185436	9.429084092	1.000977623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.7852	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.0504	0.21533698	3.364665059	0	2.51558859	0.6094816	0.024542676	2.927790141	12.74144991	0.753979152	2.592317136	0	0.012305673	3.949140853	11.8888316	26.32682391	0.681464651	0.704132822	8.325032525	5.67185436	9.429084092	1.000977623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.7852
H0351_804_0	2008	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	240.1852366	2.865346716	20.65302019	9.781923761	10.75037859	2.604622221	0.104883232	12.51192368	54.45064062	3.222133128	11.07827836	0	0.052588346	16.87667031	50.80697265	112.5077945	2.912242098	3.009114622	35.57706207	24.23869385	40.29523116	4.277682149	0	0	0	0	0	0	0	0	0											Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits											0.075152155	0.075152155	0.162913948	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											18.0504	0.21533698	3.364665059	0	2.51558859	0.6094816	0.024542676	2.927790141	12.74144991	0.753979152	2.592317136	0	0.012305673	3.949140853	11.8888316	26.32682391	0.681464651	0.704132822	8.325032525	5.67185436	9.429084092	1.000977623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.7852	0	0	18.0504	0.21533698	3.364665059	0	2.51558859	0.6094816	0.024542676	2.927790141	12.74144991	0.753979152	2.592317136	0	0.012305673	3.949140853	11.8888316	26.32682391	0.681464651	0.704132822	8.325032525	5.67185436	9.429084092	1.000977623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.7852	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.0504	0.21533698	3.364665059	0	2.51558859	0.6094816	0.024542676	2.927790141	12.74144991	0.753979152	2.592317136	0	0.012305673	3.949140853	11.8888316	26.32682391	0.681464651	0.704132822	8.325032525	5.67185436	9.429084092	1.000977623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.7852
H0351_806_0	2008	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	240.1852366	2.865346716	20.65302019	9.781923761	10.75037859	2.604622221	0.104883232	12.51192368	54.45064062	3.222133128	11.07827836	0	0.052588346	16.87667031	50.80697265	112.5077945	2.912242098	3.009114622	35.57706207	24.23869385	40.29523116	4.277682149	0	0	0	0	0	0	0	0	0											Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits											0.075152155	0.075152155	0.162913948	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											18.0504	0.21533698	3.364665059	0	2.51558859	0.6094816	0.024542676	2.927790141	12.74144991	0.753979152	2.592317136	0	0.012305673	3.949140853	11.8888316	26.32682391	0.681464651	0.704132822	8.325032525	5.67185436	9.429084092	1.000977623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.7852	0	0	18.0504	0.21533698	3.364665059	0	2.51558859	0.6094816	0.024542676	2.927790141	12.74144991	0.753979152	2.592317136	0	0.012305673	3.949140853	11.8888316	26.32682391	0.681464651	0.704132822	8.325032525	5.67185436	9.429084092	1.000977623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.7852	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.0504	0.21533698	3.364665059	0	2.51558859	0.6094816	0.024542676	2.927790141	12.74144991	0.753979152	2.592317136	0	0.012305673	3.949140853	11.8888316	26.32682391	0.681464651	0.704132822	8.325032525	5.67185436	9.429084092	1.000977623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.7852
H0354_001_0	2008	5																					none											A	A	D	P	T	P	O	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	O		V	V		V			O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	371.8720272	5.388375422	785.1450886	0	196.9607225	6.05283047	0	561.0513252	119.2912005	367.9781186	1469.921695	0	1.429140528	388.1009111	0	0	24.55844564	35.44812882	0	8265.919317	43.27402523	0	0	0	378.2758836	0	93.32350012	0	0	0	167.3188197											Contracted - $200/admit; Gastic Bypass - 20% coin.	MHSA - $876/admit	Contracted - $100/day; days 21-100; Non-contracted - $100/day	0	$100/trip	20% for high cost DME	0	"CMG Urgent Care - $0/visit; Non-CMG Urgent Care - $0/visit in-area, $25/visit OOA; Emergency Room - $50/visit"	$125/visit	$30/visit	High Tech - $150/visit; Low Tech  - $30/visit; Mammography - $0/visit	0	"$30/visit in-area, $50/visit OOA"	CMG - $20/visit; Non-CMG - $30/visit	0	0	$30/visit	$30/visit	0	Primary Care - $0/visit; CMG Specialist - $20/visit; Non-CMG Specialist - $30/visit; Gastric Bypass - 20% coin.	"20% coinsurance for immunosuppressive, anti-cancer, and anti-emetics (anti-nausea) drugs obtained from CMG pharmacies, 0% otherwise"	0	0	0	CMG Routine Exam - $0/visit; CMG Medically Needed - $0/visit; Non-Medically Needed - $30/visit	0	Hearing Aid Fitting - $0/visit; CMG Routine Exam - $0/visit	0	0	0	CMG Podiatrist - $20/visit; CMG Nail Technician - $0/visit; Non-CMG Nail Technician - $30/visitNon-CMG Podiatrist - $30/visit											200.4982096	876	100	0	100	361.4391667	0	29.22209907	125	30	50.47023512	0	30	30	0	0	30	30	0	13.17390439	0.001849893	0	0	0	5.197799978	0	0	0	0	0	10.13130148											6.2133	0.393351406	6.542875738	0	1.641339354	0.182310833	0	1.366258117	1.242616672	0.919945296	6.182274464	0	0.003572851	0.970252278	0	0	0.061396114	0.088620322	0	9.074535901	0.080052298	0	0	0	0.163850198	0	0	0	0	0	0.141263117	0	0	0	0	0	0	0	0	0	0	35.2678		0	6.2133	0.393351406	6.542875738	0	1.641339354	0.182310833	0	1.366258117	1.242616672	0.919945296	6.182274464	0	0.003572851	0.970252278	0	0	0.061396114	0.088620322	0	9.074535901	0.080052298	0	0	0	0.163850198	0	0	0	0	0	0.141263117	0	0	0	0	0	0	0	0	0	0	35.2678	none																																																																																			0		0	6.2133	0.393351406	6.542875738	0	1.641339354	0.182310833	0	1.366258117	1.242616672	0.919945296	6.182274464	0	0.003572851	0.970252278	0	0	0.061396114	0.088620322	0	9.074535901	0.080052298	0	0	0	0.163850198	0	0	0	0	0	0.141263117	0	0	0	0	0	0	0	0	0	0	35.2678
H0354_012_0	2008	4																					none											A	A	D	P	T	P	O	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	O		V	V		V			O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	531.9097386	7.707300233	1552.876041	0	383.5996159	12.97910168	0	844.7026845	165.9470858	444.2486971	2103.648242	0	0	685.111153	0	0	32.45523717	48.03145696	0	11071.22814	36.12230363	0	0	0	561.7529999	0	131.8844674	0	0	0	226.7134248											Gastic Bypass - 20% coin.	0	0	0	$50/trip	20% for high cost DME	0	"CMG Urgent Care - $0/visit; Non-CMG Urgent Care - $0/visit in-area, $25/visit OOA; Emergency Room - $50/visit"	0	0	0	0	"$0/visit in-area, $50/visit OOA"	0	0	0	0	0	0	Gastric Bypass - 20% coin.	"20% coinsurance for immunosuppressive, anti-cancer, and anti-emetics (anti-nausea) drugs obtained from CMG pharmacies, 0% otherwise"	0	0	0	0	0	0	0	0	0	0											4.110820157	0	0	0	50	552.5854286	0	28.79047852	0	0	0	0	0	0	0	0	0	0	0	0.005557385	0.001937908	0	0	0	1.70E-07	0	0	0	0	0	6.57E-09											0.1822	0	0	0	1.598331733	0.597671872	0	2.026616208	0	0	0	0	0	0	0	0	0	0	0	0.005127257	0.07000171	0	0	0	7.96E-09	0	0	0	0	0	1.24E-10	0	0	0	0	0	0	0	0	0	0	4.48		0	0.1822	0	0	0	1.598331733	0.597671872	0	2.026616208	0	0	0	0	0	0	0	0	0	0	0	0.005127257	0.07000171	0	0	0	7.96E-09	0	0	0	0	0	1.24E-10	0	0	0	0	0	0	0	0	0	0	4.48	none																																																																																			0		0	0.1822	0	0	0	1.598331733	0.597671872	0	2.026616208	0	0	0	0	0	0	0	0	0	0	0	0.005127257	0.07000171	0	0	0	7.96E-09	0	0	0	0	0	1.24E-10	0	0	0	0	0	0	0	0	0	0	4.48
H0354_014_0	2008	5																					none											A	A	D	P	T	P	O	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	O		V	V		V			O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	436.7380816	6.328275785	925.0677446	0	215.0378525	6.402301031	0	610.3500202	130.2397923	401.7512903	1604.831668	0	1.560307589	423.7209603	0	0	27.0711631	39.07503313	0	9111.653616	47.20542561	0	0	0	378.2758836	0	93.32350012	0	0	0	167.3188197											Contracted - $200/admit; Gastic Bypass - 20% coin.	MHSA - $876/admit	Contracted - $100/day; days 21-100; Non-contracted - $100/day	0	$100/trip	20% for high cost DME	0	"CMG Urgent Care - $0/visit; Non-CMG Urgent Care - $0/visit in-area, $25/visit OOA; Emergency Room - $50/visit"	$125/visit	$30/visit	High Tech - $150/visit; Low Tech  - $30/visit; Mammography - $0/visit	0	"$30/visit in-area, $50/visit OOA"	CMG - $20/visit; Non-CMG - $30/visit	0	0	$30/visit	$30/visit	0	Primary Care - $0/visit; CMG Specialist - $20/visit; Non-CMG Specialist - $30/visit; Gastric Bypass - 20% coin.	"20% coinsurance for immunosuppressive, anti-cancer, and anti-emetics (anti-nausea) drugs obtained from CMG pharmacies, 0% otherwise"	0	0	0	CMG Routine Exam - $0/visit; CMG Medically Needed - $0/visit; Non-Medically Needed - $30/visit	0	Hearing Aid Fitting - $0/visit; CMG Routine Exam - $0/visit	0	0	0	CMG Podiatrist - $20/visit; CMG Nail Technician - $0/visit; Non-CMG Nail Technician - $30/visitNon-CMG Podiatrist - $30/visit											200.4982096	876	100	0	100	361.4391667	0	29.22209907	125	30	50.47023512	0	30	30	0	0	30	30	0	13.17390439	0.001849893	0	0	0	5.197799978	0	0	0	0	0	10.13130148											7.2971	0.461964132	7.708897872	0	1.791982104	0.192836862	0	1.486309063	1.356664503	1.004378226	6.749685967	0	0.003900769	1.059302401	0	0	0.067677908	0.097687583	0	10.00300447	0.087324967	0	0	0	0.163850198	0	0	0	0	0	0.141263117	0	0	0	0	0	0	0	0	0	0	39.6738		0	7.2971	0.461964132	7.708897872	0	1.791982104	0.192836862	0	1.486309063	1.356664503	1.004378226	6.749685967	0	0.003900769	1.059302401	0	0	0.067677908	0.097687583	0	10.00300447	0.087324967	0	0	0	0.163850198	0	0	0	0	0	0.141263117	0	0	0	0	0	0	0	0	0	0	39.6738	none																																																																																			0		0	7.2971	0.461964132	7.708897872	0	1.791982104	0.192836862	0	1.486309063	1.356664503	1.004378226	6.749685967	0	0.003900769	1.059302401	0	0	0.067677908	0.097687583	0	10.00300447	0.087324967	0	0	0	0.163850198	0	0	0	0	0	0.141263117	0	0	0	0	0	0	0	0	0	0	39.6738
H0354_801_0	2008	4																					none											A	A	D	P	T	P	O	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	O			V		V			O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	350.2671016	5.07532297	588.3143223	0	146.8126003	7.284966947	0	497.8779685	151.3031597	379.3793155	1480.765499	0	0.280191036	931.3550051	0	0	23.10849492	33.14930441	0	8152.805104	50.49339243	0	0	0	0	0	0	0	0	0	0											Contracted - $250/admit; Gastic Bypass - 20% coin.	MHSA - $876/admit	Contracted - $150/day; days 21-100; Non-contracted - $150/day	0	$100/trip	20% for high cost DME	0	CMG Urgent Care - $30/visit; Non-CMG Urgent Care - $30/visit; Emergency Room - $50/visit	$150/visit	CMG Specialist - $30/visit; Non-CMG Specialist - $30/visit	High Tech - $150/visit; Low Tech  - $30/visit; Mammography - $0/visit	0	$30/visit	$30/visit	0	0	$30/visit	CMG Specialist - $30/visit; Non-CMG Specialist - $30/visit	0	Primary Care - $30/visit; CMG Specialist - $30/visit; Non-CMG Specialist - $30/visit; Gastric Bypass - 20% coin.	"20% coinsurance for immunosuppressive, anti-cancer, and anti-emetics (anti-nausea) drugs obtained from CMG pharmacies, 0% otherwise"	0	0	0	0	0	0	0	0	0	0											250.647748	876	150	0	100	380.4946923	0	41.71127203	150	30	50.47023512	0	30	30	0	0	30	30	0	30.00186957	0.001880333	0	0	0	0	0	0	0	0	0	0											7.3161	0.370498577	7.353929029	0	1.223438336	0.230990938	0	1.730593615	1.891289496	0.948448289	6.227881906	0	0.000700478	2.328387513	0	0	0.057771237	0.082873261	0	20.38328295	0.094944368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2412		0	7.3161	0.370498577	7.353929029	0	1.223438336	0.230990938	0	1.730593615	1.891289496	0.948448289	6.227881906	0	0.000700478	2.328387513	0	0	0.057771237	0.082873261	0	20.38328295	0.094944368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2412	none																																																																																			0		0	7.3161	0.370498577	7.353929029	0	1.223438336	0.230990938	0	1.730593615	1.891289496	0.948448289	6.227881906	0	0.000700478	2.328387513	0	0	0.057771237	0.082873261	0	20.38328295	0.094944368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2412
H0354_804_0	2008	4																					none											A	A	D	P	T	P	O	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	O			V		V			O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	350.2671016	5.07532297	588.3143223	0	146.8126003	7.284966947	0	497.8779685	151.3031597	379.3793155	1480.765499	0	0.280191036	931.3550051	0	0	23.10849492	33.14930441	0	8152.805104	50.49339243	0	0	0	0	0	0	0	0	0	0											Contracted - $250/admit; Gastic Bypass - 20% coin.	MHSA - $876/admit	Contracted - $150/day; days 21-100; Non-contracted - $150/day	0	$100/trip	20% for high cost DME	0	CMG Urgent Care - $30/visit; Non-CMG Urgent Care - $30/visit; Emergency Room - $50/visit	$150/visit	CMG Specialist - $30/visit; Non-CMG Specialist - $30/visit	High Tech - $150/visit; Low Tech  - $30/visit; Mammography - $0/visit	0	$30/visit	$30/visit	0	0	$30/visit	CMG Specialist - $30/visit; Non-CMG Specialist - $30/visit	0	Primary Care - $30/visit; CMG Specialist - $30/visit; Non-CMG Specialist - $30/visit; Gastric Bypass - 20% coin.	"20% coinsurance for immunosuppressive, anti-cancer, and anti-emetics (anti-nausea) drugs obtained from CMG pharmacies, 0% otherwise"	0	0	0	0	0	0	0	0	0	0											250.647748	876	150	0	100	380.4946923	0	41.71127203	150	30	50.47023512	0	30	30	0	0	30	30	0	30.00186957	0.001880333	0	0	0	0	0	0	0	0	0	0											7.3161	0.370498577	7.353929029	0	1.223438336	0.230990938	0	1.730593615	1.891289496	0.948448289	6.227881906	0	0.000700478	2.328387513	0	0	0.057771237	0.082873261	0	20.38328295	0.094944368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2412		0	7.3161	0.370498577	7.353929029	0	1.223438336	0.230990938	0	1.730593615	1.891289496	0.948448289	6.227881906	0	0.000700478	2.328387513	0	0	0.057771237	0.082873261	0	20.38328295	0.094944368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2412	none																																																																																			0		0	7.3161	0.370498577	7.353929029	0	1.223438336	0.230990938	0	1.730593615	1.891289496	0.948448289	6.227881906	0	0.000700478	2.328387513	0	0	0.057771237	0.082873261	0	20.38328295	0.094944368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2412
H0354_805_0	2008	4																					none											A	A	D	P	T	P	O	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	O			V		V			O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	350.2671016	5.07532297	588.3143223	0	146.8126003	7.284966947	0	497.8779685	151.3031597	379.3793155	1480.765499	0	0.280191036	931.3550051	0	0	23.10849492	33.14930441	0	8152.805104	50.49339243	0	0	0	0	0	0	0	0	0	0											Contracted - $250/admit; Gastic Bypass - 20% coin.	MHSA - $876/admit	Contracted - $150/day; days 21-100; Non-contracted - $150/day	0	$100/trip	20% for high cost DME	0	CMG Urgent Care - $30/visit; Non-CMG Urgent Care - $30/visit; Emergency Room - $50/visit	$150/visit	CMG Specialist - $30/visit; Non-CMG Specialist - $30/visit	High Tech - $150/visit; Low Tech  - $30/visit; Mammography - $0/visit	0	$30/visit	$30/visit	0	0	$30/visit	CMG Specialist - $30/visit; Non-CMG Specialist - $30/visit	0	Primary Care - $30/visit; CMG Specialist - $30/visit; Non-CMG Specialist - $30/visit; Gastric Bypass - 20% coin.	"20% coinsurance for immunosuppressive, anti-cancer, and anti-emetics (anti-nausea) drugs obtained from CMG pharmacies, 0% otherwise"	0	0	0	0	0	0	0	0	0	0											250.647748	876	150	0	100	380.4946923	0	41.71127203	150	30	50.47023512	0	30	30	0	0	30	30	0	30.00186957	0.001880333	0	0	0	0	0	0	0	0	0	0											7.3161	0.370498577	7.353929029	0	1.223438336	0.230990938	0	1.730593615	1.891289496	0.948448289	6.227881906	0	0.000700478	2.328387513	0	0	0.057771237	0.082873261	0	20.38328295	0.094944368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2412		0	7.3161	0.370498577	7.353929029	0	1.223438336	0.230990938	0	1.730593615	1.891289496	0.948448289	6.227881906	0	0.000700478	2.328387513	0	0	0.057771237	0.082873261	0	20.38328295	0.094944368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2412	none																																																																																			0		0	7.3161	0.370498577	7.353929029	0	1.223438336	0.230990938	0	1.730593615	1.891289496	0.948448289	6.227881906	0	0.000700478	2.328387513	0	0	0.057771237	0.082873261	0	20.38328295	0.094944368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2412
H0370_001_0	2008	7																					1700											D	D	D	COIN	T	COIN	COIN	V	COIN	COIN	COIN	COIN	COIN	COIN	P	COIN	P	P	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	COIN											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	1333.409144	40.30287718	354.0293112	0	223.5077992	4.796621925	0.30870871	255.5970184	33.87940803	0	17.52417587	1.555312889	0.689892865	15.04108337	3863.382771	115.1762571	177.3230014	1259.277714	29.09909735	0	14.83742554	0	0	0	0	0	0	0	0	0	0											1a $150 days 1-9	1b $150 days 1-9	2 $75 days 7-26		10a $115	11a 30%	"11b 30%,11c 10%"	"4a $50,4b $50"	"9a $100,9b $100"	8a 20%	8b 20%	9a 20%	12 20%	"9a 20%,9d 20%"	"14c $10,7a $10"	"7b $20,7d $30,7f $30,7g $30"	"7e $30,7h $30"	"7c $25,7i $25"	8b 20%		0.2				17a $30		18a $30															87.91685085	87.91685085	27.15882043	0	51.88125756	0.21229325	0.21229325	35.38220828	0.087119191	0	0.138891391	0.141528833	0.2	0.140520193	9.799521351	0.096308119	20.13937509	17.69110414	0.043947606	0	0.147366981	0	0	0	0	0	0	0	0	0	0											9.7691	0.29527517	0.801251541	0	0.966322141	1.018290456	0.065536775	0.753632245	2.951546606	0	2.43395717	0.220121618	0.137978573	2.113575936	3.154941829	11.09240869	0.29759787	1.856501098	1.278835662	0	2.186546603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.3934	0	11.57176362	9.7691	0.29527517	0.801251541	0	0.966322141	1.018290456	0.065536775	0.753632245	2.951546606	0	2.43395717	0.220121618	0.137978573	2.113575936	3.154941829	11.09240869	0.29759787	1.856501098	1.278835662	0	2.186546603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.3934		0.2	0.2	0.2	0.2	115	0.3	0.3	50	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2				0.2	0.2	0.2				0.2											5.757	0.0021	0.3375	0.3338	0.2333	0.1615	0.0104	0.1451	0.746	0.1281	0.4049	0.0382	0.0148	0.4939	0.4538	2.4602	0.0215	0.1161	0.6311	0.1138	0.3659	0	0	0	0.0156	0.0253	0	0	0	0	0.0086											13.0187	0	0	15.5261	0.297409066	1.138718081	0.333840961	1.199630764	1.1798072	0.075936237	0.898698242	3.697555396	0.128106797	2.838892727	0.258341309	0.152771877	2.607492218	3.608737304	13.5526535	0.319089675	1.972614498	1.909924023	0.113836898	2.552460249	0	0	0	0.015570014	0.025345547	0	0	0	0	0.00861734	0	0	0	0	0	0	0	0	0	0	54.4121
H0370_002_0	2008	10																					2000											D	D	D	COIN	T	COIN	COIN	V	V	COIN	COIN	COIN	COIN	COIN	P	COIN	P	P	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	COIN											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	1333.409144	40.30287718	354.0293112	0	223.5077992	4.796621925	0.30870871	255.5970184	473.8234231	0	17.52417587	1.555312889	0.689892865	15.04108337	0	115.1762571	177.3230014	1259.277714	29.09909735	0	14.83742554	0	0	0	0	0	0	0	0	0	0											1a $250 per stay	1b $250 per stay	2 $100 days 7-26		10a $150	11a 10%	"11b 10%,11c 10%"	"4a $50,4b $50"	"9a $100,9b $100"	8a 10%	8b 10%	9a 10%	12 10%	"9a 10%,9d 10%"		7g $10	"7e $10,7h $10"	"7c $10,7i $10"	8b 10%		0.1				17a $10		18a $10															42.90992329	42.90992329	45.64761217	0	85.30457774	0.0892038	0.0892038	44.60189994	89.20379988	0	0.0892038	0.0892038	0.1	0.088568067	0	0.004672172	8.920379988	8.920379988	0.02769961	0	0.092883509	0	0	0	0	0	0	0	0	0	0											4.768	0.144116114	1.346716058	0	1.588853203	0.427876902	0.02753799	0.950009387	3.522237484	0	1.563223077	0.13873982	0.068989286	1.332159678	0	0.538123338	0.131815713	0.936102976	0.80603364	0	1.37815215	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.6687	0	2.306998192	4.768	0.144116114	1.346716058	0	1.588853203	0.427876902	0.02753799	0.950009387	3.522237484	0	1.563223077	0.13873982	0.068989286	1.332159678	0	0.538123338	0.131815713	0.936102976	0.80603364	0	1.37815215	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.6687		0.1	0.1	0.1	0.1	150	0.1	0.1	50	0.1	0.1	0.1	0.1	0.1	0.1	0.1	0.1	0.1	0.1	0.1	0.1	0.1				0.1	0.1	0.1				0.1											2.8785	0.0011	0.1687	0.1669	0.2804	0.1615	0.0104	0.1451	0.373	0.0641	0.2025	0.0191	0.0074	0.247	0.2269	1.2301	0.0107	0.0581	0.3155	0.0569	0.183	0	0	0	0	0.013	0	0	0	0	0.0043											6.8242	0	0	7.6465	0.145183062	1.515449328	0.166920481	1.869290389	0.589393646	0.037937452	1.095075384	3.895241879	0.064053399	1.765690855	0.157849665	0.076385939	1.579117819	0.226897737	1.768245746	0.142561615	0.994159676	1.12157782	0.056918449	1.561108973	0	0	0	0	0.013047773	0	0	0	0	0.00430867	0	0	0	0	0	0	0	0	0	0	26.4929
H0370_801_0	2008	7																																COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		230.0800275	4.068353407	11.49938248	0	5.228167017	5.276284118	14.07542115	6.988309071	37.26734883	6.280285998	19.27659346	1.710844178	0.209225286	16.5451917	13.90345948	127.2587499	11.01381266	3.84056439	29.33703349	2.764522552	16.1538401	0	0	0	0	0	0	0	0	0	0											FFS Medicare 9.%	FFS Medicare 9.%	FFS Medicare 13.5%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				0.0895	0.0895	0.1354	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											20.5922	0.36411763	1.557016387	0	1.223391082	1.234650484	3.29364855	1.635264323	8.720559626	1.469586924	4.510722869	0.400337538	0.048958717	3.871574859	3.253409517	29.77854747	2.577232161	0.898692067	6.864865836	0.646898277	3.779998583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.7216	0	0	20.5922	0.36411763	1.557016387	0	1.223391082	1.234650484	3.29364855	1.635264323	8.720559626	1.469586924	4.510722869	0.400337538	0.048958717	3.871574859	3.253409517	29.77854747	2.577232161	0.898692067	6.864865836	0.646898277	3.779998583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.7216		FFS Medicare 9.%	FFS Medicare 9.%	FFS Medicare 13.5%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				2.8025	0.0159	0.2513	0	0.1573	0.1386	0.3746	0.2222	0.9601	0.1649	0.5212	0.0492	0.0054	0.6297	0.3575	3.2524	0.2358	0.1283	0.7462	0.0711	0.4666	0	0	0	0	0	0	0	0	0	0											11.5506	0	0	23.3946	0.380005802	1.80832772	0	1.380723745	1.373231849	3.668292699	1.857416125	9.680672939	1.634460372	5.03187493	0.449526279	0.054345112	4.501248008	3.610880136	33.0309571	2.813052664	1.026951542	7.61106988	0.718014342	4.246578917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.2723
H0370_802_0	2008	7																																COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		230.0800275	4.068353407	11.49938248	0	5.228167017	5.276284118	14.07542115	6.988309071	37.26734883	6.280285998	19.27659346	1.710844178	0.209225286	16.5451917	13.90345948	127.2587499	11.01381266	3.84056439	29.33703349	2.764522552	16.1538401	0	0	0	0	0	0	0	0	0	0											FFS Medicare 9.%	FFS Medicare 9.%	FFS Medicare 13.5%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				0.0895	0.0895	0.1354	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											20.5922	0.36411763	1.557016387	0	1.223391082	1.234650484	3.29364855	1.635264323	8.720559626	1.469586924	4.510722869	0.400337538	0.048958717	3.871574859	3.253409517	29.77854747	2.577232161	0.898692067	6.864865836	0.646898277	3.779998583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.7216	0	0	20.5922	0.36411763	1.557016387	0	1.223391082	1.234650484	3.29364855	1.635264323	8.720559626	1.469586924	4.510722869	0.400337538	0.048958717	3.871574859	3.253409517	29.77854747	2.577232161	0.898692067	6.864865836	0.646898277	3.779998583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.7216		FFS Medicare 9.%	FFS Medicare 9.%	FFS Medicare 13.5%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				2.8025	0.0159	0.2513	0	0.1573	0.1386	0.3746	0.2222	0.9601	0.1649	0.5212	0.0492	0.0054	0.6297	0.3575	3.2524	0.2358	0.1283	0.7462	0.0711	0.4666	0	0	0	0	0	0	0	0	0	0											11.5506	0	0	23.3946	0.380005802	1.80832772	0	1.380723745	1.373231849	3.668292699	1.857416125	9.680672939	1.634460372	5.03187493	0.449526279	0.054345112	4.501248008	3.610880136	33.0309571	2.813052664	1.026951542	7.61106988	0.718014342	4.246578917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.2723
H0370_803_0	2008	7																																COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		230.0800275	4.068353407	11.49938248	0	5.228167017	5.276284118	14.07542115	6.988309071	37.26734883	6.280285998	19.27659346	1.710844178	0.209225286	16.5451917	13.90345948	127.2587499	11.01381266	3.84056439	29.33703349	2.764522552	16.1538401	0	0	0	0	0	0	0	0	0	0											FFS Medicare 9.%	FFS Medicare 9.%	FFS Medicare 13.5%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				0.0895	0.0895	0.1354	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											20.5922	0.36411763	1.557016387	0	1.223391082	1.234650484	3.29364855	1.635264323	8.720559626	1.469586924	4.510722869	0.400337538	0.048958717	3.871574859	3.253409517	29.77854747	2.577232161	0.898692067	6.864865836	0.646898277	3.779998583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.7216	0	0	20.5922	0.36411763	1.557016387	0	1.223391082	1.234650484	3.29364855	1.635264323	8.720559626	1.469586924	4.510722869	0.400337538	0.048958717	3.871574859	3.253409517	29.77854747	2.577232161	0.898692067	6.864865836	0.646898277	3.779998583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.7216		FFS Medicare 9.%	FFS Medicare 9.%	FFS Medicare 13.5%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				2.8025	0.0159	0.2513	0	0.1573	0.1386	0.3746	0.2222	0.9601	0.1649	0.5212	0.0492	0.0054	0.6297	0.3575	3.2524	0.2358	0.1283	0.7462	0.0711	0.4666	0	0	0	0	0	0	0	0	0	0											11.5506	0	0	23.3946	0.380005802	1.80832772	0	1.380723745	1.373231849	3.668292699	1.857416125	9.680672939	1.634460372	5.03187493	0.449526279	0.054345112	4.501248008	3.610880136	33.0309571	2.813052664	1.026951542	7.61106988	0.718014342	4.246578917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.2723
H0401_002_0	2008	10																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1780.204779	141.5897814	663.3505929		124.0367706	11.05024844	2.140486039	436.1417485	23.90076388	8139.444872	37.75265591		0.237486305	20.95322545	3768.741176	3731.870452	476.0737729	1.803791191			16.63446862	737.7656783			137.0356108		14.80098834															$220 (1a); $0 (1a1)	$220 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	20% (9b)	20% (8a1); $0/$25 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											133.3428	133.3428	60.6104		106.0681	0.181831099	0.281749081	30.3052	0.121220733	6.061	0.070091415		0.181831099	0.12117752	10	24.9548	37.5	0.121220733			0.181831099	25			25		25															19.7815	1.573331564	3.35049354	0	1.096362474	2.009278819	0.603079974	1.101446299	2.897268112	4.111122799	2.64613708	0	0.043182396	2.539059895	3.140617647	7.760662664	1.48773054	0.21865689	0	0	3.024663713	1.53701183	0	0	0.285490856	0	0.030835392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.2379	0	28.88789012	19.7815	1.573331564	3.35049354	0	1.096362474	2.009278819	0.603079974	1.101446299	2.897268112	4.111122799	2.64613708	0	0.043182396	2.539059895	3.140617647	7.760662664	1.48773054	0.21865689	0	0	3.024663713	1.53701183	0	0	0.285490856	0	0.030835392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.2379	2950	$295 (1a); $0 (1a1)	$295 (1b)	"$150 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$25 (4b)"	30% (9b)	30% (8a1); $0/$25 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$25/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.3065	0.1835	1.6752	0.4459	0.2741	0.5023	0.1508	0.2754	1.0865	1.0278	0.9812		0.0108	0.952	1.5258	1.9097	0.2975	0.0579			0.5338	0.3854			0.0705		0.0076															14.6603	0	6.51293936	22.088	1.756783268	5.02574031	0.445882897	1.370453093	2.511598524	0.753849968	1.376807874	3.983743654	5.138903499	3.627378061	0	0.053977995	3.491014636	4.66644218	9.67040878	1.785276648	0.276536655	0	0	3.558427897	1.922452773	0	0	0.356023891	0	0.038453548	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.8981
H0401_004_0	2008	6																					1100											D	D	D	V	T	V	P	V	V	Coin	V	V	V	V	V		V	V		V	S	P	T		V	P	V																																																								0		2127.401141	301.2117988	1018.516752		411.4794408	3203.640328	1601.498826	713.2773829	378.4678176	7.994300741	187.0954379	69.61013372	40.32515919	3560.14187		3448.257162		935.0844876				669.720909					0.088371578															1(a) $110 per Day	1(b) $110 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per preocedure; other $0 per procedure	8(b) X-rays $0 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a), 9(d) $25 per visit; 9(c) $0/0 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  $0 per script	"13, 14(a)-(j) $0; 17(a), 16(b) $10 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															59.8115	59.8115	22.8371		40.7806	10.8017	15.4313	24.3324	13.5935	0.372665568	5.4374	13.5935	127.4259	13.5935		5.4374		5.4374				5.4374					5.4374															10.6036	1.501327403	1.938332215	0	1.398363731	2.883720341	2.059438948	1.446312834	0.428725891	2.979200626	0.0847762	0.078853908	0.428205946	4.032905637	0	1.562465346	0	0.423703059	0	0	0	0.303462202	0	0	0	0	4.00E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1534	0	26.98029871	10.6036	1.501327403	1.938332215	0	1.398363731	2.883720341	2.059438948	1.446312834	0.428725891	2.979200626	0.0847762	0.078853908	0.428205946	4.032905637	0	1.562465346	0	0.423703059	0	0	0	0.303462202	0	0	0	0	4.00E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1534		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3																																																								0	0	0	10.6036	1.501327403	1.938332215	0	1.398363731	2.883720341	2.059438948	1.446312834	0.428725891	2.979200626	0.0847762	0.078853908	0.428205946	4.032905637	0	1.562465346	0	0.423703059	0	0	0	0.303462202	0	0	0	0	4.00E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1534
H0401_005_0	2008	7																					1800											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2049.290769	140.5589007	926.0505293		267.3151703	9.973438125	17.3208223	410.3396659	387.8501438	3251.672241	427.3275749	65.12292967	15.51135942	2732.743268		4024.651	395.4982462	579.845487				720.6124341					0.071534174															(1a)$150/day	(1b)$150/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															100.4154	100.4154	28.1163		50.2077	0.133887134	0.133887134	27.6142	50.2077	13.3887	43.6901	50.2077	92.2888	48.5379		16.7359	13.3887	13.3887				16.7359					16.7359															17.1484	1.176189269	2.16975939	0	1.118439434	1.335315042	2.319035248	0.944267528	1.622754499	3.627975629	1.55583032	0.272472574	0.119293667	11.05346271	0	5.613010268	0.441267721	0.646948751	0	0	0	1.005007637	0	0	0	0	9.98E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.1695	0	25.76105721	17.1484	1.176189269	2.16975939	0	1.118439434	1.335315042	2.319035248	0.944267528	1.622754499	3.627975629	1.55583032	0.272472574	0.119293667	11.05346271	0	5.613010268	0.441267721	0.646948751	0	0	0	1.005007637	0	0	0	0	9.98E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.1695		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.0222	0.0578	0.2488	0.2483	0.0638	0.1221	0.106	0.0303	0.2581	0.0405	0.1053	0.0211	0.0049	0.1843	0.0184	0.1781	0.0268	0.0289			0.1597	0.0377			0.0051																	3.9683	0	0	19.1706	1.233946378	2.418582657	0.248339407	1.182225117	1.457438774	2.425081099	0.974609118	1.880886928	3.668498638	1.661165573	0.293608158	0.124167746	11.23772574	0.018417717	5.791063148	0.46801858	0.675848909	0	0	0.159654096	1.042756996	0	0	0.005058988	0	9.98E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1378
H0401_801_0	2008	2																					4800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2031.755454	161.5970331	928.6908301		162.7982614	14.50345107	2.809387927	572.4222188	31.3697526	10683.02139	49.55036088		0.311700775	27.5011084	4650.975733	4609.300873	588.0911312	2.228212648			20.54846123	911.3576026			164.3018602		17.70100294															$325 (1a); $0 (1a1)	$325 (1b)	"$140 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$35/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $35 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											223.0498	223.0498	96.083		120.1037	0.171576783	0.237887712	34.3154	0.137261426	4.1178	0.079366354		0.20589214	0.137202074	35	34.8018	37.5	0.137261426			0.20589214	35			35		35															37.7652	3.0036824	7.435949965	0	1.629390114	2.488455477	0.668318865	1.636906046	4.305856986	3.665916886	3.932631497	0	0.064176739	3.773209098	13.56534589	13.3676821	1.837784785	0.305847646	0	0	4.230766647	2.658126341	0	0	0.479213759	0	0.051627925	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.8661	0	33.96527371	37.7652	3.0036824	7.435949965	0	1.629390114	2.488455477	0.668318865	1.636906046	4.305856986	3.665916886	3.932631497	0	0.064176739	3.773209098	13.56534589	13.3676821	1.837784785	0.305847646	0	0	4.230766647	2.658126341	0	0	0.479213759	0	0.051627925	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.8661																																																																																				0			37.7652	3.0036824	7.435949965	0	1.629390114	2.488455477	0.668318865	1.636906046	4.305856986	3.665916886	3.932631497	0	0.064176739	3.773209098	13.56534589	13.3676821	1.837784785	0.305847646	0	0	4.230766647	2.658126341	0	0	0.479213759	0	0.051627925	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.8661
H0401_804_0	2008	2																					4800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2031.755454	161.5970331	928.6908301		162.7982614	14.50345107	2.809387927	572.4222188	31.3697526	10683.02139	49.55036088		0.311700775	27.5011084	4650.975733	4609.300873	588.0911312	2.228212648			20.54846123	911.3576026			164.3018602		17.70100294															$325 (1a); $0 (1a1)	$325 (1b)	"$140 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$35/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $35 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											223.0498	223.0498	96.083		120.1037	0.171576783	0.237887712	34.3154	0.137261426	4.1178	0.079366354		0.20589214	0.137202074	35	34.8018	37.5	0.137261426			0.20589214	35			35		35															37.7652	3.0036824	7.435949965	0	1.629390114	2.488455477	0.668318865	1.636906046	4.305856986	3.665916886	3.932631497	0	0.064176739	3.773209098	13.56534589	13.3676821	1.837784785	0.305847646	0	0	4.230766647	2.658126341	0	0	0.479213759	0	0.051627925	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.8661	0	33.96527371	37.7652	3.0036824	7.435949965	0	1.629390114	2.488455477	0.668318865	1.636906046	4.305856986	3.665916886	3.932631497	0	0.064176739	3.773209098	13.56534589	13.3676821	1.837784785	0.305847646	0	0	4.230766647	2.658126341	0	0	0.479213759	0	0.051627925	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.8661																																																																																				0			37.7652	3.0036824	7.435949965	0	1.629390114	2.488455477	0.668318865	1.636906046	4.305856986	3.665916886	3.932631497	0	0.064176739	3.773209098	13.56534589	13.3676821	1.837784785	0.305847646	0	0	4.230766647	2.658126341	0	0	0.479213759	0	0.051627925	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.8661
H0408_001_0	2008	6	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)							Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						Coin	Coin	D	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V		Coin	Coin	Coin	T				Coin					Coin	Coin	Coin	V																																																0		381.8273402	5.840544557	9356.555381	217.1057638	28.41508715	30.0429466	0.270058843	182.9361104	13.22920991	52.01094229	47.62613507	2.426573933	0.588500295	7.822931355	132.4218399	122.1752063	12.6914184	25.24385636		12.29712675	3.899968372	6.169093516	1817.255									0.988567899	0.007330573		234.745							(1a) 7.7% coins	(1b) 7.7% coins	(2a) $0/day	(6a) $0/proc	(10a) 20% coins	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) 20% coins	(8a) 10% coins	(8b) 19.2% coins	(9a) 20% coins	(12) 20% coins	(9a) 20% coins	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) 20% coins	(7e/7h) 20% coins	(7c/7i) $0/visit		(7g) 20% coins	(15) 20% coins	(Misc. PBP Cats) 20% coins	(10b) $0/trip				(18a) 20% coins					(4b) 20% coins	(9c) 20% coins	(9d) 20% coins	(7f1) $0/visit							0.077209394	0.077209394			0.2	0.2	0.2	50	0.2	0.1	0.192	0.2	0.2	0.2		0.2	0.2			0.2	0.2	0.2										0.2	0.2									29.4807	0.450944903	0	0	5.683017431	6.008589321	0.054011769	0.762233793	2.645841982	5.201094229	9.144217933	0.485314787	0.117700059	1.564586271	0	24.43504126	2.53828368	0	0	2.45942535	0.779993674	1.233818703	0	0	0	0	0	0	0	0	0	0.19771358	0.001466115	0	0	0	0	0	0	0	0	93.244		0	29.4807	0.450944903	0	0	5.683017431	6.008589321	0.054011769	0.762233793	2.645841982	5.201094229	9.144217933	0.485314787	0.117700059	1.564586271	0	24.43504126	2.53828368	0	0	2.45942535	0.779993674	1.233818703	0	0	0	0	0	0	0	0	0	0.19771358	0.001466115	0	0	0	0	0	0	0	0	93.244		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3				0.3					0.2	0.3	0.3	0.3							2.9509	0.0449	1.0024	0.1215	0.4487	0.4744	0.0043	0.0401	0.2089	0.8212	0.752	0.0383	0.0093	0.1235	0.0089	1.9291	0.2004	0.003		0.1942		0.1264	0.1433									0.0104	0.0001		0.013							9.6691		0	32.4315	0.495872169	1.002403995	0.121456292	6.131676702	6.482951636	0.058275856	0.802351362	2.854724244	6.022319633	9.89620954	0.523629112	0.126992169	1.68810624	0.008911111	26.36412346	2.738674497	0.003011984	0	2.65359051	0.779993674	1.360249297	0.14325	0	0	0	0	0	0	0	0	0.208119558	0.00158186	0	0.01305	0	0	0	0	0	0	102.913
H0408_002_0	2008	6	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)							Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						Coin	Coin	D	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V		Coin	Coin	Coin	T		V		Coin					Coin	Coin	Coin	V																																																0		347.5625035	5.316419424	8926.864441	207.1353873	25.86514319	27.34692002	0.245824009	174.5349429	12.0420327	47.34352785	43.35220922	2.208815405	0.535688816	7.120908642	126.3404924	111.2113149	11.55250211	24.08455618		11.19359383	3.549988773	5.6154847	1817.255									0.899854719	0.006672734		234.745							(1a) 8.9% coins	(1b) 8.9% coins	(2a) $0/day	(6a) $0/proc	(10a) 20% coins	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) 20% coins	(8a) 10% coins	(8b) 19.2% coins	(9a) 20% coins	(12) 20% coins	(9a) 20% coins	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) 20% coins	(7e/7h) 20% coins	(7c/7i) $0/visit		(7g) 20% coins	(15) 20% coins	(Misc. PBP Cats) 20% coins	(10b) $0/trip		(17a1) $0/visit		(18a) 20% coins					(4b) 20% coins	(9c) 20% coins	(9d) 20% coins	(7f1) $0/visit							0.0886	0.0886			0.2	0.2	0.2	50	0.2	0.1	0.192	0.2	0.2	0.2		0.2	0.2			0.2	0.2	0.2										0.2	0.2									30.794	0.471034761	0	0	5.173028639	5.469384005	0.049164802	0.727228929	2.40840654	4.734352785	8.323624171	0.441763081	0.107137763	1.424181728	0	22.24226298	2.310500422	0	0	2.238718767	0.709997755	1.12309694	0	0	0	0	0	0	0	0	0	0.179970944	0.001334547	0	0	0	0	0	0	0	0	88.9292		0	30.794	0.471034761	0	0	5.173028639	5.469384005	0.049164802	0.727228929	2.40840654	4.734352785	8.323624171	0.441763081	0.107137763	1.424181728	0	22.24226298	2.310500422	0	0	2.238718767	0.709997755	1.12309694	0	0	0	0	0	0	0	0	0	0.179970944	0.001334547	0	0	0	0	0	0	0	0	88.9292		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					0.2	0.3	0.3	0.3							2.686	0.0409	0.9124	0.1106	0.4084	0.4318	0.0039	0.0383	0.1901	0.7475	0.6845	0.0349	0.0085	0.1124	0.0081	1.756	0.1824	0.0027		0.1767		0.1151	0.1433									0.0095	0.0001		0.013							8.8172		0	33.4801	0.511930295	0.912449177	0.110556915	5.581425637	5.901177479	0.053046233	0.765504136	2.598543899	5.481882172	9.008132737	0.476639114	0.115596008	1.536617128	0.008111436	23.99823111	2.49290835	0.002741692	0	2.415459722	0.709997755	1.238181768	0.14325	0	0	0	0	0	0	0	0	0.189443099	0.001439906	0	0.01305	0	0	0	0	0	0	97.7464
H0410_001_0	2008	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							14.58012291	13.57184249	354.7205098	368.0836674		155.8026284	57.26639348		1624.920803	411.8298287	2675.70715	222.3622015	78.62001988				1376.129287		821.9323512	337.0787762		315.7253209				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/visit Tier 1, $20/visit Tier 2 + Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b)$20/visit, (7d) $0/visit Tier 1, $20/visit Tier 2, (7f)0"	"(7e) $0/visit Tier 1, $20/visit Tier 2, (7h)$20/visit"	"(7c,i)$0/visit Tier 1, $20 visit Tier 2"		"(7g) $0/ visit Tier 1, $20/visit Tier 2"	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.180389016	0.180389016	35.6268	45.0973		18.0389	45.0973		45.0829	18.0389	18.0389	18.0389	18.0389				18.0389		20	20		19.9999				20											0	0	0	0	0	2.630094031	2.448211317	1.05313063	1.38329689	0	0.234209024	0.215213091	0	6.104675215	0.619079814	4.022234842	0.334264157	0.1181849	0	0	0	2.068655071	0	1.369887252	0.56179796	0	0.526206999	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	24.6292	0	2.308156123	0	0	0	0	0	2.630094031	2.448211317	1.05313063	1.38329689	0	0.234209024	0.215213091	0	6.104675215	0.619079814	4.022234842	0.334264157	0.1181849	0	0	0	2.068655071	0	1.369887252	0.56179796	0	0.526206999	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	24.6292		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.2803	0.0285	0.5082	0.3661	0.0853	0.0893	0.0831	0.0238	0.2879	0.0485	0.1204	0.0231	0.0016	0.2061	0.0286	0.2221	0.0133	0.039			0.1804	0.0573			0.0066		0.0078															4.7072	0	0	2.2803	0.028477244	0.508205574	0.366103293	0.085267277	2.719360089	2.53130423	1.076959644	1.671155853	0.048463396	0.35461024	0.238291321	0.001643186	6.310750581	0.647677376	4.244291519	0.347538233	0.157199655	0	0	0.180372248	2.125966315	0	1.369887252	0.568429071	0	0.534049671	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	29.3364
H0410_002_0	2008	3																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							14.28114727	13.29354235	351.0647755	364.2902131		154.1969333	56.6762085		1595.522674	407.5855283	2648.131428	220.0705463	77.80976536				1361.946958		821.9323512	337.0787762		315.7252031				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/visit Tier 1, $20/visit Tier 2 + Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b)$20/visit, (7d) $0/visit Tier 1, $20/visit Tier 2, (7f)0"	"(7e) $0/visit Tier 1, $20/visit Tier 2, (7h)$20/visit"	"(7c,i)$0/visit Tier 1, $20 visit Tier 2"		"(7g) $0/ visit Tier 1, $20/visit Tier 2"	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.180779048	0.180779048	35.7039	45.1948		18.0779	45.1948		45.1802	18.0779	18.0779	18.0779	18.0779				18.0779		20	20		19.9999				20											0	0	0	0	0	2.581732208	2.40319393	1.044530691	1.37200079	0	0.232296457	0.213455646	0	6.007174541	0.614024365	3.989388987	0.331534532	0.117219794	0	0	0	2.051762287	0	1.369887252	0.56179796	0	0.526206859	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	24.3563	0	2.228350492	0	0	0	0	0	2.581732208	2.40319393	1.044530691	1.37200079	0	0.232296457	0.213455646	0	6.007174541	0.614024365	3.989388987	0.331534532	0.117219794	0	0	0	2.051762287	0	1.369887252	0.56179796	0	0.526206859	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	24.3563		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.2336	0.0279	0.4978	0.3586	0.0835	0.0874	0.0814	0.0236	0.282	0.0475	0.1179	0.0226	0.0016	0.2018	0.028	0.2175	0.013	0.0382			0.1767	0.0561			0.0066		0.0078															4.6112	0	0	2.2336	0.027893298	0.497784462	0.358596088	0.083518812	2.669167803	2.484582964	1.068114124	1.653957003	0.04746962	0.350228761	0.23606064	0.001609491	6.209024186	0.642035514	4.206892237	0.344536414	0.155434523	0	0	0.176673589	2.107898324	0	1.369887252	0.568429071	0	0.534049517	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	28.9675
H0410_003_0	2008	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0								26.22676826	530.0165206	536.8288713		195.8849935	88.9076068		2953.7604	480.3314394	3199.447235	543.9377018	90.65308648				0.098938964		821.9323512			240.9348381				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)0	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3,9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/visit Tier 1, $20/visit Tier 2 + Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b)$20/visit, (7d) $0/visit Tier 1, $20/visit Tier 2, (7f)0"	"(7e) $0/visit Tier 1, $20/visit Tier 2, (7h)$20/visit"	"(7c,i)$0/visit Tier 1, $20 visit Tier 2"		"(7g) $0/ visit Tier 1, $20/visit Tier 2"	(15) 0	"(13a,14a,17a,b)0, (16b)$20/visit"	(10b)0	(16a)$20/visit	(17a)0	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																	0.174464552	34.4567	43.6161		17.4465	43.6161		43.5612	17.4465	17.4465	17.4465	17.4465				17.4465		20			19.999				20											0	0	0	0	0	0	4.575641386	1.521887189	1.951200183	0	0.284791564	0.323150538	0	10.72244895	0.69834008	4.651584416	0.790815398	0.131797918	0	0	0	0.000143845	0	1.369887252	0	0	0.401537742	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	28.3633	0	3.754537912	0	0	0	0	0	0	4.575641386	1.521887189	1.951200183	0	0.284791564	0.323150538	0	10.72244895	0.69834008	4.651584416	0.790815398	0.131797918	0	0	0	0.000143845	0	1.369887252	0	0	0.401537742	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	28.3633		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															3.0967	0.0743	0.3831	0.37	0.0946	0.1821	0.1606	0.0304	0.4057	0.0629	0.165	0.033	0.0058	0.283	0.029	0.2784	0.035	0.0449			0.2484	0.0517			0.0066		0.006															6.0471	0	0	3.0967	0.07425895	0.38309211	0.369960606	0.094615507	0.182093353	4.736213437	1.552318686	2.35687682	0.062904071	0.449792476	0.356106737	0.005829632	11.00546058	0.727336012	4.930002554	0.825774743	0.176742861	0	0	0.248408247	0.051802108	0	1.369887252	0.006631111	0	0.407525252	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	34.4104
H0410_004_0	2008	4	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						500	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	P	P	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T		V	P	V					V	P	V	V	V																																															0		2290.781232	107.9773623	9885.876129	229.3879105	522.2875987	1901.123992	26.0211911	193.2852052	131.7082703	4932.054379	199.7747505	30.38287087	7.448228054	247.2237277	139.9132322	1472.226019	2206.320946	26.67195638		296.3860219	286.4318989	739.9071537	1817.255		287.28	278.16						110.9122277	1.401151812		234.745	287.945						(1a) $25/day	(1b) $25/day	(2a) $0/day	(6a) $0/proc	(10a) $50/trip	(11a) $0/proc	(11a/11c) $0/proc	(4a) $50/visit (waived if admitted)	(9a/9b) $0/visit	(8a) $0/visit	(8b) $0/visit	(9a) $0/visit	(12) $0/proc	(9a) $0/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $0/visit	(7e/7h) $0/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $0/visit	(15) $0/proc	(Misc. PBP Cats) $0/visit	(10b) $0/trip		(17a1) $0/visit	(17b2) $0/proc	(18a) $0/visit					(4b) $20/visit (waived if admitted)	(9c) $0/proc 75%/25% Ind/Grp Blended Copay	(9d) $0/visit	(7f1) $0/visit	(18a1) $0/visit						22.9974	22.9974			45.9948			45.9948																								18.3979										4.3902	0.206933344	0	0	2.00187737	0	0	0.74084332	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.170046296	0	0	0	0	0	0	0	0	0	7.5099		0.653950074	4.3902	0.206933344	0	0	2.00187737	0	0	0.74084332	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.170046296	0	0	0	0	0	0	0	0	0	7.5099		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					20	0.3	0.3	0.3	0.3						3.3545	0.0511	1.119	0.1356	0.5009	0.5296	0.0048	0.0424	0.2332	0.9168	0.8395	0.0428	0.0104	0.1379	0.01	2.175	0.2259	0.0034		0.2189		0.1087	0.1433		0.0146							0.0097	0.0001		0.013	0.0185						10.8594		0	7.7446	0.258005872	1.119028462	0.135587097	2.502735803	0.529551891	0.004760191	0.783230426	0.233184621	0.916770689	0.8394819	0.042771997	0.010373198	0.137890872	0.010047014	2.174983038	0.22593471	0.003395923	0	0.218915465	0	0.108739505	0.14325	0	0.01455	0	0	0	0	0	0	0.179775439	0.000129212	0	0.01305	0.01845	0	0	0	0	0	18.3692
H0423_001_0	2008	9																					0											Coin	Coin	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	437.54	40.52	0	0	0	0	0	400.1	0	0	0	0	0	259.83	0	11087.95	2016.08	868.17	0	1129.14	0	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $0	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $10"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $10, 5 Partial Hosp: $20, 9C OP Substance Abuse: $20, 9D Cardiac Rehab: $10"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $10	"7E Mental Health: $20, 7H Psychiatric: $20"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	Included in i.2.	"7B Chiropractic: $0, 7F Podiatry: $10, 7G Other Health Care: $10, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: N/A	"13B Acupuncture: Not Covered, Massage Therapy: $0, Health-related Expense Card: $0"											0.05689985	0.056909946	0	0	0	0	0	47.56460885	0	0	0	0	0	10	0	10	20	10	0	10	0	0	0	0	0	0	0	0	0	0	0											24.896	2.305991016	0	0	0	0	0	1.585883333	0	0	0	0	0	0.216525	0	9.239958333	3.360133333	0.723475	0	0.94095	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2689	0	0	24.896	2.305991016	0	0	0	0	0	1.585883333	0	0	0	0	0	0.216525	0	9.239958333	3.360133333	0.723475	0	0.94095	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.896	2.305991016	0	0	0	0	0	1.585883333	0	0	0	0	0	0.216525	0	9.239958333	3.360133333	0.723475	0	0.94095	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2689
H0423_002_0	2008	4																					0											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	1111.91	0	0	0	0	0	723.96	0	16704.31	4178.64	1793.23	0	2390.32	0	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $0	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $10"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $10, 5 Partial Hosp: $20, 9C OP Substance Abuse: $20, 9D Cardiac Rehab: $10"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $10	"7E Mental Health: $20, 7H Psychiatric: $20"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	Included in i.2.	"7B Chiropractic: $0, 7F Podiatry: $10, 7G Other Health Care: $10, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	0	0	0	48.35202489	0	0	0	0	0	10	0	10	20	10	0	10	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	4.480258333	0	0	0	0	0	0.6033	0	13.92025833	6.9644	1.494358333	0	1.991933333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.4545	0	0	0	0	0	0	0	0	0	4.480258333	0	0	0	0	0	0.6033	0	13.92025833	6.9644	1.494358333	0	1.991933333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.4545	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	4.480258333	0	0	0	0	0	0.6033	0	13.92025833	6.9644	1.494358333	0	1.991933333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.4545
H0423_003_0	2008	4																					0											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	400.1	0	0	0	0	0	259.83	0	11087.95	2016.08	868.17	0	1129.14	0	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $0	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $10"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $10, 5 Partial Hosp: $20, 9C OP Substance Abuse: $20, 9D Cardiac Rehab: $10"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $10	"7E Mental Health: $20, 7H Psychiatric: $20"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	Included in i.2.	"7B Chiropractic: $0, 7F Podiatry: $10, 7G Other Health Care: $10, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	"13B Acupuncture: Not Covered, Massage Therapy: $0, Health-related Expense Card: $0"											0	0	0	0	0	0	0	47.56460885	0	0	0	0	0	10	0	10	20	10	0	10	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.585883333	0	0	0	0	0	0.216525	0	9.239958333	3.360133333	0.723475	0	0.94095	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0669	0	0	0	0	0	0	0	0	0	1.585883333	0	0	0	0	0	0.216525	0	9.239958333	3.360133333	0.723475	0	0.94095	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	1.585883333	0	0	0	0	0	0.216525	0	9.239958333	3.360133333	0.723475	0	0.94095	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0669
H0427_001_0	2008	5																					1200															T	Coin		V							V	V	V	V			Coin				V		V																																																								0	1200					68.14567254	11.39025737		230.4326512							2395.745706	5161.496402	0	1911.054659			28.79085973				87.91902282		28.91435599																			$50 Ambulance - Waived if admitted	DME/Prosth 20% ($500 OOP Max)		$50 ER - Waived if admitted - WW Cov							PCP $15	Specialist $15	Specialist $15	Specialist $15			Part B Rx 10%				Vision $15		Hearing $15																			48.5	0.161326148		48.5							14.55	14.55	14.55	14.55			0.097				14.55		14.55															0	0	0	0	0.275422093	1.837546341	0	0.931331965	0	0	0	0	0	0	2.904841668	6.258314387	0	2.317153774	0	0	2.792713394	0	0	0	0.106601815	0	0.035058657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.459		0.53996858	0	0	0	0	0.275422093	1.837546341	0	0.931331965	0	0	0	0	0	0	2.904841668	6.258314387	0	2.317153774	0	0	2.792713394	0	0	0	0.106601815	0	0.035058657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.459	0	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit		POS - Match In-Network Benefit	0											0	0	0	0	0.0297	0.198	0	0.1004	0	0	0	0	0	0	0.3131	0.6745	0	0.2497	0	0	0.301	0	0	0	0.0115	0	0.0038	0	0	0	0											1.8817		0.058196614	0	0	0	0	0.305106474	2.035593002	0	1.031708855	0	0	0	0	0	0	3.217919048	6.932821604	0	2.566891458	0	0	3.093705837	0	0	0	0.118091122	0	0.038837201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.3407
H0427_002_0	2008	2																					1200											D	D	D		T	Coin		V	P						V	V	V	V			Coin				V		V																																																								0	1200	464.1388059	51.57097843	141.7333401		68.15160223	11.39124849		230.4527023	123.6598414						2371.99463	5110.326074	0	1892.108739			28.79336497				87.91902282		28.91687197															IP $100/day 1-5 (unlimited)	IP $100/day 1-5 (unlimited)	SNF $25/day 1-100 (no prior stay)		$50 Ambulance - Waived if admitted	DME/Prosth 20%		$50 ER - Waived if admitted - WW Cov	OP Surg $200						PCP $20	Specialist $20	Specialist $20	Specialist $20			Part B Rx 10%				Vision $20		Hearing $20															97	97	24.25		48.5	0.194		48.5	194						19.4	19.4	19.4	19.4			0.097				19.4		19.4															3.7518	0.416865409	0.286419458	0	0.275446059	2.209902208	0	0.931413005	1.999167436	0	0	0	0	0	3.834724651	8.261693819	0	3.058909129	0	0	2.792956402	0	0	0	0.142135754	0	0.046748943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.0082		0.866232091	3.7518	0.416865409	0.286419458	0	0.275446059	2.209902208	0	0.931413005	1.999167436	0	0	0	0	0	3.834724651	8.261693819	0	3.058909129	0	0	2.792956402	0	0	0	0.142135754	0	0.046748943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.0082	0	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit	POS - Match In-Network Benefit		POS - Match In-Network Benefit	0											0.4044	0.0449	0.0309	0	0.0297	0.2382	0	0.1004	0.2155	0	0	0	0	0	0.4133	0.8904	0	0.3297	0	0	0.301	0	0	0	0.0153	0	0.005	0	0	0	0											3.0187		0.09336057	4.1561	0.461794236	0.317289111	0	0.305133023	2.448080557	0	1.031798629	2.214633259	0	0	0	0	0	4.248022752	9.15212082	0	3.388591557	0	0	3.093975036	0	0	0	0.157454829	0	0.05178744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.0268
H0504_015_0	2008	9																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	O	P	P	P	V	P	P	P	Coin		T		P	P	P	P																																																							0		1233.173539	36.41031117	1208.043217	1528.154988	175.2252335	15.88184972	4.080413001	257.2986915	220.9741704	1128.504358	12.48378871	0	1.346735958	1277.331424	5478.393411	7979.685677	234.4605781	2467.36994	4814.078041	6776.814113	41.2444277	0	0	0	225.4572491	173.5427509	0	0	0	0	0											$55.00 for Days 1-10	$55.00 for Days 1-10	Days 1-20 is $0 and Days 21+ is $65	$0.00 Copay	$100 Copay per trip (1-way)	20% Coinsurance of medicare-allowable	20% Coinsurance of medicare-allowable	$50 Copay - waived if admited to hospital	$50 Copay per visit	$0.00 Copay	"$0 copay for simple x-ray and lab and 20% for complex (i.e., MRI, CAT scan, radiation therapy etc.)-"	$0.00 Copay	10% Coinsurance of medicare allowable + 20% coins for drugs	$10.00 Copay per visit	$5.00 Copay per visit	$10.00 Copay per visit	$30 Copay per visit	$10 Copay per visit	$0.00 Copay	$10 Copay per visit	20% Coinsurance of Medicare allowable	$10 Copay	Not covered	Not covered	$10 Copay per Exam	$20 Copay for Frames & Lenses	$0.00 Copay	Not covered		$0.00 Copay	$0.00 Copay											37.27409781	37.27409781	33.26476446	0	100	0.2	0.2	43.75	50	0	0.174	0	17.10481514	10	5	10	30	10	0	0	0.2	10	0	0	10	20	0	0	0	0	0											3.8305	0.113096792	3.348772755	0	1.460210279	3.176369945	0.8160826	0.938068146	0.92072571	0	2.172179236	0	0.001919639	1.064442853	2.282663921	6.649738064	0.586151445	2.056141616	0	0	8.24888554	0	0	0	0.187881041	0.289237918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.143			3.8305	0.113096792	3.348772755	0	1.460210279	3.176369945	0.8160826	0.938068146	0.92072571	0	2.172179236	0	0.001919639	1.064442853	2.282663921	6.649738064	0.586151445	2.056141616	0	0	8.24888554	0	0	0	0.187881041	0.289237918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.143																																																																																				0			3.8305	0.113096792	3.348772755	0	1.460210279	3.176369945	0.8160826	0.938068146	0.92072571	0	2.172179236	0	0.001919639	1.064442853	2.282663921	6.649738064	0.586151445	2.056141616	0	0	8.24888554	0	0	0	0.187881041	0.289237918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.143
H0504_017_0	2008	11																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	O	P	P	P	V	P	P	P	Coin		T		P	P	P	P																																																							0		1233.173539	36.41031117	1208.043217	1528.154988	175.2252335	15.88184972	4.080413001	257.2986915	220.9741704	1128.504358	5.302839379	0	1.346735958	1277.331424	5478.393411	7979.685677	234.4605781	2467.36994	4814.078041	6776.814113	30.98359104	0	0	0	225.4572491	173.5427509	0	0	0	0	0											$50.00 for Days 1-10	$50.00 for Days 1-10	Days 1-20 is $0 and Days 21+ is $75	$0.00 Copay	$110 Copay per trip (1-way)	20% Coinsurance of medicare-allowable	20% Coinsurance of medicare-allowable	$50 Copay - waived if admited to hospital	$50 Copay per visit	$0.00 Copay	"$0 copay for simple x-ray and lab and 20% for complex (i.e., MRI, CAT scan, radiation therapy etc.)-"	$0.00 Copay	10% Coinsurance of medicare allowable + 20% coins for drugs	$10.00 Copay per visit	$5.00 Copay per visit	$10.00 Copay per visit	$30 Copay per visit	$10 Copay per visit	$0.00 Copay	$10 Copay per visit	20% Coinsurance of Medicare allowable	$10 Copay	Not covered	Not covered	$10 Copay per Exam	$20 Copay for Frames & Lenses	$0.00 Copay	Not covered		$0.00 Copay	$0.00 Copay											33.88554346	33.88554346	38.38242053	0	110	0.199863455	0.2	39.66541756	50	0	0.174	0	14.95477878	10	5	10	30	10	0	0	0.200561865	10	0	0	10	20	0	0	0	0	0											3.4822	0.102815265	3.863968564	0	1.606231307	3.17420135	0.8160826	0.850488336	0.92072571	0	0.922694052	0	0.001678345	1.064442853	2.282663921	6.649738064	0.586151445	2.056141616	0	0	6.214126789	0	0	0	0.187881041	0.289237918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0715			3.4822	0.102815265	3.863968564	0	1.606231307	3.17420135	0.8160826	0.850488336	0.92072571	0	0.922694052	0	0.001678345	1.064442853	2.282663921	6.649738064	0.586151445	2.056141616	0	0	6.214126789	0	0	0	0.187881041	0.289237918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0715																																																																																				0			3.4822	0.102815265	3.863968564	0	1.606231307	3.17420135	0.8160826	0.850488336	0.92072571	0	0.922694052	0	0.001678345	1.064442853	2.282663921	6.649738064	0.586151445	2.056141616	0	0	6.214126789	0	0	0	0.187881041	0.289237918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0715
H0504_021_0	2008	10																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	O	P	P	P	V	P	P	P	Coin		T		P	P	P	P																																																							0		1233.173539	36.41031117	1208.043217	1528.154988	175.2252335	15.88184972	4.080413001	257.2986915	220.9741704	1128.504358	5.88672	0	1.346735958	1277.331424	5478.393411	7979.685677	234.4605781	2467.36994	4814.078041	6776.814113	32.91901664	0	0	3885.157357	225.4572491	173.5427509	0	0	0	0	0											$0.00 for Days 1-10	$0.00 for Days 1-10	Days 1-20 is $0 and Days 21+ is $20	$0.00 Copay	$60 Copay per trip (1-way)	20% Coinsurance of medicare-allowable	20% Coinsurance of medicare-allowable	$50 Copay - waived if admited to hospital	$0.00 Copay	$0.00 Copay	"$0 copay for simple x-ray and lab and 20% for complex (i.e., MRI, CAT scan, radiation therapy etc.)-"	$0.00 Copay	$25.00 Copay + 20% coins for drugs	$0.00 Copay	$0.00 Copay	$0.00 Copay	$30.00 Copay per visit	$0.00 Copay	$0.00 Copay	$0.00 Copay	20% Coinsurance of Medicare allowable	$0.00 Copay	$0.00 Copay (5 one-way trips/qtr)	$0.00 Copay	$10.00 Copay	$0 Copay for frames and $15 copay for lenses	$0.00 Copay	Not covered		$0.00 Copay	$0.00 Copay											0	0	10.23531214	0	60	0.20037524	0	26.67367257	0	0	0.174	0	25	0	0	0	30	0	0	0	0.20054381	0	0	10	10	15	0	0	0	0	0											0	0	1.030391617	0	0.876126167	3.182329455	0	0.571925087	0	0	1.02428928	0	0.0028057	0	0	0	0.586151445	0	0	0	6.601705026	0	0	3.237631131	0.187881041	0.216928439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.5182			0	0	1.030391617	0	0.876126167	3.182329455	0	0.571925087	0	0	1.02428928	0	0.0028057	0	0	0	0.586151445	0	0	0	6.601705026	0	0	3.237631131	0.187881041	0.216928439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.5182																																																																																				0			0	0	1.030391617	0	0.876126167	3.182329455	0	0.571925087	0	0	1.02428928	0	0.0028057	0	0	0	0.586151445	0	0	0	6.601705026	0	0	3.237631131	0.187881041	0.216928439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.5182
H0504_801_0	2008	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											13.4085	0.1699	0	0	0.0804	0.095	0.1972	0.1438	0.1741	0.0401	0.115	0	0.0012	0.1432	1.6446	2.6095	0.0993	0.6726	3.5481	1.928	1.3122	0	0	0	0	0	0	0	0	0	0											26.3827		240.2960726	3.045546033	36.18685969	18.0431061	8.336214447	9.85675554	20.45834404	14.9189866	18.05667867	4.156570482	11.93199144	0	0.120468971	14.85847254	50.5107384	80.14213528	3.050482907	20.65702427	108.9687928	59.21205108	40.29968779	0	0	0	0	0	0	0	0	0	0											"$992 Deductible to days 1-60, $248 days 61-90 and $496 days 91+"	"$992 Deductible to days 1-60, $248 days 61-90 and $496 days 91+"	$0 days 1-20 and $124/day for days 21-100	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.004548357	0.004548357	0.145	0	0.226	0.226	0.226	0.226	0.226	0.226	0.226	0.226	0.226	0.226	0.203	0.203	0.203	0.203	0.203	0.203	0.203	0.192532432	0	0	0	0	0	0	0	0	0											1.093	0.01385223	5.247094655	0	1.883984465	2.227626752	4.623585752	3.371690971	4.080809379	0.939384929	2.696630065	0	0.027225987	3.358014795	10.2536799	16.26885346	0.61924803	4.193375927	22.12066493	12.02004637	8.180836621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.2196	992		14.5015	0.183793698	5.247094655	0	1.964345375	2.322645643	4.820803706	3.51550965	4.254875335	0.97945417	2.811654181	0	0.028387305	3.501250119	11.8983278	18.87831037	0.718572857	4.865976108	25.66872823	13.94801217	9.493009029	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.6022																																																																																				0			14.5015	0.183793698	5.247094655	0	1.964345375	2.322645643	4.820803706	3.51550965	4.254875335	0.97945417	2.811654181	0	0.028387305	3.501250119	11.8983278	18.87831037	0.718572857	4.865976108	25.66872823	13.94801217	9.493009029	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.6022
H0504_803_0	2008	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											13.4085	0.1699	0	0	0.0804	0.095	0.1972	0.1438	0.1741	0.0401	0.115	0	0.0012	0.1432	1.6446	2.6095	0.0993	0.6726	3.5481	1.928	1.3122	0	0	0	0	0	0	0	0	0	0											26.3827		240.2960726	3.045546033	36.18685969	18.0431061	8.336214447	9.85675554	20.45834404	14.9189866	18.05667867	4.156570482	11.93199144	0	0.120468971	14.85847254	50.5107384	80.14213528	3.050482907	20.65702427	108.9687928	59.21205108	40.29968779	0	0	0	0	0	0	0	0	0	0											"$992 Deductible to days 1-60, $248 days 61-90 and $496 days 91+"	"$992 Deductible to days 1-60, $248 days 61-90 and $496 days 91+"	$0 days 1-20 and $124/day for days 21-100	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.004548357	0.004548357	0.145	0	0.226	0.226	0.226	0.226	0.226	0.226	0.226	0.226	0.226	0.226	0.203	0.203	0.203	0.203	0.203	0.203	0.203	0.192532432	0	0	0	0	0	0	0	0	0											1.093	0.01385223	5.247094655	0	1.883984465	2.227626752	4.623585752	3.371690971	4.080809379	0.939384929	2.696630065	0	0.027225987	3.358014795	10.2536799	16.26885346	0.61924803	4.193375927	22.12066493	12.02004637	8.180836621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.2196	992		14.5015	0.183793698	5.247094655	0	1.964345375	2.322645643	4.820803706	3.51550965	4.254875335	0.97945417	2.811654181	0	0.028387305	3.501250119	11.8983278	18.87831037	0.718572857	4.865976108	25.66872823	13.94801217	9.493009029	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.6022																																																																																				0			14.5015	0.183793698	5.247094655	0	1.964345375	2.322645643	4.820803706	3.51550965	4.254875335	0.97945417	2.811654181	0	0.028387305	3.501250119	11.8983278	18.87831037	0.718572857	4.865976108	25.66872823	13.94801217	9.493009029	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.6022
H0504_804_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											13.4085	0.1699	0	0	0.0804	0.095	0.1972	0.1438	0.1741	0.0401	0.115	0	0.0012	0.1432	1.6446	2.6095	0.0993	0.6726	3.5481	1.928	1.3122	0	0	0	0	0	0	0	0	0	0											26.3827		240.2960726	3.045546033	36.18685969	18.0431061	8.336214447	9.85675554	20.45834404	14.9189866	18.05667867	4.156570482	11.93199144	0	0.120468971	14.85847254	50.5107384	80.14213528	3.050482907	20.65702427	108.9687928	59.21205108	40.29968779	0	0	0	0	0	0	0	0	0	0											"$992 Deductible to days 1-60, $248 days 61-90 and $496 days 91+"	"$992 Deductible to days 1-60, $248 days 61-90 and $496 days 91+"	$0 days 1-20 and $124/day for days 21-100	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	$131 Deductible and 20% Coins	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.004548357	0.004548357	0.145	0	0.226	0.226	0.226	0.226	0.226	0.226	0.226	0.226	0.226	0.226	0.203	0.203	0.203	0.203	0.203	0.203	0.203	0.192532432	0	0	0	0	0	0	0	0	0											1.093	0.01385223	5.247094655	0	1.883984465	2.227626752	4.623585752	3.371690971	4.080809379	0.939384929	2.696630065	0	0.027225987	3.358014795	10.2536799	16.26885346	0.61924803	4.193375927	22.12066493	12.02004637	8.180836621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.2196	992		14.5015	0.183793698	5.247094655	0	1.964345375	2.322645643	4.820803706	3.51550965	4.254875335	0.97945417	2.811654181	0	0.028387305	3.501250119	11.8983278	18.87831037	0.718572857	4.865976108	25.66872823	13.94801217	9.493009029	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.6022																																																																																				0			14.5015	0.183793698	5.247094655	0	1.964345375	2.322645643	4.820803706	3.51550965	4.254875335	0.97945417	2.811654181	0	0.028387305	3.501250119	11.8983278	18.87831037	0.718572857	4.865976108	25.66872823	13.94801217	9.493009029	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.6022
H0523_002_0	2008	3																																D	D	D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1540.91474	0	818.2134836	293.1551683	233.8816741	25.04388613	0	870.3740689	363.59908	2147.307566	4038.310712	0	0	446.8285299	5110.851328	221.6727349	0	303.088239	0	0	8.491855906	0	0	0	84.42974454	0	0.115484889	0	0	0												$75/day 1-5	$75/day 1-5	"$0/d 1-20, $20/d 21-100"	0	$75 	20%	20%	"50 , 25"	70	$0 	"$0 , $125"	10	10	10	$5 	10	10	10	10	10	$45 	0	Not Covered	Optional	10	Not Covered	10	$500 Every 3 Yrs	0	Fitness												45.96	45.96	8.239447121	0	$75 	20%	20%	46.75	70	$0 	22.5	10	10	10	$5 	10	10	10	10	10	$45 	0	0	0	10	0	10	0	0	0												5.9017	0	0.561802228	0	1.461760463	5.008777226	0	3.39083231	2.120994633	0	7.571832586	0	0	0.372357108	2.129521387	0.184727279	0	0.252573533	0	0	0.03184446	0	0	0	0.07035812	0	9.62E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0592			5.9017	0	0.561802228	0	1.461760463	5.008777226	0	3.39083231	2.120994633	0	7.571832586	0	0	0.372357108	2.129521387	0.184727279	0	0.252573533	0	0	0.03184446	0	0	0	0.07035812	0	9.62E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0592																																																																																				0			5.9017	0	0.561802228	0	1.461760463	5.008777226	0	3.39083231	2.120994633	0	7.571832586	0	0	0.372357108	2.129521387	0.184727279	0	0.252573533	0	0	0.03184446	0	0	0	0.07035812	0	9.62E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0592
H0523_022_0	2008	2																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1852.972419	0	1348.107822	1245.983669	233.8890424	24.47634581	0	808.5512586	552.189703	2010.101427	3041.309208	0	0	674.7804331	4565.443093	16094.00553	0	311.5733318	0	0	8.561755303	0	0	0	162.4188808	0	0	0	0	0												$50/day 1-5	$50/day 1-5	"$0/d 1-20, $20/d 21-100"	0	75	0.2	0.2	"50 , $25"	50	$0 	"$0 , $125"	10	10	10	$5 	10	10	10	10	10	$45 	0	Not Covered	Optional	10	Not Covered	10	$500 Every 3 Yrs	0	Fitness												30.64193704	0	10.2993089	0	75	0.2	0.2	46.75	50	$0 	22.5	10	10	10	$5 	10	10	10	10	10	$45 	0	0	0	10	0	10	0	0	0												4.7316	0	1.157048241	0	1.461806515	4.895269162	0	3.149980945	2.300790429	0	5.702454765	0	0	0.562317028	1.902267955	13.41167128	0	0.259644443	0	0	0.032106582	0	0	0	0.135349067	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7023			4.7316	0	1.157048241	0	1.461806515	4.895269162	0	3.149980945	2.300790429	0	5.702454765	0	0	0.562317028	1.902267955	13.41167128	0	0.259644443	0	0	0.032106582	0	0	0	0.135349067	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7023																																																																																				0			4.7316	0	1.157048241	0	1.461806515	4.895269162	0	3.149980945	2.300790429	0	5.702454765	0	0	0.562317028	1.902267955	13.41167128	0	0.259644443	0	0	0.032106582	0	0	0	0.135349067	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7023
H0523_031_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0	0	0	0	0											$75/day 1-5	$75/day 1-5	"$0/d 1-20, $50/d 21-100"	0	$75 	20%	20%	$50 ER; $25 UC	85	$0 	"$0 X-ray; $125 CAT, PET, MRI"	0	0	0	$0 	0	0	0	0	0	$45 	0	0	0	$0 	Not Covered	$0 	$500 Every 3 Yrs	N/A	Fitness	0											45.96	45.96	20.5986178	0	75	0.2	0.2	47	85	0	22.5	0	0	0	$0 	0	0	0	0	0	45	0	0	0	0	0	0	0	0	0	0											6.0802	0.118449156	2.22589574	0	1.468215941	3.143561179	0.200659672	1.668763771	2.486403242	0	2.150532102	0	0	0	0	0	0	0	0	0	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.5851			6.0802	0.118449156	2.22589574	0	1.468215941	3.143561179	0.200659672	1.668763771	2.486403242	0	2.150532102	0	0	0	0	0	0	0	0	0	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.5851																																																																																				0			6.0802	0.118449156	2.22589574	0	1.468215941	3.143561179	0.200659672	1.668763771	2.486403242	0	2.150532102	0	0	0	0	0	0	0	0	0	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.5851
H0523_032_0	2008	2																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0	0	0	0												$150/day 1-5*	$150/day 1-5*	"$0/d 1-20, $25/d 21-100"	0	$50 	20%	20%	"50 , $25"	75	$0 	"$0 , $75"	15	15	15	$10 	15	15	15	15	15	$45 	0	Not Covered	Optional	15	$100 Every 2 Years	15	$500 Every 3 Yrs	0	Fitness												91.93	0	10.2993089	0	$50 	20%	20%	46.75	75	$0 	25.65	15	15	15	$10 	15	15	15	15	15	$45 	0	0	0	15	0	15	0	0	0												12.1617	0	1.11294787	0	0.978810628	3.143561179	1.67E-05	1.659887368	2.193885213	0	2.451606597	0	0	0	4.613623101	8.551931599	0.252089558	0.729369643	1.196202335	1.807988505	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.896			12.1617	0	1.11294787	0	0.978810628	3.143561179	1.67E-05	1.659887368	2.193885213	0	2.451606597	0	0	0	4.613623101	8.551931599	0.252089558	0.729369643	1.196202335	1.807988505	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.896																																																																																				0			12.1617	0	1.11294787	0	0.978810628	3.143561179	1.67E-05	1.659887368	2.193885213	0	2.451606597	0	0	0	4.613623101	8.551931599	0.252089558	0.729369643	1.196202335	1.807988505	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.896
H0523_034_0	2008	2																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0	0	0	0												$150/day 1-5*	$150/day 1-5*	"$0/d 1-20, $25/d 21-100"	0	$50 	20%	20%	"50 , $25"	75	$0 	"$0 , $75"	15	15	15	$10 	15	15	15	15	15	$45 	0	Not Covered	Optional	15	$100 Every 2 Years	15	$500 Every 3 Yrs	0	Fitness												91.93	0	10.2993089	0	$50 	20%	20%	46.75	75	$0 	25.65	15	15	15	$10 	15	15	15	15	15	$45 	0	0	0	15	0	15	0	0	0												12.1617	0	1.11294787	0	0.978810628	3.143561179	1.67E-05	1.659887368	2.193885213	0	2.451606597	0	0	0	4.613623101	8.551931599	0.252089558	0.729369643	1.196202335	1.807988505	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.896			12.1617	0	1.11294787	0	0.978810628	3.143561179	1.67E-05	1.659887368	2.193885213	0	2.451606597	0	0	0	4.613623101	8.551931599	0.252089558	0.729369643	1.196202335	1.807988505	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.896																																																																																				0			12.1617	0	1.11294787	0	0.978810628	3.143561179	1.67E-05	1.659887368	2.193885213	0	2.451606597	0	0	0	4.613623101	8.551931599	0.252089558	0.729369643	1.196202335	1.807988505	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.896
H0523_047_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1852.972419	0	1348.107822	1245.983669	233.8890424	24.47634581	0	808.5512586	552.189703	2010.101427	3041.309208	0	0	674.7804331	4565.443093	16094.00553	0	311.5733318	0	0	8.561755303	0	0	0	162.4188808	0	0	0	0	0												$50/day 1-5	$50/day 1-5	"$0/d 1-20, $20/d 21-100"	0	75	0.2	0.2	"50 , $25"	50	$0 	"$0 , $125"	10	10	10	$5 	10	10	10	10	10	$45 	0	Not Covered	Optional	10	Not Covered	10	$500 Every 3 Yrs	0	Fitness												30.64193704	0	10.2993089	0	75	0.2	0.2	46.75	50	$0 	22.5	10	10	10	$5 	10	10	10	10	10	$45 	0	0	0	10	0	10	0	0	0												4.7316	0	1.157048241	0	1.461806515	4.895269162	0	3.149980945	2.300790429	0	5.702454765	0	0	0.562317028	1.902267955	13.41167128	0	0.259644443	0	0	0.032106582	0	0	0	0.135349067	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7023			4.7316	0	1.157048241	0	1.461806515	4.895269162	0	3.149980945	2.300790429	0	5.702454765	0	0	0.562317028	1.902267955	13.41167128	0	0.259644443	0	0	0.032106582	0	0	0	0.135349067	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7023																																																																																				0			4.7316	0	1.157048241	0	1.461806515	4.895269162	0	3.149980945	2.300790429	0	5.702454765	0	0	0.562317028	1.902267955	13.41167128	0	0.259644443	0	0	0.032106582	0	0	0	0.135349067	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7023
H0523_048_0	2008	3																																D	D	D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1535.054302	0	815.1016373	292.0402345	232.9921705	24.94863871	0	867.0638444	362.2162325	2139.140882	4022.952126	0	0	445.1291424	5091.413634	201.8135621	0	301.9355276	0	0	8.459559506	0	0	0	84.1086396	0	0.115045674	0	0	0												$75/day 1-5	$75/day 1-5	"$0/d 1-20, $20/d 21-100"	0	$75 	20%	20%	"50 , 25"	70	$0 	"$0 , $125"	10	10	10	$5 	10	10	10	10	10	$45 	0	Not Covered	Optional	10	Not Covered	10	$500 Every 3 Yrs	0	Fitness												45.96	45.96	8.239447121	0	$75 	20%	20%	46.75	70	$0 	22.5	10	10	10	$5 	10	10	10	10	10	$45 	0	0	0	10	0	10	0	0	0												5.8793	0	0.55966557	0	1.456201066	4.989727742	0	3.377936227	2.112928023	0	7.543035237	0	0	0.370940952	2.121422347	0.168177968	0	0.25161294	0	0	0.031723348	0	0	0	0.070090533	0	9.59E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.9328			5.8793	0	0.55966557	0	1.456201066	4.989727742	0	3.377936227	2.112928023	0	7.543035237	0	0	0.370940952	2.121422347	0.168177968	0	0.25161294	0	0	0.031723348	0	0	0	0.070090533	0	9.59E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.9328																																																																																				0			5.8793	0	0.55966557	0	1.456201066	4.989727742	0	3.377936227	2.112928023	0	7.543035237	0	0	0.370940952	2.121422347	0.168177968	0	0.25161294	0	0	0.031723348	0	0	0	0.070090533	0	9.59E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.9328
H0523_051_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0	0	0	0	0											$75/day 1-5	$75/day 1-5	"$0/d 1-20, $50/d 21-100"	0	$75 	20%	20%	$50 ER; $25 UC	85	$0 	"$0 X-ray; $125 CAT, PET, MRI"	0	0	0	$0 	0	0	0	0	0	$45 	0	0	0	$0 	Not Covered	$0 	$500 Every 3 Yrs	N/A	Fitness	0											45.96	45.96	20.5986178	0	75	0.2	0.2	47	85	0	22.5	0	0	0	$0 	0	0	0	0	0	45	0	0	0	0	0	0	0	0	0	0											6.0802	0.118449156	2.22589574	0	1.468215941	3.143561179	0.200659672	1.668763771	2.486403242	0	2.150532102	0	0	0	0	0	0	0	0	0	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.5851			6.0802	0.118449156	2.22589574	0	1.468215941	3.143561179	0.200659672	1.668763771	2.486403242	0	2.150532102	0	0	0	0	0	0	0	0	0	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.5851																																																																																				0			6.0802	0.118449156	2.22589574	0	1.468215941	3.143561179	0.200659672	1.668763771	2.486403242	0	2.150532102	0	0	0	0	0	0	0	0	0	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.5851
H0523_801_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2313.331115	0	270.5018244	711.1933655	241.0498608	25.1362484	0	665.6703383	460.9423828	2573.723597	1659.213031	0	0	530.7027415	6304.320944	7211.483493	0	334.8696476	0	0	8.657592548	0	0	0	75.46310619	0	0	0	0	0	0											200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$39.5 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$39.5 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance	0	N/A	Not Covered	$0 per visit	Not Covered	$0 per visit	Not Covered	N/A	Not Covered	0											144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											27.8699	0	2.25418187	2.370644552	3.01312326	7.540874519	0	2.77362641	7.682373047	8.579078656	7.596430326	0	0	1.769009138	15.76080236	23.73779983	0	1.116232159	0	0	1.73151851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.7956			27.8699	0	2.25418187	2.370644552	3.01312326	7.540874519	0	2.77362641	7.682373047	8.579078656	7.596430326	0	0	1.769009138	15.76080236	23.73779983	0	1.116232159	0	0	1.73151851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.7956		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			27.8699	0	2.25418187	2.370644552	3.01312326	7.540874519	0	2.77362641	7.682373047	8.579078656	7.596430326	0	0	1.769009138	15.76080236	23.73779983	0	1.116232159	0	0	1.73151851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.7956
H0523_805_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2313.331115	0	271.8543335	714.7493323	242.2551101	25.26192964	0	668.99869	463.2470947	2586.592215	1667.509096	0	0	533.3562552	6335.842549	7247.54091	0	336.5439959	0	0	8.700880511	0	0	0	75.84042172	0	0	0	0	0	0											200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$39.5 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$39.5 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance	0	N/A	Not Covered	$0 per visit	Not Covered	$0 per visit	Not Covered	N/A	Not Covered	0											144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											27.8699	0	2.265452779	2.382497774	3.028188876	7.578578892	0	2.787494542	7.720784912	8.621974049	7.634412478	0	0	1.777854184	15.83960637	23.85648883	0	1.12181332	0	0	1.740176102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2252			27.8699	0	2.265452779	2.382497774	3.028188876	7.578578892	0	2.787494542	7.720784912	8.621974049	7.634412478	0	0	1.777854184	15.83960637	23.85648883	0	1.12181332	0	0	1.740176102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2252		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			27.8699	0	2.265452779	2.382497774	3.028188876	7.578578892	0	2.787494542	7.720784912	8.621974049	7.634412478	0	0	1.777854184	15.83960637	23.85648883	0	1.12181332	0	0	1.740176102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2252
H0524_002_0	2008	10																					4000											D	D	D		T	Coin		V	P	V	V			V	V	V	V	V			S				V					V																																																					0		1041.430128	60.00996223	563.7967745		224.2461959	7.960593657		513.4016429	77.54402912	3755.548276	1384.990733			53.82955716	10774.59169	3.290046716	295.9479104	1002.484817			622.4511774				263.56					126.3210734												$200/days 1-10	$200/days 1-10	$100/days 21-100		$300/trip	twenty percent		$50/ER visit	$100/procedure	$20/routine lab	"$20/x-ray, $50/MRI,PET, CAT Scans"			$10/visit	$10/visit	$10/visit	$10/visit	$10/visit			"$8/generic, $45/brand"				$10/visit					$10/visit												138.2	138.2	23.2		276.3	0.2		46.05	87.495	18.42	20.9067			9.21	9.21	9.21	9.21	9.21			16.14				9.21					8.7495												11.9938	0.691114732	1.090007097	0	5.163268661	1.592118731	0	1.970178804	0.565392902	5.764766604	2.412965479	0	0	0.041314185	8.26949912	0.002525111	0.227140021	0.769407097	0	0	0.837196834	0	0	0	0.2022823	0	0	0	0	0.092103853	0	0	0	0	0	0	0	0	0	0	0	41.6851		11.46636912	11.9938	0.691114732	1.090007097	0	5.163268661	1.592118731	0	1.970178804	0.565392902	5.764766604	2.412965479	0	0	0.041314185	8.26949912	0.002525111	0.227140021	0.769407097	0	0	0.837196834	0	0	0	0.2022823	0	0	0	0	0.092103853	0	0	0	0	0	0	0	0	0	0	0	41.6851																																																																																				0			11.9938	0.691114732	1.090007097	0	5.163268661	1.592118731	0	1.970178804	0.565392902	5.764766604	2.412965479	0	0	0.041314185	8.26949912	0.002525111	0.227140021	0.769407097	0	0	0.837196834	0	0	0	0.2022823	0	0	0	0	0.092103853	0	0	0	0	0	0	0	0	0	0	0	41.6851
H0524_003_0	2008	11																					4000											D	D	D		T	Coin		V	P	V	V			V	V	V	V	V			S				V					V																																																					0		982.8471482	56.63425578	467.2490687		221.5510461	7.959763411		420.8730299	72.15357895	3683.610084	1358.46099			52.79844245	10721.40024	3.273804583	294.48689	997.5358015			624.0276684				263.560429					131.6905483												$200/days 1-10	$200/days 1-10	$100/days 21-100		$300/trip	twenty percent		$50/ER visit	$050/procedure	$25/routine lab	"$25/x-ray, $50/MRI,PET, CAT Scans"			$10/visit	$10/visit	$10/visit	$10/visit	$10/visit			"$8/generic, $45/brand"				$10/visit					$10/visit												138.2	138.2	23.2		276.3	0.2		46.05	43.7475	23.025	25.09725			9.21	9.21	9.21	9.21	9.21			16.14				9.21					8.7495												11.3191	0.652237846	0.903348199	0	5.101212836	1.591952682	0	1.615100252	0.263044891	7.067926848	2.841136256	0	0	0.040522805	8.228674684	0.002512645	0.226018688	0.765608728	0	0	0.839317214	0	0	0	0.202282629	0	0	0	0	0.096018871	0	0	0	0	0	0	0	0	0	0	0	41.756		10.61251236	11.3191	0.652237846	0.903348199	0	5.101212836	1.591952682	0	1.615100252	0.263044891	7.067926848	2.841136256	0	0	0.040522805	8.228674684	0.002512645	0.226018688	0.765608728	0	0	0.839317214	0	0	0	0.202282629	0	0	0	0	0.096018871	0	0	0	0	0	0	0	0	0	0	0	41.756																																																																																				0			11.3191	0.652237846	0.903348199	0	5.101212836	1.591952682	0	1.615100252	0.263044891	7.067926848	2.841136256	0	0	0.040522805	8.228674684	0.002512645	0.226018688	0.765608728	0	0	0.839317214	0	0	0	0.202282629	0	0	0	0	0.096018871	0	0	0	0	0	0	0	0	0	0	0	41.756
H0524_008_0	2008	11																					4000											D	D	D		T	Coin		V	P	V	V			V	V	V	V	V			S				V					V																																																					0		1263.187043	58.22656161	804.9228574		276.3867136	11.11910936		581.8395574	72.45161775	2085.481011	735.1434166			27.07524215	9226.07924	2.192717428	287.7583694	826.4520869			139.9947479				292.1067454					126.4287715												$275/days 1-8	$275/days 1-8	$100/days 21-100		$300/trip	twenty percent		$50/ER visit	$225/procedure	$20/routine lab	"$20/x-ray, $50/MRI,PET, CAT Scans"			$30/visit	$30/visit	$30/visit	$30/visit	$30/visit			"$12/generic, $45/brand"				$30/visit					$30/visit												165.825	165.825	21.5		267.9	0.2		44.65	190.87875	17.86	20.77118			26.79	26.79	26.79	26.79	26.79			21.57				26.79					25.4505												17.4557	0.804618298	1.442153453	0	6.170333381	2.223821872	0	2.16492802	1.152456186	3.103890904	1.272483019	0	0	0.060445478	20.5972219	0.004895242	0.64242056	1.845054284	0	0	0.251640559	0	0	0	0.652128309	0	0	0	0	0.268139621	0	0	0	0	0	0	0	0	0	0	0	60.1123	None	21.83297875	17.4557	0.804618298	1.442153453	0	6.170333381	2.223821872	0	2.16492802	1.152456186	3.103890904	1.272483019	0	0	0.060445478	20.5972219	0.004895242	0.64242056	1.845054284	0	0	0.251640559	0	0	0	0.652128309	0	0	0	0	0.268139621	0	0	0	0	0	0	0	0	0	0	0	60.1123																																																																																				0			17.4557	0.804618298	1.442153453	0	6.170333381	2.223821872	0	2.16492802	1.152456186	3.103890904	1.272483019	0	0	0.060445478	20.5972219	0.004895242	0.64242056	1.845054284	0	0	0.251640559	0	0	0	0.652128309	0	0	0	0	0.268139621	0	0	0	0	0	0	0	0	0	0	0	60.1123
H0524_010_0	2008	10																					4000											D	D	D		T	Coin		V	P	V	V			V	V	V	V	V			S				V					V																																																					0		1123.128528	51.77056936	661.1175921		233.4614669	10.8317808		591.2098783	78.99704965	2083.973579	734.6120387			27.05567157	9155.322355	2.175900983	285.5514855	820.1138393			134.1051167				292.1067454					149.7338158												$275/days 1-8	$275/days 1-8	$100/days 21-100		$300/trip	twenty percent		$50/ER visit	$225/procedure	$20/routine lab	"$20/x-ray, $50/MRI,PET, CAT Scans"			$30/visit	$30/visit	$30/visit	$30/visit	$30/visit			"$12/generic, $45/brand"				$30/visit					$30/visit												165.825	165.825	21.5		267.9	0.2		44.65	190.87875	17.86	20.77118			26.79	26.79	26.79	26.79	26.79			21.57				26.79					25.4505												15.5202	0.715404555	1.184502352	0	5.212027249	2.166356161	0	2.199793422	1.256571508	3.101647343	1.271563241	0	0	0.060401787	20.43925716	0.004857699	0.637493691	1.830904146	0	0	0.241053947	0	0	0	0.652128309	0	0	0	0	0.317566707	0	0	0	0	0	0	0	0	0	0	0	56.8118		19.29	15.5202	0.715404555	1.184502352	0	5.212027249	2.166356161	0	2.199793422	1.256571508	3.101647343	1.271563241	0	0	0.060401787	20.43925716	0.004857699	0.637493691	1.830904146	0	0	0.241053947	0	0	0	0.652128309	0	0	0	0	0.317566707	0	0	0	0	0	0	0	0	0	0	0	56.8118																																																																																				0			15.5202	0.715404555	1.184502352	0	5.212027249	2.166356161	0	2.199793422	1.256571508	3.101647343	1.271563241	0	0	0.060401787	20.43925716	0.004857699	0.637493691	1.830904146	0	0	0.241053947	0	0	0	0.652128309	0	0	0	0	0.317566707	0	0	0	0	0	0	0	0	0	0	0	56.8118
H0524_013_0	2008	9																					4000											D	D	D		T	Coin		V	P	V	V			V	V	V	V	V			S				V					V																																																					0		1055.086569	48.63417771	676.0785836		234.1345874	10.46990263		633.6661133	112.0871136	2038.498245	718.5817358			26.46527747	8901.986956	2.11569199	277.650038	797.420606			139.6787326				292.1067454					111.1739713												$275/days 1-8	$275/days 1-8	$100/days 21-100		$300/trip	twenty percent		$50/ER visit	$225/procedure	$20/routine lab	"$20/x-ray, $50/MRI,PET, CAT Scans"			$30/visit	$30/visit	$30/visit	$30/visit	$30/visit			"$12/generic, $45/brand"				$30/visit					$30/visit												165.825	165.825	21.5		267.9	0.2		44.65	190.87875	17.86	20.77118			26.79	26.79	26.79	26.79	26.79			21.57				26.79					25.4505												14.58	0.672063543	1.211307462	0	5.227054665	2.093980525	0	2.357765996	1.782920678	3.033964888	1.243815882	0	0	0.059083732	19.87368588	0.004723282	0.61985371	1.780241503	0	0	0.251072522	0	0	0	0.652128309	0	0	0	0	0.235786096	0	0	0	0	0	0	0	0	0	0	0	55.6794		18.88215684	14.58	0.672063543	1.211307462	0	5.227054665	2.093980525	0	2.357765996	1.782920678	3.033964888	1.243815882	0	0	0.059083732	19.87368588	0.004723282	0.61985371	1.780241503	0	0	0.251072522	0	0	0	0.652128309	0	0	0	0	0.235786096	0	0	0	0	0	0	0	0	0	0	0	55.6794																																																																																				0			14.58	0.672063543	1.211307462	0	5.227054665	2.093980525	0	2.357765996	1.782920678	3.033964888	1.243815882	0	0	0.059083732	19.87368588	0.004723282	0.61985371	1.780241503	0	0	0.251072522	0	0	0	0.652128309	0	0	0	0	0.235786096	0	0	0	0	0	0	0	0	0	0	0	55.6794
H0524_015_0	2008	10																					4000											D	D	D		T	Coin		V	P	V	V			V	V	V	V	V			S				V					V																																																					0		1019.411795	58.74120755	531.1646801		229.0035262	8.620372991		458.4538078	73.4814393	3619.255808	1334.728083			51.87603062	10103.74983	3.085203588	277.52176	940.0686437			627.665119				263.56					91.02726886												$200/days 1-10	$200/days 1-10	$100/days 21-100		$300/trip	twenty percent		$050/ER visit	$100/procedure	$20/routine lab	"$20/x-ray, $50/MRI,PET, CAT Scans"			$15/visit	$15/visit	$15/visit	$15/visit	$15/visit			"$11/generic, $45/brand"				$15/visit					$15/visit												138.2	138.2	23.2		276.3	0.2		46.05	87.495	18.42	20.9067			13.815	13.815	13.815	13.815	13.815			18.48				13.815					13.12425												11.7402	0.676502907	1.026918382	0	5.272806191	1.724074598	0	1.759316488	0.535771544	5.555557666	2.325396635	0	0	0.05972228	11.63194199	0.003551841	0.319496926	1.082254026	0	0	0.966604283	0	0	0	0.30342345	0	0	0	0	0.099555386	0	0	0	0	0	0	0	0	0	0	0	45.0831		11.43506326	11.7402	0.676502907	1.026918382	0	5.272806191	1.724074598	0	1.759316488	0.535771544	5.555557666	2.325396635	0	0	0.05972228	11.63194199	0.003551841	0.319496926	1.082254026	0	0	0.966604283	0	0	0	0.30342345	0	0	0	0	0.099555386	0	0	0	0	0	0	0	0	0	0	0	45.0831																																																																																				0			11.7402	0.676502907	1.026918382	0	5.272806191	1.724074598	0	1.759316488	0.535771544	5.555557666	2.325396635	0	0	0.05972228	11.63194199	0.003551841	0.319496926	1.082254026	0	0	0.966604283	0	0	0	0.30342345	0	0	0	0	0.099555386	0	0	0	0	0	0	0	0	0	0	0	45.0831
H0524_029_0	2008	9																					0											A	A	D		T	Coin		V	P	V	V			V	V	V	V	V			S				V					V																																																					0		371.371177	21.39939081	861.2000719		478.1836769	21.29017587		805.6286831	71.64747708	4253.036168	1568.456919			60.96022116	10870.67224	3.319385136	298.5869745	1011.424301			634.4727667				263.560429					126.0523799												0	0	0		0	0		$50/ER Visit	0	0	0			0	0	0	0	0			0				0					0												0	0	0		0	0		50	0	0	0			0	0	0	0	0			0				0					0												0	0	0	0	0	0	0	3.35678618	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.3568		0	0	0	0	0	0	0	0	3.35678618	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.3568																																																																																				0			0	0	0	0	0	0	0	3.35678618	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.3568
H0524_030_0	2008	9																					0											A	A	D		T	Coin		V	P	V	V			V	V	V	V	V			S				V					V																																																					0		501.702017	23.12593655	1928.929725		640.7924867	30.12753091		1144.082377	65.14058339	2573.182862	907.0609758			33.40694483	10918.9659	2.595057577	340.5589463	978.0971879			145.9379211				284.1067454					149.7636865												0	0	0		0	0		$50/ER Visit	0	0	0			0	0	0	0	0			0				0					0												0	0	0		0	0		50	0	0	0			0	0	0	0	0			0				0					0												0	0	0	0	0	0	0	4.767009904	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.767		0	0	0	0	0	0	0	0	4.767009904	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.767																																																																																				0			0	0	0	0	0	0	0	4.767009904	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.767
H0524_031_0	2008	9																					4000											D	D	D		T	Coin		V	P	V	V			V	V	V	V	V			S				V					V																																																					0		1084.225699	49.97734484	535.134149		222.5434764	10.50140325		630.0696316	73.36066912	2083.20957	734.3427213			27.04575264	9220.407246	2.191369393	287.5814618	825.9440021			139.3641409				292.1067454					128.8275848												$275/days 1-8	$275/days 1-8	$100/days 21-100		$300/trip	twenty percent		$50/ER visit	$225/procedure	$20/routine lab	"$20/x-ray, $50/MRI,PET, CAT Scans"			$30/visit	$30/visit	$30/visit	$30/visit	$30/visit			"$12/generic, $45/brand"				$30/visit					$30/visit												165.825	165.825	21.5		267.9	0.2		44.65	190.87875	17.86	20.77118			26.79	26.79	26.79	26.79	26.79			21.57				26.79					25.4505												14.9826	0.690624434	0.958782017	0	4.96828311	2.100280649	0	2.344384088	1.166916068	3.100510243	1.27109707	0	0	0.060379643	20.58455918	0.004892232	0.642025613	1.843919985	0	0	0.250507043	0	0	0	0.652128309	0	0	0	0	0.273227204	0	0	0	0	0	0	0	0	0	0	0	55.8952		18.2424191	14.9826	0.690624434	0.958782017	0	4.96828311	2.100280649	0	2.344384088	1.166916068	3.100510243	1.27109707	0	0	0.060379643	20.58455918	0.004892232	0.642025613	1.843919985	0	0	0.250507043	0	0	0	0.652128309	0	0	0	0	0.273227204	0	0	0	0	0	0	0	0	0	0	0	55.8952																																																																																				0			14.9826	0.690624434	0.958782017	0	4.96828311	2.100280649	0	2.344384088	1.166916068	3.100510243	1.27109707	0	0	0.060379643	20.58455918	0.004892232	0.642025613	1.843919985	0	0	0.250507043	0	0	0	0.652128309	0	0	0	0	0.273227204	0	0	0	0	0	0	0	0	0	0	0	55.8952
H0524_032_0	2008	9																					4000											D	D	D		T	Coin		V	P	V	V			V	V	V	V	V			S				V					V																																																					0		1172.604316	54.05115405	710.6969538		254.7677859	10.34504697		700.9809677	66.15725318	1977.676755	697.1418291			25.67564833	8696.975829	2.066967991	271.2558085	779.0561556			139.3641409				292.1067454					124.7799584												$275/days 1-8	$275/days 1-8	$100/days 21-100		$300/trip	twenty percent		$50/ER visit	$225/procedure	$20/routine lab	"$20/x-ray, $50/MRI,PET, CAT Scans"			$30/visit	$30/visit	$30/visit	$30/visit	$30/visit			"$12/generic, $45/brand"				$30/visit					$30/visit												165.825	165.825	21.5		267.9	0.2		44.65	190.87875	17.86	20.77118			26.79	26.79	26.79	26.79	26.79			21.57				26.79					25.4505												16.2039	0.746919385	1.273332042	0	5.68769082	2.069009395	0	2.608233351	1.052334483	2.943442237	1.206704868	0	0	0.057320885	19.41599854	0.004614506	0.605578592	1.739242867	0	0	0.250507043	0	0	0	0.652128309	0	0	0	0	0.264642694	0	0	0	0	0	0	0	0	0	0	0	56.7816		20.15121088	16.2039	0.746919385	1.273332042	0	5.68769082	2.069009395	0	2.608233351	1.052334483	2.943442237	1.206704868	0	0	0.057320885	19.41599854	0.004614506	0.605578592	1.739242867	0	0	0.250507043	0	0	0	0.652128309	0	0	0	0	0.264642694	0	0	0	0	0	0	0	0	0	0	0	56.7816																																																																																				0			16.2039	0.746919385	1.273332042	0	5.68769082	2.069009395	0	2.608233351	1.052334483	2.943442237	1.206704868	0	0	0.057320885	19.41599854	0.004614506	0.605578592	1.739242867	0	0	0.250507043	0	0	0	0.652128309	0	0	0	0	0.264642694	0	0	0	0	0	0	0	0	0	0	0	56.7816
H0524_801_0	2008	4																					4000											D	D	D		T	Coin		V	P	V	V			V	V	V	V	V			S				V					V																																																					0		1082.536712	62.37863247	553.6046249		260.6789685	12.22915431		493.8223752	67.55166246	3964.8393	1462.174171			56.82939693	11195.99197	3.418722275	307.522598	1041.692556			597.2994439				283.560429					170.6444759												$300/day	$300/day	$125/days 21-100		$300/trip	twenty percent		$50/ER visit	$250/procedure	$25/routine lab	"$25/x-ray, $50/MRI,PET, CAT Scans"			$40/visit	$40/visit	$40/visit	$40/visit	$40/visit			"$11/generic, $50/brand"				$40/visit					$40/visit												223.5	223.5	11.625		248.7	0.2		41.45	196.8875	20.725	22.59025			33.16	33.16	33.16	33.16	33.16			21.92				33.16					31.502												20.1622	1.16180203	0.53630448	0	5.402571622	2.445830862	0	1.705744788	1.108339829	6.847607874	2.752573338	0	0	0.157038567	30.93825781	0.009447069	0.849787446	2.878543764	0	0	1.091066984	0	0	0	0.783571985	0	0	0	0	0.44797019	0	0	0	0	0	0	0	0	0	0	0	79.2787		23.6435143	20.1622	1.16180203	0.53630448	0	5.402571622	2.445830862	0	1.705744788	1.108339829	6.847607874	2.752573338	0	0	0.157038567	30.93825781	0.009447069	0.849787446	2.878543764	0	0	1.091066984	0	0	0	0.783571985	0	0	0	0	0.44797019	0	0	0	0	0	0	0	0	0	0	0	79.2787																																																																																				0			20.1622	1.16180203	0.53630448	0	5.402571622	2.445830862	0	1.705744788	1.108339829	6.847607874	2.752573338	0	0	0.157038567	30.93825781	0.009447069	0.849787446	2.878543764	0	0	1.091066984	0	0	0	0.783571985	0	0	0	0	0.44797019	0	0	0	0	0	0	0	0	0	0	0	79.2787
H0524_802_0	2008	4																					4000											D	D	D		T	Coin		V	P	V	V			V	V	V	V	V			S				V					V																																																					0		1280.040132	59.00340416	711.5756108		275.6107487	16.45468552		710.2586484	87.23558033	2238.443923	789.0636763			29.06111872	10596.05272	2.518312369	330.4873906	949.171328			150.3694688				292.1067454					183.7704227												$300/day	$300/day	$125/days 21-100		$300/trip	twenty percent		$50/visit	$250/procedure	$25/routine lab	"$25/x-ray, $50/MRI,PET, CAT Scans"			$40/visit	$40/visit	$40/visit	$40/visit	$40/visit			"$11/generic, $50/brand"				$40/visit					$40/visit												223.5	223.5	11.625		248.7	0.2		41.45	207.25	20.725	22.97988			33.16	33.16	33.16	33.16	33.16			22.31				33.16					31.502												23.8407	1.098938403	0.689338873	0	5.712032768	3.290937103	0	2.453351748	1.506631169	3.865979191	1.511049049	0	0	0.080305558	29.28042568	0.006958937	0.913246823	2.62287677	0	0	0.279561904	0	0	0	0.807188306	0	0	0	0	0.482427988	0	0	0	0	0	0	0	0	0	0	0	78.442		25.42645764	23.8407	1.098938403	0.689338873	0	5.712032768	3.290937103	0	2.453351748	1.506631169	3.865979191	1.511049049	0	0	0.080305558	29.28042568	0.006958937	0.913246823	2.62287677	0	0	0.279561904	0	0	0	0.807188306	0	0	0	0	0.482427988	0	0	0	0	0	0	0	0	0	0	0	78.442																																																																																				0			23.8407	1.098938403	0.689338873	0	5.712032768	3.290937103	0	2.453351748	1.506631169	3.865979191	1.511049049	0	0	0.080305558	29.28042568	0.006958937	0.913246823	2.62287677	0	0	0.279561904	0	0	0	0.807188306	0	0	0	0	0.482427988	0	0	0	0	0	0	0	0	0	0	0	78.442
H0524_803_0	2008	8																					4000											D	D	D		T	Coin		V	P	V	V			V	V	V	V	V			S				V					V																																																					0		1079.453996	62.20099819	531.2017949		243.3151115	11.56824826		430.414013	53.10977453	3396.724995	1252.662007			48.68642042	10135.13478	3.094787055	278.3838168	942.9887482			572.4119671				283.560429					165.9840741												$300/day	$300/day	$125/days 21-100		$300/trip	twenty percent		$50/ER visit	$250/procedure	$25/routine lab	"$25/x-ray, $50/MRI,PET, CAT Scans"			$40/visit	$40/visit	$40/visit	$40/visit	$40/visit			"$11/generic, $50/brand"				$40/visit					$40/visit												223.5	223.5	11.625		248.7	0.2		41.45	196.8875	20.725	22.59025			33.16	33.16	33.16	33.16	33.16			21.92				33.16					31.502												20.1048	1.158493591	0.514601739	0	5.042705687	2.313649652	0	1.486721737	0.871387561	5.866427128	2.358162325	0	0	0.134536808	28.00675576	0.008551928	0.76926728	2.605792241	0	0	1.04560586	0	0	0	0.783571985	0	0	0	0	0.435735859	0	0	0	0	0	0	0	0	0	0	0	73.5068		22.27412824	20.1048	1.158493591	0.514601739	0	5.042705687	2.313649652	0	1.486721737	0.871387561	5.866427128	2.358162325	0	0	0.134536808	28.00675576	0.008551928	0.76926728	2.605792241	0	0	1.04560586	0	0	0	0.783571985	0	0	0	0	0.435735859	0	0	0	0	0	0	0	0	0	0	0	73.5068																																																																																				0			20.1048	1.158493591	0.514601739	0	5.042705687	2.313649652	0	1.486721737	0.871387561	5.866427128	2.358162325	0	0	0.134536808	28.00675576	0.008551928	0.76926728	2.605792241	0	0	1.04560586	0	0	0	0.783571985	0	0	0	0	0.435735859	0	0	0	0	0	0	0	0	0	0	0	73.5068
H0524_804_0	2008	8																					4000											D	D	D		T	Coin		V	P	V	V			V	V	V	V	V			S				V					V																																																					0		1595.883757	73.56220474	1303.07127		381.0120139	16.00152357		821.6074414	87.88235002	2262.539065	797.5573452			29.3739395	10205.67622	2.425533484	318.3116763	914.2022515			144.3968498				292.1067454					194.9199374												$300/day	$300/day	$125/days 21-100		$300/trip	twenty percent		$50/visit	$250/procedure	$25/routine lab	"$25/x-ray, $50/MRI,PET, CAT Scans"			$40/visit	$40/visit	$40/visit	$40/visit	$40/visit			"$11/generic, $50/brand"				$40/visit					$40/visit												223.5	223.5	11.625		248.7	0.2		41.45	196.8875	20.725	22.97988			33.16	33.16	33.16	33.16	33.16			22.31				33.16					31.502												29.7233	1.370096063	1.262350293	0	7.896473989	3.200304713	0	2.837969037	1.441911349	3.90759351	1.52731434	0	0	0.081169986	28.2016853	0.006702558	0.879601266	2.526245555	0	0	0.26845781	0	0	0	0.807188306	0	0	0	0	0.511697322	0	0	0	0	0	0	0	0	0	0	0	86.4501		33.40607781	29.7233	1.370096063	1.262350293	0	7.896473989	3.200304713	0	2.837969037	1.441911349	3.90759351	1.52731434	0	0	0.081169986	28.2016853	0.006702558	0.879601266	2.526245555	0	0	0.26845781	0	0	0	0.807188306	0	0	0	0	0.511697322	0	0	0	0	0	0	0	0	0	0	0	86.4501																																																																																				0			29.7233	1.370096063	1.262350293	0	7.896473989	3.200304713	0	2.837969037	1.441911349	3.90759351	1.52731434	0	0	0.081169986	28.2016853	0.006702558	0.879601266	2.526245555	0	0	0.26845781	0	0	0	0.807188306	0	0	0	0	0.511697322	0	0	0	0	0	0	0	0	0	0	0	86.4501
H0524_805_0	2008	4																					4000											D	D	D		T	Coin		V	P	V	V			V	V	V	V	V			S				V					V																																																					0		1082.536712	62.37863247	553.6046249		260.6789685	12.22915431		493.8223752	67.55166246	3964.8393	1462.174171			56.82939693	11195.99197	3.418722275	307.522598	1041.692556			597.2994439				283.560429					170.6444759												$300/day	$300/day	$125/days 21-100		$300/trip	twenty percent		$50/ER visit	$250/procedure	$25/routine lab	"$25/x-ray, $50/MRI,PET, CAT Scans"			$40/visit	$40/visit	$40/visit	$40/visit	$40/visit			"$11/generic, $50/brand"				$40/visit					$40/visit												223.5	223.5	11.625		248.7	0.2		41.45	196.8875	20.725	22.59025			33.16	33.16	33.16	33.16	33.16			21.92				33.16					31.502												20.1622	1.16180203	0.53630448	0	5.402571622	2.445830862	0	1.705744788	1.108339829	6.847607874	2.752573338	0	0	0.157038567	30.93825781	0.009447069	0.849787446	2.878543764	0	0	1.091066984	0	0	0	0.783571985	0	0	0	0	0.44797019	0	0	0	0	0	0	0	0	0	0	0	79.2787		23.6435143	20.1622	1.16180203	0.53630448	0	5.402571622	2.445830862	0	1.705744788	1.108339829	6.847607874	2.752573338	0	0	0.157038567	30.93825781	0.009447069	0.849787446	2.878543764	0	0	1.091066984	0	0	0	0.783571985	0	0	0	0	0.44797019	0	0	0	0	0	0	0	0	0	0	0	79.2787																																																																																				0			20.1622	1.16180203	0.53630448	0	5.402571622	2.445830862	0	1.705744788	1.108339829	6.847607874	2.752573338	0	0	0.157038567	30.93825781	0.009447069	0.849787446	2.878543764	0	0	1.091066984	0	0	0	0.783571985	0	0	0	0	0.44797019	0	0	0	0	0	0	0	0	0	0	0	79.2787
H0524_806_0	2008	4																					4000											D	D	D		T	Coin		V	P	V	V			V	V	V	V	V			S				V					V																																																					0		1280.040132	59.00340416	711.5756108		275.6107487	16.45468552		710.2586484	87.23558033	2238.443923	789.0636763			29.06111872	10596.05272	2.518312369	330.4873906	949.171328			150.3694688				292.1067454					183.7704227												$300/day	$300/day	$125/days 21-100		$300/trip	twenty percent		$50/visit	$250/procedure	$25/routine lab	"$25/x-ray, $50/MRI,PET, CAT Scans"			$40/visit	$40/visit	$40/visit	$40/visit	$40/visit			"$11/generic, $50/brand"				$40/visit					$40/visit												223.5	223.5	11.625		248.7	0.2		41.45	207.25	20.725	22.97988			33.16	33.16	33.16	33.16	33.16			22.31				33.16					31.502												23.8407	1.098938403	0.689338873	0	5.712032768	3.290937103	0	2.453351748	1.506631169	3.865979191	1.511049049	0	0	0.080305558	29.28042568	0.006958937	0.913246823	2.62287677	0	0	0.279561904	0	0	0	0.807188306	0	0	0	0	0.482427988	0	0	0	0	0	0	0	0	0	0	0	78.442		25.42645764	23.8407	1.098938403	0.689338873	0	5.712032768	3.290937103	0	2.453351748	1.506631169	3.865979191	1.511049049	0	0	0.080305558	29.28042568	0.006958937	0.913246823	2.62287677	0	0	0.279561904	0	0	0	0.807188306	0	0	0	0	0.482427988	0	0	0	0	0	0	0	0	0	0	0	78.442																																																																																				0			23.8407	1.098938403	0.689338873	0	5.712032768	3.290937103	0	2.453351748	1.506631169	3.865979191	1.511049049	0	0	0.080305558	29.28042568	0.006958937	0.913246823	2.62287677	0	0	0.279561904	0	0	0	0.807188306	0	0	0	0	0.482427988	0	0	0	0	0	0	0	0	0	0	0	78.442
H0524_807_0	2008	8																					4000											D	D	D		T	Coin		V	P	V	V			V	V	V	V	V			S				V					V																																																					0		1079.453996	62.20099819	531.2017949		243.3151115	11.56824826		430.414013	53.10977453	3396.724995	1252.662007			48.68642042	10135.13478	3.094787055	278.3838168	942.9887482			572.4119671				283.560429					165.9840741												$300/day	$300/day	$125/days 21-100		$300/trip	twenty percent		$50/ER visit	$250/procedure	$25/routine lab	"$25/x-ray, $50/MRI,PET, CAT Scans"			$40/visit	$40/visit	$40/visit	$40/visit	$40/visit			"$11/generic, $50/brand"				$40/visit					$40/visit												223.5	223.5	11.625		248.7	0.2		41.45	196.8875	20.725	22.59025			33.16	33.16	33.16	33.16	33.16			21.92				33.16					31.502												20.1048	1.158493591	0.514601739	0	5.042705687	2.313649652	0	1.486721737	0.871387561	5.866427128	2.358162325	0	0	0.134536808	28.00675576	0.008551928	0.76926728	2.605792241	0	0	1.04560586	0	0	0	0.783571985	0	0	0	0	0.435735859	0	0	0	0	0	0	0	0	0	0	0	73.5068		22.27412824	20.1048	1.158493591	0.514601739	0	5.042705687	2.313649652	0	1.486721737	0.871387561	5.866427128	2.358162325	0	0	0.134536808	28.00675576	0.008551928	0.76926728	2.605792241	0	0	1.04560586	0	0	0	0.783571985	0	0	0	0	0.435735859	0	0	0	0	0	0	0	0	0	0	0	73.5068																																																																																				0			20.1048	1.158493591	0.514601739	0	5.042705687	2.313649652	0	1.486721737	0.871387561	5.866427128	2.358162325	0	0	0.134536808	28.00675576	0.008551928	0.76926728	2.605792241	0	0	1.04560586	0	0	0	0.783571985	0	0	0	0	0.435735859	0	0	0	0	0	0	0	0	0	0	0	73.5068
H0524_808_0	2008	8																					4000											D	D	D		T	Coin		V	P	V	V			V	V	V	V	V			S				V					V																																																					0		1595.883757	73.56220474	1303.07127		381.0120139	16.00152357		821.6074414	87.88235002	2262.539065	797.5573452			29.3739395	10205.67622	2.425533484	318.3116763	914.2022515			144.3968498				292.1067454					194.9199374												$300/day	$300/day	$125/days 21-100		$300/trip	twenty percent		$50/visit	$250/procedure	$25/routine lab	"$25/x-ray, $50/MRI,PET, CAT Scans"			$40/visit	$40/visit	$40/visit	$40/visit	$40/visit			"$11/generic, $50/brand"				$40/visit					$40/visit												223.5	223.5	11.625		248.7	0.2		41.45	196.8875	20.725	22.97988			33.16	33.16	33.16	33.16	33.16			22.31				33.16					31.502												29.7233	1.370096063	1.262350293	0	7.896473989	3.200304713	0	2.837969037	1.441911349	3.90759351	1.52731434	0	0	0.081169986	28.2016853	0.006702558	0.879601266	2.526245555	0	0	0.26845781	0	0	0	0.807188306	0	0	0	0	0.511697322	0	0	0	0	0	0	0	0	0	0	0	86.4501		33.40607781	29.7233	1.370096063	1.262350293	0	7.896473989	3.200304713	0	2.837969037	1.441911349	3.90759351	1.52731434	0	0	0.081169986	28.2016853	0.006702558	0.879601266	2.526245555	0	0	0.26845781	0	0	0	0.807188306	0	0	0	0	0.511697322	0	0	0	0	0	0	0	0	0	0	0	86.4501																																																																																				0			29.7233	1.370096063	1.262350293	0	7.896473989	3.200304713	0	2.837969037	1.441911349	3.90759351	1.52731434	0	0	0.081169986	28.2016853	0.006702558	0.879601266	2.526245555	0	0	0.26845781	0	0	0	0.807188306	0	0	0	0	0.511697322	0	0	0	0	0	0	0	0	0	0	0	86.4501
H0532_001_0	2008	4																					3500											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	222.9558624	3.912692792	0	0	200.8769078	12.00757293	8.353583041	264.0813164	260.0743821	0	0	58.73147224	0	64.12201633	5159.82033	5865.885565	180.4856617	489.9089981	0	1484.938616	7.129818572	680.6974864	0	0	361.4114222	0	154.8922216	0	0	0	0											PBP: 1A IP Acute: $450 per admit	1B IP Psych: $450 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $40"	9B ASC Services: $100	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $100	12 Renal Dialysis: $0	"3 CORF: $20, 5 Partial Hosp: $20, 9C OP Substance Abuse: $20, 9D Cardiac Rehab: $20"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $15, 14D Pap Smears: $0, 14D Pelvic Exams: $15, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $20"	"7B Chiropractic: $20, 7D Physician Specialist: $20, 7F Podiatry: $20"	"7E Mental Health: $20, 7H Psychiatric: $20"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	Included in i.2.	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $20"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $20	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $20	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											400.3821483	400.3821483	0	0	88.97381074	0.177947442	0.17799207	43.98643235	88.97381074	0	0	88.97381074	0	17.79476215	13.34607161	17.79476215	17.79476215	17.79476215	0	17.79476215	0.177943462	17.79476215	0	0	17.79476215	0	17.79476215	0	0	0	0											7.439	0.130547696	0	0	1.489398665	2.136716893	1.486871533	0.96799958	1.928317405	0	0	0.435463575	0	0.095086336	5.738610969	8.698503202	0.267641618	0.726484508	0	2.202010789	1.268704598	1.009404155	0	0	0.535935858	0	0.229689187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.7863	0	4.99	7.439	0.130547696	0	0	1.489398665	2.136716893	1.486871533	0.96799958	1.928317405	0	0	0.435463575	0	0.095086336	5.738610969	8.698503202	0.267641618	0.726484508	0	2.202010789	1.268704598	1.009404155	0	0	0.535935858	0	0.229689187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.7863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.439	0.130547696	0	0	1.489398665	2.136716893	1.486871533	0.96799958	1.928317405	0	0	0.435463575	0	0.095086336	5.738610969	8.698503202	0.267641618	0.726484508	0	2.202010789	1.268704598	1.009404155	0	0	0.535935858	0	0.229689187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.7863
H0532_801_0	2008	3																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	265.6586665	3.353984036	47.22455965	27.77861133	5.688981183	12.00757293	8.353583041	4.457353338	26.13576734	7.861788564	22.55584576	0.877431759	0.152088172	23.79594932	40.48620798	107.472275	1.416623773	3.65398989	36.04520489	41.81288739	7.129818572	5.85762687	0	0	0	0	0	0	0	0	0											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing											0.067139235	0.067139235	0.152887703	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234											17.8361	0.225183922	7.220054432	0	1.331221597	2.809772066	1.954738432	1.043020681	6.115769558	1.839658524	5.278067908	0.205319032	0.035588632	5.56825214	9.473772668	25.14851234	0.331489963	0.855033634	8.434577943	9.784215649	1.668377546	1.370684688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.5294	0	0	17.8361	0.225183922	7.220054432	0	1.331221597	2.809772066	1.954738432	1.043020681	6.115769558	1.839658524	5.278067908	0.205319032	0.035588632	5.56825214	9.473772668	25.14851234	0.331489963	0.855033634	8.434577943	9.784215649	1.668377546	1.370684688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.5294	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.8361	0.225183922	7.220054432	0	1.331221597	2.809772066	1.954738432	1.043020681	6.115769558	1.839658524	5.278067908	0.205319032	0.035588632	5.56825214	9.473772668	25.14851234	0.331489963	0.855033634	8.434577943	9.784215649	1.668377546	1.370684688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.5294
H0532_802_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	265.6586665	3.353984036	47.22455965	27.77861133	5.688981183	12.00757293	8.353583041	4.457353338	26.13576734	7.861788564	22.55584576	0.877431759	0.152088172	23.79594932	40.48620798	107.472275	1.416623773	3.65398989	36.04520489	41.81288739	7.129818572	5.85762687	0	0	0	0	0	0	0	0	0											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing											0.067139235	0.067139235	0.152887703	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234											17.8361	0.225183922	7.220054432	0	1.331221597	2.809772066	1.954738432	1.043020681	6.115769558	1.839658524	5.278067908	0.205319032	0.035588632	5.56825214	9.473772668	25.14851234	0.331489963	0.855033634	8.434577943	9.784215649	1.668377546	1.370684688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.5294	0	0	17.8361	0.225183922	7.220054432	0	1.331221597	2.809772066	1.954738432	1.043020681	6.115769558	1.839658524	5.278067908	0.205319032	0.035588632	5.56825214	9.473772668	25.14851234	0.331489963	0.855033634	8.434577943	9.784215649	1.668377546	1.370684688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.5294	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.8361	0.225183922	7.220054432	0	1.331221597	2.809772066	1.954738432	1.043020681	6.115769558	1.839658524	5.278067908	0.205319032	0.035588632	5.56825214	9.473772668	25.14851234	0.331489963	0.855033634	8.434577943	9.784215649	1.668377546	1.370684688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.5294
H0540_001_0	2008	12	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		none	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	A	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	none	1288.682958	8.064151024	351.8085728	7.189311463	219.570708	9.43390328	3.36340602	184.6636453	388.7682627	804.0373285	850.7067651	47.70683457	13.76910052	0.363762929	5276.22668	1872.703208	0.104732604	410.7821044	562.6661261	0	26.84783182	0	0	0	5.109492247	330.8865379	0.685313709	0	0		0	1035.08068	16.92171257	72.18007197	393.6501005	106.5183086	0.046337246	798.0485292	3.711439324	1.222938049		"$150/day, days(1-5) no yrly max"	"$500/admit, no yrly max"	$50/day for days 21 to 100	15% Coinsurance	$100 copay	30% coinsurance	30% coinsurance	$50 copay	$150 copay	$10 copay	$15/$35 copay for Lower/Higher Tier	$100 copay	$25 copay	$15 copay	$15 copay	$15 copay	50% coinsurance	$15 copay	$15/$35 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$15 copay	$0 copay	$15 copay	$15 copay	$10 copay	$0 copay	$10 copay	$10 copay	$15 copay		150	500	50	0.15	100	0.3	0.3	50	150	10	19.33492	100	25	15	15	15	0.5	15	23.33	0	0.2	0	0	0	0.5	0	10	0	0		0	15	0	15	15	10	0	10	10	15		16.1085	0.336006293	1.465869053	1.078396719	1.8297559	2.830170984	1.009021806	0.769431856	4.859603284	0.670031107	1.370695604	0.397556955	0.028685626	0.000454704	6.59528335	2.34087901	0.052366302	0.51347763	1.093916727	0	5.369566365	0	0	0	2.554746123	0	0.000571095	0	0	0	0	1.293850849	0	0.09022509	0.492062626	0.088765257	0	0.665040441	0.003092866	0.001528673	0	53.9096		0	16.1085	0.336006293	1.465869053	1.078396719	1.8297559	2.830170984	1.009021806	0.769431856	4.859603284	0.670031107	1.370695604	0.397556955	0.028685626	0.000454704	6.59528335	2.34087901	0.052366302	0.51347763	1.093916727	0	5.369566365	0	0	0	2.554746123	0	0.000571095	0	0	0	0	1.293850849	0	0.09022509	0.492062626	0.088765257	0	0.665040441	0.003092866	0.001528673	0	53.9096	none																																																																																			0		0	16.1085	0.336006293	1.465869053	1.078396719	1.8297559	2.830170984	1.009021806	0.769431856	4.859603284	0.670031107	1.370695604	0.397556955	0.028685626	0.000454704	6.59528335	2.34087901	0.052366302	0.51347763	1.093916727	0	5.369566365	0	0	0	2.554746123	0	0.000571095	0	0	0	0	1.293850849	0	0.09022509	0.492062626	0.088765257	0	0.665040441	0.003092866	0.001528673	0	53.9096
H0540_010_0	2008	10	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	349.8699234	7.882928111	327.1796448	0	214.0023177	9.887162786	3.52500358	187.9240912	396.5097046	820.0479158	867.6466688	48.65680842	14.04328105	0.371006447	5362.806621	1903.433225	0.108198012	417.5228099	571.8991637	0	28.74231235	0	0	0	4.996694235	340.4020924	0.416034682	0	0		0	1055.691973	17.25867026	73.36450674	400.1096793	108.2662147	0.04787046	811.144061	3.772341976	1.244530406		$100/admit with no yearly max	$100/admit with no yearly max	$50/day for days 21 to 100	$0 Copay	$50 copay	20% coinsurance	20% coinsurance	$25 copay	$50 copay	$0 copay	$0/$35 copay for Lower/Higher Tier	$50 copay	$10 copay	$10 copay	$10 copay	$10 copay	50% coinsurance	$10 copay	$0/$35 copay for Lower/Higher Tier	N/A	0% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay		113.1675498	113.1675498	50	0	50	0.2	0.2	25	50	0	7.586114	50	10	10	10	10	0.5	10	15.88	0	0	0	0	0	0.5	0	10	0	0		0	10	0	10	10	10	0	10	10	10		3.2995	0.074340972	1.36324852	0	0.891676324	1.977432557	0.705000716	0.391508523	1.652123769	0	0.548505545	0.202736702	0.011702734	0.000309172	4.469005517	1.586194354	0.054099006	0.347935675	0.756813227	0	0	0	0	0	2.498347117	0	0.000346696	0	0	0	0	0.879743311	0	0.061137089	0.333424733	0.090221846	0	0.675953384	0.003143618	0.001037109	0	22.8755		0	3.2995	0.074340972	1.36324852	0	0.891676324	1.977432557	0.705000716	0.391508523	1.652123769	0	0.548505545	0.202736702	0.011702734	0.000309172	4.469005517	1.586194354	0.054099006	0.347935675	0.756813227	0	0	0	0	0	2.498347117	0	0.000346696	0	0	0	0	0.879743311	0	0.061137089	0.333424733	0.090221846	0	0.675953384	0.003143618	0.001037109	0	22.8755	None																																																																																			0		0	3.2995	0.074340972	1.36324852	0	0.891676324	1.977432557	0.705000716	0.391508523	1.652123769	0	0.548505545	0.202736702	0.011702734	0.000309172	4.469005517	1.586194354	0.054099006	0.347935675	0.756813227	0	0	0	0	0	2.498347117	0	0.000346696	0	0	0	0	0.879743311	0	0.061137089	0.333424733	0.090221846	0	0.675953384	0.003143618	0.001037109	0	22.8755
H0540_012_0	2008	11	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	A	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1327.771464	8.308753949	362.4796782	7.632060251	226.2307566	10.01488371	3.57053906	190.2648881	400.5604345	828.425498	876.5105183	49.15388476	14.18674674	0.374796636	5436.265905	1929.506297	0.111182489	423.242003	579.7329915	0	28.50123703	0	0	0	5.315354993	340.9230334	0.706100738	0	0		0	1066.476887	17.43498426	74.36944773	405.5903488	109.7492364	0.049190894	822.2550456	3.824015206	1.260032372		"$150/day, days(1-5) no yrly max"	"$500/admit, no yrly max"	$50/day for days 21 to 100	15% Coinsurance	$100 copay	30% coinsurance	30% coinsurance	$50 copay	$150 copay	$10 copay	$15/$35 copay for Lower/Higher Tier	$100 copay	$25 copay	$15 copay	$15 copay	$15 copay	50% coinsurance	$15 copay	$15/$35 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$15 copay	$0 copay	$15 copay	$15 copay	$10 copay	$0 copay	$10 copay	$10 copay	$15 copay		150	500	50	0.15	100	0.3	0.3	50	150	10	19.33492	100	25	15	15	15	0.5	15	23.33	0	0.2	0	0	0	0.5	0	10	0	0		0	15	0	15	15	10	0	10	10	15		16.5971	0.346198081	1.510331993	1.144809038	1.885256305	3.004465112	1.071161718	0.792770367	5.007005431	0.690354582	1.412271729	0.409615706	0.029555722	0.000468496	6.795332381	2.411882871	0.055591244	0.529052504	1.127097558	0	5.700247406	0	0	0	2.657677496	0	0.000588417	0	0	0	0	1.333096109	0	0.09296181	0.506987936	0.091457697	0	0.685212538	0.003186679	0.00157504	0	55.8934		0	16.5971	0.346198081	1.510331993	1.144809038	1.885256305	3.004465112	1.071161718	0.792770367	5.007005431	0.690354582	1.412271729	0.409615706	0.029555722	0.000468496	6.795332381	2.411882871	0.055591244	0.529052504	1.127097558	0	5.700247406	0	0	0	2.657677496	0	0.000588417	0	0	0	0	1.333096109	0	0.09296181	0.506987936	0.091457697	0	0.685212538	0.003186679	0.00157504	0	55.8934	None																																																																																			0		0	16.5971	0.346198081	1.510331993	1.144809038	1.885256305	3.004465112	1.071161718	0.792770367	5.007005431	0.690354582	1.412271729	0.409615706	0.029555722	0.000468496	6.795332381	2.411882871	0.055591244	0.529052504	1.127097558	0	5.700247406	0	0	0	2.657677496	0	0.000588417	0	0	0	0	1.333096109	0	0.09296181	0.506987936	0.091457697	0	0.685212538	0.003186679	0.00157504	0	55.8934
H0540_020_0	2008	14	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	A	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1223.27628	7.654857706	317.7136199	9.291369496	207.8107611	9.323324427	3.323982086	182.487035	377.3370527	796.3221304	842.5437471	47.2490602	13.63697812	0.360272416	5207.648859	1848.362725	0.10202777	405.4429589	763.8768622	0	27.10321541	0	0	0	4.790244805	330.553513	0.403997886	0	0		0	1025.148488	16.75933906	71.2419106	388.5336284	105.1338356	0.045140537	787.6758836	3.663199846	1.20852341		"$200/day, days(1-5) no yrly max"	"$900/admit, no yrly max"	$100/day for days 21 to 100	15% Coinsurance	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$20 copay	$30/$35 copay for Lower/Higher Tier	$150 copay	$25 copay	$30 copay	$15 copay	$30 copay	50% coinsurance	$30 copay	$30/$35 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$25 copay	N/A	N/A		N/A	$30 copay	$0 copay	$30 copay	$30 copay	$25 copay	$0 copay	$25 copay	$25 copay	$15 copay		200	900	100	0.15	150	0.3	0.3	50	200	20	31.08373	150	25	30	15	30	0.5	30	30.79	0	0.2	0	0	0	0.5	0	25	0	0		0	30	0	30	30	25	0	25	25	15		20.3879	0.574114328	2.647613499	1.393705424	2.597634514	2.796997328	0.997194626	0.760362646	6.288950878	1.327203551	2.182450196	0.590613253	0.028410371	0.000900681	6.509561074	4.620906813	0.051013885	1.013607397	1.959980716	0	5.420643083	0	0	0	2.395122402	0	0.000841662	0	0	0	0	2.562871221	0	0.178104777	0.971334071	0.219028824	0	1.640991424	0.007631666	0.001510654	0	70.1272		0	20.3879	0.574114328	2.647613499	1.393705424	2.597634514	2.796997328	0.997194626	0.760362646	6.288950878	1.327203551	2.182450196	0.590613253	0.028410371	0.000900681	6.509561074	4.620906813	0.051013885	1.013607397	1.959980716	0	5.420643083	0	0	0	2.395122402	0	0.000841662	0	0	0	0	2.562871221	0	0.178104777	0.971334071	0.219028824	0	1.640991424	0.007631666	0.001510654	0	70.1272	None																																																																																			0		0	20.3879	0.574114328	2.647613499	1.393705424	2.597634514	2.796997328	0.997194626	0.760362646	6.288950878	1.327203551	2.182450196	0.590613253	0.028410371	0.000900681	6.509561074	4.620906813	0.051013885	1.013607397	1.959980716	0	5.420643083	0	0	0	2.395122402	0	0.000841662	0	0	0	0	2.562871221	0	0.178104777	0.971334071	0.219028824	0	1.640991424	0.007631666	0.001510654	0	70.1272
H0540_021_0	2008	12	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	A	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1267.411593	7.931041869	329.1765985	9.973922106	215.3084891	10.00822448	3.568164889	189.0710932	398.9298169	825.0531101	872.9423839	48.95378714	14.12899476	0.373270899	5395.538719	1915.050903	0.109522825	420.0711765	791.4372297	0	29.09424272	0	0	0	5.035884409	342.4797497	0.418573966	0	0		0	1062.13543	17.36400922	73.81228985	402.5517642	108.9270217	0.048456602	816.0949102	3.795366611	1.252126445		"$200/day, days(1-5) no yrly max"	"$900/admit, no yrly max"	$100/day for days 21 to 100	15% Coinsurance	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$20 copay	$30/$35 copay for Lower/Higher Tier	$150 copay	$25 copay	$30 copay	$15 copay	$30 copay	50% coinsurance	$30 copay	$30/$35 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$50 maximum per year	$25 copay	N/A	N/A		N/A	$30 copay	$0 copay	$30 copay	$30 copay	$25 copay	$0 copay	$25 copay	$25 copay	Min. $15 / Max. $30copay		200	900	100	0.15	150	0.3	0.3	50	200	20	31.08373	150	25	30	15	30	0.5	30	30.79	0	0.2	0	0	0	0.5	0	25	0	0		0	30	0	30	30	25	0	25	25	18.92933608		21.1235	0.59482814	2.743138321	1.496088316	2.691356114	3.002467343	1.070449467	0.787796222	6.648830282	1.375088517	2.261192114	0.611922339	0.029435406	0.000933177	6.744423398	4.787627258	0.054761412	1.050177941	2.030696025	0	5.818848545	0	0	0	2.517942204	0	0.000872029	0	0	0	0	2.655338576	0	0.184530725	1.006379411	0.226931295	0	1.70019773	0.007907014	0.00197516	0	73.2257		0	21.1235	0.59482814	2.743138321	1.496088316	2.691356114	3.002467343	1.070449467	0.787796222	6.648830282	1.375088517	2.261192114	0.611922339	0.029435406	0.000933177	6.744423398	4.787627258	0.054761412	1.050177941	2.030696025	0	5.818848545	0	0	0	2.517942204	0	0.000872029	0	0	0	0	2.655338576	0	0.184530725	1.006379411	0.226931295	0	1.70019773	0.007907014	0.00197516	0	73.2257	None																																																																																			0		0	21.1235	0.59482814	2.743138321	1.496088316	2.691356114	3.002467343	1.070449467	0.787796222	6.648830282	1.375088517	2.261192114	0.611922339	0.029435406	0.000933177	6.744423398	4.787627258	0.054761412	1.050177941	2.030696025	0	5.818848545	0	0	0	2.517942204	0	0.000872029	0	0	0	0	2.655338576	0	0.184530725	1.006379411	0.226931295	0	1.70019773	0.007907014	0.00197516	0	73.2257
H0540_029_0	2008	11	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	354.220954	7.980961292	331.248496	0	216.66368	10.13460815	3.613223608	190.2611411	401.4407539	830.2461447	878.4368424	49.2619112	14.21792523	0.375620334	5429.499223	1927.104583	0.110905877	422.7151811	579.0113806	0	29.46164428	0	0	0	5.076656835	344.6353797	0.421208547	0	0		0	1068.820704	17.47330146	74.27687786	405.0854984	109.6126283	0.049068511	821.2315603	3.81925534	1.260007557		$100/admit with no yearly max	$100/admit with no yearly max	$50/day for days 21 to 100	$0 Copay	$50 copay	20% coinsurance	20% coinsurance	$25 copay	$50 copay	$0 copay	$0/$35 copay for Lower/Higher Tier	$50 copay	$10 copay	$10 copay	$10 copay	$10 copay	50% coinsurance	$10 copay	$0/$35 copay for Lower/Higher Tier	N/A	0% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay		113.1675498	113.1675498	50	0	50	0.2	0.2	25	50	0	7.586114	50	10	10	10	10	0.5	10	15.88	0	0	0	0	0	0.5	0	10	0	0		0	10	0	10	10	10	0	10	10	10		3.3405	0.075265486	1.380202067	0	0.902765333	2.02692163	0.722644722	0.396377377	1.672669808	0	0.555326836	0.205257963	0.011848271	0.000313017	4.524582686	1.605920486	0.055452938	0.352262651	0.76622506	0	0	0	0	0	2.538328417	0	0.000351007	0	0	0	0	0.89068392	0	0.061897398	0.337571249	0.091343857	0	0.684359634	0.003182713	0.001050006	0	23.2033		0	3.3405	0.075265486	1.380202067	0	0.902765333	2.02692163	0.722644722	0.396377377	1.672669808	0	0.555326836	0.205257963	0.011848271	0.000313017	4.524582686	1.605920486	0.055452938	0.352262651	0.76622506	0	0	0	0	0	2.538328417	0	0.000351007	0	0	0	0	0.89068392	0	0.061897398	0.337571249	0.091343857	0	0.684359634	0.003182713	0.001050006	0	23.2033	None																																																																																			0		0	3.3405	0.075265486	1.380202067	0	0.902765333	2.02692163	0.722644722	0.396377377	1.672669808	0	0.555326836	0.205257963	0.011848271	0.000313017	4.524582686	1.605920486	0.055452938	0.352262651	0.76622506	0	0	0	0	0	2.538328417	0	0.000351007	0	0	0	0	0.89068392	0	0.061897398	0.337571249	0.091343857	0	0.684359634	0.003182713	0.001050006	0	23.2033
H0540_032_0	2008	11	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	372.4355307	8.391354381	348.2817942	0	227.8048538	11.20367952	3.994372427	200.0446565	422.083444	872.938656	923.6073921	51.79503311	14.94903243	0.394935299	5708.692277	2026.199212	0.122605027	444.4518344	608.7850206	0	32.56947046	0	0	0	5.41615479	362.3570517	0.442867727	0	0		0	1123.78108	18.37180502	78.09630715	425.9156068	115.2490752	0.054244611	863.460528	4.015647221	1.32479905		$100/admit with no yearly max	$100/admit with no yearly max	$50/day for days 21 to 100	$0 Copay	$50 copay	20% coinsurance	20% coinsurance	$25 copay	$50 copay	$0 copay	$0/$35 copay for Lower/Higher Tier	$50 copay	$10 copay	$10 copay	$10 copay	$10 copay	50% coinsurance	$10 copay	$0/$35 copay for Lower/Higher Tier	N/A	0% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay		113.1675498	113.1675498	50	0	50	0.2	0.2	25	50	0	7.586114	50	10	10	10	10	0.5	10	15.88	0	0	0	0	0	0.5	0	10	0	0		0	10	0	10	10	10	0	10	10	10		3.5123	0.079135751	1.451174142	0	0.949186891	2.240735904	0.798874485	0.416759701	1.758681017	0	0.583882581	0.215812638	0.012457527	0.000329113	4.757243564	1.688499343	0.061302513	0.370376529	0.805625511	0	0	0	0	0	2.708077395	0	0.000369056	0	0	0	0	0.936484233	0	0.065080256	0.354929672	0.096040896	0	0.71955044	0.003346373	0.001103999	0	24.5874		0	3.5123	0.079135751	1.451174142	0	0.949186891	2.240735904	0.798874485	0.416759701	1.758681017	0	0.583882581	0.215812638	0.012457527	0.000329113	4.757243564	1.688499343	0.061302513	0.370376529	0.805625511	0	0	0	0	0	2.708077395	0	0.000369056	0	0	0	0	0.936484233	0	0.065080256	0.354929672	0.096040896	0	0.71955044	0.003346373	0.001103999	0	24.5874	None																																																																																			0		0	3.5123	0.079135751	1.451174142	0	0.949186891	2.240735904	0.798874485	0.416759701	1.758681017	0	0.583882581	0.215812638	0.012457527	0.000329113	4.757243564	1.688499343	0.061302513	0.370376529	0.805625511	0	0	0	0	0	2.708077395	0	0.000369056	0	0	0	0	0.936484233	0	0.065080256	0.354929672	0.096040896	0	0.71955044	0.003346373	0.001103999	0	24.5874
H0540_033_0	2008	10	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	382.4638693	8.617303131	357.6597602	0	233.9388126	11.81515146	4.212376401	205.4311338	433.4486209	896.4437291	948.4767906	53.18968556	15.35155568	0.405569475	5862.406663	2080.757411	0.129296537	456.4193109	625.177394	0	34.3470398	0	0	0	5.606346361	372.1140133	0.454792549	0	0		0	1154.04043	18.86649112	80.19915756	437.3839699	118.352315	0.057205161	886.7103895	4.123774041	1.360471085		$100/admit with no yearly max	$100/admit with no yearly max	$50/day for days 21 to 100	$0 Copay	$50 copay	20% coinsurance	20% coinsurance	$25 copay	$50 copay	$0 copay	$0/$35 copay for Lower/Higher Tier	$50 copay	$10 copay	$10 copay	$10 copay	$10 copay	50% coinsurance	$10 copay	$0/$35 copay for Lower/Higher Tier	N/A	0% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay		113.1675498	113.1675498	50	0	50	0.2	0.2	25	50	0	7.586114	50	10	10	10	10	0.5	10	15.88	0	0	0	0	0	0.5	0	10	0	0		0	10	0	10	10	10	0	10	10	10		3.6069	0.08126659	1.490249001	0	0.974745052	2.363030292	0.84247528	0.427981529	1.80603592	0	0.599604422	0.22162369	0.012792963	0.000337975	4.885338886	1.733964509	0.064648268	0.380349426	0.827318085	0	0	0	0	0	2.803173181	0	0.000378994	0	0	0	0	0.961700358	0	0.066832631	0.364486642	0.098626929	0	0.738925325	0.003436478	0.001133726	0	25.3573		0	3.6069	0.08126659	1.490249001	0	0.974745052	2.363030292	0.84247528	0.427981529	1.80603592	0	0.599604422	0.22162369	0.012792963	0.000337975	4.885338886	1.733964509	0.064648268	0.380349426	0.827318085	0	0	0	0	0	2.803173181	0	0.000378994	0	0	0	0	0.961700358	0	0.066832631	0.364486642	0.098626929	0	0.738925325	0.003436478	0.001133726	0	25.3573	None																																																																																			0		0	3.6069	0.08126659	1.490249001	0	0.974745052	2.363030292	0.84247528	0.427981529	1.80603592	0	0.599604422	0.22162369	0.012792963	0.000337975	4.885338886	1.733964509	0.064648268	0.380349426	0.827318085	0	0	0	0	0	2.803173181	0	0.000378994	0	0	0	0	0.961700358	0	0.066832631	0.364486642	0.098626929	0	0.738925325	0.003436478	0.001133726	0	25.3573
H0540_088_0	2008	12	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	D	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1278.644298	33.85947086	332.0939961	10.15149755	217.2167064	10.18641064	3.631692401	190.746776	402.4654173	832.3653188	880.6790215	49.38765049	14.25421599	0.376579092	5443.357828	1932.023449	0.111472766	423.7941467	798.4515105	0	29.61223584	0	0	0	5.093327868	345.5150494	163.498049	0	0		0	1071.548831	17.51790145	74.46646697	406.1194649	109.8924106	0.049319322	823.3277249	3.829003855	1.263223682		"$250/day, days(1-5) no yrly max"	"$250/day, days(1-5) no yrly max"	$100/day for days 21 to 100	15% Coinsurance	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$175 copay	$20 copay	$30/$100 copay for Lower/Higher Tier	$150 copay	$25 copay	$30 copay	$20 copay	$30 copay	50% coinsurance	$30 copay	$30/$100 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$25 copay	N/A	N/A		N/A	$30 copay	$0 copay	$30 copay	$30 copay	$10 copay	$0 copay	$25 copay	$25 copay	Min. $20 / Max. $30 copay		249.4595639	249.4595639	99.78382555	0.149675738	149.6757383	0.299351477	0.299351477	49.89191278	174.6216947	19.95676511	45.0745773	149.6757383	24.94595639	29.93514767	19.95676511	29.93514767	0.498919128	29.93514767	42.21853659	0	0.199567651	0	0	0	0.498919128	0	24.94595639	0	0		0	29.93514767	0	29.93514767	29.93514767	9.978382555	0	24.94595639	24.94595639	22.57065968		26.5808	0.703880736	2.761467448	1.519432891	2.709339242	3.049317066	1.087152483	0.793060126	5.856599436	1.384276596	3.308019553	0.616011088	0.029632088	0.000939413	9.052651133	4.81961727	0.055615895	1.05719503	2.809121193	0	5.90964435	0	0	0	2.541158697	0	0.3398846	0	0	0	0	2.673081042	0	0.185763724	1.013103846	0.091379043	0	1.711558127	0.007959847	0.002375983	0	82.6701		0.179098746	26.5808	0.703880736	2.761467448	1.519432891	2.709339242	3.049317066	1.087152483	0.793060126	5.856599436	1.384276596	3.308019553	0.616011088	0.029632088	0.000939413	9.052651133	4.81961727	0.055615895	1.05719503	2.809121193	0	5.90964435	0	0	0	2.541158697	0	0.3398846	0	0	0	0	2.673081042	0	0.185763724	1.013103846	0.091379043	0	1.711558127	0.007959847	0.002375983	0	82.6701	4000																																																																																			0		0	26.5808	0.703880736	2.761467448	1.519432891	2.709339242	3.049317066	1.087152483	0.793060126	5.856599436	1.384276596	3.308019553	0.616011088	0.029632088	0.000939413	9.052651133	4.81961727	0.055615895	1.05719503	2.809121193	0	5.90964435	0	0	0	2.541158697	0	0.3398846	0	0	0	0	2.673081042	0	0.185763724	1.013103846	0.091379043	0	1.711558127	0.007959847	0.002375983	0	82.6701
H0540_089_0	2008	11	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	D	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1283.870259	33.99785828	333.4513011	10.23464772	218.1044952	10.26984678	3.661439327	191.5263792	404.1103381	835.7672883	884.2784544	49.5895033	14.31247455	0.378118212	5465.605436	1939.919844	0.112385831	425.5262404	801.7148705	0	29.85478749	0	0	0	5.120129883	346.9272078	164.1662837	0	0		0	1075.92837	17.58949905	74.77081969	407.7793202	110.3415531	0.049723293	826.6927568	3.844653419	1.268386618		"$250/day, days(1-5) no yrly max"	"$250/day, days(1-5) no yrly max"	$100/day for days 21 to 100	15% Coinsurance	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$175 copay	$20 copay	$30/$100 copay for Lower/Higher Tier	$150 copay	$25 copay	$30 copay	$20 copay	$30 copay	50% coinsurance	$30 copay	$30/$100 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$25 copay	N/A	N/A		N/A	$30 copay	$0 copay	$30 copay	$30 copay	$10 copay	$0 copay	$25 copay	$25 copay	Min $20/ max $30		249.4620922	249.4620922	99.78483688	0.149677255	149.6772553	0.299354511	0.299354511	49.89241844	174.6234645	19.95696738	45.07503414	149.6772553	24.94620922	29.93545106	19.95696738	29.93545106	0.498924184	29.93545106	42.21896448	0	0.199569674	0	0	0	0.498924184	0	24.94620922	0	0		0	29.93545106	0	29.93545106	29.93545106	9.978483688	0	24.94620922	24.94620922	22.75		26.6897	0.706764738	2.772781974	1.53189398	2.720440184	3.074324956	1.096068378	0.796309521	5.880595608	1.389948375	3.32157346	0.618535062	0.029753499	0.000943262	9.089742448	4.839364629	0.056072009	1.061526662	2.82063097	0	5.958110199	0	0	0	2.554556626	0	0.341277205	0	0	0	0	2.684033424	0	0.186524851	1.017254824	0.091753449	0	1.718570873	0.007992461	0.00240465	0	83.0595		0.179098746	26.6897	0.706764738	2.772781974	1.53189398	2.720440184	3.074324956	1.096068378	0.796309521	5.880595608	1.389948375	3.32157346	0.618535062	0.029753499	0.000943262	9.089742448	4.839364629	0.056072009	1.061526662	2.82063097	0	5.958110199	0	0	0	2.554556626	0	0.341277205	0	0	0	0	2.684033424	0	0.186524851	1.017254824	0.091753449	0	1.718570873	0.007992461	0.00240465	0	83.0595	4000																																																																																			0		0	26.6897	0.706764738	2.772781974	1.53189398	2.720440184	3.074324956	1.096068378	0.796309521	5.880595608	1.389948375	3.32157346	0.618535062	0.029753499	0.000943262	9.089742448	4.839364629	0.056072009	1.061526662	2.82063097	0	5.958110199	0	0	0	2.554556626	0	0.341277205	0	0	0	0	2.684033424	0	0.186524851	1.017254824	0.091753449	0	1.718570873	0.007992461	0.00240465	0	83.0595
H0540_807_0	2008	6																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	282.6127687	2.019688797	45.98304474	37.51786285	7.917368087	24.41228633	1.207837661	5.847899243	30.23324641	11.78382067	31.83008121	0	0.270036461	31.32674157	44.99078443	121.5831358	1.385383587	4.661261132	30.18342005	40.11583027	8.706670029	6.25869991	0	0	0	0	0	0	0	0	0											Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											0.076813085	0.076813085	0.188134857	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.7084	0.155138527	8.651013525	0	1.852664132	5.712475002	0.282634013	1.368408423	7.074579659	2.757414036	7.448239003	0	0.063188532	7.330457527	10.52784356	28.45045378	0.324179759	1.090735105	7.062920292	9.387104283	2.037360787	1.464535779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.7497	0	0	21.7084	0.155138527	8.651013525	0	1.852664132	5.712475002	0.282634013	1.368408423	7.074579659	2.757414036	7.448239003	0	0.063188532	7.330457527	10.52784356	28.45045378	0.324179759	1.090735105	7.062920292	9.387104283	2.037360787	1.464535779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.7497	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.7084	0.155138527	8.651013525	0	1.852664132	5.712475002	0.282634013	1.368408423	7.074579659	2.757414036	7.448239003	0	0.063188532	7.330457527	10.52784356	28.45045378	0.324179759	1.090735105	7.062920292	9.387104283	2.037360787	1.464535779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.7497
H0540_808_0	2008	7																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	282.6127687	2.019688797	45.98304474	37.51786285	7.917368087	24.41228633	1.207837661	5.847899243	30.23324641	11.78382067	31.83008121	0	0.270036461	31.32674157	44.99078443	121.5831358	1.385383587	4.661261132	30.18342005	40.11583027	8.706670029	6.25869991	0	0	0	0	0	0	0	0	0											Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											0.076813085	0.076813085	0.188134857	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.7084	0.155138527	8.651013525	0	1.852664132	5.712475002	0.282634013	1.368408423	7.074579659	2.757414036	7.448239003	0	0.063188532	7.330457527	10.52784356	28.45045378	0.324179759	1.090735105	7.062920292	9.387104283	2.037360787	1.464535779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.7497	0	0	21.7084	0.155138527	8.651013525	0	1.852664132	5.712475002	0.282634013	1.368408423	7.074579659	2.757414036	7.448239003	0	0.063188532	7.330457527	10.52784356	28.45045378	0.324179759	1.090735105	7.062920292	9.387104283	2.037360787	1.464535779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.7497	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.7084	0.155138527	8.651013525	0	1.852664132	5.712475002	0.282634013	1.368408423	7.074579659	2.757414036	7.448239003	0	0.063188532	7.330457527	10.52784356	28.45045378	0.324179759	1.090735105	7.062920292	9.387104283	2.037360787	1.464535779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.7497
H0543_001_0	2008	5																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		320.2026534	5.29230929	1183.453722		529.317784	16.60407595	17.54231663	366.5648285	264.2327036	16951.89798	21.96390069			756.2544581	4902.708506	4938.150455	164.1014344	384.8700427			22.77360034	1093.923124			253.7264067	0.53283227																$250 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$150 (9b)	$0 (8a1); $0/$7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$150 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5, 9a); $30/$30 (9c)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$30 (7b); $0 n/c (7b1, 7f1); $10 (7d); $10/$30( 7f); $10/$10( 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											250	912	69.5467		100	0.2	0.2	49.0226	150	2.8	0.156666704			5.4659	10	11.0953	30	7.9579			0.2	30			28.7463	0.411069113																6.6709	0.402215506	6.858771112	0	4.410981533	3.320815191	3.508463327	1.497495355	3.302908795	3.955442861	3.441011926	0	0	0.344465388	4.085590422	4.565875488	0.410253586	0.255230094	0	0	4.554720069	2.73480781	0	0	0.607806895	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1468	0	0	6.6709	0.402215506	6.858771112	0	4.410981533	3.320815191	3.508463327	1.497495355	3.302908795	3.955442861	3.441011926	0	0	0.344465388	4.085590422	4.565875488	0.410253586	0.255230094	0	0	4.554720069	2.73480781	0	0	0.607806895	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1468																																																																																				0			6.6709	0.402215506	6.858771112	0	4.410981533	3.320815191	3.508463327	1.497495355	3.302908795	3.955442861	3.441011926	0	0	0.344465388	4.085590422	4.565875488	0.410253586	0.255230094	0	0	4.554720069	2.73480781	0	0	0.607806895	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1468
H0543_004_0	2008	5																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1377.321248	5.930757965	1087.108505		529.1907465	13.14422008	14.79451429	385.1348693	263.7572072	16812.87237	12.99313536			952.3906294	4946.728729	4965.503372	167.8821727	376.9545279			23.18022927	1073.887015			254.9668385	0.533406769																$150 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$100 (9b)	$0 (8a1); $0/$7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $100 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$30 (7b); $0 n/c (7b1, 7f1); $10 (7d); $10/$30( 7f); $10/$10( 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"											64.2555	912	69.5467		100	0.2	0.2	49.0185	100	2.8	0.155618563			3.9518	10	11.1121	30	7.9579			0.2	30			26.1133	0.410843317																7.375	0.450737605	6.300397108	0	4.409922888	2.628844015	2.958902858	1.573228769	2.197976726	3.923003553	2.02197305	0	0	0.313640809	4.122273941	4.598083639	0.419705432	0.249980847	0	0	4.636045854	2.684717538	0	0	0.554835935	0.219146606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6385	0	0	7.375	0.450737605	6.300397108	0	4.409922888	2.628844015	2.958902858	1.573228769	2.197976726	3.923003553	2.02197305	0	0	0.313640809	4.122273941	4.598083639	0.419705432	0.249980847	0	0	4.636045854	2.684717538	0	0	0.554835935	0.219146606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6385																																																																																				0			7.375	0.450737605	6.300397108	0	4.409922888	2.628844015	2.958902858	1.573228769	2.197976726	3.923003553	2.02197305	0	0	0.313640809	4.122273941	4.598083639	0.419705432	0.249980847	0	0	4.636045854	2.684717538	0	0	0.554835935	0.219146606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6385
H0543_007_0	2008	4																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		320.8818991	5.637021609	1060.497174		529.3401628	13.05397321	14.00467059	392.5088633	260.6315473	16823.1521	13.91590597			950.4814718	4998.024377	5013.167313	168.9020687	376.2075228			24.40132524	1070.812848			256.2713047	0.53283227																$250 (1a); $0 (1a1)	$912 (1b)	"$120 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$100 (9b)	$0 (8a1); $0/$7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $100 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$30 (7b); $0 n/c (7b1, 7f1); $10 (7d); $10/$30( 7f); $10/$10( 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											250	912	49.4449		75	0.2	0.2	48.9958	100	2.8	0.159952411			4.8054	10	11.1077	30	7.9579			0.2	30			26.1387	0.411069113																6.685	0.428413642	4.369683583	0	3.308376018	2.610794642	2.800934117	1.602607981	2.171929561	3.925402157	2.225882714	0	0	0.380619824	4.165020314	4.640393099	0.422255172	0.249485464	0	0	4.880265047	2.677032119	0	0	0.558215931	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.3214	0	0	6.685	0.428413642	4.369683583	0	3.308376018	2.610794642	2.800934117	1.602607981	2.171929561	3.925402157	2.225882714	0	0	0.380619824	4.165020314	4.640393099	0.422255172	0.249485464	0	0	4.880265047	2.677032119	0	0	0.558215931	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.3214																																																																																				0			6.685	0.428413642	4.369683583	0	3.308376018	2.610794642	2.800934117	1.602607981	2.171929561	3.925402157	2.225882714	0	0	0.380619824	4.165020314	4.640393099	0.422255172	0.249485464	0	0	4.880265047	2.677032119	0	0	0.558215931	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.3214
H0543_013_0	2008	5																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1380.422139	5.28078469	1051.287615		529.6110654	11.00058645	13.25166611	409.1899421	252.2840351	16702.53694	3.896863724			1075.584329	5046.408844	5047.077286	172.1413053	372.4186383			26.66306872	1049.740736			259.2507831	0.53283227																$200 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$200 (9b)	$0 (8a1); $0/$7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											85.6739	912	69.5467		100	0.2	0.2	49.036	200	2.8	0.138875764			6.3275	15	30	30	30			0.2	30			25.1794	0.411069113																9.8555	0.401339636	6.092795171	0	4.413425545	2.20011729	2.650333222	1.672088118	4.204733919	3.897258618	0.541179928	0	0	0.567142618	6.308011056	12.61768714	0.430353263	0.931046596	0	0	5.332613744	2.62435184	0	0	0.543980865	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.503	0	0	9.8555	0.401339636	6.092795171	0	4.413425545	2.20011729	2.650333222	1.672088118	4.204733919	3.897258618	0.541179928	0	0	0.567142618	6.308011056	12.61768714	0.430353263	0.931046596	0	0	5.332613744	2.62435184	0	0	0.543980865	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.503																																																																																				0			9.8555	0.401339636	6.092795171	0	4.413425545	2.20011729	2.650333222	1.672088118	4.204733919	3.897258618	0.541179928	0	0	0.567142618	6.308011056	12.61768714	0.430353263	0.931046596	0	0	5.332613744	2.62435184	0	0	0.543980865	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.503
H0543_019_0	2008	4																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		327.7145348	4.477890551	1014.963044		529.1779219	14.30732102	17.37706423	404.7167902	270.3579404	16818.72819	11.15698936			838.1825436	4940.084306	4962.799717	166.6036331	376.7859004			23.76062281	1080.488502			255.2687061	0.53283227																$400 (1a); $0 (1a1)	$912 (1b)	"$120 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$175 (9b)	$0 (8a1); $0/$7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$175 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $175 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d); $0 n/c (7b1, 7f1); $10/$20( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$20 (17a); $20( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											400	912	49.4449		75	0.2	0.2	49.0943	175	2.8	0.151107318			6.0854	10	20	30	7.9579			0.2	20			27.1693	0.411069113																10.9238	0.340319682	4.182064279	0	3.307362012	2.861464204	3.475412846	1.655773194	3.942719965	3.92436991	1.685902744	0	0	0.425054323	4.116736922	8.271314435	0.416509083	0.249869021	0	0	4.752124562	1.800814171	0	0	0.577956032	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1286	0	0	10.9238	0.340319682	4.182064279	0	3.307362012	2.861464204	3.475412846	1.655773194	3.942719965	3.92436991	1.685902744	0	0	0.425054323	4.116736922	8.271314435	0.416509083	0.249869021	0	0	4.752124562	1.800814171	0	0	0.577956032	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1286																																																																																				0			10.9238	0.340319682	4.182064279	0	3.307362012	2.861464204	3.475412846	1.655773194	3.942719965	3.92436991	1.685902744	0	0	0.425054323	4.116736922	8.271314435	0.416509083	0.249869021	0	0	4.752124562	1.800814171	0	0	0.577956032	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1286
H0543_022_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1690.193425	5.213508772	1651.886836		528.9642558	19.69482186	25.18508175	411.4648803	295.7077624	17616.25909	42.53130392			18.0888647	4712.586811	4827.225853	147.71951	394.4035593			14.84811802	1194.548561			233.9774505	0.53283227																$200 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$200 (9b)	$0 (8a1); $0/$6 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d); $0 n/c (7b1, 7f1); $10/$20( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$20 (17a); $20( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											85.6739	912	69.5467		100	0.2	0.2	48.8034	200	2.4	0.159482371			28.8077	10	19.9998	30	7.9579			0.2	19.9999			27.2119	0.411069113																12.0671	0.396226667	9.573600976	0	4.408035465	3.938964372	5.03701635	1.673407605	4.928462707	3.523251818	6.782993177	0	0	0.043424925	3.927155676	8.045301522	0.369298775	0.261552332	0	0	2.969623603	1.990905276	0	0	0.530581059	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.686	0	0	12.0671	0.396226667	9.573600976	0	4.408035465	3.938964372	5.03701635	1.673407605	4.928462707	3.523251818	6.782993177	0	0	0.043424925	3.927155676	8.045301522	0.369298775	0.261552332	0	0	2.969623603	1.990905276	0	0	0.530581059	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.686																																																																																				0			12.0671	0.396226667	9.573600976	0	4.408035465	3.938964372	5.03701635	1.673407605	4.928462707	3.523251818	6.782993177	0	0	0.043424925	3.927155676	8.045301522	0.369298775	0.261552332	0	0	2.969623603	1.990905276	0	0	0.530581059	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.686
H0543_028_0	2008	4																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		313.6868989	5.459124004			529.25612	13.50802099	14.97667954	372.4185919		16774.38634	5.086396477			3.417743678	5025.874746	5026.786662	176.503579				33.41527537	1060.054078			276.5607885	0.53283227																$200 (1a); $0 (1a1)	$200 (1b)	"$0 (2a, 2a2)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$25 (10a)	20% (11a)	20% (11b); $0 (11c)	"$40 (4a, 4a1); $40/$20/$10 (4b)"	$0 (9b)	$0 (8a1); $0/$7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$0 (incl in h5)	$0 (12)	"$0 (3, 9d, 9a); $10 (5); $10/$10 (9c)"	"$10/$40/$20 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d); $0 n/c (7b1, 7f1); $10/$20( 7f, 7g)"	"$10/$10 (7e, 7h)"	"$0 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$20 (17a); $20( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											200	200			25	0.2	0.2	38.9451		2.8	0.13855488			10	10	20	10				0.2	20			30	0.411069113																5.2281	0.0909854	0	0	1.102616917	2.701604198	2.995335907	1.208655451	0	3.914023479	0.704745053	0	0	0.00284812	4.188228955	8.37797343	0.147086316	0	0	0	6.683055074	1.766756797	0	0	0.691401971	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0225	0	0	5.2281	0.0909854	0	0	1.102616917	2.701604198	2.995335907	1.208655451	0	3.914023479	0.704745053	0	0	0.00284812	4.188228955	8.37797343	0.147086316	0	0	0	6.683055074	1.766756797	0	0	0.691401971	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0225																																																																																				0			5.2281	0.0909854	0	0	1.102616917	2.701604198	2.995335907	1.208655451	0	3.914023479	0.704745053	0	0	0.00284812	4.188228955	8.37797343	0.147086316	0	0	0	6.683055074	1.766756797	0	0	0.691401971	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0225
H0543_029_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1760.06384	3.801654866	1572.194327		529.0431487	25.10220039	22.28602375	358.5341179	317.5477944	17958.32674	51.00018874			19.8820412	4704.628808	4815.15224	155.1919312	393.9360739			27.3687091	1191.181704			234.0935852	0.53283227																$250 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$200 (9b)	$0 (8a1); $0/$6 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d); $0 n/c (7b1, 7f1); $10/$20( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$20 (17a); $20( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											107.0924	912	41.2041		75	0.2	0.2	49.1323	200	2.4	0.158029191			32.1869	10	19.9998	30	7.9579			0.2	20			28.893	0.411069113																15.7075	0.28892577	5.398404879	0	3.30651968	5.020440079	4.457204749	1.467966618	5.29246324	3.591665348	8.059518563	0	0	0.053328391	3.920524007	8.025178835	0.387979828	0.261242315	0	0	5.47374182	1.98530284	0	0	0.56363801	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4805	0	0	15.7075	0.28892577	5.398404879	0	3.30651968	5.020440079	4.457204749	1.467966618	5.29246324	3.591665348	8.059518563	0	0	0.053328391	3.920524007	8.025178835	0.387979828	0.261242315	0	0	5.47374182	1.98530284	0	0	0.56363801	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4805																																																																																				0			15.7075	0.28892577	5.398404879	0	3.30651968	5.020440079	4.457204749	1.467966618	5.29246324	3.591665348	8.059518563	0	0	0.053328391	3.920524007	8.025178835	0.387979828	0.261242315	0	0	5.47374182	1.98530284	0	0	0.56363801	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4805
H0543_032_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1355.448502	4.379710938	1529.086869		528.8638219	21.87065856	16.14194452	456.7064163	333.2601594	17652.67408	55.23638011			21.15565647	4819.717339	4940.819365	157.4627622	410.9929086			17.10349379	1190.355859			234.3259362	0.53283227																$200 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$200 (9b)	$0 (8a1); $0/$6 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d); $0 n/c (7b1, 7f1); $10/$20( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$20 (17a); $20( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											85.6739	912	63.2242		100	0.2	0.2	49.0587	200	2.4	0.161623465			65.3157	10	19.9998	30	7.9579			0.2	20			27.5619	0.411069113																9.6772	0.332858031	8.056279109	0	4.407198516	4.374131712	3.228388904	1.867118495	5.554335989	3.530534816	8.927495132	0	0	0.115149685	4.016431116	8.234623937	0.393656905	0.272553711	0	0	3.420698757	1.983925991	0	0	0.538206589	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1498	0	0	9.6772	0.332858031	8.056279109	0	4.407198516	4.374131712	3.228388904	1.867118495	5.554335989	3.530534816	8.927495132	0	0	0.115149685	4.016431116	8.234623937	0.393656905	0.272553711	0	0	3.420698757	1.983925991	0	0	0.538206589	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1498																																																																																				0			9.6772	0.332858031	8.056279109	0	4.407198516	4.374131712	3.228388904	1.867118495	5.554335989	3.530534816	8.927495132	0	0	0.115149685	4.016431116	8.234623937	0.393656905	0.272553711	0	0	3.420698757	1.983925991	0	0	0.538206589	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1498
H0543_035_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1663.8721	3.307339628	1269.775544		513.6641806	21.09432878	22.65205371	386.0415218	313.3434533	17079.80282	39.04642401			1023.009398	4482.842836	4603.14224	147.190346	379.5319863			15.5558648	1128.579986			213.4975804	0.819692198																$200 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$200 (9b)	$0 (8a1); $0/$6 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$30 (7b); $0 n/c (7b1, 7f1); $10 (7d); $10/$30( 7f); $10/$10( 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											85.6739	912	63.2242		100	0.2	0.2	48.9773	200	2.4	0.156925598			5.7189	10	11.0482	30	7.9579			0.2	29.9998			30	0.419764718																11.8792	0.251357812	6.690049067	0	4.280534839	4.218865755	4.530410742	1.575605541	5.222390888	3.415960563	6.127383438	0	0	0.487543354	3.735702363	4.238041504	0.367975865	0.251690113	0	0	3.11117296	2.821430715	0	0	0.533743951	0.344077864	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.0831	0	0	11.8792	0.251357812	6.690049067	0	4.280534839	4.218865755	4.530410742	1.575605541	5.222390888	3.415960563	6.127383438	0	0	0.487543354	3.735702363	4.238041504	0.367975865	0.251690113	0	0	3.11117296	2.821430715	0	0	0.533743951	0.344077864	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.0831																																																																																				0			11.8792	0.251357812	6.690049067	0	4.280534839	4.218865755	4.530410742	1.575605541	5.222390888	3.415960563	6.127383438	0	0	0.487543354	3.735702363	4.238041504	0.367975865	0.251690113	0	0	3.11117296	2.821430715	0	0	0.533743951	0.344077864	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.0831
H0543_036_0	2008	4																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		320.6417277	5.898964675			529.5343206	15.55531736	16.03688853	387.1783696		16941.1172	6.019676692			3.439298048	5045.075176	5045.373678	175.5762157				32.66210061	1050.645244			259.8391191	0.53283227																$200 (1a); $0 (1a1)	$200 (1b)	"$0 (2a, 2a2)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$25 (10a)	20% (11a)	20% (11b); $0 (11c)	"$40 (4a, 4a1); $40/$20/$10 (4b)"	$0 (9b)	$0 (8a1); $0/$7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$0 (incl in h5)	$0 (12)	"$0 (3, 9d, 9a); $10 (5); $10/$10 (9c)"	"$10/$40/$20 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$10 (7b, 7d); $0 n/c (7b1, 7f1); $10/$10( 7f, 7g)"	"$10/$10 (7e, 7h)"	"$0 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$10 (17a); $10( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											138.0421	200			25	0.2	0.2	38.9447		2.8	0.14579347			10	10	10	10				0.2	10			27.951	0.411069113																3.6885	0.098316078	0	0	1.103196501	3.111063471	3.207377706	1.256544908	0	3.952927347	0.877629555	0	0	0.002866082	4.204229313	4.204478065	0.146313513	0	0	0	6.532420122	0.875537703	0	0	0.605230814	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.0857	0	0	3.6885	0.098316078	0	0	1.103196501	3.111063471	3.207377706	1.256544908	0	3.952927347	0.877629555	0	0	0.002866082	4.204229313	4.204478065	0.146313513	0	0	0	6.532420122	0.875537703	0	0	0.605230814	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.0857																																																																																				0			3.6885	0.098316078	0	0	1.103196501	3.111063471	3.207377706	1.256544908	0	3.952927347	0.877629555	0	0	0.002866082	4.204229313	4.204478065	0.146313513	0	0	0	6.532420122	0.875537703	0	0	0.605230814	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.0857
H0543_046_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1633.055202	2.684789586	1229.705269		521.7264094	22.60317654	14.77932259	338.0641616	340.561767	17245.50293	40.49324175			370.3142332	4689.294658	4819.857371	150.0148747	384.7108154			24.40795322	1141.866616			212.5666384	0.832549425																$200 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$200 (9b)	$0 (8a1); $0/$6 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											85.6739	912	63.2242		100	0.2	0.2	48.8589	200	2.4	0.159159837			6.8033	15	29.9998	30	7.9579			0.2	29.9929			30	0.42032376																11.6592	0.204044009	6.478931356	0	4.347720078	4.520635308	2.955864518	1.376453197	5.67602945	3.449100586	6.444897751	0	0	0.209946806	5.861618322	12.04955631	0.375037187	0.2551245	0	0	4.881590644	2.853988332	0	0	0.531416596	0.349940305	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4811	0	0	11.6592	0.204044009	6.478931356	0	4.347720078	4.520635308	2.955864518	1.376453197	5.67602945	3.449100586	6.444897751	0	0	0.209946806	5.861618322	12.04955631	0.375037187	0.2551245	0	0	4.881590644	2.853988332	0	0	0.531416596	0.349940305	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4811																																																																																				0			11.6592	0.204044009	6.478931356	0	4.347720078	4.520635308	2.955864518	1.376453197	5.67602945	3.449100586	6.444897751	0	0	0.209946806	5.861618322	12.04955631	0.375037187	0.2551245	0	0	4.881590644	2.853988332	0	0	0.531416596	0.349940305	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4811
H0543_049_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1419.93809	5.620745216	1484.554384		523.01733	19.42334767	16.22805452	592.3759063	314.1981623	17211.18787	25.64537013			20.80787282	4744.761057	4873.314948	156.6749323	387.477021			15.52689364	1158.703663			220.7902396	0.716960734																$200 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$200 (9b)	$0 (8a1); $0/$6 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d); $0 n/c (7b1, 7f1); $10/$20( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$20 (17a); $20( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											85.6739	912	63.2242		100	0.2	0.2	49.4519	200	2.4	0.150728667			32.989	10	19.9998	30	30			0.2	20			30	0.417446325																10.1376	0.427176636	7.82165141	0	4.35847775	3.884669535	3.245610904	2.441177214	5.236636038	3.442237574	3.865492467	0	0	0.057202509	3.953967547	8.122126994	0.391687331	0.968692552	0	0	3.105378728	1.931172772	0	0	0.551975599	0.299292623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2423	0	0	10.1376	0.427176636	7.82165141	0	4.35847775	3.884669535	3.245610904	2.441177214	5.236636038	3.442237574	3.865492467	0	0	0.057202509	3.953967547	8.122126994	0.391687331	0.968692552	0	0	3.105378728	1.931172772	0	0	0.551975599	0.299292623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2423																																																																																				0			10.1376	0.427176636	7.82165141	0	4.35847775	3.884669535	3.245610904	2.441177214	5.236636038	3.442237574	3.865492467	0	0	0.057202509	3.953967547	8.122126994	0.391687331	0.968692552	0	0	3.105378728	1.931172772	0	0	0.551975599	0.299292623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2423
H0543_050_0	2008	4																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		321.18454	5.607627995	1034.818428		529.231025	12.22936684	15.71268642	379.3332742	250.4627361	16738.40508	6.716485529			1085.103741	5002.027072	5010.517237	171.8468872	374.215728			23.56134375	1060.00965			257.6629466	0.533011637																$250 (1a); $0 (1a1)	$912 (1b)	"$120 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$100 (9b)	$0 (8a1); $0/$7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $100 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$30 (7b); $0 n/c (7b1, 7f1); $10 (7d); $10/$30( 7f); $10/$10( 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											250	912	49.4449		75	0.2	0.2	48.9922	100	2.8	0.144901372			3.8832	10	11.1207	30	7.9579			0.2	30			26.3768	0.41125796																6.6913	0.426179728	4.263876612	0	3.307693906	2.445873368	3.142537284	1.548696667	2.087189467	3.905627851	0.973227966	0	0	0.351142825	4.168355894	4.643381049	0.429617218	0.248164587	0	0	4.712268751	2.650024126	0	0	0.566359522	0.219205279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7808	0	0	6.6913	0.426179728	4.263876612	0	3.307693906	2.445873368	3.142537284	1.548696667	2.087189467	3.905627851	0.973227966	0	0	0.351142825	4.168355894	4.643381049	0.429617218	0.248164587	0	0	4.712268751	2.650024126	0	0	0.566359522	0.219205279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7808																																																																																				0			6.6913	0.426179728	4.263876612	0	3.307693906	2.445873368	3.142537284	1.548696667	2.087189467	3.905627851	0.973227966	0	0	0.351142825	4.168355894	4.643381049	0.429617218	0.248164587	0	0	4.712268751	2.650024126	0	0	0.566359522	0.219205279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7808
H0543_060_0	2008	4																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0			5.534432542	1039.99864		529.3704509	11.45115395	13.8552402	616.3664358	254.4220679	16705.65337	4.916175028			1078.36767	5154.450438	5157.266466	173.7058375	372.5839004			25.4679525	1049.912824			259.5240255	0.53283227																"$0 (1a, 1a1)"	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$200 (9b)	$0 (8a1); $0/$6 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$25 (7b, 7d); $0 n/c (7b1, 7f1); $10/$25( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$25 (17a); $25( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"												912	41.2041		75	0.2	0.2	49.3656	200	2.4	0.137978704			6.345	10	25	30	30			0.2	25			26.5396	0.411069113																0	0.420616873	3.571017676	0	3.308565318	2.29023079	2.77104804	2.53560629	4.240367798	3.341130674	0.67832746	0	0	0.570183901	4.295375365	10.74429953	0.434264594	0.931459751	0	0	5.0935905	2.187318383	0	0	0.573972953	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.2064	0	0	0	0.420616873	3.571017676	0	3.308565318	2.29023079	2.77104804	2.53560629	4.240367798	3.341130674	0.67832746	0	0	0.570183901	4.295375365	10.74429953	0.434264594	0.931459751	0	0	5.0935905	2.187318383	0	0	0.573972953	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.2064																																																																																				0			0	0.420616873	3.571017676	0	3.308565318	2.29023079	2.77104804	2.53560629	4.240367798	3.341130674	0.67832746	0	0	0.570183901	4.295375365	10.74429953	0.434264594	0.931459751	0	0	5.0935905	2.187318383	0	0	0.573972953	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.2064
H0543_065_0	2008	5																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		356.0586731	6.527145759	1093.341871		533.6267701	17.7735261	18.74575253	372.5007038	253.6209069	17122.10544	18.92092174			726.2179633	5015.856762	5083.650221	165.3012273	382.9255562			24.76690002	1100.829445			240.7913945	0.73456137																$400 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$175 (9b)	$0 (8a1); $0/$6 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$175 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $175 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$30 (7b); $0 n/c (7b1, 7f1); $20 (7d); $10/$30( 7f); $10/$20( 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											400	912	69.5467		100	0.2	0.2	49.0468	175	2.4	0.150242492			6.0537	10	20.5359	30	7.9579			0.2	30			30	0.417892907																11.8686	0.496063078	6.336522926	0	4.446889751	3.55470522	3.749150507	1.522498395	3.698638226	3.424421087	2.842726429	0	0	0.366359216	4.179880635	8.699789893	0.413253068	0.25394059	0	0	4.953380005	2.752073612	0	0	0.601978486	0.306967986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4679	0	0	11.8686	0.496063078	6.336522926	0	4.446889751	3.55470522	3.749150507	1.522498395	3.698638226	3.424421087	2.842726429	0	0	0.366359216	4.179880635	8.699789893	0.413253068	0.25394059	0	0	4.953380005	2.752073612	0	0	0.601978486	0.306967986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4679																																																																																				0			11.8686	0.496063078	6.336522926	0	4.446889751	3.55470522	3.749150507	1.522498395	3.698638226	3.424421087	2.842726429	0	0	0.366359216	4.179880635	8.699789893	0.413253068	0.25394059	0	0	4.953380005	2.752073612	0	0	0.601978486	0.306967986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4679
H0543_070_0	2008	4																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		346.5181383	5.739967742	1217.139635		529.1188093	20.29788782	21.5351418	416.3749186	312.2715956	17263.38259	41.64263291			970.147398	4881.697561	4919.689768	178.8185382	387.0834784			25.90740288	1099.848408			250.5661286	0.53283227																$400/$800 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$200 (9b)	$0 (8a1); $0/$6 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$15 (7b, 7d); $0 n/c (7b1, 7f1); $10/$15( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$15 (17a); $15( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											523.9158	912	41.2041		75	0.2	0.2	49.1052	200	2.4	0.164546908			6.2154	10	15	30	7.9579			0.2	15			30	0.411069113																15.1289	0.436237548	4.179262341	0	3.306992558	4.059577564	4.30702836	1.703849125	5.204526594	3.452676518	6.852166469	0	0	0.50248978	4.068081301	6.149597673	0.447046346	0.256697954	0	0	5.181480577	1.374810509	0	0	0.626415322	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.4568	0	0	15.1289	0.436237548	4.179262341	0	3.306992558	4.059577564	4.30702836	1.703849125	5.204526594	3.452676518	6.852166469	0	0	0.50248978	4.068081301	6.149597673	0.447046346	0.256697954	0	0	5.181480577	1.374810509	0	0	0.626415322	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.4568																																																																																				0			15.1289	0.436237548	4.179262341	0	3.306992558	4.059577564	4.30702836	1.703849125	5.204526594	3.452676518	6.852166469	0	0	0.50248978	4.068081301	6.149597673	0.447046346	0.256697954	0	0	5.181480577	1.374810509	0	0	0.626415322	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.4568
H0543_072_0	2008	4																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		357.0680746	5.07520408	1156.570811		531.9456912	23.29043028	23.11724983	446.4620777	293.8979946	17330.26409	32.27042073			914.7360446	4832.612025	4956.710353	165.7522389	384.779073			28.73180836	1109.654222			207.3528578	1.004187931																$400/$800 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$200 (9b)	$0 (8a1); $0/$6 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$15 (7b, 7d); $0 n/c (7b1, 7f1); $10/$15( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$15 (17a); $15( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											523.9158	912	41.2041		75	0.2	0.2	49.0235	200	2.4	0.157461558			7.1373	10	15	30	7.9579			0.2	15			30	0.424148489																15.5895	0.38571551	3.971288663	0	3.32466057	4.658086055	4.623449966	1.82392833	4.898299909	3.466052817	5.081350719	0	0	0.544062703	4.027176688	6.195872612	0.414380597	0.255169766	0	0	5.746361672	1.387067778	0	0	0.518382145	0.425924794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3367	0	0	15.5895	0.38571551	3.971288663	0	3.32466057	4.658086055	4.623449966	1.82392833	4.898299909	3.466052817	5.081350719	0	0	0.544062703	4.027176688	6.195872612	0.414380597	0.255169766	0	0	5.746361672	1.387067778	0	0	0.518382145	0.425924794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3367																																																																																				0			15.5895	0.38571551	3.971288663	0	3.32466057	4.658086055	4.623449966	1.82392833	4.898299909	3.466052817	5.081350719	0	0	0.544062703	4.027176688	6.195872612	0.414380597	0.255169766	0	0	5.746361672	1.387067778	0	0	0.518382145	0.425924794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3367
H0543_077_0	2008	6																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		306.8438891	5.579479398	1038.432944		529.3162877	12.47705245	14.86830108	361.8770593	252.4892879	16644.17533	4.221176076			1072.700756	4982.241815	4981.970823	172.3043945	373.5047861			26.11490334	1055.09666			259.3316504	0.53283227																$150/$250 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$100 (9b)	$0 (8a1); $0/$7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $100 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$30 (7b); $0 n/c (7b1, 7f1); $10 (7d); $10/$30( 7f); $10/$10( 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	$25 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"											180.979	912	69.5467		100	0.2	0.2	48.9455	100	2.8	0.13820302			3.9922	10	11.1389	30	7.9579			0.2	30			27.5644	0.411069113																4.6277	0.424040434	6.01829522	0	4.410969064	2.495410491	2.973660217	1.476021293	2.104077399	3.883640911	0.583379282	0	0	0.356874092	4.151868179	4.624454011	0.430760986	0.24769312	0	0	5.222980668	2.637741649	0	0	0.595693072	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4843	0	0	4.6277	0.424040434	6.01829522	0	4.410969064	2.495410491	2.973660217	1.476021293	2.104077399	3.883640911	0.583379282	0	0	0.356874092	4.151868179	4.624454011	0.430760986	0.24769312	0	0	5.222980668	2.637741649	0	0	0.595693072	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4843																																																																																				0			4.6277	0.424040434	6.01829522	0	4.410969064	2.495410491	2.973660217	1.476021293	2.104077399	3.883640911	0.583379282	0	0	0.356874092	4.151868179	4.624454011	0.430760986	0.24769312	0	0	5.222980668	2.637741649	0	0	0.595693072	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4843
H0543_078_0	2008	8	F2	H5a	H5b	I2a	O1a	E2b					OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)	DME						Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests	Diabetes Monitoring Supplies					A	A	D	P	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V		V	Coin	V	T	P	V	P	V	P				V	P	V	V	V	P																																														0		348.8950854	10.25620512	1298.731655	402.743396	1.697331988	14.45028957	18.57202299	390.3893921	294.2359401	3713.547776	22.0460894		15.95194153	3.693478502	3950.456991	3999.3657	91.01375637	430.1941411			25.90935322	907.8864605	1193.140297		345.5481413							56.1936486		34.87294531	78.6		450.6432912					(1a) $0/admit	(1b) $812/admit	(2a) $140/day days 21-100	(6a) $0/proc	(10a) $50/trip	(11a) 20% coins	(11b/11c) 20%/0% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $0/visit	(8a) $0/visit	(8b) 11.77% coins (0%/20%/$20)		(12) 20% coins	(5) $10/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $0/visit	(7e/7h) $10/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit			(15) 20% coins	(16b/17a) $0/visit (13a/13a1/14a10/17b N/A $0 Copay)	(10b) $0/trip		(17a1) $0/visit							(4b) $0/visit (waived if admitted)		(9d) $0/visit	(7f1) $0/visit		$0/proc						812	42		50	0.2	0.2	50			0.1177		0.2	10			10				0.2																					0	0.694003213	4.545560794	0	0.007072217	2.890057914	3.714404597	1.626622467	0	0	2.594824722	0	3.190388307	0.003077899	0	0	0.075844797	0	0	0	5.181870643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.5237		0	0	0.694003213	4.545560794	0	0.007072217	2.890057914	3.714404597	1.626622467	0	0	2.594824722	0	3.190388307	0.003077899	0	0	0.075844797	0	0	0	5.181870643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.5237																																																																																				0		0	0	0.694003213	4.545560794	0	0.007072217	2.890057914	3.714404597	1.626622467	0	0	2.594824722	0	3.190388307	0.003077899	0	0	0.075844797	0	0	0	5.181870643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.5237
H0543_079_0	2008	7	F2	H5a	H5b	I2a	O1a	E2b					OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)	DME						Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests	Diabetes Monitoring Supplies					A	A	D	P	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V		V	Coin	V	T	P	V	P	V	P				V	P	V	V	V	P																																														0		368.1539714	10.82234404	1367.724834	424.1401823	1.787507147	13.67943363	17.58129169	411.1306397	309.8685895	3910.847229	20.86987237		15.10086337	3.889711682	4168.50469	4220.112943	96.03731192	453.938949			24.52720938	956.1202808	1256.528967		364.6208656							59.17919687		36.72573231	78.6		474.5848835					(1a) $0/admit	(1b) $812/admit	(2a) $140/day days 21-100	(6a) $0/proc	(10a) $50/trip	(11a) 20% coins	(11b/11c) 20%/0% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $0/visit	(8a) $0/visit	(8b) 11.77% coins (0%/20%/$20)		(12) 20% coins	(5) $10/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $0/visit	(7e/7h) $10/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit			(15) 20% coins	(16b/17a) $0/visit (13a/13a1/14a10/17b N/A $0 Copay)	(10b) $0/trip		(17a1) $0/visit							(4b) $0/visit (waived if admitted)		(9d) $0/visit	(7f1) $0/visit		$0/proc						812	42		50	0.2	0.2	50			0.1177		0.2	10			10				0.2																					0	0.732311946	4.787036919	0	0.007447946	2.735886727	3.516258338	1.713044332	0	0	2.456383978	0	3.020172675	0.003241426	0	0	0.080031093	0	0	0	4.905441876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.9573		0	0	0.732311946	4.787036919	0	0.007447946	2.735886727	3.516258338	1.713044332	0	0	2.456383978	0	3.020172675	0.003241426	0	0	0.080031093	0	0	0	4.905441876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.9573																																																																																				0		0	0	0.732311946	4.787036919	0	0.007447946	2.735886727	3.516258338	1.713044332	0	0	2.456383978	0	3.020172675	0.003241426	0	0	0.080031093	0	0	0	4.905441876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.9573
H0543_081_0	2008	7	F2	H5a	H5b	I2a	O1a	E2b					OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)	DME						Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests	Diabetes Monitoring Supplies					A	A	D	P	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V		V	Coin	V	T	P	V	P	V	P				V	P	V	V	V	P																																														0		381.1270717	11.20370446	1418.690586	439.0962874	1.850538536	14.71903192	18.91742016	425.6329335	320.7989481	4048.799135	22.58546227		16.34221685	4.026918049	4323.778284	4377.308905	99.61462795	470.8478259			26.39120796	989.835161	1300.836911		378.2027125							61.26669418		38.02120219	78.6		491.3197785					(1a) $0/admit	(1b) $812/admit	(2a) $140/day days 21-100	(6a) $0/proc	(10a) $50/trip	(11a) 20% coins	(11b/11c) 20%/0% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $0/visit	(8a) $0/visit	(8b) 11.77% coins (0%/20%/$20)		(12) 20% coins	(5) $10/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $0/visit	(7e/7h) $10/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit			(15) 20% coins	(16b/17a) $0/visit (13a/13a1/14a10/17b N/A $0 Copay)	(10b) $0/trip		(17a1) $0/visit							(4b) $0/visit (waived if admitted)		(9d) $0/visit	(7f1) $0/visit		$0/proc						812	42		50	0.2	0.2	50			0.1177		0.2	10			10				0.2																					0	0.758117335	4.965417049	0	0.007710577	2.943806385	3.783484032	1.773470556	0	0	2.658308909	0	3.26844337	0.003355765	0	0	0.08301219	0	0	0	5.278241592	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.5234		0	0	0.758117335	4.965417049	0	0.007710577	2.943806385	3.783484032	1.773470556	0	0	2.658308909	0	3.26844337	0.003355765	0	0	0.08301219	0	0	0	5.278241592	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.5234																																																																																				0		0	0	0.758117335	4.965417049	0	0.007710577	2.943806385	3.783484032	1.773470556	0	0	2.658308909	0	3.26844337	0.003355765	0	0	0.08301219	0	0	0	5.278241592	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.5234
H0543_082_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1620.390723	4.857450209	1330.882678		547.6644318	17.75955102	19.42063826	414.6264733	349.3353262	17624.42908	39.40407101			758.9870748	4930.145213	5122.084662	168.6885904	392.645345			21.11611726	1134.665815			179.2650547	1.322939774																$200 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$200 (9b)	$0 (8a1); $0/$6 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											85.6739	912	63.2242		100	0.2	0.2	49.083	200	2.4	0.167873499			6.7997	15	29.9987	30	7.9579			0.2	30			30	0.426422507																11.5688	0.369166216	7.012003392	0	4.563870265	3.551910205	3.884127653	1.695926998	5.822255436	3.524885816	6.614899275	0	0	0.430071083	6.162681516	12.80466428	0.421721476	0.260386356	0	0	4.223223452	2.836664538	0	0	0.448162637	0.564131295	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.7595	0	0	11.5688	0.369166216	7.012003392	0	4.563870265	3.551910205	3.884127653	1.695926998	5.822255436	3.524885816	6.614899275	0	0	0.430071083	6.162681516	12.80466428	0.421721476	0.260386356	0	0	4.223223452	2.836664538	0	0	0.448162637	0.564131295	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.7595																																																																																				0			11.5688	0.369166216	7.012003392	0	4.563870265	3.551910205	3.884127653	1.695926998	5.822255436	3.524885816	6.614899275	0	0	0.430071083	6.162681516	12.80466428	0.421721476	0.260386356	0	0	4.223223452	2.836664538	0	0	0.448162637	0.564131295	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.7595
H0543_083_0	2008	4																					4000											D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1365.504363	5.379071459	1044.45408		529.4912105	11.83865456	14.48794412	373.4316238	252.8920929	16674.26683	9.757848826			1082.00434	5001.122857	5000.976282	172.2650669	373.1202733			26.34737013	1055.638612			259.5413715	0.53283227	16.8541424															$125 (1a); $0 (1a1)	$800 (1b)	"$100 (2a, 2a2)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$100 (10a)	15% (11a)	15% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$125 (9b)	$0 (8a1); $0/$11 (8a2)	"$10 (8b1); 15% (8b2, 8b3)"	$125 (incl in h5)	$0 (12)	"$10 (3, 9d); $20 (5); $20/$20 (9c); $125 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$30 (7b); $0 n/c (7b1, 7f1); $20 (7d); $20/$20( 7f); $10/$20( 7g)"	"$20/$20 (7e, 7h)"	"$10 (7c, 7i)"	$0 (incl in h2)		15%/$0 (15); 15% (15a1)	"$0 (13a, 17b, 13a1); $10/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	$25 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											99.4789	636.6649	79.5831		79.5831	0.119374673	0.119374673	38.956	99.4789	3.5017	0.056916689			2.7637	7.9583	16.3687	15.9166	7.9583			0.119374673	23.8749			20.9336	0.411069113	19.8958															11.3199	0.285388844	6.926742485	0	3.511546686	1.413235522	1.729493598	1.212283976	2.096452153	4.865630386	0.555384449	0	0	0.249194335	3.316707822	6.821611417	0.228489846	0.247450615	0	0	3.145208706	2.100275243	0	0	0.452760988	0.219030888	0.027943858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7247	0	12.95713491	11.3199	0.285388844	6.926742485	0	3.511546686	1.413235522	1.729493598	1.212283976	2.096452153	4.865630386	0.555384449	0	0	0.249194335	3.316707822	6.821611417	0.228489846	0.247450615	0	0	3.145208706	2.100275243	0	0	0.452760988	0.219030888	0.027943858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7247																																																																																				0			11.3199	0.285388844	6.926742485	0	3.511546686	1.413235522	1.729493598	1.212283976	2.096452153	4.865630386	0.555384449	0	0	0.249194335	3.316707822	6.821611417	0.228489846	0.247450615	0	0	3.145208706	2.100275243	0	0	0.452760988	0.219030888	0.027943858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7247
H0543_084_0	2008	5																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1360.473429	5.389513303	1041.231642		529.3791916	11.14362996	13.53901204	377.8409516	252.6317985	16673.27003	3.872088713			1077.279477	5006.510767	5006.117557	172.2628189	372.3219936			23.84700653	1048.854138			259.3649482	0.53283227																$150 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$200 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$25/$5 (4b)"	$100 (9b)	$0 (8a1); $0/$12 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	$0 (12)	"$10/$20 (3, 9d); $150 (5); $30/$30 (9c); $100 (9a)"	"$5/$50/$25 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $5 (14c1, 14c)"	"$10 (7b, 7d); $0 n/c (7b1, 7f1); $5/$10( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$10/$20 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $5/$10 (17a); $10( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"											64.2555	912	69.5467		198.561	0.2	0.2	48.7164	100	4.8	0.138131395			3.3376	5	10	30	15.6125			0.2	10			25.8084	0.411069113																7.2848	0.409603011	6.034515228	0	8.759504721	2.228725993	2.707802407	1.533920208	2.105264988	6.66930801	0.534857017	0	0	0.29962596	2.086046153	4.171762767	0.430657047	0.484407886	0	0	4.769401306	0.874045115	0	0	0.557816941	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.1611	0	0	7.2848	0.409603011	6.034515228	0	8.759504721	2.228725993	2.707802407	1.533920208	2.105264988	6.66930801	0.534857017	0	0	0.29962596	2.086046153	4.171762767	0.430657047	0.484407886	0	0	4.769401306	0.874045115	0	0	0.557816941	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.1611																																																																																				0			7.2848	0.409603011	6.034515228	0	8.759504721	2.228725993	2.707802407	1.533920208	2.105264988	6.66930801	0.534857017	0	0	0.29962596	2.086046153	4.171762767	0.430657047	0.484407886	0	0	4.769401306	0.874045115	0	0	0.557816941	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.1611
H0543_085_0	2008	4																																D	A	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	O	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1330.077223	6.200489735	1077.465857		496.8387799	16.75988998	14.98781095	377.3732808	48.43087627	16116.2256	24.33315103			13.0927154	4505.630513	4682.055345	176.4446094	4.284139554			27.13883764	1013.1818			162.6961536	1.567202479																$275 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$5 (4b)"	20% (9b)	$0 (8a1); $0/$7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	$0 (12)	"20% (3, 9d, 9a); $150 (5); $30/$30 (9c)"	"$5/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $5 (14c1, 14c)"	"$10 (7b, 7d); $0 n/c (7b1, 7f1); $5/$10( 7f, 7g)"	"$30/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $5/$10 (17a); $10( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											173.0517	912	87.3197		100	0.2	0.2	48.7601	0.2	2.8	0.16670153			0.010563436	5	10	30	0.2			0.2	10			30	0.427458254																19.181	0.47123722	7.840335668	0	4.140323166	3.351977995	2.997562189	1.533395742	9.686175254	3.76045264	4.056373512	0	0	0.138304055	1.877346047	3.901704918	0.441111524	0.856827911	0	0	5.427767528	0.844318166	0	0	0.406740384	0.669913635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5829	0	0	19.181	0.47123722	7.840335668	0	4.140323166	3.351977995	2.997562189	1.533395742	9.686175254	3.76045264	4.056373512	0	0	0.138304055	1.877346047	3.901704918	0.441111524	0.856827911	0	0	5.427767528	0.844318166	0	0	0.406740384	0.669913635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5829																																																																																				0			19.181	0.47123722	7.840335668	0	4.140323166	3.351977995	2.997562189	1.533395742	9.686175254	3.76045264	4.056373512	0	0	0.138304055	1.877346047	3.901704918	0.441111524	0.856827911	0	0	5.427767528	0.844318166	0	0	0.406740384	0.669913635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5829
H0543_086_0	2008	4																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		365.6180662	6.882406776	1319.252824		549.8656453	15.39895418	25.27824597	453.0993237	315.1406392	17477.67483	25.28594			1879.056801	5111.782025	5310.571324	184.56491	388.9045286			29.8884035	1091.300846			174.6903117	1.476887254																$400 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$175 (9b)	$0 (8a1); $0/$6 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$175 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $175 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d); $0 n/c (7b1, 7f1); $10/$20( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$20 (17a); $20( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											400	912	41.2041		75	0.2	0.2	49.0972	175	2.4	0.164832994			5.4178	10	20	30	7.9579			0.2	20			30	0.426941975																12.1873	0.523062915	4.529885877	0	3.436660283	3.079790836	5.055649194	1.853824808	4.595800988	3.495534965	4.16795719	0	0	0.848368572	4.259818354	8.850947803	0.461412275	0.2579056	0	0	5.977680701	1.818834744	0	0	0.436725779	0.630545161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4677	0	0	12.1873	0.523062915	4.529885877	0	3.436660283	3.079790836	5.055649194	1.853824808	4.595800988	3.495534965	4.16795719	0	0	0.848368572	4.259818354	8.850947803	0.461412275	0.2579056	0	0	5.977680701	1.818834744	0	0	0.436725779	0.630545161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4677																																																																																				0			12.1873	0.523062915	4.529885877	0	3.436660283	3.079790836	5.055649194	1.853824808	4.595800988	3.495534965	4.16795719	0	0	0.848368572	4.259818354	8.850947803	0.461412275	0.2579056	0	0	5.977680701	1.818834744	0	0	0.436725779	0.630545161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4677
H0543_089_0	2008	4																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		319.3856491	7.116235			529.4684538	16.01246214	26.53829993	399.2289472		16844.51422	26.53995433			4.315339914	5110.215506	5114.076583	173.4615153				26.87988367	1050.574077			260.1275882	0.542388689																$200 (1a); $0 (1a1)	$200 (1b)	"$0 (2a, 2a2)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$25 (10a)	20% (11a)	20% (11b); $0 (11c)	"$40 (4a, 4a1); $40/$20/$10 (4b)"	$0 (9b)	$0 (8a1); $0/$7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$0 (incl in h5)	$0 (12)	"$0 (3, 9d, 9a); $10 (5); $10/$10 (9c)"	"$10/$40/$20 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$10 (7b, 7d); $0 n/c (7b1, 7f1); $10/$10( 7f, 7g)"	"$10/$10 (7e, 7h)"	"$0 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$10 (17a); $10( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											200	200			25	0.2	0.2	38.9987		2.8	0.168999927			10	10	10	10				0.2	10			27.1161	0.415161069																5.3231	0.118603917	0	0	1.103059279	3.202492428	5.307659986	1.297449919	0	3.930386652	4.485250354	0	0	0.003596117	4.258512922	4.261730486	0.144551263	0	0	0	5.375976734	0.875478398	0	0	0.587804259	0.225178668	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5008	0	0	5.3231	0.118603917	0	0	1.103059279	3.202492428	5.307659986	1.297449919	0	3.930386652	4.485250354	0	0	0.003596117	4.258512922	4.261730486	0.144551263	0	0	0	5.375976734	0.875478398	0	0	0.587804259	0.225178668	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5008																																																																																				0			5.3231	0.118603917	0	0	1.103059279	3.202492428	5.307659986	1.297449919	0	3.930386652	4.485250354	0	0	0.003596117	4.258512922	4.261730486	0.144551263	0	0	0	5.375976734	0.875478398	0	0	0.587804259	0.225178668	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5008
H0543_091_0	2008	4																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		323.1802457	6.201085953			532.4532794	15.71523142	18.33016749	398.0356187		17142.91522	15.56966329			3.561968142	5038.678995	5078.309542	173.8783569				31.41507956	1055.403707			242.8365977	0.724948576																$200 (1a); $0 (1a1)	$200 (1b)	"$0 (2a, 2a2)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$25 (10a)	20% (11a)	20% (11b); $0 (11c)	"$40 (4a, 4a1); $40/$20/$10 (4b)"	$0 (9b)	$0 (8a1); $0/$7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$0 (incl in h5)	$0 (12)	"$0 (3, 9d, 9a); $10 (5); $10/$10 (9c)"	"$10/$40/$20 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$10 (7b, 7d); $0 n/c (7b1, 7f1); $10/$10( 7f, 7g)"	"$10/$10 (7e, 7h)"	"$0 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$10 (17a); $10( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											200	200			25	0.2	0.2	38.992		2.8	0.15867247			10	10	10	10				0.2	10			30	0.417649665																5.3863	0.103351433	0	0	1.109277665	3.143046283	3.666033499	1.293349955	0	4.000013551	2.470476926	0	0	0.002968307	4.198899163	4.231924619	0.144898631	0	0	0	6.283015911	0.879503089	0	0	0.607091494	0.30277453	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.823	0	0	5.3863	0.103351433	0	0	1.109277665	3.143046283	3.666033499	1.293349955	0	4.000013551	2.470476926	0	0	0.002968307	4.198899163	4.231924619	0.144898631	0	0	0	6.283015911	0.879503089	0	0	0.607091494	0.30277453	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.823																																																																																				0			5.3863	0.103351433	0	0	1.109277665	3.143046283	3.666033499	1.293349955	0	4.000013551	2.470476926	0	0	0.002968307	4.198899163	4.231924619	0.144898631	0	0	0	6.283015911	0.879503089	0	0	0.607091494	0.30277453	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.823
H0543_093_0	2008	4																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		308.6792224	6.877684992			511.7196437	15.7826995	25.89506068	385.696454		16279.85341	24.79972852			4.170681346	4725.033726	4942.642811	167.6467487				26.7650826	1015.356795			144	1.8025																$200 (1a); $0 (1a1)	$200 (1b)	"$0 (2a, 2a2)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$25 (10a)	20% (11a)	20% (11b); $0 (11c)	"$40 (4a, 4a1); $40/$20/$10 (4b)"	$0 (9b)	$0 (8a1); $0/$7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$0 (incl in h5)	$0 (12)	"$0 (3, 9d, 9a); $10 (5); $10/$10 (9c)"	"$10/$40/$20 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$10 (7b, 7d); $0 n/c (7b1, 7f1); $10/$10( 7f, 7g)"	"$10/$10 (7e, 7h)"	"$0 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$10 (17a); $10( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											200	200			25	0.2	0.2	38.9983		2.8	0.168994112			10	10	10	10				0.2	10			30	0.428560333																5.1447	0.114628083	0	0	1.066082591	3.1565399	5.179012136	1.253458333	0	3.798632463	4.191008089	0	0	0.003475568	3.937528105	4.118869009	0.139705624	0	0	0	5.353016521	0.846130663	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4352	0	0	5.1447	0.114628083	0	0	1.066082591	3.1565399	5.179012136	1.253458333	0	3.798632463	4.191008089	0	0	0.003475568	3.937528105	4.118869009	0.139705624	0	0	0	5.353016521	0.846130663	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4352																																																																																				0			5.1447	0.114628083	0	0	1.066082591	3.1565399	5.179012136	1.253458333	0	3.798632463	4.191008089	0	0	0.003475568	3.937528105	4.118869009	0.139705624	0	0	0	5.353016521	0.846130663	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4352
H0543_095_0	2008	4																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		315.7068282	5.642564971	1064.510014		529.2519738	11.91020739	14.68079913	375.4588102	249.8728197	16683.65382	4.772314999			1056.19948		5010.696471	171.580736	386.2535787			23.92883392	1052.707235			258.8771981	0.53283227					177.1843822											$200 (1a); $0 (1a1)	$912 (1b)	"$120 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$0 (4b)"	$100 (9b)	$0 (8a1); $0/$7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $100 (9a)"	"$0/$50/$30 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$5 (7b, 7d); $0 n/c (7b1, 7f1); $0/$5( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $0/$5 (17a); $5( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$5 (13b), $0 n/c (13c, 13d, 13e)"											200	912	49.4449		75	0.2	0.2	48.9615	100	2.8	0.140207441			3.9751		5	30	7.9579			0.2	5			26.6698	0.411069113					5											5.2618	0.428834938	4.386218131	0	3.307824836	2.382041478	2.936159826	1.531917587	2.082273497	3.892852559	0.669114073	0	0	0.349877585	0	2.087787653	0.42895184	0.256147598	0	0	4.785766783	0.438628014	0	0	0.575350524	0.219030888	0	0	0	0	0.073826826	0	0	0	0	0	0	0	0	0	0	36.0944	0	0	5.2618	0.428834938	4.386218131	0	3.307824836	2.382041478	2.936159826	1.531917587	2.082273497	3.892852559	0.669114073	0	0	0.349877585	0	2.087787653	0.42895184	0.256147598	0	0	4.785766783	0.438628014	0	0	0.575350524	0.219030888	0	0	0	0	0.073826826	0	0	0	0	0	0	0	0	0	0	36.0944																																																																																				0			5.2618	0.428834938	4.386218131	0	3.307824836	2.382041478	2.936159826	1.531917587	2.082273497	3.892852559	0.669114073	0	0	0.349877585	0	2.087787653	0.42895184	0.256147598	0	0	4.785766783	0.438628014	0	0	0.575350524	0.219030888	0	0	0	0	0.073826826	0	0	0	0	0	0	0	0	0	0	36.0944
H0543_114_0	2008	3																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1435.999522	5.144871194	956.6562502		518.980878	15.00184881	15.2436844	390.7756808	268.8203152		8.791720206			1042.785393	4738.05748	4917.600579	168.7396016	371.8210231			28.97177944	1043.188562			168.9945297	1.515300523																$100 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$100 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $100 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$15 (7b, 7d); $0 n/c (7b1, 7f1); $10/$15( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$15 (17a); $15( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											42.837	912	41.2041		75	0.2	0.2	49.0315	100		0.149750348			3.9004	10	15	30	7.9579			0.2	15			30	0.427169082																5.1262	0.391010211	3.284846968	0	3.243630487	3.000369761	3.04873688	1.596691861	2.240169294	0	1.316563158	0	0	0.33894112	3.948381233	6.146995407	0.421849004	0.246576517	0	0	5.794355888	1.303985703	0	0	0.422486324	0.647289534	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.519	0	0	5.1262	0.391010211	3.284846968	0	3.243630487	3.000369761	3.04873688	1.596691861	2.240169294	0	1.316563158	0	0	0.33894112	3.948381233	6.146995407	0.421849004	0.246576517	0	0	5.794355888	1.303985703	0	0	0.422486324	0.647289534	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.519																																																																																				0			5.1262	0.391010211	3.284846968	0	3.243630487	3.000369761	3.04873688	1.596691861	2.240169294	0	1.316563158	0	0	0.33894112	3.948381233	6.146995407	0.421849004	0.246576517	0	0	5.794355888	1.303985703	0	0	0.422486324	0.647289534	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.519
H0543_121_0	2008	3																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0			5.205265366	1035.546634		536.8164484	10.98683819	13.35796533	420.2919449			5.58414683			50.04087575		486.476252	173.9027228	378.154092			22.86025675	1067.491375		506.5453751							156.9230769											"$0 (1a, 1a1)"	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$0 (4b)"	$0 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$0 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $0 (9a)"	"$0/$50/$30 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14f1, 14h1)"	$30 (7b); $10 (7b1); $0 (7d); $0/$30( 7f); $0 n/c( 7f1); $0/$0( 7g)	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $0/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c; $20 (16)	$0 (17a1)	$0 n/c; $0 (17b)	$0 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$10 (13b), $0 n/c (13c, 13d, 13e)"												912	63.2242		100	0.2	0.2	48.9247			0.147634774			33.3992		21.771	30	7.9579			0.2	30		20							10											0	0.395600168	5.45597041	0	4.473470403	2.197367638	2.671593067	1.713555274	0	0	0.824414258	0	0	0.139277088	0	0.882588155	0.434756807	0.250776349	0	0	4.57205135	2.668728439	0	0.844242292	0	0	0	0	0	0	0.130769231	0	0	0	0	0	0	0	0	0	0	27.6552	0	0	0	0.395600168	5.45597041	0	4.473470403	2.197367638	2.671593067	1.713555274	0	0	0.824414258	0	0	0.139277088	0	0.882588155	0.434756807	0.250776349	0	0	4.57205135	2.668728439	0	0.844242292	0	0	0	0	0	0	0.130769231	0	0	0	0	0	0	0	0	0	0	27.6552																																																																																				0			0	0.395600168	5.45597041	0	4.473470403	2.197367638	2.671593067	1.713555274	0	0	0.824414258	0	0	0.139277088	0	0.882588155	0.434756807	0.250776349	0	0	4.57205135	2.668728439	0	0.844242292	0	0	0	0	0	0	0.130769231	0	0	0	0	0	0	0	0	0	0	27.6552
H0543_122_0	2008	5																					5000											D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1347.461799	5.22102906	1037.67567		529.2596612	9.823352353	11.39450098	374.9476885	253.6010468	16657.1727	7.70646219			1074.142516	4993.918282	4993.207119	172.0974125	372.418118			20.21302517	1048.888843			259.6333868	0.53283227																$200 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$200 (9b)	$0 (8a1); $0/$11 (8a2)	"$10 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											158.2332	721.5434	87.0283		79.1166	0.158233191	0.158233191	38.7425	158.2332	3.4811	0.073621202			4.9831	11.8675	23.735	23.735	23.735			0.158233191	23.735			18.4043	0.411069113																17.7678	0.313933233	7.525591896	0	3.489435207	1.554380388	1.802988248	1.210533803	3.34400857	4.832148909	0.567359006	0	0	0.446044935	4.938772654	9.876134293	0.340394034	0.736611339	0	0	3.19837147	2.074612856	0	0	0.398196918	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6363	0	17.00341338	17.7678	0.313933233	7.525591896	0	3.489435207	1.554380388	1.802988248	1.210533803	3.34400857	4.832148909	0.567359006	0	0	0.446044935	4.938772654	9.876134293	0.340394034	0.736611339	0	0	3.19837147	2.074612856	0	0	0.398196918	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6363																																																																																				0			17.7678	0.313933233	7.525591896	0	3.489435207	1.554380388	1.802988248	1.210533803	3.34400857	4.832148909	0.567359006	0	0	0.446044935	4.938772654	9.876134293	0.340394034	0.736611339	0	0	3.19837147	2.074612856	0	0	0.398196918	0.219030888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6363
H0543_125_0	2008	5																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1663.8721	3.307339628	1269.775544		513.6641806	20.47734936	22.47947844	386.0415218	313.3434533	17079.80282	38.20212826			1023.009398	4482.842836	4603.14224	147.190346	379.5319863			15.06268039	1128.579986			213.4975804	0.819692198																$250 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$200 (9b)	$0 (8a1); $0/$7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											107.0924	912	87.3197		100	0.2	0.2	48.9773	200	2.8	0.156930387			5.7172	15	29.998	30	7.9579			0.2	29.9997			30	0.419759205																14.849	0.251357812	9.239704828	0	4.280534839	4.095469873	4.495895687	1.575605541	5.222390888	3.985287324	5.995074759	0	0	0.487393848	5.603553544	11.50707398	0.367975865	0.251690113	0	0	3.012536079	2.821419433	0	0	0.533743951	0.344073345	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.9198	0	0	14.849	0.251357812	9.239704828	0	4.280534839	4.095469873	4.495895687	1.575605541	5.222390888	3.985287324	5.995074759	0	0	0.487393848	5.603553544	11.50707398	0.367975865	0.251690113	0	0	3.012536079	2.821419433	0	0	0.533743951	0.344073345	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.9198																																																																																				0			14.849	0.251357812	9.239704828	0	4.280534839	4.095469873	4.495895687	1.575605541	5.222390888	3.985287324	5.995074759	0	0	0.487393848	5.603553544	11.50707398	0.367975865	0.251690113	0	0	3.012536079	2.821419433	0	0	0.533743951	0.344073345	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.9198
H0543_126_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1413.959092	6.934599012	1023.865428		515.9542112	15.50916637	25.86198775	388.884848	246.2360347	16414.57199	26.52327931			1195.539212	4763.050141	4983.544026	169.0340542	365.4397929			25.87209639	1023.759047			144	1.8025																$100 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$100 (9b)	$0 (8a1); $0/$7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $100 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$30 (7b); $0 n/c (7b1, 7f1); $20 (7d); $10/$30( 7f); $10/$20( 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											42.837	912	69.5467		100	0.2	0.2	48.9983	100	2.8	0.169003198			4.1008	10	20.5577	30	7.9579			0.2	30			30	0.428560333																5.0475	0.527029525	5.933868378	0	4.299618427	3.101833274	5.172397549	1.587890588	2.051966955	3.830066797	4.482519012	0	0	0.40855546	3.969208451	8.53751087	0.422585135	0.242344745	0	0	5.174419277	2.559397617	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4812	0	0	5.0475	0.527029525	5.933868378	0	4.299618427	3.101833274	5.172397549	1.587890588	2.051966955	3.830066797	4.482519012	0	0	0.40855546	3.969208451	8.53751087	0.422585135	0.242344745	0	0	5.174419277	2.559397617	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4812																																																																																				0			5.0475	0.527029525	5.933868378	0	4.299618427	3.101833274	5.172397549	1.587890588	2.051966955	3.830066797	4.482519012	0	0	0.40855546	3.969208451	8.53751087	0.422585135	0.242344745	0	0	5.174419277	2.559397617	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4812
H0543_127_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1392.253078	5.637021609	1060.497174		529.3401628	12.74916604	13.7012345	392.3402377	260.6315473	16823.1521	13.80208763			950.4814718			168.9020687	376.2075228			23.86625281				144	1.8025																$100 (1a); $0 (1a1)	$912 (1b)	"$120 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$0 (4b)"	$100 (9b)	$0 (8a1); $0/$7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $100 (9a)"	"$0/$50/$30 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$0 (7b, 7d); $0 n/c (7b1, 7f1); $0/$0( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 18a, 16b, 13a1); $0/$0 (17a)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											42.837	912	49.4449		75	0.2	0.2	48.9954	100	2.8	0.15997782			4.8054			30	7.9579			0.2				30	0.428560333																4.97	0.428413642	4.369683583	0	3.308376018	2.549833208	2.7402469	1.601905375	2.171929561	3.925402157	2.20802789	0	0	0.380619824	0	0	0.422255172	0.249485464	0	0	4.773250562	0	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2319	0	0	4.97	0.428413642	4.369683583	0	3.308376018	2.549833208	2.7402469	1.601905375	2.171929561	3.925402157	2.20802789	0	0	0.380619824	0	0	0.422255172	0.249485464	0	0	4.773250562	0	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2319																																																																																				0			4.97	0.428413642	4.369683583	0	3.308376018	2.549833208	2.7402469	1.601905375	2.171929561	3.925402157	2.20802789	0	0	0.380619824	0	0	0.422255172	0.249485464	0	0	4.773250562	0	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2319
H0543_128_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0			5.607627995	1034.818428		529.231025	11.8709241	15.27095123	379.1646487	250.4627361	16738.40508	6.634877287			1085.103741			171.8468872	374.215728			22.87898456				144	1.8025																$100 (1a); $0 (1a1)	$912 (1b)	"$120 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$0 (4b)"	$100 (9b)	$0 (8a1); $0/$6 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $100 (9a)"	"$0/$50/$30 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$0 (7b, 7d); $0 n/c (7b1, 7f1); $0/$0( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 18a, 16b, 13a1); $0/$0 (17a)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"												912	49.4449		75	0.2	0.2	48.9917	100	2.4	0.14478706			3.8762			30	7.9579			0.2				30	0.428560333																0	0.426179728	4.263876612	0	3.307693906	2.37418482	3.054190247	1.54799406	2.087189467	3.347681015	0.960644375	0	0	0.350505925	0	0	0.429617218	0.248164587	0	0	4.575796912	0	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.1062	0	0	0	0.426179728	4.263876612	0	3.307693906	2.37418482	3.054190247	1.54799406	2.087189467	3.347681015	0.960644375	0	0	0.350505925	0	0	0.429617218	0.248164587	0	0	4.575796912	0	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.1062																																																																																				0			0	0.426179728	4.263876612	0	3.307693906	2.37418482	3.054190247	1.54799406	2.087189467	3.347681015	0.960644375	0	0	0.350505925	0	0	0.429617218	0.248164587	0	0	4.575796912	0	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.1062
H0543_129_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1387.5742	5.29230929	1183.453722		529.317784	15.74266277	16.83615819	366.396203	264.2327036	16951.89798	21.30450796			756.2544581			164.1014344	384.8700427			21.63895214				144	1.8025																$50 (1a); $0 (1a1)	$912 (1b)	"$120 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$0 (4b)"	$50 (9b)	$0 (8a1); $0/$7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$50 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $50 (9a)"	"$0/$50/$30 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$0 (7b, 7d); $0 n/c (7b1, 7f1); $0/$0( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 18a, 16b, 13a1); $0/$0 (17a)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"											21.4185	912	49.4449		75	0.2	0.2	49.0221	50	2.8	0.156618489			3.0863			30	7.9579			0.2				30	0.428560333																2.4766	0.402215506	4.876315023	0	3.30823615	3.148532553	3.367231638	1.496792749	1.100969598	3.955442861	3.336679841	0	0	0.194502912	0	0	0.410253586	0.255230094	0	0	4.327790427	0	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.7893	0	0	2.4766	0.402215506	4.876315023	0	3.30823615	3.148532553	3.367231638	1.496792749	1.100969598	3.955442861	3.336679841	0	0	0.194502912	0	0	0.410253586	0.255230094	0	0	4.327790427	0	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.7893																																																																																				0			2.4766	0.402215506	4.876315023	0	3.30823615	3.148532553	3.367231638	1.496792749	1.100969598	3.955442861	3.336679841	0	0	0.194502912	0	0	0.410253586	0.255230094	0	0	4.327790427	0	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.7893
H0543_130_0	2008	4	F2	H5a	H5b	I2a	O1a	E2b					OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)	DME					2900	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests	Diabetes Monitoring Supplies					D	D	D	P	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V		V	Coin	V	T	P	V	P	V	P				V	P	V	V	V	P																																														0		1719.154559	50.5366872	1454.854759	446.129947	1.88018137	17.3966459	22.3587843	445.7578719	335.9670861	4240.235998	889.1865149		19.22712234	4.217320322	4170.498818	4222.13176	96.08325423	454.1561043			31.19216687	1005.690826	1321.674354		364.7952928							64.16352934		39.81893515	78.6		499.1899796					(1a) $200/day	(1b) $200/day	(2a) $140/day days 21-100	(6a) $0/proc	(10a) $100/trip	(11a) 20% coins	(11b/11c) 20%/0% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $35/visit	(8a) $25/visit	(8b) $25/visit		(12) 20% coins	(5) $25/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $25/visit	(7e/7h) $32.5/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $25/visit			(15) 20% coins	(16b/17a) $25/visit (13a/13a1/14a10/17b N/A $0 Copay)	(10b) $0/trip		(17a1) $0/visit							(4b) $35/visit (waived if admitted)		(9d) $35/visit	(7f1) $0/visit		$0/proc					174.5856	174.5856	36.663		87.2928	0.174585587	0.174585587	43.6464	30.5525	21.8232	21.8232		0.174585587	21.8232		21.8232	28.3702	21.8232			0.174585587	21.8232										30.5525		30.5525								25.0116	0.7352481	4.44494176	0	0.01367719	3.037203636	3.903521481	1.621310411	0.855385576	7.711292609	1.617074475	0	3.356778439	0.007669618	0	7.678368245	0.227158091	0.82592823	0	0	5.445702761	1.828949199	0	0	0	0	0	0	0	0	0	0.1633629	0	0.101380594	0	0	0	0	0	0	0	68.5866		10.00090221	25.0116	0.7352481	4.44494176	0	0.01367719	3.037203636	3.903521481	1.621310411	0.855385576	7.711292609	1.617074475	0	3.356778439	0.007669618	0	7.678368245	0.227158091	0.82592823	0	0	5.445702761	1.828949199	0	0	0	0	0	0	0	0	0	0.1633629	0	0.101380594	0	0	0	0	0	0	0	68.5866																																																																																				0		0	25.0116	0.7352481	4.44494176	0	0.01367719	3.037203636	3.903521481	1.621310411	0.855385576	7.711292609	1.617074475	0	3.356778439	0.007669618	0	7.678368245	0.227158091	0.82592823	0	0	5.445702761	1.828949199	0	0	0	0	0	0	0	0	0	0.1633629	0	0.101380594	0	0	0	0	0	0	0	68.5866
H0543_131_0	2008	6	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						2800	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T				V					V	P	V	V																																																0		2346.795602	110.6176337	9505.403882	231.9892524	528.2105292	33.44505697	0.300640729	189.6416684	129.225494	4839.082328	196.008882	29.81013635	7.307824688	242.5634188	143.4281621	1544.658662	2314.870622	27.98420075		310.9680376	275.1961333	748.2979687	1912.9									108.8214686	1.374739298		247.1							(1a) $200/day	(1b) $200/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $35/visit	(8a) $0/visit	(8b) $0/visit	(9a) $35/visit	(12) $0/proc	(9a) $35/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $15/visit	(7e/7h) $32.5/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $15/visit	(15) $0/proc	(Misc. PBP Cats) $15/visit	(10b) $0/trip				(18a) $15/visit					(4b) $35/visit (waived if admitted)	(9c) $32.5/proc 75%/25% Ind/Grp Blended Copay	(9d) $35/visit	(7f1) $0/visit							180.7733	180.7733			67.79	0.180773255	0.180773255	45.1933	31.6353			31.6353		31.6353		13.558	29.3757			13.558		13.558										31.6353	29.3757									35.3532	1.666392477	0	0	2.983948025	6.04597182	0.054347803	0.714211286	0.340674151	0	0	0.078587766	0	0.639464274	0	1.745206091	5.666736533	0	0	0.351341903	0	0.845451623	0	0	0	0	0	0	0	0	0	0.286883496	0.003365322	0	0	0	0	0	0	0	0	56.7757		6.038573827	35.3532	1.666392477	0	0	2.983948025	6.04597182	0.054347803	0.714211286	0.340674151	0	0	0.078587766	0	0.639464274	0	1.745206091	5.666736533	0	0	0.351341903	0	0.845451623	0	0	0	0	0	0	0	0	0	0.286883496	0.003365322	0	0	0	0	0	0	0	0	56.7757																																																																																				0		0	35.3532	1.666392477	0	0	2.983948025	6.04597182	0.054347803	0.714211286	0.340674151	0	0	0.078587766	0	0.639464274	0	1.745206091	5.666736533	0	0	0.351341903	0	0.845451623	0	0	0	0	0	0	0	0	0	0.286883496	0.003365322	0	0	0	0	0	0	0	0	56.7757
H0543_133_0	2008	8																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1656.923377	6.319626715	1413.180022		632.0663863	18.42773564	19.80043614	437.0416117	315.5242752		25.15636721			903.0549076			195.9560093	459.5791498			25.35099475																					$50 (1a); $0 (1a1)	$912 (1b)	"$120 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$0 (4b)"	$50 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$50 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $50 (9a)"	"$0/$50/$30 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$0 (7b, 7d); $0 n/c (7b1, 7f1); $0/$0( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 18a, 16b, 13a1); $0/$0 (17a)"	$0 n/c (10b)	$0 n/c (16)	$0 (17a1)	$0 n/c; $0 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a); $0 n/c (14a1, 14a2, 14a3, 14a4, 14a5,14a6, 14a7,14a8)"	"$0 (13c), $0 n/c (13b, 13d, 13e)"											21.4185	912	49.4449		75	0.2	0.2	49.021	50		0.156600364			3.0831			30	7.9579			0.2																					2.9574	0.48029163	5.822881657	0	3.950414915	3.685547127	3.960087227	1.785352709	1.31468448	0	3.939496264	0	0	0.232019522	0	0	0.489890023	0.304774122	0	0	5.07019895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.993	0	0	2.9574	0.48029163	5.822881657	0	3.950414915	3.685547127	3.960087227	1.785352709	1.31468448	0	3.939496264	0	0	0.232019522	0	0	0.489890023	0.304774122	0	0	5.07019895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.993																																																																																				0			2.9574	0.48029163	5.822881657	0	3.950414915	3.685547127	3.960087227	1.785352709	1.31468448	0	3.939496264	0	0	0.232019522	0	0	0.489890023	0.304774122	0	0	5.07019895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.993
H0543_134_0	2008	8																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		377.4597551	6.746262676	1272.730436		632.7747852	14.14168567	17.46490986	448.2195018	298.7484745		5.705762969			1262.794344		5990.799355	205.1422928	461.8055999			28.40334507	1258.619008																				$200 (1a); $0 (1a1)	$912 (1b)	"$120 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$0 (4b)"	$100 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $100 (9a)"	"$0/$50/$30 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$5 (7b, 7d); $0 n/c (7b1, 7f1); $0/$5( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $0/$5 (17a); $5( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$0 (17a1)	$0 n/c; $0 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a); $0 n/c (14a1, 14a2, 14a3, 14a4, 14a5,14a6, 14a7,14a8)"	"$0 (13c), $0 n/c (13b, 13d, 13e)"											200	912	49.4449		75	0.2	0.2	48.9599	100		0.140207437			3.9729		5	30	7.9579			0.2	5																				6.291	0.512715963	5.244171723	0	3.954842407	2.828337134	3.492981972	1.828731217	2.489570621	0	0.799990403	0	0	0.418083058	0	2.496163356	0.512855732	0.306250613	0	0	5.680669015	0.524424587	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.3808	0	0	6.291	0.512715963	5.244171723	0	3.954842407	2.828337134	3.492981972	1.828731217	2.489570621	0	0.799990403	0	0	0.418083058	0	2.496163356	0.512855732	0.306250613	0	0	5.680669015	0.524424587	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.3808																																																																																				0			6.291	0.512715963	5.244171723	0	3.954842407	2.828337134	3.492981972	1.828731217	2.489570621	0	0.799990403	0	0	0.418083058	0	2.496163356	0.512855732	0.306250613	0	0	5.680669015	0.524424587	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.3808
H0543_135_0	2008	8																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1646.113971	6.66486587	1253.866299		625.8590847	14.27100675	15.3944441	463.4059074	308.1546293		15.96663759			1123.790534			199.6993645	444.8045178			26.80007956																					$100 (1a); $0 (1a1)	$912 (1b)	"$120 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$0 (4b)"	$100 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $100 (9a)"	"$0/$50/$30 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$0 (7b, 7d); $0 n/c (7b1, 7f1); $0/$0( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 18a, 16b, 13a1); $0/$0 (17a)"	$0 n/c (10b)	$0 n/c (16)	$0 (17a1)	$0 n/c; $0 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a); $0 n/c (14a1, 14a2, 14a3, 14a4, 14a5,14a6, 14a7,14a8)"	"$0 (13c), $0 n/c (13b, 13d, 13e)"											42.837	912	49.4449		75	0.2	0.2	48.9944	100		0.160030788			4.8054			30	7.9579			0.2																					5.8762	0.506529806	5.166443735	0	3.911619279	2.854201349	3.078888821	1.892023322	2.567955244	0	2.555153591	0	0	0.45002135	0	0	0.499248411	0.29497619	0	0	5.360015912	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0133	0	0	5.8762	0.506529806	5.166443735	0	3.911619279	2.854201349	3.078888821	1.892023322	2.567955244	0	2.555153591	0	0	0.45002135	0	0	0.499248411	0.29497619	0	0	5.360015912	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0133																																																																																				0			5.8762	0.506529806	5.166443735	0	3.911619279	2.854201349	3.078888821	1.892023322	2.567955244	0	2.555153591	0	0	0.45002135	0	0	0.499248411	0.29497619	0	0	5.360015912	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0133
H0543_136_0	2008	8	F2	H5a	H5b	I2a	O1a	E2b	I2b				OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)	DME	Professional				3500	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests	Diabetes Monitoring Supplies					D	D	D	P	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V		V	Coin	V			V	P	V					V	P	V	V		P																																														0		1584.417756	46.57593121	1252.394309	388.375452	1.636779361	13.40786607	17.23226345	376.4629117	283.7395713	3581.073248	20.4555584		14.80107723	3.561719912	3817.004285	3864.26078	87.93916724	415.6615003			1249.012363	1174.868427			333.8749767							54.18903536		33.62891205	78.6		434.5665097					(1a) $175/day	(1b) $175/day	(2a) $42/day	(6a) $0/proc	(10a) $75/trip	(11a) 15% coins	(11a/11c) 15%/0% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $75/visit	(8a) $10/visit	(8b) 11.54% coins		(12) 20% coins	$75/visit	"(7a, 14b-14i) $0/visit"	(7b) $25/visit	(7e/7h) $20/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $20/visit			(15) $0/proc	(16b/17a) $25/visit (13a/13a1/14a10/17b N/A $0 Copay)			(17a1) $0/visit							(4b) $25/visit (waived if admitted)		(9d) $25/visit	(7f1) $0/visit		$0/proc	(7d/7f$10/visit				165.4642	165.4642	39.7114		70.9132	0.141826446	0.189101928	47.2755	70.9132	9.4551	0.109111812		0.189101928	70.9132		23.6377	18.9102	18.9102				23.6377										23.6377		23.6377								21.847	0.642220716	4.144528123	0	0.009672442	1.901589993	3.258654243	1.483122134	1.676740624	2.821616064	2.231943052	0	2.79891224	0.021047753	0	7.611866289	0.138578884	0.655019926	0	0	0	2.314269633	0	0	0	0	0	0	0	0	0	0.106742199	0	0.066242626	0	0	0	0	0	0	0	53.7298		3.109488841	21.847	0.642220716	4.144528123	0	0.009672442	1.901589993	3.258654243	1.483122134	1.676740624	2.821616064	2.231943052	0	2.79891224	0.021047753	0	7.611866289	0.138578884	0.655019926	0	0	0	2.314269633	0	0	0	0	0	0	0	0	0	0.106742199	0	0.066242626	0	0	0	0	0	0	0	53.7298																																																																																				0		0	21.847	0.642220716	4.144528123	0	0.009672442	1.901589993	3.258654243	1.483122134	1.676740624	2.821616064	2.231943052	0	2.79891224	0.021047753	0	7.611866289	0.138578884	0.655019926	0	0	0	2.314269633	0	0	0	0	0	0	0	0	0	0.106742199	0	0.066242626	0	0	0	0	0	0	0	53.7298
H0543_137_0	2008	8																					5000											D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2026.034235	7.850303159	1560.241955		795.7911635	14.41399583	16.71937275	562.913768	381.3127787		11.41402162			1615.073253	6971.306798	7507.751666	258.7644783	559.9653047			29.65896469	1577.102005																				$200 (1a); $0 (1a1)	$912 (1b)	"$120 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$200 (9b)	$0 (8a1); $0/$0 (8a2)	"$10 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$0 (17a1)	$0 n/c; $0 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a); $0 n/c (14a1, 14a2, 14a3, 14a4, 14a5,14a6, 14a7,14a8)"	"$0 (13c), $0 n/c (13b, 13d, 13e)"											143.4764	654.2523	86.0858		71.7382	0.14347639	0.14347639	35.1282	143.4764		0.067763818			4.5142	10.7607	21.5214	21.5215	21.5215			0.14347639	21.5215																				24.224	0.428006601	11.19289418	0	4.757385147	2.068068091	2.398835249	1.647847726	4.559115087	0	0.77345768	0	0	0.607568519	6.251362091	13.46480786	0.464082416	1.004272507	0	0	4.255361192	2.828461284	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.9255	0	31.88122584	24.224	0.428006601	11.19289418	0	4.757385147	2.068068091	2.398835249	1.647847726	4.559115087	0	0.77345768	0	0	0.607568519	6.251362091	13.46480786	0.464082416	1.004272507	0	0	4.255361192	2.828461284	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.9255																																																																																				0			24.224	0.428006601	11.19289418	0	4.757385147	2.068068091	2.398835249	1.647847726	4.559115087	0	0.77345768	0	0	0.607568519	6.251362091	13.46480786	0.464082416	1.004272507	0	0	4.255361192	2.828461284	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.9255
H0543_138_0	2008	5																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		322.6254147	5.930757965	1087.108505		529.1907465	12.23917543	13.96372451	384.9662438	263.7572072	16812.87237	12.51395271			952.3906294		369.2307692	167.8821727	376.9545279			21.60792997				144	1.802453333					156.9230769											$50 (1a); $0 (1a1)	$912 (1b)	"$120 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$0 (4b)"	$50 (9b)	$0 (8a1); $0/$6 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$50 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $50 (9a)"	"$0/$50/$30 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$0 (7b, 7d); $10 (7b1); $0/$0( 7f, 7g); $0 n/c( 7f1)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 18a, 16b, 13a1); $0/$0 (17a)"	$0 (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$10 (13b), $0 n/c (13c, 13d, 13e)"											50	912	49.4449		75	0.2	0.2	49.0181	50	2.4	0.1555288			2.7449		10	30	7.9579			0.2				30	0.428571429					10											1.3443	0.450737605	4.479333187	0	3.307442166	2.447835087	2.792744902	1.572526162	1.098988363	3.362574474	1.946280051	0	0	0.217849043	0	0.307692308	0.419705432	0.249980847	0	0	4.321585995	0	0	0	0.36	0.77248	0	0	0	0	0.130769231	0	0	0	0	0	0	0	0	0	0	29.5828	0	0	1.3443	0.450737605	4.479333187	0	3.307442166	2.447835087	2.792744902	1.572526162	1.098988363	3.362574474	1.946280051	0	0	0.217849043	0	0.307692308	0.419705432	0.249980847	0	0	4.321585995	0	0	0	0.36	0.77248	0	0	0	0	0.130769231	0	0	0	0	0	0	0	0	0	0	29.5828																																																																																				0			1.3443	0.450737605	4.479333187	0	3.307442166	2.447835087	2.792744902	1.572526162	1.098988363	3.362574474	1.946280051	0	0	0.217849043	0	0.307692308	0.419705432	0.249980847	0	0	4.321585995	0	0	0	0.36	0.77248	0	0	0	0	0.130769231	0	0	0	0	0	0	0	0	0	0	29.5828
H0543_139_0	2008	8																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1616.453147	6.183717857	1231.041669		620.1664325	12.76556319	15.37958542	478.4892928	295.4207347		4.560373878			1259.492748	5491.427217	5910.050072	201.5748276	436.096512			30.94099483	1229.230297																				$200 (1a); $0 (1a1)	$912 (1b)	"$120 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$200 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$0 (17a1)	$0 n/c; $0 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a); $0 n/c (14a1, 14a2, 14a3, 14a4, 14a5,14a6, 14a7,14a8)"	"$0 (13c), $0 n/c (13b, 13d, 13e)"											85.6739	912	75.8691		100	0.2	0.2	49.0347	200		0.138867396			6.325	15	30	30	30			0.2	30																				11.5407	0.469962557	7.783166916	0	5.168053604	2.553112637	3.075917084	1.955215151	4.923678912	0	0.633287246	0	0	0.663860635	6.864284021	14.77511807	0.503937069	1.09024128	0	0	6.188198966	3.073075743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2618	0	0	11.5407	0.469962557	7.783166916	0	5.168053604	2.553112637	3.075917084	1.955215151	4.923678912	0	0.633287246	0	0	0.663860635	6.864284021	14.77511807	0.503937069	1.09024128	0	0	6.188198966	3.073075743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2618																																																																																				0			11.5407	0.469962557	7.783166916	0	5.168053604	2.553112637	3.075917084	1.955215151	4.923678912	0	0.633287246	0	0	0.663860635	6.864284021	14.77511807	0.503937069	1.09024128	0	0	6.188198966	3.073075743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2618
H0543_802_0	2008	3																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1289.712246	39.89502208	1029.805459		8.608163162	16.19076394	20.03755226	357.8663102	257.390842		16.16040753		11.91482151	789.3022742	4921.44854	4948.588173	0.849977652	380.529798			28.97456038	1091.519555			253.6637386																	$725 (1a); $0 (1a1)	$725 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											456.2273	481.7965	159.1696		0.3	0.3	0.3	49.1679	300		0.231459114		0.3	7.5003	20	39.9988	0.671465767	40			0.3	40			27.5303																	49.0335	1.601773509	13.65947364	0	2.582448949	4.857229183	6.011265677	1.466295307	6.434771049	0	3.740473612	0	3.574446452	0.493336529	8.202414234	16.49481234	0.570730896	1.26843266	0	0	8.692368115	3.638398517	0	0	0.581952856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.9041	0	0	49.0335	1.601773509	13.65947364	0	2.582448949	4.857229183	6.011265677	1.466295307	6.434771049	0	3.740473612	0	3.574446452	0.493336529	8.202414234	16.49481234	0.570730896	1.26843266	0	0	8.692368115	3.638398517	0	0	0.581952856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.9041																																																																																				0			49.0335	1.601773509	13.65947364	0	2.582448949	4.857229183	6.011265677	1.466295307	6.434771049	0	3.740473612	0	3.574446452	0.493336529	8.202414234	16.49481234	0.570730896	1.26843266	0	0	8.692368115	3.638398517	0	0	0.581952856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.9041
H0543_804_0	2008	3																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1274.295385	42.54741951	1006.425904		8.909160732	16.84562125	20.56707927	364.0144458	259.141335		15.66218323		12.85296064	805.0917406	4856.391357	5039.738914	0.882648994	386.3842791			30.61436979	1112.023523			166.1125951																	$850 (1a); $0 (1a1)	$850 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											534.8872	564.8649	159.1696		0.3	0.3	0.3	49.1728	300		0.229878827		0.3	7.5003	20	39.9991	0.654900826	40			0.3	40			40																	56.8004	2.002795198	13.34936417	0	2.67274822	5.053686376	6.170123781	1.491635519	6.478533376	0	3.600404314	0	3.855888193	0.503205338	8.093985595	16.79874897	0.578047555	1.287947597	0	0	9.184310938	3.706745077	0	0	0.55370865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.1822	0	0	56.8004	2.002795198	13.34936417	0	2.67274822	5.053686376	6.170123781	1.491635519	6.478533376	0	3.600404314	0	3.855888193	0.503205338	8.093985595	16.79874897	0.578047555	1.287947597	0	0	9.184310938	3.706745077	0	0	0.55370865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.1822																																																																																				0			56.8004	2.002795198	13.34936417	0	2.67274822	5.053686376	6.170123781	1.491635519	6.478533376	0	3.600404314	0	3.855888193	0.503205338	8.093985595	16.79874897	0.578047555	1.287947597	0	0	9.184310938	3.706745077	0	0	0.55370865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.1822
H0543_805_0	2008	3																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1360.520327	39.93160224	1002.020086		8.606075194	17.49371705	21.3613407	365.6955246	289.4982451		20.27133896		11.45871522	802.7437139	4925.208447	4937.251401	0.892007832	380.2170126			29.24985873	1096.078456			253.2496423																	$600 (1a); $0 (1a1)	$600 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											377.5674	398.7281	159.1696		0.3	0.3	0.3	49.1148	300		0.235971725		0.3	7.5003	20	39.9985	0.635268599	40			0.3	40			27.5867																	42.8073	1.326821124	13.29092483	0	2.581822558	5.248115114	6.40840221	1.49675549	7.237456127	0	4.783462828	0	3.437614565	0.501737428	8.208680746	16.45686812	0.566664566	1.267390042	0	0	8.77495762	3.653594853	0	0	0.582192818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.6308	0	0	42.8073	1.326821124	13.29092483	0	2.581822558	5.248115114	6.40840221	1.49675549	7.237456127	0	4.783462828	0	3.437614565	0.501737428	8.208680746	16.45686812	0.566664566	1.267390042	0	0	8.77495762	3.653594853	0	0	0.582192818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.6308																																																																																				0			42.8073	1.326821124	13.29092483	0	2.581822558	5.248115114	6.40840221	1.49675549	7.237456127	0	4.783462828	0	3.437614565	0.501737428	8.208680746	16.45686812	0.566664566	1.267390042	0	0	8.77495762	3.653594853	0	0	0.582192818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.6308
H0543_806_0	2008	3																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1395.192995	37.98978714	1062.861356		8.721639566	18.47596188	22.4731828	384.1245851	284.6702122		23.72079622		12.39695605	846.5014867	4944.196273	4958.619104	0.926249285	386.9709302			26.51099994	1096.495335			253.1547023																	$625 (1a); $0 (1a1)	$625 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											393.2994	415.3418	159.1696		0.3	0.3	0.3	49.0045	300		0.240720489		0.3	7.5003	20	39.9989	0.621450917	40			0.3	40			28.1553																	45.7274	1.314895587	14.09793135	0	2.61649187	5.542788564	6.74195484	1.568652252	7.116755306	0	5.710081678	0	3.719086816	0.529086036	8.240327121	16.52826438	0.575618467	1.289903101	0	0	7.953299983	3.654984451	0	0	0.593969557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.5215	0	0	45.7274	1.314895587	14.09793135	0	2.61649187	5.542788564	6.74195484	1.568652252	7.116755306	0	5.710081678	0	3.719086816	0.529086036	8.240327121	16.52826438	0.575618467	1.289903101	0	0	7.953299983	3.654984451	0	0	0.593969557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.5215																																																																																				0			45.7274	1.314895587	14.09793135	0	2.61649187	5.542788564	6.74195484	1.568652252	7.116755306	0	5.710081678	0	3.719086816	0.529086036	8.240327121	16.52826438	0.575618467	1.289903101	0	0	7.953299983	3.654984451	0	0	0.593969557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.5215
H0544_002_0	2008	5																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	P	P	Coin	V	T	V	V	P	V	P	P	P	P																																																				0		1239.148407	61.06352466	1063.458875		604.4484493	11.07609107		370.1153357						127.7526387			532.3994613				12.19003116			256.0743593		149.2877554																$75 / day (days 1-4) through non-preferred facilities; $0 through preferred facilities	$150 Deductible	$25 / day (32-100)		10A: $50 waived if admitted	11A: 20% if > $500		4A: $50 waived if admitted						$15 Copay for OP Substance Abuse			9c: $15				20% for drugs over $50 max $550			"16A: $15/oral exam, $20/cleaning, $10/fluoride , $5/xray; 16B: $5-$50/emergency services, $5-$15/diagnostic, $19-$430/restorative, $25-$373/edodontics/periodontics/extractions, $28-$525/prosthodontics, other oral/maxillofacial surgery/other"		$25/frames																6.1089	16.3368	0.112839342		50	0.052427088		50.1065						11.4732			5.0001				0.168960982			56.8821		39.199																0.6308	0.083132117	0.01	0	2.518535205	0.580687206	0	1.545433456	0	0	0	0	0	0.122143992	0	0	0.221835579	0	0	0	2.059639631	0	0	1.213836478	0	0.48766088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.4737	0	0	0.6308	0.083132117	0.01	0	2.518535205	0.580687206	0	1.545433456	0	0	0	0	0	0.122143992	0	0	0.221835579	0	0	0	2.059639631	0	0	1.213836478	0	0.48766088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.4737																																																																																				0	0	0	0.6308	0.083132117	0.01	0	2.518535205	0.580687206	0	1.545433456	0	0	0	0	0	0.122143992	0	0	0.221835579	0	0	0	2.059639631	0	0	1.213836478	0	0.48766088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.4737
H0544_003_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	P	P	Coin	V	T	V	V	P	V	P	P	P	P																																																				0						817.4250886	15.14044873		559.9964425													16.62858918																									10A: 20% waived if admitted	11A: 20% if > $500		4A: $50 waived if admitted													20% for drugs over $50 max $550																									53.0769	0.061806544		50.0938													0.168960982																					0	0	0	0	3.615535486	0.935778814	0	2.337694839	0	0	0	0	0	0	0	0	0	0	0	0	2.809582749	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.6986	0	0	0	0	0	0	3.615535486	0.935778814	0	2.337694839	0	0	0	0	0	0	0	0	0	0	0	0	2.809582749	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.6986																																																																																				0	0	0	0	0	0	0	3.615535486	0.935778814	0	2.337694839	0	0	0	0	0	0	0	0	0	0	0	0	2.809582749	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.6986
H0544_004_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	P	P	Coin	V	T	V	V	P	V	P	P	P	P																																																				0		1250.802335	51.77504035	1139.294936		653.2074015	11.48914157		374.9580181						128.818382			497.2661875				12.16218943			244.7837865		144.7517485																$75 / day (days 1-4) through non-preferred facilities; $0 through preferred facilities	$150 Ded.	$25 / day (32-100)		10A: $50 waived if admitted	11A: 20% if > $500		4A: $50 waived if admitted						$15 Copay for OP Substance Abuse			SA: $15				20% for drugs over $50 max $550			"16A: $15/oral exam, $20/cleaning, $10/fluoride , $5/xray; 16B: $5-$50/emergency services, $5-$15/diagnostic, $19-$430/restorative, $25-$373/edodontics/periodontics/extractions, $28-$525/prosthodontics, other oral/maxillofacial surgery/other"		$25/frames																6.1318	16.5765	0.105328301		50	0.048760975		50.1045						10.8193			4.687				0.168960982			59.5057		40.4274																0.6391	0.071520678	0.01	0	2.721697506	0.56022175	0	1.565588911	0	0	0	0	0	0.116143831	0	0	0.19422455	0	0	0	2.054935463	0	0	1.213836478	0	0.48766088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.635	0	0	0.6391	0.071520678	0.01	0	2.721697506	0.56022175	0	1.565588911	0	0	0	0	0	0.116143831	0	0	0.19422455	0	0	0	2.054935463	0	0	1.213836478	0	0.48766088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.635																																																																																				0	0	0	0.6391	0.071520678	0.01	0	2.721697506	0.56022175	0	1.565588911	0	0	0	0	0	0.116143831	0	0	0.19422455	0	0	0	2.054935463	0	0	1.213836478	0	0.48766088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.635
H0544_005_0	2008	5																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	P	P	Coin	V	T	V	V	P	V	P	P	P	P																																																				0						1944.765289	17.15339715		254.6305332													27.05326344																									10A: $50 waived if admitted	11a: 20% if > $500		4A: $50 waived if admitted													20% for drugs over $50 max $550																									50	0.115293828		50.5412													0.176207078																					0	0	0	0	8.103188703	1.977680815	0	1.072444569	0	0	0	0	0	0	0	0	0	0	0	0	4.766976498	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.9203	0	0	0	0	0	0	8.103188703	1.977680815	0	1.072444569	0	0	0	0	0	0	0	0	0	0	0	0	4.766976498	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.9203																																																																																				0	0	0	0	0	0	0	8.103188703	1.977680815	0	1.072444569	0	0	0	0	0	0	0	0	0	0	0	0	4.766976498	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.9203
H0544_007_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	P	P	P																																																				0		1301.105828	64.11670089	1116.631818		634.6708718	13.60697788	13.13247766	389.4492308	336.0224976		245.7745359			8.00586757		22.13328794	558.3860232	3837.943801	30.91661707		14.97545329			231.9048141		359.5938154																$85 / day (days 1-4)	$150 Deductible	$25 / day (32-100)		10A: $50 waived if admitted	11A: 20% if > $500	11A: 20% if > $500	4A: $50 waived if admitted	$50 OP Surgery		0.2			$30 Partial Hospitalization		$10 Copay	$10 MH; $30 SA	$10 Copay	0-20%		20% for drugs over $200 max $550			varies		$25/frames																69.2345	19.6042	0.091825789		50	0.052427088	0.052427088	50	50		161.4609			30		9.2105	10.0279	10	0.2		0.168960982			20.4744		28.5579																7.5068	0.104746467	0.008544633	0	2.644461966	0.713374233	0.688497568	1.622705128	1.40009374	0	3.30691492	0	0	0.020014669	0	0.016988269	0.466621287	3.1982865	6.183323414	0	2.530267286	0	0	0.395675147	0	0.855768911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6631	0	0	7.5068	0.104746467	0.008544633	0	2.644461966	0.713374233	0.688497568	1.622705128	1.40009374	0	3.30691492	0	0	0.020014669	0	0.016988269	0.466621287	3.1982865	6.183323414	0	2.530267286	0	0	0.395675147	0	0.855768911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6631																																																																																				0	0	0	7.5068	0.104746467	0.008544633	0	2.644461966	0.713374233	0.688497568	1.622705128	1.40009374	0	3.30691492	0	0	0.020014669	0	0.016988269	0.466621287	3.1982865	6.183323414	0	2.530267286	0	0	0.395675147	0	0.855768911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6631
H0544_008_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	P	P	Coin	V	T	V	V	P	V	P	P	P	P																																																				0		854.5640279	42.11173681	1137.827786		641.1591506	8.019523954	10.639992	318.4083647	295.442427	35.86990109	205.5639195				398.4405026	82.8648756	535.1305724	2894.172753	4124.743525	10438.82708	10.7418396			230.0960134		355.681729																$75 / day (days 1-4)	$150 Ded	$30 / day (32-100)		10A: $90 waived if admitted	11A: 20% if > $500	11A: 20% if > $500	4A: $50 waived if admitted	75	10	10				$10 Specialist	10	"7E, 7H, 9C: $10"	10	10	$10 Lab/Path	20% for drugs over $200 max $550			varies		$25/frames																61.0893	16.4119	0.382194245		90	0.052427088	0.052427088	50.2654	75	10	10				10	8.5161	10.2955	10	10	10	0.168960982			19.6527		27.4971																4.3504	0.057594312	0.036239269	0	4.808693629	0.420440292	0.557823802	1.333742751	1.846515169	0.029891584	0.171303266	0	0	0	0.332033752	0.05880717	0.45911868	2.411810628	3.437286271	8.699022568	1.814951763	0	0	0.376833473	0	0.81501801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.0175	0	0	4.3504	0.057594312	0.036239269	0	4.808693629	0.420440292	0.557823802	1.333742751	1.846515169	0.029891584	0.171303266	0	0	0	0.332033752	0.05880717	0.45911868	2.411810628	3.437286271	8.699022568	1.814951763	0	0	0.376833473	0	0.81501801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.0175																																																																																				0	0	0	4.3504	0.057594312	0.036239269	0	4.808693629	0.420440292	0.557823802	1.333742751	1.846515169	0.029891584	0.171303266	0	0	0	0.332033752	0.05880717	0.45911868	2.411810628	3.437286271	8.699022568	1.814951763	0	0	0.376833473	0	0.81501801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.0175
H0544_009_0	2008	4																																D	D	D	V	Coin	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	P	P	Coin	V	T	V	V	P	V	P	P	P	P																																																				0						20.34022661	10.96401065	13.62116949	484.1942543													15.22079409																									10A: 20%	11A: 20% if > $500	11A: 20% if > $500	4A: $50 waived if admitted													20% for drugs over $200 max $550																									0.2	0.061806544	0.061806544	50.0001													0.168960982																					0	0	0	0	4.068045321	0.677647609	0.841877415	2.01748159	0	0	0	0	0	0	0	0	0	0	0	0	2.571720309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1768	0	0	0	0	0	0	4.068045321	0.677647609	0.841877415	2.01748159	0	0	0	0	0	0	0	0	0	0	0	0	2.571720309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1768																																																																																				0	0	0	0	0	0	0	4.068045321	0.677647609	0.841877415	2.01748159	0	0	0	0	0	0	0	0	0	0	0	0	2.571720309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1768
H0544_010_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	P	P	Coin	V	T	V	V	P	V	P	P	P	P																																																				0		862.6010212	35.70604357	1218.967151		692.8794394	8.318533652	11.92754804	324.2729635						7.626765359							10.69382574			230.0960134		355.681729																$75 / day (days 1-4)	$150 Deductible	$30 / day (32-100)		10A: $90 waived if admitted	11A: 20% if > $500	11A: 20% if > $500	4A: $50 waived if admitted						$30 Partial Hospitalization							20% for drugs over $200 max $550			varies		$25/frames																61.3177	16.6526	0.431472081		90	0.048760975	0.048760975	50						30							0.168960982			19.6527		27.4971																4.4077	0.049549854	0.043829191	0	5.196595795	0.405619815	0.581598877	1.351137348	0	0	0	0	0	0.019066913	0	0	0	0	0	0	1.806839293	0	0	0.376833473	0	0.81501801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0538	0	0	4.4077	0.049549854	0.043829191	0	5.196595795	0.405619815	0.581598877	1.351137348	0	0	0	0	0	0.019066913	0	0	0	0	0	0	1.806839293	0	0	0.376833473	0	0.81501801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0538																																																																																				0	0	0	4.4077	0.049549854	0.043829191	0	5.196595795	0.405619815	0.581598877	1.351137348	0	0	0	0	0	0.019066913	0	0	0	0	0	0	1.806839293	0	0	0.376833473	0	0.81501801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0538
H0545_001_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	P	T	P	P	P	P	P	P	P	P																																																				0		1474.628095	62.88694557	1757.530418		237.9945839	9.104594072	8.604782866	239.2942228	288.5880834		111.2009713	24.93200183		755.5901193	3285.893222	6259.778703	109.6626508	1946.206555			27.1021698	5.923427315			134.170167	259.0976616																1a: $75 days 1-6	1b: $75 days 1-6	2: $25 days 21-100		10a: $85	11a: 20%	"11b: 20%, 11c: 0%"	"4a: $50, 4b: $30"	9b: $100		8b: $0-$50	9a: $100		"3, 5, 9c, 9d: $10; 9a: $10-$100"	"7a, 14c: $5"	"7b, 7d, 7f, 7g: $10"	"7e, 7h: $10"	"7c, 7i: $10"	$0 (incl in i.2.)		15: 10%	"14j, 16b: $10; 17a: $10; 17b: $0"			17a: $15	17b: $25	18a: $10															62.9883	48.0591	8.6419		100	0.2	0.2	49.9837	100		412.0845	100		87.2413	5.0067	10.1616	10	10			0.1	9.9855			15	25																7.7404	0.251857271	1.265705726	0	1.983288199	1.820918814	1.720956573	0.996733791	2.404900695	0	3.818683359	0.207766682	0	5.4932226	1.370944349	5.300784141	0.091385542	1.621838796	0	0	2.71021698	0.004929047	0	0	0.167712709	0.539786795	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.512	0	0	7.7404	0.251857271	1.265705726	0	1.983288199	1.820918814	1.720956573	0.996733791	2.404900695	0	3.818683359	0.207766682	0	5.4932226	1.370944349	5.300784141	0.091385542	1.621838796	0	0	2.71021698	0.004929047	0	0	0.167712709	0.539786795	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.512																																																																																				0	0	0	7.7404	0.251857271	1.265705726	0	1.983288199	1.820918814	1.720956573	0.996733791	2.404900695	0	3.818683359	0.207766682	0	5.4932226	1.370944349	5.300784141	0.091385542	1.621838796	0	0	2.71021698	0.004929047	0	0	0.167712709	0.539786795	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.512
H0545_008_0	2008	5																																D	D	D	V	P	P	P	V	V	V	V	V	V	V	P	P	P	P	Coin	P	Coin	P	P	P	P	P	P	P	P	P	P																																																				0						372.8151212			427.1448734						13.44323156				8.755707903																												10a: $85			"4a: $50, 4b: $30"						3: $10				7c: $10																												100			49.9856						10				10																								0	0	0	0	3.106792676	0	0	1.779258522	0	0	0	0	0	0.011202693	0	0	0	0.007296423	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.9046	0	0	0	0	0	0	3.106792676	0	0	1.779258522	0	0	0	0	0	0.011202693	0	0	0	0.007296423	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.9046																																																																																				0	0	0	0	0	0	0	3.106792676	0	0	1.779258522	0	0	0	0	0	0.011202693	0	0	0	0.007296423	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.9046
H0545_009_0	2008	6																																D	D	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	P	T	P	P	P	P	P	P	P	P																																																				0		2134.874376	57.86491961	2501.269107		271.2319252	14.42035131		291.6800573	365.4527841		5611.826536	44.97819384		950.8556053	7318.135017	7116.587434	306.077277	1677.078166			31.92271874	1318.33594			144	260	35.37748741															1a: $75 days 1-6	1b: $75 days 1-6	2: $25 days 21-100		10a: $85	11a: 20%		"4a: $50, 4b: $30"	9b: $100		8b: 0$-$50	9a: $100		"3, 5, 9c: $10; 9a: $100"	"7a, 14c: $5"	"7b, 7d, 7f, 7g: $10"	"7e, 7h: $10"	"7c, 7i: $10"	$0 (incl in i.2.)		15: 10%	16b: $10; 17a: $10;			17a1: $15	17b1: $25	18a: $10															50.6095	42.2766	11.6171		100	0.2		49.9835	100		14.6746	100		87.8349	5	10	10	10			0.1	10			15	25	10															9.0037	0.20386092	2.421447442	0	2.260266043	2.884070262	0	1.214931441	3.045439868	0	6.862598553	0.374818282	0	6.959861243	3.049222924	5.930489528	0.255064397	1.397565138	0	0	3.192271874	1.098613283	0	0	0.18	0.541666667	0.02948124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.9054	0	0	9.0037	0.20386092	2.421447442	0	2.260266043	2.884070262	0	1.214931441	3.045439868	0	6.862598553	0.374818282	0	6.959861243	3.049222924	5.930489528	0.255064397	1.397565138	0	0	3.192271874	1.098613283	0	0	0.18	0.541666667	0.02948124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.9054																																																																																				0	0	0	9.0037	0.20386092	2.421447442	0	2.260266043	2.884070262	0	1.214931441	3.045439868	0	6.862598553	0.374818282	0	6.959861243	3.049222924	5.930489528	0.255064397	1.397565138	0	0	3.192271874	1.098613283	0	0	0.18	0.541666667	0.02948124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.9054
H0545_801_0	2008	1																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		284.800144	5.189829052	75.04057313		9.676739766	9.55391986	9.029442199	9.997963382	36.48556762	17.98357823	50.18901593	1.932098195	0.905215332	20.54210963	25.17602095	92.9939262	1.614459401	14.34505851	2.483760385	7.407398246	28.43970376	2.17578424																				Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing																				0.064490888	0.064490888	0.171501538		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				18.367	0.334696683	12.86957369	0	2.264357105	2.235617247	2.112889475	2.339523431	8.537622822	4.208157305	11.74422973	0.452110978	0.211820388	4.806853653	5.891188903	21.76057873	0.3777835	3.356743691	0.58119993	1.73333119	6.65489068	0.509133512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.3493	0	0	18.367	0.334696683	12.86957369	0	2.264357105	2.235617247	2.112889475	2.339523431	8.537622822	4.208157305	11.74422973	0.452110978	0.211820388	4.806853653	5.891188903	21.76057873	0.3777835	3.356743691	0.58119993	1.73333119	6.65489068	0.509133512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.3493																																																																																				0	0	0	18.367	0.334696683	12.86957369	0	2.264357105	2.235617247	2.112889475	2.339523431	8.537622822	4.208157305	11.74422973	0.452110978	0.211820388	4.806853653	5.891188903	21.76057873	0.3777835	3.356743691	0.58119993	1.73333119	6.65489068	0.509133512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.3493
H0545_802_0	2008	1																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		284.800144	5.189829052	75.04057313		9.676739766	9.55391986	9.029442199	9.997963382	36.48556762	17.98357823	50.18901593	1.932098195	0.905215332	20.54210963	25.17602095	92.9939262	1.614459401	14.34505851	2.483760385	7.407398246	28.43970376	2.17578424																				Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing																				0.064490888	0.064490888	0.171501538		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				18.367	0.334696683	12.86957369	0	2.264357105	2.235617247	2.112889475	2.339523431	8.537622822	4.208157305	11.74422973	0.452110978	0.211820388	4.806853653	5.891188903	21.76057873	0.3777835	3.356743691	0.58119993	1.73333119	6.65489068	0.509133512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.3493	0	0	18.367	0.334696683	12.86957369	0	2.264357105	2.235617247	2.112889475	2.339523431	8.537622822	4.208157305	11.74422973	0.452110978	0.211820388	4.806853653	5.891188903	21.76057873	0.3777835	3.356743691	0.58119993	1.73333119	6.65489068	0.509133512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.3493																																																																																				0	0	0	18.367	0.334696683	12.86957369	0	2.264357105	2.235617247	2.112889475	2.339523431	8.537622822	4.208157305	11.74422973	0.452110978	0.211820388	4.806853653	5.891188903	21.76057873	0.3777835	3.356743691	0.58119993	1.73333119	6.65489068	0.509133512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.3493
H0562_002_0	2008	6																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		290.1983408	5.91913101	59.43476061	208.7860964	301.5692998	14.55882235	0.567610242	270.3230511	203.8172739	2.006639828	4.790566795	0.286662833	342.8863961	38.221711	7109.510427	6352.109607	239.4806475	3854.120744	1244.653318	361.9387127	37.33874422	0	0	0	598.0321294	0	69.89074349	0	0	500	0											"$100 per day, days 1-4"	$900 per admission	"$75 per day, days 21-100"	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$100 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$7 per office visit	$10 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$10 per office visit	20% of contracted rate				$10 per office visit		$10 per office visit			$0 per visit												292.406198	900	309.0352088	0	125	0.2	0.2	50	100	0	110.4008667	0	25	0	7	10	25	0	0	10	0.2	0	0	0	10	0	10	0	0	0	0											7.0713	0.443934826	1.530619471	0	3.141346873	2.911764471	0.113522048	1.126346046	1.698477283	0	0.044073561	0	0.714346659	0	4.147214416	5.293424672	0.498918016	0	0	0.301615594	7.467748845	0	0	0	0.498360108	0	0.058242286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.0613			7.0713	0.443934826	1.530619471	0	3.141346873	2.911764471	0.113522048	1.126346046	1.698477283	0	0.044073561	0	0.714346659	0	4.147214416	5.293424672	0.498918016	0	0	0.301615594	7.467748845	0	0	0	0.498360108	0	0.058242286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.0613																																																																																				0			7.0713	0.443934826	1.530619471	0	3.141346873	2.911764471	0.113522048	1.126346046	1.698477283	0	0.044073561	0	0.714346659	0	4.147214416	5.293424672	0.498918016	0	0	0.301615594	7.467748845	0	0	0	0.498360108	0	0.058242286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.0613
H0562_009_0	2008	5																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		305.1718237	4.828896564	36.01743529	233.4624119	291.3940698	13.72435006	0.44206233	280.219986	318.4071463	5.532798794	23.35544477	0.216972502	329.6897164	126.4949685	6875.926643	6534.798963	195.3711235	2766.785094	1820.200279	350.0471745	35.33499063	0	0	1500	1052.786089	0	140.8381791	0	0	500	0											"$200 per day, days 1-5"	$900 per admission	"$75 per day, days 21-100"	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$200 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$10 per office visit	$10 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$10 per office visit	20% of contracted rate			$35 deductible	$10 per office visit		$10 per office visit			$0 per visit												654.9622231	900	309.0352088	0	125	0.2	0.2	50	200	0	110.4008667	0	25	0	10	10	25	0	0	10	0.2	0	0	23.33333333	10	0	10	0	0	0	0											16.6563	0.362167242	0.927554636	0	3.035354894	2.744870012	0.088412466	1.167583275	5.306785772	0	0.214871779	0	0.686853576	0	5.729938869	5.445665802	0.407023174	0	0	0.291705979	7.066998126	0	0	2.916666667	0.877321741	0	0.117365149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0435			16.6563	0.362167242	0.927554636	0	3.035354894	2.744870012	0.088412466	1.167583275	5.306785772	0	0.214871779	0	0.686853576	0	5.729938869	5.445665802	0.407023174	0	0	0.291705979	7.066998126	0	0	2.916666667	0.877321741	0	0.117365149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0435																																																																																				0			16.6563	0.362167242	0.927554636	0	3.035354894	2.744870012	0.088412466	1.167583275	5.306785772	0	0.214871779	0	0.686853576	0	5.729938869	5.445665802	0.407023174	0	0	0.291705979	7.066998126	0	0	2.916666667	0.877321741	0	0.117365149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0435
H0562_010_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		299.2791461	4.582093584	71.16338558	221.7852753	306.9193869	21.99334459	1.107529578	327.2205981	292.9486609	37.32803354	27.73533617	2.619511126	328.9669389	48.24266323	6451.150251	5965.00395	185.3857832	3606.835496	1601.869603	328.4221946	36.50677916	0	0	0	893.1698111	0	82.56064231	0	0	500	0											"$100 per day, days 1-4"	$900 per admission	No charge	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$100 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$10 per office visit	$15 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$15 per office visit	20% of contracted rate				$15 per office visit		$15 per office visit			$0 per visit												292.406198	900	0	0	125	0.2	0.2	50	100	0	110.4008667	0	25	0	10	15	25	0	0	15	0.2	0	0	0	15	0	15	0	0	0	0											7.2926	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	2.441238841	0	0.255167096	0	0.685347789	0	5.375958543	7.456254938	0.386220382	0	0	0.410527743	7.301355832	0	0	0	1.116462264	0	0.103200803	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.3487			7.2926	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	2.441238841	0	0.255167096	0	0.685347789	0	5.375958543	7.456254938	0.386220382	0	0	0.410527743	7.301355832	0	0	0	1.116462264	0	0.103200803	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.3487																																																																																				0			7.2926	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	2.441238841	0	0.255167096	0	0.685347789	0	5.375958543	7.456254938	0.386220382	0	0	0.410527743	7.301355832	0	0	0	1.116462264	0	0.103200803	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.3487
H0562_011_0	2008	5																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		330.4778213	6.442512619	66.88422175	300.1448409	349.8909288	16.23781453	0.53439599	331.9944703	321.3779272	69.31086018	39.82107599	58.69431705	216.2802167	90.54394645	8027.703547	7597.196067	260.6560137	2993.802001	2483.223056	408.6830897	47.24863746	0	0	1500	693.9969936	0	77.59701851	0	0	500	0											"$175 per day, days 1-5"	$900 per admission	"$75 per day, days 21-100"	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$175 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$10 per office visit	$20 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$20 per office visit	20% of contracted rate			$35 deductible	$20 per office visit		$20 per office visit			$0 per visit												573.0919452	900	309.0352088	0	125	0.2	0.2	50	175	0	110.4008667	0	25	0	10	20	25	0	0	20	0.2	0	0	23.33333333	20	0	20	0	0	0	0											15.7828	0.483188446	1.722464953	0	3.644697175	3.247562907	0.106879198	1.383310293	4.686761438	0	0.366356775	0	0.450583785	0	6.689752956	12.66199345	0.543033362	0	0	0.681138483	9.449727492	0	0	2.916666667	1.156661656	0	0.129328364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.103			15.7828	0.483188446	1.722464953	0	3.644697175	3.247562907	0.106879198	1.383310293	4.686761438	0	0.366356775	0	0.450583785	0	6.689752956	12.66199345	0.543033362	0	0	0.681138483	9.449727492	0	0	2.916666667	1.156661656	0	0.129328364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.103																																																																																				0			15.7828	0.483188446	1.722464953	0	3.644697175	3.247562907	0.106879198	1.383310293	4.686761438	0	0.366356775	0	0.450583785	0	6.689752956	12.66199345	0.543033362	0	0	0.681138483	9.449727492	0	0	2.916666667	1.156661656	0	0.129328364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.103
H0562_012_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		253.0973827	6.64859348	59.97389546	132.0180089	264.0360178	13.089189	0.134939516	275.7290414	184.8252124	4.903526044	1.839418919	0	131.6408146	26.40360178	6120.062196	5611.887932	268.9937879	3137.739008	1667.818114	311.5668027	34.56464213	0	0	0	755.5849744	0	74.46632467	0	0	500	0											"$200 per day, days 1-5"	$900 per admission	"$75 per day, days 21-100"	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$200 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$12 per office visit	$25 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$25 per office visit	20% of contracted rate				$25 per office visit		$25 per office visit			$0 per visit												654.9622231	900	309.0352088	0	125	0.2	0.2	50	200	0	110.4008667	0	25	0	12	25	25	0	0	25	0.2	0	0	0	25	0	25	0	0	0	0											13.8141	0.498644511	1.544503776	0	2.750375185	2.617837801	0.026987903	1.148871006	3.080420207	0	0.016922787	0	0.274251697	0	6.120062196	11.69143319	0.560403725	0	0	0.649097506	6.912928426	0	0	0	1.574135363	0	0.155138176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4361			13.8141	0.498644511	1.544503776	0	2.750375185	2.617837801	0.026987903	1.148871006	3.080420207	0	0.016922787	0	0.274251697	0	6.120062196	11.69143319	0.560403725	0	0	0.649097506	6.912928426	0	0	0	1.574135363	0	0.155138176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4361																																																																																				0			13.8141	0.498644511	1.544503776	0	2.750375185	2.617837801	0.026987903	1.148871006	3.080420207	0	0.016922787	0	0.274251697	0	6.120062196	11.69143319	0.560403725	0	0	0.649097506	6.912928426	0	0	0	1.574135363	0	0.155138176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4361
H0562_017_0	2008	3																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		285.4791473	6.655986611	69.96425492	383.5540404	254.2451049	14.05343029	2.432992501	272.9855304	284.8544665	78.08510594	0	3.123404238	456.6416995	14.99234034	6129.518292	5908.170435	269.2929047	4711.959646	394.9853813	312.048204	36.63517436	0	0	0	787.6823339	0	105.8251502	0	0	500	0											"$200 per day, days 1-5"	$900 per admission	"$100 per day, days 21-100"	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$175 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$10 per office visit	$15 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$15 per office visit	20% of contracted rate				$15 per office visit		$15 per office visit			$0 per visit												654.9622231	900	412.0469451	0	125	0.2	0.2	50	175	0	110.4008667	0	25	0	10	15	25	0	0	15	0.2	0	0	0	15	0	15	0	0	0	0											15.5815	0.499198996	2.402379792	0	2.64838651	2.810686057	0.4865985	1.13743971	4.154127636	0	0	0	0.951336874	0	5.10793191	7.385213044	0.561026885	0	0	0.390060255	7.327034873	0	0	0	0.984602917	0	0.132281438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5598			15.5815	0.499198996	2.402379792	0	2.64838651	2.810686057	0.4865985	1.13743971	4.154127636	0	0	0	0.951336874	0	5.10793191	7.385213044	0.561026885	0	0	0.390060255	7.327034873	0	0	0	0.984602917	0	0.132281438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5598																																																																																				0			15.5815	0.499198996	2.402379792	0	2.64838651	2.810686057	0.4865985	1.13743971	4.154127636	0	0	0	0.951336874	0	5.10793191	7.385213044	0.561026885	0	0	0.390060255	7.327034873	0	0	0	0.984602917	0	0.132281438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5598
H0562_036_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		305.1718237	4.828896564	36.01743529	233.4624119	291.3940698	13.72435006	0.44206233	280.219986	318.4071463	5.532798794	23.35544477	0.216972502	329.6897164	126.4949685	6875.926643	6534.798963	195.3711235	2766.785094	1820.200279	350.0471745	35.33499063	0	0	0	1052.786089	0	140.8381791	0	0	500	0											"$100 per day, days 1-4"	$900 per admission	"$75 per day, days 21-100"	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$100 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$10 per office visit	$10 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$10 per office visit	20% of contracted rate				$10 per office visit		$10 per office visit			$0 per visit												292.406198	900	309.0352088	0	125	0.2	0.2	50	100	0	110.4008667	0	25	0	10	10	25	0	0	10	0.2	0	0	0	10	0	10	0	0	0	0											7.4362	0.362167242	0.927554636	0	3.035354894	2.744870012	0.088412466	1.167583275	2.653392886	0	0.214871779	0	0.686853576	0	5.729938869	5.445665802	0.407023174	0	0	0.291705979	7.066998126	0	0	0	0.877321741	0	0.117365149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.2533			7.4362	0.362167242	0.927554636	0	3.035354894	2.744870012	0.088412466	1.167583275	2.653392886	0	0.214871779	0	0.686853576	0	5.729938869	5.445665802	0.407023174	0	0	0.291705979	7.066998126	0	0	0	0.877321741	0	0.117365149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.2533																																																																																				0			7.4362	0.362167242	0.927554636	0	3.035354894	2.744870012	0.088412466	1.167583275	2.653392886	0	0.214871779	0	0.686853576	0	5.729938869	5.445665802	0.407023174	0	0	0.291705979	7.066998126	0	0	0	0.877321741	0	0.117365149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.2533
H0562_037_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		305.1718237	4.828896564	36.01743529	233.4624119	291.3940698	13.72435006	0.44206233	280.219986	318.4071463	5.532798794	23.35544477	0.216972502	329.6897164	126.4949685	6875.926643	6534.798963	195.3711235	2766.785094	1820.200279	350.0471745	35.33499063	0	0	0	1052.786089	0	140.8381791	0	0	500	0											"$100 per day, days 1-4"	$900 per admission	"$75 per day, days 21-100"	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$100 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$15 per office visit	$20 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$20 per office visit	20% of contracted rate				$20 per office visit		$20 per office visit			$0 per visit												292.406198	900	309.0352088	0	125	0.2	0.2	50	100	0	110.4008667	0	25	0	15	20	25	0	0	20	0.2	0	0	0	20	0	20	0	0	0	0											7.4362	0.362167242	0.927554636	0	3.035354894	2.744870012	0.088412466	1.167583275	2.653392886	0	0.214871779	0	0.686853576	0	8.594908303	10.8913316	0.407023174	0	0	0.583411958	7.066998126	0	0	0	1.754643482	0	0.234730299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8503			7.4362	0.362167242	0.927554636	0	3.035354894	2.744870012	0.088412466	1.167583275	2.653392886	0	0.214871779	0	0.686853576	0	8.594908303	10.8913316	0.407023174	0	0	0.583411958	7.066998126	0	0	0	1.754643482	0	0.234730299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8503																																																																																				0			7.4362	0.362167242	0.927554636	0	3.035354894	2.744870012	0.088412466	1.167583275	2.653392886	0	0.214871779	0	0.686853576	0	8.594908303	10.8913316	0.407023174	0	0	0.583411958	7.066998126	0	0	0	1.754643482	0	0.234730299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8503
H0562_039_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		299.2791461	4.582093584	71.16338558	221.7852753	306.9193869	21.99334459	1.107529578	327.2205981	292.9486609	37.32803354	27.73533617	2.619511126	328.9669389	48.24266323	6451.150251	5965.00395	185.3857832	3606.835496	1601.869603	328.4221946	36.50677916	0	0	0	893.1698111	0	82.56064231	0	0	500	0											"$150 per day, days 1-4"	$900 per admission	No charge	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$150 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$15 per office visit	$20 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$20 per office visit	20% of contracted rate				$20 per office visit		$20 per office visit			$0 per visit												438.609297	900	0	0	125	0.2	0.2	50	150	0	110.4008667	0	25	0	15	20	25	0	0	20	0.2	0	0	0	20	0	20	0	0	0	0											10.9389	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	3.661858261	0	0.255167096	0	0.685347789	0	8.063937814	9.94167325	0.386220382	0	0	0.547370324	7.301355832	0	0	0	1.488616352	0	0.137601071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9324			10.9389	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	3.661858261	0	0.255167096	0	0.685347789	0	8.063937814	9.94167325	0.386220382	0	0	0.547370324	7.301355832	0	0	0	1.488616352	0	0.137601071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9324																																																																																				0			10.9389	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	3.661858261	0	0.255167096	0	0.685347789	0	8.063937814	9.94167325	0.386220382	0	0	0.547370324	7.301355832	0	0	0	1.488616352	0	0.137601071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9324
H0562_040_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		302.9427637	6.653918871	60.95799513	277.081796	290.0122799	16.33132496	0.355521925	364.8243648	495.9764149	0	62.43445487	0	310.3316116	60.03438914	7590.35203	7049.164071	269.2092465	5917.017878	663.5138885	386.4179215	55.84024638	0	0	0	821.8673219	0	178.1326781	0	0	500	0											"$200 per day, days 1-5"	$900 per admission	"$75 per day, days 21-100"	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$200 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$15 per office visit	$25 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$25 per office visit	20% of contracted rate				$25 per office visit		$25 per office visit			$0 per visit												654.9622231	900	309.0352088	0	125	0.2	0.2	50	200	0	110.4008667	0	25	0	15	25	25	0	0	25	0.2	0	0	0	25	0	25	0	0	0	0											16.5347	0.499043915	1.56984723	0	3.020961249	3.266264993	0.071104385	1.52010152	8.266273582	0	0.574401494	0	0.646524191	0	9.487940038	14.68575848	0.560852597	0	0	0.805037337	11.16804928	0	0	0	1.712223587	0	0.371109746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7602			16.5347	0.499043915	1.56984723	0	3.020961249	3.266264993	0.071104385	1.52010152	8.266273582	0	0.574401494	0	0.646524191	0	9.487940038	14.68575848	0.560852597	0	0	0.805037337	11.16804928	0	0	0	1.712223587	0	0.371109746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7602																																																																																				0			16.5347	0.499043915	1.56984723	0	3.020961249	3.266264993	0.071104385	1.52010152	8.266273582	0	0.574401494	0	0.646524191	0	9.487940038	14.68575848	0.560852597	0	0	0.805037337	11.16804928	0	0	0	1.712223587	0	0.371109746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7602
H0562_044_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		290.1983408	5.91913101	59.43476061	208.7860964	301.5692998	14.55882235	0.567610242	270.3230511	203.8172739	2.006639828	4.790566795	0.286662833	342.8863961	38.221711	7109.510427	6352.109607	239.4806475	3854.120744	1244.653318	361.9387127	37.33874422	0	0	1500	598.0321294	246	69.89074349	0	0	500	1261.420736											"$100 per day, days 1-4"	$900 per admission	"$75 per day, days 21-100"	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$100 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$7 per office visit	$10 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$10 per office visit	20% of contracted rate			$35 deductible	$10 per office visit	$0 per office visit	$10 per office visit			$0 per visit	$10 per office visit											292.406198	900	309.0352088	0	125	0.2	0.2	50	100	0	110.4008667	0	25	0	7	10	25	0	0	10	0.2	0	0	23.33333333	10	0	10	0	0	0	10											7.0713	0.443934826	1.530619471	0	3.141346873	2.911764471	0.113522048	1.126346046	1.698477283	0	0.044073561	0	0.714346659	0	4.147214416	5.293424672	0.498918016	0	0	0.301615594	7.467748845	0	0	2.916666667	0.498360108	0	0.058242286	0	0	0	1.051183947	0	0	0	0	0	0	0	0	0	0	41.0291			7.0713	0.443934826	1.530619471	0	3.141346873	2.911764471	0.113522048	1.126346046	1.698477283	0	0.044073561	0	0.714346659	0	4.147214416	5.293424672	0.498918016	0	0	0.301615594	7.467748845	0	0	2.916666667	0.498360108	0	0.058242286	0	0	0	1.051183947	0	0	0	0	0	0	0	0	0	0	41.0291																																																																																				0			7.0713	0.443934826	1.530619471	0	3.141346873	2.911764471	0.113522048	1.126346046	1.698477283	0	0.044073561	0	0.714346659	0	4.147214416	5.293424672	0.498918016	0	0	0.301615594	7.467748845	0	0	2.916666667	0.498360108	0	0.058242286	0	0	0	1.051183947	0	0	0	0	0	0	0	0	0	0	41.0291
H0562_045_0	2008	6																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		296.2486525	3.814190015	68.31526304	235.7038459	288.3163116	19.59887417	0.914848227	300.4576498	294.7916919	35.93836113	22.04792259	2.104498625	327.3304784	53.58377267	6339.136838	5893.356424	154.3173639	3208.100381	1259.929741	322.7196936	35.3974971	0	0	0	891.3826036	0	105.5135175	0	0	500	0											"$100 per day, days 1-4"	$900 per admission	No charge	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$100 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$10 per office visit	$10 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$10 per office visit	20% of contracted rate				$10 per office visit		$10 per office visit			$0 per visit												292.406198	900	0	0	125	0.2	0.2	50	100	0	110.4008667	0	25	0	10	10	25	0	0	10	0.2	0	0	0	10	0	10	0	0	0	0											7.2187	0.286064251	0	0	3.003294912	3.919774834	0.182969645	1.251906874	2.456597433	0	0.20284248	0	0.681938497	0	5.282614032	4.911130353	0.321494508	0	0	0.268933078	7.079499421	0	0	0	0.742818836	0	0.087927931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.8986			7.2187	0.286064251	0	0	3.003294912	3.919774834	0.182969645	1.251906874	2.456597433	0	0.20284248	0	0.681938497	0	5.282614032	4.911130353	0.321494508	0	0	0.268933078	7.079499421	0	0	0	0.742818836	0	0.087927931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.8986																																																																																				0			7.2187	0.286064251	0	0	3.003294912	3.919774834	0.182969645	1.251906874	2.456597433	0	0.20284248	0	0.681938497	0	5.282614032	4.911130353	0.321494508	0	0	0.268933078	7.079499421	0	0	0	0.742818836	0	0.087927931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.8986
H0562_046_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		330.4778213	6.442512619	66.88422175	300.1448409	349.8909288	16.23781453	0.53439599	331.9944703	321.3779272	69.31086018	39.82107599	58.69431705	216.2802167	90.54394645	8027.703547	7597.196067	260.6560137	2993.802001	2483.223056	408.6830897	47.24863746	0	0	1500	693.9969936	0	77.59701851	0	0	500	0											"$175 per day, days 1-5"	$900 per admission	"$75 per day, days 21-100"	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$175 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$10 per office visit	$20 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$20 per office visit	20% of contracted rate			$35 deductible	$20 per office visit		$20 per office visit			$0 per visit												573.0919452	900	309.0352088	0	125	0.2	0.2	50	175	0	110.4008667	0	25	0	10	20	25	0	0	20	0.2	0	0	23.33333333	20	0	20	0	0	0	0											15.7828	0.483188446	1.722464953	0	3.644697175	3.247562907	0.106879198	1.383310293	4.686761438	0	0.366356775	0	0.450583785	0	6.689752956	12.66199345	0.543033362	0	0	0.681138483	9.449727492	0	0	2.916666667	1.156661656	0	0.129328364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.103			15.7828	0.483188446	1.722464953	0	3.644697175	3.247562907	0.106879198	1.383310293	4.686761438	0	0.366356775	0	0.450583785	0	6.689752956	12.66199345	0.543033362	0	0	0.681138483	9.449727492	0	0	2.916666667	1.156661656	0	0.129328364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.103																																																																																				0			15.7828	0.483188446	1.722464953	0	3.644697175	3.247562907	0.106879198	1.383310293	4.686761438	0	0.366356775	0	0.450583785	0	6.689752956	12.66199345	0.543033362	0	0	0.681138483	9.449727492	0	0	2.916666667	1.156661656	0	0.129328364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.103
H0562_047_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		302.9427637	6.653918871	60.95799513	277.081796	290.0122799	16.33132496	0.355521925	364.8243648	495.9764149	0	62.43445487	0	310.3316116	60.03438914	7590.35203	7049.164071	269.2092465	5917.017878	663.5138885	386.4179215	55.84024638	0	0	0	821.8673219	0	178.1326781	0	0	500	0											"$200 per day, days 1-5"	$900 per admission	"$75 per day, days 21-100"	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$200 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$15 per office visit	$25 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$25 per office visit	20% of contracted rate				$25 per office visit		$25 per office visit			$0 per visit												654.9622231	900	309.0352088	0	125	0.2	0.2	50	200	0	110.4008667	0	25	0	15	25	25	0	0	25	0.2	0	0	0	25	0	25	0	0	0	0											16.5347	0.499043915	1.56984723	0	3.020961249	3.266264993	0.071104385	1.52010152	8.266273582	0	0.574401494	0	0.646524191	0	9.487940038	14.68575848	0.560852597	0	0	0.805037337	11.16804928	0	0	0	1.712223587	0	0.371109746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7602			16.5347	0.499043915	1.56984723	0	3.020961249	3.266264993	0.071104385	1.52010152	8.266273582	0	0.574401494	0	0.646524191	0	9.487940038	14.68575848	0.560852597	0	0	0.805037337	11.16804928	0	0	0	1.712223587	0	0.371109746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7602																																																																																				0			16.5347	0.499043915	1.56984723	0	3.020961249	3.266264993	0.071104385	1.52010152	8.266273582	0	0.574401494	0	0.646524191	0	9.487940038	14.68575848	0.560852597	0	0	0.805037337	11.16804928	0	0	0	1.712223587	0	0.371109746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7602
H0562_048_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		253.0973827	6.64859348	59.97389546	132.0180089	264.0360178	13.089189	0.134939516	275.7290414	184.8252124	4.903526044	1.839418919	0	131.6408146	26.40360178	6120.062196	5611.887932	268.9937879	3137.739008	1667.818114	311.5668027	34.56464213	0	0	1500	755.5849744	246	74.46632467	0	0	500	1261.420736											"$200 per day, days 1-5"	$900 per admission	"$75 per day, days 21-100"	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$200 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$12 per office visit	$25 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$25 per office visit	20% of contracted rate			$35 deductible	$25 per office visit	$0 per office visit	$25 per office visit			$0 per visit	$10 per office visit											654.9622231	900	309.0352088	0	125	0.2	0.2	50	200	0	110.4008667	0	25	0	12	25	25	0	0	25	0.2	0	0	23.33333333	25	0	25	0	0	0	10											13.8141	0.498644511	1.544503776	0	2.750375185	2.617837801	0.026987903	1.148871006	3.080420207	0	0.016922787	0	0.274251697	0	6.120062196	11.69143319	0.560403725	0	0	0.649097506	6.912928426	0	0	2.916666667	1.574135363	0	0.155138176	0	0	0	1.051183947	0	0	0	0	0	0	0	0	0	0	57.404			13.8141	0.498644511	1.544503776	0	2.750375185	2.617837801	0.026987903	1.148871006	3.080420207	0	0.016922787	0	0.274251697	0	6.120062196	11.69143319	0.560403725	0	0	0.649097506	6.912928426	0	0	2.916666667	1.574135363	0	0.155138176	0	0	0	1.051183947	0	0	0	0	0	0	0	0	0	0	57.404																																																																																				0			13.8141	0.498644511	1.544503776	0	2.750375185	2.617837801	0.026987903	1.148871006	3.080420207	0	0.016922787	0	0.274251697	0	6.120062196	11.69143319	0.560403725	0	0	0.649097506	6.912928426	0	0	2.916666667	1.574135363	0	0.155138176	0	0	0	1.051183947	0	0	0	0	0	0	0	0	0	0	57.404
H0562_049_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		305.1718237	4.828896564	36.01743529	233.4624119	291.3940698	13.72435006	0.44206233	280.219986	318.4071463	5.532798794	23.35544477	0.216972502	329.6897164	126.4949685	6875.926643	6534.798963	195.3711235	2766.785094	1820.200279	350.0471745	35.33499063	0	0	1500	1052.786089	0	140.8381791	0	0	500	0											"$200 per day, days 1-5"	$900 per admission	"$75 per day, days 21-100"	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$200 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$10 per office visit	$10 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$10 per office visit	20% of contracted rate			$35 deductible	$10 per office visit		$10 per office visit			$0 per visit												654.9622231	900	309.0352088	0	125	0.2	0.2	50	200	0	110.4008667	0	25	0	10	10	25	0	0	10	0.2	0	0	23.33333333	10	0	10	0	0	0	0											16.6563	0.362167242	0.927554636	0	3.035354894	2.744870012	0.088412466	1.167583275	5.306785772	0	0.214871779	0	0.686853576	0	5.729938869	5.445665802	0.407023174	0	0	0.291705979	7.066998126	0	0	2.916666667	0.877321741	0	0.117365149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0435			16.6563	0.362167242	0.927554636	0	3.035354894	2.744870012	0.088412466	1.167583275	5.306785772	0	0.214871779	0	0.686853576	0	5.729938869	5.445665802	0.407023174	0	0	0.291705979	7.066998126	0	0	2.916666667	0.877321741	0	0.117365149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0435																																																																																				0			16.6563	0.362167242	0.927554636	0	3.035354894	2.744870012	0.088412466	1.167583275	5.306785772	0	0.214871779	0	0.686853576	0	5.729938869	5.445665802	0.407023174	0	0	0.291705979	7.066998126	0	0	2.916666667	0.877321741	0	0.117365149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0435
H0562_053_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		299.2791461	4.582093584	71.16338558	221.7852753	306.9193869	21.99334459	1.107529578	327.2205981	292.9486609	37.32803354	27.73533617	2.619511126	328.9669389	48.24266323	6451.150251	5965.00395	185.3857832	3606.835496	1601.869603	328.4221946	36.50677916	0	0	0	893.1698111	0	82.56064231	0	0	500	0											"$150 per day, days 1-4"	$900 per admission	No charge	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$150 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$10 per office visit	$20 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$20 per office visit	20% of contracted rate				$20 per office visit		$20 per office visit			$0 per visit												438.609297	900	0	0	125	0.2	0.2	50	150	0	110.4008667	0	25	0	10	20	25	0	0	20	0.2	0	0	0	20	0	20	0	0	0	0											10.9389	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	3.661858261	0	0.255167096	0	0.685347789	0	5.375958543	9.94167325	0.386220382	0	0	0.547370324	7.301355832	0	0	0	1.488616352	0	0.137601071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2444			10.9389	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	3.661858261	0	0.255167096	0	0.685347789	0	5.375958543	9.94167325	0.386220382	0	0	0.547370324	7.301355832	0	0	0	1.488616352	0	0.137601071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2444																																																																																				0			10.9389	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	3.661858261	0	0.255167096	0	0.685347789	0	5.375958543	9.94167325	0.386220382	0	0	0.547370324	7.301355832	0	0	0	1.488616352	0	0.137601071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2444
H0562_055_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		388.8657767	7.931635553	79.64257922	279.7733691	404.1028618	19.50882195	0.760597724	362.2328884	273.1151471	2.688897369	6.419359505	0.384128196	459.4677708	51.21709275	9526.743972	8511.826873	320.9040676	5164.521797	1667.835445	484.997875	50.03391726	0	7306.881243	1500	0	246	0	0	0	500	0											No charge	$900 per admission	"$50 per day, days 21-100"	No charge upon plan approval	$50 for ambulance services	15% of contracted rate	15% of contracted rate	$20 per ER visit	$0 per surgical visit	$0 per office visit	"Adv Rad and Rad Thrpy above $1,000"	$0 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$0 per office visit	$10 per office visit	$0 per office visit	$0 per office visit	$0 per office visit	20% of contracted rate		$0 per trip	$0 per visit	$0 per office visit	$0 per office visit	$0 per office visit			$0 per visit												0	900	206.0234726	0	50	0.15	0.15	20	0	0	275	0	25	0	0	0	10	0	0	0	0.2	0	0	0	0	0	0	0	0	0	0											0	0.594872667	1.367353395	0	1.683761924	2.926323293	0.114089659	0.603721481	0	0	0.147110322	0	0.957224522	0	0	0	0.267420056	0	0	0	10.00678345	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.6687			0	0.594872667	1.367353395	0	1.683761924	2.926323293	0.114089659	0.603721481	0	0	0.147110322	0	0.957224522	0	0	0	0.267420056	0	0	0	10.00678345	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.6687																																																																																				0			0	0.594872667	1.367353395	0	1.683761924	2.926323293	0.114089659	0.603721481	0	0	0.147110322	0	0.957224522	0	0	0	0.267420056	0	0	0	10.00678345	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.6687
H0562_056_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		481.7292457	9.825757477	98.66170261	346.58492	500.6050377	24.16764511	0.942233002	448.7362648	338.3366747	3.331022114	7.952340879	0.475860302	569.1914175	63.44804027	11801.78731	10544.50195	397.5378748	6397.840435	2066.124507	600.818263	61.98231541	0	7306.881243	1500	0	0	0	0	0	500	0											"$50 per day, days 1-8"	$900 per admission	"$20 per day, days 21-100"	No charge upon plan approval	$75 for ambulance services	10% of contracted rate	10% of contracted rate	$50 per ER visit	$25 per surgical visit	$10 per office visit	"Adv Rad and Rad Thrpy above $1,000"	$10 per office visit	$0 per office visit	$10 per office visit	$10 per office visit	$10 per office visit	$25 per office visit	$10 per office visit	$10 per office visit	$10 per office visit	10% of contracted rate		$0 per trip	$0 per visit	$0 per office visit		$0 per office visit			$0 per visit												195.7516968	900	82.40938902	0	75	0.1	0.1	50	25	10	275	10	0	10	10	10	25	10	10	10	0.1	0	0	0	0	0	0	0	0	0	0											7.8583	0.736931811	0.677554219	0	3.128781486	2.416764511	0.0942233	1.869734437	0.704868072	0.002775852	0.182241145	0.00039655	0	0.052873367	9.834822758	8.787084956	0.828203906	5.331533696	1.721770423	0.500681886	6.198231541	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.9278			7.8583	0.736931811	0.677554219	0	3.128781486	2.416764511	0.0942233	1.869734437	0.704868072	0.002775852	0.182241145	0.00039655	0	0.052873367	9.834822758	8.787084956	0.828203906	5.331533696	1.721770423	0.500681886	6.198231541	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.9278																																																																																				0			7.8583	0.736931811	0.677554219	0	3.128781486	2.416764511	0.0942233	1.869734437	0.704868072	0.002775852	0.182241145	0.00039655	0	0.052873367	9.834822758	8.787084956	0.828203906	5.331533696	1.721770423	0.500681886	6.198231541	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.9278
H0562_057_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		285.4791473	6.655986611	69.96425492	383.5540404	254.2451049	14.05343029	2.432992501	272.9855304	284.8544665	78.08510594	0	3.123404238	456.6416995	14.99234034	6129.518292	5908.170435	269.2929047	4711.959646	394.9853813	312.048204	36.63517436	0	0	0	787.6823339	0	105.8251502	0	0	500	0											"$200 per day, days 1-5"	$900 per admission	"$100 per day, days 21-100"	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$175 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$10 per office visit	$15 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$15 per office visit	20% of contracted rate				$15 per office visit		$15 per office visit			$0 per visit												654.9622231	900	412.0469451	0	125	0.2	0.2	50	175	0	110.4008667	0	25	0	10	15	25	0	0	15	0.2	0	0	0	15	0	15	0	0	0	0											15.5815	0.499198996	2.402379792	0	2.64838651	2.810686057	0.4865985	1.13743971	4.154127636	0	0	0	0.951336874	0	5.10793191	7.385213044	0.561026885	0	0	0.390060255	7.327034873	0	0	0	0.984602917	0	0.132281438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5598			15.5815	0.499198996	2.402379792	0	2.64838651	2.810686057	0.4865985	1.13743971	4.154127636	0	0	0	0.951336874	0	5.10793191	7.385213044	0.561026885	0	0	0.390060255	7.327034873	0	0	0	0.984602917	0	0.132281438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5598																																																																																				0			15.5815	0.499198996	2.402379792	0	2.64838651	2.810686057	0.4865985	1.13743971	4.154127636	0	0	0	0.951336874	0	5.10793191	7.385213044	0.561026885	0	0	0.390060255	7.327034873	0	0	0	0.984602917	0	0.132281438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5598
H0562_058_0	2008	5																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		299.2791461	4.582093584	71.16338558	221.7852753	306.9193869	21.99334459	1.107529578	327.2205981	292.9486609	37.32803354	27.73533617	2.619511126	328.9669389	48.24266323	6451.150251	5965.00395	185.3857832	3606.835496	1601.869603	328.4221946	36.50677916	0	0	0	893.1698111	0	82.56064231	0	0	500	0											"$100 per day, days 1-4"	$900 per admission	No charge	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$100 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$10 per office visit	$15 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$15 per office visit	20% of contracted rate				$15 per office visit		$15 per office visit			$0 per visit												292.406198	900	0	0	125	0.2	0.2	50	100	0	110.4008667	0	25	0	10	15	25	0	0	15	0.2	0	0	0	15	0	15	0	0	0	0											7.2926	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	2.441238841	0	0.255167096	0	0.685347789	0	5.375958543	7.456254938	0.386220382	0	0	0.410527743	7.301355832	0	0	0	1.116462264	0	0.103200803	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.3487			7.2926	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	2.441238841	0	0.255167096	0	0.685347789	0	5.375958543	7.456254938	0.386220382	0	0	0.410527743	7.301355832	0	0	0	1.116462264	0	0.103200803	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.3487																																																																																				0			7.2926	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	2.441238841	0	0.255167096	0	0.685347789	0	5.375958543	7.456254938	0.386220382	0	0	0.410527743	7.301355832	0	0	0	1.116462264	0	0.103200803	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.3487
H0562_059_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		299.2791461	4.582093584	71.16338558	221.7852753	306.9193869	21.99334459	1.107529578	327.2205981	292.9486609	37.32803354	27.73533617	2.619511126	328.9669389	48.24266323	6451.150251	5965.00395	185.3857832	3606.835496	1601.869603	328.4221946	36.50677916	0	0	0	893.1698111	0	82.56064231	0	0	500	0											"$150 per day, days 1-4"	$900 per admission	No charge	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$150 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$10 per office visit	$20 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$20 per office visit	20% of contracted rate				$20 per office visit		$20 per office visit			$0 per visit												438.609297	900	0	0	125	0.2	0.2	50	150	0	110.4008667	0	25	0	10	20	25	0	0	20	0.2	0	0	0	20	0	20	0	0	0	0											10.9389	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	3.661858261	0	0.255167096	0	0.685347789	0	5.375958543	9.94167325	0.386220382	0	0	0.547370324	7.301355832	0	0	0	1.488616352	0	0.137601071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2444			10.9389	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	3.661858261	0	0.255167096	0	0.685347789	0	5.375958543	9.94167325	0.386220382	0	0	0.547370324	7.301355832	0	0	0	1.488616352	0	0.137601071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2444																																																																																				0			10.9389	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	3.661858261	0	0.255167096	0	0.685347789	0	5.375958543	9.94167325	0.386220382	0	0	0.547370324	7.301355832	0	0	0	1.488616352	0	0.137601071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2444
H0562_060_0	2008	5																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		299.2791461	4.582093584	71.16338558	221.7852753	306.9193869	21.99334459	1.107529578	327.2205981	292.9486609	37.32803354	27.73533617	2.619511126	328.9669389	48.24266323	6451.150251	5965.00395	185.3857832	3606.835496	1601.869603	328.4221946	36.50677916	0	0	0	893.1698111	0	82.56064231	0	0	500	0											"$100 per day, days 1-4"	$900 per admission	No charge	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$100 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$10 per office visit	$10 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$10 per office visit	20% of contracted rate				$10 per office visit		$10 per office visit			$0 per visit												292.406198	900	0	0	125	0.2	0.2	50	100	0	110.4008667	0	25	0	10	10	25	0	0	10	0.2	0	0	0	10	0	10	0	0	0	0											7.2926	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	2.441238841	0	0.255167096	0	0.685347789	0	5.375958543	4.970836625	0.386220382	0	0	0.273685162	7.301355832	0	0	0	0.744308176	0	0.068800535	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.3198			7.2926	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	2.441238841	0	0.255167096	0	0.685347789	0	5.375958543	4.970836625	0.386220382	0	0	0.273685162	7.301355832	0	0	0	0.744308176	0	0.068800535	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.3198																																																																																				0			7.2926	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	2.441238841	0	0.255167096	0	0.685347789	0	5.375958543	4.970836625	0.386220382	0	0	0.273685162	7.301355832	0	0	0	0.744308176	0	0.068800535	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.3198
H0562_061_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		299.2791461	4.582093584	71.16338558	221.7852753	306.9193869	21.99334459	1.107529578	327.2205981	292.9486609	37.32803354	27.73533617	2.619511126	328.9669389	48.24266323	6451.150251	5965.00395	185.3857832	3606.835496	1601.869603	328.4221946	36.50677916	0	0	0	893.1698111	0	82.56064231	0	0	500	0											"$150 per day, days 1-4"	$900 per admission	No charge	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$150 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$10 per office visit	$20 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$20 per office visit	20% of contracted rate				$20 per office visit		$20 per office visit			$0 per visit												438.609297	900	0	0	125	0.2	0.2	50	150	0	110.4008667	0	25	0	10	20	25	0	0	20	0.2	0	0	0	20	0	20	0	0	0	0											10.9389	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	3.661858261	0	0.255167096	0	0.685347789	0	5.375958543	9.94167325	0.386220382	0	0	0.547370324	7.301355832	0	0	0	1.488616352	0	0.137601071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2444			10.9389	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	3.661858261	0	0.255167096	0	0.685347789	0	5.375958543	9.94167325	0.386220382	0	0	0.547370324	7.301355832	0	0	0	1.488616352	0	0.137601071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2444																																																																																				0			10.9389	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	3.661858261	0	0.255167096	0	0.685347789	0	5.375958543	9.94167325	0.386220382	0	0	0.547370324	7.301355832	0	0	0	1.488616352	0	0.137601071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2444
H0562_062_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		299.2791461	4.582093584	71.16338558	221.7852753	306.9193869	21.99334459	1.107529578	327.2205981	292.9486609	37.32803354	27.73533617	2.619511126	328.9669389	48.24266323	6451.150251	5965.00395	185.3857832	3606.835496	1601.869603	328.4221946	36.50677916	0	0	0	893.1698111	0	82.56064231	0	0	500	0											"$150 per day, days 1-4"	$900 per admission	No charge	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$150 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$10 per office visit	$20 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$20 per office visit	20% of contracted rate				$20 per office visit		$20 per office visit			$0 per visit												438.609297	900	0	0	125	0.2	0.2	50	150	0	110.4008667	0	25	0	10	20	25	0	0	20	0.2	0	0	0	20	0	20	0	0	0	0											10.9389	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	3.661858261	0	0.255167096	0	0.685347789	0	5.375958543	9.94167325	0.386220382	0	0	0.547370324	7.301355832	0	0	0	1.488616352	0	0.137601071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2444			10.9389	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	3.661858261	0	0.255167096	0	0.685347789	0	5.375958543	9.94167325	0.386220382	0	0	0.547370324	7.301355832	0	0	0	1.488616352	0	0.137601071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2444																																																																																				0			10.9389	0.343657019	0	0	3.197076947	4.398668917	0.221505916	1.363419159	3.661858261	0	0.255167096	0	0.685347789	0	5.375958543	9.94167325	0.386220382	0	0	0.547370324	7.301355832	0	0	0	1.488616352	0	0.137601071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2444
H0562_068_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		330.4778213	6.442512619	66.88422175	300.1448409	349.8909288	16.23781453	0.53439599	331.9944703	321.3779272	69.31086018	39.82107599	58.69431705	216.2802167	90.54394645	8027.703547	7597.196067	260.6560137	2993.802001	2483.223056	408.6830897	47.24863746	0	0	0	693.9969936	0	77.59701851	0	0	500	0											"$175 per day, days 1-5"	$900 per admission	"$75 per day, days 21-100"	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$175 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$10 per office visit	$20 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$20 per office visit	20% of contracted rate				$20 per office visit		$20 per office visit			$0 per visit												573.0919452	900	309.0352088	0	125	0.2	0.2	50	175	0	110.4008667	0	25	0	10	20	25	0	0	20	0.2	0	0	0	20	0	20	0	0	0	0											15.7828	0.483188446	1.722464953	0	3.644697175	3.247562907	0.106879198	1.383310293	4.686761438	0	0.366356775	0	0.450583785	0	6.689752956	12.66199345	0.543033362	0	0	0.681138483	9.449727492	0	0	0	1.156661656	0	0.129328364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.1863			15.7828	0.483188446	1.722464953	0	3.644697175	3.247562907	0.106879198	1.383310293	4.686761438	0	0.366356775	0	0.450583785	0	6.689752956	12.66199345	0.543033362	0	0	0.681138483	9.449727492	0	0	0	1.156661656	0	0.129328364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.1863																																																																																				0			15.7828	0.483188446	1.722464953	0	3.644697175	3.247562907	0.106879198	1.383310293	4.686761438	0	0.366356775	0	0.450583785	0	6.689752956	12.66199345	0.543033362	0	0	0.681138483	9.449727492	0	0	0	1.156661656	0	0.129328364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.1863
H0562_069_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		330.4778213	6.442512619	66.88422175	300.1448409	349.8909288	16.23781453	0.53439599	331.9944703	321.3779272	69.31086018	39.82107599	58.69431705	216.2802167	90.54394645	8027.703547	7597.196067	260.6560137	2993.802001	2483.223056	408.6830897	47.24863746	0	0	0	693.9969936	0	77.59701851	0	0	500	0											"$175 per day, days 1-5"	$900 per admission	"$75 per day, days 21-100"	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$175 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	$0 per office visit	$25 per office visit	$0 per office visit	$10 per office visit	$20 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$20 per office visit	20% of contracted rate				$20 per office visit		$20 per office visit			$0 per visit												573.0919452	900	309.0352088	0	125	0.2	0.2	50	175	0	110.4008667	0	25	0	10	20	25	0	0	20	0.2	0	0	0	20	0	20	0	0	0	0											15.7828	0.483188446	1.722464953	0	3.644697175	3.247562907	0.106879198	1.383310293	4.686761438	0	0.366356775	0	0.450583785	0	6.689752956	12.66199345	0.543033362	0	0	0.681138483	9.449727492	0	0	0	1.156661656	0	0.129328364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.1863			15.7828	0.483188446	1.722464953	0	3.644697175	3.247562907	0.106879198	1.383310293	4.686761438	0	0.366356775	0	0.450583785	0	6.689752956	12.66199345	0.543033362	0	0	0.681138483	9.449727492	0	0	0	1.156661656	0	0.129328364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.1863																																																																																				0			15.7828	0.483188446	1.722464953	0	3.644697175	3.247562907	0.106879198	1.383310293	4.686761438	0	0.366356775	0	0.450583785	0	6.689752956	12.66199345	0.543033362	0	0	0.681138483	9.449727492	0	0	0	1.156661656	0	0.129328364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.1863
H0562_070_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		349.9431441	0	43.60362376	15.23542018	16.36882729	18.07253895	0.606185729	31.87489458	44.05359885	1.102824304	6.805168477	1.169299833	8.762631762	6.145186607	355.2421381	53.72587439	16.01663874	60.06239526	29.73148506	4.009482526	57.76516363	5.134681211	7306.881243	1500	0	246	0	0	0	500	0											Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	$0 per trip	$0 per visit	$0 per office visit	$0 per office visit	$0 per office visit			$0 per visit												0.061884711	0.061884711	0.163977113	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.6561	0	7.149996345	0	3.830305586	4.228974115	0.141847461	7.458725331	10.30854213	0.258060887	1.592409424	0.273616161	2.050455832	1.437973666	83.12666031	12.57185461	3.747893464	14.05460049	6.957167503	0.938218911	13.51704829	1.201515403	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	196.502			21.6561	0	7.149996345	0	3.830305586	4.228974115	0.141847461	7.458725331	10.30854213	0.258060887	1.592409424	0.273616161	2.050455832	1.437973666	83.12666031	12.57185461	3.747893464	14.05460049	6.957167503	0.938218911	13.51704829	1.201515403	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	196.502																																																																																				0			21.6561	0	7.149996345	0	3.830305586	4.228974115	0.141847461	7.458725331	10.30854213	0.258060887	1.592409424	0.273616161	2.050455832	1.437973666	83.12666031	12.57185461	3.747893464	14.05460049	6.957167503	0.938218911	13.51704829	1.201515403	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	196.502
H0562_071_0	2008	5																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		290.1983408	5.91913101	59.43476061	208.7860964	301.5692998	14.55882235	0.567610242	270.3230511	203.8172739	2.006639828	4.790566795	0.286662833	342.8863961	38.221711	7109.510427	6352.109607	239.4806475	3854.120744	1244.653318	361.9387127	37.33874422	0	0	0	0	0	0	0	0	500	500											No charge	$900 per admission	"$75 per day, days 21-100"	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$0 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K"	$0 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$0 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$0 per office visit	20% of contracted rate		$0 per trip		$0 per office visit		$0 per office visit			$0 per visit	No charge											0	900	309.0352088	0	125	0.2	0.2	50	0	0	110.4008667	0	25	0	0	0	25	0	0	0	0.2	0	0	0	0	0	0	0	0	0	0											0	0.443934826	1.530619471	0	3.141346873	2.911764471	0.113522048	1.126346046	0	0	0.044073561	0	0.714346659	0	0	0	0.498918016	0	0	0	7.467748845	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.9926			0	0.443934826	1.530619471	0	3.141346873	2.911764471	0.113522048	1.126346046	0	0	0.044073561	0	0.714346659	0	0	0	0.498918016	0	0	0	7.467748845	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.9926																																																																																				0			0	0.443934826	1.530619471	0	3.141346873	2.911764471	0.113522048	1.126346046	0	0	0.044073561	0	0.714346659	0	0	0	0.498918016	0	0	0	7.467748845	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.9926
H0562_072_0	2008	4																																A	BP	A	V	T	Coin	Coin	V	V	V	V	O	V	O	V	V	V	V	P	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		306.160053	6.244699603	62.703837	220.2699097	318.1564462	15.35959789	0.598830377	285.1915673	215.0277883	2.117010574	5.054061231	0.302430082	361.7460972	40.32401093	7500.553184	6701.493221	252.6527461	4066.108055	1313.112696	381.8463439	39.39247853	0	0	0	0	0	0	0	0	500	500											No charge	$900 per admission	"$75 per day, days 21-100"	No charge upon plan approval	$125 for ambulance services	20% of contracted rate	20% of contracted rate	$50 per ER visit	$0 per surgical visit	$0 per office visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K"	$0 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$0 per office visit	$25 per office visit	$0 per office visit	$0 per office visit	$0 per office visit	20% of contracted rate		$0 per trip		$0 per office visit		$0 per office visit			$0 per visit	No charge											0	900	309.0352088	0	125	0.2	0.2	50	0	0	110.4008667	0	25	0	0	0	25	0	0	0	0.2	0	0	0	0	0	0	0	0	0	0											0	0.46835247	1.61480778	0	3.314129648	3.071919578	0.119766075	1.188298197	0	0	0.046497728	0	0.753637702	0	0	0	0.526359888	0	0	0	7.878495706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.9823			0	0.46835247	1.61480778	0	3.314129648	3.071919578	0.119766075	1.188298197	0	0	0.046497728	0	0.753637702	0	0	0	0.526359888	0	0	0	7.878495706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.9823																																																																																				0			0	0.46835247	1.61480778	0	3.314129648	3.071919578	0.119766075	1.188298197	0	0	0.046497728	0	0.753637702	0	0	0	0.526359888	0	0	0	7.878495706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.9823
H0562_801_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		247.2285047	0	24.3426283	11.65548117	10.06116179	13.76229577	0.918989776	22.15748082	43.16276731	4.649686532	5.909331966	1.083135034	11.81703229	9.651063579	188.2795295	40.9026959	10.26961926	38.51107221	13.8012844	2.568133531	32.70934005	3.634371117	0	0	0	0	0	0	0	500	0											Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits									$0 per visit												0.062893	0.062893	0.154271603	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											15.5489	0	3.755376278	0	2.354311858	3.220377209	0.215043607	5.184850511	10.10008755	1.088026648	1.38278368	0.253453598	2.765185557	2.258348877	44.0574099	9.57123084	2.403090906	9.011590896	3.229500549	0.600943246	7.653985573	0.850442841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.505			15.5489	0	3.755376278	0	2.354311858	3.220377209	0.215043607	5.184850511	10.10008755	1.088026648	1.38278368	0.253453598	2.765185557	2.258348877	44.0574099	9.57123084	2.403090906	9.011590896	3.229500549	0.600943246	7.653985573	0.850442841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.505																																																																																				0			15.5489	0	3.755376278	0	2.354311858	3.220377209	0.215043607	5.184850511	10.10008755	1.088026648	1.38278368	0.253453598	2.765185557	2.258348877	44.0574099	9.57123084	2.403090906	9.011590896	3.229500549	0.600943246	7.653985573	0.850442841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.505
H0562_803_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		247.2285047	0	24.3426283	11.65548117	10.06116179	13.76229577	0.918989776	22.15748082	43.16276731	4.649686532	5.909331966	1.083135034	11.81703229	9.651063579	188.2795295	40.9026959	10.26961926	38.51107221	13.8012844	2.568133531	32.70934005	3.634371117	0	0	0	0	0	0	0	500	0											Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits									$0 per visit												0.062893122	0.062893122	0.154272004	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											15.549	0	3.755386059	0	2.354311858	3.220377209	0.215043607	5.184850511	10.10008755	1.088026648	1.38278368	0.253453598	2.765185557	2.258348877	44.0574099	9.57123084	2.403090906	9.011590896	3.229500549	0.600943246	7.653985573	0.850442841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.505			15.549	0	3.755386059	0	2.354311858	3.220377209	0.215043607	5.184850511	10.10008755	1.088026648	1.38278368	0.253453598	2.765185557	2.258348877	44.0574099	9.57123084	2.403090906	9.011590896	3.229500549	0.600943246	7.653985573	0.850442841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.505																																																																																				0			15.549	0	3.755386059	0	2.354311858	3.220377209	0.215043607	5.184850511	10.10008755	1.088026648	1.38278368	0.253453598	2.765185557	2.258348877	44.0574099	9.57123084	2.403090906	9.011590896	3.229500549	0.600943246	7.653985573	0.850442841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.505
H0562_804_0	2008	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		247.2285047	0	24.3426283	11.65548117	10.06116179	13.76229577	0.918989776	22.15748082	43.16276731	4.649686532	5.909331966	1.083135034	11.81703229	9.651063579	188.2795295	40.9026959	10.26961926	38.51107221	13.8012844	2.568133531	32.70934005	3.634371117	0	0	0	0	0	0	0	500	0											Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits									$0 per visit												0.062893231	0.062893231	0.154271739	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											15.549	0	3.755379609	0	2.354311858	3.220377209	0.215043607	5.184850511	10.10008755	1.088026648	1.38278368	0.253453598	2.765185557	2.258348877	44.0574099	9.57123084	2.403090906	9.011590896	3.229500549	0.600943246	7.653985573	0.850442841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.505			15.549	0	3.755379609	0	2.354311858	3.220377209	0.215043607	5.184850511	10.10008755	1.088026648	1.38278368	0.253453598	2.765185557	2.258348877	44.0574099	9.57123084	2.403090906	9.011590896	3.229500549	0.600943246	7.653985573	0.850442841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.505																																																																																				0			15.549	0	3.755379609	0	2.354311858	3.220377209	0.215043607	5.184850511	10.10008755	1.088026648	1.38278368	0.253453598	2.765185557	2.258348877	44.0574099	9.57123084	2.403090906	9.011590896	3.229500549	0.600943246	7.653985573	0.850442841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.505
H0562_806_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		247.2285047	0	24.3426283	11.65548117	10.06116179	13.76229577	0.918989776	22.15748082	43.16276731	4.649686532	5.909331966	1.083135034	11.81703229	9.651063579	188.2795295	40.9026959	10.26961926	38.51107221	13.8012844	2.568133531	32.70934005	3.634371117	0	0	0	0	0	0	0	500	0											Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits	Medicare level benefits									$0 per visit												0.062892614	0.062892614	0.154270802	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											15.5488	0	3.75535678	0	2.354311858	3.220377209	0.215043607	5.184850511	10.10008755	1.088026648	1.38278368	0.253453598	2.765185557	2.258348877	44.0574099	9.57123084	2.403090906	9.011590896	3.229500549	0.600943246	7.653985573	0.850442841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.5049			15.5488	0	3.75535678	0	2.354311858	3.220377209	0.215043607	5.184850511	10.10008755	1.088026648	1.38278368	0.253453598	2.765185557	2.258348877	44.0574099	9.57123084	2.403090906	9.011590896	3.229500549	0.600943246	7.653985573	0.850442841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.5049																																																																																				0			15.5488	0	3.75535678	0	2.354311858	3.220377209	0.215043607	5.184850511	10.10008755	1.088026648	1.38278368	0.253453598	2.765185557	2.258348877	44.0574099	9.57123084	2.403090906	9.011590896	3.229500549	0.600943246	7.653985573	0.850442841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.5049
H0564_006_0	2008	5	H.	H.	I.	I.	I.	I.	I.	I.	F.	I.	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency	Professional	0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care	Vision (Covered) Eyeware	D	D	D		T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin		Coin			V	V	V	V					V	V	V	V	V	V	V	V	V	Coin																																										0	0	1948.357943	64.83832782	435.0127762	0	228.5047894	17.58036811	6.267810276	273.2647016	352.8425942	729.7370799	13.72540842	43.29829588	0.143069783	0.330147978	6268.954315	2225.054299	3.578273086	488.0711921	11.63813829	0	21.3204367	0	0	1109.489778	397.1469092	314.1453065	170.2058182	0	0		0	939.4299565	15.35799481	85.76082892	467.7157835	126.5598411	14.73311543	948.2022047	4.409750561	1.809702256	5.291475776	$50/day for days 1 to 5	$50/day for days 1 to 5	$65/day for days 21 to 100	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$100 copay	$0 copay	20% coinsurance for Higher Tier	$100 copay	20% coinsurance	$20 copay	$10 copay	$10 copay	$20 copay	$20 copay	20% coinsurance for Higher Tier	N/A	20% coinsurance	N/A	N/A	"$0/$30/$40 for cleaning, x-rays"	$20 copay	$75 glasses/$95 contacts	$20 copay	N/A	N/A		N/A	$20 copay	$0 copay	$20 copay	$20 copay	$5 copay	$0 copay	$20 copay	$20 copay	$30 copay	20% coinsurance	28.47836368	24.15794448	65	0	70	0.2	0.2	35	100	0	0.2	100	0.2	20	10	10	20	20	0.2	0	0.2	0	0	24.5	20	0	20	0	0		0	20	0	20	20	5	0	20	20	21	0.14	4.6238	0.13053006	2.356319204	0	1.332944605	3.516073621	1.253562055	0.797022046	2.940354951	0	2.745081685	0.360819132	0.028613957	0.000550247	5.224128596	1.854211916	0.005963788	0.813451987	2.327627657	0	4.264087341	0	0	2.265208297	0.661911515	0	0.283676364	0	0	0	0	1.565716594	0	0.142934715	0.779526306	0.052733267	0	1.580337008	0.007349584	0.003166979	0.740806609	42.6585		4.781951052	4.6238	0.13053006	2.356319204	0	1.332944605	3.516073621	1.253562055	0.797022046	2.940354951	0	2.745081685	0.360819132	0.028613957	0.000550247	5.224128596	1.854211916	0.005963788	0.813451987	2.327627657	0	4.264087341	0	0	2.265208297	0.661911515	0	0.283676364	0	0	0	0	1.565716594	0	0.142934715	0.779526306	0.052733267	0	1.580337008	0.007349584	0.003166979	0.740806609	42.6585	500																																																																																			0		0	4.6238	0.13053006	2.356319204	0	1.332944605	3.516073621	1.253562055	0.797022046	2.940354951	0	2.745081685	0.360819132	0.028613957	0.000550247	5.224128596	1.854211916	0.005963788	0.813451987	2.327627657	0	4.264087341	0	0	2.265208297	0.661911515	0	0.283676364	0	0	0	0	1.565716594	0	0.142934715	0.779526306	0.052733267	0	1.580337008	0.007349584	0.003166979	0.740806609	42.6585
H0564_009_0	2008	4	H.	H.	I.	I.	I.	I.	I.	I.	F.	I.	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency	Professional	0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care	Vision (Covered) Eyeware	Ded	Ded	Ded		Ded	Ded	Ded	V	Ded	V	Coin	Ded	Coin	V	V	V	V	V	Coin		Ded				V	V	V					V	V	V	V	V	V	V	V	V	Ded	56.9342	0.6907	10.8227	0	2.0983	2.736	0.9754		7.3882			0.274	0.0474								3.318																				1.0093	86.2942	0								298.4012068		796.8626171	16.36663339			0.360516943	6633.570758	2354.468448	3.786393474	516.4585073	15.5648008	0		0	0	1108.568614	396.8171743	313.8844844	170.0645033	0	0		0	1025.844286	16.77071411	90.74887107	494.9191825	133.9208453	15.59002646	1003.351772	4.666231544	1.976169384		$0 after $2000 deductible	$0 after $2000 deductible	$0 after $2000 deductible	$0 after $2000 deductible	$0 after $2000 deductible	$0 after $2000 deductible	$0 after $2000 deductible	$50 copay	$0 after $2000 deductible	$0 copay	20% coinsurance for Higher Tier	$0 after $2000 deductible	20% coinsurance	$25 copay	$15 copay	$25 copay	$25 copay	$25 copay	20% coinsurance for Higher Tier	N/A	$0 after $2000 deductible	N/A	N/A	N/A	$20 copay	$75 glasses/$95 contacts	$25 copay	N/A	N/A		N/A	$25 copay	$0 copay	$25 copay	$25 copay	$10 copay	$0 copay	$25 copay	$25 copay	$30 copay	$0 after $2000 deductible	0	0	0	0	0	0	0	50	0	0	0.2	0	0	25	15	25	25	25	0.2	0	0	0	0	24.5	20	0	25	0	0		0	25	0	25	25	10	0	25	25	30	0	0	0	0	0	0	0	0	1.243338362	0	0	3.273326678	0	0	0.000751077	8.291963447	4.905142599	0.00788832	1.075955224	3.112960159	0	0	0	0	2.263327587	0.661361957	0	0.354301048	0	0	0	0	2.137175596	0	0.189060148	1.03108163	0.111600704	0	2.090316191	0.009721316	0.004940423	0	30.7642		0	56.9342	0.690684903	10.82268309	0	2.098276107	2.735960042	0.975433413	1.243338362	7.388154778	0	3.273326678	0.274005308	0.04743423	0.000751077	8.291963447	4.905142599	0.00788832	1.075955224	3.112960159	0	3.318011463	0	0	2.263327587	0.661361957	0	0.354301048	0	0	0	0	2.137175596	0	0.189060148	1.03108163	0.111600704	0	2.090316191	0.009721316	0.004940423	1.009329733	117.0584	3000																																																																																			0		0	56.9342	0.690684903	10.82268309	0	2.098276107	2.735960042	0.975433413	1.243338362	7.388154778	0	3.273326678	0.274005308	0.04743423	0.000751077	8.291963447	4.905142599	0.00788832	1.075955224	3.112960159	0	3.318011463	0	0	2.263327587	0.661361957	0	0.354301048	0	0	0	0	2.137175596	0	0.189060148	1.03108163	0.111600704	0	2.090316191	0.009721316	0.004940423	1.009329733	117.0584
H0564_040_0	2008	5	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin		V							V	O	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																												0	None	410.2137102	9.915999275	59.3310643	0.001215196	25.701122	22.69733389	5.850774179	34.80003892	37.21987694	11.76984657	23.6696328	2.213320591	0.075099112	0.023467345	108.4432645	71.21989214	0.218911596	7.412188015	20.51314004		17.30567763		5.538815027							6000	19939.7341	23.25523151	0.530810484	0.332951335	4.427690076	0.625226605	0.054702766	13.18418072	0.04165068			FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:		FFS Medicare:		$0 Copay (12 round/24 one way trips per yr)							$0 Copay	$35.5 credit per qtr for OTC drugs	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:	FFS Medicare:			0.066	0.066	0.173	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234		0							0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			27.0741	0.654455952	10.26427412	0	6.014062548	5.31117613	1.369081158	8.143209106	8.709451205	2.754144097	5.538694074	0.517917018	0.017573192	0.005491359	25.37572388	16.66545476	0.051225313	1.734451995	4.80007477	0	4.049528566	0	0	0	0	0	0	0	0	0	0	5.441724172	0.124209653	0.077910612	1.036079478	0.146303026	0.012800447	3.085098288	0.009746259	0	0	138.984		0	27.0741	0.654455952	10.26427412	0	6.014062548	5.31117613	1.369081158	8.143209106	8.709451205	2.754144097	5.538694074	0.517917018	0.017573192	0.005491359	25.37572388	16.66545476	0.051225313	1.734451995	4.80007477	0	4.049528566	0	0	0	0	0	0	0	0	0	0	5.441724172	0.124209653	0.077910612	1.036079478	0.146303026	0.012800447	3.085098288	0.009746259	0	0	138.984	None																																																																																			0		0	27.0741	0.654455952	10.26427412	0	6.014062548	5.31117613	1.369081158	8.143209106	8.709451205	2.754144097	5.538694074	0.517917018	0.017573192	0.005491359	25.37572388	16.66545476	0.051225313	1.734451995	4.80007477	0	4.049528566	0	0	0	0	0	0	0	0	0	0	5.441724172	0.124209653	0.077910612	1.036079478	0.146303026	0.012800447	3.085098288	0.009746259	0	0	138.984
H0564_801_0	2008	3																																coin	coin	coin	V	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V																																																				0		293.9393087	3.72542791	31.62854868	18.48975284	3.904698613	3.927080677	3.125088776	13.12637785	26.97528137	6.910490377	44.44694013	0	3.489504796	0.361147258	62.42652372	180.0363034	1.832401655	6.251690484	40.48622322	33.26834637	7.939891431	0																				Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare																				0.063052086	0.063052086	0.180890968	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				18.5335	0.234895999	5.721318797	0	0.913699475	0.918936878	0.731270774	3.071572417	6.312215839	1.617054748	10.40058399	0	0.816544122	0.084508458	14.60780655	42.128495	0.428781987	1.462895573	9.473776233	7.784793051	1.857934595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.1006			18.5335	0.234895999	5.721318797	0	0.913699475	0.918936878	0.731270774	3.071572417	6.312215839	1.617054748	10.40058399	0	0.816544122	0.084508458	14.60780655	42.128495	0.428781987	1.462895573	9.473776233	7.784793051	1.857934595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.1006																																																																																				0			18.5335	0.234895999	5.721318797	0	0.913699475	0.918936878	0.731270774	3.071572417	6.312215839	1.617054748	10.40058399	0	0.816544122	0.084508458	14.60780655	42.128495	0.428781987	1.462895573	9.473776233	7.784793051	1.857934595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.1006
H0564_810_0	2008	2																																coin	coin	coin	V	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V																																																				0		293.9393087	3.72542791	31.62854868	18.48975284	3.904698613	3.927080677	3.125088776	13.12637785	26.97528137	6.910490377	44.44694013	0	3.489504796	0.361147258	62.42652372	180.0363034	1.832401655	6.251690484	40.48622322	33.26834637	7.939891431	0																				Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare																				0.063052086	0.063052086	0.180890968	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				18.5335	0.234895999	5.721318797	0	0.913699475	0.918936878	0.731270774	3.071572417	6.312215839	1.617054748	10.40058399	0	0.816544122	0.084508458	14.60780655	42.128495	0.428781987	1.462895573	9.473776233	7.784793051	1.857934595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.1006			18.5335	0.234895999	5.721318797	0	0.913699475	0.918936878	0.731270774	3.071572417	6.312215839	1.617054748	10.40058399	0	0.816544122	0.084508458	14.60780655	42.128495	0.428781987	1.462895573	9.473776233	7.784793051	1.857934595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.1006																																																																																				0			18.5335	0.234895999	5.721318797	0	0.913699475	0.918936878	0.731270774	3.071572417	6.312215839	1.617054748	10.40058399	0	0.816544122	0.084508458	14.60780655	42.128495	0.428781987	1.462895573	9.473776233	7.784793051	1.857934595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.1006
H0571_001_0	2008	3																					3500											D	D	D		T	Coin	Coin	V	V					V	V	V	V	V		V					V		V				P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		476.4514162	8.73341114	237.1884041	0	134.875075	9.637253727	5.499070415	327.9947665	243.7914363	0	0	0	0	266.6965954	3615.315567	3253.512419	139.8277944	344.9755942	0	1659.63611	0	0	0	0	387.5947552	0	166.1120379	0	0	0	274.7778318											$225/Day for days 1-5 for IP Medical; $225/Day for days 1-5 for IP Surgical;	$225/Day for days 1-5 for IP Psych;	$100/Day for days 21-100 for SNF		$100/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $15/Visit for Urgent Care; $15/Visit for Urgent Care - Worldwide;	$175/Case for OP Fac - Surgery; $175/Case for OP Fac - ASC					$25/Visit for OP Fac - Occ Therapy; $25/Visit for OP Fac - Physical/Speech Therapy; $25/Case for OP Fac - CORF; $25/Case for Prof - CORF; $25/Case for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Visit for PCP - Consults; $15/Exam for PCP - Routine Physicals;	$15/Visit for Speclst - Office Visits; $15/Visit for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $15/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$25/Visit for PT/ST (PCP); $25/Visit for Occ Therapy (PCP); $25/Visit for PT/ST (Specialist); $25/Visit for Occ Therapy (Specialist);		$15/Visit for Chiropractor; $15/Visit for Vistion Exams; $15/Visit for Podiatrist; $15/Visit for Hearing/Speech Exams;					$15/Visit for Vision (Refractions)		$15/Visit for Routine Hearing Exams				$15/Service for Acupunture;											222.9791302	222.9791302	99.10183564	0	99.10183564	0.198203671	0.198203671	39.98562457	173.4282124	0	0	0	0	24.77545891	14.86527535	14.86527535	14.86527535	24.77545891	0	14.86527535	0	0	0	0	14.86527535	0	14.86527535	0	0	0	14.86527534											8.8532	0.162280702	1.958817187	0	1.113863959	1.91013907	1.089935945	1.092922966	3.523359415	0	0	0	0	0.550627545	4.478555114	4.030363162	0.173214889	0.712244055	0	2.055912313	0	0	0	0	0.480141897	0	0.205775099	0	0	0	0.340387344	0	0	0	0	0	0	0	0	0	0	32.7318	0	0.296649469	8.8532	0.162280702	1.958817187	0	1.113863959	1.91013907	1.089935945	1.092922966	3.523359415	0	0	0	0	0.550627545	4.478555114	4.030363162	0.173214889	0.712244055	0	2.055912313	0	0	0	0	0.480141897	0	0.205775099	0	0	0	0.340387344	0	0	0	0	0	0	0	0	0	0	32.7318																																																																																				0	0		8.8532	0.162280702	1.958817187	0	1.113863959	1.91013907	1.089935945	1.092922966	3.523359415	0	0	0	0	0.550627545	4.478555114	4.030363162	0.173214889	0.712244055	0	2.055912313	0	0	0	0	0.480141897	0	0.205775099	0	0	0	0.340387344	0	0	0	0	0	0	0	0	0	0	32.7318
H0571_002_0	2008	4																					3500											D	D	D		T	Coin	Coin	V	V					V	V	V	V	V		V					V		V				P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		476.4514162	8.73341114	237.1884041	0	134.875075	9.637253727	5.499070415	327.9947665	243.7914363	0	0	0	0	266.6965954	3615.315567	3253.512419	139.8277944	344.9755942	0	1659.63611	0	0	0	0	387.5947552	0	166.1120379	0	0	0	274.7778318											$225/Day for days 1-5 for IP Medical; $225/Day for days 1-5 for IP Surgical;	$225/Day for days 1-5 for IP Psych;	$100/Day for days 21-100 for SNF		$100/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $15/Visit for Urgent Care; $15/Visit for Urgent Care - Worldwide;	$175/Case for OP Fac - Surgery; $175/Case for OP Fac - ASC					$25/Visit for OP Fac - Occ Therapy; $25/Visit for OP Fac - Physical/Speech Therapy; $25/Case for OP Fac - CORF; $25/Case for Prof - CORF; $25/Case for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Visit for PCP - Consults; $15/Exam for PCP - Routine Physicals;	$15/Visit for Speclst - Office Visits; $15/Visit for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $15/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$25/Visit for PT/ST (PCP); $25/Visit for Occ Therapy (PCP); $25/Visit for PT/ST (Specialist); $25/Visit for Occ Therapy (Specialist);		$15/Visit for Chiropractor; $15/Visit for Vistion Exams; $15/Visit for Podiatrist; $15/Visit for Hearing/Speech Exams;					$15/Visit for Vision (Refractions)		$15/Visit for Routine Hearing Exams				$15/Service for Acupunture;											222.9791302	222.9791302	99.10183564	0	99.10183564	0.198203671	0.198203671	39.98562457	173.4282124	0	0	0	0	24.77545891	14.86527535	14.86527535	14.86527535	24.77545891	0	14.86527535	0	0	0	0	14.86527535	0	14.86527535	0	0	0	14.86527534											8.8532	0.162280702	1.958817187	0	1.113863959	1.91013907	1.089935945	1.092922966	3.523359415	0	0	0	0	0.550627545	4.478555114	4.030363162	0.173214889	0.712244055	0	2.055912313	0	0	0	0	0.480141897	0	0.205775099	0	0	0	0.340387344	0	0	0	0	0	0	0	0	0	0	32.7318	0	0.296649469	8.8532	0.162280702	1.958817187	0	1.113863959	1.91013907	1.089935945	1.092922966	3.523359415	0	0	0	0	0.550627545	4.478555114	4.030363162	0.173214889	0.712244055	0	2.055912313	0	0	0	0	0.480141897	0	0.205775099	0	0	0	0.340387344	0	0	0	0	0	0	0	0	0	0	32.7318																																																																																				0	0		8.8532	0.162280702	1.958817187	0	1.113863959	1.91013907	1.089935945	1.092922966	3.523359415	0	0	0	0	0.550627545	4.478555114	4.030363162	0.173214889	0.712244055	0	2.055912313	0	0	0	0	0.480141897	0	0.205775099	0	0	0	0.340387344	0	0	0	0	0	0	0	0	0	0	32.7318
H0571_005_0	2008	4																																																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H0571_801_0	2008	1																					3500											D	D	D		T	Coin	Coin	V	V					V	V	V	V	V		V					V		V				P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		476.4514162	8.73341114	237.1884041	0	134.875075	9.637253727	5.499070415	327.9947665	243.7914363	0	0	0	0	266.6965954	3615.315567	3253.512419	139.8277944	344.9755942	0	1659.63611	0	0	0	0	387.5947552	0	166.1120379	0	0	0	274.7778318											$225/Day for days 1-5 for IP Medical; $225/Day for days 1-5 for IP Surgical;	$225/Day for days 1-5 for IP Psych;	$100/Day for days 21-100 for SNF		$100/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $15/Visit for Urgent Care; $15/Visit for Urgent Care - Worldwide;	$175/Case for OP Fac - Surgery; $175/Case for OP Fac - ASC					$25/Visit for OP Fac - Occ Therapy; $25/Visit for OP Fac - Physical/Speech Therapy; $25/Case for OP Fac - CORF; $25/Case for Prof - CORF; $25/Case for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Visit for PCP - Consults; $15/Exam for PCP - Routine Physicals;	$15/Visit for Speclst - Office Visits; $15/Visit for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $15/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$25/Visit for PT/ST (PCP); $25/Visit for Occ Therapy (PCP); $25/Visit for PT/ST (Specialist); $25/Visit for Occ Therapy (Specialist);		$15/Visit for Chiropractor; $15/Visit for Vistion Exams; $15/Visit for Podiatrist; $15/Visit for Hearing/Speech Exams;					$15/Visit for Vision (Refractions)		$15/Visit for Routine Hearing Exams				$15/Service for Acupunture;											222.9791302	222.9791302	99.10183564	0	99.10183564	0.198203671	0.198203671	39.98562457	173.4282124	0	0	0	0	24.77545891	14.86527535	14.86527535	14.86527535	24.77545891	0	14.86527535	0	0	0	0	14.86527535	0	14.86527535	0	0	0	14.86527534											8.8532	0.162280702	1.958817187	0	1.113863959	1.91013907	1.089935945	1.092922966	3.523359415	0	0	0	0	0.550627545	4.478555114	4.030363162	0.173214889	0.712244055	0	2.055912313	0	0	0	0	0.480141897	0	0.205775099	0	0	0	0.340387344	0	0	0	0	0	0	0	0	0	0	32.7318	0	0.296649469	8.8532	0.162280702	1.958817187	0	1.113863959	1.91013907	1.089935945	1.092922966	3.523359415	0	0	0	0	0.550627545	4.478555114	4.030363162	0.173214889	0.712244055	0	2.055912313	0	0	0	0	0.480141897	0	0.205775099	0	0	0	0.340387344	0	0	0	0	0	0	0	0	0	0	32.7318																																																																																				0	0		8.8532	0.162280702	1.958817187	0	1.113863959	1.91013907	1.089935945	1.092922966	3.523359415	0	0	0	0	0.550627545	4.478555114	4.030363162	0.173214889	0.712244055	0	2.055912313	0	0	0	0	0.480141897	0	0.205775099	0	0	0	0.340387344	0	0	0	0	0	0	0	0	0	0	32.7318
H0609_002_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1382.308485	11.65688023	776.9949903		534.2547053	41.88293661	9.410414789	344.8961738	305.6903565		41.35705887			909.6783711	4414.146167	4570.395444	331.3809135	1025.479815			33.76157027	2059.879625			234.4126529	3.474773176																$150 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$180 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$150 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$150 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5, 9a); $30/$30 (9c)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $10/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											64.2555	912	69.5467		180	0.2	0.2	48.2974	150		0.135864353			6.3215	10	30	30	7.9579			0.2	30			30	0.411069113																7.4017	0.885922897	4.503117185	0	8.013820579	8.376587322	1.882082958	1.38813259	3.821129457	0	5.618950064	0	0	0.479210597	3.678455139	11.42598676	0.828452284	0.680056331	0	0	6.752314053	5.149699064	0	0	0.586031632	1.428371927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9001	0	0	7.4017	0.885922897	4.503117185	0	8.013820579	8.376587322	1.882082958	1.38813259	3.821129457	0	5.618950064	0	0	0.479210597	3.678455139	11.42598676	0.828452284	0.680056331	0	0	6.752314053	5.149699064	0	0	0.586031632	1.428371927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9001																																																																																				0			7.4017	0.885922897	4.503117185	0	8.013820579	8.376587322	1.882082958	1.38813259	3.821129457	0	5.618950064	0	0	0.479210597	3.678455139	11.42598676	0.828452284	0.680056331	0	0	6.752314053	5.149699064	0	0	0.586031632	1.428371927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9001
H0609_006_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1822.014849	10.66582234	1745.267864		533.5349572	37.33253789	16.78036367	459.8223412	432.7026278		66.79976945			879.2007131	5080.225399	4901.105539	325.1854777	515.0362244			48.91530663	2047.877676			230.436284	3.474773176																$100 (1a); $0 (1a1)	$912 (1b)	"$108 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$180 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$100 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $100 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$30 (7b); $0 n/c (7b1, 7f1); $20 (7d); $10/$30( 7f); $10/$20( 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"											42.837	912	68.2822		180	0.2	0.2	48.5066	100		0.145438604			3.9443	10	20.6689	30	7.9579			0.2	30			30	0.411069113																6.5041	0.810602498	9.930890483	0	8.003024358	7.466507578	3.356072735	1.85870065	3.605855231	0	9.715265225	0	0	0.288984406	4.233521166	8.44170826	0.812963694	0.341550989	0	0	9.783061326	5.11969419	0	0	0.57609071	1.428371927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.277	0	0	6.5041	0.810602498	9.930890483	0	8.003024358	7.466507578	3.356072735	1.85870065	3.605855231	0	9.715265225	0	0	0.288984406	4.233521166	8.44170826	0.812963694	0.341550989	0	0	9.783061326	5.11969419	0	0	0.57609071	1.428371927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.277																																																																																				0			6.5041	0.810602498	9.930890483	0	8.003024358	7.466507578	3.356072735	1.85870065	3.605855231	0	9.715265225	0	0	0.288984406	4.233521166	8.44170826	0.812963694	0.341550989	0	0	9.783061326	5.11969419	0	0	0.57609071	1.428371927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.277
H0609_007_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1306.440829	10.52137761	1209.532133		531.6203557	29.22463896	11.83761447	358.4840245	366.7587705		55.2623149			439.128373	4465.063119	4290.840744	324.96846	488.6108956			34.71884073	2045.845589			230.6062949	3.474773176																$150 (1a); $0 (1a1)	$912 (1b)	"$108 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$180 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$150 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$150 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5, 9a); $30/$30 (9c)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $10/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											64.2555	912	68.2822		180	0.2	0.2	48.974	150		0.147250058			6.2066	10	30	30	7.9579			0.2	30			30	0.411069113																6.9955	0.799624699	6.88245707	0	7.974305335	5.844927792	2.367522893	1.463033672	4.584484631	0	8.137379051	0	0	0.227123659	3.720885933	10.72710186	0.81242115	0.32402679	0	0	6.943768146	5.114613972	0	0	0.576515737	1.428371927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9241	0	0	6.9955	0.799624699	6.88245707	0	7.974305335	5.844927792	2.367522893	1.463033672	4.584484631	0	8.137379051	0	0	0.227123659	3.720885933	10.72710186	0.81242115	0.32402679	0	0	6.943768146	5.114613972	0	0	0.576515737	1.428371927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9241																																																																																				0			6.9955	0.799624699	6.88245707	0	7.974305335	5.844927792	2.367522893	1.463033672	4.584484631	0	8.137379051	0	0	0.227123659	3.720885933	10.72710186	0.81242115	0.32402679	0	0	6.943768146	5.114613972	0	0	0.576515737	1.428371927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9241
H0609_011_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1467.448144	12.117353	1277.908885		508.0746602	26.23268662	8.247331017	383.2405235	294.1781666		38.45114889			988.4515951	2235.477045	4333.332294	314.3021682	548.2396479			34.99393721	1950.68416			185.4924608	1.579803075																$225 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$180 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$225 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$225 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $225 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											96.3832	912	69.5467		180	0.2	0.2	48.236	225		0.141166252			7.1813	15	30	30	7.9579			0.2	30			30	0.411069113																11.7864	0.920918828	7.406191201	0	7.621119903	5.246537323	1.649466203	1.540500404	5.515840623	0	5.428004567	0	0	0.591534084	2.794346306	10.83333004	0.78575542	0.363570143	0	0	6.998787441	4.8767104	0	0	0.463731152	0.649408248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.4722	0	0	11.7864	0.920918828	7.406191201	0	7.621119903	5.246537323	1.649466203	1.540500404	5.515840623	0	5.428004567	0	0	0.591534084	2.794346306	10.83333004	0.78575542	0.363570143	0	0	6.998787441	4.8767104	0	0	0.463731152	0.649408248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.4722																																																																																				0			11.7864	0.920918828	7.406191201	0	7.621119903	5.246537323	1.649466203	1.540500404	5.515840623	0	5.428004567	0	0	0.591534084	2.794346306	10.83333004	0.78575542	0.363570143	0	0	6.998787441	4.8767104	0	0	0.463731152	0.649408248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.4722
H0609_012_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1066.774381	13.34131291	830.6232447		529.8159388	24.08637368	9.695356926	458.0633718	319.9722994		46.14063634			464.41889	2190.416479	4389.168699	331.7380595	429.5863225			27.71403881	2031.322402			223.2936277	3.227457346																$200 (1a); $0 (1a1)	$912 (1b)	"$108 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$180 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$200 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											85.6739	912	68.2822		180	0.2	0.2	47.7158	200		0.145042161			7.0528	15	30	30	7.9579			0.2	30			30	0.411069113																7.6162	1.013939781	4.726396815	0	7.947239082	4.817274736	1.939071385	1.821406827	5.332871657	0	6.692337606	0	0	0.272953921	2.738020598	10.97292175	0.829345149	0.284884104	0	0	5.542807762	5.078306004	0	0	0.558234069	1.326708028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5109	0	0	7.6162	1.013939781	4.726396815	0	7.947239082	4.817274736	1.939071385	1.821406827	5.332871657	0	6.692337606	0	0	0.272953921	2.738020598	10.97292175	0.829345149	0.284884104	0	0	5.542807762	5.078306004	0	0	0.558234069	1.326708028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5109																																																																																				0			7.6162	1.013939781	4.726396815	0	7.947239082	4.817274736	1.939071385	1.821406827	5.332871657	0	6.692337606	0	0	0.272953921	2.738020598	10.97292175	0.829345149	0.284884104	0	0	5.542807762	5.078306004	0	0	0.558234069	1.326708028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5109
H0609_013_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1287.310115	10.85576772	723.5964487		497.5383525	36.3571021	8.161506209	321.0638321	284.6819595		35.87037175			847.161239	4004.663551	4256.2976	308.6069475	955.0042945			29.28136888	1918.315562			144																	$200 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$180 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$200 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											85.6739	912	63.2242		180	0.2	0.2	48.2967	200		0.136630995			7.5513	15	30	30	7.9579			0.2	30			30																	9.1907	0.825038347	3.812402728	0	7.463075288	7.27142042	1.632301242	1.292194183	4.744699325	0	4.901004582	0	0	0.533098866	5.005829439	10.64074271	0.771517369	0.633319844	0	0	5.856273777	4.795788905	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.7295	0	0	9.1907	0.825038347	3.812402728	0	7.463075288	7.27142042	1.632301242	1.292194183	4.744699325	0	4.901004582	0	0	0.533098866	5.005829439	10.64074271	0.771517369	0.633319844	0	0	5.856273777	4.795788905	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.7295																																																																																				0			9.1907	0.825038347	3.812402728	0	7.463075288	7.27142042	1.632301242	1.292194183	4.744699325	0	4.901004582	0	0	0.533098866	5.005829439	10.64074271	0.771517369	0.633319844	0	0	5.856273777	4.795788905	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.7295
H0609_015_0	2008	3																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0			11.65688023	776.9949903		534.2547053	41.60415603	9.409602418	344.8961738			41.33632273			78.02936214		541.5520645	331.3809135	1025.479815			33.75457347	2059.879625						0.001838371			19.85898212											"$0 (1a, 1a1)"	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$0 (4b)"	$0 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$0 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $0 (9a)"	"$0/$50/$30 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14f1, 14h1)"	$30 (7b); $10 (7b1); $0 (7d); $0/$30( 7f); $0 n/c( 7f1); $0/$0( 7g)	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $0/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c; $20 (16)	$0 (17a1)	$0 n/c; $0 (17b)	$0 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$10 (13b); $0 n/c (13c, 13d, 13e)"												912	63.2242		100	0.2	0.2	48.2974			0.135921525			30.5314		29.9999	30	7.9579			0.2	30						552.1238			10											0	0.885922897	4.093742896	0	4.452122544	8.320831207	1.881920484	1.38813259	0	0	5.618496032	0	0	0.198529057	0	1.353877387	0.828452284	0.680056331	0	0	6.750914694	5.149699064	0	0	0	0	0	8.46E-05	0	0	0.016549152	0	0	0	0	0	0	0	0	0	0	41.6193	0	0	0	0.885922897	4.093742896	0	4.452122544	8.320831207	1.881920484	1.38813259	0	0	5.618496032	0	0	0.198529057	0	1.353877387	0.828452284	0.680056331	0	0	6.750914694	5.149699064	0	0	0	0	0	8.46E-05	0	0	0.016549152	0	0	0	0	0	0	0	0	0	0	41.6193																																																																																				0			0	0.885922897	4.093742896	0	4.452122544	8.320831207	1.881920484	1.38813259	0	0	5.618496032	0	0	0.198529057	0	1.353877387	0.828452284	0.680056331	0	0	6.750914694	5.149699064	0	0	0	0	0	8.46E-05	0	0	0.016549152	0	0	0	0	0	0	0	0	0	0	41.6193
H0609_018_0	2008	3																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1208.126081	9.467818572	978.6197016		511.9809492	28.63929966	11.22668252	349.9624213	417.5688691		57.69260277			340.6362875	3520.14552	4367.260149	312.8280864	495.9900942			29.49074095	1977.095101			172.291619	1.106165923																$200 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$200 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"											85.6739	912	63.2242		100	0.2	0.2	48.6945	200		0.150613413			7.7644	15	30	30	7.9579			0.2	30			30	0.411069113																8.6254	0.719554212	5.156040258	0	4.26650791	5.727859932	2.245336503	1.420104046	6.959481152	0	8.689279811	0	0	0.220401757	4.400181899	10.91815037	0.782070216	0.328920373	0	0	5.898148191	4.942737754	0	0	0.430729048	0.454710645	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1856	0	0	8.6254	0.719554212	5.156040258	0	4.26650791	5.727859932	2.245336503	1.420104046	6.959481152	0	8.689279811	0	0	0.220401757	4.400181899	10.91815037	0.782070216	0.328920373	0	0	5.898148191	4.942737754	0	0	0.430729048	0.454710645	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1856																																																																																				0			8.6254	0.719554212	5.156040258	0	4.26650791	5.727859932	2.245336503	1.420104046	6.959481152	0	8.689279811	0	0	0.220401757	4.400181899	10.91815037	0.782070216	0.328920373	0	0	5.898148191	4.942737754	0	0	0.430729048	0.454710645	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1856
H0609_020_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1384.575548	11.67599817	778.2693056		535.1309128	41.90906132	9.440982893	345.2922647	306.1917058		41.48454367			911.1702944	4297.346376	4577.891148	331.9243967	1027.16166			33.86960862	2063.257943			144																	$200 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$180 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$200 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											85.6739	912	69.5467		180	0.2	0.2	48.2966	200		0.135869919			7.5558	15	30	30	7.9579			0.2	30			30																	9.8852	0.887375861	4.510502549	0	8.026963693	8.381812265	1.888196579	1.389702713	5.103195097	0	5.636501596	0	0	0.573718415	5.37168297	11.44472648	0.829810992	0.681171662	0	0	6.773921723	5.158144858	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9026	0	0	9.8852	0.887375861	4.510502549	0	8.026963693	8.381812265	1.888196579	1.389702713	5.103195097	0	5.636501596	0	0	0.573718415	5.37168297	11.44472648	0.829810992	0.681171662	0	0	6.773921723	5.158144858	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9026																																																																																				0			9.8852	0.887375861	4.510502549	0	8.026963693	8.381812265	1.888196579	1.389702713	5.103195097	0	5.636501596	0	0	0.573718415	5.37168297	11.44472648	0.829810992	0.681171662	0	0	6.773921723	5.158144858	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9026
H0609_801_0	2008	4																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1574.793845	88.57318389	1248.997593		9.141653608	27.53327516	11.34248042	398.6984515	425.0285623		59.73382036		1.33534799	925.7468866	4543.033658	4485.563795	2.965537839	380.6314643			55.71267379	2074.159322			144																	$265 (1a); $0 (1a1)	$265 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											166.7589	176.1049	159.1696		0.3	0.3	0.3	48.4338	300		0.227615661		0.3	8.1119	20	40	0.389896694	40			0.3	40			40																	21.8842	1.299847851	16.56686663	0	2.742496082	8.259982549	3.402744126	1.609207443	10.62571406	0	13.59635303	0	0.400604397	0.625796126	7.571722764	14.95187932	1.156253398	1.268771548	0	0	16.71380214	6.913864406	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.0702	0	0	21.8842	1.299847851	16.56686663	0	2.742496082	8.259982549	3.402744126	1.609207443	10.62571406	0	13.59635303	0	0.400604397	0.625796126	7.571722764	14.95187932	1.156253398	1.268771548	0	0	16.71380214	6.913864406	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.0702																																																																																				0			21.8842	1.299847851	16.56686663	0	2.742496082	8.259982549	3.402744126	1.609207443	10.62571406	0	13.59635303	0	0.400604397	0.625796126	7.571722764	14.95187932	1.156253398	1.268771548	0	0	16.71380214	6.913864406	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.0702
H0609_803_0	2008	4																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1572.889087	88.46605208	1247.486894		9.119552796	27.49276239	11.3165155	398.2166981	424.514478		59.61687591		1.332989145	924.6271692	4537.697177	4480.138377	2.958368498	380.1710796			55.61742869	2071.650566			144																	$265 (1a); $0 (1a1)	$265 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											166.7589	176.1049	159.1696		0.3	0.3	0.3	48.4338	300		0.227612306		0.3	8.1119	20	40	0.390119315	40			0.3	40			40																	21.8578	1.298275648	16.54682852	0	2.735865839	8.247828716	3.394954651	1.607263077	10.61286195	0	13.56953459	0	0.399896743	0.625039207	7.562828628	14.93379459	1.154116692	1.267236932	0	0	16.68522861	6.905501888	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.8848	0	0	21.8578	1.298275648	16.54682852	0	2.735865839	8.247828716	3.394954651	1.607263077	10.61286195	0	13.56953459	0	0.399896743	0.625039207	7.562828628	14.93379459	1.154116692	1.267236932	0	0	16.68522861	6.905501888	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.8848																																																																																				0			21.8578	1.298275648	16.54682852	0	2.735865839	8.247828716	3.394954651	1.607263077	10.61286195	0	13.56953459	0	0.399896743	0.625039207	7.562828628	14.93379459	1.154116692	1.267236932	0	0	16.68522861	6.905501888	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.8848
H0609_804_0	2008	4																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1554.302397	87.42065665	1232.745453		8.905296364	26.28293443	11.01911376	393.6843593	419.4980284		57.62166363		1.282850894	913.7009325	4696.953149	4427.196982	2.888861293	375.6786319			53.456909	2047.170057			231.829527																	$300 (1a); $0 (1a1)	$300 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											188.7837	199.3641	159.1696		0.3	0.3	0.3	48.4345	300		0.227687424		0.3	8.1119	20	40	0.39232084	40			0.3	40			40																	24.4522	1.452378159	16.35129613	0	2.671588909	7.88488033	3.305734128	1.588992494	10.48745071	0	13.11972817	0	0.384855268	0.617653175	7.828255249	14.75732327	1.133360489	1.252262106	0	0	16.0370727	6.823900189	0	0	0.77276509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9217	0	0	24.4522	1.452378159	16.35129613	0	2.671588909	7.88488033	3.305734128	1.588992494	10.48745071	0	13.11972817	0	0.384855268	0.617653175	7.828255249	14.75732327	1.133360489	1.252262106	0	0	16.0370727	6.823900189	0	0	0.77276509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9217																																																																																				0			24.4522	1.452378159	16.35129613	0	2.671588909	7.88488033	3.305734128	1.588992494	10.48745071	0	13.11972817	0	0.384855268	0.617653175	7.828255249	14.75732327	1.133360489	1.252262106	0	0	16.0370727	6.823900189	0	0	0.77276509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9217
H0609_805_0	2008	4																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1554.302397	87.42065665	1232.745453		8.905296364	26.28293443	11.01911376	393.6843593	419.4980284		57.62166363		1.282850894	913.7009325	4696.953149	4427.196982	2.888861293	375.6786319			53.456909	2047.170057			231.829527																	$300 (1a); $0 (1a1)	$300 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											188.7837	199.3641	159.1696		0.3	0.3	0.3	48.4345	300		0.227687424		0.3	8.1119	20	40	0.39232084	40			0.3	40			40																	24.4522	1.452378159	16.35129613	0	2.671588909	7.88488033	3.305734128	1.588992494	10.48745071	0	13.11972817	0	0.384855268	0.617653175	7.828255249	14.75732327	1.133360489	1.252262106	0	0	16.0370727	6.823900189	0	0	0.77276509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9217	0	0	24.4522	1.452378159	16.35129613	0	2.671588909	7.88488033	3.305734128	1.588992494	10.48745071	0	13.11972817	0	0.384855268	0.617653175	7.828255249	14.75732327	1.133360489	1.252262106	0	0	16.0370727	6.823900189	0	0	0.77276509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9217																																																																																				0			24.4522	1.452378159	16.35129613	0	2.671588909	7.88488033	3.305734128	1.588992494	10.48745071	0	13.11972817	0	0.384855268	0.617653175	7.828255249	14.75732327	1.133360489	1.252262106	0	0	16.0370727	6.823900189	0	0	0.77276509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9217
H0609_806_0	2008	4																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1554.302397	87.42065665	1232.745453		8.905296364	21.55278857	10.74944218	393.6843593	419.4980284		52.57849952		1.123861422	913.7009325	4696.953149	4427.196982	2.888837638	375.6786319			46.25388428	2047.170057			231.829527																	$350 (1a); $0 (1a1)	$350 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	35% (10a)	35% (11a)	"35% (11b, 11c)"	"$50 (4a, 4a1); $45/$45/$20 (4b)"	$330 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 35% (8b2, 8b3)"	$330 (incl in h5)	35% (12)	"$0 (3, 5, 9d); $45/$45 (9c); $330 (9a)"	"$20/$45/$45 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$45 (7b, 7d); $0 n/c (7b1, 7f1); $45/$45( 7f, 7g)"	55%/55% (7e); $45/$45 (7h)	"$45 (7c, 7i)"	$0 (incl in h2)		"35% (15, 15a1)"	"$0 (13a, 17b, 13a1); $45/$45 (17a); $45( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$45 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											220.2477	232.5914	159.1696		0.35	0.35	0.35	49.2173	330		0.266450559		0.35	8.9234	20	44.8796	0.436213281	45			0.35	45			45																	28.5276	1.694441185	16.35129613	0	3.116853727	7.543476	3.762304765	1.614671995	11.53619578	0	14.00957059	0	0.393351498	0.679446864	7.828255249	16.55756222	1.260149345	1.40879487	0	0	16.1888595	7.676887713	0	0	0.869360726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0191	0	0	28.5276	1.694441185	16.35129613	0	3.116853727	7.543476	3.762304765	1.614671995	11.53619578	0	14.00957059	0	0.393351498	0.679446864	7.828255249	16.55756222	1.260149345	1.40879487	0	0	16.1888595	7.676887713	0	0	0.869360726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0191																																																																																				0			28.5276	1.694441185	16.35129613	0	3.116853727	7.543476	3.762304765	1.614671995	11.53619578	0	14.00957059	0	0.393351498	0.679446864	7.828255249	16.55756222	1.260149345	1.40879487	0	0	16.1888595	7.676887713	0	0	0.869360726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0191
H0620_002_0	2008	6	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						500	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	P	P	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T				V					V	P	V	V																																																0		1017.467596	38.75012608	7488.428125	46.31670643	403.8237842	437.1139169	19.78109337	104.2309691	72.46534043	588.6568065	119.1211076	62.53858147	1.985351793	120.6101214	25593.54582	1208.473782	833.3989918	4.524424494		238.4371708	157.5936185	242.1977774	390.3147448									33.75098047	0.496337948		0.196274387							(1a) $75/day	(1b) $75/day	(2a) $0/day	(6a) $0/proc	(10a) $50/trip	(11a) $0/proc	(11a/11c) $0/proc	(4a) $50/visit (waived if admitted)	(9a/9b) $0/visit	(8a) $0/visit	(8b) $0/visit	(9a) $0/visit	(12) $0/proc	(9a) $0/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $0/visit	(7e/7h) $0/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $0/visit	(15) $0/proc	(Misc. PBP Cats) $0/visit	(10b) $0/trip				(18a) $0/visit					(4b) $10/visit (waived if admitted)	(9c) $0/proc 75%/25% Ind/Grp Blended Copay	(9d) $0/visit	(7f1) $0/visit							68.3095	68.3095			45.5397			45.5397																								9.1079										5.7919	0.220583433	0	0	1.532499734	0	0	0.395553552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.025616801	0	0	0	0	0	0	0	0	0	7.9661		0.78023714	5.7919	0.220583433	0	0	1.532499734	0	0	0.395553552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.025616801	0	0	0	0	0	0	0	0	0	7.9661		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3				0.3					10	0.3	0.3	0.3							1.508	0.0207	1.0346	0.0106	0.3169	0.1523	0.0013	0.0229	0.2213	0.4774	0.6902	0.0254	-0.0002	0.1269	0.0072	1.8632	0.0915	0.0009		0.2133		0.0529	0.023									0.0015										6.8619		0	7.2999	0.241309067	1.03461691	0.010610893	1.849426774	0.152323704	0.001262769	0.418411221	0.221315675	0.477429152	0.690219801	0.025409206	-0.000155263	0.126919907	0.007191082	1.863231361	0.091542373	0.000853512	0	0.213328165	0	0.052861552	0.022968565	0	0	0	0	0	0	0	0	0.027097108	0	0	0	0	0	0	0	0	0	14.8281
H0621_001_0	2008	3																					0											A	A	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	P	V	P	V	P	P																																																				0	0	327.0740114	117.6697985	676.9456908		17.55757348	34.74404391	0.158726003	86.23310939	25.84758262	18.32821411	29.43073624	15.96279014		39.42488728	56.71351018	121.9186345	37.98855959	4.589214331		26.02415785	34.16613632	0.404152418																				FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing							FFS Cost Sharing		FFS Cost Sharing											772.3145	467.4275	65.4467		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234	0.234	0.234	0.234		0.234	0.234	0.234																				21.0503	4.583508028	3.691986837	0	4.108472194	8.130106274	0.037141885	20.1785476	6.048334333	4.288802102	6.886792279	3.735292893	0	9.225423623	13.27096138	28.52896048	8.889322945	1.073876153	0	6.089652937	7.994875899	0.094571666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.907	0	0	21.0503	4.583508028	3.691986837	0	4.108472194	8.130106274	0.037141885	20.1785476	6.048334333	4.288802102	6.886792279	3.735292893	0	9.225423623	13.27096138	28.52896048	8.889322945	1.073876153	0	6.089652937	7.994875899	0.094571666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.907																																																																																				0	0	0	21.0503	4.583508028	3.691986837	0	4.108472194	8.130106274	0.037141885	20.1785476	6.048334333	4.288802102	6.886792279	3.735292893	0	9.225423623	13.27096138	28.52896048	8.889322945	1.073876153	0	6.089652937	7.994875899	0.094571666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.907
H0621_004_0	2008	6																					0											A	A	D	V	T	P	P	V	V	V	V	V	Coin	V	V	V	V	V	P	P	S	V	T	V	V	P	V	P	V	P	P																																																				0	0	238.3093319	241.8154815	290.5285536		603.8620553			817.2991601	245.3946641		2819.418414	197.4491356		1522.46716	5595.842178	6881.71869	12844.38972	357.9772965																								$500 per admit	$500 per admit	$20 per day		$50 per trip			$50ER/$30UC	$200 per visit		$50 per visit	$50 per visit	20% coins	$50 per visit	$10 per visit	$10chiro/pod else $30	$10 per visit	$30 per visit				$30 per visit																				500	500	20		50			50	200		50	50		40.5855	11.6005	29.3713	10	30																								9.9296	10.07564506	0.484214256	0	2.516091897	0	0	3.405413167	4.089911069	0	11.74757672	0.822704732	0	5.149171139	5.409546331	16.84374063	10.7036581	0.894943241	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.0722	0	0	9.9296	10.07564506	0.484214256	0	2.516091897	0	0	3.405413167	4.089911069	0	11.74757672	0.822704732	0	5.149171139	5.409546331	16.84374063	10.7036581	0.894943241	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.0722																																																																																				0	0	0	9.9296	10.07564506	0.484214256	0	2.516091897	0	0	3.405413167	4.089911069	0	11.74757672	0.822704732	0	5.149171139	5.409546331	16.84374063	10.7036581	0.894943241	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.0722
H0621_005_0	2008	4																					0											A	A	D	V	T	P	P	V	V	V	V	V	Coin	V	V	V	V	V	P	P	S	V	T	V	V	P	V	P	V	P	P																																																				0	0	505.5879234	87.3344302	1227.836988		674.482305			547.8280807	353.1561808		4235.342539	471.1003194	0.364247709	2114.717086	7988.536747	10822.87283	3468.361971	662.0932932																								$500 per admit	$500 per admit	$20 per day		$50 per trip			$50ER/$30UC	$200 per visit		$50 per visit	$50 per visit	20% coins	$50 per visit	$10 per visit	$10chiro/pod else $30	$30 per visit	$30 per visit				$30 per visit																				500	500	20		50			50	200		50	50	0.2	46.6452	10	29.5454	30	30																								21.0662	3.638934592	2.046394979	0	2.810342937	0	0	2.282617003	5.885936346	0	17.64726058	1.962917997	0.072849542	8.220113099	6.657113956	26.64714798	8.670904926	1.655233233	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.2639	0	0	21.0662	3.638934592	2.046394979	0	2.810342937	0	0	2.282617003	5.885936346	0	17.64726058	1.962917997	0.072849542	8.220113099	6.657113956	26.64714798	8.670904926	1.655233233	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.2639																																																																																				0	0	0	21.0662	3.638934592	2.046394979	0	2.810342937	0	0	2.282617003	5.885936346	0	17.64726058	1.962917997	0.072849542	8.220113099	6.657113956	26.64714798	8.670904926	1.655233233	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.2639
H0621_006_0	2008	4																					0											A	A	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	V	P	P																																																				0	0	113.5518788	1.100125883	177.6470268		80.67315565			191.9775529	348.1354351		3460.75827	85.91362028		2063.164163	2719.48428	3056.712391	92.29255451	745.6394388			885.1723287																					$500 per admit	$500 per admit	$20 per day		$50 per trip			$50ER/$30UC	$200 per visit		$50 per visit	$50 per visit	20% coins	$50 per visit	$10 per visit	$10chiro/pod else $30	$30 per visit	$30 per visit			20% coins	$30 per visit																				500	500	20		50			50	200		50	50		49.996	10	26.9597	30	30			71.9689																					4.7313	0.045838578	0.296078378	0	0.336138149	0	0	0.799906471	5.802257251	0	14.41982612	0.357973418	0	8.595832293	2.2662369	6.86732748	0.230731386	1.864098597	0	0	5.308740507	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.9223	0	0	4.7313	0.045838578	0.296078378	0	0.336138149	0	0	0.799906471	5.802257251	0	14.41982612	0.357973418	0	8.595832293	2.2662369	6.86732748	0.230731386	1.864098597	0	0	5.308740507	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.9223																																																																																				0	0	0	4.7313	0.045838578	0.296078378	0	0.336138149	0	0	0.799906471	5.802257251	0	14.41982612	0.357973418	0	8.595832293	2.2662369	6.86732748	0.230731386	1.864098597	0	0	5.308740507	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.9223
H0621_007_0	2008	4																					0											A	A	D	V	T	P	P	V	V	P	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	V	P	P																																																				0	0	113.5518788	1.100125883	156.1350821		73.20957083			177.8307898	322.4814487		3393.187182	79.58267369	0.013496417	1911.154501	2719.48428	3023.542404	91.89471066	743.9417906			23.88933228																					$500 per admit	$500 per admit	$20 per day		$50 per trip			$50ER/$30UC	$200 per visit		$50 per visit	$50 per visit	20% coins	$50 per visit	$10 per visit	$10chiro/pod else $30	$30 per visit	$30 per visit			20% coins	$30 per visit																				500	500	20		50			50	200		50	50	0.2	49.9958	10	27.1457	30	30			0.2																					4.7313	0.045838578	0.260225137	0	0.305039878	0	0	0.740961624	5.374690811	0	14.13827992	0.331594474	0.002699283	7.962468798	2.2662369	6.839685824	0.229736777	1.859854476	0	0	4.777866456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8665	0	0	4.7313	0.045838578	0.260225137	0	0.305039878	0	0	0.740961624	5.374690811	0	14.13827992	0.331594474	0.002699283	7.962468798	2.2662369	6.839685824	0.229736777	1.859854476	0	0	4.777866456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8665																																																																																				0	0	0	4.7313	0.045838578	0.260225137	0	0.305039878	0	0	0.740961624	5.374690811	0	14.13827992	0.331594474	0.002699283	7.962468798	2.2662369	6.839685824	0.229736777	1.859854476	0	0	4.777866456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8665
H0623_001_0	2008	4	s.										Health & Education (Non-Covered)										5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O	O	O										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0	0	0										0		306.940557	6.595531	524.866864	219.842879	73.535944	5.220234	1.786426	347.932171	410.895844	6462.655151	1514.708804		8.629832	550.796247	4993.357218	3772.042991	49.216463	313.127954			18.739194			7.18	2.99					0.08	0.02	3.4										"175/days (1-5), ltac 950/admit"	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$10/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$100-$150/Visit	$0/Visit	$0-$100/Visit		$0-$50/Proc	$15-$100/Visit	$10/Visit	$35/Visit	$35-$50/Visit	$50/Visit			15% Coins			Coin: 0% - 50%	EyeMed $200 Allowance					Active Outlook Newsletter	QuitNet	Silver Sneakers										564.855605	894.35435	27.248744	9.414239	94.142671	0.188285	0.188285	47.071287	118.693981	0	49.642154		15.706302	35.220155	9.414259	32.949909	38.854115	47.071306			0.141213			0.103064067	0					0	0	0										14.4481	0.49156182	1.191830234	0.172471117	0.576905849	0.982891759	0.336357219	1.364801256	4.064238625	0	6.266117309	0	0.011295229	1.616594099	3.917396511	10.35737277	0.159355176	1.228278478	0	0	2.646217802	0	0	0.74	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5718	0	3.1	14.4481	0.49156182	1.191830234	0.172471117	0.576905849	0.982891759	0.336357219	1.364801256	4.064238625	0	6.266117309	0	0.011295229	1.616594099	3.917396511	10.35737277	0.159355176	1.228278478	0	0	2.646217802	0	0	0.74	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5718	10000	$950/Admit	$950/Admit	20% Coins(Days 1-20) $0(Days 21-100)	20% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	20% Coins	20% Coins	20% Coins		$0-$50/Proc	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins			20% Coins			Coin: 50% - 55%	EyeMed $200 Allowance					Active Outlook Newsletter	QuitNet	Silver Sneakers										4.037	0.0867	0.3661	0.572	0.5769	2.1727	0.7435	0.2408	2.4278	0.6019	1.6234		0.002	0.8116	2.5102	2.0651	0.0711	0.2191			0.6596			2.21	0					0	0	0										21.9976	0	1.23	18.4851	0.578308577	1.557979048	0.744459902	1.153811701	3.155601293	1.079884177	1.605648153	6.492036948	0.60186588	7.889474647	0	0.013288228	2.42817486	6.427638333	12.4224952	0.23045355	1.447399146	0	0	3.305813808	0	0	2.95	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5694
H0623_801_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		306.940557	6.595531	524.866864	219.842879	73.535944	5.220234	1.786426	347.932171	410.895844	6462.655151	1514.708804		8.629832	550.796247	4993.357218	3772.042991	49.216463	313.127954			18.739194																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214508	177.214541	28.944117	0	100.000076	0.2	0.199999	49.999986	199.999998	37.551769	90.504999		33.367045	87.838659	19.999999	30.000001	59.266997	100.000014			0.2																					4.5329	0.097402	1.265983993	0	0.612799999	1.0440468	0.357283414	1.449716973	6.848263998	20.22367778	11.4240599	0	0.023995999	4.031766977	8.322261614	9.430107792	0.243075997	2.609399982	0	0	3.7478388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2645	0	0	4.5329	0.097402	1.265983993	0	0.612799999	1.0440468	0.357283414	1.449716973	6.848263998	20.22367778	11.4240599	0	0.023995999	4.031766977	8.322261614	9.430107792	0.243075997	2.609399982	0	0	3.7478388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2645		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.8751	0.1116	0.4862	0.7595	0.7495	1.4424	0.4936	0.8464	3.2236	0.7991	2.1555		0.0147	1.0776	3.333	2.742	0.0944	0.2909			0.8758																					29.3708	0	0	14.408	0.208989	1.752146993	0.759472	1.362270999	2.4864798	0.850901414	2.296089973	10.071829	21.02281878	13.5795109	0	0.038673999	5.109361977	11.65529261	12.17212179	0.337477997	2.900342982	0	0	4.6236328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.6354
H0623_802_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		306.940557	6.595531	524.866864	219.842879	73.535944	5.220234	1.786426	347.932171	410.895844	6462.655151	1514.708804		8.629832	550.796247	4993.357218	3772.042991	49.216463	313.127954			18.739194																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214508	177.214541	28.944117	0	100.000076	0.2	0.199999	49.999986	199.999998	37.551769	90.504999		33.367045	87.838659	19.999999	30.000001	59.266997	100.000014			0.2																					4.5329	0.097402	1.265983993	0	0.612799999	1.0440468	0.357283414	1.449716973	6.848263998	20.22367778	11.4240599	0	0.023995999	4.031766977	8.322261614	9.430107792	0.243075997	2.609399982	0	0	3.7478388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2645	0	0	4.5329	0.097402	1.265983993	0	0.612799999	1.0440468	0.357283414	1.449716973	6.848263998	20.22367778	11.4240599	0	0.023995999	4.031766977	8.322261614	9.430107792	0.243075997	2.609399982	0	0	3.7478388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2645		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.8751	0.1116	0.4862	0.7595	0.7495	1.4424	0.4936	0.8464	3.2236	0.7991	2.1555		0.0147	1.0776	3.333	2.742	0.0944	0.2909			0.8758																					29.3708	0	0	14.408	0.208989	1.752146993	0.759472	1.362270999	2.4864798	0.850901414	2.296089973	10.071829	21.02281878	13.5795109	0	0.038673999	5.109361977	11.65529261	12.17212179	0.337477997	2.900342982	0	0	4.6236328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.6354
H0623_803_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		306.940557	6.595531	524.866864	219.842879	73.535944	5.220234	1.786426	347.932171	410.895844	6462.655151	1514.708804		8.629832	550.796247	4993.357218	3772.042991	49.216463	313.127954			18.739194																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214508	177.214541	28.944117	0	100.000076	0.2	0.199999	49.999986	199.999998	37.551769	90.504999		33.367045	87.838659	19.999999	30.000001	59.266997	100.000014			0.2																					4.5329	0.097402	1.265983993	0	0.612799999	1.0440468	0.357283414	1.449716973	6.848263998	20.22367778	11.4240599	0	0.023995999	4.031766977	8.322261614	9.430107792	0.243075997	2.609399982	0	0	3.7478388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2645	0	0	4.5329	0.097402	1.265983993	0	0.612799999	1.0440468	0.357283414	1.449716973	6.848263998	20.22367778	11.4240599	0	0.023995999	4.031766977	8.322261614	9.430107792	0.243075997	2.609399982	0	0	3.7478388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2645		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.8751	0.1116	0.4862	0.7595	0.7495	1.4424	0.4936	0.8464	3.2236	0.7991	2.1555		0.0147	1.0776	3.333	2.742	0.0944	0.2909			0.8758																					29.3708	0	0	14.408	0.208989	1.752146993	0.759472	1.362270999	2.4864798	0.850901414	2.296089973	10.071829	21.02281878	13.5795109	0	0.038673999	5.109361977	11.65529261	12.17212179	0.337477997	2.900342982	0	0	4.6236328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.6354
H0623_804_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		306.940557	6.595531	524.866864	219.842879	73.535944	5.220234	1.786426	347.932171	410.895844	6462.655151	1514.708804		8.629832	550.796247	4993.357218	3772.042991	49.216463	313.127954			18.739194																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214508	177.214541	28.944117	0	100.000076	0.2	0.199999	49.999986	199.999998	37.551769	90.504999		33.367045	87.838659	19.999999	30.000001	59.266997	100.000014			0.2																					4.5329	0.097402	1.265983993	0	0.612799999	1.0440468	0.357283414	1.449716973	6.848263998	20.22367778	11.4240599	0	0.023995999	4.031766977	8.322261614	9.430107792	0.243075997	2.609399982	0	0	3.7478388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2645	0	0	4.5329	0.097402	1.265983993	0	0.612799999	1.0440468	0.357283414	1.449716973	6.848263998	20.22367778	11.4240599	0	0.023995999	4.031766977	8.322261614	9.430107792	0.243075997	2.609399982	0	0	3.7478388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2645		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.8751	0.1116	0.4862	0.7595	0.7495	1.4424	0.4936	0.8464	3.2236	0.7991	2.1555		0.0147	1.0776	3.333	2.742	0.0944	0.2909			0.8758																					29.3708	0	0	14.408	0.208989	1.752146993	0.759472	1.362270999	2.4864798	0.850901414	2.296089973	10.071829	21.02281878	13.5795109	0	0.038673999	5.109361977	11.65529261	12.17212179	0.337477997	2.900342982	0	0	4.6236328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.6354
H0624_001_0	2008	4																					1650											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T	V		P	V																																																								0		2619.636482	452.0242434	1667.808262		1828.701171	42.20383759	15.69945211	985.5264504	353.6487281	8262.654343	661.2533377	52.66397799	2.937246273	2744.369119		2507.577314		746.2550946			27.5451662	568.0066015																				1(a) $150 per Day	1(b) $150 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $10 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per procedure; other $0 per procedure	8(b) X-rays $10 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a)/(d) $25 Copay Per Visit; 9(c) $0 Copay per Visit"	7(a) PCP $0 per visit; Urgent Care $10 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $10 per procedure"	10(b) $0 Copay	16(a)/16(b) $0 copay per visit		17(b) $0 copay per procedure	18a $10 per visit															79.768	79.768	22.3351		39.884	0.106357393	0.106357393	19.1443	13.2947	5.3179	5.3179	13.2947	0.106357393	13.2947		5.3179		5.3179			0.106357393	5.3179																				17.4136	3.004757514	3.104215436	0	6.077996552	4.488690152	1.669752802	1.572270364	0.391803717	3.661643239	0.293038255	0.058345869	0.312397857	3.040457767	0	1.111247444	0	0.330707277	0	0	2.929632074	0.251715423	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7123	0	43.76928767	17.4136	3.004757514	3.104215436	0	6.077996552	4.488690152	1.669752802	1.572270364	0.391803717	3.661643239	0.293038255	0.058345869	0.312397857	3.040457767	0	1.111247444	0	0.330707277	0	0	2.929632074	0.251715423	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7123																																																																																				0	0	0	17.4136	3.004757514	3.104215436	0	6.077996552	4.488690152	1.669752802	1.572270364	0.391803717	3.661643239	0.293038255	0.058345869	0.312397857	3.040457767	0	1.111247444	0	0.330707277	0	0	2.929632074	0.251715423	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7123
H0624_004_0	2008	6	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						500	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	P	P	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T				V					V	P	V	V																																																0		1057.848662	40.28803391	6970.603111	44.9292272	391.7266996	424.0195817	19.18852412	101.1085902	70.2945437	571.0228002	115.5526746	60.66515415	1.92587791	116.997083	100.0345382	1214.510234	837.5619062	4.547024464		239.6281892	145.2290553	234.9424172	1912.9									32.73992446	0.481469477		247.1							(1a) $75/day	(1b) $75/day	(2a) $0/day	(6a) $0/proc	(10a) $50/trip	(11a) $0/proc	(11a/11c) $0/proc	(4a) $50/visit (waived if admitted)	(9a/9b) $0/visit	(8a) $0/visit	(8b) $0/visit	(9a) $0/visit	(12) $0/proc	(9a) $0/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $0/visit	(7e/7h) $0/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $0/visit	(15) $0/proc	(Misc. PBP Cats) $0/visit	(10b) $0/trip				(18a) $0/visit					(4b) $10/visit (waived if admitted)	(9c) $0/proc 75%/25% Ind/Grp Blended Copay	(9d) $0/visit	(7f1) $0/visit							68.098	68.098			45.3986			45.3986																								9.0797										6.0031	0.228627738	0	0	1.481988247	0	0	0.382516031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.024772467	0	0	0	0	0	0	0	0	0	8.121		0.82310234	6.0031	0.228627738	0	0	1.481988247	0	0	0.382516031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.024772467	0	0	0	0	0	0	0	0	0	8.121																																																																																				0		0	6.0031	0.228627738	0	0	1.481988247	0	0	0.382516031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.024772467	0	0	0	0	0	0	0	0	0	8.121
H0624_005_0	2008	6																					2500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2115.262851	145.0665566	949.9910008		293.6007884	11.70302235	20.32458296	456.8199401	431.7829694	3619.997874	475.7321151	72.49957851	16.27361716	3041.959098		4153.926797	409.168445	597.6834056				739.2741662					0.078275725															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															128.3077	128.3077	30.7938		54.989	0.146637333	0.146637333	30.244	54.989	14.6637	47.8507	54.989	112.3222	53.1647		18.3297	14.6637	14.6637				18.3297					18.3297															22.617	1.55109595	2.437822575	0	1.345401147	1.71609999	2.980342648	1.151336619	1.978609476	4.42355696	1.897009446	0.332223277	0.152324065	13.47708251	0	6.3450078	0.499994747	0.73035584	0	0	0	1.129220754	0	0	0	0	0.000119564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7646	0	23.56844479	22.617	1.55109595	2.437822575	0	1.345401147	1.71609999	2.980342648	1.151336619	1.978609476	4.42355696	1.897009446	0.332223277	0.152324065	13.47708251	0	6.3450078	0.499994747	0.73035584	0	0	0	1.129220754	0	0	0	0	0.000119564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7646																																																																																				0	0	0	22.617	1.55109595	2.437822575	0	1.345401147	1.71609999	2.980342648	1.151336619	1.978609476	4.42355696	1.897009446	0.332223277	0.152324065	13.47708251	0	6.3450078	0.499994747	0.73035584	0	0	0	1.129220754	0	0	0	0	0.000119564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7646
H0630_013_0	2008	6	j.	j.	j.								Part B Rx	Part B Rx	Part B Rx								3250	Generic	Brand	Office Administered								D	D	D	Coin	Coin	Coin	Coin	V	V		P	Coin		V	V	V	V	V		V		V			V		V			O	O	S	S	Coin								0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0								0		555.202877	24.45076169	9.417158277		6.647208009	8.296008063	0.970479516	175.1356884	221.6080001	0	439.0064889	0.319125197	0	112.3597793	4490.526793	1348.935359	150.6153795	505.7521279	0	0	0	62.71072175	0	0	378.9266972	0	36.54990381	0	0	47.87435281	102.2123993	100.62	379.38	0.93								$260/day days 1-5; $0 days 6-90	$260/day days 1-5; $0 days 6-90	"$0 days 1-20, $100/day days 21-100"	$0 Copay	"20% Coinsurance, max $500/trip"	20% Coinsurance	20% Coinsurance	$50/visit waived if admitted to hospital	$325/visit	$0 Copay	"MRI,CT,PET $225/procedure, Radiation Therapy $35/visit"	Partial hospital-20% Coinsurance	$0 Copay	"Pulmonary Rehab $5, OV $20/visit"	Primary Care OV $10-$30/visit	Specialty Care OV $35/visit	"$10 Group Visit, $20 OV"	Therapies=Primary Care OV	$0 Copay	"Primary Care OV chg for PA, NP"		$0 Copay			$20/visit; $35/specialty visit		$20/visit			$0-$150 copay	$3 copay	$10 Generic copay	$35 Brand copay	20% coinsurance								209.02	209.02	18.73	0	0.19	0.19	0.19	42.03	312.7	0	213.57	0.19	0	18.54	18.75	31.28	17.17	19.1	0	19.1	0	0	0	0	25.42	0	19.1	0	0	16.32	0.01	10	35	0.2								9.6707	0.425891517	0.014698615	0	1.262969522	1.576241532	0.184391108	0.613412748	5.774735137	0	7.813217986	0.060633787	0	0.173595859	7.016448114	3.516224835	0.215505506	0.804988804	0	0	0	0	0	0	0.802693054	0	0.058175264	0	0	0.06510912	8.52E-05	0.08385	1.106525	0.186	0	0	0	0	0	0	0	41.4261	0	1.69	9.6707	0.425891517	0.014698615	0	1.262969522	1.576241532	0.184391108	0.613412748	5.774735137	0	7.813217986	0.060633787	0	0.173595859	7.016448114	3.516224835	0.215505506	0.804988804	0	0	0	0	0	0	0.802693054	0	0.058175264	0	0	0.06510912	8.52E-05	0.08385	1.106525	0.186	0	0	0	0	0	0	0	41.4261	3250																																																																																			0			9.6707	0.425891517	0.014698615	0	1.262969522	1.576241532	0.184391108	0.613412748	5.774735137	0	7.813217986	0.060633787	0	0.173595859	7.016448114	3.516224835	0.215505506	0.804988804	0	0	0	0	0	0	0.802693054	0	0.058175264	0	0	0.06510912	8.52E-05	0.08385	1.106525	0.186	0	0	0	0	0	0	0	41.4261
H0630_014_0	2008	2	j.	j.	j.								Part B Rx	Part B Rx	Part B Rx								3250	Generic	Brand	Office Administered								D	D	D		Coin	Coin	Coin	V	V		P	Coin		V	V	V	V	V		V		V			V		V			O	O	S	S	Coin								0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1576.216978	197.8231914	86.41055617	0	28.76993181	37.62629753	2.88202861	622.8070648	527.7938667	0	919.8579382	0.743941307	0	178.717531	8023.543551	2158.921022	1830.461353	721.9585002	0	0	0	154.1137241	0	0	467.1314379	0	53.07390675	0	0	92.43689287	91.35607359	404.3	1016.7	0.6	0	0	0	0	0	0	0	$0-$190/day days 1-5; $0 days 6-90	$0-$190/day days 1-5; $0 days 6-90	"$0 days 1-20, $0-$100/day days 21-100"	$0 Copay	"0%-20% Coinsurance, max $500/trip"	0%-20% Coinsurance	0%-20% Coinsurance	$50/visit waived if admitted to hospital	$0-$200/visit	$0 Copay	"MRI,CT,PET $0-$125/procedure, Radiation Therapy $0-$30/visit"	Partial hospitalizaton 0%-20% coin	$0 Copay	"Pulmonary Rehab $0-$5, OV $0-$20/visit"	Primary Care OV $0-$30/visit	Specialty Care OV $0-$30/visit	"$0-$10 Group Visit, $0-$15 OV"	Therapies=Primary Care OV	$0 Copay	"Primary Care OV chg for PA, NP"		$0 Copay			$0-$15/visit; $0-$30/specialty visit		$0-$15/visit			$0-$150 copay	$0-$3 copay	$0-$10 Generic copay	$0-$30 Brand copay	0%-20% coinsurance								118.44	118.44	21.64	0	0.19	0.19	0.19	43.08	2.93	0	1.05	0.19	0	1.83	1.81	3.48	1.83	1.83	0	1.83	0	0	0	0	2.62	0	1.83	0	0	15.16	0.01	0.94	2.81	0.01	0	0	0	0	0	0	0	15.5573	1.952514899	0.155827036	0	5.466287045	7.148996531	0.547585436	2.235877363	0.128869669	0	0.08048757	0.141348848	0	0.027254423	1.210217819	0.626087096	0.279145356	0.110098671	0	0	0	0	0	0	0.101990364	0	0.008093771	0	0	0.116778608	7.61E-05	0.031670167	0.23807725	0.006	0	0	0	0	0	0	0	36.1705	0	0.25	15.5573	1.952514899	0.155827036	0	5.466287045	7.148996531	0.547585436	2.235877363	0.128869669	0	0.08048757	0.141348848	0	0.027254423	1.210217819	0.626087096	0.279145356	0.110098671	0	0	0	0	0	0	0.101990364	0	0.008093771	0	0	0.116778608	7.61E-05	0.031670167	0.23807725	0.006	0	0	0	0	0	0	0	36.1705	3250																																																																																			0			15.5573	1.952514899	0.155827036	0	5.466287045	7.148996531	0.547585436	2.235877363	0.128869669	0	0.08048757	0.141348848	0	0.027254423	1.210217819	0.626087096	0.279145356	0.110098671	0	0	0	0	0	0	0.101990364	0	0.008093771	0	0	0.116778608	7.61E-05	0.031670167	0.23807725	0.006	0	0	0	0	0	0	0	36.1705
H0630_015_0	2008	6	j.	j.	j.								Part B Rx	Part B Rx	Part B Rx								2500	Generic	Brand	Office Administered								D	D	D		Coin	Coin	Coin	V	V		P	Coin		V	V	V	V	V		V		V			V		V			O	O	S	S	Coin								0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		773.4810724	34.06358676	14.37293883	0	9.260560044	11.55758639	1.35202386	243.9903424	309.041376	0	612.8276911	0.444589374	0	158.2559385	6462.426196	1926.251486	216.7542515	727.8401734	0	0	0	87.36546281	0	0	543.2110078	0	52.59985448	0	0	66.69617051	142.397238	100.62	379.38	0.93	0	0	0	0	0	0	0	$155/day days 1-5; $0 days 6-90	$155/day days 1-5; $0 days 6-90	"$0 days 1-20, $100/day days 21-100"	$0 Copay	"20% Coinsurance, max $500/trip"	20% Coinsurance	20% Coinsurance	$50/visit waived if admitted to hospital	$225 per visit	$0 Copay	"MRI,CT,PET $150/procedure, Radiation Therapy $30/visit"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $15/visit"	Primary Care OV $15-$30/visit	Specialty Care OV $30/visit	"$10 Group Visit, $15 OV"	Therapies=Primary Care OV	$0 Copay	"Primary Care OV chg for PA, NP"		$0 Copay			$15/visit; $30/specialty visit		$15/visit			$0-$150 copay	$3 copay	$10 Generic copay	$35 Brand copay	20% coinsurance								111.96	111.96	19.61	0	0.19	0.19	0.19	40.93	209	0	138.69	0.19	0	13.59	13.77	25.81	13.04	13.95	0	13.95	0	0	0	0	20.08	0	13.95	0	0	16.43	0.01	10	35	0.2	0	0	0	0	0	0	0	7.2166	0.317813264	0.023487778	0	1.759506408	2.195941413	0.256884533	0.832210393	5.382470631	0	7.08275604	0.084471981	0	0.17922485	7.41563406	4.143045904	0.23553962	0.846114202	0	0	0	0	0	0	0.908973086	0	0.061147331	0	0	0.091318173	0.000118664	0.08385	1.106525	0.186	0	0	0	0	0	0	0	40.4096	0	2.41	7.2166	0.317813264	0.023487778	0	1.759506408	2.195941413	0.256884533	0.832210393	5.382470631	0	7.08275604	0.084471981	0	0.17922485	7.41563406	4.143045904	0.23553962	0.846114202	0	0	0	0	0	0	0.908973086	0	0.061147331	0	0	0.091318173	0.000118664	0.08385	1.106525	0.186	0	0	0	0	0	0	0	40.4096	2500																																																																																			0			7.2166	0.317813264	0.023487778	0	1.759506408	2.195941413	0.256884533	0.832210393	5.382470631	0	7.08275604	0.084471981	0	0.17922485	7.41563406	4.143045904	0.23553962	0.846114202	0	0	0	0	0	0	0.908973086	0	0.061147331	0	0	0.091318173	0.000118664	0.08385	1.106525	0.186	0	0	0	0	0	0	0	40.4096
H0630_016_0	2008	5	j.	j.	j.								Part B Rx	Part B Rx	Part B Rx								2100	Generic	Brand	Office Administered								D	D	D		Coin	Coin	Coin	V	V		P	Coin		V	V	V	V	V		V		V			V		V			O	O	S	S	Coin								0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1390.273484	52.50880619	24.37013897	0	16.15573773	25.52907769	1.58711857	366.230775	467.9817105	0	898.6469882	1.027001873	0	244.15385	8853.72597	2791.169913	465.7543259	929.1463101	0	0	0	128.3213974	0	0	628.3069148	0	62.80605822	0	0	81.06049015	224.961058	356.34	1015.66	1.77	0	0	0	0	0	0	0	$110/day days 1-5; $0 days 6-90	$110/day days 1-5; $0 days 6-90	"$0 days 1-20, $100 /day days 21-100"	$0 Copay	"20% Coinsurance, max $500/trip"	20% Coinsurance	20% Coinsurance	$50/visit waived if admitted to hospital	$150 per visit	$0 Copay	"MRI,CT,PET $110/procedure, Radiation Therapy $25/visit"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $15/visit"	Primary Care OV $15-$30/visit	Specialty Care OV $25/visit	"$10 Group Visit, $10 OV"	Therapies=Primary Care OV	$0 Copay	"Primary Care OV chg for PA, NP"		$0 Copay			$15/visit; $25/specialty visit		$15/routine visit/test			$0-$150 copay	$3 copay	$8 Generic copay	$30 Brand copay	20% coinsurance								76.48	76.48	18.19	0	0.19	0.19	0.19	40.71	138.78	0	100.99	0.19	0	13.56	13.81	21.88	13.15	13.88	0	13.88	0	0	0	0	17.93	0	13.88	0	0	18.4	0.01	8	30	0.2	0	0	0	0	0	0	0	8.8607	0.334656125	0.036941069	0	3.069590168	4.850524762	0.301552528	1.242437904	5.412208481	0	7.562863278	0.195130356	0	0.27589385	10.18916297	5.089233142	0.510389116	1.074712565	0	0	0	0	0	0	0.938795249	0	0.072645674	0	0	0.124292752	0.000187468	0.23756	2.53915	0.354	0	0	0	0	0	0	0	53.2726	0	3.2	8.8607	0.334656125	0.036941069	0	3.069590168	4.850524762	0.301552528	1.242437904	5.412208481	0	7.562863278	0.195130356	0	0.27589385	10.18916297	5.089233142	0.510389116	1.074712565	0	0	0	0	0	0	0.938795249	0	0.072645674	0	0	0.124292752	0.000187468	0.23756	2.53915	0.354	0	0	0	0	0	0	0	53.2726	2100	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	"Travel Benefit for certain routine, follow-up and diag care"	0	0	0	0	0	0	0	0	0	0																															0.0011											0.0011			8.8607	0.334656125	0.036941069	0	3.069590168	4.850524762	0.301552528	1.242437904	5.412208481	0	7.562863278	0.195130356	0	0.27589385	10.18916297	5.089233142	0.510389116	1.074712565	0	0	0	0	0	0	0.938795249	0	0.072645674	0	0	0.124292752	0.001285768	0.23756	2.53915	0.354	0	0	0	0	0	0	0	53.2737
H0630_805_0	2008	4	j.	j.	j.								Part B Rx	Part B Rx	Part B Rx								2950	Generic	Brand	Office Administered								D	D	D		Coin	Coin	Coin	V	Coin		Coin	Coin		V	V	V	V	V		V		V			V		V			O	O	Coin	Coin	Coin								0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0								0		811.4352612	31.55929554	18.81615522	0	9.197888092	14.02593108	1.169128364	241.4888385	35.64752933	0	6.844861901	0.571480186	0	182.2248179	6899.412768	2239.196642	188.7494095	891.1130962	0	0	0	86.16813795	0	0	582.6280218	0	76.80096985	0	0	76.93783762	169.0504107	2.577173367	10.99282663	0.91								$250/day; $750 max	$250/day; $750 max	"$0 days 1-20, $100 /day days 21-100"	$0 Copay	"20% Coinsurance, max $500/trip"	20% Coinsurance	20% Coinsurance	$50/visit waived if admitted to hospital	20% Coinsurance	$0 Copay	"MRI,CT,PET, Nuclear medicine 20% of cost/procedure"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $25/visit"	Primary Care OV $25-$30/visit	Specialty Care OV $40/visit	"$15 Group Visit, $25 OV"	Therapies=Primary Care OV	$0 Copay	"Primary Care OV chg for PA, NP"		$0 Copay			"$25/routine visit, $40/specialty"		$25/routine visit/test			Health education classes	$3 copay	25% Generic copay	25% Brand copay	20% coinsurance								105.69	105.69	22.59	0	0.18	0.18	0.18	40.66	0.18	0	0.18	0.18	0	22.32	22.58	34.44	21.02	23.1	0	23.1	0	0	0	0	29.21	0	23.1	0	0	18.31	0.01	0.25	0.25	0.2								7.1467	0.277958495	0.035421412	0	1.655619857	2.524667594	0.210443106	0.818244681	6.41655528	0	1.232075142	0.102866434	0	0.338938161	12.98239502	6.426494364	0.330626049	1.71539271	0	0	0	0	0	0	1.41821371	0	0.147841867	0	0	0.117394317	0.000140875	0.644293342	2.748206658	0.182	0	0	0	0	0	0	0	47.4725	3.36	0	7.1467	0.277958495	0.035421412	0	1.655619857	2.524667594	0.210443106	0.818244681	6.41655528	0	1.232075142	0.102866434	0	0.338938161	12.98239502	6.426494364	0.330626049	1.71539271	0	0	0	0	0	0	1.41821371	0	0.147841867	0	0	0.117394317	0.000140875	0.644293342	2.748206658	0.182	0	0	0	0	0	0	0	47.4725	2950																																																																																			0			7.1467	0.277958495	0.035421412	0	1.655619857	2.524667594	0.210443106	0.818244681	6.41655528	0	1.232075142	0.102866434	0	0.338938161	12.98239502	6.426494364	0.330626049	1.71539271	0	0	0	0	0	0	1.41821371	0	0.147841867	0	0	0.117394317	0.000140875	0.644293342	2.748206658	0.182	0	0	0	0	0	0	0	47.4725
H0630_806_0	2008	4	j.	j.	j.								Part B Rx	Part B Rx	Part B Rx								2950	Generic	Brand	Office Administered								D	D	D		Coin	Coin	Coin	V	Coin		Coin	Coin		V	V	V	V	V		V		V			V		V			O	O	Coin	Coin	Coin								0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0								0		811.4352612	31.55929554	18.81615522	0	9.197888092	14.02599036	1.169128364	241.4888385	35.64752933	0	6.844861901	0.571480186	0	182.2248179	6899.412768	2239.196642	188.7494095	891.1130962	0	0	0	86.16813795	0	0	582.6280218	0	76.80096985	0	0	76.93783762	169.0504107	2.577173367	10.99282663	0.91								$250/day; $750 max	$250/day; $750 max	"$0 days 1-20, $100 /day days 21-100"	$0 Copay	"20% Coinsurance, max $500/trip"	20% Coinsurance	20% Coinsurance	$50/visit waived if admitted to hospital	20% Coinsurance	$0 Copay	"MRI,CT,PET, Nuclear medicine 20% of cost/procedure"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $25/visit"	Primary Care OV $25-$30/visit	Specialty Care OV $40/visit	"$15 Group Visit, $25 OV"	Therapies=Primary Care OV	$0 Copay	"Primary Care OV chg for PA, NP"		$0 Copay			"$25/routine visit, $40/specialty"		$25/routine visit/test			Health education classes	$3 copay	25% Generic copay	25% Brand copay	20% coinsurance								105.69	105.69	22.59	0	0.18	0.18	0.18	40.66	0.18	0	0.18	0.18	0	22.32	22.58	34.44	21.02	23.1	0	23.1	0	0	0	0	29.21	0	23.1	0	0	18.31	0.01	0.25	0.25	0.2								7.1467	0.277958495	0.035421412	0	1.655619857	2.524678265	0.210443106	0.818244681	6.41655528	0	1.232075142	0.102866434	0	0.338938161	12.98239502	6.426494364	0.330626049	1.71539271	0	0	0	0	0	0	1.41821371	0	0.147841867	0	0	0.117394317	0.000140875	0.644293342	2.748206658	0.182	0	0	0	0	0	0	0	47.4725	3.36	0	7.1467	0.277958495	0.035421412	0	1.655619857	2.524678265	0.210443106	0.818244681	6.41655528	0	1.232075142	0.102866434	0	0.338938161	12.98239502	6.426494364	0.330626049	1.71539271	0	0	0	0	0	0	1.41821371	0	0.147841867	0	0	0.117394317	0.000140875	0.644293342	2.748206658	0.182	0	0	0	0	0	0	0	47.4725	2950																																																																																			0			7.1467	0.277958495	0.035421412	0	1.655619857	2.524678265	0.210443106	0.818244681	6.41655528	0	1.232075142	0.102866434	0	0.338938161	12.98239502	6.426494364	0.330626049	1.71539271	0	0	0	0	0	0	1.41821371	0	0.147841867	0	0	0.117394317	0.000140875	0.644293342	2.748206658	0.182	0	0	0	0	0	0	0	47.4725
H0630_807_0	2008	2	j.	j.	j.								Part B Rx	Part B Rx	Part B Rx								2950	Generic	Brand	Office Administered								D	D	D		Coin	Coin	Coin	V	Coin		Coin	Coin		V	V	V	V	V		V		V			V		V			O	O	Coin	Coin	Coin								0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0								0		811.4352612	31.55929554	18.81615522	0	9.197888092	14.02599036	1.169128364	241.4888385	35.64752933	0	6.844861901	0.571480186	0	182.2248179	6899.412768	2239.196642	188.7494095	891.1130962	0	0	0	86.16813795	0	0	582.6280218	0	76.80096985	0	0	76.93783762	169.0504107	2.577173367	10.99282663	0.91								$250/day; $750 max	$250/day; $750 max	"$0 days 1-20, $100 /day days 21-100"	$0 Copay	"20% Coinsurance, max $500/trip"	20% Coinsurance	20% Coinsurance	$50/visit waived if admitted to hospital	20% Coinsurance	$0 Copay	"MRI,CT,PET, Nuclear medicine 20% of cost/procedure"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $25/visit"	Primary Care OV $25-$30/visit	Specialty Care OV $40/visit	"$15 Group Visit, $25 OV"	Therapies=Primary Care OV	$0 Copay	"Primary Care OV chg for PA, NP"		$0 Copay			"$25/routine visit, $40/specialty"		$25/routine visit/test			Health education classes	$3 copay	25% Generic copay	25% Brand copay	20% coinsurance								105.69	105.69	22.59	0	0.18	0.18	0.18	40.66	0.18	0	0.18	0.18	0	22.32	22.58	34.44	21.02	23.1	0	23.1	0	0	0	0	29.21	0	23.1	0	0	18.31	0.01	0.25	0.25	0.2								7.1467	0.277958495	0.035421412	0	1.655619857	2.524678265	0.210443106	0.818244681	6.41655528	0	1.232075142	0.102866434	0	0.338938161	12.98239502	6.426494364	0.330626049	1.71539271	0	0	0	0	0	0	1.41821371	0	0.147841867	0	0	0.117394317	0.000140875	0.644293342	2.748206658	0.182	0	0	0	0	0	0	0	47.4725	3.36	0	7.1467	0.277958495	0.035421412	0	1.655619857	2.524678265	0.210443106	0.818244681	6.41655528	0	1.232075142	0.102866434	0	0.338938161	12.98239502	6.426494364	0.330626049	1.71539271	0	0	0	0	0	0	1.41821371	0	0.147841867	0	0	0.117394317	0.000140875	0.644293342	2.748206658	0.182	0	0	0	0	0	0	0	47.4725	2950																																																																																			0			7.1467	0.277958495	0.035421412	0	1.655619857	2.524678265	0.210443106	0.818244681	6.41655528	0	1.232075142	0.102866434	0	0.338938161	12.98239502	6.426494364	0.330626049	1.71539271	0	0	0	0	0	0	1.41821371	0	0.147841867	0	0	0.117394317	0.000140875	0.644293342	2.748206658	0.182	0	0	0	0	0	0	0	47.4725
H0630_808_0	2008	2	j.	j.	j.								Part B Rx	Part B Rx	Part B Rx								2950	Generic	Brand	Office Administered								D	D	D		Coin	Coin	Coin	V	Coin		Coin	Coin		V	V	V	V	V		V		V			V		V			O	O	Coin	Coin	Coin								0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0								0		811.4352612	31.55929554	18.81615522	0	9.197888092	14.02599036	1.169128364	241.4888385	35.64752933	0	6.844861901	0.571480186	0	182.2248179	6899.412768	2239.196642	188.7494095	891.1130962	0	0	0	86.16813795	0	0	582.6280218	0	76.80096985	0	0	76.93783762	169.0504107	2.577173367	10.99282663	0.91								$250/day; $750 max	$250/day; $750 max	"$0 days 1-20, $100 /day days 21-100"	$0 Copay	"20% Coinsurance, max $500/trip"	20% Coinsurance	20% Coinsurance	$50/visit waived if admitted to hospital	20% Coinsurance	$0 Copay	"MRI,CT,PET, Nuclear medicine 20% of cost/procedure"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $25/visit"	Primary Care OV $25-$30/visit	Specialty Care OV $40/visit	"$15 Group Visit, $25 OV"	Therapies=Primary Care OV	$0 Copay	"Primary Care OV chg for PA, NP"		$0 Copay			"$25/routine visit, $40/specialty"		$25/routine visit/test			Health education classes	$3 copay	25% Generic copay	25% Brand copay	20% coinsurance								105.69	105.69	22.59	0	0.18	0.18	0.18	40.66	0.18	0	0.18	0.18	0	22.32	22.58	34.44	21.02	23.1	0	23.1	0	0	0	0	29.21	0	23.1	0	0	18.31	0.01	0.25	0.25	0.2								7.1467	0.277958495	0.035421412	0	1.655619857	2.524678265	0.210443106	0.818244681	6.41655528	0	1.232075142	0.102866434	0	0.338938161	12.98239502	6.426494364	0.330626049	1.71539271	0	0	0	0	0	0	1.41821371	0	0.147841867	0	0	0.117394317	0.000140875	0.644293342	2.748206658	0.182	0	0	0	0	0	0	0	47.4725	3.36	0	7.1467	0.277958495	0.035421412	0	1.655619857	2.524678265	0.210443106	0.818244681	6.41655528	0	1.232075142	0.102866434	0	0.338938161	12.98239502	6.426494364	0.330626049	1.71539271	0	0	0	0	0	0	1.41821371	0	0.147841867	0	0	0.117394317	0.000140875	0.644293342	2.748206658	0.182	0	0	0	0	0	0	0	47.4725	2950																																																																																			0			7.1467	0.277958495	0.035421412	0	1.655619857	2.524678265	0.210443106	0.818244681	6.41655528	0	1.232075142	0.102866434	0	0.338938161	12.98239502	6.426494364	0.330626049	1.71539271	0	0	0	0	0	0	1.41821371	0	0.147841867	0	0	0.117394317	0.000140875	0.644293342	2.748206658	0.182	0	0	0	0	0	0	0	47.4725
H0710_001_0	2008	7	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)							Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						Coin	Coin	D	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V		Coin	Coin	Coin	T				Coin					Coin	Coin	Coin	V																																																0		337.8143277	6.231953371	8903.584943	165.4659373	58.33638222	31.46386022	0.195350902	255.757364	10.0251694	41.90813747	48.41341604	1.655806213	0.104889846	6.451232512	22554.84997	148.1668746	15.20134723	16.47970655		11.14980271	3.196178047	5.936493745	1030.128342									1.684426205	0.015664568		308.0611055							(1a) 6.9% coins	(1b) 6.9% coins	(2a) $0/day	(6a) $0/proc	(10a) 20% coins	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) 20% coins	(8a) 10% coins	(8b) 19.2% coins	(9a) 20% coins	(12) 20% coins	(9a) 20% coins	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) 20% coins	(7e/7h) 20% coins	(7c/7i) $0/visit		(7g) 20% coins	(15) 20% coins	(Misc. PBP Cats) 20% coins	(10b) $0/trip				(18a) 20% coins					(4b) 20% coins	(9c) 20% coins	(9d) 20% coins	(7f1) $0/visit							0.069009827	0.069009827			0.2	0.2	0.2	50	0.2	0.1	0.192	0.2	0.2	0.2		0.2	0.2			0.2	0.2	0.2										0.2	0.2									23.3125	0.430066026	0	0	11.66727644	6.292772045	0.03907018	1.065655683	2.00503388	4.190813747	9.29537588	0.331161243	0.020977969	1.290246502	0	29.63337493	3.040269446	0	0	2.229960542	0.639235609	1.187298749	0	0	0	0	0	0	0	0	0	0.336885241	0.003132914	0	0	0	0	0	0	0	0	97.0111		0	23.3125	0.430066026	0	0	11.66727644	6.292772045	0.03907018	1.065655683	2.00503388	4.190813747	9.29537588	0.331161243	0.020977969	1.290246502	0	29.63337493	3.040269446	0	0	2.229960542	0.639235609	1.187298749	0	0	0	0	0	0	0	0	0	0.336885241	0.003132914	0	0	0	0	0	0	0	0	97.0111		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3				0.3					0.2	0.3	0.3	0.3							2.6104	0.0479	0.9038	0.0393	0.9211	0.4968	0.0031	0.0561	0.1583	0.6617	0.7644	0.0261	0.0017	0.1019	0.0212	2.3395	0.24	0.0021		0.176		0.1175	0.0825									0.0177	0.0002		0.0162							9.8056		0	25.9229	0.478004129	0.903819238	0.039301069	12.58837722	6.789569838	0.042154668	1.121742824	2.163326029	4.85252118	10.05979824	0.357305551	0.022634125	1.392108068	0.021204709	31.9728519	3.280290718	0.002069186	0	2.406010059	0.639235609	1.304802648	0.082465355	0	0	0	0	0	0	0	0	0.354616043	0.003380249	0	0.016180047	0	0	0	0	0	0	106.8167
H0710_002_0	2008	6																					3900											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2241.692603	460.5787138	1545.758255		1212.396668	24.73976053	14.03577489	1192.813781	325.9099335	7347.437312	617.8990731	51.01097635	3.058641266	2652.626728		2456.361966	1212.577994	599.7439464			22.04389735	608.8917812																				1(a) $250 per Day	1(b) $250 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $150 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $75 per Visit	8(a) Diagnostic: 20% Coinsurance; other 0% coinsurance	8(b) X-rays 20% Coinsurance; other: 20% Coinsurance	9(a) $75 per Visit	12  20% Coinsurance	"3,5,9(a), 9(d) $75 per visit; 9(c) $25/$35 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $35 per Visit	7(e)/7(h) $25/35 per Visit	7(c)/7(i) $35 per Visit		7(g) $35 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $35 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $35 per visit															159.0027	159.0027	26.7125		95.4016	0.127202168	0.127202168	28.4615	47.7008	3.1907	144.2088	47.7008	0.127202168	47.4751		22.2604	20.6704	22.2604			0.127202168	22.2604																				29.7029	6.102771951	3.44091651	0	9.638717756	3.146951165	1.785380989	2.829104294	1.295514062	1.953618124	7.425540296	0.202772086	0.389065799	10.49448678	0	4.556629094	2.088701187	1.112543979	0	0	2.804031524	1.129513501	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.0992	0	51.56379035	29.7029	6.102771951	3.44091651	0	9.638717756	3.146951165	1.785380989	2.829104294	1.295514062	1.953618124	7.425540296	0.202772086	0.389065799	10.49448678	0	4.556629094	2.088701187	1.112543979	0	0	2.804031524	1.129513501	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.0992		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"4(a)$50 per Visit, 4(b) $35 per Visit"	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															2.5135	0.1705	0.4107	0.2885	0.1822	0.1515	0.0907	0.1001	0.239	0.0938	0.3688	0.0188	0.0166	0.2328	0.0847	0.1707	0.0757	0.0349			0.135	0.0492	0.0077		0.0061																	5.4416	0	0	32.2165	6.273285822	3.851608726	0.288525971	9.82092769	3.298419086	1.876104453	2.929250877	1.534555814	2.047396549	7.794322563	0.221554815	0.40570181	10.72729618	0.0846738	4.727286041	2.164423213	1.147426896	0	0	2.938994161	1.178725942	0.00774	0	0.006064851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.5408
H0710_003_0	2008	6																					2500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2032.488458	139.4064461	971.4457091		300.7904478	12.48734311	21.68670907	471.1294376	445.308205	3733.39124	490.6340204	74.77056637	16.71273321	3137.220934		4247.739568	418.8530762	612.5518781				755.9830339					0.080043513															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															127.0122	127.0122	30.4829		54.4338	0.145156746	0.145156746	29.9386	54.4338	14.5157	47.3676	54.4338	118.1453	52.6283		18.1446	14.5157	14.5157				18.1446					18.1446															21.5126	1.475526069	2.467708215	0	1.364430082	1.812622092	3.147972119	1.175412151	2.019984062	4.516057698	1.936677699	0.339170378	0.164544191	13.75887834	0	6.422792222	0.506661246	0.740966978	0	0	0	1.143083721	0	0	0	0	0.00012103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5052	0	24.37140193	21.5126	1.475526069	2.467708215	0	1.364430082	1.812622092	3.147972119	1.175412151	2.019984062	4.516057698	1.936677699	0.339170378	0.164544191	13.75887834	0	6.422792222	0.506661246	0.740966978	0	0	0	1.143083721	0	0	0	0	0.00012103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5052		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.5305	0.0723	0.3115	0.3109	0.0799	0.1529	0.1328	0.034	0.3232	0.0507	0.1319	0.0265	0.0061	0.2307	0.0231	0.2229	0.0335	0.0362			0.1999	0.0473			0.0051																	4.9617	0	0	24.043	1.547841436	2.779234755	0.310935842	1.444293585	1.965528334	3.280747889	1.209363022	2.343181355	4.566794937	2.068563758	0.365633398	0.170646831	13.98958672	0.023060087	6.645725114	0.540154928	0.77715171	0	0	0.19989651	1.190348184	0	0	0.005058988	0	0.00012103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4669
H0712_001_0	2008	9																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1755.045394	45.78400366	1208.27738	972.9458491	524.2297071	5.351657758	1.447157005	845.5377123	170.2689491	4821.140417	845.1509549	25.52174001	0.085587203	252.49289	6685.3996	18271.0444	187.8781084	1891.083604	4145.82807	832.5840057	17.86793598	11.37961097	0	526.6666667	806.4	241.92	62.4	17.82857143	0	1600	3600											"$175 days 1 - 6, $0 after day 6, unlimited coverage"	"$175 days 1 - 6, $0 after day 6, unlimited coverage"	Standard Medicare	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $125.00	$0.00 copayment	Copay between $0.00 and $125.00	$175.00 copayment	20% coinsurance	Copay between $20.00 and $125.00	Copay between $0.00 and $10.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $10.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$25.00 copayment	$25.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											77.08808052	92.6798623	30.26	0.162179244	47.40406689	0.2	0.2	28.56664533	87.71863847	0	19.89072383	126.6095435	0.2	32.43679843	5.08972912	6.18158335	21.62532862	10.38115421	9.393923611	0	0.2	0	0	50	25	25	25	0	0	0	0											11.2744	0.353604596	3.046872794	0.013149302	2.070885008	1.070331552	0.289431401	2.012847995	1.244646699	0	1.400888686	0.269274654	0.017117441	0.682505082	2.835572752	9.411998656	0.338577153	1.63596921	3.245466016	0	3.573587196	0	0	2.194444444	1.68	0.504	0.13	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.2956	0	0	11.2744	0.353604596	3.046872794	0.013149302	2.070885008	1.070331552	0.289431401	2.012847995	1.244646699	0	1.400888686	0.269274654	0.017117441	0.682505082	2.835572752	9.411998656	0.338577153	1.63596921	3.245466016	0	3.573587196	0	0	2.194444444	1.68	0.504	0.13	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.2956	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							12.2087		0											12.2087	0	0	11.2744	0.353604596	3.046872794	0.013149302	2.070885008	1.070331552	0.289431401	2.012847995	1.244646699	0	1.400888686	0.269274654	0.017117441	0.682505082	2.835572752	9.411998656	0.338577153	1.63596921	3.245466016	0	3.573587196	0	0	2.194444444	1.68	0.504	0.13	0	12.20865422	0	0	0	0	0	0	0	0	0	0	0	0	61.5042
H0712_005_0	2008	8																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		402.3000526	49.60018784	2871.841349	23.89995179	29.06192343	13.03299845	3.311689182	32.48376459	14.99195776	8.669534795	17.25861249	61.00707313	0.188974027	7.072472385	7007.829379	91.47774293	17.06417854	17.94180915	27.84036393	6.509194324	17.54007754	0.259010205	750	0	0	0	0	0	0	1600	21											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.0710798	708.4	30.26	0.128953741	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.1994121	0.005087102	0.2	0.2	0	0	0	0	0	0	0	0	0											23.7381	2.928064422	7.241826603	3.08198819	5.812384685	2.60659969	0.662337836	6.496752919	2.998391553	1.733906959	3.451722499	0	0.037794805	1.414494477	0	18.29554859	3.412835707	3.58836183	5.551705427	0.033112939	3.508015509	0.051802041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.6457	0	0	23.7381	2.928064422	7.241826603	3.08198819	5.812384685	2.60659969	0.662337836	6.496752919	2.998391553	1.733906959	3.451722499	0	0.037794805	1.414494477	0	18.29554859	3.412835707	3.58836183	5.551705427	0.033112939	3.508015509	0.051802041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.6457	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	23.7381	2.928064422	7.241826603	3.08198819	5.812384685	2.60659969	0.662337836	6.496752919	2.998391553	1.733906959	3.451722499	0	0.037794805	1.414494477	0	18.29554859	3.412835707	3.58836183	5.551705427	0.033112939	3.508015509	0.051802041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.6457
H0712_008_0	2008	7																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1378.498962	71.36705586	2099.434654	2634.530004	875.980908	11.44156441	3.195166831	934.4270259	228.3219466	5860.447973	968.8369157	54.79138282	0.046728725	533.0502288	7057.563083	21551.76689	666.3080194	4696.203206	4107.212281	763.0501619	30.25952658	36.96899015	0	671.25	806.4	241.92	62.4	17.82857143	0	1600	3600											"$150 days 1 - 7, $0 after day 7, unlimited coverage"	"$150 days 1 - 7, $0 after day 7, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$150.00 copayment	20% coinsurance	Copay between $10.00 and $100.00	Copay between $0.00 and $5.00	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$25.00 copayment	$25.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											77.01371673	44.75365443	29.23330153	0	40.31927376	0.187573317	0.187573317	17.90725994	72.15334113	0	17.03680945	101.7795947	0.187573317	20.72098799	1.969249075	4.728530712	14.06330193	6.365992463	6.100086942	0	0.187573317	0	0	18.75733175	23.44666469	23.44666469	23.44666469	0	0	0	0											8.8469	0.26616138	5.114450524	0	2.943242837	2.146132194	0.599328042	1.394418971	1.372849275	0	1.375490827	0.464720395	0.008765062	0.920443949	1.158174964	8.492349304	0.780874238	2.491332851	2.087862667	0	5.675879786	0	0	1.049238245	1.575615867	0.47268476	0.121922656	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3589	0	3.270012888	8.8469	0.26616138	5.114450524	0	2.943242837	2.146132194	0.599328042	1.394418971	1.372849275	0	1.375490827	0.464720395	0.008765062	0.920443949	1.158174964	8.492349304	0.780874238	2.491332851	2.087862667	0	5.675879786	0	0	1.049238245	1.575615867	0.47268476	0.121922656	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3589	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	8.8469	0.26616138	5.114450524	0	2.943242837	2.146132194	0.599328042	1.394418971	1.372849275	0	1.375490827	0.464720395	0.008765062	0.920443949	1.158174964	8.492349304	0.780874238	2.491332851	2.087862667	0	5.675879786	0	0	1.049238245	1.575615867	0.47268476	0.121922656	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3589
H0712_011_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1800.106488	641.4843327	3901.531939	4721.795242	2043.655327	19.32659125	4.308052061	3092.462623	201.7835143	8832.484145	1218.548777	75.03978539	0.022617112	764.8319455	6223.8778	20686.64024	3700.843851	5179.604053	4193.717198	591.3045797	18.06324329	19.80656044	0	526.6666667	806.4	241.92	62.4	17.82857143	0	1600	3600											"$75 days 1 - 7, $0 after day 7, unlimited coverage"	"$75 days 1 - 7, $0 after day 7, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $10.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $25.00 and $50.00	$0.00 copayment	Copay between $0.00 and $50.00	$75.00 copayment	20% coinsurance	Copay between $5.00 and $50.00	$0.00 copayment	$10.00 copayment	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$25.00 copayment	$25.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											37.91109329	20.11769933	31.17	0	43.75772787	0.2	0.2	18.82121347	38.63413291	0	8.152730016	54.26123291	0.2	11.37179766	0	2.082119093	6.57588675	3.649319601	3.395856264	0	0.2	0	0	50	25	25	25	0	0	0	0											5.687	1.075432411	10.13422921	0	7.452142807	3.865318251	0.861610412	4.850324933	0.649644259	0	0.827874932	0.339312606	0.004523422	0.724792844	0	3.589337385	2.028027504	1.575169216	1.186771735	0	3.612648658	0	0	2.194444444	1.68	0.504	0.13	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9726	0	0	5.687	1.075432411	10.13422921	0	7.452142807	3.865318251	0.861610412	4.850324933	0.649644259	0	0.827874932	0.339312606	0.004523422	0.724792844	0	3.589337385	2.028027504	1.575169216	1.186771735	0	3.612648658	0	0	2.194444444	1.68	0.504	0.13	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9726	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.9883		0											14.9883	0	0	5.687	1.075432411	10.13422921	0	7.452142807	3.865318251	0.861610412	4.850324933	0.649644259	0	0.827874932	0.339312606	0.004523422	0.724792844	0	3.589337385	2.028027504	1.575169216	1.186771735	0	3.612648658	0	0	2.194444444	1.68	0.504	0.13	0	14.98831879	0	0	0	0	0	0	0	0	0	0	0	0	67.9609
H0747_002_0	2008	3																					0											D	D	D	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	659.9	18.59	1141.27	44.16	8.69	18.34	12.77	372.22	376.65	2751.36	1529.51	0	0	0	4257.74	4884.46	146.86	398.66	0	1211.24	0	578.92	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $240 per day for first 10 days	1B IP Psych: $240 per day for first 10 days	2 SNF: $120	6 Home Health: 20% coinsurance	10A Ambulance: $125	11A DME: 30%	"11B Prosthetic Medical Supplies: 30%, 11C Diabetes Monitoring Supplies: 30%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $175	8A OP C/D/T: $40	8B OP X-Ray: $40	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $20, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $40, 7D Physician Specialist: $40, 7F Podiatry: $40"	"7E Mental Health: $40, 7H Psychiatric: $40"	"7C Occupational Therapy: $40, 7I Physical and Speech Therapy: $40"	Included in i.2.	"7G Other Health Care: $40, 18A Medicare Covered Hearing Exams: $40"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $40"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											240	240	120	0.199994256	0.325278097	0.299999721	0.299990751	49.32244372	175	40	40	0	0	0	20	40	40	40	0	35.90539827	0	40	0	0	0	0	0	0	0	0	0											13.198	0.3718	11.4127	8.831746348	2.826666667	5.501994879	3.830881884	1.5299	5.4928125	9.1712	5.098366667	0	0	0	7.096233333	16.28153333	0.489533333	1.328866667	0	3.624171217	0	1.929733333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.0161	0	0	13.198	0.3718	11.4127	8.831746348	2.826666667	5.501994879	3.830881884	1.5299	5.4928125	9.1712	5.098366667	0	0	0	7.096233333	16.28153333	0.489533333	1.328866667	0	3.624171217	0	1.929733333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.0161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.198	0.3718	11.4127	8.831746348	2.826666667	5.501994879	3.830881884	1.5299	5.4928125	9.1712	5.098366667	0	0	0	7.096233333	16.28153333	0.489533333	1.328866667	0	3.624171217	0	1.929733333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.0161
H0747_003_0	2008	2																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	523.3	11.55	1015.73	0	271.36	18.34	12.77	372.65	376.65	2751.36	1529.51	0	0	0	4378.75	4977.93	146.86	398.66	0	1211.24	0	578.92	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $180 per admit	1B IP Psych: $180 per admit	2 SNF: $110	6 Home Health: $0	10A Ambulance: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $35"	9B ASC Services: $135	8A OP C/D/T: $30	8B OP X-Ray: $30	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $30, 7D Physician Specialist: $30, 7F Podiatry: $30"	"7E Mental Health: $30, 7H Psychiatric: $30"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	Included in i.2.	"7G Other Health Care: $30, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $30"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											180	180	110	0	100	0.200000096	0.200022107	49.47511069	135	30	30	0	0	0	10	30	30	30	0	30	0	30	0	0	0	0	0	0	0	0	0											7.8495	0.17325	9.310858333	0	2.261333333	3.668001769	2.554282307	1.536408333	4.2373125	6.8784	3.823775	0	0	0	3.648958333	12.444825	0.36715	0.99665	0	3.0281	0	1.4473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2261	0	0	7.8495	0.17325	9.310858333	0	2.261333333	3.668001769	2.554282307	1.536408333	4.2373125	6.8784	3.823775	0	0	0	3.648958333	12.444825	0.36715	0.99665	0	3.0281	0	1.4473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.8495	0.17325	9.310858333	0	2.261333333	3.668001769	2.554282307	1.536408333	4.2373125	6.8784	3.823775	0	0	0	3.648958333	12.444825	0.36715	0.99665	0	3.0281	0	1.4473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2261
H0747_004_0	2008	3																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	523.3	11.55	1015.73	0	271.36	18.34	12.77	372.65	376.65	2751.36	1529.51	0	0	0	4378.75	4977.93	146.86	398.66	0	1211.24	0	578.92	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $180 per admit	1B IP Psych: $180 per admit	2 SNF: $110	6 Home Health: $0	10A Ambulance: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $35"	9B ASC Services: $135	8A OP C/D/T: $30	8B OP X-Ray: $30	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $30, 7D Physician Specialist: $30, 7F Podiatry: $30"	"7E Mental Health: $30, 7H Psychiatric: $30"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	Included in i.2.	"7G Other Health Care: $30, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $30"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											180	180	110	0	100	0.200000096	0.200022107	49.47511069	135	30	30	0	0	0	10	30	30	30	0	30	0	30	0	0	0	0	0	0	0	0	0											7.8495	0.17325	9.310858333	0	2.261333333	3.668001769	2.554282307	1.536408333	4.2373125	6.8784	3.823775	0	0	0	3.648958333	12.444825	0.36715	0.99665	0	3.0281	0	1.4473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2261	0	0	7.8495	0.17325	9.310858333	0	2.261333333	3.668001769	2.554282307	1.536408333	4.2373125	6.8784	3.823775	0	0	0	3.648958333	12.444825	0.36715	0.99665	0	3.0281	0	1.4473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.8495	0.17325	9.310858333	0	2.261333333	3.668001769	2.554282307	1.536408333	4.2373125	6.8784	3.823775	0	0	0	3.648958333	12.444825	0.36715	0.99665	0	3.0281	0	1.4473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2261
H0747_801_0	2008	3																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	198.23	2.59	39.52	44.2	8.69	18.34	12.77	6.14	32.67	9.82	28.19	1.1	0.19	29.73	31.6	100.39	1.15	2.97	19.47	31.26	10.68	5.27	0	0	0	0	0	0	0	0	0											Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing											0.082659443	0.08240022	0.18176474	0	0.234087294	0.233999697	0.234009767	0.233844412	0.234000009	0.234057056	0.23402869	0.233999858	0.234000033	0.234043061	0.234008607	0.234003596	0.234002758	0.233981184	0.234005547	0.233992303	0.234006188	0.23399406	0	0	0	0	0	0	0	0	0											16.3856	0.213416569	7.183342521	0	2.034218581	4.291554451	2.98830473	1.435804687	7.644780304	2.298440288	6.597268784	0.257399844	0.044460006	6.958100206	7.394671986	23.49162103	0.269103171	0.694924116	4.556087992	7.314599401	2.499186087	1.233148694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.786	0	0	16.3856	0.213416569	7.183342521	0	2.034218581	4.291554451	2.98830473	1.435804687	7.644780304	2.298440288	6.597268784	0.257399844	0.044460006	6.958100206	7.394671986	23.49162103	0.269103171	0.694924116	4.556087992	7.314599401	2.499186087	1.233148694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.3856	0.213416569	7.183342521	0	2.034218581	4.291554451	2.98830473	1.435804687	7.644780304	2.298440288	6.597268784	0.257399844	0.044460006	6.958100206	7.394671986	23.49162103	0.269103171	0.694924116	4.556087992	7.314599401	2.499186087	1.233148694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.786
H0747_802_0	2008	4																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	198.23	2.59	39.52	44.2	8.69	18.34	12.77	6.14	32.67	9.82	28.19	1.1	0.19	29.73	31.6	100.39	1.15	2.97	19.47	31.26	10.68	5.27	0	0	0	0	0	0	0	0	0											Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing											0.082659443	0.08240022	0.18176474	0	0.234087294	0.233999697	0.234009767	0.233844412	0.234000009	0.234057056	0.23402869	0.233999858	0.234000033	0.234043061	0.234008607	0.234003596	0.234002758	0.233981184	0.234005547	0.233992303	0.234006188	0.23399406	0	0	0	0	0	0	0	0	0											16.3856	0.213416569	7.183342521	0	2.034218581	4.291554451	2.98830473	1.435804687	7.644780304	2.298440288	6.597268784	0.257399844	0.044460006	6.958100206	7.394671986	23.49162103	0.269103171	0.694924116	4.556087992	7.314599401	2.499186087	1.233148694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.786	0	0	16.3856	0.213416569	7.183342521	0	2.034218581	4.291554451	2.98830473	1.435804687	7.644780304	2.298440288	6.597268784	0.257399844	0.044460006	6.958100206	7.394671986	23.49162103	0.269103171	0.694924116	4.556087992	7.314599401	2.499186087	1.233148694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.3856	0.213416569	7.183342521	0	2.034218581	4.291554451	2.98830473	1.435804687	7.644780304	2.298440288	6.597268784	0.257399844	0.044460006	6.958100206	7.394671986	23.49162103	0.269103171	0.694924116	4.556087992	7.314599401	2.499186087	1.233148694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.786
H0747_804_0	2008	4																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	198.23	2.59	39.52	44.2	8.69	18.34	12.77	6.14	32.67	9.82	28.19	1.1	0.19	29.73	31.6	100.39	1.15	2.97	19.47	31.26	10.68	5.27	0	0	0	0	0	0	0	0	0											Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing	Standard FFS Medicare Cost Sharing											0.082659443	0.08240022	0.18176474	0	0.234087294	0.233999697	0.234009767	0.233844412	0.234000009	0.234057056	0.23402869	0.233999858	0.234000033	0.234043061	0.234008607	0.234003596	0.234002758	0.233981184	0.234005547	0.233992303	0.234006188	0.23399406	0	0	0	0	0	0	0	0	0											16.3856	0.213416569	7.183342521	0	2.034218581	4.291554451	2.98830473	1.435804687	7.644780304	2.298440288	6.597268784	0.257399844	0.044460006	6.958100206	7.394671986	23.49162103	0.269103171	0.694924116	4.556087992	7.314599401	2.499186087	1.233148694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.786	0	0	16.3856	0.213416569	7.183342521	0	2.034218581	4.291554451	2.98830473	1.435804687	7.644780304	2.298440288	6.597268784	0.257399844	0.044460006	6.958100206	7.394671986	23.49162103	0.269103171	0.694924116	4.556087992	7.314599401	2.499186087	1.233148694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.3856	0.213416569	7.183342521	0	2.034218581	4.291554451	2.98830473	1.435804687	7.644780304	2.298440288	6.597268784	0.257399844	0.044460006	6.958100206	7.394671986	23.49162103	0.269103171	0.694924116	4.556087992	7.314599401	2.499186087	1.233148694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.786
H0752_002_0	2008	8																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	O	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1600.483113	82.15371381	1114.933788		9.654210701	14.99244575	6.147053127	318.505652	272.9086926		41.24256872				2758.087863	4561.349055	1.874220336	1294.633436			36.89632162	1228.343339																				$175 (1a); $0 (1a1)	$175 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $25/$25/$15 (4b)"	$300 (9b)	$0/$0 (8a1); $0 (8a2)	"20% (8b1, 8b2); $0 (8b3)"	$300 (incl in h5)	$0 (12)	"$0 (3, 5, 9d); $25/$25 (9c); $300 (9a)"	"$15/$25/$25 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1); $0/$15/$25 (14f)"	"$25 (7b, 7f, 7g); $0 n/c (7b1); $25/$250/$200 (7d); $0( 7f1)"	"50%/50% (7e, 7h)"	"$25 (7c, 7i)"	$0 (incl in h2)		"10% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c; $0 (16)	$0 (17a1)	$0; $0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a3, 14a6, 14a7); $0 n/c (14a2, 14a4, 14a5, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											91.8297	96.8601	87.3197		0.2	0.2	0.2	44.2079	300		0.125993022				15	30.3232	0.5	10			0.1	25																				12.2477	0.663118046	8.112976467	0	1.93084214	2.998489151	1.229410625	1.173372492	6.822717315	0	5.196275853	0	0	0	3.447609828	11.52623938	0.937110168	1.078861197	0	0	3.689632162	2.559048623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6134	0	0	12.2477	0.663118046	8.112976467	0	1.93084214	2.998489151	1.229410625	1.173372492	6.822717315	0	5.196275853	0	0	0	3.447609828	11.52623938	0.937110168	1.078861197	0	0	3.689632162	2.559048623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6134																																																																																				0			12.2477	0.663118046	8.112976467	0	1.93084214	2.998489151	1.229410625	1.173372492	6.822717315	0	5.196275853	0	0	0	3.447609828	11.52623938	0.937110168	1.078861197	0	0	3.689632162	2.559048623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6134
H0752_801_0	2008	7																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1680.451144	86.25911194	1170.652814		10.1365893	15.74126124	6.454194773	334.4116161	286.5451726		53.82188553		0.658384643		3271.183309	4789.262024	1.967869803	1359.325421			38.73868697	1289.721793			176.9823945																	155 (1a); $0 (1a1)	155 (1b)	"155 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a8); $0 (14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"											97.5382	103.0048	154.1955		0.3	0.3	0.3	47.6831	300		0.223814226		0.3		20	39.7821	0.535508717	40			0.3	39.7134			40																	13.659	0.740424995	15.04245093	0	3.040976791	4.722378373	1.936258432	1.328815404	7.163629314	0	12.04610366	0	0.197515393	0	5.451972181	15.87723726	1.053811433	4.531084735	0	0	11.62160609	4.268270558	0	0	0.589941315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.2715	0	0	13.659	0.740424995	15.04245093	0	3.040976791	4.722378373	1.936258432	1.328815404	7.163629314	0	12.04610366	0	0.197515393	0	5.451972181	15.87723726	1.053811433	4.531084735	0	0	11.62160609	4.268270558	0	0	0.589941315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.2715																																																																																				0			13.659	0.740424995	15.04245093	0	3.040976791	4.722378373	1.936258432	1.328815404	7.163629314	0	12.04610366	0	0.197515393	0	5.451972181	15.87723726	1.053811433	4.531084735	0	0	11.62160609	4.268270558	0	0	0.589941315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.2715
H0752_802_0	2008	7																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1680.396117	86.25686915	1170.625692		10.13626389	15.74047029	6.453987905	334.4010525	286.5363931		53.81909994		0.65833433		3271.097935	4789.110564	1.967809461	1359.28651			38.73628437	1289.683838			176.9823945																	155 (1a); $0 (1a1)	155 (1b)	"155 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a8); $0 (14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"											97.5382	103.0048	154.1955		0.3	0.3	0.3	47.6831	300		0.223814093		0.3		20	39.7821	0.535517016	16			0.3	39.7133			40																	13.6586	0.740405744	15.04210243	0	3.040879167	4.722141086	1.936196371	1.328773463	7.163409828	0	12.04547304	0	0.197500299	0	5.451829891	15.87672109	1.05379545	1.812382013	0	0	11.62088531	4.268137826	0	0	0.589941315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.5491	0	0	13.6586	0.740405744	15.04210243	0	3.040879167	4.722141086	1.936196371	1.328773463	7.163409828	0	12.04547304	0	0.197500299	0	5.451829891	15.87672109	1.05379545	1.812382013	0	0	11.62088531	4.268137826	0	0	0.589941315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.5491																																																																																				0			13.6586	0.740405744	15.04210243	0	3.040879167	4.722141086	1.936196371	1.328773463	7.163409828	0	12.04547304	0	0.197500299	0	5.451829891	15.87672109	1.05379545	1.812382013	0	0	11.62088531	4.268137826	0	0	0.589941315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.5491
H0755_001_0	2008	2																					1500											coin	coin	D	coin	T	coin	coin	V	coin	coin	P	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	276.3480285	4.32358259	932.3230686	21.62773395	320.1180612	12.43328148	1.001216301	369.3324121	31.62761742	9.199048726	1159.796218	0	0.109993078	283.0845428	3726.299158	4559.906102	267.7723649	526.0487298	27.61371362	23.21736969	32.53919133	1099.594169	0	847	650.5610189	0	34.57949828	0	0	500	0											$0/admit	$0/admit	"$50/day, days 21-100"	$0 copay	$50 copay	20% DME / 0% Diabetes Monitoring Supplies	20% coinsurance	$50 ER / $25 UC	$0 ASC / $0 OP	$0 copay	$20 - $75 Copay		20% coinsurance	$10 PT/OT/ST	$5 PCP	$15 SCP / $15 Chiro / $15 Podiatrist	$25 MH	$10 Therapy	$0 copay	$15 Hearing / $25 OPSA	0% coinsurance	$15 Vision			$15 Vision		$15 Hearing															0	0	43.72251275	0	43.72251275	0.143416837	0.174890051	35.70511347	0	0	22.86431335	0	0.174890051	8.74450255	4.372251275	13.11675382	21.86125637	8.74450255	0	0.003152273	0	13.11675382	0	0	13.11675382	0	13.11675382	0	0	0	0											0	0	3.396958938	0	1.166363834	1.783141909	0.17510277	1.098921307	0	0	2.209828679	0	0.019236695	0.206286126	1.35769302	4.984263817	0.487820027	0.383336205	0	0.073187492	0	1.201925501	0	0	0.711104061	0	0.037797564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.293	0	2.77	0	0	3.396958938	0	1.166363834	1.783141909	0.17510277	1.098921307	0	0	2.209828679	0	0.019236695	0.206286126	1.35769302	4.984263817	0.487820027	0.383336205	0	0.073187492	0	1.201925501	0	0	0.711104061	0	0.037797564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.293	1500																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	3.396958938	0	1.166363834	1.783141909	0.17510277	1.098921307	0	0	2.209828679	0	0.019236695	0.206286126	1.35769302	4.984263817	0.487820027	0.383336205	0	0.073187492	0	1.201925501	0	0	0.711104061	0	0.037797564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.293
H0755_020_0	2008	3																					none											coin	coin	D	coin	T	coin	coin	V	coin	coin	P	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	700	196.679336	3.41903552	766.6357959	17.51603485	237.8735406	9.062605126	0.729785455	274.7935188	23.92136633	6.957647538	862.9204297	0	0.078652779	210.6227211	2653.844815	3247.533989	211.8951664	374.6483133	19.93761218	16.99956453	24.61083001	783.1234584	0	762.3	463.3251154	0	24.62728255	0	0	450	0											$0/admit	$0/admit	"$50/day, days 21-100"	$0 copay	$50 copay	20% DME / 0% Diabetes Monitoring Supplies	20% coinsurance	$50 ER / $25 UC	$0 ASC / $0 OP	$0 copay	$20 - $75 Copay		20% coinsurance	$10 PT/OT/ST	$5 PCP	$15 SCP / $15 Chiro / $15 Podiatrist	$25 MH	$10 Therapy	$0 copay	$15 Hearing / $25 OPSA	0% coinsurance	$15 Vision			$15 Vision		$15 Hearing															-1.78E-18	0	50	0	50	0.164008	0.2	40.83149758	0	0	26.14707152	0	0.2	10	5	15	25	10	0	0.003778997	0	15	0	0	15	0	15	0	0	0	0											0	0	3.194315816	0	0.991139753	1.486339741	0.145957091	0.935019241	0	0	1.880236849	0	0.015730556	0.175518934	1.105768673	4.059417486	0.441448263	0.312206928	0	0.064241303	0	0.978904323	0	0	0.579156394	0	0.030784103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.3962	0	0	0	0	3.194315816	0	0.991139753	1.486339741	0.145957091	0.935019241	0	0	1.880236849	0	0.015730556	0.175518934	1.105768673	4.059417486	0.441448263	0.312206928	0	0.064241303	0	0.978904323	0	0	0.579156394	0	0.030784103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.3962	none	$100 / Day	Not Covered	Not Covered	Not Covered	$50 / trip	20% DME / 0% Diabetic Supplies	20% Prosthetics	$50 ER / $25 UC	20%		20%		20%	20%	$35 copay	"$35 PCP/Chiro/Podiatry, 20% Surgery"	Not Covered	20%	"20% in Facility, 0% Otherwise"	$35 Hearing	20%	"$35 Vision, 20% Blood"			$35 copay		$35 copay															0.8527	0	0	0	0.1052	0.4272	0.0229	0.1275	0.4724	0	0.4984	0	0.0044	0.4935	1.025	1.7378	0	0.0759	0.1084	0.1714	0.1352	0.1849	0	0	0.0981	0	0.0358	0	0	0	0											6.5767	0	0.454	0.8527	0	3.194315816	0	1.096332595	1.913535366	0.168858865	1.062538946	0.472396606	0	2.378665649	0	0.02012973	0.669027423	2.130791713	5.797203427	0.441448263	0.388139692	0.108356578	0.235667933	0.135157101	1.163822813	0	0	0.677239165	0	0.066592892	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.9729
H0755_021_0	2008	3																					600											D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1121.560995	24.42129591	1478.096687	68.90925909	946.5595675	36.22190003	2.916845149	302.3297537	347.5387326	7.656537418	949.3910996	0	0.100112529	231.7285927	0	4128.9669	246.3939907	465.3208302	25.44652964	21.72134135	27.08296732	995.6757497	0	847	589.0789972	0	31.31152279	0	0	500	0											"$50/day, limited to 6 days"	"$50/day, limited to 6 days"	"$75/day, days 11-100"	$0 copay	$50 copay	20% DME / 20% Diabetes Monitoring Supplies	20% coinsurance	$50 ER / $25 UC	$25 ASC / $25 OP	$0 copay	$10 - $100 Copay		20% coinsurance	$15 PT/OT/ST	$0 PCP	$15 SCP / $15 Chiro / $15 Podiatrist	$20 MH	$15 Therapy	$0 copay	$15 Hearing / $25 OPSA	0% coinsurance	$15 Vision			$15 Vision		$15 Hearing															38.4750126	38.4750126	57.71251891	0	50	0.2	0.2	40.83149758	25	0	18.95585761	0	0.2	15	0	15	20	15	0	0.003488997	0	15	0	0	15	0	15	0	0	0	0											3.596	0.078300806	7.108723585	0	3.943998198	7.244380007	0.58336903	1.028714717	0.724039026	0	1.499710208	0	0.020022506	0.289660741	0	5.161208626	0.410656651	0.581651038	0	0.075785699	0	1.244594687	0	0	0.736348747	0	0.039139403	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3663	0	3.23	3.596	0.078300806	7.108723585	0	3.943998198	7.244380007	0.58336903	1.028714717	0.724039026	0	1.499710208	0	0.020022506	0.289660741	0	5.161208626	0.410656651	0.581651038	0	0.075785699	0	1.244594687	0	0	0.736348747	0	0.039139403	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3663	600																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.596	0.078300806	7.108723585	0	3.943998198	7.244380007	0.58336903	1.028714717	0.724039026	0	1.499710208	0	0.020022506	0.289660741	0	5.161208626	0.410656651	0.581651038	0	0.075785699	0	1.244594687	0	0	0.736348747	0	0.039139403	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3663
H0755_022_0	2008	2																					2500											D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1075.620167	24.44573003	953.2064189	14.77606217	220.6570693	8.494414649	0.684030714	250.9776942	291.0696519	6.339020112	795.1313364	0	0.072668158	194.0766726	2346.558621	2902.727428	176.6868081	325.6543119	18.17852589	15.42934417	22.42259982	700.0586687	0	0	414.4257268	0	24.39947521	0	0	500	0											"$200/day, unlimited days"	"$200/day, unlimited days"	"$75/day, days 11-100"	$0 copay	$75 copay	20% DME / 20% Diabetes Monitoring Supplies	20% coinsurance	$50 ER / $30 UC	$125 ASC / $125 OP	$0 copay	$20 - $100 Copay		20% coinsurance	$30 PT/OT/ST	$15 PCP	$30 SCP / $30 Chiro / $30 Podiatrist	$30 MH	$30 Therapy	$0 copay	$30 Hearing / $30 OPSA	0% coinsurance	$30 Vision			$30 Vision		$30 Hearing															159.4206128	159.4206128	75	0	75	0.2	0.2	42.77766403	125	0	33.3531417	0	0.2	30	15	30	30	30	0	0.005070579	0	30	0	0	30	0	30	0	0	0	0											14.2897	0.324762772	5.957540118	0	1.379106683	1.69888293	0.136806143	0.894686623	3.031975541	0	2.210010678	0	0.014533632	0.485191682	2.933198276	7.256818571	0.44171702	0.81413578	0	0.078235713	0	1.750146672	0	0	1.036064317	0	0.060998688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7945	0	3.72	14.2897	0.324762772	5.957540118	0	1.379106683	1.69888293	0.136806143	0.894686623	3.031975541	0	2.210010678	0	0.014533632	0.485191682	2.933198276	7.256818571	0.44171702	0.81413578	0	0.078235713	0	1.750146672	0	0	1.036064317	0	0.060998688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7945	2500																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.2897	0.324762772	5.957540118	0	1.379106683	1.69888293	0.136806143	0.894686623	3.031975541	0	2.210010678	0	0.014533632	0.485191682	2.933198276	7.256818571	0.44171702	0.81413578	0	0.078235713	0	1.750146672	0	0	1.036064317	0	0.060998688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7945
H0755_023_0	2008	3																					1000											D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	655.1934895	13.72634885	854.1005414	16.32555191	244.1979321	9.385180283	0.755761502	279.3400527	321.1112591	6.979510878	877.1976842	0	0.080232679	214.1075317	2593.757213	3208.515713	195.2999081	359.9604174	20.06038903	17.01717044	24.68816577	773.8064609	0	0	458.0834711	0	26.96984182	0	0	500	0											"$100/day, limited to 5 days"	"$100/day, limited to 5 days"	"$75/day, days 16-100"	$0 copay	$75 copay	20% DME / 20% Diabetes Monitoring Supplies	20% coinsurance	$50 ER / $25 UC	$100 ASC / $100 OP	$0 copay	$20 - $100 Copay		20% coinsurance	$25 PT/OT/ST	$15 PCP	$25 SCP / $25 Chiro / $25 Podiatrist	$25 MH	$25 Therapy	$0 copay	$25 Hearing / $25 OPSA	0% coinsurance	$25 Vision			$25 Vision		$25 Hearing															79.47300678	79.47300678	59.60475509	0	75	0.2	0.2	40.83149758	100	0	33.3531417	0	0.2	25	15	25	25	25	0	0.004242266	0	25	0	0	25	0	25	0	0	0	0											4.3392	0.090906185	4.242371133	0	1.526237076	1.877036057	0.1511523	0.95048939	2.675927159	0	2.438108221	0	0.016046536	0.446057358	3.242196516	6.684407735	0.406874809	0.749917536	0	0.072191369	0	1.612096794	0	0	0.954340565	0	0.05618717	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.5317	0	2.24	4.3392	0.090906185	4.242371133	0	1.526237076	1.877036057	0.1511523	0.95048939	2.675927159	0	2.438108221	0	0.016046536	0.446057358	3.242196516	6.684407735	0.406874809	0.749917536	0	0.072191369	0	1.612096794	0	0	0.954340565	0	0.05618717	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.5317	1000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.3392	0.090906185	4.242371133	0	1.526237076	1.877036057	0.1511523	0.95048939	2.675927159	0	2.438108221	0	0.016046536	0.446057358	3.242196516	6.684407735	0.406874809	0.749917536	0	0.072191369	0	1.612096794	0	0	0.954340565	0	0.05618717	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.5317
H0755_025_0	2008	2																					none											A	A	D	coin	T	coin	coin	V	coin	coin	P	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	146.6562633	4.100183272	884.5630952	20.18390274	305.8462027	11.60325648	0.934376782	354.7218815	31.0293407	9.025036988	1113.915494	0	0.100199473	271.8859173	3371.591217	4125.846775	242.2830039	475.9739361	25.48204347	21.76495445	31.92367103	994.92335	0	0	588.6338495	0	34.65604592	0	0	500	0											$100/admit	$100/admit	"$50/day, days 21-100"	$0 copay	$50 copay	20% DME / 0% Diabetes Monitoring Supplies	20% coinsurance	$50 ER / $25 UC	$0 ASC / $0 OP	$0 copay	$20 - $75 Copay		20% coinsurance	$10 PT/OT/ST	$5 PCP	$15 SCP / $15 Chiro / $15 Podiatrist	$25 MH	$10 Therapy	$0 copay	$15 Hearing / $25 OPSA	0% coinsurance	$15 Vision			$15 Vision		$15 Hearing															100	100	50	0	50	0.164008	0.2	40.83149758	0	0	26.14707152	0	0.2	10	5	15	25	10	0	0.003479375	0	15	0	0	15	0	15	0	0	0	0											1.2221	0.034168194	3.685679564	0	1.274359178	1.903026889	0.186875356	1.20698547	0	0	2.427135675	0	0.020039895	0.226571598	1.404829674	5.157308469	0.504756258	0.396644947	0	0.07572843	0	1.243654188	0	0	0.735792312	0	0.043320057	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.749	0	0	1.2221	0.034168194	3.685679564	0	1.274359178	1.903026889	0.186875356	1.20698547	0	0	2.427135675	0	0.020039895	0.226571598	1.404829674	5.157308469	0.504756258	0.396644947	0	0.07572843	0	1.243654188	0	0	0.735792312	0	0.043320057	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.749	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.2221	0.034168194	3.685679564	0	1.274359178	1.903026889	0.186875356	1.20698547	0	0	2.427135675	0	0.020039895	0.226571598	1.404829674	5.157308469	0.504756258	0.396644947	0	0.07572843	0	1.243654188	0	0	0.735792312	0	0.043320057	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.749
H0755_027_0	2008	2																					none											coin	coin	D	coin	T	coin	coin	V	coin	coin	P	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	294.0360937	4.600319902	991.9977885	23.01204912	340.6076922	13.22909209	1.065300634	392.9720806	33.65198995	9.787847475	1234.030694	0	0.117033348	301.2037886	3964.806458	4851.769651	284.911532	559.7192585	29.38117029	24.70343185	34.6219105	1169.975323	0	847	692.2011412	0	36.79281032	0	0	500	0											$0/admit	$0/admit	"$50/day, days 21-100"	$0 copay	$50 copay	20% DME / 0% Diabetes Monitoring Supplies	20% coinsurance	$50 ER / $25 UC	$0 ASC / $0 OP	$0 copay	$20 - $75 Copay		20% coinsurance	$10 PT/OT/ST	$5 PCP	$15 SCP / $15 Chiro / $15 Podiatrist	$25 MH	$10 Therapy	$0 copay	$15 Hearing / $25 OPSA	0% coinsurance	$15 Vision			$15 Vision		$15 Hearing															0	0	50	0	50	0.164008	0.2	40.83149758	0	0	26.14707152	0	0.2	10	5	15	25	10	0	0.003604863	0	15	0	0	15	0	15	0	0	0	0											0	0	4.133324119	0	1.419198718	2.169676935	0.213060127	1.337136546	0	0	2.6888574	0	0.02340667	0.251003157	1.652002691	6.064712063	0.593565692	0.466432715	0	0.089052483	0	1.462469154	0	0	0.865251427	0	0.045991013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.4751	0	0	0	0	4.133324119	0	1.419198718	2.169676935	0.213060127	1.337136546	0	0	2.6888574	0	0.02340667	0.251003157	1.652002691	6.064712063	0.593565692	0.466432715	0	0.089052483	0	1.462469154	0	0	0.865251427	0	0.045991013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.4751	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	4.133324119	0	1.419198718	2.169676935	0.213060127	1.337136546	0	0	2.6888574	0	0.02340667	0.251003157	1.652002691	6.064712063	0.593565692	0.466432715	0	0.089052483	0	1.462469154	0	0	0.865251427	0	0.045991013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.4751
H0755_028_0	2008	3																					1000											D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1089.030024	25.40511322	786.9127769	14.94946784	224.4683622	8.59410154	0.692058212	257.7507256	296.293565	6.460245698	809.4017934	0	0.074169641	197.559824	2395.481627	2963.245905	180.3705217	332.443824	18.54886688	15.73892953	22.85140313	714.6540744	0	0	423.0660192	0	24.90817578	0	0	500	0											"$75/day, unlimited days"	"$75/day, unlimited days"	"$75/day, days 16-100"	$0 copay	$75 copay	20% DME / 20% Diabetes Monitoring Supplies	20% coinsurance	$50 ER / $25 UC	$75 ASC / $75 OP	$0 copay	$20 - $100 Copay		20% coinsurance	$25 PT/OT/ST	$15 PCP	$25 SCP / $25 Chiro / $25 Podiatrist	$25 MH	$25 Therapy	$0 copay	$25 Hearing / $25 OPSA	0% coinsurance	$25 Vision			$25 Vision		$25 Hearing															58.46436243	58.46436243	58.46436243	0	75	0.2	0.2	40.83149758	75	0	33.3531417	0	0.2	25	15	25	25	25	0	0.004236172	0	25	0	0	25	0	25	0	0	0	0											5.3058	0.123774479	3.833862816	0	1.402927264	1.718820308	0.138411642	0.877029011	1.851834781	0	2.249674392	0	0.014833928	0.411582967	2.994352034	6.173428969	0.37577192	0.6925913	0	0.066672817	0	1.488862655	0	0	0.88138754	0	0.051892033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.6535	0	2.62	5.3058	0.123774479	3.833862816	0	1.402927264	1.718820308	0.138411642	0.877029011	1.851834781	0	2.249674392	0	0.014833928	0.411582967	2.994352034	6.173428969	0.37577192	0.6925913	0	0.066672817	0	1.488862655	0	0	0.88138754	0	0.051892033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.6535	1000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.3058	0.123774479	3.833862816	0	1.402927264	1.718820308	0.138411642	0.877029011	1.851834781	0	2.249674392	0	0.014833928	0.411582967	2.994352034	6.173428969	0.37577192	0.6925913	0	0.066672817	0	1.488862655	0	0	0.88138754	0	0.051892033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.6535
H0755_801_0	2008	2																					none											D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	831.2430945	13.76505249	792.4090819	18.36116716	262.2506315	12.57623335	0.266206937	295.1013655	421.9774528	10.47519321	1007.041584	0	0.077518443	310.2637667	3732.90648	4738.027656	27.37219158	589.9756122	27.29307888	23.38610537	37.79015372	1152.058348	0	0	0	0	0	0	0	0	0											"$300/day, limited to 6 days"	"$300/day, limited to 6 days"	"$75/day, days 16-100"	$0 copay	$150 copay	20% DME / 20% Diabetes Monitoring Supplies	20% coinsurance	$50 ER / $40 UC	$200 ASC / $200 OP	$0 copay	$20 - $200 Copay		20% coinsurance	$0 Cardiac Rehab / $40 PT/OT/ST	$40 PCP	$40 SCP / $40 Chiro / $40 Podiatrist	$40 MH	$40 Therapy	$0 copay	$40 Hearing / $0 Preventive / $40 OPSA	0% coinsurance	$40 Vision																				300	300	75	0	150	0.2	0.2	46.50507857	200	0	43.97814202	0	0.2	40	40	40	40	38.57502955	0	0.005699025	0	40	0	0	0	0	0	0	0	0	0											20.7811	0.344126312	4.952556762	0	3.278132893	2.515246671	0.053241387	1.143642682	7.032957546	0	3.690651483	0	0.015503689	1.034212556	12.4430216	15.79342552	0.091240639	1.896527223	0	0.13327799	0	3.840194493	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.039	0	0	20.7811	0.344126312	4.952556762	0	3.278132893	2.515246671	0.053241387	1.143642682	7.032957546	0	3.690651483	0	0.015503689	1.034212556	12.4430216	15.79342552	0.091240639	1.896527223	0	0.13327799	0	3.840194493	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.039	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.7811	0.344126312	4.952556762	0	3.278132893	2.515246671	0.053241387	1.143642682	7.032957546	0	3.690651483	0	0.015503689	1.034212556	12.4430216	15.79342552	0.091240639	1.896527223	0	0.13327799	0	3.840194493	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.039
H0755_803_0	2008	2																					none											D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	824.7565555	13.657638	819.3277715	19.11093659	271.226556	13.0897778	0.277077369	297.8502569	425.9082046	10.34463598	1016.422252	0	0.077213041	313.1538971	3746.2751	4754.995906	27.47021933	592.0884859	27.14286183	23.22181697	37.31915733	1156.184203	0	0	0	0	0	0	0	0	0											"$300/day, limited to 6 days"	"$300/day, limited to 6 days"	"$75/day, days 16-100"	$0 copay	$150 copay	20% DME / 20% Diabetes Monitoring Supplies	20% coinsurance	$50 ER / $40 UC	$200 ASC / $200 OP	$0 copay	$20 - $200 Copay		20% coinsurance	$0 Cardiac Rehab / $40 PT/OT/ST	$40 PCP	$40 SCP / $40 Chiro / $40 Podiatrist	$40 MH	$40 Therapy	$0 copay	$40 Hearing / $0 Preventive / $40 OPSA	0% coinsurance	$40 Vision																				300	300	75	0	150	0.2	0.2	46.50507857	200	0	43.97814202	0	0.2	40	40	40	40	38.28594103	0	0.00575876	0	40	0	0	0	0	0	0	0	0	0											20.6189	0.34144095	5.120798572	0	3.390331949	2.617955559	0.055415474	1.1542958	7.098470076	0	3.72503018	0	0.015442608	1.043846324	12.48758367	15.84998635	0.091567398	1.889055405	0	0.133728881	0	3.853947343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4878	0	0	20.6189	0.34144095	5.120798572	0	3.390331949	2.617955559	0.055415474	1.1542958	7.098470076	0	3.72503018	0	0.015442608	1.043846324	12.48758367	15.84998635	0.091567398	1.889055405	0	0.133728881	0	3.853947343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4878	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.6189	0.34144095	5.120798572	0	3.390331949	2.617955559	0.055415474	1.1542958	7.098470076	0	3.72503018	0	0.015442608	1.043846324	12.48758367	15.84998635	0.091567398	1.889055405	0	0.133728881	0	3.853947343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4878
H0755_804_0	2008	2																					none											D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	831.2430945	13.76505249	792.4090819	18.36116716	262.2506315	12.57623335	0.266206937	295.1013655	421.9774528	10.47519321	1007.041584	0	0.077518443	310.2637667	3732.90648	4738.027656	27.37219158	589.9756122	27.29307888	23.38610537	37.79015372	1152.058348	0	0	0	0	0	0	0	0	0											"$300/day, limited to 6 days"	"$300/day, limited to 6 days"	"$75/day, days 16-100"	$0 copay	$150 copay	20% DME / 20% Diabetes Monitoring Supplies	20% coinsurance	$50 ER / $40 UC	$200 ASC / $200 OP	$0 copay	$20 - $200 Copay		20% coinsurance	$0 Cardiac Rehab / $40 PT/OT/ST	$40 PCP	$40 SCP / $40 Chiro / $40 Podiatrist	$40 MH	$40 Therapy	$0 copay	$40 Hearing / $0 Preventive / $40 OPSA	0% coinsurance	$40 Vision																				300	300	75	0	150	0.2	0.2	46.50507857	200	0	43.97814202	0	0.2	40	40	40	40	38.57502955	0	0.005699025	0	40	0	0	0	0	0	0	0	0	0											20.7811	0.344126312	4.952556762	0	3.278132893	2.515246671	0.053241387	1.143642682	7.032957546	0	3.690651483	0	0.015503689	1.034212556	12.4430216	15.79342552	0.091240639	1.896527223	0	0.13327799	0	3.840194493	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.039	0	0	20.7811	0.344126312	4.952556762	0	3.278132893	2.515246671	0.053241387	1.143642682	7.032957546	0	3.690651483	0	0.015503689	1.034212556	12.4430216	15.79342552	0.091240639	1.896527223	0	0.13327799	0	3.840194493	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.039	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.7811	0.344126312	4.952556762	0	3.278132893	2.515246671	0.053241387	1.143642682	7.032957546	0	3.690651483	0	0.015503689	1.034212556	12.4430216	15.79342552	0.091240639	1.896527223	0	0.13327799	0	3.840194493	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.039
H0755_806_0	2008	2																					none											D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	831.2430945	13.76505249	792.4090819	18.36116716	262.2506315	12.57623335	0.266206937	295.1013655	421.9774528	10.47519321	1007.041584	0	0.077518443	310.2637667	3732.90648	4738.027656	27.37219158	589.9756122	27.29307888	23.38610537	37.79015372	1152.058348	0	0	0	0	0	0	0	0	0											"$300/day, limited to 6 days"	"$300/day, limited to 6 days"	"$75/day, days 16-100"	$0 copay	$150 copay	20% DME / 20% Diabetes Monitoring Supplies	20% coinsurance	$50 ER / $40 UC	$200 ASC / $200 OP	$0 copay	$20 - $200 Copay		20% coinsurance	$0 Cardiac Rehab / $40 PT/OT/ST	$40 PCP	$40 SCP / $40 Chiro / $40 Podiatrist	$40 MH	$40 Therapy	$0 copay	$40 Hearing / $0 Preventive / $40 OPSA	0% coinsurance	$40 Vision																				300	300	75	0	150	0.2	0.2	46.50507857	200	0	43.97814202	0	0.2	40	40	40	40	38.57502955	0	0.005699025	0	40	0	0	0	0	0	0	0	0	0											20.7811	0.344126312	4.952556762	0	3.278132893	2.515246671	0.053241387	1.143642682	7.032957546	0	3.690651483	0	0.015503689	1.034212556	12.4430216	15.79342552	0.091240639	1.896527223	0	0.13327799	0	3.840194493	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.039	0	0	20.7811	0.344126312	4.952556762	0	3.278132893	2.515246671	0.053241387	1.143642682	7.032957546	0	3.690651483	0	0.015503689	1.034212556	12.4430216	15.79342552	0.091240639	1.896527223	0	0.13327799	0	3.840194493	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.039	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.7811	0.344126312	4.952556762	0	3.278132893	2.515246671	0.053241387	1.143642682	7.032957546	0	3.690651483	0	0.015503689	1.034212556	12.4430216	15.79342552	0.091240639	1.896527223	0	0.13327799	0	3.840194493	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.039
H0768_001_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	948.624126	0	0	0	0	0	0															$150/day 1-10	$150/day 1-10	$0/day 1-8; $75/day 9-15; $100/day 16-100	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER/UC	$100 per procedure	$25 per visit	"$25 X-ray; $175 CAT, PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$15 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	45$ per script		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															122.95	122.95	65.64	0	100	0.2	0.2	50	100	25	52	25	25	25	15	25	25	25	25	25	45	0	0	0	0	0	0															14.3135	0.278845189	6.24191691	0	1.722706705	2.766333837	0.176580511	1.562246934	2.57415865	4.091492713	4.3737044	0	0	0	6.089982493	12.54283301	0.369731351	1.069742143	1.754430091	2.651716473	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1373			14.3135	0.278845189	6.24191691	0	1.722706705	2.766333837	0.176580511	1.562246934	2.57415865	4.091492713	4.3737044	0	0	0	6.089982493	12.54283301	0.369731351	1.069742143	1.754430091	2.651716473	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1373		30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	$100 per trip	30% coins; $1000ded; 5000 max OOP	0	$50 ER/UC	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	0	0	0	30% coins; $1000ded; 5000 max OOP	0	30% coins; $1000ded; 5000 max OOP															5.7858	0	0.9382	0.8405	0.1679	0.4788	0	0.15	0.5925	0.2056	0.5773	0	0.1893	0.6379	0.7516	0.9392	0.0355	0.0994	0.6985	2.5313	0.5505	0	0	0	0.0977	0	0.0276															16.295	1000	13.08602097	20.0993	0.278845189	7.180079031	0.840459825	1.890626223	3.245098455	0.176580511	1.712203625	3.166694307	4.297115748	4.950979143	0	0.189302013	0.637899183	6.841626071	13.48200403	0.405202922	1.169170395	2.452944642	5.18302376	4.107791126	0	0	0	0.097702603	0	0.027584622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.4322
H0768_002_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	948.624126	0	0	0	0	0	0															$0/day	$0/day	$0/day 1-8; $75/day 9-15; $100/day 16-100	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER/UC	$100 per procedure	$15 per visit	"$15 X-ray; $175 CAT, PET, MRI"	$15 per visit	$15 per visit	$15 per visit	$10 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	45$ per script		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															0	0	65.64	0	100	0.2	0.2	50	100	15	43.8	15	15	15	10	15	15	15	15	15	45	0	0	0	0	0	0															0	0	6.24191691	0	1.722706705	2.766333837	0.176580511	1.562246934	2.57415865	2.454895628	3.68400486	0	0	0	4.059988329	7.525699807	0.221838811	0.641845286	1.052658054	1.591029884	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.8332			0	0	6.24191691	0	1.722706705	2.766333837	0.176580511	1.562246934	2.57415865	2.454895628	3.68400486	0	0	0	4.059988329	7.525699807	0.221838811	0.641845286	1.052658054	1.591029884	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.8332		30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	$100 per trip	30% coins; $1000ded; 5000 max OOP	0	$50 ER/UC	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	0	0	0	30% coins; $1000ded; 5000 max OOP	0	30% coins; $1000ded; 5000 max OOP															5.7858	0	0.9382	0.8405	0.1679	0.4788	0	0.15	0.5925	0.2056	0.5773	0	0.1893	0.6379	0.7516	0.9392	0.0355	0.0994	0.6985	2.5313	0.5505	0	0	0	0.0977	0	0.0276															16.295	1000	13.08602097	5.7858	0	7.180079031	0.840459825	1.890626223	3.245098455	0.176580511	1.712203625	3.166694307	2.660518663	4.261279603	0	0.189302013	0.637899183	4.811631907	8.464870828	0.257310382	0.741273537	1.751172606	4.122337171	4.107791126	0	0	0	0.097702603	0	0.027584622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1282
H0768_801_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0	Unlimited	1234.846677	24.05634262	1008.659047	1655.768182	182.7285135	13.83166919	0.882902555	331.4169026	273.0425222	1735.948155	892.1565356	0	0	0	4306.453503	5463.08541	156.8704877	907.7454267	1240.622878	2250.153009	15.90270259	0	0	0	0	0	0															$200/d 7	$200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065			14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065		"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	$50 ER/UC	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"				"30% coins; $500ded; ""Unlimited maxOOP"		"30% coins; $500ded; ""Unlimited maxOOP"															7.922	0.0614	1.2845	1.1508	0.2023	0.6555	0.0418	0.2118	0.8113	0.2815	0.7904	0	0.2592	0.8734	1.0292	1.2859	0.0486	0.1361	0.9564	3.4659	0.7537	0	0	0	0.1338	0	0.0378															22.3934	500	0	22.7988	0.351249716	9.690032461	6.669992775	2.486439732	4.805029776	0.306714469	1.592750556	5.362014101	6.068034846	4.875000015	0	0.259194098	0.873417564	11.79529122	19.26857794	0.571469634	3.161956187	5.09182229	10.96639979	3.934222733	0	0	0	0.133775323	0	0.037769123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.0999
H0768_802_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0	Unlimited	1234.846677	24.05634262	1008.659047	1655.768182	182.7285135	13.83166919	0.882902555	331.4169026	273.0425222	1735.948155	892.1565356	0	0	0	4306.453503	5463.08541	156.8704877	907.7454267	1240.622878	2250.153009	15.90270259	0	0	0	0	0	0															$200/d 7	$200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065			14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065		"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	$50 ER/UC	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	20% coinsurance				"30% coins; $500ded; ""Unlimited maxOOP"		"30% coins; $500ded; ""Unlimited maxOOP"															7.922	0.0614	1.2845	1.1508	0.2023	0.6555	0.0418	0.2118	0.8113	0.2815	0.7904	0	0.2592	0.8734	1.0292	1.2859	0.0486	0.1361	0.9564	3.4659	0.7537	0	0	0	0.1338	0	0.0378															22.3934	500	0	22.7988	0.351249716	9.690032461	6.669992775	2.486439732	4.805029776	0.306714469	1.592750556	5.362014101	6.068034846	4.875000015	0	0.259194098	0.873417564	11.79529122	19.26857794	0.571469634	3.161956187	5.09182229	10.96639979	3.934222733	0	0	0	0.133775323	0	0.037769123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.0999
H0806_001_0	2008	11																					1000											D	D	D	V	T	Coin	Coin	V	V	P	P	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	Coin	V	Coin	V	P	Coin	P	P																																																				0	3000	894.600331	43.61326305	632.5464158		62.50585472	8.25311485	15.85227507	231.3477468	277.2778581		327.3078819	5.03657117	0.245103635	473.9022246	2898.635473	3418.900538	272.7832141	924.2329326	3018.278404	1.784744022	16.04067196			6.255	129.6	2.187	224.1															1a:$100 1-3; 1a1:$100 1-3;	1b:$100 1-3;	2a:$50 21+; 2a2:$50 21+;		10a:$100;	11a:10%;	11b:10%; 11c:10%;	4a:$50; 4b:$20;	9b:$50;		8b:$$10-50;	9a:$50;	12:10%;	3:$10; 5:$10; 9c:$10; 9d:10%;	7a:$5; 14c:$5; 14i:$5;	7b:$10; 7d:$10; 7f:$10; 7f1:$10; 14j:$5; 16b:10%; 17a:$10; 18a:$10;	7e:$10; 7h:$10;	7c:$10; 7i:$10;	7g:$5-10;	7g:$5-10;	15:10%;			16a:10%;	17a1:$10;	17b1:10%;	18a1:$10;															45.2206	32.7571	6.7431		71.5064	0.071506388	0.071506388	35.7532	35.7532		22.0062	35.7532	0.070924939	35.4139	5	9.9976	7.1295	7.0697	4.315	3.5753	0.071506388			0.1	10	0.1	10															3.3712	0.119053582	0.355441135	0	0.372463992	0.590150433	1.133538932	0.689285073	0.826130755	0	0.600232564	0.015006126	0.01738396	1.39855882	1.20776478	2.848409101	0.162066858	0.544503474	1.085318653	0.000531752	1.147010513	0	0	0.6255	0.108	0.2187	0.18675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.623	0	4.952890873	3.3712	0.119053582	0.355441135	0	0.372463992	0.590150433	1.133538932	0.689285073	0.826130755	0	0.600232564	0.015006126	0.01738396	1.39855882	1.20776478	2.848409101	0.162066858	0.544503474	1.085318653	0.000531752	1.147010513	0	0	0.6255	0.108	0.2187	0.18675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.623	3000	0.2		0.2	0.2	100	0.2	0.2	50	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2		0.2	0.2	0.2	0.2			0.2	0.2	0.2	0.2				0.2											3.0399		0.4033	0.5978	0.0455	0.1441	0.2768	0.0855	0.752	0.0987	0.2682	0.0103	0.0043	0.3938	0.3971	1.3493		0.1902	0.2992	0.1775	0.2801			0.1566	0.0153	0.0548	0.0203				0.0004											9.0611	250	4.50933198	6.4111	0.119053582	0.758780446	0.597837785	0.417937952	0.73425283	1.41032544	0.774796824	1.578119557	0.098708369	0.868475969	0.025268461	0.021661983	1.792390565	1.604892429	4.197735268	0.162066858	0.734753147	1.384560876	0.17799035	1.4270865	0	0	0.782107694	0.123266596	0.273456359	0.207011971	0	0	0	0.000430692	0	0	0	0	0	0	0	0	0	0	26.6841
H0806_002_0	2008	11																					2000											D	D	D	V	T	Coin	Coin	V	V	P	P	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	Coin	V	Coin	V	P	Coin	P	P																																																				0	3000	896.0839136	43.68559019	633.5950017		62.60951285	8.266801607	15.87856408	231.7314081	277.7376887	1051.96344	327.850681	5.044923692	0.245510108	474.6881321	2903.285781	3424.374835	273.2355909	925.7656572	3023.283841	4833.738544	16.0672734			6.462	129.6	2.187	224.1															1a:$125 1-5; 1a1:$125 1-5;	1b:$125 1-5;	2a:$75 7+; 2a2:$75 7+;		10a:$100;	11a:20%;	11b:20%; 11c:20%;	4a:$50; 4b:$20;	9b:$50;	8a:$15;	8b:$15-50;	9a:$50;	12:10%;	3:$15; 5:$40; 9c:$15; 9d:10%;	7a:$5; 14c:$5; 14i:$5;	7b:$15; 7d:$15; 7f:$15; 7f1:$15; 14j:$5; 16b:20%; 17a:$15; 18a:$15;	7e:$15; 7h:$15;	7c:$15; 7i:$15;	7g:$5-15;	7g:$5-15;	15:20%;			16a:25%;	17a1:$15;	17b1:20%;	18a1:$15;															81.9572	65.1462	36.1451		86.6997	0.173399417	0.173399417	43.3499	43.3499	13.005	28.7654	43.3499	0.094761597	42.9601	5	14.9983	12.9536	12.8087	7.808	3.3629	0.173399417			0.25	15	0.2	15															6.12	0.237162374	1.908446674	0	0.45235221	1.433458581	2.753333758	0.837126898	1.003324028	1.140061546	0.785896734	0.018224726	0.02326493	1.699388907	1.209702409	4.279995367	0.294949754	0.988151699	1.967154678	1.354622002	2.786055844	0	0	1.6155	0.162	0.4374	0.280125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.7877	0	3.958822248	6.12	0.237162374	1.908446674	0	0.45235221	1.433458581	2.753333758	0.837126898	1.003324028	1.140061546	0.785896734	0.018224726	0.02326493	1.699388907	1.209702409	4.279995367	0.294949754	0.988151699	1.967154678	1.354622002	2.786055844	0	0	1.6155	0.162	0.4374	0.280125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.7877	3000	0.3		0.3	0.3	100	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3			0.3	0.3	0.3	0.3				0.3											3.2831		0.4356	0.6457	0.0327	0.1556	0.2989	0.0618	0.8121	0.1066	0.2897	0.0111	0.0046	0.4253	0.4289	1.4573		0.2055	0.3232	0.1917	0.3025			0.2313	0.0165	0.0783	0.0218				0.0004											9.8202	250	9.530102794	9.4032	0.237162374	2.344049749	0.645660191	0.485093227	1.589088057	3.052261049	0.898961569	1.815466127	1.246665822	1.07559754	0.029307969	0.027885162	2.124724151	1.638564256	5.737248388	0.294949754	1.193619877	2.290333968	1.546275917	3.088535747	0	0	1.846846867	0.178460508	0.515697059	0.301971542	0	0	0	0.000377572	0	0	0	0	0	0	0	0	0	0	43.608
H0806_003_0	2008	13																					3000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	Coin	V	Coin	V	P	Coin	P	P																																																				0	3000	875.3137567	42.67301028	618.914799		61.15829898	8.075187001	15.5105179	226.3601503	271.3000601	5.512230834	14.10042429	4.927988375	0.239819477	463.685427	2838.181475	3347.734689	266.9023156	904.3075128	2953.207725	4721.698246	15.69485316			6.462	129.6	2.187	224.1															1a:$300 1-3; 1a1:$300 1-3;	1b:$300 1-3;	2a:$100 7+; 2a2:$100 7+;		10a:$100;	11a:20%;	11b:20%; 11c:20%;	4a:$50; 4b:$35;	9b:$125;	8a:20%;	8b:20%;	9a:$125;	12:20%;	3:$25; 5:$60; 9c:$30; 9d:25%;	7a:$20; 14c:$20; 14i:$20;	7b:$30; 7d:$30; 7f:$30; 7f1:$30; 14j:$20; 16b:20%; 17a:$30; 18a:$30;	7e:$30; 7h:$30;	7c:$30; 7i:$30;	7g:$20-30;	7g:$20-30;	15:20%;			16a:25%;	17a1:$30;	17b1:20%;	18a1:$30;															168.8984	122.3472	49.4801		89.0251	0.178050137	0.178050137	44.5125	111.2813	0.178050137	0.178050137	111.2813	0.196605158	110.2252	20	29.9973	26.6548	26.506	16.1979	7.3139	0.178050137			0.25	30	0.2	30															12.3199	0.435076772	2.551998885	0	0.45371848	1.437788152	2.761649837	0.839655329	2.515886088	0.981453455	2.510582476	0.045699427	0.047149746	4.259149849	4.730302458	8.368573926	0.592853072	1.997461759	3.986318759	2.877831541	2.794470756	0	0	1.6155	0.324	0.4374	0.56025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4447	0	5.35214462	12.3199	0.435076772	2.551998885	0	0.45371848	1.437788152	2.761649837	0.839655329	2.515886088	0.981453455	2.510582476	0.045699427	0.047149746	4.259149849	4.730302458	8.368573926	0.592853072	1.997461759	3.986318759	2.877831541	2.794470756	0	0	1.6155	0.324	0.4374	0.56025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4447	3000	0.3		0.3	0.3	100	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3			0.3	0.3	0.3	0.3				0.3											3.0944		0.4106	0.6085	0.0309	0.1467	0.2817	0.0583	0.7655	0.1005	0.273	0.0104	0.0044	0.4009	0.4046	1.3736		0.1937	0.3046	0.1806	0.2851			0.2317	0.0159	0.0784	0.0211				0.0004											9.2754	250	9.664854374	15.4143	0.435076772	2.962565864	0.608545819	0.484577451	1.584471606	3.043393943	0.897963387	3.281343964	1.081929816	2.783630461	0.056145574	0.051504394	4.660035621	5.134888707	9.742178844	0.592853072	2.191119045	4.29092079	3.058468647	3.079563259	0	0	1.84719202	0.339882448	0.515813873	0.581329335	0	0	0	0.000385744	0	0	0	0	0	0	0	0	0	0	68.7201
H0806_801_0	2008	1																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		187.3847873	3.779596497	25.00335291		5.03457244	9.03328316	17.35079325	12.89313818	46.95357866	6.166240108	16.74659196	0.642640901	0.268273322	24.59714332	23.91855084	86.23184322	2.207741992	11.90959274	18.75846471	11.12426849	17.55699933																					Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																					0.0831	0.0831	0.1957		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					15.5717	0.314084469	4.893156164	0	1.178089951	2.113788259	4.06008562	3.016994334	10.98713741	1.442900185	3.91870252	0.150377971	0.062775957	5.755731537	5.596940897	20.17825131	0.516611626	2.786844702	4.389480743	2.603078828	4.108337843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.645	0	0	15.5717	0.314084469	4.893156164	0	1.178089951	2.113788259	4.06008562	3.016994334	10.98713741	1.442900185	3.91870252	0.150377971	0.062775957	5.755731537	5.596940897	20.17825131	0.516611626	2.786844702	4.389480743	2.603078828	4.108337843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.645		Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																					1.8434		0.5785		0.138	0.2472	0.4749	0.3544	1.2901	0.1693	0.4602	0.0176	0.0073	0.6757	0.6546	2.3065		0.3264	0.5134	0.3045	0.4805																					10.8426	0	0	17.4151	0.314084469	5.47166355	0	1.316096217	2.361014956	4.534949436	3.37140876	12.27727353	1.61224743	4.378909513	0.167984363	0.07011547	6.431401918	6.251553867	22.48473796	0.516611626	3.113243146	4.902870304	2.907532492	4.588845193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.4877
H0806_802_0	2008	1																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		187.3847873	3.779596497	25.00335291		5.03457244	9.03328316	17.35079325	12.89313818	46.95357866	6.166240108	16.74659196	0.642640901	0.268273322	24.59714332	23.91855084	86.23184322	2.207741992	11.90959274	18.75846471	11.12426849	17.55699933																					Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																					0.0831	0.0831	0.1957		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					15.5717	0.314084469	4.893156164	0	1.178089951	2.113788259	4.06008562	3.016994334	10.98713741	1.442900185	3.91870252	0.150377971	0.062775957	5.755731537	5.596940897	20.17825131	0.516611626	2.786844702	4.389480743	2.603078828	4.108337843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.645	0	0	15.5717	0.314084469	4.893156164	0	1.178089951	2.113788259	4.06008562	3.016994334	10.98713741	1.442900185	3.91870252	0.150377971	0.062775957	5.755731537	5.596940897	20.17825131	0.516611626	2.786844702	4.389480743	2.603078828	4.108337843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.645		Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																					1.8434		0.5785		0.138	0.2472	0.4749	0.3544	1.2901	0.1693	0.4602	0.0176	0.0073	0.6757	0.6546	2.3065		0.3264	0.5134	0.3045	0.4805																					10.8426	0	0	17.4151	0.314084469	5.47166355	0	1.316096217	2.361014956	4.534949436	3.37140876	12.27727353	1.61224743	4.378909513	0.167984363	0.07011547	6.431401918	6.251553867	22.48473796	0.516611626	3.113243146	4.902870304	2.907532492	4.588845193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.4877
H0806_803_0	2008	1																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		187.3847873	3.779596497	25.00335291		5.03457244	9.03328316	17.35079325	12.89313818	46.95357866	6.166240108	16.74659196	0.642640901	0.268273322	24.59714332	23.91855084	86.23184322	2.207741992	11.90959274	18.75846471	11.12426849	17.55699933																					Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																					0.0831	0.0831	0.1957		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					15.5717	0.314084469	4.893156164	0	1.178089951	2.113788259	4.06008562	3.016994334	10.98713741	1.442900185	3.91870252	0.150377971	0.062775957	5.755731537	5.596940897	20.17825131	0.516611626	2.786844702	4.389480743	2.603078828	4.108337843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.645	0	0	15.5717	0.314084469	4.893156164	0	1.178089951	2.113788259	4.06008562	3.016994334	10.98713741	1.442900185	3.91870252	0.150377971	0.062775957	5.755731537	5.596940897	20.17825131	0.516611626	2.786844702	4.389480743	2.603078828	4.108337843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.645		Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																					1.8434		0.5785		0.138	0.2472	0.4749	0.3544	1.2901	0.1693	0.4602	0.0176	0.0073	0.6757	0.6546	2.3065		0.3264	0.5134	0.3045	0.4805																					10.8426	0	0	17.4151	0.314084469	5.47166355	0	1.316096217	2.361014956	4.534949436	3.37140876	12.27727353	1.61224743	4.378909513	0.167984363	0.07011547	6.431401918	6.251553867	22.48473796	0.516611626	3.113243146	4.902870304	2.907532492	4.588845193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.4877
H0838_020_0	2008	4																																Coin	Coin	Coin			Coin	Coin																																			0	0	0			0	0																																			0		285.8200058	2.78479454	13.33848362			2.675300463	1.673457771																																			Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No cost sharing	No cost sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing											0.0644771	0.0644771	0.17748563			0.234	0.234																																			18.4288	0.179555475	2.367389167	0	0	0.626020308	0.391589118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.9934			18.4288	0.179555475	2.367389167	0	0	0.626020308	0.391589118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.9934																																																																																				0			18.4288	0.179555475	2.367389167	0	0	0.626020308	0.391589118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.9934
H0846_004_0	2008	3																					1000											D	Coin	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	P	T	Coin	V	P	V	P	Coin	P	P																																																				0	0		5.404927948			156.1356483			290.4829707			4.59680686		0.370691794	0.99187661		1482.874523	317.9405844	709.4226206	292.3771428		27.76934063			7.24	144		249																1b:50%;			10a:$150;			4a:$50;			8b:0-20%;		12:20%;	3:20%; 5:$30; 9c:$15;		7b:$15; 17a:$20; 18a:$20;	7e:$15; 7h:$15;	7c:$15; 7i:$15;	7g:$15;		15:20%;			16a:50%;	17a1:$20;		18a1:$20;																0.353006758			63.5412			35.3007			0.141202703		0.141202703	0.141202703		13.0248	10.5906	10.5902	13.575		0.141202703			0.353006758	14.1203		14.1203															0	1.907976093	0	0	0.826754086	0	0	0.854520432	0	0	0.649081555	0	0.052342683	0.140055659	0	1.609510067	0.28059741	0.626077449	0.330751016	0	3.921105965	0	0	2.555768929	0.169443244	0	0.292995609	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.217	0	5.92	0	1.907976093	0	0	0.826754086	0	0	0.854520432	0	0	0.649081555	0	0.052342683	0.140055659	0	1.609510067	0.28059741	0.626077449	0.330751016	0	3.921105965	0	0	2.555768929	0.169443244	0	0.292995609	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.217																																																																																				0	0	0	0	1.907976093	0	0	0.826754086	0	0	0.854520432	0	0	0.649081555	0	0.052342683	0.140055659	0	1.609510067	0.28059741	0.626077449	0.330751016	0	3.921105965	0	0	2.555768929	0.169443244	0	0.292995609	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.217
H0846_005_0	2008	4																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	P	T	Coin	V	P	V	P	Coin	P	P																																																				0	0	1623.117694	146.7255638	859.2057213		174.5803598	13.14176047	12.79399199	339.9260849	300.5506864	1282.72881	423.1557754	46.88145952	0.702121815	654.6626074	3677.1522	4405.332842	467.8147173	636.7219188	4305.642539	7557.281125	24.65570373			7.24	144		249															1a:$180 1-5; 1a1:$180 1-5;	1b:$180 1-5;	2a:$90 4-38; 2a2:$90 4-38;		10a:$150;	11a:20%;	11b:20%; 11c:20%;	4a:$50; 4b:$50;	9b:$90;	8a:$5;	8b:$15-50;20%;	9a:$90;	12:20%;	3:20%; 5:$60; 9a:$90; 9c:$30; 9d:$30;	7a:$15;	7b:$30; 7d:$30; 7f:$30; 17a:$30; 18a:$30;	7e:$30; 7h:$30;	7c:$30; 7i:$30;	8b:$15-50;20%;	7g:$15-30;	15:20%;			16a:50%;	17a1:$30;		18a1:$30;															106.6402	82.0153	55.9033		76.4751	0.169944587	0.169944587	42.4861	76.4751	4.2486	41.0419	76.4751	0.169944587	27.3482	12.7486	25.4917	25.4929	25.4917	8.0687	1.2231	0.169944587			0.424861468	25.4917		25.4917															14.4241	1.002811245	4.002700928	0	1.11258702	2.233371059	2.17426969	1.203512463	1.915386089	0.454151705	1.447261167	0.298771886	0.119321802	1.491986892	3.906550626	9.358280898	0.99382832	1.352593047	2.895081151	0.770298575	4.190103395	0	0	3.07599703	0.305900257	0	0.528952528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.2579	0	10.48	14.4241	1.002811245	4.002700928	0	1.11258702	2.233371059	2.17426969	1.203512463	1.915386089	0.454151705	1.447261167	0.298771886	0.119321802	1.491986892	3.906550626	9.358280898	0.99382832	1.352593047	2.895081151	0.770298575	4.190103395	0	0	3.07599703	0.305900257	0	0.528952528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.2579																																																																																				0	0	0	14.4241	1.002811245	4.002700928	0	1.11258702	2.233371059	2.17426969	1.203512463	1.915386089	0.454151705	1.447261167	0.298771886	0.119321802	1.491986892	3.906550626	9.358280898	0.99382832	1.352593047	2.895081151	0.770298575	4.190103395	0	0	3.07599703	0.305900257	0	0.528952528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.2579
H0846_006_0	2008	4																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	P	T	P	V	P	V	P	Coin	P	P																																																				0	0	1684.739785	150.9500675	867.3156381		170.3687971	12.92735223	12.90717715	308.6804531	309.6313237	1100.117606	392.7609801	43.60227498	0.776417317	591.4200665	3546.598481	4802.037325	735.5008017	895.7483459	4247.74665	8697.437035	27.37598616			1659.107681	144		249															1a:$265 1-11; 1a1:$265 1-11;	1b:$265 1-11;	2a:$125 1-24; 2a2:$125 1-24;		10a:$150;	11a:20%;	11b:20%; 11c:20%;	4a:$50; 4b:$50;	9b:$100;	8a:$5;	8b:$25-75;20%	9a:$100;	12:20%;	3:20%; 5:$70; 9a:$100; 9c:$35; 9d:$30;	7a:$15;	7b:$30; 7d:$30; 7f:$30; 17a:$30; 17b:20%; 18a:$30;	7e:$35; 7h:$35;	7c:$30; 7i:$30;	8b:$25-75;20%	7g:$15-30;	15:20%;			16a:50%;	17a1:$30;		18a1:$30;															169.6846	147.8123	77.9582		66.5488	0.147886218	0.147886218	36.9716	73.9431	3.6972	48.1463	73.9431	0.147886218	25.3343	11.0944	22.1829	19.6673	22.1829	11.4557	1.0994	0.147886218			19.3603	22.1829		22.1829															23.8229	1.859356074	5.634531933	0	0.94481989	1.911777232	1.908793614	0.951033017	1.907925227	0.33894215	1.5758338	0.268673981	0.114821421	1.248600934	3.278934892	8.876939237	1.205441637	1.65586044	4.055072079	0.796814238	4.048531059	0	0	2.676740547	0.266195193	0	0.460295854	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8088	0	24.6	23.8229	1.859356074	5.634531933	0	0.94481989	1.911777232	1.908793614	0.951033017	1.907925227	0.33894215	1.5758338	0.268673981	0.114821421	1.248600934	3.278934892	8.876939237	1.205441637	1.65586044	4.055072079	0.796814238	4.048531059	0	0	2.676740547	0.266195193	0	0.460295854	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8088																																																																																				0	0	0	23.8229	1.859356074	5.634531933	0	0.94481989	1.911777232	1.908793614	0.951033017	1.907925227	0.33894215	1.5758338	0.268673981	0.114821421	1.248600934	3.278934892	8.876939237	1.205441637	1.65586044	4.055072079	0.796814238	4.048531059	0	0	2.676740547	0.266195193	0	0.460295854	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8088
H0846_009_0	2008	4																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	P	T	Coin	V	P	V	P	Coin	P	P																																																				0	0	1448.968902	129.2937769	851.1800493		162.4942561	12.28411874	12.67884094	292.9626877	326.4885623	998.9226345	332.291176	37.8638011	0.648820392	580.2579458	3712.349895	5153.29408	462.2623254	922.169177	4564.551572	9132.6701	25.98753853			7.24	144		249															1a:$180 1-5; 1a1:$180 1-5;	1b:$180 1-5;	2a:$90 4-38; 2a2:$90 4-38;		10a:$150;	11a:20%;	11b:20%; 11c:20%;	4a:$50; 4b:$50;	9b:$90;	8a:$5;	8b:$15-50;20%;	9a:$90;	12:20%;	3:20%; 5:$60; 9a:$90; 9c:$30; 9d:$30;	7a:$15;	7b:$30; 7d:$30; 7f:$30; 17a:$30; 18a:$30;	7e:$30; 7h:$30;	7c:$30; 7i:$30;	8b:$15-50;20%;	7g:$15-30;	15:20%;			16a:50%;	17a1:$30;		18a1:$30;															110.1221	84.54	55.6436		77.6784	0.172618667	0.172618667	43.1547	77.6784	4.3155	42.1165	77.6784	0.172618667	28.9027	12.9499	25.8928	25.894	25.8928	8.2432	1.2841	0.172618667			0.431546668	25.8928		25.8928															13.297	0.910874574	3.946895453	0	1.051857821	2.120468202	2.188604622	1.05355893	2.113425766	0.359234778	1.166245733	0.245099958	0.111998511	1.397587116	4.006225528	11.11943444	0.997484923	1.989795176	3.135532128	0.977248774	4.48593426	0	0	3.124397873	0.310713601	0	0.537275601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6468	0	9.62	13.297	0.910874574	3.946895453	0	1.051857821	2.120468202	2.188604622	1.05355893	2.113425766	0.359234778	1.166245733	0.245099958	0.111998511	1.397587116	4.006225528	11.11943444	0.997484923	1.989795176	3.135532128	0.977248774	4.48593426	0	0	3.124397873	0.310713601	0	0.537275601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6468																																																																																				0	0	0	13.297	0.910874574	3.946895453	0	1.051857821	2.120468202	2.188604622	1.05355893	2.113425766	0.359234778	1.166245733	0.245099958	0.111998511	1.397587116	4.006225528	11.11943444	0.997484923	1.989795176	3.135532128	0.977248774	4.48593426	0	0	3.124397873	0.310713601	0	0.537275601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6468
H0846_010_0	2008	4																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	Coin	V	Coin	P	T	Coin	V	P	V	P	Coin	P	P																																																				0	0	1845.235555	165.5522706	935.8800938		174.435754	14.35089817	14.40530412	297.5998776	322.1789451	1096.810386	383.2000569	33.97314945	1.147668124	504.4303613	3858.020859	5643.811614	586.7677188	1311.850244	37.93346664	10540.22964	36.04163074			7.24	144		249															1a:$180 1-5; 1a1:$180 1-5;	1b:$180 1-5;	2a:$90 4-38; 2a2:$90 4-38;		10a:$150;	11a:20%;	11b:20%; 11c:20%;	4a:$50; 4b:$50;	9b:$90;	8a:$5;	8b:$15-50;20%;	9a:$90;	12:20%;	3:20%; 5:$60; 9a:$90; 9c:$30; 9d:$30;	7a:$15;	7b:$30; 7d:$30; 7f:$30; 17a:$30; 18a:$30;	7e:$30; 7h:$30;	7c:$30; 7i:$30;	8b:$15-50;20%;	7g:$15-30;	15:20%;			16a:50%;	17a1:$30;		18a1:$30;															100.2708	74.1204	53.6003		73.6279	0.163617561	0.163617561	40.9044	73.6279	4.0904	45.7441	73.6279	0.163617561	30.8703	12.2762	24.5426	24.5583	24.5426	0.084335742	1.2429	0.163617561			0.409043902	24.5426		24.5426															15.4186	1.022567132	4.180289913	0	1.070278222	2.348058954	2.356960722	1.01442846	1.976779993	0.373869667	1.46076246	0.208447644	0.187778659	1.297660912	3.946821495	11.54283362	1.200832698	2.683021713	3.199147064	1.091693719	5.89704371	0	0	2.961477851	0.294511609	0	0.509259658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.2431	0	14.73	15.4186	1.022567132	4.180289913	0	1.070278222	2.348058954	2.356960722	1.01442846	1.976779993	0.373869667	1.46076246	0.208447644	0.187778659	1.297660912	3.946821495	11.54283362	1.200832698	2.683021713	3.199147064	1.091693719	5.89704371	0	0	2.961477851	0.294511609	0	0.509259658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.2431																																																																																				0	0	0	15.4186	1.022567132	4.180289913	0	1.070278222	2.348058954	2.356960722	1.01442846	1.976779993	0.373869667	1.46076246	0.208447644	0.187778659	1.297660912	3.946821495	11.54283362	1.200832698	2.683021713	3.199147064	1.091693719	5.89704371	0	0	2.961477851	0.294511609	0	0.509259658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.2431
H0846_012_0	2008	5																					2500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	P	T	Coin	V	P	V	P	Coin	P	P																																																				0	0	1571.711663	64.34289914	484.721184		91.50026772	6.757768706	5.455749374	247.1699282	233.4382071	364.1480132	484.2910266	2.930876938	1.238195134	927.08649	4979.301072	4866.356562	473.4096363	666.6485288	3462.174945	11698.87665	13.68881051			7.24	144		249															1a:$170 1-4; 1a1:$170 1-4;	1b:$170 1-5;	2a:$90 4-38; 2a2:$90 4-38;		10a:$150;	11a:20%;	11b:20%; 11c:20%;	4a:$50; 4b:$50;	9b:$75;	8a:$5;	8b:$15-50;20%;	9a:$75;	12:20%;	3:20%; 5:$60; 9a:$75; 9c:$30; 9d:$30;	7a:$10;	7b:$20; 7d:$20; 7f:$20; 17a:$20; 18a:$20;	7e:$30; 7h:$30;	7c:$30; 7i:$30;	8b:$15-50;20%;	7g:$10-20;	15:20%;			16a:50%;	17a1:$20;		18a1:$20;															86.2746	78.8644	60.9198		81.0344	0.180076335	0.180076335	45.0191	67.5286	4.5019	48.1995	67.5286	0.180076335	18.8568	9.0312	18.0076	25.8675	27.0115	8.6699	1.4483	0.180076335			0.450190838	18.0076		18.0076															11.2999	0.422863844	2.460760775	0	0.617888733	1.216914222	0.982451353	0.927280309	1.313646776	0.136613416	1.945214805	0.016493174	0.222969642	1.456825679	3.74740328	7.302630459	1.020495407	1.500595298	2.501396641	1.411963199	2.465030829	0	0	3.259381666	0.216091602	0	0.373658395	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.8185	0	5.18	11.2999	0.422863844	2.460760775	0	0.617888733	1.216914222	0.982451353	0.927280309	1.313646776	0.136613416	1.945214805	0.016493174	0.222969642	1.456825679	3.74740328	7.302630459	1.020495407	1.500595298	2.501396641	1.411963199	2.465030829	0	0	3.259381666	0.216091602	0	0.373658395	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.8185																																																																																				0	0	0	11.2999	0.422863844	2.460760775	0	0.617888733	1.216914222	0.982451353	0.927280309	1.313646776	0.136613416	1.945214805	0.016493174	0.222969642	1.456825679	3.74740328	7.302630459	1.020495407	1.500595298	2.501396641	1.411963199	2.465030829	0	0	3.259381666	0.216091602	0	0.373658395	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.8185
H0846_013_0	2008	4																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	P	T	Coin	V	P	V	P	Coin	P	P																																																				0	0	1793.979012	160.9535965	909.8908473		169.5903164	13.95226211	14.00515678	289.3449343	313.22953	1066.343431	372.5556109	33.02945086	1.115788454	490.4184068	3750.853613	5487.039069	570.4686155	1275.409959	4721.440371	10247.44548	35.04047433			7.24	144		249															1a:$265 1-11; 1a1:$265 1-11;	1b:$265 1-11;	2a:$125 1-24; 2a2:$125 1-24;		10a:$150;	11a:20%;	11b:20%; 11c:20%;	4a:$50; 4b:$50;	9b:$100;	8a:$5;	8b:$25-75;20%	9a:$100;	12:20%;	3:20%; 5:$70; 9a:$100; 9c:$35; 9d:$30;	7a:$15;	7b:$30; 7d:$30; 7f:$30; 17a:$30; 17b:20%; 18a:$30;	7e:$35; 7h:$35;	7c:$30; 7i:$30;	8b:$25-75;20%	7g:$15-30;	15:20%;			16a:50%;	17a1:$30;		18a1:$30;															164.3757	141.7198	76.0851		64.9992	0.144442578	0.144442578	36.1106	72.2213	3.6111	50.8639	72.2213	0.144442578	27.6295	10.8375	21.6664	25.2935	21.6664	10.9717	1.0972	0.144442578			0.361106445	21.6664		21.6664															24.5739	1.900859769	5.769096803	0	0.918602345	2.015300711	2.022940953	0.870702673	1.88515337	0.320886238	1.579135507	0.198785793	0.161167361	1.129169927	3.387492529	9.907025873	1.202430977	2.302793785	4.316846446	0.936982917	5.061336454	0	0	2.614410665	0.259996641	0	0.449577525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7846	0	28.38	24.5739	1.900859769	5.769096803	0	0.918602345	2.015300711	2.022940953	0.870702673	1.88515337	0.320886238	1.579135507	0.198785793	0.161167361	1.129169927	3.387492529	9.907025873	1.202430977	2.302793785	4.316846446	0.936982917	5.061336454	0	0	2.614410665	0.259996641	0	0.449577525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7846																																																																																				0	0	0	24.5739	1.900859769	5.769096803	0	0.918602345	2.015300711	2.022940953	0.870702673	1.88515337	0.320886238	1.579135507	0.198785793	0.161167361	1.129169927	3.387492529	9.907025873	1.202430977	2.302793785	4.316846446	0.936982917	5.061336454	0	0	2.614410665	0.259996641	0	0.449577525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7846
H0846_801_0	2008	5																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	279.9502033	5.799325432	32.50836479		7.609448098	11.4961341	12.04604236	13.89108617	46.36444792	6.874349949	20.98960017	3.513845972	0.392421017	23.95679587	35.42233933	114.9119919	3.308200054	13.88213259	34.09340091	18.15915499	28.44083945																					MEDICARE FFS	MEDICARE FFS	MEDICARE FFS		MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS																					0.077354942	0.077354942	0.188446115		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					21.6555	0.44860648	6.126075064	0	1.780610855	2.69009538	2.818773913	3.250514163	10.84928081	1.608597888	4.911566439	0.822239958	0.091826518	5.605890233	8.288827402	26.88940611	0.774118813	3.248419026	7.977855814	4.249242268	6.655156432	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7426	0	0	21.6555	0.44860648	6.126075064	0	1.780610855	2.69009538	2.818773913	3.250514163	10.84928081	1.608597888	4.911566439	0.822239958	0.091826518	5.605890233	8.288827402	26.88940611	0.774118813	3.248419026	7.977855814	4.249242268	6.655156432	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7426																																																																																				0	0	0	21.6555	0.44860648	6.126075064	0	1.780610855	2.69009538	2.818773913	3.250514163	10.84928081	1.608597888	4.911566439	0.822239958	0.091826518	5.605890233	8.288827402	26.88940611	0.774118813	3.248419026	7.977855814	4.249242268	6.655156432	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7426
H0901_002_0	2008	3																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		2525.071246	0	0	836.8642088	237.422548	7.318000448	0	376.4977323	335.4883831	1058.383895	5383.932363	0	0	398.4522798	3464.160268	4252.809844	0	771.8391198	0	0	280.7779698	0	0	0	232.3014067	0	0	0	0	0	0											$350/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$25 per visit	"$25 X-ray; $140 CAT, PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit															59.17692516	59.17692516	68.6350679	20	100	0.2	0.2	48	200	25	45.7	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0	0											12.4522	0	0	1.394773681	1.978521234	1.46360009	0	1.505990929	5.591473052	2.204966449	20.50380908	0	0	0.830108916	2.886800223	8.860020508	0	1.607998166	0	0	1.052917387	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3331	0	0	12.4522	0	0	1.394773681	1.978521234	1.46360009	0	1.505990929	5.591473052	2.204966449	20.50380908	0	0	0.830108916	2.886800223	8.860020508	0	1.607998166	0	0	1.052917387	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3331																																																																																				0	0	0	12.4522	0	0	1.394773681	1.978521234	1.46360009	0	1.505990929	5.591473052	2.204966449	20.50380908	0	0	0.830108916	2.886800223	8.860020508	0	1.607998166	0	0	1.052917387	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3331
H0901_004_0	2008	3																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		2525.071246	0	0	836.8642088	237.422548	7.318000448	0	376.4977323	335.4883831	1058.383895	5383.932363	0	0	398.4522798	3464.160268	4252.809844	0	771.8391198	0	0	280.7779698	0	0	0	232.3014067	0	0	0	0	0	0											$150/day; $1500 max		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$35 per visit	"$35 X-ray; $140 CAT, PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$0 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															122.9471107	122.9471107	68.6350679	20	100	0.2	0.2	48	200	35	53.9	35	30	35	0	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0	0											25.8709	0	0	1.394773681	1.978521234	1.46360009	0	1.505990929	5.591473052	3.086953028	24.18282953	0	0	1.162152483	0	12.40402871	0	2.251197433	0	0	1.052917387	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.9453	0	0	25.8709	0	0	1.394773681	1.978521234	1.46360009	0	1.505990929	5.591473052	3.086953028	24.18282953	0	0	1.162152483	0	12.40402871	0	2.251197433	0	0	1.052917387	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.9453																																																																																				0	0	0	25.8709	0	0	1.394773681	1.978521234	1.46360009	0	1.505990929	5.591473052	3.086953028	24.18282953	0	0	1.162152483	0	12.40402871	0	2.251197433	0	0	1.052917387	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.9453
H0901_005_0	2008	5																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S			V	V		V																																																								0		2828.079796	0	0	937.2879139	265.9132538	8.196160502	0	421.6774602	375.7469891	1185.389963	6030.004246	0	0	446.2665533	3879.8595	4763.147025	0	864.4598142	0	0	314.4713262	0	0	3781.118076	260.1775755	0	0	0	0	0	0											$100/day; $700 max		"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$150 per procedure	$0 per visit	"$0 X-ray; $100 CAT, PET, MRI"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$45 per script			$5 per visit	$0 per visit		$0 per visit															72.2855078	0	41.19723561	0	100	0.2	0	46.675	150	0	18	0	0	0	0	0	0	0	0	0	45	0	0	5	0	0	0	0	0	0	0											17.0358	0	0	0	2.215943782	1.6392321	0	1.640149621	4.696837363	0	9.045006369	0	0	0	0	0	0	0	0	0	1.179267473	0	0	1.575465865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0277	0	0	17.0358	0	0	0	2.215943782	1.6392321	0	1.640149621	4.696837363	0	9.045006369	0	0	0	0	0	0	0	0	0	1.179267473	0	0	1.575465865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0277																																																																																				0	0	0	17.0358	0	0	0	2.215943782	1.6392321	0	1.640149621	4.696837363	0	9.045006369	0	0	0	0	0	0	0	0	0	1.179267473	0	0	1.575465865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0277
H0901_801_0	2008	1																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1376.063443	0	1256.03494	221.1183384	220.7995584	4.001414784	0	196.7865416	311.999376	688.0802247	5277.296283	0	0	550.4929219	3511.667315	4656.425039	0	910.3258876	0	0	8.373316587	0	0	0	406.6482885	0	41.35778337	0	0	0	0											$200/day; $1400 max		$100/day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$39.5 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											16.5781	0	10.46695784	0.737061128	2.75999448	1.200424435	0	0.819943924	5.1999896	2.293600749	24.16122148	0	0	1.834976406	8.779168287	15.32739909	0	3.034419625	0	0	0.000139555	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.1934	0	0	16.5781	0	10.46695784	0.737061128	2.75999448	1.200424435	0	0.819943924	5.1999896	2.293600749	24.16122148	0	0	1.834976406	8.779168287	15.32739909	0	3.034419625	0	0	0.000139555	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.1934																																																																																				0	0	0	16.5781	0	10.46695784	0.737061128	2.75999448	1.200424435	0	0.819943924	5.1999896	2.293600749	24.16122148	0	0	1.834976406	8.779168287	15.32739909	0	3.034419625	0	0	0.000139555	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.1934
H0901_802_0	2008	1																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1376.063443	0	1256.03494	221.1183384	220.7995584	4.001414784	0	196.7865416	311.999376	688.0802247	5277.296283	0	0	550.4929219	3511.667315	4656.425039	0	910.3258876	0	0	8.373316587	0	0	0	406.6482885	0	41.35778337	0	0	0	0											$200/day; $1400 max		$100/day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$39.5 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											16.5781	0	10.46695784	0.737061128	2.75999448	1.200424435	0	0.819943924	5.1999896	2.293600749	24.16122148	0	0	1.834976406	8.779168287	15.32739909	0	3.034419625	0	0	0.000139555	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.1934	0	0	16.5781	0	10.46695784	0.737061128	2.75999448	1.200424435	0	0.819943924	5.1999896	2.293600749	24.16122148	0	0	1.834976406	8.779168287	15.32739909	0	3.034419625	0	0	0.000139555	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.1934																																																																																				0	0	0	16.5781	0	10.46695784	0.737061128	2.75999448	1.200424435	0	0.819943924	5.1999896	2.293600749	24.16122148	0	0	1.834976406	8.779168287	15.32739909	0	3.034419625	0	0	0.000139555	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.1934
H0902_002_0	2008	4																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	1004.671681	0	669.7811206	0	209.6945345	7.176325444	0	297.680498	278.1452153	888.9123472	3396.431869	0	0	273.8195456	2831.950547	3313.912288	0	117.2116961	0	0	7.573963314	0	0	0	460.4745204	0	55.81509338	0	0	0	0											$350/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$25 per visit	"$25 X-ray; $150 CAT, PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit															59.17692516	59.17692516	68.6350679	20	100	0.2	0.2	48	200	25	47.5	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0	0											4.9544	0	3.830872724	0	1.747454454	1.435265089	0	1.190721992	4.635753589	1.851900723	13.44420948	0	0	0.570457387	2.359958789	6.903983934	0	0.244191034	0	0	0.028402362	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.1976	0	0	4.9544	0	3.830872724	0	1.747454454	1.435265089	0	1.190721992	4.635753589	1.851900723	13.44420948	0	0	0.570457387	2.359958789	6.903983934	0	0.244191034	0	0	0.028402362	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.1976		500 ded; 20 % coins; 5000 max OOP	500 ded; 20 % coins; 5000 max OOP	500 ded; 20 % coins; 5000 max OOP	500 ded; 20 % coins; 5000 max OOP	500 ded; 20 % coins; 5000 max OOP	500 ded; 20 % coins; 5000 max OOP	0	$50 ER; $35 UC	500 ded; 20 % coins; 5000 max OOP	500 ded; 20 % coins; 5000 max OOP	500 ded; 20 % coins; 5000 max OOP	500 ded; 20 % coins; 5000 max OOP	500 ded; 20 % coins; 5000 max OOP	500 ded; 20 % coins; 5000 max OOP	500 ded; 20 % coins; 5000 max OOP	500 ded; 20 % coins; 5000 max OOP	500 ded; 20 % coins; 5000 max OOP	500 ded; 20 % coins; 5000 max OOP	500 ded; 20 % coins; 5000 max OOP	500 ded; 20 % coins; 5000 max OOP	500 ded; 20 % coins; 5000 max OOP	0	0	0	500 ded; 20 % coins; 5000 max OOP	0	500 ded; 20 % coins; 5000 max OOP	0	0	0	0											5.9189	0	0.7679	0	0.0609	0.1829	0	0.1771	0.4853	0.332	0.9079	0	0	0.3235	0.6964	3.0553	0	0.0224	0	0	0.1359	0	0	0	0.051	0	0.0037	0	0	0	0											13.1211	500	6.33889079	10.8733	0	4.598751939	0	1.808305553	1.618118501	0	1.367832074	5.121072251	2.183874378	14.35215843	0	0	0.894003162	3.05640073	9.959307978	0	0.266610881	0	0	0.164281885	0	0	0	0.051012973	0	0.003679032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3187
H0902_801_0	2008	2																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1265.506668	0	475.5913784	285.9324684	190.2076693	12.29163636	0	328.6137459	268.7717066	1455.106905	4357.90097	0	0	497.9641499	3757.540869	4436.391833	0	1041.198534	0	0	7.213189391	0	0	0	527.0977321	0	30.32617089	0	0	0	0											$200/day; $1400 max		$100/day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$39.5 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											15.2462	0	3.963261486	0.953108228	2.377595866	3.687490908	0	1.369223941	4.479528443	4.850356351	19.95192328	0	0	1.6598805	9.393852172	14.60312312	0	3.470661779	0	0	0.00012022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.0063	0	0	15.2462	0	3.963261486	0.953108228	2.377595866	3.687490908	0	1.369223941	4.479528443	4.850356351	19.95192328	0	0	1.6598805	9.393852172	14.60312312	0	3.470661779	0	0	0.00012022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.0063		500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	0	$50 per visit	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	0	0	0	500 ded; 30% coins; No max OOP	0	500 ded; 30% coins; No max OOP															14.2745	0	0.7884	0.1299	0.1799	0.3684	0	0.1356	1.4681	0.7988	2.6128	0	0	0.9832	1.2178	5.5438	0	0.4136	0	0	0.0367	0	0	0	0.1118	0	0.0043															29.0674	500	0	29.5206	0	4.751654959	1.083005894	2.557489707	4.055892237	0	1.504793237	5.947578968	5.64917989	22.56468983	0	0	2.64307067	10.61161753	20.1469336	0	3.884223403	0	0	0.036783905	0	0	0	0.111775588	0	0.004343967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.0737
H0902_802_0	2008	2																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1265.506668	0	475.5913784	285.9324684	190.2076693	12.29163636	0	328.6137459	268.7717066	1455.106905	4357.90097	0	0	497.9641499	3757.540869	4436.391833	0	1041.198534	0	0	7.213189391	0	0	0	527.0977321	0	30.32617089	0	0	0	0											$200/day; $1400 max		$100/day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$39.5 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											15.2462	0	3.963261486	0.953108228	2.377595866	3.687490908	0	1.369223941	4.479528443	4.850356351	19.95192328	0	0	1.6598805	9.393852172	14.60312312	0	3.470661779	0	0	0.00012022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.0063	0	0	15.2462	0	3.963261486	0.953108228	2.377595866	3.687490908	0	1.369223941	4.479528443	4.850356351	19.95192328	0	0	1.6598805	9.393852172	14.60312312	0	3.470661779	0	0	0.00012022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.0063		500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	0	$50 per visit	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	0	0	0	500 ded; 30% coins; No max OOP	0	500 ded; 30% coins; No max OOP	0	0	0	0											14.2745	0	0.7884	0.1299	0.1799	0.3684	0	0.1356	1.4681	0.7988	2.6128	0	0	0.9832	1.2178	5.5438	0	0.4136	0	0	0.0367	0	0	0	0.1118	0	0.0043	0	0	0	0											29.0674	500	0	29.5206	0	4.751654959	1.083005894	2.557489707	4.055892237	0	1.504793237	5.947578968	5.64917989	22.56468983	0	0	2.64307067	10.61161753	20.1469336	0	3.884223403	0	0	0.036783905	0	0	0	0.111775588	0	0.004343967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.0737
H0908_001_0	2008	7																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		355.0108426	28.78956281	87.5710864	0	14.15944275	31.0095571	22.28168129	12.27276763	27.77355502	13.81514907	28.29955537	0	4.90365907	48.76596129	65.56829029	121.9084595	9.412843282	4.438883681	21.47933894	37.51573639	11.62978988	0.859803099	0	0	0	0	0	0	0	0	0											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing																				0.078573088	0.078573088	0.191226455	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											27.8943	2.262084856	16.74590839	0	3.313309604	7.256236362	5.213913422	2.871827624	6.499011874	3.232744882	6.622095957	0	1.147456222	11.41123494	15.34297993	28.52657952	2.202605328	1.038698781	5.026165312	8.778682316	2.721370833	0.201193925	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	158.3084			27.8943	2.262084856	16.74590839	0	3.313309604	7.256236362	5.213913422	2.871827624	6.499011874	3.232744882	6.622095957	0	1.147456222	11.41123494	15.34297993	28.52657952	2.202605328	1.038698781	5.026165312	8.778682316	2.721370833	0.201193925	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	158.3084																																																																																				0			27.8943	2.262084856	16.74590839	0	3.313309604	7.256236362	5.213913422	2.871827624	6.499011874	3.232744882	6.622095957	0	1.147456222	11.41123494	15.34297993	28.52657952	2.202605328	1.038698781	5.026165312	8.778682316	2.721370833	0.201193925	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	158.3084
H0913_001_0	2008	7																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2164.727322	105.5219848	1397.764087	2039.659217	689.9102378	11.49513508	3.153158719	899.9445365	211.2654819	3257.849631	924.391378	29.87375209	0.402589574	416.1902528	7753.281409	25900.0884	560.5437032	5074.246897	4633.920122	615.1970238	28.7846179	37.0983465	0	526.6666667	379.2	262.5230769	46.8	17.82857143	0	0	3600											"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$50.00 copayment	20% coinsurance	Copay between $20.00 and $30.00	Copay between $0.00 and $5.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											17.44086501	10.14712402	58.42551111	0	37.76773612	0.187411423	0.187411423	16.37014104	20.0752394	0	9.911147654	33.89724957	0.187411423	7.780602226	1.81251518	6.95018443	21.00898957	9.240298192	7.287457671	0	0.187411423	0	0	46.85285574	9.370571148	9.370571148	18.7411423	0	0	0	0											3.1462	0.089228722	6.805423433	0	2.171362317	2.154319623	0.590937962	1.227684916	0.353433761	0	0.76348162	0.084386503	0.075449885	0.269850901	1.171078354	15.00086593	0.981371401	3.907296202	2.814124728	0	5.3945662	0	0	2.05631978	0.296110048	0.204999264	0.073090455	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6316	0	3.333795328	3.1462	0.089228722	6.805423433	0	2.171362317	2.154319623	0.590937962	1.227684916	0.353433761	0	0.76348162	0.084386503	0.075449885	0.269850901	1.171078354	15.00086593	0.981371401	3.907296202	2.814124728	0	5.3945662	0	0	2.05631978	0.296110048	0.204999264	0.073090455	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6316	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	3.1462	0.089228722	6.805423433	0	2.171362317	2.154319623	0.590937962	1.227684916	0.353433761	0	0.76348162	0.084386503	0.075449885	0.269850901	1.171078354	15.00086593	0.981371401	3.907296202	2.814124728	0	5.3945662	0	0	2.05631978	0.296110048	0.204999264	0.073090455	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6316
H0913_002_0	2008	7																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2145.207728	125.6612513	1457.085082	1780.459638	648.5746256	11.08218748	4.103975435	891.5926658	182.4456296	3358.182107	815.9508614	20.29631061	0.089516018	452.8344388	6398.066916	28840.87382	696.8312636	5135.766504	5001.092659	633.7965543	39.44139387	29.43066163	0	526.6666667	379.2	262.5230769	46.8	17.82857143	0	0	3600											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$150.00 copayment	20% coinsurance	Copay between $20.00 and $100.00	Copay between $0.00 and $10.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $10.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											52.18508722	23.467283	56.89527357	0	39.40861092	0.182502882	0.182502882	15.85212151	65.19103818	0	15.41693307	99.02831406	0.182502882	20.68031417	3.672608169	6.870257095	19.38510533	9.109664446	7.983548582	0	0.182502882	0	0	45.62572059	9.125144118	9.125144118	18.25028824	0	0	0	0											9.329	0.245744012	6.908437863	0	2.12995209	2.022531157	0.748987346	1.17780294	0.991151667	0	1.048288318	0.167492452	0.016336931	0.780396539	1.958132735	16.51201816	1.125678953	3.898759127	3.327205517	0	7.198168066	0	0	2.002462181	0.288354554	0.199630076	0.071176124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.1477	0	5.95829232	9.329	0.245744012	6.908437863	0	2.12995209	2.022531157	0.748987346	1.17780294	0.991151667	0	1.048288318	0.167492452	0.016336931	0.780396539	1.958132735	16.51201816	1.125678953	3.898759127	3.327205517	0	7.198168066	0	0	2.002462181	0.288354554	0.199630076	0.071176124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.1477	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	9.329	0.245744012	6.908437863	0	2.12995209	2.022531157	0.748987346	1.17780294	0.991151667	0	1.048288318	0.167492452	0.016336931	0.780396539	1.958132735	16.51201816	1.125678953	3.898759127	3.327205517	0	7.198168066	0	0	2.002462181	0.288354554	0.199630076	0.071176124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.1477
H0913_003_0	2008	8																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		444.5668762	46.86492713	3414.721605	29.25288777	22.42112937	21.81449971	4.66964517	23.11683221	15.43755333	6.978394401	16.51746169	23.46259798	1.135495367	7.424956923	9340.775084	132.5802116	16.56528016	32.2927454	32.70548217	5.193690417	19.15884114	0.115825787	0	0	0	0	0	0	0	0	34.5											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.2460615	708.4	30.26	0.099795093	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.199242239	0.012631112	0.2	0.2	0	0	0	0	0	0	0	0	0											26.2386	2.766592865	8.610789648	2.919294662	4.484225874	4.362899942	0.933929034	4.623366441	3.087510665	1.39567888	3.303492337	0	0.227099073	1.484991385	0	26.51604232	3.313056032	6.45854908	6.516313485	0.065602087	3.831768228	0.023165157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.1629	0	0	26.2386	2.766592865	8.610789648	2.919294662	4.484225874	4.362899942	0.933929034	4.623366441	3.087510665	1.39567888	3.303492337	0	0.227099073	1.484991385	0	26.51604232	3.313056032	6.45854908	6.516313485	0.065602087	3.831768228	0.023165157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.1629	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	26.2386	2.766592865	8.610789648	2.919294662	4.484225874	4.362899942	0.933929034	4.623366441	3.087510665	1.39567888	3.303492337	0	0.227099073	1.484991385	0	26.51604232	3.313056032	6.45854908	6.516313485	0.065602087	3.831768228	0.023165157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.1629
H0913_004_0	2008	7																					2000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		3291.341339	505.4614417	3289.005973	2638.264864	2627.260453	21.50185978	4.458161257	2062.537793	244.3093769	6590.432058	1204.562904	25.31617104	1.268688924	437.8547024	9229.259369	26747.21864	2009.20018	7529.619148	5583.72925	543.6455212	20.46475598	7.323566788	0	526.6666667	379.2	262.5230769	46.8	17.82857143	0	0	3600											"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$25.00 copayment	20% coinsurance	Copay between $10.00 and $25.00	$0.00 copayment	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											7.357933982	5.093052943	52.47518884	0	27.65763812	0.168324583	0.168324583	15.8766447	17.85974668	0	7.23890816	15.22249903	0.168324583	5.91247877	0	3.466374059	10.48987752	5.967273511	4.013214286	0	0.168324583	0	0	42.08114582	8.416229165	8.416229165	16.83245833	0	0	0	0											2.0181	0.21452849	14.3826008	0	6.055318237	3.619291587	0.750418136	2.728848309	0.363608632	0	0.726643353	0.032114616	0.213551535	0.215733886	0	7.72632207	1.756355318	3.744274741	1.867391833	0	3.444721522	0	0	1.846894733	0.265952842	0.184121198	0.065646587	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.2225	0	9.827252709	2.0181	0.21452849	14.3826008	0	6.055318237	3.619291587	0.750418136	2.728848309	0.363608632	0	0.726643353	0.032114616	0.213551535	0.215733886	0	7.72632207	1.756355318	3.744274741	1.867391833	0	3.444721522	0	0	1.846894733	0.265952842	0.184121198	0.065646587	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.2225	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	2.0181	0.21452849	14.3826008	0	6.055318237	3.619291587	0.750418136	2.728848309	0.363608632	0	0.726643353	0.032114616	0.213551535	0.215733886	0	7.72632207	1.756355318	3.744274741	1.867391833	0	3.444721522	0	0	1.846894733	0.265952842	0.184121198	0.065646587	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.2225
H0913_005_0	2008	7																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		3172.954191	533.3646891	3408.05786	2083.233612	3081.389391	20.52040658	4.31346122	2288.224029	124.2305832	6182.592407	1031.727877	19.71680551	0.003366997	352.0567853	8567.002993	26805.51884	2648.54332	8663.25122	5797.937433	577.8444113	6.323620827	10.6718868	0	526.6666667	379.2	262.5230769	46.8	17.82857143	0	0	3600											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $15.00 and $75.00	Copay between $0.00 and $5.00	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											31.63531266	19.36193457	55.77500584	0	28.11212751	0.178909401	0.178909401	17.36673479	47.25986073	0	11.74292122	64.7189646	0.178909401	15.60149258	1.396269206	4.594899139	16.11953267	8.014433198	3.744843147	0	0.178909401	0	0	44.72735031	8.945470062	8.945470062	17.89094012	0	0	0	0											8.3648	0.860581018	15.84037059	0	7.218700955	3.671293655	0.771718764	3.311581655	0.489260005	0	1.009624932	0.106337603	0.000602387	0.45771761	0.996820205	10.26405462	3.557773382	5.785920681	1.809363855	0	1.131355216	0	0	1.963033708	0.282676854	0.19569936	0.069774666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.159	0	8.034877188	8.3648	0.860581018	15.84037059	0	7.218700955	3.671293655	0.771718764	3.311581655	0.489260005	0	1.009624932	0.106337603	0.000602387	0.45771761	0.996820205	10.26405462	3.557773382	5.785920681	1.809363855	0	1.131355216	0	0	1.963033708	0.282676854	0.19569936	0.069774666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.159	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	8.3648	0.860581018	15.84037059	0	7.218700955	3.671293655	0.771718764	3.311581655	0.489260005	0	1.009624932	0.106337603	0.000602387	0.45771761	0.996820205	10.26405462	3.557773382	5.785920681	1.809363855	0	1.131355216	0	0	1.963033708	0.282676854	0.19569936	0.069774666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.159
H0913_006_0	2008	8																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1657.758387	80.73235973	914.1928953	1549.516759	662.0827167	10.86997689	2.717918601	803.4515712	182.3964198	2817.855508	782.4101741	25.64038932	0.34214973	347.949951	6577.348774	22431.18403	500.3998801	4487.163136	4043.40879	536.7185925	24.42412321	32.03276952	0	671.25	379.2	262.5230769	46.8	17.82857143	0	1600	3600											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$150.00 copayment	20% coinsurance	Copay between $15.00 and $100.00	Copay between $0.00 and $5.00	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											52.99655081	30.83359411	59.17550725	0	38.25055465	0.189817184	0.189817184	16.59681606	67.68372746	0	15.93085797	102.9971446	0.189817184	21.12815227	1.903569501	6.047904339	17.6490005	7.80167259	6.970122344	0	0.189817184	0	0	18.98171845	9.490859223	9.490859223	18.98171845	0	0	0	0											7.3213	0.207439068	4.508152359	0	2.110419261	2.063308407	0.515907656	1.111228161	1.028772464	0	1.038705447	0.220073907	0.064945898	0.612628296	1.043370044	11.30513793	0.735963144	2.917281471	2.348587829	0	4.6361183	0	0	1.061789876	0.299911151	0.207630797	0.074028702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4327	0	2.437254046	7.3213	0.207439068	4.508152359	0	2.110419261	2.063308407	0.515907656	1.111228161	1.028772464	0	1.038705447	0.220073907	0.064945898	0.612628296	1.043370044	11.30513793	0.735963144	2.917281471	2.348587829	0	4.6361183	0	0	1.061789876	0.299911151	0.207630797	0.074028702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4327	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	7.3213	0.207439068	4.508152359	0	2.110419261	2.063308407	0.515907656	1.111228161	1.028772464	0	1.038705447	0.220073907	0.064945898	0.612628296	1.043370044	11.30513793	0.735963144	2.917281471	2.348587829	0	4.6361183	0	0	1.061789876	0.299911151	0.207630797	0.074028702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4327
H0913_007_0	2008	8																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1642.075862	95.75261375	954.6108535	1397.406439	619.8497829	10.42267096	3.493131549	795.1856692	156.8523045	2893.386442	700.9201988	17.42425398	0.076261171	389.0931504	5533.82988	24847.77831	618.5483203	4529.433211	4310.241732	550.2433121	33.27280583	25.32309268	0	526.6666667	379.2	262.5230769	46.8	17.82857143	0	1600	3600											"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $125.00	$0.00 copayment	Copay between $0.00 and $125.00	$175.00 copayment	20% coinsurance	Copay between $15.00 and $125.00	Copay between $0.00 and $5.00	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $5.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											62.77260923	28.23122095	58.66086199	0	40.62556638	0.188166358	0.188166358	16.35927736	87.32989015	0	18.40127805	119.1182832	0.188166358	25.2949277	1.995067808	6.087019872	16.55630622	7.831515045	10.40614341	0	0.188166358	0	0	47.04158941	9.408317881	9.408317881	18.81663576	0	0	0	0											8.5898	0.225267766	4.666524628	0	2.098479042	1.961196031	0.65728984	1.084055243	1.14149121	0	1.074818956	0.172962268	0.014349787	0.820173592	0.920030487	12.6040767	0.853406284	2.956027028	3.737749468	0	6.260822681	0	0	2.064603091	0.297302845	0.205825047	0.073384879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4796	0	3.300404237	8.5898	0.225267766	4.666524628	0	2.098479042	1.961196031	0.65728984	1.084055243	1.14149121	0	1.074818956	0.172962268	0.014349787	0.820173592	0.920030487	12.6040767	0.853406284	2.956027028	3.737749468	0	6.260822681	0	0	2.064603091	0.297302845	0.205825047	0.073384879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4796	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	8.5898	0.225267766	4.666524628	0	2.098479042	1.961196031	0.65728984	1.084055243	1.14149121	0	1.074818956	0.172962268	0.014349787	0.820173592	0.920030487	12.6040767	0.853406284	2.956027028	3.737749468	0	6.260822681	0	0	2.064603091	0.297302845	0.205825047	0.073384879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4796
H0967_001_0	2008	8																					4000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1366.717962	70.02536778	1536.694777	2396.829271	713.6402783	14.74784953	3.481052811	1107.724961	222.2583371	6372.561912	1219.380342	27.07515296	0.164113839	539.1955513	8473.477523	16017.55798	272.3135728	3113.723799	3890.049874	853.4619228	30.08844634	32.21485273	0	530	420	280	103.8	28.14915254	0	0	3600											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 10, $100 days 11 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $20.00 and $75.00	Copay between $0.00 and $10.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $10.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											48.32390699	31.59643824	49.04702103	0	31.16897233	0.194824314	0.194824314	17.50247434	60.91085536	0	13.89780142	70.47604982	0.194824314	17.21763539	3.719585396	7.549365424	24.52895857	10.87346555	5.022810323	0	0.194824314	0	0	0	0	9.741215696	0	9.741215696	0	0	0											5.5038	0.184379351	6.280858418	0	1.853619507	2.873239667	0.678193726	1.615660642	1.128162118	0	1.412225487	0.159012486	0.031973366	0.773639367	2.62648527	10.07686653	0.556630695	2.821414038	1.628248555	0	5.861960915	0	0	0	0	0.227295033	0	0.022850581	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3165	0	1.23043961	5.5038	0.184379351	6.280858418	0	1.853619507	2.873239667	0.678193726	1.615660642	1.128162118	0	1.412225487	0.159012486	0.031973366	0.773639367	2.62648527	10.07686653	0.556630695	2.821414038	1.628248555	0	5.861960915	0	0	0	0	0.227295033	0	0.022850581	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3165	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	N/A	N/A											5.6624	0.1211	0.5393	0.5429	0.1784	0.1708	0.1181	0.0556	0.4506	0.1463	0.4973	0.0093	0.0049	0.1899	0.4788	2.5322	0.0666	0.5243	0.5601	0.1994	0.9867	0.0187	0	0	0	0	0	0	0	0	0											14.0538	0	0	11.1661	0.305492103	6.82019073	0.542945306	2.031974998	3.04400424	0.796336072	1.671274837	1.57877472	0.146275634	1.909502864	0.168354538	0.036910927	0.963492044	3.105254004	12.60909851	0.623268782	3.345761789	2.18834513	0.19935917	6.848668926	0.018679038	0	0	0	0.227295033	0	0.022850581	0	0	0	0	0	0	0	0	0	0	0	0	0	60.3702
H0974_001_0	2008	5																																Coin		Coin	Coin	Coin	Coin		V	Coin					Coin						Coin	Coin	Coin																																																													0		234.1396079		24.18715648	7.463843447	6.255869602	32.78195636		757.5663641	34.30974423					87.57612858						163.032128	27.37270695	3.449424239																				traditional Medicare		traditional Medicare	traditional Medicare	traditional Medicare	traditional Medicare		$50 Copay (max for MA)	traditional Medicare					traditional Medicare						traditional Medicare	traditional Medicare	traditional Medicare																				0.080557348		0.157320399	0	0.234	0.234		50	0.234					0.234						0.234	0.234	0.234																				18.8617	0	3.805133114	0	1.463873487	7.670977789	0	3.156526517	8.02848015	0	0	0	0	20.49281409	0	0	0	0	0	38.14951796	6.405213426	0.807165272	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.8414			18.8617	0	3.805133114	0	1.463873487	7.670977789	0	3.156526517	8.02848015	0	0	0	0	20.49281409	0	0	0	0	0	38.14951796	6.405213426	0.807165272	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.8414																																																																																				0			18.8617	0	3.805133114	0	1.463873487	7.670977789	0	3.156526517	8.02848015	0	0	0	0	20.49281409	0	0	0	0	0	38.14951796	6.405213426	0.807165272	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.8414
H0979_004_0	2008	6	s.										Professional (Non-Covered)											Physical Exams										D	D	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin			P	V	V	V	V				V																																																			0		1108.682897	51.69584848	1214.708915	342.3184193	9.997104681	18.9775	12.6517	146.7908202	22.847	10.6927	23.2307	1.0956	0.02	36.9687	3603.069537	2700.643281	202.5012407	1781.015417	4825.1807	3732.480987	22.6976	0	0	425	508.95	274.05	80	20	0	0	0	59.60473218										$200 for 1st 7 days	$200 for 1st 7 days	$90 for days 6-100	$0 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 per visit	20% Coinsurance	10% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$10 per Visit / $25 Urg Care	$25 per Visit	$25 per Visit	$25 per Visit	$25 per Visit	$25 per Visit	20% Coinsurance	0	0	$0 per procedure	$0 - 1 / Year ($3.85 Cap)	$0 - up to $100 ($3.85 Cap)	$0 (1 / 3 Years)	$500 allowable/hearing aid				$0 / 1 per year										150.0671	73.2112	55.9142	0	0.19916	0.2	0.2	49.79	0.2	0.1	0.2	0.2	0.2	0.2	10.7049	24.895	24.895	24.895	25	24.895	0.2	0	0	0	0	72.4	0	0	0	0	0	0										13.8647	0.315392994	5.659953399	0	1.991023368	3.79549623	2.53033082	0.609059578	4.569405965	1.069272007	4.646149848	0.219124559	0.004	7.393735405	3.214193244	5.60270954	0.420105699	3.6948649	10.05245978	7.743342848	4.539511023	0	0	0	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.5883		0.159881606	13.8647	0.315392994	5.659953399	0	1.991023368	3.79549623	2.53033082	0.609059578	4.569405965	1.069272007	4.646149848	0.219124559	0.004	7.393735405	3.214193244	5.60270954	0.420105699	3.6948649	10.05245978	7.743342848	4.539511023	0	0	0	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.5883	3250																																																																																			0			13.8647	0.315392994	5.659953399	0	1.991023368	3.79549623	2.53033082	0.609059578	4.569405965	1.069272007	4.646149848	0.219124559	0.004	7.393735405	3.214193244	5.60270954	0.420105699	3.6948649	10.05245978	7.743342848	4.539511023	0	0	0	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.5883
H0979_005_0	2008	8	s.										Professional (Non-Covered)											Physical Exams										D	D	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin			P	V	V	V	V				V																																																			0		1108.682897	51.69584848	1214.708915	342.3184193	9.997104681	18.9775	12.6517	146.7908202	22.847	10.6927	23.2307	1.0956	0.02	36.9687	3603.069537	2700.643281	202.5012407	1781.015417	4825.1807	3732.480987	22.6976	0	0	425	508.95	274.05	80	20	0	0	0	59.60473218										$200 for 1st 7 days	$200 for 1st 7 days	$90 for days 6-100	$0 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 per visit	20% Coinsurance	10% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$10 per Visit / $25 Urg Care	$25 per Visit	$25 per Visit	$25 per Visit	$25 per Visit	$25 per Visit	20% Coinsurance	0	0	$0-$75 ($25 Average)	$0 - 1 / Year ($3.85 Cap)	$0 - up to $100 ($3.85 Cap)	$0 (1 / 3 Years)	$500 allowable/hearing aid				$0 / 1 per year										150.0671	73.2112	55.9142	0	0.19916	0.2	0.2	49.79	0.2	0.1	0.2	0.2	0.2	0.2	10.7049	24.895	24.895	24.895	25	24.895	0.2	0	0	24.895	0	72.4	0	0	0	0	0	0										13.8647	0.315392994	5.659953399	0	1.991023368	3.79549623	2.53033082	0.609059578	4.569405965	1.069272007	4.646149848	0.219124559	0.004	7.393735405	3.214193244	5.60270954	0.420105699	3.6948649	10.05245978	7.743342848	4.539511023	0	0	0.881697917	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.47		0.159881606	13.8647	0.315392994	5.659953399	0	1.991023368	3.79549623	2.53033082	0.609059578	4.569405965	1.069272007	4.646149848	0.219124559	0.004	7.393735405	3.214193244	5.60270954	0.420105699	3.6948649	10.05245978	7.743342848	4.539511023	0	0	0.881697917	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.47	3250																																																																																			0			13.8647	0.315392994	5.659953399	0	1.991023368	3.79549623	2.53033082	0.609059578	4.569405965	1.069272007	4.646149848	0.219124559	0.004	7.393735405	3.214193244	5.60270954	0.420105699	3.6948649	10.05245978	7.743342848	4.539511023	0	0	0.881697917	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.47
H0979_006_0	2008	7	s.										Professional (Non-Covered)											Physical Exams										D	D	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin			P	V	V	V	V				V																																																			0		1108.682897	51.69584848	1214.708915	342.3184193	9.997104681	18.9775	12.6517	146.7908202	22.847	10.6927	23.2307	1.0956	0.02	36.9687	3603.069537	2700.643281	202.5012407	1781.015417	4825.1807	3732.480987	22.6976	0	0	425	508.95	274.05	80	20	0	0	0	59.60473218										$100 for 1st 7 days	$100 for 1st 7 days	$90 for days 6-100	$0 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	$25 per visit	20% Coinsurance	10% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$5 per Visit / $15 Urg Care	$25 per Visit	$25 per Visit	$25 per Visit	$25 per Visit	$15 per Visit	20% Coinsurance	0	0	$0 per procedure	$0 - 1 / Year ($3.85 Cap)	$0 - up to $100 ($3.85 Cap)	$0 (1 / 3 Years)	$500 allowable/hearing aid				$0 / 1 per year										75.0345	36.6054	55.9142	0	0.19916	0.2	0.2	24.895	0.2	0.1	0.2	0.2	0.2	0.2	5.4769	24.895	24.895	24.895	25	14.937	0.2	0	0	0	0	72.4	0	0	0	0	0	0										6.9325	0.157695391	5.659953399	0	1.991023368	3.79549623	2.53033082	0.304529789	4.569405965	1.069272007	4.646149848	0.219124559	0.004	7.393735405	1.644470962	5.60270954	0.420105699	3.6948649	10.05245978	4.646005709	4.539511023	0	0	0	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5267		0.122073051	6.9325	0.157695391	5.659953399	0	1.991023368	3.79549623	2.53033082	0.304529789	4.569405965	1.069272007	4.646149848	0.219124559	0.004	7.393735405	1.644470962	5.60270954	0.420105699	3.6948649	10.05245978	4.646005709	4.539511023	0	0	0	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5267	3250																																																																																			0			6.9325	0.157695391	5.659953399	0	1.991023368	3.79549623	2.53033082	0.304529789	4.569405965	1.069272007	4.646149848	0.219124559	0.004	7.393735405	1.644470962	5.60270954	0.420105699	3.6948649	10.05245978	4.646005709	4.539511023	0	0	0	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5267
H0979_007_0	2008	11	s.										Professional (Non-Covered)											Physical Exams										D	D	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin			P	V	V	V	V				V																																																			0		1108.682897	51.69584848	1214.708915	342.3184193	9.997104681	18.9775	12.6517	146.7908202	22.847	10.6927	23.2307	1.0956	0.02	36.9687	3603.069537	2700.643281	202.5012407	1781.015417	4825.1807	3732.480987	22.6976	0	0	425	508.95	274.05	80	20	0	0	0	59.60473218										$100 for 1st 7 days	$100 for 1st 7 days	$90 for days 6-100	$0 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	$25 per visit	20% Coinsurance	10% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$5 per Visit / $15 Urg Care	$25 per Visit	$25 per Visit	$25 per Visit	$25 per Visit	$15 per Visit	20% Coinsurance	0	0	$0-$75 ($25 Average)	$0 - 1 / Year ($3.85 Cap)	$0 - up to $100 ($3.85 Cap)	$0 (1 / 3 Years)	$500 allowable/hearing aid				$0 / 1 per year										75.0345	36.6054	55.9142	0	0.19916	0.2	0.2	24.895	0.2	0.1	0.2	0.2	0.2	0.2	5.4769	24.895	24.895	24.895	25	14.937	0.2	0	0	24.895	0	72.4	0	0	0	0	0	0										6.9325	0.157695391	5.659953399	0	1.991023368	3.79549623	2.53033082	0.304529789	4.569405965	1.069272007	4.646149848	0.219124559	0.004	7.393735405	1.644470962	5.60270954	0.420105699	3.6948649	10.05245978	4.646005709	4.539511023	0	0	0.881697917	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.4084		0.122073051	6.9325	0.157695391	5.659953399	0	1.991023368	3.79549623	2.53033082	0.304529789	4.569405965	1.069272007	4.646149848	0.219124559	0.004	7.393735405	1.644470962	5.60270954	0.420105699	3.6948649	10.05245978	4.646005709	4.539511023	0	0	0.881697917	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.4084	3250																																																																																			0			6.9325	0.157695391	5.659953399	0	1.991023368	3.79549623	2.53033082	0.304529789	4.569405965	1.069272007	4.646149848	0.219124559	0.004	7.393735405	1.644470962	5.60270954	0.420105699	3.6948649	10.05245978	4.646005709	4.539511023	0	0	0.881697917	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.4084
H1013_011_0	2008	6																																D		D					V	V		V		V	V							S			P																																																											0				1085.475872					218.1557819	94.65298397		69.5282543		0	98.4748854							795.5297259			701.3173445																		$0 copay	$0 copay	$40 per day (days 8 through 100)  PBP L.2	$0 copay	$0 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$100 copay @ Hospital PBP L.9a	Included in OP-Facility Other	$50 copay @ Hospital PBP L.8a/8b	$0 copay	$25 copay @ Hospital PBP L.12	"$25 copay @ Hospital PBP L.9a, 8a, 7c, 7j"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $50 copay Other Part B	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay													24.23032568					50	100		50		25	25							80.72910455			85.2110681																		0	0	2.191786158	0	0	0	0	0.908982425	0.788774866	0	0.28970106	0	0	0.205156011	0	0	0	0	0	0	5.351866868	0	0	4.98	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.7163			0	0	2.191786158	0	0	0	0	0.908982425	0.788774866	0	0.28970106	0	0	0.205156011	0	0	0	0	0	0	5.351866868	0	0	4.98	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.7163																																																																																				0			0	0	2.191786158	0	0	0	0	0.908982425	0.788774866	0	0.28970106	0	0	0.205156011	0	0	0	0	0	0	5.351866868	0	0	4.98	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.7163
H1013_021_0	2008	5																																D		D					V	V		V		V	V		V					S			P																																																											0		1539.637187		852.0854114					358.0376608	96.34197657		1618.834292		2.010347224	159.0594931		5759.78501					960.9399251			701.3173445																		$50 copay (days 1-10)	$0 copay	$50 per day (days 8 through 100)  PBP L.2	$0 copay	$0 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$150 copay @ Hospital PBP L.9a	Included in OP-Facility Other	$150 copay @ Hospital PBP L.8a/8b; $50 @ Freestanding	$0 copay	$100 copay @ Hospital PBP L.12; $25 copay @ Freestanding facility	"$50 copay @ Hospital PBP L.9a, 8a, 7c, 7j"	$0 copay	$15 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $50 copay Other Part B	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											43.50447652		30.28790711		0			50	150		53.90037929		34.12302495	50		15					82.46499897			85.29530667																		5.5818	0	2.150656982	0	0	0	0	1.491823587	1.204274707	0	7.271315197	0	0.005716594	0.662747888	0	7.199731262	0	0	0	0	6.603659161	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.1566			5.5818	0	2.150656982	0	0	0	0	1.491823587	1.204274707	0	7.271315197	0	0.005716594	0.662747888	0	7.199731262	0	0	0	0	6.603659161	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.1566																																																																																				0			5.5818	0	2.150656982	0	0	0	0	1.491823587	1.204274707	0	7.271315197	0	0.005716594	0.662747888	0	7.199731262	0	0	0	0	6.603659161	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.1566
H1013_022_0	2008	4																																D		D		T			V	V		V		V	V		V					S			P																																																											0		1832.529072		775.1534254		269.8547409			256.0454656	76.67591725		52.81302888		4.126499716	155.0171176		6007.358538					348.693424			701.3173445																		$50 copay (days 1-5; Tier 1)	$0 copay	$55 per day (days 8 through 34)  PBP L.2	$0 copay	$100 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$250 copay @ Hospital	Included in OP-Facility Other	$175 copay @ Hospital PBP L.8a/8b	$0 copay	$100 copay @ Hospital PBP L.12; $25 copay @ Dialysis Center	"$50 copay @ Hospital PBP L.9a, 8a, 7c, 7j"	$0 copay	$20 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $40 copay Other Part B	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											34.34587977		29.02334274		100			50	250		175		25	50		20					61.43161879			85.29530667																		5.245	0	1.874795295	0	2.248789507	0	0	1.066856107	1.597414943	0	0.770190005	0	0.008596874	0.645904657	0	10.01226423	0	0	0	0	1.785066792	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2398			5.245	0	1.874795295	0	2.248789507	0	0	1.066856107	1.597414943	0	0.770190005	0	0.008596874	0.645904657	0	10.01226423	0	0	0	0	1.785066792	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2398																																																																																				0			5.245	0	1.874795295	0	2.248789507	0	0	1.066856107	1.597414943	0	0.770190005	0	0.008596874	0.645904657	0	10.01226423	0	0	0	0	1.785066792	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2398
H1013_023_0	2008	4																																D		D		T			V	V		V		V	V		V					S			P																																																											0		2012.58793		940.3924472		296.558151			266.6261084	80.04942208		2005.306826		5.006143351	125.8918481		5822.936282					376.979607			701.3173445																		$50 copay (days 1-5; Tier 1); $300 copay (days 1-5; Tier 2)	$0 copay	$50 per day (days 8 through 100)  PBP L.2	$0 copay	$25 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$150 copay @ Hospital	Included in OP-Facility Other	$200 copay @ Hospital PBP L.8a/8b; $50 @ Freestanding diagnostic center	$0 copay	$100 copay @ Hospital PBP L.12; $25 copay @ Dialysis Center	"$50 copay @ Hospital PBP L.9a, 8a, 7c, 7j"	$0 copay	$20 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $40 copay Other Part B	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											206.0752786		30.28790711		25			50	150		54.19761369		25	50		20					64.04929433			85.29530667																		34.5621	0	2.373543257	0	0.617829481	0	0	1.110942118	1.000617776	0	9.056903723	0	0.010429465	0.524549367	0	9.704893804	0	0	0	0	2.012106484	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.9588			34.5621	0	2.373543257	0	0.617829481	0	0	1.110942118	1.000617776	0	9.056903723	0	0.010429465	0.524549367	0	9.704893804	0	0	0	0	2.012106484	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.9588																																																																																				0			34.5621	0	2.373543257	0	0.617829481	0	0	1.110942118	1.000617776	0	9.056903723	0	0.010429465	0.524549367	0	9.704893804	0	0	0	0	2.012106484	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.9588
H1013_024_0	2008	4																																																							P																																																											0																									2100.591872																		$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay																																		23.60651183																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.132303906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1323			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.132303906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1323																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.132303906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1323
H1016_001_0	2008	9																					2000											D	D	D	P	T	Coin	P	V	V	P	P	V	P	P	V	V	V	V	P	P	S	V	T	V	V	P	V	P	P	V	V																																																				0		1579.64909	0.25264906	915.1304749		301.9040357	0.01974087		239.6496573	418.7220276		1351.759997			8.421720385		10247.36853	3.407194823	1274.41403			1586.391676	17.03597412			159.2493233																	"$150/Day for Days 1-5, unlimited days, $2,000 OOPM"	"$150/Day for Days 1-5, $2,000 OOPM"	"$100 for Days 15-100, $2,000 OOPM"	No Cost Sharing	$100/Trip	20% Coinsurance	$15/Item for Diabetes Supplies Only	$50 per ER Visit; $25 per Urgent Care Visit	$100/$50 Per Episode	No Cost Sharing	$50/$25 Complex/Simple	No Cost Sharing	No Cost Sharing	"$15 Copayment for Cardiac Rehab and CORF; $10Group MH, $15 Ind. MH"	$0/Visit Copayment	$15/Visit Copayment	$15/Visit Copayment for Individual; $10/Visit Copayment for Group	$15/Visit Copayment	No Cost Sharing	No Cost Sharing	$15/Script	$15 for Nutrition Therapy	Not Covered	Not Covered	$15/Visit Copayment	$10/Pair	Not Covered	Not Covered	N/A	Not Covered	Not Covered											61.0701	63.7216	50.1885		100	0.2		49.6455	80.44		37.17			15		15	14.5	15			15	13.4783			15																	8.0391	0.0013416	3.827416836	0	2.515866964	0.003948174	0	0.991460576	2.806833325	0	4.187076589	0	0	0.01052715	0	12.80921066	0.004117027	1.593017538	0	0	1.982989595	0.019134609	0	0	0.199061654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9911	0	0.619901759	8.0391	0.0013416	3.827416836	0	2.515866964	0.003948174	0	0.991460576	2.806833325	0	4.187076589	0	0	0.01052715	0	12.80921066	0.004117027	1.593017538	0	0	1.982989595	0.019134609	0	0	0.199061654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9911																																																																																				0	0	0	8.0391	0.0013416	3.827416836	0	2.515866964	0.003948174	0	0.991460576	2.806833325	0	4.187076589	0	0	0.01052715	0	12.80921066	0.004117027	1.593017538	0	0	1.982989595	0.019134609	0	0	0.199061654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9911
H1016_002_0	2008	9																					1700											D	D	D	P	T	Coin	P	V	V	P	P	V	P	P	V	V	V	V	P	P	S	V	T	V	V	P	V	P	P	V	V																																																				0		1388.459985	0.93002973	697.1701002		348.598373	0.003622476		333.8344777	442.175481		1371.585086			132.449886		5080.138005	243.4718841	1189.596817			1266.180408	28.16414171			143.4819258																	"$250/Day for Days 1-10, unlimited days,$1,700 OOPM"	"$250/Day for Days 1-10, unlimited days, $1,700 OOPM"	"$125 for Days 10-100, $1,700 OOPM"	No Cost Sharing	$100/Trip	20%/Device	$25/Item for Diabetes Supplies Only	$50 per ER Visit; $25 per Urgent Care Visit	$200/$50 Per Episode	No Cost Sharing	$50/$25 Complex/Simple	No Cost Sharing	No Cost Sharing	$25 Copayment for Cadiac Rehab and CORF; $25/$15 Copayment for OP MH Ind/Grp	$0/Visit Copayment	$25/Visit Copayment	$25/Visit Copayment for Individual; $15/Visit Copayment for Group	$25/Visit Copayment	No Cost Sharing	No Cost Sharing	$25/Script	$25 for Nutrition Therapy	Not Covered	Not Covered	$25/Visit Copayment	$10/Pair (1 pair per year limit)	Not Covered	Not Covered	N/A	Not Covered	Not Covered											134.6036	142.15	70.4846		100	0.2		48.7552	141.33		37.14			24.0809		25	24	25			25	14.1796			25																	15.5743	0.011016979	4.094982172	0	2.904986442	0.000724495	0	1.356348589	5.207721727	0	4.24505584	0	0	0.265792601	0	10.58362084	0.486943768	2.478326702	0	0	2.63787585	0.03327961	0	0	0.298920679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1799	0	3.321351489	15.5743	0.011016979	4.094982172	0	2.904986442	0.000724495	0	1.356348589	5.207721727	0	4.24505584	0	0	0.265792601	0	10.58362084	0.486943768	2.478326702	0	0	2.63787585	0.03327961	0	0	0.298920679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1799																																																																																				0	0	0	15.5743	0.011016979	4.094982172	0	2.904986442	0.000724495	0	1.356348589	5.207721727	0	4.24505584	0	0	0.265792601	0	10.58362084	0.486943768	2.478326702	0	0	2.63787585	0.03327961	0	0	0.298920679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1799
H1016_017_0	2008	9																																D	D	D	P	T	Coin	P	V	V	P	P	V	P	P	V	V	V	V	P	P	S	V	T	V	V	P	V	P	P	V	V																																																				0						348.598373	0.003622476		333.8344777	442.175481		1371.585086			132.449886		5080.138005	243.4718841	1189.596817			1266.180408	28.16414171			143.4819258																				No Cost Sharing	$100/Trip	20%/Device	$25/Item for Diabetes Supplies Only	$50 per ER Visit; $25 per Urgent Care Visit	$200/$50 Per Episode	No Cost Sharing	$50/$25 Complex/Simple	No Cost Sharing	No Cost Sharing	$25 Copayment for Cadiac Rehab and CORF; $25/$15 Copayment for OP MH Ind/Grp	$0/Visit Copayment	$25/Visit Copayment	$25/Visit Copayment for Individual; $15/Visit Copayment for Group	$25/Visit Copayment	No Cost Sharing	No Cost Sharing	$25/Script	$25 for Nutrition Therapy	Not Covered	Not Covered	$25/Visit Copayment	$10/Pair (1 pair per year limit)	Not Covered	Not Covered	N/A	Not Covered	Not Covered															100	0.2		48.7552	141.33		37.14			24.0809		25	24	25			25	14.1796			25																	0	0	0	0	2.904986442	0.000724495	0	1.356348589	5.207721727	0	4.24505584	0	0	0.265792601	0	10.58362084	0.486943768	2.478326702	0	0	2.63787585	0.03327961	0	0	0.298920679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.4996	0	0	0	0	0	0	2.904986442	0.000724495	0	1.356348589	5.207721727	0	4.24505584	0	0	0.265792601	0	10.58362084	0.486943768	2.478326702	0	0	2.63787585	0.03327961	0	0	0.298920679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.4996																																																																																				0	0	0	0	0	0	0	2.904986442	0.000724495	0	1.356348589	5.207721727	0	4.24505584	0	0	0.265792601	0	10.58362084	0.486943768	2.478326702	0	0	2.63787585	0.03327961	0	0	0.298920679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.4996
H1019_001_0	2008	4	s.	t.	u.								Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																			D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0								0		1537.16	8.14	886.5	27.39	341.26	366.75	2252.25	294.47	221.48	1854.41	2267.56		37.07	1930.02	6902.74	4652.26	8.66	1366.27			11674.47			3.28	2.25		0.33			0.02	1.5	1.19	0.06	4.77								$0/Day(Days 1-5)	$0/Day(Days 1-5)	$0/Day(Days 1-13) $25(Days 14-100)	$0/Visit	$50/Trip			$50/Visit	$50-$75/Visit	$0/Visit	$0-$25/Visit		$0-$5/Proc	$0-$25/Visit	$0/Visit	$5/Visit	$20/Visit	$0/Visit			$0/Script			DEN 731	VIS 140		HER 751			QuitNet	24 1 way	Silver Sneakers	Meals on Wheels	$25 OTC per Month								0	0	10.352854	0	50.000012	0	0	50.000006	61.494781	0	4.926615		2.664502	0.608112	0	5.000001	20.000036	0			0			0	0		0			0	0	0	0	0								0	0	0.764817089	0	1.421917008	0	0	1.226958481	1.134988675	0	0.930949592	0	0.008231091	0.097805694	0	1.938442054	0.014433359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.5385	0	0	0	0	0.764817089	0	1.421917008	0	0	1.226958481	1.134988675	0	0.930949592	0	0.008231091	0.097805694	0	1.938442054	0.014433359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.5385																																																																																				0	0	0	0	0	0.764817089	0	1.421917008	0	0	1.226958481	1.134988675	0	0.930949592	0	0.008231091	0.097805694	0	1.938442054	0.014433359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.5385
H1019_002_0	2008	4	s.	t.	u.	v.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1573.46	5.94	718.67	86.52	294.87	316.14	1675.32	191.58	182.77	1660.9	2514.86		25.37	2275.88	6931.29	4660.12	9.92	1515.92			4523.9			3.3	2.61		0.33			0.02	3	1.19	0.06	1.53	5.67							$0/Day(Days 1-1)	$0/Day(Days 1-1)	$0/Day(Days 1-13) $25(Days 14-100)	$0/Visit	$50/Trip			$50/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0-$25/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			$0/Script			DEN 725	VIS 140		HER 751			QuitNet	40 1 way	Silver Sneakers	Meals on Wheels	6 Visits per Year	$25 OTC per Month							0	0	10.352853	0	49.999988	0	0	49.999978	0	0	0		0	2.433617	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0	0	0.620023739	0	1.228624705	0	0	0.798249649	0	0	0	0	0	0.461551688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.1084	0	0	0	0	0.620023739	0	1.228624705	0	0	0.798249649	0	0	0	0	0	0.461551688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.1084																																																																																				0	0	0	0	0	0.620023739	0	1.228624705	0	0	0.798249649	0	0	0	0	0	0.461551688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.1084
H1019_004_0	2008	5	s.	t.									Health & Education (Non-Covered)	Other Non-Covered																				D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0									0		1314.75	6.96	758.23	23.43	291.88	313.68	1926.39	251.86	189.43	1586.1	1939.48		31.71	1650.78	5904.02	3979.15	7.4	1168.6			9985.35			2.09	0.97		0.33			0.02	0.06	1.81	1.52									$195/Day(Days 1-7)	$195/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip			$50/Visit	$75-$100/Visit	$0/Visit	$0-$50/Visit		$0/Proc	$0-$50/Visit	$0/Visit	$0/Visit	$20/Visit	$0/Visit			$0/Script			DEN 726	VIS 116		HER 751			QuitNet	Meals on Wheels	Silver Sneakers	$25 OTC per Quarter									146.146451	146.146454	28.712572	0	100.000008	0	0	50.000007	86.494785	0	9.853228		0	0.76345	0	0	19.999249	0			0			0	0		0			0	0	0	0									16.0122	0.084764943	1.814227789	0	2.432333528	0	0	1.049416814	1.36539226	0	1.592511553	0	0	0.105023999	0	0	0.01233287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.4682	0	0	16.0122	0.084764943	1.814227789	0	2.432333528	0	0	1.049416814	1.36539226	0	1.592511553	0	0	0.105023999	0	0	0.01233287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.4682																																																																																				0	0	0	16.0122	0.084764943	1.814227789	0	2.432333528	0	0	1.049416814	1.36539226	0	1.592511553	0	0	0.105023999	0	0	0.01233287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.4682
H1019_005_0	2008	5	s.	t.									Health & Education (Non-Covered)	Other Non-Covered																				D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0									0		1346.89	5.09	615.18	74.06	252.41	270.61	1434.07	164	156.45	1421.73	2152.72		21.72	1948.16	5933.19	3989.06	8.49	1297.63			3872.46			2.09	0.97		0.33			0.02	0.06	2.26	6.9									$150/Day(Days 1-7)	$150/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip			$50/Visit	$50-$100/Visit	$0/Visit	$0-$50/Visit		$0/Proc	$0-$50/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			$0/Script			Dental	VIS 116		HER 751			QuitNet	Meals on Wheels	Silver Sneakers	$25 per Month									112.420351	112.420298	28.712566	0	99.999992	0	0	50.000009	75.762831	0	10.557001		0	0.169914	0	0	0	0			0			0	0		0			0	0	0	0									12.6182	0.047684943	1.471949696	0	2.103416498	0	0	0.683333456	0.987757909	0	1.893855599	0	0	0.027584972	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.8337	0	0	12.6182	0.047684943	1.471949696	0	2.103416498	0	0	0.683333456	0.987757909	0	1.893855599	0	0	0.027584972	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.8337																																																																																				0	0	0	12.6182	0.047684943	1.471949696	0	2.103416498	0	0	0.683333456	0.987757909	0	1.893855599	0	0	0.027584972	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.8337
H1019_006_0	2008	4	s.	t.	u.	v.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1786.83	6.75	816.12	98.25	334.86	359	1902.49	217.56	207.55	1886.12	2855.88		28.81	2584.49	7871.17	5292.02	11.26	1721.48			5137.34			3.3	3.24		0.33			0.02	0.06	0.38	2.55	4.89	8.73							$0/Day(Days 1-1)	$0/Day(Days 1-1)	$0/Day(Days 1-13) $25(Days 14-100)	$0/Visit	$50/Trip			$50/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			$0/Script			DEN 731	VIS CAC		HER 751			QuitNet	Meals on Wheels	Silver Sneakers	10 Visits per Year	Unlimited	$25 OTC per Month							0	0	10.352854	0	49.999998	0	0	49.999993	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0	0	0.704097601	0	1.395249944	0	0	0.906499873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.0058	0	0	0	0	0.704097601	0	1.395249944	0	0	0.906499873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.0058																																																																																				0	0	0	0	0	0.704097601	0	1.395249944	0	0	0.906499873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.0058
H1019_010_0	2008	4	s.	t.	u.								Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																			D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0								0		1352.52	4.14	1153.1	17.67	285.08	340.96	2593.48	246.07	184.82	2033.8	2808.19		27.88	1845.97	6934.63	4646.83	7.11	2135.98			5151.03			3.3	2.25		0.33			0.02	1.5	1.19	0.06	6.24								$50/Day(Days 1-10)	$50/Day(Days 1-10)	$0/Day(Days 1-6) $50(Days 7-100)	$0/Visit	$100/Trip			$50/Visit	$0-$50/Visit	$0/Visit	$0/Visit		$0-$5/Proc	$0-$100/Visit	$0/Visit	$5/Visit	$20/Visit	$10/Visit			$0/Script			DEN 731	VIS 140		HER 751			QuitNet	24 1 way	Silver Sneakers	Meals on Wheels	$25 per Month OTC								41.786995	41.787261	36.4663	0	99.999988	0	0	49.999994	21.440472	0	0		2.770698	9.643411	0	4.999999	19.999589	10.000001			0			0	0		0			0	0	0	0	0								4.7098	0.014416605	3.504107544	0	2.375666382	0	0	1.025291544	0.330219003	0	0	0	0.006437255	1.48345395	0	1.936178779	0.011849756	1.779983511	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.1774	0	0	4.7098	0.014416605	3.504107544	0	2.375666382	0	0	1.025291544	0.330219003	0	0	0	0.006437255	1.48345395	0	1.936178779	0.011849756	1.779983511	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.1774																																																																																				0	0	0	4.7098	0.014416605	3.504107544	0	2.375666382	0	0	1.025291544	0.330219003	0	0	0	0.006437255	1.48345395	0	1.936178779	0.011849756	1.779983511	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.1774
H1019_011_0	2008	5	s.	t.									Health & Education (Non-Covered)	Other Non-Covered																				D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0									0		1088.07	3.33	927.64	14.21	229.34	274.3	2086.39	197.96	148.68	1636.14	2259.12		22.43	1485.04	5578.73	3738.25	5.72	1718.34			4143.87			3.3	2.25		0.33			0.02	0.06	1.81	0.95									$150/Day(Days 1-7)	$150/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip			$50/Visit	$50-$100/Visit	$20/Visit	$20/Visit		$0-$15/Proc	$0-$100/Visit	$0/Visit	$15/Visit	$15/Visit	$20/Visit			$0/Script			DEN 731	VIS		HER 751			QuitNet	Meals on Wheels	Silver Sneakers	$25 OTC per Quarter									112.420355	112.420161	28.712565	0	100.000017	19.999988	19.999996	50.000019	71.440404	20.000002	20.000002		8.312303	19.511767	0	15	14.999357	20.000001			0			0	0		0			0	0	0	0									10.1934	0.031196595	2.219576983	0	1.911166992	0.457166392	3.477315971	0.824833647	0.885146606	2.726900273	3.765200377	0	0.01553708	2.414646205	0	4.6728125	0.007149694	2.863900143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.466	0	0	10.1934	0.031196595	2.219576983	0	1.911166992	0.457166392	3.477315971	0.824833647	0.885146606	2.726900273	3.765200377	0	0.01553708	2.414646205	0	4.6728125	0.007149694	2.863900143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.466																																																																																				0	0	0	10.1934	0.031196595	2.219576983	0	1.911166992	0.457166392	3.477315971	0.824833647	0.885146606	2.726900273	3.765200377	0	0.01553708	2.414646205	0	4.6728125	0.007149694	2.863900143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.466
H1019_014_0	2008	4	s.	t.									Other Non-Covered	Other Non-Covered																				D	D	D	V	T	O	Coin	V	V	V	V		P	V	V	V	V	V			S		T	Coin	V		V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0		0	0	0		0			0	0	0	0									0		1191.18	11.67	740.41	439.5	199.57	200.3	1.2	224.69	197.07	1436.77	2121.62		16.1	1528.98	5780.67	3868.5	10.29	1111.66			13800.9		1.2	2.32	2.4		0.33			1.91	0.02	0.06	0.81									$75/Day(Days 1-5)	$75/Day(Days 1-5)	$0/Day(Days 1-9) $50(Days 10-100)	$0/Visit	$100/Trip		20% Coins	$50/Visit	$25-$50/Visit	$0/Visit	$0-$25/Visit		$0-$50/Proc	$0-$50/Visit	$0/Visit	$15/Visit	$25-$100/Visit	$30/Visit			$0/Script		16 1 Way	Dental	Vision		HER 751			Silver Sneakers	QuitNet	Meals on Wheels	$25 per Quarter OTC Mail Order									48.752848	48.753218	28.130295	0	100.000026	0	0.2	50.000025	35.150879	0	16.764194		30.671906	17.33729	0	15.000001	99.61314	30.000004			0		0	0	0		0			0	0	0	0									4.8395	0.047412505	1.735662643	0	1.663083766	0	0.24	0.936208801	0.57726531	0	2.96393744	0	0.041151474	2.209030805	0	4.835625322	0.085418268	2.779150371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.9534	0	0	4.8395	0.047412505	1.735662643	0	1.663083766	0	0.24	0.936208801	0.57726531	0	2.96393744	0	0.041151474	2.209030805	0	4.835625322	0.085418268	2.779150371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.9534																																																																																				0	0	0	4.8395	0.047412505	1.735662643	0	1.663083766	0	0.24	0.936208801	0.57726531	0	2.96393744	0	0.041151474	2.209030805	0	4.835625322	0.085418268	2.779150371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.9534
H1019_021_0	2008	3	s.										Other Non-Covered																					D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0										0		1142.44	3.5	974	14.93	240.8	288	2190.65	207.85	156.11	1717.9	2372.01		23.55	1559.25	5857.51	3925.05	6.01	1804.2			4350.94			2.09	2.25		0.33			2.55	0.02	0.06										$200/Day(Days 1-10)	$200/Day(Days 1-7)	$0/Day(Days 1-6) $75(Days 7-100)	$0/Visit	$100/Trip			$50/Visit	$50-$100/Visit	$0-$100/Visit	$0-$100/Visit		$0-$20/Proc	$20-$100/Visit	$0/Visit	$20/Visit	$20/Visit	$50/Visit			$0/Script			Dental	VIS 140		HER 751			Silver Sneakers	QuitNet	Meals on Wheels										167.147998	149.893481	54.69945	0	99.999985	19.999993	20	50.000028	71.440476	11.643258	43.621091		11.083275	69.072809	0	20	20.000496	50.000002			0			0	0		0			0	0	0										15.913	0.043718932	4.439772025	0	2.006666366	0.479999832	3.651083333	0.866042152	0.929381059	1.66682941	8.622472005	0	0.021750927	8.975148119	0	6.54175	0.010016915	7.517500301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6852	0	0	15.913	0.043718932	4.439772025	0	2.006666366	0.479999832	3.651083333	0.866042152	0.929381059	1.66682941	8.622472005	0	0.021750927	8.975148119	0	6.54175	0.010016915	7.517500301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6852																																																																																				0	0	0	15.913	0.043718932	4.439772025	0	2.006666366	0.479999832	3.651083333	0.866042152	0.929381059	1.66682941	8.622472005	0	0.021750927	8.975148119	0	6.54175	0.010016915	7.517500301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6852
H1019_023_0	2008	5	s.	t.	u.	v.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1573.85	8.33	907.66	28.05	349.4	375.5	2306.02	301.5	226.77	1898.68	2321.7		37.95	1976.1	7067.53	4763.33	8.86	1398.89			11953.18			3.3	2.25		1.14			0.02	0.06	3.56	2.91	3	53.33							$0/Day(Days 1-10)	$0/Day(Days 1-10)	$0/Day(Days 1-100) $0(Days 100-100)	$0/Visit	$0/Trip			$25/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			$0/Script			DEN 731	VIS 140		HER 759			QuitNet	Meals on Wheels	Silver Sneakers	$30 OTC per Monthly	48 1 way	8 Meals per Month							0	0	0	0	0	0	0	24.999985	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0	0	0	0	0	0	0	0.628124623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.6281	0	0	0	0	0	0	0	0	0	0.628124623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.6281																																																																																				0	0	0	0	0	0	0	0	0	0	0.628124623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.6281
H1019_024_0	2008	6	s.	t.	u.	v.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1761.36	6.65	804.49	96.85	330.09	353.89	1875.38	214.46	204.59	1859.24	2815.18		28.4	2547.66	7759.01	5216.62	11.1	1696.95			5064.14			3.3	2.61		0.33			0.02	3.28	3.56	0.06	8.13	80							$0/Day(Days 1-1)	$0/Day(Days 1-1)	$0/Day(Days 1-100) $0(Days 100-100)	$0/Visit	$0/Trip			$25/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			$0/Script			DEN 731	Vision		HER 751			QuitNet	40 1 way	Silver Sneakers	Meals on Wheels	$25 per Month	12 Meals per Month							0	0	0	0	0	0	0	25.00002	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0	0	0	0	0	0	0	0.446792024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4468	0	0	0	0	0	0	0	0	0	0.446792024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4468																																																																																				0	0	0	0	0	0	0	0	0	0	0.446792024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4468
H1019_025_0	2008	5	s.	t.	u.	v.							Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1415.54	4.33	1206.83	18.49	298.36	356.85	2714.33	257.54	193.43	2128.57	2939.04		29.18	1931.99	7257.76	4863.35	7.44	2235.5			5391.05			2.32	2.25		0.33			3.56	1	0.02	0.06	2.1	60							$0/Day(Days 1-1)	$0/Day(Days 1-1)	$0/Day(Days 1-100) $0(Days 100-100)	$0/Visit	$0/Trip			$25/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			$0/Script			DEN	VIS 140		HER 751			Silver Sneakers	16 1 way	QuitNet	Meals on Wheels	$25 OTC per Month	9 Meals per Month							0	0	0	0	0	0	0	24.999978	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0	0	0	0	0	0	0	0.536541195	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5365	0	0	0	0	0	0	0	0	0	0.536541195	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5365																																																																																				0	0	0	0	0	0	0	0	0	0	0.536541195	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5365
H1019_026_0	2008	6	s.	t.									Other Non-Covered	Other Non-Covered																				D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S		T	Coin	V		V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0		0	0	0		0			0	0	0	0									0		1258.48	12.33	782.24	464.33	210.84	211.61	3574.9	237.38	208.21	1517.94	2241.48		17.01	1615.35	6107.24	4087.05	10.88	1174.47			14580.57		1	3.28	2.4		0.33			3.58	0.06	0.81	53.33									$0/Day(Days 1-1)	$0/Day(Days 1-1)	$0/Day(Days 1-100) $0(Days 100-100)	$0/Visit	$0/Trip			$25/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			$0/Script		16 1 Way	DEN	VIS		HER 751			Missing Description	Missing Description	$25 per Quarter OTC Mail Order	8 Meals									0	0	0	0	0	0	0	24.999977	0	0	0		0	0	0	0	0	0			0		0	0	0		0			0	0	0	0									0	0	0	0	0	0	0	0.494541212	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4945	0	0	0	0	0	0	0	0	0	0.494541212	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4945																																																																																				0	0	0	0	0	0	0	0	0	0	0.494541212	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4945
H1019_027_0	2008	4	s.	t.									Health & Education (Non-Covered)	Other Non-Covered																				D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin		T	Coin	V		V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0		0	0	0		0			0	0	0	0									0		1438.36	6.18	797.09	51.54	195.78	2.23	0.98	253.21	262.91	2097.04	2357.13		15.47	1703.61	5919.18	3975.84	7.12	1351.46			12.41		1.01	2.32	1.05		0.33			0.02	0.06	3.05	0.8									$125/Day(Days 1-7)	$125/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$50-$75/Visit	$0/Visit	$0-$100/Visit		$0-$100/Proc	$25-$150/Visit	$0/Visit	$25/Visit	$25-$100/Visit	$100/Visit			20% Coins		12 1 Way	Dental	VIS 110 Allowance		HER 751			QuitNet	Meals on Wheels	Silver Sneakers	$25 per Quarter Mail Order OTC									93.683628	93.68271	28.712565	0	100.000015	0.2	0.2	50.000015	60.15321	0	91.051059		88.383677	100.333967	0	25	96.048564	99.999998			0.2		0	0	0		0			0	0	0	0									11.2292	0.048246596	1.907208203	0	1.631500245	0.446	0.196	1.055041983	1.317906703	0	17.88493189	0	0.11394129	14.24416246	0	8.283	0.056988815	11.26216644	0	0	2.482	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1583	0	0	11.2292	0.048246596	1.907208203	0	1.631500245	0.446	0.196	1.055041983	1.317906703	0	17.88493189	0	0.11394129	14.24416246	0	8.283	0.056988815	11.26216644	0	0	2.482	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1583																																																																																				0	0	0	11.2292	0.048246596	1.907208203	0	1.631500245	0.446	0.196	1.055041983	1.317906703	0	17.88493189	0	0.11394129	14.24416246	0	8.283	0.056988815	11.26216644	0	0	2.482	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1583
H1019_028_0	2008	6	s.	t.	u.	v.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1512.6	6.5	838.24	54.2	205.88	2.47	3158.88	266.28	276.48	2205.28	2478.8		16.27	1791.55	6224.72	4181.08	7.49	1421.22			13.72			2.32	1.05		0.33			0.02	1.01	3.05	0.06	0.8	53.33							$125/Day(Days 1-7)	$125/Day(Days 1-7)	$0/Day(Days 1-6) $100(Days 7-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$50-$75/Visit	$0/Visit	$0-$100/Visit		$0-$100/Proc	$25-$150/Visit	$0/Visit	$25/Visit	$25-$100/Visit	$100/Visit			20% Coins			Dental	VIS 110 Allowance		HER 751			QuitNet	16 1 Way	Silver Sneakers	Meals on Wheels	$25 per Quarter Mail Order OTC	8 Meals per Month							93.683624	93.684024	72.932596	0	100	0	0	49.999988	60.153188	0	91.051063		88.383585	100.333965	0	25	96.047232	99.999997			0.2			0	0		0			0	0	0	0	0	0							11.8088	0.050745513	5.094584939	0	1.715666667	0	0	1.109499734	1.385929452	0	18.80811458	0	0.119833411	14.97944292	0	8.710583333	0.059949481	11.84349964	0	0	2.744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4307	0	0	11.8088	0.050745513	5.094584939	0	1.715666667	0	0	1.109499734	1.385929452	0	18.80811458	0	0.119833411	14.97944292	0	8.710583333	0.059949481	11.84349964	0	0	2.744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4307																																																																																				0	0	0	11.8088	0.050745513	5.094584939	0	1.715666667	0	0	1.109499734	1.385929452	0	18.80811458	0	0.119833411	14.97944292	0	8.710583333	0.059949481	11.84349964	0	0	2.744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4307
H1019_029_0	2008	4	s.	t.	u.	v.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1682.5	7.23	932.38	60.28	229.01	3.06	1.35	296.18	307.53	2452.98	2757.22		18.1	1992.78	6923.87	4650.69	8.33	1580.85			16.98			2.32	1.05		0.33			0.02	0.99	3.05	1.01	0.06	0.8							$200/Day(Days 1-7)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$50-$75/Visit	$0/Visit	$0-$100/Visit		$0-$100/Proc	$25-$150/Visit	$0/Visit	$0-$25/Visit	$25-$100/Visit	$100/Visit			20% Coins			Dental	VIS 110 Allowance		HER 751			QuitNet	Unlimited Podiatry	Silver Sneakers	12 1 Way	Meals on Wheels	$25 per Quarter Mail Order OTC							149.8938	130.007865	28.71257	0	100.000013	0.199999	0.2	49.999983	60.153161	0	91.051059		88.383223	100.333965	0	24.865393	96.048018	99.999996			0.199999			0	0		0			0	0	0	0	0	0							21.0164	0.078329739	2.230918835	0	1.908416915	0.61199694	0.27	1.234082914	1.541575134	0	20.92065007	0	0.133311361	16.6619599	0	9.636769548	0.066673332	13.17374947	0	0	3.39598302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.8808	0	0	21.0164	0.078329739	2.230918835	0	1.908416915	0.61199694	0.27	1.234082914	1.541575134	0	20.92065007	0	0.133311361	16.6619599	0	9.636769548	0.066673332	13.17374947	0	0	3.39598302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.8808																																																																																				0	0	0	21.0164	0.078329739	2.230918835	0	1.908416915	0.61199694	0.27	1.234082914	1.541575134	0	20.92065007	0	0.133311361	16.6619599	0	9.636769548	0.066673332	13.17374947	0	0	3.39598302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.8808
H1019_030_0	2008	4	s.	t.									Health & Education (Non-Covered)	Other Non-Covered																				D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin		T	Coin	V		V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0		0	0	0		0			0	0	0	0									0		1473.91	6.34	816.79	52.81	200.62	2.35	1.03	259.46	269.4	2148.87	2415.39		15.85	1745.72	6065.48	4074.11	7.3	1384.86			13.03		1.01	2.32	1.05		0.33			0.02	0.06	4.57	0.8									$200/Day(Days 1-7)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$50-$75/Visit	$0/Visit	$0-$100/Visit		$0-$100/Proc	$25-$150/Visit	$0/Visit	$25/Visit	$25-$100/Visit	$100/Visit			20% Coins		12 1 Way	Dental	VIS 110 Allowance		HER 751			QuitNet	Meals on Wheels	Silver Sneakers	$25 per Quarter Mail Order OTC									149.893802	130.007443	28.712578	0	99.999988	0.2	0.199999	49.999982	60.153182	0	91.051057		88.383371	100.333961	0	24.999998	96.04763	100.000003			0.2		0	0	0		0			0	0	0	0									18.4108	0.068687266	1.954345549	0	1.671833133	0.47	0.20599897	1.081082944	1.350438936	0	18.32698438	0	0.116739703	14.5962502	0	8.487728488	0.058428975	11.54050035	0	0	2.606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.9459	0	0	18.4108	0.068687266	1.954345549	0	1.671833133	0.47	0.20599897	1.081082944	1.350438936	0	18.32698438	0	0.116739703	14.5962502	0	8.487728488	0.058428975	11.54050035	0	0	2.606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.9459																																																																																				0	0	0	18.4108	0.068687266	1.954345549	0	1.671833133	0.47	0.20599897	1.081082944	1.350438936	0	18.32698438	0	0.116739703	14.5962502	0	8.487728488	0.058428975	11.54050035	0	0	2.606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.9459
H1019_031_0	2008	3	s.										Health & Education (Non-Covered)																					D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V						Coin	V		V			O	O	O										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0						0	0		0			0	0	0										0		1289.65	6.83	743.76	22.98	286.31	307.69	1889.61	247.06	185.82	1555.82	1902.45		31.1	1619.26	5791.29	3903.18	7.26	1146.28						2.09	2.25		0.33			0.02	0.06	1.52										$200/Day(Days 1-10)	$200/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip			$50/Visit	$50-$100/Visit	$0/Visit	$0-$100/Visit		$25-$75/Proc	$0-$100/Visit	$0/Visit	$20/Visit	$20/Visit	$50/Visit						DEN 726	VIS 140		HER 751			QuitNet	Meals on Wheels	Silver Sneakers										167.147996	149.894247	28.712577	0	100.000004	0	0	50.000003	72.989467	0	57.681697		51.645728	52.792306	0	20	20.00025	49.999996						0	0		0			0	0	0										17.9635	0.085314809	1.779605522	0	2.385916762	0	0	1.029416728	1.130241896	0	9.144712038	0	0.133848512	7.123705784	0	6.5053	0.012100151	4.776166285	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.0699	0	0	17.9635	0.085314809	1.779605522	0	2.385916762	0	0	1.029416728	1.130241896	0	9.144712038	0	0.133848512	7.123705784	0	6.5053	0.012100151	4.776166285	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.0699																																																																																				0	0	0	17.9635	0.085314809	1.779605522	0	2.385916762	0	0	1.029416728	1.130241896	0	9.144712038	0	0.133848512	7.123705784	0	6.5053	0.012100151	4.776166285	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.0699
H1019_032_0	2008	4	s.	t.	u.	v.	w.						Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O	O	O						0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0						0		1838.35	9.74	1060.2	32.76	408.12	438.61	2693.56	352.17	264.88	2217.76	2711.87		44.33	2308.19	8255.26	5563.83	10.35	1633.98			13961.96			3.28	2.25		0.33			0.02	1.5	1.19	0.06	0.99	1.53	4.77						$50/Day(Days 1-5)	$50/Day(Days 1-5)	$0/Day(Days 1-13) $25(Days 14-100)	$0/Visit	$50/Trip			$50/Visit	$50-$75/Visit	$0/Visit	$0-$25/Visit		$0-$5/Proc	$0-$25/Visit	$0/Visit	$0-$5/Visit	$20/Visit	$0/Visit			$0/Script			DEN 731	VIS 140		HER 751			QuitNet	24 1 way	Silver Sneakers	Meals on Wheels	Unlimited Podiatry	Massage Therapy	$25 OTC per Month						32.501901	32.501765	10.352849	0	49.99999	0	0	49.999984	61.494723	0	4.926614		2.664562	0.608107	0	4.949049	20.000015	0			0			0	0		0			0	0	0	0	0	0	0						4.9792	0.026380599	0.914674209	0	1.70049966	0	0	1.46737453	1.357393519	0	1.113361392	0	0.009843336	0.116968875	0	2.294638941	0.017250013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.9975	0	0	4.9792	0.026380599	0.914674209	0	1.70049966	0	0	1.46737453	1.357393519	0	1.113361392	0	0.009843336	0.116968875	0	2.294638941	0.017250013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.9975																																																																																				0	0	0	4.9792	0.026380599	0.914674209	0	1.70049966	0	0	1.46737453	1.357393519	0	1.113361392	0	0.009843336	0.116968875	0	2.294638941	0.017250013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.9975
H1019_033_0	2008	4	s.	t.	u.								Hearing (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered									Professional										D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0								0		1575.15	8.34	908.41	28.07	349.69	375.81	2307.92	301.75	226.95	1900.24	2323.61		37.99	1977.73	7073.36	4767.26	8.87	1400.05			11963.03			3.28	2.25		0.33			0.02	0.06	1.5	2.71	4.77								$50/Day(Days 1-5)	$50/Day(Days 1-5)	$0/Day(Days 1-13) $25(Days 14-100)	$0/Visit	$50/Trip			$50/Visit	$50-$75/Visit	$0/Visit	$0-$25/Visit		$0-$5/Proc	$0-$25/Visit	$0/Visit	$5/Visit	$20/Visit	$0/Visit			$0/Script			DEN 731	VIS 140		HER 751			QuitNet	Meals on Wheels	24 1 way	Silver Sneakers	$25 OTC per Month								32.501903	32.5019	10.352847	0	50.000006	0	0	49.999981	61.494716	0	4.926615		2.664675	0.608109	0	5.000001	19.999188	0			0			0	0		0			0	0	0	0	0								4.2663	0.022588821	0.783719145	0	1.457041842	0	0	1.257291189	1.163018816	0	0.95396099	0	0.008435917	0.100222951	0	1.986358731	0.014782733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0137	0	0	4.2663	0.022588821	0.783719145	0	1.457041842	0	0	1.257291189	1.163018816	0	0.95396099	0	0.008435917	0.100222951	0	1.986358731	0.014782733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0137																																																																																				0	0	0	4.2663	0.022588821	0.783719145	0	1.457041842	0	0	1.257291189	1.163018816	0	0.95396099	0	0.008435917	0.100222951	0	1.986358731	0.014782733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0137
H1019_034_0	2008	3	s.										Health & Education (Non-Covered)																					D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0										0		1332.26	5.03	608.5	73.25	249.67	267.67	1418.5	162.21	154.75	1406.3	2129.35		21.48	1927.01	5868.77	3945.75	8.4	1283.54			3830.42			3.3	2.61		0.33			0.02	0.06	1.19										$175/Day(Days 1-10)	$190/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip			$50/Visit	$50-$100/Visit	$0/Visit	$0-$100/Visit		$20-$75/Proc	$0-$100/Visit	$0/Visit	$20/Visit	$20/Visit	$50/Visit			$0/Script			Den 725	VIS 140		HER 751			QuitNet	Meals on Wheels	Silver Sneakers										146.254499	142.397986	28.712566	0	100.000007	0	0	50.000026	75.762844	0	23.9948		58.253986	57.671384	0	19.999999	19.998963	49.999999			0			0	0		0			0	0	0										16.2374	0.059688489	1.455966368	0	2.080583479	0	0	0.675875351	0.977025009	0	4.257777282	0	0.104274635	9.26111114	0	6.576249671	0.013999274	5.348083226	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.0481	0	0	16.2374	0.059688489	1.455966368	0	2.080583479	0	0	0.675875351	0.977025009	0	4.257777282	0	0.104274635	9.26111114	0	6.576249671	0.013999274	5.348083226	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.0481																																																																																				0	0	0	16.2374	0.059688489	1.455966368	0	2.080583479	0	0	0.675875351	0.977025009	0	4.257777282	0	0.104274635	9.26111114	0	6.576249671	0.013999274	5.348083226	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.0481
H1019_035_0	2008	4	s.	t.	u.	v.	w.						Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O	O	O						0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0						0		1881.77	7.11	859.49	103.47	352.65	378.08	2003.58	229.12	218.58	1986.34	3007.62		30.34	2721.81	8289.4	5573.21	11.86	1812.95			5410.31			3.3	2.61		0.33			0.02	3	1.19	0.06	0.99	2.55	8.73						$50/Day(Days 1-5)	$50/Day(Days 1-5)	$0/Day(Days 1-6) $25(Days 7-100)	$0/Visit	$50/Trip			$50/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0-$25/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			$0/Script			DEN 731	VIS 140		HER 751			QuitNet	40 1 way	Silver Sneakers	Meals on Wheels	Unlimited Podiatry	10 Visits per Year	$25 OTC per Month						32.501901	32.501597	18.233153	0	49.999991	0	0	50.000004	0	0	0		0	2.433617	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0						5.0968	0.019257196	1.305934389	0	1.469374736	0	0	0.954666743	0	0	0	0	0	0.551986924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.398	0	0	5.0968	0.019257196	1.305934389	0	1.469374736	0	0	0.954666743	0	0	0	0	0	0.551986924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.398																																																																																				0	0	0	5.0968	0.019257196	1.305934389	0	1.469374736	0	0	0.954666743	0	0	0	0	0	0.551986924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.398
H1019_036_0	2008	4	s.	t.	u.	v.							Hearing (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered								Professional										D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	V	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1612.35	6.09	736.43	88.66	302.16	323.95	1716.72	196.32	187.28	1701.95	2577.02		26	2332.13	7102.6	4775.3	10.16	1553.39			4635.71			3.3	2.61		0.33			2.71	0.02	3	0.06	2.55	8.73							$50/Day(Days 1-5)	$50/Day(Days 1-5)	$0/Day(Days 1-6) $50(Days 7-100)	$0/Visit	$50/Trip			$50/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0-$25/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			$0/Script			DEN 731	VIS 140		HER 751			Silver Sneakers	QuitNet	40 1 way	Meals on Wheels	10 Visits per Year	$25 OTC per Month							32.501896	32.50165	36.466303	0	49.999996	0	0	49.999992	0	0	0		0	2.433619	0	0	0	0			0			0	0		0			0	0	0	0	0	0							4.367	0.016494587	2.237906627	0	1.258999899	0	0	0.817999869	0	0	0	0	0	0.472959657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.1714	0	0	4.367	0.016494587	2.237906627	0	1.258999899	0	0	0.817999869	0	0	0	0	0	0.472959657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.1714																																																																																				0	0	0	4.367	0.016494587	2.237906627	0	1.258999899	0	0	0.817999869	0	0	0	0	0	0.472959657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.1714
H1019_037_0	2008	4	s.	t.	u.	v.	w.						Dental (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	Coin	O	O	O	O						0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0						0		1617.53	4.95	1379.04	21.13	340.94	407.77	3101.63	294.29	221.03	2432.29	3358.41		33.35	2207.66	8293.36	5557.29	8.5	2554.48			6160.29			1.16	2.25		0.33			0.02	0.99	3.3	1.19	0.06	2.55	6.24						$125/Day(Days 1-5)	$125/Day(Days 1-5)	$0/Day(Days 1-6) $50(Days 7-100)	$0/Visit	$100/Trip			$50/Visit	$0-$50/Visit	$0/Visit	$0/Visit		$0-$5/Proc	$0-$100/Visit	$0/Visit	$0-$5/Visit	$20/Visit	$10/Visit			$0/Script			24 1 way	VIS 140		HER 751			QuitNet	Unlimited Podiatry	DEN 731	Silver Sneakers	Meals on Wheels	10 Visits Per Year	$25 per Month OTC						81.254751	81.255375	36.466301	0	100	0	0	49.999986	21.440461	0	0		2.770906	9.643413	0	4.980725	20.000131	9.999997			0			0	0		0			0	0	0	0	0	0	0						10.9527	0.033517842	4.190707311	0	2.841166667	0	0	1.22620799	0.394915425	0	0	0	0.00770081	1.774114762	0	2.306611103	0.014166759	2.128732695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.8705	0	0	10.9527	0.033517842	4.190707311	0	2.841166667	0	0	1.22620799	0.394915425	0	0	0	0.00770081	1.774114762	0	2.306611103	0.014166759	2.128732695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.8705																																																																																				0	0	0	10.9527	0.033517842	4.190707311	0	2.841166667	0	0	1.22620799	0.394915425	0	0	0	0.00770081	1.774114762	0	2.306611103	0.014166759	2.128732695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.8705
H1019_038_0	2008	4	s.	t.	u.								Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																			D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S		T	Coin	V		V			O	O	O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0		0	0	0		0			0	0	0	0	0								0		1385.94	4.24	1181.6	18.11	292.12	349.39	2657.56	252.15	189.38	2084.05	2877.58		28.57	1891.58	7105.97	4761.64	7.29	2188.75			5278.3		1.16	3.3	2.25		0.33			0.02	0.06	2.71	2.55	6.24								$125/Day(Days 1-10)	$125/Day(Days 1-10)	$0/Day(Days 1-6) $50(Days 7-100)	$0/Visit	$100/Trip			$50/Visit	$0-$50/Visit	$0/Visit	$0/Visit		$0-$5/Proc	$0-$100/Visit	$0/Visit	$5/Visit	$20/Visit	$10/Visit			$0/Script		24 1 way	DEN 731	VIS 140		HER 751			QuitNet	Meals on Wheels	Silver Sneakers	10 Visits per Year	$25 per Month OTC								104.467503	104.468438	36.466299	0	100.000015	0	0	49.99999	21.440479	0	0		2.770669	9.643412	0	5	19.999983	9.999999			0		0	0	0		0			0	0	0	0	0								12.0655	0.036912181	3.590714908	0	2.434333698	0	0	1.05062479	0.338366493	0	0	0	0.006596501	1.520107106	0	1.984016667	0.01214999	1.823958151	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.8633	0	0	12.0655	0.036912181	3.590714908	0	2.434333698	0	0	1.05062479	0.338366493	0	0	0	0.006596501	1.520107106	0	1.984016667	0.01214999	1.823958151	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.8633																																																																																				0	0	0	12.0655	0.036912181	3.590714908	0	2.434333698	0	0	1.05062479	0.338366493	0	0	0	0.006596501	1.520107106	0	1.984016667	0.01214999	1.823958151	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.8633
H1019_039_0	2008	5	s.	t.									Health & Education (Non-Covered)	Other Non-Covered																				D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0									0		981.13	9.61	609.85	362	164.37	1.33	2787.04	185.06	162.32	1183.41	1747.49		13.26	1259.35	4761.28	3186.31	8.48	915.63			13.08			1.37	0.93		0.08			0.02	1.01	2.83	0.06									$110/Day(Days 1-7)	$275/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$100/Visit	$0/Visit	$0-$50/Visit		$0-$50/Proc	$25-$50/Visit	$0/Visit	$25/Visit	$25-$50/Visit	$50/Visit			10% Coins			DEN 723	VIS 987		HER 722			QuitNet	12 1 Way	Silver Sneakers	Meals on Wheels									82.441595	206.103486	28.712564	0	100.000023	0	0	49.999988	100.000007	0	41.531689		30.672136	49.994942	0	25.000002	49.870342	49.999999			0.1			0	0		0			0	0	0	0									6.7405	0.165054542	1.45919643	0	1.369750315	0	0	0.771083148	1.352666761	0	6.048017601	0	0.03389271	5.246760851	0	6.638146364	0.035241708	3.815124924	0	0	1.308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.9834	0	0	6.7405	0.165054542	1.45919643	0	1.369750315	0	0	0.771083148	1.352666761	0	6.048017601	0	0.03389271	5.246760851	0	6.638146364	0.035241708	3.815124924	0	0	1.308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.9834																																																																																				0	0	0	6.7405	0.165054542	1.45919643	0	1.369750315	0	0	0.771083148	1.352666761	0	6.048017601	0	0.03389271	5.246760851	0	6.638146364	0.035241708	3.815124924	0	0	1.308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.9834
H1019_040_0	2008	3	s.	t.	u.	v.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	O	Coin	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1332.77	13.05	828.42	491.74	223.29	224.11	1.5	251.39	220.5	1607.55	2373.79		18.01	1710.71	6467.74	4328.3	11.52	1243.79			15441.24			2.32	2.4		0.33			0.02	0.9	1.91	0.06	0.99	2.1							$150/Day(Days 1-5)	$150/Day(Days 1-5)	$0/Day(Days 1-9) $50(Days 10-100)	$0/Visit	$100/Trip		0%-20% Coins	$50/Visit	$25-$50/Visit	$0/Visit	$0-$25/Visit		$0-$50/Proc	$0-$50/Visit	$0/Visit	$0-$25/Visit	$25/Visit	$30/Visit			$0/Script			Dental	Vision		HER 751			QuitNet	12 1 Way	Silver Sneakers	Meals on Wheels	Unlimited Podiatry	$25 per Month OTC Mail Order							97.5057	97.505974	28.130302	0	99.999977	0	0.050485	49.999993	35.150927	0	16.764199		30.671584	17.337295	0	19.958561	24.99972	30.000001			0			0	0		0			0	0	0	0	0	0							10.8294	0.106037747	1.941975399	0	1.860749572	0	0.0757275	1.047458187	0.645898284	0	3.316223995	0	0.046032936	2.471590327	0	7.198886631	0.023999731	3.109475104	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.6734	0	0	10.8294	0.106037747	1.941975399	0	1.860749572	0	0.0757275	1.047458187	0.645898284	0	3.316223995	0	0.046032936	2.471590327	0	7.198886631	0.023999731	3.109475104	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.6734																																																																																				0	0	0	10.8294	0.106037747	1.941975399	0	1.860749572	0	0.0757275	1.047458187	0.645898284	0	3.316223995	0	0.046032936	2.471590327	0	7.198886631	0.023999731	3.109475104	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.6734
H1019_041_0	2008	3	s.	t.	u.								Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																			D	D	D	V	T	O	Coin	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0								0		1220.58	11.95	758.69	450.35	204.49	205.24	1.26	230.23	201.94	1472.23	2173.98		16.5	1566.71	5923.32	3963.97	10.55	1139.1			14141.48			2.32	2.4		0.33			0.02	1.2	3.43	0.06	2.1								$150/Day(Days 1-5)	$150/Day(Days 1-5)	$0/Day(Days 1-9) $50(Days 10-100)	$0/Visit	$100/Trip		20% Coins	$50/Visit	$25-$50/Visit	$0/Visit	$0-$25/Visit		$0-$50/Proc	$0-$50/Visit	$0/Visit	$15/Visit	$25-$100/Visit	$30/Visit			$0/Script			Dental	Vision		HER 751			QuitNet	16 1 Way	Silver Sneakers	Meals on Wheels	$25 per Month OTC Mail Order								97.505695	97.506011	28.130295	0	99.999978	0	0.199999	50.000009	35.150933	0	16.764193		30.671469	17.337303	0	14.999998	99.612219	30.000002			0			0	0		0			0	0	0	0	0								9.9178	0.097099736	1.778514459	0	1.704082958	0	0.25199874	0.959291839	0.591531618	0	3.037085025	0	0.04217327	2.263543832	0	4.954961839	0.087575743	2.84775019	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.5334	0	0	9.9178	0.097099736	1.778514459	0	1.704082958	0	0.25199874	0.959291839	0.591531618	0	3.037085025	0	0.04217327	2.263543832	0	4.954961839	0.087575743	2.84775019	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.5334																																																																																				0	0	0	9.9178	0.097099736	1.778514459	0	1.704082958	0	0.25199874	0.959291839	0.591531618	0	3.037085025	0	0.04217327	2.263543832	0	4.954961839	0.087575743	2.84775019	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.5334
H1019_042_0	2008	4	s.	t.									DME/Prosthetics/Supplies	Health & Education (Non-Covered)										Prosthetics/Supplies										D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0									0		1256.77	12.31	781.18	463.7	210.55	2.18	0.34	237.06	207.93	1515.88	2238.44		16.99	1613.16	6098.95	4081.5	10.86	1172.87			21.47			2.09	0.97		0.33			0.02	0.06	3552.32	1.91									$175/Day(Days 1-10)	$175/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	0% Coins	20% Coins	$50/Visit	$75-$100/Visit	$0/Visit	$100/Visit		$0-$100/Proc	$25-$100/Visit	$0/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins			DEN 726	VIS 116		HER 751			QuitNet	Meals on Wheels		Silver Sneakers									146.254496	131.157146	28.712578	0	99.999989	0	0.200001	50.000014	85.150878	0	100.000006		61.343147	99.985858	0	30.000001	99.638458	99.999998			0.199999			0	0		0			0	0	0	0									15.3174	0.134545372	1.869140974	0	1.75458314	0	0.06800034	0.987750277	1.475451839	0	18.65366779	0	0.086851672	13.44109889	0	10.20375034	0.090172804	9.773916471	0	0	4.29397853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.1503	0	0	15.3174	0.134545372	1.869140974	0	1.75458314	0	0.06800034	0.987750277	1.475451839	0	18.65366779	0	0.086851672	13.44109889	0	10.20375034	0.090172804	9.773916471	0	0	4.29397853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.1503																																																																																				0	0	0	15.3174	0.134545372	1.869140974	0	1.75458314	0	0.06800034	0.987750277	1.475451839	0	18.65366779	0	0.086851672	13.44109889	0	10.20375034	0.090172804	9.773916471	0	0	4.29397853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.1503
H1026_001_0	2008	10	f.2.	h.6.	i.7.	g.2.	h.7.	e.3.					OP Facility - Emergency	OP Facility - Other	Professional	OP Facility - Surgery	OP Facility - Other	DME/Prosthetics/Supplies						Urgent Care	Substance Abuse and MH	Allergy Shots	Ambulatory Surgical Center	Rehab	Electric Wheelchair					D	D	D		T			V	V					V		V	V	V														V	V	O	V	V	O																																														0		1889.557858	14.3988603	938.1646117		242.858418			235.935222	196.2364011					450.5153634		5236.041518	144.6396893	189.217204														0.308909273	13.12891515	99.77443482	158.737259	293.2516493	0.589352645					$150 for days 1-5	$150 for days 1-5	$75 for days 7-25	$0 for Home Health	$100 per transport			$50 per visit	$250 per visit to outpatient facility					$50 per non-surgical outpatient visit/$50 IDTF	$0 for PCP visits and physical exams	$15 per visit	$15 per visit	$15 per visit						"$0 for limited cleanings, exams, x-rays"								$15 per visit	$15 per visit	$6 per shot	$100 per visit	$15 per visit	$500 per electric wheelchair					82.56915891	149.5944153	35.53447875		100			50	250					50		15	15	15														15	15	6	100	15	500					13.0016	0.179499091	2.778099205	0	2.02382015	0	0	0.983063425	4.088258357	0	0	0	0	1.877147348	0	6.545051897	0.180799612	0.236521505	0	0	0	0	0	0	0	0	0	0	0	0	0	0.000386137	0.016411144	0.049887217	1.322810491	0.366564562	0.02455636	0	0	0	0	33.6745			13.0016	0.179499091	2.778099205	0	2.02382015	0	0	0.983063425	4.088258357	0	0	0	0	1.877147348	0	6.545051897	0.180799612	0.236521505	0	0	0	0	0	0	0	0	0	0	0	0	0	0.000386137	0.016411144	0.049887217	1.322810491	0.366564562	0.02455636	0	0	0	0	33.6745																																																																																				0			13.0016	0.179499091	2.778099205	0	2.02382015	0	0	0.983063425	4.088258357	0	0	0	0	1.877147348	0	6.545051897	0.180799612	0.236521505	0	0	0	0	0	0	0	0	0	0	0	0	0	0.000386137	0.016411144	0.049887217	1.322810491	0.366564562	0.02455636	0	0	0	0	33.6745
H1026_033_0	2008	5	e.3.	f.1.	f.2.	f.3.	g.2.	h.6.	i.7.				DME/Prosthetics/Supplies	OP Facility - Emergency	OP Facility - Emergency	OP Facility - Emergency	OP Facility - Surgery	OP Facility - Other	Professional					Electric Wheelchairs	Urgent Care	Worldwide ER	Worldwide Urgent Care	Ambulatory Surgical Center	Cardiac Rehab	Allergy Shots				A	A	D		T	O		V	V					V	V	V	V	V														V	V	V	V	V	V	O																																													0		301.1080301	3.215769885	1503.238516		236.5123546			261.8395188	129.6301393					401.778	3805.605643	6202.842505	247.741															0.908564204	0.045481226	0	0	105.7348607	435.591	470.407				$150 for days 1-10	$150 for days 1-10	$100 for days 7-25	"$0 copay for Home Health Care, $0 copay for Respite Care"	$100 per trip	$0 copay for DME except electric wheelchairs and scooters		$50 copay	$250 copay					"$150 copay on OP Facility, $75 copay on IDTF"	$10 copay	$30 copay	$30 copay	with Cardiac Rehab														$500 copay	$30 copay	$50 copay	$30 copay	$100 copay	$30 copay for Cardiac Rehab and PT/OT/ST	$5 copay				618.781555	618.781555	47.26701697		100			50	250					82.61432625	10	30	30															314.1490667	30	0	0	100	30	5				15.5267	0.165821591	5.92113337	0	1.970936288	0	0	1.090997995	2.700627902	0	0	0	0	2.766051564	3.171338036	15.50710626	0.6193525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.023785383	0.000113703	0	0	0.881123839	1.0889775	0.196002917	0	0	0	51.63			15.5267	0.165821591	5.92113337	0	1.970936288	0	0	1.090997995	2.700627902	0	0	0	0	2.766051564	3.171338036	15.50710626	0.6193525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.023785383	0.000113703	0	0	0.881123839	1.0889775	0.196002917	0	0	0	51.63																																																																																				0			15.5267	0.165821591	5.92113337	0	1.970936288	0	0	1.090997995	2.700627902	0	0	0	0	2.766051564	3.171338036	15.50710626	0.6193525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.023785383	0.000113703	0	0	0.881123839	1.0889775	0.196002917	0	0	0	51.63
H1026_035_0	2008	8	e.3.	f.1.	f.2.	f.3.	g.2.	h.6.	i.7.				DME/Prosthetics/Supplies	OP Facility - Emergency	OP Facility - Emergency	OP Facility - Emergency	OP Facility - Surgery	OP Facility - Other	Professional					Electric Wheelchairs	Urgent Care	Worldwide ER	Worldwide Urgent Care	Ambulatory Surgical Center	Cardiac Rehab	Allergy Shots				A	A	D		T	O		V	V					V	V	V	V	V														V	V	V	V	V	V	O																																													0		277.7209986	2.96600135	1489.572711		234.5894899			164.4889285	81.43431829					252.399	3275.316332	5303.123009	207.8505															0.901177503	0.028571539	0	0	66.42318171	273.6405	394.6635				$150 for days 1-7	$150 for days 1-7	$100 for days 7-25	"$0 copay for Home Health Care, $0 copay for Respite Care"	$100 per trip	$0 copay for DME except electric wheelchairs and scooters		$50 copay	$250 copay					"$150 copay on OP Facility, $75 copay on IDTF"	$10 copay	$25 copay	$25 copay	with Cardiac Rehab														$500 copay	$25 copay	$50 copay	$25 copay	$100 copay	$25 copay for Cardiac Rehab and PT/OT/ST	$5 copay				689.3227815	689.3227815	47.26701697		100			50	250					82.61432625	10	25	25															314.1490667	25	0	0	100	25	5				15.9533	0.170377692	5.867304885	0	1.954912416	0	0	0.685370535	1.696548298	0	0	0	0	1.737647777	2.729430277	11.04817293	0.433021875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.023592006	5.95E-05	0	0	0.553526514	0.570084375	0.164443125	0	0	0	43.5878			15.9533	0.170377692	5.867304885	0	1.954912416	0	0	0.685370535	1.696548298	0	0	0	0	1.737647777	2.729430277	11.04817293	0.433021875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.023592006	5.95E-05	0	0	0.553526514	0.570084375	0.164443125	0	0	0	43.5878																																																																																				0			15.9533	0.170377692	5.867304885	0	1.954912416	0	0	0.685370535	1.696548298	0	0	0	0	1.737647777	2.729430277	11.04817293	0.433021875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.023592006	5.95E-05	0	0	0.553526514	0.570084375	0.164443125	0	0	0	43.5878
H1026_801_0	2008	3																																Coin		Coin		Coin	Coin		Coin	Coin					Coin						Coin	Coin	Coin																				0		0		0	0		0	0					0						0	0	0																				0		281.8710223		25.86495081		8.012414955	2.983942786		24.21480824	47.67191585					62.87983156						250.4675391	68.21619469	27.19019626																				7.6% coinsurance		17.3% coinsurance		23.4% coinsurance	23.4% coinsurance		23.4% coinsurance	23.4% coinsurance					23.4% coinsurance						23.4% coinsurance	23.4% coinsurance	23.4% coinsurance																				0.075744244		0.17269858		0.234	0.234		0.234	0.234					0.234						0.234	0.234	0.234																				21.3501	0	4.466840274	0	1.8749051	0.698242612	0	5.666265129	11.15522831	0	0	0	0	14.71388059	0	0	0	0	0	58.60940414	15.96258956	6.362505926	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.86			21.3501	0	4.466840274	0	1.8749051	0.698242612	0	5.666265129	11.15522831	0	0	0	0	14.71388059	0	0	0	0	0	58.60940414	15.96258956	6.362505926	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.86																																																																																				0			21.3501	0	4.466840274	0	1.8749051	0.698242612	0	5.666265129	11.15522831	0	0	0	0	14.71388059	0	0	0	0	0	58.60940414	15.96258956	6.362505926	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.86
H1026_802_0	2008	3																																Coin		Coin		Coin	Coin		Coin	Coin					Coin						Coin	Coin	Coin																																																													0		281.8710223		25.86495081		8.012414955	2.983942786		24.21480824	47.67191585					62.87983156						250.4675391	68.21619469	27.19019626																				7.6% coinsurance		17.3% coinsurance	0% coinsurance	23.4% coinsurance	23.4% coinsurance		23.4% coinsurance	23.4% coinsurance					23.4% coinsurance						23.4% coinsurance	23.4% coinsurance	23.4% coinsurance																				0.075744244		0.17269858		0.234	0.234		0.234	0.234					0.234						0.234	0.234	0.234																				21.3501	0	4.466840274	0	1.8749051	0.698242612	0	5.666265129	11.15522831	0	0	0	0	14.71388059	0	0	0	0	0	58.60940414	15.96258956	6.362505926	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.86			21.3501	0	4.466840274	0	1.8749051	0.698242612	0	5.666265129	11.15522831	0	0	0	0	14.71388059	0	0	0	0	0	58.60940414	15.96258956	6.362505926	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.86																																																																																				0			21.3501	0	4.466840274	0	1.8749051	0.698242612	0	5.666265129	11.15522831	0	0	0	0	14.71388059	0	0	0	0	0	58.60940414	15.96258956	6.362505926	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.86
H1032_002_0	2008	7																					2000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1671.047573	28.39006144	966.6113537	817.2465645	504.2025194	5.303340671	3.309125021	912.6267514	280.4625465	1072.27892	285.4672265	52.76537993	0.07139472	146.3152884	14591.84092	14340.80824	269.3028423	150.5555848	6097.127036	596.7405906	30.01304442	26.97228394	0	190	320	221.5384615	40	16	0	1600	3600											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 14, $50 days 15 - 100"	Copay between $0.00 and $15.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $5.00 and $75.00	$0.00 copayment	$15.00 copayment	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											43.09318768	47.97036725	17.89072494	2.350957141	48.10531317	0.190936232	0.190936232	11.21618071	51.0817828	0	7.378273407	69.06956903	0.190936232	12.08784705	0	3.874042633	12.30204992	4.626000674	6.677256603	0	0.190936232	0	0	19.0936232	9.546811599	9.546811599	9.546811599	0	0	0	0											6.0009	0.113490139	1.441114821	0.160109304	2.021235008	1.012599885	0.631831863	0.853015547	1.19387724	0	0.17552127	0.303706838	0.013631839	0.147386402	0	4.629741875	0.276081417	0.058039186	3.39267348	0	5.730577611	0	0	0.302315701	0.254581643	0.17624883	0.031822705	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.9205	0	1.372859926	6.0009	0.113490139	1.441114821	0.160109304	2.021235008	1.012599885	0.631831863	0.853015547	1.19387724	0	0.17552127	0.303706838	0.013631839	0.147386402	0	4.629741875	0.276081417	0.058039186	3.39267348	0	5.730577611	0	0	0.302315701	0.254581643	0.17624883	0.031822705	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.9205	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.9466		0											13.9466	0	0	6.0009	0.113490139	1.441114821	0.160109304	2.021235008	1.012599885	0.631831863	0.853015547	1.19387724	0	0.17552127	0.303706838	0.013631839	0.147386402	0	4.629741875	0.276081417	0.058039186	3.39267348	0	5.730577611	0	0	0.302315701	0.254581643	0.17624883	0.031822705	0	13.94656954	0	0	0	0	0	0	0	0	0	0	0	0	42.8671
H1032_008_0	2008	6																																A	A	D	V	T	P	P	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		291.5342594	11.26702452	738.0093406	770.4761834	581.3777155	195.5307168	228.8790912	1019.760046	183.183588	1393.251141	603.4483525	43.162891	1.285663916	124.0790989	11738.80786	14420.08887	329.4716405	508.7186293	5874.738898	459.0606137	51.5575195	3.238800176	1500	380	240	192	30	13.33333333	0	1600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	0	0	0	0	0	0	0	0	0.2	0	0	0	0	0	0	0	0.2	0	0	20	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0.257132783	0	0	0	0	0	0	0	10.3115039	0	0	0.633333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.202	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.257132783	0	0	0	0	0	0	0	10.3115039	0	0	0.633333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.202	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.3326		0											14.3326	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.257132783	0	0	0	0	0	0	0	10.3115039	0	0	0.633333333	0	0	0	0	14.33259615	0	0	0	0	0	0	0	0	0	0	0	0	25.5346
H1032_010_0	2008	6																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1572.701433	121.0664828	1013.937535	1722.026722	444.1213228	7.056332148	3.725484527	1024.902554	277.7803375	2031.724642	727.6760184	58.03740397	0.206127499	217.3315862	18393.044	22541.42264	346.8840316	3597.099371	5666.65539	626.9374679	22.98256668	25.0818733	0	190	320	221.5384615	40	16	0	0	0											"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$50.00 copayment	20% coinsurance	Copay between $10.00 and $25.00	$0.00 copayment	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											22.89135355	22.00327657	30.5580425	0.724144146	46.25182371	0.19607342	0.19607342	14.26963108	16.71649985	0	8.42509606	35.46395169	0.19607342	6.817289618	0	5.098758053	16.63852767	6.452901001	8.015019948	0	0.19607342	0	0	19.607342	9.803670998	9.803670998	9.803670998	0	0	0	0											3.0001	0.221988275	2.581995525	0.103916298	1.711785094	1.383559177	0.730468492	1.218748445	0.386959581	0	0.51089503	0.171519641	0.040416124	0.123467697	0	9.577771684	0.480969963	1.934310511	3.784862999	0	4.506270448	0	0	0.310449582	0.261431227	0.180990849	0.032678903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2556	0	0.665978191	3.0001	0.221988275	2.581995525	0.103916298	1.711785094	1.383559177	0.730468492	1.218748445	0.386959581	0	0.51089503	0.171519641	0.040416124	0.123467697	0	9.577771684	0.480969963	1.934310511	3.784862999	0	4.506270448	0	0	0.310449582	0.261431227	0.180990849	0.032678903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2556	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.9614		0											14.9614	0	0	3.0001	0.221988275	2.581995525	0.103916298	1.711785094	1.383559177	0.730468492	1.218748445	0.386959581	0	0.51089503	0.171519641	0.040416124	0.123467697	0	9.577771684	0.480969963	1.934310511	3.784862999	0	4.506270448	0	0	0.310449582	0.261431227	0.180990849	0.032678903	0	14.96140798	0	0	0	0	0	0	0	0	0	0	0	0	48.217
H1032_012_0	2008	6																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1557.339206	33.50935607	954.427146	727.288031	484.5457832	7.245854902	1.957503426	1011.712242	239.7318952	632.7415312	246.7493315	68.6666162	0.660172359	84.02636908	12844.08	13553.00726	299.2803444	412.4191047	5539.157648	655.9680894	24.37786163	15.48837296	0.387946984	190	320	221.5384615	40	16	0	1600	3600											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $75 days 8 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $25.00 and $75.00	Copay between $0.00 and $5.00	$35.00 copayment	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											44.42265598	57.67470718	45.08894766	5.290092804	48.58814188	0.192852642	0.192852642	10.97116173	47.22132072	0	7.920385399	69.7628141	0.192852642	15.97507842	1.864122875	9.382787319	28.90552468	10.40719482	8.963233194	0	0.192852642	0	0	19.28526418	9.642632091	9.642632091	9.642632091	0	0	0	0											5.7651	0.161053525	3.586176302	0.320618432	1.961931605	1.39738226	0.377509707	0.924971553	0.943371393	0	0.162862484	0.399198032	0.127315984	0.111860653	1.995245277	10.59708205	0.720904615	0.357677164	4.137396808	0	4.701335018	0	0	0.305350016	0.257136856	0.178017823	0.032142107	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5216	0	1.464720828	5.7651	0.161053525	3.586176302	0.320618432	1.961931605	1.39738226	0.377509707	0.924971553	0.943371393	0	0.162862484	0.399198032	0.127315984	0.111860653	1.995245277	10.59708205	0.720904615	0.357677164	4.137396808	0	4.701335018	0	0	0.305350016	0.257136856	0.178017823	0.032142107	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5216	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							12.5656		0											12.5656	0	0	5.7651	0.161053525	3.586176302	0.320618432	1.961931605	1.39738226	0.377509707	0.924971553	0.943371393	0	0.162862484	0.399198032	0.127315984	0.111860653	1.995245277	10.59708205	0.720904615	0.357677164	4.137396808	0	4.701335018	0	0	0.305350016	0.257136856	0.178017823	0.032142107	0	12.56556019	0	0	0	0	0	0	0	0	0	0	0	0	52.0872
H1032_014_0	2008	6																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1377.714689	51.55450031	979.8015829	734.0096626	409.2139395	3.233638745	1.671720495	936.4095763	203.3009013	608.7293073	223.7827133	65.2479369	0.061384005	75.5870318	11429.21304	11591.08726	235.4716637	290.3989552	4866.934677	616.6632555	15.37956021	14.01456008	0	190	320	221.5384615	40	16	0	1600	3600											"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$50.00 copayment	20% coinsurance	Copay between $10.00 and $25.00	$0.00 copayment	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											25.04132706	28.65270256	30.81532943	3.470962766	49.81552445	0.197724283	0.197724283	11.55367379	17.18167564	0	5.49226205	35.76254449	0.197724283	6.600748348	0	5.526659437	16.54452662	5.951433771	7.01180015	0	0.197724283	0	0	19.77242825	9.886214126	9.886214126	9.886214126	0	0	0	0											2.875	0.12309798	2.516075713	0.212310017	1.698767251	0.639368901	0.330539735	0.901580898	0.291087512	0	0.102422775	0.194452687	0.012137108	0.041577581	0	5.338332649	0.324647267	0.144024179	2.843831108	0	3.040912508	0	0	0.313063447	0.263632377	0.182514722	0.032954047	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.4223	0	0.258070741	2.875	0.12309798	2.516075713	0.212310017	1.698767251	0.639368901	0.330539735	0.901580898	0.291087512	0	0.102422775	0.194452687	0.012137108	0.041577581	0	5.338332649	0.324647267	0.144024179	2.843831108	0	3.040912508	0	0	0.313063447	0.263632377	0.182514722	0.032954047	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.4223	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							10.6278		0											10.6278	0	0	2.875	0.12309798	2.516075713	0.212310017	1.698767251	0.639368901	0.330539735	0.901580898	0.291087512	0	0.102422775	0.194452687	0.012137108	0.041577581	0	5.338332649	0.324647267	0.144024179	2.843831108	0	3.040912508	0	0	0.313063447	0.263632377	0.182514722	0.032954047	0	10.62784476	0	0	0	0	0	0	0	0	0	0	0	0	33.0502
H1032_019_0	2008	6																					3250											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		245.7463057	12.18576722	1024.131325	933.1001945	304.2823904	4.240854173	2.348873741	960.9428453	345.6927229	839.2597952	205.6026028	83.44456855	0.045819861	107.0325411	12528.38839	13634.63345	422.1468561	401.6841477	5155.683986	823.8277524	17.65400816	11.90865855	0	190	320	221.5384615	40	16	0	1600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	50.19638384	0.199235963	0.199235963	12.2389932	0	0	4.233409556	0	0.199235963	0	0	0	0	0	5.013185228	0	0.199235963	0	0	19.92359629	9.961798145	9.961798145	9.961798145	0	0	0	0											0	0	0	0	1.272822972	0.844930665	0.467980121	0.980081079	0	0	0.072533335	0	0.009128964	0	0	0	0	0	2.153866567	0	3.517313315	0	0	0.315456941	0.265647951	0.18391012	0.033205994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1169	0	0.03879656	0	0	0	0	1.272822972	0.844930665	0.467980121	0.980081079	0	0	0.072533335	0	0.009128964	0	0	0	0	0	2.153866567	0	3.517313315	0	0	0.315456941	0.265647951	0.18391012	0.033205994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1169	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							12.7109		0											12.7109	0	0	0	0	0	0	1.272822972	0.844930665	0.467980121	0.980081079	0	0	0.072533335	0	0.009128964	0	0	0	0	0	2.153866567	0	3.517313315	0	0	0.315456941	0.265647951	0.18391012	0.033205994	0	12.71086782	0	0	0	0	0	0	0	0	0	0	0	0	22.8277
H1032_025_0	2008	6																					2500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1400.78049	149.0076827	918.4178219	2551.818588	449.9365858	20.00972985	3.41571775	1401.661794	264.5957038	8995.211168	1538.52257	23.05029465	0.117764216	540.3369423	8021.990736	16882.78162	318.9965523	4063.726264	4388.535012	936.1785639	33.29259647	29.28740968	0	190	480	192	60	22.85714286	0	1600	3600											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 9, $100 days 10 - 30"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$150.00 copayment	20% coinsurance	Copay between $15.00 and $100.00	Copay between $0.00 and $10.00	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $10.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$20.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											68.34141456	38.99120473	38.41204825	0	42.88057791	0.181188907	0.181188907	17.72232285	75.57731629	0	14.83541407	98.31533475	0.181188907	21.87631889	3.842716696	7.430523285	19.24137646	8.62058277	5.051462616	0	0.181188907	0	0	18.11889069	18.11889069	0	18.11889069	0	0	0	0											7.9776	0.484165755	2.939859141	0	1.607795068	3.625541077	0.618890165	2.07005857	1.666452766	0	1.902051615	0.188849786	0.02133757	0.985048605	2.568853145	10.45399183	0.511494396	2.919307385	1.847376713	0	6.032249162	0	0	0.286882436	0.724755627	0	0.090594453	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.5232	0	5.141511645	7.9776	0.484165755	2.939859141	0	1.607795068	3.625541077	0.618890165	2.07005857	1.666452766	0	1.902051615	0.188849786	0.02133757	0.985048605	2.568853145	10.45399183	0.511494396	2.919307385	1.847376713	0	6.032249162	0	0	0.286882436	0.724755627	0	0.090594453	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.5232	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.6433		0											13.6433	0	0	7.9776	0.484165755	2.939859141	0	1.607795068	3.625541077	0.618890165	2.07005857	1.666452766	0	1.902051615	0.188849786	0.02133757	0.985048605	2.568853145	10.45399183	0.511494396	2.919307385	1.847376713	0	6.032249162	0	0	0.286882436	0.724755627	0	0.090594453	0	13.64332115	0	0	0	0	0	0	0	0	0	0	0	0	63.1665
H1032_028_0	2008	6																					2000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1351.176277	46.82914814	739.425644	464.496148	410.0102739	4.545787523	3.015997729	941.9076723	282.7095361	1047.16371	300.9688333	52.42846492	0.180019652	180.7547939	14992.71771	13358.25726	276.2757178	179.3225407	5720.788965	676.3023978	25.46130944	18.3103884	0	190	320	221.5384615	40	16	0	1600	3600											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $15.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$150.00 copayment	20% coinsurance	Copay between $5.00 and $100.00	$0.00 copayment	$15.00 copayment	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											73.39069945	91.95761089	29.51099217	2.85203009	47.70695557	0.189355099	0.189355099	11.65923836	66.35172985	0	9.469929233	102.7464113	0.189355099	13.39945384	0	4.038824908	12.20017728	4.794109885	6.846366928	0	0.189355099	0	0	18.9355099	9.467754949	9.467754949	9.467754949	0	0	0	0											8.2636	0.358858049	1.818432033	0.110396416	1.630028493	0.860768046	0.571094549	0.915160505	1.563188897	0	0.237512796	0.448903052	0.034087639	0.201834626	0	4.495971845	0.280884395	0.071640997	3.263885031	0	4.821228769	0	0	0.29981224	0.252473465	0.174789322	0.031559183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.7062	0	1.726195993	8.2636	0.358858049	1.818432033	0.110396416	1.630028493	0.860768046	0.571094549	0.915160505	1.563188897	0	0.237512796	0.448903052	0.034087639	0.201834626	0	4.495971845	0.280884395	0.071640997	3.263885031	0	4.821228769	0	0	0.29981224	0.252473465	0.174789322	0.031559183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.7062	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							12.3288		0											12.3288	0	0	8.2636	0.358858049	1.818432033	0.110396416	1.630028493	0.860768046	0.571094549	0.915160505	1.563188897	0	0.237512796	0.448903052	0.034087639	0.201834626	0	4.495971845	0.280884395	0.071640997	3.263885031	0	4.821228769	0	0	0.29981224	0.252473465	0.174789322	0.031559183	0	12.32882113	0	0	0	0	0	0	0	0	0	0	0	0	43.035
H1032_031_0	2008	6																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1114.731835	15.23747986	610.2198094	1187.655929	329.6465862	6.769557018	3.030395432	785.3870176	176.9105238	1853.762653	608.4016866	42.36662991	0.032048953	188.9165675	15029.07046	18410.85531	328.0204644	3592.39113	4775.056022	604.0092869	20.48884895	18.09257978	0	190	320	221.5384615	40	16	0	0	0											"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$50.00 copayment	20% coinsurance	Copay between $20.00 and $30.00	$0.00 copayment	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											21.58948338	21.30815444	60.75972281	0.862663703	44.25669239	0.19489887	0.19489887	16.39494477	18.02979372	0	9.806399059	35.25150998	0.19489887	8.42048652	0	7.891867388	24.82398079	9.629273687	9.311374862	0	0.19489887	0	0	19.48988703	9.744943513	9.744943513	9.744943513	0	0	0	0											2.0055	0.027056881	3.089732206	0.085378972	1.21575563	1.319379015	0.590620646	1.073031398	0.265805021	0	0.497185811	0.124457306	0.006246305	0.132564117	0	12.10800238	0.678564475	2.882676449	3.705194717	0	3.993253514	0	0	0.308589878	0.25986516	0.179906649	0.032483145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5813	0	0.905103486	2.0055	0.027056881	3.089732206	0.085378972	1.21575563	1.319379015	0.590620646	1.073031398	0.265805021	0	0.497185811	0.124457306	0.006246305	0.132564117	0	12.10800238	0.678564475	2.882676449	3.705194717	0	3.993253514	0	0	0.308589878	0.25986516	0.179906649	0.032483145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5813	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							10.8831		0											10.8831	0	0	2.0055	0.027056881	3.089732206	0.085378972	1.21575563	1.319379015	0.590620646	1.073031398	0.265805021	0	0.497185811	0.124457306	0.006246305	0.132564117	0	12.10800238	0.678564475	2.882676449	3.705194717	0	3.993253514	0	0	0.308589878	0.25986516	0.179906649	0.032483145	0	10.88314362	0	0	0	0	0	0	0	0	0	0	0	0	45.4644
H1032_032_0	2008	6																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		778.0500547	-141.6877939	309.5040131	598.1624669	247.0380205	2.680268888	1.651335654	763.2115762	194.680772	949.5573044	220.1631921	46.68440119	0.057505121	83.82594698	11408.56673	11384.20211	215.3645075	622.4492651	4021.033623	763.9987787	13.86838422	19.57621201	0	190	320	221.5384615	40	16	0	1600	3600											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 14, $50 days 15 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $15.00 and $75.00	Copay between $0.00 and $5.00	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											54.91021442	0	18.50092015	2.626199574	48.80805777	0.197448454	0.197448454	12.45526262	48.92038746	0	8.341684767	71.42531039	0.197448454	13.3836135	1.978540593	7.629391254	20.42477725	8.1205877	8.676283248	0	0.197448454	0	0	19.74484542	9.872422708	9.872422708	9.872422708	0	0	0	0											3.5602	0	0.477175753	0.130907835	1.004787165	0.529214949	0.326053672	0.792166718	0.7936549	0	0.153044329	0.277870654	0.011354297	0.093491173	1.881026032	7.237877666	0.366564341	0.421221154	2.907302221	0	2.738291026	0	0	0.312626719	0.263264606	0.182260112	0.032908076	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.4933	0	0.318914679	3.5602	0	0.477175753	0.130907835	1.004787165	0.529214949	0.326053672	0.792166718	0.7936549	0	0.153044329	0.277870654	0.011354297	0.093491173	1.881026032	7.237877666	0.366564341	0.421221154	2.907302221	0	2.738291026	0	0	0.312626719	0.263264606	0.182260112	0.032908076	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.4933	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							9.6185		0											9.6185	0	0	3.5602	0	0.477175753	0.130907835	1.004787165	0.529214949	0.326053672	0.792166718	0.7936549	0	0.153044329	0.277870654	0.011354297	0.093491173	1.881026032	7.237877666	0.366564341	0.421221154	2.907302221	0	2.738291026	0	0	0.312626719	0.263264606	0.182260112	0.032908076	0	9.618510644	0	0	0	0	0	0	0	0	0	0	0	0	34.1118
H1032_033_0	2008	6																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		711.9784007	32.57581848	427.0535815	810.9674386	241.4892452	5.422666966	1.571990994	588.025568	119.4374695	935.893675	299.8461956	42.10482878	0.027189578	95.15024564	11082.63126	10315.39117	139.1907511	1079.232651	3513.745489	499.9165962	11.92880818	14.13574431	0	190	320	221.5384615	40	16	0	0	0											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$150.00 copayment	20% coinsurance	Copay between $15.00 and $100.00	Copay between $0.00 and $5.00	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											74.82451124	62.51996318	61.47290116	0.881892379	47.2934277	0.197186531	0.197186531	12.90315902	67.11925159	0	13.89948457	106.9958431	0.197186531	20.27393205	2.040220111	6.880338771	20.86340397	8.549749567	8.380729792	0	0.197186531	0	0	19.71865314	9.859326569	9.859326569	9.859326569	0	0	0	0											4.4395	0.169719914	2.187685217	0.059598834	0.951737847	1.06927689	0.309975451	0.632282284	0.66804613	0	0.347308964	0.375420138	0.005361419	0.160755801	1.884250599	5.914448819	0.241999406	0.768930741	2.453979292	0	2.352200308	0	0	0.312212008	0.262915375	0.182018337	0.032864422	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.7824	0	0.367865334	4.4395	0.169719914	2.187685217	0.059598834	0.951737847	1.06927689	0.309975451	0.632282284	0.66804613	0	0.347308964	0.375420138	0.005361419	0.160755801	1.884250599	5.914448819	0.241999406	0.768930741	2.453979292	0	2.352200308	0	0	0.312212008	0.262915375	0.182018337	0.032864422	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.7824	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							7.1457		0											7.1457	0	0	4.4395	0.169719914	2.187685217	0.059598834	0.951737847	1.06927689	0.309975451	0.632282284	0.66804613	0	0.347308964	0.375420138	0.005361419	0.160755801	1.884250599	5.914448819	0.241999406	0.768930741	2.453979292	0	2.352200308	0	0	0.312212008	0.262915375	0.182018337	0.032864422	0	7.145681637	0	0	0	0	0	0	0	0	0	0	0	0	32.9281
H1032_035_0	2008	6																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		282.0507736	26.08003729	1034.546167	696.0451564	372.8540059	4.713128083	2.059072402	990.2634285	286.2212123	694.1127674	383.4054738	85.28516247	0.061370897	145.7730588	12079.96594	13054.4966	357.2575798	248.937706	5181.754639	695.6756463	19.68563003	13.37184557	0.985955635	190	320	221.5384615	40	22.85714286	0	1600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	50.3888787	0.2	0.2	12.54609904	0	0	3.084558556	0	0.2	0	0	0	0	0	4.68721243	0	0.2	0	0	20	10	10	10	0	0	0	0											0	0	0	0	1.565641273	0.942625617	0.41181448	1.035328588	0	0	0.098553053	0	0.012274179	0	0	0	0	0	2.02399873	0	3.937126006	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8286	0	0	0	0	0	0	1.565641273	0.942625617	0.41181448	1.035328588	0	0	0.098553053	0	0.012274179	0	0	0	0	0	2.02399873	0	3.937126006	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8286	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							12.9449		0											12.9449	0	0	0	0	0	0	1.565641273	0.942625617	0.41181448	1.035328588	0	0	0.098553053	0	0.012274179	0	0	0	0	0	2.02399873	0	3.937126006	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	12.94493529	0	0	0	0	0	0	0	0	0	0	0	0	23.7736
H1032_036_0	2008	6																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1545.863287	89.87110233	931.3714014	1511.083307	468.8526417	9.637015754	2.981436947	1218.30453	215.2450289	3542.832228	866.1362795	51.26939853	0.058865408	242.3144317	14666.84254	22153.36686	200.1365287	1893.855072	4921.472646	767.9558511	22.32206724	18.57446573	0	190	320	221.5384615	40	16	0	1600	3600											"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $150.00	$0.00 copayment	Copay between $0.00 and $150.00	$200.00 copayment	20% coinsurance	Copay between $15.00 and $150.00	$0.00 copayment	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											91.72268506	119.5743579	58.80200434	1.524946393	43.02303909	0.1886191	0.1886191	14.47156662	100.7427289	0	18.76539005	124.0065992	0.1886191	30.11538022	0	5.382547821	19.92291572	8.321973181	9.316151622	0	0.1886191	0	0	18.86190997	9.430954987	9.430954987	9.430954987	0	0	0	0											11.8159	0.895523279	4.563875432	0.192026753	1.680955461	1.817725236	0.562355953	1.469231264	1.807030965	0	1.35444876	0.529811979	0.01110314	0.608115937	0	9.936796378	0.332275266	1.31338426	3.820765448	0	4.210368228	0	0	0.298646908	0.251492133	0.174109938	0.031436517	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.6774	0	2.876757624	11.8159	0.895523279	4.563875432	0.192026753	1.680955461	1.817725236	0.562355953	1.469231264	1.807030965	0	1.35444876	0.529811979	0.01110314	0.608115937	0	9.936796378	0.332275266	1.31338426	3.820765448	0	4.210368228	0	0	0.298646908	0.251492133	0.174109938	0.031436517	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.6774	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							12.7177		0											12.7177	0	0	11.8159	0.895523279	4.563875432	0.192026753	1.680955461	1.817725236	0.562355953	1.469231264	1.807030965	0	1.35444876	0.529811979	0.01110314	0.608115937	0	9.936796378	0.332275266	1.31338426	3.820765448	0	4.210368228	0	0	0.298646908	0.251492133	0.174109938	0.031436517	0	12.71765741	0	0	0	0	0	0	0	0	0	0	0	0	60.395
H1032_037_0	2008	7																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		244.5514652	11.46334993	641.0671105	532.803845	377.2949713	5.48081276	3.062123174	763.4883572	244.3459826	895.6312495	269.5540584	51.93485364	0.105215017	142.0859203	14454.42888	12616.94184	156.158514	144.7159565	5521.77907	602.6835018	17.84726773	16.22517895	0	190	320	221.5384615	40	16	0	1600	14400											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	50.3888787	0.2	0.2	12.11107351	0	0	5.477168657	0	0.2	0	0	0	0	0	5.514103486	0	0.2	0	0	20	10	10	10	0	0	0	0											0	0	0	0	1.584289212	1.096162552	0.612424635	0.770555301	0	0	0.123032753	0	0.021043003	0	0	0	0	0	2.537305101	0	3.569453547	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.1155	0	0	0	0	0	0	1.584289212	1.096162552	0.612424635	0.770555301	0	0	0.123032753	0	0.021043003	0	0	0	0	0	2.537305101	0	3.569453547	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.1155	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	0	0	0	0	1.584289212	1.096162552	0.612424635	0.770555301	0	0	0.123032753	0	0.021043003	0	0	0	0	0	2.537305101	0	3.569453547	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.1155
H1032_040_0	2008	6																																A	A	D	V	T	P	P	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		217.6100243	8.057035759	333.5169371	864.4360943	435.465655	402.3256362	220.4181437	924.7268934	142.8547921	1216.372614	492.8986368	29.183937	0.16902033	142.4417307	10919.85706	11980.47239	329.537274	1327.871628	4948.766983	443.5006728	47.73889087	8.158351757	0	0	0	0	0	0	0	0	0											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	0	0	0	0	0	0	0	0	0.2	0	0	0	0	0	0	0	0.2	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0.033804066	0	0	0	0	0	0	0	9.547778173	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.5816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.033804066	0	0	0	0	0	0	0	9.547778173	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.5816	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							11.2238		0											11.2238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.033804066	0	0	0	0	0	0	0	9.547778173	0	0	0	0	0	0	0	11.2238281	0	0	0	0	0	0	0	0	0	0	0	0	20.8054
H1032_041_0	2008	7																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		256.8121437	17.029983	780.3236112	736.9784952	334.3824425	6.940880896	2.64989677	1014.846679	295.1323562	599.6072889	271.340652	65.61476736	0.126726998	65.82883391	12390.94805	13760.47543	359.6920159	409.4980445	5386.020084	679.1331772	18.79171286	21.77303426	0	190	320	221.5384615	40	16	0	1600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	50.3888787	0.2	0.2	13.43777749	0	0	3.945229384	0	0.2	0	0	0	0	0	5.203737916	0	0.2	0	0	20	10	10	10	0	0	0	0											0	0	0	0	1.404096361	1.388176179	0.529979354	1.136440321	0	0	0.089208426	0	0.0253454	0	0	0	0	0	2.335619744	0	3.758342573	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.4685	0	0	0	0	0	0	1.404096361	1.388176179	0.529979354	1.136440321	0	0	0.089208426	0	0.0253454	0	0	0	0	0	2.335619744	0	3.758342573	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.4685	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.0793		0											13.0793	0	0	0	0	0	0	1.404096361	1.388176179	0.529979354	1.136440321	0	0	0.089208426	0	0.0253454	0	0	0	0	0	2.335619744	0	3.758342573	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	13.07932655	0	0	0	0	0	0	0	0	0	0	0	0	24.5478
H1032_042_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1976.066811	85.66072017	1220.622157	6402.130808	771.1643144	18.25086392	5.339014278	1357.001218	284.6777605	4680.045331	1290.751366	136.5885067	0.26796859	399.0544206	9281.806715	33779.09326	856.0228618	7713.517413	5961.037434	763.0814417	51.77877608	32.86424641	0	190	320	221.5384615	40	16	0	0	0											"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 14, $50 days 15 - 100"	Copay between $0.00 and $10.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$50.00 copayment	20% coinsurance	Copay between $5.00 and $25.00	$0.00 copayment	$10.00 copayment	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											20.99606723	14.13696885	18.74	0	40.63597548	0.2	0.2	17.61761238	20.39955682	0	8.585141367	36.17415527	0.2	5.542652121	0	2.75841265	8.271339586	3.395746588	5.632821229	0	0.2	0	0	20	10	10	10	0	0	0	0											3.4575	0.100915244	1.906204936	0	2.611417847	3.650172783	1.067802856	1.992260122	0.483941679	0	0.923440246	0.411747821	0.053593718	0.184318319	0	7.764723178	0.590037982	2.182762537	2.798121517	0	10.35575522	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.336	0	0	3.4575	0.100915244	1.906204936	0	2.611417847	3.650172783	1.067802856	1.992260122	0.483941679	0	0.923440246	0.411747821	0.053593718	0.184318319	0	7.764723178	0.590037982	2.182762537	2.798121517	0	10.35575522	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.336	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							18.6633		0											18.6633	0	0	3.4575	0.100915244	1.906204936	0	2.611417847	3.650172783	1.067802856	1.992260122	0.483941679	0	0.923440246	0.411747821	0.053593718	0.184318319	0	7.764723178	0.590037982	2.182762537	2.798121517	0	10.35575522	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	18.66329231	0	0	0	0	0	0	0	0	0	0	0	0	59.9993
H1032_043_0	2008	7																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1146.415727	123.7856721	533.7959834	2802.123107	510.2848208	9.479471087	3.219758944	1074.482521	193.8960878	2638.111701	741.4873003	83.52366051	0.126758324	280.29161	11471.88057	21532.43515	558.4209951	3963.439172	4808.804275	564.9010411	61.47827325	24.35937853	0	0	0	0	0	0	0	0	0											"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 14, $50 days 15 - 100"	Copay between $0.00 and $15.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$50.00 copayment	20% coinsurance	Copay between $5.00 and $25.00	$0.00 copayment	$15.00 copayment	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											22.81718893	17.51606436	18.74	0	42.19078891	0.2	0.2	15.73104619	19.94297524	0	8.400924735	36.17415527	0.2	5.246059051	0	4.086008005	12.48567738	5.068651506	6.318398742	0	0.2	0	0	0	0	0	0	0	0	0	0											2.1798	0.180686483	0.833611394	0	1.79410993	1.895894217	0.643951789	1.40856118	0.32223874	0	0.51909825	0.251783155	0.025351665	0.122535528	0	7.331808533	0.581022032	1.674107661	2.53199524	0	12.29565465	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5922	0	0	2.1798	0.180686483	0.833611394	0	1.79410993	1.895894217	0.643951789	1.40856118	0.32223874	0	0.51909825	0.251783155	0.025351665	0.122535528	0	7.331808533	0.581022032	1.674107661	2.53199524	0	12.29565465	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5922	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							12.3824		0											12.3824	0	0	2.1798	0.180686483	0.833611394	0	1.79410993	1.895894217	0.643951789	1.40856118	0.32223874	0	0.51909825	0.251783155	0.025351665	0.122535528	0	7.331808533	0.581022032	1.674107661	2.53199524	0	12.29565465	0	0	0	0	0	0	0	12.3824499	0	0	0	0	0	0	0	0	0	0	0	0	46.9747
H1032_044_0	2008	6																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		284.1352503	26.41382908	959.1414472	4202.266346	628.5530155	11.62078467	4.144634439	1349.085606	268.1832609	3458.748427	979.143497	100.7183245	0.173970539	297.3043577	12564.00829	27728.85997	845.2667893	5366.935258	5757.818095	663.6148856	43.44976685	21.16192501	0	190	320	221.5384615	40	16	0	0	0											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	42.76647584	0.2	0.2	15.81574536	0	0	7.169355927	0	0.2	0	0	0	0	0	4.926395164	0	0.2	0	0	20	10	10	10	0	0	0	0											0	0	0	0	2.240083113	2.324156933	0.828926888	1.778066202	0	0	0.584985686	0	0.034794108	0	0	0	0	0	2.363773935	0	8.689953369	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.646	0	0	0	0	0	0	2.240083113	2.324156933	0.828926888	1.778066202	0	0	0.584985686	0	0.034794108	0	0	0	0	0	2.363773935	0	8.689953369	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.646	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							17.098		0											17.098	0	0	0	0	0	0	2.240083113	2.324156933	0.828926888	1.778066202	0	0	0.584985686	0	0.034794108	0	0	0	0	0	2.363773935	0	8.689953369	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	17.09801614	0	0	0	0	0	0	0	0	0	0	0	0	36.744
H1032_060_0	2008	5																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		292.2381104	77.46126026	2970.931904	8265.712444	1607.88781	30.25963231	3.638398858	1769.76658	112.0851446	5551.409894	901.8964577	66.48058442	0.371911719	264.4272999	7220.84029	22732.54803	3118.555406	10739.0029	4442.777083	316.4002738	176.2112266	16.54774438	1500	190	320	221.5384615	40	16	0	73600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	34.92691462	0.2	0.2	20.43297878	0	0	6.211992653	0	0.2	0	0	0	0	0	3.490042436	0	0.2	0	0	20	10	10	10	0	0	0	0											0	0	0	0	4.679880021	6.051926461	0.727679772	3.013466915	0	0	0.466881181	0	0.074382344	0	0	0	0	0	1.292123379	0	35.24224532	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.3499	0	0	0	0	0	0	4.679880021	6.051926461	0.727679772	3.013466915	0	0	0.466881181	0	0.074382344	0	0	0	0	0	1.292123379	0	35.24224532	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.3499	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							15.3904		0											15.3904	0	0	0	0	0	0	4.679880021	6.051926461	0.727679772	3.013466915	0	0	0.466881181	0	0.074382344	0	0	0	0	0	1.292123379	0	35.24224532	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	15.39037093	0	0	0	0	0	0	0	0	0	0	0	0	67.7402
H1032_061_0	2008	5																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		331.7152152	26.66383904	1086.101652	1092.448222	551.8705015	6.551045405	2.90705833	1521.301184	238.6191884	2284.022865	502.9024631	69.37724476	0.512018027	146.3573463	13735.01849	13954.36033	880.3353386	980.9914772	5724.381981	580.0043985	19.15986208	18.18558544	1500	190	320	221.5384615	40	16	0	37600	14400											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	45.41892606	0.2	0.2	13.85013231	0	0	4.431603298	0	0.2	0	0	0	0	0	4.618387098	0	0.2	0	0	20	10	10	10	0	0	0	0											0	0	0	0	2.088780459	1.310209081	0.581411666	1.75585189	0	0	0.185722018	0	0.102403605	0	0	0	0	0	2.203117657	0	3.831972416	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.8608	0	0	0	0	0	0	2.088780459	1.310209081	0.581411666	1.75585189	0	0	0.185722018	0	0.102403605	0	0	0	0	0	2.203117657	0	3.831972416	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.8608	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							12.7692		0											12.7692	0	0	0	0	0	0	2.088780459	1.310209081	0.581411666	1.75585189	0	0	0.185722018	0	0.102403605	0	0	0	0	0	2.203117657	0	3.831972416	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	12.76919746	0	0	0	0	0	0	0	0	0	0	0	0	25.6299
H1032_064_0	2008	5																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		344.286826	67.41245347	2737.239862	5106.933408	1475.445527	18.02219145	3.472130198	1935.330812	195.3710967	4762.213815	762.63007	104.0917264	0.053074079	297.5441092	7961.041472	19160.56725	2350.198758	5279.580751	5245.17425	521.5258743	28.82068634	20.86065813	1500	190	320	221.5384615	40	16	0	73600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	35.01407876	0.2	0.2	18.61903916	0	0	6.417540493	0	0.2	0	0	0	0	0	3.532345642	0	0.2	0	0	20	10	10	10	0	0	0	0											0	0	0	0	4.305113825	3.60443829	0.69442604	3.002833347	0	0	0.40785078	0	0.010614816	0	0	0	0	0	1.5439807	0	5.764137267	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.1347	0	0	0	0	0	0	4.305113825	3.60443829	0.69442604	3.002833347	0	0	0.40785078	0	0.010614816	0	0	0	0	0	1.5439807	0	5.764137267	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.1347	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.2594		0											14.2594	0	0	0	0	0	0	4.305113825	3.60443829	0.69442604	3.002833347	0	0	0.40785078	0	0.010614816	0	0	0	0	0	1.5439807	0	5.764137267	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	14.25937486	0	0	0	0	0	0	0	0	0	0	0	0	34.3941
H1032_065_0	2008	6																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		317.7872263	46.26278101	2131.796286	4539.587219	1255.298067	25.53361354	3.647799639	1809.187427	165.6426703	3766.609158	746.097399	56.50726202	0.464124582	210.0863556	8651.957029	16699.01301	1272.294353	4500.425055	5011.588958	416.1429234	22.86516733	17.749139	1500	190	320	221.5384615	40	16	0	37600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	34.10415175	0.2	0.2	19.14586071	0	0	6.304616735	0	0.2	0	0	0	0	0	4.15605068	0	0.2	0	0	20	10	10	10	0	0	0	0											0	0	0	0	3.567572981	5.106722707	0.729559928	2.88653754	0	0	0.391988179	0	0.092824916	0	0	0	0	0	1.735701475	0	4.573033466	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.8852	0	0	0	0	0	0	3.567572981	5.106722707	0.729559928	2.88653754	0	0	0.391988179	0	0.092824916	0	0	0	0	0	1.735701475	0	4.573033466	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.8852	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.2286		0											13.2286	0	0	0	0	0	0	3.567572981	5.106722707	0.729559928	2.88653754	0	0	0.391988179	0	0.092824916	0	0	0	0	0	1.735701475	0	4.573033466	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	13.22856422	0	0	0	0	0	0	0	0	0	0	0	0	33.1138
H1032_066_0	2008	5																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		299.3283055	83.19892394	3041.81543	8749.5631	1638.051788	31.84836145	3.712137196	1760.090521	116.7382712	5408.523387	911.9785206	67.05193073	0.406562717	262.7736975	7449.010029	23463.59203	3317.944619	10876.08552	4539.116447	327.8686955	191.5842353	14.72010713	1500	190	320	221.5384615	40	16	0	73600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	34.97745437	0.2	0.2	20.25992066	0	0	6.210156019	0	0.2	0	0	0	0	0	3.431315573	0	0.2	0	0	20	10	10	10	0	0	0	0											0	0	0	0	4.774573473	6.36967229	0.742427439	2.971607859	0	0	0.471960742	0	0.081312543	0	0	0	0	0	1.297928413	0	38.31684707	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8276	0	0	0	0	0	0	4.774573473	6.36967229	0.742427439	2.971607859	0	0	0.471960742	0	0.081312543	0	0	0	0	0	1.297928413	0	38.31684707	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8276	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							16.0604		0											16.0604	0	0	0	0	0	0	4.774573473	6.36967229	0.742427439	2.971607859	0	0	0.471960742	0	0.081312543	0	0	0	0	0	1.297928413	0	38.31684707	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	16.06035978	0	0	0	0	0	0	0	0	0	0	0	0	71.888
H1032_069_0	2008	7																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1449.146437	63.57216781	1084.18517	1906.841006	438.5202549	13.51475571	4.231316043	964.1018713	211.196703	3597.623795	686.1547802	52.37863819	0.093621054	280.2344038	11667.33318	19558.43918	350.706677	3949.980458	5565.45726	858.2900083	28.24254265	28.3643089	0	190	320	221.5384615	40	16	0	0	0											"$225 days 1 - 5, $0 after day 5, unlimited coverage"	"$225 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $150.00	$0.00 copayment	Copay between $0.00 and $150.00	$225.00 copayment	20% coinsurance	Copay between $25.00 and $150.00	$0.00 copayment	$35.00 copayment	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $0.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											106.7744116	106.9728686	30.26	0.950464443	42.0452512	0.2	0.2	19.43641913	121.470513	0	21.45290306	147.5987555	0.2	29.20643265	0	10.34768966	29.35763448	12.08399827	13.01948365	0	0.2	0	0	20	10	10	10	0	0	0	0											12.8943	0.566708096	2.733953605	0.151032048	1.536474523	2.702951141	0.846263209	1.561557338	2.137847655	0	1.226667665	0.644251818	0.018724211	0.682053937	0	16.86538823	0.857993203	3.977629753	6.03828165	0	5.64850853	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8919	0	0	12.8943	0.566708096	2.733953605	0.151032048	1.536474523	2.702951141	0.846263209	1.561557338	2.137847655	0	1.226667665	0.644251818	0.018724211	0.682053937	0	16.86538823	0.857993203	3.977629753	6.03828165	0	5.64850853	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8919	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.9932		0											14.9932	0	0	12.8943	0.566708096	2.733953605	0.151032048	1.536474523	2.702951141	0.846263209	1.561557338	2.137847655	0	1.226667665	0.644251818	0.018724211	0.682053937	0	16.86538823	0.857993203	3.977629753	6.03828165	0	5.64850853	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	14.99316567	0	0	0	0	0	0	0	0	0	0	0	0	76.885
H1032_070_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1285.751721	17.20977325	879.4793978	892.4157415	224.0559488	11.16081198	3.615563426	936.7237578	256.6628847	1884.576238	564.2552934	54.81375258	0.125490941	211.6403894	14704.51258	19039.93871	128.9428942	856.0807981	5186.410119	640.3216579	20.69947501	8.077744822	0	190	320	221.5384615	40	16	0	1600	3600											"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 14, $100 days 15 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$50.00 copayment	20% coinsurance	Copay between $15.00 and $25.00	$0.00 copayment	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											26.02459602	31.89019498	37.47	1.622027761	46.26300761	0.2	0.2	14.52954946	15.81043203	0	5.896913472	36.17415527	0.2	7.45993326	0	5.202255876	20.98495236	8.781291647	7.976948197	0	0.2	0	0	20	10	10	10	0	0	0	0											2.7884	0.045735252	2.746174419	0.120626926	0.863791839	2.232162397	0.723112685	1.134181181	0.338162591	0	0.277280387	0.165236766	0.025098188	0.131568598	0	8.254219419	0.225488374	0.62645793	3.447643737	0	4.139895003	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0865	0	0	2.7884	0.045735252	2.746174419	0.120626926	0.863791839	2.232162397	0.723112685	1.134181181	0.338162591	0	0.277280387	0.165236766	0.025098188	0.131568598	0	8.254219419	0.225488374	0.62645793	3.447643737	0	4.139895003	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0865	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							11.6831		0											11.6831	0	0	2.7884	0.045735252	2.746174419	0.120626926	0.863791839	2.232162397	0.723112685	1.134181181	0.338162591	0	0.277280387	0.165236766	0.025098188	0.131568598	0	8.254219419	0.225488374	0.62645793	3.447643737	0	4.139895003	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	11.68309082	0	0	0	0	0	0	0	0	0	0	0	0	40.7696
H1032_073_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1935.506932	36.3412289	877.2683185	474.4958525	438.4495316	12.77212594	3.517809693	1002.319745	238.9470675	1866.304184	750.8305606	28.24226128	0.053877213	230.8101234	11251.51426	14454.67265	158.8459089	184.1871531	5887.202513	615.3057202	26.51933861	2.412869489	0	190	320	221.5384615	40	16	0	1600	3600											"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $175.00	$0.00 copayment	Copay between $0.00 and $175.00	$200.00 copayment	20% coinsurance	Copay between $20.00 and $175.00	Copay between $0.00 and $10.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $10.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											85.10616597	102.9133333	53	4.949488825	50.3888787	0.2	0.2	9.388691648	101.9408784	0	20.84975639	144.6966211	0.2	33.67094602	4.000656018	7.865564456	25.56273701	9.173428034	10.43317211	0	0.2	0	0	20	10	10	10	0	0	0	0											13.727	0.311666417	3.87460174	0.195709327	1.841081689	2.554425188	0.703561939	0.784205918	2.02987283	0	1.304552856	0.340546648	0.010775443	0.647632934	3.751119852	9.474513285	0.338378016	0.140802299	5.118516423	0	5.303867722	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.2541	0	0	13.727	0.311666417	3.87460174	0.195709327	1.841081689	2.554425188	0.703561939	0.784205918	2.02987283	0	1.304552856	0.340546648	0.010775443	0.647632934	3.751119852	9.474513285	0.338378016	0.140802299	5.118516423	0	5.303867722	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.2541	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.7505		0											13.7505	0	0	13.727	0.311666417	3.87460174	0.195709327	1.841081689	2.554425188	0.703561939	0.784205918	2.02987283	0	1.304552856	0.340546648	0.010775443	0.647632934	3.751119852	9.474513285	0.338378016	0.140802299	5.118516423	0	5.303867722	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	13.75051682	0	0	0	0	0	0	0	0	0	0	0	0	67.0046
H1032_077_0	2008	6																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		264.6730083	4.125487647	814.64889	1712.977629	356.2214263	10.11976392	3.051390483	776.1788535	206.554577	3633.579283	805.2042943	53.12948659	0.162099143	322.9994224	12806.61465	21536.52778	213.0698558	2867.163213	4819.492841	724.3429601	26.5622679	24.41027893	0	190	320	221.5384615	40	16	0	1600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	41.24548675	0.2	0.2	17.6803681	0	0	8.643699001	0	0.2	0	0	0	0	0	5.163760353	0	0.2	0	0	20	10	10	10	0	0	0	0											0	0	0	0	1.224377177	2.023952784	0.610278097	1.143593987	0	0	0.579995296	0	0.032419829	0	0	0	0	0	2.073892171	0	5.312453579	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.8022	0	0	0	0	0	0	1.224377177	2.023952784	0.610278097	1.143593987	0	0	0.579995296	0	0.032419829	0	0	0	0	0	2.073892171	0	5.312453579	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.8022	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	0	0	0	0	1.224377177	2.023952784	0.610278097	1.143593987	0	0	0.579995296	0	0.032419829	0	0	0	0	0	2.073892171	0	5.312453579	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.8022
H1032_079_0	2008	6																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1252.479443	52.74772532	871.0027855	2277.260961	377.1423643	18.77366466	3.714185869	1422.255217	239.2833723	7981.534818	1467.375522	22.70686051	0.119552209	512.2586557	7176.203905	15394.32633	226.9950769	3370.168273	4001.987475	900.8254487	31.22644304	26.42459047	0	0	0	0	0	0	0	0	0											"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$200 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $150.00	$0.00 copayment	Copay between $0.00 and $150.00	$200.00 copayment	20% coinsurance	Copay between $20.00 and $150.00	Copay between $0.00 and $10.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $10.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											94.54044456	48.52121221	28.45829742	0	44.04534847	0.188091853	0.188091853	18.50797005	117.601059	0	22.41000005	124.6220534	0.188091853	33.64366105	4.005198701	9.123438074	23.87274667	10.71900264	7.30531086	0	0.188091853	0	0	0	0	0	0	0	0	0	0											9.8675	0.213281964	2.065604694	0	1.384280571	3.531173382	0.698608104	2.193588079	2.344998166	0	2.740323794	0.235814632	0.022486797	1.436188049	2.39517688	11.70409858	0.451582997	3.01040355	2.436313547	0	5.873439547	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6049	0	3.330428062	9.8675	0.213281964	2.065604694	0	1.384280571	3.531173382	0.698608104	2.193588079	2.344998166	0	2.740323794	0.235814632	0.022486797	1.436188049	2.39517688	11.70409858	0.451582997	3.01040355	2.436313547	0	5.873439547	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6049	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.1621		0											13.1621	0	0	9.8675	0.213281964	2.065604694	0	1.384280571	3.531173382	0.698608104	2.193588079	2.344998166	0	2.740323794	0.235814632	0.022486797	1.436188049	2.39517688	11.70409858	0.451582997	3.01040355	2.436313547	0	5.873439547	0	0	0	0	0	0	0	13.16206913	0	0	0	0	0	0	0	0	0	0	0	0	65.7669
H1032_085_0	2008	7																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		312.2445055	81.46407081	2067.180688	42.37714646	15.57046465	14.80243409	3.406083265	27.63569353	12.35657416	7.04324171	13.1647174	95.90464743	0.113890189	3.412782553	9686.386823	89.22345835	12.35375636	22.08857029	32.67763578	4.699858893	28.60716679	0.35945764	0	600	240	192	30	16	0	37600	6											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.4	708.4	30.26	0.072924605	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.199339608	0.004333182	0.2	0.2	0	0	0	0	0	0	0	0	0											18.4328	4.809095647	5.212740636	3.090336677	3.11409293	2.960486819	0.681216653	5.527138706	2.471314833	1.408648342	2.63294348	0	0.022778038	0.682556511	0	17.84469167	2.470751273	4.417714058	6.513947119	0.020365345	5.721433359	0.071891528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.107	0	0	18.4328	4.809095647	5.212740636	3.090336677	3.11409293	2.960486819	0.681216653	5.527138706	2.471314833	1.408648342	2.63294348	0	0.022778038	0.682556511	0	17.84469167	2.470751273	4.417714058	6.513947119	0.020365345	5.721433359	0.071891528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.107	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	18.4328	4.809095647	5.212740636	3.090336677	3.11409293	2.960486819	0.681216653	5.527138706	2.471314833	1.408648342	2.63294348	0	0.022778038	0.682556511	0	17.84469167	2.470751273	4.417714058	6.513947119	0.020365345	5.721433359	0.071891528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.107
H1032_086_0	2008	7																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		388.5690534	73.65315223	2725.624194	49.03730662	19.0936589	17.771981	3.931479548	31.70474235	14.58055096	6.458749005	12.20363022	110.6395891	0.062400992	3.877669078	8473.769664	101.9124809	15.41112116	26.15916608	28.97757102	4.698081246	29.97126761	0.346780147	0	600	240	192	30	16	0	73600	5.25											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.4	708.4	30.26	0.077145635	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.199388283	0.005102689	0.2	0.2	0	0	0	0	0	0	0	0	0											22.9385	4.347991087	6.873115677	3.783014135	3.81873178	3.554396199	0.78629591	6.34094847	2.916110193	1.291749801	2.440726044	0	0.012480198	0.775533816	0	20.38249618	3.082224232	5.231833216	5.777788129	0.023972846	5.994253522	0.069356029	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.4415	0	0	22.9385	4.347991087	6.873115677	3.783014135	3.81873178	3.554396199	0.78629591	6.34094847	2.916110193	1.291749801	2.440726044	0	0.012480198	0.775533816	0	20.38249618	3.082224232	5.231833216	5.777788129	0.023972846	5.994253522	0.069356029	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.4415	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	22.9385	4.347991087	6.873115677	3.783014135	3.81873178	3.554396199	0.78629591	6.34094847	2.916110193	1.291749801	2.440726044	0	0.012480198	0.775533816	0	20.38249618	3.082224232	5.231833216	5.777788129	0.023972846	5.994253522	0.069356029	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.4415
H1032_088_0	2008	7																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		336.8569874	94.18684568	3097.76689	93.01238602	18.20124413	34.67002224	4.515534772	18.60998719	8.58248105	5.084274392	12.01592366	77.27287372	0.48164796	3.18608755	8077.838793	110.4765145	26.08281797	48.50659794	30.16665328	3.430837955	218.6424864	0.311212702	0	600	240	192	30	16	0	73600	3.75											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.2179971	708.4	30.26	0.067375847	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.199666987	0.010315757	0.2	0.2	0	0	0	0	0	0	0	0	0											19.8807	5.560163456	7.811535508	6.266788297	3.640248826	6.934004449	0.903106954	3.721997437	1.71649621	1.016854878	2.403184732	0	0.096329592	0.63721751	0	22.0953029	5.216563594	9.701319587	6.023284783	0.035391692	43.72849728	0.06224254	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	147.4512	0	0	19.8807	5.560163456	7.811535508	6.266788297	3.640248826	6.934004449	0.903106954	3.721997437	1.71649621	1.016854878	2.403184732	0	0.096329592	0.63721751	0	22.0953029	5.216563594	9.701319587	6.023284783	0.035391692	43.72849728	0.06224254	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	147.4512	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	19.8807	5.560163456	7.811535508	6.266788297	3.640248826	6.934004449	0.903106954	3.721997437	1.71649621	1.016854878	2.403184732	0	0.096329592	0.63721751	0	22.0953029	5.216563594	9.701319587	6.023284783	0.035391692	43.72849728	0.06224254	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	147.4512
H1032_089_0	2008	7																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		376.592053	45.56925471	2938.327333	68.41630111	18.58928153	20.614686	3.856999252	23.59202335	9.465005646	4.933903641	12.40495071	50.57243642	0.229050455	2.638164429	9838.847483	104.3152317	15.22381652	35.42351102	34.86400447	4.146767789	64.5996335	0.363846059	0	600	240	192	30	16	0	73600	6											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.172033	708.4	30.26	0.056476543	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.199555409	0.006334476	0.2	0.2	0	0	0	0	0	0	0	0	0											22.2243	2.690105003	7.409482092	3.863916171	3.717856306	4.122937201	0.77139985	4.71840467	1.893001129	0.986780728	2.480990141	0	0.045810091	0.527632886	0	20.86304633	3.044763304	7.084702205	6.957300672	0.0262676	12.9199267	0.072769212	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.4214	0	0	22.2243	2.690105003	7.409482092	3.863916171	3.717856306	4.122937201	0.77139985	4.71840467	1.893001129	0.986780728	2.480990141	0	0.045810091	0.527632886	0	20.86304633	3.044763304	7.084702205	6.957300672	0.0262676	12.9199267	0.072769212	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.4214	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	22.2243	2.690105003	7.409482092	3.863916171	3.717856306	4.122937201	0.77139985	4.71840467	1.893001129	0.986780728	2.480990141	0	0.045810091	0.527632886	0	20.86304633	3.044763304	7.084702205	6.957300672	0.0262676	12.9199267	0.072769212	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.4214
H1032_091_0	2008	6																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		266.0743538	10.9919664	622.6338764	353.3518697	344.8022035	5.657645743	3.389204093	931.7687548	259.4833259	1086.695296	321.4747406	56.33032336	0.060129628	159.010184	15989.91759	12643.22599	213.3964188	160.1359584	5711.845262	744.3159645	19.65039847	18.07245239	0	190	320	221.5384615	40	16	0	1600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	Copay between $0.00 and $20.00	$0.00 copayment	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	4.064646876	50.3888787	0.2	0.2	12.35138463	0	0	5.278320059	0	0.2	3.145079147	0	5.541590715	17.18137313	6.399411927	7.786628585	0	0.2	0	0	20	10	10	10	0	0	0	0											0	0	0	0.119687548	1.447849701	1.131529149	0.677840819	0.959052856	0	0	0.141403881	0	0.012025926	0.041674968	0	5.838631981	0.305536958	0.085397997	3.706334799	0	3.930079695	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.1983	0	0	0	0	0	0.119687548	1.447849701	1.131529149	0.677840819	0.959052856	0	0	0.141403881	0	0.012025926	0.041674968	0	5.838631981	0.305536958	0.085397997	3.706334799	0	3.930079695	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.1983	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							12.5128		0											12.5128	0	0	0	0	0	0.119687548	1.447849701	1.131529149	0.677840819	0.959052856	0	0	0.141403881	0	0.012025926	0.041674968	0	5.838631981	0.305536958	0.085397997	3.706334799	0	3.930079695	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	12.51276665	0	0	0	0	0	0	0	0	0	0	0	0	31.7111
H1032_097_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		886.5528792	27.9398746	756.8089796	1799.184254	419.6528298	13.67022599	3.829959583	792.8974021	161.3627654	3937.113163	685.6692668	52.53797115	0.100455047	302.0509748	7456.052193	18575.95077	291.1320786	4553.28032	4186.184493	745.3103657	26.80465537	25.27592226	0	0	0	0	0	0	0	0	0											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 20, $114 days 21 - 100"	Copay between $0.00 and $40.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $150.00	$0.00 copayment	Copay between $0.00 and $150.00	$250.00 copayment	20% coinsurance	Copay between $30.00 and $150.00	Copay between $0.00 and $10.00	$40.00 copayment	Copay between $30.00 and $40.00	$40.00 copayment	Copay between $10.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											126.0970588	69.99965279	27.16	0	38.74422924	0.2	0.2	21.67335894	124.2828883	0	23.12602735	132.9939031	0.2	30.84618924	3.922166457	11.76365848	33.23665876	13.86951074	13.86730519	0	0.2	0	0	0	0	0	0	0	0	0	0											9.316	0.162981793	1.712910991	0	1.35492712	2.734045197	0.765991917	1.4320625	1.671219213	0	1.321400518	0.582269154	0.020091009	0.776426794	2.436989818	18.21009507	0.806354796	5.262647525	4.837591495	0	5.360931074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.7649	0	0	9.316	0.162981793	1.712910991	0	1.35492712	2.734045197	0.765991917	1.4320625	1.671219213	0	1.321400518	0.582269154	0.020091009	0.776426794	2.436989818	18.21009507	0.806354796	5.262647525	4.837591495	0	5.360931074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.7649	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							10.8764		0											10.8764	0	0	9.316	0.162981793	1.712910991	0	1.35492712	2.734045197	0.765991917	1.4320625	1.671219213	0	1.321400518	0.582269154	0.020091009	0.776426794	2.436989818	18.21009507	0.806354796	5.262647525	4.837591495	0	5.360931074	0	0	0	0	0	0	0	10.87642949	0	0	0	0	0	0	0	0	0	0	0	0	69.6413
H1032_098_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		995.1314092	34.55581051	773.3893284	1990.026507	356.1201503	17.2700094	4.193113835	655.5705388	161.7710678	2025.153237	525.7574433	23.2573919	0.353056154	189.4351731	7788.832189	18103.33074	116.9979069	2403.489105	4047.015434	585.1052961	26.09954926	17.47194595	0	0	0	0	0	0	0	1600	3600											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 14, $100 days 15 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $150.00	$0.00 copayment	Copay between $0.00 and $150.00	$250.00 copayment	20% coinsurance	Copay between $25.00 and $150.00	Copay between $0.00 and $15.00	$35.00 copayment	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $15.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											132.0023145	86.23336602	37.47	0	40.50307742	0.2	0.2	20.93964569	120.6243055	0	23.1826935	180.8707764	0.2	33.07656521	5.230761398	8.811476599	27.6603383	12.40812857	12.91244823	0	0.2	0	0	0	0	0	0	0	0	0	0											10.9466	0.248321988	2.414908178	0	1.201996835	3.454001881	0.838622767	1.143951234	1.626126892	0	1.015706138	0.350548544	0.070611231	0.522155405	3.395126896	13.2930896	0.269683474	2.485233487	4.354739771	0	5.219909851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8514	0	0	10.9466	0.248321988	2.414908178	0	1.201996835	3.454001881	0.838622767	1.143951234	1.626126892	0	1.015706138	0.350548544	0.070611231	0.522155405	3.395126896	13.2930896	0.269683474	2.485233487	4.354739771	0	5.219909851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8514	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							10.2548		0											10.2548	0	0	10.9466	0.248321988	2.414908178	0	1.201996835	3.454001881	0.838622767	1.143951234	1.626126892	0	1.015706138	0.350548544	0.070611231	0.522155405	3.395126896	13.2930896	0.269683474	2.485233487	4.354739771	0	5.219909851	0	0	0	0	0	0	0	10.25477737	0	0	0	0	0	0	0	0	0	0	0	0	63.1061
H1032_101_0	2008	5																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2471.298371	329.8285258	2768.343273	3388.053133	1535.004614	24.96994718	4.712072499	2292.647305	202.6543248	4914.25278	1221.612683	71.26833006	0.067011747	340.195205	9557.688215	18347.02189	782.4655757	4438.5145	5837.226767	621.0590347	14.93614825	5.732075565	1500	190	320	221.5384615	40	16	0	37600	3600											"$0 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	Copay between $0.00 and $20.00	$0.00 copayment	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	52.88354708	0.205554549	28.66011949	0.169634473	0.169634473	14.13383633	0	0	6.454763203	0	0.169634473	4.143713494	0	3.703553816	13.54162807	6.360583101	3.637931535	0	0.169634473	0	0	16.96344734	8.48172367	8.48172367	8.48172367	0	0	0	0											0	0	12.19998432	0.058035811	3.666117971	4.235763841	0.799329937	2.700325147	0	0	0.657101716	0	0.011367502	0.117472622	0	5.662431911	0.882988151	2.35262836	1.769619278	0	2.533685643	0	0	0.268587916	0.226179298	0.156585668	0.028272412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.3265	0	6.860655434	0	0	12.19998432	0.058035811	3.666117971	4.235763841	0.799329937	2.700325147	0	0	0.657101716	0	0.011367502	0.117472622	0	5.662431911	0.882988151	2.35262836	1.769619278	0	2.533685643	0	0	0.268587916	0.226179298	0.156585668	0.028272412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.3265	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							15.8291		0											15.8291	0	0	0	0	12.19998432	0.058035811	3.666117971	4.235763841	0.799329937	2.700325147	0	0	0.657101716	0	0.011367502	0.117472622	0	5.662431911	0.882988151	2.35262836	1.769619278	0	2.533685643	0	0	0.268587916	0.226179298	0.156585668	0.028272412	0	15.8291075	0	0	0	0	0	0	0	0	0	0	0	0	54.1556
H1032_102_0	2008	5																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		353.7785828	35.93457041	2987.421356	3926.383632	1277.938855	20.13617546	3.889585396	1856.158084	134.7659189	6947.610129	1018.295492	56.73235117	0.715108241	200.6775861	10560.92484	20747.23639	1084.740684	5058.524299	4899.552194	476.836637	18.05258116	19.94371592	1500	190	320	221.5384615	40	16	0	37600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	34.75048807	0.2	0.2	18.72778224	0	0	6.492207229	0	0.2	0	0	0	0	0	3.04624738	0	0.2	0	0	20	10	10	10	0	0	0	0											0	0	0	0	3.700749911	4.027235091	0.777917079	2.896810367	0	0	0.550915446	0	0.143021648	0	0	0	0	0	1.24377067	0	3.610516231	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7522	0	0	0	0	0	0	3.700749911	4.027235091	0.777917079	2.896810367	0	0	0.550915446	0	0.143021648	0	0	0	0	0	1.24377067	0	3.610516231	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7522	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.3953		0											13.3953	0	0	0	0	0	0	3.700749911	4.027235091	0.777917079	2.896810367	0	0	0.550915446	0	0.143021648	0	0	0	0	0	1.24377067	0	3.610516231	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	13.39531064	0	0	0	0	0	0	0	0	0	0	0	0	31.1475
H1032_104_0	2008	5																					2000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2422.802759	459.5863202	3679.657445	7202.032044	1962.724427	31.33149426	5.021296608	2287.949265	154.6218095	5910.552461	943.3341896	56.86032458	0.606734673	273.135215	8098.670817	20660.85142	1540.462916	7068.165359	4863.875947	429.2916051	25.98302289	20.52678851	1500	600	240	192	30	16	0	37600	3600											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $10.00 and $75.00	$0.00 copayment	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											33.3736798	25.47127262	26.68252453	0	25.90870994	0.171206446	0.171206446	18.12125449	53.05472542	0	9.624991848	61.93248543	0.171206446	12.81632591	0	3.493942945	13.62643528	6.226550111	4.184522657	0	0.171206446	0	0	0	0	0	0	0	0	0	0											6.7382	0.975520704	8.181879171	0	4.237638156	5.364153765	0.859678344	3.455042574	0.683618137	0	0.75663199	0.293458435	0.103876887	0.291715828	0	6.015653004	1.749251518	3.667523817	1.696083258	0	4.448460993	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.5183	0	8.328010215	6.7382	0.975520704	8.181879171	0	4.237638156	5.364153765	0.859678344	3.455042574	0.683618137	0	0.75663199	0.293458435	0.103876887	0.291715828	0	6.015653004	1.749251518	3.667523817	1.696083258	0	4.448460993	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.5183	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							15.1018		0											15.1018	0	0	6.7382	0.975520704	8.181879171	0	4.237638156	5.364153765	0.859678344	3.455042574	0.683618137	0	0.75663199	0.293458435	0.103876887	0.291715828	0	6.015653004	1.749251518	3.667523817	1.696083258	0	4.448460993	0	0	0	0	0	0	0	15.10178558	0	0	0	0	0	0	0	0	0	0	0	0	64.6201
H1032_106_0	2008	5																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		368.7990911	55.61241987	2580.228246	3976.94218	1180.75245	21.07217607	4.85386709	2167.72178	163.7414821	5440.120032	1021.395887	86.85633202	0.393602134	246.155164	8799.865533	19981.45538	1141.158312	4927.863293	5360.780847	485.0270531	20.28812527	14.75413964	1500	190	320	221.5384615	40	16	0	1600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	35.07456771	0.2	0.2	18.53870851	0	0	5.689849985	0	0.2	0	0	0	0	0	3.488063445	0	0.2	0	0	20	10	10	10	0	0	0	0											0	0	0	0	3.45119848	4.214435213	0.970773418	3.34889685	0	0	0.484299114	0	0.078720427	0	0	0	0	0	1.558228643	0	4.057625054	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.9655	0	0	0	0	0	0	3.45119848	4.214435213	0.970773418	3.34889685	0	0	0.484299114	0	0.078720427	0	0	0	0	0	1.558228643	0	4.057625054	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.9655	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.3761		0											14.3761	0	0	0	0	0	0	3.45119848	4.214435213	0.970773418	3.34889685	0	0	0.484299114	0	0.078720427	0	0	0	0	0	1.558228643	0	4.057625054	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	14.37612262	0	0	0	0	0	0	0	0	0	0	0	0	33.3416
H1032_107_0	2008	5																																A	A	D	V	T	P	P	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		360.5678939	26.42217059	1493.989356	8280.730335	1124.924268	3290.467622	541.4458057	1413.618155	116.0975111	2319.812749	677.7897975	21.12178996	0.396204796	152.5114267	8235.959448	20305.05178	2217.168981	17581.91496	5655.291235	311.5327656	127.7005323	2.204593829	1500	600	240	192	30	13.33333333	0	73600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	0	0	0	0	0	0	0	0	0.2	0	0	0	0	0	0	0	0.2	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0.079240959	0	0	0	0	0	0	0	25.54010646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.6193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.079240959	0	0	0	0	0	0	0	25.54010646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.6193	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							18.345		0											18.345	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.079240959	0	0	0	0	0	0	0	25.54010646	0	0	0	0	0	0	0	18.34503044	0	0	0	0	0	0	0	0	0	0	0	0	43.9644
H1032_113_0	2008	6																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		288.653705	5.34667647	1307.822712	2352.61703	519.9354893	12.29275055	5.588160074	848.3317978	223.6153682	2952.13794	991.4324331	68.84623265	0.044042831	373.3856598	13262.33995	31270.0052	528.3617922	6986.177196	6233.31919	832.1956146	32.5893213	25.52950619	0	600	320	221.5384615	40	16	0	0	0											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	45.11536574	0.2	0.2	18.96581453	0	0	6.738123973	0	0.2	0	0	0	0	0	6.527353015	0	0.2	0	0	0	10	10	10	0	0	0	0											0	0	0	0	1.954756647	2.458550109	1.117632015	1.340775295	0	0	0.556699554	0	0.008808566	0	0	0	0	0	3.390589568	0	6.51786426	0	0	0	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8303	0	0	0	0	0	0	1.954756647	2.458550109	1.117632015	1.340775295	0	0	0.556699554	0	0.008808566	0	0	0	0	0	3.390589568	0	6.51786426	0	0	0	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8303	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							17.0379		0											17.0379	0	0	0	0	0	0	1.954756647	2.458550109	1.117632015	1.340775295	0	0	0.556699554	0	0.008808566	0	0	0	0	0	3.390589568	0	6.51786426	0	0	0	0.266666667	0.184615385	0.033333333	0	17.03789519	0	0	0	0	0	0	0	0	0	0	0	0	34.8682
H1032_122_0	2008	7																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		389.7742525	42.17755991	4362.344749	63.27293532	19.57176781	27.33962743	5.243482347	19.6759327	10.35124266	8.275391527	14.2360216	125.636539	0.520176805	2.980327596	8915.126623	96.89974654	7.475252018	39.8621391	25.57940485	4.12667673	21.79190137	0.53133271	0	600	240	192	30	16	0	37600	3.75											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.4	708.4	30.26	0.060234114	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.199213128	0.011083068	0.2	0.2	0	0	0	0	0	0	0	0	0											23.0097	2.489881953	11.00037934	3.811189183	3.914353563	5.467925486	1.048696469	3.935186541	2.070248533	1.655078305	2.84720432	0	0.104035361	0.596065519	0	19.37994931	1.495050404	7.972427821	5.095753253	0.045736238	4.358380274	0.106266542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.4035	0	0	23.0097	2.489881953	11.00037934	3.811189183	3.914353563	5.467925486	1.048696469	3.935186541	2.070248533	1.655078305	2.84720432	0	0.104035361	0.596065519	0	19.37994931	1.495050404	7.972427821	5.095753253	0.045736238	4.358380274	0.106266542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.4035	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	23.0097	2.489881953	11.00037934	3.811189183	3.914353563	5.467925486	1.048696469	3.935186541	2.070248533	1.655078305	2.84720432	0	0.104035361	0.596065519	0	19.37994931	1.495050404	7.972427821	5.095753253	0.045736238	4.358380274	0.106266542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.4035
H1032_123_0	2008	7																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		470.9798928	55.40125009	4593.812323	71.38811538	23.67723856	33.27383536	5.674511257	27.29840191	11.72918252	7.135783663	17.47482772	140.5709584	0.018300881	4.625597118	9798.264665	100.7404773	8.714878693	43.98511945	23.99227664	4.516087044	20.58302888	0.184496841	0	600	240	192	30	16	0	37600	3.75											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.2844809	708.4	30.26	0.066404257	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.198722686	0.017952402	0.2	0.2	0	0	0	0	0	0	0	0	0											27.799	3.270520464	11.58406341	4.740474775	4.735447713	6.654767071	1.134902251	5.459680381	2.345836505	1.427156733	3.494965544	0	0.003660176	0.925119424	0	20.14809546	1.742975739	8.797023891	4.767809667	0.081074612	4.116605775	0.036899368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.2661	0	0	27.799	3.270520464	11.58406341	4.740474775	4.735447713	6.654767071	1.134902251	5.459680381	2.345836505	1.427156733	3.494965544	0	0.003660176	0.925119424	0	20.14809546	1.742975739	8.797023891	4.767809667	0.081074612	4.116605775	0.036899368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.2661	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	27.799	3.270520464	11.58406341	4.740474775	4.735447713	6.654767071	1.134902251	5.459680381	2.345836505	1.427156733	3.494965544	0	0.003660176	0.925119424	0	20.14809546	1.742975739	8.797023891	4.767809667	0.081074612	4.116605775	0.036899368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.2661
H1032_124_0	2008	7																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		422.15917	37.59380899	3762.473484	62.86891099	20.50489053	31.6314466	5.893813744	20.59608716	10.3488051	8.996282676	15.79644354	145.4177123	0.700850886	3.646224148	9326.919554	101.2961815	7.485464351	38.94004465	27.80859533	4.893539664	22.76440611	0.159570941	0	600	240	192	30	16	0	37600	3.75											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.4	708.4	30.26	0.066165834	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.198991035	0.011355331	0.2	0.2	0	0	0	0	0	0	0	0	0											24.9215	2.219287857	9.48770397	4.159773918	4.100978106	6.326289319	1.178762749	4.119217431	2.069761019	1.799256535	3.159288709	0	0.140170177	0.72924483	0	20.2592363	1.49709287	7.788008929	5.53366116	0.055567761	4.552881221	0.031914188	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.1296	0	0	24.9215	2.219287857	9.48770397	4.159773918	4.100978106	6.326289319	1.178762749	4.119217431	2.069761019	1.799256535	3.159288709	0	0.140170177	0.72924483	0	20.2592363	1.49709287	7.788008929	5.53366116	0.055567761	4.552881221	0.031914188	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.1296	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	24.9215	2.219287857	9.48770397	4.159773918	4.100978106	6.326289319	1.178762749	4.119217431	2.069761019	1.799256535	3.159288709	0	0.140170177	0.72924483	0	20.2592363	1.49709287	7.788008929	5.53366116	0.055567761	4.552881221	0.031914188	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.1296
H1032_125_0	2008	4																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		414.8751574	56.91100779	3970.318629	79.98227726	19.61424698	27.4101173	5.299540596	28.53860561	13.67975305	11.80784231	15.60071726	115.3503063	0.004655855	5.249747111	7585.088808	92.43581959	8.353789474	29.07827792	21.37628565	4.927583022	18.83548611	0.700074283	0	600	240	192	30	16	0	37600	3.75											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.3047731	708.4	30.26	0.045712906	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.198886421	0.01203315	0.2	0.2	0	0	0	0	0	0	0	0	0											24.4882	3.359646493	10.01182014	3.65622236	3.922849396	5.482023459	1.059908119	5.707721122	2.73595061	2.361568462	3.120143453	0	0.000931171	1.049949422	0	18.48716392	1.670757895	5.815655584	4.251452937	0.059294346	3.767097221	0.140014857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1483	0	0	24.4882	3.359646493	10.01182014	3.65622236	3.922849396	5.482023459	1.059908119	5.707721122	2.73595061	2.361568462	3.120143453	0	0.000931171	1.049949422	0	18.48716392	1.670757895	5.815655584	4.251452937	0.059294346	3.767097221	0.140014857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1483	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	24.4882	3.359646493	10.01182014	3.65622236	3.922849396	5.482023459	1.059908119	5.707721122	2.73595061	2.361568462	3.120143453	0	0.000931171	1.049949422	0	18.48716392	1.670757895	5.815655584	4.251452937	0.059294346	3.767097221	0.140014857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1483
H1032_126_0	2008	7																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2225.812621	711.4535127	3216.501709	6094.702805	1438.964441	25.32392393	5.48031296	3525.144942	213.7579777	17592.29175	1581.438974	11.31209813	0	596.1046201	7064.097685	15346.1127	1119.818583	4727.083412	4713.629917	659.5704248	27.32683466	49.4468171	1500	190	320	221.5384615	40	16	0	37600	3600											"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $25.00 and $50.00	$0.00 copayment	Copay between $0.00 and $50.00	$75.00 copayment	20% coinsurance	Copay between $10.00 and $50.00	Copay between $0.00 and $5.00	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											27.80067914	18.22603751	47.16150431	0	35.97013808	0.151279886	0.151279886	16.38039859	31.10612317	0	5.901627797	41.04316551	0	8.281415854	1.57053805	4.326075237	12.56826446	5.867304374	1.953674208	0	0.151279886	0	0	15.12798855	7.563994276	7.563994276	7.563994276	0	0	0	0											5.1566	1.080581534	12.64125493	0	4.31331247	3.831000313	0.829061117	4.811939935	0.554098499	0	0.777755351	0.03869036	0	0.411382521	0.924536184	5.532369845	1.172848008	2.311269765	0.7674081	0	4.134000419	0	0	0.239526485	0.201706514	0.139642971	0.025213314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8942	0	16.068565	5.1566	1.080581534	12.64125493	0	4.31331247	3.831000313	0.829061117	4.811939935	0.554098499	0	0.777755351	0.03869036	0	0.411382521	0.924536184	5.532369845	1.172848008	2.311269765	0.7674081	0	4.134000419	0	0	0.239526485	0.201706514	0.139642971	0.025213314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8942	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							15.8691		0											15.8691	0	0	5.1566	1.080581534	12.64125493	0	4.31331247	3.831000313	0.829061117	4.811939935	0.554098499	0	0.777755351	0.03869036	0	0.411382521	0.924536184	5.532369845	1.172848008	2.311269765	0.7674081	0	4.134000419	0	0	0.239526485	0.201706514	0.139642971	0.025213314	0	15.86913332	0	0	0	0	0	0	0	0	0	0	0	0	65.7633
H1032_127_0	2008	7																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		420.4700426	83.49698815	3996.892101	81.80544876	21.87654375	28.22897708	5.304842387	23.16503693	11.79547419	7.040478139	13.72437553	112.4208418	0.07808052	5.512144729	8696.568278	113.7261135	21.17200606	42.1793174	31.36188397	4.549930802	36.050601	0.531192547	0	600	240	192	30	16	0	1600	3.75											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.4	708.4	30.26	0.06984425	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.199389632	0.007727229	0.2	0.2	0	0	0	0	0	0	0	0	0											24.8217	4.929105534	10.07882958	5.713640247	4.375308749	5.645795416	1.060968477	4.633007387	2.359094838	1.408095628	2.744875106	0	0.015616104	1.102428946	0	22.7452227	4.234401213	8.435863479	6.25323449	0.035158358	7.210120199	0.106238509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.9088	0	0	24.8217	4.929105534	10.07882958	5.713640247	4.375308749	5.645795416	1.060968477	4.633007387	2.359094838	1.408095628	2.744875106	0	0.015616104	1.102428946	0	22.7452227	4.234401213	8.435863479	6.25323449	0.035158358	7.210120199	0.106238509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.9088	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	24.8217	4.929105534	10.07882958	5.713640247	4.375308749	5.645795416	1.060968477	4.633007387	2.359094838	1.408095628	2.744875106	0	0.015616104	1.102428946	0	22.7452227	4.234401213	8.435863479	6.25323449	0.035158358	7.210120199	0.106238509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.9088
H1032_128_0	2008	7																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		355.0556464	64.03143328	4870.388141	91.4344467	24.14753107	35.56729621	5.880045338	26.22269219	10.87980997	6.010870646	12.10090631	50.00060717	0	3.467834786	8648.837156	119.7293973	17.08240046	54.51167285	35.26951602	4.143338311	28.04849985	0.426357748	0	600	240	192	30	16	0	37600	3.75											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.4	708.4	30.26	0.049041563	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0	0.2	0	0.2	0.2	0.2	0.199547789	0.010239698	0.2	0.2	0	0	0	0	0	0	0	0	0											20.9601	3.779988945	12.28149543	4.484088206	4.829506214	7.113459242	1.176009068	5.244538439	2.175961994	1.202174129	2.420181262	0	0	0.693566957	0	23.94587945	3.416480093	10.90233457	7.037953936	0.042426532	5.60969997	0.08527155	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.4011	0	0	20.9601	3.779988945	12.28149543	4.484088206	4.829506214	7.113459242	1.176009068	5.244538439	2.175961994	1.202174129	2.420181262	0	0	0.693566957	0	23.94587945	3.416480093	10.90233457	7.037953936	0.042426532	5.60969997	0.08527155	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.4011	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	20.9601	3.779988945	12.28149543	4.484088206	4.829506214	7.113459242	1.176009068	5.244538439	2.175961994	1.202174129	2.420181262	0	0	0.693566957	0	23.94587945	3.416480093	10.90233457	7.037953936	0.042426532	5.60969997	0.08527155	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.4011
H1032_129_0	2008	7																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		279.1721183	7.608952755	1249.41221	2664.091317	553.6147418	16.21305538	5.017008926	1036.281273	203.9270209	4730.098591	1118.207044	49.9316785	0.408085558	353.0329834	8548.795122	22509.14518	273.4519447	3718.031963	4954.35057	865.2779298	35.35388548	32.82044048	0	190	320	221.5384615	40	16	0	0	0											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	Copay between $0.00 and $20.00	$0.00 copayment	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	62.35	0	41.7487992	0.2	0.2	18.35204484	0	0	9.404994573	0	0.2	4.681648085	0	4.924615456	15.26090224	7.412493097	6.038081827	0	0.2	0	0	20	10	10	10	0	0	0	0											0	0	6.491737607	0	1.926062557	3.242611075	1.003401785	1.584823365	0	0	0.876394265	0	0.081617112	0.137731349	0	9.237407022	0.347760283	2.296657188	2.492897845	0	7.070777095	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5912	0	0	0	0	6.491737607	0	1.926062557	3.242611075	1.003401785	1.584823365	0	0	0.876394265	0	0.081617112	0.137731349	0	9.237407022	0.347760283	2.296657188	2.492897845	0	7.070777095	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5912	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.7346		0											14.7346	0	0	0	0	6.491737607	0	1.926062557	3.242611075	1.003401785	1.584823365	0	0	0.876394265	0	0.081617112	0.137731349	0	9.237407022	0.347760283	2.296657188	2.492897845	0	7.070777095	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	14.73456084	0	0	0	0	0	0	0	0	0	0	0	0	52.3257
H1032_130_0	2008	6																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		420.2818002	49.21006731	3804.172871	67.97436521	19.24467094	31.46755556	6.10591369	24.33036288	11.19700277	6.637597958	14.77982454	91.17512666	0.713113075	4.530368411	8986.65456	109.5098695	9.234209913	39.53606875	32.83798638	4.841795958	27.65648119	0.339251388	0	600	240	192	30	16	0	1600	3.75											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.4	708.4	30.26	0.073573767	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.199447881	0.006540321	0.2	0.2	0	0	0	0	0	0	0	0	0											24.8106	2.905034307	9.592855922	5.001130116	3.848934189	6.293511112	1.221182738	4.866072577	2.239400553	1.327519592	2.955964909	0	0.142622615	0.906073682	0	21.90197389	1.846841983	7.907213751	6.549466814	0.031666899	5.531296239	0.067850278	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9472	0	0	24.8106	2.905034307	9.592855922	5.001130116	3.848934189	6.293511112	1.221182738	4.866072577	2.239400553	1.327519592	2.955964909	0	0.142622615	0.906073682	0	21.90197389	1.846841983	7.907213751	6.549466814	0.031666899	5.531296239	0.067850278	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9472	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	24.8106	2.905034307	9.592855922	5.001130116	3.848934189	6.293511112	1.221182738	4.866072577	2.239400553	1.327519592	2.955964909	0	0.142622615	0.906073682	0	21.90197389	1.846841983	7.907213751	6.549466814	0.031666899	5.531296239	0.067850278	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9472
H1032_131_0	2008	6																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1229.097445	47.51021927	893.0527071	2739.513407	482.7360605	15.5948076	3.441928099	824.0442212	153.3402142	3525.322555	726.2363504	76.88262698	0.046888908	298.4717136	7087.070867	19236.55825	248.6007684	3810.820573	4225.721414	683.3956578	28.10851053	32.4074927	0	190	320	221.5384615	40	16	0	0	0											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $150.00	$0.00 copayment	Copay between $0.00 and $150.00	$250.00 copayment	20% coinsurance	Copay between $25.00 and $150.00	Copay between $0.00 and $10.00	$35.00 copayment	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $10.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											105.6376221	66.22711195	57.14860207	0	41.12508899	0.183315484	0.183315484	18.11934647	115.7843129	0	22.39985924	144.3519852	0.183315484	28.66580337	3.946577283	8.453321321	26.62791196	11.47496158	11.23277937	0	0.183315484	0	0	18.33154838	9.165774189	9.165774189	9.165774189	0	0	0	0											10.8199	0.262205384	4.253059482	0	1.654380287	2.8587697	0.630958715	1.244261896	1.479532612	0	1.355632669	0.924846653	0.008595463	0.712994288	2.330806074	13.55106734	0.551643281	3.644084971	3.955549692	0	5.152725207	0	0	0.290249516	0.244420645	0.169214293	0.030552581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1255	0	5.108276491	10.8199	0.262205384	4.253059482	0	1.654380287	2.8587697	0.630958715	1.244261896	1.479532612	0	1.355632669	0.924846653	0.008595463	0.712994288	2.330806074	13.55106734	0.551643281	3.644084971	3.955549692	0	5.152725207	0	0	0.290249516	0.244420645	0.169214293	0.030552581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1255	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							11.5372		0											11.5372	0	0	10.8199	0.262205384	4.253059482	0	1.654380287	2.8587697	0.630958715	1.244261896	1.479532612	0	1.355632669	0.924846653	0.008595463	0.712994288	2.330806074	13.55106734	0.551643281	3.644084971	3.955549692	0	5.152725207	0	0	0.290249516	0.244420645	0.169214293	0.030552581	0	11.53717044	0	0	0	0	0	0	0	0	0	0	0	0	67.6626
H1032_132_0	2008	6																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		282.410906	6.42084112	1270.963909	2692.771836	398.5942343	20.22031743	5.421235224	777.8458984	203.117099	2513.486568	675.1807348	29.52688779	0.461324895	248.5148304	10403.80724	22754.98231	147.5445955	3021.47193	5054.021244	717.7932328	34.04748193	22.03248173	0	190	320	221.5384615	40	16	0	1600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	Copay between $0.00 and $25.00	$0.00 copayment	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	31.17	0	40.50307742	0.2	0.2	20.91393662	0	0	9.092425423	0	0.2	6.507063012	0	6.287023253	19.63746105	8.861983006	8.748408519	0	0.2	0	0	20	10	10	10	0	0	0	0											0	0	3.301328755	0	1.345357761	4.044063486	1.084247045	1.355651652	0	0	0.511585873	0	0.092264979	0.134758472	0	11.92175858	0.241450104	2.231352741	3.684553542	0	6.809496386	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5592	0	0	0	0	3.301328755	0	1.345357761	4.044063486	1.084247045	1.355651652	0	0	0.511585873	0	0.092264979	0.134758472	0	11.92175858	0.241450104	2.231352741	3.684553542	0	6.809496386	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5592	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.1636		0											14.1636	0	0	0	0	3.301328755	0	1.345357761	4.044063486	1.084247045	1.355651652	0	0	0.511585873	0	0.092264979	0.134758472	0	11.92175858	0.241450104	2.231352741	3.684553542	0	6.809496386	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	14.16362829	0	0	0	0	0	0	0	0	0	0	0	0	51.7228
H1032_133_0	2008	7																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1411.644907	45.82625787	1181.594261	2608.288813	429.6777194	14.93666517	4.018255441	896.3970763	250.8174555	4874.249213	1006.405856	83.76011284	0.071132392	380.634505	10904.89572	21578.66499	260.166494	4067.974938	4984.398154	790.1735621	33.086958	25.79114959	0	190	320	221.5384615	40	16	0	1600	3600											"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $25.00 and $50.00	$0.00 copayment	Copay between $0.00 and $50.00	$75.00 copayment	20% coinsurance	Copay between $10.00 and $50.00	$0.00 copayment	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											36.08534826	29.43046522	30.01692955	0	36.86805239	0.192601409	0.192601409	21.04498895	40.05205113	0	9.177569592	52.25394948	0.192601409	11.71114303	0	6.096770212	16.01807453	6.849397126	7.255308112	0	0.192601409	0	0	19.26014087	9.630070436	9.630070436	9.630070436	0	0	0	0											4.245	0.112390674	2.955652641	0	1.320115056	2.876822754	0.773921658	1.572055547	0.837146129	0	0.769696648	0.364733059	0.013700199	0.371472094	0	10.96334683	0.347280524	2.32193132	3.01361203	0	6.372594721	0	0	0.30495223	0.256801878	0.177785916	0.032100235	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0031	0	1.536678743	4.245	0.112390674	2.955652641	0	1.320115056	2.876822754	0.773921658	1.572055547	0.837146129	0	0.769696648	0.364733059	0.013700199	0.371472094	0	10.96334683	0.347280524	2.32193132	3.01361203	0	6.372594721	0	0	0.30495223	0.256801878	0.177785916	0.032100235	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0031	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.4892		0											14.4892	0	0	4.245	0.112390674	2.955652641	0	1.320115056	2.876822754	0.773921658	1.572055547	0.837146129	0	0.769696648	0.364733059	0.013700199	0.371472094	0	10.96334683	0.347280524	2.32193132	3.01361203	0	6.372594721	0	0	0.30495223	0.256801878	0.177785916	0.032100235	0	14.48921717	0	0	0	0	0	0	0	0	0	0	0	0	54.4923
H1032_136_0	2008	6																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		367.8133079	72.58635006	3879.518859	7162.222095	2074.646812	25.29479379	4.254868265	2165.491422	164.1472717	6886.39933	999.2283341	96.00683604	0.063776338	353.6568546	7906.801836	21915.28912	2681.610809	7875.506212	5008.313637	437.7433804	29.37760927	26.50492533	1500	190	320	221.5384615	40	16	0	1600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	33.17634871	0.2	0.2	20.31352246	0	0	6.74078441	0	0.2	0	0	0	0	0	3.274891035	0	0.2	0	0	20	10	10	10	0	0	0	0											0	0	0	0	5.735767174	5.058958758	0.850973653	3.665729887	0	0	0.561298565	0	0.012755268	0	0	0	0	0	1.366806786	0	5.875521854	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.9291	0	0	0	0	0	0	5.735767174	5.058958758	0.850973653	3.665729887	0	0	0.561298565	0	0.012755268	0	0	0	0	0	1.366806786	0	5.875521854	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.9291	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							15.5923		0											15.5923	0	0	0	0	0	0	5.735767174	5.058958758	0.850973653	3.665729887	0	0	0.561298565	0	0.012755268	0	0	0	0	0	1.366806786	0	5.875521854	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	15.59225236	0	0	0	0	0	0	0	0	0	0	0	0	39.5213
H1032_138_0	2008	7																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		388.7826846	82.29042119	2754.082756	57.24271768	17.4363924	19.70857723	4.482946211	29.42796809	19.84076842	5.708695917	11.26111037	108.7119476	0.083618512	4.464242794	8384.968384	108.0601003	19.33120402	30.15528017	32.91177982	5.184416727	30.57893882	0.367302452	0	600	240	192	30	16	0	73600	3.75											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.4	708.4	30.26	0.071426219	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.199442077	0.005335699	0.2	0.2	0	0	0	0	0	0	0	0	0											22.9511	4.857877865	6.944878683	4.088630886	3.48727848	3.941715446	0.896589242	5.885593618	3.968153684	1.141739183	2.252222075	0	0.016723702	0.892848559	0	21.61202006	3.866240805	6.031056034	6.563993716	0.027662485	6.115787763	0.07346049	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.6156	0	0	22.9511	4.857877865	6.944878683	4.088630886	3.48727848	3.941715446	0.896589242	5.885593618	3.968153684	1.141739183	2.252222075	0	0.016723702	0.892848559	0	21.61202006	3.866240805	6.031056034	6.563993716	0.027662485	6.115787763	0.07346049	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.6156	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	22.9511	4.857877865	6.944878683	4.088630886	3.48727848	3.941715446	0.896589242	5.885593618	3.968153684	1.141739183	2.252222075	0	0.016723702	0.892848559	0	21.61202006	3.866240805	6.031056034	6.563993716	0.027662485	6.115787763	0.07346049	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.6156
H1032_140_0	2008	6																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1270.56591	59.83230694	1205.346262	1979.288208	365.9377314	20.30589282	6.046654427	1107.841384	180.190866	3019.413625	793.8962101	61.50784895	0.068461754	298.7226045	10214.58332	23128.86134	182.3548707	4570.640139	6291.469095	876.770671	33.15024183	42.07540311	0	190	320	221.5384615	40	16	0	1600	3600											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $175.00	$0.00 copayment	Copay between $0.00 and $175.00	$250.00 copayment	20% coinsurance	Copay between $25.00 and $175.00	Copay between $0.00 and $10.00	$35.00 copayment	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $10.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											137.5704575	65.63053152	53	0	45.05847945	0.2	0.2	20.48952009	143.0946222	0	27.9842952	180.8707764	0.2	37.66189978	3.535105062	9.061336672	28.65416417	13.27757125	15.76671737	0	0.2	0	0	20	10	10	10	0	0	0	0											14.566	0.327235509	5.323612655	0	1.374049813	4.061178565	1.209330885	1.891594858	2.148695324	0	1.851385492	0.927081033	0.013692351	0.937538399	3.009135433	17.46486662	0.435435533	5.057250007	8.266317922	0	6.630048366	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2958	0	0	14.566	0.327235509	5.323612655	0	1.374049813	4.061178565	1.209330885	1.891594858	2.148695324	0	1.851385492	0.927081033	0.013692351	0.937538399	3.009135433	17.46486662	0.435435533	5.057250007	8.266317922	0	6.630048366	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2958	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							15.1369		0											15.1369	0	0	14.566	0.327235509	5.323612655	0	1.374049813	4.061178565	1.209330885	1.891594858	2.148695324	0	1.851385492	0.927081033	0.013692351	0.937538399	3.009135433	17.46486662	0.435435533	5.057250007	8.266317922	0	6.630048366	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	15.13693074	0	0	0	0	0	0	0	0	0	0	0	0	91.4327
H1032_143_0	2008	6																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1506.01738	61.5545563	884.5165491	2497.977156	476.7377317	15.14447288	5.416189508	1071.235184	157.597281	2739.783832	1074.153576	51.4928517	0.015616488	303.7622091	8680.554512	28537.31245	329.4593648	6352.139181	5439.796398	792.2676197	44.58622657	63.02827064	0	190	320	221.5384615	40	16	0	1600	3600											"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $150.00	$0.00 copayment	Copay between $0.00 and $150.00	$200.00 copayment	20% coinsurance	Copay between $15.00 and $150.00	Copay between $0.00 and $5.00	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $5.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											85.3016658	48.53013013	57.12161336	0	39.20572498	0.183228912	0.183228912	20.2005505	113.3444039	0	17.31042822	132.5630224	0.183228912	18.8925729	1.703479776	5.983000397	19.29453714	8.0646061	11.91785795	0	0.183228912	0	0	18.32289121	9.161445607	9.161445607	9.161445607	0	0	0	0											10.7055	0.248937552	4.210417694	0	1.5575707	2.77490529	0.992402511	1.803295036	1.488564155	0	1.549504864	0.568837338	0.002861392	0.478237473	1.232262421	14.22822931	0.529730496	4.268958365	5.402560064	0	8.169485791	0	0	0.290112444	0.244305216	0.16913438	0.030538152	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.9463	0	5.578466291	10.7055	0.248937552	4.210417694	0	1.5575707	2.77490529	0.992402511	1.803295036	1.488564155	0	1.549504864	0.568837338	0.002861392	0.478237473	1.232262421	14.22822931	0.529730496	4.268958365	5.402560064	0	8.169485791	0	0	0.290112444	0.244305216	0.16913438	0.030538152	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.9463	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							16.04		0											16.04	0	0	10.7055	0.248937552	4.210417694	0	1.5575707	2.77490529	0.992402511	1.803295036	1.488564155	0	1.549504864	0.568837338	0.002861392	0.478237473	1.232262421	14.22822931	0.529730496	4.268958365	5.402560064	0	8.169485791	0	0	0.290112444	0.244305216	0.16913438	0.030538152	0	16.0399747	0	0	0	0	0	0	0	0	0	0	0	0	76.9863
H1032_144_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1252.161199	58.659652	1170.473368	1935.019851	357.7706396	19.67827755	5.857228995	1087.727954	177.684219	2952.026121	784.196901	60.80639598	0.06624605	296.1924525	10599.54138	23212.24967	190.4866644	4660.242832	6272.376037	858.3356454	32.07148026	41.54315996	0	190	320	221.5384615	40	16	0	0	0											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$150.00 copayment	20% coinsurance	Copay between $10.00 and $100.00	$0.00 copayment	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											82.55374924	39.38203599	62.35	0	45.05360846	0.2	0.2	20.49438911	81.70372978	0	16.08930171	108.5224658	0.2	21.39724293	0	5.329256482	16.26641267	7.594478061	9.949030464	0	0.2	0	0	20	10	10	10	0	0	0	0											8.6142	0.192511377	6.081584543	0	1.343238193	3.93565551	1.171445799	1.857693328	1.209788618	0	1.051431712	0.549905002	0.01324921	0.528141822	0	10.30866933	0.258211224	2.949342662	5.200338356	0	6.414296052	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.481	0	0	8.6142	0.192511377	6.081584543	0	1.343238193	3.93565551	1.171445799	1.857693328	1.209788618	0	1.051431712	0.549905002	0.01324921	0.528141822	0	10.30866933	0.258211224	2.949342662	5.200338356	0	6.414296052	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.481	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.8648		0											14.8648	0	0	8.6142	0.192511377	6.081584543	0	1.343238193	3.93565551	1.171445799	1.857693328	1.209788618	0	1.051431712	0.549905002	0.01324921	0.528141822	0	10.30866933	0.258211224	2.949342662	5.200338356	0	6.414296052	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	14.86478838	0	0	0	0	0	0	0	0	0	0	0	0	67.3458
H1032_145_0	2008	6																					3200											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1571.853635	71.58652166	1088.813471	3804.822967	413.4460951	23.14620609	5.156361288	1584.02213	204.1612465	3595.21101	897.399797	50.85396216	0.03659471	231.0186907	10559.32528	15663.89908	275.507146	2467.238739	3817.601805	687.4525719	15.75766837	11.69786282	0	190	320	221.5384615	40	16	0	0	3600											"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $150.00	$0.00 copayment	Copay between $0.00 and $150.00	$200.00 copayment	20% coinsurance	Copay between $20.00 and $150.00	Copay between $0.00 and $5.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $5.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											87.39298376	51.31142652	58.56665986	0	43.70661849	0.187864186	0.187864186	17.22458105	111.5047396	0	19.59467279	135.9165644	0.187864186	30.82786471	1.577499707	7.767597153	23.57746094	10.22776988	11.24928218	0	0.187864186	0	0	18.78641856	9.39320928	9.39320928	9.39320928	0	0	0	0											11.4474	0.306100545	5.314014017	0	1.505860895	4.348343156	0.968695614	2.273676464	1.897078885	0	1.465354615	0.575991318	0.006874835	0.593484412	1.388111045	10.13923816	0.541313248	2.102862506	3.578773329	0	2.960301535	0	0	0.297451627	0.250485581	0.173413094	0.031310698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.1662	0	3.369874459	11.4474	0.306100545	5.314014017	0	1.505860895	4.348343156	0.968695614	2.273676464	1.897078885	0	1.465354615	0.575991318	0.006874835	0.593484412	1.388111045	10.13923816	0.541313248	2.102862506	3.578773329	0	2.960301535	0	0	0.297451627	0.250485581	0.173413094	0.031310698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.1662	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.0224		0											13.0224	0	0	11.4474	0.306100545	5.314014017	0	1.505860895	4.348343156	0.968695614	2.273676464	1.897078885	0	1.465354615	0.575991318	0.006874835	0.593484412	1.388111045	10.13923816	0.541313248	2.102862506	3.578773329	0	2.960301535	0	0	0.297451627	0.250485581	0.173413094	0.031310698	0	13.0224027	0	0	0	0	0	0	0	0	0	0	0	0	65.1886
H1032_146_0	2008	7																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1401.187213	24.1605809	1014.406449	2792.148239	313.0850376	17.76344132	4.572064735	1661.061757	178.3359289	5570.909133	1035.859389	34.1591685	0.007958532	407.9469045	7891.756849	18797.71354	231.0678499	3854.974098	4399.719268	793.4902954	31.04233606	20.24537979	0	190	320	221.5384615	40	16	0	0	3600											"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $150.00	$0.00 copayment	Copay between $0.00 and $150.00	$200.00 copayment	20% coinsurance	Copay between $20.00 and $150.00	Copay between $0.00 and $10.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $10.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											97.13008868	79.08339773	57.71102649	0	40.88791778	0.185119572	0.185119572	16.63391469	118.3583332	0	25.37525282	133.9308826	0.185119572	26.14390898	3.554051934	8.148357756	23.12237029	10.11953698	9.1895093	0	0.185119572	0	0	18.51195718	9.255978588	9.255978588	9.255978588	0	0	0	0											11.3415	0.159225069	4.878536453	0	1.066782939	3.28836065	0.846378666	2.30249663	1.758961942	0	2.190432823	0.381247299	0.00147328	0.888777228	2.337309474	12.76420791	0.445236366	3.250879411	3.369271761	0	5.746543957	0	0	0.293105989	0.246826096	0.170879605	0.030853262	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7592	0	4.642849042	11.3415	0.159225069	4.878536453	0	1.066782939	3.28836065	0.846378666	2.30249663	1.758961942	0	2.190432823	0.381247299	0.00147328	0.888777228	2.337309474	12.76420791	0.445236366	3.250879411	3.369271761	0	5.746543957	0	0	0.293105989	0.246826096	0.170879605	0.030853262	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7592	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.9503		0											13.9503	0	0	11.3415	0.159225069	4.878536453	0	1.066782939	3.28836065	0.846378666	2.30249663	1.758961942	0	2.190432823	0.381247299	0.00147328	0.888777228	2.337309474	12.76420791	0.445236366	3.250879411	3.369271761	0	5.746543957	0	0	0.293105989	0.246826096	0.170879605	0.030853262	0	13.95034523	0	0	0	0	0	0	0	0	0	0	0	0	71.7096
H1032_148_0	2008	7																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		409.6541923	39.25583632	4682.313364	46.78595335	16.94177865	32.06546009	6.883898464	25.22725712	9.313902293	5.862159662	14.02148171	103.9562408	0.08670977	5.029703198	9750.583936	112.6116608	6.025363851	47.65863451	38.4287865	4.944046718	28.82555412	0.526059331	0	190	240	192	30	22.85714286	0	36000	9											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											707.8413048	708.4	30.26	0.063588221	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.199545061	0.003583479	0.2	0.2	0	20	0	0	0	0	0	0	0											24.1642	2.317402871	11.80723353	2.975035564	3.388355729	6.413092019	1.376779693	5.045451424	1.862780459	1.172431932	2.804296341	0	0.017341954	1.00594064	0	22.52233217	1.20507277	9.531726902	7.668274559	0.017716887	5.765110823	0.105211866	0	0.316666667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.4824	0	0	24.1642	2.317402871	11.80723353	2.975035564	3.388355729	6.413092019	1.376779693	5.045451424	1.862780459	1.172431932	2.804296341	0	0.017341954	1.00594064	0	22.52233217	1.20507277	9.531726902	7.668274559	0.017716887	5.765110823	0.105211866	0	0.316666667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.4824	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	24.1642	2.317402871	11.80723353	2.975035564	3.388355729	6.413092019	1.376779693	5.045451424	1.862780459	1.172431932	2.804296341	0	0.017341954	1.00594064	0	22.52233217	1.20507277	9.531726902	7.668274559	0.017716887	5.765110823	0.105211866	0	0.316666667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.4824
H1032_152_0	2008	5																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2418.722363	257.1306401	4607.475059	3947.487646	1800.783305	31.42113775	6.095218853	2602.363769	109.1192565	5032.194478	944.7111204	93.57440444	0.076089722	320.135551	9283.846695	22722.57724	877.8598811	9640.383975	6033.240026	468.8369278	25.19263546	24.26858112	0	190	320	221.5384615	40	16	0	36000	3600											"$135 days 1 - 5, $0 after day 5, unlimited coverage"	"$135 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $10.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$135.00 copayment	20% coinsurance	Copay between $5.00 and $100.00	$0.00 copayment	$10.00 copayment	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											55.46871207	50.23678968	53	0	28.13503239	0.2	0.2	19.82551136	80.02948237	0	13.60967183	97.67021923	0.2	18.57996059	0	2.095225778	8.490001919	3.712605984	6.277793302	0	0.2	0	0	20	10	10	10	0	0	0	0											11.1803	1.076451491	20.34968151	0	4.222091384	6.28422755	1.219043771	4.299432706	0.727729801	0	1.071434027	0.761619383	0.015217944	0.495675494	0	3.967410798	0.621086006	2.982578936	3.156286152	0	5.038527092	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2701	0	0	11.1803	1.076451491	20.34968151	0	4.222091384	6.28422755	1.219043771	4.299432706	0.727729801	0	1.071434027	0.761619383	0.015217944	0.495675494	0	3.967410798	0.621086006	2.982578936	3.156286152	0	5.038527092	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2701	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							15.788		0											15.788	0	0	11.1803	1.076451491	20.34968151	0	4.222091384	6.28422755	1.219043771	4.299432706	0.727729801	0	1.071434027	0.761619383	0.015217944	0.495675494	0	3.967410798	0.621086006	2.982578936	3.156286152	0	5.038527092	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	15.78798409	0	0	0	0	0	0	0	0	0	0	0	0	84.058
H1032_153_0	2008	7																					3200											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1988.031661	514.7427738	4277.280171	7744.742672	1321.217456	32.23999628	5.437928938	2826.285208	140.8121665	9448.175476	989.6656828	266.4462835	0.013803624	320.1428464	7146.382218	15540.14855	840.29347	5994.095825	3963.413772	421.9546744	10.0123521	43.92383695	0	190	320	221.5384615	40	16	0	0	3600											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$150.00 copayment	20% coinsurance	Copay between $15.00 and $100.00	$0.00 copayment	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											56.44977418	27.06698433	28.839047	0	34.32147334	0.185043612	0.185043612	18.43042347	73.59228325	0	10.93473779	99.68438018	0.185043612	16.02649611	0	5.159208613	19.22700409	8.435702825	5.526604391	0	0.185043612	0	0	18.50436124	9.252180621	9.252180621	9.252180621	0	0	0	0											9.352	1.161044549	10.27939032	0	3.778844141	5.965805376	1.006254015	4.340802769	0.863557404	0	0.901811228	2.213377718	0.002554272	0.427564007	0	6.681239021	1.346360499	4.213700923	1.825351663	0	1.852721802	0	0	0.29298572	0.246724817	0.170809488	0.030840602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9537	0	4.603358777	9.352	1.161044549	10.27939032	0	3.778844141	5.965805376	1.006254015	4.340802769	0.863557404	0	0.901811228	2.213377718	0.002554272	0.427564007	0	6.681239021	1.346360499	4.213700923	1.825351663	0	1.852721802	0	0	0.29298572	0.246724817	0.170809488	0.030840602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9537	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.9385		0											13.9385	0	0	9.352	1.161044549	10.27939032	0	3.778844141	5.965805376	1.006254015	4.340802769	0.863557404	0	0.901811228	2.213377718	0.002554272	0.427564007	0	6.681239021	1.346360499	4.213700923	1.825351663	0	1.852721802	0	0	0.29298572	0.246724817	0.170809488	0.030840602	0	13.93849353	0	0	0	0	0	0	0	0	0	0	0	0	70.8922
H1032_158_0	2008	7																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1615.644985	51.64391325	1142.431747	2630.114782	592.2140175	15.95605498	5.423328898	1035.616707	211.8082716	4944.631766	1143.437811	51.78550224	0.429943517	347.1248413	7932.445221	23470.40679	281.9744047	3813.097163	5150.561923	912.4999489	37.90530358	34.07520958	0	600	320	221.5384615	40	16	0	1600	3600											"$110 days 1 - 5, $0 after day 5, unlimited coverage"	"$110 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $80.00	$0.00 copayment	Copay between $0.00 and $80.00	$110.00 copayment	20% coinsurance	Copay between $20.00 and $80.00	Copay between $0.00 and $10.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $10.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											50.78920154	43.11277484	53	0	41.74976754	0.2	0.2	18.26263199	65.36033772	0	14.90478581	79.5831416	0.2	19.14199021	4.507925962	7.385588789	23.24216965	11.09532522	7.135049828	0	0.2	0	0	0	10	10	10	0	0	0	0											6.8381	0.1855427	5.045740215	0	2.060399797	3.191210997	1.08466578	1.576090568	1.153655013	0	1.420224638	0.343437746	0.085988703	0.553721693	2.979906313	14.4452311	0.546141413	3.525629428	3.062459664	0	7.581060715	0	0	0	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1638	0	0	6.8381	0.1855427	5.045740215	0	2.060399797	3.191210997	1.08466578	1.576090568	1.153655013	0	1.420224638	0.343437746	0.085988703	0.553721693	2.979906313	14.4452311	0.546141413	3.525629428	3.062459664	0	7.581060715	0	0	0	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1638	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	6.8381	0.1855427	5.045740215	0	2.060399797	3.191210997	1.08466578	1.576090568	1.153655013	0	1.420224638	0.343437746	0.085988703	0.553721693	2.979906313	14.4452311	0.546141413	3.525629428	3.062459664	0	7.581060715	0	0	0	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1638
H1032_159_0	2008	6																																A	A	D	V	T	P	P	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		189.7285622	9.34810601	664.8673055	1877.45162	394.7907079	1107.950325	241.7507495	1037.000065	174.0232124	2782.652338	964.892025	22.43550061	0.185558506	312.7779148	3336.274504	18343.28963	639.0558691	6469.400595	4553.636742	351.3817113	40.09802163	14.27665269	1500	600	240	192	30	13.33333333	0	1600	14400											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	0	0	0	0	0	0	0	0	0.2	0	0	0	0	0	0	0	0.2	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0.037111701	0	0	0	0	0	0	0	8.019604327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.0567	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.037111701	0	0	0	0	0	0	0	8.019604327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.0567	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							15.6736		0											15.6736	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.037111701	0	0	0	0	0	0	0	8.019604327	0	0	0	0	0	0	0	15.6736396	0	0	0	0	0	0	0	0	0	0	0	0	23.7304
H1032_160_0	2008	7																																A	A	D	V	T	P	P	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		161.3782121	8.008280672	289.3058374	1078.395668	265.26196	812.8746108	361.2266461	718.0301242	104.9865478	1498.872319	549.5531981	13.64225433	0.157715579	188.7673564	3354.074656	16400.74267	745.4471487	5434.615172	2685.346881	287.809887	44.99701874	8.612968686	0	600	320	221.5384615	40	16	0	1600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	0	0	0	0	0	0	0	0	0.2	0	0	0	0	0	0	0	0.2	0	0	0	10	10	10	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0.031543116	0	0	0	0	0	0	0	8.999403748	0	0	0	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.5156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.031543116	0	0	0	0	0	0	0	8.999403748	0	0	0	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.5156	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.0919		0											13.0919	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.031543116	0	0	0	0	0	0	0	8.999403748	0	0	0	0.266666667	0.184615385	0.033333333	0	13.09190731	0	0	0	0	0	0	0	0	0	0	0	0	22.6075
H1032_161_0	2008	5																					0											A	A	D	V	T	P	P	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		219.9409707	10.86667582	706.2842446	5645.342459	547.4762168	2783.848745	548.6526238	1305.825839	230.1699162	2818.082911	1036.630708	29.65407788	0.206414861	410.5320414	5376.303025	26322.09799	1192.577562	9572.93331	4936.290261	481.4724646	54.26531758	18.93183428	1500	600	240	192	30	13.33333333	0	73600	14400											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	0	0	0	0	0	0	0	0	0.2	0	0	0	0	0	0	0	0.2	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0.041282972	0	0	0	0	0	0	0	10.85306352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.041282972	0	0	0	0	0	0	0	10.85306352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8943	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							15.0284		0											15.0284	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.041282972	0	0	0	0	0	0	0	10.85306352	0	0	0	0	0	0	0	15.02836647	0	0	0	0	0	0	0	0	0	0	0	0	25.9227
H1032_162_0	2008	6																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		362.0074151	71.43903076	3785.550096	7066.355919	2056.837857	24.77327576	4.210658711	2147.361403	162.7358008	6827.206777	990.6361615	95.18219836	0.063198192	350.6159678	7807.955211	21685.81208	2658.848799	7808.646739	4965.51794	434.0095867	29.10939306	26.27701456	1500	190	320	221.5384615	40	16	0	1600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	33.17585619	0.2	0.2	20.31369023	0	0	6.74078441	0	0.2	0	0	0	0	0	3.274797844	0	0.2	0	0	20	10	10	10	0	0	0	0											0	0	0	0	5.686446413	4.954655152	0.842131742	3.63506953	0	0	0.556472066	0	0.012639638	0	0	0	0	0	1.355088954	0	5.821878611	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6657	0	0	0	0	0	0	5.686446413	4.954655152	0.842131742	3.63506953	0	0	0.556472066	0	0.012639638	0	0	0	0	0	1.355088954	0	5.821878611	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6657	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							15.3962		0											15.3962	0	0	0	0	0	0	5.686446413	4.954655152	0.842131742	3.63506953	0	0	0.556472066	0	0.012639638	0	0	0	0	0	1.355088954	0	5.821878611	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	15.39620847	0	0	0	0	0	0	0	0	0	0	0	0	39.0619
H1032_163_0	2008	7																																A	A	D	V	T	Coin	Coin	Coin	Coin	V	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		370.700409	46.95853346	2322.57006	22304.24652	1895.460806	159.46842	9.638462608	12.71105008	9.669426875	4002.601801	9.669782774	19.50486665	0.322232463	2.441815356	10780.62194	148.794395	65.73378108	128.2742374	43.87487602	4.003750578	225.7182852	0.111017197	1500	190	240	192	30	22.85714286	0	55600	60.75											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.4	708.4	30.26	0	0	0.2	0.2	0.2	0.2	0	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.18646026	0.009151723	0.2	0.2	0	20	0	0	0	0	0	0	0											21.8837	2.772118759	5.856747501	0	0	31.893684	1.927692522	2.542210016	1.933885375	0	1.933956555	0	0.064446493	0.488363071	0	29.75887899	13.14675622	25.65484749	8.18092079	0.036641216	45.14365703	0.022203439	0	0.316666667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	193.5574	0	0	21.8837	2.772118759	5.856747501	0	0	31.893684	1.927692522	2.542210016	1.933885375	0	1.933956555	0	0.064446493	0.488363071	0	29.75887899	13.14675622	25.65484749	8.18092079	0.036641216	45.14365703	0.022203439	0	0.316666667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	193.5574	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	21.8837	2.772118759	5.856747501	0	0	31.893684	1.927692522	2.542210016	1.933885375	0	1.933956555	0	0.064446493	0.488363071	0	29.75887899	13.14675622	25.65484749	8.18092079	0.036641216	45.14365703	0.022203439	0	0.316666667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	193.5574
H1032_164_0	2008	6																					3200											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1576.029625	60.86616488	1323.531396	3400.12959	496.1668691	16.08773225	3.955589464	917.0671424	176.1872185	4021.51596	843.2331239	82.50637337	0.054004183	346.834752	8700.965882	22366.25422	291.2185651	4417.066691	4865.042917	774.420813	32.58858583	37.3195394	0	190	320	221.5384615	40	16	0	1600	3600											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $15.00 and $75.00	$0.00 copayment	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											43.86078663	27.50053269	59.32137161	0	42.70074588	0.190285073	0.190285073	18.79153649	60.12911825	0	12.2801873	68.83401788	0.190285073	15.81880091	0	6.26613768	19.6852966	8.511193945	7.962663426	0	0.190285073	0	0	19.02850733	9.514253666	9.514253666	9.514253666	0	0	0	0											5.7605	0.139487663	6.542808149	0	1.765557949	3.061255311	0.752689631	1.436091723	0.882831841	0	0.862921725	0.473270432	0.01027619	0.457209158	0	11.67916902	0.477726986	3.13287594	3.228224941	0	6.201121443	0	0	0.301284699	0.253713431	0.17564776	0.031714179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.6264	0	2.431544852	5.7605	0.139487663	6.542808149	0	1.765557949	3.061255311	0.752689631	1.436091723	0.882831841	0	0.862921725	0.473270432	0.01027619	0.457209158	0	11.67916902	0.477726986	3.13287594	3.228224941	0	6.201121443	0	0	0.301284699	0.253713431	0.17564776	0.031714179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.6264	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.0959		0											14.0959	0	0	5.7605	0.139487663	6.542808149	0	1.765557949	3.061255311	0.752689631	1.436091723	0.882831841	0	0.862921725	0.473270432	0.01027619	0.457209158	0	11.67916902	0.477726986	3.13287594	3.228224941	0	6.201121443	0	0	0.301284699	0.253713431	0.17564776	0.031714179	0	14.09591921	0	0	0	0	0	0	0	0	0	0	0	0	61.7223
H1032_165_0	2008	6																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1516.70357	58.50084979	1338.911724	3261.584015	476.0164675	15.15526734	3.725900965	886.8166439	169.7535162	3857.634487	826.1126097	79.43385249	0.050948757	346.5762816	8383.825993	22233.89532	304.1406817	4483.398923	4741.024435	744.4459979	30.67834099	35.96514345	0	190	320	221.5384615	40	16	0	1600	3600											"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$50 days 1 - 5, $0 after day 5, unlimited coverage"	$0 days 1 - 100	Copay between $0.00 and $10.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$50.00 copayment	20% coinsurance	Copay between $5.00 and $25.00	$0.00 copayment	$10.00 copayment	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											22.74335345	14.25922367	0	0	44.26728088	0.197332785	0.197332785	19.4941767	20.86470994	0	7.976093614	35.69173394	0.197332785	5.712576863	0	2.701122006	8.156303744	3.532767513	6.311559308	0	0.197332785	0	0	19.73327845	9.866639226	9.866639226	9.866639226	0	0	0	0											2.8746	0.069514725	0	0	1.755996223	2.990631105	0.735242412	1.440646697	0.295154823	0	0.549095959	0.236260994	0.01005386	0.164986971	0	5.004705327	0.206721982	1.319900505	2.493604742	0	6.053842451	0	0	0.312443575	0.263110379	0.18215334	0.032888797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.9915	0	0.364826515	2.8746	0.069514725	0	0	1.755996223	2.990631105	0.735242412	1.440646697	0.295154823	0	0.549095959	0.236260994	0.01005386	0.164986971	0	5.004705327	0.206721982	1.319900505	2.493604742	0	6.053842451	0	0	0.312443575	0.263110379	0.18215334	0.032888797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.9915	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.4906		0											13.4906	0	0	2.8746	0.069514725	0	0	1.755996223	2.990631105	0.735242412	1.440646697	0.295154823	0	0.549095959	0.236260994	0.01005386	0.164986971	0	5.004705327	0.206721982	1.319900505	2.493604742	0	6.053842451	0	0	0.312443575	0.263110379	0.18215334	0.032888797	0	13.4905633	0	0	0	0	0	0	0	0	0	0	0	0	40.4821
H1032_166_0	2008	6																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		238.0674413	5.787227128	723.1739568	1664.490108	419.6414823	7.479706994	3.803455664	850.9970338	149.9606511	3792.595332	327.7524879	70.29363908	0.054405135	322.8407977	6342.650517	18631.27498	235.3361002	3901.806126	2005.592308	386.6874427	33.09571539	31.76168585	0	190	320	221.5384615	40	22.85714286	0	1600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$10.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	44.88752601	0.2	0.2	19.89977198	0	0	7.218801804	0	0.2	0	0	0	0	0	4.767398835	0	0.2	0	0	20	10	10	10	0	0	0	0											0	0	0	0	1.569722329	1.495941399	0.760691133	1.411220577	0	0	0.197165021	0	0.010881027	0	0	0	0	0	0.796788203	0	6.619143079	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.6628	0	0	0	0	0	0	1.569722329	1.495941399	0.760691133	1.411220577	0	0	0.197165021	0	0.010881027	0	0	0	0	0	0.796788203	0	6.619143079	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.6628	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.6584		0											14.6584	0	0	0	0	0	0	1.569722329	1.495941399	0.760691133	1.411220577	0	0	0.197165021	0	0.010881027	0	0	0	0	0	0.796788203	0	6.619143079	0	0	0.316666667	0.266666667	0.184615385	0.033333333	0	14.65840317	0	0	0	0	0	0	0	0	0	0	0	0	28.3212
H1032_167_0	2008	7																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1369.808911	57.2909402	900.744876	2366.529328	440.5109328	19.69828583	4.029643144	1615.736404	262.5628806	8585.109322	1668.232674	22.18199939	0.132625774	585.1508486	7745.007725	17187.84339	217.6837063	3814.681918	4443.830076	1034.993142	33.4498057	29.20926603	0	600	0	0	0	0	0	1600	3600											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $20.00 and $75.00	Copay between $0.00 and $10.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $10.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											50.29105635	25.80982199	30.26	0	46.8338715	0.2	0.2	19.57729966	62.65649699	0	13.24510613	72.34831054	0.2	19.51123342	4.280113483	9.68348105	25.29359367	11.38799323	6.126661714	0	0.2	0	0	0	0	0	0	0	0	0	0											5.7408	0.123222414	2.271378329	0	1.719236035	3.939657167	0.805928629	2.635979647	1.370939195	0	1.841326568	0.133735848	0.026525155	0.951417899	2.762459332	13.86984631	0.458833601	3.620130989	2.268820299	0	6.689961139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2302	0	0	5.7408	0.123222414	2.271378329	0	1.719236035	3.939657167	0.805928629	2.635979647	1.370939195	0	1.841326568	0.133735848	0.026525155	0.951417899	2.762459332	13.86984631	0.458833601	3.620130989	2.268820299	0	6.689961139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2302	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	5.7408	0.123222414	2.271378329	0	1.719236035	3.939657167	0.805928629	2.635979647	1.370939195	0	1.841326568	0.133735848	0.026525155	0.951417899	2.762459332	13.86984631	0.458833601	3.620130989	2.268820299	0	6.689961139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2302
H1035_002_0	2008	10																					3250											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S		T		V				V	O																																																					0	0	1417.542	20.211	636.966	493.535	131.933	908.775	31.768	972.489	393.844	5069.651	849.624	0.889	0.474		3162.487	4138.947	186.342	1211.166	3816.641	6994.715	2247.785	0	76.991		67.92252	6.578882	17.129			2.193												PBP Line 1a: $200/day for days 1-5; $0/day for days 6-90; $0/day for Lifetime Reserve days 1-60	PBP Line 1b: $200/day for days 1-5; $0/day for days 6-90; $0/day for Lifetime Reserve days 1-60	PBP Line 2: $0/day for days 1-7; $75/day for days 8-100	PBP Line 6: $0 copay	PBP Line 10a: $100 per service	PBP Line 11a: 15% coinsurance per item	PBP Lines 11b and 11c: 15% coinsurance per item; $0 copay for Diabetes self-monitoring training; $10 copay for 50 test strips/sensors; $10 copay for lancets; $0 copay for glucometer.	"PBP Lines 4a, 4b and 7a: $50 copay per ER visit; $30 copay per urgent care visit"	"PBP Lines 8a, 8b, 9a and 9b: $75-$150 copay per hospital outpatient service/surgery as follows - $150 copay per cardiac catherization, angioplasty, endoscopy, outpatient surgery, 23-hour observation stay, colonoscopy and advanced imaging; $75 copay per nuclear study and flexible sigmoidoscopy. $75-$150 copay per ASC service as follows - $150 copay per ASC service except $75 copay per nuclear study and flexible sigmoidoscopy."	PBP Line 8a: $0 copay	"PBP Lines 8a and 8b: $0-$150 copay. $25 copay per diagnostic ultrasound; $75 copay per nuclear study; $150 copay per CT Scan, MRI, MRA, PET Scan or interventional radiology procedure"	"PBP Lines 8a, 9a and 9b: $150 copay per 23-hour observation stay"	PBP Line 12: $0 copay		PBP Line 7a: $10 per visit	PBP Line 7d: $30 copay per visit	"PBP Lines 7e, 7h and 9c: $30 copay per individual therapy visit, $15 per group therapy visit"	"PBP Lines 3, 7c and 7i: $30 copay per occupational therapy, physical therapy, speech therapy visit."	PBP Line 8b: $0 copay	PBP Lines 7b and 7f: $20 copay per chiropractic visit; $30 copay per podiatry visit	PBP Line 15: 20% coinsurance	PBP Lines 13a: $0 copay	PBP Line 10b: $0 copay if approved by FHCP		PBP Line 17a: $15 copay per visit with an optometrist; $30 copay per visit with an ophthalmologist	PBP Line 17b: $0 copay	PBP Line 18a: $0 copay per visit			PBP Line 14a: $0 copay												124.0068	98.4619	32.3252	0	96.2442	31.411	80.4263	15.9181	147.0375	0	63.0786	1751.6457	0.1279		10.0644	29.5542	29.2337	21.393	8.9122	5.8572	16.2972	0	0		16.3048	0	0			0												14.6487	0.165834455	1.715837779	0	1.058148837	2.378794294	0.212915225	1.290014763	4.825819763	0	4.466091037	0.129767752	5.05E-06	0	2.652377847	10.19360562	0.45395551	2.159206187	2.83455566	3.414120392	3.052716809	0	0	0	0.092288592	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.7448	0	2.97	14.6487	0.165834455	1.715837779	0	1.058148837	2.378794294	0.212915225	1.290014763	4.825819763	0	4.466091037	0.129767752	5.05E-06	0	2.652377847	10.19360562	0.45395551	2.159206187	2.83455566	3.414120392	3.052716809	0	0	0	0.092288592	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.7448	3250																													PBP Section D																																									0.1242													0.1242	0	0	14.6487	0.165834455	1.715837779	0	1.058148837	2.378794294	0.212915225	1.290014763	4.825819763	0	4.466091037	0.129767752	5.05E-06	0	2.652377847	10.19360562	0.45395551	2.159206187	2.83455566	3.414120392	3.052716809	0	0	0	0.092288592	0	0	0	0.124241	0	0	0	0	0	0	0	0	0	0	0	0	55.869
H1035_006_0	2008	9																					3250											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S		T		V				V	O																																																					0	0	1417.542	20.211	636.966	493.535	131.933	908.775	31.768	972.489	393.844	5069.651	849.624	0.889	0.474		3162.487	4138.947	186.342	1211.166	3816.641	6994.715	2247.785	0	76.991		67.92252	6.578882	17.129			2.193												PBP Line 1a: $200/day for days 1-5; $0/day for days 6-90; $0/day for Lifetime Reserve days 1-60	PBP Line 1b: $200/day for days 1-5; $0/day for days 6-90; $0/day for Lifetime Reserve days 1-60	PBP Line 2: $0/day for days 1-7; $75/day for days 8-100	PBP Line 6: $0 copay	PBP Line 10a: $100 per service	PBP Line 11a: 15% coinsurance per item	PBP Lines 11b and 11c: 15% coinsurance per item; $0 copay for Diabetes self-monitoring training; $10 copay for 50 test strips/sensors; $10 copay for lancets; $0 copay for glucometer.	"PBP Lines 4a, 4b and 7a: $50 copay per ER visit; $30 copay per urgent care visit"	"PBP Lines 8a, 8b, 9a and 9b: $75-$150 copay per hospital outpatient service/surgery as follows - $150 copay per cardiac catherization, angioplasty, endoscopy, outpatient surgery, 23-hour observation stay, colonoscopy and advanced imaging; $75 copay per nuclear study and flexible sigmoidoscopy. $75-$150 copay per ASC service as follows - $150 copay per ASC service except $75 copay per nuclear study and flexible sigmoidoscopy."	PBP Line 8a: $0 copay	"PBP Lines 8a and 8b: $0-$150 copay. $25 copay per diagnostic ultrasound; $75 copay per nuclear study; $150 copay per CT Scan, MRI, MRA, PET Scan or interventional radiology procedure"	"PBP Lines 8a, 9a and 9b: $150 copay per 23-hour observation stay"	PBP Line 12: $0 copay		PBP Line 7a: $10 per visit	PBP Line 7d: $30 copay per visit	"PBP Lines 7e, 7h and 9c: $30 copay per individual therapy visit, $15 per group therapy visit"	"PBP Lines 3, 7c and 7i: $30 copay per occupational therapy, physical therapy, speech therapy visit."	PBP Line 8b: $0 copay	PBP Lines 7b and 7f: $20 copay per chiropractic visit; $30 copay per podiatry visit	PBP Line 15: 20% coinsurance	PBP Lines 13a: $0 copay	PBP Line 10b: $0 copay if approved by FHCP		PBP Line 17a: $15 copay per visit with an optometrist; $30 copay per visit with an ophthalmologist	PBP Line 17b: $0 copay	PBP Line 18a: $0 copay per visit			PBP Line 14a: $0 copay												124.0068	98.4619	32.3252	0	96.2442	31.411	80.4263	15.9181	147.0375	0	63.0786	1751.6457	0.1279		10.0644	29.5542	29.2337	21.393	8.9122	5.8572	16.2972	0	0		16.3048	0	0			0												14.6487	0.165834455	1.715837779	0	1.058148837	2.378794294	0.212915225	1.290014763	4.825819763	0	4.466091037	0.129767752	5.05E-06	0	2.652377847	10.19360562	0.45395551	2.159206187	2.83455566	3.414120392	3.052716809	0	0	0	0.092288592	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.7448	0	2.97	14.6487	0.165834455	1.715837779	0	1.058148837	2.378794294	0.212915225	1.290014763	4.825819763	0	4.466091037	0.129767752	5.05E-06	0	2.652377847	10.19360562	0.45395551	2.159206187	2.83455566	3.414120392	3.052716809	0	0	0	0.092288592	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.7448	3250																													PBP Section D																																									0.1242													0.1242	0	0	14.6487	0.165834455	1.715837779	0	1.058148837	2.378794294	0.212915225	1.290014763	4.825819763	0	4.466091037	0.129767752	5.05E-06	0	2.652377847	10.19360562	0.45395551	2.159206187	2.83455566	3.414120392	3.052716809	0	0	0	0.092288592	0	0	0	0.124241	0	0	0	0	0	0	0	0	0	0	0	0	55.869
H1035_007_0	2008	3																					3250											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S		T		V				V	O																																																					0	0	1417.542	20.211	636.966	493.535	131.933	908.775	31.768	972.489	393.844	5069.651	849.624	0.889	0.474		3162.487	4138.947	186.342	1211.166	3816.641	6994.715	2247.785	0	76.991		67.92252	6.578882	17.129			2.193												PBP Line 1a: $200/day for days 1-5; $0/day for days 6-90; $0/day for Lifetime Reserve days 1-60	PBP Line 1b: $200/day for days 1-5; $0/day for days 6-90; $0/day for Lifetime Reserve days 1-60	PBP Line 2: $0/day for days 1-7; $75/day for days 8-100	PBP Line 6: $0 copay	PBP Line 10a: $100 per service	PBP Line 11a: 15% coinsurance per item	PBP Lines 11b and 11c: 15% coinsurance per item; $0 copay for Diabetes self-monitoring training; $10 copay for 50 test strips/sensors; $10 copay for lancets; $0 copay for glucometer.	"PBP Lines 4a, 4b and 7a: $50 copay per ER visit; $30 copay per urgent care visit"	"PBP Lines 8a, 8b, 9a and 9b: $75-$150 copay per hospital outpatient service/surgery as follows - $150 copay per cardiac catherization, angioplasty, endoscopy, outpatient surgery, 23-hour observation stay, colonoscopy and advanced imaging; $75 copay per nuclear study and flexible sigmoidoscopy. $75-$150 copay per ASC service as follows - $150 copay per ASC service except $75 copay per nuclear study and flexible sigmoidoscopy."	PBP Line 8a: $0 copay	"PBP Lines 8a and 8b: $0-$150 copay. $25 copay per diagnostic ultrasound; $75 copay per nuclear study; $150 copay per CT Scan, MRI, MRA, PET Scan or interventional radiology procedure"	"PBP Lines 8a, 9a and 9b: $150 copay per 23-hour observation stay"	PBP Line 12: $0 copay		PBP Line 7a: $10 per visit	PBP Line 7d: $30 copay per visit	"PBP Lines 7e, 7h and 9c: $30 copay per individual therapy visit, $15 per group therapy visit"	"PBP Lines 3, 7c and 7i: $30 copay per occupational therapy, physical therapy, speech therapy visit."	PBP Line 8b: $0 copay	PBP Lines 7b and 7f: $20 copay per chiropractic visit; $30 copay per podiatry visit	PBP Line 15: 20% coinsurance	PBP Lines 13a: $0 copay	PBP Line 10b: $0 copay if approved by FHCP		PBP Line 17a: $15 copay per visit with an optometrist; $30 copay per visit with an ophthalmologist	PBP Line 17b: $0 copay	PBP Line 18a: $0 copay per visit			PBP Line 14a: $0 copay												124.0068	98.4619	32.3252	0	96.2442	31.411	80.4263	15.9181	147.0375	0	63.0786	1751.6457	0.1279		10.0644	29.5542	29.2337	21.393	8.9122	5.8572	16.2972	0	0		16.3048	0	0			0												14.6487	0.165834455	1.715837779	0	1.058148837	2.378794294	0.212915225	1.290014763	4.825819763	0	4.466091037	0.129767752	5.05E-06	0	2.652377847	10.19360562	0.45395551	2.159206187	2.83455566	3.414120392	3.052716809	0	0	0	0.092288592	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.7448	0	2.97	14.6487	0.165834455	1.715837779	0	1.058148837	2.378794294	0.212915225	1.290014763	4.825819763	0	4.466091037	0.129767752	5.05E-06	0	2.652377847	10.19360562	0.45395551	2.159206187	2.83455566	3.414120392	3.052716809	0	0	0	0.092288592	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.7448	3250																													PBP Section D																																									0.1242													0.1242	0	0	14.6487	0.165834455	1.715837779	0	1.058148837	2.378794294	0.212915225	1.290014763	4.825819763	0	4.466091037	0.129767752	5.05E-06	0	2.652377847	10.19360562	0.45395551	2.159206187	2.83455566	3.414120392	3.052716809	0	0	0	0.092288592	0	0	0	0.124241	0	0	0	0	0	0	0	0	0	0	0	0	55.869
H1036_011_0	2008	6	s.	t.	u.								Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered																			D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0								0		1622.12	8.59	935.5	28.91	360.12	3.03	2376.74	310.75	233.72	1956.9	2392.89		39.12	2036.7	7284.27	4909.4	9.14	1441.79			25.93			1.75	0.97		0.33			0.02	0.06	0.08	2.26	0.3								$100/Day(Days 1-7)	$100/Day(Days 1-7)	$0/Day(Days 1-13) $50(Days 14-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$100-$200/Visit	$0-$25/Visit	$25-$100/Visit		$0-$25/Proc	$0-$100/Visit	$0/Visit	$25/Visit	$25/Visit	$40/Visit			0% Coins			DEN 727	VIS 116		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements								74.946897	74.946654	20.705702	0	100.000011	0	0	50.000007	145.978947	3.843173	39.779841		13.322919	31.884299	0	25.000001	24.998979	40.000003			0			0	0		0			0	0	0	0	0								10.1311	0.053649313	1.614182018	0	3.00100033	0	0	1.294791848	2.843183291	0.626725437	7.932398644	0	0.043432716	5.411562648	0	10.22791708	0.019040889	4.805967027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.0049	0	0	10.1311	0.053649313	1.614182018	0	3.00100033	0	0	1.294791848	2.843183291	0.626725437	7.932398644	0	0.043432716	5.411562648	0	10.22791708	0.019040889	4.805967027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.0049																																																																																				0	0	0	10.1311	0.053649313	1.614182018	0	3.00100033	0	0	1.294791848	2.843183291	0.626725437	7.932398644	0	0.043432716	5.411562648	0	10.22791708	0.019040889	4.805967027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.0049
H1036_025_0	2008	6	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered							3100											D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1183.62	11.59	735.71	436.71	198.3	1.96	3362.24	223.26	195.82	1427.64	2108.14		16	1519.26	5743.93	3843.92	10.23	1104.6			19.73			1.75	2.2		0.33			0.02	0.06	0.08	2.83	0.3	0.4							$75/Day(Days 1-7)	$75/Day(Days 1-7)	$0/Day(Days 1-9) $50(Days 10-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$50-$100/Visit	$0/Visit	$0-$100/Visit		$0-$100/Proc	$20-$100/Visit	$0/Visit	$20/Visit	$20-$100/Visit	$100/Visit			20% Coins			DEN 727	VIS 140		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	$10 OTC Mail Order							43.698297	43.698655	21.86875	0	77.740904	0	0	38.870457	54.653241	0	64.574219		47.688695	64.704741	0	15.54818	77.420162	77.740899			0.155481			0	0		0			0	0	0	0	0	0							4.3102	0.042205618	1.340754839	0	1.284668439	0	0	0.723184852	0.891849804	0	11.34429117	0	0.063584927	8.191943734	0	4.980496672	0.066000688	7.156049753	0	0	3.06764013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4629	0	12.4445395	4.3102	0.042205618	1.340754839	0	1.284668439	0	0	0.723184852	0.891849804	0	11.34429117	0	0.063584927	8.191943734	0	4.980496672	0.066000688	7.156049753	0	0	3.06764013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4629	3100																																																																																			0	0	0	4.3102	0.042205618	1.340754839	0	1.284668439	0	0	0.723184852	0.891849804	0	11.34429117	0	0.063584927	8.191943734	0	4.980496672	0.066000688	7.156049753	0	0	3.06764013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4629
H1036_034_0	2008	4	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1772.76	6.7	809.7	97.48	332.22	2.76	1887.51	215.85	205.91	1871.27	2833.4		28.58	2564.14	7809.19	5250.36	11.17	1707.93			5096.9			1.75	2.2		0.33			0.02	0.06	0.08	2.26	1.72	1							$100/Day(Days 1-5)	$100/Day(Days 1-5)	$0/Day(Days 1-6) $50(Days 7-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$50-$75/Visit	$0/Visit	$0-$50/Visit		$0-$25/Proc	$5-$50/Visit	$0/Visit	$5/Visit	$5-$25/Visit	$40/Visit			$0/Script			DEN 727	VIS 140		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	$25 per Month							65.003798	65.003718	36.466306	0	100.000014	0	0	49.999982	62.881442	0	26.677511		17.388263	30.672299	0	4.999997	18.592101	40			0			0	0		0			0	0	0	0	0	0							9.603	0.036293743	2.460563997	0	2.768500388	0	0	0.899374676	1.078993144	0	6.299004972	0	0.041413046	6.55400573	0	2.187648687	0.017306147	5.6931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.6392	0	0	9.603	0.036293743	2.460563997	0	2.768500388	0	0	0.899374676	1.078993144	0	6.299004972	0	0.041413046	6.55400573	0	2.187648687	0.017306147	5.6931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.6392																																																																																				0	0	0	9.603	0.036293743	2.460563997	0	2.768500388	0	0	0.899374676	1.078993144	0	6.299004972	0	0.041413046	6.55400573	0	2.187648687	0.017306147	5.6931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.6392
H1036_035_0	2008	4	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1459.99	4.47	1244.72	19.07	307.73	3.21	2799.55	265.63	199.5	2195.4	3031.32		30.1	1992.64	7485.62	5016.03	7.67	2305.69			14.62			1.75	2.2		0.33			0.02	0.06	0.08	3.78	0.3	1							$100/Day(Days 1-10)	$100/Day(Days 1-10)	$0/Day(Days 1-13) $75(Days 14-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$125-$150/Visit	$0/Visit	$0-$75/Visit		$0-$25/Proc	$20-$75/Visit	$0/Visit	$25/Visit	$25/Visit	$40/Visit			0% Coins			DEN 727	VIS 140		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutirtional Supplements	$25 per Month							83.573996	83.572678	31.058551	0	100.000004	0	0	50	135.720252	0	33.367016		13.854027	31.309983	0	24.999998	24.999364	39.999998			0			0	0		0			0	0	0	0	0	0							10.1681	0.031130823	3.221599967	0	2.564416769	0	0	1.106791667	2.25634919	0	8.428841912	0	0.034750518	5.199127044	0	10.45006166	0.01597876	7.685632949	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1628	0	0	10.1681	0.031130823	3.221599967	0	2.564416769	0	0	1.106791667	2.25634919	0	8.428841912	0	0.034750518	5.199127044	0	10.45006166	0.01597876	7.685632949	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1628																																																																																				0	0	0	10.1681	0.031130823	3.221599967	0	2.564416769	0	0	1.106791667	2.25634919	0	8.428841912	0	0.034750518	5.199127044	0	10.45006166	0.01597876	7.685632949	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1628
H1036_037_0	2008	6	s.	t.	u.	v.	w.						DME/Prosthetics/Supplies	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered							Prosthetics/Supplies										D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O	O						0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0						0		1484.57	152.25	705.42	642.32	256.28	1.41	0.43	363.86	77.25	814.9	1159.51		17.02	1741.61	6321.39	4357.77	17.78	547.78			9.6			1.4	1.05		0.08			0.02	0.06	1362	0.08	3.33	0.3	1.01						$115/Day(Days 1-10)	$115/Day(Days 1-10)	$0/Day(Days 1-20) $100(Days 21-100)	$0/Visit	$125/Trip	20% Coins	20% Coins	$50/Visit	$100/Visit	$0/Visit	$0-$50/Visit		$0/Proc	$0-$50/Visit	$0/Visit	$30/Visit	$0-$30/Visit	$0/Visit			20% Coins			DEN 723	Vision Unspecified		HER 722			QuitNet	Meals on Wheels		Active Outlook	Silver Sneakers	Nutritional Supplements	16 1 Way						96.110102	96.110128	23.155292	0	125.000021	0.199999	0.2	50.000016	100.000091	0	15.384617		0	0.459706	0	30.000001	8.108548	0			0.199999			0	0		0			0	0	0	0	0	0	0						11.8902	1.219397249	1.36118384	0	2.669583782	0.28199859	0.086	1.516083818	0.643750586	0	1.486551438	0	0	0.066719047	0	10.89442536	0.012014165	0	0	0	1.9199904	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.0479	0	0	11.8902	1.219397249	1.36118384	0	2.669583782	0.28199859	0.086	1.516083818	0.643750586	0	1.486551438	0	0	0.066719047	0	10.89442536	0.012014165	0	0	0	1.9199904	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.0479																																																																																				0	0	0	11.8902	1.219397249	1.36118384	0	2.669583782	0.28199859	0.086	1.516083818	0.643750586	0	1.486551438	0	0	0.066719047	0	10.89442536	0.012014165	0	0	0	1.9199904	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.0479
H1036_040_0	2008	4	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered							3100											D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1186.63	11.62	737.58	437.82	198.8	1.94	3370.8	223.83	196.32	1431.28	2113.51		16.04	1523.13	5758.55	3853.7	10.25	1107.41			19.14			1.75	2.2		0.33			0.02	0.06	0.08	2.83	0.3	0.4							$75/Day(Days 1-7)	$75/Day(Days 1-7)	$0/Day(Days 1-9) $50(Days 10-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$50-$100/Visit	$0/Visit	$0-$100/Visit		$0-$100/Proc	$20-$100/Visit	$0/Visit	$20/Visit	$20-$100/Visit	$100/Visit			20% Coins			DEN 727	VIS 140		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	$10 OTC Mail Order							43.695545	43.695711	21.867367	0	77.735988	0	0	38.86802	54.649787	0	64.570145		47.686128	64.700671	0	15.547202	77.415142	77.736001			0.155472			0	0		0			0	0	0	0	0	0							4.3209	0.042312013	1.344077713	0	1.287826201	0	0	0.724985743	0.894070515	0	11.3724706	0	0.063740458	8.212294418	0	4.992854362	0.066125434	7.173802072	0	0	2.97573408	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4712	0	12.45021983	4.3209	0.042312013	1.344077713	0	1.287826201	0	0	0.724985743	0.894070515	0	11.3724706	0	0.063740458	8.212294418	0	4.992854362	0.066125434	7.173802072	0	0	2.97573408	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4712	3100																																																																																			0	0	0	4.3209	0.042312013	1.344077713	0	1.287826201	0	0	0.724985743	0.894070515	0	11.3724706	0	0.063740458	8.212294418	0	4.992854362	0.066125434	7.173802072	0	0	2.97573408	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4712
H1036_044_0	2008	4	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1441.67	8.4	760.14	21.84	173.44	164.34	336.16	316.29	185.76	2978.57	3337.41		16.95	2082.96	5764.78	3868.41	13.01	241.81			3.97			1.4	1.05		0.08			0.02	0.06	0.08	4.65	0.3	0.4							$150/Day(Days 1-7)	$150/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip			$50/Visit	$150/Visit	$0/Visit	$0-$25/Visit		$0/Proc	$0-$30/Visit	$10/Visit	$30/Visit	$0-$30/Visit	$100/Visit			20% Coins			DEN 727	VIS		HER 722			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	$10 OTC Mail Order							112.420347	112.420056	28.712576	0	100.000006	0	0	50.000018	150.000018	0	4.07535		0	10.234077	10	30.000001	0.316289	100.000009			0.199999			0	0		0			0	0	0	0	0	0							13.5061	0.078694039	1.818798127	0	1.44533342	0	0	1.317875474	2.322000279	0	1.133426154	0	0	1.776431086	4.803983333	9.671025322	0.00034291	2.015083515	0	0	0.79399603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6831	0	0	13.5061	0.078694039	1.818798127	0	1.44533342	0	0	1.317875474	2.322000279	0	1.133426154	0	0	1.776431086	4.803983333	9.671025322	0.00034291	2.015083515	0	0	0.79399603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6831																																																																																				0	0	0	13.5061	0.078694039	1.818798127	0	1.44533342	0	0	1.317875474	2.322000279	0	1.133426154	0	0	1.776431086	4.803983333	9.671025322	0.00034291	2.015083515	0	0	0.79399603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6831
H1036_047_0	2008	6	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1498.48	6.44	830.41	53.69	203.96	2.45	3129.39	263.79	273.9	2184.69	2455.66		16.12	1774.82	6166.6	4142.03	7.42	1407.95			14.85			1.75	0.91		0.33			0.02	0.06	0.08	2.99	0.3	0.4							$100/Day(Days 1-7)	$100/Day(Days 1-7)	$0/Day(Days 1-6) $75(Days 7-100)	$0/Visit	$150/Trip	0% Coins		$50/Visit	$150/Visit	$0/Visit	$0-$150/Visit		$0-$100/Proc	$25-$150/Visit	$0/Visit	$25/Visit	$25-$100/Visit	$100/Visit			20% Coins			DEN 727	VIS 110 Allowance		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	OTC $10 Mail Order							74.946902	74.947734	54.699453	0	149.999983	0	0	50.000017	149.999985	0	105.342351		88.383537	100.333963	0	25	96.04822	99.999999			0.199999			0	0		0			0	0	0	0	0	0							9.3589	0.040221951	3.78524773	0	2.549499711	0	0	1.099125374	3.423749658	0	21.55708314	0	0.118728551	14.83956035	0	8.629229167	0.059389816	11.73291655	0	0	2.96998515	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1636	0	0	9.3589	0.040221951	3.78524773	0	2.549499711	0	0	1.099125374	3.423749658	0	21.55708314	0	0.118728551	14.83956035	0	8.629229167	0.059389816	11.73291655	0	0	2.96998515	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1636																																																																																				0	0	0	9.3589	0.040221951	3.78524773	0	2.549499711	0	0	1.099125374	3.423749658	0	21.55708314	0	0.118728551	14.83956035	0	8.629229167	0.059389816	11.73291655	0	0	2.96998515	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1636
H1036_052_0	2008	5	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered							3100											D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1200.39	11.76	746.14	442.9	201.11	2.02	3409.89	226.42	198.6	1447.88	2138.02		16.23	1540.79	5825.34	3898.4	10.37	1120.25			20.3			1.75	2.2		0.33			0.02	0.06	0.08	2.83	0.3	0.4							$75/Day(Days 1-7)	$75/Day(Days 1-7)	$0/Day(Days 1-9) $50(Days 10-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$50-$100/Visit	$0/Visit	$0-$50/Visit		$0-$50/Proc	$20-$75/Visit	$0/Visit	$20/Visit	$20-$50/Visit	$50/Visit			20% Coins			DEN 727	VIS 140		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	$10 OTC Mail Order							46.745282	46.745109	23.393605	0	83.161578	0	0	41.580816	58.464132	0	34.538416		25.507216	55.507448	0	16.632319	41.451986	41.580802			0.166323			0	0		0			0	0	0	0	0	0							4.676	0.045810207	1.45457537	0	1.393718746	0	0	0.784560697	0.967581385	0	6.153652015	0	0.03449851	7.127110067	0	5.403286032	0.035821425	3.88174112	0	0	3.3763569	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.3348	0	7.154354285	4.676	0.045810207	1.45457537	0	1.393718746	0	0	0.784560697	0.967581385	0	6.153652015	0	0.03449851	7.127110067	0	5.403286032	0.035821425	3.88174112	0	0	3.3763569	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.3348	3100																																																																																			0	0	0	4.676	0.045810207	1.45457537	0	1.393718746	0	0	0.784560697	0.967581385	0	6.153652015	0	0.03449851	7.127110067	0	5.403286032	0.035821425	3.88174112	0	0	3.3763569	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.3348
H1036_053_0	2008	3	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1477.907419	7.826569	852.327017	26.336899	328.102361	2.512978	2165.440835	283.119057	212.941798	1782.927052	2180.155817		35.640704	1855.629352	6636.677688	4472.943076	8.323101	1313.609997			11224.46506			1.75	2.2		0.06			0.02	0.06	0.08	2.26	0.3	0.4							$0/Day(Days 1-7)	$0/Day(Days 1-7)	$0/Day(Days 1-100) $0(Days 100-100)	$0/Visit	$75/Trip	0% Coins		$50/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			$0/Script			DEN 727	VIS 140		HER 722			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	$10 OTC Mail Order							0	0	0	0	75.000008	0	0	50.000011	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0	0	0	0	2.050639975	0	0	1.179662997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.2303	0	0	0	0	0	0	2.050639975	0	0	1.179662997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.2303																																																																																				0	0	0	0	0	0	0	2.050639975	0	0	1.179662997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.2303
H1036_054_0	2008	4	s.	t.	u.	v.	w.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O	O						0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0						0		1707.73	6.45	779.99	93.9	320.03	2.56	1818.27	207.93	198.36	1802.63	2729.46		27.53	2470.08	7522.72	5057.75	10.76	1645.28			8.94			1.75	2.2		0.33			0.02	0.06	0.08	2.26	1.72	1	1.53						$0/Day(Days 1-10)	$0/Day(Days 1-10)	$0/Day(Days 1-13) $25(Days 14-100)	$0/Visit	$50/Trip	0% Coins		$50/Visit	$0-$15/Visit	$0-$15/Visit	$0-$15/Visit		$0-$15/Proc	$0-$25/Visit	$0/Visit	$0/Visit	$0-$15/Visit	$15/Visit			0% Coins			DEN 727	VIS 140		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	$25 OTC per Month	6 Visits per Year						0	0	10.352844	0	50.000007	0	0	50.000017	7.728834	2.854268	9.672307		10.433135	15.019057	0	0	10.194684	14.999999			0			0	0		0			0	0	0	0	0	0	0						0	0	0.672926233	0	1.33345852	0	0	0.866375295	0.127757626	0.42876576	2.200014589	0	0.023935351	3.091522693	0	0	0.009141233	2.056599863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8105	0	0	0	0	0.672926233	0	1.33345852	0	0	0.866375295	0.127757626	0.42876576	2.200014589	0	0.023935351	3.091522693	0	0	0.009141233	2.056599863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8105																																																																																				0	0	0	0	0	0.672926233	0	1.33345852	0	0	0.866375295	0.127757626	0.42876576	2.200014589	0	0.023935351	3.091522693	0	0	0.009141233	2.056599863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8105
H1036_056_0	2008	3	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			Coin				V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0				0		0			0	0	0	0	0	0							0		1335.18817	7.776801	703.991374	20.230633	160.632592	152.203976	311.330761	292.926783	172.040396	2758.56825	3090.906781		15.693594	1929.113531	5338.992392	3582.690911	12.052214	223.946071			3.403452				1.05		0.08			0.02	0.06	0.08	4.14	0.3	0.4							$50/Day(Days 1-7)	$50/Day(Days 1-7)	$0/Day(Days 1-6) $50(Days 7-100)	$0/Visit	$100/Trip			$50/Visit	$50/Visit	$0/Visit	$0-$50/Visit		$0/Proc	$0-$50/Visit	$5/Visit	$20/Visit	$0-$20/Visit	$50/Visit			20% Coins				VIS 110 Allowance		HER 722			Quick Net	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	$10 OTC Mail Order							37.47345	37.472991	36.466299	0	100.000004	0	0	49.999989	50.000001	0	8.150695		0	10.447857	4.999999	20.000001	0.211081	50.000019			0.199999				0		0			0	0	0	0	0	0							4.1695	0.024284999	2.139329995	0	1.338604987	0	0	1.220527994	0.716834998	0	2.09941987	0	0	1.679591859	2.224579718	5.971151817	0.000211999	0.933108984	0	0	0.680686997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.1978	0	0	4.1695	0.024284999	2.139329995	0	1.338604987	0	0	1.220527994	0.716834998	0	2.09941987	0	0	1.679591859	2.224579718	5.971151817	0.000211999	0.933108984	0	0	0.680686997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.1978																																																																																				0	0	0	4.1695	0.024284999	2.139329995	0	1.338604987	0	0	1.220527994	0.716834998	0	2.09941987	0	0	1.679591859	2.224579718	5.971151817	0.000211999	0.933108984	0	0	0.680686997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.1978
H1036_062_0	2008	4	s.	t.	u.	v.	w.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O	O						0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0						0		1427.6	4.37	1217.11	18.65	300.9	3.07	2737.45	259.73	195.08	2146.7	2964.08		29.43	1948.44	7319.57	4904.77	7.5	2254.55			13.98			1.75	2.2		0.33			0.02	0.06	0.08	2.26	1	1.53	1.72						$50/Day(Days 1-7)	$50/Day(Days 1-7)	$0/Day(Days 1-13) $50(Days 14-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$50-$75/Visit	$0/Visit	$0-$25/Visit		$0-$20/Proc	$10-$25/Visit	$0/Visit	$10/Visit	$10-$20/Visit	$20/Visit			0% Coins			DEN 727	VIS 140		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	$25 per Month OTC Mail Order	6 Visits per Year	Nutritional Supplements						37.473453	37.472123	20.705697	0	100.000001	0	0	50.000001	60.720215	0	18.422269		11.083397	19.969465	0	10	19.555435	19.999998			0			0	0		0			0	0	0	0	0	0	0						4.4581	0.013646098	2.100092573	0	2.507500025	0	0	1.082208355	0.987108295	0	4.550423258	0	0.027182031	3.242442032	0	4.087308333	0.012222147	3.757582958	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.8258	0	0	4.4581	0.013646098	2.100092573	0	2.507500025	0	0	1.082208355	0.987108295	0	4.550423258	0	0.027182031	3.242442032	0	4.087308333	0.012222147	3.757582958	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.8258																																																																																				0	0	0	4.4581	0.013646098	2.100092573	0	2.507500025	0	0	1.082208355	0.987108295	0	4.550423258	0	0.027182031	3.242442032	0	4.087308333	0.012222147	3.757582958	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.8258
H1036_063_0	2008	3	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O	O							3.8087	0.0117	3.1599	0	2.1423	0	0	0.9246	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							10.047		1407.124034	4.306656	1199.65644	18.382868	296.588255	2.982955	2698.184687	256.008228	192.27906	2115.907618	2921.563382		29.008899	1920.496373	7214.585584	4834.418395	7.396566	2222.207429			5358.98355			1.37	2.2		0.06			0.02	0.06	0.08	2.62	0.3	0.4							$50/Day(Days 1-7)	$50/Day(Days 1-7)	$0/Day(Days 1-6) $50(Days 7-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			$0/Script			DEN 723	VIS 140		HER 722			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	$10 per Month OTC Mail Order							36.966318	36.966949	35.972801	0	98.646708	0	0	49.323352	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							4.3347	0.013266994	3.596250199	0	2.438121249	0	0	1.052265329	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.4346	100	0.156867147	8.1434	0.02492409	6.756109257	0	4.58038581	0	0	1.976842288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.4816																																																																																				0	0	0	8.1434	0.02492409	6.756109257	0	4.58038581	0	0	1.976842288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.4816
H1036_065_0	2008	7	s.	t.	u.	v.	w.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O	O						0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0						0		1561.25	8.27	900.39	27.82	346.6	2.8	2287.55	299.08	224.95	1883.47	2303.1		37.65	1960.27	7010.93	4725.18	8.79	1387.69			24.02			1.75	2.2		0.33			0.02	0.06	0.08	2.26	1	1.53	1.72						$0/Day(Days 1-7)	$0/Day(Days 1-7)	$0/Day(Days 1-6) $25(Days 7-100)	$0/Visit	$75/Trip	0% Coins		$50/Visit	$25-$75/Visit	$0/Visit	$0-$25/Visit		$0-$15/Proc	$5-$50/Visit	$0/Visit	$5/Visit	$5-$15/Visit	$15/Visit			0% Coins			DEN 727	VIS 140		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	$25 OTC per Month	6 Visits per Year	Nutritional Supplements						0	0	18.233149	0	75.000006	0	0	49.999985	47.98947	0	9.549641		7.993832	15.211928	0	4.999999	14.656664	15.000003			0			0	0		0			0	0	0	0	0	0	0						0	0	1.368078752	0	2.166250173	0	0	1.246166293	0.899602606	0	1.832814849	0	0.025080648	2.484957175	0	1.968824606	0.010736006	1.734612847	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.7371	0	0	0	0	1.368078752	0	2.166250173	0	0	1.246166293	0.899602606	0	1.832814849	0	0.025080648	2.484957175	0	1.968824606	0.010736006	1.734612847	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.7371																																																																																				0	0	0	0	0	1.368078752	0	2.166250173	0	0	1.246166293	0.899602606	0	1.832814849	0	0.025080648	2.484957175	0	1.968824606	0.010736006	1.734612847	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.7371
H1036_067_0	2008	4	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered							3100											D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1128.93	11.06	701.72	416.53	189.14	189.83	3206.9	212.94	186.78	1361.69	2010.74		15.26	1449.07	5478.56	3666.33	9.76	1053.57			17.95			1.75	2.2		0.33			0.02	0.06	0.08	2.83	0.3	0.4							$50/Day(Days 1-5)	$50/Day(Days 1-5)	$0/Day(Days 1-9) $50(Days 10-100)	$0/Visit	$100/Trip			$50/Visit	$50/Visit	$0/Visit	$0-$50/Visit		$0-$50/Proc	$20-$50/Visit	$0/Visit	$20/Visit	$20-$50/Visit	$50/Visit			20% Coins			DEN 727	VIS 140		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	$10 OTC Mail Order							28.101049	28.101316	24.321367	0	86.459687	0	0	43.229835	43.229835	0	35.908174		26.518668	43.224603	0	17.29194	43.096042	43.229845			0.172919			0	0		0			0	0	0	0	0	0							2.6437	0.025900046	1.422232471	0	1.362748767	0	0	0.767113422	0.672872382	0	6.016833482	0	0.033722906	5.219622956	0	5.283163198	0.035051447	3.795472316	0	0	3.10389605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.3823	0	4.758136569	2.6437	0.025900046	1.422232471	0	1.362748767	0	0	0.767113422	0.672872382	0	6.016833482	0	0.033722906	5.219622956	0	5.283163198	0.035051447	3.795472316	0	0	3.10389605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.3823	3100																																																																																			0	0	0	2.6437	0.025900046	1.422232471	0	1.362748767	0	0	0.767113422	0.672872382	0	6.016833482	0	0.033722906	5.219622956	0	5.283163198	0.035051447	3.795472316	0	0	3.10389605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.3823
H1036_068_0	2008	4	s.	t.	u.								Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered																			D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0								0		1449.07	148.61	688.55	626.96	250.15	178.96	1346.13	355.16	75.4	795.41	1131.79		16.61	1699.96	6170.24	4253.57	17.35	534.68			9.14			1.4	1.05		0.08			0.02	0.06	0.08	3.33	0.3								$105/Day(Days 1-5)	$105/Day(Days 1-5)	$0/Day(Days 1-4) $75(Days 5-100)	$0/Visit	$100/Trip			$50/Visit	$100/Visit	$0/Visit	$0-$100/Visit		$0-$100/Proc	$0-$100/Visit	$0/Visit	$25/Visit	$25-$100/Visit	$100/Visit			20% Coins			DEN 723	VIS		HER 722			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplement								68.253989	68.254025	64.083444	0	99.999996	0	0	49.99999	100.000045	0	37.76361		96.439023	64.843353	0	25	79.727792	100.000006			0.2			0	0		0			0	0	0	0	0								8.2421	0.845269221	3.677054614	0	2.08458325	0	0	1.479833037	0.628333616	0	3.561706347	0	0.133487681	9.18592553	0	8.861604167	0.115273099	4.455666934	0	0	1.828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0988	0	0	8.2421	0.845269221	3.677054614	0	2.08458325	0	0	1.479833037	0.628333616	0	3.561706347	0	0.133487681	9.18592553	0	8.861604167	0.115273099	4.455666934	0	0	1.828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0988																																																																																				0	0	0	8.2421	0.845269221	3.677054614	0	2.08458325	0	0	1.479833037	0.628333616	0	3.561706347	0	0.133487681	9.18592553	0	8.861604167	0.115273099	4.455666934	0	0	1.828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0988
H1036_074_0	2008	5	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered							3100											D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1129.47	11.06	702.06	416.73	189.23	189.92	3208.44	213.05	186.86	1362.34	2011.71		15.27	1449.76	5481.18	3668.08	9.76	1054.07			17.97			1.75	2.2		0.33			0.02	0.4	0.08	3.05	0.06	0.3							$50/Day(Days 1-5)	$50/Day(Days 1-5)	$0/Day(Days 1-9) $50(Days 10-100)	$0/Visit	$100/Trip			$50/Visit	$50-$100/Visit	$0/Visit	$0-$100/Visit		$0-$100/Proc	$0-$100/Visit	$0/Visit	$20/Visit	$20-$100/Visit	$100/Visit			20% Coins			DEN 727	VIS 140		HER 751			QuitNet	OTC $10 Mail Order	Active Outlook	Silver Sneakers	Meals on Wheels	Nutritional Supplements							26.422129	26.422099	22.868275	0	81.294106	0	0	40.647071	57.151238	0	58.031121		49.868388	53.65895	0	16.258821	80.958766	81.294099			0.162588			0	0		0			0	0	0	0	0	0							2.4869	0.024352368	1.337908429	0	1.281940307	0	0	0.721654873	0.889940028	0	9.728482202	0	0.063457524	6.482716613	0	4.969888011	0.065846463	7.140805911	0	0	2.92170636	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1156	0	8.770384674	2.4869	0.024352368	1.337908429	0	1.281940307	0	0	0.721654873	0.889940028	0	9.728482202	0	0.063457524	6.482716613	0	4.969888011	0.065846463	7.140805911	0	0	2.92170636	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1156	3100																																																																																			0	0	0	2.4869	0.024352368	1.337908429	0	1.281940307	0	0	0.721654873	0.889940028	0	9.728482202	0	0.063457524	6.482716613	0	4.969888011	0.065846463	7.140805911	0	0	2.92170636	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1156
H1036_077_0	2008	5	s.	t.	u.	v.	w.	x.	y.				Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered															D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O	O	O	O				0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0	0	0				0		1734.55	6.55	792.24	95.37	325.06	2.64	1846.83	211.2	201.48	1830.94	2772.32		27.97	2508.87	7640.87	5137.19	10.93	1671.12			9.23			3.3	2.2		0.33			0.02	0.06	2.26	0.08	1.72	2	2.55	18.75	53.33				$0/Day(Days 1-10)	$0/Day(Days 1-10)	$0/Day(Days 1-100) $0(Days 100-100)	$0/Visit	$0/Trip	0% Coins		$25/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			0% Coins			DEN 731	VIS 140		HER 751			QuitNet	Meals on Wheels	Silver Sneakers	Active Outlook	Nutritional Supplement	24 1 Way	10 Visits Per Year	$25 Discover Card	8 Meals per Month				0	0	0	0	0	0	0	24.999991	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0	0	0				0	0	0	0	0	0	0	0.439999842	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.44	0	0	0	0	0	0	0	0	0	0.439999842	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.44																																																																																				0	0	0	0	0	0	0	0	0	0	0.439999842	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.44
H1036_081_0	2008	5	s.	t.	u.	v.							DME/Prosthetics/Supplies	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered								Prosthetics/Supplies										D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1449.21	148.63	688.61	627.02	250.18	1.35	0.41	355.19	75.41	795.49	1131.89		16.61	1700.12	6170.82	4253.97	17.35	534.73			9.14			1.4	1.05		0.08			0.02	0.06	1329.56	0.08	3.33	0.3							$175/Day(Days 1-10)	$155/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$150/Trip	20% Coins	20% Coins	$50/Visit	$100-$200/Visit	$0/Visit	$25-$150/Visit		$0-$50/Proc	$35-$150/Visit	$5/Visit	$35/Visit	$35-$50/Visit	$50/Visit			20% Coins			DEN 723	Vision Unspecified		HER 722			QuitNet	Meals on Wheels		Active Outlook	Silver Sneakers	Nutritional Supplements							146.254501	116.167682	28.712577	0	150.000004	0.199999	0.199999	50.000006	177.014136	0	69.609406		48.219661	50.642863	5	34.999997	45.945581	49.999991			0.2			0	0		0			0	0	0	0	0	0							17.6628	1.438833548	1.647647304	0	3.127250083	0.26999865	0.08199959	1.479958511	1.112386333	0	6.565849213	0	0.066744047	7.17491202	2.571175	12.40741144	0.066429653	2.228041266	0	0	1.828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7294	0	0	17.6628	1.438833548	1.647647304	0	3.127250083	0.26999865	0.08199959	1.479958511	1.112386333	0	6.565849213	0	0.066744047	7.17491202	2.571175	12.40741144	0.066429653	2.228041266	0	0	1.828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7294																																																																																				0	0	0	17.6628	1.438833548	1.647647304	0	3.127250083	0.26999865	0.08199959	1.479958511	1.112386333	0	6.565849213	0	0.066744047	7.17491202	2.571175	12.40741144	0.066429653	2.228041266	0	0	1.828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7294
H1036_100_0	2008	5	s.	t.	u.								Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered																			D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0								0		1398.57	6.01	775.04	50.11	190.36	2.14	2920.73	246.2	255.63	2039.03	2291.92		15.04	1656.49	5755.43	3865.86	6.92	1314.08			12.93			1.4	1.05		0.08			0.02	0.06	0.08	2.99	0.3								$100/Day(Days 1-7)	$100/Day(Days 1-7)	$0/Day(Days 1-20) $75(Days 21-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			20% Coins			DEN 723	VIS		HER 722			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements								74.946896	74.945971	17.366472	0	99.999995	0	0	49.999997	0	0	0		0	0	0	0	0	0			0.199999			0	0		0			0	0	0	0	0								8.7349	0.03753544	1.121642538	0	1.586333254	0	0	1.025833272	0	0	0	0	0	0	0	0	0	0	0	0	2.58598707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0922	0	0	8.7349	0.03753544	1.121642538	0	1.586333254	0	0	1.025833272	0	0	0	0	0	0	0	0	0	0	0	0	2.58598707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0922																																																																																				0	0	0	8.7349	0.03753544	1.121642538	0	1.586333254	0	0	1.025833272	0	0	0	0	0	0	0	0	0	0	0	0	2.58598707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0922
H1036_102_0	2008	6	s.	t.	u.	v.	w.	x.					Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered																D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O	O	O	O					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0	0					0		2387.63	23.38	742.05	440.47	200.01	200.74	3391.22	225.18	197.51	1439.95	2126.31		16.14	1532.35	5793.44	3877.05	10.32	1114.12			13831.39			2.85	2.32		1.14			2.83	1	0.02	0.06	0.08	0.3	2.1	53.33					$0/Day(Days 1-10)	$0/Day(Days 1-10)	$0/Day(Days 1-100) $0(Days 100-100)	$0/Visit	$0/Trip			$25/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			$0/Script			DEN 770	VIS ADI		HER 759			Silver Sneakers	16 1 Way	QuitNet	Meals on Wheels	Active Outlook	Nutritional Supplements	$25 OTC Mail Order	8 Meals per Month					0	0	0	0	0	0	0	25.000006	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0	0					0	0	0	0	0	0	0	0.469125113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4691	0	0	0	0	0	0	0	0	0	0.469125113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4691																																																																																				0	0	0	0	0	0	0	0	0	0	0.469125113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4691
H1036_103_0	2008	6	s.	t.	u.	v.	w.	x.	y.				Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered															D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O	O	O	O	O				0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0	0	0				0		1558.39	8.25	898.74	27.77	345.97	2.79	2283.37	298.54	224.54	1880.02	2298.89		37.58	1956.69	6998.11	4716.54	8.78	1385.15			11835.74			3.3	2.2		0.33			0.02	1	0.08	2.26	0.06	1.72	2.55	18.75	33.33				$0/Day(Days 1-10)	$0/Day(Days 1-10)	$0/Day(Days 1-100) $0(Days 100-100)	$0/Visit	$0/Trip	0% Coins		$25/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			$0/Script			DEN 731	VIS 140		HER 751			QuitNet	16 1 way	Active Outlook	Silver Sneakers	Meals on Wheels	Nutritional Supplements	10 Visits per Year	$25 per Month OTC	5 Meals per Month				0	0	0	0	0	0	0	24.999986	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0	0	0				0	0	0	0	0	0	0	0.621957985	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.622	0	0	0	0	0	0	0	0	0	0.621957985	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.622																																																																																				0	0	0	0	0	0	0	0	0	0	0.621957985	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.622
H1036_104_0	2008	5	s.	t.	u.	v.	w.	x.					Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered																D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O	O	O	O					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0	0					0		1424.55	4.36	1214.51	18.61	300.26	3.06	2731.59	259.18	194.66	2142.1	2957.73		29.37	1944.27	7303.91	4894.27	7.49	2249.72			5425.33			3.3	2.2		1.14			1.01	0.02	2.26	0.06	0.08	0.3	18.75	40					$0/Day(Days 1-100)	$0/Day(Days 1-100)	$0/Day(Days 1-100) $0(Days 100-100)	$0/Visit	$0/Trip	0% Coins		$25/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			$0/Script			DEN 731	VIS 140		HER 759			16 1 way	QuitNet	Silver Sneakers	Meals on Wheels	Active Outlook	Nutritional Supplements	$25 per Month OTC	6 Meals per Month					0	0	0	0	0	0	0	25.000012	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0	0					0	0	0	0	0	0	0	0.539958593	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.54	0	0	0	0	0	0	0	0	0	0.539958593	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.54																																																																																				0	0	0	0	0	0	0	0	0	0	0.539958593	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.54
H1036_105_0	2008	6	s.	t.	u.	v.	w.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O	O						0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0						0		1619.45	9.43	853.87	24.54	194.83	184.61	377.61	355.29	208.67	3345.87	3748.97		19.03	2339.83	6475.68	4345.45	14.62	271.62			5.01			1.4	1.05		0.33			0.02	2.7	0.08	4.65	0.06	0.3	1						$125/Day(Days 1-7)	$125/Day(Days 1-7)	$0/Day(Days 1-6) $75(Days 7-100)	$0/Visit	$100/Trip			$50/Visit	$150/Visit	$0/Visit	$0-$25/Visit		$0/Proc	$0-$30/Visit	$10/Visit	$30/Visit	$0-$30/Visit	$100/Visit			20% Coins			DEN 727	VIS		HER 751			QuitNet	16  1 way	Active Outlook	Silver Sneakers	Meals on Wheels	Nutritional Supplements	$25/Month Mail Order						93.683624	93.683348	54.699448	0	100.00001	0	0	49.999987	149.999993	0	4.075349		0	10.234079	9.999999	30	0.316045	100.000001			0.2			0	0		0			0	0	0	0	0	0	0						12.643	0.073619498	3.892184805	0	1.623583496	0	0	1.480374615	2.608374878	0	1.273196762	0	0	1.995500422	5.39639946	10.863625	0.000385048	2.263500023	0	0	1.002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.1157	0	0	12.643	0.073619498	3.892184805	0	1.623583496	0	0	1.480374615	2.608374878	0	1.273196762	0	0	1.995500422	5.39639946	10.863625	0.000385048	2.263500023	0	0	1.002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.1157																																																																																				0	0	0	12.643	0.073619498	3.892184805	0	1.623583496	0	0	1.480374615	2.608374878	0	1.273196762	0	0	1.995500422	5.39639946	10.863625	0.000385048	2.263500023	0	0	1.002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.1157
H1036_106_0	2008	4	s.	t.	u.	v.	w.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O	O						0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0						0		1685.55	9.82	888.72	25.54	202.78	192.14	393.02	369.79	217.18	3482.43	3901.97		19.81	2435.32	6739.96	4522.8	15.21	282.71			5.42			1.4	1.05		0.08			0.02	0.99	0.08	4.65	0.06	0.3	0.4						$225/Day(Days 1-7)	$225/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip			$50/Visit	$150/Visit	$0/Visit	$0-$25/Visit		$0/Proc	$0-$30/Visit	$10/Visit	$30/Visit	$0-$30/Visit	$100/Visit			20% Coins			DEN 727	VIS		HER 722			QuitNet	Unlimited Podiatry	Active Outlook	Silver Sneakers	Meals on Wheels	Nutritional Supplements	$10 OTC Mail Order						168.630528	168.630226	28.712567	0	99.999995	0	0	50.000008	149.999987	0	4.075347		0	10.234077	9.999999	30	0.316271	100.000019			0.2			0	0		0			0	0	0	0	0	0	0						23.6863	0.137995735	2.126452712	0	1.689833249	0	0	1.540791913	2.714749765	0	1.325156811	0	0	2.0769377	5.616632772	11.307	0.000400873	2.355917114	0	0	1.084	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6621	0	0	23.6863	0.137995735	2.126452712	0	1.689833249	0	0	1.540791913	2.714749765	0	1.325156811	0	0	2.0769377	5.616632772	11.307	0.000400873	2.355917114	0	0	1.084	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6621																																																																																				0	0	0	23.6863	0.137995735	2.126452712	0	1.689833249	0	0	1.540791913	2.714749765	0	1.325156811	0	0	2.0769377	5.616632772	11.307	0.000400873	2.355917114	0	0	1.084	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6621
H1036_108_0	2008	5	s.	t.	u.	v.	w.						DME/Prosthetics/Supplies	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered							Prosthetics/Supplies										D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O	O						0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0						0		1704.58	174.82	809.96	737.51	294.26	1.86	0.57	417.78	88.7	935.67	1331.35		19.54	1999.71	7258.22	5003.59	20.41	628.96			12.65			1.4	1.05		0.08			0.02	0.06	1563.85	0.08	3.33	0.3	0.99						$250/Day(Days 1-10)	$250/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$150/Trip	20% Coins	20% Coins	$50/Visit	$100-$200/Visit	$0/Visit	$25-$150/Visit		$0-$50/Proc	$35-$150/Visit	$5/Visit	$35/Visit	$35-$50/Visit	$50/Visit			20% Coins			DEN 723	Vision Unspecified		HER 722			QuitNet	Meals on Wheels		Active Outlook	Silver Sneakers	Nutritional Supplements	Unlimited Podiatry						208.935	187.367273	28.712577	0	149.999999	0.2	0.2	49.999989	177.014075	0	69.609404		48.219922	50.642862	4.999999	34.999997	45.945432	50.000005			0.2			0	0		0			0	0	0	0	0	0	0						29.6789	2.729628889	1.938003239	0	3.678249975	0.372	0.114	1.740749617	1.308429038	0	7.722873335	0	0.078518106	8.439253131	3.024257728	14.59380292	0.078145522	2.620666929	0	0	2.53	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6474	0	0	29.6789	2.729628889	1.938003239	0	3.678249975	0.372	0.114	1.740749617	1.308429038	0	7.722873335	0	0.078518106	8.439253131	3.024257728	14.59380292	0.078145522	2.620666929	0	0	2.53	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6474																																																																																				0	0	0	29.6789	2.729628889	1.938003239	0	3.678249975	0.372	0.114	1.740749617	1.308429038	0	7.722873335	0	0.078518106	8.439253131	3.024257728	14.59380292	0.078145522	2.620666929	0	0	2.53	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6474
H1036_109_0	2008	6	s.	t.	u.	v.	w.	x.					DME/Prosthetics/Supplies	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered						Prosthetics/Supplies										D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O	O	O					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0	0					0		1667.1	170.97	792.15	721.29	287.79	1.78	0.54	408.6	86.75	915.09	1302.08		19.11	1955.74	7098.62	4893.57	19.96	615.13			12.1			1.4	1.05		0.08			0.02	0.06	1529.46	0.08	3.33	0.3	33.33	1.01					$125/Day(Days 1-7)	$125/Day(Days 1-7)	$0/Day(Days 1-20) $100(Days 21-100)	$0/Visit	$125/Trip	20% Coins	20% Coins	$50/Visit	$100/Visit	$0/Visit	$0-$50/Visit		$0/Proc	$0-$50/Visit	$0/Visit	$30/Visit	$0-$30/Visit	$0/Visit			20% Coins			DEN 723	Vision Unspecified		HER 722			QuitNet	Meals on Wheels		Active Outlook	Silver Sneakers	Nutritional Supplements	5 Meals Provided	16 1 Way					93.683626	93.683605	23.155297	0	125.000012	0.199999	0.2	50.000006	99.999956	0	15.384616		0	0.459717	0	30	8.108681	0			0.2			0	0		0			0	0	0	0	0	0	0	0					13.015	1.334757162	1.528539043	0	2.997812788	0.35599822	0.108	1.702500204	0.722916349	0	1.6693334	0	0	0.07492391	0	12.233925	0.013487439	0	0	0	2.42	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1772	0	0	13.015	1.334757162	1.528539043	0	2.997812788	0.35599822	0.108	1.702500204	0.722916349	0	1.6693334	0	0	0.07492391	0	12.233925	0.013487439	0	0	0	2.42	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1772																																																																																				0	0	0	13.015	1.334757162	1.528539043	0	2.997812788	0.35599822	0.108	1.702500204	0.722916349	0	1.6693334	0	0	0.07492391	0	12.233925	0.013487439	0	0	0	2.42	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1772
H1036_110_0	2008	4	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1699.71	174.32	807.64	735.4	293.42	209.91	1578.96	416.59	88.44	932.99	1327.54		19.48	1993.99	7237.46	4989.28	20.35	627.16			12.58			1.4	1.05		0.08			0.02	0.06	0.08	3.33	0.3	0.99							$180/Day(Days 1-5)	$180/Day(Days 1-5)	$0/Day(Days 1-4) $75(Days 5-100)	$0/Visit	$100/Trip			$50/Visit	$100/Visit	$0/Visit	$0-$100/Visit		$0-$100/Proc	$0-$100/Visit	$0/Visit	$25/Visit	$25-$100/Visit	$100/Visit			20% Coins			DEN 723	VIS		HER 722			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplement	Unlimited Podiatry							117.00684	117.006852	64.083444	0	100.00001	0	0	50.000006	99.999993	0	37.763609		96.439287	64.843362	0	24.999998	79.728248	99.999995			0.2			0	0		0			0	0	0	0	0	0							16.5731	1.699719537	4.313029393	0	2.445166911	0	0	1.735791875	0.736999948	0	4.177725124	0	0.156553109	10.77475128	0	10.3943325	0.135205821	5.226333072	0	0	2.516	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.8847	0	0	16.5731	1.699719537	4.313029393	0	2.445166911	0	0	1.735791875	0.736999948	0	4.177725124	0	0.156553109	10.77475128	0	10.3943325	0.135205821	5.226333072	0	0	2.516	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.8847																																																																																				0	0	0	16.5731	1.699719537	4.313029393	0	2.445166911	0	0	1.735791875	0.736999948	0	4.177725124	0	0.156553109	10.77475128	0	10.3943325	0.135205821	5.226333072	0	0	2.516	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.8847
H1036_111_0	2008	5	s.	t.	u.	v.	w.						DME/Prosthetics/Supplies	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered							Prosthetics/Supplies										D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin		T	Coin	V		V			O	O	O	O	O	O	O						0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0		0	0	0		0			0	0	0	0	0	0	0						0		1751.63	179.64	832.32	757.87	302.39	1.97	0.6	429.31	91.15	961.49	1368.1		20.08	2054.91	7458.56	5141.7	20.97	646.32			13.36		1.01	1.4	1.05		0.08			0.02	0.06	1607.02	0.08	3.33	0.3	0.99						$190/Day(Days 1-10)	$190/Day(Days 1-7)	$0/Day(Days 1-20) $100(Days 21-100)	$0/Visit	$125/Trip	20% Coins	20% Coins	$50/Visit	$100/Visit	$0/Visit	$0-$50/Visit		$0/Proc	$0-$50/Visit	$0/Visit	$30/Visit	$0-$30/Visit	$0/Visit			20% Coins		16 1 Way	DEN 723	VIS		HER 722			QuitNet	Meals on Wheels		Active Outlook	Silver Sneakers	Nutritional Supplements	Unlimited Podiatry						158.7906	142.399113	23.155295	0	125.000017	0.199999	0.2	50	99.999996	0	15.384616		0	0.45971	0	30	8.10873	0			0.2		0	0	0		0			0	0	0	0	0	0	0						23.1785	2.131714722	1.606051261	0	3.149896262	0.39399803	0.12	1.788791667	0.759583303	0	1.753974429	0	0	0.07872189	0	12.85425	0.014170006	0	0	0	2.672	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5017	0	0	23.1785	2.131714722	1.606051261	0	3.149896262	0.39399803	0.12	1.788791667	0.759583303	0	1.753974429	0	0	0.07872189	0	12.85425	0.014170006	0	0	0	2.672	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5017																																																																																				0	0	0	23.1785	2.131714722	1.606051261	0	3.149896262	0.39399803	0.12	1.788791667	0.759583303	0	1.753974429	0	0	0.07872189	0	12.85425	0.014170006	0	0	0	2.672	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5017
H1036_114_0	2008	4	s.	t.	u.	v.	w.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O	O						0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0						0		1696.29	7.29	940.03	60.78	230.89	3.14	3542.5	298.61	310.05	2473.1	2779.83		18.25	2009.12	6980.65	4688.82	8.4	1593.82			19.03			1.75	0.91		0.33			0.02	0.06	0.08	2.99	0.3	0.4	1.16						$100/Day(Days 1-7)	$100/Day(Days 1-7)	$0/Day(Days 1-6) $75(Days 7-100)	$0/Visit	$150/Trip	0% Coins		$50/Visit	$150/Visit	$0/Visit	$0-$150/Visit		$0-$100/Proc	$25-$150/Visit	$0/Visit	$25/Visit	$25-$100/Visit	$100/Visit			20% Coins			DEN 727	VIS 110 Allowance		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	OTC $10 Mail Order	16  1 way						74.946902	74.947351	54.699453	0	149.999993	0	0	49.99999	150.000005	0	105.342352		88.383794	100.333968	0	24.999996	96.048428	100.000002			0.2			0	0		0			0	0	0	0	0	0	0						10.5943	0.045530516	4.284927234	0	2.886124865	0	0	1.244208084	3.875625129	0	24.4028192	0	0.13441702	16.79858182	0	9.768373437	0.0672339	13.2818336	0	0	3.806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.19	0	0	10.5943	0.045530516	4.284927234	0	2.886124865	0	0	1.244208084	3.875625129	0	24.4028192	0	0.13441702	16.79858182	0	9.768373437	0.0672339	13.2818336	0	0	3.806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.19																																																																																				0	0	0	10.5943	0.045530516	4.284927234	0	2.886124865	0	0	1.244208084	3.875625129	0	24.4028192	0	0.13441702	16.79858182	0	9.768373437	0.0672339	13.2818336	0	0	3.806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.19
H1036_115_0	2008	6	s.	t.	u.	v.	w.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O	O						0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0						0		1797.87	7.73	996.32	64.42	244.71	3.53	3754.64	316.49	328.62	2621.19	2946.29		19.34	2129.43	7398.67	4969.6	8.9	1689.26			21.37			1.75	0.91		0.33			0.02	0.06	0.08	2.99	0.3	0.4	0.99						$175/Day(Days 1-7)	$175/Day(Days 1-7)	$0/Day(Days 1-6) $75(Days 7-100)	$0/Visit	$150/Trip	0% Coins		$50/Visit	$150/Visit	$0/Visit	$0-$150/Visit		$0-$100/Proc	$25-$150/Visit	$0/Visit	$0-$25/Visit	$25-$100/Visit	$100/Visit			20% Coins			DEN 727	VIS 110 Allowance		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	OTC $10 Mail Order	Unlimited Podiatry						131.157073	131.157101	54.699454	0	149.999996	0	0	50.000004	149.999987	0	105.342359		88.383484	100.33396	0	24.865394	96.047363	99.999998			0.2			0	0		0			0	0	0	0	0	0	0						19.6503	0.084487033	4.541513334	0	3.058874918	0	0	1.318708439	4.107749644	0	25.86409491	0	0.142444715	17.80451204	0	10.2975885	0.071235128	14.07716639	0	0	4.274	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.2927	0	0	19.6503	0.084487033	4.541513334	0	3.058874918	0	0	1.318708439	4.107749644	0	25.86409491	0	0.142444715	17.80451204	0	10.2975885	0.071235128	14.07716639	0	0	4.274	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.2927																																																																																				0	0	0	19.6503	0.084487033	4.541513334	0	3.058874918	0	0	1.318708439	4.107749644	0	25.86409491	0	0.142444715	17.80451204	0	10.2975885	0.071235128	14.07716639	0	0	4.274	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.2927
H1036_116_0	2008	5	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1533.44	6.59	849.78	54.94	208.72	2.57	3202.4	269.94	280.29	2235.66	2512.95		16.49	1816.23	6310.47	4238.67	7.59	1440.8			15.55			1.75	0.91		0.33			0.02	0.06	0.08	4.51	0.3	0.4							$175/Day(Days 1-7)	$175/Day(Days 1-7)	$0/Day(Days 1-6) $75(Days 7-100)	$0/Visit	$150/Trip	0% Coins		$50/Visit	$150/Visit	$0/Visit	$0-$150/Visit		$0-$100/Proc	$25-$150/Visit	$0/Visit	$25/Visit	$25-$100/Visit	$100/Visit			20% Coins			DEN 727	VIS 110 Allowance		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	OTC $10 Mail Order							131.157075	131.157128	54.699452	0	149.999997	0	0	49.999993	149.999988	0	105.342355		88.38372	100.333962	0	24.999998	96.047854	99.999999			0.199999			0	0		0			0	0	0	0	0	0							16.7601	0.072027123	3.873541693	0	2.608999948	0	0	1.124749843	3.50362472	0	22.06000592	0	0.121453962	15.18579598	0	8.830561794	0.060750268	12.00666655	0	0	3.10998445	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.3183	0	0	16.7601	0.072027123	3.873541693	0	2.608999948	0	0	1.124749843	3.50362472	0	22.06000592	0	0.121453962	15.18579598	0	8.830561794	0.060750268	12.00666655	0	0	3.10998445	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.3183																																																																																				0	0	0	16.7601	0.072027123	3.873541693	0	2.608999948	0	0	1.124749843	3.50362472	0	22.06000592	0	0.121453962	15.18579598	0	8.830561794	0.060750268	12.00666655	0	0	3.10998445	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.3183
H1036_117_0	2008	5	s.	t.	u.	v.	w.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered						3100											D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O	O						0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0						0		1406.33	13.77	874.15	518.88	235.61	2.77	3994.9	265.27	232.67	1696.28	2504.82		19.01	1805.13	6824.76	4567.22	12.15	1312.45			27.86			1.75	2.2		0.33			0.02	0.06	0.08	2.83	0.3	0.4	0.99						$150/Day(Days 1-7)	$150/Day(Days 1-7)	$0/Day(Days 1-9) $50(Days 10-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$50-$100/Visit	$0/Visit	$0-$100/Visit		$0-$100/Proc	$20-$100/Visit	$0/Visit	$20/Visit	$20-$100/Visit	$100/Visit			20% Coins			DEN 727	VIS 140		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	$10 OTC Mail Order	Unlimited Podiatry						80.477909	80.478063	20.137528	0	71.586596	0	0	35.79329	50.326694	0	59.462246		43.913842	59.582444	0	14.317321	71.291105	71.586598			0.143173			0	0		0			0	0	0	0	0	0	0						9.4315	0.092348577	1.466935008	0	1.405543157	0	0	0.791240503	0.975792658	0	12.41185192	0	0.069566845	8.962838095	0	5.449196235	0.072182244	7.829485879	0	0	3.98879978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9473	0	21.01513198	9.4315	0.092348577	1.466935008	0	1.405543157	0	0	0.791240503	0.975792658	0	12.41185192	0	0.069566845	8.962838095	0	5.449196235	0.072182244	7.829485879	0	0	3.98879978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9473	3100																																																																																			0	0	0	9.4315	0.092348577	1.466935008	0	1.405543157	0	0	0.791240503	0.975792658	0	12.41185192	0	0.069566845	8.962838095	0	5.449196235	0.072182244	7.829485879	0	0	3.98879978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9473
H1036_118_0	2008	5	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered							3100											D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1218.74	11.94	757.54	449.67	204.18	2.08	3462.01	229.88	201.63	1470.01	2170.7		16.47	1564.34	5914.38	3957.99	10.53	1137.38			20.92			1.75	2.2		0.33			0.02	0.06	0.08	4.35	0.3	0.4							$150/Day(Days 1-7)	$150/Day(Days 1-7)	$0/Day(Days 1-9) $50(Days 10-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$50-$100/Visit	$0/Visit	$0-$100/Visit		$0-$100/Proc	$20-$100/Visit	$0/Visit	$20/Visit	$20-$100/Visit	$100/Visit			20% Coins			DEN 727	VIS 140		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	$10 OTC Mail Order							84.340896	84.340963	21.104143	0	75.022788	0	0	37.511412	52.742426	0	62.316468		46.021367	62.442439	0	15.004558	74.713236	75.0228			0.150045			0	0		0			0	0	0	0	0	0							8.5658	0.083919258	1.332269374	0	1.276512738	0	0	0.718593616	0.886204613	0	11.27252976	0	0.063164326	8.140100419	0	4.948990877	0.065560865	7.110786022	0	0	3.1389414	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.6034	0	15.84853394	8.5658	0.083919258	1.332269374	0	1.276512738	0	0	0.718593616	0.886204613	0	11.27252976	0	0.063164326	8.140100419	0	4.948990877	0.065560865	7.110786022	0	0	3.1389414	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.6034	3100																																																																																			0	0	0	8.5658	0.083919258	1.332269374	0	1.276512738	0	0	0.718593616	0.886204613	0	11.27252976	0	0.063164326	8.140100419	0	4.948990877	0.065560865	7.110786022	0	0	3.1389414	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.6034
H1036_119_0	2008	2	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin									O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0	0	0	0	0	0							0		1229.5	12.04	764.23	453.63	205.98	2.12	3492.57	231.91	203.41	1482.98	2189.86		16.62	1578.15	5966.58	3992.92	10.63	1147.42			21.29									0.02	0.06	0.08	2.83	0.3	0.4							$275/Day(Days 1-10)	$275/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$25/Visit	$150/Trip	0% Coins		$50/Visit	$100-$150/Visit	$0/Visit	$0-$150/Visit		$0-$100/Proc	$35-$150/Visit	$10/Visit	$35/Visit	$35-$100/Visit	$150/Visit			20% Coins									QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	$10 OTC Mail Order							229.828502	206.104335	28.712566	24.999988	150.000011	0	0	50.000019	120.301806	0	124.595062		61.343709	149.97675	10	34.999998	99.664779	149.999997			0.199999									0	0	0	0	0	0							23.5478	0.206791349	1.828583693	0.945062046	2.574750189	0	0	0.966292034	2.039215863	0	22.73714521	0	0.084961037	19.72381733	4.97215	11.646016	0.088286383	14.34274971	0	0	4.25797871	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9616	0	0	23.5478	0.206791349	1.828583693	0.945062046	2.574750189	0	0	0.966292034	2.039215863	0	22.73714521	0	0.084961037	19.72381733	4.97215	11.646016	0.088286383	14.34274971	0	0	4.25797871	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9616																																																																																				0	0	0	23.5478	0.206791349	1.828583693	0.945062046	2.574750189	0	0	0.966292034	2.039215863	0	22.73714521	0	0.084961037	19.72381733	4.97215	11.646016	0.088286383	14.34274971	0	0	4.25797871	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9616
H1036_120_0	2008	6	s.	t.	u.								Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered																			D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin									O	O	O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0	0	0	0	0								0		1268.71	12.43	788.6	468.1	212.55	2.25	3603.95	239.31	209.9	1530.28	2259.69		17.15	1628.48	6156.87	4120.26	10.96	1184.01			22.67									0.02	0.06	0.08	2.83	0.3								$275/Day(Days 1-7)	$275/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$25/Visit	$150/Trip	0% Coins		$50/Visit	$125-$150/Visit	$0/Visit	$0-$150/Visit		$0-$150/Proc	$35-$150/Visit	$10/Visit	$35/Visit	$35/Visit	$150/Visit			20% Coins									QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements								206.103977	206.104426	28.712565	24.999994	149.99999	0	0	49.999983	135.150876	0	124.595064		92.01521	149.976757	9.999999	34.999998	35.000365	150.000004			0.2									0	0	0	0	0								21.7905	0.213489835	1.886894063	0.975208099	2.656874823	0	0	0.997124661	2.364014073	0	23.46218501	0	0.131505071	20.35284577	5.130724487	12.01742431	0.031967	14.80012539	0	0	4.534	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.3449	0	0	21.7905	0.213489835	1.886894063	0.975208099	2.656874823	0	0	0.997124661	2.364014073	0	23.46218501	0	0.131505071	20.35284577	5.130724487	12.01742431	0.031967	14.80012539	0	0	4.534	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.3449																																																																																				0	0	0	21.7905	0.213489835	1.886894063	0.975208099	2.656874823	0	0	0.997124661	2.364014073	0	23.46218501	0	0.131505071	20.35284577	5.130724487	12.01742431	0.031967	14.80012539	0	0	4.534	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.3449
H1036_121_0	2008	4	s.	t.	u.	v.	w.	x.					Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered																D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O	O	O					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0	0					0		1867.21	9.89	1076.84	33.27	414.53	4.01	2735.86	357.7	269.03	2252.58	2754.45		45.03	2344.43	8384.9	5651.19	10.52	1659.64			34.36			1.75	2.2		0.33			0.02	0.06	0.08	2.26	0.99	1	1.72	2.55					$50/Day(Days 1-7)	$50/Day(Days 1-7)	$0/Day(Days 1-6) $25(Days 7-100)	$0/Visit	$75/Trip	0% Coins		$50/Visit	$25-$75/Visit	$0/Visit	$0-$25/Visit		$0-$15/Proc	$5-$25/Visit	$0/Visit	$0-$5/Visit	$5-$15/Visit	$15/Visit			0% Coins			DEN 727	VIS 140		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Unlimited Podiatry	$25 per Month	Nutritional Supplements	10 Visits per Year					37.473448	37.473661	18.233154	0	74.99999	0	0	50.000011	47.989488	0	9.549643		7.993765	15.056587	0	4.949048	14.657147	14.999996			0			0	0		0			0	0	0	0	0	0	0	0					5.8309	0.030884542	1.636182463	0	2.590812155	0	0	1.490416995	1.07588433	0	2.19200118	0	0.029996603	2.941592855	0	2.330667547	0.012849432	2.074549447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2367	0	0	5.8309	0.030884542	1.636182463	0	2.590812155	0	0	1.490416995	1.07588433	0	2.19200118	0	0.029996603	2.941592855	0	2.330667547	0.012849432	2.074549447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2367																																																																																				0	0	0	5.8309	0.030884542	1.636182463	0	2.590812155	0	0	1.490416995	1.07588433	0	2.19200118	0	0.029996603	2.941592855	0	2.330667547	0.012849432	2.074549447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2367
H1036_122_0	2008	5	s.	t.	u.	v.	w.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O	O						0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0						0		1599.79	8.47	922.62	28.51	355.16	2.94	2344.03	306.47	230.5	1929.97	2359.96		38.58	2008.67	7184.02	4841.84	9.01	1421.95			25.22			1.75	2.2		0.33			0.02	0.06	0.08	3.78	1	1.72	2.55						$50/Day(Days 1-7)	$50/Day(Days 1-7)	$0/Day(Days 1-6) $25(Days 7-100)	$0/Visit	$75/Trip	0% Coins		$50/Visit	$25-$75/Visit	$0/Visit	$0-$25/Visit		$0-$15/Proc	$5-$25/Visit	$0/Visit	$5/Visit	$5-$15/Visit	$15/Visit			0% Coins			DEN 727	VIS 140		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	$25 per Month	Nutritional Supplements	10 Visits per Year						37.473448	37.472906	18.233153	0	75.000005	0	0	50.00001	47.98943	0	9.549645		7.993766	15.056603	0	4.999996	14.656491	14.999997			0			0	0		0			0	0	0	0	0	0	0						4.9958	0.026449626	1.401855968	0	2.219750148	0	0	1.276958589	0.921796968	0	1.878065018	0	0.025699958	2.520312229	0	2.017431719	0.011004582	1.777437145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.0726	0	0	4.9958	0.026449626	1.401855968	0	2.219750148	0	0	1.276958589	0.921796968	0	1.878065018	0	0.025699958	2.520312229	0	2.017431719	0.011004582	1.777437145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.0726																																																																																				0	0	0	4.9958	0.026449626	1.401855968	0	2.219750148	0	0	1.276958589	0.921796968	0	1.878065018	0	0.025699958	2.520312229	0	2.017431719	0.011004582	1.777437145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.0726
H1036_123_0	2008	3	s.	t.	u.								Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered																			D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0								0		1545.64	8.19	891.39	27.54	343.14	2.75	2264.68	296.09	222.7	1864.63	2280.07		37.27	1940.67	6940.82	4677.93	8.7	1373.81			11738.86			1.75	2.2		0.33			0.02	0.06	0.08	2.26	0.3								$200/Day(Days 1-10)	$200/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$50-$100/Visit	$0-$100/Visit	$25-$100/Visit		$25-$75/Proc	$0-$100/Visit	$0/Visit	$20/Visit	$20/Visit	$50/Visit			$0/Script			DEN 727	VIS 140		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements								167.148001	149.893656	28.712569	0	99.999994	0	0	49.999995	72.989486	15.372707	66.105391		51.645917	64.243524	0	19.999999	20.000615	50			0			0	0		0			0	0	0	0	0								21.5292	0.10230242	2.132841407	0	2.859499828	0	0	1.23370821	1.354563211	2.388700888	12.5604099	0	0.160403611	10.38962331	0	7.79654961	0.014500446	5.724208333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2465	0	0	21.5292	0.10230242	2.132841407	0	2.859499828	0	0	1.23370821	1.354563211	2.388700888	12.5604099	0	0.160403611	10.38962331	0	7.79654961	0.014500446	5.724208333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2465																																																																																				0	0	0	21.5292	0.10230242	2.132841407	0	2.859499828	0	0	1.23370821	1.354563211	2.388700888	12.5604099	0	0.160403611	10.38962331	0	7.79654961	0.014500446	5.724208333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2465
H1036_124_0	2008	4																																D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O											0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0											0		1622.41	8.59	935.66	28.91	360.18	3.03	2377.16	310.8	233.76	1957.25	2393.32		39.13	2037.06	7285.57	4910.28	9.14	1442.05			12321.92			1.37	0.97		0.08			2.62	0.3											$175/Day(Days 1-7)	$175/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$150/Visit	$100-$150/Visit	$150/Visit		$0-$150/Proc	$0-$150/Visit	$0/Visit	$30/Visit	$30/Visit	$150/Visit			$0/Script			DEN 723	VIS 116		HER 722			Silver Sneakers	Nutrition											131.157075	131.156653	28.712567	0	100.000004	0	0	50.00001	150.000008	107.686348	149.999996		79.937374	81.208691	0	29.999999	29.99973	149.999996			0			0	0		0			0	0											17.7325	0.093886304	2.238766703	0	3.00150012	0	0	1.295000259	2.922000156	17.56409205	29.9164992	0	0.260662454	13.78558134	0	12.27569959	0.022849794	18.02562452	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.1347	0	0	17.7325	0.093886304	2.238766703	0	3.00150012	0	0	1.295000259	2.922000156	17.56409205	29.9164992	0	0.260662454	13.78558134	0	12.27569959	0.022849794	18.02562452	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.1347																																																																																				0	0	0	17.7325	0.093886304	2.238766703	0	3.00150012	0	0	1.295000259	2.922000156	17.56409205	29.9164992	0	0.260662454	13.78558134	0	12.27569959	0.022849794	18.02562452	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.1347
H1036_125_0	2008	4	s.	t.	u.	v.	w.	x.					Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered																D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O	O	O					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0	0					0		2042.39	7.71	932.85	112.3	382.75	3.66	2174.6	248.68	237.23	2155.89	3264.35		32.93	2954.15	8996.96	6048.93	12.87	1967.7			12.79			1.75	2.2		0.33			0.02	0.06	0.08	2.26	1.72	0.99	1	2.55					$50/Day(Days 1-7)	$50/Day(Days 1-7)	$0/Day(Days 1-6) $25(Days 7-100)	$0/Visit	$50/Trip	0% Coins		$50/Visit	$0-$15/Visit	$0-$15/Visit	$0-$15/Visit		$0-$15/Proc	$0-$25/Visit	$0/Visit	$0/Visit	$0-$15/Visit	$15/Visit			0% Coins			DEN 727	VIS 140		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	Unlimited Podiatry	$25 OTC per Month	10 Visits per Year					37.47345	37.473107	18.233147	0	49.999995	0	0	49.99999	7.728836	2.854269	9.672303		10.433002	15.019052	0	0	10.194716	14.999996			0			0	0		0			0	0	0	0	0	0	0	0					6.3779	0.024076471	1.417399265	0	1.594791507	0	0	1.036166459	0.152792647	0.512790833	2.631148525	0	0.028629896	3.697377705	0	0	0.010933833	2.459624344	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.9437	0	0	6.3779	0.024076471	1.417399265	0	1.594791507	0	0	1.036166459	0.152792647	0.512790833	2.631148525	0	0.028629896	3.697377705	0	0	0.010933833	2.459624344	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.9437																																																																																				0	0	0	6.3779	0.024076471	1.417399265	0	1.594791507	0	0	1.036166459	0.152792647	0.512790833	2.631148525	0	0.028629896	3.697377705	0	0	0.010933833	2.459624344	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.9437
H1036_126_0	2008	4	s.	t.	u.	v.	w.						Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O	O						0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0						0		1749.93	6.61	799.27	96.22	327.94	2.69	1863.21	213.07	203.26	1847.18	2796.91		28.21	2531.13	7708.64	5182.75	11.03	1685.94			9.39			1.75	2.2		0.33			3.78	0.02	0.06	0.08	1.72	1	1.53						$50/Day(Days 1-7)	$50/Day(Days 1-7)	$0/Day(Days 1-6) $25(Days 7-100)	$0/Visit	$50/Trip	0% Coins		$50/Visit	$0-$15/Visit	$0-$15/Visit	$0-$15/Visit		$0-$15/Proc	$0-$25/Visit	$0/Visit	$0/Visit	$0-$15/Visit	$15/Visit			0% Coins			DEN 727	VIS 140		HER 751			Silver Sneakers	QuitNet	Meals on Wheels	Active Outlook	Nutritional Supplements	$25 OTC per Month	6 Visits per Year						37.473449	37.473883	18.233146	0	50.000012	0	0	50.000018	7.728866	2.85427	9.672303		10.432864	15.019057	0	0	10.194697	15.000003			0			0	0		0			0	0	0	0	0	0	0						5.4647	0.020641864	1.214433884	0	1.366416995	0	0	0.887791986	0.130914109	0.439362538	2.254380082	0	0.024525924	3.167932145	0	0	0.009370626	2.107425421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.0879	0	0	5.4647	0.020641864	1.214433884	0	1.366416995	0	0	0.887791986	0.130914109	0.439362538	2.254380082	0	0.024525924	3.167932145	0	0	0.009370626	2.107425421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.0879																																																																																				0	0	0	5.4647	0.020641864	1.214433884	0	1.366416995	0	0	0.887791986	0.130914109	0.439362538	2.254380082	0	0.024525924	3.167932145	0	0	0.009370626	2.107425421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.0879
H1036_127_0	2008	3	s.	t.	u.								Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																			D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0								0		1782.22	6.73	814.02	98	333.99	2.79	1897.59	217	207.01	1881.27	2848.53		28.74	2577.84	7850.9	5278.4	11.23	1717.05			5124.12			1.75	0.97		0.33			0.08	0.02	2.26	0.06	0.3								$190/Day(Days 1-10)	$175/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$150/Visit	$100-$150/Visit	$150/Visit		$0-$150/Proc	$0-$150/Visit	$0/Visit	$30/Visit	$30/Visit	$150/Visit			$0/Script			DEN 727	VIS 116		HER 751			Active Outlook	QuitNet	Silver Sneakers	Meals on Wheels	Nutrition								158.790597	131.156542	28.712569	0	100	0	0	49.999973	150.000011	109.514234	149.999999		104.329934	93.778566	0	29.999999	29.999989	150.000002			0			0	0		0			0	0	0	0	0								23.5833	0.073556961	1.947717118	0	2.78325	0	0	0.904166178	2.58762519	17.16882025	35.60662476	0	0.249870192	20.14551155	0	13.19599956	0.02807499	21.46312529	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.7377	0	0	23.5833	0.073556961	1.947717118	0	2.78325	0	0	0.904166178	2.58762519	17.16882025	35.60662476	0	0.249870192	20.14551155	0	13.19599956	0.02807499	21.46312529	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.7377																																																																																				0	0	0	23.5833	0.073556961	1.947717118	0	2.78325	0	0	0.904166178	2.58762519	17.16882025	35.60662476	0	0.249870192	20.14551155	0	13.19599956	0.02807499	21.46312529	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.7377
H1036_128_0	2008	3	s.	t.	u.								Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered																			D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0								0		1698.63	6.42	775.84	93.4	318.33	2.53	1808.59	206.82	197.3	1793.03	2714.92		27.39	2456.93	7482.66	5030.82	10.71	1636.51			4883.77			1.75	2.2		0.33			0.02	0.06	0.08	2.26	0.3								$175/Day(Days 1-10)	$175/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$50-$100/Visit	$0-$100/Visit	$20-$100/Visit		$25-$75/Proc	$20-$100/Visit	$0/Visit	$20/Visit	$20/Visit	$100/Visit			$0/Script			DEN 727	VIS 140		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements								146.254502	131.156279	28.712568	0	99.999986	0	0	50.00002	75.762859	19.028466	39.242582		59.776635	64.583329	0	20	19.999749	100.000003			0			0	0		0			0	0	0	0	0								20.7027	0.070168609	1.85636323	0	2.652749629	0	0	0.861750345	1.245667673	2.843217533	8.87837256	0	0.136440169	13.22305988	0	8.3847	0.017849776	13.63758374	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5106	0	0	20.7027	0.070168609	1.85636323	0	2.652749629	0	0	0.861750345	1.245667673	2.843217533	8.87837256	0	0.136440169	13.22305988	0	8.3847	0.017849776	13.63758374	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5106																																																																																				0	0	0	20.7027	0.070168609	1.85636323	0	2.652749629	0	0	0.861750345	1.245667673	2.843217533	8.87837256	0	0.136440169	13.22305988	0	8.3847	0.017849776	13.63758374	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5106
H1036_129_0	2008	4	s.	t.	u.								Other Non-Covered	Other Non-Covered	Other Non-Covered																			D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			S			Coin	V		V			O	O	O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0								0		1412.89	4.32	1204.57	18.46	297.8	3.01	2709.23	257.06	193.07	2124.57	2933.52		29.13	1928.36	7244.12	4854.21	7.43	2231.31			5380.92			1.75	2.2		0.33			2.26	0.02	0.06	0.08	0.3								$200/Day(Days 1-10)	$200/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$50-$100/Visit	$0-$100/Visit	$25-$100/Visit		$25-$75/Proc	$20-$100/Visit	$0/Visit	$20/Visit	$20/Visit	$50/Visit			$0/Script			DEN 727	VIS 140		HER 751			Silver Sneakers	QuitNet	Meals on Wheels	Active Outlook	Nutritional Supplements								167.148001	149.892884	28.712568	0	100.000001	0	0	49.999987	71.440496	11.643261	67.533544		52.708234	61.882052	0	20	19.999865	50			0			0	0		0			0	0	0	0	0								19.6801	0.053961438	2.882191503	0	2.481666691	0	0	1.071083055	1.149418047	2.061410252	16.50925017	0	0.127949238	9.944239483	0	8.09035	0.01238325	9.297125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3612	0	0	19.6801	0.053961438	2.882191503	0	2.481666691	0	0	1.071083055	1.149418047	2.061410252	16.50925017	0	0.127949238	9.944239483	0	8.09035	0.01238325	9.297125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3612																																																																																				0	0	0	19.6801	0.053961438	2.882191503	0	2.481666691	0	0	1.071083055	1.149418047	2.061410252	16.50925017	0	0.127949238	9.944239483	0	8.09035	0.01238325	9.297125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3612
H1036_130_0	2008	4	s.	t.	u.	v.	w.	x.					Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered																D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O	O	O					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0	0					0		1707.31	5.23	1455.59	22.3	359.86	4.39	3273.8	310.62	233.3	2567.31	3544.84		35.2	2330.21	8753.72	5865.77	8.97	2696.28			19.99			1.75	2.2		0.33			0.02	0.99	0.08	2.26	0.06	1	1.72	2.55					$125/Day(Days 1-7)	$125/Day(Days 1-7)	$0/Day(Days 1-13) $50(Days 14-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$50-$75/Visit	$0/Visit	$0-$25/Visit		$0-$20/Proc	$10-$25/Visit	$0/Visit	$0-$10/Visit	$10-$20/Visit	$20/Visit			0% Coins			DEN 727	VIS 140		HER 751			QuitNet	Unlimited Podiatry	Active Outlook	Silver Sneakers	Meals on Wheels	$25 per Month OTC Mail Order	Nutritional Supplements	10 Visits per Year					93.683625	93.684317	20.705701	0	99.999986	0	0	50.000012	60.720232	0	18.422266		11.083386	19.969467	0	9.961447	19.555363	19.999999			0			0	0		0			0	0	0	0	0	0	0	0					13.3289	0.040830748	2.511584277	0	2.998832913	0	0	1.294250311	1.18050251	0	5.441998784	0	0.032511266	3.877754308	0	4.869296414	0.014617634	4.493799775	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0849	0	0	13.3289	0.040830748	2.511584277	0	2.998832913	0	0	1.294250311	1.18050251	0	5.441998784	0	0.032511266	3.877754308	0	4.869296414	0.014617634	4.493799775	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0849																																																																																				0	0	0	13.3289	0.040830748	2.511584277	0	2.998832913	0	0	1.294250311	1.18050251	0	5.441998784	0	0.032511266	3.877754308	0	4.869296414	0.014617634	4.493799775	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0849
H1036_131_0	2008	4	s.	t.	u.	v.	w.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O	O						0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0	0						0		1462.83	4.48	1247.15	19.11	308.33	3.22	2805.01	266.14	199.89	2199.68	3037.23		30.16	1996.53	7500.22	5025.82	7.69	2310.19			14.68			1.75	2.2		0.33			0.02	0.06	0.08	3.78	1	1.72	2.55						$125/Day(Days 1-7)	$125/Day(Days 1-7)	$0/Day(Days 1-13) $50(Days 14-100)	$0/Visit	$100/Trip	0% Coins		$50/Visit	$50-$75/Visit	$0/Visit	$0-$25/Visit		$0-$20/Proc	$10-$25/Visit	$0/Visit	$10/Visit	$10-$20/Visit	$20/Visit			0% Coins			DEN 727	VIS 140		HER 751			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	$25 per Month OTC Mail Order	Nutritional Supplements	10 Visits per Year						93.683625	93.683474	20.705696	0	99.999985	0	0	50.000019	60.720223	0	18.422263		11.083054	19.969461	0	9.999999	19.555747	20			0			0	0		0			0	0	0	0	0	0	0						11.4203	0.034975164	2.151925731	0	2.569416281	0	0	1.108917088	1.011447115	0	4.662720821	0	0.027855409	3.322468998	0	4.188182915	0.012531975	3.850316667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.361	0	0	11.4203	0.034975164	2.151925731	0	2.569416281	0	0	1.108917088	1.011447115	0	4.662720821	0	0.027855409	3.322468998	0	4.188182915	0.012531975	3.850316667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.361																																																																																				0	0	0	11.4203	0.034975164	2.151925731	0	2.569416281	0	0	1.108917088	1.011447115	0	4.662720821	0	0.027855409	3.322468998	0	4.188182915	0.012531975	3.850316667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.361
H1036_801_0	2008	3																					500											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		212.45	2.14	723.37	429.38	194.97	1.89	1.16	219.51	192.54	1403.7	2072.79		15.73	1493.79	5647.61	3779.46	10.06	1086.08			19.08																					$1000/Admit	$1000/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$100/Visit	$100/Visit		$0-$100/Proc	$35-$100/Visit	$25/Visit	$35/Visit	$35-$100/Visit	$100/Visit			20% Coins																					267.817003	267.817752	7.751726	0	26.781706	0.053563	0.053563	13.390844	53.563396	12.329497	26.781699		16.428789	26.61786	6.695425	9.373595	26.691759	26.781699			0.053563																					4.7415	0.047760832	0.467280503	0	0.435135768	0.10123407	0.06213308	0.244952014	0.859424689	1.442242912	4.626069823	0	0.021535404	3.313457757	3.151095765	2.952260613	0.022376591	2.423922304	0	0	1.02198204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9343	0	70.90193584	4.7415	0.047760832	0.467280503	0	0.435135768	0.10123407	0.06213308	0.244952014	0.859424689	1.442242912	4.626069823	0	0.021535404	3.313457757	3.151095765	2.952260613	0.022376591	2.423922304	0	0	1.02198204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9343	500																																																																																			0	0	0	4.7415	0.047760832	0.467280503	0	0.435135768	0.10123407	0.06213308	0.244952014	0.859424689	1.442242912	4.626069823	0	0.021535404	3.313457757	3.151095765	2.952260613	0.022376591	2.423922304	0	0	1.02198204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9343
H1036_806_0	2008	3																					500											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		212.45	2.14	723.37	429.38	194.97	1.89	1.16	219.51	192.54	1403.7	2072.79		15.73	1493.79	5647.61	3779.46	10.06	1086.08			19.08																					$1000/Admit	$1000/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$100/Visit	$100/Visit		$0-$100/Proc	$35-$100/Visit	$25/Visit	$35/Visit	$35-$100/Visit	$100/Visit			20% Coins																					267.817003	267.817752	7.751726	0	26.781706	0.053563	0.053563	13.390844	53.563396	12.329497	26.781699		16.428789	26.61786	6.695425	9.373595	26.691759	26.781699			0.053563																					4.7415	0.047760832	0.467280503	0	0.435135768	0.10123407	0.06213308	0.244952014	0.859424689	1.442242912	4.626069823	0	0.021535404	3.313457757	3.151095765	2.952260613	0.022376591	2.423922304	0	0	1.02198204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9343	0	70.90193584	4.7415	0.047760832	0.467280503	0	0.435135768	0.10123407	0.06213308	0.244952014	0.859424689	1.442242912	4.626069823	0	0.021535404	3.313457757	3.151095765	2.952260613	0.022376591	2.423922304	0	0	1.02198204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9343	500																																																																																			0	0	0	4.7415	0.047760832	0.467280503	0	0.435135768	0.10123407	0.06213308	0.244952014	0.859424689	1.442242912	4.626069823	0	0.021535404	3.313457757	3.151095765	2.952260613	0.022376591	2.423922304	0	0	1.02198204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9343
H1036_807_0	2008	3																					500											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		212.45	2.14	723.37	429.38	194.97	1.89	1.16	219.51	192.54	1403.7	2072.79		15.73	1493.79	5647.61	3779.46	10.06	1086.08			19.08																					$1000/Admit	$1000/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$100/Visit	$100/Visit		$0-$100/Proc	$35-$100/Visit	$25/Visit	$35/Visit	$35-$100/Visit	$100/Visit			20% Coins																					267.817003	267.817752	7.751726	0	26.781706	0.053563	0.053563	13.390844	53.563396	12.329497	26.781699		16.428789	26.61786	6.695425	9.373595	26.691759	26.781699			0.053563																					4.7415	0.047760832	0.467280503	0	0.435135768	0.10123407	0.06213308	0.244952014	0.859424689	1.442242912	4.626069823	0	0.021535404	3.313457757	3.151095765	2.952260613	0.022376591	2.423922304	0	0	1.02198204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9343	0	70.90193584	4.7415	0.047760832	0.467280503	0	0.435135768	0.10123407	0.06213308	0.244952014	0.859424689	1.442242912	4.626069823	0	0.021535404	3.313457757	3.151095765	2.952260613	0.022376591	2.423922304	0	0	1.02198204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9343	500																																																																																			0	0	0	4.7415	0.047760832	0.467280503	0	0.435135768	0.10123407	0.06213308	0.244952014	0.859424689	1.442242912	4.626069823	0	0.021535404	3.313457757	3.151095765	2.952260613	0.022376591	2.423922304	0	0	1.02198204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9343
H1036_808_0	2008	3																					500											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		212.45	2.14	723.37	429.38	194.97	1.89	1.16	219.51	192.54	1403.7	2072.79		15.73	1493.79	5647.61	3779.46	10.06	1086.08			19.08																					$1000/Admit	$1000/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$100/Visit	$100/Visit		$0-$100/Proc	$35-$100/Visit	$25/Visit	$35/Visit	$35-$100/Visit	$100/Visit			20% Coins																					267.817003	267.817752	7.751726	0	26.781706	0.053563	0.053563	13.390844	53.563396	12.329497	26.781699		16.428789	26.61786	6.695425	9.373595	26.691759	26.781699			0.053563																					4.7415	0.047760832	0.467280503	0	0.435135768	0.10123407	0.06213308	0.244952014	0.859424689	1.442242912	4.626069823	0	0.021535404	3.313457757	3.151095765	2.952260613	0.022376591	2.423922304	0	0	1.02198204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9343	0	70.90193584	4.7415	0.047760832	0.467280503	0	0.435135768	0.10123407	0.06213308	0.244952014	0.859424689	1.442242912	4.626069823	0	0.021535404	3.313457757	3.151095765	2.952260613	0.022376591	2.423922304	0	0	1.02198204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9343	500																																																																																			0	0	0	4.7415	0.047760832	0.467280503	0	0.435135768	0.10123407	0.06213308	0.244952014	0.859424689	1.442242912	4.626069823	0	0.021535404	3.313457757	3.151095765	2.952260613	0.022376591	2.423922304	0	0	1.02198204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9343
H1045_001_0	2008	8																																							V													Coin			V																																																											0									330.4469616													1.63			350																									"$50 copay, waived if admitted"													20% Coinsurance			$12 per visit																									40													0.2			12																		0	0	0	0	0	0	0	1.101489872	0	0	0	0	0	0	0	0	0	0	0	0	0.326	0	0	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.7775			0	0	0	0	0	0	0	1.101489872	0	0	0	0	0	0	0	0	0	0	0	0	0.326	0	0	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.7775																																																																																				0			0	0	0	0	0	0	0	1.101489872	0	0	0	0	0	0	0	0	0	0	0	0	0.326	0	0	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.7775
H1045_005_0	2008	5																																D		D		T			V	V		V										Coin			V																																																											0		2262.052707		451.8482775		158.46093			385.4212933	151.9293351		449.1997081										1.63			350																		$150 copay days (1-5)		$50 for days 7-21		$100 per trip			"$50 copay, waived if admitted"	$100 per encounter		$40 Radiation Therapy										20% Coinsurance			$12 copay																		97.56354687		23.41164792		100			40	100		2.664924236										0.326			12																		18.3912	0	0.881542732	0	1.32050775	0	0	1.284737644	1.266077792	0	0.099756932	0	0	0	0	0	0	0	0	0	0.53138	0	0	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.1252			18.3912	0	0.881542732	0	1.32050775	0	0	1.284737644	1.266077792	0	0.099756932	0	0	0	0	0	0	0	0	0	0.53138	0	0	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.1252																																																																																				0			18.3912	0	0.881542732	0	1.32050775	0	0	1.284737644	1.266077792	0	0.099756932	0	0	0	0	0	0	0	0	0	0.53138	0	0	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.1252
H1045_008_0	2008	7																																																				Coin																																																														0																						1.667906977																																									20% Coinsurance																																									0.333581395																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.556382737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5564			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.556382737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5564																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.556382737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5564
H1045_009_0	2008	6																					2500											D	D						V	V		V					V	V	V			Coin			V																																																											0		2442.489725	151.4666181	404.3395691					330.4469616	180.0212189		354.101525					4336.160983	998.339392	3184.056558			1.63			350																		$150/day Days 1-5	$150/day Days 1-5	$50/dad Days 7-100					"$50 copay, waived if admitted"	125		$50-150					$35 copay	$35 copay	$35 copay			20% Coinsurance			$12 per visit																		95.60565684	63.0085251	28.17906779					39.19728624	122.4915195		42.19456925					34.29762546	34.29762546	34.29762546			0.195986431			11.75918587																		19.4597	0.795307351	0.949492677	0	0	0	0	1.079385345	1.837589388	0	1.245096776	0	0	0	0	12.39333545	2.853389213	9.10046494	0	0	0.319457883	0	0	0.342976255	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3761		1.010940677	19.4597	0.795307351	0.949492677	0	0	0	0	1.079385345	1.837589388	0	1.245096776	0	0	0	0	12.39333545	2.853389213	9.10046494	0	0	0.319457883	0	0	0.342976255	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3761																																																																																				0			19.4597	0.795307351	0.949492677	0	0	0	0	1.079385345	1.837589388	0	1.245096776	0	0	0	0	12.39333545	2.853389213	9.10046494	0	0	0.319457883	0	0	0.342976255	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3761
H1045_010_0	2008	5																																		D		T			V			V										Coin			V																																																											0				189.3251126		159.1556703			264.3575693			354.101525										1.63			350																				$25/day; days 7-21		$50 per trip			"$50 copay, waived if admitted"			$50 for diag; $40 for therapy										20% Coinsurance			$12 per visit																				25		50			50			31.13998378										0.2			12																		0	0	0.394427318	0	0.663148626	0	0	1.101489872	0	0	0.918892979	0	0	0	0	0	0	0	0	0	0.326	0	0	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.754			0	0	0.394427318	0	0.663148626	0	0	1.101489872	0	0	0.918892979	0	0	0	0	0	0	0	0	0	0.326	0	0	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.754																																																																																				0			0	0	0.394427318	0	0.663148626	0	0	1.101489872	0	0	0.918892979	0	0	0	0	0	0	0	0	0	0.326	0	0	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.754
H1045_011_0	2008	5																																				T			V	V		V										Coin			V																																																											0		2007.423354	254.6293534	222.2288682		158.46093			308.3370346	151.9293351		1073.902621										1.63			350																		$150/day; days 1-5	$150/day; days 1-5	$25/day; days 7-21		$50 per trip			"$50 copay, waived if admitted"	$100 Surgery		$50 diag; $40 therapy										20% Coinsurance			$12 copay																		97.56354687	64.29886468	11.70582396		50			50	100		31.13998378										0.326			12																		16.3209	1.364364862	0.216781001	0	0.660253875	0	0	1.284737644	1.266077792	0	2.78677585	0	0	0	0	0	0	0	0	0	0.53138	0	0	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.7813			16.3209	1.364364862	0.216781001	0	0.660253875	0	0	1.284737644	1.266077792	0	2.78677585	0	0	0	0	0	0	0	0	0	0.53138	0	0	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.7813																																																																																				0			16.3209	1.364364862	0.216781001	0	0.660253875	0	0	1.284737644	1.266077792	0	2.78677585	0	0	0	0	0	0	0	0	0	0.53138	0	0	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.7813
H1045_012_0	2008	5																																																				Coin																																																														0																						1.587201783																																									20% coinsurance																																									0.2																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.317440357	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.3174			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.317440357	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.3174																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.317440357	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.3174
H1076_003_0	2008	5																																D		D					V	V		V		V	V		V					S			P																																																											0		1415.524151		942.8390635					306.7050029	108.454892		1409.008121		0	151.6468398		5371.080769					933.1222267			701.3173445																		$50 copay (days 1-10)	$0 copay	$50 per day (days 8 through 100)  PBP L.2	$0 copay	$0 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$150 copay @ Hospital PBP L.9a	Included in OP-Facility Other	$150 copay @ Hospital PBP L.8a/8b; $50 @ Freestanding	$0 copay	$100 copay @ Hospital PBP L.12; $25 copay @ Freestanding facility	"$50 copay @ Hospital PBP L.9a, 8a, 7c, 7j"	$0 copay	$15 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $50 copay Other Part B	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											43.50447652		30.28790711		0			50	150		53.90037929		34.12302495	50		15					84.06518709			85.29530667																		5.1318	0	2.379718498	0	0	0	0	1.277937512	1.35568615	0	6.328839347	0	0	0.631861832	0	6.713850961	0	0	0	0	6.536924547	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.3415			5.1318	0	2.379718498	0	0	0	0	1.277937512	1.35568615	0	6.328839347	0	0	0.631861832	0	6.713850961	0	0	0	0	6.536924547	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.3415																																																																																				0			5.1318	0	2.379718498	0	0	0	0	1.277937512	1.35568615	0	6.328839347	0	0	0.631861832	0	6.713850961	0	0	0	0	6.536924547	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.3415
H1076_010_0	2008	5																																																				S			P																																																											0																						999.5913234			701.3173445																																						18% chemo; $50 copay Other Part B			Various copays																																						50.18511306			85.29530667																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.180383631	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.1653			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.180383631	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.1653																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.180383631	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.1653
H1076_011_0	2008	4																																																							P																																																											0																									2100.591872																		$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay																																		23.60651183																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.132303906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1323			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.132303906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1323																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.132303906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1323
H1076_016_0	2008	4																																D		D		T			V	V		V		V	V		V					S			P																																																											0		1501.515732		1106.798146		293.7810004			309.8456624	459.62677		2208.3562		0	397.6656033		5211.017393					732.5835253			701.3173445																		$150 copay (days 1-7)	$0 copay	$50 per day (days 8 through 100)  PBP L.2	$0 copay	$100 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$300 copay @ Hospital; $100 copay @ ASC	Included in OP-Facility Other	$200 copay @ Hospital PBP L.8a/8b; $100 @ Freestanding diagnostic center	$0 copay	$50 copay @ Hospital PBP L.12	"$100 copay @ Hospital PBP L.9a, 8a, 7c, 7j"	$0 copay	$30 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $50 copay Other Part B	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											118.1390462		30.28790711		100			50	100		102.4920026		75	100		30					91.05147557			85.29530667																		14.7823	0	2.793549953	0	2.448175003	0	0	1.291023593	3.830223083	0	18.86157079	0	0	3.313880028	0	13.02754348	0	0	0	0	5.55856758	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8918			14.7823	0	2.793549953	0	2.448175003	0	0	1.291023593	3.830223083	0	18.86157079	0	0	3.313880028	0	13.02754348	0	0	0	0	5.55856758	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8918																																																																																				0			14.7823	0	2.793549953	0	2.448175003	0	0	1.291023593	3.830223083	0	18.86157079	0	0	3.313880028	0	13.02754348	0	0	0	0	5.55856758	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8918
H1080_004_0	2008	10																					4000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1826.660527	104.3397336	1022.357919		171.0642889	9.857598424	2.640975703	329.0257448	39.38386944	12450.54985	51.1652425		0.21653441	26.91840354	5615.536172	6842.331841	406.6661932	3.977937915			37.30479045	1958.197966			231.9108702		19.41435271															$295 (1a); $0 (1a1)	$295 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$40/$10 (4b)"	20%/30% (9b)	20%/30% (8a1); $0/$5 (8a2)	"$15 (8b1); 20%/30% (8b2, 8b3)"	20%/30% (incl in h5)	30% (12)	"20%/30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20%/30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c; $0 (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											189.3613	189.3613	102.7044		112.333	0.192570788	0.239621241	31.3212	0.170746099	1.2838	0.079817487		0.192570788	0.192510658	10	24.9854	37.5	0.128380525			0.192570788	25			25		25															28.8249	1.646492082	8.750056452	0	1.601346489	1.898285497	0.632833876	0.85879124	6.724642059	1.332006776	4.083881103	0	0.041698202	5.18207957	4.679613476	14.24652205	1.270831854	0.510689759	0	0	7.183812894	4.079579096	0	0	0.483147646	0	0.040446568	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0717	0	38.45000209	28.8249	1.646492082	8.750056452	0	1.601346489	1.898285497	0.632833876	0.85879124	6.724642059	1.332006776	4.083881103	0	0.041698202	5.18207957	4.679613476	14.24652205	1.270831854	0.510689759	0	0	7.183812894	4.079579096	0	0	0.483147646	0	0.040446568	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0717																																																																																				0			28.8249	1.646492082	8.750056452	0	1.601346489	1.898285497	0.632833876	0.85879124	6.724642059	1.332006776	4.083881103	0	0.041698202	5.18207957	4.679613476	14.24652205	1.270831854	0.510689759	0	0	7.183812894	4.079579096	0	0	0.483147646	0	0.040446568	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0717
H1080_011_0	2008	9																					4000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1452.286995	104.096993	677.5124551		109.6742288	9.360895368	2.689068859	291.9765552	35.32271364	10448.91517	51.50321184		0.063367491	16.1787896	4993.854076	5906.596927	428.6105057	4.79860613			26.81058603	1457.943737			200.7746823		18.45841318															$295 (1a); $0 (1a1)	$295 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$15 (4b)"	15%/30% (9b)	15%/30% (8a1); $0/$25 (8a2)	"$15 (8b1); 15%/30% (8b2, 8b3)"	15%/30% (incl in h5)	30% (12)	"15%/30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"15%/30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c; $0 (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											200.3202	200.3202	101.8577		118.834	0.203715408	0.261865258	33.9526	0.166028057	6.7905	0.065756775		0.203715408	0.203596725	15	24.9985	37.5	0.101857704			0.203715408	25			25		25															24.2435	1.737727114	5.75082192	0	1.086085498	1.906958617	0.704173712	0.82611282	5.864561525	5.912791709	3.386685127	0	0.012908934	3.293948577	6.242317595	12.30466343	1.33940783	0.488775002	0	0	5.461729467	3.037382785	0	0	0.418280588	0	0.038455027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.0573	0	28.4475486	24.2435	1.737727114	5.75082192	0	1.086085498	1.906958617	0.704173712	0.82611282	5.864561525	5.912791709	3.386685127	0	0.012908934	3.293948577	6.242317595	12.30466343	1.33940783	0.488775002	0	0	5.461729467	3.037382785	0	0	0.418280588	0	0.038455027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.0573		$325 (1a); $0 (1a1)	$0 n/c (1b)	"$0 n/c (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$40 (4b)"	30% (9b)	30% (8a1); $0/$30 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $0 n/c (5, 9c)"	"$40/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $40 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	$0 n/c (7e); $0/$0 (7h)	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.0701			0.1154	0.0931	0.1634	0.047	0.0708	0.6167	0.6081	0.4927		0.0011	0.2821	0.3717	0.3978		0.0294			0.1641	0.1012			0.0104		0.0013															5.6366	0	0	26.3137	1.737727114	5.75082192	0.115427347	1.179173192	2.070402822	0.751125708	0.896918422	6.481307319	6.520929629	3.879407288	0	0.014015351	3.576077835	6.614044077	12.70245463	1.33940783	0.518154224	0	0	5.625875912	3.138554245	0	0	0.428707301	0	0.039710702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.6939
H1080_036_0	2008	6																																Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	Coin	T	V	V	P	V																																																								0		380.199716	24.83481596	57.63754665		16.67998023	28.2165652	13.92562178	759.5794196	52.19342985	16.76529922	63.54853456	41.95959651	2.722935382	49.08842862	624.7102874	148.2184877	15.77190652	5.870590507			27.39874637	6.963526401																				1(a) 20% Coinsurance	1(b) 20% Coinsurance	2(a) $140 per Day for days 21-100	6(a) $0 per Visit	10(a) 20% Coinsurance	11(a) 20% Coinsurance	11(b)/11(c) 20% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; 20% coinsurance	9(b) 20% Coinsurance	8(a) Diagnostic: 20% Coinsurance; other 0% coinsurance	8(b) X-rays 20% Coinsurance; other: 20% Coinsurance	9(a) 20% Coinsurance	12 20% Coinsurance	"3, 5, 9(a), 9(c), 9(d) 20% Coinsurance"	7(a) PCP $0 per visit; Urgent Care 20% coinsurance	7(b)/7(d)/7(f) 20% Coinsurance	7(e)/7(h) 20% Coinsurance	7(c)/7(i) 20% Coinsurance		7(g) 20% Coinsurance	15  20% per script	"13, 14(b), 14(e)-(j), 17(a), 16(b) 20% Coinsurance; 14(a) and 14(c) $0; 14(d) Pap Smear $0 copay, Pelvic Exam 20% Coinsurance"	10(b) $0 Copay	16(a) $0 copay per visit	17(a1) $0 copay per Visit	17(b) $0 copay per procedure	18a $10 per visit															0.087448495	0.087448495	0.111258767		0.2	0.2	0.2	50	0.2	0.1	0.2	237.2253	0.2	0.2	14.6463	0.2	0.2	0.2			0.2	0.2																				33.2479	2.171767279	6.412682382	0	3.335996047	5.64331304	2.785124355	3.164914248	10.43868597	1.676529922	12.70970691	0.829489835	0.544587076	9.817685725	0.762472325	29.64369754	3.154381303	1.174118101	0	0	5.479749274	1.39270528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.3855	0	0	33.2479	2.171767279	6.412682382	0	3.335996047	5.64331304	2.785124355	3.164914248	10.43868597	1.676529922	12.70970691	0.829489835	0.544587076	9.817685725	0.762472325	29.64369754	3.154381303	1.174118101	0	0	5.479749274	1.39270528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.3855																																																																																				0	0	0	33.2479	2.171767279	6.412682382	0	3.335996047	5.64331304	2.785124355	3.164914248	10.43868597	1.676529922	12.70970691	0.829489835	0.544587076	9.817685725	0.762472325	29.64369754	3.154381303	1.174118101	0	0	5.479749274	1.39270528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.3855
H1080_801_0	2008	3																					5000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1875.233588	106.8094504	828.3500984		162.9172211	9.25466974	3.063772023	325.0403675	43.48961335	13287.96892	60.04836702		0.167525538	25.88789856	5449.078457	7500.980799	418.698172	4.991533241			34.97023603	2171.4988			170.4001144		17.39696389															$475 (1a); $0 (1a1)	$475 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$30/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $30 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											248.374	314.6071	99.3496		115.9079	0.165582664	0.196588943	33.1165	0.165582664	3.974	0.091546863		0.198699196	0.165540424	30	34.4042	37.5	0.165582664			0.198699196	35			35		35															38.8133	2.800250607	6.85802079	0	1.573615601	1.532412868	0.602303702	0.897017498	7.201126024	4.400514578	5.497239617	0	0.03328719	4.285493697	13.62269614	21.50542014	1.308431787	0.82651137	0	0	6.948557801	6.333538168	0	0	0.497000334	0	0.050741145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.5875	0	41.79850872	38.8133	2.800250607	6.85802079	0	1.573615601	1.532412868	0.602303702	0.897017498	7.201126024	4.400514578	5.497239617	0	0.03328719	4.285493697	13.62269614	21.50542014	1.308431787	0.82651137	0	0	6.948557801	6.333538168	0	0	0.497000334	0	0.050741145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.5875																																																																																				0			38.8133	2.800250607	6.85802079	0	1.573615601	1.532412868	0.602303702	0.897017498	7.201126024	4.400514578	5.497239617	0	0.03328719	4.285493697	13.62269614	21.50542014	1.308431787	0.82651137	0	0	6.948557801	6.333538168	0	0	0.497000334	0	0.050741145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.5875
H1080_804_0	2008	4																					5000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1875.233588	106.8094504	828.3500984		162.9172211	9.25466974	3.063772023	325.0403675	43.48961335	13287.96892	60.04836702		0.167525538	25.88789856	5449.078457	7500.980799	418.698172	4.991533241			34.97023603	2171.4988			170.4001144		17.39696389															$475 (1a); $0 (1a1)	$475 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$30/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $30 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											247.9388	314.0558	99.1755		115.7048	0.198351059	0.235686464	33.0585	0.165292549	3.967	0.091386465		0.198351059	0.165250483	30	34.4042	37.5	0.165292549			0.198351059	35			35		35															38.7453	2.795344333	6.846004965	0	1.570858494	1.835673543	0.722089593	0.895445848	7.188509049	4.392804508	5.487607994	0	0.033228868	4.277987747	13.62269614	21.50542014	1.308431787	0.825063253	0	0	6.936383346	6.333538168	0	0	0.497000334	0	0.050741145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.8701	0	42.13178471	38.7453	2.795344333	6.846004965	0	1.570858494	1.835673543	0.722089593	0.895445848	7.188509049	4.392804508	5.487607994	0	0.033228868	4.277987747	13.62269614	21.50542014	1.308431787	0.825063253	0	0	6.936383346	6.333538168	0	0	0.497000334	0	0.050741145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.8701																																																																																				0			38.7453	2.795344333	6.846004965	0	1.570858494	1.835673543	0.722089593	0.895445848	7.188509049	4.392804508	5.487607994	0	0.033228868	4.277987747	13.62269614	21.50542014	1.308431787	0.825063253	0	0	6.936383346	6.333538168	0	0	0.497000334	0	0.050741145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.8701
H1099_001_0	2008	2	s.	t.									Professional										3100	Urgent care										D	D	D		T	Coin	Coin	Ded	V		Ded				V	V	V	V							V		V					V																																																			0		1894.45768	95.22703075	1023.240569		180.8834178	9.461329776	4.382519108	339.2084343	472.6597555		1928.029595				5087.481786	5258.238262	24.31955248	74.4102808									89.92607338					2225.378966										$200 days 1-4	$200 days 1-4	$75 days 1-14		$150 per trip	15% coin	15% coin	$50 ER	$200 per procedure		$75 Specialty Imaging				$10 per visit	$25 per visit	$25 per visit	$25 per visit									$15 per visit					$10 per urgent care visit										115.0540222	73.30045269	57.08632001		149.5531148	0.199404153	0.042179468	49.85103825	199.404153		58.13902501				9.970207651	24.92551913	24.92551913	24.92551913									14.95531148					9.970207651										18.1637	0.581682038	4.867753212	0	2.254306545	1.88662845	0.184852323	1.409157719	7.854193185	0	9.341146738	0	0	0	4.226937486	10.92202653	0.050514789	0.154559573	0	0	0	0	0	0	0	0	0.112072703	0	0	0	0	1.848957533	0	0	0	0	0	0	0	0	0	63.8585		0.168950329	18.1637	0.581682038	4.867753212	0	2.254306545	1.88662845	0.184852323	1.409157719	7.854193185	0	9.341146738	0	0	0	4.226937486	10.92202653	0.050514789	0.154559573	0	0	0	0	0	0	0	0	0.112072703	0	0	0	0	1.848957533	0	0	0	0	0	0	0	0	0	63.8585																																																																																				0			18.1637	0.581682038	4.867753212	0	2.254306545	1.88662845	0.184852323	1.409157719	7.854193185	0	9.341146738	0	0	0	4.226937486	10.92202653	0.050514789	0.154559573	0	0	0	0	0	0	0	0	0.112072703	0	0	0	0	1.848957533	0	0	0	0	0	0	0	0	0	63.8585
H1099_006_0	2008	3	s.										Professional										3100	Urgent care										Coin	Coin	Coin		Coin	Coin	Coin	V	Coin		V				V	V	V	V														V																																																			0		186.1577133	4.13923511	27.46415655		5.445468945	6.474795795	1.638202062	290.0460245	18.31341676		1180.98725				4539.742216	4396.738725	21.70120773	66.39895871														1980.747521										15% coin	15% coin	15% coin		15% coin	15% coin	15% coin	$50 ER	15% coin		$250 Imaging & $35 X-ray				$10 per visit	$30 per visit	$30 per visit	$30 per visit														$10 per urgent care visit										0.145133331	0.145133331	0.145133331		0.145133331	0.145133331	0.145133331	48.37777698	0.145133331		131.7099948				9.675555395	29.02666619	29.02666619	29.02666619														9.675555395										27.0177	0.600740979	3.985964522	0	0.790319046	0.939708681	0.237757722	1.169315157	2.657887176	0	12.96231872	0	0	0	3.660377274	10.63522227	0.052492809	0.160611701	0	0	0	0	0	0	0	0	0	0	0	0	0	1.597069363	0	0	0	0	0	0	0	0	0	66.4675		2.14	27.0177	0.600740979	3.985964522	0	0.790319046	0.939708681	0.237757722	1.169315157	2.657887176	0	12.96231872	0	0	0	3.660377274	10.63522227	0.052492809	0.160611701	0	0	0	0	0	0	0	0	0	0	0	0	0	1.597069363	0	0	0	0	0	0	0	0	0	66.4675																																																																																				0			27.0177	0.600740979	3.985964522	0	0.790319046	0.939708681	0.237757722	1.169315157	2.657887176	0	12.96231872	0	0	0	3.660377274	10.63522227	0.052492809	0.160611701	0	0	0	0	0	0	0	0	0	0	0	0	0	1.597069363	0	0	0	0	0	0	0	0	0	66.4675
H1099_008_0	2008	2	s.										Professional										2000	Urgent care										Ded	Ded	Ded		T	Coin	Coin	V	P						V	V	V	V														V																																																			0		2890.881388	145.313381	1514.683038		177.7316925	18.60831523	4.708130007	333.2980427	574.0366241						2125.000018	2196.323618	31.92006527	31.08057281														2900.317557										$250 per admission	$250 per admission	$25 days 1-14		$50 per trip	10% coin	10% coin	$50 ER	$150 per procedure						$10 per visit	$20 per visit	$20 per visit	$15 per visit														$10 per urgent care visit										42.43627825	24.57994534	16.94043867		44.3800786	0.088760157	0.088760157	44.3800786	133.1402358						8.87601572	17.75203144	17.75203144	13.31402358														8.87601572										10.2232	0.29764958	2.138282927	0	0.657312207	1.651676985	0.41789436	1.232649444	6.368947624	0	0	0	0	0	1.571794464	3.249100493	0.0472205	0.034483957	0	0	0	0	0	0	0	0	0	0	0	0	0	2.145272019	0	0	0	0	0	0	0	0	0	30.0355		3.89	10.2232	0.29764958	2.138282927	0	0.657312207	1.651676985	0.41789436	1.232649444	6.368947624	0	0	0	0	0	1.571794464	3.249100493	0.0472205	0.034483957	0	0	0	0	0	0	0	0	0	0	0	0	0	2.145272019	0	0	0	0	0	0	0	0	0	30.0355																																																																																				0			10.2232	0.29764958	2.138282927	0	0.657312207	1.651676985	0.41789436	1.232649444	6.368947624	0	0	0	0	0	1.571794464	3.249100493	0.0472205	0.034483957	0	0	0	0	0	0	0	0	0	0	0	0	0	2.145272019	0	0	0	0	0	0	0	0	0	30.0355
H1099_009_0	2008	2	s.	t.									Professional										3100	Urgent care										D	D	D		T	Coin	Coin	Ded	P		Ded				V	V	V	V									V					V																																																			0		1892.781601	95.14278075	1022.335279		180.6218122	9.447646173	4.376180818	338.7178485	471.9761636		1925.241151				5080.123932	5250.633449	24.28437993	74.30266372									89.79601633					2222.160476										$200 days 1-4	$200 days 1-4	$75 days 1-14		$150 per trip	15% coin	15% coin	$50 ER	$200 per procedure		$75 Specialty Imaging				$10 per visit	$25 per visit	$25 per visit	$25 per visit									$15 per visit					$10 per urgent care visit										115.0540222	73.30045269	57.08632001		149.5531148	0.199404153	0.042179468	49.85103825	199.404153		58.13902501				9.970207651	24.92551913	24.92551913	24.92551913									14.95531148					9.970207651										18.1477	0.581167408	4.863446576	0	2.251046218	1.883899883	0.184584977	1.407119702	7.842833929	0	9.327636951	0	0	0	4.220824208	10.90623037	0.050441731	0.154336039	0	0	0	0	0	0	0	0	0.111910616	0	0	0	0	1.846283448	0	0	0	0	0	0	0	0	0	63.7794		0.180658813	18.1477	0.581167408	4.863446576	0	2.251046218	1.883899883	0.184584977	1.407119702	7.842833929	0	9.327636951	0	0	0	4.220824208	10.90623037	0.050441731	0.154336039	0	0	0	0	0	0	0	0	0.111910616	0	0	0	0	1.846283448	0	0	0	0	0	0	0	0	0	63.7794																																																																																				0			18.1477	0.581167408	4.863446576	0	2.251046218	1.883899883	0.184584977	1.407119702	7.842833929	0	9.327636951	0	0	0	4.220824208	10.90623037	0.050441731	0.154336039	0	0	0	0	0	0	0	0	0.111910616	0	0	0	0	1.846283448	0	0	0	0	0	0	0	0	0	63.7794
H1099_010_0	2008	2	s.	t.									Professional										3100	Urgent care										D	D	D		T	Coin	Coin	Ded	P		Ded				V	V	V	V							V		V					V																																																			0		1898.663609	95.43844646	1025.512288		181.5409067	9.495720541	4.398449024	340.441415	474.3778153		1935.037744				5105.974154	5277.351308	24.40795105	74.68075298							702.5247711		90.25294354					2233.467944										$200 days 1-4	$200 days 1-4	$75 days 1-14		$150 per trip	15% coin	15% coin	$50 ER	$200 per procedure		$75 Specialty Imaging				$10 per visit	$25 per visit	$25 per visit	$25 per visit							$15 per visit		$15 per visit					$10 per urgent care visit										115.0540222	73.30045269	57.08632001		149.5531148	0.199404153	0.042179468	49.85103825	199.404153		58.13902501				9.970207651	24.92551913	24.92551913	24.92551913							14.95531148		14.95531148					9.970207651										18.2041	0.582973444	4.878560223	0	2.262500671	1.893486112	0.185524238	1.414279833	7.882742206	0	9.375100651	0	0	0	4.242301881	10.96172675	0.050698404	0.155121378	0	0	0	0	0	0	0.875539731	0	0.112480074	0	0	0	0	1.855678265	0	0	0	0	0	0	0	0	0	64.9328		0.181280041	18.2041	0.582973444	4.878560223	0	2.262500671	1.893486112	0.185524238	1.414279833	7.882742206	0	9.375100651	0	0	0	4.242301881	10.96172675	0.050698404	0.155121378	0	0	0	0	0	0	0.875539731	0	0.112480074	0	0	0	0	1.855678265	0	0	0	0	0	0	0	0	0	64.9328																																																																																				0			18.2041	0.582973444	4.878560223	0	2.262500671	1.893486112	0.185524238	1.414279833	7.882742206	0	9.375100651	0	0	0	4.242301881	10.96172675	0.050698404	0.155121378	0	0	0	0	0	0	0.875539731	0	0.112480074	0	0	0	0	1.855678265	0	0	0	0	0	0	0	0	0	64.9328
H1099_802_0	2008	2																																Coin		Coin		Coin	Coin		Coin	Coin	Coin					Coin						Coin																																																														0		230.054226		25.57059189		4.477737043	11.24377075		8.095179657	25.47341682	74.45145062					316.965663						21.97281938																					Medicare FFS Cost Sharing																																									0.085505779		0.181756909		0.234	0.234	0.234	0.234	0.234	0.234					0.234						0.234																					19.671	0	4.647631748	0	1.047790468	2.631042356	0	1.89427204	5.960779535	17.42163945	0	0	0	0	74.16996513	0	0	0	0	0	5.141639734	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.5857		0	19.671	0	4.647631748	0	1.047790468	2.631042356	0	1.89427204	5.960779535	17.42163945	0	0	0	0	74.16996513	0	0	0	0	0	5.141639734	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.5857																																																																																				0			19.671	0	4.647631748	0	1.047790468	2.631042356	0	1.89427204	5.960779535	17.42163945	0	0	0	0	74.16996513	0	0	0	0	0	5.141639734	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.5857
H1099_803_0	2008	2																																Coin		Coin		Coin	Coin		Coin	Coin	Coin					Coin						Coin																																																														0		230.054226		25.57059189		4.477737043	11.24377075		8.095179657	25.47341682	74.45145062					316.965663						21.97281938																					Medicare FFS Cost Sharing																																									0.085505779		0.181756909		0.234	0.234		0.234	0.234	0.234					0.234						0.234																					19.671	0	4.647631748	0	1.047790468	2.631042356	0	1.89427204	5.960779535	17.42163945	0	0	0	0	74.16996513	0	0	0	0	0	5.141639734	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.5857			19.671	0	4.647631748	0	1.047790468	2.631042356	0	1.89427204	5.960779535	17.42163945	0	0	0	0	74.16996513	0	0	0	0	0	5.141639734	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.5857																																																																																				0			19.671	0	4.647631748	0	1.047790468	2.631042356	0	1.89427204	5.960779535	17.42163945	0	0	0	0	74.16996513	0	0	0	0	0	5.141639734	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.5857
H1108_001_0	2008	5	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)							Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						Coin	Coin	D	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V		Coin	Coin	Coin	T		V	P	Coin					Coin	Coin	Coin	V	V																																															0		312.2668325	0.756200615	9564.663648	14.80549077	44.23251139	36.44294973	0.303459369	193.973692	11.38993747	41.50952818	53.91273383	2.983536776	0.030870166	3.407806196	32848.51899	120.8109915	4.517284497	132.1956015		5.365057575	1.655034045	5.175270893	2598.9435		7.728358244	278.16						0.56087258			90.29976475	0.406755697						(1a) 7.9% coins	(1b) 7.9% coins	(2a) $0/day	(6a) $0/proc	(10a) 20% coins	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) 20% coins	(8a) 10% coins	(8b) 19.2% coins	(9a) 20% coins	(12) 20% coins	(9a) 20% coins	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) 20% coins	(7e/7h) 20% coins	(7c/7i) $0/visit		(7g) 20% coins	(15) 20% coins	(Misc. PBP Cats) 20% coins	(10b) $0/trip		(17a1) $0/visit	(17b2) $0/proc	(18a) 20% coins					(4b) 20% coins	(9c) 20% coins	(9d) 20% coins	(7f1) $0/visit	(18a1) $0/visit						0.079372505	0.079372505			0.2	0.2	0.2	50	0.2	0.1	0.192	0.2	0.2	0.2		0.2	0.2			0.2	0.2	0.2										0.2										24.7854	0.060021537	0	0	8.846502278	7.288589946	0.060691874	0.808223717	2.277987494	4.150952818	10.35124489	0.596707355	0.006174033	0.681561239	0	24.1621983	0.903456899	0	0	1.073011515	0.331006809	1.035054179	0	0	0	0	0	0	0	0	0	0.112174516	0	0	0	0	0	0	0	0	0	87.531		0	24.7854	0.060021537	0	0	8.846502278	7.288589946	0.060691874	0.808223717	2.277987494	4.150952818	10.35124489	0.596707355	0.006174033	0.681561239	0	24.1621983	0.903456899	0	0	1.073011515	0.331006809	1.035054179	0	0	0	0	0	0	0	0	0	0.112174516	0	0	0	0	0	0	0	0	0	87.531		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					0.2	0.3	0.3	0.3	0.3						2.403	0.0058	0.94	0.0018	0.6984	0.5754	0.0048	0.0425	0.1798	0.6554	0.8513	0.0471	0.0005	0.0538	0.0064	1.9075	0.0713	0.0115		0.0847		0.0957	0.2949		0.0005							0.0059			0.0062	0.0001						8.9445		0	27.1884	0.065838465	0.940048696	0.001782238	9.544910352	7.864004941	0.065483338	0.850761807	2.457828612	4.806366421	11.20249859	0.643815831	0.006661457	0.735368705	0.006389217	26.06974027	0.974782444	0.011491225	0	1.15772295	0.331006809	1.130762971	0.294935828	0	0.000457861	0	0	0	0	0	0	0.118078438	0	0	0.006175598	0.000122382	0	0	0	0	0	96.4754
H1108_002_0	2008	3																					2400											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	S	P	T		V	P	V																																																								0		2507.165091	495.105121	1092.197753		620.4200622	35.57220912	13.72264666	1082.357728	404.3985485	9156.951823	648.3313141	53.75144357	7.732757901	2797.367919		2465.966728	1384.125478	710.7292182			1639.345481	551.1126768																				1(a) $200 per Day	1(b) $200 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $100 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $35 per Visit	8(a) Diagnostic: $25 per procedure; other $0 per procedure	8(b) X-rays $25 per visit; other: $25 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a) $25 per Visit; 9(c) $25/$35 per Visit; 9(d) $35 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $15 per Visit	7(e)/7(h) $25/35 per Visit	7(c)/7(i) $15 per Visit		7(g) $15 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $25 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $25 per visit															112.3968	112.3968	23.6033		56.1984	0.112396784	0.112396784	25.1488	19.6694	14.0496	14.0496	14.0496	0.112396784	14.1251		8.4298	18.2645	8.4298			25.6966	14.0496																				23.4831	4.637351944	2.148291511	0	2.905550821	3.998201904	1.542381353	2.268331402	0.662857654	10.72095767	0.759066194	0.062932181	0.869137119	3.292760817	0	1.73229206	2.106694043	0.49927299	0	0	3.510460715	0.64524263	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8449	0	51.32018894	23.4831	4.637351944	2.148291511	0	2.905550821	3.998201904	1.542381353	2.268331402	0.662857654	10.72095767	0.759066194	0.062932181	0.869137119	3.292760817	0	1.73229206	2.106694043	0.49927299	0	0	3.510460715	0.64524263	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8449		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"4(a)$50 per Visit, 4(b) $35 per Visit"	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															2.3024	0.1382	0.3019	0.3385	0.1084	0.2178	0.0949	0.0851	0.2182	0.073	0.2554	0.0222	0.0456	0.2731	0.103	0.1706	0.0651	0.0389			0.1912	0.0327	0.0077		0.0004																	5.0844	0	0	25.7855	4.775561394	2.45023321	0.338500924	3.013902796	4.21599094	1.637291702	2.353464742	0.881085856	10.79390872	1.014442249	0.085148587	0.914733886	3.56590749	0.103005992	1.902922132	2.171767294	0.538198973	0	0	3.701681637	0.677920622	0.00774	0	0.00042414	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.9293
H1108_006_0	2008	7																					2500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		1980.538427	135.843243	922.950342		285.7747418	11.27170584	19.57551764	447.6102694	423.078054	3547.017285	466.1411675	71.03795833	15.87841985	2980.60829		4035.688922	397.9435868	581.9727856				718.2437404					0.076047675															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															129.2929	129.2929	31.0303		55.4112	0.147763322	0.147763322	30.4762	55.4112	14.7763	48.2181	55.4112	114.2201	53.5733		18.4704	14.7763	14.7763				18.4704					18.4704															21.3391	1.463630648	2.386618653	0	1.319594539	1.665544701	2.892543519	1.136787789	1.953606837	4.367658815	1.873037944	0.328025148	0.151136204	13.30675786	0	6.211737525	0.49001222	0.716618602	0	0	0	1.105521679	0	0	0	0	0.000117053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7081	0	22.16830101	21.3391	1.463630648	2.386618653	0	1.319594539	1.665544701	2.892543519	1.136787789	1.953606837	4.367658815	1.873037944	0.328025148	0.151136204	13.30675786	0	6.211737525	0.49001222	0.716618602	0	0	0	1.105521679	0	0	0	0	0.000117053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7081		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.2844	0.0653	0.2812	0.2807	0.0721	0.138	0.1199	0.0323	0.2917	0.0458	0.119	0.0239	0.0055	0.2082	0.0208	0.2012	0.0302	0.0327			0.1804	0.0427			0.0051																	4.4811	0	0	23.6235	1.528906146	2.667824065	0.280666377	1.391683366	1.803565589	3.012393627	1.169043804	2.245341018	4.413456807	1.992084954	0.351912004	0.156644754	13.51500688	0.020815197	6.412968	0.520245307	0.749280766	0	0	0.180436674	1.148184968	0	0	0.005058988	0	0.000117053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.1892
H1108_007_0	2008	7																					3250											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1879.096293	138.5676646	900.1041272		117.3055701	12.41656725	2.379179614	457.1613709	30.55309736	9695.204581	43.91571118		0.355285404	28.1539612	4157.388299	4220.250954	483.598025	1.739203117			22.16821452	847.0379144			122.4		14.32602104															$225 (1a); $0 (1a1)	$225 (1b)	"$125 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$5 (4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$20 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	$0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											138.0629	138.0629	76.7016		107.3823	0.184083904	0.282631564	30.6807	0.122722603	3.6817	0.073177703		0.184083904	0.122686114	5	19.9613	37.5	0.122722603			0.184083904	20			20		20															21.6195	1.594254791	5.753287558	0	1.049711605	2.285690172	0.672431256	1.168834026	3.749555626	2.974551848	3.213650891	0	0.065402324	3.454100091	1.732245125	7.020131757	1.511243828	0.213439533	0	0	4.080811472	1.411729857	0	0	0.204	0	0.023876702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7984	0	32.29468338	21.6195	1.594254791	5.753287558	0	1.049711605	2.285690172	0.672431256	1.168834026	3.749555626	2.974551848	3.213650891	0	0.065402324	3.454100091	1.732245125	7.020131757	1.511243828	0.213439533	0	0	4.080811472	1.411729857	0	0	0.204	0	0.023876702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7984		$275 (1a); $0 (1a1)	$275 (1b)	"$150 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$10/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $30 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5); 50% (14a6); $0/50% (14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											3.7446	0.2761	3.7504	0.6625	0.4277	0.9312	0.1784	0.4762	2.2915	1.6159	1.8863		0.0266	2.1102	0.8766	1.8571	0.3022	0.0921			1.1736	0.3812			0.054		0.0063															23.1208	0	0	25.364	1.870386007	9.503721421	0.662466387	1.477388162	3.216932716	0.850869727	1.645043787	6.041037929	4.590419278	5.099927345	0	0.09204873	5.564335966	2.608825992	8.877228678	1.813492594	0.305514992	0	0	5.254422829	1.792921885	0	0	0.258	0	0.030197005	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.9192
H1108_801_0	2008	4																					3700											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1973.051107	145.4960478	945.1093336		123.1708486	13.03739561	2.498138595	480.0034394	32.08075223	10179.96481	46.11149673		0.373049674	29.56165926	4359.690214	4430.456002	507.7779263	1.826163273			23.27662525	889.3898101			122.4		14.32602104															$325 (1a); $0 (1a1)	$325 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$30/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $30 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											182.2954	182.2954	89.7454		98.1591	0.168272692	0.280262471	28.0454	0.168272692	3.3655	0.09438437		0.168272692	0.168186797	30	34.7236	37.5	0.168272692			0.168272692	35			35		35															29.9732	2.210271887	7.068270754	0	1.007528	2.193837658	0.700134496	1.121825986	5.398314545	2.855016808	4.352204577	0	0.062774073	4.97188077	10.89922554	12.82011524	1.58680602	0.30729341	0	0	3.916820395	2.594053613	0	0	0.357	0	0.041784228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.4383	0	51.27493067	29.9732	2.210271887	7.068270754	0	1.007528	2.193837658	0.700134496	1.121825986	5.398314545	2.855016808	4.352204577	0	0.062774073	4.97188077	10.89922554	12.82011524	1.58680602	0.30729341	0	0	3.916820395	2.594053613	0	0	0.357	0	0.041784228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.4383		$375 (1a); $0 (1a1)	$375 (1b)	"$185 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$35/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $35 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											5.3616	0.3954	4.8568	0.6956	0.4491	0.9778	0.1874	0.5	2.4061	1.6967	1.9806		0.028	2.2157	2.5224	2.2624	0.3174	0.0967			1.2323	0.4656			0.063		0.0074															28.7177	0	0	35.3347	2.605641582	11.92508261	0.695589706	1.456588386	3.171642329	0.887494891	1.621829569	7.804370962	4.55167761	6.332794853	0	0.090752799	7.187628439	13.42164398	15.08248852	1.904167224	0.403972642	0	0	5.14911232	3.059701552	0	0	0.42	0	0.049157915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.1561
H1108_802_0	2008	4																					3700											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1973.051107	145.4960478	945.1093336		123.1708486	13.03739561	2.498138595	480.0034394	32.08075223	10179.96481	46.11149673		0.373049674	29.56165926	4359.690214	4430.456002	507.7779263	1.826163273			23.27662525	889.3898101			122.4		14.32602104															$325 (1a); $0 (1a1)	$325 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$30/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $30 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											182.2954	182.2954	89.7454		98.1591	0.168272692	0.280262471	28.0454	0.168272692	3.3655	0.09438437		0.168272692	0.168186797	30	34.7236	37.5	0.168272692			0.168272692	35			35		35															29.9732	2.210271887	7.068270754	0	1.007528	2.193837658	0.700134496	1.121825986	5.398314545	2.855016808	4.352204577	0	0.062774073	4.97188077	10.89922554	12.82011524	1.58680602	0.30729341	0	0	3.916820395	2.594053613	0	0	0.357	0	0.041784228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.4383	0	51.27493067	29.9732	2.210271887	7.068270754	0	1.007528	2.193837658	0.700134496	1.121825986	5.398314545	2.855016808	4.352204577	0	0.062774073	4.97188077	10.89922554	12.82011524	1.58680602	0.30729341	0	0	3.916820395	2.594053613	0	0	0.357	0	0.041784228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.4383		$375 (1a); $0 (1a1)	$375 (1b)	"$185 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$35/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $35 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											5.3616	0.3954	4.8568	0.6956	0.4491	0.9778	0.1874	0.5	2.4061	1.6967	1.9806		0.028	2.2157	2.5224	2.2624	0.3174	0.0967			1.2323	0.4656			0.063		0.0074															28.7177	0	0	35.3347	2.605641582	11.92508261	0.695589706	1.456588386	3.171642329	0.887494891	1.621829569	7.804370962	4.55167761	6.332794853	0	0.090752799	7.187628439	13.42164398	15.08248852	1.904167224	0.403972642	0	0	5.14911232	3.059701552	0	0	0.42	0	0.049157915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.1561
H1109_001_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601		1296.725301	2128.644463	234.9145506	15.71780589		426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7711.393624	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961				0		0															200/d 10		"$0 days 1-8, $75 days 9-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$175 per visit	$35 per visit	"$35 X-ray; $175 PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$25 per visit	"$35 per visit specialist, $30 Renal Dialysis"	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															163.93		66.23	20	100	0.2		46.75	175	35	60.2	35	30	35	25	34.55	35	35	35	35	45				0		0															21.6867	0	7.156843058	3.547740771	1.957621255	3.143561179	0	1.659887368	5.119065498	6.509192953	5.753868114	0	0	0	11.53405775	22.20238748	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.6132			21.6867	0	7.156843058	3.547740771	1.957621255	3.143561179	0	1.659887368	5.119065498	6.509192953	5.753868114	0	0	0	11.53405775	22.20238748	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.6132		0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0			21.6867	0	7.156843058	3.547740771	1.957621255	3.143561179	0	1.659887368	5.119065498	6.509192953	5.753868114	0	0	0	11.53405775	22.20238748	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.6132
H1109_002_0	2008	5																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601		1296.725301	2128.644463	234.9145506	15.71780589		426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7561.88844	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961				0		0															150/d 10		"$0 days 1-8, $75 days 9-14; $100 15+"	$0 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$150 per visit	$0 per visit	"$30 X-ray; $175 PET, MRI"	$30 per visit	$30 per visit	$30 per visit	$15 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script				$0 per visit		$0 per visit															122.95		66.23	0	100	0.2		46.75	150	0	56.1	30	30	30	15	30	30	30	30	30	45				0		0															16.2654	0	7.156843058	0	1.957621255	3.143561179	0	1.659887368	4.387770426	0	5.361993375	0	0	0	6.920434651	18.9047211	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.7719			16.2654	0	7.156843058	0	1.957621255	3.143561179	0	1.659887368	4.387770426	0	5.361993375	0	0	0	6.920434651	18.9047211	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.7719		0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0			16.2654	0	7.156843058	0	1.957621255	3.143561179	0	1.659887368	4.387770426	0	5.361993375	0	0	0	6.920434651	18.9047211	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.7719
H1109_003_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601		1296.725301	2128.644463	234.9145506	15.71780589		426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7453.157397	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961				0		0															$0 per day		"$0 days 1-8, $75 days 9-14; $100 15+"	$0 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$150 per visit	$0 per visit	"$20 X-ray; $175 PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$0 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit															0		66.23	0	100	0.2		46.75	150	0	47.9	20	20	20	0	20	20	20	20	20	45				0		0															0	0	7.156843058	0	1.957621255	3.143561179	0	1.659887368	4.387770426	0	4.578243898	0	0	0	0	12.42192899	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.6625			0	0	7.156843058	0	1.957621255	3.143561179	0	1.659887368	4.387770426	0	4.578243898	0	0	0	0	12.42192899	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.6625		0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0			0	0	7.156843058	0	1.957621255	3.143561179	0	1.659887368	4.387770426	0	4.578243898	0	0	0	0	12.42192899	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.6625
H1109_004_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601		1296.725301	2128.644463	234.9145506	15.71780589		426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7561.88844	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961				0		0															150/d 10		"$0 days 1-8, $75 days 9-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$150 per visit	$30 per visit	"$30 X-ray; $150 PET, MRI"	$30 per visit	$30 per visit	$30 per visit	$15 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script				$0 per visit		$0 per visit															122.95		66.23	20	100	0.2		46.75	150	30	51.6	30	30	30	15	30	30	30	30	30	45				0		0															16.2654	0	7.156843058	3.547740771	1.957621255	3.143561179	0	1.659887368	4.387770426	5.579308245	4.931886955	0	0	0	6.920434651	18.9047211	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4689			16.2654	0	7.156843058	3.547740771	1.957621255	3.143561179	0	1.659887368	4.387770426	5.579308245	4.931886955	0	0	0	6.920434651	18.9047211	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4689		0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0			16.2654	0	7.156843058	3.547740771	1.957621255	3.143561179	0	1.659887368	4.387770426	5.579308245	4.931886955	0	0	0	6.920434651	18.9047211	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4689
H1109_801_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1644.486635		798.8252183	301.9900251	172.2499941	10.59368356		266.0752195	263.8209923	1079.097987	4071.785464	0	0	624.4955747	2793.511113	3706.214939	0	433.9966272	0	0	7.080324068				261.6549357		11.29758697															$200 per day; max $1400		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20 % per script				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2				0		0															19.812	0	6.656876819	1.006633417	2.153124926	3.178105068	0	1.108646748	4.397016539	3.596993289	18.64199112	0	0	2.081651916	6.983777784	12.19962418	0	1.446655424	0	0	1.416064814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.6791			19.812	0	6.656876819	1.006633417	2.153124926	3.178105068	0	1.108646748	4.397016539	3.596993289	18.64199112	0	0	2.081651916	6.983777784	12.19962418	0	1.446655424	0	0	1.416064814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.6791																																																																																				0			19.812	0	6.656876819	1.006633417	2.153124926	3.178105068	0	1.108646748	4.397016539	3.596993289	18.64199112	0	0	2.081651916	6.983777784	12.19962418	0	1.446655424	0	0	1.416064814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.6791
H1109_802_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1644.486635		798.8252183	301.9900251	172.2499941	10.59368356		266.0752195	263.8209923	1079.097987	4071.785464	0	0	624.4955747	2793.511113	3706.214939	0	433.9966272	0	0	7.080324068				261.6549357		11.29758697															$200 per day; max $1400		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$39.5 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20 % per script				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2				0		0															19.812	0	6.656876819	1.006633417	2.153124926	3.178105068	0	1.108646748	4.397016539	3.596993289	18.64199112	0	0	2.081651916	6.983777784	12.19962418	0	1.446655424	0	0	1.416064814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.6791			19.812	0	6.656876819	1.006633417	2.153124926	3.178105068	0	1.108646748	4.397016539	3.596993289	18.64199112	0	0	2.081651916	6.983777784	12.19962418	0	1.446655424	0	0	1.416064814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.6791																																																																																				0			19.812	0	6.656876819	1.006633417	2.153124926	3.178105068	0	1.108646748	4.397016539	3.596993289	18.64199112	0	0	2.081651916	6.983777784	12.19962418	0	1.446655424	0	0	1.416064814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.6791
H1110_001_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	948.624126				0		0															150/d 10	150/d 10	"$0 days 1-8, $75 days 9-14; $100 15+"	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $25 UC	$150 per visit	$0 per visit	"$30 X-ray; $175 PET, MRI"	$30 per visit	$30 per visit	$30 per visit	$15 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script				$0 per visit		$0 per visit															122.95	122.95	66.23	0	100	0.2	0.2	46.75	150	0	56.1	30	30	30	15	30	30	30	30	30	45				0		0															14.3135	0.278845189	6.298021891	0	1.722706705	2.766333837	0.176580511	1.460700884	3.861237975	0	4.71855417	0	0	0	6.089982493	15.05139961	0.443677622	1.283690571	2.105316109	3.182059768	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.31			14.3135	0.278845189	6.298021891	0	1.722706705	2.766333837	0.176580511	1.460700884	3.861237975	0	4.71855417	0	0	0	6.089982493	15.05139961	0.443677622	1.283690571	2.105316109	3.182059768	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.31		35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	$100 per trip	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	$50 ER; $25 UC	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max				35% coins; $0ded; $5000 OOP max		35% coins; $0ded; $5000 OOP max															4.219995216	0.032724012	0.684269578	0.613008218	0.124262501	0.349197709	0.022289974	0.105363464	0.432179167	0.149975771	0.421048277	0	0.138071668	0.465266072	0.548228097	0.685005442	0.025871985	0.072520225	0.50947725	1.846265726	0.401483526				0.071261584		0.020119462															11.9379	0	15.29351151	18.5335	0.311569201	6.982291469	0.613008218	1.846969206	3.115531546	0.198870485	1.566064348	4.293417142	0.149975771	5.139602447	0	0.138071668	0.465266072	6.63821059	15.73640506	0.469549607	1.356210796	2.614793359	5.028325494	3.958823998	0	0	0	0.071261584	0	0.020119462	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.2479
H1110_003_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	948.624126				0		0															$0 per day	$0 per day	"$0 days 1-8, $75 days 9-14; $100 15+"	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $25 UC	$150 per visit	$0 per visit	"$20 X-ray; $175 PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$0 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit															0	0	66.23	0	100	0.2	0.2	46.75	150	0	47.9	20	20	20	0	20	20	20	20	20	45				0		0															0	0	6.298021891	0	1.722706705	2.766333837	0.176580511	1.460700884	3.861237975	0	4.02885463	0	0	0	0	10.03426641	0.295785081	0.855793714	1.403544073	2.121373179	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5825			0	0	6.298021891	0	1.722706705	2.766333837	0.176580511	1.460700884	3.861237975	0	4.02885463	0	0	0	0	10.03426641	0.295785081	0.855793714	1.403544073	2.121373179	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5825		35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	$100 per trip	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	$50 ER; $25 UC	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max				35% coins; $0ded; $5000 OOP max		35% coins; $0ded; $5000 OOP max															4.219995216	0.032724012	0.684269578	0.613008218	0.124262501	0.349197709	0.022289974	0.105363464	0.432179167	0.149975771	0.421048277	0	0.138071668	0.465266072	0.548228097	0.685005442	0.025871985	0.072520225	0.50947725	1.846265726	0.401483526				0.071261584		0.020119462															11.9379	0	15.29351151	4.22	0.032724012	6.982291469	0.613008218	1.846969206	3.115531546	0.198870485	1.566064348	4.293417142	0.149975771	4.449902907	0	0.138071668	0.465266072	0.548228097	10.71927185	0.321657067	0.928313939	1.913021322	3.967638904	3.958823998	0	0	0	0.071261584	0	0.020119462	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5204
H1110_801_0	2008	2																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		825.3379229		805.4502621	0	487.2476894	4.369717658		96.12369383	292.2035995	922.0589471	2765.095453	0	0	567.2540915	2426.294617	2954.226424	0	723.9108528	0	0	7.842045319				353.0059791		19.88766079															$200 per day; max $1400		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20 % per script				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2				0		0															9.9433	0	6.712085517	0	6.090596118	1.310915297	0	0.400515391	4.870059991	3.073529824	12.65952868	0	0	1.890846972	6.065736542	9.724328646	0	2.413036176	0	0	1.568409064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.7228			9.9433	0	6.712085517	0	6.090596118	1.310915297	0	0.400515391	4.870059991	3.073529824	12.65952868	0	0	1.890846972	6.065736542	9.724328646	0	2.413036176	0	0	1.568409064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.7228		500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP		50	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP				500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP															6.1036		1.2225	0	0.3543	0.1983		0.0763	0.8029	0.5337	1.0859	0	0	0.4323	0.719	2.9427	0	0.1791	0	0	0.3809				0.0624		0.001															15.0951	500		16.0468	0	7.934604319	0	6.444937183	1.509262206	0	0.476783882	5.672950185	3.607261688	13.74546377	0	0	2.323172461	6.78473788	12.66704685	0	2.592164926	0	0	1.949286447	0	0	0	0.062391045	0	0.00100102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.8179
H1110_802_0	2008	2																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		825.3379229		805.4502621	0	487.2476894	4.369717658		96.12369383	292.2035995	922.0589471	2765.095453	0	0	567.2540915	2426.294617	2954.226424	0	723.9108528	0	0	7.842045319				353.0059791		19.88766079															$200 per day; max $1400		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$39.5 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20 % per script				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2				0		0															9.9433	0	6.712085517	0	6.090596118	1.310915297	0	0.400515391	4.870059991	3.073529824	12.65952868	0	0	1.890846972	6.065736542	9.724328646	0	2.413036176	0	0	1.568409064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.7228			9.9433	0	6.712085517	0	6.090596118	1.310915297	0	0.400515391	4.870059991	3.073529824	12.65952868	0	0	1.890846972	6.065736542	9.724328646	0	2.413036176	0	0	1.568409064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.7228		500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP		50	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP				500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP															6.1036		1.2225	0	0.3543	0.1983		0.0763	0.8029	0.5337	1.0859	0	0	0.4323	0.719	2.9427	0	0.1791	0	0	0.3809				0.0624		0.001															15.0951	500		16.0468	0	7.934604319	0	6.444937183	1.509262206	0	0.476783882	5.672950185	3.607261688	13.74546377	0	0	2.323172461	6.78473788	12.66704685	0	2.592164926	0	0	1.949286447	0	0	0	0.062391045	0	0.00100102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.8179
H1111_002_0	2008	10																					3250											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1683.380899	133.0253649	585.6067525		105.2548415	10.98813656	2.045515965	434.4152141	27.31724537	8871.342979	34.94573921		0.261357861	22.63500161	3910.665351	3831.001938	451.5829688	1.795656187			23.21112661	782.4832974			100.1080562		14.9025048															$225 (1a); $0 (1a1)	$225 (1b)	"$125 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$5 (4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$20 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 (10b)	$0 n/c (16)	$20 (17a1)	$0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											146.3677	146.3677	81.3154		113.8415	0.195156872	0.284656128	32.5261	0.130104581	3.9031	0.076285542		0.195156872	0.130056009	5	19.9733	37.5	0.130104581			0.195156872	20			20		20															20.5327	1.62255088	3.968235484	0	0.998530829	2.144410357	0.582268653	1.177487698	3.554098768	2.885505908	2.665854654	0	0.051005783	2.943817974	1.629443896	6.376486324	1.411196778	0.233623096	0	0	4.529810861	1.304138829	0	0	0.16684676	0	0.024837508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8029	0	25.44535384	20.5327	1.62255088	3.968235484	0	0.998530829	2.144410357	0.582268653	1.177487698	3.554098768	2.885505908	2.665854654	0	0.051005783	2.943817974	1.629443896	6.376486324	1.411196778	0.233623096	0	0	4.529810861	1.304138829	0	0	0.16684676	0	0.024837508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8029		$275 (1a); $0 (1a1)	$275 (1b)	"$150 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$10/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $30 (17a, 18a, 16b); 30% (17b)"	$0 n/c n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											3.3546	0.2651	2.44	0.505	0.3837	0.8241	0.1534	0.4525	2.0488	1.4786	1.4607		0.0196	1.6964	0.845	1.6872	0.2822	0.0951			1.2288	0.3542			0.0442		0.0066															19.6256	0	0	23.8873	1.887637658	6.408263619	0.504955444	1.382272438	2.968520599	0.735682351	1.630003546	5.602892171	4.364063071	4.126522958	0	0.070607622	4.640263255	2.474424001	8.063646093	1.693436133	0.328687247	0	0	5.758635211	1.658298183	0	0	0.211012079	0	0.031412142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4285
H1111_004_0	2008	7																					2400											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2155.887086	305.2450311	1032.154713		416.9891591	27.23230478	19.44823438	722.8281819	383.5355095	6662.935774	562.7271587	70.54221486	4.043055795	3622.555761		3494.429397	915.3390037	947.6052883			24.73638992	678.6884859					0.089554875															1(a) $200 per Day	1(b) $200 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $100 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $35 per Visit	8(a) Diagnostic: $25 per procedure; other $0 per procedure	8(b) X-rays $25 per visit; other: $25 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a) $25 per Visit; 9(c) $25/$35 per Visit; 9(d) $35 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $15 per Visit	7(e)/7(h) $25/35 per Visit	7(c)/7(i) $15 per Visit		7(g) $15 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $25 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $25 per visit															121.6691	121.6691	25.5505		60.8345	0.121669089	0.121669089	27.2235	21.2921	15.2086	15.2086	15.2086	0.121669089	15.2952		9.1252	19.7712	9.1252			0.121669089	15.2086					15.2086															21.8587	3.094907076	2.197673166	0	2.113945466	3.313329719	2.366248964	1.639823597	0.680522735	8.444513823	0.713192717	0.08940424	0.491914916	4.617299853	0	2.657275262	1.508114602	0.720589202	0	0	3.009654031	0.86016052	0	0	0	0	0.000113501	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.3774	0	38.87115613	21.8587	3.094907076	2.197673166	0	2.113945466	3.313329719	2.366248964	1.639823597	0.680522735	8.444513823	0.713192717	0.08940424	0.491914916	4.617299853	0	2.657275262	1.508114602	0.720589202	0	0	3.009654031	0.86016052	0	0	0	0	0.000113501	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.3774		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3																																																								0	0	0	21.8587	3.094907076	2.197673166	0	2.113945466	3.313329719	2.366248964	1.639823597	0.680522735	8.444513823	0.713192717	0.08940424	0.491914916	4.617299853	0	2.657275262	1.508114602	0.720589202	0	0	3.009654031	0.86016052	0	0	0	0	0.000113501	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.3774
H1111_005_0	2008	8																					2500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		1957.549745	134.2664712	879.2649547		271.742452	10.22992627	17.76626403	422.8100725	399.6370837	3350.49202	440.3142517	67.10204472	15.09901096	2815.49814		3844.670375	378.7773239	554.4266595				684.247593					0.072448161															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															131.4467	131.4467	31.5472		56.3343	0.150224747	0.150224747	30.9839	56.3343	15.0225	49.0213	56.3343	110.0007	54.4652		18.7781	15.0225	15.0225				18.7781					18.7781															21.4428	1.470739864	2.311528723	0	1.275701287	1.536788088	2.668932525	1.091690468	1.876105622	4.194390141	1.798732963	0.315012116	0.138408507	12.77889844	0	6.016298287	0.474181065	0.694071707	0	0	0	1.070738768	0	0	0	0	0.00011337	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1551	0	20.26304735	21.4428	1.470739864	2.311528723	0	1.275701287	1.536788088	2.668932525	1.091690468	1.876105622	4.194390141	1.798732963	0.315012116	0.138408507	12.77889844	0	6.016298287	0.474181065	0.694071707	0	0	0	1.070738768	0	0	0	0	0.00011337	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1551		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.0736	0.0592	0.2552	0.2547	0.0654	0.1253	0.1088	0.0307	0.2648	0.0416	0.108	0.0217	0.005	0.189	0.0189	0.1826	0.0274	0.0296			0.1638	0.0387			0.0051																	4.0692	0	0	23.5164	1.52998232	2.566749466	0.254725982	1.341127354	1.662052491	2.77770557	1.12241973	2.140876474	4.235955285	1.906777137	0.336691246	0.143407934	12.96790019	0.018891367	6.198930175	0.501619879	0.723715094	0	0	0.16375994	1.109458932	0	0	0.005058988	0	0.00011337	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2243
H1111_801_0	2008	4																					3750											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1921.249939	151.8224273	819.8494535		138.1469795	14.42192923	2.684739704	570.1574619	35.85388454	11643.63766	45.86628272		0.343032193	29.70843962	4826.725985	4731.820095	557.837785	2.218163525			28.67256817	966.5970144			119.1605084		17.88200547															$425 (1a); $0 (1a1)	$425 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$30/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $30 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											239.9352	239.9352	90.3286		98.7969	0.169366055	0.280881622	28.2277	0.169366055	3.3873	0.091930797		0.169366055	0.169267391	30	34.7737	37.5	0.169366055			0.169366055	35			35		35															38.4146	3.035629274	6.171318571	0	1.137374047	2.442585263	0.754094042	1.341185003	6.072430991	3.286728299	4.216523941	0	0.058098009	5.028670074	12.06681496	13.7119138	1.743243078	0.375681606	0	0	4.856159765	2.819241292	0	0	0.347551483	0	0.052155849	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.932	0	59.00641042	38.4146	3.035629274	6.171318571	0	1.137374047	2.442585263	0.754094042	1.341185003	6.072430991	3.286728299	4.216523941	0	0.058098009	5.028670074	12.06681496	13.7119138	1.743243078	0.375681606	0	0	4.856159765	2.819241292	0	0	0.347551483	0	0.052155849	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.932																																																																																				0			38.4146	3.035629274	6.171318571	0	1.137374047	2.442585263	0.754094042	1.341185003	6.072430991	3.286728299	4.216523941	0	0.058098009	5.028670074	12.06681496	13.7119138	1.743243078	0.375681606	0	0	4.856159765	2.819241292	0	0	0.347551483	0	0.052155849	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.932
H1111_804_0	2008	4																					3750											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1921.249939	151.8224273	819.8494535		138.1469795	14.42192923	2.684739704	570.1574619	35.85388454	11643.63766	45.86628272		0.343032193	29.70843962	4826.725985	4731.820095	557.837785	2.218163525			28.67256817	966.5970144			119.1605084		17.88200547															$425 (1a); $0 (1a1)	$425 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$30/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $30 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											239.9352	239.9352	90.3286		98.7969	0.169366055	0.280881622	28.2277	0.169366055	3.3873	0.091930797		0.169366055	0.169267391	30	34.7737	37.5	0.169366055			0.169366055	35			35		35															38.4146	3.035629274	6.171318571	0	1.137374047	2.442585263	0.754094042	1.341185003	6.072430991	3.286728299	4.216523941	0	0.058098009	5.028670074	12.06681496	13.7119138	1.743243078	0.375681606	0	0	4.856159765	2.819241292	0	0	0.347551483	0	0.052155849	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.932	0	59.00641042	38.4146	3.035629274	6.171318571	0	1.137374047	2.442585263	0.754094042	1.341185003	6.072430991	3.286728299	4.216523941	0	0.058098009	5.028670074	12.06681496	13.7119138	1.743243078	0.375681606	0	0	4.856159765	2.819241292	0	0	0.347551483	0	0.052155849	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.932																																																																																				0			38.4146	3.035629274	6.171318571	0	1.137374047	2.442585263	0.754094042	1.341185003	6.072430991	3.286728299	4.216523941	0	0.058098009	5.028670074	12.06681496	13.7119138	1.743243078	0.375681606	0	0	4.856159765	2.819241292	0	0	0.347551483	0	0.052155849	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.932
H1112_001_0	2008	8																					3150											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1667.409604	64.93916414	713.8106458	1415.607661	290.7100326	9.968979396	2.767316475	1148.580261	241.5064514	3076.929262	1029.690215	115.5742518	0.018528053	369.8703224	7923.501732	15609.48763	198.8331079	1756.857574	4409.479291	908.9605515	30.51256401	27.6445125	0	162.8571429	600	327.2727273	72	27.42857143	0	1600	3600											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $150.00	$0.00 copayment	Copay between $0.00 and $150.00	$250.00 copayment	20% coinsurance	Copay between $25.00 and $150.00	Copay between $0.00 and $15.00	$35.00 copayment	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $15.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$20.00 copayment	$20.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											105.6405403	75.66633682	28.02651268	0.327835695	44.97161362	0.185238022	0.185238022	19.40122604	111.7881393	0	25.11429121	81.07656531	0.185238022	24.38985194	5.844074522	9.120434305	25.63440306	11.03980784	7.561312279	0	0.185238022	0	0	0	18.52380217	18.52380217	18.52380217	0	0	0	0											14.6788	0.409475722	1.667135259	0.038673893	1.089474939	1.846634021	0.512612229	1.856988772	2.249796402	0	2.154994993	0.780863615	0.0034321	0.751756867	3.85879455	11.86377554	0.424747336	1.616280836	2.778454159	0	5.652086993	0	0	0	0.926190108	0.505194605	0.111142813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.7773	0	4.44500501	14.6788	0.409475722	1.667135259	0.038673893	1.089474939	1.846634021	0.512612229	1.856988772	2.249796402	0	2.154994993	0.780863615	0.0034321	0.751756867	3.85879455	11.86377554	0.424747336	1.616280836	2.778454159	0	5.652086993	0	0	0	0.926190108	0.505194605	0.111142813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.7773	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	14.6788	0.409475722	1.667135259	0.038673893	1.089474939	1.846634021	0.512612229	1.856988772	2.249796402	0	2.154994993	0.780863615	0.0034321	0.751756867	3.85879455	11.86377554	0.424747336	1.616280836	2.778454159	0	5.652086993	0	0	0	0.926190108	0.505194605	0.111142813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.7773
H1112_003_0	2008	8																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1374.299029	91.25758828	734.1350436	2041.958165	406.8703039	14.90679809	3.731863496	1092.334058	226.2130625	3641.26377	1019.179978	38.54578109	0.033759121	279.5131556	7265.421319	20334.5184	350.3130804	3007.828472	4238.416062	836.1790343	31.1436017	38.93348939	0	1236	600	327.2727273	72	27.42857143	0	1600	3600											"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $125.00	$0.00 copayment	Copay between $0.00 and $125.00	$175.00 copayment	20% coinsurance	Copay between $15.00 and $125.00	Copay between $0.00 and $5.00	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $5.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$20.00 copayment	$20.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											80.55669248	51.61342638	62.35	0	47.7490572	0.2	0.2	20.34210863	107.0643586	0	22.30613201	126.6095435	0.2	27.43871264	1.994824473	6.709118793	19.35484466	8.620046473	8.52668049	0	0.2	0	0	20	20	20	20	0	0	0	0											9.2257	0.392509735	3.814443331	0	1.618972784	2.981359618	0.746372699	1.851698172	2.018279703	0	1.894496928	0.406688646	0.006751824	0.63912343	1.207770021	11.36889163	0.565021271	2.160635101	3.011634962	0	6.228720339	0	0	2.06	1	0.545454545	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8646	0	0	9.2257	0.392509735	3.814443331	0	1.618972784	2.981359618	0.746372699	1.851698172	2.018279703	0	1.894496928	0.406688646	0.006751824	0.63912343	1.207770021	11.36889163	0.565021271	2.160635101	3.011634962	0	6.228720339	0	0	2.06	1	0.545454545	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8646	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	9.2257	0.392509735	3.814443331	0	1.618972784	2.981359618	0.746372699	1.851698172	2.018279703	0	1.894496928	0.406688646	0.006751824	0.63912343	1.207770021	11.36889163	0.565021271	2.160635101	3.011634962	0	6.228720339	0	0	2.06	1	0.545454545	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8646
H1112_005_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2538.451986	434.9135699	2701.219484	3823.238163	1291.635617	24.37794176	3.704274313	2955.418073	217.8833492	6263.574316	1156.067751	60.33661131	0.611442956	374.3700586	6720.543102	17213.31796	1230.541613	4917.627205	4382.5837	514.4941586	26.34603277	36.35657195	1250	1236	600	327.2727273	72	27.42857143	0	1600	3600											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $15.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $5.00 and $75.00	$0.00 copayment	$15.00 copayment	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$20.00 copayment	$20.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											38.87376306	27.38015781	31.17	0	48.55717348	0.2	0.2	19.67219829	64.1122127	0	11.74067213	72.34831054	0.2	12.0245591	0	3.28999599	9.242931003	5.420053147	2.914297489	0	0.2	0	0	20	20	20	20	0	0	0	0											8.2233	0.992333515	7.016417608	0	5.226514561	4.875588353	0.740854863	4.844964197	1.164081969	0	1.131084369	0.363770991	0.122288591	0.375136241	0	4.719312254	0.947817602	2.221150067	1.064346056	0	5.269206554	0	0	2.06	1	0.545454545	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0236	0	0	8.2233	0.992333515	7.016417608	0	5.226514561	4.875588353	0.740854863	4.844964197	1.164081969	0	1.131084369	0.363770991	0.122288591	0.375136241	0	4.719312254	0.947817602	2.221150067	1.064346056	0	5.269206554	0	0	2.06	1	0.545454545	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0236	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	8.2233	0.992333515	7.016417608	0	5.226514561	4.875588353	0.740854863	4.844964197	1.164081969	0	1.131084369	0.363770991	0.122288591	0.375136241	0	4.719312254	0.947817602	2.221150067	1.064346056	0	5.269206554	0	0	2.06	1	0.545454545	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0236
H1112_006_0	2008	7																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		389.5946444	39.62483919	2672.521801	46.11444817	20.0876591	23.63924342	4.180876341	27.76719204	13.43986517	6.665416049	16.39124238	42.94596277	0.786734501	5.044308642	9017.015077	81.4049546	7.241519669	22.25864911	20.63444403	5.033000566	27.01867141	0.4667033	0	1236	300	240	36	27.42857143	0	1600	9											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.1801591	708.4	30.26	0.062106864	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.199509539	0.012419319	0.2	0.2	0	20	0	0	0	0	0	0	0											22.9919	2.33918634	6.739209142	2.864023745	4.01753182	4.727848684	0.836175268	5.553438407	2.687973034	1.33308321	3.278248475	0	0.1573469	1.008861728	0	16.28099092	1.448303934	4.451729822	4.116768411	0.062506441	5.403734282	0.09334066	0	2.06	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.4522	0	0	22.9919	2.33918634	6.739209142	2.864023745	4.01753182	4.727848684	0.836175268	5.553438407	2.687973034	1.33308321	3.278248475	0	0.1573469	1.008861728	0	16.28099092	1.448303934	4.451729822	4.116768411	0.062506441	5.403734282	0.09334066	0	2.06	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.4522	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	22.9919	2.33918634	6.739209142	2.864023745	4.01753182	4.727848684	0.836175268	5.553438407	2.687973034	1.33308321	3.278248475	0	0.1573469	1.008861728	0	16.28099092	1.448303934	4.451729822	4.116768411	0.062506441	5.403734282	0.09334066	0	2.06	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.4522
H1112_014_0	2008	8																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1529.950666	47.13172814	644.249029	2090.038361	354.9328234	18.43718556	4.776487529	942.2740033	269.7190447	3815.84846	1085.112356	16.99253167	0.036355764	213.3544233	10594.66578	18128.64535	215.3804501	2938.343733	4189.211479	954.5419898	29.30906582	21.28297129	0	1236	600	327.2727273	72	27.42857143	0	1600	3600											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$150.00 copayment	20% coinsurance	Copay between $25.00 and $100.00	Copay between $0.00 and $5.00	$35.00 copayment	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$20.00 copayment	$20.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											68.14184263	54.02256294	53	0	50.25394435	0.2	0.2	21.29454105	83.45623552	0	18.29497369	108.5224658	0.2	21.71663126	1.503029625	10.38429038	29.95424453	11.88065054	8.030780438	0	0.2	0	0	20	20	20	20	0	0	0	0											8.6878	0.212181396	2.845433211	0	1.486397863	3.687437111	0.955297506	1.672107704	1.875811343	0	1.654341834	0.15367262	0.007271153	0.386111612	1.327008045	15.6877598	0.537629889	2.909119587	2.803553133	0	5.861813164	0	0	2.06	1	0.545454545	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.4762	0	0	8.6878	0.212181396	2.845433211	0	1.486397863	3.687437111	0.955297506	1.672107704	1.875811343	0	1.654341834	0.15367262	0.007271153	0.386111612	1.327008045	15.6877598	0.537629889	2.909119587	2.803553133	0	5.861813164	0	0	2.06	1	0.545454545	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.4762	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	8.6878	0.212181396	2.845433211	0	1.486397863	3.687437111	0.955297506	1.672107704	1.875811343	0	1.654341834	0.15367262	0.007271153	0.386111612	1.327008045	15.6877598	0.537629889	2.909119587	2.803553133	0	5.861813164	0	0	2.06	1	0.545454545	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.4762
H1112_017_0	2008	7																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1645.563781	50.74940859	704.8189451	2213.960837	364.4032596	19.11272071	5.0499672	978.853508	283.298025	4008.561568	1139.90018	17.84673985	0.038649386	223.6851687	11130.10543	19039.0428	224.9882268	3077.556358	4391.139055	1000.749771	31.1625838	22.36261248	0	162.8571429	600	327.2727273	72	27.42857143	0	0	3600											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$150.00 copayment	20% coinsurance	Copay between $25.00 and $100.00	Copay between $0.00 and $5.00	$35.00 copayment	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$20.00 copayment	$20.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											63.77977522	50.56948421	58.3644486	0	47.04159987	0.187215553	0.187215553	19.92249806	78.12887402	0	17.12435578	101.5854672	0.187215553	20.3345849	1.400249548	9.666543392	28.03888171	11.12106342	7.51981374	0	0.187215553	0	0	0	18.72155529	18.72155529	18.72155529	0	0	0	0											8.7461	0.213864285	3.428030758	0	1.428509361	3.578198574	0.945432401	1.625100593	1.844479642	0	1.626671353	0.151080784	0.007235766	0.379045421	1.298743758	15.33681111	0.525701523	2.85214162	2.751712317	0	5.834120354	0	0	0	0.936077764	0.510587871	0.112329332	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.132	0	3.696529896	8.7461	0.213864285	3.428030758	0	1.428509361	3.578198574	0.945432401	1.625100593	1.844479642	0	1.626671353	0.151080784	0.007235766	0.379045421	1.298743758	15.33681111	0.525701523	2.85214162	2.751712317	0	5.834120354	0	0	0	0.936077764	0.510587871	0.112329332	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.132	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	8.7461	0.213864285	3.428030758	0	1.428509361	3.578198574	0.945432401	1.625100593	1.844479642	0	1.626671353	0.151080784	0.007235766	0.379045421	1.298743758	15.33681111	0.525701523	2.85214162	2.751712317	0	5.834120354	0	0	0	0.936077764	0.510587871	0.112329332	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.132
H1112_024_0	2008	7																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1526.607431	48.09934786	467.225932	3723.570243	442.9991972	13.1919242	4.388957205	1187.236291	256.9856322	3012.611695	1236.758205	71.47044824	0.005441636	293.6695022	8992.654348	18428.91426	279.0899778	2127.476379	4436.499261	888.0788609	21.90391959	50.86920997	0	1236	600	327.2727273	72	27.42857143	0	0	3600											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$150.00 copayment	20% coinsurance	Copay between $15.00 and $100.00	Copay between $0.00 and $5.00	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$20.00 copayment	$20.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											65.14615082	55.27799395	62.35	0	48.13436413	0.2	0.2	21.82594906	82.60056148	0	16.44709894	78.4083845	0.2	22.64233178	2.097571593	6.708679107	20.45258447	8.22537754	5.991946538	0	0.2	0	0	20	20	20	20	0	0	0	0											8.2877	0.221569622	2.427628072	0	1.776957056	2.63838484	0.877791441	2.159379901	1.768929793	0	1.69509038	0.466990199	0.001088327	0.554113525	1.571894692	10.302806	0.475675945	1.458274702	2.215272199	0	4.380783918	0	0	2.06	1	0.545454545	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.0058	0	0	8.2877	0.221569622	2.427628072	0	1.776957056	2.63838484	0.877791441	2.159379901	1.768929793	0	1.69509038	0.466990199	0.001088327	0.554113525	1.571894692	10.302806	0.475675945	1.458274702	2.215272199	0	4.380783918	0	0	2.06	1	0.545454545	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.0058	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	8.2877	0.221569622	2.427628072	0	1.776957056	2.63838484	0.877791441	2.159379901	1.768929793	0	1.69509038	0.466990199	0.001088327	0.554113525	1.571894692	10.302806	0.475675945	1.458274702	2.215272199	0	4.380783918	0	0	2.06	1	0.545454545	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.0058
H1112_027_0	2008	7																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1639.648596	51.68189432	516.5037628	3939.732793	454.2557331	13.66061774	4.638170559	1233.819397	269.5587713	3160.955237	1297.173817	74.99088429	0.005775155	307.9912015	9439.604947	19316.46563	291.6104267	2225.805521	4647.852594	929.5511927	23.24657029	53.38345281	0	162.8571429	600	327.2727273	72	27.42857143	0	0	3600											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$150.00 copayment	20% coinsurance	Copay between $15.00 and $100.00	Copay between $0.00 and $5.00	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$20.00 copayment	$20.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											62.43691079	52.98192417	59.75904779	0	46.1341422	0.191689007	0.191689007	20.90892512	79.1775602	0	15.76509704	76.05282923	0.191689007	21.70083037	2.000249636	6.400802423	19.59839049	7.882424999	5.743824756	0	0.191689007	0	0	0	19.16890065	19.16890065	19.16890065	0	0	0	0											8.5312	0.22818385	2.572147753	0	1.746391549	2.618590243	0.889086307	2.149819782	1.77858382	0	1.704172592	0.47527241	0.001107034	0.556972068	1.573463863	10.30340667	0.476257918	1.46206209	2.224704232	0	4.456111963	0	0	0	0.958445033	0.5227882	0.115013404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.3438	0	1.965955203	8.5312	0.22818385	2.572147753	0	1.746391549	2.618590243	0.889086307	2.149819782	1.77858382	0	1.704172592	0.47527241	0.001107034	0.556972068	1.573463863	10.30340667	0.476257918	1.46206209	2.224704232	0	4.456111963	0	0	0	0.958445033	0.5227882	0.115013404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.3438	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	8.5312	0.22818385	2.572147753	0	1.746391549	2.618590243	0.889086307	2.149819782	1.77858382	0	1.704172592	0.47527241	0.001107034	0.556972068	1.573463863	10.30340667	0.476257918	1.46206209	2.224704232	0	4.456111963	0	0	0	0.958445033	0.5227882	0.115013404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.3438
H1112_028_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1244.014663	38.26248153	463.1487218	1820.984562	345.9797245	17.80815446	4.316224975	863.0155387	241.1432717	3430.215103	971.2733089	15.09030295	0.032301594	192.3270373	9173.285501	16340.86434	199.8527553	2691.483153	3765.78727	861.878222	26.04774475	18.99917205	0	162.8571429	600	327.2727273	72	27.42857143	0	0	3600											"$265 days 1 - 5, $0 after day 5, unlimited coverage"	"$265 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $150.00	$0.00 copayment	Copay between $0.00 and $150.00	$265.00 copayment	20% coinsurance	Copay between $20.00 and $150.00	Copay between $0.00 and $15.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $15.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$20.00 copayment	$20.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											120.3890592	95.41490389	30.26	0	50.25394435	0.2	0.2	21.30575348	125.2512697	0	24.80386134	191.7230229	0.2	28.80776186	4.413289579	9.122820186	25.67355087	10.18739069	9.829764391	0	0.2	0	0	0	20	20	20	0	0	0	0											12.4805	0.30423425	1.167906693	0	1.448903818	3.561630891	0.863244995	1.53226636	2.516958414	0	2.007610706	0.241096542	0.006460319	0.461709291	3.373697109	12.42289725	0.42757749	2.284932534	3.084733468	0	5.20954895	0	0	0	1	0.545454545	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.0613	0	0	12.4805	0.30423425	1.167906693	0	1.448903818	3.561630891	0.863244995	1.53226636	2.516958414	0	2.007610706	0.241096542	0.006460319	0.461709291	3.373697109	12.42289725	0.42757749	2.284932534	3.084733468	0	5.20954895	0	0	0	1	0.545454545	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.0613	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	12.4805	0.30423425	1.167906693	0	1.448903818	3.561630891	0.863244995	1.53226636	2.516958414	0	2.007610706	0.241096542	0.006460319	0.461709291	3.373697109	12.42289725	0.42757749	2.284932534	3.084733468	0	5.20954895	0	0	0	1	0.545454545	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.0613
H1112_029_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1258.016906	39.63103864	347.5758307	3280.482679	436.8036484	12.93698587	4.009074801	1100.822504	232.5204041	2739.036352	1116.624205	64.96830875	0.004914815	265.9819985	7790.625627	16578.50524	251.0231154	1922.386384	4004.739537	811.0622669	19.78918056	45.93420902	0	162.8571429	600	327.2727273	72	27.42857143	0	0	3600											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $150.00	$0.00 copayment	Copay between $0.00 and $150.00	$250.00 copayment	20% coinsurance	Copay between $20.00 and $150.00	Copay between $0.00 and $15.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $15.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$20.00 copayment	$20.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											108.5740718	92.11897463	30.26	0	48.13436413	0.2	0.2	21.85741452	123.7547371	0	23.54024879	77.8899994	0.2	33.11499674	6.217877786	8.067874217	24.60079192	9.871310227	8.294434943	0	0.2	0	0	0	20	20	20	0	0	0	0											11.3823	0.304230887	0.876470386	0	1.752105489	2.587397175	0.80181496	2.005094482	2.397958456	0	2.190467633	0.421698461	0.000982963	0.733999418	4.036763169	11.14610791	0.514613953	1.581372698	2.76808763	0	3.957836112	0	0	0	1	0.545454545	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1248	0	0	11.3823	0.304230887	0.876470386	0	1.752105489	2.587397175	0.80181496	2.005094482	2.397958456	0	2.190467633	0.421698461	0.000982963	0.733999418	4.036763169	11.14610791	0.514613953	1.581372698	2.76808763	0	3.957836112	0	0	0	1	0.545454545	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1248	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	11.3823	0.304230887	0.876470386	0	1.752105489	2.587397175	0.80181496	2.005094482	2.397958456	0	2.190467633	0.421698461	0.000982963	0.733999418	4.036763169	11.14610791	0.514613953	1.581372698	2.76808763	0	3.957836112	0	0	0	1	0.545454545	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1248
H1170_002_0	2008	16											Other Non-Covered										2700	Other non-covered svcs										A	A	D	V	T	Coin	Coin	V	Coin	Coin	Coin		V	V	V	V	V	V	Coin	V	S	Coin		Coin	V		V			V		V																																																			0		235.6834859	5.049385626	235.682239	0	222.5622221	9.039845685	0.989998426	164.3183817	76.17088099	0.05	34.22385184	0	0	292.2954612	3362.502785	2936.456599	213.0052216	238.4364231	0.04462607	139.3114217	514.3306136	0	0	10.38	458.746708	0	32.85389799	0	0	27.95035342		23.9480082										$600 per Admission	$600 per Admission	$100/day for days 11-100	$0 per visit	$150 per trip	20% coinsurance	20% coinsurance	$50 per visit	20% coinsurance	20% coinsurance	20% coinsurance		$0 per visit	$30 per visit	$15 per visit	$30 per visit	blended: Individual/Group	$30 per visit	20% coinsurance	$30 per visit	"$8 generic, $40 brand  (50/50)"			20% coinsurance	$30 per visit		$30 per visit			$0 - $75 copay (varies by class)		blended 60/40 PCP/Specialty										590.6803	590.6803	98.44671607	0	150	0.2	0.2	49.22335803	0.192246448	0.194366333	0.19438219	0	0	29.53401482	14.76700741	29.53401482	28.35265423	29.53401482	0.194924498	29.53401482	24	0.2	0	0.2	30	0	30	0	0	20		15										11.6011	0.248547717	1.933511872	0	2.782027777	1.807969137	0.197999685	0.674025211	14.64358133	0.009718317	6.65250727	0	0	0.719388207	4.137841962	7.227112726	0.50327195	0.586832071	0.008698714	0.342868799	1.028661227	0	0	2.076	1.14686677	0	0.082134745	0	0	0.046583922	0	0.02993501	0	0	0	0	0	0	0	0	0	58.4872		0.78	11.6011	0.248547717	1.933511872	0	2.782027777	1.807969137	0.197999685	0.674025211	14.64358133	0.009718317	6.65250727	0	0	0.719388207	4.137841962	7.227112726	0.50327195	0.586832071	0.008698714	0.342868799	1.028661227	0	0	2.076	1.14686677	0	0.082134745	0	0	0.046583922	0	0.02993501	0	0	0	0	0	0	0	0	0	58.4872	2700																																																																																			0			11.6011	0.248547717	1.933511872	0	2.782027777	1.807969137	0.197999685	0.674025211	14.64358133	0.009718317	6.65250727	0	0	0.719388207	4.137841962	7.227112726	0.50327195	0.586832071	0.008698714	0.342868799	1.028661227	0	0	2.076	1.14686677	0	0.082134745	0	0	0.046583922	0	0.02993501	0	0	0	0	0	0	0	0	0	58.4872
H1170_008_0	2008	13											Other Non-Covered										3250	Other non-covered svcs										A	A	D	V	T	Coin	Coin	V	Coin	Coin	Coin		V	V	V	V	V	V	Coin	V	S	Coin			V		V			V		V																																																			0	0	367.8847793	21.53015248	275.6408047	0	368.8452041	16.248982	0.139519259	264.0066014	21.23828368	0.1	35.21111701	0	0	269.1474918	3495.379185	2915.519714	444.6518952	141.6342918	0.898421424	192.9683156	518.5678601	0.1	0	0	1939.152661	0	155.8912631	0	0	36.15835371		32.95332161										$400 per Admission	$400 per Admission	$100 /day for days 11-100	$0 per visit	$150 per trip	20% coinsurance	20% coinsurance	$50 per visit	20% coinsurance	20% coinsurance	20% coinsurance		$0 per visit	$15 per visit	$5 per visit	$15 per visit	blended: Individual/Group	$15 per visit	20% coinsurance	$15 per visit	"$8 generic, $30 brand  (50/50)"	20% coinsurance			$15 per visit		$15 per visit			$0 - $75 copay (varies by class)		blended 60/40 PCP/Specialty										388.9182	0	97.22955312	0	150	0.2	0.2	48.61477656	0.194459106	0.194459106	0.194459106	0	0	14.58443297	4.861477656	14.58443297	14.35108204	14.58443297	0.194459106	14.58443297	19	0.2	0	0.2	15	0	15	0	0	20		9										11.9231	0	2.233369355	0	4.610565052	3.249796399	0.027903852	1.069551828	4.129977661	0.019445911	6.847122344	0	0	0.327113629	1.416058984	3.543433487	0.531769652	0.172137986	0.174706227	0.234527789	0.821065779	0.02	0	0	2.423940827	0	0.194864079	0	0	0.060263923	0	0.024714991	0	0	0	0	0	0	0	0	0	44.0554		0.95	11.9231	0	2.233369355	0	4.610565052	3.249796399	0.027903852	1.069551828	4.129977661	0.019445911	6.847122344	0	0	0.327113629	1.416058984	3.543433487	0.531769652	0.172137986	0.174706227	0.234527789	0.821065779	0.02	0	0	2.423940827	0	0.194864079	0	0	0.060263923	0	0.024714991	0	0	0	0	0	0	0	0	0	44.0554	3250																																																																																			0		0	11.9231	0	2.233369355	0	4.610565052	3.249796399	0.027903852	1.069551828	4.129977661	0.019445911	6.847122344	0	0	0.327113629	1.416058984	3.543433487	0.531769652	0.172137986	0.174706227	0.234527789	0.821065779	0.02	0	0	2.423940827	0	0.194864079	0	0	0.060263923	0	0.024714991	0	0	0	0	0	0	0	0	0	44.0554
H1170_009_0	2008	11											Other Non-Covered										3250	Other non-covered svcs										A	A	D	V	T	Coin	Coin	V	Coin	Coin	Coin		V	V	V	V	V	V	Coin	V	S	Coin		Coin	V		V			V		V																																																			0	0	167.7839085	3.594675515	168.4709313	0	159.09245	6.462963546	0.707672998	117.4584513	54.44864793	0.1	27.92763273	0	0	151.5181326	2164.871052	2046.50857	152.2608925	167.097729	0.031899712	99.58291742	352.4976188	0.1	0	0	312.604765	0	22.38770303	0	0	19.97953723		16.41282017										$800 per Admission	$800 per Admission	$100/day for days 11-100	$0 per visit	$150 per trip	20% coinsurance	20% coinsurance	$50 per visit	20% coinsurance	20% coinsurance	20% coinsurance		$0 per visit	$40 per visit	$25 per visit	$40 per visit	blended: Individual/Group	$40 per visit	20% coinsurance	$40 per visit	"$10 generic, $40 brand  (50/50)"	20% coinsurance			$40 per visit		$40 per visit			$0 - $75 copay (varies by class)		blended 60/40 PCP/Specialty										786.1008	786.1008	98.26259808	0	150	0.2	0.2	49.13129904	0.196525196	0.196525196	0.196525196	0	0	39.30503923	24.56564952	39.30503923	37.73283766	39.30503923	0.196525196	38.79407372	25	0.2	0	0.2	40	0	40	0	0	25	0	31										10.9913	0.235481437	1.379532617	0	1.988655625	1.292592709	0.1415346	0.480907191	10.70053122	0.01965252	5.4884835	0	0	0.496285512	4.431788628	6.70317497	0.478769628	0.547315233	0.006269097	0.321935587	0.734370039	0.02	0	0	1.042015883	0	0.074625677	0	0	0.041624036	0	0.042399785	0	0	0	0	0	0	0	0	0	47.6592		0.74	10.9913	0.235481437	1.379532617	0	1.988655625	1.292592709	0.1415346	0.480907191	10.70053122	0.01965252	5.4884835	0	0	0.496285512	4.431788628	6.70317497	0.478769628	0.547315233	0.006269097	0.321935587	0.734370039	0.02	0	0	1.042015883	0	0.074625677	0	0	0.041624036	0	0.042399785	0	0	0	0	0	0	0	0	0	47.6592	3250																																																																																			0		0	10.9913	0.235481437	1.379532617	0	1.988655625	1.292592709	0.1415346	0.480907191	10.70053122	0.01965252	5.4884835	0	0	0.496285512	4.431788628	6.70317497	0.478769628	0.547315233	0.006269097	0.321935587	0.734370039	0.02	0	0	1.042015883	0	0.074625677	0	0	0.041624036	0	0.042399785	0	0	0	0	0	0	0	0	0	47.6592
H1170_801_0	2008	5											Other Non-Covered										3250	Other non-covered svcs										A	A	Coin	V	T	Coin	Coin	V	Coin	Coin	Coin		V	Coin	V	V	V	Coin	Coin	V	S	Coin			V		Coin			V		V										21.63		1.17			0.87	0.08		6.16	2.43	3.15			0.08				0.22	0.08																							35.87		162.9191336	0	5.074928699	0	151.3996982	3.76125808	0.342140023	98.95756807	30.41250528	11.97597253	15.5469425		0	0.404493818	2154.117417	2266.596495	183.2321012	0.989974402	0.37437807	130.8881769	353.7547868	0.1			10.78096879		0.666779893			18.0459423		14.88352798										$700 per admission		20% coinsurance	$0 per visit	$150 per trip	20% coinsurance	20% coinsurance	$50 per visit	20% coinsurance	20% coinsurance	20% coinsurance			20% coinsurance	$20 per visit	$40 per visit	blended: Individual/Group	20% coinsurance	20% coinsurance	$40 per visit	$5 - $40 range	20% coinsurance			$40 per visit		20% coinsurance			20% coinsurance		blended 60/40 PCP/Specialty										678.9889	0	0.189607812	0	150	0.189607812	0.189607812	50	0.189607812	0.189607812	0.189607812	0	0	0.189607812	20	40	38.8	0.189607812	0.189607812	38.79936736	0	0.2	0		40	0	0.2	0	0	0.2	0	28										9.2184	0	0.962246128	0	1.892496227	0.713163916	0.064872421	0.4123232	5.766448592	2.270737951	2.947821755	0	0	0.076695188	3.590195694	7.555321648	0.59245046	0.187706881	0.070985007	0.423198205	0	0.02	0	0	0.035936563	0	0.133355979	0	0	0.000300766	0	0.034728232	0	0	0	0	0	0	0	0	0	36.9693	500	0.7	30.8484	0	2.132246128	0	1.892496227	1.583163916	0.144872421	0.4123232	11.92644859	4.700737951	6.097821755	0	0	0.156695188	3.590195694	7.555321648	0.59245046	0.407706881	0.150985007	0.423198205	0	0.02	0	0	0.035936563	0	0.133355979	0	0	0.000300766	0	0.034728232	0	0	0	0	0	0	0	0	0	72.8393																																																																																				0		0	30.8484	0	2.132246128	0	1.892496227	1.583163916	0.144872421	0.4123232	11.92644859	4.700737951	6.097821755	0	0	0.156695188	3.590195694	7.555321648	0.59245046	0.407706881	0.150985007	0.423198205	0	0.02	0	0	0.035936563	0	0.133355979	0	0	0.000300766	0	0.034728232	0	0	0	0	0	0	0	0	0	72.8393
H1170_802_0	2008	5											Other Non-Covered										3250	Other non-covered svcs										A	A	Coin	V	T	Coin	Coin	V	Coin	Coin	Coin		V	Coin	V	V	V	Coin	Coin	V	S	Coin			V		Coin			V		V										21.63		1.17			0.87	0.08		6.16	2.43	3.15			0.08				0.22	0.08																							35.87		162.9191336	0	5.074928699	0	151.3996982	3.76125808	0.342140023	98.95756807	30.41250528	11.97597253	15.5469425		0	0.404493818	2154.117417	2266.596495	183.2321012	0.989974402	0.37437807	130.8881769	353.7547868	0.1			10.78096879		0.666779893			18.0459423		14.88352798										$700 per admission		20% coinsurance	$0 per visit	$150 per trip	20% coinsurance	20% coinsurance	$50 per visit	20% coinsurance	20% coinsurance	20% coinsurance			20% coinsurance	$20 per visit	$40 per visit	blended: Individual/Group	20% coinsurance	20% coinsurance	$40 per visit	$5 - $40 range	20% coinsurance			$40 per visit		20% coinsurance			20% coinsurance		blended 60/40 PCP/Specialty										678.9889288	0	0.189607812	0	150	0.189607812	0.189607812	50	0.189607812	0.189607812	0.189607812	0	0	0.189607812	20	40	38.8	0.189607812	0.189607812	38.79936736	0	0.2	0		40	0	0.2	0	0	0.2	0	28										9.2184	0	0.962246128	0	1.892496227	0.713163916	0.064872421	0.4123232	5.766448592	2.270737951	2.947821755	0	0	0.076695188	3.590195694	7.555321648	0.59245046	0.187706881	0.070985007	0.423198205	0	0.02	0	0	0.035936563	0	0.133355979	0	0	0.000300766	0	0.034728232	0	0	0	0	0	0	0	0	0	36.9693	500	0.7	30.8484	0	2.132246128	0	1.892496227	1.583163916	0.144872421	0.4123232	11.92644859	4.700737951	6.097821755	0	0	0.156695188	3.590195694	7.555321648	0.59245046	0.407706881	0.150985007	0.423198205	0	0.02	0	0	0.035936563	0	0.133355979	0	0	0.000300766	0	0.034728232	0	0	0	0	0	0	0	0	0	72.8393																																																																																				0		0	30.8484	0	2.132246128	0	1.892496227	1.583163916	0.144872421	0.4123232	11.92644859	4.700737951	6.097821755	0	0	0.156695188	3.590195694	7.555321648	0.59245046	0.407706881	0.150985007	0.423198205	0	0.02	0	0	0.035936563	0	0.133355979	0	0	0.000300766	0	0.034728232	0	0	0	0	0	0	0	0	0	72.8393
H1216_001_0	2008	6																					2500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1918.865767	140.8926815	1600.589773	2637.849091	1027.985084	17.31093187	3.272682947	1117.464903	326.0122682	4760.320888	1331.607653	33.59358501	0.604599072	563.916779	8398.624983	18261.99749	473.9672899	4586.437113	4322.121531	878.8505903	28.7580431	24.34609961	740	218.5714286	200	138.4615385	46.8	17.82857143	0	1600	3600											"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $125.00	$0.00 copayment	Copay between $0.00 and $125.00	$175.00 copayment	20% coinsurance	Copay between $20.00 and $125.00	Copay between $0.00 and $5.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $5.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											72.62196411	42.79402913	54.91227401	0	29.44094767	0.176142018	0.176142018	16.71274212	88.70146212	0	18.86217928	96.81988272	0.176142018	25.82513924	1.604589678	6.622569239	19.55729172	9.381168235	4.769664339	0	0.176142018	0	0	0	8.807100884	8.807100884	17.61420177	0	0	0	0											11.6127	0.502447126	7.32433535	0	2.522071254	3.049182468	0.576456978	1.556325229	2.409813738	0	2.09308519	0.271043913	0.1064953	1.213602445	1.123028913	10.07844523	0.772459713	3.585511513	1.717922411	0	5.065499737	0	0	0	0.146785015	0.101620395	0.068695387	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8975	0	7.571169243	11.6127	0.502447126	7.32433535	0	2.522071254	3.049182468	0.576456978	1.556325229	2.409813738	0	2.09308519	0.271043913	0.1064953	1.213602445	1.123028913	10.07844523	0.772459713	3.585511513	1.717922411	0	5.065499737	0	0	0	0.146785015	0.101620395	0.068695387	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8975	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.9359		0											13.9359	0	0	11.6127	0.502447126	7.32433535	0	2.522071254	3.049182468	0.576456978	1.556325229	2.409813738	0	2.09308519	0.271043913	0.1064953	1.213602445	1.123028913	10.07844523	0.772459713	3.585511513	1.717922411	0	5.065499737	0	0	0	0.146785015	0.101620395	0.068695387	0	13.93594241	0	0	0	0	0	0	0	0	0	0	0	0	69.8334
H1216_002_0	2008	6																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1927.1893	141.7209081	1611.718317	2657.299451	1035.500957	17.4865689	3.306591198	1124.35795	327.4715808	4795.409476	1336.871694	33.83947999	0.611052988	566.9141988	8453.438115	18254.83281	468.1725653	4559.510566	4335.708057	885.0436527	29.06898797	24.43262834	740	218.5714286	200	138.4615385	46.8	17.82857143	0	1600	3600											"$225 days 1 - 5, $0 after day 5, unlimited coverage"	"$225 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $150.00	$0.00 copayment	Copay between $0.00 and $150.00	$225.00 copayment	20% coinsurance	Copay between $25.00 and $150.00	Copay between $0.00 and $5.00	$35.00 copayment	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $5.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											94.47218669	55.67043022	55.56649031	0	29.79418621	0.178240546	0.178240546	16.911247	107.8523191	0	22.7929352	98.30893611	0.178240546	31.30816814	1.623824562	7.75643753	23.19123976	11.07199479	5.153168289	0	0.178240546	0	0	0	8.912027314	8.912027314	17.82405463	0	0	0	0											15.1721	0.657471994	7.463127518	0	2.570992361	3.116815593	0.589368621	1.584524584	2.943214118	0	2.539269158	0.27722694	0.108914418	1.479087088	1.143908371	11.79937253	0.904791851	4.206906434	1.861886106	0	5.181272296	0	0	0	0.148533789	0.102831084	0.069513813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.9212	0	7.803442788	15.1721	0.657471994	7.463127518	0	2.570992361	3.116815593	0.589368621	1.584524584	2.943214118	0	2.539269158	0.27722694	0.108914418	1.479087088	1.143908371	11.79937253	0.904791851	4.206906434	1.861886106	0	5.181272296	0	0	0	0.148533789	0.102831084	0.069513813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.9212	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.0261		0											14.0261	0	0	15.1721	0.657471994	7.463127518	0	2.570992361	3.116815593	0.589368621	1.584524584	2.943214118	0	2.539269158	0.27722694	0.108914418	1.479087088	1.143908371	11.79937253	0.904791851	4.206906434	1.861886106	0	5.181272296	0	0	0	0.148533789	0.102831084	0.069513813	0	14.026071	0	0	0	0	0	0	0	0	0	0	0	0	77.9472
H1216_003_0	2008	8																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		457.5379522	104.297347	2038.995179	40.79185417	22.09090731	27.20991427	5.261823325	30.96027007	18.64978104	7.923800239	17.76544475	35.89191841	2.276505489	6.892617011	7142.810235	84.55757972	27.53383086	36.60560721	17.85642975	4.045515874	25.30936489	0.38765077	740	645	0	0	0	0	0	1600	12											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.4	708.4	30.26	0.11962558	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.196955437	0.022497701	0.2	0.2	0	0	0	0	0	0	0	0	0											27.01	6.157020051	5.141666178	4.879749203	4.418181461	5.441982855	1.052364665	6.192054014	3.729956207	1.584760048	3.553088951	0	0.455301098	1.378523402	0	16.91151594	5.506766172	7.321121441	3.516920926	0.091014806	5.061872978	0.077530154	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.4814	0	0	27.01	6.157020051	5.141666178	4.879749203	4.418181461	5.441982855	1.052364665	6.192054014	3.729956207	1.584760048	3.553088951	0	0.455301098	1.378523402	0	16.91151594	5.506766172	7.321121441	3.516920926	0.091014806	5.061872978	0.077530154	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.4814	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	27.01	6.157020051	5.141666178	4.879749203	4.418181461	5.441982855	1.052364665	6.192054014	3.729956207	1.584760048	3.553088951	0	0.455301098	1.378523402	0	16.91151594	5.506766172	7.321121441	3.516920926	0.091014806	5.061872978	0.077530154	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.4814
H1216_004_0	2008	7																					1000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2295.634667	908.4526226	1966.839397	3590.349543	2188.095638	26.17331642	4.546882335	3181.829415	381.6361713	6770.073958	1435.027098	31.96740702	1.992572333	609.0713614	6737.897289	16891.32123	2861.159537	6313.477753	4686.524798	621.1947306	21.6813967	18.00588352	740	218.5714286	200	138.4615385	46.8	17.82857143	0	1600	0											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $10.00 and $75.00	$0.00 copayment	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											31.36463321	18.02747938	40.59256966	0	20.89228563	0.130208724	0.130208724	12.86411379	41.61303282	0	7.341096589	47.10190595	0.130208724	11.32641819	0	2.816284808	8.76468328	4.812404349	1.485640696	0	0.130208724	0	0	0	6.510436193	6.510436193	13.02087239	0	0	0	0											6.0001	1.364759244	6.653255436	0	3.809526589	3.40799413	0.592043746	3.410951304	1.323419877	0	0.877889378	0.12547715	0.259450301	0.574883079	0	3.964230948	2.089763096	2.531917316	0.580207664	0	2.823106996	0	0	0	0.10850727	0.075120418	0.050781402	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6234	0	21.77397149	6.0001	1.364759244	6.653255436	0	3.809526589	3.40799413	0.592043746	3.410951304	1.323419877	0	0.877889378	0.12547715	0.259450301	0.574883079	0	3.964230948	2.089763096	2.531917316	0.580207664	0	2.823106996	0	0	0	0.10850727	0.075120418	0.050781402	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6234	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							16.3689		0											16.3689	0	0	6.0001	1.364759244	6.653255436	0	3.809526589	3.40799413	0.592043746	3.410951304	1.323419877	0	0.877889378	0.12547715	0.259450301	0.574883079	0	3.964230948	2.089763096	2.531917316	0.580207664	0	2.823106996	0	0	0	0.10850727	0.075120418	0.050781402	0	16.36888021	0	0	0	0	0	0	0	0	0	0	0	0	56.9923
H1230_001_0	2008	10																					3000											D	Coin	D		Coin	Coin	Coin	V	V		O			V	V	V	Coin	V	V	V	O	Coin			V	Coin	V			V	V											0	0	0		0	0	0	0	0		0			0	0	0	0	0	0	0	0	0			0	0	0			0	0											0	0	0	0	457.8098063	0	9.156776296	6.028717539	0.200616757	246.0031849	631.5760646	0	1916.598089	0	0	522.219166	9292.555954	1522.101516	5.41000022	424.5587771	0	0	805.8725021	0.054743682	0	0	222.940913	0	32.76546246	0	0	0	9.27813736	0										$0 copay	20% 191-220	$50/day 21 to 100	$0 copay	Twenty percent	Twenty percent	Twenty percent	$50/visit	$10/visit	$0 copay	$10 per test	$0 copay	$0 copay	$10/visit Radiation Therapy	$10/visit	$10/visit	20% for 1st 20 visit & 50% 21+	$10/visit	$0 copay	$0 copay	$10/generic $40 brand	Twenty percent	$0 copay	$0 copay	$10/visit	$0 copay	$10/visit	$0 copay	$0 copay	$10/visit	$10/visit; $10/generic $40/brand											0	0.2	24.77295191	0	0.198	0.198	0.198	49.5	9.9	0	9.9	0	0	8	9.9	9.9	0.249867243	9.9	0	0	24.75	0.198	0	0	9.9	0	9.9	0	0	9.9	10	0	0									0	0	0.94510836	0	1.813041707	1.193686073	0.039722118	1.014763138	0.521050253	0	1.581193423	0	0	0.348146111	7.666358662	1.25573375	1.351781842	0.350260991	0	0	1.662112036	0.010839249	0	0	0.183926253	0	0.027031507	0	0	0	0.007731781	0	0	0	0	0	0	0	0	0	0	19.9725	0	0.26	0	0	0.94510836	0	1.813041707	1.193686073	0.039722118	1.014763138	0.521050253	0	1.581193423	0	0	0.348146111	7.666358662	1.25573375	1.351781842	0.350260991	0	0	1.662112036	0.010839249	0	0	0.183926253	0	0.027031507	0	0	0	0.007731781	0	0	0	0	0	0	0	0	0	0	19.9725	3000																																																																																			0	0	0	0	0	0.94510836	0	1.813041707	1.193686073	0.039722118	1.014763138	0.521050253	0	1.581193423	0	0	0.348146111	7.666358662	1.25573375	1.351781842	0.350260991	0	0	1.662112036	0.010839249	0	0	0.183926253	0	0.027031507	0	0	0	0.007731781	0	0	0	0	0	0	0	0	0	0	19.9725
H1230_003_0	2008	8																					3000											D	Coin	D		Coin	Coin	Coin	V	V		O			Coin	V	V	Coin	V	V	V	O	Coin			V		V			V	V											0	0	0		0	0	0	0	0		0			0	0	0	0	0	0	0	0	0			0		0			0	0											0	0	922.5066414	0	306.7325702	0	6.135040118	4.039240751	0.134413227	164.8221338	423.1559633	0	1284.12072	0	0	21.0260401	5707.650442	935.1910768	3.324397223	260.784027	0	0	539.9345764	0.036678267	0	0	136.932569	0	20.12485206	0	0	0	6.216352031	0										$250/day (1-12 days)	20% 191-220	$50/day 21 to 100	$0 copay	Twenty percent	Twenty percent	Twenty percent	$50/visit	$250/visit	$0 copay	$25/$100 (routine/advanced)	$0 copay	$0 copay	20% Radiation therapy	$25/visit	$25/visit	20% for 1st 20 visit & 50% 21+	$25/visit	$0 copay	$0 copay	$10/generic $40 brand	20% lens/contact post cataract	$0 copay	$0 copay	$25/visit		$25/visit	$0 copay	$0 copay	$25/visit	$25/visit; $10/generic & $40/brand											205.7852553	0.163437763	20.02619523	0	0.180930472	0.180930472	0.180930472	45.23261806	226.1630903	0	32.04567143	0	0	0.088116488	22.61630903	22.61630903	0.214289578	22.61630903	0	0	25	0.198	0	0	25	0	25	0	0	25	10	0	0									15.8199	0	0.511890528	0	1.110015706	0.730821736	0.024319449	0.621278052	7.97518836	0	3.429209221	0	0	1.852740804	10.75716552	1.762547533	0.712383678	0.491497679	0	0	1.124863701	0.007262297	0	0	0.285276185	0	0.041926775	0	0	0	0.005180293	0	0	0	0	0	0	0	0	0	0	47.2634	0	6.83	15.8199	0	0.511890528	0	1.110015706	0.730821736	0.024319449	0.621278052	7.97518836	0	3.429209221	0	0	1.852740804	10.75716552	1.762547533	0.712383678	0.491497679	0	0	1.124863701	0.007262297	0	0	0.285276185	0	0.041926775	0	0	0	0.005180293	0	0	0	0	0	0	0	0	0	0	47.2634	3000																																																																																			0	0	0	15.8199	0	0.511890528	0	1.110015706	0.730821736	0.024319449	0.621278052	7.97518836	0	3.429209221	0	0	1.852740804	10.75716552	1.762547533	0.712383678	0.491497679	0	0	1.124863701	0.007262297	0	0	0.285276185	0	0.041926775	0	0	0	0.005180293	0	0	0	0	0	0	0	0	0	0	47.2634
H1230_801_0	2008	4																					3000											Coin	Coin	D		Coin	Coin	Coin	V	V	Coin	Coin				V	V	Coin	V	Coin	Coin	O	Coin			V	Coin	V			V												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	266.86124	2.152640106	0	0	9.157557525	5.147713342	0.573419777	237.2650126	642.2263525	26.38767033	45.94242773	0	0	0	9228.280029	1362.188018	2.397443498	472.0974441	0	0	673.5089157	0.054743682	0	0	232.0512521	0	37.97485279	0	0	0	5.058125883											20% room and board	20% room and board	$0 copay	$0 copay	Twenty percent	Twenty percent	Twenty percent	$50/visit	$30/visit	20% OP Lab	20% OP Radiology	$0 copay	$0 copay	$0 copay	$30/visit	$30/visit	20% for 1st 20 visit & 50% 21+	$30/visit	$0 copay	$0 copay	$10/generic $40 brand	20% lens/contact post cataract	$0 copay	$0 copay	$30/visit		$30/visit	$0 copay	$0 copay	$30/visit	$30/visit; $10/generic &$40/brand											0.095232832	0.155110107	0	0	0.172624036	0.172624036	0.172624036	43.15600888	25.89360533	0.172624036	0.172624036	0	0	0	25.89360533	25.89360533	0.181255237	25.89360533	0	0	21.57800444	0.172624036	0	0	25.89360533	0	25.89360533	0	0	25.89360533	20											25.414	0.333896236	0	0	1.580814536	0.888619051	0.098986036	0.853284249	1.385796309	4.55514614	7.930767277	0	0	0	19.91278675	2.93932991	0.43454919	1.018692075	0	0	1.211081531	0.009450075	0	0	0.500720295	0	0.081942154	0	0	0	0.00843021	0	0	0	0	0	0	0	0	0	0	69.1582	0	14.33	25.414	0.333896236	0	0	1.580814536	0.888619051	0.098986036	0.853284249	1.385796309	4.55514614	7.930767277	0	0	0	19.91278675	2.93932991	0.43454919	1.018692075	0	0	1.211081531	0.009450075	0	0	0.500720295	0	0.081942154	0	0	0	0.00843021	0	0	0	0	0	0	0	0	0	0	69.1582	3000																																																																																			0	0	0	25.414	0.333896236	0	0	1.580814536	0.888619051	0.098986036	0.853284249	1.385796309	4.55514614	7.930767277	0	0	0	19.91278675	2.93932991	0.43454919	1.018692075	0	0	1.211081531	0.009450075	0	0	0.500720295	0	0.081942154	0	0	0	0.00843021	0	0	0	0	0	0	0	0	0	0	69.1582
H1230_802_0	2008	7																					3000											Coin	Coin	D		Coin	Coin	Coin	V	V	Coin	Coin				V	V	Coin	V	Coin	Coin	O	Coin			V		V			V												0	0	0		0	0	0	0	0		0			0	0	0	0	0	0	0	0	0			0		0			0	0											0	0	266.86124	2.152640106	0	0	9.157557525	5.147713342	0.573419777	237.2650126	642.2263525	26.38767033	45.94242773	0	0	0	9228.280029	1362.188018	2.397443498	472.0974441	0	0	673.5089157	0.054743682	0	0	232.0512521		37.97485279	0	0	0	5.058125883											20% room and board	20% room and board	$0 copay	$0 copay	Twenty percent	Twenty percent	Twenty percent	$50/visit	$30/visit	20% OP Lab	20% OP Radiology	$0 copay	$0 copay	$0 copay	$30/visit	$30/visit	20% for 1st 20 visit & 50% 21+	$30/visit	$0 copay	$0 copay	$10/generic $40 brand	20% lens/contact post cataract	$0 copay	$0 copay	$30/visit		$30/visit	$0 copay	$0 copay	$30/visit	$0 copay											0.095232832	0.155110107	0	0	0.172624036	0.172624036	0.172624036	43.15600888	25.89360533	0.172624036	0.172624036	0	0	0	25.89360533	25.89360533	0.181255237	25.89360533	0	0	21.57800444	0.172624036	0	0	25.89360533	0	25.89360533	0	0	25.89360533	20	0	0									25.414	0.333896236	0	0	1.580814536	0.888619051	0.098986036	0.853284249	1.385796309	4.55514614	7.930767277	0	0	0	19.91278675	2.93932991	0.43454919	1.018692075	0	0	1.211081531	0.009450075	0	0	0.500720295	0	0.081942154	0	0	0	0.00843021	0	0	0	0	0	0	0	0	0	0	69.1582	0	14.33	25.414	0.333896236	0	0	1.580814536	0.888619051	0.098986036	0.853284249	1.385796309	4.55514614	7.930767277	0	0	0	19.91278675	2.93932991	0.43454919	1.018692075	0	0	1.211081531	0.009450075	0	0	0.500720295	0	0.081942154	0	0	0	0.00843021	0	0	0	0	0	0	0	0	0	0	69.1582	3000																																																																																			0	0	0	25.414	0.333896236	0	0	1.580814536	0.888619051	0.098986036	0.853284249	1.385796309	4.55514614	7.930767277	0	0	0	19.91278675	2.93932991	0.43454919	1.018692075	0	0	1.211081531	0.009450075	0	0	0.500720295	0	0.081942154	0	0	0	0.00843021	0	0	0	0	0	0	0	0	0	0	69.1582
H1230_803_0	2008	3																					3000											Coin	Coin	D		Coin	Coin	Coin	V	V	Coin	Coin				V	V	Coin	V	Coin	Coin	O	Coin			V	Coin	V			V	V											0	0	0		0	0	0	0	0		0			0	0	0	0	0	0	0	0				0	0	0			0	0											0	0	266.86124	2.152640106	0	0	9.157557525	5.147713342	0.573419777	237.2650126	642.2263525	26.38767033	45.94242773	0	0	0	9228.280029	1362.188018	2.397443498	472.0974441	0	0	673.5089157	0.054743682	0	0	232.0512521	0	37.97485279	0	0	0	5.058125883	0	0									20% room and board	20% room and board	$0 copay	$0 copay	Twenty percent	Twenty percent	Twenty percent	$50/visit	$30/visit	20% OP Lab	20% OP Radiology	$0 copay	$0 copay	$0 copay	$30/visit	$30/visit	20% for 1st 20 visit & 50% 21+	$30/visit	$0 copay	$0 copay	$10/generic $40 brand	20% lens/contact post cataract	$0 copay	$0 copay	$30/visit		$30/visit	$0 copay	$0 copay	$30/visit	$30/vist; $10/generic&$40 brand											0.095232832	0.155110107	0	0	0.172624036	0.172624036	0.172624036	43.15600888	25.89360533	0.172624036	0.172624036	0	0	0	25.89360533	25.89360533	0.181255237	25.89360533	0	0	21.57800444	0.172624036	0	0	25.89360533	0	25.89360533	0	0	25.89360533	20	0	0									25.414	0.333896236	0	0	1.580814536	0.888619051	0.098986036	0.853284249	1.385796309	4.55514614	7.930767277	0	0	0	19.91278675	2.93932991	0.43454919	1.018692075	0	0	1.211081531	0.009450075	0	0	0.500720295	0	0.081942154	0	0	0	0.00843021	0	0	0	0	0	0	0	0	0	0	69.1582	0	14.33	25.414	0.333896236	0	0	1.580814536	0.888619051	0.098986036	0.853284249	1.385796309	4.55514614	7.930767277	0	0	0	19.91278675	2.93932991	0.43454919	1.018692075	0	0	1.211081531	0.009450075	0	0	0.500720295	0	0.081942154	0	0	0	0.00843021	0	0	0	0	0	0	0	0	0	0	69.1582	3000																																																																																			0		0	25.414	0.333896236	0	0	1.580814536	0.888619051	0.098986036	0.853284249	1.385796309	4.55514614	7.930767277	0	0	0	19.91278675	2.93932991	0.43454919	1.018692075	0	0	1.211081531	0.009450075	0	0	0.500720295	0	0.081942154	0	0	0	0.00843021	0	0	0	0	0	0	0	0	0	0	69.1582
H1230_804_0	2008	5																					3000											Coin	Coin	D		Coin	Coin	Coin	V	V	Coin	Coin				V	V	Coin	V	Coin	Coin	O	Coin			V	Coin	V			V												0	0	0		0	0	0	0	0		0			0	0	0	0	0	0	0	0	0			0	0	0			0	0											0	0	266.86124	2.152640106	0	0	9.157557525	5.147713342	0.573419777	237.2650126	642.2263525	26.38767033	45.94242773	0	0	0	9228.280029	1362.188018	2.397443498	472.0974441	0	0	673.5089157	0.054743682	0	0	232.0512521	0	37.97485279	0	0	0	5.058125883											20% Room & Board	20% Room & Board	$0 copay	$0 copay	Twenty percent	Twenty percent	Twenty percent	$50/visit	$30/visit	20% OP Lab	20% OP Radiology	$0 copay	$0 copay	$0 copay	$30/visit	$30/visit	20% for 1st 20 visit & 50% for vis 21+	$30/visit	$0 copay	$0 copay	$10/generic & $40/brand	20% lens/contact post cataract	$0 copay	$0 copay	$30/visit	$0 copay	$30/visit	$0 copay	$0 copay	$30/visit	$10/generic & $40/brand											0.095232832	0.155110107	0	0	0.172624036	0.172624036	0.172624036	43.15600888	25.89360533	0.172624036	0.172624036	0	0	0	25.89360533	25.89360533	0.181255237	25.89360533	0	0	21.57800444	0.172624036	0	0	25.89360533	0	25.89360533	0	0	25.89360533	20											25.414	0.333896236	0	0	1.580814536	0.888619051	0.098986036	0.853284249	1.385796309	4.55514614	7.930767277	0	0	0	19.91278675	2.93932991	0.43454919	1.018692075	0	0	1.211081531	0.009450075	0	0	0.500720295	0	0.081942154	0	0	0	0.00843021	0	0	0	0	0	0	0	0	0	0	69.1582	0	14.33	25.414	0.333896236	0	0	1.580814536	0.888619051	0.098986036	0.853284249	1.385796309	4.55514614	7.930767277	0	0	0	19.91278675	2.93932991	0.43454919	1.018692075	0	0	1.211081531	0.009450075	0	0	0.500720295	0	0.081942154	0	0	0	0.00843021	0	0	0	0	0	0	0	0	0	0	69.1582	3000																																																																																			0		0	25.414	0.333896236	0	0	1.580814536	0.888619051	0.098986036	0.853284249	1.385796309	4.55514614	7.930767277	0	0	0	19.91278675	2.93932991	0.43454919	1.018692075	0	0	1.211081531	0.009450075	0	0	0.500720295	0	0.081942154	0	0	0	0.00843021	0	0	0	0	0	0	0	0	0	0	69.1582
H1254_001_0	2008	6																					3250											A	A	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	V	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		350.0452369	10.56458678	984.835628	0	200.2525253	9.531284328	10.16456949	252.1979192	319.1737554	0	1038.905529	23.39907652	0	188.9643736	4239.913273	4574.673217	359.3740845	584.7184069	0	0	27.24151001	8.587622725	0	0	0	0	0	0	0	0	0											1a (IP Acute) - $200	1b (IP Psych) - $200	"2 (SNF) - $0 days 1 - 15, $80 days 16 - 100"	6 (Home Health)- $0	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11a (Medical Equip), 11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER), 4b (UC) - $50"	"9a (OP Surgery), 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $20	9a (OP Observation) - $50	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT) - $25; 9c (OP SA) - $25; 3 (CORF), 5 (Part Hospital), 9d (Cardiac Rehab) - $0"	"7a (PCP), 14c (Routine Physical) - $10; 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14g (Bone Mass), 14h (Mamm), 14i (Diab Mon.), 14j (Nutrition Therap) - $0"	"7b (Chiro), 7d (Spec), 7f (Pod) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"			15 (Part B Rx) - 20%	"13a (Blood) - $0; 16b (MCR Comp Dental) - $25, 17a (MCR Eye Exam) - $25; 17b (MCR Eyewear) - $25; 18a (MCR Hearing Exam) - $25"					18a1 (Hearing Exam Non-covered) - $0															170.1952656	170.1952656	27.63120137	0	85.0976328	0.170195266	0.170195266	42.5488164	85.0976328	0	32.79541434	42.5488164	0	21.2744082	8.50976328	21.2744082	21.2744082	21.2744082	0	0	0.170195266	0.311002355	0	0	0	0	0	0	0	0	0											4.9647	0.149836888	2.267682629	0	1.420084656	1.622179468	1.729961605	0.894226913	2.263410919	0	2.839278107	0.082966918	0	0.335008768	3.006721523	8.110288784	0.637122581	1.036628173	0	0	4.636376031	2.670770888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.6672		6.77	4.9647	0.149836888	2.267682629	0	1.420084656	1.622179468	1.729961605	0.894226913	2.263410919	0	2.839278107	0.082966918	0	0.335008768	3.006721523	8.110288784	0.637122581	1.036628173	0	0	4.636376031	2.670770888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.6672																																																																																				0			4.9647	0.149836888	2.267682629	0	1.420084656	1.622179468	1.729961605	0.894226913	2.263410919	0	2.839278107	0.082966918	0	0.335008768	3.006721523	8.110288784	0.637122581	1.036628173	0	0	4.636376031	2.670770888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.6672
H1254_002_0	2008	5																					3250											A	A	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	V	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		385.3248706	8.098467573	765.0388909	0	194.5005661	16.02663984	15.57601463	370.431528	336.2057626	0	1080.145605	25.90813206	0	107.9831358	3998.474832	3874.280778	252.3699127	607.2529605	0	0	18.30869594	7.385065948	0	0	0	0	0	0	0	0	0											1a (IP Acute) - $200	1b (IP Psych) - $200	"2 (SNF) - $0 days 1 - 15, $80 days 16 - 100"	6 (Home Health)- $0	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11a (Medical Equip), 11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER), 4b (UC) - $50"	"9a (OP Surgery), 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $20	9a (OP Observation) - $50	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT) - $25; 9c (OP SA) - $25; 3 (CORF), 5 (Part Hospital), 9d (Cardiac Rehab) - $0"	"7a (PCP), 14c (Routine Physical) - $10; 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14g (Bone Mass), 14h (Mamm), 14i (Diab Mon.), 14j (Nutrition Therap) - $0"	"7b (Chiro), 7d (Spec), 7f (Pod) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"			15 (Part B Rx) - 20%	"13a (Blood) - $0; 16b (MCR Comp Dental) - $25, 17a (MCR Eye Exam) - $25; 17b (MCR Eyewear) - $25; 18a (MCR Hearing Exam) - $25"					18a1 (Hearing Exam Non-covered) - $0															171.1299331	171.1299331	27.78294464	0	85.56496656	0.171129933	0.171129933	42.78248328	85.56496656	0	31.67475026	42.78248328	0	21.39124164	8.556496656	21.39124164	21.39124164	21.39124164	0	0	0.171129933	0.302776371	0	0	0	0	0	0	0	0	0											5.4951	0.115490851	1.771252763	0	1.386869536	2.742637804	2.665522342	1.320665055	2.397286236	0	2.851111858	0.092367852	0	0.192491113	2.851078044	6.906306358	0.449875482	1.082491235	0	0	3.133165912	2.23602347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.6897		6.36	5.4951	0.115490851	1.771252763	0	1.386869536	2.742637804	2.665522342	1.320665055	2.397286236	0	2.851111858	0.092367852	0	0.192491113	2.851078044	6.906306358	0.449875482	1.082491235	0	0	3.133165912	2.23602347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.6897																																																																																				0			5.4951	0.115490851	1.771252763	0	1.386869536	2.742637804	2.665522342	1.320665055	2.397286236	0	2.851111858	0.092367852	0	0.192491113	2.851078044	6.906306358	0.449875482	1.082491235	0	0	3.133165912	2.23602347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.6897
H1254_003_0	2008	5																					3250											A	A	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	V	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	341.0366442	10.19553597	1194.808787	0	144.4767349	11.46044082	12.60859825	321.944595	362.6214771	0	999.9183657	66.6319317	0	202.7132456	4698.252615	4573.964217	302.341978	339.3574055	0	0	27.30948548	8.496393739	0	0	0	0	0	0	0	0	0											1a (IP Acute) - $200	1b (IP Psych) - $200	"2 (SNF) - $0 days 1 - 15, $80 days 16 - 100"	6 (Home Health)- $0	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11a (Medical Equip), 11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER), 4b (UC) - $50"	"9a (OP Surgery), 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $20	9a (OP Observation) - $50	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT) - $25; 9c (OP SA) - $25; 3 (CORF), 5 (Part Hospital), 9d (Cardiac Rehab) - $0"	"7a (PCP), 14c (Routine Physical) - $10; 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14g (Bone Mass), 14h (Mamm), 14i (Diab Mon.), 14j (Nutrition Therap) - $0"	"7b (Chiro), 7d (Spec), 7f (Pod) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"			15 (Part B Rx) - 20%	"13a (Blood) - $0; 16b (MCR Comp Dental) - $25, 17a (MCR Eye Exam) - $25; 17b (MCR Eyewear) - $25; 18a (MCR Hearing Exam) - $25"					18a1 (Hearing Exam Non-covered) - $0															169.3619851	169.3619851	27.49591828	0	84.68099255	0.169361985	0.169361985	42.34049627	84.68099255	0	32.60818084	42.34049627	0	21.17024814	8.468099255	21.17024814	21.17024814	21.17024814	0	0	0.169361985	0.294077546	0	0	0	0	0	0	0	0	0											4.8132	0.143894684	2.737697064	0	1.019536109	1.940963007	2.135417229	1.13594116	2.558928884	0	2.717126574	0.235102421	0	0.357624142	3.315439123	8.069329786	0.533387891	0.59869004	0	0	4.625188672	2.498598624	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4361		7.13	4.8132	0.143894684	2.737697064	0	1.019536109	1.940963007	2.135417229	1.13594116	2.558928884	0	2.717126574	0.235102421	0	0.357624142	3.315439123	8.069329786	0.533387891	0.59869004	0	0	4.625188672	2.498598624	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4361																																																																																				0			4.8132	0.143894684	2.737697064	0	1.019536109	1.940963007	2.135417229	1.13594116	2.558928884	0	2.717126574	0.235102421	0	0.357624142	3.315439123	8.069329786	0.533387891	0.59869004	0	0	4.625188672	2.498598624	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4361
H1254_801_0	2008	3																					3250											A	A	D	V	T	Coin	P	V	V	P	P	V	V	V	P	P	V	V	Coin	P	S	V	P	P	P	P	P	P	P	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		377.5156604	11.08851873	1143.446925	0	189.2976103	12.70926559	1140.938788	318.6452393	367.2654887	0	1107.632969	46.3494765	0	202.6729748	4767.771961	6764.325393	352.2853184	515.7678997	0	0	1151.193998	0.050575403	0	0	0	0	0	0	0	0	0											1a (IP Acute) - $200	1b (IP Psych) - $200	"2 (SNF) - $0 days 1 - 15, $50 days 16 - 100"	6 (Home Health)- $0	10a (Ambulance) - $75	11a (Medical Equip) - 20%	"11a (Medical Equip), 11b (Med Supp) - 20%; 11c (Diab Supp) - $25/75 30/90 day supply"	"4a (ER), 4b (UC) - $50"	"9a (OP Surgery), 9b (ASC) - $125"	8a (OP Diag Proc/Test/Lab) - $0	8b (X-Rays) - $5; 8b (Hi Tech) - $40; 8b (OP Diag & Therap Rad) - $0	9a (OP Observation) - $50	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT) - $25; 9c (OP SA) - $25; 3 (CORF), 5 (Part Hospital), 9d (Cardiac Rehab) - $0"	"7a (PCP), 14c (Routine Physical) - $10; 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14g (Bone Mass), 14h (Mamm), 14i (Diab Mon.), 14j (Nutrition Therap, 14j (Nutrition Therapy Diabetes)) - $0"	"16b (MCR Comp Dental), 17a (MCR Eye Exam), 7b (Chiro), 7b1 (Routine Chiro), 7d (Spec), 7f (Pod), 7f1 (Routine Podiatry) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"			15 (Part B Rx) - $25/75 30/90 day supply	"16b (MCR Comp Dental) - $25, 17a (MCR Eye Exam) - $25; 18a (MCR Hearing Exam) - $25"			17a1 (Routine Eye Exam) - $150 Allowance		18a1 (Hearing Exam Non-covered) - $250 Allowance															169.4048213	169.4048213	16.24592236	0	63.52680799	0.169404821	24.20266523	42.35120532	105.8780133	0	21.05923294	42.35120532	0	21.17560266	8.470241065	21.17560266	21.17560266	21.17560266	0	0	21.17560266	21.17560266	0	0	0	0	0	0	0	0	0											5.3294	0.156537378	1.548029164	0	1.002122745	2.153010866	2.301146628	1.124584163	3.240445025	0	1.943825059	0.163579683	0	0.357643532	3.365348154	11.93655557	0.621654494	0.910141342	0	0	2.031435558	8.92E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1856	0	6.896463251	5.3294	0.156537378	1.548029164	0	1.002122745	2.153010866	2.301146628	1.124584163	3.240445025	0	1.943825059	0.163579683	0	0.357643532	3.365348154	11.93655557	0.621654494	0.910141342	0	0	2.031435558	8.92E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1856																																																																																				0			5.3294	0.156537378	1.548029164	0	1.002122745	2.153010866	2.301146628	1.124584163	3.240445025	0	1.943825059	0.163579683	0	0.357643532	3.365348154	11.93655557	0.621654494	0.910141342	0	0	2.031435558	8.92E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1856
H1264_001_0	2008	6																					2500											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		238.8522952	10.99464246	959.6517496	4226.012783	751.6162063	20.55531297	4.713011375	976.2493674	178.3122941	3026.230522	564.5251885	53.32917716	0.044504632	308.5213091	8416.01951	20951.07953	489.6215933	4565.381065	4646.653256	601.2665834	33.25285595	23.22412442	0	434.6666667	379.2	262.5230769	46.8	17.82857143	0	0	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	Copay between $0.00 and $20.00	$0.00 copayment	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	59.4258903	0	34.28995355	0.190620338	0.190620338	19.83708509	0	0	7.17765314	0	0.190620338	5.462881274	0	4.490210338	15.35870834	6.547729019	8.125870855	0	0.190620338	0	0	47.65508444	9.531016888	9.531016888	19.06203378	0	0	0	0											0	0	4.752346633	0	2.1477404	3.918260701	0.89839582	1.613828481	0	0	0.337663833	0	0.008483488	0.140451273	0	7.839562824	0.626662937	2.491073173	3.146508689	0	6.338670632	0	0	1.726173059	0.301180134	0.208509323	0.074341932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.5699	0	1.7994558	0	0	4.752346633	0	2.1477404	3.918260701	0.89839582	1.613828481	0	0	0.337663833	0	0.008483488	0.140451273	0	7.839562824	0.626662937	2.491073173	3.146508689	0	6.338670632	0	0	1.726173059	0.301180134	0.208509323	0.074341932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.5699	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.5059		0											13.5059	0	0	0	0	4.752346633	0	2.1477404	3.918260701	0.89839582	1.613828481	0	0	0.337663833	0	0.008483488	0.140451273	0	7.839562824	0.626662937	2.491073173	3.146508689	0	6.338670632	0	0	1.726173059	0.301180134	0.208509323	0.074341932	0	13.50588622	0	0	0	0	0	0	0	0	0	0	0	0	50.0757
H1264_002_0	2008	6																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1806.974605	84.48960617	1276.097164	5776.464005	743.5212424	20.59683268	4.103107437	1510.456925	225.6312874	3230.594094	978.2170536	22.54138612	0.253455306	443.1229152	8760.749	20331.34856	467.2836092	4065.82952	4769.026531	777.3008399	35.02955585	45.24171156	0	434.6666667	379.2	262.5230769	46.8	17.82857143	0	0	3600											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $15.00 and $75.00	Copay between $0.00 and $5.00	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											38.82183495	25.12530811	59.02197999	0	32.09089501	0.189324715	0.189324715	18.35869724	57.60858769	0	11.86787331	68.48661648	0.189324715	16.79869181	1.781904766	5.495064175	18.46773652	8.592643017	7.367625447	0	0.189324715	0	0	47.33117883	9.466235765	9.466235765	18.93247153	0	0	0	0											5.8458	0.176902282	6.276481773	0	1.988355177	3.899489483	0.776819647	2.310835115	1.083191651	0	0.967446339	0.128648606	0.047985354	0.620323774	1.3009017	9.31017209	0.719139214	2.911351803	2.928033436	0	6.631960688	0	0	1.714440477	0.29913305	0.207092112	0.073836639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2184	0	2.831619201	5.8458	0.176902282	6.276481773	0	1.988355177	3.899489483	0.776819647	2.310835115	1.083191651	0	0.967446339	0.128648606	0.047985354	0.620323774	1.3009017	9.31017209	0.719139214	2.911351803	2.928033436	0	6.631960688	0	0	1.714440477	0.29913305	0.207092112	0.073836639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2184	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.8441		0											14.8441	0	0	5.8458	0.176902282	6.276481773	0	1.988355177	3.899489483	0.776819647	2.310835115	1.083191651	0	0.967446339	0.128648606	0.047985354	0.620323774	1.3009017	9.31017209	0.719139214	2.911351803	2.928033436	0	6.631960688	0	0	1.714440477	0.29913305	0.207092112	0.073836639	0	14.84408675	0	0	0	0	0	0	0	0	0	0	0	0	65.0625
H1264_003_0	2008	6																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2224.642188	95.02196551	1066.752858	3923.609839	901.0444227	16.14424042	4.286261928	1226.787026	221.3027181	4177.901967	1135.031621	65.38198958	0.347266579	417.8274868	6850.278431	21433.56974	672.8423174	3808.619026	4752.975235	691.780015	25.07818823	33.25253363	1250	434.6666667	379.2	262.5230769	46.8	17.82857143	0	1600	3600											"$100 days 1 - 3, $0 after day 3, unlimited coverage"	"$100 days 1 - 3, $0 after day 3, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $15.00 and $75.00	$0.00 copayment	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											24.89638427	19.34993114	59.42026822	0	38.26565684	0.190602304	0.190602304	17.63695206	59.7873083	0	12.49808823	68.94877334	0.190602304	14.78832371	0	5.082334268	16.50297915	8.503529265	5.903736778	0	0.190602304	0	0	47.65057596	9.530115192	9.530115192	19.06023038	0	0	0	0											4.6155	0.153222374	5.282228415	0	2.873254723	3.077129419	0.816971398	1.80306533	1.102591153	0	1.182143779	0.375667332	0.06618981	0.514914011	0	9.07771383	0.925325228	2.698891946	2.338359558	0	4.779960453	0	0	1.726009751	0.30115164	0.208489597	0.074334898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.9931	0	2.169090098	4.6155	0.153222374	5.282228415	0	2.873254723	3.077129419	0.816971398	1.80306533	1.102591153	0	1.182143779	0.375667332	0.06618981	0.514914011	0	9.07771383	0.925325228	2.698891946	2.338359558	0	4.779960453	0	0	1.726009751	0.30115164	0.208489597	0.074334898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.9931	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							16.0845		0											16.0845	0	0	4.6155	0.153222374	5.282228415	0	2.873254723	3.077129419	0.816971398	1.80306533	1.102591153	0	1.182143779	0.375667332	0.06618981	0.514914011	0	9.07771383	0.925325228	2.698891946	2.338359558	0	4.779960453	0	0	1.726009751	0.30115164	0.208489597	0.074334898	0	16.0845152	0	0	0	0	0	0	0	0	0	0	0	0	60.0776
H1264_004_0	2008	6																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2208.487224	94.29378729	1057.918244	3889.39191	893.2454994	15.9497788	4.234152807	1217.682581	220.3097917	4141.558248	1145.502986	65.04905158	0.342934274	426.3195937	6796.22658	21422.74515	684.298924	3829.678575	4734.300635	686.0284331	24.75892897	33.1145344	1250	434.6666667	379.2	262.5230769	46.8	17.82857143	0	1600	3600											"$50 days 1 - 3, $0 after day 3, unlimited coverage"	"$50 days 1 - 3, $0 after day 3, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$50.00 copayment	20% coinsurance	Copay between $10.00 and $25.00	$0.00 copayment	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											12.64599555	9.828384202	60.3618224	0	38.86848279	0.193622526	0.193622526	17.91767873	20.25107215	0	8.736795312	35.02065655	0.193622526	6.766747272	0	4.17902034	13.21481275	6.914108841	5.546995853	0	0.193622526	0	0	48.40563144	9.681126288	9.681126288	19.36225258	0	0	0	0											2.3274	0.077229631	5.321489432	0	2.89325811	3.088236457	0.819827361	1.81817044	0.371792457	0	0.834002093	0.189838375	0.0663998	0.240399746	0	7.460507308	0.753573512	2.206567875	2.188428832	0	4.793886363	0	0	1.753359539	0.305923591	0.211793255	0.075512785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.7976	0	1.244963887	2.3274	0.077229631	5.321489432	0	2.89325811	3.088236457	0.819827361	1.81817044	0.371792457	0	0.834002093	0.189838375	0.0663998	0.240399746	0	7.460507308	0.753573512	2.206567875	2.188428832	0	4.793886363	0	0	1.753359539	0.305923591	0.211793255	0.075512785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.7976	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							15.9569		0											15.9569	0	0	2.3274	0.077229631	5.321489432	0	2.89325811	3.088236457	0.819827361	1.81817044	0.371792457	0	0.834002093	0.189838375	0.0663998	0.240399746	0	7.460507308	0.753573512	2.206567875	2.188428832	0	4.793886363	0	0	1.753359539	0.305923591	0.211793255	0.075512785	0	15.95692448	0	0	0	0	0	0	0	0	0	0	0	0	53.7545
H1264_005_0	2008	7																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1803.182377	84.27848744	1272.266342	5758.079541	741.1806755	20.50727137	4.084842376	1506.395437	225.3838455	3220.329076	993.068729	22.51072226	0.252288639	446.5461969	9051.347237	20273.23071	465.9384959	4053.648934	4755.222105	774.9534322	34.86829305	45.19897673	0	483	379.2	262.5230769	46.8	17.82857143	0	0	3600											"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $25.00 and $50.00	$0.00 copayment	Copay between $0.00 and $50.00	$75.00 copayment	20% coinsurance	Copay between $15.00 and $50.00	$0.00 copayment	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											29.43690798	19.05110506	59.67120387	0	32.44248876	0.19140723	0.19140723	18.56103508	38.61710744	0	8.368928381	51.92996137	0.19140723	12.30186021	0	5.555454094	18.67146576	8.687226811	7.404298525	0	0.19140723	0	0	19.14072297	9.570361487	9.570361487	19.14072297	0	0	0	0											4.4233	0.13379986	6.326472021	0	2.003812145	3.925240003	0.781868363	2.330021546	0.725306015	0	0.692576756	0.097415078	0.048289869	0.457779074	0	9.385583546	0.724979556	2.934580642	2.934090335	0	6.674043378	0	0	0.7704141	0.302423423	0.209370062	0.07464882	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9561	0	2.063087396	4.4233	0.13379986	6.326472021	0	2.003812145	3.925240003	0.781868363	2.330021546	0.725306015	0	0.692576756	0.097415078	0.048289869	0.457779074	0	9.385583546	0.724979556	2.934580642	2.934090335	0	6.674043378	0	0	0.7704141	0.302423423	0.209370062	0.07464882	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9561	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.7944		0											14.7944	0	0	4.4233	0.13379986	6.326472021	0	2.003812145	3.925240003	0.781868363	2.330021546	0.725306015	0	0.692576756	0.097415078	0.048289869	0.457779074	0	9.385583546	0.724979556	2.934580642	2.934090335	0	6.674043378	0	0	0.7704141	0.302423423	0.209370062	0.07464882	0	14.79438904	0	0	0	0	0	0	0	0	0	0	0	0	60.7504
H1264_006_0	2008	8																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		423.6285888	61.06812423	2113.982679	99.65992542	24.87497221	30.22687391	7.398080537	22.09086858	13.10922321	6.247783808	14.44684912	73.30832385	0.5597461	5.116337022	8734.865507	110.1498531	34.66402275	53.96976083	28.72437485	4.030477991	28.65425053	0.222632614	1800	909.3333333	0	0	0	0	0	1600	6.75											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.2685212	708.4	30.26	0.15240257	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.199259693	0.015026391	0.2	0.2	0	20	0	0	0	0	0	0	0											25.0036	3.605054934	5.330759656	15.18842873	4.974994443	6.045374783	1.479616107	4.418173716	2.621844642	1.249556762	2.889369824	0	0.11194922	1.023267404	0	22.02997062	6.93280455	10.79395217	5.72361012	0.06056354	5.730850106	0.044526523	0	1.515555556	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.7738	0	0	25.0036	3.605054934	5.330759656	15.18842873	4.974994443	6.045374783	1.479616107	4.418173716	2.621844642	1.249556762	2.889369824	0	0.11194922	1.023267404	0	22.02997062	6.93280455	10.79395217	5.72361012	0.06056354	5.730850106	0.044526523	0	1.515555556	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.7738	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	25.0036	3.605054934	5.330759656	15.18842873	4.974994443	6.045374783	1.479616107	4.418173716	2.621844642	1.249556762	2.889369824	0	0.11194922	1.023267404	0	22.02997062	6.93280455	10.79395217	5.72361012	0.06056354	5.730850106	0.044526523	0	1.515555556	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.7738
H1264_007_0	2008	8																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		402.3145458	53.24567336	3059.672261	106.4052673	21.6358143	34.83493431	6.170705053	28.35477546	13.18667898	8.131678024	13.79951223	66.38684765	0.727647898	5.506455929	9156.515652	88.93573347	18.55236544	41.11541736	27.19403503	3.826018761	28.00368165	0.913642358	0	909.3333333	0	0	0	0	0	0	6.75											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.4	708.4	30.26	0.125015275	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.199336424	0.013257741	0.2	0.2	0	20	0	0	0	0	0	0	0											23.75	3.143269584	7.715473553	13.30228377	4.327162861	6.966986861	1.234141011	5.670955092	2.637335796	1.626335605	2.759902447	0	0.14552958	1.101291186	0	17.78714669	3.710473088	8.223083472	5.420761684	0.050724367	5.600736331	0.182728472	0	1.515555556	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.8718	0	0	23.75	3.143269584	7.715473553	13.30228377	4.327162861	6.966986861	1.234141011	5.670955092	2.637335796	1.626335605	2.759902447	0	0.14552958	1.101291186	0	17.78714669	3.710473088	8.223083472	5.420761684	0.050724367	5.600736331	0.182728472	0	1.515555556	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.8718	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	23.75	3.143269584	7.715473553	13.30228377	4.327162861	6.966986861	1.234141011	5.670955092	2.637335796	1.626335605	2.759902447	0	0.14552958	1.101291186	0	17.78714669	3.710473088	8.223083472	5.420761684	0.050724367	5.600736331	0.182728472	0	1.515555556	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.8718
H1264_008_0	2008	6																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1597.836288	70.6437064	695.4268182	3154.784592	843.4843943	17.10096146	3.951107304	1042.725244	184.3855478	3401.541277	842.5400928	54.49570702	0.227081428	335.57715	5903.719537	18401.41765	530.5270486	3507.831738	4170.588491	593.7050774	24.25933021	26.7220362	0	0	379.2	262.5230769	46.8	17.82857143	0	0	3600											"$150 days 1 - 3, $0 after day 3, unlimited coverage"	"$150 days 1 - 3, $0 after day 3, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$150.00 copayment	20% coinsurance	Copay between $25.00 and $100.00	Copay between $0.00 and $15.00	$35.00 copayment	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $15.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											38.18494415	31.2145859	58.98434123	0	36.93659565	0.189203981	0.189203981	18.09867295	79.48992087	0	16.20407675	102.6644131	0.189203981	19.90957864	5.837319895	7.271314744	24.18623006	11.66259189	7.76739756	0	0.189203981	0	0	0	9.460199075	9.460199075	18.92039815	0	0	0	0											5.0844	0.183759503	3.418274396	0	2.596286834	3.235569996	0.747565233	1.57266193	1.221399383	0	1.13771536	0.466230815	0.04296471	0.556766638	2.871824959	11.15020829	1.069287438	3.40920083	2.699551572	0	4.589961863	0	0	0	0.298942291	0.206960047	0.073789553	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6334	0	2.660909351	5.0844	0.183759503	3.418274396	0	2.596286834	3.235569996	0.747565233	1.57266193	1.221399383	0	1.13771536	0.466230815	0.04296471	0.556766638	2.871824959	11.15020829	1.069287438	3.40920083	2.699551572	0	4.589961863	0	0	0	0.298942291	0.206960047	0.073789553	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6334	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							12.6763		0											12.6763	0	0	5.0844	0.183759503	3.418274396	0	2.596286834	3.235569996	0.747565233	1.57266193	1.221399383	0	1.13771536	0.466230815	0.04296471	0.556766638	2.871824959	11.15020829	1.069287438	3.40920083	2.699551572	0	4.589961863	0	0	0	0.298942291	0.206960047	0.073789553	0	12.67632907	0	0	0	0	0	0	0	0	0	0	0	0	59.3097
H1264_009_0	2008	7																					2000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		376.4110722	56.53203977	2206.416951	7350.525209	2264.168658	29.49136909	6.234147194	2378.131842	171.2309467	6707.286778	1060.918018	97.11131191	0.333784399	373.1288834	8864.02519	21574.96444	2958.309155	6660.507976	5254.445021	461.575206	24.40758841	27.99531442	1250	483	379.2	262.5230769	46.8	17.82857143	0	1600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	Standard Medicare	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	28.76751334	0	32.93318662	0.190135581	0.190135581	18.31078957	0	0	6.142955581	0	0.190135581	0	0	0	0	0	2.910320186	0	0.190135581	0	0	19.01355806	9.506779029	9.506779029	19.01355806	0	0	0	0											0	0	5.289427422	0	6.213857413	5.607358585	1.185333196	3.628789311	0	0	0.543097688	0	0.06346429	0	0	0	0	0	1.274343117	0	4.640750993	0	0	0.765295712	0.300414217	0.207979074	0.074152876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7943	0	1.545755478	0	0	5.289427422	0	6.213857413	5.607358585	1.185333196	3.628789311	0	0	0.543097688	0	0.06346429	0	0	0	0	0	1.274343117	0	4.640750993	0	0	0.765295712	0.300414217	0.207979074	0.074152876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7943	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							18.81		0											18.81	0	0	0	0	5.289427422	0	6.213857413	5.607358585	1.185333196	3.628789311	0	0	0.543097688	0	0.06346429	0	0	0	0	0	1.274343117	0	4.640750993	0	0	0.765295712	0.300414217	0.207979074	0.074152876	0	18.80996472	0	0	0	0	0	0	0	0	0	0	0	0	48.6042
H1264_010_0	2008	7																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2786.964712	406.6064231	3332.832743	12408.61089	2177.528471	33.27742374	4.895502634	3237.32321	166.4108403	6905.299732	1203.096387	26.77056869	0.830919306	374.9658028	8055.074337	18263.48831	1976.624866	6236.517932	4974.572319	529.5492382	25.84109375	50.07397181	0	483	379.2	262.5230769	46.8	17.82857143	0	0	3600											"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$50 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$50.00 copayment	20% coinsurance	Copay between $10.00 and $25.00	$0.00 copayment	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											16.36006036	12.70089344	28.33760313	0	28.49863079	0.187294138	0.187294138	18.30859849	19.34694554	0	7.19986671	33.87603621	0.187294138	6.77428288	0	3.508397839	15.17618399	6.710115653	3.72342004	0	0.187294138	0	0	18.72941383	9.364706917	9.364706917	18.72941383	0	0	0	0											3.7996	0.430355404	7.870374298	0	5.17138166	6.232666406	0.916898948	4.93923757	0.268295122	0	0.721844469	0.075573396	0.155626315	0.211677035	0	5.339631909	2.499801887	3.48731305	1.543535189	0	4.839885388	0	0	0.753858907	0.295924739	0.204870973	0.073044714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8314	0	3.380514419	3.7996	0.430355404	7.870374298	0	5.17138166	6.232666406	0.916898948	4.93923757	0.268295122	0	0.721844469	0.075573396	0.155626315	0.211677035	0	5.339631909	2.499801887	3.48731305	1.543535189	0	4.839885388	0	0	0.753858907	0.295924739	0.204870973	0.073044714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8314	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							16.7204		0											16.7204	0	0	3.7996	0.430355404	7.870374298	0	5.17138166	6.232666406	0.916898948	4.93923757	0.268295122	0	0.721844469	0.075573396	0.155626315	0.211677035	0	5.339631909	2.499801887	3.48731305	1.543535189	0	4.839885388	0	0	0.753858907	0.295924739	0.204870973	0.073044714	0	16.72040221	0	0	0	0	0	0	0	0	0	0	0	0	66.5518
H1264_011_0	2008	7																					2500											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		342.7934504	53.16081074	1939.83536	6709.392956	2045.439419	26.23255126	5.55653488	2187.784948	156.7740259	6038.301217	957.9060375	83.60923085	0.298996444	339.0149091	8098.601316	19730.42782	2751.251321	6061.531581	4804.437122	421.918555	19.39101762	21.206294	0	483	379.2	262.5230769	46.8	17.82857143	0	0	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	Standard Medicare	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	29.57497267	0	33.68723421	0.19547239	0.19547239	18.7462469	0	0	6.263630494	0	0.19547239	0	0	0	0	0	2.991986859	0	0.19547239	0	0	19.54723904	9.773619522	9.773619522	19.54723904	0	0	0	0											0	0	4.780881479	0	5.74209973	5.127739502	1.086149156	3.417729732	0	0	0.499997456	0	0.05844555	0	0	0	0	0	1.197901061	0	3.790408568	0	0	0.786776372	0.308846377	0.213816722	0.076234232	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.087	0	0.627400511	0	0	4.780881479	0	5.74209973	5.127739502	1.086149156	3.417729732	0	0	0.499997456	0	0.05844555	0	0	0	0	0	1.197901061	0	3.790408568	0	0	0.786776372	0.308846377	0.213816722	0.076234232	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.087	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							16.4462		0											16.4462	0	0	0	0	4.780881479	0	5.74209973	5.127739502	1.086149156	3.417729732	0	0	0.499997456	0	0.05844555	0	0	0	0	0	1.197901061	0	3.790408568	0	0	0.786776372	0.308846377	0.213816722	0.076234232	0	16.44617236	0	0	0	0	0	0	0	0	0	0	0	0	43.5332
H1264_012_0	2008	8																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2082.447646	92.28321735	957.8793882	3913.288367	919.8912262	17.44038609	4.763607987	1161.119342	219.3799645	4023.258348	1026.747374	64.9595692	0.273580453	413.7506933	7326.342243	22755.09021	679.55673	4320.67253	4982.584393	704.8116326	29.57995968	31.85191356	1250	1029	379.2	262.5230769	46.8	17.82857143	0	1600	3600											"$50 days 1 - 3, $0 after day 3, unlimited coverage"	"$50 days 1 - 3, $0 after day 3, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$50.00 copayment	20% coinsurance	Copay between $10.00 and $25.00	$0.00 copayment	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											12.96535613	10.59996022	60.09186237	0	37.63600471	0.192756575	0.192756575	18.29840203	20.26650123	0	8.448003167	34.86403144	0.192756575	6.850847836	0	4.364481131	13.78654661	6.785697038	6.319707113	0	0.192756575	0	0	19.27565754	9.637828769	9.637828769	19.27565754	0	0	0	0											2.25	0.081516536	4.796729697	0	2.885085877	3.361749096	0.918216762	1.770552378	0.37050536	0	0.722830422	0.188729372	0.052734431	0.23621192	0	8.276180153	0.780728378	2.443231232	2.624039503	0	5.701731728	0	0	1.652887634	0.304555389	0.210846039	0.075175064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7042	0	1.492008515	2.25	0.081516536	4.796729697	0	2.885085877	3.361749096	0.918216762	1.770552378	0.37050536	0	0.722830422	0.188729372	0.052734431	0.23621192	0	8.276180153	0.780728378	2.443231232	2.624039503	0	5.701731728	0	0	1.652887634	0.304555389	0.210846039	0.075175064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7042	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	2.25	0.081516536	4.796729697	0	2.885085877	3.361749096	0.918216762	1.770552378	0.37050536	0	0.722830422	0.188729372	0.052734431	0.23621192	0	8.276180153	0.780728378	2.443231232	2.624039503	0	5.701731728	0	0	1.652887634	0.304555389	0.210846039	0.075175064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7042
H1286_001_0	2008	6	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						700	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	P	P	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T		V	P	V	P				V	P	V	V	V																																															0		1547.291069	72.93250271	8035.876591	186.4612621	424.5489862	1545.355979	21.15169942	157.1146589	107.0609618	4009.091335	162.3897791	24.69715356	6.054399295	200.9593627	113.7304831	1196.720093	1793.439712	21.68068335		240.9216405	232.8302885	601.4441713	1817.255		287.28	278.16		95.475				90.1565994	1.138946402		234.745	287.945						(1a) $75/day	(1b) $75/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) $0/proc	(11a/11c) $0/proc	(4a) $50/visit (waived if admitted)	(9a/9b) $25/visit	(8a) $0/visit	(8b) $0/visit	(9a) $25/visit	(12) $0/proc	(9a) $25/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $0/visit	(7e/7h) $0/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $0/visit	(15) $0/proc	(Misc. PBP Cats) $0/visit	(10b) $0/trip		(17a1) $0/visit	(17b2) $0/proc	(18a) $0/visit	(18b) $0/proc				(4b) $10/visit (waived if admitted)	(9c) $0/proc 75%/25% Ind/Grp Blended Copay	(9d) $0/visit	(7f1) $0/visit	(18a1) $0/visit						66.5675	66.5675			66.5675			44.3783	22.1892			22.1892		22.1892																		8.8757										8.5833	0.404577635	0	0	2.355095714	0	0	0.581040229	0.197966015	0	0	0.045667412	0	0.371593188	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.066683289	0	0	0	0	0	0	0	0	0	12.6059		1.596871356	8.5833	0.404577635	0	0	2.355095714	0	0	0.581040229	0.197966015	0	0	0.045667412	0	0.371593188	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.066683289	0	0	0	0	0	0	0	0	0	12.6059		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					10	0.3	0.3	0.3	0.3						1.8418	0.028	0.7394	0.0896	0.3309	0.3499	0.0031	0.0345	0.1541	0.6058	0.5547	0.0283	0.0069	0.0911	0.0066	1.4229	0.1478	0.0022		0.1432		0.0933	0.1433		0.0146							0.004	0.0001		0.0131	0.0185						6.8673		0	10.425	0.432618658	0.739396382	0.089588972	2.686037174	0.34990062	0.003145289	0.615495198	0.352042404	0.605754861	0.554686409	0.073928945	0.006854075	0.462704375	0.006573042	1.422935672	0.147812903	0.002221709	0	0.143220714	0	0.093258132	0.14325	0	0.01455	0	0	0	0	0	0	0.070637526	8.54E-05	0	0.01305	0.01845	0	0	0	0	0	19.4732
H1286_002_0	2008	9																					2400											D	D	D	V	T	Coin	Coin	V	V	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	3000	1829.266542	134.8931365	876.235226		114.1948688	11.76677518	2.254670802	445.0468819	217.1723397	9438.107793	41.61748494		0.336692372	26.68058936	4050.095726	4108.766886	470.7740049	1.648185982			21.00809276	824.5762195			122.4		14.32602104															$185 (1a); $0 (1a1)	$185 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$5 (4b)"	$100 (9b)	30% (8a1); $0/$20 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	$100 (incl in h5)	30% (12)	"30% (3, 9d); $60 (5); $40/$30 (9c); $100 (9a)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	$0; $0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	see OON	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											106.7685	106.7685	57.7127		100.9973	0.173138177	0.280991497	28.8564	57.7127	4.617	0.095713476		0.173138177	0.093007037	5	19.9602	37.5	0.173138177			0.173138177	20			20		20															16.2757	1.200195298	4.214160268	0	0.961114166	2.037278005	0.633543325	1.070202859	1.044467305	3.631326173	3.983354155	0	0.058294303	2.481482561	1.687539886	6.834324976	1.471168765	0.285363916	0	0	3.637302883	1.374293699	0	0	0.204	0	0.023876702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.109	0	29.995282	16.2757	1.200195298	4.214160268	0	0.961114166	2.037278005	0.633543325	1.070202859	1.044467305	3.631326173	3.983354155	0	0.058294303	2.481482561	1.687539886	6.834324976	1.471168765	0.285363916	0	0	3.637302883	1.374293699	0	0	0.204	0	0.023876702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.109		$300 (1a); $0 (1a1)	$300 (1b)	"$175 (2a, 2a2)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	40% (9b)	40% (8a1); $0/$20 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	40% (incl in h5)	30% (12)	"40% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 40% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 40% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											1.9063	0.1406	2.0419	0.8371	0.1996	0.4231	0.1559	0.2222	1.388	0.7541	1.1029		0.0121	1.2784	1.3518	2.0949	0.2942	0.0558			0.5332	0.4339			0.063		0.0074															15.2962	0	11.11052425	18.182	1.340770403	6.256051724	0.837063673	1.160695443	2.460331331	0.7894524	1.292437074	2.432461183	4.385393421	5.086244858	0	0.070399475	3.759838066	3.039381275	8.929239786	1.765402518	0.341135752	0	0	4.170461717	1.808183126	0	0	0.267	0	0.031250389	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.4052
H1286_003_0	2008	7																					2000											D	D	D	V	T	Coin	Coin	V	V	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	2500	1829.266542	134.8931365	876.235226		114.1948688	11.76677518	2.254670802	445.0468819	217.1723397	9438.107793	41.61748494		0.336692372	26.68058936	4050.095726	4108.766886	470.7740049	1.648185982			21.00809276	824.5762195			122.4		14.32602104															$125 (1a); $0 (1a1)	$125 (1b)	"$75 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	$75 (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$75 (incl in h5)	30% (12)	"20% (3, 9d); $60 (5); $40/$30 (9c); $75 (9a)"	"$8/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $8 (14c1, 14c)"	"$15 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $15 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$15 (17a1)	$0; $0 n/c (17b)	$15 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	see OON	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											75.2493	75.2493	45.1496		105.3491	0.180598398	0.282109309	30.0997	45.1496	3.612	0.068776383		0.180598398	0.07249312	8	14.9799	37.5	0.120398932			0.180598398	15			15		15															11.4709	0.845884875	3.296805799	0	1.002526895	2.125060752	0.636063622	1.116316028	0.817103681	2.840845251	2.862300063	0	0.060806103	1.934159174	2.700063817	5.12906794	1.471168765	0.198439832	0	0	3.794027904	1.030720274	0	0	0.153	0	0.017907526	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5032	0	21.43720154	11.4709	0.845884875	3.296805799	0	1.002526895	2.125060752	0.636063622	1.116316028	0.817103681	2.840845251	2.862300063	0	0.060806103	1.934159174	2.700063817	5.12906794	1.471168765	0.198439832	0	0	3.794027904	1.030720274	0	0	0.153	0	0.017907526	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5032		$250 (1a); $0 (1a1)	$250 (1b)	"$125 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $25 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											1.6073	0.1185	1.4756	0.6278	0.2019	0.428	0.1561	0.2248	1.0532	0.7629	0.8555		0.0122	0.9702	1.3131	1.507	0.2942	0.0423			0.5394	0.3103			0.045		0.0053															12.5507	0	8.94662448	13.0782	0.964406453	4.772426941	0.627797755	1.204451875	2.553082037	0.792115331	1.341159964	1.870323606	3.603767589	3.717773675	0	0.073053427	2.904350619	4.013160796	6.636053001	1.765402518	0.24075991	0	0	4.333447678	1.340979693	0	0	0.198	0	0.023174446	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0539
H1286_004_0	2008	8																					2900											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	3600	1806.133423	133.1872621	865.1542524		112.7507471	11.47104893	2.198005716	439.4228135	28.22648708	9318.752373	40.57154138		0.328230515	26.0100445	4000.285885	4057.011172	464.8205415	1.60676326			20.48011085	814.1485318			122.4		14.32602104															$275 (1a); $0 (1a1)	$275 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$13 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$13/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $13 (14c1, 14c)"	"$28 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $28 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$28 (17a1)	$0 n/c (17b)	$28 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											149.0977	149.0977	81.326		94.8804	0.162652064	0.279420297	27.1087	0.162652064	4.3374	0.089993345		0.162652064	0.162574815	13	27.9279	37.5	0.162652064			0.162652064	28			28		28															22.4409	1.654826481	5.863296853	0	0.891486054	1.865789781	0.61416741	0.992680936	4.591096371	3.368254008	3.651168725	0	0.053387371	4.228578165	4.333643042	9.441972901	1.452564192	0.26134336	0	0	3.331132291	1.899679907	0	0	0.2856	0	0.033427382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.255	0	44.96213311	22.4409	1.654826481	5.863296853	0	0.891486054	1.865789781	0.61416741	0.992680936	4.591096371	3.368254008	3.651168725	0	0.053387371	4.228578165	4.333643042	9.441972901	1.452564192	0.26134336	0	0	3.331132291	1.899679907	0	0	0.2856	0	0.033427382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.255		$375 (1a); $0 (1a1)	$375 (1b)	"$175 (2a, 2a2)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	40% (9b)	40% (8a1); $0/$20 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	40% (incl in h5)	30% (12)	"40% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 40% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 40% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.5307	0.1866	2.1686	0.816	0.212	0.4436	0.1529	0.236	1.4555	0.8009	1.1575		0.0127	1.3405	1.345	2.0672	0.2905	0.0585			0.5591	0.4283			0.063		0.0074															16.3323	0	10.65472976	24.9716	1.841447351	8.031871784	0.816026329	1.103449796	2.309408368	0.767053832	1.228705229	6.046562723	4.169105261	4.808659833	0	0.066080992	5.569047062	5.678643273	11.50915938	1.743077031	0.319826348	0	0	3.890208781	2.327964008	0	0	0.3486	0	0.04080107	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.5873
H1286_006_0	2008	6																					1100											D	D	D	V	T	V	P	V	V	Coin	V	V	V	V	V		V	V		V	S	P	T		V	P	V																																																								0		2027.489248	287.0655994	958.9878582		386.7053306	3016.398278	1507.896582	665.8972785	353.3277456	7.027068723	174.6674518	64.98621673	37.85044389	3323.656181		3246.718076		880.4319302				630.5779643					0.083206555															1(a) $110 per Day	1(b) $110 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per preocedure; other $0 per procedure	8(b) X-rays $0 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a), 9(d) $25 per visit; 9(c) $0/0 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  $0 per script	"13, 14(a)-(j) $0; 17(a), 16(b) $10 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															61.5965	61.5965	23.5187		41.9976	10.4739	14.963	25.0586	13.9992	0.407610912	5.5997	13.9992	122.9693	13.9992		5.5997		5.5997				5.5997					5.5997															10.4072	1.473520051	1.879509875	0	1.353392093	2.632779399	1.880226858	1.390536818	0.412192385	2.864309893	0.081506867	0.075812964	0.387870111	3.877379527	0	1.515049393	0	0.410844992	0	0	0	0.29425307	0	0	0	0	3.88E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.9364	0	24.31030649	10.4072	1.473520051	1.879509875	0	1.353392093	2.632779399	1.880226858	1.390536818	0.412192385	2.864309893	0.081506867	0.075812964	0.387870111	3.877379527	0	1.515049393	0	0.410844992	0	0	0	0.29425307	0	0	0	0	3.88E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.9364		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3																																																								0	0	0	10.4072	1.473520051	1.879509875	0	1.353392093	2.632779399	1.880226858	1.390536818	0.412192385	2.864309893	0.081506867	0.075812964	0.387870111	3.877379527	0	1.515049393	0	0.410844992	0	0	0	0.29425307	0	0	0	0	3.88E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.9364
H1286_007_0	2008	7																					1500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		1932.327503	132.5365017	873.1961972		252.0581575	8.86745923	15.40007405	386.9195303	365.7135976	3066.083055	402.9378545	61.40603859	14.62604861	2576.771952		3794.944052	372.9251846	546.750807				679.4834809					0.067451361															(1a)$150/day	(1b)$150/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$10/visit"	(9b)$25/visit	"(8a)$15/procedure Diag. services, $0/procedure Other services"	(8b)$15/visit	(9a)$25/visit	(12)20%	"(3,5,9a,9d)$25/visit, (9c)$15/visit"	"(7a) $0/visit PCP, $10/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b)$15 visit, (7d,f)$10/visit"	"(7e,h)$15/visit"	"(7c,i)$15/visit"		(7g)$15/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$15/visit"			(17a)0	(17b)0	(18a)$15/visit															109.5587	109.5587	30.6764		54.7793	0.146078237	0.146078237	26.2941	18.2598	10.9559	10.9559	18.2598	94.9451	18.2475		7.588	10.9559	10.9559				10.9559					10.9559															17.6419	1.210043653	2.232211813	0	1.150631599	1.295342808	2.249615661	0.847807841	0.556487473	2.799300037	0.36787782	0.093438394	0.115722648	3.918301868	0	2.399663257	0.340476584	0.499177461	0	0	0	0.620360929	0	0	0	0	6.16E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.3385	0	14.15184998	17.6419	1.210043653	2.232211813	0	1.150631599	1.295342808	2.249615661	0.847807841	0.556487473	2.799300037	0.36787782	0.093438394	0.115722648	3.918301868	0	2.399663257	0.340476584	0.499177461	0	0	0	0.620360929	0	0	0	0	6.16E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.3385		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$10/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															1.798	0.0514	0.2212	0.2208	0.0567	0.1086	0.0943	0.0286	0.2295	0.036	0.0937	0.0188	0.0043	0.1638	0.0164	0.1583	0.0238	0.0257			0.1419	0.0336			0.0051																	3.5305	0	0	19.4399	1.261395936	2.453449114	0.220800444	1.207343932	1.403923941	2.343901828	0.876417685	0.785994967	2.835329351	0.461532191	0.112230201	0.120056229	4.082131523	0.016375331	2.557971418	0.364260975	0.52487281	0	0	0.141949663	0.65392417	0	0	0.005058988	0	6.16E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.8689
H1286_801_0	2008	3																					3500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	4500	1906.97221	140.6232808	913.4569439		119.0457685	12.17875525	2.33361167	463.9384969	29.96792009	9839.030485	43.07460247		0.348480695	27.61473409	4217.410252	4282.617727	490.7720792	1.705892513			21.7436312	859.6035073			122.4		14.32602104															$275 (1a); $0 (1a1)	$275 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$35/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $35 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											159.5333	159.5333	87.0181		101.5212	0.174036281	0.281126066	29.006	0.174036281	3.4807	0.096256222		0.174036281	0.173948273	35	34.6627	37.5	0.174036281			0.174036281	35			35		35															25.3521	1.869507509	6.623943732	0	1.00713875	2.119545274	0.656039068	1.121418482	5.215505368	2.853913794	4.146198504	0	0.060648284	4.803535314	12.3007799	12.37060838	1.533662748	0.296887189	0	0	3.784180715	2.507176896	0	0	0.357	0	0.041784228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.0216	0	42.92983791	25.3521	1.869507509	6.623943732	0	1.00713875	2.119545274	0.656039068	1.121418482	5.215505368	2.853913794	4.146198504	0	0.060648284	4.803535314	12.3007799	12.37060838	1.533662748	0.296887189	0	0	3.784180715	2.507176896	0	0	0.357	0	0.041784228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.0216		$375 (1a); $0 (1a1)	$375 (1b)	"$175 (2a, 2a2)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	40% (9b)	40% (8a1); $0/$20 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	40% (incl in h5)	30% (12)	"40% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$40/$50 (7a); 40% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $40 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 40% (17b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.895	0.2135	2.4807	0.8664	0.2425	0.5103	0.1634	0.27	1.6742	0.9161	1.331		0.0146	1.5419	2.6746	2.4796	0.3067	0.0673			0.6431	0.5155			0.072		0.0084															19.8867	0	10.275977	28.2471	2.082989966	9.104656117	0.86637107	1.249611847	2.62983515	0.819486209	1.391404929	6.889713269	3.770036909	5.477152612	0	0.075249626	6.345413613	14.97537065	14.85020044	1.840395297	0.364159566	0	0	4.427280622	3.022632961	0	0	0.429	0	0.050211299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.9083
H1302_001_0	2008	5																					1500											A	A	D	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	V	V	V	V	P	Coin	Coin	Coin				V																	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	166.9449852	2.431895395	284.4887386	20.60676659	3.866004751	8.360266509	5.226213028	288.7598578	23.59820358	6.396053081	17.82338478	0	0.275979568	563.3756942	2743.95929	3697.904274	100.2272163	254.6426315	14.68329127	7.54386595	6.957538069	0	0	0	348.1771417	0	0	0	0	0	0											$500/Admit for IP Medical; $500/Admit for IP Surgical	$500/Admit for IP Psych; $500/Admit for IP Substance Abuse	$25/Day for SNF	10% Coinsurance for Home Health	10% Coinsurance for Ambulance	10% Coinsurance for DME	10% Coinsurance for Prosthetics/Supplies; 10% Coinsurance for Diabetes Monitoring Supplies; 10% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $20/Visit for Urgent Care;	10% Coinsurance for OP Fac - Surgery; 10% Coinsurance for OP Fac - ASC	10% Coinsurance for OP Fac - Pathology	10% Coinsurance for OP Fac - Radiology; 10% Coinsurance for OP Fac - CT/MRI/PET		10% Coinsurance for Renal Dialysis - Fac; 10% Coinsurance for Renal Dialysis - Prof	$20/Case for OP Fac - Cardiovascular; $20/Case for OP Fac - Occ Therapy; $20/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Service for Prof - CORF; $20/Service for Prof - CORF;	$20/Visit for PCP - Office Visits; $20/Consult for PCP - Consults; $20/Exam for PCP - Routine Physicals;	$20/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$20/Service for PT/ST (PCP); $20/Service for Occ Therapy (PCP); $20/Service for PT/ST (Specialist); $20/Service for Occ Therapy (Specialist);	10% Coinsurance for Prof Radiology (Office); 10% Coinsurance for Prof Radiology (OP); 10% Coinsurance for Prof Radiology (IP);	$20/Visit for Chiropractor; $20/Exam for Vistion Exams; $20/Service for Podiatrist; 10% Coinsurance for Hearing/Speech Exams; 10% Coinsurance for Prof Path (IP); 10% Coinsurance for Prof Path (OP); 10% Coinsurance for Prof Path (Office); 10% Coinsurance for Prof Path (Labs)	10% Coinsurance for Part B Rx				$20/Exam for Vision (Refractions)																	477.3226889	477.3226889	23.86613445	0.095464538	0.095464538	0.095464538	0.095464538	41.01256572	0.095464538	0.095464538	0.095464538	0	0.095464538	19.09290756	19.09290756	18.80773808	19.09290756	19.09290756	0.095464538	0.095464538	0.095464538	0	0	0	19.09290756	0	0	0	0	0	0											6.6406	0.096733237	0.565803874	1.967215448	0.369066357	0.798108978	0.498918011	0.986898554	2.252791597	0.610596251	1.70150119	0	0.026346262	0.896373338	4.365846756	5.795767918	0.159469081	0.405155685	1.401733614	0.720171676	0.664198156	0	0	0	0.553976165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.4772	0	1.488884055	6.6406	0.096733237	0.565803874	1.967215448	0.369066357	0.798108978	0.498918011	0.986898554	2.252791597	0.610596251	1.70150119	0	0.026346262	0.896373338	4.365846756	5.795767918	0.159469081	0.405155685	1.401733614	0.720171676	0.664198156	0	0	0	0.553976165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.4772		$750/Admit for IP Medical; $750/Admit for IP Surgical	$750/Admit for IP Psych; $750/Admit for IP Substance Abuse	$50/Day for SNF	25% Coinsurance for Home Health	10% Coinsurance for Ambulance	25% Coinsurance for DME	25% Coinsurance for Prosthetics/Supplies; 25% Coinsurance for Diabetes Monitoring Supplies; 25% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $20/Visit for Urgent Care;	25% Coinsurance for OP Fac - Surgery; 25% Coinsurance for OP Fac - ASC	25% Coinsurance for OP Fac - Pathology	25% Coinsurance for OP Fac - Radiology; 25% Coinsurance for OP Fac - CT/MRI/PET		25% Coinsurance for Renal Dialysis - Fac; 25% Coinsurance for Renal Dialysis - Prof	25% Coinsurance for OP Fac - Cardiovascular; 25% Coinsurance for OP Fac - Occ Therapy; 25% Coinsurance for OP Fac - Physical/Speech Therapy; 25% Coinsurance for OP Fac - CORF; 25% Coinsurance for Prof - CORF; 25% Coinsurance for Prof - CORF;	25% Coinsurance for PCP - Office Visits; 25% Coinsurance for PCP - Consults; 25% Coinsurance for PCP - Routine Physicals; 25% Coinsurance for PCP - Tx Injections; 25% Coinsurance for PCP - Allergy Testing; 25% Coinsurance for PCP - Allergy Tx; 25% Coinsurance for PCP - Immunizations;	25% Coinsurance for Speclst - Office Visits; 25% Coinsurance for Speclst - Tx Injections; 25% Coinsurance for Speclst - Allergy Testing; 25% Coinsurance for Speclst - Allergy Tx; 25% Coinsurance for Speclst - Consults; 25% Coinsurance for Speclst - Immunizations;	25% Coinsurance for OP Psych - Non-Physician; 25% Coinsurance for OP Psych - Psychiatrist; 25% Coinsurance for OP Substance Abuse;	25% Coinsurance for PT/ST (PCP); 25% Coinsurance for Occ Therapy (PCP); 25% Coinsurance for PT/ST (Specialist); 25% Coinsurance for Occ Therapy (Specialist);	25% Coinsurance for Prof Radiology (Office); 25% Coinsurance for Prof Radiology (OP); 25% Coinsurance for Prof Radiology (IP);	25% Coinsurance for Chiropractor; 25% Coinsurance for Vistion Exams; 25% Coinsurance for Podiatrist; 25% Coinsurance for Hearing/Speech Exams; 25% Coinsurance for Misc. Medical (PCP); 25% Coinsurance for Misc. Medical; 25% Coinsurance for Prof Path (IP); 25% Coinsurance for Prof Path (OP); 25% Coinsurance for Prof Path (Office); 25% Coinsurance for Prof Path (Labs)	25% Coinsurance for Part B Rx	25% Coinsurance for Blood Products	25% Coinsurance for Non-Emergent Transport																			3.2496	0.0562	0.4297	1.3881	0.1249	0.6959	0.4244	0.3798	1.8266	0.5444	1.5581	0	0.0241	1.0701	1.0995	1.9373	0.0496	0.0412	1.1768	1.3327	0.5796	0.0628	0.04	0	0	0	0	0	0	0	0											18.0914	0	4.062833734	9.8901	0.152884899	0.995516617	3.355361178	0.493940878	1.494020332	0.923363364	1.366691063	4.079371521	1.15502745	3.259602043	0	0.050488172	1.966460495	5.465360887	7.733033157	0.209021914	0.446390486	2.578526599	2.052891927	1.243776644	0.062797981	0.039966959	0	0.553976165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.5686
H1302_002_0	2008	7																					1500											A	A	D	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	V	V	V	V	P	Coin	Coin	Coin				V																	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	132.093389	1.649673454	161.5818338	15.32647118	2.711808915	5.693321029	3.646039125	167.6685622	21.11133755	5.163507901	14.3753609	0	0.209815669	272.4069233	2052.332854	2675.02725	78.16198325	194.8991118	12.81302895	4.981787878	5.986016467	0	0	0	380.5928298	0	0	0	0	0	0											$500/Admit for IP Medical; $500/Admit for IP Surgical	$500/Admit for IP Psych; $500/Admit for IP Substance Abuse	$25/Day for SNF	10% Coinsurance for Home Health	10% Coinsurance for Ambulance	10% Coinsurance for DME	10% Coinsurance for Prosthetics/Supplies; 10% Coinsurance for Diabetes Monitoring Supplies; 10% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $20/Visit for Urgent Care;	10% Coinsurance for OP Fac - Surgery; 10% Coinsurance for OP Fac - ASC	10% Coinsurance for OP Fac - Pathology	10% Coinsurance for OP Fac - Radiology; 10% Coinsurance for OP Fac - CT/MRI/PET		10% Coinsurance for Renal Dialysis - Fac; 10% Coinsurance for Renal Dialysis - Prof	$20/Case for OP Fac - Cardiovascular; $20/Case for OP Fac - Occ Therapy; $20/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Service for Prof - CORF; $20/Service for Prof - CORF;	$20/Visit for PCP - Office Visits; $20/Consult for PCP - Consults; $20/Exam for PCP - Routine Physicals;	$20/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$20/Service for PT/ST (PCP); $20/Service for Occ Therapy (PCP); $20/Service for PT/ST (Specialist); $20/Service for Occ Therapy (Specialist);	10% Coinsurance for Prof Radiology (Office); 10% Coinsurance for Prof Radiology (OP); 10% Coinsurance for Prof Radiology (IP);	$20/Visit for Chiropractor; $20/Exam for Vistion Exams; $20/Service for Podiatrist; 10% Coinsurance for Hearing/Speech Exams; 10% Coinsurance for Prof Path (IP); 10% Coinsurance for Prof Path (OP); 10% Coinsurance for Prof Path (Office); 10% Coinsurance for Prof Path (Labs)	10% Coinsurance for Part B Rx				$20/Exam for Vision (Refractions)																	483.0196378	483.0196381	24.15098189	0.096603928	0.096603928	0.096603928	0.096603928	39.5738023	0.096603928	0.096603928	0.096603928	0	0.096603928	19.32078551	19.32078551	19.03437172	19.32078551	19.32078551	0.096603928	0.096603928	0.096603928	0	0	0	19.32078551	0	0	0	0	0	0											5.317	0.066402056	0.325196662	1.480597312	0.261971392	0.549997172	0.3522217	0.552940211	2.039438123	0.498815143	1.388716324	0	0.020269018	0.438592978	3.304390239	4.24312192	0.125845909	0.313800328	1.237788921	0.481260275	0.578272701	0	0	0	0.612779369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.1894	0	0.844982926	5.317	0.066402056	0.325196662	1.480597312	0.261971392	0.549997172	0.3522217	0.552940211	2.039438123	0.498815143	1.388716324	0	0.020269018	0.438592978	3.304390239	4.24312192	0.125845909	0.313800328	1.237788921	0.481260275	0.578272701	0	0	0	0.612779369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.1894		$750/Admit for IP Medical; $750/Admit for IP Surgical	$750/Admit for IP Psych; $750/Admit for IP Substance Abuse	$50/Day for SNF	25% Coinsurance for Home Health	10% Coinsurance for Ambulance	25% Coinsurance for DME	25% Coinsurance for Prosthetics/Supplies; 25% Coinsurance for Diabetes Monitoring Supplies; 25% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $20/Visit for Urgent Care;	25% Coinsurance for OP Fac - Surgery; 25% Coinsurance for OP Fac - ASC	25% Coinsurance for OP Fac - Pathology	25% Coinsurance for OP Fac - Radiology; 25% Coinsurance for OP Fac - CT/MRI/PET		25% Coinsurance for Renal Dialysis - Fac; 25% Coinsurance for Renal Dialysis - Prof	25% Coinsurance for OP Fac - Cardiovascular; 25% Coinsurance for OP Fac - Occ Therapy; 25% Coinsurance for OP Fac - Physical/Speech Therapy; 25% Coinsurance for OP Fac - CORF; 25% Coinsurance for Prof - CORF; 25% Coinsurance for Prof - CORF;	25% Coinsurance for PCP - Office Visits; 25% Coinsurance for PCP - Consults; 25% Coinsurance for PCP - Routine Physicals; 25% Coinsurance for PCP - Tx Injections; 25% Coinsurance for PCP - Allergy Testing; 25% Coinsurance for PCP - Allergy Tx; 25% Coinsurance for PCP - Immunizations;	25% Coinsurance for Speclst - Office Visits; 25% Coinsurance for Speclst - Tx Injections; 25% Coinsurance for Speclst - Allergy Testing; 25% Coinsurance for Speclst - Allergy Tx; 25% Coinsurance for Speclst - Consults; 25% Coinsurance for Speclst - Immunizations;	25% Coinsurance for OP Psych - Non-Physician; 25% Coinsurance for OP Psych - Psychiatrist; 25% Coinsurance for OP Substance Abuse;	25% Coinsurance for PT/ST (PCP); 25% Coinsurance for Occ Therapy (PCP); 25% Coinsurance for PT/ST (Specialist); 25% Coinsurance for Occ Therapy (Specialist);	25% Coinsurance for Prof Radiology (Office); 25% Coinsurance for Prof Radiology (OP); 25% Coinsurance for Prof Radiology (IP);	25% Coinsurance for Chiropractor; 25% Coinsurance for Vistion Exams; 25% Coinsurance for Podiatrist; 25% Coinsurance for Hearing/Speech Exams; 25% Coinsurance for Misc. Medical (PCP); 25% Coinsurance for Misc. Medical; 25% Coinsurance for Prof Path (IP); 25% Coinsurance for Prof Path (OP); 25% Coinsurance for Prof Path (Office); 25% Coinsurance for Prof Path (Labs)	25% Coinsurance for Part B Rx	25% Coinsurance for Blood Products	25% Coinsurance for Non-Emergent Transport																			3.1132	0.0539	0.3152	0.9011	0.1003	0.5589	0.3409	0.1775	1.3927	0.4136	1.1851	0	0.0195	0.8161	0.9435	1.7595	0.053	0.0443	1.1526	1.3409	0.4418	0.0479	0.0474	0	0	0	0	0	0	0	0											15.2188	0	2.648726685	8.4301	0.120252194	0.640383141	2.381721394	0.362277042	1.108868193	0.693144022	0.730416127	3.432091944	0.912454993	2.573802576	0	0.039760212	1.254718928	4.247849577	6.002623626	0.178880578	0.358067205	2.390396609	1.822140067	1.0201213	0.047874793	0.047403551	0	0.612779369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4082
H1302_004_0	2008	4																					1500											A	A	D	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	V	V	V	V	P	Coin	Coin	Coin				V																	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	162.4968746	2.373748592	258.700031	18.50964449	3.567705427	7.718505369	4.823346002	266.9556576	22.09204158	5.988023107	16.67891018	0	0.257690684	523.5810032	2496.837102	3364.999611	91.95222334	233.5784566	13.32793408	6.804223606	6.509243197	0	0	0	344.5261334	0	0	0	0	0	0											$500/Admit for IP Medical; $500/Admit for IP Surgical	$500/Admit for IP Psych; $500/Admit for IP Substance Abuse	$25/Day for SNF	10% Coinsurance for Home Health	10% Coinsurance for Ambulance	10% Coinsurance for DME	10% Coinsurance for Prosthetics/Supplies; 10% Coinsurance for Diabetes Monitoring Supplies; 10% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $20/Visit for Urgent Care;	10% Coinsurance for OP Fac - Surgery; 10% Coinsurance for OP Fac - ASC	10% Coinsurance for OP Fac - Pathology	10% Coinsurance for OP Fac - Radiology; 10% Coinsurance for OP Fac - CT/MRI/PET		10% Coinsurance for Renal Dialysis - Fac; 10% Coinsurance for Renal Dialysis - Prof	$20/Case for OP Fac - Cardiovascular; $20/Case for OP Fac - Occ Therapy; $20/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Service for Prof - CORF; $20/Service for Prof - CORF;	$20/Visit for PCP - Office Visits; $20/Consult for PCP - Consults; $20/Exam for PCP - Routine Physicals;	$20/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$20/Service for PT/ST (PCP); $20/Service for Occ Therapy (PCP); $20/Service for PT/ST (Specialist); $20/Service for Occ Therapy (Specialist);	10% Coinsurance for Prof Radiology (Office); 10% Coinsurance for Prof Radiology (OP); 10% Coinsurance for Prof Radiology (IP);	$20/Visit for Chiropractor; $20/Exam for Vistion Exams; $20/Service for Podiatrist; 10% Coinsurance for Hearing/Speech Exams; 10% Coinsurance for Prof Path (IP); 10% Coinsurance for Prof Path (OP); 10% Coinsurance for Prof Path (Office); 10% Coinsurance for Prof Path (Labs)	10% Coinsurance for Part B Rx				$20/Exam for Vision (Refractions)																	478.8507269	478.850727	23.94253634	0.095770145	0.095770145	0.095770145	0.095770145	41.25664478	0.095770145	0.095770145	0.095770145	0	0.095770146	19.15402908	19.15402907	18.86889857	19.15402907	19.15402908	0.095770145	0.095770145	0.095770145	0	0	0	19.15402907	0	0	0	0	0	0											6.4843	0.094722603	0.516161241	1.772671343	0.341679667	0.739202381	0.461932548	0.917807895	2.115758034	0.573473843	1.597341652	0	0.024679074	0.835723813	3.985374203	5.291153027	0.146771297	0.372830712	1.276418184	0.651641484	0.623391167	0	0	0	0.549921965	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.373	0	1.291236044	6.4843	0.094722603	0.516161241	1.772671343	0.341679667	0.739202381	0.461932548	0.917807895	2.115758034	0.573473843	1.597341652	0	0.024679074	0.835723813	3.985374203	5.291153027	0.146771297	0.372830712	1.276418184	0.651641484	0.623391167	0	0	0	0.549921965	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.373		$750/Admit for IP Medical; $750/Admit for IP Surgical	$750/Admit for IP Psych; $750/Admit for IP Substance Abuse	$50/Day for SNF	25% Coinsurance for Home Health	10% Coinsurance for Ambulance	25% Coinsurance for DME	25% Coinsurance for Prosthetics/Supplies; 25% Coinsurance for Diabetes Monitoring Supplies; 25% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $20/Visit for Urgent Care;	25% Coinsurance for OP Fac - Surgery; 25% Coinsurance for OP Fac - ASC	25% Coinsurance for OP Fac - Pathology	25% Coinsurance for OP Fac - Radiology; 25% Coinsurance for OP Fac - CT/MRI/PET		25% Coinsurance for Renal Dialysis - Fac; 25% Coinsurance for Renal Dialysis - Prof	25% Coinsurance for OP Fac - Cardiovascular; 25% Coinsurance for OP Fac - Occ Therapy; 25% Coinsurance for OP Fac - Physical/Speech Therapy; 25% Coinsurance for OP Fac - CORF; 25% Coinsurance for Prof - CORF; 25% Coinsurance for Prof - CORF;	25% Coinsurance for PCP - Office Visits; 25% Coinsurance for PCP - Consults; 25% Coinsurance for PCP - Routine Physicals; 25% Coinsurance for PCP - Tx Injections; 25% Coinsurance for PCP - Allergy Testing; 25% Coinsurance for PCP - Allergy Tx; 25% Coinsurance for PCP - Immunizations;	25% Coinsurance for Speclst - Office Visits; 25% Coinsurance for Speclst - Tx Injections; 25% Coinsurance for Speclst - Allergy Testing; 25% Coinsurance for Speclst - Allergy Tx; 25% Coinsurance for Speclst - Consults; 25% Coinsurance for Speclst - Immunizations;	25% Coinsurance for OP Psych - Non-Physician; 25% Coinsurance for OP Psych - Psychiatrist; 25% Coinsurance for OP Substance Abuse;	25% Coinsurance for PT/ST (PCP); 25% Coinsurance for Occ Therapy (PCP); 25% Coinsurance for PT/ST (Specialist); 25% Coinsurance for Occ Therapy (Specialist);	25% Coinsurance for Prof Radiology (Office); 25% Coinsurance for Prof Radiology (OP); 25% Coinsurance for Prof Radiology (IP);	25% Coinsurance for Chiropractor; 25% Coinsurance for Vistion Exams; 25% Coinsurance for Podiatrist; 25% Coinsurance for Hearing/Speech Exams; 25% Coinsurance for Misc. Medical (PCP); 25% Coinsurance for Misc. Medical; 25% Coinsurance for Prof Path (IP); 25% Coinsurance for Prof Path (OP); 25% Coinsurance for Prof Path (Office); 25% Coinsurance for Prof Path (Labs)	25% Coinsurance for Part B Rx	25% Coinsurance for Blood Products	25% Coinsurance for Non-Emergent Transport																			3.2394	0.056	0.3941	1.2478	0.1178	0.6565	0.4004	0.3585	1.739	0.5183	1.4833	0	0.0229	1.0187	1.0118	1.7866	0.0463	0.0385	1.0762	1.2227	0.5518	0.0598	0.0411	0	0	0	0	0	0	0	0											17.0874	0	3.537276834	9.7238	0.150718133	0.910227852	3.020426496	0.459472511	1.395683857	0.862311586	1.276276467	3.854777293	1.091809307	3.080684966	0	0.047594175	1.854374324	4.997191692	7.077778293	0.193034101	0.411325985	2.352655795	1.874341707	1.175147817	0.059783454	0.041064001	0	0.549921965	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.4604
H1302_005_0	2008	5																					1500											A	A	D	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	V	V	V	V	P	Coin	Coin	Coin				V																	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	123.605464	1.543889459	141.3495948	13.37939909	2.365186795	4.966210649	3.180074768	147.210151	18.18946763	4.449783151	12.38105018	0	0.181349723	239.7637779	1798.706502	2337.124348	68.22698033	170.1017477	11.11784884	4.354833313	5.153073307	0	0	0	380.0093062	0	0	0	0	0	0											$500/Admit for IP Medical; $500/Admit for IP Surgical	$500/Admit for IP Psych; $500/Admit for IP Substance Abuse	$25/Day for SNF	10% Coinsurance for Home Health	10% Coinsurance for Ambulance	10% Coinsurance for DME	10% Coinsurance for Prosthetics/Supplies; 10% Coinsurance for Diabetes Monitoring Supplies; 10% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $20/Visit for Urgent Care;	10% Coinsurance for OP Fac - Surgery; 10% Coinsurance for OP Fac - ASC	10% Coinsurance for OP Fac - Pathology	10% Coinsurance for OP Fac - Radiology; 10% Coinsurance for OP Fac - CT/MRI/PET		10% Coinsurance for Renal Dialysis - Fac; 10% Coinsurance for Renal Dialysis - Prof	$20/Case for OP Fac - Cardiovascular; $20/Case for OP Fac - Occ Therapy; $20/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Service for Prof - CORF; $20/Service for Prof - CORF;	$20/Visit for PCP - Office Visits; $20/Consult for PCP - Consults; $20/Exam for PCP - Routine Physicals;	$20/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$20/Service for PT/ST (PCP); $20/Service for Occ Therapy (PCP); $20/Service for PT/ST (Specialist); $20/Service for Occ Therapy (Specialist);	10% Coinsurance for Prof Radiology (Office); 10% Coinsurance for Prof Radiology (OP); 10% Coinsurance for Prof Radiology (IP);	$20/Visit for Chiropractor; $20/Exam for Vistion Exams; $20/Service for Podiatrist; 10% Coinsurance for Hearing/Speech Exams; 10% Coinsurance for Prof Path (IP); 10% Coinsurance for Prof Path (OP); 10% Coinsurance for Prof Path (Office); 10% Coinsurance for Prof Path (Labs)	10% Coinsurance for Part B Rx				$20/Exam for Vision (Refractions)																	485.2084497	485.2084502	24.26042248	0.09704169	0.09704169	0.09704169	0.09704169	39.79218719	0.09704169	0.09704169	0.09704169	0	0.09704169	19.40833799	19.40833799	19.12056871	19.40833798	19.40833799	0.09704169	0.09704169	0.09704169	0	0	0	19.40833799	0	0	0	0	0	0											4.9979	0.062425684	0.285766741	1.298359498	0.229521724	0.481929474	0.30859983	0.488151157	1.765136678	0.431814477	1.201478033	0	0.017598484	0.387784703	2.909158645	3.72392889	0.110347691	0.275116018	1.07889484	0.422600384	0.500062942	0	0	0	0.614612421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.5912	0	0.653520991	4.9979	0.062425684	0.285766741	1.298359498	0.229521724	0.481929474	0.30859983	0.488151157	1.765136678	0.431814477	1.201478033	0	0.017598484	0.387784703	2.909158645	3.72392889	0.110347691	0.275116018	1.07889484	0.422600384	0.500062942	0	0	0	0.614612421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.5912		$750/Admit for IP Medical; $750/Admit for IP Surgical	$750/Admit for IP Psych; $750/Admit for IP Substance Abuse	$50/Day for SNF	25% Coinsurance for Home Health	10% Coinsurance for Ambulance	25% Coinsurance for DME	25% Coinsurance for Prosthetics/Supplies; 25% Coinsurance for Diabetes Monitoring Supplies; 25% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $20/Visit for Urgent Care;	25% Coinsurance for OP Fac - Surgery; 25% Coinsurance for OP Fac - ASC	25% Coinsurance for OP Fac - Pathology	25% Coinsurance for OP Fac - Radiology; 25% Coinsurance for OP Fac - CT/MRI/PET		25% Coinsurance for Renal Dialysis - Fac; 25% Coinsurance for Renal Dialysis - Prof	25% Coinsurance for OP Fac - Cardiovascular; 25% Coinsurance for OP Fac - Occ Therapy; 25% Coinsurance for OP Fac - Physical/Speech Therapy; 25% Coinsurance for OP Fac - CORF; 25% Coinsurance for Prof - CORF; 25% Coinsurance for Prof - CORF;	25% Coinsurance for PCP - Office Visits; 25% Coinsurance for PCP - Consults; 25% Coinsurance for PCP - Routine Physicals; 25% Coinsurance for PCP - Tx Injections; 25% Coinsurance for PCP - Allergy Testing; 25% Coinsurance for PCP - Allergy Tx; 25% Coinsurance for PCP - Immunizations;	25% Coinsurance for Speclst - Office Visits; 25% Coinsurance for Speclst - Tx Injections; 25% Coinsurance for Speclst - Allergy Testing; 25% Coinsurance for Speclst - Allergy Tx; 25% Coinsurance for Speclst - Consults; 25% Coinsurance for Speclst - Immunizations;	25% Coinsurance for OP Psych - Non-Physician; 25% Coinsurance for OP Psych - Psychiatrist; 25% Coinsurance for OP Substance Abuse;	25% Coinsurance for PT/ST (PCP); 25% Coinsurance for Occ Therapy (PCP); 25% Coinsurance for PT/ST (Specialist); 25% Coinsurance for Occ Therapy (Specialist);	25% Coinsurance for Prof Radiology (Office); 25% Coinsurance for Prof Radiology (OP); 25% Coinsurance for Prof Radiology (IP);	25% Coinsurance for Chiropractor; 25% Coinsurance for Vistion Exams; 25% Coinsurance for Podiatrist; 25% Coinsurance for Hearing/Speech Exams; 25% Coinsurance for Misc. Medical (PCP); 25% Coinsurance for Misc. Medical; 25% Coinsurance for Prof Path (IP); 25% Coinsurance for Prof Path (OP); 25% Coinsurance for Prof Path (Office); 25% Coinsurance for Prof Path (Labs)	25% Coinsurance for Part B Rx	25% Coinsurance for Blood Products	25% Coinsurance for Non-Emergent Transport																			2.9813	0.0516	0.2818	0.8063	0.0899	0.5008	0.3055	0.1621	1.2481	0.3708	1.0623	0	0.0174	0.7315	0.845	1.5655	0.0471	0.0393	1.0217	1.1897	0.396	0.0429	0.0484	0	0	0	0	0	0	0	0											13.8051	0	2.046549028	7.9791	0.113995177	0.567552679	2.104669875	0.31940424	0.982735857	0.614096777	0.650296961	3.013257472	0.802619005	2.263800433	0	0.035037768	1.119278773	3.754110468	5.289467911	0.157428709	0.31441008	2.100642496	1.612287468	0.896081493	0.042909055	0.048408069	0	0.614612421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.3962
H1303_001_0	2008	5																					2400											D	D	D	V	T	Coin	Coin	V	V	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	3000	1290.568318	148.1344473	852.1460792		108.220048	12.35982842	2.148623102	581.8867002	220.0738361	7748.982967	33.84966052		0.162724748	21.10837823	3841.894844	4577.522037	449.7478481	2.860505587			13.30507567	732.9180315			162.6381302		15.70055062															$195 (1a); $0 (1a1)	$195 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	$100 (9b)	30% (8a1); $0/$20 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	$100 (incl in h5)	30% (12)	"30% (3, 9d); $60 (5); $40/$30 (9c); $100 (9a)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0; $0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											120.7187	120.7187	61.907		108.3373	0.185721144	0.281854572	30.9535	61.907	4.9526	0.103331267		0.185721144	0.131108174	10	24.976	37.5	0.185721144			0.185721144	25			25		25															12.983	1.490217029	4.396154015	0	0.977022623	2.295481472	0.605599245	1.50095366	1.13534346	3.198111067	3.497728296	0	0.030221426	2.767480926	3.201579036	9.527332273	1.405462025	0.53125637	0	0	2.471033873	1.526912566	0	0	0.338829438	0	0.03270948	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.9124	0	22.97364681	12.983	1.490217029	4.396154015	0	0.977022623	2.295481472	0.605599245	1.50095366	1.13534346	3.198111067	3.497728296	0	0.030221426	2.767480926	3.201579036	9.527332273	1.405462025	0.53125637	0	0	2.471033873	1.526912566	0	0	0.338829438	0	0.03270948	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.9124		$300 (1a); $0 (1a1)	$300 (1b)	"$175 (2a, 2a2)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	40% (9b)	40% (8a1); $0/$20 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	40% (incl in h5)	30% (12)	"40% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 40% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 40% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0; $0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5); 50% (14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											1.458	0.1673	2.1526	0.5796	0.205	0.4817	0.1489	0.315	1.2627	0.6711	0.9787		0.0063	1.0962	1.3038	2.3513	0.2811	0.1049			0.366	0.3818			0.0837		0.0081															14.4039	0	8.73708408	14.4409	1.657564013	6.54878338	0.579619936	1.182055826	2.777200018	0.754455431	1.815936476	2.398041669	3.869251059	4.476416565	0	0.036563547	3.863639819	4.505338859	11.87866789	1.68655443	0.636185189	0	0	2.837075603	1.908729187	0	0	0.42254024	0	0.040790646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.3163
H1303_003_0	2008	5																					2200											D	D	D	V	T	Coin	Coin	V	V	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	2600	1290.568318	148.1344473	852.1460792		108.220048	12.35982842	2.148623102	581.8867002	220.0738361	7748.982967	33.84966052		0.162724748	21.10837823	3841.894844	4577.522037	449.7478481	2.860505587			13.30507567	732.9180315			162.6381302		15.70055062															$140 (1a); $0 (1a1)	$140 (1b)	"$75 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	$75 (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$75 (incl in h5)	30% (12)	"20% (3, 9d); $60 (5); $40/$30 (9c); $75 (9a)"	"$8/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $8 (14c1, 14c)"	"$15 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $15 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$15 (17a1)	$0; $0 n/c (17b)	$15 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											92.6065	92.6065	49.6106		115.7581	0.198442468	0.283874489	33.0737	49.6106	3.9688	0.074522401		0.198442468	0.104857411	8	14.9919	37.5	0.132294979			0.198442468	15			15		15															9.9596	1.143184207	3.522957733	0	1.043945653	2.452714857	0.609939286	1.603764347	0.909833234	2.562878843	2.522557969	0	0.032291501	2.213369889	2.561263229	5.718796694	1.405462025	0.378430526	0	0	2.640292056	0.916147539	0	0	0.203297663	0	0.019625688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.4203	0	15.89155637	9.9596	1.143184207	3.522957733	0	1.043945653	2.452714857	0.609939286	1.603764347	0.909833234	2.562878843	2.522557969	0	0.032291501	2.213369889	2.561263229	5.718796694	1.405462025	0.378430526	0	0	2.640292056	0.916147539	0	0	0.203297663	0	0.019625688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.4203		$265 (1a); $0 (1a1)	$265 (1b)	"$100 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $30 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0; $0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5); 50% (14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											1.3491	0.1548	1.2885	0.4347	0.2148	0.5046	0.1495	0.33	0.992	0.703	0.769		0.0066	0.8613	1.2665	2.0173	0.2811	0.0824			0.3834	0.3268			0.0718		0.0069															12.1943	0	6.520248464	11.3086	1.29803266	4.81149081	0.434714952	1.25872304	2.957327035	0.759427395	1.933716692	1.901864105	3.265914703	3.291583309	0	0.03893503	3.074701828	3.827769906	7.736137881	1.68655443	0.46086719	0	0	3.023729887	1.242928279	0	0	0.275049779	0	0.026552402	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.6147
H1303_004_0	2008	3																					1650											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	S	P	T		V	P	V																																																								0		2169.426872	307.1987293	1047.708083		416.5898546	27.39592631	19.56508641	718.9966926	381.5025061	6627.617606	559.7443155	70.16829233	4.066216322	3588.688344		3359.407074		907.4468092			1349.477549	649.9281564					0.089579247															1(a) $150 per Day	1(b) $150 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $10 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per procedure; other $0 per procedure	8(b) X-rays $10 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a)/(d) $25 Copay Per Visit; 9(c) $0 Copay per Visit"	7(a) PCP $0 per visit; Urgent Care $10 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $10 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															88.0733	88.0733	24.6605		44.0366	0.117431064	0.117431064	21.1376	14.6789	5.8716	5.8716	14.6789	0.117431064	14.6789		5.8716		5.8716			25.9858	5.8716					5.8716															15.9224	2.254667103	2.153085811	0	1.528768434	3.217132776	2.297548914	1.2664882	0.466669221	3.242867447	0.273880711	0.085832679	0.477500109	4.389828027	0	1.64374478	0	0.444010185	0	0	2.9222738	0.318007312	0	0	0	0	4.38E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.9047	0	30.167469	15.9224	2.254667103	2.153085811	0	1.528768434	3.217132776	2.297548914	1.2664882	0.466669221	3.242867447	0.273880711	0.085832679	0.477500109	4.389828027	0	1.64374478	0	0.444010185	0	0	2.9222738	0.318007312	0	0	0	0	4.38E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.9047		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															2.2083	0.1363	0.3033	0.3969	0.0974	0.1677	0.1198	0.0518	0.2339	0.0426	0.1073	0.021	0.022	0.2387	0.0907	0.1692	0.0678	0.049			0.1524	0.0362	0.0077		0.0066																	4.7268	0	0	18.1307	2.390963806	2.456408286	0.396872812	1.626159336	3.384862937	2.417335158	1.318301059	0.700609716	3.28548143	0.381165666	0.10687085	0.49949972	4.628573558	0.090703128	1.8129568	0.06780011	0.493051283	0	0	3.074631035	0.35424667	0.00774	0	0.006631111	0	4.38E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.6316
H1303_006_0	2008	7																					2100											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		1972.789025	135.3117189	886.1099225		273.857933	10.38982364	18.04395703	426.1015961	402.7482084	3376.575181	443.7420431	67.62442575	15.21655487	2837.416442		3874.600654	381.726058	558.7428017				689.5743749					0.073012161															(1a)$150/day	(1b)$150/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															107.2376	107.2376	30.0265		53.6188	0.142983402	0.142983402	29.4903	53.6188	14.2983	46.6583	53.6188	105.558	51.8398		17.8729	14.2983	14.2983				17.8729					17.8729															17.6298	1.20920812	2.217232699	0	1.223660592	1.485572331	2.579986365	1.047156273	1.799572157	4.023285058	1.725355823	0.302161577	0.133852381	12.2575987	0	5.77087066	0.45483742	0.665757889	0	0	0	1.027059272	0	0	0	0	0.000108745	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.553	0	22.15253525	17.6298	1.20920812	2.217232699	0	1.223660592	1.485572331	2.579986365	1.047156273	1.799572157	4.023285058	1.725355823	0.302161577	0.133852381	12.2575987	0	5.77087066	0.45483742	0.665757889	0	0	0	1.027059272	0	0	0	0	0.000108745	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.553		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.106	0.0602	0.2592	0.2587	0.0664	0.1272	0.1105	0.031	0.2689	0.0422	0.1097	0.022	0.0051	0.192	0.0192	0.1855	0.0279	0.0301			0.1663	0.0393			0.0051																	4.1325	0	0	19.7358	1.269376556	2.476441695	0.25870744	1.290109293	1.612794662	2.690459571	1.078124759	2.068481472	4.06549988	1.835088765	0.32417956	0.13892995	12.44955462	0.019186646	5.956357149	0.482705114	0.695864613	0	0	0.166319566	1.066384646	0	0	0.005058988	0	0.000108745	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.6855
H1303_801_0	2008	3																					4200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	4800	1355.096734	155.5411696	894.7533831		113.6310504	12.97781984	2.256054257	610.9738234	25.5134507	8136.432116	35.54214354		0.170860985	22.16379714	4031.480129	4806.034172	472.2352405	3.003530866			13.97032946	769.5639331			168.0115493	0.109326958	16.16271746															$190 (1a); $0 (1a1)	$190 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$35/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $35 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											135.8341	135.8341	107.2375		125.1104	0.21447492	0.286420155	35.7458	0.21447492	4.2895	0.116416474		0.21447492	0.214316216	35	34.9315	37.5	0.21447492			0.21447492	35			35	1	35															15.339	1.760649776	7.995923357	0	1.184701898	2.783416876	0.646179409	1.819980029	5.471995305	2.908434383	4.137691045	0	0.036645396	4.750061126	11.75848371	13.99014726	1.475735127	0.644182043	0	0	2.996285297	2.244561472	0	0	0.490033685	0.109326958	0.047141259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5906	0	20.69757405	15.339	1.760649776	7.995923357	0	1.184701898	2.783416876	0.646179409	1.819980029	5.471995305	2.908434383	4.137691045	0	0.036645396	4.750061126	11.75848371	13.99014726	1.475735127	0.644182043	0	0	2.996285297	2.244561472	0	0	0.490033685	0.109326958	0.047141259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5906		$415 (1a); $0 (1a1)	$415 (1b)	"$175 (2a, 2a2)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	40% (9b)	40% (8a1); $0/$20 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	40% (incl in h5)	30% (12)	"40% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$40/$50 (7a); 40% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $40 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 40% (17b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.4964	0.2865	2.6645	0.6086	0.2538	0.5963	0.1588	0.3899	1.563	0.8307	1.1819		0.0079	1.3567	2.5866	2.7763	0.2951	0.1299			0.4531	0.4575			0.0988		0.0095															19.2019	0	7.867716533	17.8355	2.047197578	10.66045946	0.608600933	1.43849309	3.379690661	0.804975588	2.209862835	7.034969878	3.739175042	5.319546205	0	0.044495707	6.106809845	14.34506173	16.76645908	1.770882152	0.774063495	0	0	3.449373702	2.702054507	0	0	0.588864009	0.109326958	0.05664874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.7925
H1304_001_0	2008	4																					1000											D	D			T	Coin		V							V	V	V	V		V					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0															0	2000	445.0822482	8.820023614			0.75552081	11.27137575		295.4284447							7105.539779	357.9085649	210.5549934	1772.694448		487.3268449					117.015859		87.81784265															$100/day (days 1-3)	$100/day (days 1-3)	No copay	No copay	50	0.1	No copay	"$50 ER, $5 Urgent"	No copay	No copay	No copay	No copay	No copay	No copay	5	5	5	5	No copay	$5 chiro	No copay	No copay	No copay	No copay	5	No copay	5															100	100			50	0.1	0	50	0	0	0	0	0	0	5	5	5	5	0	5	0	0	0	0	5	0	5															3.709	0.073500197	0	0	0.003148003	1.127137575	0	1.230951853	0	0	0	0	0	0	2.960641574	0.149128569	0.087731247	0.738622687	0	0.203052852	0	0	0	0	0.048756608	0	0.036590768	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.3683	0	0	3.709	0.073500197	0	0	0.003148003	1.127137575	0	1.230951853	0	0	0	0	0	0	2.960641574	0.149128569	0.087731247	0.738622687	0	0.203052852	0	0	0	0	0.048756608	0	0.036590768	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.3683	N/A	D	D	D	Coin	T	Coin	Coin	V	V	No cost sharing	No cost sharing	No cost sharing	No cost sharing	V	V	V	V	V	No cost sharing	V	Coin	No cost sharing	No cost sharing	No cost sharing	V	No cost sharing	V															1.1963	0.077	0.5686	0.1478	0.5184	1.3239	0.027	0.1157	1.3009					0.0233	2.372	0.8371	0.4431	0.4743		0.644	0.0414				0.036		0.0092															10.1559	250	0.498844591	4.9054	0.150452564	0.568565043	0.147848895	0.521575517	2.451056841	0.026977144	1.346621747	1.300889645	0	0	0	0	0.023275371	5.332646645	0.986198533	0.530851507	1.212874417	0	0.847041701	0.041419623	0	0	0	0.084726567	0	0.045834098	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.5242
H1304_002_0	2008	3																					1000											D	D			T	Coin		V							V	V	V	V		V					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0															0	2000	445.0822482	8.820023614			0.75552081	11.27137575		295.4284447							7105.539779	357.9085649	210.5549934	1772.694448		487.3268449					117.015859		87.81784265															$100/day (days 1-3)	$100/day (days 1-3)	No copay	No copay	50	0.1	No copay	"$50 ER, $5 Urgent"	No copay	No copay	No copay	No copay	No copay	No copay	5	5	5	5	No copay	$5 chiro	No copay	No copay	No copay	No copay	5	No copay	5															100	100			50	0.1	0	50	0	0	0	0	0	0	5	5	5	5	0	5	0	0	0	0	5	0	5															3.709	0.073500197	0	0	0.003148003	1.127137575	0	1.230951853	0	0	0	0	0	0	2.960641574	0.149128569	0.087731247	0.738622687	0	0.203052852	0	0	0	0	0.048756608	0	0.036590768	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.3683	0	0	3.709	0.073500197	0	0	0.003148003	1.127137575	0	1.230951853	0	0	0	0	0	0	2.960641574	0.149128569	0.087731247	0.738622687	0	0.203052852	0	0	0	0	0.048756608	0	0.036590768	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.3683	N/A	D	D	D	Coin	T	Coin	Coin	V	V	No cost sharing	No cost sharing	No cost sharing	No cost sharing	V	V	V	V	V	No cost sharing	V	Coin	No cost sharing	No cost sharing	No cost sharing	V	No cost sharing	V															1.1963	0.077	0.5686	0.1478	0.5184	1.3239	0.027	0.1157	1.3009					0.0233	2.372	0.8371	0.4431	0.4743		0.644	0.0414				0.036		0.0092															10.1559	250	0.498844591	4.9054	0.150452564	0.568565043	0.147848895	0.521575517	2.451056841	0.026977144	1.346621747	1.300889645	0	0	0	0	0.023275371	5.332646645	0.986198533	0.530851507	1.212874417	0	0.847041701	0.041419623	0	0	0	0.084726567	0	0.045834098	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.5242
H1304_004_0	2008	3																					1000											D	D			T	Coin		V							V	V	V	V		V					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0															0	2000	445.0822482	8.820023614			0.75552081	11.27137575		295.4284447							7105.539779	357.9085649	210.5549934	1772.694448		487.3268449					117.015859		87.81784265															$100/day (days 1-3)	$100/day (days 1-3)	No copay	No copay	50	0.1	No copay	"$50 ER, $5 Urgent"	No copay	No copay	No copay	No copay	No copay	No copay	5	5	5	5	No copay	$5 chiro	No copay	No copay	No copay	No copay	5	No copay	5															100	100			50	0.1	0	50	0	0	0	0	0	0	5	5	5	5	0	5	0	0	0	0	5	0	5															3.709	0.073500197	0	0	0.003148003	1.127137575	0	1.230951853	0	0	0	0	0	0	2.960641574	0.149128569	0.087731247	0.738622687	0	0.203052852	0	0	0	0	0.048756608	0	0.036590768	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.3683	0	0	3.709	0.073500197	0	0	0.003148003	1.127137575	0	1.230951853	0	0	0	0	0	0	2.960641574	0.149128569	0.087731247	0.738622687	0	0.203052852	0	0	0	0	0.048756608	0	0.036590768	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.3683	N/A	D	D	D	Coin	T	Coin	Coin	V	V	No cost sharing	No cost sharing	No cost sharing	No cost sharing	V	V	V	V	V	No cost sharing	V	Coin	No cost sharing	No cost sharing	No cost sharing	V	No cost sharing	V															1.1963	0.077	0.5686	0.1478	0.5184	1.3239	0.027	0.1157	1.3009					0.0233	2.372	0.8371	0.4431	0.4743		0.644	0.0414				0.036		0.0092															10.1559	250	0.498844591	4.9054	0.150452564	0.568565043	0.147848895	0.521575517	2.451056841	0.026977144	1.346621747	1.300889645	0	0	0	0	0.023275371	5.332646645	0.986198533	0.530851507	1.212874417	0	0.847041701	0.041419623	0	0	0	0.084726567	0	0.045834098	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.5242
H1340_002_0	2008	8																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.9071	1.4597	0.2332	1.2918	0.7029	0	2.7266	0.1398	0.0761	1.0278	0.6593	1.5829	0.6493	0.557	0.4063	0.006	1.0859	0.0289	0	0	0	0	0	0	0	0	0											13.5405	0	489.5138492	64.22742665	3409.910985	3137.674037	26.67815048	42.93194903	6.858132451	37.99514638	20.6730376	11670.31063	22.63521409	1.160946668	0.776536997	8.532142632	43.91172735	104.135918	17.08508798	36.64380712	26.73232986	5.044596197	31.9370627	0.848871225	0	2169	662.4	158.976	138.4	28.14915254	0	0	6											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 23%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											781.8	781.8	75.92	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.200268547	0.2	0.197540486	0.2	0.5	0.2	0.2	0.015524816	0.2	0.2	0	0	0	10	0	10	0	0	0											31.8918	4.184416846	21.57337017	0	5.335630096	8.586389806	1.37162649	7.599029276	4.134607521	0	4.527042818	0.232189334	0.155515936	1.706428526	8.674343965	20.82718359	8.542543991	7.328761424	5.346465972	0.07831643	6.387412539	0.169774245	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	148.8088	131	0	31.8918	4.184416846	21.57337017	0	6.242687213	10.04607607	1.604802993	8.890864253	4.837490799	0	7.253680408	0.372036954	0.231609523	2.734210315	9.333621063	22.41011427	9.191803881	7.885770067	5.752814	0.084268722	7.473272671	0.198635867	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	162.3493	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	31.8918	4.184416846	21.57337017	0	6.242687213	10.04607607	1.604802993	8.890864253	4.837490799	0	7.253680408	0.372036954	0.231609523	2.734210315	9.333621063	22.41011427	9.191803881	7.885770067	5.752814	0.084268722	7.473272671	0.198635867	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	162.3493
H1340_003_0	2008	7																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.9075	1.4635	0.2335	1.2968	0.7037	0	2.7282	0.1398	0.0761	1.029	0.6601	1.5839	0.65	0.5575	0.4063	0.006	1.0878	0.0289	0	0	0	0	0	0	0	0	0											13.5586	0	489.8015316	64.32884062	3417.004182	3139.643845	26.69197263	43.04517499	6.868611526	38.14201178	20.69656468	11680.68673	22.64495116	1.16041845	0.776484448	8.54071063	44.01537638	104.3197723	17.1247254	36.71667836	26.76041371	5.050159232	31.99386471	0.849578475	0	2169	662.4	158.976	138.4	28.14915254	0	0	6											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 23%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											810.03	810.03	75.94	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.200351025	0.2	0.197554492	0.2	0.5	0.2	0.2	0.015541893	0.2	0.2	0	0	0	10	0	10	0	0	0											33.0628	4.342357564	21.62394146	0	5.338394525	8.609034999	1.373722305	7.628402356	4.139312936	0	4.528990233	0.23208369	0.155569455	1.708142126	8.695435315	20.86395446	8.562362699	7.343335673	5.352082742	0.078489032	6.398772943	0.169915695	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	150.3631	131	0	33.0628	4.342357564	21.62394146	0	6.245921595	10.07257095	1.607255097	8.925230757	4.842996135	0	7.257221465	0.37188924	0.231637613	2.737114691	9.355553575	22.44785185	9.212378686	7.900808622	5.758388743	0.084447565	7.486564343	0.198801363	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	163.9217	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	33.0628	4.342357564	21.62394146	0	6.245921595	10.07257095	1.607255097	8.925230757	4.842996135	0	7.257221465	0.37188924	0.231637613	2.737114691	9.355553575	22.44785185	9.212378686	7.900808622	5.758388743	0.084447565	7.486564343	0.198801363	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	163.9217
H1340_004_0	2008	7																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.9782	1.5729	0.2514	1.3914	0.7579	0	2.9406	0.1509	0.0821	1.1082	0.7108	1.7069	0.6998	0.6005	0.4382	0.0064	1.1705	0.0311	0	0	0	0	0	0	0	0	0											14.5978	0	528.5105219	69.27335393	3677.876824	3383.731413	28.77151025	46.2618541	7.393314697	40.92245363	22.28972072	12584.19684	24.41218092	1.252525642	0.837664074	9.199866519	47.3360223	112.2706838	18.41258682	39.49616337	28.82387254	5.439170962	34.42587575	0.915365565	0	2169	662.4	158.976	138.4	28.14915254	0	0	6											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 21%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											725.68	725.68	74.83	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.200096321	0.2	0.197535609	0.2	0.5	0.2	0.2	0.015518059	0.2	0.2	0	0	0	10	0	10	0	0	0											31.9608	4.189190623	22.9346269	0	5.754302049	9.252370821	1.478662939	8.184490726	4.457944143	0	4.882436184	0.250505128	0.167613499	1.839973304	9.350549982	22.45413675	9.206293412	7.899232675	5.764774507	0.084405376	6.88517515	0.183073113	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	157.3365	131	0	31.9608	4.189190623	22.9346269	0	6.732533398	10.82527386	1.730035639	9.57585415	5.215794648	0	7.823047975	0.401380287	0.249708212	2.948159256	10.06135753	24.16104918	9.906134908	8.499714385	6.20299956	0.090821681	8.055654925	0.214195542	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	171.9343	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	31.9608	4.189190623	22.9346269	0	6.732533398	10.82527386	1.730035639	9.57585415	5.215794648	0	7.823047975	0.401380287	0.249708212	2.948159256	10.06135753	24.16104918	9.906134908	8.499714385	6.20299956	0.090821681	8.055654925	0.214195542	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	171.9343
H1340_005_0	2008	6																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.8971	1.4443	0.2307	1.2786	0.6952	0	2.6967	0.1383	0.0752	1.0166	0.652	1.5654	0.6421	0.5508	0.4018	0.0059	1.0742	0.0285	0	0	0	0	0	0	0	0	0											13.3935	0	484.4597571	63.55496883	3369.838279	3103.191759	26.38428961	42.48000805	6.784184862	37.60585245	20.44827538	11542.7595	22.38543065	1.147898465	0.767878584	8.439115649	43.44593315	103.0247474	16.90397892	36.25257811	26.44114809	4.98971029	31.59455027	0.839582482	0	2169	662.4	158.976	138.4	28.14915254	0	0	6											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 22%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											761.47	761.47	77.66	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.200205154	0.2	0.197543714	0.2	0.5	0.2	0.2	0.015528791	0.2	0.2	0	0	0	10	0	10	0	0	0											30.7418	4.03293351	21.80847006	0	5.276857922	8.496001611	1.356836972	7.521170491	4.089655077	0	4.47708613	0.229579693	0.15373325	1.68782313	8.582470975	20.60494949	8.451989462	7.250515621	5.288229619	0.077484168	6.318910055	0.167916496	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	146.7703	131	0	30.7418	4.03293351	21.80847006	0	6.173923769	9.940321885	1.587499258	8.799769474	4.78489644	0	7.173780317	0.367862988	0.228974961	2.704453744	9.234496422	22.17034382	9.094102	7.801350073	5.689985744	0.083370777	7.393124764	0.196462301	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	160.1639	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.7418	4.03293351	21.80847006	0	6.173923769	9.940321885	1.587499258	8.799769474	4.78489644	0	7.173780317	0.367862988	0.228974961	2.704453744	9.234496422	22.17034382	9.094102	7.801350073	5.689985744	0.083370777	7.393124764	0.196462301	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	160.1639
H1340_013_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1682.729686	83.86662455	1282.087857	1563.691949	639.9264793	18.57152924	4.492537598	1691.797961	327.456403	6830.89347	1352.119847	63.40921364	0.196728935	516.8487239	9647.898612	19528.6809	381.3409681	3826.237949	4727.236604	967.2495747	34.18877705	41.9096958	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $45.00 and $90.00	$20.00 copayment	"Copay between $20.00 and $90.00, 20% coinsurance"	$150.00 copayment	Coin between 25% and 28%	"Copay between $20.00 and $90.00, 20% coinsurance"	Copay between $0.00 and $15.00	"Copay between $0.00 and $30.00, 20% coinsurance"	Copay between $20.00 and $30.00	"$30.00 copayment, 20% coinsurance"	"Copay between $15.00 and $30.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											73.87420043	42.17692567	110.9173391	0	33.13757031	0.272434925	0.272434925	17.12499064	65.12114983	2.495908214	24.54641159	123.4563689	0.264318143	47.04722226	4.983357543	7.358872711	21.43965245	12.79724923	9.077581945	0	0.272434925	46.98753161	0	0	0	9.081164166	0	9.081164166	0	0	0											10.3592	0.294769699	11.85048113	0	1.767134059	5.059533174	1.223924143	2.414335353	1.777028124	1.420773593	2.765807524	0.652355939	0.051999027	2.026358065	4.00657736	11.97575641	0.681318152	4.080443387	3.575989804	0	9.31421691	0.164102763	0	0	0	0.216131707	0	0.021302256	0	0	0	0	0	0	0	0	0	0	0	0	0	75.6995	0	7.429489874	10.3592	0.294769699	11.85048113	0	1.767134059	5.059533174	1.223924143	2.414335353	1.777028124	1.420773593	2.765807524	0.652355939	0.051999027	2.026358065	4.00657736	11.97575641	0.681318152	4.080443387	3.575989804	0	9.31421691	0.164102763	0	0	0	0.216131707	0	0.021302256	0	0	0	0	0	0	0	0	0	0	0	0	0	75.6995	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.3592	0.294769699	11.85048113	0	1.767134059	5.059533174	1.223924143	2.414335353	1.777028124	1.420773593	2.765807524	0.652355939	0.051999027	2.026358065	4.00657736	11.97575641	0.681318152	4.080443387	3.575989804	0	9.31421691	0.164102763	0	0	0	0.216131707	0	0.021302256	0	0	0	0	0	0	0	0	0	0	0	0	0	75.6995
H1340_014_0	2008	8																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1881.87123	93.79011746	1417.153565	1748.847742	715.6694999	20.76658294	5.023968305	1891.561959	366.197907	7639.553781	1512.168856	70.92252016	0.220032717	578.0067569	10785.3897	21836.87016	426.4025414	4278.831006	5286.449821	1081.641201	38.23293467	46.86764377	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $45.00 and $90.00	$20.00 copayment	"Copay between $20.00 and $90.00, 20% coinsurance"	$150.00 copayment	Coin between 25% and 28%	"Copay between $20.00 and $90.00, 20% coinsurance"	Copay between $0.00 and $15.00	"Copay between $0.00 and $30.00, 20% coinsurance"	Copay between $20.00 and $30.00	"$30.00 copayment, 20% coinsurance"	"Copay between $15.00 and $30.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											71.63613669	40.89909533	123.8422188	0	32.3487938	0.265946068	0.265946068	16.71694946	63.57017859	2.436452246	23.96202964	120.5154684	0.258022522	45.96947628	4.865404897	7.187983098	20.92866476	12.49237785	8.861778269	0	0.265946068	45.87554377	0	0	0	8.864868918	0	8.864868918	0	0	0											11.2342	0.319660913	14.62528683	0	1.929253757	5.52279107	1.336104614	2.635095473	1.939938862	1.551117331	3.019552913	0.712271728	0.056773396	2.214222325	4.372940656	13.08025447	0.743669653	4.454397808	3.903945512	0	10.16789863	0.17917322	0	0	0	0.21098388	0	0.020794879	0	0	0	0	0	0	0	0	0	0	0	0	0	84.2303	0	10.46650643	11.2342	0.319660913	14.62528683	0	1.929253757	5.52279107	1.336104614	2.635095473	1.939938862	1.551117331	3.019552913	0.712271728	0.056773396	2.214222325	4.372940656	13.08025447	0.743669653	4.454397808	3.903945512	0	10.16789863	0.17917322	0	0	0	0.21098388	0	0.020794879	0	0	0	0	0	0	0	0	0	0	0	0	0	84.2303	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.2342	0.319660913	14.62528683	0	1.929253757	5.52279107	1.336104614	2.635095473	1.939938862	1.551117331	3.019552913	0.712271728	0.056773396	2.214222325	4.372940656	13.08025447	0.743669653	4.454397808	3.903945512	0	10.16789863	0.17917322	0	0	0	0.21098388	0	0.020794879	0	0	0	0	0	0	0	0	0	0	0	0	0	84.2303
H1340_015_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1737.310409	86.58335546	1310.511942	1613.306876	660.3672668	19.18344523	4.637840879	1748.556629	337.9214355	7048.28941	1395.257285	65.3891944	0.202908409	533.4555229	9960.198459	20160.42245	393.9440197	3950.086405	4879.998665	998.6767157	35.29492737	43.24680851	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $45.00 and $90.00	$20.00 copayment	"Copay between $20.00 and $90.00, 20% coinsurance"	$150.00 copayment	Coin between 25% and 28%	"Copay between $20.00 and $90.00, 20% coinsurance"	Copay between $0.00 and $15.00	"Copay between $0.00 and $30.00, 20% coinsurance"	Copay between $20.00 and $30.00	"$30.00 copayment, 20% coinsurance"	"Copay between $15.00 and $30.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											73.12960815	41.75221795	123.6880771	0	32.84578478	0.270061304	0.270061304	16.97677339	64.55110385	2.47421446	24.33090443	122.3833198	0.262015782	46.63071302	4.944463459	7.300682213	21.25497538	12.68617542	8.995979708	0	0.270061304	46.53344156	0	0	0	9.002043455	0	9.002043455	0	0	0											10.5874	0.301253927	13.50789184	0	1.807523427	5.180706227	1.252501354	2.47373747	1.817766807	1.453248298	2.828989304	0.666878891	0.053165205	2.07295095	4.103986444	12.26540313	0.697772537	4.175957422	3.65836408	0	9.531794097	0.167701903	0	0	0	0.214248634	0	0.021116658	0	0	0	0	0	0	0	0	0	0	0	0	0	78.8404	0	8.482183388	10.5874	0.301253927	13.50789184	0	1.807523427	5.180706227	1.252501354	2.47373747	1.817766807	1.453248298	2.828989304	0.666878891	0.053165205	2.07295095	4.103986444	12.26540313	0.697772537	4.175957422	3.65836408	0	9.531794097	0.167701903	0	0	0	0.214248634	0	0.021116658	0	0	0	0	0	0	0	0	0	0	0	0	0	78.8404	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.5874	0.301253927	13.50789184	0	1.807523427	5.180706227	1.252501354	2.47373747	1.817766807	1.453248298	2.828989304	0.666878891	0.053165205	2.07295095	4.103986444	12.26540313	0.697772537	4.175957422	3.65836408	0	9.531794097	0.167701903	0	0	0	0.214248634	0	0.021116658	0	0	0	0	0	0	0	0	0	0	0	0	0	78.8404
H1340_016_0	2008	8																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1784.498467	88.95709153	1365.903099	1657.520206	678.54397	19.72185572	4.76650551	1798.213381	347.2257268	7241.846923	1433.632533	67.16359187	0.208435001	548.1871333	10240.27829	20721.39914	405.0241547	4059.727286	5015.309333	1026.461806	36.27430513	44.43629486	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $45.00 and $90.00	$20.00 copayment	"Copay between $20.00 and $90.00, 20% coinsurance"	$150.00 copayment	Coin between 25% and 30%	"Copay between $20.00 and $90.00, 20% coinsurance"	Copay between $0.00 and $15.00	"Copay between $0.00 and $30.00, 20% coinsurance"	Copay between $20.00 and $30.00	"$30.00 copayment, 20% coinsurance"	"Copay between $15.00 and $30.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											78.24794707	44.67611215	104.4378419	0	32.76664076	0.269424306	0.269424306	16.93727014	64.39739444	2.468407833	24.27263088	122.0961037	0.261398125	46.51344219	4.932891788	7.287094248	21.20599792	12.6564852	8.973397124	0	0.269424306	46.39938598	0	0	0	8.980810205	0	8.980810205	0	0	0											11.6361	0.331188083	11.88766432	0	1.852800542	5.313547294	1.28421244	2.538068817	1.863369341	1.489652639	2.899836107	0.68336774	0.054484518	2.124839211	4.20951539	12.58323237	0.715745115	4.281823192	3.750363529	0	9.77317949	0.171818066	0	0	0	0.213743283	0	0.02106685	0	0	0	0	0	0	0	0	0	0	0	0	0	79.6796	0	8.771651596	11.6361	0.331188083	11.88766432	0	1.852800542	5.313547294	1.28421244	2.538068817	1.863369341	1.489652639	2.899836107	0.68336774	0.054484518	2.124839211	4.20951539	12.58323237	0.715745115	4.281823192	3.750363529	0	9.77317949	0.171818066	0	0	0	0.213743283	0	0.02106685	0	0	0	0	0	0	0	0	0	0	0	0	0	79.6796	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.6361	0.331188083	11.88766432	0	1.852800542	5.313547294	1.28421244	2.538068817	1.863369341	1.489652639	2.899836107	0.68336774	0.054484518	2.124839211	4.20951539	12.58323237	0.715745115	4.281823192	3.750363529	0	9.77317949	0.171818066	0	0	0	0.213743283	0	0.02106685	0	0	0	0	0	0	0	0	0	0	0	0	0	79.6796
H1340_017_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1861.772478	97.12309831	1376.93103	1595.103677	711.3835499	19.67422709	4.606551468	1677.335862	324.3325816	7523.912159	1410.098645	67.43655907	0.159999629	594.1358432	9001.096877	20346.52676	439.7422567	4372.183044	4962.328048	943.5621398	40.33091319	47.31268598	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 30%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											124.7468851	69.24870679	123.9936735	0	31.39435163	0.257943985	0.257943985	16.11639201	103.9051677	2.360164015	33.95785437	184.5268905	0.247098304	49.35145015	6.290958614	7.808063314	24.18540524	12.66402309	8.951735677	0	0.257943985	48.20876059	0	0	0	8.598132825	0	8.598132825	0	0	0											19.3542	0.560470746	14.22756138	0	1.861118776	5.074848531	1.188232242	2.252716857	2.808319272	1.479805561	3.990327037	1.036988213	0.039535637	2.443455454	4.718793995	13.2389141	0.886278723	4.61411892	3.701787419	0	10.40311646	0.190073829	0	0	0	0.204635561	0	0.020169179	0	0	0	0	0	0	0	0	0	0	0	0	0	94.2955	0	14.92814131	19.3542	0.560470746	14.22756138	0	1.861118776	5.074848531	1.188232242	2.252716857	2.808319272	1.479805561	3.990327037	1.036988213	0.039535637	2.443455454	4.718793995	13.2389141	0.886278723	4.61411892	3.701787419	0	10.40311646	0.190073829	0	0	0	0.204635561	0	0.020169179	0	0	0	0	0	0	0	0	0	0	0	0	0	94.2955	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.3542	0.560470746	14.22756138	0	1.861118776	5.074848531	1.188232242	2.252716857	2.808319272	1.479805561	3.990327037	1.036988213	0.039535637	2.443455454	4.718793995	13.2389141	0.886278723	4.61411892	3.701787419	0	10.40311646	0.190073829	0	0	0	0.204635561	0	0.020169179	0	0	0	0	0	0	0	0	0	0	0	0	0	94.2955
H1340_020_0	2008	8																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1699.806583	85.09152564	1296.96207	1607.327291	657.7963683	19.09033268	4.618033166	1739.112648	334.5197651	7021.624527	1377.9978	64.75643684	0.202219822	527.9960685	9749.868873	19910.867	384.5510493	3915.021573	4837.101054	994.273891	35.14386612	42.75915722	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 28%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											120.6525388	68.88995319	115.1444571	0	31.92752184	0.262487364	0.262487364	16.49972199	104.5338542	2.404775134	33.14417903	165.7559516	0.254666968	52.1450463	6.32886173	8.083145811	24.17602442	12.85684978	9.347143946	0	0.262487364	45.27345897	0	0	0	8.749578808	0	8.749578808	0	0	0											17.0905	0.488495935	12.44483279	0	1.75015066	5.010971107	1.212175354	2.3912396	2.914053363	1.407119005	3.806050482	0.894480401	0.051498709	2.294364953	5.142130998	13.4118701	0.774742963	4.194570355	3.767756653	0	9.224820787	0.161321246	0	0	0	0.208239976	0	0.020524436	0	0	0	0	0	0	0	0	0	0	0	0	0	88.6619	0	12.29227936	17.0905	0.488495935	12.44483279	0	1.75015066	5.010971107	1.212175354	2.3912396	2.914053363	1.407119005	3.806050482	0.894480401	0.051498709	2.294364953	5.142130998	13.4118701	0.774742963	4.194570355	3.767756653	0	9.224820787	0.161321246	0	0	0	0.208239976	0	0.020524436	0	0	0	0	0	0	0	0	0	0	0	0	0	88.6619	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.0905	0.488495935	12.44483279	0	1.75015066	5.010971107	1.212175354	2.3912396	2.914053363	1.407119005	3.806050482	0.894480401	0.051498709	2.294364953	5.142130998	13.4118701	0.774742963	4.194570355	3.767756653	0	9.224820787	0.161321246	0	0	0	0.208239976	0	0.020524436	0	0	0	0	0	0	0	0	0	0	0	0	0	88.6619
H1340_021_0	2008	5																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1721.057232	76.44032676	1295.788041	1429.01929	642.474693	18.59845564	4.684905535	1525.59365	309.4749464	7095.938659	1390.07554	74.07345888	0.195469007	559.5003415	9083.807336	20000.3231	378.078256	4017.57475	4808.993041	953.980808	36.61433299	41.49009159	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 29%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											125.1348785	74.73795032	120.505639	0	32.73309684	0.261362722	0.261362722	16.83337273	106.6486399	2.371851008	33.79471003	176.885144	0.250406002	51.00949645	6.548844492	8.021888366	24.49974162	12.83249313	9.239412325	0	0.261362722	47.06337236	0	0	0	8.712090731	0	8.712090731	0	0	0											17.947	0.476082779	13.01248049	0	1.752515528	4.860942989	1.224459663	2.140073879	2.750423509	1.402542439	3.91476665	1.091874536	0.048946613	2.378319224	4.957370136	13.37002993	0.771901632	4.296291697	3.702689131	0	9.569621732	0.162721969	0	0	0	0.207347759	0	0.020436498	0	0	0	0	0	0	0	0	0	0	0	0	0	90.0589	0	12.91873875	17.947	0.476082779	13.01248049	0	1.752515528	4.860942989	1.224459663	2.140073879	2.750423509	1.402542439	3.91476665	1.091874536	0.048946613	2.378319224	4.957370136	13.37002993	0.771901632	4.296291697	3.702689131	0	9.569621732	0.162721969	0	0	0	0.207347759	0	0.020436498	0	0	0	0	0	0	0	0	0	0	0	0	0	90.0589	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.947	0.476082779	13.01248049	0	1.752515528	4.860942989	1.224459663	2.140073879	2.750423509	1.402542439	3.91476665	1.091874536	0.048946613	2.378319224	4.957370136	13.37002993	0.771901632	4.296291697	3.702689131	0	9.569621732	0.162721969	0	0	0	0.207347759	0	0.020436498	0	0	0	0	0	0	0	0	0	0	0	0	0	90.0589
H1340_022_0	2008	5																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1774.057628	92.54957603	1314.859342	1519.377558	671.1148695	18.75006081	4.38918094	1583.80257	306.0437333	7151.93052	1343.025441	63.609584	0.151693471	559.8754359	8577.313236	19380.51169	418.6492544	4140.23757	4727.81727	899.036031	38.33682325	44.65294886	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$25.00 copayment	"Copay between $25.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 30%	"Copay between $25.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											124.9502675	69.36159244	122.3410861	0	31.75185083	0.260892279	0.260892279	16.30124352	105.0925218	2.983974229	34.78985741	186.6488444	0.249704928	50.15299586	6.364210384	7.899236452	24.48083411	12.7962147	9.052435842	0	0.260892279	48.72709818	0	0	0	8.696409307	0	8.696409307	0	0	0											18.4724	0.534948831	13.40511	0	1.775761602	4.8917461	1.145103419	2.151495949	2.680242311	1.778431363	3.893638632	0.989387946	0.037878607	2.339952535	4.548985497	12.7576037	0.854073579	4.414947405	3.566521876	0	10.0017812	0.181317385	0	0	0	0.206974542	0	0.020399713	0	0	0	0	0	0	0	0	0	0	0	0	0	90.6487	0	13.18277654	18.4724	0.534948831	13.40511	0	1.775761602	4.8917461	1.145103419	2.151495949	2.680242311	1.778431363	3.893638632	0.989387946	0.037878607	2.339952535	4.548985497	12.7576037	0.854073579	4.414947405	3.566521876	0	10.0017812	0.181317385	0	0	0	0.206974542	0	0.020399713	0	0	0	0	0	0	0	0	0	0	0	0	0	90.6487	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.4724	0.534948831	13.40511	0	1.775761602	4.8917461	1.145103419	2.151495949	2.680242311	1.778431363	3.893638632	0.989387946	0.037878607	2.339952535	4.548985497	12.7576037	0.854073579	4.414947405	3.566521876	0	10.0017812	0.181317385	0	0	0	0.206974542	0	0.020399713	0	0	0	0	0	0	0	0	0	0	0	0	0	90.6487
H1340_023_0	2008	5																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1789.471116	82.05149837	1278.461242	1468.196144	656.3306063	19.08319349	4.511678827	1370.206871	296.9044498	5659.151513	1274.634037	56.4535879	0.249828684	519.3476143	8046.827165	21706.48213	444.7540161	4298.055569	4838.606392	871.3922216	41.13134685	36.72443757	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$25.00 copayment	"Copay between $25.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 31%	"Copay between $25.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											127.8372842	73.62124803	131.6540645	0	31.8211947	0.258923688	0.258923688	16.37154074	106.1088853	2.866241129	35.0424307	189.032444	0.245646033	59.30932467	6.598742779	7.455941197	24.16099253	12.61428144	9.574829468	0	0.258923688	51.08535813	0	0	0	8.630789593	0	8.630789593	0	0	0											19.0634	0.503394476	14.02621823	0	1.740435334	4.941090834	1.16818052	1.869366467	2.625350017	1.351707735	3.722189575	0.889296641	0.061369425	2.566846356	4.424911888	13.48685453	0.895474872	4.518073549	3.860735922	0	10.64988001	0.156340087	0	0	0	0.205412792	0	0.020245784	0	0	0	0	0	0	0	0	0	0	0	0	0	92.7468	0	14.33607048	19.0634	0.503394476	14.02621823	0	1.740435334	4.941090834	1.16818052	1.869366467	2.625350017	1.351707735	3.722189575	0.889296641	0.061369425	2.566846356	4.424911888	13.48685453	0.895474872	4.518073549	3.860735922	0	10.64988001	0.156340087	0	0	0	0.205412792	0	0.020245784	0	0	0	0	0	0	0	0	0	0	0	0	0	92.7468	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.0634	0.503394476	14.02621823	0	1.740435334	4.941090834	1.16818052	1.869366467	2.625350017	1.351707735	3.722189575	0.889296641	0.061369425	2.566846356	4.424911888	13.48685453	0.895474872	4.518073549	3.860735922	0	10.64988001	0.156340087	0	0	0	0.205412792	0	0.020245784	0	0	0	0	0	0	0	0	0	0	0	0	0	92.7468
H1340_024_0	2008	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1727.523328	86.00128541	1304.566449	1601.054794	655.2293581	19.01583382	4.600011574	1732.325867	336.1056627	7023.418097	1406.335166	65.18987654	0.201430671	534.6064841	10249.349	20771.56337	408.0162451	4017.618131	4946.905953	990.3937978	35.00671932	43.08353973	0	2492.571429	662.4	158.976	138.4	28.14915254	0	0	2400											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $10.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $30.00 and $60.00	$10.00 copayment	"Copay between $10.00 and $60.00, 20% coinsurance"	$100.00 copayment	Coin between 25% and 28%	"Copay between $10.00 and $60.00, 20% coinsurance"	Copay between $0.00 and $5.00	"Copay between $0.00 and $10.00, 20% coinsurance"	Copay between $10.00 and $20.00	"$10.00 copayment, 20% coinsurance"	"Copay between $5.00 and $10.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$25.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											50.67825639	28.93330478	120.8899072	0	33.52063355	0.275584895	0.275584895	17.3230211	43.92044041	1.262384009	18.73665298	83.25591737	0.267374279	42.79291883	1.736758003	3.159317578	14.28809441	10.60432069	6.725202579	0	0.275584895	47.48708045	0	22.9654079	0	9.186163162	0	9.186163162	0	0	0											7.2957	0.20735845	13.14240974	0	1.8303086	5.240476563	1.267693706	2.500759796	1.230159061	0.738854225	2.195834499	0.452286915	0.05385738	1.906447657	1.483386575	5.468663773	0.485814553	3.550342589	2.772412056	0	9.647323064	0.170492626	0	4.770243299	0	0.12169829	0	0.021548559	0	0	0	0	0	0	0	0	0	0	0	0	0	66.554	0	5.739866617	7.2957	0.20735845	13.14240974	0	1.8303086	5.240476563	1.267693706	2.500759796	1.230159061	0.738854225	2.195834499	0.452286915	0.05385738	1.906447657	1.483386575	5.468663773	0.485814553	3.550342589	2.772412056	0	9.647323064	0.170492626	0	4.770243299	0	0.12169829	0	0.021548559	0	0	0	0	0	0	0	0	0	0	0	0	0	66.554	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.2957	0.20735845	13.14240974	0	1.8303086	5.240476563	1.267693706	2.500759796	1.230159061	0.738854225	2.195834499	0.452286915	0.05385738	1.906447657	1.483386575	5.468663773	0.485814553	3.550342589	2.772412056	0	9.647323064	0.170492626	0	4.770243299	0	0.12169829	0	0.021548559	0	0	0	0	0	0	0	0	0	0	0	0	0	66.554
H1340_025_0	2008	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1726.059675	76.31889807	1289.142974	1421.690986	639.179951	18.50307894	4.660880379	1517.770093	309.8668816	7059.54923	1395.096216	74.31479519	0.194466602	560.0549719	9332.457825	20191.67493	390.8070615	4032.316027	4828.995019	949.0885987	36.42656718	41.59277664	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $25.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $45.00 and $90.00	$20.00 copayment	"Copay between $20.00 and $90.00, 20% coinsurance"	$150.00 copayment	Coin between 25% and 29%	"Copay between $15.00 and $90.00, 20% coinsurance"	Copay between $0.00 and $10.00	"Copay between $0.00 and $25.00, 20% coinsurance"	Copay between $15.00 and $25.00	"$25.00 copayment, 20% coinsurance"	"Copay between $10.00 and $25.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											77.20099581	46.1053482	123.8864572	0	33.65143269	0.268695324	0.268695324	17.30563754	65.80330658	2.438393928	24.86396778	120.6115108	0.25743121	45.48403576	3.456072965	6.250189983	17.87824317	12.15492047	8.315732241	0	0.268695324	48.37763286	0	0	0	8.956510785	0	8.956510785	0	0	0											11.1045	0.293225781	13.30894632	0	1.792443425	4.971690783	1.252356761	2.188831592	1.699188784	1.434496831	2.890635614	0.746934977	0.050061773	2.122796698	2.687804598	10.51681703	0.582245306	4.084373386	3.346385797	0	9.787648254	0.167680006	0	0	0	0.213164957	0	0.021009849	0	0	0	0	0	0	0	0	0	0	0	0	0	75.2632	0	8.506294371	11.1045	0.293225781	13.30894632	0	1.792443425	4.971690783	1.252356761	2.188831592	1.699188784	1.434496831	2.890635614	0.746934977	0.050061773	2.122796698	2.687804598	10.51681703	0.582245306	4.084373386	3.346385797	0	9.787648254	0.167680006	0	0	0	0.213164957	0	0.021009849	0	0	0	0	0	0	0	0	0	0	0	0	0	75.2632	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.1045	0.293225781	13.30894632	0	1.792443425	4.971690783	1.252356761	2.188831592	1.699188784	1.434496831	2.890635614	0.746934977	0.050061773	2.122796698	2.687804598	10.51681703	0.582245306	4.084373386	3.346385797	0	9.787648254	0.167680006	0	0	0	0.213164957	0	0.021009849	0	0	0	0	0	0	0	0	0	0	0	0	0	75.2632
H1340_026_0	2008	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1773.930645	92.18149567	1306.348926	1509.5434	666.7710839	18.62870119	4.360772002	1573.551421	305.6015652	7120.500775	1341.161904	63.63285167	0.150711636	558.5789744	8528.923447	19269.80094	415.9395505	4113.439916	4697.216511	893.2170276	38.08868848	44.62397564	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $55.00 and $105.00	$20.00 copayment	"Copay between $20.00 and $105.00, 20% coinsurance"	$175.00 copayment	Coin between 25% and 30%	"Copay between $20.00 and $105.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											88.04594215	48.87517067	123.137835	0	31.95863541	0.262591346	0.262591346	16.40740571	74.20671983	2.402725938	27.18835095	138.6551215	0.251331137	45.23767919	6.400304843	7.942859213	24.64026605	12.87955031	9.111390017	0	0.262591346	49.05010194	0	0	0	8.753044852	0	8.753044852	0	0	0											13.0156	0.375448861	13.40508154	0	1.775757831	4.891735713	1.145100988	2.15149138	1.889807478	1.425717659	3.038665045	0.735251731	0.037878527	2.105734704	4.548975837	12.75477633	0.854071765	4.41493803	3.566514302	0	10.00175996	0.18240088	0	0	0	0.208322467	0	0.020532566	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5456	0	11.42304845	13.0156	0.375448861	13.40508154	0	1.775757831	4.891735713	1.145100988	2.15149138	1.889807478	1.425717659	3.038665045	0.735251731	0.037878527	2.105734704	4.548975837	12.75477633	0.854071765	4.41493803	3.566514302	0	10.00175996	0.18240088	0	0	0	0.208322467	0	0.020532566	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5456	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.0156	0.375448861	13.40508154	0	1.775757831	4.891735713	1.145100988	2.15149138	1.889807478	1.425717659	3.038665045	0.735251731	0.037878527	2.105734704	4.548975837	12.75477633	0.854071765	4.41493803	3.566514302	0	10.00175996	0.18240088	0	0	0	0.208322467	0	0.020532566	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5456
H1340_027_0	2008	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1789.371267	81.72176631	1269.909662	1458.375434	651.940435	18.95554671	4.481500373	1361.041607	296.4824087	5633.054302	1272.701138	56.54271393	0.248157589	518.0453125	8000.396864	21577.52326	441.7790728	4269.306033	4806.241132	865.5635111	40.85622079	36.69365179	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $55.00 and $105.00	$20.00 copayment	"Copay between $20.00 and $105.00, 20% coinsurance"	$175.00 copayment	Coin between 25% and 31%	"Copay between $20.00 and $105.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											90.05301455	51.86058366	132.4706892	0	32.01857543	0.260529741	0.260529741	16.47309025	74.83709212	2.307215896	27.66996655	133.1434831	0.247169728	54.86315323	6.633536572	7.494955468	24.3108585	12.6925254	9.634220288	0	0.260529741	51.40705248	0	0	0	8.684324716	0	8.684324716	0	0	0											13.4282	0.353178208	14.01881735	0	1.739517	4.938483685	1.167564134	1.868380103	1.848990111	1.083056036	2.934633161	0.627357823	0.061337044	2.368466613	4.422577099	13.47688133	0.895002377	4.515689604	3.858698819	0	10.64426064	0.157192707	0	0	0	0.206686928	0	0.020371365	0	0	0	0	0	0	0	0	0	0	0	0	0	84.6353	0	12.5023465	13.4282	0.353178208	14.01881735	0	1.739517	4.938483685	1.167564134	1.868380103	1.848990111	1.083056036	2.934633161	0.627357823	0.061337044	2.368466613	4.422577099	13.47688133	0.895002377	4.515689604	3.858698819	0	10.64426064	0.157192707	0	0	0	0.206686928	0	0.020371365	0	0	0	0	0	0	0	0	0	0	0	0	0	84.6353	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.4282	0.353178208	14.01881735	0	1.739517	4.938483685	1.167564134	1.868380103	1.848990111	1.083056036	2.934633161	0.627357823	0.061337044	2.368466613	4.422577099	13.47688133	0.895002377	4.515689604	3.858698819	0	10.64426064	0.157192707	0	0	0	0.206686928	0	0.020371365	0	0	0	0	0	0	0	0	0	0	0	0	0	84.6353
H1340_028_0	2008	6																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.877	1.4119	0.2255	1.2499	0.6797	0	2.6389	0.1353	0.0736	0.9949	0.6376	1.5303	0.6277	0.5384	0.3927	0.0058	1.0501	0.0279	0	0	0	0	0	0	0	0	0											13.0972	0	473.4871354	62.12320593	3306.55226	3033.619875	25.79354443	41.52655393	6.63217931	36.7625274	19.99030365	11284.27138	21.88424077	1.122208804	0.750690353	8.250120161	42.48908435	100.7232447	16.5251763	35.44031794	25.84898098	4.877959574	30.88672579	0.820781402	0	2169	662.4	158.976	138.4	28.14915254	0	0	6											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 22%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											770.79	770.79	72.59	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.200233877	0.2	0.19754453	0.2	0.5	0.2	0.2	0.015528606	0.2	0.2	0	0	0	10	0	10	0	0	0											30.4133	3.990328825	20.00188572	0	5.158708887	8.305310785	1.326435862	7.35250548	3.99806073	0	4.376848153	0.224441761	0.15031364	1.650024032	8.393486211	20.14464893	8.262588148	7.088063587	5.169796196	0.075747914	6.177345159	0.16415628	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	142.5799	131	0	30.4133	3.990328825	20.00188572	0	6.035689398	9.717213619	1.551929959	8.602431411	4.677731054	0	7.015785738	0.359764664	0.22393836	2.644874729	9.031090051	21.67491957	8.890248432	7.626502139	5.562515244	0.081502038	7.227493836	0.192062848	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	155.6771	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.4133	3.990328825	20.00188572	0	6.035689398	9.717213619	1.551929959	8.602431411	4.677731054	0	7.015785738	0.359764664	0.22393836	2.644874729	9.031090051	21.67491957	8.890248432	7.626502139	5.562515244	0.081502038	7.227493836	0.192062848	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	155.6771
H1340_030_0	2008	4																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.889	1.4026	0.2571	1.2971	0.7529	0	2.6714	0.1174	0.0133	1.1141	1.0014	2.3768	0.7452	0.7287	0.6313	0.0085	1.1081	0.0209	0	0	0	0	0	0	0	0	0											15.1357	0	500.4673034	55.21694387	3323.814583	4419.792148	26.14742358	41.25192651	7.562785319	38.1485745	22.14316029	10307.20758	25.31624282	1.112544812	0.411334781	10.55792715	50.15896352	117.7001634	14.7611699	36.08712038	31.26347751	5.926599026	32.59201396	0.6138538	0	2169	662.4	158.976	138.4	28.14915254	0	0	6											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 22%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											763.82	763.82	81.89	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.210175861	0.2	0.197728855	0.2	0.5	0.2	0.2	0.014189281	0.2	0.2	0	0	0	10	0	10	0	0	0											31.8556	3.514650506	22.68226468	0	5.229484717	8.250385303	1.512557064	7.6297149	4.428632057	0	5.063248564	0.222508962	0.086452642	2.11158543	9.917874447	23.54003267	7.380584948	7.217424077	6.252695502	0.084094181	6.518402793	0.12277076	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	153.7769	131	0	31.8556	3.514650506	22.68226468	0	6.118497119	9.652950804	1.769691765	8.926766433	5.181499507	0	7.734622078	0.339904848	0.099782627	3.225659392	10.91926147	25.91682049	8.12578716	7.946152277	6.884017077	0.092584995	7.626531267	0.143641789	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	168.9126	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	31.8556	3.514650506	22.68226468	0	6.118497119	9.652950804	1.769691765	8.926766433	5.181499507	0	7.734622078	0.339904848	0.099782627	3.225659392	10.91926147	25.91682049	8.12578716	7.946152277	6.884017077	0.092584995	7.626531267	0.143641789	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	168.9126
H1340_031_0	2008	6																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.8756	1.3749	0.2083	1.1385	0.6257	0	2.2358	0.0649	0.0606	0.8608	0.8098	1.9507	0.6957	0.5133	0.5187	0.0056	0.9654	0.0223	0	0	0	0	0	0	0	0	0											12.9265	0	504.8052855	58.438703	3317.013559	2111.747349	25.75230367	40.43888884	6.126437324	33.48504712	18.40318823	9094.727222	21.25218174	0.61681211	0.701603927	8.182258103	46.25504309	110.1834533	15.71901253	28.99203226	29.29862711	5.667079473	28.39295647	0.654870312	0	2169	662.4	158.976	138.4	28.14915254	0	0	6											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 24%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											843.78	843.78	81.58	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.197761851	0.2	0.5	0.2	0.2	0.011176731	0.2	0.2	0	0	0	10	0	10	0	0	0											35.4954	4.109117402	22.55016385	0	5.150460734	8.087777768	1.225287465	6.697009425	3.680637646	0	4.250436348	0.123362422	0.140320785	1.636451621	9.147482945	22.03669067	7.859506265	5.798406452	5.859725422	0.063339426	5.678591294	0.130974062	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	149.8771	131	0	35.4954	4.109117402	22.55016385	0	6.026039058	9.462699989	1.433586334	7.835501027	4.306346045	0	6.486262468	0.18825386	0.200875867	2.497262365	9.957233558	23.98741568	8.555243011	6.311691168	6.378438196	0.068946338	6.643951814	0.153239653	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	162.8036	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	35.4954	4.109117402	22.55016385	0	6.026039058	9.462699989	1.433586334	7.835501027	4.306346045	0	6.486262468	0.18825386	0.200875867	2.497262365	9.957233558	23.98741568	8.555243011	6.311691168	6.378438196	0.068946338	6.643951814	0.153239653	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	162.8036
H1340_032_0	2008	8																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1586.554034	79.09584816	1204.132143	1475.122799	603.7169025	17.52268695	4.238570895	1596.445751	308.9283563	6444.263594	1275.604262	59.81496144	0.185582728	487.6168768	9101.385969	18423.45704	359.8216847	3609.959994	4459.995229	912.5923591	32.25619405	39.53805961	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $45.00 and $90.00	$20.00 copayment	"Copay between $20.00 and $90.00, 20% coinsurance"	$150.00 copayment	Coin between 25% and 30%	"Copay between $20.00 and $90.00, 20% coinsurance"	Copay between $0.00 and $15.00	"Copay between $0.00 and $30.00, 20% coinsurance"	Copay between $20.00 and $30.00	"$30.00 copayment, 20% coinsurance"	"Copay between $15.00 and $30.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											80.15839548	45.76522554	117.9187683	0	33.35540366	0.274229694	0.274229694	17.23795938	65.54974872	2.512358995	24.70786719	124.2700823	0.266059523	47.34301305	5.017729516	7.406746896	21.58122042	12.88162118	9.136996631	0	0.274229694	47.29019015	0	0	0	9.140989787	0	9.140989787	0	0	0											10.598	0.301653278	11.83248159	0	1.678101748	4.805241074	1.162341998	2.293288917	1.687514677	1.349191967	2.626455057	0.619434182	0.049376052	1.923771014	3.805691084	11.37149027	0.647115924	3.875178093	3.395913448	0	8.845606212	0.15581353	0	0	0	0.217555557	0	0.021442593	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2626	0	6.682307163	10.598	0.301653278	11.83248159	0	1.678101748	4.805241074	1.162341998	2.293288917	1.687514677	1.349191967	2.626455057	0.619434182	0.049376052	1.923771014	3.805691084	11.37149027	0.647115924	3.875178093	3.395913448	0	8.845606212	0.15581353	0	0	0	0.217555557	0	0.021442593	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2626	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.598	0.301653278	11.83248159	0	1.678101748	4.805241074	1.162341998	2.293288917	1.687514677	1.349191967	2.626455057	0.619434182	0.049376052	1.923771014	3.805691084	11.37149027	0.647115924	3.875178093	3.395913448	0	8.845606212	0.15581353	0	0	0	0.217555557	0	0.021442593	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2626
H1340_033_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1736.751406	77.12140223	1308.265401	1441.600785	654.4190452	18.76139648	4.726042422	1553.861243	315.2266057	7158.361253	1402.367694	75.45152521	0.198372346	569.8963286	9164.274649	20183.27506	381.8395613	4077.518154	4851.222741	962.3535129	37.02215318	42.25546612	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 29%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											123.0464971	73.49067459	119.2498223	0	32.68982836	0.261016684	0.261016684	16.81104902	106.5075715	2.368709226	33.74930953	176.6546089	0.250193679	50.94466563	6.539496489	8.008557656	24.44870057	12.82915011	9.227311307	0	0.261016684	47.00569928	0	0	0	8.700556129	0	8.700556129	0	0	0											17.8084	0.472308656	13.00086805	0	1.782737189	4.897037493	1.233575921	2.17683646	2.797835021	1.413006362	3.944078447	1.110738306	0.049631507	2.419431492	4.994145157	13.46991017	0.777956758	4.359257708	3.730311871	0	9.663399652	0.165520644	0	0	0	0.207073236	0	0.02040944	0	0	0	0	0	0	0	0	0	0	0	0	0	90.4945	0	13.11253561	17.8084	0.472308656	13.00086805	0	1.782737189	4.897037493	1.233575921	2.17683646	2.797835021	1.413006362	3.944078447	1.110738306	0.049631507	2.419431492	4.994145157	13.46991017	0.777956758	4.359257708	3.730311871	0	9.663399652	0.165520644	0	0	0	0.207073236	0	0.02040944	0	0	0	0	0	0	0	0	0	0	0	0	0	90.4945	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.8084	0.472308656	13.00086805	0	1.782737189	4.897037493	1.233575921	2.17683646	2.797835021	1.413006362	3.944078447	1.110738306	0.049631507	2.419431492	4.994145157	13.46991017	0.777956758	4.359257708	3.730311871	0	9.663399652	0.165520644	0	0	0	0.207073236	0	0.02040944	0	0	0	0	0	0	0	0	0	0	0	0	0	90.4945
H1340_034_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1782.303585	92.9732797	1321.158942	1526.365731	680.7398586	18.83476023	4.409149215	1606.312299	310.4227648	7199.778986	1349.325889	64.52325589	0.153204404	568.5869168	8616.631718	19475.44581	421.0064935	4184.873593	4749.376594	903.1264152	38.60299813	45.28028187	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 30%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											124.456583	69.08762789	122.0177225	0	31.74257694	0.260814512	0.260814512	16.29629281	105.0612355	2.386462283	34.33366084	186.59138	0.249714097	49.87330504	6.361801449	7.893904775	24.45563985	12.80540339	9.049968209	0	0.260814512	48.72497891	0	0	0	8.693817064	0	8.693817064	0	0	0											18.485	0.535275279	13.43373376	0	1.800703112	4.912378797	1.149970101	2.181411297	2.717783266	1.431833417	3.860608119	1.00329028	0.038257299	2.363109062	4.568108346	12.81144289	0.857998598	4.46574954	3.581808933	0	10.06822212	0.183856732	0	0	0	0.206912846	0	0.020393632	0	0	0	0	0	0	0	0	0	0	0	0	0	90.6778	0	13.22683948	18.485	0.535275279	13.43373376	0	1.800703112	4.912378797	1.149970101	2.181411297	2.717783266	1.431833417	3.860608119	1.00329028	0.038257299	2.363109062	4.568108346	12.81144289	0.857998598	4.46574954	3.581808933	0	10.06822212	0.183856732	0	0	0	0.206912846	0	0.020393632	0	0	0	0	0	0	0	0	0	0	0	0	0	90.6778	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.485	0.535275279	13.43373376	0	1.800703112	4.912378797	1.149970101	2.181411297	2.717783266	1.431833417	3.860608119	1.00329028	0.038257299	2.363109062	4.568108346	12.81144289	0.857998598	4.46574954	3.581808933	0	10.06822212	0.183856732	0	0	0	0.206912846	0	0.020393632	0	0	0	0	0	0	0	0	0	0	0	0	0	90.6778
H1340_035_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1804.72564	82.74382089	1289.152066	1480.560746	668.2503033	19.24186908	4.549331443	1394.830896	302.2844662	5718.593272	1285.470278	57.48458449	0.253489583	529.5464205	8114.096571	21894.04593	448.9407298	4358.019776	4878.918435	878.6337121	41.57445361	37.38071118	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 31%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											126.7544862	72.99561227	131.7131223	0	31.78157278	0.258599062	0.258599062	16.35086012	105.976148	2.290119504	34.58076491	188.7955634	0.245437789	58.92557514	6.589823422	7.444179889	24.11232687	12.61384568	9.563248362	0	0.258599062	51.03132666	0	0	0	8.619968735	0	8.619968735	0	0	0											19.0631	0.503327989	14.14985364	0	1.769837137	4.975929296	1.176452844	1.900557072	2.669578611	1.091355165	3.704378789	0.904402876	0.062215923	2.600318949	4.455871969	13.5819347	0.902083802	4.580949078	3.888192395	0	10.75111471	0.158965607	0	0	0	0.205155256	0	0.020220401	0	0	0	0	0	0	0	0	0	0	0	0	0	93.1158	0	14.53162205	19.0631	0.503327989	14.14985364	0	1.769837137	4.975929296	1.176452844	1.900557072	2.669578611	1.091355165	3.704378789	0.904402876	0.062215923	2.600318949	4.455871969	13.5819347	0.902083802	4.580949078	3.888192395	0	10.75111471	0.158965607	0	0	0	0.205155256	0	0.020220401	0	0	0	0	0	0	0	0	0	0	0	0	0	93.1158	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.0631	0.503327989	14.14985364	0	1.769837137	4.975929296	1.176452844	1.900557072	2.669578611	1.091355165	3.704378789	0.904402876	0.062215923	2.600318949	4.455871969	13.5819347	0.902083802	4.580949078	3.888192395	0	10.75111471	0.158965607	0	0	0	0.205155256	0	0.020220401	0	0	0	0	0	0	0	0	0	0	0	0	0	93.1158
H1340_036_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1686.275978	87.23193041	1184.868628	1087.293402	613.6706162	14.30936775	3.628337957	966.2321075	219.2469971	4820.151228	1067.931366	41.85254678	0.184292929	412.5979998	7687.326973	21349.18863	558.7831781	4872.421184	4432.571186	763.3229433	42.62036656	25.6685123	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 34%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											133.709052	77.36283031	136.1241794	0	29.81642534	0.262450217	0.262450217	16.46059898	104.972306	2.296815011	34.60338966	189.3475355	0.243835958	55.19481464	6.611853943	7.462694978	25.86200115	11.64101621	10.85828243	0	0.262450217	51.75656895	0	0	0	8.74834058	0	8.74834058	0	0	0											18.7892	0.562375752	13.44077248	0	1.524788676	3.755496678	0.952258086	1.325396603	1.917905239	0.922582975	3.079503765	0.660389716	0.044937243	1.89777251	4.235623596	13.27687356	1.204270933	4.726661165	4.010842488	0	11.18572447	0.110709511	0	0	0	0.208210506	0	0.020521531	0	0	0	0	0	0	0	0	0	0	0	0	0	87.8528	0	12.31264813	18.7892	0.562375752	13.44077248	0	1.524788676	3.755496678	0.952258086	1.325396603	1.917905239	0.922582975	3.079503765	0.660389716	0.044937243	1.89777251	4.235623596	13.27687356	1.204270933	4.726661165	4.010842488	0	11.18572447	0.110709511	0	0	0	0.208210506	0	0.020521531	0	0	0	0	0	0	0	0	0	0	0	0	0	87.8528	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.7892	0.562375752	13.44077248	0	1.524788676	3.755496678	0.952258086	1.325396603	1.917905239	0.922582975	3.079503765	0.660389716	0.044937243	1.89777251	4.235623596	13.27687356	1.204270933	4.726661165	4.010842488	0	11.18572447	0.110709511	0	0	0	0.208210506	0	0.020521531	0	0	0	0	0	0	0	0	0	0	0	0	0	87.8528
H1340_801_0	2008	2																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.3569	0.7198	0.1745	0.5838	0.9225	0	0.8411	0.0358	0.007	0.3424	1.2178	4.1602	0.2972	0.881	1.1609	0.019	1.4049	0.036	0	0	0	0	0	0	0	0	0											13.1609	0	355.6710637	10.06143402	1520.822796	1656.433465	10.49565024	21.16974036	5.133599152	17.17017755	27.13355434	7765.162726	24.7396934	1.054238925	0.213608397	10.06937535	36.95214507	122.3578668	3.496875889	25.91314542	34.14287531	8.527424866	41.32186091	1.059780558	0	0	0	0	0	0	0	0	0											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 23%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											793.27	793.27	73.42	0	0.2	0.2	0.2	0.2	0.2	0	0.257003654	0.257003654	0.23523676	0.257003654	0.19771176	0.203977593	0.509943983	0.203977593	0.203977593	0.013368857	0.2	0.2	0	0	0	0	0	0	0	0	0											23.5119	0.665119481	9.304900809	0	2.099130049	4.233948072	1.02671983	3.434035509	5.426710868	0	6.358191605	0.270943256	0.050248547	2.58786626	7.305873632	24.95826318	1.783210819	5.285701035	6.964381532	0.114001921	8.264372183	0.211956112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.8575	1.31	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184
H1340_802_0	2008	2																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.3569	0.7198	0.1745	0.5838	0.9225	0	0.8411	0.0358	0.007	0.3424	1.2178	4.1602	0.2972	0.881	1.1609	0.019	1.4049	0.036	0	0	0	0	0	0	0	0	0											13.1609	0	355.6710637	10.06143402	1520.822796	1656.433465	10.49565024	21.16974036	5.133599152	17.17017755	27.13355434	7765.162726	24.7396934	1.054238925	0.213608397	10.06937535	36.95214507	122.3578668	3.496875889	25.91314542	34.14287531	8.527424866	41.32186091	1.059780558	0	0	0	0	0	0	0	0	0											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 23%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											793.27	793.27	73.42	0	0.2	0.2	0.2	0.2	0.2	0	0.257003654	0.257003654	0.23523676	0.257003654	0.19771176	0.203977593	0.509943983	0.203977593	0.203977593	0.013368857	0.2	0.2	0	0	0	0	0	0	0	0	0											23.5119	0.665119481	9.304900809	0	2.099130049	4.233948072	1.02671983	3.434035509	5.426710868	0	6.358191605	0.270943256	0.050248547	2.58786626	7.305873632	24.95826318	1.783210819	5.285701035	6.964381532	0.114001921	8.264372183	0.211956112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.8575	1.31	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184
H1340_803_0	2008	2																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.3569	0.7198	0.1745	0.5838	0.9225	0	0.8411	0.0358	0.007	0.3424	1.2178	4.1602	0.2972	0.881	1.1609	0.019	1.4049	0.036	0	0	0	0	0	0	0	0	0											13.1609	0	355.6710637	10.06143402	1520.822796	1656.433465	10.49565024	21.16974036	5.133599152	17.17017755	27.13355434	7765.162726	24.7396934	1.054238925	0.213608397	10.06937535	36.95214507	122.3578668	3.496875889	25.91314542	34.14287531	8.527424866	41.32186091	1.059780558	0	0	0	0	0	0	0	0	0											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 23%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											793.27	793.27	73.42	0	0.2	0.2	0.2	0.2	0.2	0	0.257003654	0.257003654	0.23523676	0.257003654	0.19771176	0.203977593	0.509943983	0.203977593	0.203977593	0.013368857	0.2	0.2	0	0	0	0	0	0	0	0	0											23.5119	0.665119481	9.304900809	0	2.099130049	4.233948072	1.02671983	3.434035509	5.426710868	0	6.358191605	0.270943256	0.050248547	2.58786626	7.305873632	24.95826318	1.783210819	5.285701035	6.964381532	0.114001921	8.264372183	0.211956112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.8575	1.31	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184
H1340_804_0	2008	2																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.3569	0.7198	0.1745	0.5838	0.9225	0	0.8411	0.0358	0.007	0.3424	1.2178	4.1602	0.2972	0.881	1.1609	0.019	1.4049	0.036	0	0	0	0	0	0	0	0	0											13.1609	0	355.6710637	10.06143402	1520.822796	1656.433465	10.49565024	21.16974036	5.133599152	17.17017755	27.13355434	7765.162726	24.7396934	1.054238925	0.213608397	10.06937535	36.95214507	122.3578668	3.496875889	25.91314542	34.14287531	8.527424866	41.32186091	1.059780558	0	0	0	0	0	0	0	0	0											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 23%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											793.27	793.27	73.42	0	0.2	0.2	0.2	0.2	0.2	0	0.257003654	0.257003654	0.23523676	0.257003654	0.19771176	0.203977593	0.509943983	0.203977593	0.203977593	0.013368857	0.2	0.2	0	0	0	0	0	0	0	0	0											23.5119	0.665119481	9.304900809	0	2.099130049	4.233948072	1.02671983	3.434035509	5.426710868	0	6.358191605	0.270943256	0.050248547	2.58786626	7.305873632	24.95826318	1.783210819	5.285701035	6.964381532	0.114001921	8.264372183	0.211956112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.8575	1.31	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184
H1350_001_0	2008	6																																		D					V						V	V	V	V	P							V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	177.3	0	0	0	0	409.4	0	0	0	0	0	377.3	3695	4188.2	246	922.4	0	0	0	0	0	0	986.9	0	0	0	0	0	0													$25/Day for Days 8-19 for SNF					$50/Case for ER - Facility; $50/Case for ER - Worldwide; $20/Visit for Urgent Care;						$10/Case for OP Fac - Cardiovascular; $10/Case for OP Fac - Occ Therapy; $10/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Service for Prof - CORF; $20/Service for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults; $10/Exam for PCP - Routine Physicals;	$20/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults; $20/Visit for Chiropractor; $20/Exam for Vistion Exams; $20/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$10/Service for PT/ST (PCP); $10/Service for Occ Therapy (PCP); $10/Service for PT/ST (Specialist); $10/Service for Occ Therapy (Specialist);							$20/Exam for Vision (Refractions)		$10/Exam for Routine Hearing Exams															0	0	25	0	0	0	0	44.42279339	0	0	0	0	0	11.41702021	10	20	20	10	0	0	0	0	0	0	20	0	10	0	0	0	0											0	0	0.369375	0	0	0	0	1.515557634	0	0	0	0	0	0.358970144	3.079166667	6.980333333	0.41	0.768666667	0	0	0	0	0	0	1.644833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1269	0	0	0	0	0.369375	0	0	0	0	1.515557634	0	0	0	0	0	0.358970144	3.079166667	6.980333333	0.41	0.768666667	0	0	0	0	0	0	1.644833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1269																																																																																				0	0		0	0	0.369375	0	0	0	0	1.515557634	0	0	0	0	0	0.358970144	3.079166667	6.980333333	0.41	0.768666667	0	0	0	0	0	0	1.644833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1269
H1350_002_0	2008	6																																		D					V						V	V	V	V	P							V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	272.3920115	0	0	0	0	286.7477362	0	0	0	0	0	316.4797173	3961.792421	4250.966698	168.9022674	829.7153706	0	0	0	0	0	0	632.4185211	0	94.02349661	0	0	0	0													$25/Day for Days 8-19 for SNF					$50/Case for ER - Facility; $50/Case for ER - Worldwide; $20/Visit for Urgent Care;						$10/Case for OP Fac - Cardiovascular; $10/Case for OP Fac - Occ Therapy; $10/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Service for Prof - CORF; $20/Service for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults; $10/Exam for PCP - Routine Physicals;	$20/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults; $20/Visit for Chiropractor; $20/Exam for Vistion Exams; $20/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$10/Service for PT/ST (PCP); $10/Service for Occ Therapy (PCP); $10/Service for PT/ST (Specialist); $10/Service for Occ Therapy (Specialist);							$20/Exam for Vision (Refractions)		$10/Exam for Routine Hearing Exams															0	0	25	0	0	0	0	38.94361432	0	0	0	0	0	13.20797131	10	20	20	10	0	0	0	0	0	0	20	0	10	0	0	0	0											0	0	0.567483357	0	0	0	0	0.93058277	0	0	0	0	0	0.348337919	3.301493684	7.084944497	0.281503779	0.691429476	0	0	0	0	0	0	1.054030869	0	0.078352914	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.3382	0	0	0	0	0.567483357	0	0	0	0	0.93058277	0	0	0	0	0	0.348337919	3.301493684	7.084944497	0.281503779	0.691429476	0	0	0	0	0	0	1.054030869	0	0.078352914	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.3382																																																																																				0	0		0	0	0.567483357	0	0	0	0	0.93058277	0	0	0	0	0	0.348337919	3.301493684	7.084944497	0.281503779	0.691429476	0	0	0	0	0	0	1.054030869	0	0.078352914	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.3382
H1350_006_0	2008	3																																		D					V						V	V	V	V	P							V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	84.9	0	0	0	0	286	0	0	0	0	0	210.3	2645.3	3388.9	99.4	808.1	0	0	0	0	0	0	906.9	0	0	0	0	0	0													$25/Day for Days 8-19 for SNF					$50/Case for ER - Facility; $50/Case for ER - Worldwide; $20/Visit for Urgent Care;						$10/Case for OP Fac - Cardiovascular; $10/Case for OP Fac - Occ Therapy; $10/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Service for Prof - CORF; $20/Service for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults; $10/Exam for PCP - Routine Physicals;	$20/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults; $20/Visit for Chiropractor; $20/Exam for Vistion Exams; $20/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$10/Service for PT/ST (PCP); $10/Service for Occ Therapy (PCP); $10/Service for PT/ST (Specialist); $10/Service for Occ Therapy (Specialist);							$20/Exam for Vision (Refractions)		$10/Exam for Routine Hearing Exams															0	0	25	0	0	0	0	42.22117334	0	0	0	0	0	12.15829137	10	20	20	10	0	0	0	0	0	0	20	0	10	0	0	0	0											0	0	0.176875	0	0	0	0	1.006271298	0	0	0	0	0	0.213074056	2.204416667	5.648166667	0.165666667	0.673416667	0	0	0	0	0	0	1.5115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.5994	0	0	0	0	0.176875	0	0	0	0	1.006271298	0	0	0	0	0	0.213074056	2.204416667	5.648166667	0.165666667	0.673416667	0	0	0	0	0	0	1.5115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.5994																																																																																				0	0		0	0	0.176875	0	0	0	0	1.006271298	0	0	0	0	0	0.213074056	2.204416667	5.648166667	0.165666667	0.673416667	0	0	0	0	0	0	1.5115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.5994
H1350_007_0	2008	4																																		D					V						V	V	V	V	P							V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	227.470386	0	0	0	0	209.0488184	0	0	0	0	0	368.1331708	2564.163374	3371.211268	100.4769236	265.903167	0	0	0	0	0	0	285.9110494	0	126.9477723	0	0	0	0													$25/Day for Days 8-19 for SNF					$50/Case for ER - Facility; $50/Case for ER - Worldwide; $20/Visit for Urgent Care;						$10/Case for OP Fac - Cardiovascular; $10/Case for OP Fac - Occ Therapy; $10/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Service for Prof - CORF; $20/Service for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults; $10/Exam for PCP - Routine Physicals;	$20/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults; $20/Visit for Chiropractor; $20/Exam for Vistion Exams; $20/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$10/Service for PT/ST (PCP); $10/Service for Occ Therapy (PCP); $10/Service for PT/ST (Specialist); $10/Service for Occ Therapy (Specialist);							$20/Exam for Vision (Refractions)		$10/Exam for Routine Hearing Exams															0	0	25	0	0	0	0	42.22117334	0	0	0	0	0	12.15829137	10	20	20	10	0	0	0	0	0	0	20	0	10	0	0	0	0											0	0	0.473896637	0	0	0	0	0.735523867	0	0	0	0	0	0.372989196	2.136802812	5.618685447	0.167461539	0.221585972	0	0	0	0	0	0	0.476518416	0	0.10578981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.3093	0	0	0	0	0.473896637	0	0	0	0	0.735523867	0	0	0	0	0	0.372989196	2.136802812	5.618685447	0.167461539	0.221585972	0	0	0	0	0	0	0.476518416	0	0.10578981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.3093																																																																																				0	0		0	0	0.473896637	0	0	0	0	0.735523867	0	0	0	0	0	0.372989196	2.136802812	5.618685447	0.167461539	0.221585972	0	0	0	0	0	0	0.476518416	0	0.10578981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.3093
H1350_009_0	2008	7																																		D					V						V	V	V	V	P							V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	773.2523046	0	0	0	0	781.6993323	0	0	0	0	0	993.8207097	6995.395994	7509.573568	1323.56405	560.4137626	0	0	0	0	0	0	290.2461911	0	152.4519738	0	0	0	0													$25/Day for Days 8-19 for SNF					$50/Case for ER - Facility; $50/Case for ER - Worldwide; $20/Visit for Urgent Care;						$10/Case for OP Fac - Cardiovascular; $10/Case for OP Fac - Occ Therapy; $10/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Service for Prof - CORF; $20/Service for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults; $10/Exam for PCP - Routine Physicals;	$20/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults; $20/Visit for Chiropractor; $20/Exam for Vistion Exams; $20/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$10/Service for PT/ST (PCP); $10/Service for Occ Therapy (PCP); $10/Service for PT/ST (Specialist); $10/Service for Occ Therapy (Specialist);							$20/Exam for Vision (Refractions)		$10/Exam for Routine Hearing Exams															0	0	25	0	0	0	0	43.5699886	0	0	0	0	0	11.07023452	10	20	20	10	0	0	0	0	0	0	20	0	9.999999999	0	0	0	0											0	0	1.610942301	0	0	0	0	2.83821925	0	0	0	0	0	0.916819028	5.829496662	12.51595595	2.205940083	0.467011469	0	0	0	0	0	0	0.483743652	0	0.127043312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.9952	0	0	0	0	1.610942301	0	0	0	0	2.83821925	0	0	0	0	0	0.916819028	5.829496662	12.51595595	2.205940083	0.467011469	0	0	0	0	0	0	0.483743652	0	0.127043312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.9952																																																																																				0	0		0	0	1.610942301	0	0	0	0	2.83821925	0	0	0	0	0	0.916819028	5.829496662	12.51595595	2.205940083	0.467011469	0	0	0	0	0	0	0.483743652	0	0.127043312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.9952
H1350_802_0	2008	4																																		D					V						V	V	V	V	P									V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	248.525643	0	0	0	0	261.0560381	0	0	0	0	0	487.1338652	2755.425942	3540.257014	99.96910233	262.2391458	0	0	0	0	0	0	0	0	144.0080953	0	0	0	0													$25/Day for for Days 8-19 for SNF					$50/Case for ER - Facility; $50/Case for ER - Worldwide; $20/Visit for Urgent Care;						$10/Case for OP Fac - Cardiovascular; $10/Case for OP Fac - Occ Therapy; $10/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Service for Prof - CORF; $20/Service for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults; $10/Exam for PCP - Routine Physicals;	$20/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults; $20/Visit for Chiropractor; $20/Exam for Vistion Exams; $20/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$10/Service for PT/ST (PCP); $10/Service for Occ Therapy (PCP); $10/Service for PT/ST (Specialist); $10/Service for Occ Therapy (Specialist);									$10/Exam for Routine Hearing Exams															0	0	25	0	0	0	0	42.47834735	0	0	0	0	0	11.04868799	10	20	20.00000001	10	0	0	0	0	0	0	0	0	10	0	0	0	0											0	0	0.517761756	0	0	0	0	0.924102422	0	0	0	0	0	0.448515841	2.296188285	5.900428357	0.166615171	0.218532622	0	0	0	0	0	0	0	0	0.120006746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.5922	0	0	0	0	0.517761756	0	0	0	0	0.924102422	0	0	0	0	0	0.448515841	2.296188285	5.900428357	0.166615171	0.218532622	0	0	0	0	0	0	0	0	0.120006746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.5922																																																																																				0	0		0	0	0.517761756	0	0	0	0	0.924102422	0	0	0	0	0	0.448515841	2.296188285	5.900428357	0.166615171	0.218532622	0	0	0	0	0	0	0	0	0.120006746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.5922
H1364_003_0	2008	4																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0.2733	0.5825	0.1874	0.9183	5.3951	0.3829	0.5748	0	0.0277	0.0408	0.8019	2.2696	0.1996	0.0548	0.307	0	0.6121	0.0112	0	0	0	0	0	0	0	0	0											12.639		291.5126448	147.506644	1282.114929	15.52556066	8.037245065	17.1329235	5.511845272	27.00917664	158.6789087	11.26175402	16.90495993	0	0.814930004	1.201445965	23.58460969	66.75256334	5.870854146	1.612209505	9.02914601	0	18.00432061	0.32934587	0	23.42620332	1.115079083	2.03198995	0.066477133	1.214723858	0	23.35579941	0.346802149											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	100% Coinsurance	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											478.3400639	85.49722546	45.13853874	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0	0	0	0	0	0	0	0											11.6202	1.050950733	4.822732866	0	1.607449013	3.426584701	1.102369054	5.401835327	31.73578175	2.252350804	3.380991986	0	0.162986001	0.240289193	4.716921938	13.35051267	1.174170829	0.322441901	1.805829202	0	3.600864122	0.065869174	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8411	135		11.6202	1.050950733	4.822732866	0	1.880715345	4.0091041	1.289771794	6.320147333	37.13086464	2.63525044	3.955760624	0	0.190693621	0.281138356	5.518798667	15.62009982	1.37377987	0.377257024	2.112820166	0	4.213011023	0.077066934	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.4801		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	100% Coinsurance	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											1.14	0.1031	0.1462	0	2.8786	0.3729	0.12	0.7358	3.6262	0.3044	0.4569	0	0.022	0.0325	1.5863	4.4899	0.3949	0.1084	0.6073	0	1.1255	0.0138	0	0	0	0	0	0	0	0	0											18.2647	135		12.7602	1.154055293	4.968951581	0	4.759347972	4.382025734	1.409744684	7.055902652	40.7570566	2.939629545	4.412662503	0	0.21271929	0.313610655	7.105127627	20.1099568	1.768660518	0.485696157	2.720131289	0	5.338526642	0.090873464	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.7449
H1406_013_0	2008	8	s.	t.	u.								DME/Prosthetics/Supplies	Health & Education (Non-Covered)	Health & Education (Non-Covered)									Prosthetics/Supplies										A	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin				V		V			O	O	O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0				0		0			0	0	0	0	0								0		522.99	100.55	370.82	220.69	179.63	0.54	0.03	438.14	132.17	1321.23	1444.61		23.95	2250.86	7911.48	5315.76	26.56	671.36			8.2				1.65		0.15			0.08	0.06	325.57	3.38	0.02								$550-$950/Admit	$195/Day(Days 1-7)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$0-$200/Visit	$0-$50/Visit	$50-$100/Visit		$0-$100/Proc	$15-$100/Visit	$10/Visit	$30/Visit	$30-$100/Visit	$50/Visit			20% Coins				VIS 740		HER X			Active Outlook	Meals on Wheels		Silver Sneakers	QuitNet								49.600371	146.146464	28.712566	0	99.999988	0.199999	0.200012	50.000008	158.307427	24.494442	57.331262		63.039563	79.355805	10	29.999999	80.002695	50.000008			0.199999				0		0			0	0	0	0	0								2.1617	1.22458558	0.887266144	0	1.496916487	0.10799946	0.00600036	1.825583625	1.743624386	2.6968993	6.9017762	0	0.125816461	14.8849006	6.5929	13.28939956	0.177072632	2.797333781	0	0	1.6399918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5598	0	0	2.1617	1.22458558	0.887266144	0	1.496916487	0.10799946	0.00600036	1.825583625	1.743624386	2.6968993	6.9017762	0	0.125816461	14.8849006	6.5929	13.28939956	0.177072632	2.797333781	0	0	1.6399918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5598																																																																																				0	0	0	2.1617	1.22458558	0.887266144	0	1.496916487	0.10799946	0.00600036	1.825583625	1.743624386	2.6968993	6.9017762	0	0.125816461	14.8849006	6.5929	13.28939956	0.177072632	2.797333781	0	0	1.6399918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5598
H1406_022_0	2008	8	s.	t.	u.								DME/Prosthetics/Supplies	Health & Education (Non-Covered)	Health & Education (Non-Covered)									Prosthetics/Supplies										A	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin				V		V			O	O	O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0				0		0			0	0	0	0	0								0		536.72	103.18	380.55	226.48	184.35	0.57	0.03	449.64	135.64	1355.9	1482.52		24.58	2309.93	8119.09	5455.25	27.26	688.98			8.64				1.65		0.15			0.02	0.06	334.11	0.08	3.38								$550-$950/Admit	$195/Day(Days 1-7)	$0/Day(Days 1-6) $100(Days 7-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$0-$200/Visit	$0-$50/Visit	$50-$100/Visit		$35-$100/Proc	$15-$100/Visit	$10/Visit	$30/Visit	$30-$100/Visit	$50/Visit			20% Coins				VIS 740		HER X			QuitNet	Meals on Wheels		Active Outlook	Silver Sneakers								49.600359	146.146498	72.932608	0	100.000015	0.2	0.199993	50.000004	158.307395	24.494437	57.331266		75.975644	79.355802	9.999999	29.999999	80.002776	49.999993			0.2				0		0			0	0	0	0	0								2.2185	1.256616305	2.312875331	0	1.53625023	0.114	0.00599979	1.87350015	1.789401255	2.767667261	7.082895706	0	0.155623444	15.27552898	6.765907657	13.63812455	0.181739639	2.870749598	0	0	1.728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5733	0	0	2.2185	1.256616305	2.312875331	0	1.53625023	0.114	0.00599979	1.87350015	1.789401255	2.767667261	7.082895706	0	0.155623444	15.27552898	6.765907657	13.63812455	0.181739639	2.870749598	0	0	1.728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5733																																																																																				0	0	0	2.2185	1.256616305	2.312875331	0	1.53625023	0.114	0.00599979	1.87350015	1.789401255	2.767667261	7.082895706	0	0.155623444	15.27552898	6.765907657	13.63812455	0.181739639	2.870749598	0	0	1.728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5733
H1406_024_0	2008	5	s.	t.	u.								Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered																			D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin				V		V			O	O	O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0				0		0			0	0	0	0	0								0		2822.36	106.34	392.17	233.4	189.97	0.6	0.23	463.37	139.78	1397.3	1527.78		25.33	2380.45	8366.97	5621.8	28.09	710.01			9.18				1.65		0.15			0.02	0.06	0.08	3.38	3.5								$0/Day(Days 1-8)	$0/Day(Days 1-7)	$0/Day(Days 1-6) $0(Days 7-100)	$0/Visit	$0/Trip	0% Coins	0% Coins	$25/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			0% Coins				VIS 740		HER X			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Transportation								0	0	0	0	0	0	0	24.999994	0	0	0		0	0	0	0	0	0			0				0		0			0	0	0	0	0								0	0	0	0	0	0	0	0.965353935	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9654	0	0	0	0	0	0	0	0	0	0.965353935	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9654																																																																																				0	0	0	0	0	0	0	0	0	0	0.965353935	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9654
H1406_801_0	2008	3																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		268.93	12.31	381.35	226.96	184.74	0.57	0.22	450.59	135.92	1358.77	1485.66		24.63	2314.82	8136.27	5466.8	27.32	690.43			8.68																					$1000/Admit	$1000/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$100/Visit	$100/Visit		$0-$100/Proc	$35-$100/Visit	$25/Visit	$35/Visit	$35-$100/Visit	$100/Visit			20% Coins																					614.795993	614.7962	17.794739	0	61.479616	0.122959	0.122958	30.739793	122.959168	41.094668	61.479599		38.756656	59.488977	15.3699	21.517859	50.063284	61.479605			0.122959																					13.7781	0.630678435	0.565501976	0	0.946478688	0.07008663	0.02705076	1.154253611	1.39271751	4.653183503	7.611481754	0	0.079548036	11.47552281	10.42113802	9.802819298	0.11397741	3.537280307	0	0	1.06728412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3271	0	42.18365653	13.7781	0.630678435	0.565501976	0	0.946478688	0.07008663	0.02705076	1.154253611	1.39271751	4.653183503	7.611481754	0	0.079548036	11.47552281	10.42113802	9.802819298	0.11397741	3.537280307	0	0	1.06728412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3271	3000																																																																																			0	0	0	13.7781	0.630678435	0.565501976	0	0.946478688	0.07008663	0.02705076	1.154253611	1.39271751	4.653183503	7.611481754	0	0.079548036	11.47552281	10.42113802	9.802819298	0.11397741	3.537280307	0	0	1.06728412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3271
H1406_802_0	2008	3																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		268.93	12.31	381.35	226.96	184.74	0.57	0.22	450.59	135.92	1358.77	1485.66		24.63	2314.82	8136.27	5466.8	27.32	690.43			8.68																					$1000/Admit	$1000/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$100/Visit	$100/Visit		$0-$100/Proc	$35-$100/Visit	$25/Visit	$35/Visit	$35-$100/Visit	$100/Visit			20% Coins																					614.795993	614.7962	17.794739	0	61.479616	0.122959	0.122958	30.739793	122.959168	41.094668	61.479599		38.756656	59.488977	15.3699	21.517859	50.063284	61.479605			0.122959																					13.7781	0.630678435	0.565501976	0	0.946478688	0.07008663	0.02705076	1.154253611	1.39271751	4.653183503	7.611481754	0	0.079548036	11.47552281	10.42113802	9.802819298	0.11397741	3.537280307	0	0	1.06728412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3271	0	42.18365653	13.7781	0.630678435	0.565501976	0	0.946478688	0.07008663	0.02705076	1.154253611	1.39271751	4.653183503	7.611481754	0	0.079548036	11.47552281	10.42113802	9.802819298	0.11397741	3.537280307	0	0	1.06728412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3271	3000																																																																																			0	0	0	13.7781	0.630678435	0.565501976	0	0.946478688	0.07008663	0.02705076	1.154253611	1.39271751	4.653183503	7.611481754	0	0.079548036	11.47552281	10.42113802	9.802819298	0.11397741	3.537280307	0	0	1.06728412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3271
H1406_803_0	2008	3																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		268.93	12.31	381.35	226.96	184.74	0.57	0.22	450.59	135.92	1358.77	1485.66		24.63	2314.82	8136.27	5466.8	27.32	690.43			8.68																					$1000/Admit	$1000/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$100/Visit	$100/Visit		$0-$100/Proc	$35-$100/Visit	$25/Visit	$35/Visit	$35-$100/Visit	$100/Visit			20% Coins																					614.795993	614.7962	17.794739	0	61.479616	0.122959	0.122958	30.739793	122.959168	41.094668	61.479599		38.756656	59.488977	15.3699	21.517859	50.063284	61.479605			0.122959																					13.7781	0.630678435	0.565501976	0	0.946478688	0.07008663	0.02705076	1.154253611	1.39271751	4.653183503	7.611481754	0	0.079548036	11.47552281	10.42113802	9.802819298	0.11397741	3.537280307	0	0	1.06728412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3271	0	42.18365653	13.7781	0.630678435	0.565501976	0	0.946478688	0.07008663	0.02705076	1.154253611	1.39271751	4.653183503	7.611481754	0	0.079548036	11.47552281	10.42113802	9.802819298	0.11397741	3.537280307	0	0	1.06728412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3271	3000																																																																																			0	0	0	13.7781	0.630678435	0.565501976	0	0.946478688	0.07008663	0.02705076	1.154253611	1.39271751	4.653183503	7.611481754	0	0.079548036	11.47552281	10.42113802	9.802819298	0.11397741	3.537280307	0	0	1.06728412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3271
H1406_804_0	2008	3																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		268.93	12.31	381.35	226.96	184.74	0.57	0.22	450.59	135.92	1358.77	1485.66		24.63	2314.82	8136.27	5466.8	27.32	690.43			8.68																					$1000/Admit	$1000/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$100/Visit	$100/Visit		$0-$100/Proc	$35-$100/Visit	$25/Visit	$35/Visit	$35-$100/Visit	$100/Visit			20% Coins																					614.795993	614.7962	17.794739	0	61.479616	0.122959	0.122958	30.739793	122.959168	41.094668	61.479599		38.756656	59.488977	15.3699	21.517859	50.063284	61.479605			0.122959																					13.7781	0.630678435	0.565501976	0	0.946478688	0.07008663	0.02705076	1.154253611	1.39271751	4.653183503	7.611481754	0	0.079548036	11.47552281	10.42113802	9.802819298	0.11397741	3.537280307	0	0	1.06728412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3271	0	42.18365653	13.7781	0.630678435	0.565501976	0	0.946478688	0.07008663	0.02705076	1.154253611	1.39271751	4.653183503	7.611481754	0	0.079548036	11.47552281	10.42113802	9.802819298	0.11397741	3.537280307	0	0	1.06728412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3271	3000																																																																																			0	0	0	13.7781	0.630678435	0.565501976	0	0.946478688	0.07008663	0.02705076	1.154253611	1.39271751	4.653183503	7.611481754	0	0.079548036	11.47552281	10.42113802	9.802819298	0.11397741	3.537280307	0	0	1.06728412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3271
H1415_005_0	2008	3																																D	D	D	V	T	COIN		V	P	P	P	P	P	P	V	V	V	V	V	V		V	T	V	V		V																0.88																																								0.88			68.4																																									Standard medicare																																									9																																								0	0.0513	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0513			0	0.9313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9313																																																																																				0			0	0.9313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9313
H1415_008_0	2008	6																																A	A	D	V	T	COIN		V	P	P	P	P	P	P	V	V	V	V	V	V		V	T		V		V																																																								0		209	46	631		47	1		551	334	180.89	744.57	34.18	237.88	633.49	4803	1492.58	198.05	28.64	109.13	33.2		201	1868		112.83		41															$175 per day 1-3	$500 PER ADMIT	$125 PER DAY		$100 COPAY	0		$50 COPAY	$100 COPAY	$100 COPAY	$100 Copay	$200 COPAY	$30 COPAY	$15 COPAY	$0 COPAY	$30 COPAY	$30 COPAY	$50 COPAY	$75 COPAY	$10 COPAY		$15 COPAY	$3.50 COPAY		$30 COPAY		$30 COPAY															525	500	112.5		100	0.2		50	100	100	100	200	30	15	0	30	30	50	75	10		15	3.5		30		30															9.1438	1.916666667	5.915625	0	0.391666667	0.2	0	2.295833333	2.783333333	1.507416667	6.20475	0.569666667	0.5947	0.7918625	0	3.73145	0.495125	0.119333333	0.6820625	0.027666667	0	0.25125	0.544833333	0	0.282075	0	0.1025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5516			9.1438	1.916666667	5.915625	0	0.391666667	0.2	0	2.295833333	2.783333333	1.507416667	6.20475	0.569666667	0.5947	0.7918625	0	3.73145	0.495125	0.119333333	0.6820625	0.027666667	0	0.25125	0.544833333	0	0.282075	0	0.1025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5516																																																																																				0			9.1438	1.916666667	5.915625	0	0.391666667	0.2	0	2.295833333	2.783333333	1.507416667	6.20475	0.569666667	0.5947	0.7918625	0	3.73145	0.495125	0.119333333	0.6820625	0.027666667	0	0.25125	0.544833333	0	0.282075	0	0.1025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5516
H1415_010_0	2008	3																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H1415_012_0	2008	3																																A	A	D	V	T	COIN		V	P	P	P	P	P	P	V	V	V	V	V	V		V	T		V		V																																																								0		209	46	272		46	1		207	118	180.89	744.57	34.18	237.88	633.49	4000	1492.58	198.05	28.64	109.13	33.2		197	1831		112.83		41															$175 per day 1-3	$500 PER ADMIT	$125 PER DAY		$100 COPAY	0		$50 COPAY	$100 COPAY	$100 COPAY	$100 Copay	$200 COPAY	$30 COPAY	$15 COPAY	$0 COPAY	$30 COPAY	$30 COPAY	$50 COPAY	$75 COPAY	$10 COPAY		$15 COPAY	$3.50 COPAY		$30 COPAY		$30 COPAY															525	500	112.5		100	0.2		50	100	100	100	200	30	15	0	30	30	50	75	10		15	3.5		30		30															9.1438	1.916666667	2.55	0	0.383333333	0.2	0	0.8625	0.983333333	1.507416667	6.20475	0.569666667	0.5947	0.7918625	0	3.73145	0.495125	0.119333333	0.6820625	0.027666667	0	0.24625	0.534041667	0	0.282075	0	0.1025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9285			9.1438	1.916666667	2.55	0	0.383333333	0.2	0	0.8625	0.983333333	1.507416667	6.20475	0.569666667	0.5947	0.7918625	0	3.73145	0.495125	0.119333333	0.6820625	0.027666667	0	0.24625	0.534041667	0	0.282075	0	0.1025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9285																																																																																				0			9.1438	1.916666667	2.55	0	0.383333333	0.2	0	0.8625	0.983333333	1.507416667	6.20475	0.569666667	0.5947	0.7918625	0	3.73145	0.495125	0.119333333	0.6820625	0.027666667	0	0.24625	0.534041667	0	0.282075	0	0.1025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9285
H1415_013_0	2008	2																																A	A	D	V	T	COIN		V	P	P	P	P	P	P	V	V	V	V	V	V		V	T		V		V																																																								0		209	46	631		47	1		551	334	180.89	744.57	34.18	237.88	633.49	4803	1492.58	198.05	28.64	109.13	33.2		201	1868		112.83		41															$175 per day 1-3	$500 PER ADMIT	$125 PER DAY		$100 COPAY	0		$50 COPAY	$100 COPAY	$100 COPAY	$100 Copay	$200 COPAY	$30 COPAY	$15 COPAY	$0 COPAY	$30 COPAY	$30 COPAY	$50 COPAY	$75 COPAY	$10 COPAY		$15 COPAY	$3.50 COPAY		$30 COPAY		$30 COPAY															525	500	112.5		100	0.2		50	100	100	100	200	30	15	0	30	30	50	75	10		15	3.5		30		30															9.1438	1.916666667	5.915625	0	0.391666667	0.2	0	2.295833333	2.783333333	1.507416667	6.20475	0.569666667	0.5947	0.7918625	0	3.73145	0.495125	0.119333333	0.6820625	0.027666667	0	0.25125	0.544833333	0	0.282075	0	0.1025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5516			9.1438	1.916666667	5.915625	0	0.391666667	0.2	0	2.295833333	2.783333333	1.507416667	6.20475	0.569666667	0.5947	0.7918625	0	3.73145	0.495125	0.119333333	0.6820625	0.027666667	0	0.25125	0.544833333	0	0.282075	0	0.1025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5516																																																																																				0			9.1438	1.916666667	5.915625	0	0.391666667	0.2	0	2.295833333	2.783333333	1.507416667	6.20475	0.569666667	0.5947	0.7918625	0	3.73145	0.495125	0.119333333	0.6820625	0.027666667	0	0.25125	0.544833333	0	0.282075	0	0.1025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5516
H1415_015_0	2008	4																																A	A	D	V	T	COIN		V	P	P	P	P	v	P	V	V	V	V	V	V	coin	V	T		V		V																																																								0		209	46	631		47	12.47		551	334	180.89	744.57	34.18	237.88	633.49	4803	1492.58	198.05	28.64	109.13	33.2	3.79	201	1868		112.83		41															$300 per day 1-3	$750 per admit	$125 PER DAY		$100 COPAY	20% coins		$50 copay	$675 copay	$100 COPAY	$100 Copay	$200 COPAY	$40 copay	$15 COPAY	$10 copay	$40 copay	$40 copay	$50 COPAY	$75 COPAY	$10 COPAY	20% coins	$15 COPAY	$3.50 COPAY		$30 COPAY		$30 COPAY	coin														900	750	112.5		100	0.2		50	675	100	100	200	40	15	10	40	40	50	75	10	0.2	15	3.5		30		30															15.675	2.875	5.915625	0	0.391666667	2.494	0	2.295833333	18.7875	1.507416667	6.20475	0.569666667	0.792933333	0.7918625	4.0025	4.975266667	0.660166667	0.119333333	0.6820625	0.027666667	0.758	0.25125	0.544833333	0	0.282075	0	0.1025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7069			15.675	2.875	5.915625	0	0.391666667	2.494	0	2.295833333	18.7875	1.507416667	6.20475	0.569666667	0.792933333	0.7918625	4.0025	4.975266667	0.660166667	0.119333333	0.6820625	0.027666667	0.758	0.25125	0.544833333	0	0.282075	0	0.1025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7069																																																																																				0			15.675	2.875	5.915625	0	0.391666667	2.494	0	2.295833333	18.7875	1.507416667	6.20475	0.569666667	0.792933333	0.7918625	4.0025	4.975266667	0.660166667	0.119333333	0.6820625	0.027666667	0.758	0.25125	0.544833333	0	0.282075	0	0.1025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7069
H1415_016_0	2008	4																																A	A	D	V	T	COIN		V	P	P	P	P	v	P	V	V	V	V	V	V	coin	V	T		V		V																																																								0		209	46	631		47	12.47		551	334	180.89	744.57	34.18	237.88	633.49	4803	1492.58	198.05	28.64	109.13	33.2	3.79	201	1868		112.83		41															$300 per day 1-3	$750 per admit	$125 PER DAY		$100 COPAY	20% coins		$50 copay	$675 copay	$100 COPAY	$100 Copay	$200 COPAY	$40 copay	$15 COPAY	$10 copay	$40 copay	$40 copay	$50 COPAY	$75 COPAY	$10 COPAY	20% coins	$15 COPAY	$3.50 COPAY		$30 COPAY		$30 COPAY	coin														900	750	112.5		100	0.2		50	675	100	100	200	40	15	10	40	40	50	75	10	0.2	15	3.5		30		30															15.675	2.875	5.915625	0	0.391666667	2.494	0	2.295833333	18.7875	1.507416667	6.20475	0.569666667	0.792933333	0.7918625	4.0025	4.975266667	0.660166667	0.119333333	0.6820625	0.027666667	0.758	0.25125	0.544833333	0	0.282075	0	0.1025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7069			15.675	2.875	5.915625	0	0.391666667	2.494	0	2.295833333	18.7875	1.507416667	6.20475	0.569666667	0.792933333	0.7918625	4.0025	4.975266667	0.660166667	0.119333333	0.6820625	0.027666667	0.758	0.25125	0.544833333	0	0.282075	0	0.1025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7069																																																																																				0			15.675	2.875	5.915625	0	0.391666667	2.494	0	2.295833333	18.7875	1.507416667	6.20475	0.569666667	0.792933333	0.7918625	4.0025	4.975266667	0.660166667	0.119333333	0.6820625	0.027666667	0.758	0.25125	0.544833333	0	0.282075	0	0.1025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7069
H1415_802_0	2008	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				22.3716	0	7.4733	0	0.2158	0.4251	0	0.2225	0.9716	0.8844	0	0	0	0	4.5233	0	0	0	0	0	0.1286	0.0943																				37.3103		255	0	631.38	93.84	6.22098	12.474702	0	6.537486	28.441884	26.128116	0	0	0	0	133.013685	0	0	0	0	0	3.787158	2.7285																				Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																				70.79717647	0	9.555069847	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2																				1.5044	0	0.50274	0	1.244196	2.4949404	0	1.3074972	5.6883768	5.2256232	0	0	0	0	26.602737	0	0	0	0	0	0.7574316	0.5457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8737	37.3103178		23.876	0	7.976	0	1.46	2.92	0	1.53	6.66	6.11	0	0	0	0	31.126	0	0	0	0	0	0.886	0.64	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.184																																																																																				0			23.876	0	7.976	0	1.46	2.92	0	1.53	6.66	6.11	0	0	0	0	31.126	0	0	0	0	0	0.886	0.64	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.184
H1415_804_0	2008	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				22.3716	0	7.4733	0	0.2158	0.4251	0	0.2225	0.9716	0.8844	0	0	0	0	4.5233	0	0	0	0	0	0.1286	0.0943																				37.3103		255	0	631.38	93.84	6.22098	12.474702	0	6.537486	28.441884	26.128116	0	0	0	0	133.013685	0	0	0	0	0	3.787158	2.7285																				Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																				70.79717647	0	9.555069847	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2																				1.5044	0	0.50274	0	1.244196	2.4949404	0	1.3074972	5.6883768	5.2256232	0	0	0	0	26.602737	0	0	0	0	0	0.7574316	0.5457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8737	37.31		23.876	0	7.976	0	1.46	2.92	0	1.53	6.66	6.11	0	0	0	0	31.126	0	0	0	0	0	0.886	0.64	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.184																																																																																				0			23.876	0	7.976	0	1.46	2.92	0	1.53	6.66	6.11	0	0	0	0	31.126	0	0	0	0	0	0.886	0.64	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.184
H1415_805_0	2008	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				22.3716	0	7.4733	0	0.2158	0.4251	0	0.2225	0.9716	0.8844	0	0	0	0	4.5233	0	0	0	0	0	0.1286	0.0943																				37.3103		255	0	631.38	93.84	6.22098	12.474702	0	6.537486	28.441884	26.128116	0	0	0	0	133.013685	0	0	0	0	0	3.787158	2.7285																				Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																				70.79717647	0	9.555069847	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2																				1.5044	0	0.50274	0	1.244196	2.4949404	0	1.3074972	5.6883768	5.2256232	0	0	0	0	26.602737	0	0	0	0	0	0.7574316	0.5457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8737	37.31		23.876	0	7.976	0	1.46	2.92	0	1.53	6.66	6.11	0	0	0	0	31.126	0	0	0	0	0	0.886	0.64	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.184																																																																																				0			23.876	0	7.976	0	1.46	2.92	0	1.53	6.66	6.11	0	0	0	0	31.126	0	0	0	0	0	0.886	0.64	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.184
H1415_806_0	2008	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				22.3716	0	7.4733	0	0.2158	0.4251	0	0.2225	0.9716	0.8844	0	0	0	0	4.5233	0	0	0	0	0	0.1286	0.0943																				37.3103		255	0	631.38	93.84	6.22098	12.474702	0	6.537486	28.441884	26.128116	0	0	0	0	133.013685	0	0	0	0	0	3.787158	2.7285																				Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																				70.79717647	0	9.555069847	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2																				1.5044	0	0.50274	0	1.244196	2.4949404	0	1.3074972	5.6883768	5.2256232	0	0	0	0	26.602737	0	0	0	0	0	0.7574316	0.5457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8737	37.31		23.876	0	7.976	0	1.46	2.92	0	1.53	6.66	6.11	0	0	0	0	31.126	0	0	0	0	0	0.886	0.64	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.184																																																																																				0			23.876	0	7.976	0	1.46	2.92	0	1.53	6.66	6.11	0	0	0	0	31.126	0	0	0	0	0	0.886	0.64	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.184
H1416_002_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1762.85716	65.24944255	1313.943123	1646.814928	524.7078894	8.952963088	1.982161408	1136.729117	232.7640665	4010.87571	886.9989402	35.45544813	0.384194336	384.4506567	5190.762351	10745.92654	356.1927972	2589.030885	2950.671736	468.5559122	20.95502283	25.56050496	1000	218.5714286	400	120	62.4	15.6	0	1600	3600											"$160 days 1 - 7, $0 after day 7, unlimited coverage"	"$160 days 1 - 7, $0 after day 7, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$160.00 copayment	20% coinsurance	Copay between $20.00 and $100.00	$0.00 copayment	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$3.00 copayment	$0.00 copayment	$25.00 copayment	$25.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											87.90597125	63.10723614	53	0.049216429	39.10230705	0.2	0.2	17.44133871	79.0847858	0	17.41466394	115.7572969	0.2	26.12279325	0	8.095821135	24.79957878	10.40473791	3.731727117	0	0.2	0	3	0	25	25	25	0	0	0	0											12.9138	0.343142665	5.803248791	0.006754196	1.709774084	1.790592618	0.396432282	1.65217313	1.534008028	0	1.287232371	0.342018903	0.076838867	0.836910418	0	7.249758264	0.736119278	2.244848984	0.917591811	0	4.191004567	0	0.25	0	0.833333333	0.25	0.13	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4956	0	0	12.9138	0.343142665	5.803248791	0.006754196	1.709774084	1.790592618	0.396432282	1.65217313	1.534008028	0	1.287232371	0.342018903	0.076838867	0.836910418	0	7.249758264	0.736119278	2.244848984	0.917591811	0	4.191004567	0	0.25	0	0.833333333	0.25	0.13	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4956	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							11.5678		0											11.5678	0	0	12.9138	0.343142665	5.803248791	0.006754196	1.709774084	1.790592618	0.396432282	1.65217313	1.534008028	0	1.287232371	0.342018903	0.076838867	0.836910418	0	7.249758264	0.736119278	2.244848984	0.917591811	0	4.191004567	0	0.25	0	0.833333333	0.25	0.13	0	11.56779978	0	0	0	0	0	0	0	0	0	0	0	0	57.0634
H1416_003_0	2008	6																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		388.2139735	90.66286283	2229.982758	3756.083133	1887.200111	17.06657248	2.976141215	2425.300991	184.5973921	5803.389151	1120.618067	28.6364442	0.341682275	422.8375405	6499.501985	13628.9946	3409.746496	4370.293216	3638.771844	358.889621	14.19246438	8.81283921	750	218.5714286	400	120	62.4	15.6	0	1600	14400											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	Copay between $0.00 and $20.00	$0.00 copayment	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$25.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0.004851618	30.63338358	0.2	0.2	17.79283431	0	0	8.715396903	0	0.2	4.863451249	0	3.97195532	16.13340565	6.945008167	2.050734701	0	0.2	0	0	0	25	25	25	0	0	0	0											0	0	0	0.00151859	4.817610408	3.413314497	0.595228243	3.596081557	0	0	0.813885936	0	0.068336455	0.171370814	0	4.511146467	4.584235282	2.529310173	0.621846308	0	2.838492876	0	0	0	0.833333333	0.25	0.13	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7757	0	0	0	0	0	0.00151859	4.817610408	3.413314497	0.595228243	3.596081557	0	0	0.813885936	0	0.068336455	0.171370814	0	4.511146467	4.584235282	2.529310173	0.621846308	0	2.838492876	0	0	0	0.833333333	0.25	0.13	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7757	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.5842		0											14.5842	0	0	0	0	0	0.00151859	4.817610408	3.413314497	0.595228243	3.596081557	0	0	0.813885936	0	0.068336455	0.171370814	0	4.511146467	4.584235282	2.529310173	0.621846308	0	2.838492876	0	0	0	0.833333333	0.25	0.13	0	14.58422507	0	0	0	0	0	0	0	0	0	0	0	0	44.3599
H1416_007_0	2008	8																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		455.5761921	88.99901647	2265.62271	45.90861623	14.06172837	16.51235843	3.443224091	22.91552092	16.39587931	6.358768634	15.00645614	38.62259997	0.888333439	6.172324459	6501.735255	67.08753352	17.82121734	25.30173605	16.38940044	2.726010018	19.92176594	0.153220819	750	645	0	0	0	0	0	1600	12.75											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											707.604432	708.4	30.26	0.138326072	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.19810459	0.019125108	0.2	0.2	0	0	0	0	0	0	0	0	0											26.864	5.253908606	5.713145267	6.350358546	2.812345673	3.302471685	0.688644818	4.583104184	3.279175862	1.271753727	3.001291227	0	0.177666688	1.234464892	0	13.4175067	3.564243468	5.060347211	3.246815457	0.052135236	3.984353189	0.030644164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.8884	0	0	26.864	5.253908606	5.713145267	6.350358546	2.812345673	3.302471685	0.688644818	4.583104184	3.279175862	1.271753727	3.001291227	0	0.177666688	1.234464892	0	13.4175067	3.564243468	5.060347211	3.246815457	0.052135236	3.984353189	0.030644164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.8884	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	26.864	5.253908606	5.713145267	6.350358546	2.812345673	3.302471685	0.688644818	4.583104184	3.279175862	1.271753727	3.001291227	0	0.177666688	1.234464892	0	13.4175067	3.564243468	5.060347211	3.246815457	0.052135236	3.984353189	0.030644164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.8884
H1416_009_0	2008	8																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1684.724932	88.28645045	1563.497694	2565.124641	684.3152239	12.06040944	2.648680577	1480.263943	239.3851649	4562.964668	1097.753873	41.4291267	0.342631032	472.9690455	7161.679993	14993.35466	508.6128261	3819.712802	3690.766299	655.1182186	23.36969358	25.8583999	1000	218.5714286	400	120	62.4	15.6	0	1600	3600											"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$25.00 copayment	20% coinsurance	Copay between $20.00 and $30.00	$0.00 copayment	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$3.00 copayment	$0.00 copayment	$25.00 copayment	$25.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											10.35796296	6.764564844	54.19963044	0	32.1998873	0.173856072	0.173856072	14.18450816	17.81952063	0	8.9966738	15.72274136	0.173856072	7.778280493	0	6.91573566	21.39043875	9.033054417	3.710494796	0	0.173856072	0	2.60784108	0	21.732009	21.732009	21.732009	0	0	0	0											1.4542	0.049768285	7.061749765	0	1.836239424	2.096775411	0.460489201	1.749734665	0.355477407	0	0.823011126	0.05428162	0.059568485	0.306573825	0	8.640839789	0.906620959	2.875306133	1.141214095	0	4.062963129	0	0.21732009	0	0.7244003	0.21732009	0.113006447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2069	0	5.294295634	1.4542	0.049768285	7.061749765	0	1.836239424	2.096775411	0.460489201	1.749734665	0.355477407	0	0.823011126	0.05428162	0.059568485	0.306573825	0	8.640839789	0.906620959	2.875306133	1.141214095	0	4.062963129	0	0.21732009	0	0.7244003	0.21732009	0.113006447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2069	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.1333		0											13.1333	0	0	1.4542	0.049768285	7.061749765	0	1.836239424	2.096775411	0.460489201	1.749734665	0.355477407	0	0.823011126	0.05428162	0.059568485	0.306573825	0	8.640839789	0.906620959	2.875306133	1.141214095	0	4.062963129	0	0.21732009	0	0.7244003	0.21732009	0.113006447	0	13.1332518	0	0	0	0	0	0	0	0	0	0	0	0	48.3401
H1416_012_0	2008	8																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1303.663693	36.702705	1287.459826	1331.913215	601.7833316	14.34697291	3.7173549	2171.192622	278.3252319	2355.72782	765.3347047	9.709452696	0.488672615	365.2345972	6541.895095	19828.35595	226.9200878	2410.731526	3889.816091	640.7630276	18.63915599	8.950914428	0	218.5714286	400	120	62.4	15.6	0	1600	3600											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$150.00 copayment	20% coinsurance	Copay between $15.00 and $100.00	Copay between $0.00 and $10.00	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $10.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$25.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											84.67699855	43.61200595	59.22535529	0	40.13820439	0.189977082	0.189977082	16.92162807	67.2515874	0	13.50143954	103.0839069	0.189977082	21.96642292	3.156697043	6.16558969	18.8906656	8.898730249	8.421994631	0	0.189977082	0	0	0	23.74713524	23.74713524	23.74713524	0	0	0	0											9.1992	0.133389882	6.354188802	0	2.012875197	2.725596047	0.706212236	3.061676169	1.559817805	0	0.861093354	0.08340736	0.092836597	0.668574802	1.720898409	10.18779225	0.357222625	1.787704129	2.730000853	0	3.541012465	0	0	0	0.791571175	0.237471352	0.123485103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.936	0	2.581794187	9.1992	0.133389882	6.354188802	0	2.012875197	2.725596047	0.706212236	3.061676169	1.559817805	0	0.861093354	0.08340736	0.092836597	0.668574802	1.720898409	10.18779225	0.357222625	1.787704129	2.730000853	0	3.541012465	0	0	0	0.791571175	0.237471352	0.123485103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.936	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							11.9849		0											11.9849	0	0	9.1992	0.133389882	6.354188802	0	2.012875197	2.725596047	0.706212236	3.061676169	1.559817805	0	0.861093354	0.08340736	0.092836597	0.668574802	1.720898409	10.18779225	0.357222625	1.787704129	2.730000853	0	3.541012465	0	0	0	0.791571175	0.237471352	0.123485103	0	11.98490538	0	0	0	0	0	0	0	0	0	0	0	0	60.9209
H1416_013_0	2008	6																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1831.089041	474.8794564	1000.497012	2190.029652	1297.575026	29.00392261	5.488387728	4704.904952	219.9491117	5638.853103	1290.575781	107.9341751	2.335079131	464.4260724	6053.775558	18900.38303	1653.708505	3205.239343	4195.568517	537.8051831	25.82382678	7.602061615	0	218.5714286	400	120	62.4	15.6	0	1600	3600											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $15.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $5.00 and $75.00	$0.00 copayment	$15.00 copayment	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$25.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											53.39364472	23.34569835	58.24060312	0	35.08630902	0.186818294	0.186818294	18.62703951	53.19742016	0	9.52529737	67.5799397	0.186818294	10.23091097	0	3.459686405	10.61353157	5.247955374	4.24039409	0	0.186818294	0	0	0	23.35228673	23.35228673	23.35228673	0	0	0	0											8.1474	0.923866045	4.855795782	0	3.793926527	5.418463337	1.025331232	7.303204201	0.975060442	0	1.024426508	0.607848754	0.436235499	0.395958483	0	5.449116519	1.462640619	1.401746086	1.482571995	0	4.82436326	0	0	0	0.778409558	0.233522867	0.121431891	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.6613	0	3.574608798	8.1474	0.923866045	4.855795782	0	3.793926527	5.418463337	1.025331232	7.303204201	0.975060442	0	1.024426508	0.607848754	0.436235499	0.395958483	0	5.449116519	1.462640619	1.401746086	1.482571995	0	4.82436326	0	0	0	0.778409558	0.233522867	0.121431891	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.6613	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.5565		0											14.5565	0	0	8.1474	0.923866045	4.855795782	0	3.793926527	5.418463337	1.025331232	7.303204201	0.975060442	0	1.024426508	0.607848754	0.436235499	0.395958483	0	5.449116519	1.462640619	1.401746086	1.482571995	0	4.82436326	0	0	0	0.778409558	0.233522867	0.121431891	0	14.556498	0	0	0	0	0	0	0	0	0	0	0	0	65.2178
H1416_014_0	2008	8																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1294.333606	36.40655395	1276.668407	1320.017748	596.4012972	14.17233988	3.670899811	2153.255903	275.7230224	2334.777883	759.9959157	9.645897637	0.482330018	362.852609	6611.734193	19856.47449	230.8138622	2424.696838	3846.850692	635.4629044	18.39901038	8.924701285	0	218.5714286	400	120	62.4	15.6	0	1600	3600											"$125 days 1 - 5, $0 after day 5, unlimited coverage"	"$125 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$125.00 copayment	20% coinsurance	Copay between $10.00 and $100.00	Copay between $0.00 and $5.00	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $5.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$25.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											71.26771931	36.70704778	59.81305245	0	40.53649848	0.191862237	0.191862237	17.09305059	72.76277753	0	13.07329466	86.7556795	0.191862237	21.67025447	1.626916897	5.03007096	15.18686777	7.193042035	10.39576788	0	0.191862237	0	0	0	23.98277965	23.98277965	23.98277965	0	0	0	0											7.687	0.11136476	6.363452866	0	2.014668356	2.719136837	0.70430705	3.067142673	1.671864411	0	0.827970879	0.069736367	0.092540916	0.655259031	0.896395173	8.32328964	0.292111634	1.45341219	3.332580572	0	3.530075295	0	0	0	0.799425988	0.239827797	0.124710454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9763	0	1.907651987	7.687	0.11136476	6.363452866	0	2.014668356	2.719136837	0.70430705	3.067142673	1.671864411	0	0.827970879	0.069736367	0.092540916	0.655259031	0.896395173	8.32328964	0.292111634	1.45341219	3.332580572	0	3.530075295	0	0	0	0.799425988	0.239827797	0.124710454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9763	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							11.869		0											11.869	0	0	7.687	0.11136476	6.363452866	0	2.014668356	2.719136837	0.70430705	3.067142673	1.671864411	0	0.827970879	0.069736367	0.092540916	0.655259031	0.896395173	8.32328964	0.292111634	1.45341219	3.332580572	0	3.530075295	0	0	0	0.799425988	0.239827797	0.124710454	0	11.86903678	0	0	0	0	0	0	0	0	0	0	0	0	56.8453
H1416_016_0	2008	8																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1864.079475	135.0475829	1591.647241	2713.543761	987.6575864	17.57744565	3.378582857	1177.371788	323.4560788	5000.138599	1343.967663	33.13428084	0.515196224	559.5044051	8319.929905	17753.55384	425.47098	4417.280763	4342.113783	859.1918618	28.34532467	28.79944562	740	218.5714286	400	120	62.4	15.6	0	1600	3600											"$225 days 1 - 5, $0 after day 5, unlimited coverage"	"$225 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $150.00	$0.00 copayment	Copay between $0.00 and $150.00	$225.00 copayment	20% coinsurance	Copay between $25.00 and $150.00	Copay between $0.00 and $5.00	$35.00 copayment	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $5.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$25.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											96.6022082	55.5824864	55.57528626	0	30.1397985	0.178268761	0.178268761	16.91876946	108.2906929	0	22.78060064	103.8029994	0.178268761	31.35903797	1.63358155	7.83103345	23.30059824	11.08788276	5.32654506	0	0.178268761	0	0	0	22.28359513	22.28359513	22.28359513	0	0	0	0											15.0062	0.62552337	7.371354252	0	2.480650053	3.133509459	0.60229578	1.659973488	2.918940242	0	2.551365884	0.286619811	0.091843393	1.462126657	1.132606999	11.58572283	0.826144031	4.081524269	1.92737206	0	5.053085911	0	0	0	0.742786504	0.222835951	0.115874695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8783	0	7.786868705	15.0062	0.62552337	7.371354252	0	2.480650053	3.133509459	0.60229578	1.659973488	2.918940242	0	2.551365884	0.286619811	0.091843393	1.462126657	1.132606999	11.58572283	0.826144031	4.081524269	1.92737206	0	5.053085911	0	0	0	0.742786504	0.222835951	0.115874695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8783	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.7189		0											13.7189	0	0	15.0062	0.62552337	7.371354252	0	2.480650053	3.133509459	0.60229578	1.659973488	2.918940242	0	2.551365884	0.286619811	0.091843393	1.462126657	1.132606999	11.58572283	0.826144031	4.081524269	1.92737206	0	5.053085911	0	0	0	0.742786504	0.222835951	0.115874695	0	13.71892282	0	0	0	0	0	0	0	0	0	0	0	0	77.5973
H1416_017_0	2008	6																					1000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2266.773871	896.8145754	1943.342154	3544.316764	2160.105867	25.69225101	4.466188111	3148.376499	376.8863604	6682.912591	1416.524916	31.55576636	1.955373018	601.268499	6656.819951	16682.86547	2826.843026	6237.484997	4628.872185	613.5576267	21.27933793	17.78196197	740	218.5714286	400	120	62.4	15.6	0	1600	3600											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $10.00 and $75.00	$0.00 copayment	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$25.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											31.35644898	18.0226607	40.58171354	0	20.88448196	0.130173901	0.130173901	12.86222344	41.60201861	0	7.339141446	47.08930895	0.130173901	11.32278886	0	2.816805671	8.764550679	4.811336779	1.485127072	0	0.130173901	0	0	0	16.27173758	16.27173758	16.27173758	0	0	0	0											5.9232	1.3469154	6.572012883	0	3.759391002	3.344460531	0.581381128	3.374593501	1.306602781	0	0.866339727	0.123828269	0.254538533	0.567336355	0	3.916032505	2.064667413	2.500886748	0.572871949	0	2.770014422	0	0	0	0.542391253	0.162717376	0.084613035	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6348	0	21.79674079	5.9232	1.3469154	6.572012883	0	3.759391002	3.344460531	0.581381128	3.374593501	1.306602781	0	0.866339727	0.123828269	0.254538533	0.567336355	0	3.916032505	2.064667413	2.500886748	0.572871949	0	2.770014422	0	0	0	0.542391253	0.162717376	0.084613035	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6348	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							16.0686		0											16.0686	0	0	5.9232	1.3469154	6.572012883	0	3.759391002	3.344460531	0.581381128	3.374593501	1.306602781	0	0.866339727	0.123828269	0.254538533	0.567336355	0	3.916032505	2.064667413	2.500886748	0.572871949	0	2.770014422	0	0	0	0.542391253	0.162717376	0.084613035	0	16.0686275	0	0	0	0	0	0	0	0	0	0	0	0	56.7034
H1416_018_0	2008	9																					2500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1851.604802	133.913844	1576.837895	2686.71746	977.9777834	17.33978707	3.3319288	1167.627796	321.1965092	4950.736938	1335.214259	32.80931628	0.507861802	555.1376052	8246.065649	17716.21596	429.7365413	4432.640871	4317.850053	851.0733383	27.93679024	28.62038268	740	218.5714286	400	120	62.4	15.6	0	1600	3600											"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $125.00	$0.00 copayment	Copay between $0.00 and $125.00	$175.00 copayment	20% coinsurance	Copay between $20.00 and $125.00	Copay between $0.00 and $5.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $5.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$25.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											74.27294747	42.73512176	54.9302856	0	29.78665917	0.176199793	0.176199793	16.72317971	89.06392217	0	18.85500482	102.127783	0.176199793	25.87272595	1.614672644	6.687046644	19.65660732	9.396238251	4.931479943	0	0.176199793	0	0	0	22.02497418	22.02497418	22.02497418	0	0	0	0											11.4603	0.476902036	7.218012991	0	2.427557576	3.0552669	0.587085166	1.627204122	2.383918408	0	2.097955941	0.279228561	0.089485145	1.19691026	1.109558052	9.87243021	0.703930203	3.470845809	1.774449245	0	4.92245667	0	0	0	0.734165806	0.220249742	0.114529866	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8225	0	7.540228767	11.4603	0.476902036	7.218012991	0	2.427557576	3.0552669	0.587085166	1.627204122	2.383918408	0	2.097955941	0.279228561	0.089485145	1.19691026	1.109558052	9.87243021	0.703930203	3.470845809	1.774449245	0	4.92245667	0	0	0	0.734165806	0.220249742	0.114529866	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8225	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.581		0											13.581	0	0	11.4603	0.476902036	7.218012991	0	2.427557576	3.0552669	0.587085166	1.627204122	2.383918408	0	2.097955941	0.279228561	0.089485145	1.19691026	1.109558052	9.87243021	0.703930203	3.470845809	1.774449245	0	4.92245667	0	0	0	0.734165806	0.220249742	0.114529866	0	13.58099322	0	0	0	0	0	0	0	0	0	0	0	0	69.4035
H1416_019_0	2008	10																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1308.760377	68.41050488	1050.897461	2026.787123	650.3734065	11.127619	2.273651445	1313.271357	207.6780071	3953.759515	950.4900645	35.9016183	0.289717528	410.1500678	6077.593076	12880.79345	446.2876249	3343.011656	3214.248829	571.6228614	19.86981961	22.39940577	1000	645	400	120	62.4	15.6	0	1600	14400											"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$25.00 copayment	20% coinsurance	Copay between $20.00 and $30.00	$0.00 copayment	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$3.00 copayment	$0.00 copayment	$25.00 copayment	$25.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											10.724173	7.002375332	56.0995882	0	33.32528286	0.179950564	0.179950564	14.69795285	18.43780353	0	9.312050494	16.27389907	0.179950564	8.048749083	0	7.313296549	22.15414638	9.355870167	3.837098084	0	0.179950564	0	2.699258454	0	22.49382045	22.49382045	22.49382045	0	0	0	0											1.1696	0.039919669	4.912909568	0	1.806156478	2.002421311	0.409144859	1.608533374	0.319093858	0	0.73758429	0.048688276	0.052134832	0.275099582	0	7.850088521	0.823926781	2.606398585	1.027782335	0	3.575585237	0	0.224938204	0	0.749794015	0.224938204	0.116967866	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.5817	0	3.407303888	1.1696	0.039919669	4.912909568	0	1.806156478	2.002421311	0.409144859	1.608533374	0.319093858	0	0.73758429	0.048688276	0.052134832	0.275099582	0	7.850088521	0.823926781	2.606398585	1.027782335	0	3.575585237	0	0.224938204	0	0.749794015	0.224938204	0.116967866	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.5817	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							10.5598		0											10.5598	0	0	1.1696	0.039919669	4.912909568	0	1.806156478	2.002421311	0.409144859	1.608533374	0.319093858	0	0.73758429	0.048688276	0.052134832	0.275099582	0	7.850088521	0.823926781	2.606398585	1.027782335	0	3.575585237	0	0.224938204	0	0.749794015	0.224938204	0.116967866	0	10.55981911	0	0	0	0	0	0	0	0	0	0	0	0	41.1415
H1416_020_0	2008	10																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1004.358674	28.13933651	868.6063062	1058.062464	561.6842587	13.03203079	3.111056852	1872.004078	237.0227981	2005.334324	652.1459744	8.301429582	0.402963311	312.8058965	5632.473811	17109.85667	201.2970404	2102.648961	3320.299515	550.504658	15.38259525	7.731445962	0	645	400	120	62.4	15.6	0	1600	14400											"$125 days 1 - 5, $0 after day 5, unlimited coverage"	"$125 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$125.00 copayment	20% coinsurance	Copay between $10.00 and $100.00	Copay between $0.00 and $5.00	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $5.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$25.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											72.31995613	37.27279952	60.69806769	0	41.13629095	0.194701099	0.194701099	17.41313046	73.81497955	0	13.26673179	88.03934745	0.194701099	21.98607671	1.691692801	5.192024363	15.40932318	7.301377758	10.53521208	0	0.194701099	0	0	0	24.33763741	24.33763741	24.33763741	0	0	0	0											6.0529	0.087402654	4.393560364	0	1.925467258	2.537350721	0.605726189	2.716454269	1.457986083	0	0.720987144	0.06090437	0.0784574	0.573114536	0.794034616	7.402899388	0.258487596	1.279352863	2.915004963	0	2.995008205	0	0	0	0.81125458	0.243376374	0.126555715	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0363	0	1.035179909	6.0529	0.087402654	4.393560364	0	1.925467258	2.537350721	0.605726189	2.716454269	1.457986083	0	0.720987144	0.06090437	0.0784574	0.573114536	0.794034616	7.402899388	0.258487596	1.279352863	2.915004963	0	2.995008205	0	0	0	0.81125458	0.243376374	0.126555715	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0363	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							9.4876		0											9.4876	0	0	6.0529	0.087402654	4.393560364	0	1.925467258	2.537350721	0.605726189	2.716454269	1.457986083	0	0.720987144	0.06090437	0.0784574	0.573114536	0.794034616	7.402899388	0.258487596	1.279352863	2.915004963	0	2.995008205	0	0	0	0.81125458	0.243376374	0.126555715	0	9.487625949	0	0	0	0	0	0	0	0	0	0	0	0	47.5239
H1416_021_0	2008	10																					2500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1455.957576	105.0410903	1078.289856	2178.786332	935.2026154	16.30618779	2.901865872	1042.598029	280.1632942	4313.274086	1162.948122	28.59163947	0.434382878	485.5783765	7046.624542	15390.50816	379.3717349	3895.962425	3781.381328	746.3717379	23.83935766	24.9354902	740	645	400	120	62.4	15.6	0	1600	14400											"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $125.00	$0.00 copayment	Copay between $0.00 and $125.00	$175.00 copayment	20% coinsurance	Copay between $20.00 and $125.00	Copay between $0.00 and $5.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $5.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$25.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											76.71579174	44.13294293	56.72077133	0	30.74144562	0.181943132	0.181943132	17.28040728	91.93153731	0	19.47023662	103.3097802	0.181943132	26.72809893	1.726857757	7.035203995	20.34004447	9.703787015	5.091250188	0	0.181943132	0	0	0	22.74289147	22.74289147	22.74289147	0	0	0	0											9.3079	0.38631437	5.096786031	0	2.395790029	2.966798874	0.527974565	1.501376548	2.146320194	0	1.886906259	0.246149666	0.079032981	1.081548907	1.014043188	9.022947043	0.643036496	3.1504658	1.604329866	0	4.337407392	0	0	0	0.758096382	0.227428915	0.118263036	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.4989	0	4.81325535	9.3079	0.38631437	5.096786031	0	2.395790029	2.966798874	0.527974565	1.501376548	2.146320194	0	1.886906259	0.246149666	0.079032981	1.081548907	1.014043188	9.022947043	0.643036496	3.1504658	1.604329866	0	4.337407392	0	0	0	0.758096382	0.227428915	0.118263036	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.4989	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							11.0616		0											11.0616	0	0	9.3079	0.38631437	5.096786031	0	2.395790029	2.966798874	0.527974565	1.501376548	2.146320194	0	1.886906259	0.246149666	0.079032981	1.081548907	1.014043188	9.022947043	0.643036496	3.1504658	1.604329866	0	4.337407392	0	0	0	0.758096382	0.227428915	0.118263036	0	11.06157618	0	0	0	0	0	0	0	0	0	0	0	0	59.5605
H1417_001_0	2008	3																					1500											A	A	A	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.339511588	11.78590228	249.4181265	0	0	0	0	0	204.8129638	2820.178844	4038.092908	41.38367917	5.556631661	0	361.765021	0	0	0	0	9.014911761	0	0	0	0	0	0											PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $0	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	"4A ER: $50, 4B Urgent Care: $10"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $10, 9D Cardiac Rehab: $10"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $10, 14D Pap Smears: $0, 14D Pelvic Exams: $10, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $10, 14J Nutrition Therapy: $10"	"7B Chiropractic: $10, 7D Physician Specialist: $10, 7F Podiatry: $10"	"7E Mental Health: $10, 7H Psychiatric: $10, 9C OP Substance Abuse: $10"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	Included in i.2.	"7G Other Health Care: $10, 17A Medicare Covered Eye Exams: $10, 18A Medicare Covered Hearing Exams: $10"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $10	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	0	0.1	0.1	48.36	0	0	0	0	0	9.51	10	10	10	10	0	10	0	0.38	0	0	10	0	10	0	0	0	0											0	0	0	0	0	0.033951159	1.178590228	1.00515505	0	0	0	0	0	0.162314274	2.350149036	3.365077424	0.034486399	0.004630526	0	0.301470851	0	0	0	0	0.007512426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.4433	0	2.958708798	0	0	0	0	0	0.033951159	1.178590228	1.00515505	0	0	0	0	0	0.162314274	2.350149036	3.365077424	0.034486399	0.004630526	0	0.301470851	0	0	0	0	0.007512426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.4433	0	PBP: 1A IP Acute: $175 days 1-5	1B IP Psych: $175 days 1-5	2 SNF: $100 days 21-100	6 Home Health: $10	10A Ambulance: $0	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $100	8A OP C/D/T: $30	8B OP X-Ray: $30	9A OP Hospital: $30	12 Renal Dialysis: $0	"3 CORF: $30, 5 Partial Hosp: $30, 9D Cardiac Rehab: $30"	"7A PCP: $30, 14B Immunizations: $0, 14C Routine Physical Exams: $30, 14D Pap Smears: $0, 14D Pelvic Exams: $30, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $30, 14J Nutrition Therapy: $30"	"7B Chiropractic: $30, 7D Physician Specialist: $30, 7F Podiatry: $30"	"7E Mental Health: $30, 7H Psychiatric: $30, 9C OP Substance Abuse: $30"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	Included in i.2.	"7G Other Health Care: $30, 17A Medicare Covered Eye Exams: $30, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $30"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $30	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $30	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											1.0646	0.0135	0.4256	0.0456	0.0062	0.0181	0.2692	0.1125	0.2766	0.103	0.0515	0.001	0.0002	0.0849	0.8115	1.2252	0.0129	0.0058	0.0272	0.1331	0.0092	0.01	0	0	0.0054	0	0.0008	0	0	0	0											4.7134	0	0	1.0646	0.013465074	0.425627888	0.045613141	0.006230627	0.052010524	1.44781958	1.117672545	0.276585022	0.103037804	0.051450573	0.001026942	0.000176266	0.247165653	3.161618252	4.590230235	0.047408	0.010427399	0.027152661	0.434529354	0.009158179	0.009955209	0	0	0.012873244	0	0.000812357	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.1567
H1417_002_0	2008	3																					1500											A	A	A	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.3857895	13.39240692	283.4156406	0	0	0	0	0	232.7304681	3204.589838	4588.514494	47.02457719	6.314041182	0	411.0762383	0	0	0	0	10.24371014	0	0	0	0	0	0											PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $0	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	"4A ER: $50, 4B Urgent Care: $10"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $10, 9D Cardiac Rehab: $10"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $10, 14D Pap Smears: $0, 14D Pelvic Exams: $10, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $10, 14J Nutrition Therapy: $10"	"7B Chiropractic: $10, 7D Physician Specialist: $10, 7F Podiatry: $10"	"7E Mental Health: $10, 7H Psychiatric: $10, 9C OP Substance Abuse: $10"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	Included in i.2.	"7G Other Health Care: $10, 17A Medicare Covered Eye Exams: $10, 18A Medicare Covered Hearing Exams: $10"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $10	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	0	0.1	0.1	48.36	0	0	0	0	0	9.51	10	10	10	10	0	10	0	0.38	0	0	10	0	10	0	0	0	0											0	0	0	0	0	0.03857895	1.339240692	1.142165032	0	0	0	0	0	0.184438896	2.670491532	3.823762079	0.039187148	0.005261701	0	0.342563532	0	0	0	0	0.008536425	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.5942	0	3.362002438	0	0	0	0	0	0.03857895	1.339240692	1.142165032	0	0	0	0	0	0.184438896	2.670491532	3.823762079	0.039187148	0.005261701	0	0.342563532	0	0	0	0	0.008536425	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.5942	0	PBP: 1A IP Acute: $175 days 1-5	1B IP Psych: $175 days 1-5	2 SNF: $100 days 21-100	6 Home Health: $10	10A Ambulance: $0	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $100	8A OP C/D/T: $30	8B OP X-Ray: $30	9A OP Hospital: $30	12 Renal Dialysis: $0	"3 CORF: $30, 5 Partial Hosp: $30, 9D Cardiac Rehab: $30"	"7A PCP: $30, 14B Immunizations: $0, 14C Routine Physical Exams: $30, 14D Pap Smears: $0, 14D Pelvic Exams: $30, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $30, 14J Nutrition Therapy: $30"	"7B Chiropractic: $30, 7D Physician Specialist: $30, 7F Podiatry: $30"	"7E Mental Health: $30, 7H Psychiatric: $30, 9C OP Substance Abuse: $30"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	Included in i.2.	"7G Other Health Care: $30, 17A Medicare Covered Eye Exams: $30, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $30"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $30	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $30	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											1.2098	0.0153	0.4836	0.0518	0.0071	0.0205	0.3059	0.1279	0.3143	0.1171	0.0585	0.0012	0.0002	0.0964	0.9221	1.3922	0.0147	0.0066	0.0309	0.1131	0	0	0	0	0.0061	0	0.0009	0	0	0	0											5.296	110	0	1.2098	0.015300462	0.483644081	0.051830545	0.007079908	0.059099938	1.645167973	1.270019484	0.314285583	0.11708261	0.058463663	0.001166922	0.000200293	0.280856139	3.592569934	5.215912176	0.053870057	0.011848729	0.030853767	0.455616206	0	0	0	0	0.014627961	0	0.000923088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.8902
H1417_003_0	2008	3																					3000											A	A	A	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	159.0212121	1.804484657	336.3216595	0	64.55545583	0.339004485	11.76829855	249.0750948	39.29086102	3.981920286	4.058761768	0	0	194.350943	2716.994401	3891.414988	39.88047651	7.068762074	0	348.6244267	25.49485715	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $125 days 1-5	1B IP Psych: $125 days 1-5	2 SNF: $100 days 21-100	6 Home Health: $0	10A Ambulance: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $35"	9B ASC Services: 10%	8A OP C/D/T: 10%	8B OP X-Ray: 10%	9A OP Hospital: 10%	12 Renal Dialysis: $0	"3 CORF: $35, 5 Partial Hosp: $35, 9D Cardiac Rehab: $35"	"7A PCP: $20, 14B Immunizations: $0, 14C Routine Physical Exams: $20, 14D Pap Smears: $0, 14D Pelvic Exams: $35, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $35, 14J Nutrition Therapy: $35"	"7B Chiropractic: $35, 7D Physician Specialist: $35, 7F Podiatry: $35"	"7E Mental Health: $35, 7H Psychiatric: $35, 9C OP Substance Abuse: $35"	"7C Occupational Therapy: $35, 7I Physical and Speech Therapy: $35"	Included in i.2.	"7G Other Health Care: $35, 17A Medicare Covered Eye Exams: $35, 18A Medicare Covered Hearing Exams: $35"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $35"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: not covered	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											380.66	500.20625	100	0	100	0.2	0.2	49.385	0.1	0.1	0.1	0.1	0	35	20	35	35	35	0	35	0.1	1.33	0	0	0	0	0	0	0	0	0											5.0444	0.075217875	2.802680496	0	0.537962132	0.067800897	2.353659709	1.025047796	3.929086102	0.398192029	0.405876177	0	0	0.566856917	4.528324002	11.34996038	0.116318056	0.020617223	0	1.016821245	2.549485715	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.7883	0	24.28370641	5.0444	0.075217875	2.802680496	0	0.537962132	0.067800897	2.353659709	1.025047796	3.929086102	0.398192029	0.405876177	0	0	0.566856917	4.528324002	11.34996038	0.116318056	0.020617223	0	1.016821245	2.549485715	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.7883	0	PBP: 1A IP Acute: $180 days 1-5	1B IP Psych: $180 days 1-5	2 SNF: $115 days 21-100	6 Home Health: $20	10A Ambulance: 15%	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: 15%"	9B ASC Services: 15%	8A OP C/D/T: 15%	8B OP X-Ray: 15%	9A OP Hospital: 15%	12 Renal Dialysis: $0	"3 CORF: 15%, 5 Partial Hosp: 15%, 9D Cardiac Rehab: 15%"	"7A PCP: 15%, 14B Immunizations: $0, 14C Routine Physical Exams: 15%, 14D Pap Smears: $0, 14D Pelvic Exams: 15%, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: 15%, 14J Nutrition Therapy: 15%"	"7B Chiropractic: 15%, 7D Physician Specialist: 15%, 7F Podiatry: 15%"	"7E Mental Health: 15%, 7H Psychiatric: 15%, 9C OP Substance Abuse: 15%"	"7C Occupational Therapy: 15%, 7I Physical and Speech Therapy: 15%"	Included in i.2.	"7G Other Health Care: 15%, 17A Medicare Covered Eye Exams: 15%, 18A Medicare Covered Hearing Exams: 15%"	15 Part B Drugs: 15%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: 15%"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: not covered	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											1.1129	0.0158	0.3961	0.0816	0.0726	0.0263	0.2481	0.0982	0.6424	0.0794	0.0884	0.0019	0.0003	0.4348	0.4692	1.5712	0.0076	1.405	0.0491	1.2168	0.3954	0.0183	0	0	0	0	0	0	0	0	0											8.4313	200	0.583725772	6.1573	0.091021145	3.198767371	0.081631131	0.610597803	0.094074817	2.601776631	1.123240775	4.571455389	0.477560545	0.494265017	0.001852201	0.000322732	1.00161626	4.997568338	12.92115213	0.123963259	1.42561775	0.049139465	2.233605906	2.944872409	0.018251834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2196
H1417_004_0	2008	3																					3000											A	A	A	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	180.6969659	2.050449109	382.1647606	0	73.35483642	0.385213275	13.37240368	283.0258512	44.64649263	4.524685133	4.612000671	0	0	220.8423974	3087.340602	4421.843302	45.31647703	8.032286025	0	396.1444849	28.96999257	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $125 days 1-5	1B IP Psych: $125 days 1-5	2 SNF: $100 days 21-100	6 Home Health: $0	10A Ambulance: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $35"	9B ASC Services: 10%	8A OP C/D/T: 10%	8B OP X-Ray: 10%	9A OP Hospital: 10%	12 Renal Dialysis: $0	"3 CORF: $35, 5 Partial Hosp: $35, 9D Cardiac Rehab: $35"	"7A PCP: $20, 14B Immunizations: $0, 14C Routine Physical Exams: $20, 14D Pap Smears: $0, 14D Pelvic Exams: $35, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $35, 14J Nutrition Therapy: $35"	"7B Chiropractic: $35, 7D Physician Specialist: $35, 7F Podiatry: $35"	"7E Mental Health: $35, 7H Psychiatric: $35, 9C OP Substance Abuse: $35"	"7C Occupational Therapy: $35, 7I Physical and Speech Therapy: $35"	Included in i.2.	"7G Other Health Care: $35, 17A Medicare Covered Eye Exams: $35, 18A Medicare Covered Hearing Exams: $35"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $35"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: not covered	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											380.66	500.20625	100	0	100	0.2	0.2	49.385	0.1	0.1	0.1	0.1	0	35	20	35	35	35	0	35	0.1	1.33	0	0	0	0	0	0	0	0	0											5.732	0.085470622	3.184706338	0	0.611290304	0.077042655	2.674480735	1.164769305	4.464649263	0.452468513	0.461200067	0	0	0.644123659	5.14556767	12.89704296	0.132173058	0.023427501	0	1.155421414	2.896999257	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.8028	0	27.59375313	5.732	0.085470622	3.184706338	0	0.611290304	0.077042655	2.674480735	1.164769305	4.464649263	0.452468513	0.461200067	0	0	0.644123659	5.14556767	12.89704296	0.132173058	0.023427501	0	1.155421414	2.896999257	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.8028	0	PBP: 1A IP Acute: $180 days 1-5	1B IP Psych: $180 days 1-5	2 SNF: $115 days 21-100	6 Home Health: $20	10A Ambulance: 15%	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: 15%"	9B ASC Services: 15%	8A OP C/D/T: 15%	8B OP X-Ray: 15%	9A OP Hospital: 15%	12 Renal Dialysis: $0	"3 CORF: 15%, 5 Partial Hosp: 15%, 9D Cardiac Rehab: 15%"	"7A PCP: 15%, 14B Immunizations: $0, 14C Routine Physical Exams: 15%, 14D Pap Smears: $0, 14D Pelvic Exams: 15%, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: 15%, 14J Nutrition Therapy: 15%"	"7B Chiropractic: 15%, 7D Physician Specialist: 15%, 7F Podiatry: 15%"	"7E Mental Health: 15%, 7H Psychiatric: 15%, 9C OP Substance Abuse: 15%"	"7C Occupational Therapy: 15%, 7I Physical and Speech Therapy: 15%"	Included in i.2.	"7G Other Health Care: 15%, 17A Medicare Covered Eye Exams: 15%, 18A Medicare Covered Hearing Exams: 15%"	15 Part B Drugs: 15%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: 15%"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: not covered	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											1.2646	0.018	0.4501	0.0928	0.0825	0.0299	0.2819	0.1116	0.7299	0.0902	0.1004	0.0021	0.0004	0.494	0.5332	1.7854	0.0087	2.3388	0.0558	1.3229	0.433	0.0004	0	0	0	0	0	0	0	0	0											10.2265	200	0.663291862	6.9966	0.103427993	3.63478275	0.092758051	0.693826748	0.106897902	2.956417807	1.276346704	5.194578181	0.542655539	0.561636952	0.00210467	0.000366723	1.138143879	5.67877344	14.68239964	0.140860358	2.362274192	0.055837533	2.478337505	3.329982571	0.000355776	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.0293
H1417_005_0	2008	3																					1500											A	A	A	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.3857895	13.39240692	283.4156406	0	0	0	0	0	232.7304681	3204.589838	4588.514494	47.02457719	6.314041182	0	411.0762383	0	0	0	0	10.24371014	0	0	0	0	0	0											PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $0	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	"4A ER: $50, 4B Urgent Care: $10"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $10, 9D Cardiac Rehab: $10"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $10, 14D Pap Smears: $0, 14D Pelvic Exams: $10, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $10, 14J Nutrition Therapy: $10"	"7B Chiropractic: $10, 7D Physician Specialist: $10, 7F Podiatry: $10"	"7E Mental Health: $10, 7H Psychiatric: $10, 9C OP Substance Abuse: $10"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	Included in i.2.	"7G Other Health Care: $10, 17A Medicare Covered Eye Exams: $10, 18A Medicare Covered Hearing Exams: $10"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $10	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	0	0.1	0.1	48.36	0	0	0	0	0	9.51	10	10	10	10	0	10	0	0.38	0	0	10	0	10	0	0	0	0											0	0	0	0	0	0.03857895	1.339240692	1.142165032	0	0	0	0	0	0.184438896	2.670491532	3.823762079	0.039187148	0.005261701	0	0.342563532	0	0	0	0	0.008536425	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.5942	0	3.362002438	0	0	0	0	0	0.03857895	1.339240692	1.142165032	0	0	0	0	0	0.184438896	2.670491532	3.823762079	0.039187148	0.005261701	0	0.342563532	0	0	0	0	0.008536425	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.5942	0	PBP: 1A IP Acute: $175 days 1-5	1B IP Psych: $175 days 1-5	2 SNF: $100 days 21-100	6 Home Health: $10	10A Ambulance: $0	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $100	8A OP C/D/T: $30	8B OP X-Ray: $30	9A OP Hospital: $30	12 Renal Dialysis: $0	"3 CORF: $30, 5 Partial Hosp: $30, 9D Cardiac Rehab: $30"	"7A PCP: $30, 14B Immunizations: $0, 14C Routine Physical Exams: $30, 14D Pap Smears: $0, 14D Pelvic Exams: $30, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $30, 14J Nutrition Therapy: $30"	"7B Chiropractic: $30, 7D Physician Specialist: $30, 7F Podiatry: $30"	"7E Mental Health: $30, 7H Psychiatric: $30, 9C OP Substance Abuse: $30"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	Included in i.2.	"7G Other Health Care: $30, 17A Medicare Covered Eye Exams: $30, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $30"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $30	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $30	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											1.2098	0.0153	0.4836	0.0518	0.0071	0.0205	0.3059	0.1279	0.3143	0.1171	0.0585	0.0012	0.0002	0.0964	0.9221	1.3922	0.0147	0.0066	0.0309	0.1131	0	0	0	0	0.0061	0	0.0009	0	0	0	0											5.296	110	0	1.2098	0.015300462	0.483644081	0.051830545	0.007079908	0.059099938	1.645167973	1.270019484	0.314285583	0.11708261	0.058463663	0.001166922	0.000200293	0.280856139	3.592569934	5.215912176	0.053870057	0.011848729	0.030853767	0.455616206	0	0	0	0	0.014627961	0	0.000923088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.8902
H1417_006_0	2008	3																					3000											A	A	A	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	180.6969659	2.050449109	382.1647606	0	73.35483642	0.385213275	13.37240368	283.0258512	44.64649263	4.524685133	4.612000671	0	0	220.8423974	3087.340602	4421.843302	45.31647703	8.032286025	0	396.1444849	28.96999257	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $125 days 1-5	1B IP Psych: $125 days 1-5	2 SNF: $100 days 21-100	6 Home Health: $0	10A Ambulance: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $35"	9B ASC Services: 10%	8A OP C/D/T: 10%	8B OP X-Ray: 10%	9A OP Hospital: 10%	12 Renal Dialysis: $0	"3 CORF: $35, 5 Partial Hosp: $35, 9D Cardiac Rehab: $35"	"7A PCP: $20, 14B Immunizations: $0, 14C Routine Physical Exams: $20, 14D Pap Smears: $0, 14D Pelvic Exams: $35, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $35, 14J Nutrition Therapy: $35"	"7B Chiropractic: $35, 7D Physician Specialist: $35, 7F Podiatry: $35"	"7E Mental Health: $35, 7H Psychiatric: $35, 9C OP Substance Abuse: $35"	"7C Occupational Therapy: $35, 7I Physical and Speech Therapy: $35"	Included in i.2.	"7G Other Health Care: $35, 17A Medicare Covered Eye Exams: $35, 18A Medicare Covered Hearing Exams: $35"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $35"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: not covered	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											380.66	500.20625	100	0	100	0.2	0.2	49.385	0.1	0.1	0.1	0.1	0	35	20	35	35	35	0	35	0.1	1.33	0	0	0	0	0	0	0	0	0											5.732	0.085470622	3.184706338	0	0.611290304	0.077042655	2.674480735	1.164769305	4.464649263	0.452468513	0.461200067	0	0	0.644123659	5.14556767	12.89704296	0.132173058	0.023427501	0	1.155421414	2.896999257	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.8028	0	27.59375313	5.732	0.085470622	3.184706338	0	0.611290304	0.077042655	2.674480735	1.164769305	4.464649263	0.452468513	0.461200067	0	0	0.644123659	5.14556767	12.89704296	0.132173058	0.023427501	0	1.155421414	2.896999257	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.8028	0	PBP: 1A IP Acute: $180 days 1-5	1B IP Psych: $180 days 1-5	2 SNF: $115 days 21-100	6 Home Health: $20	10A Ambulance: 15%	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: 15%"	9B ASC Services: 15%	8A OP C/D/T: 15%	8B OP X-Ray: 15%	9A OP Hospital: 15%	12 Renal Dialysis: $0	"3 CORF: 15%, 5 Partial Hosp: 15%, 9D Cardiac Rehab: 15%"	"7A PCP: 15%, 14B Immunizations: $0, 14C Routine Physical Exams: 15%, 14D Pap Smears: $0, 14D Pelvic Exams: 15%, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: 15%, 14J Nutrition Therapy: 15%"	"7B Chiropractic: 15%, 7D Physician Specialist: 15%, 7F Podiatry: 15%"	"7E Mental Health: 15%, 7H Psychiatric: 15%, 9C OP Substance Abuse: 15%"	"7C Occupational Therapy: 15%, 7I Physical and Speech Therapy: 15%"	Included in i.2.	"7G Other Health Care: 15%, 17A Medicare Covered Eye Exams: 15%, 18A Medicare Covered Hearing Exams: 15%"	15 Part B Drugs: 15%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: 15%"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: not covered	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											1.2646	0.018	0.4501	0.0928	0.0825	0.0299	0.2819	0.1116	0.7299	0.0902	0.1004	0.0021	0.0004	0.494	0.5332	1.7854	0.0087	2.3388	0.0558	1.3229	0.433	0.0004	0	0	0	0	0	0	0	0	0											10.2265	200	0.663291862	6.9966	0.103427993	3.63478275	0.092758051	0.693826748	0.106897902	2.956417807	1.276346704	5.194578181	0.542655539	0.561636952	0.00210467	0.000366723	1.138143879	5.67877344	14.68239964	0.140860358	2.362274192	0.055837533	2.478337505	3.329982571	0.000355776	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.0293
H1417_007_0	2008	8																					4000											A	A	A	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	103.4158807	1.173506148	221.2212093	154.2319067	42.45230774	0.288507782	10.01534158	212.1153481	150.9663972	188.2545821	73.8596969	0	0	165.5116019	2310.482452	3309.3775	33.91556851	4.645134583	0	296.4808012	670.1655028	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $250 days 1-10	1B IP Psych: $250 days 1-10	2 SNF: $200 days 21-100	6 Home Health: $65	10A Ambulance: $250	11A DME: 25%	"11B Prosthetic Medical Supplies: 25%, 11C Diabetes Monitoring Supplies: 25%"	"4A ER: $50, 4B Urgent Care: $50"	9B ASC Services: $250	8A OP C/D/T: $65	8B OP X-Ray: $65	9A OP Hospital: $65	12 Renal Dialysis: $0	"3 CORF: $65, 5 Partial Hosp: $65, 9D Cardiac Rehab: $65"	"7A PCP: $45, 14B Immunizations: $0, 14C Routine Physical Exams: $45, 14D Pap Smears: $0, 14D Pelvic Exams: $65, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $65, 14J Nutrition Therapy: $65"	"7B Chiropractic: $65, 7D Physician Specialist: $65, 7F Podiatry: $65"	"7E Mental Health: $65, 7H Psychiatric: $65, 9C OP Substance Abuse: $65"	"7C Occupational Therapy: $65, 7I Physical and Speech Therapy: $65"	Included in i.2.	"7G Other Health Care: $65, 17A Medicare Covered Eye Exams: $65, 18A Medicare Covered Hearing Exams: $65"	15 Part B Drugs: $65	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $65"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											974.82	1512.64	200	65	250	0.25	0.25	50	250	65	65	65	0	65	45	65	65	65	0	65	65	2.47	0	0	0	0	0	0	0	0	0											8.401	0.147924362	3.687020155	0.835422828	0.884423078	0.072126946	2.503835394	0.883813951	3.145133276	1.01971232	0.400073358	0	0	0.896521177	8.664309194	17.92579479	0.183709329	0.025161146	0	1.605937673	3.63006314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.912	0	76.75089162	8.401	0.147924362	3.687020155	0.835422828	0.884423078	0.072126946	2.503835394	0.883813951	3.145133276	1.01971232	0.400073358	0	0	0.896521177	8.664309194	17.92579479	0.183709329	0.025161146	0	1.605937673	3.63006314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.912	0	PBP: 1A IP Acute: $500 days 1-10	1B IP Psych: $500 days 1-10	2 SNF: $500 days 21-100	6 Home Health: $90	10A Ambulance: $500	11A DME: 30%	"11B Prosthetic Medical Supplies: 30%, 11C Diabetes Monitoring Supplies: 30%"	"4A ER: $50, 4B Urgent Care: $50"	9B ASC Services: $500	8A OP C/D/T: $90	8B OP X-Ray: $90	9A OP Hospital: $90	12 Renal Dialysis: $0	"3 CORF: $90, 5 Partial Hosp: $90, 9D Cardiac Rehab: $90"	"7A PCP: $90, 14B Immunizations: $0, 14C Routine Physical Exams: $90, 14D Pap Smears: $0, 14D Pelvic Exams: $90, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $90, 14J Nutrition Therapy: $90"	"7B Chiropractic: $90, 7D Physician Specialist: $90, 7F Podiatry: $90"	"7E Mental Health: $90, 7H Psychiatric: $90, 9C OP Substance Abuse: $90"	"7C Occupational Therapy: $90, 7I Physical and Speech Therapy: $90"	Included in i.2.	"7G Other Health Care: $90, 17A Medicare Covered Eye Exams: $90, 18A Medicare Covered Hearing Exams: $90"	15 Part B Drugs: $90	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $90"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											3.5549	0.0586	1.6525	0.2562	0.3081	0.0506	0.3585	0.0941	1.1277	0.269	0.148	0.004	0.0007	0.2417	1.9787	3.1821	0.0329	0.022	0	0.3654	0.8426	0.0384	0	0	0	0	0	0	0	0	0											14.5868	500	0	11.9559	0.206538571	5.339470991	1.091654624	1.192534435	0.122753083	2.86236113	0.9779626	4.272874051	1.288737716	0.548076748	0.003965817	0.000681625	1.138198025	10.6429642	21.10794153	0.216643344	0.047178235	0	1.971367535	4.472689135	0.03835689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4988
H1417_008_0	2008	8																					4000											A	A	A	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	117.5122213	1.333463615	251.3752775	175.2548432	48.23886766	0.327833502	11.38050586	241.0282209	171.5442209	213.9150579	83.92731358	0	0	188.0720433	2625.418102	3760.469848	38.53850846	5.278300388	0	336.893302	761.5139605	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $250 days 1-10	1B IP Psych: $250 days 1-10	2 SNF: $200 days 21-100	6 Home Health: $65	10A Ambulance: $250	11A DME: 25%	"11B Prosthetic Medical Supplies: 25%, 11C Diabetes Monitoring Supplies: 25%"	"4A ER: $50, 4B Urgent Care: $50"	9B ASC Services: $250	8A OP C/D/T: $65	8B OP X-Ray: $65	9A OP Hospital: $65	12 Renal Dialysis: $0	"3 CORF: $65, 5 Partial Hosp: $65, 9D Cardiac Rehab: $65"	"7A PCP: $45, 14B Immunizations: $0, 14C Routine Physical Exams: $45, 14D Pap Smears: $0, 14D Pelvic Exams: $65, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $65, 14J Nutrition Therapy: $65"	"7B Chiropractic: $65, 7D Physician Specialist: $65, 7F Podiatry: $65"	"7E Mental Health: $65, 7H Psychiatric: $65, 9C OP Substance Abuse: $65"	"7C Occupational Therapy: $65, 7I Physical and Speech Therapy: $65"	Included in i.2.	"7G Other Health Care: $65, 17A Medicare Covered Eye Exams: $65, 18A Medicare Covered Hearing Exams: $65"	15 Part B Drugs: $65	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $65"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											974.82	1512.64	200	65	250	0.25	0.25	50	250	65	65	65	0	65	45	65	65	65	0	65	65	2.47	0	0	0	0	0	0	0	0	0											9.5461	0.168087534	4.189587958	0.949297067	1.00497641	0.081958376	2.845126464	1.004284254	3.573837935	1.158706564	0.454606282	0	0	1.018723568	9.845317882	20.36921168	0.208750254	0.028590794	0	1.824838719	4.124867286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3969	0	87.21259928	9.5461	0.168087534	4.189587958	0.949297067	1.00497641	0.081958376	2.845126464	1.004284254	3.573837935	1.158706564	0.454606282	0	0	1.018723568	9.845317882	20.36921168	0.208750254	0.028590794	0	1.824838719	4.124867286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3969	0	PBP: 1A IP Acute: $500 days 1-10	1B IP Psych: $500 days 1-10	2 SNF: $500 days 21-100	6 Home Health: $90	10A Ambulance: $500	11A DME: 30%	"11B Prosthetic Medical Supplies: 30%, 11C Diabetes Monitoring Supplies: 30%"	"4A ER: $50, 4B Urgent Care: $50"	9B ASC Services: $500	8A OP C/D/T: $90	8B OP X-Ray: $90	9A OP Hospital: $90	12 Renal Dialysis: $0	"3 CORF: $90, 5 Partial Hosp: $90, 9D Cardiac Rehab: $90"	"7A PCP: $90, 14B Immunizations: $0, 14C Routine Physical Exams: $90, 14D Pap Smears: $0, 14D Pelvic Exams: $90, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $90, 14J Nutrition Therapy: $90"	"7B Chiropractic: $90, 7D Physician Specialist: $90, 7F Podiatry: $90"	"7E Mental Health: $90, 7H Psychiatric: $90, 9C OP Substance Abuse: $90"	"7C Occupational Therapy: $90, 7I Physical and Speech Therapy: $90"	Included in i.2.	"7G Other Health Care: $90, 17A Medicare Covered Eye Exams: $90, 18A Medicare Covered Hearing Exams: $90"	15 Part B Drugs: $90	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $90"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											4.0394	0.0666	1.8777	0.2912	0.3501	0.0575	0.4074	0.107	1.2815	0.3057	0.1682	0.0045	0.0008	0.2746	2.2484	3.6159	0.0374	0.025	0	0.2684	0.9174	0	0	0	0	0	0	0	0	0	0											16.3446	500	0	13.5855	0.234691288	6.067279924	1.240455131	1.355085597	0.139485226	3.252521879	1.111266052	4.855298023	1.464402088	0.622783615	0.004506387	0.000774535	1.293342738	12.09367803	23.98510828	0.246173416	0.053608973	0	2.093199282	5.042284765	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7415
H1417_009_0	2008	8																					4000											A	A	A	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	117.5122213	1.333463615	251.3752775	175.2548432	48.23886766	0.327833502	11.38050586	241.0282209	171.5442209	213.9150579	83.92731358	0	0	188.0720433	2625.418102	3760.469848	38.53850846	5.278300388	0	336.893302	761.5139605	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $250 days 1-10	1B IP Psych: $250 days 1-10	2 SNF: $200 days 21-100	6 Home Health: $65	10A Ambulance: $250	11A DME: 25%	"11B Prosthetic Medical Supplies: 25%, 11C Diabetes Monitoring Supplies: 25%"	"4A ER: $50, 4B Urgent Care: $50"	9B ASC Services: $250	8A OP C/D/T: $65	8B OP X-Ray: $65	9A OP Hospital: $65	12 Renal Dialysis: $0	"3 CORF: $65, 5 Partial Hosp: $65, 9D Cardiac Rehab: $65"	"7A PCP: $45, 14B Immunizations: $0, 14C Routine Physical Exams: $45, 14D Pap Smears: $0, 14D Pelvic Exams: $65, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $65, 14J Nutrition Therapy: $65"	"7B Chiropractic: $65, 7D Physician Specialist: $65, 7F Podiatry: $65"	"7E Mental Health: $65, 7H Psychiatric: $65, 9C OP Substance Abuse: $65"	"7C Occupational Therapy: $65, 7I Physical and Speech Therapy: $65"	Included in i.2.	"7G Other Health Care: $65, 17A Medicare Covered Eye Exams: $65, 18A Medicare Covered Hearing Exams: $65"	15 Part B Drugs: $65	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $65"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											974.82	1512.64	200	65	250	0.25	0.25	50	250	65	65	65	0	65	45	65	65	65	0	65	65	2.47	0	0	0	0	0	0	0	0	0											9.5461	0.168087534	4.189587958	0.949297067	1.00497641	0.081958376	2.845126464	1.004284254	3.573837935	1.158706564	0.454606282	0	0	1.018723568	9.845317882	20.36921168	0.208750254	0.028590794	0	1.824838719	4.124867286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3969	0	87.21259928	9.5461	0.168087534	4.189587958	0.949297067	1.00497641	0.081958376	2.845126464	1.004284254	3.573837935	1.158706564	0.454606282	0	0	1.018723568	9.845317882	20.36921168	0.208750254	0.028590794	0	1.824838719	4.124867286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3969	0	PBP: 1A IP Acute: $500 days 1-10	1B IP Psych: $500 days 1-10	2 SNF: $500 days 21-100	6 Home Health: $90	10A Ambulance: $500	11A DME: 30%	"11B Prosthetic Medical Supplies: 30%, 11C Diabetes Monitoring Supplies: 30%"	"4A ER: $50, 4B Urgent Care: $50"	9B ASC Services: $500	8A OP C/D/T: $90	8B OP X-Ray: $90	9A OP Hospital: $90	12 Renal Dialysis: $0	"3 CORF: $90, 5 Partial Hosp: $90, 9D Cardiac Rehab: $90"	"7A PCP: $90, 14B Immunizations: $0, 14C Routine Physical Exams: $90, 14D Pap Smears: $0, 14D Pelvic Exams: $90, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $90, 14J Nutrition Therapy: $90"	"7B Chiropractic: $90, 7D Physician Specialist: $90, 7F Podiatry: $90"	"7E Mental Health: $90, 7H Psychiatric: $90, 9C OP Substance Abuse: $90"	"7C Occupational Therapy: $90, 7I Physical and Speech Therapy: $90"	Included in i.2.	"7G Other Health Care: $90, 17A Medicare Covered Eye Exams: $90, 18A Medicare Covered Hearing Exams: $90"	15 Part B Drugs: $90	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $90"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											4.0394	0.0666	1.8777	0.2912	0.3501	0.0575	0.4074	0.107	1.2815	0.3057	0.1682	0.0045	0.0008	0.2746	2.2484	3.6159	0.0374	0.025	0	0.2684	0.9174	0	0	0	0	0	0	0	0	0	0											16.3446	500	0	13.5855	0.234691288	6.067279924	1.240455131	1.355085597	0.139485226	3.252521879	1.111266052	4.855298023	1.464402088	0.622783615	0.004506387	0.000774535	1.293342738	12.09367803	23.98510828	0.246173416	0.053608973	0	2.093199282	5.042284765	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7415
H1417_801_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	179.4155162	0.934769487	33.62916199	0	3.929205881	0.316588095	10.99012957	19.87912668	37.54465425	3.804951495	3.878377906	0	0	24.94105255	26.79618795	98.54380992	0.371079451	0.148637835	0	82.43674101	24.36178725	0.526782645	0	0	0	0	0	0	0	0	0											"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"20.6%, FFS Medicare Actuarially Equivalent Cost Sharing"	"0.0%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											0.087447077	0.087447077	0.206443434	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											15.6894	0.081742859	6.942519676	0	0.919434176	0.074081614	2.571690319	4.651715643	8.785449093	0.89035865	0.90754043	0	0	5.836206296	6.270307979	23.05925152	0.086832591	0.034781253	0	19.2901974	5.700658215	0.123267139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.9154	0	0	15.6894	0.081742859	6.942519676	0	0.919434176	0.074081614	2.571690319	4.651715643	8.785449093	0.89035865	0.90754043	0	0	5.836206296	6.270307979	23.05925152	0.086832591	0.034781253	0	19.2901974	5.700658215	0.123267139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.9154	0	"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"20.6%, FFS Medicare Actuarially Equivalent Cost Sharing"	"0.0%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											1.7433	0.0091	0.7714	0	0.1022	0.0082	0.2857	0.5169	0.9762	0.0989	0.1008	0	0	0.6485	0.6967	2.5621	0.0096	0.0039	0	2.1434	0.6334	0.0137	0	0	0	0	0	0	0	0	0											11.3239	0	0	17.4326	0.090825399	7.713910751	0	1.021593529	0.082312905	2.857433688	5.168572936	9.761610104	0.989287389	1.008378255	0	0	6.484673662	6.967008866	25.62139058	0.096480657	0.038645837	0	21.43355266	6.334064684	0.136963488	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.2393
H1417_802_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	179.4155162	0.934769487	33.62916199	0	3.929205881	0.316588095	10.99012957	19.87912668	37.54465425	3.804951495	3.878377906	0	0	24.94105255	26.79618795	98.54380992	0.371079451	0.148637835	0	82.43674101	24.36178725	0.526782645	0	0	0	0	0	0	0	0	0											"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"20.6%, FFS Medicare Actuarially Equivalent Cost Sharing"	"0.0%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											0.087447077	0.087447077	0.206443434	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											15.6894	0.081742859	6.942519676	0	0.919434176	0.074081614	2.571690319	4.651715643	8.785449093	0.89035865	0.90754043	0	0	5.836206296	6.270307979	23.05925152	0.086832591	0.034781253	0	19.2901974	5.700658215	0.123267139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.9154	0	0	15.6894	0.081742859	6.942519676	0	0.919434176	0.074081614	2.571690319	4.651715643	8.785449093	0.89035865	0.90754043	0	0	5.836206296	6.270307979	23.05925152	0.086832591	0.034781253	0	19.2901974	5.700658215	0.123267139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.9154	0	"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"20.6%, FFS Medicare Actuarially Equivalent Cost Sharing"	"0.0%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											1.7433	0.0091	0.7714	0	0.1022	0.0082	0.2857	0.5169	0.9762	0.0989	0.1008	0	0	0.6485	0.6967	2.5621	0.0096	0.0039	0	2.1434	0.6334	0.0137	0	0	0	0	0	0	0	0	0											11.3239	0	0	17.4326	0.090825399	7.713910751	0	1.021593529	0.082312905	2.857433688	5.168572936	9.761610104	0.989287389	1.008378255	0	0	6.484673662	6.967008866	25.62139058	0.096480657	0.038645837	0	21.43355266	6.334064684	0.136963488	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.2393
H1417_809_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	179.4155162	0.934769487	33.62916199	0	3.929205881	0.316588095	10.99012957	19.87912668	37.54465425	3.804951495	3.878377906	0	0	24.94105255	26.79618795	98.54380992	0.371079451	0.148637835	0	82.43674101	24.36178725	0.526782645	0	0	0	0	0	0	0	0	0											"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"20.6%, FFS Medicare Actuarially Equivalent Cost Sharing"	"0.0%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											0.087447077	0.087447077	0.206443434	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											15.6894	0.081742859	6.942519676	0	0.919434176	0.074081614	2.571690319	4.651715643	8.785449093	0.89035865	0.90754043	0	0	5.836206296	6.270307979	23.05925152	0.086832591	0.034781253	0	19.2901974	5.700658215	0.123267139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.9154	0	0	15.6894	0.081742859	6.942519676	0	0.919434176	0.074081614	2.571690319	4.651715643	8.785449093	0.89035865	0.90754043	0	0	5.836206296	6.270307979	23.05925152	0.086832591	0.034781253	0	19.2901974	5.700658215	0.123267139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.9154	0	"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"20.6%, FFS Medicare Actuarially Equivalent Cost Sharing"	"0.0%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											1.7433	0.0091	0.7714	0	0.1022	0.0082	0.2857	0.5169	0.9762	0.0989	0.1008	0	0	0.6485	0.6967	2.5621	0.0096	0.0039	0	2.1434	0.6334	0.0137	0	0	0	0	0	0	0	0	0											11.3239	0	0	17.4326	0.090825399	7.713910751	0	1.021593529	0.082312905	2.857433688	5.168572936	9.761610104	0.989287389	1.008378255	0	0	6.484673662	6.967008866	25.62139058	0.096480657	0.038645837	0	21.43355266	6.334064684	0.136963488	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.2393
H1418_002_0	2008	15	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)									Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O	O	V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0	0	0	0	0								0		302.65	6.5	517.53	216.77	72.51	5.08	1.74	343.07	405.15	6372.28	1493.53		8.51	543.09	4923.53	3719.29	20.29	308.75			18.22			3.39	1.82					0.02	0.06	28.24	0.08	3.38								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$50/Visit	$50/Visit			20% Coins			DEN 767	VIS 738					QuitNet	Meals on Wheels	$30/Visit	Active Outlook	Silver Sneakers								549.999993	550.000746	28.712562	0	100.000071	0.199999	0.199999	49.999993	85.431576	0	49.999994		16.683229	49.389029	10	30.000003	50.000202	50.000013			0.199999			0	0					0	0	29.999981	0	0								13.8715	0.297917071	1.238301018	0	0.604250429	1.01599492	0.34799826	1.429458133	2.884383585	0	6.22304092	0	0.01183119	2.23522398	4.102941667	9.29822593	0.084542008	1.286458668	0	0	3.64398178	0	0	0	0	0	0	0	0	0	0	0.070599955	0	0	0	0	0	0	0	0	0	48.6466	0	0	13.8715	0.297917071	1.238301018	0	0.604250429	1.01599492	0.34799826	1.429458133	2.884383585	0	6.22304092	0	0.01183119	2.23522398	4.102941667	9.29822593	0.084542008	1.286458668	0	0	3.64398178	0	0	0	0	0	0	0	0	0	0	0.070599955	0	0	0	0	0	0	0	0	0	48.6466		$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	30% Coins	30% Coins			30% Coins			DEN 767	VIS 738					QuitNet	Meals on Wheels	$35/Visit	Active Outlook	Silver Sneakers								4.4087	0.0947	0.7023	1.0971	0.7482	2.0837	0.7131	0.3123	4.6567	1.1544	3.1137		0.0026	1.5567	4.4453	4.332	0.0539	0.4203			1.2652			0	0					0	0	0.102	0	0								31.263	500	1.706797586	18.2802	0.392651071	1.940607018	1.097125	1.352415429	3.09971692	1.06107226	1.741803133	7.541110585	1.154431	9.33678092	0	0.01441619	3.79190398	8.548214667	13.63023293	0.138455008	1.706751668	0	0	4.90914278	0	0	0	0	0	0	0	0	0	0	0.172581955	0	0	0	0	0	0	0	0	0	79.9096
H1418_801_0	2008	2																					1000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		302.65	6.5	517.52	216.77	72.5	5.07	1.74	343.06	405.14	6372.32	2785.83		8.5	543.07	4959.11	3714.01	48.52	463.16			18.21																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					512.667899	512.668189	16.48747	0	56.96306	0.113926	0.113926	28.481554	113.926207	21.390649	54.063477		18.987432	50.035924	11.39262	17.08893	33.758099	56.963101			0.113926																					12.9299	0.277695269	0.711049623	0	0.344151821	0.57760482	0.19823124	0.81424016	3.846338625	11.35900504	12.55097134	0	0.013449431	2.264417437	4.708104647	5.289038076	0.136495247	2.198585822	0	0	2.07459246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.2939	0	45.55336524	12.9299	0.277695269	0.711049623	0	0.344151821	0.57760482	0.19823124	0.81424016	3.846338625	11.35900504	12.55097134	0	0.013449431	2.264417437	4.708104647	5.289038076	0.136495247	2.198585822	0	0	2.07459246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.2939	3000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					5.4688	0.0617	0.2691	0.4204	0.415	0.7982	0.2733	0.4686	1.785	0.4425	1.1931		0.0078	0.596	1.8456	1.5178	0.0514	0.161			0.4849																					16.2601	0	12.284893	18.3987	0.339346269	0.980197623	0.420407	0.759138821	1.37583582	0.47153424	1.28285316	5.631359625	11.80151304	13.74408634	0	0.021203431	2.860373437	6.553677647	6.806808076	0.187884247	2.359615822	0	0	2.55948946	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.554
H1418_802_0	2008	2																					1000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		302.65	6.5	517.52	216.77	72.5	5.07	1.74	343.06	405.14	6372.32	2785.83		8.5	543.07	4959.11	3714.01	48.52	463.16			18.21																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					512.667899	512.668189	16.48747	0	56.96306	0.113926	0.113926	28.481554	113.926207	21.390649	54.063477		18.987432	50.035924	11.39262	17.08893	33.758099	56.963101			0.113926																					12.9299	0.277695269	0.711049623	0	0.344151821	0.57760482	0.19823124	0.81424016	3.846338625	11.35900504	12.55097134	0	0.013449431	2.264417437	4.708104647	5.289038076	0.136495247	2.198585822	0	0	2.07459246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.2939	0	45.55336524	12.9299	0.277695269	0.711049623	0	0.344151821	0.57760482	0.19823124	0.81424016	3.846338625	11.35900504	12.55097134	0	0.013449431	2.264417437	4.708104647	5.289038076	0.136495247	2.198585822	0	0	2.07459246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.2939	3000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					5.4688	0.0617	0.2691	0.4204	0.415	0.7982	0.2733	0.4686	1.785	0.4425	1.1931		0.0078	0.596	1.8456	1.5178	0.0514	0.161			0.4849																					16.2601	0	12.284893	18.3987	0.339346269	0.980197623	0.420407	0.759138821	1.37583582	0.47153424	1.28285316	5.631359625	11.80151304	13.74408634	0	0.021203431	2.860373437	6.553677647	6.806808076	0.187884247	2.359615822	0	0	2.55948946	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.554
H1418_803_0	2008	2																					1000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		302.65	6.5	517.52	216.77	72.5	5.07	1.74	343.06	405.14	6372.32	2785.83		8.5	543.07	4959.11	3714.01	48.52	463.16			18.21																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					512.667899	512.668189	16.48747	0	56.96306	0.113926	0.113926	28.481554	113.926207	21.390649	54.063477		18.987432	50.035924	11.39262	17.08893	33.758099	56.963101			0.113926																					12.9299	0.277695269	0.711049623	0	0.344151821	0.57760482	0.19823124	0.81424016	3.846338625	11.35900504	12.55097134	0	0.013449431	2.264417437	4.708104647	5.289038076	0.136495247	2.198585822	0	0	2.07459246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.2939	0	45.55336524	12.9299	0.277695269	0.711049623	0	0.344151821	0.57760482	0.19823124	0.81424016	3.846338625	11.35900504	12.55097134	0	0.013449431	2.264417437	4.708104647	5.289038076	0.136495247	2.198585822	0	0	2.07459246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.2939	3000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					5.4688	0.0617	0.2691	0.4204	0.415	0.7982	0.2733	0.4686	1.785	0.4425	1.1931		0.0078	0.596	1.8456	1.5178	0.0514	0.161			0.4849																					16.2601	0	12.284893	18.3987	0.339346269	0.980197623	0.420407	0.759138821	1.37583582	0.47153424	1.28285316	5.631359625	11.80151304	13.74408634	0	0.021203431	2.860373437	6.553677647	6.806808076	0.187884247	2.359615822	0	0	2.55948946	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.554
H1418_804_0	2008	2																					1000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		302.65	6.5	517.52	216.77	72.5	5.07	1.74	343.06	405.14	6372.32	2785.83		8.5	543.07	4959.11	3714.01	48.52	463.16			18.21																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					512.667899	512.668189	16.48747	0	56.96306	0.113926	0.113926	28.481554	113.926207	21.390649	54.063477		18.987432	50.035924	11.39262	17.08893	33.758099	56.963101			0.113926																					12.9299	0.277695269	0.711049623	0	0.344151821	0.57760482	0.19823124	0.81424016	3.846338625	11.35900504	12.55097134	0	0.013449431	2.264417437	4.708104647	5.289038076	0.136495247	2.198585822	0	0	2.07459246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.2939	0	45.55336524	12.9299	0.277695269	0.711049623	0	0.344151821	0.57760482	0.19823124	0.81424016	3.846338625	11.35900504	12.55097134	0	0.013449431	2.264417437	4.708104647	5.289038076	0.136495247	2.198585822	0	0	2.07459246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.2939	3000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					5.4688	0.0617	0.2691	0.4204	0.415	0.7982	0.2733	0.4686	1.785	0.4425	1.1931		0.0078	0.596	1.8456	1.5178	0.0514	0.161			0.4849																					16.2601	0	12.284893	18.3987	0.339346269	0.980197623	0.420407	0.759138821	1.37583582	0.47153424	1.28285316	5.631359625	11.80151304	13.74408634	0	0.021203431	2.860373437	6.553677647	6.806808076	0.187884247	2.359615822	0	0	2.55948946	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.554
H1419_001_0	2008	2																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1961.296402		828.3566603	511.9303681	256.7481686	3.434546879		379.5293475	361.0534329	1213.084938	4447.654248	0	0	517.753786	3535.555445	4125.940397	0	293.3229215	0	0	302.17395				228.8169014		15.24433769															$750 per admit		"$0 days 1-8, $75 days 9-14; $100 15+"	$0 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$100 per procedure	$0 per visit	"$30 X-ray; $165 PET, MRI"	$30 per visit	$30 per visit	$30 per visit	$10 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script				$0 per visit		$0 per visit															126.81		66.23	0	100	0.2		47	100	0	54.3	30	30	30	10	30	30	30	30	30	45				0		0															20.726	0	4.571838468	0	2.139568071	0.686909376	0	1.486489944	3.008778608	0	20.12563547	0	0	1.294384465	2.946296204	10.31485099	0	0.733307304	0	0	1.133152313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1672			20.726	0	4.571838468	0	2.139568071	0.686909376	0	1.486489944	3.008778608	0	20.12563547	0	0	1.294384465	2.946296204	10.31485099	0	0.733307304	0	0	1.133152313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1672																																																																																				0			20.726	0	4.571838468	0	2.139568071	0.686909376	0	1.486489944	3.008778608	0	20.12563547	0	0	1.294384465	2.946296204	10.31485099	0	0.733307304	0	0	1.133152313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1672
H1419_002_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1953.061067		824.8784534	509.7808112	255.6701024	3.420125477		377.9357325	359.5373969	1207.991286	4428.978884	0	0	515.5797771	3520.709915	4108.615886	0	292.0912808	0	0	300.9051445				227.8561165		15.18032787															$250 per admit		"$0 days 1-8, $75 days 9-14; $100 15+"	$0 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$100 per procedure	$0 per visit	"$25 X-ray; $175 PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$5 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit															42.27		66.23	0	100	0.2		47	100	0	52	25	25	25	5	25	25	25	25	25	45				0		0															6.8797	0	4.552641664	0	2.130584187	0.684025095	0	1.480248286	2.996144974	0	19.19224183	0	0	1.074124536	1.466962465	8.559616429	0	0.608523502	0	0	1.128394292	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7532			6.8797	0	4.552641664	0	2.130584187	0.684025095	0	1.480248286	2.996144974	0	19.19224183	0	0	1.074124536	1.466962465	8.559616429	0	0.608523502	0	0	1.128394292	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7532																																																																																				0			6.8797	0	4.552641664	0	2.130584187	0.684025095	0	1.480248286	2.996144974	0	19.19224183	0	0	1.074124536	1.466962465	8.559616429	0	0.608523502	0	0	1.128394292	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7532
H1419_003_0	2008	2																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1966.378893		830.5032584	513.2569811	257.4135041	3.443447141		380.5128574	361.9890644	1216.228518	4459.17987	0	0	519.0954898	3544.71746	4136.632332	0	294.0830366	0	0	302.9570016				229.409856		15.28384177															$0 per admit		"$0 days 1-8, $75 days 9-14; $100 15+"	$0 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$100 per procedure	$0 per visit	"$10 X-ray; $175 PET, MRI"	$10 per visit	$10 per visit	$10 per visit	$0 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script				$0 per visit		$0 per visit															0		66.23	0	100	0.2		47	100	0	39.7	10	10	10	0	10	10	10	10	10	45				0		0															0	0	4.5836859	0	2.145112534	0.688689428	0	1.490342025	3.016575537	0	14.7524534	0	0	0.432579575	0	3.44719361	0	0.245069197	0	0	1.136088756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9378			0	0	4.5836859	0	2.145112534	0.688689428	0	1.490342025	3.016575537	0	14.7524534	0	0	0.432579575	0	3.44719361	0	0.245069197	0	0	1.136088756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9378																																																																																				0			0	0	4.5836859	0	2.145112534	0.688689428	0	1.490342025	3.016575537	0	14.7524534	0	0	0.432579575	0	3.44719361	0	0.245069197	0	0	1.136088756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9378
H1419_005_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		2294.577557		969.1184868	598.9221882	300.3771304	4.018176027		444.0223934	422.406885	1419.223259	5203.439727	0	0	605.7351738	4136.348878	4827.05736	0	343.1669949	0	0	353.5220699				267.6995307		17.83479289															$0 per admit		$0 per admit	$0 per visit	$100 per trip	20% coinsurance		$50 ER; $0 UC	$0 per procedure	$0 per visit	"$0 X-ray; $15 PET, MRI"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$45 per script				$0 per visit		$0 per visit															0		0	0	100	0.2		43.5	0	0	2.7	0	0	0	0	0	0	0	0	0	45				0		0															0	0	0	0	2.503142754	0.803635205	0	1.609581176	0	0	1.170773939	0	0	0	0	0	0	0	0	0	1.325707762	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.4128			0	0	0	0	2.503142754	0.803635205	0	1.609581176	0	0	1.170773939	0	0	0	0	0	0	0	0	0	1.325707762	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.4128																																																																																				0			0	0	0	0	2.503142754	0.803635205	0	1.609581176	0	0	1.170773939	0	0	0	0	0	0	0	0	0	1.325707762	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.4128
H1419_801_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1403.234861	27.33675297	1146.203462	1881.554753	207.6460381	15.71780589	1.003298358	376.6101166	310.2755935	1972.668358	1013.814245	0	0	0	4893.697162	6208.051603	178.2619179	1031.528894	1409.798725	2556.992056	18.07125295	0	0	0	0	0	0															200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665																																																																																				0			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665
H1419_802_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1403.234861	27.33675297	1146.203462	1881.554753	207.6460381	15.71780589	1.003298358	376.6101166	310.2755935	1972.668358	1013.814245	0	0	0	4893.697162	6208.051603	178.2619179	1031.528894	1409.798725	2556.992056	18.07125295	0	0	0	0	0	0															200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665																																																																																				0			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665
H1420_001_0	2008	2																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	1508.501111		1061.809035	446.6920766	190.1797619	7.298921165		482.0857111	268.7322722	2150.602473	5019.202823	0	0	642.3639542	3348.970104	6483.716179	0	1019.336673	0	0	224.9082401				358.8182255		25.62987325															500/admit		"$0 days 1-8, $75 days 9-14; $100 15+"	$0 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$100 per procedure	$0 per visit	"$30 X-ray; $165 PET, MRI"	$30 per visit	$30 per visit	$30 per visit	$10 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script				$0 per visit		$0 per visit															84.54		66.23	0	100	0.2		47	100	0	54.3	30	30	30	10	30	30	30	30	30	45				0		0															10.6274	0	5.86030103	0	1.584831349	1.459784233	0	1.888169035	2.239435602	0	22.71189277	0	0	1.605909885	2.79080842	16.20929045	0	2.548341683	0	0	0.8434059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.3696			10.6274	0	5.86030103	0	1.584831349	1.459784233	0	1.888169035	2.239435602	0	22.71189277	0	0	1.605909885	2.79080842	16.20929045	0	2.548341683	0	0	0.8434059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.3696		30% coins; $500ded; 5000 max OOP		30% coins; $500ded; 5000 max OOP	30% coins; $500ded; 5000 max OOP	$100 per trip	30% coins; $500ded; 5000 max OOP		$50 ER; $25 UC	30% coins; $500ded; 5000 max OOP	30% coins; $500ded; 5000 max OOP	30% coins; $500ded; 5000 max OOP	30% coins; $500ded; 5000 max OOP	30% coins; $500ded; 5000 max OOP	30% coins; $500ded; 5000 max OOP	30% coins; $500ded; 5000 max OOP	30% coins; $500ded; 5000 max OOP	30% coins; $500ded; 5000 max OOP	30% coins; $500ded; 5000 max OOP	30% coins; $500ded; 5000 max OOP	30% coins; $500ded; 5000 max OOP	30% coins; $500ded; 5000 max OOP				30% coins; $500ded; 5000 max OOP		30% coins; $500ded; 5000 max OOP															10.9669		1.0317	0.0573	0.1378	0.2035		0.1978	0.4456	0.6683	1.2237	0	0	0.24	1.0088	3.687	0	0.1781	0	0	0.2277				0.0467		0.0016															20.3225	500	12.52979307	21.5943	0	6.891961237	0.05730544	1.722597363	1.66326768	0	2.086010507	2.685077801	0.668338748	23.93559439	0	0	1.84587107	3.799602542	19.89631278	0	2.726443489	0	0	1.071127962	0	0	0	0.046730899	0	0.001558467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.6921
H1420_801_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1234.846677	24.05634262	1008.659047	1655.768182	182.7285135	13.83166919	0.882902555	331.4169026	273.0425222	1735.948155	892.1565356	0	0	0	4306.453503	5463.08541	156.8704877	907.7454267	1240.622878	2250.153009	15.90270259	0	0	0	0	0	0															200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065			14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065		"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	$50 ER/UC	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"		0	0	"30% coins; $500ded; ""Unlimited OOP"	0	"30% coins; $500ded; ""Unlimited OOP"															7.921957272	0.061430928	1.284540404	1.150765501	0.202333313	0.65552902	0.041843702	0.211846795	0.811305397	0.281540994	0.79041001	0	0.259194098	0.873417564	1.02915746	1.285921799	0.048568008	0.136138098	0.956412696	3.465889756	0.753682214	0	0	0	0.133775323	0	0.037769123															22.3934	500		22.7988	0.351249716	9.690032461	6.669992775	2.486439732	4.805029776	0.306714469	1.592750556	5.362014101	6.068034846	4.875000015	0	0.259194098	0.873417564	11.79529122	19.26857794	0.571469634	3.161956187	5.09182229	10.96639979	3.934222733	0	0	0	0.133775323	0	0.037769123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.0999
H1420_802_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1234.846677	24.05634262	1008.659047	1655.768182	182.7285135	13.83166919	0.882902555	331.4169026	273.0425222	1735.948155	892.1565356	0	0	0	4306.453503	5463.08541	156.8704877	907.7454267	1240.622878	2250.153009	15.90270259	0	0	0	0	0	0															200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065			14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065		"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	$50 ER/UC	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"		0	0	"30% coins; $500ded; ""Unlimited OOP"	0	"30% coins; $500ded; ""Unlimited OOP"															7.921957272	0.061430928	1.284540404	1.150765501	0.202333313	0.65552902	0.041843702	0.211846795	0.811305397	0.281540994	0.79041001	0	0.259194098	0.873417564	1.02915746	1.285921799	0.048568008	0.136138098	0.956412696	3.465889756	0.753682214	0	0	0	0.133775323	0	0.037769123															22.3934	500		22.7988	0.351249716	9.690032461	6.669992775	2.486439732	4.805029776	0.306714469	1.592750556	5.362014101	6.068034846	4.875000015	0	0.259194098	0.873417564	11.79529122	19.26857794	0.571469634	3.161956187	5.09182229	10.96639979	3.934222733	0	0	0	0.133775323	0	0.037769123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.0999
H1463_001_0	2008	3																					500											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	207.8069859	1.986813488	0	0	0	0.360127956	12.50158476	254.5205524	0	0	0	0	0	67.7818917	3163.902062	4368.417368	44.2072462	0	0	411.6003876	0	0	0	0	9.657512723	0	0	0	0	0	0											PBP: 1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $0	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $20, 9D Cardiac Rehab: $0"	"7A PCP: $20, 14B Immunizations: $0, 14C Routine Physical Exams: $20, 14D Pap Smears: $0, 14D Pelvic Exams: $20, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $20, 14J Nutrition Therapy: $20"	"7B Chiropractic: $20, 7D Physician Specialist: $20, 7F Podiatry: $20"	"7E Mental Health: $20, 7H Psychiatric: $20, 9C OP Substance Abuse: $20"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $20, 17A Medicare Covered Eye Exams: $20, 18A Medicare Covered Hearing Exams: $20"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $20	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $20	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	0	0	0	0.1	0.1	48.77	0	0	0	0	0	13.1	20	20	20	0	0	20	0	0.76	0	0	20	0	20	0	0	0	0											4.3293	0.041391948	0	0	0	0.036012796	1.250158476	1.034413945	0	0	0	0	0	0.073995232	5.273170104	7.280695614	0.073678744	0	0	0.686000646	0	0	0	0	0.016095855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.0949	0	25.38758809	4.3293	0.041391948	0	0	0	0.036012796	1.250158476	1.034413945	0	0	0	0	0	0.073995232	5.273170104	7.280695614	0.073678744	0	0	0.686000646	0	0	0	0	0.016095855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.0949	0																																																																																			0	0	0	4.3293	0.041391948	0	0	0	0.036012796	1.250158476	1.034413945	0	0	0	0	0	0.073995232	5.273170104	7.280695614	0.073678744	0	0	0.686000646	0	0	0	0	0.016095855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.0949
H1463_002_0	2008	3																					3000											A	A	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	207.1760794	1.980781478	368.1322795	0	66.95210371	0.360127956	12.50158476	254.5205524	41.47812388	4.024184199	3.921828553	0	0	67.7818917	3128.37533	4321.178861	43.72920481	7.560706603	0	407.1494878	28.41466898	32.64652402	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $125 days 1-5	1B IP Psych: $125 days 1-5	2 SNF: $100 days 21-100	6 Home Health: $0	10A Ambulance: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $35"	9B ASC Services: 10%	8A OP C/D/T: 10%	8B OP X-Ray: 10%	9A OP Hospital: 10%	12 Renal Dialysis: $0	"3 CORF: $35, 5 Partial Hosp: $35, 9D Cardiac Rehab: $35"	"7A PCP: $20, 14B Immunizations: $0, 14C Routine Physical Exams: $20, 14D Pap Smears: $0, 14D Pelvic Exams: $35, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $35, 14J Nutrition Therapy: $35"	"7B Chiropractic: $35, 7D Physician Specialist: $35, 7F Podiatry: $35"	"7E Mental Health: $35, 7H Psychiatric: $35, 9C OP Substance Abuse: $35"	"7C Occupational Therapy: $35, 7I Physical and Speech Therapy: $35"	Included in i.2.	"7G Other Health Care: $35, 17A Medicare Covered Eye Exams: $35, 18A Medicare Covered Hearing Exams: $35"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $35"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											380.66	500.20625	100	0	100	0.2	0.2	49.385	0.1	0.1	0.1	0.1	0	35	20	35	35	35	0	35	0.1	1.33	0	0	0	0	0	0	0	0	0											6.572	0.082566606	3.067768996	0	0.557934198	0.072025591	2.500316952	1.047458123	4.147812388	0.40241842	0.392182855	0	0	0.197697184	5.213958883	12.60343835	0.127543514	0.022052061	0	1.18751934	2.841466898	0.003618323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.0397	0	24.68109378	6.572	0.082566606	3.067768996	0	0.557934198	0.072025591	2.500316952	1.047458123	4.147812388	0.40241842	0.392182855	0	0	0.197697184	5.213958883	12.60343835	0.127543514	0.022052061	0	1.18751934	2.841466898	0.003618323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.0397	0																																																																																			0	0	0	6.572	0.082566606	3.067768996	0	0.557934198	0.072025591	2.500316952	1.047458123	4.147812388	0.40241842	0.392182855	0	0	0.197697184	5.213958883	12.60343835	0.127543514	0.022052061	0	1.18751934	2.841466898	0.003618323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.0397
H1463_003_0	2008	3																					500											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	236.1325974	2.257630692	0	0	0	0.409216029	14.20564216	289.2135645	0	0	0	0	0	77.02105909	3595.165045	4963.864593	50.23301705	0	0	467.7045297	0	0	0	0	10.97390231	0	0	0	0	0	0											PBP: 1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $0	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $20, 9D Cardiac Rehab: $0"	"7A PCP: $20, 14B Immunizations: $0, 14C Routine Physical Exams: $20, 14D Pap Smears: $0, 14D Pelvic Exams: $20, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $20, 14J Nutrition Therapy: $20"	"7B Chiropractic: $20, 7D Physician Specialist: $20, 7F Podiatry: $20"	"7E Mental Health: $20, 7H Psychiatric: $20, 9C OP Substance Abuse: $20"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $20, 17A Medicare Covered Eye Exams: $20, 18A Medicare Covered Hearing Exams: $20"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $20	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $20	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	0	0	0	0.1	0.1	48.77	0	0	0	0	0	13.1	20	20	20	0	0	20	0	0.76	0	0	20	0	20	0	0	0	0											4.9194	0.047033973	0	0	0	0.040921603	1.420564216	1.175412128	0	0	0	0	0	0.084081323	5.991941742	8.273107656	0.083721695	0	0	0.779507549	0	0	0	0	0.018289837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.834	0	28.84810195	4.9194	0.047033973	0	0	0	0.040921603	1.420564216	1.175412128	0	0	0	0	0	0.084081323	5.991941742	8.273107656	0.083721695	0	0	0.779507549	0	0	0	0	0.018289837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.834	0																																																																																			0	0	0	4.9194	0.047033973	0	0	0	0.040921603	1.420564216	1.175412128	0	0	0	0	0	0.084081323	5.991941742	8.273107656	0.083721695	0	0	0.779507549	0	0	0	0	0.018289837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.834
H1463_004_0	2008	3																					3000											A	A	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	235.4156936	2.250776475	418.3114006	0	76.07816493	0.409216029	14.20564216	289.2135645	47.13189541	4.572709926	4.456402457	0	0	77.02105909	3554.795759	4910.187132	49.68981513	8.591286189	0	462.6469397	32.28779611	37.09648393	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $125 days 1-5	1B IP Psych: $125 days 1-5	2 SNF: $100 days 21-100	6 Home Health: $0	10A Ambulance: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $35"	9B ASC Services: 10%	8A OP C/D/T: 10%	8B OP X-Ray: 10%	9A OP Hospital: 10%	12 Renal Dialysis: $0	"3 CORF: $35, 5 Partial Hosp: $35, 9D Cardiac Rehab: $35"	"7A PCP: $20, 14B Immunizations: $0, 14C Routine Physical Exams: $20, 14D Pap Smears: $0, 14D Pelvic Exams: $35, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $35, 14J Nutrition Therapy: $35"	"7B Chiropractic: $35, 7D Physician Specialist: $35, 7F Podiatry: $35"	"7E Mental Health: $35, 7H Psychiatric: $35, 9C OP Substance Abuse: $35"	"7C Occupational Therapy: $35, 7I Physical and Speech Therapy: $35"	Included in i.2.	"7G Other Health Care: $35, 17A Medicare Covered Eye Exams: $35, 18A Medicare Covered Hearing Exams: $35"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $35"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											380.66	500.20625	100	0	100	0.2	0.2	49.385	0.1	0.1	0.1	0.1	0	35	20	35	35	35	0	35	0.1	1.33	0	0	0	0	0	0	0	0	0											7.4678	0.093821038	3.485928339	0	0.633984708	0.081843206	2.841128432	1.190234324	4.713189541	0.457270993	0.445640246	0	0	0.224644756	5.924659598	14.32137914	0.144928627	0.025057918	0	1.349386908	3.228779611	0.004111527	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6338	0	28.04530731	7.4678	0.093821038	3.485928339	0	0.633984708	0.081843206	2.841128432	1.190234324	4.713189541	0.457270993	0.445640246	0	0	0.224644756	5.924659598	14.32137914	0.144928627	0.025057918	0	1.349386908	3.228779611	0.004111527	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6338	0																																																																																			0	0	0	7.4678	0.093821038	3.485928339	0	0.633984708	0.081843206	2.841128432	1.190234324	4.713189541	0.457270993	0.445640246	0	0	0.224644756	5.924659598	14.32137914	0.144928627	0.025057918	0	1.349386908	3.228779611	0.004111527	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6338
H1463_005_0	2008	4																					500											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	236.1325974	2.257630692	0	0	0	0.409216029	14.20564216	289.2135645	0	0	0	0	0	77.02105909	3595.165045	4963.864593	50.23301705	0	0	467.7045297	0	0	0	0	10.97390231	0	0	0	0	0	0											PBP: 1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $0	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $20, 9D Cardiac Rehab: $0"	"7A PCP: $20, 14B Immunizations: $0, 14C Routine Physical Exams: $20, 14D Pap Smears: $0, 14D Pelvic Exams: $20, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $20, 14J Nutrition Therapy: $20"	"7B Chiropractic: $20, 7D Physician Specialist: $20, 7F Podiatry: $20"	"7E Mental Health: $20, 7H Psychiatric: $20, 9C OP Substance Abuse: $20"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $20, 17A Medicare Covered Eye Exams: $20, 18A Medicare Covered Hearing Exams: $20"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $20	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $20	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	0	0	0	0.1	0.1	48.77	0	0	0	0	0	13.1	20	20	20	0	0	20	0	0.76	0	0	20	0	20	0	0	0	0											4.9194	0.047033973	0	0	0	0.040921603	1.420564216	1.175412128	0	0	0	0	0	0.084081323	5.991941742	8.273107656	0.083721695	0	0	0.779507549	0	0	0	0	0.018289837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.834	0	28.84810195	4.9194	0.047033973	0	0	0	0.040921603	1.420564216	1.175412128	0	0	0	0	0	0.084081323	5.991941742	8.273107656	0.083721695	0	0	0.779507549	0	0	0	0	0.018289837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.834	0																																																																																			0	0	0	4.9194	0.047033973	0	0	0	0.040921603	1.420564216	1.175412128	0	0	0	0	0	0.084081323	5.991941742	8.273107656	0.083721695	0	0	0.779507549	0	0	0	0	0.018289837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.834
H1463_006_0	2008	3																					3000											A	A	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	235.4156936	2.250776475	418.3114006	0	76.07816493	0.409216029	14.20564216	289.2135645	47.13189541	4.572709926	4.456402457	0	0	77.02105909	3554.795759	4910.187132	49.68981513	8.591286189	0	462.6469397	32.28779611	37.09648393	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $125 days 1-5	1B IP Psych: $125 days 1-5	2 SNF: $100 days 21-100	6 Home Health: $0	10A Ambulance: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $35"	9B ASC Services: 10%	8A OP C/D/T: 10%	8B OP X-Ray: 10%	9A OP Hospital: 10%	12 Renal Dialysis: $0	"3 CORF: $35, 5 Partial Hosp: $35, 9D Cardiac Rehab: $35"	"7A PCP: $20, 14B Immunizations: $0, 14C Routine Physical Exams: $20, 14D Pap Smears: $0, 14D Pelvic Exams: $35, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $35, 14J Nutrition Therapy: $35"	"7B Chiropractic: $35, 7D Physician Specialist: $35, 7F Podiatry: $35"	"7E Mental Health: $35, 7H Psychiatric: $35, 9C OP Substance Abuse: $35"	"7C Occupational Therapy: $35, 7I Physical and Speech Therapy: $35"	Included in i.2.	"7G Other Health Care: $35, 17A Medicare Covered Eye Exams: $35, 18A Medicare Covered Hearing Exams: $35"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $35"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											380.66	500.20625	100	0	100	0.2	0.2	49.385	0.1	0.1	0.1	0.1	0	35	20	35	35	35	0	35	0.1	1.33	0	0	0	0	0	0	0	0	0											7.4678	0.093821038	3.485928339	0	0.633984708	0.081843206	2.841128432	1.190234324	4.713189541	0.457270993	0.445640246	0	0	0.224644756	5.924659598	14.32137914	0.144928627	0.025057918	0	1.349386908	3.228779611	0.004111527	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6338	0	28.04530731	7.4678	0.093821038	3.485928339	0	0.633984708	0.081843206	2.841128432	1.190234324	4.713189541	0.457270993	0.445640246	0	0	0.224644756	5.924659598	14.32137914	0.144928627	0.025057918	0	1.349386908	3.228779611	0.004111527	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6338	0																																																																																			0	0	0	7.4678	0.093821038	3.485928339	0	0.633984708	0.081843206	2.841128432	1.190234324	4.713189541	0.457270993	0.445640246	0	0	0.224644756	5.924659598	14.32137914	0.144928627	0.025057918	0	1.349386908	3.228779611	0.004111527	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6338
H1463_801_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	198.6904809	0.895123506	39.61276822	0	4.425932798	0.343335814	11.91865755	22.83262534	41.77327347	4.052819447	3.949735459	0	0	26.99055797	30.46226518	110.2700166	0.401567145	0.151986982	0	92.38616918	28.61686178	0.588180257	0	0	0	0	0	0	0	0	0											"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"20.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"0.0%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											0.087495867	0.087495867	0.204103373	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											17.3846	0.078319607	8.085099604	0	1.035668275	0.080340581	2.788965867	5.342834329	9.774945993	0.948359751	0.924238097	0	0	6.315790565	7.128170053	25.80318388	0.093966712	0.035564954	0	21.61836359	6.696345658	0.13763418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2724	0	0	17.3846	0.078319607	8.085099604	0	1.035668275	0.080340581	2.788965867	5.342834329	9.774945993	0.948359751	0.924238097	0	0	6.315790565	7.128170053	25.80318388	0.093966712	0.035564954	0	21.61836359	6.696345658	0.13763418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2724	0																																																																																			0	0	0	17.3846	0.078319607	8.085099604	0	1.035668275	0.080340581	2.788965867	5.342834329	9.774945993	0.948359751	0.924238097	0	0	6.315790565	7.128170053	25.80318388	0.093966712	0.035564954	0	21.61836359	6.696345658	0.13763418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2724
H1463_802_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	198.6904809	0.895123506	39.61276822	0	4.425932798	0.343335814	11.91865755	22.83262534	41.77327347	4.052819447	3.949735459	0	0	26.99055797	30.46226518	110.2700166	0.401567145	0.151986982	0	92.38616918	28.61686178	0.588180257	0	0	0	0	0	0	0	0	0											"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"20.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"0.0%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											0.087495867	0.087495867	0.204103373	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											17.3846	0.078319607	8.085099604	0	1.035668275	0.080340581	2.788965867	5.342834329	9.774945993	0.948359751	0.924238097	0	0	6.315790565	7.128170053	25.80318388	0.093966712	0.035564954	0	21.61836359	6.696345658	0.13763418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2724	0	0	17.3846	0.078319607	8.085099604	0	1.035668275	0.080340581	2.788965867	5.342834329	9.774945993	0.948359751	0.924238097	0	0	6.315790565	7.128170053	25.80318388	0.093966712	0.035564954	0	21.61836359	6.696345658	0.13763418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2724	0																																																																																			0	0	0	17.3846	0.078319607	8.085099604	0	1.035668275	0.080340581	2.788965867	5.342834329	9.774945993	0.948359751	0.924238097	0	0	6.315790565	7.128170053	25.80318388	0.093966712	0.035564954	0	21.61836359	6.696345658	0.13763418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2724
H1463_809_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	198.6904809	0.895123506	39.61276822	0	4.425932798	0.343335814	11.91865755	22.83262534	41.77327347	4.052819447	3.949735459	0	0	26.99055797	30.46226518	110.2700166	0.401567145	0.151986982	0	92.38616918	28.61686178	0.588180257	0	0	0	0	0	0	0	0	0											"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"8.7%, FFS Medicare Actuarially Equivalent Cost Sharing"	"20.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"0.0%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											0.087495867	0.087495867	0.204103373	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											17.3846	0.078319607	8.085099604	0	1.035668275	0.080340581	2.788965867	5.342834329	9.774945993	0.948359751	0.924238097	0	0	6.315790565	7.128170053	25.80318388	0.093966712	0.035564954	0	21.61836359	6.696345658	0.13763418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2724	0	0	17.3846	0.078319607	8.085099604	0	1.035668275	0.080340581	2.788965867	5.342834329	9.774945993	0.948359751	0.924238097	0	0	6.315790565	7.128170053	25.80318388	0.093966712	0.035564954	0	21.61836359	6.696345658	0.13763418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2724	0																																																																																			0	0	0	17.3846	0.078319607	8.085099604	0	1.035668275	0.080340581	2.788965867	5.342834329	9.774945993	0.948359751	0.924238097	0	0	6.315790565	7.128170053	25.80318388	0.093966712	0.035564954	0	21.61836359	6.696345658	0.13763418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2724
H1468_004_0	2008	3																																A	A			T	Coin	Coin	V				V		V	V	V	V				Coin	V	T		V		V																																																								0		364.4607559	7.391655451	0	0	254.1746114	16.30631721	5.147909086	499.0513563	0	0	0	51.82188883	0	30.63588134	4187.972056	2676.754778	322.7312769	0	0	0	0	779.6733675	10.48102782	0	44.46999456	0	8.399887862	0	0	0	0											1a. $150 copay / admit	1b. $150 copay /admit	2. no copay	6. no copay	10a. $50 copay	"11a. 10% coinsurance (no copay on rentals), $1000 OOP Max"	"11b. 10% coins, 11c. no coins"	"4a. $50 copay, 4b. $10 copay"	9a/9b. no copay	8a. no copay	8b. no copay	5. $20 copay	12. no copay	"3/9d. no copay, 9c. $20 copay"	7a/14b-14i. $10 copay	"7b/7d/7f/7g. $15 copay, 14j. $10-$15 copay"	7e/7h. $20 copay	7c/7i. no copay			15. no copay	"13a. no copay, 16b. $10-15 copay, 17a/18a. $15 copay, 17b. no copay"	10b. $25 copay		17a1. $15 copay		18a1. $15 copay			"14a. $10 nutrition, $0 other"												150	150	0	0	50	0.026226177	0.030426454	38.60841424	0	0	0	20	0	20	10	15	20	0	0	0	0	15	25	0	15	0	15	0	0	0	0											4.5558	0.092395693	0	0	1.059060881	0.427652355	0.156632617	1.605631791	0	0	0	0.086369815	0	0.051059802	3.489976713	3.345943473	0.537885462	0	0	0	0	0.974591709	0.021835475	0	0.055587493	0	0.01049986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.4709	0		4.5558	0.092395693	0	0	1.059060881	0.427652355	0.156632617	1.605631791	0	0	0	0.086369815	0	0.051059802	3.489976713	3.345943473	0.537885462	0	0	0	0	0.974591709	0.021835475	0	0.055587493	0	0.01049986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.4709																																																																																				0			4.5558	0.092395693	0	0	1.059060881	0.427652355	0.156632617	1.605631791	0	0	0	0.086369815	0	0.051059802	3.489976713	3.345943473	0.537885462	0	0	0	0	0.974591709	0.021835475	0	0.055587493	0	0.01049986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.4709
H1468_005_0	2008	3																																A	A			T	Coin	Coin	V				V		V	V	V	V				Coin	V	T		V		V																																																								0		336.2079842	6.818658904	0	0	234.4711531	15.04226161	4.748846367	460.3652046	0	0	0	47.80468814	0	28.26100681	3863.32306	2469.254408	297.7133485	0	0	0	0	719.2335716	9.668545044	0	41.02270816	0	7.748733764	0	0	0	0											1a. $150 copay / admit	1b. $150 copay /admit	2. no copay	6. no copay	10a. $50 copay	"11a. 10% coinsurance (no copay on rentals), $1000 OOP Max"	"11b. 10% coins, 11c. no coins"	"4a. $50 copay, 4b. $10 copay"	9a/9b. no copay	8a. no copay	8b. no copay	5. $20 copay	12. no copay	"3/9d. no copay, 9c. $20 copay"	7a/14b-14i. $10 copay	"7b/7d/7f/7g. $15 copay, 14j. $10-$15 copay"	7e/7h. $20 copay	7c/7i. no copay			15. no copay	"13a. no copay, 16b. $10-15 copay, 17a/18a. $15 copay, 17b. no copay"	10b. $25 copay		17a1. $15 copay		18a1. $15 copay			"14a. $10 nutrition, $0 other"												150	150	0	0	50	0.026226177	0.030426454	38.60841424	0	0	0	20	0	20	10	15	20	0	0	0	0	15	25	0	15	0	15	0	0	0	0											4.2026	0.085233236	0	0	0.976963138	0.394501009	0.144490554	1.48116421	0	0	0	0.07967448	0	0.047101678	3.219435883	3.08656801	0.496188914	0	0	0	0	0.899041964	0.020142802	0	0.051278385	0	0.009685917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1941	0		4.2026	0.085233236	0	0	0.976963138	0.394501009	0.144490554	1.48116421	0	0	0	0.07967448	0	0.047101678	3.219435883	3.08656801	0.496188914	0	0	0	0	0.899041964	0.020142802	0	0.051278385	0	0.009685917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1941																																																																																				0			4.2026	0.085233236	0	0	0.976963138	0.394501009	0.144490554	1.48116421	0	0	0	0.07967448	0	0.047101678	3.219435883	3.08656801	0.496188914	0	0	0	0	0.899041964	0.020142802	0	0.051278385	0	0.009685917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1941
H1468_006_0	2008	3																																A	A			T	Coin	Coin	V				V		V	V	V	V				Coin	V	T		V		V																																																								0		390.2414102	7.914514799	0	0	272.154017	17.45976794	5.512053818	534.3524696	0	0	0	55.48758445	0	32.80295434	4484.214266	2866.098866	345.5601366	0	0	0	0	834.8246813	11.22241835	0	47.61564341	0	8.994065977	0	0	0	0											1a. $150 copay / admit	1b. $150 copay /admit	2. no copay	6. no copay	10a. $50 copay	"11a. 10% coinsurance (no copay on rentals), $1000 OOP Max"	"11b. 10% coins, 11c. no coins"	"4a. $50 copay, 4b. $10 copay"	9a/9b. no copay	8a. no copay	8b. no copay	5. $20 copay	12. no copay	"3/9d. no copay, 9c. $20 copay"	7a/14b-14i. $10 copay	"7b/7d/7f/7g. $15 copay, 14j. $10-$15 copay"	7e/7h. $20 copay	7c/7i. no copay			15. no copay	"13a. no copay, 16b. $10-15 copay, 17a/18a. $15 copay, 17b. no copay"	10b. $25 copay		17a1. $15 copay		18a1. $15 copay			"14a. $10 nutrition, $0 other"												150	150	0	0	50	0.026226177	0.030426454	38.60841424	0	0	0	20	0	20	10	15	20	0	0	0	0	15	25	0	15	0	15	0	0	0	0											4.878	0.098931435	0	0	1.133975071	0.457902957	0.16771225	1.719208458	0	0	0	0.092479307	0	0.054671591	3.736845221	3.582623583	0.575933561	0	0	0	0	1.043530852	0.023380038	0	0.059519554	0	0.011242582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.636	0		4.878	0.098931435	0	0	1.133975071	0.457902957	0.16771225	1.719208458	0	0	0	0.092479307	0	0.054671591	3.736845221	3.582623583	0.575933561	0	0	0	0	1.043530852	0.023380038	0	0.059519554	0	0.011242582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.636																																																																																				0			4.878	0.098931435	0	0	1.133975071	0.457902957	0.16771225	1.719208458	0	0	0	0.092479307	0	0.054671591	3.736845221	3.582623583	0.575933561	0	0	0	0	1.043530852	0.023380038	0	0.059519554	0	0.011242582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.636
H1468_007_0	2008	3																																A	A			T	Coin	Coin	V				V		V	V	V	V				Coin	V	T		V		V																																																								0		371.8771085	7.542067044	0	0	259.3467692	16.6381318	5.25266305	509.2064711	0	0	0	52.87640401	0	31.2592859	4273.192418	2731.223626	329.2984831	0	0	0	0	795.538814	10.69430455	0	45.37490724	0	8.570815813	0	0	0	0											1a. $150 copay / admit	1b. $150 copay /admit	2. no copay	6. no copay	10a. $50 copay	"11a. 10% coinsurance (no copay on rentals), $1000 OOP Max"	"11b. 10% coins, 11c. no coins"	"4a. $50 copay, 4b. $10 copay"	9a/9b. no copay	8a. no copay	8b. no copay	5. $20 copay	12. no copay	"3/9d. no copay, 9c. $20 copay"	7a/14b-14i. $10 copay	"7b/7d/7f/7g. $15 copay, 14j. $10-$15 copay"	7e/7h. $20 copay	7c/7i. no copay			15. no copay	"13a. no copay, 16b. $10-15 copay, 17a/18a. $15 copay, 17b. no copay"	10b. $25 copay		17a1. $15 copay		18a1. $15 copay			"14a. $10 nutrition, $0 other"												150	150	0	0	50	0.026226177	0.030426454	38.60841424	0	0	0	20	0	20	10	15	20	0	0	0	0	15	25	0	15	0	15	0	0	0	0											4.6485	0.094275838	0	0	1.080611538	0.436354583	0.159819908	1.638304531	0	0	0	0.08812734	0	0.05209881	3.560993681	3.414029532	0.548830805	0	0	0	0	0.994423517	0.022279801	0	0.056718634	0	0.01071352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.806	0		4.6485	0.094275838	0	0	1.080611538	0.436354583	0.159819908	1.638304531	0	0	0	0.08812734	0	0.05209881	3.560993681	3.414029532	0.548830805	0	0	0	0	0.994423517	0.022279801	0	0.056718634	0	0.01071352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.806																																																																																				0			4.6485	0.094275838	0	0	1.080611538	0.436354583	0.159819908	1.638304531	0	0	0	0.08812734	0	0.05209881	3.560993681	3.414029532	0.548830805	0	0	0	0	0.994423517	0.022279801	0	0.056718634	0	0.01071352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.806
H1509_001_0	2008	5																					2375											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	3500	1658.723829	120.5551048	1090.262348		106.04725	12.05432809	3.041411354	487.3589068	30.17429842	8493.906485	38.6780739		0.113481008	15.68231656	4041.6823	4502.364331	431.8572124	3.225342793			25.23533784	742.9181613			191.6844339	0.362839215	16.9303356															$195 (1a); $0 (1a1)	$195 (1b)	"$135 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$15 (4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $30 (17a, 18a, 16b); $15 (17b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$15; $0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											109.9664	109.9664	76.1306		98.6878	0.169179059	0.282275287	28.1965	0.11278604	3.3836	0.062078701		0.169179059	0.112737111	15	29.9941	37.5	0.11278604			0.169179059	29.2449			30	0.21111893	30															15.2003	1.104750792	6.916858443	0	0.872130681	2.039339888	0.858515263	1.145151687	3.403239616	2.394985183	2.401084591	0	0.01919861	1.76797906	5.052102875	11.25368396	1.349553789	0.36377364	0	0	4.26929072	1.810546589	0	0	0.479211085	0.076602227	0.042325839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8206	0	32.45132699	15.2003	1.104750792	6.916858443	0	0.872130681	2.039339888	0.858515263	1.145151687	3.403239616	2.394985183	2.401084591	0	0.01919861	1.76797906	5.052102875	11.25368396	1.349553789	0.36377364	0	0	4.26929072	1.810546589	0	0	0.479211085	0.076602227	0.042325839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8206		$325 (1a); $0 (1a1)	$325 (1b)	"$185 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	30%; $0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5); 50% (14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.0544	0.1493	2.9465	0.3039	0.2033	0.4755	0.2135	0.267	1.1902	0.7445	0.8295		0.0045	0.6182	2.194	2.5977	0.2699	0.0898			0.7026	0.426			0.1052	0.0192	0.01															16.4146	0	9.401014159	17.2547	1.254063395	9.863361049	0.303922394	1.075461313	2.514796465	1.071968858	1.412135088	4.593398746	3.139481944	3.230582289	0	0.02367462	2.386135432	7.246126849	13.85141189	1.619464547	0.453573582	0	0	4.971892586	2.236595291	0	0	0.584373396	0.095811362	0.05228486	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.2352
H1509_004_0	2008	6																					2400											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2823.17728	499.2144653	1308.231835		525.9273257	37.08502675	16.75668143	1160.200372	477.5163891	8800.071835	727.641879	71.93381533	3.278465685	3737.235355		3406.799674	1430.430751	1153.928558			41.28379822	623.1418409																				1(a) $200 per Day	1(b) $200 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $100 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $35 per Visit	8(a) Diagnostic: $25 per procedure; other $0 per procedure	8(b) X-rays $25 per visit; other: $25 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a) $25 per Visit; 9(c) $25/$35 per Visit; 9(d) $35 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $15 per Visit	7(e)/7(h) $25/35 per Visit	7(c)/7(i) $15 per Visit		7(g) $15 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $25 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $25 per visit															108.0178	108.0178	22.6837		54.0089	0.108017788	0.108017788	24.169	18.9031	13.5022	13.5022	13.5022	0.108017788	13.5829		8.1013	17.5529	8.1013			0.108017788	13.5022																				25.4128	4.493670196	2.472965412	0	2.367062769	4.005842563	1.810019664	2.336738308	0.752212186	9.901711407	0.818731941	0.080938871	0.354132612	4.23021025	0	2.299968534	2.092349537	0.779030066	0	0	4.45938457	0.701150035	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3689	0	59.0708707	25.4128	4.493670196	2.472965412	0	2.367062769	4.005842563	1.810019664	2.336738308	0.752212186	9.901711407	0.818731941	0.080938871	0.354132612	4.23021025	0	2.299968534	2.092349537	0.779030066	0	0	4.45938457	0.701150035	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3689		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"4(a)$50 per Visit, 4(b) $35 per Visit"	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															2.8089	0.1837	0.3399	0.3076	0.131	0.2271	0.1125	0.0926	0.2813	0.0719	0.1954	0.0226	0.0179	0.2605	0.1097	0.205	0.075	0.061			0.2528	0.0409	0.0077		0.0027																	5.8073	0	0	28.2216	4.677327853	2.812816047	0.307639697	2.49802803	4.232893747	1.922567828	2.429292133	1.033534731	9.973619655	1.014135149	0.103512546	0.372044162	4.490690672	0.109663968	2.504922411	2.167308346	0.839989164	0	0	4.712142518	0.742020148	0.00774	0	0.002659215	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1762
H1509_005_0	2008	6																					2500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		1968.285378	135.0028181	884.0870371		273.2327473	10.34244028	17.96166658	425.1288559	401.8287813	3368.866855	442.7290319	67.47004709	15.18181726	2830.938951		3865.755393	380.8546221	557.4672572				688.0001572					0.072845483															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															131.1382	131.1382	31.4732		56.2021	0.149872239	0.149872239	30.9111	56.2021	14.9872	48.9063	56.2021	110.3911	54.3374		18.734	14.9872	14.9872				18.734					18.734															21.5098	1.475335652	2.318751819	0	1.279687615	1.550044684	2.691955191	1.095101796	1.881968102	4.207496827	1.804353668	0.31599647	0.139661441	12.81883011	0	6.035098096	0.475662792	0.696240551	0	0	0	1.074084627	0	0	0	0	0.000113724	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.3702	0	20.52647723	21.5098	1.475335652	2.318751819	0	1.279687615	1.550044684	2.691955191	1.095101796	1.881968102	4.207496827	1.804353668	0.31599647	0.139661441	12.81883011	0	6.035098096	0.475662792	0.696240551	0	0	0	1.074084627	0	0	0	0	0.000113724	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.3702		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.0964	0.0599	0.258	0.2575	0.0661	0.1266	0.11	0.0309	0.2677	0.042	0.1092	0.0219	0.0051	0.1911	0.0191	0.1846	0.0277	0.03			0.1656	0.0391			0.0051																	4.1138	0	0	23.6062	1.535229686	2.576778952	0.25752759	1.345833272	1.67668681	2.801924579	1.125999585	2.149651041	4.249519126	1.913586167	0.337914038	0.144715853	13.0099106	0.019099144	6.219738664	0.503403393	0.726209971	0	0	0.165561056	1.113230655	0	0	0.005058988	0	0.000113724	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.4839
H1509_006_0	2008	6	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)							Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						Coin	Coin	D	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V		Coin	Coin	Coin	T		V		Coin					Coin	Coin	Coin	V																																																0		447.3565274	6.842898494	9128.954774	211.8246105	27.04949232	28.59911881	0.25708014	178.4861427	12.59343003	49.5113591	45.33728043	2.309955715	0.56021768	7.446970705	129.2006447	117.4627064	12.20188939	24.62979309		11.82280622	3.712540593	5.872614319	1817.255		287.28							0.941058517	0.006978275		234.745							(1a) 7.7% coins	(1b) 7.7% coins	(2a) $0/day	(6a) $0/proc	(10a) 20% coins	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) 20% coins	(8a) 10% coins	(8b) 19.2% coins	(9a) 20% coins	(12) 20% coins	(9a) 20% coins	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) 20% coins	(7e/7h) 20% coins	(7c/7i) $0/visit		(7g) 20% coins	(15) 20% coins	(Misc. PBP Cats) 20% coins	(10b) $0/trip		(17a1) $0/visit		(18a) 20% coins					(4b) 20% coins	(9c) 20% coins	(9d) 20% coins	(7f1) $0/visit							0.0768	0.0768			0.2	0.2	0.2	50	0.2	0.1	0.192	0.2	0.2	0.2		0.2	0.2			0.2	0.2	0.2										0.2	0.2									34.357	0.525534604	0	0	5.409898464	5.719823762	0.051416028	0.743692261	2.518686006	4.95113591	8.704757843	0.461991143	0.112043536	1.489394141	0	23.49254127	2.440377877	0	0	2.364561244	0.742508119	1.174522864	0	0	0	0	0	0	0	0	0	0.188211703	0.001395655	0	0	0	0	0	0	0	0	95.4495		0	34.357	0.525534604	0	0	5.409898464	5.719823762	0.051416028	0.743692261	2.518686006	4.95113591	8.704757843	0.461991143	0.112043536	1.489394141	0	23.49254127	2.440377877	0	0	2.364561244	0.742508119	1.174522864	0	0	0	0	0	0	0	0	0	0.188211703	0.001395655	0	0	0	0	0	0	0	0	95.4495		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					0.2	0.3	0.3	0.3							3.4573	0.0526	0.9542	0.1156	0.4271	0.4516	0.0041	0.0391	0.1988	0.7818	0.7159	0.0365	0.0088	0.1176	0.0086	1.8547	0.1927	0.0029		0.1867		0.1204	0.1433		0.0146							0.0099	0.0001		0.013							9.9077		0	37.8143	0.578172285	0.954229668	0.115619249	5.836995711	6.171388796	0.055475188	0.782833959	2.717529638	5.732894212	9.42060964	0.498464128	0.120889078	1.606977889	0.008567395	25.34721558	2.633039289	0.002895807	0	2.551237132	0.742508119	1.294877356	0.14325	0	0.01455	0	0	0	0	0	0	0.198117583	0.001505838	0	0.01305	0	0	0	0	0	0	105.3572
H1509_007_0	2008	5																					3900											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1953.180197	144.0307341	935.5909877		121.9303755	13.41492035	2.570477361	475.1724715	33.00971672	10077.44077	47.44675043		0.383852099	30.41767821	4316.904507	4385.998827	502.6640144	1.879043605			23.95064804	880.4326245			122.4		14.32602104															$195 (1a); $0 (1a1)	$195 (1b)	"$125 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	20% (9b)	20% (8a1); $0/$20 (8a2)	"$20 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											128.4272	128.4272	82.3252		115.2552	0.197580384	0.284653827	32.9301	0.131720256	5.2688	0.076116242		0.197580384	0.131672703	10	24.9443	37.5	0.131720256			0.197580384	25			25		25															20.9035	1.541455917	6.418556469	0	1.171092726	2.650525109	0.731696217	1.303954989	4.34804833	4.42467692	3.611468329	0	0.075841645	4.00517792	3.597420423	9.117148556	1.570825045	0.247508104	0	0	4.732178229	1.834234634	0	0	0.255	0	0.029845877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5701	0	28.77369925	20.9035	1.541455917	6.418556469	0	1.171092726	2.650525109	0.731696217	1.303954989	4.34804833	4.42467692	3.611468329	0	0.075841645	4.00517792	3.597420423	9.117148556	1.570825045	0.247508104	0	0	4.732178229	1.834234634	0	0	0.255	0	0.029845877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5701		$250 (1a); $0 (1a1)	$250 (1b)	"$175 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$195 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	30% (9b)	30% (8a1); $0/$26 (8a2)	"$26 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5); 50% (14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											3.5384	0.2609	4.548	0.7157	0.4953	1.0061	0.1928	0.495	2.4757	2.1834	2.0232		0.0288	2.2799	2.4839	2.244	0.3142	0.0995			1.268	0.4613			0.063		0.0074															27.1845	0	0	24.4418	1.80238116	10.96656821	0.715731944	1.666434877	3.656644135	0.924482019	1.798926314	6.823777084	6.608122421	5.634698415	0	0.104630552	6.28505102	6.081317705	11.36114334	1.884990054	0.346986883	0	0	6.000153714	2.295500259	0	0	0.318	0	0.037219564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.7546
H1509_801_0	2008	4																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1755.521039	127.6049945	1151.415018		112.2149086	12.84192976	3.228908401	515.0929764	32.13795532	8990.117791	41.26589168		0.124445332	16.88565073	4272.312678	4758.305385	457.0172992	3.412507029			26.82719406	747.0431799			199.8406937		17.60971991															$260 (1a); $0 (1a1)	$260 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$35/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $35 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											164.8444	164.8444	95.1026		110.953	0.190205127	0.28510679	31.7009	0.190205127	3.8041	0.052979578		0.190205127	0.190038908	35	34.7979	37.5	0.190205127			0.190205127	35			35		35															24.1157	1.752914523	9.12520999	0	1.03754831	2.442600881	0.920583711	1.360740625	6.112803871	2.849944159	2.186249531	0	0.02367014	3.208930628	12.46091198	13.79826542	1.42817906	0.649076333	0	0	5.102669852	2.178875941	0	0	0.58286869	0	0.051361683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.3891	0	34.66343568	24.1157	1.752914523	9.12520999	0	1.03754831	2.442600881	0.920583711	1.360740625	6.112803871	2.849944159	2.186249531	0	0.02367014	3.208930628	12.46091198	13.79826542	1.42817906	0.649076333	0	0	5.102669852	2.178875941	0	0	0.58286869	0	0.051361683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.3891	4400	40% (1a); $0 (1a1)	40% (1b)	"40% (2a, 2a2)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	40% (9b)	40% (8a1); $0/$20 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	40% (incl in h5)	30% (12)	"40% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$40/$50 (7a); 40% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $40 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 40% (17b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											5.9459	0.1701	2.1281	0.4386	0.2594	0.6107	0.2301	0.3402	2.0376	0.95	0.7287		0.0059	1.0696	3.0542	2.7464	0.2856	0.1527			0.9005	0.455			0.1087		0.0104															22.6285	0	8.978952968	30.0616	1.922976534	11.25334151	0.438643701	1.296935387	3.053251101	1.150729638	1.700925781	8.150405161	3.799925546	2.914999375	0	0.029587675	4.278483971	15.51511946	16.54468847	1.713814872	0.801800176	0	0	6.003141002	2.63391443	0	0	0.691565844	0	0.061720342	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.0176
H1509_803_0	2008	5																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1755.509788	127.6041648	1151.409629		112.2142063	12.84177746	3.228879217	515.0902411	32.13758054	8990.059741	41.26535299		0.124440974	16.88530538	4272.288452	4758.280213	457.0144036	3.412485696			26.82692213	747.0381083			199.8406937		17.60971991															$260 (1a); $0 (1a1)	$260 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$35/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $35 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											164.845	164.845	95.1029		110.9534	0.190205826	0.285106899	31.701	0.190205826	3.8041	0.05297981		0.190205826	0.190039606	35	34.7979	37.5	0.190205826			0.190205826	35			35		35															24.1156	1.75290957	9.125200821	0	1.037545629	2.44258089	0.920575742	1.3607384	6.112755055	2.849936233	2.186230541	0	0.023669398	3.208876783	12.46084132	13.79818859	1.428170011	0.649074661	0	0	5.102636886	2.178861149	0	0	0.58286869	0	0.051361683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.3886	0	34.66293145	24.1156	1.75290957	9.125200821	0	1.037545629	2.44258089	0.920575742	1.3607384	6.112755055	2.849936233	2.186230541	0	0.023669398	3.208876783	12.46084132	13.79818859	1.428170011	0.649074661	0	0	5.102636886	2.178861149	0	0	0.58286869	0	0.051361683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.3886	4400	40% (1a); $0 (1a1)	40% (1b)	"40% (2a, 2a2)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	40% (9b)	40% (8a1); $0/$20 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	40% (incl in h5)	30% (12)	"40% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$40/$50 (7a); 40% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $40 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 40% (17b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											5.9459	0.1701	2.1281	0.4386	0.2594	0.6106	0.2301	0.3402	2.0376	0.95	0.7287		0.0059	1.0695	3.0542	2.7464	0.2856	0.1527			0.9005	0.455			0.1087		0.0104															22.6283	0	8.978792281	30.0615	1.922969996	11.25331409	0.438632867	1.296932037	3.053226112	1.150719677	1.700923001	8.150340073	3.799914977	2.914974055	0	0.029586748	4.278412178	15.51503089	16.54459633	1.713804014	0.80179811	0	0	6.003102219	2.633896532	0	0	0.691565844	0	0.061720342	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.0169
H1510_001_0	2008	7	s.										Other Non-Covered										3000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O	O	O										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0	0	0										0		1713.215252	61.226193	532.652687	223.104007	74.626768	5.376262	1.83982	353.093363	416.991034	6558.521548	1537.177847		8.757846	558.966707	5067.428192	3827.99711	49.946536	317.772864			19.299291			4.88	1.82					3.4	0.02	0.08										$175/Day(Days 1-5)	$175/Day(Days 1-5)	$0/Day(Days 1-20) $75(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$100-$150/Visit	$0-$75/Visit	$50-$75/Visit		$0-$75/Proc	$30-$75/Visit	$10/Visit	$30/Visit	$30-$75/Visit	$75/Visit			20% Coins			Coin: 0%	EyeMed: $100 Allowance					Silver Sneakers	Quit Net	Humana Active Outlook										91.377643	91.377611	13.950015	0	80.327334	0.160654	0.160654	40.16364	101.275786	10.248836	60.245471		20.102173	59.141187	8.03273	24.09819	39.211318	60.245462			0.160654			0.354508197	0					0	0	0										13.0458	0.466225271	0.619209414	0	0.499547443	0.863717995	0.295574442	1.181792893	3.519257894	5.601434312	7.717333617	0	0.014670978	2.754829545	3.392106872	7.687316806	0.163205792	1.595364417	0	0	3.100508296	0	0	1.73	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.2479	0	12.86199198	13.0458	0.466225271	0.619209414	0	0.499547443	0.863717995	0.295574442	1.181792893	3.519257894	5.601434312	7.717333617	0	0.014670978	2.754829545	3.392106872	7.687316806	0.163205792	1.595364417	0	0	3.100508296	0	0	1.73	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.2479	5000	30% Coins	30% Coins	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$75/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			Coin: 50%						Silver Sneakers	Quit Net	Humana Active Outlook										12.5028	0.1413	0.6155	0.9616	0.6371	1.8263	0.625	0.266	4.0813	1.0118	2.729		0.0033	1.3643	4.2199	3.4716	0.1195	0.3684			1.1088			1.58	0					0	0	0										37.6335	500	6.923368851	25.5486	0.607504176	1.234737588	0.961562426	1.136647629	2.689973171	0.920540947	1.44776985	7.600593046	6.613221816	10.44633708	0	0.017972806	4.119164805	7.61203685	11.15896422	0.282728283	1.963725707	0	0	4.209344755	0	0	3.31	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8814
H1510_801_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		312.433002	6.713552	534.258919	223.776785	74.851808	5.408736	1.850932	354.158129	418.248484	6578.298995	1541.813257		8.784255	560.652288	5082.709196	3839.540565	50.097151	318.731118			19.415864																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214518	177.214684	28.944123	0	99.999989	0.199999	0.2	50.000004	199.999998	37.551769	90.504991		33.367883	87.838635	20	29.999998	59.267082	100.000013			0.2																					4.614	0.099145	1.288637989	0	0.623764998	1.081741791	0.3701864	1.475658989	6.970807997	20.58556369	11.62848291	0	0.024425999	4.103910974	8.471181993	9.598850773	0.247425996	2.656092995	0	0	3.8831728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.723	0	0	4.614	0.099145	1.288637989	0	0.623764998	1.081741791	0.3701864	1.475658989	6.970807997	20.58556369	11.62848291	0	0.024425999	4.103910974	8.471181993	9.598850773	0.247425996	2.656092995	0	0	3.8831728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.723		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					10.2317	0.1156	0.5037	0.7869	0.7765	1.4945	0.5114	0.8769	3.34	0.828	2.2333		0.0152	1.1165	3.4534	2.841	0.0978	0.3014			0.9074																					30.4314	0	0	14.8457	0.214761	1.792355989	0.786896	1.400299998	2.576260791	0.8816284	2.352593989	10.310776	21.41356169	13.86176691	0	0.039633999	5.220418974	11.92456899	12.43987777	0.345236996	2.957541995	0	0	4.7905918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.1544
H1510_802_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		312.433002	6.713552	534.258919	223.776785	74.851808	5.408736	1.850932	354.158129	418.248484	6578.298995	1541.813257		8.784255	560.652288	5082.709196	3839.540565	50.097151	318.731118			19.415864																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214518	177.214684	28.944123	0	99.999989	0.199999	0.2	50.000004	199.999998	37.551769	90.504991		33.367883	87.838635	20	29.999998	59.267082	100.000013			0.2																					4.614	0.099145	1.288637989	0	0.623764998	1.081741791	0.3701864	1.475658989	6.970807997	20.58556369	11.62848291	0	0.024425999	4.103910974	8.471181993	9.598850773	0.247425996	2.656092995	0	0	3.8831728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.723	0	0	4.614	0.099145	1.288637989	0	0.623764998	1.081741791	0.3701864	1.475658989	6.970807997	20.58556369	11.62848291	0	0.024425999	4.103910974	8.471181993	9.598850773	0.247425996	2.656092995	0	0	3.8831728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.723		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					10.2317	0.1156	0.5037	0.7869	0.7765	1.4945	0.5114	0.8769	3.34	0.828	2.2333		0.0152	1.1165	3.4534	2.841	0.0978	0.3014			0.9074																					30.4314	0	0	14.8457	0.214761	1.792355989	0.786896	1.400299998	2.576260791	0.8816284	2.352593989	10.310776	21.41356169	13.86176691	0	0.039633999	5.220418974	11.92456899	12.43987777	0.345236996	2.957541995	0	0	4.7905918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.1544
H1510_803_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		312.433002	6.713552	534.258919	223.776785	74.851808	5.408736	1.850932	354.158129	418.248484	6578.298995	1541.813257		8.784255	560.652288	5082.709196	3839.540565	50.097151	318.731118			19.415864																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214518	177.214684	28.944123	0	99.999989	0.199999	0.2	50.000004	199.999998	37.551769	90.504991		33.367883	87.838635	20	29.999998	59.267082	100.000013			0.2																					4.614	0.099145	1.288637989	0	0.623764998	1.081741791	0.3701864	1.475658989	6.970807997	20.58556369	11.62848291	0	0.024425999	4.103910974	8.471181993	9.598850773	0.247425996	2.656092995	0	0	3.8831728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.723	0	0	4.614	0.099145	1.288637989	0	0.623764998	1.081741791	0.3701864	1.475658989	6.970807997	20.58556369	11.62848291	0	0.024425999	4.103910974	8.471181993	9.598850773	0.247425996	2.656092995	0	0	3.8831728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.723		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					10.2317	0.1156	0.5037	0.7869	0.7765	1.4945	0.5114	0.8769	3.34	0.828	2.2333		0.0152	1.1165	3.4534	2.841	0.0978	0.3014			0.9074																					30.4314	0	0	14.8457	0.214761	1.792355989	0.786896	1.400299998	2.576260791	0.8816284	2.352593989	10.310776	21.41356169	13.86176691	0	0.039633999	5.220418974	11.92456899	12.43987777	0.345236996	2.957541995	0	0	4.7905918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.1544
H1510_804_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		312.433002	6.713552	534.258919	223.776785	74.851808	5.408736	1.850932	354.158129	418.248484	6578.298995	1541.813257		8.784255	560.652288	5082.709196	3839.540565	50.097151	318.731118			19.415864																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214518	177.214684	28.944123	0	99.999989	0.199999	0.2	50.000004	199.999998	37.551769	90.504991		33.367883	87.838635	20	29.999998	59.267082	100.000013			0.2																					4.614	0.099145	1.288637989	0	0.623764998	1.081741791	0.3701864	1.475658989	6.970807997	20.58556369	11.62848291	0	0.024425999	4.103910974	8.471181993	9.598850773	0.247425996	2.656092995	0	0	3.8831728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.723	0	0	4.614	0.099145	1.288637989	0	0.623764998	1.081741791	0.3701864	1.475658989	6.970807997	20.58556369	11.62848291	0	0.024425999	4.103910974	8.471181993	9.598850773	0.247425996	2.656092995	0	0	3.8831728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.723		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					10.2317	0.1156	0.5037	0.7869	0.7765	1.4945	0.5114	0.8769	3.34	0.828	2.2333		0.0152	1.1165	3.4534	2.841	0.0978	0.3014			0.9074																					30.4314	0	0	14.8457	0.214761	1.792355989	0.786896	1.400299998	2.576260791	0.8816284	2.352593989	10.310776	21.41356169	13.86176691	0	0.039633999	5.220418974	11.92456899	12.43987777	0.345236996	2.957541995	0	0	4.7905918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.1544
H1511_001_0	2008	6	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			A	A	D	D	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V		S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	312.2671055	7.035698067	444.8610709	0	235.6556462	8.610417099	3.069814036	283.6826159	363.8844934	752.5735611	796.2558416	44.65327804	12.88778598	0.340479669	4489.077752	1593.318638	2.562332615	349.4984043	478.723175		240.8383728				464.8933552	448.9404645	127.038554					968.8285922	15.83860978	61.41168203	334.9222873	90.62707087	0.034190819	678.9893828	3.157737661			$600/admit with $1200 yearly max	$600/admit with $1200 yearly max	$75/day for days 21 to 100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$175 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$175 copay	$15/$25 copay for in-home/facility	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$50/$100 copay for Lower/Higher Tier		$15/$22.50/$40/$100 copay levels				$50 max w/specialist copay	Up to $75	$50 max w/specialist copay					$25 copay	$50 copay	$25 copay	$25 copay	$10 copay	20% coinsurance	$25 copay	$25 copay			410.1477799	462.3571256	70.0276316	0	70.0276316	0.186740351	0.186740351	46.68508773	163.3978071	47.6801351	56.80389917	163.3978071	23.34254387	23.34254387	9.337017547	23.34254387	23.34254387	23.34254387	48.78591668		29.97373681				23.34254387	0	23.34254387					23.34254387	46.68508773	23.34254387	23.34254387	9.337017547	0.186740351	23.34254387	23.34254387			10.673	0.271083761	2.596047266	0	1.375200565	1.607912311	0.57325815	1.103645651	4.954827354	2.990234089	3.769203045	0.608020642	0.025069476	0.000662305	3.492883145	3.099342517	0.00498428	0.679848486	1.946245744	0	0.601568833	0	0	0	0.904316128	0	0.247116918	0	0	0	0	1.884576993	0.061618907	0.11945874	0.651494849	0.070515546	0.006384806	1.320778288	0.006142469	0	0	45.6454		3.241089319	10.673	0.271083761	2.596047266	0	1.375200565	1.607912311	0.57325815	1.103645651	4.954827354	2.990234089	3.769203045	0.608020642	0.025069476	0.000662305	3.492883145	3.099342517	0.00498428	0.679848486	1.946245744	0	0.601568833	0	0	0	0.904316128	0	0.247116918	0	0	0	0	1.884576993	0.061618907	0.11945874	0.651494849	0.070515546	0.006384806	1.320778288	0.006142469	0	0	45.6454	2750																																																																																			0		0	10.673	0.271083761	2.596047266	0	1.375200565	1.607912311	0.57325815	1.103645651	4.954827354	2.990234089	3.769203045	0.608020642	0.025069476	0.000662305	3.492883145	3.099342517	0.00498428	0.679848486	1.946245744	0	0.601568833	0	0	0	0.904316128	0	0.247116918	0	0	0	0	1.884576993	0.061618907	0.11945874	0.651494849	0.070515546	0.006384806	1.320778288	0.006142469	0	0	45.6454
H1511_005_0	2008	6	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			D	D	D	D	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V		S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	2052.142654	68.29212186	526.8054583	0	279.0639343	12.07468795	4.304907198	335.9375775	430.9128172	891.1992659	942.9279184	52.87851004	15.2617445	0.403196772	5315.975744	1886.811435	3.034319916	413.8767789	566.9050364		285.2013306				550.5277335	531.6362853	150.439335					1147.288949	18.75611652	72.72384889	396.615709	107.3207766	0.047946977	804.0607201	3.739399881			$150/day with $1500 yearly max	$150/day with $1500 yearly max	$75/day for days 21 to 100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$150 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$150 copay	$15/$25 copay for in-home/facility	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$50/$100 copay for Lower/Higher Tier		$15/$22.50/$40/$100 copay levels				$50 max w/specialist copay	Up to $75	$50 max w/specialist copay					$25 copay	$50 copay	$25 copay	$25 copay	$10 copay	20% coinsurance	$25 copay	$25 copay			92.02071955	94.16732952	70.99567651	0	70.99567651	0.189321804	0.189321804	47.33045101	141.991353	48.33925366	57.58914243	141.991353	23.6652255	23.6652255	9.466090201	23.6652255	23.6652255	23.6652255	49.4603213		30.38808644				23.6652255	0	23.6652255					23.6652255	47.33045101	23.6652255	23.6652255	9.466090201	0.189321804	23.6652255	23.6652255			15.7366	0.535907229	3.116742492	0	1.651027734	2.286001706	0.815012797	1.325006421	5.098824495	3.589992281	4.52520085	0.625690932	0.030097719	0.000795145	4.193458825	3.72098484	0.005983989	0.816207275	2.336608771	0	0.722226891	0	0	0	1.085696913	0	0.296681732	0	0	0	0	2.262570975	0.073977955	0.143418857	0.782166683	0.084659013	0.009077408	1.585689855	0.007374478	0	0	57.4637		3.241089319	15.7366	0.535907229	3.116742492	0	1.651027734	2.286001706	0.815012797	1.325006421	5.098824495	3.589992281	4.52520085	0.625690932	0.030097719	0.000795145	4.193458825	3.72098484	0.005983989	0.816207275	2.336608771	0	0.722226891	0	0	0	1.085696913	0	0.296681732	0	0	0	0	2.262570975	0.073977955	0.143418857	0.782166683	0.084659013	0.009077408	1.585689855	0.007374478	0	0	57.4637	2750																																																																																			0		0	15.7366	0.535907229	3.116742492	0	1.651027734	2.286001706	0.815012797	1.325006421	5.098824495	3.589992281	4.52520085	0.625690932	0.030097719	0.000795145	4.193458825	3.72098484	0.005983989	0.816207275	2.336608771	0	0.722226891	0	0	0	1.085696913	0	0.296681732	0	0	0	0	2.262570975	0.073977955	0.143418857	0.782166683	0.084659013	0.009077408	1.585689855	0.007374478	0	0	57.4637
H1511_801_0	2008	7																																coin	coin	coin	V	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V																																																				0		134.8552751	1.709174618	10.32157226	5.079290346	4.344314788	6.888406572	2.703138752	7.607531187	22.49460043	5.871574347	16.05841288	0	0.128810318	15.54953984	22.40606773	64.61845649	0.657683836	2.243850723	14.53127621	11.94064281	10.76633789	0																				Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare																				0.0801	0.0801	0.206979689	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				10.8019	0.136904887	2.136355818	0	1.01656966	1.611887138	0.632534468	1.780162298	5.2637365	1.373948397	3.757668615	0	0.030141614	3.638592323	5.243019848	15.12071882	0.153898018	0.525061069	3.400318634	2.794110419	2.519323065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9369			10.8019	0.136904887	2.136355818	0	1.01656966	1.611887138	0.632534468	1.780162298	5.2637365	1.373948397	3.757668615	0	0.030141614	3.638592323	5.243019848	15.12071882	0.153898018	0.525061069	3.400318634	2.794110419	2.519323065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9369																																																																																				0			10.8019	0.136904887	2.136355818	0	1.01656966	1.611887138	0.632534468	1.780162298	5.2637365	1.373948397	3.757668615	0	0.030141614	3.638592323	5.243019848	15.12071882	0.153898018	0.525061069	3.400318634	2.794110419	2.519323065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9369
H1511_803_0	2008	7																																coin	coin	coin	V	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V																																																				0		134.8552751	1.709174618	10.32157226	5.079290346	4.344314788	6.888406572	2.703138752	7.607531187	22.49460043	5.871574347	16.05841288	0	0.128810318	15.54953984	22.40606773	64.61845649	0.657683836	2.243850723	14.53127621	11.94064281	10.76633789	0																				Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare																				0.0801	0.0801	0.206979689	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				10.8019	0.136904887	2.136355818	0	1.01656966	1.611887138	0.632534468	1.780162298	5.2637365	1.373948397	3.757668615	0	0.030141614	3.638592323	5.243019848	15.12071882	0.153898018	0.525061069	3.400318634	2.794110419	2.519323065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9369			10.8019	0.136904887	2.136355818	0	1.01656966	1.611887138	0.632534468	1.780162298	5.2637365	1.373948397	3.757668615	0	0.030141614	3.638592323	5.243019848	15.12071882	0.153898018	0.525061069	3.400318634	2.794110419	2.519323065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9369																																																																																				0			10.8019	0.136904887	2.136355818	0	1.01656966	1.611887138	0.632534468	1.780162298	5.2637365	1.373948397	3.757668615	0	0.030141614	3.638592323	5.243019848	15.12071882	0.153898018	0.525061069	3.400318634	2.794110419	2.519323065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9369
H1517_001_0	2008	4	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			D	D	D	D	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V		S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	1215.222698	84.0325487	237.9801779	0.001108572	72.55527033	10.49165746	3.929483513	291.2938381	393.9865104	693.4515934	947.4227184	45.93564695	0.883377826	0.001108572	4384.727343	1747.741436	29.85655667	555.003577	637.6351045		340.0353621				409.2487463	393.5431848	179.5887209					858.4224024	17.66755652	194.6604814	347.0707901	122.5476212	0.05458394	636.6282561	2.433256017			$175/day (1-5) with $1750 yearly max	$175/day (1-5) with $1750 yearly max	$75/day for days 21 to 100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$175 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$175 copay	$15/$25 copay for in-home/facility	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$50/$100 copay for Lower/Higher Tier		$15/$22.50/$40/$100 copay levels				$50 max w/specialist copay	$75 yearly max	$50 max w/specialist copay					$25 copay	$50 copay	$25 copay	$25 copay	$10 copay	20% coinsurance	$25 copay	$25 copay			108.9370836	91.55488753	74.78543951	0	74.78543951	0.199427839	0.199427839	49.85695967	174.4993588	51.69880914	60.92078848	174.4993588	24.92847984	24.92847984	9.971391934	24.92847984	24.92847984	24.92847984	58.17841323		33.27244865				24.92847984	0	24.92847984					24.92847984	49.85695967	24.92847984	24.92847984	9.971391934	0.199427839	24.92847984	24.92847984			11.0319	0.641132545	1.483121017	0	0.452173148	2.092328571	0.783648404	1.210252095	5.729199455	2.987551798	4.809811586	0.667978412	0.001835106	2.30E-06	3.643486238	3.630711428	0.062023214	1.152949623	3.091383217	0	0.942817427	0	0	0	0.850162427	0	0.373072817	0	0	0	0	1.783263796	0.073404221	0.40438249	0.720995599	0.101830863	0.010885557	1.322514554	0.005054781	0	0	50.0599		0.143622493	11.0319	0.641132545	1.483121017	0	0.452173148	2.092328571	0.783648404	1.210252095	5.729199455	2.987551798	4.809811586	0.667978412	0.001835106	2.30E-06	3.643486238	3.630711428	0.062023214	1.152949623	3.091383217	0	0.942817427	0	0	0	0.850162427	0	0.373072817	0	0	0	0	1.783263796	0.073404221	0.40438249	0.720995599	0.101830863	0.010885557	1.322514554	0.005054781	0	0	50.0599	4000	$250/day (1-5) with no yearly max	$250/day (1-5) with no yearly max	20% coinsurance	$0 copay	$75 copay	30% coinsurance	30% coinsurance	$50 copay	$250 copay	20% coinsurance	20% coinsurance	$250 copay	$15/$25 copay for in-home/facility	$35 copay	$15 copay	$35 copay	$35 copay	$35 copay	20% coinsurance	0	$15/$22.50/$40/$100 copay levels	0	0	0	$50 max w/specialist copay	$75 yearly max	$50 max w/specialist copay	0	0	0	0	$35 copay	20% coinsurance	$35 copay	$35 copay	$15 copay	20% coinsurance	$35 copay	$35 copay	0	0	5.051682297	0.17686415	0.577530836	0	0.734781366	0.899557275	0.025690809	0.285358909	1.784640125	0.356290209	0.867703037	0.004587764	0.024773925	3.22E-06	0.043011592	0.172413989	0.002570197	0.007720029	0.480402872	0	0.015276688	0	0	0	0.486149219	0	3.22E-06	0	0	0	0	0.26397993	0.018146796	0.006433358	0.025090095	0.051007337	0.001711299	0	0.001930007	0	0	12.3653		0.035476253	16.0836	0.817996696	2.060651852	0	1.186954514	2.991885845	0.809339213	1.495611004	7.51383958	3.343842007	5.677514623	0.672566176	0.02660903	5.53E-06	3.686497831	3.803125417	0.064593411	1.160669653	3.571786089	0	0.958094115	0	0	0	1.336311645	0	0.373076041	0	0	0	0	2.047243726	0.091551017	0.410815848	0.746085695	0.1528382	0.012596857	1.322514554	0.006984788	0	0	62.4252
H1517_801_0	2008	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	260.774396	1.915735402	42.22447009	27.36865251	7.019323961	21.99892155	1.064342672	5.672393254	28.45410178	11.15039226	30.19493825	0	0.208342252	29.40249113	34.74865618	97.67154593	1.073458901	3.598425427	21.51268921	30.8076629	8.207394919	4.656220287	0	0	0	0	0	0	0	0	0											Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											0.082854722	0.082854722	0.208334644	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.6064	0.158727725	8.796819938	0	1.642521807	5.147747642	0.249056185	1.327340021	6.658259817	2.60919179	7.06561555	0	0.048752087	6.880182923	8.131185546	22.85514175	0.251189383	0.84203155	5.033969276	7.208993119	1.920530411	1.089555547	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.5232	0	0	21.6064	0.158727725	8.796819938	0	1.642521807	5.147747642	0.249056185	1.327340021	6.658259817	2.60919179	7.06561555	0	0.048752087	6.880182923	8.131185546	22.85514175	0.251189383	0.84203155	5.033969276	7.208993119	1.920530411	1.089555547	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.5232	none	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											2.658	0.0204	1.0952	0	0.1957	0.6546	0.03	0.1396	0.7146	0.28	0.7583	0	0.0068	0.7384	1.1384	3.0638	0.0344	0.116	0.7662	0.9993	0.2061	0.1525	0	0	0	0	0	0	0	0	0											13.7683	0	0	24.2644	0.179099851	9.892048707	0	1.838258008	5.802358	0.279042172	1.466910618	7.372863104	2.889225475	7.823938631	0	0.055507951	7.618604293	9.269539068	25.91893826	0.285581555	0.958051881	5.800179511	8.208325053	2.126652939	1.242041822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.2915
H1517_802_0	2008	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	260.774396	1.915735402	42.22447009	27.36865251	7.019323961	21.99892155	1.064342672	5.672393254	28.45410178	11.15039226	30.19493825	0	0.208342252	29.40249113	34.74865618	97.67154593	1.073458901	3.598425427	21.51268921	30.8076629	8.207394919	4.656220287	0	0	0	0	0	0	0	0	0											Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											0.082854722	0.082854722	0.208334644	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.6064	0.158727725	8.796819938	0	1.642521807	5.147747642	0.249056185	1.327340021	6.658259817	2.60919179	7.06561555	0	0.048752087	6.880182923	8.131185546	22.85514175	0.251189383	0.84203155	5.033969276	7.208993119	1.920530411	1.089555547	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.5232	0	0	21.6064	0.158727725	8.796819938	0	1.642521807	5.147747642	0.249056185	1.327340021	6.658259817	2.60919179	7.06561555	0	0.048752087	6.880182923	8.131185546	22.85514175	0.251189383	0.84203155	5.033969276	7.208993119	1.920530411	1.089555547	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.5232	none	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											2.658	0.0204	1.0952	0	0.1957	0.6546	0.03	0.1396	0.7146	0.28	0.7583	0	0.0068	0.7384	1.1384	3.0638	0.0344	0.116	0.7662	0.9993	0.2061	0.1525	0	0	0	0	0	0	0	0	0											13.7683	0	0	24.2644	0.179099851	9.892048707	0	1.838258008	5.802358	0.279042172	1.466910618	7.372863104	2.889225475	7.823938631	0	0.055507951	7.618604293	9.269539068	25.91893826	0.285581555	0.958051881	5.800179511	8.208325053	2.126652939	1.242041822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.2915
H1607_001_0	2008	5	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			D	D	D	D	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V		S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	1123.56985	77.69476192	220.0315658	0.001024963	67.08310698	8.968762249	3.359107323	269.3242767	364.2718042	641.1510455	875.9675112	42.47115206	0.816752924	0.001024963	4054.028496	1615.925696	27.60475671	513.1448641	589.5442707		314.3896849				378.3829529	363.8619144	166.0440286					793.6796541	16.33505848	179.9790675	320.8944965	113.3050039	0.046660919	588.6133595	2.249738344			$175/day (1-5) with $1750 yearly max	$175/day (1-5) with $1750 yearly max	$75/day for days 21 to 100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$175 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$175 copay	$15/$25 copay for in-home/facility	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$50/$100 copay for Lower/Higher Tier		$15/$22.50/$40/$100 copay levels				$50 max w/specialist copay	$75 yearly max	$50 max w/specialist copay					$25 copay	$50 copay	$25 copay	$25 copay	$10 copay	20% coinsurance	$25 copay	$25 copay			108.9090731	91.53134643	74.76621026	0	74.76621026	0.199376561	0.199376561	49.84414017	174.4544906	51.68551605	60.90512419	174.4544906	24.92207009	24.92207009	9.968828035	24.92207009	24.92207009	24.92207009	58.16345407		33.26389345				24.92207009	0	24.92207009					24.92207009	49.84414017	24.92207009	24.92207009	9.968828035	0.199376561	24.92207009	24.92207009			10.1972	0.592625514	1.370910526	0	0.417962473	1.788160971	0.669727265	1.118686417	5.29573767	2.761518554	4.445909171	0.617440266	0.001696264	2.13E-06	3.367826077	3.356017787	0.05733064	1.065719356	2.857494259	0	0.871485415	0	0	0	0.785840539	0	0.344846743	0	0	0	0	1.648344997	0.067850579	0.373787578	0.666446261	0.094126508	0.009303094	1.222455283	0.004672345	0	0	46.0712		0.144061963	10.1972	0.592625514	1.370910526	0	0.417962473	1.788160971	0.669727265	1.118686417	5.29573767	2.761518554	4.445909171	0.617440266	0.001696264	2.13E-06	3.367826077	3.356017787	0.05733064	1.065719356	2.857494259	0	0.871485415	0	0	0	0.785840539	0	0.344846743	0	0	0	0	1.648344997	0.067850579	0.373787578	0.666446261	0.094126508	0.009303094	1.222455283	0.004672345	0	0	46.0712	4000	$250/day (1-5) with no yearly max	$250/day (1-5) with no yearly max	20% coinsurance	$0 copay	$75 copay	30% coinsurance	30% coinsurance	$50 copay	$250 copay	20% coinsurance	20% coinsurance	$250 copay	$15/$25 copay for in-home/facility	$35 copay	$15 copay	$35 copay	$35 copay	$35 copay	20% coinsurance	0	$15/$22.50/$40/$100 copay levels	0	0	0	$50 max w/specialist copay	$75 yearly max	$50 max w/specialist copay	0	0	0	0	$35 copay	20% coinsurance	$35 copay	$35 copay	$15 copay	20% coinsurance	$35 copay	$35 copay	0	0	4.669480344	0.1634829	0.493573578	0	0.679189019	0.768786142	0.021956065	0.263769125	1.649617195	0.304495315	0.741562643	0.004240661	0.02289957	2.98E-06	0.039757406	0.159369431	0.00237574	0.007135945	0.410565376	0	0.014120879	0	0	0	0.44936797	0	2.98E-06	0	0	0	0	0.244007644	0.015508746	0.005946621	0.02319182	0.047148206	0.001462523	0	0.001783986	0	0	11.2048		0.035036783	14.8667	0.756108415	1.864484104	0	1.097151493	2.556947113	0.69168333	1.382455542	6.945354866	3.066013869	5.187471814	0.621680928	0.024595835	5.11E-06	3.407583483	3.515387218	0.05970638	1.0728553	3.268059636	0	0.885606294	0	0	0	1.23520851	0	0.344849723	0	0	0	0	1.892352641	0.083359325	0.379734198	0.689638081	0.141274714	0.010765617	1.222455283	0.006456331	0	0	57.276
H1607_002_0	2008	5	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			D	D	D	D	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V		S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	1203.493626	83.2214844	235.6832438	0.001097873	71.85498229	10.29010833	3.853996493	288.4823319	390.1838364	686.758546	938.2783957	45.49228585	0.874851651	0.001097873	4342.406887	1730.872607	29.56838753	549.6468005	631.4807861		336.7534131				569.5099764	547.6541391	177.8553688					850.1370919	17.49703302	192.7816598	343.7209366	121.3648176	0.05353536	630.4836556	2.409770747			$175/day (1-5) with $1750 yearly max	$175/day (1-5) with $1750 yearly max	$75/day for days 21 to 100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$150 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$150 copay	$15/$25 copay for in-home/facility	$20 copay	$10 copay	$20 copay	$20 copay	$20 copay	$50/$100 copay for Lower/Higher Tier		$15/$22.50/$40/$100 copay levels				$50 max w/specialist copay	$150 yearly max	$50 max w/specialist copay					$20 copay	$50 copay	$20 copay	$20 copay	$10 copay	20% coinsurance	$20 copay	$20 copay			108.977623	91.58895835	74.81326982	0	74.81326982	0.199502053	0.199502053	49.87551322	149.6265396	51.7180481	60.94345927	149.6265396	24.93775661	19.95020529	9.975102643	19.95020529	19.95020529	19.95020529	58.20006348		33.28483051				19.95020529	0	19.95020529					19.95020529	49.87551322	19.95020529	19.95020529	9.975102643	0.199502053	19.95020529	19.95020529			10.9295	0.635180756	1.469352843	0	0.447975515	2.052897737	0.768880212	1.19901703	4.865154772	2.959817626	4.765160933	0.567237776	0.00181807	1.83E-06	3.609662868	2.877605319	0.04915795	0.913797209	3.062685153	0	0.934065023	0	0	0	0.946820078	0	0.295687593	0	0	0	0	1.413367459	0.072722792	0.320502807	0.571441937	0.100885543	0.010680414	1.048189863	0.004006285	0	0	46.8933		0.117043236	10.9295	0.635180756	1.469352843	0	0.447975515	2.052897737	0.768880212	1.19901703	4.865154772	2.959817626	4.765160933	0.567237776	0.00181807	1.83E-06	3.609662868	2.877605319	0.04915795	0.913797209	3.062685153	0	0.934065023	0	0	0	0.946820078	0	0.295687593	0	0	0	0	1.413367459	0.072722792	0.320502807	0.571441937	0.100885543	0.010680414	1.048189863	0.004006285	0	0	46.8933	4000	20% coinsurance	20% coinsurance	20% coinsurance	0	$75 copay	30% coinsurance	30% coinsurance	$50 copay	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$15/$25 copay for in-home/facility	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0	$15/$22.50/$40/$100 copay levels	0	0	0	20% coinsurance	$150 yearly max	$50 max w/specialist copay	0	0	0	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0	0	13.51693938	0.245661021	0.670543272	0	0.861433673	1.04443268	0.029828363	0.334545465	1.776482625	0.413671423	1.007448257	0.005057927	0.02904414	0.00027916	3.503746764	3.795649927	0.041760791	0.426754172	0.557772666	0	0.01790989	0	0	0	0.186967955	0	2.16E-08	0	0	0	0	0.158270909	0.021069372	0.226329442	0.15448334	0.076407067	0.001986907	0.314803786	0.001804195	0	0	29.4211	250	0.06205551	24.4464	0.880841777	2.139896115	0	1.309409188	3.097330417	0.798708575	1.533562495	6.641637397	3.37348905	5.77260919	0.572295703	0.03086221	0.000280985	7.113409632	6.673255246	0.090918741	1.340551381	3.620457819	0	0.951974913	0	0	0	1.133788034	0	0.295687615	0	0	0	0	1.571638368	0.093792164	0.54683225	0.725925277	0.17729261	0.012667322	1.362993649	0.00581048	0	0	76.3143
H1608_001_0	2008	8																					1500											D	D	D	COIN	T	COIN	COIN	V	COIN	COIN	COIN	COIN	COIN	COIN	P	COIN	P	P	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	COIN											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	1333.409144	40.30287718	354.0293112	0	223.5077992	4.796621925	0.30870871	255.5970184	33.87940803	0	17.52417587	1.555312889	0.689892865	15.04108337	3863.382771	115.1762571	177.3230014	1259.277714	29.09909735	0	14.83742554	0	0	0	0	0	0	0	0	0	0											1a $150 days 1-7	1b $150 days 1-7	2 $75 days 7-26		10a $115	11a 30%	"11b 30%,11c 10%"	"4a $50,4b $50"	"9a $100,9b $100"	8a 20%	8b 20%	9a 20%	12 20%	"9a 20%,9d 20%"	"14c $10,7a $10"	"7b $20,7d $30,7f $30,7g $30"	"7e $30,7h $30"	"7c $25,7i $25"	8b 20%		0.2				17a $30		18a $30															77.89567928	77.89567928	26.05433306	0	49.77136498	0.203659767	0.203659767	33.94329446	0.083576252	0	0.133242995	0.135773178	0.2	0.134805557	9.799521351	0.095954588	19.32035258	16.97164723	0.042160357	0	0.141373901	0	0	0	0	0	0	0	0	0	0											8.6556	0.261618333	0.768666466	0	0.927024021	0.976878903	0.062871544	0.722983738	2.831513928	0	2.334973676	0.211169774	0.137978573	2.027621617	3.154941829	11.05169035	0.285495242	1.781001427	1.226828329	0	2.097624733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5165	0	12.36178473	8.6556	0.261618333	0.768666466	0	0.927024021	0.976878903	0.062871544	0.722983738	2.831513928	0	2.334973676	0.211169774	0.137978573	2.027621617	3.154941829	11.05169035	0.285495242	1.781001427	1.226828329	0	2.097624733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5165		0.2	0.2	0.2	0.2	115	0.3	0.3	50	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2				0.2	0.2	0.2				0.2											5.757	0.0021	0.3375	0.3338	0.2333	0.1615	0.0104	0.1451	0.746	0.1281	0.4049	0.0382	0.0148	0.4939	0.4538	2.4602	0.0215	0.1161	0.6311	0.1138	0.3659	0	0	0	0.0156	0.0253	0	0	0	0	0.0086											13.0187	0	0	14.4125	0.263752228	1.106133006	0.333840961	1.160332643	1.138395646	0.073271006	0.868049736	3.577522718	0.128106797	2.739909232	0.249389464	0.152771877	2.521537899	3.608737304	13.51193517	0.306987047	1.897114827	1.85791669	0.113836898	2.463538379	0	0	0	0.015570014	0.025345547	0	0	0	0	0.00861734	0	0	0	0	0	0	0	0	0	0	52.5351
H1608_002_0	2008	11																					2000											D	D	D	COIN	T	COIN	COIN	V	V	COIN	COIN	COIN	COIN	COIN	P	COIN	P	P	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	COIN											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	1333.409144	40.30287718	354.0293112	0	223.5077992	4.796621925	0.30870871	255.5970184	473.8234231	0	17.52417587	1.555312889	0.689892865	15.04108337	0	115.1762571	177.3230014	1259.277714	29.09909735	0	14.83742554	0	0	0	0	0	0	0	0	0	0											1a $250 per stay	1b $250 per stay	2 $100 days 16-26		10a $150	11a 10%	"11b 10%,11c 10%"	"4a $50,4b $50"	"9a $100,9b $100"	8a 10%	8b 10%	9a 10%	12 10%	"9a 10%,9d 10%"		7g $10	"7e $10,7h $10"	"7c $10,7i $10"	8b 10%		0.1				17a $10		18a $10															43.15339042	43.15339042	29.11353816	0	85.7885884	0.089709934	0.089709934	44.8549672	89.70993439	0	0.089709934	0.089709934	0.1	0.089070594	0	0.004672172	8.970993439	8.970993439	0.027856775	0	0.093410522	0	0	0	0	0	0	0	0	0	0											4.7951	0.144933816	0.858920488	0	1.597868216	0.430304638	0.027694238	0.955399656	3.54222235	0	1.572092667	0.139527017	0.068989286	1.339718235	0	0.538123338	0.132563624	0.941414342	0.810607004	0	1.385971664	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.2814	0	2.142015821	4.7951	0.144933816	0.858920488	0	1.597868216	0.430304638	0.027694238	0.955399656	3.54222235	0	1.572092667	0.139527017	0.068989286	1.339718235	0	0.538123338	0.132563624	0.941414342	0.810607004	0	1.385971664	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.2814		0.1	0.1	0.1	0.1	150	0.1	0.1	50	0.1	0.1	0.1	0.1	0.1	0.1	0.1	0.1	0.1	0.1	0.1	0.1	0.1				0.1	0.1	0.1				0.1											2.8785	0.0011	0.1687	0.1669	0.2804	0.1615	0.0104	0.1451	0.373	0.0641	0.2025	0.0191	0.0074	0.247	0.2269	1.2301	0.0107	0.0581	0.3155	0.0569	0.183	0	0	0	0	0.013	0	0	0	0	0.0043											6.8242	0	0	7.6736	0.146000764	1.027653759	0.166920481	1.878305402	0.591821382	0.0380937	1.100465654	3.915226745	0.064053399	1.774560446	0.158636862	0.076385939	1.586676376	0.226897737	1.768245746	0.143309526	0.999471042	1.126151184	0.056918449	1.568928487	0	0	0	0	0.013047773	0	0	0	0	0.00430867	0	0	0	0	0	0	0	0	0	0	26.1057
H1608_801_0	2008	5																																COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		230.0800275	4.068353407	11.49938248	0	5.228167017	5.276284118	14.07542115	6.988309071	37.26734883	6.280285998	19.27659346	1.710844178	0.209225286	16.5451917	13.90345948	127.2587499	11.01381266	3.84056439	29.33703349	2.764522552	16.1538401	0	0	0	0	0	0	0	0	0	0											FFS Medicare 9.%	FFS Medicare 9.%	FFS Medicare 14.9%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				0.090008655	0.090008655	0.149312602	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											20.7092	0.366187017	1.717002723	0	1.223391082	1.234650484	3.29364855	1.635264323	8.720559626	1.469586924	4.510722869	0.400337538	0.048958717	3.871574859	3.253409517	29.77854747	2.577232161	0.898692067	6.864865836	0.646898277	3.779998583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.0007	0	0	20.7092	0.366187017	1.717002723	0	1.223391082	1.234650484	3.29364855	1.635264323	8.720559626	1.469586924	4.510722869	0.400337538	0.048958717	3.871574859	3.253409517	29.77854747	2.577232161	0.898692067	6.864865836	0.646898277	3.779998583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.0007		FFS Medicare 9.%	FFS Medicare 9.%	FFS Medicare 14.9%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				2.8184	0.016	0.2771	0	0.1573	0.1386	0.3746	0.2222	0.9601	0.1649	0.5212	0.0492	0.0054	0.6297	0.3575	3.2524	0.2358	0.1283	0.7462	0.0711	0.4666	0	0	0	0	0	0	0	0	0	0											11.5925	0	0	23.5276	0.382165486	1.994136763	0	1.380723745	1.373231849	3.668292699	1.857416125	9.680672939	1.634460372	5.03187493	0.449526279	0.054345112	4.501248008	3.610880136	33.0309571	2.813052664	1.026951542	7.61106988	0.718014342	4.246578917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.5932
H1608_802_0	2008	5																																COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		230.0800275	4.068353407	11.49938248	0	5.228167017	5.276284118	14.07542115	6.988309071	37.26734883	6.280285998	19.27659346	1.710844178	0.209225286	16.5451917	13.90345948	127.2587499	11.01381266	3.84056439	29.33703349	2.764522552	16.1538401	0	0	0	0	0	0	0	0	0	0											FFS Medicare 9.%	FFS Medicare 9.%	FFS Medicare 15.%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				0.089958538	0.089958538	0.149989574	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											20.6977	0.365983125	1.724787478	0	1.223391082	1.234650484	3.29364855	1.635264323	8.720559626	1.469586924	4.510722869	0.400337538	0.048958717	3.871574859	3.253409517	29.77854747	2.577232161	0.898692067	6.864865836	0.646898277	3.779998583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.9968	0	0	20.6977	0.365983125	1.724787478	0	1.223391082	1.234650484	3.29364855	1.635264323	8.720559626	1.469586924	4.510722869	0.400337538	0.048958717	3.871574859	3.253409517	29.77854747	2.577232161	0.898692067	6.864865836	0.646898277	3.779998583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.9968		FFS Medicare 9.%	FFS Medicare 9.%	FFS Medicare 15.%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				2.8168	0.016	0.2784	0	0.1573	0.1386	0.3746	0.2222	0.9601	0.1649	0.5212	0.0492	0.0054	0.6297	0.3575	3.2524	0.2358	0.1283	0.7462	0.0711	0.4666	0	0	0	0	0	0	0	0	0	0											11.5922	0	0	23.5145	0.381952698	2.003178022	0	1.380723745	1.373231849	3.668292699	1.857416125	9.680672939	1.634460372	5.03187493	0.449526279	0.054345112	4.501248008	3.610880136	33.0309571	2.813052664	1.026951542	7.61106988	0.718014342	4.246578917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.5889
H1608_803_0	2008	4																																COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		230.0800275	4.068353407	11.49938248	0	5.228167017	5.276284118	14.07542115	6.988309071	37.26734883	6.280285998	19.27659346	1.710844178	0.209225286	16.5451917	13.90345948	127.2587499	11.01381266	3.84056439	29.33703349	2.764522552	16.1538401	0	0	0	0	0	0	0	0	0	0											FFS Medicare 9.%	FFS Medicare 9.%	FFS Medicare 14.9%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				0.090008655	0.090008655	0.149312602	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											20.7092	0.366187017	1.717002723	0	1.223391082	1.234650484	3.29364855	1.635264323	8.720559626	1.469586924	4.510722869	0.400337538	0.048958717	3.871574859	3.253409517	29.77854747	2.577232161	0.898692067	6.864865836	0.646898277	3.779998583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.0007	0	0	20.7092	0.366187017	1.717002723	0	1.223391082	1.234650484	3.29364855	1.635264323	8.720559626	1.469586924	4.510722869	0.400337538	0.048958717	3.871574859	3.253409517	29.77854747	2.577232161	0.898692067	6.864865836	0.646898277	3.779998583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.0007		FFS Medicare 9.%	FFS Medicare 9.%	FFS Medicare 14.9%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				2.8184	0.016	0.2771	0	0.1573	0.1386	0.3746	0.2222	0.9601	0.1649	0.5212	0.0492	0.0054	0.6297	0.3575	3.2524	0.2358	0.1283	0.7462	0.0711	0.4666	0	0	0	0	0	0	0	0	0	0											11.5925	0	0	23.5276	0.382165486	1.994136763	0	1.380723745	1.373231849	3.668292699	1.857416125	9.680672939	1.634460372	5.03187493	0.449526279	0.054345112	4.501248008	3.610880136	33.0309571	2.813052664	1.026951542	7.61106988	0.718014342	4.246578917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.5932
H1609_001_0	2008	7																					1400											D	D	D	COIN	T	COIN	COIN	V	V	COIN	COIN	COIN	COIN	COIN	P	COIN	P	P	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	COIN											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1411.739703	43.78673834	384.1941121	0	234.7343165	4.898536928	0.317986716	268.9583162	500.4145822	0	18.5032426	1.626583474	0.736049794	16.25019153	4026.406287	120.7992008	189.4548524	1308.439853	30.33916068	0	16.06185306	0	0	0	0	0	0	0	0	0	0											1a $150 days 1-9	1b $150 days 1-9	2 $75 days 7-22		10a $115	11a 30%	"11b 30%,11c 10%"	"4a $50,4b $50"	"9a $50,9b $50"	8a 20%	8b 20%	9a 20%	12 20%	"9a 20%,9d 20%"	"14c $10,7a $10"	"7b $20,7d $30,7f $30,7g $30"	"7e $30,7h $30"	"7c $25,7i $25"	8b 20%		0.2				17a $30		18a $30															81.32444516	81.32444516	21.88266907	0	49.03352149	0.196374535	0.196374535	32.72908924	32.72908924	0	0.130916357	0.130916357	0.2	0.130076558	9.801272888	0.093894954	18.68426315	16.36454462	0.040384023	0	0.135451534	0	0	0	0	0	0	0	0	0	0											9.5674	0.29674435	0.700599384	0	0.959154179	0.961947913	0.062444494	0.733563394	1.364842793	0	2.422377113	0.212946383	0.147209959	2.113768975	3.288658898	11.34243538	0.29498536	1.784335197	1.225217358	0	2.17560264	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.6542	0	13.51569617	9.5674	0.29674435	0.700599384	0	0.959154179	0.961947913	0.062444494	0.733563394	1.364842793	0	2.422377113	0.212946383	0.147209959	2.113768975	3.288658898	11.34243538	0.29498536	1.784335197	1.225217358	0	2.17560264	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.6542																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.5674	0.29674435	0.700599384	0	0.959154179	0.961947913	0.062444494	0.733563394	1.364842793	0	2.422377113	0.212946383	0.147209959	2.113768975	3.288658898	11.34243538	0.29498536	1.784335197	1.225217358	0	2.17560264	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.6542
H1609_003_0	2008	6																																D	D	D	V	T	O	O	V	V	O	O	O	O	O	P	COIN	P	P	COIN	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H1609_004_0	2008	5																					1500											D	D	D	COIN	T	COIN	COIN	V	V	COIN	COIN	COIN	COIN	COIN	P	COIN	P	P	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	COIN											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1948.579427	60.59174869	531.6669316	0	325.2317516	6.794329458	0.44090551	372.6228892	693.1944335	0	25.631665	2.25403982	1.019219809	22.49148229	5580.331051	167.379542	262.3273632	1813.619557	42.04741717	0	21.52108959	0	0	0	0	0	0	0	0	0	0											1a $150 days 1-9	1b $150 days 1-9	2 $75 days 7-22		10a $115	11a 30%	11b 30%	"4a $50,4b $50"	"9a $50,9b $50"	8a 20%	8b 20%	9a 20%	12 20%	"9a 20%,9d 20%"	"14c $10,7a $10"	"7b $20,7d $30,7g $30"	"7e $30,7h $30"	"7c $25,7i $25"	8b 20%		0.2				17a $30		18a $30															71.86635537	71.86635537	19.33806763	0	43.29619493	0.17353604	0.17353604	28.92267329	28.92267329	0	0.115690693	0.115690693	0.2	0.114946671	9.801206441	0.093184945	16.50946904	14.46133665	0.03569632	0	0.119841148	0	0	0	0	0	0	0	0	0	0											11.6698	0.362875679	0.856784257	0	1.173441443	1.179061027	0.076512996	0.898104174	1.670753011	0	2.965345092	0.260771429	0.203843962	2.585321011	4.557831387	15.59725337	0.360907123	2.185613581	1.500938068	0	2.579112094	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.6842	0	22.75777013	11.6698	0.362875679	0.856784257	0	1.173441443	1.179061027	0.076512996	0.898104174	1.670753011	0	2.965345092	0.260771429	0.203843962	2.585321011	4.557831387	15.59725337	0.360907123	2.185613581	1.500938068	0	2.579112094	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.6842																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.6698	0.362875679	0.856784257	0	1.173441443	1.179061027	0.076512996	0.898104174	1.670753011	0	2.965345092	0.260771429	0.203843962	2.585321011	4.557831387	15.59725337	0.360907123	2.185613581	1.500938068	0	2.579112094	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.6842
H1609_005_0	2008	5																					1600											D	D	D	COIN	T	COIN	COIN	V	V	COIN	COIN	COIN	COIN	COIN	P	COIN	P	P	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	COIN											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1615.786856	50.1576409	440.1083282	0	269.1568868	5.621662961	0.364832017	308.3816721	573.701776	0	21.21324752	1.865349122	0.843592014	18.61759702	4617.925063	138.5193562	217.126504	1500.800354	34.79586082	0	18.13383335	0	0	0	0	0	0	0	0	0	0											1a $250 days 1-5	1b $250 days 1-5	2 $100 days 7-26		10a $115	11a 30%	"11b 30%,11c 10%"	"4a $50,4b $50"	"9a $100,9b $100"	8a 20%	8b 20%	9a 20%	12 20%	"9a 20%,9d 20%"	"14c $10,7a $10"	"7b $20,7d $30,7f $30,7g $30"	"7e $30,7h $30"	"7c $25,7i $25"	8b 20%		0.2				17a $30		18a $30															99.30423371	99.30423371	30.67396571	0	44.87323025	0.179827652	0.179827652	29.97127526	59.94255052	0	0.119885101	0.119885101	0.2	0.119114503	9.80121996	0.093380677	17.10840584	14.98563763	0.036988608	0	0.124108068	0	0	0	0	0	0	0	0	0	0											13.3712	0.415072175	1.124988981	0	1.006494913	1.010930448	0.065606885	0.770215998	2.865762308	0	2.543152322	0.223627568	0.168718403	2.217625821	3.771774942	12.93503122	0.309557362	1.874204189	1.287050469	0	2.250555024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.2116	0	21.4583011	13.3712	0.415072175	1.124988981	0	1.006494913	1.010930448	0.065606885	0.770215998	2.865762308	0	2.543152322	0.223627568	0.168718403	2.217625821	3.771774942	12.93503122	0.309557362	1.874204189	1.287050469	0	2.250555024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.2116																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.3712	0.415072175	1.124988981	0	1.006494913	1.010930448	0.065606885	0.770215998	2.865762308	0	2.543152322	0.223627568	0.168718403	2.217625821	3.771774942	12.93503122	0.309557362	1.874204189	1.287050469	0	2.250555024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.2116
H1609_006_0	2008	5																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	278.8826386	39.57667874	50.45220438		13.93892213	26.23182159	24.35213089	810.2551946	42.52983715	14.22740082	24.01691446	4.664242718	1.81488159	41.68553973	35.44528096	86.8734239	19.9209299	14.85550902	19.27020433	9.588935294	21.19710998																					Medicare FFS	Medicare FFS	Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	4a:$50	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																					0.091011844	0.091011844	0.13600126		0.234	0.234	0.234	50	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					25.3816	3.601946531	6.861563383	0	3.261707778	6.138246253	5.698398629	3.376063311	9.951981893	3.329211792	5.619957983	1.091432796	0.424682292	9.754416298	8.294195745	20.32838119	4.661497597	3.476189111	4.509227812	2.243810859	4.960123735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.9647	0	0	25.3816	3.601946531	6.861563383	0	3.261707778	6.138246253	5.698398629	3.376063311	9.951981893	3.329211792	5.619957983	1.091432796	0.424682292	9.754416298	8.294195745	20.32838119	4.661497597	3.476189111	4.509227812	2.243810859	4.960123735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.9647																																																																																				0	0	0	25.3816	3.601946531	6.861563383	0	3.261707778	6.138246253	5.698398629	3.376063311	9.951981893	3.329211792	5.619957983	1.091432796	0.424682292	9.754416298	8.294195745	20.32838119	4.661497597	3.476189111	4.509227812	2.243810859	4.960123735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.9647
H1609_801_0	2008	4																																COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	COIN	V	V	COIN	V	V	COIN	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		240.8906014	4.291156425	12.47487925	0	5.551110724	5.38839062	15.30161386	7.404272251	39.39511621	6.381633668	20.35356686	1.789241822	0.211338673	17.87521068	14.07608214	130.5325923	11.90456698	3.963778799	33.42596396	2.803656113	17.48211836	0	0	0	0	0	0	0	0	0	0											FFS Medicare 9.1%	FFS Medicare 9.1%	FFS Medicare 13.6%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				0.091010921	0.091010921	0.135945787	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											21.9237	0.3905421	1.695907281	0	1.298959909	1.260883405	3.580577643	1.732599707	9.218457194	1.493302278	4.762734645	0.418682586	0.049453249	4.1827993	3.29380322	30.54462659	2.785668674	0.927524239	7.821675568	0.65605553	4.090815697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.1287	0	0	21.9237	0.3905421	1.695907281	0	1.298959909	1.260883405	3.580577643	1.732599707	9.218457194	1.493302278	4.762734645	0.418682586	0.049453249	4.1827993	3.29380322	30.54462659	2.785668674	0.927524239	7.821675568	0.65605553	4.090815697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.1287																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.9237	0.3905421	1.695907281	0	1.298959909	1.260883405	3.580577643	1.732599707	9.218457194	1.493302278	4.762734645	0.418682586	0.049453249	4.1827993	3.29380322	30.54462659	2.785668674	0.927524239	7.821675568	0.65605553	4.090815697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.1287
H1609_802_0	2008	6																																COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	COIN	V	V	COIN	V	V	COIN	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		240.8906014	4.291156425	12.47487925	0	5.551110724	5.38839062	15.30161386	7.404272251	39.39511621	6.381633668	20.35356686	1.789241822	0.211338673	17.87521068	14.07608214	130.5325923	11.90456698	3.963778799	33.42596396	2.803656113	17.48211836	0	0	0	0	0	0	0	0	0	0											FFS Medicare 9.1%	FFS Medicare 9.1%	FFS Medicare 13.6%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				0.091007957	0.091007957	0.135979801	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											21.923	0.390529381	1.696331596	0	1.298959909	1.260883405	3.580577643	1.732599707	9.218457194	1.493302278	4.762734645	0.418682586	0.049453249	4.1827993	3.29380322	30.54462659	2.785668674	0.927524239	7.821675568	0.65605553	4.090815697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.1284	0	0	21.923	0.390529381	1.696331596	0	1.298959909	1.260883405	3.580577643	1.732599707	9.218457194	1.493302278	4.762734645	0.418682586	0.049453249	4.1827993	3.29380322	30.54462659	2.785668674	0.927524239	7.821675568	0.65605553	4.090815697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.1284																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.923	0.390529381	1.696331596	0	1.298959909	1.260883405	3.580577643	1.732599707	9.218457194	1.493302278	4.762734645	0.418682586	0.049453249	4.1827993	3.29380322	30.54462659	2.785668674	0.927524239	7.821675568	0.65605553	4.090815697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.1284
H1609_803_0	2008	5																																COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	COIN	V	V	COIN	V	V	COIN	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		240.8906014	4.291156425	12.47487925	0	5.551110724	5.38839062	15.30161386	7.404272251	39.39511621	6.381633668	20.35356686	1.789241822	0.211338673	17.87521068	14.07608214	130.5325923	11.90456698	3.963778799	33.42596396	2.803656113	17.48211836	0	0	0	0	0	0	0	0	0	0											FFS Medicare 9.1%	FFS Medicare 9.1%	FFS Medicare 13.6%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				0.091010921	0.091010921	0.135945787	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											21.9237	0.3905421	1.695907281	0	1.298959909	1.260883405	3.580577643	1.732599707	9.218457194	1.493302278	4.762734645	0.418682586	0.049453249	4.1827993	3.29380322	30.54462659	2.785668674	0.927524239	7.821675568	0.65605553	4.090815697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.1287	0	0	21.9237	0.3905421	1.695907281	0	1.298959909	1.260883405	3.580577643	1.732599707	9.218457194	1.493302278	4.762734645	0.418682586	0.049453249	4.1827993	3.29380322	30.54462659	2.785668674	0.927524239	7.821675568	0.65605553	4.090815697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.1287																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.9237	0.3905421	1.695907281	0	1.298959909	1.260883405	3.580577643	1.732599707	9.218457194	1.493302278	4.762734645	0.418682586	0.049453249	4.1827993	3.29380322	30.54462659	2.785668674	0.927524239	7.821675568	0.65605553	4.090815697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.1287
H1643_001_0	2008	4																					5000											D		D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	983.709364	0	757.1583617	1320.684795	302.5525021	12.72382533	0.581701292	304.5593287	311.3900545	336.0024121	738.5703172	0	0	608.0927289	3657.568976	5284.097445	153.6828567	450.8256478	915.4396867	1165.374803	1120.877774	0	0	0	359.1443109	0	153.9189904	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												143.1911019	0	47.73036731	23.86518365	47.73036731	0.190921469	0.190921469	47.73036731	95.46073462	28.63822039	39.37755303	0	0	23.86518365	23.86518365	23.86518365	23.86518365	23.86518365	39.37755303	28.63822039	23.86518365	0	0	0	23.86518365	0	23.86518365	0	0	0	0											11.7382	0	3.01162056	2.626532099	1.203411838	2.429251426	0.111059265	1.211394052	2.477126946	0.801875927	2.423590986	0	0	1.209353721	7.274046278	10.50882966	0.305639133	0.896586407	3.003981234	2.781188371	2.229162827	0	0	0	0.714253745	0	0.306108748	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2632	0	2.722930355	11.7382	0	3.01162056	2.626532099	1.203411838	2.429251426	0.111059265	1.211394052	2.477126946	0.801875927	2.423590986	0	0	1.209353721	7.274046278	10.50882966	0.305639133	0.896586407	3.003981234	2.781188371	2.229162827	0	0	0	0.714253745	0	0.306108748	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2632	5000	"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.7382	0	3.01162056	2.626532099	1.203411838	2.429251426	0.111059265	1.211394052	2.477126946	0.801875927	2.423590986	0	0	1.209353721	7.274046278	10.50882966	0.305639133	0.896586407	3.003981234	2.781188371	2.229162827	0	0	0	0.714253745	0	0.306108748	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2632
H1643_002_0	2008	6																					4000											D		D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	4000	985.6966557	0	766.6228412	1363.517816	302.5525021	12.72382533	0.581701292	304.5593287	312.9787793	342.3302321	748.9784648	0	0	609.6322042	3740.695543	5397.122338	157.1756489	461.0716853	928.3403289	1187.321914	1128.695502	0	0	0	367.3066817	0	157.4171493	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												118.8476572	0	33.27734402	14.26171886	47.53906288	0.190156252	0.190156252	47.53906288	71.30859432	23.76953144	35.65429716	0	0	19.01562515	19.01562515	19.01562515	19.01562515	19.01562515	35.65429716	23.76953144	23.76953144	0	0	0	19.01562515	0	19.01562515	0	0	0	0											9.7623	0	2.125931002	1.620508979	1.198588535	2.41951493	0.110614137	1.206538757	1.859839734	0.678085768	2.225358396	0	0	0.96604479	5.927638689	8.552471273	0.249066102	0.730630528	2.758276829	2.351840463	2.235713601	0	0	0	0.582047181	0	0.249448792	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.8105	0	2.47498695	9.7623	0	2.125931002	1.620508979	1.198588535	2.41951493	0.110614137	1.206538757	1.859839734	0.678085768	2.225358396	0	0	0.96604479	5.927638689	8.552471273	0.249066102	0.730630528	2.758276829	2.351840463	2.235713601	0	0	0	0.582047181	0	0.249448792	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.8105	4000	"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.7623	0	2.125931002	1.620508979	1.198588535	2.41951493	0.110614137	1.206538757	1.859839734	0.678085768	2.225358396	0	0	0.96604479	5.927638689	8.552471273	0.249066102	0.730630528	2.758276829	2.351840463	2.235713601	0	0	0	0.582047181	0	0.249448792	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.8105
H1643_003_0	2008	5																					3000											D		D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	987.6839473	0	772.9324943	1384.934326	304.0805451	12.72382533	0.581701292	304.5593287	314.567504	350.5322461	763.9139955	0	0	611.1716795	3865.385395	5570.184152	162.4148372	476.4407414	946.8525507	1215.769389	1136.51323	0	0	0	379.5502377	0	162.6643876	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												94.4926535	0	23.62316337	9.44926535	23.62316337	0.188985307	0.188985307	47.24632675	47.24632675	18.8985307	31.89127055	0	0	14.17389802	14.17389802	14.17389802	14.17389802	14.17389802	31.89127055	18.8985307	23.62316337	0	0	0	14.17389802	0	14.17389802	0	0	0	0											7.7774	0	1.521592549	1.090550995	0.598612033	2.404616036	0.109932997	1.19910913	1.238513257	0.552045368	2.030182326	0	0	0.721890422	4.565631534	6.579268512	0.191837612	0.562751874	2.516360906	1.914687927	2.237336475	0	0	0	0.448308864	0	0.19213237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4528	0	2.241155343	7.7774	0	1.521592549	1.090550995	0.598612033	2.404616036	0.109932997	1.19910913	1.238513257	0.552045368	2.030182326	0	0	0.721890422	4.565631534	6.579268512	0.191837612	0.562751874	2.516360906	1.914687927	2.237336475	0	0	0	0.448308864	0	0.19213237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4528	3000	"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.7774	0	1.521592549	1.090550995	0.598612033	2.404616036	0.109932997	1.19910913	1.238513257	0.552045368	2.030182326	0	0	0.721890422	4.565631534	6.579268512	0.191837612	0.562751874	2.516360906	1.914687927	2.237336475	0	0	0	0.448308864	0	0.19213237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4528
H1643_004_0	2008	6																					5000											D		D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	1046.635021	0	925.9264007	1392.916228	299.8463144	12.69885531	0.580559726	371.3315748	379.6598837	409.6683078	900.4960714	0	0	741.4122944	3573.291613	5152.683544	148.6001952	435.91576	930.4480277	1040.492877	1183.176463	0	0	0	345.7666743	0	148.1857176	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												142.6123772	0	47.53745906	23.76872953	47.53745906	0.190149836	0.190149836	47.53745906	95.07491812	28.52247544	39.21840372	0	0	23.76872953	23.76872953	23.76872953	23.76872953	23.76872953	39.21840372	28.52247544	23.76872953	0	0	0	23.76872953	0	23.76872953	0	0	0	0											12.4386	0	3.668015697	2.758987423	1.187827658	2.414685258	0.110393337	1.471013295	3.00801103	0.973729521	2.94300154	0	0	1.468535691	7.077716824	10.20606179	0.294336487	0.863430316	3.040890533	2.473119378	2.34355011	0	0	0	0.684869547	0	0.29351552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7203	0	3.093637009	12.4386	0	3.668015697	2.758987423	1.187827658	2.414685258	0.110393337	1.471013295	3.00801103	0.973729521	2.94300154	0	0	1.468535691	7.077716824	10.20606179	0.294336487	0.863430316	3.040890533	2.473119378	2.34355011	0	0	0	0.684869547	0	0.29351552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7203	5000	"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.4386	0	3.668015697	2.758987423	1.187827658	2.414685258	0.110393337	1.471013295	3.00801103	0.973729521	2.94300154	0	0	1.468535691	7.077716824	10.20606179	0.294336487	0.863430316	3.040890533	2.473119378	2.34355011	0	0	0	0.684869547	0	0.29351552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7203
H1643_005_0	2008	5																					4000											D		D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	4000	1048.749435	0	937.5004807	1438.091889	299.8463144	12.69885531	0.580559726	371.3315748	381.596924	417.3834528	913.1861238	0	0	743.2892876	3654.502786	5262.878898	151.9774724	445.8229364	943.5601718	1060.088128	1190.73564	0	0	0	353.6250078	0	151.5535748	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												118.3992581	0	33.15179228	14.20791098	47.35970325	0.189438813	0.189438813	47.35970325	71.03955488	23.67985163	35.51977744	0	0	18.9438813	18.9438813	18.9438813	18.9438813	18.9438813	35.51977744	23.67985163	23.67985163	0	0	0	18.9438813	0	18.9438813	0	0	0	0											10.3476	0	2.5899851	1.702690128	1.183386039	2.405656077	0.109980545	1.465512766	2.259039635	0.823631519	2.70301399	0	0	1.17339867	5.769205583	8.308279429	0.239920266	0.703801399	2.792920608	2.091894132	2.349703606	0	0	0	0.558252514	0	0.239251078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8171	0	2.777297348	10.3476	0	2.5899851	1.702690128	1.183386039	2.405656077	0.109980545	1.465512766	2.259039635	0.823631519	2.70301399	0	0	1.17339867	5.769205583	8.308279429	0.239920266	0.703801399	2.792920608	2.091894132	2.349703606	0	0	0	0.558252514	0	0.239251078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8171	4000	"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.3476	0	2.5899851	1.702690128	1.183386039	2.405656077	0.109980545	1.465512766	2.259039635	0.823631519	2.70301399	0	0	1.17339867	5.769205583	8.308279429	0.239920266	0.703801399	2.792920608	2.091894132	2.349703606	0	0	0	0.558252514	0	0.239251078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8171
H1643_006_0	2008	5																					3000											D		D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	1050.863849	0	945.2165341	1460.67972	301.3606898	12.69885531	0.580559726	371.3315748	383.5339642	427.3836941	931.3961526	0	0	745.1662807	3776.319546	5431.547424	157.0433881	460.6837009	962.3758956	1085.487164	1198.294816	0	0	0	365.4125081	0	156.6053606	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												93.99301097	0	23.49825274	9.399301097	23.49825274	0.187986022	0.187986022	46.99650548	46.99650548	18.79860219	31.7226412	0	0	14.09895164	14.09895164	14.09895164	14.09895164	14.09895164	31.7226412	18.79860219	23.49825274	0	0	0	14.09895164	0	14.09895164	0	0	0	0											8.2312	0	1.850911418	1.144114041	0.590120805	2.387207293	0.109137113	1.454273866	1.502063004	0.669518004	2.462195497	0	0	0.87550528	4.436845556	6.381593707	0.184512261	0.541263102	2.544092103	1.700470115	2.346486205	0	0	0	0.429327773	0	0.183997617	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0248	0	2.557939887	8.2312	0	1.850911418	1.144114041	0.590120805	2.387207293	0.109137113	1.454273866	1.502063004	0.669518004	2.462195497	0	0	0.87550528	4.436845556	6.381593707	0.184512261	0.541263102	2.544092103	1.700470115	2.346486205	0	0	0	0.429327773	0	0.183997617	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0248	3000	"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.2312	0	1.850911418	1.144114041	0.590120805	2.387207293	0.109137113	1.454273866	1.502063004	0.669518004	2.462195497	0	0	0.87550528	4.436845556	6.381593707	0.184512261	0.541263102	2.544092103	1.700470115	2.346486205	0	0	0	0.429327773	0	0.183997617	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0248
H1643_801_0	2008	3																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		261.0229143	0	40.91515514	0	7.961195217	27.25304042	1.245940464	5.865594142	31.60862797	9.497082423	27.26264517	0	0	30.00444176	22.05285596	41.00864003	1.393796886	3.867538321	27.95289307	92.98588805	25.37593428	21.08408094	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.07972981	0	0.200218933	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											20.8113	0	8.19198871	0	1.862919681	6.377211459	0.291550068	1.372549029	7.396418944	2.222317287	6.379458969	0	0	7.021039372	5.160368294	9.596021767	0.326148471	0.905003967	6.540976979	21.7586978	5.93796862	4.93367494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.0856	0	0	20.8113	0	8.19198871	0	1.862919681	6.377211459	0.291550068	1.372549029	7.396418944	2.222317287	6.379458969	0	0	7.021039372	5.160368294	9.596021767	0.326148471	0.905003967	6.540976979	21.7586978	5.93796862	4.93367494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.0856		"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.8113	0	8.19198871	0	1.862919681	6.377211459	0.291550068	1.372549029	7.396418944	2.222317287	6.379458969	0	0	7.021039372	5.160368294	9.596021767	0.326148471	0.905003967	6.540976979	21.7586978	5.93796862	4.93367494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.0856
H1643_802_0	2008	3																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		261.0229143	0	40.91515514	0	7.961195217	27.25304042	1.245940464	5.865594142	31.60862797	9.497082423	27.26264517	0	0	30.00444176	22.05285596	41.00864003	1.393796886	3.867538321	27.95289307	92.98588805	25.37593428	21.08408094	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.07972981	0	0.200218933	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											20.8113	0	8.19198871	0	1.862919681	6.377211459	0.291550068	1.372549029	7.396418944	2.222317287	6.379458969	0	0	7.021039372	5.160368294	9.596021767	0.326148471	0.905003967	6.540976979	21.7586978	5.93796862	4.93367494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.0856	0	0	20.8113	0	8.19198871	0	1.862919681	6.377211459	0.291550068	1.372549029	7.396418944	2.222317287	6.379458969	0	0	7.021039372	5.160368294	9.596021767	0.326148471	0.905003967	6.540976979	21.7586978	5.93796862	4.93367494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.0856		"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.8113	0	8.19198871	0	1.862919681	6.377211459	0.291550068	1.372549029	7.396418944	2.222317287	6.379458969	0	0	7.021039372	5.160368294	9.596021767	0.326148471	0.905003967	6.540976979	21.7586978	5.93796862	4.93367494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.0856
H1643_803_0	2008	4																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		261.0229143	0	40.91515514	0	7.961195217	27.25304042	1.245940464	5.865594142	31.60862797	9.497082423	27.26264517	0	0	30.00444176	22.05285596	41.00864003	1.393796886	3.867538321	27.95289307	92.98588805	25.37593428	21.08408094	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.07972981	0	0.200218933	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											20.8113	0	8.19198871	0	1.862919681	6.377211459	0.291550068	1.372549029	7.396418944	2.222317287	6.379458969	0	0	7.021039372	5.160368294	9.596021767	0.326148471	0.905003967	6.540976979	21.7586978	5.93796862	4.93367494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.0856	0	0	20.8113	0	8.19198871	0	1.862919681	6.377211459	0.291550068	1.372549029	7.396418944	2.222317287	6.379458969	0	0	7.021039372	5.160368294	9.596021767	0.326148471	0.905003967	6.540976979	21.7586978	5.93796862	4.93367494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.0856		"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.8113	0	8.19198871	0	1.862919681	6.377211459	0.291550068	1.372549029	7.396418944	2.222317287	6.379458969	0	0	7.021039372	5.160368294	9.596021767	0.326148471	0.905003967	6.540976979	21.7586978	5.93796862	4.93367494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.0856
H1657_001_0	2008	8																					2000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1409.20501	58.81459461	1540.734695	1740.241954	493.4610254	15.96868868	3.715154244	1250.437956	281.0927765	7453.965694	1396.461139	91.89164532	0.479542844	491.4197475	6966.540562	15828.47911	259.8075506	2945.834498	3955.995507	1005.088469	29.46197626	42.17084899	0	218.5714286	200	138.4615385	46.8	17.82857143	0	1600	3600											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$150.00 copayment	20% coinsurance	Copay between $20.00 and $100.00	Copay between $0.00 and $10.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $10.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											63.58043578	38.08606023	53.94155872	0	33.63579365	0.173028256	0.173028256	17.5654888	76.05316173	0	14.67058449	93.88726484	0.173028256	18.77180142	3.820340074	7.09185356	19.55009477	9.796066416	5.197894422	0	0.173028256	0	0	0	8.651412787	8.651412787	17.30282557	0	0	0	0											7.4665	0.186668016	6.925802587	0	1.383162769	2.763034348	0.642826659	1.830379492	1.781499533	0	1.70724176	0.718954603	0.082974462	0.76873616	2.217879507	9.354437995	0.423271853	2.404799199	1.713570582	0	5.097754362	0	0	0	0.144190213	0.099823994	0.06748102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.781	0	7.448126426	7.4665	0.186668016	6.925802587	0	1.383162769	2.763034348	0.642826659	1.830379492	1.781499533	0	1.70724176	0.718954603	0.082974462	0.76873616	2.217879507	9.354437995	0.423271853	2.404799199	1.713570582	0	5.097754362	0	0	0	0.144190213	0.099823994	0.06748102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.781	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	25% coinsurance	N/A	N/A																																							10.293		0											10.293	0	0	7.4665	0.186668016	6.925802587	0	1.383162769	2.763034348	0.642826659	1.830379492	1.781499533	0	1.70724176	0.718954603	0.082974462	0.76873616	2.217879507	9.354437995	0.423271853	2.404799199	1.713570582	0	5.097754362	0	0	0	0.144190213	0.099823994	0.06748102	0	10.29295934	0	0	0	0	0	0	0	0	0	0	0	0	58.0739
H1657_002_0	2008	6																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2036.444933	36.24933416	1287.350293	2468.621825	650.0182213	16.21632758	4.544963131	1103.688495	245.4976098	6592.117709	1316.396818	77.17457424	0.704545401	524.9532783	6713.669774	16249.26357	214.2025312	3610.093111	4297.330043	628.6184291	32.93826206	31.03447437	0	218.5714286	200	138.4615385	46.8	17.82857143	0	1600	3600											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$150.00 copayment	20% coinsurance	Copay between $25.00 and $100.00	Copay between $0.00 and $5.00	$35.00 copayment	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											62.37373236	38.61798396	58.14189769	0	40.82288869	0.186501677	0.186501677	17.39105231	79.14551042	0	17.43320815	101.1981091	0.186501677	21.14937631	2.165791722	9.023509045	27.68536189	11.38192111	4.931680288	0	0.186501677	0	0	0	9.325083832	9.325083832	18.65016766	0	0	0	0											10.5851	0.11665635	6.237415753	0	2.211301791	3.024372283	0.847643244	1.599525362	1.61916947	0	1.912418311	0.650826749	0.131398899	0.925202869	1.211700869	12.2187814	0.49418955	3.424149581	1.766088155	0	6.143041101	0	0	0	0.155418064	0.107597121	0.072735654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.4547	0	4.013611731	10.5851	0.11665635	6.237415753	0	2.211301791	3.024372283	0.847643244	1.599525362	1.61916947	0	1.912418311	0.650826749	0.131398899	0.925202869	1.211700869	12.2187814	0.49418955	3.424149581	1.766088155	0	6.143041101	0	0	0	0.155418064	0.107597121	0.072735654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.4547	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.3595		0											14.3595	0	0	10.5851	0.11665635	6.237415753	0	2.211301791	3.024372283	0.847643244	1.599525362	1.61916947	0	1.912418311	0.650826749	0.131398899	0.925202869	1.211700869	12.2187814	0.49418955	3.424149581	1.766088155	0	6.143041101	0	0	0	0.155418064	0.107597121	0.072735654	0	14.35954563	0	0	0	0	0	0	0	0	0	0	0	0	69.8142
H1657_003_0	2008	8																					2000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1403.697539	58.55128406	1533.017133	1731.095147	490.8936244	15.8544375	3.688242909	1244.906988	279.6139953	7414.817625	1391.229653	91.6158185	0.475910348	490.513551	7104.364912	15882.64108	263.3671763	2969.999286	3924.871591	1000.016264	29.23695091	41.9746648	0	218.5714286	200	138.4615385	46.8	17.82857143	0	1600	3600											"$125 days 1 - 5, $0 after day 5, unlimited coverage"	"$125 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$125.00 copayment	20% coinsurance	Copay between $15.00 and $100.00	Copay between $0.00 and $5.00	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $5.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											54.06404561	32.38473001	55.04009715	0	34.31866475	0.176552036	0.176552036	17.92392364	77.69980069	0	14.50596427	79.83275945	0.176552036	18.50534839	1.980016917	6.087900984	16.52771224	8.33157912	6.308668159	0	0.176552036	0	0	0	8.827601789	8.827601789	17.65520358	0	0	0	0											6.3241	0.158013961	7.031450996	0	1.403901144	2.799133216	0.651166794	1.85946815	1.810495975	0	1.681760636	0.6094953	0.084022941	0.756427013	1.172230226	8.057662188	0.362738075	2.062065336	2.063392703	0	5.161843204	0	0	0	0.147126696	0.101856944	0.068855294	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3672	0	5.892435006	6.3241	0.158013961	7.031450996	0	1.403901144	2.799133216	0.651166794	1.85946815	1.810495975	0	1.681760636	0.6094953	0.084022941	0.756427013	1.172230226	8.057662188	0.362738075	2.062065336	2.063392703	0	5.161843204	0	0	0	0.147126696	0.101856944	0.068855294	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3672	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	25% coinsurance	N/A	N/A																																							10.2424		0											10.2424	0	0	6.3241	0.158013961	7.031450996	0	1.403901144	2.799133216	0.651166794	1.85946815	1.810495975	0	1.681760636	0.6094953	0.084022941	0.756427013	1.172230226	8.057662188	0.362738075	2.062065336	2.063392703	0	5.161843204	0	0	0	0.147126696	0.101856944	0.068855294	0	10.24236636	0	0	0	0	0	0	0	0	0	0	0	0	54.6096
H1657_004_0	2008	10																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		390.871806	53.21811434	4312.796271	50.75309892	21.48049581	29.39567706	5.166313435	26.02860183	18.37984485	9.152226626	19.15241688	90.90324539	2.575572674	7.203691971	7156.035637	75.93279902	14.50627995	44.07205743	15.37642467	3.452566776	25.75650593	2.307105573	750	645	0	0	0	0	0	1600	13.5											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.4	708.4	30.26	0.065332617	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.197510376	0.015406312	0.2	0.2	0	0	0	0	0	0	0	0	0											23.0745	3.141642683	10.8754346	3.315832774	4.296099161	5.879135412	1.033262687	5.205720365	3.675968969	1.830445325	3.830483376	0	0.515114535	1.440738394	0	15.1865598	2.901255991	8.814411487	3.03700342	0.05319132	5.151301187	0.461421115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.7195	0	0	23.0745	3.141642683	10.8754346	3.315832774	4.296099161	5.879135412	1.033262687	5.205720365	3.675968969	1.830445325	3.830483376	0	0.515114535	1.440738394	0	15.1865598	2.901255991	8.814411487	3.03700342	0.05319132	5.151301187	0.461421115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.7195	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	23.0745	3.141642683	10.8754346	3.315832774	4.296099161	5.879135412	1.033262687	5.205720365	3.675968969	1.830445325	3.830483376	0	0.515114535	1.440738394	0	15.1865598	2.901255991	8.814411487	3.03700342	0.05319132	5.151301187	0.461421115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.7195
H1657_005_0	2008	7																					1000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1964.225203	467.7778366	4092.80556	4689.999365	2371.381346	28.67695042	4.522850777	2791.535863	255.3939988	12306.4737	1426.197087	88.55798866	2.471586432	621.3246992	6677.714722	17144.64649	2282.074653	10127.04307	3974.420592	568.4558958	22.32083124	98.95825105	0	218.5714286	200	138.4615385	46.8	17.82857143	0	1600	3600											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $15.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $5.00 and $75.00	$0.00 copayment	$15.00 copayment	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											29.91083415	18.85911512	20.47830653	0	20.11059794	0.135349019	0.135349019	14.5818489	44.13615115	0	7.365684132	48.96136417	0.135349019	8.831424725	0	2.145046552	7.115563553	3.86548593	1.615649536	0	0.135349019	0	0	0	6.767450934	6.767450934	13.53490187	0	0	0	0											4.896	0.735156339	6.984477234	0	3.974158068	3.881397098	0.612163414	3.392146179	0.939342344	0	0.875409771	0.361326661	0.334526798	0.457265193	0	3.064672069	1.353187269	3.262161875	0.535105899	0	3.021102605	0	0	0	0.112790849	0.078085972	0.052786117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9232	0	18.59211848	4.896	0.735156339	6.984477234	0	3.974158068	3.881397098	0.612163414	3.392146179	0.939342344	0	0.875409771	0.361326661	0.334526798	0.457265193	0	3.064672069	1.353187269	3.262161875	0.535105899	0	3.021102605	0	0	0	0.112790849	0.078085972	0.052786117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9232	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	25% coinsurance	N/A	N/A																																							11.6503		0											11.6503	0	0	4.896	0.735156339	6.984477234	0	3.974158068	3.881397098	0.612163414	3.392146179	0.939342344	0	0.875409771	0.361326661	0.334526798	0.457265193	0	3.064672069	1.353187269	3.262161875	0.535105899	0	3.021102605	0	0	0	0.112790849	0.078085972	0.052786117	0	11.65026694	0	0	0	0	0	0	0	0	0	0	0	0	50.5735
H1657_006_0	2008	9																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2131.499649	379.4302537	4526.425881	4844.873142	2808.625501	28.33134778	4.046841205	2982.703851	271.8929563	11714.96602	1526.181395	104.2680223	2.185457247	632.2648918	6238.342854	17409.7837	2143.999414	10079.29739	4044.510096	553.1533445	18.5222803	121.1540247	0	218.5714286	200	138.4615385	46.8	17.82857143	0	1600	3600											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $10.00 and $75.00	Copay between $0.00 and $5.00	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											31.27636432	20.2743498	44.70491135	0	19.2114869	0.143399876	0.143399876	15.41475329	46.86948635	0	8.19177992	51.87369381	0.143399876	10.13343249	1.327529826	3.009897265	10.19834285	5.4542333	1.53759725	0	0.143399876	0	0	0	7.169993801	7.169993801	14.3399876	0	0	0	0											5.5555	0.641058474	16.86278898	0	4.496489334	4.062711759	0.580316527	3.831470334	1.061956934	0	1.041845175	0.450730622	0.313394298	0.5339178	0.690132183	4.366805029	1.822103425	4.581236624	0.518235634	0	2.656092699	0	0	0	0.119499897	0.082730698	0.055925952	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.3249	0	21.44211335	5.5555	0.641058474	16.86278898	0	4.496489334	4.062711759	0.580316527	3.831470334	1.061956934	0	1.041845175	0.450730622	0.313394298	0.5339178	0.690132183	4.366805029	1.822103425	4.581236624	0.518235634	0	2.656092699	0	0	0	0.119499897	0.082730698	0.055925952	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.3249	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	25% coinsurance	N/A	N/A																																							12.043		0											12.043	0	0	5.5555	0.641058474	16.86278898	0	4.496489334	4.062711759	0.580316527	3.831470334	1.061956934	0	1.041845175	0.450730622	0.313394298	0.5339178	0.690132183	4.366805029	1.822103425	4.581236624	0.518235634	0	2.656092699	0	0	0	0.119499897	0.082730698	0.055925952	0	12.04301137	0	0	0	0	0	0	0	0	0	0	0	0	66.3679
H1657_007_0	2008	7																					2000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		3197.887976	400.9744798	4552.983645	5195.869173	3239.647918	28.02930537	4.881917286	2193.053274	192.8992057	9645.842707	1333.879086	62.43337044	1.411246662	594.0035513	7682.094282	17632.58201	2093.672827	8190.607565	4872.762778	426.0237932	22.8038742	16.8419059	0	218.5714286	200	138.4615385	46.8	17.82857143	0	1600	3600											"$125 days 1 - 5, $0 after day 5, unlimited coverage"	"$125 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$125.00 copayment	20% coinsurance	Copay between $20.00 and $100.00	Copay between $0.00 and $5.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $5.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$10.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											39.35771324	32.76393811	46.49229268	0	26.26977896	0.149133256	0.149133256	14.96295939	64.88667502	0	11.69101028	67.43461966	0.149133256	12.52339294	1.443054875	4.285572549	18.96476226	8.344071739	2.027917239	0	0.149133256	0	0	0	7.45666282	7.45666282	14.91332564	0	0	0	0											10.4885	1.09479192	17.63988735	0	7.09206956	4.180101584	0.728056222	2.734547256	1.043049006	0	1.299532842	0.350847549	0.21046381	0.619911657	0.923806967	6.297142451	3.308833951	5.695251426	0.823463303	0	3.400816017	0	0	0	0.124277714	0.086038417	0.05816197	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.1995	0	23.26166064	10.4885	1.09479192	17.63988735	0	7.09206956	4.180101584	0.728056222	2.734547256	1.043049006	0	1.299532842	0.350847549	0.21046381	0.619911657	0.923806967	6.297142451	3.308833951	5.695251426	0.823463303	0	3.400816017	0	0	0	0.124277714	0.086038417	0.05816197	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.1995	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							16.2477		0											16.2477	0	0	10.4885	1.09479192	17.63988735	0	7.09206956	4.180101584	0.728056222	2.734547256	1.043049006	0	1.299532842	0.350847549	0.21046381	0.619911657	0.923806967	6.297142451	3.308833951	5.695251426	0.823463303	0	3.400816017	0	0	0	0.124277714	0.086038417	0.05816197	0	16.24765787	0	0	0	0	0	0	0	0	0	0	0	0	84.4472
H1689_009_0	2008	9	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	A	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1242.470932	7.774971475	339.1927569	6.682940623	211.6969271	8.769437212	3.126508406	178.0416278	374.8270765	775.2046403	820.2005161	45.99607284	13.27534212	0.350718432	5087.021785	1805.548282	0.097355884	396.0515043	542.488982	0	24.95683583	0	0	0	4.86995381	319.0209839	150.9610321	0	0		0	997.9628027	16.31490186	69.59170271	379.5338521	102.698574	0.043073536	769.4305986	3.578347527	1.179083628		"$150/day, days(1-5) no yrly max"	"$500/admit, no yrly max"	$50/day for days 21 to 100	15% Coinsurance	$100 copay	30% coinsurance	30% coinsurance	$50 copay	$150 copay	$10 copay	$15/$35 copay for Lower/Higher Tier	$100 copay	$25 copay	$15 copay	$15 copay	$15 copay	50% coinsurance	$15 copay	$15/$35 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$15 copay	$0 copay	$15 copay	$15 copay	$10 copay	$0 copay	$10 copay	$10 copay	$15 copay		150	500	50	0.15	100	0.3	0.3	50	150	10	19.33492	100	25	15	15	15	0.5	15	23.33	0	0.2	0	0	0	0.5	0	10	0	0		0	15	0	15	15	10	0	10	10	15		15.5309	0.323957145	1.413303154	1.002441093	1.764141059	2.630831163	0.937952522	0.741840116	4.685338457	0.646003867	1.321542614	0.383300607	0.027656963	0.000438398	6.358777231	2.256935352	0.048677942	0.49506438	1.054688996	0	4.991367167	0	0	0	2.434976905	0	0.12580086	0	0	0	0	1.247453503	0	0.086989628	0.474417315	0.085582145	0	0.641192166	0.002981956	0.001473855	0	51.716		0	15.5309	0.323957145	1.413303154	1.002441093	1.764141059	2.630831163	0.937952522	0.741840116	4.685338457	0.646003867	1.321542614	0.383300607	0.027656963	0.000438398	6.358777231	2.256935352	0.048677942	0.49506438	1.054688996	0	4.991367167	0	0	0	2.434976905	0	0.12580086	0	0	0	0	1.247453503	0	0.086989628	0.474417315	0.085582145	0	0.641192166	0.002981956	0.001473855	0	51.716	None																																																																																			0		0	15.5309	0.323957145	1.413303154	1.002441093	1.764141059	2.630831163	0.937952522	0.741840116	4.685338457	0.646003867	1.321542614	0.383300607	0.027656963	0.000438398	6.358777231	2.256935352	0.048677942	0.49506438	1.054688996	0	4.991367167	0	0	0	2.434976905	0	0.12580086	0	0	0	0	1.247453503	0	0.086989628	0.474417315	0.085582145	0	0.641192166	0.002981956	0.001473855	0	51.716
H1689_010_0	2008	7	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	A	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1130.560445	7.074672721	293.6331368	7.936302169	192.0601504	7.963596745	2.83920753	168.6557867	348.737528	735.9664503	778.6847899	43.66791	12.60339001	0.332966272	4812.945288	1708.269684	0.087147886	374.713202	705.9803078	0	23.15044164	0	0	0	4.354112197	305.4998553	144.5628212	0	0		0	947.4493615	15.4890977	65.84226917	359.0854811	97.16542191	0.038557173	727.9755289	3.38555477	1.11692574		"$200/day, days(1-5) no yrly max"	"$900/admit, no yrly max"	$100/day for days 21 to 100	15% Coinsurance	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$20 copay	$30/$35 copay for Lower/Higher Tier	$150 copay	$25 copay	$30 copay	$15 copay	$30 copay	50% coinsurance	$30 copay	$30/$35 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$50 maximum per year	$25 copay	N/A	N/A		N/A	$30 copay	$0 copay	$30 copay	$30 copay	$25 copay	$0 copay	$25 copay	$25 copay	Min. $15 / Max. $30copay		200	900	100	0.15	150	0.3	0.3	50	200	20	31.08373	150	25	30	15	30	0.5	30	30.79	0	0.2	0	0	0	0.5	0	25	0	0		0	30	0	30	30	25	0	25	25	18.92933608		18.8427	0.530600454	2.446942806	1.190445325	2.400751881	2.389079024	0.851762259	0.702732444	5.812292133	1.226610751	2.017035647	0.545848875	0.026257063	0.000832416	6.01618161	4.270674209	0.043573943	0.936783005	1.811427806	0	4.630088328	0	0	0	2.177056099	0	0.301172544	0	0	0	0	2.368623404	0	0.164605673	0.897713703	0.202427962	0	1.516615685	0.007053239	0.001761889	0	64.3296		0	18.8427	0.530600454	2.446942806	1.190445325	2.400751881	2.389079024	0.851762259	0.702732444	5.812292133	1.226610751	2.017035647	0.545848875	0.026257063	0.000832416	6.01618161	4.270674209	0.043573943	0.936783005	1.811427806	0	4.630088328	0	0	0	2.177056099	0	0.301172544	0	0	0	0	2.368623404	0	0.164605673	0.897713703	0.202427962	0	1.516615685	0.007053239	0.001761889	0	64.3296	None																																																																																			0		0	18.8427	0.530600454	2.446942806	1.190445325	2.400751881	2.389079024	0.851762259	0.702732444	5.812292133	1.226610751	2.017035647	0.545848875	0.026257063	0.000832416	6.01618161	4.270674209	0.043573943	0.936783005	1.811427806	0	4.630088328	0	0	0	2.177056099	0	0.301172544	0	0	0	0	2.368623404	0	0.164605673	0.897713703	0.202427962	0	1.516615685	0.007053239	0.001761889	0	64.3296
H1689_012_0	2008	8	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	A	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1363.367364	8.531501297	372.1973071	8.04675755	232.2957215	10.55905462	3.764548653	195.3656529	411.298961	850.6345542	900.008674	50.47163921	14.56707576	0.384844467	5582.005425	1981.233958	0.117223725	434.5885941	595.2749112	0	30.04988649	0	0	0	5.505440668	350.0627554	165.6500278	0	0		0	1095.067805	17.90239448	76.36320003	416.4637211	112.6914768	0.051863741	844.2986797	3.926532293	1.293812271		"$150/day, days(1-5) no yrly max"	"$500/admit, no yrly max"	$50/day for days 21 to 100	15% Coinsurance	$100 copay	30% coinsurance	30% coinsurance	$50 copay	$150 copay	$10 copay	$15/$35 copay for Lower/Higher Tier	$100 copay	$25 copay	$15 copay	$15 copay	$15 copay	50% coinsurance	$15 copay	$15/$35 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$15 copay	$0 copay	$15 copay	$15 copay	$10 copay	$0 copay	$10 copay	$10 copay	$15 copay		150	500	50	0.15	100	0.3	0.3	50	150	10	19.33492	100	25	15	15	15	0.5	15	23.33	0	0.2	0	0	0	0.5	0	10	0	0		0	15	0	15	15	10	0	10	10	15		17.0421	0.355479221	1.550822113	1.207013632	1.935797679	3.167716387	1.129364596	0.814023554	5.141237013	0.708862128	1.450132976	0.420596993	0.030348075	0.000481056	6.977506782	2.476542448	0.058611862	0.543235743	1.15731364	0	6.009977299	0	0	0	2.752720334	0	0.13804169	0	0	0	0	1.368834756	0	0.095454	0.520579651	0.093909564	0	0.703582233	0.00327211	0.001617265	0	57.8552		0	17.0421	0.355479221	1.550822113	1.207013632	1.935797679	3.167716387	1.129364596	0.814023554	5.141237013	0.708862128	1.450132976	0.420596993	0.030348075	0.000481056	6.977506782	2.476542448	0.058611862	0.543235743	1.15731364	0	6.009977299	0	0	0	2.752720334	0	0.13804169	0	0	0	0	1.368834756	0	0.095454	0.520579651	0.093909564	0	0.703582233	0.00327211	0.001617265	0	57.8552	None																																																																																			0		0	17.0421	0.355479221	1.550822113	1.207013632	1.935797679	3.167716387	1.129364596	0.814023554	5.141237013	0.708862128	1.450132976	0.420596993	0.030348075	0.000481056	6.977506782	2.476542448	0.058611862	0.543235743	1.15731364	0	6.009977299	0	0	0	2.752720334	0	0.13804169	0	0	0	0	1.368834756	0	0.095454	0.520579651	0.093909564	0	0.703582233	0.00327211	0.001617265	0	57.8552
H1689_013_0	2008	7	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	A	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1254.515117	7.850339998	325.8270805	9.771976635	213.1176297	9.805584473	3.495919013	187.1472109	386.9731184	816.6578285	864.0598077	48.45566063	13.98522597	0.369472702	5340.636718	1895.56441	0.107305278	415.7967659	783.3840047	0	28.50516147	0	0	0	4.970210097	338.9948663	160.4126922	0	0		0	1051.327731	17.18732272	73.06121705	398.4556214	107.818641	0.047475484	807.7907823	3.756747071	1.239385503		"$200/day, days(1-5) no yrly max"	"$900/admit, no yrly max"	$100/day for days 21 to 100	15% Coinsurance	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$20 copay	$30/$35 copay for Lower/Higher Tier	$150 copay	$25 copay	$30 copay	$15 copay	$30 copay	50% coinsurance	$30 copay	$30/$35 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$50 maximum per year	$25 copay	N/A	N/A		N/A	$30 copay	$0 copay	$30 copay	$30 copay	$25 copay	$0 copay	$25 copay	$25 copay	Min. $15 / Max. $30copay		200	900	100	0.15	150	0.3	0.3	50	200	20	31.08373	150	25	30	15	30	0.5	30	30.79	0	0.2	0	0	0	0.5	0	25	0	0		0	30	0	30	30	25	0	25	25	18.92933608		20.9086	0.5887755	2.715225671	1.465796495	2.663970371	2.941675342	1.048775704	0.779780046	6.449551974	1.361096381	2.238183481	0.605695758	0.029135887	0.000923682	6.675795897	4.738911026	0.053652639	1.039491915	2.010032792	0	5.701032294	0	0	0	2.485105048	0	0.334193109	0	0	0	0	2.628319327	0	0.182653043	0.996139053	0.224622169	0	1.682897463	0.007826556	0.001955062	0	72.5598		0	20.9086	0.5887755	2.715225671	1.465796495	2.663970371	2.941675342	1.048775704	0.779780046	6.449551974	1.361096381	2.238183481	0.605695758	0.029135887	0.000923682	6.675795897	4.738911026	0.053652639	1.039491915	2.010032792	0	5.701032294	0	0	0	2.485105048	0	0.334193109	0	0	0	0	2.628319327	0	0.182653043	0.996139053	0.224622169	0	1.682897463	0.007826556	0.001955062	0	72.5598	None																																																																																			0		0	20.9086	0.5887755	2.715225671	1.465796495	2.663970371	2.941675342	1.048775704	0.779780046	6.449551974	1.361096381	2.238183481	0.605695758	0.029135887	0.000923682	6.675795897	4.738911026	0.053652639	1.039491915	2.010032792	0	5.701032294	0	0	0	2.485105048	0	0.334193109	0	0	0	0	2.628319327	0	0.182653043	0.996139053	0.224622169	0	1.682897463	0.007826556	0.001955062	0	72.5598
H1689_016_0	2008	7	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	347.3248027	7.825583931	324.799584	0	212.4455627	9.743838115	3.473905	186.5570417	393.6253038	814.082496	861.334993	48.30285558	13.94112353	0.368307569	5323.795006	1889.586743	0.10662957	414.4855497	567.7388963	0	28.32566274	0	0	0	4.950123349	337.9258451	159.9068304	0	0		0	1048.012366	17.13312245	72.83081831	397.1990906	107.4786346	0.047176528	805.243412	3.74490016	1.235477097		$100/admit with no yearly max	$100/admit with no yearly max	$50/day for days 21 to 100	$0 Copay	$50 copay	20% coinsurance	20% coinsurance	$25 copay	$50 copay	$0 copay	$0/$35 copay for Lower/Higher Tier	$50 copay	$10 copay	$10 copay	$10 copay	$10 copay	50% coinsurance	$10 copay	$0/$35 copay for Lower/Higher Tier	N/A	0% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay		113.1675498	113.1675498	50	0	50	0.2	0.2	25	50	0	7.586114	50	10	10	10	10	0.5	10	15.88	0	0	0	0	0	0.5	0	10	0	0		0	10	0	10	10	10	0	10	10	10		3.2755	0.07380018	1.3533316	0	0.885189845	1.948767623	0.694781	0.388660504	1.640105432	0	0.544515454	0.201261898	0.011617603	0.000306923	4.436495839	1.574655619	0.053314785	0.345404625	0.751307806	0	0	0	0	0	2.475061674	0	0.133255692	0	0	0	0	0.873343638	0	0.060692349	0.330999242	0.089565529	0	0.671036177	0.00312075	0.001029564	0	22.8171		0	3.2755	0.07380018	1.3533316	0	0.885189845	1.948767623	0.694781	0.388660504	1.640105432	0	0.544515454	0.201261898	0.011617603	0.000306923	4.436495839	1.574655619	0.053314785	0.345404625	0.751307806	0	0	0	0	0	2.475061674	0	0.133255692	0	0	0	0	0.873343638	0	0.060692349	0.330999242	0.089565529	0	0.671036177	0.00312075	0.001029564	0	22.8171	None																																																																																			0		0	3.2755	0.07380018	1.3533316	0	0.885189845	1.948767623	0.694781	0.388660504	1.640105432	0	0.544515454	0.201261898	0.011617603	0.000306923	4.436495839	1.574655619	0.053314785	0.345404625	0.751307806	0	0	0	0	0	2.475061674	0	0.133255692	0	0	0	0	0.873343638	0	0.060692349	0.330999242	0.089565529	0	0.671036177	0.00312075	0.001029564	0	22.8171
H1689_017_0	2008	7	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	350.6772047	7.901116987	327.9345712	0	214.4961014	9.93284222	3.541289361	188.3577027	397.4246014	821.9400744	869.6486556	48.76907796	14.07568418	0.371862498	5375.18063	1907.82516	0.108697895	418.4861918	573.2187499	0	28.87510399	0	0	0	5.011497249	341.1875278	161.4502617	0	0		0	1058.127851	17.29849249	73.53378621	401.0328826	108.5160255	0.048091626	813.015675	3.781046185	1.247402005		$100/admit with no yearly max	$100/admit with no yearly max	$50/day for days 21 to 100	$0 Copay	$50 copay	20% coinsurance	20% coinsurance	$25 copay	$50 copay	$0 copay	$0/$35 copay for Lower/Higher Tier	$50 copay	$10 copay	$10 copay	$10 copay	$10 copay	50% coinsurance	$10 copay	$0/$35 copay for Lower/Higher Tier	N/A	0% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay		113.1675498	113.1675498	50	0	50	0.2	0.2	25	50	0	7.586114	50	10	10	10	10	0.5	10	15.88	0	0	0	0	0	0.5	0	10	0	0		0	10	0	10	10	10	0	10	10	10		3.3071	0.074512504	1.366394046	0	0.893733756	1.986568444	0.708257872	0.392411881	1.655935839	0	0.549771153	0.203204491	0.011729737	0.000309885	4.479317191	1.5898543	0.054348948	0.348738493	0.758559479	0	0	0	0	0	2.505748624	0	0.134541885	0	0	0	0	0.881773209	0	0.061278155	0.334194069	0.090430021	0	0.677513062	0.003150872	0.001039502	0	23.0704		0	3.3071	0.074512504	1.366394046	0	0.893733756	1.986568444	0.708257872	0.392411881	1.655935839	0	0.549771153	0.203204491	0.011729737	0.000309885	4.479317191	1.5898543	0.054348948	0.348738493	0.758559479	0	0	0	0	0	2.505748624	0	0.134541885	0	0	0	0	0.881773209	0	0.061278155	0.334194069	0.090430021	0	0.677513062	0.003150872	0.001039502	0	23.0704	None																																																																																			0		0	3.3071	0.074512504	1.366394046	0	0.893733756	1.986568444	0.708257872	0.392411881	1.655935839	0	0.549771153	0.203204491	0.011729737	0.000309885	4.479317191	1.5898543	0.054348948	0.348738493	0.758559479	0	0	0	0	0	2.505748624	0	0.134541885	0	0	0	0	0.881773209	0	0.061278155	0.334194069	0.090430021	0	0.677513062	0.003150872	0.001039502	0	23.0704
H1689_018_0	2008	6	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	347.3248027	7.825583931	324.799584	0	212.4455627	9.743838115	3.473905	186.5570417	393.6253038	814.082496	861.334993	48.30285558	13.94112353	0.368307569	5323.795006	1889.586743	0.10662957	414.4855497	567.7388963	0	28.32566274	0	0	0	4.950123349	337.9258451	159.9068304	0	0		0	1048.012366	17.13312245	72.83081831	397.1990906	107.4786346	0.047176528	805.243412	3.74490016	1.235477097		$100/admit with no yearly max	$100/admit with no yearly max	$50/day for days 21 to 100	$0 Copay	$50 copay	20% coinsurance	20% coinsurance	$25 copay	$50 copay	$0 copay	$0/$35 copay for Lower/Higher Tier	$50 copay	$10 copay	$10 copay	$10 copay	$10 copay	50% coinsurance	$10 copay	$0/$35 copay for Lower/Higher Tier	N/A	0% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay		113.1675498	113.1675498	50	0	50	0.2	0.2	25	50	0	7.586114	50	10	10	10	10	0.5	10	15.88	0	0	0	0	0	0.5	0	10	0	0		0	10	0	10	10	10	0	10	10	10		3.2755	0.07380018	1.3533316	0	0.885189845	1.948767623	0.694781	0.388660504	1.640105432	0	0.544515454	0.201261898	0.011617603	0.000306923	4.436495839	1.574655619	0.053314785	0.345404625	0.751307806	0	0	0	0	0	2.475061674	0	0.133255692	0	0	0	0	0.873343638	0	0.060692349	0.330999242	0.089565529	0	0.671036177	0.00312075	0.001029564	0	22.8171		0	3.2755	0.07380018	1.3533316	0	0.885189845	1.948767623	0.694781	0.388660504	1.640105432	0	0.544515454	0.201261898	0.011617603	0.000306923	4.436495839	1.574655619	0.053314785	0.345404625	0.751307806	0	0	0	0	0	2.475061674	0	0.133255692	0	0	0	0	0.873343638	0	0.060692349	0.330999242	0.089565529	0	0.671036177	0.00312075	0.001029564	0	22.8171	None																																																																																			0		0	3.2755	0.07380018	1.3533316	0	0.885189845	1.948767623	0.694781	0.388660504	1.640105432	0	0.544515454	0.201261898	0.011617603	0.000306923	4.436495839	1.574655619	0.053314785	0.345404625	0.751307806	0	0	0	0	0	2.475061674	0	0.133255692	0	0	0	0	0.873343638	0	0.060692349	0.330999242	0.089565529	0	0.671036177	0.00312075	0.001029564	0	22.8171
H1689_019_0	2008	6	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	350.5269542	7.897731689	327.7940649	0	214.4041988	9.924332429	3.538255422	188.2769993	397.2543216	821.5879074	869.2760475	48.74818245	14.06965333	0.37170317	5372.87759	1907.007737	0.10860477	418.306888	572.9731496	0	28.85036574	0	0	0	5.008740983	341.0413433	161.381087	0	0		0	1057.674488	17.29108081	73.50228006	400.8610568	108.4695309	0.048050424	812.6673317	3.779426165	1.246867545		$100/admit with no yearly max	$100/admit with no yearly max	$50/day for days 21 to 100	$0 Copay	$50 copay	20% coinsurance	20% coinsurance	$25 copay	$50 copay	$0 copay	$0/$35 copay for Lower/Higher Tier	$50 copay	$10 copay	$10 copay	$10 copay	$10 copay	50% coinsurance	$10 copay	$0/$35 copay for Lower/Higher Tier	N/A	0% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay		113.1675498	113.1675498	50	0	50	0.2	0.2	25	50	0	7.586114	50	10	10	10	10	0.5	10	15.88	0	0	0	0	0	0.5	0	10	0	0		0	10	0	10	10	10	0	10	10	10		3.3057	0.074480579	1.365808604	0	0.893350828	1.984866486	0.707651084	0.392243749	1.65522634	0	0.549535599	0.203117427	0.011724711	0.000309753	4.477397991	1.589173114	0.054302385	0.348589073	0.758234468	0	0	0	0	0	2.504370491	0	0.134484239	0	0	0	0	0.881395406	0	0.0612519	0.334050881	0.090391276	0	0.677222776	0.003149522	0.001039056	0	23.0591		0	3.3057	0.074480579	1.365808604	0	0.893350828	1.984866486	0.707651084	0.392243749	1.65522634	0	0.549535599	0.203117427	0.011724711	0.000309753	4.477397991	1.589173114	0.054302385	0.348589073	0.758234468	0	0	0	0	0	2.504370491	0	0.134484239	0	0	0	0	0.881395406	0	0.0612519	0.334050881	0.090391276	0	0.677222776	0.003149522	0.001039056	0	23.0591	None																																																																																			0		0	3.3057	0.074480579	1.365808604	0	0.893350828	1.984866486	0.707651084	0.392243749	1.65522634	0	0.549535599	0.203117427	0.011724711	0.000309753	4.477397991	1.589173114	0.054302385	0.348589073	0.758234468	0	0	0	0	0	2.504370491	0	0.134484239	0	0	0	0	0.881395406	0	0.0612519	0.334050881	0.090391276	0	0.677222776	0.003149522	0.001039056	0	23.0591
H1689_801_0	2008	5																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	294.2917212	2.168919813	47.5196641	38.12543058	8.169585462	25.55783243	1.220237577	5.962756756	30.81159577	12.10537002	32.68873913	0	0.274308799	31.88388633	45.94707502	124.1420761	1.417555032	4.772028736	30.86237842	40.98906846	8.870753485	6.310207568	0	0	0	0	0	0	0	0	0											Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											0.076813085	0.076813085	0.188134857	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.6055	0.166601421	8.940105187	0	1.911682998	5.980532788	0.285535593	1.395285081	7.209913409	2.832656584	7.649164956	0	0.064188259	7.460829402	10.75161555	29.0492458	0.331707878	1.116654724	7.22179655	9.59144202	2.075756315	1.476588571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1168	0	0	22.6055	0.166601421	8.940105187	0	1.911682998	5.980532788	0.285535593	1.395285081	7.209913409	2.832656584	7.649164956	0	0.064188259	7.460829402	10.75161555	29.0492458	0.331707878	1.116654724	7.22179655	9.59144202	2.075756315	1.476588571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1168	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.6055	0.166601421	8.940105187	0	1.911682998	5.980532788	0.285535593	1.395285081	7.209913409	2.832656584	7.649164956	0	0.064188259	7.460829402	10.75161555	29.0492458	0.331707878	1.116654724	7.22179655	9.59144202	2.075756315	1.476588571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1168
H1689_802_0	2008	5																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	294.2917212	2.168919813	47.5196641	38.12543058	8.169585462	25.55783243	1.220237577	5.962756756	30.81159577	12.10537002	32.68873913	0	0.274308799	31.88388633	45.94707502	124.1420761	1.417555032	4.772028736	30.86237842	40.98906846	8.870753485	6.310207568	0	0	0	0	0	0	0	0	0											Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											0.076813085	0.076813085	0.188134857	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.6055	0.166601421	8.940105187	0	1.911682998	5.980532788	0.285535593	1.395285081	7.209913409	2.832656584	7.649164956	0	0.064188259	7.460829402	10.75161555	29.0492458	0.331707878	1.116654724	7.22179655	9.59144202	2.075756315	1.476588571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1168	0	0	22.6055	0.166601421	8.940105187	0	1.911682998	5.980532788	0.285535593	1.395285081	7.209913409	2.832656584	7.649164956	0	0.064188259	7.460829402	10.75161555	29.0492458	0.331707878	1.116654724	7.22179655	9.59144202	2.075756315	1.476588571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1168	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.6055	0.166601421	8.940105187	0	1.911682998	5.980532788	0.285535593	1.395285081	7.209913409	2.832656584	7.649164956	0	0.064188259	7.460829402	10.75161555	29.0492458	0.331707878	1.116654724	7.22179655	9.59144202	2.075756315	1.476588571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1168
H1716_001_0	2008	16	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin			V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0			0			0	0	0	0									0		283.26	6.08	484.37	202.88	67.86	4.47	1.53	321.09	379.19	5964.14	2607.39		7.96	508.29	4633.36	3470.71	45.41	433.49			16.15			2.92			0.77			0.02	0.06	0.08	3.38									$550/Admit	$550/Admit	$0/Day(Days 1-13) $100(Days 14-100)	$5/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$100/Visit	$0/Visit	$0-$100/Visit		$0-$50/Proc	$0-$100/Visit	$10/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins			Plan 767			Plan 828			Quit Net	Meals on Wheels	Active Outlook	Silver Sneakers									477.413198	477.413242	35.946098	4.34011	86.80237	0.173604	0.173604	43.401203	86.80239	0	18.802644		14.466803	26.452582	8.680239	26.040718	33.2982	43.401194			0.173604			0			0			0	0	0	0									11.2693	0.241889376	1.450934291	0.073376793	0.490867402	0.77600988	0.26561412	1.161307689	2.742883189	0	4.085485495	0	0.009596313	1.120465242	3.351556014	7.531648364	0.126005939	1.567831966	0	0	2.8037046	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0685	0	5.940115967	11.2693	0.241889376	1.450934291	0.073376793	0.490867402	0.77600988	0.26561412	1.161307689	2.742883189	0	4.085485495	0	0.009596313	1.120465242	3.351556014	7.531648364	0.126005939	1.567831966	0	0	2.8037046	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0685	5000	30% Coins	30% Coins	25% Coins(Days 1-13) $0(Days 14-100)	25% Coins	$100/Trip	25% Coins	25% Coins	$50/Visit	25% Coins	25% Coins	25% Coins		$0-$50/Proc	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins			Plan 767			Plan 828			Quit Net	Meals on Wheels	Active Outlook	Silver Sneakers									8.9944	0.1014	0.3613	0.5644	0.4909	1.0717	0.3669	0.2049	2.4081	0.5962	1.6125		0.0017	0.8054	2.4667	2.0308	0.069	0.2176			0.6553			0			0			0	0	0	0									23.0194	0	3.499912721	20.2637	0.343285376	1.812280291	0.637794793	0.981738402	1.84767588	0.63253712	1.366243689	5.151010189	0.596223	5.697985495	0	0.011290313	1.925864242	5.818275014	9.562461364	0.194996939	1.785463966	0	0	3.4590446	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0879
H1716_002_0	2008	16	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0		0	0									0		288.86	6.2	493.94	206.89	69.2	4.62	1.41	327.43	386.68	6081.98	2658.9		8.12	518.33	4733.16	3544.78	46.31	442.06			16.59			2.92	2.99		0.77			0.02		0.08	3.38									$550/Admit	$550/Admit	$0/Day(Days 1-13) $124(Days 14-100)	$5/Visit	$100/Trip	20% Coins	0% Coins	$50/Visit	$100/Visit	$0/Visit	$0-$75/Visit		$0-$50/Proc	$0-$75/Visit	$10/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins			Plan 767	$200 Allowance		Plan 828			QuitNet		Active Outlook	Silver Sneakers									477.456657	477.456468	44.577201	4.340491	86.810348	0.17362	0	43.40515	86.810319	0	12.581094		14.468925	25.036949	8.681029	26.043089	33.301134	43.405138			0.17362			0	0		0			0		0	0									11.4932	0.246685842	1.834871888	0.074833682	0.50060634	0.8021244	0	1.184345689	2.797317846	0	2.787655903	0	0.009790639	1.081450148	3.424058268	7.693085085	0.128514626	1.598972942	0	0	2.8803558	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5378	0	5.855364062	11.4932	0.246685842	1.834871888	0.074833682	0.50060634	0.8021244	0	1.184345689	2.797317846	0	2.787655903	0	0.009790639	1.081450148	3.424058268	7.693085085	0.128514626	1.598972942	0	0	2.8803558	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5378	5000	30% Coins	30% Coins	25% Coins(Days 1-13) $0(Days 14-100)	25% Coins	$100/Trip	25% Coins	25% Coins	$50/Visit	25% Coins	25% Coins	25% Coins		$0-$50/Proc	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins			Plan 767	$200 Allowance		Plan 828			QuitNet		Active Outlook	Silver Sneakers									9.1105	0.1027	0.3736	0.5836	0.5006	1.1082	0.3375	0.209	2.4781	0.6143	1.6564		0.0017	0.8273	2.5621	2.1071	0.0713	0.2235			0.6732			0	0		0			0		0	0									23.5408	0	3.57672613	20.6037	0.349390842	2.208520888	0.658467682	1.00122234	1.9102774	0.337498	1.393349689	5.275393846	0.614317	4.444012903	0	0.011517639	1.908794148	5.986195268	9.800146085	0.199856626	1.822522942	0	0	3.5535198	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0787
H1716_004_0	2008	17	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0									0		273.63	5.87	467.9	195.99	65.55	4.15	1.26	310.17	366.29	5761.31	2518.71		7.69	491	4483.61	3357.89	43.87	418.75			14.89			5.42	2.99		0.77			0.02	0.06	0.08	3.38									$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$5/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$100/Visit	$0/Visit	$0-$75/Visit		$0-$50/Proc	$0-$75/Visit	$10/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins			Plan 750	Plan (200 Allowance)		Plan 828			QuitNet	Meal on Wheels	Active Outlook	Silver Sneakers									485.207801	485.207935	25.330111	4.410957	88.219562	0.176439	0.176439	44.109793	88.219597	0	12.785338		14.702851	25.443383	8.821959	26.465879	33.841898	44.109808			0.176439			0	0		0			0	0	0	0									11.064	0.237347548	0.987663245	0.072041955	0.481899357	0.73222185	0.22231314	1.140127875	2.692829682	0	2.683546556	0	0.009422077	1.041058421	3.296185299	7.405792536	0.123720339	1.539248508	0	0	2.62717671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.3565	0	4.854801442	11.064	0.237347548	0.987663245	0.072041955	0.481899357	0.73222185	0.22231314	1.140127875	2.692829682	0	2.683546556	0	0.009422077	1.041058421	3.296185299	7.405792536	0.123720339	1.539248508	0	0	2.62717671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.3565	5000	30% Coins	30% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	$100/Trip	25% Coins	25% Coins	$50/Visit	25% Coins	25% Coins	25% Coins		$0-$50/Proc	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins			Plan 750	Plan (200 Allowance)		Plan 828			QuitNet	Meal on Wheels	Active Outlook	Silver Sneakers									8.3079	0.0937	0.3407	0.5322	0.4819	1.0105	0.3078	0.2012	2.2598	0.5602	1.5104		0.0017	0.7545	2.3364	1.9214	0.0651	0.2039			0.6139			0	0		0			0	0	0	0									21.503	0	2.871406294	19.3718	0.331004548	1.328394245	0.604258955	0.963819357	1.74274785	0.53007814	1.341326875	4.952590682	0.560196	4.193980556	0	0.011084077	1.795513421	5.632603299	9.327225536	0.188776339	1.743104508	0	0	3.24103571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8596
H1716_006_0	2008	13	s.	t.	u.	v.							Inpatient Facility	Inpatient Facility	Health & Education (Non-Covered)	Health & Education (Non-Covered)							3900	Acute	Mental Health									D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O		D	D	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0		0	0	0	0							0		2445.25	57.8	502.87	210.63	70.45	4.79	1.46	333.35	393.67	6191.87	2706.94		8.26	527.7	4818.68	3608.83	47.15	450.05			17.2			5.42	2.99		0.77			0.02		2445.25	57.8	0.08	3.38							$100/Day(Days 1-8)	$100/Day(Days 1-8)	$0/Day(Days 1-20) $124(Days 21-100)	$5/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$100/Visit	$0/Visit	$0-$75/Visit		$0-$50/Proc	$0-$75/Visit	$10/Visit	$35/Visit	$35-$50/Visit	$50/Visit			20% Coins			Plan 750	VIS 200 Allowance		Plan 828			QuitNet		$300/Day(Days 1-8)	$300/Day(Days 1-8)	Active Outlook	Silver Sneakers							62.489545	62.48963	26.915133	4.68699	93.739977	0.187479	0.187479	46.869943	93.739901	0	13.585374		15.622987	27.178648	9.373988	32.808966	38.68705	46.869939			0.187479			0	0		0			0		42.182955	42.18287	0	0							12.7335	0.300991718	1.127901078	0.082268392	0.550331782	0.89802441	0.27371934	1.302007958	3.075215569	0	3.064566025	0	0.010753823	1.195181046	3.764187375	9.866831731	0.152007867	1.757818004	0	0	3.2246388	0	0	0	0	0	0	0	0	0	0	8.595655893	0.203180824	0	0	0	0	0	0	0	0	52.1788	0	3.484503999	12.7335	0.300991718	1.127901078	0.082268392	0.550331782	0.89802441	0.27371934	1.302007958	3.075215569	0	3.064566025	0	0.010753823	1.195181046	3.764187375	9.866831731	0.152007867	1.757818004	0	0	3.2246388	0	0	0	0	0	0	0	0	0	0	8.595655893	0.203180824	0	0	0	0	0	0	0	0	52.1788	12000	30% Coins	30% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	$100/Trip	25% Coins	25% Coins	$50/Visit	25% Coins	25% Coins	25% Coins		$0-$50/Proc	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins			Plan 750	VIS 200 Allowance		Plan 828			QuitNet				Active Outlook	Silver Sneakers							8.667	0.0977	0.4182	0.6532	0.5503	1.2402	0.3777	0.2298	2.7735	0.6875	1.8538		0.0019	0.926	2.8675	2.3582	0.0798	0.2502			0.7534			0	0		0			0		0	0	0	0							24.7861	0	1.655252698	21.4006	0.398697718	1.546089078	0.735472392	1.100676782	2.13826841	0.65144734	1.531773958	5.848677569	0.687543	4.918361025	0	0.012651823	2.121142046	6.631731375	12.22505373	0.231852867	2.008016004	0	0	3.9780438	0	0	0	0	0	0	0	0	0	0	8.595655893	0.203180824	0	0	0	0	0	0	0	0	76.9649
H1716_801_0	2008	4																					500											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		283.26	6.08	484.37	202.88	67.86	4.47	1.53	321.09	379.19	5964.14	2607.39		7.96	508.29	4633.36	3470.71	45.41	433.49			16.15																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					261.671404	261.671371	8.415391	0	29.07459	0.058149	0.058149	14.537301	58.149193	10.918025	27.594599		9.691356	25.538898	5.81492	8.722379	17.230587	29.074596			0.058149																					6.1768	0.132580161	0.339680245	0	0.164416806	0.25992603	0.08896797	0.388981832	1.837466041	5.426385802	5.995823457	0	0.006428599	1.081763872	2.245218144	2.522737335	0.065203413	1.050295552	0	0	0.93910635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.7217	0	70.06496993	6.1768	0.132580161	0.339680245	0	0.164416806	0.25992603	0.08896797	0.388981832	1.837466041	5.426385802	5.995823457	0	0.006428599	1.081763872	2.245218144	2.522737335	0.065203413	1.050295552	0	0	0.93910635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.7217	500	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					2.5106	0.0283	0.121	0.1891	0.1866	0.359	0.1229	0.2121	0.8066	0.1997	0.5401		0.0035	0.2698	0.8262	0.6802	0.0231	0.0729			0.2195																					7.3712	0	17.98157552	8.6873	0.160882161	0.460713245	0.189053	0.351031806	0.61888203	0.21186997	0.601117832	2.644072041	5.626091802	6.535933457	0	0.009923599	1.351533872	3.071450144	3.202961335	0.088312413	1.123191552	0	0	1.15861335	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.093
H1716_802_0	2008	4																					500											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		283.26	6.08	484.37	202.88	67.86	4.47	1.53	321.09	379.19	5964.14	2607.39		7.96	508.29	4633.36	3470.71	45.41	433.49			16.15																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					261.671404	261.671371	8.415391	0	29.07459	0.058149	0.058149	14.537301	58.149193	10.918025	27.594599		9.691356	25.538898	5.81492	8.722379	17.230587	29.074596			0.058149																					6.1768	0.132580161	0.339680245	0	0.164416806	0.25992603	0.08896797	0.388981832	1.837466041	5.426385802	5.995823457	0	0.006428599	1.081763872	2.245218144	2.522737335	0.065203413	1.050295552	0	0	0.93910635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.7217	0	70.06496993	6.1768	0.132580161	0.339680245	0	0.164416806	0.25992603	0.08896797	0.388981832	1.837466041	5.426385802	5.995823457	0	0.006428599	1.081763872	2.245218144	2.522737335	0.065203413	1.050295552	0	0	0.93910635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.7217	500	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					2.5106	0.0283	0.121	0.1891	0.1866	0.359	0.1229	0.2121	0.8066	0.1997	0.5401		0.0035	0.2698	0.8262	0.6802	0.0231	0.0729			0.2195																					7.3712	0	17.98157552	8.6873	0.160882161	0.460713245	0.189053	0.351031806	0.61888203	0.21186997	0.601117832	2.644072041	5.626091802	6.535933457	0	0.009923599	1.351533872	3.071450144	3.202961335	0.088312413	1.123191552	0	0	1.15861335	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.093
H1716_803_0	2008	4																					500											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		283.26	6.08	484.37	202.88	67.86	4.47	1.53	321.09	379.19	5964.14	2607.39		7.96	508.29	4633.36	3470.71	45.41	433.49			16.15																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					261.671404	261.671371	8.415391	0	29.07459	0.058149	0.058149	14.537301	58.149193	10.918025	27.594599		9.691356	25.538898	5.81492	8.722379	17.230587	29.074596			0.058149																					6.1768	0.132580161	0.339680245	0	0.164416806	0.25992603	0.08896797	0.388981832	1.837466041	5.426385802	5.995823457	0	0.006428599	1.081763872	2.245218144	2.522737335	0.065203413	1.050295552	0	0	0.93910635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.7217	0	70.06496993	6.1768	0.132580161	0.339680245	0	0.164416806	0.25992603	0.08896797	0.388981832	1.837466041	5.426385802	5.995823457	0	0.006428599	1.081763872	2.245218144	2.522737335	0.065203413	1.050295552	0	0	0.93910635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.7217	500	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					2.5106	0.0283	0.121	0.1891	0.1866	0.359	0.1229	0.2121	0.8066	0.1997	0.5401		0.0035	0.2698	0.8262	0.6802	0.0231	0.0729			0.2195																					7.3712	0	17.98157552	8.6873	0.160882161	0.460713245	0.189053	0.351031806	0.61888203	0.21186997	0.601117832	2.644072041	5.626091802	6.535933457	0	0.009923599	1.351533872	3.071450144	3.202961335	0.088312413	1.123191552	0	0	1.15861335	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.093
H1716_804_0	2008	4																					500											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		283.26	6.08	484.37	202.88	67.86	4.47	1.53	321.09	379.19	5964.14	2607.39		7.96	508.29	4633.36	3470.71	45.41	433.49			16.15																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					261.671404	261.671371	8.415391	0	29.07459	0.058149	0.058149	14.537301	58.149193	10.918025	27.594599		9.691356	25.538898	5.81492	8.722379	17.230587	29.074596			0.058149																					6.1768	0.132580161	0.339680245	0	0.164416806	0.25992603	0.08896797	0.388981832	1.837466041	5.426385802	5.995823457	0	0.006428599	1.081763872	2.245218144	2.522737335	0.065203413	1.050295552	0	0	0.93910635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.7217	0	70.06496993	6.1768	0.132580161	0.339680245	0	0.164416806	0.25992603	0.08896797	0.388981832	1.837466041	5.426385802	5.995823457	0	0.006428599	1.081763872	2.245218144	2.522737335	0.065203413	1.050295552	0	0	0.93910635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.7217	500	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					2.5106	0.0283	0.121	0.1891	0.1866	0.359	0.1229	0.2121	0.8066	0.1997	0.5401		0.0035	0.2698	0.8262	0.6802	0.0231	0.0729			0.2195																					7.3712	0	17.98157552	8.6873	0.160882161	0.460713245	0.189053	0.351031806	0.61888203	0.21186997	0.601117832	2.644072041	5.626091802	6.535933457	0	0.009923599	1.351533872	3.071450144	3.202961335	0.088312413	1.123191552	0	0	1.15861335	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.093
H1717_001_0	2008	7																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1955.959118	152.6583072	696.5765891		114.0053936	12.78082357	3.313195357	402.4850391	28.70192179	8960.11362	41.00714518		0.26286446	23.95896983	4069.155244	4617.639743	463.319609	1.830767714			22.62011006	900.0275549			151.2852304		14.9137278															$290 (1a); $0 (1a1)	$290 (1b)	"$135 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	20% (9b)	20% (8a1); $0/$20 (8a2)	"$20 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$20/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											180.3493	180.3493	83.9557		108.8315	0.186568293	0.25699315	31.0947	0.124378862	4.9752	0.068559338		0.186568293	0.124331935	20	24.9673	37.5	0.124378862			0.186568293	25			25		25															29.3963	2.294318868	4.873466434	0	1.033948205	2.384496433	0.85146851	1.042929813	3.569912363	3.714829111	2.811422724	0	0.049042173	2.978865071	6.781925406	9.60750636	1.447873778	0.227708804	0	0	4.220195314	1.875057406	0	0	0.315177563	0	0.031070266	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.5075	0	35.76816958	29.3963	2.294318868	4.873466434	0	1.033948205	2.384496433	0.85146851	1.042929813	3.569912363	3.714829111	2.811422724	0	0.049042173	2.978865071	6.781925406	9.60750636	1.447873778	0.227708804	0	0	4.220195314	1.875057406	0	0	0.315177563	0	0.031070266	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.5075	4000	30% (1a); $0 (1a1)	30% (1b)	"30% (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$30 (4b)"	30% (9b)	30% (8a1); $0/$25 (8a2)	"$25 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$30/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $30 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											4.3694	0.1617	1.3715	1.3525	0.2585	0.5961	0.2129	0.2607	1.3387	1.1609	1.0306		0.0123	1.1169	1.948	2.373	0.2896	0.0603			0.7447	0.4725			0.0779		0.0077															19.2163	0	7.71733441	33.7657	2.456008173	6.244997905	1.352530592	1.292435256	2.980620541	1.064335638	1.303662267	4.908629499	4.875713209	3.842057673	0	0.061302717	4.095742934	8.729898866	11.98054549	1.737448534	0.287984664	0	0	4.964935664	2.347559795	0	0	0.393044961	0	0.03874645	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7239
H1717_006_0	2008	7																					2400											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2136.870854	302.5886788	1062.027183		429.8599591	29.41981852	21.01047013	750.0511199	397.9801088	6913.873261	583.92042	73.19895458	4.402916102	3758.874146		3595.564661	942.8990662	975.0307418			26.72341207	698.3309887					0.092146759															1(a) $200 per Day	1(b) $200 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $100 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $35 per Visit	8(a) Diagnostic: $25 per procedure; other $0 per procedure	8(b) X-rays $25 per visit; other: $25 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a) $25 per Visit; 9(c) $25/$35 per Visit; 9(d) $35 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $15 per Visit	7(e)/7(h) $25/35 per Visit	7(c)/7(i) $15 per Visit		7(g) $15 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $25 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $25 per visit															119.5346	119.5346	25.1023		59.7673	0.11953459	0.11953459	26.7459	20.9186	14.9418	14.9418	14.9418	0.11953459	15.0267		8.9651	19.4244	8.9651			0.11953459	14.9418					14.9418															21.2858	3.014151148	2.221607226	0	2.140963923	3.516685957	2.511477941	1.671730475	0.69376401	8.608823003	0.727069669	0.091143823	0.526300773	4.706957721	0	2.686214681	1.526268435	0.728436877	0	0	3.194372116	0.869528216	0	0	0	0	0.000114737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7214	0	40.8749947	21.2858	3.014151148	2.221607226	0	2.140963923	3.516685957	2.511477941	1.671730475	0.69376401	8.608823003	0.727069669	0.091143823	0.526300773	4.706957721	0	2.686214681	1.526268435	0.728436877	0	0	3.194372116	0.869528216	0	0	0	0	0.000114737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7214		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															2.3566	0.1455	0.321	0.4226	0.1047	0.1801	0.1286	0.0536	0.2526	0.046	0.1159	0.0227	0.0236	0.2578	0.0919	0.1712	0.0706	0.0494			0.1636	0.0368	0.0077		0.0066																	5.0292	0	0	23.6424	3.159625595	2.542586172	0.422556384	2.245624461	3.696807294	2.640113472	1.725326993	0.946394501	8.654841506	0.842925844	0.113862778	0.549876478	4.964741488	0.091933139	2.85745751	1.596915198	0.777875664	0	0	3.357984843	0.906312213	0.00774	0	0.006631111	0	0.000114737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.7506
H1717_007_0	2008	5																					1650											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2364.79097	334.8629956	1128.297946		447.7986862	31.77261758	22.69074611	767.7401447	407.3659757	7076.928381	597.6914584	74.92526107	4.678939296	3831.978834		3617.813171		977.2477541			28.86057069	699.9207278					0.096469697															1(a) $150 per Day	1(b) $150 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $10 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per procedure; other $0 per procedure	8(b) X-rays $10 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a)/(d) $25 Copay Per Visit; 9(c) $0 Copay per Visit"	7(a) PCP $0 per visit; Urgent Care $10 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $10 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															84.4712	84.4712	23.6519		42.2356	0.1126283	0.1126283	20.2731	14.0785	5.6314	5.6314	14.0785	0.1126283	14.0785		5.6314		5.6314			0.1126283	5.6314					5.6314															16.6464	2.357190613	2.223869884	0	1.576087644	3.578495894	2.555620152	1.297039006	0.477926429	3.321093376	0.280487386	0.087903175	0.526980977	4.495721462	0	1.697783941	0	0.458607304	0	0	3.250517004	0.328462006	0	0	0	0	4.53E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.1602	0	35.03316798	16.6464	2.357190613	2.223869884	0	1.576087644	3.578495894	2.555620152	1.297039006	0.477926429	3.321093376	0.280487386	0.087903175	0.526980977	4.495721462	0	1.697783941	0	0.458607304	0	0	3.250517004	0.328462006	0	0	0	0	4.53E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.1602		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															2.5612	0.1581	0.3518	0.4603	0.1129	0.1945	0.1389	0.0558	0.2713	0.0494	0.1244	0.0244	0.0255	0.2769	0.1092	0.196	0.0786	0.0569			0.1767	0.042	0.0077		0.0066																	5.4793	0	0	19.2076	2.51526167	2.575640665	0.460276026	1.689037425	3.773022124	2.694543087	1.352837319	0.749240558	3.370515241	0.404911865	0.112302341	0.55249518	4.772608265	0.109189919	1.893764494	0.078631653	0.515483061	0	0	3.427214376	0.370490855	0.00774	0	0.006631111	0	4.53E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.6395
H1717_008_0	2008	6																					3500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2059.551253	141.2626574	925.0805729		285.9020615	11.32379758	19.66598512	444.8413212	420.4608637	3525.07519	463.2575858	70.59851259	15.88577099	2962.204531		4045.003562	398.5141702	583.3160176				719.9014949					0.076223198															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															144.1623	144.1623	34.599		61.7838	0.164756923	0.164756923	33.9811	61.7838	16.4757	53.7635	61.7838	126.9817	59.734		20.5946	16.4757	16.4757				20.5946					20.5946															24.7425	1.697062552	2.667234995	0	1.472010744	1.865674041	3.240107187	1.259683684	2.164807436	4.839837833	2.075528398	0.363487302	0.168100137	14.74536084	0	6.942107693	0.547149736	0.800877933	0	0	0	1.235507863	0	0	0	0	0.000130816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8271	0	15.1506011	24.7425	1.697062552	2.667234995	0	1.472010744	1.865674041	3.240107187	1.259683684	2.164807436	4.839837833	2.075528398	0.363487302	0.168100137	14.74536084	0	6.942107693	0.547149736	0.800877933	0	0	0	1.235507863	0	0	0	0	0.000130816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8271		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.2954	0.0656	0.2825	0.282	0.0724	0.1387	0.1204	0.0323	0.2931	0.046	0.1196	0.024	0.0055	0.2092	0.0209	0.2022	0.0304	0.0328			0.1813	0.0429			0.0051																	4.5021	0	0	27.0378	1.762639718	2.94973971	0.281963466	1.544432727	2.004332787	3.360511177	1.292014149	2.457889855	4.885847478	2.195125579	0.387484551	0.173634145	14.95457228	0.020911394	7.144268146	0.577522543	0.833691044	0	0	0.181270555	1.278368318	0	0	0.005058988	0	0.000130816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.3293
H1717_009_0	2008	6	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)							Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						Coin	Coin	D	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V		Coin	Coin	Coin	T				Coin					Coin	Coin	Coin	V																																																0		470.162868	7.191751062	9358.760421	217.1569287	28.42848178	30.05710859	0.270186146	182.9792226	13.23544604	52.03545979	47.64858561	2.427717798	0.588777709	7.826619016	132.4530475	123.4509827	12.82394457	25.24980553		12.42553565	3.901806783	6.172001572	1574.9385									0.989033901	0.007334029		234.745							(1a) 8.6% coins	(1b) 8.6% coins	(2a) $0/day	(6a) $0/proc	(10a) 20% coins	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) 20% coins	(8a) 10% coins	(8b) 19.2% coins	(9a) 20% coins	(12) 20% coins	(9a) 20% coins	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) 20% coins	(7e/7h) 20% coins	(7c/7i) $0/visit		(7g) 20% coins	(15) 20% coins	(Misc. PBP Cats) 20% coins	(10b) $0/trip				(18a) 20% coins					(4b) 20% coins	(9c) 20% coins	(9d) 20% coins	(7f1) $0/visit							0.0862	0.0862			0.2	0.2	0.2	50	0.2	0.1	0.192	0.2	0.2	0.2		0.2	0.2			0.2	0.2	0.2										0.2	0.2									40.528	0.619928942	0	0	5.685696355	6.011421717	0.054037229	0.762413427	2.647089209	5.203545979	9.148528437	0.48554356	0.117755542	1.565323803	0	24.69019653	2.564788913	0	0	2.48510713	0.780361357	1.234400314	0	0	0	0	0	0	0	0	0	0.19780678	0.001466806	0	0	0	0	0	0	0	0	104.7835		0	40.528	0.619928942	0	0	5.685696355	6.011421717	0.054037229	0.762413427	2.647089209	5.203545979	9.148528437	0.48554356	0.117755542	1.565323803	0	24.69019653	2.564788913	0	0	2.48510713	0.780361357	1.234400314	0	0	0	0	0	0	0	0	0	0.19780678	0.001466806	0	0	0	0	0	0	0	0	104.7835		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3				0.3					0.2	0.3	0.3	0.3							3.6335	0.0553	1.0029	0.1215	0.4489	0.4746	0.0043	0.0401	0.209	0.8216	0.7523	0.0383	0.0093	0.1236	0.009	1.9492	0.2025	0.003		0.1962		0.1265	0.1242									0.0104	0.0001		0.013							10.3695		0	44.1616	0.675250104	1.00287652	0.121513546	6.13456712	6.486007642	0.058303326	0.80254045	2.856069936	6.025158502	9.900874526	0.523875946	0.127052032	1.688901998	0.009004163	26.63942257	2.767272249	0.003043436	0	2.681299799	0.780361357	1.360890507	0.1242	0	0	0	0	0	0	0	0	0.208217663	0.001582606	0	0.01305	0	0	0	0	0	0	115.1529
H1717_010_0	2008	6																					2500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2121.19335	145.4906301	952.7681122		294.4590724	12.01178094	20.86080252	458.1553631	433.0452018	3630.580224	477.1228241	72.71151674	16.36123001	3050.862921		4166.069983	410.4416466	600.7745889				741.4480514					0.078504548															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															127.0862	127.0862	30.5007		54.4655	0.145241405	0.145241405	29.956	54.4655	14.5241	47.3952	54.4655	115.291	52.6585		18.1552	14.5241	14.5241				18.1552					18.1552															22.4645	1.5408213	2.421674137	0	1.336489044	1.74460794	3.029852268	1.143710024	1.965502924	4.394254774	1.884443422	0.330022589	0.157191893	13.38781887	0	6.302977686	0.496776012	0.727144545	0	0	0	1.121759966	0	0	0	0	0.000118772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4497	0	24.29868593	22.4645	1.5408213	2.421674137	0	1.336489044	1.74460794	3.029852268	1.143710024	1.965502924	4.394254774	1.884443422	0.330022589	0.157191893	13.38781887	0	6.302977686	0.496776012	0.727144545	0	0	0	1.121759966	0	0	0	0	0.000118772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4497		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.4348	0.0696	0.2997	0.2991	0.0768	0.1471	0.1277	0.0333	0.3109	0.0488	0.1269	0.0255	0.0059	0.2219	0.0222	0.2144	0.0322	0.0348			0.1923	0.0455			0.0051																	4.7743	0	0	24.8994	1.610382642	2.721338931	0.299094306	1.413311063	1.891690972	3.157571467	1.177008134	2.276391721	4.443059759	2.011306794	0.355477803	0.163062123	13.60974106	0.022181877	6.517420506	0.528994136	0.761951235	0	0	0.192283744	1.167224431	0	0	0.005058988	0	0.000118772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.224
H1717_801_0	2008	3																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2053.757074	160.2912226	731.4054185		119.7056633	13.41986475	3.478855125	422.5994025	30.13701788	9408.119301	43.05750244		0.276007683	25.15691832	4269.172084	4848.022665	486.4855894	1.9223061			23.75111557	945.0289327			155.0671048		15.21671355															$325 (1a); $0 (1a1)	$325 (1b)	"$135 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											197.9488	197.9488	82.2249		106.5878	0.182721989	0.25553485	30.4537	0.182721989	3.6544	0.093941214		0.182721989	0.182606038	25	29.9586	37.5	0.182721989			0.182721989	30			30		30															33.8782	2.644121547	5.011644476	0	1.063263876	2.452104377	0.888968723	1.072475046	5.506695844	2.865117116	4.044874047	0	0.050432673	4.593805188	8.894108509	12.10332135	1.520267467	0.351247594	0	0	4.339851073	2.362572332	0	0	0.387667762	0	0.038041784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0688	0	43.71763063	33.8782	2.644121547	5.011644476	0	1.063263876	2.452104377	0.888968723	1.072475046	5.506695844	2.865117116	4.044874047	0	0.050432673	4.593805188	8.894108509	12.10332135	1.520267467	0.351247594	0	0	4.339851073	2.362572332	0	0	0.387667762	0	0.038041784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0688	4600	40% (1a); $0 (1a1)	40% (1b)	"40% (2a, 2a2)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	40% (9b)	40% (8a1); $0/$20 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	40% (incl in h5)	30% (12)	"40% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$25/$50 (7a); 40% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 40% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											5.991	0.2217	1.8806	1.8935	0.2658	0.613	0.2222	0.2681	1.8356	0.955	1.3483		0.0126	1.5312	1.779	2.4916	0.3041	0.0826			0.7659	0.4994			0.0798		0.0078															23.0488	0	10.2954653	39.8692	2.865819818	6.892202722	1.893542829	1.329079844	3.065130472	1.111210903	1.340593807	7.342261126	3.820156155	5.393165396	0	0.063040841	6.124971225	10.67310917	14.59493992	1.82432096	0.433894086	0	0	5.105707145	2.861938359	0	0	0.467481713	0	0.045873916	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.1177
H1717_803_0	2008	3																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2053.757074	160.2912226	731.4054185		119.7056633	13.41986475	3.478855125	422.5994025	30.13701788	9408.119301	43.05750244		0.276007683	25.15691832	4269.172084	4848.022665	486.4855894	1.9223061			23.75111557	945.0289327			155.0671048		15.21671355															$325 (1a); $0 (1a1)	$325 (1b)	"$135 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											197.9488	197.9488	82.2249		106.5878	0.182721989	0.25553485	30.4537	0.182721989	3.6544	0.093941214		0.182721989	0.182606038	25	29.9586	37.5	0.182721989			0.182721989	30			30		30															33.8782	2.644121547	5.011644476	0	1.063263876	2.452104377	0.888968723	1.072475046	5.506695844	2.865117116	4.044874047	0	0.050432673	4.593805188	8.894108509	12.10332135	1.520267467	0.351247594	0	0	4.339851073	2.362572332	0	0	0.387667762	0	0.038041784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0688	0	43.71763063	33.8782	2.644121547	5.011644476	0	1.063263876	2.452104377	0.888968723	1.072475046	5.506695844	2.865117116	4.044874047	0	0.050432673	4.593805188	8.894108509	12.10332135	1.520267467	0.351247594	0	0	4.339851073	2.362572332	0	0	0.387667762	0	0.038041784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0688	4600	40% (1a); $0 (1a1)	40% (1b)	"40% (2a, 2a2)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	40% (9b)	40% (8a1); $0/$20 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	40% (incl in h5)	30% (12)	"40% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$25/$50 (7a); 40% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 40% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											5.991	0.2217	1.8806	1.8935	0.2658	0.613	0.2222	0.2681	1.8356	0.955	1.3483		0.0126	1.5312	1.779	2.4916	0.3041	0.0826			0.7659	0.4994			0.0798		0.0078															23.0488	0	10.2954653	39.8692	2.865819818	6.892202722	1.893542829	1.329079844	3.065130472	1.111210903	1.340593807	7.342261126	3.820156155	5.393165396	0	0.063040841	6.124971225	10.67310917	14.59493992	1.82432096	0.433894086	0	0	5.105707145	2.861938359	0	0	0.467481713	0	0.045873916	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.1177
H1777_001_0	2008	5																					2000											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	P	S	V	T	V	V	P	V	P	P	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		3069.564776	184.8124314	14859.84617	0	1031.887042	5.495577751	9.225197539	252.744275	84.01419487	0	0	15.8290717	33.70166795	8.424548019	0	2171.990709	1965.004692	0	0	0	0	520.8604326	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	"1a (IP Acute) , 1a1 (Add'l Days) - $250 1-8"	1b (IP Psych) - $250 1-8	2a (SNF) - $100 51-100		10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER), 4(b) - $35-50"	9b (OP Surg/ASC) - $35			9a (OP Observation) - $35	12 (Renal Dialysis) - $35	"5 (Partial Hospital), 9c (OP SA), 9d (Cardiac Rehab) - $35-45"		"7b (Chiro), 7d (Spec), 7f (Pod) - $15"	"7e (MH), 7h (Psychiatric) - $35-45"					"16b(Comp Den),  17a (Eye Exam), 18a (MCR Hearing Exam) - $15"																				118.6972221	118.6972221	3.937778567	0	60.11372882	0.120227458	0.120227458	29.60601144	21.03980509	0	0	21.03980509	21.03980509	22.28480457	0	9.017059323	25.54833475	0	0	0	0	9.017059323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.3624	1.828060186	4.87623198	0	5.169214817	0.660719341	1.109122046	0.623562491	0.147303524	0	0	0.027753382	0.05908971	0.015644951	0	1.632080756	4.183549805	0	0	0	0	0.391385785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.0861		33.89633062	30.3624	1.828060186	4.87623198	0	5.169214817	0.660719341	1.109122046	0.623562491	0.147303524	0	0	0.027753382	0.05908971	0.015644951	0	1.632080756	4.183549805	0	0	0	0	0.391385785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.0861																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	30.3624	1.828060186	4.87623198	0	5.169214817	0.660719341	1.109122046	0.623562491	0.147303524	0	0	0.027753382	0.05908971	0.015644951	0	1.632080756	4.183549805	0	0	0	0	0.391385785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.0861
H1804_001_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		237.020222	5.119327	571.888767	47.279532	6.108173	11.880116	5.902699	338.522813	49.171406	16.535977	0.87305		0.062361	21.400111	7939.593714	5896.16333	0.852263	5.051216			10.362268									0.08		3278.757671	34.559253	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							570.595614	570.59645	26.310699	0	0.183269	0.183269	0.183269	45.817409	0.183269	0.183269	0.183269		0.183266	0.183269	13.745219	27.490439	0.18327	0.183269			0.183269									0		0	27.490397	0	0							11.2702	0.243422484	1.253899434	0	1.119438758	2.177256979	1.081781743	1.292519848	9.011594406	3.030531969	0.160003	0	0.011428651	3.921976943	9.094287864	13.5073432	0.15619424	0.925731305	0	0	1.899082494	0	0	0	0	0	0	0	0	0	0	0	0.079170632	0	0	0	0	0	0	0	0	60.2359	0	5.376160706	11.2702	0.243422484	1.253899434	0	1.119438758	2.177256979	1.081781743	1.292519848	9.011594406	3.030531969	0.160003	0	0.011428651	3.921976943	9.094287864	13.5073432	0.15619424	0.925731305	0	0	1.899082494	0	0	0	0	0	0	0	0	0	0	0	0.079170632	0	0	0	0	0	0	0	0	60.2359	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.2702	0.243422484	1.253899434	0	1.119438758	2.177256979	1.081781743	1.292519848	9.011594406	3.030531969	0.160003	0	0.011428651	3.921976943	9.094287864	13.5073432	0.15619424	0.925731305	0	0	1.899082494	0	0	0	0	0	0	0	0	0	0	0	0.079170632	0	0	0	0	0	0	0	0	60.2359
H1804_005_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		262.511429	5.669903	633.394636	52.364382	7.492665	14.57289	7.240619	374.930489	60.316712	20.28406	1.070937		0.076496	26.250711	8793.486375	6530.287792	1.045439	6.196136			12.711004									0.08		3631.383663	38.276053	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							556.328114	556.327281	25.666333	0	0.178781	0.178781	0.178781	44.695289	0.178781	0.178781	0.17878		0.178778	0.178781	13.40859	26.81718	0.178781	0.178781			0.178781									0		0	26.817142	0	0							12.1702	0.262860143	1.354743137	0	1.339546141	2.605355847	1.294485105	1.39646888	10.78348209	3.626404531	0.191462117	0	0.013675802	4.693128363	9.825687789	14.5936586	0.18690463	1.10775139	0	0	2.272486006	0	0	0	0	0	0	0	0	0	0	0	0.085537862	0	0	0	0	0	0	0	0	67.8038	0	7.875802048	12.1702	0.262860143	1.354743137	0	1.339546141	2.605355847	1.294485105	1.39646888	10.78348209	3.626404531	0.191462117	0	0.013675802	4.693128363	9.825687789	14.5936586	0.18690463	1.10775139	0	0	2.272486006	0	0	0	0	0	0	0	0	0	0	0	0.085537862	0	0	0	0	0	0	0	0	67.8038	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.1702	0.262860143	1.354743137	0	1.339546141	2.605355847	1.294485105	1.39646888	10.78348209	3.626404531	0.191462117	0	0.013675802	4.693128363	9.825687789	14.5936586	0.18690463	1.10775139	0	0	2.272486006	0	0	0	0	0	0	0	0	0	0	0	0.085537862	0	0	0	0	0	0	0	0	67.8038
H1804_006_0	2008	10	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		261.154356	5.640593	630.120253	52.09368	7.415399	14.42261	7.165951	372.992256	59.694707	20.074885	1.059893		0.075707	25.980004	8748.027755	6496.528957	1.034658	6.13224			12.579924									0.08		3612.610941	38.078183	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							557.111859	557.112093	25.701603	0	0.179026	0.179026	0.179026	44.756688	0.179026	0.179026	0.179027		0.179022	0.179026	13.42701	26.854021	0.179027	0.179026			0.179026									0		0	26.85389	0	0							12.1243	0.261870214	1.349591715	0	1.327549221	2.582022178	1.282891544	1.391158169	10.68690462	3.593926362	0.189749464	0	0.013553219	4.651096196	9.788321346	14.53816042	0.185231718	1.097830398	0	0	2.252133474	0	0	0	0	0	0	0	0	0	0	0	0.085212278	0	0	0	0	0	0	0	0	67.4016	0	7.727437431	12.1243	0.261870214	1.349591715	0	1.327549221	2.582022178	1.282891544	1.391158169	10.68690462	3.593926362	0.189749464	0	0.013553219	4.651096196	9.788321346	14.53816042	0.185231718	1.097830398	0	0	2.252133474	0	0	0	0	0	0	0	0	0	0	0	0.085212278	0	0	0	0	0	0	0	0	67.4016	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.1243	0.261870214	1.349591715	0	1.327549221	2.582022178	1.282891544	1.391158169	10.68690462	3.593926362	0.189749464	0	0.013553219	4.651096196	9.788321346	14.53816042	0.185231718	1.097830398	0	0	2.252133474	0	0	0	0	0	0	0	0	0	0	0	0.085212278	0	0	0	0	0	0	0	0	67.4016
H1804_007_0	2008	9	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		256.710446	5.544611	619.39787	51.207233	7.165185	13.935955	6.924153	366.645267	57.680457	19.397507	1.02413		0.073152	25.103374	8599.167741	6385.981366	0.999746	5.925323			12.155446									0.08		3551.137276	37.430229	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							559.649386	559.649718	25.816274	0	0.179825	0.179825	0.179825	44.956411	0.179825	0.179825	0.179825		0.17982	0.179825	13.48692	26.97384	0.179825	0.179825			0.179825									0		0	26.973963	0	0							11.9723	0.258586665	1.332545427	0	1.288479393	2.506033108	1.245135813	1.373587943	10.37238818	3.488156696	0.184164177	0	0.013154193	4.51421423	9.664690616	14.35453663	0.179779324	1.065521208	0	0	2.185853077	0	0	0	0	0	0	0	0	0	0	0	0.084136801	0	0	0	0	0	0	0	0	66.0833	0	7.254122222	11.9723	0.258586665	1.332545427	0	1.288479393	2.506033108	1.245135813	1.373587943	10.37238818	3.488156696	0.184164177	0	0.013154193	4.51421423	9.664690616	14.35453663	0.179779324	1.065521208	0	0	2.185853077	0	0	0	0	0	0	0	0	0	0	0	0.084136801	0	0	0	0	0	0	0	0	66.0833	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.9723	0.258586665	1.332545427	0	1.288479393	2.506033108	1.245135813	1.373587943	10.37238818	3.488156696	0.184164177	0	0.013154193	4.51421423	9.664690616	14.35453663	0.179779324	1.065521208	0	0	2.185853077	0	0	0	0	0	0	0	0	0	0	0	0.084136801	0	0	0	0	0	0	0	0	66.0833
H1804_008_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		266.384152	5.753549	642.738847	53.136891	7.715377	15.006054	7.455838	380.461684	62.109561	20.886982	1.10277		0.078769	27.030984	8923.213059	6626.626442	1.076513	6.38031			13.088825									0.08		3684.955972	38.840725	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							554.088766	554.088731	25.56492	0	0.178074	0.178074	0.178074	44.518699	0.178074	0.178074	0.178074		0.178077	0.178074	13.355609	26.711221	0.178075	0.178074			0.178074									0		0	26.711271	0	0							12.3	0.265664722	1.369297267	0	1.373908044	2.67218806	1.327690896	1.411471599	11.06009797	3.719428433	0.196374665	0	0.014026947	4.813515445	9.931245387	14.75044028	0.191700052	1.136167323	0	0	2.330779423	0	0	0	0	0	0	0	0	0	0	0	0.086457094	0	0	0	0	0	0	0	0	68.9505	0	8.309673602	12.3	0.265664722	1.369297267	0	1.373908044	2.67218806	1.327690896	1.411471599	11.06009797	3.719428433	0.196374665	0	0.014026947	4.813515445	9.931245387	14.75044028	0.191700052	1.136167323	0	0	2.330779423	0	0	0	0	0	0	0	0	0	0	0	0.086457094	0	0	0	0	0	0	0	0	68.9505	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.3	0.265664722	1.369297267	0	1.373908044	2.67218806	1.327690896	1.411471599	11.06009797	3.719428433	0.196374665	0	0.014026947	4.813515445	9.931245387	14.75044028	0.191700052	1.136167323	0	0	2.330779423	0	0	0	0	0	0	0	0	0	0	0	0.086457094	0	0	0	0	0	0	0	0	68.9505
H1804_009_0	2008	19	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		257.215044	5.555509	620.615379	51.307886	7.193384	13.990802	6.951405	367.365958	57.907467	19.473849	1.02816		0.07344	25.202172	8616.070545	6398.533858	1.00368	5.948643			12.203286									0.08		3558.117507	37.503802	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							559.362505	559.361674	25.803322	0	0.179735	0.179735	0.179735	44.933835	0.179735	0.179735	0.179735		0.179735	0.179735	13.480154	26.96031	0.179735	0.179735			0.179735									0		0	26.960452	0	0							11.9897	0.258961568	1.334494872	0	1.292902873	2.514636797	1.249410778	1.375596778	10.40799858	3.50013225	0.184796338	0	0.013199738	4.529712384	9.678829818	14.37553803	0.180396425	1.06917935	0	0	2.193357609	0	0	0	0	0	0	0	0	0	0	0	0.084259954	0	0	0	0	0	0	0	0	66.2331	0	7.306881497	11.9897	0.258961568	1.334494872	0	1.292902873	2.514636797	1.249410778	1.375596778	10.40799858	3.50013225	0.184796338	0	0.013199738	4.529712384	9.678829818	14.37553803	0.180396425	1.06917935	0	0	2.193357609	0	0	0	0	0	0	0	0	0	0	0	0.084259954	0	0	0	0	0	0	0	0	66.2331	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.9897	0.258961568	1.334494872	0	1.292902873	2.514636797	1.249410778	1.375596778	10.40799858	3.50013225	0.184796338	0	0.013199738	4.529712384	9.678829818	14.37553803	0.180396425	1.06917935	0	0	2.193357609	0	0	0	0	0	0	0	0	0	0	0	0.084259954	0	0	0	0	0	0	0	0	66.2331
H1804_011_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		284.27195	6.139902	685.899008	56.705054	8.786342	17.089032	8.490777	406.009832	70.73094	23.786287	1.255844		0.089703	30.783134	9522.410236	7071.606946	1.225943	7.265956			14.905675									0.08		3932.402178	41.448894	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QuitNet							543.603134	543.603868	25.08947	0	0.174762	0.174762	0.174763	43.690759	0.174763	0.174763	0.174763		0.174766	0.174763	13.107225	26.214449	0.174763	0.174762			0.174763									0		0	26.21439	0	0							12.8776	0.27813954	1.434070215	0	1.535518701	2.98651341	1.483873661	1.47823981	12.36115127	4.156962875	0.219475065	0	0.015677034	5.379752847	10.40103113	15.44818997	0.214249477	1.269813002	0	0	2.60496048	0	0	0	0	0	0	0	0	0	0	0	0.090546456	0	0	0	0	0	0	0	0	74.2358	0	10.4999789	12.8776	0.27813954	1.434070215	0	1.535518701	2.98651341	1.483873661	1.47823981	12.36115127	4.156962875	0.219475065	0	0.015677034	5.379752847	10.40103113	15.44818997	0.214249477	1.269813002	0	0	2.60496048	0	0	0	0	0	0	0	0	0	0	0	0.090546456	0	0	0	0	0	0	0	0	74.2358	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.8776	0.27813954	1.434070215	0	1.535518701	2.98651341	1.483873661	1.47823981	12.36115127	4.156962875	0.219475065	0	0.015677034	5.379752847	10.40103113	15.44818997	0.214249477	1.269813002	0	0	2.60496048	0	0	0	0	0	0	0	0	0	0	0	0.090546456	0	0	0	0	0	0	0	0	74.2358
H1804_013_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		272.620361	5.888243	657.785739	54.380857	8.080843	15.716869	7.80901	389.368514	65.051599	21.876368	1.155006		0.0825	28.311401	9132.110679	6781.759628	1.127506	6.682536			13.708824									0.08		3771.222939	39.750009	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							550.468119	550.467546	25.400255	0	0.176927	0.176927	0.176927	44.231955	0.176927	0.176927	0.176927		0.176927	0.176927	13.269584	26.539169	0.176927	0.176927			0.176927									0		0	26.539163	0	0							12.5057	0.270107223	1.392327125	0	1.429719309	2.780738482	1.381624712	1.435210882	11.50938426	3.870520161	0.204351747	0	0.014596478	5.009051245	10.09827581	14.99852207	0.199486254	1.182321047	0	0	2.425461104	0	0	0	0	0	0	0	0	0	0	0	0.087910997	0	0	0	0	0	0	0	0	70.7953	0	9.038608758	12.5057	0.270107223	1.392327125	0	1.429719309	2.780738482	1.381624712	1.435210882	11.50938426	3.870520161	0.204351747	0	0.014596478	5.009051245	10.09827581	14.99852207	0.199486254	1.182321047	0	0	2.425461104	0	0	0	0	0	0	0	0	0	0	0	0.087910997	0	0	0	0	0	0	0	0	70.7953	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.5057	0.270107223	1.392327125	0	1.429719309	2.780738482	1.381624712	1.435210882	11.50938426	3.870520161	0.204351747	0	0.014596478	5.009051245	10.09827581	14.99852207	0.199486254	1.182321047	0	0	2.425461104	0	0	0	0	0	0	0	0	0	0	0	0.087910997	0	0	0	0	0	0	0	0	70.7953
H1804_014_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		276.262178	5.966901	666.572814	55.107308	8.298181	16.139581	8.019037	394.56992	66.801189	22.464742	1.186071		0.084719	29.072849	9254.102612	6872.354233	1.157831	6.862266			14.077528									0.08		3821.601083	40.281011	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							548.341871	548.341709	25.30358	0	0.176254	0.176254	0.176254	44.063591	0.176254	0.176254	0.176254		0.176256	0.176254	13.219079	26.438159	0.176254	0.176254			0.176254									0		0	26.438284	0	0							12.6238	0.272658391	1.405556544	0	1.462587594	2.84466571	1.413387347	1.448847298	11.77397677	3.959500636	0.209049758	0	0.014932232	5.124205928	10.19422613	15.14103283	0.204072345	1.209501832	0	0	2.48122062	0	0	0	0	0	0	0	0	0	0	0	0.088746734	0	0	0	0	0	0	0	0	71.872	0	9.481199208	12.6238	0.272658391	1.405556544	0	1.462587594	2.84466571	1.413387347	1.448847298	11.77397677	3.959500636	0.209049758	0	0.014932232	5.124205928	10.19422613	15.14103283	0.204072345	1.209501832	0	0	2.48122062	0	0	0	0	0	0	0	0	0	0	0	0.088746734	0	0	0	0	0	0	0	0	71.872	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.6238	0.272658391	1.405556544	0	1.462587594	2.84466571	1.413387347	1.448847298	11.77397677	3.959500636	0.209049758	0	0.014932232	5.124205928	10.19422613	15.14103283	0.204072345	1.209501832	0	0	2.48122062	0	0	0	0	0	0	0	0	0	0	0	0.088746734	0	0	0	0	0	0	0	0	71.872
H1804_016_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		270.701975	5.846809	653.157006	53.998188	7.967515	15.49645	7.699495	386.628591	64.139295	21.569566	1.138808		0.081343	27.914355	9067.849493	6734.037483	1.111694	6.588818			13.516567									0.08		3744.685453	39.470293	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QuitNet							551.585617	551.585078	25.450965	0	0.177281	0.177281	0.177281	44.320237	0.177281	0.17728	0.177281		0.177285	0.177281	13.296075	26.59215	0.177281	0.177281			0.17728									0		0	26.592222	0	0							12.4429	0.26875105	1.385289675	0	1.412489027	2.747226152	1.364974173	1.427955899	11.37067836	3.82385266	0.201889021	0	0.014420894	4.948684769	10.04723391	14.92271124	0.197082224	1.168072244	0	0	2.396216998	0	0	0	0	0	0	0	0	0	0	0	0.087466899	0	0	0	0	0	0	0	0	70.2279	0	8.810687992	12.4429	0.26875105	1.385289675	0	1.412489027	2.747226152	1.364974173	1.427955899	11.37067836	3.82385266	0.201889021	0	0.014420894	4.948684769	10.04723391	14.92271124	0.197082224	1.168072244	0	0	2.396216998	0	0	0	0	0	0	0	0	0	0	0	0.087466899	0	0	0	0	0	0	0	0	70.2279	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.4429	0.26875105	1.385289675	0	1.412489027	2.747226152	1.364974173	1.427955899	11.37067836	3.82385266	0.201889021	0	0.014420894	4.948684769	10.04723391	14.92271124	0.197082224	1.168072244	0	0	2.396216998	0	0	0	0	0	0	0	0	0	0	0	0.087466899	0	0	0	0	0	0	0	0	70.2279
H1804_018_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		272.695556	5.889867	657.967173	54.395857	8.08531	15.725558	7.813327	389.475911	65.087564	21.888462	1.155645		0.082546	28.327054	9134.62956	6783.630219	1.128129	6.68623			13.716403									0.08		3772.263145	39.760972	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QuitNet							550.424392	550.424543	25.398271	0	0.176914	0.176914	0.176913	44.228491	0.176914	0.176913	0.176914		0.176911	0.176914	13.26855	26.5371	0.176914	0.176914			0.176914									0		0	26.536985	0	0							12.5082	0.270160613	1.392602381	0	1.430404533	2.782071368	1.38227912	1.435494319	11.5149013	3.872353478	0.20444978	0	0.014603295	5.011452431	10.10027409	15.00148946	0.199581814	1.182887694	0	0	2.42662372	0	0	0	0	0	0	0	0	0	0	0	0.087928026	0	0	0	0	0	0	0	0	70.8177	0	9.04759409	12.5082	0.270160613	1.392602381	0	1.430404533	2.782071368	1.38227912	1.435494319	11.5149013	3.872353478	0.20444978	0	0.014603295	5.011452431	10.10027409	15.00148946	0.199581814	1.182887694	0	0	2.42662372	0	0	0	0	0	0	0	0	0	0	0	0.087928026	0	0	0	0	0	0	0	0	70.8177	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.5082	0.270160613	1.392602381	0	1.430404533	2.782071368	1.38227912	1.435494319	11.5149013	3.872353478	0.20444978	0	0.014603295	5.011452431	10.10027409	15.00148946	0.199581814	1.182887694	0	0	2.42662372	0	0	0	0	0	0	0	0	0	0	0	0.087928026	0	0	0	0	0	0	0	0	70.8177
H1804_019_0	2008	16	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		263.365677	5.688354	635.455788	52.534783	7.541509	14.66789	7.287819	376.150563	60.709911	20.41629	1.077919		0.076994	26.421836	8822.101556	6551.538222	1.052254	6.236529			12.793866									0.08		3643.200672	38.400609	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							555.834361	555.833554	25.644113	0	0.178626	0.178626	0.178626	44.656599	0.178626	0.178626	0.178626		0.178628	0.178626	13.39698	26.79396	0.178626	0.178626			0.178626									0		0	26.794093	0	0							12.199	0.263481502	1.357975003	0	1.347109587	2.620066519	1.301793957	1.399800405	10.84436856	3.646880218	0.192544359	0	0.013753284	4.719626877	9.849126509	14.62847109	0.187959923	1.114006229	0	0	2.285317108	0	0	0	0	0	0	0	0	0	0	0	0.085742457	0	0	0	0	0	0	0	0	68.057	0	7.970048726	12.199	0.263481502	1.357975003	0	1.347109587	2.620066519	1.301793957	1.399800405	10.84436856	3.646880218	0.192544359	0	0.013753284	4.719626877	9.849126509	14.62847109	0.187959923	1.114006229	0	0	2.285317108	0	0	0	0	0	0	0	0	0	0	0	0.085742457	0	0	0	0	0	0	0	0	68.057	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.199	0.263481502	1.357975003	0	1.347109587	2.620066519	1.301793957	1.399800405	10.84436856	3.646880218	0.192544359	0	0.013753284	4.719626877	9.849126509	14.62847109	0.187959923	1.114006229	0	0	2.285317108	0	0	0	0	0	0	0	0	0	0	0	0.085742457	0	0	0	0	0	0	0	0	68.057
H1804_020_0	2008	10	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		273.043687	5.897387	658.80715	54.4653	8.105962	15.765724	7.833284	389.973126	65.253809	21.944369	1.158596		0.082757	28.399406	9146.291053	6792.290367	1.131011	6.703308			13.751437									0.08		3777.078908	39.811732	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							550.22186	550.22264	25.389058	0	0.176849	0.176849	0.176849	44.212449	0.176849	0.176849	0.176849		0.176845	0.176849	13.263735	26.52747	0.176849	0.176849			0.176849									0		0	26.527382	0	0							12.5196	0.27040632	1.393874412	0	1.433531274	2.788152524	1.385308442	1.436805579	11.54007087	3.880839713	0.204896544	0	0.014635162	5.022406552	10.1094984	15.01518991	0.200018164	1.185473316	0	0	2.431927882	0	0	0	0	0	0	0	0	0	0	0	0.088008419	0	0	0	0	0	0	0	0	70.9206	0	9.089355956	12.5196	0.27040632	1.393874412	0	1.433531274	2.788152524	1.385308442	1.436805579	11.54007087	3.880839713	0.204896544	0	0.014635162	5.022406552	10.1094984	15.01518991	0.200018164	1.185473316	0	0	2.431927882	0	0	0	0	0	0	0	0	0	0	0	0.088008419	0	0	0	0	0	0	0	0	70.9206	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.5196	0.27040632	1.393874412	0	1.433531274	2.788152524	1.385308442	1.436805579	11.54007087	3.880839713	0.204896544	0	0.014635162	5.022406552	10.1094984	15.01518991	0.200018164	1.185473316	0	0	2.431927882	0	0	0	0	0	0	0	0	0	0	0	0.088008419	0	0	0	0	0	0	0	0	70.9206
H1804_022_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		236.233321	5.102331	569.990113	47.122565	6.067679	11.801356	5.863567	337.398928	48.845423	16.426352	0.867262		0.061947	21.258238	7913.2345	5876.588246	0.846613	5.017729			10.293572									0.08		3267.872294	34.444517	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							571.021259	571.020377	26.329868	0	0.183403	0.183402	0.183402	45.850754	0.183402	0.183403	0.183402		0.183397	0.183402	13.755224	27.51045	0.183403	0.183403			0.183402									0		0	27.510356	0	0							11.2412	0.242794581	1.250647036	0	1.112830532	2.164392293	1.075389915	1.289166271	8.958348269	3.012642236	0.159057585	0	0.011360894	3.898803366	9.070692759	13.47229893	0.155271364	0.920266552	0	0	1.887861692	0	0	0	0	0	0	0	0	0	0	0	0.078965077	0	0	0	0	0	0	0	0	60.002	0	5.308545637	11.2412	0.242794581	1.250647036	0	1.112830532	2.164392293	1.075389915	1.289166271	8.958348269	3.012642236	0.159057585	0	0.011360894	3.898803366	9.070692759	13.47229893	0.155271364	0.920266552	0	0	1.887861692	0	0	0	0	0	0	0	0	0	0	0	0.078965077	0	0	0	0	0	0	0	0	60.002	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.2412	0.242794581	1.250647036	0	1.112830532	2.164392293	1.075389915	1.289166271	8.958348269	3.012642236	0.159057585	0	0.011360894	3.898803366	9.070692759	13.47229893	0.155271364	0.920266552	0	0	1.887861692	0	0	0	0	0	0	0	0	0	0	0	0.078965077	0	0	0	0	0	0	0	0	60.002
H1804_023_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		257.102377	5.553075	620.343532	51.285413	7.187077	13.978534	6.94531	367.20504	57.85669	19.456773	1.027259		0.073376	25.180073	8612.296461	6395.731118	1.0028	5.943427			12.192585									0.08		3556.55895	37.487375	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							559.426883	559.427539	25.806201	0	0.179755	0.179755	0.179755	44.93885	0.179755	0.179755	0.179755		0.179752	0.179755	13.481655	26.963308	0.179755	0.179755			0.179755									0		0	26.963184	0	0							11.9858	0.25887859	1.334059156	0	1.291913026	2.512711379	1.248454199	1.375147684	10.40002931	3.497452231	0.184654942	0	0.013189483	4.526244022	9.67566747	14.370839	0.180258314	1.06836072	0	0	2.191678117	0	0	0	0	0	0	0	0	0	0	0	0.084231582	0	0	0	0	0	0	0	0	66.1996	0	7.295131285	11.9858	0.25887859	1.334059156	0	1.291913026	2.512711379	1.248454199	1.375147684	10.40002931	3.497452231	0.184654942	0	0.013189483	4.526244022	9.67566747	14.370839	0.180258314	1.06836072	0	0	2.191678117	0	0	0	0	0	0	0	0	0	0	0	0.084231582	0	0	0	0	0	0	0	0	66.1996	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.9858	0.25887859	1.334059156	0	1.291913026	2.512711379	1.248454199	1.375147684	10.40002931	3.497452231	0.184654942	0	0.013189483	4.526244022	9.67566747	14.370839	0.180258314	1.06836072	0	0	2.191678117	0	0	0	0	0	0	0	0	0	0	0	0.084231582	0	0	0	0	0	0	0	0	66.1996
H1804_025_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		239.026969	5.162669	576.7307	47.679826	6.212036	12.082125	6.003069	341.388939	50.007516	16.817154	0.887895		0.063421	21.763998	8006.814799	5946.083579	0.866755	5.137107			10.538468									0.08		3306.517486	34.851851	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							569.501861	569.501853	26.261613	0	0.182927	0.182927	0.182927	45.731902	0.182927	0.182927	0.182927		0.182924	0.182927	13.719569	27.439138	0.182927	0.182927			0.182927									0		0	27.439257	0	0							11.3439	0.245012463	1.262156537	0	1.136349109	2.21014688	1.098123403	1.301030459	9.147724879	3.07631153	0.162419969	0	0.011601223	3.981222862	9.154170675	13.59628399	0.158552892	0.939715572	0	0	1.927770336	0	0	0	0	0	0	0	0	0	0	0	0.079692408	0	0	0	0	0	0	0	0	60.8321	0	5.551192953	11.3439	0.245012463	1.262156537	0	1.136349109	2.21014688	1.098123403	1.301030459	9.147724879	3.07631153	0.162419969	0	0.011601223	3.981222862	9.154170675	13.59628399	0.158552892	0.939715572	0	0	1.927770336	0	0	0	0	0	0	0	0	0	0	0	0.079692408	0	0	0	0	0	0	0	0	60.8321	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.3439	0.245012463	1.262156537	0	1.136349109	2.21014688	1.098123403	1.301030459	9.147724879	3.07631153	0.162419969	0	0.011601223	3.981222862	9.154170675	13.59628399	0.158552892	0.939715572	0	0	1.927770336	0	0	0	0	0	0	0	0	0	0	0	0.079692408	0	0	0	0	0	0	0	0	60.8321
H1804_061_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		242.265462	5.232618	584.544625	48.325823	6.381506	12.411736	6.166837	346.0143	51.371763	17.275941	0.912118		0.065151	22.357738	8115.296365	6026.645011	0.8904	5.277251			10.825967									0.08		3351.316348	35.324046	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							567.725008	567.724609	26.18161	0	0.18237	0.18237	0.18237	45.592592	0.18237	0.18237	0.18237		0.182367	0.18237	13.677779	27.35556	0.18237	0.18237			0.18237									0		0	27.355524	0	0							11.4617	0.247557167	1.27535995	0	1.163795249	2.263528294	1.124646064	1.314640734	9.368668418	3.15061336	0.16634296	0	0.011881392	4.077380679	9.24993585	13.73852077	0.162382248	0.962412265	0	0	1.974331602	0	0	0	0	0	0	0	0	0	0	0	0.080525649	0	0	0	0	0	0	0	0	61.7942	0	5.841599605	11.4617	0.247557167	1.27535995	0	1.163795249	2.263528294	1.124646064	1.314640734	9.368668418	3.15061336	0.16634296	0	0.011881392	4.077380679	9.24993585	13.73852077	0.162382248	0.962412265	0	0	1.974331602	0	0	0	0	0	0	0	0	0	0	0	0.080525649	0	0	0	0	0	0	0	0	61.7942	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.4617	0.247557167	1.27535995	0	1.163795249	2.263528294	1.124646064	1.314640734	9.368668418	3.15061336	0.16634296	0	0.011881392	4.077380679	9.24993585	13.73852077	0.162382248	0.962412265	0	0	1.974331602	0	0	0	0	0	0	0	0	0	0	0	0.080525649	0	0	0	0	0	0	0	0	61.7942
H1804_063_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		261.215626	5.641916	630.268089	52.105903	7.418877	14.429375	7.169312	373.079766	59.722704	20.0843	1.06039		0.075742	25.99219	8750.080178	6498.053142	1.035143	6.135116			12.585825									0.08		3613.458514	38.087117	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							557.076269	557.076645	25.700011	0	0.179015	0.179015	0.179015	44.753949	0.179015	0.179015	0.179015		0.179011	0.179015	13.426184	26.85237	0.179016	0.179015			0.179015									0		0	26.852428	0	0							12.1264	0.26191497	1.349824735	0	1.328090266	2.583074566	1.283414388	1.391399402	10.69125986	3.595390965	0.189825716	0	0.013558651	4.652991893	9.79001554	14.54067727	0.185307159	1.098277791	0	0	2.253051462	0	0	0	0	0	0	0	0	0	0	0	0.085227631	0	0	0	0	0	0	0	0	67.4197	0	7.734069372	12.1264	0.26191497	1.349824735	0	1.328090266	2.583074566	1.283414388	1.391399402	10.69125986	3.595390965	0.189825716	0	0.013558651	4.652991893	9.79001554	14.54067727	0.185307159	1.098277791	0	0	2.253051462	0	0	0	0	0	0	0	0	0	0	0	0.085227631	0	0	0	0	0	0	0	0	67.4197	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.1264	0.26191497	1.349824735	0	1.328090266	2.583074566	1.283414388	1.391399402	10.69125986	3.595390965	0.189825716	0	0.013558651	4.652991893	9.79001554	14.54067727	0.185307159	1.098277791	0	0	2.253051462	0	0	0	0	0	0	0	0	0	0	0	0.085227631	0	0	0	0	0	0	0	0	67.4197
H1804_066_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		249.610623	5.391263	602.267225	49.790998	6.774328	13.175757	6.546446	356.504984	54.534022	18.339385	0.968264		0.069162	23.733999	8361.341139	6209.364711	0.94521	5.6021			11.492374									0.08		3452.923712	36.395024	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							563.651862	563.65198	25.997589	0	0.181088	0.181088	0.181088	45.272136	0.181088	0.181088	0.181088		0.181083	0.181088	13.581644	27.163292	0.181088	0.181088			0.181088									0		0	27.163421	0	0							11.7245	0.253233005	1.304791315	0	1.226749509	2.385971484	1.185482813	1.34497851	9.875456976	3.321042551	0.175340991	0	0.012524062	4.297942411	9.463396559	14.05556556	0.171166188	1.014473085	0	0	2.081131023	0	0	0	0	0	0	0	0	0	0	0	0.082384447	0	0	0	0	0	0	0	0	63.9761	0	6.535435936	11.7245	0.253233005	1.304791315	0	1.226749509	2.385971484	1.185482813	1.34497851	9.875456976	3.321042551	0.175340991	0	0.012524062	4.297942411	9.463396559	14.05556556	0.171166188	1.014473085	0	0	2.081131023	0	0	0	0	0	0	0	0	0	0	0	0.082384447	0	0	0	0	0	0	0	0	63.9761	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.7245	0.253233005	1.304791315	0	1.226749509	2.385971484	1.185482813	1.34497851	9.875456976	3.321042551	0.175340991	0	0.012524062	4.297942411	9.463396559	14.05556556	0.171166188	1.014473085	0	0	2.081131023	0	0	0	0	0	0	0	0	0	0	0	0.082384447	0	0	0	0	0	0	0	0	63.9761
H1804_067_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		249.978248	5.399203	603.15424	49.86433	6.794296	13.214594	6.565742	357.030043	54.694769	18.393442	0.971118		0.069366	23.803959	8373.655675	6218.509828	0.947996	5.618613			11.526249									0.08		3458.00916	36.448626	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							563.445606	563.444644	25.988326	0	0.181023	0.181024	0.181024	45.255994	0.181024	0.181024	0.181024		0.181021	0.181023	13.5768	27.1536	0.181023	0.181024			0.181024									0		0	27.153729	0	0							11.7374	0.253512668	1.306247418	0	1.229923845	2.392158664	1.18855688	1.346479124	9.901065863	3.329654445	0.175795665	0	0.012556703	4.30906407	9.473954031	14.07124404	0.17160908	1.0171038	0	0	2.086527699	0	0	0	0	0	0	0	0	0	0	0	0.082476343	0	0	0	0	0	0	0	0	64.0854	0	6.571398003	11.7374	0.253512668	1.306247418	0	1.229923845	2.392158664	1.18855688	1.346479124	9.901065863	3.329654445	0.175795665	0	0.012556703	4.30906407	9.473954031	14.07124404	0.17160908	1.0171038	0	0	2.086527699	0	0	0	0	0	0	0	0	0	0	0	0.082476343	0	0	0	0	0	0	0	0	64.0854	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.7374	0.253512668	1.306247418	0	1.229923845	2.392158664	1.18855688	1.346479124	9.901065863	3.329654445	0.175795665	0	0.012556703	4.30906407	9.473954031	14.07124404	0.17160908	1.0171038	0	0	2.086527699	0	0	0	0	0	0	0	0	0	0	0	0.082476343	0	0	0	0	0	0	0	0	64.0854
H1804_068_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		275.294504	5.946002	664.237984	54.914281	8.24015	16.026715	7.962959	393.187845	66.334041	22.307643	1.177776		0.084127	28.86954	9221.687904	6848.28217	1.149734	6.814277			13.979082									0.08		3808.21501	40.139917	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							548.908109	548.908827	25.329344	0	0.176433	0.176433	0.176433	44.108458	0.176433	0.176433	0.176433		0.176429	0.176433	13.232535	26.46507	0.176433	0.176433			0.176433									0		0	26.465124	0	0							12.5926	0.271984415	1.402059366	0	1.453834385	2.827641408	1.404928745	1.445242462	11.70351386	3.935804377	0.207798553	0	0.014842442	5.093539551	10.168859	15.10335558	0.202851019	1.202263334	0	0	2.466371375	0	0	0	0	0	0	0	0	0	0	0	0.088525657	0	0	0	0	0	0	0	0	71.586	0	9.362283197	12.5926	0.271984415	1.402059366	0	1.453834385	2.827641408	1.404928745	1.445242462	11.70351386	3.935804377	0.207798553	0	0.014842442	5.093539551	10.168859	15.10335558	0.202851019	1.202263334	0	0	2.466371375	0	0	0	0	0	0	0	0	0	0	0	0.088525657	0	0	0	0	0	0	0	0	71.586	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.5926	0.271984415	1.402059366	0	1.453834385	2.827641408	1.404928745	1.445242462	11.70351386	3.935804377	0.207798553	0	0.014842442	5.093539551	10.168859	15.10335558	0.202851019	1.202263334	0	0	2.466371375	0	0	0	0	0	0	0	0	0	0	0	0.088525657	0	0	0	0	0	0	0	0	71.586
H1804_075_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		262.907664	5.678461	634.350683	52.443421	7.515303	14.61692	7.262495	375.496409	60.498948	20.345345	1.074173		0.076727	26.330022	8806.759273	6540.144616	1.048597	6.214857			12.749408									0.08		3636.864878	38.333828	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							556.099395	556.099042	25.656033	0	0.178709	0.178709	0.178709	44.677339	0.178709	0.178709	0.178709		0.178704	0.178709	13.403204	26.80641	0.178709	0.178709			0.178709									0		0	26.80653	0	0							12.1836	0.263148894	1.356243505	0	1.343052284	2.612175156	1.297873219	1.39801503	10.8117065	3.63589626	0.191964383	0	0.013711422	4.705411902	9.836565926	14.6098165	0.187393721	1.11065088	0	0	2.278433954	0	0	0	0	0	0	0	0	0	0	0	0.085633076	0	0	0	0	0	0	0	0	67.9213	0	7.919442127	12.1836	0.263148894	1.356243505	0	1.343052284	2.612175156	1.297873219	1.39801503	10.8117065	3.63589626	0.191964383	0	0.013711422	4.705411902	9.836565926	14.6098165	0.187393721	1.11065088	0	0	2.278433954	0	0	0	0	0	0	0	0	0	0	0	0.085633076	0	0	0	0	0	0	0	0	67.9213	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.1836	0.263148894	1.356243505	0	1.343052284	2.612175156	1.297873219	1.39801503	10.8117065	3.63589626	0.191964383	0	0.013711422	4.705411902	9.836565926	14.6098165	0.187393721	1.11065088	0	0	2.278433954	0	0	0	0	0	0	0	0	0	0	0	0.085633076	0	0	0	0	0	0	0	0	67.9213
H1804_077_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		266.179072	5.749121	642.244024	53.095983	7.703493	14.982941	7.444355	380.168779	62.013898	20.854812	1.101071		0.078648	26.989352	8916.343379	6621.524826	1.074855	6.370483			13.068666									0.08		3682.119048	38.810821	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							554.207486	554.206787	25.570346	0	0.178112	0.178112	0.178112	44.528161	0.178112	0.178112	0.178112		0.178117	0.178112	13.358444	26.716889	0.178112	0.178112			0.178112									0		0	26.716875	0	0							12.2932	0.265516823	1.368533493	0	1.372084545	2.668641587	1.325928958	1.410684717	11.0454194	3.714492275	0.196113958	0	0.014008546	4.807127463	9.925706143	14.74221198	0.191444574	1.134659468	0	0	2.327686239	0	0	0	0	0	0	0	0	0	0	0	0.086408654	0	0	0	0	0	0	0	0	68.8899	0	8.286230495	12.2932	0.265516823	1.368533493	0	1.372084545	2.668641587	1.325928958	1.410684717	11.0454194	3.714492275	0.196113958	0	0.014008546	4.807127463	9.925706143	14.74221198	0.191444574	1.134659468	0	0	2.327686239	0	0	0	0	0	0	0	0	0	0	0	0.086408654	0	0	0	0	0	0	0	0	68.8899	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.2932	0.265516823	1.368533493	0	1.372084545	2.668641587	1.325928958	1.410684717	11.0454194	3.714492275	0.196113958	0	0.014008546	4.807127463	9.925706143	14.74221198	0.191444574	1.134659468	0	0	2.327686239	0	0	0	0	0	0	0	0	0	0	0	0.086408654	0	0	0	0	0	0	0	0	68.8899
H1804_081_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		237.439497	5.128383	572.900405	47.363167	6.129793	11.922166	5.923592	339.121642	49.345451	16.594507	0.87614		0.062581	21.475858	7953.638392	5906.593299	0.855279	5.069095			10.398946									0.08		3284.557602	34.620386	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							570.368103	570.367524	26.300486	0	0.183198	0.183198	0.183198	45.799605	0.183198	0.183198	0.183198		0.183195	0.183198	13.73988	27.479761	0.183198	0.183198			0.183198									0		0	27.479771	0	0							11.2857	0.243755259	1.255629923	0	1.122965818	2.184116967	1.085190207	1.294303104	9.039987932	3.040080493	0.160507096	0	0.011464526	3.934334234	9.106836422	13.52598102	0.156685402	0.928648066	0	0	1.905066109	0	0	0	0	0	0	0	0	0	0	0	0.079280023	0	0	0	0	0	0	0	0	60.3605	0	5.412404754	11.2857	0.243755259	1.255629923	0	1.122965818	2.184116967	1.085190207	1.294303104	9.039987932	3.040080493	0.160507096	0	0.011464526	3.934334234	9.106836422	13.52598102	0.156685402	0.928648066	0	0	1.905066109	0	0	0	0	0	0	0	0	0	0	0	0.079280023	0	0	0	0	0	0	0	0	60.3605	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.2857	0.243755259	1.255629923	0	1.122965818	2.184116967	1.085190207	1.294303104	9.039987932	3.040080493	0.160507096	0	0.011464526	3.934334234	9.106836422	13.52598102	0.156685402	0.928648066	0	0	1.905066109	0	0	0	0	0	0	0	0	0	0	0	0.079280023	0	0	0	0	0	0	0	0	60.3605
H1804_083_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		295.055686	6.372817	711.918297	58.856136	9.465598	18.410153	9.147184	421.411643	76.199015	25.625161	1.352931		0.096638	33.16292	9883.638851	7339.865372	1.320719	7.827673			16.058004									0.08		4081.576195	43.02124	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QuitNet							537.170637	537.17135	24.796376	0	0.172721	0.172721	0.172721	43.180353	0.172721	0.172721	0.172721		0.172724	0.172721	12.954105	25.908209	0.172721	0.172721			0.172721									0		0	25.908185	0	0							13.2079	0.285274559	1.471082814	0	1.634907552	3.179820036	1.579910768	1.516391959	13.16117007	4.426003433	0.233679595	0	0.016691702	5.727932705	10.66947462	15.84689717	0.228115906	1.352003508	0	0	2.773554509	0	0	0	0	0	0	0	0	0	0	0	0.09288352	0	0	0	0	0	0	0	0	77.4037	0	11.97799739	13.2079	0.285274559	1.471082814	0	1.634907552	3.179820036	1.579910768	1.516391959	13.16117007	4.426003433	0.233679595	0	0.016691702	5.727932705	10.66947462	15.84689717	0.228115906	1.352003508	0	0	2.773554509	0	0	0	0	0	0	0	0	0	0	0	0.09288352	0	0	0	0	0	0	0	0	77.4037	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	13.2079	0.285274559	1.471082814	0	1.634907552	3.179820036	1.579910768	1.516391959	13.16117007	4.426003433	0.233679595	0	0.016691702	5.727932705	10.66947462	15.84689717	0.228115906	1.352003508	0	0	2.773554509	0	0	0	0	0	0	0	0	0	0	0	0.09288352	0	0	0	0	0	0	0	0	77.4037
H1804_086_0	2008	9	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		260.647225	5.62964	628.896636	51.99252	7.386635	14.366665	7.138155	372.26795	59.463152	19.997014	1.055782		0.075413	25.879228	8731.040141	6483.913481	1.030644	6.108453			12.531127									0.08		3605.595685	38.004239	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							557.403737	557.402958	25.714749	0	0.179118	0.179118	0.179118	44.779586	0.179118	0.179118	0.179118		0.179123	0.179118	13.433879	26.86776	0.179118	0.179118			0.179118									0		0	26.867873	0	0							12.1071	0.261498166	1.347659928	0	1.323079288	2.573328301	1.278572047	1.389167057	10.65092086	3.581825154	0.18910956	0	0.013508203	4.635435561	9.7743114	14.51735261	0.184606892	1.094133884	0	0	2.244550406	0	0	0	0	0	0	0	0	0	0	0	0.085091089	0	0	0	0	0	0	0	0	67.2513	0	7.672452367	12.1071	0.261498166	1.347659928	0	1.323079288	2.573328301	1.278572047	1.389167057	10.65092086	3.581825154	0.18910956	0	0.013508203	4.635435561	9.7743114	14.51735261	0.184606892	1.094133884	0	0	2.244550406	0	0	0	0	0	0	0	0	0	0	0	0.085091089	0	0	0	0	0	0	0	0	67.2513	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.1071	0.261498166	1.347659928	0	1.323079288	2.573328301	1.278572047	1.389167057	10.65092086	3.581825154	0.18910956	0	0.013508203	4.635435561	9.7743114	14.51735261	0.184606892	1.094133884	0	0	2.244550406	0	0	0	0	0	0	0	0	0	0	0	0.085091089	0	0	0	0	0	0	0	0	67.2513
H1804_087_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		274.925612	5.938034	663.347914	54.840697	8.218091	15.98381	7.941641	392.660977	66.156462	22.247925	1.174623		0.083902	28.792254	9209.330963	6839.105561	1.146656	6.796035			13.94166									0.08		3803.112051	40.08613	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QuitNet							549.123113	549.123828	25.33913	0	0.176501	0.176502	0.176501	44.125489	0.176501	0.176502	0.176502		0.176497	0.176502	13.23765	26.4753	0.176501	0.176502			0.176502									0		0	26.475214	0	0							12.5807	0.27172633	1.400721586	0	1.45050128	2.821174433	1.401707578	1.443863135	11.6766817	3.926803258	0.207323309	0	0.014808451	5.081890416	10.15915834	15.08894762	0.202385931	1.19951377	0	0	2.460730873	0	0	0	0	0	0	0	0	0	0	0	0.088440739	0	0	0	0	0	0	0	0	71.477	0	9.317246025	12.5807	0.27172633	1.400721586	0	1.45050128	2.821174433	1.401707578	1.443863135	11.6766817	3.926803258	0.207323309	0	0.014808451	5.081890416	10.15915834	15.08894762	0.202385931	1.19951377	0	0	2.460730873	0	0	0	0	0	0	0	0	0	0	0	0.088440739	0	0	0	0	0	0	0	0	71.477	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.5807	0.27172633	1.400721586	0	1.45050128	2.821174433	1.401707578	1.443863135	11.6766817	3.926803258	0.207323309	0	0.014808451	5.081890416	10.15915834	15.08894762	0.202385931	1.19951377	0	0	2.460730873	0	0	0	0	0	0	0	0	0	0	0	0.088440739	0	0	0	0	0	0	0	0	71.477
H1804_089_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		263.784951	5.697411	636.467426	52.618417	7.565548	14.714644	7.31105	376.74939	60.903425	20.481367	1.081354		0.07724	26.506056	8836.146234	6561.968191	1.055608	6.256408			12.834647									0.08		3649.000603	38.461743	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							555.591893	555.591582	25.633181	0	0.17855	0.17855	0.17855	44.637546	0.17855	0.17855	0.17855		0.17855	0.17855	13.391265	26.782529	0.17855	0.17855			0.17855									0		0	26.78243	0	0							12.2131	0.263786133	1.359557061	0	1.350828595	2.627299686	1.305387978	1.401430686	10.87430653	3.656948078	0.193075757	0	0.013791202	4.732656299	9.860597983	14.64550861	0.188478808	1.117081648	0	0	2.291626222	0	0	0	0	0	0	0	0	0	0	0	0.085841578	0	0	0	0	0	0	0	0	68.1813	0	8.016613611	12.2131	0.263786133	1.359557061	0	1.350828595	2.627299686	1.305387978	1.401430686	10.87430653	3.656948078	0.193075757	0	0.013791202	4.732656299	9.860597983	14.64550861	0.188478808	1.117081648	0	0	2.291626222	0	0	0	0	0	0	0	0	0	0	0	0.085841578	0	0	0	0	0	0	0	0	68.1813	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.2131	0.263786133	1.359557061	0	1.350828595	2.627299686	1.305387978	1.401430686	10.87430653	3.656948078	0.193075757	0	0.013791202	4.732656299	9.860597983	14.64550861	0.188478808	1.117081648	0	0	2.291626222	0	0	0	0	0	0	0	0	0	0	0	0.085841578	0	0	0	0	0	0	0	0	68.1813
H1804_090_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		269.946723	5.830496	651.334714	53.847535	7.923124	15.410113	7.656597	385.549906	63.781949	21.449393	1.132463		0.08089	27.758831	9042.550413	6715.249683	1.1055	6.552109			13.44126									0.08		3734.237872	39.360172	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							552.024368	552.024981	25.470895	0	0.177419	0.177419	0.177419	44.354951	0.177419	0.177419	0.17742		0.177419	0.177419	13.306484	26.612968	0.177419	0.177419			0.177419									0		0	26.612853	0	0							12.4181	0.268214954	1.382506509	0	1.405712737	2.734046838	1.358425783	1.425087266	11.31612961	3.805529857	0.200921585	0	0.014351423	4.924944037	10.02704603	14.89272708	0.196136705	1.162468627	0	0	2.384734908	0	0	0	0	0	0	0	0	0	0	0	0.087290539	0	0	0	0	0	0	0	0	70.0044	0	8.721925486	12.4181	0.268214954	1.382506509	0	1.405712737	2.734046838	1.358425783	1.425087266	11.31612961	3.805529857	0.200921585	0	0.014351423	4.924944037	10.02704603	14.89272708	0.196136705	1.162468627	0	0	2.384734908	0	0	0	0	0	0	0	0	0	0	0	0.087290539	0	0	0	0	0	0	0	0	70.0044	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.4181	0.268214954	1.382506509	0	1.405712737	2.734046838	1.358425783	1.425087266	11.31612961	3.805529857	0.200921585	0	0.014351423	4.924944037	10.02704603	14.89272708	0.196136705	1.162468627	0	0	2.384734908	0	0	0	0	0	0	0	0	0	0	0	0.087290539	0	0	0	0	0	0	0	0	70.0044
H1804_091_0	2008	9	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		246.936986	5.333516	595.816201	49.257674	6.629991	12.895029	6.406964	352.686376	53.372097	17.948638	0.947634		0.067688	23.228312	8271.780875	6142.854764	0.925071	5.482739			11.247512									0.08		3415.938646	36.005187	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							565.149359	565.148782	26.064756	0	0.181556	0.181556	0.181556	45.389113	0.181556	0.181556	0.181556		0.181561	0.181556	13.616729	27.23346	0.181556	0.181556			0.181556									0		0	27.233469	0	0							11.6297	0.251185839	1.294150325	0	1.203714646	2.341169885	1.163222756	1.334010148	9.690024443	3.258682921	0.172048639	0	0.012289501	4.217239413	9.386216544	13.94093246	0.16795219	0.995424162	0	0	2.042053289	0	0	0	0	0	0	0	0	0	0	0	0.081712179	0	0	0	0	0	0	0	0	63.1817	0	6.277717664	11.6297	0.251185839	1.294150325	0	1.203714646	2.341169885	1.163222756	1.334010148	9.690024443	3.258682921	0.172048639	0	0.012289501	4.217239413	9.386216544	13.94093246	0.16795219	0.995424162	0	0	2.042053289	0	0	0	0	0	0	0	0	0	0	0	0.081712179	0	0	0	0	0	0	0	0	63.1817	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.6297	0.251185839	1.294150325	0	1.203714646	2.341169885	1.163222756	1.334010148	9.690024443	3.258682921	0.172048639	0	0.012289501	4.217239413	9.386216544	13.94093246	0.16795219	0.995424162	0	0	2.042053289	0	0	0	0	0	0	0	0	0	0	0	0.081712179	0	0	0	0	0	0	0	0	63.1817
H1804_093_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		289.236408	6.247129	697.877386	57.695337	9.095918	17.691142	8.789939	413.100292	73.223053	24.624366	1.300092		0.092864	31.867737	9688.707363	7195.103822	1.269138	7.521962			15.430857									0.08		4001.076722	42.172748	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							540.653116	540.652623	24.954523	0	0.173823	0.173822	0.173823	43.455744	0.173822	0.173822	0.173822		0.173824	0.173822	13.036724	26.07345	0.173823	0.173822			0.173822									0		0	26.073482	0	0							13.0314	0.281460557	1.45126644	0	1.581079755	3.075109685	1.527893567	1.495965045	12.72777752	4.280256547	0.225984592	0	0.016141992	5.539313781	10.52575032	15.63343165	0.220605375	1.307482479	0	0	2.682222425	0	0	0	0	0	0	0	0	0	0	0	0.091632532	0	0	0	0	0	0	0	0	75.6948	0	11.16704996	13.0314	0.281460557	1.45126644	0	1.581079755	3.075109685	1.527893567	1.495965045	12.72777752	4.280256547	0.225984592	0	0.016141992	5.539313781	10.52575032	15.63343165	0.220605375	1.307482479	0	0	2.682222425	0	0	0	0	0	0	0	0	0	0	0	0.091632532	0	0	0	0	0	0	0	0	75.6948	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	13.0314	0.281460557	1.45126644	0	1.581079755	3.075109685	1.527893567	1.495965045	12.72777752	4.280256547	0.225984592	0	0.016141992	5.539313781	10.52575032	15.63343165	0.220605375	1.307482479	0	0	2.682222425	0	0	0	0	0	0	0	0	0	0	0	0.091632532	0	0	0	0	0	0	0	0	75.6948
H1804_094_0	2008	9	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		260.51481	5.626779	628.57714	51.966106	7.379135	14.352079	7.130908	372.078828	59.402781	19.976712	1.05471		0.075336	25.852954	8726.604533	6480.619476	1.029598	6.102251			12.518405									0.08		3603.763944	37.984931	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							557.480012	557.479227	25.718174	0	0.179142	0.179142	0.179142	44.785537	0.179142	0.179142	0.179142		0.179139	0.179142	13.435665	26.87133	0.179142	0.179142			0.179142									0		0	26.871237	0	0							12.1026	0.261401034	1.347154688	0	1.321913002	2.571060136	1.277445121	1.388645843	10.64153299	3.578668141	0.188942859	0	0.013495616	4.631349885	9.770644591	14.51190538	0.184444245	1.093169449	0	0	2.242572109	0	0	0	0	0	0	0	0	0	0	0	0.085058507	0	0	0	0	0	0	0	0	67.2121	0	7.658173939	12.1026	0.261401034	1.347154688	0	1.321913002	2.571060136	1.277445121	1.388645843	10.64153299	3.578668141	0.188942859	0	0.013495616	4.631349885	9.770644591	14.51190538	0.184444245	1.093169449	0	0	2.242572109	0	0	0	0	0	0	0	0	0	0	0	0.085058507	0	0	0	0	0	0	0	0	67.2121	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.1026	0.261401034	1.347154688	0	1.321913002	2.571060136	1.277445121	1.388645843	10.64153299	3.578668141	0.188942859	0	0.013495616	4.631349885	9.770644591	14.51190538	0.184444245	1.093169449	0	0	2.242572109	0	0	0	0	0	0	0	0	0	0	0	0.085058507	0	0	0	0	0	0	0	0	67.2121
H1804_095_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		282.571304	6.103171	681.795643	56.365818	8.681524	16.885166	8.389485	403.580894	69.887143	23.502524	1.240862		0.088633	30.415901	9465.442784	7029.301331	1.211318	7.179275			14.727855									0.08		3908.876734	41.200928	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							544.611859	544.611036	25.135212	0	0.175081	0.175081	0.175081	43.770398	0.175081	0.175081	0.175081		0.175085	0.175081	13.131119	26.262239	0.175081	0.175081			0.175081									0		0	26.262158	0	0							12.8243	0.276987857	1.428089836	0	1.519969903	2.956271748	1.468839423	1.472074696	12.23591088	4.114845404	0.21725136	0	0.015518309	5.325246363	10.35765463	15.38376596	0.212078767	1.256954646	0	0	2.578567581	0	0	0	0	0	0	0	0	0	0	0	0.090168773	0	0	0	0	0	0	0	0	73.7345	0	10.27807226	12.8243	0.276987857	1.428089836	0	1.519969903	2.956271748	1.468839423	1.472074696	12.23591088	4.114845404	0.21725136	0	0.015518309	5.325246363	10.35765463	15.38376596	0.212078767	1.256954646	0	0	2.578567581	0	0	0	0	0	0	0	0	0	0	0	0.090168773	0	0	0	0	0	0	0	0	73.7345	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.8243	0.276987857	1.428089836	0	1.519969903	2.956271748	1.468839423	1.472074696	12.23591088	4.114845404	0.21725136	0	0.015518309	5.325246363	10.35765463	15.38376596	0.212078767	1.256954646	0	0	2.578567581	0	0	0	0	0	0	0	0	0	0	0	0.090168773	0	0	0	0	0	0	0	0	73.7345
H1804_097_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		242.199382	5.23119	584.385182	48.312643	6.378028	12.404971	6.163477	345.91992	51.343765	17.266525	0.91162		0.065116	22.345553	8113.082801	6025.001157	0.889915	5.274375			10.820066									0.08		3350.402228	35.314412	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							567.761243	567.761243	26.183256	0	0.182381	0.182381	0.182381	45.59545	0.182381	0.182381	0.182381		0.182378	0.182381	13.678635	27.35727	0.182381	0.182381			0.182381									0		0	27.35726	0	0							11.4593	0.247505578	1.275092235	0	1.163231125	2.262431016	1.124101099	1.314364535	9.364127204	3.149086096	0.166262167	0	0.011875726	4.075404302	9.24799153	13.73563195	0.162303588	0.961945787	0	0	1.973374457	0	0	0	0	0	0	0	0	0	0	0	0.080508796	0	0	0	0	0	0	0	0	61.7745	0	5.83558759	11.4593	0.247505578	1.275092235	0	1.163231125	2.262431016	1.124101099	1.314364535	9.364127204	3.149086096	0.166262167	0	0.011875726	4.075404302	9.24799153	13.73563195	0.162303588	0.961945787	0	0	1.973374457	0	0	0	0	0	0	0	0	0	0	0	0.080508796	0	0	0	0	0	0	0	0	61.7745	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.4593	0.247505578	1.275092235	0	1.163231125	2.262431016	1.124101099	1.314364535	9.364127204	3.149086096	0.166262167	0	0.011875726	4.075404302	9.24799153	13.73563195	0.162303588	0.961945787	0	0	1.973374457	0	0	0	0	0	0	0	0	0	0	0	0.080508796	0	0	0	0	0	0	0	0	61.7745
H1804_098_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		257.317585	5.557724	620.86279	51.328341	7.199113	14.001945	6.956941	367.512409	57.953588	19.489359	1.028979		0.073499	25.222244	8619.505384	6401.084666	1.00448	5.953381			12.213005									0.08		3559.535968	37.518753	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							559.3	559.3	25.800681	0	0.179717	0.179717	0.179716	44.929258	0.179717	0.179717	0.179717		0.179719	0.179716	13.478775	26.957548	0.179717	0.179716			0.179717									0		0	26.957583	0	0							11.9931	0.259036253	1.334890232	0	1.293802991	2.51638755	1.250273609	1.376004987	10.41524497	3.502569131	0.184925019	0	0.013209167	4.532840803	9.681697807	14.37979559	0.180522132	1.06991782	0	0	2.19488462	0	0	0	0	0	0	0	0	0	0	0	0.084284575	0	0	0	0	0	0	0	0	66.2634	0	7.31764983	11.9931	0.259036253	1.334890232	0	1.293802991	2.51638755	1.250273609	1.376004987	10.41524497	3.502569131	0.184925019	0	0.013209167	4.532840803	9.681697807	14.37979559	0.180522132	1.06991782	0	0	2.19488462	0	0	0	0	0	0	0	0	0	0	0	0.084284575	0	0	0	0	0	0	0	0	66.2634	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.9931	0.259036253	1.334890232	0	1.293802991	2.51638755	1.250273609	1.376004987	10.41524497	3.502569131	0.184925019	0	0.013209167	4.532840803	9.681697807	14.37979559	0.180522132	1.06991782	0	0	2.19488462	0	0	0	0	0	0	0	0	0	0	0	0.084284575	0	0	0	0	0	0	0	0	66.2634
H1804_103_0	2008	9	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		258.555155	5.584454	623.848832	51.575206	7.268525	14.136948	7.024018	369.279962	58.51236	19.67727	1.0389		0.074207	25.46543	8660.96093	6431.870707	1.014165	6.010781			12.330759									0.08		3576.655571	37.699201	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							558.599986	558.60004	25.768843	0	0.179495	0.179495	0.179495	44.873814	0.179495	0.179495	0.179495		0.17949	0.179495	13.462139	26.92428	0.179495	0.179495			0.179495									0		0	26.924279	0	0							12.0357	0.259956352	1.339655217	0	1.304663895	2.537511481	1.260776111	1.380916694	10.50267606	3.531971579	0.186477356	0	0.013319414	4.570917358	9.716254993	14.43112399	0.182037547	1.078905136	0	0	2.213309587	0	0	0	0	0	0	0	0	0	0	0	0.084585317	0	0	0	0	0	0	0	0	66.6308	0	7.448220555	12.0357	0.259956352	1.339655217	0	1.304663895	2.537511481	1.260776111	1.380916694	10.50267606	3.531971579	0.186477356	0	0.013319414	4.570917358	9.716254993	14.43112399	0.182037547	1.078905136	0	0	2.213309587	0	0	0	0	0	0	0	0	0	0	0	0.084585317	0	0	0	0	0	0	0	0	66.6308	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.0357	0.259956352	1.339655217	0	1.304663895	2.537511481	1.260776111	1.380916694	10.50267606	3.531971579	0.186477356	0	0.013319414	4.570917358	9.716254993	14.43112399	0.182037547	1.078905136	0	0	2.213309587	0	0	0	0	0	0	0	0	0	0	0	0.084585317	0	0	0	0	0	0	0	0	66.6308
H1804_122_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		266.568217	5.757525	643.182966	53.173608	7.726041	15.026795	7.466144	380.724575	62.195405	20.915851	1.104294		0.078878	27.068344	8929.378808	6631.205298	1.078001	6.389128			13.106916									0.08		3687.502197	38.867562	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							553.982487	553.982326	25.560073	0	0.17804	0.178041	0.178041	44.510238	0.178041	0.17804	0.178041		0.178045	0.178041	13.353075	26.706149	0.17804	0.178041			0.17804									0		0	26.706176	0	0							12.3062	0.265797258	1.36998363	0	1.37554434	2.675385609	1.329279744	1.412178454	11.0733321	3.723858112	0.196609608	0	0.014043834	4.819275034	9.936222077	14.75782973	0.191927298	1.137526738	0	0	2.333555325	0	0	0	0	0	0	0	0	0	0	0	0.086500329	0	0	0	0	0	0	0	0	69.005	0	8.330692112	12.3062	0.265797258	1.36998363	0	1.37554434	2.675385609	1.329279744	1.412178454	11.0733321	3.723858112	0.196609608	0	0.014043834	4.819275034	9.936222077	14.75782973	0.191927298	1.137526738	0	0	2.333555325	0	0	0	0	0	0	0	0	0	0	0	0.086500329	0	0	0	0	0	0	0	0	69.005	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.3062	0.265797258	1.36998363	0	1.37554434	2.675385609	1.329279744	1.412178454	11.0733321	3.723858112	0.196609608	0	0.014043834	4.819275034	9.936222077	14.75782973	0.191927298	1.137526738	0	0	2.333555325	0	0	0	0	0	0	0	0	0	0	0	0.086500329	0	0	0	0	0	0	0	0	69.005
H1804_125_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		314.441459	6.791523	758.692812	62.723108	10.750286	20.908813	10.388656	449.099266	86.540885	29.103054	1.536553		0.109754	37.663852	10533.01452	7822.109819	1.499969	8.890059			18.237426									0.08		4349.744255	45.847826	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QuitNet							525.426239	525.426017	24.261403	0	0.168994	0.168995	0.168994	42.248751	0.168995	0.168994	0.168995		0.168996	0.168994	12.674624	25.349249	0.168995	0.168995			0.168994									0		0	25.349346	0	0							13.768	0.29737024	1.533912672	0	1.816733832	3.533484853	1.755620532	1.581156922	14.62497686	4.918241508	0.259669774	0	0.018547987	6.364965005	11.12516655	16.52371746	0.253487261	1.502375521	0	0	3.082015569	0	0	0	0	0	0	0	0	0	0	0	0.096851034	0	0	0	0	0	0	0	0	83.0563	0	14.94003566	13.768	0.29737024	1.533912672	0	1.816733832	3.533484853	1.755620532	1.581156922	14.62497686	4.918241508	0.259669774	0	0.018547987	6.364965005	11.12516655	16.52371746	0.253487261	1.502375521	0	0	3.082015569	0	0	0	0	0	0	0	0	0	0	0	0.096851034	0	0	0	0	0	0	0	0	83.0563	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	13.768	0.29737024	1.533912672	0	1.816733832	3.533484853	1.755620532	1.581156922	14.62497686	4.918241508	0.259669774	0	0.018547987	6.364965005	11.12516655	16.52371746	0.253487261	1.502375521	0	0	3.082015569	0	0	0	0	0	0	0	0	0	0	0	0.096851034	0	0	0	0	0	0	0	0	83.0563
H1804_126_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		245.587254	5.304364	592.559533	48.988438	6.557708	12.754441	6.337112	350.75863	52.790209	17.752953	0.937302		0.06695	22.975067	8226.568207	6109.278579	0.914986	5.422964			11.124887									0.08		3397.267491	35.808387	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							565.897508	565.897585	26.098499	0	0.181791	0.181791	0.181791	45.44784	0.181791	0.181791	0.181791		0.181791	0.181791	13.634354	27.26871	0.181791	0.181791			0.181791									0		0	27.268719	0	0							11.5814	0.250143898	1.288742865	0	1.192132295	2.318642584	1.152029928	1.328435175	9.596784884	3.227327079	0.170393068	0	0.012170907	4.176660405	9.346995262	13.88267882	0.16633622	0.985846049	0	0	2.022404333	0	0	0	0	0	0	0	0	0	0	0	0.081370737	0	0	0	0	0	0	0	0	62.7805	0	6.15007856	11.5814	0.250143898	1.288742865	0	1.192132295	2.318642584	1.152029928	1.328435175	9.596784884	3.227327079	0.170393068	0	0.012170907	4.176660405	9.346995262	13.88267882	0.16633622	0.985846049	0	0	2.022404333	0	0	0	0	0	0	0	0	0	0	0	0.081370737	0	0	0	0	0	0	0	0	62.7805	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.5814	0.250143898	1.288742865	0	1.192132295	2.318642584	1.152029928	1.328435175	9.596784884	3.227327079	0.170393068	0	0.012170907	4.176660405	9.346995262	13.88267882	0.16633622	0.985846049	0	0	2.022404333	0	0	0	0	0	0	0	0	0	0	0	0.081370737	0	0	0	0	0	0	0	0	62.7805
H1804_127_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		260.645199	5.629595	628.891749	51.992116	7.386523	14.366448	7.138047	372.265057	59.462254	19.996713	1.055766		0.075412	25.878838	8730.972291	6483.863094	1.030629	6.108361			12.530938									0.08		3605.567665	38.003944	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							557.405008	557.404862	25.714802	0	0.179118	0.179118	0.179118	44.779688	0.179118	0.179118	0.179118		0.179114	0.179118	13.433909	26.867818	0.179118	0.179118			0.179118									0		0	26.867859	0	0							12.1071	0.261496969	1.347652234	0	1.323059227	2.573289433	1.278552703	1.389159425	10.65076001	3.581771239	0.189106694	0	0.013507345	4.635365705	9.77425727	14.51727113	0.184604205	1.094117406	0	0	2.244516553	0	0	0	0	0	0	0	0	0	0	0	0.085090384	0	0	0	0	0	0	0	0	67.2507	0	7.672221872	12.1071	0.261496969	1.347652234	0	1.323059227	2.573289433	1.278552703	1.389159425	10.65076001	3.581771239	0.189106694	0	0.013507345	4.635365705	9.77425727	14.51727113	0.184604205	1.094117406	0	0	2.244516553	0	0	0	0	0	0	0	0	0	0	0	0.085090384	0	0	0	0	0	0	0	0	67.2507	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.1071	0.261496969	1.347652234	0	1.323059227	2.573289433	1.278552703	1.389159425	10.65076001	3.581771239	0.189106694	0	0.013507345	4.635365705	9.77425727	14.51727113	0.184604205	1.094117406	0	0	2.244516553	0	0	0	0	0	0	0	0	0	0	0	0.085090384	0	0	0	0	0	0	0	0	67.2507
H1804_128_0	2008	11	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		263.49075	5.691056	635.757568	52.559731	7.548674	14.681825	7.294744	376.329199	60.767589	20.435686	1.078943		0.077067	26.446938	8826.291212	6554.649578	1.053253	6.242454			12.806021									0.08		3644.930845	38.418846	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							555.761892	555.761563	25.640839	0	0.178603	0.178603	0.178603	44.65089	0.178603	0.178603	0.178603		0.178598	0.178603	13.395269	26.790538	0.178603	0.178603			0.178603									0		0	26.790507	0	0							12.2032	0.263572515	1.358446454	0	1.348215822	2.62221799	1.302863163	1.400286139	10.8532737	3.649874827	0.192702457	0	0.013764012	4.723502468	9.852545421	14.63354905	0.188114146	1.114921012	0	0	2.287193769	0	0	0	0	0	0	0	0	0	0	0	0.085771697	0	0	0	0	0	0	0	0	68.094	0	7.983948659	12.2032	0.263572515	1.358446454	0	1.348215822	2.62221799	1.302863163	1.400286139	10.8532737	3.649874827	0.192702457	0	0.013764012	4.723502468	9.852545421	14.63354905	0.188114146	1.114921012	0	0	2.287193769	0	0	0	0	0	0	0	0	0	0	0	0.085771697	0	0	0	0	0	0	0	0	68.094	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.2032	0.263572515	1.358446454	0	1.348215822	2.62221799	1.302863163	1.400286139	10.8532737	3.649874827	0.192702457	0	0.013764012	4.723502468	9.852545421	14.63354905	0.188114146	1.114921012	0	0	2.287193769	0	0	0	0	0	0	0	0	0	0	0	0.085771697	0	0	0	0	0	0	0	0	68.094
H1804_129_0	2008	9	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		272.825694	5.892679	658.281172	54.421816	8.093019	15.740551	7.820777	389.66178	65.149618	21.90933	1.156747		0.082625	28.354062	9138.988839	6786.867541	1.129205	6.692605			13.72948									0.08		3774.063365	39.779948	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							550.348766	550.348096	25.394837	0	0.17689	0.176889	0.176889	44.222506	0.176889	0.17689	0.176889		0.17689	0.17689	13.266749	26.5335	0.17689	0.17689			0.17689									0		0	26.533534	0	0							12.5124	0.270252056	1.393078589	0	1.431574131	2.784330326	1.383409423	1.435985034	11.52425078	3.875541384	0.20461582	0	0.014615536	5.015550027	10.10372259	15.00661249	0.199745072	1.183854898	0	0	2.428607717	0	0	0	0	0	0	0	0	0	0	0	0.08795855	0	0	0	0	0	0	0	0	70.8561	0	9.063189671	12.5124	0.270252056	1.393078589	0	1.431574131	2.784330326	1.383409423	1.435985034	11.52425078	3.875541384	0.20461582	0	0.014615536	5.015550027	10.10372259	15.00661249	0.199745072	1.183854898	0	0	2.428607717	0	0	0	0	0	0	0	0	0	0	0	0.08795855	0	0	0	0	0	0	0	0	70.8561	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.5124	0.270252056	1.393078589	0	1.431574131	2.784330326	1.383409423	1.435985034	11.52425078	3.875541384	0.20461582	0	0.014615536	5.015550027	10.10372259	15.00661249	0.199745072	1.183854898	0	0	2.428607717	0	0	0	0	0	0	0	0	0	0	0	0.08795855	0	0	0	0	0	0	0	0	70.8561
H1804_130_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		234.703576	5.069291	566.299101	46.817419	5.989352	11.649016	5.787875	335.214077	48.214891	16.214308	0.856067		0.061148	20.983822	7861.991781	5838.533974	0.835684	4.952956			10.160695									0.08		3246.710953	34.221468	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							571.846269	571.847175	26.366985	0	0.183661	0.183661	0.183661	45.915389	0.183661	0.183661	0.183661		0.183667	0.183661	13.77462	27.54924	0.183661	0.183661			0.183661									0		0	27.549346	0	0							11.1845	0.241571645	1.244299992	0	1.100010378	2.139469928	1.06300691	1.282623729	8.855195096	2.977936022	0.157226121	0	0.01123087	3.853909732	9.024662436	13.40393114	0.153482559	0.909664852	0	0	1.866123404	0	0	0	0	0	0	0	0	0	0	0	0.078564922	0	0	0	0	0	0	0	0	59.5474	0	5.178606847	11.1845	0.241571645	1.244299992	0	1.100010378	2.139469928	1.06300691	1.282623729	8.855195096	2.977936022	0.157226121	0	0.01123087	3.853909732	9.024662436	13.40393114	0.153482559	0.909664852	0	0	1.866123404	0	0	0	0	0	0	0	0	0	0	0	0.078564922	0	0	0	0	0	0	0	0	59.5474	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.1845	0.241571645	1.244299992	0	1.100010378	2.139469928	1.06300691	1.282623729	8.855195096	2.977936022	0.157226121	0	0.01123087	3.853909732	9.024662436	13.40393114	0.153482559	0.909664852	0	0	1.866123404	0	0	0	0	0	0	0	0	0	0	0	0.078564922	0	0	0	0	0	0	0	0	59.5474
H1804_131_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		264.976694	5.723151	639.342896	52.856139	7.634061	14.847898	7.377257	378.45149	61.454959	20.666844	1.091147		0.077939	26.746091	8876.066705	6591.614243	1.065167	6.313065			12.950876									0.08		3665.486276	38.635506	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							554.90123	554.901657	25.601996	0	0.178332	0.178333	0.178333	44.583244	0.178333	0.178333	0.178332		0.178335	0.178333	13.374974	26.74995	0.178332	0.178333			0.178332									0		0	26.750015	0	0							12.253	0.264648831	1.364037856	0	1.361397366	2.647870194	1.315608373	1.406049593	10.9594472	3.685580291	0.194586427	0	0.013899252	4.769710646	9.893096783	14.69377928	0.189953361	1.125827821	0	0	2.309555619	0	0	0	0	0	0	0	0	0	0	0	0.08612503	0	0	0	0	0	0	0	0	68.5342	0	8.149987016	12.253	0.264648831	1.364037856	0	1.361397366	2.647870194	1.315608373	1.406049593	10.9594472	3.685580291	0.194586427	0	0.013899252	4.769710646	9.893096783	14.69377928	0.189953361	1.125827821	0	0	2.309555619	0	0	0	0	0	0	0	0	0	0	0	0.08612503	0	0	0	0	0	0	0	0	68.5342	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.253	0.264648831	1.364037856	0	1.361397366	2.647870194	1.315608373	1.406049593	10.9594472	3.685580291	0.194586427	0	0.013899252	4.769710646	9.893096783	14.69377928	0.189953361	1.125827821	0	0	2.309555619	0	0	0	0	0	0	0	0	0	0	0	0.08612503	0	0	0	0	0	0	0	0	68.5342
H1804_132_0	2008	9	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		263.13224	5.683312	634.892545	52.488218	7.528155	14.641917	7.274915	375.817158	60.602409	20.380138	1.07601		0.076858	26.37505	8814.281996	6545.7312	1.050391	6.225485			12.771212									0.08		3639.971484	38.366572	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							555.969368	555.969688	25.650195	0	0.178668	0.178668	0.178668	44.667204	0.178668	0.178668	0.178668		0.178673	0.178668	13.400159	26.80032	0.178668	0.178668			0.178668									0		0	26.800199	0	0							12.1911	0.263312433	1.357093132	0	1.345040398	2.616042027	1.299794513	1.398891805	10.82771121	3.641278496	0.192248555	0	0.013732449	4.712377433	9.842731685	14.61897423	0.187671259	1.112294954	0	0	2.281806906	0	0	0	0	0	0	0	0	0	0	0	0.08568598	0	0	0	0	0	0	0	0	67.9878	0	7.94420134	12.1911	0.263312433	1.357093132	0	1.345040398	2.616042027	1.299794513	1.398891805	10.82771121	3.641278496	0.192248555	0	0.013732449	4.712377433	9.842731685	14.61897423	0.187671259	1.112294954	0	0	2.281806906	0	0	0	0	0	0	0	0	0	0	0	0.08568598	0	0	0	0	0	0	0	0	67.9878	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.1911	0.263312433	1.357093132	0	1.345040398	2.616042027	1.299794513	1.398891805	10.82771121	3.641278496	0.192248555	0	0.013732449	4.712377433	9.842731685	14.61897423	0.187671259	1.112294954	0	0	2.281806906	0	0	0	0	0	0	0	0	0	0	0	0.08568598	0	0	0	0	0	0	0	0	67.9878
H1804_133_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		302.747898	6.538959	730.478271	60.390538	9.965575	19.382587	9.630342	432.398001	80.223887	26.978694	1.424394		0.101742	34.914602	10141.30898	7531.218381	1.39048	8.241135			16.906196									0.08		4187.984399	44.14282	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							532.526885	532.527217	24.585142	0	0.17125	0.171249	0.17125	42.812491	0.17125	0.171249	0.17125		0.171246	0.17125	12.843749	25.687501	0.17125	0.17125			0.171249									0		0	25.687488	0	0							13.4351	0.290181137	1.496576002	0	1.706604719	3.319248641	1.649196068	1.542669627	13.73834065	4.620074369	0.243927473	0	0.017422911	5.979125593	10.85436892	16.12151497	0.2381197	1.411294369	0	0	2.895169159	0	0	0	0	0	0	0	0	0	0	0	0.09449318	0	0	0	0	0	0	0	0	79.6534	0	13.10598909	13.4351	0.290181137	1.496576002	0	1.706604719	3.319248641	1.649196068	1.542669627	13.73834065	4.620074369	0.243927473	0	0.017422911	5.979125593	10.85436892	16.12151497	0.2381197	1.411294369	0	0	2.895169159	0	0	0	0	0	0	0	0	0	0	0	0.09449318	0	0	0	0	0	0	0	0	79.6534	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	13.4351	0.290181137	1.496576002	0	1.706604719	3.319248641	1.649196068	1.542669627	13.73834065	4.620074369	0.243927473	0	0.017422911	5.979125593	10.85436892	16.12151497	0.2381197	1.411294369	0	0	2.895169159	0	0	0	0	0	0	0	0	0	0	0	0.09449318	0	0	0	0	0	0	0	0	79.6534
H1804_137_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		245.115317	5.294171	591.42083	48.894298	6.532526	12.705464	6.312777	350.084587	52.587493	17.684782	0.933703		0.066693	22.886842	8210.759464	6097.538564	0.911472	5.40214			11.082167									0.08		3390.739067	35.739576	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							566.15876	566.158601	26.110292	0	0.181873	0.181873	0.181873	45.468406	0.181873	0.181873	0.181873		0.181879	0.181873	13.640519	27.281039	0.181873	0.181873			0.181873									0		0	27.281058	0	0							11.5645	0.249778371	1.286847547	0	1.188090101	2.310780854	1.148123691	1.326482345	9.564245114	3.216384357	0.169815366	0	0.012130056	4.162498615	9.333251706	13.86226561	0.165772147	0.982503408	0	0	2.015546959	0	0	0	0	0	0	0	0	0	0	0	0.08125112	0	0	0	0	0	0	0	0	62.6403	0	6.105763916	11.5645	0.249778371	1.286847547	0	1.188090101	2.310780854	1.148123691	1.326482345	9.564245114	3.216384357	0.169815366	0	0.012130056	4.162498615	9.333251706	13.86226561	0.165772147	0.982503408	0	0	2.015546959	0	0	0	0	0	0	0	0	0	0	0	0.08125112	0	0	0	0	0	0	0	0	62.6403	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.5645	0.249778371	1.286847547	0	1.188090101	2.310780854	1.148123691	1.326482345	9.564245114	3.216384357	0.169815366	0	0.012130056	4.162498615	9.333251706	13.86226561	0.165772147	0.982503408	0	0	2.015546959	0	0	0	0	0	0	0	0	0	0	0	0.08125112	0	0	0	0	0	0	0	0	62.6403
H1804_138_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		260.166679	5.61926	627.737162	51.896663	7.359418	14.31373	7.111853	371.581613	59.244054	19.923333	1.051892		0.075135	25.783874	8714.94304	6471.959327	1.026847	6.085946			12.484955									0.08		3598.94818	37.934171	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							557.67938	557.679772	25.727216	0	0.179205	0.179205	0.179205	44.801308	0.179205	0.179205	0.179204		0.179205	0.179205	13.44039	26.880779	0.179204	0.179205			0.179205									0		0	26.880658	0	0							12.0908	0.261145636	1.345827463	0	1.318844503	2.565091985	1.274479617	1.387278524	10.6168307	3.57036089	0.188503254	0	0.013464568	4.62059914	9.76101944	14.49760903	0.18401509	1.090631953	0	0	2.237366361	0	0	0	0	0	0	0	0	0	0	0	0.084974623	0	0	0	0	0	0	0	0	67.1088	0	7.620537997	12.0908	0.261145636	1.345827463	0	1.318844503	2.565091985	1.274479617	1.387278524	10.6168307	3.57036089	0.188503254	0	0.013464568	4.62059914	9.76101944	14.49760903	0.18401509	1.090631953	0	0	2.237366361	0	0	0	0	0	0	0	0	0	0	0	0.084974623	0	0	0	0	0	0	0	0	67.1088	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.0908	0.261145636	1.345827463	0	1.318844503	2.565091985	1.274479617	1.387278524	10.6168307	3.57036089	0.188503254	0	0.013464568	4.62059914	9.76101944	14.49760903	0.18401509	1.090631953	0	0	2.237366361	0	0	0	0	0	0	0	0	0	0	0	0.084974623	0	0	0	0	0	0	0	0	67.1088
H1804_145_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		295.953921	6.392218	714.085583	59.035312	9.523317	18.522414	9.202961	422.694543	76.663659	25.781417	1.361181		0.097227	33.36514	9913.727526	7362.210059	1.328772	7.875404			16.155922									0.08		4094.001703	43.152209	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							536.628759	536.628716	24.771831	0	0.17255	0.17255	0.17255	43.137593	0.17255	0.17255	0.17255		0.172546	0.17255	12.941279	25.882559	0.17255	0.17255			0.17255									0		0	25.882674	0	0							13.2348	0.285853978	1.474100615	0	1.643248348	3.196042536	1.587970921	1.519502097	13.22831436	4.448583503	0.234871782	0	0.01677613	5.757154907	10.69135949	15.87940302	0.229279609	1.35890096	0	0	2.787704341	0	0	0	0	0	0	0	0	0	0	0	0.093074546	0	0	0	0	0	0	0	0	77.6669	0	12.10642786	13.2348	0.285853978	1.474100615	0	1.643248348	3.196042536	1.587970921	1.519502097	13.22831436	4.448583503	0.234871782	0	0.01677613	5.757154907	10.69135949	15.87940302	0.229279609	1.35890096	0	0	2.787704341	0	0	0	0	0	0	0	0	0	0	0	0.093074546	0	0	0	0	0	0	0	0	77.6669	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	13.2348	0.285853978	1.474100615	0	1.643248348	3.196042536	1.587970921	1.519502097	13.22831436	4.448583503	0.234871782	0	0.01677613	5.757154907	10.69135949	15.87940302	0.229279609	1.35890096	0	0	2.787704341	0	0	0	0	0	0	0	0	0	0	0	0.093074546	0	0	0	0	0	0	0	0	77.6669
H1804_146_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		284.979856	6.155192	687.607062	56.846263	8.830161	17.174258	8.533122	407.020895	71.083685	23.904913	1.262107		0.090151	30.936654	9546.123351	7089.216964	1.232057	7.302192			14.980011									0.08		3942.194814	41.552111	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							543.182506	543.182641	25.070263	0	0.174629	0.174629	0.174629	43.657289	0.174629	0.174629	0.174628		0.174627	0.174629	13.097189	26.194379	0.174628	0.174629			0.174629									0		0	26.19431	0	0							12.8997	0.278616121	1.436540824	0	1.542002185	2.9991235	1.490130562	1.480785737	12.41327283	4.174491052	0.220399221	0	0.015742799	5.402436951	10.41894848	15.474803	0.21515165	1.275174487	0	0	2.615944341	0	0	0	0	0	0	0	0	0	0	0	0.090702406	0	0	0	0	0	0	0	0	74.4439	0	10.59361484	12.8997	0.278616121	1.436540824	0	1.542002185	2.9991235	1.490130562	1.480785737	12.41327283	4.174491052	0.220399221	0	0.015742799	5.402436951	10.41894848	15.474803	0.21515165	1.275174487	0	0	2.615944341	0	0	0	0	0	0	0	0	0	0	0	0.090702406	0	0	0	0	0	0	0	0	74.4439	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.8997	0.278616121	1.436540824	0	1.542002185	2.9991235	1.490130562	1.480785737	12.41327283	4.174491052	0.220399221	0	0.015742799	5.402436951	10.41894848	15.474803	0.21515165	1.275174487	0	0	2.615944341	0	0	0	0	0	0	0	0	0	0	0	0.090702406	0	0	0	0	0	0	0	0	74.4439
H1804_147_0	2008	6	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)																				A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0	0	0	0									0		277.679763	5.99752	669.993201	55.39008	168.005277	16.305653	8.101551	396.594577	345.573837	5948.894378	3883.137243		11.292073	1386.241505	9301.588211	6907.618362	75.347426	1662.994413			14.222383									0.08	0.18	0.02	3.4									$550/Admit	$950/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$25-$100/Visit	$15-$100/Visit	$0-$100/Visit		$25/Proc	$25-$100/Visit	$10/Visit	$25/Visit	$25-$100/Visit	$100/Visit			20% Coins									Active Outlook Newsletter	See PBP	Quit Net	Silver Sneakers									549.999994	950.000667	28.71	0	100.000001	0.2	0.199999	49.999987	73.300306	42.672802	1.079702		24.999838	64.665528	10	25	59.698973	100.000001			0.2									0	0	0	0									12.727	0.474804	1.602958733	0	1.400043989	3.2611306	1.620302098	1.652476975	2.110889	21.15466599	0.349385921	0	0.023525	7.470169905	7.751323509	14.39087159	0.374846996	13.85828691	0	0	2.8444766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0671	0	0	12.727	0.474804	1.602958733	0	1.400043989	3.2611306	1.620302098	1.652476975	2.110889	21.15466599	0.349385921	0	0.023525	7.470169905	7.751323509	14.39087159	0.374846996	13.85828691	0	0	2.8444766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0671																																											0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0	0	0	0									0	0	0	12.727	0.474804	1.602958733	0	1.400043989	3.2611306	1.620302098	1.652476975	2.110889	21.15466599	0.349385921	0	0.023525	7.470169905	7.751323509	14.39087159	0.374846996	13.85828691	0	0	2.8444766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0671
H1804_148_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		250.536774	5.411266	604.501869	49.975741	6.824698	13.273725	6.595121	357.827756	54.939508	18.475746	0.975464		0.069676	23.910473	8392.36495	6232.403855	0.952238	5.643754			11.577825									0.08		3465.735395	36.530063	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							563.131236	563.131708	25.974191	0	0.180925	0.180925	0.180925	45.2314	0.180925	0.180925	0.180925		0.180923	0.180925	13.569419	27.138838	0.180925	0.180925			0.180925									0		0	27.138793	0	0							11.7571	0.253937955	1.308453917	0	1.234758486	2.401548696	1.193222267	1.348754197	9.939930485	3.342724345	0.176485824	0	0.012605991	4.326002328	9.489959701	14.09501655	0.17228366	1.021096192	0	0	2.094717988	0	0	0	0	0	0	0	0	0	0	0	0.082615152	0	0	0	0	0	0	0	0	64.2512	0	6.62632601	11.7571	0.253937955	1.308453917	0	1.234758486	2.401548696	1.193222267	1.348754197	9.939930485	3.342724345	0.176485824	0	0.012605991	4.326002328	9.489959701	14.09501655	0.17228366	1.021096192	0	0	2.094717988	0	0	0	0	0	0	0	0	0	0	0	0.082615152	0	0	0	0	0	0	0	0	64.2512	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.7571	0.253937955	1.308453917	0	1.234758486	2.401548696	1.193222267	1.348754197	9.939930485	3.342724345	0.176485824	0	0.012605991	4.326002328	9.489959701	14.09501655	0.17228366	1.021096192	0	0	2.094717988	0	0	0	0	0	0	0	0	0	0	0	0.082615152	0	0	0	0	0	0	0	0	64.2512
H1804_149_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		253.296747	5.470878	611.161208	50.526286	6.975893	13.567792	6.74123	361.769672	56.156642	18.88506	0.997074		0.07122	24.440187	8484.817264	6301.061518	0.973334	5.768786			11.834321									0.08		3503.914771	36.932487	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							561.580628	561.581487	25.90379	0	0.180435	0.180435	0.180435	45.10881	0.180435	0.180435	0.180435		0.180435	0.180435	13.53264	27.065278	0.180435	0.180435			0.180435									0		0	27.065216	0	0							11.8539	0.25602865	1.319282632	0	1.258695253	2.44810455	1.216353835	1.359916617	10.1326237	3.407525801	0.179907047	0	0.012850581	4.409865141	9.568498125	14.21166514	0.17562352	1.040890902	0	0	2.13532571	0	0	0	0	0	0	0	0	0	0	0	0.083298812	0	0	0	0	0	0	0	0	65.0703	0	6.902774966	11.8539	0.25602865	1.319282632	0	1.258695253	2.44810455	1.216353835	1.359916617	10.1326237	3.407525801	0.179907047	0	0.012850581	4.409865141	9.568498125	14.21166514	0.17562352	1.040890902	0	0	2.13532571	0	0	0	0	0	0	0	0	0	0	0	0.083298812	0	0	0	0	0	0	0	0	65.0703	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.8539	0.25602865	1.319282632	0	1.258695253	2.44810455	1.216353835	1.359916617	10.1326237	3.407525801	0.179907047	0	0.012850581	4.409865141	9.568498125	14.21166514	0.17562352	1.040890902	0	0	2.13532571	0	0	0	0	0	0	0	0	0	0	0	0.083298812	0	0	0	0	0	0	0	0	65.0703
H1804_150_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		285.542687	6.167349	688.965077	56.958534	8.865065	17.242146	8.566853	407.824756	71.36467	23.999406	1.267096		0.090507	31.058942	9564.976805	7103.218063	1.236927	7.331057			15.039226									0.08		3949.980593	41.634177	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QuitNet							542.848751	542.848591	25.054912	0	0.174522	0.174522	0.174522	43.630554	0.174522	0.174522	0.174522		0.174518	0.174522	13.089164	26.178329	0.174521	0.174522			0.174522									0		0	26.178218	0	0							12.9172	0.278994726	1.438496615	0	1.547148874	3.009133804	1.495104319	1.48280167	12.45470494	4.188424334	0.221136128	0	0.015795101	5.420468676	10.43312917	15.49586495	0.215869737	1.27943073	0	0	2.6246758	0	0	0	0	0	0	0	0	0	0	0	0.090825713	0	0	0	0	0	0	0	0	74.6092	0	10.66864238	12.9172	0.278994726	1.438496615	0	1.547148874	3.009133804	1.495104319	1.48280167	12.45470494	4.188424334	0.221136128	0	0.015795101	5.420468676	10.43312917	15.49586495	0.215869737	1.27943073	0	0	2.6246758	0	0	0	0	0	0	0	0	0	0	0	0.090825713	0	0	0	0	0	0	0	0	74.6092	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.9172	0.278994726	1.438496615	0	1.547148874	3.009133804	1.495104319	1.48280167	12.45470494	4.188424334	0.221136128	0	0.015795101	5.420468676	10.43312917	15.49586495	0.215869737	1.27943073	0	0	2.6246758	0	0	0	0	0	0	0	0	0	0	0	0.090825713	0	0	0	0	0	0	0	0	74.6092
H1804_151_0	2008	14	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		265.268111	5.729445	640.046033	52.91427	7.650858	14.880568	7.393489	378.867704	61.590177	20.712317	1.093548		0.078111	26.804941	8885.828434	6598.863576	1.067511	6.326955			12.979371									0.08		3669.517508	38.677998	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							554.733107	554.73388	25.594323	0	0.178279	0.178279	0.178279	44.569887	0.178279	0.178279	0.178279		0.178277	0.178279	13.37097	26.74194	0.178279	0.178279			0.178279									0		0	26.741941	0	0							12.2628	0.264859771	1.365128742	0	1.363987313	2.652892782	1.318103825	1.40717423	10.98023517	3.692571162	0.194956644	0	0.013925395	4.778758077	9.901012118	14.70553448	0.190314794	1.12796321	0	0	2.313949283	0	0	0	0	0	0	0	0	0	0	0	0.086193728	0	0	0	0	0	0	0	0	68.6203	0	8.182888543	12.2628	0.264859771	1.365128742	0	1.363987313	2.652892782	1.318103825	1.40717423	10.98023517	3.692571162	0.194956644	0	0.013925395	4.778758077	9.901012118	14.70553448	0.190314794	1.12796321	0	0	2.313949283	0	0	0	0	0	0	0	0	0	0	0	0.086193728	0	0	0	0	0	0	0	0	68.6203	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.2628	0.264859771	1.365128742	0	1.363987313	2.652892782	1.318103825	1.40717423	10.98023517	3.692571162	0.194956644	0	0.013925395	4.778758077	9.901012118	14.70553448	0.190314794	1.12796321	0	0	2.313949283	0	0	0	0	0	0	0	0	0	0	0	0.086193728	0	0	0	0	0	0	0	0	68.6203
H1804_152_0	2008	14	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		291.725979	6.3009	703.88429	58.191944	9.253162	17.996976	8.941893	416.656007	74.488888	25.050057	1.322567		0.094469	32.418647	9772.101878	7257.034909	1.291078	7.651997			15.697616									0.08		4035.515563	42.535745	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							539.16561	539.16583	24.886965	0	0.173352	0.173352	0.173352	43.338107	0.173352	0.173352	0.173352		0.173354	0.173352	13.001429	26.002859	0.173352	0.173352			0.173352									0		0	26.002771	0	0							13.1074	0.283102498	1.459795307	0	1.604054139	3.119811784	1.550095035	1.504756884	12.91279771	4.342477481	0.229269635	0	0.016376579	5.619837295	10.5876074	15.72530462	0.223810953	1.326488984	0	0	2.721213129	0	0	0	0	0	0	0	0	0	0	0	0.092170603	0	0	0	0	0	0	0	0	76.4264	0	11.50981086	13.1074	0.283102498	1.459795307	0	1.604054139	3.119811784	1.550095035	1.504756884	12.91279771	4.342477481	0.229269635	0	0.016376579	5.619837295	10.5876074	15.72530462	0.223810953	1.326488984	0	0	2.721213129	0	0	0	0	0	0	0	0	0	0	0	0.092170603	0	0	0	0	0	0	0	0	76.4264	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	13.1074	0.283102498	1.459795307	0	1.604054139	3.119811784	1.550095035	1.504756884	12.91279771	4.342477481	0.229269635	0	0.016376579	5.619837295	10.5876074	15.72530462	0.223810953	1.326488984	0	0	2.721213129	0	0	0	0	0	0	0	0	0	0	0	0.092170603	0	0	0	0	0	0	0	0	76.4264
H1804_153_0	2008	15	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1489.777438	47.474404	593.430055	49.060406	148.806556	12.79195	6.355749	351.273925	306.083556	5269.087373	3439.39363		10.001677	1227.829434	8238.653754	6118.253643	66.737136	1472.956538			11.157603									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									113.684365	113.684341	25.24031	0	87.906825	0.175813	0.175813	43.953389	77.252567	0	0.474703		43.953764	43.9534	13.186019	26.372041	34.506098	43.9534			0.175813									0		0	0									14.1137	0.449758028	1.248196546	0	1.090092656	2.248991105	1.117423299	1.286639956	1.970478368	0	0.13605754	0	0.036634279	4.497273187	9.052920411	13.44590299	0.19190318	5.395120658	0	0	1.961651656	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2427	0	7.821552704	14.1137	0.449758028	1.248196546	0	1.090092656	2.248991105	1.117423299	1.286639956	1.970478368	0	0.13605754	0	0.036634279	4.497273187	9.052920411	13.44590299	0.19190318	5.395120658	0	0	1.961651656	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2427	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.1137	0.449758028	1.248196546	0	1.090092656	2.248991105	1.117423299	1.286639956	1.970478368	0	0.13605754	0	0.036634279	4.497273187	9.052920411	13.44590299	0.19190318	5.395120658	0	0	1.961651656	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2427
H1804_154_0	2008	14	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1591.514447	50.716435	633.955436	52.410744	158.968566	14.598714	7.25345	375.262446	326.986024	5628.91373	3674.270069		10.684691	1311.677994	8801.27201	6536.069622	71.29462	1573.544846			12.733529									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									111.897408	111.897377	24.853167	0	86.558496	0.173117	0.173117	43.279263	76.067684	0	0.467423		43.279691	43.27925	12.983774	25.967549	33.976859	43.27925			0.173117									0		0	0									14.8405	0.472919671	1.31298336	0	1.146673332	2.527285572	1.255695504	1.353423508	2.072755796	0	0.143119862	0	0.038535844	4.730703318	9.522810558	14.14380901	0.201863938	5.675153398	0	0	2.20439034	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6427	0	9.346716926	14.8405	0.472919671	1.31298336	0	1.146673332	2.527285572	1.255695504	1.353423508	2.072755796	0	0.143119862	0	0.038535844	4.730703318	9.522810558	14.14380901	0.201863938	5.675153398	0	0	2.20439034	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6427	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.8405	0.472919671	1.31298336	0	1.146673332	2.527285572	1.255695504	1.353423508	2.072755796	0	0.143119862	0	0.038535844	4.730703318	9.522810558	14.14380901	0.201863938	5.675153398	0	0	2.20439034	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6427
H1804_155_0	2008	18	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1609.762942	51.297955	641.224445	53.011692	160.791319	14.935415	7.42074	379.565251	330.735286	5693.455528	3716.399689		10.807203	1326.717851	8902.188447	6611.012979	72.112092	1591.587298			13.027211									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									111.577072	111.577005	24.783918	0	86.317322	0.172634	0.172634	43.158653	75.855713	0	0.466121		43.158638	43.158657	12.947595	25.895189	33.882178	43.158651			0.172634									0		0	0									14.9677	0.476972682	1.324337839	0	1.156589671	2.578360433	1.281072029	1.36512708	2.090680078	0	0.144357662	0	0.03886868	4.771613389	9.605160885	14.26611921	0.203609561	5.724230061	0	0	2.248939544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2438	0	9.634508602	14.9677	0.476972682	1.324337839	0	1.156589671	2.578360433	1.281072029	1.36512708	2.090680078	0	0.144357662	0	0.03886868	4.771613389	9.605160885	14.26611921	0.203609561	5.724230061	0	0	2.248939544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2438	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.9677	0.476972682	1.324337839	0	1.156589671	2.578360433	1.281072029	1.36512708	2.090680078	0	0.144357662	0	0.03886868	4.771613389	9.605160885	14.26611921	0.203609561	5.724230061	0	0	2.248939544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2438
H1804_156_0	2008	8	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1535.643288	48.936001	611.700015	50.570832	153.38787	13.591718	6.753117	362.088612	315.506965	5431.307019	3545.282406		10.309598	1265.630678	8492.297582	6306.616609	68.791775	1518.304521			11.85519									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									112.875847	112.875847	25.066011	0	87.299782	0.174599	0.174599	43.649913	76.719141	0	0.471425		43.650247	43.649898	13.09497	26.189939	34.267847	43.649901			0.174599									0		0	0									14.4448	0.460307713	1.277739942	0	1.115893968	2.373100371	1.179087475	1.317094701	2.017118611	0	0.139277897	0	0.037501375	4.603720833	9.267198506	13.76415869	0.196445502	5.522820169	0	0	2.069904319	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7861	0	8.49146091	14.4448	0.460307713	1.277739942	0	1.115893968	2.373100371	1.179087475	1.317094701	2.017118611	0	0.139277897	0	0.037501375	4.603720833	9.267198506	13.76415869	0.196445502	5.522820169	0	0	2.069904319	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7861	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.4448	0.460307713	1.277739942	0	1.115893968	2.373100371	1.179087475	1.317094701	2.017118611	0	0.139277897	0	0.037501375	4.603720833	9.267198506	13.76415869	0.196445502	5.522820169	0	0	2.069904319	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7861
H1804_157_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1745.345318	55.618528	695.231611	57.476605	174.333978	17.557238	8.723407	411.534156	358.591483	6172.987146	4029.413666		11.717441	1438.460739	9651.975781	7167.825927	78.185736	1725.638831			15.31406									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	Quitnet									109.212624	109.212573	24.269651	0	84.526191	0.169052	0.169052	42.263108	74.281682	0	0.456447		42.263384	42.263104	12.67893	25.35786	33.179061	42.263101			0.169052									0		0	0									15.8845	0.506186879	1.406085714	0	1.22798226	2.968086198	1.4747094	1.449392707	2.219731542	0	0.153267815	0	0.041268226	5.066151318	10.19806044	15.1467272	0.216177442	6.077570684	0	0	2.588872471	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6247	0	11.91337719	15.8845	0.506186879	1.406085714	0	1.22798226	2.968086198	1.4747094	1.449392707	2.219731542	0	0.153267815	0	0.041268226	5.066151318	10.19806044	15.1467272	0.216177442	6.077570684	0	0	2.588872471	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6247	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	15.8845	0.506186879	1.406085714	0	1.22798226	2.968086198	1.4747094	1.449392707	2.219731542	0	0.153267815	0	0.041268226	5.066151318	10.19806044	15.1467272	0.216177442	6.077570684	0	0	2.588872471	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6247
H1804_158_0	2008	10	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1480.902404	47.191586	589.894821	48.768139	147.920073	12.639989	6.280246	349.181286	304.260128	5237.697898	3418.904168		9.942093	1220.514899	8189.573712	6081.805438	66.339564	1464.181709			11.025057									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									113.839722	113.839709	25.273958	0	88.02398	0.176048	0.176048	44.011999	77.355548	0	0.475336		44.011588	44.012002	13.203599	26.4072	34.552022	44.011999			0.176047									0		0	0									14.0488	0.447689701	1.242414744	0	1.085042796	2.225244783	1.105624748	1.280680534	1.961350745	0	0.135427353	0	0.036463942	4.476442015	9.010987273	13.38362105	0.19101384	5.370130326	0	0	1.94092821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9419	0	7.6953085	14.0488	0.447689701	1.242414744	0	1.085042796	2.225244783	1.105624748	1.280680534	1.961350745	0	0.135427353	0	0.036463942	4.476442015	9.010987273	13.38362105	0.19101384	5.370130326	0	0	1.94092821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9419	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.0488	0.447689701	1.242414744	0	1.085042796	2.225244783	1.105624748	1.280680534	1.961350745	0	0.135427353	0	0.036463942	4.476442015	9.010987273	13.38362105	0.19101384	5.370130326	0	0	1.94092821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9419
H1804_159_0	2008	9	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1616.940264	51.526673	644.083421	53.248051	161.508227	15.068885	7.487056	381.257588	332.209908	5718.840485	3732.969704		10.855389	1332.633181	8941.879928	6640.488977	72.433613	1598.683582			13.143629									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									111.450965	111.450913	24.756645	0	86.222306	0.172444	0.172444	43.111142	75.772254	0	0.465606		43.111352	43.111155	12.933345	25.866689	33.844927	43.111152			0.172444									0		0	0									15.0175	0.478557896	1.328778717	0	1.160467647	2.598538805	1.291097885	1.369704168	2.097691128	0	0.144841091	0	0.038999208	4.787612969	9.637368171	14.31395526	0.204292529	5.743424242	0	0	2.266539959	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.4793	0	9.749022676	15.0175	0.478557896	1.328778717	0	1.160467647	2.598538805	1.291097885	1.369704168	2.097691128	0	0.144841091	0	0.038999208	4.787612969	9.637368171	14.31395526	0.204292529	5.743424242	0	0	2.266539959	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.4793	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	15.0175	0.478557896	1.328778717	0	1.160467647	2.598538805	1.291097885	1.369704168	2.097691128	0	0.144841091	0	0.038999208	4.787612969	9.637368171	14.31395526	0.204292529	5.743424242	0	0	2.266539959	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.4793
H1804_161_0	2008	8	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		248.508507	5.367458	599.60801	49.571153	150.35572	13.059678	6.488771	354.930893	309.270066	5323.941665	3475.199735		10.105799	1240.611859	8324.422973	6181.948253	67.431908	1488.290879			11.391125									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									515.663733	515.663558	23.847662	0	83.056477	0.166113	0.166112	41.528257	72.990123	0	0.448513		41.527761	41.528249	12.458475	24.91695	32.602258	41.52825			0.166113									0		0	0									10.6789	0.230650207	1.191604096	0	1.040668033	2.169382292	1.077862728	1.228305112	1.881138346	0	0.129889355	0	0.0349726	4.293369849	8.642467958	12.83627463	0.183202705	5.150509641	0	0	1.892213947	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6614	0	10.48891061	10.6789	0.230650207	1.191604096	0	1.040668033	2.169382292	1.077862728	1.228305112	1.881138346	0	0.129889355	0	0.0349726	4.293369849	8.642467958	12.83627463	0.183202705	5.150509641	0	0	1.892213947	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6614	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	10.6789	0.230650207	1.191604096	0	1.040668033	2.169382292	1.077862728	1.228305112	1.881138346	0	0.129889355	0	0.0349726	4.293369849	8.642467958	12.83627463	0.183202705	5.150509641	0	0	1.892213947	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6614
H1804_162_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		238.107906	5.14282	574.51316	47.496496	144.063018	11.98939	5.956992	340.076293	296.326465	5101.12357	3329.755355		9.682851	1188.689657	7976.028459	5923.220786	64.609741	1426.002792			10.457581									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									521.984356	521.983969	24.134211	0	84.054489	0.168109	0.168109	42.027263	73.86718	0	0.4539		42.027028	42.027245	12.608175	25.21635	32.994092	42.027247			0.168108									0		0	0									10.3574	0.2237058	1.155451819	0	1.00909528	2.015524364	1.001423968	1.19103965	1.824066694	0	0.125947996	0	0.033911788	4.16311262	8.380263551	12.44683404	0.177644978	4.99424763	0	0	1.758003027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8577	0	9.418402675	10.3574	0.2237058	1.155451819	0	1.00909528	2.015524364	1.001423968	1.19103965	1.824066694	0	0.125947996	0	0.033911788	4.16311262	8.380263551	12.44683404	0.177644978	4.99424763	0	0	1.758003027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8577	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	10.3574	0.2237058	1.155451819	0	1.00909528	2.015524364	1.001423968	1.19103965	1.824066694	0	0.125947996	0	0.033911788	4.16311262	8.380263551	12.44683404	0.177644978	4.99424763	0	0	1.758003027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8577
H1804_163_0	2008	6	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1569.300022	50.008533	625.106659	51.679194	156.749676	14.194018	7.052373	370.024518	322.42194	5550.345114	3622.984452		10.535553	1293.369537	8678.423486	6444.838887	70.299487	1551.58124			12.380538									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									112.286523	112.286569	24.937477	0	86.85208	0.173704	0.173704	43.426054	76.325711	0	0.469006		43.425913	43.426052	13.027814	26.055629	34.092131	43.426051			0.173704									0		0	0									14.6843	0.467940549	1.299048578	0	1.13450295	2.465557703	1.2250254	1.339058725	2.050756984	0	0.14160012	0	0.038126334	4.680494397	9.421740582	13.99369425	0.19972161	5.614920505	0	0	2.150548973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.907	0	9.002428925	14.6843	0.467940549	1.299048578	0	1.13450295	2.465557703	1.2250254	1.339058725	2.050756984	0	0.14160012	0	0.038126334	4.680494397	9.421740582	13.99369425	0.19972161	5.614920505	0	0	2.150548973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.907	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.6843	0.467940549	1.299048578	0	1.13450295	2.465557703	1.2250254	1.339058725	2.050756984	0	0.14160012	0	0.038126334	4.680494397	9.421740582	13.99369425	0.19972161	5.614920505	0	0	2.150548973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.907
H1804_165_0	2008	6	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1750.071922	55.76915	697.114381	57.632259	174.806095	17.652468	8.770723	412.64864	359.562593	6189.704334	4040.325798		11.749173	1442.356262	9678.114487	7187.237256	78.397473	1730.312067			15.397123									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									109.13098	109.130959	24.25185	0	84.464173	0.168928	0.168928	42.232091	74.227231	0	0.456112		42.232197	42.232094	12.669629	25.339259	33.154775	42.232102			0.168928									0		0	0									15.9156	0.507178402	1.40885945	0	1.230404354	2.981996114	1.481620695	1.452251243	2.224111304	0	0.15357009	0	0.041349449	5.07614377	10.21817666	15.17660553	0.216604215	6.089559642	0	0	2.601005194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.775	0	11.99701337	15.9156	0.507178402	1.40885945	0	1.230404354	2.981996114	1.481620695	1.452251243	2.224111304	0	0.15357009	0	0.041349449	5.07614377	10.21817666	15.17660553	0.216604215	6.089559642	0	0	2.601005194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.775	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	15.9156	0.507178402	1.40885945	0	1.230404354	2.981996114	1.481620695	1.452251243	2.224111304	0	0.15357009	0	0.041349449	5.07614377	10.21817666	15.17660553	0.216604215	6.089559642	0	0	2.601005194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.775
H1804_166_0	2008	9	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1500.670713	47.821538	597.769223	49.419136	149.894632	12.979685	6.449026	353.842445	308.321644	5307.615013	3464.542523		10.074808	1236.807341	8298.894906	6162.990398	67.225118	1483.726817			11.321353									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									113.492081	113.492095	25.198986	0	87.762904	0.175525	0.175525	43.881464	77.126098	0	0.473924		43.881066	43.881459	13.164435	26.328871	34.449576	43.881449			0.175525									0		0	0									14.1929	0.452280544	1.255264857	0	1.096265683	2.27825921	1.131965289	1.293927043	1.981637111	0	0.136827488	0	0.03684111	4.522742552	9.104188547	13.52204826	0.192989734	5.425673554	0	0	1.987180485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.6109	0	7.977957154	14.1929	0.452280544	1.255264857	0	1.096265683	2.27825921	1.131965289	1.293927043	1.981637111	0	0.136827488	0	0.03684111	4.522742552	9.104188547	13.52204826	0.192989734	5.425673554	0	0	1.987180485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.6109	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.1929	0.452280544	1.255264857	0	1.096265683	2.27825921	1.131965289	1.293927043	1.981637111	0	0.136827488	0	0.03684111	4.522742552	9.104188547	13.52204826	0.192989734	5.425673554	0	0	1.987180485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.6109
H1804_167_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1581.673234	50.402828	630.035339	52.08666	157.985577	14.418733	7.164024	372.941992	324.964089	5594.107047	3651.550026		10.618622	1303.567165	8746.848884	6495.653495	70.853766	1563.814748			12.576543									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									112.06967	112.069762	24.890504	0	86.688468	0.173377	0.173377	43.34425	76.181938	0	0.468124		43.343996	43.344251	13.003274	26.006548	34.027899	43.344251			0.173377									0		0	0									14.7715	0.470719412	1.30682476	0	1.14129397	2.499876671	1.242076989	1.347074245	2.06303284	0	0.142448184	0	0.038354459	4.708511866	9.47813939	14.07746037	0.200917066	5.64853158	0	0	2.180483296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.3172	0	9.193424542	14.7715	0.470719412	1.30682476	0	1.14129397	2.499876671	1.242076989	1.347074245	2.06303284	0	0.142448184	0	0.038354459	4.708511866	9.47813939	14.07746037	0.200917066	5.64853158	0	0	2.180483296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.3172	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.7715	0.470719412	1.30682476	0	1.14129397	2.499876671	1.242076989	1.347074245	2.06303284	0	0.142448184	0	0.038354459	4.708511866	9.47813939	14.07746037	0.200917066	5.64853158	0	0	2.180483296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.3172
H1804_168_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1581.829663	50.407812	630.09765	52.091811	158.001201	14.421594	7.165446	372.978876	324.996228	5594.660309	3651.911167		10.619672	1303.696087	8747.713955	6496.29592	70.860772	1563.969411			12.579038									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									112.066942	112.067032	24.8899	0	86.686421	0.173372	0.173372	43.343209	76.180081	0	0.468112		43.343559	43.343191	13.002959	26.005918	34.027087	43.343198			0.173372									0		0	0									14.7726	0.47075449	1.306922292	0	1.141379886	2.500300595	1.242287704	1.347175115	2.063186581	0	0.14245862	0	0.038357865	4.708862375	9.478847158	14.07851158	0.200932138	5.648952987	0	0	2.180852976	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.3224	0	9.195874733	14.7726	0.47075449	1.306922292	0	1.141379886	2.500300595	1.242287704	1.347175115	2.063186581	0	0.14245862	0	0.038357865	4.708862375	9.478847158	14.07851158	0.200932138	5.648952987	0	0	2.180852976	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.3224	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.7726	0.47075449	1.306922292	0	1.141379886	2.500300595	1.242287704	1.347175115	2.063186581	0	0.14245862	0	0.038357865	4.708862375	9.478847158	14.07851158	0.200932138	5.648952987	0	0	2.180852976	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.3224
H1804_169_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		234.725856	5.069771	566.35286	46.821863	5.990489	11.651225	5.788973	335.245899	48.224036	16.217384	0.856229		0.061159	20.987802	7862.738118	5839.088225	0.835843	4.953896			10.162622									0.08		3247.019161	34.224717	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							571.834375	571.8353	26.366446	0	0.183657	0.183657	0.183657	45.914452	0.183657	0.183657	0.183658		0.18366	0.183657	13.774335	27.54867	0.183658	0.183657			0.183657									0		0	27.548736	0	0							11.1854	0.241589502	1.244392675	0	1.100195238	2.13982903	1.063185414	1.282719311	8.85668178	2.978436093	0.157253306	0	0.011232462	3.854556752	9.025332405	13.40492622	0.153509254	0.909817678	0	0	1.866436669	0	0	0	0	0	0	0	0	0	0	0	0.078570641	0	0	0	0	0	0	0	0	59.554	0	5.180497828	11.1854	0.241589502	1.244392675	0	1.100195238	2.13982903	1.063185414	1.282719311	8.85668178	2.978436093	0.157253306	0	0.011232462	3.854556752	9.025332405	13.40492622	0.153509254	0.909817678	0	0	1.866436669	0	0	0	0	0	0	0	0	0	0	0	0.078570641	0	0	0	0	0	0	0	0	59.554	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.1854	0.241589502	1.244392675	0	1.100195238	2.13982903	1.063185414	1.282719311	8.85668178	2.978436093	0.157253306	0	0.011232462	3.854556752	9.025332405	13.40492622	0.153509254	0.909817678	0	0	1.866436669	0	0	0	0	0	0	0	0	0	0	0	0.078570641	0	0	0	0	0	0	0	0	59.554
H1804_170_0	2008	13	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		232.535043	5.022453	561.066808	46.384852	140.691255	11.434752	5.681418	332.116883	289.391011	4981.732906	3251.823171		9.456225	1160.86864	7789.351283	5784.589118	63.097564	1392.627514			9.973806									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									525.401868	525.401686	24.289149	0	84.59409	0.169188	0.169188	42.297039	74.34137	0	0.456817		42.297117	42.297044	12.689114	25.378228	33.20582	42.297052			0.169188									0		0	0									10.1812	0.21990044	1.135652942	0	0.991804057	1.934622821	0.961227749	1.170630063	1.792810352	0	0.123790675	0	0.033330921	4.091775995	8.236663868	12.23355179	0.174600529	4.908669865	0	0	1.68744829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8777	0	8.86670198	10.1812	0.21990044	1.135652942	0	0.991804057	1.934622821	0.961227749	1.170630063	1.792810352	0	0.123790675	0	0.033330921	4.091775995	8.236663868	12.23355179	0.174600529	4.908669865	0	0	1.68744829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8777	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	10.1812	0.21990044	1.135652942	0	0.991804057	1.934622821	0.961227749	1.170630063	1.792810352	0	0.123790675	0	0.033330921	4.091775995	8.236663868	12.23355179	0.174600529	4.908669865	0	0	1.68744829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8777
H1804_171_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		232.840385	5.029048	561.803544	46.44576	5.894634	11.464792	5.696344	332.552985	47.452394	15.957886	0.842528		0.060181	20.651971	7799.579473	5792.184857	0.822468	4.874628			10.000008									0.08		3220.936983	33.949802	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							572.844356	572.845286	26.411912	0	0.183974	0.183974	0.183974	45.993635	0.183974	0.183974	0.183975		0.183971	0.183974	13.798094	27.596189	0.183975	0.183974			0.183974									0		0	27.59635	0	0							11.1151	0.240072203	1.23652548	0	1.084459396	2.109223643	1.047979191	1.274610051	8.730006734	2.935836119	0.155004089	0	0.011071559	3.799425713	8.968277561	13.32018567	0.15131355	0.896804812	0	0	1.839741472	0	0	0	0	0	0	0	0	0	0	0	0.078074218	0	0	0	0	0	0	0	0	58.9937	0	5.023209706	11.1151	0.240072203	1.23652548	0	1.084459396	2.109223643	1.047979191	1.274610051	8.730006734	2.935836119	0.155004089	0	0.011071559	3.799425713	8.968277561	13.32018567	0.15131355	0.896804812	0	0	1.839741472	0	0	0	0	0	0	0	0	0	0	0	0.078074218	0	0	0	0	0	0	0	0	58.9937	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.1151	0.240072203	1.23652548	0	1.084459396	2.109223643	1.047979191	1.274610051	8.730006734	2.935836119	0.155004089	0	0.011071559	3.799425713	8.968277561	13.32018567	0.15131355	0.896804812	0	0	1.839741472	0	0	0	0	0	0	0	0	0	0	0	0.078074218	0	0	0	0	0	0	0	0	58.9937
H1804_172_0	2008	8	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		228.250134	4.929905	550.728064	45.530121	138.098746	11.017218	5.473964	325.996986	284.058419	4889.934823	3191.902027		9.281977	1139.477385	7645.817391	5677.996854	61.934869	1366.965654			9.609618									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									528.043133	528.043361	24.409161	0	85.012108	0.170024	0.170024	42.506057	74.708723	0	0.459073		42.506155	42.506055	12.751815	25.503629	33.36978	42.506048			0.170024									0		0	0									10.0438	0.216933634	1.120234165	0	0.978338792	1.873191473	0.930705255	1.154737206	1.768470145	0	0.12210967	0	0.032878429	4.036224033	8.124837408	12.06746044	0.172229413	4.842025642	0	0	1.633865691	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1181	0	8.452486007	10.0438	0.216933634	1.120234165	0	0.978338792	1.873191473	0.930705255	1.154737206	1.768470145	0	0.12210967	0	0.032878429	4.036224033	8.124837408	12.06746044	0.172229413	4.842025642	0	0	1.633865691	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1181	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	10.0438	0.216933634	1.120234165	0	0.978338792	1.873191473	0.930705255	1.154737206	1.768470145	0	0.12210967	0	0.032878429	4.036224033	8.124837408	12.06746044	0.172229413	4.842025642	0	0	1.633865691	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1181
H1804_173_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		229.199832	4.950416	553.019522	45.719561	5.71174	11.109073	5.519602	327.353386	45.980084	15.46276	0.816387		0.058313	20.011201	7677.629943	5701.621741	0.796949	4.723382			9.689737									0.08		3170.576352	33.418984	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							574.778112	574.777754	26.498665	0	0.184578	0.184578	0.184578	46.144685	0.184578	0.184578	0.184578		0.184585	0.184578	13.843409	27.686819	0.184579	0.184578			0.184578									0		0	27.686667	0	0							10.9783	0.237115749	1.221189921	0	1.054261546	2.050490476	1.018797098	1.258801573	8.486911945	2.854085315	0.15068708	0	0.010763705	3.693627458	8.857047621	13.15498076	0.147100049	0.871832403	0	0	1.788512276	0	0	0	0	0	0	0	0	0	0	0	0.077105023	0	0	0	0	0	0	0	0	57.9116	0	4.728876976	10.9783	0.237115749	1.221189921	0	1.054261546	2.050490476	1.018797098	1.258801573	8.486911945	2.854085315	0.15068708	0	0.010763705	3.693627458	8.857047621	13.15498076	0.147100049	0.871832403	0	0	1.788512276	0	0	0	0	0	0	0	0	0	0	0	0.077105023	0	0	0	0	0	0	0	0	57.9116	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	10.9783	0.237115749	1.221189921	0	1.054261546	2.050490476	1.018797098	1.258801573	8.486911945	2.854085315	0.15068708	0	0.010763705	3.693627458	8.857047621	13.15498076	0.147100049	0.871832403	0	0	1.788512276	0	0	0	0	0	0	0	0	0	0	0	0.077105023	0	0	0	0	0	0	0	0	57.9116
H1804_174_0	2008	9	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		238.320835	5.147418	575.026921	47.538971	144.191848	12.010848	5.967655	340.380408	296.591458	5105.685267	3332.733004		9.69151	1189.752646	7983.161052	5928.517648	64.667519	1427.278002			10.476298									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									521.854354	521.854983	24.12832	0	84.034018	0.168068	0.168068	42.017008	73.849143	0	0.453789		42.016696	42.016994	12.605099	25.210199	32.98589	42.017002			0.168068									0		0	0									10.3641	0.223850478	1.156202797	0	1.009751696	2.018639202	1.002971841	1.19181386	1.825252083	0	0.126029798	0	0.033933769	4.165819149	8.385711283	12.45492581	0.177759639	4.997495222	0	0	1.760730452	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.895	0	9.439756361	10.3641	0.223850478	1.156202797	0	1.009751696	2.018639202	1.002971841	1.19181386	1.825252083	0	0.126029798	0	0.033933769	4.165819149	8.385711283	12.45492581	0.177759639	4.997495222	0	0	1.760730452	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.895	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	10.3641	0.223850478	1.156202797	0	1.009751696	2.018639202	1.002971841	1.19181386	1.825252083	0	0.126029798	0	0.033933769	4.165819149	8.385711283	12.45492581	0.177759639	4.997495222	0	0	1.760730452	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.895
H1804_175_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		231.86942	5.008076	559.460772	46.252077	5.84558	11.369386	5.64894	331.166209	47.057511	15.82509	0.835517		0.05968	20.480113	7767.054509	5768.030914	0.815624	4.834063			9.916791									0.08		3207.505381	33.808229	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							573.362486	573.361859	26.43518	0	0.184136	0.184136	0.184136	46.034143	0.184136	0.184136	0.184136		0.184136	0.184136	13.810244	27.620491	0.184136	0.184136			0.184136									0		0	27.620629	0	0							11.0788	0.239286647	1.232453851	0	1.076381719	2.09351326	1.040173216	1.270412718	8.664981845	2.913968772	0.153848758	0	0.010989236	3.771126087	8.938743161	13.2763205	0.150185741	0.890125025	0	0	1.826038228	0	0	0	0	0	0	0	0	0	0	0	0.077817046	0	0	0	0	0	0	0	0	58.7051	0	4.943547035	11.0788	0.239286647	1.232453851	0	1.076381719	2.09351326	1.040173216	1.270412718	8.664981845	2.913968772	0.153848758	0	0.010989236	3.771126087	8.938743161	13.2763205	0.150185741	0.890125025	0	0	1.826038228	0	0	0	0	0	0	0	0	0	0	0	0.077817046	0	0	0	0	0	0	0	0	58.7051	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.0788	0.239286647	1.232453851	0	1.076381719	2.09351326	1.040173216	1.270412718	8.664981845	2.913968772	0.153848758	0	0.010989236	3.771126087	8.938743161	13.2763205	0.150185741	0.890125025	0	0	1.826038228	0	0	0	0	0	0	0	0	0	0	0	0.077817046	0	0	0	0	0	0	0	0	58.7051
H1804_176_0	2008	9	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		224.511093	4.849146	541.706405	44.784277	135.836505	10.659208	5.296085	320.656721	279.405166	4809.831176	3139.614422		9.129925	1120.811228	7520.568719	5584.983702	60.920294	1344.572936			9.297349									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									530.36687	530.367531	24.513852	0	85.376709	0.170753	0.170753	42.68836	75.029111	0	0.461041		42.687952	42.688351	12.806505	25.613009	33.512855	42.688348			0.170753									0		0	0									9.9228	0.214319133	1.10660922	0	0.96643948	1.820091744	0.904322402	1.140692462	1.746960101	0	0.120624248	0	0.03247815	3.987131925	8.026016742	11.92068649	0.170134415	4.783133117	0	0	1.587550234	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.45	0	8.099472683	9.9228	0.214319133	1.10660922	0	0.96643948	1.820091744	0.904322402	1.140692462	1.746960101	0	0.120624248	0	0.03247815	3.987131925	8.026016742	11.92068649	0.170134415	4.783133117	0	0	1.587550234	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.45	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	9.9228	0.214319133	1.10660922	0	0.96643948	1.820091744	0.904322402	1.140692462	1.746960101	0	0.120624248	0	0.03247815	3.987131925	8.026016742	11.92068649	0.170134415	4.783133117	0	0	1.587550234	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.45
H1804_177_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		251.512044	5.432331	606.855026	50.170282	6.877933	13.377265	6.646566	359.220679	55.368055	18.619864	0.983073		0.070219	24.096983	8425.034092	6256.66487	0.959666	5.687777			11.668136									0.08		3479.226539	36.672264	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							562.584391	562.584561	25.949422	0	0.180753	0.180753	0.180752	45.188255	0.180753	0.180752	0.180753		0.180755	0.180752	13.556475	27.112949	0.180752	0.180752			0.180752									0		0	27.11305	0	0							11.7914	0.254678796	1.312294764	0	1.243207024	2.417980781	1.201380098	1.35271297	10.00794205	3.365577658	0.177693394	0	0.012692435	4.355577871	9.51781367	14.13638629	0.173461549	1.028077068	0	0	2.109038918	0	0	0	0	0	0	0	0	0	0	0	0.082858077	0	0	0	0	0	0	0	0	64.5408	0	6.723087097	11.7914	0.254678796	1.312294764	0	1.243207024	2.417980781	1.201380098	1.35271297	10.00794205	3.365577658	0.177693394	0	0.012692435	4.355577871	9.51781367	14.13638629	0.173461549	1.028077068	0	0	2.109038918	0	0	0	0	0	0	0	0	0	0	0	0.082858077	0	0	0	0	0	0	0	0	64.5408	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.7914	0.254678796	1.312294764	0	1.243207024	2.417980781	1.201380098	1.35271297	10.00794205	3.365577658	0.177693394	0	0.012692435	4.355577871	9.51781367	14.13638629	0.173461549	1.028077068	0	0	2.109038918	0	0	0	0	0	0	0	0	0	0	0	0.082858077	0	0	0	0	0	0	0	0	64.5408
H1804_178_0	2008	9	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		247.254227	5.340368	596.581649	49.320956	149.59684	12.928173	6.423431	353.139475	307.709108	5297.070494	3457.659593		10.054793	1234.350203	8282.407676	6150.746523	67.091564	1480.779129			11.276422									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									516.422487	516.422191	23.882018	0	83.176177	0.166352	0.166352	41.588086	73.095329	0	0.449158		41.588128	41.588101	12.47643	24.952861	32.649288	41.588099			0.166352									0		0	0									10.6406	0.229823712	1.187297807	0	1.03690777	2.150627435	1.068550594	1.223866238	1.87434154	0	0.129419622	0	0.034846668	4.277856743	8.611239967	12.78989359	0.182540983	5.131899084	0	0	1.875855353	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4456	0	10.3570156	10.6406	0.229823712	1.187297807	0	1.03690777	2.150627435	1.068550594	1.223866238	1.87434154	0	0.129419622	0	0.034846668	4.277856743	8.611239967	12.78989359	0.182540983	5.131899084	0	0	1.875855353	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4456	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	10.6406	0.229823712	1.187297807	0	1.03690777	2.150627435	1.068550594	1.223866238	1.87434154	0	0.129419622	0	0.034846668	4.277856743	8.611239967	12.78989359	0.182540983	5.131899084	0	0	1.875855353	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4456
H1804_179_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		217.875864	4.705833	525.696748	43.460717	5.16129	10.038472	4.987669	311.179993	41.548905	13.972587	0.73771		0.052694	18.082688	7298.304909	5419.924409	0.720146	4.268182			8.75592									0.08		3013.929185	31.767868	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							580.613737	580.612639	26.760831	0	0.186405	0.186404	0.186404	46.601239	0.186405	0.186405	0.186405		0.186408	0.186405	13.980374	27.960752	0.186404	0.186404			0.186405									0		0	27.960866	0	0							10.5418	0.227688843	1.172340153	0	0.962090262	1.871211335	0.929721452	1.208447769	7.744923637	2.60456008	0.137512833	0	0.009822583	3.370703457	8.502752683	12.62876352	0.134238095	0.795606198	0	0	1.632147268	0	0	0	0	0	0	0	0	0	0	0	0.074021425	0	0	0	0	0	0	0	0	54.5484	0	3.886365332	10.5418	0.227688843	1.172340153	0	0.962090262	1.871211335	0.929721452	1.208447769	7.744923637	2.60456008	0.137512833	0	0.009822583	3.370703457	8.502752683	12.62876352	0.134238095	0.795606198	0	0	1.632147268	0	0	0	0	0	0	0	0	0	0	0	0.074021425	0	0	0	0	0	0	0	0	54.5484	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	10.5418	0.227688843	1.172340153	0	0.962090262	1.871211335	0.929721452	1.208447769	7.744923637	2.60456008	0.137512833	0	0.009822583	3.370703457	8.502752683	12.62876352	0.134238095	0.795606198	0	0	1.632147268	0	0	0	0	0	0	0	0	0	0	0	0.074021425	0	0	0	0	0	0	0	0	54.5484
H1804_180_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		241.85429	5.223736	583.552535	48.243805	6.359864	12.369645	6.145924	345.427044	51.19755	17.217354	0.909024		0.06493	22.281918	8101.523081	6016.416586	0.887381	5.259355			10.789253									0.08		3345.628493	35.264094	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							567.950642	567.951495	26.191875	0	0.182441	0.182441	0.182441	45.610438	0.182441	0.182441	0.182442		0.182441	0.182441	13.683135	27.366269	0.182441	0.182441			0.182441									0		0	27.366197	0	0							11.4468	0.247235723	1.273694588	0	1.160299948	2.256730403	1.12126852	1.312923231	9.34053222	3.141151281	0.165844157	0	0.011845894	4.065135402	9.237852835	13.72057289	0.161894677	0.959521986	0	0	1.968402107	0	0	0	0	0	0	0	0	0	0	0	0.080420345	0	0	0	0	0	0	0	0	61.6721	0	5.80408319	11.4468	0.247235723	1.273694588	0	1.160299948	2.256730403	1.12126852	1.312923231	9.34053222	3.141151281	0.165844157	0	0.011845894	4.065135402	9.237852835	13.72057289	0.161894677	0.959521986	0	0	1.968402107	0	0	0	0	0	0	0	0	0	0	0	0.080420345	0	0	0	0	0	0	0	0	61.6721	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.4468	0.247235723	1.273694588	0	1.160299948	2.256730403	1.12126852	1.312923231	9.34053222	3.141151281	0.165844157	0	0.011845894	4.065135402	9.237852835	13.72057289	0.161894677	0.959521986	0	0	1.968402107	0	0	0	0	0	0	0	0	0	0	0	0.080420345	0	0	0	0	0	0	0	0	61.6721
H1804_181_0	2008	11	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		234.100741	5.056269	564.844567	46.697169	141.638554	11.589234	5.758173	334.353082	291.339529	5015.275764	3273.718254		9.519897	1168.684967	7841.798317	5823.537746	63.522412	1402.004314			10.108551									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									524.440003	524.439315	24.245504	0	84.442079	0.168884	0.168884	42.221054	74.20777	0	0.455992		42.220797	42.221043	12.666315	25.332629	33.1462	42.221052			0.168884									0		0	0									10.231	0.220975521	1.141245101	0	0.996687831	1.957236195	0.972463289	1.176394961	1.801638063	0	0.124399111	0	0.033494803	4.111924854	8.277223971	12.29379343	0.175460548	4.93284142	0	0	1.707172527	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1539	0	9.020186177	10.231	0.220975521	1.141245101	0	0.996687831	1.957236195	0.972463289	1.176394961	1.801638063	0	0.124399111	0	0.033494803	4.111924854	8.277223971	12.29379343	0.175460548	4.93284142	0	0	1.707172527	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1539	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	10.231	0.220975521	1.141245101	0	0.996687831	1.957236195	0.972463289	1.176394961	1.801638063	0	0.124399111	0	0.033494803	4.111924854	8.277223971	12.29379343	0.175460548	4.93284142	0	0	1.707172527	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1539
H1804_184_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1459.474723	46.508755	581.359432	48.062496	145.779766	12.276855	6.099821	344.128862	299.857684	5161.911865	3369.434882		9.798238	1202.854853	8071.075985	5993.805725	65.379673	1442.995966			10.708319									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									114.214923	114.214858	25.355267	0	88.307172	0.176614	0.176614	44.153592	77.604446	0	0.476866		44.153609	44.153598	13.24608	26.492159	34.663329	44.153598			0.176614									0		0	0									13.8911	0.442665904	1.228376968	0	1.072783239	2.168264469	1.077313786	1.266210447	1.939190787	0	0.133897411	0	0.036052297	4.425864136	8.909176515	13.23240452	0.188856426	5.309455317	0	0	1.891239052	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2129	0	7.394636282	13.8911	0.442665904	1.228376968	0	1.072783239	2.168264469	1.077313786	1.266210447	1.939190787	0	0.133897411	0	0.036052297	4.425864136	8.909176515	13.23240452	0.188856426	5.309455317	0	0	1.891239052	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2129	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	13.8911	0.442665904	1.228376968	0	1.072783239	2.168264469	1.077313786	1.266210447	1.939190787	0	0.133897411	0	0.036052297	4.425864136	8.909176515	13.23240452	0.188856426	5.309455317	0	0	1.891239052	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2129
H1804_185_0	2008	6	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1596.122963	50.863294	635.791168	52.56251	159.428889	14.683384	7.295518	376.349087	327.932871	5645.213259	3684.909575		10.715631	1315.476193	8826.757672	6554.995986	71.501065	1578.101327			12.807381									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									111.816676	111.816629	24.83572	0	86.497695	0.172995	0.172995	43.248844	76.01425	0	0.467093		43.248401	43.248851	12.974654	25.94931	33.95295	43.248848			0.172995									0		0	0									14.8728	0.47394684	1.315860952	0	1.149185951	2.540152015	1.262088136	1.356388579	2.077297603	0	0.143432956	0	0.038619492	4.741069489	9.543677228	14.17480191	0.202306007	5.687588702	0	0	2.215612876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.7948	0	9.418894602	14.8728	0.47394684	1.315860952	0	1.149185951	2.540152015	1.262088136	1.356388579	2.077297603	0	0.143432956	0	0.038619492	4.741069489	9.543677228	14.17480191	0.202306007	5.687588702	0	0	2.215612876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.7948	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.8728	0.47394684	1.315860952	0	1.149185951	2.540152015	1.262088136	1.356388579	2.077297603	0	0.143432956	0	0.038619492	4.741069489	9.543677228	14.17480191	0.202306007	5.687588702	0	0	2.215612876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.7948
H1804_187_0	2008	6	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1483.846947	47.285419	591.067734	48.865107	148.214189	12.690308	6.305247	349.875577	304.865101	5248.112239	3425.702122		9.961861	1222.941704	8205.857397	6093.898153	66.471469	1467.093006			11.068948									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									113.788109	113.788188	25.26278	0	87.985082	0.17597	0.17597	43.992552	77.321383	0	0.475126		43.99281	43.992554	13.197765	26.395531	34.536836	43.992553			0.17597									0		0	0									14.0703	0.448376846	1.244334511	0	1.086719798	2.233113499	1.109534315	1.28265996	1.964382603	0	0.135636679	0	0.036520855	4.483360746	9.024914796	13.40430647	0.191309519	5.378430569	0	0	1.94780278	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0417	0	7.737088932	14.0703	0.448376846	1.244334511	0	1.086719798	2.233113499	1.109534315	1.28265996	1.964382603	0	0.135636679	0	0.036520855	4.483360746	9.024914796	13.40430647	0.191309519	5.378430569	0	0	1.94780278	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0417	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.0703	0.448376846	1.244334511	0	1.086719798	2.233113499	1.109534315	1.28265996	1.964382603	0	0.135636679	0	0.036520855	4.483360746	9.024914796	13.40430647	0.191309519	5.378430569	0	0	1.94780278	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0417
H1804_188_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1573.233746	50.133888	626.673599	51.808736	157.142596	14.265268	7.087774	370.95205	323.230147	5564.258024	3632.066094		10.561963	1296.611594	8700.177469	6460.994003	70.475703	1555.470549			12.442684									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									112.21762	112.217646	24.922542	0	86.800124	0.1736	0.1736	43.400062	76.279988	0	0.468729		43.399873	43.400055	13.020015	26.040029	34.071806	43.400048			0.1736									0		0	0									14.712	0.468825575	1.301524924	0	1.136666402	2.476450525	1.230437566	1.341611831	2.054665978	0	0.141871226	0	0.038198988	4.689417874	9.439703429	14.0203726	0.200102873	5.625624707	0	0	2.160049942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0376	0	9.062920265	14.712	0.468825575	1.301524924	0	1.136666402	2.476450525	1.230437566	1.341611831	2.054665978	0	0.141871226	0	0.038198988	4.689417874	9.439703429	14.0203726	0.200102873	5.625624707	0	0	2.160049942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0376	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.712	0.468825575	1.301524924	0	1.136666402	2.476450525	1.230437566	1.341611831	2.054665978	0	0.141871226	0	0.038198988	4.689417874	9.439703429	14.0203726	0.200102873	5.625624707	0	0	2.160049942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0376
H1804_190_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		254.364937	5.49395	613.738562	50.739363	7.034843	13.682447	6.798197	363.295307	56.631197	19.044649	1.0055		0.071821	24.64672	8520.598964	6327.634003	0.98156	5.817536			11.934327									0.08		3518.691286	37.088236	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							560.978133	560.977676	25.8764	0	0.180244	0.180244	0.180244	45.061086	0.180244	0.180244	0.180244		0.180241	0.180244	13.51833	27.036659	0.180244	0.180244			0.180244									0		0	27.036779	0	0							11.8911	0.256831942	1.323445377	0	1.267988242	2.466178977	1.22533422	1.364206756	10.20743347	3.432683714	0.181235342	0	0.012945089	4.4424234	9.598689049	14.2565069	0.176920301	1.048575959	0	0	2.151090836	0	0	0	0	0	0	0	0	0	0	0	0.083562203	0	0	0	0	0	0	0	0	65.3871	0	7.011731142	11.8911	0.256831942	1.323445377	0	1.267988242	2.466178977	1.22533422	1.364206756	10.20743347	3.432683714	0.181235342	0	0.012945089	4.4424234	9.598689049	14.2565069	0.176920301	1.048575959	0	0	2.151090836	0	0	0	0	0	0	0	0	0	0	0	0.083562203	0	0	0	0	0	0	0	0	65.3871	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.8911	0.256831942	1.323445377	0	1.267988242	2.466178977	1.22533422	1.364206756	10.20743347	3.432683714	0.181235342	0	0.012945089	4.4424234	9.598689049	14.2565069	0.176920301	1.048575959	0	0	2.151090836	0	0	0	0	0	0	0	0	0	0	0	0.083562203	0	0	0	0	0	0	0	0	65.3871
H1804_192_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		281.10207	6.071437	678.250634	56.072743	8.591489	16.710051	8.302478	401.482468	69.16235	23.258782	1.227994		0.087714	30.10046	9416.227045	6992.752352	1.198756	7.10482			14.575114									0.08		3888.552459	40.986703	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							545.490631	545.491182	25.174551	0	0.175355	0.175355	0.175355	43.83891	0.175355	0.175355	0.175355		0.175357	0.175355	13.15167	26.30334	0.175355	0.175355			0.175355									0		0	26.303402	0	0							12.7782	0.275992945	1.422887931	0	1.506560554	2.930190993	1.45588103	1.466712815	12.12796388	4.078543718	0.215334888	0	0.015381264	5.278266163	10.3199259	15.32772855	0.210207858	1.245865711	0	0	2.555819115	0	0	0	0	0	0	0	0	0	0	0	0.08984081	0	0	0	0	0	0	0	0	73.3013	0	10.08898066	12.7782	0.275992945	1.422887931	0	1.506560554	2.930190993	1.45588103	1.466712815	12.12796388	4.078543718	0.215334888	0	0.015381264	5.278266163	10.3199259	15.32772855	0.210207858	1.245865711	0	0	2.555819115	0	0	0	0	0	0	0	0	0	0	0	0.08984081	0	0	0	0	0	0	0	0	73.3013	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.7782	0.275992945	1.422887931	0	1.506560554	2.930190993	1.45588103	1.466712815	12.12796388	4.078543718	0.215334888	0	0.015381264	5.278266163	10.3199259	15.32772855	0.210207858	1.245865711	0	0	2.555819115	0	0	0	0	0	0	0	0	0	0	0	0.08984081	0	0	0	0	0	0	0	0	73.3013
H1804_193_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1489.334223	47.460281	593.253508	49.045809	148.762285	12.784318	6.351957	351.16942	305.992495	5267.519798	3438.370396		9.9987	1227.46415	8236.202721	6116.433436	66.717281	1472.518326			11.150947									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									113.692163	113.692143	25.241965	0	87.91262	0.175825	0.175825	43.956302	77.257694	0	0.474735		43.956036	43.956291	13.186889	26.37378	34.508366	43.956299			0.175825									0		0	0									14.1105	0.449655088	1.247907024	0	1.089840186	2.247802712	1.11683284	1.286342423	1.970022879	0	0.136026231	0	0.036625268	4.496230947	9.050824255	13.44278915	0.191858696	5.393871318	0	0	1.960615256	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2277	0	7.81525642	14.1105	0.449655088	1.247907024	0	1.089840186	2.247802712	1.11683284	1.286342423	1.970022879	0	0.136026231	0	0.036625268	4.496230947	9.050824255	13.44278915	0.191858696	5.393871318	0	0	1.960615256	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2277	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.1105	0.449655088	1.247907024	0	1.089840186	2.247802712	1.11683284	1.286342423	1.970022879	0	0.136026231	0	0.036625268	4.496230947	9.050824255	13.44278915	0.191858696	5.393871318	0	0	1.960615256	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2277
H1804_195_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1749.125682	55.738996	696.73746	57.601097	174.71158	17.633381	8.761239	412.425526	359.368181	6186.357643	4038.141247		11.74282	1441.576399	9672.881657	7183.351212	78.355084	1729.37651			15.380475									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									109.147358	109.147283	24.255408	0	84.476609	0.168953	0.168953	42.238307	74.238093	0	0.45618		42.23794	42.238304	12.671489	25.342978	33.159727	42.238297			0.168953									0		0	0									15.9094	0.506979998	1.40830428	0	1.229920153	2.97921262	1.480237613	1.451679665	2.223234037	0	0.15350994	0	0.041332711	5.074145182	10.21415113	15.17062598	0.216519433	6.087159888	0	0	2.598577393	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.745	0	11.98025443	15.9094	0.506979998	1.40830428	0	1.229920153	2.97921262	1.480237613	1.451679665	2.223234037	0	0.15350994	0	0.041332711	5.074145182	10.21415113	15.17062598	0.216519433	6.087159888	0	0	2.598577393	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.745	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	15.9094	0.506979998	1.40830428	0	1.229920153	2.97921262	1.480237613	1.451679665	2.223234037	0	0.15350994	0	0.041332711	5.074145182	10.21415113	15.17062598	0.216519433	6.087159888	0	0	2.598577393	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.745
H1804_196_0	2008	9	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		232.533525	5.022421	561.063142	46.384548	140.690336	11.434603	5.681343	332.114713	289.38912	4981.70036	3251.801927		9.456164	1160.861057	7789.300397	5784.551329	63.097153	1392.618416			9.973676									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									525.402495	525.401642	24.289173	0	84.594166	0.169188	0.169188	42.29709	74.341453	0	0.456817		42.297439	42.297099	12.689129	25.378259	33.205914	42.297101			0.169188									0		0	0									10.1811	0.21989902	1.135646643	0	0.99179847	1.934597612	0.961215059	1.170623826	1.792800639	0	0.123789867	0	0.03333096	4.091754588	8.236619796	12.23348682	0.174599886	4.908643483	0	0	1.687426295	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8774	0	8.866581417	10.1811	0.21989902	1.135646643	0	0.99179847	1.934597612	0.961215059	1.170623826	1.792800639	0	0.123789867	0	0.03333096	4.091754588	8.236619796	12.23348682	0.174599886	4.908643483	0	0	1.687426295	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8774	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	10.1811	0.21989902	1.135646643	0	0.99179847	1.934597612	0.961215059	1.170623826	1.792800639	0	0.123789867	0	0.03333096	4.091754588	8.236619796	12.23348682	0.174599886	4.908643483	0	0	1.687426295	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8774
H1804_197_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		206.937246	4.469574	499.303752	41.278739	125.203757	9.055795	4.499421	295.55697	257.534424	4433.336451	2893.857715		8.415271	1033.07852	6931.888088	5147.813077	56.151692	1239.325038			7.898794									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									541.318771	541.318023	25.007956	0	87.097629	0.174195	0.174195	43.548786	76.541475	0	0.470332		43.54926	43.548801	13.064639	26.12928	34.188446	43.548797			0.174195									0		0	0									9.3349	0.201621747	1.040547188	0	0.908745865	1.57747421	0.783776641	1.072595603	1.642672056	0	0.113422824	0	0.030539902	3.749110907	7.546884622	11.20905411	0.159978257	4.497592875	0	0	1.375930421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2449	0	6.539909677	9.3349	0.201621747	1.040547188	0	0.908745865	1.57747421	0.783776641	1.072595603	1.642672056	0	0.113422824	0	0.030539902	3.749110907	7.546884622	11.20905411	0.159978257	4.497592875	0	0	1.375930421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2449	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	9.3349	0.201621747	1.040547188	0	0.908745865	1.57747421	0.783776641	1.072595603	1.642672056	0	0.113422824	0	0.030539902	3.749110907	7.546884622	11.20905411	0.159978257	4.497592875	0	0	1.375930421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2449
H1804_198_0	2008	8	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1863.628508	59.387833	742.34791	61.371832	186.148705	20.017611	9.945857	439.424094	382.893462	6591.334506	4302.489654		12.51154	1535.946161	10306.09647	7653.59416	83.484436	1842.586498			17.460087									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									107.184635	107.184668	23.827437	0	82.986088	0.165972	0.165972	41.493056	72.92825	0	0.448131		41.492718	41.493052	12.447915	24.895829	32.574587	41.493051			0.165972									0		0	0									16.646	0.53045543	1.474020671	0	1.287312735	3.322362933	1.650733778	1.519420712	2.326979177	0	0.160673249	0	0.043261483	5.310924494	10.6907844	15.87854762	0.226622585	6.371211294	0	0	2.89788556	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.3372	0	14.08926674	16.646	0.53045543	1.474020671	0	1.287312735	3.322362933	1.650733778	1.519420712	2.326979177	0	0.160673249	0	0.043261483	5.310924494	10.6907844	15.87854762	0.226622585	6.371211294	0	0	2.89788556	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.3372	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	16.646	0.53045543	1.474020671	0	1.287312735	3.322362933	1.650733778	1.519420712	2.326979177	0	0.160673249	0	0.043261483	5.310924494	10.6907844	15.87854762	0.226622585	6.371211294	0	0	2.89788556	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.3372
H1804_199_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1434.662352	45.718064	571.475803	47.245391	143.301381	11.862968	5.894179	338.278366	294.759837	5074.154764	3312.151485		9.631659	1182.40525	7933.860501	5891.905687	64.26816	1418.46375			10.347311									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									114.649281	114.649286	25.449439	0	88.635187	0.17727	0.17727	44.317593	77.892666	0	0.478637		44.317696	44.317595	13.29528	26.590561	34.792056	44.317602			0.17727									0		0	0									13.7069	0.436795283	1.211978216	0	1.058462059	2.102948337	1.044861111	1.249306912	1.913302461	0	0.132109854	0	0.035571078	4.36677975	8.790241403	13.05575646	0.186335118	5.238575994	0	0	1.834267821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3642	0	7.053969184	13.7069	0.436795283	1.211978216	0	1.058462059	2.102948337	1.044861111	1.249306912	1.913302461	0	0.132109854	0	0.035571078	4.36677975	8.790241403	13.05575646	0.186335118	5.238575994	0	0	1.834267821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3642	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	13.7069	0.436795283	1.211978216	0	1.058462059	2.102948337	1.044861111	1.249306912	1.913302461	0	0.132109854	0	0.035571078	4.36677975	8.790241403	13.05575646	0.186335118	5.238575994	0	0	1.834267821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3642
H1804_200_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1534.545219	48.901009	611.262615	50.534669	153.27819	13.572279	6.743459	361.8297	315.281361	5427.423337	3542.747333		10.302227	1264.725682	8486.225124	6302.107035	68.742585	1517.21885			11.838235									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									112.895221	112.89524	25.070241	0	87.314482	0.174629	0.174629	43.657257	76.732065	0	0.471505		43.657305	43.657238	13.097174	26.19435	34.273755	43.657248			0.174629									0		0	0									14.4369	0.460057596	1.277041756	0	1.115283813	2.370113509	1.177603502	1.31637435	2.016015824	0	0.139201923	0	0.037480622	4.601202509	9.262130588	13.75663312	0.196338876	5.519799967	0	0	2.06729914	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7495	0	8.474983388	14.4369	0.460057596	1.277041756	0	1.115283813	2.370113509	1.177603502	1.31637435	2.016015824	0	0.139201923	0	0.037480622	4.601202509	9.262130588	13.75663312	0.196338876	5.519799967	0	0	2.06729914	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7495	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.4369	0.460057596	1.277041756	0	1.115283813	2.370113509	1.177603502	1.31637435	2.016015824	0	0.139201923	0	0.037480622	4.601202509	9.262130588	13.75663312	0.196338876	5.519799967	0	0	2.06729914	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7495
H1804_201_0	2008	8	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		241.760358	5.221708	583.325894	48.225069	146.272871	12.360034	6.141149	345.292886	300.871962	5179.372159	3380.832077		9.831381	1206.92354	8098.376599	6014.07992	65.600821	1447.876936			10.78087									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									519.758112	519.758205	24.033194	0	83.702728	0.167405	0.167405	41.851339	73.557977	0	0.452002		41.85126	41.851349	12.555405	25.11081	32.855858	41.851353			0.167405									0		0	0									10.4714	0.226168798	1.168265365	0	1.020286528	2.069131492	1.028059048	1.204247469	1.844294405	0	0.127345238	0	0.034287974	4.209281524	8.473199837	12.58486818	0.179614272	5.049634062	0	0	1.804771542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.4949	0	9.788277676	10.4714	0.226168798	1.168265365	0	1.020286528	2.069131492	1.028059048	1.204247469	1.844294405	0	0.127345238	0	0.034287974	4.209281524	8.473199837	12.58486818	0.179614272	5.049634062	0	0	1.804771542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.4949	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	10.4714	0.226168798	1.168265365	0	1.020286528	2.069131492	1.028059048	1.204247469	1.844294405	0	0.127345238	0	0.034287974	4.209281524	8.473199837	12.58486818	0.179614272	5.049634062	0	0	1.804771542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.4949
H1804_202_0	2008	12	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1601.242173	51.026426	637.830327	52.731091	159.940222	14.777719	7.342389	377.556142	328.984643	5663.319026	3696.728104		10.749999	1319.695292	8855.067536	6576.019675	71.730388	1583.162736			12.889663									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									111.726969	111.727052	24.816279	0	86.429988	0.17286	0.17286	43.215011	75.95474	0	0.466728		43.215325	43.215004	12.964499	25.928999	33.926356	43.214997			0.17286									0		0	0									14.9085	0.475086013	1.319047946	0	1.151969289	2.554476506	1.269205363	1.359674402	2.082328585	0	0.143780543	0	0.038713725	4.75255311	9.566792851	14.20913396	0.20279589	5.701364407	0	0	2.228107146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9635	0	9.499518645	14.9085	0.475086013	1.319047946	0	1.151969289	2.554476506	1.269205363	1.359674402	2.082328585	0	0.143780543	0	0.038713725	4.75255311	9.566792851	14.20913396	0.20279589	5.701364407	0	0	2.228107146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9635	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.9085	0.475086013	1.319047946	0	1.151969289	2.554476506	1.269205363	1.359674402	2.082328585	0	0.143780543	0	0.038713725	4.75255311	9.566792851	14.20913396	0.20279589	5.701364407	0	0	2.228107146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9635
H1804_203_0	2008	11	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1626.422611	51.828845	647.86057	53.560318	162.455372	15.246169	7.57514	383.493426	334.158113	5752.377919	3754.861243		10.91905	1340.448243	8994.31848	6679.431306	72.858391	1608.058865			13.298262									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QuitNet									111.284683	111.284689	24.72063	0	86.096914	0.172193	0.172193	43.048442	75.662009	0	0.464929		43.04841	43.048449	12.914534	25.829071	33.795776	43.048448			0.172193									0		0	0									15.083	0.480646408	1.334626787	0	1.165575516	2.625283579	1.304386082	1.375732876	2.106922846	0	0.145478657	0	0.039170645	4.808684819	9.679785985	14.37695879	0.205192155	5.768703203	0	0	2.289867629	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.79	0	9.90130427	15.083	0.480646408	1.334626787	0	1.165575516	2.625283579	1.304386082	1.375732876	2.106922846	0	0.145478657	0	0.039170645	4.808684819	9.679785985	14.37695879	0.205192155	5.768703203	0	0	2.289867629	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.79	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	15.083	0.480646408	1.334626787	0	1.165575516	2.625283579	1.304386082	1.375732876	2.106922846	0	0.145478657	0	0.039170645	4.808684819	9.679785985	14.37695879	0.205192155	5.768703203	0	0	2.289867629	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.79
H1804_204_0	2008	6	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1438.082315	45.827047	572.838094	47.358015	143.642984	11.919591	5.922312	339.084756	295.462488	5086.250588	3320.047026		9.654619	1185.22388	7952.773322	5905.950874	64.421364	1421.845098			10.3967									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									114.589349	114.589418	25.436469	0	88.590009	0.177179	0.177179	44.294995	77.852989	0	0.478395		44.295463	44.295001	13.2885	26.576999	34.77429	44.295003			0.17718									0		0	0									13.7324	0.437607887	1.214248202	0	1.060444437	2.111901214	1.049309318	1.251646464	1.916886486	0	0.132357825	0	0.035637985	4.374957746	8.806702357	13.08020421	0.186683933	5.248386073	0	0	1.842087306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.4815	0	7.100438892	13.7324	0.437607887	1.214248202	0	1.060444437	2.111901214	1.049309318	1.251646464	1.916886486	0	0.132357825	0	0.035637985	4.374957746	8.806702357	13.08020421	0.186683933	5.248386073	0	0	1.842087306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.4815	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	13.7324	0.437607887	1.214248202	0	1.060444437	2.111901214	1.049309318	1.251646464	1.916886486	0	0.132357825	0	0.035637985	4.374957746	8.806702357	13.08020421	0.186683933	5.248386073	0	0	1.842087306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.4815
H1804_205_0	2008	6	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1643.991715	52.388717	654.858952	54.138892	164.210264	15.577325	7.739677	387.636038	337.767789	5814.516825	3795.422378		11.036999	1354.928168	9091.477797	6751.584518	73.645427	1625.429598			13.587108									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									110.977604	110.977683	24.653871	0	85.864408	0.171728	0.171728	42.932195	75.457722	0	0.463675		42.931737	42.932199	12.879659	25.759321	33.704446	42.932197			0.171728									0		0	0									15.2039	0.484498202	1.345400677	0	1.174984759	2.675062868	1.329119252	1.386838831	2.123932327	0	0.146653539	0	0.039486462	4.847503812	9.757927819	14.4930194	0.206848193	5.815271976	0	0	2.333286883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3637	0	10.18677745	15.2039	0.484498202	1.345400677	0	1.174984759	2.675062868	1.329119252	1.386838831	2.123932327	0	0.146653539	0	0.039486462	4.847503812	9.757927819	14.4930194	0.206848193	5.815271976	0	0	2.333286883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3637	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	15.2039	0.484498202	1.345400677	0	1.174984759	2.675062868	1.329119252	1.386838831	2.123932327	0	0.146653539	0	0.039486462	4.847503812	9.757927819	14.4930194	0.206848193	5.815271976	0	0	2.333286883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3637
H1804_207_0	2008	8	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1477.103638	47.070532	588.381641	48.643041	147.540633	12.575206	6.248058	348.285576	303.479649	5224.262312	3410.134099		9.91659	1217.384071	8168.566063	6066.204573	66.169392	1460.425835			10.968551									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									113.906291	113.906383	25.288336	0	88.07408	0.176148	0.176148	44.037053	77.399566	0	0.475606		44.036916	44.037053	13.211115	26.42223	34.571791	44.037052			0.176148									0		0	0									14.0209	0.446802837	1.239932719	0	1.08287546	2.215097386	1.100582921	1.278122531	1.95743276	0	0.135156687	0	0.036391337	4.467500571	8.992988804	13.3568877	0.190632866	5.359404037	0	0	1.932088322	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8128	0	7.641630382	14.0209	0.446802837	1.239932719	0	1.08287546	2.215097386	1.100582921	1.278122531	1.95743276	0	0.135156687	0	0.036391337	4.467500571	8.992988804	13.3568877	0.190632866	5.359404037	0	0	1.932088322	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8128	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.0209	0.446802837	1.239932719	0	1.08287546	2.215097386	1.100582921	1.278122531	1.95743276	0	0.135156687	0	0.036391337	4.467500571	8.992988804	13.3568877	0.190632866	5.359404037	0	0	1.932088322	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8128
H1804_209_0	2008	8	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1634.648926	52.090991	651.137396	53.831222	163.277058	15.400787	7.651963	385.433107	335.848258	5781.472986	3773.853032		10.974277	1347.228124	9039.811024	6713.215334	73.226903	1616.192298			13.433126									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									111.140897	111.140885	24.689427	0	85.98819	0.171976	0.171976	42.994092	75.566499	0	0.464343		42.993955	42.994096	12.89823	25.796461	33.753046	42.994102			0.171976									0		0	0									15.1397	0.482453237	1.3396841	0	1.169991557	2.648565745	1.315953989	1.380945539	2.114906421	0	0.146030187	0	0.039318964	4.826904608	9.716463479	14.43143313	0.205969252	5.790561376	0	0	2.310175277	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.0591	0	10.03433381	15.1397	0.482453237	1.3396841	0	1.169991557	2.648565745	1.315953989	1.380945539	2.114906421	0	0.146030187	0	0.039318964	4.826904608	9.716463479	14.43143313	0.205969252	5.790561376	0	0	2.310175277	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.0591	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	15.1397	0.482453237	1.3396841	0	1.169991557	2.648565745	1.315953989	1.380945539	2.114906421	0	0.146030187	0	0.039318964	4.826904608	9.716463479	14.43143313	0.205969252	5.790561376	0	0	2.310175277	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.0591
H1804_210_0	2008	9	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		232.032218	5.011593	559.853575	46.284551	140.387029	11.385354	5.656875	331.398725	288.765243	4970.960572	3244.791537		9.435778	1158.358416	7772.507847	5772.080714	62.961124	1389.616142			9.93072									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									525.711234	525.710305	24.303245	0	84.643206	0.169286	0.169286	42.321599	74.384509	0	0.45708		42.321878	42.321605	12.69648	25.39296	33.224981	42.321598			0.169286									0		0	0									10.1652	0.21955384	1.133854883	0	0.990234018	1.927381037	0.957629741	1.168776996	1.789971735	0	0.12359411	0	0.03327832	4.085298944	8.223624202	12.21418456	0.174323512	4.900897978	0	0	1.681131866	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7889	0	8.81753625	10.1652	0.21955384	1.133854883	0	0.990234018	1.927381037	0.957629741	1.168776996	1.789971735	0	0.12359411	0	0.03327832	4.085298944	8.223624202	12.21418456	0.174323512	4.900897978	0	0	1.681131866	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7889	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	10.1652	0.21955384	1.133854883	0	0.990234018	1.927381037	0.957629741	1.168776996	1.789971735	0	0.12359411	0	0.03327832	4.085298944	8.223624202	12.21418456	0.174323512	4.900897978	0	0	1.681131866	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7889
H1804_211_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		244.828964	5.287985	590.729911	48.837178	6.517276	12.675804	6.298041	349.675607	52.464731	17.643498	0.931523		0.066537	22.833414	8201.167356	6090.415198	0.909344	5.389529			11.056296									0.08		3386.777881	35.697823	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							566.31627	566.316486	26.117473	0	0.181923	0.181923	0.181923	45.480909	0.181923	0.181923	0.181923		0.181918	0.181923	13.644269	27.28854	0.181923	0.181923			0.181923									0		0	27.288675	0	0							11.5542	0.24955609	1.285697708	0	1.185642402	2.306020291	1.145758513	1.325297038	9.544541258	3.209758087	0.169465459	0	0.012104278	4.153923175	9.324911127	13.84987823	0.165430589	0.980479284	0	0	2.011394537	0	0	0	0	0	0	0	0	0	0	0	0.081178858	0	0	0	0	0	0	0	0	62.5553	0	6.07891834	11.5542	0.24955609	1.285697708	0	1.185642402	2.306020291	1.145758513	1.325297038	9.544541258	3.209758087	0.169465459	0	0.012104278	4.153923175	9.324911127	13.84987823	0.165430589	0.980479284	0	0	2.011394537	0	0	0	0	0	0	0	0	0	0	0	0.081178858	0	0	0	0	0	0	0	0	62.5553	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.5542	0.24955609	1.285697708	0	1.185642402	2.306020291	1.145758513	1.325297038	9.544541258	3.209758087	0.169465459	0	0.012104278	4.153923175	9.324911127	13.84987823	0.165430589	0.980479284	0	0	2.011394537	0	0	0	0	0	0	0	0	0	0	0	0.081178858	0	0	0	0	0	0	0	0	62.5553
H1804_212_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		274.147067	5.921219	661.46942	54.685397	8.171603	15.893393	7.896717	391.549025	65.782226	22.122073	1.167979		0.083427	28.629382	9183.251624	6819.738317	1.14017	6.757591			13.862794									0.08		3792.342252	39.972613	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							549.578122	549.578441	25.359799	0	0.176646	0.176646	0.176645	44.161492	0.176645	0.176646	0.176646		0.176641	0.176646	13.24845	26.496898	0.176646	0.176645			0.176646									0		0	26.497023	0	0							12.5554	0.271181192	1.397894295	0	1.443480984	2.8075043	1.394915574	1.440949095	11.62010131	3.907775707	0.206318818	0	0.014736629	5.057265813	10.13865416	15.05849255	0.20140647	1.193694662	0	0	2.448807109	0	0	0	0	0	0	0	0	0	0	0	0.088262937	0	0	0	0	0	0	0	0	71.2469	0	9.222545745	12.5554	0.271181192	1.397894295	0	1.443480984	2.8075043	1.394915574	1.440949095	11.62010131	3.907775707	0.206318818	0	0.014736629	5.057265813	10.13865416	15.05849255	0.20140647	1.193694662	0	0	2.448807109	0	0	0	0	0	0	0	0	0	0	0	0.088262937	0	0	0	0	0	0	0	0	71.2469	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.5554	0.271181192	1.397894295	0	1.443480984	2.8075043	1.394915574	1.440949095	11.62010131	3.907775707	0.206318818	0	0.014736629	5.057265813	10.13865416	15.05849255	0.20140647	1.193694662	0	0	2.448807109	0	0	0	0	0	0	0	0	0	0	0	0.088262937	0	0	0	0	0	0	0	0	71.2469
H1804_213_0	2008	9	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		224.351333	4.845695	541.320932	44.752409	135.739845	10.644039	5.288548	320.428544	279.206343	4806.408546	3137.380303		9.123429	1120.01367	7515.217154	5581.009483	60.876944	1343.61615			9.284118									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									530.466238	530.46636	24.518318	0	85.392271	0.170784	0.170784	42.696152	75.042822	0	0.461124		42.695827	42.696153	12.808844	25.61769	33.519114	42.696152			0.170784									0		0	0									9.9176	0.214206516	1.106023229	0	0.965927802	1.817831557	0.903199382	1.140088818	1.746035992	0	0.120560113	0	0.032461029	3.985022918	8.021770346	11.9143809	0.170045102	4.780603281	0	0	1.585578809	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.4213	0	8.084549762	9.9176	0.214206516	1.106023229	0	0.965927802	1.817831557	0.903199382	1.140088818	1.746035992	0	0.120560113	0	0.032461029	3.985022918	8.021770346	11.9143809	0.170045102	4.780603281	0	0	1.585578809	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.4213	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	9.9176	0.214206516	1.106023229	0	0.965927802	1.817831557	0.903199382	1.140088818	1.746035992	0	0.120560113	0	0.032461029	3.985022918	8.021770346	11.9143809	0.170045102	4.780603281	0	0	1.585578809	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.4213
H1804_214_0	2008	8	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		229.509985	4.957116	553.767866	45.781429	138.860997	11.13918	5.534561	327.79636	285.626312	4916.925323	3209.520062		9.33321	1145.766848	7688.019272	5709.337148	62.276728	1374.510762			9.715998									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									527.264997	527.264744	24.373924	0	84.889401	0.169778	0.169778	42.444694	74.600851	0	0.458411		42.44429	42.444695	12.733409	25.466818	33.321739	42.444698			0.169778									0		0	0									10.0844	0.217809375	1.124791323	0	0.982318905	1.891187702	0.939646697	1.159434683	1.775663829	0	0.122606608	0	0.033011789	4.0526437	8.157891149	12.11655417	0.17293074	4.861724516	0	0	1.649562708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3422	0	8.573097129	10.0844	0.217809375	1.124791323	0	0.982318905	1.891187702	0.939646697	1.159434683	1.775663829	0	0.122606608	0	0.033011789	4.0526437	8.157891149	12.11655417	0.17293074	4.861724516	0	0	1.649562708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3422	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	10.0844	0.217809375	1.124791323	0	0.982318905	1.891187702	0.939646697	1.159434683	1.775663829	0	0.122606608	0	0.033011789	4.0526437	8.157891149	12.11655417	0.17293074	4.861724516	0	0	1.649562708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3422
H1804_215_0	2008	9	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		287.460313	6.208767	693.591976	57.341052	8.984548	17.474534	8.682315	410.563594	72.326516	24.322868	1.284174		0.091727	31.477551	9629.212548	7150.921317	1.253598	7.429864			15.241923									0.08		3976.50757	41.91378	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							541.708739	541.708278	25.002642	0	0.174158	0.174158	0.174158	43.539559	0.174158	0.174158	0.174158		0.174154	0.174158	13.061865	26.123731	0.174158	0.174158			0.174158									0		0	26.123617	0	0							12.9766	0.280278373	1.445135989	0	1.564730911	3.043329892	1.512094616	1.489646485	12.59624137	4.236022045	0.223649175	0	0.015974624	5.482067327	10.48128953	15.56739541	0.21832412	1.293970255	0	0	2.654502826	0	0	0	0	0	0	0	0	0	0	0	0.091244961	0	0	0	0	0	0	0	0	75.1725	0	10.9262504	12.9766	0.280278373	1.445135989	0	1.564730911	3.043329892	1.512094616	1.489646485	12.59624137	4.236022045	0.223649175	0	0.015974624	5.482067327	10.48128953	15.56739541	0.21832412	1.293970255	0	0	2.654502826	0	0	0	0	0	0	0	0	0	0	0	0.091244961	0	0	0	0	0	0	0	0	75.1725	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.9766	0.280278373	1.445135989	0	1.564730911	3.043329892	1.512094616	1.489646485	12.59624137	4.236022045	0.223649175	0	0.015974624	5.482067327	10.48128953	15.56739541	0.21832412	1.293970255	0	0	2.654502826	0	0	0	0	0	0	0	0	0	0	0	0.091244961	0	0	0	0	0	0	0	0	75.1725
H1804_216_0	2008	8	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1496.197155	47.67898	595.987251	49.271815	149.447791	12.90243	6.410642	352.787628	307.402523	5291.792808	3454.21459		10.044775	1233.12037	8274.155579	6144.618286	67.024719	1479.30377			11.253968									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									113.571388	113.571283	25.21595	0	87.821981	0.175644	0.175643	43.910986	77.178037	0	0.474245		43.910759	43.910995	13.173299	26.346598	34.472857	43.911002			0.175644									0		0	0									14.1604	0.451246911	1.252365393	0	1.093733422	2.266234415	1.125984393	1.290937716	1.977060274	0	0.136512	0	0.036756141	4.5122952	9.083160451	13.49081565	0.192544463	5.413142567	0	0	1.976691955	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4599	0	7.913533656	14.1604	0.451246911	1.252365393	0	1.093733422	2.266234415	1.125984393	1.290937716	1.977060274	0	0.136512	0	0.036756141	4.5122952	9.083160451	13.49081565	0.192544463	5.413142567	0	0	1.976691955	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4599	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.1604	0.451246911	1.252365393	0	1.093733422	2.266234415	1.125984393	1.290937716	1.977060274	0	0.136512	0	0.036756141	4.5122952	9.083160451	13.49081565	0.192544463	5.413142567	0	0	1.976691955	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4599
H1804_217_0	2008	10	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1622.271113	51.696551	646.206883	53.423603	162.0407	15.168412	7.536507	382.514547	333.305162	5737.694783	3745.276836		10.891177	1337.026707	8971.360181	6662.381833	72.672417	1603.954242			13.23044									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									111.357228	111.357287	24.73639	0	86.151789	0.172303	0.172303	43.07591	75.710301	0	0.465226		43.07599	43.075895	12.922769	25.84554	33.817232	43.075902			0.172303									0		0	0									15.0543	0.479732306	1.33206879	0	1.16334135	2.613562893	1.298562766	1.37309685	2.102886178	0	0.145200013	0	0.039095686	4.799468504	9.661234603	14.34940468	0.204798332	5.757647978	0	0	2.279644503	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.654	0	9.83448438	15.0543	0.479732306	1.33206879	0	1.16334135	2.613562893	1.298562766	1.37309685	2.102886178	0	0.145200013	0	0.039095686	4.799468504	9.661234603	14.34940468	0.204798332	5.757647978	0	0	2.279644503	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.654	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	15.0543	0.479732306	1.33206879	0	1.16334135	2.613562893	1.298562766	1.37309685	2.102886178	0	0.145200013	0	0.039095686	4.799468504	9.661234603	14.34940468	0.204798332	5.757647978	0	0	2.279644503	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.654
H1804_218_0	2008	12	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1547.395386	49.310502	616.381283	50.957843	154.561731	13.800546	6.856875	364.859635	317.921504	5472.872175	3572.414037		10.388498	1275.3164	8557.288141	6354.880407	69.318229	1529.923928			12.037337									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									112.669916	112.669845	25.020847	0	87.142471	0.174284	0.174285	43.571236	76.580889	0	0.470576		43.570839	43.571247	13.071374	26.142749	34.20609	43.571249			0.174284									0		0	0									14.5287	0.462983885	1.285198481	0	1.122407597	2.405214359	1.195050459	1.324782105	2.028892617	0	0.140091026	0	0.037719631	4.630593822	9.32129281	13.84450362	0.197592132	5.555058035	0	0	2.097915242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.178	0	8.668806922	14.5287	0.462983885	1.285198481	0	1.122407597	2.405214359	1.195050459	1.324782105	2.028892617	0	0.140091026	0	0.037719631	4.630593822	9.32129281	13.84450362	0.197592132	5.555058035	0	0	2.097915242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.178	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.5287	0.462983885	1.285198481	0	1.122407597	2.405214359	1.195050459	1.324782105	2.028892617	0	0.140091026	0	0.037719631	4.630593822	9.32129281	13.84450362	0.197592132	5.555058035	0	0	2.097915242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.178
H1804_219_0	2008	11	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1717.059308	54.717144	683.964311	56.545108	171.508627	16.992772	8.44295	404.86461	352.779956	6072.944375	3964.110807		11.527543	1415.148264	9495.550638	7051.660262	76.918617	1697.672193			14.821713									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									109.702491	109.702545	24.376826	0	84.899526	0.169798	0.169799	42.449753	74.609732	0	0.458462		42.44937	42.449749	12.734924	25.46985	33.325705	42.449749			0.169799									0		0	0									15.6971	0.500217496	1.389406583	0	1.213416761	2.8853387	1.433604467	1.432200224	2.193401498	0	0.151449514	0	0.040778078	5.006057384	10.07709298	14.96706076	0.213613928	6.005479873	0	0	2.516712046	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.723	0	11.4175258	15.6971	0.500217496	1.389406583	0	1.213416761	2.8853387	1.433604467	1.432200224	2.193401498	0	0.151449514	0	0.040778078	5.006057384	10.07709298	14.96706076	0.213613928	6.005479873	0	0	2.516712046	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.723	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	15.6971	0.500217496	1.389406583	0	1.213416761	2.8853387	1.433604467	1.432200224	2.193401498	0	0.151449514	0	0.040778078	5.006057384	10.07709298	14.96706076	0.213613928	6.005479873	0	0	2.516712046	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.723
H1804_221_0	2008	11	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1586.775574	50.565422	632.067779	52.254688	158.495224	14.511916	7.210323	374.145071	326.012394	5612.153147	3663.32961		10.652877	1307.772359	8775.065456	6516.607906	71.082333	1568.859478			12.65782									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									111.980358	111.980336	24.871151	0	86.62113	0.173242	0.173242	43.310555	76.122672	0	0.46776		43.310562	43.310554	12.993165	25.98633	34.001492	43.310546			0.173242									0		0	0									14.8073	0.471861079	1.310021098	0	1.144086284	2.514073352	1.249130777	1.350369223	2.068077878	0	0.142796588	0	0.038448507	4.720028781	9.50132278	14.11189363	0.201408781	5.662346716	0	0	2.192866052	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.486	0	9.272739256	14.8073	0.471861079	1.310021098	0	1.144086284	2.514073352	1.249130777	1.350369223	2.068077878	0	0.142796588	0	0.038448507	4.720028781	9.50132278	14.11189363	0.201408781	5.662346716	0	0	2.192866052	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.486	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.8073	0.471861079	1.310021098	0	1.144086284	2.514073352	1.249130777	1.350369223	2.068077878	0	0.142796588	0	0.038448507	4.720028781	9.50132278	14.11189363	0.201408781	5.662346716	0	0	2.192866052	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.486
H1804_222_0	2008	11	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1614.428201	51.446622	643.08278	53.165326	161.25731	15.022104	7.463813	380.66527	331.693789	5709.95575	3727.170199		10.838524	1330.562816	8927.98791	6630.172377	72.32108	1596.199882			13.102825									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									111.495035	111.49504	24.766195	0	86.255605	0.172511	0.172511	43.127792	75.801478	0	0.465786		43.128261	43.127794	12.93834	25.87668	33.858013	43.127801			0.172511									0		0	0									15.0001	0.478003598	1.327226128	0	1.159112236	2.591478183	1.287589844	1.368104382	2.095239954	0	0.144671975	0	0.038953891	4.782019919	9.626111925	14.29723741	0.204054006	5.736715906	0	0	2.260381444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.397	0	9.708827961	15.0001	0.478003598	1.327226128	0	1.159112236	2.591478183	1.287589844	1.368104382	2.095239954	0	0.144671975	0	0.038953891	4.782019919	9.626111925	14.29723741	0.204054006	5.736715906	0	0	2.260381444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.397	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	15.0001	0.478003598	1.327226128	0	1.159112236	2.591478183	1.287589844	1.368104382	2.095239954	0	0.144671975	0	0.038953891	4.782019919	9.626111925	14.29723741	0.204054006	5.736715906	0	0	2.260381444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.397
H1804_223_0	2008	8	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1466.418935	46.730044	584.125553	48.291178	146.47339	12.39395	6.158	345.766235	301.284414	5186.472355	3385.466726		9.844858	1208.578064	8109.47834	6022.324383	65.690752	1449.861773			10.810454									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									114.09324	114.093298	25.328889	0	88.21533	0.17643	0.17643	44.10766	77.523669	0	0.476368		44.10739	44.10765	13.232295	26.46459	34.627163	44.107652			0.17643									0		0	0									13.9424	0.444298736	1.232937608	0	1.076766536	2.186664599	1.08645594	1.270911628	1.946389432	0	0.134394001	0	0.036185916	4.442294854	8.942250808	13.2815288	0.189557031	5.329166544	0	0	1.907288399	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.4495	0	7.491491954	13.9424	0.444298736	1.232937608	0	1.076766536	2.186664599	1.08645594	1.270911628	1.946389432	0	0.134394001	0	0.036185916	4.442294854	8.942250808	13.2815288	0.189557031	5.329166544	0	0	1.907288399	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.4495	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	13.9424	0.444298736	1.232937608	0	1.076766536	2.186664599	1.08645594	1.270911628	1.946389432	0	0.134394001	0	0.036185916	4.442294854	8.942250808	13.2815288	0.189557031	5.329166544	0	0	1.907288399	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.4495
H1804_224_0	2008	8	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1736.223371	55.327842	691.598022	57.176206	173.422831	17.374193	8.632461	409.383297	356.717326	6140.724383	4008.354166		11.6562	1430.942706	9601.530284	7130.363696	77.777103	1716.619879			15.154402									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									109.370452	109.370454	24.304194	0	84.646484	0.169293	0.169292	42.323256	74.387404	0	0.457096		42.323685	42.323255	12.696975	25.393949	33.22637	42.323251			0.169292									0		0	0									15.8243	0.504269267	1.400727708	0	1.223302741	2.941329256	1.461406588	1.443869507	2.211272987	0	0.152683555	0	0.041111111	5.046846086	10.15919916	15.08900767	0.215354233	6.054411168	0	0	2.565519023	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3346	0	11.75233642	15.8243	0.504269267	1.400727708	0	1.223302741	2.941329256	1.461406588	1.443869507	2.211272987	0	0.152683555	0	0.041111111	5.046846086	10.15919916	15.08900767	0.215354233	6.054411168	0	0	2.565519023	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3346	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	15.8243	0.504269267	1.400727708	0	1.223302741	2.941329256	1.461406588	1.443869507	2.211272987	0	0.152683555	0	0.041111111	5.046846086	10.15919916	15.08900767	0.215354233	6.054411168	0	0	2.565519023	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3346
H1804_225_0	2008	9	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1530.682041	48.777902	609.723778	50.40745	152.892316	13.504039	6.709554	360.918803	314.487648	5413.759938	3533.82856		10.27629	1261.541768	8464.86127	6286.24164	68.569529	1513.399291			11.778713									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									112.962952	112.962918	25.085057	0	87.366125	0.174732	0.174732	43.683039	76.777399	0	0.471784		43.683177	43.683049	13.104915	26.209829	34.293869	43.683047			0.174732									0		0	0									14.4092	0.459174512	1.274579644	0	1.113134099	2.359587743	1.17237379	1.313835846	2.012128636	0	0.138933648	0	0.037408416	4.592332572	9.244273953	13.73010987	0.195959537	5.509157697	0	0	2.05811808	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.6203	0	8.417221791	14.4092	0.459174512	1.274579644	0	1.113134099	2.359587743	1.17237379	1.313835846	2.012128636	0	0.138933648	0	0.037408416	4.592332572	9.244273953	13.73010987	0.195959537	5.509157697	0	0	2.05811808	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.6203	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.4092	0.459174512	1.274579644	0	1.113134099	2.359587743	1.17237379	1.313835846	2.012128636	0	0.138933648	0	0.037408416	4.592332572	9.244273953	13.73010987	0.195959537	5.509157697	0	0	2.05811808	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.6203
H1804_226_0	2008	9	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1650.708951	52.602773	657.534661	54.360101	164.881215	15.704872	7.80305	389.219891	339.147883	5838.274543	3810.930214		11.082095	1360.46431	9128.624952	6779.171028	73.946339	1632.070992			13.698359									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									110.860082	110.860141	24.628272	0	85.775192	0.17155	0.17155	42.887612	75.379306	0	0.463191		42.887232	42.887597	12.866279	25.73256	33.669389	42.887601			0.17155									0		0	0									15.2498	0.485962569	1.349495207	0	1.178559823	2.694170792	1.338613228	1.391059306	2.130394338	0	0.147099048	0	0.039606698	4.862253755	9.787619627	14.53711877	0.207477338	5.832967459	0	0	2.349953486	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.5822	0	10.29725079	15.2498	0.485962569	1.349495207	0	1.178559823	2.694170792	1.338613228	1.391059306	2.130394338	0	0.147099048	0	0.039606698	4.862253755	9.787619627	14.53711877	0.207477338	5.832967459	0	0	2.349953486	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.5822	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	15.2498	0.485962569	1.349495207	0	1.178559823	2.694170792	1.338613228	1.391059306	2.130394338	0	0.147099048	0	0.039606698	4.862253755	9.787619627	14.53711877	0.207477338	5.832967459	0	0	2.349953486	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.5822
H1804_227_0	2008	10	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		263.875338	5.699362	636.685514	52.636447	7.570727	14.724716	7.316054	376.878485	60.945112	20.495387	1.082095		0.077292	26.524199	8839.173982	6564.216682	1.05633	6.26069			12.843432									0.08		3650.250951	38.474921	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							555.539367	555.539804	25.63083	0	0.178533	0.178533	0.178533	44.633449	0.178533	0.178533	0.178533		0.178529	0.178533	13.390034	26.78007	0.178533	0.178533			0.178533									0		0	26.779985	0	0							12.2161	0.263851871	1.359898181	0	1.351624603	2.628847722	1.306157069	1.40178222	10.88071368	3.659102927	0.193189667	0	0.013798863	4.73544482	9.863070013	14.64918185	0.188589764	1.117739768	0	0	2.292976445	0	0	0	0	0	0	0	0	0	0	0	0.085863151	0	0	0	0	0	0	0	0	68.2079	0	8.026656745	12.2161	0.263851871	1.359898181	0	1.351624603	2.628847722	1.306157069	1.40178222	10.88071368	3.659102927	0.193189667	0	0.013798863	4.73544482	9.863070013	14.64918185	0.188589764	1.117739768	0	0	2.292976445	0	0	0	0	0	0	0	0	0	0	0	0.085863151	0	0	0	0	0	0	0	0	68.2079	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.2161	0.263851871	1.359898181	0	1.351624603	2.628847722	1.306157069	1.40178222	10.88071368	3.659102927	0.193189667	0	0.013798863	4.73544482	9.863070013	14.64918185	0.188589764	1.117739768	0	0	2.292976445	0	0	0	0	0	0	0	0	0	0	0	0.085863151	0	0	0	0	0	0	0	0	68.2079
H1804_228_0	2008	9	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		273.215598	5.9011	659.221946	54.499593	8.116166	15.78557	7.843145	390.21866	65.33595	21.971992	1.160055		0.082861	28.435156	9152.04971	6796.566908	1.132435	6.711746			13.768747									0.08		3779.457019	39.836798	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							550.121872	550.121949	25.384529	0	0.176818	0.176818	0.176818	44.204547	0.176818	0.176818	0.176818		0.176816	0.176818	13.261364	26.522729	0.176818	0.176818			0.176818									0		0	26.522731	0	0							12.5252	0.270527053	1.394503217	0	1.43508424	2.791172916	1.386809213	1.437453258	11.55257201	3.885043681	0.205118605	0	0.014651151	5.027847414	10.11405521	15.02195852	0.200234892	1.186757504	0	0	2.434562307	0	0	0	0	0	0	0	0	0	0	0	0.08804839	0	0	0	0	0	0	0	0	70.9716	0	9.109975071	12.5252	0.270527053	1.394503217	0	1.43508424	2.791172916	1.386809213	1.437453258	11.55257201	3.885043681	0.205118605	0	0.014651151	5.027847414	10.11405521	15.02195852	0.200234892	1.186757504	0	0	2.434562307	0	0	0	0	0	0	0	0	0	0	0	0.08804839	0	0	0	0	0	0	0	0	70.9716	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.5252	0.270527053	1.394503217	0	1.43508424	2.791172916	1.386809213	1.437453258	11.55257201	3.885043681	0.205118605	0	0.014651151	5.027847414	10.11405521	15.02195852	0.200234892	1.186757504	0	0	2.434562307	0	0	0	0	0	0	0	0	0	0	0	0.08804839	0	0	0	0	0	0	0	0	70.9716
H1804_229_0	2008	12	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		281.297022	6.075649	678.721022	56.111631	8.603407	16.733232	8.313996	401.760908	69.258293	23.291047	1.229697		0.087836	30.142216	9422.757481	6997.602034	1.200419	7.114676			14.595333									0.08		3891.249286	41.015128	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							545.373766	545.37366	25.169333	0	0.175319	0.175319	0.175319	43.829805	0.175319	0.175319	0.175318		0.175317	0.175319	13.14894	26.297879	0.175319	0.175319			0.175319									0		0	26.297926	0	0							12.7843	0.276124911	1.423579618	0	1.508340712	2.933653501	1.457601465	1.467425188	12.14229467	4.083363069	0.215588019	0	0.015399144	5.284503167	10.3249394	15.3351743	0.210456259	1.247337882	0	0	2.558839186	0	0	0	0	0	0	0	0	0	0	0	0.0898844	0	0	0	0	0	0	0	0	73.3588	0	10.11397675	12.7843	0.276124911	1.423579618	0	1.508340712	2.933653501	1.457601465	1.467425188	12.14229467	4.083363069	0.215588019	0	0.015399144	5.284503167	10.3249394	15.3351743	0.210456259	1.247337882	0	0	2.558839186	0	0	0	0	0	0	0	0	0	0	0	0.0898844	0	0	0	0	0	0	0	0	73.3588	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.7843	0.276124911	1.423579618	0	1.508340712	2.933653501	1.457601465	1.467425188	12.14229467	4.083363069	0.215588019	0	0.015399144	5.284503167	10.3249394	15.3351743	0.210456259	1.247337882	0	0	2.558839186	0	0	0	0	0	0	0	0	0	0	0	0.0898844	0	0	0	0	0	0	0	0	73.3588
H1804_230_0	2008	17	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1529.981178	48.755568	609.444599	50.38437	152.822311	13.491662	6.703405	360.753546	314.343652	5411.281108	3532.210504		10.271586	1260.964138	8460.985413	6283.363321	68.53813	1512.706342			11.767918									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									112.975173	112.975131	25.087727	0	87.375382	0.17475	0.17475	43.687706	76.78559	0	0.471834		43.687419	43.687697	13.10631	26.212619	34.297475	43.687699			0.17475									0		0	0									14.4042	0.45901389	1.274131643	0	1.112742317	2.357667935	1.171420024	1.313374571	2.011421898	0	0.138884751	0	0.037394923	4.590718266	9.241024811	13.72528406	0.1958904	5.507221612	0	0	2.056443671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.5968	0	8.406804084	14.4042	0.45901389	1.274131643	0	1.112742317	2.357667935	1.171420024	1.313374571	2.011421898	0	0.138884751	0	0.037394923	4.590718266	9.241024811	13.72528406	0.1958904	5.507221612	0	0	2.056443671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.5968	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.4042	0.45901389	1.274131643	0	1.112742317	2.357667935	1.171420024	1.313374571	2.011421898	0	0.138884751	0	0.037394923	4.590718266	9.241024811	13.72528406	0.1958904	5.507221612	0	0	2.056443671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.5968
H1804_231_0	2008	16	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1653.515469	52.692208	658.652595	54.452523	165.161544	15.758322	7.829607	389.881638	339.724499	5848.200713	3817.409515		11.100937	1362.777357	9144.145339	6790.696903	74.072063	1634.84582			13.744981									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									110.811064	110.81114	24.617592	0	85.737987	0.171475	0.171476	42.869004	75.346622	0	0.462992		42.869088	42.868992	12.8607	25.721399	33.654752	42.869002			0.171475									0		0	0									15.269	0.486573636	1.351203404	0	1.180051526	2.702158265	1.34258969	1.392819792	2.133091118	0	0.147285839	0	0.039657254	4.868407635	9.800009163	14.55551871	0.207739743	5.840350727	0	0	2.356920617	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6734	0	10.34354032	15.269	0.486573636	1.351203404	0	1.180051526	2.702158265	1.34258969	1.392819792	2.133091118	0	0.147285839	0	0.039657254	4.868407635	9.800009163	14.55551871	0.207739743	5.840350727	0	0	2.356920617	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6734	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	15.269	0.486573636	1.351203404	0	1.180051526	2.702158265	1.34258969	1.392819792	2.133091118	0	0.147285839	0	0.039657254	4.868407635	9.800009163	14.55551871	0.207739743	5.840350727	0	0	2.356920617	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6734
H1804_232_0	2008	15	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1593.494345	50.779527	634.744098	52.475944	159.166329	14.635058	7.271507	375.729286	327.392806	5635.916288	3678.840984		10.697983	1313.309767	8812.221091	6544.200715	71.383311	1575.502388			12.765229									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									111.862701	111.862759	24.845672	0	86.532395	0.173064	0.173064	43.266208	76.044747	0	0.467281		43.266268	43.266191	12.979859	25.95972	33.966598	43.266198			0.173064									0		0	0									14.8544	0.473361499	1.314220305	0	1.147753638	2.532801678	1.258436087	1.354698453	2.074708592	0	0.143254374	0	0.038571817	4.735159268	9.53178227	14.15713485	0.202054019	5.680499856	0	0	2.209201592	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.708	0	9.377676002	14.8544	0.473361499	1.314220305	0	1.147753638	2.532801678	1.258436087	1.354698453	2.074708592	0	0.143254374	0	0.038571817	4.735159268	9.53178227	14.15713485	0.202054019	5.680499856	0	0	2.209201592	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.708	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.8544	0.473361499	1.314220305	0	1.147753638	2.532801678	1.258436087	1.354698453	2.074708592	0	0.143254374	0	0.038571817	4.735159268	9.53178227	14.15713485	0.202054019	5.680499856	0	0	2.209201592	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.708
H1804_233_0	2008	8	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1510.165328	48.1241	601.551259	49.731807	150.843003	13.144443	6.530887	356.081176	310.272369	5341.195843	3486.46239		10.138552	1244.632514	8351.401306	6201.983113	67.650446	1493.11423			11.46506									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									113.323595	113.323617	25.162974	0	87.637498	0.175275	0.175275	43.818762	77.015903	0	0.473249		43.818784	43.818743	13.145625	26.29125	34.400309	43.818747			0.175275									0		0	0									14.2614	0.454466423	1.261401557	0	1.101625281	2.303892247	1.144701219	1.300253025	1.991325556	0	0.13749707	0	0.037021585	4.544852688	9.148699149	13.58815738	0.193933021	5.452199557	0	0	2.009538392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.931	0	8.115544854	14.2614	0.454466423	1.261401557	0	1.101625281	2.303892247	1.144701219	1.300253025	1.991325556	0	0.13749707	0	0.037021585	4.544852688	9.148699149	13.58815738	0.193933021	5.452199557	0	0	2.009538392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.931	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.2614	0.454466423	1.261401557	0	1.101625281	2.303892247	1.144701219	1.300253025	1.991325556	0	0.13749707	0	0.037021585	4.544852688	9.148699149	13.58815738	0.193933021	5.452199557	0	0	2.009538392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.931
H1804_234_0	2008	8	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1457.496359	46.445711	580.57138	47.997346	145.582158	12.243589	6.083293	343.662385	299.451218	5154.91473	3364.867504		9.784956	1201.224344	8060.135385	5985.680932	65.291048	1441.03994			10.679303									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									114.249509	114.249444	25.362782	0	88.333425	0.176666	0.176666	44.166712	77.627459	0	0.477009		44.167079	44.166705	13.250009	26.500021	34.673597	44.166699			0.176666									0		0	0									13.8765	0.442199721	1.227075446	0	1.071647553	2.163025894	1.074711041	1.264869799	1.937136429	0	0.133756007	0	0.03601441	4.42117677	8.899738866	13.2183892	0.188656291	5.30383144	0	0	1.886669744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1454	0	7.367147335	13.8765	0.442199721	1.227075446	0	1.071647553	2.163025894	1.074711041	1.264869799	1.937136429	0	0.133756007	0	0.03601441	4.42117677	8.899738866	13.2183892	0.188656291	5.30383144	0	0	1.886669744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1454	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	13.8765	0.442199721	1.227075446	0	1.071647553	2.163025894	1.074711041	1.264869799	1.937136429	0	0.133756007	0	0.03601441	4.42117677	8.899738866	13.2183892	0.188656291	5.30383144	0	0	1.886669744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1454
H1804_235_0	2008	8	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1793.875057	57.165016	714.562691	59.074755	179.181375	18.547194	9.215273	422.976961	368.562205	6344.628515	4141.452466		12.043247	1478.45748	9920.351253	7367.129023	80.359709	1773.620626			16.177536									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									108.376417	108.376436	24.087344	0	83.891292	0.167782	0.167782	41.945649	73.723759	0	0.453019		41.945486	41.945653	12.583694	25.16739	32.929939	41.94565			0.167782									0		0	0									16.2011	0.516278391	1.434326446	0	1.252646421	3.111885304	1.546156934	1.478503595	2.264315931	0	0.156346388	0	0.042096654	5.167905369	10.40288871	15.45095078	0.220520026	6.199639168	0	0	2.714299345	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.1599	0	12.78533488	16.2011	0.516278391	1.434326446	0	1.252646421	3.111885304	1.546156934	1.478503595	2.264315931	0	0.156346388	0	0.042096654	5.167905369	10.40288871	15.45095078	0.220520026	6.199639168	0	0	2.714299345	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.1599	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	16.2011	0.516278391	1.434326446	0	1.252646421	3.111885304	1.546156934	1.478503595	2.264315931	0	0.156346388	0	0.042096654	5.167905369	10.40288871	15.45095078	0.220520026	6.199639168	0	0	2.714299345	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.1599
H1804_236_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1546.475217	49.28118	616.014747	50.927541	154.469819	13.784143	6.848725	364.642669	317.732449	5469.617695	3570.289675		10.382319	1274.558026	8552.19949	6351.101433	69.277009	1529.014148			12.02303									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									112.686037	112.686108	25.024379	0	87.154766	0.174309	0.174309	43.577386	76.591716	0	0.470641		43.577739	43.577404	13.073219	26.146439	34.210893	43.577398			0.174309									0		0	0									14.5222	0.462775364	1.284615542	0	1.121898411	2.402700182	1.193794406	1.324181195	2.027972791	0	0.140027059	0	0.037703166	4.628494168	9.317064739	13.83822385	0.197502362	5.552538173	0	0	2.095722336	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1474	0	8.654865317	14.5222	0.462775364	1.284615542	0	1.121898411	2.402700182	1.193794406	1.324181195	2.027972791	0	0.140027059	0	0.037703166	4.628494168	9.317064739	13.83822385	0.197502362	5.552538173	0	0	2.095722336	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1474	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.5222	0.462775364	1.284615542	0	1.121898411	2.402700182	1.193794406	1.324181195	2.027972791	0	0.140027059	0	0.037703166	4.628494168	9.317064739	13.83822385	0.197502362	5.552538173	0	0	2.095722336	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1474
H1804_237_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1793.617411	57.156805	714.460061	59.066272	179.15564	18.54184	9.212612	422.91621	368.509268	6343.71726	4140.857644		12.041518	1478.245134	9918.926431	7366.070911	80.348168	1773.365889			16.172866									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									108.380834	108.380849	24.088328	0	83.894718	0.167789	0.167789	41.947352	73.726738	0	0.453039		41.947356	41.947351	12.584204	25.168409	32.931242	41.947352			0.167789									0		0	0									16.1995	0.516225254	1.434179024	0	1.252517658	3.111116792	1.545774955	1.478351261	2.264082188	0	0.156330834	0	0.042092487	5.167372292	10.40181614	15.44935712	0.22049708	6.199000264	0	0	2.713629013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.1518	0	12.78059515	16.1995	0.516225254	1.434179024	0	1.252517658	3.111116792	1.545774955	1.478351261	2.264082188	0	0.156330834	0	0.042092487	5.167372292	10.40181614	15.44935712	0.22049708	6.199000264	0	0	2.713629013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.1518	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	16.1995	0.516225254	1.434179024	0	1.252517658	3.111116792	1.545774955	1.478351261	2.264082188	0	0.156330834	0	0.042092487	5.167372292	10.40181614	15.44935712	0.22049708	6.199000264	0	0	2.713629013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.1518
H1804_238_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1719.347462	54.790061	684.875763	56.62046	171.737179	17.038076	8.465459	405.404133	353.25007	6081.037187	3969.393385		11.542903	1417.034093	9508.204418	7061.05731	77.021118	1699.934513			14.861228									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									109.66284	109.662897	24.368186	0	84.86939	0.169738	0.169738	42.434702	74.583286	0	0.4583		42.434321	42.434702	12.73041	25.460819	33.313852	42.434697			0.169738									0		0	0									15.7124	0.500703068	1.390764998	0	1.214602469	2.892008944	1.43691008	1.433600298	2.195545917	0	0.151597749	0	0.040817938	5.010951622	10.08694505	14.98169184	0.21382251	6.011350498	0	0	2.522515118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.7962	0	11.45715435	15.7124	0.500703068	1.390764998	0	1.214602469	2.892008944	1.43691008	1.433600298	2.195545917	0	0.151597749	0	0.040817938	5.010951622	10.08694505	14.98169184	0.21382251	6.011350498	0	0	2.522515118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.7962	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	15.7124	0.500703068	1.390764998	0	1.214602469	2.892008944	1.43691008	1.433600298	2.195545917	0	0.151597749	0	0.040817938	5.010951622	10.08694505	14.98169184	0.21382251	6.011350498	0	0	2.522515118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.7962
H1804_239_0	2008	8	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1456.675874	46.419564	580.244553	47.970326	145.500204	12.229789	6.076436	343.468924	299.282645	5152.012816	3362.973283		9.779447	1200.548127	8055.598003	5982.311346	65.254294	1440.228719			10.667266									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									114.26394	114.263937	25.365883	0	88.344221	0.176688	0.176688	44.172114	77.636933	0	0.477065		44.172429	44.172101	13.25163	26.503259	34.67771	44.1721			0.176688									0		0	0									13.8705	0.442006845	1.22653462	0	1.071175181	2.160856959	1.073633324	1.264312372	1.936282221	0	0.133696404	0	0.035998494	4.41922776	8.895817014	13.21256225	0.188572457	5.301493917	0	0	1.884777895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1174	0	7.355802175	13.8705	0.442006845	1.22653462	0	1.071175181	2.160856959	1.073633324	1.264312372	1.936282221	0	0.133696404	0	0.035998494	4.41922776	8.895817014	13.21256225	0.188572457	5.301493917	0	0	1.884777895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1174	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	13.8705	0.442006845	1.22653462	0	1.071175181	2.160856959	1.073633324	1.264312372	1.936282221	0	0.133696404	0	0.035998494	4.41922776	8.895817014	13.21256225	0.188572457	5.301493917	0	0	1.884777895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1174
H1804_240_0	2008	8	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1586.778641	50.565521	632.069001	52.254788	158.495531	14.51197	7.21035	374.145794	326.013025	5612.163996	3663.336689		10.652898	1307.774886	8775.082418	6516.620502	71.08247	1568.862511			12.657868									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									111.980226	111.980191	24.871124	0	86.620993	0.173242	0.173242	43.310505	76.122628	0	0.467758		43.310426	43.310499	12.993149	25.986299	34.001387	43.310499			0.173242									0		0	0									14.8073	0.471861392	1.310022208	0	1.14408669	2.514082707	1.249135455	1.350370273	2.068080685	0	0.142796254	0	0.038448463	4.720031908	9.501329445	14.11190407	0.201408548	5.662351518	0	0	2.192874368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.4861	0	9.272828232	14.8073	0.471861392	1.310022208	0	1.14408669	2.514082707	1.249135455	1.350370273	2.068080685	0	0.142796254	0	0.038448463	4.720031908	9.501329445	14.11190407	0.201408548	5.662351518	0	0	2.192874368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.4861	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.8073	0.471861392	1.310022208	0	1.14408669	2.514082707	1.249135455	1.350370273	2.068080685	0	0.142796254	0	0.038448463	4.720031908	9.501329445	14.11190407	0.201408548	5.662351518	0	0	2.192874368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.4861
H1804_241_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		273.05913	5.89772	658.844415	54.468381	165.209644	15.767513	7.834173	389.995185	339.823438	5849.90389	3818.521263		11.104171	1363.174241	9146.808399	6792.674563	74.093634	1635.321939			13.752998									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									501.117511	501.117636	23.185854	0	80.751598	0.161503	0.161503	40.375801	70.964554	0	0.436067		40.375469	40.375802	12.112739	24.22548	31.697497	40.375797			0.161503									0		0	0									11.4029	0.246287625	1.272989201	0	1.11174523	2.546500652	1.265242442	1.312197332	2.009618226	0	0.138760926	0	0.037361343	4.586604437	9.232741902	13.71298348	0.195715228	5.502285553	0	0	2.221150436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.7951	0	13.22223739	11.4029	0.246287625	1.272989201	0	1.11174523	2.546500652	1.265242442	1.312197332	2.009618226	0	0.138760926	0	0.037361343	4.586604437	9.232741902	13.71298348	0.195715228	5.502285553	0	0	2.221150436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.7951	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	11.4029	0.246287625	1.272989201	0	1.11174523	2.546500652	1.265242442	1.312197332	2.009618226	0	0.138760926	0	0.037361343	4.586604437	9.232741902	13.71298348	0.195715228	5.502285553	0	0	2.221150436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.7951
H1804_242_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		293.330668	6.335559	707.756127	58.51204	9.355248	18.195529	9.040546	418.947896	75.31069	25.326423	1.337159		0.095511	32.776307	9825.854998	7296.953473	1.305322	7.736418			15.870801									0.08		4057.713608	42.76972	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							538.205001	538.204949	24.843377	0	0.173048	0.173048	0.173048	43.262194	0.173048	0.173048	0.173048		0.173046	0.173048	12.97866	25.95732	0.173048	0.173048			0.173048									0		0	25.957247	0	0							13.156	0.284152434	1.465254357	0	1.618906956	3.148699902	1.564448404	1.510383763	13.03236428	4.382686847	0.231392691	0	0.016527797	5.671874374	10.6272026	15.78411303	0.225883361	1.338771662	0	0	2.746410371	0	0	0	0	0	0	0	0	0	0	0	0.092515349	0	0	0	0	0	0	0	0	76.8976	0	11.73393193	13.156	0.284152434	1.465254357	0	1.618906956	3.148699902	1.564448404	1.510383763	13.03236428	4.382686847	0.231392691	0	0.016527797	5.671874374	10.6272026	15.78411303	0.225883361	1.338771662	0	0	2.746410371	0	0	0	0	0	0	0	0	0	0	0	0.092515349	0	0	0	0	0	0	0	0	76.8976	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	13.156	0.284152434	1.465254357	0	1.618906956	3.148699902	1.564448404	1.510383763	13.03236428	4.382686847	0.231392691	0	0.016527797	5.671874374	10.6272026	15.78411303	0.225883361	1.338771662	0	0	2.746410371	0	0	0	0	0	0	0	0	0	0	0	0.092515349	0	0	0	0	0	0	0	0	76.8976
H1804_243_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		299.798035	6.475246	723.360762	59.802115	181.387551	19.006724	9.443593	428.184876	373.100136	6422.746927	4192.444213		12.19153	1496.661028	10042.49585	7457.837001	81.34914	1795.458379			16.578355									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									485.93375	485.933179	22.492973	0	78.338403	0.156676	0.156676	39.169207	68.843844	0	0.423034		39.169167	39.169202	11.75076	23.501519	30.750193	39.169202			0.156676									0		0	0									12.1402	0.262211406	1.355877841	0	1.184134256	2.977897489	1.479584377	1.397638504	2.14047063	0	0.147795537	0	0.03979434	4.885251511	9.833913209	14.60587483	0.20845848	5.860555994	0	0	2.597430348	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1171	0	16.51101306	12.1402	0.262211406	1.355877841	0	1.184134256	2.977897489	1.479584377	1.397638504	2.14047063	0	0.147795537	0	0.03979434	4.885251511	9.833913209	14.60587483	0.20845848	5.860555994	0	0	2.597430348	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1171	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	12.1402	0.262211406	1.355877841	0	1.184134256	2.977897489	1.479584377	1.397638504	2.14047063	0	0.147795537	0	0.03979434	4.885251511	9.833913209	14.60587483	0.20845848	5.860555994	0	0	2.597430348	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1171
H1804_244_0	2008	9	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		208.661944	4.506825	503.465151	41.622773	4.733981	9.207377	4.574735	298.020262	38.109028	12.815782	0.676635		0.048331	16.585602	6989.661243	5190.717032	0.660524	3.914815			8.031008									0.08		2886.470801	30.424411	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							585.160647	585.159456	26.963769	0	0.187818	0.187818	0.187818	46.954646	0.187818	0.187818	0.187818		0.187814	0.187818	14.086395	28.172788	0.187818	0.187818			0.187818									0		0	28.172779	0	0							10.1751	0.219767605	1.131276503	0	0.889126843	1.729311133	0.859217578	1.166119659	7.157561421	2.407034544	0.127084232	0	0.009077238	3.115074596	8.204927432	12.18641421	0.124058297	0.735272724	0	0	1.508367861	0	0	0	0	0	0	0	0	0	0	0	0.071428351	0	0	0	0	0	0	0	0	51.8162	0	3.281555081	10.1751	0.219767605	1.131276503	0	0.889126843	1.729311133	0.859217578	1.166119659	7.157561421	2.407034544	0.127084232	0	0.009077238	3.115074596	8.204927432	12.18641421	0.124058297	0.735272724	0	0	1.508367861	0	0	0	0	0	0	0	0	0	0	0	0.071428351	0	0	0	0	0	0	0	0	51.8162	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	10.1751	0.219767605	1.131276503	0	0.889126843	1.729311133	0.859217578	1.166119659	7.157561421	2.407034544	0.127084232	0	0.009077238	3.115074596	8.204927432	12.18641421	0.124058297	0.735272724	0	0	1.508367861	0	0	0	0	0	0	0	0	0	0	0	0.071428351	0	0	0	0	0	0	0	0	51.8162
H1804_245_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		240.196685	5.187934	579.553023	47.913155	6.27298	12.200657	6.061962	343.059579	50.498118	16.98214	0.896606		0.064043	21.977515	8045.997415	5975.181682	0.875258	5.187505			10.641857									0.08		3322.698451	35.022403	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							568.859999	568.860219	26.232842	0	0.182727	0.182727	0.182727	45.681802	0.182727	0.182727	0.182726		0.182732	0.182727	13.70454	27.409079	0.182727	0.182727			0.182727									0		0	27.409077	0	0							11.3865	0.245934106	1.266943574	0	1.146242816	2.229389452	1.10768413	1.30596498	9.227369608	3.103095496	0.163833228	0	0.011702705	4.015885383	9.188891118	13.64785223	0.159933269	0.947897226	0	0	1.944554604	0	0	0	0	0	0	0	0	0	0	0	0.079994312	0	0	0	0	0	0	0	0	61.1797	0	5.654911851	11.3865	0.245934106	1.266943574	0	1.146242816	2.229389452	1.10768413	1.30596498	9.227369608	3.103095496	0.163833228	0	0.011702705	4.015885383	9.188891118	13.64785223	0.159933269	0.947897226	0	0	1.944554604	0	0	0	0	0	0	0	0	0	0	0	0.079994312	0	0	0	0	0	0	0	0	61.1797	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.3865	0.245934106	1.266943574	0	1.146242816	2.229389452	1.10768413	1.30596498	9.227369608	3.103095496	0.163833228	0	0.011702705	4.015885383	9.188891118	13.64785223	0.159933269	0.947897226	0	0	1.944554604	0	0	0	0	0	0	0	0	0	0	0	0.079994312	0	0	0	0	0	0	0	0	61.1797
H1804_246_0	2008	8	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		229.455297	4.955935	553.635912	45.77052	138.82791	11.133866	5.531921	327.718252	285.558252	4915.753711	3208.755293		9.330985	1145.493834	7686.187359	5707.976716	62.261887	1374.183241			9.711363									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									527.298762	527.299537	24.375488	0	84.894781	0.169789	0.169789	42.447408	74.605612	0	0.458441		42.447286	42.4474	12.734219	25.468438	33.323948	42.447403			0.169789									0		0	0									10.0826	0.217771853	1.124595461	0	0.982147085	1.890407974	0.939259335	1.159232529	1.775354013	0	0.122585415	0	0.033006249	4.051936247	8.156466092	12.11443759	0.17290099	4.860875819	0	0	1.648882612	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3325	0	8.567801459	10.0826	0.217771853	1.124595461	0	0.982147085	1.890407974	0.939259335	1.159232529	1.775354013	0	0.122585415	0	0.033006249	4.051936247	8.156466092	12.11443759	0.17290099	4.860875819	0	0	1.648882612	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3325	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	10.0826	0.217771853	1.124595461	0	0.982147085	1.890407974	0.939259335	1.159232529	1.775354013	0	0.122585415	0	0.033006249	4.051936247	8.156466092	12.11443759	0.17290099	4.860875819	0	0	1.648882612	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3325
H1804_247_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		267.497155	5.777589	645.42433	53.358908	7.779986	15.131717	7.518275	382.051324	62.629675	21.061892	1.112004		0.079429	27.257345	8960.495911	6654.313724	1.085528	6.43374			13.198433									0.08		3700.352406	39.003008	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							553.44498	553.444827	25.535553	0	0.17787	0.17787	0.17787	44.467563	0.17787	0.17787	0.17787		0.177872	0.17787	13.340265	26.680531	0.17787	0.17787			0.17787									0		0	26.680661	0	0							12.3371	0.266464729	1.373438932	0	1.38382611	2.691478503	1.337275574	1.415740943	11.13994029	3.74627873	0.197792151	0	0.014128195	4.848263955	9.961282499	14.79505197	0.193082865	1.144369334	0	0	2.347605278	0	0	0	0	0	0	0	0	0	0	0	0.086718836	0	0	0	0	0	0	0	0	69.2798	0	8.437296731	12.3371	0.266464729	1.373438932	0	1.38382611	2.691478503	1.337275574	1.415740943	11.13994029	3.74627873	0.197792151	0	0.014128195	4.848263955	9.961282499	14.79505197	0.193082865	1.144369334	0	0	2.347605278	0	0	0	0	0	0	0	0	0	0	0	0.086718836	0	0	0	0	0	0	0	0	69.2798	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.3371	0.266464729	1.373438932	0	1.38382611	2.691478503	1.337275574	1.415740943	11.13994029	3.74627873	0.197792151	0	0.014128195	4.848263955	9.961282499	14.79505197	0.193082865	1.144369334	0	0	2.347605278	0	0	0	0	0	0	0	0	0	0	0	0.086718836	0	0	0	0	0	0	0	0	69.2798
H1804_248_0	2008	9	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		276.086468	5.963107	666.148855	55.072258	167.041281	16.119057	8.008839	394.318963	343.590975	5914.760289	3860.856238		11.22728	1378.287408	9248.21674	6867.983222	74.915091	1653.452337			14.059627									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									499.363765	499.362963	23.105754	0	80.472618	0.160945	0.160945	40.236307	70.71937	0	0.43456		40.236013	40.236298	12.07089	24.141781	31.587844	40.236301			0.160945									0		0	0									11.489	0.248146232	1.282655964	0	1.120187433	2.594281629	1.288982593	1.322161571	2.024878107	0	0.139814474	0	0.037645082	4.621431906	9.30285058	13.81711224	0.197200517	5.54406716	0	0	2.262826668	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2932	0	13.57895833	11.489	0.248146232	1.282655964	0	1.120187433	2.594281629	1.288982593	1.322161571	2.024878107	0	0.139814474	0	0.037645082	4.621431906	9.30285058	13.81711224	0.197200517	5.54406716	0	0	2.262826668	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2932	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	11.489	0.248146232	1.282655964	0	1.120187433	2.594281629	1.288982593	1.322161571	2.024878107	0	0.139814474	0	0.037645082	4.621431906	9.30285058	13.81711224	0.197200517	5.54406716	0	0	2.262826668	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2932
H1804_249_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		268.701558	5.803602	648.330346	53.599156	7.8502	15.268278	7.586126	383.771505	63.194899	21.251973	1.12204		0.080146	27.503339	9000.840435	6684.274691	1.095325	6.491803			13.317547									0.08		3717.013199	39.178619	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							552.747507	552.747614	25.503707	0	0.177648	0.177648	0.177648	44.412101	0.177648	0.177648	0.177648		0.177646	0.177648	13.32363	26.64726	0.177648	0.177648			0.177648									0		0	26.647383	0	0							12.377	0.267327263	1.377902265	0	1.39457233	2.71237905	1.347660112	1.42034157	11.22644742	3.7753705	0.199328162	0	0.014237616	4.885913167	9.993655637	14.8431338	0.194582296	1.153255819	0	0	2.365835589	0	0	0	0	0	0	0	0	0	0	0	0.087000639	0	0	0	0	0	0	0	0	69.636	0	8.576736283	12.377	0.267327263	1.377902265	0	1.39457233	2.71237905	1.347660112	1.42034157	11.22644742	3.7753705	0.199328162	0	0.014237616	4.885913167	9.993655637	14.8431338	0.194582296	1.153255819	0	0	2.365835589	0	0	0	0	0	0	0	0	0	0	0	0.087000639	0	0	0	0	0	0	0	0	69.636	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.377	0.267327263	1.377902265	0	1.39457233	2.71237905	1.347660112	1.42034157	11.22644742	3.7753705	0.199328162	0	0.014237616	4.885913167	9.993655637	14.8431338	0.194582296	1.153255819	0	0	2.365835589	0	0	0	0	0	0	0	0	0	0	0	0.087000639	0	0	0	0	0	0	0	0	69.636
H1804_250_0	2008	11	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		327.749191	7.078954	790.802064	65.377662	198.298907	22.716052	11.286591	468.105959	407.885489	7021.560726	4583.319563		13.328186	1636.199652	10978.79073	8153.155648	88.933588	1962.854863			19.813765									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									470.791864	470.792487	21.801508	0	75.930204	0.15186	0.15186	37.96509	66.727517	0	0.410028		37.965025	37.965102	11.389529	22.779059	29.804863	37.9651			0.15186									0		0	0									12.8585	0.27772653	1.436723127	0	1.254739705	3.449659657	1.713981709	1.480973739	2.268098825	0	0.156607446	0	0.042167076	5.176540557	10.42027129	15.4767678	0.220887784	6.20999843	0	0	3.008918353	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.4525	0	20.27805624	12.8585	0.27772653	1.436723127	0	1.254739705	3.449659657	1.713981709	1.480973739	2.268098825	0	0.156607446	0	0.042167076	5.176540557	10.42027129	15.4767678	0.220887784	6.20999843	0	0	3.008918353	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.4525	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	12.8585	0.27772653	1.436723127	0	1.254739705	3.449659657	1.713981709	1.480973739	2.268098825	0	0.156607446	0	0.042167076	5.176540557	10.42027129	15.4767678	0.220887784	6.20999843	0	0	3.008918353	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.4525
H1804_251_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		239.587521	5.174777	578.083215	47.791643	6.241204	12.138856	6.031256	342.189546	50.242324	16.896119	0.892064		0.063719	21.86619	8025.591923	5960.027995	0.870824	5.161228			10.587951									0.08		3314.271741	34.933583	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							569.194387	569.195145	26.247827	0	0.182831	0.182831	0.182831	45.707907	0.182831	0.182831	0.182831		0.182834	0.182831	13.71237	27.424741	0.182831	0.182831			0.182831									0		0	27.424753	0	0							11.3643	0.245454829	1.264452352	0	1.141085569	2.219359181	1.102700566	1.303397329	9.185854339	3.089134333	0.163096953	0	0.01165	3.997817384	9.170823826	13.62101868	0.159213623	0.943632476	0	0	1.935805669	0	0	0	0	0	0	0	0	0	0	0	0.079837074	0	0	0	0	0	0	0	0	60.9987	0	5.600760689	11.3643	0.245454829	1.264452352	0	1.141085569	2.219359181	1.102700566	1.303397329	9.185854339	3.089134333	0.163096953	0	0.01165	3.997817384	9.170823826	13.62101868	0.159213623	0.943632476	0	0	1.935805669	0	0	0	0	0	0	0	0	0	0	0	0.079837074	0	0	0	0	0	0	0	0	60.9987	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.3643	0.245454829	1.264452352	0	1.141085569	2.219359181	1.102700566	1.303397329	9.185854339	3.089134333	0.163096953	0	0.01165	3.997817384	9.170823826	13.62101868	0.159213623	0.943632476	0	0	1.935805669	0	0	0	0	0	0	0	0	0	0	0	0.079837074	0	0	0	0	0	0	0	0	60.9987
H1804_252_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		237.929663	5.13897	574.083092	47.460943	143.955176	11.971455	5.948081	339.821719	296.104642	5097.304977	3327.262772		9.675603	1187.79983	7970.057774	5918.78679	64.561376	1424.935318			10.441938									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									522.093752	522.094359	24.13915	0	84.071667	0.168143	0.168143	42.035855	73.882278	0	0.453993		42.035836	42.035841	12.610754	25.221511	33.00072	42.035846			0.168143									0		0	0									10.3518	0.223585604	1.154823156	0	1.008545968	2.012916358	1.000128184	1.190391375	1.82307379	0	0.125879501	0	0.033893505	4.160847066	8.375703163	12.44006218	0.177547658	4.991530132	0	0	1.755738781	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8265	0	9.400523955	10.3518	0.223585604	1.154823156	0	1.008545968	2.012916358	1.000128184	1.190391375	1.82307379	0	0.125879501	0	0.033893505	4.160847066	8.375703163	12.44006218	0.177547658	4.991530132	0	0	1.755738781	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8265	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	10.3518	0.223585604	1.154823156	0	1.008545968	2.012916358	1.000128184	1.190391375	1.82307379	0	0.125879501	0	0.033893505	4.160847066	8.375703163	12.44006218	0.177547658	4.991530132	0	0	1.755738781	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8265
H1804_253_0	2008	9	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		229.20515	4.950532	553.032351	45.720623	5.712012	11.109601	5.519865	327.36098	45.982273	15.463495	0.816426		0.058316	20.012154	7677.808046	5701.754005	0.796987	4.723607			9.690198									0.08		3170.649902	33.419759	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							574.774988	574.774536	26.498536	0	0.184577	0.184577	0.184578	46.144497	0.184577	0.184578	0.184577		0.184574	0.184578	13.843349	27.686699	0.184577	0.184577			0.184578									0		0	27.686568	0	0							10.9784	0.237119978	1.221212305	0	1.054306039	2.050576824	1.018845642	1.258825647	8.487270004	2.85422098	0.150693462	0	0.010763617	3.693803361	8.857214695	13.15522891	0.147105469	0.871869209	0	0	1.788597366	0	0	0	0	0	0	0	0	0	0	0	0.077106536	0	0	0	0	0	0	0	0	57.9132	0	4.729277054	10.9784	0.237119978	1.221212305	0	1.054306039	2.050576824	1.018845642	1.258825647	8.487270004	2.85422098	0.150693462	0	0.010763617	3.693803361	8.857214695	13.15522891	0.147105469	0.871869209	0	0	1.788597366	0	0	0	0	0	0	0	0	0	0	0	0.077106536	0	0	0	0	0	0	0	0	57.9132	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	10.9784	0.237119978	1.221212305	0	1.054306039	2.050576824	1.018845642	1.258825647	8.487270004	2.85422098	0.150693462	0	0.010763617	3.693803361	8.857214695	13.15522891	0.147105469	0.871869209	0	0	1.788597366	0	0	0	0	0	0	0	0	0	0	0	0.077106536	0	0	0	0	0	0	0	0	57.9132
H1804_254_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		265.177217	5.727481	639.826723	52.896139	7.645617	14.870374	7.388424	378.737886	61.547984	20.698128	1.092799		0.078057	26.786577	8882.783723	6596.602489	1.06678	6.322621			12.97048									0.08		3668.260155	38.664745	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							554.785609	554.785063	25.596748	0	0.178296	0.178296	0.178296	44.574113	0.178296	0.178296	0.178296		0.178291	0.178296	13.37223	26.744459	0.178296	0.178296			0.178296									0		0	26.744498	0	0							12.2597	0.264793409	1.364790283	0	1.363182929	2.651328203	1.317326446	1.406825444	10.97375936	3.69039343	0.194841691	0	0.013916861	4.775939533	9.898552249	14.7018804	0.190202607	1.127298034	0	0	2.312584702	0	0	0	0	0	0	0	0	0	0	0	0.086172433	0	0	0	0	0	0	0	0	68.5935	0	8.172564372	12.2597	0.264793409	1.364790283	0	1.363182929	2.651328203	1.317326446	1.406825444	10.97375936	3.69039343	0.194841691	0	0.013916861	4.775939533	9.898552249	14.7018804	0.190202607	1.127298034	0	0	2.312584702	0	0	0	0	0	0	0	0	0	0	0	0.086172433	0	0	0	0	0	0	0	0	68.5935	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.2597	0.264793409	1.364790283	0	1.363182929	2.651328203	1.317326446	1.406825444	10.97375936	3.69039343	0.194841691	0	0.013916861	4.775939533	9.898552249	14.7018804	0.190202607	1.127298034	0	0	2.312584702	0	0	0	0	0	0	0	0	0	0	0	0.086172433	0	0	0	0	0	0	0	0	68.5935
H1804_255_0	2008	9	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		246.601514	5.32627	595.006768	49.190756	149.201928	12.860014	6.389566	352.207242	306.896805	5283.087071	3448.531924		10.02825	1231.091717	8260.543436	6134.509527	66.914451	1476.870109			11.216971									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									516.81938	516.819569	23.89991	0	83.238473	0.166477	0.166476	41.619245	73.150071	0	0.449493		41.618876	41.619243	12.485774	24.971548	32.673646	41.619246			0.166476									0		0	0									10.6207	0.22939338	1.185050684	0	1.034945055	2.140896551	1.063709389	1.221549958	1.87079359	0	0.129174247	0	0.034780374	4.269758777	8.594939872	12.76568326	0.182194924	5.122185031	0	0	1.867356464	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.3331	0	10.28871959	10.6207	0.22939338	1.185050684	0	1.034945055	2.140896551	1.063709389	1.221549958	1.87079359	0	0.129174247	0	0.034780374	4.269758777	8.594939872	12.76568326	0.182194924	5.122185031	0	0	1.867356464	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.3331	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	10.6207	0.22939338	1.185050684	0	1.034945055	2.140896551	1.063709389	1.221549958	1.87079359	0	0.129174247	0	0.034780374	4.269758777	8.594939872	12.76568326	0.182194924	5.122185031	0	0	1.867356464	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.3331
H1804_256_0	2008	9	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		361.590956	7.809892	872.456388	72.128237	14.215933	27.649337	13.737721	516.440273	114.439692	38.485214	2.031903		0.145136	49.805818	12112.40656	8995.01032	1.983525	11.756011			24.116756									0.08		5001.974578	52.722562	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							496.856867	496.85662	22.953692	0	0.159886	0.159885	0.159885	39.971491	0.159886	0.159886	0.159886		0.159884	0.159886	11.991449	23.982899	0.159886	0.159885			0.159885									0		0	23.982826	0	0							14.9716	0.323366378	1.668841268	0	2.272928664	4.420714246	2.196455522	1.720240644	18.2973046	6.153246926	0.324872843	0	0.023204924	7.963253017	12.10377546	17.977202	0.317137878	1.879609819	0	0	3.855907533	0	0	0	0	0	0	0	0	0	0	0	0.105369669	0	0	0	0	0	0	0	0	96.575	0	23.78830279	14.9716	0.323366378	1.668841268	0	2.272928664	4.420714246	2.196455522	1.720240644	18.2973046	6.153246926	0.324872843	0	0.023204924	7.963253017	12.10377546	17.977202	0.317137878	1.879609819	0	0	3.855907533	0	0	0	0	0	0	0	0	0	0	0	0.105369669	0	0	0	0	0	0	0	0	96.575	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	14.9716	0.323366378	1.668841268	0	2.272928664	4.420714246	2.196455522	1.720240644	18.2973046	6.153246926	0.324872843	0	0.023204924	7.963253017	12.10377546	17.977202	0.317137878	1.879609819	0	0	3.855907533	0	0	0	0	0	0	0	0	0	0	0	0.105369669	0	0	0	0	0	0	0	0	96.575
H1804_257_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		253.668678	5.478911	612.058609	50.600477	6.996391	13.60766	6.761038	362.300878	56.321654	18.940552	1.000004		0.071429	24.512003	8497.275978	6310.313705	0.976194	5.785737			11.869095									0.08		3509.059759	36.986717	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							561.371236	561.371353	25.894253	0	0.180368	0.180368	0.180368	45.0922	0.180368	0.180368	0.180368		0.180371	0.180368	13.52766	27.055321	0.180368	0.180368			0.180368									0		0	27.05538	0	0							11.8669	0.25630864	1.320733373	0	1.261925052	2.454386419	1.219474902	1.361411971	10.15862409	3.416269483	0.180368721	0	0.01288372	4.421180957	9.579021696	14.22729691	0.176074159	1.043561811	0	0	2.140804927	0	0	0	0	0	0	0	0	0	0	0	0.083390807	0	0	0	0	0	0	0	0	65.1806	0	6.940597509	11.8669	0.25630864	1.320733373	0	1.261925052	2.454386419	1.219474902	1.361411971	10.15862409	3.416269483	0.180368721	0	0.01288372	4.421180957	9.579021696	14.22729691	0.176074159	1.043561811	0	0	2.140804927	0	0	0	0	0	0	0	0	0	0	0	0.083390807	0	0	0	0	0	0	0	0	65.1806	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.8669	0.25630864	1.320733373	0	1.261925052	2.454386419	1.219474902	1.361411971	10.15862409	3.416269483	0.180368721	0	0.01288372	4.421180957	9.579021696	14.22729691	0.176074159	1.043561811	0	0	2.140804927	0	0	0	0	0	0	0	0	0	0	0	0.083390807	0	0	0	0	0	0	0	0	65.1806
H1804_258_0	2008	9	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		232.021077	5.011352	559.826696	46.282328	140.38029	11.384256	5.656329	331.382814	288.751378	4970.721909	3244.63575		9.435324	1158.302803	7772.13468	5771.80359	62.958103	1389.549425			9.929762									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									525.71812	525.718293	24.303549	0	84.644318	0.169288	0.169288	42.322158	74.38546	0	0.457086		42.322311	42.322152	12.696644	25.393291	33.225555	42.322148			0.169288									0		0	0									10.1648	0.219546618	1.133814628	0	0.990199492	1.92721793	0.957548624	1.168736318	1.789908673	0	0.123589798	0	0.03327706	4.085155608	8.223335596	12.21375735	0.174318159	4.900726368	0	0	1.680989549	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7869	0	8.816441065	10.1648	0.219546618	1.133814628	0	0.990199492	1.92721793	0.957548624	1.168736318	1.789908673	0	0.123589798	0	0.03327706	4.085155608	8.223335596	12.21375735	0.174318159	4.900726368	0	0	1.680989549	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7869	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	10.1648	0.219546618	1.133814628	0	0.990199492	1.92721793	0.957548624	1.168736318	1.789908673	0	0.123589798	0	0.03327706	4.085155608	8.223335596	12.21375735	0.174318159	4.900726368	0	0	1.680989549	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7869
H1804_259_0	2008	9	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		228.626115	4.938025	551.63524	45.60512	5.683192	11.053548	5.492014	326.533976	45.750269	15.385474	0.812307		0.058022	19.911182	7658.411804	5687.349816	0.792966	4.699774			9.641306									0.08		3162.639973	33.335331	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							575.079992	575.080443	26.51225	0	0.184673	0.184673	0.184673	46.168342	0.184673	0.184673	0.184672		0.184667	0.184673	13.850505	27.70101	0.184673	0.184673			0.184673									0		0	27.700901	0	0							10.9565	0.2366468	1.218757616	0	1.049532116	2.04129187	1.014226701	1.256294357	8.448839427	2.84128164	0.150010358	0	0.010714749	3.677057713	8.839405915	13.12877784	0.14643941	0.867921364	0	0	1.780488903	0	0	0	0	0	0	0	0	0	0	0	0.076951559	0	0	0	0	0	0	0	0	57.7412	0	4.683519594	10.9565	0.2366468	1.218757616	0	1.049532116	2.04129187	1.014226701	1.256294357	8.448839427	2.84128164	0.150010358	0	0.010714749	3.677057713	8.839405915	13.12877784	0.14643941	0.867921364	0	0	1.780488903	0	0	0	0	0	0	0	0	0	0	0	0.076951559	0	0	0	0	0	0	0	0	57.7412	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	10.9565	0.2366468	1.218757616	0	1.049532116	2.04129187	1.014226701	1.256294357	8.448839427	2.84128164	0.150010358	0	0.010714749	3.677057713	8.839405915	13.12877784	0.14643941	0.867921364	0	0	1.780488903	0	0	0	0	0	0	0	0	0	0	0	0.076951559	0	0	0	0	0	0	0	0	57.7412
H1804_260_0	2008	9	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		235.836834	5.093767	569.033456	47.043476	6.047327	11.761773	5.8439	336.832647	48.681591	16.371256	0.864353		0.061739	21.186936	7899.953122	5866.725122	0.843773	5.000899			10.259046									0.08		3262.387577	34.386707	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							571.235604	571.23484	26.339487	0	0.183469	0.18347	0.18347	45.867488	0.18347	0.183469	0.18347		0.183472	0.183469	13.760249	27.5205	0.18347	0.18347			0.183469									0		0	27.520574	0	0							11.2265	0.242478098	1.24900411	0	1.109497037	2.157932492	1.072180333	1.287472283	8.931611501	3.003617967	0.158582845	0	0.011327378	3.887145961	9.058776837	13.45460073	0.154807032	0.91751494	0	0	1.882216911	0	0	0	0	0	0	0	0	0	0	0	0.078861826	0	0	0	0	0	0	0	0	59.8842	0	5.274714487	11.2265	0.242478098	1.24900411	0	1.109497037	2.157932492	1.072180333	1.287472283	8.931611501	3.003617967	0.158582845	0	0.011327378	3.887145961	9.058776837	13.45460073	0.154807032	0.91751494	0	0	1.882216911	0	0	0	0	0	0	0	0	0	0	0	0.078861826	0	0	0	0	0	0	0	0	59.8842	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.2265	0.242478098	1.24900411	0	1.109497037	2.157932492	1.072180333	1.287472283	8.931611501	3.003617967	0.158582845	0	0.011327378	3.887145961	9.058776837	13.45460073	0.154807032	0.91751494	0	0	1.882216911	0	0	0	0	0	0	0	0	0	0	0	0.078861826	0	0	0	0	0	0	0	0	59.8842
H1804_261_0	2008	8	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		242.791835	5.243986	585.81467	48.430822	146.896947	12.465742	6.193671	346.766089	302.155639	5201.47009	3395.256489		9.873327	1212.072912	8132.928542	6039.739156	65.880708	1454.054342			10.873073									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									519.131247	519.130735	24.004712	0	83.603484	0.167206	0.167206	41.801758	73.47084	0	0.451463		41.801889	41.801743	12.540525	25.08105	32.81699	41.801751			0.167207									0		0	0									10.5034	0.226859526	1.17185937	0	1.023424713	2.084346857	1.035618953	1.207952678	1.849969051	0	0.127736057	0	0.034393643	4.22223003	8.499266142	12.62358331	0.180167211	5.065168129	0	0	1.818053917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.674	0	9.893989475	10.5034	0.226859526	1.17185937	0	1.023424713	2.084346857	1.035618953	1.207952678	1.849969051	0	0.127736057	0	0.034393643	4.22223003	8.499266142	12.62358331	0.180167211	5.065168129	0	0	1.818053917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.674	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	10.5034	0.226859526	1.17185937	0	1.023424713	2.084346857	1.035618953	1.207952678	1.849969051	0	0.127736057	0	0.034393643	4.22223003	8.499266142	12.62358331	0.180167211	5.065168129	0	0	1.818053917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.674
H1804_262_0	2008	10	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		223.264155	4.822215	538.69776	44.535545	5.419735	10.541137	5.23742	318.875788	43.629417	14.672247	0.77465		0.055332	18.988156	7478.799373	5553.964623	0.756206	4.481906			9.194362									0.08		3088.466703	32.553519	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							577.869354	577.869303	26.63746	0	0.185545	0.185545	0.185545	46.386395	0.185545	0.185545	0.185545		0.185538	0.185545	13.915919	27.83184	0.185545	0.185545			0.185545									0		0	27.831909	0	0							10.7515	0.232217502	1.195795003	0	1.005604731	1.955855265	0.971777094	1.232624855	8.095220177	2.72236207	0.143732434	0	0.010266189	3.523157405	8.672863858	12.88142123	0.140310242	0.831595249	0	0	1.705967897	0	0	0	0	0	0	0	0	0	0	0	0.075502215	0	0	0	0	0	0	0	0	56.1477	0	4.273910454	10.7515	0.232217502	1.195795003	0	1.005604731	1.955855265	0.971777094	1.232624855	8.095220177	2.72236207	0.143732434	0	0.010266189	3.523157405	8.672863858	12.88142123	0.140310242	0.831595249	0	0	1.705967897	0	0	0	0	0	0	0	0	0	0	0	0.075502215	0	0	0	0	0	0	0	0	56.1477	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	10.7515	0.232217502	1.195795003	0	1.005604731	1.955855265	0.971777094	1.232624855	8.095220177	2.72236207	0.143732434	0	0.010266189	3.523157405	8.672863858	12.88142123	0.140310242	0.831595249	0	0	1.705967897	0	0	0	0	0	0	0	0	0	0	0	0.075502215	0	0	0	0	0	0	0	0	56.1477
H1804_263_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		247.809715	5.352365	597.921947	49.431763	6.676926	12.986314	6.452319	353.932848	53.749923	18.075698	0.954342		0.068167	23.392749	8301.015177	6164.564972	0.93162	5.521552			11.327135									0.08		3428.011328	36.132439	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							564.661875	564.661854	26.042869	0	0.181403	0.181404	0.181404	45.350993	0.181404	0.181404	0.181403		0.181398	0.181404	13.6053	27.210599	0.181404	0.181403			0.181404									0		0	27.21057	0	0							11.6607	0.251856362	1.297633578	0	1.211214407	2.355769305	1.170476476	1.337600509	9.750451032	3.27900392	0.173120502	0	0.012365357	4.24353824	9.411483482	13.97845879	0.168999594	1.001626097	0	0	2.054787598	0	0	0	0	0	0	0	0	0	0	0	0.081932022	0	0	0	0	0	0	0	0	63.441	0	6.361133627	11.6607	0.251856362	1.297633578	0	1.211214407	2.355769305	1.170476476	1.337600509	9.750451032	3.27900392	0.173120502	0	0.012365357	4.24353824	9.411483482	13.97845879	0.168999594	1.001626097	0	0	2.054787598	0	0	0	0	0	0	0	0	0	0	0	0.081932022	0	0	0	0	0	0	0	0	63.441	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.6607	0.251856362	1.297633578	0	1.211214407	2.355769305	1.170476476	1.337600509	9.750451032	3.27900392	0.173120502	0	0.012365357	4.24353824	9.411483482	13.97845879	0.168999594	1.001626097	0	0	2.054787598	0	0	0	0	0	0	0	0	0	0	0	0.081932022	0	0	0	0	0	0	0	0	63.441
H1804_264_0	2008	9	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		273.399158	5.905065	659.664843	54.536209	165.415372	15.806812	7.853699	390.480828	340.246604	5857.188506	3823.276292		11.117998	1364.87174	9158.198497	6801.133168	74.185899	1637.358331			13.787275									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									500.919983	500.919236	23.176852	0	80.720174	0.16144	0.16144	40.360088	70.936988	0	0.435895		40.360107	40.360095	12.108029	24.216058	31.685197	40.360097			0.16144									0		0	0									11.4126	0.246496721	1.274079536	0	1.112696468	2.551851729	1.267901167	1.313320048	2.011339105	0	0.138878918	0	0.037393632	4.590529424	9.240644416	13.72471961	0.195882902	5.506995089	0	0	2.225817676	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.8511	0	13.26209455	11.4126	0.246496721	1.274079536	0	1.112696468	2.551851729	1.267901167	1.313320048	2.011339105	0	0.138878918	0	0.037393632	4.590529424	9.240644416	13.72471961	0.195882902	5.506995089	0	0	2.225817676	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.8511	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	11.4126	0.246496721	1.274079536	0	1.112696468	2.551851729	1.267901167	1.313320048	2.011339105	0	0.138878918	0	0.037393632	4.590529424	9.240644416	13.72471961	0.195882902	5.506995089	0	0	2.225817676	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.8511
H1804_265_0	2008	9	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		338.548558	7.312206	816.859069	67.531863	12.461848	24.237723	12.042643	483.530096	100.319133	33.736576	1.781189		0.127228	43.660346	11340.54296	8421.802923	1.73878	10.305453			21.141022									0.08		4683.223545	49.362813	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							510.773113	510.773041	23.591421	0	0.164328	0.164328	0.164328	41.082055	0.164328	0.164328	0.164328		0.16433	0.164328	12.324615	24.649229	0.164328	0.164328			0.164328									0		0	24.649223	0	0							14.4101	0.311239808	1.605905516	0	2.047830558	3.982936545	1.978943439	1.6553675	16.48524249	5.543864061	0.292699226	0	0.020907377	7.174617337	11.64731882	17.29924574	0.28573024	1.693474481	0	0	3.474061863	0	0	0	0	0	0	0	0	0	0	0	0.101396249	0	0	0	0	0	0	0	0	90.0109	0	19.1709444	14.4101	0.311239808	1.605905516	0	2.047830558	3.982936545	1.978943439	1.6553675	16.48524249	5.543864061	0.292699226	0	0.020907377	7.174617337	11.64731882	17.29924574	0.28573024	1.693474481	0	0	3.474061863	0	0	0	0	0	0	0	0	0	0	0	0.101396249	0	0	0	0	0	0	0	0	90.0109	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	14.4101	0.311239808	1.605905516	0	2.047830558	3.982936545	1.978943439	1.6553675	16.48524249	5.543864061	0.292699226	0	0.020907377	7.174617337	11.64731882	17.29924574	0.28573024	1.693474481	0	0	3.474061863	0	0	0	0	0	0	0	0	0	0	0	0.101396249	0	0	0	0	0	0	0	0	90.0109
H1804_266_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		233.874901	5.051393	564.299651	46.652119	5.947137	11.566908	5.74708	334.030526	47.875049	16.100022	0.850033		0.060717	20.835918	7834.233189	5817.919671	0.829794	4.918046			10.089077									0.08		3235.247683	34.100642	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							572.291229	572.290412	26.387028	0	0.183801	0.183801	0.183801	45.950304	0.183801	0.183801	0.183801		0.183795	0.183801	13.785089	27.570179	0.183801	0.183801			0.183801									0		0	27.570307	0	0							11.1537	0.240905315	1.240849224	0	1.093089728	2.126009257	1.056319051	1.279067018	8.799481881	2.959200144	0.156236915	0	0.011159481	3.829662564	8.99963348	13.36675723	0.152516967	0.903941773	0	0	1.854382442	0	0	0	0	0	0	0	0	0	0	0	0.078347097	0	0	0	0	0	0	0	0	59.3013	0	5.109068231	11.1537	0.240905315	1.240849224	0	1.093089728	2.126009257	1.056319051	1.279067018	8.799481881	2.959200144	0.156236915	0	0.011159481	3.829662564	8.99963348	13.36675723	0.152516967	0.903941773	0	0	1.854382442	0	0	0	0	0	0	0	0	0	0	0	0.078347097	0	0	0	0	0	0	0	0	59.3013	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.1537	0.240905315	1.240849224	0	1.093089728	2.126009257	1.056319051	1.279067018	8.799481881	2.959200144	0.156236915	0	0.011159481	3.829662564	8.99963348	13.36675723	0.152516967	0.903941773	0	0	1.854382442	0	0	0	0	0	0	0	0	0	0	0	0.078347097	0	0	0	0	0	0	0	0	59.3013
H1804_267_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		217.164667	4.690473	523.980751	43.318851	131.391678	9.973038	4.955157	310.164229	270.262503	4652.444438	3036.880323		8.831177	1084.136173	7274.48154	5402.232513	58.926868	1300.575976			8.698846									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									534.933137	534.932098	24.720342	0	86.095927	0.172191	0.172191	43.047951	75.661138	0	0.464925		43.048452	43.047959	12.914385	25.828769	33.795276	43.047953			0.172191									0		0	0									9.6807	0.20909038	1.079415281	0	0.942690693	1.717267386	0.853233439	1.112661211	1.704030711	0	0.117660132	0	0.031680708	3.889154127	7.82878794	11.62775131	0.165954147	4.665594457	0	0	1.497862992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1235	0	7.426904214	9.6807	0.20909038	1.079415281	0	0.942690693	1.717267386	0.853233439	1.112661211	1.704030711	0	0.117660132	0	0.031680708	3.889154127	7.82878794	11.62775131	0.165954147	4.665594457	0	0	1.497862992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1235	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	9.6807	0.20909038	1.079415281	0	0.942690693	1.717267386	0.853233439	1.112661211	1.704030711	0	0.117660132	0	0.031680708	3.889154127	7.82878794	11.62775131	0.165954147	4.665594457	0	0	1.497862992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1235
H1804_268_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		211.404448	4.566059	510.082338	42.169834	4.859242	9.451003	4.695781	301.937227	39.117386	13.154885	0.694538		0.04961	17.024456	7081.528362	5258.940111	0.678002	4.0184			8.243508									0.08		2924.408512	30.824289	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							583.833732	583.834799	26.904361	0	0.187404	0.187404	0.187404	46.851208	0.187404	0.187404	0.187405		0.187404	0.187404	14.055359	28.110719	0.187404	0.187404			0.187404									0		0	28.110821	0	0							10.2854	0.222152012	1.143619947	0	0.910641388	1.771155766	0.880008143	1.178843652	7.330754606	2.465278069	0.130159894	0	0.009297112	3.190451152	8.29445195	12.31938231	0.127060287	0.753064234	0	0	1.544866373	0	0	0	0	0	0	0	0	0	0	0	0.072208006	0	0	0	0	0	0	0	0	52.6288	0	3.454289334	10.2854	0.222152012	1.143619947	0	0.910641388	1.771155766	0.880008143	1.178843652	7.330754606	2.465278069	0.130159894	0	0.009297112	3.190451152	8.29445195	12.31938231	0.127060287	0.753064234	0	0	1.544866373	0	0	0	0	0	0	0	0	0	0	0	0.072208006	0	0	0	0	0	0	0	0	52.6288	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	10.2854	0.222152012	1.143619947	0	0.910641388	1.771155766	0.880008143	1.178843652	7.330754606	2.465278069	0.130159894	0	0.009297112	3.190451152	8.29445195	12.31938231	0.127060287	0.753064234	0	0	1.544866373	0	0	0	0	0	0	0	0	0	0	0	0.072208006	0	0	0	0	0	0	0	0	52.6288
H1804_269_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		244.235245	5.275163	589.297368	48.718746	6.485703	12.614396	6.26753	348.82763	52.210566	17.558023	0.927011		0.066215	22.722797	8181.279211	6075.64571	0.904939	5.363419			11.002734									0.08		3378.564816	35.611255	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							566.643139	566.642975	26.13234	0	0.182027	0.182027	0.182027	45.506785	0.182027	0.182027	0.182027		0.182027	0.182027	13.652039	27.304077	0.182027	0.182027			0.182027									0		0	27.304037	0	0							11.5329	0.249094505	1.283309932	0	1.18057306	2.296160661	1.140859683	1.32283533	9.503732697	3.196034253	0.168741031	0	0.012052918	4.13616257	9.307595238	13.82415819	0.164723331	0.97628707	0	0	2.002794662	0	0	0	0	0	0	0	0	0	0	0	0.081027585	0	0	0	0	0	0	0	0	62.379	0	6.023473208	11.5329	0.249094505	1.283309932	0	1.18057306	2.296160661	1.140859683	1.32283533	9.503732697	3.196034253	0.168741031	0	0.012052918	4.13616257	9.307595238	13.82415819	0.164723331	0.97628707	0	0	2.002794662	0	0	0	0	0	0	0	0	0	0	0	0.081027585	0	0	0	0	0	0	0	0	62.379	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.5329	0.249094505	1.283309932	0	1.18057306	2.296160661	1.140859683	1.32283533	9.503732697	3.196034253	0.168741031	0	0.012052918	4.13616257	9.307595238	13.82415819	0.164723331	0.97628707	0	0	2.002794662	0	0	0	0	0	0	0	0	0	0	0	0.081027585	0	0	0	0	0	0	0	0	62.379
H1804_270_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		252.303502	5.449425	608.764677	50.328159	152.651816	13.461582	6.688459	360.351075	313.992955	5405.244044	3528.269814		10.260126	1259.557351	8451.545965	6276.353324	68.461667	1511.0187			11.741681									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									513.384359	513.383979	23.743833	0	82.694869	0.165389	0.165389	41.347455	72.672338	0	0.44656		41.347909	41.347445	12.404234	24.808471	32.460255	41.347448			0.165389									0		0	0									10.7941	0.233137291	1.204533902	0	1.051960161	2.226397585	1.106197546	1.241633321	1.90155018	0	0.131298681	0	0.035352896	4.339956525	8.736246151	12.97556079	0.185190264	5.20639726	0	0	1.941944879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.3114	0	10.89295633	10.7941	0.233137291	1.204533902	0	1.051960161	2.226397585	1.106197546	1.241633321	1.90155018	0	0.131298681	0	0.035352896	4.339956525	8.736246151	12.97556079	0.185190264	5.20639726	0	0	1.941944879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.3114	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	10.7941	0.233137291	1.204533902	0	1.051960161	2.226397585	1.106197546	1.241633321	1.90155018	0	0.131298681	0	0.035352896	4.339956525	8.736246151	12.97556079	0.185190264	5.20639726	0	0	1.941944879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.3114
H1804_271_0	2008	9	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		246.261487	5.318926	594.18634	49.12293	6.593755	12.824552	6.371947	351.7216	53.080396	17.850541	0.942455		0.067318	23.101361	8249.153339	6126.050926	0.920015	5.452774			11.18604									0.08		3406.594313	35.906695	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							565.524369	565.523567	26.081664	0	0.181674	0.181674	0.181674	45.41856	0.181674	0.181674	0.181674		0.181679	0.181674	13.625565	27.251129	0.181674	0.181674			0.181674									0		0	27.251209	0	0							11.6056	0.250664834	1.291447373	0	1.197913846	2.32988766	1.157617099	1.331224049	9.643327863	3.242979186	0.17121957	0	0.012230267	4.196916658	9.366614585	13.911817	0.167142805	0.990627264	0	0	2.032212631	0	0	0	0	0	0	0	0	0	0	0	0.081541737	0	0	0	0	0	0	0	0	62.981	0	6.213597152	11.6056	0.250664834	1.291447373	0	1.197913846	2.32988766	1.157617099	1.331224049	9.643327863	3.242979186	0.17121957	0	0.012230267	4.196916658	9.366614585	13.911817	0.167142805	0.990627264	0	0	2.032212631	0	0	0	0	0	0	0	0	0	0	0	0.081541737	0	0	0	0	0	0	0	0	62.981	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.6056	0.250664834	1.291447373	0	1.197913846	2.32988766	1.157617099	1.331224049	9.643327863	3.242979186	0.17121957	0	0.012230267	4.196916658	9.366614585	13.911817	0.167142805	0.990627264	0	0	2.032212631	0	0	0	0	0	0	0	0	0	0	0	0.081541737	0	0	0	0	0	0	0	0	62.981
H1804_272_0	2008	6	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		247.96036	5.35562	598.285428	49.461813	6.685052	13.00212	6.460173	354.148007	53.815344	18.097699	0.955504		0.06825	23.42122	8306.061423	6168.312454	0.932754	5.528273			11.340921									0.08		3430.095241	36.154402	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							564.577496	564.578428	26.039113	0	0.181377	0.181377	0.181377	45.344459	0.181377	0.181377	0.181377		0.181377	0.181377	13.603335	27.206669	0.181377	0.181377			0.181377									0		0	27.206668	0	0							11.6661	0.251972293	1.298235155	0	1.212514677	2.358285519	1.171726798	1.338220815	9.760865649	3.282506352	0.173306449	0	0.01237898	4.24807062	9.415844672	13.98493627	0.169180122	1.002701572	0	0	2.056982228	0	0	0	0	0	0	0	0	0	0	0	0.081970068	0	0	0	0	0	0	0	0	63.4858	0	6.375558404	11.6661	0.251972293	1.298235155	0	1.212514677	2.358285519	1.171726798	1.338220815	9.760865649	3.282506352	0.173306449	0	0.01237898	4.24807062	9.415844672	13.98493627	0.169180122	1.002701572	0	0	2.056982228	0	0	0	0	0	0	0	0	0	0	0	0.081970068	0	0	0	0	0	0	0	0	63.4858	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.6661	0.251972293	1.298235155	0	1.212514677	2.358285519	1.171726798	1.338220815	9.760865649	3.282506352	0.173306449	0	0.01237898	4.24807062	9.415844672	13.98493627	0.169180122	1.002701572	0	0	2.056982228	0	0	0	0	0	0	0	0	0	0	0	0.081970068	0	0	0	0	0	0	0	0	63.4858
H1804_273_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		263.874325	5.69934	636.683071	52.636245	7.570671	14.724608	7.316	376.877038	60.944663	20.495236	1.082087		0.077292	26.524004	8839.140058	6564.191488	1.056323	6.260644			12.843337									0.08		3650.23694	38.474774	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							555.539982	555.540701	25.630856	0	0.178533	0.178534	0.178534	44.6335	0.178533	0.178533	0.178533		0.178529	0.178533	13.390049	26.7801	0.178534	0.178534			0.178533									0		0	26.780118	0	0							12.2161	0.263851278	1.359894343	0	1.351614606	2.628843165	1.306154744	1.40177844	10.88063352	3.659075969	0.193188238	0	0.013798863	4.735410006	9.863043208	14.64914204	0.18858957	1.117737816	0	0	2.292959485	0	0	0	0	0	0	0	0	0	0	0	0.085863249	0	0	0	0	0	0	0	0	68.2076	0	8.026539244	12.2161	0.263851278	1.359894343	0	1.351614606	2.628843165	1.306154744	1.40177844	10.88063352	3.659075969	0.193188238	0	0.013798863	4.735410006	9.863043208	14.64914204	0.18858957	1.117737816	0	0	2.292959485	0	0	0	0	0	0	0	0	0	0	0	0.085863249	0	0	0	0	0	0	0	0	68.2076	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.2161	0.263851278	1.359894343	0	1.351614606	2.628843165	1.306154744	1.40177844	10.88063352	3.659075969	0.193188238	0	0.013798863	4.735410006	9.863043208	14.64914204	0.18858957	1.117737816	0	0	2.292959485	0	0	0	0	0	0	0	0	0	0	0	0.085863249	0	0	0	0	0	0	0	0	68.2076
H1804_274_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		258.635161	5.586182	624.041874	51.591165	156.482675	14.145719	7.028375	369.394231	321.872737	5540.890846	3616.813182		10.517609	1291.166457	8663.640953	6433.860967	70.179739	1548.938329			12.338409									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									509.606238	509.606287	23.571931	0	82.096181	0.164192	0.164192	41.048109	72.146221	0	0.443326		41.047752	41.048098	12.314429	24.62886	32.225253	41.048101			0.164192									0		0	0									10.9835	0.237229456	1.225822666	0	1.070552501	2.322613894	1.154002948	1.263577888	1.935158468	0	0.133618943	0	0.035977017	4.416660605	8.890649283	13.20488842	0.18846332	5.298414748	0	0	2.025868051	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.387	0	11.58201638	10.9835	0.237229456	1.225822666	0	1.070552501	2.322613894	1.154002948	1.263577888	1.935158468	0	0.133618943	0	0.035977017	4.416660605	8.890649283	13.20488842	0.18846332	5.298414748	0	0	2.025868051	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.387	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	10.9835	0.237229456	1.225822666	0	1.070552501	2.322613894	1.154002948	1.263577888	1.935158468	0	0.133618943	0	0.035977017	4.416660605	8.890649283	13.20488842	0.18846332	5.298414748	0	0	2.025868051	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.387
H1804_275_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		272.746193	5.89096	658.089352	54.405958	165.020308	15.7314	7.81623	389.548233	339.433986	5843.199658	3814.145081		11.091445	1361.611987	9136.325777	6784.889878	74.008719	1633.447793			13.721499									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									501.299379	501.299647	23.19419	0	80.780586	0.161561	0.161561	40.390309	70.99007	0	0.436221		40.38999	40.390305	12.117089	24.23418	31.708849	40.390297			0.161561									0		0	0									11.394	0.246094681	1.271987456	0	1.110869765	2.541580715	1.262797935	1.311164458	2.008036869	0	0.138650848	0	0.037331946	4.582993621	9.225472714	13.70218688	0.195560941	5.497953458	0	0	2.2168591	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.7435	0	13.18554298	11.394	0.246094681	1.271987456	0	1.110869765	2.541580715	1.262797935	1.311164458	2.008036869	0	0.138650848	0	0.037331946	4.582993621	9.225472714	13.70218688	0.195560941	5.497953458	0	0	2.2168591	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.7435	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	11.394	0.246094681	1.271987456	0	1.110869765	2.541580715	1.262797935	1.311164458	2.008036869	0	0.138650848	0	0.037331946	4.582993621	9.225472714	13.70218688	0.195560941	5.497953458	0	0	2.2168591	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.7435
H1804_276_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		261.989107	5.658623	632.134366	52.260192	7.462884	14.514966	7.211838	374.184486	60.076965	20.203435	1.06668		0.076191	26.146369	8775.989895	6517.294418	1.041283	6.171508			12.660481									0.08		3624.158266	38.199895	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							556.63	556.630099	25.679922	0	0.178875	0.178875	0.178875	44.718949	0.178875	0.178875	0.178875		0.178873	0.178875	13.415684	26.831369	0.178876	0.178875			0.178875									0		0	26.831443	0	0							12.1526	0.26247999	1.352763434	0	1.334923376	2.596364543	1.290017522	1.394428079	10.74626711	3.613889436	0.190802385	0	0.013628513	4.676931755	9.811325602	14.57232762	0.186260538	1.103928494	0	0	2.264643539	0	0	0	0	0	0	0	0	0	0	0	0.085413192	0	0	0	0	0	0	0	0	67.649	0	7.818494185	12.1526	0.26247999	1.352763434	0	1.334923376	2.596364543	1.290017522	1.394428079	10.74626711	3.613889436	0.190802385	0	0.013628513	4.676931755	9.811325602	14.57232762	0.186260538	1.103928494	0	0	2.264643539	0	0	0	0	0	0	0	0	0	0	0	0.085413192	0	0	0	0	0	0	0	0	67.649	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.1526	0.26247999	1.352763434	0	1.334923376	2.596364543	1.290017522	1.394428079	10.74626711	3.613889436	0.190802385	0	0.013628513	4.676931755	9.811325602	14.57232762	0.186260538	1.103928494	0	0	2.264643539	0	0	0	0	0	0	0	0	0	0	0	0.085413192	0	0	0	0	0	0	0	0	67.649
H1804_277_0	2008	9	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		277.351129	5.990422	669.200263	55.324526	8.363738	16.267087	8.082389	396.125207	67.328935	22.642218	1.195441		0.085389	29.302532	9290.579762	6899.443182	1.166978	6.916479			14.188744									0.08		3836.664792	40.439788	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							547.703738	547.703494	25.274642	0	0.176052	0.176052	0.176052	44.013208	0.176052	0.176052	0.176052		0.176054	0.176052	13.20396	26.407921	0.176053	0.176052			0.176052									0		0	26.407797	0	0							12.6589	0.273414588	1.409483089	0	1.472452802	2.863853201	1.422920748	1.452895094	11.85339366	3.986207763	0.210459779	0	0.015033075	5.158769364	10.22270363	15.18332921	0.205449978	1.217659961	0	0	2.497956759	0	0	0	0	0	0	0	0	0	0	0	0.088993809	0	0	0	0	0	0	0	0	72.1938	0	9.615894349	12.6589	0.273414588	1.409483089	0	1.472452802	2.863853201	1.422920748	1.452895094	11.85339366	3.986207763	0.210459779	0	0.015033075	5.158769364	10.22270363	15.18332921	0.205449978	1.217659961	0	0	2.497956759	0	0	0	0	0	0	0	0	0	0	0	0.088993809	0	0	0	0	0	0	0	0	72.1938	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.6589	0.273414588	1.409483089	0	1.472452802	2.863853201	1.422920748	1.452895094	11.85339366	3.986207763	0.210459779	0	0.015033075	5.158769364	10.22270363	15.18332921	0.205449978	1.217659961	0	0	2.497956759	0	0	0	0	0	0	0	0	0	0	0	0.088993809	0	0	0	0	0	0	0	0	72.1938
H1804_278_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		253.119011	5.46704	610.732361	50.490832	6.966101	13.548746	6.731767	361.515821	56.077812	18.858549	0.995675		0.07112	24.405879	8478.863542	6296.640118	0.971968	5.760688			11.817708									0.08		3501.456105	36.906572	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							561.680632	561.681283	25.908328	0	0.180466	0.180466	0.180466	45.116702	0.180466	0.180466	0.180466		0.180466	0.180466	13.535009	27.070021	0.180467	0.180466			0.180466									0		0	27.069893	0	0							11.8477	0.255894503	1.318587861	0	1.257144383	2.445087996	1.214855063	1.35920013	10.12013842	3.403326904	0.179685485	0	0.012834742	4.40443136	9.563457863	14.20418169	0.175408149	1.039608321	0	0	2.132694492	0	0	0	0	0	0	0	0	0	0	0	0.083254746	0	0	0	0	0	0	0	0	65.0175	0	6.884782425	11.8477	0.255894503	1.318587861	0	1.257144383	2.445087996	1.214855063	1.35920013	10.12013842	3.403326904	0.179685485	0	0.012834742	4.40443136	9.563457863	14.20418169	0.175408149	1.039608321	0	0	2.132694492	0	0	0	0	0	0	0	0	0	0	0	0.083254746	0	0	0	0	0	0	0	0	65.0175	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.8477	0.255894503	1.318587861	0	1.257144383	2.445087996	1.214855063	1.35920013	10.12013842	3.403326904	0.179685485	0	0.012834742	4.40443136	9.563457863	14.20418169	0.175408149	1.039608321	0	0	2.132694492	0	0	0	0	0	0	0	0	0	0	0	0.083254746	0	0	0	0	0	0	0	0	65.0175
H1804_279_0	2008	11	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		1524.835897	48.591604	607.395056	50.214929	152.308374	13.401082	6.6584	359.540343	313.286524	5393.083129	3520.331786		10.237043	1256.723553	8432.531371	6262.232559	68.307639	1507.619156			11.688911									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									113.065527	113.065568	25.107337	0	87.443668	0.174887	0.174887	43.721856	76.845602	0	0.472205		43.721495	43.721848	13.116554	26.233109	34.324278	43.721846			0.174887									0		0	0									14.3672	0.457836442	1.270839364	0	1.109866907	2.343675028	1.164467601	1.309980925	2.006224295	0	0.138526523	0	0.037298235	4.578856347	9.21714609	13.68981911	0.195384199	5.492991047	0	0	2.044238578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4243	0	8.330513899	14.3672	0.457836442	1.270839364	0	1.109866907	2.343675028	1.164467601	1.309980925	2.006224295	0	0.138526523	0	0.037298235	4.578856347	9.21714609	13.68981911	0.195384199	5.492991047	0	0	2.044238578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4243	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.3672	0.457836442	1.270839364	0	1.109866907	2.343675028	1.164467601	1.309980925	2.006224295	0	0.138526523	0	0.037298235	4.578856347	9.21714609	13.68981911	0.195384199	5.492991047	0	0	2.044238578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4243
H1804_280_0	2008	8	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		249.654171	5.392203	602.372299	49.799684	6.776691	13.180352	6.548729	356.56718	54.553042	18.345781	0.968602		0.069186	23.742278	8362.799885	6210.448015	0.94554	5.604054			11.496382									0.08		3453.52612	36.401373	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							563.627482	563.627688	25.996509	0	0.18108	0.18108	0.18108	45.270262	0.181081	0.18108	0.18108		0.181078	0.18108	13.581075	27.162149	0.181081	0.181081			0.18108									0		0	27.16202	0	0							11.726	0.253266243	1.304964741	0	1.227123206	2.38669814	1.185843847	1.345157472	9.878519398	3.322054023	0.17539445	0	0.012528063	4.2992517	9.464651037	14.0574262	0.171219329	1.014787702	0	0	2.081764853	0	0	0	0	0	0	0	0	0	0	0	0.082394568	0	0	0	0	0	0	0	0	63.989	0	6.539671703	11.726	0.253266243	1.304964741	0	1.227123206	2.38669814	1.185843847	1.345157472	9.878519398	3.322054023	0.17539445	0	0.012528063	4.2992517	9.464651037	14.0574262	0.171219329	1.014787702	0	0	2.081764853	0	0	0	0	0	0	0	0	0	0	0	0.082394568	0	0	0	0	0	0	0	0	63.989	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.726	0.253266243	1.304964741	0	1.227123206	2.38669814	1.185843847	1.345157472	9.878519398	3.322054023	0.17539445	0	0.012528063	4.2992517	9.464651037	14.0574262	0.171219329	1.014787702	0	0	2.081764853	0	0	0	0	0	0	0	0	0	0	0	0.082394568	0	0	0	0	0	0	0	0	63.989
H1804_281_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		238.14715	5.143667	574.607849	47.504326	144.086763	11.993334	5.958953	340.132343	296.375304	5101.96431	3330.304149		9.684446	1188.885569	7977.343028	5924.197021	64.620391	1426.237819			10.461022									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QuitNet									521.960608	521.959996	24.13311	0	84.050698	0.168101	0.168101	42.025347	73.863818	0	0.45388		42.025497	42.025351	12.607605	25.21521	32.99247	42.025352			0.168101									0		0	0									10.3586	0.223732367	1.155589536	0	1.009216084	2.016091439	1.001705958	1.191181645	1.824284293	0	0.125963204	0	0.033916138	4.163611111	8.381265821	12.44832266	0.177665526	4.994845532	0	0	1.758508259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8645	0	9.422348503	10.3586	0.223732367	1.155589536	0	1.009216084	2.016091439	1.001705958	1.191181645	1.824284293	0	0.125963204	0	0.033916138	4.163611111	8.381265821	12.44832266	0.177665526	4.994845532	0	0	1.758508259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8645	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	10.3586	0.223732367	1.155589536	0	1.009216084	2.016091439	1.001705958	1.191181645	1.824284293	0	0.125963204	0	0.033916138	4.163611111	8.381265821	12.44832266	0.177665526	4.994845532	0	0	1.758508259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8645
H1804_282_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		232.541372	5.022589	561.08208	46.386115	140.695086	11.435362	5.681721	332.125923	289.398889	4981.868508	3251.911687		9.456483	1160.900241	7789.563311	5784.746576	63.099281	1392.665421			9.974338									0.08		3.38	0.02									$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									465.26424	465.264258	24.288967	0	84.593496	0.169186	0.169186	42.296749	74.340819	0	0.456811		42.296736	42.296747	12.689024	25.37805	33.205646	42.296753			0.169187									0		0	0									9.0161	0.194735929	1.135675344	0	0.9918241	1.934703155	0.961267649	1.1706539	1.792845869	0	0.123792419	0	0.03333153	4.091858649	8.23682965	12.23379899	0.174604366	4.908768777	0	0	1.687528323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.6883	0	8.867310601	9.0161	0.194735929	1.135675344	0	0.9918241	1.934703155	0.961267649	1.1706539	1.792845869	0	0.123792419	0	0.03333153	4.091858649	8.23682965	12.23379899	0.174604366	4.908768777	0	0	1.687528323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.6883	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	9.0161	0.194735929	1.135675344	0	0.9918241	1.934703155	0.961267649	1.1706539	1.792845869	0	0.123792419	0	0.03333153	4.091858649	8.23682965	12.23379899	0.174604366	4.908768777	0	0	1.687528323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.6883
H1804_801_0	2008	6																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		256.799821	5.54654	619.613515	51.22506	155.372234	13.945648	6.928969	366.772916	319.588647	5501.57128	3591.147361		10.442972	1282.00401	8602.161564	6388.204662	69.681727	1537.94667			12.1639																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					140.620072	140.62073	22.967217	0	79.350223	0.1587	0.1587	39.675087	158.700386	31.647587	78.921949		79.350412	73.753794	15.87004	23.80506	49.503185	79.350198			0.1587																					3.0093	0.064996542	1.185899838	0	1.027401785	2.213174338	1.09962738	1.212645613	4.226570137	14.50928798	23.61836241	0	0.069054511	7.879388305	11.37638734	12.67263294	0.287455619	10.16969773	0	0	1.93041093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.5523	0	25.12640386	3.0093	0.064996542	1.185899838	0	1.027401785	2.213174338	1.09962738	1.212645613	4.226570137	14.50928798	23.61836241	0	0.069054511	7.879388305	11.37638734	12.67263294	0.287455619	10.16969773	0	0	1.93041093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.5523	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	3.0093	0.064996542	1.185899838	0	1.027401785	2.213174338	1.09962738	1.212645613	4.226570137	14.50928798	23.61836241	0	0.069054511	7.879388305	11.37638734	12.67263294	0.287455619	10.16969773	0	0	1.93041093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.5523
H1804_804_0	2008	5																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		274.083265	5.91984	661.315474	54.672671	165.82928	15.886005	7.893047	391.457899	341.09798	5871.844521	3832.842996		11.145818	1368.286959	9181.11439	6818.151148	74.371528	1641.455372			13.85635																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					137.745804	137.745097	22.497778	0	77.728318	0.155456	0.155456	38.86416	155.45659	31.000716	77.308804		77.728453	72.246288	15.545659	23.31849	48.491303	77.728301			0.155456																					3.1462	0.067952411	1.23984406	0	1.074135917	2.469574793	1.227021514	1.267806868	4.418827402	15.16928203	24.692709	0	0.072195599	8.237804476	11.8938728	13.24908245	0.300531025	10.63229477	0	0	2.154052746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.3131	0	29.02953489	3.1462	0.067952411	1.23984406	0	1.074135917	2.469574793	1.227021514	1.267806868	4.418827402	15.16928203	24.692709	0	0.072195599	8.237804476	11.8938728	13.24908245	0.300531025	10.63229477	0	0	2.154052746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.3131	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	3.1462	0.067952411	1.23984406	0	1.074135917	2.469574793	1.227021514	1.267806868	4.418827402	15.16928203	24.692709	0	0.072195599	8.237804476	11.8938728	13.24908245	0.300531025	10.63229477	0	0	2.154052746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.3131
H1804_805_0	2008	5																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		270.266242	5.837397	652.10566	53.91127	163.519856	15.446606	7.674728	386.006259	336.347676	5790.070242	3779.464885		10.990595	1349.231502	9053.253544	6723.198123	73.335793	1618.595634			13.47309																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					138.371205	138.371289	22.599925	0	78.081173	0.156162	0.156162	39.040589	156.162411	31.141464	77.659797		78.080951	72.574306	15.61624	23.42436	48.711537	78.0812			0.156162																					3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	0	28.14902404	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751
H1804_806_0	2008	5																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		270.266242	5.837397	652.10566	53.91127	163.519856	15.446606	7.674728	386.006259	336.347676	5790.070242	3779.464885		10.990595	1349.231502	9053.253544	6723.198123	73.335793	1618.595634			13.47309																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					138.371205	138.371289	22.599925	0	78.081173	0.156162	0.156162	39.040589	156.162411	31.141464	77.659797		78.080951	72.574306	15.61624	23.42436	48.711537	78.0812			0.156162																					3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	0	28.14902404	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751
H1804_807_0	2008	4																					5000														V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																								0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0					53.91127	113.395769	7.428239	3.69076	267.682943	233.246312	4015.227753	2620.937512		7.621625	935.648714	6278.140567	4662.321968	50.856016	1122.444087			6.47918																								$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																								0	87.298023	0.174596	0.174596	43.649015	174.595976	34.817442	86.826855		87.29863	81.14105	17.4596	26.1894	54.461328	87.298002			0.174596																					0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	0	10.61682495	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	5000																																													0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671
H1804_808_0	2008	4																					5000														V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																								0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0					53.91127	113.395769	7.428239	3.69076	267.682943	233.246312	4015.227753	2620.937512		7.621625	935.648714	6278.140567	4662.321968	50.856016	1122.444087			6.47918																								$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																								0	87.298023	0.174596	0.174596	43.649015	174.595976	34.817442	86.826855		87.29863	81.14105	17.4596	26.1894	54.461328	87.298002			0.174596																					0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	0	10.61682495	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	5000																																													0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671
H1804_809_0	2008	4																					5000														V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																								0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0					53.91127	113.395769	7.428239	3.69076	267.682943	233.246312	4015.227753	2620.937512		7.621625	935.648714	6278.140567	4662.321968	50.856016	1122.444087			6.47918																								$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																								0	87.298023	0.174596	0.174596	43.649015	174.595976	34.817442	86.826855		87.29863	81.14105	17.4596	26.1894	54.461328	87.298002			0.174596																					0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	0	10.61682495	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	5000																																													0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671
H1804_810_0	2008	4																					5000														V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																								0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0					53.91127	113.395769	7.428239	3.69076	267.682943	233.246312	4015.227753	2620.937512		7.621625	935.648714	6278.140567	4662.321968	50.856016	1122.444087			6.47918																								$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																								0	87.298023	0.174596	0.174596	43.649015	174.595976	34.817442	86.826855		87.29863	81.14105	17.4596	26.1894	54.461328	87.298002			0.174596																					0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	0	10.61682495	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	5000																																													0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671
H1806_001_0	2008	9	s.	t.									Other Non-Covered	Other Non-Covered									3000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0	0	0	0									0		1624.038264	58.039222	504.926829	211.490905	70.742265	4.831133	1.653271	334.714001	395.285643	6217.134671	1457.164028		8.30198	529.871141	4803.656324	3628.740621	47.346698	301.232019			17.34243			6.62	2.99					3.4	0.02	0.08	0.18									$125/Day(Days 1-5)	$125/Day(Days 1-5)	$0/Day(Days 1-20) $50(Days 21-100)	$0/Visit	$75/Trip	20% Coins	20% Coins	$50/Visit	$75-$100/Visit	$0-$75/Visit	$50-$75/Visit		$0-$75/Proc	$25-$75/Visit	$0/Visit	$25/Visit	$25-$75/Visit	$75/Visit			20% Coins			Coin: 25%- 75%	EyeMed: $200 Allowance					Silver Sneakers	Quit Net	Humana Active Outlook	Meals On Wheels									69.613705	69.613729	9.918976	0	64.255027	0.171346	0.171346	42.83671	75.426393	10.930937	64.255048		21.440898	62.946418	0	21.418349	39.328624	64.255045			0.171346			0.355247982	0					0	0	0	0									9.4213	0.336693889	0.417363092	0	0.378795512	0.827795315	0.283281373	1.194837216	2.484580855	5.663258951	7.802512047	0	0.014833492	2.779457527	0	6.476802754	0.155173374	1.612973078	0	0	2.971556011	0	0	2.351741638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.1729	0	7.160709894	9.4213	0.336693889	0.417363092	0	0.378795512	0.827795315	0.283281373	1.194837216	2.484580855	5.663258951	7.802512047	0	0.014833492	2.779457527	0	6.476802754	0.155173374	1.612973078	0	0	2.971556011	0	0	2.351741638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.1729	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	$75/Trip	25% Coins	25% Coins	$50/Visit	25% Coins	25% Coins	25% Coins		$0-$75/Proc	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins			Coin: 50%- 80%						Silver Sneakers	Quit Net	Humana Active Outlook	Meals On Wheels									9.2722	0.1048	0.4565	0.7131	0.4486	1.3544	0.4635	0.2497	3.0268	0.7504	2.0239		0.0031	1.0118	3.1296	2.5746	0.0886	0.2732			0.8223			2.13	0					0	0	0	0									28.897	250	3.779706219	18.6935	0.44146905	0.873846763	0.713107228	0.827378688	2.182169745	0.746764597	1.444537313	5.511352306	6.413613256	9.826376111	0	0.017933019	3.79126781	3.129555001	9.051420741	0.243812733	1.886154499	0	0	3.793884267	0	0	4.481741638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.0699
H1806_002_0	2008	11	s.	t.									Other Non-Covered	Other Non-Covered									3000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0	0	0	0									0		1581.052422	56.503012	491.562178	205.89306	68.869823	4.578766	1.566908	325.854627	384.82303	6052.576503	1418.595096		8.082238	515.846252	4676.510794	3532.693335	46.093503	293.258862			16.436502			6.62	2.99					3.4	0.02	0.08	0.18									$150/Day(Days 1-5)	$150/Day(Days 1-5)	$0/Day(Days 1-20) $75(Days 21-100)	$0/Visit	$75/Trip	20% Coins	20% Coins	$50/Visit	$75-$125/Visit	$0-$75/Visit	$50-$75/Visit		$0-$75/Proc	$25-$75/Visit	$5/Visit	$25/Visit	$25-$75/Visit	$75/Visit			20% Coins			Coin: 25%- 75%	EyeMed: $200 Allowance					Silver Sneakers	Quit Net	Humana Active Outlook	Meals On Wheels									83.082169	83.082203	14.797542	0	63.905566	0.170414	0.170415	42.603762	86.12682	10.871494	63.905629		21.323387	62.604097	4.260374	21.301872	39.114756	63.905628			0.170414			0.355247982	0					0	0	0	0									10.9464	0.391199559	0.606159331	0	0.366763752	0.780285829	0.267024627	1.156886081	2.76196532	5.483379095	7.554684326	0	0.014361724	2.691174066	1.660307083	6.27108177	0.150244677	1.561740979	0	0	2.801010052	0	0	2.351741638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.8164	0	7.892932003	10.9464	0.391199559	0.606159331	0	0.366763752	0.780285829	0.267024627	1.156886081	2.76196532	5.483379095	7.554684326	0	0.014361724	2.691174066	1.660307083	6.27108177	0.150244677	1.561740979	0	0	2.801010052	0	0	2.351741638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.8164	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	$75/Trip	25% Coins	25% Coins	$50/Visit	25% Coins	25% Coins	25% Coins		$0-$75/Proc	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins			Coin: 50%- 80%						Silver Sneakers	Quit Net	Humana Active Outlook	Meals On Wheels									8.8167	0.0996	0.4341	0.6781	0.4381	1.2878	0.4407	0.2439	2.8781	0.7135	1.9244		0.003	0.9621	2.9758	2.4481	0.0843	0.2598			0.7819			2.13	0					0	0	0	0									27.6	250	3.701393551	19.7631	0.490826718	1.040216156	0.678072364	0.804905417	2.068120171	0.707736495	1.400774383	5.640033348	6.196869358	9.479116614	0	0.017388965	3.653274679	4.636107954	8.719210387	0.234528998	1.821501426	0	0	3.582936921	0	0	4.481741638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.4165
H1806_801_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		295.081029	6.340693	504.587131	211.348621	70.694672	4.824634	1.651047	334.488816	395.019709	6212.951975	1456.183693		8.296394	529.514662	4800.424572	3626.299316	47.314845	301.02936			17.3191																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.21451	177.215329	28.944115	0	99.999954	0.2	0.199999	49.999985	200.000005	37.55177	90.505001		33.367267	87.838632	20	30.000002	59.267234	100			0.2																					4.3577	0.093639	1.217068996	0	0.589121996	0.9649268	0.330207749	1.393702982	6.583661981	19.44227863	10.98265888	0	0.023068999	3.875986961	8.00070762	9.065748894	0.233684999	2.508578	0	0	3.46382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.1266	0	0	4.3577	0.093639	1.217068996	0	0.589121996	0.9649268	0.330207749	1.393702982	6.583661981	19.44227863	10.98265888	0	0.023068999	3.875986961	8.00070762	9.065748894	0.233684999	2.508578	0	0	3.46382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.1266		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.1267	0.1031	0.4493	0.7019	0.6927	1.3331	0.4562	0.7822	2.9793	0.7386	1.9921		0.0136	0.9959	3.0804	2.5342	0.0872	0.2689			0.8094																					27.145	0	0	13.4845	0.19677	1.666389996	0.701918	1.281796996	2.2980488	0.786418749	2.175935982	9.562939981	20.18085963	12.97476588	0	0.036633999	4.871918961	11.08115462	11.59996889	0.320933999	2.777473	0	0	4.273244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2716
H1806_803_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		295.081029	6.340693	504.587131	211.348621	70.694672	4.824634	1.651047	334.488816	395.019709	6212.951975	1456.183693		8.296394	529.514662	4800.424572	3626.299316	47.314845	301.02936			17.3191																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.21451	177.215329	28.944115	0	99.999954	0.2	0.199999	49.999985	200.000005	37.55177	90.505001		33.367267	87.838632	20	30.000002	59.267234	100			0.2																					4.3577	0.093639	1.217068996	0	0.589121996	0.9649268	0.330207749	1.393702982	6.583661981	19.44227863	10.98265888	0	0.023068999	3.875986961	8.00070762	9.065748894	0.233684999	2.508578	0	0	3.46382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.1266	0	0	4.3577	0.093639	1.217068996	0	0.589121996	0.9649268	0.330207749	1.393702982	6.583661981	19.44227863	10.98265888	0	0.023068999	3.875986961	8.00070762	9.065748894	0.233684999	2.508578	0	0	3.46382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.1266		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.1267	0.1031	0.4493	0.7019	0.6927	1.3331	0.4562	0.7822	2.9793	0.7386	1.9921		0.0136	0.9959	3.0804	2.5342	0.0872	0.2689			0.8094																					27.145	0	0	13.4845	0.19677	1.666389996	0.701918	1.281796996	2.2980488	0.786418749	2.175935982	9.562939981	20.18085963	12.97476588	0	0.036633999	4.871918961	11.08115462	11.59996889	0.320933999	2.777473	0	0	4.273244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2716
H1806_804_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		295.081029	6.340693	504.587131	211.348621	70.694672	4.824634	1.651047	334.488816	395.019709	6212.951975	1456.183693		8.296394	529.514662	4800.424572	3626.299316	47.314845	301.02936			17.3191																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.21451	177.215329	28.944115	0	99.999954	0.2	0.199999	49.999985	200.000005	37.55177	90.505001		33.367267	87.838632	20	30.000002	59.267234	100			0.2																					4.3577	0.093639	1.217068996	0	0.589121996	0.9649268	0.330207749	1.393702982	6.583661981	19.44227863	10.98265888	0	0.023068999	3.875986961	8.00070762	9.065748894	0.233684999	2.508578	0	0	3.46382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.1266	0	0	4.3577	0.093639	1.217068996	0	0.589121996	0.9649268	0.330207749	1.393702982	6.583661981	19.44227863	10.98265888	0	0.023068999	3.875986961	8.00070762	9.065748894	0.233684999	2.508578	0	0	3.46382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.1266		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.1267	0.1031	0.4493	0.7019	0.6927	1.3331	0.4562	0.7822	2.9793	0.7386	1.9921		0.0136	0.9959	3.0804	2.5342	0.0872	0.2689			0.8094																					27.145	0	0	13.4845	0.19677	1.666389996	0.701918	1.281796996	2.2980488	0.786418749	2.175935982	9.562939981	20.18085963	12.97476588	0	0.036633999	4.871918961	11.08115462	11.59996889	0.320933999	2.777473	0	0	4.273244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2716
H1806_805_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		295.081029	6.340693	504.587131	211.348621	70.694672	4.824634	1.651047	334.488816	395.019709	6212.951975	1456.183693		8.296394	529.514662	4800.424572	3626.299316	47.314845	301.02936			17.3191																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.21451	177.215329	28.944115	0	99.999954	0.2	0.199999	49.999985	200.000005	37.55177	90.505001		33.367267	87.838632	20	30.000002	59.267234	100			0.2																					4.3577	0.093639	1.217068996	0	0.589121996	0.9649268	0.330207749	1.393702982	6.583661981	19.44227863	10.98265888	0	0.023068999	3.875986961	8.00070762	9.065748894	0.233684999	2.508578	0	0	3.46382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.1266	0	0	4.3577	0.093639	1.217068996	0	0.589121996	0.9649268	0.330207749	1.393702982	6.583661981	19.44227863	10.98265888	0	0.023068999	3.875986961	8.00070762	9.065748894	0.233684999	2.508578	0	0	3.46382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.1266		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.1267	0.1031	0.4493	0.7019	0.6927	1.3331	0.4562	0.7822	2.9793	0.7386	1.9921		0.0136	0.9959	3.0804	2.5342	0.0872	0.2689			0.8094																					27.145	0	0	13.4845	0.19677	1.666389996	0.701918	1.281796996	2.2980488	0.786418749	2.175935982	9.562939981	20.18085963	12.97476588	0	0.036633999	4.871918961	11.08115462	11.59996889	0.320933999	2.777473	0	0	4.273244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2716
H1807_001_0	2008	8																					none											D	D	D	V	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	none	2521.870242	868.991201	1416.865001	192.0681361	21.9310461	39.98134593	2.79899185	39.96028711	31.86570953	8.152394172	25.07802101	0	1.37924563	15.66758576	51.99853537	125.089065	5.071813083	1.540407461	23.74163496	5.419223704	24.9389529	11.06404373																				"Days 1-60, initial deductible of $1052; days 61-90, $263/day; days 91-150, $526/day"	"Days 1-60, initial deductible of $1052; days 61-90, $263/day; days 91-150, $526/day"	"Days 1-53, $0/day; days 54-100, $131.5/day"	$0 copay	20% coinsurance	20% coinsurance	20% coinsurance	20%-50% coinsurance depending on APC	20%-50% coinsurance depending on APC	0% coinsurance	20% coinsurance	$0 copay	20% coinsurance	20%-50% coinsurance depending on APC	20% coinsurance	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance																				141.620744	46.97195067	22.7779476	0	0.2	0.2	0.2	0.244691668	0.244691668	0	0.2	0	0.2	0.244691668	0.2	0.2	0.5	0.2	0.2	0.2	0.2	0.2																				29.7624	3.401517652	2.68943973	0	4.386209221	7.996269186	0.55979837	9.777949313	7.797273622	0	5.015604203	0	0.275849126	3.833727695	10.39970707	25.017813	2.535906541	0.308081492	4.748326993	1.083844741	4.98779058	2.212808746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.7903	0	0	29.7624	3.401517652	2.68943973	0	4.386209221	7.996269186	0.55979837	9.777949313	7.797273622	0	5.015604203	0	0.275849126	3.833727695	10.39970707	25.017813	2.535906541	0.308081492	4.748326993	1.083844741	4.98779058	2.212808746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.7903	none																																																																																			0	0	0	29.7624	3.401517652	2.68943973	0	4.386209221	7.996269186	0.55979837	9.777949313	7.797273622	0	5.015604203	0	0.275849126	3.833727695	10.39970707	25.017813	2.535906541	0.308081492	4.748326993	1.083844741	4.98779058	2.212808746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.7903
H1837_001_0	2008	5																					2650											D	D	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	Coin	P	P	Coin	P	T	V	V	P	V	P	P	P	P																																																				0		914.1733329	52.65652803	1056.402374		142.5027751	10.34620538	9.345388495	260.4447411	47.7747082	1.841874615	41.83719363	6.88736185	0.176120996	31.43102612	4129.173695	3911.650488	208.1896763	7.865896005			23.28412171	996.1033895		600	144	128	249.0003791															1a: $280 Days 1-9	1b: $280	2: $135 days 4-23	6: $0	10a: $175	11a: 30%	11b: 30%; 11c: 0%	"4a, 4b: $50"	9b: 30%	8a: 0%-30%	8b: 30% / $15	9a: 30%	12: 30%	"9a, 9d: 30%; 9c: $30"	"7a, 14c: $5"	"7b, 7d, 7f: $25"	"7e, 7h: $30"	"7c, 7i: 30%"	$0 (incl in i.2.)	7g: $0	15: 30%	17a: $20	10b: $0	16a: $20	17a1: $20	17b1: $20	18a: $25	18b: $0		14a:  $0												185.0449	185.0449	89.2181		115.6531	0.198262407	0.198262407	33.0437	0.198262407	0.3	0.195932734	0.198262407	0.198262407	0.199369655	5	25	30	0.3			0.198262407	20		20	20	20	25															14.0969	0.811985222	7.854182913	0	1.373406962	2.051263584	1.852839219	0.717172241	9.47192865	0.552562385	8.197275742	1.36550494	0.034918173	6.266392833	1.72048904	8.14927185	0.520474191	2.359768801	0	0	4.61636602	1.660172316	0	1	0.24	0.213333333	0.51875079	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.645	0	30.07815798	14.0969	0.811985222	7.854182913	0	1.373406962	2.051263584	1.852839219	0.717172241	9.47192865	0.552562385	8.197275742	1.36550494	0.034918173	6.266392833	1.72048904	8.14927185	0.520474191	2.359768801	0	0	4.61636602	1.660172316	0	1	0.24	0.213333333	0.51875079	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.645																																																																																				0	0	0	14.0969	0.811985222	7.854182913	0	1.373406962	2.051263584	1.852839219	0.717172241	9.47192865	0.552562385	8.197275742	1.36550494	0.034918173	6.266392833	1.72048904	8.14927185	0.520474191	2.359768801	0	0	4.61636602	1.660172316	0	1	0.24	0.213333333	0.51875079	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.645
H1837_002_0	2008	5																					2950											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	Coin	Coin	P	P	P	P	P	P	Coin	P	T	V	V	P	V	P	P	P	P																																																				0		869.5646929	50.08706334	1040.340661		140.1078436	12.47182521	11.26539128	252.088076	339.4320411	1.745679302	44.21666975	99.9747657	0.17392057	24.70468877	4067.95446	3852.143054	204.9318426	907.0907259			28.06782637	980.9497973		600	144	128	249.0003733															1a: $100 Days 1-5	1b: $275	2: $75 days 11-100	6: $0	10a: $100	11a: 20%	11b: 20%; 11c: 0%	"4a, 4b: $50"	9b: $100	8a: 0%-20%	8b: 20% / $15	9a: $100	12: 20%	9a: $100; 9c: $30; 9d: 30%	"7a, 14c: $10"	"7b, 7d, 7f: $25"	"7e, 7h: $30"	"7c, 7i: $25"	$0 (incl in i.2.)	7g: $0	15: 20%	17a: $20	10b: $0	16a: $20	17a1: $20	17b1: $20	18a: $25	18b: $0		14a:  $0												62.1657	222.0257	36.1972		80.7366	0.161473206	0.161473206	40.3683	80.7366	0.2	0.161070773	80.7366	0.161473206	0.51396177	10	25	30	25			0.161473206	20		20	20	20	25															4.5048	0.926717769	3.138117533	0	0.942652614	2.013865605	1.81905885	0.848030623	2.283715833	0.34913586	7.122013176	0.672635249	0.028083512	12.69726556	3.38996205	8.025298029	0.512329607	1.889772346	0	0	4.532201918	1.634916329	0	1	0.24	0.213333333	0.518750778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3026	0	9.887095525	4.5048	0.926717769	3.138117533	0	0.942652614	2.013865605	1.81905885	0.848030623	2.283715833	0.34913586	7.122013176	0.672635249	0.028083512	12.69726556	3.38996205	8.025298029	0.512329607	1.889772346	0	0	4.532201918	1.634916329	0	1	0.24	0.213333333	0.518750778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3026																																																																																				0	0	0	4.5048	0.926717769	3.138117533	0	0.942652614	2.013865605	1.81905885	0.848030623	2.283715833	0.34913586	7.122013176	0.672635249	0.028083512	12.69726556	3.38996205	8.025298029	0.512329607	1.889772346	0	0	4.532201918	1.634916329	0	1	0.24	0.213333333	0.518750778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3026
H1837_003_0	2008	7																					1800											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	P	P	P	Coin	P	P	Coin	P	T	V	V	P	V	P	P	P	P																																																				0		1157.1228	66.65045561	1337.038248		180.3741196	15.93321402	14.39195043	329.5208043	443.9109742	2.836497185	64.42951163	10.60657568	0.271227317	48.39827684			263.5178828	12.11352374			35.85767736	1260.826477		600	144	128																1a: $275 Days 1-6	1b: $275	2: $125 days 4-15	6: $0	10a: $175	11a: 30%	11b: 30%; 11c: 0%	"4a, 4b: $50"	9b: $75	8a: 0%-30%	8b: 30% / $15	9a: 30%	12: 20%	"9a, 9d: 30%; 9c: $30"	"7a, 14c: $5"	"7b, 7d, 7f: $25"	"7e, 7h: $30"	"7c, 7i: 25%"	$0 (incl in i.2.)	7g: $0	15: 30%	17a: $20	10b: $0	16a: $20	17a1: $20	17b1: $20	18a: $25	18b: $0		14a:  $0												22.3486	20.1594	73.6882		73.6882	0.176851667	0.176851667	29.4753	44.2129	0.3	0.17424226	0.176851667	0.176851667	0.178517509			30	0.25			0.176851667	20		20	20	20																2.155	0.11196945	8.210327901	0	1.107620271	2.817815466	2.545240431	0.809393107	1.635549916	0.850949155	11.22634369	1.875790595	0.047967003	8.639939798	0	0	0.658794707	3.028380935	0	0	6.341490032	2.101377462	0	1	0.24	0.213333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6173	0	32.98002819	2.155	0.11196945	8.210327901	0	1.107620271	2.817815466	2.545240431	0.809393107	1.635549916	0.850949155	11.22634369	1.875790595	0.047967003	8.639939798	0	0	0.658794707	3.028380935	0	0	6.341490032	2.101377462	0	1	0.24	0.213333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6173																																																																																				0	0	0	2.155	0.11196945	8.210327901	0	1.107620271	2.817815466	2.545240431	0.809393107	1.635549916	0.850949155	11.22634369	1.875790595	0.047967003	8.639939798	0	0	0.658794707	3.028380935	0	0	6.341490032	2.101377462	0	1	0.24	0.213333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6173
H1837_004_0	2008	4																					1400											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	Coin	Coin	P	P	P	P	P	P	Coin	P	T	V	V	P	V	P	P	P	P																																																				0		1100.659028	63.39813346	1316.697391		177.3427144	19.98167177	18.04878974	318.930108	429.6390407	2.796831277	70.84151411	126.543924	0.278645962	39.56925438	5121.14387	4875.883375	259.3942516	1148.157929			44.96872626	1241.645687		600	144	128	249.0004725															1a: $100 Days 1-5	1b: $275	2: $75 days 11-100	6: $0	10a: $100	11a: 20%	11b: 20%; 11c: 0%	"4a, 4b: $50"	9b: $100	8a: 0%-20%	8b: 20% / $15	9a: $100	12: 20%	9a: $100; 9c: $30; 9d: 30%	"7a, 14c: $10"	"7b, 7d, 7f: $25"	"7e, 7h: $30"	"7c, 7i: $25"	$0 (incl in i.2.)	7g: $0	15: 20%	17a: $20	10b: $0	16a: $20	17a1: $20	17b1: $20	18a: $25	18b: $0		14a:  $0												34.6632	154.7499	22.261		56.2727	0.112545397	0.112545397	28.1363	56.2727	0.2	0.111717299	56.2727	0.112545397	0.285071277	10	25	30	25			0.112545397	20		20	20	20	25															3.1794	0.817571345	2.442582344	0	0.831629425	2.248845182	2.031308206	0.747794076	2.014745683	0.559366255	7.914222598	0.593414007	0.03136032	11.28005786	4.267619892	10.15809036	0.648485629	2.391995685	0	0	5.06102315	2.069409478	0	1	0.24	0.213333333	0.518750984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.261	0	30.34619727	3.1794	0.817571345	2.442582344	0	0.831629425	2.248845182	2.031308206	0.747794076	2.014745683	0.559366255	7.914222598	0.593414007	0.03136032	11.28005786	4.267619892	10.15809036	0.648485629	2.391995685	0	0	5.06102315	2.069409478	0	1	0.24	0.213333333	0.518750984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.261																																																																																				0	0	0	3.1794	0.817571345	2.442582344	0	0.831629425	2.248845182	2.031308206	0.747794076	2.014745683	0.559366255	7.914222598	0.593414007	0.03136032	11.28005786	4.267619892	10.15809036	0.648485629	2.391995685	0	0	5.06102315	2.069409478	0	1	0.24	0.213333333	0.518750984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.261
H1837_801_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		223.2384508	2.769005049	43.19100131		9.822350063	12.00449599	10.84326809	16.98152017	48.96908259	21.55484492	45.27949237	7.059546861	0.184197901	32.31245445	46.39928859	106.8450249	1.333633838	9.06887601			27.01610256	11.04377995																				Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing											0.0703	0.0703	0.1611		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				15.6937	0.194661055	6.958070311	0	2.298429915	2.809052061	2.537324734	3.97367572	11.45876533	5.043833712	10.59540122	1.651933965	0.043102309	7.561114342	10.85743353	25.00173582	0.312070318	2.122116986	0	0	6.321768	2.584244508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.0184	0	0	15.6937	0.194661055	6.958070311	0	2.298429915	2.809052061	2.537324734	3.97367572	11.45876533	5.043833712	10.59540122	1.651933965	0.043102309	7.561114342	10.85743353	25.00173582	0.312070318	2.122116986	0	0	6.321768	2.584244508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.0184																																																																																				0	0	0	15.6937	0.194661055	6.958070311	0	2.298429915	2.809052061	2.537324734	3.97367572	11.45876533	5.043833712	10.59540122	1.651933965	0.043102309	7.561114342	10.85743353	25.00173582	0.312070318	2.122116986	0	0	6.321768	2.584244508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.0184
H1849_005_0	2008	6	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			A	A	D	D	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V		S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	373.3656159	8.412310154	531.9030561	0	281.7642779	12.30949837	4.388622575	339.188255	435.0825163	899.822896	952.0520974	53.39018541	15.40942375	0.407098279	5367.415428	1905.069039	3.06368131	417.8816299	572.3906551		287.9610622				555.8548783	536.7806282	151.8950512					1158.390614	18.93760883	73.42755636	400.4535344	108.3592589	0.048879378	811.8411599	3.775583934			$600/admit with $1200 yearly max	$600/admit with $1200 yearly max	$75/day for days 21 to 100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$175 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$175 copay	$15/$25 copay for in-home/facility	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$50/$100 copay for Lower/Higher Tier		$15/$22.50/$40/$100 copay levels				$50 max w/specialist copay	Up to $75	$50 max w/specialist copay					$25 copay	$50 copay	$25 copay	$25 copay	$10 copay	20% coinsurance	$25 copay	$25 copay			415.1397982	467.9845977	70.87995662	0	70.87995662	0.189013218	0.189013218	47.25330441	165.3865655	48.26046277	57.49527461	165.3865655	23.62665221	23.62665221	9.450660883	23.62665221	23.62665221	23.62665221	49.37970311		30.33855517				23.62665221	0	23.62665221					23.62665221	47.25330441	23.62665221	23.62665221	9.450660883	0.189013218	23.62665221	23.62665221			12.9166	0.328069299	3.141772129	0	1.664286649	2.326657894	0.829507674	1.335647156	5.996400254	3.618822447	4.561541399	0.735834949	0.030339425	0.000801531	4.227135253	3.750866969	0.006032044	0.822761994	2.355373385	0	0.728026881	0	0	0	1.094415824	0	0.299064295	0	0	0	0	2.280741013	0.07457205	0.144570611	0.788448032	0.085338884	0.009238849	1.598424061	0.007433701	0	0	55.7587		3.241089319	12.9166	0.328069299	3.141772129	0	1.664286649	2.326657894	0.829507674	1.335647156	5.996400254	3.618822447	4.561541399	0.735834949	0.030339425	0.000801531	4.227135253	3.750866969	0.006032044	0.822761994	2.355373385	0	0.728026881	0	0	0	1.094415824	0	0.299064295	0	0	0	0	2.280741013	0.07457205	0.144570611	0.788448032	0.085338884	0.009238849	1.598424061	0.007433701	0	0	55.7587	2750																																																																																			0		0	12.9166	0.328069299	3.141772129	0	1.664286649	2.326657894	0.829507674	1.335647156	5.996400254	3.618822447	4.561541399	0.735834949	0.030339425	0.000801531	4.227135253	3.750866969	0.006032044	0.822761994	2.355373385	0	0.728026881	0	0	0	1.094415824	0	0.299064295	0	0	0	0	2.280741013	0.07457205	0.144570611	0.788448032	0.085338884	0.009238849	1.598424061	0.007433701	0	0	55.7587
H1849_014_0	2008	6	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			D	D	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V		S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	1976.432762	65.77261418	507.369975	0	268.7684024	11.20017762	3.993123917	323.5438008	415.0151101	858.3201675	908.1403901	50.92765819	14.69869152	0.388321596	5119.852951	1817.201123	2.922374466	398.6075839	545.9901556		274.6793711				530.217062	512.0225778	144.8891625					1104.96191	18.06414535	70.0408411	381.9833284	103.3613811	0.044474413	774.3964323	3.60144185			$150/day with $1500 yearly max	$150/day with $1500 yearly max	$75/day for days 21 to 100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$150 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$150 copay	$15/$25 copay for in-home/facility	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$50/$100 copay for Lower/Higher Tier		$15/$22.50/$40/$100 copay levels				$50 max w/specialist copay	Up to $75	$50 max w/specialist copay					$25 copay	$50 copay	$25 copay	$25 copay	$10 copay	20% coinsurance	$25 copay	$25 copay			91.81112053	93.9528411	70.83396702	0	70.83396702	0.188890579	0.188890579	47.22264468	141.667934	48.22914955	57.4579695	141.667934	23.61132234	23.61132234	9.444528935	23.61132234	23.61132234	23.61132234	49.34766369		30.31887036				23.61132234	0	23.61132234					23.61132234	47.22264468	23.61132234	23.61132234	9.444528935	0.188890579	23.61132234	23.61132234			15.1215	0.514960331	2.994919006	0	1.586494346	2.115608032	0.754263488	1.273216162	4.89952777	3.449670976	4.348325236	0.601234677	0.028921295	0.000764066	4.029549945	3.575543455	0.005750094	0.784304346	2.245278215	0	0.693997354	0	0	0	1.043260497	0	0.285085393	0	0	0	0	2.174134319	0.071086393	0.137813073	0.751594291	0.081349963	0.008400798	1.523710315	0.007086234	0	0	55.1074		3.241089319	15.1215	0.514960331	2.994919006	0	1.586494346	2.115608032	0.754263488	1.273216162	4.89952777	3.449670976	4.348325236	0.601234677	0.028921295	0.000764066	4.029549945	3.575543455	0.005750094	0.784304346	2.245278215	0	0.693997354	0	0	0	1.043260497	0	0.285085393	0	0	0	0	2.174134319	0.071086393	0.137813073	0.751594291	0.081349963	0.008400798	1.523710315	0.007086234	0	0	55.1074	2750																																																																																			0		0	15.1215	0.514960331	2.994919006	0	1.586494346	2.115608032	0.754263488	1.273216162	4.89952777	3.449670976	4.348325236	0.601234677	0.028921295	0.000764066	4.029549945	3.575543455	0.005750094	0.784304346	2.245278215	0	0.693997354	0	0	0	1.043260497	0	0.285085393	0	0	0	0	2.174134319	0.071086393	0.137813073	0.751594291	0.081349963	0.008400798	1.523710315	0.007086234	0	0	55.1074
H1849_801_0	2008	7																																coin	coin	coin	V	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V																																																				0		243.1218006	3.081359704	18.60809102	9.157122062	7.832082453	12.41865999	4.873312966	13.71512296	40.55405141	10.58547933	28.95066769	0	0.232223741	28.03325359	40.39268531	116.4913456	1.185643842	4.045116584	26.19635335	21.52607202	19.40993002	0																				Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare																				0.080131216	0.080131216	0.206158966	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				19.4816	0.2469131	3.836224803	0	1.832707294	2.905966437	1.140355234	3.209338774	9.489648031	2.477002164	6.774456239	0	0.054340355	6.55978134	9.451888362	27.25897486	0.277440659	0.946557281	6.129946683	5.037100853	4.541923625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.6522			19.4816	0.2469131	3.836224803	0	1.832707294	2.905966437	1.140355234	3.209338774	9.489648031	2.477002164	6.774456239	0	0.054340355	6.55978134	9.451888362	27.25897486	0.277440659	0.946557281	6.129946683	5.037100853	4.541923625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.6522																																																																																				0			19.4816	0.2469131	3.836224803	0	1.832707294	2.905966437	1.140355234	3.209338774	9.489648031	2.477002164	6.774456239	0	0.054340355	6.55978134	9.451888362	27.25897486	0.277440659	0.946557281	6.129946683	5.037100853	4.541923625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.6522
H1849_803_0	2008	7																																coin	coin	coin	V	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V																																																				0		243.1218006	3.081359704	18.60809102	9.157122062	7.832082453	12.41865999	4.873312966	13.71512296	40.55405141	10.58547933	28.95066769	0	0.232223741	28.03325359	40.39268531	116.4913456	1.185643842	4.045116584	26.19635335	21.52607202	19.40993002	0																				Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare																				0.080131216	0.080131216	0.206158966	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				19.4816	0.2469131	3.836224803	0	1.832707294	2.905966437	1.140355234	3.209338774	9.489648031	2.477002164	6.774456239	0	0.054340355	6.55978134	9.451888362	27.25897486	0.277440659	0.946557281	6.129946683	5.037100853	4.541923625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.6522			19.4816	0.2469131	3.836224803	0	1.832707294	2.905966437	1.140355234	3.209338774	9.489648031	2.477002164	6.774456239	0	0.054340355	6.55978134	9.451888362	27.25897486	0.277440659	0.946557281	6.129946683	5.037100853	4.541923625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.6522																																																																																				0			19.4816	0.2469131	3.836224803	0	1.832707294	2.905966437	1.140355234	3.209338774	9.489648031	2.477002164	6.774456239	0	0.054340355	6.55978134	9.451888362	27.25897486	0.277440659	0.946557281	6.129946683	5.037100853	4.541923625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.6522
H1850_001_0	2008	5																					2000											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	V	Coin			V	V		V																																																								0		1907.980272	184.80522	1836.949431		263.4831042	13.74200006	11.98531804	348.8954693				46.97293948		8.074488951		655.9827942		745.3050486			25.35884928						144				300											"$100/day, days 1-10"	"$100/day, days 1-10"	"$50/day, days 21-100"	$0 Copay	$50/trip. Waived if admitted.	10% coinsurance	10% coinsurance	$50/visit.  Waived if admitted	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$10 for PT/OT/ST; $0 Card Rehab;	$0 Copay	$10 Copay	$0 for group or individual sessons	$10 Copay	$0 Copay	$0 Copay	0.2				$10 Copay		$10 Copay															77.2218	72.26	15.34		50	0.1	0.1	49.9744				50		30.2145		10		10			0.1						10				47											12.2781	1.112835433	2.34823369	0	1.097846267	1.374200006	1.198531804	1.452986377	0	0	0	0.195720581	0	0.020330542	0	0.546652328	0	0.621087541	0	0	2.535884928	0	0	0	0	0	0.12	0	0	0	1.175	0	0	0	0	0	0	0	0	0	0	26.0774	0	0.683409797	12.2781	1.112835433	2.34823369	0	1.097846267	1.374200006	1.198531804	1.452986377	0	0	0	0.195720581	0	0.020330542	0	0.546652328	0	0.621087541	0	0	2.535884928	0	0	0	0	0	0.12	0	0	0	1.175	0	0	0	0	0	0	0	0	0	0	26.0774																																																																																				0	0	0	12.2781	1.112835433	2.34823369	0	1.097846267	1.374200006	1.198531804	1.452986377	0	0	0	0.195720581	0	0.020330542	0	0.546652328	0	0.621087541	0	0	2.535884928	0	0	0	0	0	0.12	0	0	0	1.175	0	0	0	0	0	0	0	0	0	0	26.0774
H1850_002_0	2008	8																					2000											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	V	Coin			V	V		V																																																								0		1907.980272	184.80522	1836.949431		263.4831042	13.74200006	11.98531804	348.8954693				46.97293948		8.074488951		655.9827942		745.3050486			25.35884928						144				300											"$100/day, days 1-10"	"$100/day, days 1-10"	"$50/day, days 21-100"	$0 Copay	$50/trip. Waived if admitted.	10% coinsurance	10% coinsurance	$50/visit.  Waived if admitted	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$10 for PT/OT/ST; $0 Card Rehab;	$0 Copay	$10 Copay	$0 for group or individual sessons	$10 Copay	$0 Copay	$0 Copay	0.2				$10 Copay		$10 Copay															77.2218	72.26	15.34		50	0.1	0.1	49.9744				50		30.2145		10		10			0.1						10				47											12.2781	1.112835433	2.34823369	0	1.097846267	1.374200006	1.198531804	1.452986377	0	0	0	0.195720581	0	0.020330542	0	0.546652328	0	0.621087541	0	0	2.535884928	0	0	0	0	0	0.12	0	0	0	1.175	0	0	0	0	0	0	0	0	0	0	26.0774	0	0.683409797	12.2781	1.112835433	2.34823369	0	1.097846267	1.374200006	1.198531804	1.452986377	0	0	0	0.195720581	0	0.020330542	0	0.546652328	0	0.621087541	0	0	2.535884928	0	0	0	0	0	0.12	0	0	0	1.175	0	0	0	0	0	0	0	0	0	0	26.0774																																																																																				0	0	0	12.2781	1.112835433	2.34823369	0	1.097846267	1.374200006	1.198531804	1.452986377	0	0	0	0.195720581	0	0.020330542	0	0.546652328	0	0.621087541	0	0	2.535884928	0	0	0	0	0	0.12	0	0	0	1.175	0	0	0	0	0	0	0	0	0	0	26.0774
H1903_001_0	2008	9																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2095.883263	85.35594125	1198.891505	3345.930624	538.6321859	14.42960444	4.073561199	1312.284625	325.7591776	8700.376632	1093.456851	31.28968714	0.072936293	378.5233909	9244.766086	18168.22808	249.3130371	3047.80694	6147.862488	764.4041786	30.3933888	14.95524985	0	244.2857143	356.5714286	197.0526316	26.74285714	15.6	0	1600	3600											"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $25 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$25.00 copayment	20% coinsurance	Copay between $10.00 and $25.00	Copay between $0.00 and $5.00	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$5.00 copayment	$5.00 copayment	$5.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											10.98135294	5.403217544	15.59	3.371329526	47.85322073	0.2	0.2	14.83467107	16.97026407	0	5.411681556	18.08707764	0.2	6.731806764	1.764299721	5.986922316	13.84068968	6.724711799	6.327862233	0	0.2	0	0	0	5	5	5	0	0	0	0											1.918	0.03843306	1.55755988	0.940019559	2.147940407	2.885920887	0.81471224	1.622275897	0.460684939	0	0.493120023	0.047161583	0.014587259	0.212345527	1.359211519	9.064314178	0.287555365	1.707968607	3.241902237	0	6.07867776	0	0	0	0.148571429	0.082105263	0.011142857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.1342	0	0	1.918	0.03843306	1.55755988	0.940019559	2.147940407	2.885920887	0.81471224	1.622275897	0.460684939	0	0.493120023	0.047161583	0.014587259	0.212345527	1.359211519	9.064314178	0.287555365	1.707968607	3.241902237	0	6.07867776	0	0	0	0.148571429	0.082105263	0.011142857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.1342	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							15.0982		0											15.0982	0	0	1.918	0.03843306	1.55755988	0.940019559	2.147940407	2.885920887	0.81471224	1.622275897	0.460684939	0	0.493120023	0.047161583	0.014587259	0.212345527	1.359211519	9.064314178	0.287555365	1.707968607	3.241902237	0	6.07867776	0	0	0	0.148571429	0.082105263	0.011142857	0	15.09815906	0	0	0	0	0	0	0	0	0	0	0	0	50.2323
H1903_005_0	2008	8																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		350.1069833	16.09385647	1337.69415	5592.225027	860.6192944	21.92154763	5.154878898	1340.764993	292.3869787	7561.942316	1262.467028	85.0768488	0.075005955	617.6118849	7600.535329	22556.9152	571.9981801	5627.46565	5296.784867	884.8125742	34.78428084	36.60833013	0	244.2857143	356.5714286	197.0526316	26.74285714	15.6	0	1600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	"$0 days 1 - 7, $0 days 8 - 100"	Copay between $0.00 and $15.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$5.00 copayment	$5.00 copayment	$5.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	2.783017593	44.83776937	0.2	0.2	19.73555772	0	0	7.469100512	0	0.2	0	0	0	0	0	3.917393564	0	0.2	0	0	0	5	5	5	0	0	0	0											0	0	0	1.296938386	3.215687453	4.384309525	1.03097578	2.205062075	0	0	0.785791094	0	0.015001191	0	0	0	0	0	1.729132579	0	6.956856167	0	0	0	0.148571429	0.082105263	0.011142857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.8616	0	0	0	0	0	1.296938386	3.215687453	4.384309525	1.03097578	2.205062075	0	0	0.785791094	0	0.015001191	0	0	0	0	0	1.729132579	0	6.956856167	0	0	0	0.148571429	0.082105263	0.011142857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.8616	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	0	0	0	1.296938386	3.215687453	4.384309525	1.03097578	2.205062075	0	0	0.785791094	0	0.015001191	0	0	0	0	0	1.729132579	0	6.956856167	0	0	0	0.148571429	0.082105263	0.011142857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.8616
H1903_011_0	2008	7																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		508.1324895	73.3587606	3423.889073	84.78337283	23.10960703	32.15785677	7.257471754	26.98311752	18.8613373	14.72750974	19.7058805	63.41037635	0.39108833	6.20714447	9497.983633	102.6145228	41.02941335	34.00780493	31.43654701	5.240792857	32.39021022	0.389525159	0	244.2857143	312	187.2	23.4	15.6	0	1600	6											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.4	708.4	30.26	0.173554787	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.199356266	0.012462409	0.2	0.2	0	0	0	0	0	0	0	0	0											29.9968	4.330612168	8.633906945	14.71456019	4.621921405	6.431571353	1.451494351	5.396623504	3.77226746	2.945501948	3.9411761	0	0.078217666	1.241428894	0	20.52290455	8.20588267	6.801560986	6.267072635	0.065312903	6.478042044	0.077905032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.9747	0	0	29.9968	4.330612168	8.633906945	14.71456019	4.621921405	6.431571353	1.451494351	5.396623504	3.77226746	2.945501948	3.9411761	0	0.078217666	1.241428894	0	20.52290455	8.20588267	6.801560986	6.267072635	0.065312903	6.478042044	0.077905032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.9747	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	29.9968	4.330612168	8.633906945	14.71456019	4.621921405	6.431571353	1.451494351	5.396623504	3.77226746	2.945501948	3.9411761	0	0.078217666	1.241428894	0	20.52290455	8.20588267	6.801560986	6.267072635	0.065312903	6.478042044	0.077905032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.9747
H1903_014_0	2008	7																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		448.5376453	70.70727501	2474.855782	7780.9391	1541.30294	29.66662297	6.389090307	2745.21342	265.8236238	9699.000438	1312.715134	55.0203832	0.070329336	441.9207795	8528.699179	17619.33975	2277.826573	5227.699855	5608.331443	549.1728075	19.90301069	8.217328307	0	244.2857143	356.5714286	197.0526316	26.74285714	15.6	0	1600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	Copay between $0.00 and $15.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$5.00 copayment	$5.00 copayment	$5.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	3.444347468	44.71504499	0.2	0.2	19.72319045	0	0	5.663470622	0	0.2	0	0	0	0	0	3.276917329	0	0.2	0	0	0	5	5	5	0	0	0	0											0	0	0	2.233354824	5.743285857	5.933324593	1.277818061	4.512030592	0	0	0.619543633	0	0.014065867	0	0	0	0	0	1.531503208	0	3.980602137	0	0	0	0.148571429	0.082105263	0.011142857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.0873	0	0	0	0	0	2.233354824	5.743285857	5.933324593	1.277818061	4.512030592	0	0	0.619543633	0	0.014065867	0	0	0	0	0	1.531503208	0	3.980602137	0	0	0	0.148571429	0.082105263	0.011142857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.0873	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							18.6158		0											18.6158	0	0	0	0	0	2.233354824	5.743285857	5.933324593	1.277818061	4.512030592	0	0	0.619543633	0	0.014065867	0	0	0	0	0	1.531503208	0	3.980602137	0	0	0	0.148571429	0.082105263	0.011142857	0	18.61584902	0	0	0	0	0	0	0	0	0	0	0	0	44.7032
H1903_018_0	2008	8																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		352.8781899	16.55833968	1867.551572	3457.493236	503.6793952	23.56867458	4.969130056	1311.272532	428.1869056	9358.757804	1211.802174	47.15104354	0.063630575	465.2172464	9932.444463	18973.30165	512.761315	3722.84129	6215.24172	830.0191792	28.8797032	17.60584611	0	244.2857143	356.5714286	197.0526316	26.74285714	15.6	0	1600	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	"$0 days 1 - 7, $25 days 8 - 100"	Copay between $0.00 and $15.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$5.00 copayment	$5.00 copayment	$5.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	15.59	3.139871041	46.49450829	0.2	0.2	16.22325191	0	0	5.341505458	0	0.2	0	0	0	0	0	4.707565237	0	0.2	0	0	0	5	5	5	0	0	0	0											0	0	2.426260751	0.904673574	1.951527151	4.713734916	0.993826011	1.772758718	0	0	0.539403994	0	0.012726115	0	0	0	0	0	2.438221322	0	5.77594064	0	0	0	0.148571429	0.082105263	0.011142857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.7709	0	0	0	0	2.426260751	0.904673574	1.951527151	4.713734916	0.993826011	1.772758718	0	0	0.539403994	0	0.012726115	0	0	0	0	0	2.438221322	0	5.77594064	0	0	0	0.148571429	0.082105263	0.011142857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.7709	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							16.2309		0											16.2309	0	0	0	0	2.426260751	0.904673574	1.951527151	4.713734916	0.993826011	1.772758718	0	0	0.539403994	0	0.012726115	0	0	0	0	0	2.438221322	0	5.77594064	0	0	0	0.148571429	0.082105263	0.011142857	0	16.23090574	0	0	0	0	0	0	0	0	0	0	0	0	38.0018
H1903_022_0	2008	9																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1931.992413	95.07526867	704.6786888	4647.35566	1054.889714	16.44579356	4.734208187	1141.041921	258.83246	6969.937561	1086.313778	72.42167832	0.063771916	446.6450495	6583.499376	16018.29549	269.7218806	5056.286285	4340.857011	687.3454835	31.45650099	32.76084802	0	244.2857143	356.5714286	197.0526316	26.74285714	15.6	0	1600	3600											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 20, $100 days 21 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $20.00 and $75.00	Copay between $0.00 and $5.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$5.00 copayment	$5.00 copayment	$5.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											42.75848672	21.51512727	23.83	3.480793435	41.43301963	0.2	0.2	20.05377901	65.10745586	0	11.73231563	72.34831054	0.2	17.76685692	2.247312558	8.516513621	16.18257424	9.715462735	8.021986312	0	0.2	0	0	0	5	5	5	0	0	0	0											6.8841	0.170463042	1.399374429	1.348040423	3.642272184	3.289158711	0.946841637	1.906850211	1.404326914	0	1.062081343	0.436632173	0.012754383	0.661289891	1.232931735	11.36833598	0.363732863	4.093680082	2.90185796	0	6.291300199	0	0	0	0.148571429	0.082105263	0.011142857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6578	0	0	6.8841	0.170463042	1.399374429	1.348040423	3.642272184	3.289158711	0.946841637	1.906850211	1.404326914	0	1.062081343	0.436632173	0.012754383	0.661289891	1.232931735	11.36833598	0.363732863	4.093680082	2.90185796	0	6.291300199	0	0	0	0.148571429	0.082105263	0.011142857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6578	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.2109		0											14.2109	0	0	6.8841	0.170463042	1.399374429	1.348040423	3.642272184	3.289158711	0.946841637	1.906850211	1.404326914	0	1.062081343	0.436632173	0.012754383	0.661289891	1.232931735	11.36833598	0.363732863	4.093680082	2.90185796	0	6.291300199	0	0	0	0.148571429	0.082105263	0.011142857	0	14.21086071	0	0	0	0	0	0	0	0	0	0	0	0	63.8687
H1906_001_0	2008	17	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		289.007782	6.242191	697.32575	57.649733	9.081539	17.663177	8.776044	412.773758	73.107304	24.585441	1.298037		0.092717	31.817363	9681.048943	7189.416464	1.267131	7.510072			15.406464									0.08		3997.914079	42.139413	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							540.788762	540.788559	24.960724	0	0.173866	0.173866	0.173866	43.466558	0.173866	0.173866	0.173865		0.173862	0.173866	13.039964	26.079931	0.173866	0.173866			0.173866									0		0	26.080045	0	0							13.0243	0.28130879	1.450479632	0	1.57897086	3.071025932	1.525855666	1.495154541	12.71087452	4.274572285	0.225683203	0	0.016119963	5.531957635	10.52004414	15.62495711	0.220310998	1.305746178	0	0	2.67866027	0	0	0	0	0	0	0	0	0	0	0	0.091583149	0	0	0	0	0	0	0	0	75.6277	0	11.13586568	13.0243	0.28130879	1.450479632	0	1.57897086	3.071025932	1.525855666	1.495154541	12.71087452	4.274572285	0.225683203	0	0.016119963	5.531957635	10.52004414	15.62495711	0.220310998	1.305746178	0	0	2.67866027	0	0	0	0	0	0	0	0	0	0	0	0.091583149	0	0	0	0	0	0	0	0	75.6277	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	13.0243	0.28130879	1.450479632	0	1.57897086	3.071025932	1.525855666	1.495154541	12.71087452	4.274572285	0.225683203	0	0.016119963	5.531957635	10.52004414	15.62495711	0.220310998	1.305746178	0	0	2.67866027	0	0	0	0	0	0	0	0	0	0	0	0.091583149	0	0	0	0	0	0	0	0	75.6277
H1906_002_0	2008	10	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		315.113976	6.80605	760.315478	62.857257	10.796314	20.998336	10.433136	450.059785	86.911418	29.227661	1.543132		0.110224	37.825113	10555.54216	7838.839473	1.506391	8.928123			18.315511									0.08		4359.047336	45.945884	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							525.017492	525.017839	24.242774	0	0.168865	0.168865	0.168865	42.216297	0.168865	0.168865	0.168864		0.168866	0.168865	12.66489	25.32978	0.168865	0.168865			0.168865									0		0	25.329843	0	0							13.7867	0.297774805	1.536013025	0	1.823119564	3.545884009	1.761791511	1.583321463	14.6762966	4.935528975	0.260579442	0	0.018613086	6.387337707	11.14039836	16.54633994	0.254376716	1.50764749	0	0	3.092848765	0	0	0	0	0	0	0	0	0	0	0	0.096983502	0	0	0	0	0	0	0	0	83.2516	0	15.04972168	13.7867	0.297774805	1.536013025	0	1.823119564	3.545884009	1.761791511	1.583321463	14.6762966	4.935528975	0.260579442	0	0.018613086	6.387337707	11.14039836	16.54633994	0.254376716	1.50764749	0	0	3.092848765	0	0	0	0	0	0	0	0	0	0	0	0.096983502	0	0	0	0	0	0	0	0	83.2516	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	13.7867	0.297774805	1.536013025	0	1.823119564	3.545884009	1.761791511	1.583321463	14.6762966	4.935528975	0.260579442	0	0.018613086	6.387337707	11.14039836	16.54633994	0.254376716	1.50764749	0	0	3.092848765	0	0	0	0	0	0	0	0	0	0	0	0.096983502	0	0	0	0	0	0	0	0	83.2516
H1906_003_0	2008	10	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		300.337826	6.486904	724.663186	59.90979	9.807543	19.075222	9.477626	428.955829	78.951711	26.550871	1.401806		0.100129	34.360932	10060.57752	7471.264954	1.36843	8.110448			16.638101									0.08		4154.645302	43.791414	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							533.983746	533.984408	24.651666	0	0.171713	0.171713	0.171713	42.928351	0.171713	0.171713	0.171713		0.171715	0.171713	12.878505	25.757009	0.171713	0.171713			0.171713									0		0	25.757119	0	0							13.3646	0.288658799	1.488679569	0	1.684082631	3.275463595	1.627431593	1.534530533	13.55703515	4.559129712	0.240708314	0	0.017193651	5.900218717	10.79709983	16.03645322	0.234977221	1.392669357	0	0	2.856978237	0	0	0	0	0	0	0	0	0	0	0	0.093995055	0	0	0	0	0	0	0	0	78.9499	0	12.74536986	13.3646	0.288658799	1.488679569	0	1.684082631	3.275463595	1.627431593	1.534530533	13.55703515	4.559129712	0.240708314	0	0.017193651	5.900218717	10.79709983	16.03645322	0.234977221	1.392669357	0	0	2.856978237	0	0	0	0	0	0	0	0	0	0	0	0.093995055	0	0	0	0	0	0	0	0	78.9499	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	13.3646	0.288658799	1.488679569	0	1.684082631	3.275463595	1.627431593	1.534530533	13.55703515	4.559129712	0.240708314	0	0.017193651	5.900218717	10.79709983	16.03645322	0.234977221	1.392669357	0	0	2.856978237	0	0	0	0	0	0	0	0	0	0	0	0.093995055	0	0	0	0	0	0	0	0	78.9499
H1906_006_0	2008	14	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1602.217552	51.057508	638.218854	52.763212	160.037647	14.795735	7.35134	377.786127	329.185039	5666.768777	3698.979927		10.756548	1320.499169	8860.461506	6580.025389	71.774083	1584.127103			12.905377									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									111.709943	111.709871	24.812565	0	86.417096	0.172834	0.172834	43.208553	75.943417	0	0.466657		43.208598	43.208543	12.962565	25.925129	33.921303	43.208552			0.172834									0		0	0									14.9153	0.475302303	1.3196539	0	1.152499059	2.557206063	1.270561498	1.360299324	2.083286391	0	0.14384624	0	0.03873128	4.754737094	9.57119235	14.21566725	0.202889201	5.703986525	0	0	2.230487928	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9956	0	9.514920877	14.9153	0.475302303	1.3196539	0	1.152499059	2.557206063	1.270561498	1.360299324	2.083286391	0	0.14384624	0	0.03873128	4.754737094	9.57119235	14.21566725	0.202889201	5.703986525	0	0	2.230487928	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9956	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	14.9153	0.475302303	1.3196539	0	1.152499059	2.557206063	1.270561498	1.360299324	2.083286391	0	0.14384624	0	0.03873128	4.754737094	9.57119235	14.21566725	0.202889201	5.703986525	0	0	2.230487928	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9956
H1906_007_0	2008	11	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	2000.238406	63.74115	796.764373	65.870583	199.793998	23.059869	11.45742	471.635279	410.960771	7074.500297	4617.875836		13.428675	1648.535901	11061.56613	8214.626963	89.604109	1977.653951			20.113655									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									104.89533	104.895256	23.32673	0	81.2422	0.162484	0.162484	40.6211	71.395699	0	0.438713		40.621236	40.621102	12.18633	24.37266	31.890054	40.621101			0.162484									0		0	0									17.4846	0.557178687	1.548825617	0	1.352641995	3.746859755	1.861647431	1.596528653	2.445069292	0	0.168826847	0	0.045457448	5.580445415	11.2333246	16.68435917	0.238123323	6.694540074	0	0	3.268147119	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5066	0	16.81201833	17.4846	0.557178687	1.548825617	0	1.352641995	3.746859755	1.861647431	1.596528653	2.445069292	0	0.168826847	0	0.045457448	5.580445415	11.2333246	16.68435917	0.238123323	6.694540074	0	0	3.268147119	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5066	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	17.4846	0.557178687	1.548825617	0	1.352641995	3.746859755	1.861647431	1.596528653	2.445069292	0	0.168826847	0	0.045457448	5.580445415	11.2333246	16.68435917	0.238123323	6.694540074	0	0	3.268147119	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5066
H1906_008_0	2008	13	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	1720.781393	54.835756	685.446947	56.667681	171.880407	17.06653	8.479597	405.74224	353.54468	6086.108755	3972.703848		11.55253	1418.215896	9516.134234	7066.946211	77.085354	1701.352254			14.886047									0.08		3.38	0.02									$200/Day(Days 1-5)	$200/Day(Days 1-5)	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									109.638007	109.638054	24.362764	0	84.850516	0.169701	0.1697	42.425258	74.56669	0	0.458201		42.425653	42.42525	12.727575	25.45515	33.306417	42.425251			0.1697									0		0	0									15.7219	0.501007131	1.391615184	0	1.215345102	2.896207208	1.438987611	1.434476601	2.196888046	0	0.151691406	0	0.040843636	5.014013662	10.09310935	14.99084799	0.213953079	6.015024701	0	0	2.526162176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8421	0	11.48205587	15.7219	0.501007131	1.391615184	0	1.215345102	2.896207208	1.438987611	1.434476601	2.196888046	0	0.151691406	0	0.040843636	5.014013662	10.09310935	14.99084799	0.213953079	6.015024701	0	0	2.526162176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8421	4000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	15.7219	0.501007131	1.391615184	0	1.215345102	2.896207208	1.438987611	1.434476601	2.196888046	0	0.151691406	0	0.040843636	5.014013662	10.09310935	14.99084799	0.213953079	6.015024701	0	0	2.526162176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8421
H1906_801_0	2008	9																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		270.266242	5.837397	652.10566	53.91127	163.519856	15.446606	7.674728	386.006259	336.347676	5790.070242	3779.464885		10.990595	1349.231502	9053.253544	6723.198123	73.335793	1618.595634			13.47309																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					138.371205	138.371289	22.599925	0	78.081173	0.156162	0.156162	39.040589	156.162411	31.141464	77.659797		78.080951	72.574306	15.61624	23.42436	48.711537	78.0812			0.156162																					3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	0	28.14902404	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751
H1906_802_0	2008	9																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		270.266242	5.837397	652.10566	53.91127	163.519856	15.446606	7.674728	386.006259	336.347676	5790.070242	3779.464885		10.990595	1349.231502	9053.253544	6723.198123	73.335793	1618.595634			13.47309																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					138.371205	138.371289	22.599925	0	78.081173	0.156162	0.156162	39.040589	156.162411	31.141464	77.659797		78.080951	72.574306	15.61624	23.42436	48.711537	78.0812			0.156162																					3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	0	28.14902404	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751
H1906_803_0	2008	9																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		270.266242	5.837397	652.10566	53.91127	163.519856	15.446606	7.674728	386.006259	336.347676	5790.070242	3779.464885		10.990595	1349.231502	9053.253544	6723.198123	73.335793	1618.595634			13.47309																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					138.371205	138.371289	22.599925	0	78.081173	0.156162	0.156162	39.040589	156.162411	31.141464	77.659797		78.080951	72.574306	15.61624	23.42436	48.711537	78.0812			0.156162																					3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	0	28.14902404	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751
H1906_804_0	2008	9																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		270.266242	5.837397	652.10566	53.91127	163.519856	15.446606	7.674728	386.006259	336.347676	5790.070242	3779.464885		10.990595	1349.231502	9053.253544	6723.198123	73.335793	1618.595634			13.47309																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					138.371205	138.371289	22.599925	0	78.081173	0.156162	0.156162	39.040589	156.162411	31.141464	77.659797		78.080951	72.574306	15.61624	23.42436	48.711537	78.0812			0.156162																					3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	0	28.14902404	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751
H1906_805_0	2008	4																					5000														V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																								0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0					53.91127	113.395769	7.428239	3.69076	267.682943	233.246312	4015.227753	2620.937512		7.621625	935.648714	6278.140567	4662.321968	50.856016	1122.444087			6.47918																								$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																								0	87.298023	0.174596	0.174596	43.649015	174.595976	34.817442	86.826855		87.29863	81.14105	17.4596	26.1894	54.461328	87.298002			0.174596																					0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	0	10.61682495	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	5000																																													0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671
H1906_806_0	2008	4																					5000														V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																								0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0					53.91127	113.395769	7.428239	3.69076	267.682943	233.246312	4015.227753	2620.937512		7.621625	935.648714	6278.140567	4662.321968	50.856016	1122.444087			6.47918																								$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																								0	87.298023	0.174596	0.174596	43.649015	174.595976	34.817442	86.826855		87.29863	81.14105	17.4596	26.1894	54.461328	87.298002			0.174596																					0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	0	10.61682495	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	5000																																													0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671
H1906_807_0	2008	4																					5000														V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																								0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0					53.91127	113.395769	7.428239	3.69076	267.682943	233.246312	4015.227753	2620.937512		7.621625	935.648714	6278.140567	4662.321968	50.856016	1122.444087			6.47918																								$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																								0	87.298023	0.174596	0.174596	43.649015	174.595976	34.817442	86.826855		87.29863	81.14105	17.4596	26.1894	54.461328	87.298002			0.174596																					0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	0	10.61682495	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	5000																																													0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671
H1906_808_0	2008	4																					5000														V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																								0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0					53.91127	113.395769	7.428239	3.69076	267.682943	233.246312	4015.227753	2620.937512		7.621625	935.648714	6278.140567	4662.321968	50.856016	1122.444087			6.47918																								$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																								0	87.298023	0.174596	0.174596	43.649015	174.595976	34.817442	86.826855		87.29863	81.14105	17.4596	26.1894	54.461328	87.298002			0.174596																					0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	0	10.61682495	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	5000																																													0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671
H1944_001_0	2008	7																					3600											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2084.775841	153.7348143	998.6264919		130.1454425	15.28347831	2.928517947	507.165688	37.60762467	10756.40901	54.05558604		0.437318677	34.65454233	4600.254018	4680.417679	536.5310353	2.140774707			27.28672257	939.7518303			122.4		14.32602104															$250 (1a); $0 (1a1)	$250 (1b)	"$130 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20% (9b)	20% (8a1); $0/$20 (8a2)	"$20 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											146.3219	146.3219	76.0874		102.4253	0.175586293	0.281358314	29.2644	0.117057528	4.6823	0.070992789		0.175586293	0.117016929	10	24.9478	37.5	0.117057528			0.175586293	25			25		25															25.4207	1.87456431	6.331907231	0	1.110849237	2.683569293	0.823962872	1.236824206	4.402255591	4.197062173	3.837556833	0	0.076787165	4.055168126	3.833545015	9.730521164	1.676659485	0.250593796	0	0	4.791174451	1.957816313	0	0	0.255	0	0.029845877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.5764	0	42.75743024	25.4207	1.87456431	6.331907231	0	1.110849237	2.683569293	0.823962872	1.236824206	4.402255591	4.197062173	3.837556833	0	0.076787165	4.055168126	3.833545015	9.730521164	1.676659485	0.250593796	0	0	4.791174451	1.957816313	0	0	0.255	0	0.029845877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.5764		$295 (1a); $0 (1a1)	$295 (1b)	"$175 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$25/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $30 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											4.4566	0.3286	4.8544	0.8154	0.4745	1.1463	0.2196	0.3939	2.8206	1.7927	2.3638		0.0328	2.5974	2.0177	2.0601	0.3353	0.1133			1.4446	0.4238			0.054		0.0063															28.7519	0	0	29.8773	2.203200326	11.18634157	0.81542591	1.58533783	3.829830166	1.043601718	1.630735808	7.222827442	5.989797008	6.201405407	0	0.109586066	6.652537788	5.851248256	11.79063282	2.011991382	0.363928928	0	0	6.235765645	2.381642975	0	0	0.309	0	0.036166181	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.3283
H1944_801_0	2008	4																					4500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2379.363731	175.4582119	1398.077089		170.8158933	20.05956528	3.843679805	665.6349654	49.36000739	14117.78682	70.94795667		0.573980764	45.48408681	5676.116728	5780.742427	662.7736319	2.644486403			33.70712788	1160.869908			144		16.8541424															$420 (1a); $0 (1a1)	$420 (1b)	"$135 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											228.8579	228.8579	73.5615		95.3574	0.163469899	0.279542839	27.245	0.163469899	3.2694	0.09340021		0.163469899	0.163379649	25	29.9339	37.5	0.163469899			0.163469899	30			30		30															45.378	3.34624922	8.570382016	0	1.35738054	3.279135109	1.074473164	1.511267785	8.068875419	3.846388641	6.626554057	0	0.093828578	7.431174129	11.82524318	14.4199994	2.0711676	0.432293925	0	0	5.510100788	2.90217477	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1468	0	79.79758806	45.378	3.34624922	8.570382016	0	1.35738054	3.279135109	1.074473164	1.511267785	8.068875419	3.846388641	6.626554057	0	0.093828578	7.431174129	11.82524318	14.4199994	2.0711676	0.432293925	0	0	5.510100788	2.90217477	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1468																																																																																				0			45.378	3.34624922	8.570382016	0	1.35738054	3.279135109	1.074473164	1.511267785	8.068875419	3.846388641	6.626554057	0	0.093828578	7.431174129	11.82524318	14.4199994	2.0711676	0.432293925	0	0	5.510100788	2.90217477	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1468
H1944_802_0	2008	4																					4500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2379.363731	175.4582119	1398.077089		170.8158933	20.05956528	3.843679805	665.6349654	49.36000739	14117.78682	70.94795667		0.573980764	45.48408681	5676.116728	5780.742427	662.7736319	2.644486403			33.70712788	1160.869908			144		16.8541424															$420 (1a); $0 (1a1)	$420 (1b)	"$135 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											228.8579	228.8579	73.5615		95.3574	0.163469899	0.279542839	27.245	0.163469899	3.2694	0.09340021		0.163469899	0.163379649	25	29.9339	37.5	0.163469899			0.163469899	30			30		30															45.378	3.34624922	8.570382016	0	1.35738054	3.279135109	1.074473164	1.511267785	8.068875419	3.846388641	6.626554057	0	0.093828578	7.431174129	11.82524318	14.4199994	2.0711676	0.432293925	0	0	5.510100788	2.90217477	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1468	0	79.79758806	45.378	3.34624922	8.570382016	0	1.35738054	3.279135109	1.074473164	1.511267785	8.068875419	3.846388641	6.626554057	0	0.093828578	7.431174129	11.82524318	14.4199994	2.0711676	0.432293925	0	0	5.510100788	2.90217477	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1468																																																																																				0			45.378	3.34624922	8.570382016	0	1.35738054	3.279135109	1.074473164	1.511267785	8.068875419	3.846388641	6.626554057	0	0.093828578	7.431174129	11.82524318	14.4199994	2.0711676	0.432293925	0	0	5.510100788	2.90217477	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1468
H1951_001_0	2008	4	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)																				D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin			V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0			0			0	0	0	0									0		2150.565693	70.443396	459.057845	1800.60317	192.481294	10.252147	3.228761	361.497212	456.638121	6176.510074	2755.385586		31.462416	1978.029302	6331.006325	4517.431218	62.052258	3315.387368			18.752248			3.09			0.29			0.08	11.53	3.4	0.02									$10/Day(Days 1-10)	$10/Day(Days 1-10)	$0/Day(Days 1-20) $20(Days 21-100)	$0/Visit	$100/Trip	20% Coins	0%-20% Coins	$50/Visit	$50/Visit	$0/Visit	$0-$100/Visit		$0-$50/Proc	$0-$100/Visit	$5/Visit	$15/Visit	$15-$50/Visit	$5/Visit			20% Coins			0% Coins			Hearing			Active Outlook Newsletter	See PBP	Silver Sneakers	Quit Net									8.357397	8.357348	4.63105	0	100.000013	0.199999	0.035738	49.999987	50.000004	0	12.093749		24.401304	23.600216	4.999999	14.999999	35.201555	4.999998			0.2			0			0			0	0	0	0									1.4978	0.049059998	0.177159986	0	1.604010992	2.050419148	0.115389461	1.506237992	1.90265899	0	2.776911806	0	0.063976998	3.890159898	2.637918774	5.646788646	0.182027998	1.381410851	0	0	3.7504496	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.2323	0	0	1.4978	0.049059998	0.177159986	0	1.604010992	2.050419148	0.115389461	1.506237992	1.90265899	0	2.776911806	0	0.063976998	3.890159898	2.637918774	5.646788646	0.182027998	1.381410851	0	0	3.7504496	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.2323																																																																																				0	0	0	1.4978	0.049059998	0.177159986	0	1.604010992	2.050419148	0.115389461	1.506237992	1.90265899	0	2.776911806	0	0.063976998	3.890159898	2.637918774	5.646788646	0.182027998	1.381410851	0	0	3.7504496	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.2323
H1951_005_0	2008	4	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)																				D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin			V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0			0			0	0	0	0									0		2131.863366	69.830786	455.065663	1784.944182	190.807376	9.871484	3.108876	358.35343	452.666941	6122.795683	2731.42321		31.188802	1960.827251	6275.952416	4478.147828	61.512618	3286.554901			15.555052			3.09			0.29			0.08	11.55	3.4	0.02									$10/Day(Days 1-10)	$10/Day(Days 1-10)	$0/Day(Days 1-20) $20(Days 21-100)	$0/Visit	$100/Trip	20% Coins	0%-20% Coins	$50/Visit	$50/Visit	$0/Visit	$0-$100/Visit		$0-$50/Proc	$0-$100/Visit	$5/Visit	$15/Visit	$15-$50/Visit	$5/Visit			20% Coins			0% Coins			Hearing			Active Outlook Newsletter	See PBP	Silver Sneakers	Quit Net									8.357398	8.357459	4.631067	0	99.99997	0.2	0.035738	49.99999	49.999993	0	12.093748		24.401065	23.600216	4.999999	15	35.201558	5			0.199999			0			0			0	0	0	0									1.4847	0.048633994	0.175619965	0	1.59006099	1.9742968	0.11110501	1.493138993	1.88611199	0	2.752761999	0	0.063419999	3.856328889	2.61497965	5.597684785	0.180444999	1.369397875	0	0	3.110994845	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.3097	0	0	1.4847	0.048633994	0.175619965	0	1.59006099	1.9742968	0.11110501	1.493138993	1.88611199	0	2.752761999	0	0.063419999	3.856328889	2.61497965	5.597684785	0.180444999	1.369397875	0	0	3.110994845	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.3097																																																																																				0	0	0	1.4847	0.048633994	0.175619965	0	1.59006099	1.9742968	0.11110501	1.493138993	1.88611199	0	2.752761999	0	0.063419999	3.856328889	2.61497965	5.597684785	0.180444999	1.369397875	0	0	3.110994845	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.3097
H1951_013_0	2008	3	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)																				D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin			V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0			0			0	0	0	0									0		1981.701837	64.912133	423.012316	1659.216211	177.367278	8.641569	2.721533	333.111487	420.781679	5691.514031	2539.025363		28.991905	1822.709174	5833.888634	4162.717208	57.179767	3055.05431			14.977934			3.09			0.29			0.08	11.49	3.4	0.02									$50/Day(Days 1-5)	$50/Day(Days 1-5)	$0/Day(Days 1-20) $75(Days 21-100)	$0/Visit	$100/Trip	20% Coins	0%-20% Coins	$50/Visit	$100/Visit	$0/Visit	$0-$100/Visit		$0-$50/Proc	$0-$100/Visit	$10/Visit	$20/Visit	$20-$50/Visit	$10/Visit			20% Coins			0% Coins			Hearing			Active Outlook Newsletter	See PBP	Silver Sneakers	Quit Net									32.5019	32.501905	17.366473	0	100.000023	0.2	0.035738	50.000016	100	0	12.093747		24.401156	26.11369	10	20.000002	37.315577	10.000001			0.2			0			0			0	0	0	0									5.3674	0.175813998	0.612185997	0	1.47806099	1.7283138	0.097262146	1.387964973	3.506513992	0	2.558860864	0	0.058953	3.966471861	4.861573862	6.937862707	0.177808	2.545878846	0	0	2.9955868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4565	0	0	5.3674	0.175813998	0.612185997	0	1.47806099	1.7283138	0.097262146	1.387964973	3.506513992	0	2.558860864	0	0.058953	3.966471861	4.861573862	6.937862707	0.177808	2.545878846	0	0	2.9955868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4565																																																																																				0	0	0	5.3674	0.175813998	0.612185997	0	1.47806099	1.7283138	0.097262146	1.387964973	3.506513992	0	2.558860864	0	0.058953	3.966471861	4.861573862	6.937862707	0.177808	2.545878846	0	0	2.9955868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4565
H1951_017_0	2008	6	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)																				D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S		T	Coin	V		V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0		0	0	0		0			0	0	0	0									0		2712.385926	88.84624	578.983494	2270.998144	242.765685	5308.40985	10164.09229	455.935828	575.931634	7790.080095	3475.210782		39.681752	2494.775611	7984.93741	5697.578501	78.262976	4181.50911			17760.96835		6.46	3.09	1.65		0.29			0.08	14.52	3.4	0.02									$0/Day(Days 1-7)	$0/Day(Days 1-1)	$0/Day(Days 1-100) $0(Days 100-100)	$0/Visit	$0/Trip			$0/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			$0/Script		See PBP	0% Coins	Vision		Hearing			Active Outlook Newsletter	See PBP	Silver Sneakers	Quit Net									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0		0	0	0		0			0	0	0	0									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H1951_019_0	2008	4	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)																				D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S		T	Coin	V		V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0		0	0	0		0			0	0	0	0									0		2688.797747	88.07359	573.948382	2251.248355	240.654467	5262.245141	10075.70003	451.970755	570.92301	7722.333195	3444.988404		39.336658	2473.079645	7915.501053	5648.032601	77.582359	4145.144363			17606.50902		6.46	3.09	1.65		0.29			0.08	14.54	3.4	0.02									$0/Day(Days 1-1)	$0/Day(Days 1-1)	$0/Day(Days 1-1) $0(Days 1-100)	$0/Visit	$0/Trip			$0/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			$0/Script		See PBP	0% Coins	Vision		Hearing			Active Outlook Newsletter	See PBP	Silver Sneakers	Quit Net									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0		0	0	0		0			0	0	0	0									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H1951_021_0	2008	4	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)																				D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S		T	Coin	V		V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0		0	0	0		0			0	0	0	0									0		2499.40757	81.869973	533.521322	2092.674832	223.703238	4891.582903	9365.987457	420.134531	530.707947	7178.382231	3202.327966		36.565837	2298.879187	7357.951202	5250.19794	72.117581	3853.165863			16366.32975		6.46	3.09	1.65		0.29			0.08	14.48	3.4	0.02									$0/Day(Days 1-1)	$0/Day(Days 1-1)	$0/Day(Days 1-100) $0(Days 100-100)	$0/Visit	$0/Trip			$0/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			$0/Script		See PBP	0% Coins	Vision		Hearing			Active Outlook Newsletter	See PBP	Silver Sneakers	Quit Net									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0		0	0	0		0			0	0	0	0									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H1951_023_0	2008	4	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)																				D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin						V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0						0			0	0	0	0									0		2212.422442	72.469559	472.261732	1852.39127	198.017351	10.770913	3.392138	371.894155	469.771391	6354.151336	2834.632632		32.3673	2034.91898	6513.101971	4647.363597	63.836949	3410.740503			18.668603						0.29			0.08	0.24	3.4	0.02									$100/Day(Days 1-7)	$100/Day(Days 1-7)	$0/Day(Days 1-20) $100(Days 21-100)	$0/Visit	$100/Trip	20% Coins	0%-20% Coins	$50/Visit	$150/Visit	$0/Visit	$0-$150/Visit		$0-$50/Proc	$0-$150/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$15/Visit			20% Coins						Hearing			Active Outlook Newsletter	See PBP	Silver Sneakers	Quit Net									74.946898	74.946889	23.155295	0	100.000024	0.2	0.035738	50	150.000015	0	18.140623		24.401293	29.612903	14.999999	30	41.543714	15.000001			0.2						0			0	0	0	0									13.8178	0.452614	0.911279977	0	1.650144988	2.1541826	0.121228228	1.549558979	5.872142975	0	4.285166827	0	0.065816998	5.021654864	8.141376921	11.61840899	0.221001996	4.263425913	0	0	3.7337206	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8796	0	0	13.8178	0.452614	0.911279977	0	1.650144988	2.1541826	0.121228228	1.549558979	5.872142975	0	4.285166827	0	0.065816998	5.021654864	8.141376921	11.61840899	0.221001996	4.263425913	0	0	3.7337206	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8796																																																																																				0	0	0	13.8178	0.452614	0.911279977	0	1.650144988	2.1541826	0.121228228	1.549558979	5.872142975	0	4.285166827	0	0.065816998	5.021654864	8.141376921	11.61840899	0.221001996	4.263425913	0	0	3.7337206	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8796
H1951_801_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		314.125075	7.130297	471.563728	1849.6561	197.724966	10.818343	3.407075	371.345299	469.078086	6344.773646	2830.449177		32.319533	2031.915762	6503.478761	4640.497335	63.742716	3405.706805			19.787879																					$600/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					118.143004	177.213936	28.944134	0	99.999996	0.2	0.2	49.999997	200.000023	41.87125	93.032339		48.802314	93.200245	19.999999	29.999999	70.402961	99.999999			0.2																					3.0926	0.105299	1.137416978	0	1.647707984	2.1636686	0.681415	1.547271986	7.817968999	22.13863363	21.94360895	0	0.131439	15.7812539	10.83913073	11.60124295	0.373972996	28.38088976	0	0	3.9575758	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.3411	0	0	3.0926	0.105299	1.137416978	0	1.647707984	2.1636686	0.681415	1.547271986	7.817968999	22.13863363	21.94360895	0	0.131439	15.7812539	10.83913073	11.60124295	0.373972996	28.38088976	0	0	3.9575758	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.3411																																																																																				0	0	0	3.0926	0.105299	1.137416978	0	1.647707984	2.1636686	0.681415	1.547271986	7.817968999	22.13863363	21.94360895	0	0.131439	15.7812539	10.83913073	11.60124295	0.373972996	28.38088976	0	0	3.9575758	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.3411
H1951_804_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		314.125075	7.130297	471.563728	1849.6561	197.724966	10.818343	3.407075	371.345299	469.078086	6344.773646	2830.449177		32.319533	2031.915762	6503.478761	4640.497335	63.742716	3405.706805			19.787879																					$600/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					118.143004	177.213936	28.944134	0	99.999996	0.2	0.2	49.999997	200.000023	41.87125	93.032339		48.802314	93.200245	19.999999	29.999999	70.402961	99.999999			0.2																					3.0926	0.105299	1.137416978	0	1.647707984	2.1636686	0.681415	1.547271986	7.817968999	22.13863363	21.94360895	0	0.131439	15.7812539	10.83913073	11.60124295	0.373972996	28.38088976	0	0	3.9575758	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.3411	0	0	3.0926	0.105299	1.137416978	0	1.647707984	2.1636686	0.681415	1.547271986	7.817968999	22.13863363	21.94360895	0	0.131439	15.7812539	10.83913073	11.60124295	0.373972996	28.38088976	0	0	3.9575758	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.3411																																																																																				0	0	0	3.0926	0.105299	1.137416978	0	1.647707984	2.1636686	0.681415	1.547271986	7.817968999	22.13863363	21.94360895	0	0.131439	15.7812539	10.83913073	11.60124295	0.373972996	28.38088976	0	0	3.9575758	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.3411
H1951_805_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		314.125075	7.130297	471.563728	1849.6561	197.724966	10.818343	3.407075	371.345299	469.078086	6344.773646	2830.449177		32.319533	2031.915762	6503.478761	4640.497335	63.742716	3405.706805			19.787879																					$600/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					118.143004	177.213936	28.944134	0	99.999996	0.2	0.2	49.999997	200.000023	41.87125	93.032339		48.802314	93.200245	19.999999	29.999999	70.402961	99.999999			0.2																					3.0926	0.105299	1.137416978	0	1.647707984	2.1636686	0.681415	1.547271986	7.817968999	22.13863363	21.94360895	0	0.131439	15.7812539	10.83913073	11.60124295	0.373972996	28.38088976	0	0	3.9575758	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.3411	0	0	3.0926	0.105299	1.137416978	0	1.647707984	2.1636686	0.681415	1.547271986	7.817968999	22.13863363	21.94360895	0	0.131439	15.7812539	10.83913073	11.60124295	0.373972996	28.38088976	0	0	3.9575758	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.3411																																																																																				0	0	0	3.0926	0.105299	1.137416978	0	1.647707984	2.1636686	0.681415	1.547271986	7.817968999	22.13863363	21.94360895	0	0.131439	15.7812539	10.83913073	11.60124295	0.373972996	28.38088976	0	0	3.9575758	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.3411
H1951_806_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		314.125075	7.130297	471.563728	1849.6561	197.724966	10.818343	3.407075	371.345299	469.078086	6344.773646	2830.449177		32.319533	2031.915762	6503.478761	4640.497335	63.742716	3405.706805			19.787879																					$600/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					118.143004	177.213936	28.944134	0	99.999996	0.2	0.2	49.999997	200.000023	41.87125	93.032339		48.802314	93.200245	19.999999	29.999999	70.402961	99.999999			0.2																					3.0926	0.105299	1.137416978	0	1.647707984	2.1636686	0.681415	1.547271986	7.817968999	22.13863363	21.94360895	0	0.131439	15.7812539	10.83913073	11.60124295	0.373972996	28.38088976	0	0	3.9575758	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.3411	0	0	3.0926	0.105299	1.137416978	0	1.647707984	2.1636686	0.681415	1.547271986	7.817968999	22.13863363	21.94360895	0	0.131439	15.7812539	10.83913073	11.60124295	0.373972996	28.38088976	0	0	3.9575758	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.3411																																																																																				0	0	0	3.0926	0.105299	1.137416978	0	1.647707984	2.1636686	0.681415	1.547271986	7.817968999	22.13863363	21.94360895	0	0.131439	15.7812539	10.83913073	11.60124295	0.373972996	28.38088976	0	0	3.9575758	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.3411
H1961_001_0	2008	8																																D		D	Coin	T	Coin	Coin	V	V						V	V	V	P		V	Coin		T		V																	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		134.3916873	0	573.2133429	26.35745082	471.4137181	10.86747249	13.20906249	391.3053005	21.25790226	0	0	0	0	0	2842.341723	6076.583069	6.827733929	1082.012645	0	1451.187672	8.820195102	0	0	0	0	0	0	0	0	0	0											"Choice 1: $0, Choice 2: $150 copay days 1-3, $0 Copay afterwards"		"$0 Copay days 1-20, $50 Copay 21+"	Choice 2: 10% for MC services $500 max OOP	"$55 Copay, per Trip"	"0% for Infusion Supplies, 10% otherwise"	"Choice 1: 10% of MA, Choice 2: 20% of MA"	"ER: $50 Copay, MC & WW, Urgent Care: $35 Copay, Worldwide: $50 Copay"	Choice 2: $150 Copay per visit						"Office Visit:  Choice 1: $5 Copay, Choice 2: $25 Copay, Routine Physical Choice 1: $5 Copay, Choice 2: NA"	"Office Visit:  Choice 1: $15 Copay, Choice 2: $25 Copay"	"$10 Copay Days 1-20, 50% coins after"	"$5 Copay, per Visit"		"Chiropractor & Podiatrist: Choice 1: $15 Copay, Choice 2: $25 Copay, Hearing Exams: $15 Copay, Vision Exams: $15 Copay"	"Choice 1: 5% of MA, Choice 2: 20% of MA"		"$5 Copay, 12 one-way trips"		"$15 Copay, 1 Exam per BP"																	63.21	0	8.37	0.0074	55	0.094837531	0.1074	45.78422325	150	0	0	0	0	0	6.387264467	15.72366394	10.00000001	4.999999999	0	15.39338888	0.0611	0	0	0	15	0	0	0	0	0	0											0.7079	0	0.399816307	0.195045136	2.160646208	1.030644259	1.418653312	1.492967437	0.265723778	0	0	0	0	0	1.512899024	7.962179175	0.005689778	0.450838602	0	1.861558015	0.538913921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.0035	0	0	0.7079	0	0.399816307	0.195045136	2.160646208	1.030644259	1.418653312	1.492967437	0.265723778	0	0	0	0	0	1.512899024	7.962179175	0.005689778	0.450838602	0	1.861558015	0.538913921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.0035																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.7079	0	0.399816307	0.195045136	2.160646208	1.030644259	1.418653312	1.492967437	0.265723778	0	0	0	0	0	1.512899024	7.962179175	0.005689778	0.450838602	0	1.861558015	0.538913921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.0035
H1961_002_0	2008	6																																D		D	Coin		Coin	Coin	V	V						V	V	V			V	Coin		T		V																	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		236.7922032	0	529.902668	33.60743875	0	13.05425167	14.54256357	552.787409	50.41106988	0	0	0	0	0	3182.38283	4896.406092	52.58020143	0	0	1317.43768	6.951000378	0	0	0	0	0	0	0	0	0	0											"Choice 1: $0, Choice 2: $150 copay days 1-3, $0 Copay afterwards"		"$0 Copay days 1-20, $50 Copay 21+"	Choice 2: 10% for MC services $500 max OOP		"0% for Infusion Supplies, Choice 1: 5% otherwise, Choice 2: 10% otherwise"	"Choice 1: 5% of MA, Choice 2: 20% of MA"	"ER: $50 Copay, MC & WW, Urgent Care: $25 Copay, Worldwide: $50 Copay"	Choice 2: $150 Copay per visit						"Office Visit:  Choice 1: $5 Copay, Choice 2: $25 Copay, Routine Physical Choice 1: $5 Copay, Choice 2: NA"	"Office Visit:  Choice 1: $10 Copay, Choice 2: $25 Copay"	"$10 Copay days 1 - 20, 50% coins afterwards"			"Chiropractor & Podiatrist: Choice 1: $10 Copay, Choice 2: $25 Copay, Hearing Exams: $10 Copay, Vision Exams $15 copay"	"Choice 1: 5% of MA, Choice 2: 10% of MA"		"$5 Copay, 12 one-way trips"		"$15 Copay, 1 Exam per BP"																	63.21	0	8.37	0.015	0	0.054785278	0.0725	42.804031	150	0	0	0	0	0	7.79646061	12.16337969	9.999999992	0	0	13.10688965	0.0575	0	0	0	15	0	0	0	0	0	0											1.2473	0	0.369607111	0.504111581	0	0.715180811	1.054335859	1.971794116	0.630138374	0	0	0	0	0	2.067610198	4.963070537	0.043816834	0	0	1.438959191	0.399682522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.4056	0	0	1.2473	0	0.369607111	0.504111581	0	0.715180811	1.054335859	1.971794116	0.630138374	0	0	0	0	0	2.067610198	4.963070537	0.043816834	0	0	1.438959191	0.399682522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.4056		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	20% of MA services	20% of MA services	20% of MA services	20% of MA services	20% of MA services	"ER: $50 Copay, MC & WW, Urgent Care:  $25 Copay, Worldwide:  $50 Copay, $5,000 Annual Max for WW"	20% of MA services	20% of MA services	20% of MA services		20% of MA services	20% of MA services	20% of MA services	20% of MA services	20% of MA services	20% of MA services	20% of MA services	20% of MA services	20% of MA services	20% of MA services																				3.28	0.17	0.53	1.35	0.37	0.49	0.58	0.42	1.03	0.14	1.4	0	0	0.69	1.31	3.82	0.13	0.07	0.55	1.39	0.2	0.12	0	0	0	0	0	0	0	0	0											18.04	0	0	4.5273	0.17	0.899607111	1.854111581	0.37	1.205180811	1.634335859	2.391794116	1.660138374	0.14	1.4	0	0	0.69	3.377610198	8.783070537	0.173816834	0.07	0.55	2.828959191	0.599682522	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.4456
H1961_003_0	2008	6																																D		D	Coin	T	Coin	Coin	V	V						V	V	V			V			T		V																	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		153.2956906	0	1088.356286	51.61995585	572.8215018	23.71511449	21.60038655	635.0105677	21.80538362	0	0	0	0	0	426.4043418	625.4480251	552.8815477	0	0	85.64117927	0	0	0	0	0	0	0	0	0	0	0											"Choice 1: $0, Choice 2: $150 copay days 1-3, $0 Copay afterwards"		"$0 Copay days 1-20, $50 Copay 21+"	Choice 2: 10% for MC services $500 max OOP	"$50 Copay, per Trip"	"Choice 2: 0% for Infusion Supplies, 5% otherwise"	Choice 2: 5% of MA	"ER: $50 Copay, MC & WW, Urgent Care: $10 Copay, Worldwide: $10 Copay"	Choice 2: $150 Copay per visit						Office Visit:  Choice 2: $25 Copay	Office Visit:  Choice 2: $25 Copay	"$10 Copay days 1-20, 50% coins after"			"Chiropractor & Podiatrist: Choice 2: $25 Copay, Vision Exams: Choice 2: $15 Copay"			"$5 Copay, 12 one-way trips"		Choice 2: $15 copay																	63.21	0	8.37	0.0074	50	0.003465467	0.0037	39.75054598	150	0	0	0	0	0	25	25	10	0	0	21.50355176	0	0	0	0	15	0	0	0	0	0	0											0.8075	0	0.759128509	0.381987673	2.386756258	0.082183942	0.07992143	2.103501398	0.272567295	0	0	0	0	0	0.888342379	1.303016719	0.460734623	0	0	0.153465794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.6791	0	0	0.8075	0	0.759128509	0.381987673	2.386756258	0.082183942	0.07992143	2.103501398	0.272567295	0	0	0	0	0	0.888342379	1.303016719	0.460734623	0	0	0.153465794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.6791																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.8075	0	0.759128509	0.381987673	2.386756258	0.082183942	0.07992143	2.103501398	0.272567295	0	0	0	0	0	0.888342379	1.303016719	0.460734623	0	0	0.153465794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.6791
H1991_801_0	2008	2	r.	t.									Other Non-Covered	OP Facility - Other									3750		ASC									coin		coin	coin	coin	coin		coin	coin	coin				coin	coin	coin			coin	coin													coin									23.0997		3.8121	0.0731	1.0513	1.2683		0.7319	1.7074	0.4214				6.97	0.5868	2.5093			3.5259	13.8071													1.1111									60.6754		329.9955244		54.45924706	1.044250299	15.01817868	18.11870596		10.45560843	24.39163001	6.020079554				99.57072514	8.383254314	35.84663372			50.37036901	197.2438708													15.87313753									$750 Ded; 80% to 15k		$750 Ded; 80% to 15k	$750 Ded; 80% to 15k	$750 Ded; 80% to 15k	$750 Ded; 80% to 15k		$750 Ded; 80% to 15k	$750 Ded; 80% to 15k	$750 Ded; 80% to 15k				$750 Ded; 80% to 15k	$750 Ded; 80% to 15k	$750 Ded; 80% to 15k			$750 Ded; 80% to 15k	$750 Ded; 80% to 15k													$750 Ded; 80% to 15k									0.09		0.09	0.09	0.09	0.09		0.09	0.09	0.09				0.09	0.09	0.09			0.09	0.09													0.09									29.6996	0	4.901332235	0.093982527	1.351636081	1.630683537	0	0.941004759	2.195246701	0.54180716	0	0	0	8.961365262	0.754492888	3.226197035	0	0	4.533333211	17.75194837	0	0	0	0	0	0	0	0	0	0	0	0	1.428582378	0	0	0	0	0	0	0	0	78.0112	750	75.34968639	52.7993	0	8.713479529	0.167080048	2.402908588	2.898992954	0	1.672897349	3.902660801	0.963212729	0	0	0	15.93131602	1.34132069	5.735461395	0	0	8.059259042	31.55901933	0	0	0	0	0	0	0	0	0	0	0	0	2.539702006	0	0	0	0	0	0	0	0	138.6866																																																																																				0	0	0	52.7993	0	8.713479529	0.167080048	2.402908588	2.898992954	0	1.672897349	3.902660801	0.963212729	0	0	0	15.93131602	1.34132069	5.735461395	0	0	8.059259042	31.55901933	0	0	0	0	0	0	0	0	0	0	0	0	2.539702006	0	0	0	0	0	0	0	0	138.6866
H1991_802_0	2008	2	r.	t.									Other Non-Covered	OP Facility - Other									3750		ASC									coin		coin	coin	coin	coin		coin	coin	coin				coin	coin	coin			coin	coin													coin									23.0997		3.8121	0.0731	1.0513	1.2683		0.7319	1.7074	0.4214				6.97	0.5868	2.5093			3.5259	13.8071													1.1111									60.6754		329.9955244		54.45924706	1.044250299	15.01817868	18.11870596		10.45560843	24.39163001	6.020079554				99.57072514	8.383254314	35.84663372			50.37036901	197.2438708													15.87313753									$750 Ded; 80% to 15k		$750 Ded; 80% to 15k	$750 Ded; 80% to 15k	$750 Ded; 80% to 15k	$750 Ded; 80% to 15k		$750 Ded; 80% to 15k	$750 Ded; 80% to 15k	$750 Ded; 80% to 15k				$750 Ded; 80% to 15k	$750 Ded; 80% to 15k	$750 Ded; 80% to 15k			$750 Ded; 80% to 15k	$750 Ded; 80% to 15k													$750 Ded; 80% to 15k									0.09		0.09	0.09	0.09	0.09		0.09	0.09	0.09				0.09	0.09	0.09			0.09	0.09													0.09									29.6996	0	4.901332235	0.093982527	1.351636081	1.630683537	0	0.941004759	2.195246701	0.54180716	0	0	0	8.961365262	0.754492888	3.226197035	0	0	4.533333211	17.75194837	0	0	0	0	0	0	0	0	0	0	0	0	1.428582378	0	0	0	0	0	0	0	0	78.0112	750	75.34968639	52.7993	0	8.713479529	0.167080048	2.402908588	2.898992954	0	1.672897349	3.902660801	0.963212729	0	0	0	15.93131602	1.34132069	5.735461395	0	0	8.059259042	31.55901933	0	0	0	0	0	0	0	0	0	0	0	0	2.539702006	0	0	0	0	0	0	0	0	138.6866																																																																																				0	0	0	52.7993	0	8.713479529	0.167080048	2.402908588	2.898992954	0	1.672897349	3.902660801	0.963212729	0	0	0	15.93131602	1.34132069	5.735461395	0	0	8.059259042	31.55901933	0	0	0	0	0	0	0	0	0	0	0	0	2.539702006	0	0	0	0	0	0	0	0	138.6866
H1991_803_0	2008	2	r.	t.									Other Non-Covered	OP Facility - Other									3750		ASC									coin		coin	coin	coin	coin		coin	coin	coin				coin	coin	coin			coin	coin													coin									23.0997		3.8121	0.0731	1.0513	1.2683		0.7319	1.7074	0.4214				6.97	0.5868	2.5093			3.5259	13.8071													1.1111									60.6754		329.9955244		54.45924706	1.044250299	15.01817868	18.11870596		10.45560843	24.39163001	6.020079554				99.57072514	8.383254314	35.84663372			50.37036901	197.2438708													15.87313753									$750 Ded; 80% to 15k		$750 Ded; 80% to 15k	$750 Ded; 80% to 15k	$750 Ded; 80% to 15k	$750 Ded; 80% to 15k		$750 Ded; 80% to 15k	$750 Ded; 80% to 15k	$750 Ded; 80% to 15k				$750 Ded; 80% to 15k	$750 Ded; 80% to 15k	$750 Ded; 80% to 15k			$750 Ded; 80% to 15k	$750 Ded; 80% to 15k													$750 Ded; 80% to 15k									0.09		0.09	0.09	0.09	0.09		0.09	0.09	0.09				0.09	0.09	0.09			0.09	0.09													0.09									29.6996	0	4.901332235	0.093982527	1.351636081	1.630683537	0	0.941004759	2.195246701	0.54180716	0	0	0	8.961365262	0.754492888	3.226197035	0	0	4.533333211	17.75194837	0	0	0	0	0	0	0	0	0	0	0	0	1.428582378	0	0	0	0	0	0	0	0	78.0112	750	75.34968639	52.7993	0	8.713479529	0.167080048	2.402908588	2.898992954	0	1.672897349	3.902660801	0.963212729	0	0	0	15.93131602	1.34132069	5.735461395	0	0	8.059259042	31.55901933	0	0	0	0	0	0	0	0	0	0	0	0	2.539702006	0	0	0	0	0	0	0	0	138.6866																																																																																				0	0	0	52.7993	0	8.713479529	0.167080048	2.402908588	2.898992954	0	1.672897349	3.902660801	0.963212729	0	0	0	15.93131602	1.34132069	5.735461395	0	0	8.059259042	31.55901933	0	0	0	0	0	0	0	0	0	0	0	0	2.539702006	0	0	0	0	0	0	0	0	138.6866
H2001_001_0	2008	10																					3250											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1788.107188	130.1939244	630.1133272		159.8364407	10.73937974	2.576109494	533.93782	28.07025664	8523.187937	38.29798728		0.192746148	26.70609559	4140.390174	4220.230322	475.2056722	3.59808782			16.29738162	972.5090176			128.5327351		15.65370722															$295 (1a); $0 (1a1)	$295 (1b)	"$175 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$20/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											175.5605	175.5605	104.1461		104.1461	0.178536148	0.271627224	29.756	0.119024098	3.5707	0.071056359		0.178536148	0.119024646	20	24.9683	37.5	0.119024098			0.178536148	25			25		25															26.1601	1.904743027	5.468653067	0	1.387194976	1.917367485	0.699741471	1.323988908	3.341036988	2.536161898	2.721315543	0	0.034412155	3.17868358	6.90065029	8.780985327	1.485017726	0.428259159	0	0	2.90967173	2.026060453	0	0	0.267776531	0	0.03261189	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.5044	0	36.340234	26.1601	1.904743027	5.468653067	0	1.387194976	1.917367485	0.699741471	1.323988908	3.341036988	2.536161898	2.721315543	0	0.034412155	3.17868358	6.90065029	8.780985327	1.485017726	0.428259159	0	0	2.90967173	2.026060453	0	0	0.267776531	0	0.03261189	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.5044		30% (1a); $0 (1a1)	30% (1b)	"30% (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$30 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$30/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $30 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											5.9491	0.2021	2.1924	0.3922	0.5827	0.8055	0.1932	0.5562	2.1053	1.4205	1.6962		0.0145	2.0017	2.0973	2.1686	0.297	0.1905			0.8628	0.5071			0.0662		0.0081															24.309	0	0	32.1092	2.106847421	7.661083021	0.392243884	1.969931999	2.722820966	0.892949683	1.880174138	5.446306236	3.956693221	4.417478523	0	0.048868116	5.1803424	8.997989081	10.94954469	1.782021271	0.618746161	0	0	3.772474286	2.533111206	0	0	0.333933086	0	0.040668945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.8134
H2001_003_0	2008	7																					2600											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1921.284909	141.6787229	920.3128563		119.9392615	12.36225557	2.368772774	467.4181659	30.41945415		43.72361816		0.35373134	28.03081212	4248.228114	4314.63952	494.4555483	1.731595617			22.07124787	866.055225			122.4		14.32602104															$150 (1a); $0 (1a1)	$150 (1b)	"$75 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	15% (9b)	15% (8a1); $0/$0 (8a2)	"$15 (8b1); 15% (8b2, 8b3)"	15% (incl in h5)	30% (12)	"15% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"15% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											97.1217	97.1217	48.5608		113.3086	0.194243336	0.284153816	32.3739	0.097121668		0.058607536		0.194243336	0.097115605	10	24.9434	37.5	0.097121668			0.194243336	25			25		25															15.5499	1.146672827	3.724263329	0	1.132512613	2.401285768	0.673095822	1.261012001	2.954388133	0	2.562533506	0	0.068709956	2.722229269	3.540190095	8.968483333	1.545173588	0.168175455	0	0	4.287192826	1.804281719	0	0	0.255	0	0.029845877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7949	0	20.71424725	15.5499	1.146672827	3.724263329	0	1.132512613	2.401285768	0.673095822	1.261012001	2.954388133	0	2.562533506	0	0.068709956	2.722229269	3.540190095	8.968483333	1.545173588	0.168175455	0	0	4.287192826	1.804281719	0	0	0.255	0	0.029845877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7949		$250 (1a); $0 (1a1)	$250 (1b)	"$125 (2a, 2a2)"	"25% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	25% (9b)	25% (8a1); $0/$20 (8a2)	"$20 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 25% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 25% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											3.4806	0.2567	3.1955	0.5496	0.4373	0.9272	0.1777	0.4869	1.9012	1.6521	1.6071		0.0265	1.751	1.4695	2.2002	0.309	0.0764			1.1685	0.452			0.063		0.0074															22.1954	0	0	19.0305	1.40333718	6.91979408	0.549640561	1.569791171	3.328454936	0.85075378	1.747905924	4.855604018	1.652146152	4.169586626	0	0.095239806	4.473237046	5.009702464	11.16869225	1.854208306	0.244569379	0	0	5.455670655	2.256267129	0	0	0.318	0	0.037219564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9903
H2001_007_0	2008	6																					1100											D	D	D	V	T	V	P	V	V	Coin	V	V	V	V	V		V	V		V	S	P	T		V	P	V																																																								0		2081.286147	294.7176823	996.5575643		402.6079576	3134.569947	1566.970564	697.8991459	370.3080638	7.809492883	183.0616663	68.10934151	39.45575008	3483.385328		3373.91285		914.9240966				655.2817481					0.08646629															1(a) $110 per Day	1(b) $110 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per preocedure; other $0 per procedure	8(b) X-rays $0 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a), 9(d) $25 per visit; 9(c) $0/0 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  $0 per script	"13, 14(a)-(j) $0; 17(a), 16(b) $10 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															59.8587	59.8587	22.8551		40.8127	10.793	15.4189	24.3516	13.6042	0.373554241	5.4417	13.6042	127.3235	13.6042		5.4417		5.4417				5.4417					5.4417															10.3819	1.470117902	1.898038285	0	1.369294633	2.819278849	2.013417384	1.416246972	0.419813564	2.917269188	0.083013877	0.077214698	0.418636977	3.949069844	0	1.529984913	0	0.414895146	0	0	0	0.297153849	0	0	0	0	3.92E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.4754	0	26.36573024	10.3819	1.470117902	1.898038285	0	1.369294633	2.819278849	2.013417384	1.416246972	0.419813564	2.917269188	0.083013877	0.077214698	0.418636977	3.949069844	0	1.529984913	0	0.414895146	0	0	0	0.297153849	0	0	0	0	3.92E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.4754		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															2.0753	0.1281	0.2826	0.3721	0.0922	0.1586	0.1133	0.0503	0.2224	0.0405	0.102	0.02	0.0208	0.227	0.0786	0.151	0.0622	0.0435			0.1441	0.0324	0.0077		0.0066																	4.4313	0	0	12.4573	1.598209379	2.18067012	0.372064454	1.461449118	2.977877204	2.126682053	1.466539485	0.642256838	2.957788868	0.185026215	0.097218929	0.439395584	4.176050622	0.07861004	1.680963331	0.062205069	0.458426414	0	0	0.144062384	0.329542468	0.00774	0	0.006631111	0	3.92E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.9067
H2001_801_0	2008	2																					3800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1850.755814	134.7305349	648.802276		166.1579311	10.92904926	2.638367766	554.1209025	28.61917946	8811.295863	38.98453563		0.192445891	27.25391576	4286.743832	4370.936111	492.0799311	3.729345568			16.49219132	1009.073369			131.6026268		16.04351023															$435 (1a); $0 (1a1)	$435 (1b)	"$175 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											247.9036	247.9036	99.7313		99.7313	0.170967986	0.269586793	28.4947	0.113978658	3.4194	0.068194454		0.170967986	0.113987137	15	24.9694	37.5	0.113978658			0.170967986	25			25		25															38.2341	2.783348497	5.392159243	0	1.380929225	1.868517545	0.711269105	1.315790763	3.261975656	2.510749186	2.65852912	0	0.032902087	3.106595818	5.35842979	9.094955721	1.537749785	0.425065802	0	0	2.819636741	2.102236185	0	0	0.274172139	0	0.03342398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.9025	0	49.73030999	38.2341	2.783348497	5.392159243	0	1.380929225	1.868517545	0.711269105	1.315790763	3.261975656	2.510749186	2.65852912	0	0.032902087	3.106595818	5.35842979	9.094955721	1.537749785	0.425065802	0	0	2.819636741	2.102236185	0	0	0.274172139	0	0.03342398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.9025		30% (1a); $0 (1a1)	30% (1b)	"30% (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$25/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											6.0676	0.2062	2.2317	0.3933	0.6058	0.8197	0.1979	0.5772	2.1464	1.4685	1.7301		0.0144	2.0427	1.8528	2.2448	0.3075	0.1974			0.8731	0.526			0.0677		0.0083															24.5794	0	0	44.3017	2.989597716	7.623884897	0.393326463	1.986713349	2.68819624	0.909146687	1.893000036	5.408414116	3.979298496	4.388646529	0	0.047335528	5.149325012	7.211251599	11.33976174	1.845299742	0.622501743	0	0	3.692752752	2.628221809	0	0	0.341908785	0	0.041681669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.482
H2001_803_0	2008	2																					3800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1850.755814	134.7305349	648.802276		166.1579311	10.92904926	2.638367766	554.1209025	28.61917946	8811.295863	38.98453563		0.192445891	27.25391576	4286.743832	4370.936111	492.0799311	3.729345568			16.49219132	1009.073369			131.6026268		16.04351023															$435 (1a); $0 (1a1)	$435 (1b)	"$175 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											247.9036	247.9036	99.7313		99.7313	0.170967986	0.269586793	28.4947	0.113978658	3.4194	0.068194454		0.170967986	0.113987137	15	24.9694	37.5	0.113978658			0.170967986	25			25		25															38.2341	2.783348497	5.392159243	0	1.380929225	1.868517545	0.711269105	1.315790763	3.261975656	2.510749186	2.65852912	0	0.032902087	3.106595818	5.35842979	9.094955721	1.537749785	0.425065802	0	0	2.819636741	2.102236185	0	0	0.274172139	0	0.03342398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.9025	0	49.73030999	38.2341	2.783348497	5.392159243	0	1.380929225	1.868517545	0.711269105	1.315790763	3.261975656	2.510749186	2.65852912	0	0.032902087	3.106595818	5.35842979	9.094955721	1.537749785	0.425065802	0	0	2.819636741	2.102236185	0	0	0.274172139	0	0.03342398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.9025		30% (1a); $0 (1a1)	30% (1b)	"30% (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$25/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											6.0676	0.2062	2.2317	0.3933	0.6058	0.8197	0.1979	0.5772	2.1464	1.4685	1.7301		0.0144	2.0427	1.8528	2.2448	0.3075	0.1974			0.8731	0.526			0.0677		0.0083															24.5794	0	0	44.3017	2.989597716	7.623884897	0.393326463	1.986713349	2.68819624	0.909146687	1.893000036	5.408414116	3.979298496	4.388646529	0	0.047335528	5.149325012	7.211251599	11.33976174	1.845299742	0.622501743	0	0	3.692752752	2.628221809	0	0	0.341908785	0	0.041681669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.482
H2003_001_0	2008	6	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						2400	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T		V	P	V					V	P	V	V	V																																															0		1495.267917	70.4803599	8542.263031	198.2112503	451.3022405	25.04127403	0.225098342	167.0153502	113.8074839	4261.727058	172.6228858	26.25346214	6.435921544	213.6229589	120.8972898	1272.132255	1906.454583	23.04690692		256.1034879	247.5022536	639.3446006	1817.255		287.28	278.16						95.8378812	1.210717914		234.745	287.945						(1a) $175/day	(1b) $175/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $35/visit	(8a) $0/visit	(8b) $0/visit	(9a) $35/visit	(12) $0/proc	(9a) $35/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $15/visit	(7e/7h) $32.5/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $15/visit	(15) $0/proc	(Misc. PBP Cats) $15/visit	(10b) $0/trip		(17a1) $0/visit	(17b2) $0/proc	(18a) $15/visit					(4b) $35/visit (waived if admitted)	(9c) $32.5/proc 75%/25% Ind/Grp Blended Copay	(9d) $35/visit	(7f1) $0/visit	(18a1) $0/visit						164.831	164.831			70.6419	0.18837831	0.18837831	47.0946	32.9662			32.9662		32.9662		14.1284	30.6115			14.1284		14.1284										32.9662	30.6115									20.5389	0.968112474	0	0	2.656736039	4.717232877	0.042403645	0.655459779	0.312650063	0	0	0.072123083	0	0.586861507	0	1.497763275	4.863282287	0	0	0.301527139	0	0.752741595	0	0	0	0	0	0	0	0	0	0.263284264	0.003088488	0	0	0	0	0	0	0	0	38.2321		2.358669329	20.5389	0.968112474	0	0	2.656736039	4.717232877	0.042403645	0.655459779	0.312650063	0	0	0.072123083	0	0.586861507	0	1.497763275	4.863282287	0	0	0.301527139	0	0.752741595	0	0	0	0	0	0	0	0	0	0.263284264	0.003088488	0	0	0	0	0	0	0	0	38.2321		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					35	0.3	0.3	0.3	0.3						1.892	0.0288	0.8355	0.1012	0.374	0.3954	0.0036	0.0366	0.1741	0.6845	0.6268	0.0319	0.0077	0.103	0.0074	1.6079	0.167	0.0025		0.1618		0.1054	0.1433		0.0146							0.0147	0.0001		0.0131	0.0185						7.5513		0	22.4309	0.996918313	0.83551968	0.101235752	3.030700681	5.112621415	0.04595783	0.692085952	0.486756752	0.684504442	0.626796969	0.104058683	0.007745121	0.689817367	0.007427553	3.105683988	5.030311221	0.002510537	0	0.463366888	0	0.858123507	0.14325	0	0.01455	0	0	0	0	0	0	0.277996219	0.003184965	0	0.01305	0.01845	0	0	0	0	0	45.7835
H2003_002_0	2008	7																					1800											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		1884.437788	129.2517918	878.1665013		271.9082422	10.20438203	17.72190147	425.8911085	402.549257	3374.907205	443.5228414	67.59102033	15.10795952	2835.98178		3839.867282	378.6343766	553.734022				683.392772					0.072357653															(1a)$150/day	(1b)$150/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															101.4066	101.4066	28.3938		50.7033	0.135208768	0.135208768	27.8868	50.7033	13.5209	44.1213	50.7033	99.4815	49.0215		16.9011	13.5209	13.5209				16.9011					16.9011															15.9245	1.092248471	2.077876688	0	1.148886826	1.379721922	2.396156465	0.989728645	1.700880909	3.802642045	1.630734711	0.285590581	0.125246861	11.58534562	0	5.408163797	0.426622397	0.623914124	0	0	0	0.962507237	0	0	0	0	0.00010191	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.5609	0	24.7076751	15.9245	1.092248471	2.077876688	0	1.148886826	1.379721922	2.396156465	0.989728645	1.700880909	3.802642045	1.630734711	0.285590581	0.125246861	11.58534562	0	5.408163797	0.426622397	0.623914124	0	0	0	0.962507237	0	0	0	0	0.00010191	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.5609		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.0681	0.0591	0.2546	0.2541	0.0653	0.125	0.1085	0.0307	0.2641	0.0415	0.1078	0.0216	0.005	0.1885	0.0188	0.1822	0.0274	0.0296			0.1634	0.0386			0.0051																	4.0587	0	0	17.9926	1.151342997	2.332460292	0.254089929	1.214149524	1.504673538	2.504657902	1.020419518	1.964990626	3.8441034	1.738509097	0.307215578	0.130233804	11.77387543	0.018844195	5.590339651	0.453992696	0.653483491	0	0	0.163351029	1.001130716	0	0	0.005058988	0	0.00010191	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6197
H2029_001_0	2008	6	s.	t.									Skilled Nursing Facility	Health & Education (Non-Covered)									0											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin						O	O	D	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0						0	0	0	0									0	0	268.987427	0	2.011281	149.260509	116.809957	14.051477	7.054851	863.677726	121.811304	12543.65605	2944.416949		6.520716	2131.185425	5551.284058	3936.477637	1.230066	2336.833889			6.868988			6.33						0.08	0.15	2.011281	3.4									$100/Admit	$100/Admit	$0/Day(Days 1-100) $0(Days 100-100)	$0/Visit	$10/Trip	0% Coins	0% Coins	$25/Visit	$0/Visit	$0/Visit	$0-$10/Visit		$0/Proc	$0-$5/Visit	$0/Visit	$5/Visit	$0-$5/Visit	$0/Visit			0% Coins			Puerto Rico Dental						Active Outlook Newsletter	Assist America	$0/Day(Days 1-101) $0(Days 101-100)	Silver Sneakers									100	100	0	0	10.000037	0	0	25.000005	0	0	1.095346		0	0	0	4.999999	0.85849	0			0			0						0	0	0	0									2.2416	0	0	0	0.097341991	0	0	1.799328956	0	0	0.268762944	0	0	0	0	1.640198687	8.80E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.0473	0	0	2.2416	0	0	0	0.097341991	0	0	1.799328956	0	0	0.268762944	0	0	0	0	1.640198687	8.80E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.0473	0																								Puerto Rico Dental						Active Outlook Newsletter	Assist America		Silver Sneakers									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0						0	0	0	0									0	0	0	2.2416	0	0	0	0.097341991	0	0	1.799328956	0	0	0.268762944	0	0	0	0	1.640198687	8.80E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.0473
H2029_801_0	2008	2																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		262.840652	5.647913	449.456241	188.256796	62.970614	3.827951	1.30997	297.942766	351.860091	5534.128545	1297.081933		7.389935	471.660204	4275.933046	3230.092015	42.145253	268.139071			13.741283																					$100/Admit	$100/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$25/Trip	20% Coins	20% Coins	$30/Visit	$75/Visit	$30-$35/Visit	$25-$30/Visit		$0-$25/Proc	$15-$25/Visit	$5/Visit	$15/Visit	$15-$25/Visit	$25/Visit			20% Coins																					100	100	28.944121	0	25.000042	0.199999	0.2	30.000003	74.99998	34.149411	25.949503		8.341616	23.259269	5	15.000003	19.181092	24.999997			0.2																					2.1903	0.047065942	1.084092985	0	0.131189	0.765586372	0.261994	0.744856989	2.199124982	15.74893585	2.804885959	0	0.005137	0.914205963	1.781638769	4.037615826	0.067365998	0.558622998	0	0	2.7482566	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0909	0	0	2.1903	0.047065942	1.084092985	0	0.131189	0.765586372	0.261994	0.744856989	2.199124982	15.74893585	2.804885959	0	0.005137	0.914205963	1.781638769	4.037615826	0.067365998	0.558622998	0	0	2.7482566	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0909		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					7.2413	0.0818	0.3565	0.5569	0.5496	1.0577	0.362	0.6206	2.3638	0.586	1.5806		0.0108	0.7902	2.4441	2.0107	0.0692	0.2133			0.6422																					21.5374	0	0	9.4317	0.128891942	1.440591985	0.556914	0.68077	1.823309372	0.62396	1.365493989	4.562936982	16.33493885	4.385459959	0	0.0159	1.704397963	4.225720769	6.048310826	0.136589998	0.771968998	0	0	3.3904686	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6283
H2029_802_0	2008	2																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		262.840652	5.647913	449.456241	188.256796	62.970614	3.827951	1.30997	297.942766	351.860091	5534.128545	1297.081933		7.389935	471.660204	4275.933046	3230.092015	42.145253	268.139071			13.741283																					$100/Admit	$100/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$25/Trip	20% Coins	20% Coins	$30/Visit	$75/Visit	$30-$35/Visit	$25-$30/Visit		$0-$25/Proc	$15-$25/Visit	$5/Visit	$15/Visit	$15-$25/Visit	$25/Visit			20% Coins																					100	100	28.944121	0	25.000042	0.199999	0.2	30.000003	74.99998	34.149411	25.949503		8.341616	23.259269	5	15.000003	19.181092	24.999997			0.2																					2.1903	0.047065942	1.084092985	0	0.131189	0.765586372	0.261994	0.744856989	2.199124982	15.74893585	2.804885959	0	0.005137	0.914205963	1.781638769	4.037615826	0.067365998	0.558622998	0	0	2.7482566	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0909	0	0	2.1903	0.047065942	1.084092985	0	0.131189	0.765586372	0.261994	0.744856989	2.199124982	15.74893585	2.804885959	0	0.005137	0.914205963	1.781638769	4.037615826	0.067365998	0.558622998	0	0	2.7482566	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0909		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					7.2413	0.0818	0.3565	0.5569	0.5496	1.0577	0.362	0.6206	2.3638	0.586	1.5806		0.0108	0.7902	2.4441	2.0107	0.0692	0.2133			0.6422																					21.5374	0	0	9.4317	0.128891942	1.440591985	0.556914	0.68077	1.823309372	0.62396	1.365493989	4.562936982	16.33493885	4.385459959	0	0.0159	1.704397963	4.225720769	6.048310826	0.136589998	0.771968998	0	0	3.3904686	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6283
H2029_803_0	2008	2																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		262.840652	5.647913	449.456241	188.256796	62.970614	3.827951	1.30997	297.942766	351.860091	5534.128545	1297.081933		7.389935	471.660204	4275.933046	3230.092015	42.145253	268.139071			13.741283																					$100/Admit	$100/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$25/Trip	20% Coins	20% Coins	$30/Visit	$75/Visit	$30-$35/Visit	$25-$30/Visit		$0-$25/Proc	$15-$25/Visit	$5/Visit	$15/Visit	$15-$25/Visit	$25/Visit			20% Coins																					100	100	28.944121	0	25.000042	0.199999	0.2	30.000003	74.99998	34.149411	25.949503		8.341616	23.259269	5	15.000003	19.181092	24.999997			0.2																					2.1903	0.047065942	1.084092985	0	0.131189	0.765586372	0.261994	0.744856989	2.199124982	15.74893585	2.804885959	0	0.005137	0.914205963	1.781638769	4.037615826	0.067365998	0.558622998	0	0	2.7482566	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0909	0	0	2.1903	0.047065942	1.084092985	0	0.131189	0.765586372	0.261994	0.744856989	2.199124982	15.74893585	2.804885959	0	0.005137	0.914205963	1.781638769	4.037615826	0.067365998	0.558622998	0	0	2.7482566	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0909		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					7.2413	0.0818	0.3565	0.5569	0.5496	1.0577	0.362	0.6206	2.3638	0.586	1.5806		0.0108	0.7902	2.4441	2.0107	0.0692	0.2133			0.6422																					21.5374	0	0	9.4317	0.128891942	1.440591985	0.556914	0.68077	1.823309372	0.62396	1.365493989	4.562936982	16.33493885	4.385459959	0	0.0159	1.704397963	4.225720769	6.048310826	0.136589998	0.771968998	0	0	3.3904686	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6283
H2029_804_0	2008	2																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		262.840652	5.647913	449.456241	188.256796	62.970614	3.827951	1.30997	297.942766	351.860091	5534.128545	1297.081933		7.389935	471.660204	4275.933046	3230.092015	42.145253	268.139071			13.741283																					$100/Admit	$100/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$25/Trip	20% Coins	20% Coins	$30/Visit	$75/Visit	$30-$35/Visit	$25-$30/Visit		$0-$25/Proc	$15-$25/Visit	$5/Visit	$15/Visit	$15-$25/Visit	$25/Visit			20% Coins																					100	100	28.944121	0	25.000042	0.199999	0.2	30.000003	74.99998	34.149411	25.949503		8.341616	23.259269	5	15.000003	19.181092	24.999997			0.2																					2.1903	0.047065942	1.084092985	0	0.131189	0.765586372	0.261994	0.744856989	2.199124982	15.74893585	2.804885959	0	0.005137	0.914205963	1.781638769	4.037615826	0.067365998	0.558622998	0	0	2.7482566	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0909	0	0	2.1903	0.047065942	1.084092985	0	0.131189	0.765586372	0.261994	0.744856989	2.199124982	15.74893585	2.804885959	0	0.005137	0.914205963	1.781638769	4.037615826	0.067365998	0.558622998	0	0	2.7482566	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0909		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					7.2413	0.0818	0.3565	0.5569	0.5496	1.0577	0.362	0.6206	2.3638	0.586	1.5806		0.0108	0.7902	2.4441	2.0107	0.0692	0.2133			0.6422																					21.5374	0	0	9.4317	0.128891942	1.440591985	0.556914	0.68077	1.823309372	0.62396	1.365493989	4.562936982	16.33493885	4.385459959	0	0.0159	1.704397963	4.225720769	6.048310826	0.136589998	0.771968998	0	0	3.3904686	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6283
H2034_001_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		442.3431886		442.2872759		60.68227545	26.25357985		24.90148716	17.48502392	195.169535					258.9963846						36.57042245	6.006841434																				Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co																				0.0758		0.1776		0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				33.5296	0	78.55022021	0	14.19965246	6.143337685	0	5.826947996	4.091495596	45.66967119	0	0	0	0	60.60515399	0	0	0	0	0	8.557478854	1.405600895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	258.5792	0	0	33.5296	0	78.55022021	0	14.19965246	6.143337685	0	5.826947996	4.091495596	45.66967119	0	0	0	0	60.60515399	0	0	0	0	0	8.557478854	1.405600895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	258.5792																																																																																				0	0	0	33.5296	0	78.55022021	0	14.19965246	6.143337685	0	5.826947996	4.091495596	45.66967119	0	0	0	0	60.60515399	0	0	0	0	0	8.557478854	1.405600895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	258.5792
H2034_002_0	2008	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		479.3374778		262.0354685		62.23356018	40.2280002		31.1091105	26.51460481	171.9127781					348.768415						51.9146742	5.078302016																				Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co																				0.077954806		0.176230209		0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				37.3667	0	46.17856549	0	14.56265308	9.413352046	0	7.279531856	6.204417526	40.22759007	0	0	0	0	81.61180912	0	0	0	0	0	12.14803376	1.188322672	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	256.1809	0	0	37.3667	0	46.17856549	0	14.56265308	9.413352046	0	7.279531856	6.204417526	40.22759007	0	0	0	0	81.61180912	0	0	0	0	0	12.14803376	1.188322672	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	256.1809																																																																																				0	0	0	37.3667	0	46.17856549	0	14.56265308	9.413352046	0	7.279531856	6.204417526	40.22759007	0	0	0	0	81.61180912	0	0	0	0	0	12.14803376	1.188322672	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	256.1809
H2047_001_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	948.624126	0	0	0	0	0	0															$0/day	$0/day	$0/day 1-10; $100/day 11-100	$20 per visit	$100 per trip	20% coinsurance	20% coinsurance	"$50 ER, $35 UC"	$100 per procedure	$0 per visit	"$20 X-ray; $175 CAT, PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$10 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	45$ per script		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															0	0	64.36	20	100	0.2	0.2	48	100	0	47.9	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0															0	0	6.120197628	3.122011879	1.722706705	2.766333837	0.176580511	1.499757057	2.57415865	0	4.02885463	0	0	0	4.059988329	10.03426641	0.295785081	0.855793714	1.403544073	2.121373179	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3387			0	0	6.120197628	3.122011879	1.722706705	2.766333837	0.176580511	1.499757057	2.57415865	0	4.02885463	0	0	0	4.059988329	10.03426641	0.295785081	0.855793714	1.403544073	2.121373179	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3387		30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	$100 per trip	30% coins; $1000ded; 5000 max OOP	0	"$50 ER, $35 UC"	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	0	0	0	30% coins; $1000ded; 5000 max OOP	0	30% coins; $1000ded; 5000 max OOP															5.7858	0	0.9382	0.8405	0.1679	0.4788	0	0.1454	0.5925	0.2056	0.5773	0	0.1893	0.6379	0.7516	0.9392	0.0355	0.0994	0.6985	2.5313	0.5505	0	0	0	0.0977	0	0.0276															16.2904	1000	13.08602097	5.7858	0	7.058359749	3.962471704	1.890626223	3.245098455	0.176580511	1.645114897	3.166694307	0.205623035	4.606129373	0	0.189302013	0.637899183	4.811631907	10.97343743	0.331256652	0.955221966	2.102058624	4.652680466	4.107791126	0	0	0	0.097702603	0	0.027584622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6291
H2047_002_0	2008	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	3500	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	948.624126	0	0	0	0	0	0															$0/day	$0/day	$0/day 1-10; $100/day 11-100	$20 per visit	$100 per trip	20% coinsurance	20% coinsurance	"$50 ER, $35 UC"	$100 per procedure	$0 per visit	"$15 X-ray; $175 CAT, PET, MRI"	$15 per visit	$15 per visit	$15 per visit	$5 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	45$ per script		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															0	0	64.36	20	100	0.2	0.2	48	100	0	43.8	15	15	15	5	15	15	15	15	15	45	0	0	0	0	0	0															0	0	6.120197628	3.122011879	1.722706705	2.766333837	0.176580511	1.499757057	2.57415865	0	3.68400486	0	0	0	2.029994164	7.525699807	0.221838811	0.641845286	1.052658054	1.591029884	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2862			0	0	6.120197628	3.122011879	1.722706705	2.766333837	0.176580511	1.499757057	2.57415865	0	3.68400486	0	0	0	2.029994164	7.525699807	0.221838811	0.641845286	1.052658054	1.591029884	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2862		30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	$100 per trip	30% coins; $500ded; 3500 max OOP	0	"$50 ER, $35 UC"	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	0	0	0	30% coins; $500ded; 3500 max OOP	0	30% coins; $500ded; 3500 max OOP															4.2923	0	0.696	0.6235	0.1263	0.3552	0	0.1096	0.4396	0.1525	0.4283	0	0.1404	0.4732	0.5576	0.6967	0.0263	0.0738	0.5182	1.8779	0.4084	0	0	0	0.0725	0	0.0205															12.0889	500	15.27432558	4.2923	0	6.816196235	3.745527639	1.849056127	3.121517126	0.176580511	1.609328361	3.013745778	0.152546498	4.112270304	0	0.140438347	0.473241173	2.58761941	8.222446891	0.248154267	0.715608576	1.570868227	3.468942354	3.965705807	0	0	0	0.072483075	0	0.020464329	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3751
H2047_801_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0	Unlimited	1037.271209	20.2073278	847.2735994	1390.845273	153.4919513	13.83166919	0.882902555	278.3901982	229.3557187	1458.196451	749.4114899	0	0	0	3617.420942	4588.991745	131.7712097	762.5061584	1042.123218	1890.128528	15.90270259	0	0	0	0	0	0															$200/d 7	$200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															12.4965	0.243447782	7.060613328	4.636150911	1.918649392	4.149500756	0.264870766	1.159959159	3.822595311	4.860654835	3.431055605	0	0	0	9.043552355	15.10543116	0.439237366	2.541687195	3.473744059	6.300428426	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.1286			12.4965	0.243447782	7.060613328	4.636150911	1.918649392	4.149500756	0.264870766	1.159959159	3.822595311	4.860654835	3.431055605	0	0	0	9.043552355	15.10543116	0.439237366	2.541687195	3.473744059	6.300428426	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.1286		"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"		$50 ER/UC	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"				"30% coins; $500ded; ""Unlimited OOP"		"30% coins; $500ded; ""Unlimited OOP"															7.922	0	1.2845	1.1508	0.2023	0.6555	0	0.1817	0.8113	0.2815	0.7904	0	0.2592	0.8734	1.0292	1.2859	0.0486	0.1361	0.9564	3.4659	0.5368	0	0	0	0.1338	0	0.0378															22.0432	500	0	20.4185	0.243447782	8.345153732	5.786916411	2.120982705	4.805029776	0.264870766	1.341677145	4.633900709	5.142195829	4.221465614	0	0.259194098	0.873417564	10.07270982	16.39135296	0.487805374	2.677825293	4.430156755	9.766318182	3.717367697	0	0	0	0.133775323	0	0.037769123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.1718
H2047_802_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0	Unlimited	1037.271209	20.2073278	847.2735994	1390.845273	153.4919513	13.83166919	0.882902555	278.3901982	229.3557187	1458.196451	749.4114899	0	0	0	3617.420942	4588.991745	131.7712097	762.5061584	1042.123218	1890.128528	15.90270259	0	0	0	0	0	0															$200/d 7	$200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															12.4965	0.243447782	7.060613328	4.636150911	1.918649392	4.149500756	0.264870766	1.159959159	3.822595311	4.860654835	3.431055605	0	0	0	9.043552355	15.10543116	0.439237366	2.541687195	3.473744059	6.300428426	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.1286			12.4965	0.243447782	7.060613328	4.636150911	1.918649392	4.149500756	0.264870766	1.159959159	3.822595311	4.860654835	3.431055605	0	0	0	9.043552355	15.10543116	0.439237366	2.541687195	3.473744059	6.300428426	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.1286		"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"		$50 ER/UC	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"				"30% coins; $500ded; ""Unlimited OOP"		"30% coins; $500ded; ""Unlimited OOP"															7.922	0	1.2845	1.1508	0.2021	0.6555	0	0.1817	0.8113	0.2815	0.7904	0	0.2592	0.8734	1.0292	1.2859	0.0486	0.1361	0.9564	3.4659	0.5368	0	0	0	0.1338	0	0.0378															22.0429	500	0	20.4185	0.243447782	8.345153732	5.786916411	2.120754853	4.805029776	0.264870766	1.341677145	4.633900709	5.142195829	4.221465614	0	0.259194098	0.873417564	10.07270982	16.39135296	0.487805374	2.677825293	4.430156755	9.766318182	3.717367697	0	0	0	0.133775323	0	0.037769123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.1716
H2108_001_0	2008	3																																Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	P	V	P	O	O	V																																																				0		555.0950141	16.90609958			15.62620723	17.50101801	35.43757823	271.453137	34.58520192	20.06123276	12.83404704	0.25936581	6.184405012	1.128637987	31.94444018	169.3482666	4.961180927	6.140070215	34.04144825	5.562613464	22.96311327	8.267440684																				#1A MC cost shares	#1B MC cost shares	#2 $0	#6 $0	#10A MC cost shares	#11A MC cost shares	"#11B MC cost shares, #11C MC cost shares"	"#4A $50, #4B MC cost shares"	"#9A MC cost shares, #9B MC cost shares"	#8A MC cost shares	#8B MC cost shares	#9A MC cost shares	#12 MC cost shares	"#3 MC cost shares, #5 MC cost shares, #9A MC cost shares, #9C MC cost shares, #9D MC cost shares"	"#7A MC cost shares, #14B MC cost shares, #14C $0, #14D 0%-pap smears, 20%-pelvic exams, #14E MC cost shares, #14F MC cost shares, #14G MC cost shares, #14H MC cost shares"	"#7B MC cost shares, #7D MC cost shares, #7F 20%, #7G MC cost shares"	"#7E MC cost shares, #7H MC cost shares"	"#7C MC cost shares, #7I MC cost shares"	#8B MC cost shares	"#14I MC cost shares , #14J MC cost shares"	#15 MC cost shares	"#13A MC cost shares, #16B $0, #17A MC cost shares, #17B MC cost shares, #18A $0"	#10B $0	#16A $0	#17A $0	#17B $0	#18A $0	#18B $0	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											0.063638433	0.063638433			0.234	0.234	0.234	50	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				35.3254	1.075877694	0	0	3.656532492	4.095238215	8.292393307	1.131054737	8.092937249	4.694328467	3.003167007	0.0606916	1.447150773	0.264101289	7.474999001	39.62749439	1.160916337	1.43677643	7.965698889	1.301651551	5.373368504	1.93458112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.4143	135	0	35.3254	1.075877694	0	0	3.656532492	4.095238215	8.292393307	1.131054737	8.092937249	4.694328467	3.003167007	0.0606916	1.447150773	0.264101289	7.474999001	39.62749439	1.160916337	1.43677643	7.965698889	1.301651551	5.373368504	1.93458112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.4143																																																																																				0		0	35.3254	1.075877694	0	0	3.656532492	4.095238215	8.292393307	1.131054737	8.092937249	4.694328467	3.003167007	0.0606916	1.447150773	0.264101289	7.474999001	39.62749439	1.160916337	1.43677643	7.965698889	1.301651551	5.373368504	1.93458112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.4143
H2108_002_0	2008	4																																D	Coin	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	P	Coin	Coin	P	T	V	V	P	V	P	O	O	V																																																				0		2339.308442	11.65896127	53.37222219		181.994398	8.3971927	27.2454368	180.730167	121.8645032		475.9570022	1.232251138	1.592779319	14.17088809	1029.526983	6215.550098	402.0642009	873.8848439			24.56548735	921.3704074																				"#1A $150/day days 1-8, $0/day days 9-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $35"	"#9A $200, #9B $50"	#8A $0	"#8B $15 x-ray, $150 complex radiology"	#9A $200	#12 20%	"#3 20%, #5 20%, #9A $200, #9C 20%, #9D $40"	"#7A $10, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $40, #7D $40, #7F $40, #7G $40"	"#7E $40, #7H $40"	"#7C $40, #7I $40"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0, #17A $40, #17B $0, #18A $40"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											117.1946	0.0626	0.1696		50	0.2	0.2	50	185		102.7059	200	0.2	200	10	29.2224	40	40			0.2	40																				22.8462	0.729850975	9.051928883	0	0.758309992	1.67943854	5.449087361	0.753042362	1.878744424	0	4.073632492	0.020537519	0.318555864	0.236181468	0.857939152	15.13612641	1.340214003	2.91294948	0	0	4.913097471	3.071234691	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0271	0	0	22.8462	0.729850975	9.051928883	0	0.758309992	1.67943854	5.449087361	0.753042362	1.878744424	0	4.073632492	0.020537519	0.318555864	0.236181468	0.857939152	15.13612641	1.340214003	2.91294948	0	0	4.913097471	3.071234691	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0271																																																																																				0		0	22.8462	0.729850975	9.051928883	0	0.758309992	1.67943854	5.449087361	0.753042362	1.878744424	0	4.073632492	0.020537519	0.318555864	0.236181468	0.857939152	15.13612641	1.340214003	2.91294948	0	0	4.913097471	3.071234691	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0271
H2108_020_0	2008	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	Coin	Coin	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		504.5592543	40.49751129			46.82656773	9.108465894	18.80534741	306.685966	11.48517932		5.861082749	1.188840543	2.61202009	11.10271698		341.065742	53.44352398	79.24632017			29.86741028	9.66022148																				#1A MC cost shares	#1B MC cost shares	#2 $0	#6 $0	#10A MC Cost Shares w/o Part B Deductible and PCP $0	#11A MC Cost Shares w/o Part B Deductible and PCP $0	"#11B MC Cost Shares w/o Part B Deductible and PCP $0, #11C MC Cost Shares w/o Part B Deductible and PCP $0"	"#4A $50, #4B $$50"	"#9A MC Cost Shares w/o Part B Deductible and PCP $0, #9B MC Cost Shares w/o Part B Deductible and PCP $0"	#8A 0%	#8B MC Cost Shares w/o Part B Deductible and PCP $0	#9A MC Cost Shares w/o Part B Deductible and PCP $0	#12 MC Cost Shares w/o Part B Deductible and PCP $0	"#3 MC Cost Shares w/o Part B Deductible and PCP $0, #5 MC Cost Shares w/o Part B Deductible and PCP $0, #9C MC Cost Shares w/o Part B Deductible and PCP $0, #9D MC Cost Shares w/o Part B Deductible and PCP $0"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B MC Cost Shares w/o Part B Deductible and PCP $0, #7D MC Cost Shares w/o Part B Deductible and PCP $0, #7F MC Cost Shares w/o Part B Deductible and PCP $0, #7G MC Cost Shares w/o Part B Deductible and PCP $0"	"#7E MC Cost Shares w/o Part B Deductible and PCP $0, #7H MC Cost Shares w/o Part B Deductible and PCP $0"	"#7C MC Cost Shares w/o Part B Deductible and PCP $0, #7I MC Cost Shares w/o Part B Deductible and PCP $0"	#8B MC Cost Shares w/o Part B Deductible and PCP $0	"#14I $0 , #14J $0"	#15 MC Cost Shares w/o Part B Deductible and PCP $0	"#13A MC Cost Shares w/o Part B Deductible and PCP $0, #16B MC Cost Shares w/o Part B Deductible and PCP $0, #17A MC Cost Shares w/o Part B Deductible and PCP $0, #17B MC Cost Shares w/o Part B Deductible and PCP $0, #18A MC Cost Shares w/o Part B Deductible and PCP $0"	#10B $0	"#16A $0, #16B MC Cost Shares w/o Part B Deductible and PCP $0"	#17A $0	#17B $0	#18A $0	#18B $0	#19 $0 n/c	#14A $0 n/c	"#13B $0 n/c , #13C $0, #13D $0"											0.063809983	0.063809983			0.206	0.206	0.206	50	0.206		0.206	0.206	0.206	0.206		0.206	0.206	0.206			0.206	0.206																				32.1959	2.584145491	0	0	9.646272952	1.876343974	3.873901567	1.277858192	2.365946939	0	1.207383046	0.244901152	0.538076139	2.287159697	0	70.25954284	11.00936594	16.32474195	0	0	6.152686517	1.990005625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	163.8342	0	0	32.1959	2.584145491	0	0	9.646272952	1.876343974	3.873901567	1.277858192	2.365946939	0	1.207383046	0.244901152	0.538076139	2.287159697	0	70.25954284	11.00936594	16.32474195	0	0	6.152686517	1.990005625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	163.8342																																																																																				0	0	0	32.1959	2.584145491	0	0	9.646272952	1.876343974	3.873901567	1.277858192	2.365946939	0	1.207383046	0.244901152	0.538076139	2.287159697	0	70.25954284	11.00936594	16.32474195	0	0	6.152686517	1.990005625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	163.8342
H2108_021_0	2008	3																																D	Coin	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	P	Coin	Coin	P	T	V	V	P	V	P	O	O	V																																																				0		2339.308442	11.65896127	53.37222219		181.994398	8.3971927	27.2454368	180.730167	121.8645032		475.9570022	1.232251138	1.592779319	14.17088809	1029.526983	6215.550098	402.0642009	873.8848439			24.56548735	921.3704074																				"#1A $150/day days 1-8, $0/day days 9-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $35"	"#9A $200, #9B $50"	#8A $0	"#8B $15 x-ray, $150 complex radiology"	#9A $200	#12 20%	"#3 20%, #5 20%, #9A $200, #9C 20%, #9D $40"	"#7A $10, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $40, #7D $40, #7F $40, #7G $40"	"#7E $40, #7H $40"	"#7C $40, #7I $40"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0, #17A $40, #17B $0, #18A $40"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											117.1946	0.0626	0.1696		50	0.2	0.2	50	185		102.7059	200	0.2	200	10	29.2224	40	40			0.2	40																				22.8462	0.729850975	9.051928883	0	0.758309992	1.67943854	5.449087361	0.753042362	1.878744424	0	4.073632492	0.020537519	0.318555864	0.236181468	0.857939152	15.13612641	1.340214003	2.91294948	0	0	4.913097471	3.071234691	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0271	0	0	22.8462	0.729850975	9.051928883	0	0.758309992	1.67943854	5.449087361	0.753042362	1.878744424	0	4.073632492	0.020537519	0.318555864	0.236181468	0.857939152	15.13612641	1.340214003	2.91294948	0	0	4.913097471	3.071234691	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0271																																																																																				0		0	22.8462	0.729850975	9.051928883	0	0.758309992	1.67943854	5.449087361	0.753042362	1.878744424	0	4.073632492	0.020537519	0.318555864	0.236181468	0.857939152	15.13612641	1.340214003	2.91294948	0	0	4.913097471	3.071234691	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0271
H2108_022_0	2008	4																																D	Coin	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	P	Coin	Coin	P	T	V	V	P	V	P	O	O	V																																																				0		2339.308442	9.614886521	44.01488674		181.994398	6.924978396	22.46870686	180.730167	121.8645032		475.9570022	1.232251138	1.313529744	14.17088809	1029.526983	6215.550098	402.0642009	873.8848439			20.25861205	921.3704074																				"#1A $100/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $35"	"#9A $150, #9B $50"	#8A $0	"#8B $15 x-ray, $100 complex radiology"	#9A $150	#12 20%	"#3 20%, #5 20%, #9A $150, #9C 20%, #9D $35"	"#7A $5, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $35, #7D $35, #7F $35, #7G $35"	"#7E $35, #7H $35"	"#7C $35, #7I $35"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0, #17A $35, #17B $0, #18A $35"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											64.73	0.065162861	0.167233379		50	0.2	0.2	50	140		70.2222	150	0.2	150	5	24.2224	35	35			0.2	35																				12.6186	0.626533513	7.36075825	0	0.758309992	1.384995679	4.493741373	0.753042362	1.421752537	0	2.785230181	0.015403139	0.262705949	0.177136101	0.428969576	12.54631387	1.172687253	2.548830795	0	0	4.05172241	2.687330355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0941	0	0	12.6186	0.626533513	7.36075825	0	0.758309992	1.384995679	4.493741373	0.753042362	1.421752537	0	2.785230181	0.015403139	0.262705949	0.177136101	0.428969576	12.54631387	1.172687253	2.548830795	0	0	4.05172241	2.687330355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0941																																																																																				0		0	12.6186	0.626533513	7.36075825	0	0.758309992	1.384995679	4.493741373	0.753042362	1.421752537	0	2.785230181	0.015403139	0.262705949	0.177136101	0.428969576	12.54631387	1.172687253	2.548830795	0	0	4.05172241	2.687330355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0941
H2108_023_0	2008	2																																D	Coin	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	P	V	Coin	V	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		1401.08744	5.914835297	34.18830845		54.95254749	7.918119525	29.62440337	228.4071568	346.3250502		212.5583392	6.987351179	0.548259345	248.290793	3490.214976	4872.506355	435.1797751	1072.668846			28.14100774	1030.133222																				"#1A $75/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $20"	"#9A $150, #9B $50"	#8A $0	"#8B $15 x-ray, $150 complex radiology"	#9A $150	#12 20%	"#3 20%, #5 20%, #9A $150, #9C 20%, #9D $25"	"#7A $5, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $25, #7D $25, #7F $25, #7G $25"	"#7E $25, #7H $25"	"#7C $25, #7I $25"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0, #17A $25, #17B $0, #18A $25"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	#18A $0 n/c	#18B $0	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											46.2	0.063344969	0.168862705		50	0.2	0.2	47	99.0926		91.4051	150	0.2	144.2195	5	25	25	25			0.2	25																				5.3942	0.374675061	5.773130238	0	0.228968948	1.583623905	5.924880674	0.894594697	2.859853637	0	1.619076162	0.08734189	0.109651869	2.984031653	1.45425624	10.15105491	0.906624532	2.234726762	0	0	5.628201549	2.146110879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.355	0	0	5.3942	0.374675061	5.773130238	0	0.228968948	1.583623905	5.924880674	0.894594697	2.859853637	0	1.619076162	0.08734189	0.109651869	2.984031653	1.45425624	10.15105491	0.906624532	2.234726762	0	0	5.628201549	2.146110879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.355																																																																																				0	0	0	5.3942	0.374675061	5.773130238	0	0.228968948	1.583623905	5.924880674	0.894594697	2.859853637	0	1.619076162	0.08734189	0.109651869	2.984031653	1.45425624	10.15105491	0.906624532	2.234726762	0	0	5.628201549	2.146110879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.355
H2108_025_0	2008	3																																D	Coin	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	P	Coin	Coin	P	T	V	V	P	V	P	O	O	V																																																				0		2339.308442	9.614886521	44.01488674		181.994398	6.924978396	22.46870686	180.730167	121.8645032		475.9570022	1.232251138	1.313529744	14.17088809	1029.526983	6215.550098	402.0642009	873.8848439			20.25861205	921.3704074																				"#1A $100/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $35"	"#9A $150, #9B $50"	#8A $0	"#8B $15 x-ray, $100 complex radiology"	#9A $150	#12 20%	"#3 20%, #5 20%, #9A $150, #9C 20%, #9D $35"	"#7A $5, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $35, #7D $35, #7F $35, #7G $35"	"#7E $35, #7H $35"	"#7C $35, #7I $35"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0, #17A $35, #17B $0, #18A $35"	#10B $0 n/c	#16A $0	#17A $0 n/c	#17B $0	#18A $0	#18B $0	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											64.73	0.065162861	0.167233379		50	0.2	0.2	50	140		70.2222	150	0.2	150	5	24.2224	35	35			0.2	35																				12.6186	0.626533513	7.36075825	0	0.758309992	1.384995679	4.493741373	0.753042362	1.421752537	0	2.785230181	0.015403139	0.262705949	0.177136101	0.428969576	12.54631387	1.172687253	2.548830795	0	0	4.05172241	2.687330355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0941	0	0	12.6186	0.626533513	7.36075825	0	0.758309992	1.384995679	4.493741373	0.753042362	1.421752537	0	2.785230181	0.015403139	0.262705949	0.177136101	0.428969576	12.54631387	1.172687253	2.548830795	0	0	4.05172241	2.687330355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0941																																																																																				0		0	12.6186	0.626533513	7.36075825	0	0.758309992	1.384995679	4.493741373	0.753042362	1.421752537	0	2.785230181	0.015403139	0.262705949	0.177136101	0.428969576	12.54631387	1.172687253	2.548830795	0	0	4.05172241	2.687330355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0941
H2108_026_0	2008	2																																D	Coin	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	P	V	Coin	V	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		1517.160332	6.935457804	40.08587771		59.50508353	9.284414712	34.7361827	247.4880841	375.0163001		230.1677049	7.566217301	0.642863134	268.8604087	3779.361343	5276.168456	471.2321822	1161.533945			32.99682273	1115.474463																				"#1A $75/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $20"	"#9A $150, #9B $50"	#8A $0	"#8B $15 x-ray, $150 complex radiology"	#9A $150	#12 20%	"#3 20%, #5 20%, #9A $150, #9C 20%, #9D $25"	"#7A $5, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $25, #7D $25, #7F $25, #7G $25"	"#7E $25, #7H $25"	"#7C $25, #7I $25"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0, #17A $25, #17B $0, #18A $25"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											46.2	0.0626	0.1696		50	0.2	0.2	47.0019	99.0926		91.4051	150	0.2	144.5215	5	25	25	25			0.2	25																				5.8411	0.434159659	6.79856486	0	0.247937848	1.856882942	6.947236541	0.969367971	3.096777808	0	1.753208299	0.094577716	0.128572627	3.238008882	1.574733893	10.99201762	0.981733713	2.419862385	0	0	6.599364546	2.323905132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.298	0	0	5.8411	0.434159659	6.79856486	0	0.247937848	1.856882942	6.947236541	0.969367971	3.096777808	0	1.753208299	0.094577716	0.128572627	3.238008882	1.574733893	10.99201762	0.981733713	2.419862385	0	0	6.599364546	2.323905132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.298																																																																																				0	0	0	5.8411	0.434159659	6.79856486	0	0.247937848	1.856882942	6.947236541	0.969367971	3.096777808	0	1.753208299	0.094577716	0.128572627	3.238008882	1.574733893	10.99201762	0.981733713	2.419862385	0	0	6.599364546	2.323905132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.298
H2111_001_0	2008	4	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						800	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	P	P	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T	P	V	P	V	P				V	P	V	V	V																																															0		1813.564858	74.88032144	6645.078681	70.69739214	366.5387869	1489.720945	30.81681196	141.7305342	149.190036	8208.062806	151.8008616	3.35677581	7.83247689	152.5468118	25015.74521	1271.647913	2582.470621	1.021951176		25.88942978	247.0790977	344.0606417	991.2136929	1347.86	56.20731465	278.16		95.475				67.88146638			6.131707053	0.340650392						(1a) $75/day	(1b) $75/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) $0/proc	(11a/11c) $0/proc	(4a) $50/visit (waived if admitted)	(9a/9b) $25/visit	(8a) $0/visit	(8b) $0/visit	(9a) $25/visit	(12) $0/proc	(9a) $25/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $0/visit	(7e/7h) $0/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $0/visit	(15) $0/proc	(Misc. PBP Cats) $0/visit	(10b) $0/trip	(16a) $0/proc	(17a1) $0/visit	(17b2) $0/proc	(18a) $0/visit	(18b) $0/proc				(4b) $10/visit (waived if admitted)	(9c) $0/proc 75%/25% Ind/Grp Blended Copay	(9d) $0/visit	(7f1) $0/visit	(18a1) $0/visit						67.3241	67.3241			67.3241			44.8827	22.4414			22.4414		22.4414																		8.9765										10.1747	0.420104074	0	0	2.056407274	0	0	0.530104338	0.279002283	0	0	0.006277551	0	0.285279835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.050778416	0	0	0	0	0	0	0	0	0	13.8027		1.573703771	10.1747	0.420104074	0	0	2.056407274	0	0	0.530104338	0.279002283	0	0	0.006277551	0	0.285279835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.050778416	0	0	0	0	0	0	0	0	0	13.8027		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					10	0.3	0.3	0.3	0.3						2.9547	0.0613	1.1826	0.0984	0.217	0.3567	0.0067	0.0311	0.3257	0.7492	0.7351	0.0107	0.0201	0.1092	0.0108	2.089	0.2508	0.0003		0.2808		0.0977	0.0633		0.006							0.003			0.0004	0.0001						9.6604		0	13.1294	0.481370561	1.182599445	0.098354979	2.273387235	0.356656719	0.006656598	0.561185596	0.604730012	0.749169908	0.735075925	0.016961485	0.020102572	0.394478724	0.01080576	2.088967944	0.25080946	0.000292773	0	0.280769557	0	0.097728997	0.063315602	0	0.0060286	0	0	0	0	0	0	0.053755673	0	0	0.00038443	5.73E-05	0	0	0	0	0	23.463
H2111_008_0	2008	6																					3900											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2351.318505	332.9552455	1154.000305		466.2146196	34.73606115	24.80712023	808.1578586	428.8117755	7449.493589	629.1569517	78.86970476	5.157985579	4050.197515		3906.945867	1023.394532	1059.469843			31.55240659	758.807483					0.100126805															1(a) $250 per Day	1(b) $250 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $150 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $75 per Visit	8(a) Diagnostic: 20% Coinsurance; other 0% coinsurance	8(b) X-rays 20% Coinsurance; other: 20% Coinsurance	9(a) $75 per Visit	12  20% Coinsurance	"3,5,9(a), 9(d) $75 per visit; 9(c) $25/$35 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $35 per Visit	7(e)/7(h) $25/35 per Visit	7(c)/7(i) $35 per Visit		7(g) $35 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $35 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $35 per visit															158.3657	158.3657	26.6054		95.0194	0.126692529	0.126692529	28.3475	47.5097	2.1372	63.7074	47.5097	0.126692529	47.4001		22.1712	20.5875	22.1712			0.126692529	22.1712					22.1712															31.0307	4.394056454	2.55855629	0	3.691619313	4.40079942	3.142876789	1.909101427	1.697726504	1.326724975	3.340162554	0.312256323	0.653478235	15.99832309	0	7.218470743	1.755764305	1.95747582	0	0	3.997454174	1.401972231	0	0	0	0	0.000184994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.7877	0	52.53202605	31.0307	4.394056454	2.55855629	0	3.691619313	4.40079942	3.142876789	1.909101427	1.697726504	1.326724975	3.340162554	0.312256323	0.653478235	15.99832309	0	7.218470743	1.755764305	1.95747582	0	0	3.997454174	1.401972231	0	0	0	0	0.000184994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.7877		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															2.7826	0.1718	0.379	0.4989	0.1236	0.2127	0.1519	0.0582	0.2983	0.0543	0.1368	0.0268	0.0278	0.3044	0.1132	0.2019	0.0834	0.0584			0.1932	0.0434	0.0077		0.0066																	5.9349	0	0	33.8132	4.565818537	2.937526178	0.498913492	3.8151923	4.613469182	3.294757117	1.967339484	1.996008023	1.381059149	3.476954261	0.339080655	0.681314135	16.3026891	0.113203244	7.420358703	1.839177133	2.015848333	0	0	4.190632173	1.445403199	0.00774	0	0.006631111	0	0.000184994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.7225
H2111_009_0	2008	7																					3900											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2277.71984	322.5334071	1077.473657		434.4839231	30.28182504	21.62608107	748.1708656	396.9824383	6896.541322	582.4566279	73.01545688	4.461222555	3749.679077		3647.859741	954.4449116	989.211911			27.50641334	708.4877453					0.093486972															1(a) $250 per Day	1(b) $250 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $150 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $75 per Visit	8(a) Diagnostic: 20% Coinsurance; other 0% coinsurance	8(b) X-rays 20% Coinsurance; other: 20% Coinsurance	9(a) $75 per Visit	12  20% Coinsurance	"3,5,9(a), 9(d) $75 per visit; 9(c) $25/$35 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $35 per Visit	7(e)/7(h) $25/35 per Visit	7(c)/7(i) $35 per Visit		7(g) $35 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $35 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $35 per visit															162.4941	162.4941	27.299		97.4964	0.129995265	0.129995265	29.0864	48.7482	2.0474	61.0333	48.7482	0.129995265	48.635		22.7492	21.1242	22.7492			0.129995265	22.7492					22.7492															30.843	4.367480795	2.451163282	0	3.530053287	3.936493861	2.811288133	1.813468946	1.612682411	1.176691897	2.962439305	0.296614489	0.579937807	15.19712244	0	6.915482184	1.680159527	1.875312603	0	0	3.575703483	1.343125758	0	0	0	0	0.000177229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.9684	0	46.83401053	30.843	4.367480795	2.451163282	0	3.530053287	3.936493861	2.811288133	1.813468946	1.612682411	1.176691897	2.962439305	0.296614489	0.579937807	15.19712244	0	6.915482184	1.680159527	1.875312603	0	0	3.575703483	1.343125758	0	0	0	0	0.000177229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.9684		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															2.4262	0.1497	0.3304	0.4349	0.1077	0.1854	0.1324	0.0544	0.26	0.0474	0.1193	0.0234	0.0243	0.2653	0.0953	0.1762	0.0727	0.0509			0.1684	0.0379	0.0077		0.0066																	5.1765	0	0	33.2692	4.517217672	2.781545217	0.434937369	3.637780399	4.12189279	2.943692711	1.86784499	1.872715025	1.224058751	3.081690089	0.319999113	0.604204284	15.46245933	0.095294676	7.091693992	1.752876254	1.926199956	0	0	3.744110095	1.380987534	0.00774	0	0.006631111	0	0.000177229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.1449
H2111_010_0	2008	7																					3900											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2328.987394	329.793079	1143.04045		461.7868525	34.07939864	24.33815785	800.4825636	424.7392334	7378.743722	623.181677	78.12065771	5.060477236	4011.731687		3869.84054	1013.675076	1049.40777			30.95592899	751.600882					0.099175873															1(a) $250 per Day	1(b) $250 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $150 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $75 per Visit	8(a) Diagnostic: 20% Coinsurance; other 0% coinsurance	8(b) X-rays 20% Coinsurance; other: 20% Coinsurance	9(a) $75 per Visit	12  20% Coinsurance	"3,5,9(a), 9(d) $75 per visit; 9(c) $25/$35 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $35 per Visit	7(e)/7(h) $25/35 per Visit	7(c)/7(i) $35 per Visit		7(g) $35 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $35 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $35 per visit															159.0252	159.0252	26.7162		95.4151	0.127220142	0.127220142	28.4655	47.7076	2.1257	63.3651	47.7076	0.127220142	47.5975		22.2635	20.6733	22.2635			0.127220142	22.2635					22.2635															30.864	4.370450244	2.544810946	0	3.671786809	4.335585934	3.096303898	1.898845153	1.6886058	1.307064829	3.290666173	0.310578786	0.643794632	15.91237523	0	7.179690918	1.746331804	1.946959664	0	0	3.938217681	1.394440409	0	0	0	0	0.000184	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.1407	0	51.5674995	30.864	4.370450244	2.544810946	0	3.671786809	4.335585934	3.096303898	1.898845153	1.6886058	1.307064829	3.290666173	0.310578786	0.643794632	15.91237523	0	7.179690918	1.746331804	1.946959664	0	0	3.938217681	1.394440409	0	0	0	0	0.000184	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.1407		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															2.73	0.1685	0.3718	0.4895	0.1212	0.2086	0.149	0.0577	0.2926	0.0533	0.1342	0.0263	0.0273	0.2986	0.1105	0.1981	0.0818	0.0573			0.1895	0.0426	0.0077		0.0066																	5.823	0	0	33.5939	4.538965276	2.91661779	0.489481858	3.79302373	4.544235313	3.245313027	1.956530106	1.981248502	1.36037185	3.424871922	0.336896022	0.671104313	16.21098739	0.110509176	7.37779359	1.828167768	2.004228682	0	0	4.127743777	1.437050343	0.00774	0	0.006631111	0	0.000184	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.9636
H2111_011_0	2008	6																					3500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2157.023066	147.9481562	1005.193916		311.2399646	13.37003915	23.21968306	487.496563	460.7782959	3863.089955	507.6787387	77.36810993	17.29333671	3246.20858		4395.30684	433.4041109	633.8320457				782.2460269					0.082824239															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															140.3543	140.3543	33.685		60.1519	0.16040496	0.16040496	33.0835	60.1519	16.0405	52.3433	60.1519	135.0975	58.1567		20.0506	16.0405	16.0405				20.0506					20.0506															25.229	1.730430482	2.821666568	0	1.560138562	2.144620591	3.724552325	1.344008644	2.309722625	5.163823238	2.214467124	0.387819642	0.194690524	15.73239769	0	7.344052256	0.579334741	0.847248365	0	0	0	1.30704315	0	0	0	0	0.00013839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6351	0	18.42324877	25.229	1.730430482	2.821666568	0	1.560138562	2.144620591	3.724552325	1.344008644	2.309722625	5.163823238	2.214467124	0.387819642	0.194690524	15.73239769	0	7.344052256	0.579334741	0.847248365	0	0	0	1.30704315	0	0	0	0	0.00013839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6351		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.7097	0.0774	0.3335	0.3329	0.0855	0.1637	0.1422	0.0351	0.346	0.0543	0.1412	0.0283	0.0065	0.247	0.0247	0.2387	0.0359	0.0387			0.214	0.0506			0.0051																	5.3112	0	0	27.9386	1.807857624	3.155209824	0.332915044	1.645647398	2.308335356	3.86671365	1.379138974	2.655765848	5.218146953	2.355675848	0.41615326	0.201224542	15.97941421	0.024690141	7.582743663	0.615195999	0.885990896	0	0	0.214026646	1.357648608	0	0	0.005058988	0	0.00013839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9463
H2111_012_0	2008	6																					3500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2089.506047	143.3172282	938.5352503		290.0603155	11.6555871	20.24220238	451.3112403	426.5761854	3576.345048	469.9953572	71.62532068	16.11681889	3005.287812		4103.83543	404.3102919	591.7999585				730.37198					0.077331813															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															143.392	143.392	34.4141		61.4537	0.163876555	0.163876555	33.7995	61.4537	16.3877	53.4762	61.4537	128.1401	59.4148		20.4846	16.3877	16.3877				20.4846					20.4846															24.9682	1.712545164	2.691568668	0	1.485440167	1.910077464	3.317222399	1.271176009	2.184557371	4.88399256	2.094463823	0.366803463	0.172100955	14.87988547	0	7.005441812	0.552141483	0.808184489	0	0	0	1.246779627	0	0	0	0	0.000132009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5507	0	15.77198324	24.9682	1.712545164	2.691568668	0	1.485440167	1.910077464	3.317222399	1.271176009	2.184557371	4.88399256	2.094463823	0.366803463	0.172100955	14.87988547	0	7.005441812	0.552141483	0.808184489	0	0	0	1.246779627	0	0	0	0	0.000132009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5507		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.3626	0.0675	0.2908	0.2902	0.0745	0.1427	0.1239	0.0328	0.3017	0.0474	0.1231	0.0247	0.0057	0.2153	0.0215	0.2081	0.0313	0.0338			0.1866	0.0441			0.0051																	4.6334	0	0	27.3308	1.780043754	2.982349069	0.290225051	1.559984129	2.052798939	3.44115425	1.303976698	2.486227163	4.931350296	2.217565226	0.391503836	0.17779711	15.09522684	0.021524102	7.213525606	0.58340422	0.841959031	0	0	0.186581818	1.290895902	0	0	0.005058988	0	0.000132009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1841
H2111_013_0	2008	6																					3500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2115.979506	145.1330176	986.0672141		305.3177302	12.8660731	22.34444763	478.2205404	452.0106652	3789.583571	498.0186923	75.89595939	16.9642813	3184.440137		4311.673502	425.1573527	621.7715703				767.3615491					0.08124827															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															141.3235	141.3235	33.9176		60.5672	0.161512596	0.161512596	33.312	60.5672	16.1513	52.7048	60.5672	133.442	58.5583		20.1891	16.1513	16.1513				20.1891					20.1891															24.9198	1.709225761	2.787089823	0	1.5410206	2.078032867	3.608909743	1.327539141	2.281419249	5.10054567	2.187331011	0.383067295	0.188645632	15.53961266	0	7.254058129	0.572235565	0.83686617	0	0	0	1.291026624	0	0	0	0	0.000136694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.6066	0	17.53996792	24.9198	1.709225761	2.787089823	0	1.5410206	2.078032867	3.608909743	1.327539141	2.281419249	5.10054567	2.187331011	0.383067295	0.188645632	15.53961266	0	7.254058129	0.572235565	0.83686617	0	0	0	1.291026624	0	0	0	0	0.000136694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.6066		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.6075	0.0745	0.321	0.3204	0.0823	0.1575	0.1368	0.0345	0.333	0.0523	0.1359	0.0273	0.0063	0.2377	0.0238	0.2297	0.0345	0.0373			0.206	0.0487			0.0051																	5.1119	0	0	27.5273	1.783734388	3.108062866	0.320366249	1.623306293	2.235576619	3.745712484	1.362001016	2.614418828	5.152821724	2.323217057	0.410332914	0.194933359	15.77731821	0.023759478	7.483752377	0.60674508	0.874148353	0	0	0.205959193	1.339724576	0	0	0.005058988	0	0.000136694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7184
H2112_001_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V			O												0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0			0												0		1118.552807		519.9262536	438.6081724	203.1608087	11.51949685		305.4239054	285.6616946	562.0658984	3868.404954	0	0	403.240545	3496.63692	3716.561224	0	896.2846209	0	0	239.0768644				444.5519453		36.90107813			0												$900 per Stay		"$0 for days 1-7, $75 for days 8-14, $100 for days 15-100"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$250 per procedure	$35 per visit	"$35 X-ray; $150 CAT,PET,MRI"	$35 per visit	$30 per visit	$35 per visit	$20 per visit	$35 per visit; $30 per dialysis visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit			Fitness												152.17		68.64	20	100	0.2		48	250	35	55.7	35	30	35	20	31.4	35	35	35	35	45				0		0			0												14.1842	0	2.973978171	0.731013621	1.693006739	2.303899369	0	1.221695621	5.951285305	1.63935887	17.95584633	0	0	1.176118256	5.827728199	9.725001868	0	2.614163478	0	0	0.896538242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.8938			14.1842	0	2.973978171	0.731013621	1.693006739	2.303899369	0	1.221695621	5.951285305	1.63935887	17.95584633	0	0	1.176118256	5.827728199	9.725001868	0	2.614163478	0	0	0.896538242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.8938																																																																																				0			14.1842	0	2.973978171	0.731013621	1.693006739	2.303899369	0	1.221695621	5.951285305	1.63935887	17.95584633	0	0	1.176118256	5.827728199	9.725001868	0	2.614163478	0	0	0.896538242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.8938
H2112_002_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V			O												0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0			0												0		1168.736476		543.2526505	458.2862484	212.2755815	12.03631698		319.1266934	298.4778547	587.2828829	4041.96024	0	0	421.3318588	3653.5129	3883.304068	0	936.4962677	0	0	249.8030046				464.4966876		38.55663829			0												$350 per Stay		"$0 for days 1-7, $75 for days 8-14, $100 for days 15-100"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$250 per procedure	$25 per visit	"$25 X-ray; $150 CAT,PET,MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit			Fitness												59.18		68.64	20	100	0.2		48	250	25	47.5	25	25	25	10	25	25	25	25	25	45				0		0			0												5.7638	0	3.107405161	0.763810414	1.768963179	2.407263396	0	1.276506774	6.21828864	1.223506006	15.99942595	0	0	0.877774706	3.044594083	8.090216808	0	1.951033891	0	0	0.936761267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4294			5.7638	0	3.107405161	0.763810414	1.768963179	2.407263396	0	1.276506774	6.21828864	1.223506006	15.99942595	0	0	0.877774706	3.044594083	8.090216808	0	1.951033891	0	0	0.936761267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4294																																																																																				0			5.7638	0	3.107405161	0.763810414	1.768963179	2.407263396	0	1.276506774	6.21828864	1.223506006	15.99942595	0	0	0.877774706	3.044594083	8.090216808	0	1.951033891	0	0	0.936761267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4294
H2112_007_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V			O												0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0			0												0		1117.416114		519.3978956	438.1624512	202.9543532	11.50779054		305.1135284	285.3714003	561.4947174	3864.473815	0	0	402.8307651	3493.083577	3712.78439	0	895.3738011	0	0	238.8339104				444.100184		36.86357862			0												$850 per Stay		"$0 for days 1-7, $75 for days 8-14, $100 for days 15-100"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$250 per procedure	$35 per visit	"$35 X-ray; $150 CAT,PET,MRI"	$35 per visit	$30 per visit	$35 per visit	$20 per visit	$35 per visit; $30 per dialysis visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit			Fitness												143.72		68.64	20	100	0.2		48	250	35	55.7	35	30	35	20	31.4	35	35	35	35	45				0		0			0												13.3829	0	2.970955963	0.730270752	1.691286276	2.301558107	0	1.220454113	5.945237507	1.637692926	17.93759929	0	0	1.174923065	5.821805962	9.715119155	0	2.61150692	0	0	0.895627164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.037			13.3829	0	2.970955963	0.730270752	1.691286276	2.301558107	0	1.220454113	5.945237507	1.637692926	17.93759929	0	0	1.174923065	5.821805962	9.715119155	0	2.61150692	0	0	0.895627164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.037																																																																																				0			13.3829	0	2.970955963	0.730270752	1.691286276	2.301558107	0	1.220454113	5.945237507	1.637692926	17.93759929	0	0	1.174923065	5.821805962	9.715119155	0	2.61150692	0	0	0.895627164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.037
H2112_008_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V			O												0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0			0												0		1547.440199		662.8232943	450.8093539	213.5771633	12.11093804		337.0546958	300.9948882	699.3894453	4286.854334	0	56.67267769	744.6511329	4021.595688	3924.038856	0	771.4967866	0	0	251.909568				505.3677047		51.02720711			0												$100/day 1-7		"$0 for days 1-7, $75 for days 8-14, $100 for days 15-100"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$25 per visit	"$25 X-ray; $100 CAT,PET,MRI"	$25 per visit	$25 per visit	$25 per visit	$0 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit			Fitness												71.21		68.64	20	100	0.2		48	200	25	38.5	25	25	25	0	25	25	25	25	25	45				0		0			0												9.1828	0	3.791349243	0.751348923	1.779809694	2.422187607	0	1.348218783	5.01658147	1.457061344	13.75365765	0	0.118068079	1.551356527	0	8.175080949	0	1.607284972	0	0	0.94466088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.8994			9.1828	0	3.791349243	0.751348923	1.779809694	2.422187607	0	1.348218783	5.01658147	1.457061344	13.75365765	0	0.118068079	1.551356527	0	8.175080949	0	1.607284972	0	0	0.94466088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.8994																																																																																				0			9.1828	0	3.791349243	0.751348923	1.779809694	2.422187607	0	1.348218783	5.01658147	1.457061344	13.75365765	0	0.118068079	1.551356527	0	8.175080949	0	1.607284972	0	0	0.94466088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.8994
H2112_009_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V			O												0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0			0												0		1571.34903		673.0642913	457.7746149	216.877052	12.29805892		342.2623826	305.6454305	710.1954101	4353.088673	0	57.54830281	756.1564166	4083.731629	3984.667489	0	783.4168509	0	0	255.8017141				513.1759233		51.81560649			0												$50/day 1-8		"$0 for days 1-7, $75 for days 8-14, $100 for days 15-100"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$20 per visit	"$20 X-ray; $125 CAT,PET,MRI"	$20 per visit	$20 per visit	$20 per visit	$0 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit			Fitness												38.09		68.64	20	100	0.2		48	200	20	38.9	20	20	20	0	20	20	20	20	20	45				0		0			0												4.9877	0	3.849927746	0.762957691	1.807308767	2.459611784	0	1.369049531	5.094090508	1.183659017	14.11126245	0	0.095913838	1.260260694	0	6.641112481	0	1.305694752	0	0	0.959256428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8878			4.9877	0	3.849927746	0.762957691	1.807308767	2.459611784	0	1.369049531	5.094090508	1.183659017	14.11126245	0	0.095913838	1.260260694	0	6.641112481	0	1.305694752	0	0	0.959256428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8878																																																																																				0			4.9877	0	3.849927746	0.762957691	1.807308767	2.459611784	0	1.369049531	5.094090508	1.183659017	14.11126245	0	0.095913838	1.260260694	0	6.641112481	0	1.305694752	0	0	0.959256428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8878
H2112_011_0	2008	5																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V			O												0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0			0												0		1547.440199		662.8232943	450.8093539	213.5771633	12.11093804		337.0546958	300.9948882	699.3894453	4286.854334	0	56.67267769	744.6511329	4021.595688	3924.038856	0	771.4967866	0	0	251.909568				505.3677047		51.02720711			0												$100/day 1-7		"$0 for days 1-7, $75 for days 8-14, $100 for days 15-100"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$25 per visit	"$25 X-ray; $125 CAT,PET,MRI"	$25 per visit	$25 per visit	$25 per visit	$0 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit			Fitness												71.21		68.64	20	100	0.2		48	200	25	43	25	25	25	0	25	25	25	25	25	45				0		0			0												9.1828	0	3.791349243	0.751348923	1.779809694	2.422187607	0	1.348218783	5.01658147	1.457061344	15.36122803	0	0.118068079	1.551356527	0	8.175080949	0	1.607284972	0	0	0.94466088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.507			9.1828	0	3.791349243	0.751348923	1.779809694	2.422187607	0	1.348218783	5.01658147	1.457061344	15.36122803	0	0.118068079	1.551356527	0	8.175080949	0	1.607284972	0	0	0.94466088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.507																																																																																				0			9.1828	0	3.791349243	0.751348923	1.779809694	2.422187607	0	1.348218783	5.01658147	1.457061344	15.36122803	0	0.118068079	1.551356527	0	8.175080949	0	1.607284972	0	0	0.94466088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.507
H2112_013_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S		T	V	V		V															0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0		0															0		1439.538036		655.4236896	526.6166437	245.0657928	13.89670221		372.3234068	344.7736673	704.3815642	4720.059354	0	14.46041697	564.2935981	4302.055556	4487.567807	0	1039.788979	0	0	288.5490385		0	0	545.5121764		47.4848351															$950 per admission		$0 days 1-20; $100 21+	$0 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$200 per procedure	$0 per visit	"$0 X-ray; $150 PET, MRI"	$15 per visit	$0 per visit	$15 per visit	$0 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script		0	$5 per visit	$0 per visit		$0 per visit															160.62		41.2	0	100	0.2		45.5	200	0	27	15	0	15	0	15	15	15	15	15	45		0	5	0		0															19.2682	0	2.250288001	0	2.04221494	2.779340442	0	1.411726251	5.746227788	0	10.62013355	0	0	0.705366998	0	5.609459758	0	1.299736224	0	0	1.082058894	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8148			19.2682	0	2.250288001	0	2.04221494	2.779340442	0	1.411726251	5.746227788	0	10.62013355	0	0	0.705366998	0	5.609459758	0	1.299736224	0	0	1.082058894	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8148																																																																																				0			19.2682	0	2.250288001	0	2.04221494	2.779340442	0	1.411726251	5.746227788	0	10.62013355	0	0	0.705366998	0	5.609459758	0	1.299736224	0	0	1.082058894	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8148
H2112_801_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0		1403.234861	27.33675297	1146.203462	1881.554753	207.6460381	15.71780589	1.003298358	376.6101166	310.2755935	1972.668358	1013.814245	0	0	0	4893.697162	6208.051603	178.2619179	1031.528894	1409.798725	2556.992056	18.07125295				0		0															200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2				0		0															16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665																																																																																				0			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665
H2112_802_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0		1403.234861	27.33675297	1146.203462	1881.554753	207.6460381	15.71780589	1.003298358	376.6101166	310.2755935	1972.668358	1013.814245	0	0	0	4893.697162	6208.051603	178.2619179	1031.528894	1409.798725	2556.992056	18.07125295				0		0															200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2				0		0															16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665																																																																																				0			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665
H2174_001_0	2008	5																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		301.0868017	13.5762816	52.25221006	0	12.00532068	25.01937301	19.12870312	9.964728416	22.66074912	9.498873192	19.0222059	0	3.19499939	32.1013652	54.88268611	119.1940556	8.913271951	4.302397432	30.56128877	39.99839802	8.631579966	0.638142157	0	0	0	0	0	0	0	0	0											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No Copay	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No Copay	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No Copay	No Copay	No Copay	No Copay	No Copay	No Copay	No Copay	No Copay	No Copay											0.077	0.077	0.1421	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											23.1837	1.045373683	7.42503905	0	2.809245038	5.854533285	4.47611653	2.331746449	5.302615294	2.222736327	4.45119618	0	0.747629857	7.511719457	12.84254855	27.89140901	2.085705637	1.006760999	7.151341572	9.359625136	2.019789712	0.149325265	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.8681	0	0	23.1837	1.045373683	7.42503905	0	2.809245038	5.854533285	4.47611653	2.331746449	5.302615294	2.222736327	4.45119618	0	0.747629857	7.511719457	12.84254855	27.89140901	2.085705637	1.006760999	7.151341572	9.359625136	2.019789712	0.149325265	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.8681																																																																																				0	0		23.1837	1.045373683	7.42503905	0	2.809245038	5.854533285	4.47611653	2.331746449	5.302615294	2.222736327	4.45119618	0	0.747629857	7.511719457	12.84254855	27.89140901	2.085705637	1.006760999	7.151341572	9.359625136	2.019789712	0.149325265	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.8681
H2174_002_0	2008	3																					1500											D	D			T	Coin		V	V		V			V	V	V	V	P	P	V					V																	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		832.5082095	11.28995956	0	0	161.5380878	11.19290775	0	330.0442195	233.5092441	0	150.6511466	0	0	368.3611653	3883.554503	3575.369834	143.7580358	1063.308232	1714.802405	1495.255464	0	0	0	0	387.1621121	0	0	0	0	0	0											$100/Day for IP Medical; $100/Day for IP Surgical (first 5 days only)	$100/Day for IP Medical; $100/Day for IP Surgical (first 5 days only)	No Copay	No Copay	$50/Trip for Ambulance	20% Coinsurance for DME	No Copay	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care; $25/Visit for Urgent Care - Worldwide;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No Copay	$75/Case for OP Fac - CT/MRI/PET	No Copay	No Copay	$20/Case for OP Fac - Cardiovascular; $20/Case for OP Fac - CORF; $20/Service for Prof - CORF; $20/Service for Prof - CORF;	$20/Visit for PCP - Office Visits; $20/Consult for PCP - Consults;	$20/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$20/Service for PT/ST (PCP); $20/Service for Occ Therapy (PCP); $20/Service for PT/ST (Specialist); $20/Service for Occ Therapy (Specialist);	$8/Procedure for Prof Radiology (Office);	$20/Visit for Chiropractor; $20/Exam for Vistion Exams; $20/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	No Copay	No Copay	No Copay	No Copay	$20/Exam for Vision (Refractions)	No Copay	No Copay	No Copay	No Copay	No Copay	No Copay											63.61480443	63.61480434	0	0	49.80022266	0.199200891	0	42.4245254	49.80022266	0	74.70033399	0	0	19.92008906	19.92008906	19.92008906	19.92008907	19.92008907	7.470033399	19.92008907	0	0	0	0	19.92008906	0	0	0	0	0	0											4.4133	0.059850714	0	0	0.670386062	2.229637193	0	1.166830781	0.969067696	0	0.937807581	0	0	0.611482268	6.446729298	5.935140461	0.238639406	1.765099557	1.06746927	2.482135169	0	0	0	0	0.64269198	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6363	0	0.118888199	4.4133	0.059850714	0	0	0.670386062	2.229637193	0	1.166830781	0.969067696	0	0.937807581	0	0	0.611482268	6.446729298	5.935140461	0.238639406	1.765099557	1.06746927	2.482135169	0	0	0	0	0.64269198	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6363																																																																																				0	0		4.4133	0.059850714	0	0	0.670386062	2.229637193	0	1.166830781	0.969067696	0	0.937807581	0	0	0.611482268	6.446729298	5.935140461	0.238639406	1.765099557	1.06746927	2.482135169	0	0	0	0	0.64269198	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6363
H2174_003_0	2008	5																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		435.3899403	18.49403601	282.1978138	0	44.91421549	7.065049725	33.53260827	10.67326991	11.75301333	20.57778141	12.40201032	0	2.219775648	121.1833946	54.63146913	106.8068827	9.349504821	0.774871046	33.40784534	52.60810638	3.414201538	1.211529192	0	0	0	0	0	0	0	0	0											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No Copay	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No Copay	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No Copay	No Copay	No Copay	No Copay	No Copay	No Copay	No Copay	No Copay	No Copay											0.077	0.077	0.1421	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											33.525	1.424040773	40.10030935	0	10.50992642	1.653221636	7.846630336	2.497545159	2.75020512	4.815200851	2.902070416	0	0.519427502	28.35691433	12.78376378	24.99281056	2.187784128	0.181319825	7.81743581	12.31029689	0.79892316	0.283497831	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	198.2563	0	0	33.525	1.424040773	40.10030935	0	10.50992642	1.653221636	7.846630336	2.497545159	2.75020512	4.815200851	2.902070416	0	0.519427502	28.35691433	12.78376378	24.99281056	2.187784128	0.181319825	7.81743581	12.31029689	0.79892316	0.283497831	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	198.2563																																																																																				0	0		33.525	1.424040773	40.10030935	0	10.50992642	1.653221636	7.846630336	2.497545159	2.75020512	4.815200851	2.902070416	0	0.519427502	28.35691433	12.78376378	24.99281056	2.187784128	0.181319825	7.81743581	12.31029689	0.79892316	0.283497831	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	198.2563
H2174_004_0	2008	2																					1500											D	D			T	Coin		V	V		V			V	V	V	V	P	P	V					V																	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		767.9089057	10.41550119	0	0	148.9793975	10.33421054	0	304.3398894	215.2985535	0	138.894177	0	0	339.6437235	3581.999048	3297.766741	132.5901769	980.7073539	1581.702761	1379.133985	0	0	0	0	387.1898672	0	0	0	0	0	0											$100/Day for IP Medical; $100/Day for IP Surgical (first 5 days only)	$100/Day for IP Medical; $100/Day for IP Surgical (first 5 days only)	No Copay	No Copay	$50/Trip for Ambulance	20% Coinsurance for DME	No Copay	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care; $25/Visit for Urgent Care - Worldwide;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No Copay	$75/Case for OP Fac - CT/MRI/PET	No Copay	No Copay	$20/Case for OP Fac - Cardiovascular; $20/Case for OP Fac - CORF; $20/Service for Prof - CORF; $20/Service for Prof - CORF;	$20/Visit for PCP - Office Visits; $20/Consult for PCP - Consults;	$20/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$20/Service for PT/ST (PCP); $20/Service for Occ Therapy (PCP); $20/Service for PT/ST (Specialist); $20/Service for Occ Therapy (Specialist);	$8/Procedure for Prof Radiology (Office);	$20/Visit for Chiropractor; $20/Exam for Vistion Exams; $20/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	No Copay	No Copay	No Copay	No Copay	$20/Exam for Vision (Refractions)	No Copay	No Copay	No Copay	No Copay	No Copay	No Copay											63.6406064	63.64060633	0	0	49.82042149	0.199281686	0	42.43988885	49.82042148	0	74.73063222	0	0	19.9281686	19.92816859	19.92816859	19.92816859	19.92816859	7.473063222	19.92816859	0	0	0	0	19.92816859	0	0	0	0	0	0											4.0725	0.055237401	0	0	0.618518031	2.0594189	0	1.076345923	0.89385539	0	0.864970805	0	0	0.564039782	5.948556745	5.476537634	0.22018995	1.628641791	0.985013728	2.290301214	0	0	0	0	0.642998746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.3971	0	0.098753441	4.0725	0.055237401	0	0	0.618518031	2.0594189	0	1.076345923	0.89385539	0	0.864970805	0	0	0.564039782	5.948556745	5.476537634	0.22018995	1.628641791	0.985013728	2.290301214	0	0	0	0	0.642998746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.3971																																																																																				0	0		4.0725	0.055237401	0	0	0.618518031	2.0594189	0	1.076345923	0.89385539	0	0.864970805	0	0	0.564039782	5.948556745	5.476537634	0.22018995	1.628641791	0.985013728	2.290301214	0	0	0	0	0.642998746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.3971
H2224_001_0	2008	8																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	452.6985679	10.65711257	179.7514233	41.08777515	36.33758375	33.01770341	0	14.999181	14.71189168	44.96980573	55.60362947	0	0	120.7526272	10.68055364	24.79577352	12.4903735	2.334011997	0	188.5367303	5.067673637	76.39350708	0	0	0	0	0	0	0	0	0											Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing											0.0725	0.0725	0.1783	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											32.8206	0.772640662	32.04967877	0	8.502994597	7.726142597	0	3.509808354	3.442582653	10.52293454	13.0112493	0	0	28.25611477	2.499249552	5.802211004	2.922747399	0.546158807	0	44.1175949	1.185835631	17.87608066	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	215.5647	0	0	32.8206	0.772640662	32.04967877	0	8.502994597	7.726142597	0	3.509808354	3.442582653	10.52293454	13.0112493	0	0	28.25611477	2.499249552	5.802211004	2.922747399	0.546158807	0	44.1175949	1.185835631	17.87608066	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	215.5647	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	32.8206	0.772640662	32.04967877	0	8.502994597	7.726142597	0	3.509808354	3.442582653	10.52293454	13.0112493	0	0	28.25611477	2.499249552	5.802211004	2.922747399	0.546158807	0	44.1175949	1.185835631	17.87608066	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	215.5647
H2225_001_0	2008	8																																Coin		Coin		Coin	Coin		Coin	Coin	Coin					Coin						Coin	Coin																																																													0		429.2978244		169.4265151		32.12011042	60.56896154		16.76914432	29.79309376	153.2491083					418.8062149						10.42148252	2.163629699																				Medicare FFS cost sharing		Medicare FFS cost sharing		Medicare FFS cost sharing	Medicare FFS cost sharing		Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing					Medicare FFS cost sharing						Medicare FFS cost sharing	Medicare FFS cost sharing																				0.07399513		0.184875129		0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				31.7659	0	31.32274875	0	7.516105839	14.173137	0	3.923979772	6.971583939	35.86029134	0	0	0	0	98.00065428	0	0	0	0	0	2.43862691	0.50628935	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	232.4794			31.7659	0	31.32274875	0	7.516105839	14.173137	0	3.923979772	6.971583939	35.86029134	0	0	0	0	98.00065428	0	0	0	0	0	2.43862691	0.50628935	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	232.4794																																																																																				0			31.7659	0	31.32274875	0	7.516105839	14.173137	0	3.923979772	6.971583939	35.86029134	0	0	0	0	98.00065428	0	0	0	0	0	2.43862691	0.50628935	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	232.4794
H2226_001_0	2008	6																					0											D	D	D	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin																																																							0		2501.321488	141.54994	2201.056691		25.3829055	37.08839967	27.81865485	593.7019075	47.72041194	9.290862057	22.48957246	4.428127466	6.210006896	58.2434044	83.50770584	174.3081927	8.169915533	11.28340271			30.04065536	8.975755446																				1(a) $1032/day days 1-60; $258 days 61-90; $516 for days 91+FFS	1(b) $1032/day days 1-60; $258 days 61-90; $516 for days 91+FFS	2(a) $129 per day for days 21-100	6(a) 0% Coinsurance	10(a) 20% Coinsurance after deductible	11(a) 20% Coinsurance after deductible	11(b)/11(c) 20% Coinsurance after deductible	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) urgently needed services 20% coinsurance after deductible	9(b) 20% Coinsurance after deductible	8(a) 0% for OP lab Services; 20% for other OP diagnostic procedures and tests	8(b) 20% Coinsurance	9(a) 20% Coinsurance after deductible	12   20% Coinsurance after deductible	"3, 5, 9(a), 9(c), 9(d)  20% Coinsurance after deductible"	"7(a) 20% Coinsurance after deductible, except for Evercare nurse practitioner"	7(b)/7(d)/7(f) 20% Coinsurance after deductible	7(e)/7(h) 20% Coinsurance after deductible	7(c)/7(i) 20% Coinsurance after deductible	20% Coinsurance after deductible	7(g) 20% Coinsurance after deductible	15  20% Coinsurance after deductible	"13, 14(a)-(j), 17(a), 16(b) 20% Coinsurance after deductible"					18a $0 per visit															128.7452	59.4309	86.5453		0.234	0.234	0.234	50	0.234	0.2	0.2	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.226612596																				26.8361	0.701036686	15.87425933	0	5.939599886	8.678685522	6.509565234	2.473757948	11.16657639	1.858172411	4.497914493	1.036181827	1.453141614	13.62895663	19.54080317	40.78811708	1.911760235	2.640316234	0	0	7.029513354	2.034019239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	174.5985	141	0	26.8361	0.701036686	15.87425933	0	5.939599886	8.678685522	6.509565234	2.473757948	11.16657639	1.858172411	4.497914493	1.036181827	1.453141614	13.62895663	19.54080317	40.78811708	1.911760235	2.640316234	0	0	7.029513354	2.034019239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	174.5985																																																																																				0	0	0	26.8361	0.701036686	15.87425933	0	5.939599886	8.678685522	6.509565234	2.473757948	11.16657639	1.858172411	4.497914493	1.036181827	1.453141614	13.62895663	19.54080317	40.78811708	1.911760235	2.640316234	0	0	7.029513354	2.034019239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	174.5985
H2228_001_0	2008	5	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)							Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						Coin	Coin	D	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V		Coin	Coin	Coin	T				Coin					Coin	Coin	Coin	V																																																0		278.1941943	6.526842838	10971.64284	522.4827838	38.23753497	42.65525827	0.255135386	238.7870236	10.60913211	67.90623821	50.42902587	3.322776094	0.912223299	12.08411438	27486.47913	110.2595308	14.53207597	7.02016749		11.47750711	3.924742354	8.403299046	2928.35073									1.672758377	0.002375833		382.8559636							(1a) 7.3% coins	(1b) 7.3% coins	(2a) $0/day	(6a) $0/proc	(10a) 20% coins	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) 20% coins	(8a) 10% coins	(8b) 19.2% coins	(9a) 20% coins	(12) 20% coins	(9a) 20% coins	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) 20% coins	(7e/7h) 20% coins	(7c/7i) $0/visit		(7g) 20% coins	(15) 20% coins	(Misc. PBP Cats) 20% coins	(10b) $0/trip				(18a) 20% coins					(4b) 20% coins	(9c) 20% coins	(9d) 20% coins	(7f1) $0/visit							0.072983959	0.072983959			0.2	0.2	0.2	50	0.2	0.1	0.192	0.2	0.2	0.2		0.2	0.2			0.2	0.2	0.2										0.2	0.2									20.3037	0.47635483	0	0	7.647506994	8.531051655	0.051027077	0.994945932	2.121826423	6.790623821	9.682372968	0.664555219	0.18244466	2.416822877	0	22.05190615	2.906415194	0	0	2.295501423	0.784948471	1.680659809	0	0	0	0	0	0	0	0	0	0.334551675	0.000475167	0	0	0	0	0	0	0	0	89.9177		0	20.3037	0.47635483	0	0	7.647506994	8.531051655	0.051027077	0.994945932	2.121826423	6.790623821	9.682372968	0.664555219	0.18244466	2.416822877	0	22.05190615	2.906415194	0	0	2.295501423	0.784948471	1.680659809	0	0	0	0	0	0	0	0	0	0.334551675	0.000475167	0	0	0	0	0	0	0	0	89.9177		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3				0.3					0.2	0.3	0.3	0.3							2.1512	0.0502	1.2589	0.2778	0.6038	0.6735	0.004	0.0524	0.1675	1.0722	0.7962	0.0525	0.0144	0.1908	0.0097	1.7409	0.2295	0.0025		0.1812		0.1772	0.1965									0.0176			0.0229							9.9435		0	22.4549	0.526561314	1.258898874	0.277800773	8.251257546	9.204555733	0.055055531	1.047311507	2.289339035	7.862827582	10.47862074	0.717020104	0.196848186	2.607624683	0.009712715	23.79284611	3.135869025	0.002492708	0	2.476725219	0.784948471	1.857891323	0.196530406	0	0	0	0	0	0	0	0	0.352159658	0.000475167	0	0.022923953	0	0	0	0	0	0	99.8612
H2228_002_0	2008	5	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)							Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						Coin	Coin	D	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V		Coin	Coin	Coin	T				Coin					Coin	Coin	Coin	V																																																0		296.7696032	4.224844081	10506.98529	362.3183737	40.12544188	23.81679299	0.077522483	349.0781827	10.05161712	61.03852684	51.52409945	1.168159399	0.229468291	12.66683178	9111.794688	104.8066299	7.078795447	2.036462117		5.303207886	3.165621467	7.154177679	923.8705874									1.557972088	0.000597637		543.6610529							(1a) 7.4% coins	(1b) 7.4% coins	(2a) $0/day	(6a) $0/proc	(10a) 20% coins	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) 20% coins	(8a) 10% coins	(8b) 19.2% coins	(9a) 20% coins	(12) 20% coins	(9a) 20% coins	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) 20% coins	(7e/7h) 20% coins	(7c/7i) $0/visit		(7g) 20% coins	(15) 20% coins	(Misc. PBP Cats) 20% coins	(10b) $0/trip				(18a) 20% coins					(4b) 20% coins	(9c) 20% coins	(9d) 20% coins	(7f1) $0/visit							0.0736	0.0736			0.2	0.2	0.2	50	0.2	0.1	0.192	0.2	0.2	0.2		0.2	0.2			0.2	0.2	0.2										0.2	0.2									21.8422	0.310948524	0	0	8.025088375	4.763358599	0.015504497	1.454492428	2.010323423	6.103852684	9.892627095	0.23363188	0.045893658	2.533366356	0	20.96132597	1.415759089	0	0	1.060641577	0.633124293	1.430835536	0	0	0	0	0	0	0	0	0	0.311594418	0.000119527	0	0	0	0	0	0	0	0	83.0447		0	21.8422	0.310948524	0	0	8.025088375	4.763358599	0.015504497	1.454492428	2.010323423	6.103852684	9.892627095	0.23363188	0.045893658	2.533366356	0	20.96132597	1.415759089	0	0	1.060641577	0.633124293	1.430835536	0	0	0	0	0	0	0	0	0	0.311594418	0.000119527	0	0	0	0	0	0	0	0	83.0447		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3				0.3					0.2	0.3	0.3	0.3							2.2857	0.0325	0.9686	0.2149	0.6336	0.3761	0.0012	0.0766	0.1587	0.9638	0.8135	0.0184	0.0036	0.2	0.0073	1.6548	0.1118	0.0006		0.0837		0.1301	0.0669									0.0164			0.0249							8.8439		0	24.1279	0.343447325	0.968630561	0.214945574	8.658647984	5.139413225	0.016728536	1.531044661	2.169033167	7.067618897	10.70616551	0.252076502	0.049516842	2.733368963	0.007320638	22.61616749	1.527529544	0.000648563	0	1.144376438	0.633124293	1.560915284	0.066949793	0	0	0	0	0	0	0	0	0.327994124	0.000119527	0	0.024938888	0	0	0	0	0	0	91.8886
H2228_004_0	2008	5																					3900											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	S	P	T		V	P	V																																																								0		1776.564389	935.5169063	724.557915		677.1395944	27.68418559	12.62096366	1637.884405	435.9444471	6281.686506	823.6066636	68.23644757	1.59041486	3301.974955		2242.822878	2534.651808	410.6176689			961.8036008	639.1474019																				1(a) $250 per Day	1(b) $250 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $150 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $75 per Visit	8(a) Diagnostic: 20% Coinsurance; other 0% coinsurance	8(b) X-rays 20% Coinsurance; other: 20% Coinsurance	9(a) $75 per Visit	12  20% Coinsurance	"3,5,9(a), 9(d) $75 per visit; 9(c) $25/$35 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $35 per Visit	7(e)/7(h) $25/35 per Visit	7(c)/7(i) $35 per Visit		7(g) $35 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $35 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $35 per visit															157.4613	157.4613	26.4535		94.4768	0.125969069	0.125969069	28.1856	47.2384	8.2347	105.7785	47.2384	0.125969069	46.8638		22.0446	20.47	22.0446			37.8973	22.0446																				23.3117	12.27564516	1.597258002	0	5.331165259	3.487351079	1.589851039	3.847060043	1.716109876	4.310638025	7.259991979	0.268615055	0.200343079	12.89526551	0	4.120175345	4.323687982	0.754324745	0	0	3.037482783	1.174145044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.5008	0	53.77422422	23.3117	12.27564516	1.597258002	0	5.331165259	3.487351079	1.589851039	3.847060043	1.716109876	4.310638025	7.259991979	0.268615055	0.200343079	12.89526551	0	4.120175345	4.323687982	0.754324745	0	0	3.037482783	1.174145044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.5008		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"4(a)$50 per Visit, 4(b) $35 per Visit"	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															2.0659	0.2656	0.227	0.1478	0.1252	0.1695	0.1051	0.1436	0.25	0.2314	0.3846	0.0419	0.0086	0.5152	0.129	0.1765	0.1564	0.025			0.1476	0.0459	0.0077		0.0128																	5.3824	0	0	25.3776	12.5412268	1.824220699	0.14781489	5.456360297	3.656846093	1.694961914	3.990628365	1.966125702	4.542052086	7.644621756	0.310553145	0.208933659	13.41045837	0.129001517	4.29671318	4.480093494	0.779278367	0	0	3.18511294	1.220041449	0.00774	0	0.01282343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.8832
H2228_009_0	2008	6																					3500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2128.233212	145.9734876	991.7775612		307.085835	13.01552027	22.60399181	480.9899311	454.6282736	3811.529172	500.9027347	76.33547534	17.062522	3202.881333		4336.642542	427.6194526	625.3722695				771.8053647					0.081718782															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															141.0304	141.0304	33.8473		60.4416	0.161177591	0.161177591	33.2429	60.4416	16.1178	52.5955	60.4416	133.757	58.4368		20.1472	16.1178	16.1178				20.1472					20.1472															25.0121	1.715558182	2.797415566	0	1.546729847	2.097810201	3.643256946	1.332457472	2.28987156	5.119442415	2.195434739	0.384486501	0.190186035	15.59718455	0	7.28093331	0.57435561	0.839966632	0	0	0	1.295809681	0	0	0	0	0.0001372	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9132	0	17.80326396	25.0121	1.715558182	2.797415566	0	1.546729847	2.097810201	3.643256946	1.332457472	2.28987156	5.119442415	2.195434739	0.384486501	0.190186035	15.59718455	0	7.28093331	0.57435561	0.839966632	0	0	0	1.295809681	0	0	0	0	0.0001372	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9132		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.6378	0.0754	0.3247	0.3241	0.0832	0.1594	0.1384	0.0347	0.3369	0.0529	0.1375	0.0276	0.0064	0.2405	0.024	0.2324	0.0349	0.0377			0.2084	0.0493			0.0051																	5.171	0	0	27.6499	1.790932272	3.122116207	0.324087496	1.629971337	2.257183919	3.781648733	1.367118916	2.626739129	5.172325687	2.332899183	0.412068826	0.196546798	15.8376512	0.024035459	7.513295595	0.609265974	0.87768187	0	0	0.208351533	1.345073289	0	0	0.005058988	0	0.0001372	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.0841
H2229_001_1	2008	3																					3000											D		D					V	V						P	P	P				Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	843.3113289	0	1015.141663	0	0	0	0	274.810033	278.8232272	0	0	0	0	0	2609.271657	3792.530579	128.9129363	0	0	0	1.853082839	0	0	0	273.6869921	0	117.2944252	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												96.66076622	0	24.16519155	0	0	0	0	48.33038311	144.9911493	0	0	0	0	0	14.49911493	19.33215324	19.33215324	0	0	0	0.193321532	0	0	0	19.33215324	0	19.33215324	0	0	0	0											6.7929	0	2.044257728	0	0	0	0	1.106806181	3.368908347	0	0	0	0	0	3.152677471	6.109815194	0.207680387	0	0	0	0.358240814	0	0	0	0.440913239	0	0.188962817	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7712	0	0.821197262	6.7929	0	2.044257728	0	0	0	0	1.106806181	3.368908347	0	0	0	0	0	3.152677471	6.109815194	0.207680387	0	0	0	0.358240814	0	0	0	0.440913239	0	0.188962817	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7712	3000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												3.3161	0	0.8933	1.6445	0	0.7412	0.0339	0.2418	1.2057	0.2675	0.7679	0	0	0.8827	1.4232	2.0023	0.0681	0.2396	0.7231	0.2124	0.6409	0	0	0	0.1445	0	0.0619	0	0	0	0											15.5106	0	2.850816247	10.109	0	2.93751735	1.644536448	0	0.741191593	0.033885415	1.348621403	4.574629138	0.267511064	0.767926283	0	0	0.882669885	4.575875805	8.112125544	0.275741461	0.239586994	0.723062016	0.212432756	0.999123283	0	0	0	0.58540945	0	0.250889764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.2818
H2229_001_2	2008	3																					3000											D		D					V	V						P	P	P				Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	729.7760104	0	893.2433502	0	0	0	0	254.6116475	258.3298741	0	0	0	0	0	2783.642147	4045.314899	137.4040386	0	0	0	2.055400915	0	0	0	290.6453132	0	124.5622771	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												96.89689749	0	24.22422437	0	0	0	0	48.44844875	145.3453462	0	0	0	0	0	14.53453462	19.3793795	19.3793795	0	0	0	0.193793795	0	0	0	19.3793795	0	19.3793795	0	0	0	0											5.8928	0	1.803177278	0	0	0	0	1.027961613	3.128920416	0	0	0	0	0	3.371578597	6.532974385	0.221900417	0	0	0	0.398323943	0	0	0	0.469377152	0	0.201161637	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.0481	0	0.738111393	5.8928	0	1.803177278	0	0	0	0	1.027961613	3.128920416	0	0	0	0	0	3.371578597	6.532974385	0.221900417	0	0	0	0.398323943	0	0	0	0.469377152	0	0.201161637	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.0481	3000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												3.0401	0	0.7899	1.5179	0	0.6923	0.0317	0.2252	1.1227	0.2491	0.7151	0	0	0.8219	1.527	2.1465	0.0729	0.2566	0.8097	0.2291	0.6542	0	0	0	0.1542	0	0.0661	0	0	0	0											15.1222	0	2.690099213	8.9329	0	2.5931159	1.517904659	0	0.692313197	0.031650818	1.2531271	4.251623558	0.24909209	0.715052156	0	0	0.821895301	4.898563645	8.679455839	0.294808269	0.256648506	0.809683313	0.22906764	1.052558407	0	0	0	0.62359624	0	0.267255531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1703
H2229_010_1	2008	3																					3000											D		D					V	V						P	P	P				Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	843.3113289	0	1015.141663	0	0	0	0	274.810033	278.8232272	0	0	0	0	0	2609.271657	3792.530579	128.9129363	0	0	0	1.853082839	0	0	0	273.6869921	0	117.2944252	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												96.66076622	0	24.16519155	0	0	0	0	48.33038311	144.9911493	0	0	0	0	0	14.49911493	19.33215324	19.33215324	0	0	0	0.193321532	0	0	0	19.33215324	0	19.33215324	0	0	0	0											6.7929	0	2.044257728	0	0	0	0	1.106806181	3.368908347	0	0	0	0	0	3.152677471	6.109815194	0.207680387	0	0	0	0.358240814	0	0	0	0.440913239	0	0.188962817	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7712	0	0.821197262	6.7929	0	2.044257728	0	0	0	0	1.106806181	3.368908347	0	0	0	0	0	3.152677471	6.109815194	0.207680387	0	0	0	0.358240814	0	0	0	0.440913239	0	0.188962817	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7712	3000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												3.3161	0	0.8933	1.6445	0	0.7412	0.0339	0.2418	1.2057	0.2675	0.7679	0	0	0.8827	1.4232	2.0023	0.0681	0.2396	0.7231	0.2124	0.6409	0	0	0	0.1445	0	0.0619	0	0	0	0											15.5106	0	2.850816247	10.109	0	2.93751735	1.644536448	0	0.741191593	0.033885415	1.348621403	4.574629138	0.267511064	0.767926283	0	0	0.882669885	4.575875805	8.112125544	0.275741461	0.239586994	0.723062016	0.212432756	0.999123283	0	0	0	0.58540945	0	0.250889764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.2818
H2229_010_2	2008	3																					3000											D		D					V	V						P	P	P				Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	729.7760104	0	893.2433502	0	0	0	0	254.6116475	258.3298741	0	0	0	0	0	2783.642147	4045.314899	137.4040386	0	0	0	2.055400915	0	0	0	290.6453132	0	124.5622771	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												96.89689749	0	24.22422437	0	0	0	0	48.44844875	145.3453462	0	0	0	0	0	14.53453462	19.3793795	19.3793795	0	0	0	0.193793795	0	0	0	19.3793795	0	19.3793795	0	0	0	0											5.8928	0	1.803177278	0	0	0	0	1.027961613	3.128920416	0	0	0	0	0	3.371578597	6.532974385	0.221900417	0	0	0	0.398323943	0	0	0	0.469377152	0	0.201161637	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.0481	0	0.738111393	5.8928	0	1.803177278	0	0	0	0	1.027961613	3.128920416	0	0	0	0	0	3.371578597	6.532974385	0.221900417	0	0	0	0.398323943	0	0	0	0.469377152	0	0.201161637	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.0481	3000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												3.0401	0	0.7899	1.5179	0	0.6923	0.0317	0.2252	1.1227	0.2491	0.7151	0	0	0.8219	1.527	2.1465	0.0729	0.2566	0.8097	0.2291	0.6542	0	0	0	0.1542	0	0.0661	0	0	0	0											15.1222	0	2.690099213	8.9329	0	2.5931159	1.517904659	0	0.692313197	0.031650818	1.2531271	4.251623558	0.24909209	0.715052156	0	0	0.821895301	4.898563645	8.679455839	0.294808269	0.256648506	0.809683313	0.22906764	1.052558407	0	0	0	0.62359624	0	0.267255531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1703
H2229_011_1	2008	3																					3000											D		D					V	V						P	P	P				Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	843.3113289	0	1015.141663	0	0	0	0	274.810033	278.8232272	0	0	0	0	0	2609.271657	3792.530579	128.9129363	0	0	0	1.853082839	0	0	0	273.6869921	0	117.2944252	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												96.66076622	0	24.16519155	0	0	0	0	48.33038311	144.9911493	0	0	0	0	0	14.49911493	19.33215324	19.33215324	0	0	0	0.193321532	0	0	0	19.33215324	0	19.33215324	0	0	0	0											6.7929	0	2.044257728	0	0	0	0	1.106806181	3.368908347	0	0	0	0	0	3.152677471	6.109815194	0.207680387	0	0	0	0.358240814	0	0	0	0.440913239	0	0.188962817	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7712	0	0.821197262	6.7929	0	2.044257728	0	0	0	0	1.106806181	3.368908347	0	0	0	0	0	3.152677471	6.109815194	0.207680387	0	0	0	0.358240814	0	0	0	0.440913239	0	0.188962817	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7712	3000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												3.3161	0	0.8933	1.6445	0	0.7412	0.0339	0.2418	1.2057	0.2675	0.7679	0	0	0.8827	1.4232	2.0023	0.0681	0.2396	0.7231	0.2124	0.6409	0	0	0	0.1445	0	0.0619	0	0	0	0											15.5106	0	2.850816247	10.109	0	2.93751735	1.644536448	0	0.741191593	0.033885415	1.348621403	4.574629138	0.267511064	0.767926283	0	0	0.882669885	4.575875805	8.112125544	0.275741461	0.239586994	0.723062016	0.212432756	0.999123283	0	0	0	0.58540945	0	0.250889764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.2818
H2229_011_2	2008	3																					3000											D		D					V	V						P	P	P				Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	729.7760104	0	893.2433502	0	0	0	0	254.6116475	258.3298741	0	0	0	0	0	2783.642147	4045.314899	137.4040386	0	0	0	2.055400915	0	0	0	290.6453132	0	124.5622771	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												96.89689749	0	24.22422437	0	0	0	0	48.44844875	145.3453462	0	0	0	0	0	14.53453462	19.3793795	19.3793795	0	0	0	0.193793795	0	0	0	19.3793795	0	19.3793795	0	0	0	0											5.8928	0	1.803177278	0	0	0	0	1.027961613	3.128920416	0	0	0	0	0	3.371578597	6.532974385	0.221900417	0	0	0	0.398323943	0	0	0	0.469377152	0	0.201161637	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.0481	0	0.738111393	5.8928	0	1.803177278	0	0	0	0	1.027961613	3.128920416	0	0	0	0	0	3.371578597	6.532974385	0.221900417	0	0	0	0.398323943	0	0	0	0.469377152	0	0.201161637	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.0481	3000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												3.0401	0	0.7899	1.5179	0	0.6923	0.0317	0.2252	1.1227	0.2491	0.7151	0	0	0.8219	1.527	2.1465	0.0729	0.2566	0.8097	0.2291	0.6542	0	0	0	0.1542	0	0.0661	0	0	0	0											15.1222	0	2.690099213	8.9329	0	2.5931159	1.517904659	0	0.692313197	0.031650818	1.2531271	4.251623558	0.24909209	0.715052156	0	0	0.821895301	4.898563645	8.679455839	0.294808269	0.256648506	0.809683313	0.22906764	1.052558407	0	0	0	0.62359624	0	0.267255531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1703
H2229_801_0	2008	2																					3000											D		D					V	V						P	P	P				Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	764.7449656	0	930.5361637	0	0	0	0	260.984629	264.7959236	0	0	0	0	0	2730.186518	3967.859052	134.8034022	0	0	0	1.99153296	0	0	0	285.2686002	0	122.2579715	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												96.82156506	0	24.20539126	0	0	0	0	48.41078253	145.2323476	0	0	0	0	0	14.52323476	19.36431301	19.36431301	0	0	0	0.19364313	0	0	0	19.36431301	0	19.36431301	0	0	0	0											6.1703	0	1.876999327	0	0	0	0	1.05287251	3.204744467	0	0	0	0	0	3.304261645	6.40290539	0.217531273	0	0	0	0.385646676	0	0	0	0.460335872	0	0.197286802	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.2729	0	0.763997171	6.1703	0	1.876999327	0	0	0	0	1.05287251	3.204744467	0	0	0	0	0	3.304261645	6.40290539	0.217531273	0	0	0	0.385646676	0	0	0	0.460335872	0	0.197286802	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.2729	3000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												3.1267	0	0.8216	1.5579	0	0.7082	0.0324	0.2304	1.1489	0.2549	0.7318	0	0	0.8411	1.4949	2.102	0.0714	0.2514	0.7822	0.2239	0.65	0	0	0	0.1511	0	0.0648	0	0	0	0											15.2455	0	2.741186903	9.297	0	2.698584678	1.557918469	0	0.708246587	0.032379253	1.283300038	4.353684802	0.254913288	0.731762682	0	0	0.841102716	4.799151286	8.504877348	0.288943328	0.251383038	0.782197748	0.223867459	1.035622181	0	0	0	0.611456814	0	0.26205292	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5184
H2229_802_0	2008	2																					3000											D		D					V	V						P	P	P				Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	764.7449656	0	930.5361637	0	0	0	0	260.984629	264.7959236	0	0	0	0	0	2730.186518	3967.859052	134.8034022	0	0	0	1.99153296	0	0	0	285.2686002	0	122.2579715	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												96.82156506	0	24.20539126	0	0	0	0	48.41078253	145.2323476	0	0	0	0	0	14.52323476	19.36431301	19.36431301	0	0	0	0.19364313	0	0	0	19.36431301	0	19.36431301	0	0	0	0											6.1703	0	1.876999327	0	0	0	0	1.05287251	3.204744467	0	0	0	0	0	3.304261645	6.40290539	0.217531273	0	0	0	0.385646676	0	0	0	0.460335872	0	0.197286802	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.2729	0	0.763997171	6.1703	0	1.876999327	0	0	0	0	1.05287251	3.204744467	0	0	0	0	0	3.304261645	6.40290539	0.217531273	0	0	0	0.385646676	0	0	0	0.460335872	0	0.197286802	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.2729	3000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												3.1267	0	0.8216	1.5579	0	0.7082	0.0324	0.2304	1.1489	0.2549	0.7318	0	0	0.8411	1.4949	2.102	0.0714	0.2514	0.7822	0.2239	0.65	0	0	0	0.1511	0	0.0648	0	0	0	0											15.2455	0	2.741186903	9.297	0	2.698584678	1.557918469	0	0.708246587	0.032379253	1.283300038	4.353684802	0.254913288	0.731762682	0	0	0.841102716	4.799151286	8.504877348	0.288943328	0.251383038	0.782197748	0.223867459	1.035622181	0	0	0	0.611456814	0	0.26205292	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5184
H2229_803_0	2008	2																					3000											D		D					V	V						P	P	P				Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	764.7449656	0	930.5361637	0	0	0	0	260.984629	264.7959236	0	0	0	0	0	2730.186518	3967.859052	134.8034022	0	0	0	1.99153296	0	0	0	285.2686002	0	122.2579715	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												96.82156506	0	24.20539126	0	0	0	0	48.41078253	145.2323476	0	0	0	0	0	14.52323476	19.36431301	19.36431301	0	0	0	0.19364313	0	0	0	19.36431301	0	19.36431301	0	0	0	0											6.1703	0	1.876999327	0	0	0	0	1.05287251	3.204744467	0	0	0	0	0	3.304261645	6.40290539	0.217531273	0	0	0	0.385646676	0	0	0	0.460335872	0	0.197286802	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.2729	0	0.763997171	6.1703	0	1.876999327	0	0	0	0	1.05287251	3.204744467	0	0	0	0	0	3.304261645	6.40290539	0.217531273	0	0	0	0.385646676	0	0	0	0.460335872	0	0.197286802	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.2729	3000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												3.1267	0	0.8216	1.5579	0	0.7082	0.0324	0.2304	1.1489	0.2549	0.7318	0	0	0.8411	1.4949	2.102	0.0714	0.2514	0.7822	0.2239	0.65	0	0	0	0.1511	0	0.0648	0	0	0	0											15.2455	0	2.741186903	9.297	0	2.698584678	1.557918469	0	0.708246587	0.032379253	1.283300038	4.353684802	0.254913288	0.731762682	0	0	0.841102716	4.799151286	8.504877348	0.288943328	0.251383038	0.782197748	0.223867459	1.035622181	0	0	0	0.611456814	0	0.26205292	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5184
H2230_002_0	2008	5																					2000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	Coin	V	V	S	O		V	V	V	V	V		V	V																																																				0	4000	1688.849242	104.864492	2901.06645	0	386.2712813	16.0743	1.756	331.4663012	431.7694699	0	0	0	0	1827.413625	5686.200035	6601.962284	286.051375	11.9982	0	211.003097	0	0	0	286.716945	216.539159	0	0	0	0	0	392.2822565											"$100 days 1 - 5, $0 days 6+ ($500 annual max)"	"$100 days 1 - 5, $0 days 6+ ($500 annual max)"	"$10/day, days 1-20, per benefit period ($200 calendar year max)"	$0 	$100/day	10% each item	10% each item	$0 - $50/visit	$0 - $100/visit	$0 	$0 	$0 	$0 	$0 - $100 per visit	"$0 - $15  (POC), $0 - $25 (non POC) per visit"	$0 - $25 per visit	$25/visit	10% per visit	$0 	$0 - $25 per visit	0	0	0	$25 visit every six months	$25 one exam per calendar year	0	0	0	0	0	$0 - $25 per visit											47.3734	17.7459	4.7139	0	29.3506	0.1	0.1	39.8159	83.5129	0	0	0	0	6.5067	10.8024	19.7101	25	0.1	0	9.145	0	0	0	24.9997	25	0	0	0	0	0	13.2948											6.6672	0.155076129	1.139600236	0	0.944774074	1.607432794	0.175597827	1.099801713	3.004858916	0	0	0	0	0.990870036	5.118733346	10.84377776	0.595940365	1.199819653	0	0.160801629	0	0	0	0.597320713	0.451123248	0	0	0	0	0	0.434608575	0	0	0	0	0	0	0	0	0	0	35.1873	0	0.08	6.6672	0.155076129	1.139600236	0	0.944774074	1.607432794	0.175597827	1.099801713	3.004858916	0	0	0	0	0.990870036	5.118733346	10.84377776	0.595940365	1.199819653	0	0.160801629	0	0	0	0.597320713	0.451123248	0	0	0	0	0	0.434608575	0	0	0	0	0	0	0	0	0	0	35.1873	6000	20%  per stay	20%  per stay	20%  per day	20%  per day	$100 per day	20% each item	20% each item	$50 per visit	0.2	0	20%	20%	20%	0.2	$40 per visit	$40 per visit	0.2	0.2	0.2	20%	0	0	0	$40 per exam	$40 per exam	0	$40 per exam	0	0	0	"$0 - $40 per visit, or 20%"											2.3797	0.0553	0.8388	0.2459	0.0484	0.1227	0.0135	0.0563	0.3268	0	0.2321	0.0586	0.0687	0.2575	0.6992	0.8839	0.0234	0.0192	0.1344	0.0126	0	0	0	0.0503	0.038	0.0012	0.0054	0	0	0	0.0335											6.6055	500	1.54	9.0469	0.210365897	1.978376513	0.245932879	0.993168187	1.730152515	0.18908332	1.156136798	3.331673853	0	0.232131991	0.05858451	0.068705998	1.248401383	5.817924309	11.72766826	0.619309489	1.219067832	0.134415822	0.173375585	0	0	0	0.647621404	0.489112574	0.00120132	0.005375537	0	0	0	0.468100694	0	0	0	0	0	0	0	0	0	0	41.7928
H2230_006_0	2008	5																					2000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	Coin	V	V	S	O		V	V	V	V	V		V	V																																																				0	4000	1688.849242	104.864492	2901.06645	0	386.2712813	16.0743	1.756	331.4663012	431.7694699	0	0	0	0	1827.413625	5686.200035	6601.962284	286.051375	11.9982	0	211.003097	0	0	0	286.716945	216.539159	0	0	0	0	0	392.2822565											"$100 days 1 - 5, $0 days 6+ ($500 annual max)"	"$100 days 1 - 5, $0 days 6+ ($500 annual max)"	"$10/day, days 1-20, per benefit period ($200 calendar year max)"	$0 	$100/day	10% each item	10% each item	$0 - $50/visit	$0 - $100/visit	$0 	$0 	$0 	$0 	$0 - $100 per visit	"$0 - $15  (POC), $0 - $25 (non POC) per visit"	$0 - $25 per visit	$25/visit	10% per visit	$0 	$0 - $25 per visit	0	0	0	$25 visit every six months	$25 one exam per calendar year	0	0	0	0	0	$0 - $25 per visit											47.3734	17.7459	4.7139	0	29.3506	0.1	0.1	39.8159	83.5129	0	0	0	0	6.5067	10.8024	19.7101	25	0.1	0	9.145	0	0	0	24.9997	25	0	0	0	0	0	13.2948											6.6672	0.155076129	1.139600236	0	0.944774074	1.607432794	0.175597827	1.099801713	3.004858916	0	0	0	0	0.990870036	5.118733346	10.84377776	0.595940365	1.199819653	0	0.160801629	0	0	0	0.597320713	0.451123248	0	0	0	0	0	0.434608575	0	0	0	0	0	0	0	0	0	0	35.1873	0	0.08	6.6672	0.155076129	1.139600236	0	0.944774074	1.607432794	0.175597827	1.099801713	3.004858916	0	0	0	0	0.990870036	5.118733346	10.84377776	0.595940365	1.199819653	0	0.160801629	0	0	0	0.597320713	0.451123248	0	0	0	0	0	0.434608575	0	0	0	0	0	0	0	0	0	0	35.1873	6000	20%  per stay	20%  per stay	20%  per day	20%  per day	$100 per day	20% each item	20% each item	$50 per visit	0.2	0	20%	20%	20%	0.2	$40 per visit	$40 per visit	0.2	0.2	0.2	20%	0	0	0	$40 per exam	$40 per exam	0	$40 per exam	0	0	0	"$0 - $40 per visit, or 20%"											2.3797	0.0553	0.8388	0.2459	0.0484	0.1227	0.0135	0.0563	0.3268	0	0.2321	0.0586	0.0687	0.2575	0.6992	0.8839	0.0234	0.0192	0.1344	0.0126	0	0	0	0.0503	0.038	0.0012	0.0054	0	0	0	0.0335											6.6055	500	1.54	9.0469	0.210365897	1.978376513	0.245932879	0.993168187	1.730152515	0.18908332	1.156136798	3.331673853	0	0.232131991	0.05858451	0.068705998	1.248401383	5.817924309	11.72766826	0.619309489	1.219067832	0.134415822	0.173375585	0	0	0	0.647621404	0.489112574	0.00120132	0.005375537	0	0	0	0.468100694	0	0	0	0	0	0	0	0	0	0	41.7928
H2230_801_0	2008	4																					2000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	Coin	V	V	S	O		V	V	V	V	V		V	V																																																				0	4000	1688.849242	104.864492	2901.06645	0	386.2712813	16.0743	1.756	331.4663012	431.7694699	0	0	0	0	1827.413625	5686.200035	6601.962284	286.051375	11.9982	0	211.003097	0	0	0	286.716945	216.539159	0	0	0	0	0	392.2822565											"$100 days 1 - 5, $0 days 6+ ($500 annual max)"	"$100 days 1 - 5, $0 days 6+ ($500 annual max)"	"$10/day, days 1-20, per benefit period ($200 calendar year max)"	$0 	$100/day	10% each item	10% each item	$0 - $50/visit	$0 - $100/visit	$0 	$0 	$0 	$0 	$0 - $100 per visit	"$0 - $15  (POC), $0 - $25 (non POC) per visit"	$0 - $25 per visit	$25/visit	10% per visit	$0 	$0 - $25 per visit	0	0	0	$25 visit every six months	$25 one exam per calendar year	0	0	0	0	0	$0 - $25 per visit											47.3734	17.7459	4.7139	0	29.3506	0.1	0.1	39.8159	83.5129	0	0	0	0	6.5067	10.8024	19.7101	25	0.1	0	9.145	0	0	0	24.9997	25	0	0	0	0	0	13.2948											6.6672	0.155076129	1.139600236	0	0.944774074	1.607432794	0.175597827	1.099801713	3.004858916	0	0	0	0	0.990870036	5.118733346	10.84377776	0.595940365	1.199819653	0	0.160801629	0	0	0	0.597320713	0.451123248	0	0	0	0	0	0.434608575	0	0	0	0	0	0	0	0	0	0	35.1873	0	0.08	6.6672	0.155076129	1.139600236	0	0.944774074	1.607432794	0.175597827	1.099801713	3.004858916	0	0	0	0	0.990870036	5.118733346	10.84377776	0.595940365	1.199819653	0	0.160801629	0	0	0	0.597320713	0.451123248	0	0	0	0	0	0.434608575	0	0	0	0	0	0	0	0	0	0	35.1873	6000	20%  per stay	20%  per stay	20%  per day	20%  per day	$100 per day	20% each item	20% each item	$50 per visit	0.2	0	20%	20%	20%	0.2	$40 per visit	$40 per visit	0.2	0.2	0.2	20%	0	0	0	$40 per exam	$40 per exam	0	$40 per exam	0	0	0	"$0 - $40 per visit, or 20%"											2.3797	0.0553	0.8388	0.2459	0.0484	0.1227	0.0135	0.0563	0.3268	0	0.2321	0.0586	0.0687	0.2575	0.6992	0.8839	0.0234	0.0192	0.1344	0.0126	0	0	0	0.0503	0.038	0.0012	0.0054	0	0	0	0.0335											6.6055	500	1.54	9.0469	0.210365897	1.978376513	0.245932879	0.993168187	1.730152515	0.18908332	1.156136798	3.331673853	0	0.232131991	0.05858451	0.068705998	1.248401383	5.817924309	11.72766826	0.619309489	1.219067832	0.134415822	0.173375585	0	0	0	0.647621404	0.489112574	0.00120132	0.005375537	0	0	0	0.468100694	0	0	0	0	0	0	0	0	0	0	41.7928
H2230_809_0	2008	4																					2000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	Coin	V	V	S	O		V	V	V	V	V		V	V																																																				0	4000	1688.849242	104.864492	2901.06645	0	386.2712813	16.0743	1.756	331.4663012	431.7694699	0	0	0	0	1827.413625	5686.200035	6601.962284	286.051375	11.9982	0	211.003097	0	0	0	286.716945	216.539159	0	0	0	0	0	392.2822565											"$100 days 1 - 5, $0 days 6+ ($500 annual max)"	"$100 days 1 - 5, $0 days 6+ ($500 annual max)"	"$10/day, days 1-20, per benefit period ($200 calendar year max)"	$0 	$100/day	10% each item	10% each item	$0 - $50/visit	$0 - $100/visit	$0 	$0 	$0 	$0 	$0 - $100 per visit	"$0 - $15  (POC), $0 - $25 (non POC) per visit"	$0 - $25 per visit	$25/visit	10% per visit	$0 	$0 - $25 per visit	0	0	0	$25 visit every six months	$25 one exam per calendar year	0	0	0	0	0	$0 - $25 per visit											47.3734	17.7459	4.7139	0	29.3506	0.1	0.1	39.8159	83.5129	0	0	0	0	6.5067	10.8024	19.7101	25	0.1	0	9.145	0	0	0	24.9997	25	0	0	0	0	0	13.2948											6.6672	0.155076129	1.139600236	0	0.944774074	1.607432794	0.175597827	1.099801713	3.004858916	0	0	0	0	0.990870036	5.118733346	10.84377776	0.595940365	1.199819653	0	0.160801629	0	0	0	0.597320713	0.451123248	0	0	0	0	0	0.434608575	0	0	0	0	0	0	0	0	0	0	35.1873	0	0.08	6.6672	0.155076129	1.139600236	0	0.944774074	1.607432794	0.175597827	1.099801713	3.004858916	0	0	0	0	0.990870036	5.118733346	10.84377776	0.595940365	1.199819653	0	0.160801629	0	0	0	0.597320713	0.451123248	0	0	0	0	0	0.434608575	0	0	0	0	0	0	0	0	0	0	35.1873	6000	20%  per stay	20%  per stay	20%  per day	20%  per day	$100 per day	20% each item	20% each item	$50 per visit	0.2	0	20%	20%	20%	0.2	$40 per visit	$40 per visit	0.2	0.2	0.2	20%	0	0	0	$40 per exam	$40 per exam	0	$40 per exam	0	0	0	"$0 - $40 per visit, or 20%"											2.3797	0.0553	0.8388	0.2459	0.0484	0.1227	0.0135	0.0563	0.3268	0	0.2321	0.0586	0.0687	0.2575	0.6992	0.8839	0.0234	0.0192	0.1344	0.0126	0	0	0	0.0503	0.038	0.0012	0.0054	0	0	0	0.0335											6.6055	500	1.54	9.0469	0.210365897	1.978376513	0.245932879	0.993168187	1.730152515	0.18908332	1.156136798	3.331673853	0	0.232131991	0.05858451	0.068705998	1.248401383	5.817924309	11.72766826	0.619309489	1.219067832	0.134415822	0.173375585	0	0	0	0.647621404	0.489112574	0.00120132	0.005375537	0	0	0	0.468100694	0	0	0	0	0	0	0	0	0	0	41.7928
H2237_001_0	2008	9																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	347.07	33.06	83.03	31.32	13.26	27.91	22.62	11.3	27.04	15.25	31.2	1.53	2.41	51.84	53.28	103.74	8.41	4.49	22.53	36.8	12.93	3.36	0	0	0	0	0	0	0	11.47	2.63											Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing											0.075799938	0.075800786	0.177603013	0	0.234019506	0.234000269	0.233988255	0.233905228	0.233999977	0.233938349	0.233991887	0.234000003	0.234000006	0.233983135	0.234001933	0.234008246	0.234015661	0.233955084	0.233991761	0.234000101	0.234001683	0.234005294	0	0	0	0	0	0	0	0	0											26.3079	2.505973971	14.74637814	0	3.103098645	6.530947502	5.292814335	2.643129074	6.327359385	3.567559818	7.300546888	0.358020005	0.563940014	12.12968572	12.46762299	24.27601539	1.968071712	1.050458327	5.271834376	8.611203707	3.025641762	0.786257788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.8344	0	0	26.3079	2.505973971	14.74637814	0	3.103098645	6.530947502	5.292814335	2.643129074	6.327359385	3.567559818	7.300546888	0.358020005	0.563940014	12.12968572	12.46762299	24.27601539	1.968071712	1.050458327	5.271834376	8.611203707	3.025641762	0.786257788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.8344	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.3079	2.505973971	14.74637814	0	3.103098645	6.530947502	5.292814335	2.643129074	6.327359385	3.567559818	7.300546888	0.358020005	0.563940014	12.12968572	12.46762299	24.27601539	1.968071712	1.050458327	5.271834376	8.611203707	3.025641762	0.786257788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.8344
H2237_002_0	2008	9																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	287.75	30.95	86.45	21.83	13.59	22.49	20.97	11.73	26.45	16.46	29.83	1.48	2.33	60.28	49.16	89.93	8.25	3.5	18.38	30.74	12.29	3.11	0	0	0	0	0	0	0	11.47	2.63											Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing											0.081724763	0.081726616	0.174139503	0	0.234016906	0.234000286	0.234042356	0.234070089	0.233999998	0.234004969	0.233963215	0.234000023	0.234000017	0.233964621	0.233999666	0.234001536	0.233998837	0.233997787	0.234006227	0.23397971	0.234006487	0.234004556	0	0	0	0	0	0	0	0	0											23.5163	2.529438762	15.05436007	0	3.180289749	5.26266644	4.907868208	2.745642144	6.18929996	3.851721787	6.979122711	0.346320033	0.54522004	14.10338736	11.50342357	21.04375813	1.930490406	0.818992255	4.301034447	7.192536292	2.875939726	0.727754169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.6056	0	0	23.5163	2.529438762	15.05436007	0	3.180289749	5.26266644	4.907868208	2.745642144	6.18929996	3.851721787	6.979122711	0.346320033	0.54522004	14.10338736	11.50342357	21.04375813	1.930490406	0.818992255	4.301034447	7.192536292	2.875939726	0.727754169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.6056	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5163	2.529438762	15.05436007	0	3.180289749	5.26266644	4.907868208	2.745642144	6.18929996	3.851721787	6.979122711	0.346320033	0.54522004	14.10338736	11.50342357	21.04375813	1.930490406	0.818992255	4.301034447	7.192536292	2.875939726	0.727754169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.6056
H2256_001_1	2008	4																																D	D						P	P						P	P	P	P	P	P					P			P																																																							0		263.9271465	0						326.9638061	521.0987378						4692.097422	4675.640504	199.027375			74.53761999					332.2648098			29.95973388														$200 deductible	$200 deductible						$50 per visit	"$0-$50 per visit, max 20%"						$10 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit					$15/exam			$15/test														200	0						50	43						10	15	15	0	0	15					15			15														4.3988	0	0	0	0	0	0	1.362349192	1.867270477	0	0	0	0	0	3.910081185	5.84455063	0.248784219	0	0	0.093172025	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1778			4.3988	0	0	0	0	0	0	1.362349192	1.867270477	0	0	0	0	0	3.910081185	5.84455063	0.248784219	0	0	0.093172025	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1778																																																																																				0			4.3988	0	0	0	0	0	0	1.362349192	1.867270477	0	0	0	0	0	3.910081185	5.84455063	0.248784219	0	0	0.093172025	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1778
H2256_001_2	2008	4																																D	D						P	P						P	P	P	P	P	P					P			P																																																							0		245.0464017	0						334.8099609	503.5930525						4841.232505	4838.264453	238.3479551	0	0	29.90017774					332.2648098			29.95973388														$200 deductible	$200 deductible						$50 per visit	"$0-$50 per visit, max 20%"						$10 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit					$15/exam			$15/test														200	0						50	43						10	15	15	0	0	15					15			15														4.0841	0	0	0	0	0	0	1.395041504	1.804541771	0	0	0	0	0	4.034360421	6.047830566	0.297934944	0	0	0.037375222	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	18.154			4.0841	0	0	0	0	0	0	1.395041504	1.804541771	0	0	0	0	0	4.034360421	6.047830566	0.297934944	0	0	0.037375222	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	18.154																																																																																				0			4.0841	0	0	0	0	0	0	1.395041504	1.804541771	0	0	0	0	0	4.034360421	6.047830566	0.297934944	0	0	0.037375222	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	18.154
H2256_015_1	2008	5																																D	D						P	P						P	P	P	P	P	P					P			P																																																							0		263.9271465	0						326.9638061	521.0987378						4692.097422	4675.640504	199.027375			74.53761999					332.2648098			29.95973388														$200 deductible	$200 deductible						$50 per visit	"$0-$50 per visit, max 20%"						$10 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit					$15/exam			$15/test														200	0						50	43						10	15	15	0	0	15					15			15														4.3988	0	0	0	0	0	0	1.362349192	1.867270477	0	0	0	0	0	3.910081185	5.84455063	0.248784219	0	0	0.093172025	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1778			4.3988	0	0	0	0	0	0	1.362349192	1.867270477	0	0	0	0	0	3.910081185	5.84455063	0.248784219	0	0	0.093172025	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1778																																																																																				0			4.3988	0	0	0	0	0	0	1.362349192	1.867270477	0	0	0	0	0	3.910081185	5.84455063	0.248784219	0	0	0.093172025	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1778
H2256_015_2	2008	5																																D	D						P	P						P	P	P	P	P	P					P			P																																																							0		245.0464017	0						334.8099609	503.5930525						4841.232505	4838.264453	238.3479551	0	0	29.90017774					332.2648098			29.95973388														$200 deductible	$200 deductible						$50 per visit	"$0-$50 per visit, max 20%"						$10 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit					$15/exam			$15/test														200	0						50	43						10	15	15	0	0	15					15			15														4.0841	0	0	0	0	0	0	1.395041504	1.804541771	0	0	0	0	0	4.034360421	6.047830566	0.297934944	0	0	0.037375222	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	18.154			4.0841	0	0	0	0	0	0	1.395041504	1.804541771	0	0	0	0	0	4.034360421	6.047830566	0.297934944	0	0	0.037375222	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	18.154																																																																																				0			4.0841	0	0	0	0	0	0	1.395041504	1.804541771	0	0	0	0	0	4.034360421	6.047830566	0.297934944	0	0	0.037375222	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	18.154
H2256_016_1	2008	4																																D	D						P	P						P	P	P	P	P	P					P			P																																																							0		263.9271465	0						326.9638061	521.0987378						4692.097422	4675.640504	199.027375			74.53761999					332.2648098			29.95973388														$200 deductible	$200 deductible						$50 per visit	"$0-$50 per visit, max 20%"						$10 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit					$15/exam			$15/test														200	0						50	43						10	15	15	0	0	15					15			15														4.3988	0	0	0	0	0	0	1.362349192	1.867270477	0	0	0	0	0	3.910081185	5.84455063	0.248784219	0	0	0.093172025	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1778			4.3988	0	0	0	0	0	0	1.362349192	1.867270477	0	0	0	0	0	3.910081185	5.84455063	0.248784219	0	0	0.093172025	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1778																																																																																				0			4.3988	0	0	0	0	0	0	1.362349192	1.867270477	0	0	0	0	0	3.910081185	5.84455063	0.248784219	0	0	0.093172025	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1778
H2256_016_2	2008	4																																D	D						P	P						P	P	P	P	P	P					P			P																																																							0		245.0464017	0						334.8099609	503.5930525						4841.232505	4838.264453	238.3479551	0	0	29.90017774					332.2648098			29.95973388														$200 deductible	$200 deductible						$50 per visit	"$0-$50 per visit, max 20%"						$10 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit					$15/exam			$15/test														200	0						50	43						10	15	15	0	0	15					15			15														4.0841	0	0	0	0	0	0	1.395041504	1.804541771	0	0	0	0	0	4.034360421	6.047830566	0.297934944	0	0	0.037375222	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	18.154			4.0841	0	0	0	0	0	0	1.395041504	1.804541771	0	0	0	0	0	4.034360421	6.047830566	0.297934944	0	0	0.037375222	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	18.154																																																																																				0			4.0841	0	0	0	0	0	0	1.395041504	1.804541771	0	0	0	0	0	4.034360421	6.047830566	0.297934944	0	0	0.037375222	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	18.154
H2256_017_1	2008	3																																D	D						P	P						P	P	P	P	P	P					P			P																																																							0		323.0272507	0						434.0632136	684.4784835						4360.879894	4913.66803	223.8364645	0	0	37.31391075					449.1740388			41.59421079														$100 each day for day(s) 1-5	$100 each day for day(s) 1-5						$50/ ER visit	"20%, if applicable, Max $150"						$15/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit					$15/exam			$15/test														200	0						50	43						15	20	20	0	0	20					15			15														5.3838	0	0	0	0	0	0	1.808596723	2.452714566	0	0	0	0	0	5.451099867	8.189446716	0.373060774	0	0	0.062189851	0	0	0	0	0.561467548	0	0	0.051992763	0	0	0	0	0	0	0	0	0	0	0	0	0	24.3344			5.3838	0	0	0	0	0	0	1.808596723	2.452714566	0	0	0	0	0	5.451099867	8.189446716	0.373060774	0	0	0.062189851	0	0	0	0	0.561467548	0	0	0.051992763	0	0	0	0	0	0	0	0	0	0	0	0	0	24.3344																																																																																				0			5.3838	0	0	0	0	0	0	1.808596723	2.452714566	0	0	0	0	0	5.451099867	8.189446716	0.373060774	0	0	0.062189851	0	0	0	0	0.561467548	0	0	0.051992763	0	0	0	0	0	0	0	0	0	0	0	0	0	24.3344
H2256_017_7	2008	3																																D	D						P	P						P	P	P	P	P	P					P			P																																																							0		277.7809975	0						373.2642129	588.6039507						3750.053794	4225.413193	192.4838114	0	0	32.08737135					386.2584729			35.76813207														$100 each day for day(s) 1-5	$100 each day for day(s) 1-5						$50/ ER visit	"20%, if applicable, Max $150"						$15/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit					$15/exam			$15/test														200	0						50	43						15	20	20	0	0	20					15			15														4.6297	0	0	0	0	0	0	1.555267554	2.109164157	0	0	0	0	0	4.687567243	7.042355322	0.320806352	0	0	0.053478952	0	0	0	0	0.482823091	0	0	0.044710165	0	0	0	0	0	0	0	0	0	0	0	0	0	20.9259			4.6297	0	0	0	0	0	0	1.555267554	2.109164157	0	0	0	0	0	4.687567243	7.042355322	0.320806352	0	0	0.053478952	0	0	0	0	0.482823091	0	0	0.044710165	0	0	0	0	0	0	0	0	0	0	0	0	0	20.9259																																																																																				0			4.6297	0	0	0	0	0	0	1.555267554	2.109164157	0	0	0	0	0	4.687567243	7.042355322	0.320806352	0	0	0.053478952	0	0	0	0	0.482823091	0	0	0.044710165	0	0	0	0	0	0	0	0	0	0	0	0	0	20.9259
H2256_018_1	2008	3																																D	D						P	P						P	P	P	P	P	P					P			P																																																							0		323.0272507	0						434.0632136	684.4784835						4360.879894	4913.66803	223.8364645	0	0	37.31391075					449.1740388			41.59421079														$100 each day for day(s) 1-5	$100 each day for day(s) 1-5						$50/ ER visit	"20%, if applicable, Max $150"						$15/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit					$15/exam			$15/test														200	0						50	43						15	20	20	0	0	20					15			15														5.3838	0	0	0	0	0	0	1.808596723	2.452714566	0	0	0	0	0	5.451099867	8.189446716	0.373060774	0	0	0.062189851	0	0	0	0	0.561467548	0	0	0.051992763	0	0	0	0	0	0	0	0	0	0	0	0	0	24.3344			5.3838	0	0	0	0	0	0	1.808596723	2.452714566	0	0	0	0	0	5.451099867	8.189446716	0.373060774	0	0	0.062189851	0	0	0	0	0.561467548	0	0	0.051992763	0	0	0	0	0	0	0	0	0	0	0	0	0	24.3344																																																																																				0			5.3838	0	0	0	0	0	0	1.808596723	2.452714566	0	0	0	0	0	5.451099867	8.189446716	0.373060774	0	0	0.062189851	0	0	0	0	0.561467548	0	0	0.051992763	0	0	0	0	0	0	0	0	0	0	0	0	0	24.3344
H2256_018_7	2008	3																																D	D						P	P						P	P	P	P	P	P					P			P																																																							0		277.7809975	0						373.2642129	588.6039507						3750.053794	4225.413193	192.4838114	0	0	32.08737135					386.2584729			35.76813207														$100 each day for day(s) 1-5	$100 each day for day(s) 1-5						$50/ ER visit	"20%, if applicable, Max $150"						$15/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit					$15/exam			$15/test														200	0						50	43						15	20	20	0	0	20					15			15														4.6297	0	0	0	0	0	0	1.555267554	2.109164157	0	0	0	0	0	4.687567243	7.042355322	0.320806352	0	0	0.053478952	0	0	0	0	0.482823091	0	0	0.044710165	0	0	0	0	0	0	0	0	0	0	0	0	0	20.9259			4.6297	0	0	0	0	0	0	1.555267554	2.109164157	0	0	0	0	0	4.687567243	7.042355322	0.320806352	0	0	0.053478952	0	0	0	0	0.482823091	0	0	0.044710165	0	0	0	0	0	0	0	0	0	0	0	0	0	20.9259																																																																																				0			4.6297	0	0	0	0	0	0	1.555267554	2.109164157	0	0	0	0	0	4.687567243	7.042355322	0.320806352	0	0	0.053478952	0	0	0	0	0.482823091	0	0	0.044710165	0	0	0	0	0	0	0	0	0	0	0	0	0	20.9259
H2256_019_1	2008	4																																D	D						P	P						P	P	P	P	P	P					P			P																																																							0		323.0272507	0						434.0632136	684.4784835						4360.879894	4913.66803	223.8364645	0	0	37.31391075					449.1740388			41.59421079														$100 each day for day(s) 1-5	$100 each day for day(s) 1-5						$50/ ER visit	"20%, if applicable, Max $150"						$15/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit					$15/exam			$15/test														200	0						50	43						15	20	20	0	0	20					15			15														5.3838	0	0	0	0	0	0	1.808596723	2.452714566	0	0	0	0	0	5.451099867	8.189446716	0.373060774	0	0	0.062189851	0	0	0	0	0.561467548	0	0	0.051992763	0	0	0	0	0	0	0	0	0	0	0	0	0	24.3344			5.3838	0	0	0	0	0	0	1.808596723	2.452714566	0	0	0	0	0	5.451099867	8.189446716	0.373060774	0	0	0.062189851	0	0	0	0	0.561467548	0	0	0.051992763	0	0	0	0	0	0	0	0	0	0	0	0	0	24.3344																																																																																				0			5.3838	0	0	0	0	0	0	1.808596723	2.452714566	0	0	0	0	0	5.451099867	8.189446716	0.373060774	0	0	0.062189851	0	0	0	0	0.561467548	0	0	0.051992763	0	0	0	0	0	0	0	0	0	0	0	0	0	24.3344
H2256_019_7	2008	4																																D	D						P	P						P	P	P	P	P	P					P			P																																																							0		277.7809975	0						373.2642129	588.6039507						3750.053794	4225.413193	192.4838114	0	0	32.08737135					386.2584729			35.76813207														$100 each day for day(s) 1-5	$100 each day for day(s) 1-5						$50/ ER visit	"20%, if applicable, Max $150"						$15/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit					$15/exam			$15/test														200	0						50	43						15	20	20	0	0	20					15			15														4.6297	0	0	0	0	0	0	1.555267554	2.109164157	0	0	0	0	0	4.687567243	7.042355322	0.320806352	0	0	0.053478952	0	0	0	0	0.482823091	0	0	0.044710165	0	0	0	0	0	0	0	0	0	0	0	0	0	20.9259			4.6297	0	0	0	0	0	0	1.555267554	2.109164157	0	0	0	0	0	4.687567243	7.042355322	0.320806352	0	0	0.053478952	0	0	0	0	0.482823091	0	0	0.044710165	0	0	0	0	0	0	0	0	0	0	0	0	0	20.9259																																																																																				0			4.6297	0	0	0	0	0	0	1.555267554	2.109164157	0	0	0	0	0	4.687567243	7.042355322	0.320806352	0	0	0.053478952	0	0	0	0	0.482823091	0	0	0.044710165	0	0	0	0	0	0	0	0	0	0	0	0	0	20.9259
H2256_020_1	2008	3																																D	D	D		D	O	O	P	P		P				P	P	P	P	P	P					P			P																																																							0		574.5883984	0	157.821786		914.7929323	151.8974544	151.8974544	445.7769607	683.6172818		1182.25906				3417.112169	5133.690211	233.8593205	0	0	38.98473751					276.7773424			34.61504459														$200 each day for day(s) 1-5	$200 each day for day(s) 1-5	$100/day for days 11-100		$50/Day	20% up to $50	20% up to $50	$50/ ER visit	"20%, if applicable, Max $150"		$0-$50				$25/visit	$25/visit	$25/visit	$25/visit	$25/visit	$25/visit					$25/exam			$25/test														200	0	100		50	50	50	50	43		50				25	25	25	0	0	25					25			25														9.5765	0	1.31518155	0	3.811637218	0.63290606	0.63290606	1.857404003	2.449628593	0	4.926079417	0	0	0	7.118983685	10.69518794	0.487206918	0	0	0.081218203	0	0	0	0	0.576619463	0	0	0.072114676	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2335			9.5765	0	1.31518155	0	3.811637218	0.63290606	0.63290606	1.857404003	2.449628593	0	4.926079417	0	0	0	7.118983685	10.69518794	0.487206918	0	0	0.081218203	0	0	0	0	0.576619463	0	0	0.072114676	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2335																																																																																				0			9.5765	0	1.31518155	0	3.811637218	0.63290606	0.63290606	1.857404003	2.449628593	0	4.926079417	0	0	0	7.118983685	10.69518794	0.487206918	0	0	0.081218203	0	0	0	0	0.576619463	0	0	0.072114676	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2335
H2256_020_2	2008	3																																D	D	D		D	O	O	P	P		P				P	P	P	P	P	P					P			P																																																							0		494.1061107	0	135.7157734		786.6583786	130.6212597	130.6212597	383.3372217	587.863377		1016.66067				2938.479107	4414.616986	201.1027714	0	0	33.52416631					238.009289			29.76653392														$200 each day for day(s) 1-5	$200 each day for day(s) 1-5	$100/day for days 11-100		$50/Day	20% up to $50	20% up to $50	$50/ ER visit	"20%, if applicable, Max $150"		$0-$50				$25/visit	$25/visit	$25/visit	$25/visit	$25/visit	$25/visit					$25/exam			$25/test														200	0	100		50	50	50	50	43		50				25	25	25	0	0	25					25			25														8.2351	0	1.130964778	0	3.277743244	0.544255249	0.544255249	1.597238424	2.106510434	0	4.236086124	0	0	0	6.121831472	9.197118721	0.418964107	0	0	0.069842013	0	0	0	0	0.495852685	0	0	0.062013612	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0378			8.2351	0	1.130964778	0	3.277743244	0.544255249	0.544255249	1.597238424	2.106510434	0	4.236086124	0	0	0	6.121831472	9.197118721	0.418964107	0	0	0.069842013	0	0	0	0	0.495852685	0	0	0.062013612	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0378																																																																																				0			8.2351	0	1.130964778	0	3.277743244	0.544255249	0.544255249	1.597238424	2.106510434	0	4.236086124	0	0	0	6.121831472	9.197118721	0.418964107	0	0	0.069842013	0	0	0	0	0.495852685	0	0	0.062013612	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0378
H2256_021_1	2008	3																																D	D	D		D	O	O	P	P		P				P	P	P	P	P	P					P			P																																																							0		574.5883984	0	157.821786		914.7929323	151.8974544	151.8974544	445.7769607	683.6172818		1182.25906				3417.112169	5133.690211	233.8593205	0	0	38.98473751					276.7773424			34.61504459														$200 each day for day(s) 1-5	$200 each day for day(s) 1-5	$100/day for days 11-100		$50/Day	20% up to $50	20% up to $50	$50/ ER visit	"20%, if applicable, Max $150"		$0-$50				$25/visit	$25/visit	$25/visit	$25/visit	$25/visit	$25/visit					$25/exam			$25/test														200	0	100		50	50	50	50	43		50				25	25	25	0	0	25					25			25														9.5765	0	1.31518155	0	3.811637218	0.63290606	0.63290606	1.857404003	2.449628593	0	4.926079417	0	0	0	7.118983685	10.69518794	0.487206918	0	0	0.081218203	0	0	0	0	0.576619463	0	0	0.072114676	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2335			9.5765	0	1.31518155	0	3.811637218	0.63290606	0.63290606	1.857404003	2.449628593	0	4.926079417	0	0	0	7.118983685	10.69518794	0.487206918	0	0	0.081218203	0	0	0	0	0.576619463	0	0	0.072114676	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2335																																																																																				0			9.5765	0	1.31518155	0	3.811637218	0.63290606	0.63290606	1.857404003	2.449628593	0	4.926079417	0	0	0	7.118983685	10.69518794	0.487206918	0	0	0.081218203	0	0	0	0	0.576619463	0	0	0.072114676	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2335
H2256_021_2	2008	3																																D	D	D		D	O	O	P	P		P				P	P	P	P	P	P					P			P																																																							0		494.1061107	0	135.7157734		786.6583786	130.6212597	130.6212597	383.3372217	587.863377		1016.66067				2938.479107	4414.616986	201.1027714	0	0	33.52416631					238.009289			29.76653392														$200 each day for day(s) 1-5	$200 each day for day(s) 1-5	$100/day for days 11-100		$50/Day	20% up to $50	20% up to $50	$50/ ER visit	"20%, if applicable, Max $150"		$0-$50				$25/visit	$25/visit	$25/visit	$25/visit	$25/visit	$25/visit					$25/exam			$25/test														200	0	100		50	50	50	50	43		50				25	25	25	0	0	25					25			25														8.2351	0	1.130964778	0	3.277743244	0.544255249	0.544255249	1.597238424	2.106510434	0	4.236086124	0	0	0	6.121831472	9.197118721	0.418964107	0	0	0.069842013	0	0	0	0	0.495852685	0	0	0.062013612	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0378			8.2351	0	1.130964778	0	3.277743244	0.544255249	0.544255249	1.597238424	2.106510434	0	4.236086124	0	0	0	6.121831472	9.197118721	0.418964107	0	0	0.069842013	0	0	0	0	0.495852685	0	0	0.062013612	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0378																																																																																				0			8.2351	0	1.130964778	0	3.277743244	0.544255249	0.544255249	1.597238424	2.106510434	0	4.236086124	0	0	0	6.121831472	9.197118721	0.418964107	0	0	0.069842013	0	0	0	0	0.495852685	0	0	0.062013612	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0378
H2256_022_1	2008	4																																D	D	D		D	O	O	P	P		P				P	P	P	P	P	P					P			P																																																							0		574.5883984	0	157.821786		914.7929323	151.8974544	151.8974544	445.7769607	683.6172818		1182.25906				3417.112169	5133.690211	233.8593205	0	0	38.98473751					276.7773424			34.61504459														$200 each day for day(s) 1-5	$200 each day for day(s) 1-5	$100/day for days 11-100		$50/Day	20% up to $50	20% up to $50	$50/ ER visit	"20%, if applicable, Max $150"		$0-$50				$25/visit	$25/visit	$25/visit	$25/visit	$25/visit	$25/visit					$25/exam			$25/test														200	0	100		50	50	50	50	43		50				25	25	25	0	0	25					25			25														9.5765	0	1.31518155	0	3.811637218	0.63290606	0.63290606	1.857404003	2.449628593	0	4.926079417	0	0	0	7.118983685	10.69518794	0.487206918	0	0	0.081218203	0	0	0	0	0.576619463	0	0	0.072114676	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2335			9.5765	0	1.31518155	0	3.811637218	0.63290606	0.63290606	1.857404003	2.449628593	0	4.926079417	0	0	0	7.118983685	10.69518794	0.487206918	0	0	0.081218203	0	0	0	0	0.576619463	0	0	0.072114676	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2335																																																																																				0			9.5765	0	1.31518155	0	3.811637218	0.63290606	0.63290606	1.857404003	2.449628593	0	4.926079417	0	0	0	7.118983685	10.69518794	0.487206918	0	0	0.081218203	0	0	0	0	0.576619463	0	0	0.072114676	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2335
H2256_022_2	2008	4																																D	D	D		D	O	O	P	P		P				P	P	P	P	P	P					P			P																																																							0		494.1061107	0	135.7157734		786.6583786	130.6212597	130.6212597	383.3372217	587.863377		1016.66067				2938.479107	4414.616986	201.1027714	0	0	33.52416631					238.009289			29.76653392														$200 each day for day(s) 1-5	$200 each day for day(s) 1-5	$100/day for days 11-100		$50/Day	20% up to $50	20% up to $50	$50/ ER visit	"20%, if applicable, Max $150"		$0-$50				$25/visit	$25/visit	$25/visit	$25/visit	$25/visit	$25/visit					$25/exam			$25/test														200	0	100		50	50	50	50	43		50				25	25	25	0	0	25					25			25														8.2351	0	1.130964778	0	3.277743244	0.544255249	0.544255249	1.597238424	2.106510434	0	4.236086124	0	0	0	6.121831472	9.197118721	0.418964107	0	0	0.069842013	0	0	0	0	0.495852685	0	0	0.062013612	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0378			8.2351	0	1.130964778	0	3.277743244	0.544255249	0.544255249	1.597238424	2.106510434	0	4.236086124	0	0	0	6.121831472	9.197118721	0.418964107	0	0	0.069842013	0	0	0	0	0.495852685	0	0	0.062013612	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0378																																																																																				0			8.2351	0	1.130964778	0	3.277743244	0.544255249	0.544255249	1.597238424	2.106510434	0	4.236086124	0	0	0	6.121831472	9.197118721	0.418964107	0	0	0.069842013	0	0	0	0	0.495852685	0	0	0.062013612	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0378
H2256_801_0	2008	3																																D	D						P	P						P	P	P	P	P	P					P			P																																																							0		202.2877115	0						275.1904182	503.8593295						4938.051635	4945.779963	225.2992865			37.5577656					332.2648098			29.95973388														$200 deductible	$200 deductible						$50 per visit	"$0-$50 per visit, max 20%"						$10 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit					$15/exam			$15/ test														200	0						50	43						10	15	15	0	0	15					15			15														3.3715	0	0	0	0	0	0	1.146626742	1.805495931	0	0	0	0	0	4.115043029	6.182224953	0.281624108	0	0	0.046947207	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	17.4022			3.3715	0	0	0	0	0	0	1.146626742	1.805495931	0	0	0	0	0	4.115043029	6.182224953	0.281624108	0	0	0.046947207	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	17.4022																																																																																				0			3.3715	0	0	0	0	0	0	1.146626742	1.805495931	0	0	0	0	0	4.115043029	6.182224953	0.281624108	0	0	0.046947207	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	17.4022
H2256_802_0	2008	3																																D	D						P	P						P	P	P	P	P	P					P			P																																																							0		202.2877115	0						275.1904182	503.8593295						4938.051635	4945.779963	225.2992865			37.5577656					332.2648098			29.95973388														$200 deductible	$200 deductible						$50 per visit	"$0-$50 per visit, max 20%"						$10 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit					$15/exam			$15/ test														200	0						50	43						10	15	15	0	0	15					15			15														3.3715	0	0	0	0	0	0	1.146626742	1.805495931	0	0	0	0	0	4.115043029	6.182224953	0.281624108	0	0	0.046947207	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	17.4022			3.3715	0	0	0	0	0	0	1.146626742	1.805495931	0	0	0	0	0	4.115043029	6.182224953	0.281624108	0	0	0.046947207	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	17.4022																																																																																				0			3.3715	0	0	0	0	0	0	1.146626742	1.805495931	0	0	0	0	0	4.115043029	6.182224953	0.281624108	0	0	0.046947207	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	17.4022
H2256_803_0	2008	3																																D	D						P	P						P	P	P	P	P	P					P			P																																																							0		202.2877115	0						275.1904182	503.8593295						4938.051635	4945.779963	225.2992865			37.5577656					332.2648098			29.95973388														$200 deductible	$200 deductible						$50 per visit	"$0-$50 per visit, max 20%"						$10 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit					$15/exam			$15/ test														200	0						50	43						10	15	15	0	0	15					15			15														3.3715	0	0	0	0	0	0	1.146626742	1.805495931	0	0	0	0	0	4.115043029	6.182224953	0.281624108	0	0	0.046947207	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	17.4022			3.3715	0	0	0	0	0	0	1.146626742	1.805495931	0	0	0	0	0	4.115043029	6.182224953	0.281624108	0	0	0.046947207	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	17.4022																																																																																				0			3.3715	0	0	0	0	0	0	1.146626742	1.805495931	0	0	0	0	0	4.115043029	6.182224953	0.281624108	0	0	0.046947207	0	0	0	0	0.415331012	0	0	0.037449667	0	0	0	0	0	0	0	0	0	0	0	0	0	17.4022
H2261_005_0	2008	7																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O		V	V	V	V	V		V	V																																																				0		1730.156734	107.4293682	2972.023511		395.7190742			339.5736214	442.3301011					1872.110257	5825.278561	6763.439399	297.4672036	493.0717888		216.1640128				301.8073105	227.9359569	158.8692441					412.9286911											"$100 days 1 - 5, $0 days 6+"	"$100 days 1 - 5, $0 days 6+"	"$10/day, days 1-20, $200 max per calendar year"	$0 Co-pay	$0 - $50/day	$0 Co-pay	$0 Co-pay	$0 - $50/visit	$0 - $50/visit	$0 Co-pay	$0 Co-pay	$0 Co-pay	$0 Co-pay	$0 - $30 per visit	"$$0 -10 per visit, no cost for immunization"	$0 - $20 per visit	"$20/Visit 1-10, $30/visit 11-beyond"	$15 per visit	$0 Co-pay	$0 - $20 per visit	$0 Co-pay	$0 Co-pay		$20 visit every six months	$20  exam per calendar year	$0 - $57 contact lenses every 24 mos.	$0 Co-pay	$0 Co-pay		$0 Co-pay	$0 - $20 per visit											47.37335229	17.74588821	4.713853704		14.67529355			39.8158742	41.75643428					6.18136926	7.201622614	15.76807955	21.53195753	15.00392131		9.144982111				19.99979053	20	2.430041783					10.63581708											6.8303	0.15886913	1.16747367	0	0.483941132	0	0	1.126701716	1.539177316	0	0	0	0	0.9643504	3.495954818	8.887204206	0.533754266	0.61650086	0	0.164734669	0	0	0	0.503006916	0.379893261	0.032171575	0	0	0	0	0.365986169	0	0	0	0	0	0	0	0	0	0	27.25			6.8303	0.15886913	1.16747367	0	0.483941132	0	0	1.126701716	1.539177316	0	0	0	0	0.9643504	3.495954818	8.887204206	0.533754266	0.61650086	0	0.164734669	0	0	0	0.503006916	0.379893261	0.032171575	0	0	0	0	0.365986169	0	0	0	0	0	0	0	0	0	0	27.25																																																																																				0			6.8303	0.15886913	1.16747367	0	0.483941132	0	0	1.126701716	1.539177316	0	0	0	0	0.9643504	3.495954818	8.887204206	0.533754266	0.61650086	0	0.164734669	0	0	0	0.503006916	0.379893261	0.032171575	0	0	0	0	0.365986169	0	0	0	0	0	0	0	0	0	0	27.25
H2261_011_0	2008	6																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O		V	V	V	V	V		V	V																																																				0		1730.156734	107.4293682	2972.023511		395.7190742			339.5736214	442.3301011					1872.110257	5825.278561	6763.439399	297.4672036	493.0717888		216.1640128				301.8073105	227.9359569	158.8692441					412.9286911											"$100 days 1 - 5, $0 days 6+"	"$100 days 1 - 5, $0 days 6+"	"$10/day, days 1-20, $200 max per calendar year"	$0 copay	$0 - $50/day	$0 copay	$0 copay	$0 - $50/visit	$0 - $50/visit	$0 copay	$0 copay	$0 copay	$0 copay	$0 - $30 per visit	"$$0 -10 per visit, no cost for immunization"	$0 - $20 per visit	"$20/Visit 1-10, $30/visit 11-beyond"	$15 per visit	$0 copay	$0 - $20 per visit	$0 copay	$0 copay	$0 copay	$20 visit every six months	$20  exam per calendar year	$0 - $57 contact lenses every 24 mos.	$0 copay	$0 copay		$0 copay	$0 - $20 per visit											47.37335229	17.74588821	4.713853704		14.67529355			39.8158742	41.75643428					6.18136926	7.201622614	15.76807955	21.53195753	15.00392131		9.144982111				19.99979053	20	2.430041783					10.63581708											6.8303	0.15886913	1.16747367	0	0.483941132	0	0	1.126701716	1.539177316	0	0	0	0	0.9643504	3.495954818	8.887204206	0.533754266	0.61650086	0	0.164734669	0	0	0	0.503006916	0.379893261	0.032171575	0	0	0	0	0.365986169	0	0	0	0	0	0	0	0	0	0	27.25			6.8303	0.15886913	1.16747367	0	0.483941132	0	0	1.126701716	1.539177316	0	0	0	0	0.9643504	3.495954818	8.887204206	0.533754266	0.61650086	0	0.164734669	0	0	0	0.503006916	0.379893261	0.032171575	0	0	0	0	0.365986169	0	0	0	0	0	0	0	0	0	0	27.25																																																																																				0			6.8303	0.15886913	1.16747367	0	0.483941132	0	0	1.126701716	1.539177316	0	0	0	0	0.9643504	3.495954818	8.887204206	0.533754266	0.61650086	0	0.164734669	0	0	0	0.503006916	0.379893261	0.032171575	0	0	0	0	0.365986169	0	0	0	0	0	0	0	0	0	0	27.25
H2261_801_0	2008	5																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O		V	V	V	V	V		V	V																																																				0		1730.156734	107.4293682	2972.023511		395.7190742			339.5736214	442.3301011					1872.110257	5825.278561	6763.439399	297.4672036	493.0717888		216.1640128				301.8073105	227.9359569	158.8692441					412.9286911											"$100 days 1 - 5, $0 days 6+"	"$100 days 1 - 5, $0 days 6+"	"$10/day, days 1-20, $200 max per calendar year"		$0 - $50/day			$0 - $50/visit	$0 - $50/visit					$0 - $30 per visit	"$$0 -10 per visit, no cost for immunization"	$0 - $20 per visit	"$20/Visit 1-10, $30/visit 11-beyond"	$0 - $15 per visit		$0 - $30 per visit				$20 visit every six months	$20  exam per calendar year	$0 - $57 contact lenses every 24 mos.					$0 - $20 per visit											47.37335229	17.74588821	4.713853704		14.67529355			39.8158742	41.75643428					6.18136926	7.201622614	15.76807955	21.53195753	15.00392131		9.144982111				19.99979053	20	2.430041783					10.63581708											6.8303	0.15886913	1.16747367	0	0.483941132	0	0	1.126701716	1.539177316	0	0	0	0	0.9643504	3.495954818	8.887204206	0.533754266	0.61650086	0	0.164734669	0	0	0	0.503006916	0.379893261	0.032171575	0	0	0	0	0.365986169	0	0	0	0	0	0	0	0	0	0	27.25			6.8303	0.15886913	1.16747367	0	0.483941132	0	0	1.126701716	1.539177316	0	0	0	0	0.9643504	3.495954818	8.887204206	0.533754266	0.61650086	0	0.164734669	0	0	0	0.503006916	0.379893261	0.032171575	0	0	0	0	0.365986169	0	0	0	0	0	0	0	0	0	0	27.25																																																																																				0			6.8303	0.15886913	1.16747367	0	0.483941132	0	0	1.126701716	1.539177316	0	0	0	0	0.9643504	3.495954818	8.887204206	0.533754266	0.61650086	0	0.164734669	0	0	0	0.503006916	0.379893261	0.032171575	0	0	0	0	0.365986169	0	0	0	0	0	0	0	0	0	0	27.25
H2261_809_0	2008	4																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O		V	V	V	V	V		V	V																																																				0		1730.156734	107.4293682	2972.023511		395.7190742			339.5736214	442.3301011					1872.110257	5825.278561	6763.439399	297.4672036	493.0717888		216.1640128				301.8073105	227.9359569	158.8692441					412.9286911											"$100 days 1 - 5, $0 days 6+"	"$100 days 1 - 5, $0 days 6+"	"$10/day, days 1-20, $200 max per calendar year"		$0 - $50/day			$0 - $50/visit	$0 - $50/visit					$0 - $30 per visit	"$$0 -10 per visit, no cost for immunization"	$0 - $20 per visit	"$20/Visit 1-10, $30/visit 11-beyond"	$0 - $15 per visit		$0 - $30 per visit				$20 visit every six months	$20  exam per calendar year	$0 - $57 contact lenses every 24 mos.					$0 - $20 per visit											47.37335229	17.74588821	4.713853704		14.67529355			39.8158742	41.75643428					6.18136926	7.201622614	15.76807955	21.53195753	15.00392131		9.144982111				19.99979053	20	2.430041783					10.63581708											6.8303	0.15886913	1.16747367	0	0.483941132	0	0	1.126701716	1.539177316	0	0	0	0	0.9643504	3.495954818	8.887204206	0.533754266	0.61650086	0	0.164734669	0	0	0	0.503006916	0.379893261	0.032171575	0	0	0	0	0.365986169	0	0	0	0	0	0	0	0	0	0	27.25			6.8303	0.15886913	1.16747367	0	0.483941132	0	0	1.126701716	1.539177316	0	0	0	0	0.9643504	3.495954818	8.887204206	0.533754266	0.61650086	0	0.164734669	0	0	0	0.503006916	0.379893261	0.032171575	0	0	0	0	0.365986169	0	0	0	0	0	0	0	0	0	0	27.25																																																																																				0			6.8303	0.15886913	1.16747367	0	0.483941132	0	0	1.126701716	1.539177316	0	0	0	0	0.9643504	3.495954818	8.887204206	0.533754266	0.61650086	0	0.164734669	0	0	0	0.503006916	0.379893261	0.032171575	0	0	0	0	0.365986169	0	0	0	0	0	0	0	0	0	0	27.25
H2291_002_0	2008	6																					0											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	154.65	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	"4A ER: $25, 4B Urgent Care: $0"	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	10B Transportation: Not Covered	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											0	0	0	0	0	0	0	22.02683479	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.283870833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.2839	0	0	0	0	0	0	0	0	0	0.283870833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.2839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0.283870833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.2839
H2291_003_0	2008	6																					0											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	10B Transportation: Not Covered	16B Non Medicare Covered Comprehensive Dental: No Cost Share	No Cost Share	No Cost Share	No Cost Share	"18B Hearing Aids: No Cost Share, $300 Max every 3 years"	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H2312_004_0	2008	6																					0											A	A	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	V	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	290.9430551	5.299779465	494.6357139	0	362.6388256	18.44982287	0	451.6530508	287.9432187	0	0	0	0	0	3187.163768	2378.602781	247.8734486	4.367875268	0	96.67187646	0	0	0	0	0	0	0	0	0	0	0											1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: $130 days 21-100	6 Home Health: $0	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $50	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $10, 14C Routine Physical Exams: $10, 14D Pap Smears: $10, 14D Pelvic Exams: $10, 14E Prostate Screening: $10, 14F Colorectal Screening: $10, 14G Bone Mass Measurement: $10, 14H Mammography: $10, 14I Diabetes Monitoring: $10"	"7B Chiropractic: $25, 7D Physician Specialist: $25, 7F Podiatry: $25"	"7E Mental Health: $25, 7H Psychiatric: $25, 9C OP Substance Abuse: $25"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7G Other Health Care: $25, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	130	0	50	0.2	0	49.16634945	50	0	0	0	0	0	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0	0											6.0613	0.110412072	5.358553568	0	1.510995106	3.689964574	0	1.850510977	1.199763411	0	0	0	0	0	2.655969807	4.955422461	0.516403018	0.005459844	0	0.201399743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.1162	0	0	6.0613	0.110412072	5.358553568	0	1.510995106	3.689964574	0	1.850510977	1.199763411	0	0	0	0	0	2.655969807	4.955422461	0.516403018	0.005459844	0	0.201399743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.1162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.0613	0.110412072	5.358553568	0	1.510995106	3.689964574	0	1.850510977	1.199763411	0	0	0	0	0	2.655969807	4.955422461	0.516403018	0.005459844	0	0.201399743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.1162
H2312_006_0	2008	7																					0											A	A	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	V	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	290.9430551	5.299779465	494.6357139	0	362.6388256	18.44982287	0	451.6530508	287.9432187	0	0	0	0	0	3187.163768	2378.602781	247.8734486	4.367875268	0	96.67187646	0	0	0	0	0	0	0	0	0	0	0											1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: $130 days 21-100	6 Home Health: $0	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $50	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $10, 14C Routine Physical Exams: $10, 14D Pap Smears: $10, 14D Pelvic Exams: $10, 14E Prostate Screening: $10, 14F Colorectal Screening: $10, 14G Bone Mass Measurement: $10, 14H Mammography: $10, 14I Diabetes Monitoring: $10"	"7B Chiropractic: $25, 7D Physician Specialist: $25, 7F Podiatry: $25"	"7E Mental Health: $25, 7H Psychiatric: $25, 9C OP Substance Abuse: $25"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7G Other Health Care: $25, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	130	0	50	0.2	0	49.16634945	50	0	0	0	0	0	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0	0											6.0613	0.110412072	5.358553568	0	1.510995106	3.689964574	0	1.850510977	1.199763411	0	0	0	0	0	2.655969807	4.955422461	0.516403018	0.005459844	0	0.201399743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.1162	0	0	6.0613	0.110412072	5.358553568	0	1.510995106	3.689964574	0	1.850510977	1.199763411	0	0	0	0	0	2.655969807	4.955422461	0.516403018	0.005459844	0	0.201399743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.1162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.0613	0.110412072	5.358553568	0	1.510995106	3.689964574	0	1.850510977	1.199763411	0	0	0	0	0	2.655969807	4.955422461	0.516403018	0.005459844	0	0.201399743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.1162
H2312_007_0	2008	6																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	327.964297	6.562573803	459.4954704	0	301.6157377	19.314	0	364.9078574	347.5288785	0	0	0	0	336.6657579	4873.4209	5385.740605	226.3523833	485.3912708	604.1936048	1312.393295	0	0	0	0	0	0	0	0	0	0	0											1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: $130 days 21-100	6 Home Health: $0	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $50	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $10, 14C Routine Physical Exams: $10, 14D Pap Smears: $10, 14D Pelvic Exams: $10, 14E Prostate Screening: $10, 14F Colorectal Screening: $10, 14G Bone Mass Measurement: $10, 14H Mammography: $10, 14I Diabetes Monitoring: $10"	"7B Chiropractic: $25, 7D Physician Specialist: $25, 7F Podiatry: $25"	"7E Mental Health: $25, 7H Psychiatric: $25, 9C OP Substance Abuse: $25"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7G Other Health Care: $25, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	130	0	50	0.199999723	0.199998358	49.16634945	50	0	0	0	0	15	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0	0											6.8326	0.136720288	4.977867596	0	1.256732241	3.862794655	0	1.495098936	1.448036994	0	0	0	0	0.420832197	4.061184084	11.22029293	0.471567465	0.606739088	0	2.734152698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5246	0	0	6.8326	0.136720288	4.977867596	0	1.256732241	3.862794655	0	1.495098936	1.448036994	0	0	0	0	0.420832197	4.061184084	11.22029293	0.471567465	0.606739088	0	2.734152698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.8326	0.136720288	4.977867596	0	1.256732241	3.862794655	0	1.495098936	1.448036994	0	0	0	0	0.420832197	4.061184084	11.22029293	0.471567465	0.606739088	0	2.734152698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5246
H2312_008_0	2008	5																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	327.964297	6.562573803	459.4954704	0	301.6157377	19.314	0	364.9078574	347.5288785	0	0	0	0	336.6657579	4873.4209	5385.740605	226.3523833	485.3912708	604.1936048	1312.393295	0	0	0	0	0	0	0	0	0	0	0											1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: $130 days 21-100	6 Home Health: $0	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $50	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $10, 14C Routine Physical Exams: $10, 14D Pap Smears: $10, 14D Pelvic Exams: $10, 14E Prostate Screening: $10, 14F Colorectal Screening: $10, 14G Bone Mass Measurement: $10, 14H Mammography: $10, 14I Diabetes Monitoring: $10"	"7B Chiropractic: $25, 7D Physician Specialist: $25, 7F Podiatry: $25"	"7E Mental Health: $25, 7H Psychiatric: $25, 9C OP Substance Abuse: $25"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7G Other Health Care: $25, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	130	0	50	0.199999723	0.199998358	49.17047978	50	0	0	0	0	15	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0	0											6.8326	0.136720288	4.977867596	0	1.256732241	3.862794655	0	1.495224536	1.448036994	0	0	0	0	0.420832197	4.061184084	11.22029293	0.471567465	0.606739088	0	2.734152698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5247	0	0	6.8326	0.136720288	4.977867596	0	1.256732241	3.862794655	0	1.495224536	1.448036994	0	0	0	0	0.420832197	4.061184084	11.22029293	0.471567465	0.606739088	0	2.734152698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5247	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.8326	0.136720288	4.977867596	0	1.256732241	3.862794655	0	1.495224536	1.448036994	0	0	0	0	0.420832197	4.061184084	11.22029293	0.471567465	0.606739088	0	2.734152698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5247
H2312_009_0	2008	6																					0											A	A	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	V	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	290.9430551	5.299779465	494.6357139	0	362.6388256	18.44982287	0	451.6530508	287.9432187	0	0	0	0	0	3187.163768	2378.602781	247.8734486	4.367875268	0	96.67187646	0	0	0	0	0	0	0	0	0	0	0											1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: $130 days 21-100	6 Home Health: $0	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $50	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $10, 14C Routine Physical Exams: $10, 14D Pap Smears: $10, 14D Pelvic Exams: $10, 14E Prostate Screening: $10, 14F Colorectal Screening: $10, 14G Bone Mass Measurement: $10, 14H Mammography: $10, 14I Diabetes Monitoring: $10"	"7B Chiropractic: $25, 7D Physician Specialist: $25, 7F Podiatry: $25"	"7E Mental Health: $25, 7H Psychiatric: $25, 9C OP Substance Abuse: $25"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7G Other Health Care: $25, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	130	0	50	0.2	0	49.16634945	50	0	0	0	0	0	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0	0											6.0613	0.110412072	5.358553568	0	1.510995106	3.689964574	0	1.850510977	1.199763411	0	0	0	0	0	2.655969807	4.955422461	0.516403018	0.005459844	0	0.201399743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.1162	0	0	6.0613	0.110412072	5.358553568	0	1.510995106	3.689964574	0	1.850510977	1.199763411	0	0	0	0	0	2.655969807	4.955422461	0.516403018	0.005459844	0	0.201399743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.1162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.0613	0.110412072	5.358553568	0	1.510995106	3.689964574	0	1.850510977	1.199763411	0	0	0	0	0	2.655969807	4.955422461	0.516403018	0.005459844	0	0.201399743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.1162
H2312_010_0	2008	6																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	327.964297	6.562573803	459.4954704	0	301.6157377	19.314	0	364.9078574	347.5288785	0	0	0	0	336.6657579	4873.4209	5385.740605	226.3523833	485.3912708	604.1936048	1312.393295	0	0	0	0	0	0	0	0	0	0	0											1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: $130 days 21-100	6 Home Health: $0	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $50	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $10, 14C Routine Physical Exams: $10, 14D Pap Smears: $10, 14D Pelvic Exams: $10, 14E Prostate Screening: $10, 14F Colorectal Screening: $10, 14G Bone Mass Measurement: $10, 14H Mammography: $10, 14I Diabetes Monitoring: $10"	"7B Chiropractic: $25, 7D Physician Specialist: $25, 7F Podiatry: $25"	"7E Mental Health: $25, 7H Psychiatric: $25, 9C OP Substance Abuse: $25"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7G Other Health Care: $25, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	130	0	50	0.199999723	0.199998358	49.17047978	50	0	0	0	0	15	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0	0											6.8326	0.136720288	4.977867596	0	1.256732241	3.862794655	0	1.495224536	1.448036994	0	0	0	0	0.420832197	4.061184084	11.22029293	0.471567465	0.606739088	0	2.734152698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5247	0	0	6.8326	0.136720288	4.977867596	0	1.256732241	3.862794655	0	1.495224536	1.448036994	0	0	0	0	0.420832197	4.061184084	11.22029293	0.471567465	0.606739088	0	2.734152698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5247	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.8326	0.136720288	4.977867596	0	1.256732241	3.862794655	0	1.495224536	1.448036994	0	0	0	0	0.420832197	4.061184084	11.22029293	0.471567465	0.606739088	0	2.734152698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5247
H2312_801_0	2008	2																					0											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	266.3777225	4.990158848	39.94376521	16.55871298	13.7974113	17.66015663	0	26.54935093	35.56835422	2.131953322	27.7233876	0	0.749643432	122.8772033	22.79774388	86.02128279	1.441660939	0.176593271	0	68.19709333	7.762119204	0																				6.93% Medicare Equivalent Coinsurance	6.94% Medicare Equivalent Coinsurance	19.16% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.41% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.13% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance																				0.069299364	0.069374938	0.191602132	0	0.234142423	0.234000446	0.233978206	0.231268868	0.23399998	0.233965326	0.233979262	0.233999802	0.234000025	0.23402667	0.233988983	0.234004798	0.23401001	0.233979468	0.233991978	0.234017211	0.233993589	0.234007861																				18.4598	0.34619196	7.653310588	0	3.230559314	4.132484534	0	6.140038341	8.322994165	0.498803154	6.486697771	0	0.175416582	28.7565427	5.334420914	20.12939294	0.337363091	0.0413192	0	15.95929361	1.816286134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.8209	0	0	18.4598	0.34619196	7.653310588	0	3.230559314	4.132484534	0	6.140038341	8.322994165	0.498803154	6.486697771	0	0.175416582	28.7565427	5.334420914	20.12939294	0.337363091	0.0413192	0	15.95929361	1.816286134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.8209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	0	18.4598	0.34619196	7.653310588	0	3.230559314	4.132484534	0	6.140038341	8.322994165	0.498803154	6.486697771	0	0.175416582	28.7565427	5.334420914	20.12939294	0.337363091	0.0413192	0	15.95929361	1.816286134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.8209
H2312_803_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	266.3777225	4.990158848	39.94376521	16.55871298	13.7974113	17.66015663	0	26.54935093	35.56835422	2.131953322	27.7233876	0	0.749643432	122.8772033	22.79774388	86.02128279	1.441660939	0.176593271	0	68.19709333	7.762119204	0																				6.93% Medicare Equivalent Coinsurance	6.94% Medicare Equivalent Coinsurance	19.16% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.41% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.13% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance																				0.069299364	0.069374938	0.191602132	0	0.234142423	0.234000446	0.233978206	0.231268868	0.23399998	0.233965326	0.233979262	0.233999802	0.234000025	0.23402667	0.233988983	0.234004798	0.23401001	0.233979468	0.233991978	0.234017211	0.233993589	0.234007861																				18.4598	0.34619196	7.653310588	0	3.230559314	4.132484534	0	6.140038341	8.322994165	0.498803154	6.486697771	0	0.175416582	28.7565427	5.334420914	20.12939294	0.337363091	0.0413192	0	15.95929361	1.816286134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.8209	0	0	18.4598	0.34619196	7.653310588	0	3.230559314	4.132484534	0	6.140038341	8.322994165	0.498803154	6.486697771	0	0.175416582	28.7565427	5.334420914	20.12939294	0.337363091	0.0413192	0	15.95929361	1.816286134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.8209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	0	18.4598	0.34619196	7.653310588	0	3.230559314	4.132484534	0	6.140038341	8.322994165	0.498803154	6.486697771	0	0.175416582	28.7565427	5.334420914	20.12939294	0.337363091	0.0413192	0	15.95929361	1.816286134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.8209
H2312_804_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	266.3777225	4.990158848	39.94376521	16.55871298	13.7974113	17.66015663	0	26.54935093	35.56835422	2.131953322	27.7233876	0	0.749643432	122.8772033	22.79774388	86.02128279	1.441660939	0.176593271	0	68.19709333	7.762119204	0																				6.93% Medicare Equivalent Coinsurance	6.94% Medicare Equivalent Coinsurance	19.16% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.41% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.13% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance																				0.069299364	0.069374938	0.191602132	0	0.234142423	0.234000446	0.233978206	0.231268868	0.23399998	0.233965326	0.233979262	0.233999802	0.234000025	0.23402667	0.233988983	0.234004798	0.23401001	0.233979468	0.233991978	0.234017211	0.233993589	0.234007861																				18.4598	0.34619196	7.653310588	0	3.230559314	4.132484534	0	6.140038341	8.322994165	0.498803154	6.486697771	0	0.175416582	28.7565427	5.334420914	20.12939294	0.337363091	0.0413192	0	15.95929361	1.816286134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.8209	0	0	18.4598	0.34619196	7.653310588	0	3.230559314	4.132484534	0	6.140038341	8.322994165	0.498803154	6.486697771	0	0.175416582	28.7565427	5.334420914	20.12939294	0.337363091	0.0413192	0	15.95929361	1.816286134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.8209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	0	18.4598	0.34619196	7.653310588	0	3.230559314	4.132484534	0	6.140038341	8.322994165	0.498803154	6.486697771	0	0.175416582	28.7565427	5.334420914	20.12939294	0.337363091	0.0413192	0	15.95929361	1.816286134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.8209
H2312_805_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	290.0942671	4.294803758	42.27358604	48.72219974	11.74137973	20.10020778	3.3292	18.07447685	30.00997226	4.902980302	26.95648971	0.3864	0.306859363	83.01948247	34.10664973	102.6370065	2.698262471	1.822385177	11.4492	66.20109753	9.466609418	0																				6.94% Medicare Equivalent Coinsurance	6.94% Medicare Equivalent Coinsurance	19.12% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.39% Medicare Equivalent Coinsurance	23.11% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.39% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance																				0.069383914	0.069377457	0.191223119	0	0.234033956	0.234000222	0.23391859	0.23106653	0.234000021	0.233941028	0.234014474	0.23399981	0.233999974	0.234021964	0.233990662	0.233997815	0.233989907	0.234033614	0.234000779	0.234016153	0.23399413	0.234008879																				20.1279	0.297962564	8.083686963	0	2.747881546	4.703453084	0.77876177	4.176406655	7.022334154	1.14700825	6.308208773	0.090417527	0.071805083	19.42838232	7.980637543	24.01683525	0.631366185	0.426499389	2.679121718	15.49212614	2.215131039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4259	0	0	20.1279	0.297962564	8.083686963	0	2.747881546	4.703453084	0.77876177	4.176406655	7.022334154	1.14700825	6.308208773	0.090417527	0.071805083	19.42838232	7.980637543	24.01683525	0.631366185	0.426499389	2.679121718	15.49212614	2.215131039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	0	20.1279	0.297962564	8.083686963	0	2.747881546	4.703453084	0.77876177	4.176406655	7.022334154	1.14700825	6.308208773	0.090417527	0.071805083	19.42838232	7.980637543	24.01683525	0.631366185	0.426499389	2.679121718	15.49212614	2.215131039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4259
H2312_807_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	290.0942671	4.294803758	42.27358604	48.72219974	11.74137973	20.10020778	3.3292	18.07447685	30.00997226	4.902980302	26.95648971	0.3864	0.306859363	83.01948247	34.10664973	102.6370065	2.698262471	1.822385177	11.4492	66.20109753	9.466609418	0																				6.94% Medicare Equivalent Coinsurance	6.94% Medicare Equivalent Coinsurance	19.12% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.39% Medicare Equivalent Coinsurance	23.11% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.39% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance																				0.069383914	0.069377457	0.191223119	0	0.234033956	0.234000222	0.23391859	0.23106653	0.234000021	0.233941028	0.234014474	0.23399981	0.233999974	0.234021964	0.233990662	0.233997815	0.233989907	0.234033614	0.234000779	0.234016153	0.23399413	0.234008879																				20.1279	0.297962564	8.083686963	0	2.747881546	4.703453084	0.77876177	4.176406655	7.022334154	1.14700825	6.308208773	0.090417527	0.071805083	19.42838232	7.980637543	24.01683525	0.631366185	0.426499389	2.679121718	15.49212614	2.215131039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4259	0	0	20.1279	0.297962564	8.083686963	0	2.747881546	4.703453084	0.77876177	4.176406655	7.022334154	1.14700825	6.308208773	0.090417527	0.071805083	19.42838232	7.980637543	24.01683525	0.631366185	0.426499389	2.679121718	15.49212614	2.215131039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	0	20.1279	0.297962564	8.083686963	0	2.747881546	4.703453084	0.77876177	4.176406655	7.022334154	1.14700825	6.308208773	0.090417527	0.071805083	19.42838232	7.980637543	24.01683525	0.631366185	0.426499389	2.679121718	15.49212614	2.215131039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4259
H2312_808_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	290.0942671	4.294803758	42.27358604	48.72219974	11.74137973	20.10020778	3.3292	18.07447685	30.00997226	4.902980302	26.95648971	0.3864	0.306859363	83.01948247	34.10664973	102.6370065	2.698262471	1.822385177	11.4492	66.20109753	9.466609418	0																				6.94% Medicare Equivalent Coinsurance	6.94% Medicare Equivalent Coinsurance	19.12% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.39% Medicare Equivalent Coinsurance	23.11% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.39% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance																				0.069383914	0.069377457	0.191223119	0	0.234033956	0.234000222	0.23391859	0.23106653	0.234000021	0.233941028	0.234014474	0.23399981	0.233999974	0.234021964	0.233990662	0.233997815	0.233989907	0.234033614	0.234000779	0.234016153	0.23399413	0.234008879																				20.1279	0.297962564	8.083686963	0	2.747881546	4.703453084	0.77876177	4.176406655	7.022334154	1.14700825	6.308208773	0.090417527	0.071805083	19.42838232	7.980637543	24.01683525	0.631366185	0.426499389	2.679121718	15.49212614	2.215131039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4259	0	0	20.1279	0.297962564	8.083686963	0	2.747881546	4.703453084	0.77876177	4.176406655	7.022334154	1.14700825	6.308208773	0.090417527	0.071805083	19.42838232	7.980637543	24.01683525	0.631366185	0.426499389	2.679121718	15.49212614	2.215131039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	0	20.1279	0.297962564	8.083686963	0	2.747881546	4.703453084	0.77876177	4.176406655	7.022334154	1.14700825	6.308208773	0.090417527	0.071805083	19.42838232	7.980637543	24.01683525	0.631366185	0.426499389	2.679121718	15.49212614	2.215131039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4259
H2319_008_3	2008	6																					4000											A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	48.92942841	4.035789061	124.0758231	0	308.0690267	18.96292708	0	192.7215674	28.73695012	43.41688638	462.1102934	0	0	883.7875909	2055.476953	0	166.6679382	0	865.9958898	3463.837023	0	0	0	0	0	0	0	0	0	0	928.9661143											"$165 copay for days 1-5 (PBP Section B-01, #1a)"	"$165 copay for days 1-5 (PBP Section B-01,#1b)"	"$100 for days 11-100 (PBP Section B-02,#2)"	"no cost sharing  (PBP Section B-06,#6)"	"$50 copay (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$100 copay (PBP Section B-09,#9a & #9b)"	"$0 copay (PBP Section B-08,#8a)"	"$25 copay (PBP Section B-08,#8b)"	"$0 copay (PBP Section B-05,#5)"	"$25 copay (PBP Section B-12, #12)"	"$25 copay (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"$25 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$25 copay (PBP Section B-07,#7b, #7d & #7f)"	"$25 copay (PBP Section B-07,#7e & #7h)"	"$25 copay (PBP Section B-07,#7c & #7i)"	"$25 copay (PBP Section B-07,#7d)"	"$25 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes), cost sharing included in net allowed PMPM"											699.6	699.6	100	0	50	0.015	0	50	100	25	25	0	0	25	25	0	25	0	25	25	0	0	0	0	0	0	0	0	0	0	1.862088219											2.8526	0.235286502	1.033965193	0	1.283620944	0.284443906	0	0.803006531	0.239474584	0.090451847	0.962729778	0	0	1.841224148	4.282243653	0	0.347224871	0	1.804158104	7.216327131	0	0	0	0	0	0	0	0	0	0	0.144151405	0	0	0	0	0	0	0	0	0	0	23.4209		2.36	2.8526	0.235286502	1.033965193	0	1.283620944	0.284443906	0	0.803006531	0.239474584	0.090451847	0.962729778	0	0	1.841224148	4.282243653	0	0.347224871	0	1.804158104	7.216327131	0	0	0	0	0	0	0	0	0	0	0.144151405	0	0	0	0	0	0	0	0	0	0	23.4209																																																																																				0		0	2.8526	0.235286502	1.033965193	0	1.283620944	0.284443906	0	0.803006531	0.239474584	0.090451847	0.962729778	0	0	1.841224148	4.282243653	0	0.347224871	0	1.804158104	7.216327131	0	0	0	0	0	0	0	0	0	0	0.144151405	0	0	0	0	0	0	0	0	0	0	23.4209
H2319_008_4	2008	4																					4000											A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	54.12744786	4.464531246	179.4294725	0	293.0709901	18.55129323	0	169.7755523	24.73886635	37.37642808	566.5314854	0	0	933.5240938	2519.944759	0	205.2487494	0	914.7311375	3658.769767	0	0	0	0	0	0	0	0	0	0	928.9661143											"$165 copay for days 1-5 (PBP Section B-01, #1a)"	"$165 copay for days 1-5 (PBP Section B-01,#1b)"	"$100 for days 11-100 (PBP Section B-02,#2)"	"no cost sharing  (PBP Section B-06,#6)"	"$50 copay (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$100 copay (PBP Section B-09,#9a & #9b)"	"$0 copay (PBP Section B-08,#8a)"	"$25 copay (PBP Section B-08,#8b)"	"$0 copay (PBP Section B-05,#5)"	"$25 copay (PBP Section B-12, #12)"	"$25 copay (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"$25 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$25 copay (PBP Section B-07,#7b, #7d & #7f)"	"$25 copay (PBP Section B-07,#7e & #7h)"	"$25 copay (PBP Section B-07,#7c & #7i)"	"$25 copay (PBP Section B-07,#7d)"	"$25 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes), cost sharing included in net allowed PMPM"											699.6	699.6	100	0	50	0.015	0	50	100	25	25	0	0	25	25	0	25	0	25	25	0	0	0	0	0	0	0	0	0	0	1.862088219											3.1556	0.260282172	1.495245604	0	1.221129125	0.278269398	0	0.707398135	0.20615722	0.077867558	1.180273928	0	0	1.944841862	5.249884914	0	0.427601561	0	1.90568987	7.622437015	0	0	0	0	0	0	0	0	0	0	0.144151405	0	0	0	0	0	0	0	0	0	0	25.8769		2.6	3.1556	0.260282172	1.495245604	0	1.221129125	0.278269398	0	0.707398135	0.20615722	0.077867558	1.180273928	0	0	1.944841862	5.249884914	0	0.427601561	0	1.90568987	7.622437015	0	0	0	0	0	0	0	0	0	0	0.144151405	0	0	0	0	0	0	0	0	0	0	25.8769																																																																																				0		0	3.1556	0.260282172	1.495245604	0	1.221129125	0.278269398	0	0.707398135	0.20615722	0.077867558	1.180273928	0	0	1.944841862	5.249884914	0	0.427601561	0	1.90568987	7.622437015	0	0	0	0	0	0	0	0	0	0	0.144151405	0	0	0	0	0	0	0	0	0	0	25.8769
H2319_008_5	2008	5																					4000											A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	57.96110024	4.78073793	140.6781173	0	348.9832918	21.16998967	0	168.1787466	24.40536839	36.87256658	642.5880682	0	0	1007.014083	2858.246146	0	229.7813632	0	986.7416856	3946.799775	0	0	0	0	0	0	0	0	0	0	928.9661143											"$165 copay for days 1-5 (PBP Section B-01, #1a)"	"$165 copay for days 1-5 (PBP Section B-01,#1b)"	"$100 for days 11-100 (PBP Section B-02,#2)"	"no cost sharing  (PBP Section B-06,#6)"	"$50 copay (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$100 copay (PBP Section B-09,#9a & #9b)"	"$0 copay (PBP Section B-08,#8a)"	"$25 copay (PBP Section B-08,#8b)"	"$0 copay (PBP Section B-05,#5)"	"$25 copay (PBP Section B-12, #12)"	"$25 copay (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"$25 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$25 copay (PBP Section B-07,#7b, #7d & #7f)"	"$25 copay (PBP Section B-07,#7e & #7h)"	"$25 copay (PBP Section B-07,#7c & #7i)"	"$25 copay (PBP Section B-07,#7d)"	"$25 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes), cost sharing included in net allowed PMPM"											699.6	699.6	100	0	50	0.015	0	50	100	25	25	0	0	25	25	0	25	0	25	25	0	0	0	0	0	0	0	0	0	0	1.862088219											3.3791	0.278717021	1.172317644	0	1.454097049	0.317549845	0	0.700744778	0.20337807	0.076817847	1.338725142	0	0	2.097946007	5.95467947	0	0.478711173	0	2.055711845	8.22249953	0	0	0	0	0	0	0	0	0	0	0.144151405	0	0	0	0	0	0	0	0	0	0	27.8752		2.8	3.3791	0.278717021	1.172317644	0	1.454097049	0.317549845	0	0.700744778	0.20337807	0.076817847	1.338725142	0	0	2.097946007	5.95467947	0	0.478711173	0	2.055711845	8.22249953	0	0	0	0	0	0	0	0	0	0	0.144151405	0	0	0	0	0	0	0	0	0	0	27.8752																																																																																				0		0	3.3791	0.278717021	1.172317644	0	1.454097049	0.317549845	0	0.700744778	0.20337807	0.076817847	1.338725142	0	0	2.097946007	5.95467947	0	0.478711173	0	2.055711845	8.22249953	0	0	0	0	0	0	0	0	0	0	0.144151405	0	0	0	0	0	0	0	0	0	0	27.8752
H2319_008_7	2008	7																					4000											A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	68.94443902	5.686663872	191.374212	0	374.8270439	23.35283362	0	164.6583059	23.27572832	35.16586303	883.3105303	0	0	1152.068556	3928.985058	0	318.3090305	0	1128.876039	4515.313136	0	0	0	0	0	0	0	0	0	0	928.9661143											"$165 copay for days 1-5 (PBP Section B-01, #1a)"	"$165 copay for days 1-5 (PBP Section B-01,#1b)"	"$100 for days 11-100 (PBP Section B-02,#2)"	"no cost sharing  (PBP Section B-06,#6)"	"$50 copay (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$100 copay (PBP Section B-09,#9a & #9b)"	"$0 copay (PBP Section B-08,#8a)"	"$25 copay (PBP Section B-08,#8b)"	"$0 copay (PBP Section B-05,#5)"	"$25 copay (PBP Section B-12, #12)"	"$25 copay (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"$25 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$25 copay (PBP Section B-07,#7b, #7d & #7f)"	"$25 copay (PBP Section B-07,#7e & #7h)"	"$25 copay (PBP Section B-07,#7c & #7i)"	"$25 copay (PBP Section B-07,#7d)"	"$25 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes), cost sharing included in net allowed PMPM"											699.6	699.6	100	0	50	0.015	0	50	100	25	25	0	0	25	25	0	25	0	25	25	0	0	0	0	0	0	0	0	0	0	1.862088219											4.0195	0.331532504	1.5947851	0	1.56177935	0.350292504	0	0.686076274	0.193964403	0.073262215	1.840230272	0	0	2.400142826	8.185385538	0	0.663143814	0	2.351825081	9.406902367	0	0	0	0	0	0	0	0	0	0	0.144151405	0	0	0	0	0	0	0	0	0	0	33.8029		0	4.0195	0.331532504	1.5947851	0	1.56177935	0.350292504	0	0.686076274	0.193964403	0.073262215	1.840230272	0	0	2.400142826	8.185385538	0	0.663143814	0	2.351825081	9.406902367	0	0	0	0	0	0	0	0	0	0	0.144151405	0	0	0	0	0	0	0	0	0	0	33.8029	0																																																																																			0		3.4	4.0195	0.331532504	1.5947851	0	1.56177935	0.350292504	0	0.686076274	0.193964403	0.073262215	1.840230272	0	0	2.400142826	8.185385538	0	0.663143814	0	2.351825081	9.406902367	0	0	0	0	0	0	0	0	0	0	0.144151405	0	0	0	0	0	0	0	0	0	0	33.8029
H2319_008_8	2008	7																					4000											A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	47.61318061	3.927222527	128.8820875	0	289.3534152	18.77517433	0	161.6316376	23.51444243	35.52652147	535.1694916	0	0	913.6692383	2380.445907	0	191.7974102	0	895.275984	3580.952445	0	0	0	0	0	0	0	0	0	0	928.9661143											"$165 copay for days 1-5 (PBP Section B-01, #1a)"	"$165 copay for days 1-5 (PBP Section B-01,#1b)"	"$100 for days 11-100 (PBP Section B-02,#2)"	"no cost sharing  (PBP Section B-06,#6)"	"$50 copay (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$100 copay (PBP Section B-09,#9a & #9b)"	"$0 copay (PBP Section B-08,#8a)"	"$25 copay (PBP Section B-08,#8b)"	"$0 copay (PBP Section B-05,#5)"	"$25 copay (PBP Section B-12, #12)"	"$25 copay (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"$25 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$25 copay (PBP Section B-07,#7b, #7d & #7f)"	"$25 copay (PBP Section B-07,#7e & #7h)"	"$25 copay (PBP Section B-07,#7c & #7i)"	"$25 copay (PBP Section B-07,#7d)"	"$25 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes), cost sharing included in net allowed PMPM"											699.6	699.6	100	0	50	0.015	0	50	100	25	25	0	0	25	25	0	25	0	25	25	0	0	0	0	0	0	0	0	0	0	1.862088219											2.7758	0.228957073	1.074017396	0	1.20563923	0.281627615	0	0.673465157	0.195953687	0.074013586	1.114936441	0	0	1.90347758	4.959262305	0	0.399577938	0	1.8651583	7.460317594	0	0	0	0	0	0	0	0	0	0	0.144151405	0	0	0	0	0	0	0	0	0	0	24.3564		2.45	2.7758	0.228957073	1.074017396	0	1.20563923	0.281627615	0	0.673465157	0.195953687	0.074013586	1.114936441	0	0	1.90347758	4.959262305	0	0.399577938	0	1.8651583	7.460317594	0	0	0	0	0	0	0	0	0	0	0.144151405	0	0	0	0	0	0	0	0	0	0	24.3564																																																																																				0		0	2.7758	0.228957073	1.074017396	0	1.20563923	0.281627615	0	0.673465157	0.195953687	0.074013586	1.114936441	0	0	1.90347758	4.959262305	0	0.399577938	0	1.8651583	7.460317594	0	0	0	0	0	0	0	0	0	0	0.144151405	0	0	0	0	0	0	0	0	0	0	24.3564
H2319_009_1	2008	5																																A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	0	0	171.5679997	0	532.7539513	25.07552135	0	335.1982128	35.92446409	1859.709958	1237.918315	0	0	2043.847264	3007.280921	0	281.8708291	0	1418.126895	9899.482741	0	0	0	0	0	0	0	0	0	0	1024.307143											"no cost sharing (PBP Section B-01, #1a)"	"no cost sharing  (PBP Section B-01,#1b)"	"$100  for days 11-100 (PBP Section B-02,#2)"	"no cost sharing  (PBP Section B-06,#6)"	"$50 copay per trip (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$15 copay (PBP Section B-09,#9a & #9b)"	"$0 copay (PBP Section B-08,#8a)"	"$15 copay (PBP Section B-08,#8b)"	"$0 copay (PBP Section B-05,#5)"	"$15 copay (PBP Section B-12, #12)"	"$15 copay (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"$15 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$15 copay (PBP Section B-07,#7b, #7d & #7f)"	"$15 copay (PBP Section B-07,#7e & #7h)"	"$15 copay (PBP Section B-07,#7c & #7i)"	"$15 copay (PBP Section B-07,#7d)"	"$15 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes), cost sharing included in net allowed PMPM"											0	0	100	0	50	0.015	0	50	15	15	15	0	0	15	15	0	15	0	15	15	0	0	0	0	0	0	0	0	0	0	1.644630865	0	0	0	0	0	0	0	0	0	0	0	0	1.429733331	0	2.21980813	0.37613282	0	1.39665922	0.04490558	2.324637447	1.547397894	0	0	2.55480908	3.759101151	0	0.352338536	0	1.772658619	12.37435343	0	0	0	0	0	0	0	0	0	0	0.140383929	0	0	0	0	0	0	0	0	0	0	30.2929			0	0	1.429733331	0	2.21980813	0.37613282	0	1.39665922	0.04490558	2.324637447	1.547397894	0	0	2.55480908	3.759101151	0	0.352338536	0	1.772658619	12.37435343	0	0	0	0	0	0	0	0	0	0	0.140383929	0	0	0	0	0	0	0	0	0	0	30.2929																																																																																				0		0	0	0	1.429733331	0	2.21980813	0.37613282	0	1.39665922	0.04490558	2.324637447	1.547397894	0	0	2.55480908	3.759101151	0	0.352338536	0	1.772658619	12.37435343	0	0	0	0	0	0	0	0	0	0	0.140383929	0	0	0	0	0	0	0	0	0	0	30.2929
H2319_009_2	2008	5																																A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	0	0	175.4847511	0	509.4643532	24.40227608	0	327.0521493	34.80963242	1801.998212	1199.502417	0	0	1980.421247	3004.473853	0	281.6077241	0	1416.803181	9890.242325	0	0	0	0	0	0	0	0	0	0	1024.307143											"no cost sharing (PBP Section B-01, #1a)"	"no cost sharing  (PBP Section B-01,#1b)"	"$100  for days 11-100 (PBP Section B-02,#2)"	"no cost sharing  (PBP Section B-06,#6)"	"$50 copay per trip (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$15 copay (PBP Section B-09,#9a & #9b)"	"$0 copay (PBP Section B-08,#8a)"	"$15 copay (PBP Section B-08,#8b)"	"$0 copay (PBP Section B-05,#5)"	"$15 copay (PBP Section B-12, #12)"	"$15 copay (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"$15 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$15 copay (PBP Section B-07,#7b, #7d & #7f)"	"$15 copay (PBP Section B-07,#7e & #7h)"	"$15 copay (PBP Section B-07,#7c & #7i)"	"$15 copay (PBP Section B-07,#7d)"	"$15 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes), cost sharing included in net allowed PMPM"											0	0	100	0	50	0.015	0	50	15	15	15	0	0	15	15	0	15	0	15	15	0	0	0	0	0	0	0	0	0	0	1.644630865	0	0	0	0	0	0	0	0	0	0	0	0	1.462372926	0	2.122768138	0.366034141	0	1.362717289	0.043512041	2.252497764	1.499378022	0	0	2.475526559	3.755592316	0	0.352009655	0	1.771003977	12.36280291	0	0	0	0	0	0	0	0	0	0	0.140383929	0	0	0	0	0	0	0	0	0	0	29.9666			0	0	1.462372926	0	2.122768138	0.366034141	0	1.362717289	0.043512041	2.252497764	1.499378022	0	0	2.475526559	3.755592316	0	0.352009655	0	1.771003977	12.36280291	0	0	0	0	0	0	0	0	0	0	0.140383929	0	0	0	0	0	0	0	0	0	0	29.9666																																																																																				0		0	0	0	1.462372926	0	2.122768138	0.366034141	0	1.362717289	0.043512041	2.252497764	1.499378022	0	0	2.475526559	3.755592316	0	0.352009655	0	1.771003977	12.36280291	0	0	0	0	0	0	0	0	0	0	0.140383929	0	0	0	0	0	0	0	0	0	0	29.9666
H2319_009_3	2008	6																																A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	0	0	161.2184543	0	535.4094754	24.32789652	0	380.444693	41.6980012	2158.589976	1436.868182	0	0	2372.320585	2506.024432	0	234.888327	0	1181.752134	8249.427395	0	0	0	0	0	0	0	0	0	0	1024.307143											"no cost sharing (PBP Section B-01, #1a)"	"no cost sharing  (PBP Section B-01,#1b)"	"$100  for days 11-100 (PBP Section B-02,#2)"	"no cost sharing  (PBP Section B-06,#6)"	"$50 copay per trip (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$15 copay (PBP Section B-09,#9a & #9b)"	"$0 copay (PBP Section B-08,#8a)"	"$15 copay (PBP Section B-08,#8b)"	"$0 copay (PBP Section B-05,#5)"	"$15 copay (PBP Section B-12, #12)"	"$15 copay (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"$15 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$15 copay (PBP Section B-07,#7b, #7d & #7f)"	"$15 copay (PBP Section B-07,#7e & #7h)"	"$15 copay (PBP Section B-07,#7c & #7i)"	"$15 copay (PBP Section B-07,#7d)"	"$15 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes), cost sharing included in net allowed PMPM"											0	0	100	0	50	0.015	0	50	15	15	15	0	0	15	15	0	15	0	15	15	0	0	0	0	0	0	0	0	0	0	1.644630865	0	0	0	0	0	0	0	0	0	0	0	0	1.343487119	0	2.230872814	0.364918448	0	1.585186221	0.052122502	2.698237469	1.796085227	0	0	2.965400732	3.13253054	0	0.293610409	0	1.477190168	10.31178424	0	0	0	0	0	0	0	0	0	0	0.140383929	0	0	0	0	0	0	0	0	0	0	28.3918			0	0	1.343487119	0	2.230872814	0.364918448	0	1.585186221	0.052122502	2.698237469	1.796085227	0	0	2.965400732	3.13253054	0	0.293610409	0	1.477190168	10.31178424	0	0	0	0	0	0	0	0	0	0	0.140383929	0	0	0	0	0	0	0	0	0	0	28.3918																																																																																				0		0	0	0	1.343487119	0	2.230872814	0.364918448	0	1.585186221	0.052122502	2.698237469	1.796085227	0	0	2.965400732	3.13253054	0	0.293610409	0	1.477190168	10.31178424	0	0	0	0	0	0	0	0	0	0	0.140383929	0	0	0	0	0	0	0	0	0	0	28.3918
H2319_009_4	2008	5																																A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	0	0	253.0563566	0	552.8492574	25.83266772	0	364.2145894	38.96280728	2016.996565	1342.616347	0	0	2216.707446	3333.675007	0	312.4635718	0	1572.042756	10973.91932	0	0	0	0	0	0	0	0	0	0	1024.307143											"no cost sharing (PBP Section B-01, #1a)"	"no cost sharing  (PBP Section B-01,#1b)"	"$100  for days 11-100 (PBP Section B-02,#2)"	"no cost sharing  (PBP Section B-06,#6)"	"$50 copay per trip (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$15 copay (PBP Section B-09,#9a & #9b)"	"$0 copay (PBP Section B-08,#8a)"	"$15 copay (PBP Section B-08,#8b)"	"$0 copay (PBP Section B-05,#5)"	"$15 copay (PBP Section B-12, #12)"	"$15 copay (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"$15 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$15 copay (PBP Section B-07,#7b, #7d & #7f)"	"$15 copay (PBP Section B-07,#7e & #7h)"	"$15 copay (PBP Section B-07,#7c & #7i)"	"$15 copay (PBP Section B-07,#7d)"	"$15 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes), cost sharing included in net allowed PMPM"											0	0	100	0	50	0.015	0	50	15	15	15	0	0	15	15	0	15	0	15	15	0	0	0	0	0	0	0	0	0	0	1.644630865	0	0	0	0	0	0	0	0	0	0	0	0	2.108802972	0	2.303538572	0.387490016	0	1.517560789	0.048703509	2.521245707	1.678270434	0	0	2.770884308	4.167093759	0	0.390579465	0	1.965053445	13.71739915	0	0	0	0	0	0	0	0	0	0	0.140383929	0	0	0	0	0	0	0	0	0	0	33.717			0	0	2.108802972	0	2.303538572	0.387490016	0	1.517560789	0.048703509	2.521245707	1.678270434	0	0	2.770884308	4.167093759	0	0.390579465	0	1.965053445	13.71739915	0	0	0	0	0	0	0	0	0	0	0.140383929	0	0	0	0	0	0	0	0	0	0	33.717																																																																																				0		0	0	0	2.108802972	0	2.303538572	0.387490016	0	1.517560789	0.048703509	2.521245707	1.678270434	0	0	2.770884308	4.167093759	0	0.390579465	0	1.965053445	13.71739915	0	0	0	0	0	0	0	0	0	0	0.140383929	0	0	0	0	0	0	0	0	0	0	33.717
H2319_009_5	2008	6																																A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	0	0	187.2702163	0	621.3799387	27.82495096	0	340.6156632	36.28060393	1878.146331	1250.19051	0	0	2064.109096	3565.51092	0	334.1934277	0	1681.36834	11737.08567	0	0	0	0	0	0	0	0	0	0	1024.307143											"no cost sharing (PBP Section B-01, #1a)"	"no cost sharing  (PBP Section B-01,#1b)"	"$100  for days 11-100 (PBP Section B-02,#2)"	"no cost sharing  (PBP Section B-06,#6)"	"$50 copay per trip (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$15 copay (PBP Section B-09,#9a & #9b)"	"$0 copay (PBP Section B-08,#8a)"	"$15 copay (PBP Section B-08,#8b)"	"$0 copay (PBP Section B-05,#5)"	"$15 copay (PBP Section B-12, #12)"	"$15 copay (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"$15 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$15 copay (PBP Section B-07,#7b, #7d & #7f)"	"$15 copay (PBP Section B-07,#7e & #7h)"	"$15 copay (PBP Section B-07,#7c & #7i)"	"$15 copay (PBP Section B-07,#7d)"	"$15 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes), cost sharing included in net allowed PMPM"											0	0	100	0	50	0.015	0	50	15	15	15	0	0	15	15	0	15	0	15	15	0	0	0	0	0	0	0	0	0	0	1.644630865	0	0	0	0	0	0	0	0	0	0	0	0	1.560585136	0	2.589083078	0.417374264	0	1.41923193	0.045350755	2.347682913	1.562738138	0	0	2.580136369	4.45688865	0	0.417741785	0	2.101710425	14.67135709	0	0	0	0	0	0	0	0	0	0	0.140383929	0	0	0	0	0	0	0	0	0	0	34.3103			0	0	1.560585136	0	2.589083078	0.417374264	0	1.41923193	0.045350755	2.347682913	1.562738138	0	0	2.580136369	4.45688865	0	0.417741785	0	2.101710425	14.67135709	0	0	0	0	0	0	0	0	0	0	0.140383929	0	0	0	0	0	0	0	0	0	0	34.3103																																																																																				0		0	0	0	1.560585136	0	2.589083078	0.417374264	0	1.41923193	0.045350755	2.347682913	1.562738138	0	0	2.580136369	4.45688865	0	0.417741785	0	2.101710425	14.67135709	0	0	0	0	0	0	0	0	0	0	0.140383929	0	0	0	0	0	0	0	0	0	0	34.3103
H2319_009_6	2008	4																																A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	0	0	254.2944772	0	666.1850141	30.63830215	0	333.3255956	34.53852347	1787.963653	1190.160295	0	0	1964.997071	4887.161663	0	458.0710436	0	2304.611899	16087.74631	0	0	0	0	0	0	0	0	0	0	1024.307143											"no cost sharing (PBP Section B-01, #1a)"	"no cost sharing  (PBP Section B-01,#1b)"	"$100  for days 11-100 (PBP Section B-02,#2)"	"no cost sharing  (PBP Section B-06,#6)"	"$50 copay per trip (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$15 copay (PBP Section B-09,#9a & #9b)"	"$0 copay (PBP Section B-08,#8a)"	"$15 copay (PBP Section B-08,#8b)"	"$0 copay (PBP Section B-05,#5)"	"$15 copay (PBP Section B-12, #12)"	"$15 copay (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"$15 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$15 copay (PBP Section B-07,#7b, #7d & #7f)"	"$15 copay (PBP Section B-07,#7e & #7h)"	"$15 copay (PBP Section B-07,#7c & #7i)"	"$15 copay (PBP Section B-07,#7d)"	"$15 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes), cost sharing included in net allowed PMPM"											0	0	100	0	50	0.015	0	50	15	15	15	0	0	15	15	0	15	0	15	15	0	0	0	0	0	0	0	0	0	0	1.644630865	0	0	0	0	0	0	0	0	0	0	0	0	2.119120644	0	2.775770892	0.459574532	0	1.388856648	0.043173154	2.234954566	1.487700369	0	0	2.456246338	6.108952079	0	0.572588804	0	2.880764874	20.10968289	0	0	0	0	0	0	0	0	0	0	0.140383929	0	0	0	0	0	0	0	0	0	0	42.7778			0	0	2.119120644	0	2.775770892	0.459574532	0	1.388856648	0.043173154	2.234954566	1.487700369	0	0	2.456246338	6.108952079	0	0.572588804	0	2.880764874	20.10968289	0	0	0	0	0	0	0	0	0	0	0.140383929	0	0	0	0	0	0	0	0	0	0	42.7778																																																																																				0		0	0	0	2.119120644	0	2.775770892	0.459574532	0	1.388856648	0.043173154	2.234954566	1.487700369	0	0	2.456246338	6.108952079	0	0.572588804	0	2.880764874	20.10968289	0	0	0	0	0	0	0	0	0	0	0.140383929	0	0	0	0	0	0	0	0	0	0	42.7778
H2319_010_1	2008	4																																A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	0	0	147.2325926	0	548.8906676	25.83504002	0	345.3511144	37.01258907	1916.039173	1275.413929	0	0	2105.753859	3098.369197	0	290.4084844	0	1461.080892	10199.33062	0	0	0	0	0	0	0	0	0	0	1024.55119											"no cost sharing (PBP Section B-01, #1a)"	"no cost sharing  (PBP Section B-01,#1b)"	"$100  for days 21-100 (PBP Section B-02,#2)"	"no cost sharing  (PBP Section B-06,#6)"	"$50 copay per trip (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$15 copay (PBP Section B-09,#9a & #9b)"	"$0 copay (PBP Section B-08,#8a)"	"$15 copay (PBP Section B-08,#8b)"	"$0 copay (PBP Section B-05,#5)"	"$15 copay (PBP Section B-12, #12)"	"$15 copay (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"$15 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$15 copay (PBP Section B-07,#7b, #7d & #7f)"	"$15 copay (PBP Section B-07,#7e & #7h)"	"$15 copay (PBP Section B-07,#7c & #7i)"	"$15 copay (PBP Section B-07,#7d)"	"$15 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes), cost sharing included in net allowed PMPM"											0	0	100	0	50	0.015	0	50	15	15	15	0	0	15	15	0	15	0	15	15	0	0	0	0	0	0	0	0	0	0	1.647812108	0	0	0	0	0	0	0	0	0	0	0	0	1.226938272	0	2.287044448	0.3875256	0	1.438962977	0.046265736	2.395048966	1.594267411	0	0	2.632192324	3.872961496	0	0.363010605	0	1.826351115	12.74916328	0	0	0	0	0	0	0	0	0	0	0.140688988	0	0	0	0	0	0	0	0	0	0	30.9604			0	0	1.226938272	0	2.287044448	0.3875256	0	1.438962977	0.046265736	2.395048966	1.594267411	0	0	2.632192324	3.872961496	0	0.363010605	0	1.826351115	12.74916328	0	0	0	0	0	0	0	0	0	0	0.140688988	0	0	0	0	0	0	0	0	0	0	30.9604																																																																																				0		0	0	0	1.226938272	0	2.287044448	0.3875256	0	1.438962977	0.046265736	2.395048966	1.594267411	0	0	2.632192324	3.872961496	0	0.363010605	0	1.826351115	12.74916328	0	0	0	0	0	0	0	0	0	0	0.140688988	0	0	0	0	0	0	0	0	0	0	30.9604
H2319_010_2	2008	4																																A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	0	0	150.593694	0	524.8953195	25.14138706	0	336.9581038	35.86396774	1856.57823	1235.833676	0	0	2040.405451	3095.475185	0	290.1372301	0	1459.716178	10189.804	0	0	0	0	0	0	0	0	0	0	1024.55119											"no cost sharing (PBP Section B-01, #1a)"	"no cost sharing  (PBP Section B-01,#1b)"	"$100  for days 21-100 (PBP Section B-02,#2)"	"no cost sharing  (PBP Section B-06,#6)"	"$50 copay per trip (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$15 copay (PBP Section B-09,#9a & #9b)"	"$0 copay (PBP Section B-08,#8a)"	"$15 copay (PBP Section B-08,#8b)"	"$0 copay (PBP Section B-05,#5)"	"$15 copay (PBP Section B-12, #12)"	"$15 copay (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"$15 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$15 copay (PBP Section B-07,#7b, #7d & #7f)"	"$15 copay (PBP Section B-07,#7e & #7h)"	"$15 copay (PBP Section B-07,#7c & #7i)"	"$15 copay (PBP Section B-07,#7d)"	"$15 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes), cost sharing included in net allowed PMPM"											0	0	100	0	50	0.015	0	50	15	15	15	0	0	15	15	0	15	0	15	15	0	0	0	0	0	0	0	0	0	0	1.647812108	0	0	0	0	0	0	0	0	0	0	0	0	1.25494745	0	2.187063831	0.377120806	0	1.403992099	0.04482996	2.320722787	1.544792095	0	0	2.550506814	3.869343981	0	0.362671538	0	1.824645223	12.737255	0	0	0	0	0	0	0	0	0	0	0.140688988	0	0	0	0	0	0	0	0	0	0	30.6186			0	0	1.25494745	0	2.187063831	0.377120806	0	1.403992099	0.04482996	2.320722787	1.544792095	0	0	2.550506814	3.869343981	0	0.362671538	0	1.824645223	12.737255	0	0	0	0	0	0	0	0	0	0	0.140688988	0	0	0	0	0	0	0	0	0	0	30.6186																																																																																				0		0	0	0	1.25494745	0	2.187063831	0.377120806	0	1.403992099	0.04482996	2.320722787	1.544792095	0	0	2.550506814	3.869343981	0	0.362671538	0	1.824645223	12.737255	0	0	0	0	0	0	0	0	0	0	0.140688988	0	0	0	0	0	0	0	0	0	0	30.6186
H2319_010_3	2008	4																																A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	0	0	138.3509774	0	551.62638	25.06475904	0	391.9679021	42.96098316	2223.971052	1480.389179	0	0	2444.175303	2581.928877	0	242.00281	0	1217.545975	8499.29256	0	0	0	0	0	0	0	0	0	0	1024.55119											"no cost sharing (PBP Section B-01, #1a)"	"no cost sharing  (PBP Section B-01,#1b)"	"$100  for days 21-100 (PBP Section B-02,#2)"	"no cost sharing  (PBP Section B-06,#6)"	"$50 copay per trip (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$15 copay (PBP Section B-09,#9a & #9b)"	"$0 copay (PBP Section B-08,#8a)"	"$15 copay (PBP Section B-08,#8b)"	"$0 copay (PBP Section B-05,#5)"	"$15 copay (PBP Section B-12, #12)"	"$15 copay (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"$15 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$15 copay (PBP Section B-07,#7b, #7d & #7f)"	"$15 copay (PBP Section B-07,#7e & #7h)"	"$15 copay (PBP Section B-07,#7c & #7i)"	"$15 copay (PBP Section B-07,#7d)"	"$15 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes), cost sharing included in net allowed PMPM"											0	0	100	0	50	0.015	0	50	15	15	15	0	0	15	15	0	15	0	15	15	0	0	0	0	0	0	0	0	0	0	1.647812108	0	0	0	0	0	0	0	0	0	0	0	0	1.152924812	0	2.29844325	0.375971386	0	1.633199592	0.053701229	2.779963815	1.850486473	0	0	3.055219129	3.227411097	0	0.302503512	0	1.521932469	10.6241157	0	0	0	0	0	0	0	0	0	0	0.140688988	0	0	0	0	0	0	0	0	0	0	29.0166			0	0	1.152924812	0	2.29844325	0.375971386	0	1.633199592	0.053701229	2.779963815	1.850486473	0	0	3.055219129	3.227411097	0	0.302503512	0	1.521932469	10.6241157	0	0	0	0	0	0	0	0	0	0	0.140688988	0	0	0	0	0	0	0	0	0	0	29.0166																																																																																				0		0	0	0	1.152924812	0	2.29844325	0.375971386	0	1.633199592	0.053701229	2.779963815	1.850486473	0	0	3.055219129	3.227411097	0	0.302503512	0	1.521932469	10.6241157	0	0	0	0	0	0	0	0	0	0	0.140688988	0	0	0	0	0	0	0	0	0	0	29.0166
H2319_010_4	2008	4																																A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	0	0	217.1630745	0	569.5960338	26.61518466	0	375.24729	40.14305924	2078.094939	1383.286558	0	0	2283.855414	3434.657887	0	321.928643	0	1619.662696	11306.33864	0	0	0	0	0	0	0	0	0	0	1024.55119											"no cost sharing (PBP Section B-01, #1a)"	"no cost sharing  (PBP Section B-01,#1b)"	"$100  for days 21-100 (PBP Section B-02,#2)"	"no cost sharing  (PBP Section B-06,#6)"	"$50 copay per trip (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$15 copay (PBP Section B-09,#9a & #9b)"	"$0 copay (PBP Section B-08,#8a)"	"$15 copay (PBP Section B-08,#8b)"	"$0 copay (PBP Section B-05,#5)"	"$15 copay (PBP Section B-12, #12)"	"$15 copay (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"$15 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$15 copay (PBP Section B-07,#7b, #7d & #7f)"	"$15 copay (PBP Section B-07,#7e & #7h)"	"$15 copay (PBP Section B-07,#7c & #7i)"	"$15 copay (PBP Section B-07,#7d)"	"$15 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes), cost sharing included in net allowed PMPM"											0	0	100	0	50	0.015	0	50	15	15	15	0	0	15	15	0	15	0	15	15	0	0	0	0	0	0	0	0	0	0	1.647812108	0	0	0	0	0	0	0	0	0	0	0	0	1.809692287	0	2.373316807	0.39922777	0	1.563530375	0.050178824	2.597618674	1.729108197	0	0	2.854819267	4.293322358	0	0.402410804	0	2.02457837	14.1329233	0	0	0	0	0	0	0	0	0	0	0.140688988	0	0	0	0	0	0	0	0	0	0	34.3714			0	0	1.809692287	0	2.373316807	0.39922777	0	1.563530375	0.050178824	2.597618674	1.729108197	0	0	2.854819267	4.293322358	0	0.402410804	0	2.02457837	14.1329233	0	0	0	0	0	0	0	0	0	0	0.140688988	0	0	0	0	0	0	0	0	0	0	34.3714																																																																																				0		0	0	0	1.809692287	0	2.373316807	0.39922777	0	1.563530375	0.050178824	2.597618674	1.729108197	0	0	2.854819267	4.293322358	0	0.402410804	0	2.02457837	14.1329233	0	0	0	0	0	0	0	0	0	0	0.140688988	0	0	0	0	0	0	0	0	0	0	34.3714
H2319_010_5	2008	4																																A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	0	0	160.7075776	0	640.2010263	28.66774585	0	350.9326317	37.3795136	1935.033839	1288.057753	0	0	2126.629263	3673.507314	0	344.3158719	0	1732.295605	12092.59235	0	0	0	0	0	0	0	0	0	0	1024.55119											"no cost sharing (PBP Section B-01, #1a)"	"no cost sharing  (PBP Section B-01,#1b)"	"$100  for days 21-100 (PBP Section B-02,#2)"	"no cost sharing  (PBP Section B-06,#6)"	"$50 copay per trip (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$15 copay (PBP Section B-09,#9a & #9b)"	"$0 copay (PBP Section B-08,#8a)"	"$15 copay (PBP Section B-08,#8b)"	"$0 copay (PBP Section B-05,#5)"	"$15 copay (PBP Section B-12, #12)"	"$15 copay (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"$15 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$15 copay (PBP Section B-07,#7b, #7d & #7f)"	"$15 copay (PBP Section B-07,#7e & #7h)"	"$15 copay (PBP Section B-07,#7c & #7i)"	"$15 copay (PBP Section B-07,#7d)"	"$15 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes), cost sharing included in net allowed PMPM"											0	0	100	0	50	0.015	0	50	15	15	15	0	0	15	15	0	15	0	15	15	0	0	0	0	0	0	0	0	0	0	1.647812108	0	0	0	0	0	0	0	0	0	0	0	0	1.339229813	0	2.667504276	0.430016188	0	1.462219299	0.046724392	2.418792299	1.610072191	0	0	2.658286579	4.591884143	0	0.43039484	0	2.165369506	15.11574044	0	0	0	0	0	0	0	0	0	0	0.140688988	0	0	0	0	0	0	0	0	0	0	35.0769			0	0	1.339229813	0	2.667504276	0.430016188	0	1.462219299	0.046724392	2.418792299	1.610072191	0	0	2.658286579	4.591884143	0	0.43039484	0	2.165369506	15.11574044	0	0	0	0	0	0	0	0	0	0	0.140688988	0	0	0	0	0	0	0	0	0	0	35.0769																																																																																				0		0	0	0	1.339229813	0	2.667504276	0.430016188	0	1.462219299	0.046724392	2.418792299	1.610072191	0	0	2.658286579	4.591884143	0	0.43039484	0	2.165369506	15.11574044	0	0	0	0	0	0	0	0	0	0	0.140688988	0	0	0	0	0	0	0	0	0	0	35.0769
H2319_010_6	2008	4																																A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	0	0	218.2270117	0	686.3694293	31.56659714	0	343.4248654	35.58498937	1842.136292	1226.220382	0	0	2024.533559	5035.235393	0	471.9499149	0	2374.438212	16575.1811	0	0	0	0	0	0	0	0	0	0	1024.55119											"no cost sharing (PBP Section B-01, #1a)"	"no cost sharing  (PBP Section B-01,#1b)"	"$100  for days 21-100 (PBP Section B-02,#2)"	"no cost sharing  (PBP Section B-06,#6)"	"$50 copay per trip (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$15 copay (PBP Section B-09,#9a & #9b)"	"$0 copay (PBP Section B-08,#8a)"	"$15 copay (PBP Section B-08,#8b)"	"$0 copay (PBP Section B-05,#5)"	"$15 copay (PBP Section B-12, #12)"	"$15 copay (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"$15 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$15 copay (PBP Section B-07,#7b, #7d & #7f)"	"$15 copay (PBP Section B-07,#7e & #7h)"	"$15 copay (PBP Section B-07,#7c & #7i)"	"$15 copay (PBP Section B-07,#7d)"	"$15 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes), cost sharing included in net allowed PMPM"											0	0	100	0	50	0.015	0	50	15	15	15	0	0	15	15	0	15	0	15	15	0	0	0	0	0	0	0	0	0	0	1.647812108	0	0	0	0	0	0	0	0	0	0	0	0	1.818558431	0	2.859872622	0.473498957	0	1.430936939	0.044481237	2.302670365	1.532775477	0	0	2.530666949	6.294044241	0	0.589937394	0	2.968047765	20.71897637	0	0	0	0	0	0	0	0	0	0	0.140688988	0	0	0	0	0	0	0	0	0	0	43.7052			0	0	1.818558431	0	2.859872622	0.473498957	0	1.430936939	0.044481237	2.302670365	1.532775477	0	0	2.530666949	6.294044241	0	0.589937394	0	2.968047765	20.71897637	0	0	0	0	0	0	0	0	0	0	0.140688988	0	0	0	0	0	0	0	0	0	0	43.7052																																																																																				0		0	0	0	1.818558431	0	2.859872622	0.473498957	0	1.430936939	0.044481237	2.302670365	1.532775477	0	0	2.530666949	6.294044241	0	0.589937394	0	2.968047765	20.71897637	0	0	0	0	0	0	0	0	0	0	0.140688988	0	0	0	0	0	0	0	0	0	0	43.7052
H2319_011_1	2008	4																																A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	0	0	0	0	0	26.65178297	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1025.820238											"no cost sharing (PBP Section B-01, #1a)"	"no cost sharing (PBP Section B-01,#1b)"	"no cost sharing (PBP Section B-02,#2)"	"no cost sharing (PBP Section B-06,#6)"	"no cost sharing (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"no cost sharing (PBP Section B-04,#4a)"	"no cost sharing (PBP Section B-09,#9a & #9b)"	"no cost sharing (PBP Section B-08,#8a)"	"no cost sharing (PBP Section B-08,#8b)"	"no cost sharing (PBP Section B-05,#5)"	"no cost sharing (PBP Section B-12, #12)"	"no cost sharing (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"no cost sharing (PBP Section B-07,#7a;B-14,#14b & #14c)"	"no cost sharing (PBP Section B-07,#7b, #7d & #7f)"	"no cost sharing (PBP Section B-07,#7e & #7h)"	"no cost sharing (PBP Section B-07,#7c & #7i)"	"no cost sharing (PBP Section B-07,#7d)"	"no cost sharing (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes) - included in net allowed PMPM"											0	0	0	0	0	0.015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.286775159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.399776745	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11	0	0	0	0	0	0	0	0	0	0	0.5098			0	0	0	0	0	0.399776745	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11	0	0	0	0	0	0	0	0	0	0	0.5098																																																																																				0		0	0	0	0	0	0	0.399776745	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11	0	0	0	0	0	0	0	0	0	0	0.5098
H2319_011_2	2008	4																																A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	0	0	0	0	0	25.9362573	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1025.820238											"no cost sharing (PBP Section B-01, #1a)"	"no cost sharing (PBP Section B-01,#1b)"	"no cost sharing (PBP Section B-02,#2)"	"no cost sharing (PBP Section B-06,#6)"	"no cost sharing (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"no cost sharing (PBP Section B-04,#4a)"	"no cost sharing (PBP Section B-09,#9a & #9b)"	"no cost sharing (PBP Section B-08,#8a)"	"no cost sharing (PBP Section B-08,#8b)"	"no cost sharing (PBP Section B-05,#5)"	"no cost sharing (PBP Section B-12, #12)"	"no cost sharing (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"no cost sharing (PBP Section B-07,#7a;B-14,#14b & #14c)"	"no cost sharing (PBP Section B-07,#7b, #7d & #7f)"	"no cost sharing (PBP Section B-07,#7e & #7h)"	"no cost sharing (PBP Section B-07,#7c & #7i)"	"no cost sharing (PBP Section B-07,#7d)"	"no cost sharing (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes) - included in net allowed PMPM"											0	0	0	0	0	0.015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.286775159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.389043859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11	0	0	0	0	0	0	0	0	0	0	0.499			0	0	0	0	0	0.389043859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11	0	0	0	0	0	0	0	0	0	0	0.499																																																																																				0		0	0	0	0	0	0	0.389043859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11	0	0	0	0	0	0	0	0	0	0	0.499
H2319_011_3	2008	4																																A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	0	0	0	0	0	25.85720528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1025.820238											"no cost sharing (PBP Section B-01, #1a)"	"no cost sharing (PBP Section B-01,#1b)"	"no cost sharing (PBP Section B-02,#2)"	"no cost sharing (PBP Section B-06,#6)"	"no cost sharing (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"no cost sharing (PBP Section B-04,#4a)"	"no cost sharing (PBP Section B-09,#9a & #9b)"	"no cost sharing (PBP Section B-08,#8a)"	"no cost sharing (PBP Section B-08,#8b)"	"no cost sharing (PBP Section B-05,#5)"	"no cost sharing (PBP Section B-12, #12)"	"no cost sharing (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"no cost sharing (PBP Section B-07,#7a;B-14,#14b & #14c)"	"no cost sharing (PBP Section B-07,#7b, #7d & #7f)"	"no cost sharing (PBP Section B-07,#7e & #7h)"	"no cost sharing (PBP Section B-07,#7c & #7i)"	"no cost sharing (PBP Section B-07,#7d)"	"no cost sharing (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes) - included in net allowed PMPM"											0	0	0	0	0	0.015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.286775159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.387858079	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11	0	0	0	0	0	0	0	0	0	0	0.4979			0	0	0	0	0	0.387858079	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11	0	0	0	0	0	0	0	0	0	0	0.4979																																																																																				0		0	0	0	0	0	0	0.387858079	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11	0	0	0	0	0	0	0	0	0	0	0.4979
H2319_011_4	2008	4																																A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	0	0	0	0	0	27.45664504	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1025.820238											"no cost sharing (PBP Section B-01, #1a)"	"no cost sharing (PBP Section B-01,#1b)"	"no cost sharing (PBP Section B-02,#2)"	"no cost sharing (PBP Section B-06,#6)"	"no cost sharing (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"no cost sharing (PBP Section B-04,#4a)"	"no cost sharing (PBP Section B-09,#9a & #9b)"	"no cost sharing (PBP Section B-08,#8a)"	"no cost sharing (PBP Section B-08,#8b)"	"no cost sharing (PBP Section B-05,#5)"	"no cost sharing (PBP Section B-12, #12)"	"no cost sharing (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"no cost sharing (PBP Section B-07,#7a;B-14,#14b & #14c)"	"no cost sharing (PBP Section B-07,#7b, #7d & #7f)"	"no cost sharing (PBP Section B-07,#7e & #7h)"	"no cost sharing (PBP Section B-07,#7c & #7i)"	"no cost sharing (PBP Section B-07,#7d)"	"no cost sharing (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes) - included in net allowed PMPM"											0	0	0	0	0	0.015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.286775159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.411849676	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11	0	0	0	0	0	0	0	0	0	0	0.5218			0	0	0	0	0	0.411849676	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11	0	0	0	0	0	0	0	0	0	0	0.5218																																																																																				0		0	0	0	0	0	0	0.411849676	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11	0	0	0	0	0	0	0	0	0	0	0.5218
H2319_011_5	2008	4																																A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	0	0	0	0	0	29.57406251	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1025.820238											"no cost sharing (PBP Section B-01, #1a)"	"no cost sharing (PBP Section B-01,#1b)"	"no cost sharing (PBP Section B-02,#2)"	"no cost sharing (PBP Section B-06,#6)"	"no cost sharing (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"no cost sharing (PBP Section B-04,#4a)"	"no cost sharing (PBP Section B-09,#9a & #9b)"	"no cost sharing (PBP Section B-08,#8a)"	"no cost sharing (PBP Section B-08,#8b)"	"no cost sharing (PBP Section B-05,#5)"	"no cost sharing (PBP Section B-12, #12)"	"no cost sharing (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"no cost sharing (PBP Section B-07,#7a;B-14,#14b & #14c)"	"no cost sharing (PBP Section B-07,#7b, #7d & #7f)"	"no cost sharing (PBP Section B-07,#7e & #7h)"	"no cost sharing (PBP Section B-07,#7c & #7i)"	"no cost sharing (PBP Section B-07,#7d)"	"no cost sharing (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes) - included in net allowed PMPM"											0	0	0	0	0	0.015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.286775159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.443610938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11	0	0	0	0	0	0	0	0	0	0	0.5536			0	0	0	0	0	0.443610938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11	0	0	0	0	0	0	0	0	0	0	0.5536																																																																																				0		0	0	0	0	0	0	0.443610938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11	0	0	0	0	0	0	0	0	0	0	0.5536
H2319_011_6	2008	4																																A	A	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V											V																																																				0	n/a	0	0	0	0	0	32.5648201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1025.820238											"no cost sharing (PBP Section B-01, #1a)"	"no cost sharing (PBP Section B-01,#1b)"	"no cost sharing (PBP Section B-02,#2)"	"no cost sharing (PBP Section B-06,#6)"	"no cost sharing (PBP Section B-10,#10a)"	"50% on non-contracted DME (PBP Section B-11,#11a)"	"50% on non-contracted DME (PBP Section B-11,#11b & #11c)"	"no cost sharing (PBP Section B-04,#4a)"	"no cost sharing (PBP Section B-09,#9a & #9b)"	"no cost sharing (PBP Section B-08,#8a)"	"no cost sharing (PBP Section B-08,#8b)"	"no cost sharing (PBP Section B-05,#5)"	"no cost sharing (PBP Section B-12, #12)"	"no cost sharing (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"no cost sharing (PBP Section B-07,#7a;B-14,#14b & #14c)"	"no cost sharing (PBP Section B-07,#7b, #7d & #7f)"	"no cost sharing (PBP Section B-07,#7e & #7h)"	"no cost sharing (PBP Section B-07,#7c & #7i)"	"no cost sharing (PBP Section B-07,#7d)"	"no cost sharing (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"no cost sharing (PBP B-15, #15)"	"no cost sharing (PBP B-15, #13a)"	"not covered (PBP B-10, #10b)"	"not covered (PBP B-16, #16a & #16b)"	"not covered (PBP B-17, #17a)"	"not covered (PBP B-17, #17b)"	"not covered (PBP B-18, #18a)"	"not covered (PBP B-18, #18b)"	"not covered (PBP B-19, #19)"	"not covered (PBP B-14, #14a)"	"foreign travel: $250 deductible, 20% coins., $50,000 lifetime max (PBP Section A-3, Notes) - included in net allowed PMPM"											0	0	0	0	0	0.015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.286775159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.488472301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11	0	0	0	0	0	0	0	0	0	0	0.5985			0	0	0	0	0	0.488472301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11	0	0	0	0	0	0	0	0	0	0	0.5985																																																																																				0		0	0	0	0	0	0	0.488472301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11	0	0	0	0	0	0	0	0	0	0	0.5985
H2319_801_0	2008	3																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		279.246208	3.539205497	39.39577566	0	7.971779788	21.9190955	1.252607397	6.588261647	36.3274982	10.91490731	31.33270113	0	13.09582407	34.1946955	28.10179874	43.33637561	1.760118585	4.884015846	33.97922056	126.2454553	23.96291366	3.09170469	0	0	0	0	0	0	0	0	0											"Medicare FFS Cost Sharing (PBP Section B-01, #1a)"	"Medicare FFS Cost Sharing (PBP Section B-01,#1b)"	"Medicare FFS Cost Sharing (PBP Section B-02,#2)"	"Medicare FFS Cost Sharing (PBP Section B-06,#6)"	"Medicare FFS Cost Sharing (PBP Section B-10,#10a)"	"Medicare FFS Cost Sharing (PBP Section B-11,#11a)"	"Medicare FFS Cost Sharing (PBP Section B-11,#11b & #11c)"	"Medicare FFS Cost Sharing (PBP Section B-04,#4a)"	"Medicare FFS Cost Sharing (PBP Section B-09,#9a & #9b)"	"Medicare FFS Cost Sharing (PBP Section B-08,#8a)"	"Medicare FFS Cost Sharing (PBP Section B-08,#8b)"	"Medicare FFS Cost Sharing (PBP Section B-05,#5)"	"Medicare FFS Cost Sharing (PBP Section B-12, #12)"	"Medicare FFS Cost Sharing (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7a;B-14,#14b & #14c)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7b, #7d & #7f)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7e & #7h)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7c & #7i)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7d)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"Medicare FFS Cost Sharing (PBP B-15, #15)"	"Medicare FFS Cost Sharing (PBP B-15, #13a)"	"Medicare FFS Cost Sharing (PBP B-10, #10b)"	"Medicare FFS Cost Sharing (PBP B-16, #16a & #16b)"	"Medicare FFS Cost Sharing (PBP B-17, #17a)"	"Medicare FFS Cost Sharing (PBP B-17, #17b)"	"Medicare FFS Cost Sharing (PBP B-18, #18a)"	"Medicare FFS Cost Sharing (PBP B-18, #18b)"	"Medicare FFS Cost Sharing (PBP B-19, #19)"	"Medicare FFS Cost Sharing (PBP B-14, #14b)"	"Medicare FFS Cost Sharing (PBP Section B-13, #13b)"											0.074029233	0.074029233	0.19395681	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											20.6724	0.262004668	7.641078983	0	1.86539647	5.129068347	0.293110131	1.541653225	8.500634578	2.554088312	7.331852064	0	3.064422832	8.001558747	6.575820906	10.14071189	0.411867749	1.142859708	7.951137612	29.54143655	5.607321796	0.723458898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.9519			20.6724	0.262004668	7.641078983	0	1.86539647	5.129068347	0.293110131	1.541653225	8.500634578	2.554088312	7.331852064	0	3.064422832	8.001558747	6.575820906	10.14071189	0.411867749	1.142859708	7.951137612	29.54143655	5.607321796	0.723458898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.9519																																																																																				0			20.6724	0.262004668	7.641078983	0	1.86539647	5.129068347	0.293110131	1.541653225	8.500634578	2.554088312	7.331852064	0	3.064422832	8.001558747	6.575820906	10.14071189	0.411867749	1.142859708	7.951137612	29.54143655	5.607321796	0.723458898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.9519
H2319_802_0	2008	4																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		288.1816891	3.652455033	42.94622903	0	8.153795169	22.41956247	1.281207511	6.104436501	33.4375023	10.04658335	28.84006105	0	12.05399956	31.47437247	30.89188124	47.46595661	1.89293596	5.252560425	39.06306067	137.4619168	25.77113915	3.335227588	0	0	0	0	0	0	0	0	0											"Medicare FFS Cost Sharing (PBP Section B-01, #1a)"	"Medicare FFS Cost Sharing (PBP Section B-01,#1b)"	"Medicare FFS Cost Sharing (PBP Section B-02,#2)"	"Medicare FFS Cost Sharing (PBP Section B-06,#6)"	"Medicare FFS Cost Sharing (PBP Section B-10,#10a)"	"Medicare FFS Cost Sharing (PBP Section B-11,#11a)"	"Medicare FFS Cost Sharing (PBP Section B-11,#11b & #11c)"	"Medicare FFS Cost Sharing (PBP Section B-04,#4a)"	"Medicare FFS Cost Sharing (PBP Section B-09,#9a & #9b)"	"Medicare FFS Cost Sharing (PBP Section B-08,#8a)"	"Medicare FFS Cost Sharing (PBP Section B-08,#8b)"	"Medicare FFS Cost Sharing (PBP Section B-05,#5)"	"Medicare FFS Cost Sharing (PBP Section B-12, #12)"	"Medicare FFS Cost Sharing (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7a;B-14,#14b & #14c)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7b, #7d & #7f)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7e & #7h)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7c & #7i)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7d)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"Medicare FFS Cost Sharing (PBP B-15, #15)"	"Medicare FFS Cost Sharing (PBP B-15, #13a)"	"Medicare FFS Cost Sharing (PBP B-10, #10b)"	"Medicare FFS Cost Sharing (PBP B-16, #16a & #16b)"	"Medicare FFS Cost Sharing (PBP B-17, #17a)"	"Medicare FFS Cost Sharing (PBP B-17, #17b)"	"Medicare FFS Cost Sharing (PBP B-18, #18a)"	"Medicare FFS Cost Sharing (PBP B-18, #18b)"	"Medicare FFS Cost Sharing (PBP B-19, #19)"	"Medicare FFS Cost Sharing (PBP B-14, #14b)"	"Medicare FFS Cost Sharing (PBP Section B-13, #13b)"											0.07471119	0.07471119	0.193109059	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.5304	0.272879262	8.293305873	0	1.90798807	5.246177619	0.299802557	1.428438141	7.824375537	2.350900503	6.748574286	0	2.820635897	7.365003158	7.228700211	11.10703385	0.442947015	1.22909914	9.140756198	32.16608852	6.030446561	0.780443256	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.214			21.5304	0.272879262	8.293305873	0	1.90798807	5.246177619	0.299802557	1.428438141	7.824375537	2.350900503	6.748574286	0	2.820635897	7.365003158	7.228700211	11.10703385	0.442947015	1.22909914	9.140756198	32.16608852	6.030446561	0.780443256	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.214																																																																																				0			21.5304	0.272879262	8.293305873	0	1.90798807	5.246177619	0.299802557	1.428438141	7.824375537	2.350900503	6.748574286	0	2.820635897	7.365003158	7.228700211	11.10703385	0.442947015	1.22909914	9.140756198	32.16608852	6.030446561	0.780443256	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.214
H2319_803_0	2008	3																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		260.4933142	3.301528698	37.2365158	0	7.87738775	21.65955646	1.237775556	5.924614191	32.7111923	9.828357299	28.213614	0	11.79216959	30.79070444	24.33111566	37.08526006	1.418233873	3.935346611	26.93064569	108.7349553	19.30836714	2.516948585	0	0	0	0	0	0	0	0	0											"Medicare FFS Cost Sharing (PBP Section B-01, #1a)"	"Medicare FFS Cost Sharing (PBP Section B-01,#1b)"	"Medicare FFS Cost Sharing (PBP Section B-02,#2)"	"Medicare FFS Cost Sharing (PBP Section B-06,#6)"	"Medicare FFS Cost Sharing (PBP Section B-10,#10a)"	"Medicare FFS Cost Sharing (PBP Section B-11,#11a)"	"Medicare FFS Cost Sharing (PBP Section B-11,#11b & #11c)"	"Medicare FFS Cost Sharing (PBP Section B-04,#4a)"	"Medicare FFS Cost Sharing (PBP Section B-09,#9a & #9b)"	"Medicare FFS Cost Sharing (PBP Section B-08,#8a)"	"Medicare FFS Cost Sharing (PBP Section B-08,#8b)"	"Medicare FFS Cost Sharing (PBP Section B-05,#5)"	"Medicare FFS Cost Sharing (PBP Section B-12, #12)"	"Medicare FFS Cost Sharing (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7a;B-14,#14b & #14c)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7b, #7d & #7f)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7e & #7h)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7c & #7i)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7d)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"Medicare FFS Cost Sharing (PBP B-15, #15)"	"Medicare FFS Cost Sharing (PBP B-15, #13a)"	"Medicare FFS Cost Sharing (PBP B-10, #10b)"	"Medicare FFS Cost Sharing (PBP B-16, #16a & #16b)"	"Medicare FFS Cost Sharing (PBP B-17, #17a)"	"Medicare FFS Cost Sharing (PBP B-17, #17b)"	"Medicare FFS Cost Sharing (PBP B-18, #18a)"	"Medicare FFS Cost Sharing (PBP B-18, #18b)"	"Medicare FFS Cost Sharing (PBP B-19, #19)"	"Medicare FFS Cost Sharing (PBP B-14, #14b)"	"Medicare FFS Cost Sharing (PBP Section B-13, #13b)"											0.080270574	0.080270574	0.190905461	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											20.9099	0.265015605	7.108654212	0	1.843308734	5.068336211	0.28963948	1.386359721	7.654418997	2.299835608	6.601985676	0	2.759367683	7.205024838	5.693481065	8.677950854	0.331866726	0.920871107	6.301771092	25.44397954	4.51815791	0.588965969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.8689			20.9099	0.265015605	7.108654212	0	1.843308734	5.068336211	0.28963948	1.386359721	7.654418997	2.299835608	6.601985676	0	2.759367683	7.205024838	5.693481065	8.677950854	0.331866726	0.920871107	6.301771092	25.44397954	4.51815791	0.588965969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.8689																																																																																				0			20.9099	0.265015605	7.108654212	0	1.843308734	5.068336211	0.28963948	1.386359721	7.654418997	2.299835608	6.601985676	0	2.759367683	7.205024838	5.693481065	8.677950854	0.331866726	0.920871107	6.301771092	25.44397954	4.51815791	0.588965969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.8689
H2319_804_0	2008	3																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		260.4933142	3.301528698	37.2365158	0	7.87738775	21.65955646	1.237775556	5.924614191	32.7111923	9.828357299	28.213614	0	11.79216959	30.79070444	24.33111566	37.08526006	1.418233873	3.935346611	26.93064569	108.7349553	19.30836714	2.516948585	0	0	0	0	0	0	0	0	0											"Medicare FFS Cost Sharing (PBP Section B-01, #1a)"	"Medicare FFS Cost Sharing (PBP Section B-01,#1b)"	"Medicare FFS Cost Sharing (PBP Section B-02,#2)"	"Medicare FFS Cost Sharing (PBP Section B-06,#6)"	"Medicare FFS Cost Sharing (PBP Section B-10,#10a)"	"Medicare FFS Cost Sharing (PBP Section B-11,#11a)"	"Medicare FFS Cost Sharing (PBP Section B-11,#11b & #11c)"	"Medicare FFS Cost Sharing (PBP Section B-04,#4a)"	"Medicare FFS Cost Sharing (PBP Section B-09,#9a & #9b)"	"Medicare FFS Cost Sharing (PBP Section B-08,#8a)"	"Medicare FFS Cost Sharing (PBP Section B-08,#8b)"	"Medicare FFS Cost Sharing (PBP Section B-05,#5)"	"Medicare FFS Cost Sharing (PBP Section B-12, #12)"	"Medicare FFS Cost Sharing (PBP Sections B-04, #4b; B-03, #3; B-09, #9c & #9d)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7a;B-14,#14b & #14c)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7b, #7d & #7f)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7e & #7h)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7c & #7i)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7d)"	"Medicare FFS Cost Sharing (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h & #14i)"	"Medicare FFS Cost Sharing (PBP B-15, #15)"	"Medicare FFS Cost Sharing (PBP B-15, #13a)"	"Medicare FFS Cost Sharing (PBP B-10, #10b)"	"Medicare FFS Cost Sharing (PBP B-16, #16a & #16b)"	"Medicare FFS Cost Sharing (PBP B-17, #17a)"	"Medicare FFS Cost Sharing (PBP B-17, #17b)"	"Medicare FFS Cost Sharing (PBP B-18, #18a)"	"Medicare FFS Cost Sharing (PBP B-18, #18b)"	"Medicare FFS Cost Sharing (PBP B-19, #19)"	"Medicare FFS Cost Sharing (PBP B-14, #14b)"	"Medicare FFS Cost Sharing (PBP Section B-13, #13b)"											0.080270574	0.080270574	0.190905461	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											20.9099	0.265015605	7.108654212	0	1.843308734	5.068336211	0.28963948	1.386359721	7.654418997	2.299835608	6.601985676	0	2.759367683	7.205024838	5.693481065	8.677950854	0.331866726	0.920871107	6.301771092	25.44397954	4.51815791	0.588965969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.8689			20.9099	0.265015605	7.108654212	0	1.843308734	5.068336211	0.28963948	1.386359721	7.654418997	2.299835608	6.601985676	0	2.759367683	7.205024838	5.693481065	8.677950854	0.331866726	0.920871107	6.301771092	25.44397954	4.51815791	0.588965969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.8689																																																																																				0			20.9099	0.265015605	7.108654212	0	1.843308734	5.068336211	0.28963948	1.386359721	7.654418997	2.299835608	6.601985676	0	2.759367683	7.205024838	5.693481065	8.677950854	0.331866726	0.920871107	6.301771092	25.44397954	4.51815791	0.588965969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.8689
H2320_007_0	2008	3																					2000											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O			V	P	V	P														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	2000	748.1252268	22.08892053	530.0515246	0	211.6014444	20.6855476	0.94569121	518.5938898	506.5058111	0	1185.036808	0	0	202.4082478	3678.773968	4160.94208	124.712701	378.754344	719.8590399	0	1746.092508	0	0	0	0	0	117.1484761	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												46.57539292	46.57539292	23.28769646	0	93.15078585	0.186301572	0.186301572	45.3178119	46.57539292	0	23.28769646	0	0	23.28769646	9.315078585	23.28769646	40.48476462	23.28769646	23.28769646	0	29.51079785	0	0	0	0	0	23.28769646	0	0	0	0											2.9037	0.085733346	1.028639918	0	1.64257007	3.853750029	0.176183759	1.958461696	1.965892264	0	2.299731456	0	0	0.39280182	2.855672384	8.074896346	0.420747029	0.73502635	1.396988235	0	4.294048587	0	0	0	0	0	0.227343179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3122	0	2.522913918	2.9037	0.085733346	1.028639918	0	1.64257007	3.853750029	0.176183759	1.958461696	1.965892264	0	2.299731456	0	0	0.39280182	2.855672384	8.074896346	0.420747029	0.73502635	1.396988235	0	4.294048587	0	0	0	0	0	0.227343179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3122		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.913	0.0369	0.3939	0.4507	0.0932	0.3255	0.0149	0.1307	0.6145	0.179	0.4793	0	0.2238	0.3631	0.2854	0.511	0.0243	0.039	0.2472	0.928	0.3471	0.2337	0	0	0	0.0075	0.0047	0.0025	0	0	0											8.8491	500	8.824409688	5.8167	0.122652867	1.422567362	0.450735955	1.735763634	4.179284164	0.191066361	2.08921081	2.580423487	0.179045971	2.779013522	0	0.223772184	0.755874068	3.141093513	8.58592176	0.445000268	0.774073875	1.644225814	0.928009206	4.641132349	0.233730132	0	0	0	0.00749737	0.232019539	0.002506092	0	0	0	0	0	0	0	0	0	0	0	0	0	43.1613
H2320_008_0	2008	5																					2000											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O			V	P	V	P														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	2000	722.5243552	21.33303689	708.2600227	0	224.3401185	22.02347818	1.006858031	512.5015711	500.3652438	0	1170.670145	0	0	199.9543737	3659.763482	4227.400971	136.7822822	415.4098431	789.5740274	0	1778.010065	0	0	0	0	0	116.543098	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												46.48217884	46.48217884	23.24108942	0	92.96435769	0.185928715	0.185928715	45.21875801	46.48217884	0	23.24108942	0	0	23.24108942	9.296435769	23.24108942	40.40374007	23.24108942	23.24108942	0	28.31671615	0	0	0	0	0	23.24108942	0	0	0	0											2.7987	0.082633836	1.371727877	0	1.737969585	4.094797005	0.18720382	1.93122371	1.938172229	0	2.267304127	0	0	0.387263123	2.835229679	8.187450332	0.460542982	0.804548109	1.529213381	0	4.195617192	0	0	0	0	0	0.225715713	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0353	0	2.651510717	2.7987	0.082633836	1.371727877	0	1.737969585	4.094797005	0.18720382	1.93122371	1.938172229	0	2.267304127	0	0	0.387263123	2.835229679	8.187450332	0.460542982	0.804548109	1.529213381	0	4.195617192	0	0	0	0	0	0.225715713	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0353		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.8796	0.0365	0.5065	0.3612	0.0992	0.3466	0.0158	0.1265	0.569	0.1658	0.4438	0	0.2072	0.3362	0.2783	0.5132	0.0265	0.042	0.2871	1.0023	0.3411	0.2508	0	0	0	0.0075	0.0046	0.0025	0	0	0											8.8494	500	8.82815234	5.6783	0.11913025	1.878178134	0.361159282	1.837186718	4.441372048	0.203048359	2.057697208	2.507153526	0.16577483	2.711061126	0	0.207185872	0.723423942	3.113493978	8.700625453	0.487015006	0.846517642	1.816285567	1.002292158	4.536734848	0.250779897	0	0	0	0.007499088	0.230274815	0.002506666	0	0	0	0	0	0	0	0	0	0	0	0	0	43.8847
H2320_009_0	2008	5																					2000											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O			V	P	V	P														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	2000	748.1252268	22.08892053	530.0515246	0	211.6014444	20.6855476	0.94569121	518.5938898	506.5058111	0	1185.036808	0	0	202.4082478	3678.773968	4160.94208	124.712701	378.754344	719.8590399	0	1746.092508	0	0	0	0	0	117.1484761	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												46.57539292	46.57539292	23.28769646	0	93.15078585	0.186301572	0.186301572	45.3178119	46.57539292	0	23.28769646	0	0	23.28769646	9.315078585	23.28769646	40.48476462	23.28769646	23.28769646	0	29.51079785	0	0	0	0	0	23.28769646	0	0	0	0											2.9037	0.085733346	1.028639918	0	1.64257007	3.853750029	0.176183759	1.958461696	1.965892264	0	2.299731456	0	0	0.39280182	2.855672384	8.074896346	0.420747029	0.73502635	1.396988235	0	4.294048587	0	0	0	0	0	0.227343179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3122	0	2.522913918	2.9037	0.085733346	1.028639918	0	1.64257007	3.853750029	0.176183759	1.958461696	1.965892264	0	2.299731456	0	0	0.39280182	2.855672384	8.074896346	0.420747029	0.73502635	1.396988235	0	4.294048587	0	0	0	0	0	0.227343179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3122		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.913	0.0369	0.3939	0.4507	0.0932	0.3255	0.0149	0.1307	0.6145	0.179	0.4793	0	0.2238	0.3631	0.2854	0.511	0.0243	0.039	0.2472	0.928	0.3471	0.2337	0	0	0	0.0075	0.0047	0.0025	0	0	0											8.8491	500	8.824409688	5.8167	0.122652867	1.422567362	0.450735955	1.735763634	4.179284164	0.191066361	2.08921081	2.580423487	0.179045971	2.779013522	0	0.223772184	0.755874068	3.141093513	8.58592176	0.445000268	0.774073875	1.644225814	0.928009206	4.641132349	0.233730132	0	0	0	0.00749737	0.232019539	0.002506092	0	0	0	0	0	0	0	0	0	0	0	0	0	43.1613
H2320_010_0	2008	5																					2000											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O			V	P	V	P														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	2000	722.5243552	21.33303689	708.2600227	0	224.3401185	22.02347818	1.006858031	512.5015711	500.3652438	0	1170.670145	0	0	199.9543737	3659.763482	4227.400971	136.7822822	415.4098431	789.5740274	0	1778.010065	0	0	0	0	0	116.543098	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												46.48217884	46.48217884	23.24108942	0	92.96435769	0.185928715	0.185928715	45.21875801	46.48217884	0	23.24108942	0	0	23.24108942	9.296435769	23.24108942	40.40374007	23.24108942	23.24108942	0	28.31671615	0	0	0	0	0	23.24108942	0	0	0	0											2.7987	0.082633836	1.371727877	0	1.737969585	4.094797005	0.18720382	1.93122371	1.938172229	0	2.267304127	0	0	0.387263123	2.835229679	8.187450332	0.460542982	0.804548109	1.529213381	0	4.195617192	0	0	0	0	0	0.225715713	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0353	0	2.651510717	2.7987	0.082633836	1.371727877	0	1.737969585	4.094797005	0.18720382	1.93122371	1.938172229	0	2.267304127	0	0	0.387263123	2.835229679	8.187450332	0.460542982	0.804548109	1.529213381	0	4.195617192	0	0	0	0	0	0.225715713	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0353		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.8796	0.0365	0.5065	0.3612	0.0992	0.3466	0.0158	0.1265	0.569	0.1658	0.4438	0	0.2072	0.3362	0.2783	0.5132	0.0265	0.042	0.2871	1.0023	0.3411	0.2508	0	0	0	0.0075	0.0046	0.0025	0	0	0											8.8494	500	8.82815234	5.6783	0.11913025	1.878178134	0.361159282	1.837186718	4.441372048	0.203048359	2.057697208	2.507153526	0.16577483	2.711061126	0	0.207185872	0.723423942	3.113493978	8.700625453	0.487015006	0.846517642	1.816285567	1.002292158	4.536734848	0.250779897	0	0	0	0.007499088	0.230274815	0.002506666	0	0	0	0	0	0	0	0	0	0	0	0	0	43.8847
H2320_011_0	2008	5																					4000											A	A	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O			V	P	V	P														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	223.3103389	3.915741807	616.6484374	0	211.6014444	20.6855476	0.94569121	517.3209316	501.3895908	565.9161096	1141.600681	0	0	200.87097	3563.812282	4000.369006	124.712701	365.842264	693.4734559	713.1374024	1746.092508	0	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												521.2727573	521.2727573	94.77686496	0	94.77686496	0.18955373	0.18955373	46.89868102	94.77686496	9.477686496	37.91074598	0	0	37.91074598	14.21652974	37.38499383	41.19148362	37.91074598	37.91074598	9.477686496	30.02595069	0	0	0	0	0	0	0	0	0	0											9.7005	0.170097461	4.870333806	0	1.67124346	3.921022703	0.179259296	2.021805779	3.960011128	0.446964623	3.606577787	0	0	0.63459736	4.222086942	12.46281422	0.428091765	1.155779428	2.190841336	0.563241061	4.369007296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.5742	0	3.11779573	9.7005	0.170097461	4.870333806	0	1.67124346	3.921022703	0.179259296	2.021805779	3.960011128	0.446964623	3.606577787	0	0	0.63459736	4.222086942	12.46281422	0.428091765	1.155779428	2.190841336	0.563241061	4.369007296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.5742		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												4.9555	0.0628	0.6361	0.7753	0.1603	0.5599	0.0256	0.1737	1.0464	0.2918	0.7942	0	0.3849	0.622	0.4737	0.8508	0.0334	0.0649	0.411	1.5767	0.5856	0.3945	0	0	0	0	0	0	0	0	0											14.8791	500	9.259017222	14.6559	0.23290355	5.506436741	0.775303264	1.831544128	4.480968441	0.204858607	2.195521119	5.006378631	0.738741856	4.40076514	0	0.384906734	1.256644404	4.695797525	13.31360432	0.461448382	1.220654698	2.60183975	2.139975442	4.954602137	0.394545731	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.4534
H2320_012_0	2008	5																					4000											A	A	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O			V	P	V	P														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	227.7519493	3.993625347	823.9716631	0	224.3401185	22.02347818	1.006858031	511.235191	495.3110495	559.0552882	1127.760612	0	0	198.4357329	3545.395874	4064.600242	136.7822822	401.2481439	760.6331229	749.2448456	1778.010065	0	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												519.4353767	519.4353767	94.44279577	0	94.44279577	0.188885592	0.188885592	46.73011519	94.44279577	9.444279577	37.77711831	0	0	37.77711831	14.16641937	37.11934006	41.04629201	37.77711831	37.77711831	9.444279577	28.76704477	0	0	0	0	0	0	0	0	0	0											9.8585	0.172869191	6.484848958	0	1.765608999	4.159917703	0.190180975	1.990839947	3.898213357	0.439989537	3.550295504	0	0	0.62469418	4.18546373	12.57293988	0.467867125	1.26316655	2.394543956	0.589673149	4.262341261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.872	0	3.46414635	9.8585	0.172869191	6.484848958	0	1.765608999	4.159917703	0.190180975	1.990839947	3.898213357	0.439989537	3.550295504	0	0	0.62469418	4.18546373	12.57293988	0.467867125	1.26316655	2.394543956	0.589673149	4.262341261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.872		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												4.9005	0.0621	0.8181	0.6215	0.1707	0.5964	0.0273	0.1689	0.9692	0.2703	0.7356	0	0.3565	0.5762	0.462	0.8549	0.0365	0.0698	0.4774	1.7038	0.5747	0.4235	0	0	0	0	0	0	0	0	0											14.8756	500	9.252107101	14.759	0.234978759	7.302956853	0.621456618	1.936334624	4.756278822	0.217445105	2.159770438	4.867385468	0.710241008	4.285891966	0	0.356510376	1.200849924	4.647468198	13.42781348	0.504334828	1.332922687	2.871940649	2.293431467	4.837035619	0.423470834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7475
H2320_013_0	2008	5																					2000											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O			V	P	V	P														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	2000	610.4306587	13.57117967	394.0107971	0	134.0743679	7.763766182	7.580766827	237.3556364	231.8205138	0	721.9634018	0	0	316.7242907	3257.385357	3828.275002	111.5938148	186.5426361	492.3369941	107.5702229	613.2520889	0	0	0	0	0	95.85445491	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												48.90842271	48.55031574	24.25313336	0	97.34856058	0.190594037	0.144621163	47.27564069	48.47673028	0	24.42782233	0	0	24.77722776	9.779290512	24.44857667	42.33649472	23.82425465	24.28428315	25	30.30374879	0	0	0	0	0	24.40289406	0	0	0	0											2.4879	0.054907088	0.796333034	0	1.087662227	1.47972754	1.096339315	0.935094982	0.93649171	0	1.469666143	0	0	0.653962491	2.654576476	7.79965624	0.393707579	0.370353272	0.996337581	0.224104631	1.548653104	0	0	0	0	0	0.194927176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.1804	0	1.324360147	2.4879	0.054907088	0.796333034	0	1.087662227	1.47972754	1.096339315	0.935094982	0.93649171	0	1.469666143	0	0	0.653962491	2.654576476	7.79965624	0.393707579	0.370353272	0.996337581	0.224104631	1.548653104	0	0	0	0	0	0.194927176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.1804		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												1.5587	0.0259	0.2995	0.2279	0.1797	0.1385	0.5999	0.1376	0.2281	0.1452	0.1951	0	0.0737	0.2544	0.1268	1.1691	0.2525	0.0206	0.2825	0.8709	0.2111	0.1227	0	0	0	0.0043	0.0089	0.0014	0	0	0											7.135	500	5.498994773	4.0467	0.080825962	1.095833163	0.22789017	1.267328107	1.618207325	1.696192079	1.072732538	1.164632082	0.145166626	1.664750852	0	0.073657457	0.908383464	2.781376993	8.968790767	0.646170198	0.390913841	1.278869265	1.095021437	1.759774095	0.122708119	0	0	0	0.004302475	0.203782027	0.001438158	0	0	0	0	0	0	0	0	0	0	0	0	0	32.3154
H2320_014_0	2008	5																					2000											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O			V	P	V	P														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	2000	610.4306587	13.57117967	394.0107971	0	134.0743679	7.763766182	7.580766827	237.3556364	231.8205138	0	721.9634018	0	0	316.7242907	3257.385357	3828.275002	111.5938148	186.5426361	492.3369941	107.5702229	613.2520889	0	0	0	0	0	95.85445491	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												48.90842271	48.55031574	24.25313336	0	97.34856058	0.190594037	0.144621163	47.27564069	48.47673028	0	24.42782233	0	0	24.77722776	9.779290512	24.44857667	42.33649472	23.82425465	24.28428315	25	30.30374879	0	0	0	0	0	24.40289406	0	0	0	0											2.4879	0.054907088	0.796333034	0	1.087662227	1.47972754	1.096339315	0.935094982	0.93649171	0	1.469666143	0	0	0.653962491	2.654576476	7.79965624	0.393707579	0.370353272	0.996337581	0.224104631	1.548653104	0	0	0	0	0	0.194927176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.1804	0	1.324360147	2.4879	0.054907088	0.796333034	0	1.087662227	1.47972754	1.096339315	0.935094982	0.93649171	0	1.469666143	0	0	0.653962491	2.654576476	7.79965624	0.393707579	0.370353272	0.996337581	0.224104631	1.548653104	0	0	0	0	0	0.194927176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.1804		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												1.5587	0.0259	0.2995	0.2279	0.1797	0.1385	0.5999	0.1376	0.2281	0.1452	0.1951	0	0.0737	0.2544	0.1268	1.1691	0.2525	0.0206	0.2825	0.8709	0.2111	0.1227	0	0	0	0.0043	0.0089	0.0014	0	0	0											7.135	500	5.498994773	4.0467	0.080825962	1.095833163	0.22789017	1.267328107	1.618207325	1.696192079	1.072732538	1.164632082	0.145166626	1.664750852	0	0.073657457	0.908383464	2.781376993	8.968790767	0.646170198	0.390913841	1.278869265	1.095021437	1.759774095	0.122708119	0	0	0	0.004302475	0.203782027	0.001438158	0	0	0	0	0	0	0	0	0	0	0	0	0	32.3154
H2320_015_0	2008	4																					4000											A	A	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O			V	P	V	P														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	189.9888054	3.331449463	617.6158424	0	160.3301397	16.46771771	0.752862636	332.0791237	315.309643	355.8885341	717.9201761	0	0	126.3220358	3141.156409	3661.915893	130.2843165	382.1864888	612.3980352	806.4366102	1300.757699	0	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												528.7650024	528.7650024	96.13909135	0	96.13909135	0.192278183	0.192278183	47.38741648	96.13909135	9.613909135	38.45563654	0	0	38.45563654	14.4208637	37.56402869	41.78352816	38.45563654	38.45563654	9.613909135	30.5714155	0	0	0	0	0	0	0	0	0	0											8.3716	0.146796157	4.948085491	0	1.284499496	3.166382835	0.144759059	1.311364312	2.526131881	0.285123336	2.300673113	0	0	0.404816191	3.774849037	11.46302614	0.453644867	1.224768725	1.962513022	0.646084024	3.313833673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.729	0	1.916776963	8.3716	0.146796157	4.948085491	0	1.284499496	3.166382835	0.144759059	1.311364312	2.526131881	0.285123336	2.300673113	0	0	0.404816191	3.774849037	11.46302614	0.453644867	1.224768725	1.962513022	0.646084024	3.313833673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.729		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.8509	0.0361	0.4529	0.4386	0.09	0.3144	0.0144	0.0777	0.4546	0.1268	0.345	0	0.1672	0.2702	0.279	0.5261	0.0227	0.0451	0.2592	1.0481	0.3181	0.2734	0	0	0	0	0	0	0	0	0											8.4103	500	10.09283764	11.2225	0.182928278	5.400958246	0.438624126	1.374494969	3.480745728	0.15913094	1.389079317	2.980690975	0.411876121	2.645681041	0	0.167209758	0.675043564	4.053825861	11.98913927	0.476297352	1.269852086	2.221738392	1.69420797	3.631914452	0.273355011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1393
H2320_802_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		216.9608912	2.74979268	32.90084055	25.39643443	6.168696369	21.11689601	0.965411374	6.800798191	35.6243607	10.70364364	29.39753822	0	12.84234763	20.97402229	22.65399144	43.40207462	1.352320658	3.752449168	24.83807633	76.50968009	26.36808289	20.78402918	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.074039213	0.074039213	0.196984489	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											16.0636	0.203592487	6.480955251	0	1.44347495	4.941353666	0.225906262	1.591386777	8.336100404	2.504652613	6.879023943	0	3.005109345	4.907921216	5.301033997	10.15608546	0.316443034	0.878073105	5.812109862	17.90326514	6.170131396	4.863462829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.9837	0	0	16.0636	0.203592487	6.480955251	0	1.44347495	4.941353666	0.225906262	1.591386777	8.336100404	2.504652613	6.879023943	0	3.005109345	4.907921216	5.301033997	10.15608546	0.316443034	0.878073105	5.812109862	17.90326514	6.170131396	4.863462829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.9837		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.9332	0.0118	0.3688	0	0.0894	0.306	0.014	0.0905	0.4743	0.1425	0.4091	0	0.171	0.2793	0.2812	0.5656	0.0176	0.0489	0.3457	0.9971	0.3472	0.2709	0	0	0	0	0	0	0	0	0											6.164	0	0	16.9968	0.215420122	6.849715152	0	1.532854204	5.247319838	0.239894265	1.681881558	8.810416217	2.647164852	7.288124385	0	3.176097074	5.187177046	5.582214939	10.72172653	0.334067263	0.926977205	6.157760166	18.90038378	6.517314477	5.134332382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.1477
H2320_803_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		216.9608912	2.74979268	32.90084055	25.39643443	6.168696369	21.11689601	0.965411374	6.800798191	35.6243607	10.70364364	29.39753822	0	12.84234763	20.97402229	22.65399144	43.40207462	1.352320658	3.752449168	24.83807633	76.50968009	26.36808289	20.78402918	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.074039213	0.074039213	0.196984489	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											16.0636	0.203592487	6.480955251	0	1.44347495	4.941353666	0.225906262	1.591386777	8.336100404	2.504652613	6.879023943	0	3.005109345	4.907921216	5.301033997	10.15608546	0.316443034	0.878073105	5.812109862	17.90326514	6.170131396	4.863462829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.9837	0	0	16.0636	0.203592487	6.480955251	0	1.44347495	4.941353666	0.225906262	1.591386777	8.336100404	2.504652613	6.879023943	0	3.005109345	4.907921216	5.301033997	10.15608546	0.316443034	0.878073105	5.812109862	17.90326514	6.170131396	4.863462829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.9837		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.9332	0.0118	0.3688	0	0.0894	0.306	0.014	0.0905	0.4743	0.1425	0.4091	0	0.171	0.2793	0.2812	0.5656	0.0176	0.0489	0.3457	0.9971	0.3472	0.2709	0	0	0	0	0	0	0	0	0											6.164	0	0	16.9968	0.215420122	6.849715152	0	1.532854204	5.247319838	0.239894265	1.681881558	8.810416217	2.647164852	7.288124385	0	3.176097074	5.187177046	5.582214939	10.72172653	0.334067263	0.926977205	6.157760166	18.90038378	6.517314477	5.134332382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.1477
H2320_804_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		228.3798855	2.894518611	34.63246374	26.73308887	6.493364599	22.22831159	1.016222499	7.158734938	37.49932705	11.26699331	30.94477707	0	13.51826066	22.0779182	23.84630678	45.68639434	1.423495429	3.949946493	26.14534351	80.53650536	27.75587672	21.87792546	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.074039213	0.074039213	0.196984489	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											16.9091	0.214307881	6.822058159	0	1.519447316	5.201424912	0.237796065	1.675143975	8.774842531	2.636476435	7.241077834	0	3.163272995	5.166232859	5.580035786	10.69061628	0.33309793	0.924287479	6.118010381	18.84554225	6.494875153	5.119434557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.667	0	0	16.9091	0.214307881	6.822058159	0	1.519447316	5.201424912	0.237796065	1.675143975	8.774842531	2.636476435	7.241077834	0	3.163272995	5.166232859	5.580035786	10.69061628	0.33309793	0.924287479	6.118010381	18.84554225	6.494875153	5.119434557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.667		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.9091	0.214307881	6.822058159	0	1.519447316	5.201424912	0.237796065	1.675143975	8.774842531	2.636476435	7.241077834	0	3.163272995	5.166232859	5.580035786	10.69061628	0.33309793	0.924287479	6.118010381	18.84554225	6.494875153	5.119434557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.667
H2320_805_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		228.3798855	2.894518611	34.63246374	26.73308887	6.493364599	22.22831159	1.016222499	7.158734938	37.49932705	11.26699331	30.94477707	0	13.51826066	22.0779182	23.84630678	45.68639434	1.423495429	3.949946493	26.14534351	80.53650536	27.75587672	21.87792546	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.074039213	0.074039213	0.196984489	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											16.9091	0.214307881	6.822058159	0	1.519447316	5.201424912	0.237796065	1.675143975	8.774842531	2.636476435	7.241077834	0	3.163272995	5.166232859	5.580035786	10.69061628	0.33309793	0.924287479	6.118010381	18.84554225	6.494875153	5.119434557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.667	0	0	16.9091	0.214307881	6.822058159	0	1.519447316	5.201424912	0.237796065	1.675143975	8.774842531	2.636476435	7.241077834	0	3.163272995	5.166232859	5.580035786	10.69061628	0.33309793	0.924287479	6.118010381	18.84554225	6.494875153	5.119434557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.667		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.9091	0.214307881	6.822058159	0	1.519447316	5.201424912	0.237796065	1.675143975	8.774842531	2.636476435	7.241077834	0	3.163272995	5.166232859	5.580035786	10.69061628	0.33309793	0.924287479	6.118010381	18.84554225	6.494875153	5.119434557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.667
H2320_806_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		216.9608912	2.74979268	32.90084055	25.39643443	6.168696369	21.11689601	0.965411374	6.800798191	35.6243607	10.70364364	29.39753822	0	12.84234763	20.97402229	22.65399144	43.40207462	1.352320658	3.752449168	24.83807633	76.50968009	26.36808289	20.78402918	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.074039213	0.074039213	0.196984489	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											16.0636	0.203592487	6.480955251	0	1.44347495	4.941353666	0.225906262	1.591386777	8.336100404	2.504652613	6.879023943	0	3.005109345	4.907921216	5.301033997	10.15608546	0.316443034	0.878073105	5.812109862	17.90326514	6.170131396	4.863462829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.9837	0	0	16.0636	0.203592487	6.480955251	0	1.44347495	4.941353666	0.225906262	1.591386777	8.336100404	2.504652613	6.879023943	0	3.005109345	4.907921216	5.301033997	10.15608546	0.316443034	0.878073105	5.812109862	17.90326514	6.170131396	4.863462829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.9837		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.9332	0.0118	0.3688	0	0.0894	0.306	0.014	0.0905	0.4743	0.1425	0.4091	0	0.171	0.2793	0.2812	0.5656	0.0176	0.0489	0.3457	0.9971	0.3472	0.2709	0	0	0	0	0	0	0	0	0											6.164	0	0	16.9968	0.215420122	6.849715152	0	1.532854204	5.247319838	0.239894265	1.681881558	8.810416217	2.647164852	7.288124385	0	3.176097074	5.187177046	5.582214939	10.72172653	0.334067263	0.926977205	6.157760166	18.90038378	6.517314477	5.134332382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.1477
H2320_807_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		216.9608912	2.74979268	32.90084055	25.39643443	6.168696369	21.11689601	0.965411374	6.800798191	35.6243607	10.70364364	29.39753822	0	12.84234763	20.97402229	22.65399144	43.40207462	1.352320658	3.752449168	24.83807633	76.50968009	26.36808289	20.78402918	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.074039213	0.074039213	0.196984489	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											16.0636	0.203592487	6.480955251	0	1.44347495	4.941353666	0.225906262	1.591386777	8.336100404	2.504652613	6.879023943	0	3.005109345	4.907921216	5.301033997	10.15608546	0.316443034	0.878073105	5.812109862	17.90326514	6.170131396	4.863462829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.9837	0	0	16.0636	0.203592487	6.480955251	0	1.44347495	4.941353666	0.225906262	1.591386777	8.336100404	2.504652613	6.879023943	0	3.005109345	4.907921216	5.301033997	10.15608546	0.316443034	0.878073105	5.812109862	17.90326514	6.170131396	4.863462829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.9837		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.9332	0.0118	0.3688	0	0.0894	0.306	0.014	0.0905	0.4743	0.1425	0.4091	0	0.171	0.2793	0.2812	0.5656	0.0176	0.0489	0.3457	0.9971	0.3472	0.2709	0	0	0	0	0	0	0	0	0											6.164	0	0	16.9968	0.215420122	6.849715152	0	1.532854204	5.247319838	0.239894265	1.681881558	8.810416217	2.647164852	7.288124385	0	3.176097074	5.187177046	5.582214939	10.72172653	0.334067263	0.926977205	6.157760166	18.90038378	6.517314477	5.134332382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.1477
H2320_808_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		228.3798855	2.894518611	34.63246374	26.73308887	6.493364599	22.22831159	1.016222499	7.158734938	37.49932705	11.26699331	30.94477707	0	13.51826066	22.0779182	23.84630678	45.68639434	1.423495429	3.949946493	26.14534351	80.53650536	27.75587672	21.87792546	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.074039213	0.074039213	0.196984489	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											16.9091	0.214307881	6.822058159	0	1.519447316	5.201424912	0.237796065	1.675143975	8.774842531	2.636476435	7.241077834	0	3.163272995	5.166232859	5.580035786	10.69061628	0.33309793	0.924287479	6.118010381	18.84554225	6.494875153	5.119434557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.667	0	0	16.9091	0.214307881	6.822058159	0	1.519447316	5.201424912	0.237796065	1.675143975	8.774842531	2.636476435	7.241077834	0	3.163272995	5.166232859	5.580035786	10.69061628	0.33309793	0.924287479	6.118010381	18.84554225	6.494875153	5.119434557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.667		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.9091	0.214307881	6.822058159	0	1.519447316	5.201424912	0.237796065	1.675143975	8.774842531	2.636476435	7.241077834	0	3.163272995	5.166232859	5.580035786	10.69061628	0.33309793	0.924287479	6.118010381	18.84554225	6.494875153	5.119434557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.667
H2320_809_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		228.3798855	2.894518611	34.63246374	26.73308887	6.493364599	22.22831159	1.016222499	7.158734938	37.49932705	11.26699331	30.94477707	0	13.51826066	22.0779182	23.84630678	45.68639434	1.423495429	3.949946493	26.14534351	80.53650536	27.75587672	21.87792546	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.074039213	0.074039213	0.196984489	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											16.9091	0.214307881	6.822058159	0	1.519447316	5.201424912	0.237796065	1.675143975	8.774842531	2.636476435	7.241077834	0	3.163272995	5.166232859	5.580035786	10.69061628	0.33309793	0.924287479	6.118010381	18.84554225	6.494875153	5.119434557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.667	0	0	16.9091	0.214307881	6.822058159	0	1.519447316	5.201424912	0.237796065	1.675143975	8.774842531	2.636476435	7.241077834	0	3.163272995	5.166232859	5.580035786	10.69061628	0.33309793	0.924287479	6.118010381	18.84554225	6.494875153	5.119434557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.667		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.9091	0.214307881	6.822058159	0	1.519447316	5.201424912	0.237796065	1.675143975	8.774842531	2.636476435	7.241077834	0	3.163272995	5.166232859	5.580035786	10.69061628	0.33309793	0.924287479	6.118010381	18.84554225	6.494875153	5.119434557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.667
H2322_001_0	2008	7																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	261.9729109	6.477998225	375.9545859	0	307.4077899	14.66193971	0	260.7124811	238.3281056	0	0	0	0	97.61187402	3373.968714	2712.704857	186.0497466	153.1050583	1122.091821	425.3584633	0	0	0	0	0	0	0	0	0	0	0											1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: $130 days 21-100	6 Home Health: $0	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $50	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $10, 14C Routine Physical Exams: $10, 14D Pap Smears: $10, 14D Pelvic Exams: $10, 14E Prostate Screening: $10, 14F Colorectal Screening: $10, 14G Bone Mass Measurement: $10, 14H Mammography: $10, 14I Diabetes Monitoring: $10"	"7B Chiropractic: $25, 7D Physician Specialist: $25, 7F Podiatry: $25"	"7E Mental Health: $25, 7H Psychiatric: $25, 9C OP Substance Abuse: $25"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7G Other Health Care: $25, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	130	0	50	0.199999691	0.200043796	49.17041836	50	0	0	0	0	15	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0	0											5.4578	0.134958296	4.072841347	0	1.280865791	2.932383407	0	1.068278481	0.993033773	0	0	0	0	0.122014843	2.811640595	5.651468451	0.387603639	0.191381323	0	0.886163465	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9904	0	0	5.4578	0.134958296	4.072841347	0	1.280865791	2.932383407	0	1.068278481	0.993033773	0	0	0	0	0.122014843	2.811640595	5.651468451	0.387603639	0.191381323	0	0.886163465	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9904	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											5.085	0.0817	1.351	0.4772	0.3596	2.7671	0	0.281	0.5967	0.1285	0.369	0.0144	0	0.3892	0.4386	2.347	0.1004	0.0708	0.5006	0.7456	0.1398	0.0915	0	0	0.045	0.0918	0.0141	0.0408	0	0	0											16.5264	0	0	10.5428	0.216650822	5.423838323	0.47715525	1.640451214	5.699519728	0	1.349287665	1.589705963	0.128544876	0.368994513	0.014352098	0	0.511185493	3.250237602	7.998479991	0.487991983	0.262181857	0.50055541	1.631796563	0.139776952	0.091520623	0	0	0.045032307	0.091832626	0.014144096	0.040768278	0	0	0	0	0	0	0	0	0	0	0	0	0	42.5168
H2322_003_0	2008	5																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	261.9729109	6.477998225	375.9545859	0	307.4077899	14.66193971	0	260.7124811	238.3281056	0	0	0	0	97.61187402	3373.968714	2712.704857	186.0497466	153.1050583	1122.091821	425.3584633	0	0	0	0	0	0	0	0	0	0	0											1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: $130 days 21-100	6 Home Health: $0	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $50	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $10, 14C Routine Physical Exams: $10, 14D Pap Smears: $10, 14D Pelvic Exams: $10, 14E Prostate Screening: $10, 14F Colorectal Screening: $10, 14G Bone Mass Measurement: $10, 14H Mammography: $10, 14I Diabetes Monitoring: $10"	"7B Chiropractic: $25, 7D Physician Specialist: $25, 7F Podiatry: $25"	"7E Mental Health: $25, 7H Psychiatric: $25, 9C OP Substance Abuse: $25"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7G Other Health Care: $25, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	130	0	50	0.199999691	0.200043796	49.17041836	50	0	0	0	0	15	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0	0											5.4578	0.134958296	4.072841347	0	1.280865791	2.932383407	0	1.068278481	0.993033773	0	0	0	0	0.122014843	2.811640595	5.651468451	0.387603639	0.191381323	0	0.886163465	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9904	0	0	5.4578	0.134958296	4.072841347	0	1.280865791	2.932383407	0	1.068278481	0.993033773	0	0	0	0	0.122014843	2.811640595	5.651468451	0.387603639	0.191381323	0	0.886163465	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9904	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											5.085	0.0817	1.351	0.4772	0.3596	2.7671	0	0.281	0.5967	0.1285	0.369	0.0144	0	0.3892	0.4386	2.347	0.1004	0.0708	0.5006	0.7456	0.1398	0.0915	0	0	0.045	0.0918	0.0141	0.0408	0	0	0											16.5264	0	0	10.5428	0.216650822	5.423838323	0.47715525	1.640451214	5.699519728	0	1.349287665	1.589705963	0.128544876	0.368994513	0.014352098	0	0.511185493	3.250237602	7.998479991	0.487991983	0.262181857	0.50055541	1.631796563	0.139776952	0.091520623	0	0	0.045032307	0.091832626	0.014144096	0.040768278	0	0	0	0	0	0	0	0	0	0	0	0	0	42.5168
H2322_004_0	2008	6																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	261.9729109	6.477998225	375.9545859	0	307.4077899	14.66193971	0	260.7124811	238.3281056	0	0	0	0	97.61187402	3373.968714	2712.704857	186.0497466	153.1050583	1122.091821	425.3584633	0	0	0	0	0	0	0	0	0	0	0											1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: $130 days 21-100	6 Home Health: $0	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $50	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $10, 14C Routine Physical Exams: $10, 14D Pap Smears: $10, 14D Pelvic Exams: $10, 14E Prostate Screening: $10, 14F Colorectal Screening: $10, 14G Bone Mass Measurement: $10, 14H Mammography: $10, 14I Diabetes Monitoring: $10"	"7B Chiropractic: $25, 7D Physician Specialist: $25, 7F Podiatry: $25"	"7E Mental Health: $25, 7H Psychiatric: $25, 9C OP Substance Abuse: $25"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7G Other Health Care: $25, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	130	0	50	0.199999691	0.200043796	49.17041836	50	0	0	0	0	15	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0	0											5.4578	0.134958296	4.072841347	0	1.280865791	2.932383407	0	1.068278481	0.993033773	0	0	0	0	0.122014843	2.811640595	5.651468451	0.387603639	0.191381323	0	0.886163465	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9904	0	0	5.4578	0.134958296	4.072841347	0	1.280865791	2.932383407	0	1.068278481	0.993033773	0	0	0	0	0.122014843	2.811640595	5.651468451	0.387603639	0.191381323	0	0.886163465	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9904	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											5.085	0.0817	1.351	0.4772	0.3596	2.7671	0	0.281	0.5967	0.1285	0.369	0.0144	0	0.3892	0.4386	2.347	0.1004	0.0708	0.5006	0.7456	0.1398	0.0915	0	0	0.045	0.0918	0.0141	0.0408	0	0	0											16.5264	0	0	10.5428	0.216650822	5.423838323	0.47715525	1.640451214	5.699519728	0	1.349287665	1.589705963	0.128544876	0.368994513	0.014352098	0	0.511185493	3.250237602	7.998479991	0.487991983	0.262181857	0.50055541	1.631796563	0.139776952	0.091520623	0	0	0.045032307	0.091832626	0.014144096	0.040768278	0	0	0	0	0	0	0	0	0	0	0	0	0	42.5168
H2322_005_0	2008	4																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											10.9544	0.1368	1.5774	1.5305	0.2274	0.4512	0.3142	0.0054	1.3145	0.4124	1.1838	0.0463	0.008	1.2277	2.0686	3.9516	0.0505	0.1551	1.3524	1.7469	0.4485	0.2457	0	0	0.0911	0.2605	0.0186	0.0232	0	0.0237	0.0855											29.912	0	261.6317909	6.471758225	375.0310659	0	306.8815499	14.41524365	0	260.6792011	237.5668256	0	0	0	0	96.69667402	3360.227714	2699.605017	185.5963066	151.8029783	1122.091821	421.8536633	0	0	0	0	0	0	0	0	0	0	0											1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: $130 days 21-100	6 Home Health: $0	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $50	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $10, 14C Routine Physical Exams: $10, 14D Pap Smears: $10, 14D Pelvic Exams: $10, 14E Prostate Screening: $10, 14F Colorectal Screening: $10, 14G Bone Mass Measurement: $10, 14H Mammography: $10, 14I Diabetes Monitoring: $10"	"7B Chiropractic: $25, 7D Physician Specialist: $25, 7F Podiatry: $25"	"7E Mental Health: $25, 7H Psychiatric: $25, 9C OP Substance Abuse: $25"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7G Other Health Care: $25, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	130	0	50	0.207718863	0.207723393	49.17884214	50	0	0	0	0	15	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0	0											5.4507	0.134828296	4.062836547	0	1.278673125	2.994318016	0	1.068325107	0.989861773	0	0	0	0	0.120870843	2.800189762	5.624177118	0.386658972	0.189753723	0	0.878861799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.98	500	0	16.4051	0.271605796	5.640221106	1.530528118	1.506073334	3.445500887	0.314155232	1.073741771	2.304348378	0.412445046	1.183785643	0.046333606	0.007975457	1.348539537	4.868780325	9.575799907	0.437155165	0.344886325	1.352409585	2.625741586	0.448524493	0.245720023	0	0	0.091148076	0.260531585	0.018609399	0.023166803	0	0.023736478	0.085451322	0	0	0	0	0	0	0	0	0	0	55.892	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											7.1116	0.107	1.6428	0.7603	0.4017	2.7499	0	0.282	0.8399	0.2048	0.588	0.0229	0	0.6163	0.8213	3.0781	0.1097	0.0801	0.7508	1.0688	0.2228	0.137	0	0	0.0619	0.14	0.0176	0.0451	0	0	0											21.8602	500	0	23.5167	0.378602159	7.283034225	2.29083107	1.907727794	6.195387394	0.314155232	1.355753038	3.144200589	0.617292255	1.771780501	0.06925742	0.007975457	1.964828897	5.690066585	12.65386166	0.546885305	0.425028654	2.103160768	3.694547444	0.671278476	0.38269885	0	0	0.153042777	0.400562554	0.036196234	0.068220939	0	0.023736478	0.085451322	0	0	0	0	0	0	0	0	0	0	77.7522
H2322_006_0	2008	6																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											10.9544	0.1368	1.5774	1.5305	0.2274	0.4512	0.3142	0.0054	1.3145	0.4124	1.1838	0.0463	0.008	1.2277	2.0686	3.9516	0.0505	0.1551	1.3524	1.7469	0.4485	0.2457	0	0	0.0911	0.2605	0.0186	0.0232	0	0.0237	0.0855											29.912	0	261.6317909	6.471758225	375.0310659	0	306.8815499	14.41524365	0	260.6792011	237.5668256	0	0	0	0	96.69667402	3360.227714	2699.605017	185.5963066	151.8029783	1122.091821	421.8536633	0	0	0	0	0	0	0	0	0	0	0											1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: $130 days 21-100	6 Home Health: $0	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $50	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $10, 14C Routine Physical Exams: $10, 14D Pap Smears: $10, 14D Pelvic Exams: $10, 14E Prostate Screening: $10, 14F Colorectal Screening: $10, 14G Bone Mass Measurement: $10, 14H Mammography: $10, 14I Diabetes Monitoring: $10"	"7B Chiropractic: $25, 7D Physician Specialist: $25, 7F Podiatry: $25"	"7E Mental Health: $25, 7H Psychiatric: $25, 9C OP Substance Abuse: $25"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7G Other Health Care: $25, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	130	0	50	0.207718863	0.207723393	49.17884214	50	0	0	0	0	15	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0	0											5.4507	0.134828296	4.062836547	0	1.278673125	2.994318016	0	1.068325107	0.989861773	0	0	0	0	0.120870843	2.800189762	5.624177118	0.386658972	0.189753723	0	0.878861799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.98	500	0	16.4051	0.271605796	5.640221106	1.530528118	1.506073334	3.445500887	0.314155232	1.073741771	2.304348378	0.412445046	1.183785643	0.046333606	0.007975457	1.348539537	4.868780325	9.575799907	0.437155165	0.344886325	1.352409585	2.625741586	0.448524493	0.245720023	0	0	0.091148076	0.260531585	0.018609399	0.023166803	0	0.023736478	0.085451322	0	0	0	0	0	0	0	0	0	0	55.892	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											7.1116	0.107	1.6428	0.7603	0.4017	2.7499	0	0.282	0.8399	0.2048	0.588	0.0229	0	0.6163	0.8213	3.0781	0.1097	0.0801	0.7508	1.0688	0.2228	0.137	0	0	0.0619	0.14	0.0176	0.0451	0	0	0											21.8602	500	0	23.5167	0.378602159	7.283034225	2.29083107	1.907727794	6.195387394	0.314155232	1.355753038	3.144200589	0.617292255	1.771780501	0.06925742	0.007975457	1.964828897	5.690066585	12.65386166	0.546885305	0.425028654	2.103160768	3.694547444	0.671278476	0.38269885	0	0	0.153042777	0.400562554	0.036196234	0.068220939	0	0.023736478	0.085451322	0	0	0	0	0	0	0	0	0	0	77.7522
H2322_007_0	2008	4																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											10.9544	0.1368	1.5774	1.5305	0.2274	0.4512	0.3142	0.0054	1.3145	0.4124	1.1838	0.0463	0.008	1.2277	2.0686	3.9516	0.0505	0.1551	1.3524	1.7469	0.4485	0.2457	0	0	0.0911	0.2605	0.0186	0.0232	0	0.0237	0.0855											29.912	0	261.6317909	6.471758225	375.0310659	0	306.8815499	14.41524365	0	260.6792011	237.5668256	0	0	0	0	96.69667402	3360.227714	2699.605017	185.5963066	151.8029783	1122.091821	421.8536633	0	0	0	0	0	0	0	0	0	0	0											1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: $130 days 21-100	6 Home Health: $0	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $50	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $10, 14C Routine Physical Exams: $10, 14D Pap Smears: $10, 14D Pelvic Exams: $10, 14E Prostate Screening: $10, 14F Colorectal Screening: $10, 14G Bone Mass Measurement: $10, 14H Mammography: $10, 14I Diabetes Monitoring: $10"	"7B Chiropractic: $25, 7D Physician Specialist: $25, 7F Podiatry: $25"	"7E Mental Health: $25, 7H Psychiatric: $25, 9C OP Substance Abuse: $25"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7G Other Health Care: $25, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	130	0	50	0.207718863	0.207723393	49.17884214	50	0	0	0	0	15	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0	0											5.4507	0.134828296	4.062836547	0	1.278673125	2.994318016	0	1.068325107	0.989861773	0	0	0	0	0.120870843	2.800189762	5.624177118	0.386658972	0.189753723	0	0.878861799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.98	500	0	16.4051	0.271605796	5.640221106	1.530528118	1.506073334	3.445500887	0.314155232	1.073741771	2.304348378	0.412445046	1.183785643	0.046333606	0.007975457	1.348539537	4.868780325	9.575799907	0.437155165	0.344886325	1.352409585	2.625741586	0.448524493	0.245720023	0	0	0.091148076	0.260531585	0.018609399	0.023166803	0	0.023736478	0.085451322	0	0	0	0	0	0	0	0	0	0	55.892	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											7.1116	0.107	1.6428	0.7603	0.4017	2.7499	0	0.282	0.8399	0.2048	0.588	0.0229	0	0.6163	0.8213	3.0781	0.1097	0.0801	0.7508	1.0688	0.2228	0.137	0	0	0.0619	0.14	0.0176	0.0451	0	0	0											21.8602	500	0	23.5167	0.378602159	7.283034225	2.29083107	1.907727794	6.195387394	0.314155232	1.355753038	3.144200589	0.617292255	1.771780501	0.06925742	0.007975457	1.964828897	5.690066585	12.65386166	0.546885305	0.425028654	2.103160768	3.694547444	0.671278476	0.38269885	0	0	0.153042777	0.400562554	0.036196234	0.068220939	0	0.023736478	0.085451322	0	0	0	0	0	0	0	0	0	0	77.7522
H2322_801_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	214.4368884	3.174321086	31.24709104	36.01222113	8.678528399	14.85838117	2.45952	13.36255603	22.185239	3.62420913	19.92833834	0.28672	0.226447742	61.37237291	28.17266682	75.855744	1.99521943	1.346076507	8.45824	49.0898581	6.9983149	0																				6.94% Medicare Equivalent Coinsurance	6.94% Medicare Equivalent Coinsurance	19.12% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.41% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.12% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance																				0.069389565	0.069421682	0.191215116	0	0.234146706	0.234000055	0.233999056	0.231174794	0.234000023	0.233980885	0.233998644	0.234000193	0.233999983	0.233974067	0.234009633	0.233999351	0.234012004	0.234012934	0.234005477	0.234000608	0.233997939	0.234001532																				14.8797	0.22036671	5.974916149	0	2.032048834	3.476862014	0.575525359	3.089086138	5.191346426	0.847995661	4.663204143	0.067092535	0.052988768	14.35954367	6.592675432	17.75019487	0.466905298	0.314999313	1.979274488	11.48705664	1.637591263	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.6594	0	0	14.8797	0.22036671	5.974916149	0	2.032048834	3.476862014	0.575525359	3.089086138	5.191346426	0.847995661	4.663204143	0.067092535	0.052988768	14.35954367	6.592675432	17.75019487	0.466905298	0.314999313	1.979274488	11.48705664	1.637591263	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.6594	0	6.94% Medicare Equivalent Coinsurance	6.94% Medicare Equivalent Coinsurance	19.12% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.41% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.12% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance																				3.903	0.0574	1.577	0	0.5374	0.9311	0.187	0.7865	1.3725	0.2344	1.2302	0.0193	0.0136	3.658	0.7876	4.9439	0.1254	0.1001	0.6434	3.0766	0.4338	0																				24.6183	0	0	18.7827	0.27777911	7.551959107	0	2.569447321	4.407929646	0.762526497	3.875612852	6.563877452	1.082437851	5.893435705	0.086355432	0.06662908	18.01752316	7.380236295	22.69409271	0.592298114	0.415115733	2.622697353	14.56362971	2.071367273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.2777
H2322_803_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	214.4368884	3.174321086	31.24709104	36.01222113	8.678528399	14.85838117	2.45952	13.36255603	22.185239	3.62420913	19.92833834	0.28672	0.226447742	61.37237291	28.17266682	75.855744	1.99521943	1.346076507	8.45824	49.0898581	6.9983149	0																				6.94% Medicare Equivalent Coinsurance	6.94% Medicare Equivalent Coinsurance	19.12% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.41% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.12% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance																				0.069389565	0.069421682	0.191215116	0	0.234146706	0.234000055	0.233999056	0.231174794	0.234000023	0.233980885	0.233998644	0.234000193	0.233999983	0.233974067	0.234009633	0.233999351	0.234012004	0.234012934	0.234005477	0.234000608	0.233997939	0.234001532																				14.8797	0.22036671	5.974916149	0	2.032048834	3.476862014	0.575525359	3.089086138	5.191346426	0.847995661	4.663204143	0.067092535	0.052988768	14.35954367	6.592675432	17.75019487	0.466905298	0.314999313	1.979274488	11.48705664	1.637591263	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.6594	0	0	14.8797	0.22036671	5.974916149	0	2.032048834	3.476862014	0.575525359	3.089086138	5.191346426	0.847995661	4.663204143	0.067092535	0.052988768	14.35954367	6.592675432	17.75019487	0.466905298	0.314999313	1.979274488	11.48705664	1.637591263	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.6594	0	6.94% Medicare Equivalent Coinsurance	6.94% Medicare Equivalent Coinsurance	19.12% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.41% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.12% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance																				3.903	0.0574	1.577	0	0.5374	0.9311	0.187	0.7865	1.3725	0.2344	1.2302	0.0193	0.0136	3.658	0.7876	4.9439	0.1254	0.1001	0.6434	3.0766	0.4338	0																				24.6183	0	0	18.7827	0.27777911	7.551959107	0	2.569447321	4.407929646	0.762526497	3.875612852	6.563877452	1.082437851	5.893435705	0.086355432	0.06662908	18.01752316	7.380236295	22.69409271	0.592298114	0.415115733	2.622697353	14.56362971	2.071367273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.2777
H2322_804_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0	0	214.4368884	3.174321086	31.24709104	36.01222113	8.678528399	14.85838117	2.45952	13.36255603	22.185239	3.62420913	19.92833834	0.28672	0.226447742	61.37237291	28.17266682	75.855744	1.99521943	1.346076507	8.45824	49.0898581	6.9983149	0																				6.94% Medicare Equivalent Coinsurance	6.94% Medicare Equivalent Coinsurance	19.12% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.41% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.12% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance																				0.069389565	0.069421682	0.191215116	0	0.234146706	0.234000055	0.233999056	0.231174794	0.234000023	0.233980885	0.233998644	0.234000193	0.233999983	0.233974067	0.234009633	0.233999351	0.234012004	0.234012934	0.234005477	0.234000608	0.233997939	0.234001532																				14.8797	0.22036671	5.974916149	0	2.032048834	3.476862014	0.575525359	3.089086138	5.191346426	0.847995661	4.663204143	0.067092535	0.052988768	14.35954367	6.592675432	17.75019487	0.466905298	0.314999313	1.979274488	11.48705664	1.637591263	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.6594	0	0	14.8797	0.22036671	5.974916149	0	2.032048834	3.476862014	0.575525359	3.089086138	5.191346426	0.847995661	4.663204143	0.067092535	0.052988768	14.35954367	6.592675432	17.75019487	0.466905298	0.314999313	1.979274488	11.48705664	1.637591263	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.6594	0	6.94% Medicare Equivalent Coinsurance	6.94% Medicare Equivalent Coinsurance	19.12% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.41% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.12% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance	23.40% Medicare Equivalent Coinsurance																				3.903	0.0574	1.577	0	0.5374	0.9311	0.187	0.7865	1.3725	0.2344	1.2302	0.0193	0.0136	3.658	0.7876	4.9439	0.1254	0.1001	0.6434	3.0766	0.4338	0																				24.6183	0	0	18.7827	0.27777911	7.551959107	0	2.569447321	4.407929646	0.762526497	3.875612852	6.563877452	1.082437851	5.893435705	0.086355432	0.06662908	18.01752316	7.380236295	22.69409271	0.592298114	0.415115733	2.622697353	14.56362971	2.071367273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.2777
H2323_005_0	2008	7																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	443.64	21.3	394.63	6.23	49.77	8.45	40.81	9.23	9.83	23.52	16.19	0.71	1.09	131.07	78.06	118.49	7.99	0.93	23.69	45.16	3.3	5.28	13.33	0	0	0	0	0	0	0	52.5											PBP: 1A IP Acute: Medicare Cost Sharing	1B IP Psych: Medicare Cost Sharing	2 SNF: $0	6 Home Health: Medicare Cost Sharing	10A Ambulance: Medicare Cost Sharing	11A DME: Medicare Cost Sharing	11B Prosthetic Medical Supplies: Medicare Cost Sharing	"4A ER: $0, 4B Urgent Care: Medicare Cost Sharing"	9B ASC Services: Medicare Cost Sharing	8A OP C/D/T: Medicare Cost Sharing	8B OP X-Ray: Medicare Cost Sharing	9A OP Hospital: Medicare Cost Sharing	12 Renal Dialysis: Medicare Cost Sharing	"3 CORF, 5 Partial Hosp, 9C OP Substance Abuse, 9D Cardiac Rehab: Medicare Cost Sharing"	"7A PCP and 14C Routine Physical Exams:$0; 14B Immunizations, 14D Pap Smears, 14D Pelvic Exams, 14E Prostate Screening, 14F Colorectal Screening, 14G Bone Mass Measurement, 14H Mammography, 14I Diabetes Monitoring: Medicare Cost Sharing"	"7B Chiropractic, 7D Physician Specialist, 7F Podiatry: Medicare Cost Sharing"	"7E Mental Health, 7H Psychiatric:Medicare Cost Sharing"	"7C Occupational Therapy, 7I Physical and Speech Therapy: Medicare Cost Sharing"	Included in i.2.	"7G Other Health Care, 18A Medicare Covered Hearing Exams: Medicare Cost Sharing"	15 Part B Drugs: Medicare Cost Sharing	"13A Blood, 16B Medicare Covered Comprehensive Dental Services, 17A Medicare Covered Eye Exams: Medicare Cost Sharing"	10B Transportation: $0	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: $0"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.070576294	0.070566681	0	0	0.233995453	0.234000077	0.23398113	0.234099901	0.233999958	0.234013076	0.234017991	0.234000325	0.233999975	0.233993467	0	0.233997937	0.23399782	0.234012192	0.234011442	0.233023947	0.233983354	0.233994159	0	0	0	0	0	0	0	0	0											31.3105	1.503070298	0	0	11.64595368	1.977300654	9.548769926	2.160742082	2.300219585	5.503987537	3.788751273	0.166140231	0.255059972	30.66952376	0	27.72641552	1.869642585	0.217631338	5.543731056	10.52336147	0.772145068	1.235489162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.7184	0	0	31.3105	1.503070298	0	0	11.64595368	1.977300654	9.548769926	2.160742082	2.300219585	5.503987537	3.788751273	0.166140231	0.255059972	30.66952376	0	27.72641552	1.869642585	0.217631338	5.543731056	10.52336147	0.772145068	1.235489162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.7184	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	31.3105	1.503070298	0	0	11.64595368	1.977300654	9.548769926	2.160742082	2.300219585	5.503987537	3.788751273	0.166140231	0.255059972	30.66952376	0	27.72641552	1.869642585	0.217631338	5.543731056	10.52336147	0.772145068	1.235489162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.7184
H2323_006_0	2008	5																					500											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	2068.49	159.13	0	0	1836.92	0	0	465.29	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											"PBP: 1A IP Acute: $25 per day for days 1-20, $0 thereafter"	"1B IP Psych: $25 per day for days 1- 20, $0 thereafter"	2 SNF: $0	6 Home Health: $0	10A Ambulance: $50	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $0, 7D Physician Specialist: $0, 7F Podiatry: $0"	"7E Mental Health: $0, 7H Psychiatric: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: $0	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: $0"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											19.02450655	19.02450655	0	0	38.04901311	0	0	37.87924855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											3.2793	0.252280811	0	0	5.824416096	0	0	1.468736296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8248	0	0	3.2793	0.252280811	0	0	5.824416096	0	0	1.468736296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.2793	0.252280811	0	0	5.824416096	0	0	1.468736296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8248
H2323_007_0	2008	8																					500											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	2492.61	206.79	0	0	2203.97	0	0	545.6	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											"PBP: 1A IP Acute: $25 per day for days 1-20, $0 thereafter"	"1B IP Psych: $25 per day for days 1- 20, $0 thereafter"	2 SNF: $0	6 Home Health: $0	10A Ambulance: $50	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $0, 7D Physician Specialist: $0, 7F Podiatry: $0"	"7E Mental Health: $0, 7H Psychiatric: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: $0	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: $0"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											18.21921369	18.21921369	0	0	36.43842738	0	0	36.27814105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											3.7844	0.3139626	0	0	6.6924334	0	0	1.649446146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.4403	0	0	3.7844	0.3139626	0	0	6.6924334	0	0	1.649446146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.4403	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.7844	0.3139626	0	0	6.6924334	0	0	1.649446146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.4403
H2354_001_0	2008	5																					0											A	A	D	V	T	Coin	O	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	P	T	P	V	P	V	P	O	O	O																																																				0	0	311.2373013	0.85779688	627.5593017		239.1762701	24.40687406		169.0047198	459.5742379						4638.786421	1766.375926	124.8861921			556.456892					516.8186284		10.0619556															1A IP Acute: $300 per admit	1B IP Psych: $300 per admit	2 SNF: $0 per day for days 1-20 plus $100 per day for days 21-100		10A Ambulance: $50	"11A DME: 20%, 11B Prosthetics/Supplies: 20%"		"4A ER: $50, 4B Urgent Care: $30"	"9A Outpatient Hospital: $200, 9B ASC Services: $200"						"7A PCP: $20, 14C Routine Physical Exams: $20"	"3 CORF: $35, 7B Chiropractic: $35, 7C Occupational Therapy: $35, 7D Physician Specialist: $35, 7F Podiatry: $35, 7I PT and ST: $35, 17A Medicare Covered Eye Exams: $35, 18A Medicare Covered Hearing Exams: $35"	"7E Mental Health: $35, 7H Psychiatric: $35, 9C Outpatient Substance Abuse: $35"			7G Other Health Care: $35					17A Routine Eye Exams: $35		18A Routine Hearing Exams: $35															300	300	47.99154334		50	0.2		50	200						20	35	35			35					35		35															7.7809	0.021444922	2.509794952	0	0.996567792	4.881374813	0	0.704186332	7.659570632	0	0	0	0	0	7.731310702	5.151929783	0.364251394	0	0	1.622999268	0	0	0	0	1.507387666	0	0.02934737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.9611	0	0	7.7809	0.021444922	2.509794952	0	0.996567792	4.881374813	0	0.704186332	7.659570632	0	0	0	0	0	7.731310702	5.151929783	0.364251394	0	0	1.622999268	0	0	0	0	1.507387666	0	0.02934737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.9611	0																																																																																			0	0	0	7.7809	0.021444922	2.509794952	0	0.996567792	4.881374813	0	0.704186332	7.659570632	0	0	0	0	0	7.731310702	5.151929783	0.364251394	0	0	1.622999268	0	0	0	0	1.507387666	0	0.02934737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.9611
H2354_013_0	2008	5																					0											A	A	D	V	T	Coin	O	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	P	T	P	V	P	V	P	O	O	O																																																				0	0	355.6997729	0.980339291	724.3694914		273.3443086	27.89357036		193.1482511	525.2277005						5301.470196	2081.800198	147.1872978			641.434745					609.1076691		11.85873338															1A IP Acute: $300 per admit	1B IP Psych: $300 per admit	2 SNF: $0 per day for days 1-20 plus $75 per day for days 21-100		10A Ambulance: $25	"11A DME: 20%, 11B Prosthetics/Supplies: 20%"		"4A ER: $50, 4B Urgent Care: $30"	"9A Outpatient Hospital: $150, 9B ASC Services: $150"						"7A PCP: $20, 14C Routine Physical Exams: $20"	"3 CORF: $30, 7B Chiropractic: $30, 7C Occupational Therapy: $30, 7D Physician Specialist: $30, 7F Podiatry: $30, 7I PT and ST: $30, 17A Medicare Covered Eye Exams: $30, 18A Medicare Covered Hearing Exams: $30"	"7E Mental Health: $30, 7H Psychiatric: $30, 9C Outpatient Substance Abuse: $30"			7G Other Health Care: $30					17A Routine Eye Exams: $30		18A Routine Hearing Exams: $30															300	300	35.99365751		25	0.2		50	150						20	30	30			30					30		30															8.8925	0.024508482	2.172725615	0	0.56946731	5.578714072	0	0.80478438	6.565346256	0	0	0	0	0	8.835783659	5.204500496	0.367968245	0	0	1.603586862	0	0	0	0	1.522769173	0	0.029646833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1723	0	0	8.8925	0.024508482	2.172725615	0	0.56946731	5.578714072	0	0.80478438	6.565346256	0	0	0	0	0	8.835783659	5.204500496	0.367968245	0	0	1.603586862	0	0	0	0	1.522769173	0	0.029646833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1723	0																																																																																			0	0	0	8.8925	0.024508482	2.172725615	0	0.56946731	5.578714072	0	0.80478438	6.565346256	0	0	0	0	0	8.835783659	5.204500496	0.367968245	0	0	1.603586862	0	0	0	0	1.522769173	0	0.029646833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1723
H2354_014_0	2008	5																					0											A	A	D	V	T	Coin	O	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	P	T	P	V	P	V	P	O	O	O																																																				0	0	446.403215	1.230325811	918.0680821		343.0471073	35.0064308		242.4010552	659.1607641						6913.531775	2723.499338	192.5566673			814.5383214					796.8604937		15.51409811															1A IP Acute: $300 per admit	1B IP Psych: $300 per admit	2 SNF: $0 per day for days 1-20 plus $50 per day for days 21-100		10A Ambulance: $0	"11A DME: 20%, 11B Prosthetics/Supplies: 20%"		"4A ER: $50, 4B Urgent Care: $30"	"9A Outpatient Hospital: $100, 9B ASC Services: $100"						"7A PCP: $15, 14C Routine Physical Exams: $15"	"3 CORF: $25, 7B Chiropractic: $25, 7C Occupational Therapy: $25, 7D Physician Specialist: $25, 7F Podiatry: $25, 7I PT and ST: $25, 17A Medicare Covered Eye Exams: $25, 18A Medicare Covered Hearing Exams: $25"	"7E Mental Health: $25, 7H Psychiatric: $25, 9C Outpatient Substance Abuse: $25"			7G Other Health Care: $25					17A Routine Eye Exams: $25		18A Routine Hearing Exams: $25															300	300	23.99577167		0	0.2		50	100						15	25	25			25					25		25															11.1601	0.030758145	1.835812673	0	0	7.00128616	0	1.010004397	5.493006368	0	0	0	0	0	8.641914719	5.673956954	0.401159724	0	0	1.696954836	0	0	0	0	1.660126029	0	0.032321038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.6374	0	0	11.1601	0.030758145	1.835812673	0	0	7.00128616	0	1.010004397	5.493006368	0	0	0	0	0	8.641914719	5.673956954	0.401159724	0	0	1.696954836	0	0	0	0	1.660126029	0	0.032321038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.6374	0																																																																																			0	0	0	11.1601	0.030758145	1.835812673	0	0	7.00128616	0	1.010004397	5.493006368	0	0	0	0	0	8.641914719	5.673956954	0.401159724	0	0	1.696954836	0	0	0	0	1.660126029	0	0.032321038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.6374
H2354_801_0	2008	1																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0	0	288.8548634	0.12359775	8.976710172	4.973397242	5.958466261	24.122112	0	14.04971146	59.55585655	19.18006086	0	0	0	28.86803143	5.470524	14.600385	1.737261	3.868794	0	218.266515	23.733248	14.964992																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.065865435	0.065865435	0.18830704	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				19.0256	0.00814082	1.690377726	0	1.394281105	5.644574208	0	3.287632482	13.93607043	4.488134241	0	0	0	6.755119355	1.280102616	3.41649009	0.406519074	0.905297796	0	51.07436451	5.553580032	3.501808128	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.368	0	0	19.0256	0.00814082	1.690377726	0	1.394281105	5.644574208	0	3.287632482	13.93607043	4.488134241	0	0	0	6.755119355	1.280102616	3.41649009	0.406519074	0.905297796	0	51.07436451	5.553580032	3.501808128	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.368	0																																																																																			0	0	0	19.0256	0.00814082	1.690377726	0	1.394281105	5.644574208	0	3.287632482	13.93607043	4.488134241	0	0	0	6.755119355	1.280102616	3.41649009	0.406519074	0.905297796	0	51.07436451	5.553580032	3.501808128	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.368
H2354_802_0	2008	5																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0	0	288.8548634	0.12359775	8.976710172	4.973397242	5.958466261	24.122112	0	14.04971146	59.55585655	19.18006086	0	0	0	28.86803143	5.470524	14.600385	1.737261	3.868794	0	218.266515	23.733248	14.964992																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.065865435	0.065865435	0.18830704	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				19.0256	0.00814082	1.690377726	0	1.394281105	5.644574208	0	3.287632482	13.93607043	4.488134241	0	0	0	6.755119355	1.280102616	3.41649009	0.406519074	0.905297796	0	51.07436451	5.553580032	3.501808128	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.368	0	0	19.0256	0.00814082	1.690377726	0	1.394281105	5.644574208	0	3.287632482	13.93607043	4.488134241	0	0	0	6.755119355	1.280102616	3.41649009	0.406519074	0.905297796	0	51.07436451	5.553580032	3.501808128	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.368	0																																																																																			0	0	0	19.0256	0.00814082	1.690377726	0	1.394281105	5.644574208	0	3.287632482	13.93607043	4.488134241	0	0	0	6.755119355	1.280102616	3.41649009	0.406519074	0.905297796	0	51.07436451	5.553580032	3.501808128	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.368
H2354_803_0	2008	5																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0	0	288.8548634	0.12359775	8.976710172	4.973397242	5.958466261	24.122112	0	14.04971146	59.55585655	19.18006086	0	0	0	28.86803143	5.470524	14.600385	1.737261	3.868794	0	218.266515	23.733248	14.964992																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.065865435	0.065865435	0.18830704	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				19.0256	0.00814082	1.690377726	0	1.394281105	5.644574208	0	3.287632482	13.93607043	4.488134241	0	0	0	6.755119355	1.280102616	3.41649009	0.406519074	0.905297796	0	51.07436451	5.553580032	3.501808128	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.368	0	0	19.0256	0.00814082	1.690377726	0	1.394281105	5.644574208	0	3.287632482	13.93607043	4.488134241	0	0	0	6.755119355	1.280102616	3.41649009	0.406519074	0.905297796	0	51.07436451	5.553580032	3.501808128	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.368	0																																																																																			0	0	0	19.0256	0.00814082	1.690377726	0	1.394281105	5.644574208	0	3.287632482	13.93607043	4.488134241	0	0	0	6.755119355	1.280102616	3.41649009	0.406519074	0.905297796	0	51.07436451	5.553580032	3.501808128	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.368
H2406_001_0	2008	5	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						2400	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T				V					V	P	V	V																																																0		2044.217564	102.6500227	5860.42108	182.525119	704.4001	15.05374534	0.406869277	255.2205157	173.2046206	659.9042086	274.6453329	67.44728216	6.474939087	253.7598841	36161.44366	1546.428591	1784.227534	21.57351236		4.903070991	485.6532734	589.5351544	1089.1085									97.12408631			8.825527785							(1a) $175/day	(1b) $175/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $35/visit	(8a) $0/visit	(8b) $0/visit	(9a) $35/visit	(12) $0/proc	(9a) $35/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $15/visit	(7e/7h) $32.5/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $15/visit	(15) $0/proc	(Misc. PBP Cats) $15/visit	(10b) $0/trip				(18a) $15/visit					(4b) $35/visit (waived if admitted)	(9c) $32.5/proc 75%/25% Ind/Grp Blended Copay	(9d) $35/visit	(7f1) $0/visit							160.4305	160.4305			68.7559	0.183349096	0.183349096	45.8373	32.0861			32.0861		32.0861		13.7512	29.7942			13.7512		13.7512										32.0861										27.3296	1.372349186	0	0	4.035972543	2.760090597	0.074599114	0.974884391	0.463121612	0	0	0.180343307	0	0.678513577	0	1.772101773	4.429973504	0	0	0.005618585	0	0.675567109	0	0	0	0	0	0	0	0	0	0.259694362	0	0	0	0	0	0	0	0	0	45.0124		4.087814258	27.3296	1.372349186	0	0	4.035972543	2.760090597	0.074599114	0.974884391	0.463121612	0	0	0.180343307	0	0.678513577	0	1.772101773	4.429973504	0	0	0.005618585	0	0.675567109	0	0	0	0	0	0	0	0	0	0.259694362	0	0	0	0	0	0	0	0	0	45.0124		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3				0.3					35	0.3	0.3	0.3							2.6843	0.0486	0.6742	0.0203	0.8053	0.2377	0.0064	0.056	0.4716	0.7342	0.6646	0.0505	0.0048	0.108	0.016	2.1032	0.1856	0.0044		0.1153		0.1096	0.0484									0.0149			0.0003							9.1641		0	30.0138	1.420983699	0.674229732	0.020307429	4.841267368	2.997781313	0.081023366	1.030853802	0.934702414	0.734233161	0.664571914	0.230801312	0.004845888	0.786468599	0.015951676	3.875335832	4.615559269	0.004401229	0	0.120933014	0	0.785127201	0.048393663	0	0	0	0	0	0	0	0	0.274603761	0	0	0.000349893	0	0	0	0	0	0	54.1765
H2407_001_0	2008	6																					3250											Coin		Coin		Coin	Coin		Coin	Coin	Coin					Coin						Coin																																																														0	0	677.7833837		161.7140165		35.66494782	179.4344462		56.21314692	143.7168962	44.79138716					378.3580181						20.85403849																					FFS Medicare Actl. Equiv. cost sharing		FFS Medicare Actl. Equiv. cost sharing		FFS Medicare Actl. Equiv. cost sharing	FFS Medicare Actl. Equiv. cost sharing		FFS Medicare Actl. Equiv. cost sharing	FFS Medicare Actl. Equiv. cost sharing	FFS Medicare Actl. Equiv. cost sharing					FFS Medicare Actl. Equiv. cost sharing						FFS Medicare Actl. Equiv. cost sharing																					0.0788		0.1512		0.234	0.234		0.234	0.234	0.234					0.234						0.234																					53.4093	0	24.4511593	0	8.345597789	41.98766041	0	13.15387638	33.6297537	10.4811846	0	0	0	0	88.53577624	0	0	0	0	0	4.879845006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	278.8742		0	53.4093	0	24.4511593	0	8.345597789	41.98766041	0	13.15387638	33.6297537	10.4811846	0	0	0	0	88.53577624	0	0	0	0	0	4.879845006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	278.8742	0																																																																																			0		0	53.4093	0	24.4511593	0	8.345597789	41.98766041	0	13.15387638	33.6297537	10.4811846	0	0	0	0	88.53577624	0	0	0	0	0	4.879845006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	278.8742
H2407_002_0	2008	6																					0											Coin		Coin		Coin	Coin		Coin	Coin	Coin					Coin						Coin																																																														0	0	677.7833837		161.7140165		35.66494782	179.4344462		56.21314692	143.7168962	44.79138716					378.3580181						20.85403849																					FFS Medicare Actl. Equiv. cost sharing		FFS Medicare Actl. Equiv. cost sharing		FFS Medicare Actl. Equiv. cost sharing	FFS Medicare Actl. Equiv. cost sharing		FFS Medicare Actl. Equiv. cost sharing	FFS Medicare Actl. Equiv. cost sharing	FFS Medicare Actl. Equiv. cost sharing					FFS Medicare Actl. Equiv. cost sharing						FFS Medicare Actl. Equiv. cost sharing																					0.0788	0	0.1512		0.234	0.234		0.234	0.234	0.234					0.234						0.234																					53.4093	0	24.4511593	0	8.345597789	41.98766041	0	13.15387638	33.6297537	10.4811846	0	0	0	0	88.53577624	0	0	0	0	0	4.879845006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	278.8742		0	53.4093	0	24.4511593	0	8.345597789	41.98766041	0	13.15387638	33.6297537	10.4811846	0	0	0	0	88.53577624	0	0	0	0	0	4.879845006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	278.8742	0																																																																																			0		0	53.4093	0	24.4511593	0	8.345597789	41.98766041	0	13.15387638	33.6297537	10.4811846	0	0	0	0	88.53577624	0	0	0	0	0	4.879845006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	278.8742
H2408_001_0	2008	8																					2950											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1317.927783	51.99139907	1565.720077		125.0716842	11.84942444	0.807966742	554.8244825	35.99098287	10166.10237	39.17064154		0.100485752	27.10562879	3989.408337	4917.848793	168.1230097	3.100942417			22.57493029	863.1726143			286.6387266		22.05048089															$175 (1a); $0 (1a1)	$175 (1b)	"$75 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	20% (9b)	20% (8a1); $0/$5 (8a2)	"$5 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	$0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											119.3079	119.3079	51.132		68.176	0.20452788	0.250785839	34.088	0.13635192	1.3635	0.07592424		0.20452788	0.136460994	6.8176	13.6352	25.566	0.13635192			0.20452788	13.6352			13.6352		13.6352															13.1033	0.516915516	6.67152933	0	0.710573511	2.42353766	0.202626617	1.576070488	4.907439614	1.155139647	2.974001196	0	0.020552138	3.698861061	2.266514525	5.587984374	0.358185862	0.422819452	0	0	4.617202631	0.980793693	0	0	0.325697839	0	0.025055212	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5448	0	24.47269354	13.1033	0.516915516	6.67152933	0	0.710573511	2.42353766	0.202626617	1.576070488	4.907439614	1.155139647	2.974001196	0	0.020552138	3.698861061	2.266514525	5.587984374	0.358185862	0.422819452	0	0	4.617202631	0.980793693	0	0	0.325697839	0	0.025055212	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5448																																																																																				0			13.1033	0.516915516	6.67152933	0	0.710573511	2.42353766	0.202626617	1.576070488	4.907439614	1.155139647	2.974001196	0	0.020552138	3.698861061	2.266514525	5.587984374	0.358185862	0.422819452	0	0	4.617202631	0.980793693	0	0	0.325697839	0	0.025055212	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5448
H2408_011_0	2008	9																					3240											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2046.692079	68.22922723	2088.654858		147.0275466	18.69161216	2.185761379	654.9804343	33.52544441	9687.921069	43.24628075		0.319204568	26.60692691	4553.015912	4852.569246	209.092401	2.920645098			23.51375132	862.1930467			206.7819877		19.12640021															$180 (1a); $0 (1a1)	$180 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	$0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											113.7753	113.7753	63.2085		63.2085	0.18962557	0.261789436	31.6043	0.126417047	3.7925	0.074412387		0.18962557	0.126429119	6.3209	12.6417	23.7032	0.126417047			0.18962557	12.6417			12.6417		12.6417															19.4053	0.646900306	11.00173246	0	0.77444951	3.544407614	0.572209238	1.725014421	4.238187676	3.061795929	3.218058966	0	0.060529348	3.363890321	2.398245108	5.11206228	0.413013185	0.369219328	0	0	4.458808503	0.908299156	0	0	0.217839735	0	0.020149192	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5101	0	37.88158265	19.4053	0.646900306	11.00173246	0	0.77444951	3.544407614	0.572209238	1.725014421	4.238187676	3.061795929	3.218058966	0	0.060529348	3.363890321	2.398245108	5.11206228	0.413013185	0.369219328	0	0	4.458808503	0.908299156	0	0	0.217839735	0	0.020149192	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5101																																																																																				0			19.4053	0.646900306	11.00173246	0	0.77444951	3.544407614	0.572209238	1.725014421	4.238187676	3.061795929	3.218058966	0	0.060529348	3.363890321	2.398245108	5.11206228	0.413013185	0.369219328	0	0	4.458808503	0.908299156	0	0	0.217839735	0	0.020149192	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5101
H2408_017_0	2008	10																					2850											A	A	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		313.4440538	8.179134731	1644.006081		131.3252684	12.44189567	0.848365079	582.5657066	37.79053201	10674.40749	41.12917362		0.10551004	28.46091023	4188.878754	5163.741233	176.5291602	3.255989538			23.70367681	906.331245			300.9706629		23.15300494															$200 (1a); $0 (1a1)	$200 (1b)	"$75 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$15 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $15 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$15 (17a1)	$0 n/c (17b)	$15 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											142.0999	142.0999	53.2875		53.2875	0.213149809	0.255230289	35.525	0.142099873	4.263	0.085087498		0.213149809	0.142213546	7.105	10.6575	26.6437	0.142099873			0.213149809	10.6575			10.6575		10.6575															3.7117	0.0968545	7.300407973	0	0.583165749	2.651987689	0.216528464	1.724635685	5.370029796	3.792079869	3.499578459	0	0.022489445	4.047526953	2.480163077	4.58604358	0.39194955	0.4626757	0	0	5.052434192	0.804934717	0	0	0.267299331	0	0.020562744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.083	0	19.13424878	3.7117	0.0968545	7.300407973	0	0.583165749	2.651987689	0.216528464	1.724635685	5.370029796	3.792079869	3.499578459	0	0.022489445	4.047526953	2.480163077	4.58604358	0.39194955	0.4626757	0	0	5.052434192	0.804934717	0	0	0.267299331	0	0.020562744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.083																																																																																				0			3.7117	0.0968545	7.300407973	0	0.583165749	2.651987689	0.216528464	1.724635685	5.370029796	3.792079869	3.499578459	0	0.022489445	4.047526953	2.480163077	4.58604358	0.39194955	0.4626757	0	0	5.052434192	0.804934717	0	0	0.267299331	0	0.020562744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.083
H2408_018_0	2008	7																					2800											D	D	D	V	T	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1492.602842	58.88221721	1773.236945		141.648392	15.19856403	1.036331708	628.1156288	414.5086171		50.24189203		0.1288872	939.2903105	4482.142766	5585.580977	190.4056393	1045.409411			28.95554338	977.5754889			144		16.8541424															$90 (1a); $0 (1a1)	$90 (1b)	"$50 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	30% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $30 (4b)"	$100 (9b)	20% (8a1); $0/$0 (8a2)	"$25 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	20% (12)	"$20 (3, 9d); $40 (5); $25/$25 (9c); $100 (9a)"	"$5/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$15 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$25/$25 (7e, 7h)"	"$20 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $15 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$15 (17a1)	$0 n/c (17b)	$15 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											66.1624	66.1624	36.7569		73.5138	0.220541467	0.172693703	30.5343	73.5138		0.09240263		0.147027645	70.9078	5	14.9826	25	14.7028			0.147027645	15			15		15															8.2295	0.324649264	5.431559402	0	0.86775956	3.351913606	0.178967961	1.598254443	2.539342734	0	4.642482956	0	0.018949981	5.550252878	1.867559486	6.973869554	0.396678415	1.280867361	0	0	4.257265341	1.221969361	0	0	0.18	0	0.021067678	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9329	0	13.74737801	8.2295	0.324649264	5.431559402	0	0.86775956	3.351913606	0.178967961	1.598254443	2.539342734	0	4.642482956	0	0.018949981	5.550252878	1.867559486	6.973869554	0.396678415	1.280867361	0	0	4.257265341	1.221969361	0	0	0.18	0	0.021067678	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9329																																																																																				0			8.2295	0.324649264	5.431559402	0	0.86775956	3.351913606	0.178967961	1.598254443	2.539342734	0	4.642482956	0	0.018949981	5.550252878	1.867559486	6.973869554	0.396678415	1.280867361	0	0	4.257265341	1.221969361	0	0	0.18	0	0.021067678	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9329
H2408_019_0	2008	8																					2900											D	D	D	V	T	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2160.246172	72.01470531	2204.53712		155.1848947	20.82323651	2.435029454	691.1197321	350.606002		48.17816273		0.355607219	779.3470558	4832.740959	5138.492777	220.6932169	1009.82388			26.19530091	910.0290403			144		16.8541424															$100 (1a); $0 (1a1)	$100 (1b)	"$50 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	30% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $30 (4b)"	$125 (9b)	20% (8a1); $0/$0 (8a2)	"$25 (8b1); 20% (8b2, 8b3)"	$125 (incl in h5)	20% (12)	"$25 (3, 9d); $40 (5); $25/$25 (9c); $125 (9a)"	"$10/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$25/$25 (7e, 7h)"	"$25 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	$0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											69.3934	69.3934	34.6967		86.7418	0.208180216	0.178808584	30.9878	86.7418		0.086809726		0.138786811	85.0597	10	19.9626	25	17.3484			0.138786811	20			20		20															12.4922	0.416445471	6.374180763	0	1.121750867	4.334985885	0.435404168	1.784688629	2.534348382	0	4.182333084	0	0.049353592	5.524252644	4.027284132	8.548131296	0.459777535	1.459898291	0	0	3.635562276	1.516715067	0	0	0.24	0	0.028090237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.1654	0	19.41553233	12.4922	0.416445471	6.374180763	0	1.121750867	4.334985885	0.435404168	1.784688629	2.534348382	0	4.182333084	0	0.049353592	5.524252644	4.027284132	8.548131296	0.459777535	1.459898291	0	0	3.635562276	1.516715067	0	0	0.24	0	0.028090237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.1654																																																																																				0			12.4922	0.416445471	6.374180763	0	1.121750867	4.334985885	0.435404168	1.784688629	2.534348382	0	4.182333084	0	0.049353592	5.524252644	4.027284132	8.548131296	0.459777535	1.459898291	0	0	3.635562276	1.516715067	0	0	0.24	0	0.028090237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.1654
H2408_020_0	2008	7																					3200											D	D	D	V	T	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2190.683182	73.0293639	2235.598173		157.3713882	21.41415254	2.504130045	700.8516988	355.5459013		49.54534927		0.365698542	790.3277463	4898.986622	5210.624397	223.8026966	1024.051897			26.93866389	922.8509881			144		16.8541424															$110 (1a); $0 (1a1)	$110 (1b)	"$75 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	30% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	$125 (9b)	20% (8a1); $0/$0 (8a2)	"$25 (8b1); 20% (8b2, 8b3)"	$125 (incl in h5)	20% (12)	"$25 (3, 9d); $40 (5); $25/$25 (9c); $125 (9a)"	"$10/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$25/$25 (7e, 7h)"	"$25 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	$0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											75.8385	75.8385	51.7081		86.1801	0.206832285	0.17849749	32.6296	86.1801		0.086055062		0.13788819	84.5096	10	19.9631	25	17.236			0.13788819	20			20		20															13.8448	0.461536479	9.633205817	0	1.130190412	4.429138109	0.446980927	1.90570786	2.553415671	0	4.263628126	0	0.05042551	5.565859153	4.082488851	8.668350662	0.466255618	1.470881904	0	0	3.714523612	1.53808498	0	0	0.24	0	0.028090237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4936	0	22.13334463	13.8448	0.461536479	9.633205817	0	1.130190412	4.429138109	0.446980927	1.90570786	2.553415671	0	4.263628126	0	0.05042551	5.565859153	4.082488851	8.668350662	0.466255618	1.470881904	0	0	3.714523612	1.53808498	0	0	0.24	0	0.028090237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4936																																																																																				0			13.8448	0.461536479	9.633205817	0	1.130190412	4.429138109	0.446980927	1.90570786	2.553415671	0	4.263628126	0	0.05042551	5.565859153	4.082488851	8.668350662	0.466255618	1.470881904	0	0	3.714523612	1.53808498	0	0	0.24	0	0.028090237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4936
H2408_021_0	2008	7																					2800											A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		338.0830418	8.822074355	1773.236945		141.648392	15.19856403	1.036331708	628.1156288	414.5086171		50.24189203		0.1288872	939.2903105	4482.142766	5585.580977	190.4056393	1045.409411			28.95554338	977.5754889			144		16.8541424															$400 (1a); $0 (1a1)	$400 (1b)	"$50 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	30% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $30 (4b)"	$100 (9b)	20% (8a1); $0/$0 (8a2)	"$25 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	20% (12)	"$20 (3, 9d); $40 (5); $25/$25 (9c); $100 (9a)"	"$10/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$25/$25 (7e, 7h)"	"$20 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	$0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											294.1748	294.1748	36.7719		73.5437	0.220631103	0.172724507	30.5467	73.5437		0.092440186		0.147087402	70.9366	10	19.9656	25	14.7087			0.147087402	20			20		20															8.288	0.216269332	5.433766979	0	0.868112248	3.353275941	0.178999883	1.59890403	2.540374812	0	4.644369824	0	0.018957683	5.552502693	3.735118972	9.293278295	0.396678415	1.28138795	0	0	4.258995642	1.629292482	0	0	0.24	0	0.028090237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5563	0	13.71265354	8.288	0.216269332	5.433766979	0	0.868112248	3.353275941	0.178999883	1.59890403	2.540374812	0	4.644369824	0	0.018957683	5.552502693	3.735118972	9.293278295	0.396678415	1.28138795	0	0	4.258995642	1.629292482	0	0	0.24	0	0.028090237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5563																																																																																				0			8.288	0.216269332	5.433766979	0	0.868112248	3.353275941	0.178999883	1.59890403	2.540374812	0	4.644369824	0	0.018957683	5.552502693	3.735118972	9.293278295	0.396678415	1.28138795	0	0	4.258995642	1.629292482	0	0	0.24	0	0.028090237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5563
H2408_022_0	2008	8																					2900											A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		434.7002159	8.871376741	2204.53712		155.1848947	20.82323651	2.435029454	691.1197321	350.606002		48.17816273		0.355607219	779.3470558	4832.740959	5138.492777	220.6932169	1009.82388			26.19530091	910.0290403			144		16.8541424															$450 (1a); $0 (1a1)	$450 (1b)	"$50 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	30% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $30 (4b)"	$125 (9b)	20% (8a1); $0/$0 (8a2)	"$25 (8b1); 20% (8b2, 8b3)"	$125 (incl in h5)	20% (12)	"$25 (3, 9d); $40 (5); $25/$25 (9c); $125 (9a)"	"$15/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$25/$25 (7e, 7h)"	"$25 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											315.8999	315.8999	35.1		87.75	0.21059996	0.179367045	31.348	87.75		0.087818742		0.140399974	86.0472	15	24.9441	25	17.55			0.140399974	25			25		25															11.4435	0.233538949	6.448269864	0	1.134789329	4.385372784	0.436764038	1.805432624	2.563805907	0	4.230945652	0	0.049927244	5.588383928	6.040926199	10.68125329	0.459777535	1.476867146	0	0	3.677819556	1.895893834	0	0	0.3	0	0.035112797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8884	0	18.31733562	11.4435	0.233538949	6.448269864	0	1.134789329	4.385372784	0.436764038	1.805432624	2.563805907	0	4.230945652	0	0.049927244	5.588383928	6.040926199	10.68125329	0.459777535	1.476867146	0	0	3.677819556	1.895893834	0	0	0.3	0	0.035112797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8884																																																																																				0			11.4435	0.233538949	6.448269864	0	1.134789329	4.385372784	0.436764038	1.805432624	2.563805907	0	4.230945652	0	0.049927244	5.588383928	6.040926199	10.68125329	0.459777535	1.476867146	0	0	3.677819556	1.895893834	0	0	0.3	0	0.035112797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8884
H2408_023_0	2008	7																					3200											A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		440.8249693	8.996370916	2235.598173		157.3713882	21.41415254	2.504130045	700.8516988	355.5459013		49.54534927		0.365698542	790.3277463	4898.986622	5210.624397	223.8026966	1024.051897			26.93866389	922.8509881			144		16.8541424															$500 (1a); $0 (1a1)	$500 (1b)	"$75 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	30% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	$125 (9b)	20% (8a1); $0/$0 (8a2)	"$25 (8b1); 20% (8b2, 8b3)"	$125 (incl in h5)	20% (12)	"$25 (3, 9d); $40 (5); $25/$25 (9c); $125 (9a)"	"$15/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$25/$25 (7e, 7h)"	"$25 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											348.307	348.307	52.2461		87.0768	0.208984201	0.178994138	32.9691	87.0768		0.086950393		0.1393228	85.3878	15	24.9449	25	17.4154			0.1393228	25			25		25															12.7952	0.261124915	9.733431193	0	1.14194909	4.475219553	0.448224599	1.925535141	2.579981806	0	4.307987578	0	0.050950145	5.623695659	6.123733277	10.83152749	0.466255618	1.486185189	0	0	3.753170095	1.922606225	0	0	0.3	0	0.035112797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2619	0	21.01288355	12.7952	0.261124915	9.733431193	0	1.14194909	4.475219553	0.448224599	1.925535141	2.579981806	0	4.307987578	0	0.050950145	5.623695659	6.123733277	10.83152749	0.466255618	1.486185189	0	0	3.753170095	1.922606225	0	0	0.3	0	0.035112797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2619																																																																																				0			12.7952	0.261124915	9.733431193	0	1.14194909	4.475219553	0.448224599	1.925535141	2.579981806	0	4.307987578	0	0.050950145	5.623695659	6.123733277	10.83152749	0.466255618	1.486185189	0	0	3.753170095	1.922606225	0	0	0.3	0	0.035112797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2619
H2408_024_0	2008	8																					2400											A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		354.9871938	9.263178073	1861.898793		148.7308116	15.95849223	1.088148293	659.5014102	435.234048		52.75398664		0.13533156	986.254826	4699.699904	5863.910026	199.9259213	1097.679882			30.40332055	1026.454263			144		16.8541424															$150 (1a); $0 (1a1)	$150 (1b)	"$50 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$50 (10a)	30% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $30 (4b)"	$100 (9b)	20% (8a1); $0/$0 (8a2)	"$25 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	20% (12)	"$20 (3, 9d); $40 (5); $25/$25 (9c); $100 (9a)"	"$5/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$15 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$25/$25 (7e, 7h)"	"$20 (7c, 7i)"	$0 (incl in h2)		20%/$25 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$15 (17a1)	$0 n/c (17b)	$15 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											105.4454	105.4454	35.1485		35.1485	0.21089077	0.169377196	29.1979	70.2969		0.088359174		0.140593846	67.7572	3.5148	10.5329	17.5742	14.0594			0.140593846	10.5445			10.5445		10.5445															3.1193	0.081396615	5.453573186	0	0.435638269	3.36549871	0.184307507	1.604673491	2.549634538	0	4.66129866	0	0.019026785	5.568820197	1.376560181	5.146986673	0.292795357	1.28605864	0	0	4.274519781	0.901957207	0	0	0.126534462	0	0.014809929	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4634	0	17.05274533	3.1193	0.081396615	5.453573186	0	0.435638269	3.36549871	0.184307507	1.604673491	2.549634538	0	4.66129866	0	0.019026785	5.568820197	1.376560181	5.146986673	0.292795357	1.28605864	0	0	4.274519781	0.901957207	0	0	0.126534462	0	0.014809929	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4634																																																																																				0			3.1193	0.081396615	5.453573186	0	0.435638269	3.36549871	0.184307507	1.604673491	2.549634538	0	4.66129866	0	0.019026785	5.568820197	1.376560181	5.146986673	0.292795357	1.28605864	0	0	4.274519781	0.901957207	0	0	0.126534462	0	0.014809929	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4634
H2408_025_0	2008	8																					3425											A	A	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		298.5181465	7.789652125	1565.720077		125.0716842	11.84942444	0.807966742	554.8244825	35.99098287	10166.10237	39.17064154		0.100485752	27.10562879	3989.408337	4917.848793	168.1230097	3.100942417			22.57493029	863.1726143			286.6387266		22.05048089															$450 (1a); $0 (1a1)	$450 (1b)	"$75 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$15 (4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											324.2375	324.2375	54.0396		72.0528	0.216158337	0.256781131	36.0264	0.144105558	4.3232	0.086288475		0.216158337	0.144220835	10.8079	18.0132	27.0198	0.144105558			0.216158337	18.0132			18.0132		18.0132															8.0659	0.210474781	7.050905173	0	0.750980202	2.561351884	0.207470614	1.665693577	5.186500673	3.66247964	3.379974921	0	0.021720833	3.909196422	3.593099468	7.382180677	0.378554065	0.446863038	0	0	4.879759393	1.295708035	0	0	0.430273267	0	0.033099967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1122	0	21.33089441	8.0659	0.210474781	7.050905173	0	0.750980202	2.561351884	0.207470614	1.665693577	5.186500673	3.66247964	3.379974921	0	0.021720833	3.909196422	3.593099468	7.382180677	0.378554065	0.446863038	0	0	4.879759393	1.295708035	0	0	0.430273267	0	0.033099967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1122																																																																																				0			8.0659	0.210474781	7.050905173	0	0.750980202	2.561351884	0.207470614	1.665693577	5.186500673	3.66247964	3.379974921	0	0.021720833	3.909196422	3.593099468	7.382180677	0.378554065	0.446863038	0	0	4.879759393	1.295708035	0	0	0.430273267	0	0.033099967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1122
H2408_026_0	2008	7																					3500											A	A	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		411.8500475	8.405049731	2088.654858		147.0275466	18.69161216	2.185761379	654.9804343	33.52544441	9687.921069	43.24628075		0.319204568	26.60692691	4553.015912	4852.569246	209.092401	2.920645098			23.51375132	862.1930467			206.7819877		19.12640021															$645 (1a); $0 (1a1)	$645 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$15 (4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											428.0954	428.0954	66.3714		66.3714	0.199114145	0.265074289	33.1857	0.132742763	3.9823	0.078135869		0.199114145	0.132755439	9.9557	16.5928	24.8893	0.132742763			0.199114145	16.5928			16.5928		16.5928															14.6926	0.299846935	11.55224238	0	0.813201783	3.721764367	0.579389143	1.811331513	4.450260125	3.215003529	3.37908573	0	0.063558145	3.532214264	3.777374454	6.709827603	0.433679735	0.3876945	0	0	4.681920482	1.192186327	0	0	0.285925129	0	0.026446783	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6055	0	33.02336799	14.6926	0.299846935	11.55224238	0	0.813201783	3.721764367	0.579389143	1.811331513	4.450260125	3.215003529	3.37908573	0	0.063558145	3.532214264	3.777374454	6.709827603	0.433679735	0.3876945	0	0	4.681920482	1.192186327	0	0	0.285925129	0	0.026446783	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6055																																																																																				0			14.6926	0.299846935	11.55224238	0	0.813201783	3.721764367	0.579389143	1.811331513	4.450260125	3.215003529	3.37908573	0	0.063558145	3.532214264	3.777374454	6.709827603	0.433679735	0.3876945	0	0	4.681920482	1.192186327	0	0	0.285925129	0	0.026446783	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6055
H2408_801_0	2008	5																					7700											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1503.32227	46.59766405	1358.589036		133.7871984	15.26011111	1.366866831	610.7351019	43.78875279	11576.24191	50.23240706		0.502146116	27.94264583	4380.997691	5625.206723	156.0955739	3.813353594			34.78734061	977.2892478			229.8759515		18.35281288															$450 (1a); $0 (1a1)	$450 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											333.7125	333.7125	118.6533		129.7771	0.185395828	0.217971594	37.0792	0.185395828	4.4495	0.108135181		0.222474994	0.185352898	18.5396	25.9197	27.8094	0.185395828			0.222474994	25.9554			25.9554		25.9554															41.8065	1.295851878	13.43342611	0	1.446875993	2.829160939	0.297938141	1.887129001	8.11825209	4.292373911	5.431890419	0	0.111714954	5.179250395	6.768489127	12.15030623	0.361743353	0.706979848	0	0	7.739313388	2.113829078	0	0	0.497210495	0	0.039696241	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.5079	0	40.53901152	41.8065	1.295851878	13.43342611	0	1.446875993	2.829160939	0.297938141	1.887129001	8.11825209	4.292373911	5.431890419	0	0.111714954	5.179250395	6.768489127	12.15030623	0.361743353	0.706979848	0	0	7.739313388	2.113829078	0	0	0.497210495	0	0.039696241	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.5079																																																																																				0			41.8065	1.295851878	13.43342611	0	1.446875993	2.829160939	0.297938141	1.887129001	8.11825209	4.292373911	5.431890419	0	0.111714954	5.179250395	6.768489127	12.15030623	0.361743353	0.706979848	0	0	7.739313388	2.113829078	0	0	0.497210495	0	0.039696241	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.5079
H2408_802_0	2008	5																					7700											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1502.24977	46.55884432	1357.410516		133.6985841	15.23902207	1.364877601	610.3416099	43.73876116	11569.67028	50.17391011		0.501870066	27.9041744	4378.292878	5621.983032	155.973262	3.809026935			34.75431831	976.7202203			229.8759515		18.35281288															$450 (1a); $0 (1a1)	$450 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											333.8018	333.8018	118.6851		129.8118	0.185445454	0.217987464	37.0891	0.185445454	4.4507	0.108170386		0.222534545	0.185402854	18.5445	25.9266	27.8168	0.185445454			0.222534545	25.9624			25.9624		25.9624															41.7878	1.295118906	13.42536586	0	1.446304689	2.826007372	0.297526207	1.886417952	8.111154434	4.291085524	5.427331206	0	0.111683427	5.173513585	6.766120932	12.14658403	0.361556655	0.70636673	0	0	7.734036418	2.113163792	0	0	0.497343586	0	0.039706867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.4442	0	40.47496493	41.7878	1.295118906	13.42536586	0	1.446304689	2.826007372	0.297526207	1.886417952	8.111154434	4.291085524	5.427331206	0	0.111683427	5.173513585	6.766120932	12.14658403	0.361556655	0.70636673	0	0	7.734036418	2.113163792	0	0	0.497343586	0	0.039706867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.4442																																																																																				0			41.7878	1.295118906	13.42536586	0	1.446304689	2.826007372	0.297526207	1.886417952	8.111154434	4.291085524	5.427331206	0	0.111683427	5.173513585	6.766120932	12.14658403	0.361556655	0.70636673	0	0	7.734036418	2.113163792	0	0	0.497343586	0	0.039706867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.4442
H2409_003_0	2008	6																					4000											A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	P	P	Coin	V					V			V																																																					0	0	315.0430015	9.187608913	1796.696222		7.311809901	8.692203847	9.103050062	275.6557808	46.03584916	7.075903614	21.11795393	3.666914677		34.82817239	3333.499139	4471.898035	361.6777703	359.1823721			22.95014578	6.702165739					249															$550 (1a); $0 (1a1)	$550 (1b)	"$90 days 4-100 (2a, 2a2)"	$0 (6a)	20% (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); 20% (4b)"	20% (9b)	"20% (8a1, 8a2)"	"20% (8b1, 8b2, 8b3)"	20% (9a)	0% (12)	"20% (5, 9a); $30 (3, 9c, 9d)"	"$15 (7a, 14c); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7g, 16b, 17a, 18a)"	"$30 (7e, 7h)"	"$30 (7c, 7i)"			"20% (15, 15a1)"	"$0 (13a, 13a1); $30 (17b)"					$30 (18a1)			$0 (14a)												473.6111	473.6111	60.9925		0.172222222	0.172222222	0.172222222	43.0556	0.172222222	0.172222222	0.172222222	0.172222222		0.170667826	12.9823	25.8333	25.8333	25.8333			0.172222222	25.8333					30															12.434	0.362612805	9.132082861	0	1.25925615	1.496990662	1.567747511	0.989042732	7.928396244	1.218627845	3.636980954	0.631524194	0	5.944048466	3.6063706	9.627002715	0.778611867	0.773239829	0	0	3.952525107	0.014428273	0	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.976	0	10.51971414	12.434	0.362612805	9.132082861	0	1.25925615	1.496990662	1.567747511	0.989042732	7.928396244	1.218627845	3.636980954	0.631524194	0	5.944048466	3.6063706	9.627002715	0.778611867	0.773239829	0	0	3.952525107	0.014428273	0	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.976																																																																																				0	0	0	12.434	0.362612805	9.132082861	0	1.25925615	1.496990662	1.567747511	0.989042732	7.928396244	1.218627845	3.636980954	0.631524194	0	5.944048466	3.6063706	9.627002715	0.778611867	0.773239829	0	0	3.952525107	0.014428273	0	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.976
H2409_006_0	2008	6																					4000											A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	P	P	Coin	V					V			V																																																					0	0	315.0430015	9.187608913	1796.696222		7.311809901	8.692203847	9.103050062	275.6557808	46.03584916	7.075903614	21.11795393	3.666914677		34.82817239	3333.499139	4471.898035	361.6777703	359.1823721			22.95014578	6.702165739					249															$550 (1a); $0 (1a1)	$550 (1b)	"$90 days 4-100 (2a, 2a2)"	$0 (6a)	20% (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1); 20% (4b)"	20% (9b)	"20% (8a1, 8a2)"	"20% (8b1, 8b2, 8b3)"	20% (9a)	0% (12)	"20% (5, 9a); $30 (3, 9c, 9d)"	"$15 (7a, 14c); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7g, 16b, 17a, 18a)"	"$30 (7e, 7h)"	"$30 (7c, 7i)"			"25% (15, 15a1)"	"$0 (13a, 13a1); $30 (17b)"					$30 (18a1)			$0 (14a)												473.6111	473.6111	60.9925		0.172222222	0.215277778	0.215277778	43.0556	0.172222222	0.172222222	0.172222222	0.172222222		0.170667826	12.9823	25.8333	25.8333	25.8333			0.215277778	25.8333					30															12.434	0.362612805	9.132082861	0	1.25925615	1.871238328	1.959684388	0.989042732	7.928396244	1.218627845	3.636980954	0.631524194	0	5.944048466	3.6063706	9.627002715	0.778611867	0.773239829	0	0	4.940656384	0.014428273	0	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.7303	0	10.8026683	12.434	0.362612805	9.132082861	0	1.25925615	1.871238328	1.959684388	0.989042732	7.928396244	1.218627845	3.636980954	0.631524194	0	5.944048466	3.6063706	9.627002715	0.778611867	0.773239829	0	0	4.940656384	0.014428273	0	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.7303																																																																																				0	0	0	12.434	0.362612805	9.132082861	0	1.25925615	1.871238328	1.959684388	0.989042732	7.928396244	1.218627845	3.636980954	0.631524194	0	5.944048466	3.6063706	9.627002715	0.778611867	0.773239829	0	0	4.940656384	0.014428273	0	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.7303
H2409_801_0	2008	4																					0											Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0	0	263.0607289	4.656572084	70.48974875		8.016944464	9.530460509	9.980927812	14.93799441	50.4754433	7.758287904	23.15452209	4.020543712	0.150471943	38.18692329	39.47947004	101.4409836	2.66692514	4.646308395	19.92793994		25.16340642	1.12466222																				mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin		mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin																				0.083473467	0.083473467	0.16878142		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234																				21.9586	0.388700218	11.89735989	0	1.875965005	2.230127759	2.335537108	3.495490693	11.81125373	1.815439369	5.418158168	0.940807229	0.035210435	8.935740051	9.238195989	23.73719016	0.624060483	1.087236165	4.663137945	0	5.888237101	0.26317096	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6396	0	0	21.9586	0.388700218	11.89735989	0	1.875965005	2.230127759	2.335537108	3.495490693	11.81125373	1.815439369	5.418158168	0.940807229	0.035210435	8.935740051	9.238195989	23.73719016	0.624060483	1.087236165	4.663137945	0	5.888237101	0.26317096	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6396																																																																																				0	0	0	21.9586	0.388700218	11.89735989	0	1.875965005	2.230127759	2.335537108	3.495490693	11.81125373	1.815439369	5.418158168	0.940807229	0.035210435	8.935740051	9.238195989	23.73719016	0.624060483	1.087236165	4.663137945	0	5.888237101	0.26317096	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6396
H2409_802_0	2008	4																					0											Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0	0	263.0607289	4.656572084	70.48974875		8.016944464	9.530460509	9.980927812	14.93799441	50.4754433	7.758287904	23.15452209	4.020543712	0.150471943	38.18692329	39.47947004	101.4409836	2.66692514	4.646308395	19.92793994		25.16340642	1.12466222																				mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin		mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin																				0.083473467	0.083473467	0.16878142		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234																				21.9586	0.388700218	11.89735989	0	1.875965005	2.230127759	2.335537108	3.495490693	11.81125373	1.815439369	5.418158168	0.940807229	0.035210435	8.935740051	9.238195989	23.73719016	0.624060483	1.087236165	4.663137945	0	5.888237101	0.26317096	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6396	0	0	21.9586	0.388700218	11.89735989	0	1.875965005	2.230127759	2.335537108	3.495490693	11.81125373	1.815439369	5.418158168	0.940807229	0.035210435	8.935740051	9.238195989	23.73719016	0.624060483	1.087236165	4.663137945	0	5.888237101	0.26317096	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6396																																																																																				0	0	0	21.9586	0.388700218	11.89735989	0	1.875965005	2.230127759	2.335537108	3.495490693	11.81125373	1.815439369	5.418158168	0.940807229	0.035210435	8.935740051	9.238195989	23.73719016	0.624060483	1.087236165	4.663137945	0	5.888237101	0.26317096	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6396
H2409_803_0	2008	3																					0											Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0	0	263.0607289	4.656572084	70.48974875		8.016944464	9.530460509	9.980927812	14.93799441	50.4754433	7.758287904	23.15452209	4.020543712	0.150471943	38.18692329	39.47947004	101.4409836	2.66692514	4.646308395	19.92793994		25.16340642	1.12466222																				mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin		mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin																				0.083473467	0.083473467	0.16878142		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234																				21.9586	0.388700218	11.89735989	0	1.875965005	2.230127759	2.335537108	3.495490693	11.81125373	1.815439369	5.418158168	0.940807229	0.035210435	8.935740051	9.238195989	23.73719016	0.624060483	1.087236165	4.663137945	0	5.888237101	0.26317096	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6396	0	0	21.9586	0.388700218	11.89735989	0	1.875965005	2.230127759	2.335537108	3.495490693	11.81125373	1.815439369	5.418158168	0.940807229	0.035210435	8.935740051	9.238195989	23.73719016	0.624060483	1.087236165	4.663137945	0	5.888237101	0.26317096	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6396																																																																																				0	0	0	21.9586	0.388700218	11.89735989	0	1.875965005	2.230127759	2.335537108	3.495490693	11.81125373	1.815439369	5.418158168	0.940807229	0.035210435	8.935740051	9.238195989	23.73719016	0.624060483	1.087236165	4.663137945	0	5.888237101	0.26317096	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6396
H2410_001_0	2008	5																					4000											A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	P	P	Coin	V					V			V																																																					0	0	307.6395774	9.851070532	1709.339368		7.294433166	8.394813739	7.733947649	264.0180521	38.49560887	7.822926831	17.82281587	3.448407095		40.40249341	3353.879857	3741.01136	360.7968095	304.8334458			19.7530574	5.92751825					249															$550 (1a); $0 (1a1)	$550 (1b)	"$90 days 4-100 (2a, 2a2)"	$0 (6a)	20% (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); 20% (4b)"	20% (9b)	"20% (8a1, 8a2)"	"20% (8b1, 8b2, 8b3)"	20% (9a)	0% (12)	"20% (5, 9a); $30 (3, 9c, 9d)"	"$15 (7a, 14c); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7g, 16b, 17a, 18a)"	"$30 (7e, 7h)"	"$30 (7c, 7i)"			"20% (15, 15a1)"	"$0 (13a, 13a1); $30 (17b)"					$30 (18a1)			$0 (14a)												473.6111	473.6111	60.9925		0.172222222	0.172222222	0.172222222	43.0556	0.172222222	0.172222222	0.172222222	0.172222222		0.170014636	12.9819	25.8333	25.8333	25.8333			0.172222222	25.8333					30															12.1418	0.388798038	8.688073451	0	1.25626349	1.445773477	1.331957651	0.947286993	6.629799305	1.347281843	3.069484956	0.593892333	0	6.869015228	3.628308179	8.053566122	0.776715354	0.656238668	0	0	3.401915441	0.01276063	0	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8614	0	9.856076559	12.1418	0.388798038	8.688073451	0	1.25626349	1.445773477	1.331957651	0.947286993	6.629799305	1.347281843	3.069484956	0.593892333	0	6.869015228	3.628308179	8.053566122	0.776715354	0.656238668	0	0	3.401915441	0.01276063	0	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8614																																																																																				0	0	0	12.1418	0.388798038	8.688073451	0	1.25626349	1.445773477	1.331957651	0.947286993	6.629799305	1.347281843	3.069484956	0.593892333	0	6.869015228	3.628308179	8.053566122	0.776715354	0.656238668	0	0	3.401915441	0.01276063	0	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8614
H2410_009_0	2008	4																					0											Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin								V																																																					0	0	426.4251762	8.143566691	78.17711565		18.77386348	17.86778379	15.25568176						0.751963089	223.201076	38.76531969	195.1672666	3.094576695	14.64184877	47.34894204	4.377932882	39.01562314	3.748398226																				FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins		FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins								$0 (14a)												0.07920301	0.07920301	0.152665362		0.234	0.234	0.234						0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				33.7742	0.644994991	11.93493765	0	4.393084055	4.181061406	3.569829533	0	0	0	0	0	0.175959363	52.22905178	9.071084807	45.66914038	0.724130947	3.426192612	11.07965244	1.024436294	9.129655814	0.877125185	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	191.9045	0	0	33.7742	0.644994991	11.93493765	0	4.393084055	4.181061406	3.569829533	0	0	0	0	0	0.175959363	52.22905178	9.071084807	45.66914038	0.724130947	3.426192612	11.07965244	1.024436294	9.129655814	0.877125185	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	191.9045																																																																																				0	0	0	33.7742	0.644994991	11.93493765	0	4.393084055	4.181061406	3.569829533	0	0	0	0	0	0.175959363	52.22905178	9.071084807	45.66914038	0.724130947	3.426192612	11.07965244	1.024436294	9.129655814	0.877125185	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	191.9045
H2410_015_0	2008	6																					4000											A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	P	P	Coin	V					V			V																																																					0	0	307.6395774	9.851070532	1709.339368		7.294433166	8.394813739	7.733947649	264.0180521	38.49560887	7.822926831	17.82281587	3.448407095		40.40249341	3353.879857	3741.01136	360.7968095	304.8334458			19.7530574	5.92751825					249															$550 (1a); $0 (1a1)	$550 (1b)	"$90 days 4-100 (2a, 2a2)"	$0 (6a)	20% (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1); 20% (4b)"	20% (9b)	"20% (8a1, 8a2)"	"20% (8b1, 8b2, 8b3)"	20% (9a)	0% (12)	"20% (5, 9a); $30 (3, 9c, 9d)"	"$15 (7a, 14c); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7g, 16b, 17a, 18a)"	"$30 (7e, 7h)"	"$30 (7c, 7i)"			"25% (15, 15a1)"	"$0 (13a, 13a1); $30 (17b)"					$30 (18a1)			$0 (14a)												473.6111	473.6111	60.9925		0.172222222	0.215277778	0.215277778	43.0556	0.172222222	0.172222222	0.172222222	0.172222222		0.170014636	12.9819	25.8333	25.8333	25.8333			0.215277778	25.8333					30															12.1418	0.388798038	8.688073451	0	1.25626349	1.807216846	1.664947063	0.947286993	6.629799305	1.347281843	3.069484956	0.593892333	0	6.869015228	3.628308179	8.053566122	0.776715354	0.656238668	0	0	4.252394301	0.01276063	0	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4063	0	10.10525586	12.1418	0.388798038	8.688073451	0	1.25626349	1.807216846	1.664947063	0.947286993	6.629799305	1.347281843	3.069484956	0.593892333	0	6.869015228	3.628308179	8.053566122	0.776715354	0.656238668	0	0	4.252394301	0.01276063	0	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4063																																																																																				0	0	0	12.1418	0.388798038	8.688073451	0	1.25626349	1.807216846	1.664947063	0.947286993	6.629799305	1.347281843	3.069484956	0.593892333	0	6.869015228	3.628308179	8.053566122	0.776715354	0.656238668	0	0	4.252394301	0.01276063	0	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4063
H2410_801_0	2008	3																					0											Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0	0	268.2122294	6.839379836	70.0192531		8.320775882	9.575982411	8.822131015	15.09289609	43.91202532	8.923629764	20.33052509	3.933605523	0.253158769	46.08721269	41.91903814	85.76382664	2.750738918	3.555808635	22.85776268		22.53235582	7.489396105																				mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin		mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin																				0.081688025	0.081688025	0.160577459		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234																				21.9097	0.558695434	11.24351375	0	1.947061556	2.240779884	2.064378658	3.531737684	10.27541392	2.088129365	4.75734287	0.920463692	0.059239152	10.78440777	9.809054925	20.06873543	0.643672907	0.832059221	5.348716468	0	5.272571263	1.752518689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1082	0	0	21.9097	0.558695434	11.24351375	0	1.947061556	2.240779884	2.064378658	3.531737684	10.27541392	2.088129365	4.75734287	0.920463692	0.059239152	10.78440777	9.809054925	20.06873543	0.643672907	0.832059221	5.348716468	0	5.272571263	1.752518689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1082																																																																																				0	0	0	21.9097	0.558695434	11.24351375	0	1.947061556	2.240779884	2.064378658	3.531737684	10.27541392	2.088129365	4.75734287	0.920463692	0.059239152	10.78440777	9.809054925	20.06873543	0.643672907	0.832059221	5.348716468	0	5.272571263	1.752518689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1082
H2410_802_0	2008	3																					0											Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0	0	268.2122294	6.839379836	70.0192531		8.320775882	9.575982411	8.822131015	15.09289609	43.91202532	8.923629764	20.33052509	3.933605523	0.253158769	46.08721269	41.91903814	85.76382664	2.750738918	3.555808635	22.85776268		22.53235582	7.489396105																				mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin		mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin																				0.081688025	0.081688025	0.160577459		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234																				21.9097	0.558695434	11.24351375	0	1.947061556	2.240779884	2.064378658	3.531737684	10.27541392	2.088129365	4.75734287	0.920463692	0.059239152	10.78440777	9.809054925	20.06873543	0.643672907	0.832059221	5.348716468	0	5.272571263	1.752518689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1082	0	0	21.9097	0.558695434	11.24351375	0	1.947061556	2.240779884	2.064378658	3.531737684	10.27541392	2.088129365	4.75734287	0.920463692	0.059239152	10.78440777	9.809054925	20.06873543	0.643672907	0.832059221	5.348716468	0	5.272571263	1.752518689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1082																																																																																				0	0	0	21.9097	0.558695434	11.24351375	0	1.947061556	2.240779884	2.064378658	3.531737684	10.27541392	2.088129365	4.75734287	0.920463692	0.059239152	10.78440777	9.809054925	20.06873543	0.643672907	0.832059221	5.348716468	0	5.272571263	1.752518689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1082
H2410_803_0	2008	3																					0											Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0	0	268.2122294	6.839379836	70.0192531		8.320775882	9.575982411	8.822131015	15.09289609	43.91202532	8.923629764	20.33052509	3.933605523	0.253158769	46.08721269	41.91903814	85.76382664	2.750738918	3.555808635	22.85776268		22.53235582	7.489396105																				mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin		mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin	mcare ffs ded/coin																				0.081688025	0.081688025	0.160577459		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234																				21.9097	0.558695434	11.24351375	0	1.947061556	2.240779884	2.064378658	3.531737684	10.27541392	2.088129365	4.75734287	0.920463692	0.059239152	10.78440777	9.809054925	20.06873543	0.643672907	0.832059221	5.348716468	0	5.272571263	1.752518689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1082	0	0	21.9097	0.558695434	11.24351375	0	1.947061556	2.240779884	2.064378658	3.531737684	10.27541392	2.088129365	4.75734287	0.920463692	0.059239152	10.78440777	9.809054925	20.06873543	0.643672907	0.832059221	5.348716468	0	5.272571263	1.752518689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1082																																																																																				0	0	0	21.9097	0.558695434	11.24351375	0	1.947061556	2.240779884	2.064378658	3.531737684	10.27541392	2.088129365	4.75734287	0.920463692	0.059239152	10.78440777	9.809054925	20.06873543	0.643672907	0.832059221	5.348716468	0	5.272571263	1.752518689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1082
H2411_002_0	2008	4																					3250											A	A	A	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	O	V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	259.4168388	5.494003131	90.65098597	0	407.9173887	0	0	1189.506563	484.8353672	0	1543.648638	79.43553821	0	0	5104.952173	2469.625888	291.207771	594.1339441	0	1145.994026	474.5588177	0	0	0	3.285533332	0	0	0	0	197.1319999	0											"PBP: 1A IP Acute: $250 per admit, $750 annual OOP Max"	"1B IP Psych: $250 per admit, $750 annual OOP Max"	"2 SNF: $250 per admit, $750 annual OOP Max"	6 Home Health: $0	"10A Ambulance: $50, $200 annual OOP Max"	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $15"	9A OP Hospital and 9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: $50, $150 annual OOP Max"	Included in g.	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $15, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $15"	"7B Chiropractic: $15, 7D Physician Specialist: $15, 7F Podiatry: $15"	"7E Mental Health: $15, 7H Psychiatric: $15, 9C OP Substance Abuse: $15"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7G Other Health Care: $15, 18A Medicare Covered Hearing Exams: $15, 17A Medicare Covered Eye Exams: $15"	15 Part B Drugs: $5-$40	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10-$15"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non-Medicare Covered Comprehensive Dental Services: Not Covered"	17A Routine Eye Exams: $15	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $15	13B Acupuncture: Not Covered											99.5	99.5	254.123	0	49.75	0	0	47.37534517	49.75	0	49.75	49.75	0	0	9.769839959	9.95	9.95	9.95	0	9.95	10.69875079	0	0	0	9.95	0	0	0	0	9.95	0											2.151	0.045554443	1.919708376	0	1.691157507	0	0	4.696106999	2.010046627	0	6.399709977	0.329326502	0	0	4.15621381	2.047731465	0.241459777	0.492636062	0	0.950220047	0.423098877	0	0	0	0.002724255	0	0	0	0	0.163455283	0	0	0	0	0	0	0	0	0	0	0	27.7201	0	0.146541078	2.151	0.045554443	1.919708376	0	1.691157507	0	0	4.696106999	2.010046627	0	6.399709977	0.329326502	0	0	4.15621381	2.047731465	0.241459777	0.492636062	0	0.950220047	0.423098877	0	0	0	0.002724255	0	0	0	0	0.163455283	0	0	0	0	0	0	0	0	0	0	0	27.7201	10600	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins											3.8475	0.0406	1.0392	0.5023	0.0865	0.1921	0.1043	0.3806	0.5516	0.8107	0.6648	0.7007	0.0043	0.013	0.7431	0.3498	0.069	0.0457	0	0.1379	0.057	0.029	0	0.0554	0.0001	0.0024	0	0	0	0.014	0.0081											10.4497	500	0.847273765	5.9985	0.086187722	2.958940775	0.502323512	1.777614819	0.192062209	0.104314391	5.076697954	2.56168993	0.810680083	7.064488712	1.030036876	0.004320664	0.012991471	4.899274488	2.397564487	0.310502413	0.538371931	0	1.088081155	0.480144484	0.02898503	0	0.055372076	0.002797395	0.002420304	0	0	0	0.17742318	0.008115375	0	0	0	0	0	0	0	0	0	0	38.1699
H2411_801_0	2008	4																					3250											A	A	A	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	O	V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	215.4476788	2.818941592	61.77333709	0	337.0502535	0	0	960.9883078	468.8363603	0	2607.930165	63.0111594	0	0	4898.446497	2405.758219	218.0876947	605.5988877	0	1136.329781	369.8395548	0	0	0	2.77288868	0	0	0	0	228.7633161	0											"PBP: 1A IP Acute: $450 per admit, $1,350 annual OOP Max"	1B IP Psych: $450 per admit	2 SNF: $450 per admit	6 Home Health: $0	10A Ambulance: $50	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $20"	9A OP Hospital and 9B ASC Services: $225	8A OP C/D/T: $0	8B OP X-Ray: $50	Included in g.	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $20, 14B Immunizations: $0, 14C Routine Physical Exams: $20, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $20"	"7B Chiropractic: $20, 7D Physician Specialist: $25, 7F Podiatry: $20"	"7E Mental Health: $20, 7H Psychiatric: $25, 9C OP Substance Abuse: $20"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	Included in i.2.	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $20, 17A Medicare Covered Eye Exams: $20-$25"	15 Part B Drugs: $0-$40	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10-$20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non-Medicare Covered Comprehensive Dental Services: Not Covered"	17A Routine Eye Exams: $20	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $20	13B Acupuncture: Not Covered											447.75	447.75	447.75	0	49.75	0	0	47.24520167	223.875	0	49.75	223.875	0	0	19.50741841	23.63583737	24.52077241	19.9	0	19.9	10.64708529	0	0	0	19.9	0	0	0	0	19.9	0											8.0389	0.105181758	2.30491764	0	1.397354176	0	0	3.7835072	8.746728347	0	10.81204381	1.175551943	0	0	7.963003784	4.738509167	0.445639894	1.004284822	0	1.884413553	0.328142774	0	0	0	0.004598374	0	0	0	0	0.379365833	0	0	0	0	0	0	0	0	0	0	0	53.1121	0	0.280424864	8.0389	0.105181758	2.30491764	0	1.397354176	0	0	3.7835072	8.746728347	0	10.81204381	1.175551943	0	0	7.963003784	4.738509167	0.445639894	1.004284822	0	1.884413553	0.328142774	0	0	0	0.004598374	0	0	0	0	0.379365833	0	0	0	0	0	0	0	0	0	0	0	53.1121	10600	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins											3.1387	0.0414	0.6487	0.3633	0.0694	0.1408	0.0968	0.2855	0.5428	0.719	0.5102	0.5409	0.0001	0.0167	0.7132	0.3492	0.0715	0.0486	0	0.1343	0.0492	0.0145	0	0.0483	0.0001	0.0036	0	0	0	0.0162	0.0068											8.5697	500	0.69484421	11.1776	0.146541242	2.953638848	0.363346125	1.466707844	0.140767035	0.096789482	4.068965118	9.289512683	0.719039677	11.3221985	1.716411019	8.13E-05	0.016702579	8.676228097	5.087724602	0.517152094	1.052908769	0	2.018691354	0.377307556	0.014457215	0	0.04829094	0.004743129	0.00363489	0	0	0	0.395574984	0.006845356	0	0	0	0	0	0	0	0	0	0	61.6819
H2411_803_0	2008	5																					3250											A	A	A	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	O	V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	215.4476788	2.818941592	61.77333709	0	337.0502535	0	0	960.9883078	468.8363603	0	2607.930165	63.0111594	0	0	4898.446497	2405.758219	218.0876947	605.5988877	0	1136.329781	369.8395548	0	0	0	2.77288868	0	0	0	0	228.7633161	0											"PBP: 1A IP Acute: $450 per admit, $1,350 annual OOP Max"	1B IP Psych: $450 per admit	2 SNF: $450 per admit	6 Home Health: $0	10A Ambulance: $50	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $20"	9A OP Hospital and 9B ASC Services: $225	8A OP C/D/T: $0	8B OP X-Ray: $50	Included in g.	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $20, 14B Immunizations: $0, 14C Routine Physical Exams: $20, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $20"	"7B Chiropractic: $20, 7D Physician Specialist: $25, 7F Podiatry: $20"	"7E Mental Health: $20, 7H Psychiatric: $25, 9C OP Substance Abuse: $20"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	Included in i.2.	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $20, 17A Medicare Covered Eye Exams: $20-$25"	15 Part B Drugs: $0-$40	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10-$20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non-Medicare Covered Comprehensive Dental Services: Not Covered"	17A Routine Eye Exams: $20	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $20	13B Acupuncture: Not Covered											447.75	447.75	447.75	0	49.75	0	0	47.24520167	223.875	0	49.75	223.875	0	0	19.50741841	23.63583737	24.52077241	19.9	0	19.9	10.64708529	0	0	0	19.9	0	0	0	0	19.9	0											8.0389	0.105181758	2.30491764	0	1.397354176	0	0	3.7835072	8.746728347	0	10.81204381	1.175551943	0	0	7.963003784	4.738509167	0.445639894	1.004284822	0	1.884413553	0.328142774	0	0	0	0.004598374	0	0	0	0	0.379365833	0	0	0	0	0	0	0	0	0	0	0	53.1121	0	0.280424864	8.0389	0.105181758	2.30491764	0	1.397354176	0	0	3.7835072	8.746728347	0	10.81204381	1.175551943	0	0	7.963003784	4.738509167	0.445639894	1.004284822	0	1.884413553	0.328142774	0	0	0	0.004598374	0	0	0	0	0.379365833	0	0	0	0	0	0	0	0	0	0	0	53.1121	10600	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins	Coins											3.1387	0.0414	0.6487	0.3633	0.0694	0.1408	0.0968	0.2855	0.5428	0.719	0.5102	0.5409	0.0001	0.0167	0.7132	0.3492	0.0715	0.0486	0	0.1343	0.0492	0.0145	0	0.0483	0.0001	0.0036	0	0	0	0.0162	0.0068											8.5697	500	0.69484421	11.1776	0.146541242	2.953638848	0.363346125	1.466707844	0.140767035	0.096789482	4.068965118	9.289512683	0.719039677	11.3221985	1.716411019	8.13E-05	0.016702579	8.676228097	5.087724602	0.517152094	1.052908769	0	2.018691354	0.377307556	0.014457215	0	0.04829094	0.004743129	0.00363489	0	0	0	0.395574984	0.006845356	0	0	0	0	0	0	0	0	0	0	61.6819
H2416_001_0	2008	7																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		368.9591593		190.6646963	27.53020268	21.18803068	33.41442727		2.269599095	5.887261543	175.5220126					215.3474335						29.9391424	0.54834572																				Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare											0.0834		0.1658	0	0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				30.7712	0	31.61220664	0	4.95799918	7.818975982	0	0.531086188	1.377619201	41.07215094	0	0	0	0	50.39129944	0	0	0	0	0	7.005759322	0.128312898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	175.6666			30.7712	0	31.61220664	0	4.95799918	7.818975982	0	0.531086188	1.377619201	41.07215094	0	0	0	0	50.39129944	0	0	0	0	0	7.005759322	0.128312898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	175.6666																																																																																				0			30.7712	0	31.61220664	0	4.95799918	7.818975982	0	0.531086188	1.377619201	41.07215094	0	0	0	0	50.39129944	0	0	0	0	0	7.005759322	0.128312898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	175.6666
H2417_001_0	2008	7																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		454.8338632		106.3203952	49.52528076	4.975838	30.31365148		18.63332662	51.18531402	166.957978					151.3545173						10.39336508	0.607286813																				Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare											0.0834		0.1658	0	0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				37.9331	0	17.62792152	0	1.164346092	7.093394447	0	4.360198428	11.97736348	39.06816684	0	0	0	0	35.41695704	0	0	0	0	0	2.432047429	0.142105114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.2156			37.9331	0	17.62792152	0	1.164346092	7.093394447	0	4.360198428	11.97736348	39.06816684	0	0	0	0	35.41695704	0	0	0	0	0	2.432047429	0.142105114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.2156																																																																																				0			37.9331	0	17.62792152	0	1.164346092	7.093394447	0	4.360198428	11.97736348	39.06816684	0	0	0	0	35.41695704	0	0	0	0	0	2.432047429	0.142105114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.2156
H2419_001_0	2008	9																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		398.9213742		241.926664		27.57781119	66.17965418		36.7696564	38.86631405	112.3945011					128.8312512						11.09069654	1.691227956																				Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co											0.0834		0.1658		0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				33.27	0	40.11144089	0	6.453207818	15.48603908	0	8.604099598	9.094717487	26.30031327	0	0	0	0	30.14651278	0	0	0	0	0	2.595222991	0.395747342	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	172.4573	0	0	33.27	0	40.11144089	0	6.453207818	15.48603908	0	8.604099598	9.094717487	26.30031327	0	0	0	0	30.14651278	0	0	0	0	0	2.595222991	0.395747342	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	172.4573																																																																																				0	0	0	33.27	0	40.11144089	0	6.453207818	15.48603908	0	8.604099598	9.094717487	26.30031327	0	0	0	0	30.14651278	0	0	0	0	0	2.595222991	0.395747342	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	172.4573
H2422_002_0	2008	7																																Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		402.87		116.07	26.59	35.47	38.66		21.79	23.33	302.82					215.29						8.78	0																				1a: First 60 days  all but $992 Day 61-90 $248 per day Day 90-150 (lifetime days) $496 per day Beyond 150  no coverage	1b: First 60 days  all but $992 Day 61-90 $248 per day Day 90-150 $496 per day 190 days lifetime	2: Days 1-20  no copay Days 21-100 $124 per day No coverage after day 100	6: No member cost sharing	10a: 20% coinsurance	11a: 20% coinsurance	"11b, 11c: 20% coinsurance"	"4a, 4b: 20% coinsurance"	"9a, 9b: 20% coinsurance"	8a: 20% coinsurance	8b: 20% coinsurance	5: 20% coinsurance	12: 20% coinsurance	"3, 9c, 9d: 20% coinsurance"	7a: 20% coins; 14b:No co-pay for flu or pneumonia vaccines;14c:1 exam covered within 6 months of enrollment	"7b: 20% coinsurance on Medicare approved amounts, 100% coinsurance on routine care;7d:20% coinsurance;7f:20% coinsurance, 100% coinsurance for routine care"	"7e, 7h: 50% coinsurance"	"7c, 7i: 20% coinsurance"	7d: 20% coinsurance	"7g, 14e, 14f, 14g, 14h, 14i: 20% coins; 14d: 0% coins"	15: 20% coinsurance	13a: No member cost sharing																				0.11		0.121	0	0.218	0.218		0.218	0.218	0.218					0.218						0.218	0.218																				44.3157	0	14.04447	0	7.73246	8.42788	0	4.75022	5.08594	66.01476	0	0	0	0	46.93322	0	0	0	0	0	1.91404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	199.2187			44.3157	0	14.04447	0	7.73246	8.42788	0	4.75022	5.08594	66.01476	0	0	0	0	46.93322	0	0	0	0	0	1.91404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	199.2187																																																																																				0			44.3157	0	14.04447	0	7.73246	8.42788	0	4.75022	5.08594	66.01476	0	0	0	0	46.93322	0	0	0	0	0	1.91404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	199.2187
H2424_001_0	2008	3																																Coin		Coin	Coin	Coin	Coin		V	Coin					Coin						Coin	Coin	Coin																																																													0		433.9765891		236.7094184	3.449493636	19.4777332	70.27846519		518.443686	39.91127437					78.38396782						156.3502843	16.79920478	0.56753224																				traditional Medicare		traditional Medicare	traditional Medicare	traditional Medicare	traditional Medicare		$50 Copay (max for MA)	traditional Medicare					traditional Medicare						traditional Medicare	traditional Medicare	traditional Medicare																				0.0834		0.1658	0	0.234	0.234		50	0.234					0.234						0.234	0.234	0.234																				36.1936	0	39.24642158	0	4.557789569	16.44516085	0	2.160182025	9.339238204	0	0	0	0	18.34184847	0	0	0	0	0	36.58596652	3.931013919	0.132802544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	166.9341			36.1936	0	39.24642158	0	4.557789569	16.44516085	0	2.160182025	9.339238204	0	0	0	0	18.34184847	0	0	0	0	0	36.58596652	3.931013919	0.132802544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	166.9341																																																																																				0			36.1936	0	39.24642158	0	4.557789569	16.44516085	0	2.160182025	9.339238204	0	0	0	0	18.34184847	0	0	0	0	0	36.58596652	3.931013919	0.132802544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	166.9341
H2425_001_0	2008	5																																Coin		Coin	Coin	Coin	Coin		V	Coin					Coin						Coin	Coin	Coin																																																													0		406.4493187		231.099673	8.273671762	20.15243452	75.70307125		583.917231	38.36989454					100.0805957						151.5612166	17.34917912	0.320969468																				traditional Medicare		traditional Medicare	traditional Medicare	traditional Medicare	traditional Medicare		$50 Copay (max for MA)	traditional Medicare					traditional Medicare						traditional Medicare	traditional Medicare	traditional Medicare																				0.082520626		0.163342021	0	0.234	0.234		50	0.234					0.234						0.234	0.234	0.234																				33.5405	0	37.74828762	0	4.715669677	17.71451867	0	2.432988462	8.978555323	0	0	0	0	23.41885938	0	0	0	0	0	35.46532468	4.059707913	0.075106856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	168.1495			33.5405	0	37.74828762	0	4.715669677	17.71451867	0	2.432988462	8.978555323	0	0	0	0	23.41885938	0	0	0	0	0	35.46532468	4.059707913	0.075106856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	168.1495																																																																																				0			33.5405	0	37.74828762	0	4.715669677	17.71451867	0	2.432988462	8.978555323	0	0	0	0	23.41885938	0	0	0	0	0	35.46532468	4.059707913	0.075106856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	168.1495
H2456_002_0	2008	6																					3250											Coin		Coin		Coin	Coin		Coin	Coin	Coin					Coin						Coin																																																														0	0	416.8845601		134.0305701		18.40860442	55.49862792		31.67184766	75.90619238	34.03940026					316.766266						8.574728822																					FFS Medicare Actl. Equiv. cost sharing		FFS Medicare Actl. Equiv. cost sharing		FFS Medicare Actl. Equiv. cost sharing	FFS Medicare Actl. Equiv. cost sharing		FFS Medicare Actl. Equiv. cost sharing	FFS Medicare Actl. Equiv. cost sharing	FFS Medicare Actl. Equiv. cost sharing					FFS Medicare Actl. Equiv. cost sharing						FFS Medicare Actl. Equiv. cost sharing																					0.08065802		0.157648794		0.234	0.234		0.234	0.234	0.234					0.234						0.234																					33.6251	0	21.12975779	0	4.307613433	12.98667893	0	7.411212351	17.76204902	7.96521966	0	0	0	0	74.12330624	0	0	0	0	0	2.006486544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	181.3174		0	33.6251	0	21.12975779	0	4.307613433	12.98667893	0	7.411212351	17.76204902	7.96521966	0	0	0	0	74.12330624	0	0	0	0	0	2.006486544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	181.3174	0																																																																																			0		0	33.6251	0	21.12975779	0	4.307613433	12.98667893	0	7.411212351	17.76204902	7.96521966	0	0	0	0	74.12330624	0	0	0	0	0	2.006486544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	181.3174
H2457_002_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		557.6640353		103.2664008	23.83307996	22.8916976	42.42791583		12.39246892	42.35802429	165.9010306					226.3788468						14.56429012	0.706924408																				same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare	same as Medicare											0.079065684		0.152175098	0	0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				44.0921	0	15.7145747	0	5.356657238	9.928132305	0	2.899837727	9.911777683	38.82084116	0	0	0	0	52.97265014	0	0	0	0	0	3.408043888	0.165420311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	183.27			44.0921	0	15.7145747	0	5.356657238	9.928132305	0	2.899837727	9.911777683	38.82084116	0	0	0	0	52.97265014	0	0	0	0	0	3.408043888	0.165420311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	183.27																																																																																				0			44.0921	0	15.7145747	0	5.356657238	9.928132305	0	2.899837727	9.911777683	38.82084116	0	0	0	0	52.97265014	0	0	0	0	0	3.408043888	0.165420311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	183.27
H2458_002_0	2008	5																					0											Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin								V																																																					0	0	407.1517326	15.73767693	166.3482396		15.32197082	14.3404604							0.286933936	334.5707835	3.071892533	165.5557417	3.233831754	3.085212369	24.98639046	6.614856329	11.97764773	0.256477354																				FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins		FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins								$0 (14a)												0.08058447	0.08058447	0.157409096		0.234	0.234							0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				32.8101	1.268212357	26.184726	0	3.585341171	3.355667733	0	0	0	0	0	0	0.067142541	78.28956334	0.718822853	38.74004356	0.75671663	0.721939694	5.846815367	1.547876381	2.802769569	0.060015701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	196.7558	0	0	32.8101	1.268212357	26.184726	0	3.585341171	3.355667733	0	0	0	0	0	0	0.067142541	78.28956334	0.718822853	38.74004356	0.75671663	0.721939694	5.846815367	1.547876381	2.802769569	0.060015701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	196.7558																																																																																				0	0	0	32.8101	1.268212357	26.184726	0	3.585341171	3.355667733	0	0	0	0	0	0	0.067142541	78.28956334	0.718822853	38.74004356	0.75671663	0.721939694	5.846815367	1.547876381	2.802769569	0.060015701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	196.7558
H2459_001_0	2008	5																					3250											A	A	D		T	Coin		V	P	V	V			V		V	V	V		V									Coin																																																						0	0	277.3255672	4.644360267	624.4700778		189.8710789	12.34850853		180.6979241	409.31255	1361.079691	307.9586226			1977.610328		1683.000414	133.2932449	512.9780829		1235.24873									3.183736746													$250 Per Admit	$250 Per Admit	$50 days 21 to 100		$100 per Trip	"20% Coinsurance DME , 20% Coinsurance Prosthetics, 10% Coinsurance Supplies"		$50 per ER Visit	$100 per Surgery/Procedure	$25 per visit	$25 per visit			$25 per UC visit and $25 per OP Facility Other		$25 per visit	$25 per visit	$25 per PT and ST visit		$25 per podiatry visit and $15 per Medicare covered hearing and vision exams.									20% Coinsurance													249.325	249.325	49.865		99.73	0.19841711		49.865	99.73	24.9325	24.9325			24.9325		24.9325	24.9325	24.9325		17.33277196									0.19946													5.762	0.09649626	2.594933369	0	1.577986892	2.450155376	0	0.750875165	3.401728385	2.827926616	0.639848196	0	0	4.108897458	0	3.496783986	0.276944486	1.065818838	0	1.784190378	0	0	0	0	0	0	0	0	0.635028131	0	0	0	0	0	0	0	0	0	0	0	0	31.4696		0.08	5.762	0.09649626	2.594933369	0	1.577986892	2.450155376	0	0.750875165	3.401728385	2.827926616	0.639848196	0	0	4.108897458	0	3.496783986	0.276944486	1.065818838	0	1.784190378	0	0	0	0	0	0	0	0	0.635028131	0	0	0	0	0	0	0	0	0	0	0	0	31.4696	0																																																																																			0		0	5.762	0.09649626	2.594933369	0	1.577986892	2.450155376	0	0.750875165	3.401728385	2.827926616	0.639848196	0	0	4.108897458	0	3.496783986	0.276944486	1.065818838	0	1.784190378	0	0	0	0	0	0	0	0	0.635028131	0	0	0	0	0	0	0	0	0	0	0	0	31.4696
H2459_002_0	2008	5																					3250											A	A			T	Coin		V						V		V	V	V		V									Coin																																																						0	0	328.3166264	5.498305512			224.7821314	14.61899349		213.9223348						114.2166905		1992.448889	157.8014927	607.2978965		1462.370382									4.839881067													$100 Per Admit	$100 Per Admit			$100 per Trip	"20% Coinsurance DME, 10% Coinsurance Prosthetics/Supplies"		$50 per Visit						$20 per UC visit		$10 per visit	$10 per visit	$10 per PT and ST visit		$10 per Podiatry and Medicare covered hearing and vision exams									20% Coinsurance													100	100			100	0.184171101		50						20		10	10	10		10									0.2													2.736	0.045819213	0	0	1.873184428	2.69239612	0	0.891343062	0	0	0	0	0	0.190361151	0	1.660374074	0.131501244	0.50608158	0	1.218641985	0	0	0	0	0	0	0	0	0.967976213	0	0	0	0	0	0	0	0	0	0	0	0	12.9137		0	2.736	0.045819213	0	0	1.873184428	2.69239612	0	0.891343062	0	0	0	0	0	0.190361151	0	1.660374074	0.131501244	0.50608158	0	1.218641985	0	0	0	0	0	0	0	0	0.967976213	0	0	0	0	0	0	0	0	0	0	0	0	12.9137	0																																																																																			0		0	2.736	0.045819213	0	0	1.873184428	2.69239612	0	0.891343062	0	0	0	0	0	0.190361151	0	1.660374074	0.131501244	0.50608158	0	1.218641985	0	0	0	0	0	0	0	0	0.967976213	0	0	0	0	0	0	0	0	0	0	0	0	12.9137
H2459_005_0	2008	5																					3250											A	A	D	V	T	Coin		V	V	V	V	V	V	V	V	V	V	V	P	P	Coin	P	T	P	V	P	V	P	Coin	P	P	P	P	P	P	P	P	P	P	P	P																																										0	0	210.3082363	5.208616532	806.2978359		119.1082396	8.84871109		147.7436356	632.8612644	1627.932005	421.958491			2578.622162		1445.60851	70.45745966	392.2121181		949.9260369									4.253805668													$250 Per Admit	$250 Per Admit	$50 days 21 to 100		$100 per Trip	"20% Coinsurance DME , 20% Coinsurance Prosthetics, 10% Coinsurance Supplies"		$50 per ER Visit	$100 per Surgery/Procedure	$25 per visit	$25 per visit			$25 per UC visit and $25 per OP Facility Other		$25 per visit	$25 per visit	$25 per PT and ST visit		$25 per podiatry visit and $15 per Medicare covered hearing and vision exams.									20% Coinsurance													249.325	249.325	49.865		99.73	0.198892508		49.865	99.73	24.9325	24.9325			24.9325		24.9325	24.9325	24.9325		15.81483245									0.19946													4.3696	0.10821986	3.350503466	0	0.989888728	1.759942342	0	0.613936366	5.259604491	3.382367893	0.876706673	0	0	5.357624754	0	3.003552849	0.146390051	0.814902386	0	1.251910093	0	0	0	0	0	0	0	0	0.848464078	0	0	0	0	0	0	0	0	0	0	0	0	32.1336		0.09	4.3696	0.10821986	3.350503466	0	0.989888728	1.759942342	0	0.613936366	5.259604491	3.382367893	0.876706673	0	0	5.357624754	0	3.003552849	0.146390051	0.814902386	0	1.251910093	0	0	0	0	0	0	0	0	0.848464078	0	0	0	0	0	0	0	0	0	0	0	0	32.1336	0																																																																																			0		0	4.3696	0.10821986	3.350503466	0	0.989888728	1.759942342	0	0.613936366	5.259604491	3.382367893	0.876706673	0	0	5.357624754	0	3.003552849	0.146390051	0.814902386	0	1.251910093	0	0	0	0	0	0	0	0	0.848464078	0	0	0	0	0	0	0	0	0	0	0	0	32.1336
H2459_006_0	2008	5																					3250											A	A			T	Coin		V						V		V	V	V		P									Coin																																																						0	0	248.9770105	6.166309963			141.0083311	10.46897167		174.9088355						60.07337542		1711.408415	83.41227134	464.327039		1124.586222									6.790286329													$100 Per Admit	$100 Per Admit			$100 per Trip	20% Coinsurance DME and 10% Coinsurance Prosthetics/Supplies		$50 per Visit						$20 per UC visit		$10 per visit	$10 per visit	$10 per PT and ST visit		$10 per Podiatry and Medicare covered hearing and vision exams									20% Coinsurance													100	100			100	0.188925081		50						20		10	10	10		10									0.2													2.0748	0.051385916	0	0	1.175069426	1.977851325	0	0.728786815	0	0	0	0	0	0.100122292	0	1.426173679	0.069510226	0.386939199	0	0.937155185	0	0	0	0	0	0	0	0	1.358057266	0	0	0	0	0	0	0	0	0	0	0	0	10.2859		0	2.0748	0.051385916	0	0	1.175069426	1.977851325	0	0.728786815	0	0	0	0	0	0.100122292	0	1.426173679	0.069510226	0.386939199	0	0.937155185	0	0	0	0	0	0	0	0	1.358057266	0	0	0	0	0	0	0	0	0	0	0	0	10.2859	0																																																																																			0		0	2.0748	0.051385916	0	0	1.175069426	1.977851325	0	0.728786815	0	0	0	0	0	0.100122292	0	1.426173679	0.069510226	0.386939199	0	0.937155185	0	0	0	0	0	0	0	0	1.358057266	0	0	0	0	0	0	0	0	0	0	0	0	10.2859
H2459_013_0	2008	5																					3250											A	A	D		T	Coin		V	P	V	V			V		V	V	V		V									Coin																																																						0	0	289.1686519	4.842695937	651.1378392		197.9794524	12.87584697		188.4145614	426.7920895	1419.20409	321.1098805			2062.063438		1754.872318	138.9854831	534.8846203		1287.999565									4.020516485													$250 per Admit	$250 per Admit	$50 days 21 to 100		$100 per Trip	"20% Coinsurance DME, 20% Coinsurance Prosthetics, 10% Coinsurance Supplies"		$50 per ER Visit	$100 per Surgery/Procedure	$25 per visit	$25 per visit			$25 per UC visit and $25 per OP Facility Other		$25 per visit	$25 per visit	$25 per PT and SP visit		$25 per podiatry visit and $15 per Medicare covered hearing and vision exams.									20% Coinsurance													249.325	249.325	49.865		99.73	0.19841711		49.865	99.73	24.9325	24.9325			24.9325		24.9325	24.9325	24.9325		17.33277196									0.19946													6.0081	0.100617097	2.705749029	0	1.645374232	2.554788345	0	0.782941009	3.546997924	2.948692165	0.667172675	0	0	4.284366388	0	3.646112839	0.288771296	1.111334233	0	1.860383562	0	0	0	0	0	0	0	0	0.801932218	0	0	0	0	0	0	0	0	0	0	0	0	32.9533		0.09	6.0081	0.100617097	2.705749029	0	1.645374232	2.554788345	0	0.782941009	3.546997924	2.948692165	0.667172675	0	0	4.284366388	0	3.646112839	0.288771296	1.111334233	0	1.860383562	0	0	0	0	0	0	0	0	0.801932218	0	0	0	0	0	0	0	0	0	0	0	0	32.9533	0																																																																																			0		0	6.0081	0.100617097	2.705749029	0	1.645374232	2.554788345	0	0.782941009	3.546997924	2.948692165	0.667172675	0	0	4.284366388	0	3.646112839	0.288771296	1.111334233	0	1.860383562	0	0	0	0	0	0	0	0	0.801932218	0	0	0	0	0	0	0	0	0	0	0	0	32.9533
H2459_014_0	2008	5																					3250											A	A	D		T	Coin		V	V	V	V			V		V	V	V		P									Coin																																																						0	0	219.2893709	5.431048555	840.7304837		124.1947125	9.231309511		154.0529724	584.0754268	1697.452233	439.9780707			2688.741258		1507.342682	73.46631914	408.9613901		990.4922733									6.457505803													$250 per Admit	$250 per Admit	$50 days 21 to 100		$100 per Trip	"20% Coinsurance DME, 20% Coinsurance Prosthetics, 10% Coinsurance Supplies"		$50 per ER Visit	$100 per Surgery/Procedure	$25 per visit	$25 per visit			$25 per UC visit and $25 per OP Facility Other		$25 per visit	$25 per visit	$25 per PT and SP visit		$25 per podiatry visit and $15 per Medicare covered hearing and vision exams.									20% Coinsurance													249.325	249.325	49.865		99.73	0.198892508		49.865	99.73	24.9325	24.9325			24.9325		24.9325	24.9325	24.9325		15.81483245									0.19946													4.5562	0.112841348	3.493585464	0	1.032161556	1.836038302	0	0.640154289	4.854153526	3.52681065	0.914146104	0	0	5.586420118	0	3.131818451	0.152641584	0.849702488	0	1.305372445	0	0	0	0	0	0	0	0	1.288014107	0	0	0	0	0	0	0	0	0	0	0	0	33.2801		0.09	4.5562	0.112841348	3.493585464	0	1.032161556	1.836038302	0	0.640154289	4.854153526	3.52681065	0.914146104	0	0	5.586420118	0	3.131818451	0.152641584	0.849702488	0	1.305372445	0	0	0	0	0	0	0	0	1.288014107	0	0	0	0	0	0	0	0	0	0	0	0	33.2801	0																																																																																			0		0	4.5562	0.112841348	3.493585464	0	1.032161556	1.836038302	0	0.640154289	4.854153526	3.52681065	0.914146104	0	0	5.586420118	0	3.131818451	0.152641584	0.849702488	0	1.305372445	0	0	0	0	0	0	0	0	1.288014107	0	0	0	0	0	0	0	0	0	0	0	0	33.2801
H2459_016_0	2008	6																					3250											Coin		Coin		Coin	Coin		Coin	Coin	Coin					Coin						Coin																																																														0	0	599.5094172		143.0384369		31.5461733	158.7124188		49.72135901	127.1197181	39.61864374					298.1537393						18.44570516																					FFS Medicare Actl. Equiv. cost sharing		FFS Medicare Actl. Equiv. cost sharing		FFS Medicare Actl. Equiv. cost sharing	FFS Medicare Actl. Equiv. cost sharing		FFS Medicare Actl. Equiv. cost sharing	FFS Medicare Actl. Equiv. cost sharing	FFS Medicare Actl. Equiv. cost sharing					FFS Medicare Actl. Equiv. cost sharing						FFS Medicare Actl. Equiv. cost sharing																					0.082888015		0.164385596		0.234	0.234		0.234	0.234	0.234					0.234						0.234																					49.6921	0	23.51345864	0	7.381804552	37.138706	0	11.63479801	29.74601403	9.270762635	0	0	0	0	69.76797501	0	0	0	0	0	4.316295008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	242.462		0	49.6921	0	23.51345864	0	7.381804552	37.138706	0	11.63479801	29.74601403	9.270762635	0	0	0	0	69.76797501	0	0	0	0	0	4.316295008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	242.462	0																																																																																			0		0	49.6921	0	23.51345864	0	7.381804552	37.138706	0	11.63479801	29.74601403	9.270762635	0	0	0	0	69.76797501	0	0	0	0	0	4.316295008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	242.462
H2459_017_0	2008	5																					3250											A	A	D	V	T	P	P	V	V	V	V	V	V	V	P	P	P	P	P	P	S	P	T	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P																																										0	0	476.3451618	11.2561119			313.509039	2454.827195	2195.301017	344.040602								147.7543397	298.6863552	505.9506276				1078.745478					0.030575611															#1A $100	#1B $100	#2 $0	#6 $0	#10A $100	#11A 20%	"#11B 10%, #11C $0"	"#4A $50, #4B $20"	"#9A $0, #9B $0"	#8A $0	#8B $0	$9A $0	#12 $0	"#3 $0, #5 $0, #9A $0, #9C $0, #9D $0"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0, #14I"	"#7B $0, #7D $/, #7F $10"	"#7E $10, #7H $10"	"#7C $0, #7I $10"	#7D	#7G $0	#15 $0	"#13A $0, #14J $0, #16B $0, #17A $10, #18A $10"	#10B $0	"#16A $0, #16B opt. supp."	#17A $10	#17B $0 n/c	#18A $0	#18B $0	#19 n/c	#14A $0	#13B $0 n/c											100	100			100	19.824	12.9147	46.9859								10	10	10				10					10															3.9695	0.093800933	0	0	2.612575325	4.055374166	2.362643522	1.347087006	0	0	0	0	0	0	0	0.123128616	0.248905296	0.421625523	0	0	0	0.898954565	0	0	0	0	2.55E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.1337	0	0	3.9695	0.093800933	0	0	2.612575325	4.055374166	2.362643522	1.347087006	0	0	0	0	0	0	0	0.123128616	0.248905296	0.421625523	0	0	0	0.898954565	0	0	0	0	2.55E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.1337																																																																																				0	0	0	3.9695	0.093800933	0	0	2.612575325	4.055374166	2.362643522	1.347087006	0	0	0	0	0	0	0	0.123128616	0.248905296	0.421625523	0	0	0	0.898954565	0	0	0	0	2.55E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.1337
H2459_801_0	2008	3																					3250											A	A	D		T	Coin		V	P	V	V			V	V	V	V	V		V									Coin																																																						0	0	154.7651425	2.361900837	627.492277		150.4907464	12.93261273		188.1170356	645.3496059	1292.282244	305.2614448			2575.066293	3157.900401	2252.16518	211.900498	891.9591538		1445.283062									6.68296492													$250 per Admission	$250 per Admission	$50 days 21 to 100		$100 per Trip	"20% Coinsurance DME/20% Coinsurance Prosthetics, 10% Coinsurance Supplies"		$50 per Visit	$100 per surgery/procedure	$25 per visit	$25 per visit			$25 per UC visit and $25 per OP Facility Other	$25 per visit	$25 per visit	$25 per visit	$25 per PT and ST visit		$25 per podiatry visit and $15 per Medicare hearing and vision.									20% Coinsurance													249.325	249.325	49.865		99.73	0.2		49.865	99.73	24.9325	24.9325			24.9325	24.9325	24.9325	24.9325	24.9325		16.21530744									0.19946													3.2156	0.049073411	2.607491866	0	1.250703511	2.586522545	0	0.781704665	5.363393017	2.684985588	0.634244248	0	0	5.350236697	6.561195978	4.679342362	0.440267431	1.853230967	0	1.952975765	0	0	0	0	0	0	0	0	1.332984183	0	0	0	0	0	0	0	0	0	0	0	0	41.3439		0.11	3.2156	0.049073411	2.607491866	0	1.250703511	2.586522545	0	0.781704665	5.363393017	2.684985588	0.634244248	0	0	5.350236697	6.561195978	4.679342362	0.440267431	1.853230967	0	1.952975765	0	0	0	0	0	0	0	0	1.332984183	0	0	0	0	0	0	0	0	0	0	0	0	41.3439	0																																																																																			0		0	3.2156	0.049073411	2.607491866	0	1.250703511	2.586522545	0	0.781704665	5.363393017	2.684985588	0.634244248	0	0	5.350236697	6.561195978	4.679342362	0.440267431	1.853230967	0	1.952975765	0	0	0	0	0	0	0	0	1.332984183	0	0	0	0	0	0	0	0	0	0	0	0	41.3439
H2459_803_0	2008	3																					3250											A	A	D		T	Coin		V	P	V	V			V	V	V	V	V		V									Coin																																																						0	0	154.7651425	2.361900837	627.492277		150.4907464	12.93261273		188.1170356	645.3496059	1292.282244	305.2614448			2575.066293	3157.900401	2252.16518	211.900498	891.9591538		1445.283062									6.68296492													$250 per Admission	$250 per Admission	$50 days 21 to 100		$100 per Trip	"20% Coinsurance DME, 20% Coinsurance Prosthetics, 10% Coinsurance Supplies"		$50 per Visit	$100 per surgery/procedure	$25 per visit	$25 per visit			$25 per UC visit and $25 per OP Facility Other	$25 per visit	$25 per visit	$25 per visit	$25 per PT and ST visit		$25 per podiatry visit and $15 per Medicare hearing and vision.									20% Coinsurance													249.325	249.325	49.865		99.73	0.2		49.865	99.73	24.9325	24.9325			24.9325	24.9325	24.9325	24.9325	24.9325		16.21530744									0.19946													3.2156	0.049073411	2.607491866	0	1.250703511	2.586522545	0	0.781704665	5.363393017	2.684985588	0.634244248	0	0	5.350236697	6.561195978	4.679342362	0.440267431	1.853230967	0	1.952975765	0	0	0	0	0	0	0	0	1.332984183	0	0	0	0	0	0	0	0	0	0	0	0	41.3439		0.11	3.2156	0.049073411	2.607491866	0	1.250703511	2.586522545	0	0.781704665	5.363393017	2.684985588	0.634244248	0	0	5.350236697	6.561195978	4.679342362	0.440267431	1.853230967	0	1.952975765	0	0	0	0	0	0	0	0	1.332984183	0	0	0	0	0	0	0	0	0	0	0	0	41.3439	0																																																																																			0		0	3.2156	0.049073411	2.607491866	0	1.250703511	2.586522545	0	0.781704665	5.363393017	2.684985588	0.634244248	0	0	5.350236697	6.561195978	4.679342362	0.440267431	1.853230967	0	1.952975765	0	0	0	0	0	0	0	0	1.332984183	0	0	0	0	0	0	0	0	0	0	0	0	41.3439
H2481_003_0	2008	5																					2000											D	D	D		T	Coin	Coin	V	V				P	V	V	V	V	V		V					V						V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	4000	418.6306125	8.602226902	125.925904	0	171.0428189	11.65527608	6.670464858	325.3581547	248.3014413	0	0	0	24.04515132	614.1933558	3388.243556	2967.700689	128.6534757	328.6117024	0	1452.210603	0	0	0	0	365.797469	0	0	0	0	0	580.2											$100/Day for IP Medical; $100/Day for IP Surgical	$100/Day for IP Psych; $100/Day for IP Substance Abuse	$100/Day for SNF	No cost-sharing	$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	$100/Case for OP Fac - Surgery; $100/Case for OP Fac - ASC	No cost-sharing	No cost-sharing	No cost-sharing	$25/Case for Renal Dialysis - Fac; $25/Procedure for Renal Dialysis - Prof	$15/Case for OP Fac - Cardiovascular; $15/Case for OP Fac - Occ Therapy; $15/Case for OP Fac - Physical/Speech Therapy; $15/Case for OP Fac - CORF; $15/Visit for Prof - CORF; $15/Visit for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Consult for PCP - Consults;	$25/Visit for Speclst - Office Visits; $25/Consult for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $25/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$15/Visit for PT/ST (PCP); $15/Visit for Occ Therapy (PCP); $15/Visit for PT/ST (Specialist); $15/Visit for Occ Therapy (Specialist);	No cost-sharing	$15/Visit for Chiropractor; $25/Exam for Vistion Exams; $25/Service for Podiatrist; $25/Exam for Hearing/Speech Exams;	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$25/Exam for Vision (Refractions)	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$15/Visit for Alternative Medicine$15/Visit for Care Coord											94.6416492	94.64164918	94.64164921	0	47.3208246	0.189283298	0.189283298	41.32950007	94.6416492	0	0	0	23.6604123	14.19624738	14.19624738	23.6604123	18.3976432	14.19624738	0	21.54138127	0	0	0	0	23.6604123	0	0	0	0	0	14.19624738											3.3017	0.067844078	0.993152936	0	0.674490603	2.206149101	1.26260759	1.120574156	1.958304826	0	0	0	0.04740985	0.726603401	4.008361976	5.85141849	0.197243395	0.388754418	0	2.606885189	0	0	0	0	0.721243245	0	0	0	0	0	0.686388561	0	0	0	0	0	0	0	0	0	0	26.8191	0	1.594145821	3.3017	0.067844078	0.993152936	0	0.674490603	2.206149101	1.26260759	1.120574156	1.958304826	0	0	0	0.04740985	0.726603401	4.008361976	5.85141849	0.197243395	0.388754418	0	2.606885189	0	0	0	0	0.721243245	0	0	0	0	0	0.686388561	0	0	0	0	0	0	0	0	0	0	26.8191		20% Coinsurance for IP Medical; 20% Coinsurance for IP Surgical	20% Coinsurance for IP Psych; 20% Coinsurance for IP Substance Abuse	20% Coinsurance for SNF	20% Coinsurance for Home Health	$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	20% Coinsurance for OP Fac - Pathology	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	20% Coinsurance for OP Fac - Cardiovascular; 20% Coinsurance for OP Fac - Occ Therapy; 20% Coinsurance for OP Fac - Physical/Speech Therapy; 20% Coinsurance for OP Fac - CORF; 20% Coinsurance for OP Fac - Other; 20% Coinsurance for Prof - CORF; 20% Coinsurance for Prof - CORF;	20% Coinsurance for PCP - Office Visits; 20% Coinsurance for PCP - Consults; 20% Coinsurance for PCP - Primary Surgeon (IP); 20% Coinsurance for PCP - Asst Surgeon (IP); 20% Coinsurance for PCP - Primary Surgeon (OP); 20% Coinsurance for PCP - Asst Surgeon (OP); 20% Coinsurance for PCP - IP Visits; 20% Coinsurance for PCP - Tx Injections; 20% Coinsurance for PCP - Allergy Testing; 20% Coinsurance for PCP - Allergy Tx; 20% Coinsurance for PCP - ER Visits; 20% Coinsurance for PCP - Cardio; 20% Coinsurance for PCP - Immunizations;	20% Coinsurance for Speclst - Primary Surgeon (IP); 20% Coinsurance for Speclst - Asst Surgeon (IP); 20% Coinsurance for Speclst - Anesthesia (IP); 20% Coinsurance for Speclst - Primary Surgeon (OP); 20% Coinsurance for Speclst - Asst Surgeon (OP); 20% Coinsurance for Speclst - Anesthesia (OP); 20% Coinsurance for Speclst - IP Visits; 20% Coinsurance for Speclst - Office Visits; 20% Coinsurance for Speclst - Tx Injections; 20% Coinsurance for Speclst - Allergy Testing; 20% Coinsurance for Speclst - Allergy Tx; 20% Coinsurance for Speclst - ER Visits; 20% Coinsurance for Speclst - Consults; 20% Coinsurance for Speclst - Cardio; 20% Coinsurance for Speclst - Immunizations;	20% Coinsurance for OP Psych - Non-Physician; 20% Coinsurance for OP Psych - Psychiatrist; 20% Coinsurance for OP Substance Abuse;	20% Coinsurance for PT/ST (PCP); 20% Coinsurance for Occ Therapy (PCP); 20% Coinsurance for PT/ST (Specialist); 20% Coinsurance for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	20% Coinsurance for Chiropractor; 20% Coinsurance for Vistion Exams; 20% Coinsurance for Podiatrist; 20% Coinsurance for Hearing/Speech Exams; 20% Coinsurance for Misc. Medical (PCP); 20% Coinsurance for Misc. Medical; 20% Coinsurance for Prof Path (IP); 20% Coinsurance for Prof Path (OP); 20% Coinsurance for Prof Path (Office); 20% Coinsurance for Prof Path (Labs)	20% Coinsurance for Part B Rx	20% Coinsurance for Blood Products																				1.491	0.0169	0.106	0.166	0.031	0.1038	0.0637	0.0549	0.2263	0.0656	0.1862	0	0.003	0.2029	0.2128	0.642	0.0079	0.0065	0.1369	0.2601	0.0697	0.0076	0	0	0	0	0	0	0	0	0											4.0607	0	35.0041341	4.7927	0.08473619	1.099169812	0.166003564	0.705446813	2.309940373	1.326301179	1.175501102	2.184561914	0.065618446	0.186202805	0	0.050424205	0.929489163	4.221166744	6.493405693	0.205127782	0.395274667	0.13685956	2.86696079	0.069694958	0.007551527	0	0	0.721243245	0	0	0	0	0	0.686388561	0	0	0	0	0	0	0	0	0	0	30.8798
H2481_004_0	2008	6																					2000											D	D	D		T	Coin	Coin	V	V				V	V	V	V	V	V		V					V						V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	4000	471.0745372	10.03246128	137.1849403	0	194.748301	13.31283919	6.449255518	368.0656076	282.8270327	0	0	0	27.3118046	705.3962214	3779.996016	3313.541086	143.7499187	368.5742933	0	1638.322821	0	0	0	0	363.3982369	0	0	0	0	0	580.2											$100/Day for IP Medical; $100/Day for IP Surgical	$100/Day for IP Psych; $100/Day for IP Substance Abuse	$100/Day for SNF	No cost-sharing	$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	$100/Case for OP Fac - Surgery; $100/Case for OP Fac - ASC	No cost-sharing	No cost-sharing	No cost-sharing	$25/Case for Renal Dialysis - Fac; $25/Procedure for Renal Dialysis - Prof	$15/Case for OP Fac - Cardiovascular; $15/Case for OP Fac - Occ Therapy; $15/Case for OP Fac - Physical/Speech Therapy; $15/Case for OP Fac - CORF; $15/Visit for Prof - CORF; $15/Visit for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Consult for PCP - Consults;	$25/Visit for Speclst - Office Visits; $25/Consult for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $25/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$15/Visit for PT/ST (PCP); $15/Visit for Occ Therapy (PCP); $15/Visit for PT/ST (Specialist); $15/Visit for Occ Therapy (Specialist);	No cost-sharing	$15/Visit for Chiropractor; $25/Exam for Vistion Exams; $25/Service for Podiatrist; $25/Exam for Hearing/Speech Exams;	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$25/Exam for Vision (Refractions)	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$15/Visit for Alternative Medicine$15/Visit for Care Coord											93.75265143	93.75265141	93.75265143	0	46.87632571	0.187505303	0.187505303	41.03538034	93.75265143	0	0	0	23.43816285	14.06289771	14.06289771	23.43816286	18.22110192	14.06289771	0	21.27384554	0	0	0	0	23.43816286	0	0	0	0	0	14.06289771											3.6804	0.07838082	1.071787657	0	0.760757066	2.496227945	1.209269609	1.258642683	2.209648684	0	0	0	0.053344877	0.826659576	4.42980811	6.471942967	0.218273493	0.431935216	0	2.90445222	0	0	0	0	0.709782255	0	0	0	0	0	0.679941104	0	0	0	0	0	0	0	0	0	0	29.4912	0	2.063749387	3.6804	0.07838082	1.071787657	0	0.760757066	2.496227945	1.209269609	1.258642683	2.209648684	0	0	0	0.053344877	0.826659576	4.42980811	6.471942967	0.218273493	0.431935216	0	2.90445222	0	0	0	0	0.709782255	0	0	0	0	0	0.679941104	0	0	0	0	0	0	0	0	0	0	29.4912		20% Coinsurance for IP Medical; 20% Coinsurance for IP Surgical	20% Coinsurance for IP Psych; 20% Coinsurance for IP Substance Abuse	20% Coinsurance for SNF	20% Coinsurance for Home Health	$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	20% Coinsurance for OP Fac - Pathology	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	20% Coinsurance for OP Fac - Cardiovascular; 20% Coinsurance for OP Fac - Occ Therapy; 20% Coinsurance for OP Fac - Physical/Speech Therapy; 20% Coinsurance for OP Fac - CORF; 20% Coinsurance for OP Fac - Other; 20% Coinsurance for Prof - CORF; 20% Coinsurance for Prof - CORF;	20% Coinsurance for PCP - Office Visits; 20% Coinsurance for PCP - Consults; 20% Coinsurance for PCP - Primary Surgeon (IP); 20% Coinsurance for PCP - Asst Surgeon (IP); 20% Coinsurance for PCP - Primary Surgeon (OP); 20% Coinsurance for PCP - Asst Surgeon (OP); 20% Coinsurance for PCP - IP Visits; 20% Coinsurance for PCP - Tx Injections; 20% Coinsurance for PCP - Allergy Testing; 20% Coinsurance for PCP - Allergy Tx; 20% Coinsurance for PCP - ER Visits; 20% Coinsurance for PCP - Cardio; 20% Coinsurance for PCP - Immunizations;	20% Coinsurance for Speclst - Primary Surgeon (IP); 20% Coinsurance for Speclst - Asst Surgeon (IP); 20% Coinsurance for Speclst - Anesthesia (IP); 20% Coinsurance for Speclst - Primary Surgeon (OP); 20% Coinsurance for Speclst - Asst Surgeon (OP); 20% Coinsurance for Speclst - Anesthesia (OP); 20% Coinsurance for Speclst - IP Visits; 20% Coinsurance for Speclst - Office Visits; 20% Coinsurance for Speclst - Tx Injections; 20% Coinsurance for Speclst - Allergy Testing; 20% Coinsurance for Speclst - Allergy Tx; 20% Coinsurance for Speclst - ER Visits; 20% Coinsurance for Speclst - Consults; 20% Coinsurance for Speclst - Cardio; 20% Coinsurance for Speclst - Immunizations;	20% Coinsurance for OP Psych - Non-Physician; 20% Coinsurance for OP Psych - Psychiatrist; 20% Coinsurance for OP Substance Abuse;	20% Coinsurance for PT/ST (PCP); 20% Coinsurance for Occ Therapy (PCP); 20% Coinsurance for PT/ST (Specialist); 20% Coinsurance for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	20% Coinsurance for Chiropractor; 20% Coinsurance for Vistion Exams; 20% Coinsurance for Podiatrist; 20% Coinsurance for Hearing/Speech Exams; 20% Coinsurance for Misc. Medical (PCP); 20% Coinsurance for Misc. Medical; 20% Coinsurance for Prof Path (IP); 20% Coinsurance for Prof Path (OP); 20% Coinsurance for Prof Path (Office); 20% Coinsurance for Prof Path (Labs)	20% Coinsurance for Part B Rx	20% Coinsurance for Blood Products																				1.5892	0.018	0.1118	0.1748	0.033	0.1105	0.0678	0.0587	0.2425	0.0703	0.1995	0	0.0032	0.2174	0.2246	0.6783	0.0083	0.0068	0.1431	0.2735	0.0747	0.0081	0	0	0	0	0	0	0	0	0											4.3139	0	42.41343809	5.2696	0.096383985	1.18354335	0.174819589	0.793709447	2.606685522	1.277055124	1.317316566	2.452109902	0.070321213	0.199543385	0	0.056561834	1.044065893	4.654367129	7.150200899	0.226549045	0.438776609	0.143132739	3.177932955	0.074685707	0.00809228	0	0	0.709782255	0	0	0	0	0	0.679941104	0	0	0	0	0	0	0	0	0	0	33.8051
H2481_005_0	2008	6																					2000											D	D	D		T	Coin	Coin	V	V				P	V	V	V	V	V		P					V						V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	4000	521.0023721	11.32794242	197.5747955	0	193.4998362	13.3449908	6.464831002	343.3285046	255.5354821	0	0	0	27.62685454	646.7560835	3869.014916	3395.268334	162.9502323	421.4940312	0	1828.544964	0	0	0	0	393.4932091	0	0	0	0	0	580.2											$100/Day for IP Medical; $100/Day for IP Surgical	$100/Day for IP Psych; $100/Day for IP Substance Abuse	$100/Day for SNF	No cost-sharing	$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	$100/Case for OP Fac - Surgery; $100/Case for OP Fac - ASC	No cost-sharing	No cost-sharing	No cost-sharing	$25/Case for Renal Dialysis - Fac; $25/Procedure for Renal Dialysis - Prof	$15/Case for OP Fac - Cardiovascular; $15/Case for OP Fac - Occ Therapy; $15/Case for OP Fac - Physical/Speech Therapy; $15/Case for OP Fac - CORF; $15/Visit for Prof - CORF; $15/Visit for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Consult for PCP - Consults;	$25/Visit for Speclst - Office Visits; $25/Consult for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $25/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$15/Visit for PT/ST (PCP); $15/Visit for Occ Therapy (PCP); $15/Visit for PT/ST (Specialist); $15/Visit for Occ Therapy (Specialist);	No cost-sharing	$15/Visit for Chiropractor; $25/Exam for Vistion Exams; $25/Service for Podiatrist; $25/Exam for Hearing/Speech Exams;	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$25/Exam for Vision (Refractions)	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$15/Visit for Alternative Medicine$15/Visit for Care Coord											93.38001909	93.3800191	93.38001909	0	46.69000954	0.186760038	0.186760038	40.32373655	93.38001908	0	0	0	23.34500476	14.00700286	14.00700286	23.34500477	18.14006516	14.00700287	0	20.95526372	0	0	0	0	23.34500477	0	0	0	0	0	14.00700286											4.0543	0.08815029	1.537461515	0	0.752875767	2.492310991	1.207372085	1.153690681	1.98849235	0	0	0	0.053745754	0.754926193	4.516108584	6.605212955	0.246327319	0.491989009	0	3.193136829	0	0	0	0	0.765508404	0	0	0	0	0	0.677238588	0	0	0	0	0	0	0	0	0	0	30.5788	0	2.276533711	4.0543	0.08815029	1.537461515	0	0.752875767	2.492310991	1.207372085	1.153690681	1.98849235	0	0	0	0.053745754	0.754926193	4.516108584	6.605212955	0.246327319	0.491989009	0	3.193136829	0	0	0	0	0.765508404	0	0	0	0	0	0.677238588	0	0	0	0	0	0	0	0	0	0	30.5788		20% Coinsurance for IP Medical; 20% Coinsurance for IP Surgical	20% Coinsurance for IP Psych; 20% Coinsurance for IP Substance Abuse	20% Coinsurance for SNF	20% Coinsurance for Home Health	$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	20% Coinsurance for OP Fac - Pathology	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	20% Coinsurance for OP Fac - Cardiovascular; 20% Coinsurance for OP Fac - Occ Therapy; 20% Coinsurance for OP Fac - Physical/Speech Therapy; 20% Coinsurance for OP Fac - CORF; 20% Coinsurance for OP Fac - Other; 20% Coinsurance for Prof - CORF; 20% Coinsurance for Prof - CORF;	20% Coinsurance for PCP - Office Visits; 20% Coinsurance for PCP - Consults; 20% Coinsurance for PCP - Primary Surgeon (IP); 20% Coinsurance for PCP - Asst Surgeon (IP); 20% Coinsurance for PCP - Primary Surgeon (OP); 20% Coinsurance for PCP - Asst Surgeon (OP); 20% Coinsurance for PCP - IP Visits; 20% Coinsurance for PCP - Tx Injections; 20% Coinsurance for PCP - Allergy Testing; 20% Coinsurance for PCP - Allergy Tx; 20% Coinsurance for PCP - ER Visits; 20% Coinsurance for PCP - Cardio; 20% Coinsurance for PCP - Immunizations;	20% Coinsurance for Speclst - Primary Surgeon (IP); 20% Coinsurance for Speclst - Asst Surgeon (IP); 20% Coinsurance for Speclst - Anesthesia (IP); 20% Coinsurance for Speclst - Primary Surgeon (OP); 20% Coinsurance for Speclst - Asst Surgeon (OP); 20% Coinsurance for Speclst - Anesthesia (OP); 20% Coinsurance for Speclst - IP Visits; 20% Coinsurance for Speclst - Office Visits; 20% Coinsurance for Speclst - Tx Injections; 20% Coinsurance for Speclst - Allergy Testing; 20% Coinsurance for Speclst - Allergy Tx; 20% Coinsurance for Speclst - ER Visits; 20% Coinsurance for Speclst - Consults; 20% Coinsurance for Speclst - Cardio; 20% Coinsurance for Speclst - Immunizations;	20% Coinsurance for OP Psych - Non-Physician; 20% Coinsurance for OP Psych - Psychiatrist; 20% Coinsurance for OP Substance Abuse;	20% Coinsurance for PT/ST (PCP); 20% Coinsurance for Occ Therapy (PCP); 20% Coinsurance for PT/ST (Specialist); 20% Coinsurance for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	20% Coinsurance for Chiropractor; 20% Coinsurance for Vistion Exams; 20% Coinsurance for Podiatrist; 20% Coinsurance for Hearing/Speech Exams; 20% Coinsurance for Misc. Medical (PCP); 20% Coinsurance for Misc. Medical; 20% Coinsurance for Prof Path (IP); 20% Coinsurance for Prof Path (OP); 20% Coinsurance for Prof Path (Office); 20% Coinsurance for Prof Path (Labs)	20% Coinsurance for Part B Rx	20% Coinsurance for Blood Products																				1.4815	0.0167	0.1378	0.2201	0.0318	0.1072	0.0658	0.0511	0.1904	0.055	0.1563	0	0.0029	0.1707	0.2669	0.7906	0.0112	0.0093	0.206	0.3551	0.0586	0.0064	0	0	0	0	0	0	0	0	0											4.3914	0	44.93159975	5.5358	0.104884994	1.675300249	0.220058372	0.784657443	2.599511565	1.273153789	1.204792951	2.178880053	0.055048095	0.156299965	0	0.056627793	0.925623608	4.783042002	7.395837824	0.257517528	0.501324035	0.20604318	3.548189394	0.058612454	0.006350725	0	0	0.765508404	0	0	0	0	0	0.677238588	0	0	0	0	0	0	0	0	0	0	34.9703
H2481_006_0	2008	6																					2000											D	D	D		T	Coin	Coin	V	V				P	V	V	V	V	V		P					V						V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	4000	575.9890565	12.35522555	219.7908849	0	212.7750345	14.65543877	7.099662813	379.2902641	281.903859	0	0	0	30.38588195	710.8670043	4280.223674	3754.894108	179.4822201	463.55903	0	2009.005075	0	0	0	0	393.0794735	0	0	0	0	0	580.2											$100/Day for IP Medical; $100/Day for IP Surgical	$100/Day for IP Psych; $100/Day for IP Substance Abuse	$100/Day for SNF	No cost-sharing	$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	$100/Case for OP Fac - Surgery; $100/Case for OP Fac - ASC	No cost-sharing	No cost-sharing	No cost-sharing	$25/Case for Renal Dialysis - Fac; $25/Procedure for Renal Dialysis - Prof	$15/Case for OP Fac - Cardiovascular; $15/Case for OP Fac - Occ Therapy; $15/Case for OP Fac - Physical/Speech Therapy; $15/Case for OP Fac - CORF; $15/Visit for Prof - CORF; $15/Visit for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Consult for PCP - Consults;	$25/Visit for Speclst - Office Visits; $25/Consult for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $25/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$15/Visit for PT/ST (PCP); $15/Visit for Occ Therapy (PCP); $15/Visit for PT/ST (Specialist); $15/Visit for Occ Therapy (Specialist);	No cost-sharing	$15/Visit for Chiropractor; $25/Exam for Vistion Exams; $25/Service for Podiatrist; $25/Exam for Hearing/Speech Exams;	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$25/Exam for Vision (Refractions)	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$15/Visit for Alternative Medicine$15/Visit for Care Coord											92.50591451	92.50591458	92.50591451	0	46.25295726	0.185011829	0.185011829	39.93225975	92.50591451	0	0	0	23.12647862	13.87588718	13.87588718	23.12647863	17.97172515	13.87588718	0	20.78728169	0	0	0	0	23.12647863	0	0	0	0	0	13.87588718											4.4402	0.095244287	1.694329734	0	0.820122881	2.711429532	1.313521603	1.262159779	2.173147856	0	0	0	0.058559871	0.821992529	4.949325066	7.236456528	0.268800427	0.5360244	0	3.480146201	0	0	0	0	0.757545337	0	0	0	0	0	0.670899145	0	0	0	0	0	0	0	0	0	0	33.2899	0	2.832730937	4.4402	0.095244287	1.694329734	0	0.820122881	2.711429532	1.313521603	1.262159779	2.173147856	0	0	0	0.058559871	0.821992529	4.949325066	7.236456528	0.268800427	0.5360244	0	3.480146201	0	0	0	0	0.757545337	0	0	0	0	0	0.670899145	0	0	0	0	0	0	0	0	0	0	33.2899		20% Coinsurance for IP Medical; 20% Coinsurance for IP Surgical	20% Coinsurance for IP Psych; 20% Coinsurance for IP Substance Abuse	20% Coinsurance for SNF	20% Coinsurance for Home Health	$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	20% Coinsurance for OP Fac - Pathology	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	20% Coinsurance for OP Fac - Cardiovascular; 20% Coinsurance for OP Fac - Occ Therapy; 20% Coinsurance for OP Fac - Physical/Speech Therapy; 20% Coinsurance for OP Fac - CORF; 20% Coinsurance for OP Fac - Other; 20% Coinsurance for Prof - CORF; 20% Coinsurance for Prof - CORF;	20% Coinsurance for PCP - Office Visits; 20% Coinsurance for PCP - Consults; 20% Coinsurance for PCP - Primary Surgeon (IP); 20% Coinsurance for PCP - Asst Surgeon (IP); 20% Coinsurance for PCP - Primary Surgeon (OP); 20% Coinsurance for PCP - Asst Surgeon (OP); 20% Coinsurance for PCP - IP Visits; 20% Coinsurance for PCP - Tx Injections; 20% Coinsurance for PCP - Allergy Testing; 20% Coinsurance for PCP - Allergy Tx; 20% Coinsurance for PCP - ER Visits; 20% Coinsurance for PCP - Cardio; 20% Coinsurance for PCP - Immunizations;	20% Coinsurance for Speclst - Primary Surgeon (IP); 20% Coinsurance for Speclst - Asst Surgeon (IP); 20% Coinsurance for Speclst - Anesthesia (IP); 20% Coinsurance for Speclst - Primary Surgeon (OP); 20% Coinsurance for Speclst - Asst Surgeon (OP); 20% Coinsurance for Speclst - Anesthesia (OP); 20% Coinsurance for Speclst - IP Visits; 20% Coinsurance for Speclst - Office Visits; 20% Coinsurance for Speclst - Tx Injections; 20% Coinsurance for Speclst - Allergy Testing; 20% Coinsurance for Speclst - Allergy Tx; 20% Coinsurance for Speclst - ER Visits; 20% Coinsurance for Speclst - Consults; 20% Coinsurance for Speclst - Cardio; 20% Coinsurance for Speclst - Immunizations;	20% Coinsurance for OP Psych - Non-Physician; 20% Coinsurance for OP Psych - Psychiatrist; 20% Coinsurance for OP Substance Abuse;	20% Coinsurance for PT/ST (PCP); 20% Coinsurance for Occ Therapy (PCP); 20% Coinsurance for PT/ST (Specialist); 20% Coinsurance for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	20% Coinsurance for Chiropractor; 20% Coinsurance for Vistion Exams; 20% Coinsurance for Podiatrist; 20% Coinsurance for Hearing/Speech Exams; 20% Coinsurance for Misc. Medical (PCP); 20% Coinsurance for Misc. Medical; 20% Coinsurance for Prof Path (IP); 20% Coinsurance for Prof Path (OP); 20% Coinsurance for Prof Path (Office); 20% Coinsurance for Prof Path (Labs)	20% Coinsurance for Part B Rx	20% Coinsurance for Blood Products																				1.5743	0.0178	0.1465	0.2338	0.0338	0.1139	0.0699	0.0543	0.2023	0.0585	0.1661	0	0.0031	0.1814	0.2837	0.8401	0.0119	0.0099	0.2189	0.3773	0.0623	0.0067	0	0	0	0	0	0	0	0	0											4.6665	0	54.11347009	6.0145	0.113027063	1.840801128	0.233840341	0.853895003	2.825343939	1.383423129	1.316462518	2.375459293	0.058495686	0.166088827	0	0.061622408	1.003380501	5.232976176	8.076597202	0.280691464	0.545944067	0.218947396	3.857435244	0.062283275	0.006748463	0	0	0.757545337	0	0	0	0	0	0.670899145	0	0	0	0	0	0	0	0	0	0	37.9564
H2486_002_0	2008	4	s.	t.									Other Non-Covered	Other Non-Covered									2500											D	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0									0		1857.797135	1.87534	769.89851	23.147139	215.116296	2.977291	0.847771	332.552639	188.114628	11113.8053	1336.641926		125.694725	250.700104	4898.735193	2420.867149	12.639813	243.64053			14.67356			2.65	2.72		0.15			0.08	0.02	0.18	3.4									$125/Day(Days 1-5)	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$40/Visit	$0-$50/Visit	$0-$50/Visit		$0-$50/Proc	$15-$50/Visit	$5/Visit	$15/Visit	$15-$50/Visit	$40/Visit			20% Coins			Coin:  0%	Vision		Hearing			Active Outlook Newsletter	Quit Net	See PBP	Silver Sneakers									67.720226	791.757229	24.122928	0	83.343109	0.166686	0.166686	41.67155	33.337252	1.157525	27.429826		8.050843	34.022161	4.167155	12.501461	41.671639	33.337235			0.166686			0	0		0			0	0	0	0									10.4842	0.1237345	1.54768386	0	1.494038409	0.496272728	0.141311557	1.154831994	0.522602063	1.07204229	3.055321288	0	0.084329041	0.710779942	1.701149071	2.522031354	0.043893477	0.676858467	0	0	2.445877022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.277	0	5.651416828	10.4842	0.1237345	1.54768386	0	1.494038409	0.496272728	0.141311557	1.154831994	0.522602063	1.07204229	3.055321288	0	0.084329041	0.710779942	1.701149071	2.522031354	0.043893477	0.676858467	0	0	2.445877022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.277	2500																																																																																			0	0	0	10.4842	0.1237345	1.54768386	0	1.494038409	0.496272728	0.141311557	1.154831994	0.522602063	1.07204229	3.055321288	0	0.084329041	0.710779942	1.701149071	2.522031354	0.043893477	0.676858467	0	0	2.445877022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.277
H2486_801_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		298.58588	1.87534	769.89851	23.147139	215.116296	2.977291	0.847771	332.552639	188.114628	11113.8053	1336.641926		125.694725	250.700104	4898.735193	2420.867149	12.639813	243.64053			14.67356																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214501	177.215865	28.944121	0	100.000011	0.199999	0.2	50	200.000012	35.41666	84.50527		19.319856	87.723745	20	30	100.000213	100.000012			0.2																					4.4095	0.027695	1.857002969	0	1.792635997	0.595455223	0.1695542	1.385635996	3.135243988	32.80115531	9.412773904	0	0.202366999	1.832696	8.164558655	6.052167873	0.105331999	2.030337994	0	0	2.934712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9088	0	0	4.4095	0.027695	1.857002969	0	1.792635997	0.595455223	0.1695542	1.385635996	3.135243988	32.80115531	9.412773904	0	0.202366999	1.832696	8.164558655	6.052167873	0.105331999	2.030337994	0	0	2.934712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9088																																																																																				0	0	0	4.4095	0.027695	1.857002969	0	1.792635997	0.595455223	0.1695542	1.385635996	3.135243988	32.80115531	9.412773904	0	0.202366999	1.832696	8.164558655	6.052167873	0.105331999	2.030337994	0	0	2.934712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9088
H2486_802_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		298.58588	1.87534	769.89851	23.147139	215.116296	2.977291	0.847771	332.552639	188.114628	11113.8053	1336.641926		125.694725	250.700104	4898.735193	2420.867149	12.639813	243.64053			14.67356																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214501	177.215865	28.944121	0	100.000011	0.199999	0.2	50	200.000012	35.41666	84.50527		19.319856	87.723745	20	30	100.000213	100.000012			0.2																					4.4095	0.027695	1.857002969	0	1.792635997	0.595455223	0.1695542	1.385635996	3.135243988	32.80115531	9.412773904	0	0.202366999	1.832696	8.164558655	6.052167873	0.105331999	2.030337994	0	0	2.934712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9088	0	0	4.4095	0.027695	1.857002969	0	1.792635997	0.595455223	0.1695542	1.385635996	3.135243988	32.80115531	9.412773904	0	0.202366999	1.832696	8.164558655	6.052167873	0.105331999	2.030337994	0	0	2.934712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9088																																																																																				0	0	0	4.4095	0.027695	1.857002969	0	1.792635997	0.595455223	0.1695542	1.385635996	3.135243988	32.80115531	9.412773904	0	0.202366999	1.832696	8.164558655	6.052167873	0.105331999	2.030337994	0	0	2.934712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9088
H2486_803_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		298.58588	1.87534	769.89851	23.147139	215.116296	2.977291	0.847771	332.552639	188.114628	11113.8053	1336.641926		125.694725	250.700104	4898.735193	2420.867149	12.639813	243.64053			14.67356																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214501	177.215865	28.944121	0	100.000011	0.199999	0.2	50	200.000012	35.41666	84.50527		19.319856	87.723745	20	30	100.000213	100.000012			0.2																					4.4095	0.027695	1.857002969	0	1.792635997	0.595455223	0.1695542	1.385635996	3.135243988	32.80115531	9.412773904	0	0.202366999	1.832696	8.164558655	6.052167873	0.105331999	2.030337994	0	0	2.934712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9088	0	0	4.4095	0.027695	1.857002969	0	1.792635997	0.595455223	0.1695542	1.385635996	3.135243988	32.80115531	9.412773904	0	0.202366999	1.832696	8.164558655	6.052167873	0.105331999	2.030337994	0	0	2.934712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9088																																																																																				0	0	0	4.4095	0.027695	1.857002969	0	1.792635997	0.595455223	0.1695542	1.385635996	3.135243988	32.80115531	9.412773904	0	0.202366999	1.832696	8.164558655	6.052167873	0.105331999	2.030337994	0	0	2.934712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9088
H2486_804_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		298.58588	1.87534	769.89851	23.147139	215.116296	2.977291	0.847771	332.552639	188.114628	11113.8053	1336.641926		125.694725	250.700104	4898.735193	2420.867149	12.639813	243.64053			14.67356																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214501	177.215865	28.944121	0	100.000011	0.199999	0.2	50	200.000012	35.41666	84.50527		19.319856	87.723745	20	30	100.000213	100.000012			0.2																					4.4095	0.027695	1.857002969	0	1.792635997	0.595455223	0.1695542	1.385635996	3.135243988	32.80115531	9.412773904	0	0.202366999	1.832696	8.164558655	6.052167873	0.105331999	2.030337994	0	0	2.934712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9088	0	0	4.4095	0.027695	1.857002969	0	1.792635997	0.595455223	0.1695542	1.385635996	3.135243988	32.80115531	9.412773904	0	0.202366999	1.832696	8.164558655	6.052167873	0.105331999	2.030337994	0	0	2.934712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9088																																																																																				0	0	0	4.4095	0.027695	1.857002969	0	1.792635997	0.595455223	0.1695542	1.385635996	3.135243988	32.80115531	9.412773904	0	0.202366999	1.832696	8.164558655	6.052167873	0.105331999	2.030337994	0	0	2.934712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9088
H2610_005_0	2008	4																					1250											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	V	T	V	V	P	V	V	V	V	V																																																				0	0	1049.283462	14.82075793	598.2603706		162.5679238	5.833707917	2.480842017	233.6899508	321.7494186	1.472605787	14.54845204	4.285885325	0.015713807	26.62912904	4736.735277	2956.989992	117.7576585	343.447537			41.90245883			600	145.3283672	128	19.5790692															1a: $150 Days 1-6	1b: $275	2: $100 days 4-12	6: $0	10a: $150	11a: 20%	"11b, 11c: 20%"	"4a: $50, 4b: $25"	9b: $200	8a: 0%-20%	8b: 20% / $15	9a:  20%	12:  20%	9a: 20%; 9d: $20; 9c:$25/$35	"7a, 14c: $5"	"7b, 7d, 7f: $20"	"7e, 7h: $25/$35"	"7c, 7i: $20"	$0 (incl in i.2.)	7g: $0	15: 20%		10b: $0	16a: $20	17a1: $20	17b1: $20	18a: $20	18b: $0		14a:  $0												71.9173	131.8483	40.3048		71.9173	0.096532278	0.095889702	22.6192	95.8897	0.095889702	0.092395201	0.095889702	0.095889702	0.095251114	5.0019	19.851	26.849	20			0.2			20	20	20	20															6.2885	0.162841027	2.009397044	0	0.974286857	0.563141112	0.237887201	0.440490672	2.57103798	0.14120773	1.344207147	0.410972265	0.001506792	2.536454216	1.974370438	4.891601381	0.263472656	0.572412562	0	0	8.380491767	0	0	1	0.242213945	0.213333333	0.032631782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2524	0	16.43757374	6.2885	0.162841027	2.009397044	0	0.974286857	0.563141112	0.237887201	0.440490672	2.57103798	0.14120773	1.344207147	0.410972265	0.001506792	2.536454216	1.974370438	4.891601381	0.263472656	0.572412562	0	0	8.380491767	0	0	1	0.242213945	0.213333333	0.032631782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2524																																																																																				0	0	0	6.2885	0.162841027	2.009397044	0	0.974286857	0.563141112	0.237887201	0.440490672	2.57103798	0.14120773	1.344207147	0.410972265	0.001506792	2.536454216	1.974370438	4.891601381	0.263472656	0.572412562	0	0	8.380491767	0	0	1	0.242213945	0.213333333	0.032631782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2524
H2610_006_0	2008	5																					850											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	V	T	V	V	P	V	V	V	V	V																																																				0	0	1212.420044	17.12500446	691.2744656		187.8430533	7.788704729	3.312223755	270.0227256	371.773175	1.966106603	19.42394079	5.722174605	0.020979831	35.4164439	5581.605362	3527.166917	136.0659446	10.80768797			57.15800621			600	167.9231892	128	22.62311071															1a: $100 Days 1-6	1b: $275	2: $100 days 4-9	6: $0	10a: $150	11a: 20%	"11b, 11c: 20%"	"4a: $50, 4b: $20"	9b: $200	8a: 0%-20%	8b: 20% / $15	9a:  20%	12:  20%	9a: 20%; 9d: $20; 9c:$25/$35	"7a, 14c: $5"	"7b, 7d, 7f: $15"	"7e, 7h: $25/$35"	"7c, 7i: $15"	$0 (incl in i.2.)	7g: $0	15: 20%		10b: $0	16a: $20	17a1: $20	17b1: $20	18a: $20	18b: $0		14a:  $0												28.467	78.2844	31.8473		150	0.057817107	0.056934095	13.2694	56.9341	0.056934095	0.056934095	0.048754069	0.056934095	0.082780258	5.0609	19.7874	26.849	15			0.056934095			20	20	20	20															2.8762	0.111718363	1.834600619	0	2.348038166	0.450320376	0.18857846	0.298586246	1.763880756	0.111938499	1.105884481	0.278979296	0.001194468	2.931782371	2.353976731	5.816129582	0.304435875	0.01350961	0	0	3.254239327	0	0	1	0.279871982	0.213333333	0.037705185	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.5749	0	32.23848921	2.8762	0.111718363	1.834600619	0	2.348038166	0.450320376	0.18857846	0.298586246	1.763880756	0.111938499	1.105884481	0.278979296	0.001194468	2.931782371	2.353976731	5.816129582	0.304435875	0.01350961	0	0	3.254239327	0	0	1	0.279871982	0.213333333	0.037705185	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.5749																																																																																				0	0	0	2.8762	0.111718363	1.834600619	0	2.348038166	0.450320376	0.18857846	0.298586246	1.763880756	0.111938499	1.105884481	0.278979296	0.001194468	2.931782371	2.353976731	5.816129582	0.304435875	0.01350961	0	0	3.254239327	0	0	1	0.279871982	0.213333333	0.037705185	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.5749
H2610_010_0	2008	6																					1100											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	V	T	V	V	P	V	V	V	V	V																																																				0		2460.695942	86.25214304	1363.720714		311.0857052	25.15796533	27.08040755	433.8068438	475.063573	5.875764243	45.87319352	5.47040976	0.626959791	52.49707272	105	4075.437167	252.4657563	304.8630789			30.30960899	405.2080312		600	144	128	249.0711364															1a: $150 Days 1-6	1b: $275	2: $100 days 4-12	6: $0	10a: $150	11a: 20%	"11b, 11c: 20%"	"4a: $50, 4b: $25"	9b: $200	8a: 0%-20%	8b: 20% / $15	9a:  20%	12:  20%	9a: 20%; 9d: $20; 9c:$25/$35	14c: $5	"7b, 7d, 7f: $20"	"7e, 7h: $25/$35"	"7c, 7i: $20"	$0 (incl in i.2.)	7g: $0	15: 20%	"17a, 17b: $20"	10b: $0	16a: $20	17a1: $20	17b1: $20	18a: $20	18b: $0		14a:  $0												70.3219	128.9236	17.9918		70.3219	0.093762588	0.093762588	23.4406	200	0.093762588	0.094299674	0.093762588	0.093762588	0.100024725	5	20	30	20			0.093762588	20		20	20	20	20															14.4201	0.926661103	2.044652233	0	1.823012555	2.358875944	2.539129102	0.84739276	7.917726216	0.550926863	4.325827187	0.512919778	0.058785373	5.251005246	0.04375	6.792395278	0.631164391	0.508105132	0	0	2.841907387	0.675346719	0	1	0.24	0.213333333	0.415118561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9381	0	43.129081	14.4201	0.926661103	2.044652233	0	1.823012555	2.358875944	2.539129102	0.84739276	7.917726216	0.550926863	4.325827187	0.512919778	0.058785373	5.251005246	0.04375	6.792395278	0.631164391	0.508105132	0	0	2.841907387	0.675346719	0	1	0.24	0.213333333	0.415118561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9381																																																																																				0	0	0	14.4201	0.926661103	2.044652233	0	1.823012555	2.358875944	2.539129102	0.84739276	7.917726216	0.550926863	4.325827187	0.512919778	0.058785373	5.251005246	0.04375	6.792395278	0.631164391	0.508105132	0	0	2.841907387	0.675346719	0	1	0.24	0.213333333	0.415118561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9381
H2610_803_0	2008	4																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	189.1231413	0.609512808	19.86263349		5.35601301	6.125393313	2.604884117	8.428334081	29.71929529	1.546236076	16.60743735	4.500179592	0.052352517	29.18782671	191.427508	136.5418133	2.804500337	1.98289151		1.324287437	44.95166799																					Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing											0.0808	0.0808	0.1998		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234																					15.2811	0.049248635	3.968554172	0	1.253307044	1.433342035	0.609542883	1.972230175	6.954315098	0.361819242	3.88614034	1.053042024	0.012250489	6.829951449	44.79403688	31.95078432	0.656253079	0.463996613	0	0.30988326	10.51869031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.3585	0	0	15.2811	0.049248635	3.968554172	0	1.253307044	1.433342035	0.609542883	1.972230175	6.954315098	0.361819242	3.88614034	1.053042024	0.012250489	6.829951449	44.79403688	31.95078432	0.656253079	0.463996613	0	0.30988326	10.51869031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.3585																																																																																				0	0	0	15.2811	0.049248635	3.968554172	0	1.253307044	1.433342035	0.609542883	1.972230175	6.954315098	0.361819242	3.88614034	1.053042024	0.012250489	6.829951449	44.79403688	31.95078432	0.656253079	0.463996613	0	0.30988326	10.51869031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.3585
H2610_804_0	2008	4																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	189.1231413	0.609512808	19.86263349		5.35601301	6.125393313	2.604884117	8.428334081	29.71929529	1.546236076	16.60743735	4.500179592	0.052352517	29.18782671	191.427508	136.5418133	2.804500337	1.98289151		1.324287437	44.95166799																					Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing											0.0808	0.0808	0.1998		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234																					15.2811	0.049248635	3.968554172	0	1.253307044	1.433342035	0.609542883	1.972230175	6.954315098	0.361819242	3.88614034	1.053042024	0.012250489	6.829951449	44.79403688	31.95078432	0.656253079	0.463996613	0	0.30988326	10.51869031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.3585	0	0	15.2811	0.049248635	3.968554172	0	1.253307044	1.433342035	0.609542883	1.972230175	6.954315098	0.361819242	3.88614034	1.053042024	0.012250489	6.829951449	44.79403688	31.95078432	0.656253079	0.463996613	0	0.30988326	10.51869031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.3585																																																																																				0	0	0	15.2811	0.049248635	3.968554172	0	1.253307044	1.433342035	0.609542883	1.972230175	6.954315098	0.361819242	3.88614034	1.053042024	0.012250489	6.829951449	44.79403688	31.95078432	0.656253079	0.463996613	0	0.30988326	10.51869031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.3585
H2611_001_0	2008	9	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									Coin	Coin	Coin	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									41.3683	0.7013	1.1582	1.395	1.1346	1.1088	0.038	0	1.9153	1.1031	0.231	0.677	0	1.9934	0	0	0	0	5.7687	20.0593	0.0239	0	0.0379	0	0.0986	0	0.0035	0	0	0	0	0.4341	1.5279									80.7779	None	314.0103782	5.323620292	8.791113547	1676.80848	545.7069019	8.416145449	0.288796224	3037.340415	385.9052444	6872.054915	1.75325776	5.13887531	0	2449.552799	3582.03249	3373.012328	0	0	54.51073595	152.2620669	39.34560726	0	10.38885867	0	83.11086934	0	4.085506217	0	0	0	0	3.294928784	3383.501901									Full Coverage	Full Coverage	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$45 Copay - Waived if Admitted	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	Full Coverage	Full Coverage	$15 Copay	$30 Copay	$30 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$30 Copay on Specialist Visits and Fullcoverage on rest of services									0	0	0	0	0	0.117748712	0.117748712	45	0	0	0	0	0	0	15	30	0	0	0.127297115	0.000149235	0.199076998	0	0	0	0	0	0	0	0	0	0	0	21.60964409									0	0	0	0	0	0.99099029	0.034005384	11.39002656	0	0	0	0	0	0	4.477540612	8.43253082	0	0	6.939059403	0.022722818	7.832805379	0	0	0	0	0	0	0	0	0	0	0	6.093022655	0	0	0	0	0	0	0	0	46.2127	1225	4.080989278	41.3683	0.70134357	1.158157536	1.394992728	1.134559068	2.099748836	0.072051932	11.39002656	1.915280729	1.103103424	0.230977416	0.677004925	0	1.993427187	4.477540612	8.43253082	0	0	12.70777328	20.08200874	7.856727112	0	0.037897063	0	0.098641977	0	0.003501955	0	0	0	0	0.434080004	7.620969838	0	0	0	0	0	0	0	0	126.9907	4800	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$45 Copay - Waived if Admitted	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance									3.408	0.0578	0.0954	0.1698	0.1381	0.1349	0.0812	0.2274	0.2331	0.1343	0.0281	0.0824	0	0.166	0.0552	0.3603	0	0	0.9982	2.7851	0.4723	0	0.0046	0	0.012	0	0.0004	0	0	0	0	0.0528	0.4887									10.1862	1225	0.18525664	44.7763	0.759120961	1.253567722	1.564777812	1.272646674	2.234696252	0.15327825	11.61744601	2.148390259	1.237362552	0.259089763	0.759403446	0	2.159452294	4.532725277	8.792844613	0	0	13.70599466	22.86711531	8.328994238	0	0.042509529	0	0.110647728	0	0.003928179	0	0	0	0	0.486912043	8.109708749	0	0	0	0	0	0	0	0	137.1769
H2611_002_0	2008	9	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0									0	None	331.3806937	5.032516327	20.31486255	1496.846478	339.6235775	8.265054047	12.22609951	3282.743395	318.4619751	1208.548173	1.746455127	1.819429225	0	1556.086665	2447.174308	1886.163815	0	0	83.67115284	125.5209917	27.42084297	0	102.8169103	0	0.833541443	0	0	0	0	0	0	2.024964335	2313.465479									Full Coverage	$100/day for days 1-10	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$40 Copay - Waived if Admitted	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	Full Coverage	Full Coverage	$5 Copay	$5 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$5 Copay on Specialist Visits and Fullcoverage on rest of services									0	382.6418625	0	0	0	0.194301008	0.00401851	3.14767633	0	0	0.194301008	0.194301008	0	0	0	4.857525201	0	0	0.186344126	0.000335173	0.174058673	0	0	0	0	0	0	0	0	0	0	0	1.790245949									0	0.160470952	0	0	0	1.605908333	0.049130709	0.861084473	0	0	0.339337992	0.353516932	0	0	0	0.763507355	0	0	15.59162788	0.04207122	4.772835544	0	0	0	0	0	0	0	0	0	0	0	0.34513935	0	0	0	0	0	0	0	0	24.8846	0	0.729884585	0	0.160470952	0	0	0	1.605908333	0.049130709	0.861084473	0	0	0.339337992	0.353516932	0	0	0	0.763507355	0	0	15.59162788	0.04207122	4.772835544	0	0	0	0	0	0	0	0	0	0	0	0.34513935	0	0	0	0	0	0	0	0	24.8846	4800	$25/day for days 1-10	$100/day for days 1-10	$25/day for days 21-30	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	Full Coverage	$5 Copay	$15 Copay	$15 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	$15 Copay on Specialist Visits and Fullcoverage on rest of services									0.1072	0.0073	0.0009	0	0	0.1441	0.2131	0.0345	0	0	0.0304	0.0317	0	0.1736	0.0099	0.248	0	0	1.7407	2.1388	0.4158	0	0.0379	0	0.0004	0	0	0	0	0	0	0.0384	0.1636									5.5363	0	0.05838749	0.1072	0.167813376	0.000863978	0	0	1.749964413	0.262225985	0.895557406	0	0	0.369777899	0.385228745	0	0.173569344	0.009909445	1.011528429	0	0	17.33236289	2.180831848	5.188645103	0	0.037852783	0	0.000413408	0	0	0	0	0	0	0.038382717	0.50877662	0	0	0	0	0	0	0	0	30.4209
H2611_003_0	2008	7	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0									0	None	331.7589486	6.086373746	20.94125204	1579.107879	310.4686677	10.77723964	11.96081241	3244.973268	324.5074266	1110.677924	1.42965918	1.475531192	0	1636.474894	2343.939123	1762.604542	0	0	57.67853272	125.231541	12.2903571	0	102.9172324	0	1.009982654	0	0	0	0	0	0	2.974062887	2147.359277									Full Coverage	$100/day for days 1-10	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$40 Copay - Waived if Admitted	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	Full Coverage	Full Coverage	$5 Copay	$5 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$5 Copay on Specialist Visits and Fullcoverage on rest of services									0	387.8340486	0	0	0	0.196937539	0.003102166	3.190388127	0	0	0.196937539	0.196937539	0	0	0	4.923438467	0	0	0.185226931	0.000496764	0.147142377	0	0	0	0	0	0	0	0	0	0	0	1.704773337									0	0.196708581	0	0	0	2.122443048	0.037104431	0.862727016	0	0	0.28155356	0.290587481	0	0	0	0.723172917	0	0	10.68361762	0.06221047	1.808432363	0	0	0	0	0	0	0	0	0	0	0	0.305063403	0	0	0	0	0	0	0	0	17.3736	0	0.270167089	0	0.196708581	0	0	0	2.122443048	0.037104431	0.862727016	0	0	0.28155356	0.290587481	0	0	0	0.723172917	0	0	10.68361762	0.06221047	1.808432363	0	0	0	0	0	0	0	0	0	0	0	0.305063403	0	0	0	0	0	0	0	0	17.3736	4800	$25/day for days 1-10	$100/day for days 1-10	$25/day for days 21-30	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	Full Coverage	$5 Copay	$15 Copay	$15 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	$15 Copay on Specialist Visits and Fullcoverage on rest of services									0.0616	0.0051	0.0005	0	0	0.108	0.1199	0.0196	0	0	0.0143	0.0148	0	0.1064	0.0055	0.1333	0	0	0.6696	1.2423	0.1248	0	0.023	0	0.0003	0	0	0	0	0	0	0.0302	0.086									2.7652	0	0.012212232	0.0616	0.201814536	0.000512101	0	0	2.230451443	0.156974471	0.882320717	0	0	0.295881458	0.305375104	0	0.106408831	0.005457514	0.856441609	0	0	11.35319917	1.304549228	1.933268919	0	0.022977506	0	0.000349121	0	0	0	0	0	0	0.030181319	0.39105383	0	0	0	0	0	0	0	0	20.1388
H2611_004_0	2008	5	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									Coin	Coin	Coin	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									22.9265	0.3887	0.6419	0.7731	0.6288	0.6145	0.0211	0	1.0615	0.6113	0.128	0.3752	0	1.1048	0	0	0	0	3.197	11.1169	0.0133	0	0.021	0	0.0547	0	0.0019	0	0	0	0	0.2406	0.8468									44.7675	None	314.0103782	5.323620292	8.791113547	1676.80848	545.7069019	8.416145449	0.288796224	3049.538569	385.9052444	6872.054915	1.75325776	5.13887531	0	2449.552799	3582.03249	3373.012328	0	0	54.51073595	152.2620669	39.34560726	0	10.38885867	0	83.11086934	0	4.085506217	0	0	0	0	3.294928784	3383.501901									Full Coverage	Full Coverage	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	Full Coverage	Full Coverage	$10 Copay	$20 Copay	$20 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$20 Copay on Specialist Visits and Fullcoverage on rest of services									0	0	0	0	0	0.177007858	0.177007858	6	0	0	0	0.177007858	0	0	10	20	0	0	0.148761712	0.00022434	0.199076998	0	0	0	0	0	0	0	0	0	0	0	4.922247987									0	0	0	0	0	1.489723876	0.051119201	1.524769285	0	0	0	0.90962131	0	0	2.985027075	5.621687213	0	0	8.109110381	0.034158483	7.832805379	0	0	0	0	0	0	0	0	0	0	0	1.387869618	0	0	0	0	0	0	0	0	29.9459	625	1.09749339	22.9265	0.388687855	0.64185627	0.77311143	0.62877789	2.104202997	0.072204774	1.524769285	1.06145745	0.611345026	0.128008753	1.284820574	0	1.104766579	2.985027075	5.621687213	0	0	11.30615833	11.15110764	7.846062914	0	0.021002728	0	0.05466784	0	0.0019408	0	0	0	0	0.240569148	2.234665024	0	0	0	0	0	0	0	0	74.7134	4800	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance									2.8617	0.0485	0.0801	0.1426	0.116	0.1133	0.0682	0.2283	0.1957	0.1127	0.0236	0.0692	0	0.1394	0.0463	0.3026	0	0	0.8599	2.3387	0.4718	0	0.0039	0	0.0101	0	0.0004	0	0	0	0	0.0444	0.4104									8.6879	625	0.04982121	25.7882	0.437204752	0.721974221	0.915683557	0.744732974	2.217521196	0.140412232	1.753102066	1.257204453	0.724085256	0.151615286	1.354012356	0	1.244181372	3.031366805	5.924250325	0	0	12.16610427	13.48982053	8.317863384	0	0.024875913	0	0.064749324	0	0.002298709	0	0	0	0	0.284933329	2.645069424	0	0	0	0	0	0	0	0	83.4013
H2611_005_0	2008	4	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0									0	None	331.8444486	5.473714783	20.59315399	1531.084545	327.6209585	9.267235695	12.15007518	3267.625157	321.0097706	1168.26691	1.61220554	1.67853943	0	1589.559251	2406.594619	1840.259938	0	0	73.25483433	125.7256955	20.82407429	0	102.8739817	0	0.906617648	0	0	0	0	0	0	2.395583547	2251.043062									Full Coverage	$100/day for days 1-10	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	Full Coverage	Full Coverage	$5 Copay	$5 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$5 Copay on Specialist Visits and Fullcoverage on rest of services									0	383.6106744	0	0	0	0.194792959	0.003607778	3.944557425	0	0	0.194792959	0.194792959	0	0	0	4.869823982	0	0	0.185655248	0.000396875	0.167091545	0	0	0	0	0	0	0	0	0	0	0	1.751718926									0	0.174981285	0	0	0	1.805192265	0.04383477	1.074111256	0	0	0.314046288	0.326967663	0	0	0	0.746811832	0	0	13.60014445	0.049897324	3.47952674	0	0	0	0	0	0	0	0	0	0	0	0.328599561	0	0	0	0	0	0	0	0	21.9441	0	0.586591491	0	0.174981285	0	0	0	1.805192265	0.04383477	1.074111256	0	0	0.314046288	0.326967663	0	0	0	0.746811832	0	0	13.60014445	0.049897324	3.47952674	0	0	0	0	0	0	0	0	0	0	0	0.328599561	0	0	0	0	0	0	0	0	21.9441	4800	$25/day for days 1-10	$100/day for days 1-10	$25/day for days 21-30	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	Full Coverage	$5 Copay	$15 Copay	$15 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	$15 Copay on Specialist Visits and Fullcoverage on rest of services									0.1075	0.008	0.0009	0	0	0.1618	0.2121	0.0344	0	0	0.0281	0.0293	0	0.1787	0.0098	0.2424	0	0	1.5123	2.1581	0.3328	0	0.0388	0	0.0005	0	0	0	0	0	0	0.044	0.1585									5.2582	0	0.046751212	0.1075	0.182981618	0.000877371	0	0	1.96700314	0.255981558	1.108486448	0	0	0.342196256	0.356275856	0	0.178699044	0.009762454	0.989227086	0	0	15.11247364	2.208028426	3.812349849	0	0.038798459	0	0.000489941	0	0	0	0	0	0	0.044045324	0.48713375	0	0	0	0	0	0	0	0	27.2023
H2611_006_0	2008	6	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0									0	None	337.4609491	6.190981343	21.3011731	1583.549811	311.3419968	10.80755534	11.99445743	3254.101176	325.4202458	1113.802192	1.433680723	1.47968177	0	1641.078196	2382.65468	1858.368303	0	0	60.73407928	131.289129	12.63542627	0	103.2067322	0	1.012823672	0	0	0	0	0	0	2.982428741	2262.896375									Full Coverage	$100/day for days 1-10	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	Full Coverage	Full Coverage	$5 Copay	$5 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$5 Copay on Specialist Visits and Fullcoverage on rest of services									0	387.133743	0	0	0	0.196581932	0.003096565	3.980784119	0	0	0.196581932	0.196581932	0	0	0	4.914548295	0	0	0.18495468	0.000498685	0.148098119	0	0	0	0	0	0	0	0	0	0	0	1.702545345									0	0.199728148	0	0	0	2.124570107	0.037141617	1.079489523	0	0	0.281835726	0.290878701	0	0	0	0.761086731	0	0	11.2330522	0.06547198	1.871282861	0	0	0	0	0	0	0	0	0	0	0	0.321056974	0	0	0	0	0	0	0	0	18.2656	0	0.317593014	0	0.199728148	0	0	0	2.124570107	0.037141617	1.079489523	0	0	0.281835726	0.290878701	0	0	0	0.761086731	0	0	11.2330522	0.06547198	1.871282861	0	0	0	0	0	0	0	0	0	0	0	0.321056974	0	0	0	0	0	0	0	0	18.2656	4800	$25/day for days 1-10	$100/day for days 1-10	$25/day for days 21-30	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	Full Coverage	$5 Copay	$15 Copay	$15 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	$15 Copay on Specialist Visits and Fullcoverage on rest of services									0.0626	0.0052	0.0005	0	0	0.1082	0.1201	0.0196	0	0	0.0144	0.0148	0	0.1066	0.0055	0.1404	0	0	0.7055	1.3084	0.1288	0	0.023	0	0.0003	0	0	0	0	0	0	0.0302	0.0906									2.8851	0	0.014423334	0.0626	0.204918848	0.0005206	0	0	2.232819503	0.157279125	1.099126945	0	0	0.296195594	0.30569932	0	0.106646264	0.00554444	0.901514528	0	0	11.93851258	1.373892114	2.000084624	0	0.023028777	0	0.0003499	0	0	0	0	0	0	0.030248664	0.411664118	0	0	0	0	0	0	0	0	21.1507
H2611_008_0	2008	7																																D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	P	P	P	S	V	T	Coin	V	V	V	V	Coin	V	V											17.6973	0.5451	2.5825	1.6262	0.532	1.1384	0.84	0	2.8768	0.2737	0.9375	0.1646	0.0102	1.6448	0.6695	1.5446	0.0276	0.0491	0.3894	0	2.0171	0.2841	0	0	0	0	0	0	0	0												35.8505		0	0	0	0	0	12.59358758	9.29257752	279.4726695	0	3.028411373	10.37168612	0	6.04343091	0	3959.944565	3131.198104	246.9576558	0	0	0	1161.662224	681.9090276	0	0	0	0	0															$0/day	$0/day	$0/day	$0/visit	$0/Trip	20% Coinsurance	20% Coinsurance; 0% Diabetic Supplies	ER $45/Visit; UC $25/Visit	$0/Visit	20% Coinsurance	Thera Rad 20% Coinsurance	$0/Visit	Renal Dialysis 20% Coinsurance	Partial Hosp $25/Visit	$15/Visit	$30/Visit	MH/SA: $30/Visit	$0/Visit	$0/Visit	$30/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $30/Visit	Not Covered	Not Covered	$0/Visit		Not Covered															0	0	0	0	0	0.190636626	0.190636626	45	0	0.190636626	0.191677659	0	42.6037	0	14.8436	29.7493	28.5955	0	0	0	43.9437	30	0	0	0	0	0			0												0	0	0	0	0	2.400799048	1.771505627	1.048022511	0	0.577326127	1.988020517	0	0.021456026	0	4.898315738	7.762587576	0.588489679	0	0	0	4.253974102	1.704772569	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.0153	540	0.675521805	17.6973	0.545086317	2.582484365	1.626165627	0.532040945	3.539170125	2.611488785	1.048022511	2.876830288	0.851073055	2.925547446	0.16459011	0.031629689	1.644803156	5.567814198	9.307220963	0.616052112	0.049069552	0.389352822	0	6.27105299	1.98888563	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8657	4800	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	Not Covered	20% Coinsurance		Not Covered															4.9996	0.154	0.3724	0.4616	0.151	0.3232	0.2384	0.2924	0.8167	0.0777	0.2676	0.0558	0.0029	0.4669	0.717	1.7418	0.032	0.0594	0.4737	0	0.5726	0.1321	0	0	0	0	0	0	0													12.4088	60	0.448715486	22.6969	0.699075404	2.954864598	2.087792345	0.683073725	3.862324479	2.849938462	1.340432358	3.693488629	0.928782787	3.19314064	0.22040042	0.034517731	2.111720591	6.284860057	11.04906551	0.648016582	0.108446905	0.863067613	0	6.843649958	2.120947167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.2745
H2611_009_0	2008	7																																D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	P	P	P	S	V	T	Coin	V	V	V	V	Coin	V	V											32.2332	0.9928	4.3483	2.9618	0.969	2.0734	1.5299	0	5.2397	0.4986	1.7076	0.2771	0.0185	2.9958	1.2237	2.8361	0.0484	0.0899	0.6834	0	3.6738	0.5175	0	0	0	0	0	0	0	0												64.9186		0	0	0	0	0	14.07179387	10.38331885	303.6841974	0	3.383879321	11.58909074	0	0.125760121	0	4285.318715	3368.853549	255.0964653	0	0	0	1199.946308	715.4263572	0	0	0	0	0															$0/day	$0/day	$0/day	$0/visit	$0/Trip	20% Coinsurance	20% Coinsurance; 0% Diabetic Supplies	ER $45/Visit; UC $25/Visit	$0/Visit	20% Coinsurance	Thera Rad 20% Coinsurance	$0/Visit	Renal Dialysis 20% Coinsurance	Partial Hosp $25/Visit	$15/Visit	$30/Visit	MH/SA: $30/Visit	$0/Visit	$0/Visit	$30/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $30/Visit	Not Covered	Not Covered	$0/Visit		Not Covered															0	0	0	0	0	0.186628681	0.186628681	45	0	0.186628681	0.188115323	0	0.186628681	0	14.7801	29.6589	27.9943	0	0	0	46.5357	30	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.626200328	1.937825101	1.13881574	0	0.631528934	2.180085544	0	0.023470445	0	5.278102907	8.326372066	0.59510396	0	0	0	4.653362467	1.788565893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1794	1102.5	1.062000536	32.2332	0.992798641	4.348260391	2.961833702	0.969038317	4.699584345	3.467737176	1.13881574	5.239744809	1.130120753	3.887659982	0.277128747	0.042000352	2.99577936	6.501801932	11.16246138	0.643483542	0.089870142	0.683420319	0	8.32719011	2.306038176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.098	4800	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	Not Covered	20% Coinsurance		Not Covered															5.7272	0.1764	0.4266	0.5288	0.173	0.3702	0.2732	0.3422	0.9355	0.089	0.3073	0.0639	0.0033	0.5349	0.8387	2.0367	0.0366	0.068	0.5543	0	0.6559	0.1535	0	0	0	0	0	0	0													14.2952	122.5	0.749806238	37.9604	1.169198441	4.774834767	3.490642999	1.142051566	5.069768783	3.74088949	1.480974842	6.175255053	1.219139927	4.194960888	0.341061378	0.045308703	3.530649356	7.340482057	13.19918361	0.680099943	0.157888944	1.237730744	0	8.983119649	2.459568934	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.3932
H2611_010_0	2008	5																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0			106.1120694						279.8214955			1.258968654		0.122878643		882.8219231	3173.671171	269.6175586				24.362506	756.1512372																				$0/day	$100/day for days 1-10	$0/day	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $5/Visit	$0/Visit; $5 copay for immunization	$5/Visit	MH/SA: $5/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $5/Visit	Not Covered		$0/Visit		$0/Visit																66.3905						49.979			0.199806697		0.199806697		5	4.9993	4.9952				0.2	5																				0	0.587069097	0	0	0	0	0	1.165432141	0	0	0.251550369	0	0.024551976	0	0.367842468	1.322174882	0.112232071	0	0	0	4.8725012	0.315063015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.0184	0	0.001131758	0	0.587069097	0	0	0	0	0	1.165432141	0	0	0.251550369	0	0.024551976	0	0.367842468	1.322174882	0.112232071	0	0	0	4.8725012	0.315063015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.0184	3200	$25/day for days 1-10	$100/day for days 1-10	$25/day for days 21-30	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $15/Visit	$5/Visit	$15/Visit	MH/SA: $15/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $15/Visit	Not Covered		$0/Visit		$0/Visit															0.2402	0.0724	0.0406					0.1435			0.031		0.003		0.1926	0.4689	0.0415				0.6007	0.1165																				1.951	0	0.000484379	0.2402	0.659450256	0.040649719	0	0	0	0	1.308939547	0	0	0.282564618	0	0.027579048	0	0.560416238	1.791028096	0.153744155	0	0	0	5.473243568	0.431597642	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9694
H2611_011_0	2008	5																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0			114.115602						300.856			1.46451432		0.14294044		933.1171539	3403.165498	289.9535387				28.34005342	813.1841566																				$0/day	$100/day for days 1-10	$0/day	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $5/Visit	$0/Visit; $5 copay for immunization	$5/Visit	MH/SA: $5/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $5/Visit	Not Covered		$0/Visit		$0/Visit																66.3738						49.9819			0.199756585		0.199756585		5	4.9991	4.9939				0.2	5																				0	0.631190603	0	0	0	0	0	1.253112967	0	0	0.292546379	0	0.028553294	0	0.388798814	1.417730887	0.120666935	0	0	0	5.668010685	0.338826732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1394	0	0.001562199	0	0.631190603	0	0	0	0	0	1.253112967	0	0	0.292546379	0	0.028553294	0	0.388798814	1.417730887	0.120666935	0	0	0	5.668010685	0.338826732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1394	3200	$25/day for days 1-10	$100/day for days 1-10	$25/day for days 21-30	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $15/Visit	$5/Visit	$15/Visit	MH/SA: $15/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $15/Visit	Not Covered		$0/Visit		$0/Visit															0.2597	0.0783	0.044					0.1552			0.0363		0.0035		0.2083	0.5071	0.0449				0.7029	0.1261																				2.1663	0	0.000663436	0.2597	0.709464157	0.043958927	0	0	0	0	1.408341938	0	0	0.328824873	0	0.03209417	0	0.597101849	1.924860129	0.165558429	0	0	0	6.370897165	0.464879809	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.3057
H2611_012_0	2008	7	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0									0	None	481.8450362	15.10179482	21.18597115	1676.80848	545.7069019	8.416145449	5.06576958	3049.538569	385.9052444	6872.054915	1.75325776	5.13887531	0	1133.202696	3582.03249	3373.012328	0	0	54.51073595	152.2620669	39.34560726	0	10.38885867	0	83.11086934	0	4.085506217	0	0	0	0	3.294928784	3383.501901									Full Coverage	$100/day for days 1-10	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	Full Coverage	$5 Copay	$5 Copay	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$5 Copay on Specialist Visits and Fullcoverage on rest of services									0	391.3037464	0	0	0	0.19869941	0.011327724	50	0	0	0	0.19869941	0	0	0	5	0	0	0.039087054	0.000251832	0.197964462	0	0	0	0	0	0	0	0	0	0	0	3.601607349									0	0.492449074	0	0	0	1.672283137	0.057383639	12.70641071	0	0	0	1.021091493	0	0	0	1.405421803	0	0	2.13066406	0.038344458	7.789031981	0	0	0	0	0	0	0	0	0	0	0	1.015503776	0	0	0	0	0	0	0	0	28.3286	0	0.079133114	0	0.492449074	0	0	0	1.672283137	0.057383639	12.70641071	0	0	0	1.021091493	0	0	0	1.405421803	0	0	2.13066406	0.038344458	7.789031981	0	0	0	0	0	0	0	0	0	0	0	1.015503776	0	0	0	0	0	0	0	0	28.3286	4800	$25/day for days 1-10	$100/day for days 1-10	$25/day for days 21-30	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	$5 Copay	$15 Copay	$15 Copay	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	$15 Copay on Specialist Visits and Fullcoverage on rest of services									0.09	0.0127	0.0005	0	0	0.0846	0.0509	0.2283	0	0	0.0176	0.0517	0	0.1036	0.0084	0.2562	0	0	0.6446	1.6481	0.4707	0	0.0029	0	0.0075	0	0.0003	0	0	0	0	0.0286	0.2503									3.9577	0	0.003592284	0.09	0.50516085	0.000519829	0	0	1.756912776	0.108323141	12.93474349	0	0	0.01763011	1.072766119	0	0.103594952	0.008368302	1.661578058	0	0	2.775310249	1.68644063	8.259766792	0	0.002892618	0	0.007529173	0	0.000267298	0	0	0	0	0.028640619	1.265803606	0	0	0	0	0	0	0	0	32.2862
H2611_013_0	2008	5	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0									0	None	481.8450362	15.10179482	21.18597115	1676.80848	545.7069019	8.416145449	5.06576958	3049.538569	385.9052444	6872.054915	1.75325776	5.13887531	0	1133.202696	3582.03249	3373.012328	0	0	54.51073595	152.2620669	39.34560726	0	10.38885867	0	83.11086934	0	4.085506217	0	0	0	0	3.294928784	3383.501901									Full Coverage	$100/day for days 1-10	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	Full Coverage	$5 Copay	$5 Copay	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$5 Copay on Specialist Visits and Fullcoverage on rest of services									0	391.3037464	0	0	0	0.19869941	0.011327724	50	0	0	0	0.19869941	0	0	0	5	0	0	0.039087054	0.000251832	0.197964462	0	0	0	0	0	0	0	0	0	0	0	3.601607349									0	0.492449074	0	0	0	1.672283137	0.057383639	12.70641071	0	0	0	1.021091493	0	0	0	1.405421803	0	0	2.13066406	0.038344458	7.789031981	0	0	0	0	0	0	0	0	0	0	0	1.015503776	0	0	0	0	0	0	0	0	28.3286	0	0.079133114	0	0.492449074	0	0	0	1.672283137	0.057383639	12.70641071	0	0	0	1.021091493	0	0	0	1.405421803	0	0	2.13066406	0.038344458	7.789031981	0	0	0	0	0	0	0	0	0	0	0	1.015503776	0	0	0	0	0	0	0	0	28.3286	4800	$25/day for days 1-10	$100/day for days 1-10	$25/day for days 21-30	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	$5 Copay	$15 Copay	$15 Copay	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	$15 Copay on Specialist Visits and Fullcoverage on rest of services									0.09	0.0127	0.0005	0	0	0.0846	0.0509	0.2283	0	0	0.0176	0.0517	0	0.1036	0.0084	0.2562	0	0	0.6446	1.6481	0.4707	0	0.0029	0	0.0075	0	0.0003	0	0	0	0	0.0286	0.2503									3.9577	0	0.003592284	0.09	0.50516085	0.000519829	0	0	1.756912776	0.108323141	12.93474349	0	0	0.01763011	1.072766119	0	0.103594952	0.008368302	1.661578058	0	0	2.775310249	1.68644063	8.259766792	0	0.002892618	0	0.007529173	0	0.000267298	0	0	0	0	0.028640619	1.265803606	0	0	0	0	0	0	0	0	32.2862
H2611_014_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0			114.1187037						300.8641537			1.464593933		0.14294821		933.1366453	3403.254436	289.9614197				28.34159402	813.2062591																				$0/day	$100/day for days 1-10	$0/day	$0/visit	$0/Trip			ER $40/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $5/Visit	$0/Visit; $5 copay for immunization	$5/Visit	MH/SA: $5/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $5/Visit	Not Covered		$0/Visit		$0/Visit																66.3738						40			0.199756519		0.199756519		5	4.9991	4.9939				0.2	5																				0	0.63120755	0	0	0	0	0	1.002880512	0	0	0.292562185	0	0.028554837	0	0.388806936	1.417767868	0.120670174	0	0	0	5.668318804	0.338835941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.8896	0	0.001562677	0	0.63120755	0	0	0	0	0	1.002880512	0	0	0.292562185	0	0.028554837	0	0.388806936	1.417767868	0.120670174	0	0	0	5.668318804	0.338835941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.8896	3200	$25/day for days 1-10	$100/day for days 1-10	$25/day for days 21-30	$0/visit	$0/Trip			ER $40/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $15/Visit	$5/Visit	$15/Visit	MH/SA: $15/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $15/Visit	Not Covered		$0/Visit		$0/Visit															0.2597	0.0783	0.044					0.12			0.0363		0.0035		0.2083	0.5071	0.0449				0.7029	0.1261																				2.1311	0	0.000663636	0.2597	0.709483205	0.043960107	0	0	0	0	1.122880512	0	0	0.32884264	0	0.032095904	0	0.597115632	1.924910868	0.165562874	0	0	0	6.371243494	0.464892444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0207
H2611_015_0	2008	5																																D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	P	P	P	S	V	T	Coin	V	V	V	V	Coin	V	V											31.6355	0.9744	4.2677	2.9069	0.9511	2.0349	1.5015	0	5.1426	0.4893	1.6759	0.272	0.0182	2.9402	1.2005	2.7826	0.0476	0.0882	0.6721	0	3.6057	0.5079	0	0	0	0	0	0	0	0												63.7148		0	0	0	0	0	14.10936533	10.41104215	303.6759671	0	3.392914224	11.62003342	0	0.126095898	0	4285.208113	3369.969571	255.7845208	0	0	0	1203.182847	716.7498507	0	0	0	0	0	0	0													$0/day	$0/day	$0/day	$0/visit	$0/Trip	20% Coinsurance	20% Coinsurance; 0% Diabetic Supplies	ER $50/Visit; UC $25/Visit	$0/Visit	20% Coinsurance	Thera Rad 20% Coinsurance	$0/Visit	Renal Dialysis 20% Coinsurance	Partial Hosp $25/Visit	$15/Visit	$30/Visit	MH/SA: $30/Visit	$0/Visit	$0/Visit	$30/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $30/Visit	Not Covered	Not Covered	$0/Visit		Not Covered															0	0	0	0	0	0.18660165	0.18660165	49.9821	0	0.18660165	0.188091297	0	0.18660165	0	14.7796	29.6576	27.9902	0	0	0	46.5277	30	0	0	0	0	0	0	0	0	0											0	0	0	0	0	2.632830856	1.942717646	1.26486283	0	0.633123393	2.185627162	0	0.023529703	0	5.27780752	8.328768896	0.596622671	0	0	0	4.665111093	1.791874627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.3429	900	1.066721485	31.6355	0.974388062	4.267741718	2.906909099	0.951068353	4.667765788	3.444258845	1.26486283	5.142578346	1.122469265	3.861536132	0.27199703	0.041715988	2.940225265	6.47826943	11.11133414	0.644203855	0.088185704	0.672141986	0	8.270810831	2.299750841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0577	4800	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	Not Covered	20% Coinsurance		Not Covered															5.726	0.1764	0.4265	0.5287	0.173	0.3701	0.2731	0.3421	0.9353	0.089	0.3072	0.0639	0.0033	0.5348	0.8386	2.0366	0.0366	0.068	0.5543	0	0.6558	0.1535	0	0	0	0	0	0	0	0	0	0										14.2929	100	0.751281161	37.3615	1.150752726	4.694231126	3.435613064	1.12404714	5.03787649	3.717356751	1.607003333	6.077902249	1.211470707	4.168781089	0.335916927	0.045023681	3.474988721	7.316901535	13.14793573	0.680812963	0.156190958	1.226422279	0	8.926609718	2.453266515	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.3506
H2611_016_0	2008	7																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0			106.1101677						279.8164977			1.25892353		0.122874239		882.809973	3173.616643	269.6127268				24.36163281	756.1376862																				$0/day	$100/day for days 1-10	$0/day	$0/visit	$0/Trip			ER $45/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $5/Visit	$0/Visit; $5 copay for immunization	$5/Visit	MH/SA: $5/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $5/Visit	Not Covered		$0/Visit		$0/Visit																66.3905						45			0.199806707		0.199806707		5	4.9993	4.9952				0.2	5																				0	0.587058606	0	0	0	0	0	1.049311866	0	0	0.251541365	0	0.024551097	0	0.367837489	1.322152175	0.112230065	0	0	0	4.872326561	0.315057369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.9021	0	0.001131674	0	0.587058606	0	0	0	0	0	1.049311866	0	0	0.251541365	0	0.024551097	0	0.367837489	1.322152175	0.112230065	0	0	0	4.872326561	0.315057369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.9021	3200	$25/day for days 1-10	$100/day for days 1-10	$25/day for days 21-30	$0/visit	$0/Trip			ER $45/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $15/Visit	$5/Visit	$15/Visit	MH/SA: $15/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $15/Visit	Not Covered		$0/Visit		$0/Visit															0.2402	0.0724	0.0406					0.13			0.031		0.003		0.1926	0.4688	0.0415				0.6007	0.1165																				1.9374	0	0.000484345	0.2402	0.65943847	0.040648993	0	0	0	0	1.179311866	0	0	0.282554504	0	0.027578061	0	0.560407808	1.79099699	0.153741407	0	0	0	5.473047398	0.431589907	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8395
H2611_017_0	2008	5																																D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	P	P	P	S	V	T	Coin	V	V	V	V	Coin	V	V											27.4163	0.8444	4.0007	2.5192	0.8242	1.7635	1.3013	0	4.4567	0.4258	1.4584	0.2367	0.0158	2.5586	1.0408	2.4123	0.0411	0.0764	0.5813	0	3.1248	0.4401	0	0	0	0	0	0	0	0												55.5386		0	0	0	0	0	11.96891227	8.831641054	279.4776611	0	2.878194145	9.85722301	0	5.743557792	0	3960.011661	3110.014989	234.7036955	0	0	0	1104.020915	658.2341693	0	0	0	0	0	0														$0/day	$0/day	$0/day	$0/visit	$0/Trip	20% Coinsurance	20% Coinsurance; 0% Diabetic Supplies	ER $50/Visit; UC $25/Visit	$0/Visit	20% Coinsurance	Thera Rad 20% Coinsurance	$0/Visit	Renal Dialysis 20% Coinsurance	Partial Hosp $25/Visit	$15/Visit	$30/Visit	MH/SA: $30/Visit	$0/Visit	$0/Visit	$30/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $30/Visit	Not Covered	Not Covered	$0/Visit		Not Covered															0	0	0	0	0	0.189306137	0.189306137	49.9789	0	0.189306137	0.190495096	0	42.3071	0	14.8214	29.7227	28.3959	0	0	0	43.6378	30	0	0	0	0	0	0														0	0	0	0	0	2.265788548	1.671883852	1.163999497	0	0.544859815	1.87775264	0	0.020249433	0	4.891064579	7.703173459	0.555385625	0	0	0	4.014749093	1.645585423	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.3545	1102.5	0.737033063	27.4163	0.844435325	4.000654348	2.519218805	0.824225732	4.029327129	2.973166658	1.163999497	4.456720055	0.970689062	3.336130231	0.236685643	0.036075156	2.558586842	5.931894654	10.11543905	0.596535386	0.076439995	0.58129034	0	7.139561833	2.085726916	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.8931	4800	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	Not Covered	20% Coinsurance		Not Covered															4.9649	0.1529	0.3698	0.4584	0.15	0.3209	0.2368	0.2924	0.811	0.0772	0.266	0.0554	0.0029	0.4637	0.717	1.7415	0.0317	0.059	0.4737	0	0.5686	0.1318	0	0	0	0	0	0	0	0												12.3455	122.5	0.512494103	32.3812	0.997355174	4.370448923	2.977640174	0.974209802	4.350237631	3.209960636	1.456419826	5.26770785	1.047859209	3.60208203	0.292108429	0.038943144	3.022262191	6.648863913	11.85692852	0.628277908	0.135405055	1.055022109	0	7.708182919	2.217509731	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.2386
H2611_801_0	2008	1	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									Coin	Coin	Coin	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									16.6091	0.1811	0.3586	0.5186	0.3464	0.5214	0.0206	0	1.1811	0.5682	0.1242	0.2091	0	0.9972	0	0	0	0	3.0011	10.1991	0.0189	0	0.0108	0	0.0831	0	0.1195	0	0	0	0	0.3131	0.7303									36.1113	None	250.8932758	2.735251354	5.416325284	1325.989126	312.4450408	7.875912151	0.31075982	2247.169353	462.4046127	6056.446846	1.876288036	3.158216183	0	2491.014621	3172.962966	3845.865055	0	0	56.85794954	154.0655402	39.92253149	0	9.365156713	0	141.6479953	0	44.83568776	0	0	0	0	4.729168672	3422.04675									Full Coverage	Full Coverage	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	Full Coverage	Full Coverage	$15 Copay	$30 Copay	$30 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$30 Copay on Specialist Visits and Fullcoverage on rest of services									0	0	0	0	0	0.12301579	0.12301579	50	0	0	0	0	0	0	15	30	0	0	0.131408692	0.000369246	0.198572057	0	0	0	0	0	0	0	0	0	0	0	22.12185338									0	0	0	0	0	0.968861558	0.038228365	9.363205639	0	0	0	0	0	0	3.966203708	9.614662638	0	0	7.47162876	0.056888134	7.927499217	0	0	0	0	0	0	0	0	0	0	0	6.30850137	0	0	0	0	0	0	0	0	45.7157	500	3.899271976	16.6091	0.181073186	0.358559836	0.518555126	0.346412337	1.490245638	0.058800614	9.363205639	1.181101491	0.568239043	0.124209957	0.209073388	0	0.997219658	3.966203708	9.614662638	0	0	10.47272134	10.25600137	7.946368514	0	0.010838146	0	0.08305093	0	0.119478284	0	0	0	0	0.313070182	7.038773463	0	0	0	0	0	0	0	0	81.827	4800	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance									2.1829	0.0238	0.0471	0.1007	0.0673	0.1012	0.0675	0.1683	0.2293	0.1103	0.0241	0.0406	0	0.1301	0.0396	0.3268	0	0	0.8615	2.2968	0.4781	0	0.0021	0	0.0161	0	0.0232	0	0	0	0	0.0608	0.3776									7.7759	500	0.183436309	18.792	0.20487096	0.405684018	0.6192431	0.413675304	1.59148291	0.126336198	9.531461398	1.410436252	0.678574155	0.148327834	0.249669218	0	1.127308974	4.005798448	9.941433311	0	0	11.3342284	12.55281378	8.424504413	0	0.012942591	0	0.099176949	0	0.142677412	0	0	0	0	0.373859095	7.41635362	0	0	0	0	0	0	0	0	89.6028
H2611_802_0	2008	1	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									Coin	Coin	Coin	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									16.6091	0.1811	0.3586	0.5186	0.3464	0.5214	0.0206	0	1.1811	0.5682	0.1242	0.2091	0	0.9972	0	0	0	0	3.0011	10.1991	0.0189	0	0.0108	0	0.0831	0	0.1195	0	0	0	0	0.3131	0.7303									36.1113	None	250.8932758	2.735251354	5.416325284	1325.989126	312.4450408	7.875912151	0.31075982	2247.169353	462.4046127	6056.446846	1.876288036	3.158216183	0	2491.014621	3172.962966	3845.865055	0	0	56.85794954	154.0655402	39.92253149	0	9.365156713	0	141.6479953	0	44.83568776	0	0	0	0	4.729168672	3422.04675									Full Coverage	Full Coverage	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	Full Coverage	Full Coverage	$15 Copay	$30 Copay	$30 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$30 Copay on Specialist Visits and Fullcoverage on rest of services									0	0	0	0	0	0.12301579	0.12301579	50	0	0	0	0	0	0	15	30	0	0	0.131408692	0.000369246	0.198572057	0	0	0	0	0	0	0	0	0	0	0	22.12185338									0	0	0	0	0	0.968861558	0.038228365	9.363205639	0	0	0	0	0	0	3.966203708	9.614662638	0	0	7.47162876	0.056888134	7.927499217	0	0	0	0	0	0	0	0	0	0	0	6.30850137	0	0	0	0	0	0	0	0	45.7157	500	3.899271976	16.6091	0.181073186	0.358559836	0.518555126	0.346412337	1.490245638	0.058800614	9.363205639	1.181101491	0.568239043	0.124209957	0.209073388	0	0.997219658	3.966203708	9.614662638	0	0	10.47272134	10.25600137	7.946368514	0	0.010838146	0	0.08305093	0	0.119478284	0	0	0	0	0.313070182	7.038773463	0	0	0	0	0	0	0	0	81.827	4800	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance									2.1829	0.0238	0.0471	0.1007	0.0673	0.1012	0.0675	0.1683	0.2293	0.1103	0.0241	0.0406	0	0.1301	0.0396	0.3268	0	0	0.8615	2.2968	0.4781	0	0.0021	0	0.0161	0	0.0232	0	0	0	0	0.0608	0.3776									7.7759	500	0.183436309	18.792	0.20487096	0.405684018	0.6192431	0.413675304	1.59148291	0.126336198	9.531461398	1.410436252	0.678574155	0.148327834	0.249669218	0	1.127308974	4.005798448	9.941433311	0	0	11.3342284	12.55281378	8.424504413	0	0.012942591	0	0.099176949	0	0.142677412	0	0	0	0	0.373859095	7.41635362	0	0	0	0	0	0	0	0	89.6028
H2611_803_0	2008	1	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									Coin	Coin	Coin	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									16.6091	0.1811	0.3586	0.5186	0.3464	0.5214	0.0206	0	1.1811	0.5682	0.1242	0.2091	0	0.9972	0	0	0	0	3.0011	10.1991	0.0189	0	0.0108	0	0.0831	0	0.1195	0	0	0	0	0.3131	0.7303									36.1113	None	250.8932758	2.735251354	5.416325284	1325.989126	312.4450408	7.875912151	0.31075982	2247.169353	462.4046127	6056.446846	1.876288036	3.158216183	0	2491.014621	3172.962966	3845.865055	0	0	56.85794954	154.0655402	39.92253149	0	9.365156713	0	141.6479953	0	44.83568776	0	0	0	0	4.729168672	3422.04675									Full Coverage	Full Coverage	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	Full Coverage	Full Coverage	$15 Copay	$30 Copay	$30 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$30 Copay on Specialist Visits and Fullcoverage on rest of services									0	0	0	0	0	0.12301579	0.12301579	50	0	0	0	0	0	0	15	30	0	0	0.131408692	0.000369246	0.198572057	0	0	0	0	0	0	0	0	0	0	0	22.12185338									0	0	0	0	0	0.968861558	0.038228365	9.363205639	0	0	0	0	0	0	3.966203708	9.614662638	0	0	7.47162876	0.056888134	7.927499217	0	0	0	0	0	0	0	0	0	0	0	6.30850137	0	0	0	0	0	0	0	0	45.7157	500	3.899271976	16.6091	0.181073186	0.358559836	0.518555126	0.346412337	1.490245638	0.058800614	9.363205639	1.181101491	0.568239043	0.124209957	0.209073388	0	0.997219658	3.966203708	9.614662638	0	0	10.47272134	10.25600137	7.946368514	0	0.010838146	0	0.08305093	0	0.119478284	0	0	0	0	0.313070182	7.038773463	0	0	0	0	0	0	0	0	81.827	4800	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance									2.1829	0.0238	0.0471	0.1007	0.0673	0.1012	0.0675	0.1683	0.2293	0.1103	0.0241	0.0406	0	0.1301	0.0396	0.3268	0	0	0.8615	2.2968	0.4781	0	0.0021	0	0.0161	0	0.0232	0	0	0	0	0.0608	0.3776									7.7759	500	0.183436309	18.792	0.20487096	0.405684018	0.6192431	0.413675304	1.59148291	0.126336198	9.531461398	1.410436252	0.678574155	0.148327834	0.249669218	0	1.127308974	4.005798448	9.941433311	0	0	11.3342284	12.55281378	8.424504413	0	0.012942591	0	0.099176949	0	0.142677412	0	0	0	0	0.373859095	7.41635362	0	0	0	0	0	0	0	0	89.6028
H2611_804_0	2008	1	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									Coin	Coin	Coin	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									16.6091	0.1811	0.3586	0.5186	0.3464	0.5214	0.0206	0	1.1811	0.5682	0.1242	0.2091	0	0.9972	0	0	0	0	3.0011	10.1991	0.0189	0	0.0108	0	0.0831	0	0.1195	0	0	0	0	0.3131	0.7303									36.1113	None	250.8932758	2.735251354	5.416325284	1325.989126	312.4450408	7.875912151	0.31075982	2247.169353	462.4046127	6056.446846	1.876288036	3.158216183	0	2491.014621	3172.962966	3845.865055	0	0	56.85794954	154.0655402	39.92253149	0	9.365156713	0	141.6479953	0	44.83568776	0	0	0	0	4.729168672	3422.04675									Full Coverage	Full Coverage	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	Full Coverage	Full Coverage	$15 Copay	$30 Copay	$30 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$30 Copay on Specialist Visits and Fullcoverage on rest of services									0	0	0	0	0	0.12301579	0.12301579	50	0	0	0	0	0	0	15	30	0	0	0.131408692	0.000369246	0.198572057	0	0	0	0	0	0	0	0	0	0	0	22.12185338									0	0	0	0	0	0.968861558	0.038228365	9.363205639	0	0	0	0	0	0	3.966203708	9.614662638	0	0	7.47162876	0.056888134	7.927499217	0	0	0	0	0	0	0	0	0	0	0	6.30850137	0	0	0	0	0	0	0	0	45.7157	500	3.899271976	16.6091	0.181073186	0.358559836	0.518555126	0.346412337	1.490245638	0.058800614	9.363205639	1.181101491	0.568239043	0.124209957	0.209073388	0	0.997219658	3.966203708	9.614662638	0	0	10.47272134	10.25600137	7.946368514	0	0.010838146	0	0.08305093	0	0.119478284	0	0	0	0	0.313070182	7.038773463	0	0	0	0	0	0	0	0	81.827	4800	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance									2.1829	0.0238	0.0471	0.1007	0.0673	0.1012	0.0675	0.1683	0.2293	0.1103	0.0241	0.0406	0	0.1301	0.0396	0.3268	0	0	0.8615	2.2968	0.4781	0	0.0021	0	0.0161	0	0.0232	0	0	0	0	0.0608	0.3776									7.7759	500	0.183436309	18.792	0.20487096	0.405684018	0.6192431	0.413675304	1.59148291	0.126336198	9.531461398	1.410436252	0.678574155	0.148327834	0.249669218	0	1.127308974	4.005798448	9.941433311	0	0	11.3342284	12.55281378	8.424504413	0	0.012942591	0	0.099176949	0	0.142677412	0	0	0	0	0.373859095	7.41635362	0	0	0	0	0	0	0	0	89.6028
H2611_805_0	2008	1	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									Coin	Coin	Coin	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									16.6091	0.1811	0.3586	0.5186	0.3464	0.5214	0.0206	0	1.1811	0.5682	0.1242	0.2091	0	0.9972	0	0	0	0	3.0011	10.1991	0.0189	0	0.0108	0	0.0831	0	0.1195	0	0	0	0	0.3131	0.7303									36.1113	None	250.8932758	2.735251354	5.416325284	1325.989126	312.4450408	7.875912151	0.31075982	2247.169353	462.4046127	6056.446846	1.876288036	3.158216183	0	2491.014621	3172.962966	3845.865055	0	0	56.85794954	154.0655402	39.92253149	0	9.365156713	0	141.6479953	0	44.83568776	0	0	0	0	4.729168672	3422.04675									Full Coverage	Full Coverage	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	Full Coverage	Full Coverage	$15 Copay	$30 Copay	$30 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$30 Copay on Specialist Visits and Fullcoverage on rest of services									0	0	0	0	0	0.12301579	0.12301579	50	0	0	0	0	0	0	15	30	0	0	0.131408692	0.000369246	0.198572057	0	0	0	0	0	0	0	0	0	0	0	22.12185338									0	0	0	0	0	0.968861558	0.038228365	9.363205639	0	0	0	0	0	0	3.966203708	9.614662638	0	0	7.47162876	0.056888134	7.927499217	0	0	0	0	0	0	0	0	0	0	0	6.30850137	0	0	0	0	0	0	0	0	45.7157	500	3.899271976	16.6091	0.181073186	0.358559836	0.518555126	0.346412337	1.490245638	0.058800614	9.363205639	1.181101491	0.568239043	0.124209957	0.209073388	0	0.997219658	3.966203708	9.614662638	0	0	10.47272134	10.25600137	7.946368514	0	0.010838146	0	0.08305093	0	0.119478284	0	0	0	0	0.313070182	7.038773463	0	0	0	0	0	0	0	0	81.827	4800	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance									2.1829	0.0238	0.0471	0.1007	0.0673	0.1012	0.0675	0.1683	0.2293	0.1103	0.0241	0.0406	0	0.1301	0.0396	0.3268	0	0	0.8615	2.2968	0.4781	0	0.0021	0	0.0161	0	0.0232	0	0	0	0	0.0608	0.3776									7.7759	500	0.183436309	18.792	0.20487096	0.405684018	0.6192431	0.413675304	1.59148291	0.126336198	9.531461398	1.410436252	0.678574155	0.148327834	0.249669218	0	1.127308974	4.005798448	9.941433311	0	0	11.3342284	12.55281378	8.424504413	0	0.012942591	0	0.099176949	0	0.142677412	0	0	0	0	0.373859095	7.41635362	0	0	0	0	0	0	0	0	89.6028
H2611_806_0	2008	1	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									Coin	Coin	Coin	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									16.6091	0.1811	0.3586	0.5186	0.3464	0.5214	0.0206	0	1.1811	0.5682	0.1242	0.2091	0	0.9972	0	0	0	0	3.0011	10.1991	0.0189	0	0.0108	0	0.0831	0	0.1195	0	0	0	0	0.3131	0.7303									36.1113	None	250.8932758	2.735251354	5.416325284	1325.989126	312.4450408	7.875912151	0.31075982	2247.169353	462.4046127	6056.446846	1.876288036	3.158216183	0	2491.014621	3172.962966	3845.865055	0	0	56.85794954	154.0655402	39.92253149	0	9.365156713	0	141.6479953	0	44.83568776	0	0	0	0	4.729168672	3422.04675									Full Coverage	Full Coverage	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	Full Coverage	Full Coverage	$15 Copay	$30 Copay	$30 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$30 Copay on Specialist Visits and Fullcoverage on rest of services									0	0	0	0	0	0.12301579	0.12301579	50	0	0	0	0	0	0	15	30	0	0	0.131408692	0.000369246	0.198572057	0	0	0	0	0	0	0	0	0	0	0	22.12185338									0	0	0	0	0	0.968861558	0.038228365	9.363205639	0	0	0	0	0	0	3.966203708	9.614662638	0	0	7.47162876	0.056888134	7.927499217	0	0	0	0	0	0	0	0	0	0	0	6.30850137	0	0	0	0	0	0	0	0	45.7157	500	3.899271976	16.6091	0.181073186	0.358559836	0.518555126	0.346412337	1.490245638	0.058800614	9.363205639	1.181101491	0.568239043	0.124209957	0.209073388	0	0.997219658	3.966203708	9.614662638	0	0	10.47272134	10.25600137	7.946368514	0	0.010838146	0	0.08305093	0	0.119478284	0	0	0	0	0.313070182	7.038773463	0	0	0	0	0	0	0	0	81.827	4800	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance									2.1829	0.0238	0.0471	0.1007	0.0673	0.1012	0.0675	0.1683	0.2293	0.1103	0.0241	0.0406	0	0.1301	0.0396	0.3268	0	0	0.8615	2.2968	0.4781	0	0.0021	0	0.0161	0	0.0232	0	0	0	0	0.0608	0.3776									7.7759	500	0.183436309	18.792	0.20487096	0.405684018	0.6192431	0.413675304	1.59148291	0.126336198	9.531461398	1.410436252	0.678574155	0.148327834	0.249669218	0	1.127308974	4.005798448	9.941433311	0	0	11.3342284	12.55281378	8.424504413	0	0.012942591	0	0.099176949	0	0.142677412	0	0	0	0	0.373859095	7.41635362	0	0	0	0	0	0	0	0	89.6028
H2611_807_0	2008	1	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									Coin	Coin	Coin	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									16.6091	0.1811	0.3586	0.5186	0.3464	0.5214	0.0206	0	1.1811	0.5682	0.1242	0.2091	0	0.9972	0	0	0	0	3.0011	10.1991	0.0189	0	0.0108	0	0.0831	0	0.1195	0	0	0	0	0.3131	0.7303									36.1113	None	250.8932758	2.735251354	5.416325284	1325.989126	312.4450408	7.875912151	0.31075982	2247.169353	462.4046127	6056.446846	1.876288036	3.158216183	0	2491.014621	3172.962966	3845.865055	0	0	56.85794954	154.0655402	39.92253149	0	9.365156713	0	141.6479953	0	44.83568776	0	0	0	0	4.729168672	3422.04675									Full Coverage	Full Coverage	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	Full Coverage	Full Coverage	$15 Copay	$30 Copay	$30 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$30 Copay on Specialist Visits and Fullcoverage on rest of services									0	0	0	0	0	0.12301579	0.12301579	50	0	0	0	0	0	0	15	30	0	0	0.131408692	0.000369246	0.198572057	0	0	0	0	0	0	0	0	0	0	0	22.12185338									0	0	0	0	0	0.968861558	0.038228365	9.363205639	0	0	0	0	0	0	3.966203708	9.614662638	0	0	7.47162876	0.056888134	7.927499217	0	0	0	0	0	0	0	0	0	0	0	6.30850137	0	0	0	0	0	0	0	0	45.7157	500	3.899271976	16.6091	0.181073186	0.358559836	0.518555126	0.346412337	1.490245638	0.058800614	9.363205639	1.181101491	0.568239043	0.124209957	0.209073388	0	0.997219658	3.966203708	9.614662638	0	0	10.47272134	10.25600137	7.946368514	0	0.010838146	0	0.08305093	0	0.119478284	0	0	0	0	0.313070182	7.038773463	0	0	0	0	0	0	0	0	81.827	4800	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance									2.1829	0.0238	0.0471	0.1007	0.0673	0.1012	0.0675	0.1683	0.2293	0.1103	0.0241	0.0406	0	0.1301	0.0396	0.3268	0	0	0.8615	2.2968	0.4781	0	0.0021	0	0.0161	0	0.0232	0	0	0	0	0.0608	0.3776									7.7759	500	0.183436309	18.792	0.20487096	0.405684018	0.6192431	0.413675304	1.59148291	0.126336198	9.531461398	1.410436252	0.678574155	0.148327834	0.249669218	0	1.127308974	4.005798448	9.941433311	0	0	11.3342284	12.55281378	8.424504413	0	0.012942591	0	0.099176949	0	0.142677412	0	0	0	0	0.373859095	7.41635362	0	0	0	0	0	0	0	0	89.6028
H2611_808_0	2008	1	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									Coin	Coin	Coin	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									16.6091	0.1811	0.3586	0.5186	0.3464	0.5214	0.0206	0	1.1811	0.5682	0.1242	0.2091	0	0.9972	0	0	0	0	3.0011	10.1991	0.0189	0	0.0108	0	0.0831	0	0.1195	0	0	0	0	0.3131	0.7303									36.1113	None	250.8932758	2.735251354	5.416325284	1325.989126	312.4450408	7.875912151	0.31075982	2247.169353	462.4046127	6056.446846	1.876288036	3.158216183	0	2491.014621	3172.962966	3845.865055	0	0	56.85794954	154.0655402	39.92253149	0	9.365156713	0	141.6479953	0	44.83568776	0	0	0	0	4.729168672	3422.04675									Full Coverage	Full Coverage	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	Full Coverage	Full Coverage	$15 Copay	$30 Copay	$30 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$30 Copay on Specialist Visits and Fullcoverage on rest of services									0	0	0	0	0	0.12301579	0.12301579	50	0	0	0	0	0	0	15	30	0	0	0.131408692	0.000369246	0.198572057	0	0	0	0	0	0	0	0	0	0	0	22.12185338									0	0	0	0	0	0.968861558	0.038228365	9.363205639	0	0	0	0	0	0	3.966203708	9.614662638	0	0	7.47162876	0.056888134	7.927499217	0	0	0	0	0	0	0	0	0	0	0	6.30850137	0	0	0	0	0	0	0	0	45.7157	500	3.899271976	16.6091	0.181073186	0.358559836	0.518555126	0.346412337	1.490245638	0.058800614	9.363205639	1.181101491	0.568239043	0.124209957	0.209073388	0	0.997219658	3.966203708	9.614662638	0	0	10.47272134	10.25600137	7.946368514	0	0.010838146	0	0.08305093	0	0.119478284	0	0	0	0	0.313070182	7.038773463	0	0	0	0	0	0	0	0	81.827	4800	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance									2.1829	0.0238	0.0471	0.1007	0.0673	0.1012	0.0675	0.1683	0.2293	0.1103	0.0241	0.0406	0	0.1301	0.0396	0.3268	0	0	0.8615	2.2968	0.4781	0	0.0021	0	0.0161	0	0.0232	0	0	0	0	0.0608	0.3776									7.7759	500	0.183436309	18.792	0.20487096	0.405684018	0.6192431	0.413675304	1.59148291	0.126336198	9.531461398	1.410436252	0.678574155	0.148327834	0.249669218	0	1.127308974	4.005798448	9.941433311	0	0	11.3342284	12.55281378	8.424504413	0	0.012942591	0	0.099176949	0	0.142677412	0	0	0	0	0.373859095	7.41635362	0	0	0	0	0	0	0	0	89.6028
H2611_809_0	2008	1	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									Coin	Coin	Coin	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									16.6091	0.1811	0.3586	0.5186	0.3464	0.5214	0.0206	0	1.1811	0.5682	0.1242	0.2091	0	0.9972	0	0	0	0	3.0011	10.1991	0.0189	0	0.0108	0	0.0831	0	0.1195	0	0	0	0	0.3131	0.7303									36.1113	None	250.8932758	2.735251354	5.416325284	1325.989126	312.4450408	7.875912151	0.31075982	2247.169353	462.4046127	6056.446846	1.876288036	3.158216183	0	2491.014621	3172.962966	3845.865055	0	0	56.85794954	154.0655402	39.92253149	0	9.365156713	0	141.6479953	0	44.83568776	0	0	0	0	4.729168672	3422.04675									Full Coverage	Full Coverage	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	Full Coverage	Full Coverage	$15 Copay	$30 Copay	$30 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$30 Copay on Specialist Visits and Fullcoverage on rest of services									0	0	0	0	0	0.12301579	0.12301579	50	0	0	0	0	0	0	15	30	0	0	0.131408692	0.000369246	0.198572057	0	0	0	0	0	0	0	0	0	0	0	22.12185338									0	0	0	0	0	0.968861558	0.038228365	9.363205639	0	0	0	0	0	0	3.966203708	9.614662638	0	0	7.47162876	0.056888134	7.927499217	0	0	0	0	0	0	0	0	0	0	0	6.30850137	0	0	0	0	0	0	0	0	45.7157	500	3.899271976	16.6091	0.181073186	0.358559836	0.518555126	0.346412337	1.490245638	0.058800614	9.363205639	1.181101491	0.568239043	0.124209957	0.209073388	0	0.997219658	3.966203708	9.614662638	0	0	10.47272134	10.25600137	7.946368514	0	0.010838146	0	0.08305093	0	0.119478284	0	0	0	0	0.313070182	7.038773463	0	0	0	0	0	0	0	0	81.827	4800	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance									2.1829	0.0238	0.0471	0.1007	0.0673	0.1012	0.0675	0.1683	0.2293	0.1103	0.0241	0.0406	0	0.1301	0.0396	0.3268	0	0	0.8615	2.2968	0.4781	0	0.0021	0	0.0161	0	0.0232	0	0	0	0	0.0608	0.3776									7.7759	500	0.183436309	18.792	0.20487096	0.405684018	0.6192431	0.413675304	1.59148291	0.126336198	9.531461398	1.410436252	0.678574155	0.148327834	0.249669218	0	1.127308974	4.005798448	9.941433311	0	0	11.3342284	12.55281378	8.424504413	0	0.012942591	0	0.099176949	0	0.142677412	0	0	0	0	0.373859095	7.41635362	0	0	0	0	0	0	0	0	89.6028
H2611_810_0	2008	1	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									Coin	Coin	Coin	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									16.6091	0.1811	0.3586	0.5186	0.3464	0.5214	0.0206	0	1.1811	0.5682	0.1242	0.2091	0	0.9972	0	0	0	0	3.0011	10.1991	0.0189	0	0.0108	0	0.0831	0	0.1195	0	0	0	0	0.3131	0.7303									36.1113	None	250.8932758	2.735251354	5.416325284	1325.989126	312.4450408	7.875912151	0.31075982	2247.169353	462.4046127	6056.446846	1.876288036	3.158216183	0	2491.014621	3172.962966	3845.865055	0	0	56.85794954	154.0655402	39.92253149	0	9.365156713	0	141.6479953	0	44.83568776	0	0	0	0	4.729168672	3422.04675									Full Coverage	Full Coverage	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	Full Coverage	Full Coverage	$15 Copay	$30 Copay	$30 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$30 Copay on Specialist Visits and Fullcoverage on rest of services									0	0	0	0	0	0.12301579	0.12301579	50	0	0	0	0	0	0	15	30	0	0	0.131408692	0.000369246	0.198572057	0	0	0	0	0	0	0	0	0	0	0	22.12185338									0	0	0	0	0	0.968861558	0.038228365	9.363205639	0	0	0	0	0	0	3.966203708	9.614662638	0	0	7.47162876	0.056888134	7.927499217	0	0	0	0	0	0	0	0	0	0	0	6.30850137	0	0	0	0	0	0	0	0	45.7157	500	3.899271976	16.6091	0.181073186	0.358559836	0.518555126	0.346412337	1.490245638	0.058800614	9.363205639	1.181101491	0.568239043	0.124209957	0.209073388	0	0.997219658	3.966203708	9.614662638	0	0	10.47272134	10.25600137	7.946368514	0	0.010838146	0	0.08305093	0	0.119478284	0	0	0	0	0.313070182	7.038773463	0	0	0	0	0	0	0	0	81.827	4800	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance									2.1829	0.0238	0.0471	0.1007	0.0673	0.1012	0.0675	0.1683	0.2293	0.1103	0.0241	0.0406	0	0.1301	0.0396	0.3268	0	0	0.8615	2.2968	0.4781	0	0.0021	0	0.0161	0	0.0232	0	0	0	0	0.0608	0.3776									7.7759	500	0.183436309	18.792	0.20487096	0.405684018	0.6192431	0.413675304	1.59148291	0.126336198	9.531461398	1.410436252	0.678574155	0.148327834	0.249669218	0	1.127308974	4.005798448	9.941433311	0	0	11.3342284	12.55281378	8.424504413	0	0.012942591	0	0.099176949	0	0.142677412	0	0	0	0	0.373859095	7.41635362	0	0	0	0	0	0	0	0	89.6028
H2611_811_0	2008	1	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									Coin	Coin	Coin	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									16.6091	0.1811	0.3586	0.5186	0.3464	0.5214	0.0206	0	1.1811	0.5682	0.1242	0.2091	0	0.9972	0	0	0	0	3.0011	10.1991	0.0189	0	0.0108	0	0.0831	0	0.1195	0	0	0	0	0.3131	0.7303									36.1113	None	250.8932758	2.735251354	5.416325284	1325.989126	312.4450408	7.875912151	0.31075982	2247.169353	462.4046127	6056.446846	1.876288036	3.158216183	0	2491.014621	3172.962966	3845.865055	0	0	56.85794954	154.0655402	39.92253149	0	9.365156713	0	141.6479953	0	44.83568776	0	0	0	0	4.729168672	3422.04675									Full Coverage	Full Coverage	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	Full Coverage	Full Coverage	$15 Copay	$30 Copay	$30 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$30 Copay on Specialist Visits and Fullcoverage on rest of services									0	0	0	0	0	0.12301579	0.12301579	50	0	0	0	0	0	0	15	30	0	0	0.131408692	0.000369246	0.198572057	0	0	0	0	0	0	0	0	0	0	0	22.12185338									0	0	0	0	0	0.968861558	0.038228365	9.363205639	0	0	0	0	0	0	3.966203708	9.614662638	0	0	7.47162876	0.056888134	7.927499217	0	0	0	0	0	0	0	0	0	0	0	6.30850137	0	0	0	0	0	0	0	0	45.7157	500	3.899271976	16.6091	0.181073186	0.358559836	0.518555126	0.346412337	1.490245638	0.058800614	9.363205639	1.181101491	0.568239043	0.124209957	0.209073388	0	0.997219658	3.966203708	9.614662638	0	0	10.47272134	10.25600137	7.946368514	0	0.010838146	0	0.08305093	0	0.119478284	0	0	0	0	0.313070182	7.038773463	0	0	0	0	0	0	0	0	81.827	4800	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance									2.1829	0.0238	0.0471	0.1007	0.0673	0.1012	0.0675	0.1683	0.2293	0.1103	0.0241	0.0406	0	0.1301	0.0396	0.3268	0	0	0.8615	2.2968	0.4781	0	0.0021	0	0.0161	0	0.0232	0	0	0	0	0.0608	0.3776									7.7759	500	0.183436309	18.792	0.20487096	0.405684018	0.6192431	0.413675304	1.59148291	0.126336198	9.531461398	1.410436252	0.678574155	0.148327834	0.249669218	0	1.127308974	4.005798448	9.941433311	0	0	11.3342284	12.55281378	8.424504413	0	0.012942591	0	0.099176949	0	0.142677412	0	0	0	0	0.373859095	7.41635362	0	0	0	0	0	0	0	0	89.6028
H2611_812_0	2008	1	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									Coin	Coin	Coin	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V									16.6091	0.1811	0.3586	0.5186	0.3464	0.5214	0.0206	0	1.1811	0.5682	0.1242	0.2091	0	0.9972	0	0	0	0	3.0011	10.1991	0.0189	0	0.0108	0	0.0831	0	0.1195	0	0	0	0	0.3131	0.7303									36.1113	None	250.8932758	2.735251354	5.416325284	1325.989126	312.4450408	7.875912151	0.31075982	2247.169353	462.4046127	6056.446846	1.876288036	3.158216183	0	2491.014621	3172.962966	3845.865055	0	0	56.85794954	154.0655402	39.92253149	0	9.365156713	0	141.6479953	0	44.83568776	0	0	0	0	4.729168672	3422.04675									Full Coverage	Full Coverage	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	Full Coverage	Full Coverage	$15 Copay	$30 Copay	$30 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage	$30 Copay on Specialist Visits and Fullcoverage on rest of services									0	0	0	0	0	0.12301579	0.12301579	50	0	0	0	0	0	0	15	30	0	0	0.131408692	0.000369246	0.198572057	0	0	0	0	0	0	0	0	0	0	0	22.12185338									0	0	0	0	0	0.968861558	0.038228365	9.363205639	0	0	0	0	0	0	3.966203708	9.614662638	0	0	7.47162876	0.056888134	7.927499217	0	0	0	0	0	0	0	0	0	0	0	6.30850137	0	0	0	0	0	0	0	0	45.7157	500	3.899271976	16.6091	0.181073186	0.358559836	0.518555126	0.346412337	1.490245638	0.058800614	9.363205639	1.181101491	0.568239043	0.124209957	0.209073388	0	0.997219658	3.966203708	9.614662638	0	0	10.47272134	10.25600137	7.946368514	0	0.010838146	0	0.08305093	0	0.119478284	0	0	0	0	0.313070182	7.038773463	0	0	0	0	0	0	0	0	81.827	4800	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A	20% Coinsurance	20% Coinsurance									2.1829	0.0238	0.0471	0.1007	0.0673	0.1012	0.0675	0.1683	0.2293	0.1103	0.0241	0.0406	0	0.1301	0.0396	0.3268	0	0	0.8615	2.2968	0.4781	0	0.0021	0	0.0161	0	0.0232	0	0	0	0	0.0608	0.3776									7.7759	500	0.183436309	18.792	0.20487096	0.405684018	0.6192431	0.413675304	1.59148291	0.126336198	9.531461398	1.410436252	0.678574155	0.148327834	0.249669218	0	1.127308974	4.005798448	9.941433311	0	0	11.3342284	12.55281378	8.424504413	0	0.012942591	0	0.099176949	0	0.142677412	0	0	0	0	0.373859095	7.41635362	0	0	0	0	0	0	0	0	89.6028
H2611_813_0	2008	2																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0			114.1191026						300.8652023			1.464604172		0.14294921		933.1391521	3403.265875	289.9624333				28.34179216	813.2091017																				$0/day	$100/day for days 1-10	$0/day	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $5/Visit	$0/Visit; $5 copay for immunization	$5/Visit	MH/SA: $5/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $5/Visit	Not Covered		$0/Visit		$0/Visit																66.3738						49.9819			0.19975651		0.19975651		5	4.9991	4.9939				0.2	5																				0	0.631209729	0	0	0	0	0	1.253151324	0	0	0.292564218	0	0.028555035	0	0.38880798	1.417772624	0.120670591	0	0	0	5.668358432	0.338837126	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1399	0	0.001562739	0	0.631209729	0	0	0	0	0	1.253151324	0	0	0.292564218	0	0.028555035	0	0.38880798	1.417772624	0.120670591	0	0	0	5.668358432	0.338837126	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1399	3200	$25/day for days 1-10	$100/day for days 1-10	$25/day for days 21-30	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $15/Visit	$5/Visit	$15/Visit	MH/SA: $15/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $15/Visit	Not Covered		$0/Visit		$0/Visit															0.2597	0.0783	0.044					0.1552			0.0363		0.0035		0.2083	0.5071	0.0449				0.7029	0.1261																				2.1664	0	0.000663662	0.2597	0.709485655	0.043960259	0	0	0	0	1.408385057	0	0	0.328844925	0	0.032096127	0	0.597117405	1.924917394	0.165563446	0	0	0	6.371288036	0.46489407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.3063
H2611_814_0	2008	2																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0			114.115602						300.856			1.46451432		0.14294044		933.1171539	3403.165498	289.9535387				28.34005342	813.1841566																				$0/day	$100/day for days 1-10	$0/day	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $5/Visit	$0/Visit; $5 copay for immunization	$5/Visit	MH/SA: $5/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $5/Visit	Not Covered		$0/Visit		$0/Visit																66.3738						49.9819			0.199756585		0.199756585		5	4.9991	4.9939				0.2	5																				0	0.631190603	0	0	0	0	0	1.253112967	0	0	0.292546379	0	0.028553294	0	0.388798814	1.417730887	0.120666935	0	0	0	5.668010685	0.338826732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1394	0	0.001562199	0	0.631190603	0	0	0	0	0	1.253112967	0	0	0.292546379	0	0.028553294	0	0.388798814	1.417730887	0.120666935	0	0	0	5.668010685	0.338826732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1394	3200	$25/day for days 1-10	$100/day for days 1-10	$25/day for days 21-30	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $15/Visit	$5/Visit	$15/Visit	MH/SA: $15/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $15/Visit	Not Covered		$0/Visit		$0/Visit															0.2597	0.0783	0.044					0.1552			0.0363		0.0035		0.2083	0.5071	0.0449				0.7029	0.1261																				2.1663	0	0.000663436	0.2597	0.709464157	0.043958927	0	0	0	0	1.408341938	0	0	0.328824873	0	0.03209417	0	0.597101849	1.924860129	0.165558429	0	0	0	6.370897165	0.464879809	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.3057
H2611_815_0	2008	2																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0			106.1105876						279.8176011			1.258933492		0.122875212		882.8126112	3173.628681	269.6137935				24.36182558	756.1406778																				$0/day	$100/day for days 1-10	$0/day	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $5/Visit	$0/Visit; $5 copay for immunization	$5/Visit	MH/SA: $5/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $5/Visit	Not Covered		$0/Visit		$0/Visit																66.3905						49.979			0.199806705		0.199806705		5	4.9993	4.9952				0.2	5																				0	0.587060922	0	0	0	0	0	1.165415907	0	0	0.251543353	0	0.024551291	0	0.367838588	1.322157188	0.112230508	0	0	0	4.872365116	0.315058616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.0182	0	0.001131693	0	0.587060922	0	0	0	0	0	1.165415907	0	0	0.251543353	0	0.024551291	0	0.367838588	1.322157188	0.112230508	0	0	0	4.872365116	0.315058616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.0182	3200	$25/day for days 1-10	$100/day for days 1-10	$25/day for days 21-30	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $15/Visit	$5/Visit	$15/Visit	MH/SA: $15/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $15/Visit	Not Covered		$0/Visit		$0/Visit															0.2402	0.0724	0.0406					0.1435			0.031		0.003		0.1926	0.4688	0.0415				0.6007	0.1165																				1.9509	0	0.000484352	0.2402	0.659441072	0.040649153	0	0	0	0	1.308921309	0	0	0.282556737	0	0.027578279	0	0.560409669	1.791003857	0.153742014	0	0	0	5.473090706	0.431591615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9692
H2611_816_0	2008	2																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0			106.1120694						279.8214955			1.258968654		0.122878643		882.8219231	3173.671171	269.6175586				24.362506	756.1512372																				$0/day	$100/day for days 1-10	$0/day	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $5/Visit	$0/Visit; $5 copay for immunization	$5/Visit	MH/SA: $5/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $5/Visit	Not Covered		$0/Visit		$0/Visit																66.3905						49.979			0.199806697		0.199806697		5	4.9993	4.9952				0.2	5																				0	0.587069097	0	0	0	0	0	1.165432141	0	0	0.251550369	0	0.024551976	0	0.367842468	1.322174882	0.112232071	0	0	0	4.8725012	0.315063015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.0184	0	0.001131758	0	0.587069097	0	0	0	0	0	1.165432141	0	0	0.251550369	0	0.024551976	0	0.367842468	1.322174882	0.112232071	0	0	0	4.8725012	0.315063015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.0184	3200	$25/day for days 1-10	$100/day for days 1-10	$25/day for days 21-30	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $15/Visit	$5/Visit	$15/Visit	MH/SA: $15/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $15/Visit	Not Covered		$0/Visit		$0/Visit															0.2402	0.0724	0.0406					0.1435			0.031		0.003		0.1926	0.4689	0.0415				0.6007	0.1165																				1.951	0	0.000484379	0.2402	0.659450256	0.040649719	0	0	0	0	1.308939547	0	0	0.282564618	0	0.027579048	0	0.560416238	1.791028096	0.153744155	0	0	0	5.473243568	0.431597642	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9694
H2611_817_0	2008	2																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0			114.1191026						300.8652023			1.464604172		0.14294921		933.1391521	3403.265875	289.9624333				28.34179216	813.2091017																				$0/day	$100/day for days 1-10	$0/day	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $5/Visit	$0/Visit; $5 copay for immunization	$5/Visit	MH/SA: $5/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $5/Visit	Not Covered		$0/Visit		$0/Visit																66.3738						49.9819			0.19975651		0.19975651		5	4.9991	4.9939				0.2	5																				0	0.631209729	0	0	0	0	0	1.253151324	0	0	0.292564218	0	0.028555035	0	0.38880798	1.417772624	0.120670591	0	0	0	5.668358432	0.338837126	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1399	0	0.001562739	0	0.631209729	0	0	0	0	0	1.253151324	0	0	0.292564218	0	0.028555035	0	0.38880798	1.417772624	0.120670591	0	0	0	5.668358432	0.338837126	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1399	3200	$25/day for days 1-10	$100/day for days 1-10	$25/day for days 21-30	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $15/Visit	$5/Visit	$15/Visit	MH/SA: $15/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $15/Visit	Not Covered		$0/Visit		$0/Visit															0.2597	0.0783	0.044					0.1552			0.0363		0.0035		0.2083	0.5071	0.0449				0.7029	0.1261																				2.1664	0	0.000663662	0.2597	0.709485655	0.043960259	0	0	0	0	1.408385057	0	0	0.328844925	0	0.032096127	0	0.597117405	1.924917394	0.165563446	0	0	0	6.371288036	0.46489407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.3063
H2611_818_0	2008	2																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0			114.115602						300.856			1.46451432		0.14294044		933.1171539	3403.165498	289.9535387				28.34005342	813.1841566																				$0/day	$100/day for days 1-10	$0/day	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $5/Visit	$0/Visit; $5 copay for immunization	$5/Visit	MH/SA: $5/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $5/Visit	Not Covered		$0/Visit		$0/Visit																66.3738						49.9819			0.199756585		0.199756585		5	4.9991	4.9939				0.2	5																				0	0.631190603	0	0	0	0	0	1.253112967	0	0	0.292546379	0	0.028553294	0	0.388798814	1.417730887	0.120666935	0	0	0	5.668010685	0.338826732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1394	0	0.001562199	0	0.631190603	0	0	0	0	0	1.253112967	0	0	0.292546379	0	0.028553294	0	0.388798814	1.417730887	0.120666935	0	0	0	5.668010685	0.338826732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1394	3200	$25/day for days 1-10	$100/day for days 1-10	$25/day for days 21-30	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $15/Visit	$5/Visit	$15/Visit	MH/SA: $15/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $15/Visit	Not Covered		$0/Visit		$0/Visit															0.2597	0.0783	0.044					0.1552			0.0363		0.0035		0.2083	0.5071	0.0449				0.7029	0.1261																				2.1663	0	0.000663436	0.2597	0.709464157	0.043958927	0	0	0	0	1.408341938	0	0	0.328824873	0	0.03209417	0	0.597101849	1.924860129	0.165558429	0	0	0	6.370897165	0.464879809	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.3057
H2611_819_0	2008	2																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0			106.1105876						279.8176011			1.258933492		0.122875212		882.8126112	3173.628681	269.6137935				24.36182558	756.1406778																				$0/day	$100/day for days 1-10	$0/day	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $5/Visit	$0/Visit; $5 copay for immunization	$5/Visit	MH/SA: $5/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $5/Visit	Not Covered		$0/Visit		$0/Visit																66.3905						49.979			0.199806705		0.199806705		5	4.9993	4.9952				0.2	5																				0	0.587060922	0	0	0	0	0	1.165415907	0	0	0.251543353	0	0.024551291	0	0.367838588	1.322157188	0.112230508	0	0	0	4.872365116	0.315058616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.0182	0	0.001131693	0	0.587060922	0	0	0	0	0	1.165415907	0	0	0.251543353	0	0.024551291	0	0.367838588	1.322157188	0.112230508	0	0	0	4.872365116	0.315058616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.0182	3200	$25/day for days 1-10	$100/day for days 1-10	$25/day for days 21-30	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $15/Visit	$5/Visit	$15/Visit	MH/SA: $15/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $15/Visit	Not Covered		$0/Visit		$0/Visit															0.2402	0.0724	0.0406					0.1435			0.031		0.003		0.1926	0.4688	0.0415				0.6007	0.1165																				1.9509	0	0.000484352	0.2402	0.659441072	0.040649153	0	0	0	0	1.308921309	0	0	0.282556737	0	0.027578279	0	0.560409669	1.791003857	0.153742014	0	0	0	5.473090706	0.431591615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9692
H2611_820_0	2008	2																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0			106.1120694						279.8214955			1.258968654		0.122878643		882.8219231	3173.671171	269.6175586				24.362506	756.1512372																				$0/day	$100/day for days 1-10	$0/day	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $5/Visit	$0/Visit; $5 copay for immunization	$5/Visit	MH/SA: $5/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $5/Visit	Not Covered		$0/Visit		$0/Visit																66.3905						49.979			0.199806697		0.199806697		5	4.9993	4.9952				0.2	5																				0	0.587069097	0	0	0	0	0	1.165432141	0	0	0.251550369	0	0.024551976	0	0.367842468	1.322174882	0.112232071	0	0	0	4.8725012	0.315063015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.0184	0	0.001131758	0	0.587069097	0	0	0	0	0	1.165432141	0	0	0.251550369	0	0.024551976	0	0.367842468	1.322174882	0.112232071	0	0	0	4.8725012	0.315063015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.0184	3200	$25/day for days 1-10	$100/day for days 1-10	$25/day for days 21-30	$0/visit	$0/Trip			ER $50/Visit; UC $25/Visit	$0/Visit	$0/Visit	Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance Renal Dialysis	Partial Hospitalization $15/Visit	$5/Visit	$15/Visit	MH/SA: $15/visit	$0/Visit		$5/Visit	20% Coinsurance	Eye Exam/ Hearing Exam: $15/Visit	Not Covered		$0/Visit		$0/Visit															0.2402	0.0724	0.0406					0.1435			0.031		0.003		0.1926	0.4689	0.0415				0.6007	0.1165																				1.951	0	0.000484379	0.2402	0.659450256	0.040649719	0	0	0	0	1.308939547	0	0	0.282564618	0	0.027579048	0	0.560416238	1.791028096	0.153744155	0	0	0	5.473243568	0.431597642	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9694
H2613_001_0	2008	9	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	A	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1348.138358	8.436203223	367.6408711	7.857708605	229.5925653	10.32667221	3.681698915	193.0968159	406.7451627	841.2165431	890.0440051	49.91282996	14.40579278	0.380583566	5519.245413	1958.958403	0.114602587	429.7023958	588.5820727	0	29.43299282	0	0	0	5.422408582	346.2857589	0.715071906	0	0		0	1082.943491	17.70418368	75.5046277	411.7813056	111.4244557	0.050704061	834.8059989	3.882385217	1.27878686		"$150/day, days(1-5) no yrly max"	"$500/admit, no yrly max"	$50/day for days 21 to 100	15% Coinsurance	$100 copay	30% coinsurance	30% coinsurance	$50 copay	$150 copay	$10 copay	$15/$35 copay for Lower/Higher Tier	$100 copay	$25 copay	$15 copay	$15 copay	$15 copay	50% coinsurance	$15 copay	$15/$35 copay for Lower/Higher Tier	N/A	20% conisurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$15 copay	$0 copay	$15 copay	$15 copay	$10 copay	$0 copay	$10 copay	$10 copay	$15 copay		150	500	50	0.15	100	0.3	0.3	50	150	10	19.33492	100	25	15	15	15	0.5	15	23.33	0	0.2	0	0	0	0.5	0	10	0	0		0	15	0	15	15	10	0	10	10	15		16.8517	0.351508468	1.531836963	1.178656291	1.913271377	3.098001663	1.104509675	0.804570066	5.084314534	0.701013786	1.43407747	0.41594025	0.030012068	0.000475729	6.899056766	2.448698004	0.057301293	0.537127995	1.144301646	0	5.886598564	0	0	0	2.711204291	0	0.000595893	0	0	0	0	1.353679363	0	0.094380785	0.514726632	0.092853713	0	0.695671666	0.003235321	0.001598484	0	56.9409		0	16.8517	0.351508468	1.531836963	1.178656291	1.913271377	3.098001663	1.104509675	0.804570066	5.084314534	0.701013786	1.43407747	0.41594025	0.030012068	0.000475729	6.899056766	2.448698004	0.057301293	0.537127995	1.144301646	0	5.886598564	0	0	0	2.711204291	0	0.000595893	0	0	0	0	1.353679363	0	0.094380785	0.514726632	0.092853713	0	0.695671666	0.003235321	0.001598484	0	56.9409	None																																																																																			0		0	16.8517	0.351508468	1.531836963	1.178656291	1.913271377	3.098001663	1.104509675	0.804570066	5.084314534	0.701013786	1.43407747	0.41594025	0.030012068	0.000475729	6.899056766	2.448698004	0.057301293	0.537127995	1.144301646	0	5.886598564	0	0	0	2.711204291	0	0.000595893	0	0	0	0	1.353679363	0	0.094380785	0.514726632	0.092853713	0	0.695671666	0.003235321	0.001598484	0	56.9409
H2613_004_0	2008	8	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	A	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1178.193832	7.372746679	306.0046478	8.619143503	200.1521331	8.648786511	3.083493624	175.761684	363.4307272	766.974589	811.4927608	45.50775012	13.13440289	0.346994988	5015.726916	1780.243431	0.094646111	390.5008224	735.725054	0	25.14231117	0	0	0	4.587623811	318.3713413	0.389109006	0	0		0	987.3678132	16.14169279	68.61637146	374.2146659	101.2592483	0.041874641	758.6469897	3.528196805	1.163984662		"$200/day, days(1-5) no yrly max"	"$900/admit, no yrly max"	$100/day for days 21 to 100	15% Coinsurance	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$20 copay	$30/$35 copay for Lower/Higher Tier	$150 copay	$25 copay	$30 copay	$15 copay	$30 copay	50% coinsurance	$30 copay	$30/$35 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$50 maximum per year	$25 copay	N/A	N/A		N/A	$30 copay	$0 copay	$30 copay	$30 copay	$25 copay	$0 copay	$25 copay	$25 copay	Min. $15 / Max. $30copay		200	900	100	0.15	150	0.3	0.3	50	200	20	31.08373	150	25	30	15	30	0.5	30	30.79	0	0.2	0	0	0	0.5	0	25	0	0		0	30	0	30	30	25	0	25	25	18.92933608		19.6366	0.552956001	2.550038731	1.292871525	2.501901664	2.594635953	0.925048087	0.73234035	6.057178786	1.278290982	2.10201849	0.568846877	0.027363339	0.000867487	6.269658645	4.450608577	0.047323056	0.976252056	1.887747868	0	5.028462233	0	0	0	2.293811906	0	0.000810644	0	0	0	0	2.468419533	0	0.171540929	0.935536665	0.210956767	0	1.580514562	0.00735041	0.001836121	0	67.1518		0	19.6366	0.552956001	2.550038731	1.292871525	2.501901664	2.594635953	0.925048087	0.73234035	6.057178786	1.278290982	2.10201849	0.568846877	0.027363339	0.000867487	6.269658645	4.450608577	0.047323056	0.976252056	1.887747868	0	5.028462233	0	0	0	2.293811906	0	0.000810644	0	0	0	0	2.468419533	0	0.171540929	0.935536665	0.210956767	0	1.580514562	0.00735041	0.001836121	0	67.1518	None																																																																																			0		0	19.6366	0.552956001	2.550038731	1.292871525	2.501901664	2.594635953	0.925048087	0.73234035	6.057178786	1.278290982	2.10201849	0.568846877	0.027363339	0.000867487	6.269658645	4.450608577	0.047323056	0.976252056	1.887747868	0	5.028462233	0	0	0	2.293811906	0	0.000810644	0	0	0	0	2.468419533	0	0.171540929	0.935536665	0.210956767	0	1.580514562	0.00735041	0.001836121	0	67.1518
H2613_803_0	2008	4																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	285.9122137	2.043501984	46.80387343	37.80788994	7.805966553	24.11308608	1.194581845	5.927216786	30.68669121	11.9602751	32.30725597	0	0.271010558	31.79161019	45.08044356	122.1861488	1.390093239	4.678092661	30.38007063	40.22895375	8.836025994	6.270019692	0	0	0	0	0	0	0	0	0											Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											0.076417137	0.076417137	0.188152825	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.8486	0.156158572	8.806281007	0	1.826596174	5.642462143	0.279532152	1.386968728	7.180685744	2.798704372	7.559897898	0	0.063416471	7.439236785	10.54882379	28.59155882	0.325281818	1.094673683	7.108936527	9.413575178	2.067630083	1.467184608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.6062	0	0	21.8486	0.156158572	8.806281007	0	1.826596174	5.642462143	0.279532152	1.386968728	7.180685744	2.798704372	7.559897898	0	0.063416471	7.439236785	10.54882379	28.59155882	0.325281818	1.094673683	7.108936527	9.413575178	2.067630083	1.467184608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.6062	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.8486	0.156158572	8.806281007	0	1.826596174	5.642462143	0.279532152	1.386968728	7.180685744	2.798704372	7.559897898	0	0.063416471	7.439236785	10.54882379	28.59155882	0.325281818	1.094673683	7.108936527	9.413575178	2.067630083	1.467184608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.6062
H2613_804_0	2008	4																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	285.9122137	2.043501984	46.80387343	37.80788994	7.805966553	24.11308608	1.194581845	5.927216786	30.68669121	11.9602751	32.30725597	0	0.271010558	31.79161019	45.08044356	122.1861488	1.390093239	4.678092661	30.38007063	40.22895375	8.836025994	6.270019692	0	0	0	0	0	0	0	0	0											Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											0.076417137	0.076417137	0.188152825	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.8486	0.156158572	8.806281007	0	1.826596174	5.642462143	0.279532152	1.386968728	7.180685744	2.798704372	7.559897898	0	0.063416471	7.439236785	10.54882379	28.59155882	0.325281818	1.094673683	7.108936527	9.413575178	2.067630083	1.467184608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.6062	0	0	21.8486	0.156158572	8.806281007	0	1.826596174	5.642462143	0.279532152	1.386968728	7.180685744	2.798704372	7.559897898	0	0.063416471	7.439236785	10.54882379	28.59155882	0.325281818	1.094673683	7.108936527	9.413575178	2.067630083	1.467184608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.6062	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.8486	0.156158572	8.806281007	0	1.826596174	5.642462143	0.279532152	1.386968728	7.180685744	2.798704372	7.559897898	0	0.063416471	7.439236785	10.54882379	28.59155882	0.325281818	1.094673683	7.108936527	9.413575178	2.067630083	1.467184608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.6062
H2643_001_0	2008	7																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	310.96	15.78	61.37	68.65	14.84	30.43	24.63	8.87	26.18	13.83	29.11	1.48	2.63	48.19	90.42	165.95	7.51	9.25	38.87	73.12	10.77	6.12	4.32	0	2.85	1.07	0	0	0	0	6.77											PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $0	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $0, 4B Urgent Care: $0"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $0, 7D Physician Specialist: $0, 7F Podiatry: $0"	"7E Mental Health: $0, 7H Psychiatric: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.024998408	0.025006495	0.076106916	0	0.096858601	0.096847929	0.096857522	0.096865983	0.096847916	0.096837685	0.096834652	0.096848001	0.09681668	0.09686491	0.096850597	0.096848275	0.096844234	0.096849647	0.096848354	0.091706265	0.096845266	0.09684892	0	0	0	0	0	0	0	0	0											7.7735	0.39460249	4.670681434	0	1.437381642	2.947082479	2.385600756	0.859201269	2.535478429	1.339265187	2.818856707	0.143335041	0.254627869	4.667920015	8.757231007	16.07197129	0.727300198	0.895859232	3.764495532	6.705562119	1.04302351	0.592715388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7857	0	0	7.7735	0.39460249	4.670681434	0	1.437381642	2.947082479	2.385600756	0.859201269	2.535478429	1.339265187	2.818856707	0.143335041	0.254627869	4.667920015	8.757231007	16.07197129	0.727300198	0.895859232	3.764495532	6.705562119	1.04302351	0.592715388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.7735	0.39460249	4.670681434	0	1.437381642	2.947082479	2.385600756	0.859201269	2.535478429	1.339265187	2.818856707	0.143335041	0.254627869	4.667920015	8.757231007	16.07197129	0.727300198	0.895859232	3.764495532	6.705562119	1.04302351	0.592715388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7857
H2648_001_0	2008	6																																A	A	V	V	T	Coin	Coin	V	Coin		V	Coin		V	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		232.9333487	1.033052118	35.88202383	74.61136378	215.6271959	10.45417515	2.485939552	262.6233841	34.96786507		1911.62057	0.447230417		1477.039867	4418.329092	6577.484657	0.899653307	1011.978292	2092.541521	2570.431814	17.47308568	87.89072138			569.9874573	1.050611427	0	19.04073759		100												$475 Copay	$475 Copay	$475 Copay	$35 Copay	$75 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		$35 Copay	$5 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	$35 Copay			$35 Copay	$35 Copay	$35 Copay	$35 Copay		$10 Copay												475	475	475	35	75	0.3	0.3	50	0.2		35	0.5		35	5	35	0.5	35	35	35	0.2	35			35	35	35	35		10												9.2203	0.040891646	1.42033011	0.217616478	1.347669975	3.136252545	0.745781866	1.094264101	6.993573014	0	5.575559995	0.223615209	0	4.308032944	1.840970455	19.18433025	0.449826653	2.951603353	6.103246103	7.497092791	3.494617136	0.256347937	0	0	1.662463417	0.003064283	0	0.055535485	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	77.9063			9.2203	0.040891646	1.42033011	0.217616478	1.347669975	3.136252545	0.745781866	1.094264101	6.993573014	0	5.575559995	0.223615209	0	4.308032944	1.840970455	19.18433025	0.449826653	2.951603353	6.103246103	7.497092791	3.494617136	0.256347937	0	0	1.662463417	0.003064283	0	0.055535485	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	77.9063																																																																																				0			9.2203	0.040891646	1.42033011	0.217616478	1.347669975	3.136252545	0.745781866	1.094264101	6.993573014	0	5.575559995	0.223615209	0	4.308032944	1.840970455	19.18433025	0.449826653	2.951603353	6.103246103	7.497092791	3.494617136	0.256347937	0	0	1.662463417	0.003064283	0	0.055535485	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	77.9063
H2648_002_0	2008	6																																A	A	V	V	T	Coin	Coin	V	Coin		V	Coin		V	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		290.8447565	1.256656508	25.64117582	37.11471568	206.5714397	12.29193306	3.461616011	243.3563818	24.37926812		657.2669793	0.023898738		1205.07613	4695.512338	5831.014321	0.803917235	1124.706771	1172.918693	1700.558121	8.610080613	17.52748099			789.1357455	0	0	34.00241867		100												$475 Copay	$475 Copay	$475 Copay	$35 Copay	$75 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		$35 Copay	$5 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	$35 Copay			$35 Copay	$35 Copay	$35 Copay	$35 Copay		$10 Copay												475	475	475	35	75	0.3	0.3	50	0.2		35	0.5		35	5	35	0.5	35	35	35	0.2	35			35	35	35	35		10												11.5126	0.049742653	1.01496321	0.108251254	1.291071498	3.687579917	1.038484803	1.013984924	4.875853625	0	1.91702869	0.011949369	0	3.51480538	1.956463474	17.0071251	0.401958618	3.280394748	3.421012856	4.959961186	1.722016123	0.05112182	0	0	2.301645924	0	0	0.099173721	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	65.3205			11.5126	0.049742653	1.01496321	0.108251254	1.291071498	3.687579917	1.038484803	1.013984924	4.875853625	0	1.91702869	0.011949369	0	3.51480538	1.956463474	17.0071251	0.401958618	3.280394748	3.421012856	4.959961186	1.722016123	0.05112182	0	0	2.301645924	0	0	0.099173721	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	65.3205																																																																																				0			11.5126	0.049742653	1.01496321	0.108251254	1.291071498	3.687579917	1.038484803	1.013984924	4.875853625	0	1.91702869	0.011949369	0	3.51480538	1.956463474	17.0071251	0.401958618	3.280394748	3.421012856	4.959961186	1.722016123	0.05112182	0	0	2.301645924	0	0	0.099173721	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	65.3205
H2648_003_0	2008	8																																A	A	V	V	T	Coin	Coin	V	Coin	Coin	V	Coin		V	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		232.9333487	1.033052118	35.88202383	74.61136378	215.6271959	10.45417515	2.485939552	262.6233841	34.96786507		1911.62057	0.447230417		1477.039867	4418.329092	6577.484657	0.899653307	1011.978292	2092.541521	2570.431814	17.47308568	87.89072138			569.9874573	1.050611427	0	19.04073759		100												$475 Copay	$475 Copay	$475 Copay	$35 Copay	$75 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		$35 Copay	$5 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	$35 Copay			$35 Copay	$35 Copay	$35 Copay	$35 Copay		$10 Copay												475	475	475	35	75	0.3	0.3	50	0.2		35	0.5		35	5	35	0.5	35	35	35	0.2	35			35	35	35	35		10												9.2203	0.040891646	1.42033011	0.217616478	1.347669975	3.136252545	0.745781866	1.094264101	6.993573014	0	5.575559995	0.223615209	0	4.308032944	1.840970455	19.18433025	0.449826653	2.951603353	6.103246103	7.497092791	3.494617136	0.256347937	0	0	1.662463417	0.003064283	0	0.055535485	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	77.9063			9.2203	0.040891646	1.42033011	0.217616478	1.347669975	3.136252545	0.745781866	1.094264101	6.993573014	0	5.575559995	0.223615209	0	4.308032944	1.840970455	19.18433025	0.449826653	2.951603353	6.103246103	7.497092791	3.494617136	0.256347937	0	0	1.662463417	0.003064283	0	0.055535485	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	77.9063																																																																																				0			9.2203	0.040891646	1.42033011	0.217616478	1.347669975	3.136252545	0.745781866	1.094264101	6.993573014	0	5.575559995	0.223615209	0	4.308032944	1.840970455	19.18433025	0.449826653	2.951603353	6.103246103	7.497092791	3.494617136	0.256347937	0	0	1.662463417	0.003064283	0	0.055535485	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	77.9063
H2648_004_0	2008	9																																A	A	V	V	T	Coin	Coin	V	Coin		V	Coin		V	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		290.8447565	1.256656508	25.64117582	37.11471568	206.5714397	12.29193306	3.461616011	243.3563818	24.37926812		657.2669793	0.023898738		1205.07613	4695.512338	5831.014321	0.803917235	1124.706771	1172.918693	1700.558121	8.610080613	17.52748099			789.1357455	0	0	34.00241867		100												$475 Copay	$475 Copay	$475 Copay	$35 Copay	$75 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		$35 Copay	$5 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	$35 Copay			$35 Copay	$35 Copay	$35 Copay	$35 Copay		$10 Copay												475	475	475	35	75	0.3	0.3	50	0.2		35	0.5		35	5	35	0.5	35	35	35	0.2	35			35	35	35	35		10												11.5126	0.049742653	1.01496321	0.108251254	1.291071498	3.687579917	1.038484803	1.013984924	4.875853625	0	1.91702869	0.011949369	0	3.51480538	1.956463474	17.0071251	0.401958618	3.280394748	3.421012856	4.959961186	1.722016123	0.05112182	0	0	2.301645924	0	0	0.099173721	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	65.3205			11.5126	0.049742653	1.01496321	0.108251254	1.291071498	3.687579917	1.038484803	1.013984924	4.875853625	0	1.91702869	0.011949369	0	3.51480538	1.956463474	17.0071251	0.401958618	3.280394748	3.421012856	4.959961186	1.722016123	0.05112182	0	0	2.301645924	0	0	0.099173721	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	65.3205																																																																																				0			11.5126	0.049742653	1.01496321	0.108251254	1.291071498	3.687579917	1.038484803	1.013984924	4.875853625	0	1.91702869	0.011949369	0	3.51480538	1.956463474	17.0071251	0.401958618	3.280394748	3.421012856	4.959961186	1.722016123	0.05112182	0	0	2.301645924	0	0	0.099173721	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	65.3205
H2648_005_0	2008	5																																A	A	V	V	T	Coin	Coin	V	Coin		V	Coin		V	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		235.521497	1.044530475	36.28071298	73.52726704	214.2165507	10.38578335	2.469676396	258.8074888	34.45978498		1883.844886	0.440732197		1455.578604	4389.424135	6534.454384	0.893767724	1005.357874	2078.851997	2553.615905	17.47308568	86.61367671			566.2585674	1.043738268	0	18.91617202		100												$475 Copay	$475 Copay	$475 Copay	$35 Copay	$75 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		$35 Copay	$5 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	$35 Copay			$35 Copay	$35 Copay	$35 Copay	$35 Copay		$10 Copay												475	475	475	35	75	0.3	0.3	50	0.2		35	0.5		35	5	35	0.5	35	35	35	0.2	35			35	35	35	35		10												9.3227	0.041345998	1.436111555	0.214454529	1.338853442	3.115735005	0.740902919	1.078364537	6.891956995	0	5.494547585	0.220366099	0	4.245437594	1.828926723	19.05882529	0.446883862	2.932293798	6.063318325	7.44804639	3.494617136	0.252623224	0	0	1.651587488	0.003044237	0	0.055172168	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	77.4595			9.3227	0.041345998	1.436111555	0.214454529	1.338853442	3.115735005	0.740902919	1.078364537	6.891956995	0	5.494547585	0.220366099	0	4.245437594	1.828926723	19.05882529	0.446883862	2.932293798	6.063318325	7.44804639	3.494617136	0.252623224	0	0	1.651587488	0.003044237	0	0.055172168	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	77.4595																																																																																				0			9.3227	0.041345998	1.436111555	0.214454529	1.338853442	3.115735005	0.740902919	1.078364537	6.891956995	0	5.494547585	0.220366099	0	4.245437594	1.828926723	19.05882529	0.446883862	2.932293798	6.063318325	7.44804639	3.494617136	0.252623224	0	0	1.651587488	0.003044237	0	0.055172168	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	77.4595
H2648_006_0	2008	5																																A	A	V	V	T	Coin	Coin	V	Coin		V	Coin		V	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		295.1907127	1.275434134	26.02431983	36.8082639	207.8899809	12.37039221	3.483711432	241.3470172	24.17797141		651.8400042	0.023701409		1195.12596	4725.483693	5868.233561	0.809048622	1131.88575	1180.405409	1711.412747	8.610080613	17.38275867			794.1727821	0	0	34.21945539		100												$475 Copay	$475 Copay	$475 Copay	$35 Copay	$75 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		$35 Copay	$5 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	$35 Copay			$35 Copay	$35 Copay	$35 Copay	$35 Copay		$10 Copay												475	475	475	35	75	0.3	0.3	50	0.2		35	0.5		35	5	35	0.5	35	35	35	0.2	35			35	35	35	35		10												11.6846	0.050485934	1.030129327	0.107357436	1.29931238	3.711117662	1.04511343	1.005612572	4.835594283	0	1.901200012	0.011850704	0	3.485784051	1.968951539	17.11568122	0.404524311	3.301333438	3.442849108	4.991620512	1.722016123	0.050699713	0	0	2.316337281	0	0	0.099806745	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	65.6653			11.6846	0.050485934	1.030129327	0.107357436	1.29931238	3.711117662	1.04511343	1.005612572	4.835594283	0	1.901200012	0.011850704	0	3.485784051	1.968951539	17.11568122	0.404524311	3.301333438	3.442849108	4.991620512	1.722016123	0.050699713	0	0	2.316337281	0	0	0.099806745	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	65.6653																																																																																				0			11.6846	0.050485934	1.030129327	0.107357436	1.29931238	3.711117662	1.04511343	1.005612572	4.835594283	0	1.901200012	0.011850704	0	3.485784051	1.968951539	17.11568122	0.404524311	3.301333438	3.442849108	4.991620512	1.722016123	0.050699713	0	0	2.316337281	0	0	0.099806745	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	65.6653
H2648_801_0	2008	4																																A	A	V	V	T	Coin	Coin	V	Coin		V	Coin		V	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		235.521497	1.044530475	36.28071298	73.52726704	214.2165507	10.38578335	2.469676396	258.8074888	34.45978498		1883.844886	0.440732197		1455.578604	4389.424135	6534.454384	0.893767724	1005.357874	2078.851997	2553.615905	17.47308568	86.61367671			566.2585674	1.043738268	0	18.91617202		100												$475 Copay	$475 Copay	$475 Copay	$35 Copay	$75 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		$35 Copay	$5 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	$35 Copay			$35 Copay	$35 Copay	$35 Copay	$35 Copay		$10 Copay												475	475	475	35	75	0.3	0.3	50	0.2		35	0.5		35	5	35	0.5	35	35	35	0.2	35			35	35	35	35		10												9.3227	0.041345998	1.436111555	0.214454529	1.338853442	3.115735005	0.740902919	1.078364537	6.891956995	0	5.494547585	0.220366099	0	4.245437594	1.828926723	19.05882529	0.446883862	2.932293798	6.063318325	7.44804639	3.494617136	0.252623224	0	0	1.651587488	0.003044237	0	0.055172168	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	77.4595			9.3227	0.041345998	1.436111555	0.214454529	1.338853442	3.115735005	0.740902919	1.078364537	6.891956995	0	5.494547585	0.220366099	0	4.245437594	1.828926723	19.05882529	0.446883862	2.932293798	6.063318325	7.44804639	3.494617136	0.252623224	0	0	1.651587488	0.003044237	0	0.055172168	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	77.4595																																																																																				0			9.3227	0.041345998	1.436111555	0.214454529	1.338853442	3.115735005	0.740902919	1.078364537	6.891956995	0	5.494547585	0.220366099	0	4.245437594	1.828926723	19.05882529	0.446883862	2.932293798	6.063318325	7.44804639	3.494617136	0.252623224	0	0	1.651587488	0.003044237	0	0.055172168	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	77.4595
H2648_802_0	2008	3																																A	A	V	V	T	Coin	Coin	V	Coin		V	Coin		V	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		295.1907127	1.275434134	26.02431983	36.8082639	207.8899809	12.37039221	3.483711432	241.3470172	24.17797141		651.8400042	0.023701409		1195.12596	4725.483693	5868.233561	0.809048622	1131.88575	1180.405409	1711.412747	8.610080613	17.38275867			794.1727821	0	0	34.21945539		100												$475 Copay	$475 Copay	$475 Copay	$35 Copay	$75 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		$35 Copay	$5 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	$35 Copay			$35 Copay	$35 Copay	$35 Copay	$35 Copay		$10 Copay												475	475	475	35	75	0.3	0.3	50	0.2		35	0.5		35	5	35	0.5	35	35	35	0.2	35			35	35	35	35		10												11.6846	0.050485934	1.030129327	0.107357436	1.29931238	3.711117662	1.04511343	1.005612572	4.835594283	0	1.901200012	0.011850704	0	3.485784051	1.968951539	17.11568122	0.404524311	3.301333438	3.442849108	4.991620512	1.722016123	0.050699713	0	0	2.316337281	0	0	0.099806745	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	65.6653			11.6846	0.050485934	1.030129327	0.107357436	1.29931238	3.711117662	1.04511343	1.005612572	4.835594283	0	1.901200012	0.011850704	0	3.485784051	1.968951539	17.11568122	0.404524311	3.301333438	3.442849108	4.991620512	1.722016123	0.050699713	0	0	2.316337281	0	0	0.099806745	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	65.6653																																																																																				0			11.6846	0.050485934	1.030129327	0.107357436	1.29931238	3.711117662	1.04511343	1.005612572	4.835594283	0	1.901200012	0.011850704	0	3.485784051	1.968951539	17.11568122	0.404524311	3.301333438	3.442849108	4.991620512	1.722016123	0.050699713	0	0	2.316337281	0	0	0.099806745	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	65.6653
H2649_004_0	2008	5	s.	t.	u.								Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered								2900											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0								0		286.92	8.22	985.96	1134.73	225.6	10.39	1.82	326.3	257.33	3737.96	2411.45		20.93	2229.38	4464.53	3146.6	58.12	1112.32			15.96			3.1	3.19		0.15			0.02	0.3	0.08	3.38	0.06								$550/Admit	$550/Admit	$0/Day(Days 1-13) $100(Days 14-100)	$5/Visit	$100/Trip	20% Coins	0%-20% Coins	$50/Visit	$175/Visit	$0/Visit	$0-$100/Visit		$0-$50/Proc	$0-$50/Visit	$5/Visit	$30/Visit	$30-$50/Visit	$30/Visit			20% Coins			Plan 723	Plan 993		$250 Allowance			QuitNet	Nutritional Supplements	Active Outlook	Silver Sneakers	Meals on Wheels								427.051888	427.052424	32.15421	3.882291	77.645787	0.155291	0.010834	38.8229	135.880138	0	19.182993		35.098304	21.422652	3.88229	23.293741	27.810629	23.293735			0.155291			0	0		0			0	0	0	0	0								10.2108	0.29253091	2.641897074	0.367112672	1.459740796	1.61347349	0.01971788	1.055659356	2.913836326	0	3.854902372	0	0.061217292	3.979935993	1.444383348	6.108007119	0.134696146	2.159173943	0	0	2.47844436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7955	0	11.74469974	10.2108	0.29253091	2.641897074	0.367112672	1.459740796	1.61347349	0.01971788	1.055659356	2.913836326	0	3.854902372	0	0.061217292	3.979935993	1.444383348	6.108007119	0.134696146	2.159173943	0	0	2.47844436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7955	2900																																																																																			0	0	0	10.2108	0.29253091	2.641897074	0.367112672	1.459740796	1.61347349	0.01971788	1.055659356	2.913836326	0	3.854902372	0	0.061217292	3.979935993	1.444383348	6.108007119	0.134696146	2.159173943	0	0	2.47844436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7955
H2649_011_0	2008	5	s.	t.	u.								Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered								2900											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0								0		300.45	8.6	1032.46	1188.25	236.24	11.39	2	341.69	269.47	3914.26	2525.19		21.92	2334.53	4675.1	3295.01	60.86	1164.78			17.5			3.1	3.19		0.15			0.02	0.3	0.08	3.38	0.06								$550/Admit	$550/Admit	$0/Day(Days 1-13) $100(Days 14-100)	$5/Visit	$100/Trip	20% Coins	0%-20% Coins	$50/Visit	$175/Visit	$0/Visit	$0-$100/Visit		$0-$50/Proc	$0-$50/Visit	$5/Visit	$30/Visit	$30-$50/Visit	$30/Visit			20% Coins			Plan 723	Plan 993		$250 Allowance			QuitNet	Nutritional Supplements	Active Outlook	Silver Sneakers	Meals on Wheels								421.123998	421.124058	31.707878	3.828402	76.568009	0.153135	0.010684	38.284005	133.993992	0	18.916719		34.611106	21.125285	3.8284	22.970399	27.424637	22.970399			0.153136			0	0		0			0	0	0	0	0								10.5439	0.301805575	2.728092977	0.379091556	1.507368871	1.74420765	0.021368	1.090105139	3.008946752	0	3.980692471	0	0.063222954	4.109800966	1.491512737	6.307307867	0.139088617	2.229621779	0	0	2.67988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.326	0	12.95288952	10.5439	0.301805575	2.728092977	0.379091556	1.507368871	1.74420765	0.021368	1.090105139	3.008946752	0	3.980692471	0	0.063222954	4.109800966	1.491512737	6.307307867	0.139088617	2.229621779	0	0	2.67988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.326	2900																																																																																			0	0	0	10.5439	0.301805575	2.728092977	0.379091556	1.507368871	1.74420765	0.021368	1.090105139	3.008946752	0	3.980692471	0	0.063222954	4.109800966	1.491512737	6.307307867	0.139088617	2.229621779	0	0	2.67988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.326
H2649_012_0	2008	4	s.	t.	u.								Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered								4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0								0		1611.362927	66.645372	931.677642	1072.256858	213.178663	9.273288	1.629219	308.333717	243.165621	3532.173301	2278.693669		19.779819	2106.648418	4218.745359	2973.368621	54.918078	1051.083168			14.249771			3.1	3.19		0.15			0.02	0.3	0.08	3.38	0.06								$285/Day(Days 1-5)	$285/Day(Days 1-5)	$0/Day(Days 1-13) $100(Days 14-100)	$5/Visit	$100/Trip	20% Coins	0%-20% Coins	$50/Visit	$200/Visit	$0/Visit	$0-$150/Visit		$0-$50/Proc	$0-$100/Visit	$0/Visit	$0/Visit	$0-$50/Visit	$0/Visit			20% Coins			Plan 723	Plan 993		$250 Allowance			QuitNet	Nutritional Supplements	Active Outlook	Silver Sneakers	Meals on Wheels								154.607385	154.607376	34.559428	4.172697	83.453906	0.166907	0.011644	41.726955	166.907785	0	32.809135		37.723701	23.498381	0	0	12.13704	0			0.166907			0	0		0			0	0	0	0	0								20.7607	0.858655507	2.683187199	0.372850248	1.482549342	1.54777668	0.018970626	1.072152261	3.382186266	0	6.230164017	0	0.062180665	4.125235597	0	0	0.055545242	0	0	0	2.378386528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0306	0	8.928048217	20.7607	0.858655507	2.683187199	0.372850248	1.482549342	1.54777668	0.018970626	1.072152261	3.382186266	0	6.230164017	0	0.062180665	4.125235597	0	0	0.055545242	0	0	0	2.378386528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0306	4000																																																																																			0	0	0	20.7607	0.858655507	2.683187199	0.372850248	1.482549342	1.54777668	0.018970626	1.072152261	3.382186266	0	6.230164017	0	0.062180665	4.125235597	0	0	0.055545242	0	0	0	2.378386528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0306
H2649_015_0	2008	3	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		1917.93	79.33	1108.93	1276.26	253.74	13.14	2.31	367	289.43	4204.19	2712.23		23.54	2507.45	5021.38	3539.07	65.37	1251.06			20.19			3.1	3.19		0.15			0.02	0.3	0.08	3.38	4.9	0.06							$0/Day(Days 1-5)	$0/Day(Days 1-5)	$0/Day(Days 1-7) $0(Days 8-100)	$0/Visit	$0/Trip	0% Coins	0% Coins	$25/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			0% Coins			Plan 723	Plan 993		$250 Allowance			QuitNet	Nutritional Supplements	Active Outlook	Silver Sneakers	Transportation	Meals on Wheels							0	0	0	0	0	0	0	25.00001	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0	0	0	0	0	0	0	0.764583639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7646	0	0	0	0	0	0	0	0	0	0.764583639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7646																																																																																				0	0	0	0	0	0	0	0	0	0	0.764583639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7646
H2649_801_0	2008	3																					150											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		286.92	8.22	985.96	1134.73	225.6	10.39	1.82	326.3	257.33	3737.96	2411.45		20.93	2229.38	4464.53	3146.6	58.12	1112.32			15.96																					$1000/Admit	$1000/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$100/Visit	$100/Visit		$0-$100/Proc	$35-$100/Visit	$25/Visit	$35/Visit	$35-$100/Visit	$100/Visit			20% Coins																					101.167	101.166963	2.928189	0	10.116698	0.020233	0.020233	5.05835	20.233401	4.10563	10.1167		9.146123	9.826252	2.529174	3.540845	5.45355	10.116699			0.020233																					2.4189	0.06929937	0.240589769	0	0.190193922	0.21022087	0.03682406	0.137544967	0.433888423	1.27889006	2.032993018	0	0.015952363	1.825537474	0.940964433	0.928468573	0.026413361	0.937750553	0	0	0.32291868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0474	0	107.0358263	2.4189	0.06929937	0.240589769	0	0.190193922	0.21022087	0.03682406	0.137544967	0.433888423	1.27889006	2.032993018	0	0.015952363	1.825537474	0.940964433	0.928468573	0.026413361	0.937750553	0	0	0.32291868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0474	150																																																																																			0	0	0	2.4189	0.06929937	0.240589769	0	0.190193922	0.21022087	0.03682406	0.137544967	0.433888423	1.27889006	2.032993018	0	0.015952363	1.825537474	0.940964433	0.928468573	0.026413361	0.937750553	0	0	0.32291868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0474
H2649_802_0	2008	3																					150											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		286.92	8.22	985.96	1134.73	225.6	10.39	1.82	326.3	257.33	3737.96	2411.45		20.93	2229.38	4464.53	3146.6	58.12	1112.32			15.96																					$1000/Admit	$1000/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$100/Visit	$100/Visit		$0-$100/Proc	$35-$100/Visit	$25/Visit	$35/Visit	$35-$100/Visit	$100/Visit			20% Coins																					101.167	101.166963	2.928189	0	10.116698	0.020233	0.020233	5.05835	20.233401	4.10563	10.1167		9.146123	9.826252	2.529174	3.540845	5.45355	10.116699			0.020233																					2.4189	0.06929937	0.240589769	0	0.190193922	0.21022087	0.03682406	0.137544967	0.433888423	1.27889006	2.032993018	0	0.015952363	1.825537474	0.940964433	0.928468573	0.026413361	0.937750553	0	0	0.32291868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0474	0	107.0358263	2.4189	0.06929937	0.240589769	0	0.190193922	0.21022087	0.03682406	0.137544967	0.433888423	1.27889006	2.032993018	0	0.015952363	1.825537474	0.940964433	0.928468573	0.026413361	0.937750553	0	0	0.32291868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0474	150																																																																																			0	0	0	2.4189	0.06929937	0.240589769	0	0.190193922	0.21022087	0.03682406	0.137544967	0.433888423	1.27889006	2.032993018	0	0.015952363	1.825537474	0.940964433	0.928468573	0.026413361	0.937750553	0	0	0.32291868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0474
H2649_803_0	2008	3																					150											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		286.92	8.22	985.96	1134.73	225.6	10.39	1.82	326.3	257.33	3737.96	2411.45		20.93	2229.38	4464.53	3146.6	58.12	1112.32			15.96																					$1000/Admit	$1000/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$100/Visit	$100/Visit		$0-$100/Proc	$35-$100/Visit	$25/Visit	$35/Visit	$35-$100/Visit	$100/Visit			20% Coins																					101.167	101.166963	2.928189	0	10.116698	0.020233	0.020233	5.05835	20.233401	4.10563	10.1167		9.146123	9.826252	2.529174	3.540845	5.45355	10.116699			0.020233																					2.4189	0.06929937	0.240589769	0	0.190193922	0.21022087	0.03682406	0.137544967	0.433888423	1.27889006	2.032993018	0	0.015952363	1.825537474	0.940964433	0.928468573	0.026413361	0.937750553	0	0	0.32291868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0474	0	107.0358263	2.4189	0.06929937	0.240589769	0	0.190193922	0.21022087	0.03682406	0.137544967	0.433888423	1.27889006	2.032993018	0	0.015952363	1.825537474	0.940964433	0.928468573	0.026413361	0.937750553	0	0	0.32291868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0474	150																																																																																			0	0	0	2.4189	0.06929937	0.240589769	0	0.190193922	0.21022087	0.03682406	0.137544967	0.433888423	1.27889006	2.032993018	0	0.015952363	1.825537474	0.940964433	0.928468573	0.026413361	0.937750553	0	0	0.32291868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0474
H2649_804_0	2008	3																					150											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		286.92	8.22	985.96	1134.73	225.6	10.39	1.82	326.3	257.33	3737.96	2411.45		20.93	2229.38	4464.53	3146.6	58.12	1112.32			15.96																					$1000/Admit	$1000/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$100/Visit	$100/Visit		$0-$100/Proc	$35-$100/Visit	$25/Visit	$35/Visit	$35-$100/Visit	$100/Visit			20% Coins																					101.167	101.166963	2.928189	0	10.116698	0.020233	0.020233	5.05835	20.233401	4.10563	10.1167		9.146123	9.826252	2.529174	3.540845	5.45355	10.116699			0.020233																					2.4189	0.06929937	0.240589769	0	0.190193922	0.21022087	0.03682406	0.137544967	0.433888423	1.27889006	2.032993018	0	0.015952363	1.825537474	0.940964433	0.928468573	0.026413361	0.937750553	0	0	0.32291868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0474	0	107.0358263	2.4189	0.06929937	0.240589769	0	0.190193922	0.21022087	0.03682406	0.137544967	0.433888423	1.27889006	2.032993018	0	0.015952363	1.825537474	0.940964433	0.928468573	0.026413361	0.937750553	0	0	0.32291868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0474	150																																																																																			0	0	0	2.4189	0.06929937	0.240589769	0	0.190193922	0.21022087	0.03682406	0.137544967	0.433888423	1.27889006	2.032993018	0	0.015952363	1.825537474	0.940964433	0.928468573	0.026413361	0.937750553	0	0	0.32291868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0474
H2654_004_0	2008	7																					4800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1645.964929	117.1487916	697.6683448		169.3723206	10.30042733	1.68647617	355.1826881	30.33838529	6235.588324	41.17046681		0.51214456	24.58057919	3998.628592	3289.902695	455.9088731	1.566730901			21.32024086	2178.578406			243.4719342	2.426726277	19.16747223															$275 (1a); $0 (1a1)	$275 (1b)	"$85 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$5 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 (10b)	$0 n/c (16)	$30 (17a1)	$10; $0 n/c; $5 (17b)	$30 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											208.5141	208.5141	64.4498		132.6908	0.189558251	0.230512511	37.9117	0.189558251	1.5165	0.121002575		0.227469901	0.189489543	15	30	37.5	0.189558251			0.227469901	30			30	0.120886355	30															28.6006	2.035597667	3.747049078	0	1.87284538	1.952530986	0.388753857	1.12213015	5.750891244	0.78800481	4.981732502	0	0.116497472	4.657762712	4.99828574	8.224756738	1.424715228	0.296986769	0	0	4.849713075	5.446446015	0	0	0.608679836	0.293358093	0.047918681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.2052	0	19.40958827	28.6006	2.035597667	3.747049078	0	1.87284538	1.952530986	0.388753857	1.12213015	5.750891244	0.78800481	4.981732502	0	0.116497472	4.657762712	4.99828574	8.224756738	1.424715228	0.296986769	0	0	4.849713075	5.446446015	0	0	0.608679836	0.293358093	0.047918681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.2052																																																																																				0			28.6006	2.035597667	3.747049078	0	1.87284538	1.952530986	0.388753857	1.12213015	5.750891244	0.78800481	4.981732502	0	0.116497472	4.657762712	4.99828574	8.224756738	1.424715228	0.296986769	0	0	4.849713075	5.446446015	0	0	0.608679836	0.293358093	0.047918681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.2052
H2654_010_0	2008	6																					2500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1189.05014	113.6458602	443.8874588		12.04229858	12.96039609	2.611340972	1378.498225	26.73721512	6939.123673	33.40995509		0.052960459	24.80308824	3611.282505	3064.998618	460.0755462	1.494851496			13.36365227	541.9071747			102.1159379	2.430922832	18.90861406															$150 (1a); $0 (1a1)	$150 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $50/$15 (4b)"	20% (9b)	20% (8a1); $0/$16 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	20% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 (10b)	$0 n/c (16)	$30 (17a1)	$10; $0 n/c; $5 (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											107.4563	107.4563	71.6376		125.3657	0.143275104	0.17759637	35.8188	0.143275104	4.5848	0.092488277		0.143275104	0.143213932	15	30	37.5	0.143275104			0.143275104	30			20.6755	0.120886355	30															10.6476	1.017663904	2.64991758	0	0.125807615	1.8569021	0.463764679	4.114676601	3.830777282	2.651209779	3.090029195	0	0.007587915	3.552147792	4.514103131	7.662496544	1.437736082	0.214175004	0	0	1.914678672	1.354767937	0	0	0.175941355	0.2938654	0.047271535	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6231	0	14.1814804	10.6476	1.017663904	2.64991758	0	0.125807615	1.8569021	0.463764679	4.114676601	3.830777282	2.651209779	3.090029195	0	0.007587915	3.552147792	4.514103131	7.662496544	1.437736082	0.214175004	0	0	1.914678672	1.354767937	0	0	0.175941355	0.2938654	0.047271535	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6231																																																																																				0			10.6476	1.017663904	2.64991758	0	0.125807615	1.8569021	0.463764679	4.114676601	3.830777282	2.651209779	3.090029195	0	0.007587915	3.552147792	4.514103131	7.662496544	1.437736082	0.214175004	0	0	1.914678672	1.354767937	0	0	0.175941355	0.2938654	0.047271535	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6231
H2654_013_0	2008	6																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1215.280339	119.4657279	461.4430725		158.9655663	8.558649274	1.58780347	367.8574049	25.03587097	5762.94831	37.77280908		0.271675375	19.23736501	1497.094208	2914.353585	470.5421683	1.487426755			16.28912856	2178.267404			243.2067065	2.426726277	19.12470741															$195/$275/$300 (1a); $0 (1a1)	$195 (1b)	"$85 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	20% (incl in h5)	25% (12)	"25% (3, 9d); $60 (5); $40/$30 (9c); 20% (9a)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"25% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 (10b)	$0 n/c (16)	$30 (17a1)	$10; $0 n/c; $5 (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											173.9478	126.4368	55.1135		113.4689	0.162098428	0.236489012	32.4197	0.129678742	3.8904	0.104195705		0.162098428	0.130450842	10	29.9989	37.5	0.162098428			0.162098428	30			30	0.120886355	30															17.6163	1.258738436	2.119310573	0	1.503137324	1.387343594	0.375498074	0.993818452	3.246620264	1.868329725	3.935764476	0	0.044038151	2.509530462	1.247578507	7.285618937	1.470444276	0.241109539	0	0	2.640442135	5.44566851	0	0	0.608016766	0.293358093	0.047811769	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1385	0	21.36691972	17.6163	1.258738436	2.119310573	0	1.503137324	1.387343594	0.375498074	0.993818452	3.246620264	1.868329725	3.935764476	0	0.044038151	2.509530462	1.247578507	7.285618937	1.470444276	0.241109539	0	0	2.640442135	5.44566851	0	0	0.608016766	0.293358093	0.047811769	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1385	2700	$350 (1a); $0 (1a1)	$0 n/c (1b)	"$0 n/c (2a, 2a2)"	"$0 n/c (6a, 6a1, 6a2, 6a3)"	$0 n/c (10a)	$0 n/c (11a)	"$0 n/c (11b, 11c)"	"$0 n/c (4a, 4a1, 4b)"	35% (9b)	35% (8a1); $0/$20 (8a2)	"$20 (8b1); 35% (8b2, 8b3)"	35% (incl in h5)	$0 n/c (12)	"35% (3, 9d, 9a); $0 n/c (5); $45/$35 (9c)"	"$0 n/c (7a, 14b, 14b1, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j, 14c)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1, 7g)"	"$45/$35 (7e, 7h)"	"35% (7c, 7i)"	$0 (incl in h2)		"$0 n/c (15, 15a1)"	"$0 n/c (13a, 17a, 17b, 18a, 16b, 13a1)"	$0 n/c n/c (10b)	$0 n/c (16)	$0 n/c n/c (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											6.2946																																									6.2946	0	3.413411963	23.9109	1.258738436	2.119310573	0	1.503137324	1.387343594	0.375498074	0.993818452	3.246620264	1.868329725	3.935764476	0	0.044038151	2.509530462	1.247578507	7.285618937	1.470444276	0.241109539	0	0	2.640442135	5.44566851	0	0	0.608016766	0.293358093	0.047811769	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.4331
H2654_020_0	2008	5																					4000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1645.964929	117.1487916	697.6683448		169.3723206	10.30042733	1.68647617	355.1826881	30.33838529	6235.588324	41.17046681		0.51214456	24.58057919	3998.628592	3289.902695	455.9088731	1.566730901			21.32024086	2178.578406			243.4719342	2.426726277	19.16747223															$275 (1a); $0 (1a1)	$275 (1b)	"$85 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$5 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 (10b)	$0 n/c (16)	$30 (17a1)	$10; $0 n/c; $5 (17b)	$30 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											196.7726	196.7726	60.8206		125.2189	0.178884188	0.227071005	35.7768	0.178884188	1.4311	0.114188896		0.214661026	0.178825686	15	30	37.5	0.178884188			0.214661026	30			30	0.120886355	30															26.9901	1.920972761	3.536052008	0	1.767385088	1.842583582	0.382949839	1.058942781	5.427057427	0.743632104	4.701210165	0	0.109937477	4.395638935	4.99828574	8.224756738	1.424715228	0.280263385	0	0	4.576624777	5.446446015	0	0	0.608679836	0.293358093	0.047918681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7775	0	22.83733744	26.9901	1.920972761	3.536052008	0	1.767385088	1.842583582	0.382949839	1.058942781	5.427057427	0.743632104	4.701210165	0	0.109937477	4.395638935	4.99828574	8.224756738	1.424715228	0.280263385	0	0	4.576624777	5.446446015	0	0	0.608679836	0.293358093	0.047918681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7775																																																																																				0			26.9901	1.920972761	3.536052008	0	1.767385088	1.842583582	0.382949839	1.058942781	5.427057427	0.743632104	4.701210165	0	0.109937477	4.395638935	4.99828574	8.224756738	1.424715228	0.280263385	0	0	4.576624777	5.446446015	0	0	0.608679836	0.293358093	0.047918681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7775
H2654_022_0	2008	3																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1215.280339	119.4657279	461.4430725		158.9655663	8.558649274	1.58780347	367.8574049	25.03587097	5762.94831	37.77280908		0.271675375	19.23736501	1497.094208	2914.353585	470.5421683	1.487426755			16.28912856	2178.267404			243.2067065	2.426726277	19.12470741															$195/$275/$300 (1a); $0 (1a1)	$195 (1b)	"$85 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	20% (incl in h5)	25% (12)	"25% (3, 9d); $60 (5); $40/$30 (9c); 20% (9a)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"25% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 (10b)	$0 n/c (16)	$30 (17a1)	$10; $0 n/c; $5 (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											156.3836	113.6699	49.5484		102.0115	0.145730697	0.233973196	29.1461	0.116584557	3.4975	0.093674645		0.145730697	0.117286554	10	29.9989	37.5	0.145730697			0.145730697	30			30	0.120886355	30															15.8375	1.131638543	1.905315244	0	1.351359491	1.24725792	0.371503452	0.893468598	2.918795932	1.679676943	3.538354475	0	0.039591442	2.256284252	1.247578507	7.285618937	1.470444276	0.216763737	0	0	2.373826052	5.44566851	0	0	0.608016766	0.293358093	0.047811769	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.1598	0	25.34555171	15.8375	1.131638543	1.905315244	0	1.351359491	1.24725792	0.371503452	0.893468598	2.918795932	1.679676943	3.538354475	0	0.039591442	2.256284252	1.247578507	7.285618937	1.470444276	0.216763737	0	0	2.373826052	5.44566851	0	0	0.608016766	0.293358093	0.047811769	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.1598	2100	$350 (1a); $0 (1a1)	$0 n/c (1b)	"$0 n/c (2a, 2a2)"	"$0 n/c (6a, 6a1, 6a2, 6a3)"	$0 n/c (10a)	$0 n/c (11a)	"$0 n/c (11b, 11c)"	"$0 n/c (4a, 4a1, 4b)"	35% (9b)	35% (8a1); $0/$20 (8a2)	"$20 (8b1); 35% (8b2, 8b3)"	35% (incl in h5)	$0 n/c (12)	"35% (3, 9d, 9a); $0 n/c (5); $45/$35 (9c)"	"$0 n/c (7a, 14b, 14b1, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j, 14c)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1, 7g)"	"$45/$35 (7e, 7h)"	"35% (7c, 7i)"	$0 (incl in h2)		"$0 n/c (15, 15a1)"	"$0 n/c (13a, 17a, 17b, 18a, 16b, 13a1)"	$0 n/c n/c (10b)	$0 n/c (16)	$0 n/c n/c (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											5.659																																									5.659	0	4.049007088	21.4965	1.131638543	1.905315244	0	1.351359491	1.24725792	0.371503452	0.893468598	2.918795932	1.679676943	3.538354475	0	0.039591442	2.256284252	1.247578507	7.285618937	1.470444276	0.216763737	0	0	2.373826052	5.44566851	0	0	0.608016766	0.293358093	0.047811769	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8189
H2654_023_0	2008	5																					1650											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2139.014192	302.8560529	1024.076628		413.7256236	26.8077095	19.14500524	717.1710194	380.5337966	6610.788788	558.3230152	69.9901213	3.980698284	3579.575962		3467.080497		940.1889239			24.35070995	673.3767795					0.08885398															1(a) $150 per Day	1(b) $150 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $10 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per procedure; other $0 per procedure	8(b) X-rays $10 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a)/(d) $25 Copay Per Visit; 9(c) $0 Copay per Visit"	7(a) PCP $0 per visit; Urgent Care $10 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $10 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															89.1444	89.1444	24.9604		44.5722	0.11885919	0.11885919	21.3947	14.8574	5.943	5.943	14.8574	0.11885919	14.8574		5.943		5.943			0.11885919	5.943					5.943															15.8901	2.249826578	2.130116081	0	1.536721645	3.186342647	2.275559822	1.278635501	0.471145198	3.273970846	0.27650759	0.086655929	0.473142575	4.431932299	0	1.71705992	0	0.465625393	0	0	2.89430567	0.333487578	0	0	0	0	4.40E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.9712	0	29.33484347	15.8901	2.249826578	2.130116081	0	1.536721645	3.186342647	2.275559822	1.278635501	0.471145198	3.273970846	0.27650759	0.086655929	0.473142575	4.431932299	0	1.71705992	0	0.465625393	0	0	2.89430567	0.333487578	0	0	0	0	4.40E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.9712																																																																																				0	0	0	15.8901	2.249826578	2.130116081	0	1.536721645	3.186342647	2.275559822	1.278635501	0.471145198	3.273970846	0.27650759	0.086655929	0.473142575	4.431932299	0	1.71705992	0	0.465625393	0	0	2.89430567	0.333487578	0	0	0	0	4.40E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.9712
H2654_024_0	2008	5																					1100											D	D	D	V	T	V	P	V	V	Coin	V	V	V	V	V		V	V		V	S	P	T		V	P	V																																																								0		2628.725754	380.7311832	927.1058452		594.7966925	2929.961368	829.0070161	1426.471706	404.4518697	17.5170408	289.5338049	52.55163042	19.64621187	2655.796168		2338.743936		496.1806332				411.035257																				1(a) $110 per Day	1(b) $110 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per preocedure; other $0 per procedure	8(b) X-rays $0 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a), 9(d) $25 per visit; 9(c) $0/0 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  $0 per script	"13, 14(a)-(j) $0; 17(a), 16(b) $10 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															58.4422	58.4422	22.3143		39.847	10.8868	16.4037	23.7754	13.2823	0.171405147	5.3129	13.2823	119.6025	13.2823		5.3129		5.3129				5.3129																				12.8024	1.854230873	1.72397627	0	1.975069954	2.658160165	1.133228825	2.826238938	0.447671586	3.00251096	0.128189352	0.058167296	0.195811293	2.939594476	0	1.035464821	0	0.219680993	0	0	0	0.181983389	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1824	0	29.27352005	12.8024	1.854230873	1.72397627	0	1.975069954	2.658160165	1.133228825	2.826238938	0.447671586	3.00251096	0.128189352	0.058167296	0.195811293	2.939594476	0	1.035464821	0	0.219680993	0	0	0	0.181983389	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1824																																																																																				0	0	0	12.8024	1.854230873	1.72397627	0	1.975069954	2.658160165	1.133228825	2.826238938	0.447671586	3.00251096	0.128189352	0.058167296	0.195811293	2.939594476	0	1.035464821	0	0.219680993	0	0	0	0.181983389	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1824
H2654_026_0	2008	7																					2500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2184.644162	149.824787	981.1510153		303.2309899	12.48333908	21.67975529	471.803783	445.9455916	3738.734984	491.3362835	74.87758832	16.8073971	3141.736348		4290.17695	422.5893034	617.2876162				763.5225998					0.080843194															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															126.6113	126.6113	30.3867		54.262	0.14469858	0.14469858	29.8441	54.262	14.4699	47.218	54.262	116.1566	52.4618		18.0873	14.4699	14.4699				18.0873					18.0873															23.05	1.580792057	2.484495277	0	1.371159177	1.806321438	3.137029804	1.173379237	2.016490433	4.508247027	1.933328151	0.338583772	0.162690818	13.73510451	0	6.466484507	0.509567268	0.744338679	0	0	0	1.150839958	0	0	0	0	0.000121853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.169	0	25.2887121	23.05	1.580792057	2.484495277	0	1.371159177	1.806321438	3.137029804	1.173379237	2.016490433	4.508247027	1.933328151	0.338583772	0.162690818	13.73510451	0	6.466484507	0.509567268	0.744338679	0	0	0	1.150839958	0	0	0	0	0.000121853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.169																																																																																				0	0	0	23.05	1.580792057	2.484495277	0	1.371159177	1.806321438	3.137029804	1.173379237	2.016490433	4.508247027	1.933328151	0.338583772	0.162690818	13.73510451	0	6.466484507	0.509567268	0.744338679	0	0	0	1.150839958	0	0	0	0	0.000121853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.169
H2654_027_0	2008	7																					2500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		1986.191818	136.2147535	892.0235858		275.6855884	10.31838497	17.91988985	428.9452855	405.4360435	3399.109551	446.7034602	68.07573329	15.28061878	2856.342071		3900.458714	384.2014327	561.213416				694.1644627					0.073499425															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															131.7753	131.7753	31.6261		56.4751	0.150600351	0.150600351	31.0613	56.4751	15.06	49.1439	56.4751	109.9122	54.6016		18.825	15.06	15.06				18.825					18.825															21.8109	1.495811744	2.350933633	0	1.297448321	1.553952394	2.698741693	1.110300647	1.908087821	4.265892417	1.829396182	0.320382166	0.139960574	12.99673195	0	6.11885885	0.48217392	0.704324476	0	0	0	1.088973036	0	0	0	0	0.000115302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.173	0	20.39387446	21.8109	1.495811744	2.350933633	0	1.297448321	1.553952394	2.698741693	1.110300647	1.908087821	4.265892417	1.829396182	0.320382166	0.139960574	12.99673195	0	6.11885885	0.48217392	0.704324476	0	0	0	1.088973036	0	0	0	0	0.000115302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.173																																																																																				0	0	0	21.8109	1.495811744	2.350933633	0	1.297448321	1.553952394	2.698741693	1.110300647	1.908087821	4.265892417	1.829396182	0.320382166	0.139960574	12.99673195	0	6.11885885	0.48217392	0.704324476	0	0	0	1.088973036	0	0	0	0	0.000115302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.173
H2654_801_0	2008	3																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1475.724065	114.5498073	618.0331211		129.045538	9.52896405	2.384731604	326.5052961	36.01654189	7256.677492	51.48837093		0.062001864	29.97846922	1472.358636	3896.44871	456.0868902	2.534933468			24.76345655	2179.361929			243.7527582		20.13114902															$395 (1a); $0 (1a1)	$395 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$40/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $40 (14c1, 14c)"	"$50 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $50 (17a, 18a, 16b)"	$0 (10b)	$0 n/c (16)	$50 (17a1)	$0 n/c (17b)	$50 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											395	395	150		175	0.25	0.25	50	0.25	6	0.1586776		0.3	0.249862392	40	49.3826	37.5	0.25			0.3	49.9875			50		48.0074															48.5759	3.770597823	7.725414014	0	1.881914096	2.382241012	0.596182901	1.360438734	9.004135472	3.628338746	8.170051136	0	0.018600559	7.490492028	4.907862119	16.03474255	1.425271532	0.633733367	0	0	7.429036965	9.078411539	0	0	1.015636493	0	0.080537016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.2096	0	0	48.5759	3.770597823	7.725414014	0	1.881914096	2.382241012	0.596182901	1.360438734	9.004135472	3.628338746	8.170051136	0	0.018600559	7.490492028	4.907862119	16.03474255	1.425271532	0.633733367	0	0	7.429036965	9.078411539	0	0	1.015636493	0	0.080537016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.2096																																																																																				0			48.5759	3.770597823	7.725414014	0	1.881914096	2.382241012	0.596182901	1.360438734	9.004135472	3.628338746	8.170051136	0	0.018600559	7.490492028	4.907862119	16.03474255	1.425271532	0.633733367	0	0	7.429036965	9.078411539	0	0	1.015636493	0	0.080537016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.2096
H2654_802_0	2008	3																					6000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1561.850973	114.6525685	640.6934668		139.1009262	11.05598826	5.30732855	346.3222018	34.71147434	7587.649843	52.63239151		0.059334368	34.1680199	1124.832752	4087.067945	454.4172765	2.133055278			27.25637259	2175.710038			208.2568309		18.01244423															$600 (1a); $0 (1a1)	$600 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$40/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $40 (14c1, 14c)"	"$50 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $50 (17a, 18a, 16b)"	$0 (10b)	$0 n/c (16)	$50 (17a1)	$0 n/c (17b)	$50 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											410.6554	410.6554	102.6639		119.7745	0.171106431	0.238734273	34.2213	0.171106431	4.1066	0.10923353		0.205327718	0.171037978	40	49.1041	37.5	0.171106431			0.205327718	49.9868			50		48.1122															53.4485	3.923558371	5.481338636	0	1.388395347	1.891750697	1.267041225	0.987632601	5.939356502	2.596591374	5.749221932	0	0.01218299	5.844029029	3.749442506	16.7243079	1.420053989	0.364979476	0	0	5.596488775	9.063072443	0	0	0.867736795	0	0.072218261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.3879	0	43.0427575	53.4485	3.923558371	5.481338636	0	1.388395347	1.891750697	1.267041225	0.987632601	5.939356502	2.596591374	5.749221932	0	0.01218299	5.844029029	3.749442506	16.7243079	1.420053989	0.364979476	0	0	5.596488775	9.063072443	0	0	0.867736795	0	0.072218261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.3879																																																																																				0			53.4485	3.923558371	5.481338636	0	1.388395347	1.891750697	1.267041225	0.987632601	5.939356502	2.596591374	5.749221932	0	0.01218299	5.844029029	3.749442506	16.7243079	1.420053989	0.364979476	0	0	5.596488775	9.063072443	0	0	0.867736795	0	0.072218261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.3879
H2654_803_0	2008	2																					5400											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1274.310023	121.4732474	414.5477553		12.22053371	12.40867025	2.971715082	1312.530656	26.91342136	7734.757238	37.68486848		0.183215572	29.37626458	3916.40565	3545.306797	468.8061862	2.331087728			15.56125424	623.7015554			137.7083762		17.7788254															$350 (1a); $0 (1a1)	$350 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											271.4704	271.4704	116.3444		135.7352	0.193907402	0.229304983	38.7815	0.193907402	4.6538	0.122846115		0.232688882	0.193808401	25	34.805	37.5	0.193907402			0.232688882	35			35		35															28.8281	2.748032204	4.019193903	0	0.138229696	2.406133005	0.681429076	4.241823482	5.218711602	2.999653355	4.629439669	0	0.042632227	5.693366858	8.159178438	10.28286722	1.465019332	0.452015164	0	0	3.620930849	1.819129537	0	0	0.401649431	0	0.051854907	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.8994	0	18.87501631	28.8281	2.748032204	4.019193903	0	0.138229696	2.406133005	0.681429076	4.241823482	5.218711602	2.999653355	4.629439669	0	0.042632227	5.693366858	8.159178438	10.28286722	1.465019332	0.452015164	0	0	3.620930849	1.819129537	0	0	0.401649431	0	0.051854907	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.8994																																																																																				0			28.8281	2.748032204	4.019193903	0	0.138229696	2.406133005	0.681429076	4.241823482	5.218711602	2.999653355	4.629439669	0	0.042632227	5.693366858	8.159178438	10.28286722	1.465019332	0.452015164	0	0	3.620930849	1.819129537	0	0	0.401649431	0	0.051854907	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.8994
H2654_804_0	2008	2																					5400											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1274.11513	121.4546201	414.4749993		12.2185599	12.4044321	2.970861153	1312.304804	26.90467807	7733.619871	37.67394315		0.183198254	29.36815377	3915.829073	3544.80486	468.7307768	2.3305989			15.55688422	623.6127333			137.7083762		17.7788254															$350 (1a); $0 (1a1)	$350 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											271.4884	271.4884	116.3522		135.7442	0.193920312	0.229310165	38.7841	0.193920312	4.6541	0.122855932		0.232704374	0.19382132	25	34.8046	37.5	0.193920312			0.232704374	35			35		35															28.8256	2.747793745	4.018756059	0	0.138216572	2.405471343	0.681248662	4.241375951	5.217363566	2.999411957	4.628467391	0	0.042631035	5.692174322	8.157977236	10.28129747	1.464783678	0.451950466	0	0	3.620155009	1.818870472	0	0	0.401649431	0	0.051854907	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.8871	0	18.86683159	28.8256	2.747793745	4.018756059	0	0.138216572	2.405471343	0.681248662	4.241375951	5.217363566	2.999411957	4.628467391	0	0.042631035	5.692174322	8.157977236	10.28129747	1.464783678	0.451950466	0	0	3.620155009	1.818870472	0	0	0.401649431	0	0.051854907	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.8871																																																																																				0			28.8256	2.747793745	4.018756059	0	0.138216572	2.405471343	0.681248662	4.241375951	5.217363566	2.999411957	4.628467391	0	0.042631035	5.692174322	8.157977236	10.28129747	1.464783678	0.451950466	0	0	3.620155009	1.818870472	0	0	0.401649431	0	0.051854907	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.8871
H2663_002_0	2008	11																					1500											D	D	D	COIN	T	COIN	COIN	V	V	O	COIN	COIN	COIN	COIN	P	COIN	P	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	COIN	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2530.915921	25.45497876	1133.557393	0	328.1932461	7.956411173	36.69064388	278.1433438	319.35563	1030.854686	56.96856315	2.739914599	0.948222175	27.89036821	4591.147174	114.9269211	136.3161993	4.842573741	44.50978134	4.399555435	20.19437247	0	0	0	82.25434672	101.1410471	0.296568149	0	0	0	460.6135957											1a $175 days 1-5	1b $300 days 1-5	2 $75 days 6-25	6 0%	10a $100	11a 20%	11b 20%	4a $50	"9a $250,9b $250"	8a $5	"8a 20%, 8b $15"	9a 20%	12 20%	"9a 20%,9d 20%, 4b $50"	"14c $15,7a $15"	"17a $25,17b $15,18a $25,7b $25,7d $25,7f $25,8a 20%"	"7h $30,9C 20%"	"7c 20%,7i 20%"	"8a 20%, 8b $15"	7g $25	0.2				17a $25	17b $15	18a $25				7f $25											56.79505269	209.3121019	19.01702608	0	46.51567997	0.09303136	0.09303136	23.25783999	116.2891999	2.325783999	0.09189119	0.09303136	0.09303136	0.091083136	12.795	0.073664195	24.29607317	0.09303136	0.088444409	0.001045354	0.063413988	0	0	0	20.73	15	10.26	0	0	0	21.78894701											11.9786	0.444002926	1.796407542	0	1.272177667	0.740195752	3.413380498	0.539084449	3.094800892	0.199795444	5.234909038	0.254897981	0.088214398	2.540342205	4.895310674	8.465999155	0.275995696	0.450511221	3.936641319	0.004599094	1.280605688	0	0	0	0.142094384	0.126426309	0.000253566	0	0	0	0.836357102	0	0	0	0	0	0	0	0	0	0	52.0116	0	41.34072561	11.9786	0.444002926	1.796407542	0	1.272177667	0.740195752	3.413380498	0.539084449	3.094800892	0.199795444	5.234909038	0.254897981	0.088214398	2.540342205	4.895310674	8.465999155	0.275995696	0.450511221	3.936641319	0.004599094	1.280605688	0	0	0	0.142094384	0.126426309	0.000253566	0	0	0	0.836357102	0	0	0	0	0	0	0	0	0	0	52.0116																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.9786	0.444002926	1.796407542	0	1.272177667	0.740195752	3.413380498	0.539084449	3.094800892	0.199795444	5.234909038	0.254897981	0.088214398	2.540342205	4.895310674	8.465999155	0.275995696	0.450511221	3.936641319	0.004599094	1.280605688	0	0	0	0.142094384	0.126426309	0.000253566	0	0	0	0.836357102	0	0	0	0	0	0	0	0	0	0	52.0116
H2663_005_0	2008	10																					2800											D	D	D	COIN	T	COIN	COIN	V	V	O	COIN	COIN	COIN	COIN	P	COIN	P	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	COIN	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1668.395471	41.32839829	707.7771588	0	202.4182082	10.92008861	24.58756208	253.3158224	283.8091503	670.0572845	41.86605258	5.143888663	0.057295265	17.1284009	3350.853996	178.2718218	143.9151969	8.905697988	87.43021847	0	29.33234006	0	0	0	86.16785696	113.4256161	0.139108367	0	0	0	263.1914118											1a $325 days 1-5	1b $300 days 1-5	2 $125 days 6-28	6 0%	10a $150	11a 20%	11b 20%	4a $50	"9a $250,9b $150"	8a $5	"8a 20%, 8b $15"	9a 20%	12 20%	"9a 20%,9d 20%, 4b $25"	"14c $10,7a $10"	"17a $25,17b $15,18a $30,7b $30,7d $30,7f $30,8a 20%"	"7h $30,9C 20%"	"7c 20%,7i 15%"	8a 20% 8b$15	7g $25	0.2				17a $25	17b $15	18a $30				7f $30											136.7331208	209.3121019	44.02748834	0	92.00466298	0.1211671	0.121431348	30.47162632	133.6916956	2.917609479	0.029047788	0.119392396	0.086527026	0.108268291	8.53	0.062905299	22.1861988	0.121428598	0.115493339	0	0.064855103	0	0	0	20.73	15	12.312	0	0	0	22.33429694											19.0104	0.720877826	2.596804217	0	1.551951586	1.323155468	2.985700809	0.643245423	3.161910544	0.16291379	1.21611623	0.61414119	0.004957589	1.854462684	2.381898716	11.2142422	0.266077597	1.081406417	10.0976079	0	1.902351944	0	0	0	0.148854973	0.14178202	0.000142725	0	0	0	0.489849595	0	0	0	0	0	0	0	0	0	0	63.5709	0	25.01997081	19.0104	0.720877826	2.596804217	0	1.551951586	1.323155468	2.985700809	0.643245423	3.161910544	0.16291379	1.21611623	0.61414119	0.004957589	1.854462684	2.381898716	11.2142422	0.266077597	1.081406417	10.0976079	0	1.902351944	0	0	0	0.148854973	0.14178202	0.000142725	0	0	0	0.489849595	0	0	0	0	0	0	0	0	0	0	63.5709																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.0104	0.720877826	2.596804217	0	1.551951586	1.323155468	2.985700809	0.643245423	3.161910544	0.16291379	1.21611623	0.61414119	0.004957589	1.854462684	2.381898716	11.2142422	0.266077597	1.081406417	10.0976079	0	1.902351944	0	0	0	0.148854973	0.14178202	0.000142725	0	0	0	0.489849595	0	0	0	0	0	0	0	0	0	0	63.5709
H2663_006_0	2008	10																					4300											D	D	D	COIN	T	COIN	COIN	V	V	O	COIN	COIN	COIN	COIN	P	COIN	P	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1844.443013	18.55072411	826.0981338	0	237.1266338	5.738952825	26.52317493	202.7014236	232.7355383	751.2518889	41.51675425	1.996756716	0.691032121	20.32555324	3345.872152	83.74679923	99.34261695	3.529103295	32.43721716	3.206246599	14.59408505	0	0	0	59.94417465	73.70705327	0.213914362	0	0	0	332.9613285											1a $320 days 1-5	1b $300 days 1-5	2 $100 days 6-48	6 0%	10a $100	11a 20%	11b 20%	4a $50	"9a $250,9b $250"	8a $5	8a 20% 8b$15	9a 20%	12 20%	"9a 20%,9d 20% 4b $50"	"14c $15,7a $15"	"17a $25,17b $15,18a $30,7b $30,7d $30,7f $30,8a 20%"	"7h $30,9C 20%"	"7c 20%,7i 20%"	"8a 20%, 8b $15"	7g $30	0.2				17a $25	17b $15	18a $30				7f $30											165.4400025	209.3121019	49.6902471	0	74.0998733	0.148199747	0.148199747	37.04993665	185.2496833	3.704993665	0.146383446	0.148199747	0.148199747	0.145096166	12.795	0.087391507	24.82346294	0.148199747	0.140892695	0.001254425	0.063442735	0	0	0	20.73	15	12.312	0	0	0	25.49495161											25.4287	0.323574255	3.4207517	0	1.46425446	0.850511355	3.930727804	0.625839575	3.592848729	0.231948624	6.077365537	0.295918839	0.102410785	2.949159845	3.567536182	7.318758979	0.205502314	0.523012214	4.570166953	0.004021996	0.925888667	0	0	0	0.103553562	0.092133817	0.000219476	0	0	0	0.707402747	0	0	0	0	0	0	0	0	0	0	67.3122	0	19.06498825	25.4287	0.323574255	3.4207517	0	1.46425446	0.850511355	3.930727804	0.625839575	3.592848729	0.231948624	6.077365537	0.295918839	0.102410785	2.949159845	3.567536182	7.318758979	0.205502314	0.523012214	4.570166953	0.004021996	0.925888667	0	0	0	0.103553562	0.092133817	0.000219476	0	0	0	0.707402747	0	0	0	0	0	0	0	0	0	0	67.3122																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.4287	0.323574255	3.4207517	0	1.46425446	0.850511355	3.930727804	0.625839575	3.592848729	0.231948624	6.077365537	0.295918839	0.102410785	2.949159845	3.567536182	7.318758979	0.205502314	0.523012214	4.570166953	0.004021996	0.925888667	0	0	0	0.103553562	0.092133817	0.000219476	0	0	0	0.707402747	0	0	0	0	0	0	0	0	0	0	67.3122
H2663_007_0	2008	10																					1750											D	D	D	COIN	T	COIN	COIN	V	V	O	COIN	COIN	COIN	COIN	P	COIN	P	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	COIN	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1857.838376	45.0396108	763.5624725	0	218.1867994	7.286651172	16.06368388	276.5119465	309.496911	756.3491795	28.73979826	3.961195089	0.069381121	12.61169042	3688.830701	108.517252	156.0327258	5.799758877	54.057197	0	18.36613237	0	0	0	93.18658284	122.6746437	0.147877266	0	0	0	286.7499511											1a $175 days 1-5	1b $300 days 1-5	2 $100 days 6-23	6 0%	10a $150	11a 20%	11b 20%	4a $50	"9a $200,9b $150"	8a $5	"8a 20%, 8b $15"	9a 20%	12 20%	"9a 20%,9d 15%, 4b $25"	"14c $10,7a $10,8a $5"	"17a $20,17b $15,18a $15,7b $15,7d $25,7f $10,8a 20%"	"7h $30,9C 20%"	"7c 15%,7i 15%"	"8a 20%, 8b $15"	7g $25	0.2				17a $25	17b $15	18a $15				7f $15											72.42088709	209.3121019	30.9156978	0	88.90501051	0.118572545	0.118562724	29.64553744	109.7678781	2.96876909	0.064967084	0.118642945	0.089467726	0.10554356	8.53	0.063339662	22.05427042	0.088919895	0.112187815	0	0.06	0	0	0	20.73	15	6.156	0	0	0	12.78989033											11.2122	0.7856113	1.967172221	0	1.616491641	0.863996777	1.904554115	0.683112105	2.831068266	0.187118839	1.867140877	0.46996785	0.006207371	1.331082703	2.622143823	6.873446112	0.286765661	0.515713951	6.064558843	0	1.101967942	0	0	0	0.160979822	0.153343305	7.59E-05	0	0	0	0.305625036	0	0	0	0	0	0	0	0	0	0	43.8103	0	22.05034145	11.2122	0.7856113	1.967172221	0	1.616491641	0.863996777	1.904554115	0.683112105	2.831068266	0.187118839	1.867140877	0.46996785	0.006207371	1.331082703	2.622143823	6.873446112	0.286765661	0.515713951	6.064558843	0	1.101967942	0	0	0	0.160979822	0.153343305	7.59E-05	0	0	0	0.305625036	0	0	0	0	0	0	0	0	0	0	43.8103																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.2122	0.7856113	1.967172221	0	1.616491641	0.863996777	1.904554115	0.683112105	2.831068266	0.187118839	1.867140877	0.46996785	0.006207371	1.331082703	2.622143823	6.873446112	0.286765661	0.515713951	6.064558843	0	1.101967942	0	0	0	0.160979822	0.153343305	7.59E-05	0	0	0	0.305625036	0	0	0	0	0	0	0	0	0	0	43.8103
H2663_008_0	2008	11																					4300											D	D	D	COIN	T	COIN	COIN	V	V	O	COIN	COIN	COIN	COIN	P	COIN	P	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2693.510408	27.09032922	1206.38258	0	346.2850581	8.380811473	38.73280292	296.0126121	339.8725741	1097.081757	60.62849808	2.915939912	1.009140535	29.68217982	4886.104586	122.2986418	145.0738086	5.153684006	47.36930412	4.682204071	21.31229845	0	0	0	87.5387622	107.6372182	0.312387293	0	0	0	486.2361144											1a $320 days 1-5	1b $300 days 1-5	2 $100 days 6-48	6 0%	10a $100	11a 20%	11b 20%	4a $50	"9a $250,9b $250"	8a $5	8a 20% 8b$15	9a 20%	12 20%	"9a 20%,9d 20% 4b $50"	"14c $15,7a $15"	"17a $25,17b $15,18a $30,7b $30,7d $30,7f $30,8a 20%"	"7h $30,9C 20%"	"7c 20%,7i 20%"	"8a 20%, 8b $15"	7g $30	0.2				17a $25	17b $15	18a $30				7f $30											144.1889916	209.3121019	43.30746202	0	64.58163596	0.129163272	0.129163272	32.29081798	161.4540899	3.229081798	0.127580277	0.129163272	0.129163272	0.126458351	12.795	0.085721458	24.64148115	0.129163272	0.122794822	0.001254425	0.036779025	0	0	0	20.73	15	12.312	0	0	0	10.61211972											32.3645	0.472527813	4.353780648	0	1.863637963	1.082493031	5.002855556	0.796540781	4.572818094	0.295213894	7.735000605	0.37663234	0.130343893	3.753559506	5.209809015	10.48361792	0.297902793	0.665666689	5.816705269	0.005873474	0.783845564	0	0	0	0.151223212	0.134546523	0.000320509	0	0	0	0.429999655	0	0	0	0	0	0	0	0	0	0	86.7795	0	38.07295342	32.3645	0.472527813	4.353780648	0	1.863637963	1.082493031	5.002855556	0.796540781	4.572818094	0.295213894	7.735000605	0.37663234	0.130343893	3.753559506	5.209809015	10.48361792	0.297902793	0.665666689	5.816705269	0.005873474	0.783845564	0	0	0	0.151223212	0.134546523	0.000320509	0	0	0	0.429999655	0	0	0	0	0	0	0	0	0	0	86.7795																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	32.3645	0.472527813	4.353780648	0	1.863637963	1.082493031	5.002855556	0.796540781	4.572818094	0.295213894	7.735000605	0.37663234	0.130343893	3.753559506	5.209809015	10.48361792	0.297902793	0.665666689	5.816705269	0.005873474	0.783845564	0	0	0	0.151223212	0.134546523	0.000320509	0	0	0	0.429999655	0	0	0	0	0	0	0	0	0	0	86.7795
H2663_009_0	2008	11																					1500											D	D	D	COIN	T	COIN	COIN	V	V	O	COIN	COIN	COIN	COIN	P	COIN	P	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	COIN	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		3166.018416	31.84259535	1418.0098	0	410.54934	9.952975556	45.89771365	347.9400249	399.4940319	1289.535102	71.26412954	3.427462764	1.186166969	34.88911609	5743.239584	143.7664308	170.5230876	6.057758583	55.67896833	5.503570234	25.26190405	0	0	0	102.8950722	126.5211598	0.370988311	0	0	0	576.1989619											1a $210 days 1-5	1b $300 days 1-5	2 $75 days 6-25	6 0%	10a $100	11a 20%	11b 20%	4a $50	"9a $250,9b $250"	8a $5	"8a 20%, 8b $15"	9a 20%	12 20%	"9a 20%,9d 20%, 4b $50"	"14c $15,7a $15"	"17a $25,17b $15,18a $25,7b $25,7d $25,7f $25,8a 20%"	"7h $30,9C 20%"	"7c 20%,7i 20%"	"8a 20%, 8b $15"	7g $25	0.2				17a $25	17b $15	18a $25				7f $25											58.56969899	209.3121019	16.34270124	0	39.97427659	0.079948553	0.079948553	19.9871383	99.93569148	1.99871383	0.078968723	0.079948553	0.079948553	0.078274304	12.795	0.072449564	24.17100628	0.079948553	0.076006656	0.001045354	0.036699205	0	0	0	20.73	15	10.26	0	0	0	10.6025959											15.4527	0.555420047	1.931175877	0	1.367617739	0.795725996	3.669455801	0.579527116	3.326976027	0.214784304	5.62763728	0.274020689	0.094832333	2.730921281	6.123729207	10.41581528	0.343476218	0.484309034	4.231972186	0.00575318	0.927091799	0	0	0	0.177751237	0.15815145	0.000317195	0	0	0	0.509100396	0	0	0	0	0	0	0	0	0	0	59.9983	0	61.90696918	15.4527	0.555420047	1.931175877	0	1.367617739	0.795725996	3.669455801	0.579527116	3.326976027	0.214784304	5.62763728	0.274020689	0.094832333	2.730921281	6.123729207	10.41581528	0.343476218	0.484309034	4.231972186	0.00575318	0.927091799	0	0	0	0.177751237	0.15815145	0.000317195	0	0	0	0.509100396	0	0	0	0	0	0	0	0	0	0	59.9983																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.4527	0.555420047	1.931175877	0	1.367617739	0.795725996	3.669455801	0.579527116	3.326976027	0.214784304	5.62763728	0.274020689	0.094832333	2.730921281	6.123729207	10.41581528	0.343476218	0.484309034	4.231972186	0.00575318	0.927091799	0	0	0	0.177751237	0.15815145	0.000317195	0	0	0	0.509100396	0	0	0	0	0	0	0	0	0	0	59.9983
H2663_010_0	2008	12																					4300											D	D	D	COIN	T	COIN	COIN	V	V	O	COIN	COIN	COIN	COIN	P	COIN	P	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1897.972291	19.92610071	850.0730878	0	257.0975761	6.222290753	28.75697207	219.7730548	252.33666	814.5227577	45.01331932	2.164924722	0.749231246	22.03738309	3627.663441	90.80000312	107.7093096	3.826326417	35.16909836	3.476278543	15.82320734	0	0	0	64.99270773	79.91470395	0.231930353	0	0	0	361.0035243											1a $320 days 1-5	1b $300 days 1-5	2 $100 days 6-48	6 0%	10a $100	11a 20%	11b 20%	4a $50	"9a $250,9b $250"	8a $5	8a 20% 8b$15	9a 20%	12 20%	"9a 20%,9d 20% 4b $50"	"14c $15,7a $15"	"17a $25,17b $15,18a $30,7b $30,7d $30,7f $30,8a 20%"	"7h $30,9C 20%"	"7c 20%,7i 20%"	"8a 20%, 8b $15"	7g $30	0.2				17a $25	17b $15	18a $30				7f $30											162.5610722	209.3121019	48.82555444	0	72.81041269	0.145620825	0.145620825	36.40520635	182.0260317	3.640520635	0.143836131	0.145620825	0.145620825	0.142571252	12.795	0.087293996	24.79880939	0.145620825	0.138440929	0.001254425	0.063442735	0	0	0	20.73	15	12.312	0	0	0	25.49495161											25.7114	0.347564502	3.458774152	0	1.559948385	0.906095115	4.187614009	0.666740284	3.827653407	0.247107242	6.474541695	0.315258125	0.109103672	3.141897301	3.867996143	7.926295106	0.222588553	0.557192811	4.868842644	0.004360731	1.003867547	0	0	0	0.112274903	0.09989338	0.000237961	0	0	0	0.766980615	0	0	0	0	0	0	0	0	0	0	70.3842	0	21.11543815	25.7114	0.347564502	3.458774152	0	1.559948385	0.906095115	4.187614009	0.666740284	3.827653407	0.247107242	6.474541695	0.315258125	0.109103672	3.141897301	3.867996143	7.926295106	0.222588553	0.557192811	4.868842644	0.004360731	1.003867547	0	0	0	0.112274903	0.09989338	0.000237961	0	0	0	0.766980615	0	0	0	0	0	0	0	0	0	0	70.3842																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.7114	0.347564502	3.458774152	0	1.559948385	0.906095115	4.187614009	0.666740284	3.827653407	0.247107242	6.474541695	0.315258125	0.109103672	3.141897301	3.867996143	7.926295106	0.222588553	0.557192811	4.868842644	0.004360731	1.003867547	0	0	0	0.112274903	0.09989338	0.000237961	0	0	0	0.766980615	0	0	0	0	0	0	0	0	0	0	70.3842
H2663_011_0	2008	11																					1500											D	D	D	COIN	T	COIN	COIN	V	V	O	COIN	COIN	COIN	COIN	P	COIN	P	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	COIN	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2769.341692	27.85297346	1240.344542	0	359.1107994	8.705947519	40.14709812	304.3459294	349.4406327	1127.966693	62.33530548	2.99802916	1.037549758	30.51778957	5023.657712	125.7536497	149.1579119	5.298770001	48.70284002	4.81401701	22.09679001	0	0	0	90.00314465	110.6690728	0.32450645	0	0	0	504.0058518											1a $210 days 1-5	1b $300 days 1-5	2 $75 days 6-25	6 0%	10a $100	11a 20%	11b 20%	4a $50	"9a $250,9b $250"	8a $5	"8a 20%, 8b $15"	9a 20%	12 20%	"9a 20%,9d 20%, 4b $50"	"14c $15,7a $15"	"17a $25,17b $15,18a $25,7b $25,7d $25,7f $25,8a 20%"	"7h $30,9C 20%"	"7c 20%,7i 20%"	"8a 20%, 8b $15"	7g $25	0.2				17a $25	17b $15	18a $25				7f $25											62.93946573	209.3121019	17.56199711	0	42.95667649	0.085913353	0.085913353	21.47833824	107.3916912	2.147833824	0.084860419	0.085913353	0.085913353	0.084114191	12.795	0.073395084	24.2280276	0.085913353	0.081677359	0.001045354	0.063413988	0	0	0	20.73	15	10.26	0	0	0	21.78894701											14.5251	0.485830368	1.815243938	0	1.285517203	0.747957142	3.449171812	0.544737068	3.127251711	0.201890418	5.289800157	0.257570737	0.089139379	2.566979196	5.356475035	9.229699688	0.301150167	0.455235097	3.977919333	0.005032353	1.40124557	0	0	0	0.155480432	0.138336341	0.000277453	0	0	0	0.9151464	0	0	0	0	0	0	0	0	0	0	56.3222	0	51.4600339	14.5251	0.485830368	1.815243938	0	1.285517203	0.747957142	3.449171812	0.544737068	3.127251711	0.201890418	5.289800157	0.257570737	0.089139379	2.566979196	5.356475035	9.229699688	0.301150167	0.455235097	3.977919333	0.005032353	1.40124557	0	0	0	0.155480432	0.138336341	0.000277453	0	0	0	0.9151464	0	0	0	0	0	0	0	0	0	0	56.3222																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.5251	0.485830368	1.815243938	0	1.285517203	0.747957142	3.449171812	0.544737068	3.127251711	0.201890418	5.289800157	0.257570737	0.089139379	2.566979196	5.356475035	9.229699688	0.301150167	0.455235097	3.977919333	0.005032353	1.40124557	0	0	0	0.155480432	0.138336341	0.000277453	0	0	0	0.9151464	0	0	0	0	0	0	0	0	0	0	56.3222
H2663_802_0	2008	2																																COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		327.8182083	1.682894874	29.36726316	0	7.408396906	8.404391678	39.76450386	7.166307135	34.83046018	3.266192957	43.74162667	2.489588133	0.924691444	23.25244267	28.06962546	113.8479104	2.157482171	6.138228818	62.25931501	6.328900583	24.20520475	0	0	0	0	0	0	0	0	0	0											FFS Medicare 8.1%	FFS Medicare 8.1%	FFS Medicare 20.%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				0.080867397	0.080867397	0.20007562	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											26.5098	0.136091328	5.875673391	0	1.733564876	1.966627653	9.304893903	1.67691587	8.150327681	0.764289152	10.23554064	0.582563623	0.216377798	5.441071586	6.568292358	26.64041104	0.504850828	1.436345543	14.56867971	1.480962736	5.664017913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.4573	0	0	26.5098	0.136091328	5.875673391	0	1.733564876	1.966627653	9.304893903	1.67691587	8.150327681	0.764289152	10.23554064	0.582563623	0.216377798	5.441071586	6.568292358	26.64041104	0.504850828	1.436345543	14.56867971	1.480962736	5.664017913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.4573																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.5098	0.136091328	5.875673391	0	1.733564876	1.966627653	9.304893903	1.67691587	8.150327681	0.764289152	10.23554064	0.582563623	0.216377798	5.441071586	6.568292358	26.64041104	0.504850828	1.436345543	14.56867971	1.480962736	5.664017913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.4573
H2663_804_0	2008	2																																COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		327.8182083	1.682894874	29.36726316	0	7.408396906	8.404391678	39.76450386	7.166307135	34.83046018	3.266192957	43.74162667	2.489588133	0.924691444	23.25244267	28.06962546	113.8479104	2.157482171	6.138228818	62.25931501	6.328900583	24.20520475	0	0	0	0	0	0	0	0	0	0											FFS Medicare 8.1%	FFS Medicare 8.1%	FFS Medicare 20.%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				0.080868243	0.080868243	0.20008754	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											26.5101	0.136092751	5.876023442	0	1.733564876	1.966627653	9.304893903	1.67691587	8.150327681	0.764289152	10.23554064	0.582563623	0.216377798	5.441071586	6.568292358	26.64041104	0.504850828	1.436345543	14.56867971	1.480962736	5.664017913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.4579	0	0	26.5101	0.136092751	5.876023442	0	1.733564876	1.966627653	9.304893903	1.67691587	8.150327681	0.764289152	10.23554064	0.582563623	0.216377798	5.441071586	6.568292358	26.64041104	0.504850828	1.436345543	14.56867971	1.480962736	5.664017913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.4579																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.5101	0.136092751	5.876023442	0	1.733564876	1.966627653	9.304893903	1.67691587	8.150327681	0.764289152	10.23554064	0.582563623	0.216377798	5.441071586	6.568292358	26.64041104	0.504850828	1.436345543	14.56867971	1.480962736	5.664017913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.4579
H2663_805_0	2008	2																																COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		327.8182083	1.682894874	29.36726316	0	7.408396906	8.404391678	39.76450386	7.166307135	34.83046018	3.266192957	43.74162667	2.489588133	0.924691444	23.25244267	28.06962546	113.8479104	2.157482171	6.138228818	62.25931501	6.328900583	24.20520475	0	0	0	0	0	0	0	0	0	0											FFS Medicare 8.1%	FFS Medicare 8.1%	FFS Medicare 20.%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				0.0808	0.0808	0.1998	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											26.4877	0.135977906	5.86757918	0	1.733564876	1.966627653	9.304893903	1.67691587	8.150327681	0.764289152	10.23554064	0.582563623	0.216377798	5.441071586	6.568292358	26.64041104	0.504850828	1.436345543	14.56867971	1.480962736	5.664017913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.427	0	0	26.4877	0.135977906	5.86757918	0	1.733564876	1.966627653	9.304893903	1.67691587	8.150327681	0.764289152	10.23554064	0.582563623	0.216377798	5.441071586	6.568292358	26.64041104	0.504850828	1.436345543	14.56867971	1.480962736	5.664017913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.427																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.4877	0.135977906	5.86757918	0	1.733564876	1.966627653	9.304893903	1.67691587	8.150327681	0.764289152	10.23554064	0.582563623	0.216377798	5.441071586	6.568292358	26.64041104	0.504850828	1.436345543	14.56867971	1.480962736	5.664017913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.427
H2667_001_0	2008	5	h.6.	j.6.									OP Facility - Other	Professional									None	Other Coin	Other Coin									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	P	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	Coin																																																		0	None	343.2368475	6.296944653	21.66575872	1609.773498	316.4978403	11.33578704	0.198171599	3307.989301	330.809226	1132.246828	1.503753517	1.552002918	0	1561.382481	2376.805528	1921.118147	112.2060974	479.7917813	62.86819428	27867.9742	9.83362487	8.153282658	104.9158423	0	1.029596097	0	0	0	0	0	0	11.35693319	0.345170803	0	0	0	0	0	0	0	0	$150/day $750/admit	$150/day $750/admit	$125/day for days 6-100	Full Coverage	$75 Copay	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	$150 Copay	Full Coverage	"20% Coinsurance with a $2,400 MOOP"	20% Coinsurance	20% Coinsurance	$15 Urgent Care Copay;  Full Coverage on all other benefits	$15 Copay	$30 Copay	$30 Copay	$30 Copay	"20% Coinsurance with a $2,400 MOOP"	$30 Chiropractor and Podiatrist Copay; Full Coverage on all other benefits	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage; On the other line item we are seeing about an 8% Coinsurance	20% on Prosthetics									523.534456	588.0368098	707.2330654	0	17.61273652	0.2	0.2	4.05	59.13340336	0	0.18077577	0.2	0	2.544015826	15	30	25.5	30	0.170137095	1.286924131	0.2	0.2	0	0	0	0	0	0	0	0	0	0.043784494	0.2	0	0	0	0	0	0	0	0	14.9747	0.308569604	1.27689508	0	0.464532756	2.267157407	0.03963432	1.116446389	1.630156283	0	0.2718422	0.310400584	0	0.331015145	2.97100691	4.802795367	0.238437957	1.199479453	10.69621197	2.988664041	1.966724974	1.630656532	0	0	0	0	0	0	0	0	0	0.497257571	0.069034161	0	0	0	0	0	0	0	0	50.0516	0	0	14.9747	0.308569604	1.27689508	0	0.464532756	2.267157407	0.03963432	1.116446389	1.630156283	0	0.2718422	0.310400584	0	0.331015145	2.97100691	4.802795367	0.238437957	1.199479453	10.69621197	2.988664041	1.966724974	1.630656532	0	0	0	0	0	0	0	0	0	0.497257571	0.069034161	0	0	0	0	0	0	0	0	50.0516	None																																																																																			0	N/A	N/A	14.9747	0.308569604	1.27689508	0	0.464532756	2.267157407	0.03963432	1.116446389	1.630156283	0	0.2718422	0.310400584	0	0.331015145	2.97100691	4.802795367	0.238437957	1.199479453	10.69621197	2.988664041	1.966724974	1.630656532	0	0	0	0	0	0	0	0	0	0.497257571	0.069034161	0	0	0	0	0	0	0	0	50.0516
H2667_003_0	2008	6	h.6.	i.7.									OP Facility - Other	Professional									4800	Other Coin	Other Copay									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V																																																		0	None	495.3125991	15.5238898	21.77811879	1713.290144	557.5796328	8.875988135	0.510513501	3115.886183	394.3012333	7021.567517	1.849052535	5.419653992	0	491.7434922	3602.383813	3589.719168	0	0	58.09455561	161.3092568	41.65354582	6.028355236	10.61488499	0	84.9190799	0	4.174392973	0	0	0	0	17.00377967	3595.797486									$225/day	$225/day	$100/day	Full Coverage	$100 Copay	20% Coinsurance	20% Coinsurance	$40 Copay - Waived if Admitted	$150 Copay	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	$30 Urgent Care Copay;  Full Coverage on all other benefits	$15 Copay	$30 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage; On the other line item we are seeing about an 8% Coinsurance	$30 Copay on Specialist Visits and Fullcoverage on rest of services									915.04128	1158.894607	810.9371638	0	33.48651465	0.159459594	0.159459594	3.827030245	36.11716384	0	0.022539635	0.159459594	0	2.256258494	15	30	0	0	0.137987572	0	0.2	0.2	0	0	0	0	0	0	0	0	0	0.082976858	11.39157811									37.7693	1.499212682	1.471723824	0	1.555949878	1.41536146	0.081406275	0.993715889	1.186753521	0	0.041676969	0.864215823	0	0.092458369	4.502979766	8.974297921	0	0	8.016326673	0	8.330709163	1.205671047	0	0	0	0	0	0	0	0	0	1.410920214	3.413483995	0	0	0	0	0	0	0	0	82.8262	0	13.75698275	37.7693	1.499212682	1.471723824	0	1.555949878	1.41536146	0.081406275	0.993715889	1.186753521	0	0.041676969	0.864215823	0	0.092458369	4.502979766	8.974297921	0	0	8.016326673	0	8.330709163	1.205671047	0	0	0	0	0	0	0	0	0	1.410920214	3.413483995	0	0	0	0	0	0	0	0	82.8262	None																																																																																			0	0	0	37.7693	1.499212682	1.471723824	0	1.555949878	1.41536146	0.081406275	0.993715889	1.186753521	0	0.041676969	0.864215823	0	0.092458369	4.502979766	8.974297921	0	0	8.016326673	0	8.330709163	1.205671047	0	0	0	0	0	0	0	0	0	1.410920214	3.413483995	0	0	0	0	0	0	0	0	82.8262
H2667_005_0	2008	6	h.6.	j.6.									OP Facility - Other	Professional									4800	Other Coin	Other Coin									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V																																																		0	None	512.8339947	18.041358	15.56125356	1431.324185	700.3682282	10.92538051	0.283686599	3829.881988	346.5898056	8093.335335	1.070701306	4.51949187	0	399.732484	3906.909941	3285.351383	0	0	65.14317107	169.1713818	34.72604796	7.486438345	15.0735664	0	87.85007957	0	12.9749265	0	0	0	0	17.68471937	0									$225/day	$225/day	$100/day	Full Coverage	$100 Copay	20% Coinsurance	20% Coinsurance	$40 Copay - Waived if Admitted	$150 Copay	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	$30 Urgent Care Copay;  Full Coverage on all other benefits	$15 Copay	$30 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage; On the other line item we are seeing about an 8% Coinsurance	$30 Copay on Specialist Visits and Fullcoverage on rest of services									915.2835993	1158.93102	810.9626438	0	18.72405368	0.159464604	0.159464604	2.583326582	13.49505286	0	0.159464604	0.159464604	0	3.141695219	15	30	0	0	0.158903489	0	0.2	0.2	0	0	0	0	0	0	0	0	0	0.076039378	0									39.1157	1.742390786	1.051632944	0	1.092811025	1.742211475	0.045237971	0.824486329	0.389770645	0	0.17073896	0.720698981	0	0.104653136	4.883637426	8.213378458	0	0	10.35147717	0	6.945209591	1.497287669	0	0	0	0	0	0	0	0	0	1.344735061	0	0	0	0	0	0	0	0	0	80.2361	0	14.26648061	39.1157	1.742390786	1.051632944	0	1.092811025	1.742211475	0.045237971	0.824486329	0.389770645	0	0.17073896	0.720698981	0	0.104653136	4.883637426	8.213378458	0	0	10.35147717	0	6.945209591	1.497287669	0	0	0	0	0	0	0	0	0	1.344735061	0	0	0	0	0	0	0	0	0	80.2361	None																																																																																			0	N/A	N/A	39.1157	1.742390786	1.051632944	0	1.092811025	1.742211475	0.045237971	0.824486329	0.389770645	0	0.17073896	0.720698981	0	0.104653136	4.883637426	8.213378458	0	0	10.35147717	0	6.945209591	1.497287669	0	0	0	0	0	0	0	0	0	1.344735061	0	0	0	0	0	0	0	0	0	80.2361
H2667_012_0	2008	3	h.6.	j.6.									OP Facility - Other	Professional									None	Other Coin	Other Coin									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	P	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	Coin																																																		0	None	315.1596905	6.449149065	10.30123531	1451.069048	241.6694597	8.47308409	0.144561108	3213.445225	305.3092217	965.8175718	2.221442635	1.444521799	0	1528.029291	2029.562105	1840.046229	61.23260703	175.1189131	61.55862345	25931.51497	7.674712999	2.814334953	96.47559476	0	1.919791279	0	0	0	0	0	0	11.83303409	0.04104521									$100/day $750/admit	$100/day $750/admit	$125/day for days 6-100	Full Coverage	$75 Copay	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	$150 Copay	Full Coverage	"20% Coinsurance with a $2,400 MOOP"	20% Coinsurance	20% Coinsurance	$25 Urgent Care Copay;  Full Coverage on all other benefits	$10 Copay	$20 Copay	$20 Copay	$30 Copay	"20% Coinsurance with a $2,400 MOOP"	$20 Chiropractor and Podiatrist Copay; Full Coverage on all other benefits	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage; On the other line item we are seeing about an 8% Coinsurance	20% on Prosthetics									412.9175488	485.8895706	337.2560276	0	17.61273652	0.2	0.2	4.05	60.84972825	0	0.18077577	0.2	0	3.895777994	10	20	17	30	0.173705189	0.834540896	0.2	0.2	0	0	0	0	0	0	0	0	0	0.043091862	0.2									10.8446	0.261131189	0.289512808	0	0.354705043	1.694616818	0.028912222	1.084537763	1.548165264	0	0.401583002	0.28890436	0	0.496071907	1.691301754	3.066743715	0.086746193	0.437797283	10.69305231	1.803409145	1.5349426	0.562866991	0	0	0	0	0	0	0	0	0	0.50990747	0.008209042	0	0	0	0	0	0	0	0	37.6877	0	0	10.8446	0.261131189	0.289512808	0	0.354705043	1.694616818	0.028912222	1.084537763	1.548165264	0	0.401583002	0.28890436	0	0.496071907	1.691301754	3.066743715	0.086746193	0.437797283	10.69305231	1.803409145	1.5349426	0.562866991	0	0	0	0	0	0	0	0	0	0.50990747	0.008209042	0	0	0	0	0	0	0	0	37.6877	None																																																																																			0	N/A	N/A	10.8446	0.261131189	0.289512808	0	0.354705043	1.694616818	0.028912222	1.084537763	1.548165264	0	0.401583002	0.28890436	0	0.496071907	1.691301754	3.066743715	0.086746193	0.437797283	10.69305231	1.803409145	1.5349426	0.562866991	0	0	0	0	0	0	0	0	0	0.50990747	0.008209042	0	0	0	0	0	0	0	0	37.6877
H2667_013_0	2008	7	h.6.	j.6.									OP Facility - Other	Professional									None	Other Coin	Other Copay									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V																																																		0	None	499.3229514	14.63341894	22.01288613	1828.546604	547.1869965	7.556186686	0.373628052	3287.447365	403.5139917	6622.417851	1.810249581	5.138209177	0	529.8448305	3422.027377	3643.74632	0	0	57.39519314	161.1673869	35.15089038	4.712202692	18.84876823	0	87.54984582	0	3.269117634	0	0	0	0	21.23899901	3372.387808									$225/day	$225/day	$100/day	Full Coverage	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	$150 Copay	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 Urgent Care Copay;  Full Coverage on all other benefits	$15 Copay	$30 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage; On the other line item we are seeing about an 8% Coinsurance	$30 Copay on Specialist Visits and Fullcoverage on rest of services									921.3357771	1167.04262	816.6387401	0	33.72195326	0.16058073	0.16058073	4.817421894	35.05861161	0	0.01719852	0.16058073	0	2.68346179	15	30	0	0	0.139145296	0	0.2	0.2	0	0	0	0	0	0	0	0	0	0.074841728	10.27532216									38.337	1.423151964	1.498047966	0	1.537684527	1.213377972	0.059997465	1.319751742	1.178886693	0	0.031133614	0.82509738	0	0.118484863	4.277534221	9.109365799	0	0	7.986271163	0	7.030178076	0.942440538	0	0	0	0	0	0	0	0	0	1.589563395	2.887697598	0	0	0	0	0	0	0	0	81.3657	0	13.43011557	38.337	1.423151964	1.498047966	0	1.537684527	1.213377972	0.059997465	1.319751742	1.178886693	0	0.031133614	0.82509738	0	0.118484863	4.277534221	9.109365799	0	0	7.986271163	0	7.030178076	0.942440538	0	0	0	0	0	0	0	0	0	1.589563395	2.887697598	0	0	0	0	0	0	0	0	81.3657	4800																																																																																			0	N/A	N/A	38.337	1.423151964	1.498047966	0	1.537684527	1.213377972	0.059997465	1.319751742	1.178886693	0	0.031133614	0.82509738	0	0.118484863	4.277534221	9.109365799	0	0	7.986271163	0	7.030178076	0.942440538	0	0	0	0	0	0	0	0	0	1.589563395	2.887697598	0	0	0	0	0	0	0	0	81.3657
H2667_014_0	2008	5	h.6.	j.6.									OP Facility - Other	Professional									None	Other Coin	Other Coin									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V																																																		0	None	492.3566709	15.43124628	21.64815126	1696.187924	552.0138213	8.903577016	0.511080307	3084.783119	390.365282	6951.47758	1.854799871	5.436499687	0	486.8348632	3601.720232	3557.985597	0	0	58.00502348	161.2338679	41.618175	0	10.50892622	0	84.07140979	0	4.132723796	0	0	0	0	17.05663184	0									$225/day	$225/day	$100/day	Full Coverage	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	$150 Copay	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 Urgent Care Copay;  Full Coverage on all other benefits	$15 Copay	$30 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage; On the other line item we are seeing about an 8% Coinsurance	$30 Copay on Specialist Visits and Fullcoverage on rest of services									916.3652446	1160.571401	812.1105011	0	18.75055619	0.159690314	0.159690314	3.233728861	15.60132345	0	0.159690314	0.159690314	0	4.487053818	15	30	0	0	0.158704326	0	0.2	0.2	0	0	0	0	0	0	0	0	0	0.083096917	0									37.5982	1.492421926	1.46505758	0	0.862547181	1.421815011	0.081614575	0.83127935	0.507517919	0	0.296193574	0.868156343	0	0.182037853	4.50215029	8.894963991	0	0	9.205648132	0	8.323635001	0	0	0	0	0	0	0	0	0	0	1.417353514	0	0	0	0	0	0	0	0	0	77.9506	0	13.61725935	37.5982	1.492421926	1.46505758	0	0.862547181	1.421815011	0.081614575	0.83127935	0.507517919	0	0.296193574	0.868156343	0	0.182037853	4.50215029	8.894963991	0	0	9.205648132	0	8.323635001	0	0	0	0	0	0	0	0	0	0	1.417353514	0	0	0	0	0	0	0	0	0	77.9506	4800																																																																																			0	N/A	N/A	37.5982	1.492421926	1.46505758	0	0.862547181	1.421815011	0.081614575	0.83127935	0.507517919	0	0.296193574	0.868156343	0	0.182037853	4.50215029	8.894963991	0	0	9.205648132	0	8.323635001	0	0	0	0	0	0	0	0	0	0	1.417353514	0	0	0	0	0	0	0	0	0	77.9506
H2667_803_0	2008	3	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V																																																		0	None	317.9743126	5.628803798	145.0744526	1091.58257	223.4200169	9.059375859	1.121122786	2899.356717	463.1712432	796.7135122	1.988187878	1.107551319	0	704.510226	2450.23776	1877.487062	0	0	69.25117704	126.2367071	33.54664498	0	53.6434863	0	0	0	0	0	0	0	0	27.68142321	2533.576106									$150/day	$150/day	Full Coverage	Full Coverage	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	$150 Copay	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 Urgent Care Copay;  Full Coverage on all other benefits	$10 Copay	$20 Copay	$20 Copay	20% Coinsurance	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage; On the other line item we are seeing about an 8% Coinsurance	$20 Copay on Specialist Visits and Fullcoverage on rest of services									693.5670151	879.6220603	0	0	38.12530943	0.181549093	0.181549093	5.446472776	68.96509468	0	0.009077455	0.181549093	0	8.500659248	10	20	0	0	0.160662461	0	0.2	0.2	0	0	0	0	0	0	0	0	0	0.06982959	5.879280104									18.378	0.412601666	0	0	0.709829773	1.644721466	0.203538824	1.315938952	2.661887387	0	0.018047685	0.201074937	0	0.499066781	2.0418648	3.129145104	0	0	11.12606452	0	6.709328996	0	0	0	0	0	0	0	0	0	0	1.932982426	1.241300299	0	0	0	0	0	0	0	0	52.2254	0	3.714549334	18.378	0.412601666	0	0	0.709829773	1.644721466	0.203538824	1.315938952	2.661887387	0	0.018047685	0.201074937	0	0.499066781	2.0418648	3.129145104	0	0	11.12606452	0	6.709328996	0	0	0	0	0	0	0	0	0	0	1.932982426	1.241300299	0	0	0	0	0	0	0	0	52.2254	4800																																																																																			0	0	0	18.378	0.412601666	0	0	0.709829773	1.644721466	0.203538824	1.315938952	2.661887387	0	0.018047685	0.201074937	0	0.499066781	2.0418648	3.129145104	0	0	11.12606452	0	6.709328996	0	0	0	0	0	0	0	0	0	0	1.932982426	1.241300299	0	0	0	0	0	0	0	0	52.2254
H2667_804_0	2008	3	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V																																																		0	None	442.347982	7.238826494	471.9714874	1345.296532	316.9944773	8.250017659	0.816019301	2279.889841	469.1375741	6144.6333	1.965411642	3.308231324	0	358.0885534	3190.574735	4067.418756	0	0	60.23610789	162.1851884	41.90529267	0	9.501520489	0	143.7104974	0	45.48852934	0	0	0	0	19.11607892	3615.568561									$150/day	$150/day	Full Coverage	Full Coverage	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	$150 Copay	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 Urgent Care Copay;  Full Coverage on all other benefits	$10 Copay	$20 Copay	$20 Copay	20% Coinsurance	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage; On the other line item we are seeing about an 8% Coinsurance	$20 Copay on Specialist Visits and Fullcoverage on rest of services									740.7527355	938.1519706	0	0	40.66216138	0.19362934	0.19362934	5.808880198	43.05777299	0	0.029579949	0.19362934	0	2.305184586	10	20	0	0	0.156987143	0	0.2	0.2	0	0	0	0	0	0	0	0	0	0.103891526	7.815518004									27.3059	0.565926612	0	0	1.07414005	1.597445474	0.158005279	1.103633913	1.683334931	0	0.058136776	0.640570648	0	0.068788351	2.658812279	6.77903126	0	0	9.456294483	0	8.381058533	0	0	0	0	0	0	0	0	0	0	1.985998607	2.354795098	0	0	0	0	0	0	0	0	65.8718	0	0.643578689	27.3059	0.565926612	0	0	1.07414005	1.597445474	0.158005279	1.103633913	1.683334931	0	0.058136776	0.640570648	0	0.068788351	2.658812279	6.77903126	0	0	9.456294483	0	8.381058533	0	0	0	0	0	0	0	0	0	0	1.985998607	2.354795098	0	0	0	0	0	0	0	0	65.8718	4800																																																																																			0	0	0	27.3059	0.565926612	0	0	1.07414005	1.597445474	0.158005279	1.103633913	1.683334931	0	0.058136776	0.640570648	0	0.068788351	2.658812279	6.77903126	0	0	9.456294483	0	8.381058533	0	0	0	0	0	0	0	0	0	0	1.985998607	2.354795098	0	0	0	0	0	0	0	0	65.8718
H2667_805_0	2008	3	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V																																																		0	None	317.9743126	5.628803798	145.0744526	1091.58257	223.4200169	9.059375859	1.121122786	2899.356717	463.1712432	796.7135122	1.988187878	1.107551319	0	704.510226	2450.23776	1877.487062	0	0	69.25117704	126.2367071	33.54664498	0	53.6434863	0	0	0	0	0	0	0	0	27.68142321	2533.576106									$150/day	$150/day	Full Coverage	Full Coverage	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	$150 Copay	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 Urgent Care Copay;  Full Coverage on all other benefits	$10 Copay	$20 Copay	$20 Copay	20% Coinsurance	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage; On the other line item we are seeing about an 8% Coinsurance	$20 Copay on Specialist Visits and Fullcoverage on rest of services									693.5670151	879.6220603	0	0	38.12530943	0.181549093	0.181549093	5.446472776	68.96509468	0	0.009077455	0.181549093	0	8.500659248	10	20	0	0	0.160662461	0	0.2	0.2	0	0	0	0	0	0	0	0	0	0.06982959	5.879280104									18.378	0.412601666	0	0	0.709829773	1.644721466	0.203538824	1.315938952	2.661887387	0	0.018047685	0.201074937	0	0.499066781	2.0418648	3.129145104	0	0	11.12606452	0	6.709328996	0	0	0	0	0	0	0	0	0	0	1.932982426	1.241300299	0	0	0	0	0	0	0	0	52.2254	0	3.714549334	18.378	0.412601666	0	0	0.709829773	1.644721466	0.203538824	1.315938952	2.661887387	0	0.018047685	0.201074937	0	0.499066781	2.0418648	3.129145104	0	0	11.12606452	0	6.709328996	0	0	0	0	0	0	0	0	0	0	1.932982426	1.241300299	0	0	0	0	0	0	0	0	52.2254	4800																																																																																			0	0	0	18.378	0.412601666	0	0	0.709829773	1.644721466	0.203538824	1.315938952	2.661887387	0	0.018047685	0.201074937	0	0.499066781	2.0418648	3.129145104	0	0	11.12606452	0	6.709328996	0	0	0	0	0	0	0	0	0	0	1.932982426	1.241300299	0	0	0	0	0	0	0	0	52.2254
H2667_806_0	2008	4	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V																																																		0	None	442.347982	7.238826494	471.9714874	1345.296532	316.9944773	8.250017659	0.816019301	2279.889841	469.1375741	6144.6333	1.965411642	3.308231324	0	358.0885534	3190.574735	4067.418756	0	0	60.23610789	162.1851884	41.90529267	0	9.501520489	0	143.7104974	0	45.48852934	0	0	0	0	19.11607892	3615.568561									$150/day	$150/day	Full Coverage	Full Coverage	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	$150 Copay	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 Urgent Care Copay;  Full Coverage on all other benefits	$10 Copay	$20 Copay	$20 Copay	20% Coinsurance	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage; On the other line item we are seeing about an 8% Coinsurance	$20 Copay on Specialist Visits and Fullcoverage on rest of services									740.7527355	938.1519706	0	0	40.66216138	0.19362934	0.19362934	5.808880198	43.05777299	0	0.029579949	0.19362934	0	2.305184586	10	20	0	0	0.156987143	0	0.2	0.2	0	0	0	0	0	0	0	0	0	0.103891526	7.815518004									27.3059	0.565926612	0	0	1.07414005	1.597445474	0.158005279	1.103633913	1.683334931	0	0.058136776	0.640570648	0	0.068788351	2.658812279	6.77903126	0	0	9.456294483	0	8.381058533	0	0	0	0	0	0	0	0	0	0	1.985998607	2.354795098	0	0	0	0	0	0	0	0	65.8718	0	0.643578689	27.3059	0.565926612	0	0	1.07414005	1.597445474	0.158005279	1.103633913	1.683334931	0	0.058136776	0.640570648	0	0.068788351	2.658812279	6.77903126	0	0	9.456294483	0	8.381058533	0	0	0	0	0	0	0	0	0	0	1.985998607	2.354795098	0	0	0	0	0	0	0	0	65.8718	4800																																																																																			0	0	0	27.3059	0.565926612	0	0	1.07414005	1.597445474	0.158005279	1.103633913	1.683334931	0	0.058136776	0.640570648	0	0.068788351	2.658812279	6.77903126	0	0	9.456294483	0	8.381058533	0	0	0	0	0	0	0	0	0	0	1.985998607	2.354795098	0	0	0	0	0	0	0	0	65.8718
H2667_807_0	2008	3	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V																																																		0	None	317.9743126	5.628803798	145.0744526	1091.58257	223.4200169	9.059375859	1.121122786	2899.356717	463.1712432	796.7135122	1.988187878	1.107551319	0	704.510226	2450.23776	1877.487062	0	0	69.25117704	126.2367071	33.54664498	0	53.6434863	0	0	0	0	0	0	0	0	27.68142321	2533.576106									$150/day	$150/day	Full Coverage	Full Coverage	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	$150 Copay	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 Urgent Care Copay;  Full Coverage on all other benefits	$10 Copay	$20 Copay	$20 Copay	20% Coinsurance	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage; On the other line item we are seeing about an 8% Coinsurance	$20 Copay on Specialist Visits and Fullcoverage on rest of services									693.5670151	879.6220603	0	0	38.12530943	0.181549093	0.181549093	5.446472776	68.96509468	0	0.009077455	0.181549093	0	8.500659248	10	20	0	0	0.160662461	0	0.2	0.2	0	0	0	0	0	0	0	0	0	0.06982959	5.879280104									18.378	0.412601666	0	0	0.709829773	1.644721466	0.203538824	1.315938952	2.661887387	0	0.018047685	0.201074937	0	0.499066781	2.0418648	3.129145104	0	0	11.12606452	0	6.709328996	0	0	0	0	0	0	0	0	0	0	1.932982426	1.241300299	0	0	0	0	0	0	0	0	52.2254	0	3.714549334	18.378	0.412601666	0	0	0.709829773	1.644721466	0.203538824	1.315938952	2.661887387	0	0.018047685	0.201074937	0	0.499066781	2.0418648	3.129145104	0	0	11.12606452	0	6.709328996	0	0	0	0	0	0	0	0	0	0	1.932982426	1.241300299	0	0	0	0	0	0	0	0	52.2254	4800																																																																																			0	0	0	18.378	0.412601666	0	0	0.709829773	1.644721466	0.203538824	1.315938952	2.661887387	0	0.018047685	0.201074937	0	0.499066781	2.0418648	3.129145104	0	0	11.12606452	0	6.709328996	0	0	0	0	0	0	0	0	0	0	1.932982426	1.241300299	0	0	0	0	0	0	0	0	52.2254
H2667_808_0	2008	3	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V																																																		0	None	317.9743126	5.628803798	145.0744526	1091.58257	223.4200169	9.059375859	1.121122786	2899.356717	463.1712432	796.7135122	1.988187878	1.107551319	0	704.510226	2450.23776	1877.487062	0	0	69.25117704	126.2367071	33.54664498	0	53.6434863	0	0	0	0	0	0	0	0	27.68142321	2533.576106									$150/day	$150/day	Full Coverage	Full Coverage	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	$150 Copay	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 Urgent Care Copay;  Full Coverage on all other benefits	$10 Copay	$20 Copay	$20 Copay	20% Coinsurance	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage; On the other line item we are seeing about an 8% Coinsurance	$20 Copay on Specialist Visits and Fullcoverage on rest of services									693.5670151	879.6220603	0	0	38.12530943	0.181549093	0.181549093	5.446472776	68.96509468	0	0.009077455	0.181549093	0	8.500659248	10	20	0	0	0.160662461	0	0.2	0.2	0	0	0	0	0	0	0	0	0	0.06982959	5.879280104									18.378	0.412601666	0	0	0.709829773	1.644721466	0.203538824	1.315938952	2.661887387	0	0.018047685	0.201074937	0	0.499066781	2.0418648	3.129145104	0	0	11.12606452	0	6.709328996	0	0	0	0	0	0	0	0	0	0	1.932982426	1.241300299	0	0	0	0	0	0	0	0	52.2254	0	3.714549334	18.378	0.412601666	0	0	0.709829773	1.644721466	0.203538824	1.315938952	2.661887387	0	0.018047685	0.201074937	0	0.499066781	2.0418648	3.129145104	0	0	11.12606452	0	6.709328996	0	0	0	0	0	0	0	0	0	0	1.932982426	1.241300299	0	0	0	0	0	0	0	0	52.2254	4800																																																																																			0	0	0	18.378	0.412601666	0	0	0.709829773	1.644721466	0.203538824	1.315938952	2.661887387	0	0.018047685	0.201074937	0	0.499066781	2.0418648	3.129145104	0	0	11.12606452	0	6.709328996	0	0	0	0	0	0	0	0	0	0	1.932982426	1.241300299	0	0	0	0	0	0	0	0	52.2254
H2667_809_0	2008	3	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V																																																		0	None	442.347982	7.238826494	471.9714874	1345.296532	316.9944773	8.250017659	0.816019301	2279.889841	469.1375741	6144.6333	1.965411642	3.308231324	0	358.0885534	3190.574735	4067.418756	0	0	60.23610789	162.1851884	41.90529267	0	9.501520489	0	143.7104974	0	45.48852934	0	0	0	0	19.11607892	3615.568561									$150/day	$150/day	Full Coverage	Full Coverage	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	$150 Copay	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 Urgent Care Copay;  Full Coverage on all other benefits	$10 Copay	$20 Copay	$20 Copay	20% Coinsurance	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage; On the other line item we are seeing about an 8% Coinsurance	$20 Copay on Specialist Visits and Fullcoverage on rest of services									740.7527355	938.1519706	0	0	40.66216138	0.19362934	0.19362934	5.808880198	43.05777299	0	0.029579949	0.19362934	0	2.305184586	10	20	0	0	0.156987143	0	0.2	0.2	0	0	0	0	0	0	0	0	0	0.103891526	7.815518004									27.3059	0.565926612	0	0	1.07414005	1.597445474	0.158005279	1.103633913	1.683334931	0	0.058136776	0.640570648	0	0.068788351	2.658812279	6.77903126	0	0	9.456294483	0	8.381058533	0	0	0	0	0	0	0	0	0	0	1.985998607	2.354795098	0	0	0	0	0	0	0	0	65.8718	0	0.643578689	27.3059	0.565926612	0	0	1.07414005	1.597445474	0.158005279	1.103633913	1.683334931	0	0.058136776	0.640570648	0	0.068788351	2.658812279	6.77903126	0	0	9.456294483	0	8.381058533	0	0	0	0	0	0	0	0	0	0	1.985998607	2.354795098	0	0	0	0	0	0	0	0	65.8718	4800																																																																																			0	0	0	27.3059	0.565926612	0	0	1.07414005	1.597445474	0.158005279	1.103633913	1.683334931	0	0.058136776	0.640570648	0	0.068788351	2.658812279	6.77903126	0	0	9.456294483	0	8.381058533	0	0	0	0	0	0	0	0	0	0	1.985998607	2.354795098	0	0	0	0	0	0	0	0	65.8718
H2667_810_0	2008	4	h.6.	i.7.									OP Facility - Other	Professional									None	Other Coin	Other Copay									A	A	A	V	T	Coin	Coin	V	P	P	Coin	Coin	P	P	V	V	V	V	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P	P	Coin	V																																																		0	None	442.347982	7.238826494	471.9714874	1345.296532	316.9944773	8.250017659	0.816019301	2279.889841	469.1375741	6144.6333	1.965411642	3.308231324	0	358.0885534	3190.574735	4067.418756	0	0	60.23610789	162.1851884	41.90529267	0	9.501520489	0	143.7104974	0	45.48852934	0	0	0	0	19.11607892	3615.568561									$150/day	$150/day	Full Coverage	Full Coverage	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	$150 Copay	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 Urgent Care Copay;  Full Coverage on all other benefits	$10 Copay	$20 Copay	$20 Copay	20% Coinsurance	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit	N/A	Full Coverage; On the other line item we are seeing about an 8% Coinsurance	$20 Copay on Specialist Visits and Fullcoverage on rest of services									740.7527355	938.1519706	0	0	40.66216138	0.19362934	0.19362934	5.808880198	43.05777299	0	0.029579949	0.19362934	0	2.305184586	10	20	0	0	0.156987143	0	0.2	0.2	0	0	0	0	0	0	0	0	0	0.103891526	7.815518004									27.3059	0.565926612	0	0	1.07414005	1.597445474	0.158005279	1.103633913	1.683334931	0	0.058136776	0.640570648	0	0.068788351	2.658812279	6.77903126	0	0	9.456294483	0	8.381058533	0	0	0	0	0	0	0	0	0	0	1.985998607	2.354795098	0	0	0	0	0	0	0	0	65.8718	0	0.643578689	27.3059	0.565926612	0	0	1.07414005	1.597445474	0.158005279	1.103633913	1.683334931	0	0.058136776	0.640570648	0	0.068788351	2.658812279	6.77903126	0	0	9.456294483	0	8.381058533	0	0	0	0	0	0	0	0	0	0	1.985998607	2.354795098	0	0	0	0	0	0	0	0	65.8718	4800																																																																																			0	0	0	27.3059	0.565926612	0	0	1.07414005	1.597445474	0.158005279	1.103633913	1.683334931	0	0.058136776	0.640570648	0	0.068788351	2.658812279	6.77903126	0	0	9.456294483	0	8.381058533	0	0	0	0	0	0	0	0	0	0	1.985998607	2.354795098	0	0	0	0	0	0	0	0	65.8718
H2672_001_0	2008	8																					2000											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	O	O	P	P	P	P	P	P	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1787.258082	34.3531635	1113.300643	0	239.9849216	12.37330916	1.922365495	432.8829409	532.6319357	0	24.05080558	0	0	1014.472497	6410.022546	14419.47216	232.0101902	723.6988803	4009.782401	855.5074892	26.19800277	0	0	0	578.3740336	0	0.102278535	0	0	0	624.8117441											1a $165 days 1-5	1b $100 days 1-90	2 $100 days 8-100		10a $100	11a 20%	11b 20%	"4a $50, 4b $10"	"9a $100,9b $100"		8b $100			9d $30	"17a $5,7a $5,7f $5"	"17a $30,18a $30,7b $30,7d $30,7f $30"	7e $30	"7c $30,7i $30"	8b $100	7g $30	20%				17a $5		18a $5				"14c $5,7f $30"											74.78624908	68.41597899	46.77723038	0	63.83816924	0.136831958	0.136831958	34.20798949	68.41597899	0	0.070441765	0	0	1.155756837	2.075692271	6.794671059	20.5247937	20.2326871	11.73298509	0.14493855	0.149412023	0	0	0	3.420194022	0	3.420798949	0	0	0	3.048343429											11.1385	0.195858776	4.339760053	0	1.27668317	1.693064119	0.263041035	1.234004591	3.036711277	0	1.694181207	0	0	0.09770696	1.108769521	8.164630847	0.396830108	1.22019775	3.920559759	0.010333001	3.914296601	0	0	0	0.164845951	0	2.92E-05	0	0	0	0.158720065	0	0	0	0	0	0	0	0	0	0	44.0288	0	20.32573422	11.1385	0.195858776	4.339760053	0	1.27668317	1.693064119	0.263041035	1.234004591	3.036711277	0	1.694181207	0	0	0.09770696	1.108769521	8.164630847	0.396830108	1.22019775	3.920559759	0.010333001	3.914296601	0	0	0	0.164845951	0	2.92E-05	0	0	0	0.158720065	0	0	0	0	0	0	0	0	0	0	44.0288																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.1385	0.195858776	4.339760053	0	1.27668317	1.693064119	0.263041035	1.234004591	3.036711277	0	1.694181207	0	0	0.09770696	1.108769521	8.164630847	0.396830108	1.22019775	3.920559759	0.010333001	3.914296601	0	0	0	0.164845951	0	2.92E-05	0	0	0	0.158720065	0	0	0	0	0	0	0	0	0	0	44.0288
H2672_003_0	2008	8																					2750											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	O	O	P	P	P	P	P	P	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1380.687777	26.53841291	860.0439999	0	185.4233553	9.577541981	1.470358141	334.4091985	411.4673816	0	18.0150391	0	0	783.6975483	4951.853272	16057.33619	179.2318844	559.0699007	3097.62625	660.8943305	20.27852599	0	0	0	446.8041	0	0.079168551	0	0	0	482.9071612											1a $180 days 1-7	1b $180 days 1-7	2 $90 days 4-100		10a $150	11a 20%	11b 20%	"4a $50, 4b $15"	"9a $150,9b $150"		8b $100			9d $30	"17a $10,7a $10,7f $10"	"17a $30,18a $30,7b $30,7d $30,7f $30"	7e $30	"7c $30,7i $30"	8b $100	7g $30	20%				17a $10		18a $10				"14c $10,7f $30"											109.2129506	109.2566239	61.10275627	0	111.0439096	0.158696425	0.158696425	39.67410634	119.022319	0	0.083625862	0	0	1.367670718	4.814736972	5.467312837	23.80446381	23.53343781	13.60780639	0.206149296	0.173286668	0	0	0	7.933415309	0	7.934821268	0	0	0	10.88017045											12.5657	0.241624783	4.379254909	0	1.715844525	1.519921676	0.233340581	1.105615509	4.081150164	0	1.506523183	0	0	0.089320016	1.986822585	7.315873355	0.355543242	1.096403061	3.51265819	0.011353575	3.513998191	0	0	0	0.295390207	0	5.23E-05	0	0	0	0.437842685	0	0	0	0	0	0	0	0	0	0	45.9643	0	11.96302394	12.5657	0.241624783	4.379254909	0	1.715844525	1.519921676	0.233340581	1.105615509	4.081150164	0	1.506523183	0	0	0.089320016	1.986822585	7.315873355	0.355543242	1.096403061	3.51265819	0.011353575	3.513998191	0	0	0	0.295390207	0	5.23E-05	0	0	0	0.437842685	0	0	0	0	0	0	0	0	0	0	45.9643																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.5657	0.241624783	4.379254909	0	1.715844525	1.519921676	0.233340581	1.105615509	4.081150164	0	1.506523183	0	0	0.089320016	1.986822585	7.315873355	0.355543242	1.096403061	3.51265819	0.011353575	3.513998191	0	0	0	0.295390207	0	5.23E-05	0	0	0	0.437842685	0	0	0	0	0	0	0	0	0	0	45.9643
H2672_007_0	2008	8																					3250											D	D	D	V	COIN	COIN	COIN	V	V	COIN	COIN	COIN	COIN	COIN	P	P	COIN	COIN	COIN	P	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1675.828861	32.21136525	1043.890285	0	8.295143111	11.72949774	1.815062448	405.8942434	499.4242181	0	22.55132291	0.156412575	0.356097037	12.32503642	6010.380309	13522.87639	1.529067345	5.165798807	34.13548567	802.1696227	24.8348611	0	0	0	542.3155129	0	0.09695675	0	0	0	587.4013445											1a $300 days 1-7	1b $300 days 1-7	2 $100 days 8-100		10a 20%	11a 20%	11b 20%	"4a $50, 4b 20%"	"9a $300, 9b $300"		8a 20%	9a 20%	12 20%	9d 20%	"17a $15,7a $15,7f $15"	"17a $35,18a $35,7b $35,7d $35,7f $35"	7e 20%	"7c 20%,7i 20%"	8a 20%	"7e 20%,7g $35"	20%				17a $15		18a $15				"14c $15,7f $35"											161.9400116	162.0400868	48.27697484	0	0.13776342	0.141218985	0.141218985	35.30474624	211.8284774	0	0.133899873	0.141218985	0.141218985	0.133235372	6.426725741	8.183653373	0.141218985	0.141218985	0.13079726	0.236593662	0.154619321	0	0	0	14.76621608	0	10.59142387	0	0	0	12.85380119											22.6153	0.434961035	4.199655418	0	1.142767282	1.656427765	0.256321276	1.194166105	8.816022643	0	3.01961928	0.022088425	0.050287662	1.642130806	3.218922154	9.222211082	0.215933338	0.729508864	4.464827993	0.015815687	3.839949369	0	0	0	0.667329004	0	8.56E-05	0	0	0	0.629195009	0	0	0	0	0	0	0	0	0	0	68.0535	0	28.32661653	22.6153	0.434961035	4.199655418	0	1.142767282	1.656427765	0.256321276	1.194166105	8.816022643	0	3.01961928	0.022088425	0.050287662	1.642130806	3.218922154	9.222211082	0.215933338	0.729508864	4.464827993	0.015815687	3.839949369	0	0	0	0.667329004	0	8.56E-05	0	0	0	0.629195009	0	0	0	0	0	0	0	0	0	0	68.0535																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.6153	0.434961035	4.199655418	0	1.142767282	1.656427765	0.256321276	1.194166105	8.816022643	0	3.01961928	0.022088425	0.050287662	1.642130806	3.218922154	9.222211082	0.215933338	0.729508864	4.464827993	0.015815687	3.839949369	0	0	0	0.667329004	0	8.56E-05	0	0	0	0.629195009	0	0	0	0	0	0	0	0	0	0	68.0535
H2672_801_0	2008	6																																COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		235.3895254	3.217116793	30.61174084	0	8.238774742	11.64979174	1.80272847	11.29444269	46.98636525	4.833215128	22.39807886	0.155349697	0.353677235	11.72817186	30.73639065	109.0545426	1.518676804	5.130695416	33.90352323	2.416976423	24.66609962	0	0	0	0	0	0	0	0	0	0											FFS Medicare 8.6%	FFS Medicare 8.6%	FFS Medicare 19.2%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				0.086133149	0.086133149	0.191669576	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											20.2748	0.277100399	5.867339396	0	1.92787329	2.726051268	0.421838462	2.642899591	10.99480947	1.13097234	5.241150454	0.036351829	0.082760473	2.744392215	7.192315411	25.51876298	0.355370372	1.200582727	7.933424437	0.565572483	5.771867311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.9063	0	0	20.2748	0.277100399	5.867339396	0	1.92787329	2.726051268	0.421838462	2.642899591	10.99480947	1.13097234	5.241150454	0.036351829	0.082760473	2.744392215	7.192315411	25.51876298	0.355370372	1.200582727	7.933424437	0.565572483	5.771867311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.9063																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.2748	0.277100399	5.867339396	0	1.92787329	2.726051268	0.421838462	2.642899591	10.99480947	1.13097234	5.241150454	0.036351829	0.082760473	2.744392215	7.192315411	25.51876298	0.355370372	1.200582727	7.933424437	0.565572483	5.771867311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.9063
H2672_802_0	2008	6																																COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		235.3895254	3.217116793	30.61174084	0	8.238774742	11.64979174	1.80272847	11.29444269	46.98636525	4.833215128	22.39807886	0.155349697	0.353677235	11.72817186	30.73639065	109.0545426	1.518676804	5.130695416	33.90352323	2.416976423	24.66609962	0	0	0	0	0	0	0	0	0	0											FFS Medicare 8.6%	FFS Medicare 8.6%	FFS Medicare 19.2%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				0.086133458	0.086133458	0.191669253	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											20.2749	0.277101394	5.867329501	0	1.92787329	2.726051268	0.421838462	2.642899591	10.99480947	1.13097234	5.241150454	0.036351829	0.082760473	2.744392215	7.192315411	25.51876298	0.355370372	1.200582727	7.933424437	0.565572483	5.771867311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.9063	0	0	20.2749	0.277101394	5.867329501	0	1.92787329	2.726051268	0.421838462	2.642899591	10.99480947	1.13097234	5.241150454	0.036351829	0.082760473	2.744392215	7.192315411	25.51876298	0.355370372	1.200582727	7.933424437	0.565572483	5.771867311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.9063																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.2749	0.277101394	5.867329501	0	1.92787329	2.726051268	0.421838462	2.642899591	10.99480947	1.13097234	5.241150454	0.036351829	0.082760473	2.744392215	7.192315411	25.51876298	0.355370372	1.200582727	7.933424437	0.565572483	5.771867311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.9063
H2672_803_0	2008	6																																COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		235.3895254	3.217116793	30.61174084	0	8.238774742	11.64979174	1.80272847	11.29444269	46.98636525	4.833215128	22.39807886	0.155349697	0.353677235	11.72817186	30.73639065	109.0545426	1.518676804	5.130695416	33.90352323	2.416976423	24.66609962	0	0	0	0	0	0	0	0	0	0											FFS Medicare 8.6%	FFS Medicare 8.6%	FFS Medicare 19.2%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				0.086133458	0.086133458	0.191669253	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											20.2749	0.277101394	5.867329501	0	1.92787329	2.726051268	0.421838462	2.642899591	10.99480947	1.13097234	5.241150454	0.036351829	0.082760473	2.744392215	7.192315411	25.51876298	0.355370372	1.200582727	7.933424437	0.565572483	5.771867311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.9063	0	0	20.2749	0.277101394	5.867329501	0	1.92787329	2.726051268	0.421838462	2.642899591	10.99480947	1.13097234	5.241150454	0.036351829	0.082760473	2.744392215	7.192315411	25.51876298	0.355370372	1.200582727	7.933424437	0.565572483	5.771867311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.9063																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.2749	0.277101394	5.867329501	0	1.92787329	2.726051268	0.421838462	2.642899591	10.99480947	1.13097234	5.241150454	0.036351829	0.082760473	2.744392215	7.192315411	25.51876298	0.355370372	1.200582727	7.933424437	0.565572483	5.771867311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.9063
H2701_001_0	2008	2																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	195.608	3.168	394.472	0	207.808	10.888	7.584	324.352	328.56	2761.728	1535.28	85.392	1.656	548.12	2647.8	2373.96	106.824	287.328	0	878.456	922.52	417.872	0	0	221.936	0	95.12	0	0	0	0											PBP: 1A IP Acute: $100 per admit	1B IP Psych: $100 per admit	2 SNF: $30	6 Home Health: $0	10A Ambulance: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $50	8A OP C/D/T: $10	8B OP X-Ray: $10	9A OP Hospital: $10	12 Renal Dialysis: $10	"3 CORF: $10, 5 Partial Hosp: $10, 9C OP Substance Abuse: $10, 9D Cardiac Rehab: $10"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $10, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $10, 7D Physician Specialist: $10, 7F Podiatry: $10"	"7E Mental Health: $10, 7H Psychiatric: $10"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	Included in i.2.	"7G Other Health Care: $10, 18A Medicare Covered Hearing Exams: $10"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: Not Covered, Routine: Not Covered"	18A Routine Hearing Exams: $10	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											100	100	30	0	100	0.200000346	0.199985923	49.29829321	50	10	10	10	10	10	10	10	10	10	0	10	11.645	10	0	0	10	0	10	0	0	0	0											1.6301	0.0264	0.98618	0	1.731733333	2.177603769	1.516693242	1.3325	1.369	2.30144	1.2794	0.07116	0.00138	0.456766667	2.2065	1.9783	0.08902	0.23944	0	0.732046667	0.895228783	0.348226667	0	0	0.184946667	0	0.079266667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.6333	0	0	1.6301	0.0264	0.98618	0	1.731733333	2.177603769	1.516693242	1.3325	1.369	2.30144	1.2794	0.07116	0.00138	0.456766667	2.2065	1.9783	0.08902	0.23944	0	0.732046667	0.895228783	0.348226667	0	0	0.184946667	0	0.079266667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.6333	0	PBP: 1A IP Acute: $150 per admit	1B IP Psych: $150 per admit	2 SNF: $30	6 Home Health: $25	10A Ambulance: $100	11A DME: 50%	"11B Prosthetic Medical Supplies: 50%, 11C Diabetes Monitoring Supplies: 50%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $150	8A OP C/D/T: $25	8B OP X-Ray: $25	9A OP Hospital: $25	12 Renal Dialysis: $25	"3 CORF: $25, 5 Partial Hosp: $25, 9C OP Substance Abuse: $25, 9D Cardiac Rehab: $25"	"7A PCP: $25, 14B Immunizations: $0, 14C Routine Physical Exams: $25, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $25, 7D Physician Specialist: $25, 7F Podiatry: $25"	"7E Mental Health: $25, 7H Psychiatric: $25"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	Included in i.2.	"7G Other Health Care: $25, 18A Medicare Covered Hearing Exams: $25"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $25"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $25	"17B Eye Wear: Medicare Covered: Not Covered, Routine: Not Covered"	18A Routine Hearing Exams: $25	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											1.786	0.0449	0.5788	0.4394	0.4502	1.4151	0.984	0.3811	1.2288	1.4959	0.8316	0.0463	0.0009	0.2969	1.4929	1.3327	0.0597	0.1621	0	0.5004	0.4652	0.2358	0	0	0.1252	0	0.0537	0	0	0	0											14.4077	0	0	3.4161	0.071275	1.56498	0.439404167	2.181983333	3.592661039	2.500651241	1.713633333	2.5978	3.7973775	2.1110125	0.117414167	0.002275833	0.7536625	3.699429167	3.311025	0.148745	0.401560833	0	1.232488333	1.360429495	0.584005833	0	0	0.310171667	0	0.132933333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.041
H2701_003_0	2008	2																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	195.128	3.16	397.84	0	205.488	10.872	7.568	307.84	311.784	2598.48	1444.528	80.344	1.56	515.712	2502.32	2257.984	104.872	281.912	0	854.856	885.584	394.824	0	0	209.52	0	89.792	0	0	0	0											PBP: 1A IP Acute: $200 per admit	1B IP Psych: $200 per admit	2 SNF: $124	6 Home Health: $0	10A Ambulance: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $40"	9B ASC Services: $150	8A OP C/D/T: $20	8B OP X-Ray: $20	9A OP Hospital: $20	12 Renal Dialysis: $20	"3 CORF: $20, 5 Partial Hosp: $20, 9C OP Substance Abuse: $20, 9D Cardiac Rehab: $20"	"7A PCP: $20, 14B Immunizations: $0, 14C Routine Physical Exams: $20, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $20, 7D Physician Specialist: $20, 7F Podiatry: $20"	"7E Mental Health: $20, 7H Psychiatric: $20"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	Included in i.2.	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $20"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $20, 17A Medicare Covered Eye Exams: $20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $20	"17B Eye Wear: Medicare Covered: Not Covered, Routine: Not Covered"	18A Routine Hearing Exams: $20	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											200	200	124	0	100	0.20000048	0.199979137	49.72089397	150	20	20	20	20	20	20	20	20	20	0	20	23.284	20	0	0	20	0	20	0	0	0	0											3.2521	0.052666667	4.111013333	0	1.7124	2.174405217	1.513442108	1.275506667	3.8973	4.3308	2.407546667	0.133906667	0.0026	0.85952	4.170533333	3.763306667	0.174786667	0.469853333	0	1.42476	1.718328155	0.65804	0	0	0.3492	0	0.149653333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.6017	0	0	3.2521	0.052666667	4.111013333	0	1.7124	2.174405217	1.513442108	1.275506667	3.8973	4.3308	2.407546667	0.133906667	0.0026	0.85952	4.170533333	3.763306667	0.174786667	0.469853333	0	1.42476	1.718328155	0.65804	0	0	0.3492	0	0.149653333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.6017	0	PBP: 1A IP Acute: $900 per admit	1B IP Psych: $900 per admit	2 SNF: $75	6 Home Health: $0	10A Ambulance: $100	11A DME: 50%	"11B Prosthetic Medical Supplies: 50%, 11C Diabetes Monitoring Supplies: 50%"	"4A ER: $50, 4B Urgent Care: $40"	9B ASC Services: $300	8A OP C/D/T: $40	8B OP X-Ray: $40	9A OP Hospital: $40	12 Renal Dialysis: $40	"3 CORF: $40, 5 Partial Hosp: $40, 9C OP Substance Abuse: $40, 9D Cardiac Rehab: $40"	"7A PCP: $40, 14B Immunizations: $0, 14C Routine Physical Exams: $40, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $40, 7D Physician Specialist: $40, 7F Podiatry: $40"	"7E Mental Health: $40, 7H Psychiatric: $40"	"7C Occupational Therapy: $40, 7I Physical and Speech Therapy: $40"	Included in i.2.	"7G Other Health Care: $40, 18A Medicare Covered Hearing Exams: $40"	15 Part B Drugs: 30%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $40, 17A Medicare Covered Eye Exams: $40"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $40	"17B Eye Wear: Medicare Covered: Not Covered, Routine: Not Covered"	18A Routine Hearing Exams: $40	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											3.9798	0.0697	1.4285	0	0.4452	1.4139	0.9845	0.362	2.3121	2.252	1.2519	0.0696	0.0014	0.447	2.419	2.2343	0.1	0.8226	0	0.8806	0.6702	0.3802	0	0	0.2018	0	0.0865	0	0	0	0											22.813	0	0	7.2319	0.122416667	5.539500833	0	2.157616667	3.588335899	2.497973021	1.637555	6.20945	6.582813333	3.659466667	0.20354	0.003953333	1.306473333	6.589566667	5.997613333	0.274793333	1.292493333	0	2.305366667	2.388534164	1.03826	0	0	0.550966667	0	0.236126667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.4147
H2701_805_0	2008	1																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	138.2	1.608	26.312	16.336	5.168	10.888	7.584	4.144	20.072	8.232	23.624	0.92	0.16	24.92	23.184	64.464	0.808	2.088	13.936	21.568	8.952	3.824	0	0	0	0	0	0	0	0	0											Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	0	0	0	0	0	0	0	0	0											0.092100521	0.092370528	0.167498317	0	0.233890893	0.234000514	0.23401689	0.234185685	0.233999967	0.233940593	0.233999663	0.234000378	0.233999959	0.233984154	0.234006655	0.234003572	0.233995061	0.23403014	0.233991769	0.234004873	0.234007524	0.233997086	0	0	0	0	0	0	0	0	0											12.7283	0.148531809	4.40721571	0	1.208748135	2.5477976	1.774784091	0.970465479	4.69684734	1.925798963	5.528008035	0.215280348	0.037439993	5.830885107	5.425210287	15.08480629	0.189068009	0.488654932	3.260909288	5.047017099	2.094835353	0.894804856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5054	0	0	12.7283	0.148531809	4.40721571	0	1.208748135	2.5477976	1.774784091	0.970465479	4.69684734	1.925798963	5.528008035	0.215280348	0.037439993	5.830885107	5.425210287	15.08480629	0.189068009	0.488654932	3.260909288	5.047017099	2.094835353	0.894804856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5054	0	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	0	0	0	0	0	0	0	0	0											3.4131	0.0433	1.2057	0	0.3022	0.6369	0.4428	0.3002	1.6015	0.4814	1.382	0.0538	0.0094	1.4577	1.3774	3.9008	0.0473	0.1222	0.8185	1.2589	0.5237	0.2242	0	0	0	0	0	0	0	0	0											19.6029	0	0	16.1414	0.191794832	5.61289458	0	1.510935169	3.184711276	2.217546923	1.270620983	6.298335915	2.407248704	6.910010044	0.269100435	0.046799992	7.288606384	6.802582739	18.98565293	0.236335675	0.610818665	4.079419213	6.305966069	2.618544191	1.11897407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.1083
H2701_806_0	2008	1																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	138.2	1.608	26.312	16.336	5.168	10.888	7.584	4.144	20.072	8.232	23.624	0.92	0.16	24.92	23.184	64.464	0.808	2.088	13.936	21.568	8.952	3.824	0	0	0	0	0	0	0	0	0											Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	0	0	0	0	0	0	0	0	0											0.092100521	0.092370528	0.167498317	0	0.233890893	0.234000514	0.23401689	0.234185685	0.233999967	0.233940593	0.233999663	0.234000378	0.233999959	0.233984154	0.234006655	0.234003572	0.233995061	0.23403014	0.233991769	0.234004873	0.234007524	0.233997086	0	0	0	0	0	0	0	0	0											12.7283	0.148531809	4.40721571	0	1.208748135	2.5477976	1.774784091	0.970465479	4.69684734	1.925798963	5.528008035	0.215280348	0.037439993	5.830885107	5.425210287	15.08480629	0.189068009	0.488654932	3.260909288	5.047017099	2.094835353	0.894804856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5054	0	0	12.7283	0.148531809	4.40721571	0	1.208748135	2.5477976	1.774784091	0.970465479	4.69684734	1.925798963	5.528008035	0.215280348	0.037439993	5.830885107	5.425210287	15.08480629	0.189068009	0.488654932	3.260909288	5.047017099	2.094835353	0.894804856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5054	0	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	0	0	0	0	0	0	0	0	0											3.4131	0.0433	1.2057	0	0.3022	0.6369	0.4428	0.3002	1.6015	0.4814	1.382	0.0538	0.0094	1.4577	1.3774	3.9008	0.0473	0.1222	0.8185	1.2589	0.5237	0.2242	0	0	0	0	0	0	0	0	0											19.6029	0	0	16.1414	0.191794832	5.61289458	0	1.510935169	3.184711276	2.217546923	1.270620983	6.298335915	2.407248704	6.910010044	0.269100435	0.046799992	7.288606384	6.802582739	18.98565293	0.236335675	0.610818665	4.079419213	6.305966069	2.618544191	1.11897407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.1083
H2701_807_0	2008	1																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	138.2	1.608	26.312	16.336	5.168	10.888	7.584	4.144	20.072	8.232	23.624	0.92	0.16	24.92	23.184	64.464	0.808	2.088	13.936	21.568	8.952	3.824	0	0	0	0	0	0	0	0	0											Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	0	0	0	0	0	0	0	0	0											0.092100521	0.092370528	0.167498317	0	0.233890893	0.234000514	0.23401689	0.234185685	0.233999967	0.233940593	0.233999663	0.234000378	0.233999959	0.233984154	0.234006655	0.234003572	0.233995061	0.23403014	0.233991769	0.234004873	0.234007524	0.233997086	0	0	0	0	0	0	0	0	0											12.7283	0.148531809	4.40721571	0	1.208748135	2.5477976	1.774784091	0.970465479	4.69684734	1.925798963	5.528008035	0.215280348	0.037439993	5.830885107	5.425210287	15.08480629	0.189068009	0.488654932	3.260909288	5.047017099	2.094835353	0.894804856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5054	0	0	12.7283	0.148531809	4.40721571	0	1.208748135	2.5477976	1.774784091	0.970465479	4.69684734	1.925798963	5.528008035	0.215280348	0.037439993	5.830885107	5.425210287	15.08480629	0.189068009	0.488654932	3.260909288	5.047017099	2.094835353	0.894804856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5054	0	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	0	0	0	0	0	0	0	0	0											3.4131	0.0433	1.2057	0	0.3022	0.6369	0.4428	0.3002	1.6015	0.4814	1.382	0.0538	0.0094	1.4577	1.3774	3.9008	0.0473	0.1222	0.8185	1.2589	0.5237	0.2242	0	0	0	0	0	0	0	0	0											19.6029	0	0	16.1414	0.191794832	5.61289458	0	1.510935169	3.184711276	2.217546923	1.270620983	6.298335915	2.407248704	6.910010044	0.269100435	0.046799992	7.288606384	6.802582739	18.98565293	0.236335675	0.610818665	4.079419213	6.305966069	2.618544191	1.11897407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.1083
H2762_001_0	2008	4																					3000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	P	Coin	V	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1528.239602	22.63182829	1373.386034	1628.565168	188.9899627	9.851269308	6.369312594	383.6709971	387.8999476	20.97658025	22.58708578	0.74554333	46.22368643	0	5064.235078	6419.654461	213.5047958	407.2546688	37.54093953	0	6.660382429	723.2348289	0	0	411.3077477	0	176.274749	0	0	0	43.62800038											1a $150/day for days 1-5	1b. $150/day for days 1-5	2. $0/day for days 1-3; $100/day for days 4-100	6. $0/visit	10a. $150/trip	11a. 20% coins; 17b. $30 copay	11b. 20% prothetics; 0% supplies; 11c. 0% coins	4a. $50/visit 4b. $15/visit	"9a., 9b. $100 copay surgical"	8a. 0% lab services; 10% diag tests/proced	8b. 10% coins	"5. $30 copay; 9a., 9b. $30 copay non-surgical"	12. $30 copay		"7a., 7g. $15/visit"	"7b., 7d., 7f., 7g., 16b. $30/visit"	"7e., 7h., 9c. $15 group session, $30 indiv session"	"3., 7c., 7i., 9d. $30/visit"	"8a. 0% lab services, 10% diag test/proced; 8b. 10% coins"		15. 20% coins	"17a. , 18a. $30/visit"			17a. $30/visit		18a. $30/visit				14c. $0/exam											66.45946954	58.81301185	68.71387649	0	116.632764	0.156284329	0.02582641	37.68262033	77.75517603	0.045804113	0.077755176	23.32655281	23.32655281	0	11.6632764	23.32655281	17.49491461	23.32655281	0.060732076	0	0.155510352	23.32655281	0	0	23.32655281	0	23.32655281	0	0	0	0											8.4638	0.110920499	7.864223191	0	1.836868477	1.539599017	0.164496479	1.20481071	2.513435726	0.960813648	1.756262831	0.001449246	0.089853272	0	4.922131124	12.47903407	0.311270681	0.791653962	2.279939181	0	1.035758416	1.405881286	0	0	0.799532658	0	0.342656853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8744	0	14.55456301	8.4638	0.110920499	7.864223191	0	1.836868477	1.539599017	0.164496479	1.20481071	2.513435726	0.960813648	1.756262831	0.001449246	0.089853272	0	4.922131124	12.47903407	0.311270681	0.791653962	2.279939181	0	1.035758416	1.405881286	0	0	0.799532658	0	0.342656853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8744	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.4638	0.110920499	7.864223191	0	1.836868477	1.539599017	0.164496479	1.20481071	2.513435726	0.960813648	1.756262831	0.001449246	0.089853272	0	4.922131124	12.47903407	0.311270681	0.791653962	2.279939181	0	1.035758416	1.405881286	0	0	0.799532658	0	0.342656853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8744
H2762_002_0	2008	3																					2500											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	P	Coin	V	T	P	V	Coin	V	V	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1621.77152	24.0169503	1523.486583	1714.279125	198.9368028	10.36975717	6.704539573	403.8642075	408.3157343	22.02214245	23.71292246	0.799297783	49.55646256	0	5499.186339	6971.01844	231.8420528	437.4180569	39.82370707	0	7.140602967	785.6661059	0	0	411.3077477	0	176.274749	0	0	0	43.62800038											1a. $100/day for days 1-5	1b. $100/day for days 1-5	2. $0/day for days 1-20; $100/day for days 21-100	6. $0/visit	10a. $150/trip	11a. 20% coins; 17b. $30 copay	11b. 20% prothetics; 0% supplies; 11c. 0%	4a. $50/visit 4b. $10/visit	"9a., 9b. $100 copay surgical"	8a. 0% lab services; 10% diag tests/proced	8b. 10% coins	"5. $20 copay; 9a., 9b. $20 copay non-surgical;"	12. $20 copay		"7a., 7g. $10/visit"	"7b., 7d., 7f., 7g., 16b. $20/visit;"	"7e. ,7h., 9c. $10 group session, $20 indiv session;"	"3., 7c., 7i., 9d. $20/visit"	8a. 0% lab services; 10% diag tests/proced; 8b. 10% coins		15. 20% coins	"17a., 18a. $20/visit"			17a. $20/visit		18a. $20/visit				14c. $0/exam											45.99122478	40.69972972	18.14458169	0	121.0681571	0.161282368	0.026808555	38.93844008	80.71210474	0.047545984	0.080712105	16.14242095	16.14242095	0	8.071210474	16.14242095	12.10681571	16.14242095	0.063041638	0	0.161424209	16.14242095	0	0	16.14242095	0	16.14242095	0	0	0	0											6.2156	0.081456949	2.303585563	0	2.007076008	1.672458989	0.179739019	1.310486854	2.746335193	1.047064431	1.913919881	0.001075217	0.06666344	0	3.698757532	9.377426175	0.233905751	0.588415534	2.510551722	0	1.152666189	1.056879417	0	0	0.5532919	0	0.2371251	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9545	0	9.309013104	6.2156	0.081456949	2.303585563	0	2.007076008	1.672458989	0.179739019	1.310486854	2.746335193	1.047064431	1.913919881	0.001075217	0.06666344	0	3.698757532	9.377426175	0.233905751	0.588415534	2.510551722	0	1.152666189	1.056879417	0	0	0.5532919	0	0.2371251	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9545	2500																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.2156	0.081456949	2.303585563	0	2.007076008	1.672458989	0.179739019	1.310486854	2.746335193	1.047064431	1.913919881	0.001075217	0.06666344	0	3.698757532	9.377426175	0.233905751	0.588415534	2.510551722	0	1.152666189	1.056879417	0	0	0.5532919	0	0.2371251	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9545
H2762_003_0	2008	4																					1000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	P	Coin	V	T	P	V	Coin	V	V	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1711.333552	25.34328194	1622.577384	1799.993081	208.8836429	10.88824502	7.039766552	424.0574179	458.1358637	22.84966787	24.60398226	0.947108892	58.72075129	0	6536.257141	8744.137045	290.8124114	517.676395	43.804305	0	8.4610876	987.1411384	0	0	420.2652711	2.420658728	176.274749	0	0	0	43.62800038											1a $0/admit	1b. $0/admit	2. $0/day for days 1-20; $50/day for days 21-100	6. $0/visit	10a. $100/trip	11a. 20% coins; 17b. $0 copay	11b. 20% prosthetics; 0% supplies; 11c. 0%	4a. $50/visit 4b. $0/visit	"9a., 9b. $0 copay surgical"	8a. 0% lab services; 10% diag tests/proced	8b. 10% coins	"5. $0 copay; 9a., 9b. $0 copay non-surgical"	12. $0 copay		"7a., 7g. $0/visit"	"7b., 7d., 7f., 7g., 16b. $0/visit"	"7e. ,7h., 9c. $0 group session, $0 indiv session;"	"3., 7c., 7i., 9d. $0/visit"	8a. 0% lab services; 10% diag tests/proced; 8b. 10% coins		15. 20% coins	"17a., 18a. $0/visit"			17a. $10/visit	17b. 0% coins up to $100	18a. $10/visit				14c. $0/exam											0	0	9.44761108	0	84.05116065	0.165985897	0.027917624	40.18025677	0	0.049512959	0.084051161	0	0	0	0	0	0	0	0.065649667	0	0.168102321	0	0	0	8.405116065	0	8.405116065	0	0	0	0											0	0	1.277456673	0	1.463076052	1.807295113	0.196533554	1.419894661	0	1.131354669	2.067993266	0	0	0	0	0	0	0	2.875738057	0	1.422328466	0	0	0	0.294364865	0	0.123467477	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.0795	0	2.671607715	0	0	1.277456673	0	1.463076052	1.807295113	0.196533554	1.419894661	0	1.131354669	2.067993266	0	0	0	0	0	0	0	2.875738057	0	1.422328466	0	0	0	0.294364865	0	0.123467477	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.0795	1000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	1.277456673	0	1.463076052	1.807295113	0.196533554	1.419894661	0	1.131354669	2.067993266	0	0	0	0	0	0	0	2.875738057	0	1.422328466	0	0	0	0.294364865	0	0.123467477	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.0795
H2762_004_0	2008	3																					3000											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	P	Coin	V	V	V	V	Coin	Coin	Coin	V	T	P	V	Coin	V	V	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1556.710338	23.05345381	1207.598178	26.23413704	213.0434942	10.62661255	6.870608756	384.0609972	24.72928571	21.37943855	23.93917414	0.085800905	45.67289935	2.150413383	5030.252899	6287.558184	203.1198158	382.2284907	35.85179047	17.32335	7.042985755	722.5650347	0	0	0	0	0	0	0	0	42.64728242											1a. $200/day for days 1-5	1b. $200/day for days 1-5	2. $0/day for days 1-3; $100/day for days 4-100	6. 15% coins	10a. $150/trip	11a. 30% coins; 17b. $30 copay	11b. 30% prosthetics; 0% supplies; 11c. 0%	4a. $50/visit; 4b. $15/visit	"9a., 9b. 20% coins"	8a. 20% lab services; 20% diag tests/proced	8b. 20% coins	"5. 20% coins; 9a., 9b. 20% coins"	12. $30 copay	"9a. , 9b. 20% coins"	"7a., 7g. $15/visit"	"7b., 7d, 7f, 7g, 16b. $30/visit"	"7e., 7h., 9c. $15 group session, $30 indiv session"	"3. , 7c., 7i., 9d. $30/visit"	"8a., 8b. 20% coins"	"9a., 9b. 20% coins surgical"	15. 20% coins	"17a., 18a. $30/visit"									14c. $0/exam											79.58572363	70.42903199	61.7140449	0.104751471	104.7514709	0.209318854	0.034793239	33.84391977	0.139668628	0.139668628	0.139668628	0.139668628	20.95029419	0.139668628	10.47514709	20.95029419	15.71272064	20.95029419	0.139668628	0.139668628	0.139668628	20.95029419	0	0	20.95029419	0	20.95029419	0	0	0	0											10.3243	0.135302703	6.210480684	2.748064444	1.859718283	2.22435036	0.239050735	1.083177465	3.453905405	2.986036848	3.343551606	0.011983695	0.07973839	0.300345287	4.391053253	10.97718281	0.265963744	0.667316611	5.007370384	2.419528526	0.983684157	1.261495837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.9736	0	26.33821695	10.3243	0.135302703	6.210480684	2.748064444	1.859718283	2.22435036	0.239050735	1.083177465	3.453905405	2.986036848	3.343551606	0.011983695	0.07973839	0.300345287	4.391053253	10.97718281	0.265963744	0.667316611	5.007370384	2.419528526	0.983684157	1.261495837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.9736	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.3243	0.135302703	6.210480684	2.748064444	1.859718283	2.22435036	0.239050735	1.083177465	3.453905405	2.986036848	3.343551606	0.011983695	0.07973839	0.300345287	4.391053253	10.97718281	0.265963744	0.667316611	5.007370384	2.419528526	0.983684157	1.261495837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.9736
H2762_005_0	2008	3																					2500											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	Coin	P	Coin	V	V	V	V	Coin	P	Coin	V	T	P	V	Coin	V	V	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1648.097798	24.40681835	1339.579388	2040.529028	224.2563097	11.18590795	7.232219744	404.2747339	399.7923624	22.93497815	25.24973381	0.09049811	48.07673616	2.29468753	5465.205295	6831.226376	220.6830382	413.2233466	38.36702577	0	7.413669216	784.9384936	0	0	0	0	0	0	0	0	42.64728242											1a $150/day for days 1-5	1b. $150/day for days 1-5	2. $0/day for days 1-20; $100/day for days 21-100	6. $0/visit	10a. $150/trip	11a. 20% coins; 17b. $20 copay	11b. 20% prothetics; 0% supplies; 11c. 0%	4a. $50/visit 4b. $10/visit	"9a., 9b. $200 copay surgical;"	8a. 0% lab services; 20% diag tests/proced	8b. 20% coins	"5. 20% coins; 9a., 9b. 20% non-surgical;"	12. $20 copay	"9a., 9b. 20% coins non-surgical"	"7a., 7g. $10/visit"	"7b., 7d., 7f., 7g., 16b. $20/visit"	"7e., 7h., 9c. $10 group session, $20 indiv session"	"3., 7c., 7i., 9d. $20/visit"	8a. 0% lab services; 20% diag tests/proced; 8b. 20% coins		15. 20% coins	"17a., 18a. $20/visit"									14c. $0/exam											63.46503125	56.16309701	16.69226321	0	111.3776873	0.148373094	0.02466276	35.82175119	148.503583	0.08748067	0.148503583	0.148503583	14.8503583	0.148503583	7.425179151	14.8503583	11.13776873	14.8503583	0.115991389	0	0.148503583	14.8503583	0	0	22.27553745	0	22.27553745	0	0	0	0											8.7164	0.114230209	1.863384311	0	2.081429094	1.659687777	0.178366498	1.206819078	4.947549857	2.006367247	3.749675941	0.013439294	0.059496396	0.34076932	3.381677368	8.45384661	0.204826387	0.51137623	4.450244599	0	1.100956442	0.971384823	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0119	0	15.95549686	8.7164	0.114230209	1.863384311	0	2.081429094	1.659687777	0.178366498	1.206819078	4.947549857	2.006367247	3.749675941	0.013439294	0.059496396	0.34076932	3.381677368	8.45384661	0.204826387	0.51137623	4.450244599	0	1.100956442	0.971384823	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0119	2500																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.7164	0.114230209	1.863384311	0	2.081429094	1.659687777	0.178366498	1.206819078	4.947549857	2.006367247	3.749675941	0.013439294	0.059496396	0.34076932	3.381677368	8.45384661	0.204826387	0.51137623	4.450244599	0	1.100956442	0.971384823	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0119
H2762_006_0	2008	4																					1000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	P	Coin	V	T	P	V	Coin	V	V	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1753.27403	25.96438199	1426.708475	2142.555479	235.4691252	11.74520335	7.593830731	424.4884706	458.601557	24.47849802	26.35786806	0.948071624	58.7804407	0	6509.503422	8586.77508	277.3961085	493.7939779	42.58339452	0	9.064233108	986.2269383	0	0	411.0521037	2.422037615	172.3122522	0	0	0	42.64728242											1a $0/admit	1b. $0/admit	2. $0/day for days 1-20; $50/day for days 21-100	6. $0/visit	10a. $100/trip	11a. 20% coins; 17b. $0 copay	11b. 20% prosthetics; 0% supplies; 11c. 0%	4a. $50/visit 4b. $0/visit	"9a. , 9b.$0 copay surgical"	8a. 0% lab services; 10% diag tests/proced	8b. 10% coins	"5. $0 copay; 9a., 9b. $0 copay non-surgical;"	12. $0 copay		"7a., 7g. $0/visit"	"7b., 7d., 7f., 7g., 16b. $0/visit"	"7e. ,7h., 9c. $0 group session, $0 indiv session"	"3., 7c., 7i., 9d. $0/visit"	8a. 0% lab services; 10% diag tests/proced; 8b. 10% coins		15. 20% coins	"17a. , 18a. $0/visit"			17a. $10/visit	17b. 0% coins up to $100	18a. $10/visit				14c. $0/exam											0	0	9.369727988	0	83.35826969	0.164617562	0.02768748	39.84902355	0	0.04910479	0.08335827	0	0	0	0	0	0	0	0.065108473	0	0.166716539	0	0	0	8.335826969	0	8.335826969	0	0	0	0											0	0	1.113989194	0	1.63569157	1.933466739	0.210254035	1.409620922	0	1.202011504	2.197146275	0	0	0	0	0	0	0	2.772539773	0	1.511157576	0	0	0	0.285538268	0	0.119697093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.3911	0	2.873056524	0	0	1.113989194	0	1.63569157	1.933466739	0.210254035	1.409620922	0	1.202011504	2.197146275	0	0	0	0	0	0	0	2.772539773	0	1.511157576	0	0	0	0.285538268	0	0.119697093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.3911	1000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	1.113989194	0	1.63569157	1.933466739	0.210254035	1.409620922	0	1.202011504	2.197146275	0	0	0	0	0	0	0	2.772539773	0	1.511157576	0	0	0	0.285538268	0	0.119697093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.3911
H2762_007_0	2008	4																					3500											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	P	Coin	V	V	V	V	Coin	Coin	Coin	V	T	P	V	Coin	V	V	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1608.555778	23.82123727	1259.202975	28.73883714	229.6559925	12.07353081	7.806109997	390.1553238	27.26437076	23.62325076	26.45163541	0.094805871	46.39764247	2.376103305	4930.816569	6188.58758	204.2226237	388.1032302	38.49983013	18.76297659	7.76498671	702.1653664	0	0	0	0	0	0	0	0	42.15382128											1a $250/day for days 1-5	1b. $250/day for days 1-5	2. $125/day for days 1-100	6. 20% coins	10a. $150/trip	11a. 30% coins; 17b. $45 copay	11b. 30% prothetics; 0% supplies; 11c. 0%	4a. $50/visit 4b. $20/visit	"9a., 9b. 20% coins surgical"	8a. 20% lab services; 20% diag tests/proced	8b. 20% coins	5. 20% coins; 9a. 20% coins non-surgical;	12. $45 copay	"9a., 9b. 20% coins non-surgical"	"7a., 7g. $20/visit"	"7b., 7d., 7f., 7g., 16b. $45/visit"	"7e. ,7h., 9c. $20 group session, $45 indiv session;"	"3., 7c., 7i., 9d. $45/visit"	8a. 20% lab services; 20% diag tests/proced; 8b. 20% coins	"9a., 9b. 20% coins surgical"	15. 20% coins	"17a., 18a. $45/visit"									14c. $0/exam											95.47872311	84.49347117	83.77998996	0.134047984	100.535988	0.202072714	0.033393065	32.62909835	0.134047984	0.134047984	0.134047984	0.134047984	30.16079639	0.134047984	13.40479839	30.16079639	21.78279739	30.16079639	0.134047984	0.134047984	0.201071976	30.16079639	0	0	0	0	0	0	0	0	0											12.7986	0.167728252	8.791334385	3.852383179	1.924057675	2.439731139	0.26066994	1.060868036	3.654733934	3.166649139	3.545788399	0.012708536	0.116615821	0.318511858	5.508050169	15.55439416	0.37071167	0.975458542	5.160824611	2.515139185	1.561321221	1.764822221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5211	0	37.15659778	12.7986	0.167728252	8.791334385	3.852383179	1.924057675	2.439731139	0.26066994	1.060868036	3.654733934	3.166649139	3.545788399	0.012708536	0.116615821	0.318511858	5.508050169	15.55439416	0.37071167	0.975458542	5.160824611	2.515139185	1.561321221	1.764822221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5211	3500																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.7986	0.167728252	8.791334385	3.852383179	1.924057675	2.439731139	0.26066994	1.060868036	3.654733934	3.166649139	3.545788399	0.012708536	0.116615821	0.318511858	5.508050169	15.55439416	0.37071167	0.975458542	5.160824611	2.515139185	1.561321221	1.764822221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5211
H2762_008_0	2008	3																					2500											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	Coin	P	Coin	V	V	V	V	Coin	P	Coin	V	T	P	V	Coin	V	V	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1705.338351	25.2544985	1415.498886	2186.519054	241.74315	12.7089798	8.216957891	410.6898145	406.1363163	25.34926151	27.90768324	0.100024523	48.83962366	2.536241103	5309.382098	6704.70294	221.2543666	418.786929	41.15221941	0	8.173670221	760.4775607	0	0	0	0	0	0	0	0	42.15382128											1a $175/day for days 1-5	1b. $175/day for days 1-5	2. $0/day for days 1-20; $100/day for days 21-100	6. $0/visit	10a. $150/trip	11a. 20% coins; 17b. $30 copay	11b. 20% prothetics; 0% supplies; 11c. 0%	4a. $50/visit 4b. $15/visit	"9a., 9b. $200 copay surgical"	8a. 0% lab services; 20% diag tests/proced	8b. 20% coins	"5. 20% coins; 9a., 9b. 20% coins non-surgical;"	12. $30 copay	"9a., 9b. 20% coins non-surgical"	"7a., 7g. $30/visit"	"7b., 7d., 7f., 7g., 16b. $30/visit"	"7e. ,7h., 9c. $15 group session, $30 indiv session"	"3., 7c., 7i., 9d. $30/visit"	8a. 0% lab services; 20% diag tests/proced; 8b. 20% coins		15. 20% coins	"17a., 18a. $30/visit"									14c. $0/exam											68.71632109	60.81020259	15.49151303	0	103.3657852	0.138506984	0.022888656	33.39622165	137.821047	0.081187788	0.137821047	0.137821047	20.67315704	0.137821047	10.33657852	20.67315704	15.50486778	20.67315704	0.107647602	0	0.137821047	20.67315704	0	0	0	0	0	0	0	0	0											9.7654	0.127977598	1.82735162	0	2.082330877	1.760282466	0.188075119	1.14295734	4.664511026	2.058050481	3.846266123	0.013785485	0.084139101	0.349547404	4.573403746	11.55061473	0.285876642	0.721470663	4.429937744	0	1.126503787	1.31012267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.9086	0	23.41893063	9.7654	0.127977598	1.82735162	0	2.082330877	1.760282466	0.188075119	1.14295734	4.664511026	2.058050481	3.846266123	0.013785485	0.084139101	0.349547404	4.573403746	11.55061473	0.285876642	0.721470663	4.429937744	0	1.126503787	1.31012267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.9086	2500																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.7654	0.127977598	1.82735162	0	2.082330877	1.760282466	0.188075119	1.14295734	4.664511026	2.058050481	3.846266123	0.013785485	0.084139101	0.349547404	4.573403746	11.55061473	0.285876642	0.721470663	4.429937744	0	1.126503787	1.31012267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.9086
H2762_009_0	2008	3																					1000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	P	Coin	V	T	P	V	Coin	V	V	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1819.769223	26.94911487	1507.565938	2295.845006	253.8303075	13.34442879	8.627805786	431.2243052	455.6902065	27.13401126	29.21726196	0.90863526	56.33538611	0	6080.893388	8103.879591	267.4270228	486.8382	45.16354827	0	9.428141197	917.7788709	0	0	397.4097629	0	170.3184698	0	0	0	42.15382128											1a. $50/day for days 1-3	1b. $50/day for days 1-3	2. $0/day for days 1-20; $50/day for days 21-100	6. $0/visit	10a. $100/trip	11a. 20% coins; 17b. $5 copay	11b. 20% prosthetics; 0% supplies; 11c. 0%	4a. $50/visit 4b. $5/visit	"9a., 9b. $25 copay surgical"	8a. 0% lab services; 10% diag tests/proced	8b. 10% coins	"5. $25 copay; 9a., 9b. $25 copay non-surgical;"	12. $5 copay		"7a., 7g. $5/visit"	"7b., 7d., 7f., 7g., 16b. $5/visit"	"7e. ,7h., 9c. $5 group session, $5 indiv session"	"3., 7c., 7i., 9d. $5/visit"	8a. 0% lab services; 10% diag tests/proced; 8b. 10% coins		15. 20% coins	"17a., 18a. $5/visit"			17a. $10/visit		18a. $10/visit				14c. $0/exam											15.24425764	11.821961	7.804770231	0	69.43554205	0.137529278	0.023063041	33.34577406	17.35888551	0.040903173	0.069435542	17.35888551	3.471777103	0	3.471777103	3.471777103	3.471777103	3.471777103	0.054233876	0	0.138871084	3.471777103	0	0	6.943554205	0	6.943554205	0	0	0	0											2.3118	0.026549282	0.980517146	0	1.468737083	1.835249651	0.198983436	1.198292354	0.65918951	1.109867151	2.028716421	0.001314408	0.016298659	0	1.759292202	2.344571967	0.077370585	0.140849476	2.449394289	0	1.309296189	0.265526972	0	0	0.229953019	0	0.098551294	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.5103	0	9.028307096	2.3118	0.026549282	0.980517146	0	1.468737083	1.835249651	0.198983436	1.198292354	0.65918951	1.109867151	2.028716421	0.001314408	0.016298659	0	1.759292202	2.344571967	0.077370585	0.140849476	2.449394289	0	1.309296189	0.265526972	0	0	0.229953019	0	0.098551294	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.5103	1000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.3118	0.026549282	0.980517146	0	1.468737083	1.835249651	0.198983436	1.198292354	0.65918951	1.109867151	2.028716421	0.001314408	0.016298659	0	1.759292202	2.344571967	0.077370585	0.140849476	2.449394289	0	1.309296189	0.265526972	0	0	0.229953019	0	0.098551294	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.5103
H2762_010_0	2008	3																					3000											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	P	Coin	V	V	V	V	Coin	Coin	Coin	V	T	P	V	Coin	V	V	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1895.280444	28.06736688	1343.627631	33.20694493	266.3801094	14.98098125	9.685914535	329.2075765	27.18438414	23.50196755	26.31583109	0.094319132	39.14967835	2.363904245	5373.079814	6995.497171	245.0636055	461.157823	45.49423639	20.15819355	7.742206244	762.1485205	0	0	0	0	0	0	0	0	43.3930836											1a. $200/day for days 1-5	1b. $200/day for days 1-5	2. $0/day for days 1-3; $100/day for days 4-100	6. 15% coins	10a. $150/trip	11a. 30% coins; 17b. $30 copay	11b. 30% prosthetics; 0% supplies; 11c. 0%	4a. $50/visit 4b. $15/visit	"9a., 9b. 20% coins surgical"	8a. 20% lab services; 20% diag tests/proced	8b. 20% coins	"5. 20% coins; 9a., 9b. 20% coins non-surgical;"	12. $30 copay	"9a., 9b. 20% coins"	"7a., 7g. $15/visit"	"7b., 7d., 7f., 7g., 16b $30/visit"	"7e., 7h., 9c. $15 group session, $30 indiv session"	"3., 7c., 7i., 9d. $30/visit"	"8a., 8b. 20% coins"	"9a., 9b. 20% coins surgical"	15. 20% coins	"17a., 18a. $30/visit"									14c. $0/exam											74.89918558	66.281701	58.07991046	0.098583006	98.58300591	0.196992764	0.032744381	31.85096412	0.131444008	0.131444008	0.131444008	0.131444008	19.71660118	0.131444008	9.858300591	19.71660118	14.78745089	19.71660118	0.131444008	0.131444008	0.131444008	19.71660118	0	0	0	0	0	0	0	0	0											11.8296	0.155029402	6.503147709	3.273640448	2.188379325	2.951144907	0.31715928	0.873798226	3.573224403	3.089192807	3.459058309	0.012397685	0.064324883	0.310721048	4.414119659	11.49395232	0.301988836	0.757705407	5.979944766	2.649673752	1.017666618	1.252248202	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4681	0	34.66712926	11.8296	0.155029402	6.503147709	3.273640448	2.188379325	2.951144907	0.31715928	0.873798226	3.573224403	3.089192807	3.459058309	0.012397685	0.064324883	0.310721048	4.414119659	11.49395232	0.301988836	0.757705407	5.979944766	2.649673752	1.017666618	1.252248202	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4681	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.8296	0.155029402	6.503147709	3.273640448	2.188379325	2.951144907	0.31715928	0.873798226	3.573224403	3.089192807	3.459058309	0.012397685	0.064324883	0.310721048	4.414119659	11.49395232	0.301988836	0.757705407	5.979944766	2.649673752	1.017666618	1.252248202	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4681
H2762_011_0	2008	3																					2500											D	D	D	Coin	T	Coin	Coin	V	P	Coin	Coin	Coin	P	Coin	V	V	V	V	Coin	P	Coin	V	T	P	V	Coin	V	V	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	2006.543832	29.7150757	1490.475816	38.19057224	280.4001151	15.76945395	10.19569951	346.534291	342.6921132	25.21193954	27.7565018	0.099482671	41.21018774	2.522501783	5839.852629	7603.213419	266.3528908	498.7389778	48.70906277	0	8.149690783	827.938916	0	0	0	0	0	0	0	0	43.3930836											1a. $150/day for days 1-5	1b. $150/day for days 1-5	2. $0/day for days 1-20; $100/day for days 21-100	6. $0/visit	10a. $150/trip	11a. 20% coins; 17b. $20 copay	11b. 20% prosthetics; 0% supplies; 11c. 0%	4a. $50/visit 4b. $10/visit	"9a., 9b. $200 copay surgical"	8a. 0% lab services; 20% diag tests/proced	8b. 20% coins	"5. 20% coins; 9a., 9b. 20% coins non-surgical"	12. $20 copay	"9a., 9b. 20% coins non-surgical"	"7a., 7g. $10/visit"	"7b., 7d., 7f., 7g., 16b. $20/visit"	"7e., 7h., 9c. $10 group session, $20 indiv session"	"3., 7c., 7i., 9d. $20/visit"	8a. 0% lab services; 20% diag tests/proced; 8b. 20% coins		15. 20% coins	"17a., 18a. $20/visit"									14c. $0/exam											60.66900645	53.6887673	15.95686639	0	106.4708154	0.141836347	0.023576214	34.24358283	141.9610872	0.083626608	0.141961087	0.141961087	14.19610872	0.141961087	7.09805436	14.19610872	10.64708154	14.19610872	0.110881255	0	0.141961087	14.19610872	0	0	0	0	0	0	0	0	0											10.1446	0.132947149	1.981943621	0	2.487869075	2.23668175	0.240375988	0.988881308	4.054078747	2.108388993	3.940343172	0.014122668	0.048752025	0.358097096	3.454299284	8.994670359	0.236323412	0.590012729	5.400922005	0	1.156938964	0.979459239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.5497	0	20.25773645	10.1446	0.132947149	1.981943621	0	2.487869075	2.23668175	0.240375988	0.988881308	4.054078747	2.108388993	3.940343172	0.014122668	0.048752025	0.358097096	3.454299284	8.994670359	0.236323412	0.590012729	5.400922005	0	1.156938964	0.979459239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.5497	2500																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.1446	0.132947149	1.981943621	0	2.487869075	2.23668175	0.240375988	0.988881308	4.054078747	2.108388993	3.940343172	0.014122668	0.048752025	0.358097096	3.454299284	8.994670359	0.236323412	0.590012729	5.400922005	0	1.156938964	0.979459239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.5497
H2762_802_0	2008	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		293.1038378	2.244648496	50.67866186	32.08835204	7.195406458	12.59056204	8.140395198	6.181526431	28.10710559	24.40055123	28.17034816	0.0995125	0.759612085	14.53102735	25.48142574	38.5296756	1.832479177	3.919577083	63.9030491	97.92781701	8.353869085	4.636172143	0	0	0	0	0	0	0	0	0											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing																				0.077356888	0.077356888	0.190255406	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.6736	0.173639022	9.641889384	0	1.683725111	2.946191517	1.904852476	1.446477185	6.577062708	5.709728988	6.591861468	0.023285925	0.177749228	3.400260401	5.962653622	9.015944091	0.428800127	0.917181037	14.95331349	22.91510918	1.954805366	1.084864281	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.183	0	0	22.6736	0.173639022	9.641889384	0	1.683725111	2.946191517	1.904852476	1.446477185	6.577062708	5.709728988	6.591861468	0.023285925	0.177749228	3.400260401	5.962653622	9.015944091	0.428800127	0.917181037	14.95331349	22.91510918	1.954805366	1.084864281	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.183																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.6736	0.173639022	9.641889384	0	1.683725111	2.946191517	1.904852476	1.446477185	6.577062708	5.709728988	6.591861468	0.023285925	0.177749228	3.400260401	5.962653622	9.015944091	0.428800127	0.917181037	14.95331349	22.91510918	1.954805366	1.084864281	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.183
H2762_803_0	2008	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		293.1038378	2.244648496	50.67866186	32.08835204	7.195406458	12.59056204	8.140395198	6.181526431	28.10710559	24.40055123	28.17034816	0.0995125	0.759612085	14.53102735	25.48142574	38.5296756	1.832479177	3.919577083	63.9030491	97.92781701	8.353869085	4.636172143	0	0	0	0	0	0	0	0	0											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing																				0.077356888	0.077356888	0.190255406	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.6736	0.173639022	9.641889384	0	1.683725111	2.946191517	1.904852476	1.446477185	6.577062708	5.709728988	6.591861468	0.023285925	0.177749228	3.400260401	5.962653622	9.015944091	0.428800127	0.917181037	14.95331349	22.91510918	1.954805366	1.084864281	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.183	0	0	22.6736	0.173639022	9.641889384	0	1.683725111	2.946191517	1.904852476	1.446477185	6.577062708	5.709728988	6.591861468	0.023285925	0.177749228	3.400260401	5.962653622	9.015944091	0.428800127	0.917181037	14.95331349	22.91510918	1.954805366	1.084864281	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.183																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.6736	0.173639022	9.641889384	0	1.683725111	2.946191517	1.904852476	1.446477185	6.577062708	5.709728988	6.591861468	0.023285925	0.177749228	3.400260401	5.962653622	9.015944091	0.428800127	0.917181037	14.95331349	22.91510918	1.954805366	1.084864281	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.183
H2762_804_0	2008	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		293.1038378	2.244648496	50.67866186	32.08835204	7.195406458	12.59056204	8.140395198	6.181526431	28.10710559	24.40055123	28.17034816	0.0995125	0.759612085	14.53102735	25.48142574	38.5296756	1.832479177	3.919577083	63.9030491	97.92781701	8.353869085	4.636172143	0	0	0	0	0	0	0	0	0											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing																				0.077356888	0.077356888	0.190255406	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.6736	0.173639022	9.641889384	0	1.683725111	2.946191517	1.904852476	1.446477185	6.577062708	5.709728988	6.591861468	0.023285925	0.177749228	3.400260401	5.962653622	9.015944091	0.428800127	0.917181037	14.95331349	22.91510918	1.954805366	1.084864281	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.183	0	0	22.6736	0.173639022	9.641889384	0	1.683725111	2.946191517	1.904852476	1.446477185	6.577062708	5.709728988	6.591861468	0.023285925	0.177749228	3.400260401	5.962653622	9.015944091	0.428800127	0.917181037	14.95331349	22.91510918	1.954805366	1.084864281	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.183																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.6736	0.173639022	9.641889384	0	1.683725111	2.946191517	1.904852476	1.446477185	6.577062708	5.709728988	6.591861468	0.023285925	0.177749228	3.400260401	5.962653622	9.015944091	0.428800127	0.917181037	14.95331349	22.91510918	1.954805366	1.084864281	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.183
H2788_801_0	2008	5																																Ded	Ded	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																						22.44355228	0.806707074	0	0	0.190951382	0.700666563	0.0262	0.250426823	0.423638063	0.341605637	0.566340037	0.0271391	0.03675	1.774346838	1.032165964	3.010866288	0.122515726	0.14725	0.775102453	1.598999734																						34.2753		2282.663489	192.6263152	2224.908022	27.6137879	7.638055299	28.17666253	1.05	10.01707291	16.94552251	13.66422548	22.6536015	1.085563981	1.47	70.97387352	41.28663857	120.5446515	4.900629055	5.89	31.0040981	63.95998937																						PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	"PBP 11a, 11c"	PBP 11b	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9cd"	"PBP 7a, 14bc"	PBP 7bfg	"PBP 7e,7h"	PBP 7ci	PBP 7d	PBP 14d-i																						5.204454452	2.803301666	61.10808977	0	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209																						0.99	0.044999139	11.32998993	0	1.596353558	5.888922469	0.21945	2.093568239	3.541614204	2.855823126	4.734602713	0.226882872	0.30723	14.83353956	8.628907462	25.19383217	1.024231473	1.23101	6.479856504	13.36763778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.5885	Medicare levels		23.4336	0.851706213	11.32998993	0	1.78730494	6.589589032	0.2457	2.343995062	3.965252267	3.197428763	5.30094275	0.254021971	0.34398	16.6078864	9.661073426	28.20469845	1.146747199	1.37826	7.254958956	14.96663751	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.8637																																																																																				0			23.4336	0.851706213	11.32998993	0	1.78730494	6.589589032	0.2457	2.343995062	3.965252267	3.197428763	5.30094275	0.254021971	0.34398	16.6078864	9.661073426	28.20469845	1.146747199	1.37826	7.254958956	14.96663751	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.8637
H2788_802_0	2008	3																																Ded	Ded	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																						22.44355228	0.806707074	0	0	0.190951382	0.700666563	0.0262	0.250426823	0.423638063	0.341605637	0.566340037	0.0271391	0.03675	1.774346838	1.032165964	3.010866288	0.122515726	0.14725	0.775102453	1.598999734																						34.2753		2282.663489	192.6263152	2224.908022	27.6137879	7.638055299	28.17666253	1.05	10.01707291	16.94552251	13.66422548	22.6536015	1.085563981	1.47	70.97387352	41.28663857	120.5446515	4.900629055	5.89	31.0040981	63.95998937																						PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	"PBP 11a, 11c"	PBP 11b	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9cd"	"PBP 7a, 14bc"	PBP 7bfg	"PBP 7e,7h"	PBP 7ci	PBP 7d	PBP 14d-i																						5.204454452	2.803301666	61.10808977	0	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209																						0.99	0.044999139	11.32998993	0	1.596353558	5.888922469	0.21945	2.093568239	3.541614204	2.855823126	4.734602713	0.226882872	0.30723	14.83353956	8.628907462	25.19383217	1.024231473	1.23101	6.479856504	13.36763778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.5885	Medicare levels		23.4336	0.851706213	11.32998993	0	1.78730494	6.589589032	0.2457	2.343995062	3.965252267	3.197428763	5.30094275	0.254021971	0.34398	16.6078864	9.661073426	28.20469845	1.146747199	1.37826	7.254958956	14.96663751	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.8637																																																																																				0			23.4336	0.851706213	11.32998993	0	1.78730494	6.589589032	0.2457	2.343995062	3.965252267	3.197428763	5.30094275	0.254021971	0.34398	16.6078864	9.661073426	28.20469845	1.146747199	1.37826	7.254958956	14.96663751	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.8637
H2788_803_0	2008	3																																Ded	Ded	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																						22.44355228	0.806707074	0	0	0.190951382	0.700666563	0.0262	0.250426823	0.423638063	0.341605637	0.566340037	0.0271391	0.03675	1.774346838	1.032165964	3.010866288	0.122515726	0.14725	0.775102453	1.598999734																						34.2753		2282.663489	192.6263152	2224.908022	27.6137879	7.638055299	28.17666253	1.05	10.01707291	16.94552251	13.66422548	22.6536015	1.085563981	1.47	70.97387352	41.28663857	120.5446515	4.900629055	5.89	31.0040981	63.95998937																						PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	"PBP 11a, 11c"	PBP 11b	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9cd"	"PBP 7a, 14bc"	PBP 7bfg	"PBP 7e,7h"	PBP 7ci	PBP 7d	PBP 14d-i																						5.204454452	2.803301666	61.10808977	0	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209																						0.99	0.044999139	11.32998993	0	1.596353558	5.888922469	0.21945	2.093568239	3.541614204	2.855823126	4.734602713	0.226882872	0.30723	14.83353956	8.628907462	25.19383217	1.024231473	1.23101	6.479856504	13.36763778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.5885	Medicare levels		23.4336	0.851706213	11.32998993	0	1.78730494	6.589589032	0.2457	2.343995062	3.965252267	3.197428763	5.30094275	0.254021971	0.34398	16.6078864	9.661073426	28.20469845	1.146747199	1.37826	7.254958956	14.96663751	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.8637																																																																																				0			23.4336	0.851706213	11.32998993	0	1.78730494	6.589589032	0.2457	2.343995062	3.965252267	3.197428763	5.30094275	0.254021971	0.34398	16.6078864	9.661073426	28.20469845	1.146747199	1.37826	7.254958956	14.96663751	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.8637
H2788_804_0	2008	3																																Ded	Ded	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																						22.44355228	0.806707074	0	0	0.190951382	0.700666563	0.0262	0.250426823	0.423638063	0.341605637	0.566340037	0.0271391	0.03675	1.774346838	1.032165964	3.010866288	0.122515726	0.14725	0.775102453	1.598999734																						34.2753		2282.663489	192.6263152	2224.908022	27.6137879	7.638055299	28.17666253	1.05	10.01707291	16.94552251	13.66422548	22.6536015	1.085563981	1.47	70.97387352	41.28663857	120.5446515	4.900629055	5.89	31.0040981	63.95998937																						PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	"PBP 11a, 11c"	PBP 11b	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9cd"	"PBP 7a, 14bc"	PBP 7bfg	"PBP 7e,7h"	PBP 7ci	PBP 7d	PBP 14d-i																						5.204454452	2.803301666	61.10808977	0	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209	0.209																						0.99	0.044999139	11.32998993	0	1.596353558	5.888922469	0.21945	2.093568239	3.541614204	2.855823126	4.734602713	0.226882872	0.30723	14.83353956	8.628907462	25.19383217	1.024231473	1.23101	6.479856504	13.36763778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.5885	Medicare levels		23.4336	0.851706213	11.32998993	0	1.78730494	6.589589032	0.2457	2.343995062	3.965252267	3.197428763	5.30094275	0.254021971	0.34398	16.6078864	9.661073426	28.20469845	1.146747199	1.37826	7.254958956	14.96663751	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.8637																																																																																				0			23.4336	0.851706213	11.32998993	0	1.78730494	6.589589032	0.2457	2.343995062	3.965252267	3.197428763	5.30094275	0.254021971	0.34398	16.6078864	9.661073426	28.20469845	1.146747199	1.37826	7.254958956	14.96663751	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.8637
H2802_001_0	2008	11																					3900											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2144.803399	166.2177853	1597.410464		127.710546	15.20207896	1.613975486	388.1899409	27.10410219	8957.558297	44.13362659		0.023407353	25.68124629	4053.358611	4765.189928	474.3590112	2.760005814			34.69611863	1547.099105			358.0383474	0.04726413	19.9295941															$285 (1a); $0 (1a1)	$285 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1); $50/$40 (4b)"	25% (9b)	25% (8a1); $0/$10 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$20/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$15; $0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											175.2409	175.2409	92.2321		107.6041	0.153720095	0.236014603	29.7892	0.153720095	2.4595	0.091542583		0.184464114	0.153656785	20	30	37.5	0.153720095			0.184464114	30			30	0.124419775	30															31.3214	2.427346311	12.27770444	0	1.145181176	2.336865027	0.380921784	0.963654742	4.166445172	1.835942287	4.040106171	0	0.004317817	3.946097752	6.755597685	11.91297482	1.48237191	0.424268357	0	0	6.400188796	3.867747762	0	0	0.895095869	0.005880592	0.049823985	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.64	0	44.672223	31.3214	2.427346311	12.27770444	0	1.145181176	2.336865027	0.380921784	0.963654742	4.166445172	1.835942287	4.040106171	0	0.004317817	3.946097752	6.755597685	11.91297482	1.48237191	0.424268357	0	0	6.400188796	3.867747762	0	0	0.895095869	0.005880592	0.049823985	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.64																																																																																				0			31.3214	2.427346311	12.27770444	0	1.145181176	2.336865027	0.380921784	0.963654742	4.166445172	1.835942287	4.040106171	0	0.004317817	3.946097752	6.755597685	11.91297482	1.48237191	0.424268357	0	0	6.400188796	3.867747762	0	0	0.895095869	0.005880592	0.049823985	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.64
H2802_005_0	2008	5	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						2400	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T		V		V					V	P	V	V																																																0		1974.569207	93.07251683	9257.942093	223.8625314	509.7070011	30.34493732	0.272773465	188.6294497	128.5357486	4813.253565	194.9626781	29.65102376	7.268818931	241.2687285	133.4096617	1436.763789	2153.176211	26.02949589		289.2468263	265.5558496	722.0846471	1912.9		302.4							108.2406304	1.367401581		247.1							(1a) $175/day	(1b) $175/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $35/visit	(8a) $0/visit	(8b) $0/visit	(9a) $35/visit	(12) $0/proc	(9a) $35/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $15/visit	(7e/7h) $32.5/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $15/visit	(15) $0/proc	(Misc. PBP Cats) $15/visit	(10b) $0/trip		(17a1) $0/visit		(18a) $15/visit					(4b) $35/visit (waived if admitted)	(9c) $32.5/proc 75%/25% Ind/Grp Blended Copay	(9d) $35/visit	(7f1) $0/visit							159.6598	159.6598			68.4256	0.182468303	0.182468303	45.6171	31.932			31.932		31.932		13.6851	29.6511			13.6851		13.6851										31.932	29.6511									26.2716	1.238328015	0	0	2.906417861	5.53698922	0.049772511	0.717060325	0.342033124	0	0	0.078901258	0	0.642015142	0	1.638524065	5.320336794	0	0	0.32986486	0	0.823484751	0	0	0	0	0	0	0	0	0	0.288027894	0.003378747	0	0	0	0	0	0	0	0	46.1867		4.437657942	26.2716	1.238328015	0	0	2.906417861	5.53698922	0.049772511	0.717060325	0.342033124	0	0	0.078901258	0	0.642015142	0	1.638524065	5.320336794	0	0	0.32986486	0	0.823484751	0	0	0	0	0	0	0	0	0	0.288027894	0.003378747	0	0	0	0	0	0	0	0	46.1867																																																																																				0		0	26.2716	1.238328015	0	0	2.906417861	5.53698922	0.049772511	0.717060325	0.342033124	0	0	0.078901258	0	0.642015142	0	1.638524065	5.320336794	0	0	0.32986486	0	0.823484751	0	0	0	0	0	0	0	0	0	0.288027894	0.003378747	0	0	0	0	0	0	0	0	46.1867
H2803_001_0	2008	10																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1484.168146	141.3041635	719.278925		53.20768926	10.13406912	1.663544199	303.0040888	20.08171805	5709.207894	31.52909416		0.873394218	23.83010668	3513.222473	4782.147123	422.5661891	2.845362514			33.55299235	1128.651646			258.824446	0.131611503	18.78498251															$285 (1a); $0 (1a1)	$285 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1); $50/$40/$20 (4b)"	25% (9b)	25% (8a1); $0/$10 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$20/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$15; $0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	see OON	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											187.2095	187.2095	98.5313		114.9532	0.16421886	0.228052958	31.6649	0.16421886	2.6275	0.099439785		0.197062631	0.164220363	20	29.9997	37.5	0.16421886			0.197062631	30			30	0.118292399	30															23.1542	2.204456816	5.905958239	0	0.50969952	1.664205273	0.379376175	0.799550105	3.297796836	1.250079479	3.135246347	0	0.172113363	3.91338877	5.855370789	11.95524067	1.320519341	0.467262187	0	0	6.612040967	2.821629114	0	0	0.647061115	0.01556864	0.046962456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1277	0	27.76476034	23.1542	2.204456816	5.905958239	0	0.50969952	1.664205273	0.379376175	0.799550105	3.297796836	1.250079479	3.135246347	0	0.172113363	3.91338877	5.855370789	11.95524067	1.320519341	0.467262187	0	0	6.612040967	2.821629114	0	0	0.647061115	0.01556864	0.046962456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1277	3900	$325 (1a); $0 (1a1)	$325 (1b)	"$150 (2a, 2a2)"	"25% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 25% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $30 (17a, 18a, 16b); 25% (17b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.7717	0.2639	1.167	0.8398	0.2133	0.6964	0.1587	0.347	1.3799	0.7846	1.3119		0.072	1.6378	0.7448	1.3284	0.1663	0.0519			0.7347	0.3161			0.0719		0.0052															15.0633	0	6.035335033	25.9259	2.46834207	7.07300388	0.839826268	0.722978042	2.360574856	0.538122233	1.146569037	4.677726008	2.034703833	4.447157939	0	0.24413243	5.551151696	6.600135493	13.28360075	1.486806962	0.519180208	0	0	7.346712186	3.137736239	0	0	0.718956794	0.01556864	0.052180507	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.191
H2803_002_0	2008	10																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1305.673137	136.7238704	678.5521855		48.03657005	9.925943525	1.546839078	343.0566245	22.13275132	5647.788309	31.67531665		0.483468603	24.69949379	3327.005158	4570.896005	413.9924138	3.217490782			32.0616567	1088.097229			211.7984238	0.110807096	16.00783372															$285 (1a); $0 (1a1)	$285 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1); $50/$40/$20 (4b)"	25% (9b)	25% (8a1); $0/$10 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$20/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$15; $0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	see OON	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											191.1254	191.1254	100.5923		117.3577	0.1676539	0.236332145	32.069	0.1676539	2.6825	0.102642077		0.20118468	0.167621517	20	29.9635	37.5	0.1676539			0.20118468	30			30	0.141010825	30															20.7956	2.17761756	5.688096016	0	0.469788568	1.664123144	0.365567797	0.916790187	3.710642078	1.262498316	3.251220294	0	0.097266476	4.140166625	5.545008596	11.41333615	1.293726293	0.539424878	0	0	6.450314147	2.720243073	0	0	0.52949606	0.015625	0.040019584	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.0866	0	25.14998711	20.7956	2.17761756	5.688096016	0	0.469788568	1.664123144	0.365567797	0.916790187	3.710642078	1.262498316	3.251220294	0	0.097266476	4.140166625	5.545008596	11.41333615	1.293726293	0.539424878	0	0	6.450314147	2.720243073	0	0	0.52949606	0.015625	0.040019584	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.0866	3900	$325 (1a); $0 (1a1)	$325 (1b)	"$150 (2a, 2a2)"	"25% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 25% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $30 (17a, 18a, 16b); 25% (17b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.4893	0.2607	1.124	0.7635	0.1966	0.6963	0.153	0.4011	1.5527	0.7924	1.3604		0.0407	1.7326	0.7049	1.2681	0.1629	0.0599			0.7167	0.3049			0.0588		0.0044															14.844	0	5.662805423	23.285	2.438290012	6.812091037	0.763466162	0.666366764	2.36045836	0.518535882	1.317897998	5.263322097	2.054917471	4.611659992	0	0.137966633	5.872759577	6.249870995	12.68148461	1.456639974	0.599360976	0	0	7.167015719	3.02514271	0	0	0.588328955	0.015625	0.044466205	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.9306
H2803_010_0	2008	5																					1650											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2188.284656	309.8320975	1087.450169		440.1500193	30.22828647	21.58784595	768.00597	407.5070236	7079.378724	597.8984054	74.95120348	4.523909934	3833.305634		3681.635893		998.371192			27.45778173	715.0477535					0.094352584															1(a) $150 per Day	1(b) $150 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $10 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per procedure; other $0 per procedure	8(b) X-rays $10 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a)/(d) $25 Copay Per Visit; 9(c) $0 Copay per Visit"	7(a) PCP $0 per visit; Urgent Care $10 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $10 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															86.9606	86.9606	24.349		43.4803	0.115947523	0.115947523	20.8706	14.4934	5.7974	5.7974	14.4934	0.115947523	14.4934		5.7974		5.7974			0.115947523	5.7974					5.7974															15.8579	2.245266515	2.206525184	0	1.594822014	3.504894939	2.503057263	1.335725847	0.492181562	3.420151779	0.288853496	0.090525067	0.524536151	4.629815551	0	1.778652343	0	0.482327778	0	0	3.183661778	0.345450066	0	0	0	0	4.56E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4844	0	32.24753917	15.8579	2.245266515	2.206525184	0	1.594822014	3.504894939	2.503057263	1.335725847	0.492181562	3.420151779	0.288853496	0.090525067	0.524536151	4.629815551	0	1.778652343	0	0.482327778	0	0	3.183661778	0.345450066	0	0	0	0	4.56E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4844		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3																																																								0	0	0	15.8579	2.245266515	2.206525184	0	1.594822014	3.504894939	2.503057263	1.335725847	0.492181562	3.420151779	0.288853496	0.090525067	0.524536151	4.629815551	0	1.778652343	0	0.482327778	0	0	3.183661778	0.345450066	0	0	0	0	4.56E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4844
H2803_011_0	2008	5	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						2400	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T		V		V					V	P	V	V																																																0		1786.247364	84.19585256	8503.824324	197.3193339	449.2714584	24.81641827	0.223077093	166.2638099	113.2953699	4242.550022	171.8461126	26.1353261	6.406961009	212.6616925	120.3532729	1266.40788	1897.875866	22.94319982		254.9510665	246.3885363	636.4676604	1817.255		287.28							95.4066273	1.205269893		234.745							(1a) $175/day	(1b) $175/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $35/visit	(8a) $0/visit	(8b) $0/visit	(9a) $35/visit	(12) $0/proc	(9a) $35/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $15/visit	(7e/7h) $32.5/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $15/visit	(15) $0/proc	(Misc. PBP Cats) $15/visit	(10b) $0/trip		(17a1) $0/visit		(18a) $15/visit					(4b) $35/visit (waived if admitted)	(9c) $32.5/proc 75%/25% Ind/Grp Blended Copay	(9d) $35/visit	(7f1) $0/visit							162.8053	162.8053			69.7737	0.186063143	0.186063143	46.5158	32.5611			32.5611		32.5611		13.9547	30.2353			13.9547		13.9547										32.5611	30.2353									24.2342	1.142293905	0	0	2.612276868	4.617420791	0.041506425	0.644490981	0.307418018	0	0	0.070916139	0	0.577040668	0	1.472698943	4.781897649	0	0	0.29648123	0	0.740144835	0	0	0	0	0	0	0	0	0	0.258878331	0.003036804	0	0	0	0	0	0	0	0	41.8007		3.131036225	24.2342	1.142293905	0	0	2.612276868	4.617420791	0.041506425	0.644490981	0.307418018	0	0	0.070916139	0	0.577040668	0	1.472698943	4.781897649	0	0	0.29648123	0	0.740144835	0	0	0	0	0	0	0	0	0	0.258878331	0.003036804	0	0	0	0	0	0	0	0	41.8007		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					35	0.3	0.3	0.3							2.25	0.0343	0.828	0.1003	0.3706	0.3918	0.0035	0.0365	0.1725	0.6784	0.6212	0.0316	0.0077	0.102	0.0074	1.5935	0.1655	0.0025		0.1604		0.1044	0.1433		0.0146							0.0146	0.0001		0.0131							7.8477		0	26.4842	1.176550521	0.82801721	0.100326715	2.982883529	5.009258974	0.045028695	0.680952343	0.479961332	0.678357999	0.621168705	0.102564976	0.007675575	0.679072045	0.007360858	3.066181483	4.947426763	0.002487994	0	0.456867755	0	0.84458048	0.14325	0	0.01455	0	0	0	0	0	0	0.273524085	0.003132414	0	0.01305	0	0	0	0	0	0	49.6484
H2803_012_0	2008	5																					1650											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2146.680159	303.9414522	1015.364303		409.4387485	26.35351695	18.82063889	705.0436773	374.0989806	6499.000533	548.8817885	68.80659029	3.882490705	3519.045432		3437.584333		932.1902729			23.93814539	667.648031					0.088098056															1(a) $150 per Day	1(b) $150 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $10 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per procedure; other $0 per procedure	8(b) X-rays $10 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a)/(d) $25 Copay Per Visit; 9(c) $0 Copay per Visit"	7(a) PCP $0 per visit; Urgent Care $10 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $10 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															89.4018	89.4018	25.0325		44.7009	0.119202399	0.119202399	21.4564	14.9003	5.9601	5.9601	14.9003	0.119202399	14.9003		5.9601		5.9601			0.119202399	5.9601					5.9601															15.9931	2.264409385	2.118092558	0	1.525190029	3.141402434	2.243465301	1.260643463	0.464515582	3.227901886	0.272616774	0.085436569	0.462802205	4.369569339	0	1.707367909	0	0.462997152	0	0	2.85348435	0.331605195	0	0	0	0	4.38E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.7846	0	29.00021937	15.9931	2.264409385	2.118092558	0	1.525190029	3.141402434	2.243465301	1.260643463	0.464515582	3.227901886	0.272616774	0.085436569	0.462802205	4.369569339	0	1.707367909	0	0.462997152	0	0	2.85348435	0.331605195	0	0	0	0	4.38E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.7846		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3																																																								0	0	0	15.9931	2.264409385	2.118092558	0	1.525190029	3.141402434	2.243465301	1.260643463	0.464515582	3.227901886	0.272616774	0.085436569	0.462802205	4.369569339	0	1.707367909	0	0.462997152	0	0	2.85348435	0.331605195	0	0	0	0	4.38E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.7846
H2803_014_0	2008	6																					3500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2052.754003	140.7964405	922.0274787		284.9584832	11.24917582	19.53638987	443.3731869	419.0731936	3513.44119	461.7286714	70.36551244	15.83334231	2952.428205		4031.653614	397.198932	581.3908677				717.5255644					0.075971634															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															144.3403	144.3403	34.6417		61.8601	0.164960288	0.164960288	34.0231	61.8601	16.496	53.8298	61.8601	126.7188	59.8077		20.62	16.496	16.496				20.62					20.62															24.6913	1.693549478	2.661713576	0	1.468963547	1.855667286	3.222728503	1.257076024	2.160326087	4.829818928	2.071231865	0.36273485	0.167198513	14.7148366	0	6.927736897	0.546017086	0.799220042	0	0	0	1.232950249	0	0	0	0	0.000130545	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.6632	0	15.00977314	24.6913	1.693549478	2.661713576	0	1.468963547	1.855667286	3.222728503	1.257076024	2.160326087	4.829818928	2.071231865	0.36273485	0.167198513	14.7148366	0	6.927736897	0.546017086	0.799220042	0	0	0	1.232950249	0	0	0	0	0.000130545	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.6632		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.2802	0.0651	0.2806	0.2801	0.0719	0.1377	0.1196	0.0322	0.2912	0.0457	0.1188	0.0238	0.0055	0.2078	0.0208	0.2008	0.0302	0.0326			0.1801	0.0426			0.0051																	4.4726	0	0	26.9715	1.758694503	2.942357031	0.280105378	1.540908283	1.993412296	3.342339053	1.289299786	2.451477147	4.875525378	2.190040923	0.386573961	0.172696053	14.92266937	0.020773592	7.12856515	0.576189742	0.831816922	0	0	0.180076015	1.275528262	0	0	0.005058988	0	0.000130545	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1357
H2803_015_0	2008	6																					1800											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2050.537955	140.6444439	926.614118		267.4778566	9.985581366	17.34191141	410.5893961	388.086187	3253.651189	427.5876439	65.16256308	15.52079954	2734.406399		4027.100378	395.738944	580.1983774				721.0509944					0.071577709															(1a)$150/day	(1b)$150/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															100.3855	100.3855	28.1079		50.1928	0.133847356	0.133847356	27.606	50.1928	13.3847	43.6771	50.1928	92.3175	48.5235		16.7309	13.3847	13.3847				16.7309					16.7309															17.1537	1.176555435	2.17043487	0	1.118787622	1.336543664	2.32116899	0.944561493	1.623259688	3.629105075	1.556314674	0.272557399	0.119403429	11.05690382	0	5.614757686	0.441405094	0.647150156	0	0	0	1.005320512	0	0	0	0	9.98E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.188	0	25.79337952	17.1537	1.176555435	2.17043487	0	1.118787622	1.336543664	2.32116899	0.944561493	1.623259688	3.629105075	1.556314674	0.272557399	0.119403429	11.05690382	0	5.614757686	0.441405094	0.647150156	0	0	0	1.005320512	0	0	0	0	9.98E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.188		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.0247	0.0578	0.2491	0.2486	0.0639	0.1223	0.1062	0.0304	0.2584	0.0406	0.1055	0.0212	0.0049	0.1845	0.0184	0.1783	0.0268	0.0289			0.1598	0.0378			0.0051																	3.9731	0	0	19.1784	1.234382866	2.419561021	0.248641775	1.182650968	1.458816089	2.427343958	0.974921549	1.881706408	3.669677422	1.66177818	0.293718717	0.124283442	11.24139121	0.018440141	5.793027356	0.468188525	0.676085502	0	0	0.159848484	1.043115833	0	0	0.005058988	0	9.98E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1611
H2803_801_0	2008	4																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1558.376553	148.3693717	755.2428713		55.86807373	10.64077257	1.746721409	318.1542932	21.08580395	5994.668288	33.10554886		0.917063929	25.02161201	3688.883597	5021.254479	443.6944986	2.98763064			35.23064197	1185.084228			271.7656683		19.72423164															$430 (1a); $0 (1a1)	$430 (1b)	"$165 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1); $50/$40 (4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$20/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											280.9839	280.9839	107.8194		114.3539	0.163362719	0.227833915	31.4998	0.163362719	3.9207	0.098921364		0.196035263	0.163364917	20	29.9997	37.5	0.163362719			0.196035263	30			30		30															36.4899	3.474116768	6.785819088	0	0.532394358	1.738305538	0.397962376	0.835150806	3.444634263	1.958610621	3.274846065	0	0.179776868	4.08765358	6.148139328	12.55300271	1.386545308	0.488067464	0	0	6.906448152	2.96271057	0	0	0.679414171	0	0.049310579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.3728	0	37.2643076	36.4899	3.474116768	6.785819088	0	0.532394358	1.738305538	0.397962376	0.835150806	3.444634263	1.958610621	3.274846065	0	0.179776868	4.08765358	6.148139328	12.55300271	1.386545308	0.488067464	0	0	6.906448152	2.96271057	0	0	0.679414171	0	0.049310579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.3728	5000	$460 (1a); $0 (1a1)	$460 (1b)	"$165 (2a, 2a2)"	"25% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 25% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $30 (17a, 18a, 16b); 25% (17b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											4.0977	0.3901	1.3409	0.8818	0.2228	0.7274	0.1665	0.3625	1.4414	0.8196	1.3703		0.0752	1.7107	0.7815	1.3948	0.1746	0.0542			0.7674	0.3319			0.0755		0.0055															17.1922	0	7.163489615	40.5876	3.864246288	8.126729447	0.881817582	0.755169302	2.465681615	0.56448564	1.197621075	4.886006047	2.778171093	4.645171723	0	0.25500265	5.798347742	6.929626784	13.94778079	1.56114731	0.542297183	0	0	7.67383128	3.294623051	0	0	0.754904634	0	0.054789532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.565
H2803_803_0	2008	4																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1558.376553	148.3693717	755.2428713		55.86807373	10.64077257	1.746721409	318.1542932	21.08580395	5994.668288	33.10554886		0.917063929	25.02161201	3688.883597	5021.254479	443.6944986	2.98763064			35.23064197	1185.084228			271.7656683		19.72423164															$430 (1a); $0 (1a1)	$430 (1b)	"$165 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1); $50/$40 (4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$20/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											280.9839	280.9839	107.8194		114.3539	0.163362719	0.227833915	31.4998	0.163362719	3.9207	0.098921364		0.196035263	0.163364917	20	29.9997	37.5	0.163362719			0.196035263	30			30		30															36.4899	3.474116768	6.785819088	0	0.532394358	1.738305538	0.397962376	0.835150806	3.444634263	1.958610621	3.274846065	0	0.179776868	4.08765358	6.148139328	12.55300271	1.386545308	0.488067464	0	0	6.906448152	2.96271057	0	0	0.679414171	0	0.049310579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.3728	0	37.2643076	36.4899	3.474116768	6.785819088	0	0.532394358	1.738305538	0.397962376	0.835150806	3.444634263	1.958610621	3.274846065	0	0.179776868	4.08765358	6.148139328	12.55300271	1.386545308	0.488067464	0	0	6.906448152	2.96271057	0	0	0.679414171	0	0.049310579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.3728	5000	$460 (1a); $0 (1a1)	$460 (1b)	"$165 (2a, 2a2)"	"25% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 25% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $30 (17a, 18a, 16b); 25% (17b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											4.0977	0.3901	1.3409	0.8818	0.2228	0.7274	0.1665	0.3625	1.4414	0.8196	1.3703		0.0752	1.7107	0.7815	1.3948	0.1746	0.0542			0.7674	0.3319			0.0755		0.0055															17.1922	0	7.163489615	40.5876	3.864246288	8.126729447	0.881817582	0.755169302	2.465681615	0.56448564	1.197621075	4.886006047	2.778171093	4.645171723	0	0.25500265	5.798347742	6.929626784	13.94778079	1.56114731	0.542297183	0	0	7.67383128	3.294623051	0	0	0.754904634	0	0.054789532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.565
H2899_001_0	2008	9																					5100											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1609.754212	111.1534458	1420.555787	2073.692138	243.1533478	11.55163524	5.412334578	320.2191584	238.0055086	0	18.75816988	2.132924624	0.56814618	29.5309783	4002.860738	7037.000858	368.4960205	317.5397315	0	0	22.55043433	0	0	0	144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 185 days 1-5	1b 260 days 1-5	2a 25 days 11-100	6a 15 copay	10a 125 copay	11a 25% coin	11b 15% coin	4a 50 copay; 4b 30 copay; 4a World 50 copay	9b 450 copay; ASC:9b 280 copay		8b 15% coin; TherRad:8b 20% coin	9a 15% coin	12 20% coin	3 35 copay; 5 50 copay; 9a 15% coin; 9a 20% coin; 9c 50 copay; 9d 32 copay	7a 15 copay	7b 15 copay; ; 7d 34 copay; 16b 34 copay; 17a 34 copay	7e 50 copay; 7h 50 copay	7c 25 copay; 7i 25 copay			RX 20% coin				17a1 25 copay	17b1 70 allowance																97.1276546	136.5037308	10.94101699	12.78474591	106.5395493	0.213079099	0.127847459	42.62294518	343.0983926	0	0.136880635	0.127847459	0.170463279	0.133162116	12.78474591	20.81955706	42.61581972	21.30790986	0	0	0.170463279	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.0293	1.264405003	1.29519375	2.209302257	2.15878734	2.461412024	0.691953224	1.137390303	6.804942285	0	2.567630201	0.272688994	0.096848061	3.932407549	4.264629789	12.20893674	1.308646665	0.563842331	0	0	3.844020976	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4123		10.4156359	13.0293	1.264405003	1.29519375	2.209302257	2.15878734	2.461412024	0.691953224	1.137390303	6.804942285	0	2.567630201	0.272688994	0.096848061	3.932407549	4.264629789	12.20893674	1.308646665	0.563842331	0	0	3.844020976	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4123																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	13.0293	1.264405003	1.29519375	2.209302257	2.15878734	2.461412024	0.691953224	1.137390303	6.804942285	0	2.567630201	0.272688994	0.096848061	3.932407549	4.264629789	12.20893674	1.308646665	0.563842331	0	0	3.844020976	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4123
H2899_002_0	2008	9																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	V	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		386.2063172	26.38649004	59.31027859	0	19.97760114	16.36844573	6.817866849	34.04609029	37.60578426	18.60876214	20.37777724	2.52834442	2.570204143	37.44922406	52.07192395	123.3814935	7.128126834	3.052641886	0	0	26.6339184	7.54550784	0	0	144	0	0.086494918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a: MC CS; 1a1 0% coin	1b: MC CS; 1a1 0% coin	2a: MC CS; 2a2 0% coin	6a 0% coin	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS; 14c 0% coin	MC CS; ;	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS; 13a1 0% coin			17a1 5 copay	17b1 70 allowance																0.078042781	0.078042781	0.206838247	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0	0	5	0	25.09998909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.1406	2.059275068	12.26763404	0	4.674758668	3.830216302	1.595380843	7.966785128	8.799753516	4.354450341	4.768399875	0.591632594	0.601427769	8.763118431	12.1848302	28.87126949	1.667981679	0.714318201	0	0	6.232336905	1.765648834	0	0	0.06	0	0.000180918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.91		0	30.1406	2.059275068	12.26763404	0	4.674758668	3.830216302	1.595380843	7.966785128	8.799753516	4.354450341	4.768399875	0.591632594	0.601427769	8.763118431	12.1848302	28.87126949	1.667981679	0.714318201	0	0	6.232336905	1.765648834	0	0	0.06	0	0.000180918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.91																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	30.1406	2.059275068	12.26763404	0	4.674758668	3.830216302	1.595380843	7.966785128	8.799753516	4.354450341	4.768399875	0.591632594	0.601427769	8.763118431	12.1848302	28.87126949	1.667981679	0.714318201	0	0	6.232336905	1.765648834	0	0	0.06	0	0.000180918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.91
H2905_001_0	2008	9	h.5.	h.5.									OP Facility - Other	OP Facility - Other									3500	Complex diag	PET scans									A	A	D		T	Coin	Coin	V	V		Coin		V			V	V	V	V		Coin											P	V																																																		0	7500	481.9613471	0	1816.903204		1413.308757	18.47341192	0.972284838	286.7878091	319.1511618		6.373482546		0		28155.84647	9175.143525	95.5982888	584.6754871	2602.070539	5622.255187	6.948908422											45.288257	3.802524									$500/Stay	$500/Stay	$50/Day > 20	No cost sharing	$100 Trip	25 % Coins	25 % Coins	$50/visit	$50/visit	No cost sharing	20 % Coins	No cost sharing	$25/visit	No cost sharing	$5/visit	$25/visit	$25/visit	$25/visit	$25/visit	No cost sharing	25 % Coins											$50/procedure	$200/visit									442.225	442.225	44.2225		88.445	0.2211125	0.2211125	44.2225	44.2225		0.17689		22.11125		4.42225	22.11125	22.11125	22.11125	22.11125		0.2211125											44.2225	176.89									17.7613	0	6.695666828	0	10.41667442	4.084702293	0.214984331	1.056872824	1.176138521	0	1.127405327	0	0	0	10.37601601	16.90615769	0.176149805	1.077325489	4.794586018	0	1.536490513	0	0	0	0	0	0	0	0	0	0	0.166896662	0.056052373	0	0	0	0	0	0	0	0	77.6234	0	8.115247071	17.7613	0	6.695666828	0	10.41667442	4.084702293	0.214984331	1.056872824	1.176138521	0	1.127405327	0	0	0	10.37601601	16.90615769	0.176149805	1.077325489	4.794586018	0	1.536490513	0	0	0	0	0	0	0	0	0	0	0.166896662	0.056052373	0	0	0	0	0	0	0	0	77.6234	7500	$912/Stay	$912/Stay	40% Coins	40% Coins	40% - not l.t. $100	50% Coins	50% Coins	$50/visit	$50/visit	None	40% Coins	None	$35/visit	None	$25/visit	$35/visit	$35/visit	$35/visit	$35/visit	$35/visit	25 % Coins	None										40% Coins	40% Coins									1.8315	0	0.4198	0.3303	0.1378	0.2431	0.2431	0.0597	0.0665	0	0.1275	0	0	0	2.9329	1.338	0.0139	0.0853	0.3795	0.8199	0.0869	0										0	0									9.1156	500	0	19.5927	0	7.115495973	0.330320674	10.55446355	4.327773502	0.458055541	1.116620284	1.242628347	0	1.254874978	0	0	0	13.30891668	18.24419945	0.190091222	1.162590664	5.174054638	0.819912215	1.623351869	0	0	0	0	0	0	0	0	0	0	0.166896662	0.056052373	0	0	0	0	0	0	0	0	86.739
H2905_801_0	2008	7	h.1.	h.2.									OP Facility - Other	OP Facility - Other									3500	Complex diag	PET scans									A	A	D		T	Coin	Coin	V	V		Coin					V	V	V	V	V	Coin											P	V																																																		0	7500	524.0576629	0	1245.258423		1342.643319	6.538567818	8.188955289	272.4484186	303.1936038		17.48625308				26748.05415	8716.386349	90.81837436	555.4417128	2471.967012	5341.142427	6.601463001											43.02384415	3.6123978									$500/Stay	$500/Stay	$50/Day > 20	No cost sharing	$100 Trip	20% coinsurance	20% coinsurance	$50/visit	$50/visit	No cost sharing	20% coinsurance	No cost sharing	No cost sharing	No cost sharing	$5/visit	$25/visit	$25/visit	$25/visit	$25/visit	None	20% coinsurance											$50/procedure	$200/visit									473	473	47.3		94.6	0.2365	0.2365	47.3	47.3		0.1892				4.73	23.65	23.65	23.65	23.65		0.2365											47.3	189.2									20.6566	0	4.908393618	0	10.58450483	1.546371289	1.936687926	1.07390085	1.195088121	0	3.308399083	0	0	0	10.54319134	17.17854476	0.178987879	1.094683042	4.871834987	0	1.561246	0	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	0	0	0	0	0	0	80.865	0	8.454142832	20.6566	0	4.908393618	0	10.58450483	1.546371289	1.936687926	1.07390085	1.195088121	0	3.308399083	0	0	0	10.54319134	17.17854476	0.178987879	1.094683042	4.871834987	0	1.561246	0	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	0	0	0	0	0	0	80.865	7500	$912/Stay	$912/Stay	40% Coins	40% Coins	40% - not l.t. $100	50% Coins	50% Coins	$50/visit	$50/visit	None	40% Coins	None	None	None	20% coinsurance	40% Coins	40% Coins	40% Coins	40% Coins	None	20% coinsurance											40% Coins	40% Coins									1.9914	0	0.4198	0.3303	0.1378	0.2431	0.1116	0.0568	0.0632	0	0	0	0	0	0	0.0001	0.0001	0.0001	0.0001	0	0.0001											0	0									3.3545	500	0	22.648	0	5.328222763	0.330320674	10.72229396	1.789442499	2.048263494	1.130660937	1.258253456	0	3.30842976	0	0	0	10.54324107	17.17866092	0.179104041	1.094799204	4.871951148	0	1.56130408	0	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	0	0	0	0	0	0	84.2195
H2905_802_0	2008	7	h.1.	h.2.									OP Facility - Other	OP Facility - Other									3500	Complex diag	PET scans									A	A	D		T	Coin	Coin	V	V		Coin					V	V	V	V	V	Coin											P	V																																																		0	7500	524.0576629	0	1245.258423		1342.643319	6.538567818	8.188955289	272.4484186	303.1936038		17.48625308				26748.05415	8716.386349	90.81837436	555.4417128	2471.967012	5341.142427	6.601463001											43.02384415	3.6123978									$500/Stay	$500/Stay	$50/Day > 20	No cost sharing	$100 Trip	20% coinsurance	20% coinsurance	$50/visit	$50/visit	No cost sharing	20% coinsurance	No cost sharing	No cost sharing	No cost sharing	$5/visit	$25/visit	$25/visit	$25/visit	$25/visit	None	20% coinsurance											$50/procedure	$200/visit									473	473	47.3		94.6	0.2365	0.2365	47.3	47.3		0.1892				4.73	23.65	23.65	23.65	23.65		0.2365											47.3	189.2									20.6566	0	4.908393618	0	10.58450483	1.546371289	1.936687926	1.07390085	1.195088121	0	3.308399083	0	0	0	10.54319134	17.17854476	0.178987879	1.094683042	4.871834987	0	1.561246	0	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	0	0	0	0	0	0	80.865	0	8.454142832	20.6566	0	4.908393618	0	10.58450483	1.546371289	1.936687926	1.07390085	1.195088121	0	3.308399083	0	0	0	10.54319134	17.17854476	0.178987879	1.094683042	4.871834987	0	1.561246	0	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	0	0	0	0	0	0	80.865	7500	$912/Stay	$912/Stay	40% Coins	40% Coins	40% - not l.t. $100	50% Coins	50% Coins	$50/visit	$50/visit	None	40% Coins	None	None	None	20% coinsurance	40% Coins	40% Coins	40% Coins	40% Coins	None	20% coinsurance											40% Coins	40% Coins									1.9914	0	0.4198	0.3303	0.1378	0.2431	0.1116	0.0568	0.0632	0	0	0	0	0	0	0.0001	0.0001	0.0001	0.0001	0	0.0001											0	0									3.3545	500	0	22.648	0	5.328222763	0.330320674	10.72229396	1.789442499	2.048263494	1.130660937	1.258253456	0	3.30842976	0	0	0	10.54324107	17.17866092	0.179104041	1.094799204	4.871951148	0	1.56130408	0	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	0	0	0	0	0	0	84.2195
H2905_803_0	2008	7	h.1.	h.2.									OP Facility - Other	OP Facility - Other									3500	Complex diag	PET scans									A	A	D		T	Coin	Coin	V	V		Coin					V	V	V	V	V	Coin											P	V																																																		0	7500	524.0576629	0	1245.258423		1342.643319	6.538567818	8.188955289	272.4484186	303.1936038		17.48625308				26748.05415	8716.386349	90.81837436	555.4417128	2471.967012	5341.142427	6.601463001											43.02384415	3.6123978									$500/Stay	$500/Stay	$50/Day > 20	No cost sharing	$100 Trip	20% coinsurance	20% coinsurance	$50/visit	$50/visit	No cost sharing	20% coinsurance	No cost sharing	No cost sharing	No cost sharing	$5/visit	$25/visit	$25/visit	$25/visit	$25/visit	None	20% coinsurance											$50/procedure	$200/visit									473	473	47.3		94.6	0.2365	0.2365	47.3	47.3		0.1892				4.73	23.65	23.65	23.65	23.65		0.2365											47.3	189.2									20.6566	0	4.908393618	0	10.58450483	1.546371289	1.936687926	1.07390085	1.195088121	0	3.308399083	0	0	0	10.54319134	17.17854476	0.178987879	1.094683042	4.871834987	0	1.561246	0	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	0	0	0	0	0	0	80.865	0	8.454142832	20.6566	0	4.908393618	0	10.58450483	1.546371289	1.936687926	1.07390085	1.195088121	0	3.308399083	0	0	0	10.54319134	17.17854476	0.178987879	1.094683042	4.871834987	0	1.561246	0	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	0	0	0	0	0	0	80.865	7500	$912/Stay	$912/Stay	40% Coins	40% Coins	40% - not l.t. $100	50% Coins	50% Coins	$50/visit	$50/visit	None	40% Coins	None	None	None	20% coinsurance	40% Coins	40% Coins	40% Coins	40% Coins	None	20% coinsurance											40% Coins	40% Coins									1.9914	0	0.4198	0.3303	0.1378	0.2431	0.1116	0.0568	0.0632	0	0	0	0	0	0	0.0001	0.0001	0.0001	0.0001	0	0.0001											0	0									3.3545	500	0	22.648	0	5.328222763	0.330320674	10.72229396	1.789442499	2.048263494	1.130660937	1.258253456	0	3.30842976	0	0	0	10.54324107	17.17866092	0.179104041	1.094799204	4.871951148	0	1.56130408	0	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	0	0	0	0	0	0	84.2195
H2906_003_0	2008	9																					2500											A	A	A	V	T	Coin	Coin	V	P	Coin	Coin	P	Coin	V	V	V	V	Coin	V	V	Coin	V	T	Coin	V	Coin	Coin	Coin	P	V	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1112.267597	29.44728618	157.2108019	1361.934638	299.3048904	15.5519182	14.61639544	818.4993492	212.0928319	5.516079971	6.63231325	49.84245096	26.19294315	1971.270686	6066.384405	3701.968434	222.4326183	9.925943222	783.0600171	602.9950301	0.902457152	260.0752247	0.300925918	0	1355.827107	0	0	0	0	38.51851752	0											PBP: 1A IP Acute: $200 per stay	1B IP Psych: $200 per stay	2 SNF: $0 per stay plus $30 per day for days 35-100 only	"6 Home Health: $0, Custodial Care: $0 per episode"	10A Ambulance: $0	11A DME: 10%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0-10%"	"4A ER: $50, 4B Urgent Care: $15"	9B ASC Services: $50	8A OP C/D/T: 10%	8B OP X-Ray: 10%	9A OP Hospital: $0	12 Renal Dialysis: 10%	"3 CORF: 10%, 5 Partial Hosp: $20, 9C OP Substance Abuse: $20, 9D Cardiac Rehab: $10"	"7A PCP: $10, 14B Immunizations: $0, separate office visit copay applies, 14C Routine Physical Exams: $0, separate office visit copay applies, 14D Pap/Pelvic: $0, separate office visit copay applies, 14E Prostate Screening: $0, separate office visit copay applies, 14F Colorectal Screening: $50, 14G Bone Mass Measurement: $0, separate office visit copay applies, 14H Mammography: $0, 14I Diabetes Monitoring: $0, separate office visit copay may apply"	"7B Chiropractic: $20, 7D Physician Specialist: $20, 7F Podiatry: $20"	"7E Mental Health: $20, 7H Psychiatric: $20"	"7C Occupational Therapy: 10%, 7I Physical and Speech Therapy: 10%"	Included in i.2.	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $15"	15 Part B Drugs: 20%	"13A Blood: 10%, 16B Comprehensive Dental Services: 20%, 17A Medicare Covered Eye Exams: $15"	10B Transportation: $0	"16A Preventive Dental Services: $0, Additional Comprehensive Dental Coverage 20%-50%"	17A Routine Eye Exams: $15	17B Eye Wear: No member cost sharing	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											191.5	191.5	0	0	0	0.09575	0.143625	47.00683197	47.875	0.09575	0.09575	0	0.09575	11.66617007	9.575	19.15	19.15	0.09575	0	19.15	0.1915	14.78000416	0	0	14.3625	0	0	0	0	0	0											17.7499	0.469929609	0	0	0	1.489096168	2.099279796	3.206255115	0.846162027	0.528164657	0.635043994	0	2.507974307	1.91643159	4.840469223	5.907724625	0.354965387	0.950409063	0	0.962279569	0.172820545	0.320326075	0	0	1.622755569	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.58	0	2.07	17.7499	0.469929609	0	0	0	1.489096168	2.099279796	3.206255115	0.846162027	0.528164657	0.635043994	0	2.507974307	1.91643159	4.840469223	5.907724625	0.354965387	0.950409063	0	0.962279569	0.172820545	0.320326075	0	0	1.622755569	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.58	0	"20% Coinsurance, $500 combined IP Acute and IP Psych Deductible"	"20% Coinsurance, $500 combined IP Acute and IP Psych Deductible"	20% Coinsurance	20% Coinsurance	$0 Ambulance Copay	20% Coinsurance	20% Coinsurance	"$50 ER Copay, 20% Urgent Care Coinsurane"	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance											7.2438	0.0147	1.1397	0.3067	0	0	0	0.5679	1.2087	0.1174	0.2251	0	0	1.6311	1.3219	1.9555	0.0583	0.1659	0	0.9631	0.0192	0.0948	0	0	0.112	0	0	0	0	0.0119	0											17.1578	500	0	24.9937	0.484670805	1.139723532	0.306665731	0	1.489096168	2.099279796	3.774166965	2.054819888	0.645534581	0.860177127	0	2.507974307	3.547518077	6.162334344	7.863209621	0.413301371	1.116357484	0	1.925394352	0.192022827	0.415139828	2.83E-05	0	1.734783069	0	0	0	0	0.011875284	0	0	0	0	0	0	0	0	0	0	0	63.7378
H2926_001_0	2008	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		433.6376999		224.0882175	32.3562472	24.90229246	39.27197637		2.667459817	6.919298491	206.2910214					253.0978386						35.18747406	0.644470724																				Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare	Same as Medicare											0.0834		0.1658	0	0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				36.1654	0	37.15382647	0	5.827136436	9.189642471	0	0.624185597	1.619115847	48.272099	0	0	0	0	59.22489423	0	0	0	0	0	8.233868931	0.150806149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	206.461			36.1654	0	37.15382647	0	5.827136436	9.189642471	0	0.624185597	1.619115847	48.272099	0	0	0	0	59.22489423	0	0	0	0	0	8.233868931	0.150806149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	206.461																																																																																				0			36.1654	0	37.15382647	0	5.827136436	9.189642471	0	0.624185597	1.619115847	48.272099	0	0	0	0	59.22489423	0	0	0	0	0	8.233868931	0.150806149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	206.461
H2931_002_0	2008	13	h.5.	h.5.	f.	g.							OP Facility - Other	OP Facility - Other	OP Facility - Emergency	OP Facility - Surgery							3250	Complex diag	PET scans	Urgent Care	ASC							A		D	V	Coin	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	V	V	Coin											P	V	V	V																																																0		434.9992533	3.900496532	276.3663923	7527.898337	10.65499889	31.51841794	2.372978287	115.6068821	200.9048094	428.1476726	1359.370782	0	22.00885257	7264.296902	6787.02359	4658.187388	13.13653388	257.2284644	2602.546816	2777.242084	18.45865245											45.288257	3.802524	547.751789	146.814774							$600/Admit	$600/Admit	$25/day >20	No Cost Sharing	20% coins	20% coins	20% coins	$50/visit	$50/visit	$20/procedure	$50/procedure	$50/visit	$10/visit	$10/visit	$10/visit	$20/visit	$10/visit	$10/visit	$20/visit	$20/visit	20% coins											$50/visit	$200/visit	$25/visit	$25/visit							567.6	567.6	23.65	0	0.1892	0.1892	0.1892	47.3	47.3	18.92	47.3	47.3	9.46	9.46	9.46	18.92	9.46	9.46	18.92	18.92	0.1892											47.3	189.2	23.65	23.65							20.5755	0.184493486	0.544672098	0	2.015925791	5.963284674	0.448967492	0.455683794	0.79189979	0.675046164	5.358186499	0	0.017350312	5.726687391	5.35043693	7.344408782	0.010355968	0.202781773	4.103348814	4.378785019	3.492377043	0	0	0	0	0	0	0	0	0	0	0.178511213	0.059953128	1.079527484	0.28934745	0	0	0	0	0	0	69.2475	0	3.952816884	20.5755	0.184493486	0.544672098	0	2.015925791	5.963284674	0.448967492	0.455683794	0.79189979	0.675046164	5.358186499	0	0.017350312	5.726687391	5.35043693	7.344408782	0.010355968	0.202781773	4.103348814	4.378785019	3.492377043	0	0	0	0	0	0	0	0	0	0	0.178511213	0.059953128	1.079527484	0.28934745	0	0	0	0	0	0	69.2475																														20% Coins																																									1.7389													1.7389	0	0	20.5755	0.184493486	0.544672098	0	2.015925791	5.963284674	0.448967492	0.455683794	0.79189979	0.675046164	5.358186499	0	0.017350312	5.726687391	5.35043693	7.344408782	0.010355968	0.202781773	4.103348814	4.378785019	3.492377043	0	0	0	0	0	0	0	1.738910592	0	0	0.178511213	0.059953128	1.079527484	0.28934745	0	0	0	0	0	0	70.9864
H2931_004_0	2008	10	g.	f.									OP Facility - Surgery	OP Facility - Emergency									2500	ASC	Urgent Care									A	A			Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	V	V	V	V	V	V	Coin	Coin										V	V																																																		0	N/A	360.2237636	0.17390148			11.93487909	22.69779337	3.349857066	236.9615324	21.05029402	0.846346112	23.91191393	0	578.4989858	29.86061062	5686.530698	7354.418315	215.0977287	420.3551439	2820.359977	2014.007952	1.76119333	7.435772974										146.814774	547.751789									$800/Stay	$800/Stay	No cost Sharing	No cost Sharing	20% of EME	20% of EME	20% of EME	$50/visit	20% of EME	20% of EME	20% of EME	20% of EME	$20/visit	20% of EME	$10/visit	$40/visit	$20/visit	$20/visit	$20/visit	$20/visit	0.2	0.2										$25/visit	$40/visit									704	704			0.176	0.176	0.176	44	0.176	0.176	0.176	0.176	17.6	0.176	8.8	35.2	17.6	17.6	17.6	17.6	0.176	0.176										22	35.2									21.1331	0.01020222	0	0	2.100538719	3.994811634	0.589574844	0.868858952	3.704851748	0.148956916	4.208496851	0	0.848465179	5.255467468	4.170122512	21.57296039	0.315476669	0.616520878	4.136527966	2.953878329	0.309970026	1.308696043	0	0	0	0	0	0	0	0	0	0.269160419	1.606738581	0	0	0	0	0	0	0	0	80.1234	0	10.9259187	21.1331	0.01020222	0	0	2.100538719	3.994811634	0.589574844	0.868858952	3.704851748	0.148956916	4.208496851	0	0.848465179	5.255467468	4.170122512	21.57296039	0.315476669	0.616520878	4.136527966	2.953878329	0.309970026	1.308696043	0	0	0	0	0	0	0	0	0	0.269160419	1.606738581	0	0	0	0	0	0	0	0	80.1234	N/A																																																																																			0		0	21.1331	0.01020222	0	0	2.100538719	3.994811634	0.589574844	0.868858952	3.704851748	0.148956916	4.208496851	0	0.848465179	5.255467468	4.170122512	21.57296039	0.315476669	0.616520878	4.136527966	2.953878329	0.309970026	1.308696043	0	0	0	0	0	0	0	0	0	0.269160419	1.606738581	0	0	0	0	0	0	0	0	80.1234
H2931_006_0	2008	14	f.										OP Facility - Emergency										3250	Urgent Care										A	A		V	Coin	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin								Coin			V																																																			0		302.8139846	7.673875323	154.1256585		9.003453249	21.45471021	2.557177102	403.2069581	280.7913342	0.510617324	20.1337352	0	72.74104644	1542.877614	5770.984125	7451.076509	218.2922494	426.598042	2862.246511	2043.918961	1.509752009								10.6			547.751789										$625/Admit	$625/Admit	$25/day >20	No cost sharing	20% coinsurance	20% coinsurance	20% coinsurance	$50 per visit	"$25/vist ASC, $50 OH"	20% coinsurance	20% coinsurance	$20 per visit	$20 per visit	$20 per visit	$10 per visit	$40 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	20% coinsurance								20% coinsurance			$25/visit										600.625	600.625	24.025	0	0.1922	0.1922	0.1922	48.05	28.83	0.1922	0.1922	19.22	19.22	19.22	9.61	38.44	19.22	19.22	19.22	19.22	0.1922											23.65										15.1565	0.384093447	0.308572412	0	1.730463714	4.123595302	0.491489439	1.614507861	0.674601181	0.09814065	3.869703906	0	0.116506909	2.471175644	4.621596453	23.86828175	0.34963142	0.683267864	4.584364829	3.273676869	0.290174336	0	0	0	0	0	0	0	0	0	0	1.079527484	0	0	0	0	0	0	0	0	0	69.7898	0	2.832262069	15.1565	0.384093447	0.308572412	0	1.730463714	4.123595302	0.491489439	1.614507861	0.674601181	0.09814065	3.869703906	0	0.116506909	2.471175644	4.621596453	23.86828175	0.34963142	0.683267864	4.584364829	3.273676869	0.290174336	0	0	0	0	0	0	0	0	0	0	1.079527484	0	0	0	0	0	0	0	0	0	69.7898																														0.2																																									2.12													2.12	0	0	15.1565	0.384093447	0.308572412	0	1.730463714	4.123595302	0.491489439	1.614507861	0.674601181	0.09814065	3.869703906	0	0.116506909	2.471175644	4.621596453	23.86828175	0.34963142	0.683267864	4.584364829	3.273676869	0.290174336	0	0	0	0	0	0	0	2.12	0	0	1.079527484	0	0	0	0	0	0	0	0	0	71.9098
H2931_015_0	2008	9	h.5.	h.5.	f.	g.							OP Facility - Other	OP Facility - Other	OP Facility - Emergency	OP Facility - Surgery							3250	Complex diag	PET scans	Urgent Care	ASC							A	A	D	V	Coin	Coin	Coin	V	V	V	V	V	Coin	v	V	V	V	V	V	V	Coin											P	V	V	V																																																0		1062.006052	0.970821423	1019.362494	2296.963486	37.54613928	18.07057049	5.795367324	1922.017911	433.0892225	1527.425705	357.9094979	0	28.34312389	6053.395178	1934.523488	5960	117.145785	96.434928	325	827.1398522	9.594899951											45.288257	3.802524	547.751789	146.814774							"$1,200/stay"	"$1,200/stay"	$200/day	No Cost Sharing	20% of Allowed Cost	20% of Allowed Cost	20% of Allowed Cost	$50/visit ER	$50/OH visit	$25/visit	$25/visit	$25/visit	10% coinsurance	$25/visit	$10/visit	$40/visit	$20/visit	$20/visit	$20/visit	$20/visit	20% of Allowed Cost											$50/visit	$200/visit	$25/visit	$25/visit							672	672	112	0	0.112	0.112	0.112	28	28	14	14	14	0.056	14	5.6	22.4	11.2	11.2	11.2	11.2	0.112											28	112	14	14							59.4723	0.054366	9.514049943	0	4.205167599	2.023903895	0.64908114	4.484708458	1.010541519	1.781996656	0.417561081	0	1.587214938	7.062294375	0.902777628	11.12533333	0.109336066	0.090005933	0.303333333	0.771997195	1.074628795	0	0	0	0	0	0	0	0	0	0	0.1056726	0.035490224	0.639043754	0.171283903	0	0	0	0	0	0	107.5921	0	84.53667142	59.4723	0.054366	9.514049943	0	4.205167599	2.023903895	0.64908114	4.484708458	1.010541519	1.781996656	0.417561081	0	1.587214938	7.062294375	0.902777628	11.12533333	0.109336066	0.090005933	0.303333333	0.771997195	1.074628795	0	0	0	0	0	0	0	0	0	0	0.1056726	0.035490224	0.639043754	0.171283903	0	0	0	0	0	0	107.5921																																																																																				0			59.4723	0.054366	9.514049943	0	4.205167599	2.023903895	0.64908114	4.484708458	1.010541519	1.781996656	0.417561081	0	1.587214938	7.062294375	0.902777628	11.12533333	0.109336066	0.090005933	0.303333333	0.771997195	1.074628795	0	0	0	0	0	0	0	0	0	0	0.1056726	0.035490224	0.639043754	0.171283903	0	0	0	0	0	0	107.5921
H2931_801_0	2008	9	f.	g.									OP Facility - Emergency	OP Facility - Surgery									2500	Urgent care center	ASC													Coin	Coin	Coin	V	V		Coin	V	V	V	V	V	V	V	V	V	Coin											V	V																																																		0						10.05584063	34.74905578	2.616208562	202.9852552	176.8601397		2.682309737	0	3.835675457	2799.162188	11805.40762	7896.874164	119.4239884	97.44330245	1420.098213	514.9046181	17.45660186											116.120365	139.89151									No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% Coinsurance	20% Coinsurance	20% Coinsurance	50	50	No Cost Sharing	20% Coinsurance	$25/visit	$25/visit	$25/visit	$10/visit	$20/visit	$10/visit	$10/visit	$10/visit	$10/visit	20% Coinsurance											25	25													0.1946	0.1946	0.1946	48.65	48.65		0.1946	24.325	24.325	24.325	9.73	19.46	9.73	9.73	9.73	9.73	0.1946											24.325	24.325									0	0	0	0	1.956866587	6.762166254	0.509114186	0.822936056	0.717020483	0	0.521977475	0	0.007775234	5.674135018	9.572218016	12.8060976	0.096832951	0.079010278	1.151462967	0.417501828	3.397054721	0	0	0	0	0	0	0	0	0	0	0.235385657	0.283571748	0	0	0	0	0	0	0	0	45.0111		1.249024081	0	0	0	0	1.956866587	6.762166254	0.509114186	0.822936056	0.717020483	0	0.521977475	0	0.007775234	5.674135018	9.572218016	12.8060976	0.096832951	0.079010278	1.151462967	0.417501828	3.397054721	0	0	0	0	0	0	0	0	0	0	0.235385657	0.283571748	0	0	0	0	0	0	0	0	45.0111																																																																																				0			0	0	0	0	1.956866587	6.762166254	0.509114186	0.822936056	0.717020483	0	0.521977475	0	0.007775234	5.674135018	9.572218016	12.8060976	0.096832951	0.079010278	1.151462967	0.417501828	3.397054721	0	0	0	0	0	0	0	0	0	0	0.235385657	0.283571748	0	0	0	0	0	0	0	0	45.0111
H2931_803_0	2008	9	f.	g.									OP Facility - Emergency	OP Facility - Surgery									2500	Urgent care center	ASC													Coin	Coin	Coin	V	V		Coin	V	V	V	V	V	V	V	V	V	Coin											V	V																																																		0						10.05584063	34.74905578	2.616208562	202.9852552	176.8601397		2.682309737	0	3.835675457	2799.162188	11805.40762	7896.874164	119.4239884	97.44330245	1420.098213	514.9046181	17.45660186											116.120365	139.89151									No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% Coinsurance	20% Coinsurance	20% Coinsurance	50	50	No Cost Sharing	20% Coinsurance	$25/visit	$25/visit	$25/visit	$10/visit	$20/visit	$10/visit	$10/visit	$10/visit	$10/visit	20% Coinsurance											25	25													0.1946	0.1946	0.1946	48.65	48.65		0.1946	24.325	24.325	24.325	9.73	19.46	9.73	9.73	9.73	9.73	0.1946											24.325	24.325									0	0	0	0	1.956866587	6.762166254	0.509114186	0.822936056	0.717020483	0	0.521977475	0	0.007775234	5.674135018	9.572218016	12.8060976	0.096832951	0.079010278	1.151462967	0.417501828	3.397054721	0	0	0	0	0	0	0	0	0	0	0.235385657	0.283571748	0	0	0	0	0	0	0	0	45.0111		1.249024081	0	0	0	0	1.956866587	6.762166254	0.509114186	0.822936056	0.717020483	0	0.521977475	0	0.007775234	5.674135018	9.572218016	12.8060976	0.096832951	0.079010278	1.151462967	0.417501828	3.397054721	0	0	0	0	0	0	0	0	0	0	0.235385657	0.283571748	0	0	0	0	0	0	0	0	45.0111																																																																																				0			0	0	0	0	1.956866587	6.762166254	0.509114186	0.822936056	0.717020483	0	0.521977475	0	0.007775234	5.674135018	9.572218016	12.8060976	0.096832951	0.079010278	1.151462967	0.417501828	3.397054721	0	0	0	0	0	0	0	0	0	0	0.235385657	0.283571748	0	0	0	0	0	0	0	0	45.0111
H2931_804_0	2008	9	f.	g.									OP Facility - Emergency	OP Facility - Surgery									2500	Urgent care center	ASC													Coin	Coin	Coin	V	V		Coin	V	V	V	V	V	V	V	V	V	Coin											V	V																																																		0						10.05584063	34.74905578	2.616208562	202.9852552	176.8601397		2.682309737	0	3.835675457	2799.162188	11805.40762	7896.874164	119.4239884	97.44330245	1420.098213	514.9046181	17.45660186											116.120365	139.89151									No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% Coinsurance	20% Coinsurance	20% Coinsurance	50	50	No Cost Sharing	20% Coinsurance	$25/visit	$25/visit	$25/visit	$10/visit	$20/visit	$10/visit	$10/visit	$10/visit	$10/visit	20% Coinsurance											25	25													0.1946	0.1946	0.1946	48.65	48.65		0.1946	24.325	24.325	24.325	9.73	19.46	9.73	9.73	9.73	9.73	0.1946											24.325	24.325									0	0	0	0	1.956866587	6.762166254	0.509114186	0.822936056	0.717020483	0	0.521977475	0	0.007775234	5.674135018	9.572218016	12.8060976	0.096832951	0.079010278	1.151462967	0.417501828	3.397054721	0	0	0	0	0	0	0	0	0	0	0.235385657	0.283571748	0	0	0	0	0	0	0	0	45.0111		1.680913459	0	0	0	0	1.956866587	6.762166254	0.509114186	0.822936056	0.717020483	0	0.521977475	0	0.007775234	5.674135018	9.572218016	12.8060976	0.096832951	0.079010278	1.151462967	0.417501828	3.397054721	0	0	0	0	0	0	0	0	0	0	0.235385657	0.283571748	0	0	0	0	0	0	0	0	45.0111																																																																																				0			0	0	0	0	1.956866587	6.762166254	0.509114186	0.822936056	0.717020483	0	0.521977475	0	0.007775234	5.674135018	9.572218016	12.8060976	0.096832951	0.079010278	1.151462967	0.417501828	3.397054721	0	0	0	0	0	0	0	0	0	0	0.235385657	0.283571748	0	0	0	0	0	0	0	0	45.0111
H2949_002_0	2008	5																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1305.735936	7.090639443	293.7823293		528.8923349	16.28921212	16.97850361	513.8164795	130.0190412	13407.64503	52.6481588			501.2764998	5909.369915	5527.535544	197.2744818	526.8807066			30.3578538	953.8200085			108.4057046	0.728236595																$195 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	$75 (9b)	$0 (8a1); $0/$8 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$175 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $175 (9a)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $10/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/20% (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $10/$30 (17a); $30( 18a, 16b)"	$0 (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											83.5321	912	41.2041		100	0.2	0.2	46.4826	75	3.2	0.114064725			5.9002	10	29.8196	30	7.9579			0.2	30			30	0.413715545																9.0892	0.538888598	1.008753137	0	4.407436124	3.257842425	3.395700722	1.990295864	0.812619008	3.575372008	6.005297747	0	0	0.246469979	4.924474929	13.73574183	0.493186204	0.349405766	0	0	6.071570761	2.384550021	0	0	0.271014262	0.3012828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8591	0	0	9.0892	0.538888598	1.008753137	0	4.407436124	3.257842425	3.395700722	1.990295864	0.812619008	3.575372008	6.005297747	0	0	0.246469979	4.924474929	13.73574183	0.493186204	0.349405766	0	0	6.071570761	2.384550021	0	0	0.271014262	0.3012828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8591																																																																																				0			9.0892	0.538888598	1.008753137	0	4.407436124	3.257842425	3.395700722	1.990295864	0.812619008	3.575372008	6.005297747	0	0	0.246469979	4.924474929	13.73574183	0.493186204	0.349405766	0	0	6.071570761	2.384550021	0	0	0.271014262	0.3012828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8591
H2949_007_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1124.687911	7.361661382	217.8809826		530.51053	15.91674832	21.69462959	568.1038015	136.1988028	13165.94425	50.06658675			481.4720688	5947.052939	5824.218896	193.4943882	466.4100383			27.18320982	938.4636624			133.5519972	0.220746814																$100 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$5 (4b)"	$75 (9b)	$0 (8a1); $0/$8 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $100 (9a)"	"$5/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $5 (14c1, 14c)"	"$30 (7b); $0 n/c (7b1, 7f1); $15 (7d); $5/$30( 7f); $5/$15( 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/20% (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $5/$30 (17a); $30( 18a, 16b)"	$0 (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											42.837	912	69.5467		100	0.2	0.2	46.8703	75	3.2	0.11378489			4.0553	5	15.5633	30	7.9579			0.2	30			30	0.414429443																4.0149	0.559486265	1.262741214	0	4.420921084	3.183349663	4.338925919	2.218934974	0.851242517	3.510918467	5.696821053	0	0	0.162709806	2.477938725	7.553668832	0.483735971	0.309304088	0	0	5.436641965	2.346159156	0	0	0.333879993	0.091483979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.2537	0	0	4.0149	0.559486265	1.262741214	0	4.420921084	3.183349663	4.338925919	2.218934974	0.851242517	3.510918467	5.696821053	0	0	0.162709806	2.477938725	7.553668832	0.483735971	0.309304088	0	0	5.436641965	2.346159156	0	0	0.333879993	0.091483979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.2537																																																																																				0			4.0149	0.559486265	1.262741214	0	4.420921084	3.183349663	4.338925919	2.218934974	0.851242517	3.510918467	5.696821053	0	0	0.162709806	2.477938725	7.553668832	0.483735971	0.309304088	0	0	5.436641965	2.346159156	0	0	0.333879993	0.091483979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.2537
H2949_009_0	2008	5																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0			7.090639443	293.7823293		528.8923349	16.02734776	16.92461554	513.6478546			51.85751845			28.07327425		459.2596349	197.2744818	526.8807066			30.12454164	953.8200085																				"$0 (1a, 1a1)"	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$0 (4b)"	$0 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$0 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $0 (9a)"	"$0/$50/$30 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14f1, 14h1)"	$30 (7b); $10 (7b1); $0 (7d); $0/$30( 7f); $0 n/c( 7f1); $0/$0( 7g)	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/20% (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $0/$30 (17a); $30( 18a, 16b)"	$0 (10b)	$0 n/c; $20 (16)	$0 (17a1)	$0 n/c; $0 (17b)	$0 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"												912	63.2242		100	0.2	0.2	46.4815			0.11449231			31.6093		18.8088	30	7.9579			0.2	30																				0	0.538888598	1.547846946	0	4.407436124	3.205469551	3.384923107	1.98959326	0	0	5.9372871	0	0	0.07394797	0	0.719844889	0.493186204	0.349405766	0	0	6.024908328	2.384550021	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.0573	0	0	0	0.538888598	1.547846946	0	4.407436124	3.205469551	3.384923107	1.98959326	0	0	5.9372871	0	0	0.07394797	0	0.719844889	0.493186204	0.349405766	0	0	6.024908328	2.384550021	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.0573																																																																																				0			0	0.538888598	1.547846946	0	4.407436124	3.205469551	3.384923107	1.98959326	0	0	5.9372871	0	0	0.07394797	0	0.719844889	0.493186204	0.349405766	0	0	6.024908328	2.384550021	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.0573
H2949_011_0	2008	3																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0			7.122262569	295.0925518		531.2511108	15.89493288	17.01918065	515.9368586			51.4887112			28.19847659		255.3935925	198.1542947	529.230511			30.14820961	958.0738943																				"$0 (1a, 1a1)"	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$0 (4b)"	$0 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$0 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $0 (9a)"	"$0/$50/$30 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$30 (7b); $0 n/c (7b1, 7f1); $0 (7d); $0/$30( 7f); $0/$0( 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/20% (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $0/$30 (17a); $30( 18a, 16b)"	$0 (10b)	$0 n/c; $20 (16)	$0 (17a1)	$0 n/c; $0 (17b)	$0 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"												912	63.2242		100	0.2	0.2	46.4815			0.114896348			31.6191		25.8526	30	7.9579			0.2	30																				0	0.541291955	1.554750098	0	4.42709259	3.178986577	3.40383613	1.998459097	0	0	5.91586487	0	0	0.07430077	0	0.550215024	0.495385737	0.35096406	0	0	6.029641921	2.395184736	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.916	0	0	0	0.541291955	1.554750098	0	4.42709259	3.178986577	3.40383613	1.998459097	0	0	5.91586487	0	0	0.07430077	0	0.550215024	0.495385737	0.35096406	0	0	6.029641921	2.395184736	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.916																																																																																				0			0	0.541291955	1.554750098	0	4.42709259	3.178986577	3.40383613	1.998459097	0	0	5.91586487	0	0	0.07430077	0	0.550215024	0.495385737	0.35096406	0	0	6.029641921	2.395184736	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.916
H2949_012_0	2008	6																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		342.5522349	7.090639443	293.7823293		528.8923349	16.2436705	16.96913177	513.6478546	130.0190412	13407.64503	52.51065613			501.2764998		5527.535544	197.2744818	526.8807066			30.31727778	953.8200085			144																	$50 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$0 (4b)"	$50 (9b)	$0 (8a1); $0/$8 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$50 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $50 (9a)"	"$0/$50/$30 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$30 (7b); $0 n/c (7b1, 7f1); $15 (7d); $0/$30( 7f); $0/$15( 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/20% (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $0/$30 (17a); $30( 18a, 16b)"	$0 (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											50	912	41.2041		100	0.2	0.2	46.4815	50	3.2	0.114138163			2.9502		15.5082	30	7.9579			0.2	30			30																	1.4273	0.538888598	1.008753137	0	4.407436124	3.248734099	3.393826354	1.98959326	0.541746005	3.575372008	5.993469808	0	0	0.123239972	0	7.143495262	0.493186204	0.349405766	0	0	6.063455555	2.384550021	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0425	0	0	1.4273	0.538888598	1.008753137	0	4.407436124	3.248734099	3.393826354	1.98959326	0.541746005	3.575372008	5.993469808	0	0	0.123239972	0	7.143495262	0.493186204	0.349405766	0	0	6.063455555	2.384550021	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0425																																																																																				0			1.4273	0.538888598	1.008753137	0	4.407436124	3.248734099	3.393826354	1.98959326	0.541746005	3.575372008	5.993469808	0	0	0.123239972	0	7.143495262	0.493186204	0.349405766	0	0	6.063455555	2.384550021	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0425
H2949_801_0	2008	4																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1458.698514	53.82636189	283.0778099		9.383034246	17.30314324	19.86282341	568.8187148	155.00527		43.96496201		7.521348493	640.5738271	5940.906952	5801.184356	1.765779087	544.1081349			31.94335862	1019.124699			145.803291																	$550 (1a); $0 (1a1)	$550 (1b)	"$200 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											505.6174	518.9961	198.962		0.3	0.3	0.3	46.6111	300		0.201650137		0.3	7.5098	20	39.4399	0.400816906	40			0.3	40			40																	61.4619	2.327972833	4.693476141	0	2.814910274	5.190942973	5.958847024	2.209441172	3.875131749	0	8.865540608	0	2.256404548	0.40088279	9.901511587	19.06648999	0.70775411	1.813693783	0	0	9.583007585	3.397082331	0	0	0.48601097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.011	0	0	61.4619	2.327972833	4.693476141	0	2.814910274	5.190942973	5.958847024	2.209441172	3.875131749	0	8.865540608	0	2.256404548	0.40088279	9.901511587	19.06648999	0.70775411	1.813693783	0	0	9.583007585	3.397082331	0	0	0.48601097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.011																																																																																				0			61.4619	2.327972833	4.693476141	0	2.814910274	5.190942973	5.958847024	2.209441172	3.875131749	0	8.865540608	0	2.256404548	0.40088279	9.901511587	19.06648999	0.70775411	1.813693783	0	0	9.583007585	3.397082331	0	0	0.48601097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.011
H2949_802_0	2008	4																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1458.698514	53.82636189	283.0778099		9.383034246	17.30314324	19.86282341	568.8187148	155.00527		43.96496201		7.521348493	640.5738271	5940.906952	5801.184356	1.765779087	544.1081349			31.94335862	1019.124699			145.803291																	$550 (1a); $0 (1a1)	$550 (1b)	"$175 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											505.6174	518.9961	174.0917		0.3	0.3	0.3	46.6111	300		0.201650137		0.3	7.5098	20	39.4399	0.400816906	40			0.3	40			40																	61.4619	2.327972833	4.106791623	0	2.814910274	5.190942973	5.958847024	2.209441172	3.875131749	0	8.865540608	0	2.256404548	0.40088279	9.901511587	19.06648999	0.70775411	1.813693783	0	0	9.583007585	3.397082331	0	0	0.48601097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.4244	0	0	61.4619	2.327972833	4.106791623	0	2.814910274	5.190942973	5.958847024	2.209441172	3.875131749	0	8.865540608	0	2.256404548	0.40088279	9.901511587	19.06648999	0.70775411	1.813693783	0	0	9.583007585	3.397082331	0	0	0.48601097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.4244																																																																																				0			61.4619	2.327972833	4.106791623	0	2.814910274	5.190942973	5.958847024	2.209441172	3.875131749	0	8.865540608	0	2.256404548	0.40088279	9.901511587	19.06648999	0.70775411	1.813693783	0	0	9.583007585	3.397082331	0	0	0.48601097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.4244
H2949_803_0	2008	6																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1302.182327	51.22481695	267.9849909		9.270602943	17.43595784	11.44061645	447.5250057	131.1878872		39.31252571		4.648921595	504.9699138	5679.847159	5491.63777	1.734514569	589.9999478			26.48138371	24.80392652			132.449743																	$600 (1a); $0 (1a1)	$600 (1b)	"$200 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											551.5826	566.1776	198.962		0.3	0.3	0.3	47.1342	300		0.203658016		0.3	7.5123	20	39.2484	0.402463702	40			0.3	40			40																	59.8551	2.41686202	4.443234747	0	2.781180883	5.230787351	3.432184935	1.757809955	3.27969718	0	8.006310978	0	1.394676479	0.316124176	9.466411932	17.96147691	0.698079155	1.966666493	0	0	7.944415112	0.082679755	0	0	0.441499143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.4752	0	0	59.8551	2.41686202	4.443234747	0	2.781180883	5.230787351	3.432184935	1.757809955	3.27969718	0	8.006310978	0	1.394676479	0.316124176	9.466411932	17.96147691	0.698079155	1.966666493	0	0	7.944415112	0.082679755	0	0	0.441499143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.4752																																																																																				0			59.8551	2.41686202	4.443234747	0	2.781180883	5.230787351	3.432184935	1.757809955	3.27969718	0	8.006310978	0	1.394676479	0.316124176	9.466411932	17.96147691	0.698079155	1.966666493	0	0	7.944415112	0.082679755	0	0	0.441499143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.4752
H2949_804_0	2008	4																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1302.182327	51.22481695	267.9849909		9.270602943	17.46952053	11.45068645	447.5250057	131.1878872		39.37720827		4.656730927	504.9699138	5679.847159	5491.63777	1.734799989	589.9999478			26.50998871	985.9507507			132.449743																	$580 (1a); $0 (1a1)	$580 (1b)	"$200 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											533.1965	547.305	198.962		0.3	0.3	0.3	47.1342	300		0.203659939		0.3	7.5123	20	39.2493	0.402397486	40			0.3	40			40																	57.8599	2.336299952	4.443234747	0	2.781180883	5.240856159	3.435205936	1.757809955	3.27969718	0	8.01955985	0	1.397019278	0.316124176	9.466411932	17.96190702	0.698079155	1.966666493	0	0	7.952996612	3.286502502	0	0	0.441499143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.641	0	0	57.8599	2.336299952	4.443234747	0	2.781180883	5.240856159	3.435205936	1.757809955	3.27969718	0	8.01955985	0	1.397019278	0.316124176	9.466411932	17.96190702	0.698079155	1.966666493	0	0	7.952996612	3.286502502	0	0	0.441499143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.641																																																																																				0			57.8599	2.336299952	4.443234747	0	2.781180883	5.240856159	3.435205936	1.757809955	3.27969718	0	8.01955985	0	1.397019278	0.316124176	9.466411932	17.96190702	0.698079155	1.966666493	0	0	7.952996612	3.286502502	0	0	0.441499143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.641
H2960_004_0	2008	6																					3500											D	D	A	V	T	Coin	Coin	V	P	P	P	P	Coin	V	V	V	V	V	V	V	Coin	V	T	Coin	V	Coin	Coin	Coin	P	V	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	877.9919623	23.24483842	123.4068458	1069.087211	234.9474209	12.20789633	11.47353259	652.4383737	166.4879708	374.1199875	1059.919155	39.12517196	20.56085496	691.9	4689.825358	2627.582594	165.0727918	341.2221826	664.7227711	398.1600864	0.708408005	204.1530401	0.23621989	0	1064.292941	0	0	0	0	30.23614595	0											PBP: 1A IP Acute: $200 per day (days 1-4)	1B IP Psych: $200 per day (days 1-4)	2 SNF: $200 per stay plus $50 per day for days 35-100 only	"6 Home Health: $10, 13C Custodial Care: $150 per episode"	10A Ambulance: $150	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0-20%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $200	8A OP C/D/T: $0-$50	8B OP X-Ray: $0-$50	9A OP Hospital: $0	12 Renal Dialysis: 20%	"3 CORF: $50, 5 Partial Hosp: $40, 9C OP Substance Abuse: $40, 9D Cardiac Rehab: $15"	"7A PCP: $15, 14B Immunizations: $0, separate office visit copay applies, 14C Routine Physical Exams: $0, separate office visit copay applies, 14D Pap/Pelvic: $0, separate office visit copay applies, 14E Prostate Screening: $0, separate office visit copay applies, 14F Colorectal Screening: $50, 14G Bone Mass Measurement: $0, separate office visit copay applies, 14H Mammography: $0, 14I Diabetes Monitoring: $0-$30, separate office visit copay may apply"	"7B Chiropractic: $40, 7D Physician Specialist: $40, 7F Podiatry: $40"	"7E Mental Health: $40, 7H Psychiatric: $40"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	Included in i.2.	"7G Other Health Care: $40, 18A Medicare Covered Hearing Exams: $40"	15 Part B Drugs: 20%	"13A Blood: 20%, 16B Comprehensive Dental Services: $40, 17A Medicare Covered Eye Exams: $20"	10B Transportation: $0	16A Preventive Dental Services: Not Covered	17A Routine Eye Exams: $20	17B Eye Wear: No member cost sharing	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											194	194	321.1131528	15.811	145.5	0.194	0.194	47.62049819	194	48.5	48.5	0	0.194	30.59623689	14.55	38.8	38.8	24.25	0	38.8	0.194	20.59902324	0	0	19.4	0	0	0	0	0	0											14.1942	0.375791554	3.302296778	1.408611492	2.848737479	2.368331887	2.225865322	2.589120033	2.691555528	1.512068283	4.283839918	0	3.988805862	1.764128025	5.686413247	8.495850387	0.53373536	0.689553161	0	1.287384279	0.137431153	0.350446102	0	0	1.720606921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.4548	0	1.93	14.1942	0.375791554	3.302296778	1.408611492	2.848737479	2.368331887	2.225865322	2.589120033	2.691555528	1.512068283	4.283839918	0	3.988805862	1.764128025	5.686413247	8.495850387	0.53373536	0.689553161	0	1.287384279	0.137431153	0.350446102	0	0	1.720606921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.4548	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.1942	0.375791554	3.302296778	1.408611492	2.848737479	2.368331887	2.225865322	2.589120033	2.691555528	1.512068283	4.283839918	0	3.988805862	1.764128025	5.686413247	8.495850387	0.53373536	0.689553161	0	1.287384279	0.137431153	0.350446102	0	0	1.720606921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.4548
H2960_009_0	2008	4																					4000											D	D	A	V	T	Coin	Coin	V	P	P	P	P	Coin	V	V	V	V	V	V	V	Coin	V	T	Coin	V	Coin	Coin	Coin	P	V	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	894.1512631	23.67265593	125.6781289	1088.763589	239.2715904	12.43258069	11.68470111	664.446397	169.5521551	381.0056056	1079.426796	39.84526445	20.93927419	691.9	4776.140839	2697.106857	167.4859761	347.502322	668.8978761	422.3050765	0.721446141	207.910444	0.240567479	0	1083.881081	0	0	0	0	30.79263735	0											PBP: 1A IP Acute: $200 per day (days 1-4)	1B IP Psych: $200 per day (days 1-4)	2 SNF: $200 per stay plus $50 per day for days 35-100 only	"6 Home Health: $10, 13C Custodial Care: $150 per episode"	10A Ambulance: $150	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0-20%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $200	8A OP C/D/T: $0-$50	8B OP X-Ray: $0-$50	9A OP Hospital: $0	12 Renal Dialysis: 20%	"3 CORF: $50, 5 Partial Hosp: $40, 9C OP Substance Abuse: $40, 9D Cardiac Rehab: $15"	"7A PCP: $15, 14B Immunizations: $0, separate office visit copay applies, 14C Routine Physical Exams: $0, separate office visit copay applies, 14D Pap/Pelvic: $0, separate office visit copay applies, 14E Prostate Screening: $0, separate office visit copay applies, 14F Colorectal Screening: $50, 14G Bone Mass Measurement: $0, separate office visit copay applies, 14H Mammography: $0, 14I Diabetes Monitoring: $0-$30, separate office visit copay may apply"	"7B Chiropractic: $40, 7D Physician Specialist: $40, 7F Podiatry: $40"	"7E Mental Health: $40, 7H Psychiatric: $40"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	Included in i.2.	"7G Other Health Care: $40, 18A Medicare Covered Hearing Exams: $40"	15 Part B Drugs: 20%	"13A Blood: 20%, 16B Comprehensive Dental Services: $40, 17A Medicare Covered Eye Exams: $20"	10B Transportation: $0	16A Preventive Dental Services: Not Covered	17A Routine Eye Exams: Not Covered	17B Eye Wear: No member cost sharing	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											195	195	322.7683752	15.8925	146.25	0.195	0.195	47.86596467	195	48.75	48.75	0	0.195	30.75394945	14.625	39	39	24.375	0	39	0.195	30.05323009	0	0	19.5	0	0	0	0	0	0											14.53	0.384680659	3.380410457	1.441931279	2.916122508	2.424353235	2.278516716	2.65036398	2.75522252	1.547835273	4.38517136	0	4.083158466	1.773221469	5.820921648	8.765597284	0.544329422	0.705864091	0	1.372491499	0.140681997	0.520698368	0	0	1.761306757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1828	0	1.64571377	14.53	0.384680659	3.380410457	1.441931279	2.916122508	2.424353235	2.278516716	2.65036398	2.75522252	1.547835273	4.38517136	0	4.083158466	1.773221469	5.820921648	8.765597284	0.544329422	0.705864091	0	1.372491499	0.140681997	0.520698368	0	0	1.761306757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1828	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.53	0.384680659	3.380410457	1.441931279	2.916122508	2.424353235	2.278516716	2.65036398	2.75522252	1.547835273	4.38517136	0	4.083158466	1.773221469	5.820921648	8.765597284	0.544329422	0.705864091	0	1.372491499	0.140681997	0.520698368	0	0	1.761306757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1828
H2960_010_0	2008	6																					3500											D	D	A	V	T	Coin	Coin	V	P	P	P	P	Coin	V	V	V	V	V	V	V	Coin	V	T	Coin	V	Coin	Coin	Coin	P	V	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	914.6848824	24.21628353	150.2112147	1301.296436	285.9787661	14.85949117	13.96562124	794.1501137	179.4478666	455.3800674	1290.137048	47.62328675	25.02673963	691.9	5708.470703	3340.13668	207.4156201	415.3367522	828.3670728	505.2275808	0.862276532	248.4957454	0.28752762	0	1295.460835	0	0	0	0	36.80353534	0											PBP: 1A IP Acute: $200 per day (days 1-4)	1B IP Psych: $200 per day (days 1-4)	2 SNF: $200 per stay plus $50 per day for days 35-100 only	"6 Home Health: $0, 13C Custodial Care: $150 per episode"	10A Ambulance: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0-20%"	"4A ER: $50, 4B Urgent Care: $15"	9B ASC Services: $200	8A OP C/D/T: $0-$50	8B OP X-Ray: $0-$50	9A OP Hospital: $0	12 Renal Dialysis: 20%	"3 CORF: $50, 5 Partial Hosp: $30, 9C OP Substance Abuse: $30, 9D Cardiac Rehab: $15"	"7A PCP: $15, 14B Immunizations: $0, separate office visit copay applies, 14C Routine Physical Exams: $0, separate office visit copay applies, 14D Pap/Pelvic: $0, separate office visit copay applies, 14E Prostate Screening: $0, separate office visit copay applies, 14F Colorectal Screening: $50, 14G Bone Mass Measurement: $0, separate office visit copay applies, 14H Mammography: $0, 14I Diabetes Monitoring: $0-$30, separate office visit copay may apply"	"7B Chiropractic: $30, 7D Physician Specialist: $30, 7F Podiatry: $30"	"7E Mental Health: $30, 7H Psychiatric: $30"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	Included in i.2.	"7G Other Health Care: $30, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: 20%	"13A Blood: 20%, 16B Comprehensive Dental Services: 0-20%, 17A Medicare Covered Eye Exams: $15"	10B Transportation: $0	"16A Preventive Dental Services: $0, Additional Comprehensive Dental Coverage 20%-50%"	17A Routine Eye Exams: $15	17B Eye Wear: No member cost sharing	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											194	194	321.1131528	7.275	97	0.194	0.194	47.62049819	194	48.5	48.5	0	0.194	30.59623689	14.55	29.1	29.1	24.25	0	29.1	0.194	15.92558026	0	0	14.55	0	0	0	0	0	0											14.7874	0.391496584	4.019566395	0.788910964	2.311661692	2.882741288	2.70933052	3.151485338	2.901073844	1.840494439	5.214303902	0	4.855187488	1.764128025	6.921520727	8.099831449	0.502982879	0.839326353	0	1.225176883	0.167281647	0.329786578	0	0	1.570746262	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.2744	0	2.08	14.7874	0.391496584	4.019566395	0.788910964	2.311661692	2.882741288	2.70933052	3.151485338	2.901073844	1.840494439	5.214303902	0	4.855187488	1.764128025	6.921520727	8.099831449	0.502982879	0.839326353	0	1.225176883	0.167281647	0.329786578	0	0	1.570746262	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.2744	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.7874	0.391496584	4.019566395	0.788910964	2.311661692	2.882741288	2.70933052	3.151485338	2.901073844	1.840494439	5.214303902	0	4.855187488	1.764128025	6.921520727	8.099831449	0.502982879	0.839326353	0	1.225176883	0.167281647	0.329786578	0	0	1.570746262	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.2744
H2960_012_0	2008	6																					4000											Coin	Coin	A	V	T	Coin	Coin	V	Coin	P	P	P	Coin	V	V	V	V	V	V	V	Coin	V	T	Coin	V	Coin	Coin	Coin	P	V	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	262.5302934	0.464323775	107.0114423	927.05201	203.7331253	10.58599776	9.949199029	565.757685	49.4913388	324.4157097	919.1019896	33.92713796	17.82921142	691.9	4066.751504	2088.125947	137.2008128	295.8885925	569.5479961	295.4969058	0.614291386	177.0299787	0.204836539	0	922.8946898	0	0	0	0	26.21907697	0											PBP: 1A IP Acute: 20% Coinsurance	1B IP Psych: 20% Coinsurance	2 SNF: $200 per stay plus $50 per day for days 35-100 only	"6 Home Health: $10, 13C Custodial Care: $150 per episode"	10A Ambulance: $150	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0-20%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: 20% Coinsurance	8A OP C/D/T: $0-$50	8B OP X-Ray: $0-$50	9A OP Hospital: $0	12 Renal Dialysis: 20%	"3 CORF: $50, 5 Partial Hosp: $40, 9C OP Substance Abuse: $40, 9D Cardiac Rehab: $15"	"7A PCP: $15, 14B Immunizations: $0, separate office visit copay applies, 14C Routine Physical Exams: $0, separate office visit copay applies, 14D Pap/Pelvic: $0, separate office visit copay applies, 14E Prostate Screening: $0, separate office visit copay applies, 14F Colorectal Screening: $50, 14G Bone Mass Measurement: $0, separate office visit copay applies, 14H Mammography: $0, 14I Diabetes Monitoring: $0-$30, separate office visit copay may apply"	"7B Chiropractic: $40, 7D Physician Specialist: $40, 7F Podiatry: $40"	"7E Mental Health: $40, 7H Psychiatric: $40"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	Included in i.2.	"7G Other Health Care: $40, 18A Medicare Covered Hearing Exams: $40"	15 Part B Drugs: 20%	"13A Blood: 20%, 16B Comprehensive Dental Services: $30, 17A Medicare Covered Eye Exams: $20"	10B Transportation: $0	16A Preventive Dental Services: Not Covered	17A Routine Eye Exams: Not Covered	17B Eye Wear: No member cost sharing	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.18	0.18	297.9400387	14.67	135	0.18	0.18	44.18396739	0.18	45	45	0	0.18	28.38826103	13.5	36	36	22.5	0	36	0.18	27.74144316	0	0	18	0	0	0	0	0	0											47.2555	0.08357828	2.656916105	1.133321082	2.29199766	1.905479597	1.790855825	2.083118259	8.908440984	1.216558911	3.446632461	0	3.209258056	1.636819817	4.575095442	6.264377841	0.411602439	0.554791111	0	0.886490717	0.11057245	0.409255591	0	0	1.384342035	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.215	0	10.25	47.2555	0.08357828	2.656916105	1.133321082	2.29199766	1.905479597	1.790855825	2.083118259	8.908440984	1.216558911	3.446632461	0	3.209258056	1.636819817	4.575095442	6.264377841	0.411602439	0.554791111	0	0.886490717	0.11057245	0.409255591	0	0	1.384342035	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.215	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	47.2555	0.08357828	2.656916105	1.133321082	2.29199766	1.905479597	1.790855825	2.083118259	8.908440984	1.216558911	3.446632461	0	3.209258056	1.636819817	4.575095442	6.264377841	0.411602439	0.554791111	0	0.886490717	0.11057245	0.409255591	0	0	1.384342035	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.215
H2960_803_0	2008	6																					0											D	D	A	V	T	Coin	Coin	V	P	P	P	P	Coin	V	V	V	V	V	V	V	Coin	V	T	Coin	V	Coin	Coin	Coin	P	V	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	894.1512631	23.67265593	125.6781289	1088.763589	239.2715904	12.43258069	11.68470111	664.446397	169.5521551	381.0056056	1079.426796	39.84526445	20.93927419	691.9	4690.736841	2697.106857	167.4859761	347.502322	668.8978761	422.3050765	0.721446141	207.910444	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $200 per day (days 1-4)	1B IP Psych: $200 per day (days 1-4)	2 SNF: $200 per stay plus $50 per day for days 35-100 only	"6 Home Health: $10, 13C Custodial Care: $150 per episode"	10A Ambulance: $150	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0-20%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $200	8A OP C/D/T: $0-$50	8B OP X-Ray: $0-$50	9A OP Hospital: $0	12 Renal Dialysis: 20%	"3 CORF: $50, 5 Partial Hosp: $40, 9C OP Substance Abuse: $40, 9D Cardiac Rehab: $15"	"7A PCP: $15, 14B Immunizations: $0, separate office visit copay applies, 14C Routine Physical Exams: $0, separate office visit copay applies, 14D Pap/Pelvic: $0, separate office visit copay applies, 14E Prostate Screening: $0, separate office visit copay applies, 14F Colorectal Screening: $50, 14G Bone Mass Measurement: $0, separate office visit copay applies, 14H Mammography: $0, 14I Diabetes Monitoring: $0-$30, separate office visit copay may apply"	"7B Chiropractic: $40, 7D Physician Specialist: $40, 7F Podiatry: $40"	"7E Mental Health: $40, 7H Psychiatric: $40"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	Included in i.2.	"7G Other Health Care: $40, 18A Medicare Covered Hearing Exams: $40"	15 Part B Drugs: 20%	"13A Blood: 20%, 16B Comprehensive Dental Services: $40, 17A Medicare Covered Eye Exams: $20"	10B Transportation: $0	16A Preventive Dental Services: Not Covered	17A Routine Eye Exams: Not Covered	17B Eye Wear: No member cost sharing	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											195	195	322.7683752	15.8925	146.25	0.195	0.195	47.86596467	195	48.75	48.75	0	0.195	30.75394945	14.625	39	39	24.375	0	39	0.195	30.05323009	0	0	19.5	0	0	0	0	0	0											14.53	0.384680659	3.380410457	1.441931279	2.916122508	2.424353235	2.278516716	2.65036398	2.75522252	1.547835273	4.38517136	0	4.083158466	1.773221469	5.716835525	8.765597284	0.544329422	0.705864091	0	1.372491499	0.140681997	0.520698368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3174	0	0	14.53	0.384680659	3.380410457	1.441931279	2.916122508	2.424353235	2.278516716	2.65036398	2.75522252	1.547835273	4.38517136	0	4.083158466	1.773221469	5.716835525	8.765597284	0.544329422	0.705864091	0	1.372491499	0.140681997	0.520698368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3174	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.53	0.384680659	3.380410457	1.441931279	2.916122508	2.424353235	2.278516716	2.65036398	2.75522252	1.547835273	4.38517136	0	4.083158466	1.773221469	5.716835525	8.765597284	0.544329422	0.705864091	0	1.372491499	0.140681997	0.520698368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3174
H2961_002_0	2008	13	h.5.	h.5.	f.	g.							OP Facility - Other	OP Facility - Other	OP Facility - Emergency	OP Facility - Surgery							2500	Complex diag	PET scans	Urgent Care	ASC							A	A	D	V	Coin	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	V	V	Coin											P	V	V	V																																																0		294.0138742	14.63201176	637.6975836	0	10.42189688	18.32846708	18.32846708	184.1076265	160.4121467	481.4760286	149.2512808	0	3.835675457	2799.162188	11805.40762	7896.874164	119.4239884	97.44330245	1420.098213	514.9046181	18.26560721											45.288257	3.802524	547.751789	146.814774							$250/Admit	$250/Admit	$50/day >10	No cost sharing	20% coins	20% coins	20% coins	$50/visit	$50/visit	$20/procedure	$50/procedure	$50/visit	$10/visit	$10/visit	$10/visit	$20/visit	$10/visit	$10/visit	$20/visit	$20/visit	20% coins											$50/procedure	$200/visit	$25/visit	$25/visit							240.625	240.625	48	0	0.192	0.192	0.192	48	48	19.2	48	48	9.6	9.6	9.6	19.2	9.6	9.6	19.2	19.2	0.192											48	192	24	24							5.8956	0.293402319	2.550790335	0	2.001004202	3.519065679	3.519065679	0.736430506	0.641648587	0.770361646	0.597005123	0	0.00306854	2.23932975	9.4443261	12.63499866	0.095539191	0.077954642	2.27215714	0.823847389	3.506996583	0	0	0	0	0	0	0	0	0	0	0.181153028	0.060840384	1.095503578	0.293629548	0	0	0	0	0	0	53.2537	0	2.218904555	5.8956	0.293402319	2.550790335	0	2.001004202	3.519065679	3.519065679	0.736430506	0.641648587	0.770361646	0.597005123	0	0.00306854	2.23932975	9.4443261	12.63499866	0.095539191	0.077954642	2.27215714	0.823847389	3.506996583	0	0	0	0	0	0	0	0	0	0	0.181153028	0.060840384	1.095503578	0.293629548	0	0	0	0	0	0	53.2537																														20% Coins																																									1.7212													1.7212	0	0	5.8956	0.293402319	2.550790335	0	2.001004202	3.519065679	3.519065679	0.736430506	0.641648587	0.770361646	0.597005123	0	0.00306854	2.23932975	9.4443261	12.63499866	0.095539191	0.077954642	2.27215714	0.823847389	3.506996583	0	0	0	0	0	0	0	1.72116324	0	0	0.181153028	0.060840384	1.095503578	0.293629548	0	0	0	0	0	0	54.9749
H2961_011_0	2008	13	f.										OP Facility - Emergency										2500	Urgent Care										A	A	D	V	Coin	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin								Coin			V																																																			0		302.8139846	14.90072878	565.1274145		21.6115488	19.29561489	19.29561489	403.2069581	280.7913342	11.18212286	27.08298535	0	72.74104644	1542.877614	5770.984125	7451.076509	218.2922494	426.598042	2862.246511	2043.918961	1.719594539								10.6			547.751789										$250/Admit	$250/Admit	$50/day >10	No cost Sharing	20% coinsurance	20% coinsurance	20% coinsurance	$50 per visit	"$25/vist ASC, $50 OH"	20% coinsurance	20% coinsurance	$20 per visit	$20 per visit	$20 per visit	$10 per visit	$40 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	20% coinsurance								20% coinsurance			$25/visit										240	240	46.5	0	0.186	0.186	0.186	46.5	27.9	0.186	0.186	18.6	18.6	18.6	9.3	37.2	18.6	18.6	18.6	18.6	0.186											24.1										6.0563	0.298014576	2.189868731	0	4.019748077	3.58898437	3.58898437	1.562426963	0.652839852	2.079874851	5.037435276	0	0.112748622	2.391460301	4.472512697	23.09833718	0.338352987	0.661226965	4.436482092	3.168074389	0.319844584	0	0	0	0	0	0	0	0	0	0	1.100068176	0	0	0	0	0	0	0	0	0	69.1736	0	5.206612401	6.0563	0.298014576	2.189868731	0	4.019748077	3.58898437	3.58898437	1.562426963	0.652839852	2.079874851	5.037435276	0	0.112748622	2.391460301	4.472512697	23.09833718	0.338352987	0.661226965	4.436482092	3.168074389	0.319844584	0	0	0	0	0	0	0	0	0	0	1.100068176	0	0	0	0	0	0	0	0	0	69.1736																														0.2																																									2.12													2.12			6.0563	0.298014576	2.189868731	0	4.019748077	3.58898437	3.58898437	1.562426963	0.652839852	2.079874851	5.037435276	0	0.112748622	2.391460301	4.472512697	23.09833718	0.338352987	0.661226965	4.436482092	3.168074389	0.319844584	0	0	0	0	0	0	0	2.12	0	0	1.100068176	0	0	0	0	0	0	0	0	0	71.2936
H2961_801_0	2008	6	f.	g.									OP Facility - Emergency	OP Facility - Surgery									2500	Urgent care center	ASC												V	Coin	Coin	Coin	V	V		Coin	V	V	V	V	V	V	V	V	V	Coin											V	V																																																		0					451.6202183	7.038721587	38.51486873	4.742442691	5019.943917	799.9930086		3.947957516	0	0	503.3526954	1789.853818	1545.807537	8.438823395	58.32036168	106.5545954	57.45335928	14.46292264											116.120365	139.89151									No Cost Sharing	No Cost Sharing	No Cost Sharing	"$3PC,$5CGR,$3HS"	20% coinsurance	20% coinsurance	20% coinsurance	$50/visit	$50/visit	No Cost Sharing	20% coinsurance	$25/visit	$25/visit	$25/visit	$10/visit	$20/visit	$10/visit	$10/visit	$10/visit	$10/visit	20% coinsurance											$25/visit	$25/visit												3.6632	0.1928	0.1928	0.1928	48.2	48.2		0.1928	24.1	24.1	24.1	9.64	19.28	9.64	9.64	9.64	9.64	0.1928											24.1	24.1									0	0	0	0.137864599	1.357065522	7.425666691	0.914342951	20.1634414	3.213305251	0	0.761166209	0	0	1.010899997	1.437849234	2.483597443	0.006779188	0.046850691	0.085598858	0.046154199	2.788451484	0	0	0	0	0	0	0	0	0	0	0.2332084	0.280948783	0	0	0	0	0	0	0	0	42.3932	0	1.583148208	0	0	0	0.137864599	1.357065522	7.425666691	0.914342951	20.1634414	3.213305251	0	0.761166209	0	0	1.010899997	1.437849234	2.483597443	0.006779188	0.046850691	0.085598858	0.046154199	2.788451484	0	0	0	0	0	0	0	0	0	0	0.2332084	0.280948783	0	0	0	0	0	0	0	0	42.3932																																																																																				0			0	0	0	0.137864599	1.357065522	7.425666691	0.914342951	20.1634414	3.213305251	0	0.761166209	0	0	1.010899997	1.437849234	2.483597443	0.006779188	0.046850691	0.085598858	0.046154199	2.788451484	0	0	0	0	0	0	0	0	0	0	0.2332084	0.280948783	0	0	0	0	0	0	0	0	42.3932
H2961_805_0	2008	6	f.	g.									OP Facility - Emergency	OP Facility - Surgery									2500	Urgent care center	ASC												V	Coin	Coin	Coin	V	V		Coin	V	V	V	V	V	V	V	V	V	Coin											V	V																																																		0					451.6202183	7.038721587	38.51486873	4.742442691	5019.943917	799.9930086		3.947957516	0	0	503.3526954	1789.853818	1545.807537	8.438823395	58.32036168	106.5545954	57.45335928	14.46292264											116.120365	139.89151									No cost Sharing	No cost Sharing	No cost Sharing	"$3PC,$5CGR,$3HS"	20% coinsurance	20% coinsurance	20% coinsurance	$50/visit	$50/visit	No cost Sharing	20% coinsurance	$25/visit	$25/visit	$25/visit	$10/visit	$20/visit	$10/visit	$10/visit	$10/visit	$10/visit	20% coinsurance											25	25												3.6632	0.1928	0.1928	0.1928	48.2	48.2		0.1928	24.1	24.1	24.1	9.64	19.28	9.64	9.64	9.64	9.64	0.1928											24.1	24.1									0	0	0	0.137864599	1.357065522	7.425666691	0.914342951	20.1634414	3.213305251	0	0.761166209	0	0	1.010899997	1.437849234	2.483597443	0.006779188	0.046850691	0.085598858	0.046154199	2.788451484	0	0	0	0	0	0	0	0	0	0	0.2332084	0.280948783	0	0	0	0	0	0	0	0	42.3932	0	1.583148208	0	0	0	0.137864599	1.357065522	7.425666691	0.914342951	20.1634414	3.213305251	0	0.761166209	0	0	1.010899997	1.437849234	2.483597443	0.006779188	0.046850691	0.085598858	0.046154199	2.788451484	0	0	0	0	0	0	0	0	0	0	0.2332084	0.280948783	0	0	0	0	0	0	0	0	42.3932																																																																																				0			0	0	0	0.137864599	1.357065522	7.425666691	0.914342951	20.1634414	3.213305251	0	0.761166209	0	0	1.010899997	1.437849234	2.483597443	0.006779188	0.046850691	0.085598858	0.046154199	2.788451484	0	0	0	0	0	0	0	0	0	0	0.2332084	0.280948783	0	0	0	0	0	0	0	0	42.3932
H2961_806_0	2008	6	f.	g.									OP Facility - Emergency	OP Facility - Surgery									2500	Urgent care center	ASC												V	Coin	Coin	Coin	V	V		Coin	V	V	V	V	V	V	V	V	V	Coin											V	V																																																		0					451.6202183	7.038721587	38.51486873	4.742442691	5019.943917	799.9930086		3.947957516	0	0	503.3526954	1789.853818	1545.807537	8.438823395	58.32036168	106.5545954	57.45335928	14.46292264											116.120365	139.89151									No Cost Sharing	No Cost Sharing	No Cost Sharing	"$3PC,$5CGR,$3HS"	20% coinsurance	20% coinsurance	20% coinsurance	$50/visit	$50/visit	No Cost Sharing	20% coinsurance	$25/visit	$25/visit	$25/visit	$10/visit	$20/visit	$10/visit	$10/visit	$10/visit	$10/visit	20% coinsurance											$25/visit	$25/visit												3.6632	0.1928	0.1928	0.1928	48.2	48.2		0.1928	24.1	24.1	24.1	9.64	19.28	9.64	9.64	9.64	9.64	0.1928											24.1	24.1									0	0	0	0.137864599	1.357065522	7.425666691	0.914342951	20.1634414	3.213305251	0	0.761166209	0	0	1.010899997	1.437849234	2.483597443	0.006779188	0.046850691	0.085598858	0.046154199	2.788451484	0	0	0	0	0	0	0	0	0	0	0.2332084	0.280948783	0	0	0	0	0	0	0	0	42.3932	0	1.583148208	0	0	0	0.137864599	1.357065522	7.425666691	0.914342951	20.1634414	3.213305251	0	0.761166209	0	0	1.010899997	1.437849234	2.483597443	0.006779188	0.046850691	0.085598858	0.046154199	2.788451484	0	0	0	0	0	0	0	0	0	0	0.2332084	0.280948783	0	0	0	0	0	0	0	0	42.3932																																																																																				0			0	0	0	0.137864599	1.357065522	7.425666691	0.914342951	20.1634414	3.213305251	0	0.761166209	0	0	1.010899997	1.437849234	2.483597443	0.006779188	0.046850691	0.085598858	0.046154199	2.788451484	0	0	0	0	0	0	0	0	0	0	0.2332084	0.280948783	0	0	0	0	0	0	0	0	42.3932
H2997_001_0	2008	7	H.	H.	I.	I.	I.	I.	I.	I.	0		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	0		0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	0		A	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin		S				V	V	V					V	V	V	V	V	Coin	V	V	0																																											0	0	238.4324977	10.31786914	243.0354094	0	74.09650662	10.9421242	4.098198669	297.481571	402.3556655	8.258918657	21.95703169	46.91142288	0.025048821	0	4477.868763	1784.867374	30.49077674	566.7930949	14.21463518		347.2584741				587.2759048	564.7382722	183.4035872					876.657215	18.04285495	198.7955056	354.4433503	125.1508069	0.05692754	650.1516648	2.48494382	0		$300/admit	$700/admit	$50/day for days 21 to 100	$0 copay	$100 copay	10% coinsurance	10% coinsurance	$50 copay	$75 copay	10% coinsurance	10% coinsurance	$75 copay	10% Coinsurance	$25 copay	$10 copay	$20 copay	$20 copay	$20 copay	10% coinsurance		$10 copay				$20 copay	$75 glasses/$95 contacts	$10 copay					$20 copay	$0 copay	$20 copay	$20 copay	$10 copay	20% coinsurance	$20 copay	$10 copay	0		399.9101751	933.1237418	66.65169584	0	133.3033917	0.133303392	0.133303392	66.65169584	99.97754377	0.133303392	0.133303392	99.97754377	0.133303392	0	13.33033917	26.66067834	26.66067834	26.66067834	0.133303392		13.33033917				26.66067834	0	13.33033917					26.66067834	0	26.66067834	26.66067834	13.33033917	0.266606783	26.66067834	13.33033917	0		7.946	0.802320721	1.349893516	0	0.823109637	1.458622268	0.546303782	1.652304266	3.352210929	1.100941869	2.926946796	0.390840736	0.003339093	0	4.974292447	3.965481245	0.067742066	1.259257366	1.894859081	0	0.385756103	0	0	0	1.304764499	0	0.203736002	0	0	0	0	1.947689669	0	0.441668586	0.787475013	0.139025225	0.015177268	1.444457034	0.002760429	0	0	41.1869		1.165527534	7.946	0.802320721	1.349893516	0	0.823109637	1.458622268	0.546303782	1.652304266	3.352210929	1.100941869	2.926946796	0.390840736	0.003339093	0	4.974292447	3.965481245	0.067742066	1.259257366	1.894859081	0	0.385756103	0	0	0	1.304764499	0	0.203736002	0	0	0	0	1.947689669	0	0.441668586	0.787475013	0.139025225	0.015177268	1.444457034	0.002760429	0	0	41.1869	3000	20% coinsurance	20% coinsurance	$50/day for days 21 to 100	20% coinsurance	$100 copay	20% coinsurance	20% coinsurance	$50 copay	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0	20% coinsurance	0	0	0	20% coinsurance	$75 glasses/$95 contacts	20% coinsurance	0	0	0	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0		16.23191214	0.295003773	0.170325547	0	1.33755316	0.836142908	0.023879733	0.389588041	2.133301711	0.496760251	1.209801356	0.006073848	0.042679567	0	4.207499054	4.558033029	0.050148741	0.512470763	0.669805247	0	0.049030204	0	0	0	0.391626439	0	0.002489042	0	0	0	0	0.190060739	0.025301304	0.27178931	0.18551241	0.091753967	0.002385992	0.378034351	0.00216658	0		34.7611		0.983686878	24.1779	1.097324494	1.520219063	0	2.160662797	2.294765176	0.570183516	2.041892307	5.48551264	1.59770212	4.136748152	0.396914584	0.04601866	0	9.181791501	8.523514275	0.117890806	1.771728128	2.564664328	0	0.434786307	0	0	0	1.696390939	0	0.206225044	0	0	0	0	2.137750408	0.025301304	0.713457895	0.972987422	0.230779192	0.01756326	1.822491384	0.004927009	0	0	75.9481
H3011_001_0	2008	6																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O		V	V	V	V	V		V	V																																																				0		1195.024746	74.20180549	2052.78607	0	273.3244202	0	0	234.5445778	305.5188044	0	0	0	0	1293.072495	4023.538387	4671.529055	205.4615415	340.5662491	0	149.3051695	0	0	0	208.4592671	157.4360887	0	0	0	0	0	285.2111572											"$200 days 1 - 5, $0 days 6+"	"$200 days 1 - 5, $0 days 6+"	"$10/day, days 1-20, $200 max per calendar year"	0	$0 - $100 / day	0	0	$0 - $50 / day	$0 - $100 / day	0	0	0	0	$0 - $25 per visit	"$0 -25 per visit, no cost for immunization"	$0 - $25 per visit	$25 / visit	$0 - $25 per visit	0	$0 - $25 per visit	0	0	0	$25 visit every six months	$25 exam per calendar year	0	0	0	0	0	$0 - $25 per visit											94.7467	35.4918	4.7139	0	29.3506	0	0	39.8159	83.5129	0	0	0	0	6.1814	18.0041	19.7101	23.3972	18.7549	0	11.4312	0	0	0	24.9997	25	0	0	0	0	0	13.2948											9.4354	0.219462824	0.806377768	0	0.66851935	0	0	0.77821645	2.126229313	0	0	0	0	0.666079881	6.036667716	7.673025183	0.400601363	0.532273875	0	0.142228448	0	0	0	0.434285591	0.327991851	0	0	0	0	0	0.31598476	0	0	0	0	0	0	0	0	0	0	30.5633			9.4354	0.219462824	0.806377768	0	0.66851935	0	0	0.77821645	2.126229313	0	0	0	0	0.666079881	6.036667716	7.673025183	0.400601363	0.532273875	0	0.142228448	0	0	0	0.434285591	0.327991851	0	0	0	0	0	0.31598476	0	0	0	0	0	0	0	0	0	0	30.5633																																																																																				0			9.4354	0.219462824	0.806377768	0	0.66851935	0	0	0.77821645	2.126229313	0	0	0	0	0.666079881	6.036667716	7.673025183	0.400601363	0.532273875	0	0.142228448	0	0	0	0.434285591	0.327991851	0	0	0	0	0	0.31598476	0	0	0	0	0	0	0	0	0	0	30.5633
H3011_801_0	2008	10																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O		V	V	V	V	V		V	V																																																				0		1195.024746	74.20180549	2052.78607	0	273.3244202	0	0	234.5445778	305.5188044	0	0	0	0	1293.072495	4023.538387	4671.529055	205.4615415	340.5662491	0	149.3051695	0	0	0	208.4592671	157.4360887	0	0	0	0	0	285.2111572											"$200 days 1 - 5, $0 days 6+"	"$200 days 1 - 5, $0 days 6+"	"$10/day, days 1-20, $200 max per calendar year"	0	$0 - $100 / day	0	0	$0 - $50 / day	$0 - $100 / day	0	0	0	0	$0 - $25 per visit	"$0 -25 per visit, no cost for immunization"	$0 - $25 per visit	$25 / visit	$0 - $25 per visit	0	$0 - $25 per visit	0	0	0	$25 visit every six months	$25 exam per calendar year	0	0	0	0	0	$0 - $25 per visit											94.7467	35.4918	4.7139	0	29.3506	0	0	39.8159	83.5129	0	0	0	0	6.1814	18.0041	19.7101	23.3972	18.7549	0	11.4312	0	0	0	24.9997	25	0	0	0	0	0	13.2948											9.4354	0.219462824	0.806377768	0	0.66851935	0	0	0.77821645	2.126229313	0	0	0	0	0.666079881	6.036667716	7.673025183	0.400601363	0.532273875	0	0.142228448	0	0	0	0.434285591	0.327991851	0	0	0	0	0	0.31598476	0	0	0	0	0	0	0	0	0	0	30.5633			9.4354	0.219462824	0.806377768	0	0.66851935	0	0	0.77821645	2.126229313	0	0	0	0	0.666079881	6.036667716	7.673025183	0.400601363	0.532273875	0	0.142228448	0	0	0	0.434285591	0.327991851	0	0	0	0	0	0.31598476	0	0	0	0	0	0	0	0	0	0	30.5633																																																																																				0			9.4354	0.219462824	0.806377768	0	0.66851935	0	0	0.77821645	2.126229313	0	0	0	0	0.666079881	6.036667716	7.673025183	0.400601363	0.532273875	0	0.142228448	0	0	0	0.434285591	0.327991851	0	0	0	0	0	0.31598476	0	0	0	0	0	0	0	0	0	0	30.5633
H3011_802_0	2008	10																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O		V	V	V	V	V		V	V																																																				0		1195.024746	74.20180549	2052.78607	0	273.3244202	0	0	234.5445778	305.5188044	0	0	0	0	1293.072495	4023.538387	4671.529055	205.4615415	340.5662491	0	149.3051695	0	0	0	208.4592671	157.4360887	0	0	0	0	0	285.2111572											"$200 days 1 - 5, $0 days 6+"	"$200 days 1 - 5, $0 days 6+"	"$10/day, days 1-20, $200 max per calendar year"	0	$0 - $100 / day	0	0	$0 - $50 / day	$0 - $100 / day	0	0	0	0	$0 - $25 per visit	"$0 -25 per visit, no cost for immunization"	$0 - $25 per visit	$25 / visit	$0 - $25 per visit	0	$0 - $25 per visit	0	0	0	$25 visit every six months	$25 exam per calendar year	0	0	0	0	0	$0 - $25 per visit											94.7467	35.4918	4.7139	0	29.3506	0	0	39.8159	83.5129	0	0	0	0	6.1814	18.0041	19.7101	23.3972	18.7549	0	11.4312	0	0	0	24.9997	25	0	0	0	0	0	13.2948											9.4354	0.219462824	0.806377768	0	0.66851935	0	0	0.77821645	2.126229313	0	0	0	0	0.666079881	6.036667716	7.673025183	0.400601363	0.532273875	0	0.142228448	0	0	0	0.434285591	0.327991851	0	0	0	0	0	0.31598476	0	0	0	0	0	0	0	0	0	0	30.5633			9.4354	0.219462824	0.806377768	0	0.66851935	0	0	0.77821645	2.126229313	0	0	0	0	0.666079881	6.036667716	7.673025183	0.400601363	0.532273875	0	0.142228448	0	0	0	0.434285591	0.327991851	0	0	0	0	0	0.31598476	0	0	0	0	0	0	0	0	0	0	30.5633																																																																																				0			9.4354	0.219462824	0.806377768	0	0.66851935	0	0	0.77821645	2.126229313	0	0	0	0	0.666079881	6.036667716	7.673025183	0.400601363	0.532273875	0	0.142228448	0	0	0	0.434285591	0.327991851	0	0	0	0	0	0.31598476	0	0	0	0	0	0	0	0	0	0	30.5633
H3044_001_0	2008	5																					5000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	P	P	P	V	P	P	S	P	T	P	P	P	P	P	P	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1937.00712	51.26789022	1657.858197	0	240.4402579	13.15598111	13.85270122	395.3935268	193.8177895	11.35250268	18.87141393	0	0	153.0736145	5985.028038	13546.25302	170.9489824	378.2465512	0	259.3256408	0	1660.561619	0	0	144	0	249	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1A: $150 Days 1-10	1B: $150 Days 1-10	2A: $50 Days 21 to 100		10A: $75 Copay	11A: 20% Coin	"11B: 20% Coin, 11C: 20% Coin"	"4A: $50 Copay, 4B: $50 Copay"	9A: $160 Copay	8A: 20% Coin	8B: 20% Coin			"3: $25 Copay, 9C: $25 Copay, 9D: $25 Copay"	"7A: $10 Copay, 14G: $50 Copay, 18A: $25 Copay"	"7B: $25 Copay, 7D: $25 Copay, 7F: $25 Copay, 14D: $25 Copay if Specialist, 14E: $25 Copay if Specialist, 14F: $25 Copay if Specialist, 14G: $25 Copay if Specialist"	"7E: $25 Copay, 7H: $25 Copay"	"7C: $25 Copay, 7I: $25 Copay"		7G: $25 Copay		17A: $25 Copay; 17B: $25 Copay			17A: $25 Copay	17B: $25 Copay	18A: $25 Copay															101.2051584	101.2051584	12.69232664	0	62.07244436	0.165526518	0.165526518	41.38907445	132.4212146	0.165526518	0.165526518	0	0	20.69081479	8.363809389	20.69081479	20.69081479	20.69081479	0	20.69081479	0	20.69081479	0	0	25	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.3363	0.432381246	1.75350648	0	1.243726211	2.177663748	2.292989401	1.363747676	2.138798925	1.879140242	3.123719443	0	0	0.263934817	4.171469475	23.35691769	0.294756144	0.652185778	0	0.447138234	0	2.863197742	0	0	0.3	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6103		13.49355183	16.3363	0.432381246	1.75350648	0	1.243726211	2.177663748	2.292989401	1.363747676	2.138798925	1.879140242	3.123719443	0	0	0.263934817	4.171469475	23.35691769	0.294756144	0.652185778	0	0.447138234	0	2.863197742	0	0	0.3	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6103																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	16.3363	0.432381246	1.75350648	0	1.243726211	2.177663748	2.292989401	1.363747676	2.138798925	1.879140242	3.123719443	0	0	0.263934817	4.171469475	23.35691769	0.294756144	0.652185778	0	0.447138234	0	2.863197742	0	0	0.3	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6103
H3044_002_0	2008	2																					5000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	P	P	P	V	P	P	S	P	T	P	P	P	P	P	P	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1937.00712	51.26789022	1657.858197	0	240.4402579	13.15598111	13.85270122	395.3935268	193.8177895	11.35250268	18.87141393	0	0	153.0736145	5985.028038	13546.25302	170.9489824	378.2465512	0	259.3256408	0	1660.561619	0	0	144	0	249	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1A: $150 Days 1-10	1B: $150 Days 1-10	2A: $50 Days 21 to 100		10A: $75 Copay	11A: 20% Coin	"11B: 20% Coin, 11C: 20% Coin"	"4A: $50 Copay, 4B: $50 Copay"	9A: $160 Copay	8A: 20% Coin	8B: 20% Coin			"3: $25 Copay, 9C: $25 Copay, 9D: $25 Copay"	"7A: $10 Copay, 14G: $50 Copay, 18A: $25 Copay"	"7B: $25 Copay, 7D: $25 Copay, 7F: $25 Copay, 14D: $25 Copay if Specialist, 14E: $25 Copay if Specialist, 14F: $25 Copay if Specialist, 14G: $25 Copay if Specialist"	"7E: $25 Copay, 7H: $25 Copay"	"7C: $25 Copay, 7I: $25 Copay"		7G: $25 Copay		17A: $25 Copay; 17B: $25 Copay			17A: $25 Copay	17B: $25 Copay	18A: $25 Copay															101.2051584	101.2051584	12.69232664	0	62.07244436	0.165526518	0.165526518	41.38907445	132.4212146	0.165526518	0.165526518	0	0	20.69081479	8.363809389	20.69081479	20.69081479	20.69081479	0	20.69081479	0	20.69081479	0	0	25	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.3363	0.432381246	1.75350648	0	1.243726211	2.177663748	2.292989401	1.363747676	2.138798925	1.879140242	3.123719443	0	0	0.263934817	4.171469475	23.35691769	0.294756144	0.652185778	0	0.447138234	0	2.863197742	0	0	0.3	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6103		13.49355183	16.3363	0.432381246	1.75350648	0	1.243726211	2.177663748	2.292989401	1.363747676	2.138798925	1.879140242	3.123719443	0	0	0.263934817	4.171469475	23.35691769	0.294756144	0.652185778	0	0.447138234	0	2.863197742	0	0	0.3	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6103																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	16.3363	0.432381246	1.75350648	0	1.243726211	2.177663748	2.292989401	1.363747676	2.138798925	1.879140242	3.123719443	0	0	0.263934817	4.171469475	23.35691769	0.294756144	0.652185778	0	0.447138234	0	2.863197742	0	0	0.3	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6103
H3057_001_1	2008	5																																Ded							V	V						P	P	P				Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		201	0	0	0	0	0	0	344.2056454	355.516645	0	0	0	0	0	3260.008527	4892.443767	166.5180138	0	0	0	2.329102643	0	0	0	353.5630301	0	151.5270129	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												200	0	0	0	0	0	0	50	50	0	0	0	0	0	15	15	15	0	0	0	0.2	0	0	0	15	0	15	0	0	0	0											3.35	0	0	0	0	0	0	1.434190189	1.481319354	0	0	0	0	0	4.075010659	6.115554708	0.208147517	0	0	0	0.465820529	0	0	0	0.441953788	0	0.189408766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7614	0	0	3.35	0	0	0	0	0	0	1.434190189	1.481319354	0	0	0	0	0	4.075010659	6.115554708	0.208147517	0	0	0	0.465820529	0	0	0	0.441953788	0	0.189408766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7614																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.35	0	0	0	0	0	0	1.434190189	1.481319354	0	0	0	0	0	4.075010659	6.115554708	0.208147517	0	0	0	0.465820529	0	0	0	0.441953788	0	0.189408766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7614
H3057_001_2	2008	5																																Ded							V	V						P	P	P				Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		201	0	0	0	0	0	0	306.0192862	316.0754375	0	0	0	0	0	3470.286921	5173.703715	172.0361589	0	0	0	2.515555504	0	0	0	369.6803506	0	158.434436	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												200	0	0	0	0	0	0	50	50	0	0	0	0	0	15	15	15	0	0	0	0.2	0	0	0	15	0	15	0	0	0	0											3.35	0	0	0	0	0	0	1.275080359	1.316980989	0	0	0	0	0	4.337858651	6.467129644	0.215045199	0	0	0	0.503111101	0	0	0	0.462100438	0	0.198043045	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1253	0	0	3.35	0	0	0	0	0	0	1.275080359	1.316980989	0	0	0	0	0	4.337858651	6.467129644	0.215045199	0	0	0	0.503111101	0	0	0	0.462100438	0	0.198043045	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1253																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.35	0	0	0	0	0	0	1.275080359	1.316980989	0	0	0	0	0	4.337858651	6.467129644	0.215045199	0	0	0	0.503111101	0	0	0	0.462100438	0	0.198043045	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1253
H3057_002_1	2008	5																																Ded							V	V						P	P	P				Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		201	0	0	0	0	0	0	344.2056454	355.516645	0	0	0	0	0	3260.008527	4892.443767	166.5180138	0	0	0	2.329102643	0	0	0	353.5630301	0	151.5270129	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												200	0	0	0	0	0	0	50	50	0	0	0	0	0	15	15	15	0	0	0	0.2	0	0	0	15	0	15	0	0	0	0											3.35	0	0	0	0	0	0	1.434190189	1.481319354	0	0	0	0	0	4.075010659	6.115554708	0.208147517	0	0	0	0.465820529	0	0	0	0.441953788	0	0.189408766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7614	0	0	3.35	0	0	0	0	0	0	1.434190189	1.481319354	0	0	0	0	0	4.075010659	6.115554708	0.208147517	0	0	0	0.465820529	0	0	0	0.441953788	0	0.189408766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7614																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.35	0	0	0	0	0	0	1.434190189	1.481319354	0	0	0	0	0	4.075010659	6.115554708	0.208147517	0	0	0	0.465820529	0	0	0	0.441953788	0	0.189408766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7614
H3057_002_2	2008	5																																Ded							V	V						P	P	P				Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		201	0	0	0	0	0	0	306.0192862	316.0754375	0	0	0	0	0	3470.286921	5173.703715	172.0361589	0	0	0	2.515555504	0	0	0	369.6803506	0	158.434436	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												200	0	0	0	0	0	0	50	50	0	0	0	0	0	15	15	15	0	0	0	0.2	0	0	0	15	0	15	0	0	0	0											3.35	0	0	0	0	0	0	1.275080359	1.316980989	0	0	0	0	0	4.337858651	6.467129644	0.215045199	0	0	0	0.503111101	0	0	0	0.462100438	0	0.198043045	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1253	0	0	3.35	0	0	0	0	0	0	1.275080359	1.316980989	0	0	0	0	0	4.337858651	6.467129644	0.215045199	0	0	0	0.503111101	0	0	0	0.462100438	0	0.198043045	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1253																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.35	0	0	0	0	0	0	1.275080359	1.316980989	0	0	0	0	0	4.337858651	6.467129644	0.215045199	0	0	0	0.503111101	0	0	0	0.462100438	0	0.198043045	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1253
H3057_003_1	2008	5																																Ded							V	V						P	P	P				Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		201	0	0	0	0	0	0	344.2056454	355.516645	0	0	0	0	0	3260.008527	4892.443767	166.5180138	0	0	0	2.329102643	0	0	0	353.5630301	0	151.5270129	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												200	0	0	0	0	0	0	50	50	0	0	0	0	0	15	15	15	0	0	0	0.2	0	0	0	15	0	15	0	0	0	0											3.35	0	0	0	0	0	0	1.434190189	1.481319354	0	0	0	0	0	4.075010659	6.115554708	0.208147517	0	0	0	0.465820529	0	0	0	0.441953788	0	0.189408766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7614	0	0	3.35	0	0	0	0	0	0	1.434190189	1.481319354	0	0	0	0	0	4.075010659	6.115554708	0.208147517	0	0	0	0.465820529	0	0	0	0.441953788	0	0.189408766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7614																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.35	0	0	0	0	0	0	1.434190189	1.481319354	0	0	0	0	0	4.075010659	6.115554708	0.208147517	0	0	0	0.465820529	0	0	0	0.441953788	0	0.189408766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7614
H3057_003_2	2008	5																																Ded							V	V						P	P	P				Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		201	0	0	0	0	0	0	306.0192862	316.0754375	0	0	0	0	0	3470.286921	5173.703715	172.0361589	0	0	0	2.515555504	0	0	0	369.6803506	0	158.434436	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												200	0	0	0	0	0	0	50	50	0	0	0	0	0	15	15	15	0	0	0	0.2	0	0	0	15	0	15	0	0	0	0											3.35	0	0	0	0	0	0	1.275080359	1.316980989	0	0	0	0	0	4.337858651	6.467129644	0.215045199	0	0	0	0.503111101	0	0	0	0.462100438	0	0.198043045	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1253	0	0	3.35	0	0	0	0	0	0	1.275080359	1.316980989	0	0	0	0	0	4.337858651	6.467129644	0.215045199	0	0	0	0.503111101	0	0	0	0.462100438	0	0.198043045	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1253																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.35	0	0	0	0	0	0	1.275080359	1.316980989	0	0	0	0	0	4.337858651	6.467129644	0.215045199	0	0	0	0.503111101	0	0	0	0.462100438	0	0.198043045	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1253
H3057_004_1	2008	5																					3500											D		D		P	Coin	Coin	V	V		V			V	P	P	P	P	P		Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1039.71471	0	1191.525456	0	188.0980499	19.93900387	0.911561108	344.2056454	349.2322598	0	830.7206013	0	0	687.251811	3084.739251	4639.327522	157.5654324	462.2151075	746.0010622	0	2.280068903	0	0	0	334.554265	0	143.3803993	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												182.5927417	0	91.29637084	0	45.64818542	0.159768649	0.159768649	45.64818542	136.9445563	0	45.64818542	0	0	22.82409271	22.82409271	22.82409271	22.82409271	22.82409271	36.51854834	0	0.182592742	0	0	0	22.82409271	0	22.82409271	0	0	0	0											15.8204	0	9.065162489	0	0.715527888	3.185627709	0.145638887	1.309363594	3.985454738	0	3.160074004	0	0	1.307158254	5.867197888	8.82403679	0.29969067	0.879136705	2.270239654	0	0.416324032	0	0	0	0.636324797	0	0.272710627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.16	0	5.544616352	15.8204	0	9.065162489	0	0.715527888	3.185627709	0.145638887	1.309363594	3.985454738	0	3.160074004	0	0	1.307158254	5.867197888	8.82403679	0.29969067	0.879136705	2.270239654	0	0.416324032	0	0	0	0.636324797	0	0.272710627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.16																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.8204	0	9.065162489	0	0.715527888	3.185627709	0.145638887	1.309363594	3.985454738	0	3.160074004	0	0	1.307158254	5.867197888	8.82403679	0.29969067	0.879136705	2.270239654	0	0.416324032	0	0	0	0.636324797	0	0.272710627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.16
H3057_004_2	2008	5																					3500											D		D		P	Coin	Coin	V	V		V			V	P	P	P	P	P		Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		897.6146512	0	1066.094278	0	185.3997654	18.31874372	0.837486889	306.0192862	310.4882454	0	738.5600117	0	0	611.007726	3283.712355	4906.348539	162.786903	477.5321893	755.7437269	0	2.462596441	0	0	0	349.8050629	0	149.9164555	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												184.0129663	0	92.00648316	0	46.00324158	0.161011346	0.161011346	46.00324158	138.0097247	0	46.00324158	0	0	23.00162079	23.00162079	23.00162079	23.00162079	23.00162079	36.80259326	0	0.184012966	0	0	0	23.00162079	0	23.00162079	0	0	0	0											13.7644	0	8.173965439	0	0.710749183	2.949525575	0.134844891	1.173156596	3.57086644	0	2.83134622	0	0	1.171180668	6.294225531	9.404497381	0.312030218	0.915334528	2.317777416	0	0.453149676	0	0	0	0.670506951	0	0.287360122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1349	0	4.790117255	13.7644	0	8.173965439	0	0.710749183	2.949525575	0.134844891	1.173156596	3.57086644	0	2.83134622	0	0	1.171180668	6.294225531	9.404497381	0.312030218	0.915334528	2.317777416	0	0.453149676	0	0	0	0.670506951	0	0.287360122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1349																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.7644	0	8.173965439	0	0.710749183	2.949525575	0.134844891	1.173156596	3.57086644	0	2.83134622	0	0	1.171180668	6.294225531	9.404497381	0.312030218	0.915334528	2.317777416	0	0.453149676	0	0	0	0.670506951	0	0.287360122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1349
H3057_005_1	2008	5																					3500											D		D		P	Coin	Coin	V	V		V			V	P	P	P	P	P		Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1039.71471	0	1191.525456	0	188.0980499	19.93900387	0.911561108	344.2056454	349.2322598	0	830.7206013	0	0	687.251811	3084.739251	4639.327522	157.5654324	462.2151075	746.0010622	0	2.280068903	0	0	0	334.554265	0	143.3803993	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												182.5927417	0	91.29637084	0	45.64818542	0.159768649	0.159768649	45.64818542	136.9445563	0	45.64818542	0	0	22.82409271	22.82409271	22.82409271	22.82409271	22.82409271	36.51854834	0	0.182592742	0	0	0	22.82409271	0	22.82409271	0	0	0	0											15.8204	0	9.065162489	0	0.715527888	3.185627709	0.145638887	1.309363594	3.985454738	0	3.160074004	0	0	1.307158254	5.867197888	8.82403679	0.29969067	0.879136705	2.270239654	0	0.416324032	0	0	0	0.636324797	0	0.272710627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.16	0	5.544616352	15.8204	0	9.065162489	0	0.715527888	3.185627709	0.145638887	1.309363594	3.985454738	0	3.160074004	0	0	1.307158254	5.867197888	8.82403679	0.29969067	0.879136705	2.270239654	0	0.416324032	0	0	0	0.636324797	0	0.272710627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.16																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.8204	0	9.065162489	0	0.715527888	3.185627709	0.145638887	1.309363594	3.985454738	0	3.160074004	0	0	1.307158254	5.867197888	8.82403679	0.29969067	0.879136705	2.270239654	0	0.416324032	0	0	0	0.636324797	0	0.272710627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.16
H3057_005_2	2008	5																					3500											D		D		P	Coin	Coin	V	V		V			V	P	P	P	P	P		Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		897.6146512	0	1066.094278	0	185.3997654	18.31874372	0.837486889	306.0192862	310.4882454	0	738.5600117	0	0	611.007726	3283.712355	4906.348539	162.786903	477.5321893	755.7437269	0	2.462596441	0	0	0	349.8050629	0	149.9164555	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												184.0129663	0	92.00648316	0	46.00324158	0.161011346	0.161011346	46.00324158	138.0097247	0	46.00324158	0	0	23.00162079	23.00162079	23.00162079	23.00162079	23.00162079	36.80259326	0	0.184012966	0	0	0	23.00162079	0	23.00162079	0	0	0	0											13.7644	0	8.173965439	0	0.710749183	2.949525575	0.134844891	1.173156596	3.57086644	0	2.83134622	0	0	1.171180668	6.294225531	9.404497381	0.312030218	0.915334528	2.317777416	0	0.453149676	0	0	0	0.670506951	0	0.287360122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1349	0	4.790117255	13.7644	0	8.173965439	0	0.710749183	2.949525575	0.134844891	1.173156596	3.57086644	0	2.83134622	0	0	1.171180668	6.294225531	9.404497381	0.312030218	0.915334528	2.317777416	0	0.453149676	0	0	0	0.670506951	0	0.287360122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1349																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.7644	0	8.173965439	0	0.710749183	2.949525575	0.134844891	1.173156596	3.57086644	0	2.83134622	0	0	1.171180668	6.294225531	9.404497381	0.312030218	0.915334528	2.317777416	0	0.453149676	0	0	0	0.670506951	0	0.287360122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1349
H3057_006_1	2008	5																					3500											D		D		P	Coin	Coin	V	V		V			V	P	P	P	P	P		Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1039.71471	0	1191.525456	0	188.0980499	19.93900387	0.911561108	344.2056454	349.2322598	0	830.7206013	0	0	687.251811	3084.739251	4639.327522	157.5654324	462.2151075	746.0010622	0	2.280068903	0	0	0	334.554265	0	143.3803993	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												182.5927417	0	91.29637084	0	45.64818542	0.159768649	0.159768649	45.64818542	136.9445563	0	45.64818542	0	0	22.82409271	22.82409271	22.82409271	22.82409271	22.82409271	36.51854834	0	0.182592742	0	0	0	22.82409271	0	22.82409271	0	0	0	0											15.8204	0	9.065162489	0	0.715527888	3.185627709	0.145638887	1.309363594	3.985454738	0	3.160074004	0	0	1.307158254	5.867197888	8.82403679	0.29969067	0.879136705	2.270239654	0	0.416324032	0	0	0	0.636324797	0	0.272710627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.16	0	5.544616352	15.8204	0	9.065162489	0	0.715527888	3.185627709	0.145638887	1.309363594	3.985454738	0	3.160074004	0	0	1.307158254	5.867197888	8.82403679	0.29969067	0.879136705	2.270239654	0	0.416324032	0	0	0	0.636324797	0	0.272710627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.16																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.8204	0	9.065162489	0	0.715527888	3.185627709	0.145638887	1.309363594	3.985454738	0	3.160074004	0	0	1.307158254	5.867197888	8.82403679	0.29969067	0.879136705	2.270239654	0	0.416324032	0	0	0	0.636324797	0	0.272710627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.16
H3057_006_2	2008	4																					3500											D		D		P	Coin	Coin	V	V		V			V	P	P	P	P	P		Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		897.6146512	0	1066.094278	0	185.3997654	18.31874372	0.837486889	306.0192862	310.4882454	0	738.5600117	0	0	611.007726	3283.712355	4906.348539	162.786903	477.5321893	755.7437269	0	2.462596441	0	0	0	349.8050629	0	149.9164555	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												184.0129663	0	92.00648316	0	46.00324158	0.161011346	0.161011346	46.00324158	138.0097247	0	46.00324158	0	0	23.00162079	23.00162079	23.00162079	23.00162079	23.00162079	36.80259326	0	0.184012966	0	0	0	23.00162079	0	23.00162079	0	0	0	0											13.7644	0	8.173965439	0	0.710749183	2.949525575	0.134844891	1.173156596	3.57086644	0	2.83134622	0	0	1.171180668	6.294225531	9.404497381	0.312030218	0.915334528	2.317777416	0	0.453149676	0	0	0	0.670506951	0	0.287360122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1349	0	4.790117255	13.7644	0	8.173965439	0	0.710749183	2.949525575	0.134844891	1.173156596	3.57086644	0	2.83134622	0	0	1.171180668	6.294225531	9.404497381	0.312030218	0.915334528	2.317777416	0	0.453149676	0	0	0	0.670506951	0	0.287360122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1349																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.7644	0	8.173965439	0	0.710749183	2.949525575	0.134844891	1.173156596	3.57086644	0	2.83134622	0	0	1.171180668	6.294225531	9.404497381	0.312030218	0.915334528	2.317777416	0	0.453149676	0	0	0	0.670506951	0	0.287360122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1349
H3057_801_0	2008	6																					3500											D		D		P	Coin	Coin	V	V		V			V	P	P	P	P	P		Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		938.6590436	0	1088.401144	0	188.6124034	18.98018326	0.867726241	315.3690806	319.9745797	0	761.1252048	0	0	629.6758194	3246.477667	4857.866798	162.023196	475.2918696	755.8190887	0	2.417970402	0	0	0	346.4677033	0	148.4861586	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												183.5855487	0	91.79277435	0	45.89638718	0.160637355	0.160637355	45.89638718	137.6891615	0	45.89638718	0	0	22.94819359	22.94819359	22.94819359	22.94819359	22.94819359	36.71710974	0	0.183585549	0	0	0	22.94819359	0	22.94819359	0	0	0	0											14.3604	0	8.325613385	0	0.721385658	3.048926438	0.139389248	1.206191786	3.671419299	0	2.911074757	0	0	1.204160217	6.208399832	9.289938975	0.309844972	0.908924153	2.312624369	0	0.443904423	0	0	0	0.662567327	0	0.283957426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0087	0	5.007756209	14.3604	0	8.325613385	0	0.721385658	3.048926438	0.139389248	1.206191786	3.671419299	0	2.911074757	0	0	1.204160217	6.208399832	9.289938975	0.309844972	0.908924153	2.312624369	0	0.443904423	0	0	0	0.662567327	0	0.283957426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0087																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.3604	0	8.325613385	0	0.721385658	3.048926438	0.139389248	1.206191786	3.671419299	0	2.911074757	0	0	1.204160217	6.208399832	9.289938975	0.309844972	0.908924153	2.312624369	0	0.443904423	0	0	0	0.662567327	0	0.283957426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0087
H3057_802_0	2008	6																					3500											D		D		P	Coin	Coin	V	V		V			V	P	P	P	P	P		Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		938.6590436	0	1088.401144	0	188.6124034	18.98018326	0.867726241	315.3690806	319.9745797	0	761.1252048	0	0	629.6758194	3246.477667	4857.866798	162.023196	475.2918696	755.8190887	0	2.417970402	0	0	0	346.4677033	0	148.4861586	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												183.5855487	0	91.79277435	0	45.89638718	0.160637355	0.160637355	45.89638718	137.6891615	0	45.89638718	0	0	22.94819359	22.94819359	22.94819359	22.94819359	22.94819359	36.71710974	0	0.183585549	0	0	0	22.94819359	0	22.94819359	0	0	0	0											14.3604	0	8.325613385	0	0.721385658	3.048926438	0.139389248	1.206191786	3.671419299	0	2.911074757	0	0	1.204160217	6.208399832	9.289938975	0.309844972	0.908924153	2.312624369	0	0.443904423	0	0	0	0.662567327	0	0.283957426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0087	0	5.007756209	14.3604	0	8.325613385	0	0.721385658	3.048926438	0.139389248	1.206191786	3.671419299	0	2.911074757	0	0	1.204160217	6.208399832	9.289938975	0.309844972	0.908924153	2.312624369	0	0.443904423	0	0	0	0.662567327	0	0.283957426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0087																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.3604	0	8.325613385	0	0.721385658	3.048926438	0.139389248	1.206191786	3.671419299	0	2.911074757	0	0	1.204160217	6.208399832	9.289938975	0.309844972	0.908924153	2.312624369	0	0.443904423	0	0	0	0.662567327	0	0.283957426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0087
H3057_803_0	2008	6																					3500											D		D		P	Coin	Coin	V	V		V			V	P	P	P	P	P		Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		938.6590436	0	1088.401144	0	188.6124034	18.98018326	0.867726241	315.3690806	319.9745797	0	761.1252048	0	0	629.6758194	3246.477667	4857.866798	162.023196	475.2918696	755.8190887	0	2.417970402	0	0	0	346.4677033	0	148.4861586	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												183.5855487	0	91.79277435	0	45.89638718	0.160637355	0.160637355	45.89638718	137.6891615	0	45.89638718	0	0	22.94819359	22.94819359	22.94819359	22.94819359	22.94819359	36.71710974	0	0.183585549	0	0	0	22.94819359	0	22.94819359	0	0	0	0											14.3604	0	8.325613385	0	0.721385658	3.048926438	0.139389248	1.206191786	3.671419299	0	2.911074757	0	0	1.204160217	6.208399832	9.289938975	0.309844972	0.908924153	2.312624369	0	0.443904423	0	0	0	0.662567327	0	0.283957426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0087	0	5.007756209	14.3604	0	8.325613385	0	0.721385658	3.048926438	0.139389248	1.206191786	3.671419299	0	2.911074757	0	0	1.204160217	6.208399832	9.289938975	0.309844972	0.908924153	2.312624369	0	0.443904423	0	0	0	0.662567327	0	0.283957426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0087																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.3604	0	8.325613385	0	0.721385658	3.048926438	0.139389248	1.206191786	3.671419299	0	2.911074757	0	0	1.204160217	6.208399832	9.289938975	0.309844972	0.908924153	2.312624369	0	0.443904423	0	0	0	0.662567327	0	0.283957426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0087
H3059_001_0	2008	3																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	V	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1628.303171	55.2086994	630.6641375		245.3575678	6.529162495	5.33666194	293.0546551	282.4361245		17.3354661			676.4433836		3270.282264	217.3405402	805.652041	3527.821171		19.50204152				144		249															"$50/Day, days 1-5; $75/Day, days 1-5"	Medicare Cost Share	$75 / days 11-100	No cost sharing	$100 / Trip	20% / Item	20% / Item	"$50/Visit for ER, $30/Visit for UC"	$50/Visit	No cost sharing	20%/Procedure	No cost sharing	No cost sharing	"$10/Visit for OT and MH/SA, $20/Visit for Cardiac Rehab,  and $10/Visit for CORF"	No cost sharing	$10 / Visit	"$10 / Visit, Ind or Grp"	$10 / Visit	"$0/Visit for PCP, $10/Visit for Spec"	No cost sharing	20% / Script	No cost sharing	Not covered	Not covered	$10 / Exam	No copay up to $300 every two year	$10 / Exam	No copay up to $800 every three years	Not covered	No cost sharing	No cost sharing for $100 per quarter for Medical catalogue											31.3574	149.23	40.92		100	0.2	0.2	49.984	50		0.2			1.6346		10	10	10	10		0.2				10		10															4.255	0.686566184	2.150564709	0	2.044646398	1.305832499	1.067332388	1.220669894	1.176817185	0	3.46709322	0	0	0.092145422	0	2.72523522	0.181117117	0.671376701	2.939850976	0	3.900408303	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.2121	0	0	4.255	0.686566184	2.150564709	0	2.044646398	1.305832499	1.067332388	1.220669894	1.176817185	0	3.46709322	0	0	0.092145422	0	2.72523522	0.181117117	0.671376701	2.939850976	0	3.900408303	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.2121																																																																																				0	0	0	4.255	0.686566184	2.150564709	0	2.044646398	1.305832499	1.067332388	1.220669894	1.176817185	0	3.46709322	0	0	0.092145422	0	2.72523522	0.181117117	0.671376701	2.939850976	0	3.900408303	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.2121
H3059_002_0	2008	3																																D	D	D	V	T	Coin	Coin	V	Coin	P	Coin	V	V	V	V	V	V	V	V	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1628.509788	55.21570487	630.7441629		245.3887014	6.53081958	5.338016371	293.0917219	32.57817768		17.3398658			676.529218		3270.697233	217.3681187	805.7542708	3528.268818		19.50699108				144		249															"$150/Day, days 1-5. $75/day, days 1-5 for IP Rehab"	Medicare Cost Share	$75 / days 11-100	No cost sharing	$100 / Trip	20% / Item	20% / Item	$50/Visit for ER; $30/Visit for UC	20% / Procedure	No cost sharing	20%/Procedure	No cost sharing	No cost sharing	"$25/Visit for OT and MH/SA, $20/Visit for Cardiac Rehab, $25/Visit for CORF"	No cost sharing	$25 / Visit	"$25 / Visit, Ind or Grp"	$25 / Visit	$25/Visit	No cost sharing	20% / Script	No cost sharing	Not covered	Not covered	$25 / Exam	No copay up to $300 every two year	$25 / Exam	No copay up to $800 every three years	Not covered	No cost sharing	Medical Catelogue - $50.qtr											89.6557	149.23	40.92		100	0.2	0.2	49.984	0.2		0.2			3.1814		25	25	25	25		0.2				25		25															12.1671	0.686653303	2.150837596	0	2.044905845	1.306163916	1.067603274	1.220824388	6.515635537	0	3.467973159	0	0	0.179361712	0	6.813952568	0.452850247	1.678654731	7.350560038	0	3.901398217	0	0	0	0.3	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.8232	0	0	12.1671	0.686653303	2.150837596	0	2.044905845	1.306163916	1.067603274	1.220824388	6.515635537	0	3.467973159	0	0	0.179361712	0	6.813952568	0.452850247	1.678654731	7.350560038	0	3.901398217	0	0	0	0.3	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.8232																																																																																				0	0	0	12.1671	0.686653303	2.150837596	0	2.044905845	1.306163916	1.067603274	1.220824388	6.515635537	0	3.467973159	0	0	0.179361712	0	6.813952568	0.452850247	1.678654731	7.350560038	0	3.901398217	0	0	0	0.3	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.8232
H3059_004_0	2008	3																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		2065.31105	70.02574147	799.9222635		315.2873704	9.321361949		371.6582499			19.62115598			713.9453576		4100.384957	293.1866496	1021.874852	18.60349906		25.45218209																					"No Cost Sharing, except $75/day days 1-5 for IP Rehab"	Medicare Cost Share	$75 for days 11-100	No cost sharing	$100 / Trip	10% / Item	$0 copay	$50 / Visit	No Cost Sharing	No Cost Sharing	10% for Therapeutic	No cost sharing	No cost sharing	"$10 / Visit for OT visits, $0 for other"	$0 copay	$5 / Visit	$5 / Visit	$10 / Visit	"$10 - MRI, CT, PET"	No cost sharing	"20% for Diab. Items, 20% for rest"	No cost sharing	Not covered	No cost sharing for preventive services	Not covered	No copay up to $300 every two years	$10 / Exam	No copay up to $800 every three years	Not covered	No cost sharing	No cost sharing for $100 per quarter for Medical catalogue											2.2083	149.23	40.92		100	0.1		49.9852			0.1			1.152		5.0301	5	5	0.1024626		0.2																					0.3801	0.87082845	2.727734918	0	2.627394754	0.932136195	0	1.548119148	0	0	1.962115598	0	0	0.068537867	0	1.718780538	0.122161104	0.425781188	1.906162888	0	5.090436418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.3803	0	0	0.3801	0.87082845	2.727734918	0	2.627394754	0.932136195	0	1.548119148	0	0	1.962115598	0	0	0.068537867	0	1.718780538	0.122161104	0.425781188	1.906162888	0	5.090436418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.3803																																																																																				0	0	0	0.3801	0.87082845	2.727734918	0	2.627394754	0.932136195	0	1.548119148	0	0	1.962115598	0	0	0.068537867	0	1.718780538	0.122161104	0.425781188	1.906162888	0	5.090436418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.3803
H3107_004_0	2008	12																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	O	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1902.432931	77.53951627	820.4646236		5.916265803	14.38014869	3.760998948	366.001878	303.5291154		37.95335286				2951.621361	5236.4002	1.097048254	1345.254031			43.68104282	1312.210018					38.14172954															$120 (1a); $0 (1a1)	$120 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $27/$27/$15 (4b)"	$300 (9b)	$0/$0 (8a1); $0 (8a2)	"20% (8b1, 8b2); $0 (8b3)"	$300 (incl in h5)	$0 (12)	"$0 (3, 5, 9d); $27/$27 (9c); $300 (9a)"	"$15/$27/$27 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1); $0/$15/$27 (14f)"	"$27 (7b, 7f, 7g); $0 n/c (7b1); $27/$250/$200 (7d); $0( 7f1)"	"50%/50% (7e, 7h)"	"$27 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $27 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c; $0 (16)	$0 (17a1)	$0; $0 n/c (17b)	$27/$0 (18a1); $0 (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a3, 14a6, 14a7); $0 n/c (14a2, 14a4, 14a5, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											71.8216	75.8374	79.3816		0.2	0.2	0.2	44.5939	300		0.125629302				15	32.1667	0.5	10.8776			0.2	27					27															11.3863	0.490032837	5.427481031	0	1.183253161	2.876029739	0.75219979	1.360122289	7.588227886	0	4.768053226	0	0	0	3.689526702	14.03647168	0.548524127	1.219432389	0	0	8.736208564	2.95247254	0	0	0	0	0.085818891	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.1002	0	0	11.3863	0.490032837	5.427481031	0	1.183253161	2.876029739	0.75219979	1.360122289	7.588227886	0	4.768053226	0	0	0	3.689526702	14.03647168	0.548524127	1.219432389	0	0	8.736208564	2.95247254	0	0	0	0	0.085818891	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.1002																																																																																				0			11.3863	0.490032837	5.427481031	0	1.183253161	2.876029739	0.75219979	1.360122289	7.588227886	0	4.768053226	0	0	0	3.689526702	14.03647168	0.548524127	1.219432389	0	0	8.736208564	2.95247254	0	0	0	0	0.085818891	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.1002
H3107_005_0	2008	11																																D	D	D	V	T	O	O	V	V	O	O	O	O	O	V	V	Coin	V	P	P	S	O	T	V	P	Coin	P	P	O	O	O											26.3295	0.4679	3.1449	0.5466	0.7724	1.307	0.4193		2.9428				0.1629								4.0935																					40.1868									336.1178407							2637.500932	4621.629296	1.211363072	1118.697111				1211.673019					39.22620125															"$0 (1a, 1a1)"	$0 (1b)	"$0 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$0 (10a)	$0 (11a)	"$0 (11b, 11c)"	"$50 (4a, 4a1); $20/$20/$10 (4b)"	$0 (9b)	$0/$0 (8a1); $0 (8a2)	"$0 (8b1, 8b2, 8b3)"	$0 (incl in h5)	$0 (12)	"$0 (3, 5, 9d, 9a); $20/$20 (9c)"	"$10/$20/$20 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1); $0/$10/$20 (14f)"	"$20 (7b, 7d, 7f, 7g); $0 n/c (7b1); $0( 7f1)"	"50%/50% (7e, 7h)"	"$20 (7c, 7i)"	$0 (incl in h2)		"$0 (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c; $0 (16)	$0 (17a1)	$0; $0 n/c (17b)	$20/$0 (18a1); $0 (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a3, 14a6, 14a7); $0 n/c (14a2, 14a4, 14a5, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"																		42.8087							10	20	0.5	8				20					20															0	0	0	0	0	0	0	1.199064225	0	0	0	0	0	0	2.197917443	7.702715493	0.605681536	0.745798074	0	0	0	2.019455031	0	0	0	0	0.065377002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.536	2000	0	26.3295	0.467877213	3.144891047	0.546649716	0.772380412	1.307029217	0.419330352	1.199064225	2.942784592	0	0	0	0.162890279	0	2.197917443	7.702715493	0.605681536	0.745798074	0	0	4.093468497	2.019455031	0	0	0	0	0.065377002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7228																																																																																				0			26.3295	0.467877213	3.144891047	0.546649716	0.772380412	1.307029217	0.419330352	1.199064225	2.942784592	0	0	0	0.162890279	0	2.197917443	7.702715493	0.605681536	0.745798074	0	0	4.093468497	2.019455031	0	0	0	0	0.065377002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7228
H3107_008_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2091.367592	111.3293344	852.5174917			13.2927834	4.25947806	385.4918715	330.5334129		36.49302894				3052.342252	5582.242692	1.153722203	1608.681119			38.80046347	1516.087642					21.79750013															$80 (1a); $0 (1a1)	$80 (1b)	"$75 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$0 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $20/$20 (4b)"	$100 (9b)	$0/$0 (8a1); $0 (8a2)	"$0 (8b1, 8b3); 20% (8b2)"	$100 (incl in h5)	$0 (12)	"$0 (3, 5, 9d); $20/$20 (9c); $100 (9a)"	"$10/$20/$20 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1)"	"$20 (7b, 7f, 7g); $0 n/c (7b1); $20/$0/$0 (7d); $0( 7f1)"	"50%/50% (7e, 7h)"	"$20 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c; $0 (16)	$0 (17a1)	$0; $0 n/c (17b)	$20/$0 (18a1); $0 (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a3, 14a6, 14a7); $0 n/c (14a2, 14a4, 14a5, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											50.3423	53.1638	47.4182			0.2	0.2	43.1217	100		0.135701048				10	19.456	0.5	8			0.2	20					20															8.7737	0.49322376	3.36873545	0	0	2.65855668	0.851895612	1.385256918	2.754445108	0	4.952142284	0	0	0	2.543618544	9.050655662	0.576861102	1.07245408	0	0	7.760092693	2.526812737	0	0	0	0	0.036329167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8048	0	0	8.7737	0.49322376	3.36873545	0	0	2.65855668	0.851895612	1.385256918	2.754445108	0	4.952142284	0	0	0	2.543618544	9.050655662	0.576861102	1.07245408	0	0	7.760092693	2.526812737	0	0	0	0	0.036329167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8048																																																																																				0			8.7737	0.49322376	3.36873545	0	0	2.65855668	0.851895612	1.385256918	2.754445108	0	4.952142284	0	0	0	2.543618544	9.050655662	0.576861102	1.07245408	0	0	7.760092693	2.526812737	0	0	0	0	0.036329167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8048
H3107_801_0	2008	3																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1982.830018	80.81634728	855.1375756		6.120834525	14.87737595	3.89104428	381.0490969	316.3562991		52.39504243		0.946364128		3207.357301	5457.691219	1.134981262	1402.104658			45.19141699	1367.6642			144																	195 (1a); $0 (1a1)	195 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a8); $0 (14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"											122.7094	129.5866	159.1696		0.3	0.3	0.3	47.6469	300		0.226386725		0.3		20	39.6763	0.507429105	16			0.3	39.6531			40																	20.276	0.872726612	11.3426561	0	1.836250357	4.463212786	1.167313284	1.512985604	7.908907478	0	11.86154207	0	0.283909238	0	5.345595502	18.04506534	0.575922526	1.869472877	0	0	13.5574251	4.51934631	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.9183	0	0	20.276	0.872726612	11.3426561	0	1.836250357	4.463212786	1.167313284	1.512985604	7.908907478	0	11.86154207	0	0.283909238	0	5.345595502	18.04506534	0.575922526	1.869472877	0	0	13.5574251	4.51934631	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.9183																																																																																				0			20.276	0.872726612	11.3426561	0	1.836250357	4.463212786	1.167313284	1.512985604	7.908907478	0	11.86154207	0	0.283909238	0	5.345595502	18.04506534	0.575922526	1.869472877	0	0	13.5574251	4.51934631	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.9183
H3107_803_0	2008	5																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1997.632512	81.41966856	861.5214658		6.212563832	15.10033434	3.949357046	383.8907707	318.7180055		53.18025578		0.960546724		3230.323345	5498.434724	1.151990551	1412.571842			45.86867389	1377.874274			144																	195 (1a); $0 (1a1)	195 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a8); $0 (14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"											122.7094	129.5866	159.1696		0.3	0.3	0.3	47.6469	300		0.226386725		0.3		20	39.6862	0.503669046	16			0.3	39.672			40																	20.4274	0.87924181	11.42733285	0	1.86376915	4.530100302	1.184807114	1.524268109	7.967950138	0	12.03930394	0	0.288164017	0	5.383872242	18.18433291	0.580221982	1.883429122	0	0	13.76060217	4.555249015	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.96	0	0	20.4274	0.87924181	11.42733285	0	1.86376915	4.530100302	1.184807114	1.524268109	7.967950138	0	12.03930394	0	0.288164017	0	5.383872242	18.18433291	0.580221982	1.883429122	0	0	13.76060217	4.555249015	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.96																																																																																				0			20.4274	0.87924181	11.42733285	0	1.86376915	4.530100302	1.184807114	1.524268109	7.967950138	0	12.03930394	0	0.288164017	0	5.383872242	18.18433291	0.580221982	1.883429122	0	0	13.76060217	4.555249015	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.96
H3112_001_0	2008	6	a.1.	a.2.	i.2.	a.1.	h.5.	h.5.					Inpatient Facility	Inpatient Facility	Professional	Inpatient Facility	OP Facility - Other	OP Facility - Other						IP Copays days 61-150	IPMH Copays	podiatry visits	non-residential IP SATF	"Partial Hosptialization, Outpatient Sub Abuse"	CORF					bp	bp	d		coin	coin	coin	coin	coin		v		coin	coin		coin	coin	v	coin	coin	coin											d	d	v	d	coin	v					0	0	0		0	0	0	0	0		0		0	0	0	0	0	0	0	0	0											0	0	0	0	0	0					0		245.0209196	49.07147005	346.0055467		13.47024964	11.10156697	6.748449552	69.83630843	64.60580301		534.149258		2.040749657	58.11081747	0	19.10410468	11.57918021	300.8696699	17.31386439	105.9277097	7.346832659											48.09594843	5.898101207	59.68716722	47.10213758	0.627136472	0.0001					PBP 1a - Medicare FFS level desired per benefit period	PBP 1b - Medicare FFS level desired per benefit period	PBP 2 - Medicare FFS level desired per benefit period	$0 copay	PBP 10a	PBP 11a	"PBP 11b, 11c, 14i"	PBP 4a	"PBP 9a, 9b"	0% coinsurance	PBP 8b (Radiology)	20% coinsurance	PBP 12	"PBP 9a, 9d, 8b (radiation therapy)"	0% coinsurance	"PBP 4b, 7b, 7d, 7f, 7g, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	0% coinsurance	0% coinsurance		0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance		0% coinsurance	0% coinsurance	PBP 1a - Medicare FFS level desired per benefit period	PBP 1b - Medicare FFS level desired per benefit period	PBP category 7f	PBP Category 1b $20/day	"PBP category 5, 9c"	PBP Category 3					1032	1032	129	0	0.2	0.199809447	0.2	0.084067005	0.2	0	20	0.2	0.2	0.2	0	0.2	0.394285714	20	0.2	0.2	0.2	0	0		0	0	0	0	0	0	0	258	258	20	20	0.431733685	0.0001					21.0718	4.220146424	3.719559627	0	2.694049928	2.218197954	1.34968991	5.870929297	12.9211606	0	0.890248763	0	0.408149931	11.62216349	0	3.820820936	4.565505339	0.50144945	3.462772878	21.18554194	1.469366532	0	0	0	0	0	0	0	0	0	0	1.034062891	0.126809176	0.099478612	0.078503563	0.27075594	8.33E-13	0	0	0	0	103.6012			21.0718	4.220146424	3.719559627	0	2.694049928	2.218197954	1.34968991	5.870929297	12.9211606	0	0.890248763	0	0.408149931	11.62216349	0	3.820820936	4.565505339	0.50144945	3.462772878	21.18554194	1.469366532	0	0	0	0	0	0	0	0	0	0	1.034062891	0.126809176	0.099478612	0.078503563	0.27075594	8.33E-13	0	0	0	0	103.6012																																																																																				0			21.0718	4.220146424	3.719559627	0	2.694049928	2.218197954	1.34968991	5.870929297	12.9211606	0	0.890248763	0	0.408149931	11.62216349	0	3.820820936	4.565505339	0.50144945	3.462772878	21.18554194	1.469366532	0	0	0	0	0	0	0	0	0	0	1.034062891	0.126809176	0.099478612	0.078503563	0.27075594	8.33E-13	0	0	0	0	103.6012
H3113_001_0	2008	5	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)							Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						Coin	Coin	D	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V		Coin	Coin	Coin	T		V	P	Coin					Coin	Coin	Coin	V																																																0		350.9861801	5.368789	10201.55274	246.6795966	34.84948381	36.84596058	0.331211768	207.8554024	16.22487146	63.7884544	58.41073842	2.976054535	0.721762048	9.594379145	147.007368	149.8409225	15.56530084	28.68253792		15.08172462	4.543934344	7.566041358	1912.9		302.4	292.8						1.212422147	0.00899053		247.1							(1a) 6.7% coins	(1b) 6.7% coins	(2a) $0/day	(6a) $0/proc	(10a) 20% coins	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) 20% coins	(8a) 10% coins	(8b) 19.2% coins	(9a) 20% coins	(12) 20% coins	(9a) 20% coins	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) 20% coins	(7e/7h) 20% coins	(7c/7i) $0/visit		(7g) 20% coins	(15) 20% coins	(Misc. PBP Cats) 20% coins	(10b) $0/trip		(17a1) $0/visit	(17b2) $0/proc	(18a) 20% coins					(4b) 20% coins	(9c) 20% coins	(9d) 20% coins	(7f1) $0/visit							0.066616709	0.066616709			0.2	0.2	0.2	50	0.2	0.1	0.192	0.2	0.2	0.2		0.2	0.2			0.2	0.2	0.2										0.2	0.2									23.3815	0.357651054	0	0	6.969896762	7.369192117	0.066242354	0.866064177	3.244974292	6.37884544	11.21486178	0.595210907	0.14435241	1.918875829	0	29.96818451	3.113060169	0	0	3.016344925	0.908786869	1.513208272	0	0	0	0	0	0	0	0	0	0.242484429	0.001798106	0	0	0	0	0	0	0	0	101.2716		0	23.3815	0.357651054	0	0	6.969896762	7.369192117	0.066242354	0.866064177	3.244974292	6.37884544	11.21486178	0.595210907	0.14435241	1.918875829	0	29.96818451	3.113060169	0	0	3.016344925	0.908786869	1.513208272	0	0	0	0	0	0	0	0	0	0.242484429	0.001798106	0	0	0	0	0	0	0	0	101.2716																																																																																				0		0	23.3815	0.357651054	0	0	6.969896762	7.369192117	0.066242354	0.866064177	3.244974292	6.37884544	11.21486178	0.595210907	0.14435241	1.918875829	0	29.96818451	3.113060169	0	0	3.016344925	0.908786869	1.513208272	0	0	0	0	0	0	0	0	0	0.242484429	0.001798106	0	0	0	0	0	0	0	0	101.2716
H3113_002_0	2008	6																					3500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2238.817787	153.5400611	1043.186608		323.0037088	14.11182097	24.507932	505.9221686	478.1940478	4009.100773	526.8671575	80.29234446	17.90312225	3368.891191		4561.433531	449.7008245	656.317085				811.7981213					0.085954696															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															139.5174	139.5174	33.4842		59.7932	0.159448403	0.159448403	32.8862	59.7932	15.9448	52.0312	59.7932	136.8633	57.8101		19.9311	15.9448	15.9448				19.9311					19.9311															26.0295	1.785125242	2.910852685	0	1.609450802	2.250107323	3.907750629	1.386489535	2.382727421	5.327039313	2.284461122	0.400077692	0.20419002	16.22964879	0	7.576180145	0.597533987	0.872072595	0	0	0	1.348332441	0	0	0	0	0.000142764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.1017	0	19.60882657	26.0295	1.785125242	2.910852685	0	1.609450802	2.250107323	3.907750629	1.386489535	2.382727421	5.327039313	2.284461122	0.400077692	0.20419002	16.22964879	0	7.576180145	0.597533987	0.872072595	0	0	0	1.348332441	0	0	0	0	0.000142764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.1017																																																																																				0	0	0	26.0295	1.785125242	2.910852685	0	1.609450802	2.250107323	3.907750629	1.386489535	2.382727421	5.327039313	2.284461122	0.400077692	0.20419002	16.22964879	0	7.576180145	0.597533987	0.872072595	0	0	0	1.348332441	0	0	0	0	0.000142764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.1017
H3113_003_0	2008	5																					3900											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2465.650987	349.103493	1209.969035		488.8259139	37.42340607	26.72631562	847.3533157	449.609041	7810.792193	659.6709089	82.69486602	5.557031581	4246.631097		4096.43178	1073.028915	1110.85387			33.99344903	795.6094591					0.10498293															1(a) $250 per Day	1(b) $250 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $150 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $75 per Visit	8(a) Diagnostic: 20% Coinsurance; other 0% coinsurance	8(b) X-rays 20% Coinsurance; other: 20% Coinsurance	9(a) $75 per Visit	12  20% Coinsurance	"3,5,9(a), 9(d) $75 per visit; 9(c) $25/$35 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $35 per Visit	7(e)/7(h) $25/35 per Visit	7(c)/7(i) $35 per Visit		7(g) $35 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $35 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $35 per visit															156.3059	156.3059	26.2594		93.7836	0.125044757	0.125044757	27.9788	46.8918	2.1674	64.6099	46.8918	0.125044757	46.7836		21.8828	20.3198	21.8828			0.125044757	21.8828					21.8828															32.1163	4.547246001	2.64775498	0	3.820319866	4.679600736	3.341985655	1.975658238	1.756914172	1.41077622	3.551769953	0.323142483	0.694877666	16.55607102	0	7.470127561	1.816975339	2.025719102	0	0	4.25070259	1.450849048	0	0	0	0	0.000191444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.437	0	56.60812166	32.1163	4.547246001	2.64775498	0	3.820319866	4.679600736	3.341985655	1.975658238	1.756914172	1.41077622	3.551769953	0.323142483	0.694877666	16.55607102	0	7.470127561	1.816975339	2.025719102	0	0	4.25070259	1.450849048	0	0	0	0	0.000191444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.437																																																																																				0	0	0	32.1163	4.547246001	2.64775498	0	3.820319866	4.679600736	3.341985655	1.975658238	1.756914172	1.41077622	3.551769953	0.323142483	0.694877666	16.55607102	0	7.470127561	1.816975339	2.025719102	0	0	4.25070259	1.450849048	0	0	0	0	0.000191444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.437
H3132_001_0	2008	4																																																							V																																																											0																									2814																																									$5 co-pay per oral exam; $5 co-pay per cleaning; $10 co-pay per X ray																																									6.589833145																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.545315873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.5453			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.545315873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.5453																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.545315873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.5453
H3152_022_0	2008	8																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1767.009113		1134.094372	1086.947205	217.4795213	10.01946617		302.9333986	296.6473002	599.1577888	3725.194913	0	0	447.8527425	3655.835112	5282.521844	0	818.8854849	0	0	248.2709713				605.9634991		35.84733836															900/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$250 per procedure	$35 per visit	"$35 X-ray; $150  PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$20 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															152.17		68.64	20	100	0.2		48	250	35	55.7	35	30	35	20	35	35	35	35	35	45				0		0															22.4071	0	6.487019809	1.811578675	1.812329344	2.003893234	0	1.211733594	6.180152088	1.747543551	17.29111305	0	0	1.306237166	6.09305852	15.40735538	0	2.388415998	0	0	0.931016142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.0786			22.4071	0	6.487019809	1.811578675	1.812329344	2.003893234	0	1.211733594	6.180152088	1.747543551	17.29111305	0	0	1.306237166	6.09305852	15.40735538	0	2.388415998	0	0	0.931016142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.0786																																																																																				0			22.4071	0	6.487019809	1.811578675	1.812329344	2.003893234	0	1.211733594	6.180152088	1.747543551	17.29111305	0	0	1.306237166	6.09305852	15.40735538	0	2.388415998	0	0	0.931016142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.0786
H3152_041_0	2008	5																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1767.099864		1134.152618	1087.003029	217.4906907	10.01998076		302.9489568	296.6625356	599.1885606	3725.386233	0	0	447.8757435	3656.02287	5282.793146	0	818.9275416	0	0	248.2837221				605.9946204		35.84917942															900/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$250 per procedure	$35 per visit	"$35 X-ray; $150 PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$20 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															152.17		68.64	20	100	0.2		48	250	35	55.7	35	30	35	20	35	35	35	35	35	45				0		0															22.4083	0	6.487352973	1.811671715	1.812422423	2.003996151	0	1.211795827	6.180469491	1.747633302	17.2920011	0	0	1.306304252	6.09337145	15.40814668	0	2.388538663	0	0	0.931063958	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.0831			22.4083	0	6.487352973	1.811671715	1.812422423	2.003996151	0	1.211795827	6.180469491	1.747633302	17.2920011	0	0	1.306304252	6.09337145	15.40814668	0	2.388538663	0	0	0.931063958	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.0831																																																																																				0			22.4083	0	6.487352973	1.811671715	1.812422423	2.003996151	0	1.211795827	6.180469491	1.747633302	17.2920011	0	0	1.306304252	6.09337145	15.40814668	0	2.388538663	0	0	0.931063958	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.0831
H3152_045_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1521.615046		1026.986914	639.9933379	200.138508	8.608876516		259.5351545	282.8044134	990.6785475	4226.573805	0	0	746.9449494	3772.814431	6717.995045	0	788.1460714	0	0	236.6855398				800.7221968		45.6881595															$75/day 1-10		"$0/day 1-5, $75 day 6-14; $100/day 15-100"	$25 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$100 per procedure	$25 per visit	"$25 X-ray; $150 CAT, PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit															61.47		73.75	25	100	0.2		48	100	25	47.5	25	25	25	10	25	25	25	25	25	45				0		0															7.7945	0	6.311690407	1.333319454	1.6678209	1.721775303	0	1.038140618	2.356703445	2.063913641	16.73018798	0	0	1.556135311	3.144012025	13.99582301	0	1.641970982	0	0	0.887570774	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2435			7.7945	0	6.311690407	1.333319454	1.6678209	1.721775303	0	1.038140618	2.356703445	2.063913641	16.73018798	0	0	1.556135311	3.144012025	13.99582301	0	1.641970982	0	0	0.887570774	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2435																																																																																				0			7.7945	0	6.311690407	1.333319454	1.6678209	1.721775303	0	1.038140618	2.356703445	2.063913641	16.73018798	0	0	1.556135311	3.144012025	13.99582301	0	1.641970982	0	0	0.887570774	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2435
H3152_046_0	2008	5																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1518.642988		1024.980976	638.7432861	199.7475922	8.592061432		259.0282236	282.2520324	988.7435281	4218.31835	0	0	745.4859969	3765.44527	6664.26925	0	786.6066438	0	0	236.2232394				799.1582051		45.59892019															$150/day 1-10		"$0/day 1-5, $75 day 6-14; $100/day 15-100"	$25 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$100 per procedure	$35 per visit	"$35 X-ray; $175 CAT, PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$15 per visit	"$35 per visit Specialist, $30 Renal Dialysis"	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															122.95		73.75	25	100	0.2		48	100	35	60.2	35	30	35	15	34.57	35	35	35	35	45				0		0															15.5598	0	6.299362247	1.330715179	1.664563268	1.718412286	0	1.036112894	2.35210027	2.88383529	21.16189706	0	0	2.174334158	4.706806588	19.198649	0	2.294269378	0	0	0.885837148	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.2667			15.5598	0	6.299362247	1.330715179	1.664563268	1.718412286	0	1.036112894	2.35210027	2.88383529	21.16189706	0	0	2.174334158	4.706806588	19.198649	0	2.294269378	0	0	0.885837148	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.2667																																																																																				0			15.5598	0	6.299362247	1.330715179	1.664563268	1.718412286	0	1.036112894	2.35210027	2.88383529	21.16189706	0	0	2.174334158	4.706806588	19.198649	0	2.294269378	0	0	0.885837148	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.2667
H3152_047_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1507.903014		1017.732222	634.2260387	198.33496	8.531297634		257.1963537	280.2559218	981.7510488	4188.48604	0	0	740.2138558	3738.815717	6617.138965	0	781.043694	0	0	234.5526484				793.5064895		45.2764407															$75/day 1-10		"$0/day 1-5, $75 day 6-14; $100/day 15-100"	$25 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$100 per procedure	$30 per visit	"$30 X-ray; $175 CAT, PET, MRI"	$30 per visit	$30 per visit	$30 per visit	$10 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script				$0 per visit		$0 per visit															61.47		73.75	25	100	0.2		48	100	30	56.1	30	30	30	10	30	30	30	30	30	45				0		0															7.7242	0	6.254812615	1.321304247	1.652791333	1.706259527	0	1.028785415	2.335466015	2.454377622	19.58117224	0	0	1.85053464	3.115679764	16.54284741	0	1.952609235	0	0	0.879572431	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.4004			7.7242	0	6.254812615	1.321304247	1.652791333	1.706259527	0	1.028785415	2.335466015	2.454377622	19.58117224	0	0	1.85053464	3.115679764	16.54284741	0	1.952609235	0	0	0.879572431	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.4004																																																																																				0			7.7242	0	6.254812615	1.321304247	1.652791333	1.706259527	0	1.028785415	2.335466015	2.454377622	19.58117224	0	0	1.85053464	3.115679764	16.54284741	0	1.952609235	0	0	0.879572431	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.4004
H3152_048_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1507.694994		1017.591823	634.1385452	198.3075991	8.530120715		257.1608727	280.2172596	981.6156132	4187.908225	0	0	740.111741	3738.299936	6717.004393	0	780.9359466	0	0	234.5202911				793.3970229		45.27019468															$0/day		"$0/day 1-5, $75 day 6-14; $100/day 15-100"	$25 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$100 per procedure	$20 per visit	"$20 X-ray; $175 CAT, PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$10 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit															0		73.75	25	100	0.2		48	100	20	47.9	20	20	20	10	20	20	20	20	20	45				0		0															0	0	6.253949745	1.321121969	1.652563326	1.706024143	0	1.028643491	2.33514383	1.636026022	16.71673367	0	0	1.233519568	3.115249947	11.19500732	0	1.301559911	0	0	0.879451092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.375			0	0	6.253949745	1.321121969	1.652563326	1.706024143	0	1.028643491	2.33514383	1.636026022	16.71673367	0	0	1.233519568	3.115249947	11.19500732	0	1.301559911	0	0	0.879451092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.375																																																																																				0			0	0	6.253949745	1.321121969	1.652563326	1.706024143	0	1.028643491	2.33514383	1.636026022	16.71673367	0	0	1.233519568	3.115249947	11.19500732	0	1.301559911	0	0	0.879451092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.375
H3152_053_0	2008	6																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1790.797774		1149.362311	1101.580417	220.4073764	10.15435494		307.011691	300.6409649	607.2240524	3775.345983	0	0	453.8820362	3705.052414	5353.638692	0	829.90987	0	0	251.6133614				614.1213857		36.32993925															350/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$250 per procedure	$35 per visit	"$35 X-ray; $150 PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$10 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															59.18		68.64	20	100	0.2		48	250	35	55.7	35	30	35	10	35	35	35	35	35	45				0		0															8.8316	0	6.574352416	1.835967361	1.836728136	2.030870988	0	1.228046764	6.263353436	1.771070153	17.5238976	0	0	1.323822606	3.087543678	15.61477952	0	2.420570454	0	0	0.943550105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2862			8.8316	0	6.574352416	1.835967361	1.836728136	2.030870988	0	1.228046764	6.263353436	1.771070153	17.5238976	0	0	1.323822606	3.087543678	15.61477952	0	2.420570454	0	0	0.943550105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2862																																																																																				0			8.8316	0	6.574352416	1.835967361	1.836728136	2.030870988	0	1.228046764	6.263353436	1.771070153	17.5238976	0	0	1.323822606	3.087543678	15.61477952	0	2.420570454	0	0	0.943550105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2862
H3152_073_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		2060.386		1322.388294	1267.413273	253.587691	11.6830002		353.2294931	345.8997125	698.6360796	4343.68979	0	0	522.2098254	4262.814167	6159.580031	0	954.8452103	0	0	289.4914517				706.5717434		41.79907932															$950 per admission		$0 1-20; $100 21+	$0 per visit	$200 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$15 per visit	"$10 X-ray; $150 PET, MRI"	$15 per visit	$0 per visit	$15 per visit	$0 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script				$0 per visit		$0 per visit															160.62		41.2	0	200	0.2		46.75	200	15	39.3	15	0	15	0	15	15	15	15	15	45				0		0															27.5783	0	4.54019981	0	4.226461516	2.33660004	0	1.376123233	5.764995208	0.8732951	14.22558406	0	0	0.652762282	0	7.699475039	0	1.193556513	0	0	1.085592944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5529			27.5783	0	4.54019981	0	4.226461516	2.33660004	0	1.376123233	5.764995208	0.8732951	14.22558406	0	0	0.652762282	0	7.699475039	0	1.193556513	0	0	1.085592944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5529																																																																																				0			27.5783	0	4.54019981	0	4.226461516	2.33660004	0	1.376123233	5.764995208	0.8732951	14.22558406	0	0	0.652762282	0	7.699475039	0	1.193556513	0	0	1.085592944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5529
H3152_074_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S			V	V		V																																																								0		1841.787604		1243.081666	774.6583468	242.2509056	10.42032417		314.1455728	342.3110623	1199.133429	5115.913686	0	0	904.1143171	4566.675958	8205.436427	0	953.9848254	0	0	286.4880275			3781.118076	969.2071721		55.30169146															$100/day 1-7		$0/day 1-20; $100/day 21-100	$0 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$100 per procedure	$0 per visit	"$10 X-ray; $115 CAT, PET, MRI"	$10 per visit	$0 per visit	$10 per visit	$0 per visit	"$10 Specialist, $0 Renal Dialysis"	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script			$5 per visit	$0 per visit		$0 per visit															72.29		49.44	0	100	0.2		46.75	100	0	28.9	10	0	10	0	9.29	10	10	10	10	45			5	0		0															11.0952	0	5.121496464	0	2.018757547	2.084064835	0	1.223858794	2.852592186	0	12.32082546	0	0	0.753428598	0	6.352375367	0	0.794987355	0	0	1.074330103	0	0	1.575465865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2674			11.0952	0	5.121496464	0	2.018757547	2.084064835	0	1.223858794	2.852592186	0	12.32082546	0	0	0.753428598	0	6.352375367	0	0.794987355	0	0	1.074330103	0	0	1.575465865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2674																																																																																				0			11.0952	0	5.121496464	0	2.018757547	2.084064835	0	1.223858794	2.852592186	0	12.32082546	0	0	0.753428598	0	6.352375367	0	0.794987355	0	0	1.074330103	0	0	1.575465865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2674
H3152_801_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1550.287156		1089.111832	940.9358261	216.889172	10.50818565		265.7266567	296.3289849	961.1055407	4627.145	0	0	778.8567522	3768.548075	6767.95171	0	1099.505456	0	0	7.95276079				840.7449631		47.59603308															$200 per day; max $1400		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20 % per script				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	60.52	40	30	40	30	40	40	40	40	40	0.2				0		0															18.6771	0	9.075931937	3.136452754	2.71111465	3.152455694	0	1.107194403	4.938816414	3.203685136	23.33623462	0	0	2.596189174	9.421370189	22.55983903	0	3.665018188	0	0	1.590552158	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.1719			18.6771	0	9.075931937	3.136452754	2.71111465	3.152455694	0	1.107194403	4.938816414	3.203685136	23.33623462	0	0	2.596189174	9.421370189	22.55983903	0	3.665018188	0	0	1.590552158	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.1719																																																																																				0			18.6771	0	9.075931937	3.136452754	2.71111465	3.152455694	0	1.107194403	4.938816414	3.203685136	23.33623462	0	0	2.596189174	9.421370189	22.55983903	0	3.665018188	0	0	1.590552158	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.1719
H3152_804_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1539.098988		1081.251891	934.1452469	215.3239185	10.4323498		263.8089511	294.1904273	954.1694	4593.751655	0	0	773.235871	3741.351083	6719.108515	0	1091.570506	0	0	7.895367023				834.6774449		47.25254033															$200 per day; max $1400		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20 % per script				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	60.52	40	30	40	30	40	40	40	40	40	0.2				0		0															18.5423	0	9.010432428	3.11381749	2.691548981	3.129704939	0	1.099203963	4.903173788	3.180564667	23.16782085	0	0	2.577452903	9.353377709	22.39702838	0	3.638568355	0	0	1.579073405	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.3841			18.5423	0	9.010432428	3.11381749	2.691548981	3.129704939	0	1.099203963	4.903173788	3.180564667	23.16782085	0	0	2.577452903	9.353377709	22.39702838	0	3.638568355	0	0	1.579073405	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.3841																																																																																				0			18.5423	0	9.010432428	3.11381749	2.691548981	3.129704939	0	1.099203963	4.903173788	3.180564667	23.16782085	0	0	2.577452903	9.353377709	22.39702838	0	3.638568355	0	0	1.579073405	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.3841
H3154_004_0	2008	4	t.										OP Facility - Other										5000	ASC										A		D	P	T	coin		V	V					V	V	V			V	V												P																																																			0		359.3982643		1264.908504	313.0876522	324.0735625	16.75617927		228.1357014	168.4937914					2439.31095	7998.099815	4594.29762			997.9408116	3788.664197												194.9513456										$900 /Admission		$0 copay each days 1-5; $75 copay days 6-20; $100 copay each day 21+	$35 copay	$150 /Trip	20% Coinsurance		$50 copay per visit	$200 Copay					$200 Copay	$15 /PCP visit	$35 /visit			$35 /visit	$35 /visit												$100 Copay										756		56.32325174	29.4	126	0.168		42	168					168	12.6	29.4			29.4	29.4												84										22.6421	0	5.93698001	0.767064748	3.402772407	2.815038118	0	0.798474955	2.35891308	0	0	0	0	34.1503533	8.398004805	11.25602917	0	0	2.444954988	9.282227283	0	0	0	0	0	0	0	0	0	0	0	1.364659419	0	0	0	0	0	0	0	0	0	105.6176	0	20.11763104	22.6421	0	5.93698001	0.767064748	3.402772407	2.815038118	0	0.798474955	2.35891308	0	0	0	0	34.1503533	8.398004805	11.25602917	0	0	2.444954988	9.282227283	0	0	0	0	0	0	0	0	0	0	0	1.364659419	0	0	0	0	0	0	0	0	0	105.6176																																																																																				0	0	0	22.6421	0	5.93698001	0.767064748	3.402772407	2.815038118	0	0.798474955	2.35891308	0	0	0	0	34.1503533	8.398004805	11.25602917	0	0	2.444954988	9.282227283	0	0	0	0	0	0	0	0	0	0	0	1.364659419	0	0	0	0	0	0	0	0	0	105.6176
H3154_005_0	2008	4	h.5.										OP Facility - Other										5000	Other										D		D	P	T	coin		V	V					V	V	V			V	V												P																																																			0	6200	2140.867581		1264.908504	313.0876522	324.0735625	16.75617927		228.1357014	168.4937914					2439.31095	7998.099815	4594.29762			997.9408116	3788.664197												194.9513456										$75 /Day		$0 copay each days 1-5; $50 copay days 6-20; $100 copay each day 21+	$35 copay	$150 /Trip	20% Coinsurance		$50 copay per visit	$200 Copay					$200 Copay	$15 /visit	$35 /visit			$35 /visit	$35 /visit												$100 Copay										64.095		47.85319478	29.911	128.19	0.17092		42.73	170.92					170.92	12.819	29.911			29.911	29.911												85.46										11.4349	0	5.04415942	0.780397064	3.461915832	2.863966162	0	0.81235321	2.399913236	0	0	0	0	34.74391896	8.543970127	11.45166968	0	0	2.487450635	9.443561234	0	0	0	0	0	0	0	0	0	0	0	1.388378499	0	0	0	0	0	0	0	0	0	94.8566	0	16.13871316	11.4349	0	5.04415942	0.780397064	3.461915832	2.863966162	0	0.81235321	2.399913236	0	0	0	0	34.74391896	8.543970127	11.45166968	0	0	2.487450635	9.443561234	0	0	0	0	0	0	0	0	0	0	0	1.388378499	0	0	0	0	0	0	0	0	0	94.8566		$900 deductible;35% coins		$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins		$900 deductible;35% coins	$900 deductible;35% coins					$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins		$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins												$900 deductible;35% coins										0.116054869		0.080989047	0	0.111404989	0.170064599		0.00358582	0.01626751					0.047597914	0.000163277	0.089025782			0.038960073	0.229245745												0.253199966										1.1566	900	0.781002373	11.551	0	5.125148467	0.780397064	3.57332082	3.034030761	0	0.81593903	2.416180746	0	0	0	0	34.79151688	8.544133404	11.54069546	0	0	2.526410707	9.672806979	0	0	0	0	0	0	0	0	0	0	0	1.641578466	0	0	0	0	0	0	0	0	0	96.0131
H3154_006_0	2008	4	h.5.										OP Facility - Other										5000	Other										D		D	P	T	coin		V	V					V	V	V			V	V												P																																																			0	6200	2140.867581		1264.908504	313.0876522	324.0735625	16.75617927		228.1357014	168.4937914					2439.31095	7998.099815	4594.29762			997.9408116	3788.664197												194.9513456										$75 /Day		$0 copay each days 1-5; $50 copay days 6-20; $100 copay each day 21+	$35 copay	$150 /Trip	20% Coinsurance		$50 copay per visit	$200 Copay					$200 Copay	$15 /visit	$35 /visit			$35 /visit	$35 /visit												$100 Copay										64.095	0	47.85319478	29.911	128.19	0.17092	0	42.73	170.92	0	0	0	0	170.92	12.819	29.911	0	0	29.911	29.911	0	0	0	0	0	0	0	0	0	0	0	85.46	0									11.4349	0	5.04415942	0.780397064	3.461915832	2.863966162	0	0.81235321	2.399913236	0	0	0	0	34.74391896	8.543970127	11.45166968	0	0	2.487450635	9.443561234	0	0	0	0	0	0	0	0	0	0	0	1.388378499	0	0	0	0	0	0	0	0	0	94.8566	0	16.13871316	11.4349	0	5.04415942	0.780397064	3.461915832	2.863966162	0	0.81235321	2.399913236	0	0	0	0	34.74391896	8.543970127	11.45166968	0	0	2.487450635	9.443561234	0	0	0	0	0	0	0	0	0	0	0	1.388378499	0	0	0	0	0	0	0	0	0	94.8566	0	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	0.1161	0	0.081	0	0.1114	0.1701	0	0.0036	0.0163	0	0	0	0	0.0476	0.0002	0.089	0	0	0.039	0.2292	0	0	0	0	0	0	0	0	0	0	0	0.2532	0	0	0	0	0	0	0	0	0	1.1566	900	0.781002373	11.551	0	5.125148467	0.780397064	3.57332082	3.034030761	0	0.81593903	2.416180746	0	0	0	0	34.79151688	8.544133404	11.54069546	0	0	2.526410707	9.672806979	0	0	0	0	0	0	0	0	0	0	0	1.641578466	0	0	0	0	0	0	0	0	0	96.0131
H3154_012_0	2008	4	h.5.										OP Facility - Other										5000	Other										D		D	P	T	coin		V	V					V	V	V			V	V												P																																																			0	6200	2140.867581		1264.908504	313.0876522	324.0735625	16.75617927		228.1357014	168.4937914					2439.31095	7998.099815	4594.29762			997.9408116	3788.664197												194.9513456										$75 /Day		$0 copay each days 1-5; $50 copay days 6-20; $100 copay each day 21+	$35 copay	$150 /Trip	20% Coinsurance		$50 copay per visit	$200 Copay					$200 Copay	$15 /visit	$35 /visit			$35 /visit	$35 /visit												$100 Copay										64.095	0	47.85319478	29.911	128.19	0.17092		42.73	170.92					170.92	12.819	29.911			29.911	29.911												85.46										11.4349	0	5.04415942	0.780397064	3.461915832	2.863966162	0	0.81235321	2.399913236	0	0	0	0	34.74391896	8.543970127	11.45166968	0	0	2.487450635	9.443561234	0	0	0	0	0	0	0	0	0	0	0	1.388378499	0	0	0	0	0	0	0	0	0	94.8566	0	16.13871316	11.4349	0	5.04415942	0.780397064	3.461915832	2.863966162	0	0.81235321	2.399913236	0	0	0	0	34.74391896	8.543970127	11.45166968	0	0	2.487450635	9.443561234	0	0	0	0	0	0	0	0	0	0	0	1.388378499	0	0	0	0	0	0	0	0	0	94.8566	0	$900 deductible;35% coins		$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins		$900 deductible;35% coins	$900 deductible;35% coins					$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins		$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins												$900 deductible;35% coins										0.1161		0.081	0	0.1114	0.1701		0.0036	0.0163					0.0476	0.0002	0.089		0	0.039	0.2292												0.2532										1.1566	900	0.781002373	11.551	0	5.125148467	0.780397064	3.57332082	3.034030761	0	0.81593903	2.416180746	0	0	0	0	34.79151688	8.544133404	11.54069546	0	0	2.526410707	9.672806979	0	0	0	0	0	0	0	0	0	0	0	1.641578466	0	0	0	0	0	0	0	0	0	96.0131
H3154_013_0	2008	5	t.										OP Facility - Other										5000	ASC										A		D	P	T	coin		V	V					V	V	V			V	V												P																																																			0	0	359.3982643		1264.908504	313.0876522	324.0735625	16.75617927		228.1357014	168.4937914					2439.31095	7998.099815	4594.29762			997.9408116	3788.664197												194.9513456										$900 /Admission		$0 copay each days 1-5; $75 copay days 6-20; $100 copay each day 21+	$35 copay	$150 /Trip	20% Coinsurance		$50 copay per visit	$200 Copay					$200 Copay	$15 /PCP visit	$35 /visit			$35 /visit	$35 /visit												$100 Copay										756	0	56.32325174	29.4	126	0.168	0	42	168	0	0	0	0	168	12.6	29.4	0	0	29.4	29.4	0	0	0	0	0	0	0	0	0	0	0	84	0	0								22.6421	0	5.93698001	0.767064748	3.402772407	2.815038118	0	0.798474955	2.35891308	0	0	0	0	34.1503533	8.398004805	11.25602917	0	0	2.444954988	9.282227283	0	0	0	0	0	0	0	0	0	0	0	1.364659419	0	0	0	0	0	0	0	0	0	105.6176	0	20.11763104	22.6421	0	5.93698001	0.767064748	3.402772407	2.815038118	0	0.798474955	2.35891308	0	0	0	0	34.1503533	8.398004805	11.25602917	0	0	2.444954988	9.282227283	0	0	0	0	0	0	0	0	0	0	0	1.364659419	0	0	0	0	0	0	0	0	0	105.6176	0																																																																																			0	0	0	22.6421	0	5.93698001	0.767064748	3.402772407	2.815038118	0	0.798474955	2.35891308	0	0	0	0	34.1503533	8.398004805	11.25602917	0	0	2.444954988	9.282227283	0	0	0	0	0	0	0	0	0	0	0	1.364659419	0	0	0	0	0	0	0	0	0	105.6176
H3154_014_0	2008	5																					3250											D		D					V							V	V			V	V																																																															0		2345.202933		1385.637842					249.9101396							8240.18161	5032.800885			1093.189387	4150.273687																						$75 /Day		$0 copay each days 1-5; $0 copay days 6-20; $124 copay each day 21+					$50 copay per visit							$10 /PCP visit	$20 /visit			$20 /visit	$20 /visit																						68.0175		38.1017					45.345							9.069	18.138			18.138	18.138																						13.2929	0	4.399597204	0	0	0	0	0.94434794	0	0	0	0	0	0	6.227517252	7.607078537	0	0	1.652355759	6.273138678	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3969	0	4.147044875	13.2929	0	4.399597204	0	0	0	0	0.94434794	0	0	0	0	0	0	6.227517252	7.607078537	0	0	1.652355759	6.273138678	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3969																																																																																				0	0	0	13.2929	0	4.399597204	0	0	0	0	0.94434794	0	0	0	0	0	0	6.227517252	7.607078537	0	0	1.652355759	6.273138678	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3969
H3154_015_0	2008	4	h.5.										OP Facility - Other										5000	Other										D		D	P	T	coin		V	V					V	V	V			V	V												P																																																			0	6200	2140.867581		1264.908504	313.0876522	324.0735625	16.75617927		228.1357014	168.4937914					2439.31095	7998.099815	4594.29762			997.9408116	3788.664197												194.9513456										$75 /Day		$0 copay each days 1-5; $50 copay days 6-20; $100 copay each day 21+	$35 copay	$150 /Trip	20% Coinsurance		$50 copay per visit	$200 Copay					$200 Copay	$15 /visit	$35 /visit			$35 /visit	$35 /visit												$100 Copay										64.095		47.85319478	29.911	128.19	0.17092		42.73	170.92					170.92	12.819	29.911			29.911	29.911												85.46										11.4349	0	5.04415942	0.780397064	3.461915832	2.863966162	0	0.81235321	2.399913236	0	0	0	0	34.74391896	8.543970127	11.45166968	0	0	2.487450635	9.443561234	0	0	0	0	0	0	0	0	0	0	0	1.388378499	0	0	0	0	0	0	0	0	0	94.8566	0	16.13871316	11.4349	0	5.04415942	0.780397064	3.461915832	2.863966162	0	0.81235321	2.399913236	0	0	0	0	34.74391896	8.543970127	11.45166968	0	0	2.487450635	9.443561234	0	0	0	0	0	0	0	0	0	0	0	1.388378499	0	0	0	0	0	0	0	0	0	94.8566	0	$900 deductible;35% coins		$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins		$900 deductible;35% coins	$900 deductible;35% coins					$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins			$900 deductible;35% coins	$900 deductible;35% coins												$900 deductible;35% coins										0.1161		0.081	0	0.1114	0.1701		0.0036	0.0163					0.0476	0.0002	0.089			0.039	0.2292												0.2532										1.1566	900	0.781002373	11.551	0	5.125148467	0.780397064	3.57332082	3.034030761	0	0.81593903	2.416180746	0	0	0	0	34.79151688	8.544133404	11.54069546	0	0	2.526410707	9.672806979	0	0	0	0	0	0	0	0	0	0	0	1.641578466	0	0	0	0	0	0	0	0	0	96.0131
H3154_016_0	2008	4	t.										OP Facility - Other										5000	ASC										A		D	P	T	coin		V	V					V	V	V			V	V												P																																																			0	0	359.3982643		1264.908504	313.0876522	324.0735625	16.75617927		228.1357014	168.4937914					2439.31095	7998.099815	4594.29762			997.9408116	3788.664197												194.9513456										$900 /Admission		$0 copay each days 1-5; $75 copay days 6-20; $100 copay each day 21+	$35 copay	$150 /Trip	20% Coinsurance		$50 copay per visit	$200 Copay					$200 Copay	$15 /PCP visit	$35 /visit			$35 /visit	$35 /visit												$100 Copay										756		56.32325174	29.4	126	0.168		42	168					168	12.6	29.4			29.4	29.4												84										22.6421	0	5.93698001	0.767064748	3.402772407	2.815038118	0	0.798474955	2.35891308	0	0	0	0	34.1503533	8.398004805	11.25602917	0	0	2.444954988	9.282227283	0	0	0	0	0	0	0	0	0	0	0	1.364659419	0	0	0	0	0	0	0	0	0	105.6176	0	20.11763104	22.6421	0	5.93698001	0.767064748	3.402772407	2.815038118	0	0.798474955	2.35891308	0	0	0	0	34.1503533	8.398004805	11.25602917	0	0	2.444954988	9.282227283	0	0	0	0	0	0	0	0	0	0	0	1.364659419	0	0	0	0	0	0	0	0	0	105.6176	0																																																																																			0	0	0	22.6421	0	5.93698001	0.767064748	3.402772407	2.815038118	0	0.798474955	2.35891308	0	0	0	0	34.1503533	8.398004805	11.25602917	0	0	2.444954988	9.282227283	0	0	0	0	0	0	0	0	0	0	0	1.364659419	0	0	0	0	0	0	0	0	0	105.6176
H3154_017_0	2008	4	t.										OP Facility - Other										5000	ASC										A		D	P	T	coin		V	V					V	V	V			V	V												P																																																			0	0	359.3982643		1264.908504	313.0876522	324.0735625	16.75617927		228.1357014	168.4937914					2439.31095	7998.099815	4594.29762			997.9408116	3788.664197												194.9513456										$900 /Admission		$0 copay each days 1-5; $75 copay days 6-20; $100 copay each day 21+	$35 copay	$150 /Trip	20% Coinsurance		$50 copay per visit	$200 Copay					$200 Copay	$15 /PCP visit	$35 /visit			$35 /visit	$35 /visit												$100 Copay										756		56.32325174	29.4	126	0.168		42	168					168	12.6	29.4			29.4	29.4												84										22.6421	0	5.93698001	0.767064748	3.402772407	2.815038118	0	0.798474955	2.35891308	0	0	0	0	34.1503533	8.398004805	11.25602917	0	0	2.444954988	9.282227283	0	0	0	0	0	0	0	0	0	0	0	1.364659419	0	0	0	0	0	0	0	0	0	105.6176	0	20.11763104	22.6421	0	5.93698001	0.767064748	3.402772407	2.815038118	0	0.798474955	2.35891308	0	0	0	0	34.1503533	8.398004805	11.25602917	0	0	2.444954988	9.282227283	0	0	0	0	0	0	0	0	0	0	0	1.364659419	0	0	0	0	0	0	0	0	0	105.6176	0																																																																																			0	0	0	22.6421	0	5.93698001	0.767064748	3.402772407	2.815038118	0	0.798474955	2.35891308	0	0	0	0	34.1503533	8.398004805	11.25602917	0	0	2.444954988	9.282227283	0	0	0	0	0	0	0	0	0	0	0	1.364659419	0	0	0	0	0	0	0	0	0	105.6176
H3154_801_0	2008	3	h.5.										OP Facility - Other										5000	Other										D		D	P	T	coin		V	V					V	V	V			V	V												P																																																			0	6200	2140.867581		1264.908504	313.0876522	324.0735625	16.75617927		228.1357014	168.4937914					2439.31095	7998.099815	4594.29762			997.9408116	3788.664197												194.9513456										$75 /Day		$0 copay each days 1-5; $50 copay days 6-20; $100 copay each day 21+	$35 copay	$150 /Trip	20% Coinsurance		$50 copay per visit	$200 Copay					$200 Copay	$15 /visit	$35 /visit			$35 /visit	$35 /visit												$100 Copay										64.095		47.85319478	29.911	128.19	0.17092	0	42.73	170.92	0	0	0	0	170.92	12.819	29.911	0	0	29.911	29.911	0	0	0	0	0	0	0	0	0	0	0	85.46										11.4349	0	5.04415942	0.780397064	3.461915832	2.863966162	0	0.81235321	2.399913236	0	0	0	0	34.74391896	8.543970127	11.45166968	0	0	2.487450635	9.443561234	0	0	0	0	0	0	0	0	0	0	0	1.388378499	0	0	0	0	0	0	0	0	0	94.8566	0	16.13871316	11.4349	0	5.04415942	0.780397064	3.461915832	2.863966162	0	0.81235321	2.399913236	0	0	0	0	34.74391896	8.543970127	11.45166968	0	0	2.487450635	9.443561234	0	0	0	0	0	0	0	0	0	0	0	1.388378499	0	0	0	0	0	0	0	0	0	94.8566	0	$900 deductible;35% coins		$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins		$900 deductible;35% coins	$900 deductible;35% coins					$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins			$900 deductible;35% coins	$900 deductible;35% coins												$900 deductible;35% coins										0.1161		0.081	0	0.1114	0.1701		0.0036	0.0163					0.0476	0.0002	0.089			0.039	0.2292												0.2532										1.1566	900	0.781002373	11.551	0	5.125148467	0.780397064	3.57332082	3.034030761	0	0.81593903	2.416180746	0	0	0	0	34.79151688	8.544133404	11.54069546	0	0	2.526410707	9.672806979	0	0	0	0	0	0	0	0	0	0	0	1.641578466	0	0	0	0	0	0	0	0	0	96.0131
H3154_802_0	2008	3	h.5.										OP Facility - Other										5000	Other										D		D	P	T	coin		V	V					V	V	V			V	V												P																																																			0	6200	2140.867581		1264.908504	313.0876522	324.0735625	16.75617927		228.1357014	168.4937914					2439.31095	7998.099815	4594.29762			997.9408116	3788.664197												194.9513456										$75 /Day		$0 copay each days 1-5; $50 copay days 6-20; $100 copay each day 21+	$35 copay	$150 /Trip	20% Coinsurance		$50 copay per visit	$200 Copay					$200 Copay	$15 /visit	$35 /visit			$35 /visit	$35 /visit												$100 Copay										64.095		47.85319478	29.911	128.19	0.17092		42.73	170.92					170.92	12.819	29.911			29.911	29.911												85.46										11.4349	0	5.04415942	0.780397064	3.461915832	2.863966162	0	0.81235321	2.399913236	0	0	0	0	34.74391896	8.543970127	11.45166968	0	0	2.487450635	9.443561234	0	0	0	0	0	0	0	0	0	0	0	1.388378499	0	0	0	0	0	0	0	0	0	94.8566	0	16.13871316	11.4349	0	5.04415942	0.780397064	3.461915832	2.863966162	0	0.81235321	2.399913236	0	0	0	0	34.74391896	8.543970127	11.45166968	0	0	2.487450635	9.443561234	0	0	0	0	0	0	0	0	0	0	0	1.388378499	0	0	0	0	0	0	0	0	0	94.8566	0	$900 deductible;35% coins		$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins		$900 deductible;35% coins	$900 deductible;35% coins					$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins			$900 deductible;35% coins	$900 deductible;35% coins												$900 deductible;35% coins										0.116054869		0.080989047	0	0.111404989	0.170064599		0.00358582	0.01626751					0.047597914	0.000163277	0.089025782			0.038960073	0.229245745												0.253199966										1.1566	900	0.781002373	11.551	0	5.125148467	0.780397064	3.57332082	3.034030761	0	0.81593903	2.416180746	0	0	0	0	34.79151688	8.544133404	11.54069546	0	0	2.526410707	9.672806979	0	0	0	0	0	0	0	0	0	0	0	1.641578466	0	0	0	0	0	0	0	0	0	96.0131
H3154_805_0	2008	3	h.5.										OP Facility - Other										5000	Other										D		D	P	T	coin		V	V					V	V	V			V	V												P										0		0	0	0	0		0	0					0	0	0			0	0												0										0	6200	2140.867581		1264.908504	313.0876522	324.0735625	16.75617927		228.1357014	168.4937914					2439.31095	7998.099815	4594.29762			997.9408116	3788.664197												194.9513456										$75 /Day		$0 copay each days 1-5; $50 copay days 6-20; $100 copay each day 21+	$35 copay	$150 /Trip	20% Coinsurance		$50 copay per visit	$200 Copay					$200 Copay	$15 /visit	$35 /visit			$35 /visit	$35 /visit												$100 Copay										64.095		47.85319478	29.911	128.19	0.17092		42.73	170.92					170.92	12.819	29.911			29.911	29.911												85.46										11.4349	0	5.04415942	0.780397064	3.461915832	2.863966162	0	0.81235321	2.399913236	0	0	0	0	34.74391896	8.543970127	11.45166968	0	0	2.487450635	9.443561234	0	0	0	0	0	0	0	0	0	0	0	1.388378499	0	0	0	0	0	0	0	0	0	94.8566	0	16.13871316	11.4349	0	5.04415942	0.780397064	3.461915832	2.863966162	0	0.81235321	2.399913236	0	0	0	0	34.74391896	8.543970127	11.45166968	0	0	2.487450635	9.443561234	0	0	0	0	0	0	0	0	0	0	0	1.388378499	0	0	0	0	0	0	0	0	0	94.8566	0	$900 deductible;35% coins		$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins		$900 deductible;35% coins	$900 deductible;35% coins					$900 deductible;35% coins	$900 deductible;35% coins	$900 deductible;35% coins			$900 deductible;35% coins	$900 deductible;35% coins												$900 deductible;35% coins										0.116054869		0.080989047	0	0.111404989	0.170064599		0.00358582	0.01626751					0.047597914	0.000163277	0.089025782			0.038960073	0.229245745												0.253199966										1.1566	900	0.781002373	11.551	0	5.125148467	0.780397064	3.57332082	3.034030761	0	0.81593903	2.416180746	0	0	0	0	34.79151688	8.544133404	11.54069546	0	0	2.526410707	9.672806979	0	0	0	0	0	0	0	0	0	0	0	1.641578466	0	0	0	0	0	0	0	0	0	96.0131
H3156_021_0	2008	5																					None											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	P	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1388.333765	41.08561455	1487.83507	0	229.7482995	21.62536218	0.988657169	225.8425484	190.342714	0	463.5718618	0	0	230.8743307	5337.566422	6290.472882	230.9338129	677.4398137	940.1657851	0	729.751912	0	0	509.7980659	338.7201465	0	137.1010117	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												165	150	25	0	50	0.2	0.2	47.32219575	110	0	25	0	0	25	15	35.07835142	25	25	25	0	25	0	0	10	40	0	39.08785158	0	0	0	0											19.0896	0.513570182	3.099656395	0	0.957284581	4.325072437	0.197731434	0.890613774	1.744808211	0	0.965774712	0	0	0.480988189	6.671958028	18.38828486	0.48111211	1.411332945	1.958678719	0	1.520316483	0	0	0.424831722	1.129067155	0	0.446582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6973	0	0	19.0896	0.513570182	3.099656395	0	0.957284581	4.325072437	0.197731434	0.890613774	1.744808211	0	0.965774712	0	0	0.480988189	6.671958028	18.38828486	0.48111211	1.411332945	1.958678719	0	1.520316483	0	0	0.424831722	1.129067155	0	0.446582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6973	None	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.8726	0.0111	0.1489	0.0952	0.0192	0.0663	0.003	0.0084	0.0693	0.0201	0.0538	0	0.0255	0.0414	0.0927	0.1803	0.0057	0.016	0.1188	0.3064	0.0712	0.0938	0	0	0	0	0	0	0	0	0											2.3199	0	0	19.9622	0.524655349	3.248575045	0.095217912	0.976455126	4.391360594	0.200761962	0.89901687	1.814128893	0.020114923	1.019619663	0	0.025538732	0.522424997	6.764615952	18.56856276	0.486861089	1.427285338	2.077496184	0.306429676	1.591510271	0.093811595	0	0.424831722	1.129067155	0	0.446582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.0171
H3156_024_0	2008	4																					None											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	P	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1388.333765	41.08561455	1487.83507	0	229.7482995	21.62536218	0.988657169	225.8425484	190.342714	0	463.5718618	0	0	230.8743307	5337.566422	6290.472882	230.9338129	677.4398137	940.1657851	0	729.751912	0	0	509.7980659	338.7201465	0	137.1010117	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												165	150	25	0	50	0.2	0.2	47.32219575	110	0	25	0	0	25	15	35.07835142	25	25	25	0	25	0	0	10	40	0	39.08785158	0	0	0	0											19.0896	0.513570182	3.099656395	0	0.957284581	4.325072437	0.197731434	0.890613774	1.744808211	0	0.965774712	0	0	0.480988189	6.671958028	18.38828486	0.48111211	1.411332945	1.958678719	0	1.520316483	0	0	0.424831722	1.129067155	0	0.446582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6973	0	0	19.0896	0.513570182	3.099656395	0	0.957284581	4.325072437	0.197731434	0.890613774	1.744808211	0	0.965774712	0	0	0.480988189	6.671958028	18.38828486	0.48111211	1.411332945	1.958678719	0	1.520316483	0	0	0.424831722	1.129067155	0	0.446582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6973	None	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.8726	0.0111	0.1489	0.0952	0.0192	0.0663	0.003	0.0084	0.0693	0.0201	0.0538	0	0.0255	0.0414	0.0927	0.1803	0.0057	0.016	0.1188	0.3064	0.0712	0.0938	0	0	0	0	0	0	0	0	0											2.3199	0	0	19.9622	0.524655349	3.248575045	0.095217912	0.976455126	4.391360594	0.200761962	0.89901687	1.814128893	0.020114923	1.019619663	0	0.025538732	0.522424997	6.764615952	18.56856276	0.486861089	1.427285338	2.077496184	0.306429676	1.591510271	0.093811595	0	0.424831722	1.129067155	0	0.446582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.0171
H3156_025_0	2008	4																					None											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	P	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1486.389683	44.00471521	1504.558027	0	241.5971416	22.97269755	1.050253953	238.0552009	199.1192084	0	487.7763008	0	0	243.5733268	5670.753053	6624.169658	245.3217936	719.646673	996.0992143	0	774.0446964	0	0	497.5107406	364.7191502	0	147.6244179	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												192.5	175	75	0	100	0.2	0.2	48.2220292	165	0	25	0	0	25	15	39.65393217	25	25	25	0	25	0	0	10	40	0	39.08785158	0	0	0	0											23.8442	0.64173543	9.403487669	0	2.013309514	4.59453951	0.210050791	0.956625404	2.737889116	0	1.016200627	0	0	0.507444431	7.088441317	21.88953119	0.51108707	1.499263902	2.075206696	0	1.612593117	0	0	0.414592284	1.215730501	0	0.480860112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.7128	0	0	23.8442	0.64173543	9.403487669	0	2.013309514	4.59453951	0.210050791	0.956625404	2.737889116	0	1.016200627	0	0	0.507444431	7.088441317	21.88953119	0.51108707	1.499263902	2.075206696	0	1.612593117	0	0	0.414592284	1.215730501	0	0.480860112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.7128	None	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.8442	0.64173543	9.403487669	0	2.013309514	4.59453951	0.210050791	0.956625404	2.737889116	0	1.016200627	0	0	0.507444431	7.088441317	21.88953119	0.51108707	1.499263902	2.075206696	0	1.612593117	0	0	0.414592284	1.215730501	0	0.480860112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.7128
H3156_026_0	2008	5																					None											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	P	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1486.389683	44.00471521	1504.558027	0	241.5971416	22.97269755	1.050253953	238.0552009	199.1192084	0	487.7763008	0	0	243.5733268	5670.753053	6624.169658	245.3217936	719.646673	996.0992143	0	774.0446964	0	0	497.5107406	364.7191502	0	147.6244179	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												192.5	175	75	0	100	0.2	0.2	48.2220292	165	0	25	0	0	25	15	39.65393217	25	25	25	0	25	0	0	10	40	0	39.08785158	0	0	0	0											23.8442	0.64173543	9.403487669	0	2.013309514	4.59453951	0.210050791	0.956625404	2.737889116	0	1.016200627	0	0	0.507444431	7.088441317	21.88953119	0.51108707	1.499263902	2.075206696	0	1.612593117	0	0	0.414592284	1.215730501	0	0.480860112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.7128	0	0	23.8442	0.64173543	9.403487669	0	2.013309514	4.59453951	0.210050791	0.956625404	2.737889116	0	1.016200627	0	0	0.507444431	7.088441317	21.88953119	0.51108707	1.499263902	2.075206696	0	1.612593117	0	0	0.414592284	1.215730501	0	0.480860112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.7128	None	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.8442	0.64173543	9.403487669	0	2.013309514	4.59453951	0.210050791	0.956625404	2.737889116	0	1.016200627	0	0	0.507444431	7.088441317	21.88953119	0.51108707	1.499263902	2.075206696	0	1.612593117	0	0	0.414592284	1.215730501	0	0.480860112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.7128
H3156_027_0	2008	4																					None											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	P	V	V	P	V	P	O	O	O											44.0382	0.5581	7.505	4.3475	0.8901	3.0471	0.1393	0	4.0468	1.2159	3.4904	0	1.4589	1.1357	0	0	0	0	6.1346	13.7127	0	0	0	0	0	0	0	0	0	0	0											91.7203	N/A	0	0	0	0	0	18.13023823	0.828868892	229.8947891	0	0	0	0	0	236.703949	5620.410286	6360.910498	235.5721627	730.3103174	0	0	744.4091186	0	0	497.5107406	345.5234054	0	139.8547117	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0.1	0.1	48.23208651	0	0	0	0	0	15	10	39.65393217	25	15	0	0	25	0	0	10	40	0	39.08785158	0	0	0	0											0	0	0	0	0	1.813023823	0.082886889	0.924025446	0	0	0	0	0	0.295879936	4.683675238	21.01959279	0.490775339	0.912887897	0	0	1.550852331	0	0	0.414592284	1.151744685	0	0.455551685	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.7955	1500	0	44.0382	0.558146007	7.504978597	4.347531417	0.890118617	4.860108839	0.222191952	0.924025446	4.046842461	1.215908405	3.490427682	0	1.458860079	1.431582516	4.683675238	21.01959279	0.490775339	0.912887897	6.1345818	13.71266349	1.550852331	0	0	0.414592284	1.151744685	0	0.455551685	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.5158	None	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	44.0382	0.558146007	7.504978597	4.347531417	0.890118617	4.860108839	0.222191952	0.924025446	4.046842461	1.215908405	3.490427682	0	1.458860079	1.431582516	4.683675238	21.01959279	0.490775339	0.912887897	6.1345818	13.71266349	1.550852331	0	0	0.414592284	1.151744685	0	0.455551685	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.5158
H3156_028_0	2008	5																					None											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	P	V	V	P	V	P	O	O	O											44.0382	0.5581	7.505	4.3475	0.8901	3.0471	0.1393	0	4.0468	1.2159	3.4904	0	1.4589	1.1357	0	0	0	0	6.1346	13.7127	0	0	0	0	0	0	0	0	0	0	0											91.7203	N/A	0	0	0	0	0	18.13023823	0.828868892	229.8947891	0	0	0	0	0	236.703949	5620.410286	6360.910498	235.5721627	730.3103174	0	0	744.4091186	0	0	497.5107406	345.5234054	0	139.8547117	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0.1	0.1	48.23208651	0	0	0	0	0	15	10	39.65393217	25	15	0	0	25	0	0	10	40	0	39.08785158	0	0	0	0											0	0	0	0	0	1.813023823	0.082886889	0.924025446	0	0	0	0	0	0.295879936	4.683675238	21.01959279	0.490775339	0.912887897	0	0	1.550852331	0	0	0.414592284	1.151744685	0	0.455551685	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.7955	1500	0	44.0382	0.558146007	7.504978597	4.347531417	0.890118617	4.860108839	0.222191952	0.924025446	4.046842461	1.215908405	3.490427682	0	1.458860079	1.431582516	4.683675238	21.01959279	0.490775339	0.912887897	6.1345818	13.71266349	1.550852331	0	0	0.414592284	1.151744685	0	0.455551685	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.5158	None	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	44.0382	0.558146007	7.504978597	4.347531417	0.890118617	4.860108839	0.222191952	0.924025446	4.046842461	1.215908405	3.490427682	0	1.458860079	1.431582516	4.683675238	21.01959279	0.490775339	0.912887897	6.1345818	13.71266349	1.550852331	0	0	0.414592284	1.151744685	0	0.455551685	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.5158
H3156_801_0	2008	3																					None											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0	N/A	407.0964511		43.86604031	11.44936987	16.28961779	18.65768948		9.15336953	47.76990719	76.28522648					301.2802796						80.45199426	0.052248925																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.072763512		0.166732317	0	0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				29.6218	0	7.313886518	0	3.811770562	4.365899338	0	2.14188847	11.17815828	17.850743	0	0	0	0	70.49958544	0	0	0	0	0	18.82576666	0.012226248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.6217	135	0	29.6218	0	7.313886518	0	3.811770562	4.365899338	0	2.14188847	11.17815828	17.850743	0	0	0	0	70.49958544	0	0	0	0	0	18.82576666	0.012226248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.6217	None																																																																																			0	N/A	0	29.6218	0	7.313886518	0	3.811770562	4.365899338	0	2.14188847	11.17815828	17.850743	0	0	0	0	70.49958544	0	0	0	0	0	18.82576666	0.012226248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.6217
H3156_802_0	2008	3																					None											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0	N/A	407.0964511		43.86604031	11.44936987	16.28961779	18.65768948		9.15336953	47.76990719	76.28522648					301.2802796						80.45199426	0.052248925																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.072763476		0.166732253	0	0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				29.6218	0	7.31388371	0	3.811770562	4.365899338	0	2.14188847	11.17815828	17.850743	0	0	0	0	70.49958544	0	0	0	0	0	18.82576666	0.012226248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.6217	135	0	29.6218	0	7.31388371	0	3.811770562	4.365899338	0	2.14188847	11.17815828	17.850743	0	0	0	0	70.49958544	0	0	0	0	0	18.82576666	0.012226248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.6217	None																																																																																			0	N/A	0	29.6218	0	7.31388371	0	3.811770562	4.365899338	0	2.14188847	11.17815828	17.850743	0	0	0	0	70.49958544	0	0	0	0	0	18.82576666	0.012226248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.6217
H3164_003_0	2008	8																																Coin	Coin	Coin	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	Coin	P	Coin	P	P	P	P															0.0001	0.0001	0.0001		0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001																				0.0017		378.287737	21.11635166	48.25234436		10.70320693	4.048250969	3.730335761	637.9695913	48.79547904	31.30781471	58.18730482	1.122147055	19.88081181	59.54040674	72.59061675	134.8187108	11.09267364	4.907540974			10.11975975	4.228086411																				$0 1-60 days; $100 61-90 days (1a)	$0 1-60 days; $100 61-90 days (1b)	ffs medicare (2)	$0 (6)	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a);  20% (4b)	20% (9b)	0% or 20% (8a)	20% (8b)	20% (9a)	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"20% (7a, 14b, 14c, 14e, 14f, 14g, 14h)"	"20% (7b, 7d, 7f, 7g)"	50% (7e);  50% (7h)	"20% (7c, 7i)"	20% (incl in h2)	20% (14i)	20% (15)	"20% (13a, 14j, 16b, 17a), $0 17b"	$0 (10b)	"$0 n/c (16a, 16b1-16b3, 16b5-16b8)"	$0 n/c (17a)	$0 n/c (17b1-17b5)	$0 n/c (18a)	$0 n/c (18b)	$0 n/c	$0 (14a)	"$0 (13c, 13d, 13e)"											0.029116454	0.029116454	0.157027485		0.234	0.234	0.234	50.0006	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				11.0144	0.614833277	7.576944271	0	2.504550422	0.947290727	0.872898568	2.658236198	11.4181421	7.326028643	13.61582933	0.262582411	4.652109962	13.93245518	16.98620432	31.54757833	2.595685631	1.148364588	0	0	2.368023781	0.98937222	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.0315	135	0	11.0144	0.614833277	7.576944271	0	2.504650422	0.947390727	0.872998568	2.658236198	11.4182421	7.326128643	13.61592933	0.262682411	4.652209962	13.93255518	16.98630432	31.54767833	2.595785631	1.148464588	0.0001	0.0001	2.368123781	0.98947222	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.0332																																																																																				0	0	0	11.0144	0.614833277	7.576944271	0	2.504650422	0.947390727	0.872998568	2.658236198	11.4182421	7.326128643	13.61592933	0.262682411	4.652209962	13.93255518	16.98630432	31.54767833	2.595785631	1.148464588	0.0001	0.0001	2.368123781	0.98947222	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.0332
H3204_001_0	2008	9																																BP	BP	D		T	O	O	V	V		V			V	V	V	V	P	P	P					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		201.8074859	4.347284719	198.612385	0	172.2282255	1984.364668	46.17296358	395.1169664	301.9574816	0	908.4215181	0	0	853.8335228	3075.684043	2756.274403	115.8306913	954.0009612	1003.549489	1479.909284	0	0	0	0	294.5982348	0	125.2548869	0	0	0	0											$550 Deductible	$550 Deductible	$125 per Day for SNF Days 21-100		$50 per Trip	$35 per Unit for DME	$35 per Unit for Prosthetics	$50 per Case for ER; $25/$40 for Urgent Care	$250 per Surgery		$5 Radiology Copay			$20 Therapy Copay	$20 per Visit for PCP	$35 per Visit for Specialist	$35 Copay	$20 Therapy Copay	$5 Radiology Copay	$35 per Visit for Specialist					$35 per Exam for Vision		$35 per Exam for Routine Hearing Exams															550	550.0000001	125	0	50	35	35.00000001	45.21510662	250	0	4.999999999	0	0	20	20	35	35	20	5	35	0	0	0	0	35	0	35	0	0	0	0											9.2495	0.19925055	2.068879011	0	0.717617606	5.787730282	0.134671144	1.488771314	6.290780866	0	0.378508966	0	0	1.423055871	5.126140072	8.039133676	0.337839516	1.590001602	0.418145621	4.31640208	0	0	0	0	0.859244851	0	0.365326753	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.791	0	0	9.2495	0.19925055	2.068879011	0	0.717617606	5.787730282	0.134671144	1.488771314	6.290780866	0	0.378508966	0	0	1.423055871	5.126140072	8.039133676	0.337839516	1.590001602	0.418145621	4.31640208	0	0	0	0	0.859244851	0	0.365326753	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.791																																																																																				0	0		9.2495	0.19925055	2.068879011	0	0.717617606	5.787730282	0.134671144	1.488771314	6.290780866	0	0.378508966	0	0	1.423055871	5.126140072	8.039133676	0.337839516	1.590001602	0.418145621	4.31640208	0	0	0	0	0.859244851	0	0.365326753	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.791
H3204_007_0	2008	9																																BP	BP	D		T	O	O	V	V					V	V	V	V	P		P					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		248.3147233	5.349131609	244.3833003	0	211.9188194	2441.668411	56.81368371	486.1730462	371.5446339	0	0	0	0	1050.602429	3784.486134	3391.467431	142.5242772	1173.853802	0	1820.959529	0	0	0	0	362.4894231	0	154.1203115	0	0	0	0											$250 Deductible	$250 Deductible	$75 per Day for SNF Days 21-100		$50 per Trip	$10 per Unit for DME	$10 per Unit for Prosthetics	$50 per Case for ER; $25/$40 for Urgent Care	$150 per Surgery					$15 Therapy Copay	$15 per Visit for PCP	$30 per Visit for Specialist	$30 Copay	$15 Therapy Copay		$30 per Visit for Specialist					$30 per Exam for Vision		$30 per Exam for Routine Hearing Exams															250	250	75	0	50	10	9.999999998	45.21510662	150	0	0	0	0	15	15	30	30.00000001	15	0	30	0	0	0	0	30	0	30	0	0	0	0											5.1732	0.111440242	1.527395627	0	0.882995081	2.034723676	0.047344736	1.831863843	4.644307924	0	0	0	0	1.313253037	4.730607667	8.478668576	0.356310693	1.467317253	0	4.552398822	0	0	0	0	0.906223558	0	0.385300779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4434	0	0	5.1732	0.111440242	1.527395627	0	0.882995081	2.034723676	0.047344736	1.831863843	4.644307924	0	0	0	0	1.313253037	4.730607667	8.478668576	0.356310693	1.467317253	0	4.552398822	0	0	0	0	0.906223558	0	0.385300779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4434																																																																																				0	0		5.1732	0.111440242	1.527395627	0	0.882995081	2.034723676	0.047344736	1.831863843	4.644307924	0	0	0	0	1.313253037	4.730607667	8.478668576	0.356310693	1.467317253	0	4.552398822	0	0	0	0	0.906223558	0	0.385300779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4434
H3204_008_0	2008	8																																BP	BP	D		T	O	O	V	V					V	V	V	V	P		P					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		204.5523386	4.406413627	201.3137801	0	174.5707606	2011.354692	46.80097787	400.4910876	306.0645087	0	0	0	0	865.4468049	3117.517475	2793.763435	117.4061442	966.976655	0	1500.038037	0	0	0	0	298.6051662	0	126.9585215	0	0	0	0											$250 Deductible	$250 Deductible	$75 per Day for SNF Days 21-100		$50 per Trip	$10 per Unit for DME	$10 per Unit for Prosthetics	$50 per Case for ER; $25/$40 for Urgent Care	$150 per Surgery					$15 Therapy Copay	$15 per Visit for PCP	$30 per Visit for Specialist	$30 Copay	$15 Therapy Copay		$30 per Visit for Specialist					$30 per Exam for Vision		$30 per Exam for Routine Hearing Exams															250	250	75	0	50	10	9.999999998	45.21510662	150	0	0	0	0	15	15	30	30.00000001	15	0	30	0	0	0	0	30	0	30	0	0	0	0											4.2615	0.091800284	1.258211126	0	0.727378169	1.67612891	0.039000815	1.509020602	3.825806358	0	0	0	0	1.081808506	3.896896844	6.984408588	0.293515361	1.208720819	0	3.750095093	0	0	0	0	0.746512916	0	0.317396304	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6682	0	0	4.2615	0.091800284	1.258211126	0	0.727378169	1.67612891	0.039000815	1.509020602	3.825806358	0	0	0	0	1.081808506	3.896896844	6.984408588	0.293515361	1.208720819	0	3.750095093	0	0	0	0	0.746512916	0	0.317396304	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6682																																																																																				0	0		4.2615	0.091800284	1.258211126	0	0.727378169	1.67612891	0.039000815	1.509020602	3.825806358	0	0	0	0	1.081808506	3.896896844	6.984408588	0.293515361	1.208720819	0	3.750095093	0	0	0	0	0.746512916	0	0.317396304	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6682
H3204_801_0	2008	8																																BP	BP	D		T	O	O	V	V		V			V	V	V	V	P	P	P					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		168.8216253	3.636711832	166.1487704	0	144.0771576	1660.016064	38.62589498	330.5342622	252.6018923	0	759.9380987	0	0	714.2726268	2572.956978	2305.75552	96.89791973	798.0674854	839.5172018	1238.01498	0	0	0	0	246.4455299	0	104.7817106	0	0	0	0											$550 Deductible	$550 Deductible	$125 per Day for SNF Days 21-100		$50 per Trip	$35 per Unit for DME	$35 per Unit for Prosthetics	$50 per Case for ER; $25/$40 for Urgent Care	$250 per Surgery		$5 Radiology Copay			$20 Therapy Copay	$20 per Visit for PCP	$35 per Visit for Specialist	$35 Copay	$20 Therapy Copay	$5 Radiology Copay	$35 per Visit for Specialist					$35 per Exam for Vision		$35 per Exam for Routine Hearing Exams															550	550.0000001	125	0	50	35	35.00000001	45.21510662	250	0	4.999999999	0	0	20	20	35	35	20	5	35	0	0	0	0	35	0	35	0	0	0	0											7.7377	0.166682626	1.730716359	0	0.60032149	4.841713521	0.11265886	1.245428492	5.262539422	0	0.316640874	0	0	1.190454378	4.288261631	6.725120266	0.282618933	1.330112476	0.349798834	3.610877026	0	0	0	0	0.718799462	0	0.305613323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.816	0	0	7.7377	0.166682626	1.730716359	0	0.60032149	4.841713521	0.11265886	1.245428492	5.262539422	0	0.316640874	0	0	1.190454378	4.288261631	6.725120266	0.282618933	1.330112476	0.349798834	3.610877026	0	0	0	0	0.718799462	0	0.305613323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.816																																																																																				0	0		7.7377	0.166682626	1.730716359	0	0.60032149	4.841713521	0.11265886	1.245428492	5.262539422	0	0.316640874	0	0	1.190454378	4.288261631	6.725120266	0.282618933	1.330112476	0.349798834	3.610877026	0	0	0	0	0.718799462	0	0.305613323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.816
H3204_802_0	2008	8																																BP	BP	D		T	O	O	V	V		V			V	V	V	V	P	P	P					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		168.8216253	3.636711832	166.1487704	0	144.0771576	1660.016064	38.62589498	330.5342622	252.6018923	0	759.9380987	0	0	714.2726268	2572.956978	2305.75552	96.89791973	798.0674854	839.5172018	1238.01498	0	0	0	0	246.4455299	0	104.7817106	0	0	0	0											$550 Deductible	$550 Deductible	$125 per Day for SNF Days 21-100		$50 per Trip	$35 per Unit for DME	$35 per Unit for Prosthetics	$50 per Case for ER; $25/$40 for Urgent Care	$250 per Surgery		$5 Radiology Copay			$20 Therapy Copay	$20 per Visit for PCP	$35 per Visit for Specialist	$35 Copay	$20 Therapy Copay	$5 Radiology Copay	$35 per Visit for Specialist					$35 per Exam for Vision		$35 per Exam for Routine Hearing Exams															550	550.0000001	125	0	50	35	35.00000001	45.21510662	250	0	4.999999999	0	0	20	20	35	35	20	5	35	0	0	0	0	35	0	35	0	0	0	0											7.7377	0.166682626	1.730716359	0	0.60032149	4.841713521	0.11265886	1.245428492	5.262539422	0	0.316640874	0	0	1.190454378	4.288261631	6.725120266	0.282618933	1.330112476	0.349798834	3.610877026	0	0	0	0	0.718799462	0	0.305613323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.816	0	0	7.7377	0.166682626	1.730716359	0	0.60032149	4.841713521	0.11265886	1.245428492	5.262539422	0	0.316640874	0	0	1.190454378	4.288261631	6.725120266	0.282618933	1.330112476	0.349798834	3.610877026	0	0	0	0	0.718799462	0	0.305613323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.816																																																																																				0	0		7.7377	0.166682626	1.730716359	0	0.60032149	4.841713521	0.11265886	1.245428492	5.262539422	0	0.316640874	0	0	1.190454378	4.288261631	6.725120266	0.282618933	1.330112476	0.349798834	3.610877026	0	0	0	0	0.718799462	0	0.305613323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.816
H3204_803_0	2008	8																																BP	BP	D		T	O	O	V	V		V			V	V	V	V	P	P	P					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		168.8216253	3.636711832	166.1487704	0	144.0771576	1660.016064	38.62589498	330.5342622	252.6018923	0	759.9380987	0	0	714.2726268	2572.956978	2305.75552	96.89791973	798.0674854	839.5172018	1238.01498	0	0	0	0	246.4455299	0	104.7817106	0	0	0	0											$550 Deductible	$550 Deductible	$125 per Day for SNF Days 21-100		$50 per Trip	$35 per Unit for DME	$35 per Unit for Prosthetics	$50 per Case for ER; $25/$40 for Urgent Care	$250 per Surgery		$5 Radiology Copay			$20 Therapy Copay	$20 per Visit for PCP	$35 per Visit for Specialist	$35 Copay	$20 Therapy Copay	$5 Radiology Copay	$35 per Visit for Specialist					$35 per Exam for Vision		$35 per Exam for Routine Hearing Exams															550	550.0000001	125	0	50	35	35.00000001	45.21510662	250	0	4.999999999	0	0	20	20	35	35	20	5	35	0	0	0	0	35	0	35	0	0	0	0											7.7377	0.166682626	1.730716359	0	0.60032149	4.841713521	0.11265886	1.245428492	5.262539422	0	0.316640874	0	0	1.190454378	4.288261631	6.725120266	0.282618933	1.330112476	0.349798834	3.610877026	0	0	0	0	0.718799462	0	0.305613323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.816	0	0	7.7377	0.166682626	1.730716359	0	0.60032149	4.841713521	0.11265886	1.245428492	5.262539422	0	0.316640874	0	0	1.190454378	4.288261631	6.725120266	0.282618933	1.330112476	0.349798834	3.610877026	0	0	0	0	0.718799462	0	0.305613323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.816																																																																																				0	0		7.7377	0.166682626	1.730716359	0	0.60032149	4.841713521	0.11265886	1.245428492	5.262539422	0	0.316640874	0	0	1.190454378	4.288261631	6.725120266	0.282618933	1.330112476	0.349798834	3.610877026	0	0	0	0	0.718799462	0	0.305613323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.816
H3204_804_0	2008	8																																BP	BP	D		T	O	O	V	V		V			V	V	V	V	P	P	P					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		168.8216253	3.636711832	166.1487704	0	144.0771576	1660.016064	38.62589498	330.5342622	252.6018923	0	759.9380987	0	0	714.2726268	2572.956978	2305.75552	96.89791973	798.0674854	839.5172018	1238.01498	0	0	0	0	246.4455299	0	104.7817106	0	0	0	0											$550 Deductible	$550 Deductible	$125 per Day for SNF Days 21-100		$50 per Trip	$35 per Unit for DME	$35 per Unit for Prosthetics	$50 per Case for ER; $25/$40 for Urgent Care	$250 per Surgery		$5 Radiology Copay			$20 Therapy Copay	$20 per Visit for PCP	$35 per Visit for Specialist	$35 Copay	$20 Therapy Copay	$5 Radiology Copay	$35 per Visit for Specialist					$35 per Exam for Vision		$35 per Exam for Routine Hearing Exams															550	550.0000001	125	0	50	35	35.00000001	45.21510662	250	0	4.999999999	0	0	20	20	35	35	20	5	35	0	0	0	0	35	0	35	0	0	0	0											7.7377	0.166682626	1.730716359	0	0.60032149	4.841713521	0.11265886	1.245428492	5.262539422	0	0.316640874	0	0	1.190454378	4.288261631	6.725120266	0.282618933	1.330112476	0.349798834	3.610877026	0	0	0	0	0.718799462	0	0.305613323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.816	0	0	7.7377	0.166682626	1.730716359	0	0.60032149	4.841713521	0.11265886	1.245428492	5.262539422	0	0.316640874	0	0	1.190454378	4.288261631	6.725120266	0.282618933	1.330112476	0.349798834	3.610877026	0	0	0	0	0.718799462	0	0.305613323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.816																																																																																				0	0		7.7377	0.166682626	1.730716359	0	0.60032149	4.841713521	0.11265886	1.245428492	5.262539422	0	0.316640874	0	0	1.190454378	4.288261631	6.725120266	0.282618933	1.330112476	0.349798834	3.610877026	0	0	0	0	0.718799462	0	0.305613323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.816
H3206_001_0	2008	9																																BP	BP	D		T	O	O	V	V					V	V	V	V	P		P					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		224.2060311	6.155333557	86.57031523	0	234.509545	2750.773894	56.81938521	316.8789835	325.7467098	0	0	0	0	953.369281	3265.908569	2965.128188	121.0151469	1022.387217	0	1560.693769	0	0	0	0	300.6177479	0	127.8142147	0	0	0	0											$350 Deductible	$350 Deductible	$125 per Day for SNF Days 21-100		$50 per Trip	$20 per Unit for DME	$20 per Unit for Prosthetics	$50 per Case for ER; $25 Copay for Urgent Care	$250 per Surgery					$20 Therapy Copay	$20 per Visit for PCP	$30 per Visit for Specialist	$30 Copay	$20 Therapy Copay		$30 per Visit for Specialist					$25 per Exam for Vision		$30 per Exam for Routine Hearing Exams															350	350.0000002	125	0	50	20	20	43.89036457	250	0	0	0	0	20	20	30	30	20	0	30	0	0	0	0	30	0	30	0	0	0	0											6.5393	0.179530562	0.901774117	0	0.977123104	4.584623157	0.094698975	1.158994509	6.786389788	0	0	0	0	1.588948802	5.443180948	7.412820471	0.302537867	1.703978695	0	3.901734423	0	0	0	0	0.75154437	0	0.319535537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.6468	0	0	6.5393	0.179530562	0.901774117	0	0.977123104	4.584623157	0.094698975	1.158994509	6.786389788	0	0	0	0	1.588948802	5.443180948	7.412820471	0.302537867	1.703978695	0	3.901734423	0	0	0	0	0.75154437	0	0.319535537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.6468		$750 Deductible	$750 Deductible	$125 per Day for SNF Days 21-100		$50 per Trip	$30 per Unit for DME	$30 per Unit for Prosthetics; 10% Coinsurance for Diabetes Monitoring Supplies	$50 per Case for ER; $25/$40 for Urgent Care	20% Coinsurance	10% Coinsurance	10% Coinsurance			$25 Therapy Copay	$30 per Visit for PCP; $30 Copay for Routine Physicals	$50 per Visit for Specialist	50% Coinsurance	$25 Therapy Copay	10% Coinsurance	$40 for Chiro/Podiatry/Hearing; $50 for Vision; 10% Coinsurance Lab/Path					$50 per Exam for Vision		$40 per Exam for Routine Hearing Exams															1.557	0.0427	0.1002	0	0.1086	0.7641	0.0256	0.1288	0.6368	0.0957	0.2746	0	0	0.2207	0.9159	1.3727	0.0555	0.2367	0.2307	0.7441	0	0	0	0	0.1392	0	0.0473	0	0	0	0											7.6968	0		8.0963	0.222275934	1.001971241	0	1.085692338	5.348727017	0.120257328	1.287771677	7.423158642	0.095661322	0.274608619	0	0	1.809636135	6.359086174	8.785565003	0.358013604	1.940642403	0.230672734	4.645850509	0	0	0	0	0.890719253	0	0.366874135	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3435
H3206_002_0	2008	9																																BP	BP	D		T	O	O	V	V					V	V	V	V	P		P					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		251.1222085	6.894288033	96.96317555	0	262.6626705	3081.007286	63.64061409	354.9206495	364.852956	0	0	0	0	1067.822298	3657.984438	3321.095046	135.5431466	1145.125912	0	1748.056751	0	0	0	0	336.7072349	0	143.1584499	0	0	0	0											$350 Deductible	$350 Deductible	$125 per Day for SNF Days 21-100		$50 per Trip	$20 per Unit for DME	$20 per Unit for Prosthetics	$50 per Case for ER; $25 Copay for Urgent Care	$250 per Surgery					$20 Therapy Copay	$20 per Visit for PCP	$30 per Visit for Specialist	$30 Copay	$20 Therapy Copay		$30 per Visit for Specialist					$25 per Exam for Vision		$30 per Exam for Routine Hearing Exams															350	350.0000002	125	0	50	20	20	43.89036457	250	0	0	0	0	20	20	30	30	20	0	30	0	0	0	0	30	0	30	0	0	0	0											7.3244	0.201083401	1.010033079	0	1.094427794	5.135012144	0.10606769	1.298133058	7.601103249	0	0	0	0	1.77970383	6.09664073	8.302737616	0.338857867	1.908543187	0	4.370141877	0	0	0	0	0.841768087	0	0.357896125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.7665	0	0	7.3244	0.201083401	1.010033079	0	1.094427794	5.135012144	0.10606769	1.298133058	7.601103249	0	0	0	0	1.77970383	6.09664073	8.302737616	0.338857867	1.908543187	0	4.370141877	0	0	0	0	0.841768087	0	0.357896125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.7665		$750 Deductible	$750 Deductible	$125 per Day for SNF Days 21-100		$50 per Trip	$30 per Unit for DME	$30 per Unit for Prosthetics; 10% Coinsurance for Diabetes Monitoring Supplies	$50 per Case for ER; $25/$40 for Urgent Care	20% Coinsurance	10% Coinsurance	10% Coinsurance			$25 Therapy Copay	$30 per Visit for PCP; $30 Copay for Routine Physicals	$50 per Visit for Specialist	50% Coinsurance	$25 Therapy Copay	10% Coinsurance	$40 for Chiro/Podiatry/Hearing; $50 for Vision; 10% Coinsurance Lab/Path					$50 per Exam for Vision		$40 per Exam for Routine Hearing Exams															1.7439	0.0479	0.1122	0	0.1216	0.8558	0.0286	0.1442	0.7132	0.1071	0.3076	0	0	0.2472	1.0259	1.5375	0.0621	0.2651	0.2584	0.8334	0	0	0	0	0.1559	0	0.053	0	0	0	0											8.6208	0		9.0683	0.248960401	1.122258976	0	1.216030882	5.990847502	0.134694351	1.442370065	8.314316896	0.107145568	0.307575681	0	0	2.026884918	7.122501373	9.840281619	0.400993526	2.17361863	0.258365246	5.203589906	0	0	0	0	0.997651066	0	0.410917773	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3873
H3206_003_0	2008	8																																BP	BP	D		T	O	O	V	V					V	V	V	V	P		P					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		211.6069693	5.809439973	81.7055721	0	221.3314863	2596.196562	53.62646957	299.0722463	307.4416585	0	0	0	0	899.7955283	3082.383694	2798.505404	114.2148066	964.9350617	0	1472.991948	0	0	0	0	283.7247966	0	120.6318067	0	0	0	0											$350 Deductible	$350 Deductible	$125 per Day for SNF Days 21-100		$50 per Trip	$20 per Unit for DME	$20 per Unit for Prosthetics	$50 per Case for ER; $25 Copay for Urgent Care	$250 per Surgery					$20 Therapy Copay	$20 per Visit for PCP	$30 per Visit for Specialist	$30 Copay	$20 Therapy Copay		$30 per Visit for Specialist					$25 per Exam for Vision		$30 per Exam for Routine Hearing Exams															350	350.0000002	125	0	50	20	20	43.89036457	250	0	0	0	0	20	20	30	30	20	0	30	0	0	0	0	30	0	30	0	0	0	0											6.1719	0.169441999	0.851099709	0	0.922214526	4.32699427	0.089377449	1.093865827	6.405034551	0	0	0	0	1.499659214	5.137306157	6.99626351	0.285537016	1.608225103	0	3.682479871	0	0	0	0	0.709311991	0	0.301579517	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2503	0	0	6.1719	0.169441999	0.851099709	0	0.922214526	4.32699427	0.089377449	1.093865827	6.405034551	0	0	0	0	1.499659214	5.137306157	6.99626351	0.285537016	1.608225103	0	3.682479871	0	0	0	0	0.709311991	0	0.301579517	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2503		$750 Deductible	$750 Deductible	$125 per Day for SNF Days 21-100		$50 per Trip	$30 per Unit for DME	$30 per Unit for Prosthetics; 10% Coinsurance for Diabetes Monitoring Supplies	$50 per Case for ER; $25/$40 for Urgent Care	20% Coinsurance	10% Coinsurance	10% Coinsurance			$25 Therapy Copay	$30 per Visit for PCP; $30 Copay for Routine Physicals	$50 per Visit for Specialist	50% Coinsurance	$25 Therapy Copay	10% Coinsurance	$40 for Chiro/Podiatry/Hearing; $50 for Vision; 10% Coinsurance Lab/Path					$50 per Exam for Vision		$40 per Exam for Routine Hearing Exams															1.4695	0.0403	0.0946	0	0.1025	0.7212	0.0241	0.1215	0.601	0.0903	0.2592	0	0	0.2083	0.8644	1.2956	0.0524	0.2234	0.2177	0.7023	0	0	0	0	0.1314	0	0.0447	0	0	0	0											7.2642	0		7.6414	0.209785332	0.945666344	0	1.024682807	5.048159981	0.113499573	1.215406474	7.006020737	0.090285718	0.259177228	0	0	1.707945216	6.00174289	8.291867864	0.337895343	1.831589701	0.217710281	4.384781004	0	0	0	0	0.840666064	0	0.346257964	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5145
H3206_801_0	2008	7																																BP	BP	D		T	O	O	V	V					V	V	V	V	P		P					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		228.2148235	6.265390607	88.11818804	0	238.7025637	2799.957591	57.83531292	322.5447636	331.5710444	0	0	0	0	970.415475	3324.302847	3018.144529	123.1788915	1040.667448	0	1588.598894	0	0	0	0	305.9927779	0	130.0995263	0	0	0	0											$350 Deductible	$350 Deductible	$125 per Day for SNF Days 21-100		$50 per Trip	$20 per Unit for DME	$20 per Unit for Prosthetics	$50 per Case for ER; $25 Copay for Urgent Care	$250 per Surgery					$20 Therapy Copay	$20 per Visit for PCP	$30 per Visit for Specialist	$30 Copay	$20 Therapy Copay		$30 per Visit for Specialist					$25 per Exam for Vision		$30 per Exam for Routine Hearing Exams															350	350.0000002	125	0	50	20	20	43.89036457	250	0	0	0	0	20	20	30	30	20	0	30	0	0	0	0	30	0	30	0	0	0	0											6.6563	0.182740559	0.917897792	0	0.994594015	4.666595985	0.096392188	1.179717272	6.907730091	0	0	0	0	1.617359125	5.540504746	7.545361323	0.307947229	1.734445747	0	3.971497236	0	0	0	0	0.764981945	0	0.325248816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4093	0	0	6.6563	0.182740559	0.917897792	0	0.994594015	4.666595985	0.096392188	1.179717272	6.907730091	0	0	0	0	1.617359125	5.540504746	7.545361323	0.307947229	1.734445747	0	3.971497236	0	0	0	0	0.764981945	0	0.325248816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4093		$750 Deductible	$750 Deductible	$125 per Day for SNF Days 21-100		$50 per Trip	$30 per Unit for DME	$30 per Unit for Prosthetics; 10% Coinsurance for Diabetes Monitoring Supplies	$50 per Case for ER; $25/$40 for Urgent Care	20% Coinsurance	10% Coinsurance	10% Coinsurance			$25 Therapy Copay	$30 per Visit for PCP; $30 Copay for Routine Physicals	$50 per Visit for Specialist	50% Coinsurance	$25 Therapy Copay	10% Coinsurance	$40 for Chiro/Podiatry/Hearing; $50 for Vision; 10% Coinsurance Lab/Path					$50 per Exam for Vision		$40 per Exam for Routine Hearing Exams															1.5848	0.0435	0.102	0	0.1105	0.7778	0.026	0.1311	0.6482	0.0974	0.2795	0	0	0.2246	0.9323	1.3973	0.0565	0.2409	0.2348	0.7574	0	0	0	0	0.1417	0	0.0482	0	0	0	0											7.8344	0		8.2411	0.226250216	1.019886436	0	1.105104462	5.444361983	0.122407523	1.310796969	7.55588434	0.097371742	0.279518607	0	0	1.841992337	6.47278631	8.942650456	0.364414869	1.97534099	0.234797151	4.728918079	0	0	0	0	0.906645268	0	0.373433825	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2437
H3206_802_0	2008	7																																BP	BP	D		T	O	O	V	V					V	V	V	V	P		P					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		228.2148235	6.265390607	88.11818804	0	238.7025637	2799.957591	57.83531292	322.5447636	331.5710444	0	0	0	0	970.415475	3324.302847	3018.144529	123.1788915	1040.667448	0	1588.598894	0	0	0	0	305.9927779	0	130.0995263	0	0	0	0											$350 Deductible	$350 Deductible	$125 per Day for SNF Days 21-100		$50 per Trip	$20 per Unit for DME	$20 per Unit for Prosthetics	$50 per Case for ER; $25 Copay for Urgent Care	$250 per Surgery					$20 Therapy Copay	$20 per Visit for PCP	$30 per Visit for Specialist	$30 Copay	$20 Therapy Copay		$30 per Visit for Specialist					$25 per Exam for Vision		$30 per Exam for Routine Hearing Exams															350	350.0000002	125	0	50	20	20	43.89036457	250	0	0	0	0	20	20	30	30	20	0	30	0	0	0	0	30	0	30	0	0	0	0											6.6563	0.182740559	0.917897792	0	0.994594015	4.666595985	0.096392188	1.179717272	6.907730091	0	0	0	0	1.617359125	5.540504746	7.545361323	0.307947229	1.734445747	0	3.971497236	0	0	0	0	0.764981945	0	0.325248816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4093	0	0	6.6563	0.182740559	0.917897792	0	0.994594015	4.666595985	0.096392188	1.179717272	6.907730091	0	0	0	0	1.617359125	5.540504746	7.545361323	0.307947229	1.734445747	0	3.971497236	0	0	0	0	0.764981945	0	0.325248816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4093		$750 Deductible	$750 Deductible	$125 per Day for SNF Days 21-100		$50 per Trip	$30 per Unit for DME	$30 per Unit for Prosthetics; 10% Coinsurance for Diabetes Monitoring Supplies	$50 per Case for ER; $25/$40 for Urgent Care	20% Coinsurance	10% Coinsurance	10% Coinsurance			$25 Therapy Copay	$30 per Visit for PCP; $30 Copay for Routine Physicals	$50 per Visit for Specialist	50% Coinsurance	$25 Therapy Copay	10% Coinsurance	$40 for Chiro/Podiatry/Hearing; $50 for Vision; 10% Coinsurance Lab/Path					$50 per Exam for Vision		$40 per Exam for Routine Hearing Exams															1.5848	0.0435	0.102	0	0.1105	0.7778	0.026	0.1311	0.6482	0.0974	0.2795	0	0	0.2246	0.9323	1.3973	0.0565	0.2409	0.2348	0.7574	0	0	0	0	0.1417	0	0.0482	0	0	0	0											7.8344	0		8.2411	0.226250216	1.019886436	0	1.105104462	5.444361983	0.122407523	1.310796969	7.55588434	0.097371742	0.279518607	0	0	1.841992337	6.47278631	8.942650456	0.364414869	1.97534099	0.234797151	4.728918079	0	0	0	0	0.906645268	0	0.373433825	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2437
H3206_803_0	2008	7																																BP	BP	D		T	O	O	V	V					V	V	V	V	P		P					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		228.2148235	6.265390607	88.11818804	0	238.7025637	2799.957591	57.83531292	322.5447636	331.5710444	0	0	0	0	970.415475	3324.302847	3018.144529	123.1788915	1040.667448	0	1588.598894	0	0	0	0	305.9927779	0	130.0995263	0	0	0	0											$350 Deductible	$350 Deductible	$125 per Day for SNF Days 21-100		$50 per Trip	$20 per Unit for DME	$20 per Unit for Prosthetics	$50 per Case for ER; $25 Copay for Urgent Care	$250 per Surgery					$20 Therapy Copay	$20 per Visit for PCP	$30 per Visit for Specialist	$30 Copay	$20 Therapy Copay		$30 per Visit for Specialist					$25 per Exam for Vision		$30 per Exam for Routine Hearing Exams															350	350.0000002	125	0	50	20	20	43.89036457	250	0	0	0	0	20	20	30	30	20	0	30	0	0	0	0	30	0	30	0	0	0	0											6.6563	0.182740559	0.917897792	0	0.994594015	4.666595985	0.096392188	1.179717272	6.907730091	0	0	0	0	1.617359125	5.540504746	7.545361323	0.307947229	1.734445747	0	3.971497236	0	0	0	0	0.764981945	0	0.325248816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4093	0	0	6.6563	0.182740559	0.917897792	0	0.994594015	4.666595985	0.096392188	1.179717272	6.907730091	0	0	0	0	1.617359125	5.540504746	7.545361323	0.307947229	1.734445747	0	3.971497236	0	0	0	0	0.764981945	0	0.325248816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4093		$750 Deductible	$750 Deductible	$125 per Day for SNF Days 21-100		$50 per Trip	$30 per Unit for DME	$30 per Unit for Prosthetics; 10% Coinsurance for Diabetes Monitoring Supplies	$50 per Case for ER; $25/$40 for Urgent Care	20% Coinsurance	10% Coinsurance	10% Coinsurance			$25 Therapy Copay	$30 per Visit for PCP; $30 Copay for Routine Physicals	$50 per Visit for Specialist	50% Coinsurance	$25 Therapy Copay	10% Coinsurance	$40 for Chiro/Podiatry/Hearing; $50 for Vision; 10% Coinsurance Lab/Path					$50 per Exam for Vision		$40 per Exam for Routine Hearing Exams															1.5848	0.0435	0.102	0	0.1105	0.7778	0.026	0.1311	0.6482	0.0974	0.2795	0	0	0.2246	0.9323	1.3973	0.0565	0.2409	0.2348	0.7574	0	0	0	0	0.1417	0	0.0482	0	0	0	0											7.8344	0		8.2411	0.226250216	1.019886436	0	1.105104462	5.444361983	0.122407523	1.310796969	7.55588434	0.097371742	0.279518607	0	0	1.841992337	6.47278631	8.942650456	0.364414869	1.97534099	0.234797151	4.728918079	0	0	0	0	0.906645268	0	0.373433825	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2437
H3206_804_0	2008	7																																BP	BP	D		T	O	O	V	V					V	V	V	V	P		P					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		228.2148235	6.265390607	88.11818804	0	238.7025637	2799.957591	57.83531292	322.5447636	331.5710444	0	0	0	0	970.415475	3324.302847	3018.144529	123.1788915	1040.667448	0	1588.598894	0	0	0	0	305.9927779	0	130.0995263	0	0	0	0											$350 Deductible	$350 Deductible	$125 per Day for SNF Days 21-100		$50 per Trip	$20 per Unit for DME	$20 per Unit for Prosthetics	$50 per Case for ER; $25 Copay for Urgent Care	$250 per Surgery					$20 Therapy Copay	$20 per Visit for PCP	$30 per Visit for Specialist	$30 Copay	$20 Therapy Copay		$30 per Visit for Specialist					$25 per Exam for Vision		$30 per Exam for Routine Hearing Exams															350	350.0000002	125	0	50	20	20	43.89036457	250	0	0	0	0	20	20	30	30	20	0	30	0	0	0	0	30	0	30	0	0	0	0											6.6563	0.182740559	0.917897792	0	0.994594015	4.666595985	0.096392188	1.179717272	6.907730091	0	0	0	0	1.617359125	5.540504746	7.545361323	0.307947229	1.734445747	0	3.971497236	0	0	0	0	0.764981945	0	0.325248816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4093	0	0	6.6563	0.182740559	0.917897792	0	0.994594015	4.666595985	0.096392188	1.179717272	6.907730091	0	0	0	0	1.617359125	5.540504746	7.545361323	0.307947229	1.734445747	0	3.971497236	0	0	0	0	0.764981945	0	0.325248816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4093		$750 Deductible	$750 Deductible	$125 per Day for SNF Days 21-100		$50 per Trip	$30 per Unit for DME	$30 per Unit for Prosthetics; 10% Coinsurance for Diabetes Monitoring Supplies	$50 per Case for ER; $25/$40 for Urgent Care	20% Coinsurance	10% Coinsurance	10% Coinsurance			$25 Therapy Copay	$30 per Visit for PCP; $30 Copay for Routine Physicals	$50 per Visit for Specialist	50% Coinsurance	$25 Therapy Copay	10% Coinsurance	$40 for Chiro/Podiatry/Hearing; $50 for Vision; 10% Coinsurance Lab/Path					$50 per Exam for Vision		$40 per Exam for Routine Hearing Exams															1.5848	0.0435	0.102	0	0.1105	0.7778	0.026	0.1311	0.6482	0.0974	0.2795	0	0	0.2246	0.9323	1.3973	0.0565	0.2409	0.2348	0.7574	0	0	0	0	0.1417	0	0.0482	0	0	0	0											7.8344	0		8.2411	0.226250216	1.019886436	0	1.105104462	5.444361983	0.122407523	1.310796969	7.55588434	0.097371742	0.279518607	0	0	1.841992337	6.47278631	8.942650456	0.364414869	1.97534099	0.234797151	4.728918079	0	0	0	0	0.906645268	0	0.373433825	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2437
H3207_001_0	2008	3																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	P	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1015.058516	37.41275056	0	0	124.3913851	9.116099915	15.88198118	318.2491668	310.7376178	0	875.6273705	0	4.624108927	58.64247362	2877.618809	3553.926603	249.4107876	419.9490795	0	0	0	0	0	0	122.4	0	211.65	0	0	0	15	0	0	0	0	0	0	0	0	0	0	"$100 per admit, unlimited days"	"$100 per day for days 1-5, Medicare Limits Apply"	"$0 per day for days 0-100, waiver 3 day hosp stay"	$0 per visit copayment	$50 per trip	10% per Item	10% per Item	"$50 per ER visit, $20 per Urgent Care visit"	$75 per visit copayment	$0 Copayment	"$50 per MRI, MRA, PET, CT, and NM; $10 Therapeutic Radiology; $0 for OP X-Rays"	$0 Copayment	$75 per monthly bill copayment	"$5 OP Rehab, $5 CORF, $10 Partial Hosp."	$10 per visit Copayment	$20 per visit Copayment	$10 per visit Copayment	$5 per visit Copayment	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	Not Covered	Not Covered	$30 Routine Vision; $20 Med Covered	$150 Maximum 2-Year Benefit	$20 Routine Hearing; $10 Med Covered	Not Covered	Not Covered	No Cost Sharing	"Sleep Study - $50 for OP, $150 for IP"											22.19537808	44.7	0	0	50	0.1	0.1	49.9784687	75	0	37.4	0	7.5	5.245855178	10	18.29658857	10	5	0	0	0	0	0	0	30	0	20	0	0	0	100	0	0	0	0	0	0	0	0	0	0	1.8775	0.139362496	0	0	0.518297438	0.911609992	1.588198118	1.325467168	1.942110111	0	2.729038638	0	0.002890068	0.025635827	2.398015674	5.418727737	0.207842323	0.174978783	0	0	0	0	0	0	0.306	0	0.35275	0	0	0	0.125	0	0	0	0	0	0	0	0	0	0	20.0434	0	0	1.8775	0.139362496	0	0	0.518297438	0.911609992	1.588198118	1.325467168	1.942110111	0	2.729038638	0	0.002890068	0.025635827	2.398015674	5.418727737	0.207842323	0.174978783	0	0	0	0	0	0	0.306	0	0.35275	0	0	0	0.125	0	0	0	0	0	0	0	0	0	0	20.0434		"$200 per day for days 1-5, unlimited Days"	"$200 per day for days 1-5, Medicare Limits Apply"	20% for days 21-100	No Cost Sharing	$50 per trip	20% per item	20% per item	"$50 per ER visit, $40 per Urgent Care visit"	$150 per visit copayment	10% Coinsurance	"20% per MRI, MRA, PET, CT, and NM; 20% Therapeutic Radiology; 10% for OP X-Rays"	No Cost Sharing	$150 per monthly bill copayment	"20% for OP Rehab, $10 for CORF, $20 Partial Hosp."	"$20 per visit Copayment, 20% for Routine Physical Exams, Med Cov Hearing"	"$40 per visit Copayment, 20% for Routine Physical Exams, Med Cov Hearing"	$20 per visit Copayment	20% Coinsurance	No Cost Sharing	No Cost Sharing	20% Coinsurance	No Cost Sharing	Not Covered	Not Covered	20% Coinsurance	$150 Maximum 2-Year Benefit	20% Coinsurance	Not Covered	Not Covered	No Cost Sharing	Not Covered											1.2917	0.0497	0.3192	0	0.0924	0.4062	0.7078	0.2363	0.6924	0	0.3952	0	0.001	0.0089	0.9274	1.7083	0.0741	0.1545	0	0	0.684	0.0707	0	0	0.0307	0	0.0407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.8912	0	0	3.1692	0.189040538	0.319241275	0	0.610685573	1.317853303	2.29595129	1.56180063	2.634484483	0	3.12418942	0	0.003920395	0.034534977	3.325424179	7.127018129	0.281939408	0.329485309	0	0	0.683952318	0.070708297	0	0	0.3366792	0	0.393467725	0	0	0	0.125	0	0	0	0	0	0	0	0	0	0	27.9346
H3207_002_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	P	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1023.830187	37.73605443	0	0	125.4663186	9.274335003	16.15765682	320.991469	313.4228702	0	883.1941417	0	4.664068361	59.14923505	2901.714617	3584.638011	251.5660815	423.5780873	0	0	0	0	0	0	122.4	0	211.65	0	0	0	15	0	0	0	0	0	0	0	0	0	0	"$100 per admit, unlimited days"	"$100 per day for days 1-5, Medicare Limits Apply"	"$0 per day for days 0-100, waiver 3 day hosp stay"	$0 per visit copayment	$50 per trip	10% per Item	10% per Item	"$50 per ER visit, $20 per Urgent Care visit"	$75 per visit copayment	$0 Copayment	"$50 per MRI, MRA, PET, CT, and NM; $10 Therapeutic Radiology; $0 for OP X-Rays"	$0 Copayment	$75 per monthly bill copayment	"$5 OP Rehab, $5 CORF, $10 Partial Hosp."	$10 per visit Copayment	$20 per visit Copayment	$10 per visit Copayment	$5 per visit Copayment	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	Not Covered	Not Covered	$30 Routine Vision; $20 Med Covered	$150 Maximum 2-Year Benefit	$20 Routine Hearing; $10 Med Covered	Not Covered	Not Covered	No Cost Sharing	"Sleep Study - $50 for OP, $150 for IP"											22.19537808	44.7	0	0	50	0.1	0.1	49.97883554	75	0	37.4	0	7.5	5.245855178	10	18.29658857	10	5	0	0	0	0	0	0	30	0	20	0	0	0	100	0	0	0	0	0	0	0	0	0	0	1.8937	0.140566803	0	0	0.522776327	0.9274335	1.615765682	1.33689832	1.958892939	0	2.752621742	0	0.002915043	0.02585736	2.418095514	5.465553904	0.209638401	0.17649087	0	0	0	0	0	0	0.306	0	0.35275	0	0	0	0.125	0	0	0	0	0	0	0	0	0	0	20.2309	0	0	1.8937	0.140566803	0	0	0.522776327	0.9274335	1.615765682	1.33689832	1.958892939	0	2.752621742	0	0.002915043	0.02585736	2.418095514	5.465553904	0.209638401	0.17649087	0	0	0	0	0	0	0.306	0	0.35275	0	0	0	0.125	0	0	0	0	0	0	0	0	0	0	20.2309		"$200 per day for days 1-5, unlimited Days"	"$200 per day for days 1-5, Medicare Limits Apply"	20% for days 21-100	No Cost Sharing	$50 per trip	20% per item	20% per item	"$50 per ER visit, $40 per Urgent Care visit"	$150 per visit copayment	10% Coinsurance	"20% per MRI, MRA, PET, CT, and NM; 20% Therapeutic Radiology; 10% for OP X-Rays"	No Cost Sharing	$150 per monthly bill copayment	"20% for OP Rehab, $10 for CORF, $20 Partial Hosp."	"$20 per visit Copayment, 20% for Routine Physical Exams, Med Cov Hearing"	"$40 per visit Copayment, 20% for Routine Physical Exams, Med Cov Hearing"	$20 per visit Copayment	20% Coinsurance	No Cost Sharing	No Cost Sharing	20% Coinsurance	No Cost Sharing	Not Covered	Not Covered	20% Coinsurance	$150 Maximum 2-Year Benefit	20% Coinsurance	Not Covered	Not Covered	No Cost Sharing	Not Covered											1.3029	0.0501	0.3248	0	0.0932	0.4133	0.72	0.2384	0.6984	0	0.402	0	0.001	0.009	0.9351	1.7249	0.0747	0.1572	0	0	0.6958	0.0719	0	0	0.0307	0	0.0407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.9842	0	0	3.1966	0.190674139	0.324782589	0	0.615962838	1.340728286	2.335803865	1.575268865	2.657250493	0	3.154631457	0	0.003954274	0.034903512	3.35324443	7.190409178	0.284375799	0.333679283	0	0	0.695824199	0.071935635	0	0	0.3366792	0	0.393467725	0	0	0	0.125	0	0	0	0	0	0	0	0	0	0	28.2152
H3207_003_0	2008	7																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	P	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1302.584108	48.01029058	0	0	159.6265032	11.79941902	20.55683379	408.2631493	398.7571912	0	1123.65768	0	5.933934553	75.25354744	3667.452478	4560.612261	320.058916	538.903904	0	0	0	0	0	0	122.4	0	211.65	0	0	0	15	0	0	0	0	0	0	0	0	0	0	"$100 per admit, unlimited days"	"$100 per day for days 1-5, Medicare Limits Apply"	"$0 per day for days 0-100, waiver 3 day hosp stay"	$0 per visit copayment	$50 per trip	10% per Item	10% per Item	"$50 per ER visit, $20 per Urgent Care visit"	$75 per visit copayment	$0 Copayment	"$50 per MRI, MRA, PET, CT, and NM; $10 Therapeutic Radiology; $0 for OP X-Rays"	$0 Copayment	$75 per monthly bill copayment	"$5 OP Rehab, $5 CORF, $10 Partial Hosp."	$10 per visit Copayment	$20 per visit Copayment	$10 per visit Copayment	$5 per visit Copayment	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	Not Covered	Not Covered	$30 Routine Vision; $20 Med Covered	$150 Maximum 2-Year Benefit	$20 Routine Hearing; $10 Med Covered	Not Covered	Not Covered	No Cost Sharing	"Sleep Study - $50 for OP, $150 for IP"											22.19537808	44.7	0	0	50	0.1	0.1	49.98335973	75	0	37.4	0	7.5	5.245855178	10	18.29658857	10	5	0	0	0	0	0	0	30	0	20	0	0	0	100	0	0	0	0	0	0	0	0	0	0	2.4093	0.178838332	0	0	0.66511043	1.179941902	2.055683379	1.700530321	2.492232445	0	3.502066437	0	0.003708709	0.032897434	3.056210399	6.953637179	0.266715763	0.224543293	0	0	0	0	0	0	0.306	0	0.35275	0	0	0	0.125	0	0	0	0	0	0	0	0	0	0	25.5051	0	0	2.4093	0.178838332	0	0	0.66511043	1.179941902	2.055683379	1.700530321	2.492232445	0	3.502066437	0	0.003708709	0.032897434	3.056210399	6.953637179	0.266715763	0.224543293	0	0	0	0	0	0	0.306	0	0.35275	0	0	0	0.125	0	0	0	0	0	0	0	0	0	0	25.5051		"$200 per day for days 1-5, unlimited Days"	"$200 per day for days 1-5, Medicare Limits Apply"	20% for days 21-100	No Cost Sharing	$50 per trip	20% per item	20% per item	"$50 per ER visit, $40 per Urgent Care visit"	$150 per visit copayment	10% Coinsurance	"20% per MRI, MRA, PET, CT, and NM; 20% Therapeutic Radiology; 10% for OP X-Rays"	No Cost Sharing	$150 per monthly bill copayment	"20% for OP Rehab, $10 for CORF, $20 Partial Hosp."	"$20 per visit Copayment, 20% for Routine Physical Exams, Med Cov Hearing"	"$40 per visit Copayment, 20% for Routine Physical Exams, Med Cov Hearing"	$20 per visit Copayment	20% Coinsurance	No Cost Sharing	No Cost Sharing	20% Coinsurance	No Cost Sharing	Not Covered	Not Covered	20% Coinsurance	$150 Maximum 2-Year Benefit	20% Coinsurance	Not Covered	Not Covered	No Cost Sharing	Not Covered											1.6746	0.0644	0.4174	0	0.1198	0.5312	0.9254	0.3063	0.8976	0	0.5167	0	0.0013	0.0116	1.1929	2.2169	0.0961	0.202	0	0	0.8943	0.0925	0	0	0.0307	0	0.0407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.2322	0	0	4.0838	0.243238691	0.417426199	0	0.784878214	1.711128232	2.981111071	2.006810113	3.38979515	0	4.018748651	0	0.005044379	0.044523984	4.249069948	9.170504108	0.362771861	0.426569399	0	0	0.894306716	0.092455136	0	0	0.3366792	0	0.393467725	0	0	0	0.125	0	0	0	0	0	0	0	0	0	0	35.7374
H3207_004_0	2008	7																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	P	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1292.11741	47.62451188	0	0	158.343851	11.61055633	20.22779904	404.9899267	395.5530441	0	1114.628716	0	5.886253409	74.64886008	3638.700428	4523.96622	317.4871358	534.5736314	0	0	0	0	0	0	122.4	0	211.65	0	0	0	15	0	0	0	0	0	0	0	0	0	0	"$100 per admit, unlimited days"	"$100 per day for days 1-5, Medicare Limits Apply"	"$0 per day for days 0-100, waiver 3 day hosp stay"	$0 per visit copayment	$50 per trip	10% per Item	10% per Item	"$50 per ER visit, $20 per Urgent Care visit"	$75 per visit copayment	$0 Copayment	"$50 per MRI, MRA, PET, CT, and NM; $10 Therapeutic Radiology; $0 for OP X-Rays"	$0 Copayment	$75 per monthly bill copayment	"$5 OP Rehab, $5 CORF, $10 Partial Hosp."	$10 per visit Copayment	$20 per visit Copayment	$10 per visit Copayment	$5 per visit Copayment	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	Not Covered	Not Covered	$30 Routine Vision; $20 Med Covered	$150 Maximum 2-Year Benefit	$20 Routine Hearing; $10 Med Covered	Not Covered	Not Covered	No Cost Sharing	"Sleep Study - $50 for OP, $150 for IP"											22.19537808	44.7	0	0	50	0.1	0.1	49.98308935	75	0	37.4	0	7.5	5.245855178	10	18.29658857	10	5	0	0	0	0	0	0	30	0	20	0	0	0	100	0	0	0	0	0	0	0	0	0	0	2.3899	0.177401307	0	0	0.659766046	1.161055633	2.022779904	1.686887308	2.472206526	0	3.473926165	0	0.003678908	0.032633092	3.032250356	6.897762385	0.264572613	0.222739013	0	0	0	0	0	0	0.306	0	0.35275	0	0	0	0.125	0	0	0	0	0	0	0	0	0	0	25.2813	0	0	2.3899	0.177401307	0	0	0.659766046	1.161055633	2.022779904	1.686887308	2.472206526	0	3.473926165	0	0.003678908	0.032633092	3.032250356	6.897762385	0.264572613	0.222739013	0	0	0	0	0	0	0.306	0	0.35275	0	0	0	0.125	0	0	0	0	0	0	0	0	0	0	25.2813		"$200 per day for days 1-5, unlimited Days"	"$200 per day for days 1-5, Medicare Limits Apply"	20% for days 21-100	No Cost Sharing	$50 per trip	20% per item	20% per item	"$50 per ER visit, $40 per Urgent Care visit"	$150 per visit copayment	10% Coinsurance	"20% per MRI, MRA, PET, CT, and NM; 20% Therapeutic Radiology; 10% for OP X-Rays"	No Cost Sharing	$150 per monthly bill copayment	"20% for OP Rehab, $10 for CORF, $20 Partial Hosp."	"$20 per visit Copayment, 20% for Routine Physical Exams, Med Cov Hearing"	"$40 per visit Copayment, 20% for Routine Physical Exams, Med Cov Hearing"	$20 per visit Copayment	20% Coinsurance	No Cost Sharing	No Cost Sharing	20% Coinsurance	No Cost Sharing	Not Covered	Not Covered	20% Coinsurance	$150 Maximum 2-Year Benefit	20% Coinsurance	Not Covered	Not Covered	No Cost Sharing	Not Covered											1.6611	0.0639	0.4107	0	0.1188	0.5227	0.9106	0.3038	0.8904	0	0.5084	0	0.0013	0.0114	1.1835	2.1969	0.0953	0.1988	0	0	0.88	0.091	0	0	0.0307	0	0.0407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1201	0	0	4.051	0.241284187	0.410744833	0	0.778571456	1.683739742	2.933395107	1.990710875	3.362557015	0	3.982338311	0	0.005003845	0.044082399	4.215779502	9.094660606	0.359856868	0.421531469	0	0	0.879992353	0.09097529	0	0	0.3366792	0	0.393467725	0	0	0	0.125	0	0	0	0	0	0	0	0	0	0	35.4014
H3208_001_0	2008	5																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V		V	V	V	V	V	Coin	Coin	Coin	Coin			V		V				V																																																				0	5000	161.4797562	58.74851356	580.9949523	1002.749316	187.6906859	5.383261607	0.87678871	180.9081122	243.4297469	504.7088331	417.4200164	10.86623401		613.3934774	3907.626257	3698.295457	293.6152949	1484.270477	24.95539822	2.502975977	8.920982536	0.931123604			518.3588362		74.54108414				543.283752											$275 per admission.	$100/day-First seven days per stay	$20 per day.	$10 per visit	$100 per service	10% coinsurance.	10% coinsurance.	$50 emrg/$30 Urgent	$50 per visit.	$0 per visit.	$50 per visit.	$50 per visit.		$50 per visit.	"$10 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$30 per visit	$30 per visit	$25 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.			$30 per exam		$30 per exam				$10 PCP copay/$30 Specialist copay for routine physicals											267.6119989	58.88671717	19.46269083	9.731345416	97.31345416	0.097313454	0.097313454	43.79105437	48.65672708	0	48.65672708	48.65672708		48.65672708	9.731345416	29.19403625	29.19403625	24.32836354	0.097313454	0.097313454	0.097313454	0.092447781			29.19403625		29.19403625				7.785076333											3.6012	0.288292258	0.942310428	0.813174996	1.522069079	0.523863782	0.085323338	0.660179748	0.98704123	0	1.692524318	0.044059615	0	2.487143252	3.168871739	8.997347636	0.714317964	3.00915598	2.428496	0.243573238	0.868131625	0.086080311	0	0	1.261082221	0	0.181346259	0	0	0	0.35245879	0	0	0	0	0	0	0	0	0	0	34.958	0	0.965090394	3.6012	0.288292258	0.942310428	0.813174996	1.522069079	0.523863782	0.085323338	0.660179748	0.98704123	0	1.692524318	0.044059615	0	2.487143252	3.168871739	8.997347636	0.714317964	3.00915598	2.428496	0.243573238	0.868131625	0.086080311	0	0	1.261082221	0	0.181346259	0	0	0	0.35245879	0	0	0	0	0	0	0	0	0	0	34.958	7700	$550 per admission	$200/day-First seven days per stay	20% coinsurance	$20 per visit	$100 per service	20% coinsurance	20% coinsurance	$50 emrg/$30 Urgent	$50 per visit.	$50 per visit.	$50 per visit.	$50 per visit.		$100 per visit.	$20 per visit.	$60 per visit	$60 per visit	20% coinsurance	20% coinsurance	20% coinsurance except 10% Diabetes supplies/self-monitoring training	20% coinsurance	20% coinsurance			$50 per exam		$50 per exam				$20 PCP copay/$50 Specialist copay for routine physicals											5.3249	0.1902	1.3241	0.734	0.2992	0.2532	0.0412	0.3102	0.6803	0.4986	0.6182	0.0428		0.7079	1.9683	4.2231	0.1844	0.675	1.1738	0.1177	0.4196	0.0431			0.3151		0.0706				0.2643											20.48	500	0.102501024	8.926	0.478464913	2.266414111	1.547223885	1.821284234	0.77707594	0.126564797	0.970386333	1.667359988	0.498621872	2.310741185	0.086823482	0	3.195051604	5.137209877	13.22048555	0.898724352	3.684191552	3.602321594	0.361305571	1.287747354	0.129138196	0	0	1.576147081	0	0.251903957	0	0	0	0.616794117	0	0	0	0	0	0	0	0	0	0	55.438
H3208_003_0	2008	6																					2700											D	D	D	V	T	Coin	Coin	V	V	V	V	V		V	V	V	V	V	Coin	Coin	Coin	Coin			V		V				V																																																				0	5000	797.1442066	57.31857893	566.8535766	978.3424688	183.122308	5.252233404	0.855447736	176.5048216	237.5046842	492.4242561	407.260043	10.60175065		598.4635239	3812.514913	3608.27921	286.4687196	1448.14344	24.34798561	2.44205372	8.703846458	0.908460122			505.7420192		72.72675947				530.0602643											$275/day-First five days per stay	$275/day-First five days per stay	$50 per day.	$40 per visit	$150 per service	20% coinsurance.	20% coinsurance.	$50 emrg/$30 Urgent	$100 per visit.	$0 per visit.	$100 per visit.	$100 per visit.		$100 per visit.	"$10 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$40 per visit	$40 per visit	$40 per visit	20% coinsurance	20% coinsurance except sustitute $0 copay for lab.	20% coinsurance.	20% coinsurance.			$40 per exam		$40 per exam				$10 PCP copay/$40 Specialist copay for routine physicals											129.7021977	102.223196	38.14615593	30.51692474	114.4384678	0.152584624	0.152584624	34.33154033	76.29231185	0	76.29231185	76.29231185		76.29231185	7.629231185	30.51692474	30.51692474	30.51692474	0.152584624	0.152584624	0.152584624	0.144955393			30.51692474		30.51692474				6.103384948											8.6159	0.488274027	1.80194041	2.488000291	1.746353028	0.801410058	0.130528171	0.504973534	1.509981786	0	2.589234183	0.067402672	0	3.80484715	2.423879806	9.17613209	0.72851203	3.682740364	3.715128222	0.372619848	1.328073137	0.131686194	0	0	1.286140928	0	0.184949754	0	0	0	0.26959682	0	0	0	0	0	0	0	0	0	0	47.8484	0	14.86878234	8.6159	0.488274027	1.80194041	2.488000291	1.746353028	0.801410058	0.130528171	0.504973534	1.509981786	0	2.589234183	0.067402672	0	3.80484715	2.423879806	9.17613209	0.72851203	3.682740364	3.715128222	0.372619848	1.328073137	0.131686194	0	0	1.286140928	0	0.184949754	0	0	0	0.26959682	0	0	0	0	0	0	0	0	0	0	47.8484	7700	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	$150 per service	30% coinsurance	30% coinsurance	$50 emrg/$30 Urgent	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance		30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance			$50 per exam		$50 per exam				30% coinsurance											8.0741	0.2439	1.4949	1.0249	0.3481	0.2859	0.0466	0.3021	1.0223	0.5653	0.8183	0.0668		0.5148	2.4735	4.6955	0.1156	0.7621	1.3252	0.1329	0.4737	0.0494			0.281		0.0312				0.3525											25.5006	500	0.618662072	16.6901	0.732220973	3.296824726	3.512944122	2.094453229	1.087281088	0.177088883	0.807042725	2.532254886	0.565257636	3.407550647	0.134162347	0	4.319647285	4.897349843	13.87158901	0.844138143	4.444840871	5.040351836	0.505537097	1.801810186	0.181132288	0	0	1.567127378	0	0.21613812	0	0	0	0.62210001	0	0	0	0	0	0	0	0	0	0	73.3489
H3208_004_0	2008	3											Other Non-Covered										2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V		V	V	V	V	V	Coin	Coin	Coin	Coin			V		V				V	V																																																			0	5000	161.5130722	58.76063439	581.1148216	1002.9562	187.7294097	5.384372267	0.876969607	180.9454366	243.4799706	504.8129632	417.5061373	10.8684759		613.520031	3908.432468	3699.058479	293.6758728	1484.576708	24.96054695	2.503492384	8.922823089	0.931315711			518.4657826		74.55646325				543.3958408											$100 per admission.	$100/day-First seven days per stay	$20 per day.	$10 per visit	$100 per service	10% coinsurance.	10% coinsurance.	$50 emrg/$20 Urgent	$50 per visit.	$0 per visit.	$50 per visit.	$50 per visit.		$50 per visit.	"$0 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$20 per visit	$20 per visit	$30 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.			$20 per exam		$20 per exam				$0 PCP copay/$20 Specialist copay for routine physicals											100	60.51241082	20	10	100	0.1	0.1	42.5	50	0	50	50		50	10	20	20	30	0.1	0.1	0.1	0.095			20		30				4											1.3459	0.296312304	0.968524703	0.835796833	1.564411747	0.538437227	0.087696961	0.640848421	1.014499878	0	1.739608905	0.045285316	0	2.556333463	3.257027057	6.165097465	0.489459788	3.71144177	2.496054695	0.250349238	0.892282309	0.088474993	0	0	0.864109638	0	0.186391158	0	0	0	0.181131947	0	0	0	0	0	0	0	0	0	0	30.2155	0	0	1.3459	0.296312304	0.968524703	0.835796833	1.564411747	0.538437227	0.087696961	0.640848421	1.014499878	0	1.739608905	0.045285316	0	2.556333463	3.257027057	6.165097465	0.489459788	3.71144177	2.496054695	0.250349238	0.892282309	0.088474993	0	0	0.864109638	0	0.186391158	0	0	0	0.181131947	0	0	0	0	0	0	0	0	0	0	30.2155	7700	$200 per admission	$200/day-First seven days per stay	20% coinsurance	$20 per visit	$100 per service	20% coinsurance	20% coinsurance/10% diabetes supplies	$50 emrg/$20 Urgent	$50 per visit.	$50 per visit.	$50 per visit.	$50 per visit.		$100 per visit.	$20 per visit.	$40 per visit	$40 per visit	20% coinsurance	20% coinsurance	20% coinsurance except 10% Diabetes self-monitoring training	20% coinsurance	20% coinsurance			$50 per exam		$50 per exam				$20 PCP copay/$40 Specialist copay for routine physicals/$50 copay fro accidental emergency servces during foreign travel	$50 copay for emergency services due to accident during foreign travel										4.9572	0.1906	1.3272	0.7354	0.3	0.2538	0.0413	0.3078	0.6814	0.4998	0.6194	0.0428		0.7102	1.9725	3.7416	0.146	0.6766	1.1766	0.118	0.4206	0.0432			0.3161		0.0707				0.2937	0.0299										19.6726	500	0.02827617	6.3032	0.486870453	2.295737182	1.571170424	1.864425877	0.79225441	0.129036962	0.948604862	1.695903315	0.499808333	2.359046845	0.088112043	0	3.266538431	5.22953374	9.906720888	0.635461966	4.38809027	3.672685026	0.368362881	1.312900667	0.131633983	0	0	1.180163477	0	0.257120493	0	0	0	0.474879817	0.02991189	0	0	0	0	0	0	0	0	0	49.8881
H3208_801_0	2008	1																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V		V	V	V	V	V	Coin	Coin	Coin	Coin																																																													0	5000	161.4797562	58.74851356	580.9949523	1002.749316	187.6906859	5.383261607	0.87678871	180.9081122	243.4297469	504.7088331	417.4200164	10.86623401		613.3934774	3907.626257	3698.295457	293.6152949	1484.270477	24.95539822	2.502975977	8.920982536	0.931123604																				$275 per admission.	$100/day-First seven days per stay	$20 per day.	$10 per visit	$100 per service	10% coinsurance.	10% coinsurance.	$50 emrg/$30 Urgent	$50 per visit.	$0 per visit.	$50 per visit.	$50 per visit.		$50 per visit.	"$10 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$30 per visit	$30 per visit	$25 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.																				267.6119989	58.88671717	19.46269083	9.731345416	97.31345416	0.097313454	0.097313454	43.79105437	48.65672708	0	48.65672708	48.65672708		48.65672708	9.731345416	29.19403625	29.19403625	24.32836354	0.097313454	0.097313454	0.097313454	0.092447781																				3.6012	0.288292258	0.942310428	0.813174996	1.522069079	0.523863782	0.085323338	0.660179748	0.98704123	0	1.692524318	0.044059615	0	2.487143252	3.168871739	8.997347636	0.714317964	3.00915598	2.428496	0.243573238	0.868131625	0.086080311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1631	0	0.965090394	3.6012	0.288292258	0.942310428	0.813174996	1.522069079	0.523863782	0.085323338	0.660179748	0.98704123	0	1.692524318	0.044059615	0	2.487143252	3.168871739	8.997347636	0.714317964	3.00915598	2.428496	0.243573238	0.868131625	0.086080311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1631	7700	$550 per admission	$200/day-First seven days per stay	20% coinsurance	$20 per visit	$100 per service	20% coinsurance	20% coinsurance	$50 emrg/$30 Urgent	$50 per visit.	$50 per visit.	$50 per visit.	$50 per visit.		$100 per visit.	$20 per visit.	$60 per visit	$60 per visit	20% coinsurance	20% coinsurance	20% coinsurance except 10% Diabetes supplies/self-monitoring training	20% coinsurance	20% coinsurance																				5.3249	0.1902	1.3241	0.734	0.2992	0.2532	0.0412	0.3102	0.6803	0.4986	0.6182	0.0428		0.7079	1.9683	4.2231	0.1844	0.675	1.1738	0.1177	0.4196	0.0431																				19.83	500	0.102501024	8.926	0.478464913	2.266414111	1.547223885	1.821284234	0.77707594	0.126564797	0.970386333	1.667359988	0.498621872	2.310741185	0.086823482	0	3.195051604	5.137209877	13.22048555	0.898724352	3.684191552	3.602321594	0.361305571	1.287747354	0.129138196	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9932
H3208_802_0	2008	1																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V		V	V	V	V	V	Coin	Coin	Coin	Coin																																																													0	5000	161.4797562	58.74851356	580.9949523	1002.749316	187.6906859	5.383261607	0.87678871	180.9081122	243.4297469	504.7088331	417.4200164	10.86623401		613.3934774	3907.626257	3698.295457	293.6152949	1484.270477	24.95539822	2.502975977	8.920982536	0.931123604																				$275 per admission.	$100/day-First seven days per stay	$20 per day.	$10 per visit	$100 per service	10% coinsurance.	10% coinsurance.	$50 emrg/$30 Urgent	$50 per visit.	$0 per visit.	$50 per visit.	$50 per visit.		$50 per visit.	"$10 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$30 per visit	$30 per visit	$25 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.																				267.6119989	58.88671717	19.46269083	9.731345416	97.31345416	0.097313454	0.097313454	43.79105437	48.65672708	0	48.65672708	48.65672708		48.65672708	9.731345416	29.19403625	29.19403625	24.32836354	0.097313454	0.097313454	0.097313454	0.092447781																				3.6012	0.288292258	0.942310428	0.813174996	1.522069079	0.523863782	0.085323338	0.660179748	0.98704123	0	1.692524318	0.044059615	0	2.487143252	3.168871739	8.997347636	0.714317964	3.00915598	2.428496	0.243573238	0.868131625	0.086080311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1631	0	0.965090394	3.6012	0.288292258	0.942310428	0.813174996	1.522069079	0.523863782	0.085323338	0.660179748	0.98704123	0	1.692524318	0.044059615	0	2.487143252	3.168871739	8.997347636	0.714317964	3.00915598	2.428496	0.243573238	0.868131625	0.086080311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1631	7700	$550 per admission	$200/day-First seven days per stay	20% coinsurance	$20 per visit	$100 per service	20% coinsurance	20% coinsurance	$50 emrg/$30 Urgent	$50 per visit.	$50 per visit.	$50 per visit.	$50 per visit.		$100 per visit.	$20 per visit.	$60 per visit	$60 per visit	20% coinsurance	20% coinsurance	20% coinsurance except 10% Diabetes supplies/self-monitoring training	20% coinsurance	20% coinsurance																				5.3249	0.1902	1.3241	0.734	0.2992	0.2532	0.0412	0.3102	0.6803	0.4986	0.6182	0.0428		0.7079	1.9683	4.2231	0.1844	0.675	1.1738	0.1177	0.4196	0.0431																				19.83	500	0.102501024	8.926	0.478464913	2.266414111	1.547223885	1.821284234	0.77707594	0.126564797	0.970386333	1.667359988	0.498621872	2.310741185	0.086823482	0	3.195051604	5.137209877	13.22048555	0.898724352	3.684191552	3.602321594	0.361305571	1.287747354	0.129138196	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9932
H3208_803_0	2008	1																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V		V	V	V	V	V	Coin	Coin	Coin	Coin																																																													0	5000	161.4797562	58.74851356	580.9949523	1002.749316	187.6906859	5.383261607	0.87678871	180.9081122	243.4297469	504.7088331	417.4200164	10.86623401		613.3934774	3907.626257	3698.295457	293.6152949	1484.270477	24.95539822	2.502975977	8.920982536	0.931123604																				$275 per admission.	$100/day-First seven days per stay	$20 per day.	$10 per visit	$100 per service	10% coinsurance.	10% coinsurance.	$50 emrg/$30 Urgent	$50 per visit.	$0 per visit.	$50 per visit.	$50 per visit.		$50 per visit.	"$10 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$30 per visit	$30 per visit	$25 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.																				267.6119989	58.88671717	19.46269083	9.731345416	97.31345416	0.097313454	0.097313454	43.79105437	48.65672708	0	48.65672708	48.65672708		48.65672708	9.731345416	29.19403625	29.19403625	24.32836354	0.097313454	0.097313454	0.097313454	0.092447781																				3.6012	0.288292258	0.942310428	0.813174996	1.522069079	0.523863782	0.085323338	0.660179748	0.98704123	0	1.692524318	0.044059615	0	2.487143252	3.168871739	8.997347636	0.714317964	3.00915598	2.428496	0.243573238	0.868131625	0.086080311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1631	0	0.965090394	3.6012	0.288292258	0.942310428	0.813174996	1.522069079	0.523863782	0.085323338	0.660179748	0.98704123	0	1.692524318	0.044059615	0	2.487143252	3.168871739	8.997347636	0.714317964	3.00915598	2.428496	0.243573238	0.868131625	0.086080311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1631	7700	$550 per admission	$200/day-First seven days per stay	20% coinsurance	$20 per visit	$100 per service	20% coinsurance	20% coinsurance	$50 emrg/$30 Urgent	$50 per visit.	$50 per visit.	$50 per visit.	$50 per visit.		$100 per visit.	$20 per visit.	$60 per visit	$60 per visit	20% coinsurance	20% coinsurance	20% coinsurance except 10% Diabetes supplies/self-monitoring training	20% coinsurance	20% coinsurance																				5.3249	0.1902	1.3241	0.734	0.2992	0.2532	0.0412	0.3102	0.6803	0.4986	0.6182	0.0428		0.7079	1.9683	4.2231	0.1844	0.675	1.1738	0.1177	0.4196	0.0431																				19.83	500	0.102501024	8.926	0.478464913	2.266414111	1.547223885	1.821284234	0.77707594	0.126564797	0.970386333	1.667359988	0.498621872	2.310741185	0.086823482	0	3.195051604	5.137209877	13.22048555	0.898724352	3.684191552	3.602321594	0.361305571	1.287747354	0.129138196	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9932
H3208_804_0	2008	1																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V		V	V	V	V	V	Coin	Coin	Coin	Coin																																																													0	5000	161.4797562	58.74851356	580.9949523	1002.749316	187.6906859	5.383261607	0.87678871	180.9081122	243.4297469	504.7088331	417.4200164	10.86623401		613.3934774	3907.626257	3698.295457	293.6152949	1484.270477	24.95539822	2.502975977	8.920982536	0.931123604																				$275 per admission.	$100/day-First seven days per stay	$20 per day.	$10 per visit	$100 per service	10% coinsurance.	10% coinsurance.	$50 emrg/$30 Urgent	$50 per visit.	$0 per visit.	$50 per visit.	$50 per visit.		$50 per visit.	"$10 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$30 per visit	$30 per visit	$25 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.																				267.6119989	58.88671717	19.46269083	9.731345416	97.31345416	0.097313454	0.097313454	43.79105437	48.65672708	0	48.65672708	48.65672708		48.65672708	9.731345416	29.19403625	29.19403625	24.32836354	0.097313454	0.097313454	0.097313454	0.092447781																				3.6012	0.288292258	0.942310428	0.813174996	1.522069079	0.523863782	0.085323338	0.660179748	0.98704123	0	1.692524318	0.044059615	0	2.487143252	3.168871739	8.997347636	0.714317964	3.00915598	2.428496	0.243573238	0.868131625	0.086080311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1631	0	0.965090394	3.6012	0.288292258	0.942310428	0.813174996	1.522069079	0.523863782	0.085323338	0.660179748	0.98704123	0	1.692524318	0.044059615	0	2.487143252	3.168871739	8.997347636	0.714317964	3.00915598	2.428496	0.243573238	0.868131625	0.086080311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1631	7700	$550 per admission	$200/day-First seven days per stay	20% coinsurance	$20 per visit	$100 per service	20% coinsurance	20% coinsurance	$50 emrg/$30 Urgent	$50 per visit.	$50 per visit.	$50 per visit.	$50 per visit.		$100 per visit.	$20 per visit.	$60 per visit	$60 per visit	20% coinsurance	20% coinsurance	20% coinsurance except 10% Diabetes supplies/self-monitoring training	20% coinsurance	20% coinsurance																				5.3249	0.1902	1.3241	0.734	0.2992	0.2532	0.0412	0.3102	0.6803	0.4986	0.6182	0.0428		0.7079	1.9683	4.2231	0.1844	0.675	1.1738	0.1177	0.4196	0.0431																				19.83	500	0.102501024	8.926	0.478464913	2.266414111	1.547223885	1.821284234	0.77707594	0.126564797	0.970386333	1.667359988	0.498621872	2.310741185	0.086823482	0	3.195051604	5.137209877	13.22048555	0.898724352	3.684191552	3.602321594	0.361305571	1.287747354	0.129138196	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9932
H3209_001_0	2008	6	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						800	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	P	P	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T	P	V	P	V	P				V	P	V	V	V																																															0		1446.755978	68.19372025	8265.120897	191.7805552	436.6603515	1589.441282	21.75510673	161.5967637	110.1151545	4123.461105	167.0223704	25.40170418	6.227116801	206.6922518	116.9749413	1230.85965	1844.60225	22.29918129		247.7945577	239.4723788	618.6019324	1817.255	1347.86	287.28	278.16		95.475				92.72855117	1.171437814		234.745	287.945						(1a) $75/day	(1b) $75/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) $0/proc	(11a/11c) $0/proc	(4a) $50/visit (waived if admitted)	(9a/9b) $25/visit	(8a) $0/visit	(8b) $0/visit	(9a) $25/visit	(12) $0/proc	(9a) $25/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $0/visit	(7e/7h) $0/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $0/visit	(15) $0/proc	(Misc. PBP Cats) $0/visit	(10b) $0/trip	(16a) $0/proc	(17a1) $0/visit	(17b2) $0/proc	(18a) $0/visit	(18b) $0/proc				(4b) $10/visit (waived if admitted)	(9c) $0/proc 75%/25% Ind/Grp Blended Copay	(9d) $0/visit	(7f1) $0/visit	(18a1) $0/visit						68.5428	68.5428			68.5428			45.6952	22.8476			22.8476		22.8476																		9.139										8.2637	0.389515682	0	0	2.494160076	0	0	0.615349657	0.209655568	0	0	0.048363994	0	0.393535128	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.070620823	0	0	0	0	0	0	0	0	0	12.4849		1.176166318	8.2637	0.389515682	0	0	2.494160076	0	0	0.615349657	0.209655568	0	0	0.048363994	0	0.393535128	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.070620823	0	0	0	0	0	0	0	0	0	12.4849		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					10	0.3	0.3	0.3	0.3						1.7712	0.027	0.7822	0.0948	0.3501	0.3701	0.0033	0.0354	0.163	0.6408	0.5868	0.0299	0.0073	0.0964	0.007	1.5053	0.1564	0.0024		0.1515		0.0987	0.1433		0.0146							0.0041	0.0001		0.0131	0.0185						7.0728		0	10.0349	0.416482709	0.782184535	0.094773399	2.844252797	0.37014903	0.003327304	0.650787544	0.372648209	0.640809309	0.586785575	0.078260995	0.007250714	0.489918832	0.006953417	1.505279582	0.156366693	0.002350277	0	0.151508758	0	0.09865489	0.14325	0	0.01455	0	0	0	0	0	0	0.074687865	9.03E-05	0	0.01305	0.01845	0	0	0	0	0	19.5578
H3209_002_0	2008	6																					1100											D	D	D	V	T	V	P	V	V	Coin	V	V	V	V	V		V	V		V	S	P	T	V	V	P	V	P																																																							0		2017.601765	285.6997424	966.0643268		390.2887293	3038.656586	1519.023504	676.5444293	358.9771662	7.33888605	177.4602409	66.02529298	38.2484605	3376.798714		3270.675938		886.9287266				635.231063					0.083820545															1(a) $110 per Day	1(b) $110 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per preocedure; other $0 per procedure	8(b) X-rays $0 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a), 9(d) $25 per visit; 9(c) $0/0 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  $0 per script	"13, 14(a)-(j) $0; 17(a), 16(b) $10 per procedure"	10(b) $0 Copay	16(a)/16(b) $0 copay per visit	17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a/18a1 $10/$0 per visit	18(b) $0 copay per procedure														60.7952	60.7952	23.2127		41.4513	10.6264	15.181	24.7326	13.8171	0.391374107	5.5268	13.8171	125.3718	13.8171		5.5268		5.5268				5.5268					5.5268															10.2217	1.447431085	1.868747813	0	1.348163717	2.690837168	1.921689418	1.39439149	0.413335013	2.872249974	0.08173281	0.076023123	0.399606677	3.888127912	0	1.50637423	0	0.408492496	0	0	0	0.292568179	0	0	0	0	3.86E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.8315	0	24.95359309	10.2217	1.447431085	1.868747813	0	1.348163717	2.690837168	1.921689418	1.39439149	0.413335013	2.872249974	0.08173281	0.076023123	0.399606677	3.888127912	0	1.50637423	0	0.408492496	0	0	0	0.292568179	0	0	0	0	3.86E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.8315		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															1.9503	0.1204	0.2656	0.3496	0.0866	0.149	0.1064	0.0488	0.209	0.0381	0.0959	0.0188	0.0195	0.2133	0.0741	0.142	0.0585	0.0409			0.1354	0.0304	0.0077		0.0066		0.006															4.1729	0	0	12.172	1.567803658	2.134351623	0.349643527	1.434764893	2.839878248	2.02812866	1.443145124	0.622373662	2.910327902	0.177597795	0.094821881	0.419114352	4.101430631	0.074095107	1.648354241	0.058456538	0.449400532	0	0	0.135381059	0.323005032	0.00774	0	0.006631111	0	0.006024628	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0045
H3209_003_0	2008	8																					1500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		1981.135343	135.884185	895.2518895		258.4247875	9.321075412	16.1878671	396.6925666	374.9510022	3143.527946	413.1154908	62.95706767	14.99548177	2641.857541		3890.798934	382.3447436	560.5609537				696.6462659					0.069155086															(1a)$150/day	(1b)$150/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$10/visit"	(9b)$25/visit	"(8a)$15/procedure Diag. services, $0/procedure Other services"	(8b)$15/visit	(9a)$25/visit	(12)20%	"(3,5,9a,9d)$25/visit, (9c)$15/visit"	"(7a) $0/visit PCP, $10/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b)$15 visit, (7d,f)$10/visit"	"(7e,h)$15/visit"	"(7c,i)$15/visit"		(7g)$15/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$15/visit"			(17a)0	(17b)0	(18a)$15/visit															108.4215	108.4215	30.358		54.2107	0.144561989	0.144561989	26.0212	18.0702	10.8421	10.8421	18.0702	96.3329	18.0581		7.5092	10.8421	10.8421				10.8421					10.8421															17.8998	1.227730503	2.264839391	0	1.16745004	1.347473201	2.340150265	0.860199997	0.564621486	2.840216577	0.373254981	0.094804155	0.120379846	3.975574525	0	2.434738424	0.345453229	0.50647379	0	0	0	0.629428561	0	0	0	0	6.25E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9927	0	14.95327564	17.8998	1.227730503	2.264839391	0	1.16745004	1.347473201	2.340150265	0.860199997	0.564621486	2.840216577	0.373254981	0.094804155	0.120379846	3.975574525	0	2.434738424	0.345453229	0.50647379	0	0	0	0.629428561	0	0	0	0	6.25E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9927		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$10/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															1.89	0.054	0.2326	0.2321	0.0596	0.1141	0.0991	0.0293	0.2412	0.0379	0.0984	0.0198	0.0046	0.1722	0.0172	0.1664	0.025	0.027			0.1492	0.0353			0.0051																	3.7101	0	0	19.7898	1.281709719	2.49739105	0.232095523	1.227063501	1.461608818	2.439259656	0.889532485	0.805869469	2.878088975	0.471700255	0.11455726	0.124935111	4.147784911	0.017213014	2.601144862	0.370454314	0.533483588	0	0	0.149211119	0.664708734	0	0	0.005058988	0	6.25E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.7027
H3214_001_0	2008	3																																							V	V								V																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	281.388268	255.7588134	0	0	0	0	0	0	0	313.3853367	0	0	0	0	0	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	25	50	0	0	0	0	0	0	0	5	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.586225558	1.065661723	0	0	0	0	0	0	0	0.130577224	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.7825	0	0	0	0	0	0	0	0	0	0.586225558	1.065661723	0	0	0	0	0	0	0	0.130577224	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.7825		"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0.586225558	1.065661723	0	0	0	0	0	0	0	0.130577224	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.7825
H3214_002_0	2008	7																																							V	V								V																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	281.388268	255.7588134	0	0	0	0	0	0	0	313.3853367	0	0	0	0	0	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	25	50	0	0	0	0	0	0	0	5	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.586225558	1.065661723	0	0	0	0	0	0	0	0.130577224	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.7825	0	0	0	0	0	0	0	0	0	0.586225558	1.065661723	0	0	0	0	0	0	0	0.130577224	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.7825		"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0.586225558	1.065661723	0	0	0	0	0	0	0	0.130577224	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.7825
H3214_801_0	2008	2																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		209.2387248	0	23.85757896	0	12.80863013	43.84694826	2.004572194	5.428095086	29.25102453	8.78872032	25.22919702	0	0	27.7664903	30.24300306	58.56705161	2.475620579	6.869406547	48.12633037	126.880185	35.59187491	37.44891753	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.0692	0	0.2071	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											14.4793	0	4.940904602	0	2.997219451	10.26018589	0.469069894	1.27017425	6.84473974	2.056560555	5.903632102	0	0	6.497358731	7.076862715	13.70469008	0.579295215	1.607441132	11.26156131	29.6899633	8.32849873	8.763046702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.7305	0	0	14.4793	0	4.940904602	0	2.997219451	10.26018589	0.469069894	1.27017425	6.84473974	2.056560555	5.903632102	0	0	6.497358731	7.076862715	13.70469008	0.579295215	1.607441132	11.26156131	29.6899633	8.32849873	8.763046702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.7305		"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.4793	0	4.940904602	0	2.997219451	10.26018589	0.469069894	1.27017425	6.84473974	2.056560555	5.903632102	0	0	6.497358731	7.076862715	13.70469008	0.579295215	1.607441132	11.26156131	29.6899633	8.32849873	8.763046702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.7305
H3214_802_0	2008	2																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		209.2387248	0	23.85757896	0	12.80863013	43.84694826	2.004572194	5.428095086	29.25102453	8.78872032	25.22919702	0	0	27.7664903	30.24300306	58.56705161	2.475620579	6.869406547	48.12633037	126.880185	35.59187491	37.44891753	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.0692	0	0.2071	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											14.4793	0	4.940904602	0	2.997219451	10.26018589	0.469069894	1.27017425	6.84473974	2.056560555	5.903632102	0	0	6.497358731	7.076862715	13.70469008	0.579295215	1.607441132	11.26156131	29.6899633	8.32849873	8.763046702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.7305	0	0	14.4793	0	4.940904602	0	2.997219451	10.26018589	0.469069894	1.27017425	6.84473974	2.056560555	5.903632102	0	0	6.497358731	7.076862715	13.70469008	0.579295215	1.607441132	11.26156131	29.6899633	8.32849873	8.763046702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.7305		"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.4793	0	4.940904602	0	2.997219451	10.26018589	0.469069894	1.27017425	6.84473974	2.056560555	5.903632102	0	0	6.497358731	7.076862715	13.70469008	0.579295215	1.607441132	11.26156131	29.6899633	8.32849873	8.763046702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.7305
H3214_803_0	2008	2																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		209.2387248	0	23.85757896	0	12.80863013	43.84694826	2.004572194	5.428095086	29.25102453	8.78872032	25.22919702	0	0	27.7664903	30.24300306	58.56705161	2.475620579	6.869406547	48.12633037	126.880185	35.59187491	37.44891753	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.0692	0	0.2071	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											14.4793	0	4.940904602	0	2.997219451	10.26018589	0.469069894	1.27017425	6.84473974	2.056560555	5.903632102	0	0	6.497358731	7.076862715	13.70469008	0.579295215	1.607441132	11.26156131	29.6899633	8.32849873	8.763046702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.7305	0	0	14.4793	0	4.940904602	0	2.997219451	10.26018589	0.469069894	1.27017425	6.84473974	2.056560555	5.903632102	0	0	6.497358731	7.076862715	13.70469008	0.579295215	1.607441132	11.26156131	29.6899633	8.32849873	8.763046702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.7305		"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.4793	0	4.940904602	0	2.997219451	10.26018589	0.469069894	1.27017425	6.84473974	2.056560555	5.903632102	0	0	6.497358731	7.076862715	13.70469008	0.579295215	1.607441132	11.26156131	29.6899633	8.32849873	8.763046702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.7305
H3240_008_0	2008	8																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1038.622	17.98	906.912	0	207.43	13.72	8.37	269.91	254.48	0	881.36	25.34	0.39	495.87	6749.32	8112.48	206.7	802.94	2535.78	2631.21	260.97	868.53	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute:   $100   for 1st 10   Days	1B IP Psych:   $100   for 1st 10   Days	2 SNF:   $125   for Days 6   - 100	6 Home Health:   $0	10A Ambulance:     $100	11A DME:     20%	"11B Prosthetic Medical Supplies:      20%,  11C Diabetes Monitoring Supplies:     20%"	"4A ER:     $50,  4B Urgent Care:     $25"	9B ASC Services:     $250	8A OP Clinical/Diagnostic/Therapy Radiological Lab Services:      $0	8B OP X-Ray:     $42.6	"5 Partial Hospitalization:     $202.49,  9A OP Hospital,  $250"	12 Renal Dialysis:      $30	"3 CORF ,  250,  9D Cardiac Rehab:     $30"	"7A PCP:     $15,  14B Immunizations:     $0,  14C Routine Physical Exams:     $0,  14D Pap Smears:      $,  14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement:      $40.5,  14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist:     $30	"7E Mental Health:     $30,  7H Psychiatric:     $30,  9C OP Substance Abuse,  30"	"7C Occupational Therapy:     $30,  7I Physical and Speech Therapy:     $30"	7D Physician Specialist Services - Radiology:   40.5	"7G Other Health Care:     $30,  18A Medicare Covered Hearing Exams:   $30,  7B Chiropractic:     $30,  7F Podiatry:     $30"	15 Part B Drugs:     $250	"13A Blood:     $250,  16B Medicare Covered Dental Services:     $30,  17A Medicare Covered Eye Exams:   $30"	10B Transportation:     Not Covered	"16A Preventive Dental Services:   $0,  16B Non Medicare Covered Comprehensive Dental:   $0"	17A Routine Eye Exams:    $0	17B Eye Wear: $0	18A Routine Hearing Exams:   $0	18B Hearing Aids:   $0	19 POS:   $0	14A Health Education/Wellness Programs:   $0	13B Acupuncture: Not Covered											100	100	125	0	100	0.200017162	0.201244967	48.25126894	250	0	42.6	202.4866785	30	192.4756456	15	30	30	30	40.5	30	143.4675	32.80658123	0	0	0	0	0	0	0	0	0											8.6552	0.149833333	9.447	0	1.728583333	2.744235458	1.684420375	1.085291667	5.301666667	0	3.128828	0.427584369	0.000975	7.953574867	8.43665	20.2812	0.51675	2.00735	8.5582575	6.578025	3.120059456	2.374458333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.1799	0	0	8.6552	0.149833333	9.447	0	1.728583333	2.744235458	1.684420375	1.085291667	5.301666667	0	3.128828	0.427584369	0.000975	7.953574867	8.43665	20.2812	0.51675	2.00735	8.5582575	6.578025	3.120059456	2.374458333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.1799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.6552	0.149833333	9.447	0	1.728583333	2.744235458	1.684420375	1.085291667	5.301666667	0	3.128828	0.427584369	0.000975	7.953574867	8.43665	20.2812	0.51675	2.00735	8.5582575	6.578025	3.120059456	2.374458333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.1799
H3240_009_0	2008	6																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	965.2021	14.85	814.432	0	207.81	13.94	8.5	260.99	245.54	0	836.82	24.06	0.38	470.8	6582.77	7802.51	185.06	734.92	2540.87	2418.05	247.78	868.4	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute:   $150   for 1st 14   Days	1B IP Psych:   $116.55   for 1st 14   Days	2 SNF:   $80   for Days 6   - 100	6 Home Health:   $0	10A Ambulance:     $100	11A DME:     20%	"11B Prosthetic Medical Supplies:      20%,  11C Diabetes Monitoring Supplies:     20%"	"4A ER:     $50,  4B Urgent Care:     $25"	9B ASC Services:     $250	8A OP Clinical/Diagnostic/Therapy Radiological Lab Services:      $0	8B OP X-Ray:     $60.8	"5 Partial Hospitalization:     $193.58,  9A OP Hospital,  $250"	12 Renal Dialysis:      $20	"3 CORF ,  250,  9D Cardiac Rehab:     $35"	"7A PCP:     $20,  14B Immunizations:     $0,  14C Routine Physical Exams:     $0,  14D Pap Smears:      $,  14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement:      $59,  14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist:     $35	"7E Mental Health:     $35,  7H Psychiatric:     $35,  9C OP Substance Abuse,  35"	"7C Occupational Therapy:     $35,  7I Physical and Speech Therapy:     $35"	7D Physician Specialist Services - Radiology:   59	"7G Other Health Care:     $35,  18A Medicare Covered Hearing Exams:   $35,  7B Chiropractic:     $35,  7F Podiatry:     $35"	15 Part B Drugs:     $250	"13A Blood:     $250,  16B Medicare Covered Dental Services:     $35,  17A Medicare Covered Eye Exams:   $35"	10B Transportation:     Not Covered	"16A Preventive Dental Services:   $0,  16B Non Medicare Covered Comprehensive Dental:   $0"	17A Routine Eye Exams:    $0	17B Eye Wear: $0	18A Routine Hearing Exams:   $0	18B Hearing Aids:   $0	19 POS:   $0	14A Health Education/Wellness Programs:   $0	13B Acupuncture: Not Covered											150	116.5454545	80	0	100	0.199986765	0.198866964	48.21065941	250	0	60.8	193.5785536	20	188.2540357	20	35	35	35	59	35	137.3025	37.60456011	0	0	0	0	0	0	0	0	0											12.065	0.144225	5.429546667	0	1.73175	2.7878155	1.690369192	1.048541667	5.115416667	0	4.239888	0.388125	0.000633333	7.385833333	10.97128333	22.75732083	0.539758333	2.143516667	12.49261083	7.052645833	2.835067788	2.721316667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.5407	0	0	12.065	0.144225	5.429546667	0	1.73175	2.7878155	1.690369192	1.048541667	5.115416667	0	4.239888	0.388125	0.000633333	7.385833333	10.97128333	22.75732083	0.539758333	2.143516667	12.49261083	7.052645833	2.835067788	2.721316667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.5407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.065	0.144225	5.429546667	0	1.73175	2.7878155	1.690369192	1.048541667	5.115416667	0	4.239888	0.388125	0.000633333	7.385833333	10.97128333	22.75732083	0.539758333	2.143516667	12.49261083	7.052645833	2.835067788	2.721316667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.5407
H3240_010_0	2008	8																					3250											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											25.613	0.2199	4.4795	3.4781	0	1.2346	0.752	0	2.4425	1.0147	2.7576	0.0666	0.0086	1.6344	0	0	0	0	0	0	0.7253	0.0533	0	0	0	0	0	0	0	0	0											44.48	0	0	0	0	0	207.73	0	0	267.39	0	0	0	0	0	247.89	6723.85	8041.98	200.34	783.62	2542.11	2570.78	0	858.26	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute:   $0	1B IP Psych:   $0	2 SNF:   $0	6 Home Health:   $0	10A Ambulance:     $100	11A DME:     $0	"11B Prosthetic Medical Supplies:      $0,11C Diabetes Monitoring Supplies:     $0"	"4A ER:     $50,4B Urgent Care:     $25"	9B ASC Services:     $0	8A OP Clinical/Diagnostic/Therapy Radiological Lab Services:      $0	8B OP X-Ray:     $0	"9A OP Hospital,  $0,  5 Partial Hosp:     $0"	12 Renal Dialysis:      $0	"3 CORF:,  $0,   9D Cardiac Rehab:     $30"	"7A PCP:     $15,  14B Immunizations:     $0,  14C Routine Physical Exams:     $0,  14D Pap Smears:      $,  14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement:40.5,   14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist:     $30	"7E Mental Health:     $30,  7H Psychiatric:     $30,     9C OP Substance Abuse: $30"	"7C Occupational Therapy:     $30,  7I Physical and Speech Therapy:     $30"	7D Physician Specialist Services - Radiology:   $40.5	"7G Other Health Care:     $30,  18A Medicare Covered Hearing Exams:   $30,  7B Chiropractic:     $30,  7F Podiatry:     $30"	15 Part B Drugs:     $0	"13A Blood:     $0,  16B Medicare Covered Comprehensive Dental Services:     $30,  17A Medicare Covered Eye Exams:   $30"	"10B Transportation:     $0,  Number of Trips Covered - 12"	"16A Preventive Dental Services:   $0,  16B Non Medicare Covered Comprehensive Dental:   NotCovered"	17A Routine Eye Exams:    $0	17B Eye Wear:    $0	18A Routine Hearing Exams:   $0	18B Hearing Aids:   $0	19 POS:   $0	14A Health Education/Wellness Programs:   $0	13B Acupuncture: Not Covered											0	0	0	0	100	0	0	48.23291821	0	0	0	0	0	30	15	30	30	30	40.5	30	0	30	0	0	0	0	0	0	0	0	0											0	0	0	0	1.731083333	0	0	1.07475	0	0	0	0	0	0.619725	8.4048125	20.10495	0.50085	1.95905	8.57962125	6.42695	0	2.14565	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.5474	1600	0	25.613	0.2198823	4.479506944	3.478138201	1.731083333	1.234577243	0.751978429	1.07475	2.442502086	1.014694943	2.757571529	0.066631	0.008566843	2.254088243	8.4048125	20.10495	0.50085	1.95905	8.57962125	6.42695	0.725326029	2.1989548	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.0274	3250	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.613	0.2198823	4.479506944	3.478138201	1.731083333	1.234577243	0.751978429	1.07475	2.442502086	1.014694943	2.757571529	0.066631	0.008566843	2.254088243	8.4048125	20.10495	0.50085	1.95905	8.57962125	6.42695	0.725326029	2.1989548	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.0274
H3240_013_0	2008	5																					0											Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	483.2914	33.82005	159.87	0	18.08	31.23	23.48	9.87	19.93	16.38	28.24	0.93	1.11	52.73	95.92	168.41	12.9	7.87	44.24	68.4	8.94	5.79	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Medicare FFS cost sharing	1B IP Psych: Medicare FFS cost sharing	2 SNF: Medicare FFS cost sharing	6 Home Health: $0	10A Ambulance: Medicare FFS cost sharing	11A DME: Medicare FFS cost sharing	"11B Prosthetic/Medical Supplies: Medicare FFS cost sharing, 11C Diabetes Monitoring Supplies: Medicare FFS cost sharing"	"4A ER: Medicare FFS cost sharing, 4B Urgent Care: Medicare FFS cost sharing"	9B ASC Services: Medicare FFS cost sharing	8A OP C/D/T: Medicare FFS cost sharing	8B OP X-Ray: Medicare FFS cost sharing	9A OP Hospital: Medicare FFS cost sharing	12 Renal Dialysis: Medicare FFS cost sharing	"3 CORF: Medicare FFS cost sharing, 5 Partial Hosp: Medicare FFS cost sharing, 9C OP Substance Abuse: Medicare FFS cost sharing, 9D Cardiac Rehab: Medicare FFS cost sharing"	"7A PCP: Medicare FFS cost sharing, 14B Immunizations: Medicare FFS cost sharing, 14C Routine Physical Exams: Medicare FFS cost sharing, 14D Pap Smears: Medicare FFS cost sharing, 14D Pelvic Exams: Medicare FFS cost sharing, 14E Prostate Screening: Medicare FFS cost sharing, 14F Colorectal Screening: Medicare FFS cost sharing, 14G Bone Mass Measurement: Medicare FFS cost sharing, 14H Mammography: Medicare FFS cost sharing, 14I Diabetes Monitoring: Medicare FFS cost sharing"	"7D Physician Specialist: Medicare FFS cost sharing,"	"7E Mental Health: Medicare FFS cost sharing, 7H Psychiatric: Medicare FFS cost sharing"	"7C Occupational Therapy: Medicare FFS cost sharing, 7I Physical and Speech Therapy: Medicare FFS cost sharing"	7D Physician Specialist: Medicare FFS cost sharing	"7B Chiropractic: Medicare FFS cost sharing, 7F Podiatry: Medicare FFS cost sharing, 7G Other Health Care: Medicare FFS cost sharing, 18A Medicare Covered Hearing Exams: Medicare FFS cost sharing"	15 Part B Drugs: Medicare FFS cost sharing	"13A Blood: Medicare FFS cost sharing, 16B Medicare Covered Comprehensive Dental Services: Medicare FFS cost sharing, 17A Medicare Covered Eye Exams: Medicare FFS cost sharing"	10B Transportation: $0	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental:$0"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.067655842	0.067673905	0.156494005	0	0.233960012	0.234029174	0.23398298	0.23405253	0.233999004	0.234123534	0.233976385	0.234016756	0.234001727	0.234017956	0.232747687	0.234006624	0.233997079	0.233934699	0.233984749	0.22768384	0.234009564	0.233985023	0	0	0	0	0	0	0	0	0											32.6975	2.288734853	25.01869657	0	4.229997025	7.3087311	5.493920364	2.310098467	4.663600142	3.834943483	6.6074931	0.217635583	0.259741917	12.33976684	22.32515818	39.40905561	3.018562325	1.841066083	10.35148529	15.57357464	2.0920455	1.354773283	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	203.2366	0	0	32.6975	2.288734853	25.01869657	0	4.229997025	7.3087311	5.493920364	2.310098467	4.663600142	3.834943483	6.6074931	0.217635583	0.259741917	12.33976684	22.32515818	39.40905561	3.018562325	1.841066083	10.35148529	15.57357464	2.0920455	1.354773283	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	203.2366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	32.6975	2.288734853	25.01869657	0	4.229997025	7.3087311	5.493920364	2.310098467	4.663600142	3.834943483	6.6074931	0.217635583	0.259741917	12.33976684	22.32515818	39.40905561	3.018562325	1.841066083	10.35148529	15.57357464	2.0920455	1.354773283	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	203.2366
H3251_002_0	2008	6																																D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	P	P	P	P		P	P																																																				0		748.6000897	22.90040093	615.5883462	298.8076391	206.7766476	1628.795131	118.3977742	567.2168045	226.442095	3258.733588	869.6265701	2.223134172	0.127036238	770.8558947	4512.168561	3579.182499	152.6340405	256.295611	1211.671642	840.2176809	800.150682		0	0.063518119	618.602963	300.4407038	16.13360228	0		45.22490087	15											$200 Copay / Adm	$200 Copay / Adm	Various Copays	0	$75 Copay	0	0	$50 Copay	$50 Copay	Various Copays	CT $50; MRI $50 Copay	Various Copays	0	Various Copays	$5 Copay	$15 Copay	$20 Copay	$10 Copay	Various Copays	Various Copays	Various Copays		Various Copays	Various Copays	$15-$30 Copay	Various Copays	$15 Copay	Various Copays		Various Copays	$50 Outpatient; $150 InPatient											46.42899157	35.22336046	1.330735343	0	75	0	0	50	50	0.102229693	11.44261445	17.80071429	0	11.40926782	5	15	20	10	0.400724542	16.30880556	1.071976944		0	5.990625	23.31229421	0.107681801	15			6.899315309	100											2.8964	0.06721909	0.068265431	0	1.292354047	0	0	2.363403352	0.943508729	0.027761611	0.829233463	0.003297781	0	0.732908446	1.880070234	4.473978124	0.254390067	0.213579676	0.040462214	1.141912232	0.07147859	0	0	3.17E-05	1.201754522	0.002696	0.020167003	0	0	0.026001738	0.125	0	0	0	0	0	0	0	0	0	0	18.6759			2.8964	0.06721909	0.068265431	0	1.292354047	0	0	2.363403352	0.943508729	0.027761611	0.829233463	0.003297781	0	0.732908446	1.880070234	4.473978124	0.254390067	0.213579676	0.040462214	1.141912232	0.07147859	0	0	3.17E-05	1.201754522	0.002696	0.020167003	0	0	0.026001738	0.125	0	0	0	0	0	0	0	0	0	0	18.6759																																																																																				0			2.8964	0.06721909	0.068265431	0	1.292354047	0	0	2.363403352	0.943508729	0.027761611	0.829233463	0.003297781	0	0.732908446	1.880070234	4.473978124	0.254390067	0.213579676	0.040462214	1.141912232	0.07147859	0	0	3.17E-05	1.201754522	0.002696	0.020167003	0	0	0.026001738	0.125	0	0	0	0	0	0	0	0	0	0	18.6759
H3251_021_0	2008	6																																D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	P	P	P	P		P	P																																																				0		4344.515826	91.74671629	4107.01484	1804.586354	1179.514303	10116.3524	574.0263997	2838.802158	932.9920299	16199.12058	4041.018411	8.496227933	6.37217095	3658.688154	21594.38647	18019.43742	919.1856595	1074.241819	6181.005821	4206.163841	4103.994574		0	0.531014246	2473.995371	1173.541483	57.34953855	0		212.4056983	15											$200 Copay / Adm	$200 Copay / Adm	Various Copays	0	$75 Copay	0	0	$50 Copay	$50 Copay	Various Copays	CT $50; MRI $50 Copay	Various Copays	0	Various Copays	$5 Copay	$15 Copay	$20 Copay	$10 Copay	Various Copays	Various Copays	Various Copays		Various Copays	Various Copays	$15-$30 Copay	Various Copays	$15 Copay	Various Copays		Various Copays	$50 Outpatient; $150 InPatient											44.89922922	33.29522038	1.093380144	0	75	0	0	50	50	0.098806234	10.83609598	13.47890625	0	10.67862102	5	15	20	10	0.369214854	15.82548059	1.081677409		0	0	22.87516106	0.145943552	15			1.25803125	100											16.2555	0.254560595	0.374210706	0	7.371964396	0	0	11.82834233	3.887466791	0.133381175	3.649071946	0.009543322	0	3.255812019	8.997661031	22.52429677	1.531976099	0.895201516	0.190176597	5.547047019	0.369933185	0	0	0	4.716086881	0.014272568	0.071686923	0	0	0.022267751	0.125	0	0	0	0	0	0	0	0	0	0	92.0254			16.2555	0.254560595	0.374210706	0	7.371964396	0	0	11.82834233	3.887466791	0.133381175	3.649071946	0.009543322	0	3.255812019	8.997661031	22.52429677	1.531976099	0.895201516	0.190176597	5.547047019	0.369933185	0	0	0	4.716086881	0.014272568	0.071686923	0	0	0.022267751	0.125	0	0	0	0	0	0	0	0	0	0	92.0254																																																																																				0			16.2555	0.254560595	0.374210706	0	7.371964396	0	0	11.82834233	3.887466791	0.133381175	3.649071946	0.009543322	0	3.255812019	8.997661031	22.52429677	1.531976099	0.895201516	0.190176597	5.547047019	0.369933185	0	0	0	4.716086881	0.014272568	0.071686923	0	0	0.022267751	0.125	0	0	0	0	0	0	0	0	0	0	92.0254
H3251_023_0	2008	6																																D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	P	P	P	P		P	P																																																				0		748.6000897	22.90040093	615.5883462	298.8076391	206.7766476	1628.795131	118.3977742	567.2168045	226.442095	3258.733588	869.6265701	2.223134172	0.127036238	770.8558947	4512.168561	3579.182499	152.6340405	256.295611	1211.671642	840.2176809	800.150682		0	0.063518119	618.602963	300.4407038	16.13360228	0		45.22490087	15											$0 Copay / Adm	$200 Copay / Adm	0	0	$50 Copay	0	0	$50 Copay	$50 Copay	Various Copays	CT $100; MRI $100 Copay	Various Copays	0	Various Copays	$5 Copay	$15 Copay	$20 Copay	$5 Copay	Various Copays	Various Copays	Various Copays		Various Copays	Various Copays	$15-$30 Copay	Various Copays	$15 Copay	Various Copays		Various Copays	$50 Outpatient; $150 InPatient											0	35.22336046	0	0	50	0	0	50	50	0.102229693	11.44261445	17.80071429	0	11.14085061	5	15	20	5	0.400724542	16.30880556	1.071976944		0	5.990625	23.31229421	0.107681801	15			6.899315309	100											0	0.06721909	0	0	0.861569365	0	0	2.363403352	0.943508729	0.027761611	0.829233463	0.003297781	0	0.715665864	1.880070234	4.473978124	0.254390067	0.106789838	0.040462214	1.141912232	0.07147859	0	0	3.17E-05	1.201754522	0.002696	0.020167003	0	0	0.026001738	0.125	0	0	0	0	0	0	0	0	0	0	15.1564			0	0.06721909	0	0	0.861569365	0	0	2.363403352	0.943508729	0.027761611	0.829233463	0.003297781	0	0.715665864	1.880070234	4.473978124	0.254390067	0.106789838	0.040462214	1.141912232	0.07147859	0	0	3.17E-05	1.201754522	0.002696	0.020167003	0	0	0.026001738	0.125	0	0	0	0	0	0	0	0	0	0	15.1564																																																																																				0			0	0.06721909	0	0	0.861569365	0	0	2.363403352	0.943508729	0.027761611	0.829233463	0.003297781	0	0.715665864	1.880070234	4.473978124	0.254390067	0.106789838	0.040462214	1.141912232	0.07147859	0	0	3.17E-05	1.201754522	0.002696	0.020167003	0	0	0.026001738	0.125	0	0	0	0	0	0	0	0	0	0	15.1564
H3251_804_0	2008	5																																D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	P	P	P	P		P	P																																																				0		1069.317683	39.20023251	582.3781563	382.9975568	232.0749856	2468.742596	184.3418345	637.9066299	335.3303793	5227.079624	1098.861076	2.995804461	1.597762379	1265.028364	6134.009494	5458.954889	204.7133048	344.9169536	1877.570516	1152.386116	1424.111807		1.597762379	0.199720297	896.1449744	416.4168201	29.55860402	0		100.8587502	15											$500 Copay / Adm	$500 Copay / Adm	Various Copays	0	$100 Copay	Various Copays	Various Copays	$50 Copay	$100 Copay	Various Copays	CT $50; MRI $100 Copay	Various Copays	Various Copays	Various Copays	$20 Copay	$40 Copay	$40 Copay	$40 Copay	Various Copays	Various Copays	Various Copays		Various Copays	Various Copays	$20-$30 Copay	Various Copays	$20 Copay	Various Copays		Various Copays	$50 Outpatient; $150 InPatient											49.21101528	21.59831129	0.438989925	0	100	7.676504071	0	50	100	0.068093455	11.50408081	2.341457601	0	12.98730639	20	40	40	40	0.312913225	15.51121642	0.772577507		0	0	22.54846108	0	20	0		3.616508769	100											4.3852	0.070554902	0.021304845	0	1.933958213	1.579276049	0	2.657944291	2.794419828	0.029660826	1.053448885	0.000584546	0	1.369109246	10.22334916	18.1965163	0.682377683	1.149723179	0.04895972	1.48957587	0.091686396	0	0	0	1.68389084	0	0.04926434	0	0	0.03039638	0.125	0	0	0	0	0	0	0	0	0	0	49.6662			4.3852	0.070554902	0.021304845	0	1.933958213	1.579276049	0	2.657944291	2.794419828	0.029660826	1.053448885	0.000584546	0	1.369109246	10.22334916	18.1965163	0.682377683	1.149723179	0.04895972	1.48957587	0.091686396	0	0	0	1.68389084	0	0.04926434	0	0	0.03039638	0.125	0	0	0	0	0	0	0	0	0	0	49.6662																																																																																				0			4.3852	0.070554902	0.021304845	0	1.933958213	1.579276049	0	2.657944291	2.794419828	0.029660826	1.053448885	0.000584546	0	1.369109246	10.22334916	18.1965163	0.682377683	1.149723179	0.04895972	1.48957587	0.091686396	0	0	0	1.68389084	0	0.04926434	0	0	0.03039638	0.125	0	0	0	0	0	0	0	0	0	0	49.6662
H3292_001_0	2008	10																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1290.916659	108.5678996	795.2042716	2009.537789	362.4970939	15.15747792	3.079325411	1224.516401	216.3788659	3138.0195	934.8645031	20.5779884	0.031145013	254.5178945	7122.165629	17647.81532	311.8220007	2764.451218	3712.71402	802.0273513	29.08877939	34.26199229	0	530	420	280	103.8	28.14915254	0	0	3600											"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $125.00	$0.00 copayment	Copay between $0.00 and $125.00	$175.00 copayment	20% coinsurance	Copay between $20.00 and $125.00	Copay between $0.00 and $5.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $5.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											78.19674393	47.92869496	62.35	0	47.88067277	0.2	0.2	19.03778683	104.7959064	0	22.16990945	120.2513315	0.2	27.48865869	1.919239619	7.700486846	23.106437	10.43623104	8.593042472	0	0.2	0	0	0	0	10	0	10	0	0	0											8.4121	0.433626478	4.131748861	0	1.446383728	3.031495584	0.615865082	1.942673518	1.889634949	0	1.727155115	0.206210875	0.006229003	0.583029628	1.139095204	11.32473081	0.600424618	2.4042043	2.658625772	0	5.817755877	0	0	0	0	0.233333333	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	48.6278	0	0	8.4121	0.433626478	4.131748861	0	1.446383728	3.031495584	0.615865082	1.942673518	1.889634949	0	1.727155115	0.206210875	0.006229003	0.583029628	1.139095204	11.32473081	0.600424618	2.4042043	2.658625772	0	5.817755877	0	0	0	0	0.233333333	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	48.6278	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	N/A	N/A											7.5424	0.2631	0.4478	0.7561	0.2418	0.2633	0.1517	0.124	0.7039	0.145	0.6052	0	0.0016	0.1481	0.5804	4.338	0.1416	0.8697	1.1667	0.3544	1.477	0.0165	0	0	0	0	0	0	0	0	0											20.3382	0	0	15.9545	0.696766997	4.579579157	0.756075013	1.688162694	3.294757043	0.767555762	2.066682863	2.593500422	0.1450299	2.332380546	0.206210875	0.007806399	0.731168011	1.719544624	15.66272294	0.742018206	3.273874729	3.825292259	0.354386921	7.294725533	0.016479491	0	0	0	0.233333333	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	68.966
H3305_007_0	2008	3	h.6.										OP Facility - Other											MH. Sub Abuse										A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	P	P	V	P	P	P	Coin	Coin	T	P	P	P	P	P	Coin	V	Coin	V																																																			0		272.9300605	2.715560945	1651.271435	1339.028965	2.689794057	0.292758282	3.077029917	288.6619722	284.8134026		574.3127594			314.7910866	4285.845438	5779.153494	99.39532586	967.7869737			3.694392387				522.1547788						0.679877034	32.40952673										"$100 per admit, $300 OOP Max, Unlimited Days"	"$100 per admit, $300 OOP Max"	"$0 for days 0-15, $65 for days 16-100"	"No Copay for visits 1-20, $20 per Visit for Visits 21+"	$50 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care Visit"	$75 Ambulatory Surgical Copay	No Cost Sharing	$20 per Visit	No Cost Sharing	No Cost Sharing	"$20 OP Rehab, includes Cardiac Rehab"	$15 per Visit	$20 per Specialist Visit	$20 per Visit	$20 per Visit	No Cost Sharing	No Cost Sharing	20% Coinsurance	No Cost Sharing	No Cost Sharing	"$300 MAB Preventive Only, no cost sharing prior to MAB"	$15 per Visit	"$100 MAB, no cost sharing prior to MAB"	$20 per Visit	"$600 Max Benefit, Every 3 Years"	Not Applicable	Check with PBP	"30% Travel Benefit with $3,000 MAB"	$20 per Visit MH; 50% Coinsurance Sub Abuse										84.859	84.859	33.3472	5.9467	50	0.2	0.2	48.7038	75		20			20	15	19.9788	20	19.999			0.2				15						0.3	21.7616										1.93	0.01920332	4.588779504	0.663572161	0.011207475	0.058551656	0.615405983	1.171578284	1.780083766	0	0.957187932	0	0	0.524651811	5.357306798	9.62170859	0.165658876	1.61289396	0	0	0.738878477	0	0	0	0.652693474	0	0	0	0	0	0.20396311	0.058773594	0	0	0	0	0	0	0	0	0	30.7321	0	0	1.93	0.01920332	4.588779504	0.663572161	0.011207475	0.058551656	0.615405983	1.171578284	1.780083766	0	0.957187932	0	0	0.524651811	5.357306798	9.62170859	0.165658876	1.61289396	0	0	0.738878477	0	0	0	0.652693474	0	0	0	0	0	0.20396311	0.058773594	0	0	0	0	0	0	0	0	0	30.7321																																																																																				0	0	0	1.93	0.01920332	4.588779504	0.663572161	0.011207475	0.058551656	0.615405983	1.171578284	1.780083766	0	0.957187932	0	0	0.524651811	5.357306798	9.62170859	0.165658876	1.61289396	0	0	0.738878477	0	0	0	0.652693474	0	0	0	0	0	0.20396311	0.058773594	0	0	0	0	0	0	0	0	0	30.7321
H3305_011_0	2008	5	h.6.										OP Facility - Other											MH. Sub Abuse										A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	P	P	Coin	P	P	P	Coin	Coin	T	P	P	P	P	P	Coin	V	Coin	Coin																																																			0		288.3397812	6.005283356	1724.100606	1784.805302	3.999253405	0.362682797	3.384675419	322.9614842	296.5505996		612.1845598			400.6247437	4470.347319	6204.601434	1.627181742	1214.698983			4.416516976				521.4877707		0.100323575				0.592766433	0.735485247										"$100 per admit, $300 OOP Max, Unlimited Days"	"$100 per admit, $300 OOP Max"	"$0 for days 0-15, $65 for days 16-100"	"No Copay for visits 1-20, $20 per Visit for Visits 21+"	$50 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care Visit"	$75 Ambulatory Surgical Copay	No Cost Sharing	$20 per Visit	No Cost Sharing	No Cost Sharing	"$20 OP Rehab, includes Cardiac Rehab"	$15 per Visit	$20 per Specialist Visit	$20 per Visit	$20 per Visit	No Cost Sharing	No Cost Sharing	20% Coinsurance	No Cost Sharing	No Cost Sharing	"$300 MAB Preventive Only, no cost sharing prior to MAB"	$15 per Visit	"$100 MAB, no cost sharing prior to MAB"	$20 per Visit	"$600 Max Benefit, Every 3 Years"	Not Applicable	Check with PBP	"30% Travel Benefit with $3,000 MAB"	$20 per Visit MH; 50% Coinsurance Sub Abuse										84.859	84.859	33.3472	5.9467	50	0.2	0.2	48.4171	75		20			20	15	19.9761	0.257614823	19.9959			0.2				15		20				0.3	0.148961156										2.039	0.042466871	4.791167193	0.884482071	0.016663556	0.072536559	0.676935084	1.303071962	1.853441248	0	1.0203076	0	0	0.667707906	5.587934149	10.32866486	0.419186137	2.02408004	0	0	0.883303395	0	0	0	0.651859713	0	0.000167206	0	0	0	0.17782993	0.109558732	0	0	0	0	0	0	0	0	0	33.5504	0	0	2.039	0.042466871	4.791167193	0.884482071	0.016663556	0.072536559	0.676935084	1.303071962	1.853441248	0	1.0203076	0	0	0.667707906	5.587934149	10.32866486	0.419186137	2.02408004	0	0	0.883303395	0	0	0	0.651859713	0	0.000167206	0	0	0	0.17782993	0.109558732	0	0	0	0	0	0	0	0	0	33.5504																																																																																				0	0	0	2.039	0.042466871	4.791167193	0.884482071	0.016663556	0.072536559	0.676935084	1.303071962	1.853441248	0	1.0203076	0	0	0.667707906	5.587934149	10.32866486	0.419186137	2.02408004	0	0	0.883303395	0	0	0	0.651859713	0	0.000167206	0	0	0	0.17782993	0.109558732	0	0	0	0	0	0	0	0	0	33.5504
H3305_801_0	2008	2	h.6.										OP Facility - Other											MH. Sub Abuse										A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	P	P	V	P	P	P	Coin	Coin	T	P	P	P	P	P	Coin	V	Coin	V																																																			0		281.2134547	3.151770429	1496.794923	1666.235325	1.933248588	0.501472136	3.932805138	278.6301896			450.5196585			369.7954244	4854.895121	7502.90864	180.6009594	1301.238503			0.71411465						0.105392856				0.666362308	34.02810512										"$100 per admit, $300 OOP Max, Unlimited Days"	"$100 per admit, $300 OOP Max"	"$0 for days 0-15, $65 for days 16-100"	"No Copay for visits 1-20, $20 per Visit for Visits 21+"	$50 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care Visit"	"No Cost Sharing, Includes ASC"	No Cost Sharing	$20 per Visit	No Cost Sharing	No Cost Sharing	"$20 OP Rehab, includes Cardiac Rehab"	$15 per Visit	$20 per Specialist Visit	$20 per Visit	$20 per Visit	No Cost Sharing	No Cost Sharing	20% Coinsurance	No Cost Sharing	No Cost Sharing	"Not Covered, rider available"	$15 per Visit	"Not Covered, rider available"	$20 per Visit	"Not Covered, rider available"	Not Applicable	Check with PBP	"30% Travel Benefit - $3,000 MAB"	$20 per Visit MH; 50% Coinsurance Sub Abuse										84.859	84.859	33.3472	5.9467	50	0.2	0.2	48.267			20			20	15	19.9846	20	19.9913			0.2						20				0.3	22.9983										1.9886	0.022288012	4.159498991	0.82572327	0.008055202	0.100294427	0.786561028	1.12072103	0	0	0.750866098	0	0	0.616325707	6.068618901	12.49520842	0.301001599	2.167786412	0	0	0.14282293	0	0	0	0	0	0.000175655	0	0	0	0.199908692	0.065215691	0	0	0	0	0	0	0	0	0	31.8197	0	0	1.9886	0.022288012	4.159498991	0.82572327	0.008055202	0.100294427	0.786561028	1.12072103	0	0	0.750866098	0	0	0.616325707	6.068618901	12.49520842	0.301001599	2.167786412	0	0	0.14282293	0	0	0	0	0	0.000175655	0	0	0	0.199908692	0.065215691	0	0	0	0	0	0	0	0	0	31.8197																																																																																				0	0	0	1.9886	0.022288012	4.159498991	0.82572327	0.008055202	0.100294427	0.786561028	1.12072103	0	0	0.750866098	0	0	0.616325707	6.068618901	12.49520842	0.301001599	2.167786412	0	0	0.14282293	0	0	0	0	0	0.000175655	0	0	0	0.199908692	0.065215691	0	0	0	0	0	0	0	0	0	31.8197
H3305_803_0	2008	2	h.6.										OP Facility - Other											MH. Sub Abuse										A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	P	P	Coin	P	P	P	Coin	Coin	T	P	P	P	P	P	Coin	V	Coin	Coin																																																			0		254.9198292	3.025505331	1329.101806	1526.854801	2.695802306	0.582156119	3.745295698	240.1779592			488.6567526			340.0485494	4610.407997	7024.508205	1.110076261	1587.425079			5.241049861						0.08569644				0.651322482	0.513600758										"$100 per admit, $300 OOP Max, Unlimited Days"	"$100 per admit, $300 OOP Max"	"$0 for days 0-15, $65 for days 16-100"	"No Copay for visits 1-20, $20 per Visit for Visits 21+"	$50 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care Visit"	"No Cost Sharing, Includes ASC"	No Cost Sharing	$20 per Visit	No Cost Sharing	No Cost Sharing	"$20 OP Rehab, includes Cardiac Rehab"	$15 per Visit	$20 per Specialist Visit	$20 per Visit	$20 per Visit	No Cost Sharing	No Cost Sharing	20% Coinsurance	No Cost Sharing	No Cost Sharing	"Not Covered, rider available"	$15 per Visit	"Not Covered, rider available"	$20 per Visit	"Not Covered, rider available"	Not Applicable	Check with PBP	"30% Travel Benefit - $3,000 MAB"	$20 per Visit MH; 50% Coinsurance Sub Abuse										84.859	84.859	33.3472	5.9467	50	0.2	0.2	48.1361			20			20	15	19.9842	0.219321149	19.9957			0.2						20				0.3	0.116861106										1.8027	0.021395118	3.693490361	0.756651549	0.01123251	0.116431224	0.74905914	0.96343519	0	0	0.814427921	0	0	0.566747582	5.763009996	11.69826191	0.243463201	2.645136814	0	0	1.048209972	0	0	0	0	0	0.000142827	0	0	0	0.195396745	0.060019952	0	0	0	0	0	0	0	0	0	31.1492	0	0	1.8027	0.021395118	3.693490361	0.756651549	0.01123251	0.116431224	0.74905914	0.96343519	0	0	0.814427921	0	0	0.566747582	5.763009996	11.69826191	0.243463201	2.645136814	0	0	1.048209972	0	0	0	0	0	0.000142827	0	0	0	0.195396745	0.060019952	0	0	0	0	0	0	0	0	0	31.1492																																																																																				0	0	0	1.8027	0.021395118	3.693490361	0.756651549	0.01123251	0.116431224	0.74905914	0.96343519	0	0	0.814427921	0	0	0.566747582	5.763009996	11.69826191	0.243463201	2.645136814	0	0	1.048209972	0	0	0	0	0	0.000142827	0	0	0	0.195396745	0.060019952	0	0	0	0	0	0	0	0	0	31.1492
H3307_002_0	2008	13																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	O	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2143.838215	72.10923303	1398.727776		8.43318058	9.605872391	5.710838696	292.3042769	200.2631963		42.52934752				3753.001261	5967.398039	3.459006169	2058.277077			51.43823176	2013.055833					75.31822826															$110 (1a); $0 (1a1)	$110 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $27/$27/$15 (4b)"	$300 (9b)	$0/$0 (8a1); $0 (8a2)	"20% (8b1, 8b2); $0 (8b3)"	$300 (incl in h5)	$0 (12)	"$0 (3, 5, 9d); $27/$27 (9c); $300 (9a)"	"$15/$27/$27 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1); $0/$15/$27 (14f)"	"$27 (7b, 7f, 7g); $0 n/c (7b1); $27/$250/$200 (7d); $0( 7f1)"	"50%/50% (7e, 7h)"	"$27 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $27 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c; $0 (16)	$0 (17a1)	$0; $0 n/c (17b)	$27/$0 (18a1); $0 (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a3, 14a6, 14a7); $0 n/c (14a2, 14a4, 14a5, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											52.7918	55.4672	63.2242		0.2	0.2	0.2	42.4563	300		0.12563564				15	32.2174	0.5	10.8			0.2	27					27															9.4314	0.333307993	7.369457932	0	1.686636116	1.921174478	1.142167739	1.034180262	5.006579908	0	5.343201787	0	0	0	4.691251576	16.02114712	1.729503085	1.85244937	0	0	10.28764635	4.529375623	0	0	0	0	0.169466014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.549	0	0	9.4314	0.333307993	7.369457932	0	1.686636116	1.921174478	1.142167739	1.034180262	5.006579908	0	5.343201787	0	0	0	4.691251576	16.02114712	1.729503085	1.85244937	0	0	10.28764635	4.529375623	0	0	0	0	0.169466014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.549																																																																																				0			9.4314	0.333307993	7.369457932	0	1.686636116	1.921174478	1.142167739	1.034180262	5.006579908	0	5.343201787	0	0	0	4.691251576	16.02114712	1.729503085	1.85244937	0	0	10.28764635	4.529375623	0	0	0	0	0.169466014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.549
H3307_011_0	2008	11																																D	D	D	V	T	O	O	V	V	O	O	O	O	O	V	V	Coin	V	P	P	S	O	T	V	P	Coin	P	P	O	O	O											29.5389	0.4079	2.2562	0.5779	0.5335	0.7652	0.3717		2.7482				0.1301								6.3753																					43.7049									273.4199151							3977.378582	6128.647375	4.729640304	2212.577371				2255.266489					79.96910999															"$0 (1a, 1a1)"	$0 (1b)	"$0 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$0 (10a)	$0 (11a)	"$0 (11b, 11c)"	"$50 (4a, 4a1); $30/$30/$10 (4b)"	$0 (9b)	$0/$0 (8a1); $0 (8a2)	"$0 (8b1, 8b2, 8b3)"	$0 (incl in h5)	$0 (12)	"$0 (3, 5, 9d, 9a); $30/$30 (9c)"	"$10/$30/$30 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1); $0/$10/$30 (14f)"	"$30 (7b, 7d, 7f, 7g); $0 n/c (7b1); $0( 7f1)"	"50%/50% (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		"$0 (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c; $0 (16)	$0 (17a1)	$0; $0 n/c (17b)	$30/$0 (18a1); $0 (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a3, 14a6, 14a7); $0 n/c (14a2, 14a4, 14a5, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"																		42.851							10	29.9156	0.5	12				30					30															0	0	0	0	0	0	0	0.97636086	0	0	0	0	0	0	3.314482151	15.27852168	2.364820152	2.212577371	0	0	0	5.638166222	0	0	0	0	0.199922775	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9849	2050	0	29.5389	0.407937254	2.256156134	0.577883747	0.53350848	0.765176065	0.371744071	0.97636086	2.748237405	0	0	0	0.130067381	0	3.314482151	15.27852168	2.364820152	2.212577371	0	0	6.375286944	5.638166222	0	0	0	0	0.199922775	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.6898																																																																																				0			29.5389	0.407937254	2.256156134	0.577883747	0.53350848	0.765176065	0.371744071	0.97636086	2.748237405	0	0	0	0.130067381	0	3.314482151	15.27852168	2.364820152	2.212577371	0	0	6.375286944	5.638166222	0	0	0	0	0.199922775	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.6898
H3307_012_0	2008	9																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	O	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1869.268741	46.03914515	897.2222299		6.950532761	8.333022825	5.230967177	333.8471546	213.5252766		35.30902748				3287.027829	5257.26329	2.518557274	1625.525916			35.94385432	1653.028282					33.57868854															$130 (1a); $0 (1a1)	$130 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $30/$30/$15 (4b)"	$300 (9b)	$0/$0 (8a1); $0 (8a2)	"20% (8b1, 8b2); $0 (8b3)"	$300 (incl in h5)	$0 (12)	"$0 (3, 5, 9d); $30/$30 (9c); $300 (9a)"	"$15/$30/$30 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1); $0/$15/$30 (14f)"	"$30 (7b, 7f, 7g); $0 n/c (7b1); $30/$250/$200 (7d); $0( 7f1)"	"50%/50% (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c; $0 (16)	$0 (17a1)	$0; $0 n/c (17b)	$30/$0 (18a1); $0 (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a3, 14a6, 14a7); $0 n/c (14a2, 14a4, 14a5, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											88.6104	93.5539	87.3197		0.2	0.2	0.2	44.8504	300		0.126612091				15	35.0795	0.5	12			0.2	30					30															13.8031	0.35892862	6.528766924	0	1.390106552	1.666604565	1.046193435	1.24776609	5.338131914	0	4.470549801	0	0	0	4.108784786	15.36849788	1.259278637	1.625525916	0	0	7.188770864	4.132570706	0	0	0	0	0.083946721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.6175	0	0	13.8031	0.35892862	6.528766924	0	1.390106552	1.666604565	1.046193435	1.24776609	5.338131914	0	4.470549801	0	0	0	4.108784786	15.36849788	1.259278637	1.625525916	0	0	7.188770864	4.132570706	0	0	0	0	0.083946721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.6175																																																																																				0			13.8031	0.35892862	6.528766924	0	1.390106552	1.666604565	1.046193435	1.24776609	5.338131914	0	4.470549801	0	0	0	4.108784786	15.36849788	1.259278637	1.625525916	0	0	7.188770864	4.132570706	0	0	0	0	0.083946721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.6175
H3307_013_0	2008	11																																D	D	D	V	T	O	O	V	V	O	O	O	O	O	V	V	Coin	V	P	P	S	O	T	V	P	Coin	P	P	O	O	O											33.4398	0.7335	2.4143	0.7515	0.7567	0.9595	0.3038		3.2535				0.1118								5.0913																					47.8156									307.748378							3324.995907	5269.888413	3.537099433	1769.867338				1804.914514					31.65629133															"$0 (1a, 1a1)"	$0 (1b)	"$0 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$0 (10a)	$0 (11a)	"$0 (11b, 11c)"	"$50 (4a, 4a1); $22/$22/$10 (4b)"	$0 (9b)	$0/$0 (8a1); $0 (8a2)	"$0 (8b1, 8b2, 8b3)"	$0 (incl in h5)	$0 (12)	"$0 (3, 5, 9d, 9a); $22/$22 (9c)"	"$10/$22/$22 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1); $0/$10/$22 (14f)"	"$22 (7b, 7d, 7f, 7g); $0 n/c (7b1); $0( 7f1)"	"50%/50% (7e, 7h)"	"$22 (7c, 7i)"	$0 (incl in h2)		"$0 (15, 15a1)"	"$0 (13a, 17b, 13a1); $22 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c; $0 (16)	$0 (17a1)	$0; $0 n/c (17b)	$22/$0 (18a1); $0 (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a3, 14a6, 14a7); $0 n/c (14a2, 14a4, 14a5, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"																		42.3695							10	22	0.5	8.8				22					22															0	0	0	0	0	0	0	1.086595165	0	0	0	0	0	0	2.770829922	9.66146209	1.768549717	1.297902715	0	0	0	3.309009943	0	0	0	0	0.058036534	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.9524	2400	0	33.4398	0.733500904	2.414269913	0.751458543	0.756736136	0.959507017	0.303821166	1.086595165	3.253467489	0	0	0	0.111774831	0	2.770829922	9.66146209	1.768549717	1.297902715	0	0	5.091298276	3.309009943	0	0	0	0	0.058036534	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.768																																																																																				0			33.4398	0.733500904	2.414269913	0.751458543	0.756736136	0.959507017	0.303821166	1.086595165	3.253467489	0	0	0	0.111774831	0	2.770829922	9.66146209	1.768549717	1.297902715	0	0	5.091298276	3.309009943	0	0	0	0	0.058036534	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.768
H3307_015_0	2008	9																																D	D	D	V	T	O	O	V	V	O	O	O	O	O	V	V	Coin	V	P	P	S	O	T	V	P	Coin	P	P	O	O	O																																																				0									156.9537402								5383.052525	0.527182558	5982.983814				5748.986986					107.6391112				140											"$0 (1a, 1a1)"	$0 (1b)	"$0 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$0 (10a)	$0 (11a)	"$0 (11b, 11c)"	"$50 (4a, 4a1); $5/$5 (4b)"	$0 (9b)	$0/$0 (8a1); $0 (8a2)	"$0 (8b1, 8b2, 8b3)"	$0 (incl in h5)	$0 (12)	"$0 (3, 5, 9d, 9a); $5/$5 (9c)"	"$0/$5/$5 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1)"	"$5 (7b, 7f, 7g); $0 n/c (7b1); $5/$0/$0 (7d); $0( 7f1)"	"50%/50% (7e, 7h)"	"$5 (7c, 7i)"	$0 (incl in h2)		"$0 (15, 15a1)"	"$0 (13a, 17b, 13a1); $5 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c; $0 (16)	$0 (17a1)	$0; $0 n/c (17b)	$5/$0 (18a1); $0 (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a3, 14a6, 14a7); $0 n/c (14a2, 14a4, 14a5, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"																		24.8315								4.8635	0.5	2				5					5				4.7533											0	0	0	0	0	0	0	0.324783305	0	0	0	0	0	0	0	2.181705629	0.263591279	0.997163969	0	0	0	2.395411244	0	0	0	0	0.04484963	0	0	0	0.05545566	0	0	0	0	0	0	0	0	0	0	6.263	0	0	0	0	0	0	0	0	0	0.324783305	0	0	0	0	0	0	0	2.181705629	0.263591279	0.997163969	0	0	0	2.395411244	0	0	0	0	0.04484963	0	0	0	0.05545566	0	0	0	0	0	0	0	0	0	0	6.263																																																																																				0			0	0	0	0	0	0	0	0.324783305	0	0	0	0	0	0	0	2.181705629	0.263591279	0.997163969	0	0	0	2.395411244	0	0	0	0	0.04484963	0	0	0	0.05545566	0	0	0	0	0	0	0	0	0	0	6.263
H3307_018_0	2008	8																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1947.464361	48.22227598	1180.737578			9.804008807	8.306991417	306.1759624	290.1275701		56.47194796				4664.286441	7109.261325	2.901918971	2897.922767			62.35679453	2916.457207					93.7219768															$80 (1a); $0 (1a1)	$80 (1b)	"$75 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$0 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $20/$20 (4b)"	$100 (9b)	$0/$0 (8a1); $0 (8a2)	"$0 (8b1, 8b3); 20% (8b2)"	$100 (incl in h5)	$0 (12)	"$0 (3, 5, 9d); $20/$20 (9c); $100 (9a)"	"$10/$20/$20 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1)"	"$20 (7b, 7f, 7g); $0 n/c (7b1); $20/$0/$0 (7d); $0( 7f1)"	"50%/50% (7e, 7h)"	"$20 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c; $0 (16)	$0 (17a1)	$0; $0 n/c (17b)	$20/$0 (18a1); $0 (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a3, 14a6, 14a7); $0 n/c (14a2, 14a4, 14a5, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											50.3423	53.1638	47.4182			0.2	0.2	38.5368	100		0.135701048				10	19.4642	0.5	8			0.2	20					20															8.17	0.21363976	4.665701967	0	0	1.960801761	1.661398283	0.983252496	2.417729751	0	7.663302539	0	0	0	3.886905367	11.53132174	1.450959486	1.931948511	0	0	12.47135891	4.860762012	0	0	0	0	0.156203295	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.0253	0	0	8.17	0.21363976	4.665701967	0	0	1.960801761	1.661398283	0.983252496	2.417729751	0	7.663302539	0	0	0	3.886905367	11.53132174	1.450959486	1.931948511	0	0	12.47135891	4.860762012	0	0	0	0	0.156203295	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.0253																																																																																				0			8.17	0.21363976	4.665701967	0	0	1.960801761	1.661398283	0.983252496	2.417729751	0	7.663302539	0	0	0	3.886905367	11.53132174	1.450959486	1.931948511	0	0	12.47135891	4.860762012	0	0	0	0	0.156203295	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.0253
H3307_019_0	2008	7																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1856.675534	35.66199224	973.6508683			7.561475487	7.957505222	303.0203476	271.3821554		48.6175803				4270.409598	6568.224615	2.251333634	2560.166392			46.34337536	2542.572007					23.24575593															$80 (1a); $0 (1a1)	$80 (1b)	"$75 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$0 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $20/$20 (4b)"	$100 (9b)	$0/$0 (8a1); $0 (8a2)	"$0 (8b1, 8b3); 20% (8b2)"	$100 (incl in h5)	$0 (12)	"$0 (3, 5, 9d); $20/$20 (9c); $100 (9a)"	"$10/$20/$20 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1)"	"$20 (7b, 7f, 7g); $0 n/c (7b1); $20/$0/$0 (7d); $0( 7f1)"	"50%/50% (7e, 7h)"	"$20 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c; $0 (16)	$0 (17a1)	$0; $0 n/c (17b)	$20/$0 (18a1); $0 (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a3, 14a6, 14a7); $0 n/c (14a2, 14a4, 14a5, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											50.3423	53.1638	47.4182			0.2	0.2	39.6159	100		0.135701048				10	19.4665	0.5	8			0.2	20					20															7.7891	0.157993776	3.847395776	0	0	1.512295097	1.591501044	1.000369903	2.261517962	0	6.597456614	0	0	0	3.558674665	10.65502877	1.125666817	1.706777594	0	0	9.268675072	4.237620011	0	0	0	0	0.038742927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3488	0	0	7.7891	0.157993776	3.847395776	0	0	1.512295097	1.591501044	1.000369903	2.261517962	0	6.597456614	0	0	0	3.558674665	10.65502877	1.125666817	1.706777594	0	0	9.268675072	4.237620011	0	0	0	0	0.038742927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3488																																																																																				0			7.7891	0.157993776	3.847395776	0	0	1.512295097	1.591501044	1.000369903	2.261517962	0	6.597456614	0	0	0	3.558674665	10.65502877	1.125666817	1.706777594	0	0	9.268675072	4.237620011	0	0	0	0	0.038742927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3488
H3307_020_0	2008	7																					0											D	D	D	V	T	P	P	V	P	V	V	V	V	V	V	V	V	V		V	S	V			V	P	V	P																																																							0	0								362.9828299						3.310617891		3266.810112	1089.451587	5264.491271				419.5470367																				(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)0	"(11b,c)0"	"(4a)$50/visit, (4b)20%"	(9b)0	(8a)0	(8b)0	(9a)0	(12)0	"(3,5,9a,9d)0, (9c)$20/visit"	"(7a,14b,c,d,e,f,g,h,i,j) 0"	"(7b,d)$10, (7f)$0/$10 visit"	"(7e,h)$20/visit"	"(7c,i)$10 visit"		(7g)$10 visit	(15) 0	"(13a,14a,17b)0, (16b, 17a,18a)$10/visit"			(17a)0	(17b)0	(18a)0	(18b)0																					36						20		10	20	10				10																				0	0	0	0	0	0	0	1.08894849	0	0	0	0	0	0.005517696	0	2.72234176	1.815752646	4.387076059	0	0	0	0.349622531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.3693	0	0	0	0	0	0	0	0	0	1.08894849	0	0	0	0	0	0.005517696	0	2.72234176	1.815752646	4.387076059	0	0	0	0.349622531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.3693																																																																																				0	0	0	0	0	0	0	0	0	0	1.08894849	0	0	0	0	0	0.005517696	0	2.72234176	1.815752646	4.387076059	0	0	0	0.349622531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.3693
H3307_021_0	2008	7																																D	D	D	V	T	Coin	Coin	V	V	O	O	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0				1404.311541		303.3961032	9.68271937	5.756525406	293.1489517	201.0626534				3.230075772		3767.983361	5991.220082	3.486678218	2066.493785			51.84973761	2021.092015																				"$0 (1a, 1a1)"	$0 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	10% (11a)	10% (11b); $0 (11c)	"$50 (4a, 4a1); $20/$20/$5 (4b)"	$100 (9b)	$0/$0 (8a1); $0 (8a2)	"$0 (8b1, 8b2, 8b3)"	$100 (incl in h5)	10% (12)	"$0 (3, 5, 9d); $20/$20 (9c); $100 (9a)"	"$5/$20/$20 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1); $0/$5/$20 (14f)"	"$20 (7b, 7f, 7g); $0 n/c (7b1); $20/$0/$0 (7d); $0( 7f1)"	"50%/50% (7e, 7h)"	"$20 (7c, 7i)"	$0 (incl in h2)		"10% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$0 n/c (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a3, 14a6, 14a7); $0 n/c (14a2, 14a4, 14a5, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"													69.5467		75	0.1	0.1	40.1496	100				0.1		5	19.4498	0.5	8			0.1	20																				0	0	8.138764747	0	1.896225645	0.968271937	0.575652541	0.980817734	1.675522112	0	0	0	0.323007577	0	1.569993067	9.710689243	1.743339109	1.377662523	0	0	5.184973761	3.368486692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5134	0	0	0	0	8.138764747	0	1.896225645	0.968271937	0.575652541	0.980817734	1.675522112	0	0	0	0.323007577	0	1.569993067	9.710689243	1.743339109	1.377662523	0	0	5.184973761	3.368486692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5134																																																																																				0			0	0	8.138764747	0	1.896225645	0.968271937	0.575652541	0.980817734	1.675522112	0	0	0	0.323007577	0	1.569993067	9.710689243	1.743339109	1.377662523	0	0	5.184973761	3.368486692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5134
H3307_802_0	2008	11																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2218.195595	74.61028632	1447.241573		8.598402312	9.794069342	5.822724675	302.0983346	207.2091713		52.2188542		3.267221209		4014.171223	6174.372651	3.52677455	2129.666835			52.44600263	2082.877126			144																	225 (1a); $0 (1a1)	225 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a8); $0 (14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"											141.5878	149.5231	159.1696		0.3	0.3	0.3	46.7164	300		0.22181614		0.3		20	39.8314	0.475487305	16			0.3	39.716			40																	26.1724	0.929663146	19.19640058	0	2.579520694	2.938220803	1.746817402	1.176078887	5.180229282	0	11.58298466	0	0.980166363	0	6.690285372	20.49447493	1.676936526	2.83955578	0	0	15.73380079	6.893622021	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.2912	0	0	26.1724	0.929663146	19.19640058	0	2.579520694	2.938220803	1.746817402	1.176078887	5.180229282	0	11.58298466	0	0.980166363	0	6.690285372	20.49447493	1.676936526	2.83955578	0	0	15.73380079	6.893622021	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.2912																																																																																				0			26.1724	0.929663146	19.19640058	0	2.579520694	2.938220803	1.746817402	1.176078887	5.180229282	0	11.58298466	0	0.980166363	0	6.690285372	20.49447493	1.676936526	2.83955578	0	0	15.73380079	6.893622021	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.2912
H3307_804_0	2008	10																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2235.988484	75.20876039	1458.850382		8.736896872	9.951822524	5.916511365	304.5183578	208.8712654		53.05994385		3.319846377		4045.319439	6223.89936	3.583580346	2146.749605			53.29075097	2099.58458			144																	225 (1a); $0 (1a1)	225 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a8); $0 (14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"											141.5878	149.5231	159.1696		0.3	0.3	0.3	46.7164	300		0.22181614		0.3		20	39.8408	0.471703612	16			0.3	39.7542			40																	26.3824	0.937120285	19.35038133	0	2.621069062	2.985546757	1.774953409	1.185499241	5.221781635	0	11.76955192	0	0.995953913	0	6.742199065	20.6637575	1.690387795	2.862332807	0	0	15.98722529	6.955611476	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.6058	0	0	26.3824	0.937120285	19.35038133	0	2.621069062	2.985546757	1.774953409	1.185499241	5.221781635	0	11.76955192	0	0.995953913	0	6.742199065	20.6637575	1.690387795	2.862332807	0	0	15.98722529	6.955611476	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.6058																																																																																				0			26.3824	0.937120285	19.35038133	0	2.621069062	2.985546757	1.774953409	1.185499241	5.221781635	0	11.76955192	0	0.995953913	0	6.742199065	20.6637575	1.690387795	2.862332807	0	0	15.98722529	6.955611476	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.6058
H3312_002_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		2181.273449		989.6084633	436.1118561	200.481611	9.098528058		189.7014137	283.2892333	1332.44782	3735.727001	0	0	366.5564115	5714.357486	6909.486043	0	485.5641206	0	0	237.0912968				932.3709502		76.59554978															75/d 10		$0 days 1-15; $100 16+	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$150 per procedure	$20 per visit	"$20 X-ray; $125 PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$10 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit															61.47		51.41	20	100	0.2		48.05	150	20	38.9	20	20	20	10	20	20	20	20	20	45				0		0															11.1736	0	4.239647592	0.726853093	1.670680092	1.819705612	0	0.759596077	3.541115416	2.220746366	12.10998169	0	0	0.610927352	4.761964571	11.51581007	0	0.809273534	0	0	0.889092363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.849			11.1736	0	4.239647592	0.726853093	1.670680092	1.819705612	0	0.759596077	3.541115416	2.220746366	12.10998169	0	0	0.610927352	4.761964571	11.51581007	0	0.809273534	0	0	0.889092363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.849		0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0	0	0	11.1736	0	4.239647592	0.726853093	1.670680092	1.819705612	0	0.759596077	3.541115416	2.220746366	12.10998169	0	0	0.610927352	4.761964571	11.51581007	0	0.809273534	0	0	0.889092363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.849
H3312_018_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1815.176595		1386.902259	680.1377448	193.0961285	8.805676838		282.476477	272.8532254	1245.55516	4775.859028	0	0	559.8021808	4709.826823	6847.021579	0	491.9127798	0	0	228.357161				927.4470696		88.97961404															$200/d 10		"$0 days 1-8, $75 days 9-15; $100 16+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$100 per procedure	$35 per visit	"$35 X-ray; $125 PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$20 per visit	"$35 per visit Specialist, $30 Renal Dialysis"	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															163.93		65.64	20	100	0.2		48.05	100	35	51.2	35	30	35	20	34.57	35	35	35	35	45				0		0															24.7968	0	7.586355355	1.133562908	1.609134404	1.761135368	0	1.131082893	2.273776879	3.632869217	20.37699852	0	0	1.632756361	7.849711372	19.725128	0	1.434745608	0	0	0.856339354	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.8004			24.7968	0	7.586355355	1.133562908	1.609134404	1.761135368	0	1.131082893	2.273776879	3.632869217	20.37699852	0	0	1.632756361	7.849711372	19.725128	0	1.434745608	0	0	0.856339354	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.8004																																																																																				0			24.7968	0	7.586355355	1.133562908	1.609134404	1.761135368	0	1.131082893	2.273776879	3.632869217	20.37699852	0	0	1.632756361	7.849711372	19.725128	0	1.434745608	0	0	0.856339354	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.8004
H3312_025_0	2008	5																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		2117.108271		1323.525515	714.6887962	206.2266981	9.005644418		239.9859754	291.4072906	1319.067011	4341.2413	0	0	447.4372374	5513.064879	7467.045947	0	632.745525	0	0	243.8854863				1020.046909		93.46052624															$150/d 10		$0 days 1-15; $100 16+	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$20 per visit	"$20 X-ray; $125 PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$10 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit															122.95		51.41	20	100	0.2		48.05	200	20	38.9	20	20	20	10	20	20	20	20	20	45				0		0															21.6915	0	5.670203895	1.191147994	1.718555817	1.801128884	0	0.960943843	4.856788177	2.198445019	14.07285721	0	0	0.745728729	4.594220732	12.44507658	0	1.054575875	0	0	0.914570574	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9158			21.6915	0	5.670203895	1.191147994	1.718555817	1.801128884	0	0.960943843	4.856788177	2.198445019	14.07285721	0	0	0.745728729	4.594220732	12.44507658	0	1.054575875	0	0	0.914570574	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9158		0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0	0		21.6915	0	5.670203895	1.191147994	1.718555817	1.801128884	0	0.960943843	4.856788177	2.198445019	14.07285721	0	0	0.745728729	4.594220732	12.44507658	0	1.054575875	0	0	0.914570574	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9158
H3312_028_0	2008	6																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		2245.535804		1018.763254	448.9601192	206.3879867	9.366579203		195.2901947	291.635199	1371.702978	3845.785011	0	0	377.3555061	5882.707801	7005.840228	0	499.8692937	0	0	244.0762281				959.8394703		78.8521263															0		$0 days 1-15; $100 16+	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$100 per procedure	$20 per visit	"$20 X-ray; $125 PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$0 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit															0		51.41	20	100	0.2		48.05	100	20	38.9	20	20	20	0	20	20	20	20	20	45				0		0															0	0	4.364551574	0.748266865	1.719899889	1.873315841	0	0.781974488	2.430293325	2.28617163	12.46675308	0	0	0.628925844	0	11.67640038	0	0.833115489	0	0	0.915285855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.725			0	0	4.364551574	0.748266865	1.719899889	1.873315841	0	0.781974488	2.430293325	2.28617163	12.46675308	0	0	0.628925844	0	11.67640038	0	0.833115489	0	0	0.915285855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.725		0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0	0	0	0	0	4.364551574	0.748266865	1.719899889	1.873315841	0	0.781974488	2.430293325	2.28617163	12.46675308	0	0	0.628925844	0	11.67640038	0	0.833115489	0	0	0.915285855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.725
H3312_036_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		2270.485317		1030.082444	453.9483881	208.6811053	9.470648615		197.4600088	294.8754752	1386.943582	3888.514441	0	0	381.5481964	5948.068903	7192.077005	0	505.4232	0	0	246.78809				970.5039751		79.72822997															0		$0 days 1-15; $100 16+	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$0 per procedure	$10 per visit	"$10 X-ray; $100 PET, MRI"	$10 per visit	$10 per visit	$10 per visit	$0 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script				$0 per visit		$0 per visit															0		51.41	20	100	0.2		48.05	0	10	26.2	10	10	10	0	10	10	10	10	10	45				0		0															0	0	4.413044872	0.756580647	1.739009211	1.894129723	0	0.790662785	0	1.155786318	8.489923196	0	0	0.31795683	0	5.993397504	0	0.421186	0	0	0.925455338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.8971			0	0	4.413044872	0.756580647	1.739009211	1.894129723	0	0.790662785	0	1.155786318	8.489923196	0	0	0.31795683	0	5.993397504	0	0.421186	0	0	0.925455338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.8971		0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0	0	0	0	0	4.413044872	0.756580647	1.739009211	1.894129723	0	0.790662785	0	1.155786318	8.489923196	0	0	0.31795683	0	5.993397504	0	0.421186	0	0	0.925455338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.8971
H3312_037_0	2008	5																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		2197.433321		996.939936	439.3427724	201.9668706	9.165934121		191.1068086	285.3879696	1342.319203	3763.402977	0	0	369.2720292	5756.692063	6960.67468	0	489.161402	0	0	238.8477777				939.2783811		77.16300468															0		$0 days 1-15; $100 16+	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$150 per procedure	$20 per visit	"$20 X-ray; $125 PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$10 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit															0		51.41	20	100	0.2		48.05	150	20	38.9	20	20	20	10	20	20	20	20	20	45				0		0															0	0	4.271056842	0.732237954	1.683057255	1.833186824	0	0.765223513	3.56734962	2.237198672	12.19969798	0	0	0.615453382	4.797243385	11.60112447	0	0.815269003	0	0	0.895679166	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0138			0	0	4.271056842	0.732237954	1.683057255	1.833186824	0	0.765223513	3.56734962	2.237198672	12.19969798	0	0	0.615453382	4.797243385	11.60112447	0	0.815269003	0	0	0.895679166	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0138		0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0	0	0	0	0	4.271056842	0.732237954	1.683057255	1.833186824	0	0.765223513	3.56734962	2.237198672	12.19969798	0	0	0.615453382	4.797243385	11.60112447	0	0.815269003	0	0	0.895679166	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0138
H3312_040_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1787.68036		1365.893509	669.8350407	190.1711147	8.672288736		278.1975327	268.7200538	1226.687532	4703.514474	0	0	551.3223159	4638.482522	6804.839444	0	484.4613013	0	0	224.8980142				913.3981321		87.63175378															$200/d 10		"$0 days 1-8, $75 days 9-15; $100 16+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$35 per visit	"$35 X-ray; $100 PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$25 per visit	"$35 per visit Specialist, $30 Renal Dialysis"	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															163.93		65.64	20	100	0.2		48.05	200	35	46.7	35	30	35	25	34.55	35	35	35	35	45				0		0															24.4212	0	7.471437495	1.116391735	1.58475929	1.734457747	0	1.113949287	4.478667563	3.577838634	18.30451049	0	0	1.608023421	9.663505254	19.5922669	0	1.413012129	0	0	0.843367553	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.9234			24.4212	0	7.471437495	1.116391735	1.58475929	1.734457747	0	1.113949287	4.478667563	3.577838634	18.30451049	0	0	1.608023421	9.663505254	19.5922669	0	1.413012129	0	0	0.843367553	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.9234																																																																																				0			24.4212	0	7.471437495	1.116391735	1.58475929	1.734457747	0	1.113949287	4.478667563	3.577838634	18.30451049	0	0	1.608023421	9.663505254	19.5922669	0	1.413012129	0	0	0.843367553	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.9234
H3312_043_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		2055.25135		1284.855214	693.8072715	200.2012393	8.742520682		232.9741499	282.8930554	1280.526978	4214.400446	0	0	434.3641744	5351.986097	7248.876437	0	614.2581899	0	0	236.7597264				990.2435385		90.72982962															$200/d 10		"$0 days 1-8, $75 days 9-15; $100 16+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$250 per procedure	$25 per visit	"$25 X-ray; $125 PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$15 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit															163.93		65.64	20	100	0.2		48.05	250	25	43	25	25	25	15	25	25	25	25	25	45				0		0															28.0764	0	7.028158023	1.156345453	1.668343661	1.748504136	0	0.932867325	5.893605321	2.667764537	15.1016016	0	0	0.904925363	6.689982622	15.10182591	0	1.279704562	0	0	0.887848974	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.1379			28.0764	0	7.028158023	1.156345453	1.668343661	1.748504136	0	0.932867325	5.893605321	2.667764537	15.1016016	0	0	0.904925363	6.689982622	15.10182591	0	1.279704562	0	0	0.887848974	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.1379		0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0	0		28.0764	0	7.028158023	1.156345453	1.668343661	1.748504136	0	0.932867325	5.893605321	2.667764537	15.1016016	0	0	0.904925363	6.689982622	15.10182591	0	1.279704562	0	0	0.887848974	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.1379
H3312_044_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		2107.686019		1317.635126	711.5080526	205.3088801	8.965564533		238.9179107	290.1103739	1313.196465	4321.920477	0	0	445.4459048	5488.528821	7366.589488	0	629.9294724	0	0	242.8000668				1015.50716		93.04457742															0		$0 days 1-15; $100 16+	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$175 per procedure	$25 per visit	"$25 X-ray; $125 PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit															0		51.41	20	100	0.2		48.05	175	25	43	25	25	25	10	25	25	25	25	25	45				0		0															0	0	5.644968485	1.185846754	1.710907334	1.793112907	0	0.956667134	4.230776286	2.735825968	15.48688171	0	0	0.928012302	4.573774018	15.34706143	0	1.312353068	0	0	0.91050025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.8167			0	0	5.644968485	1.185846754	1.710907334	1.793112907	0	0.956667134	4.230776286	2.735825968	15.48688171	0	0	0.928012302	4.573774018	15.34706143	0	1.312353068	0	0	0.91050025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.8167		0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0	0		0	0	5.644968485	1.185846754	1.710907334	1.793112907	0	0.956667134	4.230776286	2.735825968	15.48688171	0	0	0.928012302	4.573774018	15.34706143	0	1.312353068	0	0	0.91050025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.8167
H3312_048_0	2008	3																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V			O																																																					0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7299.926107	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961				0		0															250/stay	250/stay	"$0 days 1-8, $75 days 9-15; $100 16+"	$0 per visit	$150 per trip	20% coinsurance	20% coinsurance	$50 ER; $50 UC	$225 per procedure	$0 per visit	"$25 X-ray; $125 PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$15 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit															42.27	42.27	65.64	0	150	0.2	0.2	50	225	0	43	25	25	25	15	25	25	25	25	25	45				0		0															5.592	0.108939204	7.093087398	0	2.936431883	3.143561179	0.200659672	1.775280607	6.58165564	0	4.109905796	0	0	0	6.920434651	15.20817939	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3553			5.592	0.108939204	7.093087398	0	2.936431883	3.143561179	0.200659672	1.775280607	6.58165564	0	4.109905796	0	0	0	6.920434651	15.20817939	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3553																																																																																				0	0	0	5.592	0.108939204	7.093087398	0	2.936431883	3.143561179	0.200659672	1.775280607	6.58165564	0	4.109905796	0	0	0	6.920434651	15.20817939	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3553
H3312_050_0	2008	5																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V			O																																																					0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7299.926107	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961				0		0															0	0	"$0 days 1-8, $75 days 9-15; $100 16+"	$0 per visit	$150 per trip	20% coinsurance	20% coinsurance	$50 ER; $50 UC	$225 per procedure	$0 per visit	"$10 X-ray; $125 PET, MRI"	$10 per visit	$10 per visit	$10 per visit	$0 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script				$0 per visit		$0 per visit															0	0	65.64	0	150	0.2	0.2	50	225	0	30.7	10	10	10	0	10	10	10	10	10	45				0		0															0	0	7.093087398	0	2.936431883	3.143561179	0.200659672	1.775280607	6.58165564	0	2.93428158	0	0	0	0	6.083271756	0.168059705	0.486246428	0.797468223	1.20532567	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.4478			0	0	7.093087398	0	2.936431883	3.143561179	0.200659672	1.775280607	6.58165564	0	2.93428158	0	0	0	0	6.083271756	0.168059705	0.486246428	0.797468223	1.20532567	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.4478																																																																																				0	0	0	0	0	7.093087398	0	2.936431883	3.143561179	0.200659672	1.775280607	6.58165564	0	2.93428158	0	0	0	0	6.083271756	0.168059705	0.486246428	0.797468223	1.20532567	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.4478
H3312_052_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1840.496702		1406.248318	689.6250645	195.7896486	8.928508237		286.4167739	276.6592865	1262.929552	4842.478036	0	0	567.6109259	4775.52474	6942.531471	0	498.7745278	0	0	231.5425413				940.3841355		90.22080091															$100/d 10		"$0 days 1-8, $75 days 9-15; $100 16+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$225 per procedure	$25 per visit	"$25 X-ray; $125 PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit															81.96		65.64	20	100	0.2		48.05	225	25	43	25	25	25	10	25	25	25	25	25	45				0		0															12.5706	0	7.692178299	1.149375107	1.631580405	1.785701647	0	1.146860499	5.187361621	2.631103234	17.35221296	0	0	1.182522762	3.97960395	14.46360723	0	1.0391136	0	0	0.86828453	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.6801			12.5706	0	7.692178299	1.149375107	1.631580405	1.785701647	0	1.146860499	5.187361621	2.631103234	17.35221296	0	0	1.182522762	3.97960395	14.46360723	0	1.0391136	0	0	0.86828453	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.6801																																																																																				0			12.5706	0	7.692178299	1.149375107	1.631580405	1.785701647	0	1.146860499	5.187361621	2.631103234	17.35221296	0	0	1.182522762	3.97960395	14.46360723	0	1.0391136	0	0	0.86828453	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.6801
H3312_053_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		2066.992233		1292.195112	697.7707331	201.3449141	8.792463435		234.3050442	284.5091177	1287.84215	4238.47574	0	0	436.8455345	5382.559994	7290.286559	0	617.7672173	0	0	238.1122462				995.9004297		91.24813522															$150/d 10		$0 days 1-15; $100 16+	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$250 per procedure	$25 per visit	"$25 X-ray; $100 PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$15 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit															122.95		51.41	20	100	0.2		48.05	250	25	38.5	25	25	25	15	25	25	25	25	25	45				0		0															21.1781	0	5.535979226	1.162951222	1.677874285	1.758492687	0	0.938196448	5.927273285	2.683004478	13.598443	0	0	0.910094864	6.728199992	15.188097	0	1.287015036	0	0	0.892920923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4666			21.1781	0	5.535979226	1.162951222	1.677874285	1.758492687	0	0.938196448	5.927273285	2.683004478	13.598443	0	0	0.910094864	6.728199992	15.188097	0	1.287015036	0	0	0.892920923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4666		0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0	0		21.1781	0	5.535979226	1.162951222	1.677874285	1.758492687	0	0.938196448	5.927273285	2.683004478	13.598443	0	0	0.910094864	6.728199992	15.188097	0	1.287015036	0	0	0.892920923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4666
H3312_054_0	2008	4																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7299.926107	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961				0		0															250/stay	250/stay	"$0 days 1-8, $75 days 9-15; $100 16+"	$0 per visit	$150 per trip	20% coinsurance	20% coinsurance	$50 ER; $50 UC	$200 per procedure	$0 per visit	"$25 X-ray; $100 PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$15 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit															42.27	42.27	65.64	0	150	0.2	0.2	50	200	0	38.5	25	25	25	15	25	25	25	25	25	45				0		0															5.592	0.108939204	7.093087398	0	2.936431883	3.143561179	0.200659672	1.775280607	5.850360569	0	3.679799375	0	0	0	6.920434651	15.20817939	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.1939			5.592	0.108939204	7.093087398	0	2.936431883	3.143561179	0.200659672	1.775280607	5.850360569	0	3.679799375	0	0	0	6.920434651	15.20817939	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.1939																																																																																				0	0	0	5.592	0.108939204	7.093087398	0	2.936431883	3.143561179	0.200659672	1.775280607	5.850360569	0	3.679799375	0	0	0	6.920434651	15.20817939	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.1939
H3312_801_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1616.186925		767.1472076	609.6052747	367.3722076	7.92785795		203.2391176	287.4360722	1236.80931	4470.30347	0	0	555.0771454	5076.021668	6908.487187	0	785.9825513	0	0	7.714096297				1025.299811		96.25071941															$200 per day; max $1400		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit Specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20 % per script				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2				0		0															19.471	0	6.392893396	2.032017582	4.592152595	2.378357385	0	0.846829657	4.790601203	4.122697702	20.46653939	0	0	1.850257151	12.69005417	22.74043699	0	2.619941838	0	0	1.542819259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.5366			19.471	0	6.392893396	2.032017582	4.592152595	2.378357385	0	0.846829657	4.790601203	4.122697702	20.46653939	0	0	1.850257151	12.69005417	22.74043699	0	2.619941838	0	0	1.542819259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.5366																																																																																				0			19.471	0	6.392893396	2.032017582	4.592152595	2.378357385	0	0.846829657	4.790601203	4.122697702	20.46653939	0	0	1.850257151	12.69005417	22.74043699	0	2.619941838	0	0	1.542819259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.5366
H3312_804_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1616.430455		767.262803	609.6971313	367.427564	7.929052536		203.2697421	287.4793837	1236.995676	4470.977065	0	0	555.1607856	5076.786533	6909.528172	0	786.1009849	0	0	7.715258673				1025.454305		96.26522268															$200 per day; max $1400		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit Specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20 % per script				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2				0		0															19.4739	0	6.393856691	2.032323771	4.59284455	2.378715761	0	0.846957259	4.791323062	4.123318919	20.46962333	0	0	1.850535952	12.69196633	22.74386357	0	2.620336616	0	0	1.543051735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.5527			19.4739	0	6.393856691	2.032323771	4.59284455	2.378715761	0	0.846957259	4.791323062	4.123318919	20.46962333	0	0	1.850535952	12.69196633	22.74386357	0	2.620336616	0	0	1.543051735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.5527																																																																																				0	0		19.4739	0	6.393856691	2.032323771	4.59284455	2.378715761	0	0.846957259	4.791323062	4.123318919	20.46962333	0	0	1.850535952	12.69196633	22.74386357	0	2.620336616	0	0	1.543051735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.5527
H3327_001_0	2008	3																					0											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	V	S	V	T	V	V	V	V	V	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	551.6353459	0	0	2.2380163	0	207.3845209	0	0	0	0	0	796.5110311	0	3021.935708	112.5717917	330.8833493	0	115.9948781	0	39.49689322	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $0 copay	"1B IP Psych: $0 copay, 190-day lifetime limit"	"2 SNF: $0 copay days 1-10, $25 copay days 11-100"	6 Home Health: $0 copay	10A Ambulance: $0 copay	"11A DME:  0% coins for first $200 covered expenses, 20% coins after first $200 covered expenses"	"11B Prosthetic Medical Supplies: $0 copay, 11C Diabetes Monitoring Supplies: $0 copay"	"4A ER: $50 copay,  4B Urgent Care: $25 copay"	"9A Outpatient Hospital: $0 copay,   9B ASC Services: $0 copay"	8A OP C/D/T: $0 copay	8B OP X-Ray: $0 copay	0	12 Renal Dialysis: $0 copay	"3 CORF: $15 copay,  5  Partial Hosp:  $0 copay, 9D Cardiac Rehab: $15 copay"	"7A PCP: $0 copay, 14B Immunizations: $0 copay, 14C Routine Physical:  $0 copay,  14D Pap Smears:  $0 copay, 14D Pelvic Exams:  $0 copay, 14E Prostate Screening:  $0 copay, 14F Colorectal Screening:  $0 copay, 14G Bone Mass Measurement:  $0 copay, 14H Mammography:  $0 copay, 14I Diabetes Monitoring:  $0 copay, 14J Nutrition Therapy: $0 copay"	7D Physician Specialist: $15 copay	"7E Mental Health: $15 copay, 7H Psychiatric: $15 copay,   9C OP Substance Abuse: $15 copay"	"7C Occupational Therapy:  $15 copay, 7I Physical and Speech Therapy:  $15 copay"	7D Physician Specialist: $0 copay for radiology services	"7B Chiropractic:  $15 copay, 7F Podiatry:  $15 copay for medically necessary services, $0 copay for 4 routine exams, 7G Other Health Care:  $15 copay, 18A Medicare Covered Hearing Exams:  $0 copay"	15 Part B Drugs: $0 copay	"13A Blood: $0 copay, 17A Medicare Covered Eye Exams: $15 copay"	10B Transportation: Not Covered	"16A Preventive Dental: $0 copay, 16B Comp Dental: Not Covered"	17A Routine Eye Exams: $0 copay	17B Eye Wear:  $0 copay for eye wear	18A Routine Hearing Exams: $0 copay	18B Hearing Aids: $0 copay	Not Covered	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: Not Covered"											0	0	25	0	0	0.053	0	49.09014558	0	0	0	0	0	15	0	15	15	15	0	15	0	15	0	0	0	0	0	0	0	0	0											0	0	1.149240304	0	0	0.118614864	0	0.848378027	0	0	0	0	0	0.995638789	0	3.777419636	0.14071474	0.413604187	0	0.144993598	0	0.049371117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.638	0	0	0	0	1.149240304	0	0	0.118614864	0	0.848378027	0	0	0	0	0	0.995638789	0	3.777419636	0.14071474	0.413604187	0	0.144993598	0	0.049371117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.638	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	1.149240304	0	0	0.118614864	0	0.848378027	0	0	0	0	0	0.995638789	0	3.777419636	0.14071474	0.413604187	0	0.144993598	0	0.049371117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.638
H3327_002_0	2008	3																					0											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	V	S	O	T	V	V	V	V	V	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	243.4161838	0	0	0	0	0	934.8994547	0	0	118.6558586	410.4625513	0	137.1838004	0	46.69125048	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $0 copay	"1B IP Psych: $0 copay, 190-day lifetime limit"	"2 SNF: $0 copay, up to 100 days"	6 Home Health: $0 copay	10A Ambulance: $0 copay	11A DME: $0 copay	"11B Prosthetic Medical Supplies: $0 copay, 11C Diabetes Monitoring Supplies: $0 copay"	"4A ER: $50 copay,  4B Urgent Care: $5 copay"	"9A Outpatient Hospital: $0 copay,   9B ASC Services: $0 copay"	8A OP C/D/T: $0 copay	8B OP X-Ray: $0 copay	0	12 Renal Dialysis: $0 copay	"3 CORF: $5 copay,  5  Partial Hosp:  $0 copay, 9D Cardiac Rehab: $5 copay"	"7A PCP: $0 copay, 14B Immunizations: $0 copay, 14C Routine Physical:  $0 copay,  14D Pap Smears:  $0 copay, 14D Pelvic Exams:  $0 copay, 14E Prostate Screening:  $0 copay, 14F Colorectal Screening:  $0 copay, 14G Bone Mass Measurement:  $0 copay, 14H Mamm"	7D Physician Specialist: $0 copay	"7E Mental Health: $5 copay, 7H Psychiatric: $5 copay,   9C OP Substance Abuse: $5 copay"	"7C Occupational Therapy:  $5 copay, 7I Physical and Speech Therapy:  $5 copay"	7D Physician Specialist: $0 copay for radiology services	"7B Chiropractic:  $5 copay, 7F Podiatry:  $5 copay for medically necessary services, $0 copay for 4 routine exams, 7G Other Health Care:  $5 copay, 18A Medicare Covered Hearing Exams:  $0 copay"	15 Part B Drugs: $0 copay	"13A Blood: $0 copay, 17A Medicare Covered Eye Exams: $5 copay"	10B Transportation: $0 copay	"16A Preventive Dental: $0 copay, 16B Comp Dental: $0 copay"	17A Routine Eye Exams: $0 copay	17B Eye Wear:  $0 copay for eye wear	18A Routine Hearing Exams: $0 copay	18B Hearing Aids: $0 copay	Not Covered	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: $0 copay"											0	0	0	0	0	0	0	48.21308725	0	0	0	0	0	5	0	0	5	5	0	5	0	5	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.977987142	0	0	0	0	0	0.389541439	0	0	0.049439941	0.171026063	0	0.057159917	0	0.019454688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6646	0	0	0	0	0	0	0	0	0	0.977987142	0	0	0	0	0	0.389541439	0	0	0.049439941	0.171026063	0	0.057159917	0	0.019454688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6646	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0.977987142	0	0	0	0	0	0.389541439	0	0	0.049439941	0.171026063	0	0.057159917	0	0.019454688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6646
H3327_003_0	2008	3																					0											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	V	S	O	T	V	V	V	V	V	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3500	0	0	583.5928927	0	0	2.409186777	0	219.8109408	0	0	0	0	0	844.2377394	0	3201.217263	122.7963351	350.5881377	0	123.672951	0	41.87131882	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $0 copay	"1B IP Psych: $0 copay, 190-day lifetime limit"	"2 SNF: $0 copay days 1-10, $25 copay days 11-100"	6 Home Health: $0 copay	10A Ambulance: $0 copay	"11A DME:  0% coins for first $200 covered expenses, 20% coins after first $200 covered expenses"	"11B Prosthetic Medical Supplies: $0 copay, 11C Diabetes Monitoring Supplies: $0 copay"	"4A ER: $50 copay,  4B Urgent Care: $25 copay"	"9A Outpatient Hospital: $0 copay,   9B ASC Services: $0 copay"	8A OP C/D/T: $0 copay	8B OP X-Ray: $0 - $20 copay depending on the radiology service	0	12 Renal Dialysis: $0 copay	"3 CORF: $20 copay,  5  Partial Hosp:  $0 copay, 9D Cardiac Rehab: $20 copay"	"7A PCP: $0 copay, 14B Immunizations: $0 copay, 14C Routine Physical:  $0 copay,  14D Pap Smears:  $0 copay, 14D Pelvic Exams:  $0 copay, 14E Prostate Screening:  $0 copay, 14F Colorectal Screening:  $0 copay, 14G Bone Mass Measurement:  $0 copay, 14H Mamm"	7D Physician Specialist: $20 copay	"7E Mental Health: $20 copay, 7H Psychiatric: $20 copay,   9C OP Substance Abuse: $20 copay"	"7C Occupational Therapy:  $20 copay, 7I Physical and Speech Therapy:  $20 copay"	7D Physician Specialist: $0 copay for radiology services	"7B Chiropractic:  $20 copay, 7F Podiatry:  $20 copay for medically necessary services, $0 copay for 4 routine exams, 7G Other Health Care:  $20 copay, 18A Medicare Covered Hearing Exams:  $0 copay"	15 Part B Drugs: $0 copay	"13A Blood: $0 copay, 17A Medicare Covered Eye Exams: $20 copay"	10B Transportation: Not Covered	"16A Preventive Dental: $0 copay, 16B Comp Dental: Not Covered"	17A Routine Eye Exams: $0 copay	17B Eye Wear:  $0 copay for eye wear	18A Routine Hearing Exams: $0 copay	18B Hearing Aids: $0 copay	Not Covered	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: Not Covered"											0	0	25	0	0	0.053	0	49.10714286	0	0	0	0	0	20	0	20	20	20	0	20	0	20	0	0	0	0	0	0	0	0	0											0	0	1.215818526	0	0	0.127686899	0	0.899523939	0	0	0	0	0	1.407062899	0	5.335362106	0.204660558	0.584313563	0	0.206121585	0	0.069785531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.0503	0	0	0	0	1.215818526	0	0	0.127686899	0	0.899523939	0	0	0	0	0	1.407062899	0	5.335362106	0.204660558	0.584313563	0	0.206121585	0	0.069785531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.0503	0	PBP: 1A IP Acute: 15% coins	1B IP Psych: 15% coins	2 SNF: 15% coins	6 Home Health: 15% coins	10A Ambulance: 15% coins	11A DME:  15% coins	"11B Prosthetic Medical Supplies: 15% coins, 11C Diabetes Monitoring Supplies: 15% coins"	"4A ER: $50 copay,  4B Urgent Care: $25 copay"	"9A Outpatient Hospital: 15% coins,   9B ASC Services: 15% coins"	8A OP C/D/T: 15% coins	8B OP X-Ray: 15% coins	0	12 Renal Dialysis: Not Covered	"3 CORF: 15% coins,  5  Partial Hosp:  15% coins, 9D Cardiac Rehab: 15% coins"	"7A PCP: $0 copay, 14B Immunizations: 15% coins, 14C Routine Physical:  15% coins,  14D Pap Smears:  15% coins, 14D Pelvic Exams:  15% coins, 14E Prostate Screening:  15% coins, 14F Colorectal Screening:  15% coins, 14G Bone Mass Measurement:  15% coins, 14H Mammography:  15% coins, 14I Diabetes Monitoring:  15% coins, 14J Nutrition Therapy: 15% coins"	7D Physician Specialist: $30 copay	"7E Mental Health: 15% coins, 7H Psychiatric: 15% coins,   9C OP Substance Abuse: 15% coins"	"7C Occupational Therapy:  15% coins, 7I Physical and Speech Therapy:  15% coins"	7D Physician Specialist: 15% coins for radiology services	"7B Chiropractic:  15% coins, 7F Podiatry:  15% coins for medically necessary services, 15% coins for 4 routine exams, 7G Other Health Care:  15% coins, 18A Medicare Covered Hearing Exams:  15% coins"	15 Part B Drugs: Not Covered	"13A Blood: 15% coins, 17A Medicare Covered Eye Exams: 15% coins"	10B Transportation: Not Covered	"16A Preventive Dental: Not Covered, 16B Comp Dental: Not Covered"	17A Routine Eye Exams: 15% coins	17B Eye Wear:  15% coins	18A Routine Hearing Exams: 15% coins	18B Hearing Aids: 15% coins	0	14A Health Ed/Wellness: Not Covered	"13B Acupuncture: Not Covered, 13C Other1: Not Covered"											4.3593	0.0732	0.2352	0.2179	0.1365	0.0253	0.0024	0.0688	0.1269	0.0103	0.0389	0	0	0.1171	0.1853	1.6848	0.1185	0.0596	0.0117	0.413	0.0011	0.0031	0	0	0.0204	0.0103	0.0023	0.0066	0	0	0											7.9284	0	7.601625348	4.3593	0.073178132	1.451033656	0.21785498	0.136466512	0.152953739	0.002387252	0.968359109	0.126919436	0.010253174	0.038928422	0	0	1.524148362	0.185268923	7.020179389	0.323137273	0.643934933	0.011678526	0.619126372	0.001074969	0.072887447	0	0	0.020421156	0.010316472	0.002307467	0.006637868	0	0	0	0	0	0	0	0	0	0	0	0	0	17.9787
H3327_014_0	2008	3																					0											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	V	S	O	T	V	V	V	V	V	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	2.255753302	0	208.9969619	0	0	236.6097206	0	0	802.7040054	0	0	118.0847013	347.0936617	0	121.6221455	0	39.80858925	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $0 copay	"1B IP Psych: $0 copay, 190-day lifetime limit"	"2 SNF: $0 copay, up to 100 days"	6 Home Health: $0 copay	10A Ambulance: $0 copay	"11A DME:  0% coins for first $200 covered expenses, 20% coins after first $200 covered expenses"	"11B Prosthetic Medical Supplies: $0 copay, 11C Diabetes Monitoring Supplies: $0 copay"	"4A ER: $50 copay,  4B Urgent Care: $25 copay"	"9A Outpatient Hospital: $0 copay,   9B ASC Services: $0 copay"	8A OP C/D/T: $0 copay	8B OP X-Ray: $0 - $10 copay depending on the radiology service	0	12 Renal Dialysis: $0 copay	"3 CORF: $10 copay,  5  Partial Hosp:  $0 copay, 9D Cardiac Rehab: $10 copay"	"7A PCP: $0 copay, 14B Immunizations: $0 copay, 14C Routine Physical:  $0 copay,  14D Pap Smears:  $0 copay, 14D Pelvic Exams:  $0 copay, 14E Prostate Screening:  $0 copay, 14F Colorectal Screening:  $0 copay, 14G Bone Mass Measurement:  $0 copay, 14H Mamm"	7D Physician Specialist: $0 copay	"7E Mental Health: $10 copay, 7H Psychiatric: $10 copay,   9C OP Substance Abuse: $10 copay"	"7C Occupational Therapy:  $10 copay, 7I Physical and Speech Therapy:  $10 copay"	7D Physician Specialist: $0 copay for radiology services	"7B Chiropractic:  $10 copay, 7F Podiatry:  $10 copay for medically necessary services, $0 copay for 4 routine exams, 7G Other Health Care:  $10 copay, 18A Medicare Covered Hearing Exams:  $0 copay"	15 Part B Drugs: $0 copay	"13A Blood: $0 copay, 17A Medicare Covered Eye Exams: $10 copay"	10B Transportation: $0 copay	"16A Preventive Dental: $0 copay, 16B Comp Dental: $0 copay"	17A Routine Eye Exams: $0 copay	17B Eye Wear:  $0 copay for eye wear	18A Routine Hearing Exams: $0 copay	18B Hearing Aids: $0 copay	Not Covered	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: $0 copay"											0	0	0	0	0	0.053	0	49.01716501	0	0	10	0	0	10	0	0	10	10	0	10	0	10	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0.119554925	0	0.853703214	0	0	0.197174767	0	0	0.668920004	0	0	0.098403918	0.289244718	0	0.101351788	0	0.033173824	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.3615	0	0	0	0	0	0	0	0.119554925	0	0.853703214	0	0	0.197174767	0	0	0.668920004	0	0	0.098403918	0.289244718	0	0.101351788	0	0.033173824	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.3615	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0.119554925	0	0.853703214	0	0	0.197174767	0	0	0.668920004	0	0	0.098403918	0.289244718	0	0.101351788	0	0.033173824	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.3615
H3327_015_0	2008	5																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	384.03	5.03	35.89	13.75	6.26	6.61	5.1	5.53	29.2	6.14	17.64	0.69	0.12	18.6	60.6	140.85	2.72	7.02	45.07	75.11	6.68	7.32	0	0	0	0	0	0	0	1.53	0.39											Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	0	0	0	0	0	0	0	14A Health Education/Wellness Programs: $0 copay	0											0.057123817	0.057146194	0.18038016	0	0.234133622	0.234000193	0.233998151	0.234053542	0.233999976	0.234181545	0.233975136	0.233999922	0.234000006	0.233998136	0.234008765	0.234006974	0.233990766	0.233970092	0.23400245	0.233997178	0.233994919	0.234003922	0	0	0	0	0	0	0	0	0											21.9373	0.287445357	6.473843954	0	1.465676474	1.546741276	1.193390568	1.294316087	6.832799285	1.437874688	4.127321405	0.161459946	0.028080001	4.352365325	14.18093118	32.95988231	0.636454883	1.642470047	10.54649043	17.57552802	1.563086057	1.712908711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9563	138	0	21.9373	0.287445357	6.473843954	0	1.465676474	1.546741276	1.193390568	1.294316087	6.832799285	1.437874688	4.127321405	0.161459946	0.028080001	4.352365325	14.18093118	32.95988231	0.636454883	1.642470047	10.54649043	17.57552802	1.563086057	1.712908711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9563	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.9373	0.287445357	6.473843954	0	1.465676474	1.546741276	1.193390568	1.294316087	6.832799285	1.437874688	4.127321405	0.161459946	0.028080001	4.352365325	14.18093118	32.95988231	0.636454883	1.642470047	10.54649043	17.57552802	1.563086057	1.712908711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9563
H3327_021_0	2008	4																					0											D	D	D	V	T	Coin	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	865.43	18.08	361.12	0	231.54	9.93	0	253.31	0	0	282.61	0	0	61.72	0	3739.6	184.48	489.63	0	1409.47	0	599.21	0	0	0	0	0	0	0	0	0											"PBP: 1A IP Acute: $50 copay days 1-5, $500 annual max"	"1B IP Psych: $50 copay days 1-5, 190-day lifetime limit"	"2 SNF: $25 copay days 1-10, $0 copay days 11-100"	6 Home Health: $0 copay	10A Ambulance: $50 copay	"11A DME:  0% coins for first $200 covered expenses, 20% coins after first $200 covered expenses"	"11B Prosthetic Medical Supplies: $0 copay, 11C Diabetes Monitoring Supplies: $0 copay"	"4A ER: $50 copay,  4B Urgent Care: $25 copay"	"9A Outpatient Hospital: $0 copay,   9B ASC Services: $0 copay"	8A OP C/D/T: $0 copay	8B OP X-Ray: $0 - $15 copay depending on the radiology service	0	12 Renal Dialysis: $0 copay	"3 CORF: $25 copay,  5  Partial Hosp:  $0 copay, 9D Cardiac Rehab: $25 copay"	"7A PCP: $0 copay, 14B Immunizations: $0 copay, 14C Routine Physical:  $0 copay,  14D Pap Smears:  $0 copay, 14D Pelvic Exams:  $0 copay, 14E Prostate Screening:  $0 copay, 14F Colorectal Screening:  $0 copay, 14G Bone Mass Measurement:  $0 copay, 14H Mammography:  $0 copay, 14I Diabetes Monitoring:  $0 copay, 14J Nutrition Therapy: $0 copay"	7D Physician Specialist: $20 copay	"7E Mental Health: $20 copay, 7H Psychiatric: $20 copay,   9C OP Substance Abuse: $20 copay"	"7C Occupational Therapy:  $25 copay, 7I Physical and Speech Therapy:  $25 copay"	7D Physician Specialist: $0 copay	"7B Chiropractic:  $25 copay, 7F Podiatry:  $20 copay for medically necessary services, $0 copay for 4 routine exams, 7G Other Health Care:  $20 copay, 18A Medicare Covered Hearing Exams:  $0 copay"	15 Part B Drugs: $0 copay	"13A Blood: $0 copay, 17A Medicare Covered Eye Exams: $25 copay"	10B Transportation: Not Covered	"16A Preventive Dental: OPTIONAL SUPPLEMENTAL, 16B Comp Dental: Not Covered"	17A Routine Eye Exams: $0 copay	17B Eye Wear:  $0 copay for eye wear	18A Routine Hearing Exams: $0 copay	18B Hearing Aids: $0 copay	Not Covered	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: Not Covered"											50	50	25	0	50	0.099999936	0	48.58079034	0	0	15	0	0	25	0	20	20	25	0	22.37415482	0	25	0	0	0	0	0	0	0	0	0											3.606	0.075333333	0.752333333	0	0.96475	0.99299936	0	1.0255	0	0	0.3532625	0	0	0.128583333	0	6.232666667	0.307466667	1.0200625	0	2.627975	0	1.248354167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.3352	0	0	3.606	0.075333333	0.752333333	0	0.96475	0.99299936	0	1.0255	0	0	0.3532625	0	0	0.128583333	0	6.232666667	0.307466667	1.0200625	0	2.627975	0	1.248354167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.3352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.606	0.075333333	0.752333333	0	0.96475	0.99299936	0	1.0255	0	0	0.3532625	0	0	0.128583333	0	6.232666667	0.307466667	1.0200625	0	2.627975	0	1.248354167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.3352
H3327_022_0	2008	4																					0											D	D	D	V	T	Coin	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	2000	744.504	14.464	0	0	0	7.944	0	202.968	0	0	226.176	0	0	49.392	0	3043.616	152.504	413.968	0	1185.112	0	506.664	0	0	0	0	0	0	0	0	0											"PBP: 1A IP Acute: $50 copay days 1-5, $500 annual max"	"1B IP Psych: $50 copay days 1-5, 190-day lifetime limit"	"2 SNF: $0 copay, up to 100 days"	6 Home Health: $0 copay	10A Ambulance: $0 copay	"11A DME:  0% coins for first $200 covered expenses, 20% coins after first $200 covered expenses"	"11B Prosthetic Medical Supplies: $0 copay, 11C Diabetes Monitoring Supplies: $0 copay"	"4A ER: $50 copay,  4B Urgent Care: $25 copay"	"9A Outpatient Hospital: $0 copay,   9B ASC Services: $0 copay"	8A OP C/D/T: $0 copay	8B OP X-Ray: $0 - $15 copay depending on the radiology service	0	12 Renal Dialysis: $0 copay	"3 CORF: $15 copay,  5  Partial Hosp:  $0 copay, 9D Cardiac Rehab: $15 copay"	"7A PCP: $0 copay, 14B Immunizations: $0 copay, 14C Routine Physical:  $0 copay,  14D Pap Smears:  $0 copay, 14D Pelvic Exams:  $0 copay, 14E Prostate Screening:  $0 copay, 14F Colorectal Screening:  $0 copay, 14G Bone Mass Measurement:  $0 copay, 14H Mammography:  $0 copay, 14I Diabetes Monitoring:  $0 copay, 14J Nutrition Therapy: $0 copay"	7D Physician Specialist: $15 copay	"7E Mental Health: $15 copay, 7H Psychiatric: $15 copay,   9C OP Substance Abuse: $15 copay"	"7C Occupational Therapy:  $15 copay, 7I Physical and Speech Therapy:  $15 copay"	7D Physician Specialist: $0 copay	"7B Chiropractic:  $15 copay, 7F Podiatry:  $15 copay for medically necessary services, $0 copay for 4 routine exams, 7G Other Health Care:  $15 copay, 18A Medicare Covered Hearing Exams:  $0 copay"	15 Part B Drugs: $0 copay	"13A Blood: $0 copay, 17A Medicare Covered Eye Exams: $15 copay"	10B Transportation: Not Covered	"16A Preventive Dental: OPTIONAL SUPPLEMENTAL, 16B Comp Dental: Not Covered"	17A Routine Eye Exams: $0 copay	17B Eye Wear:  $0 copay for eye wear	18A Routine Hearing Exams: $0 copay	18B Hearing Aids: $0 copay	Not Covered	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: $0 copay"											50	50	0	0	0	0.100000303	0	48.55346656	0	0	15	0	0	15	0	15	15	15	0	15	0	15	0	0	0	0	0	0	0	0	0											3.1021	0.060266667	0	0	0	0.794402411	0	0.821233333	0	0	0.28272	0	0	0.06174	0	3.80452	0.19063	0.51746	0	1.48139	0	0.63333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.7498	0	0	3.1021	0.060266667	0	0	0	0.794402411	0	0.821233333	0	0	0.28272	0	0	0.06174	0	3.80452	0.19063	0.51746	0	1.48139	0	0.63333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.7498	0	PBP: 1A IP Acute: 15% coins	1B IP Psych: 15% coins	2 SNF: 15% coins	6 Home Health: 15% coins	10A Ambulance: 15% coins	11A DME:  15% coins	"11B Prosthetic Medical Supplies: 15% coins, 11C Diabetes Monitoring Supplies: 15% coins"	"4A ER: $50 copay,  4B Urgent Care: $25 copay"	"9A Outpatient Hospital: 15% coins,   9B ASC Services: 15% coins"	8A OP C/D/T: 15% coins	8B OP X-Ray: 15% coins	0	12 Renal Dialysis: Not Covered	"3 CORF: 15% coins,  5  Partial Hosp:  15% coins, 9D Cardiac Rehab: 15% coins"	"7A PCP: 15% coins, 14B Immunizations: 15% coins, 14C Routine Physical:  15% coins,  14D Pap Smears:  15% coins, 14D Pelvic Exams:  15% coins, 14E Prostate Screening:  15% coins, 14F Colorectal Screening:  15% coins, 14G Bone Mass Measurement:  15% coins, 14H Mammography:  15% coins, 14I Diabetes Monitoring:  15% coins, 14J Nutrition Therapy: 15% coins"	7D Physician Specialist: 15% coins	"7E Mental Health: 15% coins, 7H Psychiatric: 15% coins,   9C OP Substance Abuse: 15% coins"	"7C Occupational Therapy:  15% coins, 7I Physical and Speech Therapy:  15% coins"	7D Physician Specialist: 15% coins	"7B Chiropractic:  15% coins, 7F Podiatry:  15% coins for medically necessary services, 15% coins for 4 routine exams, 7G Other Health Care:  15% coins, 18A Medicare Covered Hearing Exams:  15% coins"	15 Part B Drugs: Not Covered	"13A Blood: 15% coins, 17A Medicare Covered Eye Exams: 15% coins"	10B Transportation: Not Covered	"16A Preventive Dental: OPTIONAL SUPPLEMENTAL, 16B Comp Dental: Not Covered"	17A Routine Eye Exams: 15% coins	17B Eye Wear:  15% coins	18A Routine Hearing Exams: 15% coins	18B Hearing Aids: 15% coins	0	14A Health Ed/Wellness: Not Covered	"13B Acupuncture: Not Covered, 13C Other1: Not Covered"											3.9148	0.0494	0.8142	0.3704	0.1264	0.2668	0.1858	0.3268	0.508	0.1527	0.4383	0.0172	0.003	0.4624	0.7199	1.764	0.0281	0.0725	0.6262	0.8375	0.1661	0.1045	0	0	0.0567	0.0287	0.0136	0.0115	0	0	0											12.0654	0	11.862	7.0169	0.109663878	0.814233192	0.370404469	0.126403137	1.061236895	0.18579918	1.148024101	0.508000327	0.152668724	0.72102698	0.017162173	0.002984726	0.524162814	0.719915858	5.568492935	0.218686422	0.589988836	0.626195468	2.318904053	0.16609999	0.737795402	0	0	0.05670979	0.028653367	0.013580502	0.011491194	0	0	0	0	0	0	0	0	0	0	0	0	0	23.8152
H3327_023_0	2008	4																					0											D	D	D	V	T	Coin	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3500	677.128	14.464	288.944	0	185.272	7.944	0	202.232	0	0	226.16	0	0	49.384	3182.6	2883.992	147.6	400.656	0	1140.312	0	490.344	0	0	0	0	0	0	0	0	0											"PBP: 1A IP Acute: $50 copay days 1-5, $500 annual max"	"1B IP Psych: $50 copay days 1-5, 190-day lifetime limit"	"2 SNF: $25 copay days 1-10, $0 copay days 11-100"	6 Home Health: $0 copay	10A Ambulance: $50 copay	"11A DME:  0% coins for first $200 covered expenses, 20% coins after first $200 covered expenses"	"11B Prosthetic Medical Supplies: $0 copay, 11C Diabetes Monitoring Supplies: $0 copay"	"4A ER: $50 copay,  4B Urgent Care: $25 copay"	"9A Outpatient Hospital: $0 copay,   9B ASC Services: $0 copay"	8A OP C/D/T: $0 copay	8B OP X-Ray: $0 - $15 copay depending on the radiology service	0	12 Renal Dialysis: $0 copay	"3 CORF: $20 copay,  5  Partial Hosp:  $0 copay, 9D Cardiac Rehab: $20 copay"	"7A PCP: $10 copay, 14B Immunizations: $0 copay, 14C Routine Physical:  $0 copay,  14D Pap Smears:  $0 copay, 14D Pelvic Exams:  $0 copay, 14E Prostate Screening:  $0 copay, 14F Colorectal Screening:  $0 copay, 14G Bone Mass Measurement:  $0 copay, 14H Mammography:  $0 copay, 14I Diabetes Monitoring:  $0 copay, 14J Nutrition Therapy: $0 copay"	7D Physician Specialist: $20 copay	"7E Mental Health: $20 copay, 7H Psychiatric: $20 copay,   9C OP Substance Abuse: $20 copay"	"7C Occupational Therapy:  $20 copay, 7I Physical and Speech Therapy:  $20 copay"	7D Physician Specialist: $0 copay	"7B Chiropractic:  $20 copay, 7F Podiatry:  $20 copay for medically necessary services, $0 copay for 4 routine exams, 7G Other Health Care:  $20 copay, 18A Medicare Covered Hearing Exams:  $0 copay"	15 Part B Drugs: $0 copay	"13A Blood: $0 copay, 17A Medicare Covered Eye Exams: $20 copay"	10B Transportation: Not Covered	"16A Preventive Dental: OPTIONAL SUPPLEMENTAL, 16B Comp Dental: Not Covered"	17A Routine Eye Exams: $0 copay	17B Eye Wear:  $0 copay for eye wear	18A Routine Hearing Exams: $0 copay	18B Hearing Aids: $0 copay	Not Covered	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: Not Covered"											50	50	25	0	50	0.100000376	0	48.63621979	0	0	15	0	0	20	10	20	20	20	0	20	0	20	0	0	0	0	0	0	0	0	0											2.8214	0.060266667	0.601966667	0	0.771966667	0.794402989	0	0.81965	0	0	0.2827	0	0	0.082306667	2.652166667	4.806653333	0.246	0.66776	0	1.90052	0	0.81724	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.325	0	0	2.8214	0.060266667	0.601966667	0	0.771966667	0.794402989	0	0.81965	0	0	0.2827	0	0	0.082306667	2.652166667	4.806653333	0.246	0.66776	0	1.90052	0	0.81724	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.325	0	PBP: 1A IP Acute: 15% coins	1B IP Psych: 15% coins	2 SNF: 15% coins	6 Home Health: 15% coins	10A Ambulance: 15% coins	11A DME:  15% coins	"11B Prosthetic Medical Supplies: 15% coins, 11C Diabetes Monitoring Supplies: 15% coins"	"4A ER: $50 copay,  4B Urgent Care: $25 copay"	"9A Outpatient Hospital: 15% coins,   9B ASC Services: 15% coins"	8A OP C/D/T: 15% coins	8B OP X-Ray: 15% coins	0	12 Renal Dialysis: Not Covered	"3 CORF: 15% coins,  5  Partial Hosp:  15% coins, 9D Cardiac Rehab: 15% coins"	"7A PCP: 15% coins, 14B Immunizations: 15% coins, 14C Routine Physical:  15% coins,  14D Pap Smears:  15% coins, 14D Pelvic Exams:  15% coins, 14E Prostate Screening:  15% coins, 14F Colorectal Screening:  15% coins, 14G Bone Mass Measurement:  15% coins, 14H Mammography:  15% coins, 14I Diabetes Monitoring:  15% coins, 14J Nutrition Therapy: 15% coins"	7D Physician Specialist: 15% coins	"7E Mental Health: 15% coins, 7H Psychiatric: 15% coins,   9C OP Substance Abuse: 15% coins"	"7C Occupational Therapy:  15% coins, 7I Physical and Speech Therapy:  15% coins"	7D Physician Specialist: 15% coins	"7B Chiropractic:  15% coins, 7F Podiatry:  15% coins for medically necessary services, 15% coins for 4 routine exams, 7G Other Health Care:  15% coins, 18A Medicare Covered Hearing Exams:  15% coins"	15 Part B Drugs: Not Covered	"13A Blood: 15% coins, 17A Medicare Covered Eye Exams: 15% coins"	10B Transportation: Not Covered	"16A Preventive Dental: OPTIONAL SUPPLEMENTAL, 16B Comp Dental: Not Covered"	17A Routine Eye Exams: 15% coins	17B Eye Wear:  15% coins	18A Routine Hearing Exams: 15% coins	18B Hearing Aids: 15% coins	0	14A Health Ed/Wellness: Not Covered	"13B Acupuncture: Not Covered, 13C Other1: Not Covered"											5.0749	0.064	1.0555	0.4802	0.1639	0.3459	0.2408	0.3278	0.6585	0.1979	0.5682	0.0222	0.0039	0.5994	0.9332	2.287	0.0364	0.094	0.8119	1.0859	0.2153	0.1354	0	0	0.0735	0.0371	0.0176	0.0149	0	0	0											15.5453	0	8.384	7.8962	0.124299759	1.657448703	0.480151469	0.935821741	1.140297762	0.240849548	1.147424429	0.658515552	0.197902882	0.85087279	0.022247147	0.003869069	0.681740561	3.585386121	7.093660047	0.282369249	0.761778378	0.81192414	2.986374228	0.215313693	0.952657417	0	0	0.073512312	0.037143063	0.017604264	0.014895916	0	0	0	0	0	0	0	0	0	0	0	0	0	32.8703
H3327_026_0	2008	6																					0											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	347.44	0	0	0	0	0	82.37	0	5542.44	1145.73	1045.94	0	1412.97	0	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $0 copay	"1B IP Psych: $0 copay, 190-day lifetime limit"	"2 SNF: $0 copay, up to 100 days"	6 Home Health: $0 copay	10A Ambulance: $0 copay	11A DME:  0% coins	"11B Prosthetic Medical Supplies: $0 copay, 11C Diabetes Monitoring Supplies: $0 copay"	"4A ER: $50 copay,  4B Urgent Care: $10 copay"	"9A Outpatient Hospital: $0 copay,   9B ASC Services: $0 copay"	8A OP C/D/T: $0 copay	8B OP X-Ray: $0 copay	0	12 Renal Dialysis: $0 copay	"3 CORF: $10 copay,  5  Partial Hosp:  $0 copay, 9D Cardiac Rehab: $10 copay"	"7A PCP: $0 copay, 14B Immunizations: $0 copay, 14C Routine Physical:  $0 copay,  14D Pap Smears:  $0 copay, 14D Pelvic Exams:  $0 copay, 14E Prostate Screening:  $0 copay, 14F Colorectal Screening:  $0 copay, 14G Bone Mass Measurement:  $0 copay, 14H Mammography:  $0 copay, 14I Diabetes Monitoring:  $0 copay, 14J Nutrition Therapy: $0 copay"	7D Physician Specialist: $10 copay	"7E Mental Health: $20 copay, 7H Psychiatric: $20 copay,   9C OP Substance Abuse: $20 copay"	"7C Occupational Therapy:  $10 copay, 7I Physical and Speech Therapy:  $10 copay"	7D Physician Specialist: $0 copay for radiology services	"7B Chiropractic:  $0 copay, 7F Podiatry:  $10 copay for medically necessary services, $0 copay for 4 routine exams, 7G Other Health Care:  $10 copay, 18A Medicare Covered Hearing Exams:  $0 copay"	15 Part B Drugs: $0 copay	"13A Blood: $0 copay, 17A Medicare Covered Eye Exams: $0 copay"	10B Transportation: $0 copay	"16A Preventive Dental: Not Covered, 16B Comp Dental: Not Covered"	17A Routine Eye Exams: $0 copay 1 exam every 2 yrs.	17B Eye Wear:  $0 for eye wear every 2 yrs.	18A Routine Hearing Exams: $0 copay per yr.	18B Hearing Aids: $0 copay	Not Covered	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: $0 copay"											0	0	0	0	0	0	0	47.47294497	0	0	0	0	0	10	0	10	20	10	0	7.731324174	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.3745	0	0	0	0	0	0.068641667	0	4.6187	1.90955	0.871616667	0	0.910344093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.7534	0	0	0	0	0	0	0	0	0	1.3745	0	0	0	0	0	0.068641667	0	4.6187	1.90955	0.871616667	0	0.910344093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.7534	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	1.3745	0	0	0	0	0	0.068641667	0	4.6187	1.90955	0.871616667	0	0.910344093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.7534
H3327_027_0	2008	5																					0											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	522.3	0	0	0	0	0	106.11	0	5319.36	1516.19	651.74	0	872.35	0	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $0 copay	"1B IP Psych: $0 copay, 190-day lifetime limit"	"2 SNF: $0 copay, up to 100 days"	6 Home Health: $0 copay	10A Ambulance: $0 copay	11A DME:  0% coins	"11B Prosthetic Medical Supplies: $0 copay, 11C Diabetes Monitoring Supplies: $0 copay"	"4A ER: $50 copay,  4B Urgent Care: $10 copay"	"9A Outpatient Hospital: $0 copay,   9B ASC Services: $0 copay"	8A OP C/D/T: $0 copay	8B OP X-Ray: $0 copay	0	12 Renal Dialysis: $0 copay	"3 CORF: $10 copay,  5  Partial Hosp:  $0 copay, 9D Cardiac Rehab: $10 copay"	"7A PCP: $0 copay, 14B Immunizations: $0 copay, 14C Routine Physical:  $0 copay,  14D Pap Smears:  $0 copay, 14D Pelvic Exams:  $0 copay, 14E Prostate Screening:  $0 copay, 14F Colorectal Screening:  $0 copay, 14G Bone Mass Measurement:  $0 copay, 14H Mammography:  $0 copay, 14I Diabetes Monitoring:  $0 copay, 14J Nutrition Therapy: $0 copay"	7D Physician Specialist: $10 copay	"7E Mental Health: $20 copay, 7H Psychiatric: $20 copay,   9C OP Substance Abuse: $20 copay"	"7C Occupational Therapy:  $10 copay, 7I Physical and Speech Therapy:  $10 copay"	7D Physician Specialist: $0 copay for radiology services	"7B Chiropractic:  $0 copay, 7F Podiatry:  $10 copay for medically necessary services, $0 copay for 4 routine exams, 7G Other Health Care:  $10 copay, 18A Medicare Covered Hearing Exams:  $0 copay"	15 Part B Drugs: $0 copay	"13A Blood: $0 copay, 17A Medicare Covered Eye Exams: $0 copay"	10B Transportation: Not Covered	"16A Preventive Dental: Not Covered, 16B Comp Dental: Not Covered"	17A Routine Eye Exams: $0 copay 1 exam every 2 yrs.	17B Eye Wear:  $0 for eye wear every 2 yrs.	18A Routine Hearing Exams: $0 copay per yr.	18B Hearing Aids: $0 copay	Not Covered	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: $0 copay"											0	0	0	0	0	0	0	48.36569022	0	0	0	0	0	10	0	10	20	10	0	7.234121949	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	2.105116667	0	0	0	0	0	0.088425	0	4.4328	2.526983333	0.543116667	0	0.525890524	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.2223	0	0	0	0	0	0	0	0	0	2.105116667	0	0	0	0	0	0.088425	0	4.4328	2.526983333	0.543116667	0	0.525890524	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.2223	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	2.105116667	0	0	0	0	0	0.088425	0	4.4328	2.526983333	0.543116667	0	0.525890524	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.2223
H3327_028_0	2008	3																					0											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	V	S	V	T	V	V	V	V	V	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	210.3252068	0	0	0	0	0	807.8054551	0	0	118.7181478	0	0	0	0	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $0 copay	"1B IP Psych: $0 copay, 190-day lifetime limit"	"2 SNF: $0 copay, up to 100 days"	6 Home Health: $0 copay	10A Ambulance: $0 copay	11A DME:  0% coins	"11B Prosthetic Medical Supplies: $0 copay, 11C Diabetes Monitoring Supplies: $0 copay"	"4A ER: $50 copay,  4B Urgent Care: $5 copay"	"9A Outpatient Hospital: $0 copay,   9B ASC Services: $0 copay"	8A OP C/D/T: $0 copay	8B OP X-Ray: $0 copay	0	12 Renal Dialysis: $0 copay	"3 CORF: $0 copay,  5  Partial Hosp:  $0 copay, 9D Cardiac Rehab: $0 copay"	"7A PCP: $0 copay, 14B Immunizations: $0 copay, 14C Routine Physical:  $0 copay,  14D Pap Smears:  $0 copay, 14D Pelvic Exams:  $0 copay, 14E Prostate Screening:  $0 copay, 14F Colorectal Screening:  $0 copay, 14G Bone Mass Measurement:  $0 copay, 14H Mamm"	7D Physician Specialist: $0 copay	"7E Mental Health: $50 copay, 7H Psychiatric: $50 copay,   9C OP Substance Abuse: $50 copay"	"7C Occupational Therapy:  $0 copay, 7I Physical and Speech Therapy:  $0copay"	7D Physician Specialist: $0 copay for radiology services	"7B Chiropractic:  $0 copay, 7F Podiatry:  $0 copay for medically necessary services, $0 copay for 4 routine exams, 7G Other Health Care:  $0 copay, 18A Medicare Covered Hearing Exams:  $0 copay"	15 Part B Drugs: $0 copay	"13A Blood: $0 copay, 17A Medicare Covered Eye Exams: $0 copay"	10B Transportation: Not Covered	"16A Preventive Dental: $0 copay, 16B Comp Dental: Not Covered"	17A Routine Eye Exams: $0 copay	17B Eye Wear:  $0 copay for eye wear	18A Routine Hearing Exams: $0 copay	18B Hearing Aids: $0 copay	Not Covered	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: $0 copay"											0	0	0	0	0	0	0	48.22328114	0	0	0	0	0	0	0	0	50	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.845214298	0	0	0	0	0	0	0	0	0.494658949	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.3399	0	0	0	0	0	0	0	0	0	0.845214298	0	0	0	0	0	0	0	0	0.494658949	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.3399	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0.845214298	0	0	0	0	0	0	0	0	0.494658949	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.3399
H3327_029_0	2008	6																					0											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	265.82	0	0	0	0	0	63.02	0	4240.41	876.58	800.23	0	1081.04	0	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $0 copay	"1B IP Psych: $0 copay, 190-day lifetime limit"	"2 SNF: $0 copay, up to 100 days"	6 Home Health: $0 copay	10A Ambulance: $0 copay	11A DME:  0% coins	"11B Prosthetic Medical Supplies: $0 copay, 11C Diabetes Monitoring Supplies: $0 copay"	"4A ER: $50 copay,  4B Urgent Care: $10 copay"	"9A Outpatient Hospital: $0 copay,   9B ASC Services: $0 copay"	8A OP C/D/T: $0 copay	8B OP X-Ray: $0 copay	0	12 Renal Dialysis: $0 copay	"3 CORF: $10 copay,  5  Partial Hosp:  $0 copay, 9D Cardiac Rehab: $10 copay"	"7A PCP: $0 copay, 14B Immunizations: $0 copay, 14C Routine Physical:  $0 copay,  14D Pap Smears:  $0 copay, 14D Pelvic Exams:  $0 copay, 14E Prostate Screening:  $0 copay, 14F Colorectal Screening:  $0 copay, 14G Bone Mass Measurement:  $0 copay, 14H Mammography:  $0 copay, 14I Diabetes Monitoring:  $0 copay, 14J Nutrition Therapy: $0 copay"	7D Physician Specialist: $10 copay	"7E Mental Health: $20 copay, 7H Psychiatric: $20 copay,   9C OP Substance Abuse: $20 copay"	"7C Occupational Therapy:  $10 copay, 7I Physical and Speech Therapy:  $10 copay"	7D Physician Specialist: $0 copay for radiology services	"7B Chiropractic:  $0 copay, 7F Podiatry:  $10 copay for medically necessary services, $0 copay for 4 routine exams, 7G Other Health Care:  $10 copay, 18A Medicare Covered Hearing Exams:  $0 copay"	15 Part B Drugs: $0 copay	"13A Blood: $0 copay, 17A Medicare Covered Eye Exams: $0 copay"	10B Transportation: Not Covered	"16A Preventive Dental: Not Covered, 16B Comp Dental: Not Covered"	17A Routine Eye Exams: $0 copay 1 exam every 2 yrs.	17B Eye Wear:  $0 for eye wear every 2 yrs.	18A Routine Hearing Exams: $0 copay per yr.	18B Hearing Aids: $0 copay	Not Covered	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: $0 copay"											0	0	0	0	0	0	0	47.47197352	0	0	0	0	0	10	0	10	20	10	0	7.731222244	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.051583333	0	0	0	0	0	0.052516667	0	3.533675	1.460966667	0.666858333	0	0.696480041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.4621	0	0	0	0	0	0	0	0	0	1.051583333	0	0	0	0	0	0.052516667	0	3.533675	1.460966667	0.666858333	0	0.696480041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.4621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	1.051583333	0	0	0	0	0	0.052516667	0	3.533675	1.460966667	0.666858333	0	0.696480041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.4621
H3327_030_0	2008	5																					0											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	362.3	0	0	0	0	0	77.9	0	5977.39	1728.34	1041.74	0	1406.94	0	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $0 copay	"1B IP Psych: $0 copay, 190-day lifetime limit"	"2 SNF: $0 copay, up to 100 days"	6 Home Health: $0 copay	10A Ambulance: $0 copay	11A DME:  0% coins	"11B Prosthetic Medical Supplies: $0 copay, 11C Diabetes Monitoring Supplies: $0 copay"	"4A ER: $50 copay,  4B Urgent Care: $10 copay"	"9A Outpatient Hospital: $0 copay,   9B ASC Services: $0 copay"	8A OP C/D/T: $0 copay	8B OP X-Ray: $0 copay	0	12 Renal Dialysis: $0 copay	"3 CORF: $10 copay,  5  Partial Hosp:  $0 copay, 9D Cardiac Rehab: $10 copay"	"7A PCP: $0 copay, 14B Immunizations: $0 copay, 14C Routine Physical:  $0 copay,  14D Pap Smears:  $0 copay, 14D Pelvic Exams:  $0 copay, 14E Prostate Screening:  $0 copay, 14F Colorectal Screening:  $0 copay, 14G Bone Mass Measurement:  $0 copay, 14H Mammography:  $0 copay, 14I Diabetes Monitoring:  $0 copay, 14J Nutrition Therapy: $0 copay"	7D Physician Specialist: $10 copay	"7E Mental Health: $20 copay, 7H Psychiatric: $20 copay,   9C OP Substance Abuse: $20 copay"	"7C Occupational Therapy:  $10 copay, 7I Physical and Speech Therapy:  $10 copay"	7D Physician Specialist: $0 copay for radiology services	"7B Chiropractic:  $0 copay, 7F Podiatry:  $10 copay for medically necessary services, $0 copay for 4 routine exams, 7G Other Health Care:  $10 copay, 18A Medicare Covered Hearing Exams:  $0 copay"	15 Part B Drugs: $0 copay	"13A Blood: $0 copay, 17A Medicare Covered Eye Exams: $0 copay"	10B Transportation: $0 copay	"16A Preventive Dental: Not Covered, 16B Comp Dental: Not Covered"	17A Routine Eye Exams: $0 copay 1 exam every 2 yrs.	17B Eye Wear:  $0 for eye wear every 2 yrs.	18A Routine Hearing Exams: $0 copay per yr.	18B Hearing Aids: $0 copay	Not Covered	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: $0 copay"											0	0	0	0	0	0	0	47.36903119	0	0	0	0	0	10	0	10	20	10	0	7.505040807	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.43015	0	0	0	0	0	0.064916667	0	4.981158333	2.880566667	0.868116667	0	0.879928509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.1048	0	0	0	0	0	0	0	0	0	1.43015	0	0	0	0	0	0.064916667	0	4.981158333	2.880566667	0.868116667	0	0.879928509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.1048	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	1.43015	0	0	0	0	0	0.064916667	0	4.981158333	2.880566667	0.868116667	0	0.879928509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.1048
H3327_031_0	2008	3																					0											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	V	S	V	T	V	V	V	V	V	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	2.192063409	0	219.1037307	0	0	0	0	0	841.5215258	0	2946.327314	112.0560946	322.6908502	0	113.8171511	0	41.73649091	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $0 copay	"1B IP Psych: $0 copay, 190-day lifetime limit"	"2 SNF: $0 copay, up to 100 days"	6 Home Health: $0 copay	10A Ambulance: $0 copay	"11A DME:  0% coins for first $200 covered expenses, 20% coins after first $200 covered expenses"	"11B Prosthetic Medical Supplies: $0 copay, 11C Diabetes Monitoring Supplies: $0 copay"	"4A ER: $50 copay,  4B Urgent Care: $25 copay"	"9A Outpatient Hospital: $0 copay,   9B ASC Services: $0 copay"	8A OP C/D/T: $0 copay	8B OP X-Ray: $0 copay	0	12 Renal Dialysis: $0 copay	"3 CORF: $15 copay,  5  Partial Hosp:  $0 copay, 9D Cardiac Rehab: $15 copay"	"7A PCP: $0 copay, 14B Immunizations: $0 copay, 14C Routine Physical:  $0 copay,  14D Pap Smears:  $0 copay, 14D Pelvic Exams:  $0 copay, 14E Prostate Screening:  $0 copay, 14F Colorectal Screening:  $0 copay, 14G Bone Mass Measurement:  $0 copay, 14H Mammography:  $0 copay, 14I Diabetes Monitoring:  $0 copay, 14J Nutrition Therapy: $0 copay"	7D Physician Specialist: $20 copay	"7E Mental Health: $15 copay, 7H Psychiatric: $15 copay,   9C OP Substance Abuse: $15 copay"	"7C Occupational Therapy:  $15 copay, 7I Physical and Speech Therapy:  $15 copay"	7D Physician Specialist: $0 copay for radiology services	"7B Chiropractic:  $15 copay, 7F Podiatry:  $15 copay for medically necessary services, $0 copay for 4 routine exams, 7G Other Health Care:  $15 copay, 18A Medicare Covered Hearing Exams:  $0 copay"	15 Part B Drugs: $0 copay	"13A Blood: $0 copay, 17A Medicare Covered Eye Exams: $15 copay"	10B Transportation: Not Covered	"16A Preventive Dental: $0 copay, 16B Comp Dental: Not Covered"	17A Routine Eye Exams: $0 copay	17B Eye Wear:  $0 copay for eye wear	18A Routine Hearing Exams: $0 copay	18B Hearing Aids: $0 copay	Not Covered	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: Not Covered"											0	0	0	0	0	0.053	0	49.11194833	0	0	0	0	0	15	0	20	15	15	0	15	0	15	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0.116179361	0	0.896717592	0	0	0	0	0	1.051901907	0	4.910545523	0.140070118	0.403363563	0	0.142271439	0	0.052170614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.7132	0	0	0	0	0	0	0	0.116179361	0	0.896717592	0	0	0	0	0	1.051901907	0	4.910545523	0.140070118	0.403363563	0	0.142271439	0	0.052170614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.7132	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0.116179361	0	0.896717592	0	0	0	0	0	1.051901907	0	4.910545523	0.140070118	0.403363563	0	0.142271439	0	0.052170614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.7132
H3327_033_0	2008	3																					0											A	A	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	V	S	V	T	V	V	V	V	V	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	366.1211571	6.907946361	827.3821297	0	0	2.181878951	0	202.1825851	0	0	228.8950258	0	0	776.531723	3710.482376	2866.088066	109.513203	313.8741209	0	104.7140068	0	38.51397775	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $400 copay per stay	"1B IP Psych: $400 copay per stay, 190-day lifetime limit"	"2 SNF: $0 copay days 1-10, $25 copay days 11-100"	6 Home Health: $0 copay	10A Ambulance: $0 copay	"11A DME:  0% coins for first $200 covered expenses, 20% coins after first $200 covered expenses"	"11B Prosthetic Medical Supplies: $0 copay, 11C Diabetes Monitoring Supplies: $0 copay"	"4A ER: $50 copay,  4B Urgent Care: $25 copay"	"9A Outpatient Hospital: $0 copay,   9B ASC Services: $0 copay"	8A OP C/D/T: $0 copay	8B OP X-Ray: $0 copay	0	12 Renal Dialysis: $0 copay	"3 CORF: $25 copay,  5  Partial Hosp:  $0 copay, 9D Cardiac Rehab: $25 copay"	"7A PCP: $10 copay, 14B Immunizations: $0 copay, 14C Routine Physical:  $0 copay,  14D Pap Smears:  $0 copay, 14D Pelvic Exams:  $0 copay, 14E Prostate Screening:  $0 copay, 14F Colorectal Screening:  $0 copay, 14G Bone Mass Measurement:  $0 copay, 14H Mammography:  $0 copay, 14I Diabetes Monitoring:  $0 copay, 14J Nutrition Therapy: $0 copay"	7D Physician Specialist: $25 copay	"7E Mental Health: $25 copay, 7H Psychiatric: $25 copay,   9C OP Substance Abuse: $25 copay"	"7C Occupational Therapy:  $25 copay, 7I Physical and Speech Therapy:  $25 copay"	7D Physician Specialist: $0 copay for radiology services	"7B Chiropractic:  $25 copay, 7F Podiatry:  $25 copay for medically necessary services, $0 copay for 4 routine exams, 7G Other Health Care:  $25 copay, 18A Medicare Covered Hearing Exams:  $0 copay"	15 Part B Drugs: $0 copay	"13A Blood: $0 copay, 17A Medicare Covered Eye Exams: $25 copay"	10B Transportation: Not Covered	"16A Preventive Dental: $0 copay, 16B Comp Dental: Not Covered"	17A Routine Eye Exams: $0 copay	17B Eye Wear:  $0 copay for eye wear	18A Routine Hearing Exams: $0 copay	18B Hearing Aids: $0 copay	Not Covered	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: Not Covered"											400	400	25	0	0	0.053	0	49.15777653	0	0	0	0	0	25	10	25	25	25	0	25	0	25	0	0	0	0	0	0	0	0	0											12.204	0.230264879	1.72371277	0	0	0.115639584	0	0.828237195	0	0	0	0	0	1.617774423	3.092068647	5.971016804	0.228152506	0.653904419	0	0.218154181	0	0.080237454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.9632	0	0	12.204	0.230264879	1.72371277	0	0	0.115639584	0	0.828237195	0	0	0	0	0	1.617774423	3.092068647	5.971016804	0.228152506	0.653904419	0	0.218154181	0	0.080237454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.9632	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.204	0.230264879	1.72371277	0	0	0.115639584	0	0.828237195	0	0	0	0	0	1.617774423	3.092068647	5.971016804	0.228152506	0.653904419	0	0.218154181	0	0.080237454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.9632
H3327_801_0	2008	4																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	205	2.6	22.53	11.87	6.73	9.65	7.05	3.85	20.35	6.12	17.56	0.69	0.12	18.51	32.92	84.84	1.32	3.4	29.36	38.37	6.65	4.81	0	0	0	0	0	0	0	0	0											Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing																				0.086952903	0.086890454	0.205513378	0	0.234001648	0.23399981	0.234102117	0.233868074	0.233999985	0.23387613	0.233986807	0.234000253	0.234000009	0.234074126	0.234008017	0.233998226	0.233988351	0.233976977	0.233998178	0.23400664	0.23400478	0.23400262	0	0	0	0	0	0	0	0	0											17.8253	0.225915179	4.630216413	0	1.574831093	2.258098171	1.650419923	0.900392083	4.761899693	1.431321918	4.108808331	0.161460174	0.028080001	4.332712078	7.70354391	19.85240946	0.308864624	0.795521723	6.870186503	8.978834783	1.556131788	1.125552605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.0805	0	0	17.8253	0.225915179	4.630216413	0	1.574831093	2.258098171	1.650419923	0.900392083	4.761899693	1.431321918	4.108808331	0.161460174	0.028080001	4.332712078	7.70354391	19.85240946	0.308864624	0.795521723	6.870186503	8.978834783	1.556131788	1.125552605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.0805	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.8253	0.225915179	4.630216413	0	1.574831093	2.258098171	1.650419923	0.900392083	4.761899693	1.431321918	4.108808331	0.161460174	0.028080001	4.332712078	7.70354391	19.85240946	0.308864624	0.795521723	6.870186503	8.978834783	1.556131788	1.125552605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.0805
H3327_802_0	2008	4																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	205	2.6	22.53	11.87	6.73	9.65	7.05	3.85	20.35	6.12	17.56	0.69	0.12	18.51	32.92	84.84	1.32	3.4	29.36	38.37	6.65	4.81	0	0	0	0	0	0	0	0	0											Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing																				0.086952903	0.086890454	0.205513378	0	0.234001648	0.23399981	0.234102117	0.233868074	0.233999985	0.23387613	0.233986807	0.234000253	0.234000009	0.234074126	0.234008017	0.233998226	0.233988351	0.233976977	0.233998178	0.23400664	0.23400478	0.23400262	0	0	0	0	0	0	0	0	0											17.8253	0.225915179	4.630216413	0	1.574831093	2.258098171	1.650419923	0.900392083	4.761899693	1.431321918	4.108808331	0.161460174	0.028080001	4.332712078	7.70354391	19.85240946	0.308864624	0.795521723	6.870186503	8.978834783	1.556131788	1.125552605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.0805	0	0	17.8253	0.225915179	4.630216413	0	1.574831093	2.258098171	1.650419923	0.900392083	4.761899693	1.431321918	4.108808331	0.161460174	0.028080001	4.332712078	7.70354391	19.85240946	0.308864624	0.795521723	6.870186503	8.978834783	1.556131788	1.125552605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.0805	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.8253	0.225915179	4.630216413	0	1.574831093	2.258098171	1.650419923	0.900392083	4.761899693	1.431321918	4.108808331	0.161460174	0.028080001	4.332712078	7.70354391	19.85240946	0.308864624	0.795521723	6.870186503	8.978834783	1.556131788	1.125552605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.0805
H3327_803_0	2008	4																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	205	2.6	22.53	11.87	6.73	9.65	7.05	3.85	20.35	6.12	17.56	0.69	0.12	18.51	32.92	84.84	1.32	3.4	29.36	38.37	6.65	4.81	0	0	0	0	0	0	0	0	0											Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing																				0.086952903	0.086890454	0.205513378	0	0.234001648	0.23399981	0.234102117	0.233868074	0.233999985	0.23387613	0.233986807	0.234000253	0.234000009	0.234074126	0.234008017	0.233998226	0.233988351	0.233976977	0.233998178	0.23400664	0.23400478	0.23400262	0	0	0	0	0	0	0	0	0											17.8253	0.225915179	4.630216413	0	1.574831093	2.258098171	1.650419923	0.900392083	4.761899693	1.431321918	4.108808331	0.161460174	0.028080001	4.332712078	7.70354391	19.85240946	0.308864624	0.795521723	6.870186503	8.978834783	1.556131788	1.125552605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.0805	0	0	17.8253	0.225915179	4.630216413	0	1.574831093	2.258098171	1.650419923	0.900392083	4.761899693	1.431321918	4.108808331	0.161460174	0.028080001	4.332712078	7.70354391	19.85240946	0.308864624	0.795521723	6.870186503	8.978834783	1.556131788	1.125552605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.0805	0	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.8253	0.225915179	4.630216413	0	1.574831093	2.258098171	1.650419923	0.900392083	4.761899693	1.431321918	4.108808331	0.161460174	0.028080001	4.332712078	7.70354391	19.85240946	0.308864624	0.795521723	6.870186503	8.978834783	1.556131788	1.125552605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.0805
H3327_805_0	2008	4																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	164	2.08	18.024	9.496	5.384	7.72	5.64	3.08	16.28	4.896	14.048	0.552	0.096	14.808	26.336	67.872	1.056	2.72	23.488	30.696	5.32	3.848	0	0	0	0	0	0	0	0	0											Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing																				0.086952903	0.086890454	0.205513378	0	0.234001648	0.23399981	0.234102117	0.233868074	0.233999985	0.23387613	0.233986807	0.234000253	0.234000009	0.234074126	0.234008017	0.233998226	0.233988351	0.233976977	0.233998178	0.23400664	0.23400478	0.23400262	0	0	0	0	0	0	0	0	0											14.2603	0.180732143	3.70417313	0	1.259864874	1.806478537	1.320335938	0.720313666	3.809519754	1.145057534	3.287046665	0.12916814	0.022464001	3.466169662	6.162835128	15.88192757	0.247091699	0.636417378	5.496149203	7.183067826	1.244905431	0.900442084	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8644	0	0	14.2603	0.180732143	3.70417313	0	1.259864874	1.806478537	1.320335938	0.720313666	3.809519754	1.145057534	3.287046665	0.12916814	0.022464001	3.466169662	6.162835128	15.88192757	0.247091699	0.636417378	5.496149203	7.183067826	1.244905431	0.900442084	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8644	0	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing																				4.4563	0.0565	2.2022	0	0.389	0.8209	0.5717	0.2947	1.5645	0.4703	1.35	0.0529	0.0089	1.4242	2.1916	5.5985	0.0866	0.2232	1.9286	2.5212	0.5115	0.3215	0	0	0	0	0	0	0	0	0											27.0448	0	0	18.7166	0.237211534	5.90639947	0	1.648850326	2.627363684	1.892023805	1.01498272	5.374038741	1.61531024	4.637048344	0.182052145	0.031356001	4.890345005	8.354394187	21.48045361	0.333668719	0.859637787	7.42479738	9.70428338	1.756420544	1.221961723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9092
H3327_806_0	2008	4																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	164	2.08	18.024	9.496	5.384	7.72	5.64	3.08	16.28	4.896	14.048	0.552	0.096	14.808	26.336	67.872	1.056	2.72	23.488	30.696	5.32	3.848	0	0	0	0	0	0	0	0	0											Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing																				0.086952903	0.086890454	0.205513378	0	0.234001648	0.23399981	0.234102117	0.233868074	0.233999985	0.23387613	0.233986807	0.234000253	0.234000009	0.234074126	0.234008017	0.233998226	0.233988351	0.233976977	0.233998178	0.23400664	0.23400478	0.23400262	0	0	0	0	0	0	0	0	0											14.2603	0.180732143	3.70417313	0	1.259864874	1.806478537	1.320335938	0.720313666	3.809519754	1.145057534	3.287046665	0.12916814	0.022464001	3.466169662	6.162835128	15.88192757	0.247091699	0.636417378	5.496149203	7.183067826	1.244905431	0.900442084	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8644	0	0	14.2603	0.180732143	3.70417313	0	1.259864874	1.806478537	1.320335938	0.720313666	3.809519754	1.145057534	3.287046665	0.12916814	0.022464001	3.466169662	6.162835128	15.88192757	0.247091699	0.636417378	5.496149203	7.183067826	1.244905431	0.900442084	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8644	0	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing																				4.4563	0.0565	2.2022	0	0.389	0.8209	0.5717	0.2947	1.5645	0.4703	1.35	0.0529	0.0089	1.4242	2.1916	5.5985	0.0866	0.2232	1.9286	2.5212	0.5115	0.3215	0	0	0	0	0	0	0	0	0											27.0448	0	0	18.7166	0.237211534	5.90639947	0	1.648850326	2.627363684	1.892023805	1.01498272	5.374038741	1.61531024	4.637048344	0.182052145	0.031356001	4.890345005	8.354394187	21.48045361	0.333668719	0.859637787	7.42479738	9.70428338	1.756420544	1.221961723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9092
H3327_807_0	2008	5																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	164	2.08	18.024	9.496	5.384	7.72	5.64	3.08	16.28	4.896	14.048	0.552	0.096	14.808	26.336	67.872	1.056	2.72	23.488	30.696	5.32	3.848	0	0	0	0	0	0	0	0	0											Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing																				0.086952903	0.086890454	0.205513378	0	0.234001648	0.23399981	0.234102117	0.233868074	0.233999985	0.23387613	0.233986807	0.234000253	0.234000009	0.234074126	0.234008017	0.233998226	0.233988351	0.233976977	0.233998178	0.23400664	0.23400478	0.23400262	0	0	0	0	0	0	0	0	0											14.2603	0.180732143	3.70417313	0	1.259864874	1.806478537	1.320335938	0.720313666	3.809519754	1.145057534	3.287046665	0.12916814	0.022464001	3.466169662	6.162835128	15.88192757	0.247091699	0.636417378	5.496149203	7.183067826	1.244905431	0.900442084	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8644	0	0	14.2603	0.180732143	3.70417313	0	1.259864874	1.806478537	1.320335938	0.720313666	3.809519754	1.145057534	3.287046665	0.12916814	0.022464001	3.466169662	6.162835128	15.88192757	0.247091699	0.636417378	5.496149203	7.183067826	1.244905431	0.900442084	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8644	0	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing																				4.4563	0.0565	2.2022	0	0.389	0.8209	0.5717	0.2947	1.5645	0.4703	1.35	0.0529	0.0089	1.4242	2.1916	5.5985	0.0866	0.2232	1.9286	2.5212	0.5115	0.3215	0	0	0	0	0	0	0	0	0											27.0448	0	0	18.7166	0.237211534	5.90639947	0	1.648850326	2.627363684	1.892023805	1.01498272	5.374038741	1.61531024	4.637048344	0.182052145	0.031356001	4.890345005	8.354394187	21.48045361	0.333668719	0.859637787	7.42479738	9.70428338	1.756420544	1.221961723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9092
H3328_001_0	2008	4																					3250											D	D	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	V	P	V																																																				0	6500	1695.442856		602.4867177		87.94908239	10.86236323		263.1496558	26.84600183		25.80674777	1.479731441	0.284838555	12.03391439		4738.678484	423.0002555	1060.344583			22.32747645																					"$75 per day, days 1-10"		"$75 per day, days 1-40"		$50 per trip	0.1	0.1	$50 per visit	0.1		0%x-rays or 20%	0.1	0.1	0.1	$0 per visit	$10 per visit	$10 per visit	$10 per visit			0.2																					47.73		64.5		25.8	0.086		43	0.086		0.146312748	0.086	0.086	0.086		8.6	8.6	8.6			0.172																					6.7436	0	3.238366108	0	0.189090527	0.934163238	0	0.942952933	2.308756158	0	3.775856194	0.127256904	0.024496116	1.034916637	0	3.396052914	0.303150183	0.759913618	0	0	3.84032595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.6189	0	4.49610349	6.7436	0	3.238366108	0	0.189090527	0.934163238	0	0.942952933	2.308756158	0	3.775856194	0.127256904	0.024496116	1.034916637	0	3.396052914	0.303150183	0.759913618	0	0	3.84032595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.6189		"$150 per day, days 1-10"		"$100 per day, days 1-40"		$50 per trip	0.2	0.2	$50 per visit	0.2	0.2	20% xrays/ 30% other	0.2	0.2	0.2	$10 per visit	$30 per visit	$30 per visit	$30 per visit			0.3																					1.5863		2.0687		0.1156	0.1847		0.1039	0.5091	0.3072	0.7866	0.0237	0.0051	0.2419	0.2334	1.0403	0.3474	0.4411			0.732																					8.7271	0	0.557048714	8.33	0	5.307105426	0	0.304647116	1.118904871	0	1.046897725	2.81786526	0.30720808	4.56249684	0.150965673	0.029597523	1.276812685	0.233354139	4.436310998	0.650560123	1.201020265	0	0	4.572318506	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.346
H3328_002_0	2008	4																					0											D	D	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	V	P	V																																																				0	0								877.1617081								6732.871408	3692.239523	4883.091117																															$50ER/$10UC							$0 per visit	$10 per visit	$20 per visit	$10 per visit																															50								10	20	10																								0	0	0	0	0	0	0	3.65484045	0	0	0	0	0	0	0	5.610726173	6.153732539	4.069242597	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.4885	0	0	0	0	0	0	0	0	0	3.65484045	0	0	0	0	0	0	0	5.610726173	6.153732539	4.069242597	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.4885																																																																																				0	0	0	0	0	0	0	0	0	0	3.65484045	0	0	0	0	0	0	0	5.610726173	6.153732539	4.069242597	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.4885
H3328_003_0	2008	6																					3250											D	D	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	V	P	V																																																				0	6500	1820.804522		647.0348064		94.45206977	11.66553035		282.6070378	28.83100505		27.71490815	1.589143326	0.305899622	12.92370643		5089.058108	454.2770494	1138.74685			23.97837824																					"$75 per day, days 1-10"		"$75 per day, days 1-40"		$50 per trip	0.1	0.1	$50 per visit	0.1		0%x-rays or 20%	0.1	0.1	0.1	$0 per visit	$10 per visit	$10 per visit	$10 per visit			0.2																					47.73		64.5		25.8	0.086		43	0.086		0.146312748	0.086	0.086	0.086		8.6	8.6	8.6			0.172																					7.2422	0	3.477812084	0	0.20307195	1.00323561	0	1.012675219	2.479466434	0	4.055044384	0.136666326	0.026307367	1.111438753	0	3.647158311	0.325565219	0.816101909	0	0	4.124281057	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6611	0	4.828547029	7.2422	0	3.477812084	0	0.20307195	1.00323561	0	1.012675219	2.479466434	0	4.055044384	0.136666326	0.026307367	1.111438753	0	3.647158311	0.325565219	0.816101909	0	0	4.124281057	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6611		"$150 per day, days 1-10"		"$100 per day, days 1-40"		$50 per trip	0.2	0.2	$50 per visit	0.2	0.2	20% xrays/ 30% other	0.2	0.2	0.2	$10 per visit	$30 per visit	$30 per visit	$30 per visit			0.3																					1.7036		2.2217		0.1241	0.1984		0.1116	0.5468	0.3299	0.8448	0.0255	0.0055	0.2598	0.2506	1.1172	0.3731	0.4737			0.7861																					9.3724	0	0.598237101	8.9459	0	5.699514746	0	0.327172835	1.201637107	0	1.124305727	3.02621925	0.329923158	4.899849528	0.162128131	0.031785975	1.371220683	0.25060843	4.764333459	0.698662777	1.289824143	0	0	4.910397412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0335
H3328_012_0	2008	2																					3250											D	D	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	V	P	V																																																				0	6500	1820.804522		647.0348064		94.45206977	11.66553035		282.6070378	28.83100505		27.71490815	1.589143326	0.305899622	12.92370643		5089.058108	454.2770494	1138.74685			23.97837824																					"$75 per day, days 1-10"		"$75 per day, days 1-40"		$50 per trip	0.1	0.1	$50 per visit	0.1		0%x-rays or 20%	0.1	0.1	0.1	$0 per visit	$10 per visit	$10 per visit	$10 per visit			0.2																					47.73		64.5		25.8	0.086		43	0.086		0.146312748	0.086	0.086	0.086		8.6	8.6	8.6			0.172																					7.2422	0	3.477812084	0	0.20307195	1.00323561	0	1.012675219	2.479466434	0	4.055044384	0.136666326	0.026307367	1.111438753	0	3.647158311	0.325565219	0.816101909	0	0	4.124281057	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6611	0	4.828547029	7.2422	0	3.477812084	0	0.20307195	1.00323561	0	1.012675219	2.479466434	0	4.055044384	0.136666326	0.026307367	1.111438753	0	3.647158311	0.325565219	0.816101909	0	0	4.124281057	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6611		"$150 per day, days 1-10"		"$100 per day, days 1-40"		$50 per trip	0.2	0.2	$50 per visit	0.2	0.2	20% xrays/ 30% other	0.2	0.2	0.2	$10 per visit	$30 per visit	$30 per visit	$30 per visit			0.3																					1.7036		2.2217		0.1241	0.1984		0.1116	0.5468	0.3299	0.8448	0.0255	0.0055	0.2598	0.2506	1.1172	0.3731	0.4737			0.7861																					9.3724	0	0.598237101	8.9459	0	5.699514746	0	0.327172835	1.201637107	0	1.124305727	3.02621925	0.329923158	4.899849528	0.162128131	0.031785975	1.371220683	0.25060843	4.764333459	0.698662777	1.289824143	0	0	4.910397412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0335
H3328_013_0	2008	4																					0											A	A	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	V	P	V																																																				0	0	460.5124264		902.504681		322.1858521	32.82895021		851.6475119	24.67990259	22.71827374	50.87982274	2.406230228	9.954358124	35.49104623	8799.722494	24237.30227	3481.891504	4600.284827			11.30002191	4.965657023																				FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing									FFS Cost Sharing											769.5972		73.4035		142.6449	0.234		50	0.234	0.234	0.234	0.234	0.234	0.234	17.1225	21.3039	24.3117	19.4536			0.234	8.9724																				29.5341	0	5.520586665	0	3.82984668	7.681974349	0	3.5485313	5.775097205	5.316076054	11.90587852	0.563057873	2.329319801	8.304904818	12.55608849	43.02918021	7.054225857	7.457659367	0	0	2.644205128	0.00371281	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.0544	0	0	29.5341	0	5.520586665	0	3.82984668	7.681974349	0	3.5485313	5.775097205	5.316076054	11.90587852	0.563057873	2.329319801	8.304904818	12.55608849	43.02918021	7.054225857	7.457659367	0	0	2.644205128	0.00371281	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.0544																																																																																				0	0	0	29.5341	0	5.520586665	0	3.82984668	7.681974349	0	3.5485313	5.775097205	5.316076054	11.90587852	0.563057873	2.329319801	8.304904818	12.55608849	43.02918021	7.054225857	7.457659367	0	0	2.644205128	0.00371281	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.0544
H3330_021_1	2008	11																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	1908.011875	96.03107161	1509.266524	198.919604	476.000899	6.492912	6.492912	216.1201681	73.30523528	0	0	0	0	985.7543044	6606.916539	8154.158342	153.0692744	49.73918565	391.6633386	4737.357995	74.77010572	0	0	42.69312	1402.111071	0	67.23015107	0	0	0	0											$150 Copay	$0 Copay	$50 (days 21-100) Copay	$0 Copay	$125 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$0 Copay	$5 Copay	$25 Copay	$5 Copay	$0 Copay	$5 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											22.63698364	0	9.478857112	0	125	0.2	0.2	50	75	0	0	0	0	75	0	5	25	5	0	5	0	0	0	10	15	0	15	0	0	0	0											3.5993	0	1.19217681	0	4.958342698	1.2985824	1.2985824	0.9005007	0.45815772	0	0	0	0	6.160964403	0	3.397565976	0.318894322	0.020724661	0	1.973899165	0	0	0	0.0355776	1.752638839	0	0.084037689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.4499	0	0	3.5993	0	1.19217681	0	4.958342698	1.2985824	1.2985824	0.9005007	0.45815772	0	0	0	0	6.160964403	0	3.397565976	0.318894322	0.020724661	0	1.973899165	0	0	0	0.0355776	1.752638839	0	0.084037689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.4499	none																																																																																			0	0	0	3.5993	0	1.19217681	0	4.958342698	1.2985824	1.2985824	0.9005007	0.45815772	0	0	0	0	6.160964403	0	3.397565976	0.318894322	0.020724661	0	1.973899165	0	0	0	0.0355776	1.752638839	0	0.084037689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.4499
H3330_021_2	2008	10																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2019.653592	96.03107161	1396.286055	246.7126966	233.9852077	6.9136634	6.9136634	201.0630583	135.7111196	0	0	0	0	682.4783726	6158.428324	7194.84462	142.6786837	46.36280903	365.0765957	4415.778448	42.70699234	0	0	42.674352	1390.053926	0	71.86730463	0	0	0	0											$250 (day 1) /$50 day (days 2-10) Copay	$0 Copay	$50 (days 21-100) Copay	$0 Copay	$150 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$5 Copay	$10 Copay	$30 Copay	$10 Copay	$0 Copay	$10 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											80.18264485	0	9.478857112	0	150	0.2	0.2	50	75	0	0	0	0	75	5	10	30	10	0	10	0	0	0	10	15	0	15	0	0	0	0											13.4951	0	1.102933	0	2.924815096	1.38273268	1.38273268	0.837762743	0.848194498	0	0	0	0	4.265489829	2.566011802	5.99570385	0.356696709	0.038635674	0	3.679815373	0	0	0	0.03556196	1.737567408	0	0.089834131	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7396	0	0	13.4951	0	1.102933	0	2.924815096	1.38273268	1.38273268	0.837762743	0.848194498	0	0	0	0	4.265489829	2.566011802	5.99570385	0.356696709	0.038635674	0	3.679815373	0	0	0	0.03556196	1.737567408	0	0.089834131	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7396	none																																																																																			0	0	0	13.4951	0	1.102933	0	2.924815096	1.38273268	1.38273268	0.837762743	0.848194498	0	0	0	0	4.265489829	2.566011802	5.99570385	0.356696709	0.038635674	0	3.679815373	0	0	0	0.03556196	1.737567408	0	0.089834131	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7396
H3330_021_3	2008	8																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2200.44961	96.03107161	1184.779854	215.2154572	157.7829145	6.0205365	6.0205365	275.037431	127.7091279	0	0	0	0	1342.150272	7041.318288	9214.61348	163.1335094	53.00951442	417.4150245	5048.837123	96.74371127	0	0	45.11256	1388.84532	0	67.09344349	0	0	0	0											$250 (day 1) /$50 day (days 2-10) Copay	$0 Copay	$50 (days 21-100) Copay	$0 Copay	$150 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$5 Copay	$10 Copay	$30 Copay	$10 Copay	$0 Copay	$10 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											80.18264485	0	9.478857112	0	150	0.2	0.2	50	75	0	0	0	0	75	5	10	30	10	0	10	0	0	0	10	15	0	15	0	0	0	0											14.7032	0	0.935863246	0	1.972286431	1.2041073	1.2041073	1.145989296	0.798182049	0	0	0	0	8.388439201	2.93388262	7.678844566	0.407833774	0.044174595	0	4.207364269	0	0	0	0.0375938	1.736056651	0	0.083866804	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4817	0	0	14.7032	0	0.935863246	0	1.972286431	1.2041073	1.2041073	1.145989296	0.798182049	0	0	0	0	8.388439201	2.93388262	7.678844566	0.407833774	0.044174595	0	4.207364269	0	0	0	0.0375938	1.736056651	0	0.083866804	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4817	none																																																																																			0	0	0	14.7032	0	0.935863246	0	1.972286431	1.2041073	1.2041073	1.145989296	0.798182049	0	0	0	0	8.388439201	2.93388262	7.678844566	0.407833774	0.044174595	0	4.207364269	0	0	0	0.0375938	1.736056651	0	0.083866804	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4817
H3330_023_1	2008	9																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	1953.29885	96.03107161	1539.267234	202.8736634	485.4626906	6.621976	6.621976	221.0040098	74.96177281	0	0	0	0	1008.03019	6606.916539	8023.742074	153.0692744	49.73918565	391.6633386	4737.357995	76.25636165	0	0	43.54176	1429.98178	0	68.56653022	0	0	0	0											$300 Copay	$0 Copay	$50 (days 21-100) Copay	$0 Copay	$125 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$5 Copay	$10 Copay	$25 Copay	$10 Copay	$0 Copay	$10 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											45.27396727	0	9.478857112	0	125	0.2	0.2	50	75	0	0	0	0	75	5	10	25	10	0	10	0	0	0	10	15	0	15	0	0	0	0											7.3695	0	1.215874514	0	5.056903027	1.3243952	1.3243952	0.920850041	0.46851108	0	0	0	0	6.300188685	2.752881891	6.686451728	0.318894322	0.041449321	0	3.947798329	0	0	0	0.0362848	1.787477225	0	0.085708163	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.6375	0	0	7.3695	0	1.215874514	0	5.056903027	1.3243952	1.3243952	0.920850041	0.46851108	0	0	0	0	6.300188685	2.752881891	6.686451728	0.318894322	0.041449321	0	3.947798329	0	0	0	0.0362848	1.787477225	0	0.085708163	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.6375	none																																																																																			0	0	0	7.3695	0	1.215874514	0	5.056903027	1.3243952	1.3243952	0.920850041	0.46851108	0	0	0	0	6.300188685	2.752881891	6.686451728	0.318894322	0.041449321	0	3.947798329	0	0	0	0.0362848	1.787477225	0	0.085708163	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.6375
H3330_023_2	2008	10																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2039.46357	96.03107161	1435.727391	253.6816686	240.5946623	7.10895585	7.10895585	202.9456899	136.9818356	0	0	0	0	688.8686828	6158.428324	7684.1777	142.6786837	46.36280903	365.0765957	4415.778448	43.91335035	0	0	43.879788	1429.319222	0	73.89736325	0	0	0	0											$300 (day 1) /$50 day (days 2-10) Copay	$0 Copay	$50 (days 21-100) Copay	$0 Copay	$150 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$10 Copay	$15 Copay	$30 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											87.72830606	0	9.478857112	0	150	0.2	0.2	50	75	0	0	0	0	75	10	15	30	15	0	15	0	0	0	10	15	0	15	0	0	0	0											14.9099	0	1.134087899	0	3.007433278	1.42179117	1.42179117	0.845607041	0.856136473	0	0	0	0	4.305429268	5.132023604	9.605222126	0.356696709	0.057953511	0	5.51972306	0	0	0	0.03656649	1.786649027	0	0.092371704	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4894	0	0	14.9099	0	1.134087899	0	3.007433278	1.42179117	1.42179117	0.845607041	0.856136473	0	0	0	0	4.305429268	5.132023604	9.605222126	0.356696709	0.057953511	0	5.51972306	0	0	0	0.03656649	1.786649027	0	0.092371704	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4894	none																																																																																			0	0	0	14.9099	0	1.134087899	0	3.007433278	1.42179117	1.42179117	0.845607041	0.856136473	0	0	0	0	4.305429268	5.132023604	9.605222126	0.356696709	0.057953511	0	5.51972306	0	0	0	0.03656649	1.786649027	0	0.092371704	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4894
H3330_023_3	2008	8																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2260.284603	96.03107161	1195.387904	217.1424112	159.1956402	6.074442	6.074442	282.2035539	131.0365997	0	0	0	0	1377.120108	7041.318288	9402.086969	163.1335094	53.00951442	417.4150245	5048.837123	97.60991615	0	0	45.51648	1401.280492	0	67.69417161	0	0	0	0											$300 (day 1) /$50 day (days 2-10) Copay	$0 Copay	$50 (days 21-100) Copay	$0 Copay	$150 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$10 Copay	$15 Copay	$30 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											87.72830606	0	9.478857112	0	150	0.2	0.2	50	75	0	0	0	0	75	10	15	30	15	0	15	0	0	0	10	15	0	15	0	0	0	0											16.5242	0	0.944242595	0	1.989945503	1.2148884	1.2148884	1.175848141	0.818978748	0	0	0	0	8.607000674	5.86776524	11.75260871	0.407833774	0.066261893	0	6.311046403	0	0	0	0.0379304	1.751600614	0	0.084617715	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.7697	0	0	16.5242	0	0.944242595	0	1.989945503	1.2148884	1.2148884	1.175848141	0.818978748	0	0	0	0	8.607000674	5.86776524	11.75260871	0.407833774	0.066261893	0	6.311046403	0	0	0	0.0379304	1.751600614	0	0.084617715	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.7697	none																																																																																			0	0	0	16.5242	0	0.944242595	0	1.989945503	1.2148884	1.2148884	1.175848141	0.818978748	0	0	0	0	8.607000674	5.86776524	11.75260871	0.407833774	0.066261893	0	6.311046403	0	0	0	0.0379304	1.751600614	0	0.084617715	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.7697
H3330_025_1	2008	6																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2015.938221	96.03107161	1518.180196	200.0944158	478.8121429	6.5312589	6.5312589	227.7591702	77.253038	0	0	0	0	1038.84142	5465.53824	7905.345654	153.0692744	49.73918565	391.6633386	4737.357995	75.21169522	0	0	42.945264	1410.391887	0	67.62720988	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.03578772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.03578772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0358	none																																																																																			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.03578772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0358
H3330_025_2	2008	6																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2070.572572	96.03107161	1381.040833	244.0189866	231.4304616	6.8381772	6.8381772	205.9021187	138.9773303	0	0	0	0	698.9038367	3397.235976	8766.89553	142.6786837	46.36280903	365.0765957	4415.778448	42.24069996	0	0	42.208416	1374.87675	0	71.08262805	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.03517368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.03517368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0352	none																																																																																			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.03517368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0352
H3330_025_3	2008	8																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2232.528447	96.03107161	1172.243068	212.9381479	156.1133295	5.95683	5.95683	278.8793448	129.4930577	0	0	0	0	1360.898359	7510.629349	7523.742841	163.1335094	53.00951442	417.4150245	5048.837123	95.72001458	0	0	44.6352	1374.149209	0	66.38349206	0	0	0	0											$250 (day 1) /$50 day (days 2-10) Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$100 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$5 Copay	$10 Copay	$30 Copay	$10 Copay	$0 Copay	$10 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											80.18264485	0	4.739428556	0	100	0.2	0.2	50	75	0	0	0	0	75	5	10	30	10	0	10	0	0	0	10	15	0	15	0	0	0	0											14.9175	0	0.462980189	0	1.300944413	1.191366	1.191366	1.16199727	0.809331611	0	0	0	0	8.505614744	3.129428896	6.2697857	0.407833774	0.044174595	0	4.207364269	0	0	0	0.037196	1.717686512	0	0.082979365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4376	0	0	14.9175	0	0.462980189	0	1.300944413	1.191366	1.191366	1.16199727	0.809331611	0	0	0	0	8.505614744	3.129428896	6.2697857	0.407833774	0.044174595	0	4.207364269	0	0	0	0.037196	1.717686512	0	0.082979365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4376	none																																																																																			0	0	0	14.9175	0	0.462980189	0	1.300944413	1.191366	1.191366	1.16199727	0.809331611	0	0	0	0	8.505614744	3.129428896	6.2697857	0.407833774	0.044174595	0	4.207364269	0	0	0	0.037196	1.717686512	0	0.082979365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4376
H3330_026_0	2008	8																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2116.036729	96.03107161	1463.623792	210.279745	402.6542542	6.553544609	6.553544609	235.2567983	97.46280707	0	0	0	0	1030.736465	4950.426579	8331.039311	151.8599603	49.34622434	388.569027	4699.930796	70.29728698	0	0	42.9828	1401.786144	0	68.30105205	0	0	0	0											150 Copay	$0 Copay	$50 (days 21-100) Copay	$0 Copay	$150 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$0 Copay	$5 Copay	$25 Copay	$5 Copay	$0 Copay	$5 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											150	0	9.478857112	0	150	0.2	0.2	50	75	0	0	0	0	75	0	5	25	5	0	5	0	0	0	10	15	0	15	0	0	0	0											26.4505	0	1.156123399	0	5.033178177	1.310708922	1.310708922	0.980236659	0.609142544	0	0	0	0	6.442102907	0	3.47126638	0.316374917	0.020560927	0	1.958304498	0	0	0	0.035819	1.75223268	0	0.085376315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.9326	0	0	26.4505	0	1.156123399	0	5.033178177	1.310708922	1.310708922	0.980236659	0.609142544	0	0	0	0	6.442102907	0	3.47126638	0.316374917	0.020560927	0	1.958304498	0	0	0	0.035819	1.75223268	0	0.085376315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.9326	none																																																																																			0	0	0	26.4505	0	1.156123399	0	5.033178177	1.310708922	1.310708922	0.980236659	0.609142544	0	0	0	0	6.442102907	0	3.47126638	0.316374917	0.020560927	0	1.958304498	0	0	0	0.035819	1.75223268	0	0.085376315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.9326
H3330_029_0	2008	6																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2342.628883	96.03107161	1609.152593	231.1879589	442.6903558	8.699950498	8.699950498	259.3552209	107.4463652	0	0	0	0	1136.319484	8796.966926	6331.039311	151.8599603	49.34622434	388.569027	4699.930796	0	0	0	0	785.5387911	0	75.09225774	0	0	0	0											$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	0% Coinsurance	0% Coinsurance	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	none																																																																																			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H3330_030_1	2008	7	s.										Professional										none	Podiatry										D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O	V																																																			0	n/a	2408.491517	96.03107161	2019.278606	266.1386139	636.8513558	10.85875	10.85875	270.0929358	91.61211737	0	0	0	0	1231.931644	8638.652673	8206.332082	153.0692744	49.73918565	391.6633386	4737.357995	100.0364564	0	0	57.12	1875.91313	0	89.94859662	0	0	0	0	2699.013571										$300 Copay	$0 Copay	$50 (days 21-100) Copay	$0 Copay	$125 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$0 Copay	$5 Copay	$25 Copay	$5 Copay	$0 Copay	$5 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay										37.72830606	0	9.478857112	0	125	0.2	0.2	50	75	0	0	0	0	75	0	5	25	5	0	5	0	0	0	10	15	0	15	0	0	0	0	0										7.5724	0	1.595037781	0	6.633868289	2.17175	2.17175	1.125387232	0.572575734	0	0	0	0	7.699572777	0	3.419305034	0.318894322	0.020724661	0	1.973899165	0	0	0	0.0476	2.344891412	0	0.112435746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.7801	0	0	7.5724	0	1.595037781	0	6.633868289	2.17175	2.17175	1.125387232	0.572575734	0	0	0	0	7.699572777	0	3.419305034	0.318894322	0.020724661	0	1.973899165	0	0	0	0.0476	2.344891412	0	0.112435746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.7801	none																																																																																			0	0	0	7.5724	0	1.595037781	0	6.633868289	2.17175	2.17175	1.125387232	0.572575734	0	0	0	0	7.699572777	0	3.419305034	0.318894322	0.020724661	0	1.973899165	0	0	0	0.0476	2.344891412	0	0.112435746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.7801
H3330_030_2	2008	8	s.										Professional										none	Podiatry										D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O	V																																																			0	n/a	2649.527034	96.03107161	1802.193409	318.4333139	302.0058802	10.7082	10.7082	260.9227731	176.1145084	0	0	0	0	885.6631897	7122.309602	7567.881959	142.6786837	46.36280903	365.0765957	4415.778448	55.12212906	0	0	55.08	1794.149569	0	92.75949027	0	0	0	0	2699.013571										$300 (day 1) /$50 day (days 2-10) Copay	$0 Copay	$50 (days 21-100) Copay	$0 Copay	$150 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$5 Copay	$10 Copay	$30 Copay	$10 Copay	$0 Copay	$10 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay										87.72830606	0	9.478857112	0	150	0.2	0.2	50	75	0	0	0	0	75	5	10	30	10	0	10	0	0	0	10	15	0	15	0	0	0	0	0										19.3699	0	1.423561151	0	3.775073503	2.14164	2.14164	1.087178221	1.100715678	0	0	0	0	5.535394935	2.967629001	6.306568299	0.356696709	0.038635674	0	3.679815373	0	0	0	0.0459	2.242686962	0	0.115949363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.329	0	0	19.3699	0	1.423561151	0	3.775073503	2.14164	2.14164	1.087178221	1.100715678	0	0	0	0	5.535394935	2.967629001	6.306568299	0.356696709	0.038635674	0	3.679815373	0	0	0	0.0459	2.242686962	0	0.115949363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.329	none																																																																																			0	0	0	19.3699	0	1.423561151	0	3.775073503	2.14164	2.14164	1.087178221	1.100715678	0	0	0	0	5.535394935	2.967629001	6.306568299	0.356696709	0.038635674	0	3.679815373	0	0	0	0.0459	2.242686962	0	0.115949363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.329
H3330_030_3	2008	8	s.										Professional										none	Podiatry										D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O	V																																																			0	n/a	2932.120095	96.03107161	1446.552233	262.7664531	192.6444194	8.8209	8.8209	362.6657625	168.3979089	0	0	0	0	1769.76621	8358.428659	8824.729269	163.1335094	53.00951442	417.4150245	5048.837123	118.118848	0	0	55.08	1695.705148	0	81.91747192	0	0	0	0	2699.013571										$300 (day 1) /$50 day (days 2-10) Copay	$0 Copay	$50 (days 21-100) Copay	$0 Copay	$150 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$5 Copay	$10 Copay	$30 Copay	$10 Copay	$0 Copay	$10 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay										87.72830606	0	9.478857112	0	150	0.2	0.2	50	75	0	0	0	0	75	5	10	30	10	0	10	0	0	0	10	15	0	15	0	0	0	0	0										21.4358	0	1.142638493	0	2.408055243	1.76418	1.76418	1.511107344	1.052486931	0	0	0	0	11.06103881	3.482678608	7.353941058	0.407833774	0.044174595	0	4.207364269	0	0	0	0.0459	2.119631436	0	0.10239684	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9034	0	0	21.4358	0	1.142638493	0	2.408055243	1.76418	1.76418	1.511107344	1.052486931	0	0	0	0	11.06103881	3.482678608	7.353941058	0.407833774	0.044174595	0	4.207364269	0	0	0	0.0459	2.119631436	0	0.10239684	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9034	none																																																																																			0	0	0	21.4358	0	1.142638493	0	2.408055243	1.76418	1.76418	1.511107344	1.052486931	0	0	0	0	11.06103881	3.482678608	7.353941058	0.407833774	0.044174595	0	4.207364269	0	0	0	0.0459	2.119631436	0	0.10239684	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9034
H3330_031_1	2008	6																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2181.302191	96.03107161	1880.626283	247.864396	593.1224123	9.412503231	9.412503231	245.5923653	83.30183286	0	0	0	0	1120.181117	11430.5717	6405.345654	153.0692744	49.73918565	391.6633386	4737.357995	0	0	0	0	791.0759335	0	83.77234048	0	0	0	0											$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	0% Coinsurance	0% Coinsurance	$50 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$20 Copay	$10 Copay	$0 Copay	$10 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											0	0	0	0	0	0	0	50	0	0	0	0	0	0	0	10	20	10	0	10	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.023301522	0	0	0	0	0	0	0	5.337788045	0.255115457	0.041449321	0	3.947798329	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.6055	0	0	0	0	0	0	0	0	0	1.023301522	0	0	0	0	0	0	0	5.337788045	0.255115457	0.041449321	0	3.947798329	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.6055	none																																																																																			0	0	0	0	0	0	0	0	0	0	1.023301522	0	0	0	0	0	0	0	5.337788045	0.255115457	0.041449321	0	3.947798329	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.6055
H3330_031_2	2008	8																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a								313.1212742								11539.92259	187.8088955	61.02767229		5812.518389																						$0 Copay	$0 Copay	0 Copay	$0 Copay	$0 Copay	0%Coinsurance	0%Coinsurance	$50 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$20 Copay	$10 Copay	$0 Copay	$10 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											0	0	0	0	0	0	0	50	0	0	0	0	0	0	0	10	20	10	0	10	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.304671976	0	0	0	0	0	0	0	9.616602162	0.313014826	0.050856394	0	4.843765324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.1289	0	0	0	0	0	0	0	0	0	1.304671976	0	0	0	0	0	0	0	9.616602162	0.313014826	0.050856394	0	4.843765324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.1289	none																																																																																			0	0	0	0	0	0	0	0	0	0	1.304671976	0	0	0	0	0	0	0	9.616602162	0.313014826	0.050856394	0	4.843765324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.1289
H3330_802_1	2008	4																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	1907.932459	96.03107161	1522.536069	200.6685149	480.1859222	6.549998	6.549998	216.1116037	73.30233035	0	0	0	0	985.7152411	6606.916539	8317.628069	153.0692744	49.73918565	391.6633386	4737.357995	75.42748815	0	0	43.06848	1414.4385	0	67.82124185	0	0	0	0											$150 Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$100 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$0 Copay	$5 Copay	$25 Copay	$5 Copay	$0 Copay	$5 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											22.63698364	0	4.739428556	0	100	0.2	0.2	50	75	0	0	0	0	75	0	5	25	5	0	5	0	0	0	10	15	0	15	0	0	0	0											3.5992	0	0.601329243	0	4.001549352	1.3099996	1.3099996	0.900465015	0.458139565	0	0	0	0	6.160720257	0	3.465678362	0.318894322	0.020724661	0	1.973899165	0	0	0	0.0358904	1.768048125	0	0.084776552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.0093	0	0	3.5992	0	0.601329243	0	4.001549352	1.3099996	1.3099996	0.900465015	0.458139565	0	0	0	0	6.160720257	0	3.465678362	0.318894322	0.020724661	0	1.973899165	0	0	0	0.0358904	1.768048125	0	0.084776552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.0093	none																																																																																			0	0	0	3.5992	0	0.601329243	0	4.001549352	1.3099996	1.3099996	0.900465015	0.458139565	0	0	0	0	6.160720257	0	3.465678362	0.318894322	0.020724661	0	1.973899165	0	0	0	0.0358904	1.768048125	0	0.084776552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.0093
H3330_802_2	2008	4																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2019.443963	96.03107161	1413.32012	249.7224811	236.8397225	6.998007	6.998007	201.0431363	135.6976729	0	0	0	0	682.4107503	6158.428324	7406.179536	142.6786837	46.36280903	365.0765957	4415.778448	43.22799854	0	0	43.19496	1407.011962	0	72.74405359	0	0	0	0											$250 (day 1) /$50 day (days 2-10) Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$100 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$5 Copay	$10 Copay	$30 Copay	$10 Copay	$0 Copay	$10 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											80.18264485	0	4.739428556	0	100	0.2	0.2	50	75	0	0	0	0	75	5	10	30	10	0	10	0	0	0	10	15	0	15	0	0	0	0											13.4937	0	0.558194145	0	1.973664354	1.3996014	1.3996014	0.837679735	0.848110456	0	0	0	0	4.265067189	2.566011802	6.17181628	0.356696709	0.038635674	0	3.679815373	0	0	0	0.0359958	1.758764953	0	0.090930067	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4743	0	0	13.4937	0	0.558194145	0	1.973664354	1.3996014	1.3996014	0.837679735	0.848110456	0	0	0	0	4.265067189	2.566011802	6.17181628	0.356696709	0.038635674	0	3.679815373	0	0	0	0.0359958	1.758764953	0	0.090930067	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4743	none																																																																																			0	0	0	13.4937	0	0.558194145	0	1.973664354	1.3996014	1.3996014	0.837679735	0.848110456	0	0	0	0	4.265067189	2.566011802	6.17181628	0.356696709	0.038635674	0	3.679815373	0	0	0	0.0359958	1.758764953	0	0.090930067	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4743
H3330_802_3	2008	4																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2199.539572	96.03107161	1187.244351	215.6631334	158.1111235	6.03306	6.03306	274.9284406	127.65852	0	0	0	0	1341.618412	7041.318288	9258.167927	163.1335094	53.00951442	417.4150245	5048.837123	96.94495078	0	0	45.2064	1391.7343	0	67.23300659	0	0	0	0											$250 (day 1) /$50 day (days 2-10) Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$100 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$5 Copay	$10 Copay	$30 Copay	$10 Copay	$0 Copay	$10 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											80.18264485	0	4.739428556	0	100	0.2	0.2	50	75	0	0	0	0	75	5	10	30	10	0	10	0	0	0	10	15	0	15	0	0	0	0											14.6971	0	0.468904982	0	1.317592696	1.206612	1.206612	1.145535169	0.79786575	0	0	0	0	8.385115072	2.93388262	7.715139939	0.407833774	0.044174595	0	4.207364269	0	0	0	0.037672	1.739667875	0	0.084041258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3951	0	0	14.6971	0	0.468904982	0	1.317592696	1.206612	1.206612	1.145535169	0.79786575	0	0	0	0	8.385115072	2.93388262	7.715139939	0.407833774	0.044174595	0	4.207364269	0	0	0	0.037672	1.739667875	0	0.084041258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3951	none																																																																																			0	0	0	14.6971	0	0.468904982	0	1.317592696	1.206612	1.206612	1.145535169	0.79786575	0	0	0	0	8.385115072	2.93388262	7.715139939	0.407833774	0.044174595	0	4.207364269	0	0	0	0.037672	1.739667875	0	0.084041258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3951
H3330_804_1	2008	4																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	1953.179726	96.03107161	1549.79633	204.2613861	488.7834155	6.6672725	6.6672725	220.9911633	74.95741541	0	0	0	0	1007.971595	6606.916539	8153.451749	153.0692744	49.73918565	391.6633386	4737.357995	76.77798031	0	0	43.8396	1439.763327	0	69.03554791	0	0	0	0											$300 Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$5 Copay	$10 Copay	$25 Copay	$10 Copay	$0 Copay	$10 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											45.27396727	0	4.739428556	0	100	0.2	0.2	50	75	0	0	0	0	75	5	10	25	10	0	10	0	0	0	10	15	0	15	0	0	0	0											7.369	0	0.612095749	0	4.073195129	1.3334545	1.3334545	0.920796514	0.468483846	0	0	0	0	6.299822466	2.752881891	6.794543124	0.318894322	0.041449321	0	3.947798329	0	0	0	0.036533	1.799704159	0	0.086294435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1884	0	0	7.369	0	0.612095749	0	4.073195129	1.3334545	1.3334545	0.920796514	0.468483846	0	0	0	0	6.299822466	2.752881891	6.794543124	0.318894322	0.041449321	0	3.947798329	0	0	0	0.036533	1.799704159	0	0.086294435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1884	none																																																																																			0	0	0	7.369	0	0.612095749	0	4.073195129	1.3334545	1.3334545	0.920796514	0.468483846	0	0	0	0	6.299822466	2.752881891	6.794543124	0.318894322	0.041449321	0	3.947798329	0	0	0	0.036533	1.799704159	0	0.086294435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1884
H3330_804_2	2008	4																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2071.390127	96.03107161	1425.801978	251.9279266	238.9313929	7.0598105	7.0598105	205.9798146	139.0297725	0	0	0	0	699.1675638	6158.428324	7561.037018	142.6786837	46.36280903	365.0765957	4415.778448	43.60977032	0	0	43.57644	1419.438109	0	73.38649895	0	0	0	0											$300 (day 1) /$50 day (days 2-10) Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$10 Copay	$15 Copay	$30 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											87.72830606	0	4.739428556	0	100	0.2	0.2	50	75	0	0	0	0	75	10	15	30	15	0	15	0	0	0	10	15	0	15	0	0	0	0											15.1433	0	0.563123884	0	1.99109494	1.4119621	1.4119621	0.858249228	0.868936078	0	0	0	0	4.369797274	5.132023604	9.451296273	0.356696709	0.057953511	0	5.51972306	0	0	0	0.0363137	1.774297637	0	0.091733124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0385	0	0	15.1433	0	0.563123884	0	1.99109494	1.4119621	1.4119621	0.858249228	0.868936078	0	0	0	0	4.369797274	5.132023604	9.451296273	0.356696709	0.057953511	0	5.51972306	0	0	0	0.0363137	1.774297637	0	0.091733124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0385	none																																																																																			0	0	0	15.1433	0	0.563123884	0	1.99109494	1.4119621	1.4119621	0.858249228	0.868936078	0	0	0	0	4.369797274	5.132023604	9.451296273	0.356696709	0.057953511	0	5.51972306	0	0	0	0.0363137	1.774297637	0	0.091733124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0385
H3330_804_3	2008	4																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2260.284603	96.03107161	1202.888545	218.5049039	160.1945372	6.112557	6.112557	282.2035539	131.0365997	0	0	0	0	1377.120108	7041.318288	9534.643981	163.1335094	53.00951442	417.4150245	5048.837123	98.22238425	0	0	45.80208	1410.073037	0	68.11892887	0	0	0	0											$300 (day 1) /$50 day (days 2-10) Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$100 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$10 Copay	$15 Copay	$30 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											87.72830606	0	4.739428556	0	100	0.2	0.2	50	75	0	0	0	0	75	10	15	30	15	0	15	0	0	0	10	15	0	15	0	0	0	0											16.5242	0	0.475083693	0	1.334954477	1.2225114	1.2225114	1.175848141	0.818978748	0	0	0	0	8.607000674	5.86776524	11.91830498	0.407833774	0.066261893	0	6.311046403	0	0	0	0.0381684	1.762591296	0	0.085148661	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8383	0	0	16.5242	0	0.475083693	0	1.334954477	1.2225114	1.2225114	1.175848141	0.818978748	0	0	0	0	8.607000674	5.86776524	11.91830498	0.407833774	0.066261893	0	6.311046403	0	0	0	0.0381684	1.762591296	0	0.085148661	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8383	none																																																																																			0	0	0	16.5242	0	0.475083693	0	1.334954477	1.2225114	1.2225114	1.175848141	0.818978748	0	0	0	0	8.607000674	5.86776524	11.91830498	0.407833774	0.066261893	0	6.311046403	0	0	0	0.0381684	1.762591296	0	0.085148661	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8383
H3330_806_1	2008	4																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2016.037491	96.03107161	1527.641959	201.3414653	481.7962464	6.5719637	6.5719637	227.7698757	77.25666917	0	0	0	0	1038.89025	5582.099263	7905.345654	153.0692744	49.73918565	391.6633386	4737.357995	75.68043748	0	0	43.212912	1419.18188	0	68.0486833	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.03601076	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.036	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.03601076	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.036	none																																																																																			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.03601076	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.036
H3330_806_2	2008	4																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2070.572572	96.03107161	1380.480151	243.9199185	231.3365042	6.835401	6.835401	205.9021187	138.9773303	0	0	0	0	698.9038367	3390.279812	8766.89553	142.6786837	46.36280903	365.0765957	4415.778448	42.22355086	0	0	42.19128	1374.31857	0	71.05376954	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0351594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0351594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0352	none																																																																																			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0351594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0352
H3330_806_3	2008	4																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2232.528447	96.03107161	1170.957244	212.7045778	155.94209	5.950296	5.950296	278.8793448	129.4930577	0	0	0	0	1360.898359	7487.90529	7523.742841	163.1335094	53.00951442	417.4150245	5048.837123	95.61502005	0	0	44.58624	1372.641916	0	66.31067653	0	0	0	0											$250 (day 1) /$50 day (days 2-10) Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$100 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$5 Copay	$10 Copay	$30 Copay	$10 Copay	$0 Copay	$10 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											80.18264485	0	4.739428556	0	100	0.2	0.2	50	75	0	0	0	0	75	5	10	30	10	0	10	0	0	0	10	15	0	15	0	0	0	0											14.9175	0	0.46247235	0	1.299517417	1.1900592	1.1900592	1.16199727	0.809331611	0	0	0	0	8.505614744	3.119960538	6.2697857	0.407833774	0.044174595	0	4.207364269	0	0	0	0.0371552	1.715802395	0	0.082888346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4215	0	0	14.9175	0	0.46247235	0	1.299517417	1.1900592	1.1900592	1.16199727	0.809331611	0	0	0	0	8.505614744	3.119960538	6.2697857	0.407833774	0.044174595	0	4.207364269	0	0	0	0.0371552	1.715802395	0	0.082888346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4215	none																																																																																			0	0	0	14.9175	0	0.46247235	0	1.299517417	1.1900592	1.1900592	1.16199727	0.809331611	0	0	0	0	8.505614744	3.119960538	6.2697857	0.407833774	0.044174595	0	4.207364269	0	0	0	0.0371552	1.715802395	0	0.082888346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4215
H3330_808_0	2008	5																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2241.018051	96.03107161	1581.713989	227.2458374	435.141783	7.082307108	7.082307108	248.5487533	102.9694333	0	0	0	0	1088.972839	6448.812541	8331.039311	151.8599603	49.34622434	388.569027	4699.930796	75.96911365	0	0	46.4508	1514.887067	0	73.81181562	0	0	0	0											150 Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$100 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$0 Copay	$5 Copay	$25 Copay	$5 Copay	$0 Copay	$5 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											150	0	4.739428556	0	100	0.2	0.2	50	75	0	0	0	0	75	0	5	25	5	0	5	0	0	0	10	15	0	15	0	0	0	0											28.0127	0	0.624701704	0	3.626181525	1.416461422	1.416461422	1.035619806	0.643558958	0	0	0	0	6.806080242	0	3.47126638	0.316374917	0.020560927	0	1.958304498	0	0	0	0.038709	1.893608833	0	0.09226477	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.3729	0	0	28.0127	0	0.624701704	0	3.626181525	1.416461422	1.416461422	1.035619806	0.643558958	0	0	0	0	6.806080242	0	3.47126638	0.316374917	0.020560927	0	1.958304498	0	0	0	0.038709	1.893608833	0	0.09226477	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.3729	none																																																																																			0	0	0	28.0127	0	0.624701704	0	3.626181525	1.416461422	1.416461422	1.035619806	0.643558958	0	0	0	0	6.806080242	0	3.47126638	0.316374917	0.020560927	0	1.958304498	0	0	0	0.038709	1.893608833	0	0.09226477	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.3729
H3330_810_0	2008	4																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2342.628883	96.03107161	1592.092033	228.7368575	437.9968634	8.286874176	8.286874176	259.3552209	107.4463652	0	0	0	0	1136.319484	8580.494225	6331.039311	151.8599603	49.34622434	388.569027	4699.930796	0	0	0	0	777.2103504	0	74.29611449	0	0	0	0											$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	0% Coinsurance	0% Coinsurance	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	none																																																																																			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H3330_811_1	2008	4	s.										Professional										none	Podiatry										D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O	V																																																			0	n/a	2549.613752	96.03107161	1947.161513	256.6336634	614.1066645	10.4709375	10.4709375	285.3118517	96.7741817	0	0	0	0	1301.347248	7750.23024	8206.332082	153.0692744	49.73918565	391.6633386	4737.357995	96.46372585	0	0	55.08	1808.916232	0	86.73614674	0	0	0	0	2699.013571										$300 Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$100 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$0 Copay	$5 Copay	$25 Copay	$5 Copay	$0 Copay	$5 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay										37.72830606	0	4.739428556	0	100	0.2	0.2	50	75	0	0	0	0	75	0	5	25	5	0	5	0	0	0	10	15	0	15	0	0	0	0	0										8.0161	0	0.769036073	0	5.117555537	2.0941875	2.0941875	1.188799382	0.604838636	0	0	0	0	8.133420298	0	3.419305034	0.318894322	0.020724661	0	1.973899165	0	0	0	0.0459	2.261145291	0	0.108420183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1664	0	0	8.0161	0	0.769036073	0	5.117555537	2.0941875	2.0941875	1.188799382	0.604838636	0	0	0	0	8.133420298	0	3.419305034	0.318894322	0.020724661	0	1.973899165	0	0	0	0.0459	2.261145291	0	0.108420183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1664	none																																																																																			0	0	0	8.0161	0	0.769036073	0	5.117555537	2.0941875	2.0941875	1.188799382	0.604838636	0	0	0	0	8.133420298	0	3.419305034	0.318894322	0.020724661	0	1.973899165	0	0	0	0.0459	2.261145291	0	0.108420183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1664
H3330_811_2	2008	4	s.										Professional										none	Podiatry										D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O	V																																																			0	n/a	2658.813616	96.03107161	1802.193409	318.4333139	302.0058802	10.7082	10.7082	261.8053189	176.7101985	0	0	0	0	888.6588589	7122.309602	7567.881959	142.6786837	46.36280903	365.0765957	4415.778448	55.12212906	0	0	55.08	1794.149569	0	92.75949027	0	0	0	0	2699.013571										$300 (day 1) /$50 day (days 2-10) Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$100 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$5 Copay	$10 Copay	$30 Copay	$10 Copay	$0 Copay	$10 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay										87.72830606	0	4.739428556	0	100	0.2	0.2	50	75	0	0	0	0	75	5	10	30	10	0	10	0	0	0	10	15	0	15	0	0	0	0	0										19.4378	0	0.711780575	0	2.516715668	2.14164	2.14164	1.090855495	1.104438741	0	0	0	0	5.554117868	2.967629001	6.306568299	0.356696709	0.038635674	0	3.679815373	0	0	0	0.0459	2.242686962	0	0.115949363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4528	0	0	19.4378	0	0.711780575	0	2.516715668	2.14164	2.14164	1.090855495	1.104438741	0	0	0	0	5.554117868	2.967629001	6.306568299	0.356696709	0.038635674	0	3.679815373	0	0	0	0.0459	2.242686962	0	0.115949363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4528	none																																																																																			0	0	0	19.4378	0	0.711780575	0	2.516715668	2.14164	2.14164	1.090855495	1.104438741	0	0	0	0	5.554117868	2.967629001	6.306568299	0.356696709	0.038635674	0	3.679815373	0	0	0	0.0459	2.242686962	0	0.115949363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4528
H3330_811_3	2008	4	s.										Professional										none	Podiatry										D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O	O	V																																																			0	n/a	2903.226391	96.03107161	1446.552233	262.7664531	192.6444194	8.8209	8.8209	359.2053153	166.7911069	0	0	0	0	1752.879635	8358.428659	8824.729269	163.1335094	53.00951442	417.4150245	5048.837123	118.118848	0	0	55.08	1695.705148	0	81.91747192	0	0	0	0	2699.013571										$300 (day 1) /$50 day (days 2-10) Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$100 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$5 Copay	$10 Copay	$30 Copay	$10 Copay	$0 Copay	$10 Copay	$0 Copay	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay										87.72830606	0	4.739428556	0	100	0.2	0.2	50	75	0	0	0	0	75	5	10	30	10	0	10	0	0	0	10	15	0	15	0	0	0	0	0										21.2246	0	0.571319247	0	1.605370162	1.76418	1.76418	1.496688814	1.042444418	0	0	0	0	10.95549772	3.482678608	7.353941058	0.407833774	0.044174595	0	4.207364269	0	0	0	0.0459	2.119631436	0	0.10239684	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1882	0	0	21.2246	0	0.571319247	0	1.605370162	1.76418	1.76418	1.496688814	1.042444418	0	0	0	0	10.95549772	3.482678608	7.353941058	0.407833774	0.044174595	0	4.207364269	0	0	0	0.0459	2.119631436	0	0.10239684	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1882	none																																																																																			0	0	0	21.2246	0	0.571319247	0	1.605370162	1.76418	1.76418	1.496688814	1.042444418	0	0	0	0	10.95549772	3.482678608	7.353941058	0.407833774	0.044174595	0	4.207364269	0	0	0	0.0459	2.119631436	0	0.10239684	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1882
H3333_031_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		277.5535688	179.4203427	884.1453836	21.82883513	170.2594852	9.052856539	11.37244936	304.1268446	280.276535		38.53816254		11.14532179	0.481741894	3638.778472	4067.06429	5.661076197	719.3414499			20.0168569	8.397333859			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															157.9048	40.9824	24.8356	0.121465246	40.4884	0.161953661	0.161953661	28.3419	35.1062		0.08097683		40.4884	0.326265135	8.0977	19.6405	0.404884152	20.2442			0.161953661	0.169281394			12.1465		12.1465															3.6523	0.612755964	1.829856309	2.651444823	0.574461395	1.466143259	1.841809809	0.718294148	0.819954345	0	3.120698255	0	0.037604701	0.157175584	2.455472896	6.656593956	2.292080038	1.213541472	0	0	3.241803255	1.421512384	0	0	0.437274885	0	0.252040385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4528	0	8.328605627	3.6523	0.612755964	1.829856309	2.651444823	0.574461395	1.466143259	1.841809809	0.718294148	0.819954345	0	3.120698255	0	0.037604701	0.157175584	2.455472896	6.656593956	2.292080038	1.213541472	0	0	3.241803255	1.421512384	0	0	0.437274885	0	0.252040385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4528																																																																																				0	0	0	3.6523	0.612755964	1.829856309	2.651444823	0.574461395	1.466143259	1.841809809	0.718294148	0.819954345	0	3.120698255	0	0.037604701	0.157175584	2.455472896	6.656593956	2.292080038	1.213541472	0	0	3.241803255	1.421512384	0	0	0.437274885	0	0.252040385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4528
H3333_032_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		281.8234619	104.4394533	782.9193612	18.85741451	164.7891085	9.705737583	10.21256781	292.1075828	292.6023815		37.42220332		7.608600907	0.437612706	3459.106666	3350.29921	3.036859615	484.7635576			16.93853014	6.950183369			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															163.2826	42.3781	25.6814	0.125601968	41.8673	0.16746929	0.16746929	29.3071	34.8633		0.083734645		41.8673	0.249987475	8.3735	20.272	0.418673225	20.9337			0.16746929	0.180956177			12.5602		12.5602															3.8347	0.368828833	1.675539793	2.368528365	0.574939896	1.625412983	1.710291481	0.713402805	0.850089989	0	3.133534911	0	0.026545979	0.109397695	2.413725573	5.659784024	1.271451809	0.845656342	0	0	2.836683618	1.257678611	0	0	0.452167083	0	0.260624083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.989	0	6.213829356	3.8347	0.368828833	1.675539793	2.368528365	0.574939896	1.625412983	1.710291481	0.713402805	0.850089989	0	3.133534911	0	0.026545979	0.109397695	2.413725573	5.659784024	1.271451809	0.845656342	0	0	2.836683618	1.257678611	0	0	0.452167083	0	0.260624083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.989																																																																																				0	0	0	3.8347	0.368828833	1.675539793	2.368528365	0.574939896	1.625412983	1.710291481	0.713402805	0.850089989	0	3.133534911	0	0.026545979	0.109397695	2.413725573	5.659784024	1.271451809	0.845656342	0	0	2.836683618	1.257678611	0	0	0.452167083	0	0.260624083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.989
H3333_033_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		285.0319555	142.0476584	965.1675257	26.23068679	208.4306524	9.380634292	10.2804169	324.1905413	302.8557649		42.41963667		8.329992494	0.654578004	3521.364013	3846.55092	4.686223791	575.4682757			19.09088204	8.379833917			432		249.1557848															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															158.1452	41.0448	24.8734	0.121650174	40.5501	0.162200233	0.162200233	28.385	34.8001		0.081100116		40.5501	0.160070736	8.11	19.6281	0.405500582	20.275			0.162200233	0.166957639			12.165		12.165															3.7564	0.485859442	2.000583618	3.190967626	0.704322923	1.521541065	1.667486013	0.76684681	0.878284732	0	3.440237468	0	0.028148473	0.104778782	2.379858593	6.291706889	1.900266473	0.972303002	0	0	3.096545508	1.399077287	0	0	0.437940628	0	0.252582039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2757	0	8.220786862	3.7564	0.485859442	2.000583618	3.190967626	0.704322923	1.521541065	1.667486013	0.76684681	0.878284732	0	3.440237468	0	0.028148473	0.104778782	2.379858593	6.291706889	1.900266473	0.972303002	0	0	3.096545508	1.399077287	0	0	0.437940628	0	0.252582039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2757																																																																																				0	0	0	3.7564	0.485859442	2.000583618	3.190967626	0.704322923	1.521541065	1.667486013	0.76684681	0.878284732	0	3.440237468	0	0.028148473	0.104778782	2.379858593	6.291706889	1.900266473	0.972303002	0	0	3.096545508	1.399077287	0	0	0.437940628	0	0.252582039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2757
H3333_034_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		320.1342638	179.13203	1004.676649	33.90344001	255.9051518	8.603806592	8.728432394	303.5304022	309.68912		47.38870305		13.80734796	0.524894705	3590.917531	4657.498323	9.092660274	1043.235602			20.21705796	9.562689917			432		249.0071543															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															151.9525	39.4375	23.8994	0.116886531	38.9622	0.155848708	0.155848708	27.2735	33.3759		0.077924354		38.9622	0.179764513	7.7924	18.9684	0.389621769	19.4811			0.155848708	0.155761163			11.6887		11.6887															4.0538	0.588710184	2.000930703	3.962855484	0.83088515	1.340892138	1.360314909	0.689861972	0.861346139	0	3.692734064	0	0.044830361	0.094357441	2.331832736	7.362122753	3.542698382	1.693613754	0	0	3.150802355	1.489495705	0	0	0.420791511	0	0.24254652	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7554	0	11.26253672	4.0538	0.588710184	2.000930703	3.962855484	0.83088515	1.340892138	1.360314909	0.689861972	0.861346139	0	3.692734064	0	0.044830361	0.094357441	2.331832736	7.362122753	3.542698382	1.693613754	0	0	3.150802355	1.489495705	0	0	0.420791511	0	0.24254652	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7554																																																																																				0	0	0	4.0538	0.588710184	2.000930703	3.962855484	0.83088515	1.340892138	1.360314909	0.689861972	0.861346139	0	3.692734064	0	0.044830361	0.094357441	2.331832736	7.362122753	3.542698382	1.693613754	0	0	3.150802355	1.489495705	0	0	0.420791511	0	0.24254652	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7554
H3333_035_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		353.5097501	163.810227	1243.596217	37.7350288	256.7504898	10.14143721	10.3040373	309.8002127	350.2763567		54.28044635		13.7033812	0.864953472	4072.050694	5187.014502	7.203027629	876.6718893			25.02296328	11.08783346			432		249.0238478															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															148.3951	38.5142	23.3399	0.114150066	38.05	0.152200088	0.152200088	26.635	31.0468		0.076100044		38.05	0.14893616	7.61	18.5561	0.380500221	19.025			0.152200088	0.143587585			11.415		11.415															4.3716	0.525752096	2.418782574	4.30745604	0.814113484	1.54352764	1.568275388	0.687627788	0.906247734	0	4.130744367	0	0.043451163	0.128822848	2.582360316	8.020886446	2.740753605	1.389891032	0	0	3.808497224	1.592075224	0	0	0.410940239	0	0.236884073	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.2287	0	13.26232642	4.3716	0.525752096	2.418782574	4.30745604	0.814113484	1.54352764	1.568275388	0.687627788	0.906247734	0	4.130744367	0	0.043451163	0.128822848	2.582360316	8.020886446	2.740753605	1.389891032	0	0	3.808497224	1.592075224	0	0	0.410940239	0	0.236884073	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.2287																																																																																				0	0	0	4.3716	0.525752096	2.418782574	4.30745604	0.814113484	1.54352764	1.568275388	0.687627788	0.906247734	0	4.130744367	0	0.043451163	0.128822848	2.582360316	8.020886446	2.740753605	1.389891032	0	0	3.808497224	1.592075224	0	0	0.410940239	0	0.236884073	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.2287
H3333_036_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		326.6130788	159.9660585	1058.122862	29.51930124	180.8135652	8.736804883	8.345133701	239.0534603	291.4373135		55.15597522		15.64485988	0.705462637	3860.116142	6074.15649	6.746392297	1543.412601			26.91716745	11.82602702			432		249.0153901															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															148.5736	38.5606	23.368	0.114287413	38.0958	0.152383217	0.152383217	26.6671	30.2802		0.076191608		38.0958	0.156226282	7.6192	18.5019	0.380958042	19.0479			0.152383217	0.144556447			11.4287		11.4287															4.0438	0.514031906	2.060514947	3.373684559	0.574019848	1.331342432	1.271658317	0.531237806	0.735397255	0	4.202422463	0	0.04966696	0.110211805	2.450903811	9.365272527	2.570092399	2.449897675	0	0	4.101724562	1.709528451	0	0	0.411434685	0	0.237161038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.094	0	13.15356794	4.0438	0.514031906	2.060514947	3.373684559	0.574019848	1.331342432	1.271658317	0.531237806	0.735397255	0	4.202422463	0	0.04966696	0.110211805	2.450903811	9.365272527	2.570092399	2.449897675	0	0	4.101724562	1.709528451	0	0	0.411434685	0	0.237161038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.094																																																																																				0	0	0	4.0438	0.514031906	2.060514947	3.373684559	0.574019848	1.331342432	1.271658317	0.531237806	0.735397255	0	4.202422463	0	0.04966696	0.110211805	2.450903811	9.365272527	2.570092399	2.449897675	0	0	4.101724562	1.709528451	0	0	0.411434685	0	0.237161038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.094
H3333_037_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1366.370713	157.8620799	758.3570361	18.79348244	146.8548534	7.824198164	9.806657608	263.0303153	240.19456		33.10532114		9.604452588	0.420650741	3119.630705	3482.695932	4.978243835	615.0717457			17.19109895	7.199892067			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												101.7663	101.7663	23.7207	0.116012667	77.3418	0.154683556	0.154683556	38.6709	134.1632		0.154683556		38.6709	0.430678055	15.4684	23.779	0.386708889	23.0326			0.154683556	0.274616406			23.2025		23.2025															11.5875	1.338753464	1.499064783	2.180282016	0.946501287	1.210274793	1.516928668	0.847634676	2.68543907	0	5.120848787	0	0.03095106	0.181165043	4.021296416	6.901265595	1.925131144	1.180558426	0	0	2.659180313	1.977208483	0	0	0.835291201	0	0.481452567	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1268	0	14.39228965	11.5875	1.338753464	1.499064783	2.180282016	0.946501287	1.210274793	1.516928668	0.847634676	2.68543907	0	5.120848787	0	0.03095106	0.181165043	4.021296416	6.901265595	1.925131144	1.180558426	0	0	2.659180313	1.977208483	0	0	0.835291201	0	0.481452567	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1268																																																																																				0	0	0	11.5875	1.338753464	1.499064783	2.180282016	0.946501287	1.210274793	1.516928668	0.847634676	2.68543907	0	5.120848787	0	0.03095106	0.181165043	4.021296416	6.901265595	1.925131144	1.180558426	0	0	2.659180313	1.977208483	0	0	0.835291201	0	0.481452567	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1268
H3333_038_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1367.940215	103.5775438	699.7149979	16.77819915	150.5687011	8.817910147	9.198886569	270.3849251	257.825021		32.9082109		6.846784417	0.384671147	3056.32864	2953.610238	2.947591612	425.8642379			14.73312584	6.062800953			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												104.0578	104.0578	24.2548	0.118624909	79.0833	0.158166545	0.158166545	39.5416	131.9253		0.158166545		39.5416	0.404445167	15.8167	24.3487	0.395416362	23.426			0.158166545	0.295377567			23.725		23.725															11.8621	0.898170685	1.41428959	1.990312341	0.9922888	1.39469838	1.454956105	0.890955195	2.834471328	0	5.204978014	0	0.022561088	0.155578386	4.02840784	5.993042301	1.165525952	0.83135844	0	0	2.330287608	1.790815398	0	0	0.854099342	0	0.492293371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6012	0	12.32553595	11.8621	0.898170685	1.41428959	1.990312341	0.9922888	1.39469838	1.454956105	0.890955195	2.834471328	0	5.204978014	0	0.022561088	0.155578386	4.02840784	5.993042301	1.165525952	0.83135844	0	0	2.330287608	1.790815398	0	0	0.854099342	0	0.492293371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6012																																																																																				0	0	0	11.8621	0.898170685	1.41428959	1.990312341	0.9922888	1.39469838	1.454956105	0.890955195	2.834471328	0	5.204978014	0	0.022561088	0.155578386	4.02840784	5.993042301	1.165525952	0.83135844	0	0	2.330287608	1.790815398	0	0	0.854099342	0	0.492293371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6012
H3333_039_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1344.62684	110.8563797	826.3391581	22.43676852	175.0648594	7.893356951	8.708941485	269.4177842	261.2091821		36.55344715		6.921937635	0.566077306	3025.035813	3316.121977	3.747915783	496.7419248			16.63405324	7.283649279			432		249.0989523															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												102.0834	102.0834	23.7946	0.116374199	77.5828	0.155165598	0.155165598	38.7914	133.0364		0.155165598		38.7914	0.274590623	15.5166	23.8945	0.387913996	22.911			0.155165598	0.271595721			23.2748		23.2748															11.4387	0.943050115	1.638537209	2.61106096	1.131835152	1.224777454	1.351328117	0.87092441	2.895861074	0	5.671837499	0	0.022375971	0.15543952	3.911512433	6.603098555	1.453868988	0.948404317	0	0	2.581032825	1.978207975	0	0	0.837894231	0	0.48314485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7529	0	14.08692254	11.4387	0.943050115	1.638537209	2.61106096	1.131835152	1.224777454	1.351328117	0.87092441	2.895861074	0	5.671837499	0	0.022375971	0.15543952	3.911512433	6.603098555	1.453868988	0.948404317	0	0	2.581032825	1.978207975	0	0	0.837894231	0	0.48314485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7529																																																																																				0	0	0	11.4387	0.943050115	1.638537209	2.61106096	1.131835152	1.224777454	1.351328117	0.87092441	2.895861074	0	5.671837499	0	0.022375971	0.15543952	3.911512433	6.603098555	1.453868988	0.948404317	0	0	2.581032825	1.978207975	0	0	0.837894231	0	0.48314485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7529
H3333_040_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1648.361027	149.9436031	864.1103277	28.94770079	218.3697935	7.335045455	7.453879552	258.8068473	266.9453079		40.65417396		11.67919129	0.448667209	3086.198588	4012.004631	7.66130152	898.2409862			17.39746393	8.210088944			432		249.0056067															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												97.4333	97.4333	22.7107	0.111073067	74.0487	0.148097423	0.148097423	37.0244	126.8168		0.148097423		37.0244	0.29383123	14.8097	22.7015	0.370243558	22.0064			0.148097423	0.24764905			22.2146		22.2146															13.3838	1.217458271	1.635382069	3.215309917	1.347500153	1.08630133	1.103900353	0.798513066	2.821094976	0	6.020778398	0	0.036034544	0.131832438	3.808817148	7.589888102	2.83654753	1.647251781	0	0	2.576519575	2.033220728	0	0	0.799726084	0	0.460963608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5508	0	19.1180075	13.3838	1.217458271	1.635382069	3.215309917	1.347500153	1.08630133	1.103900353	0.798513066	2.821094976	0	6.020778398	0	0.036034544	0.131832438	3.808817148	7.589888102	2.83654753	1.647251781	0	0	2.576519575	2.033220728	0	0	0.799726084	0	0.460963608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5508																																																																																				0	0	0	13.3838	1.217458271	1.635382069	3.215309917	1.347500153	1.08630133	1.103900353	0.798513066	2.821094976	0	6.020778398	0	0.036034544	0.131832438	3.808817148	7.589888102	2.83654753	1.647251781	0	0	2.576519575	2.033220728	0	0	0.799726084	0	0.460963608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5508
H3333_041_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1704.618365	147.6634376	1079.806554	32.90703827	224.4249807	8.882859817	8.997111389	271.8621594	303.4394203		47.13973906		12.10939573	0.751742974	3533.415837	4494.45177	6.450348251	760.0818996			21.6956145	9.609121269			432		249.0234848															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												94.8676	94.8676	22.1127	0.108148155	72.0988	0.14419754	0.14419754	36.0494	117.7173		0.14419754		36.0494	0.234830527	14.4198	22.0739	0.360493851	21.4357			0.14419754	0.228534538			21.6296		21.6296															13.4761	1.167372524	1.989785886	3.558835484	1.348397092	1.280886537	1.297361333	0.816705306	2.976672498	0	6.797434425	0	0.036378023	0.176532199	4.245915607	8.267496852	2.325310881	1.357742433	0	0	3.128454247	2.196016088	0	0	0.778666718	0	0.448857175	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6709	0	22.31784443	13.4761	1.167372524	1.989785886	3.558835484	1.348397092	1.280886537	1.297361333	0.816705306	2.976672498	0	6.797434425	0	0.036378023	0.176532199	4.245915607	8.267496852	2.325310881	1.357742433	0	0	3.128454247	2.196016088	0	0	0.778666718	0	0.448857175	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6709																																																																																				0	0	0	13.4761	1.167372524	1.989785886	3.558835484	1.348397092	1.280886537	1.297361333	0.816705306	2.976672498	0	6.797434425	0	0.036378023	0.176532199	4.245915607	8.267496852	2.325310881	1.357742433	0	0	3.128454247	2.196016088	0	0	0.778666718	0	0.448857175	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6709
H3333_042_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1789.450735	190.2505169	930.215582	26.88839408	170.8903104	8.1990606	7.71630546	231.7234688	251.3290868		48.16966879		16.73749084	0.657619257	3435.302439	5242.870472	7.302341909	1396.152408			22.91900929	10.27847441			432		249.0253593															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												88.0969	88.0969	20.5345	0.10042964	66.9531	0.133906186	0.133906186	33.4765	106.9379		0.133906186		33.4765	0.217695563	13.3906	20.5738	0.334765465	19.9906			0.133906186	0.203569325			20.0859		20.0859															13.1371	1.39670641	1.591793713	2.700391726	0.953469571	1.097904935	1.033261035	0.64644179	2.239718012	0	6.450216634	0	0.046692783	0.143160795	3.833402064	8.988820216	2.444571887	2.3258233	0	0	3.068997123	2.092382102	0	0	0.723093405	0	0.416825451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3308	0	27.31032046	13.1371	1.39670641	1.591793713	2.700391726	0.953469571	1.097904935	1.033261035	0.64644179	2.239718012	0	6.450216634	0	0.046692783	0.143160795	3.833402064	8.988820216	2.444571887	2.3258233	0	0	3.068997123	2.092382102	0	0	0.723093405	0	0.416825451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3308																																																																																				0	0	0	13.1371	1.39670641	1.591793713	2.700391726	0.953469571	1.097904935	1.033261035	0.64644179	2.239718012	0	6.450216634	0	0.046692783	0.143160795	3.833402064	8.988820216	2.444571887	2.3258233	0	0	3.068997123	2.092382102	0	0	0.723093405	0	0.416825451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3308
H3333_043_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1405.568083	162.3907034	780.1121877	19.33261512	151.0677102	8.048652622	10.08798331	270.5613957	247.0850731		34.05502061		9.879977587	0.432718039	5641.6473	3582.60478	5.121055788	632.7164413			17.68426371	7.406436922			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												127.9362	127.9362	25.7106	0.141812583	124.086	0.141812583	0.141812583	39.0084	245.9994		0.141812583		35.4531	0.430876413	14.1813	25.8743	0.354531456	24.6095			0.141812583	0.286409122			24.8172		24.8172															14.9853	1.731304415	1.671430747	2.741608077	1.56211578	1.141400214	1.430602966	0.879514232	5.065231052	0	4.829430422	0	0.02918969	0.186447997	6.667138113	7.7247784	1.815575367	1.297568369	0	0	2.507851108	2.121271095	0	0	0.89341927	0	0.51495694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7961	0	24.5350588	14.9853	1.731304415	1.671430747	2.741608077	1.56211578	1.141400214	1.430602966	0.879514232	5.065231052	0	4.829430422	0	0.02918969	0.186447997	6.667138113	7.7247784	1.815575367	1.297568369	0	0	2.507851108	2.121271095	0	0	0.89341927	0	0.51495694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7961																																																																																				0	0	0	14.9853	1.731304415	1.671430747	2.741608077	1.56211578	1.141400214	1.430602966	0.879514232	5.065231052	0	4.829430422	0	0.02918969	0.186447997	6.667138113	7.7247784	1.815575367	1.297568369	0	0	2.507851108	2.121271095	0	0	0.89341927	0	0.51495694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7961
H3333_044_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1344.532205	101.8051387	687.7415683	16.49109285	147.9921895	8.667019245	9.04147645	265.7659572	253.4131536		32.34508998		6.729623156	0.378088706	5355.094508	2903.068453	2.897152817	418.5769059			14.48101456	5.959055112			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												132.6592	132.6592	26.6598	0.147047845	128.6669	0.147047845	0.147047845	40.4476	245.3027		0.147047845		36.762	0.427295897	14.7048	26.8931	0.367619614	25.3628			0.147047845	0.312977212			25.7334		25.7334															14.8637	1.125449139	1.527919587	2.424979672	1.586807586	1.274466506	1.329529632	0.895800545	5.180243731	0	4.756275793	0	0.020616179	0.161555753	6.562125913	6.506037419	1.065050199	0.88468917	0	0	2.12940199	1.865048458	0	0	0.926401426	0	0.533967489	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6201	0	20.02887665	14.8637	1.125449139	1.527919587	2.424979672	1.586807586	1.274466506	1.329529632	0.895800545	5.180243731	0	4.756275793	0	0.020616179	0.161555753	6.562125913	6.506037419	1.065050199	0.88468917	0	0	2.12940199	1.865048458	0	0	0.926401426	0	0.533967489	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6201																																																																																				0	0	0	14.8637	1.125449139	1.527919587	2.424979672	1.586807586	1.274466506	1.329529632	0.895800545	5.180243731	0	4.756275793	0	0.020616179	0.161555753	6.562125913	6.506037419	1.065050199	0.88468917	0	0	2.12940199	1.865048458	0	0	0.926401426	0	0.533967489	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6201
H3333_045_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1345.970698	109.332515	827.2879735	22.45400076	174.7463383	7.879343829	8.702622812	268.4673299	261.8031052		36.62294262		6.897676835	0.56746209	5414.969932	3323.436769	3.710717092	497.9335393			16.69366027	7.307065456			432		249.093783															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												129.3004	129.3004	25.9848	0.143324691	125.4091	0.143324691	0.143324691	39.4232	245.7328		0.143324691		35.8312	0.291464039	14.3325	26.2269	0.358311728	24.6351			0.143324691	0.285386293			25.0818		25.0818															14.5029	1.178061221	1.791407069	3.218212724	1.826231821	1.129304521	1.247300727	0.881986652	5.361134012	0	5.248971941	0	0.020595988	0.165394793	6.467490776	7.263608269	1.329593453	1.02222122	0	0	2.392613703	2.085336325	0	0	0.902945554	0	0.520643806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5559	0	23.15494567	14.5029	1.178061221	1.791407069	3.218212724	1.826231821	1.129304521	1.247300727	0.881986652	5.361134012	0	5.248971941	0	0.020595988	0.165394793	6.467490776	7.263608269	1.329593453	1.02222122	0	0	2.392613703	2.085336325	0	0	0.902945554	0	0.520643806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5559																																																																																				0	0	0	14.5029	1.178061221	1.791407069	3.218212724	1.826231821	1.129304521	1.247300727	0.881986652	5.361134012	0	5.248971941	0	0.020595988	0.165394793	6.467490776	7.263608269	1.329593453	1.02222122	0	0	2.392613703	2.085336325	0	0	0.902945554	0	0.520643806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5559
H3333_046_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1639.720341	149.1576007	859.5806731	28.79595734	217.225102	7.296595247	7.414806416	257.4526699	265.5459842		40.44106534		11.61796912	0.446315301	5684.104364	3990.973758	7.621141081	893.5324192			17.30626666	8.16705177			432		249.0055773															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												122.642	122.642	24.6467	0.135944109	118.9511	0.135944109	0.135944109	37.394	232.8196		0.135944109		33.986	0.307455661	13.5944	24.6841	0.339860272	23.5353			0.135944109	0.257633353			23.7902		23.7902															16.7582	1.524415261	1.76548321	3.914640752	2.153263646	0.991929137	1.007999249	0.80226575	5.152025922	0	5.497724578	0	0.032904051	0.137222166	6.439337508	8.209480495	2.590123077	1.752466043	0	0	2.352684994	2.104104928	0	0	0.856447884	0	0.493658102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5364	0	30.40908472	16.7582	1.524415261	1.76548321	3.914640752	2.153263646	0.991929137	1.007999249	0.80226575	5.152025922	0	5.497724578	0	0.032904051	0.137222166	6.439337508	8.209480495	2.590123077	1.752466043	0	0	2.352684994	2.104104928	0	0	0.856447884	0	0.493658102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5364																																																																																				0	0	0	16.7582	1.524415261	1.76548321	3.914640752	2.153263646	0.991929137	1.007999249	0.80226575	5.152025922	0	5.497724578	0	0.032904051	0.137222166	6.439337508	8.209480495	2.590123077	1.752466043	0	0	2.352684994	2.104104928	0	0	0.856447884	0	0.493658102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5364
H3333_047_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1676.683597	145.7805051	1075.390943	31.79981797	220.3807591	8.786996058	8.930478067	271.6712729	294.9469067		46.3820718		11.13666516	0.705120206	6322.153716	4416.743896	6.26083569	713.5090338			21.75616804	9.499113204			432		249.0255187															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												119.6768	119.6768	24.0508	0.132657337	116.0752	0.132657337	0.132657337	36.4885	217.0023		0.132657337		33.1643	0.252176935	13.2657	24.04	0.331643343	22.9592			0.132657337	0.238548406			23.215		23.215															16.7217	1.453878901	2.155332157	4.21847918	2.131727842	1.1656595	1.184693441	0.826073332	5.333680136	0	6.152922144	0	0.030778341	0.177815052	6.989000651	8.848227855	2.07636448	1.365132486	0	0	2.886115323	2.265998313	0	0	0.835741225	0	0.481761324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3011	0	34.16496036	16.7217	1.453878901	2.155332157	4.21847918	2.131727842	1.1656595	1.184693441	0.826073332	5.333680136	0	6.152922144	0	0.030778341	0.177815052	6.989000651	8.848227855	2.07636448	1.365132486	0	0	2.886115323	2.265998313	0	0	0.835741225	0	0.481761324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3011																																																																																				0	0	0	16.7217	1.453878901	2.155332157	4.21847918	2.131727842	1.1656595	1.184693441	0.826073332	5.333680136	0	6.152922144	0	0.030778341	0.177815052	6.989000651	8.848227855	2.07636448	1.365132486	0	0	2.886115323	2.265998313	0	0	0.835741225	0	0.481761324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3011
H3333_048_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1756.665317	186.7648424	913.172639	26.39575842	167.7593439	8.048841526	7.574931184	227.4860911	246.7243614		47.28712829		16.43083493	0.645570687	6397.067031	5146.81323	7.168552065	1370.572805			22.4990987	10.09015736			432		249.0248947															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												110.2704	110.2704	22.1604	0.122230627	106.9518	0.122230627	0.122230627	33.6224	195.2276		0.122230627		30.5577	0.219027188	12.2231	22.2811	0.305576566	21.2743			0.122230627	0.209476346			21.3904		21.3904															16.1423	1.716218863	1.68635687	3.226370089	1.495180292	0.983814943	0.925888584	0.63738528	4.01395053	0	5.779935318	0	0.041840651	0.141397532	6.515979259	9.556367956	2.190541525	2.429831328	0	0	2.750078931	2.113649298	0	0	0.770052947	0	0.443894338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.5611	0	40.44080702	16.1423	1.716218863	1.68635687	3.226370089	1.495180292	0.983814943	0.925888584	0.63738528	4.01395053	0	5.779935318	0	0.041840651	0.141397532	6.515979259	9.556367956	2.190541525	2.429831328	0	0	2.750078931	2.113649298	0	0	0.770052947	0	0.443894338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.5611																																																																																				0	0	0	16.1423	1.716218863	1.68635687	3.226370089	1.495180292	0.983814943	0.925888584	0.63738528	4.01395053	0	5.779935318	0	0.041840651	0.141397532	6.515979259	9.556367956	2.190541525	2.429831328	0	0	2.750078931	2.113649298	0	0	0.770052947	0	0.443894338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.5611
H3333_049_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		277.5535688	179.4203427	884.1453836	21.82883513	170.2594852	9.052856539	11.37244936	304.1268446	280.276535		38.53816254		11.14532179	0.481741894	3638.778472	4067.06429	5.661076197	719.3414499			20.0168569	8.397333859			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															157.9048	40.9824	24.8356	0.121465246	40.4884	0.161953661	0.161953661	28.3419	35.1062		0.08097683		40.4884	0.326265135	8.0977	19.6405	0.404884152	20.2442			0.161953661	0.169281394			12.1465		12.1465															3.6523	0.612755964	1.829856309	2.651444823	0.574461395	1.466143259	1.841809809	0.718294148	0.819954345	0	3.120698255	0	0.037604701	0.157175584	2.455472896	6.656593956	2.292080038	1.213541472	0	0	3.241803255	1.421512384	0	0	0.437274885	0	0.252040385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4528	0	8.328605627	3.6523	0.612755964	1.829856309	2.651444823	0.574461395	1.466143259	1.841809809	0.718294148	0.819954345	0	3.120698255	0	0.037604701	0.157175584	2.455472896	6.656593956	2.292080038	1.213541472	0	0	3.241803255	1.421512384	0	0	0.437274885	0	0.252040385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4528																																																																																				0	0	0	3.6523	0.612755964	1.829856309	2.651444823	0.574461395	1.466143259	1.841809809	0.718294148	0.819954345	0	3.120698255	0	0.037604701	0.157175584	2.455472896	6.656593956	2.292080038	1.213541472	0	0	3.241803255	1.421512384	0	0	0.437274885	0	0.252040385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4528
H3333_050_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		281.8234619	104.4394533	782.9193612	18.85741451	164.7891085	9.705737583	10.21256781	292.1075828	292.6023815		37.42220332		7.608600907	0.437612706	3459.106666	3350.29921	3.036859615	484.7635576			16.93853014	6.950183369			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															163.2826	42.3781	25.6814	0.125601968	41.8673	0.16746929	0.16746929	29.3071	34.8633		0.083734645		41.8673	0.249987475	8.3735	20.272	0.418673225	20.9337			0.16746929	0.180956177			12.5602		12.5602															3.8347	0.368828833	1.675539793	2.368528365	0.574939896	1.625412983	1.710291481	0.713402805	0.850089989	0	3.133534911	0	0.026545979	0.109397695	2.413725573	5.659784024	1.271451809	0.845656342	0	0	2.836683618	1.257678611	0	0	0.452167083	0	0.260624083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.989	0	6.213829356	3.8347	0.368828833	1.675539793	2.368528365	0.574939896	1.625412983	1.710291481	0.713402805	0.850089989	0	3.133534911	0	0.026545979	0.109397695	2.413725573	5.659784024	1.271451809	0.845656342	0	0	2.836683618	1.257678611	0	0	0.452167083	0	0.260624083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.989																																																																																				0	0	0	3.8347	0.368828833	1.675539793	2.368528365	0.574939896	1.625412983	1.710291481	0.713402805	0.850089989	0	3.133534911	0	0.026545979	0.109397695	2.413725573	5.659784024	1.271451809	0.845656342	0	0	2.836683618	1.257678611	0	0	0.452167083	0	0.260624083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.989
H3333_051_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		285.0319555	142.0476584	965.1675257	26.23068679	208.4306524	9.380634292	10.2804169	324.1905413	302.8557649		42.41963667		8.329992494	0.654578004	3521.364013	3846.55092	4.686223791	575.4682757			19.09088204	8.379833917			432		249.1557848															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															158.1452	41.0448	24.8734	0.121650174	40.5501	0.162200233	0.162200233	28.385	34.8001		0.081100116		40.5501	0.160070736	8.11	19.6281	0.405500582	20.275			0.162200233	0.166957639			12.165		12.165															3.7564	0.485859442	2.000583618	3.190967626	0.704322923	1.521541065	1.667486013	0.76684681	0.878284732	0	3.440237468	0	0.028148473	0.104778782	2.379858593	6.291706889	1.900266473	0.972303002	0	0	3.096545508	1.399077287	0	0	0.437940628	0	0.252582039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2757	0	8.220786862	3.7564	0.485859442	2.000583618	3.190967626	0.704322923	1.521541065	1.667486013	0.76684681	0.878284732	0	3.440237468	0	0.028148473	0.104778782	2.379858593	6.291706889	1.900266473	0.972303002	0	0	3.096545508	1.399077287	0	0	0.437940628	0	0.252582039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2757																																																																																				0	0	0	3.7564	0.485859442	2.000583618	3.190967626	0.704322923	1.521541065	1.667486013	0.76684681	0.878284732	0	3.440237468	0	0.028148473	0.104778782	2.379858593	6.291706889	1.900266473	0.972303002	0	0	3.096545508	1.399077287	0	0	0.437940628	0	0.252582039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2757
H3333_052_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		320.1342638	179.13203	1004.676649	33.90344001	255.9051518	8.603806592	8.728432394	303.5304022	309.68912		47.38870305		13.80734796	0.524894705	3590.917531	4657.498323	9.092660274	1043.235602			20.21705796	9.562689917			432		249.0071543															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															151.9525	39.4375	23.8994	0.116886531	38.9622	0.155848708	0.155848708	27.2735	33.3759		0.077924354		38.9622	0.179764513	7.7924	18.9684	0.389621769	19.4811			0.155848708	0.155761163			11.6887		11.6887															4.0538	0.588710184	2.000930703	3.962855484	0.83088515	1.340892138	1.360314909	0.689861972	0.861346139	0	3.692734064	0	0.044830361	0.094357441	2.331832736	7.362122753	3.542698382	1.693613754	0	0	3.150802355	1.489495705	0	0	0.420791511	0	0.24254652	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7554	0	11.26253672	4.0538	0.588710184	2.000930703	3.962855484	0.83088515	1.340892138	1.360314909	0.689861972	0.861346139	0	3.692734064	0	0.044830361	0.094357441	2.331832736	7.362122753	3.542698382	1.693613754	0	0	3.150802355	1.489495705	0	0	0.420791511	0	0.24254652	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7554																																																																																				0	0	0	4.0538	0.588710184	2.000930703	3.962855484	0.83088515	1.340892138	1.360314909	0.689861972	0.861346139	0	3.692734064	0	0.044830361	0.094357441	2.331832736	7.362122753	3.542698382	1.693613754	0	0	3.150802355	1.489495705	0	0	0.420791511	0	0.24254652	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7554
H3333_053_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		353.5097501	163.810227	1243.596217	37.7350288	256.7504898	10.14143721	10.3040373	309.8002127	350.2763567		54.28044635		13.7033812	0.864953472	4072.050694	5187.014502	7.203027629	876.6718893			25.02296328	11.08783346			432		249.0238478															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															148.3951	38.5142	23.3399	0.114150066	38.05	0.152200088	0.152200088	26.635	31.0468		0.076100044		38.05	0.14893616	7.61	18.5561	0.380500221	19.025			0.152200088	0.143587585			11.415		11.415															4.3716	0.525752096	2.418782574	4.30745604	0.814113484	1.54352764	1.568275388	0.687627788	0.906247734	0	4.130744367	0	0.043451163	0.128822848	2.582360316	8.020886446	2.740753605	1.389891032	0	0	3.808497224	1.592075224	0	0	0.410940239	0	0.236884073	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.2287	0	13.26232642	4.3716	0.525752096	2.418782574	4.30745604	0.814113484	1.54352764	1.568275388	0.687627788	0.906247734	0	4.130744367	0	0.043451163	0.128822848	2.582360316	8.020886446	2.740753605	1.389891032	0	0	3.808497224	1.592075224	0	0	0.410940239	0	0.236884073	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.2287																																																																																				0	0	0	4.3716	0.525752096	2.418782574	4.30745604	0.814113484	1.54352764	1.568275388	0.687627788	0.906247734	0	4.130744367	0	0.043451163	0.128822848	2.582360316	8.020886446	2.740753605	1.389891032	0	0	3.808497224	1.592075224	0	0	0.410940239	0	0.236884073	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.2287
H3333_054_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		326.6130788	159.9660585	1058.122862	29.51930124	180.8135652	8.736804883	8.345133701	239.0534603	291.4373135		55.15597522		15.64485988	0.705462637	3860.116142	6074.15649	6.746392297	1543.412601			26.91716745	11.82602702			432		249.0153901															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															148.5736	38.5606	23.368	0.114287413	38.0958	0.152383217	0.152383217	26.6671	30.2802		0.076191608		38.0958	0.156226282	7.6192	18.5019	0.380958042	19.0479			0.152383217	0.144556447			11.4287		11.4287															4.0438	0.514031906	2.060514947	3.373684559	0.574019848	1.331342432	1.271658317	0.531237806	0.735397255	0	4.202422463	0	0.04966696	0.110211805	2.450903811	9.365272527	2.570092399	2.449897675	0	0	4.101724562	1.709528451	0	0	0.411434685	0	0.237161038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.094	0	13.15356794	4.0438	0.514031906	2.060514947	3.373684559	0.574019848	1.331342432	1.271658317	0.531237806	0.735397255	0	4.202422463	0	0.04966696	0.110211805	2.450903811	9.365272527	2.570092399	2.449897675	0	0	4.101724562	1.709528451	0	0	0.411434685	0	0.237161038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.094																																																																																				0	0	0	4.0438	0.514031906	2.060514947	3.373684559	0.574019848	1.331342432	1.271658317	0.531237806	0.735397255	0	4.202422463	0	0.04966696	0.110211805	2.450903811	9.365272527	2.570092399	2.449897675	0	0	4.101724562	1.709528451	0	0	0.411434685	0	0.237161038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.094
H3333_055_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1366.370713	157.8620799	758.3570361	18.79348244	146.8548534	7.824198164	9.806657608	263.0303153	240.19456		33.10532114		9.604452588	0.420650741	3119.630705	3482.695932	4.978243835	615.0717457			17.19109895	7.199892067			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												101.7663	101.7663	23.7207	0.116012667	77.3418	0.154683556	0.154683556	38.6709	134.1632		0.154683556		38.6709	0.430678055	15.4684	23.779	0.386708889	23.0326			0.154683556	0.274616406			23.2025		23.2025															11.5875	1.338753464	1.499064783	2.180282016	0.946501287	1.210274793	1.516928668	0.847634676	2.68543907	0	5.120848787	0	0.03095106	0.181165043	4.021296416	6.901265595	1.925131144	1.180558426	0	0	2.659180313	1.977208483	0	0	0.835291201	0	0.481452567	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1268	0	14.39228965	11.5875	1.338753464	1.499064783	2.180282016	0.946501287	1.210274793	1.516928668	0.847634676	2.68543907	0	5.120848787	0	0.03095106	0.181165043	4.021296416	6.901265595	1.925131144	1.180558426	0	0	2.659180313	1.977208483	0	0	0.835291201	0	0.481452567	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1268																																																																																				0	0	0	11.5875	1.338753464	1.499064783	2.180282016	0.946501287	1.210274793	1.516928668	0.847634676	2.68543907	0	5.120848787	0	0.03095106	0.181165043	4.021296416	6.901265595	1.925131144	1.180558426	0	0	2.659180313	1.977208483	0	0	0.835291201	0	0.481452567	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1268
H3333_056_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1367.940215	103.5775438	699.7149979	16.77819915	150.5687011	8.817910147	9.198886569	270.3849251	257.825021		32.9082109		6.846784417	0.384671147	3056.32864	2953.610238	2.947591612	425.8642379			14.73312584	6.062800953			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												104.0578	104.0578	24.2548	0.118624909	79.0833	0.158166545	0.158166545	39.5416	131.9253		0.158166545		39.5416	0.404445167	15.8167	24.3487	0.395416362	23.426			0.158166545	0.295377567			23.725		23.725															11.8621	0.898170685	1.41428959	1.990312341	0.9922888	1.39469838	1.454956105	0.890955195	2.834471328	0	5.204978014	0	0.022561088	0.155578386	4.02840784	5.993042301	1.165525952	0.83135844	0	0	2.330287608	1.790815398	0	0	0.854099342	0	0.492293371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6012	0	12.32553595	11.8621	0.898170685	1.41428959	1.990312341	0.9922888	1.39469838	1.454956105	0.890955195	2.834471328	0	5.204978014	0	0.022561088	0.155578386	4.02840784	5.993042301	1.165525952	0.83135844	0	0	2.330287608	1.790815398	0	0	0.854099342	0	0.492293371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6012																																																																																				0	0	0	11.8621	0.898170685	1.41428959	1.990312341	0.9922888	1.39469838	1.454956105	0.890955195	2.834471328	0	5.204978014	0	0.022561088	0.155578386	4.02840784	5.993042301	1.165525952	0.83135844	0	0	2.330287608	1.790815398	0	0	0.854099342	0	0.492293371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6012
H3333_057_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1344.62684	110.8563797	826.3391581	22.43676852	175.0648594	7.893356951	8.708941485	269.4177842	261.2091821		36.55344715		6.921937635	0.566077306	3025.035813	3316.121977	3.747915783	496.7419248			16.63405324	7.283649279			432		249.0989523															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												102.0834	102.0834	23.7946	0.116374199	77.5828	0.155165598	0.155165598	38.7914	133.0364		0.155165598		38.7914	0.274590623	15.5166	23.8945	0.387913996	22.911			0.155165598	0.271595721			23.2748		23.2748															11.4387	0.943050115	1.638537209	2.61106096	1.131835152	1.224777454	1.351328117	0.87092441	2.895861074	0	5.671837499	0	0.022375971	0.15543952	3.911512433	6.603098555	1.453868988	0.948404317	0	0	2.581032825	1.978207975	0	0	0.837894231	0	0.48314485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7529	0	14.08692254	11.4387	0.943050115	1.638537209	2.61106096	1.131835152	1.224777454	1.351328117	0.87092441	2.895861074	0	5.671837499	0	0.022375971	0.15543952	3.911512433	6.603098555	1.453868988	0.948404317	0	0	2.581032825	1.978207975	0	0	0.837894231	0	0.48314485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7529																																																																																				0	0	0	11.4387	0.943050115	1.638537209	2.61106096	1.131835152	1.224777454	1.351328117	0.87092441	2.895861074	0	5.671837499	0	0.022375971	0.15543952	3.911512433	6.603098555	1.453868988	0.948404317	0	0	2.581032825	1.978207975	0	0	0.837894231	0	0.48314485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7529
H3333_058_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1648.361027	149.9436031	864.1103277	28.94770079	218.3697935	7.335045455	7.453879552	258.8068473	266.9453079		40.65417396		11.67919129	0.448667209	3086.198588	4012.004631	7.66130152	898.2409862			17.39746393	8.210088944			432		249.0056067															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												97.4333	97.4333	22.7107	0.111073067	74.0487	0.148097423	0.148097423	37.0244	126.8168		0.148097423		37.0244	0.29383123	14.8097	22.7015	0.370243558	22.0064			0.148097423	0.24764905			22.2146		22.2146															13.3838	1.217458271	1.635382069	3.215309917	1.347500153	1.08630133	1.103900353	0.798513066	2.821094976	0	6.020778398	0	0.036034544	0.131832438	3.808817148	7.589888102	2.83654753	1.647251781	0	0	2.576519575	2.033220728	0	0	0.799726084	0	0.460963608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5508	0	19.1180075	13.3838	1.217458271	1.635382069	3.215309917	1.347500153	1.08630133	1.103900353	0.798513066	2.821094976	0	6.020778398	0	0.036034544	0.131832438	3.808817148	7.589888102	2.83654753	1.647251781	0	0	2.576519575	2.033220728	0	0	0.799726084	0	0.460963608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5508																																																																																				0	0	0	13.3838	1.217458271	1.635382069	3.215309917	1.347500153	1.08630133	1.103900353	0.798513066	2.821094976	0	6.020778398	0	0.036034544	0.131832438	3.808817148	7.589888102	2.83654753	1.647251781	0	0	2.576519575	2.033220728	0	0	0.799726084	0	0.460963608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5508
H3333_059_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1704.618365	147.6634376	1079.806554	32.90703827	224.4249807	8.882859817	8.997111389	271.8621594	303.4394203		47.13973906		12.10939573	0.751742974	3533.415837	4494.45177	6.450348251	760.0818996			21.6956145	9.609121269			432		249.0234848															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												94.8676	94.8676	22.1127	0.108148155	72.0988	0.14419754	0.14419754	36.0494	117.7173		0.14419754		36.0494	0.234830527	14.4198	22.0739	0.360493851	21.4357			0.14419754	0.228534538			21.6296		21.6296															13.4761	1.167372524	1.989785886	3.558835484	1.348397092	1.280886537	1.297361333	0.816705306	2.976672498	0	6.797434425	0	0.036378023	0.176532199	4.245915607	8.267496852	2.325310881	1.357742433	0	0	3.128454247	2.196016088	0	0	0.778666718	0	0.448857175	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6709	0	22.31784443	13.4761	1.167372524	1.989785886	3.558835484	1.348397092	1.280886537	1.297361333	0.816705306	2.976672498	0	6.797434425	0	0.036378023	0.176532199	4.245915607	8.267496852	2.325310881	1.357742433	0	0	3.128454247	2.196016088	0	0	0.778666718	0	0.448857175	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6709																																																																																				0	0	0	13.4761	1.167372524	1.989785886	3.558835484	1.348397092	1.280886537	1.297361333	0.816705306	2.976672498	0	6.797434425	0	0.036378023	0.176532199	4.245915607	8.267496852	2.325310881	1.357742433	0	0	3.128454247	2.196016088	0	0	0.778666718	0	0.448857175	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6709
H3333_060_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1789.450735	190.2505169	930.215582	26.88839408	170.8903104	8.1990606	7.71630546	231.7234688	251.3290868		48.16966879		16.73749084	0.657619257	3435.302439	5242.870472	7.302341909	1396.152408			22.91900929	10.27847441			432		249.0253593															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												88.0969	88.0969	20.5345	0.10042964	66.9531	0.133906186	0.133906186	33.4765	106.9379		0.133906186		33.4765	0.217695563	13.3906	20.5738	0.334765465	19.9906			0.133906186	0.203569325			20.0859		20.0859															13.1371	1.39670641	1.591793713	2.700391726	0.953469571	1.097904935	1.033261035	0.64644179	2.239718012	0	6.450216634	0	0.046692783	0.143160795	3.833402064	8.988820216	2.444571887	2.3258233	0	0	3.068997123	2.092382102	0	0	0.723093405	0	0.416825451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3308	0	27.31032046	13.1371	1.39670641	1.591793713	2.700391726	0.953469571	1.097904935	1.033261035	0.64644179	2.239718012	0	6.450216634	0	0.046692783	0.143160795	3.833402064	8.988820216	2.444571887	2.3258233	0	0	3.068997123	2.092382102	0	0	0.723093405	0	0.416825451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3308																																																																																				0	0	0	13.1371	1.39670641	1.591793713	2.700391726	0.953469571	1.097904935	1.033261035	0.64644179	2.239718012	0	6.450216634	0	0.046692783	0.143160795	3.833402064	8.988820216	2.444571887	2.3258233	0	0	3.068997123	2.092382102	0	0	0.723093405	0	0.416825451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3308
H3333_061_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1405.568083	162.3907034	780.1121877	19.33261512	151.0677102	8.048652622	10.08798331	270.5613957	247.0850731		34.05502061		9.879977587	0.432718039	5641.6473	3582.60478	5.121055788	632.7164413			17.68426371	7.406436922			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												127.9362	127.9362	25.7106	0.141812583	124.086	0.141812583	0.141812583	39.0084	245.9994		0.141812583		35.4531	0.430876413	14.1813	25.8743	0.354531456	24.6095			0.141812583	0.286409122			24.8172		24.8172															14.9853	1.731304415	1.671430747	2.741608077	1.56211578	1.141400214	1.430602966	0.879514232	5.065231052	0	4.829430422	0	0.02918969	0.186447997	6.667138113	7.7247784	1.815575367	1.297568369	0	0	2.507851108	2.121271095	0	0	0.89341927	0	0.51495694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7961	0	24.5350588	14.9853	1.731304415	1.671430747	2.741608077	1.56211578	1.141400214	1.430602966	0.879514232	5.065231052	0	4.829430422	0	0.02918969	0.186447997	6.667138113	7.7247784	1.815575367	1.297568369	0	0	2.507851108	2.121271095	0	0	0.89341927	0	0.51495694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7961																																																																																				0	0	0	14.9853	1.731304415	1.671430747	2.741608077	1.56211578	1.141400214	1.430602966	0.879514232	5.065231052	0	4.829430422	0	0.02918969	0.186447997	6.667138113	7.7247784	1.815575367	1.297568369	0	0	2.507851108	2.121271095	0	0	0.89341927	0	0.51495694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7961
H3333_062_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1344.532205	101.8051387	687.7415683	16.49109285	147.9921895	8.667019245	9.04147645	265.7659572	253.4131536		32.34508998		6.729623156	0.378088706	5355.094508	2903.068453	2.897152817	418.5769059			14.48101456	5.959055112			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												132.6592	132.6592	26.6598	0.147047845	128.6669	0.147047845	0.147047845	40.4476	245.3027		0.147047845		36.762	0.427295897	14.7048	26.8931	0.367619614	25.3628			0.147047845	0.312977212			25.7334		25.7334															14.8637	1.125449139	1.527919587	2.424979672	1.586807586	1.274466506	1.329529632	0.895800545	5.180243731	0	4.756275793	0	0.020616179	0.161555753	6.562125913	6.506037419	1.065050199	0.88468917	0	0	2.12940199	1.865048458	0	0	0.926401426	0	0.533967489	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6201	0	20.02887665	14.8637	1.125449139	1.527919587	2.424979672	1.586807586	1.274466506	1.329529632	0.895800545	5.180243731	0	4.756275793	0	0.020616179	0.161555753	6.562125913	6.506037419	1.065050199	0.88468917	0	0	2.12940199	1.865048458	0	0	0.926401426	0	0.533967489	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6201																																																																																				0	0	0	14.8637	1.125449139	1.527919587	2.424979672	1.586807586	1.274466506	1.329529632	0.895800545	5.180243731	0	4.756275793	0	0.020616179	0.161555753	6.562125913	6.506037419	1.065050199	0.88468917	0	0	2.12940199	1.865048458	0	0	0.926401426	0	0.533967489	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6201
H3333_063_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1345.970698	109.332515	827.2879735	22.45400076	174.7463383	7.879343829	8.702622812	268.4673299	261.8031052		36.62294262		6.897676835	0.56746209	5414.969932	3323.436769	3.710717092	497.9335393			16.69366027	7.307065456			432		249.093783															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												129.3004	129.3004	25.9848	0.143324691	125.4091	0.143324691	0.143324691	39.4232	245.7328		0.143324691		35.8312	0.291464039	14.3325	26.2269	0.358311728	24.6351			0.143324691	0.285386293			25.0818		25.0818															14.5029	1.178061221	1.791407069	3.218212724	1.826231821	1.129304521	1.247300727	0.881986652	5.361134012	0	5.248971941	0	0.020595988	0.165394793	6.467490776	7.263608269	1.329593453	1.02222122	0	0	2.392613703	2.085336325	0	0	0.902945554	0	0.520643806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5559	0	23.15494567	14.5029	1.178061221	1.791407069	3.218212724	1.826231821	1.129304521	1.247300727	0.881986652	5.361134012	0	5.248971941	0	0.020595988	0.165394793	6.467490776	7.263608269	1.329593453	1.02222122	0	0	2.392613703	2.085336325	0	0	0.902945554	0	0.520643806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5559																																																																																				0	0	0	14.5029	1.178061221	1.791407069	3.218212724	1.826231821	1.129304521	1.247300727	0.881986652	5.361134012	0	5.248971941	0	0.020595988	0.165394793	6.467490776	7.263608269	1.329593453	1.02222122	0	0	2.392613703	2.085336325	0	0	0.902945554	0	0.520643806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5559
H3333_064_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1639.720341	149.1576007	859.5806731	28.79595734	217.225102	7.296595247	7.414806416	257.4526699	265.5459842		40.44106534		11.61796912	0.446315301	5684.104364	3990.973758	7.621141081	893.5324192			17.30626666	8.16705177			432		249.0055773															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												122.642	122.642	24.6467	0.135944109	118.9511	0.135944109	0.135944109	37.394	232.8196		0.135944109		33.986	0.307455661	13.5944	24.6841	0.339860272	23.5353			0.135944109	0.257633353			23.7902		23.7902															16.7582	1.524415261	1.76548321	3.914640752	2.153263646	0.991929137	1.007999249	0.80226575	5.152025922	0	5.497724578	0	0.032904051	0.137222166	6.439337508	8.209480495	2.590123077	1.752466043	0	0	2.352684994	2.104104928	0	0	0.856447884	0	0.493658102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5364	0	30.40908472	16.7582	1.524415261	1.76548321	3.914640752	2.153263646	0.991929137	1.007999249	0.80226575	5.152025922	0	5.497724578	0	0.032904051	0.137222166	6.439337508	8.209480495	2.590123077	1.752466043	0	0	2.352684994	2.104104928	0	0	0.856447884	0	0.493658102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5364																																																																																				0	0	0	16.7582	1.524415261	1.76548321	3.914640752	2.153263646	0.991929137	1.007999249	0.80226575	5.152025922	0	5.497724578	0	0.032904051	0.137222166	6.439337508	8.209480495	2.590123077	1.752466043	0	0	2.352684994	2.104104928	0	0	0.856447884	0	0.493658102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5364
H3333_065_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1676.683597	145.7805051	1075.390943	31.79981797	220.3807591	8.786996058	8.930478067	271.6712729	294.9469067		46.3820718		11.13666516	0.705120206	6322.153716	4416.743896	6.26083569	713.5090338			21.75616804	9.499113204			432		249.0255187															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												119.6768	119.6768	24.0508	0.132657337	116.0752	0.132657337	0.132657337	36.4885	217.0023		0.132657337		33.1643	0.252176935	13.2657	24.04	0.331643343	22.9592			0.132657337	0.238548406			23.215		23.215															16.7217	1.453878901	2.155332157	4.21847918	2.131727842	1.1656595	1.184693441	0.826073332	5.333680136	0	6.152922144	0	0.030778341	0.177815052	6.989000651	8.848227855	2.07636448	1.365132486	0	0	2.886115323	2.265998313	0	0	0.835741225	0	0.481761324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3011	0	34.16496036	16.7217	1.453878901	2.155332157	4.21847918	2.131727842	1.1656595	1.184693441	0.826073332	5.333680136	0	6.152922144	0	0.030778341	0.177815052	6.989000651	8.848227855	2.07636448	1.365132486	0	0	2.886115323	2.265998313	0	0	0.835741225	0	0.481761324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3011																																																																																				0	0	0	16.7217	1.453878901	2.155332157	4.21847918	2.131727842	1.1656595	1.184693441	0.826073332	5.333680136	0	6.152922144	0	0.030778341	0.177815052	6.989000651	8.848227855	2.07636448	1.365132486	0	0	2.886115323	2.265998313	0	0	0.835741225	0	0.481761324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3011
H3333_066_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1756.665317	186.7648424	913.172639	26.39575842	167.7593439	8.048841526	7.574931184	227.4860911	246.7243614		47.28712829		16.43083493	0.645570687	6397.067031	5146.81323	7.168552065	1370.572805			22.4990987	10.09015736			432		249.0248947															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												110.2704	110.2704	22.1604	0.122230627	106.9518	0.122230627	0.122230627	33.6224	195.2276		0.122230627		30.5577	0.219027188	12.2231	22.2811	0.305576566	21.2743			0.122230627	0.209476346			21.3904		21.3904															16.1423	1.716218863	1.68635687	3.226370089	1.495180292	0.983814943	0.925888584	0.63738528	4.01395053	0	5.779935318	0	0.041840651	0.141397532	6.515979259	9.556367956	2.190541525	2.429831328	0	0	2.750078931	2.113649298	0	0	0.770052947	0	0.443894338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.5611	0	40.44080702	16.1423	1.716218863	1.68635687	3.226370089	1.495180292	0.983814943	0.925888584	0.63738528	4.01395053	0	5.779935318	0	0.041840651	0.141397532	6.515979259	9.556367956	2.190541525	2.429831328	0	0	2.750078931	2.113649298	0	0	0.770052947	0	0.443894338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.5611																																																																																				0	0	0	16.1423	1.716218863	1.68635687	3.226370089	1.495180292	0.983814943	0.925888584	0.63738528	4.01395053	0	5.779935318	0	0.041840651	0.141397532	6.515979259	9.556367956	2.190541525	2.429831328	0	0	2.750078931	2.113649298	0	0	0.770052947	0	0.443894338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.5611
H3333_067_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		278.5150304	194.3611765	889.6586111	22.80025759	170.3764718	9.168309602	11.55005935	304.145982	280.0711236		39.05088607		12.49544158	0.537540944	3661.612869	4119.152231	6.28366244	761.1961864			21.35591311	8.496704311			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															156.9423	40.7326	24.6842	0.120724809	40.2416	0.160966412	0.160966412	28.1691	35.1233		0.080483206		40.2416	0.325339596	8.0483	19.5238	0.40241603	20.1208			0.160966412	0.166620641			12.0725		12.0725															3.6426	0.659735537	1.830042535	2.752556739	0.571351861	1.475789899	1.85917161	0.713960441	0.819751178	0	3.142940504	0	0.04190305	0.174883354	2.455819521	6.701792925	2.52864649	1.276323113	0	0	3.437584704	1.415726321	0	0	0.434609312	0	0.250503978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1857	0	8.774849649	3.6426	0.659735537	1.830042535	2.752556739	0.571351861	1.475789899	1.85917161	0.713960441	0.819751178	0	3.142940504	0	0.04190305	0.174883354	2.455819521	6.701792925	2.52864649	1.276323113	0	0	3.437584704	1.415726321	0	0	0.434609312	0	0.250503978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1857																																																																																				0	0	0	3.6426	0.659735537	1.830042535	2.752556739	0.571351861	1.475789899	1.85917161	0.713960441	0.819751178	0	3.142940504	0	0.04190305	0.174883354	2.455819521	6.701792925	2.52864649	1.276323113	0	0	3.437584704	1.415726321	0	0	0.434609312	0	0.250503978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1857
H3333_068_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		286.3763242	114.4327035	840.5175266	21.40752513	158.1181427	9.455698608	11.62768448	350.8488025	277.3081348		37.3791704		9.679701361	0.497823235	3346.338468	3169.582477	3.68868786	493.336758			13.24859267	7.410836068			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															162.9674	42.2963	25.6318	0.125359532	41.7865	0.167146042	0.167146042	29.2506	38.2681		0.083573021		41.7865	0.302663684	8.3573	20.1301	0.417865105	20.8933			0.167146042	0.175331226			12.536		12.536															3.8892	0.403340053	1.79533462	2.683637324	0.550600453	1.580482598	1.94352144	0.855210252	0.884337969	0	3.123890196	0	0.033706745	0.150673014	2.330530128	5.316988359	1.541373941	0.858950902	0	0	2.214449829	1.299350976	0	0	0.451294314	0	0.260121028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.167	0	6.32268624	3.8892	0.403340053	1.79533462	2.683637324	0.550600453	1.580482598	1.94352144	0.855210252	0.884337969	0	3.123890196	0	0.033706745	0.150673014	2.330530128	5.316988359	1.541373941	0.858950902	0	0	2.214449829	1.299350976	0	0	0.451294314	0	0.260121028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.167																																																																																				0	0	0	3.8892	0.403340053	1.79533462	2.683637324	0.550600453	1.580482598	1.94352144	0.855210252	0.884337969	0	3.123890196	0	0.033706745	0.150673014	2.330530128	5.316988359	1.541373941	0.858950902	0	0	2.214449829	1.299350976	0	0	0.451294314	0	0.260121028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.167
H3333_069_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		230.0735356	149.0788674	878.9074403	22.46355719	197.3564849	7.849353212	8.976708472	335.80935	260.3735732		37.37835949		10.91399286	0.338840416	2835.160857	3436.652993	5.269983795	516.8399982			15.99112264	7.731617597			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															162.8397	42.2632	25.6118	0.125261314	41.7538	0.167015085	0.167015085	29.2276	36.5711		0.083507543		41.7538	0.235566043	8.3508	20.1103	0.417537713	20.8769			0.167015085	0.173543967			12.5261		12.5261															3.1221	0.525045427	1.875864112	2.813814689	0.686698128	1.310960396	1.499245731	0.817909564	0.793511974	0	3.121374948	0	0.03797503	0.079819296	1.972977635	5.759354698	2.200416982	0.899167462	0	0	2.670758711	1.341775593	0	0	0.45094073	0	0.259917226	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.2396	0	6.367216085	3.1221	0.525045427	1.875864112	2.813814689	0.686698128	1.310960396	1.499245731	0.817909564	0.793511974	0	3.121374948	0	0.03797503	0.079819296	1.972977635	5.759354698	2.200416982	0.899167462	0	0	2.670758711	1.341775593	0	0	0.45094073	0	0.259917226	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.2396																																																																																				0	0	0	3.1221	0.525045427	1.875864112	2.813814689	0.686698128	1.310960396	1.499245731	0.817909564	0.793511974	0	3.121374948	0	0.03797503	0.079819296	1.972977635	5.759354698	2.200416982	0.899167462	0	0	2.670758711	1.341775593	0	0	0.45094073	0	0.259917226	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.2396
H3333_070_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		258.1562395	200.3432859	744.549867	33.58618515	238.2210896	6.797700142	4.901928575	251.6985711	194.5535643		40.26864299		8.865679471	0.198486248	2930.246978	5113.475992	15.50943955	2051.47851			10.64914723	10.85260282			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															152.0146	39.4536	23.9092	0.116934327	38.9781	0.155912436	0.155912436	27.2847	36.1314		0.077956218		38.9781	0.288004489	7.7956	18.928	0.389781089	19.4891			0.155912436	0.158935273			11.6934		11.6934															3.2703	0.658689354	1.483464236	3.927377948	0.773783965	1.059845986	0.764271623	0.572292835	0.585791861	0	3.139191104	0	0.028797285	0.05716493	1.903591431	8.065641839	6.045286239	3.331781367	0	0	1.660334483	1.724861393	0	0	0.420963576	0	0.242638728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7161	0	11.23056357	3.2703	0.658689354	1.483464236	3.927377948	0.773783965	1.059845986	0.764271623	0.572292835	0.585791861	0	3.139191104	0	0.028797285	0.05716493	1.903591431	8.065641839	6.045286239	3.331781367	0	0	1.660334483	1.724861393	0	0	0.420963576	0	0.242638728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7161																																																																																				0	0	0	3.2703	0.658689354	1.483464236	3.927377948	0.773783965	1.059845986	0.764271623	0.572292835	0.585791861	0	3.139191104	0	0.028797285	0.05716493	1.903591431	8.065641839	6.045286239	3.331781367	0	0	1.660334483	1.724861393	0	0	0.420963576	0	0.242638728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7161
H3333_071_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		253.0356316	116.8904629	829.3093765	24.35961124	263.4951647	7.629126385	8.92986489	378.4705831	268.5047821		37.32454391		8.21885585	0.526529713	3022.209685	2950.541163	4.306062142	451.3821201			11.83019158	8.698563525			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															164.33	42.6499	25.8462	0.126407663	42.1359	0.168543551	0.168543551	29.4951	37.0608		0.084271775		42.1359	0.255727897	8.4272	20.1532	0.421358877	21.0679			0.168543551	0.171410065			12.6408		12.6408															3.4651	0.415447656	1.786204787	3.079241528	0.925216888	1.285840049	1.505071135	0.930252982	0.82925001	0	3.145405579	0	0.028859066	0.134648336	2.122391463	4.955247438	1.814397507	0.792474429	0	0	1.993902494	1.49102134	0	0	0.455067587	0	0.262295901	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.4173	0	5.863637	3.4651	0.415447656	1.786204787	3.079241528	0.925216888	1.285840049	1.505071135	0.930252982	0.82925001	0	3.145405579	0	0.028859066	0.134648336	2.122391463	4.955247438	1.814397507	0.792474429	0	0	1.993902494	1.49102134	0	0	0.455067587	0	0.262295901	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.4173																																																																																				0	0	0	3.4651	0.415447656	1.786204787	3.079241528	0.925216888	1.285840049	1.505071135	0.930252982	0.82925001	0	3.145405579	0	0.028859066	0.134648336	2.122391463	4.955247438	1.814397507	0.792474429	0	0	1.993902494	1.49102134	0	0	0.455067587	0	0.262295901	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.4173
H3333_072_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		295.5494224	171.0872072	972.1131032	29.85695918	162.7366651	7.397158975	6.695075331	184.8049098	192.6279325		53.7144511		17.79214686	0.493837142	3765.328044	6378.453487	7.737546909	2139.088536			24.58709081	12.20671068			432		249.0142068															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															148.6663	38.5846	23.3825	0.114358674	38.1196	0.152478232	0.152478232	26.6837	33.4525		0.076239116		38.1196	0.189512244	7.6239	18.398	0.381195581	19.0598			0.152478232	0.141650294			11.4359		11.4359															3.6615	0.550111193	1.894205879	3.414402271	0.516954147	1.127905725	1.020853252	0.410939754	0.536990439	0	4.095142279	0	0.056519065	0.093588185	2.392210686	9.779231019	2.94951869	3.39754624	0	0	3.748996146	1.729084152	0	0	0.411691228	0	0.237307788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.0247	0	13.09753416	3.6615	0.550111193	1.894205879	3.414402271	0.516954147	1.127905725	1.020853252	0.410939754	0.536990439	0	4.095142279	0	0.056519065	0.093588185	2.392210686	9.779231019	2.94951869	3.39754624	0	0	3.748996146	1.729084152	0	0	0.411691228	0	0.237307788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.0247																																																																																				0	0	0	3.6615	0.550111193	1.894205879	3.414402271	0.516954147	1.127905725	1.020853252	0.410939754	0.536990439	0	4.095142279	0	0.056519065	0.093588185	2.392210686	9.779231019	2.94951869	3.39754624	0	0	3.748996146	1.729084152	0	0	0.411691228	0	0.237307788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.0247
H3333_073_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1472.34786	180.2010588	806.8298205	20.6676992	155.2341971	8.342068386	10.48493537	277.7646583	253.8011488		35.33834496		11.3760045	0.493572934	3319.27057	3729.787815	5.803487981	688.4102192			19.32498941	7.676389165			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												99.6141	99.6141	23.2191	0.113559134	75.7061	0.151412179	0.151412179	37.853	132.188		0.151412179		37.853	0.418849849	15.1412	23.2733	0.378530446	22.5478			0.151412179	0.267593498			22.7118		22.7118															12.2222	1.495880107	1.561152338	2.347006021	0.979347832	1.263090748	1.587546906	0.876186501	2.795788322	0	5.350655796	0	0.0358847	0.206732949	4.188149901	7.233697955	2.196796895	1.293513594	0	0	2.926038747	2.054151827	0	0	0.817625764	0	0.471270406	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.9027	0	16.65546762	12.2222	1.495880107	1.561152338	2.347006021	0.979347832	1.263090748	1.587546906	0.876186501	2.795788322	0	5.350655796	0	0.0358847	0.206732949	4.188149901	7.233697955	2.196796895	1.293513594	0	0	2.926038747	2.054151827	0	0	0.817625764	0	0.471270406	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.9027																																																																																				0	0	0	12.2222	1.495880107	1.561152338	2.347006021	0.979347832	1.263090748	1.587546906	0.876186501	2.795788322	0	5.350655796	0	0.0358847	0.206732949	4.188149901	7.233697955	2.196796895	1.293513594	0	0	2.926038747	2.054151827	0	0	0.817625764	0	0.471270406	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.9027
H3333_074_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1272.323445	107.6179244	715.284997	18.03962422	137.3102838	8.175084444	9.934476876	306.0407785	232.6967578		31.34206888		8.025034043	0.420002692	2819.186548	2661.1629	3.409285664	411.3835875			11.03949756	6.162869718			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												105.2075	105.2075	24.5228	0.119935586	79.9571	0.159914115	0.159914115	39.9785	146.5263		0.159914115		39.9785	0.479105498	15.9914	24.7162	0.399785287	23.6826			0.159914115	0.289645704			23.9871		23.9871															11.1548	0.943517697	1.461734335	2.163592903	0.91491052	1.307311392	1.588663075	1.019588337	2.841350247	0	5.012039198	0	0.026735754	0.201225599	3.756897676	5.481153594	1.362982247	0.811887031	0	0	1.765371479	1.785048735	0	0	0.86353622	0	0.497732682	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9601	0	11.27021074	11.1548	0.943517697	1.461734335	2.163592903	0.91491052	1.307311392	1.588663075	1.019588337	2.841350247	0	5.012039198	0	0.026735754	0.201225599	3.756897676	5.481153594	1.362982247	0.811887031	0	0	1.765371479	1.785048735	0	0	0.86353622	0	0.497732682	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9601																																																																																				0	0	0	11.1548	0.943517697	1.461734335	2.163592903	0.91491052	1.307311392	1.588663075	1.019588337	2.841350247	0	5.012039198	0	0.026735754	0.201225599	3.756897676	5.481153594	1.362982247	0.811887031	0	0	1.765371479	1.785048735	0	0	0.86353622	0	0.497732682	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9601
H3333_075_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1199.37531	121.1158773	836.2297419	21.31838671	182.0882809	7.282850202	8.429474089	304.2368477	249.8929916		35.83238678		9.948735815	0.324417137	2709.395537	3294.009036	4.458066885	499.1321089			15.59998839	7.482989293			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												103.1486	103.1486	24.0429	0.117588483	78.3923	0.156784644	0.156784644	39.1962	137.0868		0.156784644		39.1962	0.408629941	15.6785	24.2394	0.39196161	23.0768			0.156784644	0.274966578			23.5177		23.5177															10.3095	1.041077939	1.675450757	2.506796752	1.189526928	1.141839075	1.321612093	0.993743038	2.854753458	0	5.617968001	0	0.032496021	0.132566556	3.53993012	6.653724435	1.747391072	0.959862787	0	0	2.445838624	2.057571961	0	0	0.846637077	0	0.487992204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5563	0	13.10817906	10.3095	1.041077939	1.675450757	2.506796752	1.189526928	1.141839075	1.321612093	0.993743038	2.854753458	0	5.617968001	0	0.032496021	0.132566556	3.53993012	6.653724435	1.747391072	0.959862787	0	0	2.445838624	2.057571961	0	0	0.846637077	0	0.487992204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5563																																																																																				0	0	0	10.3095	1.041077939	1.675450757	2.506796752	1.189526928	1.141839075	1.321612093	0.993743038	2.854753458	0	5.617968001	0	0.032496021	0.132566556	3.53993012	6.653724435	1.747391072	0.959862787	0	0	2.445838624	2.057571961	0	0	0.846637077	0	0.487992204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5563
H3333_076_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1423.409354	148.2879513	582.1350885	26.22091124	183.6219964	5.256536091	3.812695931	192.6287311	152.7698885		31.70025913		6.657786215	0.154763573	2270.866366	4015.177001	12.01951522	1607.249883			8.432853447	8.537559494			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												100.7502	100.7502	23.4839	0.11485433	76.5696	0.153139107	0.153139107	38.2848	141.9619		0.153139107		38.2848	0.451734444	15.3139	23.519	0.382847767	22.8496			0.153139107	0.244081129			22.9709		22.9709															11.9507	1.245003622	1.139232645	3.011585193	1.171654521	0.804981241	0.583872849	0.614562329	1.807291822	0	4.854549366	0	0.021240988	0.069912037	2.897987056	7.869419385	4.601644558	3.060423597	0	0	1.291399644	2.083857159	0	0	0.826951176	0	0.47664547	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3829	0	15.41728963	11.9507	1.245003622	1.139232645	3.011585193	1.171654521	0.804981241	0.583872849	0.614562329	1.807291822	0	4.854549366	0	0.021240988	0.069912037	2.897987056	7.869419385	4.601644558	3.060423597	0	0	1.291399644	2.083857159	0	0	0.826951176	0	0.47664547	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3829																																																																																				0	0	0	11.9507	1.245003622	1.139232645	3.011585193	1.171654521	0.804981241	0.583872849	0.614562329	1.807291822	0	4.854549366	0	0.021240988	0.069912037	2.897987056	7.869419385	4.601644558	3.060423597	0	0	1.291399644	2.083857159	0	0	0.826951176	0	0.47664547	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3829
H3333_077_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1245.876167	90.61147617	800.1094161	22.40090654	247.5418233	6.679278221	7.88231614	342.3181969	266.8780991		34.81302683		8.238682978	0.483219652	2994.59264	2928.382816	3.117252006	441.8225073			11.24362603	8.266188798			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												103.5666	103.5666	24.1403	0.118064944	78.71	0.157419925	0.157419925	39.355	138.1889		0.157419925		39.355	0.479567836	15.742	24.4659	0.393549813	23.1529			0.157419925	0.288182149			23.613		23.613															10.7526	0.78202664	1.60957648	2.644761774	1.623667305	1.051451478	1.240833617	1.12266052	3.073298741	0	5.480264079	0	0.027019435	0.231736603	3.928404578	5.970453974	1.226793944	0.852457378	0	0	1.769970768	2.382168054	0	0	0.850067596	0	0.489969517	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1102	0	12.74269955	10.7526	0.78202664	1.60957648	2.644761774	1.623667305	1.051451478	1.240833617	1.12266052	3.073298741	0	5.480264079	0	0.027019435	0.231736603	3.928404578	5.970453974	1.226793944	0.852457378	0	0	1.769970768	2.382168054	0	0	0.850067596	0	0.489969517	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1102																																																																																				0	0	0	10.7526	0.78202664	1.60957648	2.644761774	1.623667305	1.051451478	1.240833617	1.12266052	3.073298741	0	5.480264079	0	0.027019435	0.231736603	3.928404578	5.970453974	1.226793944	0.852457378	0	0	1.769970768	2.382168054	0	0	0.850067596	0	0.489969517	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1102
H3333_078_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1848.389302	215.9997352	880.8261035	28.95552762	161.1353476	7.263976602	6.477615732	185.3418353	173.2590726		49.30130877		19.5750551	0.521635585	3529.3132	5712.703487	8.76827956	2037.344367			21.93212014	11.2715839			432		249.0119021															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												92.5478	92.5478	21.572	0.105503676	70.3358	0.140671568	0.140671568	35.1679	123.6278		0.140671568		35.1679	0.242007543	14.0672	21.7236	0.351678921	21.0447			0.140671568	0.202748426			21.1007		21.1007															14.2554	1.665858805	1.583430625	3.054914612	0.944465086	1.021834981	0.911216364	0.543173472	1.784969265	0	6.935292428	0	0.057367785	0.126239746	4.137283527	10.34169153	3.083619094	3.572943263	0	0	3.085225738	2.285295899	0	0	0.759626469	0	0.437861185	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5877	0	25.55293804	14.2554	1.665858805	1.583430625	3.054914612	0.944465086	1.021834981	0.911216364	0.543173472	1.784969265	0	6.935292428	0	0.057367785	0.126239746	4.137283527	10.34169153	3.083619094	3.572943263	0	0	3.085225738	2.285295899	0	0	0.759626469	0	0.437861185	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5877																																																																																				0	0	0	14.2554	1.665858805	1.583430625	3.054914612	0.944465086	1.021834981	0.911216364	0.543173472	1.784969265	0	6.935292428	0	0.057367785	0.126239746	4.137283527	10.34169153	3.083619094	3.572943263	0	0	3.085225738	2.285295899	0	0	0.759626469	0	0.437861185	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5877
H3333_079_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1474.345834	180.4455914	807.9246877	20.69574525	155.4448497	8.353388564	10.49916342	278.1408925	254.1455567		35.38629906		11.39144172	0.494242712	5856.198073	3734.849133	5.811363308	689.3443911			19.3512134	7.686806016			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												125.8049	125.8049	25.2823	0.139450109	122.0188	0.139450109	0.139450109	38.3584	243.4894		0.139450109		34.8625	0.419984782	13.945	25.438	0.348625271	24.2024			0.139450109	0.280436782			24.4038		24.4038															15.4567	1.891745198	1.702183177	2.886023922	1.580600086	1.164880942	1.464109479	0.889085922	5.156811639	0	4.934623246	0	0.033094537	0.207574417	6.805395476	7.917242701	2.025988111	1.390315342	0	0	2.69852881	2.155663144	0	0	0.878535684	0	0.506378207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.7454	0	26.81016096	15.4567	1.891745198	1.702183177	2.886023922	1.580600086	1.164880942	1.464109479	0.889085922	5.156811639	0	4.934623246	0	0.033094537	0.207574417	6.805395476	7.917242701	2.025988111	1.390315342	0	0	2.69852881	2.155663144	0	0	0.878535684	0	0.506378207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.7454																																																																																				0	0	0	15.4567	1.891745198	1.702183177	2.886023922	1.580600086	1.164880942	1.464109479	0.889085922	5.156811639	0	4.934623246	0	0.033094537	0.207574417	6.805395476	7.917242701	2.025988111	1.390315342	0	0	2.69852881	2.155663144	0	0	0.878535684	0	0.506378207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.7454
H3333_080_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1274.0366	107.7628296	716.2481124	18.06391418	137.495169	8.186092013	9.947853428	306.4521602	233.0100788		31.38427028		8.035839573	0.420568217	5259.479822	2664.746097	3.413876192	411.9375064			11.054362	6.171167885			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												133.6474	133.6474	26.8584	0.148143245	129.6253	0.148143245	0.148143245	40.7488	271.4818		0.148143245		37.0358	0.501880195	14.8143	27.2759	0.370358113	25.549			0.148143245	0.30577536			25.9251		25.9251															14.1893	1.200185422	1.603104754	2.676046865	1.485238163	1.212714235	1.473707288	1.040628639	5.271499833	0	4.649367643	0	0.024801153	0.211074859	6.492970068	6.05694737	1.264356743	0.877048096	0	0	1.637629058	1.88699108	0	0	0.933302444	0	0.537945159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7249	0	19.15614913	14.1893	1.200185422	1.603104754	2.676046865	1.485238163	1.212714235	1.473707288	1.040628639	5.271499833	0	4.649367643	0	0.024801153	0.211074859	6.492970068	6.05694737	1.264356743	0.877048096	0	0	1.637629058	1.88699108	0	0	0.933302444	0	0.537945159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7249																																																																																				0	0	0	14.1893	1.200185422	1.603104754	2.676046865	1.485238163	1.212714235	1.473707288	1.040628639	5.271499833	0	4.649367643	0	0.024801153	0.211074859	6.492970068	6.05694737	1.264356743	0.877048096	0	0	1.637629058	1.88699108	0	0	0.933302444	0	0.537945159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7249
H3333_081_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1199.8167	121.1604499	836.5374882	21.32623223	182.1552924	7.28553041	8.432576273	304.3486511	249.9849563		35.84557369		9.952397113	0.324536528	4798.806673	3295.221285	4.459707527	499.3157977			15.60572944	7.485743156			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												131.1562	131.1562	26.3577	0.145381857	127.2091	0.145381857	0.145381857	39.9878	254.2333		0.145381857		36.3455	0.4376793	14.5382	26.7802	0.363454642	24.8967			0.145381857	0.289752688			25.4418		25.4418															13.1136	1.324245775	1.837435815	3.10044724	1.930984608	1.059183939	1.225943596	1.01418688	5.296208681	0	5.21129606	0	0.030143708	0.14204292	5.813828537	7.35388841	1.620901402	1.035941796	0	0	2.268789923	2.169014203	0	0	0.915905698	0	0.527917867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9919	0	21.41115368	13.1136	1.324245775	1.837435815	3.10044724	1.930984608	1.059183939	1.225943596	1.01418688	5.296208681	0	5.21129606	0	0.030143708	0.14204292	5.813828537	7.35388841	1.620901402	1.035941796	0	0	2.268789923	2.169014203	0	0	0.915905698	0	0.527917867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9919																																																																																				0	0	0	13.1136	1.324245775	1.837435815	3.10044724	1.930984608	1.059183939	1.225943596	1.01418688	5.296208681	0	5.21129606	0	0.030143708	0.14204292	5.813828537	7.35388841	1.620901402	1.035941796	0	0	2.268789923	2.169014203	0	0	0.915905698	0	0.527917867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9919
H3333_082_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1366.874071	142.3982181	559.0137199	25.17946336	176.3288578	5.047755842	3.661262441	185.0009564	146.7021407		30.44118131		6.393350807	0.148616639	4223.121529	3855.701324	11.54212148	1543.412781			8.097915532	8.198462841			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												129.7676	129.7676	26.0787	0.143842622	125.8623	0.143842622	0.143842622	39.5737	266.6879		0.143842622		35.9607	0.478000247	14.3843	26.2022	0.359606556	25.0206			0.143842622	0.257018357			25.1725		25.1725															14.7813	1.53988984	1.214861073	3.621880035	1.849429552	0.726082437	0.52664559	0.610097316	3.260306656	0	4.378739343	0	0.019159091	0.07103879	5.062207289	8.418993345	4.150622551	3.2180977	0	0	1.164825405	2.107155446	0	0	0.90620852	0	0.522328522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1499	0	22.702214	14.7813	1.53988984	1.214861073	3.621880035	1.849429552	0.726082437	0.52664559	0.610097316	3.260306656	0	4.378739343	0	0.019159091	0.07103879	5.062207289	8.418993345	4.150622551	3.2180977	0	0	1.164825405	2.107155446	0	0	0.90620852	0	0.522328522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1499																																																																																				0	0	0	14.7813	1.53988984	1.214861073	3.621880035	1.849429552	0.726082437	0.52664559	0.610097316	3.260306656	0	4.378739343	0	0.019159091	0.07103879	5.062207289	8.418993345	4.150622551	3.2180977	0	0	1.164825405	2.107155446	0	0	0.90620852	0	0.522328522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1499
H3333_083_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1219.475092	88.69134928	783.154482	21.9262141	242.2962216	6.537739177	7.715283796	335.0748197	261.2227468		34.07531201		8.064098947	0.472979856	5413.126446	2866.328131	3.051195037	432.4599484			11.00536494	8.091021898			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												131.7361	131.7361	26.4743	0.146024587	127.7715	0.146024587	0.146024587	40.1649	256.3713		0.146024587		36.5061	0.516724459	14.6025	27.1366	0.365061466	24.9853			0.146024587	0.303858558			25.5543		25.5543															13.3874	0.973654229	1.727786121	3.201766348	2.579879574	0.95467066	1.126621126	1.121521747	5.580834114	0	4.975833347	0	0.024532432	0.24440026	6.587079593	6.481865997	1.113873735	0.900428569	0	0	1.607053865	2.458526249	0	0	0.919954895	0	0.53025178	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.4979	0	20.8834674	13.3874	0.973654229	1.727786121	3.201766348	2.579879574	0.95467066	1.126621126	1.121521747	5.580834114	0	4.975833347	0	0.024532432	0.24440026	6.587079593	6.481865997	1.113873735	0.900428569	0	0	1.607053865	2.458526249	0	0	0.919954895	0	0.53025178	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.4979																																																																																				0	0	0	13.3874	0.973654229	1.727786121	3.201766348	2.579879574	0.95467066	1.126621126	1.121521747	5.580834114	0	4.975833347	0	0.024532432	0.24440026	6.587079593	6.481865997	1.113873735	0.900428569	0	0	1.607053865	2.458526249	0	0	0.919954895	0	0.53025178	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.4979
H3333_084_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1818.51372	212.5085237	866.5892797	28.48751839	158.5309112	7.146568688	6.372917797	182.3538421	170.45868		48.50444995		19.25866279	0.51320437	6978.40729	5620.368856	8.626557543	2004.414697			21.5776305	11.08940088			432		249.0117097															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												116.5349	116.5349	23.4194	0.129174654	113.0278	0.129174654	0.129174654	35.5357	227.0476		0.129174654		32.2937	0.236995886	12.9175	23.7494	0.322936636	22.537			0.129174654	0.209155451			22.6056		22.6056															17.66	2.063721884	1.69124754	3.679865338	1.493200307	0.923155539	0.823219453	0.54000556	3.225186639	0	6.265545552	0	0.051827731	0.121627324	7.511944574	11.12337593	2.78583147	3.764452487	0	0	2.787282959	2.319408646	0	0	0.813800322	0	0.469087522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1138	0	38.44279847	17.66	2.063721884	1.69124754	3.679865338	1.493200307	0.923155539	0.823219453	0.54000556	3.225186639	0	6.265545552	0	0.051827731	0.121627324	7.511944574	11.12337593	2.78583147	3.764452487	0	0	2.787282959	2.319408646	0	0	0.813800322	0	0.469087522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1138																																																																																				0	0	0	17.66	2.063721884	1.69124754	3.679865338	1.493200307	0.923155539	0.823219453	0.54000556	3.225186639	0	6.265545552	0	0.051827731	0.121627324	7.511944574	11.12337593	2.78583147	3.764452487	0	0	2.787282959	2.319408646	0	0	0.813800322	0	0.469087522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1138
H3333_085_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		265.6234031	80.56494353	732.6822733	13.26005709	158.338537	10.26680658	9.446915482	218.8250681	271.0858106		45.19193087		3.027797249	0.251966632	4311.770286	3439.646782	2.38364182	312.3644973			30.75254545	7.432506669			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															161.2942	41.862	25.3687	0.124072443	41.3575	0.165429924	0.165429924	28.9502	29.5861		0.082714962		41.3575	0.269931345	8.2715	19.9153	0.413574811	20.6787			0.165429924	0.17455471			12.4072		12.4072															3.5703	0.28105109	1.548931777	1.645207681	0.545706921	1.698437035	1.562802514	0.527919794	0.668364535	0	3.738048853	0	0.010435172	0.068013692	2.972065968	5.708452398	0.985814215	0.538275366	0	0	5.087391267	1.297379045	0	0	0.446660796	0	0.25745032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1587	0	6.929210652	3.5703	0.28105109	1.548931777	1.645207681	0.545706921	1.698437035	1.562802514	0.527919794	0.668364535	0	3.738048853	0	0.010435172	0.068013692	2.972065968	5.708452398	0.985814215	0.538275366	0	0	5.087391267	1.297379045	0	0	0.446660796	0	0.25745032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1587																																																																																				0	0	0	3.5703	0.28105109	1.548931777	1.645207681	0.545706921	1.698437035	1.562802514	0.527919794	0.668364535	0	3.738048853	0	0.010435172	0.068013692	2.972065968	5.708452398	0.985814215	0.538275366	0	0	5.087391267	1.297379045	0	0	0.446660796	0	0.25745032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1587
H3333_086_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1315.662516	89.25335453	708.4037297	12.64027592	154.1870296	10.15851599	9.114140795	219.243801	255.9433905		43.04654559		2.786522852	0.241477426	4074.484835	3244.22635	2.642987303	291.5988437			28.76135558	6.944917496			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												101.4641	101.4641	23.6503	0.115668098	77.1121	0.15422413	0.15422413	38.556	110.6175		0.15422413		38.556	0.460760244	15.4224	23.8412	0.385560326	22.6201			0.15422413	0.283396948			23.1336		23.1336															11.1244	0.754667276	1.396161647	1.462076671	0.99080669	1.566688294	1.405620439	0.704430928	2.359318103	0	6.638816061	0	0.008953105	0.111263198	5.236532338	6.445514672	1.019031046	0.5496666	0	0	4.435695054	1.968168422	0	0	0.832810304	0	0.480022606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4906	0	14.68950362	11.1244	0.754667276	1.396161647	1.462076671	0.99080669	1.566688294	1.405620439	0.704430928	2.359318103	0	6.638816061	0	0.008953105	0.111263198	5.236532338	6.445514672	1.019031046	0.5496666	0	0	4.435695054	1.968168422	0	0	0.832810304	0	0.480022606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4906																																																																																				0	0	0	11.1244	0.754667276	1.396161647	1.462076671	0.99080669	1.566688294	1.405620439	0.704430928	2.359318103	0	6.638816061	0	0.008953105	0.111263198	5.236532338	6.445514672	1.019031046	0.5496666	0	0	4.435695054	1.968168422	0	0	0.832810304	0	0.480022606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4906
H3333_087_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1298.286871	88.07460648	699.0480083	12.47333877	152.1507178	10.02435485	8.993772481	216.3540873	252.5632063		42.47803999		2.749721901	0.23828829	6130.657866	3201.380616	2.608081991	287.7477664			28.38151112	6.853197604			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												130.3069	130.3069	26.187	0.144440428	126.3854	0.144440428	0.144440428	39.7321	207.2002		0.144440428		36.1101	0.496550801	14.444	26.6024	0.361101071	24.6358			0.144440428	0.303194909			25.2771		25.2771															14.098	0.956394317	1.525500409	1.801654395	1.602468792	1.447922109	1.29906435	0.71634999	4.360929812	0	6.135546293	0	0.008274396	0.118322241	7.379290403	7.097038862	0.9417812	0.590742229	0	0	4.099437625	2.077854621	0	0	0.909974699	0	0.524499306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.691	0	22.1910778	14.098	0.956394317	1.525500409	1.801654395	1.602468792	1.447922109	1.29906435	0.71634999	4.360929812	0	6.135546293	0	0.008274396	0.118322241	7.379290403	7.097038862	0.9417812	0.590742229	0	0	4.099437625	2.077854621	0	0	0.909974699	0	0.524499306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.691																																																																																				0	0	0	14.098	0.956394317	1.525500409	1.801654395	1.602468792	1.447922109	1.29906435	0.71634999	4.360929812	0	6.135546293	0	0.008274396	0.118322241	7.379290403	7.097038862	0.9417812	0.590742229	0	0	4.099437625	2.077854621	0	0	0.909974699	0	0.524499306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.691
H3333_088_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		265.6234031	80.56494353	732.6822733	13.26005709	158.338537	10.26680658	9.446915482	218.8250681	271.0858106		45.19193087		3.027797249	0.251966632	4311.770286	3439.646782	2.38364182	312.3644973			30.75254545	7.432506669			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															161.2942	41.862	25.3687	0.124072443	41.3575	0.165429924	0.165429924	28.9502	29.5861		0.082714962		41.3575	0.269931345	8.2715	19.9153	0.413574811	20.6787			0.165429924	0.17455471			12.4072		12.4072															3.5703	0.28105109	1.548931777	1.645207681	0.545706921	1.698437035	1.562802514	0.527919794	0.668364535	0	3.738048853	0	0.010435172	0.068013692	2.972065968	5.708452398	0.985814215	0.538275366	0	0	5.087391267	1.297379045	0	0	0.446660796	0	0.25745032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1587	0	6.929210652	3.5703	0.28105109	1.548931777	1.645207681	0.545706921	1.698437035	1.562802514	0.527919794	0.668364535	0	3.738048853	0	0.010435172	0.068013692	2.972065968	5.708452398	0.985814215	0.538275366	0	0	5.087391267	1.297379045	0	0	0.446660796	0	0.25745032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1587																																																																																				0	0	0	3.5703	0.28105109	1.548931777	1.645207681	0.545706921	1.698437035	1.562802514	0.527919794	0.668364535	0	3.738048853	0	0.010435172	0.068013692	2.972065968	5.708452398	0.985814215	0.538275366	0	0	5.087391267	1.297379045	0	0	0.446660796	0	0.25745032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1587
H3333_089_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1315.662516	89.25335453	708.4037297	12.64027592	154.1870296	10.15851599	9.114140795	219.243801	255.9433905		43.04654559		2.786522852	0.241477426	4074.484835	3244.22635	2.642987303	291.5988437			28.76135558	6.944917496			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												101.4641	101.4641	23.6503	0.115668098	77.1121	0.15422413	0.15422413	38.556	110.6175		0.15422413		38.556	0.460760244	15.4224	23.8412	0.385560326	22.6201			0.15422413	0.283396948			23.1336		23.1336															11.1244	0.754667276	1.396161647	1.462076671	0.99080669	1.566688294	1.405620439	0.704430928	2.359318103	0	6.638816061	0	0.008953105	0.111263198	5.236532338	6.445514672	1.019031046	0.5496666	0	0	4.435695054	1.968168422	0	0	0.832810304	0	0.480022606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4906	0	14.68950362	11.1244	0.754667276	1.396161647	1.462076671	0.99080669	1.566688294	1.405620439	0.704430928	2.359318103	0	6.638816061	0	0.008953105	0.111263198	5.236532338	6.445514672	1.019031046	0.5496666	0	0	4.435695054	1.968168422	0	0	0.832810304	0	0.480022606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4906																																																																																				0	0	0	11.1244	0.754667276	1.396161647	1.462076671	0.99080669	1.566688294	1.405620439	0.704430928	2.359318103	0	6.638816061	0	0.008953105	0.111263198	5.236532338	6.445514672	1.019031046	0.5496666	0	0	4.435695054	1.968168422	0	0	0.832810304	0	0.480022606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4906
H3333_090_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1298.286871	88.07460648	699.0480083	12.47333877	152.1507178	10.02435485	8.993772481	216.3540873	252.5632063		42.47803999		2.749721901	0.23828829	6130.657866	3201.380616	2.608081991	287.7477664			28.38151112	6.853197604			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												130.3069	130.3069	26.187	0.144440428	126.3854	0.144440428	0.144440428	39.7321	207.2002		0.144440428		36.1101	0.496550801	14.444	26.6024	0.361101071	24.6358			0.144440428	0.303194909			25.2771		25.2771															14.098	0.956394317	1.525500409	1.801654395	1.602468792	1.447922109	1.29906435	0.71634999	4.360929812	0	6.135546293	0	0.008274396	0.118322241	7.379290403	7.097038862	0.9417812	0.590742229	0	0	4.099437625	2.077854621	0	0	0.909974699	0	0.524499306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.691	0	22.1910778	14.098	0.956394317	1.525500409	1.801654395	1.602468792	1.447922109	1.29906435	0.71634999	4.360929812	0	6.135546293	0	0.008274396	0.118322241	7.379290403	7.097038862	0.9417812	0.590742229	0	0	4.099437625	2.077854621	0	0	0.909974699	0	0.524499306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.691																																																																																				0	0	0	14.098	0.956394317	1.525500409	1.801654395	1.602468792	1.447922109	1.29906435	0.71634999	4.360929812	0	6.135546293	0	0.008274396	0.118322241	7.379290403	7.097038862	0.9417812	0.590742229	0	0	4.099437625	2.077854621	0	0	0.909974699	0	0.524499306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.691
H3333_091_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		269.3208966	148.1573287	1089.323249	23.04504407	121.6610537	10.35834876	11.45750499	225.8452403	248.6636603		39.29588036		8.539033554	0.649395949	3541.099426	4211.808627	3.826265262	1085.882472			27.20913727	7.948471352			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															156.6333	40.6524	24.6356	0.120487149	40.1624	0.160649533	0.160649533	28.1137	34.8749		0.080324766		40.1624	0.202137248	8.0325	19.4718	0.401623831	20.0812			0.160649533	0.164288974			12.0487		12.0487															3.5154	0.501912141	2.236344848	2.776631669	0.407183154	1.664063886	1.840642821	0.529111513	0.722676982	0	3.156432406	0	0.028578995	0.13126711	2.370316532	6.834289263	1.536719315	1.817151162	0	0	4.371135184	1.305846206	0	0	0.433753738	0	0.250010835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.4295	0	8.923250309	3.5154	0.501912141	2.236344848	2.776631669	0.407183154	1.664063886	1.840642821	0.529111513	0.722676982	0	3.156432406	0	0.028578995	0.13126711	2.370316532	6.834289263	1.536719315	1.817151162	0	0	4.371135184	1.305846206	0	0	0.433753738	0	0.250010835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.4295																																																																																				0	0	0	3.5154	0.501912141	2.236344848	2.776631669	0.407183154	1.664063886	1.840642821	0.529111513	0.722676982	0	3.156432406	0	0.028578995	0.13126711	2.370316532	6.834289263	1.536719315	1.817151162	0	0	4.371135184	1.305846206	0	0	0.433753738	0	0.250010835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.4295
H3333_092_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1345.030259	135.1630097	966.5569423	20.42221626	108.9634074	9.210595689	10.14378086	203.0302888	220.1892084		34.69384881		7.525064942	0.573449288	3138.041937	3730.644235	3.457440188	960.7068928			24.02536462	7.004655235			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												100.8105	100.8105	23.4979	0.114923004	76.6153	0.153230672	0.153230672	38.3077	133.1212		0.153230672		38.3077	0.289360448	15.3231	23.5655	0.38307668	22.9266			0.153230672	0.270345409			22.9846		22.9846															11.2994	1.135487088	1.892673427	2.34698244	0.695689005	1.411345766	1.554338357	0.648134741	2.442654125	0	5.316161764	0	0.024022307	0.165933543	4.007035621	7.326220001	1.324464708	1.835478024	0	0	3.681422763	1.893676385	0	0	0.827445628	0	0.476930466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3055	0	15.35433778	11.2994	1.135487088	1.892673427	2.34698244	0.695689005	1.411345766	1.554338357	0.648134741	2.442654125	0	5.316161764	0	0.024022307	0.165933543	4.007035621	7.326220001	1.324464708	1.835478024	0	0	3.681422763	1.893676385	0	0	0.827445628	0	0.476930466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3055																																																																																				0	0	0	11.2994	1.135487088	1.892673427	2.34698244	0.695689005	1.411345766	1.554338357	0.648134741	2.442654125	0	5.316161764	0	0.024022307	0.165933543	4.007035621	7.326220001	1.324464708	1.835478024	0	0	3.681422763	1.893676385	0	0	0.827445628	0	0.476930466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3055
H3333_093_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1328.902271	133.5422972	954.9671516	20.17733756	107.656849	9.100153281	10.02214882	200.6014156	217.5489637		34.27784182		7.434833396	0.566573172	5681.945483	3685.910827	3.415982715	949.1872488			23.73728128	6.920663817			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												128.4527	128.4527	25.8144	0.14238511	124.587	0.14238511	0.14238511	39.1684	247.3979		0.14238511		35.5963	0.297903093	14.2385	25.997	0.355962776	24.8455			0.14238511	0.286245376			24.9174		24.9174															14.2251	1.429489356	2.054326967	2.872952433	1.117720064	1.295726328	1.427004765	0.654769472	4.485096902	0	4.880654287	0	0.022054366	0.1687839	6.741870285	7.985228728	1.215962689	1.965254658	0	0	3.379835413	1.981008017	0	0	0.897026195	0	0.517035932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3169	0	24.0020625	14.2251	1.429489356	2.054326967	2.872952433	1.117720064	1.295726328	1.427004765	0.654769472	4.485096902	0	4.880654287	0	0.022054366	0.1687839	6.741870285	7.985228728	1.215962689	1.965254658	0	0	3.379835413	1.981008017	0	0	0.897026195	0	0.517035932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3169																																																																																				0	0	0	14.2251	1.429489356	2.054326967	2.872952433	1.117720064	1.295726328	1.427004765	0.654769472	4.485096902	0	4.880654287	0	0.022054366	0.1687839	6.741870285	7.985228728	1.215962689	1.965254658	0	0	3.379835413	1.981008017	0	0	0.897026195	0	0.517035932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3169
H3333_094_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		269.3208966	148.1573287	1089.323249	23.04504407	121.6610537	10.35834876	11.45750499	225.8452403	248.6636603		39.29588036		8.539033554	0.649395949	3541.099426	4211.808627	3.826265262	1085.882472			27.20913727	7.948471352			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															156.6333	40.6524	24.6356	0.120487149	40.1624	0.160649533	0.160649533	28.1137	34.8749		0.080324766		40.1624	0.202137248	8.0325	19.4718	0.401623831	20.0812			0.160649533	0.164288974			12.0487		12.0487															3.5154	0.501912141	2.236344848	2.776631669	0.407183154	1.664063886	1.840642821	0.529111513	0.722676982	0	3.156432406	0	0.028578995	0.13126711	2.370316532	6.834289263	1.536719315	1.817151162	0	0	4.371135184	1.305846206	0	0	0.433753738	0	0.250010835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.4295	0	8.923250309	3.5154	0.501912141	2.236344848	2.776631669	0.407183154	1.664063886	1.840642821	0.529111513	0.722676982	0	3.156432406	0	0.028578995	0.13126711	2.370316532	6.834289263	1.536719315	1.817151162	0	0	4.371135184	1.305846206	0	0	0.433753738	0	0.250010835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.4295																																																																																				0	0	0	3.5154	0.501912141	2.236344848	2.776631669	0.407183154	1.664063886	1.840642821	0.529111513	0.722676982	0	3.156432406	0	0.028578995	0.13126711	2.370316532	6.834289263	1.536719315	1.817151162	0	0	4.371135184	1.305846206	0	0	0.433753738	0	0.250010835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.4295
H3333_095_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1345.030259	135.1630097	966.5569423	20.42221626	108.9634074	9.210595689	10.14378086	203.0302888	220.1892084		34.69384881		7.525064942	0.573449288	3138.041937	3730.644235	3.457440188	960.7068928			24.02536462	7.004655235			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												100.8105	100.8105	23.4979	0.114923004	76.6153	0.153230672	0.153230672	38.3077	133.1212		0.153230672		38.3077	0.289360448	15.3231	23.5655	0.38307668	22.9266			0.153230672	0.270345409			22.9846		22.9846															11.2994	1.135487088	1.892673427	2.34698244	0.695689005	1.411345766	1.554338357	0.648134741	2.442654125	0	5.316161764	0	0.024022307	0.165933543	4.007035621	7.326220001	1.324464708	1.835478024	0	0	3.681422763	1.893676385	0	0	0.827445628	0	0.476930466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3055	0	15.35433778	11.2994	1.135487088	1.892673427	2.34698244	0.695689005	1.411345766	1.554338357	0.648134741	2.442654125	0	5.316161764	0	0.024022307	0.165933543	4.007035621	7.326220001	1.324464708	1.835478024	0	0	3.681422763	1.893676385	0	0	0.827445628	0	0.476930466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3055																																																																																				0	0	0	11.2994	1.135487088	1.892673427	2.34698244	0.695689005	1.411345766	1.554338357	0.648134741	2.442654125	0	5.316161764	0	0.024022307	0.165933543	4.007035621	7.326220001	1.324464708	1.835478024	0	0	3.681422763	1.893676385	0	0	0.827445628	0	0.476930466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3055
H3333_096_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1328.902271	133.5422972	954.9671516	20.17733756	107.656849	9.100153281	10.02214882	200.6014156	217.5489637		34.27784182		7.434833396	0.566573172	5681.945483	3685.910827	3.415982715	949.1872488			23.73728128	6.920663817			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												128.4527	128.4527	25.8144	0.14238511	124.587	0.14238511	0.14238511	39.1684	247.3979		0.14238511		35.5963	0.297903093	14.2385	25.997	0.355962776	24.8455			0.14238511	0.286245376			24.9174		24.9174															14.2251	1.429489356	2.054326967	2.872952433	1.117720064	1.295726328	1.427004765	0.654769472	4.485096902	0	4.880654287	0	0.022054366	0.1687839	6.741870285	7.985228728	1.215962689	1.965254658	0	0	3.379835413	1.981008017	0	0	0.897026195	0	0.517035932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3169	0	24.0020625	14.2251	1.429489356	2.054326967	2.872952433	1.117720064	1.295726328	1.427004765	0.654769472	4.485096902	0	4.880654287	0	0.022054366	0.1687839	6.741870285	7.985228728	1.215962689	1.965254658	0	0	3.379835413	1.981008017	0	0	0.897026195	0	0.517035932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3169																																																																																				0	0	0	14.2251	1.429489356	2.054326967	2.872952433	1.117720064	1.295726328	1.427004765	0.654769472	4.485096902	0	4.880654287	0	0.022054366	0.1687839	6.741870285	7.985228728	1.215962689	1.965254658	0	0	3.379835413	1.981008017	0	0	0.897026195	0	0.517035932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3169
H3333_097_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		269.3208966	148.1573287	1089.323249	23.04504407	121.6610537	10.35834876	11.45750499	225.8452403	248.6636603		39.29588036		8.539033554	0.649395949	3541.099426	4211.808627	3.826265262	1085.882472			27.20913727	7.948471352			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															156.6333	40.6524	24.6356	0.120487149	40.1624	0.160649533	0.160649533	28.1137	34.8749		0.080324766		40.1624	0.202137248	8.0325	19.4718	0.401623831	20.0812			0.160649533	0.164288974			12.0487		12.0487															3.5154	0.501912141	2.236344848	2.776631669	0.407183154	1.664063886	1.840642821	0.529111513	0.722676982	0	3.156432406	0	0.028578995	0.13126711	2.370316532	6.834289263	1.536719315	1.817151162	0	0	4.371135184	1.305846206	0	0	0.433753738	0	0.250010835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.4295	0	8.923250309	3.5154	0.501912141	2.236344848	2.776631669	0.407183154	1.664063886	1.840642821	0.529111513	0.722676982	0	3.156432406	0	0.028578995	0.13126711	2.370316532	6.834289263	1.536719315	1.817151162	0	0	4.371135184	1.305846206	0	0	0.433753738	0	0.250010835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.4295																																																																																				0	0	0	3.5154	0.501912141	2.236344848	2.776631669	0.407183154	1.664063886	1.840642821	0.529111513	0.722676982	0	3.156432406	0	0.028578995	0.13126711	2.370316532	6.834289263	1.536719315	1.817151162	0	0	4.371135184	1.305846206	0	0	0.433753738	0	0.250010835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.4295
H3333_098_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1345.030259	135.1630097	966.5569423	20.42221626	108.9634074	9.210595689	10.14378086	203.0302888	220.1892084		34.69384881		7.525064942	0.573449288	3138.041937	3730.644235	3.457440188	960.7068928			24.02536462	7.004655235			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												100.8105	100.8105	23.4979	0.114923004	76.6153	0.153230672	0.153230672	38.3077	133.1212		0.153230672		38.3077	0.289360448	15.3231	23.5655	0.38307668	22.9266			0.153230672	0.270345409			22.9846		22.9846															11.2994	1.135487088	1.892673427	2.34698244	0.695689005	1.411345766	1.554338357	0.648134741	2.442654125	0	5.316161764	0	0.024022307	0.165933543	4.007035621	7.326220001	1.324464708	1.835478024	0	0	3.681422763	1.893676385	0	0	0.827445628	0	0.476930466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3055	0	15.35433778	11.2994	1.135487088	1.892673427	2.34698244	0.695689005	1.411345766	1.554338357	0.648134741	2.442654125	0	5.316161764	0	0.024022307	0.165933543	4.007035621	7.326220001	1.324464708	1.835478024	0	0	3.681422763	1.893676385	0	0	0.827445628	0	0.476930466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3055																																																																																				0	0	0	11.2994	1.135487088	1.892673427	2.34698244	0.695689005	1.411345766	1.554338357	0.648134741	2.442654125	0	5.316161764	0	0.024022307	0.165933543	4.007035621	7.326220001	1.324464708	1.835478024	0	0	3.681422763	1.893676385	0	0	0.827445628	0	0.476930466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3055
H3333_099_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1328.902271	133.5422972	954.9671516	20.17733756	107.656849	9.100153281	10.02214882	200.6014156	217.5489637		34.27784182		7.434833396	0.566573172	5681.945483	3685.910827	3.415982715	949.1872488			23.73728128	6.920663817			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												128.4527	128.4527	25.8144	0.14238511	124.587	0.14238511	0.14238511	39.1684	247.3979		0.14238511		35.5963	0.297903093	14.2385	25.997	0.355962776	24.8455			0.14238511	0.286245376			24.9174		24.9174															14.2251	1.429489356	2.054326967	2.872952433	1.117720064	1.295726328	1.427004765	0.654769472	4.485096902	0	4.880654287	0	0.022054366	0.1687839	6.741870285	7.985228728	1.215962689	1.965254658	0	0	3.379835413	1.981008017	0	0	0.897026195	0	0.517035932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3169	0	24.0020625	14.2251	1.429489356	2.054326967	2.872952433	1.117720064	1.295726328	1.427004765	0.654769472	4.485096902	0	4.880654287	0	0.022054366	0.1687839	6.741870285	7.985228728	1.215962689	1.965254658	0	0	3.379835413	1.981008017	0	0	0.897026195	0	0.517035932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3169																																																																																				0	0	0	14.2251	1.429489356	2.054326967	2.872952433	1.117720064	1.295726328	1.427004765	0.654769472	4.485096902	0	4.880654287	0	0.022054366	0.1687839	6.741870285	7.985228728	1.215962689	1.965254658	0	0	3.379835413	1.981008017	0	0	0.897026195	0	0.517035932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3169
H3333_801_0	2008	5																																A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		264.4880452	170.9743308	842.5252292		162.2447105	8.62670345	10.83710404	289.3277075	267.0828308	17.14899922	36.72402167	41.51648682	10.62066824	25.74325831	7931.543182	12017.96637	5.394587371	685.4792562			19.07458576	8.684992945																				Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare											776.9627	51.1061	83.055		125.3532	0.234	0.234	110.8673	363.4079	0.234	0.234	109.3284	183.447	0.234	11.4676	19.17	0.234	20.6794			0.234	0.234																				17.1248	0.728152656	5.831330454	0	1.694824564	2.018648607	2.535882345	2.673081541	8.088333989	4.012865817	8.593421072	0.378244374	0.162360834	6.023922445	7.579647695	19.19869915	1.262333445	1.181276773	0	0	4.463453068	2.032288349	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.5835	0	0	17.1248	0.728152656	5.831330454	0	1.694824564	2.018648607	2.535882345	2.673081541	8.088333989	4.012865817	8.593421072	0.378244374	0.162360834	6.023922445	7.579647695	19.19869915	1.262333445	1.181276773	0	0	4.463453068	2.032288349	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.5835																																																																																				0	0	0	17.1248	0.728152656	5.831330454	0	1.694824564	2.018648607	2.535882345	2.673081541	8.088333989	4.012865817	8.593421072	0.378244374	0.162360834	6.023922445	7.579647695	19.19869915	1.262333445	1.181276773	0	0	4.463453068	2.032288349	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.5835
H3333_805_0	2008	5																																A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		264.4880452	170.9743308	842.5252292		162.2447105	8.62670345	10.83710404	289.3277075	267.0828308	17.14899922	36.72402167	41.51648682	10.62066824	25.74325831	7931.543182	12017.96637	5.394587371	685.4792562			19.07458576	8.684992945																				Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare											776.9627	51.1061	83.055		125.3532	0.234	0.234	110.8673	363.4079	0.234	0.234	109.3284	183.447	0.234	11.4676	19.17	0.234	20.6794			0.234	0.234																				17.1248	0.728152656	5.831330454	0	1.694824564	2.018648607	2.535882345	2.673081541	8.088333989	4.012865817	8.593421072	0.378244374	0.162360834	6.023922445	7.579647695	19.19869915	1.262333445	1.181276773	0	0	4.463453068	2.032288349	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.5835	0	0	17.1248	0.728152656	5.831330454	0	1.694824564	2.018648607	2.535882345	2.673081541	8.088333989	4.012865817	8.593421072	0.378244374	0.162360834	6.023922445	7.579647695	19.19869915	1.262333445	1.181276773	0	0	4.463453068	2.032288349	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.5835																																																																																				0	0	0	17.1248	0.728152656	5.831330454	0	1.694824564	2.018648607	2.535882345	2.673081541	8.088333989	4.012865817	8.593421072	0.378244374	0.162360834	6.023922445	7.579647695	19.19869915	1.262333445	1.181276773	0	0	4.463453068	2.032288349	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.5835
H3333_806_0	2008	5																																A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		264.4880452	170.9743308	842.5252292		162.2447105	8.62670345	10.83710404	289.3277075	267.0828308	17.14899922	36.72402167	41.51648682	10.62066824	25.74325831	7931.543182	12017.96637	5.394587371	685.4792562			19.07458576	8.684992945																				Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare											776.9627	51.1061	83.055		125.3532	0.234	0.234	110.8673	363.4079	0.234	0.234	109.3284	183.447	0.234	11.4676	19.17	0.234	20.6794			0.234	0.234																				17.1248	0.728152656	5.831330454	0	1.694824564	2.018648607	2.535882345	2.673081541	8.088333989	4.012865817	8.593421072	0.378244374	0.162360834	6.023922445	7.579647695	19.19869915	1.262333445	1.181276773	0	0	4.463453068	2.032288349	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.5835	0	0	17.1248	0.728152656	5.831330454	0	1.694824564	2.018648607	2.535882345	2.673081541	8.088333989	4.012865817	8.593421072	0.378244374	0.162360834	6.023922445	7.579647695	19.19869915	1.262333445	1.181276773	0	0	4.463453068	2.032288349	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.5835																																																																																				0	0	0	17.1248	0.728152656	5.831330454	0	1.694824564	2.018648607	2.535882345	2.673081541	8.088333989	4.012865817	8.593421072	0.378244374	0.162360834	6.023922445	7.579647695	19.19869915	1.262333445	1.181276773	0	0	4.463453068	2.032288349	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.5835
H3335_002_0	2008	8																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		216.6824574	3.799522054	1297.046642	0	205.603249	51688.89863	53.37393258	354.4037609	331.5896047	0	782.8319223	0	359.2178586	283.4031973	3881.076961	5577.840614	155.6701144	456.6552293	807.1069445	57.53154585	853.9041991	12.39307861	0	0	280.9097817	0	120.3899065	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												560.3918632	560.3918632	46.69932193	0	93.39864386	1.401175916	62.0358975	45.90639104	93.39864386	0	37.35945754	0	37.35945754	37.35945754	18.67972877	36.75130058	41.52418133	37.35945754	37.35945754	37.35945754	37.35945754	37.35945754	0	0	37.35945754	0	32.18744697	0	0	0	0											10.1189	0.177435104	5.047599889	0	1.600255385	6.035436659	0.275924984	1.355783136	2.58083495	0	2.43718133	0	1.118348695	0.88231581	6.041455414	17.08274142	0.538672838	1.421699304	2.512756469	0.179112279	2.658449806	0.038583224	0	0	0.874553089	0	0.322920311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.301	0	4.474072873	10.1189	0.177435104	5.047599889	0	1.600255385	6.035436659	0.275924984	1.355783136	2.58083495	0	2.43718133	0	1.118348695	0.88231581	6.041455414	17.08274142	0.538672838	1.421699304	2.512756469	0.179112279	2.658449806	0.038583224	0	0	0.874553089	0	0.322920311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.301	4000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												3.4563	0.0438	0.7245	0.4493	0.1881	0.5198	0.0238	0.0911	0.4613	0.1322	0.3473	0	0.1663	0.2716	0.3712	0.8157	0.0348	0.0579	0.4652	1.1617	0.3319	0.3459	0	0	0.0588	0	0.0063	0	0	0	0											10.5248	0	0.743883748	13.5752	0.221240594	5.772093677	0.449333648	1.788390764	6.555261728	0.299690079	1.446865303	3.042096228	0.132226072	2.784490279	0	1.284630351	1.153885717	6.412664306	17.89846642	0.573469282	1.479631668	2.977922673	1.340841077	2.990362246	0.384491502	0	0	0.933305988	0	0.329178179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.8258
H3335_005_0	2008	10																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		257.5329595	4.515834696	1819.004703	0	232.212152	58378.40816	60.281517	319.8669643	295.933142	0	708.5008126	0	318.9713333	251.6508952	4341.751732	6289.869462	181.1975726	531.5395277	855.4150259	67.65797057	924.2804579	13.4168788	0	0	307.6937538	0	131.8687516	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												286.8306261	286.8306261	23.90255218	0	95.6102087	0.870812316	38.55449052	45.81145204	47.80510435	0	28.68306261	0	28.68306261	28.68306261	14.34153131	28.68306261	28.68306261	28.68306261	28.68306261	28.68306261	28.68306261	28.68306261	0	0	28.68306261	0	28.68306261	0	0	0	0											6.1557	0.107939974	3.623237902	0	1.85015436	4.236386401	0.193676931	1.221130841	1.178926228	0	1.693497764	0	0.762422894	0.601509865	5.188947365	15.0343933	0.433108443	1.270515129	2.044660229	0.161719817	2.209266187	0.032069765	0	0	0.7354666	0	0.315199972	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0499	0	2.252049616	6.1557	0.107939974	3.623237902	0	1.85015436	4.236386401	0.193676931	1.221130841	1.178926228	0	1.693497764	0	0.762422894	0.601509865	5.188947365	15.0343933	0.433108443	1.270515129	2.044660229	0.161719817	2.209266187	0.032069765	0	0	0.7354666	0	0.315199972	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0499	4000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.4799	0.0314	0.578	0.2186	0.1367	0.2683	0.0123	0.0516	0.315	0.0906	0.2405	0	0.113	0.1845	0.2542	0.4836	0.0248	0.0413	0.3311	0.8582	0.2325	0.2497	0	0	0.0231	0	0.0042	0	0	0	0											7.2229	0	0.331629288	8.6356	0.139370105	4.201216751	0.218599412	1.986837231	4.504645774	0.205941075	1.272681033	1.493922903	0.090580467	1.934019357	0	0.875403616	0.786029103	5.44315685	15.5180293	0.457924389	1.31183103	2.375724518	1.019934691	2.441742377	0.281787953	0	0	0.758517021	0	0.319399757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.2729
H3335_006_0	2008	8																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		258.5693094	4.534007069	1819.004703	0	232.212152	58378.40816	60.281517	320.6425256	296.8299091	0	723.6681765	0	319.7809052	252.2896031	4481.808239	6414.603296	185.4114697	543.900912	873.7274833	68.39338329	932.2743186	13.4168788	0	0	314.8494225	0	134.9354668	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												97.88328349	97.88328349	24.47082087	0	97.88328349	0.891515351	39.47110017	46.33731072	34.25914922	0	24.47082087	0	24.47082087	24.47082087	9.788328349	24.47082087	24.47082087	24.47082087	24.47082087	24.47082087	24.47082087	24.47082087	0	0	24.47082087	0	24.47082087	0	0	0	0											2.1091	0.036983625	3.709378188	0	1.894140659	4.337103922	0.198281483	1.238142695	0.847428346	0	1.475729527	0	0.652108437	0.514477807	3.65578422	13.08088402	0.378097572	1.109141816	1.781735728	0.139470186	1.901126488	0.02736017	0	0	0.642051985	0	0.275165136	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0037	0	0.865076701	2.1091	0.036983625	3.709378188	0	1.894140659	4.337103922	0.198281483	1.238142695	0.847428346	0	1.475729527	0	0.652108437	0.514477807	3.65578422	13.08088402	0.378097572	1.109141816	1.781735728	0.139470186	1.901126488	0.02736017	0	0	0.642051985	0	0.275165136	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0037	5000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.549	0.0323	0.5917	0.2238	0.1399	0.2746	0.0126	0.0523	0.3235	0.094	0.2515	0	0.116	0.1894	0.2685	0.5039	0.026	0.0433	0.3456	0.8833	0.2396	0.2583	0	0	0.0241	0	0.0044	0	0	0	0											7.4477	0	0.161056759	4.6582	0.069290474	4.301098134	0.223796481	2.034073082	4.611740999	0.210837199	1.290411043	1.170891105	0.093957366	1.727240801	0	0.768068779	0.703863335	3.924314837	13.58482822	0.404094337	1.152423655	2.127319973	1.022815409	2.140774249	0.285696543	0	0	0.666199216	0	0.27956476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4515
H3335_008_0	2008	9																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		208.9536283	3.663997208	1102.841628	0	179.1559446	45040.01521	46.50829867	461.7041657	445.6305076	0	1066.894957	0	480.3225356	378.9481482	3938.493079	5463.658316	145.7351444	427.5111896	784.6854588	54.41653533	916.2345912	12.17072913	0	0	279.1153881	0	119.6208806	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												288.929803	288.929803	24.07748358	0	96.30993433	0.935531445	41.41987607	46.89288701	48.15496717	0	28.8929803	0	28.8929803	28.8929803	14.44649015	28.8929803	28.8929803	28.8929803	28.8929803	28.8929803	28.8929803	28.8929803	0	0	28.8929803	0	28.8929803	0	0	0	0											5.0311	0.088219833	2.212804267	0	1.437874772	3.511362541	0.160530664	1.804220106	1.788276872	0	2.56881458	0	1.156495797	0.912411782	4.741450123	13.15511434	0.350893555	1.029339365	1.889325125	0.131021324	2.206062333	0.029304053	0	0	0.672039618	0	0.288016979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.1647	0	1.730460581	5.0311	0.088219833	2.212804267	0	1.437874772	3.511362541	0.160530664	1.804220106	1.788276872	0	2.56881458	0	1.156495797	0.912411782	4.741450123	13.15511434	0.350893555	1.029339365	1.889325125	0.131021324	2.206062333	0.029304053	0	0	0.672039618	0	0.288016979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.1647	4000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.1021	0.0266	0.362	0.1749	0.1062	0.2223	0.0102	0.0762	0.3717	0.1069	0.2838	0	0.1333	0.2177	0.2275	0.4168	0.0197	0.0328	0.2529	0.6966	0.2271	0.1985	0	0	0.0206	0	0.0038	0	0	0	0											6.2902	0	0.241005826	7.1332	0.114862388	2.574815985	0.174884572	1.544099883	3.733711455	0.170695897	1.880385484	2.159936176	0.106874377	2.852601983	0	1.28979986	1.130122942	4.968920855	13.57187517	0.370582	1.062118525	2.14225005	0.827637781	2.433207485	0.227836409	0	0	0.692665505	0	0.291775014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.4549
H3335_009_0	2008	8																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		209.794488	3.678741664	1102.841628	0	179.1559446	45040.01521	46.50829867	462.4076934	446.9809031	0	1089.73471	0	481.5416283	379.9099456	4065.541243	5572.576747	149.1243338	437.4533103	801.4837598	55.00801941	923.1026587	12.17072913	0	0	285.6064437	0	122.4027616	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												98.29005189	98.29005189	24.57251297	0	98.29005189	0.954765828	42.2714624	47.5000544	34.40151816	0	24.57251297	0	24.57251297	24.57251297	9.829005189	24.57251297	24.57251297	24.57251297	24.57251297	24.57251297	24.57251297	24.57251297	0	0	24.57251297	0	24.57251297	0	0	0	0											1.7184	0.030131976	2.258299185	0	1.467437258	3.583555619	0.16383115	1.830365882	1.281401805	0	2.231460026	0	0.986057326	0.777945172	3.330018831	11.41101787	0.305363302	0.895777262	1.64120584	0.112640439	1.890246005	0.024922117	0	0	0.584839004	0	0.250645287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.7756	0	0.639782845	1.7184	0.030131976	2.258299185	0	1.467437258	3.583555619	0.16383115	1.830365882	1.281401805	0	2.231460026	0	0.986057326	0.777945172	3.330018831	11.41101787	0.305363302	0.895777262	1.64120584	0.112640439	1.890246005	0.024922117	0	0	0.584839004	0	0.250645287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.7756	5000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.154	0.0273	0.3695	0.1785	0.1084	0.2269	0.0104	0.0773	0.3804	0.1105	0.2958	0	0.1364	0.2228	0.2395	0.4329	0.0206	0.0342	0.2632	0.7144	0.2332	0.2047	0	0	0.0215	0	0.0039	0	0	0	0											6.4664	0	0.112495254	3.8724	0.057431716	2.627753809	0.178480172	1.575846341	3.810475992	0.174205379	1.907635007	1.661851763	0.110510639	2.527282191	0	1.122447392	1.000696367	3.56954987	11.84394865	0.325923824	0.930008335	1.904394663	0.827043967	2.123472525	0.229656863	0	0	0.606378489	0	0.25456978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2419
H3335_014_0	2008	9																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		218.2300383	3.82665885	1393.139458	0	225.5955285	56714.98124	58.56386313	256.8341874	229.1768906	0	548.6780294	0	247.0181536	194.8837811	4550.00237	6700.864771	198.3041241	581.7212613	909.8359667	74.04544333	932.7035909	14.0604148	0	0	322.4521795	0	138.1937912	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												287.5228914	287.5228914	23.96024095	0	95.84096379	0.931440416	41.23874918	45.31217001	47.9204819	0	28.75228914	0	28.75228914	28.75228914	14.37614457	28.75228914	28.75228914	28.75228914	28.75228914	28.75228914	28.75228914	28.75228914	0	0	28.75228914	0	28.75228914	0	0	0	0											5.2288	0.091687668	2.78166309	0	1.801774407	4.40221881	0.201258372	0.96980953	0.91518892	0	1.314645779	0	0.591861448	0.466946235	5.450957654	16.05543345	0.47514146	1.393818158	2.179988899	0.177414666	2.234780277	0.033689093	0	0	0.772603191	0	0.331115653	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.8708	0	2.077363931	5.2288	0.091687668	2.78166309	0	1.801774407	4.40221881	0.201258372	0.96980953	0.91518892	0	1.314645779	0	0.591861448	0.466946235	5.450957654	16.05543345	0.47514146	1.393818158	2.179988899	0.177414666	2.234780277	0.033689093	0	0	0.772603191	0	0.331115653	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.8708	4000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.2194	0.0281	0.4955	0.2642	0.1331	0.2788	0.0127	0.0409	0.2392	0.0688	0.1826	0	0.0858	0.1401	0.2603	0.5023	0.0265	0.0442	0.362	0.8359	0.2143	0.2668	0	0	0.0236	0	0.0043	0	0	0	0											6.7294	0	0.292021805	7.4482	0.119816111	3.277176134	0.264158292	1.934883138	4.680979137	0.214002593	1.010750161	1.154341915	0.068770853	1.497255514	0	0.67763911	0.607037645	5.711227348	16.55775809	0.501675013	1.437993692	2.541989129	1.013322263	2.449097378	0.30050729	0	0	0.796203121	0	0.335415559	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.6002
H3335_015_0	2008	8																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		219.1082276	3.84205788	1393.139458	0	225.5955285	56714.98124	58.56386313	257.6469482	229.871366	0	560.4239571	0	247.6451033	195.37841	4696.776639	6833.491977	202.915848	595.2496627	929.3134507	74.85028511	941.2520455	14.0604148	0	0	329.9510674	0	141.4076003	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												98.0068266	98.0068266	24.50170665	0	98.0068266	0.95248958	42.1706834	45.60256909	34.30238931	0	24.50170665	0	24.50170665	24.50170665	9.80068266	24.50170665	24.50170665	24.50170665	24.50170665	24.50170665	24.50170665	24.50170665	0	0	24.50170665	0	24.50170665	0	0	0	0											1.7895	0.031378992	2.844524526	0	1.842491821	4.501702388	0.205806511	0.979113563	0.657094757	0	1.144278616	0	0.505643973	0.398925374	3.835968114	13.95268465	0.414315382	1.215386052	1.897480463	0.152829977	1.921856792	0.02870868	0	0	0.673697022	0	0.288727295	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.2821	0	0.798883978	1.7895	0.031378992	2.844524526	0	1.842491821	4.501702388	0.205806511	0.979113563	0.657094757	0	1.144278616	0	0.505643973	0.398925374	3.835968114	13.95268465	0.414315382	1.215386052	1.897480463	0.152829977	1.921856792	0.02870868	0	0	0.673697022	0	0.288727295	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.2821	5000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.2786	0.0289	0.5067	0.2701	0.1361	0.2851	0.013	0.0413	0.2453	0.0713	0.1907	0	0.0879	0.1436	0.2746	0.5228	0.0278	0.0462	0.3774	0.8595	0.2208	0.2757	0	0	0.0247	0	0.0045	0	0	0	0											6.9328	0	0.140993383	4.0682	0.060258846	3.351235425	0.270127875	1.97860861	4.786762282	0.218838732	1.020446964	0.902393337	0.071252742	1.335012655	0	0.593582711	0.542546238	4.110584565	14.47548606	0.442079558	1.261610441	2.274923429	1.012318261	2.142684645	0.304420146	0	0	0.698391513	0	0.29322663	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.2149
H3335_017_0	2008	9																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		269.9409194	4.733407997	1000.748289	0	187.6614125	47178.29984	48.71629038	610.4531005	602.9746181	0	1443.596361	0	649.9157768	512.747918	3471.216307	4746.484059	123.136316	361.2179694	653.8774323	45.97828284	962.6808926	10.72675071	0	0	246.0001496	0	105.4286356	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												288.0287745	288.0287745	24.00239787	0	96.00959149	0.918090526	40.64769393	47.16612103	48.00479575	0	28.80287745	0	28.80287745	28.80287745	14.40143872	28.80287745	28.80287745	28.80287745	28.80287745	28.80287745	28.80287745	28.80287745	0	0	28.80287745	0	28.80287745	0	0	0	0											6.4792	0.113613142	2.001696549	0	1.501441296	3.609495845	0.165017072	2.399392068	2.412139449	0	3.464977422	0	1.559953706	1.230717954	4.165875746	11.39269989	0.295556685	0.867009742	1.569462629	0.110358904	2.310664981	0.025746774	0	0	0.590459347	0	0.253054006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.5186	0	1.933432533	6.4792	0.113613142	2.001696549	0	1.501441296	3.609495845	0.165017072	2.399392068	2.412139449	0	3.464977422	0	1.559953706	1.230717954	4.165875746	11.39269989	0.295556685	0.867009742	1.569462629	0.110358904	2.310664981	0.025746774	0	0	0.590459347	0	0.253054006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.5186	4000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.5059	0.0318	0.3253	0.239	0.1109	0.2286	0.0104	0.1013	0.4913	0.1413	0.3751	0	0.1762	0.2878	0.2098	0.3796	0.0174	0.029	0.2046	0.6042	0.2579	0.1757	0	0	0.019	0	0.0035	0	0	0	0											6.9256	0	0.287845751	8.9851	0.145373443	2.326973975	0.238978469	1.612362477	3.838058822	0.175466396	2.500682704	2.903450392	0.141281411	3.840127068	0	1.736173551	1.518518835	4.375663867	11.7722924	0.312964211	0.895991415	1.774094655	0.714575356	2.568565925	0.201417299	0	0	0.609481865	0	0.256519907	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4442
H3335_018_0	2008	8																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		271.0272008	4.752455916	1000.748289	0	187.6614125	47178.29984	48.71629038	611.0731591	604.8018139	0	1474.50042	0	651.5653092	514.0493087	3583.191027	4841.274885	125.9999512	369.6183873	667.875436	46.47804678	968.9624332	10.72675071	0	0	251.7210834	0	107.8804643	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												98.19451767	98.19451767	24.54862942	0	98.19451767	0.938983856	41.5727287	48.00123626	34.36808119	0	24.54862942	0	24.54862942	24.54862942	9.819451767	24.54862942	24.54862942	24.54862942	24.54862942	24.54862942	24.54862942	24.54862942	0	0	24.54862942	0	24.54862942	0	0	0	0											2.2178	0.03888876	2.047249906	0	1.535610157	3.691638491	0.168772427	2.44435559	1.732156487	0	3.0164137	0	1.33291961	1.051600498	2.932080955	9.903888589	0.257760509	0.756135401	1.366285548	0.095081029	1.982224974	0.021943919	0	0	0.514950633	0	0.220693128	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.3284	0	0.686350181	2.2178	0.03888876	2.047249906	0	1.535610157	3.691638491	0.168772427	2.44435559	1.732156487	0	3.0164137	0	1.33291961	1.051600498	2.932080955	9.903888589	0.257760509	0.756135401	1.366285548	0.095081029	1.982224974	0.021943919	0	0	0.514950633	0	0.220693128	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.3284	5000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.5733	0.0326	0.3327	0.2444	0.1134	0.2338	0.0107	0.1032	0.504	0.1464	0.3919	0	0.1807	0.2951	0.2214	0.3952	0.0182	0.0303	0.2134	0.621	0.2652	0.1815	0	0	0.0199	0	0.0036	0	0	0	0											7.1319	0	0.131133349	4.791	0.071502558	2.379929792	0.244416992	1.649055613	3.925402962	0.179459551	2.547544367	2.236171079	0.146402893	3.408314619	0	1.513607193	1.346698054	3.153467544	10.2990684	0.275978224	0.786465952	1.579680213	0.716096514	2.247393699	0.203491204	0	0	0.534858505	0	0.224320341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4604
H3335_020_0	2008	9																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		244.4269462	4.286021046	1110.315143	0	219.6509521	55220.50774	57.02067049	560.8885439	547.0869544	0	1309.794331	0	589.6772969	465.2230598	4062.934179	5555.589341	144.1266411	422.7926767	765.3400808	53.81593087	994.6826744	12.55527695	0	0	287.9343514	0	123.4004363	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												286.8856703	286.8856703	23.90713919	0	95.62855677	0.914446887	40.48637481	46.75013445	47.81427839	0	28.68856703	0	28.68856703	28.68856703	14.34428352	28.68856703	28.68856703	28.68856703	28.68856703	28.68856703	28.68856703	28.68856703	0	0	28.68856703	0	28.68856703	0	0	0	0											5.8435	0.102466502	2.212038223	0	1.750408629	4.208018448	0.19238002	2.18513457	2.179880662	0	3.131343538	0	1.409749722	1.112215245	4.856656648	13.28182477	0.344565567	1.010776337	1.829709184	0.128658495	2.378001715	0.030016075	0	0	0.688368662	0	0.295015141	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1708	0	2.247730889	5.8435	0.102466502	2.212038223	0	1.750408629	4.208018448	0.19238002	2.18513457	2.179880662	0	3.131343538	0	1.409749722	1.112215245	4.856656648	13.28182477	0.344565567	1.010776337	1.829709184	0.128658495	2.378001715	0.030016075	0	0	0.688368662	0	0.295015141	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1708	4000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.3641	0.03	0.3595	0.2106	0.1293	0.2665	0.0122	0.0922	0.444	0.1277	0.339	0	0.1593	0.2601	0.2446	0.4425	0.0203	0.0338	0.2386	0.7044	0.2555	0.2048	0	0	0.0222	0	0.004	0	0	0	0											6.965	0	0.318390755	8.2076	0.132428977	2.571496353	0.210615931	1.879722637	4.474481486	0.20456204	2.277380299	2.623884521	0.127677782	3.470370976	0	1.569001805	1.372304509	5.101231603	13.72436089	0.36485959	1.044563719	2.068273066	0.83306545	2.633498903	0.234816092	0	0	0.710545473	0	0.299055754	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1358
H3335_021_0	2008	8																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		245.4105557	4.303268616	1110.315143	0	219.6509521	55220.50774	57.02067049	561.6143003	548.7447937	0	1337.833998	0	591.1739398	466.403829	4193.996572	5666.538602	147.4784235	432.6250645	781.7242419	54.40088664	1001.699711	12.55527695	0	0	294.6304991	0	126.2702139	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												97.90251827	97.90251827	24.47562957	0	97.90251827	0.936191615	41.44910457	47.55957947	34.2658814	0	24.47562957	0	24.47562957	24.47562957	9.790251827	24.47562957	24.47562957	24.47562957	24.47562957	24.47562957	24.47562957	24.47562957	0	0	24.47562957	0	24.47562957	0	0	0	0											2.0022	0.035108403	2.264638512	0	1.792031779	4.308081361	0.196954644	2.225844995	1.566935335	0	2.728694114	0	1.20577953	0.951293946	3.421690217	11.55767498	0.300802272	0.882397568	1.594432747	0.110957996	2.043102589	0.025608192	0	0	0.600938913	0	0.257545248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0727	0	0.858525092	2.0022	0.035108403	2.264638512	0	1.792031779	4.308081361	0.196954644	2.225844995	1.566935335	0	2.728694114	0	1.20577953	0.951293946	3.421690217	11.55767498	0.300802272	0.882397568	1.594432747	0.110957996	2.043102589	0.025608192	0	0	0.600938913	0	0.257545248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0727	5000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.43	0.0308	0.368	0.2156	0.1324	0.2728	0.0125	0.094	0.4559	0.1324	0.3545	0	0.1635	0.2669	0.2584	0.4612	0.0213	0.0354	0.249	0.7247	0.2631	0.2119	0	0	0.0232	0	0.0042	0	0	0	0											7.1817	0	0.153862225	4.4322	0.065906799	2.632644235	0.215624189	1.92442076	4.580880651	0.209426342	2.31980932	2.022874668	0.132438303	3.083213698	0	1.36923229	1.218243722	3.680044722	12.01884332	0.322062046	0.917792822	1.84346081	0.835672846	2.306190084	0.237470886	0	0	0.624171072	0	0.261778146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2544
H3335_032_0	2008	10																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		267.7981586	4.695834733	1877.093838	0	232.7872609	58522.99121	60.43081338	541.4028959	517.7250705	0	1222.269053	0	560.8622483	442.4895661	4519.166801	6220.632916	160.0399246	469.4739821	874.9665148	59.14651184	1025.836173	14.43063097	0	0	327.094302	0	140.1832723	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												550.9399354	550.9399354	45.91166128	0	91.82332257	1.428749098	63.25667716	45.31746267	91.82332257	0	36.72932903	0	36.72932903	36.72932903	18.36466451	36.13600845	40.38189776	36.72932903	36.72932903	36.72932903	36.72932903	36.72932903	0	0	36.72932903	0	31.30200648	0	0	0	0											12.2951	0.215593574	7.181708041	0	1.781274979	6.967889241	0.318554371	2.044583794	3.961603013	0	3.741093517	0	1.716674505	1.354362072	6.916081848	18.73240364	0.538559656	1.436955363	2.678077751	0.181034308	3.139856195	0.044168949	0	0	1.001162853	0	0.365668141	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.6124	0	6.822172968	12.2951	0.215593574	7.181708041	0	1.781274979	6.967889241	0.318554371	2.044583794	3.961603013	0	3.741093517	0	1.716674505	1.354362072	6.916081848	18.73240364	0.538559656	1.436955363	2.678077751	0.181034308	3.139856195	0.044168949	0	0	1.001162853	0	0.365668141	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.6124	4000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												3.4916	0.0443	0.8146	0.6119	0.1641	0.489	0.0224	0.1076	0.4811	0.1379	0.3622	0	0.1734	0.2832	0.3425	0.6246	0.0283	0.0472	0.4176	1.0604	0.3075	0.2853	0	0	0.0317	0	0.0058	0	0	0	0											10.3342	0	0.920238916	15.7866	0.259846326	7.996280912	0.611903076	1.945339779	7.456863924	0.340909064	2.152193467	4.442673669	0.137904667	4.103318035	0	1.890097311	1.637594851	7.25857094	19.35704325	0.566904901	1.48414717	3.095726894	1.24147477	3.447363851	0.329473976	0	0	1.032851711	0	0.371441849	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.9466
H3335_036_0	2008	10																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		255.9784346	4.488576137	1781.882158	0	232.212152	58378.40816	60.281517	319.0914031	292.9439184	0	691.5954163	0	317.3521894	250.3734795	4201.695224	6175.095838	179.0906241	525.3588355	835.0041389	66.18714512	908.2927364	13.4168788	0	0	304.1159194	0	130.335394	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												558.6017605	558.6017605	46.55014671	0	93.10029342	1.271928227	56.31356361	45.59975787	93.10029342	0	37.24011737	0	37.24011737	37.24011737	18.62005868	36.28790948	37.90865781	37.24011737	37.24011737	37.24011737	37.24011737	37.24011737	0	0	37.24011737	0	29.38487585	0	0	0	0											11.9158	0.208943878	6.912239657	0	1.801584957	6.187762097	0.28288892	1.212540893	2.27276373	0	2.146257873	0	0.984852732	0.776994814	6.519650971	18.67344323	0.565757099	1.630368725	2.591304345	0.205401421	2.818744009	0.041637178	0	0	0.943776044	0	0.319157448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.0119	0	5.114504676	11.9158	0.208943878	6.912239657	0	1.801584957	6.187762097	0.28288892	1.212540893	2.27276373	0	2.146257873	0	0.984852732	0.776994814	6.519650971	18.67344323	0.565757099	1.630368725	2.591304345	0.205401421	2.818744009	0.041637178	0	0	0.943776044	0	0.319157448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.0119	4000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.4002	0.0304	0.5513	0.2129	0.1331	0.3483	0.0159	0.0512	0.3036	0.087	0.2286	0	0.1095	0.1788	0.2398	0.4628	0.0239	0.0398	0.3153	0.8285	0.2232	0.2396	0	0	0.0222	0	0.004	0	0	0	0											7.0499	0	0.522469201	14.316	0.23936418	7.463559833	0.212860841	1.934679692	6.536051632	0.298811842	1.263728459	2.576392999	0.087038968	2.374877025	0	1.094309085	0.955758079	6.759416246	19.13625501	0.589640605	1.670132213	2.90657731	1.033921276	3.041988884	0.281229507	0	0	0.965960364	0	0.323199429	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0618
H3335_037_0	2008	10																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		207.6923388	3.641880525	1080.334656	0	179.1559446	45040.01521	46.50829867	461.000638	441.1291893	0	1041.437989	0	477.8843502	377.0245536	3811.444916	5363.576528	144.0405497	422.5401293	765.9622359	53.23356717	902.4984562	12.17072913	0	0	275.8698604	0	118.2299402	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												564.0519064	564.0519064	47.00432554	0	94.00865107	1.369766002	60.64524969	46.40177042	94.00865107	0	37.60346043	0	37.60346043	37.60346043	18.80173021	36.63453941	37.48495824	37.60346043	37.60346043	37.60346043	37.60346043	37.60346043	0	0	37.60346043	0	29.05644536	0	0	0	0											9.7624	0.171184138	4.231700156	0	1.40351739	5.141190131	0.235042282	1.782603814	3.455830003	0	3.263472685	0	1.497508771	1.181452323	5.971813252	16.37434631	0.449946166	1.324080919	2.400235886	0.166813861	2.828088749	0.038138461	0	0	0.864471781	0	0.286278483	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8302	0	4.004284402	9.7624	0.171184138	4.231700156	0	1.40351739	5.141190131	0.235042282	1.782603814	3.455830003	0	3.263472685	0	1.497508771	1.181452323	5.971813252	16.37434631	0.449946166	1.324080919	2.400235886	0.166813861	2.828088749	0.038138461	0	0	0.864471781	0	0.286278483	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8302	4000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.0395	0.0258	0.3462	0.1707	0.1037	0.2894	0.0132	0.0753	0.3591	0.1029	0.2704	0	0.1295	0.2114	0.2151	0.3998	0.019	0.0316	0.2414	0.6742	0.219	0.1909	0	0	0.0199	0	0.0036	0	0	0	0											6.1517	0	0.392057346	11.8019	0.197033103	4.577850303	0.170705782	1.507204299	5.430571443	0.248272068	1.857856657	3.814944242	0.102944399	3.533869518	0	1.626967091	1.392882645	6.186878386	16.77413786	0.4689407	1.35570479	2.641679639	0.84096594	3.04710672	0.229087459	0	0	0.884370717	0	0.289904068	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.9818
H3335_038_0	2008	10																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		216.9127544	3.803560306	1364.70804	0	225.5955285	56714.98124	58.56386313	256.0214267	226.8619725	0	535.5861326	0	245.7642544	193.8945234	4403.2281	6578.765151	195.9982622	574.9570606	888.1265526	72.43575978	915.6066819	14.0604148	0	0	318.7027356	0	136.5868867	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												560.9416462	560.9416462	46.74513718	0	93.49027437	1.362892493	60.3409308	45.49860889	93.49027437	0	37.39610975	0	37.39610975	37.39610975	18.69805487	36.32514023	37.10155386	37.39610975	37.39610975	37.39610975	37.39610975	37.39610975	0	0	37.39610975	0	28.75924965	0	0	0	0											10.1396	0.177797948	5.316122046	0	1.757582322	6.441368514	0.294483168	0.97071823	1.767449004	0	1.669069816	0	0.765885586	0.60424174	6.860983385	19.91454722	0.605986674	1.791763111	2.767706502	0.225734635	2.853343997	0.043817068	0	0	0.993186873	0	0.327344698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.2887	0	4.615684054	10.1396	0.177797948	5.316122046	0	1.757582322	6.441368514	0.294483168	0.97071823	1.767449004	0	1.669069816	0	0.765885586	0.60424174	6.860983385	19.91454722	0.605986674	1.791763111	2.767706502	0.225734635	2.853343997	0.043817068	0	0	0.993186873	0	0.327344698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.2887	4000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.1519	0.0273	0.4735	0.2577	0.1298	0.3626	0.0166	0.041	0.2309	0.0662	0.1739	0	0.0832	0.136	0.2459	0.4815	0.0256	0.0426	0.3453	0.8081	0.2059	0.2564	0	0	0.0228	0	0.0041	0	0	0	0											6.5888	0	0.458775039	12.2915	0.20507086	5.789617169	0.257679286	1.887426297	6.803932751	0.311058693	1.011697221	1.998379861	0.066199097	1.842950341	0	0.84913464	0.740203448	7.106899287	20.39608976	0.631568477	1.834354082	3.113050347	1.033802834	3.059223225	0.300266767	0	0	1.015940281	0	0.331490367	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8775
H3335_039_0	2008	10																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		268.3114974	4.704836117	980.3248541	0	187.6614125	47178.29984	48.71629038	609.8330418	596.8839654	0	1409.150997	0	646.6167119	510.1451367	3359.241588	4659.424925	121.7044984	357.0177604	638.2753936	44.97875495	950.1178112	10.72675071	0	0	243.1396828	0	104.2027212	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												561.2653085	561.2653085	46.77210904	0	93.54421808	1.341773136	59.40588882	46.37263545	93.54421808	0	37.41768723	0	37.41768723	37.41768723	18.70884362	36.63499436	39.15312246	37.41768723	37.41768723	37.41768723	37.41768723	37.41768723	0	0	37.41768723	0	30.34952196	0	0	0	0											12.5495	0.220055108	3.820988414	0	1.462886675	5.275214609	0.241169544	2.356630444	4.652920319	0	4.393930938	0	2.016241824	1.590704264	5.237293794	14.22483382	0.397092594	1.113231575	1.990232421	0.140250082	2.962600925	0.033447517	0	0	0.758143717	0	0.263541898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.7009	0	4.534226956	12.5495	0.220055108	3.820988414	0	1.462886675	5.275214609	0.241169544	2.356630444	4.652920319	0	4.393930938	0	2.016241824	1.590704264	5.237293794	14.22483382	0.397092594	1.113231575	1.990232421	0.140250082	2.962600925	0.033447517	0	0	0.758143717	0	0.263541898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.7009	4000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.4268	0.0308	0.3105	0.2328	0.1081	0.2969	0.0136	0.0995	0.4739	0.1358	0.3568	0	0.1708	0.279	0.198	0.3635	0.0168	0.0279	0.195	0.5837	0.2486	0.1687	0	0	0.0183	0	0.0033	0	0	0	0											6.759	0	0.466459254	14.9763	0.250813066	4.13144538	0.232841883	1.570959577	5.572139735	0.254744214	2.456115893	5.126779878	0.13583752	4.750725824	0	2.187065077	1.869691473	5.435278194	14.5883081	0.413855908	1.141140702	2.185218471	0.723954171	3.211214593	0.202101135	0	0	0.776462255	0	0.266879534	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.4599
H3335_040_0	2008	10																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		242.9515321	4.260149692	1087.65565	0	219.6509521	55220.50774	57.02067049	560.1627875	541.5608236	0	1278.54159	0	586.6840112	462.8615215	3931.871786	5453.689747	142.4507499	417.8764828	747.0784541	52.64601933	980.6486006	12.55527695	0	0	284.5862776	0	121.9655475	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												559.0155143	559.0155143	46.58462619	0	93.16925239	1.336394728	59.16776432	46.07763719	93.16925239	0	37.26770096	0	37.26770096	37.26770096	18.63385048	36.48814545	38.99617981	37.26770096	37.26770096	37.26770096	37.26770096	37.26770096	0	0	37.26770096	0	30.22786795	0	0	0	0											11.3178	0.198457481	4.222335992	0	1.705392916	6.14969962	0.281148799	2.150914807	4.204734754	0	3.970692137	0	1.822030357	1.437482064	6.10549258	16.58291873	0.462919588	1.29777465	2.320158035	0.163499675	3.045543232	0.038992192	0	0	0.883823024	0	0.307229872	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.669	0	5.034503503	11.3178	0.198457481	4.222335992	0	1.705392916	6.14969962	0.281148799	2.150914807	4.204734754	0	3.970692137	0	1.822030357	1.437482064	6.10549258	16.58291873	0.462919588	1.29777465	2.320158035	0.163499675	3.045543232	0.038992192	0	0	0.883823024	0	0.307229872	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.669	4000	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.2894	0.029	0.3431	0.2052	0.126	0.3461	0.0158	0.0908	0.4282	0.1228	0.3224	0	0.1544	0.2521	0.2308	0.4237	0.0195	0.0325	0.2273	0.6805	0.246	0.1966	0	0	0.0214	0	0.0039	0	0	0	0											6.8076	0	0.499100482	13.6072	0.227473194	4.565402622	0.205199466	1.831381323	6.495846738	0.296973775	2.241715945	4.632950503	0.122753175	4.293119291	0	1.976399317	1.689596248	6.33629733	17.00664701	0.482461797	1.33031034	2.547467391	0.843965794	3.29158658	0.235603926	0	0	0.90517827	0	0.311120796	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.4766
H3335_801_0	2008	5																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0		260.3429602	4.565107997	1678.42381	0	239.4568007	59232.65756	61.16361453	369.4153821	322.6071127	2354.069798	1308.658071	0	1048.460819	827.1781073	5933.002116	9085.163819	208.708854	1836.729997	5788.81318	14150.43812	1783.045846	6046.911374																				FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				882.8250507	638.0987973	72.82664461	0	84.21354608	1.170106147	51.8054758	35.95079057	224.210827	9.231998932	47.67236275	0	24.86999257	51.48327112	11.70285601	15.38814922	20.91207951	6.593680684	17.10190897	16.03528367	39.29687558	11.10180999																				19.1531	0.24274916	10.18616453	0	1.68045886	5.775708061	0.264050846	1.106731253	6.027667294	1.811064155	5.198901856	0	2.172934398	3.548819563	5.786089121	11.65032138	0.363711346	1.009234259	8.249979673	18.90885745	5.839010896	5.594305089	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5699	135	0	19.1531	0.24274916	10.18616453	0	1.68045886	5.775708061	0.264050846	1.106731253	6.027667294	1.811064155	5.198901856	0	2.172934398	3.548819563	5.786089121	11.65032138	0.363711346	1.009234259	8.249979673	18.90885745	5.839010896	5.594305089	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5699		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g																				1.2372	0.0157	0.658	0	0.1086	0.3731	0.0171	0.0715	0.3894	0.117	0.3358	0	0.1404	0.2292	0.3738	0.7526	0.0235	0.0652	0.5329	1.2214	0.3772	0.3614									0											7.4008	135	0	20.3903	0.258429935	10.84415632	0	1.78901082	6.148799274	0.281107638	1.17822235	6.417034221	1.928052776	5.534733339	0	2.313298613	3.778061308	6.159850916	12.40289275	0.387205869	1.07442738	8.782900466	20.13030571	6.216191258	5.955678283	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.9707
H3335_811_0	2008	5																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0		282.8101913	4.959070391	1349.945126	0	236.6802462	58545.84182	60.45440891	450.3062562	398.2992552	2906.396699	1615.703791	0	1294.457397	1021.255921	6454.107108	9731.869757	219.5127608	1931.809143	5841.409408	16823.97751	2023.432996	6360.452554																				FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				819.9814188	592.6759291	69.96687688	0	78.80165493	1.094910559	48.47625373	32.60115402	201.8178308	8.309955515	42.91109831	0	22.38610873	46.34139322	10.57152039	13.96723561	18.89047211	5.956258008	14.42644677	13.32753893	34.93184803	10.0334388																				19.3249	0.244926804	7.870953703	0	1.554232924	5.341871702	0.244216939	1.223375301	6.698657641	2.01266894	5.777635352	0	2.414822003	3.943868519	5.68581041	11.32727649	0.345558307	0.958862807	7.022565157	18.6851846	5.890187826	5.318100951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.8857	135	0	19.3249	0.244926804	7.870953703	0	1.554232924	5.341871702	0.244216939	1.223375301	6.698657641	2.01266894	5.777635352	0	2.414822003	3.943868519	5.68581041	11.32727649	0.345558307	0.958862807	7.022565157	18.6851846	5.890187826	5.318100951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.8857		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g																				0.8158	0.0103	0.3323	0	0.0656	0.2255	0.0103	0.0516	0.2828	0.085	0.2439	0	0.1019	0.1665	0.24	0.4782	0.0146	0.0405	0.2965	0.7888	0.2487	0.2245																				4.7233	135	0	20.1407	0.25526642	8.203226998	0	1.619845061	5.567379484	0.254526587	1.275020243	6.981442312	2.097634011	6.021538951	0	2.516764016	4.110359422	5.925837607	11.80545888	0.360146094	0.99934132	7.319023624	19.47398201	6.138842841	5.542605248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.609
H3335_813_0	2008	4																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0		260.3429602	4.565107997	1678.42381	0	239.4568007	59232.65756	61.16361453	369.4153821	322.6071127	2354.069798	1308.658071	0	1048.460819	827.1781073	5933.002116	9085.163819	208.708854	1836.729997	5788.81318	14150.43812	1783.045846	6046.911374																				FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				882.8250507	638.0987973	72.82664461	0	84.21354608	1.170106147	51.8054758	35.95079057	224.210827	9.231998932	47.67236275	0	24.86999257	51.48327112	11.70285601	15.38814922	20.91207951	6.593680684	17.10190897	16.03528367	39.29687558	11.10180999																				19.1531	0.24274916	10.18616453	0	1.68045886	5.775708061	0.264050846	1.106731253	6.027667294	1.811064155	5.198901856	0	2.172934398	3.548819563	5.786089121	11.65032138	0.363711346	1.009234259	8.249979673	18.90885745	5.839010896	5.594305089	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5699	135	0	19.1531	0.24274916	10.18616453	0	1.68045886	5.775708061	0.264050846	1.106731253	6.027667294	1.811064155	5.198901856	0	2.172934398	3.548819563	5.786089121	11.65032138	0.363711346	1.009234259	8.249979673	18.90885745	5.839010896	5.594305089	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5699		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g																				1.2372	0.0157	0.658	0	0.1086	0.3731	0.0171	0.0715	0.3894	0.117	0.3358	0	0.1404	0.2292	0.3738	0.7526	0.0235	0.0652	0.5329	1.2214	0.3772	0.3614									0											7.4008	135	0	20.3903	0.258429935	10.84415632	0	1.78901082	6.148799274	0.281107638	1.17822235	6.417034221	1.928052776	5.534733339	0	2.313298613	3.778061308	6.159850916	12.40289275	0.387205869	1.07442738	8.782900466	20.13030571	6.216191258	5.955678283	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.9707
H3335_819_0	2008	4																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0		282.8101913	4.959070391	1349.945126	0	236.6802462	58545.84182	60.45440891	450.3062562	398.2992552	2906.396699	1615.703791	0	1294.457397	1021.255921	6454.107108	9731.869757	219.5127608	1931.809143	5841.409408	16823.97751	2023.432996	6360.452554																				FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				819.9814188	592.6759291	69.96687688	0	78.80165493	1.094910559	48.47625373	32.60115402	201.8178308	8.309955515	42.91109831	0	22.38610873	46.34139322	10.57152039	13.96723561	18.89047211	5.956258008	14.42644677	13.32753893	34.93184803	10.0334388																				19.3249	0.244926804	7.870953703	0	1.554232924	5.341871702	0.244216939	1.223375301	6.698657641	2.01266894	5.777635352	0	2.414822003	3.943868519	5.68581041	11.32727649	0.345558307	0.958862807	7.022565157	18.6851846	5.890187826	5.318100951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.8857	135	0	19.3249	0.244926804	7.870953703	0	1.554232924	5.341871702	0.244216939	1.223375301	6.698657641	2.01266894	5.777635352	0	2.414822003	3.943868519	5.68581041	11.32727649	0.345558307	0.958862807	7.022565157	18.6851846	5.890187826	5.318100951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.8857		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g																				0.8158	0.0103	0.3323	0	0.0656	0.2255	0.0103	0.0516	0.2828	0.085	0.2439	0	0.1019	0.1665	0.24	0.4782	0.0146	0.0405	0.2965	0.7888	0.2487	0.2245																				4.7233	135	0	20.1407	0.25526642	8.203226998	0	1.619845061	5.567379484	0.254526587	1.275020243	6.981442312	2.097634011	6.021538951	0	2.516764016	4.110359422	5.925837607	11.80545888	0.360146094	0.99934132	7.319023624	19.47398201	6.138842841	5.542605248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.609
H3335_820_0	2008	4																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0		282.8101913	4.959070391	1349.945126	0	236.6802462	58545.84182	60.45440891	450.3062562	398.2992552	2906.396699	1615.703791	0	1294.457397	1021.255921	6454.107108	9731.869757	219.5127608	1931.809143	5841.409408	16823.97751	2023.432996	6360.452554																				FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				819.9814188	592.6759291	69.96687688	0	78.80165493	1.094910559	48.47625373	32.60115402	201.8178308	8.309955515	42.91109831	0	22.38610873	46.34139322	10.57152039	13.96723561	18.89047211	5.956258008	14.42644677	13.32753893	34.93184803	10.0334388																				19.3249	0.244926804	7.870953703	0	1.554232924	5.341871702	0.244216939	1.223375301	6.698657641	2.01266894	5.777635352	0	2.414822003	3.943868519	5.68581041	11.32727649	0.345558307	0.958862807	7.022565157	18.6851846	5.890187826	5.318100951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.8857	135	0	19.3249	0.244926804	7.870953703	0	1.554232924	5.341871702	0.244216939	1.223375301	6.698657641	2.01266894	5.777635352	0	2.414822003	3.943868519	5.68581041	11.32727649	0.345558307	0.958862807	7.022565157	18.6851846	5.890187826	5.318100951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.8857		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g																				0.8158	0.0103	0.3323	0	0.0656	0.2255	0.0103	0.0516	0.2828	0.085	0.2439	0	0.1019	0.1665	0.24	0.4782	0.0146	0.0405	0.2965	0.7888	0.2487	0.2245																				4.7233	135	0	20.1407	0.25526642	8.203226998	0	1.619845061	5.567379484	0.254526587	1.275020243	6.981442312	2.097634011	6.021538951	0	2.516764016	4.110359422	5.925837607	11.80545888	0.360146094	0.99934132	7.319023624	19.47398201	6.138842841	5.542605248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.609
H3335_822_0	2008	4																																A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0		260.3429602	4.565107997	1678.42381	0	239.4568007	59232.65756	61.16361453	369.4153821	322.6071127	2354.069798	1308.658071	0	1048.460819	827.1781073	5933.002116	9085.163819	208.708854	1836.729997	5788.81318	14150.43812	1783.045846	6046.911374																				FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				882.8250507	638.0987973	72.82664461	0	84.21354608	1.170106147	51.8054758	35.95079057	224.210827	9.231998932	47.67236275	0	24.86999257	51.48327112	11.70285601	15.38814922	20.91207951	6.593680684	17.10190897	16.03528367	39.29687558	11.10180999																				19.1531	0.24274916	10.18616453	0	1.68045886	5.775708061	0.264050846	1.106731253	6.027667294	1.811064155	5.198901856	0	2.172934398	3.548819563	5.786089121	11.65032138	0.363711346	1.009234259	8.249979673	18.90885745	5.839010896	5.594305089	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5699	135	0	19.1531	0.24274916	10.18616453	0	1.68045886	5.775708061	0.264050846	1.106731253	6.027667294	1.811064155	5.198901856	0	2.172934398	3.548819563	5.786089121	11.65032138	0.363711346	1.009234259	8.249979673	18.90885745	5.839010896	5.594305089	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5699		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g																				1.2372	0.0157	0.658	0	0.1086	0.3731	0.0171	0.0715	0.3894	0.117	0.3358	0	0.1404	0.2292	0.3738	0.7526	0.0235	0.0652	0.5329	1.2214	0.3772	0.3614									0											7.4008	135	0	20.3903	0.258429935	10.84415632	0	1.78901082	6.148799274	0.281107638	1.17822235	6.417034221	1.928052776	5.534733339	0	2.313298613	3.778061308	6.159850916	12.40289275	0.387205869	1.07442738	8.782900466	20.13030571	6.216191258	5.955678283	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.9707
H3336_001_0	2008	7																					UNLIMITED											D	D	D		T	COIN		V		P	P			V		V	COIN	V		V							P																																																								0	0	2242.612995	164.3044495	804.8278375		665.3162844	3.56		879.9586006		6279.875026	2359.158106			62.418		5417.811026	14.11	800.7461519		578.6710648							87.97143335															$50 days 1-20	$50 days 1-20	$60 days 1-30		$40 per trip	10% coinsurance		$50 per ER visit/ $25 per UR visit		$5 per procedure	$5 per procedure			$25 per Substance Abuse visit		$10 per visit	50% coinsurance	$10 per visit		$15 Chiro copay/ $10 podiatry							$15 per procedure															45.72269339	45.72269339	55.87982833		40	0.1		49.22958872		5	5			25		10	0.5	10		11.40544327							15															8.5449	0.626036831	3.747803449	0	2.217720948	0.356	0	3.61	0	2.616614594	0.982982544	0	0	0.1300375	0	4.514842522	7.055	0.66728846	0	0.55	0	0	0	0	0	0	0.109964292	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.7292	0	0	8.5449	0.626036831	3.747803449	0	2.217720948	0.356	0	3.61	0	2.616614594	0.982982544	0	0	0.1300375	0	4.514842522	7.055	0.66728846	0	0.55	0	0	0	0	0	0	0.109964292	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.7292																																																																																				0	0	0	8.5449	0.626036831	3.747803449	0	2.217720948	0.356	0	3.61	0	2.616614594	0.982982544	0	0	0.1300375	0	4.514842522	7.055	0.66728846	0	0.55	0	0	0	0	0	0	0.109964292	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.7292
H3336_003_0	2008	5																					UNLIMITED																		V						V		V	V	V		V																																																															0	0								1575.465146						349.5408		7985.085488	2379.93912	2215.799398		1103.028603																													$50 COPAY ER/ $10 UR						$20 Copay Substance Abuse		$10 copay	$20 copay	$10 copay		$10 chiro copay/ $10 podiatry																													48.97601206						20		10	20	10		10																						0	0	0	0	0	0	0	6.43	0	0	0	0	0	0.582568	0	6.654237906	3.966565199	1.846499499	0	0.919190503	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.3991		0	0	0	0	0	0	0	0	6.43	0	0	0	0	0	0.582568	0	6.654237906	3.966565199	1.846499499	0	0.919190503	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.3991																																																																																				0		0	0	0	0	0	0	0	0	6.43	0	0	0	0	0	0.582568	0	6.654237906	3.966565199	1.846499499	0	0.919190503	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.3991
H3336_004_0	2008	8																																D	D	D		T	COIN		V		P	P			V		V	V	V		V							P																																																								0		2306.626503	165.4046778	1352.207211		803.5777296	5.93		844.7646773		5332.955731	2548.053355			68.6598		4880.877386	551.6018897	773.4345254		659.8655699							57.37421379															$40 days 1-15	$40 days 1-15	$50 days 1-30		$40 per trip	10% coinsurance		$50 per ER visit/ $25 per UR visit		$5 per procedure	$5 per procedure			$25 per Substance Abuse visit		$10 per visit	50% coinsurance	$10 per visit		$15 Chiro copay/ $10 podiatry							$15 per procedure															29.19398329	29.19398329	50		40	0.1		49.14978232		5	5			25		10	66.9	10		11.27502379							15															5.6116	0.402401783	5.634196714	0	2.678592432	0.593	0	3.46	0	2.222064888	1.061688898	0	0	0.14304125	0	4.067397822	3.075180535	0.644528771	0	0.62	0	0	0	0	0	0	0.071717767	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2854	0	0	5.6116	0.402401783	5.634196714	0	2.678592432	0.593	0	3.46	0	2.222064888	1.061688898	0	0	0.14304125	0	4.067397822	3.075180535	0.644528771	0	0.62	0	0	0	0	0	0	0.071717767	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2854																																																																																				0	0	0	5.6116	0.402401783	5.634196714	0	2.678592432	0.593	0	3.46	0	2.222064888	1.061688898	0	0	0.14304125	0	4.067397822	3.075180535	0.644528771	0	0.62	0	0	0	0	0	0	0.071717767	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2854
H3336_006_0	2008	4																					UNLIMITED											D	D	D		COIN			V	COIN			COIN	COIN																																																																						0	0	3037.975298	167.9316678	1072.434215		16.23			1102.584394	22.05			6.27	3.01																													Same as Medicare Covered	Same as Medicare Covered	Same as Medicare Covered		20% coinsurance			$50 ER/ 20% coinsurance UR	20% coinsurance			20% coinsurance	20% coinsurance																													166.3360581	166.3360581	77.55		0.2			48.4316668	0.2			0.2	0.2																													42.1104	2.327757637	6.930606111	0	3.246	0	0	4.45	4.41	0	0	1.254	0.602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3308	0	0	42.1104	2.327757637	6.930606111	0	3.246	0	0	4.45	4.41	0	0	1.254	0.602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3308																																																																																				0	0	0	42.1104	2.327757637	6.930606111	0	3.246	0	0	4.45	4.41	0	0	1.254	0.602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3308
H3336_009_0	2008	8																																D	D	D	V	P	P	P	V	P	P	P	V	V	V	P	P	P	V	P	P	S	P	P	P	P	P	P	P	P	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0	0	545.9038888	0	0	0	0	0	20.08350927	0	9046.706549	1949.422774	3734.528697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0								"4A: $50 Copay, 4B: $10 Copay"						9C: $20 Copay		"7B: $10 Copay, 7D: $10 Copay, 7F: $10 Copay"	"7E: $20 Copay, 7H: $20 Copay"	"7C: $10 Copay, 7I: $10 Copay"																								0	0	0	0	0	0	0	49.2	0	0	0	0	0	20	0	10	20	10	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.238205944	0	0	0	0	0	0.033472515	0	7.538922124	3.249037957	3.112107247	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.1717		0	0	0	0	0	0	0	0	2.238205944	0	0	0	0	0	0.033472515	0	7.538922124	3.249037957	3.112107247	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.1717																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0	0	0	2.238205944	0	0	0	0	0	0.033472515	0	7.538922124	3.249037957	3.112107247	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.1717
H3337_001_0	2008	4																					None													A		T	Coin	Coin	V					Coin				V	V									V																	0		0	0	0	0					0				0	0									0															0	None			75		204	5.95	0.49	138					0.18				422	956									100																	$0 0-20 days. $25 after		$50 co-pay/trip	20% co-insurance	20% co-insurance	$50 co-pay/visit					20% co-insurance				$20 co-pay/visit	$20 co-pay/visit									$20 co-pay/visit																	25		50	0.2	0.2	50					0.2				20	20									20															0	0	0.15625	0	0.85	1.19	0.098	0.575	0	0	0	0	0.036	0	0	0	0.703333333	1.593333333	0	0	0	0	0	0	0	0	0.166666667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.3686	0	0	0	0	0.15625	0	0.85	1.19	0.098	0.575	0	0	0	0	0.036	0	0	0	0.703333333	1.593333333	0	0	0	0	0	0	0	0	0.166666667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.3686	None																																																																																			0	0	0	0	0	0.15625	0	0.85	1.19	0.098	0.575	0	0	0	0	0.036	0	0	0	0.703333333	1.593333333	0	0	0	0	0	0	0	0	0.166666667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.3686
H3337_002_0	2008	4																					None																		V								V	V	V		V																													0								0	0	0		0																						0	None								266								15894	431	1601		95																													$50 co-pay/visit								$10 co-pay/visit	$20 co-pay/visit	$10 co-pay/visit		$10 co-pay/visit																													50								10	20	10		10																						0	0	0	0	0	0	0	1.108333333	0	0	0	0	0	0	0	13.245	0.718333333	1.334166667	0	0.079166667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.485	0	0	0	0	0	0	0	0	0	1.108333333	0	0	0	0	0	0	0	13.245	0.718333333	1.334166667	0	0.079166667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.485	None																																																																																			0	0	0	0	0	0	0	0	0	0	1.108333333	0	0	0	0	0	0	0	13.245	0.718333333	1.334166667	0	0.079166667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.485
H3337_003_0	2008	4																					None																		V								V	V	V		V																													0								0	0	0		0																						0	None								181								10351	28	851		34																													$50 co-pay/visit								$10 co-pay/visit	$20 co-pay/visit	$10 co-pay/visit		$10 co-pay/visit																													50								10	20	10		10																						0	0	0	0	0	0	0	0.754166667	0	0	0	0	0	0	0	8.625833333	0.046666667	0.709166667	0	0.028333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1642	0	0	0	0	0	0	0	0	0	0.754166667	0	0	0	0	0	0	0	8.625833333	0.046666667	0.709166667	0	0.028333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1642	None																																																																																			0	0	0	0	0	0	0	0	0	0	0.754166667	0	0	0	0	0	0	0	8.625833333	0.046666667	0.709166667	0	0.028333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1642
H3337_004_0	2008	4																					None											D	D			T		Coin	V					Coin				V	V									V															0	0			0		0	0					0				0	0									0															0	None	1387.482001	29.51799942			578		0.659709066	100					0.242342106				568.1576038	255									134.6345033															$150 0-9 days	$150 0-9 days			$50 co-pay/trip		20% co-insurance	$50 co-pay/visit					20% co-insurance				$20 co-pay/visit	$20 co-pay/visit									$20 co-pay/visit															150	150			50		0.2	50					0.2				20	20									20															17.3435	0.368974993	0	0	2.408333333	0	0.131941813	0.416666667	0	0	0	0	0.048468421	0	0	0	0.94692934	0.425	0	0	0	0	0	0	0	0	0.224390839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.3142	0	0	17.3435	0.368974993	0	0	2.408333333	0	0.131941813	0.416666667	0	0	0	0	0.048468421	0	0	0	0.94692934	0.425	0	0	0	0	0	0	0	0	0.224390839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.3142	None																																																																																			0	0	0	17.3435	0.368974993	0	0	2.408333333	0	0.131941813	0.416666667	0	0	0	0	0.048468421	0	0	0	0.94692934	0.425	0	0	0	0	0	0	0	0	0.224390839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.3142
H3342_001_0	2008	8	e.3.	i.8	i.9	i.10.	i.11.	i.12.	h.6	0	0	0	DME/Prosthetics/Supplies	Professional	Professional	Professional	Professional	Professional	OP Facility - Other	0	0	0		Diabetes Monitoring Supplies	Chiropractic	Immunizations	"Pelvic, Prostate, Colorectal"	"Bone Mass Measurement, Mammography Screening, Diabetes Monitoring"	Nutrition Therapy	CORF	0	0	0	D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V	0	0	0																																										0		1399.506022	73.9896322	521.0759204	1328.664885	220.3946491	13.75720528	7.47639085	203.0779267	271.5576927	399.0717396	332.9533449	23.61486396	0	502.9720742	3915.153517	5758.597332	634.42174	1092.84261	15.35524389	938.2515062	56.14326107	0	0	0	357.0393316	283.2071241	227.7936123	19.83551842	0	0	0	0.222284122	70.05516503	336.9918715	60.94416488	544.15036	6.196272851	0.001151557	0.001151557	0.001151557	0	$75/days 1-8	$75/days 1-8	$25/days 1-100	$0 copay	$50 copay	20% coinsurance	20% coinsurance	$50 emergency copay; $25 urgent care copay	$100 copay	$0 copay	$50 radiology copay; $100 chemo copay	0	$0 copay	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$25 copay	$0 copay	10% coinsurance	$0 copay	n/c	Preventive n/c; Comp $0 copay	$10 copay	$0/$25/$45	$0 copay	$0 copay	0	0	0	$0 copay	$25 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	0	0	0	75	57.44680851	25	0	50	0.2	0.2	49.1	100	0	56.85579196	0	0	25	10	25	25	25	25	0	0.1	0	0	0	10	27	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	8.7469	0.354205686	1.085574834	0	0.918311038	2.751441055	1.49527817	0.830927183	2.262980772	0	1.577527176	0	0	1.047858488	3.262627931	11.99707777	1.321711958	2.276755438	0.031990091	0	5.614326107	0	0	0	0.297532776	0.637216029	0	0	0	0	0	0	0.14594826	0	0	0	0	0	0	0	0	46.6562		0	8.7469	0.354205686	1.085574834	0	0.918311038	2.751441055	1.49527817	0.830927183	2.262980772	0	1.577527176	0	0	1.047858488	3.262627931	11.99707777	1.321711958	2.276755438	0.031990091	0	5.614326107	0	0	0	0.297532776	0.637216029	0	0	0	0	0	0	0.14594826	0	0	0	0	0	0	0	0	46.6562		$150/days 1-8	$150/days 1-8	$100/days 1-100	$50 copay	$100 copay	50% coinsurance	50% coinsurance	$50 emergency copay; $25 urgent care copay	$250 copay	$50 copay	$50 radiology copay; $250 chemo copay	0	$100 copay	$100 copay	$25 copay	$40 copay	$100 copay	$50 copay	$50 copay	$50 copay	20% coinsurance	$50 copay	n/c	Preventive n/c; Comp 20% coinsurance	50% coinsurance	50% coinsurance	50% coinsurance	50% coinsurance	0	0	0	20% coinsurance	$50 copay	$25 copay	$50 copay	$100 copay	20% coinsurance	$50 copay	0	0	0	5.309643785	0.215013697	1.317954325	1.680292221	0.557442917	2.087761206	1.13459954	0.256821915	1.717123271	0.504684927	0.652009126	0	0	1.272164371	2.475643812	5.826074831	1.604639254	1.382060261	0.019417509	1.186557066	3.408067847	0	0	0	0.48600039	0	0.137077033	0.5078081	0	0	0	0.01430136	0.088593606	0.213087172	0.077071406	1.37631346	0.001208552	0	0	0	0	35.5094	150	0	14.0566	0.569219383	2.40352916	1.680292221	1.475753955	4.839202261	2.62987771	1.087749099	3.980104044	0.504684927	2.229536302	0	0	2.320022859	5.738271743	17.82315261	2.926351212	3.658815699	0.0514076	1.186557066	9.022393954	0	0	0	0.783533166	0.637216029	0.137077033	0.5078081	0	0	0	0.01430136	0.234541867	0.213087172	0.077071406	1.37631346	0.001208552	0	0	0	0	82.1656
H3342_002_0	2008	8	e.3.	i.8	i.9	i.10.	i.11.	i.12.	h.6				DME/Prosthetics/Supplies	Professional	Professional	Professional	Professional	Professional	OP Facility - Other					Diabetes Monitoring Supplies	Chiropractic	Immunizations	"Pelvic, Prostate, Colorectal"	"Bone Mass Measurement, Mammography Screening, Diabetes Monitoring"	Nutrition Therapy	CORF				D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V																																													0		1268.330265	67.05458092	472.2354529	1204.12907	199.7370495	11.2991399	6.140548494	184.0434242	246.1045789	361.666729	301.7456141	21.40144179	0	455.8284809	3548.186016	5218.843766	574.9573641	990.4104271	13.91599625	850.3091538	46.11187726	0	0	0	323.5740203	256.6621087	206.4425076	17.97633446	0	0	0	0.201449422	63.48889151	305.4056095	55.23186579	493.1471243	5.61549594	0.001043621	0.001043621	0.001043621	0.001043621	$125/days 1-10	$125/days 1-10	$50/days 1-100	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 emergency copay; $25 urgent care copay	$300 copay	$0 copay	$50 radiology copay; $100 chemo copay		$0 copay	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$25 copay	$0 copay	10% coinsurance	$0 copay	n/c	Preventive n/c; Comp $0 copay	$10 copay	$0/$25/$45	$0 copay	$0 copay				$0 copay	$25 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay				125	119.6808511	50	0	100	0.2	0.2	49.1	300	0	56.85579196	0	0	25	10	25	25	25	25	0	0.1	0	0	0	10	27	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	13.2118	0.668762443	1.96764772	0	1.664475413	2.259827979	1.228109699	0.753044344	6.152614473	0	1.429665489	0	0	0.949642669	2.95682168	10.87259118	1.197827842	2.063355056	0.028991659	0	4.611187726	0	0	0	0.269645017	0.577489745	0	0	0	0	0	0	0.132268524	0	0	0	0	0	0	0	0	52.9957		0	13.2118	0.668762443	1.96764772	0	1.664475413	2.259827979	1.228109699	0.753044344	6.152614473	0	1.429665489	0	0	0.949642669	2.95682168	10.87259118	1.197827842	2.063355056	0.028991659	0	4.611187726	0	0	0	0.269645017	0.577489745	0	0	0	0	0	0	0.132268524	0	0	0	0	0	0	0	0	52.9957		$250/days 1-10	$250/days 1-10	$200/days 1-100	$50 copay	$200 copay	50% coinsurance	50% coinsurance	$50 emergency copay; $25 urgent care copay	$500 copay	$75 copay	$100 radiology copay; $500 chemo copay		$100 copay	$100 copay	$25 copay	$40 copay	$100 copay	$50 copay	$50 copay	$50 copay	20% coinsurance	$50 copay	n/c	Preventive n/c; Comp 20% coinsurance	50% coinsurance	50% coinsurance	50% coinsurance	50% coinsurance				20% coinsurance	$50 copay	$25 copay	$50 copay	$100 copay	20% coinsurance	$50 copay				7.64336936	0.309517769	2.276675148	1.45129443	0.962944171	1.634214723	0.888118463	0.221821068	2.966211956	0.653856288	1.126300772	0	0	1.098788081	2.138251923	5.032071113	1.385951789	1.193706864	0.016771203	1.024847725	2.667697167	0	0	0	0.380421377	0	0.107298337	0.397491567	0	0	0	0.011194524	0.076519671	0.184046692	0.066567768	1.188743263	0.000946005	0	0	0	0	37.1056	150	0	20.8551	0.978280212	4.244322868	1.45129443	2.627419584	3.894042703	2.116228162	0.974865412	9.118826429	0.653856288	2.55596626	0	0	2.04843075	5.095073603	15.90466229	2.583779631	3.25706192	0.045762862	1.024847725	7.278884893	0	0	0	0.650066394	0.577489745	0.107298337	0.397491567	0	0	0	0.011194524	0.208788195	0.184046692	0.066567768	1.188743263	0.000946005	0	0	0	0	90.1014
H3342_004_0	2008	7	e.3.	i.8	i.9	i.10.	i.11.	i.12.	h.6				DME/Prosthetics/Supplies	Professional	Professional	Professional	Professional	Professional	OP Facility - Other					Diabetes Monitoring Supplies	Chiropractic	Immunizations	"Pelvic, Prostate, Colorectal"	"Bone Mass Measurement, Mammography Screening, Diabetes Monitoring"	Nutrition Therapy	CORF				D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V																																													0		1292.942146	68.35577147	481.3991566	1227.49513	203.6129363	11.74191302	6.38117476	187.614777	250.8802251	368.6848525	307.6009716	21.81673562	0	464.6738082	3617.038376	5320.11515	586.1143809	1009.629288	14.18603541	866.8093574	47.9188378	0	7.271890582	0	329.8529568	261.6426232	141.3655529	18.32516427	0	0	0	0.205358538	64.72089006	311.331989	56.30363719	502.7166178	5.724464339	0.001063873	0.001063873	0	0	$100/days 1-8	$100/days 1-8	$50/days 1-100	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 emergency copay; $25 urgent care copay	$200 copay	$0 copay	$50 radiology copay; $100 chemo copay		$0 copay	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$25 copay	$0 copay	10% coinsurance	$0 copay	n/c	Preventive n/c; Comp $0 copay	$10 copay	$0/$25/$45	$0 copay	$0 copay				$0 copay	$25 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay				100	76.59574468	50	0	100	0.2	0.2	49.1	200	0	56.85579196	0	0	25	10	25	25	25	25	0	0.1	0	0	0	10	27	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	10.7745	0.436313435	2.005829819	0	1.696774469	2.348382604	1.276234952	0.767657129	4.181337085	0	1.457408071	0	0	0.968070434	3.014198646	11.08357323	1.221071627	2.103394351	0.02955424	0	4.79188378	0	0	0	0.274877464	0.588695902	0	0	0	0	0	0	0.134835188	0	0	0	0	0	0	0	0	49.1546		0	10.7745	0.436313435	2.005829819	0	1.696774469	2.348382604	1.276234952	0.767657129	4.181337085	0	1.457408071	0	0	0.968070434	3.014198646	11.08357323	1.221071627	2.103394351	0.02955424	0	4.79188378	0	0	0	0.274877464	0.588695902	0	0	0	0	0	0	0.134835188	0	0	0	0	0	0	0	0	49.1546		$200/days 1-8	$200/days 1-8	$200/days 1-100	$50 copay	$200 copay	50% coinsurance	50% coinsurance	$50 emergency copay; $25 urgent care copay	$450 copay	$50 copay	$100 radiology copay; $450 chemo copay		$100 copay	$100 copay	$25 copay	$40 copay	$100 copay	$50 copay	$50 copay	$50 copay	20% coinsurance	$50 copay	n/c	Preventive n/c; Comp 20% coinsurance	50% coinsurance	50% coinsurance	50% coinsurance	50% coinsurance				20% coinsurance	$50 copay	$25 copay	$50 copay	$100 copay	20% coinsurance	$50 copay				6.325538513	0.256152291	2.355178006	1.501337037	0.996147797	1.723369989	0.936570136	0.22946976	2.761641884	0.450934762	1.113550931	0	0	1.13667579	2.211981761	5.205583775	1.433741294	1.234867502	0.017354702	1.06018587	2.813234498	5.20E-06	0	0	0.401175424	0	0.113152043	0	0	0	0	0.011805246	0.079158173	0.190392873	0.068863115	1.229732749	0.000997615	0	0	0	0	35.8588	150	0	17.1001	0.692465726	4.361007825	1.501337037	2.692922266	4.071752593	2.212805088	0.99712689	6.942978969	0.450934762	2.570959001	0	0	2.104746224	5.226180407	16.289157	2.654812921	3.338261853	0.046908942	1.06018587	7.605118278	5.20E-06	0	0	0.676052888	0.588695902	0.113152043	0	0	0	0	0.011805246	0.213993361	0.190392873	0.068863115	1.229732749	0.000997615	0	0	0	0	85.0134
H3342_006_0	2008	4	e.3.	i.8	i.9	i.10.	i.11.	i.12.	h.6				DME/Prosthetics/Supplies	Professional	Professional	Professional	Professional	Professional	OP Facility - Other					Diabetes Monitoring Supplies	Chiropractic	Immunizations	"Pelvic, Prostate, Colorectal"	"Bone Mass Measurement, Mammography Screening, Diabetes Monitoring"	Nutrition Therapy	CORF				D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V																																													0		1182.956233	62.54099321	440.4482713	1123.076559	186.2923202	9.829196752	5.34170387	171.6550665	229.5387517	337.3221655	281.4344694	19.96086482	0	425.1456879	3309.350002	4867.552195	536.2557502	923.7437762	12.97928068	793.0730202	40.11302792	0	0	0	301.7935587	239.3856314	129.3400966	16.76630882	0	0	0	0.18788943	59.215318	284.8481026	51.5140904	459.9523332	5.23750486	0.000973373	0.000973373	0	0	$125/days 1-10	$125/days 1-10	$50/days 1-100	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 emergency copay; $25 urgent care copay	$300 copay	$0 copay	$50 radiology copay; $100 chemo copay		$0 copay	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$25 copay	$0 copay	10% coinsurance	$0 copay	n/c	Preventive n/c; Comp $0 copay	$10 copay	$0/$25/$45	$0 copay	$0 copay				$0 copay	$25 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay				125	119.6808511	50	0	100	0.2	0.2	49.1	300	0	56.85579196	0	0	25	10	25	25	25	25	0	0.1	0	0	0	10	27	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	12.3225	0.623746608	1.83520113	0	1.552436002	1.96583935	1.068340774	0.702355314	5.738468791	0	1.333431637	0	0	0.885720183	2.757791668	10.14073374	1.11719948	1.9244662	0.027040168	0	4.011302792	0	0	0	0.251494632	0.538617671	0	0	0	0	0	0	0.123365246	0	0	0	0	0	0	0	0	48.92		0	12.3225	0.623746608	1.83520113	0	1.552436002	1.96583935	1.068340774	0.702355314	5.738468791	0	1.333431637	0	0	0.885720183	2.757791668	10.14073374	1.11719948	1.9244662	0.027040168	0	4.011302792	0	0	0	0.251494632	0.538617671	0	0	0	0	0	0	0.123365246	0	0	0	0	0	0	0	0	48.92		$250/days 1-10	$250/days 1-10	$200/days 1-100	$50 copay	$200 copay	50% coinsurance	50% coinsurance	$50 emergency copay; $25 urgent care copay	$500 copay	$75 copay	$100 radiology copay; $500 chemo copay		$100 copay	$100 copay	$25 copay	$40 copay	$100 copay	$50 copay	$50 copay	$50 copay	20% coinsurance	$50 copay	n/c	Preventive n/c; Comp 20% coinsurance	50% coinsurance	50% coinsurance	50% coinsurance	50% coinsurance				20% coinsurance	$50 copay	$25 copay	$50 copay	$100 copay	20% coinsurance	$50 copay				7.073501374	0.358051251	2.106932693	1.343090025	0.891149779	1.410571275	0.766578819	0.205282717	2.745059588	0.605106614	1.042326974	0	0	1.016865552	1.978829912	4.656894133	1.282619147	1.104707459	0.01552079	0.94843798	2.30262091	0	0	0	0.328360441	0	0.092614483	0.343094563	0	0	0	0.009662545	0.070814581	0.170324692	0.061604664	1.10011393	0.000816544	0	0	0	0	34.0316	150	0	19.396	0.981797858	3.942133823	1.343090025	2.443585781	3.376410625	1.834919593	0.907638031	8.48352838	0.605106614	2.375758611	0	0	1.902585735	4.736621581	14.79762787	2.399818627	3.029173659	0.042560958	0.94843798	6.313923702	0	0	0	0.579855073	0.538617671	0.092614483	0.343094563	0	0	0	0.009662545	0.194179827	0.170324692	0.061604664	1.10011393	0.000816544	0	0	0	0	82.9516
H3342_007_0	2008	6	e.3.	i.8	i.9	i.10.	i.11.	i.12.	h.6				DME/Prosthetics/Supplies	Professional	Professional	Professional	Professional	Professional	OP Facility - Other					Diabetes Monitoring Supplies	Chiropractic	Immunizations	"Pelvic, Prostate, Colorectal"	"Bone Mass Measurement, Mammography Screening, Diabetes Monitoring"	Nutrition Therapy	CORF				D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V																																													0		1259.429931	66.58403461	468.9216054	1195.67926	198.3354222	11.14111598	6.054669964	182.7519248	244.3775738	359.1287824	299.6281557	21.25126011	0	452.6297672	3523.287108	5182.221247	570.9226797	983.460358	13.81834266	844.3422261	45.46698043	0	0	0	321.303384	254.8610176	137.7014503	17.850188	0	0	0	0.200035779	63.04336694	303.2624676	54.84428376	489.6865321	5.576089969	0.001036298	0.001036298	0.001036298	0.001036298	$75/days 1-8	$75/days 1-8	$25/days 1-100	$0 copay	$50 copay	20% coinsurance	20% coinsurance	$50 emergency copay; $25 urgent care copay	$100 copay	$0 copay	$50 radiology copay; $100 chemo copay		$0 copay	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$25 copay	$0 copay	10% coinsurance	$0 copay	n/c	Preventive n/c; Comp $0 copay	$10 copay	$0/$25/$45	$0 copay	$0 copay				$0 copay	$25 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay				75	57.44680851	25	0	50	0.2	0.2	49.1	100	0	56.85579196	0	0	25	10	25	25	25	25	0	0.1	0	0	0	10	27	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	7.8714	0.318753357	0.976920011	0	0.826397593	2.228223196	1.210933993	0.747759959	2.036479782	0	1.419633007	0	0	0.942978682	2.93607259	10.79629426	1.189422249	2.048875746	0.028788214	0	4.546698043	0	0	0	0.26775282	0.57343729	0	0	0	0	0	0	0.131340348	0	0	0	0	0	0	0	0	41.0982		0	7.8714	0.318753357	0.976920011	0	0.826397593	2.228223196	1.210933993	0.747759959	2.036479782	0	1.419633007	0	0	0.942978682	2.93607259	10.79629426	1.189422249	2.048875746	0.028788214	0	4.546698043	0	0	0	0.26775282	0.57343729	0	0	0	0	0	0	0.131340348	0	0	0	0	0	0	0	0	41.0982		$150/days 1-8	$150/days 1-8	$100/days 1-100	$50 copay	$100 copay	50% coinsurance	50% coinsurance	$50 emergency copay; $25 urgent care copay	$250 copay	$50 copay	$100 radiology copay; $250 chemo copay		$100 copay	$100 copay	$25 copay	$40 copay	$100 copay	$50 copay	$50 copay	$50 copay	20% coinsurance	$50 copay	n/c	Preventive n/c; Comp 20% coinsurance	50% coinsurance	50% coinsurance	50% coinsurance	50% coinsurance				20% coinsurance	$50 copay	$25 copay	$50 copay	$100 copay	20% coinsurance	$50 copay				4.708303157	0.190662445	1.168690173	1.4899917	0.494310043	1.666015719	0.905400801	0.227735698	1.522651471	0.447527128	0.900350435	0	0	1.128086133	2.195266208	5.166246104	1.422906766	1.225535827	0.017223556	1.052174234	2.71960921	0	0	0	0.387824185	0	0.109386309	0.405226553	0	0	0	0.011412364	0.078565154	0.188956691	0.068347894	1.220450208	0.001206886	5.17E-06	0	0	0	31.1201	150	0	12.5797	0.509415802	2.145610184	1.4899917	1.320707635	3.894238915	2.116334794	0.975495657	3.559131253	0.447527128	2.319983442	0	0	2.071064815	5.131338798	15.96254037	2.612329015	3.274411573	0.046011769	1.052174234	7.266307253	0	0	0	0.655577005	0.57343729	0.109386309	0.405226553	0	0	0	0.011412364	0.209905502	0.188956691	0.068347894	1.220450208	0.001206886	5.17E-06	0	0	0	72.2183
H3342_008_0	2008	7	e.3.	i.8	i.9	i.10.	i.11.	i.12.	h.6				DME/Prosthetics/Supplies	Professional	Professional	Professional	Professional	Professional	OP Facility - Other					Diabetes Monitoring Supplies	Chiropractic	Immunizations	"Pelvic, Prostate, Colorectal"	"Bone Mass Measurement, Mammography Screening, Diabetes Monitoring"	Nutrition Therapy	CORF				D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V																																													0		1336.528132	70.66009246	497.6274597	1268.874852	210.4768712	12.54691291	6.818654151	193.9394027	259.3375734	381.1134774	317.9704161	22.55219308	0	480.3382881	3738.971276	5499.459962	605.8727077	1043.6646	14.66425661	896.0301087	51.20404856	0	0	0	340.9725313	270.4627794	146.1310848	18.9429184	0	0	0	0.212281318	66.90267664	321.8272086	58.20167228	519.6635475	5.917440045	0.001099737	0.001099737	0.001099737	0.001099737	$100/days 1-8	$100/days 1-8	$50/days 1-100	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 emergency copay; $25 urgent care copay	$200 copay	$0 copay	$50 radiology copay; $100 chemo copay		$0 copay	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$25 copay	$0 copay	10% coinsurance	$0 copay	n/c	Preventive n/c; Comp $0 copay	$10 copay	$0/$25/$45	$0 copay	$0 copay				$0 copay	$25 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay				100	76.59574468	50	0	100	0.2	0.2	49.1	200	0	56.85579196	0	0	25	10	25	25	25	25	0	0.1	0	0	0	10	27	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	11.1377	0.451021867	2.073447749	0	1.753973926	2.509382582	1.36373083	0.793535389	4.32229289	0	1.506538319	0	0	1.000704767	3.115809396	11.45720825	1.262234808	2.174301249	0.030550535	0	5.120404856	0	0	0	0.284143776	0.608541254	0	0	0	0	0	0	0.139380576	0	0	0	0	0	0	0	0	51.1049		0	11.1377	0.451021867	2.073447749	0	1.753973926	2.509382582	1.36373083	0.793535389	4.32229289	0	1.506538319	0	0	1.000704767	3.115809396	11.45720825	1.262234808	2.174301249	0.030550535	0	5.120404856	0	0	0	0.284143776	0.608541254	0	0	0	0	0	0	0.139380576	0	0	0	0	0	0	0	0	51.1049		$200/days 1-8	$200/days 1-8	$200/days 1-100	$50 copay	$200 copay	50% coinsurance	50% coinsurance	$50 emergency copay; $25 urgent care copay	$450 copay	$50 copay	$100 radiology copay; $450 chemo copay		$100 copay	$100 copay	$25 copay	$40 copay	$100 copay	$50 copay	$50 copay	$50 copay	20% coinsurance	$50 copay	n/c	Preventive n/c; Comp 20% coinsurance	50% coinsurance	50% coinsurance	50% coinsurance	50% coinsurance				20% coinsurance	$50 copay	$25 copay	$50 copay	$100 copay	20% coinsurance	$50 copay				6.560819991	0.26568	2.442779997	1.557179998	1.033199999	1.847728493	1.004153105	0.238005	2.864362496	0.467707499	1.154969998	0	0	1.178954998	2.294257497	5.399207993	1.487069998	1.280798998	0.018000218	1.099619999	3.016237705	0	0	0	0.430124272	0	0.121317102	0.44942472	0	0	0	0.012657113	0.082107898	0.197477328	0.071429911	1.275484053	0.001338521	5.40E-06	0	0	0	37.8521	150	0	17.6986	0.716701866	4.516227745	1.557179998	2.787173925	4.357111074	2.367883935	1.031540389	7.186655386	0.467707499	2.661508317	0	0	2.179659765	5.410066893	16.85641625	2.749304806	3.455100248	0.048550753	1.099619999	8.13664256	0	0	0	0.714268048	0.608541254	0.121317102	0.44942472	0	0	0	0.012657113	0.221488475	0.197477328	0.071429911	1.275484053	0.001338521	5.40E-06	0	0	0	88.957
H3342_010_0	2008	8	e.3.	i.8	i.9	i.10.	i.11.	i.12.	h.6				DME/Prosthetics/Supplies	Professional	Professional	Professional	Professional	Professional	OP Facility - Other					Diabetes Monitoring Supplies	Chiropractic	Immunizations	"Pelvic, Prostate, Colorectal"	"Bone Mass Measurement, Mammography Screening, Diabetes Monitoring"	Nutrition Therapy	CORF				D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V	V																																													0		1237.423239	65.4205762	460.7278877	1174.786517	194.8698015	10.75516829	5.844925638	179.5586028	240.1074339	352.8535334	294.3925929	20.87992549	0	444.7207255	3461.72283	5091.669527	560.9466428	966.2758298	13.57688738	829.5885834	43.89192494	0	0	0	315.6890784	250.4076949	135.2953193	17.53828213	0	0	0	0.196540447	61.94177651	297.9634005	53.88596029	481.1299777	5.47865597	0.00101819	0.00101819	0.00101819	0.00101819	$75/days 1-8	$75/days 1-8	$25/days 1-100	$0 copay	$50 copay	20% coinsurance	20% coinsurance	$50 emergency copay; $25 urgent care copay	$100 copay	$0 copay	$50 radiology copay; $100 chemo copay		$0 copay	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$25 copay	$0 copay	10% coinsurance	$0 copay	n/c	Preventive n/c; Comp $0 copay	$10 copay	$0/$25/$45	$0 copay	$0 copay				$0 copay	$25 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay				75	57.44680851	25	0	50	0.2	0.2	49.1	100	0	56.85579196	0	0	25	10	25	25	25	25	0	0.1	0	0	0	10	27	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	7.7339	0.313183609	0.959849766	0	0.811957506	2.151033659	1.168985128	0.73469395	2.000895283	0	1.394827002	0	0	0.926501511	2.884769025	10.60764485	1.168638839	2.013074645	0.028285182	0	4.389192494	0	0	0	0.263074232	0.563417313	0	0	0	0	0	0	0.129045368	0	0	0	0	0	0	0	0	40.243		0	7.7339	0.313183609	0.959849766	0	0.811957506	2.151033659	1.168985128	0.73469395	2.000895283	0	1.394827002	0	0	0.926501511	2.884769025	10.60764485	1.168638839	2.013074645	0.028285182	0	4.389192494	0	0	0	0.263074232	0.563417313	0	0	0	0	0	0	0.129045368	0	0	0	0	0	0	0	0	40.243		$150/days 1-8	$150/days 1-8	$150/days 1-100	$50 copay	$100 copay	50% coinsurance	50% coinsurance	$50 emergency copay; $25 urgent care copay	$250 copay	$50 copay	$100 radiology copay; $250 chemo copay		$100 copay	$100 copay	$30 copay	$40 copay	$100 copay	$50 copay	$50 copay	$50 copay	20% coinsurance	$50 copay	n/c	Preventive n/c; Comp 20% coinsurance	50% coinsurance	50% coinsurance	50% coinsurance	50% coinsurance				20% coinsurance	$50 copay	$25 copay	$50 copay	$100 copay	20% coinsurance	$50 copay				4.606049405	0.186521686	1.714963277	1.457632433	0.483574741	1.601354652	0.870260567	0.222789791	1.489582907	0.437807846	0.880796849	0	0	1.10358664	2.577107957	5.054046861	1.392004432	1.198919946	0.016849499	1.029323377	2.614056285	0	0	0	0.372772031	0	0.105140829	0.389498981	0	0	0	0.010969429	0.076858896	0.184852976	0.066863532	1.193944775	0.001160044	5.05E-06	0	0	0	31.3393	150	0	12.3399	0.499705295	2.674813043	1.457632433	1.295532247	3.752388311	2.039245695	0.957483741	3.490478189	0.437807846	2.275623851	0	0	2.030088152	5.461876982	15.66169171	2.560643271	3.211994592	0.045134681	1.029323377	7.003248779	0	0	0	0.635846263	0.563417313	0.105140829	0.389498981	0	0	0	0.010969429	0.205904264	0.184852976	0.066863532	1.193944775	0.001160044	5.05E-06	0	0	0	71.5823
H3344_001_0	2008	10																					0											A	A	Coin	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	170.136	3.231	40.689	1266.327	225.612	6.336	5.229	253.206	474.579	0	551.439	17.397	0	785.394	6438.051	2682.81	235.143	726.174	950.859	1088.901	6.165	580.815	0	0	457	457	20.133	0	0	0	0											PBP: 1A IP Acute: $100 per admit	1B IP Psych: $100 per admit	2 SNF: $0.2	6 Home Health: $10	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic & Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $50	8A OP C/D/T: $0	8B OP X-Ray: $20	9A OP Hospital: $15	12 Renal Dialysis: $0	"3 CORF: $15, 5 Partial Hosp: $15, 9C OP Substance Abuse: $15, 9D Cardiac Rehab: $15"	"7A PCP: $5, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $20	"7E Mental Health: $20, 7H Psychiatric: $20"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7B Chiropractic: $20, 7F Podiatry: $20 7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $20"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $5	"17B Eye Wear: Medicare Covered: Not Covered, Routine: Not Covered"	18A Routine Hearing Exams: $20	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											100	100	0.199987027	10	50	0.125481807	0.143855887	48.42183835	50	0	20	15	0	15	5	20	20	15.50343306	20	19.56669615	0.199991439	20	0	0	5	34.62	20	0	0	0	0											1.4178	0.026925	8.13727215	1.0552725	0.94005	0.795052731	0.752222431	1.021725	1.9774125	0	0.919065	0.02174625	0	0.9817425	2.68252125	4.47135	0.391905	0.9381825	1.584765	1.77551625	1.232947221	0.968025	0	0	0.190416667	1.318445	0.033555	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.6339	0	0	1.4178	0.026925	8.13727215	1.0552725	0.94005	0.795052731	0.752222431	1.021725	1.9774125	0	0.919065	0.02174625	0	0.9817425	2.68252125	4.47135	0.391905	0.9381825	1.584765	1.77551625	1.232947221	0.968025	0	0	0.190416667	1.318445	0.033555	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.6339	4000	"PBP: 1A IP Acute: $250 Deductible, 20% Coinsurance"	"1B IP Psych: $250 Deductible, 40% Coinsurance"	"2 SNF: $250 Deductible, 20% Coinsurance"	"6 Home Health: $250 Deductible, 20% Coinsurance"	10A Ambulance: $50	"11A DME: $250 Deductible, 40% Coinsurance, 11C Diabetes Monitoring Supplies: $250 Deductible, 20% Coinsurance"	"11B Prosthetic Medical Supplies: $250 Deductible, 20% Coinsurance"	"4A ER: $50, 4B Urgent Care: $30"	"9B ASC Services: $250 Deductible, 20% Coinsurance"	"8A OP C/D/T: $250 Deductible, 20% Coinsurance"	"8B OP X-Ray: $250 Deductible, 20% Coinsurance"	"9A OP Hospital: $250 Deductible, 20% Coinsurance"	"12 Renal Dialysis: $250 Deductible, 20% Coinsurance"	"3 CORF: $250 Deductible, 20% Coinsurance, 5 Partial Hosp: $250 Deductible, 40% Coinsurance, 9C OP Substance Abuse: $250 Deductible, 50% Coinsurance, 9D Cardiac Rehab: $25"	"7A PCP: $30, 14B Immunizations: $250 Deductible, 20% Coinsurance, 14C Routine Physical Exams: $30, 14D Pap Smears: $250 Deductible, 20% Coinsurance, 14D Pelvic Exams: $250 Deductible, 20% Coinsurance, 14E Prostate Screening: $250 Deductible, 20% Coinsurance, 14F Colorectal Screening: $250 Deductible, 20% Coinsurance, 14G Bone Mass Measurement: $250 Deductible, 20% Coinsurance, 14H Mammography: $250 Deductible, 20% Coinsurance, 14I Diabetes Monitoring: $250 Deductible, 20% Coinsurance"	7D Physician Specialist: $30	"7E Mental Health: $250 Deductible, 50% Coinsurance, 7H Psychiatric: $250 Deductible, 50% Coinsurance"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	"8B OP X-Ray: $250 Deductible, 20% Coinsurance"	"7B Chiropractic: $250 Deductible, 20% Coinsurance, 7F Podiatry: $250 Deductible, 20% Coinsurance, 18A Medicare Covered Hearing Exams: $250 Deductible, 20% Coinsurance"	"15 Part B Drugs: $250 Deductible, 20% Coinsurance"	"13A Blood: $250 Deductible, 20% Coinsurance, 16B Comprehensive Dental Services: $250 Deductible, 20% Coinsurance, 17A Medicare Covered Eye Exams: $30"	10B Transportation: Not Covered	16A Preventive Dental Services: Not Covered	17A Routine Eye Exams: $30	17B Eye Wear: Various cost sharing	18A Routine Hearing Exams: $20	18B Hearing Aids: Not Covered	19 POS: N/A	"14A Health Education/Wellness Programs: $250 Deductible, 20% Coinsurance"	13B Acupuncture: Not Covered											3.241	0.0485	0.7562	0.7156	0.0199	0.5516	0.3577	0.1348	0.392	0.1178	0.3383	0.0138	0.0036	0.3328	1.9902	1.4307	0.0791	0.4034	0.4712	0.5511	0.1383	0.2184	0	0	0	0	0.0124	0	0	0	0											12.3183	250	7.063	4.6588	0.075394386	8.893475234	1.770898834	0.959916667	1.346664902	1.109950068	1.156523333	2.369376774	0.11780347	1.257363248	0.035549485	0.003569802	1.314572232	4.672695253	5.902045285	0.470995145	1.341575418	2.055978881	2.326574705	1.371217557	1.186462901	0	0	0.190416667	1.318445	0.045930314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9522
H3344_003_0	2008	10																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	Coin	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	1266.327	225.612	6.336	5.229	254.043	474.579	0	551.439	17.397	0	785.394	0	2817.189	250.821	728.505	1021.257	1118.214	6.165	619.533	0	0	457	457	21.474	3.843	0	0	0											PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: $0	6 Home Health: $10	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic & Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $10"	9B ASC Services: $25	8A OP C/D/T: $0	8B OP X-Ray: $10	9A OP Hospital: $15	12 Renal Dialysis: $0	"3 CORF: $15, 5 Partial Hosp: $15, 9C OP Substance Abuse: $15, 9D Cardiac Rehab: $10"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $10	"7E Mental Health: $10, 7H Psychiatric: $10"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7B Chiropractic: $10, 7F Podiatry: $10 7G Other Health Care: $10, 18A Medicare Covered Hearing Exams: $10"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $5	"17B Eye Wear: Medicare Covered: Not Covered, Routine: Not Covered"	18A Routine Hearing Exams: $10	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											0	0	0	10	50	0.125481807	0.143855887	47.77092854	25	0	10	15	0	14.99982811	0	10	10	14.48217926	10	10	0.199991439	10	0	0	5	34.62	10	0.500506846	0	0	0											0	0	0	1.0552725	0.94005	0.795052731	0.752222431	1.0113225	0.98870625	0	0.4595325	0.02174625	0	0.98173125	0	2.3476575	0.2090175	0.879195	0.8510475	0.931845	1.232947221	0.5162775	0	0	0.190416667	1.318445	0.017895	1.92344781	0	0	0	0	0	0	0	0	0	0	0	0	0	17.4238	0	0	0	0	0	1.0552725	0.94005	0.795052731	0.752222431	1.0113225	0.98870625	0	0.4595325	0.02174625	0	0.98173125	0	2.3476575	0.2090175	0.879195	0.8510475	0.931845	1.232947221	0.5162775	0	0	0.190416667	1.318445	0.017895	1.92344781	0	0	0	0	0	0	0	0	0	0	0	0	0	17.4238	3500	"PBP: 1A IP Acute: $250 Deductible, 20% Coinsurance"	"1B IP Psych: $250 Deductible, 40% Coinsurance"	"2 SNF: $250 Deductible, 20% Coinsurance"	"6 Home Health: $250 Deductible, 20% Coinsurance"	10A Ambulance: $50	"11A DME: $250 Deductible, 40% Coinsurance, 11C Diabetes Monitoring Supplies: $250 Deductible, 20% Coinsurance"	"11B Prosthetic Medical Supplies: $250 Deductible, 20% Coinsurance"	"4A ER: $50, 4B Urgent Care: $30"	"9B ASC Services: $250 Deductible, 20% Coinsurance"	"8A OP C/D/T: $250 Deductible, 20% Coinsurance"	"8B OP X-Ray: $250 Deductible, 20% Coinsurance"	"9A OP Hospital: $250 Deductible, 20% Coinsurance"	"12 Renal Dialysis: $250 Deductible, 20% Coinsurance"	"3 CORF: $250 Deductible, 20% Coinsurance, 5 Partial Hosp: $250 Deductible, 40% Coinsurance, 9C OP Substance Abuse: $250 Deductible, 50% Coinsurance, 9D Cardiac Rehab: $25"	"7A PCP: $30, 14B Immunizations: $250 Deductible, 20% Coinsurance, 14C Routine Physical Exams: $30, 14D Pap Smears: $250 Deductible, 20% Coinsurance, 14D Pelvic Exams: $250 Deductible, 20% Coinsurance, 14E Prostate Screening: $250 Deductible, 20% Coinsurance, 14F Colorectal Screening: $250 Deductible, 20% Coinsurance, 14G Bone Mass Measurement: $250 Deductible, 20% Coinsurance, 14H Mammography: $250 Deductible, 20% Coinsurance, 14I Diabetes Monitoring: $250 Deductible, 20% Coinsurance"	7D Physician Specialist: $30	"7E Mental Health: $250 Deductible, 50% Coinsurance, 7H Psychiatric: $250 Deductible, 50% Coinsurance"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	"8B OP X-Ray: $250 Deductible, 20% Coinsurance"	"7B Chiropractic: $250 Deductible, 20% Coinsurance, 7F Podiatry: $250 Deductible, 20% Coinsurance, 18A Medicare Covered Hearing Exams: $250 Deductible, 20% Coinsurance"	"15 Part B Drugs: $250 Deductible, 20% Coinsurance"	"13A Blood: $250 Deductible, 20% Coinsurance, 16B Comprehensive Dental Services: $250 Deductible, 20% Coinsurance, 17A Medicare Covered Eye Exams: $30"	10B Transportation: Not Covered	16A Preventive Dental Services: Not Covered	17A Routine Eye Exams: $30	17B Eye Wear: Various cost sharing	18A Routine Hearing Exams: $20	18B Hearing Aids: Not Covered	19 POS: N/A	"14A Health Education/Wellness Programs: $250 Deductible, 20% Coinsurance"	13B Acupuncture: Not Covered											2.7916	0.0429	0.6514	0.6164	0.0199	0.54	0.3484	0.1341	0.3375	0.1015	0.2913	0.0116	0.003	0.4146	1.6668	1.2115	0.0788	0.4	0.406	0.4746	0.1191	0.2035	0	0	0	0	0.0106	0.2351	0	0	0.5469											11.657	0	7.085	2.7916	0.042917375	0.651405218	1.671637579	0.959916667	1.335052167	1.100588854	1.14541625	1.326256241	0.101505961	0.75079738	0.033392829	0.003012046	1.396293641	1.666756167	3.559138482	0.28781318	1.279233968	1.257071345	1.406443099	1.352023452	0.719729681	0	0	0.190416667	1.318445	0.028537564	2.158578234	0	0	0.546899567	0	0	0	0	0	0	0	0	0	0	29.0808
H3344_801_0	2008	4																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	212.967	2.592	40.689	12.159	11.286	6.336	5.229	9.594	58.14	8.046	14.256	1.674	0.387	17.676	55.944	90.036	1.647	4.446	37.926	40.194	6.165	24.438	0	0	0	0	0	0	0	0	0											Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing																				0.08935329	0.089246923	0.191349304	0	0.234058322	0.233999985	0.234047399	0.234046496	0.234000003	0.233876867	0.234057908	0.233999991	0.233999321	0.234030077	0.233996076	0.234000021	0.234012734	0.233997137	0.234009614	0.234013963	0.233990601	0.038089773	0	0	0	0	0	0	0	0	0											19.0293	0.231328023	7.785811814	0	2.641582227	1.482623906	1.223833847	2.245442086	13.60476015	1.881773269	3.33672954	0.391715986	0.090557737	4.136715635	13.09067648	21.06842585	0.385418972	1.040351272	8.875048603	9.405957218	1.442552055	0.930837863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.3214	0	0	19.0293	0.231328023	7.785811814	0	2.641582227	1.482623906	1.223833847	2.245442086	13.60476015	1.881773269	3.33672954	0.391715986	0.090557737	4.136715635	13.09067648	21.06842585	0.385418972	1.040351272	8.875048603	9.405957218	1.442552055	0.930837863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.3214	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											2.4311	0.0308	1.1715	0	0.1751	0.3695	0.2574	0.1383	0.7336	0.2205	0.633	0.0248	0.0063	0.6678	1.5977	2.1207	0.04	0.1568	0.8998	1.0523	0.2588	0.135	0	0	0	0	0	0	0	0	0											13.121	0	0	21.4604	0.262143332	8.957337747	0	2.816690737	1.852109716	1.481260724	2.383752021	14.3383525	2.102279486	3.969778195	0.416519986	0.096875703	4.804544049	14.68840438	23.18912746	0.425432817	1.197138148	9.774808224	10.45827144	1.701350833	1.065853617	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.4424
H3344_803_0	2008	4																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	212.967	2.592	40.689	12.159	11.286	6.336	5.229	9.594	58.14	8.046	14.256	1.674	0.387	17.676	55.944	90.036	1.647	4.446	37.926	40.194	6.165	24.438	0	0	0	0	0	0	0	0	0											Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing																				0.08935329	0.089246923	0.191349304	0	0.234058322	0.233999985	0.234047399	0.234046496	0.234000003	0.233876867	0.234057908	0.233999991	0.233999321	0.234030077	0.233996076	0.234000021	0.234012734	0.233997137	0.234009614	0.234013963	0.233990601	0.038089773	0	0	0	0	0	0	0	0	0											19.0293	0.231328023	7.785811814	0	2.641582227	1.482623906	1.223833847	2.245442086	13.60476015	1.881773269	3.33672954	0.391715986	0.090557737	4.136715635	13.09067648	21.06842585	0.385418972	1.040351272	8.875048603	9.405957218	1.442552055	0.930837863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.3214	0	0	19.0293	0.231328023	7.785811814	0	2.641582227	1.482623906	1.223833847	2.245442086	13.60476015	1.881773269	3.33672954	0.391715986	0.090557737	4.136715635	13.09067648	21.06842585	0.385418972	1.040351272	8.875048603	9.405957218	1.442552055	0.930837863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.3214	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											2.4311	0.0308	1.1715	0	0.1751	0.3695	0.2574	0.1383	0.7336	0.2205	0.633	0.0248	0.0063	0.6678	1.5977	2.1207	0.04	0.1568	0.8998	1.0523	0.2588	0.135	0	0	0	0	0	0	0	0	0											13.121	0	0	21.4604	0.262143332	8.957337747	0	2.816690737	1.852109716	1.481260724	2.383752021	14.3383525	2.102279486	3.969778195	0.416519986	0.096875703	4.804544049	14.68840438	23.18912746	0.425432817	1.197138148	9.774808224	10.45827144	1.701350833	1.065853617	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.4424
H3344_804_0	2008	4																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	212.967	2.592	40.689	12.159	11.286	6.336	5.229	9.594	58.14	8.046	14.256	1.674	0.387	17.676	55.944	90.036	1.647	4.446	37.926	40.194	6.165	24.438	0	0	0	0	0	0	0	0	0											Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing	Traditional Medicare Cost Sharing																				0.08935329	0.089246923	0.191349304	0	0.234058322	0.233999985	0.234047399	0.234046496	0.234000003	0.233876867	0.234057908	0.233999991	0.233999321	0.234030077	0.233996076	0.234000021	0.234012734	0.233997137	0.234009614	0.234013963	0.233990601	0.038089773	0	0	0	0	0	0	0	0	0											19.0293	0.231328023	7.785811814	0	2.641582227	1.482623906	1.223833847	2.245442086	13.60476015	1.881773269	3.33672954	0.391715986	0.090557737	4.136715635	13.09067648	21.06842585	0.385418972	1.040351272	8.875048603	9.405957218	1.442552055	0.930837863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.3214	0	0	19.0293	0.231328023	7.785811814	0	2.641582227	1.482623906	1.223833847	2.245442086	13.60476015	1.881773269	3.33672954	0.391715986	0.090557737	4.136715635	13.09067648	21.06842585	0.385418972	1.040351272	8.875048603	9.405957218	1.442552055	0.930837863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.3214	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											2.4311	0.0308	1.1715	0	0.1751	0.3695	0.2574	0.1383	0.7336	0.2205	0.633	0.0248	0.0063	0.6678	1.5977	2.1207	0.04	0.1568	0.8998	1.0523	0.2588	0.135	0	0	0	0	0	0	0	0	0											13.121	0	0	21.4604	0.262143332	8.957337747	0	2.816690737	1.852109716	1.481260724	2.383752021	14.3383525	2.102279486	3.969778195	0.416519986	0.096875703	4.804544049	14.68840438	23.18912746	0.425432817	1.197138148	9.774808224	10.45827144	1.701350833	1.065853617	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.4424
H3346_001_0	2008	4	h.6.										OP Facility - Other											MH. Sub Abuse										A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	Coin	T	P	P	P	P	P	Coin	V	Coin	V										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2500	0	0	1596.066142	1294.20814	431.204343	0.282958891	1.231133695	279.0100585	0	0	555.109616	0	0	304.2655006	4142.259538	5512.354683	96.06686262	935.3785748	0	0	3.570749317	0	0	0	504.6768835	0	0	0	0	0	0	31.32585798	0	0	0	0	0	0	0	0	0	No Cost Sharing	No Cost Sharing	"$0 for days 0-15, $65 for days 16-100"	"No Copay for visits 1-20, $15 per Visit for Visits 21+"	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care Visit"	No Cost Sharing	No Cost Sharing	$15 per Visit	No Cost Sharing	No Cost Sharing	"$15 OP Rehab, includes Cardiac Rehab"	$10 per Visit	$15 per Specialist Visit	$15 per Visit	$15 per Visit	No Cost Sharing	No Cost Sharing	20% Coinsurance	No Cost Sharing	No Cost Sharing	"$300 MAB, no cost sharing prior to MAB"	$10 per Visit	"$100 MAB, no cost sharing prior to MAB"	$15 per Visit	"$600 Max Benefit, Every 3 Years"	Not Applicable	Check with PBP	No Cost Sharing	$15 per Visit MH; 50% Coinsurance Sub Abuse										0	0	33.01788419	4.460059945	35	0.2	0.2	48.70381542	0	0	15	0	0	15	10.00055156	15	15	14.99895437	0	0	0.2	0	0	0	10	0	0	0	0	0	0	15	0	0	0	0	0	0	0	0	0	0	0	4.391560585	0.48102049	1.257679334	0.056591778	0.246226739	1.132404532	0	0	0.69388702	0	0	0.380331876	3.452073342	6.890443353	0.120083578	1.169141713	0	0	0.714149863	0	0	0	0.42056407	0	0	0	0	0	0	0.039157322	0	0	0	0	0	0	0	0	0	21.4453	0	0	0	0	4.391560585	0.48102049	1.257679334	0.056591778	0.246226739	1.132404532	0	0	0.69388702	0	0	0.380331876	3.452073342	6.890443353	0.120083578	1.169141713	0	0	0.714149863	0	0	0	0.42056407	0	0	0	0	0	0	0.039157322	0	0	0	0	0	0	0	0	0	21.4453		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care Visit"	20% Coinsurance	20% Coinsurance	$25 per Visit	No Cost Sharing	20% Coinsurance	"20% Coinsurance OP Rehab, includes Cardiac Rehab"	$25 per Visit	$25 per Specialist Visit	50% Coinsurance	20% Coinsurance	No Cost Sharing	No Cost Sharing	20% Coinsurance	No Cost Sharing	No Cost Sharing	"$300 MAB, no cost sharing prior to MAB"	$25 per Visit	"$100 MAB, no cost sharing prior to MAB"	$25 per Visit	"$600 Max Benefit, Every 3 Years"	Not Applicable	Check with PBP	No Cost Sharing	50% Coinsurance MH and Sub Abuse										6.23	0.0557	1.0893	0.3257	0.1651	0.0078	0.082	0.2588	1.2485	0.4943	0.2775	0.0275	0.1054	0.5836	0.9926	1.892	0.044	0.0688	0.2164	0	0.0984	0.0313	0.0011	0.0451	0.1154	0.0002	0	0.0086	0	0	0.0328	0.032	0	0	0	0	0	0	0	0	0	14.5296	500	0.579923103	6.23	0.055667943	5.480812584	0.806722476	1.422765825	0.064387261	0.328192843	1.391207054	1.24851285	0.494259866	0.971373833	0.027454264	0.10541867	0.963915159	4.444717307	8.782476844	0.16404998	1.237906558	0.216379714	0	0.812523565	0.031301631	0.001054781	0.045051165	0.535995932	0.000200416	0	0.008618309	0	0	0.032775398	0.071197824	0	0	0	0	0	0	0	0	0	35.9749
H3346_002_0	2008	6	h.6.										OP Facility - Other											MH. Sub Abuse										A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	Coin	T	P	P	P	P	P	Coin	V	Coin	V										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2500	0	0	1666.535825	1725.141155	554.7216554	0.350558696	1.696362199	312.1768187	0	0	591.741857	0	0	387.246666	4320.843585	5808.926611	243.1002698	1174.075286	0	0	4.268898985	0	0	0	504.0549878	0	0.096968411	0	0	0	0	52.05382925	0	0	0	0	0	0	0	0	0	No Cost Sharing	No Cost Sharing	"$0 for days 0-15, $65 for days 16-100"	"No Copay for visits 1-20, $15 per Visit for Visits 21+"	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care Visit"	No Cost Sharing	No Cost Sharing	$15 per Visit	No Cost Sharing	No Cost Sharing	"$15 OP Rehab, includes Cardiac Rehab"	$10 per Visit	$15 per Specialist Visit	$15 per Visit	$15 per Visit	No Cost Sharing	No Cost Sharing	20% Coinsurance	No Cost Sharing	No Cost Sharing	"$300 MAB, no cost sharing prior to MAB"	$10 per Visit	"$100 MAB, no cost sharing prior to MAB"	$15 per Visit	"$600 Max Benefit, Every 3 Years"	Not Applicable	Check with PBP	No Cost Sharing	$15 per Visit MH; 50% Coinsurance Sub Abuse										0	0	33.01788419	4.460059945	35	0.2	0.2	48.41711569	0	0	15	0	0	15	10.00067366	15	15	14.99586797	0	0	0.2	0	0	0	10	0	15	0	0	0	0	15	0	0	0	0	0	0	0	0	0	0	0	4.585457238	0.64118608	1.617938161	0.070111739	0.33927244	1.259558429	0	0	0.739677321	0	0	0.484058332	3.600945554	7.261158264	0.303875337	1.467189831	0	0	0.853779797	0	0	0	0.420045823	0	0.000121211	0	0	0	0	0.065067287	0	0	0	0	0	0	0	0	0	23.7094	0	0	0	0	4.585457238	0.64118608	1.617938161	0.070111739	0.33927244	1.259558429	0	0	0.739677321	0	0	0.484058332	3.600945554	7.261158264	0.303875337	1.467189831	0	0	0.853779797	0	0	0	0.420045823	0	0.000121211	0	0	0	0	0.065067287	0	0	0	0	0	0	0	0	0	23.7094		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care Visit"	20% Coinsurance	20% Coinsurance	$25 per Visit	No Cost Sharing	20% Coinsurance	"20% Coinsurance OP Rehab, includes Cardiac Rehab"	$25 per Visit	$25 per Specialist Visit	50% Coinsurance	20% Coinsurance	No Cost Sharing	No Cost Sharing	20% Coinsurance	No Cost Sharing	No Cost Sharing	"$300 MAB, no cost sharing prior to MAB"	$25 per Visit	"$100 MAB, no cost sharing prior to MAB"	$25 per Visit	"$600 Max Benefit, Every 3 Years"	Not Applicable	Check with PBP	No Cost Sharing	50% Coinsurance MH and Sub Abuse										5.5629	0.0928	1.0957	0.4248	0.1995	0.0097	0.0941	0.2605	1.0837	0.5142	0.276	0.0334	0.15	0.6012	1.0124	1.8679	0.0937	0.0752	0.2137	0	0.1178	0.0295	0.0008	0.0443	0.1113	0.0003	0	0.0067	0	0	0.0322	0.0415	0	0	0	0	0	0	0	0	0	14.0458	500	0.543591065	5.5629	0.092771876	5.681118148	1.065950175	1.817455527	0.079785279	0.433421641	1.520077471	1.083676187	0.514179379	1.015663928	0.033439229	0.149962323	1.085211578	4.613336253	9.129083144	0.397577259	1.542436616	0.213702749	0	0.971578507	0.029498071	0.000759865	0.044334448	0.531344634	0.000302632	0.000139212	0.006697431	0	0	0.032237255	0.1066121	0	0	0	0	0	0	0	0	0	37.7553
H3346_801_0	2008	2	h.6.										OP Facility - Other											MH. Sub Abuse										A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	Coin	T	P	P	P	P	P	Coin	V	Coin	V										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2500	0	0	1446.710721	1610.413767	449.6045649	0.484672015	2.001637163	269.3056332	0	0	435.4426993	0	0	357.4199589	4692.178011	7070.547982	174.5479211	1257.626074	0	0	0.690194136	0	0	0	0	0	0.1018605	0	0	0	0	32.8893305	0	0	0	0	0	0	0	0	0	No Cost Sharing	No Cost Sharing	"$0 for days 0-15, $65 for days 16-100"	"No Copay for visits 1-20, $15 per Visit for Visits 21+"	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care Visit"	No Cost Sharing	No Cost Sharing	$15 per Visit	No Cost Sharing	No Cost Sharing	"$15 OP Rehab, includes Cardiac Rehab"	$10 per Visit	$15 per Specialist Visit	$15 per Visit	$15 per Visit	No Cost Sharing	No Cost Sharing	20% Coinsurance	No Cost Sharing	No Cost Sharing	"Not Covered, rider available"	$10 per Visit	"Not Covered, rider available"	$15 per Visit	"Not Covered, rider available"	Not Applicable	Check with PBP	No Cost Sharing	$15 per Visit MH; 50% Coinsurance Sub Abuse										0	0	33.01788419	4.460059945	35	0.2	0.2	48.26703229	0	0	15	0	0	15	10.00021706	15	15	14.99129052	0	0	0.2	0	0	0	0	0	15	0	0	0	0	15	0	0	0	0	0	0	0	0	0	0	0	3.980610586	0.598545161	1.311346647	0.096934403	0.400327433	1.083215308	0	0	0.544303374	0	0	0.446774949	3.910233216	8.838184978	0.218184901	1.57111982	0	0	0.138038827	0	0	0	0	0	0.000127326	0	0	0	0	0.041111663	0	0	0	0	0	0	0	0	0	23.1791	0	0	0	0	3.980610586	0.598545161	1.311346647	0.096934403	0.400327433	1.083215308	0	0	0.544303374	0	0	0.446774949	3.910233216	8.838184978	0.218184901	1.57111982	0	0	0.138038827	0	0	0	0	0	0.000127326	0	0	0	0	0.041111663	0	0	0	0	0	0	0	0	0	23.1791		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care Visit"	20% Coinsurance	20% Coinsurance	$25 per Visit	No Cost Sharing	20% Coinsurance	"20% Coinsurance OP Rehab, includes Cardiac Rehab"	$25 per Visit	$25 per Specialist Visit	50% Coinsurance	20% Coinsurance	No Cost Sharing	No Cost Sharing	20% Coinsurance	No Cost Sharing	No Cost Sharing	"Not Covered, rider available"	$25 per Visit	"Not Covered, rider available"	$25 per Visit	"Not Covered, rider available"	Not Applicable	Check with PBP	No Cost Sharing	50% Coinsurance MH and Sub Abuse										6.1332	0.0514	1.0863	0.3937	0.1662	0.0133	0.1031	0.2509	1.241	0.5528	0.2454	0.0323	0.097	0.644	1.1079	2.2742	0.0763	0.09	0.2371	0	0.019	0.0211	0.0008	0	0	0	0	0	0	0	0.0332	0.0257	0	0	0	0	0	0	0	0	0	14.8959	500	0.626828574	6.1332	0.051442712	5.0668799	0.992233481	1.477525928	0.11025809	0.50345146	1.33409654	1.240963011	0.552823314	0.789745305	0.032302032	0.096961073	1.090819578	5.01809277	11.11234683	0.294490358	1.661142384	0.23714852	0	0.157012341	0.021085337	0.000807139	0	0	0	0.000146395	0	0	0	0.03316265	0.066820513	0	0	0	0	0	0	0	0	0	38.075
H3346_802_0	2008	2	h.6.										OP Facility - Other											MH. Sub Abuse										A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	Coin	T	P	P	P	P	P	Coin	V	Coin	V										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2500	0	0	1284.69716	1475.781269	373.4122263	0.562682905	1.866850137	232.152591	0	0	472.32865	0	0	328.6860796	4456.122334	6608.161682	141.1894749	1534.302463	0	0	5.065761418	0	0	0	0	0	0.082828639	0	0	0	0	30.46623066	0	0	0	0	0	0	0	0	0	No Cost Sharing	No Cost Sharing	"$0 for days 0-15, $65 for days 16-100"	"No Copay for visits 1-20, $15 per Visit for Visits 21+"	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care Visit"	No Cost Sharing	No Cost Sharing	$15 per Visit	No Cost Sharing	No Cost Sharing	"$15 OP Rehab, includes Cardiac Rehab"	$10 per Visit	$15 per Specialist Visit	$15 per Visit	$15 per Visit	No Cost Sharing	No Cost Sharing	20% Coinsurance	No Cost Sharing	No Cost Sharing	"Not Covered, rider available"	$10 per Visit	"Not Covered, rider available"	$15 per Visit	"Not Covered, rider available"	Not Applicable	Check with PBP	No Cost Sharing	$15 per Visit MH; 50% Coinsurance Sub Abuse										0	0	33.01788419	4.460059945	35	0.2	0.2	48.13606679	0	0	15	0	0	15	10.00055796	15	15	14.99567866	0	0	0.2	0	0	0	0	0	15	0	0	0	0	15	0	0	0	0	0	0	0	0	0	0	0	3.534831838	0.548506077	1.089118993	0.112536581	0.373370027	0.931242719	0	0	0.590410813	0	0	0.4108576	3.713642473	8.260202103	0.176486844	1.917325559	0	0	1.013152284	0	0	0	0	0	0.000103536	0	0	0	0	0.038082788	0	0	0	0	0	0	0	0	0	22.7099	0	0	0	0	3.534831838	0.548506077	1.089118993	0.112536581	0.373370027	0.931242719	0	0	0.590410813	0	0	0.4108576	3.713642473	8.260202103	0.176486844	1.917325559	0	0	1.013152284	0	0	0	0	0	0.000103536	0	0	0	0	0.038082788	0	0	0	0	0	0	0	0	0	22.7099		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care Visit"	20% Coinsurance	20% Coinsurance	$25 per Visit	No Cost Sharing	20% Coinsurance	"20% Coinsurance OP Rehab, includes Cardiac Rehab"	$25 per Visit	$25 per Specialist Visit	50% Coinsurance	20% Coinsurance	No Cost Sharing	No Cost Sharing	20% Coinsurance	No Cost Sharing	No Cost Sharing	"Not Covered, rider available"	$25 per Visit	"Not Covered, rider available"	$25 per Visit	"Not Covered, rider available"	Not Applicable	Check with PBP	No Cost Sharing	50% Coinsurance MH and Sub Abuse										5.6933	0.0643	0.9857	0.3828	0.1406	0.0155	0.0994	0.2271	1.2355	0.5314	0.2607	0.0305	0.1043	0.5811	1.0465	2.1426	0.0638	0.1043	0.2363	0	0.1396	0.038	0.0006	0	0	0	0	0	0	0	0.033	0.029	0	0	0	0	0	0	0	0	0	14.186	500	0.54871313	5.6933	0.064337516	4.520576465	0.931297251	1.229736002	0.128042391	0.472776962	1.158343179	1.235495283	0.531429791	0.851144606	0.030487507	0.104317076	0.992004475	4.760105241	10.4027549	0.240319577	2.021615039	0.236259948	0	1.152749087	0.037963708	0.000623461	0	0	0	0.000120334	0	0	0	0.03299952	0.067052668	0	0	0	0	0	0	0	0	0	36.8959
H3347_001_0	2008	7																																D	D	D	P	T	Coin	P	V	V	V	P	V	V	V	P	P	P	P	P	V	Coin	P	T	V	V	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P																																										0		3113.40052		1830.207483		730.3590645	8.005892712		210.4034679	176.0463603		314.0158475				17819.25704		267.8907542	3257.229642	4593.842865	81.97010707	5.399213181		806.2657602																			"#1A $200/day day 1, $100/day days 2-7, $0/day days 8-90, #1B $200/day day 1, $100/day days 2-7, $0/day days 8-90"		"#2 $0/day days 1-7, $100/day days 8-39 and $0/day days 40-100"	#6 $0	#10A $50	"#11A 20% $1000/year OOP, #11B 20% $1000/year OOP, #11C $0"		"#4A $50, #4B $50"	"#9A $200, #9B $200"	#8A $0	#8B 0% X-Ray; 20% Therapeutic Radiological;$175 for Diagnostic Radiological			"#3 $25, #5 $20, #9C $20, #9D $0, #12 20%"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $20, #7D $20, #7F $20, #7G $20"	"#7E $20, #7H $20"	"#7C $25, #7I $25"	#8B 0% X-Ray; 20% Therapeutic Radiological;$175 for Diagnostic Radiological	"#14I $0 , #14J $25"	"#15 Coins: 20%; Copay: $0 for Chemotherapy Drugs, $75 for other Drugs"	#13A $0	#10B $5/$50	"#16A $0 , #16B $0"	#17A $20	#17B $10	#18A $0	#18B $0	#19 $0 n/c	#14A $0	#13B $20											72.6019		60.19		50	0.176		46.7095	173.757		108.9655				9.4608		8.5913	9.9783	12.362	17.8379	0.206815703		5.45																			18.8366	0	9.180015698	0	3.043162769	1.409037117	0	0.818985861	2.5491079	0	2.851407523	0	0	0	14.04873623	0	0.191793368	2.708478333	4.732439135	0.121847967	1.11664207	0	0.366179033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9744	0	0	18.8366	0	9.180015698	0	3.043162769	1.409037117	0	0.818985861	2.5491079	0	2.851407523	0	0	0	14.04873623	0	0.191793368	2.708478333	4.732439135	0.121847967	1.11664207	0	0.366179033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9744																																																																																				0	0	0	18.8366	0	9.180015698	0	3.043162769	1.409037117	0	0.818985861	2.5491079	0	2.851407523	0	0	0	14.04873623	0	0.191793368	2.708478333	4.732439135	0.121847967	1.11664207	0	0.366179033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9744
H3347_002_0	2008	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																										0		592.2674474		80.54271107			4.686354068		14.95009883	21.19554264	8.603695942	21.70259457	0.344827803		39.05715516							5.013619463																					#1A MC cost share; $992	#1B MC cost share; $992	#2 MC cost share	#6 $0	#10A $0	"#11A 20%, #11B 20%, #11C $0"		"#4A 20%, #4B $0"	"#9A 20%, #9B 20%"	#8A 20%	#8B 20%	#9A 20%		"#3 $0, #5 20%, #9C $0, #9D $0, #12 20%"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $0, #7D $0, #7F $0, #7G $0"	"#7E $0, #7H $0"	"#7C $0, #7I $0"		"#14I $0 , #14J $0"	#15 20%	#13A $0	#10B n/c	"#16A n/c, #16B n/c"	#17A $0	#17B $0	#18A $0	#18B n/c	#19 n/c	#14A $0	"#13B $0 , #13C n/c"											0.0569		0.1798			0.2		0.2	0.2	0.2	0.2	0.2		0.2							0.2																					33.7	0	14.48157945	0	0	0.937270814	0	2.990019765	4.239108528	1.720739188	4.340518915	0.068965561	0	7.811431033	0	0	0	0	0	0	1.002723893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2924	0	0	33.7	0	14.48157945	0	0	0.937270814	0	2.990019765	4.239108528	1.720739188	4.340518915	0.068965561	0	7.811431033	0	0	0	0	0	0	1.002723893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2924																																																																																				0	0	0	33.7	0	14.48157945	0	0	0.937270814	0	2.990019765	4.239108528	1.720739188	4.340518915	0.068965561	0	7.811431033	0	0	0	0	0	0	1.002723893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2924
H3347_003_0	2008	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	P	P	P																																										0		900.9092973		159.270522			23.4348423		13.39479336	46.25671218	9.026196917	31.59567929	0.512281242		18.57874282							6.702963246																					#1A MC cost share; $992	#1B MC cost share; $992	#2 MC cost share	#6 $0	#10A $0	"#11A 20%, #11B 20%, #11C $0"		"#4A 20%, #4B $0"	"#9A 20%, #9B 20%"	#8A 20%	#8B 20%	#9A 20%		"#3 $0, #5 20%, #9C $0, #9D $0, #12 20%"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $0, #7D $0, #7F $0, #7G $0"	"#7E $0, #7H $0"	"#7C $0, #7I $0"		"#14I $0 , #14J $0"	#15 20%	#13A 0	#10B n/c	"#16A n/c, #16B $0"	#17A $0	#17B $0	#18A $0	#18B n/c	#19 $0 n/c	#14A $0	"#13B $0 , #13C n/c"											0.0569		0.1798			0.2		0.2	0.2	0.2	0.2	0.2		0.2							0.2																					51.2617	0	28.63683986	0	0	4.68696846	0	2.678958671	9.251342435	1.805239383	6.319135858	0.102456248	0	3.715748564	0	0	0	0	0	0	1.340592649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.799	0	0	51.2617	0	28.63683986	0	0	4.68696846	0	2.678958671	9.251342435	1.805239383	6.319135858	0.102456248	0	3.715748564	0	0	0	0	0	0	1.340592649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.799																																																																																				0	0	0	51.2617	0	28.63683986	0	0	4.68696846	0	2.678958671	9.251342435	1.805239383	6.319135858	0.102456248	0	3.715748564	0	0	0	0	0	0	1.340592649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.799
H3347_004_0	2008	6																																D	D	D	P	T	Coin	P	V	V	V	P	V	V	V	P	P	P	P	P	V	Coin	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P																																										0		2019.117228		833.0815094		374.6207225	3.048416693		166.6612523	176.2057293		336.8099097				15082.2156		161.1548233	3099.38536	4243.437767	105.9069852	3.884410312																					"#1A $200/day day 1-10, $0/day days 11-90, #1B $200/day day 1-10, $0/day days 11-90"		"#2 $0/day days 1-7, $100/day days 8-39 and $0/day days 40-100"	#6 $0	#10A $50	"#11A 20%, #11B 20%, #11C $0"		"#4A $50, #4B $50"	"#9A $200, #9B $200"	#8A $0	#8B #20 X-Ray; 20% Therapeutic Radiological; $250 for MC Diagnostic Radiological			"#3 $30, #5 $30, #9C $30, #9D $30, #12 20%"	"#7A $20, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $30, #7D $30, #7F $30, #7G $30"	"#7E $30, #7H $30"	"#7C $30, #7I $30"	#8B #20 X-Ray; 20% Therapeutic Radiological; $250 for MC Diagnostic Radiological	"#14I $0 , #14J $25"	#15 20%	#13A $0	#10B n/c	"#16A $0 , #16B n/c"	#17A $30	#17B $10	#18A $30	#18B $0	#19 n/c	#14A $0	#13B $30											140.59		60.19		50	0.2		50	200		122				19.1525		30	12	15.8	30	0.2																					23.6556	0	4.178598004	0	1.560919677	0.609683339	0	0.694421885	2.936762156	0	3.424234082	0	0	0	24.07186415	0	0.402887058	3.09938536	5.58719306	0.264767463	0.776882062	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2632	0	0	23.6556	0	4.178598004	0	1.560919677	0.609683339	0	0.694421885	2.936762156	0	3.424234082	0	0	0	24.07186415	0	0.402887058	3.09938536	5.58719306	0.264767463	0.776882062	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2632																																																																																				0	0	0	23.6556	0	4.178598004	0	1.560919677	0.609683339	0	0.694421885	2.936762156	0	3.424234082	0	0	0	24.07186415	0	0.402887058	3.09938536	5.58719306	0.264767463	0.776882062	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2632
H3351_001_0	2008	7																					3500											D	D	D		T	Coin	Coin	V	P		P		P	P	V	V	V	V	V	V	S				V		V				O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		286.7047086	4.855261703	2311.85442	0	258.4403507	6.393801156	13.6887311	285.8523559	379.1098395	0	891.9318339	0	8.613046228	512.049962	4439.75933	4931.069914	224.2875645	779.2045223	608.5787707	85.4353084	890.8192837	0	0	0	993.570123	0	54.72348612	0	0	0	60.68391658											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 4a	PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-g, 14i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 14h"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a	"PBP 1a, 3, 4a-b, 5, 6, 7a-d, 7f-7i, 8a-b, 9a-d, 10a-b, 11a-c, 12, 13a-b, 14a-i, 15"											97.39226901	97.39226901	24.34806725	0	97.39226901	0.194602293	0.041634246	48.69613451	34.08729415	0	24.34806725	0	24.34806725	24.34806725	9.739226901	24.34806725	24.34806725	24.34806725	24.34806725	24.34806725	24.34806725	0	0	0	24.34806725	0	24.34806725	0	0	0	27.18023432											2.3269	0.039405413	4.690765576	0	2.09750768	1.244248367	0.569919993	1.159992064	1.076902385	0	1.80973469	0	0.017475919	1.038952243	3.603318625	10.00516849	0.455080725	1.581010343	1.234809736	0.17334872	1.807477319	0	0	0	2.015959348	0	0.11103426	0	0	0	0.137450256	0	0	0	0	0	0	0	0	0	0	37.1965		0.995955559	2.3269	0.039405413	4.690765576	0	2.09750768	1.244248367	0.569919993	1.159992064	1.076902385	0	1.80973469	0	0.017475919	1.038952243	3.603318625	10.00516849	0.455080725	1.581010343	1.234809736	0.17334872	1.807477319	0	0	0	2.015959348	0	0.11103426	0	0	0	0.137450256	0	0	0	0	0	0	0	0	0	0	37.1965																																																																																				0			2.3269	0.039405413	4.690765576	0	2.09750768	1.244248367	0.569919993	1.159992064	1.076902385	0	1.80973469	0	0.017475919	1.038952243	3.603318625	10.00516849	0.455080725	1.581010343	1.234809736	0.17334872	1.807477319	0	0	0	2.015959348	0	0.11103426	0	0	0	0.137450256	0	0	0	0	0	0	0	0	0	0	37.1965
H3351_002_0	2008	8																					3500											D	D	D		T	Coin	Coin	V	P		P		P	P	V	V	V	V	V	V	S				V		V				O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		285.5555915	4.835801736	2311.85442	0	258.4403507	6.393801156	13.6887311	285.8523559	377.9644925	0	873.2378314	0	8.591241048	510.753633	4301.016851	4818.604783	219.1901198	761.4953286	595.823566	84.51664917	881.2405818	0	0	0	970.9889839	0	53.47977053	0	0	0	54.78619855											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 4a	PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-g, 14i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 14h"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a	"PBP 1a, 3, 4a-b, 5, 6, 7a-d, 7f-7i, 8a-b, 9a-d, 10a-b, 11a-c, 12, 13a-b, 14a-i, 15"											287.7752004	287.7752004	23.9812667	0	95.92506679	0.239588293	0.051258789	47.9625334	47.9625334	0	28.77752004	0	28.77752004	28.77752004	14.38876002	28.77752004	28.77752004	28.77752004	28.77752004	28.77752004	28.77752004	0	0	0	28.77752004	0	28.77752004	0	0	0	26.77076752											6.848	0.115968651	4.620099785	0	2.065908992	1.531879904	0.701667775	1.14251693	1.510677883	0	2.094134933	0	0.020602884	1.224851909	5.157191609	11.55562464	0.525645672	1.826162257	1.428860384	0.20268163	2.113326542	0	0	0	2.328554578	0	0.128251264	0	0	0	0.122222382	0	0	0	0	0	0	0	0	0	0	47.2648		2.007827279	6.848	0.115968651	4.620099785	0	2.065908992	1.531879904	0.701667775	1.14251693	1.510677883	0	2.094134933	0	0.020602884	1.224851909	5.157191609	11.55562464	0.525645672	1.826162257	1.428860384	0.20268163	2.113326542	0	0	0	2.328554578	0	0.128251264	0	0	0	0.122222382	0	0	0	0	0	0	0	0	0	0	47.2648																																																																																				0			6.848	0.115968651	4.620099785	0	2.065908992	1.531879904	0.701667775	1.14251693	1.510677883	0	2.094134933	0	0.020602884	1.224851909	5.157191609	11.55562464	0.525645672	1.826162257	1.428860384	0.20268163	2.113326542	0	0	0	2.328554578	0	0.128251264	0	0	0	0.122222382	0	0	0	0	0	0	0	0	0	0	47.2648
H3351_006_0	2008	8																					3500											D	D	D		T	Coin	Coin	V	P		P		P	P	V	V	V	V	V	V	S	O			V		V				O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		245.980812	4.950537856	895.8907824	0	209.334132	11.72292337	2.511387916	171.0408351	369.6421513	0	559.8160273	0	51.06309089	1259.701664	5048.11432	4891.001464	770.7491414	564.655158	749.000737	886.4530463	561.9407468	3.76993545	0	0	718.2941895	0	36.89430117	0	0	0	242.5555581											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 4a	PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-g, 14i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 14h"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a	"PBP 1a, 3, 4a-b, 5, 6, 7a-d, 7f-7i, 8a-b, 9a-d, 10a-b, 11a-c, 12, 13a-b, 14a-i, 15"											287.6033865	287.6033865	23.96694888	0	95.8677955	0.210577896	0.084387017	45.33232316	47.93389775	0	28.76033865	0	28.76033865	28.76033865	14.38016933	28.76033865	28.76033865	28.76033865	28.76033865	28.76033865	28.76033865	28.76033865	0	0	28.76033865	0	28.76033865	0	0	0	39.1459934											5.8954	0.118649288	1.789314048	0	1.672366813	2.468588538	0.211928534	0.646139867	1.476532424	0	1.341708211	0	0.122382649	3.019120537	6.049394891	11.7222382	1.847250527	1.35330613	1.795126237	2.124557484	1.346800515	0.009035385	0	0	1.721532012	0	0.088424383	0	0	0	0.791256523	0	0	0	0	0	0	0	0	0	0	47.6111		2.052187042	5.8954	0.118649288	1.789314048	0	1.672366813	2.468588538	0.211928534	0.646139867	1.476532424	0	1.341708211	0	0.122382649	3.019120537	6.049394891	11.7222382	1.847250527	1.35330613	1.795126237	2.124557484	1.346800515	0.009035385	0	0	1.721532012	0	0.088424383	0	0	0	0.791256523	0	0	0	0	0	0	0	0	0	0	47.6111																																																																																				0			5.8954	0.118649288	1.789314048	0	1.672366813	2.468588538	0.211928534	0.646139867	1.476532424	0	1.341708211	0	0.122382649	3.019120537	6.049394891	11.7222382	1.847250527	1.35330613	1.795126237	2.124557484	1.346800515	0.009035385	0	0	1.721532012	0	0.088424383	0	0	0	0.791256523	0	0	0	0	0	0	0	0	0	0	47.6111
H3351_007_0	2008	7																					3500											D	D	D		T	Coin	Coin	V	P		P		P	P	V	V	V	V	V	V	S	O			V		V				O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		246.9706744	4.970459538	895.8907824	0	209.334132	11.72292337	2.511387916	171.5805506	370.762279	0	571.8003938	0	51.19269264	1262.898876	5210.956717	5005.147409	788.67354	577.7866733	765.0351107	896.0884055	568.0487984	3.810913009	0	0	734.9987056	0	37.75230818	0	0	0	268.666592											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 4a	PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-g, 14i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 14h"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a	"PBP 1a, 3, 4a-b, 5, 6, 7a-d, 7f-7i, 8a-b, 9a-d, 10a-b, 11a-c, 12, 13a-b, 14a-i, 15"											97.36599001	97.36599001	24.3414975	0	97.36599001	0.171094998	0.068564634	45.31402759	34.0780965	0	24.3414975	0	24.3414975	24.3414975	9.736599001	24.3414975	24.3414975	24.3414975	24.3414975	24.3414975	24.3414975	24.3414975	0	0	24.3414975	0	24.3414975	0	0	0	39.7577558											2.0039	0.040329476	1.817276937	0	1.698502084	2.005733547	0.172192394	0.64791715	1.05290606	0	1.159873155	0	0.103842233	2.561737486	4.228082997	10.15273193	1.59979125	1.172016072	1.551841686	1.817677807	1.152263201	0.007730277	0	0	1.490914096	0	0.076578976	0	0	0	0.89013173	0	0	0	0	0	0	0	0	0	0	37.4039		1.011876691	2.0039	0.040329476	1.817276937	0	1.698502084	2.005733547	0.172192394	0.64791715	1.05290606	0	1.159873155	0	0.103842233	2.561737486	4.228082997	10.15273193	1.59979125	1.172016072	1.551841686	1.817677807	1.152263201	0.007730277	0	0	1.490914096	0	0.076578976	0	0	0	0.89013173	0	0	0	0	0	0	0	0	0	0	37.4039																																																																																				0			2.0039	0.040329476	1.817276937	0	1.698502084	2.005733547	0.172192394	0.64791715	1.05290606	0	1.159873155	0	0.103842233	2.561737486	4.228082997	10.15273193	1.59979125	1.172016072	1.551841686	1.817677807	1.152263201	0.007730277	0	0	1.490914096	0	0.076578976	0	0	0	0.89013173	0	0	0	0	0	0	0	0	0	0	37.4039
H3351_010_0	2008	8																					3500											D	D	D		T	Coin	Coin	V	P		P		P	P	V	V	Coin	V	V	V	S				V		V				O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		283.8319159	4.806611786	2264.673718	0	258.4403507	6.393801156	13.6887311	285.8523559	374.1466694	0	852.4016781	0	8.547630687	508.160975	4162.274372	4718.543446	1.729551457	752.6407318	581.606739	82.67933071	862.0831778	0	0	0	959.6984143	0	52.85791273	0	0	0	48.04604293											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 4a	PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-g, 14i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 14h"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a	"PBP 1a, 3, 4a-b, 5, 6, 7a-d, 7f-7i, 8a-b, 9a-d, 10a-b, 11a-c, 12, 13a-b, 14a-i, 15"											558.2545356	558.2545356	46.5212113	0	93.0424226	0.27886611	0.059662093	46.5212113	93.0424226	0	37.21696904	0	37.21696904	37.21696904	18.60848452	36.50107736	0.465212113	37.21696904	37.21696904	37.21696904	37.21696904	0	0	0	37.21696904	0	37.21696904	0	0	0	25.96627919											13.2042	0.223609403	8.779613714	0	2.003826361	1.783014457	0.816698348	1.108183154	2.900959377	0	2.643650572	0	0.026509742	1.576017606	6.454468185	14.35265995	0.804608288	2.334250568	1.803803333	0.256422841	2.673676912	0	0	0	2.976422181	0	0.163934275	0	0	0	0.103964747	0	0	0	0	0	0	0	0	0	0	66.9905		5.009452306	13.2042	0.223609403	8.779613714	0	2.003826361	1.783014457	0.816698348	1.108183154	2.900959377	0	2.643650572	0	0.026509742	1.576017606	6.454468185	14.35265995	0.804608288	2.334250568	1.803803333	0.256422841	2.673676912	0	0	0	2.976422181	0	0.163934275	0	0	0	0.103964747	0	0	0	0	0	0	0	0	0	0	66.9905																																																																																				0			13.2042	0.223609403	8.779613714	0	2.003826361	1.783014457	0.816698348	1.108183154	2.900959377	0	2.643650572	0	0.026509742	1.576017606	6.454468185	14.35265995	0.804608288	2.334250568	1.803803333	0.256422841	2.673676912	0	0	0	2.976422181	0	0.163934275	0	0	0	0.103964747	0	0	0	0	0	0	0	0	0	0	66.9905
H3351_011_0	2008	9																					3500											D	D	D		T	Coin	Coin	V	P		P		P	P	V	V	V	V	V	V	S	O			V		V				O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		244.4960183	4.920655334	877.6072971	0	209.334132	11.72292337	2.511387916	170.5011196	365.9083922	0	546.458369	0	50.80388738	1253.307239	4885.271922	4791.201882	779.1374134	558.0894003	731.1289802	867.1823279	549.7246436	3.687980332	0	0	709.9419315	0	36.46529767	0	0	0	212.7147907											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 4a	PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-g, 14i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 14h"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a	"PBP 1a, 3, 4a-b, 5, 6, 7a-d, 7f-7i, 8a-b, 9a-d, 10a-b, 11a-c, 12, 13a-b, 14a-i, 15"											559.3502729	559.3502729	46.61252274	0	93.22504549	0.245727573	0.098472903	45.37309972	93.22504549	0	37.29001819	0	37.29001819	37.29001819	18.6450091	37.29001819	41.78180609	37.29001819	37.29001819	37.29001819	37.29001819	37.29001819	0	0	37.29001819	0	37.29001819	0	0	0	38.06687112											11.3966	0.229364159	3.408957508	0	1.626265331	2.880645508	0.247303659	0.644680358	2.842652209	0	1.69812021	0	0.157873157	3.894654145	7.590494953	14.88866711	2.712814027	1.734263658	2.271984414	2.694770399	1.708270163	0.011460404	0	0	2.206145629	0	0.113315968	0	0	0	0.67478221	0	0	0	0	0	0	0	0	0	0	65.6341		4.769831736	11.3966	0.229364159	3.408957508	0	1.626265331	2.880645508	0.247303659	0.644680358	2.842652209	0	1.69812021	0	0.157873157	3.894654145	7.590494953	14.88866711	2.712814027	1.734263658	2.271984414	2.694770399	1.708270163	0.011460404	0	0	2.206145629	0	0.113315968	0	0	0	0.67478221	0	0	0	0	0	0	0	0	0	0	65.6341																																																																																				0			11.3966	0.229364159	3.408957508	0	1.626265331	2.880645508	0.247303659	0.644680358	2.842652209	0	1.69812021	0	0.157873157	3.894654145	7.590494953	14.88866711	2.712814027	1.734263658	2.271984414	2.694770399	1.708270163	0.011460404	0	0	2.206145629	0	0.113315968	0	0	0	0.67478221	0	0	0	0	0	0	0	0	0	0	65.6341
H3351_801_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	S	O																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0		1831.531774	22.62578969	2183.942899	2147.991721	223.0770529	6.042324094	13.95116437	488.1446152	641.0966734	15838.12323	2178.498215	0	85.23822158	1357.465972	7381.52003	9360.110003	271.2713579	1153.114753	3313.419545	2456.963043	3756.738484	55.32142756																				FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				145.5255455	64.15761069	49.88424238	0	137.7477085	0.234	0.234	106.6993795	230.2849424	3.1300131	31.74739333	0	66.77989534	21.8210743	20.91814078	35.36415685	19.24744296	12.00996903	32.97596416	17.58439061	45.92240353	97.37702666																				22.2112	0.120968051	9.078694743	0	2.560696072	1.413903838	3.264572462	4.340393963	12.30290921	4.131127765	5.763469974	0	0.47434996	2.468447153	12.86730627	27.58436652	0.435106666	1.154072706	9.105267014	3.600349821	14.37653838	0.448919677	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.7027	135	0	22.2112	0.120968051	9.078694743	0	2.560696072	1.413903838	3.264572462	4.340393963	12.30290921	4.131127765	5.763469974	0	0.47434996	2.468447153	12.86730627	27.58436652	0.435106666	1.154072706	9.105267014	3.600349821	14.37653838	0.448919677	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.7027																																																																																				0			22.2112	0.120968051	9.078694743	0	2.560696072	1.413903838	3.264572462	4.340393963	12.30290921	4.131127765	5.763469974	0	0.47434996	2.468447153	12.86730627	27.58436652	0.435106666	1.154072706	9.105267014	3.600349821	14.37653838	0.448919677	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.7027
H3351_802_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	S	O																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0		1101.355153	81.69512408	1140.300725	1767.002388	202.1215548	10.63081131	3.049863687	333.1617288	538.990742	439.8190695	548.7251386	36.767191	90.26915251	1231.413015	5448.430295	9108.150898	445.4983481	670.6043127	2421.505189	11226.75579	1654.414936	18.8779826																				FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				172.7076336	86.70046675	65.19092905	0	104.3777853	0.234	0.234	127.2252593	195.1963356	33.46919883	69.63980988	346.5086306	52.00201508	44.12462303	13.95911831	21.88876251	21.9704195	17.58126716	33.50146779	22.21102592	70.44960956	208.5290412																				15.851	0.590250449	6.194771971	0	1.758083354	2.487609847	0.713668103	3.532215611	8.767418147	1.226699324	3.184426194	1.061679084	0.391181486	4.527969589	6.337940256	16.613846	0.815648799	0.982506132	6.760331509	20.77981364	9.712740524	0.328050634	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.6179	135	0	15.851	0.590250449	6.194771971	0	1.758083354	2.487609847	0.713668103	3.532215611	8.767418147	1.226699324	3.184426194	1.061679084	0.391181486	4.527969589	6.337940256	16.613846	0.815648799	0.982506132	6.760331509	20.77981364	9.712740524	0.328050634	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.6179																																																																																				0			15.851	0.590250449	6.194771971	0	1.758083354	2.487609847	0.713668103	3.532215611	8.767418147	1.226699324	3.184426194	1.061679084	0.391181486	4.527969589	6.337940256	16.613846	0.815648799	0.982506132	6.760331509	20.77981364	9.712740524	0.328050634	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.6179
H3351_803_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	S	O																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0		1831.531774	22.62578969	2183.942899	2147.991721	223.0770529	6.042324094	13.95116437	488.1446152	641.0966734	15838.12323	2178.498215	0	85.23822158	1357.465972	7381.52003	9360.110003	271.2713579	1153.114753	3313.419545	2456.963043	3756.738484	55.32142756																				FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				145.5255455	64.15761069	49.88424238	0	137.7477085	0.234	0.234	106.6993795	230.2849424	3.1300131	31.74739333	0	66.77989534	21.8210743	20.91814078	35.36415685	19.24744296	12.00996903	32.97596416	17.58439061	45.92240353	97.37702666																				22.2112	0.120968051	9.078694743	0	2.560696072	1.413903838	3.264572462	4.340393963	12.30290921	4.131127765	5.763469974	0	0.47434996	2.468447153	12.86730627	27.58436652	0.435106666	1.154072706	9.105267014	3.600349821	14.37653838	0.448919677	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.7027	135	0	22.2112	0.120968051	9.078694743	0	2.560696072	1.413903838	3.264572462	4.340393963	12.30290921	4.131127765	5.763469974	0	0.47434996	2.468447153	12.86730627	27.58436652	0.435106666	1.154072706	9.105267014	3.600349821	14.37653838	0.448919677	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.7027																																																																																				0			22.2112	0.120968051	9.078694743	0	2.560696072	1.413903838	3.264572462	4.340393963	12.30290921	4.131127765	5.763469974	0	0.47434996	2.468447153	12.86730627	27.58436652	0.435106666	1.154072706	9.105267014	3.600349821	14.37653838	0.448919677	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.7027
H3351_804_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	S	O																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0		1101.355153	81.69512408	1140.300725	1767.002388	202.1215548	10.63081131	3.049863687	333.1617288	538.990742	439.8190695	548.7251386	36.767191	90.26915251	1231.413015	5448.430295	9108.150898	445.4983481	670.6043127	2421.505189	11226.75579	1654.414936	18.8779826																				FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				172.7076336	86.70046675	65.19092905	0	104.3777853	0.234	0.234	127.2252593	195.1963356	33.46919883	69.63980988	346.5086306	52.00201508	44.12462303	13.95911831	21.88876251	21.9704195	17.58126716	33.50146779	22.21102592	70.44960956	208.5290412																				15.851	0.590250449	6.194771971	0	1.758083354	2.487609847	0.713668103	3.532215611	8.767418147	1.226699324	3.184426194	1.061679084	0.391181486	4.527969589	6.337940256	16.613846	0.815648799	0.982506132	6.760331509	20.77981364	9.712740524	0.328050634	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.6179	135	0	15.851	0.590250449	6.194771971	0	1.758083354	2.487609847	0.713668103	3.532215611	8.767418147	1.226699324	3.184426194	1.061679084	0.391181486	4.527969589	6.337940256	16.613846	0.815648799	0.982506132	6.760331509	20.77981364	9.712740524	0.328050634	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.6179																																																																																				0			15.851	0.590250449	6.194771971	0	1.758083354	2.487609847	0.713668103	3.532215611	8.767418147	1.226699324	3.184426194	1.061679084	0.391181486	4.527969589	6.337940256	16.613846	0.815648799	0.982506132	6.760331509	20.77981364	9.712740524	0.328050634	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.6179
H3351_805_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	S	O																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0		1831.531774	22.62578969	2183.942899	2147.991721	223.0770529	6.042324094	13.95116437	488.1446152	641.0966734	15838.12323	2178.498215	0	85.23822158	1357.465972	7381.52003	9360.110003	271.2713579	1153.114753	3313.419545	2456.963043	3756.738484	55.32142756																				FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				145.5255455	64.15761069	49.88424238	0	137.7477085	0.234	0.234	106.6993795	230.2849424	3.1300131	31.74739333	0	66.77989534	21.8210743	20.91814078	35.36415685	19.24744296	12.00996903	32.97596416	17.58439061	45.92240353	97.37702666																				22.2112	0.120968051	9.078694743	0	2.560696072	1.413903838	3.264572462	4.340393963	12.30290921	4.131127765	5.763469974	0	0.47434996	2.468447153	12.86730627	27.58436652	0.435106666	1.154072706	9.105267014	3.600349821	14.37653838	0.448919677	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.7027	135	0	22.2112	0.120968051	9.078694743	0	2.560696072	1.413903838	3.264572462	4.340393963	12.30290921	4.131127765	5.763469974	0	0.47434996	2.468447153	12.86730627	27.58436652	0.435106666	1.154072706	9.105267014	3.600349821	14.37653838	0.448919677	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.7027																																																																																				0			22.2112	0.120968051	9.078694743	0	2.560696072	1.413903838	3.264572462	4.340393963	12.30290921	4.131127765	5.763469974	0	0.47434996	2.468447153	12.86730627	27.58436652	0.435106666	1.154072706	9.105267014	3.600349821	14.37653838	0.448919677	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.7027
H3351_806_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	S	O																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0		1101.355153	81.69512408	1140.300725	1767.002388	202.1215548	10.63081131	3.049863687	333.1617288	538.990742	439.8190695	548.7251386	36.767191	90.26915251	1231.413015	5448.430295	9108.150898	445.4983481	670.6043127	2421.505189	11226.75579	1654.414936	18.8779826																				FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				172.7076336	86.70046675	65.19092905	0	104.3777853	0.234	0.234	127.2252593	195.1963356	33.46919883	69.63980988	346.5086306	52.00201508	44.12462303	13.95911831	21.88876251	21.9704195	17.58126716	33.50146779	22.21102592	70.44960956	208.5290412																				15.851	0.590250449	6.194771971	0	1.758083354	2.487609847	0.713668103	3.532215611	8.767418147	1.226699324	3.184426194	1.061679084	0.391181486	4.527969589	6.337940256	16.613846	0.815648799	0.982506132	6.760331509	20.77981364	9.712740524	0.328050634	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.6179	135	0	15.851	0.590250449	6.194771971	0	1.758083354	2.487609847	0.713668103	3.532215611	8.767418147	1.226699324	3.184426194	1.061679084	0.391181486	4.527969589	6.337940256	16.613846	0.815648799	0.982506132	6.760331509	20.77981364	9.712740524	0.328050634	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.6179																																																																																				0			15.851	0.590250449	6.194771971	0	1.758083354	2.487609847	0.713668103	3.532215611	8.767418147	1.226699324	3.184426194	1.061679084	0.391181486	4.527969589	6.337940256	16.613846	0.815648799	0.982506132	6.760331509	20.77981364	9.712740524	0.328050634	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.6179
H3359_001_0	2008	4																																D	D	D			Coin		P						P		V	Coin	V			Coin			P			V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1348.934769	92.9217802	449.664143	0	0	3.522126747	0	169.0582064	0	0	0	0	0	20.31225521	0	4425.879605	4.34429749	490.4234298	0	239.6776243	5.304340303	12.69767928	0	1190.594903	0	0	0.308432625	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 7g, 9a, 9c, 9d, 13a, 13b"	"PBP 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 8b"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	50	0	0	0.094951851	0	50	0	0	0	0	0	10	0	10	0.284295054	10	0	10	0.2	10	0	18.52499421	0	0	10	0	0	0	0											5.6206	0.387174084	1.873600596	0	0	0.334432455	0	0.704409193	0	0	0	0	0	0.016926879	0	3.688233004	1.235062291	0.408686191	0	0.199731354	1.060868061	0.010581399	0	1.837980307	0	0	0.000257027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.3785	0	0	5.6206	0.387174084	1.873600596	0	0	0.334432455	0	0.704409193	0	0	0	0	0	0.016926879	0	3.688233004	1.235062291	0.408686191	0	0.199731354	1.060868061	0.010581399	0	1.837980307	0	0	0.000257027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.3785																																																																																				0			5.6206	0.387174084	1.873600596	0	0	0.334432455	0	0.704409193	0	0	0	0	0	0.016926879	0	3.688233004	1.235062291	0.408686191	0	0.199731354	1.060868061	0.010581399	0	1.837980307	0	0	0.000257027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.3785
H3359_019_0	2008	4																																D	D	D			Coin		P						P		V	Coin	V			Coin			P			V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1365.628466	68.82812601	487.4745133	0	0	4.395595329	0	185.3291822	0	0	0	0	0	67.66078127	0	5255.534286	4.369572525	318.3693917	0	200.0236257	4.507782057	4.900233891	0	674.152892	0	0	0.582241115	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 7g, 9a, 9c, 9d, 13a, 13b"	"PBP 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 8b"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	50	0	0	0.092232529	0	50	0	0	0	0	0	10	0	10	0.244505331	10	0	10	0.2	10	0	0	0	0	10	0	0	0	0											5.6901	0.286783858	2.031143806	0	0	0.405416875	0	0.772204926	0	0	0	0	0	0.056383984	0	4.379611905	1.068383776	0.265307826	0	0.166686355	0.901556411	0.004083528	0	0	0	0	0.000485201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0282	0	0	5.6901	0.286783858	2.031143806	0	0	0.405416875	0	0.772204926	0	0	0	0	0	0.056383984	0	4.379611905	1.068383776	0.265307826	0	0.166686355	0.901556411	0.004083528	0	0	0	0	0.000485201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0282																																																																																				0			5.6901	0.286783858	2.031143806	0	0	0.405416875	0	0.772204926	0	0	0	0	0	0.056383984	0	4.379611905	1.068383776	0.265307826	0	0.166686355	0.901556411	0.004083528	0	0	0	0	0.000485201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0282
H3359_021_0	2008	6																																Coin	Coin	Coin		Coin			Coin	Coin	Coin	Coin		Coin	Coin							Coin																					0	0	0	0	0.1711	0.2469	0.0347	0.5968	0.1707	0.7592	0.1645	0	0.0047	0.1199	0	5.3752	0.2372	0.2023	0.0461	0.9524	0.0564	0.0338	0	0	0	0	0	0	0	0	0											9.172		562.3292443	23.19392483	28.99881199	0	16.93739088	0	0	6.707405019	10.15269853	7.589304884	26.79645322	0	0.269197871	8.13986501	0	0	0	0	0	0	4.718360078	0	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 7g, 9a, 9c, 9d, 13a, 13b"	"PBP 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.058513872	0.075190877	0.121240851	0	0.2	0	0	0.058035578	0.144729041	0.001169229	0.155380456	0	0	0.128019899	0	0	0	0	0	0	0.202062061	0	0	0	0	0	0	0	0	0	0											32.9041	1.743971541	3.515840645	0	3.387478176	0	0	0.38926813	1.469390319	0.008873633	4.163645115	0	0	1.0420647	0	0	0	0	0	0	0.953401564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.578	135	0	32.9041	1.743971541	3.515840645	0	3.558618397	0.246887954	0.034692153	0.986095386	1.640118617	0.768076963	4.32813351	0	0.004704247	1.161965516	0	5.375196319	0.23721796	0.202272473	0.046083387	0.952445376	1.00983741	0.033799145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.75																																																																																				0			32.9041	1.743971541	3.515840645	0	3.558618397	0.246887954	0.034692153	0.986095386	1.640118617	0.768076963	4.32813351	0	0.004704247	1.161965516	0	5.375196319	0.23721796	0.202272473	0.046083387	0.952445376	1.00983741	0.033799145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.75
H3359_026_0	2008	5																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	645.9284008	0	0	0	0	0	595.182949	0	9099.552839	2159.520255	5429.217118	0	0	0	0	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	46.49324138	0	0	0	0	0	10	0	10	20	10	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	2.502608754	0	0	0	0	0	0.495985791	0	7.582960699	3.599200425	4.524347598	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.7051	0	0	0	0	0	0	0	0	0	2.502608754	0	0	0	0	0	0.495985791	0	7.582960699	3.599200425	4.524347598	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.7051																																																																																				0	0	0	0	0	0	0	0	0	0	2.502608754	0	0	0	0	0	0.495985791	0	7.582960699	3.599200425	4.524347598	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.7051
H3359_027_0	2008	4																																D	D	D			Coin		P						P		V	Coin	V			Coin			P			V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1363.239717	166.8700001	457.5043445	0	0	4.021316516	0	141.2744993	0	0	0	0	0	36.066325	0	5641.569704	4.082306095	445.4244398	0	251.5804301	7.077553712	0.362773105	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 7g, 9a, 9c, 9d, 13a, 13b"	"PBP 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 8b"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	50	0	0	0.094375717	0	50	0	0	0	0	0	10	0	10	0.281032618	10	0	10	0.2	10	0	0	0	0	0	0	0	0	0											5.6802	0.695291667	1.906268102	0	0	0.379514629	0	0.588643747	0	0	0	0	0	0.030055271	0	4.701308087	1.14726117	0.371187033	0	0.209650358	1.415510742	0.000302311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.1252	0	0	5.6802	0.695291667	1.906268102	0	0	0.379514629	0	0.588643747	0	0	0	0	0	0.030055271	0	4.701308087	1.14726117	0.371187033	0	0.209650358	1.415510742	0.000302311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.1252																																																																																				0			5.6802	0.695291667	1.906268102	0	0	0.379514629	0	0.588643747	0	0	0	0	0	0.030055271	0	4.701308087	1.14726117	0.371187033	0	0.209650358	1.415510742	0.000302311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.1252
H3359_031_0	2008	5																																D	D	D	V	P	Coin	O	V	Coin	Coin	Coin	V	V	V	P	P	Coin	P	P	P	S	O		P	V	P	V	P			O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1154.474109	34.08665546	1017.605687	0	0	18.10706824	0	168.1841793	25.39124978	7.784712254	22.3470576	0	0	303.3480221	4791.708742	6096.410911	2.11697772	773.8562532	0	0	1427.199323	0	0	1524	0	0	174.4766057	0	0	0	60											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 8b"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a	PBP 13											150	150	50	0	0	0.1	0	50	0.2	0	0	0	0	62.09236382	10	25	0.5	25	0	0	45.52454336	0	0	13.02288565	0	0	25	0	0	0	28.77315487											14.4309	0.426083193	4.240023698	0	0	1.810706824	0	0.700767414	5.078249956	0	0	0	0	1.569632979	3.993090618	12.70085606	1.05848886	1.612200528	0	0	5.414383123	0	0	1.653906477	0	0	0.363492929	0	0	0	0.143865774	0	0	0	0	0	0	0	0	0	0	55.1967	0	0	14.4309	0.426083193	4.240023698	0	0	1.810706824	0	0.700767414	5.078249956	0	0	0	0	1.569632979	3.993090618	12.70085606	1.05848886	1.612200528	0	0	5.414383123	0	0	1.653906477	0	0	0.363492929	0	0	0	0.143865774	0	0	0	0	0	0	0	0	0	0	55.1967																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.4309	0.426083193	4.240023698	0	0	1.810706824	0	0.700767414	5.078249956	0	0	0	0	1.569632979	3.993090618	12.70085606	1.05848886	1.612200528	0	0	5.414383123	0	0	1.653906477	0	0	0.363492929	0	0	0	0.143865774	0	0	0	0	0	0	0	0	0	0	55.1967
H3359_804_0	2008	4																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O		P			V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1821.708922	53.78722995	1387.379661	0	164.1754489	40448.42294	41.76702264	205.2349391	150.8690943	1100.894446	612.0015654	0	490.3188058	386.8346574	6283.06403	11506.08883	314.8234858	2770.585574	4887.653458	22955.43759	1846.749343	9114.120388	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 8b"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												104.8399103	45.00336031	82.9881794	0	85.78457534	1.191934833	52.77192267	60.32453238	416.3755817	17.14448395	88.53099575	0	46.18535938	95.60812582	13.07651119	16.32497561	23.36669285	7.367632244	25.42404964	12.06589106	52.66850904	12.34647436	0	0	0	0	0	0	0	0	0											15.9157	0.201717174	9.594676018	0	1.17364343	4.017657019	0.183677174	1.031725144	5.234850577	1.572855597	4.515092332	0	1.887129188	3.082044717	6.846713093	15.65305163	0.613031974	1.701054634	10.35532868	23.0814841	8.105461207	9.377271143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.1441	0	0	15.9157	0.201717174	9.594676018	0	1.17364343	4.017657019	0.183677174	1.031725144	5.234850577	1.572855597	4.515092332	0	1.887129188	3.082044717	6.846713093	15.65305163	0.613031974	1.701054634	10.35532868	23.0814841	8.105461207	9.377271143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.1441																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.9157	0.201717174	9.594676018	0	1.17364343	4.017657019	0.183677174	1.031725144	5.234850577	1.572855597	4.515092332	0	1.887129188	3.082044717	6.846713093	15.65305163	0.613031974	1.701054634	10.35532868	23.0814841	8.105461207	9.377271143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.1441
H3359_805_0	2008	4																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O		P			V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1821.708922	53.78722995	1387.379661	0	164.1754489	40448.42294	41.76702264	205.2349391	150.8690943	1100.894446	612.0015654	0	490.3188058	386.8346574	6283.06403	11506.08883	314.8234858	2770.585574	4887.653458	22955.43759	1846.749343	9114.120388	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 8b"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												104.8399103	45.00336031	82.9881794	0	85.78457534	1.191934833	52.77192267	60.32453238	416.3755817	17.14448395	88.53099575	0	46.18535938	95.60812582	13.07651119	16.32497561	23.36669285	7.367632244	25.42404964	12.06589106	52.66850904	12.34647436	0	0	0	0	0	0	0	0	0											15.9157	0.201717174	9.594676018	0	1.17364343	4.017657019	0.183677174	1.031725144	5.234850577	1.572855597	4.515092332	0	1.887129188	3.082044717	6.846713093	15.65305163	0.613031974	1.701054634	10.35532868	23.0814841	8.105461207	9.377271143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.1441	0	0	15.9157	0.201717174	9.594676018	0	1.17364343	4.017657019	0.183677174	1.031725144	5.234850577	1.572855597	4.515092332	0	1.887129188	3.082044717	6.846713093	15.65305163	0.613031974	1.701054634	10.35532868	23.0814841	8.105461207	9.377271143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.1441																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.9157	0.201717174	9.594676018	0	1.17364343	4.017657019	0.183677174	1.031725144	5.234850577	1.572855597	4.515092332	0	1.887129188	3.082044717	6.846713093	15.65305163	0.613031974	1.701054634	10.35532868	23.0814841	8.105461207	9.377271143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.1441
H3359_806_0	2008	4																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O		P			V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1821.708922	53.78722995	1387.379661	0	164.1754489	40448.42294	41.76702264	205.2349391	150.8690943	1100.894446	612.0015654	0	490.3188058	386.8346574	6283.06403	11506.08883	314.8234858	2770.585574	4887.653458	22955.43759	1846.749343	9114.120388	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 8b"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												104.8399103	45.00336031	82.9881794	0	85.78457534	1.191934833	52.77192267	60.32453238	416.3755817	17.14448395	88.53099575	0	46.18535938	95.60812582	13.07651119	16.32497561	23.36669285	7.367632244	25.42404964	12.06589106	52.66850904	12.34647436	0	0	0	0	0	0	0	0	0											15.9157	0.201717174	9.594676018	0	1.17364343	4.017657019	0.183677174	1.031725144	5.234850577	1.572855597	4.515092332	0	1.887129188	3.082044717	6.846713093	15.65305163	0.613031974	1.701054634	10.35532868	23.0814841	8.105461207	9.377271143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.1441	0	0	15.9157	0.201717174	9.594676018	0	1.17364343	4.017657019	0.183677174	1.031725144	5.234850577	1.572855597	4.515092332	0	1.887129188	3.082044717	6.846713093	15.65305163	0.613031974	1.701054634	10.35532868	23.0814841	8.105461207	9.377271143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.1441																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.9157	0.201717174	9.594676018	0	1.17364343	4.017657019	0.183677174	1.031725144	5.234850577	1.572855597	4.515092332	0	1.887129188	3.082044717	6.846713093	15.65305163	0.613031974	1.701054634	10.35532868	23.0814841	8.105461207	9.377271143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.1441
H3359_807_0	2008	4																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O		P			V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1821.708922	53.78722995	1387.379661	0	164.1754489	40448.42294	41.76702264	205.2349391	150.8690943	1100.894446	612.0015654	0	490.3188058	386.8346574	6283.06403	11506.08883	314.8234858	2770.585574	4887.653458	22955.43759	1846.749343	9114.120388	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 8b"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												104.8399103	45.00336031	82.9881794	0	85.78457534	1.191934833	52.77192267	60.32453238	416.3755817	17.14448395	88.53099575	0	46.18535938	95.60812582	13.07651119	16.32497561	23.36669285	7.367632244	25.42404964	12.06589106	52.66850904	12.34647436	0	0	0	0	0	0	0	0	0											15.9157	0.201717174	9.594676018	0	1.17364343	4.017657019	0.183677174	1.031725144	5.234850577	1.572855597	4.515092332	0	1.887129188	3.082044717	6.846713093	15.65305163	0.613031974	1.701054634	10.35532868	23.0814841	8.105461207	9.377271143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.1441	0	0	15.9157	0.201717174	9.594676018	0	1.17364343	4.017657019	0.183677174	1.031725144	5.234850577	1.572855597	4.515092332	0	1.887129188	3.082044717	6.846713093	15.65305163	0.613031974	1.701054634	10.35532868	23.0814841	8.105461207	9.377271143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.1441																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.9157	0.201717174	9.594676018	0	1.17364343	4.017657019	0.183677174	1.031725144	5.234850577	1.572855597	4.515092332	0	1.887129188	3.082044717	6.846713093	15.65305163	0.613031974	1.701054634	10.35532868	23.0814841	8.105461207	9.377271143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.1441
H3361_019_0	2008	8																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2095.491284	280.0142696	1034.24082	836.0632347	684.999867	12.49833863	1.881416613	1526.063257	391.0137683	5452.838118	1243.510126	8.088685797	0.029732476	360.5678569	8474.852822	15375.53004	454.967223	1955.802447	4372.390801	928.4554617	17.96933809	7.783782352	0	526.6666667	402	201	105.6	10.05714286	0	1600	3600											"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$200 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $30.00 and $150.00	$0.00 copayment	Copay between $0.00 and $75.00	$200.00 copayment	20% coinsurance	Copay between $20.00 and $30.00	Copay between $0.00 and $5.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $5.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$0.00 copayment	$0.00 copayment	$35.00 copayment	$0.00 copayment	N/A	$0.00 copayment	Copay between $0.00 and $30.00											89.05620027	46.92572168	30.26	0	49.71532781	0.2	0.2	17.99033084	100.1912273	0	10.54298859	144.6966211	0.2	9.713417816	2.254666511	9.900777394	23.80963962	9.655642028	6.804056862	0	0.2	0	0	50	0	0	35	0	0	0	0											15.5514	1.094989307	2.6080106	0	2.837916078	2.499667727	0.376283323	2.287865239	3.264679111	0	1.09252609	0.097533792	0.005946495	0.291862187	1.59233057	12.68580836	0.902717135	1.573710692	2.479166303	0	3.593867618	0	0	2.194444444	0	0	0.308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3387	0	0	15.5514	1.094989307	2.6080106	0	2.837916078	2.499667727	0.376283323	2.287865239	3.264679111	0	1.09252609	0.097533792	0.005946495	0.291862187	1.59233057	12.68580836	0.902717135	1.573710692	2.479166303	0	3.593867618	0	0	2.194444444	0	0	0.308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3387	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							12.3076		0											12.3076	0	0	15.5514	1.094989307	2.6080106	0	2.837916078	2.499667727	0.376283323	2.287865239	3.264679111	0	1.09252609	0.097533792	0.005946495	0.291862187	1.59233057	12.68580836	0.902717135	1.573710692	2.479166303	0	3.593867618	0	0	2.194444444	0	0	0.308	0	12.307574	0	0	0	0	0	0	0	0	0	0	0	0	69.6463
H3361_020_0	2008	10																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		373.7686661	14.3371053	1176.554339	1375.488988	967.234542	10.91144956	1.428512751	1026.334403	139.8312775	2675.381319	512.1325023	10.39790158	0.234089899	221.1061455	7891.529617	16226.4051	770.0760383	3726.972358	3769.10192	396.8085908	14.4589761	8.602343817	980	526.6666667	402	201	26.4	10.05714286	0	1600	7380											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $10.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	Copay between $0.00 and $10.00	$0.00 copayment	$10.00 copayment	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	Copay between $0.00 and $15.00											0	0	31.17	0.094108539	40.96520084	0.2	0.2	15.29995532	0	0	6.39268256	0	0.2	2.326065486	0	2.786050424	7.580849465	3.070046747	6.068122816	0	0.2	0	0	50	0	0	20	0	0	0	0											0	0	3.056099894	0.010787105	3.301913106	2.182289913	0.28570255	1.308572542	0	0	0.272825043	0	0.04681798	0.042858948	0	3.767298568	0.486485877	0.95349828	1.90594778	0	2.89179522	0	0	2.194444444	0	0	0.044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.7513	0	0	0	0	3.056099894	0.010787105	3.301913106	2.182289913	0.28570255	1.308572542	0	0	0.272825043	0	0.04681798	0.042858948	0	3.767298568	0.486485877	0.95349828	1.90594778	0	2.89179522	0	0	2.194444444	0	0	0.044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.7513	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							15.449		0											15.449	0	0	0	0	3.056099894	0.010787105	3.301913106	2.182289913	0.28570255	1.308572542	0	0	0.272825043	0	0.04681798	0.042858948	0	3.767298568	0.486485877	0.95349828	1.90594778	0	2.89179522	0	0	2.194444444	0	0	0.044	0	15.44901673	0	0	0	0	0	0	0	0	0	0	0	0	38.2004
H3361_021_0	2008	8																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2054.119013	46.99011026	1300.112601	906.9731602	585.0815602	9.67638213	2.509881553	1064.472955	242.0138484	2516.098517	821.6713965	14.34421297	0.177721286	377.0296822	8227.646283	15594.86298	532.9106924	2302.846907	4484.525177	795.6143982	21.51640499	7.889510383	0	526.6666667	402	201	35.2	10.05714286	0	1600	3690.297608											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $150.00	$0.00 copayment	Copay between $0.00 and $150.00	$250.00 copayment	20% coinsurance	Copay between $25.00 and $150.00	Copay between $0.00 and $10.00	$35.00 copayment	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $10.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	Copay between $0.00 and $30.00											97.74250298	69.00074132	31.17	0.25202455	45.26681291	0.2	0.2	16.60934034	99.96593962	0	18.32612841	180.8707764	0.2	27.73195044	4.829746228	10.89761835	29.19200166	11.4267103	11.15123054	0	0.2	0	0	50	0	0	25	0	0	0	0.162503535											16.7312	0.270196037	3.377042481	0.019048292	2.207064793	1.935276426	0.501976311	1.473349466	2.016095146	0	1.254837961	0.216204078	0.035544257	0.871314039	3.311453633	14.16223875	1.296394152	2.192830373	4.167331177	0	4.303280999	0	0	2.194444444	0	0	0.073333333	0	0	0	0.049973867	0	0	0	0	0	0	0	0	0	0	62.6605	0	0	16.7312	0.270196037	3.377042481	0.019048292	2.207064793	1.935276426	0.501976311	1.473349466	2.016095146	0	1.254837961	0.216204078	0.035544257	0.871314039	3.311453633	14.16223875	1.296394152	2.192830373	4.167331177	0	4.303280999	0	0	2.194444444	0	0	0.073333333	0	0	0	0.049973867	0	0	0	0	0	0	0	0	0	0	62.6605	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.4319		0											13.4319	0	0	16.7312	0.270196037	3.377042481	0.019048292	2.207064793	1.935276426	0.501976311	1.473349466	2.016095146	0	1.254837961	0.216204078	0.035544257	0.871314039	3.311453633	14.16223875	1.296394152	2.192830373	4.167331177	0	4.303280999	0	0	2.194444444	0	0	0.073333333	0	13.43192864	0	0.049973867	0	0	0	0	0	0	0	0	0	0	76.0924
H3361_022_0	2008	8																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1819.855304	107.1908585	777.648238	834.8625092	540.5582029	7.843659623	1.804582522	1037.524462	270.7663879	2112.732159	1184.823909	13.54385632	0.083581893	236.2184452	8753.666411	15512.1149	469.5962033	1847.512833	4731.839546	947.1380647	23.66879336	11.93410373	0	526.6666667	402	201	35.2	10.05714286	0	1600	3697.156135											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $30.00 and $100.00	$0.00 copayment	Copay between $0.00 and $50.00	$150.00 copayment	20% coinsurance	Copay between $20.00 and $30.00	Copay between $0.00 and $10.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $10.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	Copay between $0.00 and $30.00											70.07344187	32.18366374	31.17	1.009188293	45.38984673	0.2	0.2	16.89853697	62.06778076	0	7.796105206	108.5224658	0.2	9.184356589	4.980059676	9.096411694	25.38705619	9.7992409	7.238207296	0	0.2	0	0	50	0	0	25	0	0	0	0.174522086											10.627	0.287482879	2.019941298	0.070211123	2.044654498	1.568731925	0.360916504	1.46105379	1.400489067	0	0.769750987	0.12248439	0.016716379	0.180792869	3.632815093	11.75871528	0.9934721	1.508685276	2.854169627	0	4.733758672	0	0	2.194444444	0	0	0.073333333	0	0	0	0.053769617	0	0	0	0	0	0	0	0	0	0	48.7333	0	0	10.627	0.287482879	2.019941298	0.070211123	2.044654498	1.568731925	0.360916504	1.46105379	1.400489067	0	0.769750987	0.12248439	0.016716379	0.180792869	3.632815093	11.75871528	0.9934721	1.508685276	2.854169627	0	4.733758672	0	0	2.194444444	0	0	0.073333333	0	0	0	0.053769617	0	0	0	0	0	0	0	0	0	0	48.7333	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							12.1327		0											12.1327	0	0	10.627	0.287482879	2.019941298	0.070211123	2.044654498	1.568731925	0.360916504	1.46105379	1.400489067	0	0.769750987	0.12248439	0.016716379	0.180792869	3.632815093	11.75871528	0.9934721	1.508685276	2.854169627	0	4.733758672	0	0	2.194444444	0	0	0.073333333	0	12.13272079	0	0.053769617	0	0	0	0	0	0	0	0	0	0	60.8661
H3361_024_0	2008	8																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		267.7283806	16.75863833	1025.412106	1587.44048	700.3322625	8.46679907	1.87575463	887.2644744	151.5603063	2363.284257	537.8379181	12.04557706	0.511264927	192.7119335	8407.138631	18996.99513	882.230082	4956.45	4679.908228	519.5232901	16.5518018	14.1744479	982.7764354	526.6666667	402	201	26.4	10.05714286	0	1600	7380											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $10.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	Copay between $0.00 and $10.00	$0.00 copayment	$10.00 copayment	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	Copay between $0.00 and $15.00											0	0	31.17	0.015415674	35.31162742	0.2	0.2	16.31924543	0	0	6.784051826	0	0.2	2.057772746	0	3.01748209	7.483950672	3.073180589	7.893625513	0	0.2	0	0	50	0	0	20	0	0	0	0											0	0	2.663507945	0.002039289	2.06082266	1.693359814	0.375150926	1.206623893	0	0	0.304060026	0	0.102252985	0.033046447	0	4.776924382	0.550213868	1.269338827	3.078453582	0	3.310360361	0	0	2.194444444	0	0	0.044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6646	0	0	0	0	2.663507945	0.002039289	2.06082266	1.693359814	0.375150926	1.206623893	0	0	0.304060026	0	0.102252985	0.033046447	0	4.776924382	0.550213868	1.269338827	3.078453582	0	3.310360361	0	0	2.194444444	0	0	0.044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6646	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.4671		0											14.4671	0	0	0	0	2.663507945	0.002039289	2.06082266	1.693359814	0.375150926	1.206623893	0	0	0.304060026	0	0.102252985	0.033046447	0	4.776924382	0.550213868	1.269338827	3.078453582	0	3.310360361	0	0	2.194444444	0	0	0.044	0	14.46705247	0	0	0	0	0	0	0	0	0	0	0	0	38.1317
H3361_027_0	2008	8																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2111.072216	100.9494743	1536.636599	1942.703387	833.1327002	11.37456598	2.317422138	1102.94207	199.1837408	3144.708358	878.1171431	17.46826754	0.330849305	236.4735248	7886.650653	20561.93045	921.345022	4833.152227	4214.517945	558.5048367	18.74153053	11.9760497	0	526.6666667	402	201	35.2	10.05714286	0	0	3600											"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $25 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $25.00 and $50.00	$0.00 copayment	Copay between $0.00 and $50.00	$75.00 copayment	20% coinsurance	Copay between $20.00 and $50.00	Copay between $0.00 and $5.00	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											26.91941328	12.42674048	15.59	0	35.11086309	0.2	0.2	15.95419537	35.40030912	0	8.980456078	54.26123291	0.2	12.57923248	1.986498229	7.889166931	23.06515706	9.429856384	8.558546923	0	0.2	0	0	50	0	0	25	0	0	0	0											4.7357	0.10453941	1.996347048	0	2.437667347	2.274913196	0.463484428	1.46637944	0.587597166	0	0.657157703	0.078987478	0.066169861	0.247887954	1.30556813	13.51804181	1.77091397	3.797994282	3.005845799	0	3.748306107	0	0	2.194444444	0	0	0.073333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5313	0	0	4.7357	0.10453941	1.996347048	0	2.437667347	2.274913196	0.463484428	1.46637944	0.587597166	0	0.657157703	0.078987478	0.066169861	0.247887954	1.30556813	13.51804181	1.77091397	3.797994282	3.005845799	0	3.748306107	0	0	2.194444444	0	0	0.073333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5313	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							15.2217		0											15.2217	0	0	4.7357	0.10453941	1.996347048	0	2.437667347	2.274913196	0.463484428	1.46637944	0.587597166	0	0.657157703	0.078987478	0.066169861	0.247887954	1.30556813	13.51804181	1.77091397	3.797994282	3.005845799	0	3.748306107	0	0	2.194444444	0	0	0.073333333	0	15.22169799	0	0	0	0	0	0	0	0	0	0	0	0	59.753
H3361_028_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2141.161555	84.35970406	1701.936547	2422.583992	795.9843839	14.88555511	4.263518364	1173.41182	285.3940533	7038.365785	1119.901535	61.27217363	0.251484057	353.0614548	8761.862666	21051.37259	688.3214797	3655.027363	4615.785006	808.2934963	20.62176568	23.44272487	0	526.6666667	402	201	105.6	10.05714286	0	0	0											"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$200 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $150.00	$0.00 copayment	Copay between $0.00 and $150.00	$200.00 copayment	20% coinsurance	Copay between $25.00 and $150.00	Copay between $0.00 and $15.00	$35.00 copayment	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $15.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$0.00 copayment	$0.00 copayment	$35.00 copayment	$0.00 copayment	N/A	$0.00 copayment	Copay between $0.00 and $35.00											83.5939251	43.62734985	30.26	0	41.31816071	0.2	0.2	18.7733519	121.8751125	0	23.71842755	134.6978993	0.2	33.50572065	5.945238621	9.767478478	28.90440439	11.30333885	9.919627956	0	0.2	0	0	50	0	0	35	0	0	0	0											14.9157	0.306699194	4.29171666	0	2.740717558	2.977111022	0.852703673	1.835739418	2.898536028	0	2.213525285	0.687769423	0.050296811	0.985798206	4.340947026	17.13490239	1.6579602	3.442834399	3.815572499	0	4.124353135	0	0	2.194444444	0	0	0.308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7753	0	0	14.9157	0.306699194	4.29171666	0	2.740717558	2.977111022	0.852703673	1.835739418	2.898536028	0	2.213525285	0.687769423	0.050296811	0.985798206	4.340947026	17.13490239	1.6579602	3.442834399	3.815572499	0	4.124353135	0	0	2.194444444	0	0	0.308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7753	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							15.7531		0											15.7531	0	0	14.9157	0.306699194	4.29171666	0	2.740717558	2.977111022	0.852703673	1.835739418	2.898536028	0	2.213525285	0.687769423	0.050296811	0.985798206	4.340947026	17.13490239	1.6579602	3.442834399	3.815572499	0	4.124353135	0	0	2.194444444	0	0	0.308	0	15.75309232	0	0	0	0	0	0	0	0	0	0	0	0	87.5284
H3361_029_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2260.873187	162.3663341	1999.366074	3130.196268	1102.162766	15.43059713	2.597253426	1342.135314	193.2161985	4084.185024	804.922933	23.19860598	0.501037687	313.1198869	8168.223015	26984.27132	1406.733744	6816.533882	4562.979176	504.3855944	26.95966528	19.08212899	0	526.6666667	402	201	105.6	10.05714286	0	0	0											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $15.00 and $75.00	Copay between $0.00 and $15.00	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $15.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$0.00 copayment	$0.00 copayment	$35.00 copayment	$0.00 copayment	N/A	$0.00 copayment	Copay between $0.00 and $25.00											35.00207931	16.55701632	31.17	0	31.80336349	0.2	0.2	16.51957342	60.10306999	0	12.71844395	72.34831054	0.2	15.7616021	5.092185621	6.024744958	18.90073209	7.738890146	8.658752495	0	0.2	0	0	50	0	0	35	0	0	0	0											6.5946	0.22402517	5.193353377	0	2.921040256	3.086119426	0.519450685	1.847625239	0.967740558	0	0.853113934	0.139864996	0.100207537	0.411272589	3.466175649	13.54777938	2.215691469	4.396033907	3.29247561	0	5.391933056	0	0	2.194444444	0	0	0.308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.671	0	0	6.5946	0.22402517	5.193353377	0	2.921040256	3.086119426	0.519450685	1.847625239	0.967740558	0	0.853113934	0.139864996	0.100207537	0.411272589	3.466175649	13.54777938	2.215691469	4.396033907	3.29247561	0	5.391933056	0	0	2.194444444	0	0	0.308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.671	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							18.4874		0											18.4874	0	0	6.5946	0.22402517	5.193353377	0	2.921040256	3.086119426	0.519450685	1.847625239	0.967740558	0	0.853113934	0.139864996	0.100207537	0.411272589	3.466175649	13.54777938	2.215691469	4.396033907	3.29247561	0	5.391933056	0	0	2.194444444	0	0	0.308	0	18.48736263	0	0	0	0	0	0	0	0	0	0	0	0	76.1583
H3361_031_0	2008	7																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		463.3347356	34.59374195	939.5850604	28.37724674	18.40565234	9.86505291	1.78756422	23.51642648	12.76899387	3.639674539	8.077692489	8.333253652	1.263744826	3.966700106	10192.55084	98.69823789	14.63759836	20.11160046	39.2670822	5.553782533	11.95893505	0.141359397	980	671.25	0	0	0	0	0	38023.6	43.49											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											705.5539369	708.4	30.26	0.183768431	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.19851337	0.004409143	0.2	0.2	0	20	0	0	0	0	0	0	0											27.2423	2.0421839	2.369320327	5.214842105	3.681130467	1.973010582	0.357512844	4.703285297	2.553798774	0.727934908	1.615538498	0	0.252748965	0.793340021	0	19.73964758	2.927519671	4.022320093	7.795040831	0.024487424	2.39178701	0.028271879	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.5748	0	0	27.2423	2.0421839	2.369320327	5.214842105	3.681130467	1.973010582	0.357512844	4.703285297	2.553798774	0.727934908	1.615538498	0	0.252748965	0.793340021	0	19.73964758	2.927519671	4.022320093	7.795040831	0.024487424	2.39178701	0.028271879	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.5748	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	27.2423	2.0421839	2.369320327	5.214842105	3.681130467	1.973010582	0.357512844	4.703285297	2.553798774	0.727934908	1.615538498	0	0.252748965	0.793340021	0	19.73964758	2.927519671	4.022320093	7.795040831	0.024487424	2.39178701	0.028271879	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.5748
H3361_039_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1743.526039	125.285114	1231.757174	2216.449742	1063.333168	13.21928857	2.238904571	1162.435022	166.7659272	3551.710342	692.5443672	20.0056088	0.415654199	270.9736464	6840.319169	24152.07857	1324.513453	6341.545864	4004.606803	445.5777799	22.54920362	16.49968125	0	0	0	0	0	0	0	1600	0											"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$200 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $15.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $150.00	$0.00 copayment	Copay between $0.00 and $150.00	$200.00 copayment	20% coinsurance	Copay between $5.00 and $150.00	Copay between $0.00 and $5.00	$15.00 copayment	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $5.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											70.00192672	33.10866686	30.26	0	31.79235171	0.2	0.2	16.48805414	120.1358996	0	21.10538407	144.6966211	0.2	27.04438619	1.799880518	3.840785159	11.1289636	4.638005318	10.62915634	0	0.2	0	0	0	0	0	0	0	0	0	0											10.1708	0.345668592	3.106081007	0	2.817155173	2.643857714	0.447780914	1.597190964	1.669547891	0	1.218034571	0.241228666	0.08313084	0.610692995	1.025979767	7.730245412	1.228371834	2.451010287	3.54713265	0	4.509840724	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4438	0	0	10.1708	0.345668592	3.106081007	0	2.817155173	2.643857714	0.447780914	1.597190964	1.669547891	0	1.218034571	0.241228666	0.08313084	0.610692995	1.025979767	7.730245412	1.228371834	2.451010287	3.54713265	0	4.509840724	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4438	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	10.1708	0.345668592	3.106081007	0	2.817155173	2.643857714	0.447780914	1.597190964	1.669547891	0	1.218034571	0.241228666	0.08313084	0.610692995	1.025979767	7.730245412	1.228371834	2.451010287	3.54713265	0	4.509840724	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4438
H3361_043_0	2008	7																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		333.390352	46.04608416	1784.816094	4576.774248	1600.996334	19.38371018	2.253592006	3631.364673	155.4502873	5219.509707	845.2289377	16.42238828	1.578870796	309.6202297	9694.362214	22322.98663	3852.339246	9711.38905	4373.648475	413.2517026	15.72160887	16.96520892	980	671.25	402	201	0	0	0	1600	10800											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	34.29097806	0.2	0.2	16.22553542	0	0	6.487278177	0	0.2	0	0	0	0	0	5.685320413	0	0.2	0	0	20	0	0	0	0	0	0	0											0	0	0	0	4.574977514	3.876742037	0.450718401	4.910069677	0	0	0.45693627	0	0.315774159	0	0	0	0	0	2.072132746	0	3.144321774	0	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.9204	0	0	0	0	0	0	4.574977514	3.876742037	0.450718401	4.910069677	0	0	0.45693627	0	0.315774159	0	0	0	0	0	2.072132746	0	3.144321774	0	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.9204	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							19.3486		0											19.3486	0	0	0	0	0	0	4.574977514	3.876742037	0.450718401	4.910069677	0	0	0.45693627	0	0.315774159	0	0	0	0	0	2.072132746	0	3.144321774	0	0	1.11875	0	0	0	0	19.34860252	0	0	0	0	0	0	0	0	0	0	0	0	40.269
H3361_047_0	2008	8																																A	A	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		356.5137047	74.37356644	1529.982886	3750.327147	1378.656756	2309.038976	225.5111294	3462.037586	213.5953222	16917.64211	1686.919981	54.25878218	6.894489769	388.1021512	7909.356521	16410.19464	4774.512441	2927.249948	4716.852354	741.123067	22.65858419	11.76374044	0	0	402	0	90	0	0	1600	0											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $10.00 and $50.00	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $20.00	$0.00 copayment	Copay between $0.00 and $10.00	$20.00 copayment	$10.00 copayment	Copay between $0.00 and $10.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	0	0	0	13.25492674	0	0	0	0	0	0.27520787	0	2.636835086	13.85282039	3.445263359	0.871924039	0	0.2	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	3.824087882	0	0	0	0	0	0.008900731	0	3.60591475	5.511705275	0.840428916	0.34272808	0	4.531716839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.6655	0	0	0	0	0	0	0	0	0	3.824087882	0	0	0	0	0	0.008900731	0	3.60591475	5.511705275	0.840428916	0.34272808	0	4.531716839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.6655	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	0	0	0	0	0	0	0	3.824087882	0	0	0	0	0	0.008900731	0	3.60591475	5.511705275	0.840428916	0.34272808	0	4.531716839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.6655
H3361_050_0	2008	8																																A	A	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		377.8790291	53.52922422	1958.975506	4811.591476	1972.445201	2231.477982	316.2776967	4101.841631	185.5230696	5919.279537	1008.567381	17.87787887	94.66953506	375.876805	10229.13973	24340.0635	3861.641594	10399.65757	4972.255959	461.8349709	17.16050881	18.13288752	5460	455	402	0	90	0	0	1600	0											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $10.00 and $50.00	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $20.00	$0.00 copayment	Copay between $0.00 and $10.00	$20.00 copayment	$10.00 copayment	Copay between $0.00 and $10.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	0	0	0	9.886972244	0	0	0	0	0	0.387555785	0	1.974878782	14.16538224	3.014938489	1.171984189	0	0.2	0	0	20	0	0	0	0	0	0	0											0	0	0	0	0	0	0	3.379566196	0	0	0	0	0	0.012139436	0	4.005722913	4.558469106	2.612860656	0.485617114	0	3.432101762	0	0	0.758333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.2448	0	0	0	0	0	0	0	0	0	3.379566196	0	0	0	0	0	0.012139436	0	4.005722913	4.558469106	2.612860656	0.485617114	0	3.432101762	0	0	0.758333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.2448	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	0	0	0	0	0	0	0	3.379566196	0	0	0	0	0	0.012139436	0	4.005722913	4.558469106	2.612860656	0.485617114	0	3.432101762	0	0	0.758333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.2448
H3361_051_0	2008	9																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2120.323215	132.4122121	597.312766	971.4820932	794.9460833	6.551544236	1.612686268	834.8649441	108.3746546	1664.070337	457.3657031	6.647436927	0.168282175	123.6020925	8391.83053	14565.60753	612.1818236	4353.16236	4360.107497	451.2585963	12.84596248	5.564257696	982.5655455	1145.454545	402	201	26.4	10.05714286	0	1600	14465.09377											"$100 days 1 - 3, $0 after day 3, unlimited coverage"	"$100 days 1 - 3, $0 after day 3, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $10.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $5.00 and $75.00	$0.00 copayment	$10.00 copayment	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											26.81613958	20.2477401	31.17	0.004648708	42.21523137	0.2	0.2	15.93182821	53.23093148	0	9.093456044	72.34831054	0.2	13.6442316	0	2.920417214	7.767141042	3.031025672	7.204784296	0	0.2	0	0	0	0	0	20	0	0	0	0											4.7382	0.223420671	1.55151991	0.000376345	2.796569403	1.310308847	0.322537254	1.108410405	0.480740318	0	0.346586243	0.040077569	0.033656435	0.140537965	0	3.544804247	0.396241881	1.099545572	2.617802836	0	2.569192496	0	0	0	0	0	0.044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.3646	0	0	4.7382	0.223420671	1.55151991	0.000376345	2.796569403	1.310308847	0.322537254	1.108410405	0.480740318	0	0.346586243	0.040077569	0.033656435	0.140537965	0	3.544804247	0.396241881	1.099545572	2.617802836	0	2.569192496	0	0	0	0	0	0.044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.3646	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.2911		0											13.2911	0	0	4.7382	0.223420671	1.55151991	0.000376345	2.796569403	1.310308847	0.322537254	1.108410405	0.480740318	0	0.346586243	0.040077569	0.033656435	0.140537965	0	3.544804247	0.396241881	1.099545572	2.617802836	0	2.569192496	0	0	0	0	0	0.044	0	13.29114923	0	0	0	0	0	0	0	0	0	0	0	0	36.6557
H3361_056_0	2008	8																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1878.493984	138.5291328	1588.688277	1968.435661	826.7829992	12.01828388	3.000435173	898.3629703	256.2956236	5013.424195	1013.211705	21.98298947	0.272672776	338.3862846	8695.129529	27553.6442	1045.286775	5973.309303	4662.029489	655.8877112	28.47791711	14.81811086	0	1145.454545	402	201	35.2	10.05714286	0	0	3600											"$50 days 1 - 10, $0 after day 10, unlimited coverage"	"$50 days 1 - 10, $0 after day 10, unlimited coverage"	"$0 days 1 - 7, $75 days 8 - 100"	Copay between $0.00 and $15.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$50.00 copayment	20% coinsurance	Copay between $5.00 and $25.00	$0.00 copayment	$15.00 copayment	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	Copay between $0.00 and $10.00											25.26052317	9.995240631	46.76	0	37.72456905	0.2	0.2	18.83104146	21.03976335	0	8.805246728	36.17415527	0.2	6.418339226	0	4.112833128	11.06747074	4.803973443	6.925277008	0	0.2	0	0	0	0	0	25	0	0	0	0											3.9543	0.115386001	6.190588654	0	2.599169362	2.403656776	0.600087035	1.409759195	0.449366606	0	0.743464921	0.066268006	0.054534555	0.18098983	0	9.443628387	0.964056733	2.391301605	2.690487136	0	5.695583421	0	0	0	0	0	0.073333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.026	0	0	3.9543	0.115386001	6.190588654	0	2.599169362	2.403656776	0.600087035	1.409759195	0.449366606	0	0.743464921	0.066268006	0.054534555	0.18098983	0	9.443628387	0.964056733	2.391301605	2.690487136	0	5.695583421	0	0	0	0	0	0.073333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.026	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	3.9543	0.115386001	6.190588654	0	2.599169362	2.403656776	0.600087035	1.409759195	0.449366606	0	0.743464921	0.066268006	0.054534555	0.18098983	0	9.443628387	0.964056733	2.391301605	2.690487136	0	5.695583421	0	0	0	0	0	0.073333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.026
H3361_059_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1925.176499	92.50826918	1055.379445	1328.800553	643.9146916	11.90628143	2.581892125	1300.060966	290.8642311	7246.496015	1398.332586	15.581098	0.028098835	314.4329253	8402.831738	17589.82894	546.2657175	2522.608518	4719.118505	944.412844	20.95363917	18.42770061	0	1145.454545	402	201	105.6	10.05714286	0	1600	0											"$100 days 1 - 10, $0 after day 10, unlimited coverage"	"$100 days 1 - 10, $0 after day 10, unlimited coverage"	Standard Medicare	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $20.00 and $75.00	$0.00 copayment	Copay between $0.00 and $50.00	$100.00 copayment	20% coinsurance	Copay between $10.00 and $20.00	Copay between $0.00 and $10.00	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $10.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$35.00 copayment	$0.00 copayment	N/A	$0.00 copayment	Copay between $0.00 and $10.00											51.45752977	33.27657147	30.26	0	48.99107648	0.2	0.2	17.72793578	46.39383351	0	7.636031804	72.34831054	0.2	6.564743728	3.715846463	6.695811082	14.78661707	6.424611525	5.700039326	0	0.2	0	0	0	0	0	35	0	0	0	0											8.2554	0.256529836	2.661315168	0	2.628839492	2.381256285	0.516378425	1.920616442	1.124525559	0	0.889809342	0.093938843	0.005619767	0.172014298	2.601969383	9.81484763	0.673118498	1.35056498	2.241596755	0	4.190727833	0	0	0	0	0	0.308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.0871	0	0	8.2554	0.256529836	2.661315168	0	2.628839492	2.381256285	0.516378425	1.920616442	1.124525559	0	0.889809342	0.093938843	0.005619767	0.172014298	2.601969383	9.81484763	0.673118498	1.35056498	2.241596755	0	4.190727833	0	0	0	0	0	0.308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.0871	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	8.2554	0.256529836	2.661315168	0	2.628839492	2.381256285	0.516378425	1.920616442	1.124525559	0	0.889809342	0.093938843	0.005619767	0.172014298	2.601969383	9.81484763	0.673118498	1.35056498	2.241596755	0	4.190727833	0	0	0	0	0	0.308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.0871
H3361_065_0	2008	9																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		483.6920469	61.55321126	1718.834871	19.50384743	20.17472719	23.83509079	2.359519321	38.96172231	17.60516402	9.843267837	18.77932316	17.54232052	0.596172464	8.377795025	9209.273141	100.1668068	28.06615801	14.21963007	27.57784095	6.272598714	26.20586255	0.261145191	0	0	0	0	0	0	0	423.6	13.44											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											703.8966939	708.4	30.26	0.138885237	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.199395605	0.007641631	0.2	0.2	0	0	0	0	0	0	0	0	0											28.3724	3.633691238	4.3343286	2.708796474	4.034945438	4.767018157	0.471903864	7.792344463	3.521032804	1.968653567	3.755864632	0	0.119234493	1.675559005	0	20.03336136	5.613231601	2.843926014	5.498900276	0.047932885	5.241172511	0.052229038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.4866	0	0	28.3724	3.633691238	4.3343286	2.708796474	4.034945438	4.767018157	0.471903864	7.792344463	3.521032804	1.968653567	3.755864632	0	0.119234493	1.675559005	0	20.03336136	5.613231601	2.843926014	5.498900276	0.047932885	5.241172511	0.052229038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.4866	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	28.3724	3.633691238	4.3343286	2.708796474	4.034945438	4.767018157	0.471903864	7.792344463	3.521032804	1.968653567	3.755864632	0	0.119234493	1.675559005	0	20.03336136	5.613231601	2.843926014	5.498900276	0.047932885	5.241172511	0.052229038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.4866
H3361_076_0	2008	7																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1546.767212	72.55417313	1707.831818	2028.198453	794.4274187	12.16633851	3.528323603	945.4417776	270.6450706	5595.080762	1042.965167	38.94960386	0.102442192	451.6952892	7384.620373	22171.52543	753.3139173	4872.638684	4186.963497	802.0932284	30.74947402	21.31480734	0	1145.454545	402	201	35.2	10.05714286	0	1600	3600											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $100.00	$0.00 copayment	Copay between $0.00 and $100.00	$150.00 copayment	20% coinsurance	Copay between $10.00 and $100.00	Copay between $0.00 and $10.00	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $10.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	Copay between $0.00 and $15.00											65.80632685	33.3489557	31.17	0	39.99651808	0.2	0.2	19.65457595	75.39002455	0	17.32712405	108.5224658	0.2	20.546221	4.08329009	5.484995572	16.02133768	6.484445692	6.866865416	0	0.2	0	0	0	0	0	25	0	0	0	0											8.4823	0.201633825	4.436093148	0	2.647860884	2.433267702	0.705664721	1.548521435	1.70032821	0	1.505965568	0.352242254	0.020488438	0.773385936	2.512795599	10.13422656	1.005758054	2.633030077	2.395942903	0	6.149894804	0	0	0	0	0	0.073333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7127	0	0	8.4823	0.201633825	4.436093148	0	2.647860884	2.433267702	0.705664721	1.548521435	1.70032821	0	1.505965568	0.352242254	0.020488438	0.773385936	2.512795599	10.13422656	1.005758054	2.633030077	2.395942903	0	6.149894804	0	0	0	0	0	0.073333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7127	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	8.4823	0.201633825	4.436093148	0	2.647860884	2.433267702	0.705664721	1.548521435	1.70032821	0	1.505965568	0.352242254	0.020488438	0.773385936	2.512795599	10.13422656	1.005758054	2.633030077	2.395942903	0	6.149894804	0	0	0	0	0	0.073333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7127
H3361_077_0	2008	7																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1783.651745	67.79538259	1300.178693	1466.485429	749.3978294	11.81561115	2.675846291	1065.499734	263.4331177	3997.075431	1205.106398	28.33315348	0.068883551	276.3142076	8456.484446	19512.01748	665.8263542	3008.017075	4582.256154	888.7803811	21.78152515	13.83585476	0	1145.454545	402	201	35.2	10.05714286	0	1600	3604.397509											"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $75 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $20.00 and $50.00	$0.00 copayment	Copay between $0.00 and $50.00	$75.00 copayment	20% coinsurance	Copay between $10.00 and $20.00	$0.00 copayment	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	Copay between $0.00 and $15.00											33.45971717	20.7792458	46.76	0	42.19503064	0.2	0.2	17.66816153	33.73430919	0	7.331980166	54.26123291	0.2	6.343889263	0	5.737159642	16.75688387	6.41365892	6.515529876	0	0.2	0	0	0	0	0	25	0	0	0	0.004051278											4.9734	0.117394743	5.066362975	0	2.635072031	2.36312223	0.535169258	1.568785118	0.740561187	0	0.736318018	0.128115987	0.01377671	0.146075561	0	9.328629933	0.929764575	1.607699629	2.487985573	0	4.35630503	0	0	0	0	0	0.073333333	0	0	0	0.001216868	0	0	0	0	0	0	0	0	0	0	37.8091	0	0	4.9734	0.117394743	5.066362975	0	2.635072031	2.36312223	0.535169258	1.568785118	0.740561187	0	0.736318018	0.128115987	0.01377671	0.146075561	0	9.328629933	0.929764575	1.607699629	2.487985573	0	4.35630503	0	0	0	0	0	0.073333333	0	0	0	0.001216868	0	0	0	0	0	0	0	0	0	0	37.8091	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	4.9734	0.117394743	5.066362975	0	2.635072031	2.36312223	0.535169258	1.568785118	0.740561187	0	0.736318018	0.128115987	0.01377671	0.146075561	0	9.328629933	0.929764575	1.607699629	2.487985573	0	4.35630503	0	0	0	0	0	0.073333333	0	0	0	0.001216868	0	0	0	0	0	0	0	0	0	0	37.8091
H3361_084_0	2008	6																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		269.8963786	48.89410825	1288.604731	4389.000886	1010.680483	29.14077034	3.452589464	4502.176081	216.6418357	14327.40506	1463.060202	83.60269236	0	701.8654855	6042.970794	12649.42241	5274.104439	2029.628361	3608.066145	721.1717151	15.63789494	23.2766752	0	671.25	402	201	26.4	10.05714286	0	0	3600											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	48.85693509	0.2	0.2	18.4513781	0	0	5.412093886	0	0	0	0	0	0	0	3.25409858	0	0.2	0	0	20	0	0	20	0	0	0	0											0	0	0	0	4.114895896	5.828154069	0.690517893	6.922612763	0	0	0.659851598	0	0	0	0	0	0	0	0.97841691	0	3.127578988	0	0	1.11875	0	0	0.044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.4848	0	0	0	0	0	0	4.114895896	5.828154069	0.690517893	6.922612763	0	0	0.659851598	0	0	0	0	0	0	0	0.97841691	0	3.127578988	0	0	1.11875	0	0	0.044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.4848	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							12.7327		0											12.7327	0	0	0	0	0	0	4.114895896	5.828154069	0.690517893	6.922612763	0	0	0.659851598	0	0	0	0	0	0	0	0.97841691	0	3.127578988	0	0	1.11875	0	0	0.044	0	12.73270818	0	0	0	0	0	0	0	0	0	0	0	0	36.2175
H3361_086_0	2008	8																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		187.0684648	6.607250167	909.7645228	1970.114623	1047.774111	13.25852099	1.843282381	1145.719384	132.2216266	2911.909491	571.0625004	18.77877286	0.401163272	245.0665479	6102.6087	20443.15705	1250.073678	5734.663229	3463.555356	342.7428568	17.67056348	15.00485865	980	671.25	402	201	13.2	10.05714286	0	0	10800											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	Copay between $0.00 and $5.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	Copay between $0.00 and $5.00	$0.00 copayment	$5.00 copayment	$5.00 copayment	$5.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											0	0	0	0	30.60458129	0.2	0.2	16.09966928	0	0	6.725711871	0	0.2	1.005713973	0	1.288439289	3.942879674	1.533966331	6.764515989	0	0.2	0	0	20	0	0	0	0	0	0	0											0	0	0	0	2.672223997	2.651704199	0.368656476	1.537141931	0	0	0.32006682	0	0.080232654	0.020538904	0	2.194980561	0.410740841	0.733065026	1.952439632	0	3.534112697	0	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.5947	0	0	0	0	0	0	2.672223997	2.651704199	0.368656476	1.537141931	0	0	0.32006682	0	0.080232654	0.020538904	0	2.194980561	0.410740841	0.733065026	1.952439632	0	3.534112697	0	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.5947	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							12.3081		0											12.3081	0	0	0	0	0	0	2.672223997	2.651704199	0.368656476	1.537141931	0	0	0.32006682	0	0.080232654	0.020538904	0	2.194980561	0.410740841	0.733065026	1.952439632	0	3.534112697	0	0	1.11875	0	0	0	0	12.30812468	0	0	0	0	0	0	0	0	0	0	0	0	29.9028
H3361_098_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2070.843589	1001.996075	2197.241229	2886.924155	1459.147752	23.21273523	2.259674548	3472.088547	235.0013927	9910.253487	1285.355778	25.09527252	0.783908251	397.3408506	7868.831481	17957.0919	4873.878733	3591.067399	4422.506164	601.6953363	17.75817595	17.49395186	0	526.6666667	402	201	105.6	10.05714286	0	1600	3600											"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $75 days 8 - 100"	Copay between $0.00 and $15.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $15.00 and $50.00	$0.00 copayment	Copay between $0.00 and $50.00	$75.00 copayment	20% coinsurance	Copay between $5.00 and $15.00	$0.00 copayment	$15.00 copayment	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$0.00 copayment	$0.00 copayment	$35.00 copayment	$0.00 copayment	N/A	$0.00 copayment	Copay between $0.00 and $10.00											29.82131716	13.99620336	46.76	0	38.74216677	0.2	0.2	18.12985631	33.3381163	0	7.499157091	54.26123291	0.2	4.73001117	0	3.818983629	9.914092528	5.13480275	4.214429163	0	0.2	0	0	50	0	0	35	0	0	0	0											5.1463	1.168678403	8.561916655	0	4.710878797	4.642547045	0.45193491	5.245705539	0.652875313	0	0.803257075	0.113475036	0.15678165	0.156618888	0	5.714819999	4.026673728	1.536618563	1.553194912	0	3.551635189	0	0	2.194444444	0	0	0.308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.6963	0	0	5.1463	1.168678403	8.561916655	0	4.710878797	4.642547045	0.45193491	5.245705539	0.652875313	0	0.803257075	0.113475036	0.15678165	0.156618888	0	5.714819999	4.026673728	1.536618563	1.553194912	0	3.551635189	0	0	2.194444444	0	0	0.308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.6963	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							15.2975		0											15.2975	0	0	5.1463	1.168678403	8.561916655	0	4.710878797	4.642547045	0.45193491	5.245705539	0.652875313	0	0.803257075	0.113475036	0.15678165	0.156618888	0	5.714819999	4.026673728	1.536618563	1.553194912	0	3.551635189	0	0	2.194444444	0	0	0.308	0	15.29750566	0	0	0	0	0	0	0	0	0	0	0	0	65.9938
H3361_099_0	2008	8																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1912.85943	121.2923243	1429.292195	2473.507676	793.0393011	19.294215	3.660039734	1510.271951	346.4304302	10138.24878	1378.749802	20.9464156	0.04564942	359.2353257	11202.39805	20070.3737	708.2213714	3354.267788	4700.618951	996.5280818	24.78755746	25.77212941	0	526.6666667	402	201	105.6	10.05714286	0	1600	3600											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $30.00 and $75.00	$0.00 copayment	Copay between $0.00 and $50.00	$100.00 copayment	20% coinsurance	Copay between $20.00 and $30.00	$0.00 copayment	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$0.00 copayment	$0.00 copayment	$35.00 copayment	$0.00 copayment	N/A	$0.00 copayment	Copay between $0.00 and $30.00											43.98792846	21.68287637	30.26	0	48.47896213	0.2	0.2	17.62606658	49.54323215	0	9.948627545	72.34831054	0.2	9.633586618	0	9.162526841	21.63538379	9.638704442	6.953141547	0	0.2	0	0	50	0	0	35	0	0	0	0											7.0119	0.219163873	3.604198484	0	3.203810187	3.858842999	0.732007947	2.218346164	1.430273603	0	1.143055689	0.126286482	0.009129884	0.288393719	0	15.32461148	1.276886765	2.694232986	2.72367241	0	4.957511492	0	0	2.194444444	0	0	0.308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.3248	0	0	7.0119	0.219163873	3.604198484	0	3.203810187	3.858842999	0.732007947	2.218346164	1.430273603	0	1.143055689	0.126286482	0.009129884	0.288393719	0	15.32461148	1.276886765	2.694232986	2.72367241	0	4.957511492	0	0	2.194444444	0	0	0.308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.3248	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.1159		0											14.1159	0	0	7.0119	0.219163873	3.604198484	0	3.203810187	3.858842999	0.732007947	2.218346164	1.430273603	0	1.143055689	0.126286482	0.009129884	0.288393719	0	15.32461148	1.276886765	2.694232986	2.72367241	0	4.957511492	0	0	2.194444444	0	0	0.308	0	14.11589283	0	0	0	0	0	0	0	0	0	0	0	0	67.4407
H3361_101_0	2008	7																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		296.2172505	18.54899936	1769.46221	3794.381588	671.6254031	19.26405873	3.169594649	1954.549405	215.9761224	13123.21425	992.1377972	57.30253367	2.04609431	616.946547	7173.059533	17061.00625	887.6849613	3195.345241	4409.725162	834.3427917	22.07708475	42.42145588	0	671.25	402	201	26.4	10.05714286	0	1600	3600											"$100 per admission, unlimited coverage"	"$100 per admission, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $10.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $50.00 and $75.00	$0.00 copayment	Copay between $0.00 and $75.00	$100.00 copayment	20% coinsurance	Copay between $5.00 and $75.00	$0.00 copayment	$10.00 copayment	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	Copay between $0.00 and $15.00											70	70	31.17	0	47.67782551	0.2	0.2	17.07570009	60.01373361	0	9.210986676	72.34831054	0.2	15.86487697	0	3.093052896	5.943027355	3.383384669	5.867427379	0	0.2	0	0	20	0	0	20	0	0	0	0											1.7279	0.108202496	4.596178091	0	2.668469898	3.852811745	0.63391893	2.781274954	1.08012779	0	0.761547336	0.345478458	0.409218862	0.815648422	0	4.397549566	0.439628001	0.900923508	2.156145179	0	4.415416951	0	0	1.11875	0	0	0.044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2532	0	0	1.7279	0.108202496	4.596178091	0	2.668469898	3.852811745	0.63391893	2.781274954	1.08012779	0	0.761547336	0.345478458	0.409218862	0.815648422	0	4.397549566	0.439628001	0.900923508	2.156145179	0	4.415416951	0	0	1.11875	0	0	0.044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2532	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	1.7279	0.108202496	4.596178091	0	2.668469898	3.852811745	0.63391893	2.781274954	1.08012779	0	0.761547336	0.345478458	0.409218862	0.815648422	0	4.397549566	0.439628001	0.900923508	2.156145179	0	4.415416951	0	0	1.11875	0	0	0.044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2532
H3361_102_0	2008	8																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		280.2376205	13.14730652	1456.765349	2874.315727	553.3315181	14.83739695	2.31987555	1570.342031	170.5276423	9946.117084	845.2842221	40.53917382	1.460102451	522.7461075	6950.865565	12589.09014	570.8193199	2137.255752	3738.581249	731.0943276	17.78025442	30.01267717	0	526.6666667	402	201	26.4	10.05714286	0	0	0											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	"$0 days 1 - 7, $25 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	Copay between $0.00 and $30.00	$0.00 copayment	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	Copay between $0.00 and $30.00											0	0	15.59	0	48.13079002	0.2	0.2	17.99381502	0	0	7.911133883	0	0.2	4.633728888	0	9.19762565	18.23315771	10.24483878	7.998032808	0	0.2	0	0	50	0	0	20	0	0	0	0											0	0	1.892580982	0	2.219356926	2.96747939	0.46397511	2.354703669	0	0	0.557263054	0	0.29202049	0.201855312	0	9.649144867	0.86731989	1.824653385	2.491774624	0	3.556050884	0	0	2.194444444	0	0	0.044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.5766	0	0	0	0	1.892580982	0	2.219356926	2.96747939	0.46397511	2.354703669	0	0	0.557263054	0	0.29202049	0.201855312	0	9.649144867	0.86731989	1.824653385	2.491774624	0	3.556050884	0	0	2.194444444	0	0	0.044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.5766	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							11.1227		0											11.1227	0	0	0	0	1.892580982	0	2.219356926	2.96747939	0.46397511	2.354703669	0	0	0.557263054	0	0.29202049	0.201855312	0	9.649144867	0.86731989	1.824653385	2.491774624	0	3.556050884	0	0	2.194444444	0	0	0.044	0	11.1227266	0	0	0	0	0	0	0	0	0	0	0	0	42.6993
H3361_104_0	2008	9																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1717.602846	85.22033158	1687.507772	1989.460724	815.3362823	14.49999589	3.110507379	1201.015707	277.6035536	5553.423442	1061.347561	39.51436869	0.094724331	335.8704865	8201.906634	20721.38575	745.0096774	3617.776025	4222.922471	837.9721708	24.75695182	16.32176727	0	526.6666667	402	201	35.2	10.05714286	0	1600	3600											"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $75 days 8 - 100"	Copay between $0.00 and $25.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$50.00 copayment	20% coinsurance	Copay between $15.00 and $25.00	$0.00 copayment	$25.00 copayment	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	Copay between $0.00 and $30.00											21.32331097	10.94835022	46.76	0	40.15910198	0.2	0.2	18.31020828	21.26621134	0	9.280764548	36.17415527	0.2	7.518493969	0	6.658288975	20.87004622	7.963862178	7.306051071	0	0.2	0	0	50	0	0	25	0	0	0	0											3.0521	0.077751836	6.575655286	0	2.728597742	2.899999178	0.622101476	1.832570645	0.491964653	0	0.820843068	0.119116576	0.018944866	0.210436686	0	11.49741452	1.295698867	2.400955804	2.571073937	0	4.951390364	0	0	2.194444444	0	0	0.073333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4344	0	0	3.0521	0.077751836	6.575655286	0	2.728597742	2.899999178	0.622101476	1.832570645	0.491964653	0	0.820843068	0.119116576	0.018944866	0.210436686	0	11.49741452	1.295698867	2.400955804	2.571073937	0	4.951390364	0	0	2.194444444	0	0	0.073333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4344	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							12.7385		0											12.7385	0	0	3.0521	0.077751836	6.575655286	0	2.728597742	2.899999178	0.622101476	1.832570645	0.491964653	0	0.820843068	0.119116576	0.018944866	0.210436686	0	11.49741452	1.295698867	2.400955804	2.571073937	0	4.951390364	0	0	2.194444444	0	0	0.073333333	0	12.73848841	0	0	0	0	0	0	0	0	0	0	0	0	57.1729
H3361_105_0	2008	7																																D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	P	T	V	V	P	V	P	P	P	P																																																				0									1121						4224.775854		13865.72464	1587.53087	2566.981791																								100% Covered	100% Covered	100% Covered	100% Covered	100% Covered	100% Covered	100% Covered	"$50 ER Copay, $10 UC Copay"	100% Covered	100% Covered	100% Covered	100% Covered	100% Covered	"$10 OP Rehab, $20 MH/SA Copay"	100% Covered	$10 Specialist Copay	$20 MH Copay	$10 Therapy (PT/OT/ST) Copay	100% Covered	$10 Specialist Copay	100% Covered	100% Covered	Not Covered	Not Covered	100% Covered	100% Covered	100% Covered	100% Covered	Not Covered	100% Covered	100% Covered																		46						6.5144		10	20	10																								0	0	0	0	0	0	0	4.297166667	0	0	0	0	0	2.293476389	0	11.55477053	2.645884783	2.139151492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.9304	0	0	0	0	0	0	0	0	0	4.297166667	0	0	0	0	0	2.293476389	0	11.55477053	2.645884783	2.139151492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.9304																																																																																				0	0	0	0	0	0	0	0	0	0	4.297166667	0	0	0	0	0	2.293476389	0	11.55477053	2.645884783	2.139151492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.9304
H3361_106_0	2008	7																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		353.1706827	6.219590315	1282.69487	1605.963284	818.4484638	8.902679581	1.913330246	953.0287098	148.8853843	2469.943129	627.077794	11.69877486	2.274255275	181.0752577	7554.865123	17618.09951	912.2339498	4730.31969	4135.059504	434.5750159	17.77969097	9.666968252	980	526.6666667	402	201	26.4	10.05714286	0	1600	7380											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $10.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	Copay between $0.00 and $10.00	$0.00 copayment	$10.00 copayment	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	Copay between $0.00 and $15.00											0	0	31.17	0.02358781	37.85898439	0.2	0.2	15.97541158	0	0	6.512163159	0	0.2	2.019181966	0	2.773651528	7.548227295	3.058227559	6.704344401	0	0.2	0	0	50	0	0	20	0	0	0	0											0	0	3.331799926	0.003156763	2.582135634	1.780535916	0.382666049	1.268752158	0	0	0.340302742	0	0.454851055	0.030468658	0	4.072205718	0.573812433	1.205532836	2.310238586	0	3.555938193	0	0	2.194444444	0	0	0.044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.1308	0	0	0	0	3.331799926	0.003156763	2.582135634	1.780535916	0.382666049	1.268752158	0	0	0.340302742	0	0.454851055	0.030468658	0	4.072205718	0.573812433	1.205532836	2.310238586	0	3.555938193	0	0	2.194444444	0	0	0.044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.1308	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							15.9682		0											15.9682	0	0	0	0	3.331799926	0.003156763	2.582135634	1.780535916	0.382666049	1.268752158	0	0	0.340302742	0	0.454851055	0.030468658	0	4.072205718	0.573812433	1.205532836	2.310238586	0	3.555938193	0	0	2.194444444	0	0	0.044	0	15.96822152	0	0	0	0	0	0	0	0	0	0	0	0	40.0991
H3361_107_0	2008	8																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		319.8899523	15.55094431	812.6266032	848.4499654	650.4930475	4.194594485	1.172698623	730.2589072	132.0468388	1885.424206	516.8384915	6.662307601	0.210530169	160.4575074	8338.9472	12013.83766	521.9291794	2686.745634	3588.982821	362.1989739	13.14153646	4.878219185	980	526.6666667	402	201	26.4	10.05714286	0	1600	7380.795005											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	"$0 days 1 - 7, $50 days 8 - 100"	Copay between $0.00 and $10.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	Copay between $0.00 and $10.00	$0.00 copayment	$10.00 copayment	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	Copay between $0.00 and $15.00											0	0	31.17	0.01109239	42.48986213	0.2	0.2	15.79489939	0	0	5.964555076	0	0.2	2.414720975	0	3.083057929	7.696872639	3.067072853	6.22174975	0	0.2	0	0	50	0	0	20	0	0	0	0.000357672											0	0	2.110797602	0.000784278	2.303279992	0.838918897	0.234539725	0.961197164	0	0	0.256892637	0	0.042106034	0.032288342	0	3.086613122	0.334768535	0.686703716	1.860812747	0	2.628307293	0	0	2.194444444	0	0	0.044	0	0	0	0.000219992	0	0	0	0	0	0	0	0	0	0	17.6167	0	0	0	0	2.110797602	0.000784278	2.303279992	0.838918897	0.234539725	0.961197164	0	0	0.256892637	0	0.042106034	0.032288342	0	3.086613122	0.334768535	0.686703716	1.860812747	0	2.628307293	0	0	2.194444444	0	0	0.044	0	0	0	0.000219992	0	0	0	0	0	0	0	0	0	0	17.6167	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							14.2238		0											14.2238	0	0	0	0	2.110797602	0.000784278	2.303279992	0.838918897	0.234539725	0.961197164	0	0	0.256892637	0	0.042106034	0.032288342	0	3.086613122	0.334768535	0.686703716	1.860812747	0	2.628307293	0	0	2.194444444	0	0	0.044	0	14.22375359	0	0.000219992	0	0	0	0	0	0	0	0	0	0	31.8404
H3361_109_0	2008	8																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		399.0069902	11.63591952	794.6992694	17.23236898	13.78798034	5.658023542	1.225227391	12.39807001	15.38320844	2.269585529	10.06634939	1.850288635	0.275763546	5.025858839	10725.85852	90.3921043	5.536233294	11.81044392	41.93765304	7.530182131	11.68501362	0.032703838	980	671.25	0	0	0	0	0	38023.6	43.59											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											707.999008	708.4	30.26	0.19408207	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.198209728	0.001435998	0.2	0.2	0	20	0	0	0	0	0	0	0											23.5414	0.686907116	2.003966658	3.344493848	2.757596068	1.131604708	0.245045478	2.479614002	3.076641687	0.453917106	2.013269879	0	0.055152709	1.005171768	0	18.07842086	1.107246659	2.362088783	8.312450814	0.010813329	2.337002723	0.006540768	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1281	0	0	23.5414	0.686907116	2.003966658	3.344493848	2.757596068	1.131604708	0.245045478	2.479614002	3.076641687	0.453917106	2.013269879	0	0.055152709	1.005171768	0	18.07842086	1.107246659	2.362088783	8.312450814	0.010813329	2.337002723	0.006540768	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1281	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	23.5414	0.686907116	2.003966658	3.344493848	2.757596068	1.131604708	0.245045478	2.479614002	3.076641687	0.453917106	2.013269879	0	0.055152709	1.005171768	0	18.07842086	1.107246659	2.362088783	8.312450814	0.010813329	2.337002723	0.006540768	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1281
H3361_110_0	2008	8																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		337.4382091	24.28286804	712.4111832	22.85938475	14.68736102	8.385263018	1.477777618	18.35294613	10.23941188	3.311127207	8.140061968	7.10245939	0.734084628	4.528671675	10980.67992	92.22687731	12.44866554	22.59189279	42.65552496	7.572275918	14.62584715	0.119726401	980.982771	671.25	0	0	0	0	0	38023.6	43.61899253											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.3071537	708.4	30.26	0.182926252	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.198932926	0.00269951	0.2	0.2	0	20	0	0	0	0	0	0	0											19.9175	1.433498643	1.796463534	4.181581567	2.937472204	1.677052604	0.295555524	3.670589226	2.047882376	0.662225441	1.628012394	0	0.146816926	0.905734335	0	18.44537546	2.489733109	4.518378558	8.485588376	0.020441434	2.92516943	0.02394528	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3278	0	0	19.9175	1.433498643	1.796463534	4.181581567	2.937472204	1.677052604	0.295555524	3.670589226	2.047882376	0.662225441	1.628012394	0	0.146816926	0.905734335	0	18.44537546	2.489733109	4.518378558	8.485588376	0.020441434	2.92516943	0.02394528	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3278	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	19.9175	1.433498643	1.796463534	4.181581567	2.937472204	1.677052604	0.295555524	3.670589226	2.047882376	0.662225441	1.628012394	0	0.146816926	0.905734335	0	18.44537546	2.489733109	4.518378558	8.485588376	0.020441434	2.92516943	0.02394528	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3278
H3361_111_0	2008	8																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		339.7033741	23.89208378	974.2862243	23.89976265	12.16221607	10.2216339	2.593802884	18.68115859	15.44617372	3.059915922	7.244031858	7.34519697	0.761655805	5.002646229	11637.54431	114.2104689	13.68233994	24.54262546	54.53377437	7.578096384	10.829735	0.121678739	981.0755309	671.25	0	0	0	0	0	38023.6	43.59396176											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.3541093	708.4	30.26	0.182838151	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.199168076	0.002873126	0.2	0.2	0	20	0	0	0	0	0	0	0											20.0525	1.410429346	2.456825096	4.369788424	2.432443215	2.044326781	0.518760577	3.736231719	3.089234744	0.611983184	1.448806372	0	0.152331161	1.000529246	0	22.84209378	2.736467989	4.908525092	10.86138694	0.021772827	2.165947	0.024335748	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.0035	0	0	20.0525	1.410429346	2.456825096	4.369788424	2.432443215	2.044326781	0.518760577	3.736231719	3.089234744	0.611983184	1.448806372	0	0.152331161	1.000529246	0	22.84209378	2.736467989	4.908525092	10.86138694	0.021772827	2.165947	0.024335748	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.0035	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	20.0525	1.410429346	2.456825096	4.369788424	2.432443215	2.044326781	0.518760577	3.736231719	3.089234744	0.611983184	1.448806372	0	0.152331161	1.000529246	0	22.84209378	2.736467989	4.908525092	10.86138694	0.021772827	2.165947	0.024335748	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.0035
H3361_112_0	2008	8																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2072.260465	128.2176228	1617.98822	2045.682075	840.3318029	13.39386995	3.352697494	759.4480023	166.2818548	2953.222476	684.4344847	80.17328093	0.206762755	254.3633565	10025.61747	31852.83366	1065.099338	8135.755064	5120.136572	666.4721275	30.66682465	37.92266701	0	526.6666667	402	201	35.2	10.05714286	0	0	3600											"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$50.00 copayment	20% coinsurance	Copay between $10.00 and $25.00	$0.00 copayment	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											17.11255108	7.923603524	58.91045398	0	23.5037794	0.188966973	0.188966973	15.77288549	20.0802138	0	8.053074995	34.1786032	0.188966973	6.836546647	0	4.662220065	15.19269986	5.682173045	8.581174981	0	0.188966973	0	0	47.24174337	0	0	23.62087168	0	0	0	0											2.9551	0.084662134	7.943035048	0	1.645914443	2.530999068	0.633549098	0.998223865	0.278247933	0	0.459316853	0.228350896	0.039071332	0.144913913	0	12.37541002	1.348477879	3.852397344	3.661398988	0	5.79501704	0	0	2.073387626	0	0	0.06928789	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1168	0	2.750961687	2.9551	0.084662134	7.943035048	0	1.645914443	2.530999068	0.633549098	0.998223865	0.278247933	0	0.459316853	0.228350896	0.039071332	0.144913913	0	12.37541002	1.348477879	3.852397344	3.661398988	0	5.79501704	0	0	2.073387626	0	0	0.06928789	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1168	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							17.7501		0											17.7501	0	0	2.9551	0.084662134	7.943035048	0	1.645914443	2.530999068	0.633549098	0.998223865	0.278247933	0	0.459316853	0.228350896	0.039071332	0.144913913	0	12.37541002	1.348477879	3.852397344	3.661398988	0	5.79501704	0	0	2.073387626	0	0	0.06928789	0	17.75008231	0	0	0	0	0	0	0	0	0	0	0	0	64.8669
H3361_113_0	2008	7																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1779.794655	98.68023007	2171.143638	2378.821894	687.8260075	16.83612976	3.379263764	1290.577824	265.175373	8508.683941	982.7747416	10.29739146	0.0303466	389.8125613	7650.376688	18241.11287	486.4718778	3745.659511	4642.923403	755.5865022	28.78084481	38.6768131	0	526.6666667	402	201	35.2	10.05714286	0	0	3600											"$150 days 1 - 3, $0 after day 3, unlimited coverage"	"$150 days 1 - 3, $0 after day 3, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $20.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $20.00 and $100.00	$0.00 copayment	Copay between $0.00 and $50.00	$150.00 copayment	20% coinsurance	Copay between $10.00 and $20.00	Copay between $0.00 and $5.00	$20.00 copayment	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											43.87469492	20.88501	58.5614737	0	41.52200236	0.18784755	0.18784755	16.77035832	55.58507979	0	6.881148501	101.9283966	0.18784755	5.855906297	2.005116282	5.188223713	14.83247063	6.073958907	6.139449906	0	0.18784755	0	0	46.96188749	0	0	23.48094375	0	0	0	0											6.5073	0.171744799	10.59544759	0	2.379992759	3.162625726	0.634786419	1.803621046	1.228316189	0	0.563551578	0.087466383	0.005700535	0.190225486	1.278324572	7.886581194	0.60129832	1.895915163	2.375416304	0	5.406411183	0	0	2.061105062	0	0	0.068877435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9047	0	3.163801546	6.5073	0.171744799	10.59544759	0	2.379992759	3.162625726	0.634786419	1.803621046	1.228316189	0	0.563551578	0.087466383	0.005700535	0.190225486	1.278324572	7.886581194	0.60129832	1.895915163	2.375416304	0	5.406411183	0	0	2.061105062	0	0	0.068877435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9047	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							13.2487		0											13.2487	0	0	6.5073	0.171744799	10.59544759	0	2.379992759	3.162625726	0.634786419	1.803621046	1.228316189	0	0.563551578	0.087466383	0.005700535	0.190225486	1.278324572	7.886581194	0.60129832	1.895915163	2.375416304	0	5.406411183	0	0	2.061105062	0	0	0.068877435	0	13.24871702	0	0	0	0	0	0	0	0	0	0	0	0	62.1535
H3361_114_0	2008	7																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2045.948844	126.50818	1596.756877	2017.57718	828.9054469	13.13010335	3.289517078	751.2875099	163.9740036	2912.599195	678.2879341	79.21159946	0.202691	253.2441218	9897.439179	32150.07325	1110.099603	8354.210367	5094.675525	657.4316942	30.05501798	37.44460771	0	526.6666667	402	201	35.2	10.05714286	0	0	3600											"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $10.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$25.00 copayment	20% coinsurance	Copay between $5.00 and $25.00	$0.00 copayment	$10.00 copayment	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											8.780373961	4.066212891	60.44984121	0	24.11106779	0.193904864	0.193904864	16.18589823	20.60492924	0	7.018036226	17.53586161	0.193904864	5.913443212	0	2.460789916	7.808079647	2.915523353	7.669338871	0	0.193904864	0	0	48.47621589	0	0	24.23810794	0	0	0	0											1.497	0.042867433	8.043641637	0	1.665482952	2.545990899	0.63785336	1.013355265	0.281556062	0	0.396687441	0.115753637	0.039302771	0.124795394	0	6.592881338	0.722312176	2.029741285	3.256066087	0	5.827814161	0	0	2.127567253	0	0	0.07109845	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.0318	0	1.164043912	1.497	0.042867433	8.043641637	0	1.665482952	2.545990899	0.63785336	1.013355265	0.281556062	0	0.396687441	0.115753637	0.039302771	0.124795394	0	6.592881338	0.722312176	2.029741285	3.256066087	0	5.827814161	0	0	2.127567253	0	0	0.07109845	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.0318	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							17.613		0											17.613	0	0	1.497	0.042867433	8.043641637	0	1.665482952	2.545990899	0.63785336	1.013355265	0.281556062	0	0.396687441	0.115753637	0.039302771	0.124795394	0	6.592881338	0.722312176	2.029741285	3.256066087	0	5.827814161	0	0	2.127567253	0	0	0.07109845	0	17.61296071	0	0	0	0	0	0	0	0	0	0	0	0	54.6447
H3361_115_0	2008	9																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1492.210165	149.3095971	1811.758614	2741.206314	1037.300962	15.77984415	3.575044196	1256.405708	269.3493903	2839.391001	712.6013874	7.974057105	0.250012116	381.1878046	12783.04126	23387.58102	553.4855706	4837.380732	5078.124714	882.1088836	30.52302987	52.275686	0	526.6666667	402	201	35.2	10.05714286	0	0	3600											"$150 days 1 - 3, $0 after day 3, unlimited coverage"	"$150 days 1 - 3, $0 after day 3, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $30.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $30.00 and $100.00	$0.00 copayment	Copay between $0.00 and $50.00	$150.00 copayment	20% coinsurance	Copay between $20.00 and $30.00	$0.00 copayment	$30.00 copayment	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											46.43905183	20.66858889	57.73833314	0	25.48910851	0.185207163	0.185207163	16.53896333	54.51642257	0	8.357031192	100.4956902	0.185207163	8.757281603	0	6.611056136	20.64869625	8.446198262	8.961830324	0	0.185207163	0	0	46.30179081	0	0	23.1508954	0	0	0	0											5.7747	0.257168223	8.717326867	0	2.203323065	2.922540171	0.662123794	1.731637327	1.223663765	0	0.496269335	0.066779864	0.046304035	0.278180746	0	12.88471758	0.952396286	3.404789728	3.792441004	0	5.653083775	0	0	2.032134152	0	0	0.067909293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1675	0	4.246587966	5.7747	0.257168223	8.717326867	0	2.203323065	2.922540171	0.662123794	1.731637327	1.223663765	0	0.496269335	0.066779864	0.046304035	0.278180746	0	12.88471758	0.952396286	3.404789728	3.792441004	0	5.653083775	0	0	2.032134152	0	0	0.067909293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1675	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	25% coinsurance	N/A	N/A																																							11.0429		0											11.0429	0	0	5.7747	0.257168223	8.717326867	0	2.203323065	2.922540171	0.662123794	1.731637327	1.223663765	0	0.496269335	0.066779864	0.046304035	0.278180746	0	12.88471758	0.952396286	3.404789728	3.792441004	0	5.653083775	0	0	2.032134152	0	0	0.067909293	0	11.04292736	0	0	0	0	0	0	0	0	0	0	0	0	64.2105
H3361_116_0	2008	7																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	V	V	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		345.8484131	68.49547709	2836.132052	27.07259498	15.40120313	19.25526943	2.69309057	23.60714433	13.52062625	5.576572132	13.46504379	73.09265766	3.648404392	4.760880636	10239.50969	119.8167254	46.87676771	24.55289719	34.07005089	5.030632866	16.75042087	0.077857386	780	671.25	0	0	13.2	0	0	423.6	6.44											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	20% coinsurance	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											708.4	708.4	30.26	0.112380767	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.2	0.2	0.19903234	0.008132068	0.2	0.2	0	20	0	0	0	0	0	0	0											20.4166	4.043516331	7.151779657	3.042438979	3.080240627	3.851053886	0.538618114	4.721428866	2.704125251	1.115314426	2.693008758	0	0.729680878	0.952176127	0	23.96334508	9.375353541	4.910579438	6.781041968	0.040909449	3.350084173	0.015571477	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.5956	0	0	20.4166	4.043516331	7.151779657	3.042438979	3.080240627	3.851053886	0.538618114	4.721428866	2.704125251	1.115314426	2.693008758	0	0.729680878	0.952176127	0	23.96334508	9.375353541	4.910579438	6.781041968	0.040909449	3.350084173	0.015571477	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.5956	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	20.4166	4.043516331	7.151779657	3.042438979	3.080240627	3.851053886	0.538618114	4.721428866	2.704125251	1.115314426	2.693008758	0	0.729680878	0.952176127	0	23.96334508	9.375353541	4.910579438	6.781041968	0.040909449	3.350084173	0.015571477	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.5956
H3361_117_0	2008	6																					2000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	Coin	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2416.517008	948.8283153	2712.977024	2370.645716	1624.513299	18.27248607	2.324015306	2173.890971	159.388195	5273.191077	956.1695372	64.85847788	3.141740345	264.3258365	9609.886718	25568.58903	6295.835635	5495.456941	4570.70742	430.3166629	14.42879096	4.709114107	0	526.6666667	402	201	35.2	10.05714286	0	0	3600											"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $5.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$25.00 copayment	20% coinsurance	Copay between $5.00 and $25.00	$0.00 copayment	$5.00 copayment	$5.00 copayment	$5.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$50.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											7.886399409	3.903755375	57.09532327	0	25.25917318	0.183144581	0.183144581	17.08106093	19.18383884	0	6.140878715	16.56275132	0.183144581	5.213220496	0	0.962747849	3.679700831	1.468619305	4.112639409	0	0.183144581	0	0	45.78614536	0	0	22.89307268	0	0	0	0											1.5881	0.308666136	12.90819168	0	3.419488562	3.346506814	0.42563081	3.094363679	0.254806454	0	0.489310097	0.08951957	0.575392721	0.114832406	0	2.051342007	1.930565968	0.67256118	1.566472622	0	2.64255488	0	0	2.009503047	0	0	0.067153013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.555	0	3.456314019	1.5881	0.308666136	12.90819168	0	3.419488562	3.346506814	0.42563081	3.094363679	0.254806454	0	0.489310097	0.08951957	0.575392721	0.114832406	0	2.051342007	1.930565968	0.67256118	1.566472622	0	2.64255488	0	0	2.009503047	0	0	0.067153013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.555	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	30% coinsurance	N/A	N/A																																							17.4906		0											17.4906	0	0	1.5881	0.308666136	12.90819168	0	3.419488562	3.346506814	0.42563081	3.094363679	0.254806454	0	0.489310097	0.08951957	0.575392721	0.114832406	0	2.051342007	1.930565968	0.67256118	1.566472622	0	2.64255488	0	0	2.009503047	0	0	0.067153013	0	17.49055552	0	0	0	0	0	0	0	0	0	0	0	0	55.0456
H3361_118_0	2008	7																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2081.09869	128.6608992	1508.722616	1930.791976	884.5798266	12.98681871	3.514944255	744.2970953	170.9556665	3037.471387	705.4188092	82.45234967	0.21298673	262.4929501	9520.771863	33617.51718	1160.466827	8764.706076	5301.620454	687.44272	31.71219572	39.05725101	0	671.25	402	201	35.2	10.05714286	0	1600	0											"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$50 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $15.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$25.00 copayment	$0.00 copayment	Copay between $0.00 and $50.00	$50.00 copayment	20% coinsurance	Copay between $5.00 and $25.00	Copay between $0.00 and $5.00	$15.00 copayment	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $5.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	Copay between $0.00 and $15.00											18.11226221	8.387972201	30.26	0	24.86499577	0.2	0.2	16.66355607	21.25261725	0	7.884877781	36.17415527	0.2	6.673728022	1.613337752	3.826437368	12.00353487	4.50408954	8.527580296	0	0.2	0	0	20	0	0	25	0	0	0	0											3.1411	0.08993367	3.804495529	0	1.832922804	2.597363743	0.702988851	1.033553032	0.302771279	0	0.463511758	0.248553675	0.042597346	0.14598388	1.280018389	10.71961033	1.160808669	3.289751747	3.76749951	0	6.342439144	0	0	1.11875	0	0	0.073333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.158	0	0	3.1411	0.08993367	3.804495529	0	1.832922804	2.597363743	0.702988851	1.033553032	0.302771279	0	0.463511758	0.248553675	0.042597346	0.14598388	1.280018389	10.71961033	1.160808669	3.289751747	3.76749951	0	6.342439144	0	0	1.11875	0	0	0.073333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.158	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	3.1411	0.08993367	3.804495529	0	1.832922804	2.597363743	0.702988851	1.033553032	0.302771279	0	0.463511758	0.248553675	0.042597346	0.14598388	1.280018389	10.71961033	1.160808669	3.289751747	3.76749951	0	6.342439144	0	0	1.11875	0	0	0.073333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.158
H3361_119_0	2008	7																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1447.084238	144.2235221	1583.914714	2494.488082	1049.410726	14.48954256	3.553727914	1211.611841	267.9462	2807.648345	706.982984	7.947939716	0.242131768	388.6831569	12180.56735	24232.89253	608.6995711	5127.651395	5118.047759	881.36921	29.93739999	52.12029885	0	1145.454545	402	201	35.2	10.05714286	0	0	3600											"$50 days 1 - 3, $0 after day 3, unlimited coverage"	"$50 days 1 - 3, $0 after day 3, unlimited coverage"	"$0 days 1 - 7, $100 days 8 - 100"	Copay between $0.00 and $15.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $15.00 and $25.00	$0.00 copayment	Copay between $0.00 and $50.00	$50.00 copayment	20% coinsurance	Copay between $5.00 and $15.00	$0.00 copayment	$15.00 copayment	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $50.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$25.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											16.1960574	7.207386889	60.3955185	0	26.65953941	0.193730613	0.193730613	17.23308065	18.92823559	0	7.869337107	35.04020632	0.193730613	4.584207829	0	3.645367687	10.48533258	4.412590143	7.426557453	0	0.193730613	0	0	0	0	0	24.21632659	0	0	0	0											1.9531	0.086622894	7.9717792	0	2.331400551	2.807067958	0.688465886	1.739983714	0.422645733	0	0.463623952	0.023208121	0.046908336	0.148483698	0	7.361483615	0.53186812	1.885518667	3.167456311	0	5.799790842	0	0	0	0	0	0.071034558	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5004	0	1.213565165	1.9531	0.086622894	7.9717792	0	2.331400551	2.807067958	0.688465886	1.739983714	0.422645733	0	0.463623952	0.023208121	0.046908336	0.148483698	0	7.361483615	0.53186812	1.885518667	3.167456311	0	5.799790842	0	0	0	0	0	0.071034558	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5004	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	1.9531	0.086622894	7.9717792	0	2.331400551	2.807067958	0.688465886	1.739983714	0.422645733	0	0.463623952	0.023208121	0.046908336	0.148483698	0	7.361483615	0.53186812	1.885518667	3.167456311	0	5.799790842	0	0	0	0	0	0.071034558	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5004
H3361_120_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1746.290205	125.493138	1223.590119	2218.451544	1073.268163	13.27982614	2.272673477	1170.967604	168.333446	3584.735143	699.0539483	20.1882717	0.422440142	273.5190069	6882.556572	24346.63345	1336.963236	6393.24896	4039.743808	449.5525735	22.92409845	16.65477024	980	1145.454545	0	0	0	0	0	1600	0											"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$200 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $15.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $100.00 and $150.00	$0.00 copayment	Copay between $0.00 and $150.00	$200.00 copayment	20% coinsurance	Copay between $5.00 and $150.00	Copay between $0.00 and $5.00	$15.00 copayment	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $5.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											70.00153463	33.10860392	30.26	0	31.79412373	0.2	0.2	16.48314773	120.1358996	0	21.10538407	144.6966211	0.2	27.04453028	1.802154322	3.839317969	11.1289636	4.637793135	10.63081618	0	0.2	0	0	0	0	0	0	0	0	0	0											10.1869	0.346241883	3.085486416	0	2.843635065	2.655965228	0.454534695	1.608436	1.685240831	0	1.229483506	0.243431225	0.084488028	0.616432755	1.03361909	7.789538942	1.239917933	2.470880512	3.578814487	0	4.58481969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7379	0	0	10.1869	0.346241883	3.085486416	0	2.843635065	2.655965228	0.454534695	1.608436	1.685240831	0	1.229483506	0.243431225	0.084488028	0.616432755	1.03361909	7.789538942	1.239917933	2.470880512	3.578814487	0	4.58481969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7379	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	10.1869	0.346241883	3.085486416	0	2.843635065	2.655965228	0.454534695	1.608436	1.685240831	0	1.229483506	0.243431225	0.084488028	0.616432755	1.03361909	7.789538942	1.239917933	2.470880512	3.578814487	0	4.58481969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7379
H3361_123_0	2008	8																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1484.545593	192.0354077	1237.557962	3025.446425	649.9968475	18.22086991	2.827708208	1771.93167	191.9524958	11708.22413	875.9678931	50.37576596	1.806250168	555.7746101	5744.13714	14368.18982	720.150295	2653.456701	3837.448443	750.063543	19.4641336	37.50038936	0	671.25	0	0	0	0	0	0	0											"$265 days 1 - 5, $0 after day 5, unlimited coverage"	"$265 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $35.00 and $150.00	$0.00 copayment	Copay between $0.00 and $75.00	$265.00 copayment	20% coinsurance	Copay between $25.00 and $35.00	Copay between $0.00 and $15.00	$35.00 copayment	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $15.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											111.5598295	53.8991092	30.26	0	47.67519243	0.2	0.2	17.093555	97.20289925	0	12.30038684	191.7230229	0.2	10.36665627	7.493193679	10.47612113	21.79231374	11.83266633	11.05467294	0	0.2	0	0	20	0	0	0	0	0	0	0											13.8013	0.862544784	3.120708661	0	2.582393732	3.644173982	0.565541642	2.524050955	1.554861592	0	0.897895329	0.804849511	0.361250034	0.480127029	3.586827676	12.54357475	1.307811764	2.616455646	3.535144789	0	3.892826719	0	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8011	0	0	13.8013	0.862544784	3.120708661	0	2.582393732	3.644173982	0.565541642	2.524050955	1.554861592	0	0.897895329	0.804849511	0.361250034	0.480127029	3.586827676	12.54357475	1.307811764	2.616455646	3.535144789	0	3.892826719	0	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8011	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	13.8013	0.862544784	3.120708661	0	2.582393732	3.644173982	0.565541642	2.524050955	1.554861592	0	0.897895329	0.804849511	0.361250034	0.480127029	3.586827676	12.54357475	1.307811764	2.616455646	3.535144789	0	3.892826719	0	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8011
H3361_124_0	2008	7																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1451.937713	80.3191138	1446.405228	1828.616026	703.5561638	15.69815624	3.163822853	1167.1645	243.6785165	7841.457418	887.3969867	9.413746239	0.028308884	352.1007373	6348.952878	16635.65918	440.296707	3415.860093	4231.467255	708.7405003	26.3525276	35.3954458	0	671.25	0	0	0	0	0	0	0											"$225 days 1 - 5, $0 after day 5, unlimited coverage"	"$225 days 1 - 5, $0 after day 5, unlimited coverage"	Standard Medicare	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	Copay between $35.00 and $150.00	$0.00 copayment	Copay between $0.00 and $75.00	$225.00 copayment	20% coinsurance	Copay between $25.00 and $35.00	Copay between $0.00 and $15.00	$35.00 copayment	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $15.00 and $75.00	$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	$0.00 copayment	$20.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											96.64560934	45.75294858	30.26	0	44.20134988	0.2	0.2	17.78041532	93.46751355	0	11.15171875	162.7836987	0.2	10.89461631	6.272244436	9.72700237	28.02356901	11.28799025	10.42194941	0	0.2	0	0	20	0	0	0	0	0	0	0											11.6936	0.306236357	3.647351851	0	2.591511013	3.139631248	0.632764571	1.729389129	1.898002087	0	0.824666801	0.127700369	0.005661777	0.31966687	3.318515363	13.48459135	1.028223763	3.213182953	3.67501147	0	5.27050552	0	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.025	0	0	11.6936	0.306236357	3.647351851	0	2.591511013	3.139631248	0.632764571	1.729389129	1.898002087	0	0.824666801	0.127700369	0.005661777	0.31966687	3.318515363	13.48459135	1.028223763	3.213182953	3.67501147	0	5.27050552	0	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.025	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A																																							0		0											0	0	0	11.6936	0.306236357	3.647351851	0	2.591511013	3.139631248	0.632764571	1.729389129	1.898002087	0	0.824666801	0.127700369	0.005661777	0.31966687	3.318515363	13.48459135	1.028223763	3.213182953	3.67501147	0	5.27050552	0	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.025
H3362_003_0	2008	12																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	176.72	3.36	0	1319.29	235.05	6.6	5.45	265.48	494.39	0	574.5	18.12	0	818.24	6604.36	2752.16	1.51	658.42	981.87	1210.6	1189.54	605.6	0	0	457	457	20.98	0	0	0	0											PBP: 1A IP Acute: $375 per admit	1B IP Psych: $375 per admit	2 SNF: 0%	6 Home Health: $10	10A Ambulance: $25	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $75	8A OP C/D/T: $0	8B OP X-Ray: $20	9A OP Hospital: $20	12 Renal Dialysis: $0	"3 CORF: $20, 5 Partial Hosp: $20, 9C OP Substance Abuse: $20, 9D Cardiac Rehab: $20"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, 14J Nutrition therapy $25"	7D Physician Specialist: $20	"7E Mental Health: 50%, 7H Psychiatric: 50%"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	Included in i.2.	"7B Chiropractic: $20, 7F Podiatry: $20, 7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $20"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $20, 17A Medicare Covered Eye Exams: $20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $5	17B Eye Wear: Medicare Covered: $60	18A Routine Hearing Exams: $20	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											375	375	0	10	25	0.125450379	0.094622022	47.04215007	75	0	20	20	0	20	10	20	0.499967042	20	20	19.72930778	12.974	20	0	0	5	34.62	20	0	0	0	0											5.5225	0.105	0	1.099408333	0.4896875	0.827972504	0.51569002	1.040729167	3.0899375	0	0.9575	0.0302	0	1.363733333	5.503633333	4.586933333	0.754950233	1.097366667	1.63645	1.990358333	1.286090997	1.009333333	0	0	0.190416667	1.318445	0.034966667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.4513	0	0	5.5225	0.105	0	1.099408333	0.4896875	0.827972504	0.51569002	1.040729167	3.0899375	0	0.9575	0.0302	0	1.363733333	5.503633333	4.586933333	0.754950233	1.097366667	1.63645	1.990358333	1.286090997	1.009333333	0	0	0.190416667	1.318445	0.034966667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.4513	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.5225	0.105	0	1.099408333	0.4896875	0.827972504	0.51569002	1.040729167	3.0899375	0	0.9575	0.0302	0	1.363733333	5.503633333	4.586933333	0.754950233	1.097366667	1.63645	1.990358333	1.286090997	1.009333333	0	0	0.190416667	1.318445	0.034966667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.4513
H3362_004_0	2008	12																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	176.89	3.36	0	1319.29	235.05	6.6	5.45	265.48	494.39	0	574.5	18.12	0	818.24	6604.36	2752.16	1.51	658.42	981.87	1210.6	1189.54	605.6	0	0	457	457	20.98	0	0	0	0											PBP: 1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: 0%	6 Home Health: $10	10A Ambulance: $25	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $35	8A OP C/D/T: $0	8B OP X-Ray: $20	9A OP Hospital: $20	12 Renal Dialysis: $0	"3 CORF: $20, 5 Partial Hosp: $20, 9C OP Substance Abuse: $20, 9D Cardiac Rehab: $20"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, 14J Nutrition therapy $25"	7D Physician Specialist: $20	"7E Mental Health: 50%, 7H Psychiatric: 50%"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	Included in i.2.	"7B Chiropractic: $20, 7F Podiatry: $20, 7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $20"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $20, 17A Medicare Covered Eye Exams: $20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $5	17B Eye Wear: Medicare Covered: $60	18A Routine Hearing Exams: $20	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											250	250	0	10	25	0.125450379	0.094622022	47.04215007	35	0	20	20	0	20	10	20	0.499967042	20	20	19.72930778	12.974	20	0	0	5	34.62	20	0	0	0	0											3.6852	0.07	0	1.099408333	0.4896875	0.827972504	0.51569002	1.040729167	1.441970833	0	0.9575	0.0302	0	1.363733333	5.503633333	4.586933333	0.754950233	1.097366667	1.63645	1.990358333	1.286090997	1.009333333	0	0	0.190416667	1.318445	0.034966667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.931	0	0	3.6852	0.07	0	1.099408333	0.4896875	0.827972504	0.51569002	1.040729167	1.441970833	0	0.9575	0.0302	0	1.363733333	5.503633333	4.586933333	0.754950233	1.097366667	1.63645	1.990358333	1.286090997	1.009333333	0	0	0.190416667	1.318445	0.034966667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.6852	0.07	0	1.099408333	0.4896875	0.827972504	0.51569002	1.040729167	1.441970833	0	0.9575	0.0302	0	1.363733333	5.503633333	4.586933333	0.754950233	1.097366667	1.63645	1.990358333	1.286090997	1.009333333	0	0	0.190416667	1.318445	0.034966667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.931
H3362_016_0	2008	3																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	176.89	3.36	0	1339.69	235.05	6.6	5.45	265.78	494.39	0	574.5	18.12	0.72	818.24	6707.26	2795.01	1.51	658.42	990.62	1210.6	1189.54	605.6	0	0	457	457	20.98	0	0	0	0											PBP: 1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: 0%	6 Home Health: $5	10A Ambulance: $25	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $35	8A OP C/D/T: $0	8B OP X-Ray: $20	9A OP Hospital: $20	12 Renal Dialysis: $20	"3 CORF: $20, 5 Partial Hosp: $20, 9C OP Substance Abuse: $20, 9D Cardiac Rehab: $20"	"7A PCP: $5, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, 14J Nutrition therapy $25"	7D Physician Specialist: $20	"7E Mental Health: 50%, 7H Psychiatric: 50%"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	Included in i.2.	"7B Chiropractic: $20, 7F Podiatry: $20, 7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $20"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $20, 17A Medicare Covered Eye Exams: $20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $5	17B Eye Wear: Medicare Covered: $60	18A Routine Hearing Exams: $20	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											250	250	0	5	25	0.125450379	0.094622022	47.01162616	35	0	20	20	20	20	5	20	0.499967042	20	20	19.59396167	12.974	20	0	0	5	34.62	20	0	0	0	0											3.6852	0.07	0	0.558204167	0.4896875	0.827972504	0.51569002	1.041229167	1.441970833	0	0.9575	0.0302	0.0012	1.363733333	2.794691667	4.65835	0.754950233	1.097366667	1.651033333	1.976704167	1.286090997	1.009333333	0	0	0.190416667	1.318445	0.034966667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.7549	0	0	3.6852	0.07	0	0.558204167	0.4896875	0.827972504	0.51569002	1.041229167	1.441970833	0	0.9575	0.0302	0.0012	1.363733333	2.794691667	4.65835	0.754950233	1.097366667	1.651033333	1.976704167	1.286090997	1.009333333	0	0	0.190416667	1.318445	0.034966667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.7549	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.6852	0.07	0	0.558204167	0.4896875	0.827972504	0.51569002	1.041229167	1.441970833	0	0.9575	0.0302	0.0012	1.363733333	2.794691667	4.65835	0.754950233	1.097366667	1.651033333	1.976704167	1.286090997	1.009333333	0	0	0.190416667	1.318445	0.034966667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.7549
H3362_017_0	2008	7																					0											A	A	Coin	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	176.54	3.35	42.39	1298.88	235.05	6.6	5.45	264.75	494.39	0	574.5	18.12	0.72	818.24	6339.24	2640.56	1.51	680.38	958.88	1199.75	1189.54	592.15	0	0	457	457	20.51	0	0	0	0											PBP: 1A IP Acute: $500 per admit	1B IP Psych: $500 per admit	2 SNF: 20%	6 Home Health: $15	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $75	8A OP C/D/T: $0	8B OP X-Ray: $30	9A OP Hospital: $30	12 Renal Dialysis: $20	"3 CORF: $15, 5 Partial Hosp: $30, 9C OP Substance Abuse: $30, 9D Cardiac Rehab: $15"	"7A PCP: $20, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, 14J Nutrition therapy $25"	7D Physician Specialist: $30	"7E Mental Health: 50%, 7H Psychiatric: 50%"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	Included in i.2.	"7B Chiropractic: $25, 7F Podiatry: $30, 7G Other Health Care: $30, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $30, 17A Medicare Covered Eye Exams: $30"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $5	17B Eye Wear: Medicare Covered: $60	18A Routine Hearing Exams: $30	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											500	500	0.199990203	15	50	0.125450379	0.143874604	47.35939566	75	0	30	30	20	15	20	30	0.499967042	15	30	28.52127527	12.974	30	0	0	5	34.62	30	0	0	0	0											7.3558	0.139583333	8.477584725	1.6236	0.979375	0.827972504	0.78411659	1.044866667	3.0899375	0	1.43625	0.0453	0.0012	1.0228	10.5654	6.6014	0.754950233	0.850475	2.3972	2.851533333	1.286090997	1.480375	0	0	0.190416667	1.318445	0.051275	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.176	0	0	7.3558	0.139583333	8.477584725	1.6236	0.979375	0.827972504	0.78411659	1.044866667	3.0899375	0	1.43625	0.0453	0.0012	1.0228	10.5654	6.6014	0.754950233	0.850475	2.3972	2.851533333	1.286090997	1.480375	0	0	0.190416667	1.318445	0.051275	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.3558	0.139583333	8.477584725	1.6236	0.979375	0.827972504	0.78411659	1.044866667	3.0899375	0	1.43625	0.0453	0.0012	1.0228	10.5654	6.6014	0.754950233	0.850475	2.3972	2.851533333	1.286090997	1.480375	0	0	0.190416667	1.318445	0.051275	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.176
H3362_018_0	2008	4																					0											A	A	Coin	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	176.54	3.35	42.39	1298.88	235.05	6.6	5.45	264.75	494.39	0	574.5	18.12	0.72	818.24	6339.24	2640.56	1.51	680.38	958.88	1199.75	1189.54	592.15	0	0	457	457	20.51	0	0	0	0											PBP: 1A IP Acute: $500 per admit	1B IP Psych: $500 per admit	2 SNF: 20%	6 Home Health: $15	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $75	8A OP C/D/T: $0	8B OP X-Ray: $30	9A OP Hospital: $30	12 Renal Dialysis: $20	"3 CORF: $15, 5 Partial Hosp: $30, 9C OP Substance Abuse: $30, 9D Cardiac Rehab: $15"	"7A PCP: $20, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, , 14J Nutrition therapy $25"	7D Physician Specialist: $30	"7E Mental Health: 50%, 7H Psychiatric: 50%"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	Included in i.2.	"7B Chiropractic: $25, 7F Podiatry: $30, 7G Other Health Care: $30, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $30, 17A Medicare Covered Eye Exams: $30"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $5	17B Eye Wear: Medicare Covered: $60	18A Routine Hearing Exams: $30	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											500	500	0.199990203	15	50	0.125450379	0.143874604	47.35939566	75	0	30	30	20	15	20	30	0.499967042	15	30	28.52127527	12.974	30	0	0	5	34.62	30	0	0	0	0											7.3558	0.139583333	8.477584725	1.6236	0.979375	0.827972504	0.78411659	1.044866667	3.0899375	0	1.43625	0.0453	0.0012	1.0228	10.5654	6.6014	0.754950233	0.850475	2.3972	2.851533333	1.286090997	1.480375	0	0	0.190416667	1.318445	0.051275	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.176	0	0	7.3558	0.139583333	8.477584725	1.6236	0.979375	0.827972504	0.78411659	1.044866667	3.0899375	0	1.43625	0.0453	0.0012	1.0228	10.5654	6.6014	0.754950233	0.850475	2.3972	2.851533333	1.286090997	1.480375	0	0	0.190416667	1.318445	0.051275	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.3558	0.139583333	8.477584725	1.6236	0.979375	0.827972504	0.78411659	1.044866667	3.0899375	0	1.43625	0.0453	0.0012	1.0228	10.5654	6.6014	0.754950233	0.850475	2.3972	2.851533333	1.286090997	1.480375	0	0	0.190416667	1.318445	0.051275	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.176
H3362_020_0	2008	7																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	479.75	24.43	0	0	1722.73	6.61	31.25	531.49	133.46	0	1064.44	62.14	8.57	3894.97	0	5123.64	6.16	83.06	736.89	10023.19	942.92	433.3	0	0	457	457	140.51	0	0	0	0											PBP: 1A IP Acute: $250 per Admit	1B IP Psych: $250 per Admit	2 SNF: 0%	6 Home Health: $0	10A Ambulance: $50	"11A DME: 20%, 11C Diabetes Monitoring Supplies: 0%"	11B Prosthetic Medical Supplies: 0%	"4A ER: $50, 4B Urgent Care: $5"	9B ASC Services: $75	8A OP C/D/T: $0	8B OP X-Ray: $5	9C OP Hospital: $5	12 Renal Dialysis: $0	"3 CORF: $5, 5 Partial Hosp: $5, 9C OP Substance Abuse: 50%, 9D Cardiac Rehab: $5"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, Nutrition Therapy: $5"	7D Physician Specialist: $5	"7E Mental Health: 50%, 7H Psychiatric: 50%"	"7C Occupational Therapy: $5, 7I Physical and Speech Therapy: $5"	8B OP X-Ray: $5	"7B Chiropractic: $5, 7F Podiatry: $5, 7G Other Health Care: $5, 18A Medicare Covered Hearing Exams: $5"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Comprehensive Dental Services: $5, 17A Medicare Covered Eye Exams: $5"	10B Transportation: Not Covered	16A Preventive Dental Services: Not Covered	17A Routine Eye Exams: $5	17B Eye Wear: Various cost sharing	18A Routine Hearing Exams: $10	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	0	0	55	0.20000026	0.199978002	49.75954392	75	0	5	5	5	5.446539602	0	5	0.499969337	5	5	5	7.788	5	0	0	5	34.62	5	0	0	0	0											9.9948	0.508958333	0	0	7.895845833	1.322001721	6.24931255	2.203891667	0.834125	0	0.443516667	0.025891667	0.003570833	1.767842363	0	2.13485	3.079811117	0.034608333	0.3070375	4.176329167	0.61195508	0.180541667	0	0	0.190416667	1.318445	0.058545833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.3423	0	0	9.9948	0.508958333	0	0	7.895845833	1.322001721	6.24931255	2.203891667	0.834125	0	0.443516667	0.025891667	0.003570833	1.767842363	0	2.13485	3.079811117	0.034608333	0.3070375	4.176329167	0.61195508	0.180541667	0	0	0.190416667	1.318445	0.058545833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.3423	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.9948	0.508958333	0	0	7.895845833	1.322001721	6.24931255	2.203891667	0.834125	0	0.443516667	0.025891667	0.003570833	1.767842363	0	2.13485	3.079811117	0.034608333	0.3070375	4.176329167	0.61195508	0.180541667	0	0	0.190416667	1.318445	0.058545833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.3423
H3362_022_0	2008	13																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	176.72	3.36	131.4881181	1339.69	235.05	6.6	5.45	265.34	494.39	0	574.5	18.12	0	818.24	6545.05	2726.27	1.51	643.79	972.01	1189.39	1189.54	592.15	0	0	457	457	20.51	0	0	0	0											PBP: 1A IP Acute: $375 per admit	1B IP Psych: $375 per admit	2 SNF: $375	6 Home Health: $5	10A Ambulance: $50	11A DME: 25%	"11B Prosthetic Medical Supplies: 25%, 11C Diabetes Monitoring Supplies: 25%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $75	8A OP C/D/T: $0	8B OP X-Ray: $25	9A OP Hospital: $25	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $25, 9C OP Substance Abuse: 50%, 9D Cardiac Rehab: $25"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, , 14J Nutrition therapy $25"	7D Physician Specialist: $25	"7E Mental Health: 50%, 7H Psychiatric: 50%"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	Included in i.2.	"7B Chiropractic: $25, 7F Podiatry: $25, 7G Other Health Care: $25, 18A Medicare Covered Hearing Exams: $25"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $25, 17A Medicare Covered Eye Exams: $25"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $5	17B Eye Wear: Medicare Covered: $60	18A Routine Hearing Exams: $25	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											375	375	375	5	50	0.156813005	0.179842926	47.30967815	75	0	25	25	0	25	10	25	0.499967042	25	25	24.59113495	12.974	25	0	0	5	34.62	25	0	0	0	0											5.5225	0.105	4.109003691	0.558204167	0.979375	1.034965836	0.980143944	1.046095833	3.0899375	0	1.196875	0.03775	0	1.704666667	5.454208333	5.679729167	0.754950233	1.341229167	2.025020833	2.437370833	1.286090997	1.233645833	0	0	0.190416667	1.318445	0.042729167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1284	0	0	5.5225	0.105	4.109003691	0.558204167	0.979375	1.034965836	0.980143944	1.046095833	3.0899375	0	1.196875	0.03775	0	1.704666667	5.454208333	5.679729167	0.754950233	1.341229167	2.025020833	2.437370833	1.286090997	1.233645833	0	0	0.190416667	1.318445	0.042729167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1284	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.5225	0.105	4.109003691	0.558204167	0.979375	1.034965836	0.980143944	1.046095833	3.0899375	0	1.196875	0.03775	0	1.704666667	5.454208333	5.679729167	0.754950233	1.341229167	2.025020833	2.437370833	1.286090997	1.233645833	0	0	0.190416667	1.318445	0.042729167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1284
H3362_801_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	221.15	2.7	42.18	12.41	11.76	6.6	5.45	8.86	60.57	8.38	14.86	1.74	0.3	18.42	57.2	91.91	1.68	2.56	38.65	43.05	6.43	20.68	0	0	0	0	0	0	0	0	0											Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing																				0.089354477	0.089262914	0.191348004	0	0.234015963	0.23400001	0.234092527	0.233920434	0.234049505	0.233945486	0.233935199	0.233999891	0.234000018	0.234019157	0.233997863	0.23399861	0.233996135	0.233981865	0.233999263	0.233997476	0.234016866	0.042656196	0	0	0	0	0	0	0	0	0											19.7607	0.241009869	8.071058825	0	2.752027729	1.544400065	1.275804272	2.072535048	14.17637852	1.960463171	3.476277054	0.40715981	0.070200005	4.310632873	13.38467775	21.50681228	0.393113507	0.598993574	9.044071501	10.07359136	1.504728449	0.882130127	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.5068	0	0	19.7607	0.241009869	8.071058825	0	2.752027729	1.544400065	1.275804272	2.072535048	14.17637852	1.960463171	3.476277054	0.40715981	0.070200005	4.310632873	13.38467775	21.50681228	0.393113507	0.598993574	9.044071501	10.07359136	1.504728449	0.882130127	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.5068	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.7607	0.241009869	8.071058825	0	2.752027729	1.544400065	1.275804272	2.072535048	14.17637852	1.960463171	3.476277054	0.40715981	0.070200005	4.310632873	13.38467775	21.50681228	0.393113507	0.598993574	9.044071501	10.07359136	1.504728449	0.882130127	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.5068
H3362_807_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	221.15	2.7	42.18	12.41	11.76	6.6	5.45	8.86	60.57	8.38	14.86	1.74	0.3	18.42	57.2	91.91	1.68	2.56	38.65	43.05	6.43	20.68	0	0	0	0	0	0	14.31	0	0											Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing							Standard Medicare Fee-for-Service Cost Sharing													0.089354477	0.089262914	0.191348004	0	0.234015963	0.23400001	0.234092527	0.233920434	0.234049505	0.233945486	0.233935199	0.233999891	0.234000018	0.234019157	0.233997863	0.23399861	0.233996135	0.233981865	0.233999263	0.233997476	0.234016866	0.042656196	0	0	0	0	0	0	0.164220825	0	0											19.7607	0.241009869	8.071058825	0	2.752027729	1.544400065	1.275804272	2.072535048	14.17637852	1.960463171	3.476277054	0.40715981	0.070200005	4.310632873	13.38467775	21.50681228	0.393113507	0.598993574	9.044071501	10.07359136	1.504728449	0.882130127	0	0	0	0	0	0	2.35	0	0	0	0	0	0	0	0	0	0	0	0	119.8568	0	0	19.7607	0.241009869	8.071058825	0	2.752027729	1.544400065	1.275804272	2.072535048	14.17637852	1.960463171	3.476277054	0.40715981	0.070200005	4.310632873	13.38467775	21.50681228	0.393113507	0.598993574	9.044071501	10.07359136	1.504728449	0.882130127	0	0	0	0	0	0	2.35	0	0	0	0	0	0	0	0	0	0	0	0	119.8568	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.7607	0.241009869	8.071058825	0	2.752027729	1.544400065	1.275804272	2.072535048	14.17637852	1.960463171	3.476277054	0.40715981	0.070200005	4.310632873	13.38467775	21.50681228	0.393113507	0.598993574	9.044071501	10.07359136	1.504728449	0.882130127	0	0	0	0	0	0	2.35	0	0	0	0	0	0	0	0	0	0	0	0	119.8568
H3362_817_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	221.15	2.7	42.18	12.41	11.76	6.6	5.45	8.86	60.57	8.38	14.86	1.74	0.3	18.42	57.2	91.91	1.68	2.56	38.65	43.05	6.43	20.68	0	0	0	0	0	0	14.31	0	0											Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing							Standard Medicare Fee-for-Service Cost Sharing													0.089354477	0.089262914	0.191348004	0	0.234015963	0.23400001	0.234092527	0.233920434	0.234049505	0.233945486	0.233935199	0.233999891	0.234000018	0.234019157	0.233997863	0.23399861	0.233996135	0.233981865	0.233999263	0.233997476	0.234016866	0.042656196	0	0	0	0	0	0	0.164220825	0	0											19.7607	0.241009869	8.071058825	0	2.752027729	1.544400065	1.275804272	2.072535048	14.17637852	1.960463171	3.476277054	0.40715981	0.070200005	4.310632873	13.38467775	21.50681228	0.393113507	0.598993574	9.044071501	10.07359136	1.504728449	0.882130127	0	0	0	0	0	0	2.35	0	0	0	0	0	0	0	0	0	0	0	0	119.8568	0	0	19.7607	0.241009869	8.071058825	0	2.752027729	1.544400065	1.275804272	2.072535048	14.17637852	1.960463171	3.476277054	0.40715981	0.070200005	4.310632873	13.38467775	21.50681228	0.393113507	0.598993574	9.044071501	10.07359136	1.504728449	0.882130127	0	0	0	0	0	0	2.35	0	0	0	0	0	0	0	0	0	0	0	0	119.8568	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.7607	0.241009869	8.071058825	0	2.752027729	1.544400065	1.275804272	2.072535048	14.17637852	1.960463171	3.476277054	0.40715981	0.070200005	4.310632873	13.38467775	21.50681228	0.393113507	0.598993574	9.044071501	10.07359136	1.504728449	0.882130127	0	0	0	0	0	0	2.35	0	0	0	0	0	0	0	0	0	0	0	0	119.8568
H3362_818_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	221.15	2.7	42.18	12.41	11.76	6.6	5.45	8.86	60.57	8.38	14.86	1.74	0.3	18.42	57.2	91.91	1.68	2.56	38.65	43.05	6.43	20.68	0	0	0	0	0	0	0	0	0											Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing																				0.089354477	0.089262914	0.191348004	0	0.234015963	0.23400001	0.234092527	0.233920434	0.234049505	0.233945486	0.233935199	0.233999891	0.234000018	0.234019157	0.233997863	0.23399861	0.233996135	0.233981865	0.233999263	0.233997476	0.234016866	0.042656196	0	0	0	0	0	0	0	0	0											19.7607	0.241009869	8.071058825	0	2.752027729	1.544400065	1.275804272	2.072535048	14.17637852	1.960463171	3.476277054	0.40715981	0.070200005	4.310632873	13.38467775	21.50681228	0.393113507	0.598993574	9.044071501	10.07359136	1.504728449	0.882130127	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.5068	0	0	19.7607	0.241009869	8.071058825	0	2.752027729	1.544400065	1.275804272	2.072535048	14.17637852	1.960463171	3.476277054	0.40715981	0.070200005	4.310632873	13.38467775	21.50681228	0.393113507	0.598993574	9.044071501	10.07359136	1.504728449	0.882130127	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.5068	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.7607	0.241009869	8.071058825	0	2.752027729	1.544400065	1.275804272	2.072535048	14.17637852	1.960463171	3.476277054	0.40715981	0.070200005	4.310632873	13.38467775	21.50681228	0.393113507	0.598993574	9.044071501	10.07359136	1.504728449	0.882130127	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.5068
H3362_819_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	221.15	2.7	42.18	12.41	11.76	6.6	5.45	8.86	60.57	8.38	14.86	1.74	0.3	18.42	57.2	91.91	1.68	2.56	38.65	43.05	6.43	20.68	0	0	0	0	0	0	14.31	0	0											Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing							Standard Medicare Fee-for-Service Cost Sharing													0.089354477	0.089262914	0.191348004	0	0.234015963	0.23400001	0.234092527	0.233920434	0.234049505	0.233945486	0.233935199	0.233999891	0.234000018	0.234019157	0.233997863	0.23399861	0.233996135	0.233981865	0.233999263	0.233997476	0.234016866	0.042656196	0	0	0	0	0	0	0.164220825	0	0											19.7607	0.241009869	8.071058825	0	2.752027729	1.544400065	1.275804272	2.072535048	14.17637852	1.960463171	3.476277054	0.40715981	0.070200005	4.310632873	13.38467775	21.50681228	0.393113507	0.598993574	9.044071501	10.07359136	1.504728449	0.882130127	0	0	0	0	0	0	2.35	0	0	0	0	0	0	0	0	0	0	0	0	119.8568	0	0	19.7607	0.241009869	8.071058825	0	2.752027729	1.544400065	1.275804272	2.072535048	14.17637852	1.960463171	3.476277054	0.40715981	0.070200005	4.310632873	13.38467775	21.50681228	0.393113507	0.598993574	9.044071501	10.07359136	1.504728449	0.882130127	0	0	0	0	0	0	2.35	0	0	0	0	0	0	0	0	0	0	0	0	119.8568	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.7607	0.241009869	8.071058825	0	2.752027729	1.544400065	1.275804272	2.072535048	14.17637852	1.960463171	3.476277054	0.40715981	0.070200005	4.310632873	13.38467775	21.50681228	0.393113507	0.598993574	9.044071501	10.07359136	1.504728449	0.882130127	0	0	0	0	0	0	2.35	0	0	0	0	0	0	0	0	0	0	0	0	119.8568
H3366_008_0	2008	2																					none											coin	coin	coin	coin	coin	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	352.0532647	2.27290117	70.58986495	42.14108211	6.449379881	19.3729956	1.075673508	286.1979107	26.4571879	10.19899699	27.20420216	0	0.420529915	516.1971653	0	7291.374468	270.5333376	879.7392697	42.65403038	62.82142386	7.564627448	909.9222298	0	3220.595942	0	0	0	0	0	500	0																"0% of first $200/year, then 20% for DME / 0% for Supplies"	"0% of first $200/year, then 20%"	$50 ER / $25 UC					20%	$20 OP SA/$20 OP Therapy	$0 PCP	$20 SCP / $20 Chiro / $20 Medicare Podiatrist /$0 Routine Podiatrist	$25 MH	$20 Therapy / $20 Cardiac		$0 Hearing / $0 Preventive	20%	$15 Vision/$0 Blood		$5 for Preventive / $5 - $660 for Emergency / $5 - $45 for Diagnostic / $5 - $485 for Restorative / $5 - $425 for Endo/Perio/Extractions / $5 - $600 for Oral/Maxillo																		0	0	0	0	0	0.0984048	0.12	40.96969709	0	0	0	0	0.2	20	0	20	25	20	0	0.000768857	0.2	15	0	6.126296923	0	0	0	0	0	0	0											0	0	0	0	0	1.906395757	0.129080821	0.977120142	0	0	0	0	0.084105983	0.860328609	0	12.15229078	0.56361112	1.466232116	0	0.048300677	1.51292549	1.137402787	0	1.644193917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.482	0	0	0	0	0	0	0	1.906395757	0.129080821	0.977120142	0	0	0	0	0.084105983	0.860328609	0	12.15229078	0.56361112	1.466232116	0	0.048300677	1.51292549	1.137402787	0	1.644193917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.482	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	1.906395757	0.129080821	0.977120142	0	0	0	0	0.084105983	0.860328609	0	12.15229078	0.56361112	1.466232116	0	0.048300677	1.51292549	1.137402787	0	1.644193917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.482
H3366_021_0	2008	3																					none											coin	coin	coin	coin	coin	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	334.9784072	2.162663693	67.16620152	40.09720681	6.145644291	18.46061823	1.025014323	299.130761	25.21117825	9.71867199	25.92301164	0	0.400724926	490.862603	0	0	257.2557682	836.5623387	43.80897701	61.7856283	7.20836892	7.943872522	0	3220.595942	0	0	0	0	0	500	0																"0% of first $200/year, then 20% for DME / 0% for Supplies"	"0% of first $200/year, then 20%"	$25 ER / $10 UC					20%	$20 OP SA/$20 OP Therapy	$0 PCP	$0 SCP / $0 Chiro / $0 Medicare Podiatrist /$0 Routine Podiatrist	$25 MH	$20 Therapy / $20 Cardiac		$0 Hearing / $0 Preventive	20%	$0 Vision/$0 Blood		$5 for Preventive / $5 - $660 for Emergency / $5 - $45 for Diagnostic / $5 - $485 for Restorative / $5 - $425 for Endo/Perio/Extractions / $5 - $600 for Oral/Maxillo																		0	0	0	0	0	0.0984048	0.12	19.67867516	0	0	0	0	0.2	20	0	0	25	20	0	0.000743379	0.2	0	0	6.126296923	0	0	0	0	0	0	0											0	0	0	0	0	1.816613445	0.123001719	0.490541423	0	0	0	0	0.080144985	0.818104338	0	0	0.535949517	1.394270564	0	0.045930116	1.441673784	0	0	1.644193917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.3904	0	0	0	0	0	0	0	1.816613445	0.123001719	0.490541423	0	0	0	0	0.080144985	0.818104338	0	0	0.535949517	1.394270564	0	0.045930116	1.441673784	0	0	1.644193917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.3904	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	1.816613445	0.123001719	0.490541423	0	0	0	0	0.080144985	0.818104338	0	0	0.535949517	1.394270564	0	0.045930116	1.441673784	0	0	1.644193917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.3904
H3366_022_0	2008	2																					none											coin	coin	coin	coin	coin	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	392.7144789	2.5354152	80.89799018	71.46219388	19.60110547	58.8788592	3.269211965	404.3681623	33.97182065	13.0958172	34.93100931	0	0.343217407	663.553317	0	6661.37082	225.5728979	718.8056093	35.49089886	51.6840883	9.713207916	763.7312084	0	3220.595942	0	0	0	0	0	500	0																"0% of first $200/year, then 20% for DME / 0% for Supplies"	"0% of first $200/year, then 20%"	$25 ER / $10 UC					20%	$20 OP SA/$20 OP Therapy	$0 PCP	$10 SCP / $10 Chiro / $10 Medicare Podiatrist /$10 Routine Podiatrist	$20 MH	$20 Therapy / $20 Cardiac		$0 Hearing / $0 Preventive	20%	$10 Vision/$0 Blood		$5 for Preventive / $5 - $660 for Emergency / $5 - $45 for Diagnostic / $5 - $485 for Restorative / $5 - $425 for Endo/Perio/Extractions / $5 - $600 for Oral/Maxillo																		0	0	0	0	0	0.0984048	0.12	19.67867516	0	0	0	0	0.2	20	0	10	20	20	0	0.000763579	0.2	10	0	6.126296923	0	0	0	0	0	0	0											0	0	0	0	0	5.793962364	0.392305436	0.663119143	0	0	0	0	0.068643481	1.105922195	0	5.55114235	0.37595483	1.198009349	0	0.039464872	1.942641583	0.636442674	0	1.644193917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.4118	0	0	0	0	0	0	0	5.793962364	0.392305436	0.663119143	0	0	0	0	0.068643481	1.105922195	0	5.55114235	0.37595483	1.198009349	0	0.039464872	1.942641583	0.636442674	0	1.644193917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.4118	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	5.793962364	0.392305436	0.663119143	0	0	0	0	0.068643481	1.105922195	0	5.55114235	0.37595483	1.198009349	0	0.039464872	1.942641583	0.636442674	0	1.644193917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.4118
H3366_803_0	2008	1																					none											D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1057.83335	11.95495925	940.4787788	42.16946626	213.3429172	19.37206801	1.075622004	278.7217153	264.5768531	10.19850865	859.5809723	0	0.42050978	513.8242701	5072.757766	7123.936877	269.289729	857.9856512	42.37460832	62.57712034	7.564265251	864.5124034	0	0	0	0	0	0	0	0	0											$300 per day; days 1-6	$300 per day; days 1-6	$75 per day; days 16-100		$150 	20%	20%	$50 ER / $40 UC	$200 		$20 for x-rays/radiation therapy / $150 for CT / $200 for MRI/MRA/SPECT		20%	$40 OP SA/$40 OP Therapy	$40 PCP	$40 SCP / $40 Chiro / $40 Medicare Podiatrist /$0 Routine Podiatrist	$40 MH	$40 Therapy / $0 Cardiac		$40 Hearing / $0 Preventive	20%	$40 Vision/$0 Blood																				300	300	75	0	150	0.2	0.2	46.52906995	200	0	43.97814202	0	0.2	30.4339385	40	39.33276677	40	40	0	0.007269818	0.2	40	0	0	0	0	0	0	0	0	0											26.4458	0.298873981	5.877992367	0	2.666786465	3.874413603	0.215124401	1.080721849	4.409614218	0	3.150231173	0	0.084101956	1.303141353	16.90919255	23.35034564	0.89763243	2.859952171	0	0.45492426	1.51285305	2.881708011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.2734	0	0	26.4458	0.298873981	5.877992367	0	2.666786465	3.874413603	0.215124401	1.080721849	4.409614218	0	3.150231173	0	0.084101956	1.303141353	16.90919255	23.35034564	0.89763243	2.859952171	0	0.45492426	1.51285305	2.881708011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.2734	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.4458	0.298873981	5.877992367	0	2.666786465	3.874413603	0.215124401	1.080721849	4.409614218	0	3.150231173	0	0.084101956	1.303141353	16.90919255	23.35034564	0.89763243	2.859952171	0	0.45492426	1.51285305	2.881708011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.2734
H3366_805_0	2008	1																					none											D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1057.83335	11.95495925	940.4787788	42.16946626	213.3429172	19.37206801	1.075622004	278.7217153	264.5768531	10.19850865	859.5809723	0	0.42050978	513.8242701	5072.757766	7123.936877	269.289729	857.9856512	42.37460832	62.57712034	7.564265251	864.5124034	0	0	0	0	0	0	0	0	0											$300 per day; days 1-6	$300 per day; days 1-6	$75 per day; days 16-100		$150 	20%	20%	$50 ER / $40 UC	$200 		$20 for x-rays/radiation therapy / $150 for CT / $200 for MRI/MRA/SPECT		20%	$40 OP SA/$40 OP Therapy	$40 PCP	$40 SCP / $40 Chiro / $40 Medicare Podiatrist /$0 Routine Podiatrist	$40 MH	$40 Therapy / $0 Cardiac		$40 Hearing / $0 Preventive	20%	$40 Vision/$0 Blood																				300	300	75	0	150	0.2	0.2	46.52906995	200	0	43.97814202	0	0.2	30.4339385	40	39.33276677	40	40	0	0.007269818	0.2	40	0	0	0	0	0	0	0	0	0											26.4458	0.298873981	5.877992367	0	2.666786465	3.874413603	0.215124401	1.080721849	4.409614218	0	3.150231173	0	0.084101956	1.303141353	16.90919255	23.35034564	0.89763243	2.859952171	0	0.45492426	1.51285305	2.881708011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.2734	0	0	26.4458	0.298873981	5.877992367	0	2.666786465	3.874413603	0.215124401	1.080721849	4.409614218	0	3.150231173	0	0.084101956	1.303141353	16.90919255	23.35034564	0.89763243	2.859952171	0	0.45492426	1.51285305	2.881708011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.2734	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.4458	0.298873981	5.877992367	0	2.666786465	3.874413603	0.215124401	1.080721849	4.409614218	0	3.150231173	0	0.084101956	1.303141353	16.90919255	23.35034564	0.89763243	2.859952171	0	0.45492426	1.51285305	2.881708011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.2734
H3366_806_0	2008	1																					none											D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1057.83335	11.95495925	940.4787788	42.16946626	213.3429172	19.37206801	1.075622004	278.7217153	264.5768531	10.19850865	859.5809723	0	0.42050978	513.8242701	5072.757766	7123.936877	269.289729	857.9856512	42.37460832	62.57712034	7.564265251	864.5124034	0	0	0	0	0	0	0	0	0											$300 per day; days 1-6	$300 per day; days 1-6	$75 per day; days 16-100		$150 	20%	20%	$50 ER / $40 UC	$200 		$20 for x-rays/radiation therapy / $150 for CT / $200 for MRI/MRA/SPECT		20%	$40 OP SA/$40 OP Therapy	$40 PCP	$40 SCP / $40 Chiro / $40 Medicare Podiatrist /$0 Routine Podiatrist	$40 MH	$40 Therapy / $0 Cardiac		$40 Hearing / $0 Preventive	20%	$40 Vision/$0 Blood																				300	300	75	0	150	0.2	0.2	46.52906995	200	0	43.97814202	0	0.2	30.4339385	40	39.33276677	40	40	0	0.007269818	0.2	40	0	0	0	0	0	0	0	0	0											26.4458	0.298873981	5.877992367	0	2.666786465	3.874413603	0.215124401	1.080721849	4.409614218	0	3.150231173	0	0.084101956	1.303141353	16.90919255	23.35034564	0.89763243	2.859952171	0	0.45492426	1.51285305	2.881708011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.2734	0	0	26.4458	0.298873981	5.877992367	0	2.666786465	3.874413603	0.215124401	1.080721849	4.409614218	0	3.150231173	0	0.084101956	1.303141353	16.90919255	23.35034564	0.89763243	2.859952171	0	0.45492426	1.51285305	2.881708011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.2734	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.4458	0.298873981	5.877992367	0	2.666786465	3.874413603	0.215124401	1.080721849	4.409614218	0	3.150231173	0	0.084101956	1.303141353	16.90919255	23.35034564	0.89763243	2.859952171	0	0.45492426	1.51285305	2.881708011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.2734
H3366_808_0	2008	1																					none											D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1057.83335	11.95495925	940.4787788	42.16946626	213.3429172	19.37206801	1.075622004	278.7217153	264.5768531	10.19850865	859.5809723	0	0.42050978	513.8242701	5072.757766	7123.936877	269.289729	857.9856512	42.37460832	62.57712034	7.564265251	864.5124034	0	0	0	0	0	0	0	0	0											$300 per day; days 1-6	$300 per day; days 1-6	$75 per day; days 16-100		$150 	20%	20%	$50 ER / $40 UC	$200 		$20 for x-rays/radiation therapy / $150 for CT / $200 for MRI/MRA/SPECT		20%	$40 OP SA/$40 OP Therapy	$40 PCP	$40 SCP / $40 Chiro / $40 Medicare Podiatrist /$0 Routine Podiatrist	$40 MH	$40 Therapy / $0 Cardiac		$40 Hearing / $0 Preventive	20%	$40 Vision/$0 Blood																				300	300	75	0	150	0.2	0.2	46.52906995	200	0	43.97814202	0	0.2	30.4339385	40	39.33276677	40	40	0	0.007269818	0.2	40	0	0	0	0	0	0	0	0	0											26.4458	0.298873981	5.877992367	0	2.666786465	3.874413603	0.215124401	1.080721849	4.409614218	0	3.150231173	0	0.084101956	1.303141353	16.90919255	23.35034564	0.89763243	2.859952171	0	0.45492426	1.51285305	2.881708011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.2734	0	0	26.4458	0.298873981	5.877992367	0	2.666786465	3.874413603	0.215124401	1.080721849	4.409614218	0	3.150231173	0	0.084101956	1.303141353	16.90919255	23.35034564	0.89763243	2.859952171	0	0.45492426	1.51285305	2.881708011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.2734	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.4458	0.298873981	5.877992367	0	2.666786465	3.874413603	0.215124401	1.080721849	4.409614218	0	3.150231173	0	0.084101956	1.303141353	16.90919255	23.35034564	0.89763243	2.859952171	0	0.45492426	1.51285305	2.881708011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.2734
H3370_001_0	2008	5	r.2.	0	0	0	0	0	0	0	0	0	Other Non-Covered	0	0	0	0	0	0	0	0	0		Visitor/Travel	0	0	0	0	0	0	0	0	0	D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V	Coin	0	0	0	0	0	0	0	0	0																																										0		2038.612236	62.15121977	1190.919516	1752.748135	445.3768684	9.819746538	8.328198441	226.7220756	207.9158775	309.0712213	381.8863057	20.74444129	1.781088394	463.3449072	5061.591291	6048.733341	224.1552129	1604.446333	49.15104618	426.98975	33.05941904	0	0	2837.567263	435.1926835	344.2921002	261.997867	24.17737131	0	0	0	0.141328697	0	0	0	0	0	0	0	0	0	$50/day days 1-6	$50/day days 1-6	$25/day days 1-100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 emergency copay; $15 urgent care copay	$0 copay	$0 copay	$30 radiology copay; $50 chemo copay		$0 copay	$25 copay	$0 copay	$15 copay	$25 copay	$15 copay	$15 copay	$0 copay	10% coinsurance	$0 copay	n/c	$0 copay	$10 copay	$0/$25/$40 copay	$0 copay	$0 copay				30% coinsurance										48.63576973	22.94117647	25	0	75	0.2	0.2	49.62601626	0	0	36.69504325	0	0	25	0	15	25	15	15	0	0.1	0	0	0	10	27	0	0	0	0	0	0.3	0	0	0	0	0	0	0	0	0	8.2625	0.118818508	2.481082325	0	2.783605428	1.963949308	1.665639688	0.937609451	0	0	1.167777875	0	0	0.96530189	0	7.560916676	0.466990027	2.005557917	0.061438808	0	3.305941904	0	0	0	0.36266057	0.774657226	0	0	0	0	0	0.042398609	0	0	0	0	0	0	0	0	0	34.9268		0	8.2625	0.118818508	2.481082325	0	2.783605428	1.963949308	1.665639688	0.937609451	0	0	1.167777875	0	0	0.96530189	0	7.560916676	0.466990027	2.005557917	0.061438808	0	3.305941904	0	0	0	0.36266057	0.774657226	0	0	0	0	0	0.042398609	0	0	0	0	0	0	0	0	0	34.9268																																																																																				0		0	8.2625	0.118818508	2.481082325	0	2.783605428	1.963949308	1.665639688	0.937609451	0	0	1.167777875	0	0	0.96530189	0	7.560916676	0.466990027	2.005557917	0.061438808	0	3.305941904	0	0	0	0.36266057	0.774657226	0	0	0	0	0	0.042398609	0	0	0	0	0	0	0	0	0	34.9268
H3370_002_0	2008	4	r.2.										Other Non-Covered											Visitor/Travel										D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V	Coin																																																			0		2086.823364	79.27935968	1220.815495	1771.69874	529.3088615	8.320941064	7.334161481	223.3685129	246.7624223	90.97631439	433.9136976	9.87742842	10.91715773	480.7015164	4695.244264	6478.46667	204.2201648	1285.711933	26.28152527	530.6085232	41.15043781	0	0	0	425.6483695	337.0547969	253.8649865	23.64231808	0	0	0	0.13011416	0	0	0	0	0	0	0	0	0	$125/day days 1-10	$125/day days 1-10	$50/day days 1-100	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 emergency copay; $25 urgent care copay	$300 copay	$0 copay	$50 radiology copay; $100 chemo copay		$0 copay	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$25 copay	$0 copay	10% coinsurance	$0 copay	n/c	n/c	$10 copay	$0/$25/$40 copay	$0 copay	$0 copay				30% coinsurance										125	86.06557377	50	0	100	0.2	0.2	49.95147516	300	0	54.57633893	0	0	25	10	25	25	25	25	0	0.1	0	0	0	10	27	0	0	0	0	0	0.3	0	0	0	0	0	0	0	0	0	21.7377	0.568601965	5.086731229	0	4.410907179	1.664188213	1.466832296	0.929798893	6.169060557	0	1.973451752	0	0	1.001461493	3.912703553	13.49680556	0.425458677	2.678566526	0.054753178	0	4.115043781	0	0	0	0.354706975	0.758373293	0	0	0	0	0	0.039034248	0	0	0	0	0	0	0	0	0	70.8442		0	21.7377	0.568601965	5.086731229	0	4.410907179	1.664188213	1.466832296	0.929798893	6.169060557	0	1.973451752	0	0	1.001461493	3.912703553	13.49680556	0.425458677	2.678566526	0.054753178	0	4.115043781	0	0	0	0.354706975	0.758373293	0	0	0	0	0	0.039034248	0	0	0	0	0	0	0	0	0	70.8442																																																																																				0		0	21.7377	0.568601965	5.086731229	0	4.410907179	1.664188213	1.466832296	0.929798893	6.169060557	0	1.973451752	0	0	1.001461493	3.912703553	13.49680556	0.425458677	2.678566526	0.054753178	0	4.115043781	0	0	0	0.354706975	0.758373293	0	0	0	0	0	0.039034248	0	0	0	0	0	0	0	0	0	70.8442
H3370_003_0	2008	5	r.2.										Other Non-Covered											Visitor/Travel										D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V	Coin																																																			0		2645.126625	72.33410287	1430.607812	2084.902652	387.6085007	12.72934698	8.415820026	195.9961929	244.40159	70.69014598	156.5412277	33.06179954	5.479856278	123.2967663	5027.220149	6736.935308	251.708065	2099.33294	6.769906142	394.9149758	49.64079115	0	0	0	427.2865874	338.1686133	277.559013	23.73814374	0	0	0	0.13117104	0	0	0	0	0	0	0	0	0	$100/day days 1-8	$100/day days 1-8	$50/day days 1-100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 emergency copay; $25 urgent care copay	$200 copay	$0 copay	$50 radiology copay; $100 chemo copay		$0 copay	$25 copay	$15 copay	$25 copay	$25 copay	$25 copay	$25 copay	$0 copay	10% coinsurance	$0 copay	n/c	n/c	$10 copay	$0/$25/$40 copay	$0 copay	$0 copay				30% coinsurance										100	56.56565657	50	0	75	0.2	0.2	49.90645463	200	0	54.97076023	0	0	25	15	25	25	25	25	0	0.1	0	0	0	10	27	0	0	0	0	0	0.3	0	0	0	0	0	0	0	0	0	22.0427	0.340968835	5.960865884	0	2.422553129	2.545869396	1.683164005	0.815122926	4.073359833	0	0.717099191	0	0	0.256868263	6.284025187	14.03528189	0.524391802	4.373610292	0.014103971	0	4.964079115	0	0	0	0.356072156	0.76087938	0	0	0	0	0	0.039351312	0	0	0	0	0	0	0	0	0	72.2104		0	22.0427	0.340968835	5.960865884	0	2.422553129	2.545869396	1.683164005	0.815122926	4.073359833	0	0.717099191	0	0	0.256868263	6.284025187	14.03528189	0.524391802	4.373610292	0.014103971	0	4.964079115	0	0	0	0.356072156	0.76087938	0	0	0	0	0	0.039351312	0	0	0	0	0	0	0	0	0	72.2104																																																																																				0		0	22.0427	0.340968835	5.960865884	0	2.422553129	2.545869396	1.683164005	0.815122926	4.073359833	0	0.717099191	0	0	0.256868263	6.284025187	14.03528189	0.524391802	4.373610292	0.014103971	0	4.964079115	0	0	0	0.356072156	0.76087938	0	0	0	0	0	0.039351312	0	0	0	0	0	0	0	0	0	72.2104
H3370_004_0	2008	5	r.2.										Other Non-Covered											Visitor/Travel										D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V	Coin																																																			0		2477.860421	43.69256811	1200.725942	1947.70492	280.4022234	13.31501539	10.1690915	233.1458243	275.1990301	90.73513737	348.0437359	10.12128005	1.282979162	411.6937576	5838.339228	6776.410825	240.9862525	1603.937782	44.90872787	440.133129	65.94388362	0	0	0	427.2865874	338.1285046	258.2483807	23.73814374	0	0	0	0.13117104	0	0	0	0	0	0	0	0	0	$100/day days 1-8	$100/day days 1-8	$50/day days 1-100	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 emergency copay; $25 urgent care copay	$200 copay	$0 copay	$50 radiology copay; $100 chemo copay		$0 copay	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$25 copay	$0 copay	10% coinsurance	$0 copay	n/c	n/c	$10 copay	$0/$25/$40 copay	$0 copay	$0 copay				30% coinsurance										100	71.77814029	50	0	100	0.2	0.2	49.90820073	200	0	53.85245902	0	0	25	10	25	25	25	25	0	0.1	0	0	0	10	27	0	0	0	0	0	0.3	0	0	0	0	0	0	0	0	0	20.6488	0.261347607	5.003024758	0	2.336685195	2.663003079	2.033818299	0.969657383	4.586650502	0	1.561917585	0	0	0.857695328	4.86528269	14.11752255	0.502054693	3.341537045	0.09355985	0	6.594388362	0	0	0	0.356072156	0.760789135	0	0	0	0	0	0.039351312	0	0	0	0	0	0	0	0	0	71.5932		0	20.6488	0.261347607	5.003024758	0	2.336685195	2.663003079	2.033818299	0.969657383	4.586650502	0	1.561917585	0	0	0.857695328	4.86528269	14.11752255	0.502054693	3.341537045	0.09355985	0	6.594388362	0	0	0	0.356072156	0.760789135	0	0	0	0	0	0.039351312	0	0	0	0	0	0	0	0	0	71.5932																																																																																				0		0	20.6488	0.261347607	5.003024758	0	2.336685195	2.663003079	2.033818299	0.969657383	4.586650502	0	1.561917585	0	0	0.857695328	4.86528269	14.11752255	0.502054693	3.341537045	0.09355985	0	6.594388362	0	0	0	0.356072156	0.760789135	0	0	0	0	0	0.039351312	0	0	0	0	0	0	0	0	0	71.5932
H3370_009_0	2008	4	r.2.										Other Non-Covered											Visitor/Travel										D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V	Coin																																																			0		2721.759533	26.90030963	1473.309266	2149.265764	239.3437805	14.28420187	12.18830969	291.0751452	331.7704854	118.637263	466.2720336	11.72577599	0.689751529	742.1726451	7476.216822	8630.860882	145.5375726	1582.290007	59.87338554	586.9785511	59.98109452	0	0	0	427.2865874	337.9859514	292.1035647	23.73814374	0	0	0	0.13117104	0	0	0	0	0	0	0	0	0	$100/day days 1-8	$100/day days 1-8	$50/day days 1-100	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 emergency copay; $25 urgent care copay	$200 copay	$0 copay	$50 radiology copay; $100 chemo copay		$0 copay	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$25 copay	$0 copay	10% coinsurance	$0 copay	n/c	n/c	$10 copay	$0/$25/$40 copay	$0 copay	$0 copay				30% coinsurance										100	61.53846154	50	0	100	0.2	0.2	50	200	0	55.0295858	0	0	25	10	25	25	25	25	0	0.1	0	0	0	10	27	0	0	0	0	0	0.3	0	0	0	0	0	0	0	0	0	22.6813	0.137950306	6.138788608	0	1.994531505	2.856840373	2.437661937	1.212813105	5.52950809	0	2.13822974	0	0	1.546193011	6.230180685	17.98096017	0.303203276	3.296437515	0.12473622	0	5.998109452	0	0	0	0.356072156	0.760468391	0	0	0	0	0	0.039351312	0	0	0	0	0	0	0	0	0	81.7634		0	22.6813	0.137950306	6.138788608	0	1.994531505	2.856840373	2.437661937	1.212813105	5.52950809	0	2.13822974	0	0	1.546193011	6.230180685	17.98096017	0.303203276	3.296437515	0.12473622	0	5.998109452	0	0	0	0.356072156	0.760468391	0	0	0	0	0	0.039351312	0	0	0	0	0	0	0	0	0	81.7634																																																																																				0		0	22.6813	0.137950306	6.138788608	0	1.994531505	2.856840373	2.437661937	1.212813105	5.52950809	0	2.13822974	0	0	1.546193011	6.230180685	17.98096017	0.303203276	3.296437515	0.12473622	0	5.998109452	0	0	0	0.356072156	0.760468391	0	0	0	0	0	0.039351312	0	0	0	0	0	0	0	0	0	81.7634
H3370_010_0	2008	5	r.2.										Other Non-Covered											Visitor/Travel										D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V	Coin																																																			0		2324.127183	59.03853278	1230.215051	1873.834308	376.3067357	10.96667686	8.553223701	220.8756927	256.4852815	86.67807004	343.5844109	13.65435246	5.263241588	393.2393358	5247.060879	6593.72891	220.3644064	1537.738738	31.79769769	460.5186011	51.68153481	0	0	0	417.0313382	330.0908103	255.5280783	23.16673681	0	0	0	0.12493214	0	0	0	0	0	0	0			$125/day days 1-10	$125/day days 1-10	$50/day days 1-100	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 emergency copay; $25 urgent care copay	$300 copay	$0 copay	$50 radiology copay; $100 chemo copay		$0 copay	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$25 copay	$0 copay	10% coinsurance	$0 copay	n/c	n/c	$10 copay	$0/$25/$40 copay	$0 copay	$0 copay				30% coinsurance										125	94.88028528	50	0	100	0.2	0.2	49.92842536	300	0	54.32325887	0	0	25	10	25	25	25	25	0	0.1	0	0	0	10	27	0	0	0	0	0	0.3	0	0	0	0	0	0	0			24.2097	0.466799403	5.125896045	0	3.135889464	2.193335373	1.71064474	0.918997961	6.412132037	0	1.555385408	0	0	0.819248616	4.372550733	13.73693523	0.459092513	3.203622371	0.066245204	0	5.168153481	0	0	0	0.347526115	0.742704323	0	0	0	0	0	0.037479642	0	0	0	0	0	0	0	0	0	74.6823		0	24.2097	0.466799403	5.125896045	0	3.135889464	2.193335373	1.71064474	0.918997961	6.412132037	0	1.555385408	0	0	0.819248616	4.372550733	13.73693523	0.459092513	3.203622371	0.066245204	0	5.168153481	0	0	0	0.347526115	0.742704323	0	0	0	0	0	0.037479642	0	0	0	0	0	0	0	0	0	74.6823																																																																																				0		0	24.2097	0.466799403	5.125896045	0	3.135889464	2.193335373	1.71064474	0.918997961	6.412132037	0	1.555385408	0	0	0.819248616	4.372550733	13.73693523	0.459092513	3.203622371	0.066245204	0	5.168153481	0	0	0	0.347526115	0.742704323	0	0	0	0	0	0.037479642	0	0	0	0	0	0	0	0	0	74.6823
H3370_014_0	2008	4	r.2.										Other Non-Covered											Visitor/Travel										D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V	Coin																																																			0		2012.033425	51.11058561	1065.016502	1622.207807	325.7746547	8.219126209	6.410330674	191.2155582	222.0433388	75.03856737	297.4464239	11.8207875	4.556470954	340.4334727	4542.46306	5708.294737	190.7729296	1331.244591	27.52776659	398.67819	38.73343425	0	0	2353.84169	361.0305831	285.7648018	221.214673	20.05580812	0	0	0	0.093632104	0	0	0	0	0	0	0	0	0	$50/day days 1-8	$50/day days 1-8	$25/day days 1-100	$0 copay	$50 copay	20% coinsurance	20% coinsurance	$50 emergency copay; $15 urgent care copay	$100 copay	$0 copay	$30 radiology copay; $50 chemo copay		$0 copay	$25 copay	$0 copay	$15 copay	$25 copay	$15 copay	$15 copay	$0 copay	10% coinsurance	$0 copay	n/c	$0 copay	$10 copay	$0/$25/$40 copay	$0 copay	$0 copay				30% coinsurance										50	30.36169129	25	0	50	0.2	0.2	49.8997955	100	0	31.72930355	0	0	25	0	15	25	15	15	0	0.1	0	0	0	10	27	0	0	0	0	0	0.3	0	0	0	0	0	0	0	0	0	8.3835	0.129316985	2.21878438	0	1.357394395	1.643825242	1.282066135	0.795134771	1.850361157	0	0.786480656	0	0	0.709236401	0	7.135368421	0.397443603	1.664055739	0.034409708	0	3.873343425	0	0	0	0.300858819	0.642970804	0	0	0	0	0	0.028089631	0	0	0	0	0	0	0	0	0	33.2326		0	8.3835	0.129316985	2.21878438	0	1.357394395	1.643825242	1.282066135	0.795134771	1.850361157	0	0.786480656	0	0	0.709236401	0	7.135368421	0.397443603	1.664055739	0.034409708	0	3.873343425	0	0	0	0.300858819	0.642970804	0	0	0	0	0	0.028089631	0	0	0	0	0	0	0	0	0	33.2326																																																																																				0		0	8.3835	0.129316985	2.21878438	0	1.357394395	1.643825242	1.282066135	0.795134771	1.850361157	0	0.786480656	0	0	0.709236401	0	7.135368421	0.397443603	1.664055739	0.034409708	0	3.873343425	0	0	0	0.300858819	0.642970804	0	0	0	0	0	0.028089631	0	0	0	0	0	0	0	0	0	33.2326
H3370_018_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V																																																				0		2424.166386	63.85620353	1326.372856	1995.937078	437.9782725	12.41254323	9.952935771	243.273264	260.4682985	183.038537	390.0459101	17.71609616	4.356075409	456.8668563	5650.079915	6961.665876	235.0613954	1697.786515	41.59162322	489.0267814	53.92657707	0	0	3089.465091	462.1537771	365.7371786	281.3226239	25.67405192	0	0	0	0	0	0	0	0	0	0	0	0	0	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay		$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	Max $40 copay per trip; 12 trips per year	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H3370_019_0	2008	3	r.2.										Other Non-Covered										none	Visitor/Travel										D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V	Coin																																																			0	none	2214.805777	58.3413289	1211.822043	1823.560048	400.1527344	10.36113231	8.308022169	222.2632215	237.9732247	167.2306041	356.3600006	16.18606394	3.979867486	417.4100253	5162.116638	6360.428841	214.7605624	1551.158948	37.99960592	446.7924919	45.01417553	0	0	2822.64665	422.2403466	334.1506675	257.026488	23.45673912	0	0	0	0.12807953										$50/day days 1-5	$50/day days 1-5	$25/day days 1-100	$0 copay	$50 copay	20% coinsurance	20% coinsurance	$50 emergency copay; $15 urgent care copay	$0 copay	$0 copay	$30 radiology copay; $50 chemo copay		$0 copay	$25 copay	$0 copay	$15 copay	$25 copay	$15 copay	$15 copay	$0 copay	10% coinsurance	$0 copay	n/c	$0 copay	$10 copay	$0/$25/$40 copay	$0 copay	$0 copay				30% coinsurance										41.32311343	19.58381324	25	0	50	0.2	0.2	49.79853952	0	0	33.66349342	0	0	25	0	15	25	15	15	0	0.1	0	0	0	10	27	0	0	0	0	0	0.3										7.6269	0.095212141	2.524629257	0	1.66730306	2.072226461	1.661604434	0.922365318	0	0	0.999693545	0	0	0.869604219	0	7.950536051	0.447417838	1.938948685	0.047499507	0	4.501417553	0	0	0	0.351866956	0.751839002	0	0	0	0	0	0.038423859	0	0	0	0	0	0	0	0	0	34.4675		0	7.6269	0.095212141	2.524629257	0	1.66730306	2.072226461	1.661604434	0.922365318	0	0	0.999693545	0	0	0.869604219	0	7.950536051	0.447417838	1.938948685	0.047499507	0	4.501417553	0	0	0	0.351866956	0.751839002	0	0	0	0	0	0.038423859	0	0	0	0	0	0	0	0	0	34.4675	none																																																																																			0		0	7.6269	0.095212141	2.524629257	0	1.66730306	2.072226461	1.661604434	0.922365318	0	0	0.999693545	0	0	0.869604219	0	7.950536051	0.447417838	1.938948685	0.047499507	0	4.501417553	0	0	0	0.351866956	0.751839002	0	0	0	0	0	0.038423859	0	0	0	0	0	0	0	0	0	34.4675
H3370_801_0	2008	3																																coin	coin	coin	V	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V																																																				0		315.3462649	3.996742667	22.64341105	10.69625136	4.731367572	10.36019677	8.244428193	9.394472829	52.28307515	6.179791715	39.74722739	0	3.120532937	0.322960414	51.94179594	149.7986493	1.524644128	5.201699727	33.68643678	27.68082468	47.77888452	0																				Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare																				0.059417231	0.059417231	0.179082956	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				18.737	0.237475384	4.055048976	0	1.107140012	2.424286045	1.929196197	2.198306642	12.23423958	1.446071261	9.30085121	0	0.730204707	0.075572737	12.15438025	35.05288393	0.356766726	1.217197736	7.882626206	6.477312975	11.18025898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.7968			18.737	0.237475384	4.055048976	0	1.107140012	2.424286045	1.929196197	2.198306642	12.23423958	1.446071261	9.30085121	0	0.730204707	0.075572737	12.15438025	35.05288393	0.356766726	1.217197736	7.882626206	6.477312975	11.18025898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.7968																																																																																				0			18.737	0.237475384	4.055048976	0	1.107140012	2.424286045	1.929196197	2.198306642	12.23423958	1.446071261	9.30085121	0	0.730204707	0.075572737	12.15438025	35.05288393	0.356766726	1.217197736	7.882626206	6.477312975	11.18025898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.7968
H3370_803_0	2008	3																																coin	coin	coin	V	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V																																																				0		315.3462649	3.996742667	22.64341105	10.69625136	4.731367572	10.36019677	8.244428193	9.394472829	52.28307515	6.179791715	39.74722739	0	3.120532937	0.322960414	51.94179594	149.7986493	1.524644128	5.201699727	33.68643678	27.68082468	47.77888452	0																				Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare																				0.059417231	0.059417231	0.179082956	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				18.737	0.237475384	4.055048976	0	1.107140012	2.424286045	1.929196197	2.198306642	12.23423958	1.446071261	9.30085121	0	0.730204707	0.075572737	12.15438025	35.05288393	0.356766726	1.217197736	7.882626206	6.477312975	11.18025898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.7968			18.737	0.237475384	4.055048976	0	1.107140012	2.424286045	1.929196197	2.198306642	12.23423958	1.446071261	9.30085121	0	0.730204707	0.075572737	12.15438025	35.05288393	0.356766726	1.217197736	7.882626206	6.477312975	11.18025898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.7968																																																																																				0			18.737	0.237475384	4.055048976	0	1.107140012	2.424286045	1.929196197	2.198306642	12.23423958	1.446071261	9.30085121	0	0.730204707	0.075572737	12.15438025	35.05288393	0.356766726	1.217197736	7.882626206	6.477312975	11.18025898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.7968
H3379_001_0	2008	6																					2400											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		3352.328254	196.219711	1861.835416		219.8976183	9.25507471	1.668514457	224.6061465	19.82013582	15983.80034	60.7391939		0.47206402	17.76926779	4901.004079	5057.390919	803.3959095	7.196904483			17.93612986	2013.57538			57.5699232		21.21488377															$250 (1a); $0 (1a1)	$250 (1b)	"$125 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$5 (4b)"	20% (9b)	20% (8a1); $0/$14 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$21 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $21 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$21 (17a1)	$0 n/c (17b)	$21 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											116.7773	116.7773	58.3886		81.7441	0.14013273	0.268177884	23.3555	0.09342182	2.6158	0.049024027		0.14013273	0.093363724	5	21	37.5	0.09342182			0.14013273	21			21		21															32.623	1.909500256	9.0591694	0	1.497944266	1.296938881	0.447458677	0.437148227	1.851633155	3.484216664	2.977679869	0	0.06615162	1.659005017	2.042085033	8.850434109	2.510612217	0.672347913	0	0	2.513438835	3.523756915	0	0	0.100747366	0	0.037126047	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.5604	0	68.5547232	32.623	1.909500256	9.0591694	0	1.497944266	1.296938881	0.447458677	0.437148227	1.851633155	3.484216664	2.977679869	0	0.06615162	1.659005017	2.042085033	8.850434109	2.510612217	0.672347913	0	0	2.513438835	3.523756915	0	0	0.100747366	0	0.037126047	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.5604																																																																																				0			32.623	1.909500256	9.0591694	0	1.497944266	1.296938881	0.447458677	0.437148227	1.851633155	3.484216664	2.977679869	0	0.06615162	1.659005017	2.042085033	8.850434109	2.510612217	0.672347913	0	0	2.513438835	3.523756915	0	0	0.100747366	0	0.037126047	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.5604
H3379_002_0	2008	7	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)							Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						Coin	Coin	D	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V		Coin	Coin	Coin	T				Coin					Coin	Coin	Coin	V																																																0		441.6900724	19.26594786	12270.68737	26.93345582	26.0398875	42.59536107	0.018081075	143.754944	9.756211866	28.17337607	68.105249	0.249287164	0.821884957	7.379052744	41617.31684	239.5654143	22.53245063	11.04608679		36.83625849	2.465049697	8.168504273	11.72397489									0.028244359	0.031611037		9.553372359							(1a) 5.9% coins	(1b) 5.9% coins	(2a) $0/day	(6a) $0/proc	(10a) 20% coins	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) 20% coins	(8a) 10% coins	(8b) 19.2% coins	(9a) 20% coins	(12) 20% coins	(9a) 20% coins	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) 20% coins	(7e/7h) 20% coins	(7c/7i) $0/visit		(7g) 20% coins	(15) 20% coins	(Misc. PBP Cats) 20% coins	(10b) $0/trip				(18a) 20% coins					(4b) 20% coins	(9c) 20% coins	(9d) 20% coins	(7f1) $0/visit							0.059037978	0.059037978			0.2	0.2	0.2	50	0.2	0.1	0.192	0.2	0.2	0.2		0.2	0.2			0.2	0.2	0.2										0.2	0.2									26.0765	1.137422606	0	0	5.207977501	8.519072213	0.003616215	0.598978933	1.951242373	2.817337607	13.07620781	0.049857433	0.164376991	1.475810549	0	47.91308286	4.506490125	0	0	7.367251698	0.493009939	1.633700855	0	0	0	0	0	0	0	0	0	0.005648872	0.006322207	0	0	0	0	0	0	0	0	123.0039		0	26.0765	1.137422606	0	0	5.207977501	8.519072213	0.003616215	0.598978933	1.951242373	2.817337607	13.07620781	0.049857433	0.164376991	1.475810549	0	47.91308286	4.506490125	0	0	7.367251698	0.493009939	1.633700855	0	0	0	0	0	0	0	0	0	0.005648872	0.006322207	0	0	0	0	0	0	0	0	123.0039																																																																																				0		0	26.0765	1.137422606	0	0	5.207977501	8.519072213	0.003616215	0.598978933	1.951242373	2.817337607	13.07620781	0.049857433	0.164376991	1.475810549	0	47.91308286	4.506490125	0	0	7.367251698	0.493009939	1.633700855	0	0	0	0	0	0	0	0	0	0.005648872	0.006322207	0	0	0	0	0	0	0	0	123.0039
H3379_005_0	2008	4																					3250											D	D	D	V	T	Coin	Coin	V	V	O	O	Coin	Coin	Coin	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0							5.035432136	0.784378689	104.5318026		18474.69328	1187.716484		0.188596587	0.044989522	7209.196783	4529.006418	6.892603348				17.98844234	2013.553908			98.29572663		58.02515901															"$0 (1a, 1a1)"	$0 (1b)	"$0 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $50/$4 (4b)"	$0 (9b)	$0 (8a1); $0/$8 (8a2)	"$5 (8b1); $0 (8b2, 8b3)"	$0 (incl in h5)	20% (12)	"$0 (3, 9d, 9a); 50% (5); 50%/50% (9c)"	"$4/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $4 (14c1, 14c)"	"$10 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"50%/50% (7e, 7h)"	"$0 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $10 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$10 (17a1)	$0 n/c; $0 (17b)	$10 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"																0.195446878	0.198122609	48.8617		3.1272	1.5146		0.195446878	0.498761928	4	10	0.5				0.195446878	10			10		10															0	0	0	0	0	0.984159493	0.155403152	0.425633636	0	4.814428175	0.149904903	0	0.036860614	0.022439061	2.403065594	3.774172015	3.446301674	0	0	0	3.515784904	1.67796159	0	0	0.081913106	0	0.048354299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.5364	0	0.232781907	0	0	0	0	0	0.984159493	0.155403152	0.425633636	0	4.814428175	0.149904903	0	0.036860614	0.022439061	2.403065594	3.774172015	3.446301674	0	0	0	3.515784904	1.67796159	0	0	0.081913106	0	0.048354299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.5364																																																																																				0			0	0	0	0	0	0.984159493	0.155403152	0.425633636	0	4.814428175	0.149904903	0	0.036860614	0.022439061	2.403065594	3.774172015	3.446301674	0	0	0	3.515784904	1.67796159	0	0	0.081913106	0	0.048354299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.5364
H3379_007_0	2008	7																					3500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2088.787093	127.0202836	1000.61777		172.1901018	12.5606926	2.558172836	479.7337321	33.4617796	11628.53304	49.37628861		0.289643947	26.53552601	4584.759083	4499.000385	496.9169191	2.254637364			21.77858659	880.0939604			128.2719979		17.48989125															$325 (1a); $0 (1a1)	$325 (1b)	"$180 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											185.1103	185.1103	102.5226		99.6748	0.170871044	0.28359421	28.4785	0.170871044	4.5566	0.086227608		0.170871044	0.170769767	10	29.9452	37.5	0.170871044			0.170871044	30			30		30															32.2213	1.95939688	8.548830163	0	1.430250817	2.146258662	0.725483005	1.138508386	5.717649225	4.415510186	4.257599252	0	0.049491764	4.53146559	3.820632569	11.2269509	1.552865372	0.385252241	0	0	3.721329835	2.200234901	0	0	0.320679995	0	0.043724728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.4134	0	53.33536711	32.2213	1.95939688	8.548830163	0	1.430250817	2.146258662	0.725483005	1.138508386	5.717649225	4.415510186	4.257599252	0	0.049491764	4.53146559	3.820632569	11.2269509	1.552865372	0.385252241	0	0	3.721329835	2.200234901	0	0	0.320679995	0	0.043724728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.4134																																																																																				0			32.2213	1.95939688	8.548830163	0	1.430250817	2.146258662	0.725483005	1.138508386	5.717649225	4.415510186	4.257599252	0	0.049491764	4.53146559	3.820632569	11.2269509	1.552865372	0.385252241	0	0	3.721329835	2.200234901	0	0	0.320679995	0	0.043724728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.4134
H3379_022_0	2008	6	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)							Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						Coin	Coin	D	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V		Coin	Coin	Coin	T				Coin					Coin	Coin	Coin	V																																																0		265.9073124	2.622177056	8201.910031	129.6470486	30.19573706	20.17924905	0.115605072	198.2386107	8.794300825	39.69372765	36.41106126	4.859293061	0.239557198	6.273919247	21429.47299	95.73867375	6.142531823	11.16412892		11.5117714	3.098634966	3.718140592	1078.526492									0.402410259	0.002984011		247.1							(1a) 8.8% coins	(1b) 8.8% coins	(2a) $0/day	(6a) $0/proc	(10a) 20% coins	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) 20% coins	(8a) 10% coins	(8b) 19.2% coins	(9a) 20% coins	(12) 20% coins	(9a) 20% coins	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) 20% coins	(7e/7h) 20% coins	(7c/7i) $0/visit		(7g) 20% coins	(15) 20% coins	(Misc. PBP Cats) 20% coins	(10b) $0/trip				(18a) 20% coins					(4b) 20% coins	(9c) 20% coins	(9d) 20% coins	(7f1) $0/visit							0.088403416	0.088403416			0.2	0.2	0.2	50	0.2	0.1	0.192	0.2	0.2	0.2		0.2	0.2			0.2	0.2	0.2										0.2	0.2									23.5071	0.23180941	0	0	6.039147412	4.03584981	0.023121014	0.825994211	1.758860165	3.969372765	6.990923761	0.971858612	0.04791144	1.254783849	0	19.14773475	1.228506365	0	0	2.302354279	0.619726993	0.743628118	0	0	0	0	0	0	0	0	0	0.080482052	0.000596802	0	0	0	0	0	0	0	0	73.7798		0	23.5071	0.23180941	0	0	6.039147412	4.03584981	0.023121014	0.825994211	1.758860165	3.969372765	6.990923761	0.971858612	0.04791144	1.254783849	0	19.14773475	1.228506365	0	0	2.302354279	0.619726993	0.743628118	0	0	0	0	0	0	0	0	0	0.080482052	0.000596802	0	0	0	0	0	0	0	0	73.7798																																																																																				0		0	23.5071	0.23180941	0	0	6.039147412	4.03584981	0.023121014	0.825994211	1.758860165	3.969372765	6.990923761	0.971858612	0.04791144	1.254783849	0	19.14773475	1.228506365	0	0	2.302354279	0.619726993	0.743628118	0	0	0	0	0	0	0	0	0	0.080482052	0.000596802	0	0	0	0	0	0	0	0	73.7798
H3379_036_0	2008	5																																D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	S	P				P	V	P																																																							0									914.0731823						18.64433857		4418.981272	1157.518283	1198.321542				0.051846452																				1(a) $0 per Day	1(b) $0 per Day	2(a) 0 per Day	6(a) $0 per visit	10(a) $0 per Trip	11(a) 0% Coinsurance	11(b)/11(c) 0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $10 per visit	9(b) $0 per Visit	8(a) Diagnostic: $0 per procedure; other $0 per procedure	8(b) X-rays $0 per visit; other: $0 per visit	9(a) $0 per Visit	12  $0 per Visit	"3,5,9(a), 9(d) $0 per visit; 9(c) $20/20 per Visit"	7(a) PCP $0 per visit; Urgent Care $10 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $20 perVisit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  $0 per script	"13, 14(a)-(j), 17(a) $0 , 16(b), $10 per procedure"				17(b) $0 copay per procedure	18a/18a1 $10/$0 per visit	18(b) $0 copay per procedure																					36						20		10	20	10				10																				0	0	0	0	0	0	0	2.742219547	0	0	0	0	0	0.031073898	0	3.682484394	1.929197138	0.998601285	0	0	0	4.32E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.3836	0	0	0	0	0	0	0	0	0	2.742219547	0	0	0	0	0	0.031073898	0	3.682484394	1.929197138	0.998601285	0	0	0	4.32E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.3836																																																																																				0	0	0	0	0	0	0	0	0	0	2.742219547	0	0	0	0	0	0.031073898	0	3.682484394	1.929197138	0.998601285	0	0	0	4.32E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.3836
H3384_013_0	2008	6																																A	A	A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		237.1448491	0.892028247	34.09986617		266.6358046	10.93821234	0.188258414	257.140233	336.20905		1475.327497	0.169176413		6.311787392	4498.80685	4191.539495	0.346025628	520.9721586	922.6881228	2017.832828	7.887204624	0			545.3764018	0	0	0.413161057		100												$250 Copay	$250 Copay	$250 Copay		$50 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	$100 Copay		$75 Copay	50% Coinsurance		20% Coinsurance	$10 Copay	$25 Copay	50% Coinsurance	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$25 Copay			$25 Copay	$25 Copay	$25 Copay	$25 Copay		$10 Copay												250	250	250		50	0.25	0.25	50	100		75	0.5		0.2	10	25	0.5	25	25	25	0.2	25			25	25	25	25		10												4.9405	0.018583922	0.710413878	0	1.110982519	2.734553086	0.047064603	1.071417637	2.801742083	0	9.220796857	0.084588207	0	1.262357478	3.749005708	8.732373949	0.173012814	1.085358664	1.922266922	4.203818392	1.577440925	0	0	0	1.136200837	0	0	0.000860752	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	46.6667			4.9405	0.018583922	0.710413878	0	1.110982519	2.734553086	0.047064603	1.071417637	2.801742083	0	9.220796857	0.084588207	0	1.262357478	3.749005708	8.732373949	0.173012814	1.085358664	1.922266922	4.203818392	1.577440925	0	0	0	1.136200837	0	0	0.000860752	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	46.6667																																																																																				0			4.9405	0.018583922	0.710413878	0	1.110982519	2.734553086	0.047064603	1.071417637	2.801742083	0	9.220796857	0.084588207	0	1.262357478	3.749005708	8.732373949	0.173012814	1.085358664	1.922266922	4.203818392	1.577440925	0	0	0	1.136200837	0	0	0.000860752	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	46.6667
H3384_015_0	2008	7																																A	A	A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		237.1448491	0.892028247	34.09986617		266.6358046	10.80608737	0.188258414	257.140233	336.20905		1475.327497	0.169176413		6.311787392	4498.80685	4191.539495	0.346025628	520.9721586	922.6881228	2017.832828	7.887204624	0			545.3764018	0	0	0.413161057		100												$250 Copay	$250 Copay	$250 Copay		$50 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	$100 Copay		$75 Copay	50% Coinsurance		20% Coinsurance	$10 Copay	$25 Copay	50% Coinsurance	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$25 Copay			$25 Copay	$25 Copay	$25 Copay	$25 Copay		$10 Copay												250	250	250		50	0.25	0.25	50	100		75	0.5		0.2	10	25	0.5	25	25	25	0.2	25			25	25	25	25		10												4.9405	0.018583922	0.710413878	0	1.110982519	2.701521842	0.047064603	1.071417637	2.801742083	0	9.220796857	0.084588207	0	1.262357478	3.749005708	8.732373949	0.173012814	1.085358664	1.922266922	4.203818392	1.577440925	0	0	0	1.136200837	0	0	0.000860752	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	46.6337			4.9405	0.018583922	0.710413878	0	1.110982519	2.701521842	0.047064603	1.071417637	2.801742083	0	9.220796857	0.084588207	0	1.262357478	3.749005708	8.732373949	0.173012814	1.085358664	1.922266922	4.203818392	1.577440925	0	0	0	1.136200837	0	0	0.000860752	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	46.6337																																																																																				0			4.9405	0.018583922	0.710413878	0	1.110982519	2.701521842	0.047064603	1.071417637	2.801742083	0	9.220796857	0.084588207	0	1.262357478	3.749005708	8.732373949	0.173012814	1.085358664	1.922266922	4.203818392	1.577440925	0	0	0	1.136200837	0	0	0.000860752	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	46.6337
H3384_019_0	2008	5																																A	A	A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V																																																							0		156.0102115	1.110329036	10.41001745		245.924358	13.48006872	0.579616667	249.4353593	333.0396962		568.8580916	0.020809301		2.920324491	5525.5343	3521.811661	0.73048421	405.1892362	883.2478968	1070.080585	7.90505947	14.64905384			623.6763186	0	0	1.805706296		100												$500 Copay	$500 Copay	$500 Copay		$75 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$75 Copay		$35 Copay	50% Coinsurance		50% Coinsurance	$20 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	$35 Copay			$35 Copay	$35 Copay	$35 Copay	$35 Copay		$10 Copay												500	500	500		75	0.3	0.3	50	75		35	0.5		0.5	20	35	0.5	35	35	35	0.2	35			35	35	35	35		10												6.5004	0.04626371	0.433750727	0	1.537027237	4.044020616	0.173885	1.039313997	2.081498102	0	1.659169434	0.01040465	0	1.460162245	9.209223834	10.27195068	0.365242105	1.181801939	2.576139699	3.121068372	1.581011894	0.042726407	0	0	1.819055929	0	0	0.005266643	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	49.2427			6.5004	0.04626371	0.433750727	0	1.537027237	4.044020616	0.173885	1.039313997	2.081498102	0	1.659169434	0.01040465	0	1.460162245	9.209223834	10.27195068	0.365242105	1.181801939	2.576139699	3.121068372	1.581011894	0.042726407	0	0	1.819055929	0	0	0.005266643	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	49.2427																																																																																				0			6.5004	0.04626371	0.433750727	0	1.537027237	4.044020616	0.173885	1.039313997	2.081498102	0	1.659169434	0.01040465	0	1.460162245	9.209223834	10.27195068	0.365242105	1.181801939	2.576139699	3.121068372	1.581011894	0.042726407	0	0	1.819055929	0	0	0.005266643	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	49.2427
H3384_022_0	2008	7																																A	A	A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		157.7936167	1.110329036	10.41111897		252.5194951	13.48006872	0.579616667	249.4353593	333.0396962		575.3355736	0.020809301		2.920324491	6142.341875	3582.978002	0.73048421	421.9399293	886.2555304	1077.776388	7.90505947	14.91782229			641.751373	0	0	1.832139099		100												$250 Copay	$250 Copay	$250 Copay		$50 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$75 Copay		$25 Copay	50% Coinsurance		50% Coinsurance	$5 Copay	$25 Copay	50% Coinsurance	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$25 Copay			$25 Copay	$25 Copay	$25 Copay	$25 Copay		$10 Copay												250	250	250		50	0.3	0.3	50	75		25	0.5		0.5	5	25	0.5	25	25	25	0.2	25			25	25	25	25		10												3.2874	0.023131855	0.216898312	0	1.052164563	4.044020616	0.173885	1.039313997	2.081498102	0	1.198615778	0.01040465	0	1.460162245	2.559309114	7.464537503	0.365242105	0.879041519	1.846365688	2.245367476	1.581011894	0.031078796	0	0	1.336982027	0	0	0.003816956	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	32.9835			3.2874	0.023131855	0.216898312	0	1.052164563	4.044020616	0.173885	1.039313997	2.081498102	0	1.198615778	0.01040465	0	1.460162245	2.559309114	7.464537503	0.365242105	0.879041519	1.846365688	2.245367476	1.581011894	0.031078796	0	0	1.336982027	0	0	0.003816956	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	32.9835																																																																																				0			3.2874	0.023131855	0.216898312	0	1.052164563	4.044020616	0.173885	1.039313997	2.081498102	0	1.198615778	0.01040465	0	1.460162245	2.559309114	7.464537503	0.365242105	0.879041519	1.846365688	2.245367476	1.581011894	0.031078796	0	0	1.336982027	0	0	0.003816956	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	32.9835
H3384_040_0	2008	12																																A	A	A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin				V	V	V	V		V																																																					0		237.1448491	0.892028247	34.09986617		266.6358046	10.95244595	0.188258414	257.140233	336.20905		1380.853129	0.169176413		6.311787392	4498.80685	4228.449375	0.346025628	532.4535448	924.2705726	2027.060595	7.887204624	0			553.177498	0	0	0.419003738		100												$250 Copay	$250 Copay	$250 Copay		$50 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	$100 Copay		$75 Copay	50% Coinsurance		20% Coinsurance	$10 Copay	$20 Copay	50% Coinsurance	$20 Copay	$20 Copay	$20 Copay	20% Coinsurance	$20 Copay			$20 Copay	$20 Copay	$20 Copay	$20 Copay		$10 Copay												250	250	250		50	0.25	0.25	50	100		75	0.5		0.2	10	20	0.5	20	20	20	0.2	20			20	20	20	20		10												4.9405	0.018583922	0.710413878	0	1.110982519	2.738111487	0.047064603	1.071417637	2.801742083	0	8.630332056	0.084588207	0	1.262357478	3.749005708	7.047415625	0.173012814	0.887422575	1.540450954	3.378434324	1.577440925	0	0	0	0.921962497	0	0	0.00069834	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	42.7753			4.9405	0.018583922	0.710413878	0	1.110982519	2.738111487	0.047064603	1.071417637	2.801742083	0	8.630332056	0.084588207	0	1.262357478	3.749005708	7.047415625	0.173012814	0.887422575	1.540450954	3.378434324	1.577440925	0	0	0	0.921962497	0	0	0.00069834	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	42.7753																																																																																				0			4.9405	0.018583922	0.710413878	0	1.110982519	2.738111487	0.047064603	1.071417637	2.801742083	0	8.630332056	0.084588207	0	1.262357478	3.749005708	7.047415625	0.173012814	0.887422575	1.540450954	3.378434324	1.577440925	0	0	0	0.921962497	0	0	0.00069834	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	42.7753
H3384_041_0	2008	7																																A	A	A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		157.7936167	1.110329036	10.41111897	0	252.5194951	13.48006872	0.579616667	249.4353593	358.6457058	0	572.1688046	0.020809301	0	2.920324491	6142.341875	3582.978002	0.73048421	421.9399293	884.7851318	1077.776388	7.90505947	14.91782229			641.751373	0	0	1.832139099		100												$250 Copay	$250 Copay	$250 Copay	0% Coinsurance	$50 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$50 Copay	0% Coinsurance	$25 Copay	50% Coinsurance	0% Coinsurance	50% Coinsurance	$5 Copay	$25 Copay	50% Coinsurance	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$25 Copay			$25 Copay	$25 Copay	$25 Copay	$25 Copay		$10 Copay												250	250	250	0	50	0.3	0.3	50	50	0	25	0.5	0	0.5	5	25	0.5	25	25	25	0.2	25			25	25	25	25		10												3.2874	0.023131855	0.216898312	0	1.052164563	4.044020616	0.173885	1.039313997	1.494357108	0	1.192018343	0.01040465	0	1.460162245	2.559309114	7.464537503	0.365242105	0.879041519	1.843302358	2.245367476	1.581011894	0.031078796	0	0	1.336982027	0	0	0.003816956	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	32.3867			3.2874	0.023131855	0.216898312	0	1.052164563	4.044020616	0.173885	1.039313997	1.494357108	0	1.192018343	0.01040465	0	1.460162245	2.559309114	7.464537503	0.365242105	0.879041519	1.843302358	2.245367476	1.581011894	0.031078796	0	0	1.336982027	0	0	0.003816956	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	32.3867																																																																																				0			3.2874	0.023131855	0.216898312	0	1.052164563	4.044020616	0.173885	1.039313997	1.494357108	0	1.192018343	0.01040465	0	1.460162245	2.559309114	7.464537503	0.365242105	0.879041519	1.843302358	2.245367476	1.581011894	0.031078796	0	0	1.336982027	0	0	0.003816956	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	32.3867
H3384_044_0	2008	11																																							V				V	V	V		V	V	V	V	V		V																																																													0									334.9574799				0.648587245	154.2633303	401.5642298		3515.521262	174.7046285	362.3484796	737.4711388	1578.194349		5.072591652																											$50 Copay				$10 Copay	$10 Copay	$10 Copay		$10 Copay	$20 Copay	$10 Copay	$10 Copay	$10 Copay		$10 Copay																											50				10	10	10		10	20	10	10	10		10																				0	0	0	0	0	0	0	1.395656166	0	0	0	0.000540489	0.128552775	0.334636858	0	2.929601052	0.291174381	0.301957066	0.614559282	1.315161958	0	0.00422716	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.3161			0	0	0	0	0	0	0	1.395656166	0	0	0	0.000540489	0.128552775	0.334636858	0	2.929601052	0.291174381	0.301957066	0.614559282	1.315161958	0	0.00422716	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.3161																																																																																				0			0	0	0	0	0	0	0	1.395656166	0	0	0	0.000540489	0.128552775	0.334636858	0	2.929601052	0.291174381	0.301957066	0.614559282	1.315161958	0	0.00422716	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.3161
H3384_045_0	2008	10																																							V				V	V	V		V	V	V	V	V		V																																																													0									334.9574799				0.648587245	154.2633303	401.5642298		3300.958931	174.7046285	362.3484796	737.4711388	1578.194349		5.072591652																											$50 Copay				$10 Copay	$10 Copay	$10 Copay		$10 Copay	$20 Copay	$10 Copay	$10 Copay	$10 Copay		$10 Copay																											50				10	10	10		10	20	10	10	10		10																				0	0	0	0	0	0	0	1.395656166	0	0	0	0.000540489	0.128552775	0.334636858	0	2.750799109	0.291174381	0.301957066	0.614559282	1.315161958	0	0.00422716	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.1373			0	0	0	0	0	0	0	1.395656166	0	0	0	0.000540489	0.128552775	0.334636858	0	2.750799109	0.291174381	0.301957066	0.614559282	1.315161958	0	0.00422716	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.1373																																																																																				0			0	0	0	0	0	0	0	1.395656166	0	0	0	0.000540489	0.128552775	0.334636858	0	2.750799109	0.291174381	0.301957066	0.614559282	1.315161958	0	0.00422716	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.1373
H3384_051_0	2008	6																																A	A	A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		158.8636598	1.110329036	10.41177988		252.5194951	13.48006872	0.579616667	249.4353593	333.0396962		584.4040483	0.020809301		2.920324491	6142.341875	3659.435927	0.73048421	442.8782957	892.2206703	1087.396143	7.90505947	15.25378284			664.3451909	0	0	1.865180103		100												$100 Copay	$100 Copay	$100 Copay		$50 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$75 Copay		$15 Copay	50% Coinsurance		50% Coinsurance	$5 Copay	$15 Copay	50% Coinsurance	$15 Copay	$15 Copay	$15 Copay	20% Coinsurance	$15 Copay			$15 Copay	$15 Copay	$15 Copay	$15 Copay		$10 Copay												100	100	100		50	0.3	0.3	50	75		15	0.5		0.5	5	15	0.5	15	15	15	0.2	15			15	15	15	15		10												1.3239	0.009252742	0.086764832	0	1.052164563	4.044020616	0.173885	1.039313997	2.081498102	0	0.73050506	0.01040465	0	1.460162245	2.559309114	4.574294909	0.365242105	0.55359787	1.115275838	1.359245179	1.581011894	0.019067229	0	0	0.830431489	0	0	0.002331475	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	25.055			1.3239	0.009252742	0.086764832	0	1.052164563	4.044020616	0.173885	1.039313997	2.081498102	0	0.73050506	0.01040465	0	1.460162245	2.559309114	4.574294909	0.365242105	0.55359787	1.115275838	1.359245179	1.581011894	0.019067229	0	0	0.830431489	0	0	0.002331475	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	25.055																																																																																				0			1.3239	0.009252742	0.086764832	0	1.052164563	4.044020616	0.173885	1.039313997	2.081498102	0	0.73050506	0.01040465	0	1.460162245	2.559309114	4.574294909	0.365242105	0.55359787	1.115275838	1.359245179	1.581011894	0.019067229	0	0	0.830431489	0	0	0.002331475	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	25.055
H3384_052_0	2008	7																																A	A	A		T	Coin	Coin	V	V		V	Coin	V	Coin	V	V	Coin	V	V	V	Coin	V			V		V			V																																																					0		157.0802546	1.110329036	10.41067836	0	252.5194951	13.48006872	0.579616667	249.4353593	333.0396962	0	578.5743146	0.020809301	0	2.753551508	5895.618845	3613.561172	0.73048421	430.3152759	887.7593472	1081.62429	7.90505947	301.3454756			650.7889001	0	0	36.94405407		100												$350 Copay	$350 Copay	$350 Copay	0% Coinsurance	$50 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$75 Copay	0% Coinsurance	$20 Copay	50% Coinsurance	0% Coinsurance	50% Coinsurance	$10 Copay	$20 Copay	50% Coinsurance	$20 Copay	$20 Copay	$20 Copay	20% Coinsurance	$20 Copay			$20 Copay	$20 Copay	$20 Copay	$20 Copay		$10 Copay												350	350	350	0	50	0.3	0.3	50	75	0	20	0.5	0	0.5	10	20	0.5	20	20	20	0.2	20			20	20	20	20		10												4.5815	0.032384597	0.303644786	0	1.052164563	4.044020616	0.173885	1.039313997	2.081498102	0	0.964290524	0.01040465	0	1.376775754	4.913015704	6.022601953	0.365242105	0.717192126	1.479598912	1.802707151	1.581011894	0.502242459	0	0	1.084648167	0	0	0.061573423	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	34.2731			4.5815	0.032384597	0.303644786	0	1.052164563	4.044020616	0.173885	1.039313997	2.081498102	0	0.964290524	0.01040465	0	1.376775754	4.913015704	6.022601953	0.365242105	0.717192126	1.479598912	1.802707151	1.581011894	0.502242459	0	0	1.084648167	0	0	0.061573423	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	34.2731																																																																																				0			4.5815	0.032384597	0.303644786	0	1.052164563	4.044020616	0.173885	1.039313997	2.081498102	0	0.964290524	0.01040465	0	1.376775754	4.913015704	6.022601953	0.365242105	0.717192126	1.479598912	1.802707151	1.581011894	0.502242459	0	0	1.084648167	0	0	0.061573423	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	34.2731
H3384_053_0	2008	10																																D	D	D		T	Coin	Coin	V	Coin		V	Coin		Coin	V	V	Coin	V	V	V	Coin				V	V	V	V		V																																																					0		802.6320195	4.653072268	217.1959262		266.6358046	10.95244595	0.188258414	257.140233	27.82586629		1380.853129	0.169176413		6.311787392	4498.80685	4154.629616	0.346025628	509.4907724	921.4264641	2008.605062	7.887204624	0			537.5753056	0	0	0.407318375		100												$260 Copay	$260 Copay	$260 Copay		$50 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	20% Coinsurance		$75 Copay	50% Coinsurance		20% Coinsurance	$10 Copay	$30 Copay	50% Coinsurance	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$30 Copay			$30 Copay	$30 Copay	$30 Copay	$30 Copay		$10 Copay												260	260	260		50	0.25	0.25	50	0.2		75	0.5		0.2	10	30	0.5	30	30	30	0.2	30			30	30	30	30		10												17.3904	0.100816566	4.705911734	0	1.110982519	2.738111487	0.047064603	1.071417637	5.565173258	0	8.630332056	0.084588207	0	1.262357478	3.749005708	10.38657404	0.173012814	1.273726931	2.30356616	5.021512655	1.577440925	0	0	0	1.343938264	0	0	0.001018296	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	68.6202			17.3904	0.100816566	4.705911734	0	1.110982519	2.738111487	0.047064603	1.071417637	5.565173258	0	8.630332056	0.084588207	0	1.262357478	3.749005708	10.38657404	0.173012814	1.273726931	2.30356616	5.021512655	1.577440925	0	0	0	1.343938264	0	0	0.001018296	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	68.6202																																																																																				0			17.3904	0.100816566	4.705911734	0	1.110982519	2.738111487	0.047064603	1.071417637	5.565173258	0	8.630332056	0.084588207	0	1.262357478	3.749005708	10.38657404	0.173012814	1.273726931	2.30356616	5.021512655	1.577440925	0	0	0	1.343938264	0	0	0.001018296	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	68.6202
H3384_054_0	2008	9																																A	A	A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		158.8636598	1.110329036	10.41177988		252.5194951	13.48006872	0.579616667	249.4353593	358.6457058		584.2421113	0.020809301		2.920324491	6142.341875	3659.435927	0.73048421	442.8782957	890.3910265	1087.396143	7.90505947	15.25378284			664.3451909	0	0	1.865180103		100												$100 Copay	$100 Copay	$100 Copay		$50 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$50 Copay		$15 Copay	50% Coinsurance		50% Coinsurance	$5 Copay	$15 Copay	50% Coinsurance	$15 Copay	$15 Copay	$15 Copay	20% Coinsurance	$15 Copay			$15 Copay	$15 Copay	$15 Copay	$15 Copay		$10 Copay												100	100	100		50	0.3	0.3	50	50		15	0.5		0.5	5	15	0.5	15	15	15	0.2	15			15	15	15	15		10												1.3239	0.009252742	0.086764832	0	1.052164563	4.044020616	0.173885	1.039313997	1.494357108	0	0.730302639	0.01040465	0	1.460162245	2.559309114	4.574294909	0.365242105	0.55359787	1.112988783	1.359245179	1.581011894	0.019067229	0	0	0.830431489	0	0	0.002331475	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	24.4653			1.3239	0.009252742	0.086764832	0	1.052164563	4.044020616	0.173885	1.039313997	1.494357108	0	0.730302639	0.01040465	0	1.460162245	2.559309114	4.574294909	0.365242105	0.55359787	1.112988783	1.359245179	1.581011894	0.019067229	0	0	0.830431489	0	0	0.002331475	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	24.4653																																																																																				0			1.3239	0.009252742	0.086764832	0	1.052164563	4.044020616	0.173885	1.039313997	1.494357108	0	0.730302639	0.01040465	0	1.460162245	2.559309114	4.574294909	0.365242105	0.55359787	1.112988783	1.359245179	1.581011894	0.019067229	0	0	0.830431489	0	0	0.002331475	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	24.4653
H3384_801_0	2008	2																																A	A	A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		178.6405724	1.023599779	17.19656295		241.2320877	12.00151914	0.382994044	249.9702388	316.6295812		928.7434345	0.089859733		4.075042495	4617.211196	3636.157148	0.536846959	451.6242013	892.312092	1555.551559	7.929525244	7.682928698			564.760101	0	0	1.114738229		100												$500 Copay	$500 Copay	$500 Copay		$75 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$100 Copay		$35 Copay	50% Coinsurance		50% Coinsurance	$25 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	$35 Copay			$35 Copay	$35 Copay	$35 Copay	$35 Copay		$10 Copay												500	500	500		75	0.3	0.3	50	100		35	0.5		0.5	25	35	0.5	35	35	35	0.2	35			35	35	35	35		10												7.4434	0.042649991	0.716523456	0	1.507700548	3.600455743	0.114898213	1.041542662	2.638579843	0	2.708835017	0.044929866	0	2.037521247	9.619189992	10.60545835	0.268423479	1.317237254	2.602576935	4.537025381	1.585905049	0.022408542	0	0	1.647216961	0	0	0.00325132	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	54.189			7.4434	0.042649991	0.716523456	0	1.507700548	3.600455743	0.114898213	1.041542662	2.638579843	0	2.708835017	0.044929866	0	2.037521247	9.619189992	10.60545835	0.268423479	1.317237254	2.602576935	4.537025381	1.585905049	0.022408542	0	0	1.647216961	0	0	0.00325132	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	54.189																																																																																				0			7.4434	0.042649991	0.716523456	0	1.507700548	3.600455743	0.114898213	1.041542662	2.638579843	0	2.708835017	0.044929866	0	2.037521247	9.619189992	10.60545835	0.268423479	1.317237254	2.602576935	4.537025381	1.585905049	0.022408542	0	0	1.647216961	0	0	0.00325132	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	54.189
H3384_802_0	2008	2																																A	A	A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		178.6405724	1.023599779	17.19656295		241.2320877	12.00151914	0.382994044	249.9702388	316.6295812		928.7434345	0.089859733		4.075042495	4617.211196	3636.157148	0.536846959	451.6242013	892.312092	1555.551559	7.929525244	7.682928698			564.760101	0	0	1.114738229		100												$500 Copay	$500 Copay	$500 Copay		$75 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$100 Copay		$35 Copay	50% Coinsurance		50% Coinsurance	$25 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	$35 Copay			$35 Copay	$35 Copay	$35 Copay	$35 Copay		$10 Copay												500	500	500		75	0.3	0.3	50	100		35	0.5		0.5	25	35	0.5	35	35	35	0.2	35			35	35	35	35		10												7.4434	0.042649991	0.716523456	0	1.507700548	3.600455743	0.114898213	1.041542662	2.638579843	0	2.708835017	0.044929866	0	2.037521247	9.619189992	10.60545835	0.268423479	1.317237254	2.602576935	4.537025381	1.585905049	0.022408542	0	0	1.647216961	0	0	0.00325132	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	54.189			7.4434	0.042649991	0.716523456	0	1.507700548	3.600455743	0.114898213	1.041542662	2.638579843	0	2.708835017	0.044929866	0	2.037521247	9.619189992	10.60545835	0.268423479	1.317237254	2.602576935	4.537025381	1.585905049	0.022408542	0	0	1.647216961	0	0	0.00325132	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	54.189																																																																																				0			7.4434	0.042649991	0.716523456	0	1.507700548	3.600455743	0.114898213	1.041542662	2.638579843	0	2.708835017	0.044929866	0	2.037521247	9.619189992	10.60545835	0.268423479	1.317237254	2.602576935	4.537025381	1.585905049	0.022408542	0	0	1.647216961	0	0	0.00325132	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	54.189
H3384_803_0	2008	2																																A	A	A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		182.1650163	1.043794632	17.53583819		245.703033	12.33981527	0.393789794	253.1610001	320.67122		940.5984403	0.094624615		4.291124784	4702.785626	3703.548926	0.55197948	459.9945101	908.8500183	1584.381828	7.929525244	7.780997939			575.2272469	0	0	1.135398555		100												$500 Copay	$500 Copay	$500 Copay		$75 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$100 Copay		$35 Copay	50% Coinsurance		50% Coinsurance	$25 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	$35 Copay			$35 Copay	$35 Copay	$35 Copay	$35 Copay		$10 Copay												500	500	500		75	0.3	0.3	50	100		35	0.5		0.5	25	35	0.5	35	35	35	0.2	35			35	35	35	35		10												7.5902	0.043491443	0.730659924	0	1.535643956	3.701944581	0.118136938	1.054837501	2.672260167	0	2.743412118	0.047312307	0	2.145562392	9.797470054	10.8020177	0.27598974	1.341650655	2.650812553	4.621113664	1.585905049	0.022694577	0	0	1.677746137	0	0	0.003311579	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	55.2455			7.5902	0.043491443	0.730659924	0	1.535643956	3.701944581	0.118136938	1.054837501	2.672260167	0	2.743412118	0.047312307	0	2.145562392	9.797470054	10.8020177	0.27598974	1.341650655	2.650812553	4.621113664	1.585905049	0.022694577	0	0	1.677746137	0	0	0.003311579	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	55.2455																																																																																				0			7.5902	0.043491443	0.730659924	0	1.535643956	3.701944581	0.118136938	1.054837501	2.672260167	0	2.743412118	0.047312307	0	2.145562392	9.797470054	10.8020177	0.27598974	1.341650655	2.650812553	4.621113664	1.585905049	0.022694577	0	0	1.677746137	0	0	0.003311579	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	55.2455
H3384_804_0	2008	2																																A	A	A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		182.1650163	1.043794632	17.53583819		245.703033	12.33981527	0.393789794	253.1610001	320.67122		940.5984403	0.094624615		4.291124784	4702.785626	3703.548926	0.55197948	459.9945101	908.8500183	1584.381828	7.929525244	7.780997939			575.2272469	0	0	1.135398555		100												$500 Copay	$500 Copay	$500 Copay		$75 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$100 Copay		$35 Copay	50% Coinsurance		50% Coinsurance	$25 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	$35 Copay			$35 Copay	$35 Copay	$35 Copay	$35 Copay		$10 Copay												500	500	500		75	0.3	0.3	50	100		35	0.5		0.5	25	35	0.5	35	35	35	0.2	35			35	35	35	35		10												7.5902	0.043491443	0.730659924	0	1.535643956	3.701944581	0.118136938	1.054837501	2.672260167	0	2.743412118	0.047312307	0	2.145562392	9.797470054	10.8020177	0.27598974	1.341650655	2.650812553	4.621113664	1.585905049	0.022694577	0	0	1.677746137	0	0	0.003311579	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	55.2455			7.5902	0.043491443	0.730659924	0	1.535643956	3.701944581	0.118136938	1.054837501	2.672260167	0	2.743412118	0.047312307	0	2.145562392	9.797470054	10.8020177	0.27598974	1.341650655	2.650812553	4.621113664	1.585905049	0.022694577	0	0	1.677746137	0	0	0.003311579	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	55.2455																																																																																				0			7.5902	0.043491443	0.730659924	0	1.535643956	3.701944581	0.118136938	1.054837501	2.672260167	0	2.743412118	0.047312307	0	2.145562392	9.797470054	10.8020177	0.27598974	1.341650655	2.650812553	4.621113664	1.585905049	0.022694577	0	0	1.677746137	0	0	0.003311579	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	55.2455
H3387_005_0	2008	8																																Coin	Coin	Coin	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	Coin	P	Coin	P	P	P	P															0.0001	0.0001	0.0001		0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001																				0.0017		498.5827514	26.85100255	21.67996601		6.344747649	5.344172256	4.444748094	291.0748489	15.95988793	13.65169071	41.75120835	1.217652737	4.20420319	41.50868552	61.89556886	105.5772663	13.92449288	12.72756804			9.776098615	5.458603646																				ffs medicare (1a)	ffs medicare (1b)	ffs medicare (2)	$0 (6)	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a);  20% (4b)	20% (9b)	0% or 20% (8a)	20% (8b)	20% (9a)	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"20% (7a, 14b, 14c, 14e, 14f, 14g, 14h)"	"20% (7b, 7d, 7f, 7g)"	50% (7e);  50% (7h)	"20% (7c, 7i)"	20% (incl in h2)	20% (14i)	20% (15)	"20% (13a, 14j, 16b, 17a), $0 (14a, 17b)"	$0 (10b)	"$0 n/c (16a, 16b1-16b3, 16b5-16b8)"	$0 (17a)	$0 (17b1-17b5)	$0 n/c (18a)	$0 n/c (18b)	$0 n/c	$0 n/c (14a)	$0 (13c)											0.057363291	0.0569	0.1798		0.234	0.234	0.234	49.9997	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234138015	0.234	0.234			0.234	0.234																				28.6003	1.527822045	3.898057888	0	1.48467095	1.250536308	1.040071054	1.212803916	3.734613776	3.194495627	9.769782753	0.28493074	0.983783546	9.713032412	14.48356311	24.71965156	3.258331334	2.978250922	0	0	2.287607076	1.277313253	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.6997	135	0	28.6003	1.527822045	3.898057888	0	1.48477095	1.250636308	1.040171054	1.212803916	3.734713776	3.194595627	9.769882753	0.28503074	0.983883546	9.713132412	14.48366311	24.71975156	3.258431334	2.978350922	0.0001	0.0001	2.287707076	1.277413253	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.7014																																																																																				0	0	0	28.6003	1.527822045	3.898057888	0	1.48477095	1.250636308	1.040171054	1.212803916	3.734713776	3.194595627	9.769882753	0.28503074	0.983883546	9.713132412	14.48366311	24.71975156	3.258431334	2.978350922	0.0001	0.0001	2.287707076	1.277413253	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.7014
H3388_001_0	2008	2	h.5.	i.6.	i.6.	i.6.	f.	i.6.	i.6.				OP Facility - Other	Professional	Professional	Professional	OP Facility - Emergency	Professional	Professional					Cardiac Rehab	Podiatrist	Chiropractor	Physical Exam	Urgent Care	Bone Mass	Substance Abuse				D	D			t	coin		v	p	v	v		v	o	v	v	v	v		v					v	coin	v					v	v	v	v	v	v	v																																													0		1907.351468	81.0217597			614.778641	19.30776739		271.3063608	403.2046443	7816.785343	4990.721039		9.425563114	1675.656046	3534.871791	5405.234836	279.0018613	1039.668174		2344.666425					1501.143363	0.218980395	118.8152211					208.9158927	331.7188887	639.6301379	379.2356278	68.68360238	230.5165223	60.88965703				$250 inpatient copay per stay - capped at 3 copays	$250 copay for each Medicare-covered hospital stay			$50 for Medicare-covered ambulance services waived if admitted within 24 hours	20% coin per tiem		$50 for Medicare-covered emergency room visits. (Wavied if Admitted)	$100 copay for each Medicare-covered ambulatory surgical center visit.	$0 to $12 copay for Medicare-covered clinical/diagnostic lab benefits.	$0 to $12 copay for Medicare-covered X-rays.		$12 per session in area/ $12 persession out of area	$12 per session in area/ $12 persession out of area	$12 copay for each Medicare covered service	$12 copay for each Medicare covered service	Visits 110 = $10 copayment/visit. Visits 11+ = $25 copayment/visit. No visit limit.	$12 copay for each Medicare covered service		$12 copay for each Medicare covered service					$12 copay for each Routine Eye exam	20% after cataract surg	$12 copay for each Medicare covered service					$12 copay for each Medicare covered service	$12 copay for each Medicare covered service	$12 copay for each Medicare covered service	$12 copay for each Medicare covered service	$12 to $35 for Medicare-covered urgently needed care visits - Waived if admitteed within 24 hours	$0 - $12 copay for each Medicare covered service (waived if preferred radiology facility used)	Visits 110 = $10 copayment/visit. Visits 11+ = $25 copayment/visit. No visit limit.				36.07	15.51			23.04	0.2		45.06	100.02	1.71	0.92		15.27	6.07	10.99	11.72484772	17.82	11.87		4.43					6.55	0.2	2.88					13.12	11.02	11.79	2.41	11.97639944	1.98	17.82				5.7332	0.104720624	0	0	1.180374991	3.861553477	0	1.018755385	3.360710711	1.113891911	0.382621946	0	0.011994029	0.847602683	3.237353415	5.281296279	0.414317764	1.028405102	0	0.865572689	0	0	0	0	0.819374086	0.043796079	0.028515653	0	0	0	0	0.228414709	0.304628513	0.62843661	0.076163155	0.068548521	0.038035226	0.090421141	0	0	0	30.7687			5.7332	0.104720624	0	0	1.180374991	3.861553477	0	1.018755385	3.360710711	1.113891911	0.382621946	0	0.011994029	0.847602683	3.237353415	5.281296279	0.414317764	1.028405102	0	0.865572689	0	0	0	0	0.819374086	0.043796079	0.028515653	0	0	0	0	0.228414709	0.304628513	0.62843661	0.076163155	0.068548521	0.038035226	0.090421141	0	0	0	30.7687																																																																																				0			5.7332	0.104720624	0	0	1.180374991	3.861553477	0	1.018755385	3.360710711	1.113891911	0.382621946	0	0.011994029	0.847602683	3.237353415	5.281296279	0.414317764	1.028405102	0	0.865572689	0	0	0	0	0.819374086	0.043796079	0.028515653	0	0	0	0	0.228414709	0.304628513	0.62843661	0.076163155	0.068548521	0.038035226	0.090421141	0	0	0	30.7687
H3388_002_0	2008	3	h.5.	i.6.	i.6.	i.6.	f.	i.6.	i.6.				OP Facility - Other	Professional	Professional	Professional	OP Facility - Emergency	Professional	Professional					Cardiac Rehab	Podiatrist	Chiropractor	Physical Exam	Urgent Care	Bone Mass	Substance Abuse				D	D			t	coin		v	p	v	v		v	o	v	v	v	v		v					v	coin	v					v	v	v	v	v	v	v																																													0		2067.452233	87.82262779			666.3824133	20.92843792		294.0794871	437.0491524	8472.916809	5409.6361		10.21673343	1816.308579	3831.584635	5858.943682	302.4209386	1126.936657		2541.474877					1627.147513	0.237361343	128.7884265					226.4520389	359.5629692	693.3199146	411.0682057	74.44882052	249.8657992	66.00066088				$250 inpatient copay per stay - capped at 3 copays	$250 copay for each Medicare-covered hospital stay			$50 for Medicare-covered ambulance services waived if admitted within 24 hours	20% coin per tiem		$50 for Medicare-covered emergency room visits. (Wavied if Admitted)	$100 copay for each Medicare-covered ambulatory surgical center visit.	$0 to $12 copay for Medicare-covered clinical/diagnostic lab benefits.	$0 to $12 copay for Medicare-covered X-rays.		$12 per session in area/ $12 persession out of area	$12 per session in area/ $12 persession out of area	$12 copay for each Medicare covered service	$12 copay for each Medicare covered service	Visits 110 = $10 copayment/visit. Visits 11+ = $25 copayment/visit. No visit limit.	$12 copay for each Medicare covered service		$12 copay for each Medicare covered service					$12 copay for each Routine Eye exam	20% after cataract surg	$12 copay for each Medicare covered service					$12 copay for each Medicare covered service	$12 copay for each Medicare covered service	$12 copay for each Medicare covered service	$12 copay for each Medicare covered service	$12 to $35 for Medicare-covered urgently needed care visits - Waived if admitteed within 24 hours	$0 - $12 copay for each Medicare covered service (waived if preferred radiology facility used)	Visits 110 = $10 copayment/visit. Visits 11+ = $25 copayment/visit. No visit limit.				36.07	15.51			23.04	0.2		45.06	100.02	1.71	0.92		15.27	6.07	10.99	11.72484772	17.82	11.87		4.43					6.55	0.2	2.88					13.12	11.02	11.79	2.41	11.97639944	1.98	17.82				6.2144	0.113510746	0	0	1.279454234	4.185687585	0	1.104268474	3.642804685	1.207390645	0.414738768	0	0.013000793	0.918749423	3.509092928	5.724601873	0.449095094	1.114728177	0	0.938227809	0	0	0	0	0.888151351	0.047472269	0.030909222	0	0	0	0	0.247587563	0.33019866	0.681186816	0.082556198	0.074302401	0.041227857	0.098010981	0	0	0	33.3514			6.2144	0.113510746	0	0	1.279454234	4.185687585	0	1.104268474	3.642804685	1.207390645	0.414738768	0	0.013000793	0.918749423	3.509092928	5.724601873	0.449095094	1.114728177	0	0.938227809	0	0	0	0	0.888151351	0.047472269	0.030909222	0	0	0	0	0.247587563	0.33019866	0.681186816	0.082556198	0.074302401	0.041227857	0.098010981	0	0	0	33.3514																																																																																				0			6.2144	0.113510746	0	0	1.279454234	4.185687585	0	1.104268474	3.642804685	1.207390645	0.414738768	0	0.013000793	0.918749423	3.509092928	5.724601873	0.449095094	1.114728177	0	0.938227809	0	0	0	0	0.888151351	0.047472269	0.030909222	0	0	0	0	0.247587563	0.33019866	0.681186816	0.082556198	0.074302401	0.041227857	0.098010981	0	0	0	33.3514
H3388_003_0	2008	2	h.5.	i.6.	i.6.	i.6.	i6	i.6.	i.6.				OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional					Urgent Care	Podiatrist	Chiropractor	Physical Exam	Cardiac Rehab	Bone Mass	Substance Abuse				D	D			t	coin		v	p	v	v		v	o	v	v	v	v		v					v	coin	v					v	v	v	v	v	v	v																																													0		1975.140248	83.3431			639.5920676	20.06504082		282.3979366	419.1409337	8136.352002	5194.752234		9.8109	1741.884796	3881.207595	5534.914666	284.3070361	1027.378481		2440.521331					1483.398672	0.227932775	117.4107321					217.4568147	327.7977114	624.1683431	394.7395795	69.8565913	253.1018181	62.0474639				$500 inpatient copay per stay - capped at 3 copays	$500 inpatient copay per stay - capped at 3 copays			$100  for Medicare-covered ambulance services waived if admitted within 24 hours	30% coin per tiem		$50 for Medicare-covered emergency room visits. (Wavied if Admitted)	$125  copay for each Medicare-covered ambulatory surgical center visit.	$0 to $20 copay for Medicare-covered clinical/diagnostic lab benefits.	$0 to $20 copay for Medicare-covered X-rays.		$20 per session in area/ $20 persession out of area	$20 copay for each Medicare covered service	$20 copay for each Medicare covered service	$20 copay for each Medicare covered service	Visits 110 =$20 copayment/visit.Visits 11+ = $25 copayment/visit.	$20 copay for each Medicare covered service		$20 copay for each Medicare covered service					$20 copay for each Medicare covered service	30% after cataract surg	$20 copay for each Medicare covered service					$20 to $35 for Medicare-covered urgently needed care visits - Waived if admitteed within 24 hours	$20 copay for each Medicare covered service	$20 copay for each Medicare covered service	$20 copay for each Medicare covered service	$20 copay for each Medicare covered service	$0 - $20 copay for each Medicare covered service (waived if preferred radiology facility used)	Visits 110 =$20 copayment/visit.Visits 11+ = $25 copayment/visit.				72.38	32.82			46.08	0.3		45.06	125.025	2.85	1.533333333		25.45	7.5875	4.579166667	19.54141287	22.66	19.78333333		4.43					10.91666667	0.3	4.8					13.12	18.36666667	19.65	2.41	19.96066573	3.3	22.66				11.9134	0.227943379	0	0	2.456033539	6.019512246	0	1.060404252	4.366924603	1.932383601	0.663773897	0	0.020807284	1.101379241	1.481058037	9.013337724	0.536866453	1.693747579	0	0.900959125	0	0	0	0	1.349480736	0.068379833	0.046964293	0	0	0	0	0.237752784	0.501712608	1.022075662	0.079276866	0.116198672	0.069603	0.117166294	0	0	0	46.9971			11.9134	0.227943379	0	0	2.456033539	6.019512246	0	1.060404252	4.366924603	1.932383601	0.663773897	0	0.020807284	1.101379241	1.481058037	9.013337724	0.536866453	1.693747579	0	0.900959125	0	0	0	0	1.349480736	0.068379833	0.046964293	0	0	0	0	0.237752784	0.501712608	1.022075662	0.079276866	0.116198672	0.069603	0.117166294	0	0	0	46.9971																																																																																				0			11.9134	0.227943379	0	0	2.456033539	6.019512246	0	1.060404252	4.366924603	1.932383601	0.663773897	0	0.020807284	1.101379241	1.481058037	9.013337724	0.536866453	1.693747579	0	0.900959125	0	0	0	0	1.349480736	0.068379833	0.046964293	0	0	0	0	0.237752784	0.501712608	1.022075662	0.079276866	0.116198672	0.069603	0.117166294	0	0	0	46.9971
H3388_004_0	2008	2	h.5.	i.6.	i.6.	i.6.	i6	i.6.	i.6.				OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional					Urgent Care	Podiatrist	Chiropractor	Physical Exam	Cardiac Rehab	Bone Mass	Substance Abuse				D	D			t	coin		v	p	v	v		v	o	v	v	v	v		v					v	coin	v					v	v	v	v	v	v	v																																													0		1975.140248	83.3431			639.5920676	20.06504082		282.3979366	419.1409337	8136.352002	5194.752234		9.8109	1741.884796	3881.207595	5534.914666	284.3070361	1027.378481		2440.521331					1483.398672	0.227932775	117.4107321					217.4568147	327.7977114	624.1683431	394.7395795	69.8565913	253.1018181	62.0474639				$500 inpatient copay per stay - capped at 3 copays	$500 inpatient copay per stay - capped at 3 copays			$100  for Medicare-covered ambulance services waived if admitted within 24 hours	30% coin per tiem		$50 for Medicare-covered emergency room visits. (Wavied if Admitted)	$125  copay for each Medicare-covered ambulatory surgical center visit.	$0 to $20 copay for Medicare-covered clinical/diagnostic lab benefits.	$0 to $20 copay for Medicare-covered X-rays.		$20 per session in area/ $20 persession out of area	$20 copay for each Medicare covered service	$20 copay for each Medicare covered service	$20 copay for each Medicare covered service	Visits 110 =$20 copayment/visit.Visits 11+ = $25 copayment/visit.	$20 copay for each Medicare covered service		$20 copay for each Medicare covered service					$20 copay for each Medicare covered service	30% after cataract surg	$20 copay for each Medicare covered service					$20 to $35 for Medicare-covered urgently needed care visits - Waived if admitteed within 24 hours	$20 copay for each Medicare covered service	$20 copay for each Medicare covered service	$20 copay for each Medicare covered service	$20 copay for each Medicare covered service	$0 - $20 copay for each Medicare covered service (waived if preferred radiology facility used)	Visits 110 =$20 copayment/visit.Visits 11+ = $25 copayment/visit.				72.38	32.82			46.08	0.3		45.06	125.025	2.85	1.533333333		25.45	7.5875	4.579166667	19.54141287	22.66	19.78333333		4.43					10.91666667	0.3	4.8					13.12	18.36666667	19.65	2.41	19.96066573	3.3	22.66				11.9134	0.227943379	0	0	2.456033539	6.019512246	0	1.060404252	4.366924603	1.932383601	0.663773897	0	0.020807284	1.101379241	1.481058037	9.013337724	0.536866453	1.693747579	0	0.900959125	0	0	0	0	1.349480736	0.068379833	0.046964293	0	0	0	0	0.237752784	0.501712608	1.022075662	0.079276866	0.116198672	0.069603	0.117166294	0	0	0	46.9971			11.9134	0.227943379	0	0	2.456033539	6.019512246	0	1.060404252	4.366924603	1.932383601	0.663773897	0	0.020807284	1.101379241	1.481058037	9.013337724	0.536866453	1.693747579	0	0.900959125	0	0	0	0	1.349480736	0.068379833	0.046964293	0	0	0	0	0.237752784	0.501712608	1.022075662	0.079276866	0.116198672	0.069603	0.117166294	0	0	0	46.9971																																																																																				0			11.9134	0.227943379	0	0	2.456033539	6.019512246	0	1.060404252	4.366924603	1.932383601	0.663773897	0	0.020807284	1.101379241	1.481058037	9.013337724	0.536866453	1.693747579	0	0.900959125	0	0	0	0	1.349480736	0.068379833	0.046964293	0	0	0	0	0.237752784	0.501712608	1.022075662	0.079276866	0.116198672	0.069603	0.117166294	0	0	0	46.9971
H3388_005_0	2008	2	h.5.	i.6.	i.6.	i.6.	i6	i.6.	i.6.				OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional					Urgent Care	Podiatrist	Chiropractor	Physical Exam	Cardiac Rehab	Bone Mass	Substance Abuse				D	D			t	coin		v	p	v	v		v	o	v	v	v	v		v					v	coin	v					v	v	v	v	v	v	v																																													0		1926.924399	82.3521			639.9120876	20.06504082		282.3979366	418.5933674	8136.352002	5194.752234		9.8109	1739.609195		5477.853691	276.9858249	1004.547848		2440.521331					1450.434257	0.227932775	114.8016047					217.4568147	320.5133178	609.8196456	394.7395795	69.11343607	273.3499636	60.44967513				"$125 per day (days 1-8), $0 fordays 9+"	$750 inpatient copay per stay - capped at 3 copays			$50 for Medicare-covered ambulance services.	30% coin per tiem		$ 50 ( waived if admitted)	$250 min/max for medicare covered service	"$0-$25 copay for each Medicare covered service, $0 if use preferred provider"	"$0-$25 copay for each Medicare covered service, $0 if use preferred provider"		$25 per session in area/ $25 persession out of area	$25 copay for each Medicare covered service		$25 copay for each Medicare covered service	Visits 110 =$30 copayment/visit.Visits 11+ = $35 copayment/visit.	$25 copay for each Medicare covered service		$25 copay for each Medicare covered service					$25 copay for each Medicare covered service	30% after cataract surg	$25 copay for each Medicare covered service					$35 copay for each Medicare covered service	$25 copay for each Medicare covered service	$25 copay for each Medicare covered service	$25 copay for each Medicare covered service	$25 copay for each Medicare covered service	$25 copay for each Medicare covered service	Visits 110 =$30 copayment/visit.Visits 11+ = $35 copayment/visit.				108.78	49.1			23.04	0.3		45.06	250.05	3.5625	1.916666667		31.8125	15.175		24.42676609	27.14	24.72916667		4.43					13.64583333	0.3	6					13.12	22.95833333	24.5625	2.41	24.95083216	4.125	27.14				17.4676	0.336957343	0	0	1.228631208	6.019512246	0	1.060404252	8.722439294	2.415479501	0.829717371	0	0.026009105	2.199880795	0	11.1505209	0.626449607	2.07013593	0	0.900959125	0	0	0	0	1.649365344	0.068379833	0.057400802	0	0	0	0	0.237752784	0.613204299	1.248224587	0.079276866	0.143703145	0.09396405	0.136717015	0	0	0	59.3827			17.4676	0.336957343	0	0	1.228631208	6.019512246	0	1.060404252	8.722439294	2.415479501	0.829717371	0	0.026009105	2.199880795	0	11.1505209	0.626449607	2.07013593	0	0.900959125	0	0	0	0	1.649365344	0.068379833	0.057400802	0	0	0	0	0.237752784	0.613204299	1.248224587	0.079276866	0.143703145	0.09396405	0.136717015	0	0	0	59.3827																																																																																				0			17.4676	0.336957343	0	0	1.228631208	6.019512246	0	1.060404252	8.722439294	2.415479501	0.829717371	0	0.026009105	2.199880795	0	11.1505209	0.626449607	2.07013593	0	0.900959125	0	0	0	0	1.649365344	0.068379833	0.057400802	0	0	0	0	0.237752784	0.613204299	1.248224587	0.079276866	0.143703145	0.09396405	0.136717015	0	0	0	59.3827
H3388_006_0	2008	2	h.5.	i.6.	i.6.	i.6.	i6	i.6.	i.6.				OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional					Urgent Care	Podiatrist	Chiropractor	Physical Exam	Cardiac Rehab	Bone Mass	Substance Abuse				D	D			t	coin		v	p	v	v		v	o	v	v	v	v		v					v	coin	v					v	v	v	v	v	v	v																																													0		1926.924399	82.3521			639.9120876	20.06504082		282.3979366	418.5933674	8136.352002	5194.752234		9.8109	1739.609195		5477.853691	276.9858249	1004.547848		2440.521331					1450.434257	0.227932775	114.8016047					217.4568147	320.5133178	609.8196456	394.7395795	69.11343607	273.3499636	60.44967513				"$125 per day (days 1-8), $0 fordays 9+"	$750 inpatient copay per stay - capped at 3 copays			$50 for Medicare-covered ambulance services.	30% coin per tiem		$ 50 ( waived if admitted)	$250 min/max for medicare covered service	"$0-$25 copay for each Medicare covered service, $0 if use preferred provider"	"$0-$25 copay for each Medicare covered service, $0 if use preferred provider"		$25 per session in area/ $25 persession out of area	$25 copay for each Medicare covered service		$25 copay for each Medicare covered service	Visits 110 =$30 copayment/visit.Visits 11+ = $35 copayment/visit.	$25 copay for each Medicare covered service		$25 copay for each Medicare covered service					$25 copay for each Medicare covered service	30% after cataract surg	$25 copay for each Medicare covered service					$35 copay for each Medicare covered service	$25 copay for each Medicare covered service	$25 copay for each Medicare covered service	$25 copay for each Medicare covered service	$25 copay for each Medicare covered service	$25 copay for each Medicare covered service	Visits 110 =$30 copayment/visit.Visits 11+ = $35 copayment/visit.				108.78	49.1			23.04	0.3		45.06	250.05	3.5625	1.916666667		31.8125	15.175		24.42676609	27.14	24.72916667		4.43					13.64583333	0.3	6					13.12	22.95833333	24.5625	2.41	24.95083216	4.125	27.14				17.4676	0.336957343	0	0	1.228631208	6.019512246	0	1.060404252	8.722439294	2.415479501	0.829717371	0	0.026009105	2.199880795	0	11.1505209	0.626449607	2.07013593	0	0.900959125	0	0	0	0	1.649365344	0.068379833	0.057400802	0	0	0	0	0.237752784	0.613204299	1.248224587	0.079276866	0.143703145	0.09396405	0.136717015	0	0	0	59.3827			17.4676	0.336957343	0	0	1.228631208	6.019512246	0	1.060404252	8.722439294	2.415479501	0.829717371	0	0.026009105	2.199880795	0	11.1505209	0.626449607	2.07013593	0	0.900959125	0	0	0	0	1.649365344	0.068379833	0.057400802	0	0	0	0	0.237752784	0.613204299	1.248224587	0.079276866	0.143703145	0.09396405	0.136717015	0	0	0	59.3827																																																																																				0			17.4676	0.336957343	0	0	1.228631208	6.019512246	0	1.060404252	8.722439294	2.415479501	0.829717371	0	0.026009105	2.199880795	0	11.1505209	0.626449607	2.07013593	0	0.900959125	0	0	0	0	1.649365344	0.068379833	0.057400802	0	0	0	0	0.237752784	0.613204299	1.248224587	0.079276866	0.143703145	0.09396405	0.136717015	0	0	0	59.3827
H3388_007_0	2008	3	h.5.	i.6.	i.6.	i.6.	f.	i.6.	i.6.				OP Facility - Other	Professional	Professional	Professional	OP Facility - Emergency	Professional	Professional					Cardiac Rehab	Podiatrist	Chiropractor	Physical Exam	Urgent Care	Bone Mass	Substance Abuse				D	D			t	coin		v		v	v		v	o	v	v	v	v							v	coin	v					v	v	v	v	v	v	v																																													0		2067.452233	87.82262779			666.3824133	20.92843792		294.0794871	437.0491524	8472.916809	5409.6361		10.21673343	1816.308579	3831.584635	5858.943682	302.4209386	1126.936657		2541.474877					1627.147513	0.237361343	128.7884265					226.4520389	359.5629692	693.3199146	411.0682057	74.44882052	249.8657992	66.00066088				$250 inpatient copay per stay - capped at 3 copays	$250 copay for each Medicare-covered hospital stay			$50 for Medicare-covered ambulance services waived if admitted within 24 hours	20% coin per tiem		$50 for Medicare-covered emergency room visits. (Wavied if Admitted)	$100 copay for each Medicare-covered ambulatory surgical center visit.	$0 to $12 copay for Medicare-covered clinical/diagnostic lab benefits.	$0 to $12 copay for Medicare-covered X-rays.		$12 per session in area/ $12 persession out of area	$12 per session in area/ $12 persession out of area	$12 copay for each Medicare covered service	$12 copay for each Medicare covered service	Visits 110 = $10 copayment/visit. Visits 11+ = $25 copayment/visit. No visit limit.	$12 copay for each Medicare covered service		$12 copay for each Medicare covered service					$12 copay for each Routine Eye exam	20% after cataract surg	$12 copay for each Medicare covered service					$12 copay for each Medicare covered service	$12 copay for each Medicare covered service	$12 copay for each Medicare covered service	$12 copay for each Medicare covered service	$12 to $35 for Medicare-covered urgently needed care visits - Waived if admitteed within 24 hours	$0 - $12 copay for each Medicare covered service (waived if preferred radiology facility used)	Visits 110 = $10 copayment/visit. Visits 11+ = $25 copayment/visit. No visit limit.				36.07	15.51			23.04	0.2		45.06	100.02	1.71	0.92		15.27	6.07	10.99	11.72484772	17.82	11.87		4.43					6.55	0.2	2.88					13.12	11.02	11.79	2.41	11.97639944	1.98	17.82				6.2144	0.113510746	0	0	1.279454234	4.185687585	0	1.104268474	3.642804685	1.207390645	0.414738768	0	0.013000793	0.918749423	3.509092928	5.724601873	0.449095094	1.114728177	0	0.938227809	0	0	0	0	0.888151351	0.047472269	0.030909222	0	0	0	0	0.247587563	0.33019866	0.681186816	0.082556198	0.074302401	0.041227857	0.098010981	0	0	0	33.3514			6.2144	0.113510746	0	0	1.279454234	4.185687585	0	1.104268474	3.642804685	1.207390645	0.414738768	0	0.013000793	0.918749423	3.509092928	5.724601873	0.449095094	1.114728177	0	0.938227809	0	0	0	0	0.888151351	0.047472269	0.030909222	0	0	0	0	0.247587563	0.33019866	0.681186816	0.082556198	0.074302401	0.041227857	0.098010981	0	0	0	33.3514																																																																																				0			6.2144	0.113510746	0	0	1.279454234	4.185687585	0	1.104268474	3.642804685	1.207390645	0.414738768	0	0.013000793	0.918749423	3.509092928	5.724601873	0.449095094	1.114728177	0	0.938227809	0	0	0	0	0.888151351	0.047472269	0.030909222	0	0	0	0	0.247587563	0.33019866	0.681186816	0.082556198	0.074302401	0.041227857	0.098010981	0	0	0	33.3514
H3388_801_0	2008	1	h.5.	i.6.	i.6.	i.6.	i6	i.6.	i.6.				OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional					Urgent Care	Podiatrist	Chiropractor	Physical Exam	Cardiac Rehab	Bone Mass	Substance Abuse				D	D			t	coin		v	v	p	p		v	o	v	v		v		v					v	coin	v		coin			v	v	v	v	v	v	v																																													0		1973.912528	80.97409806			628.8897405	19.72929146		277.6725574	412.1274269	8000.206005	5107.828177		9.646733704	1712.737748	3358.31157	5386.192482	272.3510068	987.7386972		2399.683961					1426.164066	0.224118764	112.8806235		5.906993897			204.9090112	315.1501519	599.615502	388.1343818	67.95695739	219.0026541	59.4381676				$500 inpatient copay per stay - capped at 3 copays	$500 inpatient copay per stay - capped at 3 copays			$100 for Medicare-covered ambulance services.	30% coin per tiem		$ 50 ( waived if admitted)	$125 min/max for medicare covered service	$50 copay for each Medicare covered service	$50 copay for each Medicare covered service		$50 per session in area/ $20 persession out of area	$50 per session in area	$50 copay for each Medicare covered service	$50 copay for each Medicare covered service	Visits 110 =$50 copayment/visit.Visits 11+ = $30 copayment/visit.	$50 copay for each Medicare covered service		$50 copay for each Medicare covered service					$50 copay for each Medicare covered service	30% after cataract surg	$50 copay for each Medicare covered service		travel benefit 30% coin up to $3000 max			$50 copay for each Medicare covered service	$50 copay for each Medicare covered service	$50 copay for each Medicare covered service	$50 copay for each Medicare covered service	$50 copay for each Medicare covered service	$50 copay for each Medicare covered service	Visits 110 =$50 copayment/visit.Visits 11+ = $30 copayment/visit.				72.52	49.1			46.08	0.5		45.06	125.025	7.125	3.833333333		63.625	7.5875	45.79166667	48.85353217	27.14	49.45833333		4.43					27.29166667	0.3	12		0.3			18.74285714	45.91666667	49.125	2.41	49.90166432	8.25	27.14				11.929	0.331319018	0	0	2.414936604	9.864645729	0	1.042660453	4.293852629	4.750122315	1.631667334	0	0.051147786	1.082949805	12.81522367	21.92787731	0.615967194	4.070992478	0	0.885883329	0	0	0	0	3.243532858	0.067235629	0.112880624	0	1.772098169	0	0	0.32004836	1.20588704	2.454675961	0.077950322	0.282597106	0.150564325	0.134429322	0	0	0	87.5302			11.929	0.331319018	0	0	2.414936604	9.864645729	0	1.042660453	4.293852629	4.750122315	1.631667334	0	0.051147786	1.082949805	12.81522367	21.92787731	0.615967194	4.070992478	0	0.885883329	0	0	0	0	3.243532858	0.067235629	0.112880624	0	1.772098169	0	0	0.32004836	1.20588704	2.454675961	0.077950322	0.282597106	0.150564325	0.134429322	0	0	0	87.5302																																																																																				0			11.929	0.331319018	0	0	2.414936604	9.864645729	0	1.042660453	4.293852629	4.750122315	1.631667334	0	0.051147786	1.082949805	12.81522367	21.92787731	0.615967194	4.070992478	0	0.885883329	0	0	0	0	3.243532858	0.067235629	0.112880624	0	1.772098169	0	0	0.32004836	1.20588704	2.454675961	0.077950322	0.282597106	0.150564325	0.134429322	0	0	0	87.5302
H3388_803_0	2008	1	h.5.	i.6.	i.6.	i.6.	i6	i.6.	i.6.				OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional					Urgent Care	Podiatrist	Chiropractor	Physical Exam	Cardiac Rehab	Bone Mass	Substance Abuse				D	D			t	coin		v	v	p	p		v	o	v	v		v		v					v	coin	v		coin			v	v	v	v	v	v	v																																													0		1973.912528	80.97409806			628.8897405	19.72929146		277.6725574	412.1274269	8000.206005	5107.828177		9.646733704	1712.737748	3358.31157	5386.192482	272.3510068	987.7386972		2399.683961					1426.164066	0.224118764	112.8806235		5.906993897			204.9090112	315.1501519	599.615502	388.1343818	67.95695739	219.0026541	59.4381676				$500 inpatient copay per stay - capped at 3 copays	$500 inpatient copay per stay - capped at 3 copays			$100 for Medicare-covered ambulance services.	30% coin per tiem		$ 50 ( waived if admitted)	$125 min/max for medicare covered service	$50 copay for each Medicare covered service	$50 copay for each Medicare covered service		$50 per session in area/ $20 persession out of area	$50 per session in area	$50 copay for each Medicare covered service	$50 copay for each Medicare covered service	Visits 110 =$50 copayment/visit.Visits 11+ = $30 copayment/visit.	$50 copay for each Medicare covered service		$50 copay for each Medicare covered service					$50 copay for each Medicare covered service	30% after cataract surg	$50 copay for each Medicare covered service		travel benefit 30% coin up to $3000 max			$50 copay for each Medicare covered service	$50 copay for each Medicare covered service	$50 copay for each Medicare covered service	$50 copay for each Medicare covered service	$50 copay for each Medicare covered service	$50 copay for each Medicare covered service	Visits 110 =$50 copayment/visit.Visits 11+ = $30 copayment/visit.				72.52	49.1			46.08	0.5		45.06	125.025	7.125	3.833333333		63.625	7.5875	45.79166667	48.85353217	27.14	49.45833333		4.43					27.29166667	0.3	12		0.3			18.74285714	45.91666667	49.125	2.41	49.90166432	8.25	27.14				11.929	0.331319018	0	0	2.414936604	9.864645729	0	1.042660453	4.293852629	4.750122315	1.631667334	0	0.051147786	1.082949805	12.81522367	21.92787731	0.615967194	4.070992478	0	0.885883329	0	0	0	0	3.243532858	0.067235629	0.112880624	0	1.772098169	0	0	0.32004836	1.20588704	2.454675961	0.077950322	0.282597106	0.150564325	0.134429322	0	0	0	87.5302			11.929	0.331319018	0	0	2.414936604	9.864645729	0	1.042660453	4.293852629	4.750122315	1.631667334	0	0.051147786	1.082949805	12.81522367	21.92787731	0.615967194	4.070992478	0	0.885883329	0	0	0	0	3.243532858	0.067235629	0.112880624	0	1.772098169	0	0	0.32004836	1.20588704	2.454675961	0.077950322	0.282597106	0.150564325	0.134429322	0	0	0	87.5302																																																																																				0			11.929	0.331319018	0	0	2.414936604	9.864645729	0	1.042660453	4.293852629	4.750122315	1.631667334	0	0.051147786	1.082949805	12.81522367	21.92787731	0.615967194	4.070992478	0	0.885883329	0	0	0	0	3.243532858	0.067235629	0.112880624	0	1.772098169	0	0	0.32004836	1.20588704	2.454675961	0.077950322	0.282597106	0.150564325	0.134429322	0	0	0	87.5302
H3388_804_0	2008	1	h.5.	i.6.	i.6.	i.6.	i6	i.6.	i.6.				OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional					Urgent Care	Podiatrist	Chiropractor	Physical Exam	Cardiac Rehab	Bone Mass	Substance Abuse				D	D			t	coin		v	v	p	p		v	o	v	v		v		v					v	coin	v		coin			v	v	v	v	v	v	v																																													0		1973.912528	80.97409806			628.8897405	19.72929146		277.6725574	412.1274269	8000.206005	5107.828177		9.646733704	1712.737748	3358.31157	5386.192482	272.3510068	987.7386972		2399.683961					1426.164066	0.224118764	112.8806235		5.906993897			204.9090112	315.1501519	599.615502	388.1343818	67.95695739	219.0026541	59.4381676				$500 inpatient copay per stay - capped at 3 copays	$500 inpatient copay per stay - capped at 3 copays			$100 for Medicare-covered ambulance services.	30% coin per tiem		$ 50 ( waived if admitted)	$125 min/max for medicare covered service	$50 copay for each Medicare covered service	$50 copay for each Medicare covered service		$50 per session in area/ $20 persession out of area	$50 per session in area	$50 copay for each Medicare covered service	$50 copay for each Medicare covered service	Visits 110 =$50 copayment/visit.Visits 11+ = $30 copayment/visit.	$50 copay for each Medicare covered service		$50 copay for each Medicare covered service					$50 copay for each Medicare covered service	30% after cataract surg	$50 copay for each Medicare covered service		travel benefit 30% coin up to $3000 max			$50 copay for each Medicare covered service	$50 copay for each Medicare covered service	$50 copay for each Medicare covered service	$50 copay for each Medicare covered service	$50 copay for each Medicare covered service	$50 copay for each Medicare covered service	Visits 110 =$50 copayment/visit.Visits 11+ = $30 copayment/visit.				72.52	49.1			46.08	0.5		45.06	125.025	7.125	3.833333333		63.625	7.5875	45.79166667	48.85353217	27.14	49.45833333		4.43					27.29166667	0.3	12		0.3			18.74285714	45.91666667	49.125	2.41	49.90166432	8.25	27.14				11.929	0.331319018	0	0	2.414936604	9.864645729	0	1.042660453	4.293852629	4.750122315	1.631667334	0	0.051147786	1.082949805	12.81522367	21.92787731	0.615967194	4.070992478	0	0.885883329	0	0	0	0	3.243532858	0.067235629	0.112880624	0	1.772098169	0	0	0.32004836	1.20588704	2.454675961	0.077950322	0.282597106	0.150564325	0.134429322	0	0	0	87.5302			11.929	0.331319018	0	0	2.414936604	9.864645729	0	1.042660453	4.293852629	4.750122315	1.631667334	0	0.051147786	1.082949805	12.81522367	21.92787731	0.615967194	4.070992478	0	0.885883329	0	0	0	0	3.243532858	0.067235629	0.112880624	0	1.772098169	0	0	0.32004836	1.20588704	2.454675961	0.077950322	0.282597106	0.150564325	0.134429322	0	0	0	87.5302																																																																																				0			11.929	0.331319018	0	0	2.414936604	9.864645729	0	1.042660453	4.293852629	4.750122315	1.631667334	0	0.051147786	1.082949805	12.81522367	21.92787731	0.615967194	4.070992478	0	0.885883329	0	0	0	0	3.243532858	0.067235629	0.112880624	0	1.772098169	0	0	0.32004836	1.20588704	2.454675961	0.077950322	0.282597106	0.150564325	0.134429322	0	0	0	87.5302
H3404_001_0	2008	10																					3250											A		D	V	T	Coin	Coin	V	V	V	Coin			V	V	V	V	V		V	Coin	V			V	Coin				O																																																					0		249.8412737	0	2664.261763	17.95019229	186.3734167	19.04518638	0.651230292	632.6399165	530.6078041	4393.58641	0	0	0	2075.565817	6568.953573	8876.619982	1.537738937	375.9552024	0	1270.142105	37.37613137	866.9682053	0	0	67.07463061	0.009698872	0	0	0	242.5162431	0											$350 copay		$100 copay for days 1-32	None	$100 copay	20% coinsurance	20% coinsurance	$50 copay / $30 copay	$75 copay	None	10% Coinsurance			$75 copay / 10% coinsurance / None	$15 copay	$30 copay	$30 copay	$30 copay		$30 copay / None	20% coinsurance	$30 copay / $20 copay / None			$15 copay	20% coinsurance				None												283.4307641	0	57.44711439	0	80.98021833	0.161960437	0.161960437	39.98047615	60.73516374	0	0	0	0	17.00177408	11.82043053	24.2940655	24.2940655	24.2940655	0	12.80195815	0.161960437	0	0	0	12.14703275	0.161960437	0	0	0	0	0											5.9011	0	12.75451252	0	1.257713331	3.084566702	0.105473543	2.107770424	2.685545989	0	0	0	0	2.940691759	6.470654948	17.9707656	0.003113161	0.761123359	0	1.355025506	6.053454558	0	0	0	0.067896478	0.001570834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.5209		14.44948052	5.9011	0	12.75451252	0	1.257713331	3.084566702	0.105473543	2.107770424	2.685545989	0	0	0	0	2.940691759	6.470654948	17.9707656	0.003113161	0.761123359	0	1.355025506	6.053454558	0	0	0	0.067896478	0.001570834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.5209		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 copay / $30 copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance											4.3966	0	1.2548	0.0034	0.1576	0.4232	0.0145	0.292	0.7938	0.143	0	0	0	1.6887	1.2146	2.1651	0.0011	0.0705	0	0.1987	0.8306	0.0472	0	0	0.0063	0.0002	0	0	0	0.0012	0											13.7032			10.2977	0	14.00936222	0.003376179	1.415297176	3.507793066	0.119945327	2.399737656	3.479354228	0.143040351	0	0	0	4.629438991	7.685236837	20.13584001	0.004239459	0.831598478	0	1.553762431	6.884035255	0.047186547	0	0	0.074165679	0.001786364	0	0	0	0.00124869	0	0	0	0	0	0	0	0	0	0	0	77.2241
H3404_002_0	2008	10																																A		D	V	T	Coin	Coin	V	V	V				V	V	V	V	V		V	Coin	V			V	Coin				O																																																					0		222.0811322	0	2368.232678	15.95572648	165.6652592	16.92905456	0.578871371	562.3465924	471.6513814	3905.410142	0	0	0	1844.947393	5839.069843	7890.328873	1.366879055	334.1824021	0	1129.015205	33.22322789	770.6384047	0	0	59.62189388	0.00862122	0	0	0	238.6148243	0											$350 copay		$100 copay for days 1-32	None	$100 copay	20% coinsurance	20% coinsurance	$50 copay / $30 copay	$75 copay	None				None	$10 copay	$20 copay	$20 copay	$20 copay		$20 copay / None	20% coinsurance	$20 copay / None			$15 copay	20% coinsurance				None												313.6863901	0	59.84621535	0	85.33896861	0.170677937	0.170677937	42.13242036	0	0	0	0	0	0	8.533896861	19.06779372	19.06779372	19.06779372	0	8.994014645	0.170677937	0	0	0	12.80084529	0.170677937	0	0	0	0	0											5.8053	0	11.81081357	0	1.178141863	2.889416112	0.098800572	1.974418585	0	0	0	0	0	0	4.15250165	12.53759694	0.002171947	0.531010092	0	0.846198274	5.670472004	0	0	0	0.063600887	0.001471452	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5619		7.385619073	5.8053	0	11.81081357	0	1.178141863	2.889416112	0.098800572	1.974418585	0	0	0	0	0	0	4.15250165	12.53759694	0.002171947	0.531010092	0	0.846198274	5.670472004	0	0	0	0.063600887	0.001471452	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5619	3250	$350 copay		$100 copay for days 1-32	None	$50 copay	20% coinsurance	20% coinsurance	$50 copay / $30 copay	$75 copay	None				None	$10 copay	$20 copay	$20 copay	$20 copay		$20 copay / None	20% coinsurance	$20 copay / None			$15 copay	20% coinsurance				None												1.4513	0	2.9527	0	0.2945	0.7224	0.0247	0.4936	0	0	0	0	0	0	1.0381	3.1344	0.0005	0.1328	0	0.2115	1.4176	0	0	0	0.0159	0.0004	0	0	0	0	0											11.8905		1.846404768	7.2566	0	14.76351696	0	1.472677329	3.611770139	0.123500714	2.468023231	0	0	0	0	0	0	5.190627063	15.67199618	0.002714934	0.663762616	0	1.057747842	7.088090005	0	0	0	0.079501108	0.001839315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4524
H3404_801_0	2008	9																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		165.5539486	0	28.91774627	0.191199135	4.798117969	12.56144348	1.545452337	30.10933853	39.59609142	7.724625038	0	0	0	79.56734426	55.17998807	111.6083015	0.01388585	5.579464476	0	11.63476532	48.16204308	2.842833804																				FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				0.08328181	0.08328181	0.215028916	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				13.7876	0	6.218151647	0	1.122759605	2.939377774	0.361635847	7.045585215	9.265485392	1.807562259	0	0	0	18.61875856	12.91211721	26.11634254	0.003249289	1.305594687	0	2.722535086	11.26991808	0.66522311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1619			13.7876	0	6.218151647	0	1.122759605	2.939377774	0.361635847	7.045585215	9.265485392	1.807562259	0	0	0	18.61875856	12.91211721	26.11634254	0.003249289	1.305594687	0	2.722535086	11.26991808	0.66522311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1619																																																																																				0			13.7876	0	6.218151647	0	1.122759605	2.939377774	0.361635847	7.045585215	9.265485392	1.807562259	0	0	0	18.61875856	12.91211721	26.11634254	0.003249289	1.305594687	0	2.722535086	11.26991808	0.66522311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1619
H3404_803_0	2008	9																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		165.5539486	0	28.91774627	0.191199135	4.798117969	12.56144348	1.545452337	30.10933853	39.59609142	7.724625038	0	0	0	79.56734426	55.17998807	111.6083015	0.01388585	5.579464476	0	11.63476532	48.16204308	2.842833804																				FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				0.08328181	0.08328181	0.215028916	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				13.7876	0	6.218151647	0	1.122759605	2.939377774	0.361635847	7.045585215	9.265485392	1.807562259	0	0	0	18.61875856	12.91211721	26.11634254	0.003249289	1.305594687	0	2.722535086	11.26991808	0.66522311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1619			13.7876	0	6.218151647	0	1.122759605	2.939377774	0.361635847	7.045585215	9.265485392	1.807562259	0	0	0	18.61875856	12.91211721	26.11634254	0.003249289	1.305594687	0	2.722535086	11.26991808	0.66522311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1619																																																																																				0			13.7876	0	6.218151647	0	1.122759605	2.939377774	0.361635847	7.045585215	9.265485392	1.807562259	0	0	0	18.61875856	12.91211721	26.11634254	0.003249289	1.305594687	0	2.722535086	11.26991808	0.66522311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1619
H3405_001_0	2008	10	s.										Other Non-Covered										3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O	O	O										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0	0	0										0		289.783865	6.226869	495.529007	207.554583	69.425593	4.652968	1.5923	328.484221	387.928489	6101.419826	1430.042932		8.147462	520.009049	4714.249486	3561.201604	46.46547	295.625414			16.702867			8.6	2.99					3.4	0.02	0.08										$550/Admit	$550/Admit	$0/Day(Days 1-20) $75(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$100-$125/Visit	$0-$75/Visit	$50-$75/Visit		$0-$75/Proc	$30-$75/Visit	$5/Visit	$30/Visit	$30-$75/Visit	$75/Visit			20% Coins			Coin: 0%- 50%	EyeMed: $200 Allowance					Silver Sneakers	Quit Net	Humana Active Outlook										466.313633	466.313384	14.72405	0	84.784357	0.169568	0.169568	42.392142	95.839691	10.817499	63.588222		21.217454	62.422691	4.239215	25.435289	41.387092	63.58823			0.169568			0.354651163	0					0	0	0										11.2608	0.241972696	0.608016156	0	0.490517022	0.788994478	0.270003126	1.160429145	3.098245543	5.500175239	7.577823952	0	0.0144057	2.705030349	1.665393095	7.548349332	0.16025589	1.566524735	0	0	2.832271751	0	0	3.05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5393	0	8.522597799	11.2608	0.241972696	0.608016156	0	0.490517022	0.788994478	0.270003126	1.160429145	3.098245543	5.500175239	7.577823952	0	0.0144057	2.705030349	1.665393095	7.548349332	0.16025589	1.566524735	0	0	2.832271751	0	0	3.05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5393	5000	$850/Admit	$850/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$75/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			Coin: 50%- 55%						Silver Sneakers	Quit Net	Humana Active Outlook										3.0711	0.066	0.4409	0.6887	0.4905	1.7441	0.5969	0.2048	2.9233	0.7247	1.9547		0.0025	0.9772	3.0226	2.4866	0.0856	0.2638			0.7942			2.78	0					0	0	0										23.3183	0	3.685872622	14.332	0.307965404	1.048894516	0.688729152	0.981034046	2.533093161	0.866854076	1.365211208	6.021545467	6.224878369	9.532500554	0	0.016947533	3.682249951	4.687961868	10.03495246	0.245864294	1.830366694	0	0	3.626487834	0	0	5.83	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.8575
H3405_002_0	2008	5	s.										Other Non-Covered										3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O	O	O										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0	0	0										0		296.835203	6.378387	507.586759	212.605028	71.114931	4.882167	1.670734	336.477257	397.367987	6249.886229	1464.840296		8.345713	532.662476	4828.961747	3647.856646	47.596117	302.818894			17.525627			8.6	2.99					3.4	0.02	0.08										$550/Admit	$550/Admit	$0/Day(Days 1-20) $75(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$100-$125/Visit	$0-$75/Visit	$50-$75/Visit		$0-$75/Proc	$30-$75/Visit	$5/Visit	$30/Visit	$30-$75/Visit	$75/Visit			20% Coins			Coin: 0%- 50%	EyeMed: $200 Allowance					Silver Sneakers	Quit Net	Humana Active Outlook										463.155556	463.155965	14.624331	0	84.210039	0.16842	0.16842	42.105062	95.190628	10.744238	63.157576		21.074438	61.999928	4.210504	25.263031	41.106727	63.157572			0.16842			0.354651163	0					0	0	0										11.4567	0.246182332	0.618593065	0	0.499049259	0.822254566	0.28138502	1.180616314	3.152142352	5.595855426	7.70964686	0	0.014656768	2.752086263	1.694363563	7.679659628	0.163043382	1.593775508	0	0	2.951666099	0	0	3.05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.4617	0	9.077488612	11.4567	0.246182332	0.618593065	0	0.499049259	0.822254566	0.28138502	1.180616314	3.152142352	5.595855426	7.70964686	0	0.014656768	2.752086263	1.694363563	7.679659628	0.163043382	1.593775508	0	0	2.951666099	0	0	3.05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.4617	5000	$850/Admit	$850/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$75/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			Coin: 50%- 55%						Silver Sneakers	Quit Net	Humana Active Outlook										3.1246	0.0671	0.4595	0.7178	0.499	1.8176	0.622	0.2083	3.0465	0.7553	2.0371		0.0026	1.0184	3.15	2.5914	0.0892	0.275			0.8277			2.78	0					0	0	0										24.0891	0	3.995578299	14.5813	0.313323045	1.078056002	0.717760577	0.998098522	2.63987147	0.903394503	1.388960522	6.198665877	6.35110634	9.746718653	0	0.01724286	3.770498792	4.844340879	10.27107977	0.252261457	1.868739169	0	0	3.779360435	0	0	5.83	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5508
H3405_801_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		296.179457	6.364297	506.465436	212.135358	70.95783	4.860618	1.663361	335.733937	396.490154	6236.079452	1461.604282		8.327278	531.485756	4818.29397	3639.798077	47.490973	302.14993			17.448273																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214491	177.214231	28.944127	0	99.999957	0.2	0.2	49.999985	199.999992	37.551768	90.504997		33.367446	87.838628	20	29.999999	59.267263	99.999996			0.2																					4.3739	0.093987	1.221599992	0	0.591314996	0.9721236	0.3326722	1.398890984	6.608168969	19.51465073	11.02354093	0	0.023155	3.890414967	8.03048995	9.099494889	0.234554999	2.517915983	0	0	3.4896546	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4166	0	0	4.3739	0.093987	1.221599992	0	0.591314996	0.9721236	0.3326722	1.398890984	6.608168969	19.51465073	11.02354093	0	0.023155	3.890414967	8.03048995	9.099494889	0.234554999	2.517915983	0	0	3.4896546	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4166		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.1948	0.1039	0.4527	0.7072	0.6978	1.3431	0.4596	0.7881	3.0015	0.7441	2.007		0.0137	1.0034	3.1034	2.5531	0.0879	0.2709			0.8155																					27.3475	0	0	13.5687	0.197887	1.674271992	0.707153	1.289155996	2.3151886	0.7922852	2.186957984	9.609666969	20.25873973	13.03050493	0	0.036821	4.893775967	11.13391295	11.65261489	0.322453999	2.788815983	0	0	4.3051156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.7641
H3405_802_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		296.179457	6.364297	506.465436	212.135358	70.95783	4.860618	1.663361	335.733937	396.490154	6236.079452	1461.604282		8.327278	531.485756	4818.29397	3639.798077	47.490973	302.14993			17.448273																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214491	177.214231	28.944127	0	99.999957	0.2	0.2	49.999985	199.999992	37.551768	90.504997		33.367446	87.838628	20	29.999999	59.267263	99.999996			0.2																					4.3739	0.093987	1.221599992	0	0.591314996	0.9721236	0.3326722	1.398890984	6.608168969	19.51465073	11.02354093	0	0.023155	3.890414967	8.03048995	9.099494889	0.234554999	2.517915983	0	0	3.4896546	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4166	0	0	4.3739	0.093987	1.221599992	0	0.591314996	0.9721236	0.3326722	1.398890984	6.608168969	19.51465073	11.02354093	0	0.023155	3.890414967	8.03048995	9.099494889	0.234554999	2.517915983	0	0	3.4896546	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4166		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.1948	0.1039	0.4527	0.7072	0.6978	1.3431	0.4596	0.7881	3.0015	0.7441	2.007		0.0137	1.0034	3.1034	2.5531	0.0879	0.2709			0.8155																					27.3475	0	0	13.5687	0.197887	1.674271992	0.707153	1.289155996	2.3151886	0.7922852	2.186957984	9.609666969	20.25873973	13.03050493	0	0.036821	4.893775967	11.13391295	11.65261489	0.322453999	2.788815983	0	0	4.3051156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.7641
H3405_803_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		296.179457	6.364297	506.465436	212.135358	70.95783	4.860618	1.663361	335.733937	396.490154	6236.079452	1461.604282		8.327278	531.485756	4818.29397	3639.798077	47.490973	302.14993			17.448273																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214491	177.214231	28.944127	0	99.999957	0.2	0.2	49.999985	199.999992	37.551768	90.504997		33.367446	87.838628	20	29.999999	59.267263	99.999996			0.2																					4.3739	0.093987	1.221599992	0	0.591314996	0.9721236	0.3326722	1.398890984	6.608168969	19.51465073	11.02354093	0	0.023155	3.890414967	8.03048995	9.099494889	0.234554999	2.517915983	0	0	3.4896546	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4166	0	0	4.3739	0.093987	1.221599992	0	0.591314996	0.9721236	0.3326722	1.398890984	6.608168969	19.51465073	11.02354093	0	0.023155	3.890414967	8.03048995	9.099494889	0.234554999	2.517915983	0	0	3.4896546	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4166		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.1948	0.1039	0.4527	0.7072	0.6978	1.3431	0.4596	0.7881	3.0015	0.7441	2.007		0.0137	1.0034	3.1034	2.5531	0.0879	0.2709			0.8155																					27.3475	0	0	13.5687	0.197887	1.674271992	0.707153	1.289155996	2.3151886	0.7922852	2.186957984	9.609666969	20.25873973	13.03050493	0	0.036821	4.893775967	11.13391295	11.65261489	0.322453999	2.788815983	0	0	4.3051156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.7641
H3405_804_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		296.179457	6.364297	506.465436	212.135358	70.95783	4.860618	1.663361	335.733937	396.490154	6236.079452	1461.604282		8.327278	531.485756	4818.29397	3639.798077	47.490973	302.14993			17.448273																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214491	177.214231	28.944127	0	99.999957	0.2	0.2	49.999985	199.999992	37.551768	90.504997		33.367446	87.838628	20	29.999999	59.267263	99.999996			0.2																					4.3739	0.093987	1.221599992	0	0.591314996	0.9721236	0.3326722	1.398890984	6.608168969	19.51465073	11.02354093	0	0.023155	3.890414967	8.03048995	9.099494889	0.234554999	2.517915983	0	0	3.4896546	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4166	0	0	4.3739	0.093987	1.221599992	0	0.591314996	0.9721236	0.3326722	1.398890984	6.608168969	19.51465073	11.02354093	0	0.023155	3.890414967	8.03048995	9.099494889	0.234554999	2.517915983	0	0	3.4896546	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4166		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.1948	0.1039	0.4527	0.7072	0.6978	1.3431	0.4596	0.7881	3.0015	0.7441	2.007		0.0137	1.0034	3.1034	2.5531	0.0879	0.2709			0.8155																					27.3475	0	0	13.5687	0.197887	1.674271992	0.707153	1.289155996	2.3151886	0.7922852	2.186957984	9.609666969	20.25873973	13.03050493	0	0.036821	4.893775967	11.13391295	11.65261489	0.322453999	2.788815983	0	0	4.3051156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.7641
H3435_001_0	2008	5																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							14.08548322	13.11140933	348.6515358	361.7860609		153.1369746	56.28661294		1576.043182		4877.639868	218.5577685					1352.584855		821.9323512	337.0787762		315.7251253				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/PCP visit, $20/visit Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d)$20/visit, (7f)0"	"(7e,h)$20/visit"	"(7c,i)0"		(7g)$20/visit	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.17804178	0.17804178	35.1633	44.5104		17.8042	44.5104		44.4961		17.8042	17.8042					17.8042		20	20		19.9999				20											0	0	0	0	0	2.5078045	2.334378652	1.02164347	1.341938212	0	0.227206496	0.208778515	0	5.8439765	0	7.236864023	0.324270117	0	0	0	0	2.006805123	0	1.369887252	0.56179796	0	0.526206485	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	26.4516	0	2.843253059	0	0	0	0	0	2.5078045	2.334378652	1.02164347	1.341938212	0	0.227206496	0.208778515	0	5.8439765	0	7.236864023	0.324270117	0	0	0	0	2.006805123	0	1.369887252	0.56179796	0	0.526206485	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	26.4516		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.203	0.0275	0.491	0.3537	0.0824	0.0862	0.0803	0.0234	0.2781	0.0468	0.1163	0.0223	0.0016	0.1991	0.0276	0.2145	0.0128	0.0377			0.1743	0.0554			0.0066		0.0078															4.5484	0	0	2.203	0.027511136	0.490964385	0.353683012	0.082374532	2.594042152	2.414652587	1.045064789	1.620031381	0.046819246	0.343523025	0.231073802	0.001587439	6.043060631	0.027627372	7.451387291	0.337093863	0.037691155	0	0	0.174253008	2.062172049	0	1.369887252	0.568429071	0	0.534049135	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	31
H3435_002_0	2008	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							14.04482921	13.07356673	348.1480272	361.263584		152.9158203	56.20532607		1571.971433		4870.595776	218.2421361					1350.631506		821.9323512	337.0787762		315.725109				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/PCP visit, $20/visit Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d)$20/visit, (7f)0"	"(7e,h)$20/visit"	"(7c,i)0"		(7g)$20/visit	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.178089286	0.178089286	35.1726	44.5223		17.8089	44.5223		44.5079		17.8089	17.8089					17.8089		20	20		19.9999				20											0	0	0	0	0	2.501233603	2.328262162	1.02044026	1.340357784	0	0.22693891	0.208532633	0	5.830431574	0	7.228341025	0.323888218	0	0	0	0	2.004441669	0	1.369887252	0.56179796	0	0.526206466	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	26.4108	0	2.8313255	0	0	0	0	0	2.501233603	2.328262162	1.02044026	1.340357784	0	0.22693891	0.208532633	0	5.830431574	0	7.228341025	0.323888218	0	0	0	0	2.004441669	0	1.369887252	0.56179796	0	0.526206466	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	26.4108		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.1966	0.0274	0.4895	0.3527	0.0821	0.086	0.08	0.0234	0.2773	0.0467	0.116	0.0222	0.0016	0.1985	0.0275	0.2139	0.0128	0.0376			0.1738	0.0552			0.0066		0.0078															4.5353	0	0	2.1966	0.027431732	0.489547347	0.3526622	0.08213678	2.587222353	2.408304407	1.043827755	1.617648312	0.046684114	0.342919723	0.23076357	0.001582858	6.028941102	0.027547633	7.442245128	0.336674951	0.037582369	0	0	0.173750073	2.059648792	0	1.369887252	0.568429071	0	0.534049113	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	30.9462
H3435_003_0	2008	5																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0								25.25803458	511.2446458	517.8157198		188.9472313	85.75871916		2819.620009		5855.369787	533.1182801					0.097094526		821.9323512			240.9330577				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)0	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3,9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/PCP visit, $20/visit Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d)$20/visit, (7f)0"	"(7e,h)$20/visit"	"(7c,i)0"		(7g)$20/visit	(15) 0	"(13a,14a,17a,b)0, (16b)$20/visit"	(10b)0	(16a)$20/visit	(17a)0	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																	0.171869684	33.9443	42.9674		17.187	42.9674		42.9119		17.187	17.187					17.187		20			19.9989				20											0	0	0	0	0	0	4.34109043	1.446151878	1.854100507	0	0.270619175	0.30706925	0	10.0829393	0	8.386337974	0.763557254	0	0	0	0	0.000139063	0	1.369887252	0	0	0.401533127	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	30.1635	0	4.493156197	0	0	0	0	0	0	4.34109043	1.446151878	1.854100507	0	0.270619175	0.30706925	0	10.0829393	0	8.386337974	0.763557254	0	0	0	0	0.000139063	0	1.369887252	0	0	0.401533127	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	30.1635		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.9823	0.0715	0.3689	0.3563	0.0911	0.1754	0.1546	0.0299	0.3907	0.0606	0.1589	0.0317	0.0056	0.2726	0.0279	0.2681	0.0337	0.0433			0.2392	0.0498			0.0066		0.006															5.8248	0	0	2.9823	0.07151606	0.368941902	0.356295434	0.09112071	0.175367402	4.495731458	1.476016065	2.244792735	0.060580594	0.429525476	0.338808152	0.005614304	10.35549737	0.027924914	8.654472228	0.797225313	0.043284819	0	0	0.239232834	0.049889235	0	1.369887252	0.006631111	0	0.407520441	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	35.9883
H3449_005_0	2008	8																					3250											A		D	V	T	Coin	Coin	V	V	V	Coin			V	V	V	V	V		V	Coin	V			V	Coin				O																																																					0		269.5159371	0	2165.669596	19.36374572	201.0500719	21.1613182	0.723589214	682.4594568	572.3924531	4739.575415	0	0	0	2239.013826	7086.249809	9575.641836	1.658833805	405.5611676	0	1370.164084	46.26924489	935.2407824	0	0	72.35666733	0.010776525	0	0	0	245.2813264	0											$350 copay		$100 copay for days 1-32	None	$100 copay	20% coinsurance	20% coinsurance	$50 copay / $30 copay	$75 copay	None	10% Coinsurance			$75 copay / 10% coinsurance / None	$15 copay	$30 copay	$30 copay	$30 copay		$30 copay / None	20% coinsurance	$30 copay / $20 copay / None			$15 copay	20% coinsurance				None												280.2210749	0	52.20046364	0	80.06316425	0.160126328	0.160126328	39.52772041	60.04737319	0	0	0	0	16.80923883	9.570438013	24.01894927	24.01894927	24.01894927	0	12.65698338	0.160126328	0	0	0	12.00947464	0.160126328	0	0	0	0	0											6.2937	0	9.420746419	0	1.341392077	3.38848419	0.115865684	2.24800555	2.864221937	0	0	0	0	3.13634318	5.651542879	19.16640463	0.003320287	0.811762759	0	1.44517867	7.408924307	0	0	0	0.072413797	0.001725605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.37		15.72831454	6.2937	0	9.420746419	0	1.341392077	3.38848419	0.115865684	2.24800555	2.864221937	0	0	0	0	3.13634318	5.651542879	19.16640463	0.003320287	0.811762759	0	1.44517867	7.408924307	0	0	0	0.072413797	0.001725605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.37																																																																																				0			6.2937	0	9.420746419	0	1.341392077	3.38848419	0.115865684	2.24800555	2.864221937	0	0	0	0	3.13634318	5.651542879	19.16640463	0.003320287	0.811762759	0	1.44517867	7.408924307	0	0	0	0.072413797	0.001725605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.37
H3449_012_0	2008	8																					3250											A		D	V	T	Coin	Coin	V	V	V				V	V	V	V	V		V	Coin	V			V	Coin				O																																																					0		229.7763064	0	1114.855047	12.97583757	135.655173	12.51446505	0.501478495	517.5019881	534.8648984	3444.505304	0	0	0	1728.820973	5690.046739	8031.243061	1.476711481	342.8924059	0	1078.26952	27.28031607	842.0760447	0	0	66.35098424	0.005227653	0	0	0	300.0595303	0											$350 copay		$100 copay for days 1-32	None	$100 copay	20% coinsurance	20% coinsurance	$50 copay / $30 copay	$75 copay	None				None	$10 copay	$20 copay	$20 copay	$20 copay		$20 copay / None	20% coinsurance	$30 copay / $10 copay / None			$10 copay	20% coinsurance				None												323.8086994	0	68.75210683	0	92.51677125	0.185033543	0.185033543	45.77400304	0	0	0	0	0	0	6.900735135	18.50335425	18.50335425	18.50335425	0	11.58070466	0.185033543	0	0	0	9.251677125	0.185033543	0	0	0	0	0											6.2003	0	6.387386107	0	1.045864884	2.3155958	0.092790342	1.974011465	0	0	0	0	0	0	3.272125454	12.38374462	0.00227701	0.528721638	0	1.040593405	5.047773523	0	0	0	0.051154824	0.000967291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3433		3.197625887	6.2003	0	6.387386107	0	1.045864884	2.3155958	0.092790342	1.974011465	0	0	0	0	0	0	3.272125454	12.38374462	0.00227701	0.528721638	0	1.040593405	5.047773523	0	0	0	0.051154824	0.000967291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3433																																																																																				0			6.2003	0	6.387386107	0	1.045864884	2.3155958	0.092790342	1.974011465	0	0	0	0	0	0	3.272125454	12.38374462	0.00227701	0.528721638	0	1.040593405	5.047773523	0	0	0	0.051154824	0.000967291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3433
H3449_013_0	2008	7																					3250											A		D	V	T	Coin	Coin	V	Coin	Coin	Coin			Coin	V	V	V	V		V	Coin	V			V	Coin				O																																																					0		248.6488403	0	2120.371716	26.86218713	317.3370446	15.23768457	0.292758659	682.2547828	26.8027068	5.766732483	0	0	0	60.89533105	5952.68375	7179.4088	1.055484975	283.9254583	0	1144.768319	28.05433352	739.823136	0	0	48.34994704	0.00380939	0	0	0	244.2445655	0											$950 copay		$100 copay for days 1-32	None	$100 copay	20% coinsurance	20% coinsurance	$50 copay / $45 copay	30% coinsurance	30% coinsurance	30% coinsurance			30% coinsurance / 10% coinsurance	$15 copay	$30 copay	$30 copay	$30 copay		$30 copay / None	20% coinsurance	$30 copay / 30% coinsurance / None			$15 copay	20% coinsurance				None												698.9955296	0	45.17808753	0	73.57847681	0.147156954	0.147156954	36.71826238	0.22073543	0.22073543	0	0	0	0.220286729	7.924468549	22.07354304	22.07354304	22.07354304	0	12.61822278	0.147156954	1.496878199	0	0	11.03677152	0.147156954	0	0	0	0	0											14.4837	0	7.98286158	0	1.945764698	2.242331241	0.043081472	2.087600844	5.916307023	1.272922177	0	0	0	13.41443326	3.93098793	13.2062491	0.001941524	0.522270069	0	1.20374514	4.128390256	0.092285427	0	0	0.044468943	0.000560578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5199		26.43112015	14.4837	0	7.98286158	0	1.945764698	2.242331241	0.043081472	2.087600844	5.916307023	1.272922177	0	0	0	13.41443326	3.93098793	13.2062491	0.001941524	0.522270069	0	1.20374514	4.128390256	0.092285427	0	0	0.044468943	0.000560578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5199																																																																																				0			14.4837	0	7.98286158	0	1.945764698	2.242331241	0.043081472	2.087600844	5.916307023	1.272922177	0	0	0	13.41443326	3.93098793	13.2062491	0.001941524	0.522270069	0	1.20374514	4.128390256	0.092285427	0	0	0.044468943	0.000560578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5199
H3449_801_0	2008	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		165.5539486	0	28.91774627	0.191199135	4.798117969	12.56144348	1.545452337	30.10933853	39.59609142	7.724625038	0	0	0	79.56734426	55.17998807	111.6083015	0.01388585	5.579464476	0	11.63476532	48.16204308	2.842833804																				FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				0.08328181	0.08328181	0.215028916	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				13.7876	0	6.218151647	0	1.122759605	2.939377774	0.361635847	7.045585215	9.265485392	1.807562259	0	0	0	18.61875856	12.91211721	26.11634254	0.003249289	1.305594687	0	2.722535086	11.26991808	0.66522311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1619			13.7876	0	6.218151647	0	1.122759605	2.939377774	0.361635847	7.045585215	9.265485392	1.807562259	0	0	0	18.61875856	12.91211721	26.11634254	0.003249289	1.305594687	0	2.722535086	11.26991808	0.66522311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1619																																																																																				0			13.7876	0	6.218151647	0	1.122759605	2.939377774	0.361635847	7.045585215	9.265485392	1.807562259	0	0	0	18.61875856	12.91211721	26.11634254	0.003249289	1.305594687	0	2.722535086	11.26991808	0.66522311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1619
H3449_805_0	2008	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		165.5539486	0	28.91774627	0.191199135	4.798117969	12.56144348	1.545452337	30.10933853	39.59609142	7.724625038	0	0	0	79.56734426	55.17998807	111.6083015	0.01388585	5.579464476	0	11.63476532	48.16204308	2.842833804																				FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				0.08328181	0.08328181	0.215028916	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				13.7876	0	6.218151647	0	1.122759605	2.939377774	0.361635847	7.045585215	9.265485392	1.807562259	0	0	0	18.61875856	12.91211721	26.11634254	0.003249289	1.305594687	0	2.722535086	11.26991808	0.66522311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1619			13.7876	0	6.218151647	0	1.122759605	2.939377774	0.361635847	7.045585215	9.265485392	1.807562259	0	0	0	18.61875856	12.91211721	26.11634254	0.003249289	1.305594687	0	2.722535086	11.26991808	0.66522311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1619																																																																																				0			13.7876	0	6.218151647	0	1.122759605	2.939377774	0.361635847	7.045585215	9.265485392	1.807562259	0	0	0	18.61875856	12.91211721	26.11634254	0.003249289	1.305594687	0	2.722535086	11.26991808	0.66522311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1619
H3449_810_0	2008	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		185.0645217	0	33.09985214	0.073138411	5.705358971	14.83243029	0.533044567	33.60996337	38.22948003	0.561883614	0	0	0	69.26002764	71.91998839	117.6190761	1.626405847	4.353363443	0	14.44931197	17.42914589	3.023399228																				FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				0.08328181	0.08328181	0.215028916	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				15.4125	0	7.117425342	0	1.335053999	3.470788687	0.124732429	7.864731429	8.945698328	0.131480766	0	0	0	16.20684647	16.82927728	27.52286382	0.380578968	1.018687046	0	3.381139001	4.078420139	0.707475419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5277			15.4125	0	7.117425342	0	1.335053999	3.470788687	0.124732429	7.864731429	8.945698328	0.131480766	0	0	0	16.20684647	16.82927728	27.52286382	0.380578968	1.018687046	0	3.381139001	4.078420139	0.707475419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5277																																																																																				0			15.4125	0	7.117425342	0	1.335053999	3.470788687	0.124732429	7.864731429	8.945698328	0.131480766	0	0	0	16.20684647	16.82927728	27.52286382	0.380578968	1.018687046	0	3.381139001	4.078420139	0.707475419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5277
H3449_811_0	2008	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		185.0645217	0	33.09985214	0.073138411	5.705358971	14.83243029	0.533044567	33.60996337	38.22948003	0.561883614	0	0	0	69.26002764	71.91998839	117.6190761	1.626405847	4.353363443	0	14.44931197	17.42914589	3.023399228																				FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				0.08328181	0.08328181	0.215028916	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				15.4125	0	7.117425342	0	1.335053999	3.470788687	0.124732429	7.864731429	8.945698328	0.131480766	0	0	0	16.20684647	16.82927728	27.52286382	0.380578968	1.018687046	0	3.381139001	4.078420139	0.707475419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5277			15.4125	0	7.117425342	0	1.335053999	3.470788687	0.124732429	7.864731429	8.945698328	0.131480766	0	0	0	16.20684647	16.82927728	27.52286382	0.380578968	1.018687046	0	3.381139001	4.078420139	0.707475419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5277																																																																																				0			15.4125	0	7.117425342	0	1.335053999	3.470788687	0.124732429	7.864731429	8.945698328	0.131480766	0	0	0	16.20684647	16.82927728	27.52286382	0.380578968	1.018687046	0	3.381139001	4.078420139	0.707475419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5277
H3449_812_0	2008	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		185.0645217	0	33.09985214	0.073138411	5.705358971	14.83243029	0.533044567	33.60996337	38.22948003	0.561883614	0	0	0	69.26002764	71.91998839	117.6190761	1.626405847	4.353363443	0	14.44931197	17.42914589	3.023399228																				FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				0.08328181	0.08328181	0.215028916	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				15.4125	0	7.117425342	0	1.335053999	3.470788687	0.124732429	7.864731429	8.945698328	0.131480766	0	0	0	16.20684647	16.82927728	27.52286382	0.380578968	1.018687046	0	3.381139001	4.078420139	0.707475419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5277			15.4125	0	7.117425342	0	1.335053999	3.470788687	0.124732429	7.864731429	8.945698328	0.131480766	0	0	0	16.20684647	16.82927728	27.52286382	0.380578968	1.018687046	0	3.381139001	4.078420139	0.707475419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5277																																																																																				0			15.4125	0	7.117425342	0	1.335053999	3.470788687	0.124732429	7.864731429	8.945698328	0.131480766	0	0	0	16.20684647	16.82927728	27.52286382	0.380578968	1.018687046	0	3.381139001	4.078420139	0.707475419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5277
H3456_001_0	2008	8																					3600											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	3600	1831.086686	135.0273569	767.468705		114.3084942	12.37971317	2.372117883	445.6242913	30.46241158	9447.498833	43.78536332		0.354230868	28.07039638	4138.51957	4103.690306	471.2424311	1.734040924			22.10241622	825.3966836			194.8234476		17.5936029															$295 (1a); $0 (1a1)	$295 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$40/$15 (4b)"	20% (9b)	20% (8a1); $0/$20 (8a2)	"$20 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	see OON	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											178.3956	178.3956	96.7569		105.8279	0.181419279	0.282232307	29.3139	0.120946186	4.8378	0.071924601		0.181419279	0.120909135	15	30	37.5	0.120946186			0.181419279	30			30		30															27.2215	2.007357469	6.188160846	0	1.008085779	2.245918637	0.669488302	1.088583421	3.684312495	3.808796501	3.149244779	0	0.064264309	3.393967349	5.173149462	10.25922577	1.472632597	0.209725636	0	0	4.009804412	2.063491709	0	0	0.487058619	0	0.043984007	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2487	0	38.0034803	27.2215	2.007357469	6.188160846	0	1.008085779	2.245918637	0.669488302	1.088583421	3.684312495	3.808796501	3.149244779	0	0.064264309	3.393967349	5.173149462	10.25922577	1.472632597	0.209725636	0	0	4.009804412	2.063491709	0	0	0.487058619	0	0.043984007	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2487		$325 (1a); $0 (1a1)	$325 (1b)	"$190 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.1741	0.1603	2.0421	0.6605	0.2101	0.4681	0.1647	0.234	1.1518	1.8413	1.4079		0.0134	1.061	1.3505	2.1033	0.2945	0.0463			0.5899	0.4323			0.1003		0.0091															16.5156	0	11.35612372	29.3956	2.16768	8.230276311	0.660500096	1.218194381	2.714020494	0.834179443	1.322610516	4.836157554	5.6501132	4.557154908	0	0.07765849	4.454952405	6.523667642	12.36249571	1.767159117	0.25600863	0	0	4.599736284	2.49580481	0	0	0.587335394	0	0.053039538	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.7643
H3456_010_0	2008	6	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)							Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						Coin	Coin	D	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V		Coin	Coin	Coin	T		V	P	Coin					Coin	Coin	Coin	V																																																0		355.1485198	7.242763104	10596.88386	140.4184362	28.05841935	21.03897116	0.216953873	313.2235987	10.10852276	42.1821908	42.33213542	3.515085829	0.229657342	8.757288143	25837.32892	134.4412072	9.747936656	12.63604938		19.21952396	6.000218801	5.811608706	809.2136306		151.19894	292.8						1.00731877	0.002860695		176.3880131							(1a) 8.1% coins	(1b) 8.1% coins	(2a) $0/day	(6a) $0/proc	(10a) 20% coins	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) 20% coins	(8a) 10% coins	(8b) 19.2% coins	(9a) 20% coins	(12) 20% coins	(9a) 20% coins	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) 20% coins	(7e/7h) 20% coins	(7c/7i) $0/visit		(7g) 20% coins	(15) 20% coins	(Misc. PBP Cats) 20% coins	(10b) $0/trip		(17a1) $0/visit	(17b2) $0/proc	(18a) 20% coins					(4b) 20% coins	(9c) 20% coins	(9d) 20% coins	(7f1) $0/visit							0.080539575	0.080539575			0.2	0.2	0.2	50	0.2	0.1	0.192	0.2	0.2	0.2		0.2	0.2			0.2	0.2	0.2										0.2	0.2									28.6035	0.583329062	0	0	5.611683869	4.207794232	0.043390775	1.305098328	2.021704553	4.21821908	8.127770001	0.703017166	0.045931468	1.751457629	0	26.88824145	1.949587331	0	0	3.843904791	1.20004376	1.162321741	0	0	0	0	0	0	0	0	0	0.201463754	0.000572139	0	0	0	0	0	0	0	0	92.469		0	28.6035	0.583329062	0	0	5.611683869	4.207794232	0.043390775	1.305098328	2.021704553	4.21821908	8.127770001	0.703017166	0.045931468	1.751457629	0	26.88824145	1.949587331	0	0	3.843904791	1.20004376	1.162321741	0	0	0	0	0	0	0	0	0	0.201463754	0.000572139	0	0	0	0	0	0	0	0	92.469																																																																																				0		0	28.6035	0.583329062	0	0	5.611683869	4.207794232	0.043390775	1.305098328	2.021704553	4.21821908	8.127770001	0.703017166	0.045931468	1.751457629	0	26.88824145	1.949587331	0	0	3.843904791	1.20004376	1.162321741	0	0	0	0	0	0	0	0	0	0.201463754	0.000572139	0	0	0	0	0	0	0	0	92.469
H3456_016_0	2008	5																					1650											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2406.81277	382.3172138	1165.208488		597.0470938	26.79247176	9.26801849	1289.925981	329.1189364	7833.638866	612.1148551	41.4691372	4.843127406	2137.740304		1957.669492		495.5065945			32.21477422	456.7749951																				1(a) $150 per Day	1(b) $150 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $10 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per procedure; other $0 per procedure	8(b) X-rays $10 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a)/(d) $25 Copay Per Visit; 9(c) $0 Copay per Visit"	7(a) PCP $0 per visit; Urgent Care $10 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $10 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															87.3798	87.3798	24.4664		43.6899	0.116506441	0.116506441	20.9712	14.5633	5.8253	5.8253	14.5633	0.116506441	14.5633		5.8253		5.8253			0.116506441	5.8253																				17.5256	2.78390111	2.375700137	0	2.173744743	3.12149552	1.079783846	2.254270271	0.399421623	3.802789089	0.297147179	0.050327308	0.564255535	2.594380351	0	0.950337935	0	0.240540457	0	0	3.753228679	0.221738453	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.1886	0	31.66749007	17.5256	2.78390111	2.375700137	0	2.173744743	3.12149552	1.079783846	2.254270271	0.399421623	3.802789089	0.297147179	0.050327308	0.564255535	2.594380351	0	0.950337935	0	0.240540457	0	0	3.753228679	0.221738453	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.1886																																																																																				0	0	0	17.5256	2.78390111	2.375700137	0	2.173744743	3.12149552	1.079783846	2.254270271	0.399421623	3.802789089	0.297147179	0.050327308	0.564255535	2.594380351	0	0.950337935	0	0.240540457	0	0	3.753228679	0.221738453	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.1886
H3456_020_0	2008	8																					3000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	3000	1716.728401	133.1082416	819.9053995		103.7398279	12.26872896	2.22809236	436.6142238	32.78463348	9969.250132	48.88686564		0.280270934	31.23473235	4299.821148	4407.284696	471.8261594	2.17658413			26.15942472	896.5727583			153.5589011		14.6541814															$295 (1a); $0 (1a1)	$295 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$40 (4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											164.792	164.792	89.3787		97.758	0.167585103	0.280052178	27.0766	0.111723402	3.3517	0.065800939		0.167585103	0.111695355	15	29.9388	37.5	0.111723402			0.167585103	30			30		30															23.5753	1.827931314	6.106841378	0	0.845116308	2.056056208	0.623982118	0.985168015	3.662810791	2.784496354	3.216801667	0	0.046969233	3.488774518	5.374776435	10.99574015	1.474456748	0.243175384	0	0	4.383929892	2.241431896	0	0	0.383897253	0	0.036635454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3543	0	42.09669506	23.5753	1.827931314	6.106841378	0	0.845116308	2.056056208	0.623982118	0.985168015	3.662810791	2.784496354	3.216801667	0	0.046969233	3.488774518	5.374776435	10.99574015	1.474456748	0.243175384	0	0	4.383929892	2.241431896	0	0	0.383897253	0	0.036635454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3543		$325 (1a); $0 (1a1)	$325 (1b)	"$190 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											1.9735	0.153	2.1123	0.6514	0.1846	0.4492	0.1542	0.222	1.2003	0.8111	1.0446		0.0103	1.1431	1.4089	2.2501	0.2949	0.0562			0.676	0.4696			0.079		0.0075															15.3519	0	10.6876948	25.5488	1.980951796	8.219139389	0.651396678	1.029737979	2.505216318	0.778203341	1.207175179	4.863061413	3.595553744	4.261375921	0	0.057229997	4.631884879	6.783695025	13.24585365	1.769348098	0.299423683	0	0	5.059953902	2.711045164	0	0	0.462934922	0	0.044178047	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.7062
H3456_022_0	2008	6																					2100											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2036.151613	139.6410395	914.4611542		282.6200623	10.84400166	18.83272582	439.7347863	415.6342031	3484.609256	457.9396423	69.7880803	15.66498074	2928.189241		3998.569135	393.8654663	575.329931				711.6251699					0.075348197															(1a)$150/day	(1b)$150/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															106.7567	106.7567	29.8919		53.3784	0.142342279	0.142342279	29.3581	53.3784	14.2342	46.4491	53.3784	106.4983	51.6075		17.7928	14.2342	14.2342				17.7928					17.7928															18.1144	1.242301491	2.27791349	0	1.257149496	1.543559914	2.680693122	1.075814641	1.848822496	4.133393537	1.772575024	0.310431076	0.13902455	12.59305266	0	5.92880672	0.467197569	0.682448115	0	0	0	1.055149467	0	0	0	0	0.000111721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1228	0	23.13840467	18.1144	1.242301491	2.27791349	0	1.257149496	1.543559914	2.680693122	1.075814641	1.848822496	4.133393537	1.772575024	0.310431076	0.13902455	12.59305266	0	5.92880672	0.467197569	0.682448115	0	0	0	1.055149467	0	0	0	0	0.000111721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1228																																																																																				0	0	0	18.1144	1.242301491	2.27791349	0	1.257149496	1.543559914	2.680693122	1.075814641	1.848822496	4.133393537	1.772575024	0.310431076	0.13902455	12.59305266	0	5.92880672	0.467197569	0.682448115	0	0	0	1.055149467	0	0	0	0	0.000111721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1228
H3456_801_0	2008	3																					4300											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1490.588312	143.0702328	556.5441318		95.09124069	11.63181969	2.206052806	461.780647	41.98461957	12350.62633	55.04155038		0.241363239	33.88064601	4891.387219	5016.85706	566.0666137	3.023519682			26.99524719	1153.596008			248.5411701		17.91965928															$410 (1a); $0 (1a1)	$410 (1b)	"$165 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$40 (4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$35/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $35 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											261.4207	261.4207	105.2059		111.582	0.191283446	0.282515952	30.4549	0.191283446	3.8257	0.103648703		0.191283446	0.191166356	35	34.6947	37.5	0.191283446			0.191283446	35			35		35															32.4726	3.116793484	4.87931031	0	0.884205983	2.224974556	0.623245108	1.171958836	8.03096272	3.937450612	5.704985319	0	0.046168792	6.476839646	14.26654606	14.50485257	1.768958168	0.578349264	0	0	5.163743914	3.364655024	0	0	0.724911746	0	0.052265673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9937	0	42.48673426	32.4726	3.116793484	4.87931031	0	0.884205983	2.224974556	0.623245108	1.171958836	8.03096272	3.937450612	5.704985319	0	0.046168792	6.476839646	14.26654606	14.50485257	1.768958168	0.578349264	0	0	5.163743914	3.364655024	0	0	0.724911746	0	0.052265673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9937																																																																																				0			32.4726	3.116793484	4.87931031	0	0.884205983	2.224974556	0.623245108	1.171958836	8.03096272	3.937450612	5.704985319	0	0.046168792	6.476839646	14.26654606	14.50485257	1.768958168	0.578349264	0	0	5.163743914	3.364655024	0	0	0.724911746	0	0.052265673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9937
H3518_001_0	2008	13	g.1.	i.7.									OP Facility - Surgery	Professional									3000	ASC	Allergy Injections																																																																																											0		311.5404557		1440.912773		201.2749577	0.776995242		329.3379268	231.341643					777.7000343	4378.506513	7593.720211	436.1118603					814										188.8767926	652.9490386									$150/Day - Days 1-5		$0 Days 1-6 $100 Days 7-25		$100 Copay	$500 for Elec Scooter		"$50 Copay, waived if admitted"	$200 Surgery					$75 per Service / $50 IDTF	$10 Copay PCP	$25 Copay Specialists	$25 Copay Specialists					Medicare Covered Diag Exam $10 Medicare Cov Eye Exam $10										$100 Surgery / Ambulatory Surgery Center	$6 Copay Allergy Injections									466.1179778		47.37776602		100	500		50	194.0231928					72.75869731	9.701159641	24.2528991	24.2528991					9.701159641										100	6									12.1012	0	5.688935685	0	1.677291314	0.032374802	0	1.372241362	3.74047035	0	0	0	0	4.715370116	3.539715889	15.34747751	0.881414745	0	0	0	0	0.658061996	0	0	0	0	0	0	0	0	0	1.573973272	0.326474519	0	0	0	0	0	0	0	0	51.655	0	1.262487413	12.1012	0	5.688935685	0	1.677291314	0.032374802	0	1.372241362	3.74047035	0	0	0	0	4.715370116	3.539715889	15.34747751	0.881414745	0	0	0	0	0.658061996	0	0	0	0	0	0	0	0	0	1.573973272	0.326474519	0	0	0	0	0	0	0	0	51.655		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.1012	0	5.688935685	0	1.677291314	0.032374802	0	1.372241362	3.74047035	0	0	0	0	4.715370116	3.539715889	15.34747751	0.881414745	0	0	0	0	0.658061996	0	0	0	0	0	0	0	0	0	1.573973272	0.326474519	0	0	0	0	0	0	0	0	51.655
H3518_801_0	2008	4																																Coin		Coin		Coin	Coin		Coin	Coin					Coin		Coin					Coin	Coin																																																													0		289.5277498		56.84997116		8.899856646	56.93752668		4.897746487	13.57892961					59.95082881		322.6477698					34.18824864	1.84522538																				8.2% coinsurance		18.9% coinsurance	0% coinsurance	23.4% coinsurance	23.4% coinsurance		23.4% coinsurance	23.4% coinsurance					23.4% coinsurance		23.4% coinsurance					23.4% coinsurance	23.4% coinsurance																				0.082418684		0.188750064		0.234	0.234		0.234	0.234					0.234		0.234					0.234	0.234																				23.8625	0	10.7304357	0	2.082566455	13.32338124	0	1.146072678	3.177469529	0	0	0	0	14.02849394	0	75.49957814	0	0	0	0	8.000050182	0.431782739	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.2823	0	0	23.8625	0	10.7304357	0	2.082566455	13.32338124	0	1.146072678	3.177469529	0	0	0	0	14.02849394	0	75.49957814	0	0	0	0	8.000050182	0.431782739	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.2823																																																																																				0	0	0	23.8625	0	10.7304357	0	2.082566455	13.32338124	0	1.146072678	3.177469529	0	0	0	0	14.02849394	0	75.49957814	0	0	0	0	8.000050182	0.431782739	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.2823
H3518_802_0	2008	4																																Coin		Coin		Coin	Coin		Coin	Coin					Coin		Coin					Coin	Coin																																																													0		289.5277498		56.84997116		8.899856646	56.93752668		4.897746487	13.57892961					59.95082881		322.6477698					34.18824864	1.84522538																				8.2% coinsurance		18.9% coinsurance	0% coinsurance	23.4% coinsurance	23.4% coinsurance		23.4% coinsurance	23.4% coinsurance					23.4% coinsurance		23.4% coinsurance					23.4% coinsurance	23.4% coinsurance																				0.082418684		0.188750064		0.234	0.234		0.234	0.234					0.234		0.234					0.234	0.234																				23.8625	0	10.7304357	0	2.082566455	13.32338124	0	1.146072678	3.177469529	0	0	0	0	14.02849394	0	75.49957814	0	0	0	0	8.000050182	0.431782739	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.2823	0	0	23.8625	0	10.7304357	0	2.082566455	13.32338124	0	1.146072678	3.177469529	0	0	0	0	14.02849394	0	75.49957814	0	0	0	0	8.000050182	0.431782739	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.2823																																																																																				0	0	0	23.8625	0	10.7304357	0	2.082566455	13.32338124	0	1.146072678	3.177469529	0	0	0	0	14.02849394	0	75.49957814	0	0	0	0	8.000050182	0.431782739	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.2823
H3518_803_0	2008	4																																Coin		Coin		Coin	Coin		Coin	Coin					Coin		Coin					Coin	Coin																																																													0		289.5277498		56.84997116		8.899856646	56.93752668		4.897746487	13.57892961					59.95082881		322.6477698					34.18824864	1.84522538																				8.2% coinsurance		18.9% coinsurance	0% coinsurance	23.4% coinsurance	23.4% coinsurance		23.4% coinsurance	23.4% coinsurance					23.4% coinsurance		23.4% coinsurance					23.4% coinsurance	23.4% coinsurance																				0.082418684		0.188750064		0.234	0.234		0.234	0.234					0.234		0.234					0.234	0.234																				23.8625	0	10.7304357	0	2.082566455	13.32338124	0	1.146072678	3.177469529	0	0	0	0	14.02849394	0	75.49957814	0	0	0	0	8.000050182	0.431782739	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.2823	0	0	23.8625	0	10.7304357	0	2.082566455	13.32338124	0	1.146072678	3.177469529	0	0	0	0	14.02849394	0	75.49957814	0	0	0	0	8.000050182	0.431782739	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.2823																																																																																				0	0	0	23.8625	0	10.7304357	0	2.082566455	13.32338124	0	1.146072678	3.177469529	0	0	0	0	14.02849394	0	75.49957814	0	0	0	0	8.000050182	0.431782739	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.2823
H3528_001_0	2008	13																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	1940.8496	74.70552732	1666.466504	192.5869216	535.8007209	10.30585363	10.30585363	325.7900699	49.53557839	0	0	0	0	3145.641807	8954.938329	11960.78712	134.3240749	223.8734582	313.4228415	0	10.14371232	0	0	344.485824	1414.183912	344.485824	67.80903454	0	0	0	0											$200 days 1-7 copay max $2400	$225 days 1-7 copay max $2400	$75 days 21-100 copay	0	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$100 copay	0	0	0	0	$175 copay	$15 copay	$30 copay	$30 copay	$30 copay	$20 copay	0	0% coinsurance	0	0	$150 max benefit	$30 copay	$40 1 year max benefit	$30 copay	0	0	0	0											104.9758582	208.125	63	0	100	0.2	0.2	50	100	0	0	0	0	175	15	30	30	30	20	0	0	0	0	11.875	30	1.697777778	30	0	0	0	0											16.9785	1.295673989	8.748949145	0	4.465006007	2.061170727	2.061170727	1.357458625	0.412796487	0	0	0	0	45.87394302	11.19367291	29.9019678	0.335810187	0.559683646	0.522371403	0	0	0	0	0.34089743	3.535459779	0.048738365	0.169522586	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.8628	0	0	16.9785	1.295673989	8.748949145	0	4.465006007	2.061170727	2.061170727	1.357458625	0.412796487	0	0	0	0	45.87394302	11.19367291	29.9019678	0.335810187	0.559683646	0.522371403	0	0	0	0	0.34089743	3.535459779	0.048738365	0.169522586	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.8628	none	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.9785	1.295673989	8.748949145	0	4.465006007	2.061170727	2.061170727	1.357458625	0.412796487	0	0	0	0	45.87394302	11.19367291	29.9019678	0.335810187	0.559683646	0.522371403	0	0	0	0	0.34089743	3.535459779	0.048738365	0.169522586	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.8628
H3528_002_0	2008	13																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	1989.889623	76.59313408	1913.627068	197.4530726	549.3389569	10.5662547	10.5662547	334.0219044	50.78720857	0	0	0	0	3737.757322	9181.205416	13083.21772	137.7180812	229.5301354	321.3421896	0	10.40001651	0	0	344.485824	1414.183912	344.485824	67.80903454	100	0	0	0											0	$50 days 1-7 copay max $2400	$50 days 21-100 copay	0	$75 copay	20% coinsurance	20% coinsurance	$50 copay	0	0	0	0	0	$60 copay	$5 copay	$15 copay	$25 copay	$15 copay	$20 copay	0	0% coinsurance	0	0	$150 max benefit	$15 copay	$100 1 year max benefit	$15 copay	$500 every 3 years	0	0	0											0	46.25	21	0	75	0.2	0.2	50	0	0	0	0	0	60	5	15	25	15	20	0	0	0	0	11.875	15	4.244444444	15	166.6666667	0	0	0											0	0.295202704	3.348847368	0	3.433368481	2.11325094	2.11325094	1.391757935	0	0	0	0	0	18.68878661	3.825502257	16.35402215	0.286912669	0.286912669	0.535570316	0	0	0	0	0.34089743	1.76772989	0.121845912	0.084761293	1.388888889	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3775	0	0	0	0.295202704	3.348847368	0	3.433368481	2.11325094	2.11325094	1.391757935	0	0	0	0	0	18.68878661	3.825502257	16.35402215	0.286912669	0.286912669	0.535570316	0	0	0	0	0.34089743	1.76772989	0.121845912	0.084761293	1.388888889	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3775	none	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0.295202704	3.348847368	0	3.433368481	2.11325094	2.11325094	1.391757935	0	0	0	0	0	18.68878661	3.825502257	16.35402215	0.286912669	0.286912669	0.535570316	0	0	0	0	0.34089743	1.76772989	0.121845912	0.084761293	1.388888889	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3775
H3528_003_0	2008	12																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2026.800695	78.01388357	1949.123522	201.11569	559.5288134	10.76225139	10.76225139	340.217779	51.72927604	0	0	0	0	3807.090126	9351.510406	13325.90233	140.2726561	233.7877602	327.3028642	0	10.5929296	0	0	344.485824	1414.183912	344.485824	67.80903454	0	0	0	0											$100 days 1-5 copay max $1000	$100 days 1-5 copay max $1000	$75 days 21-100 copay	0	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$100 copay	0	0	0	0	$175 copay	$10 copay	$20 copay	$25 copay	$20 copay	$20 copay	0	0% coinsurance	0	0	$150 max benefit	$20 copay	0	$20 copay	0	0	0	0											43.42627648	92.5	63	0	75	0.2	0.2	50	100	0	0	0	0	175	10	20	25	20	20	0	0	0	0	11.875	20	0	20	0	0	0	0											7.3347	0.601357019	10.23289849	0	3.497055084	2.152450279	2.152450279	1.417574079	0.4310773	0	0	0	0	55.52006434	7.792925338	22.20983721	0.2922347	0.389646267	0.545504774	0	0	0	0	0.34089743	2.356973186	0	0.113015058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.3807	0	0	7.3347	0.601357019	10.23289849	0	3.497055084	2.152450279	2.152450279	1.417574079	0.4310773	0	0	0	0	55.52006434	7.792925338	22.20983721	0.2922347	0.389646267	0.545504774	0	0	0	0	0.34089743	2.356973186	0	0.113015058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.3807	none	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.3347	0.601357019	10.23289849	0	3.497055084	2.152450279	2.152450279	1.417574079	0.4310773	0	0	0	0	55.52006434	7.792925338	22.20983721	0.2922347	0.389646267	0.545504774	0	0	0	0	0.34089743	2.356973186	0	0.113015058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.3807
H3528_004_0	2008	13	s.										Professional										none	Podiatry										D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	O	O	V																																																			0	n/a	2773.290752	106.7471421	2667.004334	275.1885199	765.6086203	14.72609139	14.72609139	465.523237	70.78166257	0	0	0	0	5209.277788	12795.76102	15577.03576	191.9364153	319.8940255	447.8516357	0	14.49440676	0	0	344.485824	1414.183912	344.485824	67.80903454	100	0	0	0	2656.923691										0	0	$50 days 21-100 copay	0	$75 copay	20% coinsurance	20% coinsurance	$50 copay	0	0	0	0	0	$60 copay	$5 copay	$15 copay	$25 copay	$15 copay	$20 copay	0	0% coinsurance	0	0	$150 max benefit	$15 copay	$100 1 year max benefit	$15 copay	$500 every 3 years	0	0	0	$5 copay										0	0	21	0	75	0.2	0.2	50	0	0	0	0	0	60	5	15	25	15	20	0	0	0	0	11.875	15	0	15	166.6666667	0	0	0	5										0	0	4.667257585	0	4.785053877	2.945218278	2.945218278	1.939680154	0	0	0	0	0	26.04638894	5.331567092	19.4712947	0.399867532	0.399867532	0.746419393	0	0	0	0	0.34089743	1.76772989	0	0.084761293	1.388888889	0	0	0	1.107051538	0	0	0	0	0	0	0	0	0	74.3672	0	0	0	0	4.667257585	0	4.785053877	2.945218278	2.945218278	1.939680154	0	0	0	0	0	26.04638894	5.331567092	19.4712947	0.399867532	0.399867532	0.746419393	0	0	0	0	0.34089743	1.76772989	0	0.084761293	1.388888889	0	0	0	1.107051538	0	0	0	0	0	0	0	0	0	74.3672	none	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0										0	0	0	0	0	4.667257585	0	4.785053877	2.945218278	2.945218278	1.939680154	0	0	0	0	0	26.04638894	5.331567092	19.4712947	0.399867532	0.399867532	0.746419393	0	0	0	0	0.34089743	1.76772989	0	0.084761293	1.388888889	0	0	0	1.107051538	0	0	0	0	0	0	0	0	0	74.3672
H3528_005_0	2008	12																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2061.579674	79.35256637	1982.569596	204.5667439	569.1300736	10.94692674	10.94692674	346.0557615	52.61692692	0	0	0	0	3872.418064	9511.978077	13554.56876	142.6796711	237.7994519	332.9192327	0	10.77469946	0	0	344.485824	1414.183912	344.485824	67.80903454	0	0	0	0											$75 days 1-7 copay max $1000	$125 days 1-7 copay max $1000	$75 days 21-100 copay	0	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$75 copay	0	0	0	0	$175 copay	$15 copay	$25 copay	$25 copay	$25 copay	$20 copay	0	0% coinsurance	0	0	$150 max benefit	$25 copay	$40 1 year max benefit	$25 copay	0	0	0	0											39.36594681	115.625	63	0	100	0.2	0.2	50	75	0	0	0	0	175	15	25	25	25	20	0	0	0	0	11.875	25	1.697777778	25	0	0	0	0											6.763	0.764595041	10.40849038	0	4.742750614	2.189385348	2.189385348	1.441899006	0.328855793	0	0	0	0	56.47276343	11.8899726	28.23868492	0.297249315	0.495415525	0.554865388	0	0	0	0	0.34089743	2.946216483	0.048738365	0.141268822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.2544	0	0	6.763	0.764595041	10.40849038	0	4.742750614	2.189385348	2.189385348	1.441899006	0.328855793	0	0	0	0	56.47276343	11.8899726	28.23868492	0.297249315	0.495415525	0.554865388	0	0	0	0	0.34089743	2.946216483	0.048738365	0.141268822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.2544	none	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.763	0.764595041	10.40849038	0	4.742750614	2.189385348	2.189385348	1.441899006	0.328855793	0	0	0	0	56.47276343	11.8899726	28.23868492	0.297249315	0.495415525	0.554865388	0	0	0	0	0.34089743	2.946216483	0.048738365	0.141268822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.2544
H3528_801_0	2008	10																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	1940.8496	74.70552732	1866.466504	192.5869216	535.8007209	10.30585363	10.30585363	325.7900699	49.53557839	0	0	0	0	2845.641807	8954.938329	12760.78712	134.3240749	223.8734582	313.4228415	0	10.14371232	0	0	344.485824	1414.183912	344.485824	67.80903454	0	0	0	0											$200 days 1-7 copay max $2400	$200 days 1-7 copay max $2400	$75 days 21-100 copay	0	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$100 copay	0	0	0	0	$175 copay	$15 copay	$30 copay	$30 copay	$30 copay	$20 copay	0	0% coinsurance	0	0	$150 max benefit	$30 copay	$40 1 year max benefit	$30 copay	0	0	0	0											104.9758582	185	63	0	75	0.2	0.2	50	100	0	0	0	0	175	15	30	30	30	20	0	0	0	0	11.875	30	1.697777778	30	0	0	0	0											16.9785	1.151710213	9.798949145	0	3.348754505	2.061170727	2.061170727	1.357458625	0.412796487	0	0	0	0	41.49894302	11.19367291	31.9019678	0.335810187	0.559683646	0.522371403	0	0	0	0	0.34089743	3.535459779	0.048738365	0.169522586	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.2776	0	0	16.9785	1.151710213	9.798949145	0	3.348754505	2.061170727	2.061170727	1.357458625	0.412796487	0	0	0	0	41.49894302	11.19367291	31.9019678	0.335810187	0.559683646	0.522371403	0	0	0	0	0.34089743	3.535459779	0.048738365	0.169522586	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.2776	none	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.9785	1.151710213	9.798949145	0	3.348754505	2.061170727	2.061170727	1.357458625	0.412796487	0	0	0	0	41.49894302	11.19367291	31.9019678	0.335810187	0.559683646	0.522371403	0	0	0	0	0.34089743	3.535459779	0.048738365	0.169522586	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.2776
H3597_001_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7299.926107	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0															$125/day 1-7	$125/day 1-7	$0/day 1-10; $100/day 11-100	$20 per visit	$100 per trip	20% coinsurance	20% coinsurance	"$50 ER, $35 UC"	$100 per procedure	$0 per visit	"$20 X-ray; $175 CAT, PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$10 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	45$ per script		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															90.16	90.16	64.36	20	100	0.2	0.2	48	100	0	47.9	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0															11.9275	0.2323624	6.954770032	3.547740771	1.957621255	3.143561179	0.200659672	1.704269383	2.925180284	0	4.578243898	0	0	0	4.613623101	12.16654351	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3087			11.9275	0.2323624	6.954770032	3.547740771	1.957621255	3.143561179	0.200659672	1.704269383	2.925180284	0	4.578243898	0	0	0	4.613623101	12.16654351	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3087																																																																																				0			11.9275	0.2323624	6.954770032	3.547740771	1.957621255	3.143561179	0.200659672	1.704269383	2.925180284	0	4.578243898	0	0	0	4.613623101	12.16654351	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3087
H3597_002_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7299.926107	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0															$0/day	$0/day	$0/day 1-10; $100/day 11-100	$20 per visit	$100 per trip	20% coinsurance	20% coinsurance	"$50 ER, $35 UC"	$100 per procedure	$0 per visit	"$15 X-ray; $175 CAT, PET, MRI"	$15 per visit	$15 per visit	$15 per visit	$5 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	45$ per script		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															0	0	64.36	20	100	0.2	0.2	48	100	0	43.8	15	15	15	5	15	15	15	15	15	45	0	0	0	0	0	0															0	0	6.954770032	3.547740771	1.957621255	3.143561179	0.200659672	1.704269383	2.925180284	0	4.186369159	0	0	0	2.30681155	9.124907634	0.252089558	0.729369643	1.196202335	1.807988505	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.08			0	0	6.954770032	3.547740771	1.957621255	3.143561179	0.200659672	1.704269383	2.925180284	0	4.186369159	0	0	0	2.30681155	9.124907634	0.252089558	0.729369643	1.196202335	1.807988505	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.08																																																																																				0			0	0	6.954770032	3.547740771	1.957621255	3.143561179	0.200659672	1.704269383	2.925180284	0	4.186369159	0	0	0	2.30681155	9.124907634	0.252089558	0.729369643	1.196202335	1.807988505	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.08
H3597_801_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1178.717283	22.9628725	962.8109084	1580.505992	174.422672	15.71780589	1.003298358	316.3524979	260.6314985	1657.041421	851.6039658	0	0	0	4110.705616	5214.763346	149.740011	866.4842709	1184.230929	2147.873327	18.07125295	0	0	0	0	0	0															$200/d 7	$200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															14.2006	0.276645206	8.023424236	5.268353307	2.1802834	4.715341768	0.300989507	1.318135408	4.343858308	5.523471404	3.898926823	0	0	0	10.27676404	17.16526268	0.49913337	2.888280903	3.947436431	7.159577757	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.6007			14.2006	0.276645206	8.023424236	5.268353307	2.1802834	4.715341768	0.300989507	1.318135408	4.343858308	5.523471404	3.898926823	0	0	0	10.27676404	17.16526268	0.49913337	2.888280903	3.947436431	7.159577757	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.6007																																																																																				0			14.2006	0.276645206	8.023424236	5.268353307	2.1802834	4.715341768	0.300989507	1.318135408	4.343858308	5.523471404	3.898926823	0	0	0	10.27676404	17.16526268	0.49913337	2.888280903	3.947436431	7.159577757	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.6007
H3597_802_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1178.717283	22.9628725	962.8109084	1580.505992	174.422672	15.71780589	1.003298358	316.3524979	260.6314985	1657.041421	851.6039658	0	0	0	4110.705616	5214.763346	149.740011	866.4842709	1184.230929	2147.873327	18.07125295	0	0	0	0	0	0															$200/d 7	$200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															14.2006	0.276645206	8.023424236	5.268353307	2.1802834	4.715341768	0.300989507	1.318135408	4.343858308	5.523471404	3.898926823	0	0	0	10.27676404	17.16526268	0.49913337	2.888280903	3.947436431	7.159577757	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.6007			14.2006	0.276645206	8.023424236	5.268353307	2.1802834	4.715341768	0.300989507	1.318135408	4.343858308	5.523471404	3.898926823	0	0	0	10.27676404	17.16526268	0.49913337	2.888280903	3.947436431	7.159577757	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.6007																																																																																				0			14.2006	0.276645206	8.023424236	5.268353307	2.1802834	4.715341768	0.300989507	1.318135408	4.343858308	5.523471404	3.898926823	0	0	0	10.27676404	17.16526268	0.49913337	2.888280903	3.947436431	7.159577757	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.6007
H3619_001_0	2008	3	s.	t.									Other Non-Covered	Other Non-Covered									3000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0	0	0	0									0		1611.874624	57.604523	501.145053	209.906891	70.212423	4.759035	1.628598	332.207077	392.325053	6170.569886	1446.250234		8.2398	525.902537	4767.67814	3601.56226	46.992083	298.975866			17.083617			6.26	1.82					3.4	0.02	0.08	0.18									$150/Day(Days 1-5)	$150/Day(Days 1-5)	$0/Day(Days 1-20) $75(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$125/Visit	$0-$75/Visit	$50-$75/Visit		$0-$75/Proc	$25-$75/Visit	$5/Visit	$25/Visit	$25-$75/Visit	$75/Visit			20% Coins			Coin: 25%- 75%	EyeMed: $100 Allowance					Silver Sneakers	Quit Net	Humana Active Outlook	Meals On Wheels									83.139112	83.139092	14.807676	0	85.265969	0.170531	0.170532	42.632945	106.582367	10.878946	63.949425		21.338516	62.64703	4.263295	21.316472	39.141464	63.949419			0.170531			0.354632588	0					0	0	0	0									11.1675	0.399098978	0.618399464	0	0.49889419	0.811562998	0.277728074	1.18024717	3.484577732	5.594108048	7.707239239	0	0.014652092	2.745519334	1.693834865	6.397716756	0.153278244	1.593277744	0	0	2.913286291	0	0	2.22	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4709	0	8.165044288	11.1675	0.399098978	0.618399464	0	0.49889419	0.811562998	0.277728074	1.18024717	3.484577732	5.594108048	7.707239239	0	0.014652092	2.745519334	1.693834865	6.397716756	0.153278244	1.593277744	0	0	2.913286291	0	0	2.22	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4709	5000	$850/Admit	$850/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$75/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			Coin: 50%- 80%						Silver Sneakers	Quit Net	Humana Active Outlook	Meals On Wheels									2.8326	0.0609	0.6326	0.9883	0.696	1.877	0.6423	0.2906	4.1948	1.0399	2.8049		0.0036	1.4023	4.3373	3.5682	0.1228	0.3786			1.1397			2.02	0					0	0	0	0									29.0325	500	3.34595454	14.0001	0.459966256	1.251045648	0.988304025	1.194881834	2.688606598	0.92007472	1.470809022	7.679414443	6.634033282	10.51213473	0	0.018258689	4.147796977	6.031120276	9.965910745	0.276123803	1.971882442	0	0	4.052960348	0	0	4.24	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.5034
H3619_004_0	2008	3	s.	t.									Other Non-Covered	Other Non-Covered									4000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0	0	0	0									0		1714.739502	61.280666	533.126588	223.302503	74.693164	5.385828	1.843093	353.407511	417.36203	6564.356671	1538.545472		8.765637	559.46402	5071.936687	3831.402881	49.990973	318.055586			19.333631									3.4	0.02	0.08	0.18									$175/Day(Days 1-5)	$175/Day(Days 1-5)	$0/Day(Days 1-20) $100(Days 21-100)	$10/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$100-$150/Visit	$0-$90/Visit	$50-$90/Visit		$0-$90/Proc	$30-$90/Visit	$10/Visit	$30/Visit	$30-$90/Visit	$90/Visit			20% Coins									Silver Sneakers	Quit Net	Humana Active Outlook	Meals On Wheels									93.006414	93.006476	18.931573	8.175891	81.759095	0.163518	0.163517	40.879541	103.080986	12.517821	73.583189		24.553369	72.08458	8.17591	24.527732	45.037903	73.583193			0.163518									0	0	0	0									13.2901	0.474958233	0.841077077	0.15214141	0.508903791	0.880679823	0.301377038	1.20392807	3.585174131	6.847620149	9.434256854	0	0.017935493	3.360727409	3.45564149	7.831301921	0.187624049	1.950295464	0	0	3.161396674	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.4852	0	12.8252596	13.2901	0.474958233	0.841077077	0.15214141	0.508903791	0.880679823	0.301377038	1.20392807	3.585174131	6.847620149	9.434256854	0	0.017935493	3.360727409	3.45564149	7.831301921	0.187624049	1.950295464	0	0	3.161396674	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.4852		30% Coins	30% Coins	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$90/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins									Silver Sneakers	Quit Net	Humana Active Outlook	Meals On Wheels									12.696	0.1435	0.625	0.9764	0.6464	1.8545	0.6346	0.2698	4.1444	1.0274	2.7712		0.004	1.3854	4.2851	3.5253	0.1214	0.3741			1.126									0	0	0	0									36.6105	500	6.430874532	25.9861	0.618420934	1.466116791	1.12856256	1.155274122	2.735155799	0.936000525	1.473775271	7.729577624	7.875042252	12.20543012	0	0.021955298	4.746146854	7.740780738	11.35659416	0.308991841	2.324348143	0	0	4.287367866	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0957
H3619_801_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		291.337852	6.260261	498.186315	208.66761	69.797892	4.703002	1.609422	330.245741	390.008783	6134.139107	1437.711635		8.191152	522.797633	4739.529972	3580.298792	46.714645	297.210726			16.882475																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.2145	177.214975	28.944135	0	99.999982	0.199999	0.199999	50.000002	200.000018	37.551769	90.505		33.3682	87.83863	20	30	59.267323	99.999997			0.2																					4.3024	0.092451	1.201630996	0	0.581648995	0.940595697	0.321882791	1.376023976	6.500146968	19.1956479	10.84334096	0	0.022777	3.826818987	7.89921662	8.95074698	0.230720996	2.476755976	0	0	3.376495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1393	0	0	4.3024	0.092451	1.201630996	0	0.581648995	0.940595697	0.321882791	1.376023976	6.500146968	19.1956479	10.84334096	0	0.022777	3.826818987	7.89921662	8.95074698	0.230720996	2.476755976	0	0	3.376495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1393		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.8966	0.1005	0.438	0.6842	0.6752	1.2995	0.4447	0.7625	2.9042	0.72	1.9419		0.0132	0.9708	3.0028	2.4703	0.085	0.2621			0.789																					26.4607	0	0	13.1991	0.192982	1.639623996	0.684222	1.256860995	2.240109697	0.766590791	2.138535976	9.404314968	19.9156079	12.78522496	0	0.036	4.797642987	10.90200362	11.42107698	0.315769996	2.738871976	0	0	4.165513	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.6
H3619_804_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		291.337852	6.260261	498.186315	208.66761	69.797892	4.703002	1.609422	330.245741	390.008783	6134.139107	1437.711635		8.191152	522.797633	4739.529972	3580.298792	46.714645	297.210726			16.882475																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.2145	177.214975	28.944135	0	99.999982	0.199999	0.199999	50.000002	200.000018	37.551769	90.505		33.3682	87.83863	20	30	59.267323	99.999997			0.2																					4.3024	0.092451	1.201630996	0	0.581648995	0.940595697	0.321882791	1.376023976	6.500146968	19.1956479	10.84334096	0	0.022777	3.826818987	7.89921662	8.95074698	0.230720996	2.476755976	0	0	3.376495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1393	0	0	4.3024	0.092451	1.201630996	0	0.581648995	0.940595697	0.321882791	1.376023976	6.500146968	19.1956479	10.84334096	0	0.022777	3.826818987	7.89921662	8.95074698	0.230720996	2.476755976	0	0	3.376495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1393		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.8966	0.1005	0.438	0.6842	0.6752	1.2995	0.4447	0.7625	2.9042	0.72	1.9419		0.0132	0.9708	3.0028	2.4703	0.085	0.2621			0.789																					26.4607	0	0	13.1991	0.192982	1.639623996	0.684222	1.256860995	2.240109697	0.766590791	2.138535976	9.404314968	19.9156079	12.78522496	0	0.036	4.797642987	10.90200362	11.42107698	0.315769996	2.738871976	0	0	4.165513	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.6
H3619_806_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		291.337852	6.260261	498.186315	208.66761	69.797892	4.703002	1.609422	330.245741	390.008783	6134.139107	1437.711635		8.191152	522.797633	4739.529972	3580.298792	46.714645	297.210726			16.882475																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.2145	177.214975	28.944135	0	99.999982	0.199999	0.199999	50.000002	200.000018	37.551769	90.505		33.3682	87.83863	20	30	59.267323	99.999997			0.2																					4.3024	0.092451	1.201630996	0	0.581648995	0.940595697	0.321882791	1.376023976	6.500146968	19.1956479	10.84334096	0	0.022777	3.826818987	7.89921662	8.95074698	0.230720996	2.476755976	0	0	3.376495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1393	0	0	4.3024	0.092451	1.201630996	0	0.581648995	0.940595697	0.321882791	1.376023976	6.500146968	19.1956479	10.84334096	0	0.022777	3.826818987	7.89921662	8.95074698	0.230720996	2.476755976	0	0	3.376495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1393		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.8966	0.1005	0.438	0.6842	0.6752	1.2995	0.4447	0.7625	2.9042	0.72	1.9419		0.0132	0.9708	3.0028	2.4703	0.085	0.2621			0.789																					26.4607	0	0	13.1991	0.192982	1.639623996	0.684222	1.256860995	2.240109697	0.766590791	2.138535976	9.404314968	19.9156079	12.78522496	0	0.036	4.797642987	10.90200362	11.42107698	0.315769996	2.738871976	0	0	4.165513	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.6
H3619_807_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		291.337852	6.260261	498.186315	208.66761	69.797892	4.703002	1.609422	330.245741	390.008783	6134.139107	1437.711635		8.191152	522.797633	4739.529972	3580.298792	46.714645	297.210726			16.882475																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.2145	177.214975	28.944135	0	99.999982	0.199999	0.199999	50.000002	200.000018	37.551769	90.505		33.3682	87.83863	20	30	59.267323	99.999997			0.2																					4.3024	0.092451	1.201630996	0	0.581648995	0.940595697	0.321882791	1.376023976	6.500146968	19.1956479	10.84334096	0	0.022777	3.826818987	7.89921662	8.95074698	0.230720996	2.476755976	0	0	3.376495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1393	0	0	4.3024	0.092451	1.201630996	0	0.581648995	0.940595697	0.321882791	1.376023976	6.500146968	19.1956479	10.84334096	0	0.022777	3.826818987	7.89921662	8.95074698	0.230720996	2.476755976	0	0	3.376495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1393		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.8966	0.1005	0.438	0.6842	0.6752	1.2995	0.4447	0.7625	2.9042	0.72	1.9419		0.0132	0.9708	3.0028	2.4703	0.085	0.2621			0.789																					26.4607	0	0	13.1991	0.192982	1.639623996	0.684222	1.256860995	2.240109697	0.766590791	2.138535976	9.404314968	19.9156079	12.78522496	0	0.036	4.797642987	10.90200362	11.42107698	0.315769996	2.738871976	0	0	4.165513	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.6
H3620_001_0	2008	5																					4000											A	A	D		T	Coin	Coin	V	Coin	V	V			V	V	V	V	V	P		Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		285.5451463	5.007027767	673.6110653	0	184.5533932	12.36195643	7.523374526	378.5865229	28.66534136	2259.653459	1256.170798	0	0	415.6763378	3790.409097	6477.674302	148.4048648	391.4166775	1333.890174	0	9.16086974	0	0	0	349.8785475	0	141.6175073	0	0	0	0											$650/Admit for IP Medical$650/Admit for IP Surgical	$650/Admit for IP Psych$650/Admit for IP Substance Abuse	$25/Day for Days 11-30 SNF; $75/Day for Days 31-100 SNF		$75/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $40/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	$15/Case for OP Fac - Pathology	$15/Case for OP Fac - Radiology; 15% Coinsurance for Radiation Therapy$15/Case for OP Fac - CT/MRI/PET			$30/Case for OP Fac - Occ Therapy; $30/Case for OP Fac - Physical/Speech Therapy; $30/Case for OP Fac - CORF; $30/Case for Prof - CORF; $30/Case for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Consult for PCP - Consults; $15/Exam for PCP - Routine Physicals;	$30/Visit for Speclst - Office Visits; $30/Visit for Speclst - Consults; $30/Visit for Chiropractor; $30/Exam for Vistion Exams; $30/Service for Podiatrist; $30/Exam for Hearing/Speech Exams; $15/Procedure for Prof Path (Office); $15/Procedure for Prof Path (Labs)	$30/Visit for OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/Visit for OP Substance Abuse;	$30/Case for PT/ST (PCP); $30/Case for Occ Therapy (PCP); $30/Case for PT/ST (Specialist); $30/Case for Occ Therapy (Specialist);	$15/Procedure for Prof Radiology (Office);		15% Coinsurance for Part B Rx				$30/Exam for Vision (Refractions)		$30/Exam for Routine Hearing Exams															633.0220003	633.0220004	39.72405265	0	73.04100004	0.194776	0.194776	46.55258133	0.194776	14.60820001	16.87609999	0	0	29.21640001	14.60820001	26.38868255	29.21640002	29.21640002	14.60820001	0	0.066029064	0	0	0	29.21640001	0	29.21640002	0	0	0	0											15.063	0.264129894	2.229880119	0	1.123330367	2.407812428	1.465372797	1.468681658	5.583320531	2.750789139	1.766605332	0	0	1.01204718	4.614254516	14.24477424	0.361321325	0.952982185	1.623811204	0	0.604883655	0	0	0	0.8518493	0	0.344796145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.7337	0	1.867454988	15.063	0.264129894	2.229880119	0	1.123330367	2.407812428	1.465372797	1.468681658	5.583320531	2.750789139	1.766605332	0	0	1.01204718	4.614254516	14.24477424	0.361321325	0.952982185	1.623811204	0	0.604883655	0	0	0	0.8518493	0	0.344796145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.7337		$850/Admit for IP Medical; $850/Admit for IP Surgical	$850/Admit for IP Psych; $850/Admit for IP Substance Abuse	$100/Day for SNF	20% Coinsurance for Home Health	$75/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $40/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	20% Coinsurance for OP Fac - Pathology	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET			20% Coinsurance for OP Fac - Occ Therapy; 20% Coinsurance for OP Fac - Physical/Speech Therapy; 20% Coinsurance for OP Fac - CORF; 20% Coinsurance for Prof - CORF; 20% Coinsurance for Prof - CORF;	20% Coinsurance for PCP - Office Visits; 20% Coinsurance for PCP - Consults; 20% Coinsurance for PCP - Routine Physicals; 20% Coinsurance for PCP - Tx Injections; 20% Coinsurance for PCP - Allergy Testing; 20% Coinsurance for PCP - Allergy Tx; 20% Coinsurance for PCP - Immunizations;	20% Coinsurance for Speclst - Office Visits; 20% Coinsurance for Speclst - Tx Injections; 20% Coinsurance for Speclst - Allergy Testing; 20% Coinsurance for Speclst - Allergy Tx; 20% Coinsurance for Speclst - ER Visits; 20% Coinsurance for Speclst - Consults; 20% Coinsurance for Speclst - Immunizations; 20% Coinsurance for Chiropractor; $30/Exam for Vistion Exams; 20% Coinsurance for Podiatrist; $30/Exam for Hearing/Speech Exams; 20% Coinsurance for Misc. Medical (PCP); 20% Coinsurance for Misc. Medical; 20% Coinsurance for Prof Path (IP); 20% Coinsurance for Prof Path (OP); 20% Coinsurance for Prof Path (Office); 20% Coinsurance for Prof Path (Labs)	20% Coinsurance for OP Psych - Non-Physician; 20% Coinsurance for OP Psych - Psychiatrist; 20% Coinsurance for OP Substance Abuse;	20% Coinsurance for PT/ST (PCP); 20% Coinsurance for Occ Therapy (PCP); 20% Coinsurance for PT/ST (Specialist); 20% Coinsurance for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);		20% Coinsurance for Part B Rx																					3.8296	0.0672	2.0122	0.6927	0.2162	0.4634	0.282	0.3248	1.0746	0.3229	0.9269	0	0	0.3447	1.0324	2.9882	0.048	0.1198	0.8263	0	0.1552	0	0	0	0	0	0	0	0	0	0											15.7272	0	0	18.8927	0.331282236	4.242088945	0.692678196	1.339542831	2.87125495	1.747419712	1.793473872	6.657967426	3.073675984	2.693495199	0	0	1.356732309	5.646649116	17.23298753	0.409293413	1.072784792	2.450119071	0	0.76011657	0	0	0	0.8518493	0	0.344796145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4609
H3620_801_0	2008	1																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		268.8634004	4.515978348	27.61136407	6.253849735	6.058810098	8.999728739	8.473730844	4.428638802	15.39369152	20.82340041	33.96167425	0	0.650559377	61.32924379	54.09165546	205.9294273	1.743317849	5.704036913	37.49720428	0	54.38212483	0	0	0	0	0	0	0	0	0	0											8% Coinsurance for IP Medical; 8% Coinsurance for IP Surgical	8% Coinsurance for IP Psych; 8% Coinsurance for IP Substance Abuse	21% Coinsurance for SNF		23% Coinsurance for Ambulance	23% Coinsurance for DME	23% Coinsurance for Prosthetics/Supplies; 23% Coinsurance for Diabetes Monitoring Supplies; 23% Coinsurance for Prosthetics;	23% Coinsurance for ER - Facility; 23% Coinsurance for Urgent Care;	23% Coinsurance for OP Fac - Surgery; 23% Coinsurance for OP Fac - ASC	23% Coinsurance for OP Fac - Pathology	23% Coinsurance for OP Fac - Radiology; 23% Coinsurance for OP Fac - CT/MRI/PET		23% Coinsurance for Renal Dialysis - Fac; 23% Coinsurance for Renal Dialysis - Prof	23% Coinsurance for OP Fac - Cardiovascular; 23% Coinsurance for OP Fac - Occ Therapy; 23% Coinsurance for OP Fac - Physical/Speech Therapy; 23% Coinsurance for OP Fac - CORF; 23% Coinsurance for OP Fac - Other; 23% Coinsurance for Prof - CORF; 23% Coinsurance for Prof - CORF;	23% Coinsurance for PCP - Office Visits; 23% Coinsurance for PCP - Consults; 23% Coinsurance for PCP - Primary Surgeon (IP); 23% Coinsurance for PCP - Asst Surgeon (IP); 23% Coinsurance for PCP - Primary Surgeon (OP); 23% Coinsurance for PCP - Asst Surgeon (OP); 23% Coinsurance for PCP - IP Visits; 23% Coinsurance for PCP - Tx Injections; 23% Coinsurance for PCP - Allergy Testing; 23% Coinsurance for PCP - Allergy Tx; 23% Coinsurance for PCP - ER Visits; 23% Coinsurance for PCP - Cardio; 23% Coinsurance for PCP - Immunizations; 23% Coinsurance for Misc. Medical (PCP);	23% Coinsurance for Speclst - Primary Surgeon (IP); 23% Coinsurance for Speclst - Asst Surgeon (IP); 23% Coinsurance for Speclst - Anesthesia (IP); 23% Coinsurance for Speclst - Primary Surgeon (OP); 23% Coinsurance for Speclst - Asst Surgeon (OP); 23% Coinsurance for Speclst - Anesthesia (OP); 23% Coinsurance for Speclst - IP Visits; 23% Coinsurance for Speclst - Office Visits; 23% Coinsurance for Speclst - Tx Injections; 23% Coinsurance for Speclst - Allergy Testing; 23% Coinsurance for Speclst - Allergy Tx; 23% Coinsurance for Speclst - ER Visits; 23% Coinsurance for Speclst - Consults; 23% Coinsurance for Speclst - Cardio; 23% Coinsurance for Speclst - Immunizations; 23% Coinsurance for Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical; 23% Coinsurance for Prof Path (IP); 23% Coinsurance for Prof Path (OP); 23% Coinsurance for Prof Path (Office); 23% Coinsurance for Prof Path (Labs)	23% Coinsurance for OP Psych - Non-Physician; 23% Coinsurance for OP Psych - Psychiatrist; 23% Coinsurance for OP Substance Abuse;	23% Coinsurance for PT/ST (PCP); 23% Coinsurance for Occ Therapy (PCP); 23% Coinsurance for PT/ST (Specialist); 23% Coinsurance for Occ Therapy (Specialist);	23% Coinsurance for Prof Radiology (Office); 23% Coinsurance for Prof Radiology (OP); 23% Coinsurance for Prof Radiology (IP);		23% Coinsurance for Part B Rx	23% Coinsurance for Blood Products																				0.080085835	0.080085835	0.206398262	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.5321	0.361665897	5.698937561	0	1.417761563	2.105936525	1.982853018	1.03630148	3.602123815	4.872675695	7.947031776	0	0.152230894	14.35104305	12.65744738	48.187486	0.407936377	1.334744638	8.774345803	0	12.72541721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	149.1481	0	0	21.5321	0.361665897	5.698937561	0	1.417761563	2.105936525	1.982853018	1.03630148	3.602123815	4.872675695	7.947031776	0	0.152230894	14.35104305	12.65744738	48.187486	0.407936377	1.334744638	8.774345803	0	12.72541721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	149.1481																																																																																				0	0		21.5321	0.361665897	5.698937561	0	1.417761563	2.105936525	1.982853018	1.03630148	3.602123815	4.872675695	7.947031776	0	0.152230894	14.35104305	12.65744738	48.187486	0.407936377	1.334744638	8.774345803	0	12.72541721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	149.1481
H3620_802_0	2008	1																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		268.8634004	4.515978348	27.61136407	6.253849735	6.058810098	8.999728739	8.473730844	4.428638802	15.39369152	20.82340041	33.96167425	0	0.650559377	61.32924379	54.09165546	205.9294273	1.743317849	5.704036913	37.49720428	0	54.38212483	0	0	0	0	0	0	0	0	0	0											8% Coinsurance for IP Medical; 8% Coinsurance for IP Surgical	8% Coinsurance for IP Psych; 8% Coinsurance for IP Substance Abuse	21% Coinsurance for SNF		23% Coinsurance for Ambulance	23% Coinsurance for DME	23% Coinsurance for Prosthetics/Supplies; 23% Coinsurance for Diabetes Monitoring Supplies; 23% Coinsurance for Prosthetics;	23% Coinsurance for ER - Facility; 23% Coinsurance for Urgent Care;	23% Coinsurance for OP Fac - Surgery; 23% Coinsurance for OP Fac - ASC	23% Coinsurance for OP Fac - Pathology	23% Coinsurance for OP Fac - Radiology; 23% Coinsurance for OP Fac - CT/MRI/PET		23% Coinsurance for Renal Dialysis - Fac; 23% Coinsurance for Renal Dialysis - Prof	23% Coinsurance for OP Fac - Cardiovascular; 23% Coinsurance for OP Fac - Occ Therapy; 23% Coinsurance for OP Fac - Physical/Speech Therapy; 23% Coinsurance for OP Fac - CORF; 23% Coinsurance for OP Fac - Other; 23% Coinsurance for Prof - CORF; 23% Coinsurance for Prof - CORF;	23% Coinsurance for PCP - Office Visits; 23% Coinsurance for PCP - Consults; 23% Coinsurance for PCP - Primary Surgeon (IP); 23% Coinsurance for PCP - Asst Surgeon (IP); 23% Coinsurance for PCP - Primary Surgeon (OP); 23% Coinsurance for PCP - Asst Surgeon (OP); 23% Coinsurance for PCP - IP Visits; 23% Coinsurance for PCP - Tx Injections; 23% Coinsurance for PCP - Allergy Testing; 23% Coinsurance for PCP - Allergy Tx; 23% Coinsurance for PCP - ER Visits; 23% Coinsurance for PCP - Cardio; 23% Coinsurance for PCP - Immunizations; 23% Coinsurance for Misc. Medical (PCP);	23% Coinsurance for Speclst - Primary Surgeon (IP); 23% Coinsurance for Speclst - Asst Surgeon (IP); 23% Coinsurance for Speclst - Anesthesia (IP); 23% Coinsurance for Speclst - Primary Surgeon (OP); 23% Coinsurance for Speclst - Asst Surgeon (OP); 23% Coinsurance for Speclst - Anesthesia (OP); 23% Coinsurance for Speclst - IP Visits; 23% Coinsurance for Speclst - Office Visits; 23% Coinsurance for Speclst - Tx Injections; 23% Coinsurance for Speclst - Allergy Testing; 23% Coinsurance for Speclst - Allergy Tx; 23% Coinsurance for Speclst - ER Visits; 23% Coinsurance for Speclst - Consults; 23% Coinsurance for Speclst - Cardio; 23% Coinsurance for Speclst - Immunizations; 23% Coinsurance for Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical; 23% Coinsurance for Prof Path (IP); 23% Coinsurance for Prof Path (OP); 23% Coinsurance for Prof Path (Office); 23% Coinsurance for Prof Path (Labs)	23% Coinsurance for OP Psych - Non-Physician; 23% Coinsurance for OP Psych - Psychiatrist; 23% Coinsurance for OP Substance Abuse;	23% Coinsurance for PT/ST (PCP); 23% Coinsurance for Occ Therapy (PCP); 23% Coinsurance for PT/ST (Specialist); 23% Coinsurance for Occ Therapy (Specialist);	23% Coinsurance for Prof Radiology (Office); 23% Coinsurance for Prof Radiology (OP); 23% Coinsurance for Prof Radiology (IP);		23% Coinsurance for Part B Rx	23% Coinsurance for Blood Products																				0.080085835	0.080085835	0.206398262	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.5321	0.361665897	5.698937561	0	1.417761563	2.105936525	1.982853018	1.03630148	3.602123815	4.872675695	7.947031776	0	0.152230894	14.35104305	12.65744738	48.187486	0.407936377	1.334744638	8.774345803	0	12.72541721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	149.1481	0	0	21.5321	0.361665897	5.698937561	0	1.417761563	2.105936525	1.982853018	1.03630148	3.602123815	4.872675695	7.947031776	0	0.152230894	14.35104305	12.65744738	48.187486	0.407936377	1.334744638	8.774345803	0	12.72541721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	149.1481																																																																																				0	0		21.5321	0.361665897	5.698937561	0	1.417761563	2.105936525	1.982853018	1.03630148	3.602123815	4.872675695	7.947031776	0	0.152230894	14.35104305	12.65744738	48.187486	0.407936377	1.334744638	8.774345803	0	12.72541721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	149.1481
H3620_803_0	2008	1																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		268.8634004	4.515978348	27.61136407	6.253849735	6.058810098	8.999728739	8.473730844	4.428638802	15.39369152	20.82340041	33.96167425	0	0.650559377	61.32924379	54.09165546	205.9294273	1.743317849	5.704036913	37.49720428	0	54.38212483	0	0	0	0	0	0	0	0	0	0											8% Coinsurance for IP Medical; 8% Coinsurance for IP Surgical	8% Coinsurance for IP Psych; 8% Coinsurance for IP Substance Abuse	21% Coinsurance for SNF		23% Coinsurance for Ambulance	23% Coinsurance for DME	23% Coinsurance for Prosthetics/Supplies; 23% Coinsurance for Diabetes Monitoring Supplies; 23% Coinsurance for Prosthetics;	23% Coinsurance for ER - Facility; 23% Coinsurance for Urgent Care;	23% Coinsurance for OP Fac - Surgery; 23% Coinsurance for OP Fac - ASC	23% Coinsurance for OP Fac - Pathology	23% Coinsurance for OP Fac - Radiology; 23% Coinsurance for OP Fac - CT/MRI/PET		23% Coinsurance for Renal Dialysis - Fac; 23% Coinsurance for Renal Dialysis - Prof	23% Coinsurance for OP Fac - Cardiovascular; 23% Coinsurance for OP Fac - Occ Therapy; 23% Coinsurance for OP Fac - Physical/Speech Therapy; 23% Coinsurance for OP Fac - CORF; 23% Coinsurance for OP Fac - Other; 23% Coinsurance for Prof - CORF; 23% Coinsurance for Prof - CORF;	23% Coinsurance for PCP - Office Visits; 23% Coinsurance for PCP - Consults; 23% Coinsurance for PCP - Primary Surgeon (IP); 23% Coinsurance for PCP - Asst Surgeon (IP); 23% Coinsurance for PCP - Primary Surgeon (OP); 23% Coinsurance for PCP - Asst Surgeon (OP); 23% Coinsurance for PCP - IP Visits; 23% Coinsurance for PCP - Tx Injections; 23% Coinsurance for PCP - Allergy Testing; 23% Coinsurance for PCP - Allergy Tx; 23% Coinsurance for PCP - ER Visits; 23% Coinsurance for PCP - Cardio; 23% Coinsurance for PCP - Immunizations; 23% Coinsurance for Misc. Medical (PCP);	23% Coinsurance for Speclst - Primary Surgeon (IP); 23% Coinsurance for Speclst - Asst Surgeon (IP); 23% Coinsurance for Speclst - Anesthesia (IP); 23% Coinsurance for Speclst - Primary Surgeon (OP); 23% Coinsurance for Speclst - Asst Surgeon (OP); 23% Coinsurance for Speclst - Anesthesia (OP); 23% Coinsurance for Speclst - IP Visits; 23% Coinsurance for Speclst - Office Visits; 23% Coinsurance for Speclst - Tx Injections; 23% Coinsurance for Speclst - Allergy Testing; 23% Coinsurance for Speclst - Allergy Tx; 23% Coinsurance for Speclst - ER Visits; 23% Coinsurance for Speclst - Consults; 23% Coinsurance for Speclst - Cardio; 23% Coinsurance for Speclst - Immunizations; 23% Coinsurance for Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical; 23% Coinsurance for Prof Path (IP); 23% Coinsurance for Prof Path (OP); 23% Coinsurance for Prof Path (Office); 23% Coinsurance for Prof Path (Labs)	23% Coinsurance for OP Psych - Non-Physician; 23% Coinsurance for OP Psych - Psychiatrist; 23% Coinsurance for OP Substance Abuse;	23% Coinsurance for PT/ST (PCP); 23% Coinsurance for Occ Therapy (PCP); 23% Coinsurance for PT/ST (Specialist); 23% Coinsurance for Occ Therapy (Specialist);	23% Coinsurance for Prof Radiology (Office); 23% Coinsurance for Prof Radiology (OP); 23% Coinsurance for Prof Radiology (IP);		23% Coinsurance for Part B Rx	23% Coinsurance for Blood Products																				0.080085835	0.080085835	0.206398262	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.5321	0.361665897	5.698937561	0	1.417761563	2.105936525	1.982853018	1.03630148	3.602123815	4.872675695	7.947031776	0	0.152230894	14.35104305	12.65744738	48.187486	0.407936377	1.334744638	8.774345803	0	12.72541721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	149.1481	0	0	21.5321	0.361665897	5.698937561	0	1.417761563	2.105936525	1.982853018	1.03630148	3.602123815	4.872675695	7.947031776	0	0.152230894	14.35104305	12.65744738	48.187486	0.407936377	1.334744638	8.774345803	0	12.72541721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	149.1481																																																																																				0	0		21.5321	0.361665897	5.698937561	0	1.417761563	2.105936525	1.982853018	1.03630148	3.602123815	4.872675695	7.947031776	0	0.152230894	14.35104305	12.65744738	48.187486	0.407936377	1.334744638	8.774345803	0	12.72541721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	149.1481
H3620_804_0	2008	1																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		268.8634004	4.515978348	27.61136407	6.253849735	6.058810098	8.999728739	8.473730844	4.428638802	15.39369152	20.82340041	33.96167425	0	0.650559377	61.32924379	54.09165546	205.9294273	1.743317849	5.704036913	37.49720428	0	54.38212483	0	0	0	0	0	0	0	0	0	0											8% Coinsurance for IP Medical; 8% Coinsurance for IP Surgical	8% Coinsurance for IP Psych; 8% Coinsurance for IP Substance Abuse	21% Coinsurance for SNF		23% Coinsurance for Ambulance	23% Coinsurance for DME	23% Coinsurance for Prosthetics/Supplies; 23% Coinsurance for Diabetes Monitoring Supplies; 23% Coinsurance for Prosthetics;	23% Coinsurance for ER - Facility; 23% Coinsurance for Urgent Care;	23% Coinsurance for OP Fac - Surgery; 23% Coinsurance for OP Fac - ASC	23% Coinsurance for OP Fac - Pathology	23% Coinsurance for OP Fac - Radiology; 23% Coinsurance for OP Fac - CT/MRI/PET		23% Coinsurance for Renal Dialysis - Fac; 23% Coinsurance for Renal Dialysis - Prof	23% Coinsurance for OP Fac - Cardiovascular; 23% Coinsurance for OP Fac - Occ Therapy; 23% Coinsurance for OP Fac - Physical/Speech Therapy; 23% Coinsurance for OP Fac - CORF; 23% Coinsurance for OP Fac - Other; 23% Coinsurance for Prof - CORF; 23% Coinsurance for Prof - CORF;	23% Coinsurance for PCP - Office Visits; 23% Coinsurance for PCP - Consults; 23% Coinsurance for PCP - Primary Surgeon (IP); 23% Coinsurance for PCP - Asst Surgeon (IP); 23% Coinsurance for PCP - Primary Surgeon (OP); 23% Coinsurance for PCP - Asst Surgeon (OP); 23% Coinsurance for PCP - IP Visits; 23% Coinsurance for PCP - Tx Injections; 23% Coinsurance for PCP - Allergy Testing; 23% Coinsurance for PCP - Allergy Tx; 23% Coinsurance for PCP - ER Visits; 23% Coinsurance for PCP - Cardio; 23% Coinsurance for PCP - Immunizations; 23% Coinsurance for Misc. Medical (PCP);	23% Coinsurance for Speclst - Primary Surgeon (IP); 23% Coinsurance for Speclst - Asst Surgeon (IP); 23% Coinsurance for Speclst - Anesthesia (IP); 23% Coinsurance for Speclst - Primary Surgeon (OP); 23% Coinsurance for Speclst - Asst Surgeon (OP); 23% Coinsurance for Speclst - Anesthesia (OP); 23% Coinsurance for Speclst - IP Visits; 23% Coinsurance for Speclst - Office Visits; 23% Coinsurance for Speclst - Tx Injections; 23% Coinsurance for Speclst - Allergy Testing; 23% Coinsurance for Speclst - Allergy Tx; 23% Coinsurance for Speclst - ER Visits; 23% Coinsurance for Speclst - Consults; 23% Coinsurance for Speclst - Cardio; 23% Coinsurance for Speclst - Immunizations; 23% Coinsurance for Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical; 23% Coinsurance for Prof Path (IP); 23% Coinsurance for Prof Path (OP); 23% Coinsurance for Prof Path (Office); 23% Coinsurance for Prof Path (Labs)	23% Coinsurance for OP Psych - Non-Physician; 23% Coinsurance for OP Psych - Psychiatrist; 23% Coinsurance for OP Substance Abuse;	23% Coinsurance for PT/ST (PCP); 23% Coinsurance for Occ Therapy (PCP); 23% Coinsurance for PT/ST (Specialist); 23% Coinsurance for Occ Therapy (Specialist);	23% Coinsurance for Prof Radiology (Office); 23% Coinsurance for Prof Radiology (OP); 23% Coinsurance for Prof Radiology (IP);		23% Coinsurance for Part B Rx	23% Coinsurance for Blood Products																				0.080085835	0.080085835	0.206398262	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.5321	0.361665897	5.698937561	0	1.417761563	2.105936525	1.982853018	1.03630148	3.602123815	4.872675695	7.947031776	0	0.152230894	14.35104305	12.65744738	48.187486	0.407936377	1.334744638	8.774345803	0	12.72541721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	149.1481	0	0	21.5321	0.361665897	5.698937561	0	1.417761563	2.105936525	1.982853018	1.03630148	3.602123815	4.872675695	7.947031776	0	0.152230894	14.35104305	12.65744738	48.187486	0.407936377	1.334744638	8.774345803	0	12.72541721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	149.1481																																																																																				0	0		21.5321	0.361665897	5.698937561	0	1.417761563	2.105936525	1.982853018	1.03630148	3.602123815	4.872675695	7.947031776	0	0.152230894	14.35104305	12.65744738	48.187486	0.407936377	1.334744638	8.774345803	0	12.72541721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	149.1481
H3623_001_0	2008	2																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1313.153455		609.3670698	1040.770129	233.0275602	7.809466282		493.89616	332.1541758	1795.009256	5351.236215	0	0	687.4126027	4852.065335	4758.040347	0	235.4441423	0	0	277.9874948				456.5829815		31.5234505															$900 per admit		"$0 days 1-8, $75 days 9-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$150 per procedure	$35 per visit	"$35 X-ray; $165 PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$15 per visit	"$35 per visit specialist, $30 Renal Dialysis"	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															152.17		66.23	20	100	0.2		47	150	35	58.4	35	30	35	15	34.55	35	35	35	35	45				0		0															16.6519	0	3.363198419	1.734616881	1.941896335	1.561893256	0	1.934426627	4.151927198	5.235443662	26.04268291	0	0	2.004953425	6.065081669	13.69919117	0	0.686712082	0	0	1.042453106	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.1164			16.6519	0	3.363198419	1.734616881	1.941896335	1.561893256	0	1.934426627	4.151927198	5.235443662	26.04268291	0	0	2.004953425	6.065081669	13.69919117	0	0.686712082	0	0	1.042453106	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.1164																																																																																				0			16.6519	0	3.363198419	1.734616881	1.941896335	1.561893256	0	1.934426627	4.151927198	5.235443662	26.04268291	0	0	2.004953425	6.065081669	13.69919117	0	0.686712082	0	0	1.042453106	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.1164
H3623_002_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1318.564604		611.8781064	1045.058861	233.9878036	7.841646977		495.9313723	333.5228932	1802.406003	5373.28721	0	0	690.2452438	4872.059382	4847.346066	0	236.4143438	0	0	279.133006				458.4644363		31.6533501															$500 per admit		"$0 days 1-8, $75 days 9-14; $100 15+"	$0 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$150 per procedure	$0 per visit	"$25 X-ray; $165 PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit															85.54		66.23	0	100	0.2		47	150	0	50.2	25	25	25	10	25	25	25	25	25	45				0		0															9.3992	0	3.377057249	0	1.949898363	1.568329395	0	1.942397875	4.169036165	0	22.4782515	0	0	1.438010925	4.060049485	10.09863764	0	0.492529883	0	0	1.046748773	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0201			9.3992	0	3.377057249	0	1.949898363	1.568329395	0	1.942397875	4.169036165	0	22.4782515	0	0	1.438010925	4.060049485	10.09863764	0	0.492529883	0	0	1.046748773	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0201																																																																																				0			9.3992	0	3.377057249	0	1.949898363	1.568329395	0	1.942397875	4.169036165	0	22.4782515	0	0	1.438010925	4.060049485	10.09863764	0	0.492529883	0	0	1.046748773	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0201
H3623_003_0	2008	2																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1326.465783		615.5446374	1051.321122	235.3899187	7.888636142		498.9031206	335.5214482	1813.206483	5405.485329	0	0	694.3813708	4901.254015	4806.275831	0	237.8309993	0	0	280.8056428				461.2116731		31.84302511															$0 per admit		"$0 days 1-8, $75 days 9-14; $100 15+"	$0 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$150 per procedure	$0 per visit	"$20 X-ray; $165 PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$0 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit															0		66.23	0	100	0.2		47	150	0	46.1	20	20	20	0	20	20	20	20	20	45				0		0															0	0	3.397293445	0	1.961582656	1.577727228	0	1.954037222	4.194018102	0	20.7660728	0	0	1.157302285	0	8.010459719	0	0.396384999	0	0	1.05302116	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4679			0	0	3.397293445	0	1.961582656	1.577727228	0	1.954037222	4.194018102	0	20.7660728	0	0	1.157302285	0	8.010459719	0	0.396384999	0	0	1.05302116	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4679																																																																																				0			0	0	3.397293445	0	1.961582656	1.577727228	0	1.954037222	4.194018102	0	20.7660728	0	0	1.157302285	0	8.010459719	0	0.396384999	0	0	1.05302116	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4679
H3623_004_0	2008	2																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1229.490125		783.0785897	437.5414811	273.8943595	8.01458742		892.5537379	357.5254483	2349.775707	5471.068681	0	0	1065.285184	3803.350153	5610.618446	0	628.8042789	0	0	299.2212983				499.6318636		15.36997324															$500 per admit		"$0 days 1-8, $75 days 9-14; $100 15+"	$0 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$150 per procedure	$0 per visit	"$30 X-ray; $115 PET, MRI"	$30 per visit	$30 per visit	$30 per visit	$15 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script				$0 per visit		$0 per visit															84.54		66.23	0	100	0.2		47	150	0	45.3	30	30	30	15	30	30	30	30	30	45				0		0															8.6618	0	4.32194125	0	2.282452996	1.602917484	0	3.495835473	4.469068104	0	20.65328427	0	0	2.66321296	4.754187691	14.02654612	0	1.572010697	0	0	1.122079869	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.6253			8.6618	0	4.32194125	0	2.282452996	1.602917484	0	3.495835473	4.469068104	0	20.65328427	0	0	2.66321296	4.754187691	14.02654612	0	1.572010697	0	0	1.122079869	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.6253																																																																																				0			8.6618	0	4.32194125	0	2.282452996	1.602917484	0	3.495835473	4.469068104	0	20.65328427	0	0	2.66321296	4.754187691	14.02654612	0	1.572010697	0	0	1.122079869	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.6253
H3623_005_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1277.217192		813.4765925	454.5262223	284.526551	8.325702363		927.201411	371.4040803	2440.990675	5683.447825	0	0	1106.638047	3950.990824	5943.647599	0	653.2135712	0	0	310.8366457				519.0268656		15.96661385															$250 per admit		"$0 days 1-8, $75 days 9-14; $100 15+"	$0 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$150 per procedure	$0 per visit	"$20 X-ray; $115 PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$10 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit															42.27		66.23	0	100	0.2		47	150	0	37.1	20	20	20	10	20	20	20	20	20	45				0		0															4.499	0	4.489712893	0	2.371054592	1.665140473	0	3.63153886	4.642551004	0	17.57132619	0	0	1.844396746	3.292492353	9.906079332	0	1.088689285	0	0	1.165637421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1676			4.499	0	4.489712893	0	2.371054592	1.665140473	0	3.63153886	4.642551004	0	17.57132619	0	0	1.844396746	3.292492353	9.906079332	0	1.088689285	0	0	1.165637421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1676																																																																																				0			4.499	0	4.489712893	0	2.371054592	1.665140473	0	3.63153886	4.642551004	0	17.57132619	0	0	1.844396746	3.292492353	9.906079332	0	1.088689285	0	0	1.165637421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1676
H3623_006_0	2008	2																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1292.22118		823.0328313	459.8657258	287.8689996	8.423507759		938.0936213	375.7671144	2469.66598	5750.213588	0	0	1119.638173	3997.404713	6013.470034	0	660.8871355	0	0	314.4881696				525.1240843		16.15418013															$0 per admit		"$0 days 1-8, $75 days 9-14; $100 15+"	$0 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$150 per procedure	$0 per visit	"$10 X-ray; $115 PET, MRI"	$10 per visit	$10 per visit	$10 per visit	$0 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script				$0 per visit		$0 per visit															0		66.23	0	100	0.2		47	150	0	28.9	10	10	10	0	10	10	10	10	10	45				0		0															0	0	4.542455368	0	2.39890833	1.684701552	0	3.674200017	4.69708893	0	13.84843106	0	0	0.93303181	0	5.011225028	0	0.55073928	0	0	1.179330636	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5201			0	0	4.542455368	0	2.39890833	1.684701552	0	3.674200017	4.69708893	0	13.84843106	0	0	0.93303181	0	5.011225028	0	0.55073928	0	0	1.179330636	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5201																																																																																				0			0	0	4.542455368	0	2.39890833	1.684701552	0	3.674200017	4.69708893	0	13.84843106	0	0	0.93303181	0	5.011225028	0	0.55073928	0	0	1.179330636	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5201
H3623_801_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1403.234861	27.33675297	1146.203462	1881.554753	207.6460381	15.71780589	1.003298358	376.6101166	310.2755935	1972.668358	1013.814245	0	0	0	4893.697162	6208.051603	178.2619179	1031.528894	1409.798725	2556.992056	18.07125295	0	0	0	0	0	0															200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665																																																																																				0			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665
H3623_802_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1403.234861	27.33675297	1146.203462	1881.554753	207.6460381	15.71780589	1.003298358	376.6101166	310.2755935	1972.668358	1013.814245	0	0	0	4893.697162	6208.051603	178.2619179	1031.528894	1409.798725	2556.992056	18.07125295	0	0	0	0	0	0															200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665																																																																																				0			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665
H3624_001_0	2008	2																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	1385.562712		2867.345057	481.098164	150.1186638	2.3354171		692.7813562	212.1241988	1122.092223	3909.598245	0	0	915.8345016	3784.63889	4023.937292	0	731.2692093	0	0	177.5316372				182.8173023		38.48785312															$900 per stay		"$0 days 1-8, $75 days 9-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$150 per procedure	$35 per visit	"$35 X-ray; $175 PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$15 per visit	"$35 per visit specialist, $30 Renal Dialysis"	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															152.17		66.23	20	100	0.2		47	150	35	60.2	35	30	35	15	34.55	35	35	35	35	45				0		0															17.5701	0	15.82535526	0.801830273	1.250988865	0.46708342	0	2.713393645	2.651552485	3.272768983	19.6131512	0	0	2.671183963	4.730798613	11.58558612	0	2.132868527	0	0	0.665743639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.9524			17.5701	0	15.82535526	0.801830273	1.250988865	0.46708342	0	2.713393645	2.651552485	3.272768983	19.6131512	0	0	2.671183963	4.730798613	11.58558612	0	2.132868527	0	0	0.665743639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.9524		30% coins; $500ded; $5000 max OOP		30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	$100 per trip	30% coins; $500ded; $5000 max OOP		$50 ER; $25 UC	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP				30% coins; $500ded; $5000 max OOP		30% coins; $500ded; $5000 max OOP															10.206		2.1818	0.0765	0.1171	0.0655		0.2799	0.7844	0.3079	0.8165	0	0	0.5229	0.6203	2.604	0	0.5443	0	0	0.181				0.0233		0.0038															19.3354	500	12.52979307	27.7761	0	18.00712373	0.878356911	1.36804474	0.532631235	0	2.993329562	3.435977401	3.580707322	20.42969456	0	0	3.194133907	5.351136941	14.1896136	0	2.677156006	0	0	0.846710415	0	0	0	0.02332214	0	0.003831798	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.2878
H3624_002_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	1349.493129		859.5100964	480.2472262	300.627511	8.796842229		979.6704435	392.4213184	2579.122927	6005.066198	0	0	1169.261149	4174.571875	5571.604846	0	690.1780147	0	0	328.4264572				548.3978708		16.87014222															$250 per admit		"$0 days 1-8, $75 days 9-14; $100 15+"	$0 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$150 per procedure	$0 per visit	"$20 X-ray; $115 PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$10 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit															42.27		66.23	0	100	0.2		47	150	0	37.1	20	20	20	10	20	20	20	20	20	45				0		0															4.7536	0	4.743779474	0	2.505229259	1.759368446	0	3.837042571	4.90526648	0	18.565663	0	0	1.948768581	3.478809896	9.286008076	0	1.150296691	0	0	1.231599215	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1654			4.7536	0	4.743779474	0	2.505229259	1.759368446	0	3.837042571	4.90526648	0	18.565663	0	0	1.948768581	3.478809896	9.286008076	0	1.150296691	0	0	1.231599215	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1654		30% coins; $500ded; $5000 max OOP		30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	$100 per trip	30% coins; $500ded; $5000 max OOP		$50 ER; $25 UC	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP	30% coins; $500ded; $5000 max OOP				30% coins; $500ded; $5000 max OOP		30% coins; $500ded; $5000 max OOP															6.8368		0.4947	0.0634	0.1927	0.2238		0.3818	1.2301	0.6184	1.1959	0	0	0.82	0.9772	2.6504	0	0.1227	0	0	0.292				0.0718		0.0012															16.1728	500	12.52979307	11.5904	0	5.238465071	0.063354398	2.697894825	1.983178713	0	4.218843909	6.135326872	0.618423552	19.76153607	0	0	2.768808842	4.455994673	11.93644344	0	1.27300406	0	0	1.523589574	0	0	0	0.071787498	0	0.001165266	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3382
H3624_801_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1234.846677	24.05634262	1008.659047	1655.768182	182.7285135	13.83166919	0.882902555	331.4169026	273.0425222	1735.948155	892.1565356	0	0	0	4306.453503	5463.08541	156.8704877	907.7454267	1240.622878	2250.153009	15.90270259	0	0	0	0	0	0															200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per visit	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065			14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065		"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	$50 ER/UC	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"		0	0	"30% coins; $500ded; ""Unlimited OOP"	0	"30% coins; $500ded; ""Unlimited OOP"															7.921957272	0.061430928	1.284540404	1.150765501	0.202333313	0.65552902	0.041843702	0.211846795	0.811305397	0.281540994	0.79041001	0	0.259194098	0.873417564	1.02915746	1.285921799	0.048568008	0.136138098	0.956412696	3.465889756	0.753682214	0	0	0	0.133775323	0	0.037769123															22.3934	500		22.7988	0.351249716	9.690032461	6.669992775	2.486439732	4.805029776	0.306714469	1.592750556	5.362014101	6.068034846	4.875000015	0	0.259194098	0.873417564	11.79529122	19.26857794	0.571469634	3.161956187	5.09182229	10.96639979	3.934222733	0	0	0	0.133775323	0	0.037769123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.0999
H3624_802_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1234.846677	24.05634262	1008.659047	1655.768182	182.7285135	13.83166919	0.882902555	331.4169026	273.0425222	1735.948155	892.1565356	0	0	0	4306.453503	5463.08541	156.8704877	907.7454267	1240.622878	2250.153009	15.90270259	0	0	0	0	0	0															200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per visit	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065			14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065		"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	$50 ER/UC	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"		0	0	"30% coins; $500ded; ""Unlimited OOP"	0	"30% coins; $500ded; ""Unlimited OOP"															7.921957272	0.061430928	1.284540404	1.150765501	0.202333313	0.65552902	0.041843702	0.211846795	0.811305397	0.281540994	0.79041001	0	0.259194098	0.873417564	1.02915746	1.285921799	0.048568008	0.136138098	0.956412696	3.465889756	0.753682214	0	0	0	0.133775323	0	0.037769123															22.3934	500		22.7988	0.351249716	9.690032461	6.669992775	2.486439732	4.805029776	0.306714469	1.592750556	5.362014101	6.068034846	4.875000015	0	0.259194098	0.873417564	11.79529122	19.26857794	0.571469634	3.161956187	5.09182229	10.96639979	3.934222733	0	0	0	0.133775323	0	0.037769123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.0999
H3653_004_0	2008	2																					Unlimited											A	A	D		T	Coin	Coin	V	V						V	V	V			V					V		V																																																								0		397.0685828	17.54600055	1007.928759		70.77217293	0.001187794	7.046951696	467.0963413	431.0231464						4967.287704	5736.007232	169.3009222			5104.730562					225.1032637		23.06496782															$325 per admit OOP $975	$325 per admit OOP $975	$75 per day after 15 days		$50 per trip	20% Coinsurance	20% Coinsurance	$50 per visit if ER	$100 per visit						$10 per visit	$20 per visit	$25 per visit			$20 per visit					$20 per visit		$20 per visit															325	325	75		50	0.2	0.2	50	100						10	20	25			20					20		20															10.7539	0.475204182	6.299554744	0	0.294884054	0.000237559	1.409390339	1.946234756	3.591859553	0	0	0	0	0	4.13940642	9.560012054	0.352710255	0	0	8.50788427	0	0	0	0	0.375172106	0	0.038441613	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.7449		0	10.7539	0.475204182	6.299554744	0	0.294884054	0.000237559	1.409390339	1.946234756	3.591859553	0	0	0	0	0	4.13940642	9.560012054	0.352710255	0	0	8.50788427	0	0	0	0	0.375172106	0	0.038441613	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.7449																																																																																				0			10.7539	0.475204182	6.299554744	0	0.294884054	0.000237559	1.409390339	1.946234756	3.591859553	0	0	0	0	0	4.13940642	9.560012054	0.352710255	0	0	8.50788427	0	0	0	0	0.375172106	0	0.038441613	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.7449
H3653_015_0	2008	4																					Unlimited											A	A	D		T	Coin	Coin	V	V	V	V				V	V	V	V		V							V																																																								0		522.4182143	23.08505551	1765.543822		87.33698118	0.001465806	8.696348609	576.4240758	531.9076533	9804.975225	1977.716261				6129.922182	7078.566829	208.9271933	33.22134356		6299.534669							28.46351295															$600 per Admission	$600 per Admission	$95 per day after 5 days		$175 per trip	20% Coinsurance	20% Coinsurance	$50 per visit if ER	$175 per visit	$2 per visit	$5 or $50 per visit routine or advanced respectively.				$15 per visit	$35 per visit	$35 per visit	$35 per visit		$35 per visit							$30 per visit															600	600	95		175	0.2	0.2	50	175	2	5				15	35	35	35		35							30															26.1209	1.154252776	13.97722192	0	1.273664309	0.000293161	1.739269722	2.401766982	7.756986611	1.634162537	0.824048442	0	0	0	7.662402727	20.64581992	0.60937098	0.096895585	0	18.37364279	0	0	0	0	0	0	0.071158782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.3419		0	26.1209	1.154252776	13.97722192	0	1.273664309	0.000293161	1.739269722	2.401766982	7.756986611	1.634162537	0.824048442	0	0	0	7.662402727	20.64581992	0.60937098	0.096895585	0	18.37364279	0	0	0	0	0	0	0.071158782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.3419																																																																																				0			26.1209	1.154252776	13.97722192	0	1.273664309	0.000293161	1.739269722	2.401766982	7.756986611	1.634162537	0.824048442	0	0	0	7.662402727	20.64581992	0.60937098	0.096895585	0	18.37364279	0	0	0	0	0	0	0.071158782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.3419
H3653_018_0	2008	2																					Unlimited											A	A	D		T	Coin	Coin	V	V						V	V	V			V					V		V																																																								0		455.3583136	20.12175621	1155.89286		81.16153911	0.001362162	8.081445319	535.6661581	494.2974125						5696.486324	6578.054002	194.1543243			5854.105816					258.1484584		26.45090875															$325 per admit OOP $975	$325 per admit OOP $975	$75 per day after 15 days		$50 per trip	20% Coinsurance	20% Coinsurance	$50 per visit if ER	$100 per visit						$10 per visit	$20 per visit	$25 per visit			$20 per visit					$20 per visit		$20 per visit															325	325	75		50	0.2	0.2	50	100						10	20	25			20					20		20															12.3326	0.544964231	7.224330377	0	0.33817308	0.000272432	1.616289064	2.231942326	4.119145104	0	0	0	0	0	4.747071937	10.96342334	0.404488176	0	0	9.756843026	0	0	0	0	0.430247431	0	0.044084848	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7539		0	12.3326	0.544964231	7.224330377	0	0.33817308	0.000272432	1.616289064	2.231942326	4.119145104	0	0	0	0	0	4.747071937	10.96342334	0.404488176	0	0	9.756843026	0	0	0	0	0.430247431	0	0.044084848	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7539																																																																																				0			12.3326	0.544964231	7.224330377	0	0.33817308	0.000272432	1.616289064	2.231942326	4.119145104	0	0	0	0	0	4.747071937	10.96342334	0.404488176	0	0	9.756843026	0	0	0	0	0.430247431	0	0.044084848	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7539
H3653_020_0	2008	2																					Unlimited											A	A	D		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin				Coin																																																								0		873.8060221	38.61247555	3699.592657		3.398338989	0.002451734	14.54566778	48.60265351	67.0235543	33.91030488	62.17473361	15.68068148	0	87.30077784	96.28560843	327.496744	4.40213738	2.491516774	0	116.7732829	4.116527837	47.66792871	10.26283324				0.851066581															$685 per admit	$685 per admit	$70 per day		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance				20% Coinsurance															685	685	70		0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2				0.2															49.8798	2.204128813	21.58095717	0	0.679667798	0.000490347	2.909133555	9.720530703	13.40471086	6.782060976	12.43494672	3.136136296	0	17.46015557	19.25712169	65.4993488	0.880427476	0.498303355	0	23.35465659	0.823305567	9.533585743	2.052566648	0	0	0	0.170213316	0	0	0	0	0	0	0	0	0	0	0	0	0	0	262.2622			49.8798	2.204128813	21.58095717	0	0.679667798	0.000490347	2.909133555	9.720530703	13.40471086	6.782060976	12.43494672	3.136136296	0	17.46015557	19.25712169	65.4993488	0.880427476	0.498303355	0	23.35465659	0.823305567	9.533585743	2.052566648	0	0	0	0.170213316	0	0	0	0	0	0	0	0	0	0	0	0	0	0	262.2622																																																																																				0			49.8798	2.204128813	21.58095717	0	0.679667798	0.000490347	2.909133555	9.720530703	13.40471086	6.782060976	12.43494672	3.136136296	0	17.46015557	19.25712169	65.4993488	0.880427476	0.498303355	0	23.35465659	0.823305567	9.533585743	2.052566648	0	0	0	0.170213316	0	0	0	0	0	0	0	0	0	0	0	0	0	0	262.2622
H3653_021_0	2008	4																					Unlimited											A	A	D		T	Coin	Coin	V	V	V	V				V	V	V	V		V							V																																																								0		415.5644736	18.36331253	1404.425169		69.47335605	0.001165995	6.917625445	458.5241499	423.1129733	7799.49714	1573.20054				4876.127622	5630.739545	166.1938974	26.42635684		5011.048117							22.64167759															$600 per Admission	$600 per Admission	$95 per day after 5 days		$175 per trip	20% Coinsurance	20% Coinsurance	$50 per visit if ER	$175 per visit	$2 per visit	$5 or $50 per visit routine or advanced respectively.				$15 per visit	$35 per visit	$35 per visit	$35 per visit		$35 per visit							$30 per visit															600	600	95		175	0.2	0.2	50	175	2	5				15	35	35	35		35							30															20.7782	0.918165627	11.11836592	0	1.013153109	0.000233199	1.383525089	1.910517291	6.170397528	1.29991619	0.655500225	0	0	0	6.095159527	16.42299034	0.484732201	0.077076874	0	14.61555701	0	0	0	0	0	0	0.056604194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.0001		0	20.7782	0.918165627	11.11836592	0	1.013153109	0.000233199	1.383525089	1.910517291	6.170397528	1.29991619	0.655500225	0	0	0	6.095159527	16.42299034	0.484732201	0.077076874	0	14.61555701	0	0	0	0	0	0	0.056604194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.0001																																																																																				0			20.7782	0.918165627	11.11836592	0	1.013153109	0.000233199	1.383525089	1.910517291	6.170397528	1.29991619	0.655500225	0	0	0	6.095159527	16.42299034	0.484732201	0.077076874	0	14.61555701	0	0	0	0	0	0	0.056604194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.0001
H3653_803_0	2008	1																					Unlimited											A	A	D		T	Coin	Coin	V	V	V	V				V	V	V	V		V							V																																																								0		388.6708625	17.17491502	1645.587044		64.97732826	0.001090537	6.469945384	428.8503665	395.7308546	7294.745996	1471.389519				4560.564843	5266.341408	155.4385169	24.7161525		4686.753842							21.17640202															$600 per Admission	$600 per Admission	$95 per day		$150 per trip	20% Coinsurance	20% Coinsurance	$50 per visit if ER	$175 per visit	$2 per visit	$5 or $50 per visit routine or advanced respectively.				$15 per visit	$35 per visit	$35 per visit	$35 per visit		$35 per visit							$35 per visit															600	600	95		150	0.2	0.2	50	175	2	5				15	35	35	35		35							35															19.4335	0.858745751	13.0275641	0	0.812216603	0.000218107	1.293989077	1.786876527	5.771074962	1.215790999	0.613078966	0	0	0	5.700706053	15.36016244	0.453362341	0.072088778	0	13.66969871	0	0	0	0	0	0	0.061764506	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1309		0	19.4335	0.858745751	13.0275641	0	0.812216603	0.000218107	1.293989077	1.786876527	5.771074962	1.215790999	0.613078966	0	0	0	5.700706053	15.36016244	0.453362341	0.072088778	0	13.66969871	0	0	0	0	0	0	0.061764506	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1309																																																																																				0			19.4335	0.858745751	13.0275641	0	0.812216603	0.000218107	1.293989077	1.786876527	5.771074962	1.215790999	0.613078966	0	0	0	5.700706053	15.36016244	0.453362341	0.072088778	0	13.66969871	0	0	0	0	0	0	0.061764506	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1309
H3653_806_0	2008	3																																A	A	D		T	Coin	Coin	V	V	V	V				V	V	V	V		V							V																																																								0		254.225831	11.23394487	1076.362481		42.50103845	0.000713309	4.23192835	280.5068538	258.8437031	4771.422408	962.4215737				2983.021108	3444.662695	101.6708221	16.16659496		3065.560105							13.8512786															$600 per Admission	$600 per Admission	$95 per day		$150 per trip	20% Coinsurance	20% Coinsurance	$50 per visit if ER	$175 per visit	$2 per visit	$5 or $50 per visit routine or advanced respectively.				$15 per visit	$35 per visit	$35 per visit	$35 per visit		$35 per visit							$35 per visit															600	600	95		150	0.2	0.2	50	175	2	5				15	35	35	35		35							35															12.7113	0.561697244	8.521202971	0	0.531262981	0.000142662	0.84638567	1.168778557	3.774804004	0.795237068	0.401008989	0	0	0	3.728776385	10.04693286	0.296539898	0.047152569	0	8.941216974	0	0	0	0	0	0	0.040399563	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4128		0	12.7113	0.561697244	8.521202971	0	0.531262981	0.000142662	0.84638567	1.168778557	3.774804004	0.795237068	0.401008989	0	0	0	3.728776385	10.04693286	0.296539898	0.047152569	0	8.941216974	0	0	0	0	0	0	0.040399563	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4128																																																																																				0			12.7113	0.561697244	8.521202971	0	0.531262981	0.000142662	0.84638567	1.168778557	3.774804004	0.795237068	0.401008989	0	0	0	3.728776385	10.04693286	0.296539898	0.047152569	0	8.941216974	0	0	0	0	0	0	0.040399563	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4128
H3653_809_0	2008	1																					Unlimited											A	A	D		T	Coin	Coin	V	V	V	V				V	V	V	V		V							V																																																								0		349.1046392	15.42652947	1478.068275		58.36271491	0.000979521	5.811312777	385.1939184	355.4459327	6552.149685	1321.603847				4096.304863	4730.234229	139.615064	22.2000781		4209.647975							19.02066993															$600 per Admission	$600 per Admission	$95 per day		$150 per trip	20% Coinsurance	20% Coinsurance	$50 per visit if ER	$175 per visit	$2 per visit	$5 or $50 per visit routine or advanced respectively.				$15 per visit	$35 per visit	$35 per visit	$35 per visit		$35 per visit							$35 per visit															600	600	95		150	0.2	0.2	50	175	2	5				15	35	35	35		35							35															17.4552	0.771326473	11.70137384	0	0.729533936	0.000195904	1.162262555	1.60497466	5.183586518	1.092024948	0.55066827	0	0	0	5.120381079	13.7965165	0.407210603	0.064750228	0	12.27813993	0	0	0	0	0	0	0.055476954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9737		0	17.4552	0.771326473	11.70137384	0	0.729533936	0.000195904	1.162262555	1.60497466	5.183586518	1.092024948	0.55066827	0	0	0	5.120381079	13.7965165	0.407210603	0.064750228	0	12.27813993	0	0	0	0	0	0	0.055476954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9737																																																																																				0			17.4552	0.771326473	11.70137384	0	0.729533936	0.000195904	1.162262555	1.60497466	5.183586518	1.092024948	0.55066827	0	0	0	5.120381079	13.7965165	0.407210603	0.064750228	0	12.27813993	0	0	0	0	0	0	0.055476954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9737
H3653_810_0	2008	3																																A	A	D		T	Coin	Coin	V	V	V	V				V	V	V	V		V							V																																																								0		254.225831	11.23394487	1076.362481		42.50103845	0.000713309	4.23192835	280.5068538	258.8437031	4771.422408	962.4215737				2983.021108	3444.662695	101.6708221	16.16659496		3065.560105							13.8512786															$600 per Admission	$600 per Admission	$95 per day		$150 per trip	20% Coinsurance	20% Coinsurance	$50 per visit if ER	$175 per visit	$2 per visit	$5 or $50 per visit routine or advanced respectively.				$15 per visit	$35 per visit	$35 per visit	$35 per visit		$35 per visit							$30 per visit															600	600	95		150	0.2	0.2	50	175	2	5				15	35	35	35		35							30															12.7113	0.561697244	8.521202971	0	0.531262981	0.000142662	0.84638567	1.168778557	3.774804004	0.795237068	0.401008989	0	0	0	3.728776385	10.04693286	0.296539898	0.047152569	0	8.941216974	0	0	0	0	0	0	0.034628197	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4071			12.7113	0.561697244	8.521202971	0	0.531262981	0.000142662	0.84638567	1.168778557	3.774804004	0.795237068	0.401008989	0	0	0	3.728776385	10.04693286	0.296539898	0.047152569	0	8.941216974	0	0	0	0	0	0	0.034628197	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4071																																																																																				0			12.7113	0.561697244	8.521202971	0	0.531262981	0.000142662	0.84638567	1.168778557	3.774804004	0.795237068	0.401008989	0	0	0	3.728776385	10.04693286	0.296539898	0.047152569	0	8.941216974	0	0	0	0	0	0	0.034628197	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4071
H3655_013_0	2008	7	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			A	A	D	D	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V		S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	377.5716459	8.507076323	537.8950386	0	284.9384025	12.58839787	4.488056737	343.009271	439.9837981	909.9595609	962.7771336	53.99163534	15.58301364	0.411684313	5427.880317	1926.529981	3.098194225	422.5891407	578.8387376		291.2049948				562.1166823	542.8275574	153.6061759					1171.44009	19.15094436	74.25473083	404.9647147	109.5799452	0.049986851	820.9866949	3.818116559			$600/admit with $1200 yearly max	$600/admit with $1200 yearly max	$75/day for days 21 to 100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$175 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$175 copay	$15/$25 copay for in-home/facility	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$50/$100 copay for Lower/Higher Tier		$15/$22.50/$40/$100 copay levels				$50 max w/specialist copay	Up to $75	$50 max w/specialist copay					$25 copay	$50 copay	$25 copay	$25 copay	$10 copay	20% coinsurance	$25 copay	$25 copay			415.4238588	468.3048177	70.92845645	0	70.92845645	0.189142551	0.189142551	47.28563764	165.4997317	48.29348514	57.53461593	165.4997317	23.64281882	23.64281882	9.457127527	23.64281882	23.64281882	23.64281882	49.41349133		30.35931442				23.64281882	0	23.64281882					23.64281882	47.28563764	23.64281882	23.64281882	9.457127527	0.189142551	23.64281882	23.64281882			13.071	0.331992069	3.179338735	0	1.684186756	2.38100168	0.848882498	1.351617674	6.068100046	3.662093211	4.616084384	0.74463343	0.030702197	0.000811115	4.277679697	3.795716607	0.00610417	0.832599874	2.383536912	0	0.736732	0	0	0	1.107501906	0	0.302640249	0	0	0	0	2.308012151	0.075463718	0.146299262	0.797875615	0.086359293	0.00945464	1.61753664	0.007522587	0	0	56.4615		3.241089319	13.071	0.331992069	3.179338735	0	1.684186756	2.38100168	0.848882498	1.351617674	6.068100046	3.662093211	4.616084384	0.74463343	0.030702197	0.000811115	4.277679697	3.795716607	0.00610417	0.832599874	2.383536912	0	0.736732	0	0	0	1.107501906	0	0.302640249	0	0	0	0	2.308012151	0.075463718	0.146299262	0.797875615	0.086359293	0.00945464	1.61753664	0.007522587	0	0	56.4615	2750																																																																																			0		0	13.071	0.331992069	3.179338735	0	1.684186756	2.38100168	0.848882498	1.351617674	6.068100046	3.662093211	4.616084384	0.74463343	0.030702197	0.000811115	4.277679697	3.795716607	0.00610417	0.832599874	2.383536912	0	0.736732	0	0	0	1.107501906	0	0.302640249	0	0	0	0	2.308012151	0.075463718	0.146299262	0.797875615	0.086359293	0.00945464	1.61753664	0.007522587	0	0	56.4615
H3655_023_0	2008	6	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			D	D	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V		S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	1944.930219	64.72425847	499.2829585	0	264.4844782	10.84598176	3.866844854	318.3868066	408.4001463	844.6393239	893.6654573	50.11591759	14.46440773	0.382132102	5038.247146	1788.236588	2.875794472	392.2541412	537.2875685		270.3012315				521.7658837	503.8614031	142.5797608					1087.349821	17.77621929	68.92445372	375.8948611	101.7138946	0.043067949	762.0532567	3.544038139			$150/day with $1500 yearly max	$150/day with $1500 yearly max	$75/day for days 21 to 100	0	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$150 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$150 copay	$15/$25 copay for in-home/facility	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$50/$100 copay for Lower/Higher Tier		$15/$22.50/$40/$100 copay levels				$50 max w/specialist copay	Up to $75	$50 max w/specialist copay					$25 copay	$50 copay	$25 copay	$25 copay	$10 copay	20% coinsurance	$25 copay	$25 copay			91.71908686	93.85866051	70.76296135	0	70.76296135	0.18870123	0.18870123	47.17530756	141.5259227	48.18080349	57.40037225	141.5259227	23.58765378	23.58765378	9.435061513	23.58765378	23.58765378	23.58765378	49.2981964		30.288478				23.58765378	0	23.58765378					23.58765378	47.17530756	23.58765378	23.58765378	9.435061513	0.18870123	23.58765378	23.58765378			14.8656	0.50624435	2.944228391	0	1.559642076	2.046650102	0.729678381	1.251666294	4.816600627	3.39128344	4.274727493	0.591058457	0.028431787	0.000751133	3.961347645	3.51502546	0.00565277	0.771029573	2.207275673	0	0.682251075	0	0	0	1.025602752	0	0.28026017	0	0	0	0	2.137335927	0.069883218	0.135480513	0.738873154	0.079973071	0.008126975	1.497920699	0.006966295	0	0	54.1296		3.241089319	14.8656	0.50624435	2.944228391	0	1.559642076	2.046650102	0.729678381	1.251666294	4.816600627	3.39128344	4.274727493	0.591058457	0.028431787	0.000751133	3.961347645	3.51502546	0.00565277	0.771029573	2.207275673	0	0.682251075	0	0	0	1.025602752	0	0.28026017	0	0	0	0	2.137335927	0.069883218	0.135480513	0.738873154	0.079973071	0.008126975	1.497920699	0.006966295	0	0	54.1296	2750																																																																																			0		0	14.8656	0.50624435	2.944228391	0	1.559642076	2.046650102	0.729678381	1.251666294	4.816600627	3.39128344	4.274727493	0.591058457	0.028431787	0.000751133	3.961347645	3.51502546	0.00565277	0.771029573	2.207275673	0	0.682251075	0	0	0	1.025602752	0	0.28026017	0	0	0	0	2.137335927	0.069883218	0.135480513	0.738873154	0.079973071	0.008126975	1.497920699	0.006966295	0	0	54.1296
H3655_801_0	2008	8																																coin	coin	coin	V	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V																																																				0		263.4112037	3.338510437	20.16100425	9.921317377	8.485698368	13.45504257	5.28000875	14.85970012	43.93843527	11.46887629	31.36670675	0	0.251603661	30.37273109	43.76360258	126.2129743	1.284590155	4.382696352	28.38253481	23.32250143	21.02975965	0																				Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare																				0.078343397	0.078343397	0.191126328	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				20.6365	0.261550247	3.853298716	0	1.985653418	3.148479961	1.235522047	3.477169828	10.28159385	2.683717051	7.33980938	0	0.058875257	7.107219076	10.240683	29.53383598	0.300594096	1.025550946	6.641513146	5.457465335	4.920963757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.19			20.6365	0.261550247	3.853298716	0	1.985653418	3.148479961	1.235522047	3.477169828	10.28159385	2.683717051	7.33980938	0	0.058875257	7.107219076	10.240683	29.53383598	0.300594096	1.025550946	6.641513146	5.457465335	4.920963757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.19																																																																																				0			20.6365	0.261550247	3.853298716	0	1.985653418	3.148479961	1.235522047	3.477169828	10.28159385	2.683717051	7.33980938	0	0.058875257	7.107219076	10.240683	29.53383598	0.300594096	1.025550946	6.641513146	5.457465335	4.920963757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.19
H3655_803_0	2008	8																																coin	coin	coin	V	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V																																																				0		263.4112037	3.338510437	20.16100425	9.921317377	8.485698368	13.45504257	5.28000875	14.85970012	43.93843527	11.46887629	31.36670675	0	0.251603661	30.37273109	43.76360258	126.2129743	1.284590155	4.382696352	28.38253481	23.32250143	21.02975965	0																				Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare																				0.078343397	0.078343397	0.191126328	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				20.6365	0.261550247	3.853298716	0	1.985653418	3.148479961	1.235522047	3.477169828	10.28159385	2.683717051	7.33980938	0	0.058875257	7.107219076	10.240683	29.53383598	0.300594096	1.025550946	6.641513146	5.457465335	4.920963757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.19			20.6365	0.261550247	3.853298716	0	1.985653418	3.148479961	1.235522047	3.477169828	10.28159385	2.683717051	7.33980938	0	0.058875257	7.107219076	10.240683	29.53383598	0.300594096	1.025550946	6.641513146	5.457465335	4.920963757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.19																																																																																				0			20.6365	0.261550247	3.853298716	0	1.985653418	3.148479961	1.235522047	3.477169828	10.28159385	2.683717051	7.33980938	0	0.058875257	7.107219076	10.240683	29.53383598	0.300594096	1.025550946	6.641513146	5.457465335	4.920963757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.19
H3659_001_0	2008	6																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2034.309628	146.5949943	1148.544185		210.5219261	11.89244621	1.852884343	378.689152	34.10788081	8465.568575	42.9033041		0.347602117	15.86825383	3741.161244	4127.646451	495.9648538	1.992014844			33.55862474	675.171474			208.8624851		17.98943749															$285 (1a); $0 (1a1)	$285 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$195 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1); $50/$40/$25 (4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	see OON	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											177.7399	177.7399	93.5473		121.6115	0.15591216	0.221968174	30.4124	0.124729728	3.7419	0.076999895		0.187094592	0.124654432	25	35	37.5	0.124729728			0.187094592	35			30.4453		35															30.1315	2.171314511	8.953600239	0	2.133490335	1.854176977	0.411281354	0.959735974	4.254266697	2.639770165	3.303549916	0	0.065034476	1.978048171	7.794085925	12.03896882	1.549890168	0.24846347	0	0	6.278637205	1.969250133	0	0	0.529906588	0	0.052469193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.3174	0	39.2592288	30.1315	2.171314511	8.953600239	0	2.133490335	1.854176977	0.411281354	0.959735974	4.254266697	2.639770165	3.303549916	0	0.065034476	1.978048171	7.794085925	12.03896882	1.549890168	0.24846347	0	0	6.278637205	1.969250133	0	0	0.529906588	0	0.052469193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.3174	4400	$300/$375 (1a); $0 (1a1)	$300/$375 (1b)	"$170/$225 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$195 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$25 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$25/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$38 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $38 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$38 (17a1)	$0 n/c (17b)	$38 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.758	0.1987	3.3825	1.1497	0.5334	0.5563	0.1234	0.246	1.5954	0.8799	1.226		0.0163	0.7416	1.5182	2.3043	0.31	0.0658			1.108	0.3861			0.0935		0.0101															19.2029	0	8.132262773	32.8895	2.370061834	12.33607144	1.149674699	2.666862919	2.41043007	0.53466576	1.205745323	5.849616708	3.519693553	4.529568131	0	0.081293095	2.719634592	9.312238956	14.34324878	1.859868202	0.314233212	0	0	7.386632006	2.355365459	0	0	0.623419515	0	0.062522114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.5204
H3659_003_0	2008	7																					2550											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2388.162023	148.7660738	1799.913335		264.6242225	12.12279334	2.250717769	586.7667737	23.27116611		47.24400314		2.612085285	36.01189248	4555.190834	5022.724633	529.2535637	4.993323109			27.03652982	1023.759957			154.1187195		19.99675605															$100 (1a); $0 (1a1)	$100 (1b)	"$75 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $50/$40/$5 (4b)"	10% (9b)	10% (8a1); $0/$0 (8a2)	"$15 (8b1); 10% (8b2, 8b3)"	10% (incl in h5)	20% (12)	"10% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$5/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$15 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"10% (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $15 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$15 (17a1)	$0 n/c (17b)	$15 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											69.0133	69.0133	51.76		120.7732	0.138026568	0.184114998	33.2483	0.069013284		0.045774323		0.138026568	0.069026583	5	15	37.5	0.069013284			0.138026568	15			15		15															13.7346	0.855569608	7.763620636	0	2.663293882	1.673267559	0.414390898	1.625749259	1.606019596	0	2.162562275	0	0.360537167	2.485777875	1.897996181	6.278405792	1.653917386	0.344605626	0	0	3.731759422	1.279699947	0	0	0.192648399	0	0.024995945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7494	0	17.54913608	13.7346	0.855569608	7.763620636	0	2.663293882	1.673267559	0.414390898	1.625749259	1.606019596	0	2.162562275	0	0.360537167	2.485777875	1.897996181	6.278405792	1.653917386	0.344605626	0	0	3.731759422	1.279699947	0	0	0.192648399	0	0.024995945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7494																																																																																				0			13.7346	0.855569608	7.763620636	0	2.663293882	1.673267559	0.414390898	1.625749259	1.606019596	0	2.162562275	0	0.360537167	2.485777875	1.897996181	6.278405792	1.653917386	0.344605626	0	0	3.731759422	1.279699947	0	0	0.192648399	0	0.024995945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7494
H3659_031_0	2008	6																					2950											D	D	D	V	T	Coin	Coin	V	V	O	O	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2077.30158	146.6132536	1315.196324		211.8121079	13.25220887	2.638502586	553.5567438	379.0588644	10025.22671	5663.12539		0.711656839	829.2108466	4711.992498	4609.109543	561.6704138	817.2221668			35.48566111	791.9519193			191.7094239		21.02406835															$225 (1a); $0 (1a1)	$225 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$40/$20 (4b)"	$195 (9b)	$100 (8a1); $0/$25 (8a2)	"$25 (8b1); $100 (8b2, 8b3)"	$195/$100 (incl in h5)	30% (12)	"$50 (3, 9d); $60 (5); $35/$35 (9c); $195/$100 (9a)"	"$20/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$35/$35 (7e, 7h)"	"$50 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											123.3987	123.3987	54.8439		95.9768	0.164531636	0.26737323	26.4822	106.9456	5.4844	11.486		0.164531636	105.7018	20	34.9883	35	22.0364			0.164531636	35			29.5881		35															21.3614	1.507657406	6.010872308	0	1.694087144	2.180407608	0.705464959	1.22161729	3.378221989	4.581852649	5.420564699	0	0.117090064	7.304088908	7.85332083	13.43873815	1.638205374	1.500722401	0	0	5.838513884	2.309859765	0	0	0.472693698	0	0.061320199	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.5967	0	51.22913042	21.3614	1.507657406	6.010872308	0	1.694087144	2.180407608	0.705464959	1.22161729	3.378221989	4.581852649	5.420564699	0	0.117090064	7.304088908	7.85332083	13.43873815	1.638205374	1.500722401	0	0	5.838513884	2.309859765	0	0	0.472693698	0	0.061320199	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.5967																																																																																				0			21.3614	1.507657406	6.010872308	0	1.694087144	2.180407608	0.705464959	1.22161729	3.378221989	4.581852649	5.420564699	0	0.117090064	7.304088908	7.85332083	13.43873815	1.638205374	1.500722401	0	0	5.838513884	2.309859765	0	0	0.472693698	0	0.061320199	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.5967
H3659_033_0	2008	8																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1906.175662	134.5354081	983.8466047		169.0115212	10.54700962	2.099899906	441.5665558	29.89602108	7999.442682	42.64545048		0.56638494	22.01518678	4019.318927	3922.126356	476.1853336	2.313887352			30.00702288	671.4184683			122.4		14.32602104															$280 (1a); $0 (1a1)	$280 (1b)	"$140 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$195 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$40/$15 (4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											172.0256	172.0256	86.0128		119.8035	0.184313149	0.272137493	29.6658	0.122875432	3.6863	0.075021169		0.184313149	0.122827698	15	29.9172	37.5	0.122875432			0.184313149	30			30		30															27.3259	1.928627919	7.051950324	0	1.687348305	1.943952552	0.571461496	1.091619869	3.673486518	2.457337447	3.199311557	0	0.104392192	2.704074707	5.024148659	9.778237724	1.488079168	0.284319909	0	0	5.530688869	1.678546171	0	0	0.306	0	0.035815053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8653	0	37.07909026	27.3259	1.928627919	7.051950324	0	1.687348305	1.943952552	0.571461496	1.091619869	3.673486518	2.457337447	3.199311557	0	0.104392192	2.704074707	5.024148659	9.778237724	1.488079168	0.284319909	0	0	5.530688869	1.678546171	0	0	0.306	0	0.035815053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8653	3900	$295 (1a); $0 (1a1)	$295 (1b)	"$150 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$195 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.5035	0.1767	2.5186	0.9324	0.4218	0.486	0.1429	0.2826	1.3776	0.8191	1.1874		0.0261	1.0138	1.3302	2.0119	0.2976	0.0753			0.976	0.3537			0.063		0.0074															17.0035	0	7.55413425	29.8294	2.105318986	9.570504012	0.932355068	2.109185381	2.42994069	0.71432687	1.37421196	5.051043962	3.276449929	4.386671914	0	0.13049024	3.71791741	6.354383257	11.79018461	1.785695001	0.359581061	0	0	6.506692787	2.032293395	0	0	0.369	0	0.04318874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.8688
H3659_054_0	2008	5																					2350											D	D	D	V	T	Coin	Coin	V	V	O	O	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2085.010642	143.7831312	1381.889528		212.913224	11.62385197	2.580200829	558.6837156	379.8248001	10730.57561	5864.346438		0.526721731	869.8421162	4868.958928	4789.320603	559.4055602	995.740414			32.92796509	807.7953428			155.1724011		17.32537001															$200 (1a); $0 (1a1)	$200 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$40 (4b)"	$150 (9b)	$100 (8a1); $0/$25 (8a2)	"$25 (8b1); $100 (8b2, 8b3)"	$150/$100 (incl in h5)	30% (12)	"$50 (3, 9d); $60 (5); $35/$35 (9c); $150/$100 (9a)"	"$15/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$35/$35 (7e, 7h)"	"$50 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											102.0146	102.0146	51.0073		89.2628	0.153021909	0.264305743	24.6928	76.511	5.1007	10.3053		0.153021909	75.447	15	34.8111	35	19.7478			0.153021909	35			35		35															17.7251	1.22233162	5.87387147	0	1.583768856	1.778704013	0.681961897	1.149622161	2.421729826	4.561147667	5.036133437	0	0.080599965	5.468917844	6.086198659	13.89346685	1.63159955	1.638641376	0	0	5.038700062	2.35606975	0	0	0.45258617	0	0.050532329	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7317	0	51.55347963	17.7251	1.22233162	5.87387147	0	1.583768856	1.778704013	0.681961897	1.149622161	2.421729826	4.561147667	5.036133437	0	0.080599965	5.468917844	6.086198659	13.89346685	1.63159955	1.638641376	0	0	5.038700062	2.35606975	0	0	0.45258617	0	0.050532329	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7317																																																																																				0			17.7251	1.22233162	5.87387147	0	1.583768856	1.778704013	0.681961897	1.149622161	2.421729826	4.561147667	5.036133437	0	0.080599965	5.468917844	6.086198659	13.89346685	1.63159955	1.638641376	0	0	5.038700062	2.35606975	0	0	0.45258617	0	0.050532329	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7317
H3659_056_0	2008	5																					2400											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		3068.944807	466.43985	1395.929832		1229.708902	31.92939178	10.41463124	1465.134695	452.2519822	8891.944102	998.6654883	54.63898351	3.119248496	2844.513617		2223.274541	1348.196199	536.9875716			50.98844338	525.9764206																				1(a) $200 per Day	1(b) $200 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $100 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $35 per Visit	8(a) Diagnostic: $25 per procedure; other $0 per procedure	8(b) X-rays $25 per visit; other: $25 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a) $25 per Visit; 9(c) $25/$35 per Visit; 9(d) $35 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $15 per Visit	7(e)/7(h) $25/35 per Visit	7(c)/7(i) $15 per Visit		7(g) $15 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $25 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $25 per visit															106.6568	106.6568	22.3979		53.3284	0.106656839	0.106656839	23.8645	18.6649	13.3321	13.3321	13.3321	0.106656839	13.4021		7.9993	17.3317	7.9993			0.106656839	13.3321																				27.277	4.145750004	2.605495613	0	5.464869359	3.405488004	1.110791649	2.91372164	0.703438268	9.879027624	1.109526087	0.060704388	0.332689185	3.176877356	0	1.482046469	1.947215091	0.357958732	0	0	5.438266205	0.584364401	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9952	0	63.00826113	27.277	4.145750004	2.605495613	0	5.464869359	3.405488004	1.110791649	2.91372164	0.703438268	9.879027624	1.109526087	0.060704388	0.332689185	3.176877356	0	1.482046469	1.947215091	0.357958732	0	0	5.438266205	0.584364401	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9952																																																																																				0	0	0	27.277	4.145750004	2.605495613	0	5.464869359	3.405488004	1.110791649	2.91372164	0.703438268	9.879027624	1.109526087	0.060704388	0.332689185	3.176877356	0	1.482046469	1.947215091	0.357958732	0	0	5.438266205	0.584364401	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9952
H3659_057_0	2008	6	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						2400	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T				V					V	P	V	V																																																0		1850.321326	87.21601761	9464.067197	228.8467586	521.0554636	31.71122034	0.28505511	192.8292237	131.3975557	4920.419108	199.3034594	30.31119427	7.430656847	246.6404992	136.3799849	1468.752872	2201.115987	26.60903424		295.6868139	271.4683652	738.1616296	1912.9									110.6505733	1.397846338		247.1							(1a) $175/day	(1b) $175/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $35/visit	(8a) $0/visit	(8b) $0/visit	(9a) $35/visit	(12) $0/proc	(9a) $35/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $15/visit	(7e/7h) $32.5/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $15/visit	(15) $0/proc	(Misc. PBP Cats) $15/visit	(10b) $0/trip				(18a) $15/visit					(4b) $35/visit (waived if admitted)	(9c) $32.5/proc 75%/25% Ind/Grp Blended Copay	(9d) $35/visit	(7f1) $0/visit							160.3152	160.3152			68.7065	0.183217423	0.183217423	45.8044	32.063			32.063		32.063		13.7413	29.7728			13.7413		13.7413										32.063	29.7728									24.7196	1.165171438	0	0	2.983326229	5.810048074	0.052227063	0.736034864	0.351083856	0	0	0.080989109	0	0.659003868	0	1.681881978	5.461121237	0	0	0.338593601	0	0.845275448	0	0	0	0	0	0	0	0	0	0.295649563	0.003468154	0	0	0	0	0	0	0	0	45.1834		4.138768278	24.7196	1.165171438	0	0	2.983326229	5.810048074	0.052227063	0.736034864	0.351083856	0	0	0.080989109	0	0.659003868	0	1.681881978	5.461121237	0	0	0.338593601	0	0.845275448	0	0	0	0	0	0	0	0	0	0.295649563	0.003468154	0	0	0	0	0	0	0	0	45.1834																																																																																				0		0	24.7196	1.165171438	0	0	2.983326229	5.810048074	0.052227063	0.736034864	0.351083856	0	0	0.080989109	0	0.659003868	0	1.681881978	5.461121237	0	0	0.338593601	0	0.845275448	0	0	0	0	0	0	0	0	0	0.295649563	0.003468154	0	0	0	0	0	0	0	0	45.1834
H3659_058_0	2008	6	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						2400	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T				V					V	P	V	V																																																0		1760.919881	83.0020263	9006.794577	217.7896354	495.8797762	28.72088646	0.258174721	183.5123494	125.0488577	4682.68063	189.6737713	28.84665699	7.071631932	234.7236409	129.7905523	1397.787561	2094.765297	25.32337317		281.4001989	258.351906	702.4960858	1912.9									105.3043012	1.330306997		247.1							(1a) $175/day	(1b) $175/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $35/visit	(8a) $0/visit	(8b) $0/visit	(9a) $35/visit	(12) $0/proc	(9a) $35/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $15/visit	(7e/7h) $32.5/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $15/visit	(15) $0/proc	(Misc. PBP Cats) $15/visit	(10b) $0/trip				(18a) $15/visit					(4b) $35/visit (waived if admitted)	(9c) $32.5/proc 75%/25% Ind/Grp Blended Copay	(9d) $35/visit	(7f1) $0/visit							161.7779	161.7779			69.3334	0.184889033	0.184889033	46.2223	32.3556			32.3556		32.3556		13.8667	30.0445			13.8667		13.8667										32.3556	30.0445									23.7398	1.118991151	0	0	2.865085379	5.310176915	0.047733674	0.706862933	0.337169034	0	0	0.077779195	0	0.632884976	0	1.615222438	5.244675711	0	0	0.325173816	0	0.811773886	0	0	0	0	0	0	0	0	0	0.283931818	0.003330697	0	0	0	0	0	0	0	0	43.1206		3.524245071	23.7398	1.118991151	0	0	2.865085379	5.310176915	0.047733674	0.706862933	0.337169034	0	0	0.077779195	0	0.632884976	0	1.615222438	5.244675711	0	0	0.325173816	0	0.811773886	0	0	0	0	0	0	0	0	0	0.283931818	0.003330697	0	0	0	0	0	0	0	0	43.1206																																																																																				0		0	23.7398	1.118991151	0	0	2.865085379	5.310176915	0.047733674	0.706862933	0.337169034	0	0	0.077779195	0	0.632884976	0	1.615222438	5.244675711	0	0	0.325173816	0	0.811773886	0	0	0	0	0	0	0	0	0	0.283931818	0.003330697	0	0	0	0	0	0	0	0	43.1206
H3659_059_0	2008	6																					3500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2108.932413	144.6324097	947.1479217		292.7221166	11.63307889	20.20311248	455.4527953	430.4907539	3609.16415	474.3083711	72.2826059	16.2249144	3032.855295		4141.495162	407.9439089	595.8946927				737.0617085					0.078041465															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															143.9814	143.9814	34.5555		61.7063	0.1645502	0.1645502	33.9385	61.7063	16.455	53.696	61.7063	127.5146	59.6592		20.5688	16.455	16.455				20.5688					20.5688															25.3039	1.735365038	2.727434151	0	1.505233839	1.914225459	3.324426202	1.288114585	2.213666865	4.949072359	2.12237281	0.371691164	0.172409461	15.07815026	0	7.098790182	0.559393765	0.817121591	0	0	0	1.263371371	0	0	0	0	0.000133768	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.4449	0	15.60713457	25.3039	1.735365038	2.727434151	0	1.505233839	1.914225459	3.324426202	1.288114585	2.213666865	4.949072359	2.12237281	0.371691164	0.172409461	15.07815026	0	7.098790182	0.559393765	0.817121591	0	0	0	1.263371371	0	0	0	0	0.000133768	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.4449																																																																																				0	0	0	25.3039	1.735365038	2.727434151	0	1.505233839	1.914225459	3.324426202	1.288114585	2.213666865	4.949072359	2.12237281	0.371691164	0.172409461	15.07815026	0	7.098790182	0.559393765	0.817121591	0	0	0	1.263371371	0	0	0	0	0.000133768	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.4449
H3659_801_0	2008	2																					5000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1791.5859	151.2482593	906.485557		151.2838096	10.525926	2.573381049	360.0846497	53.41024182	11160.44504	60.53287297		0.229002682	25.29486814	4453.883966	5161.519939	586.2911036	4.462061454			51.52925071	940.7314352			337.3171727		20.36175662															$425 (1a); $0 (1a1)	$425 (1b)	"$175 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1); $50/$40 (4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$35/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $35 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											268.1187	268.1187	110.4018		110.4018	0.157716877	0.207352494	30.5073	0.157716877	3.7852	0.096651946		0.189260253	0.15761301	35	39.5397	37.5	0.157716877			0.189260253	40			34.5008		40															40.0298	3.379373781	8.339804166	0	1.391833919	1.66011618	0.533596979	0.915435065	8.423696558	3.520381084	5.850619997	0	0.043341106	3.986800313	12.9904949	17.00707408	1.832159699	0.703742399	0	0	9.752439017	3.135771451	0	0	0.969809784	0	0.067872522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5342	0	51.59754571	40.0298	3.379373781	8.339804166	0	1.391833919	1.66011618	0.533596979	0.915435065	8.423696558	3.520381084	5.850619997	0	0.043341106	3.986800313	12.9904949	17.00707408	1.832159699	0.703742399	0	0	9.752439017	3.135771451	0	0	0.969809784	0	0.067872522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5342																																																																																				0			40.0298	3.379373781	8.339804166	0	1.391833919	1.66011618	0.533596979	0.915435065	8.423696558	3.520381084	5.850619997	0	0.043341106	3.986800313	12.9904949	17.00707408	1.832159699	0.703742399	0	0	9.752439017	3.135771451	0	0	0.969809784	0	0.067872522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5342
H3659_802_0	2008	2																					4500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2061.517157	161.3285259	1511.941572		242.5331249	14.66306494	2.481814321	598.3738053	45.29125665	11370.6976	61.96730014		0.559853962	29.02340196	5041.923832	5250.905747	586.0727917	4.780339739			38.38902941	977.9017142			224.4262133		20.33038154															$375 (1a); $0 (1a1)	$375 (1b)	"$175 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1); $50/$40 (4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$35/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $35 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											220.8334	220.8334	103.0556		103.0556	0.147222238	0.22635197	28.4182	0.147222238	3.5333	0.089184662		0.176666685	0.147144253	35	39.384	37.5	0.147222238			0.176666685	40			40		40															37.9376	2.968893324	12.98449959	0	2.082865713	2.158729232	0.561763561	1.417057802	6.667880153	3.348039091	5.526532724	0	0.098907544	4.270626815	14.70561118	17.23347795	1.831477474	0.703772313	0	0	6.782062577	3.259672381	0	0	0.748087378	0	0.067767938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.3554	0	60.75648855	37.9376	2.968893324	12.98449959	0	2.082865713	2.158729232	0.561763561	1.417057802	6.667880153	3.348039091	5.526532724	0	0.098907544	4.270626815	14.70561118	17.23347795	1.831477474	0.703772313	0	0	6.782062577	3.259672381	0	0	0.748087378	0	0.067767938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.3554																																																																																				0			37.9376	2.968893324	12.98449959	0	2.082865713	2.158729232	0.561763561	1.417057802	6.667880153	3.348039091	5.526532724	0	0.098907544	4.270626815	14.70561118	17.23347795	1.831477474	0.703772313	0	0	6.782062577	3.259672381	0	0	0.748087378	0	0.067767938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.3554
H3660_028_0	2008	4																					2000											D	D	A	V	T	Coin	Coin	P	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1550.53845	37.04913347	131.8115027	0	192.4198699	19.32521267	0.535320265	313.4975819	459.2348776	0	913.5965104	0	0	950.6611896	0	4203.607457	211.1623513	400.2598232	0	0	0	0	0	0	692.1559857	0	58.83734472	0	0	0	0											"1A IP Acute: $100 per day (days 1-10), 1B IP Psych: $100 per day (days 1-10)"	0	2 SNF: $75 per day for days 11-100 only	0	10A Ambulance: $75	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $35"	"9A OP Hospital: $0-$150, 9B ASC Services: $0-$150"	0	"8A OP C/D/T: $0-$50, 8B OP X-Ray: $0-$100"	0	0	"3 CORF: $25, 5 Partial Hosp: $25, Part B Rx: $50"	"7A PCP: $0, 14B through 14I Diabetes Monitoring: $0"	"7B Chiropractic: $25, 7D Physician Specialist: $25, 7F Podiatry: $25, 7G Other Health Care: $25, 16D Comp Dental: $25, 17A Medicare Covered Vision Exams: $25, 18A Medicare Covered Hearing Exams: $25"	"7E Mental Health: $25, 7H Psychiatric: $25, 9C OP Substance Abuse: $25"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	0	0	included in h.5.	0	0	0	17A Routine Eye Exams: $25	0	18A Routine Hearing Exams: $25	0	0	0	0											89.0102693	0	75	0	75	0.2	0.2	49.15727578	150	0	82.40648395	0	0	27.02741307	0	25	25	25	0	0	0	0	0	0	25	0	25	0	0	0	0											11.5012	0	0.823821892	0	1.202624187	3.865042534	0.107064053	1.284223924	5.740435971	0	6.273856347	0	0	2.141159388	0	8.757515535	0.439921565	0.833874632	0	0	0	0	0	0	1.441991637	0	0.122577801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5353	0	1.42	11.5012	0	0.823821892	0	1.202624187	3.865042534	0.107064053	1.284223924	5.740435971	0	6.273856347	0	0	2.141159388	0	8.757515535	0.439921565	0.833874632	0	0	0	0	0	0	1.441991637	0	0.122577801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5353	0	15% coinsurance	15% coinsurance	$75 copay	20% coinsurance	$75 copay	30% coinsurance	30% coinsurance	"$50 copay for ER, $35 copay for UC"	20% coinsurance	0	20% coinsurance	0	0	Combination of 20% coinsurance and $40 copay	$15 copay	$40 copay	$40 copay	$40 copay	0	0	0	0	0	0	$40 copay	0	$40 copay	0	0	0	0											5.0062	0.0468	0.4482	0.3566	0.1336	0.6442	0.0178	0.1435	0.8107	0	0.7864	0	0	0.487	0.7442	1.5569	0.0783	0.2202	0	0	0	0	0	0	0.2564	0	0.0218	0	0	0	0											11.7588	0	0	16.5074	0.046759476	1.271981001	0.356647455	1.336249097	4.50921629	0.124908062	1.427773254	6.551115151	0	7.060287509	0	0	2.628124564	0.74418759	10.31440719	0.518206431	1.054096153	0	0	0	0	0	0	1.698345706	0	0.144369411	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.294
H3660_029_0	2008	4																					3000											D	D	A	V	T	Coin	Coin	P	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1132.2504	30.60451028	96.25277376	0	167.0794841	14.11185887	0.390907161	234.7446553	276.2266908	0	667.7555316	0	0	693.1782469	0	3095.752823	162.0644239	303.5368147	0	0	0	0	0	0	505.4333814	0	42.96482108	0	0	0	0											"1A IP Acute: $175 per day (days 1-10), 1B IP Psych: $175 per day (days 1-10)"	0	2 SNF: $100 per day for days 11-100 only	0	10A Ambulance: $75	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $35"	"9A OP Hospital: $0-$250, 9B ASC Services: $0-$150"	0	"8A OP C/D/T: $0-$50, 8B OP X-Ray: $0-$100"	0	0	"3 CORF: $30, 5 Partial Hosp: $30, Part B Rx: $50"	"7A PCP: $0, 14B through 14I Diabetes Monitoring: $0"	"7B Chiropractic: $30, 7D Physician Specialist: $30, 7F Podiatry: $30, 7G Other Health Care: $30, 16B Comp Dental: $30, 17A Medicare Covered Vision Exams: $30, 18A Medicare Covered Hearing Exams: $30"	"7E Mental Health: $30, 7H Psychiatric: $30, 9C OP Substance Abuse: $30"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	0	0	included in h.5.	0	0	0	17A Routine Eye Exams: $30	0	18A Routine Hearing Exams: $30	0	0	0	0											165.8854084	0	100	0	75	0.2	0.199998331	49.33210247	250	0	83.76068376	0	0	28.53351047	0	30	30	30	0	0	0	0	0	0	30	0	30	0	0	0	0											15.652	0	0.802106448	0	1.044246776	2.822371774	0.07818078	0.965037283	5.754722725	0	4.660971659	0	0	1.648234064	0	7.739382058	0.40516106	0.758842037	0	0	0	0	0	0	1.263583453	0	0.107412053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7022	0	0.86	15.652	0	0.802106448	0	1.044246776	2.822371774	0.07818078	0.965037283	5.754722725	0	4.660971659	0	0	1.648234064	0	7.739382058	0.40516106	0.758842037	0	0	0	0	0	0	1.263583453	0	0.107412053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7022	0	20% coinsurance	20% coinsurance	$100 copay	20% coinsurance	$75 copay	30% coinsurance	30% coinsurance	"$50 copay for ER, $35 copay for UC"	20% coinsurance	20% coinsurance	20% coinsurance	0	0	Combination of 20% coinsurance and $40 copay	$15 copay	$45 copay	$45 copay	$45 copay	0	0	0	0	0	0	$45 copay	0	$45 copay	0	0	0	0											4.8742	0.0455	0.4363	0.2604	0.116	0.4704	0.013	0.1079	0.592	0.2738	0.5743	0	0	0.2653	0.5434	1.2899	0.0676	0.179	0	0	0	0	0	0	0.2106	0	0.0179	0	0	0	0											10.3377	0	0	20.5262	0.045526925	1.238452356	0.260434834	1.160274195	3.29276707	0.09121091	1.072890026	6.346705353	0.273847575	5.235247645	0	0	1.913566267	0.543428444	9.029279068	0.47274383	0.937875611	0	0	0	0	0	0	1.474180696	0	0.125314061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.04
H3660_032_0	2008	4																					0											D	D	A	V	T	Coin	Coin	P	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1909.720682	51.61938228	162.3456373	0	281.8061679	23.80189819	0.659327204	395.9342591	465.9003206	0	849.4734207	0	0	1169.155546	0	5221.48033	273.34747	511.9631953	0	0	0	0	0	0	852.4939198	0	72.46701562	0	0	0	0											0	0	0	0	0	0	0	"4A ER: $50, 4B Urgent Care: $35"	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	49.33210247	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.62768912	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6277	0	0	0	0	0	0	0	0	0	1.62768912	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6277	0	15% coinsurance	15% coinsurance	$50 copay	0	$75 copay	20% coinsurance	20% coinsurance	"$50 copay for ER, $35 copay for UC"	$150 copay	0	0	0	0	Combination of 20% coinsurance and $40 copay	$10 copay	$30 copay	$30 copay	$30 copay	0	0	0	0	0	0	$30 copay	0	$30 copay	0	0	0	0											6.1659	0.0576	0.368	0	0.1957	0.5289	0.0147	0.1819	0.8068	0	0	0	0	0.3217	0.6111	1.4504	0.076	0.2013	0	0	0	0	0	0	0.2368	0	0.0201	0	0	0	0											11.2368	0	0	6.1659	0.057591309	0.367983444	0	0.195698728	0.528931071	0.014651593	1.809599955	0.806782046	0	0	0	0	0.32168677	0.61105243	1.450411203	0.075992739	0.20131243	0	0	0	0	0	0	0.236803867	0	0.020129727	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.8645
H3660_801_0	2008	3																					0											D	D	A	V	T	Coin	Coin	P	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1218.4218	9.591067857	163.6783183	0	152.0395379	15.92582378	1.656581031	248.665335	141.5431337	0	172.6882629	0	0	774.6704057	4696.14326	4413.165632	114.9329541	551.3146505	0	0	0	0	0	0	811.2011636	0	43.11789969	0	0	0	0											"1A IP Acute: $175 per day (days 1-10), 1B IP Psych: $175 per day (days 1-10)"	0	2 SNF: $100 per day for days 11-100 only	0	10A Ambulance: $75	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $35"	"9A OP Hospital: $0-$250, 9B ASC Services: $0-$250"	0	"8A OP C/D/T: $0-$50, 8B OP X-Ray: $0-$100"	0	0	"3 CORF: $40, 5 Partial Hosp: $40, Part B Rx: $50"	"7A PCP: $20, 14B through 14I Diabetes Monitoring: $0"	"7B Chiropractic: $40, 7D Physician Specialist: $40, 7F Podiatry: $40, 7G Other Health Care: $40, 16B Comp Dental: $40, 17A Medicare Covered Vision Exams: $40, 18A Medicare Covered Hearing Exams: $40"	"7E Mental Health: $40, 7H Psychiatric: $40, 9C OP Substance Abuse: $40"	"7C Occupational Therapy: $40, 7I Physical and Speech Therapy: $40"	0	0	included in h.5.	0	0	0	17A Routine Eye Exams: $40	0	18A Routine Hearing Exams: $40	0	0	0	0											175	0	100	0	75	0.2	0.199998257	48.3346755	250	0	57.63105508	0	0	32.84197049	20	40	40	37.39077707	0	0	0	0	0	0	40	0	40	0	0	0	0											17.7687	0	1.363985986	0	0.950247112	3.185164756	0.331313319	1.001596523	2.948815285	0	0.829350566	0	0	2.120141883	7.826905434	14.71055211	0.383109847	1.717840266	0	0	0	0	0	0	2.704003879	0	0.143726332	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9854	0	0	17.7687	0	1.363985986	0	0.950247112	3.185164756	0.331313319	1.001596523	2.948815285	0	0.829350566	0	0	2.120141883	7.826905434	14.71055211	0.383109847	1.717840266	0	0	0	0	0	0	2.704003879	0	0.143726332	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9854	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.7687	0	1.363985986	0	0.950247112	3.185164756	0.331313319	1.001596523	2.948815285	0	0.829350566	0	0	2.120141883	7.826905434	14.71055211	0.383109847	1.717840266	0	0	0	0	0	0	2.704003879	0	0.143726332	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9854
H3660_802_0	2008	3																					0											D	D	A	V	T	Coin	Coin	P	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1218.4218	9.591067857	163.6783183	0	152.0395379	15.92582378	1.656581031	248.665335	141.5431337	0	172.6882629	0	0	774.6704057	4696.14326	4413.165632	114.9329541	551.3146505	0	0	0	0	0	0	811.2011636	0	43.11789969	0	0	0	0											"1A IP Acute: $175 per day (days 1-10), 1B IP Psych: $175 per day (days 1-10)"	0	2 SNF: $100 per day for days 11-100 only	0	10A Ambulance: $75	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $35"	"9A OP Hospital: $0-$250, 9B ASC Services: $0-$250"	0	"8A OP C/D/T: $0-$50, 8B OP X-Ray: $0-$100"	0	0	"3 CORF: $40, 5 Partial Hosp: $40, Part B Rx: $50"	"7A PCP: $20, 14B through 14I Diabetes Monitoring: $0"	"7B Chiropractic: $40, 7D Physician Specialist: $40, 7F Podiatry: $40, 7G Other Health Care: $40, 16B Comp Dental: $40, 17A Medicare Covered Vision Exams: $40, 18A Medicare Covered Hearing Exams: $40"	"7E Mental Health: $40, 7H Psychiatric: $40, 9C OP Substance Abuse: $40"	"7C Occupational Therapy: $40, 7I Physical and Speech Therapy: $40"	0	0	included in h.5.	0	0	0	17A Routine Eye Exams: $40	0	18A Routine Hearing Exams: $40	0	0	0	0											175	0	100	0	75	0.2	0.199998257	48.3346755	250	0	57.63105508	0	0	32.84197049	20	40	40	37.39077707	0	0	0	0	0	0	40	0	40	0	0	0	0											17.7687	0	1.363985986	0	0.950247112	3.185164756	0.331313319	1.001596523	2.948815285	0	0.829350566	0	0	2.120141883	7.826905434	14.71055211	0.383109847	1.717840266	0	0	0	0	0	0	2.704003879	0	0.143726332	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9854	0	0	17.7687	0	1.363985986	0	0.950247112	3.185164756	0.331313319	1.001596523	2.948815285	0	0.829350566	0	0	2.120141883	7.826905434	14.71055211	0.383109847	1.717840266	0	0	0	0	0	0	2.704003879	0	0.143726332	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9854	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.7687	0	1.363985986	0	0.950247112	3.185164756	0.331313319	1.001596523	2.948815285	0	0.829350566	0	0	2.120141883	7.826905434	14.71055211	0.383109847	1.717840266	0	0	0	0	0	0	2.704003879	0	0.143726332	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9854
H3660_805_0	2008	3																					0											D	D	A	V	T	Coin	Coin	P	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1114.92288	8.776353966	149.7746528	0	139.1245294	14.57300363	1.515862647	227.5424417	129.5197429	0	158.019247	0	0	708.8659771	4297.229062	4038.288987	105.1699667	504.4831913	0	0	0	0	0	0	742.2936274	0	39.45524686	0	0	0	0											"1A IP Acute: $175 per day (days 1-10), 1B IP Psych: $175 per day (days 1-10)"	0	2 SNF: $100 per day for days 11-100 only	0	10A Ambulance: $75	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $35"	"9A OP Hospital: $0-$250, 9B ASC Services: $0-$250"	0	"8A OP C/D/T: $0-$50, 8B OP X-Ray: $0-$100"	0	0	"3 CORF: $40, 5 Partial Hosp: $40, Part B Rx: $50"	"7A PCP: $20, 14B through 14I Diabetes Monitoring: $0"	"7B Chiropractic: $40, 7D Physician Specialist: $40, 7F Podiatry: $40, 7G Other Health Care: $40, 16B Comp Dental: $40, 17A Medicare Covered Vision Exams: $40, 18A Medicare Covered Hearing Exams: $40"	"7E Mental Health: $40, 7H Psychiatric: $40, 9C OP Substance Abuse: $40"	"7C Occupational Therapy: $40, 7I Physical and Speech Therapy: $40"	0	0	included in h.5.	0	0	0	17A Routine Eye Exams: $40	0	18A Routine Hearing Exams: $40	0	0	0	0											175	0	100	0	75	0.2	0.199998257	48.3346755	250	0	57.63105508	0	0	32.84197049	20	40	40	37.39077707	0	0	0	0	0	0	40	0	40	0	0	0	0											16.2593	0	1.248122106	0	0.869528309	2.914600726	0.303169887	0.91651584	2.698327977	0	0.758901327	0	0	1.940046292	7.162048436	13.46096329	0.350566556	1.571918211	0	0	0	0	0	0	2.474312091	0	0.13151749	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0598	0	0	16.2593	0	1.248122106	0	0.869528309	2.914600726	0.303169887	0.91651584	2.698327977	0	0.758901327	0	0	1.940046292	7.162048436	13.46096329	0.350566556	1.571918211	0	0	0	0	0	0	2.474312091	0	0.13151749	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0598	0	20% coinsurance	20% coinsurance	$100 copay	20% coinsurance	$75 copay	30% coinsurance	30% coinsurance	"$50 copay for ER, $35 copay for UC"	20% coinsurance	20% coinsurance	20% coinsurance	0	0	Combination of 20% coinsurance and $40 copay	$35 copay	$55 copay	$55 copay	$55 copay	0	0	0	0	0	0	$55 copay	0	$55 copay	0	0	0	0											6.033	0.0187	0.6463	0.2489	0.0966	0.4858	0.0505	0.1018	0.7212	0.3771	0.6623	0	0	0.5153	1.4604	2.0565	0.0538	0.2786	0	0	0	0	0	0	0.378	0	0.0201	0	0	0	0											14.2048	0	0	22.2923	0.018682897	1.894390125	0.24888421	0.966142565	3.400367514	0.353698202	1.018350934	3.419500944	0.377073503	1.421204268	0	0	2.45530147	8.622436886	15.51749935	0.404330072	1.850562924	0	0	0	0	0	0	2.852331994	0	0.151610439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.2646
H3660_806_0	2008	2																					0											D	D	A	V	T	Coin	Coin	P	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1114.92288	8.776353966	149.7746528	0	139.1245294	14.57300363	1.515862647	227.5424417	129.5197429	0	158.019247	0	0	708.8659771	4297.229062	4038.288987	105.1699667	504.4831913	0	0	0	0	0	0	742.2936274	0	39.45524686	0	0	0	0											"1A IP Acute: $175 per day (days 1-10), 1B IP Psych: $175 per day (days 1-10)"	0	2 SNF: $100 per day for days 11-100 only	0	10A Ambulance: $75	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $35"	"9A OP Hospital: $0-$250, 9B ASC Services: $0-$250"	0	"8A OP C/D/T: $0-$50, 8B OP X-Ray: $0-$100"	0	0	"3 CORF: $40, 5 Partial Hosp: $40, Part B Rx: $50"	"7A PCP: $20, 14B through 14I Diabetes Monitoring: $0"	"7B Chiropractic: $40, 7D Physician Specialist: $40, 7F Podiatry: $40, 7G Other Health Care: $40, 16B Comp Dental: $40, 17A Medicare Covered Vision Exams: $40, 18A Medicare Covered Hearing Exams: $40"	"7E Mental Health: $40, 7H Psychiatric: $40, 9C OP Substance Abuse: $40"	"7C Occupational Therapy: $40, 7I Physical and Speech Therapy: $40"	0	0	included in h.5.	0	0	0	17A Routine Eye Exams: $40	0	18A Routine Hearing Exams: $40	0	0	0	0											175	0	100	0	75	0.2	0.199998257	48.3346755	250	0	57.63105508	0	0	32.84197049	20	40	40	37.39077707	0	0	0	0	0	0	40	0	40	0	0	0	0											16.2593	0	1.248122106	0	0.869528309	2.914600726	0.303169887	0.91651584	2.698327977	0	0.758901327	0	0	1.940046292	7.162048436	13.46096329	0.350566556	1.571918211	0	0	0	0	0	0	2.474312091	0	0.13151749	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0598	0	0	16.2593	0	1.248122106	0	0.869528309	2.914600726	0.303169887	0.91651584	2.698327977	0	0.758901327	0	0	1.940046292	7.162048436	13.46096329	0.350566556	1.571918211	0	0	0	0	0	0	2.474312091	0	0.13151749	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0598	0	20% coinsurance	20% coinsurance	$100 copay	20% coinsurance	$75 copay	30% coinsurance	30% coinsurance	"$50 copay for ER, $35 copay for UC"	20% coinsurance	20% coinsurance	20% coinsurance	0	0	Combination of 20% coinsurance and $40 copay	$35 copay	$55 copay	$55 copay	$55 copay	0	0	0	0	0	0	$55 copay	0	$55 copay	0	0	0	0											6.033	0.0187	0.6463	0.2489	0.0966	0.4858	0.0505	0.1018	0.7212	0.3771	0.6623	0	0	0.5153	1.4604	2.0565	0.0538	0.2786	0	0	0	0	0	0	0.378	0	0.0201	0	0	0	0											14.2048	0	0	22.2923	0.018682897	1.894390125	0.24888421	0.966142565	3.400367514	0.353698202	1.018350934	3.419500944	0.377073503	1.421204268	0	0	2.45530147	8.622436886	15.51749935	0.404330072	1.850562924	0	0	0	0	0	0	2.852331994	0	0.151610439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.2646
H3664_001_0	2008	5																																A	A	D		T	Coin	Coin	V	Coin	V	V			V	V	V	V	P	P		Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		330.4225225	5.463384857	764.3977397	0	195.3153274	7.708139826	6.291129839	290.8976372	13.69897753	2784.624055	1346.793873	0	0	251.0673428	3406.5997	8278.754719	147.8367453	126.3594198	1660.960226	0	21.51711822	0	0	0	92.38503631	0	6.276878066	0	0	0	0											$600/Admit for IP Medical$600/Admit for IP Surgical	$600/Admit for IP Psych$600/Admit for IP Substance Abuse	$50/Day for Days 11-30 SNF; $75 for Days 31-100		$75/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $40/Visit for Urgent Care;	20% Coinsurance for OP Fac - ASC	$15/Case for OP Fac - Pathology	$15/Case for OP Fac - Radiology; 15% Coinsurance for Radiation Therapy$15/Case for OP Fac - CT/MRI/PET			$30/Case for OP Fac - Occ Therapy; $30/Case for OP Fac - Physical/Speech Therapy; $30/Case for OP Fac - CORF; $30/Service for Prof - CORF; $30/Service for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Consult for PCP - Consults; $15/Exam for PCP - Routine Physicals;	$30/Visit for Speclst - Office Visits; $30/Consult for Speclst - Consults; $30/Visit for Chiropractor; $30/Exam for Vistion Exams; $30/Service for Podiatrist; $30/Exam for Hearing/Speech Exams; $15/Procedure for Prof Path (Office); $15/Procedure for Prof Path (Labs)	$30/Visit for OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/Visit for OP Substance Abuse;	$30/Service for PT/ST (PCP); $30/Service for Occ Therapy (PCP); $30/Service for PT/ST (Specialist); $30/Service for Occ Therapy (Specialist);	$15/Procedure for Prof Radiology (Office);		15% Coinsurance for Part B Rx				$30/Exam for Vision (Refractions)		$30/Exam for Routine Hearing Exams															600	600	57.89473684	0	75	0.2	0.2	47.79515114	0.2	15	18	0	0	30	15	27.11	30	30	15	0	0.15	0	0	0	30	0	30	0	0	0	0											16.5211	0.273169243	3.687883832	0	1.220720796	1.541627965	1.258225968	1.158624711	2.739795506	3.480780069	2.02019081	0	0	0.627668357	4.258249626	18.7030867	0.369591863	0.315898549	2.076200283	0	3.227567733	0	0	0	0.230962591	0	0.015692195	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7271	0	1.498178625	16.5211	0.273169243	3.687883832	0	1.220720796	1.541627965	1.258225968	1.158624711	2.739795506	3.480780069	2.02019081	0	0	0.627668357	4.258249626	18.7030867	0.369591863	0.315898549	2.076200283	0	3.227567733	0	0	0	0.230962591	0	0.015692195	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7271	4000																																																																																			0	0		16.5211	0.273169243	3.687883832	0	1.220720796	1.541627965	1.258225968	1.158624711	2.739795506	3.480780069	2.02019081	0	0	0.627668357	4.258249626	18.7030867	0.369591863	0.315898549	2.076200283	0	3.227567733	0	0	0	0.230962591	0	0.015692195	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7271
H3664_011_0	2008	5																																A	A	D		T	Coin	Coin	V	Coin	V	V			V	V	V	V	P	P		Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		279.2432761	4.617159491	950.5322829	0	165.0628761	6.514223671	5.316694798	245.8404124	11.57713868	2353.312776	1138.188555	0	0	212.1794447	2786.081054	6915.101709	123.4854957	105.5458543	1388.917863	0	18.18432514	0	0	0	77.16763501	0	5.242968503	0	0	0	0											$800/Admit for IP Medical$800/Admit for IP Surgical	$800/Admit for IP Psych$800/Admit for IP Substance Abuse	$50/Day for Days 5-30 SNF; $75 for Days 31-100		$125/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $40/Visit for Urgent Care;	20% Coinsurance for OP Fac - ASC	$20/Case for OP Fac - Pathology	$20/Case for OP Fac - Radiology; 15% Coinsurance for Radiation Therapy$20/Case for OP Fac - CT/MRI/PET			$35/Case for OP Fac - Occ Therapy; $35/Case for OP Fac - Physical/Speech Therapy; $35/Case for OP Fac - CORF; $35/Service for Prof - CORF; $35/Service for Prof - CORF;	$20/Visit for PCP - Office Visits; $20/Consult for PCP - Consults; $20/Exam for PCP - Routine Physicals;	$35/Visit for Speclst - Office Visits; $35/Consult for Speclst - Consults; $35/Visit for Chiropractor; $35/Exam for Vistion Exams; $35/Service for Podiatrist; $35/Exam for Hearing/Speech Exams; $20/Procedure for Prof Path (Office); $20/Procedure for Prof Path (Labs)	$35/Visit for OP Psych - Non-Physician; $35/Visit for OP Psych - Psychiatrist; $35/Visit for OP Substance Abuse;	$35/Service for PT/ST (PCP); $35/Service for Occ Therapy (PCP); $35/Service for PT/ST (Specialist); $35/Service for Occ Therapy (Specialist);	$20/Procedure for Prof Radiology (Office);		15% Coinsurance for Part B Rx				$35/Exam for Vision (Refractions)		$35/Exam for Routine Hearing Exams															800	800	55.36541431	0	125	0.2	0.2	47.79515114	0.2	20	22.75	0	0	35	20	30.45589213	35	35	20	0	0.15	0	0	0	35	0	35	0	0	0	0											18.6162	0.307810633	4.385551138	0	1.719404959	1.302844734	1.06333896	0.979164972	2.315427735	3.92218796	2.157815802	0	0	0.618856714	4.643468423	17.55046598	0.360166029	0.307842075	2.314863104	0	2.727648771	0	0	0	0.225072269	0	0.015291991	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5334	0	1.611190537	18.6162	0.307810633	4.385551138	0	1.719404959	1.302844734	1.06333896	0.979164972	2.315427735	3.92218796	2.157815802	0	0	0.618856714	4.643468423	17.55046598	0.360166029	0.307842075	2.314863104	0	2.727648771	0	0	0	0.225072269	0	0.015291991	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5334	4000																																																																																			0	0		18.6162	0.307810633	4.385551138	0	1.719404959	1.302844734	1.06333896	0.979164972	2.315427735	3.92218796	2.157815802	0	0	0.618856714	4.643468423	17.55046598	0.360166029	0.307842075	2.314863104	0	2.727648771	0	0	0	0.225072269	0	0.015291991	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5334
H3664_012_0	2008	5																																A	A	D		T	Coin	Coin	V	Coin	V	V			V	V	V	V	P	P		Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		325.1930385	5.376917738	752.2403209	0	192.2241387	7.58614574	6.191562284	286.2937	13.48216851	2740.552765	1325.478628	0	0	247.0937861	3352.684615	8276.534443	148.8806346	127.2516556	1634.672778	0	21.17657417	0	0	0	93.03737583	0	6.321199698	0	0	0	0											$500/Admit for IP Medical$500/Admit for IP Surgical	$500/Admit for IP Psych$500/Admit for IP Substance Abuse	$20/Day for Days 11-30 SNF; $75 for Days 31-100		$75/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $40/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	$15/Case for OP Fac - Pathology	$15/Case for OP Fac - Radiology; 15% Coinsurance for Radiation Therapy$15/Case for OP Fac - CT/MRI/PET			$25/Case for OP Fac - Occ Therapy; $25/Case for OP Fac - Physical/Speech Therapy; $25/Case for OP Fac - CORF; $25/Service for Prof - CORF; $25/Service for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Consult for PCP - Consults; $15/Exam for PCP - Routine Physicals;	$25/Visit for Speclst - Office Visits; $25/Consult for Speclst - Consults; $25/Visit for Chiropractor; $25/Exam for Vistion Exams; $25/Service for Podiatrist; $25/Exam for Hearing/Speech Exams; $15/Procedure for Prof Path (Office); $15/Procedure for Prof Path (Labs)	$25/Visit for OP Psych - Non-Physician; $25/Visit for OP Psych - Psychiatrist; $25/Visit for OP Substance Abuse;	$25/Service for PT/ST (PCP); $25/Service for Occ Therapy (PCP); $25/Service for PT/ST (Specialist); $25/Service for Occ Therapy (Specialist);	$15/Procedure for Prof Radiology (Office);		15% Coinsurance for Part B Rx				$25/Exam for Vision (Refractions)		$25/Exam for Routine Hearing Exams															500	500	37.36842105	0	75	0.2	0.2	47.75879686	0.2	15	18	0	0	25	15	23.1305465	25	25	15	0	0.15	0	0	0	25	0	25	0	0	0	0											13.5497	0.224038239	2.342502754	0	1.201400867	1.517229148	1.238312457	1.139420222	2.696433702	3.425690956	1.988217943	0	0	0.514778721	4.190855769	15.95339706	0.310167989	0.265107616	2.043340973	0	3.176486125	0	0	0	0.193827866	0	0.013169166	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.9841	0	1.070574232	13.5497	0.224038239	2.342502754	0	1.201400867	1.517229148	1.238312457	1.139420222	2.696433702	3.425690956	1.988217943	0	0	0.514778721	4.190855769	15.95339706	0.310167989	0.265107616	2.043340973	0	3.176486125	0	0	0	0.193827866	0	0.013169166	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.9841	4000																																																																																			0	0		13.5497	0.224038239	2.342502754	0	1.201400867	1.517229148	1.238312457	1.139420222	2.696433702	3.425690956	1.988217943	0	0	0.514778721	4.190855769	15.95339706	0.310167989	0.265107616	2.043340973	0	3.176486125	0	0	0	0.193827866	0	0.013169166	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.9841
H3664_013_0	2008	7																																A	A	D		T	Coin	Coin	V	Coin	V	V			V	V	V	V	P	P		Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		429.7196163	7.105216759	994.0592487	0	254.0106132	10.02455542	8.18171195	378.3168898	17.81573279	3621.446782	1751.526325	0	0	326.5169742	4430.335757	10936.8553	196.735236	168.154069	2160.104541	0	27.98334604	0	0	0	122.9423165	0	8.35301863	0	0	0	0											$500/Admit for IP Medical$500/Admit for IP Surgical	$500/Admit for IP Psych$500/Admit for IP Substance Abuse	$20/Day for Days 11-30 SNF; $75 for Days 31-100		$75/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $40/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	$15/Case for OP Fac - Pathology	$15/Case for OP Fac - Radiology; 15% Coinsurance for Radiation Therapy$15/Case for OP Fac - CT/MRI/PET			$25/Case for OP Fac - Occ Therapy; $25/Case for OP Fac - Physical/Speech Therapy; $25/Case for OP Fac - CORF; $25/Service for Prof - CORF; $25/Service for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Consult for PCP - Consults; $15/Exam for PCP - Routine Physicals;	$25/Visit for Speclst - Office Visits; $25/Consult for Speclst - Consults; $25/Visit for Chiropractor; $25/Exam for Vistion Exams; $25/Service for Podiatrist; $25/Exam for Hearing/Speech Exams; $15/Procedure for Prof Path (Office); $15/Procedure for Prof Path (Labs)	$25/Visit for OP Psych - Non-Physician; $25/Visit for OP Psych - Psychiatrist; $25/Visit for OP Substance Abuse;	$25/Service for PT/ST (PCP); $25/Service for Occ Therapy (PCP); $25/Service for PT/ST (Specialist); $25/Service for Occ Therapy (Specialist);	$15/Procedure for Prof Radiology (Office);		15% Coinsurance for Part B Rx				$25/Exam for Vision (Refractions)		$25/Exam for Routine Hearing Exams															500	500	37.36842105	0	75	0.2	0.2	47.75879686	0.2	15	18	0	0	25	15	23.1305465	25	25	15	0	0.15	0	0	0	25	0	25	0	0	0	0											17.905	0.296050698	3.09553538	0	1.587566333	2.004911084	1.63634239	1.505663291	3.563146558	4.526808477	2.627289487	0	0	0.680243696	5.537919696	21.08128666	0.409865075	0.350320977	2.700130676	0	4.197501906	0	0	0	0.256129826	0	0.017402122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9791	0	1.553578929	17.905	0.296050698	3.09553538	0	1.587566333	2.004911084	1.63634239	1.505663291	3.563146558	4.526808477	2.627289487	0	0	0.680243696	5.537919696	21.08128666	0.409865075	0.350320977	2.700130676	0	4.197501906	0	0	0	0.256129826	0	0.017402122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9791	5000																																																																																			0	0		17.905	0.296050698	3.09553538	0	1.587566333	2.004911084	1.63634239	1.505663291	3.563146558	4.526808477	2.627289487	0	0	0.680243696	5.537919696	21.08128666	0.409865075	0.350320977	2.700130676	0	4.197501906	0	0	0	0.256129826	0	0.017402122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9791
H3664_014_0	2008	3																																A	A	D		T	Coin	Coin	V	Coin	V	V			V	V	V	V	P	P		Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		294.461058	4.868778535	1002.332968	0	174.0582255	6.869226078	5.60643607	259.2378551	12.20805224	2481.560092	1200.21585	0	0	223.7424823	2937.912727	7291.950568	130.2150233	111.2977343	1464.609029	0	19.17530727	0	0	0	81.37300123	0	5.52869195	0	0	0	0											$800/Admit for IP Medical$800/Admit for IP Surgical	$800/Admit for IP Psych$800/Admit for IP Substance Abuse	$50/Day for Days 11-30 SNF; $75 for Days 31-100		$125/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $40/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	$20/Case for OP Fac - Pathology	$20/Case for OP Fac - Radiology; 15% Coinsurance for Radiation Therapy$20/Case for OP Fac - CT/MRI/PET			$35/Case for OP Fac - Occ Therapy; $35/Case for OP Fac - Physical/Speech Therapy; $35/Case for OP Fac - CORF; $35/Service for Prof - CORF; $35/Service for Prof - CORF;	$20/Visit for PCP - Office Visits; $20/Consult for PCP - Consults; $20/Exam for PCP - Routine Physicals;	$35/Visit for Speclst - Office Visits; $35/Consult for Speclst - Consults; $35/Visit for Chiropractor; $35/Exam for Vistion Exams; $35/Service for Podiatrist; $35/Exam for Hearing/Speech Exams; $20/Procedure for Prof Path (Office); $20/Procedure for Prof Path (Labs)	$35/Visit for OP Psych - Non-Physician; $35/Visit for OP Psych - Psychiatrist; $35/Visit for OP Substance Abuse;	$35/Service for PT/ST (PCP); $35/Service for Occ Therapy (PCP); $35/Service for PT/ST (Specialist); $35/Service for Occ Therapy (Specialist);	$20/Procedure for Prof Radiology (Office);		15% Coinsurance for Part B Rx				$35/Exam for Vision (Refractions)		$35/Exam for Routine Hearing Exams															800	800	55.36541431	0	125	0.2	0.2	47.79515114	0.2	20	22.75	0	0	35	20	30.45589213	35	35	20	0	0.15	0	0	0	35	0	35	0	0	0	0											19.6307	0.324585236	4.624548337	0	1.813106516	1.373845216	1.121287214	1.032526039	2.441610449	4.135933487	2.275409216	0	0	0.65258224	4.896521212	18.50690499	0.379793818	0.324618392	2.441015048	0	2.87629609	0	0	0	0.23733792	0	0.016125352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1048	0	1.834744589	19.6307	0.324585236	4.624548337	0	1.813106516	1.373845216	1.121287214	1.032526039	2.441610449	4.135933487	2.275409216	0	0	0.65258224	4.896521212	18.50690499	0.379793818	0.324618392	2.441015048	0	2.87629609	0	0	0	0.23733792	0	0.016125352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1048	4000																																																																																			0	0		19.6307	0.324585236	4.624548337	0	1.813106516	1.373845216	1.121287214	1.032526039	2.441610449	4.135933487	2.275409216	0	0	0.65258224	4.896521212	18.50690499	0.379793818	0.324618392	2.441015048	0	2.87629609	0	0	0	0.23733792	0	0.016125352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1048
H3664_016_0	2008	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	V	V	V	P	Coin		Coin	Coin			V		V															8.4528	0.0702	1.1736	0.1526	0.2543	0.2656	0.2168	0.1476	0.4724	0.5978	0.9336	0	0.0153	1.7566	0.6038	1.5022	0.0849	0.0726	0.9309	0	1.6414	0	0	0	0.0531	0	0.0036	0	0	0	0											19.4019		231.4575128	1.920922562	32.13676134	4.178689364	6.964482273	7.274014819	5.935741755	4.042130888	12.93663962	16.36880932	25.5637467	0	0.418779326	44.71834892	3216.134187	6308.455355	139.5627624	119.261069	25.49091551	0	44.94594638	0	0	0	87.21534664	0	5.917533958	0	0	0	0											15% Coinsurance for IP Medical; 15% Coinsurance for IP Surgical	15% Coinsurance for IP Psych; 15% Coinsurance for IP Substance Abuse	15% Coinsurance for SNF	15% Coinsurance for Home Health	15% Coinsurance for Ambulance	15% Coinsurance for DME	15% Coinsurance for Prosthetics/Supplies; 15% Coinsurance for Diabetes Monitoring Supplies; 15% Coinsurance for Prosthetics;	15% Coinsurance for ER - Facility; 15% Coinsurance for Urgent Care;	15% Coinsurance for OP Fac - Surgery; 15% Coinsurance for OP Fac - ASC	15% Coinsurance for OP Fac - Pathology	15% Coinsurance for OP Fac - Radiology; 15% Coinsurance for OP Fac - CT/MRI/PET		15% Coinsurance for Renal Dialysis - Fac; 15% Coinsurance for Renal Dialysis - Prof	15% Coinsurance for OP Fac - Cardiovascular; 15% Coinsurance for OP Fac - Occ Therapy; 15% Coinsurance for OP Fac - Physical/Speech Therapy; 15% Coinsurance for OP Fac - CORF; 15% Coinsurance for OP Fac - Other; $30/Service for Prof - CORF; $30/Service for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Consult for PCP - Consults; $15/Exam for PCP - Routine Physicals; 15% Coinsurance for PCP - Primary Surgeon (IP); 15% Coinsurance for PCP - Asst Surgeon (IP); 15% Coinsurance for PCP - Primary Surgeon (OP); 15% Coinsurance for PCP - Asst Surgeon (OP); 15% Coinsurance for PCP - IP Visits; 15% Coinsurance for PCP - Tx Injections; 15% Coinsurance for PCP - Allergy Testing; 15% Coinsurance for PCP - Allergy Tx; 15% Coinsurance for PCP - ER Visits; 15% Coinsurance for PCP - Immunizations;	$30/Visit for Speclst - Office Visits; 15% Coinsurance for Speclst - Primary Surgeon (IP); 15% Coinsurance for Speclst - Asst Surgeon (IP); 15% Coinsurance for Speclst - Anesthesia (IP); 15% Coinsurance for Speclst - Primary Surgeon (OP); 15% Coinsurance for Speclst - Asst Surgeon (OP); 15% Coinsurance for Speclst - Anesthesia (OP); 15% Coinsurance for Speclst - IP Visits; 15% Coinsurance for Speclst - Tx Injections; 15% Coinsurance for Speclst - Allergy Testing; 15% Coinsurance for Speclst - Allergy Tx; $30/Consult for Speclst - Consults; 15% Coinsurance for Speclst - Immunizations; $30/Visit for Chiropractor; $30/Exam for Vistion Exams; $30/Service for Podiatrist; $30/Exam for Hearing/Speech Exams; 15% Coinsurance for Misc. Medical (PCP); 15% Coinsurance for Misc. Medical; 15% Coinsurance for Prof Path (IP); 15% Coinsurance for Prof Path (OP); 15% Coinsurance for Prof Path (Office); 15% Coinsurance for Prof Path (Labs)	$30/Visit for OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/Visit for OP Substance Abuse;	$30/Service for PT/ST (PCP); $30/Service for Occ Therapy (PCP); $30/Service for PT/ST (Specialist); $30/Service for Occ Therapy (Specialist);	15% Coinsurance for Prof Radiology (Office); 15% Coinsurance for Prof Radiology (OP); 15% Coinsurance for Prof Radiology (IP);	0	15% Coinsurance for Part B Rx	15% Coinsurance for Blood Products			$30/Exam for Vision (Refractions)		$30/Exam for Routine Hearing Exams															0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0	0.15	0.161343181	9.25341896	11.73666829	30	30	0.15	0	0.15	0.15	0	0	30	0	30	0	0	0	0											34.7186	0.288138384	4.820514201	0.626803405	1.044672341	1.091102223	0.890361263	0.606319633	1.940495943	2.455321397	3.834562005	0	0.062816899	7.21500066	2.480019755	6.170020661	0.348906906	0.298152673	3.823637327	0	6.741891957	0	0	0	0.218038367	0	0.014793835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.6902	250	7.843948821	43.1714	0.358290333	5.994146337	0.77940883	1.299014716	1.356748703	1.107134111	0.753937953	2.412941061	3.053109097	4.768148134	0	0.078110689	8.971609246	3.083820669	7.672211967	0.433853935	0.370742762	4.754563667	0	8.383314579	0	0	0	0.271123333	0	0.018395633	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.0921	7500																																																																																			0	0		43.1714	0.358290333	5.994146337	0.77940883	1.299014716	1.356748703	1.107134111	0.753937953	2.412941061	3.053109097	4.768148134	0	0.078110689	8.971609246	3.083820669	7.672211967	0.433853935	0.370742762	4.754563667	0	8.383314579	0	0	0	0.271123333	0	0.018395633	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.0921
H3664_801_0	2008	1																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		209.1159781	3.512427604	21.47550539	4.86410535	4.712407854	6.999789019	6.590679546	3.444496846	11.97287118	16.19597809	26.41463553	0	0.505990627	47.70052295	42.07128758	160.1673324	1.355913882	4.436473154	29.16449222	0	42.2972082	0	0	0	0	0	0	0	0	0	0											8% Coinsurance for IP Medical; 8% Coinsurance for IP Surgical	8% Coinsurance for IP Psych; 8% Coinsurance for IP Substance Abuse	21% Coinsurance for SNF		23% Coinsurance for Ambulance	23% Coinsurance for DME	23% Coinsurance for Prosthetics/Supplies; 23% Coinsurance for Diabetes Monitoring Supplies; 23% Coinsurance for Prosthetics;	23% Coinsurance for ER - Facility; 23% Coinsurance for Urgent Care;	23% Coinsurance for OP Fac - Surgery; 23% Coinsurance for OP Fac - ASC	23% Coinsurance for OP Fac - Pathology	23% Coinsurance for OP Fac - Radiology; 23% Coinsurance for OP Fac - CT/MRI/PET		23% Coinsurance for Renal Dialysis - Fac; 23% Coinsurance for Renal Dialysis - Prof	23% Coinsurance for OP Fac - Cardiovascular; 23% Coinsurance for OP Fac - Occ Therapy; 23% Coinsurance for OP Fac - Physical/Speech Therapy; 23% Coinsurance for OP Fac - CORF; 23% Coinsurance for OP Fac - Other; 23% Coinsurance for Prof - CORF; 23% Coinsurance for Prof - CORF;	23% Coinsurance for PCP - Office Visits; 23% Coinsurance for PCP - Consults; 23% Coinsurance for PCP - Primary Surgeon (IP); 23% Coinsurance for PCP - Asst Surgeon (IP); 23% Coinsurance for PCP - Primary Surgeon (OP); 23% Coinsurance for PCP - Asst Surgeon (OP); 23% Coinsurance for PCP - IP Visits; 23% Coinsurance for PCP - Tx Injections; 23% Coinsurance for PCP - Allergy Testing; 23% Coinsurance for PCP - Allergy Tx; 23% Coinsurance for PCP - ER Visits; 23% Coinsurance for PCP - Cardio; 23% Coinsurance for PCP - Immunizations; 23% Coinsurance for Misc. Medical (PCP);	23% Coinsurance for Speclst - Primary Surgeon (IP); 23% Coinsurance for Speclst - Asst Surgeon (IP); 23% Coinsurance for Speclst - Anesthesia (IP); 23% Coinsurance for Speclst - Primary Surgeon (OP); 23% Coinsurance for Speclst - Asst Surgeon (OP); 23% Coinsurance for Speclst - Anesthesia (OP); 23% Coinsurance for Speclst - IP Visits; 23% Coinsurance for Speclst - Office Visits; 23% Coinsurance for Speclst - Tx Injections; 23% Coinsurance for Speclst - Allergy Testing; 23% Coinsurance for Speclst - Allergy Tx; 23% Coinsurance for Speclst - ER Visits; 23% Coinsurance for Speclst - Consults; 23% Coinsurance for Speclst - Cardio; 23% Coinsurance for Speclst - Immunizations; 23% Coinsurance for Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical; 23% Coinsurance for Prof Path (IP); 23% Coinsurance for Prof Path (OP); 23% Coinsurance for Prof Path (Office); 23% Coinsurance for Prof Path (Labs)	23% Coinsurance for OP Psych - Non-Physician; 23% Coinsurance for OP Psych - Psychiatrist; 23% Coinsurance for OP Substance Abuse;	23% Coinsurance for PT/ST (PCP); 23% Coinsurance for Occ Therapy (PCP); 23% Coinsurance for PT/ST (Specialist); 23% Coinsurance for Occ Therapy (Specialist);	23% Coinsurance for Prof Radiology (Office); 23% Coinsurance for Prof Radiology (OP); 23% Coinsurance for Prof Radiology (IP);		23% Coinsurance for Part B Rx	23% Coinsurance for Blood Products																				0.080191096	0.080191096	0.206681949	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											16.7692	0.281665418	4.438599317	0	1.102703438	1.637950631	1.542219014	0.806012262	2.801651856	3.789858874	6.181024714	0	0.118401807	11.16192237	9.844681293	37.47915578	0.317283848	1.038134718	6.82449118	0	9.897546718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0325	0	0	16.7692	0.281665418	4.438599317	0	1.102703438	1.637950631	1.542219014	0.806012262	2.801651856	3.789858874	6.181024714	0	0.118401807	11.16192237	9.844681293	37.47915578	0.317283848	1.038134718	6.82449118	0	9.897546718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0325																																																																																				0	0		16.7692	0.281665418	4.438599317	0	1.102703438	1.637950631	1.542219014	0.806012262	2.801651856	3.789858874	6.181024714	0	0.118401807	11.16192237	9.844681293	37.47915578	0.317283848	1.038134718	6.82449118	0	9.897546718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0325
H3664_802_0	2008	1																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		209.1159781	3.512427604	21.47550539	4.86410535	4.712407854	6.999789019	6.590679546	3.444496846	11.97287118	16.19597809	26.41463553	0	0.505990627	47.70052295	42.07128758	160.1673324	1.355913882	4.436473154	29.16449222	0	42.2972082	0	0	0	0	0	0	0	0	0	0											8% Coinsurance for IP Medical; 8% Coinsurance for IP Surgical	8% Coinsurance for IP Psych; 8% Coinsurance for IP Substance Abuse	21% Coinsurance for SNF		23% Coinsurance for Ambulance	23% Coinsurance for DME	23% Coinsurance for Prosthetics/Supplies; 23% Coinsurance for Diabetes Monitoring Supplies; 23% Coinsurance for Prosthetics;	23% Coinsurance for ER - Facility; 23% Coinsurance for Urgent Care;	23% Coinsurance for OP Fac - Surgery; 23% Coinsurance for OP Fac - ASC	23% Coinsurance for OP Fac - Pathology	23% Coinsurance for OP Fac - Radiology; 23% Coinsurance for OP Fac - CT/MRI/PET		23% Coinsurance for Renal Dialysis - Fac; 23% Coinsurance for Renal Dialysis - Prof	23% Coinsurance for OP Fac - Cardiovascular; 23% Coinsurance for OP Fac - Occ Therapy; 23% Coinsurance for OP Fac - Physical/Speech Therapy; 23% Coinsurance for OP Fac - CORF; 23% Coinsurance for OP Fac - Other; 23% Coinsurance for Prof - CORF; 23% Coinsurance for Prof - CORF;	23% Coinsurance for PCP - Office Visits; 23% Coinsurance for PCP - Consults; 23% Coinsurance for PCP - Primary Surgeon (IP); 23% Coinsurance for PCP - Asst Surgeon (IP); 23% Coinsurance for PCP - Primary Surgeon (OP); 23% Coinsurance for PCP - Asst Surgeon (OP); 23% Coinsurance for PCP - IP Visits; 23% Coinsurance for PCP - Tx Injections; 23% Coinsurance for PCP - Allergy Testing; 23% Coinsurance for PCP - Allergy Tx; 23% Coinsurance for PCP - ER Visits; 23% Coinsurance for PCP - Cardio; 23% Coinsurance for PCP - Immunizations; 23% Coinsurance for Misc. Medical (PCP);	23% Coinsurance for Speclst - Primary Surgeon (IP); 23% Coinsurance for Speclst - Asst Surgeon (IP); 23% Coinsurance for Speclst - Anesthesia (IP); 23% Coinsurance for Speclst - Primary Surgeon (OP); 23% Coinsurance for Speclst - Asst Surgeon (OP); 23% Coinsurance for Speclst - Anesthesia (OP); 23% Coinsurance for Speclst - IP Visits; 23% Coinsurance for Speclst - Office Visits; 23% Coinsurance for Speclst - Tx Injections; 23% Coinsurance for Speclst - Allergy Testing; 23% Coinsurance for Speclst - Allergy Tx; 23% Coinsurance for Speclst - ER Visits; 23% Coinsurance for Speclst - Consults; 23% Coinsurance for Speclst - Cardio; 23% Coinsurance for Speclst - Immunizations; 23% Coinsurance for Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical; 23% Coinsurance for Prof Path (IP); 23% Coinsurance for Prof Path (OP); 23% Coinsurance for Prof Path (Office); 23% Coinsurance for Prof Path (Labs)	23% Coinsurance for OP Psych - Non-Physician; 23% Coinsurance for OP Psych - Psychiatrist; 23% Coinsurance for OP Substance Abuse;	23% Coinsurance for PT/ST (PCP); 23% Coinsurance for Occ Therapy (PCP); 23% Coinsurance for PT/ST (Specialist); 23% Coinsurance for Occ Therapy (Specialist);	23% Coinsurance for Prof Radiology (Office); 23% Coinsurance for Prof Radiology (OP); 23% Coinsurance for Prof Radiology (IP);		23% Coinsurance for Part B Rx	23% Coinsurance for Blood Products																				0.080191096	0.080191096	0.206681949	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											16.7692	0.281665418	4.438599317	0	1.102703438	1.637950631	1.542219014	0.806012262	2.801651856	3.789858874	6.181024714	0	0.118401807	11.16192237	9.844681293	37.47915578	0.317283848	1.038134718	6.82449118	0	9.897546718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0325	0	0	16.7692	0.281665418	4.438599317	0	1.102703438	1.637950631	1.542219014	0.806012262	2.801651856	3.789858874	6.181024714	0	0.118401807	11.16192237	9.844681293	37.47915578	0.317283848	1.038134718	6.82449118	0	9.897546718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0325																																																																																				0	0		16.7692	0.281665418	4.438599317	0	1.102703438	1.637950631	1.542219014	0.806012262	2.801651856	3.789858874	6.181024714	0	0.118401807	11.16192237	9.844681293	37.47915578	0.317283848	1.038134718	6.82449118	0	9.897546718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0325
H3664_803_0	2008	1																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		209.1159781	3.512427604	21.47550539	4.86410535	4.712407854	6.999789019	6.590679546	3.444496846	11.97287118	16.19597809	26.41463553	0	0.505990627	47.70052295	42.07128758	160.1673324	1.355913882	4.436473154	29.16449222	0	42.2972082	0	0	0	0	0	0	0	0	0	0											8% Coinsurance for IP Medical; 8% Coinsurance for IP Surgical	8% Coinsurance for IP Psych; 8% Coinsurance for IP Substance Abuse	21% Coinsurance for SNF		23% Coinsurance for Ambulance	23% Coinsurance for DME	23% Coinsurance for Prosthetics/Supplies; 23% Coinsurance for Diabetes Monitoring Supplies; 23% Coinsurance for Prosthetics;	23% Coinsurance for ER - Facility; 23% Coinsurance for Urgent Care;	23% Coinsurance for OP Fac - Surgery; 23% Coinsurance for OP Fac - ASC	23% Coinsurance for OP Fac - Pathology	23% Coinsurance for OP Fac - Radiology; 23% Coinsurance for OP Fac - CT/MRI/PET		23% Coinsurance for Renal Dialysis - Fac; 23% Coinsurance for Renal Dialysis - Prof	23% Coinsurance for OP Fac - Cardiovascular; 23% Coinsurance for OP Fac - Occ Therapy; 23% Coinsurance for OP Fac - Physical/Speech Therapy; 23% Coinsurance for OP Fac - CORF; 23% Coinsurance for OP Fac - Other; 23% Coinsurance for Prof - CORF; 23% Coinsurance for Prof - CORF;	23% Coinsurance for PCP - Office Visits; 23% Coinsurance for PCP - Consults; 23% Coinsurance for PCP - Primary Surgeon (IP); 23% Coinsurance for PCP - Asst Surgeon (IP); 23% Coinsurance for PCP - Primary Surgeon (OP); 23% Coinsurance for PCP - Asst Surgeon (OP); 23% Coinsurance for PCP - IP Visits; 23% Coinsurance for PCP - Tx Injections; 23% Coinsurance for PCP - Allergy Testing; 23% Coinsurance for PCP - Allergy Tx; 23% Coinsurance for PCP - ER Visits; 23% Coinsurance for PCP - Cardio; 23% Coinsurance for PCP - Immunizations; 23% Coinsurance for Misc. Medical (PCP);	23% Coinsurance for Speclst - Primary Surgeon (IP); 23% Coinsurance for Speclst - Asst Surgeon (IP); 23% Coinsurance for Speclst - Anesthesia (IP); 23% Coinsurance for Speclst - Primary Surgeon (OP); 23% Coinsurance for Speclst - Asst Surgeon (OP); 23% Coinsurance for Speclst - Anesthesia (OP); 23% Coinsurance for Speclst - IP Visits; 23% Coinsurance for Speclst - Office Visits; 23% Coinsurance for Speclst - Tx Injections; 23% Coinsurance for Speclst - Allergy Testing; 23% Coinsurance for Speclst - Allergy Tx; 23% Coinsurance for Speclst - ER Visits; 23% Coinsurance for Speclst - Consults; 23% Coinsurance for Speclst - Cardio; 23% Coinsurance for Speclst - Immunizations; 23% Coinsurance for Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical; 23% Coinsurance for Prof Path (IP); 23% Coinsurance for Prof Path (OP); 23% Coinsurance for Prof Path (Office); 23% Coinsurance for Prof Path (Labs)	23% Coinsurance for OP Psych - Non-Physician; 23% Coinsurance for OP Psych - Psychiatrist; 23% Coinsurance for OP Substance Abuse;	23% Coinsurance for PT/ST (PCP); 23% Coinsurance for Occ Therapy (PCP); 23% Coinsurance for PT/ST (Specialist); 23% Coinsurance for Occ Therapy (Specialist);	23% Coinsurance for Prof Radiology (Office); 23% Coinsurance for Prof Radiology (OP); 23% Coinsurance for Prof Radiology (IP);		23% Coinsurance for Part B Rx	23% Coinsurance for Blood Products																				0.080191096	0.080191096	0.206681949	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											16.7692	0.281665418	4.438599317	0	1.102703438	1.637950631	1.542219014	0.806012262	2.801651856	3.789858874	6.181024714	0	0.118401807	11.16192237	9.844681293	37.47915578	0.317283848	1.038134718	6.82449118	0	9.897546718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0325	0	0	16.7692	0.281665418	4.438599317	0	1.102703438	1.637950631	1.542219014	0.806012262	2.801651856	3.789858874	6.181024714	0	0.118401807	11.16192237	9.844681293	37.47915578	0.317283848	1.038134718	6.82449118	0	9.897546718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0325																																																																																				0	0		16.7692	0.281665418	4.438599317	0	1.102703438	1.637950631	1.542219014	0.806012262	2.801651856	3.789858874	6.181024714	0	0.118401807	11.16192237	9.844681293	37.47915578	0.317283848	1.038134718	6.82449118	0	9.897546718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0325
H3664_804_0	2008	1																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		209.1159781	3.512427604	21.47550539	4.86410535	4.712407854	6.999789019	6.590679546	3.444496846	11.97287118	16.19597809	26.41463553	0	0.505990627	47.70052295	42.07128758	160.1673324	1.355913882	4.436473154	29.16449222	0	42.2972082	0	0	0	0	0	0	0	0	0	0											8% Coinsurance for IP Medical; 8% Coinsurance for IP Surgical	8% Coinsurance for IP Psych; 8% Coinsurance for IP Substance Abuse	21% Coinsurance for SNF		23% Coinsurance for Ambulance	23% Coinsurance for DME	23% Coinsurance for Prosthetics/Supplies; 23% Coinsurance for Diabetes Monitoring Supplies; 23% Coinsurance for Prosthetics;	23% Coinsurance for ER - Facility; 23% Coinsurance for Urgent Care;	23% Coinsurance for OP Fac - Surgery; 23% Coinsurance for OP Fac - ASC	23% Coinsurance for OP Fac - Pathology	23% Coinsurance for OP Fac - Radiology; 23% Coinsurance for OP Fac - CT/MRI/PET		23% Coinsurance for Renal Dialysis - Fac; 23% Coinsurance for Renal Dialysis - Prof	23% Coinsurance for OP Fac - Cardiovascular; 23% Coinsurance for OP Fac - Occ Therapy; 23% Coinsurance for OP Fac - Physical/Speech Therapy; 23% Coinsurance for OP Fac - CORF; 23% Coinsurance for OP Fac - Other; 23% Coinsurance for Prof - CORF; 23% Coinsurance for Prof - CORF;	23% Coinsurance for PCP - Office Visits; 23% Coinsurance for PCP - Consults; 23% Coinsurance for PCP - Primary Surgeon (IP); 23% Coinsurance for PCP - Asst Surgeon (IP); 23% Coinsurance for PCP - Primary Surgeon (OP); 23% Coinsurance for PCP - Asst Surgeon (OP); 23% Coinsurance for PCP - IP Visits; 23% Coinsurance for PCP - Tx Injections; 23% Coinsurance for PCP - Allergy Testing; 23% Coinsurance for PCP - Allergy Tx; 23% Coinsurance for PCP - ER Visits; 23% Coinsurance for PCP - Cardio; 23% Coinsurance for PCP - Immunizations; 23% Coinsurance for Misc. Medical (PCP);	23% Coinsurance for Speclst - Primary Surgeon (IP); 23% Coinsurance for Speclst - Asst Surgeon (IP); 23% Coinsurance for Speclst - Anesthesia (IP); 23% Coinsurance for Speclst - Primary Surgeon (OP); 23% Coinsurance for Speclst - Asst Surgeon (OP); 23% Coinsurance for Speclst - Anesthesia (OP); 23% Coinsurance for Speclst - IP Visits; 23% Coinsurance for Speclst - Office Visits; 23% Coinsurance for Speclst - Tx Injections; 23% Coinsurance for Speclst - Allergy Testing; 23% Coinsurance for Speclst - Allergy Tx; 23% Coinsurance for Speclst - ER Visits; 23% Coinsurance for Speclst - Consults; 23% Coinsurance for Speclst - Cardio; 23% Coinsurance for Speclst - Immunizations; 23% Coinsurance for Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical; 23% Coinsurance for Prof Path (IP); 23% Coinsurance for Prof Path (OP); 23% Coinsurance for Prof Path (Office); 23% Coinsurance for Prof Path (Labs)	23% Coinsurance for OP Psych - Non-Physician; 23% Coinsurance for OP Psych - Psychiatrist; 23% Coinsurance for OP Substance Abuse;	23% Coinsurance for PT/ST (PCP); 23% Coinsurance for Occ Therapy (PCP); 23% Coinsurance for PT/ST (Specialist); 23% Coinsurance for Occ Therapy (Specialist);	23% Coinsurance for Prof Radiology (Office); 23% Coinsurance for Prof Radiology (OP); 23% Coinsurance for Prof Radiology (IP);		23% Coinsurance for Part B Rx	23% Coinsurance for Blood Products																				0.080191096	0.080191096	0.206681949	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											16.7692	0.281665418	4.438599317	0	1.102703438	1.637950631	1.542219014	0.806012262	2.801651856	3.789858874	6.181024714	0	0.118401807	11.16192237	9.844681293	37.47915578	0.317283848	1.038134718	6.82449118	0	9.897546718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0325	0	0	16.7692	0.281665418	4.438599317	0	1.102703438	1.637950631	1.542219014	0.806012262	2.801651856	3.789858874	6.181024714	0	0.118401807	11.16192237	9.844681293	37.47915578	0.317283848	1.038134718	6.82449118	0	9.897546718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0325																																																																																				0	0		16.7692	0.281665418	4.438599317	0	1.102703438	1.637950631	1.542219014	0.806012262	2.801651856	3.789858874	6.181024714	0	0.118401807	11.16192237	9.844681293	37.47915578	0.317283848	1.038134718	6.82449118	0	9.897546718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0325
H3668_005_0	2008	7																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	73.02	0	235.96	5.75	4.00687163	390.6	434.96	0	1290.29	180.31	0.43	533.94	4356.62	4015.77	63.55	434.67	482.06	1321.13	564.54	626.95	0	0	332.83	0	142.64	0	0	0	0											PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: $200 per admit	6 Home Health: $0	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $15	8A OP C/D/T: $0	8B OP X-Ray: $10-$25	9A OP Hospital: $15	12 Renal Dialysis: $15	"3 CORF: $15, 5 Partial Hosp: $15, 9C OP Substance Abuse: $25, 9D Cardiac Rehab: $15"	"7A PCP: $10, 14B Immunizations: $10, 14C Routine Physical Exams: $0, 14D Pap Smears: $10-$25, 14D Pelvic Exams: $10-$25, 14E Prostate Screening: $10-$25, 14F Colorectal Screening: $10-$25, 14G Bone Mass Measurement: $10-$25, 14H Mammography: $10-$25, 14I Diabetes Monitoring: $10-$25, 14J Nutrition THerapy: $10-$25"	7D Physician Specialist: $25	"7E Mental Health: $25, 7H Psychiatric: $25"	"7C Occupational Therapy: $10- $25, 7I Physical and Speech Therapy: $10-$25"	8B OP X-Rays: $10-$25	"7B Chiropractic: $25, 7F Podiatry: $25, 7G Other Health Care: $10-$25, 18A Medicare Covered Hearing Exams: $25"	15 Part B Drugs: 5%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $25, 17A Medicare Covered Eye Exams: $25"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $25	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $25	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	200	0	50	0.199997226	0.199778379	43.20020481	15	0	25	15	15	15	10	25	25	25	25	25	24.6	25	0	0	25	0	25	0	0	0	0											0	0	1.217	0	0.983166667	1.14998405	0.800486318	1.406166667	0.5437	0	2.688104167	0.2253875	0.0005375	0.667425	3.630516667	8.3661875	0.132395833	0.9055625	1.004291667	2.752354167	1.157307	1.306145833	0	0	0.693395833	0	0.297166667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9273	0	0	0	0	1.217	0	0.983166667	1.14998405	0.800486318	1.406166667	0.5437	0	2.688104167	0.2253875	0.0005375	0.667425	3.630516667	8.3661875	0.132395833	0.9055625	1.004291667	2.752354167	1.157307	1.306145833	0	0	0.693395833	0	0.297166667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	1.217	0	0.983166667	1.14998405	0.800486318	1.406166667	0.5437	0	2.688104167	0.2253875	0.0005375	0.667425	3.630516667	8.3661875	0.132395833	0.9055625	1.004291667	2.752354167	1.157307	1.306145833	0	0	0.693395833	0	0.297166667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9273
H3668_010_0	2008	6																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	73.75695	0	238.31565	5.8089	4.043918282	394.5027	439.3257	0	1303.21365	182.11605	0.43215	539.29305	4400.28195	4056.0192	64.18935	439.03425	486.89235	1334.36865	570.1968	633.2304	0	0	336.16245	0	144.06675	0	0	0	0											PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: $200 per admit	6 Home Health: $0	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $15	8A OP C/D/T: $0	8B OP X-Ray: $10-$25	9A OP Hospital: $15	12 Renal Dialysis: $15	"3 CORF: $15, 5 Partial Hosp: $15, 9C OP Substance Abuse: $25, 9D Cardiac Rehab: $15"	"7A PCP: $10, 14B Immunizations: $10, 14C Routine Physical Exams: $0, 14D Pap Smears: $10-$25, 14D Pelvic Exams: $10-$25, 14E Prostate Screening: $10-$25, 14F Colorectal Screening: $10-$25, 14G Bone Mass Measurement: $10-$25, 14H Mammography: $10-$25, 14I Diabetes Monitoring: $10-$25, 14J Nutrition THerapy: $10-$25"	7D Physician Specialist: $25	"7E Mental Health: $25, 7H Psychiatric: $25"	"7C Occupational Therapy: $10- $25, 7I Physical and Speech Therapy: $10-$25"	8B OP X-Rays: $10-$25	"7B Chiropractic: $25, 7F Podiatry: $25, 7G Other Health Care: $10-$25, 18A Medicare Covered Hearing Exams: $25"	15 Part B Drugs: 5%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $25, 17A Medicare Covered Eye Exams: $25"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $25	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $25	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	200	0	50	0.200000903	0.199936438	43.20005605	15	0	25	15	15	15	10	25	25	25	25	25	24.6	25	0	0	25	0	25	0	0	0	0											0	0	1.2292825	0	0.992981875	1.161785243	0.808526619	1.420211563	0.549157125	0	2.715028438	0.227645063	0.000540188	0.674116313	3.666901625	8.45004	0.133727813	0.914654688	1.014359063	2.779934688	1.16890344	1.31923	0	0	0.700338438	0	0.300139063	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2275	0	0	0	0	1.2292825	0	0.992981875	1.161785243	0.808526619	1.420211563	0.549157125	0	2.715028438	0.227645063	0.000540188	0.674116313	3.666901625	8.45004	0.133727813	0.914654688	1.014359063	2.779934688	1.16890344	1.31923	0	0	0.700338438	0	0.300139063	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2275	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	1.2292825	0	0.992981875	1.161785243	0.808526619	1.420211563	0.549157125	0	2.715028438	0.227645063	0.000540188	0.674116313	3.666901625	8.45004	0.133727813	0.914654688	1.014359063	2.779934688	1.16890344	1.31923	0	0	0.700338438	0	0.300139063	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2275
H3668_011_0	2008	5																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	248.16	3.12	73.02	0	235.96	5.75	4.00687163	392.29	434.96	0	1290.29	180.31	0.43	533.94	4310.17	3977.43	63.55	434.67	478.26	1321.13	564.54	626.95	0	0	332.83	0	142.64	0	0	0	0											PBP: 1A IP Acute: $600 per admit	1B IP Psych: $600 per admit	2 SNF: $400 per admit	6 Home Health: $0	10A Ambulance: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $200	8A OP C/D/T: $0	8B OP X-Ray: $10-$30	9A OP Hospital: $30	12 Renal Dialysis: $30	"3 CORF: $30, 5 Partial Hosp: $30, 9C OP Substance Abuse: $30, 9D Cardiac Rehab: $30"	"7A PCP: $10, 14B Immunizations: $10, 14C Routine Physical Exams: $0, 14D Pap Smears: $10-$30, 14D Pelvic Exams: $10-$30, 14E Prostate Screening: $10-$30, 14F Colorectal Screening: $10-$30, 14G Bone Mass Measurement: $10-$30, 14H Mammography: $10-$30, 14I Diabetes Monitoring: $10-$30, 14J Nutrition THerapy: $10-$30"	7D Physician Specialist: $30	7E Mental Health: $30 7H Psychiatric: $30	"7C Occupational Therapy: $10-$30, 7I Physical and Speech Therapy: $10-$30"	8B OP X-Rays: $30	"7B Chiropractic: $30, 7F Podiatry: $30, 7G Other Health Care: $10-$30, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $30, 17A Medicare Covered Eye Exams: $30"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $30	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $30	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											582.6904933	582.6904933	388.4603289	0	97.11508222	0.194227471	0.194014937	43.35433736	194.2301644	0	29.13452466	29.13452466	29.13452466	29.13452466	9.711508222	29.13452466	29.13452466	29.13452466	29.13452466	29.13452466	47.78062045	29.13452466	0	0	29.13452466	0	29.13452466	0	0	0	0											12.05	0.151499528	2.363781101	0	1.909606233	1.116807956	0.777392946	1.417289417	7.040196027	0	3.132665486	0.437770512	0.001043987	1.296340675	3.488187616	9.656711036	0.154291587	1.05532532	1.161156481	3.207541214	2.247839289	1.52215752	0	0	0.80807032	0	0.346312383	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.342	0	1.644	12.05	0.151499528	2.363781101	0	1.909606233	1.116807956	0.777392946	1.417289417	7.040196027	0	3.132665486	0.437770512	0.001043987	1.296340675	3.488187616	9.656711036	0.154291587	1.05532532	1.161156481	3.207541214	2.247839289	1.52215752	0	0	0.80807032	0	0.346312383	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.342	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.05	0.151499528	2.363781101	0	1.909606233	1.116807956	0.777392946	1.417289417	7.040196027	0	3.132665486	0.437770512	0.001043987	1.296340675	3.488187616	9.656711036	0.154291587	1.05532532	1.161156481	3.207541214	2.247839289	1.52215752	0	0	0.80807032	0	0.346312383	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.342
H3668_012_0	2008	3																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	250.647	3.1557	73.75695	0	238.31565	5.8089	4.043918282	396.2112	439.3257	0	1303.21365	182.11605	0.43215	539.29305	4353.38865	4017.3066	64.18935	439.03425	483.05325	1334.36865	570.1968	633.2304	0	0	336.16245	0	144.06675	0	0	0	0											PBP: 1A IP Acute: $600 per admit	1B IP Psych: $600 per admit	2 SNF: $400 per admit	6 Home Health: $0	10A Ambulance: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $200	8A OP C/D/T: $0	8B OP X-Ray: $10-$30	9A OP Hospital: $30	12 Renal Dialysis: $30	"3 CORF: $30, 5 Partial Hosp: $30, 9C OP Substance Abuse: $30, 9D Cardiac Rehab: $30"	"7A PCP: $10, 14B Immunizations: $10, 14C Routine Physical Exams: $0, 14D Pap Smears: $10-$30, 14D Pelvic Exams: $10-$30, 14E Prostate Screening: $10-$30, 14F Colorectal Screening: $10-$30, 14G Bone Mass Measurement: $10-$30, 14H Mammography: $10-$30, 14I Diabetes Monitoring: $10-$30, 14J Nutrition THerapy: $10-$30"	7D Physician Specialist: $30	7E Mental Health: $30 7H Psychiatric: $30	"7C Occupational Therapy: $10-$30, 7I Physical and Speech Therapy: $10-$30"	8B OP X-Rays: $30	"7B Chiropractic: $30, 7F Podiatry: $30, 7G Other Health Care: $10-$30, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $30, 17A Medicare Covered Eye Exams: $30"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $30	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $30	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											582.6301021	582.6301021	388.420068	0	97.10501701	0.19421091	0.194148313	43.3499614	194.210034	0	29.1315051	29.1315051	29.1315051	29.1315051	9.710501701	29.1315051	29.1315051	29.1315051	29.1315051	29.1315051	47.77566837	29.1315051	0	0	29.1315051	0	29.1315051	0	0	0	0											12.1695	0.153217151	2.387389961	0	1.928470437	1.128151758	0.785119911	1.431311686	7.110121595	0	3.163714591	0.442109553	0.001049098	1.30920152	3.522798991	9.752515643	0.155827698	1.065810708	1.172672351	3.239347261	2.270127768	1.537246219	0	0	0.816076511	0	0.349740105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8916	0	1.658	12.1695	0.153217151	2.387389961	0	1.928470437	1.128151758	0.785119911	1.431311686	7.110121595	0	3.163714591	0.442109553	0.001049098	1.30920152	3.522798991	9.752515643	0.155827698	1.065810708	1.172672351	3.239347261	2.270127768	1.537246219	0	0	0.816076511	0	0.349740105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8916	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.1695	0.153217151	2.387389961	0	1.928470437	1.128151758	0.785119911	1.431311686	7.110121595	0	3.163714591	0.442109553	0.001049098	1.30920152	3.522798991	9.752515643	0.155827698	1.065810708	1.172672351	3.239347261	2.270127768	1.537246219	0	0	0.816076511	0	0.349740105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8916
H3668_013_0	2008	2																					0											A	A	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $0	1B IP Psych: $0	2 SNF: $0	6 Home Health: $0	10A Ambulance: $0	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $0"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, 14J Nutrition THerapy: $0"	7D Physician Specialist: $0	"7E Mental Health: $0, 7H Psychiatric: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	8B OP X-Rays: $0	"7B Chiropractic: $0, 7F Podiatry: $0, 7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H3668_801_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	226.4819172	1.210170545	23.00070834	19.32577646	6.42336951	5.755933927	4.01100667	12.7080398	42.82426486	4.631217763	43.02131231	39.91049433	0.080021041	13.5570499	40.69702092	111.3193299	0.509768345	3.325299177	18.83084895	30.51244716	23.16886043	6.437523042	0	0	0	0	0	0	0	0	0											Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing																				0.076869147	0.077002114	0.187458554	0	0.233923834	0.233996633	0.233740706	0.234039167	0.233998944	0.233826725	0.233994176	0.234000278	0.234000177	0.234044587	0.234010447	0.234066231	0.234005812	0.234024847	0.233996176	0.233708741	0.23406209	0.233997205	0	0	0	0	0	0	0	0	0											17.4095	0.093185691	4.311679515	0	1.502579225	1.346869161	0.937535533	2.974179045	10.02083277	1.082902483	10.06673651	9.339066749	0.018724938	3.172954151	9.523528074	26.05609595	0.119288756	0.778202632	4.40634665	7.131025612	5.422951892	1.506362402	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.2205	0	0	17.4095	0.093185691	4.311679515	0	1.502579225	1.346869161	0.937535533	2.974179045	10.02083277	1.082902483	10.06673651	9.339066749	0.018724938	3.172954151	9.523528074	26.05609595	0.119288756	0.778202632	4.40634665	7.131025612	5.422951892	1.506362402	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.2205	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.4095	0.093185691	4.311679515	0	1.502579225	1.346869161	0.937535533	2.974179045	10.02083277	1.082902483	10.06673651	9.339066749	0.018724938	3.172954151	9.523528074	26.05609595	0.119288756	0.778202632	4.40634665	7.131025612	5.422951892	1.506362402	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.2205
H3668_802_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	226.4819172	1.210170545	23.00070834	19.32577646	6.42336951	5.755933927	4.01100667	12.7080398	42.82426486	4.631217763	43.02131231	39.91049433	0.080021041	13.5570499	40.69702092	111.3193299	0.509768345	3.325299177	18.83084895	30.51244716	23.16886043	6.437523042	0	0	0	0	0	0	0	0	0											Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing																				0.076869147	0.077002114	0.187458554	0	0.233923834	0.233996633	0.233740706	0.234039167	0.233998944	0.233826725	0.233994176	0.234000278	0.234000177	0.234044587	0.234010447	0.234066231	0.234005812	0.234024847	0.233996176	0.233708741	0.23406209	0.233997205	0	0	0	0	0	0	0	0	0											17.4095	0.093185691	4.311679515	0	1.502579225	1.346869161	0.937535533	2.974179045	10.02083277	1.082902483	10.06673651	9.339066749	0.018724938	3.172954151	9.523528074	26.05609595	0.119288756	0.778202632	4.40634665	7.131025612	5.422951892	1.506362402	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.2205	0	0	17.4095	0.093185691	4.311679515	0	1.502579225	1.346869161	0.937535533	2.974179045	10.02083277	1.082902483	10.06673651	9.339066749	0.018724938	3.172954151	9.523528074	26.05609595	0.119288756	0.778202632	4.40634665	7.131025612	5.422951892	1.506362402	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.2205	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.4095	0.093185691	4.311679515	0	1.502579225	1.346869161	0.937535533	2.974179045	10.02083277	1.082902483	10.06673651	9.339066749	0.018724938	3.172954151	9.523528074	26.05609595	0.119288756	0.778202632	4.40634665	7.131025612	5.422951892	1.506362402	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.2205
H3672_013_0	2008	4																					3250											D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1878.6	57.5	1764.4	362.6	293	14.48223187	0	351.3	422	7929.8	637.6	252.7	456.2	4979.5	4249.5	3390.8	135.9	234.7	97.2	0	25.91265242	0	0	0	126	0	0.7	0	0	0	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	"$50 Scans, $25 Rad Ther"	$0.00 	$0.00 	$0.00 	"$15.00, $0.00 Prev."	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	"20%, 10% Chemo, $5 Diab Supp"	$0.00 	$0.00 	$0.00 	$15.00 	$0.00 	$25.00 	$0.00 	$0.00 	$0.00 	$0.00 											40.38444706	40.38444706	5.942771672	0	23.54778254	0.18838226	0.18838226	47.09556508	94.19113016	0	7.064334762	0	0	0	14.12866952	23.54778254	23.54778254	23.54778254	0	0	0.169544034	0	0	0	14.12866952	0	23.54778254	0	0	0	0											6.3222	0.193508809	0.873785528	0	0.574958357	2.728195573	0	1.378722668	3.312388077	0	0.375351654	0	0	0	5.003315095	6.65381842	0.266678637	0.46055538	0	0	4.39333563	0	0	0	0.14835103	0	0.001373621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.6865		2.015813604	6.3222	0.193508809	0.873785528	0	0.574958357	2.728195573	0	1.378722668	3.312388077	0	0.375351654	0	0	0	5.003315095	6.65381842	0.266678637	0.46055538	0	0	4.39333563	0	0	0	0.14835103	0	0.001373621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.6865	0																																																																																			0		0	6.3222	0.193508809	0.873785528	0	0.574958357	2.728195573	0	1.378722668	3.312388077	0	0.375351654	0	0	0	5.003315095	6.65381842	0.266678637	0.46055538	0	0	4.39333563	0	0	0	0.14835103	0	0.001373621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.6865
H3672_014_0	2008	3																					3250											D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1615.9	23.4	1268.9	348.9	228.5	10.85909017	0	308.7	369	6627.6	576.1	192.7	186.1	4277.4	3700	3129	76.1	183.1	72.5	0	11.55885035	0	0	0	103.4	0	0.3	0	0	0	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	"$50 Scans, $25 Rad Ther"	$0.00 	$0.00 	$0.00 	"$15.00, $0.00 Prev."	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	"20%, 10% Chemo, $5 Diab Supp"	$0.00 	$0.00 	$0.00 	$15.00 	$0.00 	$25.00 	$0.00 	$0.00 	$0.00 	$0.00 											40.38444706	40.38444706	5.942771672	0	23.54778254	0.18838226	0.18838226	47.09556508	94.19113016	0	7.064334762	0	0	0	14.12866952	23.54778254	23.54778254	23.54778254	0	0	0.169544034	0	0	0	14.12866952	0	23.54778254	0	0	0	0											5.4381	0.078749672	0.628398581	0	0.448389026	2.045659952	0	1.211533412	2.896377252	0	0.339146938	0	0	0	4.35633977	6.140084297	0.149332188	0.359299915	0	0	1.959734119	0	0	0	0.121742036	0	0.000588695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.1735		1.614146978	5.4381	0.078749672	0.628398581	0	0.448389026	2.045659952	0	1.211533412	2.896377252	0	0.339146938	0	0	0	4.35633977	6.140084297	0.149332188	0.359299915	0	0	1.959734119	0	0	0	0.121742036	0	0.000588695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.1735	0																																																																																			0		0	5.4381	0.078749672	0.628398581	0	0.448389026	2.045659952	0	1.211533412	2.896377252	0	0.339146938	0	0	0	4.35633977	6.140084297	0.149332188	0.359299915	0	0	1.959734119	0	0	0	0.121742036	0	0.000588695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.1735
H3672_804_0	2008	3																					3250											D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1739.6	31.9	1233.1	234.8	225.1	11.59938286	0	330.4	416.7	7183.5	671.6	204.5	302	4540.5	4192.7	3359.6	87.1	269.3	94.5	0	28.15436177	0	0	0	127.2	0	0.4	0	0	0	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	"$50 Scans, $25 Rad Ther"	$0.00 	$0.00 	$0.00 	"$15.00, $0.00 Prev."	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	"20%, 10% Chemo, $5 Diab Supp"	$0.00 	$0.00 	$0.00 	$15.00 	$0.00 	$25.00 	$0.00 	$0.00 	$0.00 	$0.00 											40.38444706	40.38444706	5.942771672	0	23.54778254	0.18838226	0.18838226	47.09556508	94.19113016	0	7.064334762	0	0	0	14.12866952	23.54778254	23.54778254	23.54778254	0	0	0.169544034	0	0	0	14.12866952	0	23.54778254	0	0	0	0											5.8544	0.107355322	0.610669312	0	0.441717154	2.185117962	0	1.296697892	3.270786995	0	0.395367269	0	0	0	4.936439393	6.592594185	0.170917655	0.528451486	0	0	4.773404078	0	0	0	0.149763897	0	0.000784926	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.3145		1.931197322	5.8544	0.107355322	0.610669312	0	0.441717154	2.185117962	0	1.296697892	3.270786995	0	0.395367269	0	0	0	4.936439393	6.592594185	0.170917655	0.528451486	0	0	4.773404078	0	0	0	0.149763897	0	0.000784926	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.3145	0																																																																																			0		0	5.8544	0.107355322	0.610669312	0	0.441717154	2.185117962	0	1.296697892	3.270786995	0	0.395367269	0	0	0	4.936439393	6.592594185	0.170917655	0.528451486	0	0	4.773404078	0	0	0	0.149763897	0	0.000784926	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.3145
H3672_805_0	2008	3																					3250											D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1743.5	53.3	1637.5	336.5	271.9	13.44063859	0	326	391.7	7359.5	591.7	234.5	423.4	4621.4	3943.9	3146.9	126.2	217.8	90.2	0	24.04895871	0	0	0	116.9	0	0.6	0	0	0	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	"$50 Scans, $25 Rad Ther"	$0.00 	$0.00 	$0.00 	"$15.00, $0.00 Prev."	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	"20%, 10% Chemo, $5 Diab Supp"	$0.00 	$0.00 	$0.00 	$15.00 	$0.00 	$25.00 	$0.00 	$0.00 	$0.00 	$0.00 											40.38444706	40.38444706	5.942771672	0	23.54778254	0.18838226	0.18838226	47.09556508	94.19113016	0	7.064334762	0	0	0	14.12866952	23.54778254	23.54778254	23.54778254	0	0	0.169544034	0	0	0	14.12866952	0	23.54778254	0	0	0	0											5.8675	0.179374252	0.810940718	0	0.533553506	2.531977878	0	1.279429518	3.074555474	0	0.348330573	0	0	0	4.643504978	6.17520974	0.24764418	0.427392253	0	0	4.07735748	0	0	0	0.137636789	0	0.001177389	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.3356		1.870830089	5.8675	0.179374252	0.810940718	0	0.533553506	2.531977878	0	1.279429518	3.074555474	0	0.348330573	0	0	0	4.643504978	6.17520974	0.24764418	0.427392253	0	0	4.07735748	0	0	0	0.137636789	0	0.001177389	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.3356	0																																																																																			0		0	5.8675	0.179374252	0.810940718	0	0.533553506	2.531977878	0	1.279429518	3.074555474	0	0.348330573	0	0	0	4.643504978	6.17520974	0.24764418	0.427392253	0	0	4.07735748	0	0	0	0.137636789	0	0.001177389	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.3356
H3706_001_0	2008	5																					2500											A	A	D		T	Coin	Coin	V	V		Coin		Coin	V		V	V	P	Coin	V	Coin																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		291.87064	4.513305719	526.0951122	0	246.0237518	14.45503739	1.983881786	346.6513401	248.0001751	0	16.56498457	0	0.374123113	558.3307491	0	3500.845978	154.7862105	392.1561156	25.08527049	1770.736542	8.407318151	0	0	0	0	0	0	0	0	0	0											$195/admit	$195/admit	copay for days 21-100		$50/trip	20% coinsurance	"20% coins prosthetics, diab monit. Supplies"	$50 ER and urgent care	$250 surgery/ASC		20% coinsurance		20% coinsurance	"$25 cardio, PT/OT/ST"		$25/visit	$25/visit	$25/visit	20% coinsurance	"$25 chiro, pod, vision, hearing"	20% coinsurance																					194.0096708	194.0096707	104.4667458	0	49.74606945	0.198984278	0.198984278	49.74606945	248.7303472	0	0.198984278	0	0.198984278	24.87303472	0	24.87303472	24.87303472	24.87303472	0.198984278	24.87303472	0.198984278	0	0	0	0	0	0	0	0	0	0											4.7188	0.072968746	4.579953698	0	1.019892887	2.876325176	0.394761285	1.437045136	5.140430805	0	3.296171492	0	0.074444617	1.157281676	0	7.256388632	0.320833566	0.812842723	4.991574431	3.670299292	1.67292413	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4929	0	0.222011279	4.7188	0.072968746	4.579953698	0	1.019892887	2.876325176	0.394761285	1.437045136	5.140430805	0	3.296171492	0	0.074444617	1.157281676	0	7.256388632	0.320833566	0.812842723	4.991574431	3.670299292	1.67292413	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4929																																																																																				0	0		4.7188	0.072968746	4.579953698	0	1.019892887	2.876325176	0.394761285	1.437045136	5.140430805	0	3.296171492	0	0.074444617	1.157281676	0	7.256388632	0.320833566	0.812842723	4.991574431	3.670299292	1.67292413	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4929
H3706_006_0	2008	5																					2500											D	D	D		T	Coin	Coin	V	V		Coin		Coin	V	V	V	V	P	Coin	V	Coin																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		759.7461694	23.09117755	465.5979756	0	204.3480119	13.84923132	1.958413472	318.8804195	236.6371046	0	25.50759332	0	0.387883331	523.2596214	3899.237637	3374.852581	154.3833463	362.131065	16.92385306	1626.85814	10.09727237	0	0	0	0	0	0	0	0	0	0											$250/day for days 1-5	$250/day for days 1-5	copay for days 21-100		$50/trip	20% coinsurance	"20% prosth, 10%-20% diab supp, 0% med supp"	$50 ER/urgent care	$200/surgery		20% coinsurance		20% coinsurance	$25/visit cardio & PT/OT/ST	$15/visit	$25/visit	$25/visit	$25/visit	20% coinsurance	"$25/visit chiro, pod, hearing, vision"	20% coinsurance																					248.2125467	248.2125467	104.2492696	0	49.64250934	0.198570037	0.179673971	49.64250934	198.5700374	0	0.198570037	0	0.198570038	24.82125467	14.8927528	24.82125467	24.82125467	24.82125467	0.198570037	24.82125467	0.198570037	0	0	0	0	0	0	0	0	0	0											15.7149	0.477626666	4.044854075	0	0.845362341	2.750042382	0.351875926	1.319168684	3.915753225	0	5.065043758	0	0.077022008	1.082330027	4.839198521	6.98067295	0.319332363	0.749045616	3.360570135	3.365055017	2.005015752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2628	0	0.412367005	15.7149	0.477626666	4.044854075	0	0.845362341	2.750042382	0.351875926	1.319168684	3.915753225	0	5.065043758	0	0.077022008	1.082330027	4.839198521	6.98067295	0.319332363	0.749045616	3.360570135	3.365055017	2.005015752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2628	2500																																																																																			0	0		15.7149	0.477626666	4.044854075	0	0.845362341	2.750042382	0.351875926	1.319168684	3.915753225	0	5.065043758	0	0.077022008	1.082330027	4.839198521	6.98067295	0.319332363	0.749045616	3.360570135	3.365055017	2.005015752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2628
H3706_009_0	2008	3																					2500											A	A	D		T	Coin	Coin	V	V		Coin		Coin	V		V	V	P	Coin	V	Coin																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		291.87064	4.513305719	526.0951122	0	246.0237518	14.45503739	1.983881786	346.6513401	248.0001751	0	16.56498457	0	0.374123113	558.3307491	0	3500.845978	154.7862105	392.1561156	25.08527049	1770.736542	8.407318151	0	0	0	0	0	0	0	0	0	0											$195/admit	$195/admit	copay for days 21-100		$50/trip	20% coinsurance	"20% coins prosthetics, diab monit. Supplies"	$50 ER and urgent care	$250 surgery/ASC		20% coinsurance		20% coinsurance	"$25 cardio, PT/OT/ST"		$25/visit	$25/visit	$25/visit	20% coinsurance	"$25 chiro, pod, vision, hearing"	20% coinsurance																					194.0096708	194.0096707	104.4667458	0	49.74606945	0.198984278	0.198984278	49.74606945	248.7303472	0	0.198984278	0	0.198984278	24.87303472	0	24.87303472	24.87303472	24.87303472	0.198984278	24.87303472	0.198984278	0	0	0	0	0	0	0	0	0	0											4.7188	0.072968746	4.579953698	0	1.019892887	2.876325176	0.394761285	1.437045136	5.140430805	0	3.296171492	0	0.074444617	1.157281676	0	7.256388632	0.320833566	0.812842723	4.991574431	3.670299292	1.67292413	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4929	0	0.222011279	4.7188	0.072968746	4.579953698	0	1.019892887	2.876325176	0.394761285	1.437045136	5.140430805	0	3.296171492	0	0.074444617	1.157281676	0	7.256388632	0.320833566	0.812842723	4.991574431	3.670299292	1.67292413	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4929																																																																																				0	0		4.7188	0.072968746	4.579953698	0	1.019892887	2.876325176	0.394761285	1.437045136	5.140430805	0	3.296171492	0	0.074444617	1.157281676	0	7.256388632	0.320833566	0.812842723	4.991574431	3.670299292	1.67292413	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4929
H3706_010_0	2008	3																					2500											D	D	D		T	Coin	Coin	V	V		Coin		Coin	V	V	V	V	P	Coin	V	Coin																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		759.7461694	23.09117755	465.5979756	0	204.3480119	13.84923132	1.958413472	318.8804195	236.6371046	0	25.50759332	0	0.387883331	523.2596214	3899.237637	3374.852581	154.3833463	362.131065	16.92385306	1626.85814	10.09727237	0	0	0	0	0	0	0	0	0	0											$250/day for days 1-5	$250/day for days 1-5	copay for days 21-100		$50/trip	20% coinsurance	"20% prosth, 10%-20% diab supp, 0% med supp"	$50 ER/urgent care	$200/surgery		20% coinsurance		20% coinsurance	$25/visit cardio & PT/OT/ST	$15/visit	$25/visit	$25/visit	$25/visit	20% coinsurance	"$25/visit chiro, pod, hearing, vision"	20% coinsurance																					248.2125467	248.2125467	104.2492696	0	49.64250934	0.198570037	0.179673971	49.64250934	198.5700374	0	0.198570037	0	0.198570038	24.82125467	14.8927528	24.82125467	24.82125467	24.82125467	0.198570037	24.82125467	0.198570037	0	0	0	0	0	0	0	0	0	0											15.7149	0.477626666	4.044854075	0	0.845362341	2.750042382	0.351875926	1.319168684	3.915753225	0	5.065043758	0	0.077022008	1.082330027	4.839198521	6.98067295	0.319332363	0.749045616	3.360570135	3.365055017	2.005015752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2628	0	0.412367005	15.7149	0.477626666	4.044854075	0	0.845362341	2.750042382	0.351875926	1.319168684	3.915753225	0	5.065043758	0	0.077022008	1.082330027	4.839198521	6.98067295	0.319332363	0.749045616	3.360570135	3.365055017	2.005015752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2628	2500																																																																																			0	0		15.7149	0.477626666	4.044854075	0	0.845362341	2.750042382	0.351875926	1.319168684	3.915753225	0	5.065043758	0	0.077022008	1.082330027	4.839198521	6.98067295	0.319332363	0.749045616	3.360570135	3.365055017	2.005015752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2628
H3706_012_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V		Coin		P	V	V	V	Coin	P	Coin	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		256.809784	23.63112431	465.4189358	32.10316366	204.314864	13.84530409	8.665100408	334.354251	236.577865	0	25.44640606	0	24.64397373	524.5248416	3925.982633	3373.715613	1.511604537	374.7569225	16.98522444	1666.130235	10.07326551	0	0	0	392.4714766	0	168.2020614	0	0	0	0											$195/admit	$95/days 1-5	copay for days 21-100	15% coinsurance	$50/trip	20% coinsurance	20% coinsurance	$35 ER/urgent care	"$50/surgery, $25/ASC"		10% coinsurance		$50/dialysis	$15/visit cardio & PT/OT/ST	$10/visit	$25/visit	50% coinsurance	$15/visit	10% coinsurance	"$20/visit chiro/pod, $15/visit hearing/vision"	20% coinsurance				$15/routine vision exams		$15/routine hearing exams															194.06812	94.54600715	99.5221128	0.149283169	49.7610564	0.199044226	0.199044226	34.83273948	37.3207923	0	0.099522113	0	49.76105636	14.92831692	9.95221128	24.8805282	0.497610564	14.92831692	0.099522113	17.77370529	0.199044226	0	0	0	14.92831692	0	14.92831692	0	0	0	0											4.1532	0.186185704	3.859956319	4.792462013	0.847243623	2.755827831	1.7247382	0.970539543	0.73577278	0	2.532480094	0	0.102192514	0.652522756	3.256017387	6.994985537	0.752190386	0.466207509	1.690405423	2.467775648	2.005025333	0	0	0	0.488244882	0	0.209247807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6432	0	0.1999633	4.1532	0.186185704	3.859956319	4.792462013	0.847243623	2.755827831	1.7247382	0.970539543	0.73577278	0	2.532480094	0	0.102192514	0.652522756	3.256017387	6.994985537	0.752190386	0.466207509	1.690405423	2.467775648	2.005025333	0	0	0	0.488244882	0	0.209247807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6432	2500																																																																																			0	0		4.1532	0.186185704	3.859956319	4.792462013	0.847243623	2.755827831	1.7247382	0.970539543	0.73577278	0	2.532480094	0	0.102192514	0.652522756	3.256017387	6.994985537	0.752190386	0.466207509	1.690405423	2.467775648	2.005025333	0	0	0	0.488244882	0	0.209247807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6432
H3706_014_0	2008	6																					2500											A	D	D	Coin	T	Coin	Coin	V	V		Coin		P	V	V	V	Coin	P	Coin	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		256.809784	23.63112431	465.4189358	32.10316366	204.314864	13.84530409	8.665100408	334.354251	236.577865	0	25.44640606	0	24.64397373	524.5248416	3925.982633	3373.715613	1.511604537	374.7569225	16.98522444	1666.130235	10.07326551	0	0	0	392.4714766	0	168.2020614	0	0	0	0											$195/admit	$95/days 1-5	copay for days 21-100	15% coinsurance	$50/trip	20% coinsurance	20% coinsurance	$35 ER/urgent care	"$50/surgery, $25/ASC"		10% coinsurance		$50/dialysis	$15/visit cardio & PT/OT/ST	$10/visit	$25/visit	50% coinsurance	$15/visit	10% coinsurance	"$20/visit chiro/pod, $15/visit hearing/vision"	20% coinsurance				$15/routine vision exams		$15/routine hearing exams															194.06812	94.54600715	99.5221128	0.149283169	49.7610564	0.199044226	0.199044226	34.83273948	37.3207923	0	0.099522113	0	49.76105636	14.92831692	9.95221128	24.8805282	0.497610564	14.92831692	0.099522113	17.77370529	0.199044226	0	0	0	14.92831692	0	14.92831692	0	0	0	0											4.1532	0.186185704	3.859956319	4.792462013	0.847243623	2.755827831	1.7247382	0.970539543	0.73577278	0	2.532480094	0	0.102192514	0.652522756	3.256017387	6.994985537	0.752190386	0.466207509	1.690405423	2.467775648	2.005025333	0	0	0	0.488244882	0	0.209247807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6432	0	0.1999633	4.1532	0.186185704	3.859956319	4.792462013	0.847243623	2.755827831	1.7247382	0.970539543	0.73577278	0	2.532480094	0	0.102192514	0.652522756	3.256017387	6.994985537	0.752190386	0.466207509	1.690405423	2.467775648	2.005025333	0	0	0	0.488244882	0	0.209247807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6432	2500																																																																																			0	0		4.1532	0.186185704	3.859956319	4.792462013	0.847243623	2.755827831	1.7247382	0.970539543	0.73577278	0	2.532480094	0	0.102192514	0.652522756	3.256017387	6.994985537	0.752190386	0.466207509	1.690405423	2.467775648	2.005025333	0	0	0	0.488244882	0	0.209247807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6432
H3706_015_0	2008	7																					3250											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin		Coin	V	V	V	V	P	Coin	V	Coin	Coin		P	V																	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1024.062518	21.20323482	747.1164311	33.22074895	246.0329343	14.49808587	9.010769034	351.623919	28.36580697	6.495096708	18.25620749	0	0.377520432	559.404267	4185.720593	3503.133915	155.5508891	392.7379001	25.46376509	8422.775116	8.416202764	0.911905038	0	496.8	400.2427394	0	0	0	0	0	0											$300/days 1-7	$300/days 1-7	$100 days 6-100	20% coinsurance	$100/trip	20% coinsurance	"20% prosth/supplies, 15% diab supplies"	"$50 ER, $25 urgent care"	"20% surgery, 15% ASC"	0%-10% coinsurance	0%-20% coinsurance		20% coinsurance	$25/visit cardio & PT/ST/OT	$5/visit	$25/visit	"$25/visit Psych, $15/visit SA"	$25/visit	0%-20% coinsurance	"$25 chiro, pod, hearing, $20 vision, 5% Pathology"	20% coinsurance	20% coinsurance		$20/procedure	$20/exam																	297.8417841	297.8417841	99.28059469	0.198561189	99.28059469	0.198561189	0.194262069	42.80476517	0.173741041	0.049640297	0.099280595	0	0.198561189	24.82014867	4.964029735	24.82014867	23.842814	24.82014867	0.099280595	5.611795329	0.198561189	0.198561189	0	19.85611894	19.85611894	0	0	0	0	0	0											25.4174	0.52626744	6.181180299	6.596351424	2.035524669	2.878757173	1.750450639	1.25426494	4.928304823	0.322418532	1.812487136	0	0.074960906	1.157041423	1.731503457	7.24569205	0.309064243	0.812317756	2.528057741	3.938907505	1.671131231	0.181068949	0	0.822043324	0.662272287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8375	0	0.542285837	25.4174	0.52626744	6.181180299	6.596351424	2.035524669	2.878757173	1.750450639	1.25426494	4.928304823	0.322418532	1.812487136	0	0.074960906	1.157041423	1.731503457	7.24569205	0.309064243	0.812317756	2.528057741	3.938907505	1.671131231	0.181068949	0	0.822043324	0.662272287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8375																																																																																				0	0		25.4174	0.52626744	6.181180299	6.596351424	2.035524669	2.878757173	1.750450639	1.25426494	4.928304823	0.322418532	1.812487136	0	0.074960906	1.157041423	1.731503457	7.24569205	0.309064243	0.812317756	2.528057741	3.938907505	1.671131231	0.181068949	0	0.822043324	0.662272287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8375
H3706_016_0	2008	7																					3250											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin		Coin	V	V	V	V	P	Coin	V	Coin	Coin		P	V																	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		853.0145995	29.02073558	661.773066	32.22551939	205.2063906	13.92523303	8.709378463	323.3451139	34.92153865	9.196505316	25.78637365	0	0.392378783	524.550185	4025.086444	3371.25968	155.0109587	362.7430869	17.04026356	8815.931467	10.19184117	1.104297457	0	496.8	392.5939253	0	0	0	0	0	0											$300/days 1-7	$300/days 1-7	$100 days 6-100	20% coinsurance	$100/trip	20% coinsurance	"20% prosth/supplies, 15% diab supplies"	"$50 ER, $25 urgent care"	"20% surgery, 15% ASC"	0%-10% coinsurance	0%-20% coinsurance		20% coinsurance	$25/visit cardio & PT/ST/OT	$5/visit	$25/visit	"$25/visit Psych, $15/visit SA"	$25/visit	0%-20% coinsurance	"$25 chiro, pod, hearing, $20 vision, 5% Pathology"	20% coinsurance	20% coinsurance		$20/procedure	$20/exam																	298.0066744	298.0066744	99.33555812	0.198671116	99.33555812	0.198671116	0.194396605	42.4986108	0.173837227	0.049667779	0.099335558	0	0.198671116	24.83388953	4.966777906	24.83388953	23.84193739	24.83388954	0.099335558	4.983673643	0.198671116	0.198671116	0	19.86711162	19.86711162	0	0	0	0	0	0											21.1837	0.720697741	5.478133071	6.402279909	1.698690945	2.76654159	1.693073607	1.145143179	6.070663431	0.456769994	2.561503819	0	0.077954331	1.085551779	1.665975868	6.976790872	0.307980131	0.750693479	1.692704091	3.661310441	2.024824463	0.219392008	0	0.822498421	0.649975611	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1128	0	0.468975002	21.1837	0.720697741	5.478133071	6.402279909	1.698690945	2.76654159	1.693073607	1.145143179	6.070663431	0.456769994	2.561503819	0	0.077954331	1.085551779	1.665975868	6.976790872	0.307980131	0.750693479	1.692704091	3.661310441	2.024824463	0.219392008	0	0.822498421	0.649975611	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1128	3250																																																																																			0	0		21.1837	0.720697741	5.478133071	6.402279909	1.698690945	2.76654159	1.693073607	1.145143179	6.070663431	0.456769994	2.561503819	0	0.077954331	1.085551779	1.665975868	6.976790872	0.307980131	0.750693479	1.692704091	3.661310441	2.024824463	0.219392008	0	0.822498421	0.649975611	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1128
H3706_803_0	2008	5																																A	A	D		T	Coin	Coin	V	V		Coin		Coin	V	V	V	V	P	Coin	V	Coin																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		260.6143089	3.973453371	439.463983	0	202.9279629	11.76567076	1.631469218	286.6888918	204.3591851	0	15.77081696	0	0.319300889	581.0627879	3367.207947	3263.449786	128.8312845	984.5743434	26.7379435	1602.742664	6.980198366	0	0	0	0	0	0	0	0	0	0											$100/Admit for IP Medical; $100/Admit for IP Surgical	$100/Admit for IP Psych; $100/Admit for IP Substance Abuse	$105/Day for SNF		$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Visit for Urgent Care;	$150/Case for OP Fac - Surgery; $150/Case for OP Fac - ASC		20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET		20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	$15/Case for OP Fac - Cardiovascular; $25/Case for OP Fac - Occ Therapy; $25/Case for OP Fac - Physical/Speech Therapy; $25/Case for OP Fac - CORF; $25/Service for Prof - CORF; $25/Service for Prof - CORF;	$25/Visit for PCP - Office Visits; $25/Consult for PCP - Consults;	$25/Visit for Speclst - Office Visits; $25/Consult for Speclst - Consults;	$25/Visit for OP Psych - Non-Physician; $25/Visit for OP Psych - Psychiatrist; $25/Visit for OP Substance Abuse;	$25/Service for PT/ST (PCP); $25/Service for Occ Therapy (PCP); $25/Service for PT/ST (Specialist); $25/Service for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	$25/Visit for Chiropractor; $25/Exam for Vistion Exams; $25/Visit for Podiatrist; $25/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx																					100	100.0000002	105	0	50	0.2	0.2	50	150	0	0.2	0	0.2	20.94526258	25	25	25	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0	0											2.1718	0.033112112	3.845309851	0	0.845533179	2.353134152	0.326293844	1.194537049	2.554489813	0	3.154163392	0	0.063860178	1.014209389	7.015016556	6.79885372	0.268398509	2.051196549	5.3475887	3.339047217	1.396039673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7726	0	0	2.1718	0.033112112	3.845309851	0	0.845533179	2.353134152	0.326293844	1.194537049	2.554489813	0	3.154163392	0	0.063860178	1.014209389	7.015016556	6.79885372	0.268398509	2.051196549	5.3475887	3.339047217	1.396039673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7726																																																																																				0	0		2.1718	0.033112112	3.845309851	0	0.845533179	2.353134152	0.326293844	1.194537049	2.554489813	0	3.154163392	0	0.063860178	1.014209389	7.015016556	6.79885372	0.268398509	2.051196549	5.3475887	3.339047217	1.396039673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7726
H3706_804_0	2008	5																																A	A	D		T	Coin	Coin	V	V		Coin		Coin	V	V	V	V	P	Coin	V	Coin																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		260.6143089	3.973453371	439.463983	0	202.9279629	11.76567076	1.631469218	286.6888918	204.3591851	0	15.77081696	0	0.319300889	581.0627879	3367.207947	3263.449786	128.8312845	984.5743434	26.7379435	1602.742664	6.980198366	0	0	0	0	0	0	0	0	0	0											$100/Admit for IP Medical; $100/Admit for IP Surgical	$100/Admit for IP Psych; $100/Admit for IP Substance Abuse	$105/Day for SNF		$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Visit for Urgent Care;	$150/Case for OP Fac - Surgery; $150/Case for OP Fac - ASC		20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET		20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	$15/Case for OP Fac - Cardiovascular; $25/Case for OP Fac - Occ Therapy; $25/Case for OP Fac - Physical/Speech Therapy; $25/Case for OP Fac - CORF; $25/Service for Prof - CORF; $25/Service for Prof - CORF;	$25/Visit for PCP - Office Visits; $25/Consult for PCP - Consults;	$25/Visit for Speclst - Office Visits; $25/Consult for Speclst - Consults;	$25/Visit for OP Psych - Non-Physician; $25/Visit for OP Psych - Psychiatrist; $25/Visit for OP Substance Abuse;	$25/Service for PT/ST (PCP); $25/Service for Occ Therapy (PCP); $25/Service for PT/ST (Specialist); $25/Service for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	$25/Visit for Chiropractor; $25/Exam for Vistion Exams; $25/Visit for Podiatrist; $25/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx																					100	100.0000002	105	0	50	0.2	0.2	50	150	0	0.2	0	0.2	20.94526258	25	25	25	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0	0											2.1718	0.033112112	3.845309851	0	0.845533179	2.353134152	0.326293844	1.194537049	2.554489813	0	3.154163392	0	0.063860178	1.014209389	7.015016556	6.79885372	0.268398509	2.051196549	5.3475887	3.339047217	1.396039673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7726	0	0	2.1718	0.033112112	3.845309851	0	0.845533179	2.353134152	0.326293844	1.194537049	2.554489813	0	3.154163392	0	0.063860178	1.014209389	7.015016556	6.79885372	0.268398509	2.051196549	5.3475887	3.339047217	1.396039673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7726																																																																																				0	0		2.1718	0.033112112	3.845309851	0	0.845533179	2.353134152	0.326293844	1.194537049	2.554489813	0	3.154163392	0	0.063860178	1.014209389	7.015016556	6.79885372	0.268398509	2.051196549	5.3475887	3.339047217	1.396039673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7726
H3706_807_0	2008	5																																A	A	D		T	Coin	Coin	V	V		Coin		Coin	V	V	V	V	P	Coin	V	Coin																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		260.6143089	3.973453371	439.463983	0	202.9279629	11.76567076	1.631469218	286.6888918	204.3591851	0	15.77081696	0	0.319300889	581.0627879	3367.207947	3263.449786	128.8312845	984.5743434	26.7379435	1602.742664	6.980198366	0	0	0	0	0	0	0	0	0	0											$100/Admit for IP Medical; $100/Admit for IP Surgical	$100/Admit for IP Psych; $100/Admit for IP Substance Abuse	$105/Day for SNF		$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Visit for Urgent Care;	$150/Case for OP Fac - Surgery; $150/Case for OP Fac - ASC		20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET		20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	$15/Case for OP Fac - Cardiovascular; $25/Case for OP Fac - Occ Therapy; $25/Case for OP Fac - Physical/Speech Therapy; $25/Case for OP Fac - CORF; $25/Service for Prof - CORF; $25/Service for Prof - CORF;	$25/Visit for PCP - Office Visits; $25/Consult for PCP - Consults;	$25/Visit for Speclst - Office Visits; $25/Consult for Speclst - Consults;	$25/Visit for OP Psych - Non-Physician; $25/Visit for OP Psych - Psychiatrist; $25/Visit for OP Substance Abuse;	$25/Service for PT/ST (PCP); $25/Service for Occ Therapy (PCP); $25/Service for PT/ST (Specialist); $25/Service for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	$25/Visit for Chiropractor; $25/Exam for Vistion Exams; $25/Visit for Podiatrist; $25/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx																					100	100.0000002	105	0	50	0.2	0.2	50	150	0	0.2	0	0.2	20.94526258	25	25	25	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0	0											2.1718	0.033112112	3.845309851	0	0.845533179	2.353134152	0.326293844	1.194537049	2.554489813	0	3.154163392	0	0.063860178	1.014209389	7.015016556	6.79885372	0.268398509	2.051196549	5.3475887	3.339047217	1.396039673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7726	0	0	2.1718	0.033112112	3.845309851	0	0.845533179	2.353134152	0.326293844	1.194537049	2.554489813	0	3.154163392	0	0.063860178	1.014209389	7.015016556	6.79885372	0.268398509	2.051196549	5.3475887	3.339047217	1.396039673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7726																																																																																				0	0		2.1718	0.033112112	3.845309851	0	0.845533179	2.353134152	0.326293844	1.194537049	2.554489813	0	3.154163392	0	0.063860178	1.014209389	7.015016556	6.79885372	0.268398509	2.051196549	5.3475887	3.339047217	1.396039673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7726
H3708_001_0	2008	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		508.2054373	28.43088059	531.1309631		48.09538435	9.928039278	12.17857631	24.71053002	16.7167278	38.03084668	6.094773374	2.003345998	5.354810508	105.1277782	83.77649803	123.1734611	61.83214604	18.44368545	28.8084016		31.85270357	6.267660316																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.083248457	0.083248457	0.194583106		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234																				42.3073	2.366826952	103.3491123	0	11.25431994	2.323161191	2.849786857	5.782264024	3.911714306	8.899218123	1.426176969	0.468782964	1.253025659	24.59990011	19.60370054	28.8225899	14.46872217	4.315822396	6.741165975	0	7.453532635	1.466632514	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	293.6638	0	0	42.3073	2.366826952	103.3491123	0	11.25431994	2.323161191	2.849786857	5.782264024	3.911714306	8.899218123	1.426176969	0.468782964	1.253025659	24.59990011	19.60370054	28.8225899	14.46872217	4.315822396	6.741165975	0	7.453532635	1.466632514	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	293.6638																																																																																				0	0	0	42.3073	2.366826952	103.3491123	0	11.25431994	2.323161191	2.849786857	5.782264024	3.911714306	8.899218123	1.426176969	0.468782964	1.253025659	24.59990011	19.60370054	28.8225899	14.46872217	4.315822396	6.741165975	0	7.453532635	1.466632514	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	293.6638
H3709_001_0	2008	7																					2500											D	D	D		T	Coin	Coin	P	P		V		P	Coin	V	V	V	Coin		Coin	Coin	V																																																													0	2500	1492.704241	107.3327575	955.7915955		215.225014	6.296117274	1.025468377	207.4474329	279.1410263		478.6557651		53.32243742	11.33812692	4480.877205	4240.837459	336.6888221	16.78475136		2.927413051	10.43374005	16.54949804																				$100 / day up to 5 days.	$200 / day up to 5 days.	$100/day for days 21 to 100.		$100 copay	20% coinsurance	20% coinsurance	$50 copay for ER and $20 copay for Urgent Care	$150 copay for Amb. Surg. Svcs and 20% coinsurance for Cardiac Rehabilitation Services and $40 copay for Outpatient Substance Abuse Svcs		"$100 copay for CT, MRI, PET, and nuclear medicine studies. $0 copay for all other lab plus 0% for Hospital Based physician costs"		$35 copay	20% coinsurance and 0% for medical/surgical supplies	$20 copay for Office Visits and 20% coinsurance for other services	$20 copay for Office Visits and 20% coinsurance for other services	$40 copay	20% coinsurance		$20 copay for Office Visits and 20% coinsurance for other services	20% coinsurance	$20 copay for Vision Exams and 0% Coinsurance for OP Blood																				55.55656331	42.12508767	38.38810935		89.86726136	0.179734523	0.179734523	38.19358608	134.800892		44.93363068		31.45354148	0.179734523	17.97345227	17.97345227	35.94690454	0.179734523		0.179734523	0.179734523	0.085373898																				6.9108	0.376783485	3.057586023	0	1.611806882	1.131629633	0.184312069	0.660263449	3.135704945	0	1.792311781	0	0.139764958	2.03785283	6.711402715	6.351874139	1.008576746	3.016799275	0	0.526157188	1.875303289	0.000117741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.529	0	4.575002423	6.9108	0.376783485	3.057586023	0	1.611806882	1.131629633	0.184312069	0.660263449	3.135704945	0	1.792311781	0	0.139764958	2.03785283	6.711402715	6.351874139	1.008576746	3.016799275	0	0.526157188	1.875303289	0.000117741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.529	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	$50 copay for ER and $20 copay for Urgent Care	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance																				4.2434	0.1282	0.7905	0.4716	0.1255	0.1203	0.0196	0.1187	0.43	0.2378	0.3442	0.0281	0.0049	0.2165	1.0405	1.9751	0.0486	0.3206	0.5575	0.0559	0.1993	0.0208																				11.4975	500	0.396068157	11.1542	0.504992012	3.848046302	0.471593957	1.737291337	1.25188033	0.203897678	0.778931973	3.56572072	0.237773742	2.136533876	0.028082235	0.144711831	2.254401792	7.751859647	8.327002451	1.057214485	3.337374314	0.557450899	0.582068385	2.074579201	0.020917076	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.0265
H3709_003_0	2008	5																					2500											D	D	D		T	Coin	Coin	P	P		V		P	Coin	V	V	V	Coin		Coin	Coin	V																																																													0	2500	1492.704241	107.3327575	955.7915955		215.225014	6.296117274	1.025468377	207.4474329	279.1410263		478.6557651		53.32243742	11.33812692	4480.877205	4240.837459	336.6888221	16.78475136		2.927413051	10.43374005	16.54949804																				$100 / day up to 5 days.	$200 / day up to 5 days.	$100/day for days 21 to 100.		$100 copay	20% coinsurance	20% coinsurance	$50 copay for ER and $20 copay for Urgent Care	$150 copay for Amb. Surg. Svcs and 20% coinsurance for Cardiac Rehabilitation Services and $40 copay for Outpatient Substance Abuse Svcs		"$100 copay for CT, MRI, PET, and nuclear medicine studies. $0 copay for all other lab plus 0% for Hospital Based physician costs"		$35 copay	20% coinsurance and 0% for medical/surgical supplies	$20 copay for Office Visits and 20% coinsurance for other services	$20 copay for Office Visits and 20% coinsurance for other services	$40 copay	20% coinsurance		$20 copay for Office Visits and 20% coinsurance for other services	20% coinsurance	$20 copay for Vision Exams and 0% Coinsurance for OP Blood																				55.55656331	42.12508767	38.38810935		89.86726136	0.179734523	0.179734523	38.19358608	134.800892		44.93363068		31.45354148	0.179734523	17.97345227	17.97345227	35.94690454	0.179734523		0.179734523	0.179734523	0.085373898																				6.9108	0.376783485	3.057586023	0	1.611806882	1.131629633	0.184312069	0.660263449	3.135704945	0	1.792311781	0	0.139764958	2.03785283	6.711402715	6.351874139	1.008576746	3.016799275	0	0.526157188	1.875303289	0.000117741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.529	0	4.575002423	6.9108	0.376783485	3.057586023	0	1.611806882	1.131629633	0.184312069	0.660263449	3.135704945	0	1.792311781	0	0.139764958	2.03785283	6.711402715	6.351874139	1.008576746	3.016799275	0	0.526157188	1.875303289	0.000117741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.529	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	$50 copay for ER and $20 copay for Urgent Care	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance																				4.2434	0.1282	0.7905	0.4716	0.1255	0.1203	0.0196	0.1187	0.43	0.2378	0.3442	0.0281	0.0049	0.2165	1.0405	1.9751	0.0486	0.3206	0.5575	0.0559	0.1993	0.0208																				11.4975	500	0.396068157	11.1542	0.504992012	3.848046302	0.471593957	1.737291337	1.25188033	0.203897678	0.778931973	3.56572072	0.237773742	2.136533876	0.028082235	0.144711831	2.254401792	7.751859647	8.327002451	1.057214485	3.337374314	0.557450899	0.582068385	2.074579201	0.020917076	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.0265
H3709_801_0	2008	4																					2500											D	D	D		T	Coin	Coin	P	P		V		P	Coin	V	V	V	Coin		Coin	Coin	V																																																													0	2500	1492.704241	107.3327575	955.7915955		215.225014	6.296117274	1.025468377	207.4474329	279.1410263		478.6557651		53.32243742	11.33812692	4480.877205	4240.837459	336.6888221	16.78475136		2.927413051	10.43374005	16.54949804																				$100 / day up to 5 days.	$200 / day up to 5 days.	$200/day for days 21 to 100.		$200 copay	20% coinsurance	20% coinsurance	$50 copay for ER and $20 copay for Urgent Care	$250 copay for Amb. Surg. Svcs and 20% coinsurance for Cardiac Rehabilitation Services and $40 copay for Outpatient Substance Abuse Svcs		"$150 copay for CT, MRI, PET, and nuclear medicine studies. $0 copay for all other lab plus 0% for Hospital Based physician costs"		$35 copay	20% coinsurance and 0% for medical/surgical supplies	$40 copay for Office Visits and 20% coinsurance for other services	$40 copay for Office Visits and 20% coinsurance for other services	$40 copay	20% coinsurance		20% coinsurance for other services	20% coinsurance	$40 copay for Vision Exams and 0% Coinsurance for OP Blood																				46.1122119	34.9640232	63.72462684		149.1805091	0.149180509	0.149180509	31.70085818	186.4756364		111.8853818		26.10658909	0.149180509	29.83610182	29.83610182	29.83610182	0.149180509		0.149180509	0.149180509	28.34429673																				5.736	0.312732085	5.075621897	0	2.675614762	0.93925798	0.152979895	0.548021804	4.337750042	0	4.46288192	0	0.11600558	1.691427546	11.14099238	10.54417152	0.837123498	2.503957753	0	0.436712969	1.556510653	0.039090324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1068	0	18.0912559	5.736	0.312732085	5.075621897	0	2.675614762	0.93925798	0.152979895	0.548021804	4.337750042	0	4.46288192	0	0.11600558	1.691427546	11.14099238	10.54417152	0.837123498	2.503957753	0	0.436712969	1.556510653	0.039090324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1068	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	$50 copay for ER and $20 copay for Urgent Care	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance																				4.2434	0.1282	0.7905	0.4716	0.1255	0.1203	0.0196	0.1187	0.43	0.2378	0.3442	0.0281	0.0049	0.2165	1.0405	1.9751	0.0486	0.3206	0.5575	0.0559	0.1993	0.0208																				11.4975	500	0.396068157	9.9794	0.440940612	5.866082175	0.471593957	2.801099218	1.059508677	0.172565503	0.666690328	4.767765816	0.237773742	4.807104015	0.028082235	0.120952453	1.907976508	12.18144931	12.51929983	0.885761238	2.824532792	0.557450899	0.492624167	1.755786565	0.059889659	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6044
H3709_802_0	2008	4																					2500											D	D	D		T	Coin	Coin	P	P		V		P	Coin	V	V	V	Coin		Coin	Coin	V																																																													0	2500	1492.704241	107.3327575	955.7915955		215.225014	6.296117274	1.025468377	207.4474329	279.1410263		478.6557651		53.32243742	11.33812692	4480.877205	4240.837459	336.6888221	16.78475136		2.927413051	10.43374005	16.54949804																				$100 / day up to 5 days.	$200 / day up to 5 days.	$200/day for days 21 to 100.		$200 copay	20% coinsurance	20% coinsurance	$50 copay for ER and $20 copay for Urgent Care	$250 copay for Amb. Surg. Svcs and 20% coinsurance for Cardiac Rehabilitation Services and $40 copay for Outpatient Substance Abuse Svcs		"$150 copay for CT, MRI, PET, and nuclear medicine studies. $0 copay for all other lab plus 0% for Hospital Based physician costs"		$35 copay	20% coinsurance and 0% for medical/surgical supplies	$40 copay for Office Visits and 20% coinsurance for other services	$40 copay for Office Visits and 20% coinsurance for other services	$40 copay	20% coinsurance		20% coinsurance for other services	20% coinsurance	$40 copay for Vision Exams and 0% Coinsurance for OP Blood																				46.1122119	34.9640232	63.72462684		149.1805091	0.149180509	0.149180509	31.70085818	186.4756364		111.8853818		26.10658909	0.149180509	29.83610182	29.83610182	29.83610182	0.149180509		0.149180509	0.149180509	28.34429673																				5.736	0.312732085	5.075621897	0	2.675614762	0.93925798	0.152979895	0.548021804	4.337750042	0	4.46288192	0	0.11600558	1.691427546	11.14099238	10.54417152	0.837123498	2.503957753	0	0.436712969	1.556510653	0.039090324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1068	0	18.0912559	5.736	0.312732085	5.075621897	0	2.675614762	0.93925798	0.152979895	0.548021804	4.337750042	0	4.46288192	0	0.11600558	1.691427546	11.14099238	10.54417152	0.837123498	2.503957753	0	0.436712969	1.556510653	0.039090324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1068	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	$50 copay for ER and $20 copay for Urgent Care	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance																				4.2434	0.1282	0.7905	0.4716	0.1255	0.1203	0.0196	0.1187	0.43	0.2378	0.3442	0.0281	0.0049	0.2165	1.0405	1.9751	0.0486	0.3206	0.5575	0.0559	0.1993	0.0208																				11.4975	500	0.396068157	9.9794	0.440940612	5.866082175	0.471593957	2.801099218	1.059508677	0.172565503	0.666690328	4.767765816	0.237773742	4.807104015	0.028082235	0.120952453	1.907976508	12.18144931	12.51929983	0.885761238	2.824532792	0.557450899	0.492624167	1.755786565	0.059889659	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6044
H3709_803_0	2008	4																					2500											D	D	D		T	Coin	Coin	P	P		V		P	Coin	V	V	V	Coin		Coin	Coin	V																																																													0	2500	1492.704241	107.3327575	955.7915955		215.225014	6.296117274	1.025468377	207.4474329	279.1410263		478.6557651		53.32243742	11.33812692	4480.877205	4240.837459	336.6888221	16.78475136		2.927413051	10.43374005	16.54949804																				$100 / day up to 5 days.	$200 / day up to 5 days.	$200/day for days 21 to 100.		$200 copay	20% coinsurance	20% coinsurance	$50 copay for ER and $20 copay for Urgent Care	$250 copay for Amb. Surg. Svcs and 20% coinsurance for Cardiac Rehabilitation Services and $40 copay for Outpatient Substance Abuse Svcs		"$150 copay for CT, MRI, PET, and nuclear medicine studies. $0 copay for all other lab plus 0% for Hospital Based physician costs"		$35 copay	20% coinsurance and 0% for medical/surgical supplies	$40 copay for Office Visits and 20% coinsurance for other services	$40 copay for Office Visits and 20% coinsurance for other services	$40 copay	20% coinsurance		20% coinsurance for other services	20% coinsurance	$40 copay for Vision Exams and 0% Coinsurance for OP Blood																				46.1122119	34.9640232	63.72462684		149.1805091	0.149180509	0.149180509	31.70085818	186.4756364		111.8853818		26.10658909	0.149180509	29.83610182	29.83610182	29.83610182	0.149180509		0.149180509	0.149180509	28.34429673																				5.736	0.312732085	5.075621897	0	2.675614762	0.93925798	0.152979895	0.548021804	4.337750042	0	4.46288192	0	0.11600558	1.691427546	11.14099238	10.54417152	0.837123498	2.503957753	0	0.436712969	1.556510653	0.039090324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1068	0	18.0912559	5.736	0.312732085	5.075621897	0	2.675614762	0.93925798	0.152979895	0.548021804	4.337750042	0	4.46288192	0	0.11600558	1.691427546	11.14099238	10.54417152	0.837123498	2.503957753	0	0.436712969	1.556510653	0.039090324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1068	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	$50 copay for ER and $20 copay for Urgent Care	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance																				4.2434	0.1282	0.7905	0.4716	0.1255	0.1203	0.0196	0.1187	0.43	0.2378	0.3442	0.0281	0.0049	0.2165	1.0405	1.9751	0.0486	0.3206	0.5575	0.0559	0.1993	0.0208																				11.4975	500	0.396068157	9.9794	0.440940612	5.866082175	0.471593957	2.801099218	1.059508677	0.172565503	0.666690328	4.767765816	0.237773742	4.807104015	0.028082235	0.120952453	1.907976508	12.18144931	12.51929983	0.885761238	2.824532792	0.557450899	0.492624167	1.755786565	0.059889659	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6044
H3709_804_0	2008	4																					2500											D	D	D		T	Coin	Coin	P	P		V		P	Coin	V	V	V	Coin		Coin	Coin	V																																																													0	2500	1492.704241	107.3327575	955.7915955		215.225014	6.296117274	1.025468377	207.4474329	279.1410263		478.6557651		53.32243742	11.33812692	4480.877205	4240.837459	336.6888221	16.78475136		2.927413051	10.43374005	16.54949804																				$100 / day up to 5 days.	$200 / day up to 5 days.	$200/day for days 21 to 100.		$200 copay	20% coinsurance	20% coinsurance	$50 copay for ER and $20 copay for Urgent Care	$250 copay for Amb. Surg. Svcs and 20% coinsurance for Cardiac Rehabilitation Services and $40 copay for Outpatient Substance Abuse Svcs		"$150 copay for CT, MRI, PET, and nuclear medicine studies. $0 copay for all other lab plus 0% for Hospital Based physician costs"		$35 copay	20% coinsurance and 0% for medical/surgical supplies	$40 copay for Office Visits and 20% coinsurance for other services	$40 copay for Office Visits and 20% coinsurance for other services	$40 copay	20% coinsurance		20% coinsurance for other services	20% coinsurance	$40 copay for Vision Exams and 0% Coinsurance for OP Blood																				46.1122119	34.9640232	63.72462684		149.1805091	0.149180509	0.149180509	31.70085818	186.4756364		111.8853818		26.10658909	0.149180509	29.83610182	29.83610182	29.83610182	0.149180509		0.149180509	0.149180509	28.34429673																				5.736	0.312732085	5.075621897	0	2.675614762	0.93925798	0.152979895	0.548021804	4.337750042	0	4.46288192	0	0.11600558	1.691427546	11.14099238	10.54417152	0.837123498	2.503957753	0	0.436712969	1.556510653	0.039090324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1068	0	18.0912559	5.736	0.312732085	5.075621897	0	2.675614762	0.93925798	0.152979895	0.548021804	4.337750042	0	4.46288192	0	0.11600558	1.691427546	11.14099238	10.54417152	0.837123498	2.503957753	0	0.436712969	1.556510653	0.039090324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1068	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	$50 copay for ER and $20 copay for Urgent Care	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance																				4.2434	0.1282	0.7905	0.4716	0.1255	0.1203	0.0196	0.1187	0.43	0.2378	0.3442	0.0281	0.0049	0.2165	1.0405	1.9751	0.0486	0.3206	0.5575	0.0559	0.1993	0.0208																				11.4975	500	0.396068157	9.9794	0.440940612	5.866082175	0.471593957	2.801099218	1.059508677	0.172565503	0.666690328	4.767765816	0.237773742	4.807104015	0.028082235	0.120952453	1.907976508	12.18144931	12.51929983	0.885761238	2.824532792	0.557450899	0.492624167	1.755786565	0.059889659	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6044
H3749_001_0	2008	6																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		377.5786665	9.588885284	743.5594241		554.3835095	18.14344289	6.657300492	398.9363501	284.7497213		63.06254043			1463.598356	4293.863287	4426.302053	299.0899807	404.8009216			29.59746402	911.2298733			95.43156731	0.43618349																$250 (1a); $0 (1a1)	$912 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$180 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$5 (4b)"	$200 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$5/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $5 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $5/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $5/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											250	912	69.5467		180	0.2	0.2	49.0715	200		0.155702234			5.7189	5	30	30	7.9579			0.2	30			30	0.412814067																7.8662	0.728755282	4.309339523	0	8.315752642	3.628688578	1.331460098	1.631368737	4.745828688	0	9.81897843	0	0	0.697514233	1.789109703	11.06574464	0.747724952	0.268447438	0	0	5.919492804	2.278074683	0	0	0.238578918	0.180062681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5611	0	0	7.8662	0.728755282	4.309339523	0	8.315752642	3.628688578	1.331460098	1.631368737	4.745828688	0	9.81897843	0	0	0.697514233	1.789109703	11.06574464	0.747724952	0.268447438	0	0	5.919492804	2.278074683	0	0	0.238578918	0.180062681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5611																																																																																				0			7.8662	0.728755282	4.309339523	0	8.315752642	3.628688578	1.331460098	1.631368737	4.745828688	0	9.81897843	0	0	0.697514233	1.789109703	11.06574464	0.747724952	0.268447438	0	0	5.919492804	2.278074683	0	0	0.238578918	0.180062681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5611
H3749_004_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1997.976399	11.92934123	772.5880688		534.4984355	17.0376381	10.02533593	325.2662495	287.5984244		93.84040617			1048.253892	4019.061829	4263.992448	298.0017073	574.6528779			33.16132864	887.2680813			83.75524095	0.35661293																$200 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$180 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$200 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											85.6739	912	63.2242		180	0.2	0.2	49.1876	200		0.160152856			5.8587	15	30	30	7.9579			0.2	30			30	0.413340463																14.2645	0.906629933	4.070524208	0	8.017476533	3.407527619	2.005067186	1.333255715	4.793307073	0	15.02880907	0	0	0.511785056	5.023827286	10.65998007	0.745004268	0.381086319	0	0	6.632265728	2.218170203	0	0	0.209388102	0.147402554	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.356	0	0	14.2645	0.906629933	4.070524208	0	8.017476533	3.407527619	2.005067186	1.333255715	4.793307073	0	15.02880907	0	0	0.511785056	5.023827286	10.65998007	0.745004268	0.381086319	0	0	6.632265728	2.218170203	0	0	0.209388102	0.147402554	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.356																																																																																				0			14.2645	0.906629933	4.070524208	0	8.017476533	3.407527619	2.005067186	1.333255715	4.793307073	0	15.02880907	0	0	0.511785056	5.023827286	10.65998007	0.745004268	0.381086319	0	0	6.632265728	2.218170203	0	0	0.209388102	0.147402554	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.356
H3749_011_0	2008	5																					2800											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2320.62313	328.5694711	1167.999495		471.8702743	34.87226124	24.90438895	817.9616305	434.0136959	7539.863478	636.7892616	79.82647402	5.17821004	4099.330506		3954.341071	1035.809343	1072.322284			31.67612358	768.012585					0.101341444															1(a) $200 per Day	1(b) $200 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $100 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $35 per Visit	8(a) Diagnostic: $25 per preocedure; other $0 per procedure	8(b) X-rays $25 per visit; other: $25 per visit	9(a) $35 per Visit	12  20% Coinsurance	3 $50 per visit; 5 $25 per visit; 9(a) $35 per Visit; 9(c) $25/$35 per Visit; 9(d) $35 per Visit	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $25 per Visit	7(e)/7(h) $25/35 per Visit	7(c)/7(i) $25 per Visit		7(g) $25 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $25 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $25 per visit															119.9277	119.9277	25.1848		59.9638	0.119927685	0.119927685	26.8338	20.9873	14.991	14.991	20.9873	0.119927685	21.0379		14.991	19.4882	14.991			0.119927685	14.991					14.991															23.1922	3.283714658	2.451320814	0	2.35792956	4.182149548	2.986725703	1.829086225	0.759066257	9.419149678	0.795506893	0.139612145	0.621010741	7.18676097	0	4.939947591	1.682175844	1.33959509	0	0	3.798844158	0.959437199	0	0	0	0	0.0001266	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9244	0	48.02188719	23.1922	3.283714658	2.451320814	0	2.35792956	4.182149548	2.986725703	1.829086225	0.759066257	9.419149678	0.795506893	0.139612145	0.621010741	7.18676097	0	4.939947591	1.682175844	1.33959509	0	0	3.798844158	0.959437199	0	0	0	0	0.0001266	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9244																																																																																				0	0	0	23.1922	3.283714658	2.451320814	0	2.35792956	4.182149548	2.986725703	1.829086225	0.759066257	9.419149678	0.795506893	0.139612145	0.621010741	7.18676097	0	4.939947591	1.682175844	1.33959509	0	0	3.798844158	0.959437199	0	0	0	0	0.0001266	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9244
H3749_012_0	2008	5																					2800											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2264.294623	320.5941011	1111.157416		448.9061485	31.56065283	22.53936927	778.1545589	412.8919053	7172.927091	605.799158	75.94162411	4.68646665	3899.831731		3761.898379	985.4004541	1020.13645			28.66803308	730.6363429					0.096409543															1(a) $200 per Day	1(b) $200 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $100 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $35 per Visit	8(a) Diagnostic: $25 per preocedure; other $0 per procedure	8(b) X-rays $25 per visit; other: $25 per visit	9(a) $35 per Visit	12  20% Coinsurance	3 $50 per visit; 5 $25 per visit; 9(a) $35 per Visit; 9(c) $25/$35 per Visit; 9(d) $35 per Visit	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $25 per Visit	7(e)/7(h) $25/35 per Visit	7(c)/7(i) $25 per Visit		7(g) $25 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $25 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $25 per visit															122.3142	122.3142	25.686		61.1571	0.122314173	0.122314173	27.3678	21.405	15.2893	15.2893	21.405	0.122314173	21.4565		15.2893	19.8761	15.2893			0.122314173	15.2893					15.2893															23.0796	3.26776686	2.378430256	0	2.287816011	3.860315147	2.75688431	1.774697948	0.736495257	9.139069213	0.771852322	0.135460747	0.573221292	6.973061069	0	4.793057175	1.632155979	1.299761938	0	0	3.506506755	0.930908125	0	0	0	0	0.000122836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8972	0	44.39404826	23.0796	3.26776686	2.378430256	0	2.287816011	3.860315147	2.75688431	1.774697948	0.736495257	9.139069213	0.771852322	0.135460747	0.573221292	6.973061069	0	4.793057175	1.632155979	1.299761938	0	0	3.506506755	0.930908125	0	0	0	0	0.000122836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8972																																																																																				0	0	0	23.0796	3.26776686	2.378430256	0	2.287816011	3.860315147	2.75688431	1.774697948	0.736495257	9.139069213	0.771852322	0.135460747	0.573221292	6.973061069	0	4.793057175	1.632155979	1.299761938	0	0	3.506506755	0.930908125	0	0	0	0	0.000122836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8972
H3749_013_0	2008	5	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)							Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						Coin	Coin	D	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V		Coin	Coin	Coin	T				Coin					Coin	Coin	Coin	V																																																0		521.3148089	7.974186363	9829.044708	237.6721313	32.35090336	34.20424005	0.307465097	200.2655964	15.06160755	59.21505566	54.22290224	2.762682316	0.670014351	8.906497273	141.6394179	139.098496	14.44939007	27.63519973		14.0004825	4.218150881	7.023583882	1657.83									1.125495916	0.008345942		247.1							(1a) 7.8% coins	(1b) 7.8% coins	(2a) $0/day	(6a) $0/proc	(10a) 20% coins	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) 20% coins	(8a) 10% coins	(8b) 19.2% coins	(9a) 20% coins	(12) 20% coins	(9a) 20% coins	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) 20% coins	(7e/7h) 20% coins	(7c/7i) $0/visit		(7g) 20% coins	(15) 20% coins	(Misc. PBP Cats) 20% coins	(10b) $0/trip				(18a) 20% coins					(4b) 20% coins	(9c) 20% coins	(9d) 20% coins	(7f1) $0/visit							0.078	0.078			0.2	0.2	0.2	50	0.2	0.1	0.192	0.2	0.2	0.2		0.2	0.2			0.2	0.2	0.2										0.2	0.2									40.6626	0.621986536	0	0	6.470180672	6.840848011	0.061493019	0.834439985	3.012321511	5.921505566	10.41079723	0.552536463	0.13400287	1.781299455	0	27.81969921	2.889878013	0	0	2.800096499	0.843630176	1.404716776	0	0	0	0	0	0	0	0	0	0.225099183	0.001669188	0	0	0	0	0	0	0	0	113.2888		0	40.6626	0.621986536	0	0	6.470180672	6.840848011	0.061493019	0.834439985	3.012321511	5.921505566	10.41079723	0.552536463	0.13400287	1.781299455	0	27.81969921	2.889878013	0	0	2.800096499	0.843630176	1.404716776	0	0	0	0	0	0	0	0	0	0.225099183	0.001669188	0	0	0	0	0	0	0	0	113.2888																																																																																				0		0	40.6626	0.621986536	0	0	6.470180672	6.840848011	0.061493019	0.834439985	3.012321511	5.921505566	10.41079723	0.552536463	0.13400287	1.781299455	0	27.81969921	2.889878013	0	0	2.800096499	0.843630176	1.404716776	0	0	0	0	0	0	0	0	0	0.225099183	0.001669188	0	0	0	0	0	0	0	0	113.2888
H3749_014_0	2008	6																					3500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2175.477261	149.196113	1013.672822		313.8653032	13.32461462	23.14079451	491.6086427	464.6650046	3895.675485	511.961057	78.02071728	17.39660797	3273.578682		4432.381671	436.9779102	637.7485934				788.8307675					0.08352287															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															140.9476	140.9476	33.8274		60.4061	0.161082916	0.161082916	33.2234	60.4061	16.1083	52.5646	60.4061	134.3545	58.4027		20.1354	16.1083	16.1083				20.1354					20.1354															25.5523	1.752402234	2.857494045	0	1.579948071	2.146367777	3.727586656	1.361073891	2.339049809	5.229389723	2.242584823	0.392743895	0.194775989	15.93214422	0	7.43730171	0.586580633	0.856086692	0	0	0	1.323616252	0	0	0	0	0.000140147	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5116	0	18.24335416	25.5523	1.752402234	2.857494045	0	1.579948071	2.146367777	3.727586656	1.361073891	2.339049809	5.229389723	2.242584823	0.392743895	0.194775989	15.93214422	0	7.43730171	0.586580633	0.856086692	0	0	0	1.323616252	0	0	0	0	0.000140147	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5116																																																																																				0	0	0	25.5523	1.752402234	2.857494045	0	1.579948071	2.146367777	3.727586656	1.361073891	2.339049809	5.229389723	2.242584823	0.392743895	0.194775989	15.93214422	0	7.43730171	0.586580633	0.856086692	0	0	0	1.323616252	0	0	0	0	0.000140147	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5116
H3749_015_0	2008	5	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)							Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						Coin	Coin	D	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V		Coin	Coin	Coin	T				Coin					Coin	Coin	Coin	V																																																0		477.2425235	7.300043578	9404.39466	227.4038413	29.61593742	31.31259185	0.281471802	191.613403	13.78828968	54.20897721	49.63886361	2.529123397	0.613370912	8.15353633	135.5200861	127.3390207	13.22782944	26.4412598		12.8168728	3.861545723	6.429805635	1657.83									1.030345776	0.00764037		247.1							(1a) 7.9% coins	(1b) 7.9% coins	(2a) $0/day	(6a) $0/proc	(10a) 20% coins	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) 20% coins	(8a) 10% coins	(8b) 19.2% coins	(9a) 20% coins	(12) 20% coins	(9a) 20% coins	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) 20% coins	(7e/7h) 20% coins	(7c/7i) $0/visit		(7g) 20% coins	(15) 20% coins	(Misc. PBP Cats) 20% coins	(10b) $0/trip				(18a) 20% coins					(4b) 20% coins	(9c) 20% coins	(9d) 20% coins	(7f1) $0/visit							0.079	0.079			0.2	0.2	0.2	50	0.2	0.1	0.192	0.2	0.2	0.2		0.2	0.2			0.2	0.2	0.2										0.2	0.2									37.7022	0.576703443	0	0	5.923187484	6.262518371	0.05629436	0.798389179	2.757657935	5.420897721	9.530661813	0.505824679	0.122674182	1.630707266	0	25.46780415	2.645565889	0	0	2.563374561	0.772309145	1.285961127	0	0	0	0	0	0	0	0	0	0.206069155	0.001528074	0	0	0	0	0	0	0	0	104.2303		0	37.7022	0.576703443	0	0	5.923187484	6.262518371	0.05629436	0.798389179	2.757657935	5.420897721	9.530661813	0.505824679	0.122674182	1.630707266	0	25.46780415	2.645565889	0	0	2.563374561	0.772309145	1.285961127	0	0	0	0	0	0	0	0	0	0.206069155	0.001528074	0	0	0	0	0	0	0	0	104.2303																																																																																				0		0	37.7022	0.576703443	0	0	5.923187484	6.262518371	0.05629436	0.798389179	2.757657935	5.420897721	9.530661813	0.505824679	0.122674182	1.630707266	0	25.46780415	2.645565889	0	0	2.563374561	0.772309145	1.285961127	0	0	0	0	0	0	0	0	0	0.206069155	0.001528074	0	0	0	0	0	0	0	0	104.2303
H3749_016_0	2008	6																					3500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2157.581166	147.9687833	968.9966852		299.4746166	12.17597183	21.14595206	465.9591589	440.4212942	3692.420178	485.2496941	73.95001763	16.59918996	3102.817058		4237.030976	417.3543397	609.6407633				754.0642131					0.079841722															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															142.774	142.774	34.2658		61.1889	0.163170303	0.163170303	33.6539	61.1889	16.317	53.2457	61.1889	129.3621	59.1589		20.3963	16.317	16.317				20.3963					20.3963															25.6705	1.760508107	2.766950946	0	1.527042621	1.986757012	3.450391402	1.306777606	2.245739874	5.020777657	2.153123093	0.377076462	0.178942195	15.29661206	0	7.201641955	0.567498617	0.828960567	0	0	0	1.281675896	0	0	0	0	0.000135706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.6212	0	16.61726929	25.6705	1.760508107	2.766950946	0	1.527042621	1.986757012	3.450391402	1.306777606	2.245739874	5.020777657	2.153123093	0.377076462	0.178942195	15.29661206	0	7.201641955	0.567498617	0.828960567	0	0	0	1.281675896	0	0	0	0	0.000135706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.6212																																																																																				0	0	0	25.6705	1.760508107	2.766950946	0	1.527042621	1.986757012	3.450391402	1.306777606	2.245739874	5.020777657	2.153123093	0.377076462	0.178942195	15.29661206	0	7.201641955	0.567498617	0.828960567	0	0	0	1.281675896	0	0	0	0	0.000135706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.6212
H3749_801_0	2008	3																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2041.043342	81.69623158	774.6987274		10.61402917	21.45660354	9.1762603	398.3777184	380.225216		72.30063462		1.331278822	2417.602526	2131.18598	6156.084488	2.595202503	829.4647225			44.43642265	1174.888505			126.1012992																	$250 (1a); $0 (1a1)	$250 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											157.3198	166.1367	159.1696		0.3	0.3	0.3	49.0728	300		0.237962196		0.3	7.5042	20	40	0.397863881	40			0.3	40			40																	26.758	1.13106203	10.27570475	0	3.184208752	6.436981061	2.75287809	1.629126665	9.5056304	0	17.2048178	0	0.399383647	1.511843525	3.551976633	20.52028163	1.032537339	2.764882408	0	0	13.33092679	3.916295017	0	0	0.420337664	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.3269	0	0	26.758	1.13106203	10.27570475	0	3.184208752	6.436981061	2.75287809	1.629126665	9.5056304	0	17.2048178	0	0.399383647	1.511843525	3.551976633	20.52028163	1.032537339	2.764882408	0	0	13.33092679	3.916295017	0	0	0.420337664	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.3269																																																																																				0			26.758	1.13106203	10.27570475	0	3.184208752	6.436981061	2.75287809	1.629126665	9.5056304	0	17.2048178	0	0.399383647	1.511843525	3.551976633	20.52028163	1.032537339	2.764882408	0	0	13.33092679	3.916295017	0	0	0.420337664	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.3269
H3749_802_0	2008	3																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2041.043342	81.69623158	774.6987274		10.61402917	21.45660354	9.1762603	398.3777184	380.225216		72.30063462		1.331278822	2417.602526	2131.18598	6156.084488	2.595202503	829.4647225			44.43642265	1174.888505			126.1012992																	$250 (1a); $0 (1a1)	$250 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											157.3198	166.1367	159.1696		0.3	0.3	0.3	49.0728	300		0.237962196		0.3	7.5042	20	40	0.397863881	40			0.3	40			40																	26.758	1.13106203	10.27570475	0	3.184208752	6.436981061	2.75287809	1.629126665	9.5056304	0	17.2048178	0	0.399383647	1.511843525	3.551976633	20.52028163	1.032537339	2.764882408	0	0	13.33092679	3.916295017	0	0	0.420337664	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.3269	0	0	26.758	1.13106203	10.27570475	0	3.184208752	6.436981061	2.75287809	1.629126665	9.5056304	0	17.2048178	0	0.399383647	1.511843525	3.551976633	20.52028163	1.032537339	2.764882408	0	0	13.33092679	3.916295017	0	0	0.420337664	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.3269																																																																																				0			26.758	1.13106203	10.27570475	0	3.184208752	6.436981061	2.75287809	1.629126665	9.5056304	0	17.2048178	0	0.399383647	1.511843525	3.551976633	20.52028163	1.032537339	2.764882408	0	0	13.33092679	3.916295017	0	0	0.420337664	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.3269
H3749_803_0	2008	3																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1571.643311	81.69707603	580.9358553		10.74314749	15.98194537	6.634254012	284.0294065	278.5188878		49.77277481		0.751061603	1155.028768	1857.937622	4906.756736	2.681911248	624.6709149			48.72530687	941.5599183			116.3294557																	$350 (1a); $0 (1a1)	$350 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											220.2477	232.5914	159.1696		0.3	0.3	0.3	49.1508	300		0.232890096		0.3	7.5088	20	40	0.393626468	40			0.3	40			40																	28.8459	1.583503209	7.705608792	0	3.222944248	4.794583611	1.990276204	1.163355625	6.962972196	0	11.5915863	0	0.225318481	0.722742757	3.096562703	16.35585579	1.055671253	2.082236383	0	0	14.61759206	3.138533061	0	0	0.387764852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.543	0	0	28.8459	1.583503209	7.705608792	0	3.222944248	4.794583611	1.990276204	1.163355625	6.962972196	0	11.5915863	0	0.225318481	0.722742757	3.096562703	16.35585579	1.055671253	2.082236383	0	0	14.61759206	3.138533061	0	0	0.387764852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.543																																																																																				0			28.8459	1.583503209	7.705608792	0	3.222944248	4.794583611	1.990276204	1.163355625	6.962972196	0	11.5915863	0	0.225318481	0.722742757	3.096562703	16.35585579	1.055671253	2.082236383	0	0	14.61759206	3.138533061	0	0	0.387764852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.543
H3749_804_0	2008	3																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1571.643311	81.69707603	580.9358553		10.74314749	15.98194537	6.634254012	284.0294065	278.5188878		49.77277481		0.751061603	1155.028768	1857.937622	4906.756736	2.681911248	624.6709149			48.72530687	941.5599183			116.3294557																	$350 (1a); $0 (1a1)	$350 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											220.2477	232.5914	159.1696		0.3	0.3	0.3	49.1508	300		0.232890096		0.3	7.5088	20	40	0.393626468	40			0.3	40			40																	28.8459	1.583503209	7.705608792	0	3.222944248	4.794583611	1.990276204	1.163355625	6.962972196	0	11.5915863	0	0.225318481	0.722742757	3.096562703	16.35585579	1.055671253	2.082236383	0	0	14.61759206	3.138533061	0	0	0.387764852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.543	0	0	28.8459	1.583503209	7.705608792	0	3.222944248	4.794583611	1.990276204	1.163355625	6.962972196	0	11.5915863	0	0.225318481	0.722742757	3.096562703	16.35585579	1.055671253	2.082236383	0	0	14.61759206	3.138533061	0	0	0.387764852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.543																																																																																				0			28.8459	1.583503209	7.705608792	0	3.222944248	4.794583611	1.990276204	1.163355625	6.962972196	0	11.5915863	0	0.225318481	0.722742757	3.096562703	16.35585579	1.055671253	2.082236383	0	0	14.61759206	3.138533061	0	0	0.387764852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.543
H3755_001_0	2008	4																																D	D	D	V	T	O	O	V	V	P	P	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	O	O	V																																																				0		764	26.9	25.1	0	209.2	25.2	0	301.4	357.6	0.2	288.9	0	0	200.8	2619	3949.7	129.4	121	838.8	176.9	0	261.3	0	0	248.7	9.7	57.70069582	0	0	0	0											1a. $135 copay day (1st 5 days)	1b. $135 copay day (1st 5 days)	"2. $50 copay/day, days 21-100"	6. no copay	10a. $50 copay	"11a. Wheelchairs - $50 copay, Power wheelchairs & Scooters - 20% Coins"	11b. No copay	"4a. $50 copay, 4b. $50 copay if at ER"	9a/9b. $100 copay	8a. $100 copay	8b/14g $100 copay for MRI/CT/Endo/PET/Nuclear	no copay	no copay	3/5. $50 copay	"7a/7g/14b/14c/14d/14f/14i $20 copay, 14a/14h no copay"	"7d/7g/16b $30 copay, 13d 20%"	7e/7h/9c. $15 group copay/$25 individual copay	7c/7i. $20 copay	8b. $100 copay for MRI/CT/Endo/PET/Nuclear	7b/7f/18a. $30 copay	15. no copay	"13a. no copay, 17a $30 copay"	no copay	no copay	17a1. $20 copay	17b1. $25 copay	18a1. $20 copay	no copay	no copay	no copay	no copay											135	135	50	0	50	76	0	50	100	100	100	0	0	50	20	30	24	20	20	30	0	30	0	0	20	25	20	0	0	0	0											8.595	0.302625	0.104583333	0	0.871666667	0.1596	0	1.255833333	2.98	0.001666667	2.4075	0	0	0.836666667	4.365	9.87425	0.2588	0.201666667	1.398	0.44225	0	0.65325	0	0	0.4145	0.020208333	0.096167826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2392			8.595	0.302625	0.104583333	0	0.871666667	0.1596	0	1.255833333	2.98	0.001666667	2.4075	0	0	0.836666667	4.365	9.87425	0.2588	0.201666667	1.398	0.44225	0	0.65325	0	0	0.4145	0.020208333	0.096167826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2392																																																																																				0			8.595	0.302625	0.104583333	0	0.871666667	0.1596	0	1.255833333	2.98	0.001666667	2.4075	0	0	0.836666667	4.365	9.87425	0.2588	0.201666667	1.398	0.44225	0	0.65325	0	0	0.4145	0.020208333	0.096167826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2392
H3755_002_0	2008	6																																D	D	D	V	T	O	O	V	V	P	P	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	O	O	V																																																				0		677.2	23.9	22.9	0	183.5	22.1	0	264.4	316.8	0.3	253.4	0	0	232.2	2450.7	3625.9	115.6	106.2	735.8	158.6	0	234.2	0	0	218.1	8.5	53.99109333	0	0	0	0											1a. $50 copay day (1st 5 days)	1b. $50 copay day (1st 5 days)	2. no copay	6. no copay	10a. $50 copay	"11a. Wheelchairs - $50 copay, Power wheelchairs & Scooters - 20% Coins"	11b. No copay	"4a. $50 copay, 4b. $50 copay if at ER"	9a/9b. No copay	8a. No copay	8b/14g $100 copay for MRI/CT/Endo/PET/Nuclear	no copay	no copay	3/5. no copay	"7a/7g/14b/14c/14d/14f/14i $10 copay, 14a/14h no copay"	"7d/7g/16b $20 copay, 13d no copay"	7e/7h/9c. $20 group copay/$20 individual copay	7c/7i. $20 copay	8b. $100 copay for MRI/CT/Endo/PET/Nuclear	7b/7f/18a. $20 copay	15. no copay	"13a. no copay, 17a $20 copay"	no copay	no copay	17a1. $20 copay	17b1. $20 copay	18a1. $10 copay	no copay	no copay	no copay	no copay											50	50	0	0	50	76	0	50	0	0	100	0	0	0	10	20	20	20	20	20	0	20	0	0	20	20	10	0	0	0	0											2.8217	0.099583333	0	0	0.764583333	0.139966667	0	1.101666667	0	0	2.111666667	0	0	0	2.04225	6.043166667	0.192666667	0.177	1.226333333	0.264333333	0	0.390333333	0	0	0.3635	0.014166667	0.044992578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7979			2.8217	0.099583333	0	0	0.764583333	0.139966667	0	1.101666667	0	0	2.111666667	0	0	0	2.04225	6.043166667	0.192666667	0.177	1.226333333	0.264333333	0	0.390333333	0	0	0.3635	0.014166667	0.044992578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7979																																																																																				0			2.8217	0.099583333	0	0	0.764583333	0.139966667	0	1.101666667	0	0	2.111666667	0	0	0	2.04225	6.043166667	0.192666667	0.177	1.226333333	0.264333333	0	0.390333333	0	0	0.3635	0.014166667	0.044992578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7979
H3755_004_0	2008	4																																D	D	D	V	T	O	O	V	V	P	P	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	O	O	V																																																				0		804.8	28.4	27.2	0	218.1	26.2	0	314.2	376.6	0.4	301.2	0	0	275.9	2912.6	4309.4	137.4	126.2	874.5	188.4	0	278.3	0	0	259.3	10.1	64.1677441	0	0	0	0											1a. $50 copay day (1st 5 days)	1b. $50 copay day (1st 5 days)	2. no copay	6. no copay	10a. $50 copay	"11a. Wheelchairs - $50 copay, Power wheelchairs & Scooters - 20% Coins"	11b. No copay	"4a. $50 copay, 4b. $50 copay if at ER"	9a/9b. No copay	8a. No copay	8b/14g $100 copay for MRI/CT/Endo/PET/Nuclear	no copay	no copay	3/5. no copay	"7a/7g/14b/14c/14d/14f/14i $10 copay, 14a/14h no copay"	"7d/7g/16b $20 copay, 13d no copay"	7e/7h/9c. $20 group copay/$20 individual copay	7c/7i. $20 copay	8b. $100 copay for MRI/CT/Endo/PET/Nuclear	7b/7f/18a. $20 copay	15. no copay	"13a. no copay, 17a $20 copay"	no copay	no copay	17a1. $20 copay	17b1. $20 copay	18a1. $10 copay	no copay	no copay	no copay	no copay											50	50	0	0	50	76	0	50	0	0	100	0	0	0	10	20	20	20	20	20	0	20	0	0	20	20	10	0	0	0	0											3.3533	0.118333333	0	0	0.90875	0.165933333	0	1.309166667	0	0	2.51	0	0	0	2.427166667	7.182333333	0.229	0.210333333	1.4575	0.314	0	0.463833333	0	0	0.432166667	0.016833333	0.05347312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.1522			3.3533	0.118333333	0	0	0.90875	0.165933333	0	1.309166667	0	0	2.51	0	0	0	2.427166667	7.182333333	0.229	0.210333333	1.4575	0.314	0	0.463833333	0	0	0.432166667	0.016833333	0.05347312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.1522																																																																																				0			3.3533	0.118333333	0	0	0.90875	0.165933333	0	1.309166667	0	0	2.51	0	0	0	2.427166667	7.182333333	0.229	0.210333333	1.4575	0.314	0	0.463833333	0	0	0.432166667	0.016833333	0.05347312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.1522
H3755_801_0	2008	3																																D	D	D	V	T	O	O	V	V	P	P	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	O	O	V																																																				0		670.9	16.3	34	0	75.8	24.4	0	205.6	359.8	0.4	320.1	0	0	162.6	2768.9	4175.6	132.7	106.6	1065.9	146.7	0	261.8	0	0	249.2	11	75.18353381	0	0	0	0											1a. $100 copay day (1st 5 days)	1b. $100 copay day (1st 5 days)	"2. $50 copay/day, days 21-100"	6. no copay	10a. $50 copay	"11a. Wheelchairs - $50 copay, Power wheelchairs & Scooters - 20% Coins"	11b. No copay	"4a. $50 copay, 4b. $50 copay if at ER"	9a/9b. $100 copay	8a. $100 copay	8b/14g $100 copay for MRI/CT/Endo/PET/Nuclear	no copay	no copay	3/5. $50 copay	"7a/7g/14b/14c/14d/14f/14i $20 copay, 14a/14h no copay"	"7d/7g/16b $30 copay, 13d 20%"	7e/7h/9c. $15 group copay/$25 individual copay	7c/7i. $20 copay	8b. $100 copay for MRI/CT/Endo/PET/Nuclear	7b/7f/18a. $30 copay	15. no copay	"13a. no copay, 17a $30 copay"	no copay	no copay	17a1. $20 copay	17b1. $25 copay	18a1. $20 copay	no copay	no copay	no copay	no copay											100	100	50	0	50	76	0	50	100	100	100	0	0	50	20	30	24	20	20	30	0	30	0	0	20	25	20	0	0	0	0											5.5908	0.135833333	0.141666667	0	0.315833333	0.154533333	0	0.856666667	2.998333333	0.003333333	2.6675	0	0	0.6775	4.614833333	10.439	0.2654	0.177666667	1.7765	0.36675	0	0.6545	0	0	0.415333333	0.022916667	0.12530589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.4002			5.5908	0.135833333	0.141666667	0	0.315833333	0.154533333	0	0.856666667	2.998333333	0.003333333	2.6675	0	0	0.6775	4.614833333	10.439	0.2654	0.177666667	1.7765	0.36675	0	0.6545	0	0	0.415333333	0.022916667	0.12530589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.4002																																																																																				0			5.5908	0.135833333	0.141666667	0	0.315833333	0.154533333	0	0.856666667	2.998333333	0.003333333	2.6675	0	0	0.6775	4.614833333	10.439	0.2654	0.177666667	1.7765	0.36675	0	0.6545	0	0	0.415333333	0.022916667	0.12530589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.4002
H3805_001_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1359.047122	9.962187141	1216.827799		531.3942951	14.3785729	13.18813161	383.3604767	203.7962692	13867.37175	44.48057934			1300.306676	4455.085405	3292.862081	346.3147273	238.7872694			29.57927424	1250.481559			172.7284747	0.029198841																$200 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$200 (9b)	$0 (8a1); $0/$8 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											85.6739	912	63.2242		100	0.2	0.2	49.0917	200	3.2	0.13523444			5.7591	15	29.9995	30	7.9579			0.2	30			30	0.390658857																9.7029	0.757126223	6.41108401	0	4.428285793	2.87571458	2.637626322	1.568319274	3.396604487	3.697965801	6.015306217	0	0	0.624049817	5.568856756	8.232024433	0.865786818	0.158353965	0	0	5.915854848	3.126203898	0	0	0.431821187	0.011406786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4253	0	0	9.7029	0.757126223	6.41108401	0	4.428285793	2.87571458	2.637626322	1.568319274	3.396604487	3.697965801	6.015306217	0	0	0.624049817	5.568856756	8.232024433	0.865786818	0.158353965	0	0	5.915854848	3.126203898	0	0	0.431821187	0.011406786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4253																																																																																				0			9.7029	0.757126223	6.41108401	0	4.428285793	2.87571458	2.637626322	1.568319274	3.396604487	3.697965801	6.015306217	0	0	0.624049817	5.568856756	8.232024433	0.865786818	0.158353965	0	0	5.915854848	3.126203898	0	0	0.431821187	0.011406786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4253
H3805_007_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1009.661954	9.672829273	1037.131176		530.6361475	16.62667954	9.353716509	378.3640991	138.3770522	11981.74057	61.54622595			1119.766592	4356.591818	3110.83237	321.6066789	236.3805917			20.0229645	916.5450699			212.402239	0.001458006																$150 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$150 (9b)	$0 (8a1); $0/$9 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$150 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5, 9a); $30/$30 (9c)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											64.2555	912	63.2242		100	0.2	0.2	48.4903	150	3.6	0.148125522			4.9981	15	30	30	7.9579			0.2	30			30	0.826208217																5.4064	0.735135025	5.464318865	0	4.421967896	3.325335908	1.870743302	1.528914922	1.729713153	3.594522171	9.116566866	0	0	0.46638826	5.445739772	7.777080924	0.804016697	0.156757954	0	0	4.0045929	2.291362675	0	0	0.531005598	0.001204616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.6717	0	0	5.4064	0.735135025	5.464318865	0	4.421967896	3.325335908	1.870743302	1.528914922	1.729713153	3.594522171	9.116566866	0	0	0.46638826	5.445739772	7.777080924	0.804016697	0.156757954	0	0	4.0045929	2.291362675	0	0	0.531005598	0.001204616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.6717																																																																																				0			5.4064	0.735135025	5.464318865	0	4.421967896	3.325335908	1.870743302	1.528914922	1.729713153	3.594522171	9.116566866	0	0	0.46638826	5.445739772	7.777080924	0.804016697	0.156757954	0	0	4.0045929	2.291362675	0	0	0.531005598	0.001204616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.6717
H3805_011_0	2008	3																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1402.427566	10.28017766	1255.668637		548.3562678	14.76946358	13.71927726	395.410471	210.301395		46.56369384			1341.812139	4367.536456	3397.969413	357.3690066	246.4092991			30.65095762	1290.396617			144																	$200 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$200 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											85.6739	912	63.2242		100	0.2	0.2	49.0913	200		0.136110631			5.7605	15	29.9995	30	7.9579			0.2	30			30																	10.0126	0.781293502	6.615724204	0	4.569635565	2.953892717	2.743855453	1.617601399	3.50502325	0	6.337813753	0	0	0.64412988	5.45942057	8.494788588	0.893422516	0.163408583	0	0	6.130191523	3.225991543	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5088	0	0	10.0126	0.781293502	6.615724204	0	4.569635565	2.953892717	2.743855453	1.617601399	3.50502325	0	6.337813753	0	0	0.64412988	5.45942057	8.494788588	0.893422516	0.163408583	0	0	6.130191523	3.225991543	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5088																																																																																				0			10.0126	0.781293502	6.615724204	0	4.569635565	2.953892717	2.743855453	1.617601399	3.50502325	0	6.337813753	0	0	0.64412988	5.45942057	8.494788588	0.893422516	0.163408583	0	0	6.130191523	3.225991543	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5088
H3805_801_0	2008	2																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1463.721923	91.48278012	1374.933116		9.446518076	17.61301398	15.98356069	395.6457921	228.3635457		41.26533909		5.9636338	1496.053528	4500.295966	3575.791778	3.146977591	268.1037527			33.49892955	1301.328667			150.8743973																	$470 (1a); $0 (1a1)	$470 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											173.153	178.7345	159.1696		0.3	0.3	0.3	49.0762	300		0.225652427		0.3	7.5077	20	39.9939	0.406631801	40			0.3	40			40																	21.1206	1.362594074	18.2372918	0	2.833955423	5.283904194	4.795068206	1.618064766	5.709088643	0	9.311623919	0	1.78909014	0.93599179	7.500493277	11.91748701	1.279661166	0.893679176	0	0	10.04967887	4.337762222	0	0	0.502914658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.479	0	0	21.1206	1.362594074	18.2372918	0	2.833955423	5.283904194	4.795068206	1.618064766	5.709088643	0	9.311623919	0	1.78909014	0.93599179	7.500493277	11.91748701	1.279661166	0.893679176	0	0	10.04967887	4.337762222	0	0	0.502914658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.479																																																																																				0			21.1206	1.362594074	18.2372918	0	2.833955423	5.283904194	4.795068206	1.618064766	5.709088643	0	9.311623919	0	1.78909014	0.93599179	7.500493277	11.91748701	1.279661166	0.893679176	0	0	10.04967887	4.337762222	0	0	0.502914658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.479
H3805_802_0	2008	2																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1463.721923	91.48278012	1374.933116		9.446518076	17.61301398	15.98356069	395.6457921	228.3635457		41.26533909		5.9636338	1496.053528	4500.295966	3575.791778	3.146977591	268.1037527			33.49892955	1301.328667			150.8743973																	$470 (1a); $0 (1a1)	$470 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											173.153	178.7345	159.1696		0.3	0.3	0.3	49.0762	300		0.225652427		0.3	7.5077	20	39.9939	0.406631801	40			0.3	40			40																	21.1206	1.362594074	18.2372918	0	2.833955423	5.283904194	4.795068206	1.618064766	5.709088643	0	9.311623919	0	1.78909014	0.93599179	7.500493277	11.91748701	1.279661166	0.893679176	0	0	10.04967887	4.337762222	0	0	0.502914658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.479	0	0	21.1206	1.362594074	18.2372918	0	2.833955423	5.283904194	4.795068206	1.618064766	5.709088643	0	9.311623919	0	1.78909014	0.93599179	7.500493277	11.91748701	1.279661166	0.893679176	0	0	10.04967887	4.337762222	0	0	0.502914658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.479																																																																																				0			21.1206	1.362594074	18.2372918	0	2.833955423	5.283904194	4.795068206	1.618064766	5.709088643	0	9.311623919	0	1.78909014	0.93599179	7.500493277	11.91748701	1.279661166	0.893679176	0	0	10.04967887	4.337762222	0	0	0.502914658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.479
H3805_803_0	2008	2																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1344.867628	94.70265001	1112.104416		10.05432492	16.36533494	15.5060092	393.3642475	221.0506731		42.66275966		4.866286574	1527.491143	4451.250208	3576.55673	3.058742807	303.6699703			41.97733232	1257.205073			170.8325315																	$520 (1a); $0 (1a1)	$520 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											222.7522	232.4233	159.1696		0.3	0.3	0.3	48.8672	300		0.225795223		0.3	7.5074	20	39.9974	0.403092778	40			0.3	40			40																	24.9644	1.834258913	14.75109771	0	3.016297475	4.909600482	4.651802759	1.601883591	5.526266827	0	9.633047351	0	1.459885972	0.955625991	7.418750347	11.92109409	1.232957135	1.012233234	0	0	12.59319969	4.190683578	0	0	0.569441772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2425	0	0	24.9644	1.834258913	14.75109771	0	3.016297475	4.909600482	4.651802759	1.601883591	5.526266827	0	9.633047351	0	1.459885972	0.955625991	7.418750347	11.92109409	1.232957135	1.012233234	0	0	12.59319969	4.190683578	0	0	0.569441772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2425																																																																																				0			24.9644	1.834258913	14.75109771	0	3.016297475	4.909600482	4.651802759	1.601883591	5.526266827	0	9.633047351	0	1.459885972	0.955625991	7.418750347	11.92109409	1.232957135	1.012233234	0	0	12.59319969	4.190683578	0	0	0.569441772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2425
H3805_804_0	2008	2																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1344.867628	94.70265001	1112.104416		10.05432492	16.36533494	15.5060092	393.3642475	221.0506731		42.66275966		4.866286574	1527.491143	4451.250208	3576.55673	3.058742807	303.6699703			41.97733232	1257.205073			170.8325315																	$520 (1a); $0 (1a1)	$520 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											222.7522	232.4233	159.1696		0.3	0.3	0.3	48.8672	300		0.225795223		0.3	7.5074	20	39.9974	0.403092778	40			0.3	40			40																	24.9644	1.834258913	14.75109771	0	3.016297475	4.909600482	4.651802759	1.601883591	5.526266827	0	9.633047351	0	1.459885972	0.955625991	7.418750347	11.92109409	1.232957135	1.012233234	0	0	12.59319969	4.190683578	0	0	0.569441772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2425	0	0	24.9644	1.834258913	14.75109771	0	3.016297475	4.909600482	4.651802759	1.601883591	5.526266827	0	9.633047351	0	1.459885972	0.955625991	7.418750347	11.92109409	1.232957135	1.012233234	0	0	12.59319969	4.190683578	0	0	0.569441772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2425																																																																																				0			24.9644	1.834258913	14.75109771	0	3.016297475	4.909600482	4.651802759	1.601883591	5.526266827	0	9.633047351	0	1.459885972	0.955625991	7.418750347	11.92109409	1.232957135	1.012233234	0	0	12.59319969	4.190683578	0	0	0.569441772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2425
H3810_001_0	2008	6																					2000											A	A			T			V	V					V	V	V	V	V		V					V						V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		210.0154024	2.874956813	0	0	171.1397965	0	0	331.2292842	249.8236375	0	0	0	0	606.9581052	3523.29688	3166.480263	134.2664591	335.4114202	0	1504.644556	0	0	0	0	378.9512399	0	0	0	0	0	580.2											$100/Admit for IP Medical; $100/Admit for IP Surgical	$100/Admit for IP Psych; $100/Admit for IP Substance Abuse	No cost-sharing	No cost-sharing	$50/Trip for Ambulance	No cost-sharing	No cost-sharing	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$15/Case for OP Fac - Cardiovascular; $15/Case for OP Fac - Occ Therapy; $15/Case for OP Fac - Physical/Speech Therapy; $15/Case for OP Fac - CORF; $15/Visit for Prof - CORF; $15/Visit for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Consult for PCP - Consults;	$15/Visit for Speclst - Office Visits; $15/Consult for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $15/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$15/Visit for PT/ST (PCP); $15/Visit for Occ Therapy (PCP); $15/Visit for PT/ST (Specialist); $15/Visit for Occ Therapy (Specialist);	No cost-sharing	$15/Visit for Chiropractor; $15/Exam for Vistion Exams; $15/Service for Podiatrist; $15/Exam for Hearing/Speech Exams;	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$15/Exam for Vision (Refractions)	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$15/Visit for Care Coord; $15/Visit for Alt Med;											98.98160644	98.98160669	0	0	49.49080322	0	0	43.06381409	49.49080322	0	0	0	0	14.84724097	14.84724097	14.84724097	14.84724096	14.84724096	0	14.84724097	0	0	0	0	14.84724097	0	0	0	0	0	14.84724097											1.7323	0.023713987	0	0	0.705820499	0	0	1.18866636	1.03033104	0	0	0	0	0.750971104	4.359269814	3.91779129	0.166123873	0.414994515	0	1.861651691	0	0	0	0	0.468865031	0	0	0	0	0	0.717864101	0	0	0	0	0	0	0	0	0	0	17.3384	0	0.178389535	1.7323	0.023713987	0	0	0.705820499	0	0	1.18866636	1.03033104	0	0	0	0	0.750971104	4.359269814	3.91779129	0.166123873	0.414994515	0	1.861651691	0	0	0	0	0.468865031	0	0	0	0	0	0.717864101	0	0	0	0	0	0	0	0	0	0	17.3384																																																																																				0	0		1.7323	0.023713987	0	0	0.705820499	0	0	1.18866636	1.03033104	0	0	0	0	0.750971104	4.359269814	3.91779129	0.166123873	0.414994515	0	1.861651691	0	0	0	0	0.468865031	0	0	0	0	0	0.717864101	0	0	0	0	0	0	0	0	0	0	17.3384
H3810_002_0	2008	6																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin			V																	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0																	0		330.2956316	26.60943579	60.35292694		19.18062681	41.02594168	26.92998338	17.91754269	24.79549346	2.751049422	30.79252735	0	3.955684381	50.38418718	58.280026	126.1528075	9.258963013	4.698244309	24.02295933	44.55745105	7.721823409	0.97867191			322.7756145																	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No cost-sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing			Medicare FFS Cost-Sharing																	0.077	0.077	0.1421		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.23	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			15																	25.4328	2.048926556	8.576150918	0	4.488266673	9.600070353	6.301616112	4.19270499	5.802145469	0.643745565	7.2054514	0	0.925630145	11.7898998	13.63752608	29.51975695	2.166597345	1.099389168	5.621372484	10.42644354	1.806906678	0.229009227	0	0	0.403469518	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.9178	0	0	25.4328	2.048926556	8.576150918	0	4.488266673	9.600070353	6.301616112	4.19270499	5.802145469	0.643745565	7.2054514	0	0.925630145	11.7898998	13.63752608	29.51975695	2.166597345	1.099389168	5.621372484	10.42644354	1.806906678	0.229009227	0	0	0.403469518	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.9178																																																																																				0	0		25.4328	2.048926556	8.576150918	0	4.488266673	9.600070353	6.301616112	4.19270499	5.802145469	0.643745565	7.2054514	0	0.925630145	11.7898998	13.63752608	29.51975695	2.166597345	1.099389168	5.621372484	10.42644354	1.806906678	0.229009227	0	0	0.403469518	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.9178
H3810_003_0	2008	6																					2000											A	A			T			V	V					V	V	V	V	V		V					V						V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		208.8851361	2.618545091	0	0	172.1289265	0	0	345.3492555	254.2959552	0	0	0	0	594.4549428	3827.393195	3409.306981	142.4974488	351.2874129	0	1538.075461	0	0	0	0	381.782041	0	0	0	0	0	580.2											$100/Admit for IP Medical; $100/Admit for IP Surgical	$100/Admit for IP Psych; $100/Admit for IP Substance Abuse	No cost-sharing	No cost-sharing	$50/Trip for Ambulance	No cost-sharing	No cost-sharing	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$15/Case for OP Fac - Cardiovascular; $15/Case for OP Fac - Occ Therapy; $15/Case for OP Fac - Physical/Speech Therapy; $15/Case for OP Fac - CORF; $15/Visit for Prof - CORF; $15/Visit for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Consult for PCP - Consults;	$15/Visit for Speclst - Office Visits; $15/Consult for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $15/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$15/Visit for PT/ST (PCP); $15/Visit for Occ Therapy (PCP); $15/Visit for PT/ST (Specialist); $15/Visit for Occ Therapy (Specialist);	No cost-sharing	$15/Visit for Chiropractor; $15/Exam for Vistion Exams; $15/Service for Podiatrist; $15/Exam for Hearing/Speech Exams;	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$15/Exam for Vision (Refractions)	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$15/Visit for Care Coord; $15/Visit for Alt Med;											98.88548207	98.88548212	0	0	49.44274104	0	0	42.70049089	49.44274104	0	0	0	0	14.83282231	14.83282231	14.83282231	14.83282231	14.83282231	0	14.83282231	0	0	0	0	14.83282231	0	0	0	0	0	14.83282231											1.7213	0.021578008	0	0	0.709210495	0	0	1.228881895	1.047757422	0	0	0	0	0.734787045	4.730920265	4.214137054	0.176136612	0.434215315	0	1.901166668	0	0	0	0	0.471908765	0	0	0	0	0	0.717166959	0	0	0	0	0	0	0	0	0	0	18.1092	0	0.204104792	1.7213	0.021578008	0	0	0.709210495	0	0	1.228881895	1.047757422	0	0	0	0	0.734787045	4.730920265	4.214137054	0.176136612	0.434215315	0	1.901166668	0	0	0	0	0.471908765	0	0	0	0	0	0.717166959	0	0	0	0	0	0	0	0	0	0	18.1092																																																																																				0	0		1.7213	0.021578008	0	0	0.709210495	0	0	1.228881895	1.047757422	0	0	0	0	0.734787045	4.730920265	4.214137054	0.176136612	0.434215315	0	1.901166668	0	0	0	0	0.471908765	0	0	0	0	0	0.717166959	0	0	0	0	0	0	0	0	0	0	18.1092
H3810_004_0	2008	6																					500											A	A			T			V	V					V	V	V	V	V		V					V				Coin		V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		220.2314329	3.06147321	0	0	188.2339288	0	0	361.535431	274.102102	0	0	0	0	673.1464717	3969.713211	3563.187023	152.4635231	382.4030002	0	1734.37759	0	0	0	0	393.3021498	0	0	0	8.827287232	0	580.2											$100/Admit for IP Medical; $100/Admit for IP Surgical	$100/Admit for IP Psych; $100/Admit for IP Substance Abuse	No cost-sharing	No cost-sharing	$50/Trip for Ambulance	No cost-sharing	No cost-sharing	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$5/Case for OP Fac - Cardiovascular; $5/Case for OP Fac - Occ Therapy; $5/Case for OP Fac - Physical/Speech Therapy; $5/Case for OP Fac - CORF; $5/Visit for Prof - CORF; $5/Visit for Prof - CORF;	$5/Visit for PCP - Office Visits; $5/Consult for PCP - Consults;	$5/Visit for Speclst - Office Visits; $5/Consult for Speclst - Consults;	$5/Visit for OP Psych - Non-Physician; $5/Visit for OP Psych - Psychiatrist; $5/Visit for OP Substance Abuse;	$5/Visit for PT/ST (PCP); $5/Visit for Occ Therapy (PCP); $5/Visit for PT/ST (Specialist); $5/Visit for Occ Therapy (Specialist);	No cost-sharing	$5/Visit for Chiropractor; $5/Exam for Vistion Exams; $5/Service for Podiatrist; $5/Exam for Hearing/Speech Exams;	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$5/Exam for Vision (Refractions)	No cost-sharing	No cost-sharing	No cost-sharing	20% Coinsurance for Point of Service;	No cost-sharing	$5/Visit for Care Coord; $5/Visit for Alt Med;											96.02880785	96.02880803	0	0	48.01440393	0	0	41.84782685	48.01440392	0	0	0	0	4.801440393	4.801440393	4.801440392	4.801440403	4.801440393	0	4.801440393	0	0	0	0	4.801440394	0	0	0	0.2	0	4.801440393											1.7624	0.024499135	0	0	0.753161658	0	0	1.260789343	1.09673742	0	0	0	0	0.269339388	1.58836178	1.425702508	0.06100371	0.153007101	0	0.693959218	0	0	0	0	0.157368069	0	0	0	1.765457446	0	0.232149643	0	0	0	0	0	0	0	0	0	0	11.2439	0	0.39197386	1.7624	0.024499135	0	0	0.753161658	0	0	1.260789343	1.09673742	0	0	0	0	0.269339388	1.58836178	1.425702508	0.06100371	0.153007101	0	0.693959218	0	0	0	0	0.157368069	0	0	0	1.765457446	0	0.232149643	0	0	0	0	0	0	0	0	0	0	11.2439																																																																																				0	0		1.7624	0.024499135	0	0	0.753161658	0	0	1.260789343	1.09673742	0	0	0	0	0.269339388	1.58836178	1.425702508	0.06100371	0.153007101	0	0.693959218	0	0	0	0	0.157368069	0	0	0	1.765457446	0	0.232149643	0	0	0	0	0	0	0	0	0	0	11.2439
H3810_005_0	2008	6																					500											A	A			T			V	V					V	V	V	V	V		V					V				Coin		V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		221.6072572	3.105540929	0	0	190.1920146	0	0	364.1928359	276.8044567	0	0	0	0	682.1467817	3983.51284	3578.449653	153.2513401	384.8632391	0	1750.053744	0	0	0	0	393.1283524	0	0	0	9.184980572	0	580.2											$100/Admit for IP Medical; $100/Admit for IP Surgical	$100/Admit for IP Psych; $100/Admit for IP Substance Abuse	No cost-sharing	No cost-sharing	$50/Trip for Ambulance	No cost-sharing	No cost-sharing	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$5/Case for OP Fac - Cardiovascular; $5/Case for OP Fac - Occ Therapy; $5/Case for OP Fac - Physical/Speech Therapy; $5/Case for OP Fac - CORF; $5/Visit for Prof - CORF; $5/Visit for Prof - CORF;	$5/Visit for PCP - Office Visits; $5/Consult for PCP - Consults;	$5/Visit for Speclst - Office Visits; $5/Consult for Speclst - Consults;	$5/Visit for OP Psych - Non-Physician; $5/Visit for OP Psych - Psychiatrist; $5/Visit for OP Substance Abuse;	$5/Visit for PT/ST (PCP); $5/Visit for Occ Therapy (PCP); $5/Visit for PT/ST (Specialist); $5/Visit for Occ Therapy (Specialist);	No cost-sharing	$5/Visit for Chiropractor; $5/Exam for Vistion Exams; $5/Service for Podiatrist; $5/Exam for Hearing/Speech Exams;	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$5/Exam for Vision (Refractions)	No cost-sharing	No cost-sharing	No cost-sharing	20% Coinsurance for Point of Service;	No cost-sharing	$5/Visit for Care Coord; $5/Visit for Alt Med;											95.99553288	95.99553311	0	0	47.99776644	0	0	41.8671158	47.99776644	0	0	0	0	4.799776642	4.799776644	4.799776644	4.799776647	4.799776645	0	4.799776644	0	0	0	0	4.799776645	0	0	0	0.2	0	4.799776644											1.7728	0.024843171	0	0	0.760732658	0	0	1.27064197	1.107166305	0	0	0	0	0.272846016	1.593330991	1.431313256	0.061297684	0.153938132	0	0.699988924	0	0	0	0	0.157244024	0	0	0	1.836996114	0	0.232069201	0	0	0	0	0	0	0	0	0	0	11.3752	0	0.397886846	1.7728	0.024843171	0	0	0.760732658	0	0	1.27064197	1.107166305	0	0	0	0	0.272846016	1.593330991	1.431313256	0.061297684	0.153938132	0	0.699988924	0	0	0	0	0.157244024	0	0	0	1.836996114	0	0.232069201	0	0	0	0	0	0	0	0	0	0	11.3752																																																																																				0	0		1.7728	0.024843171	0	0	0.760732658	0	0	1.27064197	1.107166305	0	0	0	0	0.272846016	1.593330991	1.431313256	0.061297684	0.153938132	0	0.699988924	0	0	0	0	0.157244024	0	0	0	1.836996114	0	0.232069201	0	0	0	0	0	0	0	0	0	0	11.3752
H3810_006_0	2008	6																					3250											D	D	D		T	Coin	Coin	V	V				Coin	V	V	V	V	V		V					V						V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		584.4412164	11.31124403	234.4174094	0	156.3712231	10.2922892	4.985983976	301.2824549	227.9338433	0	0	0	0.294376883	556.3984291	3187.336603	2788.280685	120.0932485	304.881522	0	1322.809935	0	0	0	0	366.7602634	0	0	0	0	0	495											$250/Day for IP Medical; $250/Day for IP Surgical	$250/Day for IP Psych; $250/Day for IP Substance Abuse	$250/Day for SNF	No cost-sharing	$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	$200/Case for OP Fac - Surgery; $200/Case for OP Fac - ASC	No cost-sharing	No cost-sharing	No cost-sharing	20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	$15/Case for OP Fac - Cardiovascular; $15/Case for OP Fac - Occ Therapy; $15/Case for OP Fac - Physical/Speech Therapy; $15/Case for OP Fac - CORF; $15/Visit for Prof - CORF; $15/Visit for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Consult for PCP - Consults;	$25/Visit for Speclst - Office Visits; $25/Consult for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $25/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$15/Visit for PT/ST (PCP); $15/Visit for Occ Therapy (PCP); $15/Visit for PT/ST (Specialist); $15/Visit for Occ Therapy (Specialist);	No cost-sharing	$25/Visit for Chiropractor; $25/Exam for Vistion Exams; $25/Service for Podiatrist; $25/Exam for Hearing/Speech Exams;	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$25/Exam for Vision (Refractions)	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$25/Visit for Alt Med;											244.7881521	244.7881521	244.7881521	0	48.95763043	0.195830522	0.195830522	42.64111582	195.8305217	0	0	0	0.195830522	14.68728913	14.68728913	24.47881521	19.04020472	14.68728912	0	24.47881521	0	0	0	0	24.47881522	0	0	0	0	0	24.47881521											11.922	0.23073821	4.781883706	0	0.637963713	2.015544363	0.976407843	1.070585005	3.719700288	0	0	0	0.057647979	0.680998717	3.901111186	5.687817305	0.190550003	0.373156922	0	2.698401664	0	0	0	0	0.748154726	0	0	0	0	0	1.009751128	0	0	0	0	0	0	0	0	0	0	40.7024	0	0.866606103	11.922	0.23073821	4.781883706	0	0.637963713	2.015544363	0.976407843	1.070585005	3.719700288	0	0	0	0.057647979	0.680998717	3.901111186	5.687817305	0.190550003	0.373156922	0	2.698401664	0	0	0	0	0.748154726	0	0	0	0	0	1.009751128	0	0	0	0	0	0	0	0	0	0	40.7024																																																																																				0	0		11.922	0.23073821	4.781883706	0	0.637963713	2.015544363	0.976407843	1.070585005	3.719700288	0	0	0	0.057647979	0.680998717	3.901111186	5.687817305	0.190550003	0.373156922	0	2.698401664	0	0	0	0	0.748154726	0	0	0	0	0	1.009751128	0	0	0	0	0	0	0	0	0	0	40.7024
H3810_007_0	2008	6																					3250											D	D	D		T	Coin	Coin	V	V				Coin	V	V	V	V	V		V					V						V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		591.7067892	12.32492766	225.2083928	0	162.5435028	10.77255495	5.21864333	308.0586493	235.7988068	0	0	0	0.308899335	585.647054	3189.853277	2795.043537	121.3383121	310.5167088	0	1358.392154	0	0	0	0	363.7772143	0	0	0	0	0	495											$250/Day for IP Medical; $250/Day for IP Surgical	$250/Day for IP Psych; $250/Day for IP Substance Abuse	$250/Day for SNF	No cost-sharing	$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	$200/Case for OP Fac - Surgery; $200/Case for OP Fac - ASC	No cost-sharing	No cost-sharing	No cost-sharing	20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	$15/Case for OP Fac - Cardiovascular; $15/Case for OP Fac - Occ Therapy; $15/Case for OP Fac - Physical/Speech Therapy; $15/Case for OP Fac - CORF; $15/Visit for Prof - CORF; $15/Visit for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Consult for PCP - Consults;	$25/Visit for Speclst - Office Visits; $25/Consult for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $25/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$15/Visit for PT/ST (PCP); $15/Visit for Occ Therapy (PCP); $15/Visit for PT/ST (Specialist); $15/Visit for Occ Therapy (Specialist);	No cost-sharing	$25/Visit for Chiropractor; $25/Exam for Vistion Exams; $25/Service for Podiatrist; $25/Exam for Hearing/Speech Exams;	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$25/Exam for Vision (Refractions)	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$25/Visit for Alt Med;											244.7078435	244.7078435	244.7078435	0	48.9415687	0.195766275	0.195766275	42.78640543	195.7662748	0	0	0	0.195766275	14.68247061	14.68247061	24.47078435	19.02582695	14.68247061	0	24.47078435	0	0	0	0	24.47078435	0	0	0	0	0	24.47078435											12.0663	0.251333872	4.592521678	0	0.662927834	2.108902953	1.021634364	1.098393522	3.846787834	0	0	0	0.060472072	0.716562138	3.902910582	5.699742303	0.192380144	0.379929371	0	2.770076789	0	0	0	0	0.741826147	0	0	0	0	0	1.009419854	0	0	0	0	0	0	0	0	0	0	41.1221	0	0.889324033	12.0663	0.251333872	4.592521678	0	0.662927834	2.108902953	1.021634364	1.098393522	3.846787834	0	0	0	0.060472072	0.716562138	3.902910582	5.699742303	0.192380144	0.379929371	0	2.770076789	0	0	0	0	0.741826147	0	0	0	0	0	1.009419854	0	0	0	0	0	0	0	0	0	0	41.1221																																																																																				0	0		12.0663	0.251333872	4.592521678	0	0.662927834	2.108902953	1.021634364	1.098393522	3.846787834	0	0	0	0.060472072	0.716562138	3.902910582	5.699742303	0.192380144	0.379929371	0	2.770076789	0	0	0	0	0.741826147	0	0	0	0	0	1.009419854	0	0	0	0	0	0	0	0	0	0	41.1221
H3810_008_0	2008	6																					2000											A	A			T			V	V					V	V	V	V	V		V					V						V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		208.3177868	2.835797782	0	0	168.1728367	0	0	327.3387544	246.8141665	0	0	0	0	597.617907	3477.85659	3122.942132	131.5817333	328.2137461	0	1471.308117	0	0	0	0	377.705317	0	0	0	0	0	580.2											$100/Admit for IP Medical; $100/Admit for IP Surgical	$100/Admit for IP Psych; $100/Admit for IP Substance Abuse	No cost-sharing	No cost-sharing	$50/Trip for Ambulance	No cost-sharing	No cost-sharing	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$15/Case for OP Fac - Cardiovascular; $15/Case for OP Fac - Occ Therapy; $15/Case for OP Fac - Physical/Speech Therapy; $15/Case for OP Fac - CORF; $15/Visit for Prof - CORF; $15/Visit for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Consult for PCP - Consults;	$15/Visit for Speclst - Office Visits; $15/Consult for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $15/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$15/Visit for PT/ST (PCP); $15/Visit for Occ Therapy (PCP); $15/Visit for PT/ST (Specialist); $15/Visit for Occ Therapy (Specialist);	No cost-sharing	$15/Visit for Chiropractor; $15/Exam for Vistion Exams; $15/Service for Podiatrist; $15/Exam for Hearing/Speech Exams;	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$15/Exam for Vision (Refractions)	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$15/Visit for Care Coord; $15/Visit for Alt Med;											99.00370628	99.00370592	0	0	49.50185314	0	0	43.07600507	49.50185314	0	0	0	0	14.85055594	14.85055594	14.85055594	14.85055593	14.85055595	0	14.85055594	0	0	0	0	14.85055594	0	0	0	0	0	14.85055594											1.7187	0.023396207	0	0	0.693738922	0	0	1.175037154	1.018146552	0	0	0	0	0.739579847	4.304008654	3.86478557	0.162838491	0.406179717	0	1.820811959	0	0	0	0	0.467427828	0	0	0	0	0	0.71802438	0	0	0	0	0	0	0	0	0	0	17.1127	0	0.172208069	1.7187	0.023396207	0	0	0.693738922	0	0	1.175037154	1.018146552	0	0	0	0	0.739579847	4.304008654	3.86478557	0.162838491	0.406179717	0	1.820811959	0	0	0	0	0.467427828	0	0	0	0	0	0.71802438	0	0	0	0	0	0	0	0	0	0	17.1127																																																																																				0	0		1.7187	0.023396207	0	0	0.693738922	0	0	1.175037154	1.018146552	0	0	0	0	0.739579847	4.304008654	3.86478557	0.162838491	0.406179717	0	1.820811959	0	0	0	0	0.467427828	0	0	0	0	0	0.71802438	0	0	0	0	0	0	0	0	0	0	17.1127
H3810_010_0	2008	6																					2000											A	A			T			V	V					V	V	V	V	V		V					V						V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		222.4237831	3.067171483	0	0	191.4231139	0	0	370.4738916	280.4793815	0	0	0	0	683.3087799	3907.209474	3513.886186	148.3597303	370.8905157	0	1669.546992	0	0	0	0	377.1888997	0	0	0	0	0	580.2											$100/Admit for IP Medical; $100/Admit for IP Surgical	$100/Admit for IP Psych; $100/Admit for IP Substance Abuse	No cost-sharing	No cost-sharing	$50/Trip for Ambulance	No cost-sharing	No cost-sharing	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$15/Case for OP Fac - Cardiovascular; $15/Case for OP Fac - Occ Therapy; $15/Case for OP Fac - Physical/Speech Therapy; $15/Case for OP Fac - CORF; $15/Visit for Prof - CORF; $15/Visit for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Consult for PCP - Consults;	$15/Visit for Speclst - Office Visits; $15/Consult for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $15/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$15/Visit for PT/ST (PCP); $15/Visit for Occ Therapy (PCP); $15/Visit for PT/ST (Specialist); $15/Visit for Occ Therapy (Specialist);	No cost-sharing	$15/Visit for Chiropractor; $15/Exam for Vistion Exams; $15/Service for Podiatrist; $15/Exam for Hearing/Speech Exams;	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$15/Exam for Vision (Refractions)	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$15/Visit for Care Coord; $15/Visit for Alt Med;											98.74883392	98.74883407	0	0	49.37441696	0	0	43.02091051	49.37441696	0	0	0	0	14.81232509	14.81232509	14.81232509	14.81232509	14.81232509	0	14.81232509	0	0	0	0	14.81232509	0	0	0	0	0	14.81232509											1.8303	0.025239967	0	0	0.787617053	0	0	1.328177011	1.154042161	0	0	0	0	0.843449315	4.822904743	4.337402043	0.18312938	0.457812574	0	2.060822733	0	0	0	0	0.46558705	0	0	0	0	0	0.716175918	0	0	0	0	0	0	0	0	0	0	19.0127	0	0.240894451	1.8303	0.025239967	0	0	0.787617053	0	0	1.328177011	1.154042161	0	0	0	0	0.843449315	4.822904743	4.337402043	0.18312938	0.457812574	0	2.060822733	0	0	0	0	0.46558705	0	0	0	0	0	0.716175918	0	0	0	0	0	0	0	0	0	0	19.0127																																																																																				0	0		1.8303	0.025239967	0	0	0.787617053	0	0	1.328177011	1.154042161	0	0	0	0	0.843449315	4.822904743	4.337402043	0.18312938	0.457812574	0	2.060822733	0	0	0	0	0.46558705	0	0	0	0	0	0.716175918	0	0	0	0	0	0	0	0	0	0	19.0127
H3810_011_0	2008	6																					500											A	A			T			V	V					V	V	V	V	V		V					V				Coin		V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		219.4205338	3.053687231	0	0	186.2806786	0	0	358.9248423	272.6000814	0	0	0	0	669.0738277	3920.559413	3518.626956	149.6545159	375.1903969	0	1704.108422	0	0	0	0	391.6502075	0	0	0	9.031203275	0	580.2											$100/Admit for IP Medical; $100/Admit for IP Surgical	$100/Admit for IP Psych; $100/Admit for IP Substance Abuse	No cost-sharing	No cost-sharing	$50/Trip for Ambulance	No cost-sharing	No cost-sharing	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$5/Case for OP Fac - Cardiovascular; $5/Case for OP Fac - Occ Therapy; $5/Case for OP Fac - Physical/Speech Therapy; $5/Case for OP Fac - CORF; $5/Visit for Prof - CORF; $5/Visit for Prof - CORF;	$5/Visit for PCP - Office Visits; $5/Consult for PCP - Consults;	$5/Visit for Speclst - Office Visits; $5/Consult for Speclst - Consults;	$5/Visit for OP Psych - Non-Physician; $5/Visit for OP Psych - Psychiatrist; $5/Visit for OP Substance Abuse;	$5/Visit for PT/ST (PCP); $5/Visit for Occ Therapy (PCP); $5/Visit for PT/ST (Specialist); $5/Visit for Occ Therapy (Specialist);	No cost-sharing	$5/Visit for Chiropractor; $5/Exam for Vistion Exams; $5/Service for Podiatrist; $5/Exam for Hearing/Speech Exams;	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$5/Exam for Vision (Refractions)	No cost-sharing	No cost-sharing	No cost-sharing	20% Coinsurance for Point of Service;	No cost-sharing	$5/Visit for Care Coord; $5/Visit for Alt Med;											96.07410192	96.07410196	0	0	48.03705096	0	0	41.8980737	48.03705096	0	0	0	0	4.803705097	4.803705096	4.803705096	4.80370509	4.803705094	0	4.803705096	0	0	0	0	4.803705097	0	0	0	0.2	0	4.803705096											1.7567	0.024448355	0	0	0.745697871	0	0	1.253188291	1.091242	0	0	0	0	0.267836113	1.569434269	1.408537187	0.059908013	0.150192002	0	0.682169526	0	0	0	0	0.156781008	0	0	0	1.806240655	0	0.232259141	0	0	0	0	0	0	0	0	0	0	11.2047	0	0.384049508	1.7567	0.024448355	0	0	0.745697871	0	0	1.253188291	1.091242	0	0	0	0	0.267836113	1.569434269	1.408537187	0.059908013	0.150192002	0	0.682169526	0	0	0	0	0.156781008	0	0	0	1.806240655	0	0.232259141	0	0	0	0	0	0	0	0	0	0	11.2047																																																																																				0	0		1.7567	0.024448355	0	0	0.745697871	0	0	1.253188291	1.091242	0	0	0	0	0.267836113	1.569434269	1.408537187	0.059908013	0.150192002	0	0.682169526	0	0	0	0	0.156781008	0	0	0	1.806240655	0	0.232259141	0	0	0	0	0	0	0	0	0	0	11.2047
H3810_012_0	2008	6																					500											A	A			T			V	V					V	V	V	V	V		V					V				Coin		V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		220.3917599	3.069431035	0	0	188.2019891	0	0	362.3363493	275.349031	0	0	0	0	676.4023863	3954.476798	3549.773536	151.0284558	378.7556292	0	1721.352472	0	0	0	0	391.6540451	0	0	0	9.131885279	0	580.2											$100/Admit for IP Medical; $100/Admit for IP Surgical	$100/Admit for IP Psych; $100/Admit for IP Substance Abuse	No cost-sharing	No cost-sharing	$50/Trip for Ambulance	No cost-sharing	No cost-sharing	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$5/Case for OP Fac - Cardiovascular; $5/Case for OP Fac - Occ Therapy; $5/Case for OP Fac - Physical/Speech Therapy; $5/Case for OP Fac - CORF; $5/Visit for Prof - CORF; $5/Visit for Prof - CORF;	$5/Visit for PCP - Office Visits; $5/Consult for PCP - Consults;	$5/Visit for Speclst - Office Visits; $5/Consult for Speclst - Consults;	$5/Visit for OP Psych - Non-Physician; $5/Visit for OP Psych - Psychiatrist; $5/Visit for OP Substance Abuse;	$5/Visit for PT/ST (PCP); $5/Visit for Occ Therapy (PCP); $5/Visit for PT/ST (Specialist); $5/Visit for Occ Therapy (Specialist);	No cost-sharing	$5/Visit for Chiropractor; $5/Exam for Vistion Exams; $5/Service for Podiatrist; $5/Exam for Hearing/Speech Exams;	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$5/Exam for Vision (Refractions)	No cost-sharing	No cost-sharing	No cost-sharing	20% Coinsurance for Point of Service;	No cost-sharing	$5/Visit for Care Coord; $5/Visit for Alt Med;											96.03301548	96.03301527	0	0	48.01650774	0	0	41.88783454	48.01650774	0	0	0	0	4.801650774	4.801650774	4.801650774	4.801650777	4.801650771	0	4.801650773	0	0	0	0	4.801650775	0	0	0	0.2	0	4.801650774											1.7637	0.024563893	0	0	0.753066855	0	0	1.264790421	1.101774907	0	0	0	0	0.270654003	1.582334715	1.420397737	0.060432159	0.151554355	0	0.688777786	0	0	0	0	0.156715496	0	0	0	1.826377056	0	0.232159815	0	0	0	0	0	0	0	0	0	0	11.2973	0	0.391231721	1.7637	0.024563893	0	0	0.753066855	0	0	1.264790421	1.101774907	0	0	0	0	0.270654003	1.582334715	1.420397737	0.060432159	0.151554355	0	0.688777786	0	0	0	0	0.156715496	0	0	0	1.826377056	0	0.232159815	0	0	0	0	0	0	0	0	0	0	11.2973																																																																																				0	0		1.7637	0.024563893	0	0	0.753066855	0	0	1.264790421	1.101774907	0	0	0	0	0.270654003	1.582334715	1.420397737	0.060432159	0.151554355	0	0.688777786	0	0	0	0	0.156715496	0	0	0	1.826377056	0	0.232159815	0	0	0	0	0	0	0	0	0	0	11.2973
H3810_013_0	2008	6																					3000											D	D	D		T	Coin	Coin	V	V				Coin	V	V	V	V	V		P					V						V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		589.6871117	10.92207325	265.4896641	0	158.6259109	10.51045909	5.09167393	296.2782721	217.1704709	0	0	0	0.285621072	527.544131	3388.886305	2963.560387	136.1067068	346.1900551	0	1467.38353	0	0	0	0	389.5564524	0	0	0	0	0	495											$295/Day for IP Medical; $295/Day for IP Surgical	$295/Day for IP Psych; $295/Day for IP Substance Abuse	$295/Day for SNF	No cost-sharing	$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	$200/Case for OP Fac - Surgery; $200/Case for OP Fac - ASC	No cost-sharing	No cost-sharing	No cost-sharing	20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	$15/Case for OP Fac - Cardiovascular; $15/Case for OP Fac - Occ Therapy; $15/Case for OP Fac - Physical/Speech Therapy; $15/Case for OP Fac - CORF; $15/Visit for Prof - CORF; $15/Visit for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Consult for PCP - Consults;	$25/Visit for Speclst - Office Visits; $25/Consult for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $25/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$15/Visit for PT/ST (PCP); $15/Visit for Occ Therapy (PCP); $15/Visit for PT/ST (Specialist); $15/Visit for Occ Therapy (Specialist);	No cost-sharing	$25/Visit for Chiropractor; $25/Exam for Vistion Exams; $25/Service for Podiatrist; $25/Exam for Hearing/Speech Exams;	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$25/Exam for Vision (Refractions)	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$25/Visit for Alt Med;											286.6213717	286.6213716	286.6213717	0	48.5798935	0.194319574	0.194319574	41.79729589	194.319574	0	0	0	0.194319574	14.57396805	14.57396805	24.28994675	18.89139343	14.57396805	0	24.28994675	0	0	0	0	24.28994675	0	0	0	0	0	24.28994675											14.0847	0.260874968	6.341250973	0	0.642169155	2.042387932	0.989411909	1.031969217	3.516706115	0	0	0	0.055501765	0.640700942	4.115793395	5.998726999	0.214270446	0.4204469	0	2.970222317	0	0	0	0	0.788525457	0	0	0	0	0	1.001960303	0	0	0	0	0	0	0	0	0	0	45.1157	0	1.318838751	14.0847	0.260874968	6.341250973	0	0.642169155	2.042387932	0.989411909	1.031969217	3.516706115	0	0	0	0.055501765	0.640700942	4.115793395	5.998726999	0.214270446	0.4204469	0	2.970222317	0	0	0	0	0.788525457	0	0	0	0	0	1.001960303	0	0	0	0	0	0	0	0	0	0	45.1157																																																																																				0	0		14.0847	0.260874968	6.341250973	0	0.642169155	2.042387932	0.989411909	1.031969217	3.516706115	0	0	0	0.055501765	0.640700942	4.115793395	5.998726999	0.214270446	0.4204469	0	2.970222317	0	0	0	0	0.788525457	0	0	0	0	0	1.001960303	0	0	0	0	0	0	0	0	0	0	45.1157
H3810_014_0	2008	6																					3000											D	D	D		T	Coin	Coin	V	V				Coin	V	V	V	V	V		P					V						V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		598.0281873	11.42358439	266.2909985	0	162.8083201	10.92843035	5.294155415	301.1159876	221.3540849	0	0	0	0.296574066	541.9849682	3434.676951	3005.5507	139.1889714	355.1853456	0	1507.910753	0	0	0	0	390.2083994	0	0	0	0	0	495											$295/Day for IP Medical; $295/Day for IP Surgical	$295/Day for IP Psych; $295/Day for IP Substance Abuse	$295/Day for SNF	No cost-sharing	$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	$200/Case for OP Fac - Surgery; $200/Case for OP Fac - ASC	No cost-sharing	No cost-sharing	No cost-sharing	20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	$15/Case for OP Fac - Cardiovascular; $15/Case for OP Fac - Occ Therapy; $15/Case for OP Fac - Physical/Speech Therapy; $15/Case for OP Fac - CORF; $15/Visit for Prof - CORF; $15/Visit for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Consult for PCP - Consults;	$25/Visit for Speclst - Office Visits; $25/Consult for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $25/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$15/Visit for PT/ST (PCP); $15/Visit for Occ Therapy (PCP); $15/Visit for PT/ST (Specialist); $15/Visit for Occ Therapy (Specialist);	No cost-sharing	$25/Visit for Chiropractor; $25/Exam for Vistion Exams; $25/Service for Podiatrist; $25/Exam for Hearing/Speech Exams;	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$25/Exam for Vision (Refractions)	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	No cost-sharing	$25/Visit for Alt Med;											286.4391045	286.4391046	286.4391045	0	48.54900076	0.194196003	0.194196003	41.80043978	194.1960031	0	0	0	0.194196003	14.56470023	14.56470023	24.27450038	18.87609645	14.56470023	0	24.27450038	0	0	0	0	24.27450038	0	0	0	0	0	24.27450038											14.2749	0.272680107	6.356346262	0	0.658681772	2.122257493	1.028103821	1.048898392	3.582173212	0	0	0	0.057593498	0.657820716	4.168753348	6.079853467	0.218945371	0.43109734	0	3.050315012	0	0	0	0	0.789342828	0	0	0	0	0	1.001323141	0	0	0	0	0	0	0	0	0	0	45.7991	0	1.368811309	14.2749	0.272680107	6.356346262	0	0.658681772	2.122257493	1.028103821	1.048898392	3.582173212	0	0	0	0.057593498	0.657820716	4.168753348	6.079853467	0.218945371	0.43109734	0	3.050315012	0	0	0	0	0.789342828	0	0	0	0	0	1.001323141	0	0	0	0	0	0	0	0	0	0	45.7991																																																																																				0	0		14.2749	0.272680107	6.356346262	0	0.658681772	2.122257493	1.028103821	1.048898392	3.582173212	0	0	0	0.057593498	0.657820716	4.168753348	6.079853467	0.218945371	0.43109734	0	3.050315012	0	0	0	0	0.789342828	0	0	0	0	0	1.001323141	0	0	0	0	0	0	0	0	0	0	45.7991
H3811_001_0	2008	5																																D	D	D		T	Coin	Coin	V	V					V			P			P		V			V																																																										0		936.3467175	14.47444911	406.4674193		178.9261855	14.01045897	0.977820076	181.9053105	221.2076813					1135.486883			300.1501142			9319.456137		1339.685104			286.2722055																	"$50 days 1-5, $0 days 6-90"	"$50 days 1-5, $0 days 6-90"	"$0 days 1-10, $50 days 11-20, $80 days 21-100"		$75 copay	20% coinsurance	20% coinsurance	$50 copay	$50 copay					"$15 copay for therapy and rehab, $0 other"			"$15, $20, $30, $40 Copays"			"$15 PCP, $20 SCP"		"Copays ($25, $22.50, $0)"			$15 copay																	35.989921	24.8445728	37.61		75	0.2	0.2	74.6179402	50					15			22.59			16.11343065		10.39233234			15																	2.8083	0.029967625	1.273936637	0	1.11828866	2.802091793	0.195564015	1.131116631	0.921698672	0	0	0	0	1.419358604	0	0	0.56503259	0	0	12.51403418	0	1.160204404	0	0	0.357840257	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2974			2.8083	0.029967625	1.273936637	0	1.11828866	2.802091793	0.195564015	1.131116631	0.921698672	0	0	0	0	1.419358604	0	0	0.56503259	0	0	12.51403418	0	1.160204404	0	0	0.357840257	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2974																																																																																				0			2.8083	0.029967625	1.273936637	0	1.11828866	2.802091793	0.195564015	1.131116631	0.921698672	0	0	0	0	1.419358604	0	0	0.56503259	0	0	12.51403418	0	1.160204404	0	0	0.357840257	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2974
H3811_002_0	2008	7																																D	D	D		T	Coin	Coin	V	V					V			P			P		V			V																																																										0		1159.387422	16.92432743	590.9056096		213.2559581	16.01020926	1.117386951	224.4334766	252.0328288					1432.994943			368.416855			11138.43566		1677.454145			618.1752049																	"$50 days 1-4, $0 days 5-90"	"$50 days 1-4, $0 days 5-90"	"$0 days 1-10, $50 days 11-20, $80 days 21-100"		$50 copay	20% coinsurance	20% coinsurance	$50 copay	$30 copay					"$15 copay for therapy and rehab, $0 other"			"$15, $20, $30, $40 Copays"			"$10 PCP, $15 SCP"		"Copays ($25, $22.50, $0)"			$15 copay																	31.49	21.75807094	37.61		50	0.2	0.2	50	30					15			22.59			13.00537666		10.16981305			8.055178959																	3.0424	0.030686726	1.851996665	0	0.888566492	3.202041851	0.22347739	0.935139486	0.630082072	0	0	0	0	1.791243679	0	0	0.69354473	0	0	12.07162926	0	1.421616254	0	0	0.414959325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.1974			3.0424	0.030686726	1.851996665	0	0.888566492	3.202041851	0.22347739	0.935139486	0.630082072	0	0	0	0	1.791243679	0	0	0.69354473	0	0	12.07162926	0	1.421616254	0	0	0.414959325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.1974																																																																																				0			3.0424	0.030686726	1.851996665	0	0.888566492	3.202041851	0.22347739	0.935139486	0.630082072	0	0	0	0	1.791243679	0	0	0.69354473	0	0	12.07162926	0	1.421616254	0	0	0.414959325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.1974
H3811_003_0	2008	7																																D	D	D		T	Coin	Coin	V	V					V			P			P		V			V																																																										0		2115.028701	44.43656411	696.7011471		442.1665623	21.91039408	1.529804158	415.1235293	289.6141818					1837.042674			1553.22817			12016.30763		1923.454568			776.9075888																	"$50 days 1-4, $0 days 5-90"	"$50 days 1-4, $0 days 5-90"	"$0 days 1-10, $50 days 11-20, $80 days 21-100"		$50 copay	20% coinsurance	20% coinsurance	"$75 ER, $50 WorldWide ER"	$30 copay					"$15 copay for therapy, rehab and CORF; $0 other"			"$15, $20, $30, $40 Copays"			"$10 PCP, $15 SCP"		"Copays ($25, $22.50, $0)"			$15 copay																	31.49	21.64479563	60.01		50	0.2	0.2	74.61975574	30					15			22.59			12.93996399		9.479436559			8.054714533																	5.5502	0.080151696	3.48408632	0	1.842360676	4.382078815	0.305960832	2.58136803	0.724035455	0	0	0	0	2.296303342	0	0	2.923952031	0	0	12.957549	0	1.519438796	0	0	0.521480737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.169			5.5502	0.080151696	3.48408632	0	1.842360676	4.382078815	0.305960832	2.58136803	0.724035455	0	0	0	0	2.296303342	0	0	2.923952031	0	0	12.957549	0	1.519438796	0	0	0.521480737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.169																																																																																				0			5.5502	0.080151696	3.48408632	0	1.842360676	4.382078815	0.305960832	2.58136803	0.724035455	0	0	0	0	2.296303342	0	0	2.923952031	0	0	12.957549	0	1.519438796	0	0	0.521480737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.169
H3811_009_0	2008	3																																D	D	D		T	Coin	Coin	V	V					V			P			P		V			V																																																										0		1152.110506	16.78270364	590.9056096		210.7862048	16.01020926	1.117386951	224.4334766	248.1446813					1432.994943			368.416855			11138.43566		2166.883133			618.1752049																	"$50 days 1-4, $0 days 5-90"	"$50 days 1-4, $0 days 5-90"	"$0 days 1-10, $50 days 11-20, $80 days 21-100"		$50 copay	"20% coinsurance, $2,000 benefit max"	20% coinsurance	$50 copay	$30 copay					"$15 copay for therapy and rehab, $0 other"			"$15, $20, $30, $40 Copays"			"$10 PCP, $15 SCP"		"Copays ($25, $22.50, $0)"			$15 copay																	31.49	21.7588263	37.61		50	0.16	0.2	50	30					15			22.59			13.00537666		7.866851249			8.055178959																	3.0233	0.030430994	1.851996665	0	0.878275854	2.561633481	0.22347739	0.935139486	0.620361703	0	0	0	0	1.791243679	0	0	0.69354473	0	0	12.07162926	0	1.420545607	0	0	0.414959325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.5166			3.0233	0.030430994	1.851996665	0	0.878275854	2.561633481	0.22347739	0.935139486	0.620361703	0	0	0	0	1.791243679	0	0	0.69354473	0	0	12.07162926	0	1.420545607	0	0	0.414959325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.5166																																																																																				0			3.0233	0.030430994	1.851996665	0	0.878275854	2.561633481	0.22347739	0.935139486	0.620361703	0	0	0	0	1.791243679	0	0	0.69354473	0	0	12.07162926	0	1.420545607	0	0	0.414959325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.5166
H3812_001_0	2008	6																					2900											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	3600	1169.759206	137.5598481	496.4979041		95.34875196	9.279028604	2.433816972	391.3996724	24.54669736	7098.113256	30.81213431		0.12793024	18.47367401	3931.985548	3371.656379	433.3063925	1.696378592			19.70988221	683.7756423			164.8690832		15.35785839															$275 (1a); $0 (1a1)	$275 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$13 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$13/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $13 (14c1, 14c)"	"$28 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $28 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$28 (17a1)	$0 n/c (17b)	$28 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											172.1142	172.1142	93.8805		109.5272	0.18776098	0.287925098	31.2935	0.18776098	5.007	0.105620412		0.18776098	0.187623734	13	27.9895	37.5	0.18776098			0.18776098	28			28		28															16.7777	1.97300063	3.884288875	0	0.87027379	1.742239503	0.70075699	1.020688695	4.60891195	2.961663779	3.254390333	0	0.024020307	3.4660997	4.25965101	7.864236356	1.354082476	0.318513707	0	0	3.700746799	1.595476499	0	0	0.384694527	0	0.035835003	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7973	0	26.69083875	16.7777	1.97300063	3.884288875	0	0.87027379	1.742239503	0.70075699	1.020688695	4.60891195	2.961663779	3.254390333	0	0.024020307	3.4660997	4.25965101	7.864236356	1.354082476	0.318513707	0	0	3.700746799	1.595476499	0	0	0.384694527	0	0.035835003	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7973		$375 (1a); $0 (1a1)	$375 (1b)	"$175 (2a, 2a2)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	40% (9b)	40% (8a1); $0/$20 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	40% (incl in h5)	30% (12)	"40% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 40% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 40% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											1.871	0.22	1.4206	0.4922	0.2046	0.4096	0.1745	0.24	1.4449	0.6963	1.0202		0.0056	1.0865	1.3541	1.7258	0.2708	0.0705			0.6142	0.3631			0.0849		0.0079															13.7774	0	6.648629103	18.6487	2.193027475	5.304931268	0.492224488	1.074891691	2.15187311	0.875214652	1.260671998	6.053768965	3.6580072	4.27461566	0	0.029667938	4.552636931	5.613714485	9.59000286	1.624898972	0.388997117	0	0	4.314946244	1.958587301	0	0	0.469553614	0	0.043739783	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5747
H3812_004_0	2008	6																					1100											D	D	D	V	T	V	P	V	V	Coin	V	V	V	V	V		V	V		V	S	P	T		V	P	V																																																								0		2086.646524	295.4767311	999.1242097		403.644879	3142.643068	1571.006315	699.6965932	371.2617965	7.849771562	183.5331438	68.2847579	39.55736881	3492.356827		3382.602401		917.2804941				656.9694338					0.086688985															1(a) $110 per Day	1(b) $110 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per preocedure; other $0 per procedure	8(b) X-rays $0 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a), 9(d) $25 per visit; 9(c) $0/0 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  $0 per script	"13, 14(a)-(j) $0; 17(a), 16(b) $10 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															59.7825	59.7825	22.826		40.7608	10.807	15.439	24.3206	13.5869	0.37212033	5.4348	13.5869	127.5024	13.5869		5.4348		5.4348				5.4348					5.4348															10.3954	1.47202802	1.900504398	0	1.371073751	2.830212446	2.021225726	1.418087096	0.420359026	2.921059584	0.083121737	0.077315023	0.420304804	3.954200854	0	1.531972816	0	0.415434217	0	0	0	0.297539939	0	0	0	0	3.93E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.5299	0	26.48521778	10.3954	1.47202802	1.900504398	0	1.371073751	2.830212446	2.021225726	1.418087096	0.420359026	2.921059584	0.083121737	0.077315023	0.420304804	3.954200854	0	1.531972816	0	0.415434217	0	0	0	0.297539939	0	0	0	0	3.93E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.5299		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															2.086	0.1288	0.2841	0.374	0.0926	0.1594	0.1138	0.0504	0.2236	0.0407	0.1025	0.0201	0.0209	0.2282	0.0804	0.1517	0.0625	0.0438			0.1448	0.0326	0.0077		0.0066																	4.4553	0	0	12.4814	1.600780148	2.184593641	0.373983435	1.463703538	2.989628796	2.135074575	1.468509138	0.643949586	2.96178825	0.185660219	0.097422428	0.441170477	4.182352321	0.080410445	1.683721396	0.062525902	0.459190005	0	0	0.144805408	0.330095608	0.00774	0	0.006631111	0	3.93E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.9852
H3812_005_0	2008	6	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						700	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	P	P	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T		V	P	V	P				V	P	V	V	V																																															0		1505.261637	70.95141993	8599.355797	199.5360079	454.3185481	1653.717021	22.6348659	168.131608	114.5681236	4290.210585	173.7766219	26.42892884	6.47893644	215.0507217	121.7053146	1280.634633	1919.196495	23.20094241		257.8151721	249.1564509	643.6177015	1817.255		287.28	278.16		95.475				96.47841986	1.218809825		234.745	287.945						(1a) $75/day	(1b) $75/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) $0/proc	(11a/11c) $0/proc	(4a) $50/visit (waived if admitted)	(9a/9b) $25/visit	(8a) $0/visit	(8b) $0/visit	(9a) $25/visit	(12) $0/proc	(9a) $25/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $0/visit	(7e/7h) $0/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $0/visit	(15) $0/proc	(Misc. PBP Cats) $0/visit	(10b) $0/trip		(17a1) $0/visit	(17b2) $0/proc	(18a) $0/visit	(18b) $0/proc				(4b) $10/visit (waived if admitted)	(9c) $0/proc 75%/25% Ind/Grp Blended Copay	(9d) $0/visit	(7f1) $0/visit	(18a1) $0/visit						66.5572	66.5572			66.5572			44.3714	22.1857			22.1857		22.1857																		8.8743										8.3488	0.393527055	0	0	2.519845838	0	0	0.62168675	0.211814677	0	0	0.048862064	0	0.397587895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.071348102	0	0	0	0	0	0	0	0	0	12.6135		1.600035713	8.3488	0.393527055	0	0	2.519845838	0	0	0.62168675	0.211814677	0	0	0.048862064	0	0.397587895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.071348102	0	0	0	0	0	0	0	0	0	12.6135		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					10	0.3	0.3	0.3	0.3						1.9174	0.0292	0.8467	0.1026	0.379	0.4007	0.0036	0.0369	0.1764	0.6937	0.6352	0.0324	0.0078	0.1043	0.0075	1.6295	0.1693	0.0025		0.164		0.1068	0.1433		0.0146							0.0042	0.0001		0.0131	0.0185						7.6392		0	10.2662	0.422719232	0.846725502	0.102593506	2.898826018	0.400691409	0.003601852	0.658557717	0.38825645	0.693684878	0.635203444	0.081225978	0.007848997	0.501924578	0.00752717	1.629485822	0.169269093	0.002544208	0	0.164010312	0	0.106795273	0.14325	0	0.01455	0	0	0	0	0	0	0.075579611	9.78E-05	0	0.01305	0.01845	0	0	0	0	0	20.2527
H3812_007_0	2008	6																					1500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		1960.62661	134.4775105	880.6469785		272.1695752	10.26211022	17.82215776	423.474643	400.265231	3355.758304	441.0063352	67.20751534	15.1227435	2819.923525		3850.713407	379.372684	555.2981042				685.3230895					0.072562035															(1a)$150/day	(1b)$150/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$10/visit"	(9b)$25/visit	"(8a)$15/procedure Diag. services, $0/procedure Other services"	(8b)$15/visit	(9a)$25/visit	(12)20%	"(3,5,9a,9d)$25/visit, (9c)$15/visit"	"(7a) $0/visit PCP, $10/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b)$15 visit, (7d,f)$10/visit"	"(7e,h)$15/visit"	"(7c,i)$15/visit"		(7g)$15/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$15/visit"			(17a)0	(17b)0	(18a)$15/visit															107.6314	107.6314	30.1368		53.8157	0.143508588	0.143508588	25.8315	17.9386	10.7631	10.7631	17.9386	105.2925	17.9272		7.4713	10.7631	10.7631				10.7631					10.7631															17.5854	1.206167355	2.21165708	0	1.220583484	1.47270095	2.557632698	0.911583722	0.59834894	3.009875853	0.395551228	0.100467246	0.13269265	4.212789494	0	2.397485353	0.340270239	0.498062794	0	0	0	0.614685931	0	0	0	0	6.51E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.466	0	15.53560301	17.5854	1.206167355	2.21165708	0	1.220583484	1.47270095	2.557632698	0.911583722	0.59834894	3.009875853	0.395551228	0.100467246	0.13269265	4.212789494	0	2.397485353	0.340270239	0.498062794	0	0	0	0.614685931	0	0	0	0	6.51E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.466		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$10/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.0802	0.0594	0.256	0.2555	0.0656	0.1257	0.1091	0.0308	0.2656	0.0417	0.1084	0.0217	0.005	0.1896	0.019	0.1832	0.0275	0.0297			0.1643	0.0388			0.0051																	4.082	0	0	19.6656	1.265596191	2.467680574	0.255527365	1.286215386	1.598359442	2.666747949	0.942361285	0.863952777	3.051571764	0.503935315	0.12221458	0.137707805	4.402385853	0.018950801	2.580691812	0.367795378	0.52779944	0	0	0.164275138	0.653527911	0	0	0.005058988	0	6.51E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.548
H3812_801_0	2008	3																					3500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	4100	1228.247167	144.4378405	521.3227993		100.1161896	9.742980034	2.555507821	410.9643858	25.77403223	7453.018919	32.35274103		0.134326752	19.39735771	4126.750961	3539.973218	454.9717121	1.781197522			20.69537633	717.9644244			171.0966865		15.88981078															$305 (1a); $0 (1a1)	$305 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$35/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $35 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											199.6847	199.6847	98.2056		114.5732	0.196411149	0.288855701	32.7352	0.196411149	3.9282	0.110486357		0.196411149	0.196263953	35	34.8074	37.5	0.196411149			0.196411149	35			35		35															20.4385	2.403501859	4.266400425	0	0.955885771	1.913629907	0.738173003	1.121083158	5.062307294	2.43976002	3.574536485	0	0.026383272	3.807002105	12.03635697	10.26809171	1.4217866	0.349847052	0	0	4.06480265	2.094062905	0	0	0.499032002	0	0.046345281	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.5275	0	26.62152065	20.4385	2.403501859	4.266400425	0	0.955885771	1.913629907	0.738173003	1.121083158	5.062307294	2.43976002	3.574536485	0	0.026383272	3.807002105	12.03635697	10.26809171	1.4217866	0.349847052	0	0	4.06480265	2.094062905	0	0	0.499032002	0	0.046345281	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.5275		$405 (1a); $0 (1a1)	$405 (1b)	"$175 (2a, 2a2)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	40% (9b)	40% (8a1); $0/$20 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	40% (incl in h5)	30% (12)	"40% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$40/$50 (7a); 40% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $40 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 40% (17b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.1843	0.2569	1.5356	0.5168	0.2212	0.4428	0.1835	0.2594	1.5618	0.7527	1.1028		0.0061	1.1745	2.6411	2.0578	0.2844	0.0762			0.6639	0.4341			0.1006		0.0093															16.4658	0	6.804315087	22.6228	2.660364477	5.802029223	0.516835713	1.17706539	2.356419145	0.92171118	1.380487317	6.624110639	3.192465287	4.67733857	0	0.03248802	4.98147061	14.67744813	12.32592582	1.70614392	0.426035371	0	0	4.72871523	2.528120749	0	0	0.599677112	0	0.055692229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.9933
H3813_001_0	2008	9																					1500											A	A	D	v	T	O	O	V	P	P	P	V	P	P	V	V	V	V	P	P	S	V	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	1500	209.7382441	2.097058707	561.6258206	0	172.6585512	24248.97481	8251.186391	279.5038845	255.9697902	41.37326295	786.091996	12.23911134	671.103177	182.8383147	3205.103167	5094.279283	118.2054348	426.8131649	955.5369958	1744.86826	134.2206354	408.1561979	0	0	0	0	58.66750809	0	0	0	0											$400 copay per admit	$400 copay per admit	"$0 for 1st 20 days, $50 21-100th"	$0 copay	$50 copay	10% coinsurance	"Supplies 10% coins, Equipment $10 copay"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	$400 or 10% copay	$0 copay	"O/P Diag 10% to $100, O/P Radiation Therapy $35 O/P X-Ray $10"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	10% coinsurance	"10% coinsurance, $20 Physical Therapy and O/P Psych copays"	"$20 Office and Hospital Outpatient, $20 Inpatient Hospital, $10 diabetes monitoring, $20 Urgent Care and $0 and 10% Immunizations"	"$35 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $35 inpatient visits"	$25 copay per visit	$20 copay per visit	$20 copay per visit	$20 copay per visit	10% coinsurance	$20 copay per visit	N/A	N/A	N/A	N/A	$20 copay per visit	N/A	N/A	N/A	N/A											217.78	217.78	13.61	0	27.22	0.26	0.36	24.91	196	5.44	5.44	27.22	2.04	4.44	11.86	12.74	19.06	10.89	10.89	2.04	2.04	10.89	0	0	0	0	10.89	0	0	0	0											3.8064	0.03805812	0.636977285	0	0.391647147	0.525394454	0.247535592	0.58020348	4.180839907	0.018755879	0.356361705	0.027762384	0.11408754	0.067650176	3.167710297	5.408426505	0.187749632	0.387332947	0.867149824	0.296627604	0.022817508	0.37040175	0	0	0	0	0.053240764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.7531	0	18.20087598	3.8064	0.03805812	0.636977285	0	0.391647147	0.525394454	0.247535592	0.58020348	4.180839907	0.018755879	0.356361705	0.027762384	0.11408754	0.067650176	3.167710297	5.408426505	0.187749632	0.387332947	0.867149824	0.296627604	0.022817508	0.37040175	0	0	0	0	0.053240764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.7531	1500	$400 copay per admit	$400 copay per admit	"$0 for 1st 20 days, $50 21-100th"	$0 copay	$50 copay	10% coinsurance	"Supplies 10% coins, Equipment $10 copay"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	$400 or 10% copay	$0 copay	"O/P Diag 10% to $100, O/P Radiation Therapy $35 O/P X-Ray $10"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	10% coinsurance	"10% coinsurance, $20 Physical Therapy and O/P Psych copays"	"$20 Office and Hospital Outpatient, $20 Inpatient Hospital, $10 diabetes monitoring, $20 Urgent Care and $0 and 10% Immunizations"	"$35 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $35 inpatient visits"	$25 copay per visit	$20 copay per visit	$20 copay per visit	$20 copay per visit	10% coinsurance	$20 copay per visit	N/A	N/A	N/A	N/A	$20 copay per visit	N/A	N/A	N/A	N/A											0.900951558	0.008993456	0.169172203	0	0.095839405	0.128947493	0.060752628	0.158027925	1.048194196	0.004707403	0.089440663	0.006960197	0.028391206	0.016813192	0.758368122	1.331690241	0.047210129	0.095944319	0.223719408	0.073817136	0.005678241	0.083957286	0	0	0	0	0.021796688	0	0	0	0											5.3594	0	4.513161649	4.7074	0.047051576	0.806149488	0	0.487486552	0.654341947	0.30828822	0.738231406	5.229034103	0.023463283	0.445802368	0.034722581	0.142478746	0.084463368	3.926078418	6.740116746	0.234959761	0.483277266	1.090869231	0.37044474	0.028495749	0.454359035	0	0	0	0	0.075037452	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.1125
H3813_002_0	2008	4																					1500											A	A	D	v	T	O	O	V	P	P	P	V	P	P	V	V	V	V	P	P	S	V	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1500	227.240341	2.272052662	608.4919971	0	187.0664467	26272.48707	8939.725885	302.827738	277.3297864	44.82575137	851.6892761	13.26043253	727.1049469	198.0956843	3472.560476	5519.383299	128.069363	462.429585	1035.274009	1890.472862	145.4209894	442.2157438	0	0	0	0	63.56315514	0	0	0	0	0	0	0	0	0	0	0	0	0	0	$400 copay per admit	$400 copay per admit	"$0 for 1st 20 days, $50 21-100th"	$0 copay	$50 copay	10% coinsurance	"Supplies 10% coins, Equipment $10 copay"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	$400 or 10% copay	$0 copay	"O/P Diag 10% to $100, O/P Radiation Therapy $35 O/P X-Ray $10"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	10% coinsurance	"10% coinsurance, $20 Physical Therapy and O/P Psych copays"	"$20 Office and Hospital Outpatient, $20 Inpatient Hospital, $10 diabetes monitoring, $20 Urgent Care and $0 and 10% Immunizations"	"$35 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $35 inpatient visits"	$25 copay per visit	$20 copay per visit	$20 copay per visit	$20 copay per visit	10% coinsurance	$20 copay per visit	N/A	N/A	N/A	N/A	$20 copay per visit	N/A	N/A	N/A	N/A	0	0	0	0	0	0	0	0	0	0	217.68	217.68	13.61	0	27.21	0.26	0.36	24.9	195.92	5.44	5.44	27.21	2.04	4.44	11.9	12.75	19.05	10.88	10.88	2.04	2.04	10.88	0	0	0	0	10.88	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1221	0.041215035	0.69013134	0	0.424173168	0.56923722	0.268191777	0.628367556	4.527870979	0.020321007	0.386099138	0.030068031	0.123607841	0.073295403	3.443622472	5.864344756	0.203310114	0.41926949	0.938648435	0.321380387	0.024721568	0.400942274	0	0	0	0	0.057630594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.5786	0	19.74750023	4.1221	0.041215035	0.69013134	0	0.424173168	0.56923722	0.268191777	0.628367556	4.527870979	0.020321007	0.386099138	0.030068031	0.123607841	0.073295403	3.443622472	5.864344756	0.203310114	0.41926949	0.938648435	0.321380387	0.024721568	0.400942274	0	0	0	0	0.057630594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.5786	1500	$400 copay per admit	$400 copay per admit	"$0 for 1st 20 days, $50 21-100th"	$0 copay	$50 copay	10% coinsurance	"Supplies 10% coins, Equipment $10 copay"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	$400 or 10% copay	$0 copay	"O/P Diag 10% to $100, O/P Radiation Therapy $35 O/P X-Ray $10"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	10% coinsurance	"10% coinsurance, $20 Physical Therapy and O/P Psych copays"	"$20 Office and Hospital Outpatient, $20 Inpatient Hospital, $10 diabetes monitoring, $20 Urgent Care and $0 and 10% Immunizations"	"$35 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $35 inpatient visits"	$25 copay per visit	$20 copay per visit	$20 copay per visit	$20 copay per visit	10% coinsurance	$20 copay per visit	N/A	N/A	N/A	N/A	$20 copay per visit	N/A	N/A	N/A	N/A	0	0	0	0	0	0	0	0	0	0	0.9757	0.0097	0.1832	0	0.1038	0.1397	0.0658	0.1712	1.1351	0.0051	0.0969	0.0075	0.0308	0.0182	0.8242	1.4441	0.0511	0.1039	0.2422	0.08	0.0062	0.091	0	0	0	0	0.0236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.8089	0	4.896781384	5.0978	0.050954484	0.873285443	0	0.527971856	0.708945037	0.33401405	0.799519521	5.663011185	0.025421231	0.483003386	0.037606259	0.154368218	0.091511611	4.26786363	7.308422198	0.254432881	0.523124388	1.180813437	0.401357366	0.030873644	0.491905572	0	0	0	0	0.081234115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.3875
H3813_003_0	2008	4																					1500											A	A	D	v	T	O	O	V	P	P	P	V	P	P	V	V	V	V	P	P	S	V	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1500	241.0784238	2.41041213	645.5468729	0	198.4580903	27872.38279	9484.121593	321.2688092	294.2181281	47.55547117	903.5539521	14.06794304	771.3829055	210.158967	3684.026359	5855.492999	135.8683059	490.5898088	1098.318305	2005.595554	154.2765811	469.1450206	0	0	0	0	67.4339124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	$400 copay per admit	$400 copay per admit	"$0 for 1st 20 days, $50 21-100th"	$0 copay	$50 copay	10% coinsurance	"Supplies 10% coins, Equipment $10 copay"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	$400 or 10% copay	$0 copay	"O/P Diag 10% to $100, O/P Radiation Therapy $35 O/P X-Ray $10"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	10% coinsurance	"10% coinsurance, $20 Physical Therapy and O/P Psych copays"	"$20 Office and Hospital Outpatient, $20 Inpatient Hospital, $10 diabetes monitoring, $20 Urgent Care and $0 and 10% Immunizations"	"$35 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $35 inpatient visits"	$25 copay per visit	$20 copay per visit	$20 copay per visit	$20 copay per visit	10% coinsurance	$20 copay per visit	N/A	N/A	N/A	N/A	$20 copay per visit	N/A	N/A	N/A	N/A	0	0	0	0	0	0	0	0	0	0	217.61	217.61	13.6	0	27.2	0.26	0.36	24.9	195.85	5.44	5.44	27.2	2.04	4.44	11.93	12.76	19.04	10.88	10.88	2.04	2.04	10.88	0	0	0	0	10.88	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.3718	0.043710815	0.731619789	0	0.449838338	0.603901627	0.284523648	0.666632779	4.801885032	0.02155848	0.409611125	0.031887338	0.131135094	0.077758818	3.662536205	6.226340889	0.215577712	0.444801427	0.995808597	0.340951244	0.026227019	0.425358152	0	0	0	0	0.061140081	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.0246	0	20.97353061	4.3718	0.043710815	0.731619789	0	0.449838338	0.603901627	0.284523648	0.666632779	4.801885032	0.02155848	0.409611125	0.031887338	0.131135094	0.077758818	3.662536205	6.226340889	0.215577712	0.444801427	0.995808597	0.340951244	0.026227019	0.425358152	0	0	0	0	0.061140081	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.0246	1500	$400 copay per admit	$400 copay per admit	"$0 for 1st 20 days, $50 21-100th"	$0 copay	$50 copay	10% coinsurance	"Supplies 10% coins, Equipment $10 copay"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	$400 or 10% copay	$0 copay	"O/P Diag 10% to $100, O/P Radiation Therapy $35 O/P X-Ray $10"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	10% coinsurance	"10% coinsurance, $20 Physical Therapy and O/P Psych copays"	"$20 Office and Hospital Outpatient, $20 Inpatient Hospital, $10 diabetes monitoring, $20 Urgent Care and $0 and 10% Immunizations"	"$35 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $35 inpatient visits"	$25 copay per visit	$20 copay per visit	$20 copay per visit	$20 copay per visit	10% coinsurance	$20 copay per visit	N/A	N/A	N/A	N/A	$20 copay per visit	N/A	N/A	N/A	N/A	0	0	0	0	0	0	0	0	0	0	1.0347	0.0103	0.1943	0	0.1101	0.1482	0.0698	0.1815	1.2038	0.0054	0.1026	0.008	0.0326	0.0193	0.8763	1.5334	0.0542	0.1102	0.2569	0.0848	0.0065	0.0965	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.1646	0	5.200719916	5.4065	0.054039551	0.925927289	0	0.559917386	0.752117125	0.35435425	0.84814045	6.005719463	0.026959324	0.512227149	0.039881668	0.163768662	0.097084324	4.538801827	7.759695226	0.269785103	0.554980698	1.252720537	0.425798521	0.032753732	0.521860772	0	0	0	0	0.086168191	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.1892
H3813_801_0	2008	4																					1500											A	A	D	v	T	O	O	V	P	P	P	V	P	P	V	V	V	V	P	P	S	V	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	1500	178.7796168	1.787520219	478.726469	0	147.1731098	20669.68017	7033.261615	238.2474287	218.1871084	35.2663203	670.0600858	10.43254484	572.0443086	155.8502789	2732.010647	4342.332997	100.7576011	363.8129727	814.4939837	1487.315202	114.4088617	347.9098863	0	0	0	0	50.00783077	0	0	0	0											$400 copay per admit	$400 copay per admit	"$0 for 1st 20 days, $50 21-100th"	$0 copay	$50 copay	10% coinsurance	"Supplies 10% coins, Equipment $10 copay"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	$400 or 10% copay	$0 copay	"O/P Diag 10% to $100, O/P Radiation Therapy $35 O/P X-Ray $10"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	10% coinsurance	"10% coinsurance, $20 Physical Therapy and O/P Psych copays"	"$20 Office and Hospital Outpatient, $20 Inpatient Hospital, $10 diabetes monitoring, $20 Urgent Care and $0 and 10% Immunizations"	"$35 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $35 inpatient visits"	$25 copay per visit	$20 copay per visit	$20 copay per visit	$20 copay per visit	10% coinsurance	$20 copay per visit	N/A	N/A	N/A	N/A	$20 copay per visit	N/A	N/A	N/A	N/A											218.01	218.01	13.63	0	27.25	0.26	0.36	24.91	196.21	5.45	5.45	27.25	2.04	4.45	11.78	12.71	19.08	10.9	10.9	2.04	2.04	10.9	0	0	0	0	10.9	0	0	0	0											3.248	0.032474774	0.543753481	0	0.334205604	0.44784307	0.210997848	0.494561954	3.567541046	0.016016787	0.304318956	0.023690571	0.097247532	0.057794478	2.681923786	4.599254366	0.160204586	0.33046345	0.739832035	0.252843584	0.019449506	0.316018147	0	0	0	0	0.04542378	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.5238	0	15.46366794	3.248	0.032474774	0.543753481	0	0.334205604	0.44784307	0.210997848	0.494561954	3.567541046	0.016016787	0.304318956	0.023690571	0.097247532	0.057794478	2.681923786	4.599254366	0.160204586	0.33046345	0.739832035	0.252843584	0.019449506	0.316018147	0	0	0	0	0.04542378	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.5238	1500	$400 copay per admit	$400 copay per admit	"$0 for 1st 20 days, $50 21-100th"	$0 copay	$50 copay	10% coinsurance	"Supplies 10% coins, Equipment $10 copay"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	$400 or 10% copay	$0 copay	"O/P Diag 10% to $100, O/P Radiation Therapy $35 O/P X-Ray $10"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	10% coinsurance	"10% coinsurance, $20 Physical Therapy and O/P Psych copays"	"$20 Office and Hospital Outpatient, $20 Inpatient Hospital, $10 diabetes monitoring, $20 Urgent Care and $0 and 10% Immunizations"	"$35 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $35 inpatient visits"	$25 copay per visit	$20 copay per visit	$20 copay per visit	$20 copay per visit	10% coinsurance	$20 copay per visit	N/A	N/A	N/A	N/A	$20 copay per visit	N/A	N/A	N/A	N/A											0.7688	0.0077	0.1444	0	0.0818	0.1099	0.0518	0.1349	0.8945	0.004	0.0762	0.0059	0.0242	0.0144	0.6417	1.1331	0.0403	0.0819	0.1909	0.0629	0.0048	0.0717	0	0	0	0	0.0186	0	0	0	0											4.5644	0	3.834237901	4.0168	0.040149567	0.688167378	0	0.415988837	0.557757137	0.262783023	0.62941263	4.462021274	0.020029349	0.380557638	0.029629959	0.121448026	0.072158366	3.323599058	5.732394628	0.200488575	0.412321117	0.930704707	0.315764867	0.024289605	0.387738746	0	0	0	0	0.064022094	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.0883
H3813_802_0	2008	6																					1500											A	A	D	v	T	O	O	V	P	P	P	V	P	P	V	V	V	V	P	P	S	V	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	1500	180.185523	1.80157711	482.491129	0	148.3304653	20832.22459	7088.570525	240.1209842	219.9029114	35.54365134	675.3293755	10.51458539	576.5428114	157.0758709	2753.494923	4376.480697	101.5499495	366.6739638	820.8990881	1499.01131	115.3085623	350.6458171	0	0	0	0	50.40108766	0	0	0	0											$400 copay per admit	$400 copay per admit	"$0 for 1st 20 days, $50 21-100th"	$0 copay	$50 copay	10% coinsurance	"Supplies 10% coins, Equipment $10 copay"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	$400 or 10% copay	$0 copay	"O/P Diag 10% to $100, O/P Radiation Therapy $35 O/P X-Ray $10"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	10% coinsurance	"10% coinsurance, $20 Physical Therapy and O/P Psych copays"	"$20 Office and Hospital Outpatient, $20 Inpatient Hospital, $10 diabetes monitoring, $20 Urgent Care and $0 and 10% Immunizations"	"$35 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $35 inpatient visits"	$25 copay per visit	$20 copay per visit	$20 copay per visit	$20 copay per visit	10% coinsurance	$20 copay per visit	N/A	N/A	N/A	N/A	$20 copay per visit	N/A	N/A	N/A	N/A											217.99	217.99	13.62	0	27.25	0.26	0.36	24.91	196.2	5.45	5.45	27.25	2.04	4.45	11.78	12.72	19.07	10.9	10.9	2.04	2.04	10.9	0	0	0	0	10.9	0	0	0	0											3.2732	0.03272715	0.547627431	0	0.336833765	0.451364866	0.212657116	0.498451143	3.595412602	0.016142742	0.306712091	0.023876871	0.098012278	0.058248969	2.703014183	4.639069539	0.161379795	0.333062184	0.745650005	0.254831923	0.019602456	0.318503284	0	0	0	0	0.045780988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.6722	0	15.58953356	3.2732	0.03272715	0.547627431	0	0.336833765	0.451364866	0.212657116	0.498451143	3.595412602	0.016142742	0.306712091	0.023876871	0.098012278	0.058248969	2.703014183	4.639069539	0.161379795	0.333062184	0.745650005	0.254831923	0.019602456	0.318503284	0	0	0	0	0.045780988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.6722	1500	$400 copay per admit	$400 copay per admit	"$0 for 1st 20 days, $50 21-100th"	$0 copay	$50 copay	10% coinsurance	"Supplies 10% coins, Equipment $10 copay"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	$400 or 10% copay	$0 copay	"O/P Diag 10% to $100, O/P Radiation Therapy $35 O/P X-Ray $10"	"$50 ER copay, $20 Primary Care and $35 Specialist copay"	10% coinsurance	"10% coinsurance, $20 Physical Therapy and O/P Psych copays"	"$20 Office and Hospital Outpatient, $20 Inpatient Hospital, $10 diabetes monitoring, $20 Urgent Care and $0 and 10% Immunizations"	"$35 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $35 inpatient visits"	$25 copay per visit	$20 copay per visit	$20 copay per visit	$20 copay per visit	10% coinsurance	$20 copay per visit	N/A	N/A	N/A	N/A	$20 copay per visit	N/A	N/A	N/A	N/A											0.7749	0.0077	0.1455	0	0.0824	0.1108	0.0522	0.1359	0.9015	0.004	0.0768	0.006	0.0244	0.0145	0.6467	1.1421	0.0406	0.0825	0.1924	0.0634	0.0049	0.0721	0	0	0	0	0.0187	0	0	0	0											4.6001	0	3.86469168	4.0481	0.040461941	0.693176986	0	0.419260134	0.562143287	0.264849524	0.634362272	4.49688086	0.020186858	0.383550308	0.029862966	0.122403082	0.072725813	3.349735529	5.78112071	0.201980573	0.415563571	0.938023682	0.318248012	0.024480616	0.390630747	0	0	0	0	0.064525558	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.2723
H3814_001_0	2008	7																					3000											D	D	D		T	Coin		V	V		Coin				V	V	V	V	Coin		Coin				V		V															0	0	0		0	0		0	0		0				0	0	0	0	0		0				0		0															0	0	925.5120788	102.8346754	1243.179502		280.4054729	30.51652579		603.550691	72.39573982		6.478591905				2612.832281	3652.952566	0	650.9349438	12.68663684		17.00963741				91.00222395		46.59745096															IP $150/day 1-5	IP $150/day 1-5	$25 per day days 1-100		Amb $50 - Waived if admited	20% Coins		$50 ER - waived if admited	$200 OP Surgeries		0				$15 PCP Visit	$20 Specialist Visit	$20 MH Visit	$20 Therapy	10% X-Ray		10% Coins				$20 Vision Visit		$20 Hearing Visit															148.5	148.5	24.75		49.5	0.198		49.5	198		0.099				14.85	19.8	19.8	19.8	0.099		0.099				19.8		19.8															11.4532	1.272579108	2.564057724	0	1.156672576	6.042272106	0	2.489646601	1.194529707	0	0.641380599	0	0	0	3.233379948	6.027371734	0	1.074042657	1.255977048	0	1.683954103	0	0	0	0.15015367	0	0.076885794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3161		0.407233488	11.4532	1.272579108	2.564057724	0	1.156672576	6.042272106	0	2.489646601	1.194529707	0	0.641380599	0	0	0	3.233379948	6.027371734	0	1.074042657	1.255977048	0	1.683954103	0	0	0	0.15015367	0	0.076885794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3161	0																																																																																			0		0	11.4532	1.272579108	2.564057724	0	1.156672576	6.042272106	0	2.489646601	1.194529707	0	0.641380599	0	0	0	3.233379948	6.027371734	0	1.074042657	1.255977048	0	1.683954103	0	0	0	0.15015367	0	0.076885794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3161
H3814_004_0	2008	10																					3000											D	D	D		T	Coin		V	V		Coin				V	V	V	V	Coin		Coin				V		V															0	0	0		0	0		0	0		0				0	0	0	0	0		0				0		0		0													0	0	925.5120788	102.8346754	1243.179502		280.4054729	30.51652579		603.550691	72.39573982		6.478591905				2612.832281	3652.952566	0	650.9349438	12.68663684		17.00963741				91.00222395		46.59745096		0													IP $150/day 1-5	IP $150/day 1-5	$25 per day days 1-100		Amb $50 - Waived if admited	20% Coins		$50 ER - waived if admited	$200 OP Surgeries		0				$15 PCP Visit	$20 Specialist Visit	$20 MH Visit	$20 Therapy	10% X-Ray		10% Coins				$20 Vision Visit		$20 Hearing Visit		0													148.5	148.5	24.75		49.5	0.198		49.5	198		0.099				14.85	19.8	19.8	19.8	0.099		0.099				19.8		19.8		35.4717													11.4532	1.272579108	2.564057724	0	1.156672576	6.042272106	0	2.489646601	1.194529707	0	0.641380599	0	0	0	3.233379948	6.027371734	0	1.074042657	1.255977048	0	1.683954103	0	0	0	0.15015367	0	0.076885794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3161		0.407233488	11.4532	1.272579108	2.564057724	0	1.156672576	6.042272106	0	2.489646601	1.194529707	0	0.641380599	0	0	0	3.233379948	6.027371734	0	1.074042657	1.255977048	0	1.683954103	0	0	0	0.15015367	0	0.076885794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3161	0																																																																																			0		0	11.4532	1.272579108	2.564057724	0	1.156672576	6.042272106	0	2.489646601	1.194529707	0	0.641380599	0	0	0	3.233379948	6.027371734	0	1.074042657	1.255977048	0	1.683954103	0	0	0	0.15015367	0	0.076885794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3161
H3814_005_0	2008	7	r.	r.									Other Non-Covered	Other Non-Covered									1200	Chiro Benefit	Routine Footcare									D	D	D		T	P		V	V						V	V	V	V							V		V					V	V									0	0	0		0	0		0	0						0	0	0	0							0		0					0	0									0	0	1053.507343	117.0563715	1243.179502		280.4054729	3288.090215		603.550691	73.12700992						2612.832281	3652.952566	0	650.9349438							91.00222395		46.59745096					250	150									IP $100/day 1-5	IP $100/day 1-5	$25 per day days 1-100		Amb $50 - Waived if admited	$0 DME/Prosth		$50 ER - waived if admited	$100 OP Surg						$15 PCP Visit	$15 Specialist Visit	$15 MH Visit	$15 Therapy							$15 Vision Visit		$15 Hearing Visit					$15 copay	$15 copay									90	90	22.5		45	0		45	90						13.5	13.5	13.5	13.5							13.5		13.5					15	15									7.9013	0.877922786	2.330961567	0	1.051520523	0	0	2.263315091	0.548452574	0	0	0	0	0	2.939436317	4.109571637	0	0.732301812	0	0	0	0	0	0	0.102377502	0	0.052422132	0	0	0	0	0.3125	0.1875	0	0	0	0	0	0	0	0	23.4096		2.601065224	7.9013	0.877922786	2.330961567	0	1.051520523	0	0	2.263315091	0.548452574	0	0	0	0	0	2.939436317	4.109571637	0	0.732301812	0	0	0	0	0	0	0.102377502	0	0.052422132	0	0	0	0	0.3125	0.1875	0	0	0	0	0	0	0	0	23.4096	0																																																																																			0		0	7.9013	0.877922786	2.330961567	0	1.051520523	0	0	2.263315091	0.548452574	0	0	0	0	0	2.939436317	4.109571637	0	0.732301812	0	0	0	0	0	0	0.102377502	0	0.052422132	0	0	0	0	0.3125	0.1875	0	0	0	0	0	0	0	0	23.4096
H3814_006_0	2008	8	r.	r.									Other Non-Covered	Other Non-Covered									1200	Chiro Benefit	Routine Footcare									D	D	D		T			V	V						V	V		V							V		V					V	V									0	0	0		0			0	0						0	0		0							0		0					0	0									0	0	1053.507343	117.0563715	1243.179502		280.4054729			603.550691	73.12700992						2612.832281	3652.952566		650.9349438							91.00222395		46.59745096					250	150									IP $100/day 1-5	IP $100/day 1-5	$25 per day days 1-100		Amb $50 - Waived if admited			$50 ER - waived if admited	$100 OP Surg						$15 PCP Visit	$15 Specialist Visit		$15 Therapy							$15 Vision Visit		$15 Hearing Visit					$15 copay	$15 copay									90	90	22.5		45			45	90						13.5	13.5		13.5							13.5		13.5					15	15									7.9013	0.877922786	2.330961567	0	1.051520523	0	0	2.263315091	0.548452574	0	0	0	0	0	2.939436317	4.109571637	0	0.732301812	0	0	0	0	0	0	0.102377502	0	0.052422132	0	0	0	0	0.3125	0.1875	0	0	0	0	0	0	0	0	23.4096		2.601065224	7.9013	0.877922786	2.330961567	0	1.051520523	0	0	2.263315091	0.548452574	0	0	0	0	0	2.939436317	4.109571637	0	0.732301812	0	0	0	0	0	0	0.102377502	0	0.052422132	0	0	0	0	0.3125	0.1875	0	0	0	0	0	0	0	0	23.4096	0																																																																																			0		0	7.9013	0.877922786	2.330961567	0	1.051520523	0	0	2.263315091	0.548452574	0	0	0	0	0	2.939436317	4.109571637	0	0.732301812	0	0	0	0	0	0	0.102377502	0	0.052422132	0	0	0	0	0.3125	0.1875	0	0	0	0	0	0	0	0	23.4096
H3814_007_0	2008	8																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	331.5321302	36.83690336	72.31946681	39.83538452	29.59637746	44.06058527	10.06789786	42.05894957	22.29580663	0	9.690394212	0	0	54.63818308	22.72132233	31.76626119	0	3.903133221	18.33473035	123.1777678	28.79495794	0	0	0	0	0	0	0	0	0	0											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	0	0	0	0	0	0	0	0	0											0.077	0.077	0.1421	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											25.528	2.836441558	10.27659623	0	6.925552325	10.31017695	2.3558881	9.8417942	5.217218752	0	2.267552246	0	0	12.78533484	5.316789425	7.43330512	0	0.913333174	4.290326901	28.82359767	6.738020159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.8599		0	25.528	2.836441558	10.27659623	0	6.925552325	10.31017695	2.3558881	9.8417942	5.217218752	0	2.267552246	0	0	12.78533484	5.316789425	7.43330512	0	0.913333174	4.290326901	28.82359767	6.738020159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.8599	0																																																																																			0		0	25.528	2.836441558	10.27659623	0	6.925552325	10.31017695	2.3558881	9.8417942	5.217218752	0	2.267552246	0	0	12.78533484	5.316789425	7.43330512	0	0.913333174	4.290326901	28.82359767	6.738020159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.8599
H3814_008_0	2008	9	r.	r.									Other Non-Covered	Other Non-Covered									1200	Chiro Benefit	Routine Footcare									D	D	D		T	P		V	V						V	V	V	V							V		V															0	0	0		0	0		0	0						0	0	0	0							0		0					0	0									0	0	1053.507343	117.0563715	1243.179502		280.4054729	3288.090215		603.550691	73.12700992						2612.832281	3652.952566	0	650.9349438							91.00222395		46.59745096					250	150									IP $100/day 1-5	IP $100/day 1-5	$25 per day days 1-100		Amb $50 - Waived if admited	$0 DME/Prosth		$50 ER - waived if admited	$100 OP Surg						$15 PCP Visit	$15 Specialist Visit	$15 MH Visit	$15 Therapy							$15 Vision Visit		$15 Hearing Visit					$15 copay	$15 copay									90	90	22.5		45	0		45	90						13.5	13.5	13.5	13.5							13.5		13.5					15	15									7.9013	0.877922786	2.330961567	0	1.051520523	0	0	2.263315091	0.548452574	0	0	0	0	0	2.939436317	4.109571637	0	0.732301812	0	0	0	0	0	0	0.102377502	0	0.052422132	0	0	0	0	0.3125	0.1875	0	0	0	0	0	0	0	0	23.4096		2.601065224	7.9013	0.877922786	2.330961567	0	1.051520523	0	0	2.263315091	0.548452574	0	0	0	0	0	2.939436317	4.109571637	0	0.732301812	0	0	0	0	0	0	0.102377502	0	0.052422132	0	0	0	0	0.3125	0.1875	0	0	0	0	0	0	0	0	23.4096	0																																																																																			0		0	7.9013	0.877922786	2.330961567	0	1.051520523	0	0	2.263315091	0.548452574	0	0	0	0	0	2.939436317	4.109571637	0	0.732301812	0	0	0	0	0	0	0.102377502	0	0.052422132	0	0	0	0	0.3125	0.1875	0	0	0	0	0	0	0	0	23.4096
H3814_011_0	2008	9																					3000											D	D	D		T	Coin		V	Coin		Coin				V	V	V		Coin		Coin				V		V															0	0	0		0	0		0	0		0				0	0	0		0		0				0		0															0	0	1058.22648	117.5807199	919.0912089		207.3057065	22.79129378		446.2092024	11.61949132		4.765719488				1506.868824	2106.725478	0		9.100044515		12.57534264				72.80177916		34.44981795															$170/Day days 1-11	$170/Day days 1-11	$25/day Days 1-100		$150 Ambulance	10% Coinsurance		$50 ER	20% Coinsurance		20% Coinsurance				$10 PCP	$25 Specialist	$25 Specialist		20% Coinsurance		10% Coinsurance				$25 Vision Exams		$25 Hearing Exams															170	170	25		150	0.1		50	0.2		0.2				10	25	25		0.2		0.1				25		25															14.9915	1.665726866	1.914773352	0	2.591321331	2.279129378	0	1.85920501	2.323898264	0	0.953143898	0	0	0	1.25572402	4.389011413	0	0	1.820008903	0	1.257534264	0	0	0	0.151670373	0	0.071770454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5245		9.38111483	14.9915	1.665726866	1.914773352	0	2.591321331	2.279129378	0	1.85920501	2.323898264	0	0.953143898	0	0	0	1.25572402	4.389011413	0	0	1.820008903	0	1.257534264	0	0	0	0.151670373	0	0.071770454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5245	0																																																																																			0		0	14.9915	1.665726866	1.914773352	0	2.591321331	2.279129378	0	1.85920501	2.323898264	0	0.953143898	0	0	0	1.25572402	4.389011413	0	0	1.820008903	0	1.257534264	0	0	0	0.151670373	0	0.071770454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5245
H3814_012_0	2008	11																					5000											D	D	D		T	Coin		V	Coin		Coin				V	V	V		Coin		Coin				V		V															0	0	0		0	0		0	0		0				0	0	0		0		0				0		0															0	0	1190.504789	132.2783099	1033.97761		233.2189198	25.6402055		501.9853527	13.07192774		5.361434424				1695.227427	2370.066163	0		10.23755008		14.14726047				81.90200155		38.75604519															$250/Day days 1-11	$250/Day days 1-11	$25/day Days 1-100		$150 Ambulance	10% Coinsurance		$50 ER	20% Coinsurance		20% Coinsurance				$15 PCP	$30 Specialist	$30 Specialist		20% Coinsurance		10% Coinsurance				$30 Vision Exams		$30 Hearing Exams															250	250	25		150	0.1		50	0.2		0.2				15	30	30		0.2		0.1				30		30															24.8022	2.755798124	2.154120021	0	2.915236497	2.56402055	0	2.091605636	2.614385547	0	1.072286885	0	0	0	2.119034284	5.925165408	0	0	2.047510016	0	1.414726047	0	0	0	0.204755004	0	0.096890113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7777		5.864190805	24.8022	2.755798124	2.154120021	0	2.915236497	2.56402055	0	2.091605636	2.614385547	0	1.072286885	0	0	0	2.119034284	5.925165408	0	0	2.047510016	0	1.414726047	0	0	0	0.204755004	0	0.096890113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7777	0																																																																																			0		0	24.8022	2.755798124	2.154120021	0	2.915236497	2.56402055	0	2.091605636	2.614385547	0	1.072286885	0	0	0	2.119034284	5.925165408	0	0	2.047510016	0	1.414726047	0	0	0	0.204755004	0	0.096890113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7777
H3815_001_0	2008	11																					Unlimited											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	P	T	P	P	P	P	P	P	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.999572496	0	0	276.6114422	14.31	2.47	316.3626803	0	0	0	0	1.973149116	0	0.863615267	0	185.1371173	0	0	0	6.06	0	0	1183.889469	0	0	0	0	0	0	0											1A - no cost sharing	1B - $150 per admit	2 - no cost sharing	6 - no cost sharing	10A - $50 copay	11A - 20% coinsurance	11B - 20% coinsurance	4A - $50 copay	9 - no cost sharing	8A - no cost sharing	8B - no cost sharing	no cost sharing	12 - $25 copay	9D - no cost sharing	no cost sharing	No Cost Sharing	7E & 7H - $30 copay	7C & 7I - no cost sharing	no cost sharing	7B - no cost sharing	20% coinsurance	no cost sharing	no cost sharing	16A - $20 copay	17A - no cost sharing	17B - no cost sharing	18A - no cost sharing	18B - no cost sharing	no cost sharing	no cost sharing	no cost sharing											0	150	0	0	50	0.039993052	0.19965894	50	0	0	0	0	25	0	25	0	30	0	0	0	0.199875393	0	0	20	0	0	0	0	0	0	0											0	0.024994656	0	0	1.152547676	0.572300569	0.493157583	1.318177834	0	0	0	0	0.004110727	0	0.001799198	0	0.462842793	0	0	0	1.211244879	0	0	1.973149116	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.2143	0	0	0	0.024994656	0	0	1.152547676	0.572300569	0.493157583	1.318177834	0	0	0	0	0.004110727	0	0.001799198	0	0.462842793	0	0	0	1.211244879	0	0	1.973149116	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.2143	0	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0.024994656	0	0	1.152547676	0.572300569	0.493157583	1.318177834	0	0	0	0	0.004110727	0	0.001799198	0	0.462842793	0	0	0	1.211244879	0	0	1.973149116	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.2143
H3817_001_0	2008	2																					1000											D	D			T	Coin		V							V	V	V	V		V					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0															0	2000	452.5505476	6.944957558			3.304204884	11.58414137		288.5954664							8938.809772	19.2236752	369.7242887	1501.439384		0					186.0443427		79.96175818															$100/day (days 1-3)	$100/day (days 1-3)			50	0.1		"$50 ER, $5 Urgent"							5	5	5	5		$5 chiro					5		5															100	100			50	0.1	0	50	0	0	0	0	0	0	5	5	5	5	0	5	0	0	0	0	5	0	5															3.7713	0.057874646	0	0	0.01376752	1.158414137	0	1.20248111	0	0	0	0	0	0	3.724504072	0.008009865	0.154051787	0.625599744	0	0	0	0	0	0	0.077518476	0	0.033317399	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8268	0	0	3.7713	0.057874646	0	0	0.01376752	1.158414137	0	1.20248111	0	0	0	0	0	0	3.724504072	0.008009865	0.154051787	0.625599744	0	0	0	0	0	0	0.077518476	0	0.033317399	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8268	N/A	D	D	D	Coin	T	Coin	Coin	V	V	No cost sharing	No cost sharing	No cost sharing	No cost sharing	V	V	V	V	V	No cost sharing	V	Coin	No cost sharing	No cost sharing	No cost sharing	V	No cost sharing	V															1.3579	0.0693	0.1928	0.0408	0.6858	0.4066	0.0159	0.0928	0.6951					0.0487	0.9009	0.3006	0.2962	0.1391		0.7077	0.0255				0.0294		0.0064															6.0114	250	0.263481215	5.1292	0.127209809	0.192770757	0.04075137	0.699609076	1.564985563	0.01586958	1.295257351	0.695085528	0	0	0	0	0.048735887	4.625378369	0.308646446	0.450230202	0.76468164	0	0.707665532	0.025520227	0	0	0	0.106876656	0	0.03972426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.8382
H3817_002_0	2008	3																					1000											D	D			T	Coin		V							V	V	V	V		V					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0															0	2000	452.5505476	6.944957558			3.304204884	11.58414137		288.5954664							8938.809772	19.2236752	369.7242887	1501.439384		0					186.0443427		79.96175818															$100/day (days 1-3)	$100/day (days 1-3)			50	0.1		"$50 ER, $5 Urgent"							5	5	5	5		$5 chiro					5		5															100	100			50	0.1	0	50	0	0	0	0	0	0	5	5	5	5	0	5	0	0	0	0	5	0	5															3.7713	0.057874646	0	0	0.01376752	1.158414137	0	1.20248111	0	0	0	0	0	0	3.724504072	0.008009865	0.154051787	0.625599744	0	0	0	0	0	0	0.077518476	0	0.033317399	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8268	0	0	3.7713	0.057874646	0	0	0.01376752	1.158414137	0	1.20248111	0	0	0	0	0	0	3.724504072	0.008009865	0.154051787	0.625599744	0	0	0	0	0	0	0.077518476	0	0.033317399	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8268	N/A	D	D	D	Coin	T	Coin	Coin	V	V	No cost sharing	No cost sharing	No cost sharing	No cost sharing	V	V	V	V	V	No cost sharing	V	Coin	No cost sharing	No cost sharing	No cost sharing	V	No cost sharing	V															1.3579	0.0693	0.1928	0.0408	0.6858	0.4066	0.0159	0.0928	0.6951					0.0487	0.9009	0.3006	0.2962	0.1391		0.7077	0.0255				0.0294		0.0064															6.0114	250	0.263481215	5.1292	0.127209809	0.192770757	0.04075137	0.699609076	1.564985563	0.01586958	1.295257351	0.695085528	0	0	0	0	0.048735887	4.625378369	0.308646446	0.450230202	0.76468164	0	0.707665532	0.025520227	0	0	0	0.106876656	0	0.03972426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.8382
H3817_003_0	2008	3																					1000											D	D			T	Coin		V							V	V	V	V		V					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0															0	2000	452.5505476	6.944957558			3.304204884	11.58414137		288.5954664							8938.809772	19.2236752	369.7242887	1501.439384		0					186.0443427		79.96175818															$100/day (days 1-3)	$100/day (days 1-3)			50	0.1		"$50 ER, $5 Urgent"							5	5	5	5		$5 chiro					5		5															100	100			50	0.1	0	50	0	0	0	0	0	0	5	5	5	5	0	5	0	0	0	0	5	0	5															3.7713	0.057874646	0	0	0.01376752	1.158414137	0	1.20248111	0	0	0	0	0	0	3.724504072	0.008009865	0.154051787	0.625599744	0	0	0	0	0	0	0.077518476	0	0.033317399	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8268	0	0	3.7713	0.057874646	0	0	0.01376752	1.158414137	0	1.20248111	0	0	0	0	0	0	3.724504072	0.008009865	0.154051787	0.625599744	0	0	0	0	0	0	0.077518476	0	0.033317399	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8268	N/A	D	D	D	Coin	T	Coin	Coin	V	V	No cost sharing	No cost sharing	No cost sharing	No cost sharing	V	V	V	V	V	No cost sharing	V	Coin	No cost sharing	No cost sharing	No cost sharing	V	No cost sharing	V															1.3579	0.0693	0.1928	0.0408	0.6858	0.4066	0.0159	0.0928	0.6951					0.0487	0.9009	0.3006	0.2962	0.1391		0.7077	0.0255				0.0294		0.0064															6.0114	250	0.263481215	5.1292	0.127209809	0.192770757	0.04075137	0.699609076	1.564985563	0.01586958	1.295257351	0.695085528	0	0	0	0	0.048735887	4.625378369	0.308646446	0.450230202	0.76468164	0	0.707665532	0.025520227	0	0	0	0.106876656	0	0.03972426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.8382
H3818_001_0	2008	6																					1500											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	V	V																																																				0		971.6792694	35.91017752		1597.163198	121.4260686	9.662969969	11.63212609	283.3974536						153.9530789	4014.967751	5299.845725	163.559172	662.6571845			875.9684981			1676.84	144		249															"#1A  $100/day days 1-5, $0/day days 6-90"	"#1B  $100/day days 1-5, $0/day days 6-90"	#2 $0	#6 $20	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $20"	"#9A $0, #9B $0"	#8A $0	"#8A $0, #8B $0"	#9A $0	#12 $0	"#3 $0, #5 $0, #9C $0, #9D $0"	"#7A $15, #14B $0, #14C $20, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0, #14I $0, #17A $20, #18A $20"	"#7B $25, #7D $25, #7F $20 or $25, #7G $25, #14J $0, #17A $20"	"#7E $25, #7H $25"	"#7C $25, #7I $25"	$0 (incl in h2)		#15 20%	"#13A $0, #16B $0"	#10B $0 n/c	"#16A $12/$35/$8/$40, #16B $45/$870/$200/$830/$50/$250"	#17A $25	#17B $0	#18A $20	#18B $0	$0 n/c	#14A $0	#13B $0 n/c											55.2665	55.2665		15.6896	39.2239	0.156895759	0.156895759	39.2192						24.911	11.6774	17.9949	19.612	25			66.8458			16.2152	19.612		15.6896															4.4751	0.165385912	0	2.088234439	0.396900734	1.51607901	1.825031255	0.926217719	0	0	0	0	0	0.319593365	3.907040307	7.947530972	0.267309797	1.380535801	0	0	4.879567222	0	0	2.265854745	0.235343639	0	0.325558701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.9213	0	7.114701461	4.4751	0.165385912	0	2.088234439	0.396900734	1.51607901	1.825031255	0.926217719	0	0	0	0	0	0.319593365	3.907040307	7.947530972	0.267309797	1.380535801	0	0	4.879567222	0	0	2.265854745	0.235343639	0	0.325558701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.9213																																																																																				0	0	0	4.4751	0.165385912	0	2.088234439	0.396900734	1.51607901	1.825031255	0.926217719	0	0	0	0	0	0.319593365	3.907040307	7.947530972	0.267309797	1.380535801	0	0	4.879567222	0	0	2.265854745	0.235343639	0	0.325558701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.9213
H3818_002_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	Coin	V	V																																																				0		283.08335	18.42789323	33.19567365		22.0809427	18.54072645	26.78893833		29.81551051	13.38229242	26.13119036	2.633775896	0.024101328	33.0407608	66.59609912	68.41743942	3.106690426	2.302190804			10.84681581	0.901161762																				1/2 FFS Medicare Ded & Coin	1/2 FFS Medicare Ded & Coin	FFS Medicare Ded & Coin		20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins																				0.038253923	0.038253923	0.146570133		0.2	0.2	0.2		0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2			0.2	0.2																				10.829	0.704939211	4.865494292	0	4.41618854	3.708145289	5.357787665	0	5.963102103	2.676458485	5.226238073	0.526755179	0.004820266	6.60815216	13.31921982	13.68348788	0.621338085	0.460438161	0	0	2.169363161	0.180232352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.3212	0	0	10.829	0.704939211	4.865494292	0	4.41618854	3.708145289	5.357787665	0	5.963102103	2.676458485	5.226238073	0.526755179	0.004820266	6.60815216	13.31921982	13.68348788	0.621338085	0.460438161	0	0	2.169363161	0.180232352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.3212																																																																																				0	0	0	10.829	0.704939211	4.865494292	0	4.41618854	3.708145289	5.357787665	0	5.963102103	2.676458485	5.226238073	0.526755179	0.004820266	6.60815216	13.31921982	13.68348788	0.621338085	0.460438161	0	0	2.169363161	0.180232352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.3212
H3818_003_0	2008	6																					3000											D	D	D	V	T	Coin	Coin	V	Coin	P	Coin	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	V	V																																																				0		959.8239808	35.47204373		1577.676489	119.9445704	9.428615991	11.35001458	279.9476299	35.63046522		13.06554932		0.15417139	152.0921754	3965.981833	5238.062631	163.3202206	654.5722202			865.2809599			1676.84	144		249															"#1A $200/day days 1-5, $0/day days 6-90"	"#1B $200/day days 1-5, $0/day days 6-90"	#2 $0	#6 $20	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $20"	"#9A 20%, #9B 20%"	#8A 20%	"#8A 20%, #8B 20%"	#9A 20%	#12 20%	"#3 $0, #5 20%, #9C $30, #9D 20%"	"#7A $15, #14B $0, #14C $20, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0, #14I $0, #17A $20, #18A $20"	"#7B $30, #7D $30, #7F $30 or $20, #7G $30, #14J $0, #17A $20"	"#7E $30, #7H $30"	"#7C 20%, #7I 20%"	$0 (incl in h2)		#15 20%	"#13A $0, #16B $0"	#10B $0 n/c	"#16A $12/$35/$8/$40, #16B $45/$870/$200/$830/$50/$250"	#17A $25	#17B $0	#18A $20	#18B $0 n/c	$0 n/c	#14A $0	#13B $0 n/c											113.2307	113.2307		16.0725	40.1812	0.160724653	0.160724653	40.1672	0.160724653		0.160724653		261.2762	75.3305	11.9624	21.0086	24.1087	16.3926			53.0634			16.6109	20.0906		16.0725															9.0568	0.334710481	0	2.113095886	0.40162603	1.515411033	1.824227155	0.937059608	5.726694158	0	2.099955881	0	0.003356777	0.954765044	3.953555522	9.170343373	0.328119822	0.894179018	0	0	3.82623046	0	0	2.321150802	0.241086979	0	0.333503655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0359	0	11.24951733	9.0568	0.334710481	0	2.113095886	0.40162603	1.515411033	1.824227155	0.937059608	5.726694158	0	2.099955881	0	0.003356777	0.954765044	3.953555522	9.170343373	0.328119822	0.894179018	0	0	3.82623046	0	0	2.321150802	0.241086979	0	0.333503655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0359																																																																																				0	0	0	9.0568	0.334710481	0	2.113095886	0.40162603	1.515411033	1.824227155	0.937059608	5.726694158	0	2.099955881	0	0.003356777	0.954765044	3.953555522	9.170343373	0.328119822	0.894179018	0	0	3.82623046	0	0	2.321150802	0.241086979	0	0.333503655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0359
H3818_004_0	2008	3																					3000											D	D	D	V	T	Coin	Coin	V	Coin	P	Coin	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	V	V																																																				0		961.5067813	35.53423469		1580.442533	120.1548619	9.461706202	11.38984804	280.4373096	35.75551216		13.11140354		0.154441689	152.3588293	3972.935146	5246.83244	163.6065599	655.7198416			866.7980039			1676.84	144		249															"#1A $200/day days 1-5, $0/day days 6-90"	"#1B $200/day days 1-5, $0/day days 6-90"	#2 $0	#6 $20	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $20"	"#9A 20%, #9B 20%"	#8A 20%	"#8A 20%, #8B 20%"	#9A 20%	#12 20%	"#3 $0, #5 20%, #9C $30, #9D 20%"	"#7A $15, #14B $0, #14C $20, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0, #14I $0, #17A $20, #18A $20"	"#7B $30, #7D $30, #7F $30 or $20, #7G $30, #14J $0, #17A $20"	"#7E $30, #7H $30"	"#7C 20%, #7I 20%"	$0 (incl in h2)		#15 20%	"#13A $0, #16B $0"	#10B $0 n/c	"#16A $12/$35/$8/$40, #16B $45/$870/$200/$830/$50/$250"	#17A $25	#17B $0	#18A $20	#18B $0 n/c	$0 n/c	#14A $0	#13B $0 n/c											113.1694	113.1694		16.0638	40.1594	0.160637616	0.160637616	40.1455	0.160637616		0.160637616		261.5926	75.421	11.9559	20.9976	24.0956	16.4125			53.1277			16.6019	20.0797		16.0638															9.0678	0.335115735	0	2.115654338	0.402112303	1.519905926	1.829638034	0.938191503	5.743680228	0	2.106184605	0	0.003366733	0.95758807	3.958342329	9.180892574	0.328517097	0.896831262	0	0	3.837579524	0	0	2.319893831	0.240956424	0	0.333323053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.1155	0	11.30007745	9.0678	0.335115735	0	2.115654338	0.402112303	1.519905926	1.829638034	0.938191503	5.743680228	0	2.106184605	0	0.003366733	0.95758807	3.958342329	9.180892574	0.328517097	0.896831262	0	0	3.837579524	0	0	2.319893831	0.240956424	0	0.333323053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.1155																																																																																				0	0	0	9.0678	0.335115735	0	2.115654338	0.402112303	1.519905926	1.829638034	0.938191503	5.743680228	0	2.106184605	0	0.003366733	0.95758807	3.958342329	9.180892574	0.328517097	0.896831262	0	0	3.837579524	0	0	2.319893831	0.240956424	0	0.333323053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.1155
H3864_001_0	2008	4																					1500											D	D			T	Coin		V							V	V	V	V			Coin				V		V																																																								0	0	0	0			73.45423794	12.27756135		248.383414							2985.721595	6432.56554	0	2373.754452			31.0336751				111.4728446		36.15335499															IP $0 (unlimited)	IP $0 (unlimited)			$50 Ambulance - Waived if admitted	DME/Prosth 20%		$50 ER - Waived if admitted - WW Cov							PCP $15	Specialist $15	Specialist $15	Specialist $15			Part B Rx 10%				Hear/Vis Exam $15		Hear/Vis Exam $15															0	0			49	0.196		49							14.7	14.7	14.7	14.7			0.098				14.7		14.7															0	0	0	0	0.299938138	2.406402024	0	1.014232274	0	0	0	0	0	0	3.657508954	7.879892787	0	2.907849204	0	0	3.04130016	0	0	0	0.136554235	0	0.04428786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.388		0.436489095	0	0	0	0	0.299938138	2.406402024	0	1.014232274	0	0	0	0	0	0	3.657508954	7.879892787	0	2.907849204	0	0	3.04130016	0	0	0	0.136554235	0	0.04428786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.388	0																																																																																			0		0	0	0	0	0	0.299938138	2.406402024	0	1.014232274	0	0	0	0	0	0	3.657508954	7.879892787	0	2.907849204	0	0	3.04130016	0	0	0	0.136554235	0	0.04428786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.388
H3864_002_0	2008	4																					1500											D	D	D		T	Coin		V	P						V	V	V	V			Coin				V		V																																																								0	0	426.6129919	47.40144355	79.35394631		54.48722589	8.113500524		190.8199055	107.0051269						1783.371015	3842.170334	0	1549.231846			20.41017465				86.78442131		21.30980206															IP $100/day 1-5 (unlimited)	IP $100/day 1-5 (unlimited)	SNF $25/day 1-100 (no prior stay)		$50 Ambulance - Waived if admitted	DME/Prosth 20%		$50 ER - Waived if admitted - WW Cov	OP Surg $200						PCP $20	Specialist $20	Specialist $20	Specialist $20			Part B Rx 10%				Hear/Vis Exam $20		Hear/Vis Exam $20															98	98	24.5		49	0.196		49	196						19.6	19.6	19.6	19.6			0.098				19.6		19.6															3.484	0.387111789	0.162014307	0	0.222489506	1.590246103	0	0.779181281	1.747750406	0	0	0	0	0	2.912839325	6.275544879	0	2.530412015	0	0	2.000197115	0	0	0	0.141747888	0	0.03480601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2683		0.454456056	3.484	0.387111789	0.162014307	0	0.222489506	1.590246103	0	0.779181281	1.747750406	0	0	0	0	0	2.912839325	6.275544879	0	2.530412015	0	0	2.000197115	0	0	0	0.141747888	0	0.03480601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2683	0																																																																																			0		0	3.484	0.387111789	0.162014307	0	0.222489506	1.590246103	0	0.779181281	1.747750406	0	0	0	0	0	2.912839325	6.275544879	0	2.530412015	0	0	2.000197115	0	0	0	0.141747888	0	0.03480601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2683
H3864_006_0	2008	5																					1500											D	D	D		T	Coin		V	P						V	V	V	V							V		V																																																								0	0	830.009133	92.223237	233.0407104		185.3324718	26.59938298		619.1279246	116.3772035						2355.796824	5075.428832	0	1689.183563							124.4817102		30.28931821															IP $100/day 1-5 (unlimited)	IP $100/day 1-5 (unlimited)	SNF $25/day 1-100 (no prior stay)		$50 Ambulance - Waived if admitted	DME/Prosth 20%		$50 ER - Waived if admitted - WW Cov	OP Surg $200						PCP $15	Specialist $15	Specialist $15	Specialist $15							Hear/Vis Exam $15		Hear/Vis Exam $15															98	98	24.5		49	0.196		49	196						14.7	14.7	14.7	14.7							14.7		14.7															6.7784	0.753156435	0.47579145	0	0.75677426	5.213479064	0	2.528105692	1.900827657	0	0	0	0	0	2.885851109	6.217400319	0	2.069249865	0	0	0	0	0	0	0.152490095	0	0.037104415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7686		0.60752323	6.7784	0.753156435	0.47579145	0	0.75677426	5.213479064	0	2.528105692	1.900827657	0	0	0	0	0	2.885851109	6.217400319	0	2.069249865	0	0	0	0	0	0	0.152490095	0	0.037104415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7686	0																																																																																			0		0	6.7784	0.753156435	0.47579145	0	0.75677426	5.213479064	0	2.528105692	1.900827657	0	0	0	0	0	2.885851109	6.217400319	0	2.069249865	0	0	0	0	0	0	0.152490095	0	0.037104415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7686
H3864_007_0	2008	3																					1500											A	A			T	Coin		V							V	V	V	V							V		V																																																								0	0	210.1501883	23.35002092			74.24335622	12.40945909		251.051795							2561.168869	5517.891097	0	2036.219993							97.12998371		31.50161634															IP $100/admit (unlimited)	IP $100/admit (unlimited)			$50 Ambulance - Waived if admitted	DME/Prosth 20%		$50 ER - Waived if admitted - WW Cov							PCP $10	Specialist $15	Specialist $15	Specialist $15							Hear/Vis Exam $15		Hear/Vis Exam $15															98	98			49	0.196		49							9.8	14.7	14.7	14.7							14.7		14.7															1.7162	0.190691838	0	0	0.303160371	2.432253982	0	1.025128163	0	0	0	0	0	0	2.091621243	6.759416594	0	2.494369491	0	0	0	0	0	0	0.11898423	0	0.03858948	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.1704		0.350417182	1.7162	0.190691838	0	0	0.303160371	2.432253982	0	1.025128163	0	0	0	0	0	0	2.091621243	6.759416594	0	2.494369491	0	0	0	0	0	0	0.11898423	0	0.03858948	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.1704	0																													10% POS Coinsurance																																									0.4417													0.4417		0	1.7162	0.190691838	0	0	0.303160371	2.432253982	0	1.025128163	0	0	0	0	0	0	2.091621243	6.759416594	0	2.494369491	0	0	0	0	0	0	0.11898423	0	0.03858948	0	0.44172454	0	0	0	0	0	0	0	0	0	0	0	0	17.6122
H3864_801_0	2008	3																					0															T			V							V	V	V	V							V		V																																																								0	0					55.11327544			199.9436275							2268.168835	4886.639368	0	1998.590995							109.0051098		34.75230434																			$50 Ambulance - Waived if admitted			$50 ER - Waived if admitted - WW Cov							PCP $10	Specialist $10	Specialist $10	Specialist $10							Hear/Vis Exam $10		Hear/Vis Exam $10																			50			50							10	10	10	10							10		10															0	0	0	0	0.229638648	0	0	0.833098448	0	0	0	0	0	0	1.890140696	4.072199473	0	1.665492496	0	0	0	0	0	0	0.090837591	0	0.028960254	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.8104		0	0	0	0	0	0.229638648	0	0	0.833098448	0	0	0	0	0	0	1.890140696	4.072199473	0	1.665492496	0	0	0	0	0	0	0.090837591	0	0.028960254	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.8104	0																																																																																			0		0	0	0	0	0	0.229638648	0	0	0.833098448	0	0	0	0	0	0	1.890140696	4.072199473	0	1.665492496	0	0	0	0	0	0	0.090837591	0	0.028960254	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.8104
H3887_001_0	2008	7	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)							Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						Coin	Coin	D	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V		Coin	Coin	Coin	T		V	P	Coin					Coin	Coin	Coin	V																																																0		515.5544384	7.886074023	9800.120851	227.3980793	31.17309119	32.95895272	0.296271093	191.6085479	14.51325363	57.05918964	52.24878753	2.662100245	0.645620873	8.582234893	138.6995514	134.0336852	13.9232634	26.44058983		13.49070131	4.278504198	6.767873477	1817.255		287.28	278.16						1.08451954	0.008042088		234.745							(1a) 7.2% coins	(1b) 7.2% coins	(2a) $0/day	(6a) $0/proc	(10a) 20% coins	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) 20% coins	(8a) 10% coins	(8b) 19.2% coins	(9a) 20% coins	(12) 20% coins	(9a) 20% coins	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) 20% coins	(7e/7h) 20% coins	(7c/7i) $0/visit		(7g) 20% coins	(15) 20% coins	(Misc. PBP Cats) 20% coins	(10b) $0/trip		(17a1) $0/visit	(17b2) $0/proc	(18a) 20% coins					(4b) 20% coins	(9c) 20% coins	(9d) 20% coins	(7f1) $0/visit							0.0722	0.0722			0.2	0.2	0.2	50	0.2	0.1	0.192	0.2	0.2	0.2		0.2	0.2			0.2	0.2	0.2										0.2	0.2									37.223	0.569374544	0	0	6.234618237	6.591790543	0.059254219	0.79836895	2.902650727	5.705918964	10.03176721	0.532420049	0.129124175	1.716446979	0	26.80673704	2.78465268	0	0	2.698140263	0.85570084	1.353574695	0	0	0	0	0	0	0	0	0	0.216903908	0.001608418	0	0	0	0	0	0	0	0	107.2121		0	37.223	0.569374544	0	0	6.234618237	6.591790543	0.059254219	0.79836895	2.902650727	5.705918964	10.03176721	0.532420049	0.129124175	1.716446979	0	26.80673704	2.78465268	0	0	2.698140263	0.85570084	1.353574695	0	0	0	0	0	0	0	0	0	0.216903908	0.001608418	0	0	0	0	0	0	0	0	107.2121		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					0.2	0.3	0.3	0.3							3.9843	0.0607	1.0997	0.1332	0.4922	0.5204	0.0047	0.042	0.2292	0.9009	0.825	0.042	0.0102	0.1355	0.0098	2.1163	0.2198	0.0033		0.213		0.1387	0.1433		0.0146							0.0114	0.0001		0.013							11.3634		0	41.2074	0.630036652	1.099698586	0.133244992	6.72682494	7.11219506	0.063932183	0.840388368	3.131807363	6.606853537	10.85674806	0.574453211	0.139318188	1.851955951	0.009776035	28.92305838	3.004493682	0.003304331	0	2.911151336	0.85570084	1.492276802	0.14325	0	0.01455	0	0	0	0	0	0	0.228319903	0.001735398	0	0.01305	0	0	0	0	0	0	118.5755
H3887_002_0	2008	5																					3900											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2396.687048	339.3391134	1176.126358		475.1535162	35.35922725	25.25216079	823.652953	437.0335342	7592.325345	641.2199988	80.3819013	5.251073331	4127.853374		3981.855112	1043.016435	1079.783431			32.11845782	773.3563654					0.102046571															1(a) $250 per Day	1(b) $250 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $150 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $75 per Visit	8(a) Diagnostic: 20% Coinsurance; other 0% coinsurance	8(b) X-rays 20% Coinsurance; other: 20% Coinsurance	9(a) $75 per Visit	12  20% Coinsurance	"3,5,9(a), 9(d) $75 per visit; 9(c) $25/$35 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $35 per Visit	7(e)/7(h) $25/35 per Visit	7(c)/7(i) $35 per Visit		7(g) $35 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $35 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $35 per visit															158.4489	158.4489	26.6194		95.0694	0.126759146	0.126759146	28.3624	47.5347	2.1357	63.6638	47.5347	0.126759146	47.4251		22.1829	20.5984	22.1829			0.126759146	22.1829					22.1829															31.646	4.480660036	2.60898353	0	3.764378382	4.482105462	3.200942347	1.946728395	1.731187429	1.351236603	3.401873024	0.318410662	0.665621573	16.31363813	0	7.360741428	1.790369113	1.996056211	0	0	4.071308296	1.42960406	0	0	0	0	0.00018864	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.5601	0	53.48078723	31.646	4.480660036	2.60898353	0	3.764378382	4.482105462	3.200942347	1.946728395	1.731187429	1.351236603	3.401873024	0.318410662	0.665621573	16.31363813	0	7.360741428	1.790369113	1.996056211	0	0	4.071308296	1.42960406	0	0	0	0	0.00018864	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.5601		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3																																																								0	0	0	31.646	4.480660036	2.60898353	0	3.764378382	4.482105462	3.200942347	1.946728395	1.731187429	1.351236603	3.401873024	0.318410662	0.665621573	16.31363813	0	7.360741428	1.790369113	1.996056211	0	0	4.071308296	1.42960406	0	0	0	0	0.00018864	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.5601
H3887_003_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2023.727405	149.2330018	969.383739		126.334397	14.4014924	2.759517703	492.3237392	35.43734679	10441.42937	50.93612172		0.412081693	32.65468226	4468.805561	4543.834052	520.8198113	2.017233908			25.71204799	912.2331025			122.4		14.32602104															$195 (1a); $0 (1a1)	$195 (1b)	"$125 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$195 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$8 (4b)"	20% (9b)	20% (8a1); $0/$20 (8a2)	"$20 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$8/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $8 (14c1, 14c)"	"$28 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $28 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$28 (17a1)	$0 n/c (17b)	$28 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											123.8339	123.8339	79.3807		123.8339	0.190513697	0.283594981	31.7523	0.127009131	5.0804	0.075091331		0.190513697	0.126962486	8	27.9356	37.5	0.127009131			0.190513697	28			28		28															20.8838	1.540008755	6.412530549	0	1.303706788	2.743681557	0.782585369	1.302700217	4.500866629	4.42052291	3.824861153	0	0.078507207	4.145919654	2.979203707	10.57789296	1.62756191	0.256207126	0	0	4.898497317	2.128543906	0	0	0.2856	0	0.033427382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7267	0	32.40596463	20.8838	1.540008755	6.412530549	0	1.303706788	2.743681557	0.782585369	1.302700217	4.500866629	4.42052291	3.824861153	0	0.078507207	4.145919654	2.979203707	10.57789296	1.62756191	0.256207126	0	0	4.898497317	2.128543906	0	0	0.2856	0	0.033427382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7267		$295 (1a); $0 (1a1)	$295 (1b)	"$175 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$195 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); $0 (14b); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											4.3261	0.319	4.7123	0.7684	0.5132	1.0801	0.207	0.5128	2.6578	1.7402	2.1749		0.0309	2.4475	1.56	2.644	0.3255	0.1068			1.3612	0.5453			0.072		0.0084															28.1135	0	0	25.2099	1.859021331	11.12481261	0.768368942	1.816940276	3.823793487	0.989549197	1.815537445	7.158667638	6.160761138	5.999798839	0	0.109413334	6.593426928	4.539174027	13.22187781	1.953074292	0.363001862	0	0	6.259723387	2.673849215	0	0	0.3576	0	0.041854454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.8402
H3887_004_0	2008	8																					3250											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2023.715178	149.2321001	969.3778817		126.3336337	14.40131836	2.759484355	492.3207663	35.43691854	10441.36628	50.93550618		0.412076713	32.65428764	4468.779232	4543.806695	520.8166643	2.017209531			25.71173727	912.2275905			122.4		14.32602104															$195 (1a); $0 (1a1)	$195 (1b)	"$125 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											117.9215	117.9215	75.5907		105.827	0.181417766	0.28223208	30.2363	0.120945178	3.6284	0.069519341		0.181417766	0.120903705	5	24.9463	37.5	0.120945178			0.181417766	25			25		25															19.8866	1.466473356	6.106332293	0	1.114126107	2.61265501	0.77881501	1.240496302	4.285924406	3.157082246	3.541002811	0	0.074758037	3.94802437	1.861991347	9.445914947	1.627552076	0.243971765	0	0	4.664565945	1.900474147	0	0	0.255	0	0.029845877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2416	0	34.26066383	19.8866	1.466473356	6.106332293	0	1.114126107	2.61265501	0.77881501	1.240496302	4.285924406	3.157082246	3.541002811	0	0.074758037	3.94802437	1.861991347	9.445914947	1.627552076	0.243971765	0	0	4.664565945	1.900474147	0	0	0.255	0	0.029845877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2416		$295 (1a); $0 (1a1)	$295 (1b)	"$175 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$15/$50 (7a); $0 (14b); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											4.3261	0.319	4.7123	0.7684	0.4606	1.0801	0.207	0.5128	2.6578	1.7402	2.1749		0.0309	2.4475	1.2314	2.644	0.3255	0.1068			1.3612	0.5453			0.072		0.0084															27.732	0	0	24.2127	1.785484005	10.81858588	0.768359656	1.57471748	3.692753887	0.985776337	1.753330434	6.943693296	4.897309959	5.715915226	0	0.10566379	6.395502072	3.093364247	12.08988309	1.953062491	0.350765211	0	0	6.025775565	2.445776108	0	0	0.327	0	0.038272948	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.9737
H3887_005_0	2008	6																					3500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2169.517796	148.8051578	1011.016583		313.0428472	13.52538182	23.48946594	490.3204261	463.4473913	3885.467214	510.6195087	77.81627094	17.39350975	3265.012505		4420.767009	435.9146391	637.5035689				786.77725					0.083304006															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															140.0666	140.0666	33.616		60.0286	0.160076137	0.160076137	33.0157	60.0286	16.0076	52.236	60.0286	135.6015	58.0375		20.0095	16.0076	16.0076				20.0095					20.0095															25.3231	1.736886295	2.832193516	0	1.565959058	2.16509088	3.760102979	1.349022811	2.318339635	5.1830882	2.22272876	0.389266503	0.196548834	15.79109143	0	7.371451121	0.581496098	0.850409241	0	0	0	1.311919409	0	0	0	0	0.000138906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9488	0	18.69264461	25.3231	1.736886295	2.832193516	0	1.565959058	2.16509088	3.760102979	1.349022811	2.318339635	5.1830882	2.22272876	0.389266503	0.196548834	15.79109143	0	7.371451121	0.581496098	0.850409241	0	0	0	1.311919409	0	0	0	0	0.000138906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9488		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.7412	0.0783	0.3374	0.3368	0.0865	0.1656	0.1438	0.0353	0.3501	0.055	0.1428	0.0287	0.0066	0.2499	0.025	0.2415	0.0363	0.0392			0.2165	0.0512			0.0051																	5.3727	0	0	28.0642	1.815213041	3.169611419	0.336783089	1.652461396	2.3307078	3.903916036	1.384356637	2.668403437	5.238043087	2.365578147	0.417929321	0.20315877	16.04097796	0.024977009	7.612915815	0.617774018	0.889601911	0	0	0.21651336	1.363112837	0	0	0.005058988	0	0.000138906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.3215
H3887_006_0	2008	5																					3900											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1902.915944	140.324165	911.5139557		118.7925497	12.7333502	2.439879446	462.9523472	31.33259626	9818.102165	45.03612944		0.364349774	28.87225111	4208.676369	4273.542645	489.728172	1.783575277			22.73379052	857.7750692			122.4		14.32602104															$150 (1a); $0 (1a1)	$150 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$5 (4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$28 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $28 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$28 (17a1)	$0 n/c (17b)	$28 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											105.8277	105.8277	70.5518		123.4657	0.211655442	0.286762781	35.2759	0.141103628	4.2331	0.081547878		0.211655442	0.14105054	5	27.9315	37.5	0.141103628			0.211655442	28			28		28															16.7818	1.237515549	5.359080255	0	1.222233522	2.695082865	0.699666615	1.360921995	4.421143006	3.463424588	3.672600789	0	0.077116612	4.072446608	1.753615154	9.947213006	1.530400537	0.251668942	0	0	4.811730481	2.001475162	0	0	0.2856	0	0.033427382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6781	0	20.66212767	16.7818	1.237515549	5.359080255	0	1.222233522	2.695082865	0.699666615	1.360921995	4.421143006	3.463424588	3.672600789	0	0.077116612	4.072446608	1.753615154	9.947213006	1.530400537	0.251668942	0	0	4.811730481	2.001475162	0	0	0.2856	0	0.033427382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6781		$225 (1a); $0 (1a1)	$225 (1b)	"$175 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$10/$50 (7a); $0 (14b); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $30 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											3.1026	0.2288	4.431	0.6794	0.4331	0.955	0.183	0.4822	2.3499	1.6364	1.9324		0.0273	2.1641	0.8361	1.8806	0.3061	0.0944			1.2036	0.3861			0.054		0.0063															23.3723	0	0	19.8844	1.466304948	9.790050873	0.679367842	1.65533136	3.65008413	0.882657573	1.843164024	6.771087725	5.099774949	5.605006935	0	0.104442846	6.236509458	2.589703925	11.82782097	1.836480645	0.346093516	0	0	6.015284097	2.387595487	0	0	0.3396	0	0.039747686	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.0505
H3887_008_0	2008	4																					3900											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2086.587724	153.8684255	999.4944002		130.2585522	15.31005565	2.93361052	507.6061885	37.6730228	10765.75742	54.1495865		0.438079157	34.71480517	4604.155333	4684.471403	536.9973355	2.144497427			27.33417307	940.5685705			122.4		14.32602104															$195 (1a); $0 (1a1)	$195 (1b)	"$125 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$195 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$8 (4b)"	20% (9b)	20% (8a1); $0/$20 (8a2)	"$20 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$8/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $8 (14c1, 14c)"	"$28 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $28 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$28 (17a1)	$0 n/c (17b)	$28 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											123.7086	123.7086	79.3004		123.7086	0.190320999	0.283566107	31.7202	0.126880666	5.0752	0.074764206		0.190320999	0.126831564	8	27.9375	37.5	0.126880666			0.190320999	28			28		28															21.5107	1.586237926	6.605026838	0	1.342842465	2.91382509	0.831872516	1.341779403	4.779978229	4.553221577	4.048450856	0	0.083375663	4.402933017	3.069436889	10.90604677	1.678116673	0.272095262	0	0	5.202267131	2.194659998	0	0	0.2856	0	0.033427382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.6419	0	33.84192587	21.5107	1.586237926	6.605026838	0	1.342842465	2.91382509	0.831872516	1.341779403	4.779978229	4.553221577	4.048450856	0	0.083375663	4.402933017	3.069436889	10.90604677	1.678116673	0.272095262	0	0	5.202267131	2.194659998	0	0	0.2856	0	0.033427382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.6419		$295 (1a); $0 (1a1)	$295 (1b)	"$175 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$195 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); $0 (14b); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											4.4605	0.3289	4.8587	0.8168	0.5292	1.1483	0.22	0.5288	2.8255	1.7943	2.3068		0.0329	2.6019	1.6153	2.73	0.3356	0.1135			1.4471	0.5625			0.072		0.0084															29.3369	0	0	25.9712	1.91515956	11.46368017	0.816843903	1.872017833	4.062079264	1.051893305	1.870535849	7.605454939	6.347514481	6.355241591	0	0.1162316	7.004818548	4.684711404	13.63605792	2.013740008	0.385627479	0	0	6.649370411	2.757181944	0	0	0.3576	0	0.041854454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.9788
H3887_009_0	2008	4																					3450											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2086.587724	153.8684255	999.4944002		130.2585522	15.31005565	2.93361052	507.6061885	37.6730228	10765.75742	54.1495865		0.438079157	34.71480517	4604.155333	4684.471403	536.9973355	2.144497427			27.33417307	940.5685705			122.4		14.32602104															$195 (1a); $0 (1a1)	$195 (1b)	"$125 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											118.7643	118.7643	76.1309		106.5833	0.182714274	0.282426344	30.4524	0.121809516	3.6543	0.069835277		0.182714274	0.121764767	5	24.9479	37.5	0.121809516			0.182714274	25			25		25															20.651	1.52283937	6.341037964	0	1.156949148	2.797365698	0.828528894	1.288151334	4.588932665	3.278429246	3.781551346	0	0.080043315	4.227040154	1.918398056	9.738966422	1.678116673	0.261220193	0	0	4.994343578	1.959517855	0	0	0.255	0	0.029845877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.3773	0	35.33519658	20.651	1.52283937	6.341037964	0	1.156949148	2.797365698	0.828528894	1.288151334	4.588932665	3.278429246	3.781551346	0	0.080043315	4.227040154	1.918398056	9.738966422	1.678116673	0.261220193	0	0	4.994343578	1.959517855	0	0	0.255	0	0.029845877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.3773		$295 (1a); $0 (1a1)	$295 (1b)	"$175 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$15/$50 (7a); $0 (14b); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											4.4605	0.3289	4.8587	0.8168	0.4749	1.1483	0.22	0.5288	2.8255	1.7943	2.3068		0.0329	2.6019	1.2767	2.73	0.3356	0.1135			1.4471	0.5625			0.072		0.0084															28.9441	0	0	25.1115	1.851761004	11.1996913	0.816843903	1.631850119	3.945619873	1.048549683	1.81690778	7.414409375	5.07272215	6.088342081	0	0.112899252	6.828925685	3.195131737	12.46897757	2.013740008	0.37475241	0	0	6.441446858	2.522039802	0	0	0.327	0	0.038272948	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.3213
H3887_801_0	2008	3																					4800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2053.20942	151.4070542	983.5058907		128.1748586	14.11824359	2.70524346	499.4913356	34.74036442	10593.54194	49.93430918		0.403976862	32.01242939	4532.285735	4609.794145	528.4072053	1.977558916			25.20634297	925.5226738			122.4		14.32602104															$315 (1a); $0 (1a1)	$315 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$20/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											199.0658	199.0658	94.7932		110.5921	0.157988726	0.236213374	31.5977	0.157988726	3.7917	0.089472242		0.189586471	0.157912769	20	29.9295	37.5	0.157988726			0.189586471	30			30		30															34.0603	2.511663795	7.769142122	0	1.181260651	2.230523315	0.639014684	1.315233327	5.488585907	3.347320383	4.467734615	0	0.076588548	5.055171367	7.553809559	11.4974072	1.651272517	0.312432013	0	0	4.778781608	2.313806684	0	0	0.306	0	0.035815053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.5919	0	42.31466447	34.0603	2.511663795	7.769142122	0	1.181260651	2.230523315	0.639014684	1.315233327	5.488585907	3.347320383	4.467734615	0	0.076588548	5.055171367	7.553809559	11.4974072	1.651272517	0.312432013	0	0	4.778781608	2.313806684	0	0	0.306	0	0.035815053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.5919		$365 (1a); $0 (1a1)	$365 (1b)	"$175 (2a, 2a2)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	40% (9b)	40% (8a1); $0/$20 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	40% (incl in h5)	30% (12)	"40% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$25/$50 (7a); 40% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 40% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											5.4306	0.4005	4.7809	1.0043	0.4673	1.0589	0.2029	0.5203	3.474	1.7656	2.7939		0.0303	3.1989	2.0683	2.3589	0.3303	0.1396			1.3345	0.4877			0.063		0.0074															31.9181	0	0	39.4909	2.912124482	12.55007354	1.004342197	1.648564823	3.289391584	0.841907944	1.835536802	8.962622349	5.112910706	7.261658457	0	0.106886812	8.254053188	9.622151911	13.85634505	1.98152702	0.452024407	0	0	6.11323506	2.801547365	0	0	0.369	0	0.04318874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.51
H3887_802_0	2008	3																					4800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2053.085876	151.3979439	983.4467121		128.1671462	14.11654462	2.704917915	499.4613	34.73618382	10592.90451	49.92830016		0.403928249	32.00857706	4532.019723	4609.517741	528.3754105	1.977320939			25.20330968	925.4669841			122.4		14.32602104															$315 (1a); $0 (1a1)	$315 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$20/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											199.0724	199.0724	94.7964		110.5958	0.157993972	0.23621416	31.5988	0.157993972	3.7919	0.089475601		0.189592766	0.157918016	20	29.9295	37.5	0.157993972			0.189592766	30			30		30															34.0594	2.511596065	7.768932618	0	1.181228797	2.230328957	0.638939913	1.315197911	5.488107656	3.347230119	4.467364685	0	0.076581874	5.054730984	7.553366205	11.49671618	1.651173158	0.312404789	0	0	4.778365206	2.31366746	0	0	0.306	0	0.035815053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.5871	0	42.30892973	34.0594	2.511596065	7.768932618	0	1.181228797	2.230328957	0.638939913	1.315197911	5.488107656	3.347230119	4.467364685	0	0.076581874	5.054730984	7.553366205	11.49671618	1.651173158	0.312404789	0	0	4.778365206	2.31366746	0	0	0.306	0	0.035815053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.5871		$365 (1a); $0 (1a1)	$365 (1b)	"$175 (2a, 2a2)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	40% (9b)	40% (8a1); $0/$20 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	40% (incl in h5)	30% (12)	"40% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$25/$50 (7a); 40% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 40% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											5.4303	0.4004	4.7806	1.0042	0.4673	1.0587	0.2029	0.5203	3.4736	1.7655	2.7936		0.0303	3.1985	2.0682	2.3588	0.3302	0.1396			1.3343	0.4877			0.063		0.0074															31.9154	0	0	39.4897	2.912032656	12.54957636	1.004221336	1.64850485	3.289069803	0.841808756	1.835470099	8.961726038	5.112714204	7.260962526	0	0.106876493	8.253227915	9.621562375	13.85550492	1.981407789	0.451980385	0	0	6.112658072	2.801378109	0	0	0.369	0	0.04318874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.5025
H3907_002_0	2008	4																					3100											A	A	D		T	coin	coin	V	V		P	V		V	V	V	V	V			S	P	T		V																																																										0	N/A	296.9438653	5.023777002	1208.643458		180.0868107	3.540363936	1.382607314	285.1308187	288.6322856		2431.848364	1597.225973		63.25983593	6827.22389	6516.196049	53.31779194	718.0837351			212.6472986	505.3978039	17.78586045		0																	"1a:  $250 per Admit, max 3"	"1b:  $250 per Admit, max 3"	"2:  $60 per day, day 16 - 100"		10a:  $100 per Trip	11a:  20% Coinsurance	11b:  20% Coinsurance	"4a,b:  $50 Copay"	"9a,b:  $150 Copay, max 3x per year"		8b:  $15/$50 Copay depending on type of Service	9a:  $50 Observation		"7c,i:  $30 Copay"	"7a, 14c:  $10 copay"	"7b,d,f,g 16b,17a, 18a:  $30 Copay"	"7e,h 9c:  $30 Copay"	"7c,i:  $30 Copay"			15:  $20/$60 Copay per 30/90 day supply	11c:  $20/$60 Copay per 30/90 day supply	10a:  $100 per Trip		17a:  $30 copay																	236.201848	237.5	5.32894232		95	0.19	0.19	47.5	142.5		25.27172846	47.5		27.74949681	7.447454308	21.16404149	16.54701493	28.5			0	20.58100999	95		0																	5.8449	0.09942892	0.536732606	0	1.425687251	0.672669148	0.26269539	1.128642824	3.427508392	0	5.121417626	6.322352811	0	0.146285718	4.237119831	11.4924203	0.073520858	1.705448871	0	0	0	0.866799771	0.140804729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5044		0.810115847	5.8449	0.09942892	0.536732606	0	1.425687251	0.672669148	0.26269539	1.128642824	3.427508392	0	5.121417626	6.322352811	0	0.146285718	4.237119831	11.4924203	0.073520858	1.705448871	0	0	0	0.866799771	0.140804729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5044																																																																																				0			5.8449	0.09942892	0.536732606	0	1.425687251	0.672669148	0.26269539	1.128642824	3.427508392	0	5.121417626	6.322352811	0	0.146285718	4.237119831	11.4924203	0.073520858	1.705448871	0	0	0	0.866799771	0.140804729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5044
H3907_006_0	2008	3																					3100											A	A	D		T	coin	coin	V	V		P	V		V	V	V	V	V			S	P	T		V		V																																																								0		343.8136491	11.37917515	1220.010136		218.6427225	17.36455715	3.340748246	311.1856061	276.5836245		2537.32383	1545.013312		11965.31878	17646.38345	6763.979854	86.65995951	946.0652141			219.6527532	87.22882209	45.28447253		0		0.359617143															"1a:  $100 per Admit, max 3"	"1b:  $100 per Admit, max 3"	"2:  $60 per day, day 16 - 100"		10a:  $100 per Trip	11a:  20% Coinsurance	11b:  20% Coinsurance	"4a,b:  $50 Copay"	"9a,b:  $60 Copay, max 3x"		8b:  $15/$50 Copay depending on type of Service	9a:  $50 Observation copay- no PBP code		"7c,i:  $25 Copay"	0	"7b,d,f,g 16b, 17a, 18a:  $25 Copay"	"7e,h 9c:  $25 Copay"	"7c,i:  $25 Copay"			15:  $15/$45 Copay per 30/90 day supply	11c:  $15/$45 Copay per 30/90 day supply	10a:  $100 per Trip		17a:  $25 copay		18a:  $25 copay															96.38635596	100	6.058817931		100	0.055527495	0.2	50	60		26.74308988	50		0.396417204	0	18.42974388	12.38159675	25			0	124.2064301	50		0		25															2.7616	0.09482646	0.61598494	0	1.822022688	0.964210364	0.668149649	1.296606692	1.382918123	0	5.654656603	6.437555465	0	0.395271518	0	10.38820136	0.089415723	1.970969196	0	0	0	0.902865049	0.188685302	0	0	0	0.000749202	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.6347		0.938965313	2.7616	0.09482646	0.61598494	0	1.822022688	0.964210364	0.668149649	1.296606692	1.382918123	0	5.654656603	6.437555465	0	0.395271518	0	10.38820136	0.089415723	1.970969196	0	0	0	0.902865049	0.188685302	0	0	0	0.000749202	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.6347																																																																																				0			2.7616	0.09482646	0.61598494	0	1.822022688	0.964210364	0.668149649	1.296606692	1.382918123	0	5.654656603	6.437555465	0	0.395271518	0	10.38820136	0.089415723	1.970969196	0	0	0	0.902865049	0.188685302	0	0	0	0.000749202	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.6347
H3907_020_0	2008	3																					N/A											Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		329.5442234	60.28986808		34.64476379	21.41641918	17.62688661	3.367438856	36.92661202	22.68416388	31.02572938	37.70758588	16.12251257	1.221568381	66.20029529	90.26715685	47.2151426	2.473885565	9.070632456	0	0	53.7000532	16.7736647																				Medicare Cost Sharing	Medicare Cost Sharing		Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.072985231	0.072985231		0	0.236	0.236	0.236	0.236	0.236	0.236	0.236	0.236	0.236	0.236	0.236	0.236	0.236	0.236	0.236	0.236	0.236	0.236																				24.0519	4.400269928	0	0	5.054274926	4.159945241	0.79471557	8.714680437	5.353462675	7.322072133	8.898990268	3.804912967	0.288290138	15.62326969	21.30304902	11.14277365	0.583836993	2.14066926	0	0	12.67321256	3.958584868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2689		0	24.0519	4.400269928	0	0	5.054274926	4.159945241	0.79471557	8.714680437	5.353462675	7.322072133	8.898990268	3.804912967	0.288290138	15.62326969	21.30304902	11.14277365	0.583836993	2.14066926	0	0	12.67321256	3.958584868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2689	N/A																																																																																			0			24.0519	4.400269928	0	0	5.054274926	4.159945241	0.79471557	8.714680437	5.353462675	7.322072133	8.898990268	3.804912967	0.288290138	15.62326969	21.30304902	11.14277365	0.583836993	2.14066926	0	0	12.67321256	3.958584868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2689
H3907_021_0	2008	3																					3100											A	A	D		T	coin	coin	V	V		P	V		V	V	V	V	V			S	P	T		V		V																																																								0		296.9303895	5.023549015	1208.588608		180.0786381	14.78886917	1.382544569	285.117879	288.619187		2431.738003	1597.153489		63.2569651	6826.91406	6515.90612	53.3153723	718.0511473			212.6472986	505.3924948	17.7850533		0		0.080536558															"1a:  $250 per Admit, max 3"	"1b:  $250 per Admit, max 3"	"2:  $60 per day, day 16 - 100"		10a:  $100 per Trip	11a:  20% Coinsurance	11b:  20% Coinsurance	"4a,b:  $50 Copay"	"9a,b:  $150 Copay, max 3x"		8b:  $15/$50 Copay depending on type of Service	9a:  $50 Observation Copay - no PBP code		"7c,i:  $30 Copay"	"7a, 14c:  $10"	"7b,d,f,g 16b, 17a, 18a:  $30 Copay"	"7e,h 9c:  $30 Copay"	"7c,i:  $30 Copay"			15:  $20/$60 Copay per 30/90 day supply	11c:  $20/$60 Copay per 30/90 day supply	10a:  $100 per Trip		17a:  $30 copay		18a:  $30 copay															236.201848	237.5	5.32894232		95	0.045482762	0.19	47.5	142.5		25.27172846	47.5		27.74949681	7.447454308	21.16404801	16.54701493	28.5			0	20.58122619	95		0		28.5															5.8446	0.099424408	0.536708248	0	1.425622551	0.672638621	0.262683468	1.128591604	3.427352846	0	5.121185208	6.322065892	0	0.146279079	4.236927544	11.49191249	0.073517522	1.705371475	0	0	0	0.866799771	0.140798339	0	0	0	0.000191274	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5027		0.806833758	5.8446	0.099424408	0.536708248	0	1.425622551	0.672638621	0.262683468	1.128591604	3.427352846	0	5.121185208	6.322065892	0	0.146279079	4.236927544	11.49191249	0.073517522	1.705371475	0	0	0	0.866799771	0.140798339	0	0	0	0.000191274	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5027																																																																																				0			5.8446	0.099424408	0.536708248	0	1.425622551	0.672638621	0.262683468	1.128591604	3.427352846	0	5.121185208	6.322065892	0	0.146279079	4.236927544	11.49191249	0.073517522	1.705371475	0	0	0	0.866799771	0.140798339	0	0	0	0.000191274	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5027
H3907_801_0	2008	3																					3250											A	A	D		T	coin	coin	V	V		P	V		V	V	V	V	V			S	P	T	V	V		V															0	0	0		0	0	0	0	0		0	0		0	0	0	0	0			0	0	0	0	0		0															0		362.2867881	4.834071302	1075.580865		237.1128178	4.518884463	1.790979914	589.6712349	340.1151789		2689.675077	1707.627063		10836.26316	18871.00036	8619.074743	60.41883462	1339.575283			242.1870058	632.8329407	26.82209134	210.1230685	0		0.139928548															"1a:  $100 per Admit, max 3"	"1b:  $100 per Admit, max 3"	"2:  $25 per day, day 16 - 100"		10a:  $75 per Trip	11a:  15% Coinsurance	11b:  15% Coinsurance	"4a,b:  $50 Copay"	"9a,b:  $100 Copay, max 3x per year"		8b:  $5/$40 Copay depending on type of Service	9a: $50 per observation		"7c, i:  $25 Copay"	"7a, 14c:  $5 Copay"	"7b,d,f,g 16b, 17a, 18a:  $25 Copay"	"7e,h 9c:  $25 Copay"	"7c,i:  $25 Copay"			15:  $20/$60 Copay per 30/90 day supply	11c:  $20/$60 Copay per 30/90 day supply	10a:  $75 per Trip	"16a:  $25 Copay, 16b:  20% coinsurance"	17a:  $25 copay		18a:  $25 copay															89.19014085	95	2.395755306		71.25	0.1425	0.1425	47.5	95		17.16289709	47.5		0.340294347	1.465010514	17.50966691	13.26086957	23.75			0	3.111674561	71.25	0	0		23.75															2.6927	0.038269731	0.214735714	0	1.407857356	0.643941036	0.255214638	2.334115305	2.692578499	0	3.846884713	6.759357123	0	0.307293258	2.30385116	12.57642732	0.06676719	2.651242747	0	0	0	0.164097514	0.159256167	0	0	0	0.000276942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1149		0	2.6927	0.038269731	0.214735714	0	1.407857356	0.643941036	0.255214638	2.334115305	2.692578499	0	3.846884713	6.759357123	0	0.307293258	2.30385116	12.57642732	0.06676719	2.651242747	0	0	0	0.164097514	0.159256167	0	0	0	0.000276942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1149																																																																																				0			2.6927	0.038269731	0.214735714	0	1.407857356	0.643941036	0.255214638	2.334115305	2.692578499	0	3.846884713	6.759357123	0	0.307293258	2.30385116	12.57642732	0.06676719	2.651242747	0	0	0	0.164097514	0.159256167	0	0	0	0.000276942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1149
H3907_802_0	2008	3																					3250											A	A	D		T	coin	coin	V	V		P	V		V	V	V	V	V			S	P	T	V	V		V															0	0	0		0	0	0	0	0		0	0		0	0	0	0	0			0	0	0	0	0		0															0		362.2867881	4.834071302	1075.580865		237.1128178	4.518884463	1.790979914	589.6712349	340.1151789		2689.675077	1707.627063		10836.26316	18871.00036	8619.074743	60.41883462	1339.575283			242.1870058	632.8329407	26.82209134	210.1230685	0		0.139928548															"1a:  $100 per Admit, max 3"	"1b:  $100 per Admit, max 3"	"2:  $25 per day, day 16 - 100"		10a:  $75 per Trip	11a:  15% Coinsurance	11b:  15% Coinsurance	"4a,b:  $50 Copay"	"9a,b:  $100 Copay, max 3x per year"		8b:  $5/$40 Copay depending on type of Service	9a: $50 per observation		"7c, i:  $25 Copay"	"7a, 14c:  $5 Copay"	"7b,d,f,g 16b, 17a, 18a:  $25 Copay"	"7e,h 9c:  $25 Copay"	"7c,i:  $25 Copay"			15:  $20/$60 Copay per 30/90 day supply	11c:  $20/$60 Copay per 30/90 day supply	10a:  $75 per Trip	"16a:  $25 Copay, 16b:  20% coinsurance"	17a:  $25 copay		18a:  $25 copay															89.19014085	95	2.395755306		71.25	0.1425	0.1425	47.5	95		17.16289709	47.5		0.340294347	1.465010514	17.50966691	13.26086957	23.75			0	3.111674561	71.25	0	0		23.75															2.6927	0.038269731	0.214735714	0	1.407857356	0.643941036	0.255214638	2.334115305	2.692578499	0	3.846884713	6.759357123	0	0.307293258	2.30385116	12.57642732	0.06676719	2.651242747	0	0	0	0.164097514	0.159256167	0	0	0	0.000276942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1149		0	2.6927	0.038269731	0.214735714	0	1.407857356	0.643941036	0.255214638	2.334115305	2.692578499	0	3.846884713	6.759357123	0	0.307293258	2.30385116	12.57642732	0.06676719	2.651242747	0	0	0	0.164097514	0.159256167	0	0	0	0.000276942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1149																																																																																				0			2.6927	0.038269731	0.214735714	0	1.407857356	0.643941036	0.255214638	2.334115305	2.692578499	0	3.846884713	6.759357123	0	0.307293258	2.30385116	12.57642732	0.06676719	2.651242747	0	0	0	0.164097514	0.159256167	0	0	0	0.000276942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1149
H3907_803_0	2008	3																					3250											A	A	D		T	coin	coin	V	V		P	V		V	V	V	V	V			S	P	T	V	V		V															0	0	0		0	0	0	0	0		0	0		0	0	0	0	0			0	0	0	0	0		0															0		362.2867881	4.834071302	1075.580865		237.1128178	4.518884463	1.790979914	589.6712349	340.1151789		2689.675077	1707.627063		10836.26316	18871.00036	8619.074743	60.41883462	1339.575283			242.1870058	632.8329407	26.82209134	210.1230685	0		0.139928548															"1a:  $100 per Admit, max 3"	"1b:  $100 per Admit, max 3"	"2:  $25 per day, day 16 - 100"		10a:  $75 per Trip	11a:  15% Coinsurance	11b:  15% Coinsurance	"4a,b:  $50 Copay"	"9a,b:  $100 Copay, max 3x per year"		8b:  $5/$40 Copay depending on type of Service	9a: $50 per observation		"7c, i:  $25 Copay"	"7a, 14c:  $5 Copay"	"7b,d,f,g 16b, 17a, 18a:  $25 Copay"	"7e,h 9c:  $25 Copay"	"7c,i:  $25 Copay"			15:  $20/$60 Copay per 30/90 day supply	11c:  $20/$60 Copay per 30/90 day supply	10a:  $75 per Trip	"16a:  $25 Copay, 16b:  20% coinsurance"	17a:  $25 copay		18a:  $25 copay															89.19014085	95	2.395755306		71.25	0.1425	0.1425	47.5	95		17.16289709	47.5		0.340294347	1.465010514	17.50966691	13.26086957	23.75			0	3.111674561	71.25	0	0		23.75															2.6927	0.038269731	0.214735714	0	1.407857356	0.643941036	0.255214638	2.334115305	2.692578499	0	3.846884713	6.759357123	0	0.307293258	2.30385116	12.57642732	0.06676719	2.651242747	0	0	0	0.164097514	0.159256167	0	0	0	0.000276942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1149		0	2.6927	0.038269731	0.214735714	0	1.407857356	0.643941036	0.255214638	2.334115305	2.692578499	0	3.846884713	6.759357123	0	0.307293258	2.30385116	12.57642732	0.06676719	2.651242747	0	0	0	0.164097514	0.159256167	0	0	0	0.000276942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1149																																																																																				0			2.6927	0.038269731	0.214735714	0	1.407857356	0.643941036	0.255214638	2.334115305	2.692578499	0	3.846884713	6.759357123	0	0.307293258	2.30385116	12.57642732	0.06676719	2.651242747	0	0	0	0.164097514	0.159256167	0	0	0	0.000276942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1149
H3909_001_0	2008	3																																d	d	d		t	coin	coin	v	v		v			v	v	v	v	v	v	v	s																																																														0		874.3717222	18.10408884	528.3088939	0	122.8373635	7.864491388	15.59327521	206.3334306	428.4845088	0	845.8998429	0	0	375.4310361	3208.892945	5964.862345	169.4365342	831.0623517	187.0183162	345.5797329	2.951056387																					$150 per day 10 day max (PBP category 1A)	$150 per day 10 day max (PBP category 1B)	$50 per day 100 day max (PBP category 2)	$0 copay	$100 per trip (PBP category 10A)	20% coinsurance (PBP category 11A)	20% coinsurance (PBP categories 11B and 11C)	"$50 per visit (PBP category 4A), 25-40 per Visit (PBP category 4B)"	$150 per visit (PBP categories 9A and 9B)	$0 copay	$40 per visit (PBP category 8B)	$0 copay	$0 copay	"$40 per visit (PBP categories 3, 5, 9C, and 9D)"	$25 per visit (PBP category 7A)	"$40 per visit (PBP categories 4B, 7B, 7D, and 7F)"	"$40 per visit (PBP categories 7E, 7H and 9C)"	$40 per visit (PBP categories 7C and 7I)	$40 per visit (per note in PBP category 8B)	"$40 per visit (PBP category 17A - Medicare covered vision exams, PBP category 18A - Medicare Covered Hearing Exams) and 7D"	$50 per script for certain injectible drugs (PBP category 15)																					150	150	50	0	100	0.2	0.2	50	150	0	40	0	0	40	25	40	40	40	40	40	50																					10.9296	0.22630111	2.201287058	0	1.023644696	1.572898278	3.118655042	0.859722627	5.35605636	0	2.819666143	0	0	1.251436787	6.685193635	19.88287448	0.564788447	2.770207839	0.623394387	1.151932443	0.012296068	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.05			10.9296	0.22630111	2.201287058	0	1.023644696	1.572898278	3.118655042	0.859722627	5.35605636	0	2.819666143	0	0	1.251436787	6.685193635	19.88287448	0.564788447	2.770207839	0.623394387	1.151932443	0.012296068	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.05		$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	"$50 per visit (PBP category 4A), 25-40 per Visit (PBP category 4B)"	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter																				0.3362	0.0169	0.0468	0.0153	2.1922	0.1017	0.1669	0.0221	0.2824	0.0042	0.0027	0	0	0.0513	0.4082	1.0701	0.6458	0.7066	0.5244	1.8249	0	0																				8.4186			11.2659	0.243158317	2.248052728	0.01533287	3.215807781	1.674574133	3.285520114	0.88185266	5.638413536	0.004247997	2.82240299	0	0	1.302775684	7.093388819	20.95293988	1.210538493	3.476840336	1.147775632	2.976791806	0.012296068	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4686
H3909_007_0	2008	3																																d	d	d		t	coin	coin	v	v		v			v	v	v	v	v	v	v	s																																																														0		874.3717222	18.10408884	528.3088939	0	122.8373635	7.864491388	15.59327521	206.3334306	428.4845088	0	845.8998429	0	0	375.4310361	3208.892945	5964.862345	169.4365342	831.0623517	187.0183162	345.5797329	2.951056387																					$150 per day 10 day max (PBP category 1A)	$150 per day 10 day max (PBP category 1B)	$50 per day 100 day max (PBP category 2)	$0 copay	$100 per trip (PBP category 10A)	20% coinsurance (PBP category 11A)	20% coinsurance (PBP categories 11B and 11C)	"$50 per visit (PBP category 4A), 25-40 per Visit (PBP category 4B)"	$150 per visit (PBP categories 9A and 9B)	$0 copay	$40 per visit (PBP category 8B)	$0 copay	$0 copay	"$40 per visit (PBP categories 3, 5, 9C, and 9D)"	$25 per visit (PBP category 7A)	"$40 per visit (PBP categories 4B, 7B, 7D, and 7F)"	"$40 per visit (PBP categories 7E, 7H and 9C)"	$40 per visit (PBP categories 7C and 7I)	$40 per visit (per note in PBP category 8B)	"$40 per visit (PBP category 17A - Medicare covered vision exams, PBP category 18A - Medicare Covered Hearing Exams) and 7D"	$50 per script for certain injectible drugs (PBP category 15)																					150	150	50	0	100	0.2	0.2	50	150	0	40	0	0	40	25	40	40	40	40	40	50																					10.9296	0.22630111	2.201287058	0	1.023644696	1.572898278	3.118655042	0.859722627	5.35605636	0	2.819666143	0	0	1.251436787	6.685193635	19.88287448	0.564788447	2.770207839	0.623394387	1.151932443	0.012296068	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.05			10.9296	0.22630111	2.201287058	0	1.023644696	1.572898278	3.118655042	0.859722627	5.35605636	0	2.819666143	0	0	1.251436787	6.685193635	19.88287448	0.564788447	2.770207839	0.623394387	1.151932443	0.012296068	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.05		$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	"$50 per visit (PBP category 4A), 25-40 per Visit (PBP category 4B)"	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter	$500 plan level oon deductible; 30% coinsurance thereafter																				0.3362	0.0169	0.0468	0.0153	2.1922	0.1017	0.1669	0.0221	0.2824	0.0042	0.0027	0	0	0.0513	0.4082	1.0701	0.6458	0.7066	0.5244	1.8249	0	0																				8.4186			11.2659	0.243158317	2.248052728	0.01533287	3.215807781	1.674574133	3.285520114	0.88185266	5.638413536	0.004247997	2.82240299	0	0	1.302775684	7.093388819	20.95293988	1.210538493	3.476840336	1.147775632	2.976791806	0.012296068	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4686
H3909_801_0	2008	4																																coin		coin	coin	coin	coin		coin	coin	coin					coin						coin	coin																				0		0	0	0	0		0	0	0					0						0	0																				0		307.0319314		18.34884	9.594277315	2.946532691	18.25178888		6.202889008	96.25789331	175.1700037					386.9471571						4.508534994	3.598350174																				Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS					Medicare FFS						Medicare FFS	Medicare FFS																				0.073		0.1705	0	0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				22.4133	0	3.128477219	0	0.68948865	4.270918597	0	1.451476028	22.52434703	40.98978087	0	0	0	0	90.54563476	0	0	0	0	0	1.054997189	0.842013941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	187.9105			22.4133	0	3.128477219	0	0.68948865	4.270918597	0	1.451476028	22.52434703	40.98978087	0	0	0	0	90.54563476	0	0	0	0	0	1.054997189	0.842013941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	187.9105		Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS					Medicare FFS						Medicare FFS	Medicare FFS																				0.0213		0	0	0.756	0.0348		0.028	0.1896	0.0087					4.6788						0	0																				5.7172			22.4347	0	3.128477219	0	1.445469734	4.305722007	0	1.479490144	22.71391287	40.99850486	0	0	0	0	95.22441733	0	0	0	0	0	1.054997189	0.842013941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	193.6277
H3909_802_0	2008	4																																coin		coin	coin	coin	coin		coin	coin	coin					coin						coin	coin																				0		0	0	0	0		0	0	0					0						0	0																				0		307.0319314		18.34884	9.594277315	2.946532691	18.25178888		6.202889008	96.25789331	175.1700037					386.9471571						4.508534994	3.598350174																				Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS					Medicare FFS						Medicare FFS	Medicare FFS																				0.073		0.1705	0	0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				22.4133	0	3.128477219	0	0.68948865	4.270918597	0	1.451476028	22.52434703	40.98978087	0	0	0	0	90.54563476	0	0	0	0	0	1.054997189	0.842013941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	187.9105			22.4133	0	3.128477219	0	0.68948865	4.270918597	0	1.451476028	22.52434703	40.98978087	0	0	0	0	90.54563476	0	0	0	0	0	1.054997189	0.842013941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	187.9105		Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS					Medicare FFS						Medicare FFS	Medicare FFS																				0.0213		0	0	0.756	0.0348		0.028	0.1896	0.0087					4.6788						0	0																				5.7172			22.4347	0	3.128477219	0	1.445469734	4.305722007	0	1.479490144	22.71391287	40.99850486	0	0	0	0	95.22441733	0	0	0	0	0	1.054997189	0.842013941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	193.6277
H3912_001_0	2008	4	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						2400	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T				V					V	P	V	V																																																0		1807.473729	98.5458564	8760.703944	95.20695325	540.1271308	34.72053067	0.116156336	182.5629852	89.2394323	4856.296599	211.3278157	16.21933262	29.09733231	276.9607436	21859.97357	1745.786015	2326.029584	12.70571069		108.8424372	201.358236	764.7197735	691.4732177									118.9569822	0.485964233	2.840790938	91.98785025							(1a) $175/day	(1b) $175/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $35/visit	(8a) $0/visit	(8b) $0/visit	(9a) $35/visit	(12) $0/proc	(9a) $35/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $15/visit	(7e/7h) $32.5/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $15/visit	(15) $0/proc	(Misc. PBP Cats) $15/visit	(10b) $0/trip				(18a) $15/visit					(4b) $35/visit (waived if admitted)	(9c) $32.5/proc 75%/25% Ind/Grp Blended Copay	(9d) $35/visit	(7f1) $0/visit							159.9971	159.9971			68.5702	0.18285385	0.18285385	45.7135	31.9994			31.9994		31.9994		13.714	29.7138			13.714		13.714										31.9994	29.7138	31.9994								24.0992	1.313921091	0	0	3.086385169	6.348782709	0.021239633	0.695465515	0.237967534	0	0	0.043250775	0	0.738548683	0	1.995148089	5.759588585	0	0	0.124389117	0	0.873949718	0	0	0	0	0	0	0	0	0	0.317212907	0.001203318	0.007575306	0	0	0	0	0	0	0	45.6638		4.28188476	24.0992	1.313921091	0	0	3.086385169	6.348782709	0.021239633	0.695465515	0.237967534	0	0	0.043250775	0	0.738548683	0	1.995148089	5.759588585	0	0	0.124389117	0	0.873949718	0	0	0	0	0	0	0	0	0	0.317212907	0.001203318	0.007575306	0	0	0	0	0	0	0	45.6638		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3				0.3					35	0.3	0.3	0.3							2.5186	0.0456	0.8887	0.0563	0.413	0.5482	0.0018	0.04	0.2367	0.5588	0.5535	0.0257	0.0062	0.1178	0.0089	2.4115	0.2491	0.0015		0.168		0.1287	0.0528									0.0183		0.0014	0.0051							9.0559		0	26.6178	1.359509108	0.888664734	0.056344795	3.499342033	6.897001614	0.023073681	0.735501258	0.474629749	0.558772753	0.553484901	0.068936687	0.006156327	0.856358813	0.008866483	4.406646433	6.008670292	0.00148677	0	0.29235025	0	1.002615265	0.052807675	0	0	0	0	0	0	0	0	0.335473847	0.001203318	0.008926129	0.005112053	0	0	0	0	0	0	54.7198
H3912_005_0	2008	6																					2400											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2955.832787	506.0124952	1178.552669		1051.677799	28.26225603	14.95126449	1146.881926	364.0737132	6025.23867	718.7878164	62.00027766	2.940384619	3147.225367		2805.770186	1387.429254	685.5801088			33.68935855	620.9087913																				1(a) $200 per Day	1(b) $200 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $100 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $35 per Visit	8(a) Diagnostic: $25 per procedure; other $0 per procedure	8(b) X-rays $25 per visit; other: $25 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a) $25 per Visit; 9(c) $25/$35 per Visit; 9(d) $35 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $15 per Visit	7(e)/7(h) $25/35 per Visit	7(c)/7(i) $15 per Visit		7(g) $15 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $25 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															110.376	110.376	23.179		55.188	0.110375961	0.110375961	24.6966	19.3158	13.797	13.797	13.797	0.110375961	13.8742		8.2782	17.9361	8.2782			0.110375961	13.797																				27.1877	4.654301286	2.27646796	0	4.836664487	3.11947367	1.650260186	2.36034238	0.586031045	6.927515713	0.826426	0.071284794	0.324547778	3.638771858	0	1.935559879	2.073755087	0.472947271	0	0	3.718495326	0.713889631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3745	0	54.70731575	27.1877	4.654301286	2.27646796	0	4.836664487	3.11947367	1.650260186	2.36034238	0.586031045	6.927515713	0.826426	0.071284794	0.324547778	3.638771858	0	1.935559879	2.073755087	0.472947271	0	0	3.718495326	0.713889631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3745		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"4(a)$50 per Visit, 4(b) $35 per Visit"	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															2.6015	0.1528	0.2765	0.2838	0.1523	0.173	0.1028	0.0966	0.2175	0.0778	0.1764	0.0191	0.016	0.2199	0.1005	0.1803	0.0861	0.037			0.2063	0.0373	0.0077		0.0026																	5.2238	0	0	29.7892	4.807120095	2.553005563	0.283756787	4.988928936	3.29250789	1.753081357	2.456912327	0.803495073	7.005340245	1.002783553	0.090396582	0.340535355	3.858718175	0.10046419	2.115840634	2.159903241	0.509965325	0	0	3.924756705	0.751200569	0.00774	0	0.002589759	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5982
H3912_006_0	2008	6																					2800											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2398.914613	339.6950274	1207.548648		487.8480804	38.03452489	27.1627525	845.6582943	448.7096559	7795.167708	658.3513221	82.52944557	5.648372288	4238.136258		4088.237395	1070.882459	1108.631749			34.54855715	794.0179447					0.104772925															1(a) $200 per Day	1(b) $200 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $100 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $35 per Visit	8(a) Diagnostic: $25 per preocedure; other $0 per procedure	8(b) X-rays $25 per visit; other: $25 per visit	9(a) $35 per Visit	12  20% Coinsurance	3 $50 per visit; 5 $25 per visit; 9(a) $35 per Visit; 9(c) $25/$35 per Visit; 9(d) $35 per Visit	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $25 per Visit	7(e)/7(h) $25/35 per Visit	7(c)/7(i) $25 per Visit		7(g) $25 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $25 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															117.0013	117.0013	24.5703		58.5006	0.117001296	0.117001296	26.179	20.4752	14.6252	14.6252	20.4752	0.117001296	20.5245		14.6252	19.0127	14.6252			0.117001296	14.6252					14.6252															23.3897	3.312063196	2.472483238	0	2.37828573	4.450088694	3.178077238	1.844876854	0.765619329	9.500465856	0.80237456	0.140817426	0.660866876	7.24880478	0	4.982594504	1.696698185	1.351159908	0	0	4.042225952	0.967720087	0	0	0	0	0.000127693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.185	0	51.91619754	23.3897	3.312063196	2.472483238	0	2.37828573	4.450088694	3.178077238	1.844876854	0.765619329	9.500465856	0.80237456	0.140817426	0.660866876	7.24880478	0	4.982594504	1.696698185	1.351159908	0	0	4.042225952	0.967720087	0	0	0	0	0.000127693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.185		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															3.0464	0.1881	0.415	0.5463	0.1353	0.2329	0.1663	0.0609	0.3266	0.0595	0.1498	0.0294	0.0305	0.3333	0.1291	0.2209	0.0913	0.0639			0.2115	0.0476	0.0077		0.0066																	6.4989	0	0	26.4361	3.500135447	2.887433616	0.546289274	2.51359295	4.682953132	3.344379804	1.905817294	1.092225038	9.55995949	0.95215572	0.170188941	0.691346015	7.582072747	0.129134016	5.203496242	1.788031721	1.415075352	0	0	4.25374773	1.015275169	0.00774	0	0.006631111	0	0.000127693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.6839
H3912_007_0	2008	6																					2800											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2262.927563	320.4387669	1070.476182		431.6622387	29.88978155	21.34609912	743.311993	394.4043012	6851.752869	578.6739591	72.54127	4.403465361	3725.327402		3624.169316	948.2464261	982.7876369			27.15030171	703.8865881					0.092879836															1(a) $200 per Day	1(b) $200 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $100 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $35 per Visit	8(a) Diagnostic: $25 per preocedure; other $0 per procedure	8(b) X-rays $25 per visit; other: $25 per visit	9(a) $35 per Visit	12  20% Coinsurance	3 $50 per visit; 5 $25 per visit; 9(a) $35 per Visit; 9(c) $25/$35 per Visit; 9(d) $35 per Visit	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $25 per Visit	7(e)/7(h) $25/35 per Visit	7(c)/7(i) $25 per Visit		7(g) $25 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $25 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $25 per visit															122.7289	122.7289	25.7731		61.3644	0.122728878	0.122728878	27.4606	21.4776	15.3411	15.3411	21.4776	0.122728878	21.5292		15.3411	19.9434	15.3411			0.122728878	15.3411					15.3411															23.1439	3.27725752	2.299120957	0	2.207392587	3.668339344	2.619782789	1.700981933	0.705903293	8.759457706	0.739791725	0.129834085	0.540432362	6.683609181	0	4.63323159	1.575941516	1.25642108	0	0	3.332126057	0.899866781	0	0	0	0	0.00011874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.1735	0	42.92259593	23.1439	3.27725752	2.299120957	0	2.207392587	3.668339344	2.619782789	1.700981933	0.705903293	8.759457706	0.739791725	0.129834085	0.540432362	6.683609181	0	4.63323159	1.575941516	1.25642108	0	0	3.332126057	0.899866781	0	0	0	0	0.00011874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.1735		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															2.3948	0.1478	0.3261	0.4293	0.1063	0.183	0.1307	0.054	0.2567	0.0468	0.1177	0.0231	0.024	0.2619	0.0938	0.174	0.0718	0.0502			0.1662	0.0374	0.0077		0.0066																	5.1098	0	0	25.5386	3.42505583	2.62522638	0.429306455	2.313725011	3.851338006	2.750473192	1.755004841	0.962569396	8.806211326	0.857498628	0.15291596	0.564384673	6.94551088	0.093761422	4.80718349	1.647716816	1.306649621	0	0	3.498352394	0.93723838	0.00774	0	0.006631111	0	0.00011874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2833
H3912_008_0	2008	7																					2500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2051.571543	140.7153368	927.0811844		267.6126808	9.995650509	17.35939845	410.7963566	388.2818046	3255.291215	427.8031725	65.19540874	15.52862291	2735.784696		4029.130266	395.938419	580.4908305				721.4144453					0.071613788															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															130.7007	130.7007	31.3682		56.0146	0.149372217	0.149372217	30.808	56.0146	14.9372	48.7431	56.0146	103.0773	54.1517		18.6715	14.9372	14.9372				18.6715					18.6715															22.3452	1.532632638	2.423403015	0	1.249184361	1.493072482	2.59301184	1.054651859	1.812453568	4.052083895	1.73770599	0.304324462	0.133387317	12.34560615	0	6.269167942	0.492851664	0.722576688	0	0	0	1.122492452	0	0	0	0	0.000111428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6839	0	20.9069502	22.3452	1.532632638	2.423403015	0	1.249184361	1.493072482	2.59301184	1.054651859	1.812453568	4.052083895	1.73770599	0.304324462	0.133387317	12.34560615	0	6.269167942	0.492851664	0.722576688	0	0	0	1.122492452	0	0	0	0	0.000111428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6839		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.0267	0.0579	0.2494	0.2489	0.0639	0.1224	0.1063	0.0304	0.2587	0.0406	0.1056	0.0212	0.0049	0.1847	0.0185	0.1784	0.0268	0.029			0.16	0.0378			0.0051																	3.9771	0	0	24.3719	1.590518381	2.672780317	0.248892497	1.313112105	1.615468202	2.699293872	1.085027219	2.071160897	4.092697154	1.843275841	0.325507118	0.138272251	12.53027956	0.018458736	6.447617374	0.519662102	0.751541211	0	0	0.16000967	1.160325885	0	0	0.005058988	0	0.000111428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.661
H3912_009_0	2008	6																					3500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2153.979612	147.7394086	1003.775636		310.8008201	13.33233681	23.1542056	486.808729	460.1281602	3857.639323	506.9624287	77.25894729	17.26893665	3241.628338		4389.105276	432.7925988	632.9377395				781.1423158					0.082707378															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															140.4249	140.4249	33.702		60.1821	0.160485635	0.160485635	33.1002	60.1821	16.0486	52.3697	60.1821	134.9747	58.1859		20.0607	16.0486	16.0486				20.0607					20.0607															25.206	1.728858019	2.819102486	0	1.558720845	2.139648543	3.715917394	1.342787327	2.307623752	5.15913081	2.212454812	0.387467226	0.194239157	15.71810148	0	7.337378629	0.578808293	0.84647846	0	0	0	1.305855425	0	0	0	0	0.000138264	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5587	0	18.35766508	25.206	1.728858019	2.819102486	0	1.558720845	2.139648543	3.715917394	1.342787327	2.307623752	5.15913081	2.212454812	0.387467226	0.194239157	15.71810148	0	7.337378629	0.578808293	0.84647846	0	0	0	1.305855425	0	0	0	0	0.000138264	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5587		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.702	0.0772	0.3326	0.332	0.0853	0.1633	0.1418	0.0351	0.3451	0.0542	0.1408	0.0283	0.0065	0.2463	0.0246	0.238	0.0358	0.0386			0.2134	0.0505			0.0051																	5.2963	0	0	27.9081	1.806066823	3.151705349	0.331976253	1.643988554	2.302901647	3.857677836	1.37786809	2.652691164	5.213301337	2.353265339	0.415720945	0.20075475	15.96442143	0.024620517	7.575396947	0.614568426	0.885111741	0	0	0.21342311	1.35631818	0	0	0.005058988	0	0.000138264	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.855
H3912_011_0	2008	6																					3500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2075.884797	142.3829597	932.4170468		288.1694456	11.50411954	19.97914941	448.3691941	423.7953843	3553.031265	466.9315114	71.15840344	16.0117552	2985.696686		4077.082998	401.6746396	587.9420825				725.610769					0.076827696															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															143.7395	143.7395	34.4975		61.6026	0.164273716	0.164273716	33.8815	61.6026	16.4274	53.6058	61.6026	127.6133	59.5588		20.5342	16.4274	16.4274				20.5342					20.5342															24.8656	1.705504633	2.680503223	0	1.479333298	1.889824462	3.282049107	1.265950013	2.175576326	4.863913729	2.085853166	0.365295479	0.170276128	14.81871201	0	6.976641383	0.549871546	0.80486192	0	0	0	1.241653928	0	0	0	0	0.000131466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2215	0	15.48926897	24.8656	1.705504633	2.680503223	0	1.479333298	1.889824462	3.282049107	1.265950013	2.175576326	4.863913729	2.085853166	0.365295479	0.170276128	14.81871201	0	6.976641383	0.549871546	0.80486192	0	0	0	1.241653928	0	0	0	0	0.000131466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2215		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.3319	0.0666	0.287	0.2865	0.0736	0.1409	0.1223	0.0326	0.2977	0.0467	0.1215	0.0244	0.0056	0.2125	0.0212	0.2054	0.0309	0.0333			0.1842	0.0435			0.0051																	4.5735	0	0	27.1975	1.77212606	2.967505632	0.286453497	1.552908541	2.030691232	3.40437043	1.298536878	2.473325836	4.910656039	2.207354832	0.389674863	0.17589826	15.03125496	0.02124439	7.182021072	0.580728015	0.838197553	0	0	0.184157136	1.2851969	0	0	0.005058988	0	0.000131466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.795
H3916_001_0	2008	7																																		D		T	Coin		V						V	V	V					S			Coin	V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	0	0	1045	0	482.6501434	14.16972412	0	206.1778781	0	0	0	0	0	992.6689374	3680.993327	5230.283861	0	0	0	0	1888.806893	0	0	8.712857143	481.3113566	0	0.498597596	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												0	0	25	0	50	0.135	0	50	0	0	0	0	0	15	15	15	0	0	0	0	25	0	0	0.3	15	0	15	0	0	0	0											0	0	2.177083333	0	2.011042264	1.912912757	0	0.859074492	0	0	0	0	0	1.240836172	4.601241658	6.537854827	0	0	0	0	3.93501436	0	0	2.613857143	0.601639196	0	0.000623247	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.4912	0	0	0	0	2.177083333	0	2.011042264	1.912912757	0	0.859074492	0	0	0	0	0	1.240836172	4.601241658	6.537854827	0	0	0	0	3.93501436	0	0	2.613857143	0.601639196	0	0.000623247	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.4912		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												1.9141	0	0.357	0.1518	0.1551	1.0897	0	0.0461	0.2006	0	0	0	0	0.4286	0.2895	1.1598	0	0	0	0	0.9663	0	0	0.2339	0.0355	0	0.009	0	0	0	0											7.0371	250	3.657429352	1.9141	0	2.534124578	0.151825706	2.16612376	3.002615608	0	0.905193228	0.200631492	0	0	0	0	1.669421477	4.890761407	7.697632115	0	0	0	0	4.901290137	0	0	2.847728571	0.637168901	0	0.009633211	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.5282
H3916_002_0	2008	6																																		D		T	Coin		V						V	V	V					S			Coin	V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	0	0	1045	0	330.5289356	11.66509	0	217.1778692	0	0	0	0	0	1348.209413	3446.756025	5051.984016	0	0	0	0	1683.218626	0	0	8.712857143	459.4302517	0	3.524664502	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												0	0	25	0	50	0.135	0	50	0	0	0	0	0	15	15	15	0	0	0	0	25	0	0	0.3	15	0	15	0	0	0	0											0	0	2.177083333	0	1.377203898	1.57478715	0	0.904907788	0	0	0	0	0	1.685261767	4.308445031	6.31498002	0	0	0	0	3.506705471	0	0	2.613857143	0.574287815	0	0.004405831	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.0419	0	0	0	0	2.177083333	0	1.377203898	1.57478715	0	0.904907788	0	0	0	0	0	1.685261767	4.308445031	6.31498002	0	0	0	0	3.506705471	0	0	2.613857143	0.574287815	0	0.004405831	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.0419		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												1.6481	0	0.3001	0.1326	0.1233	0.8911	0	0.0486	0.2283	0	0	0	0	0.5278	0.2549	1.0219	0	0	0	0	0.822	0	0	0.2339	0.0352	0	0.0104	0	0	0	0											6.2782	250	2.643363605	1.6481	0	2.47715742	0.132646445	1.500537625	2.465869517	0	0.953487049	0.228330785	0	0	0	0	2.21310005	4.563348339	7.336892685	0	0	0	0	4.328659524	0	0	2.847728571	0.609523852	0	0.014799449	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.3202
H3916_003_0	2008	6																																		D		T	Coin		V						V	V	V					S			Coin	V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	0	0	1045	0	305.4405039	12.71138568	0	200.6421033	0	0	0	0	0	939.3961196	3462.282347	4937.932284	0	0	0	0	1904.523573	0	0	8.712857143	481.2630108	0	2.895443302	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												0	0	25	0	50	0.135	0	50	0	0	0	0	0	15	15	15	0	0	0	0	25	0	0	0.3	15	0	15	0	0	0	0											0	0	2.177083333	0	1.272668766	1.716037066	0	0.836008764	0	0	0	0	0	1.17424515	4.327852933	6.172415354	0	0	0	0	3.967757445	0	0	2.613857143	0.601578763	0	0.003619304	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.8631	0	0	0	0	2.177083333	0	1.272668766	1.716037066	0	0.836008764	0	0	0	0	0	1.17424515	4.327852933	6.172415354	0	0	0	0	3.967757445	0	0	2.613857143	0.601578763	0	0.003619304	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.8631		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												1.678	0	0.3952	0.1102	0.1136	1.0204	0	0.0449	0.1932	0	0	0	0	0.6022	0.2689	1.0781	0	0	0	0	0.9742	0	0	0.2339	0.0355	0	0.0125	0	0	0	0											6.7608	250	3.168525919	1.678	0	2.572241358	0.110240636	1.386284009	2.736452103	0	0.880889234	0.193156831	0	0	0	0	1.776468949	4.596792555	7.250535389	0	0	0	0	4.941975694	0	0	2.847728571	0.63710782	0	0.016125485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.624
H3916_005_0	2008	6																																		D		T	Coin		V						V	V	V					S			Coin	V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	0	0	334.2236731	0	145.94518	6.568483915	0	100.3751885	0	0	0	0	0	1211.085737	3561.906504	5221.561606	0	0	0	0	1214.979484	0	0	8.254285714	398.5988095	0	2.993333296	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												0	0	25	0	50	0.135	0	50	0	0	0	0	0	15	15	15	0	0	0	0	25	0	0	0.3	15	0	15	0	0	0	0											0	0	0.696299319	0	0.608104917	0.886745328	0	0.418229952	0	0	0	0	0	1.513857171	4.45238313	6.526952008	0	0	0	0	2.531207258	0	0	2.476285714	0.498248512	0	0.003741667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.6121	0	0	0	0	0.696299319	0	0.608104917	0.886745328	0	0.418229952	0	0	0	0	0	1.513857171	4.45238313	6.526952008	0	0	0	0	2.531207258	0	0	2.476285714	0.498248512	0	0.003741667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.6121		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												3.4063	0	0.209	0.1108	0.114	1.0396	0	0.0465	0.4179	0	0	0	0	1.0309	0.5859	2.3493	0	0	0	0	1.2034	0	0	0.4586	0.0681	0	0.0183	0	0	0	0											11.0586	250	4.430848022	3.4063	0	0.905327196	0.11080797	0.722137084	1.926367904	0	0.464699947	0.417907623	0	0	0	0	2.544765404	5.038295409	8.876246046	0	0	0	0	3.734565654	0	0	2.934857143	0.566320699	0	0.022010675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6706
H3916_012_0	2008	7																																A		D		T	Coin		V	V					V	V	V					S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	378.6568795	0	328.8880443	0	143.6152753	6.463623024	0	98.77277435	333.8754126	0	0	0	0	9883.243097	3505.043354	5112.542733	0	0	0	0	1195.583253	0	0	0	398.5988092	0	2.945546988	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												205	0	25	0	50	0.135	0	50	50	0	0	0	0	15	15	15	0	0	0	0	25	0	0	0	15	0	15	0	0	0	0											6.4687	0	0.685183426	0	0.598396981	0.872589108	0	0.411553226	1.391147553	0	0	0	0	12.35405387	4.381304192	6.390678416	0	0	0	0	2.490798444	0	0	0	0.498248511	0	0.003681934	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.5464	0	0	6.4687	0	0.685183426	0	0.598396981	0.872589108	0	0.411553226	1.391147553	0	0	0	0	12.35405387	4.381304192	6.390678416	0	0	0	0	2.490798444	0	0	0	0.498248511	0	0.003681934	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.5464		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												4.1002	0	0.2516	0.1334	0.1602	1.0232	0	0.0457	0.503	0	0	0	0	1.2409	0.7053	2.8137	0	0	0	0	1.1841	0	0	0	0.1021	0	0.027	0	0	0	0											12.2904	250	7.847613166	10.5689	0	0.936786469	0.133377532	0.758620448	1.895804346	0	0.457281363	1.894175336	0	0	0	0	13.59493931	5.086556115	9.204358535	0	0	0	0	3.674946131	0	0	0	0.600356791	0	0.030647969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8367
H3916_015_0	2008	6																																A		D		T	Coin		V						V	V	V					S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	383.9537091	0	333.4886841	0	145.624233	6.554039206	0	100.1544541	0	0	0	0	0	1208.422447	3554.073539	5184.059371	0	0	0	0	1212.307631	0	0	0	398.5988095	0	2.986750677	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												82	0	25	0	50	0.135	0	50	0	0	0	0	0	15	15	15	0	0	0	0	25	0	0	0	15	0	15	0	0	0	0											2.6237	0	0.694768092	0	0.606767637	0.884795293	0	0.417310225	0	0	0	0	0	1.510528058	4.442591924	6.480074214	0	0	0	0	2.525640897	0	0	0	0.498248512	0	0.003733438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.6881	0	0	2.6237	0	0.694768092	0	0.606767637	0.884795293	0	0.417310225	0	0	0	0	0	1.510528058	4.442591924	6.480074214	0	0	0	0	2.525640897	0	0	0	0.498248512	0	0.003733438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.6881		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												3.4289	0	0.2104	0.1115	0.1138	1.0374	0	0.0464	0.4207	0	0	0	0	1.0377	0.5898	2.353	0	0	0	0	1.2007	0	0	0	0.0681	0	0.0182	0	0	0	0											10.6367	250	4.348306081	6.0526	0	0.905180861	0.111542116	0.720595135	1.922170919	0	0.463678028	0.420676425	0	0	0	0	2.548266462	5.032386102	8.833122961	0	0	0	0	3.726352996	0	0	0	0.566320698	0	0.021962271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.3248
H3916_018_0	2008	6																																D		D		T	Coin		V	V					V	V	V					S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	900.462276	0	325.879106	0	142.3013647	6.404488485	0	97.86911978	330.8208457	0	0	0	0	9792.823061	3472.976335	5065.768987	0	0	0	0	1184.645074	0	0	0	457.8960164	0	2.918598701	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												102.5	0	50	0	50	0.135	0	50	100	0	0	0	0	15	25	25	0	0	0	0	25	0	0	0	25	0	25	0	0	0	0											7.6914	0	1.357829608	0	0.592922353	0.864605945	0	0.407787999	2.756840381	0	0	0	0	12.24102883	7.235367364	10.55368539	0	0	0	0	2.468010571	0	0	0	0.953950034	0	0.006080414	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1296	0	0	7.6914	0	1.357829608	0	0.592922353	0.864605945	0	0.407787999	2.756840381	0	0	0	0	12.24102883	7.235367364	10.55368539	0	0	0	0	2.468010571	0	0	0	0.953950034	0	0.006080414	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1296		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												4.0844	0	0.2506	0.1329	0.1589	1.014	0	0.0453	0.5011	0	0	0	0	1.2361	0.7025	2.8029	0	0	0	0	1.1733	0	0	0	0.1173	0	0.0267	0	0	0	0											12.2461	250	7.735252439	11.7759	0	1.60846872	0.132866542	0.751782607	1.87855992	0	0.453097777	3.257940985	0	0	0	0	13.47716023	7.937917354	13.35658585	0	0	0	0	3.641324701	0	0	0	1.071248364	0	0.032799742	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3756
H3916_019_0	2008	5																																					Ded		V							V	V									V		V															31.8846	0	5.9475	2.5291	1.4253	0	0	0	3.3421	0	0	0	0	7.1393	2.6652	16.0036	0	0	0	0	6.5076	0	0	0	0	0	0	0	0	0	0											77.4445	3250	0	0	0	0	0	3050.613404	0	196.9354679	0	0	0	0	0	0	3515.984109	4975.281404	0	0	0	0	0	0	0	0	459.7354386	0	0.476246782	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												0	0	0	0	0	26.61995669	0	50	0	0	0	0	0	0	15	15	0	0	0	0	0	0	0	0	15	0	15	0	0	0	0											0	0	0	0	0	6.767266391	0	0.82056445	0	0	0	0	0	0	4.394980137	6.219101755	0	0	0	0	0	0	0	0	0.574669298	0	0.000595308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.7772	1250	0	31.8846	0	5.947546742	2.529092919	1.425286667	6.767266391	0	0.82056445	3.34209338	0	0	0	0	7.139318421	7.060206666	22.22274686	0	0	0	0	6.507641117	0	0	0	0.574669298	0	0.000595308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.2217		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												2.8004	0	0.5224	0.2221	0.1252	1.0323	0	0.0441	0.2935	0	0	0	0	0.627	0.4236	1.6898	0	0	0	0	0.5716	0	0	0	0.0327	0	0.008	0	0	0	0											8.3928	1250	7.402056119	34.6851	0	6.469917148	2.751222034	1.550468966	7.799588013	0	0.864615804	3.635627967	0	0	0	0	7.766361607	7.483789518	23.91258572	0	0	0	0	7.079204365	0	0	0	0.607404134	0	0.008589554	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.6144
H3916_020_0	2008	5																																					Ded		V							V	V									V		V															24.3636	0	4.436	1.9609	1.11	0	0	0	3.3754	0	0	0	0	7.8031	1.6176	11.8053	0	0	0	0	5.528	0	0	0	0	0	0	0	0	0	0											62	3250	0	0	0	0	0	2398.77014	0	207.8178618	0	0	0	0	0	0	3298.206534	4810.020093	0	0	0	0	0	0	0	0	439.6295668	0	3.372757284	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												0	0	0	0	0	27.92016719	0	50	0	0	0	0	0	0	15	15	0	0	0	0	0	0	0	0	15	0	15	0	0	0	0											0	0	0	0	0	5.581171945	0	0.865907757	0	0	0	0	0	0	4.122758167	6.012525116	0	0	0	0	0	0	0	0	0.549536958	0	0.004215947	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.1361	1000	0	24.3636	0	4.436027502	1.960926667	1.110006187	5.581171945	0	0.865907757	3.375438552	0	0	0	0	7.803090115	5.740343943	17.81782982	0	0	0	0	5.528007937	0	0	0	0.549536958	0	0.004215947	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.1361		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												2.3452	0	0.427	0.1888	0.1068	0.8442	0	0.0465	0.3249	0	0	0	0	0.7511	0.3627	1.4469	0	0	0	0	0.5321	0	0	0	0.0355	0	0.0101	0	0	0	0											7.4217	1000	5.455649937	26.7088	0	4.863028211	2.149680474	1.216852555	6.425344737	0	0.912393332	3.70034967	0	0	0	0	8.554195695	6.103067343	19.26470645	0	0	0	0	6.060119902	0	0	0	0.585024741	0	0.014308789	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.5579
H3916_021_0	2008	6																																					Ded		V							V	V									V		V															23.908	0	5.6303	1.5707	0.9344	0	0	0	2.7521	0	0	0	0	8.5806	1.895	12.3842	0	0	0	0	5.9224	0	0	0	0	0	0	0	0	0	0											63.5778	3250	0	0	0	0	0	1741.810678	0	192.69867	0	0	0	0	0	0	3325.210374	4720.303403	0	0	0	0	0	0	0	0	462.2097784	0	2.780812522	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												0	0	0	0	0	42.05327693	0	50	0	0	0	0	0	0	15	15	0	0	0	0	0	0	0	0	15	0	15	0	0	0	0											0	0	0	0	0	6.104070565	0	0.802911125	0	0	0	0	0	0	4.156512968	5.900379253	0	0	0	0	0	0	0	0	0.577762223	0	0.003476016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.5451	1000	0	23.908	0	5.63029155	1.570730905	0.934395748	6.104070565	0	0.802911125	2.752137637	0	0	0	0	8.580606631	6.051510259	18.28458811	0	0	0	0	5.922440043	0	0	0	0.577762223	0	0.003476016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.123		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												2.3611	0	0.556	0.1551	0.0923	0.9712	0	0.0431	0.2718	0	0	0	0	0.8474	0.3784	1.51	0	0	0	0	0.5849	0	0	0	0.0331	0	0.0113	0	0	0	0											7.8157	1000	6.458873241	26.2692	0	6.186329718	1.72585366	1.026675107	7.075284076	0	0.846014775	3.023934143	0	0	0	0	9.428012977	6.429942899	19.79456066	0	0	0	0	6.507330306	0	0	0	0.61083719	0	0.014738498	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.9387
H3916_022_0	2008	5																																A		D		T	Coin		V	V					V	V	V					S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	405.4878049	0	1045	0	474.466821	13.92947677	0	202.6821368	403.75	0	0	0	0	10855.83826	3618.582167	5120.462438	0	0	0	0	1888.806893	0	0	0	473.1507334	0	0.490143885	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												164	0	35	0	50	0.135	0	50	100	0	0	0	0	18	20	20	0	0	0	0	25	0	0	0	20	0	20	0	0	0	0											5.5417	0	3.047916667	0	1.976945088	1.880479364	0	0.844508903	3.364583333	0	0	0	0	16.28375739	6.030970279	8.534104064	0	0	0	0	3.93501436	0	0	0	0.788584556	0	0.000816906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.2293	0	0	5.5417	0	3.047916667	0	1.976945088	1.880479364	0	0.844508903	3.364583333	0	0	0	0	16.28375739	6.030970279	8.534104064	0	0	0	0	3.93501436	0	0	0	0.788584556	0	0.000816906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.2293		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												2.2814	0	0.4256	0.181	0.2203	1.0714	0	0.0453	0.2391	0	0	0	0	0.5108	0.3451	1.3767	0	0	0	0	1.2138	0	0	0	0.0563	0	0.0133	0	0	0	0											7.98	250	6.21790209	7.8231	0	3.473474061	0.180961031	2.197239898	2.95186292	0	0.889845697	3.603715973	0	0	0	0	16.79458813	6.376048814	9.91075828	0	0	0	0	5.148766006	0	0	0	0.844889917	0	0.014102706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.2093
H3916_023_0	2008	6																																A		D		T	Coin		V	V					V	V	V					S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	405.4878049	0	1045	0	299.8257399	12.47771846	0	196.9537973	403.75	0	0	0	0	10802.12766	3398.636897	4824.536045	0	0	0	0	1904.523573	0	0	0	472.4161873	0	2.842217778	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												164	0	35	0	50	0.135	0	50	100	0	0	0	0	18	20	20	0	0	0	0	25	0	0	0	20	0	20	0	0	0	0											5.5417	0	3.047916667	0	1.249273916	1.684491993	0	0.820640822	3.364583333	0	0	0	0	16.20319149	5.664394828	8.040893409	0	0	0	0	3.967757445	0	0	0	0.787360312	0	0.00473703	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3769	0	0	5.5417	0	3.047916667	0	1.249273916	1.684491993	0	0.820640822	3.364583333	0	0	0	0	16.20319149	5.664394828	8.040893409	0	0	0	0	3.967757445	0	0	0	0.787360312	0	0.00473703	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3769		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												2.0013	0	0.4713	0.1315	0.1606	1.0018	0	0.0441	0.2304	0	0	0	0	0.7183	0.3208	1.2799	0	0	0	0	1.222	0	0	0	0.0563	0	0.0184	0	0	0	0											7.6566	250	5.429793165	7.543	0	3.519227283	0.13148558	1.409904373	2.686316861	0	0.864696277	3.594964242	0	0	0	0	16.92147241	5.985162953	9.320780538	0	0	0	0	5.18970869	0	0	0	0.843645957	0	0.023151459	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0335
H3916_024_0	2008	6																																A		D		T	Coin		V	V					V	V	V					S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	405.4878049	0	1045	0	323.6526211	11.4224098	0	212.6597071	403.75	0	0	0	0	11200.1613	3375.049812	4922.086364	0	0	0	0	1683.218626	0	0	0	449.8722779	0	3.451337483	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												164	0	35	0	50	0.135	0	50	100	0	0	0	0	18	20	20	0	0	0	0	25	0	0	0	20	0	20	0	0	0	0											5.5417	0	3.047916667	0	1.348552588	1.542025323	0	0.886082113	3.364583333	0	0	0	0	16.80024196	5.625083019	8.203477274	0	0	0	0	3.506705471	0	0	0	0.74978713	0	0.005752229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.6219	0	0	5.5417	0	3.047916667	0	1.348552588	1.542025323	0	0.886082113	3.364583333	0	0	0	0	16.80024196	5.625083019	8.203477274	0	0	0	0	3.506705471	0	0	0	0.74978713	0	0.005752229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.6219		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												1.9702	0	0.3587	0.1586	0.1733	0.8727	0	0.0476	0.273	0	0	0	0	0.631	0.3047	1.2156	0	0	0	0	1.0284	0	0	0	0.0557	0	0.0153	0	0	0	0											7.1048	250	4.568372977	7.5119	0	3.406651426	0.15857714	1.521804606	2.414754218	0	0.933650731	3.637549886	0	0	0	0	17.43126592	5.929816686	9.419037178	0	0	0	0	4.535130211	0	0	0	0.805467649	0	0.021018313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7266
H3916_025_0	2008	6																																					Ded		V							V	V									V		V															24.5199	0	1.5046	0.7976	0.5308	0	0	0	3.0082	0	0	0	0	7.4208	2.0008	13.5013	0	0	0	0	4.2317	0	0	0	0	0	0	0	0	0	0											57.5159	3250	0	0	0	0	0	1722.02545	0	95.61322538	0	0	0	0	0	0	3194.696076	4459.958136	0	0	0	0	0	0	0	0	416.4908892	0	2.851324668	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												0	0	0	0	0	21.80059869	0	50	0	0	0	0	0	0	15	15	0	0	0	0	0	0	0	0	15	0	15	0	0	0	0											0	0	0	0	0	3.128432146	0	0.398388439	0	0	0	0	0	0	3.993370095	5.57494767	0	0	0	0	0	0	0	0	0.520613611	0	0.003564156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.6193	1000	0	24.5199	0	1.504646842	0.797629791	0.530829999	3.128432146	0	0.398388439	3.008227388	0	0	0	0	7.420793986	5.994181661	19.07628558	0	0	0	0	4.231715916	0	0	0	0.520613611	0	0.003564156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.1352		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												4.8574	0	0.2981	0.158	0.1052	0.9794	0	0.0443	0.5959	0	0	0	0	1.4701	0.8355	3.3333	0	0	0	0	0.8383	0	0	0	0.0753	0	0.0191	0	0	0	0											13.6098	1000	9.173886554	29.3773	0	1.802717611	0.955640374	0.635987503	4.107794954	0	0.442653821	3.604157692	0	0	0	0	8.890854405	6.829684205	22.40961488	0	0	0	0	5.070019484	0	0	0	0.595892539	0	0.022669331	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.745
H3916_026_0	2008	7																																		D			Coin										V					S			Coin	V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	0	0	1045	0	0	14.25997861	0	0	0	0	0	0	0	0	0	5263.598313	0	0	0	0	1888.806893	0	0	8.712857143	484.3770839	0	0.501773429	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												0	0	25	0	0	0.135	0	0	0	0	0	0	0	0	0	10	0	0	0	0	25	0	0	0.3	10	0	10	0	0	0	0											0	0	2.177083333	0	0	1.925097112	0	0	0	0	0	0	0	0	0	4.386331927	0	0	0	0	3.93501436	0	0	2.613857143	0.40364757	0	0.000418145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.4414	0	0	0	0	2.177083333	0	0	1.925097112	0	0	0	0	0	0	0	0	0	4.386331927	0	0	0	0	3.93501436	0	0	2.613857143	0.40364757	0	0.000418145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.4414		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												1.9507	0	0.3639	0.1547	0.156	1.0966	0	0	0.2045	0	0	0	0	0.4368	0.2951	1.182	0	0	0	0	0.6483	0	0	0.2339	0.0334	0	0.0091	0	0	0	0											6.7648	250	3.61868226	1.9507	0	2.540956737	0.154730965	0.155982282	3.021685316	0	0	0.204470674	0	0	0	0	0.436786495	0.295059851	5.568302122	0	0	0	0	4.58330136	0	0	2.847728571	0.43705147	0	0.009485497	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2063
H3916_027_0	2008	7																																		D			Coin										V					S			Coin	V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	0	0	1045	0	0	11.75195257	0	0	0	0	0	0	0	0	0	5089.602954	0	0	0	0	1683.218626	0	0	8.712857143	462.8513389	0	3.550910455	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												0	0	25	0	0	0.135	0	0	0	0	0	0	0	0	0	10	0	0	0	0	25	0	0	0.3	10	0	10	0	0	0	0											0	0	2.177083333	0	0	1.586513596	0	0	0	0	0	0	0	0	0	4.241335795	0	0	0	0	3.506705471	0	0	2.613857143	0.385709449	0	0.002959092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.5142	0	0	0	0	2.177083333	0	0	1.586513596	0	0	0	0	0	0	0	0	0	4.241335795	0	0	0	0	3.506705471	0	0	2.613857143	0.385709449	0	0.002959092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.5142		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												1.6811	0	0.3061	0.1353	0.1242	0.8977	0	0	0.2329	0	0	0	0	0.5384	0.26	1.0424	0	0	0	0	0.552	0	0	0.2339	0.0332	0	0.0105	0	0	0	0											6.0477	250	2.606042675	1.6811	0	2.483176021	0.135306941	0.124158538	2.484168768	0	0	0.232910427	0	0	0	0	0.538425161	0.260015916	5.283745011	0	0	0	0	4.058755221	0	0	2.847728571	0.418920751	0	0.013430105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.5619
H3916_028_0	2008	7																																		D			Coin										V					S			Coin	V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	0	0	1045	0	0	12.78967853	0	0	0	0	0	0	0	0	0	4968.346342	0	0	0	0	1904.523573	0	0	8.712857143	484.2272396	0	2.913277119	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												0	0	25	0	0	0.135	0	0	0	0	0	0	0	0	0	10	0	0	0	0	25	0	0	0.3	10	0	10	0	0	0	0											0	0	2.177083333	0	0	1.726606602	0	0	0	0	0	0	0	0	0	4.140288619	0	0	0	0	3.967757445	0	0	2.613857143	0.4035227	0	0.002427731	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0315	0	0	0	0	2.177083333	0	0	1.726606602	0	0	0	0	0	0	0	0	0	4.140288619	0	0	0	0	3.967757445	0	0	2.613857143	0.4035227	0	0.002427731	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0315		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												1.7101	0	0.4027	0.1123	0.1143	1.0266	0	0	0.1969	0	0	0	0	0.6137	0.2741	1.0987	0	0	0	0	0.6535	0	0	0.2339	0.0334	0	0.0126	0	0	0	0											6.4828	250	3.127708678	1.7101	0	2.579798407	0.112348891	0.114250606	2.753253668	0	0	0.196850785	0	0	0	0	0.613740798	0.274082855	5.239026748	0	0	0	0	4.621236593	0	0	2.847728571	0.436925259	0	0.015010941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.5143
H3916_801_0	2008	4																																Coin		Coin		Coin	Coin		Coin	Coin					Coin	Coin	Coin					Coin																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		269.0935292	0	40.15349047	0	10.03737282	25.53819931	0	3.67189433	31.74850367	0	0	0	0	69.82343181	43.79294513	175.1717805	0	0	0	0	63.42730482	0	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												0.080660713	0	0.198196842	0	0.234	0.234	0	0.234	0.234	0	0	0	0	0.234	0.234	0.234	0	0	0	0	0.234	0	0	0	0	0	0	0	0	0	0											21.7053	0	7.958295003	0	2.34874524	5.975938639	0	0.859223273	7.429149859	0	0	0	0	16.33868304	10.24754916	40.99019664	0	0	0	0	14.84198933	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.695	0	0	21.7053	0	7.958295003	0	2.34874524	5.975938639	0	0.859223273	7.429149859	0	0	0	0	16.33868304	10.24754916	40.99019664	0	0	0	0	14.84198933	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.695		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												1.1652	0	0.4272	0	0.1261	0.3208	0	0.0461	0.3988	0	0	0	0	0.8771	0.5501	2.2005	0	0	0	0	0.7968	0	0	0	0	0	0	0	0	0	0											6.9089	0	0	22.8705	0	8.385529787	0	2.474835774	6.296752187	0	0.905349996	7.827977904	0	0	0	0	17.21581234	10.79768075	43.19072299	0	0	0	0	15.63876981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.6039
H3916_802_0	2008	4																																Coin		Coin		Coin	Coin		Coin	Coin					Coin	Coin	Coin					Coin																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		269.0935292	0	40.15349047	0	10.03737282	25.53819931	0	3.67189433	31.74850367	0	0	0	0	69.82343181	43.79294513	175.1717805	0	0	0	0	63.42730482	0	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												0.080660713	0	0.198196842	0	0.234	0.234	0	0.234	0.234	0	0	0	0	0.234	0.234	0.234	0	0	0	0	0.234	0	0	0	0	0	0	0	0	0	0											21.7053	0	7.958295003	0	2.34874524	5.975938639	0	0.859223273	7.429149859	0	0	0	0	16.33868304	10.24754916	40.99019664	0	0	0	0	14.84198933	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.695	0	0	21.7053	0	7.958295003	0	2.34874524	5.975938639	0	0.859223273	7.429149859	0	0	0	0	16.33868304	10.24754916	40.99019664	0	0	0	0	14.84198933	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.695		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												1.1652	0	0.4272	0	0.1261	0.3208	0	0.0461	0.3988	0	0	0	0	0.8771	0.5501	2.2005	0	0	0	0	0.7968	0	0	0	0	0	0	0	0	0	0											6.9089	0	0	22.8705	0	8.385529787	0	2.474835774	6.296752187	0	0.905349996	7.827977904	0	0	0	0	17.21581234	10.79768075	43.19072299	0	0	0	0	15.63876981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.6039
H3916_804_0	2008	4																																Coin		Coin		Coin	Coin		Coin	Coin					Coin	Coin	Coin					Coin																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		269.0935292	0	40.15349047	0	10.03737282	25.53819931	0	3.67189433	31.74850367	0	0	0	0	69.82343181	43.79294513	175.1717805	0	0	0	0	63.42730482	0	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												0.080660713	0	0.198196842	0	0.234	0.234	0	0.234	0.234	0	0	0	0	0.234	0.234	0.234	0	0	0	0	0.234	0	0	0	0	0	0	0	0	0	0											21.7053	0	7.958295003	0	2.34874524	5.975938639	0	0.859223273	7.429149859	0	0	0	0	16.33868304	10.24754916	40.99019664	0	0	0	0	14.84198933	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.695	0	0	21.7053	0	7.958295003	0	2.34874524	5.975938639	0	0.859223273	7.429149859	0	0	0	0	16.33868304	10.24754916	40.99019664	0	0	0	0	14.84198933	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.695		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												1.1652	0	0.4272	0	0.1261	0.3208	0	0.0461	0.3988	0	0	0	0	0.8771	0.5501	2.2005	0	0	0	0	0.7968	0	0	0	0	0	0	0	0	0	0											6.9089	0	0	22.8705	0	8.385529787	0	2.474835774	6.296752187	0	0.905349996	7.827977904	0	0	0	0	17.21581234	10.79768075	43.19072299	0	0	0	0	15.63876981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.6039
H3920_001_0	2008	5																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	Coin	V	V	V	V	V	V	V	V																																																				0		1352.174482	310.4461886	985.5365048	339.1125576	280.7353248	15.70824243	5.318161748	1011.324517	314.8909028	3104.613706	997.3146394	0	10.12631682	2986.091121	4149.669962	6805.267161	899.6731847	178.8657563	2163.135651	0	14.52548263	19.80642879	0	1634.680193	327.1131856	466.8790063	22.16448553	76.65027958	0	1.48342991	46.24634724											$150/day - 1st 15 days	$150/day - 1st 15 days	$0/Day 1-5; $100/Day 6-100	Zero Cost Sharing	$150 Per Service	20% Coinsurance	20% Coinsurance/10% Diabetic Supplies	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $35 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$35/visit	$15/visit	$35/visit	$35/visit	$35/visit	$35/visit	$30/visit	20% Coinsurance	Zero Cost Sharing	100% Coinsurance	$0/visit preventitive  / $50/visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											121.2727905	121.2727905	81.04961118	0	126.3157895	0.2	0.121870541	44.1609844	65.85289683	0	0	0	0.2	0	12.82945736	11.3914	35	35	28	0	0.2	0	0	48.97674419	0	0	0	0	0	0	0											13.6652	3.137389632	6.656445876	0	2.955108683	3.141648486	0.64812725	3.721757185	1.728039844	0	0	0	0.000168772	0	4.436501154	6.460126694	2.624046789	0.521691789	5.047316518	0	2.905096527	0	0	6.671776135	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3204			13.6652	3.137389632	6.656445876	0	2.955108683	3.141648486	0.64812725	3.721757185	1.728039844	0	0	0	0.000168772	0	4.436501154	6.460126694	2.624046789	0.521691789	5.047316518	0	2.905096527	0	0	6.671776135	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3204		$150/day - 1st 15 days	$150/day - 1st 15 days	$0/Day 1-5; $100/Day 6-100	Zero Cost Sharing	$150 Per Service	20% Coinsurance	20% Coinsurance/10% Diabetic Supplies	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $35 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$35/visit	$15/visit	$35/visit	$35/visit	$35/visit	$35/visit	$30/visit	20% Coinsurance	Zero Cost Sharing	100% Coinsurance	$0/visit preventitive  / $50/visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											1.5489	0.3911	0.2835	0	5.256	0.0018	0.0685	0.4216	0.178	0	0	0	0	0	1.2987	1.9008	0.8255	0.182	1.4024	0	1.0543	0	0	1.115	0	0	0	0	0	0	0											15.9282			15.2141	3.528505887	6.939984141	0	8.21113693	3.1434669	0.716610267	4.143354523	1.905998145	0	0	0	0.000170491	0	5.73522978	8.360906113	3.449589542	0.70364195	6.449726707	0	3.959441045	0	0	7.786745108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.2486
H3920_002_0	2008	5																																D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	Coin	V	V	V	V	V	V	V	V																																																				0		1354.861673	328.1588626	1185.678677	390.2128633	344.4862332	22.17140296	7.375302425	1035.915569	4322.758228	4097.67826	1357.35838	0	14.31957911	226.1615873	5195.657179	8275.512154	1000.207279	278.0110121	2519.110636	0	26.2396977	10.69820483	0	1748.046753	318.9534527	444.2823012	31.8300888	86.77260166	0	2.097711568	59.06479786											$50/day - 1st 5 days	$50/day - 1st 5 days	$ 50/Day 6-20; $100/Day 21-100	Zero Cost Sharing	$150 Per Service	20% Coinsurance	20% Coinsurance/10% Diabetic Supplies	$50 visit ER / $20 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $20 Radiation Therapy	Zero Cost Sharing	Zero Cost Sharing	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit	20% Coinsurance	Zero Cost Sharing	100% Coinsurance	$5/visit preventitive  / $20/visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											52.52496398	52.52496398	66.25150746	0	126.3157895	0.2	0.121870541	44.1609844	65.85289683	0	0	0	0	0	4.276485788	6.509371429	20	20	16	0	0.2	0	0	19.59069767	0	0	0	0	0	0	0											5.9303	1.436377703	6.546083312	0	3.626170876	4.434280592	0.898832097	3.812254273	23.7221793	0	0	0	0	0	1.851596174	4.489031864	1.667012132	0.463351687	3.358814182	0	5.247939539	0	0	2.853787955	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.3381			5.9303	1.436377703	6.546083312	0	3.626170876	4.434280592	0.898832097	3.812254273	23.7221793	0	0	0	0	0	1.851596174	4.489031864	1.667012132	0.463351687	3.358814182	0	5.247939539	0	0	2.853787955	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.3381		$50/day - 1st 5 days	$50/day - 1st 5 days	$ 50/Day 6-20; $100/Day 21-100	Zero Cost Sharing	$150 Per Service	20% Coinsurance	20% Coinsurance/10% Diabetic Supplies	$50 visit ER / $20 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $20 Radiation Therapy	Zero Cost Sharing	Zero Cost Sharing	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit	20% Coinsurance	Zero Cost Sharing	100% Coinsurance	$5/visit preventitive  / $20/visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.8203	0.2071	0.2834	0	6.4268	0.0022	0.0837	0.5155	2.2203	0	0	0	0	0	0.5293	1.3281	0.5768	0.1271	0.9799	0	1.2892	0	0	0.4236	0	0	0	0	0	0	0											15.8133			6.7506	1.643507263	6.829477103	0	10.05292248	4.436504038	0.982568964	4.327757852	25.94243567	0	0	0	0	0	2.380931627	5.817121833	2.243825537	0.590481737	4.338689534	0	6.537127879	0	0	3.277365763	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.1513
H3920_003_0	2008	5																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0.277505125	0.590958182	0.189496367	0.925903034	5.39478406	0.379352805	0.576698807	0	0.028507563	0.040960878	0.807118336	2.284250536	0.20277697	0.055454948	0.308382898	0	0.621030947	0.01054308	0	0	0	0	0	0	0	0	0											12.6937		286.5725773	146.3149621	1276.855596	17.95415083	9.312252504	19.83081147	6.358938476	31.07057162	181.0330222	12.7299599	19.35230895	0	0.956629628	1.374526115	27.08450793	76.65270254	6.804596306	1.860904286	10.3484194	0	20.83996467	0.35379464	0	0	1.349321206	2.459430603	0.080816653	0.026423416	0	0.002248104	0.381035187											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	100% Coinsurance	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											557.5596637	99.72776503	55.46252609	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0	0	0	0	0	0	0	0											13.3151	1.215972013	5.901469735	0	1.862450501	3.966162293	1.271787695	6.214114323	36.20660443	2.545991979	3.87046179	0	0.191325926	0.274905223	5.416901586	15.33054051	1.360919261	0.372180857	2.069683881	0	4.167992933	0.070758928	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.6253	135		13.3151	1.215972013	5.901469735	0	2.139955625	4.557120475	1.461284062	7.140017358	41.60138849	2.925344784	4.447160596	0	0.219833489	0.315866101	6.224019922	17.61479104	1.563696231	0.427635805	2.378066779	0	4.78902388	0.081302008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.3191		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	100% Coinsurance	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											1.506	0.1375	0.2063	0	3.2754	0.4239	0.1359	0.8312	4.0628	0.3379	0.5137	0	0.0254	0.0365	1.789	5.0632	0.4495	0.1229	0.6836	0	1.2794	0.0146	0	0	0	0	0	0	0	0	0											20.8947	135		14.8211	1.353506995	6.107753009	0	5.415382764	4.981017877	1.597210799	7.971217244	45.66417081	3.263230631	4.960820604	0	0.245224897	0.352349556	8.013058379	22.67800404	2.013166626	0.550555865	3.061620651	0	6.068422664	0.095867251	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.2137
H3920_007_0	2008	3																																D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	Coin	V	V	V	V	V	V	V	V																																																				0		1355.061862	342.1638678	1200.986582	360.7732756	326.2256616	18.77795767	6.04107041	984.0884909	332.054129	3291.869788	1028.077526	0	14.93070318	3177.096695	4226.12822	6966.059232	984.7002975	217.0285871	2090.978518	0	19.73302281	11.15477764	0	2109.125269	277.1957026	390.2555823	23.48106057	108.2544166	0	2.187236688	47.58666058											$50/day - 1st 10 days	$50/day - 1st 10 days	$ 50/Day 6-14; $100/Day 15-100	Zero Cost Sharing	$150 Per Service	20% Coinsurance	20% Coinsurance/10% Diabetic Supplies	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $20 Radiation Therapy	Zero Cost Sharing	Zero Cost Sharing	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit	20% Coinsurance	Zero Cost Sharing	100% Coinsurance	$0/visit preventitive  / $15/visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											35.01664265	35.01664265	71.44758182	0	126.3157895	0.2	0.121870541	44.1609844	65.85289683	0	0	0	0	0	4.276485788	6.509371429	20	20	16	0	0.2	0	0	34.28372093	0	0	0	0	0	0	0											3.9541	0.998452491	7.150632254	0	3.433954333	3.755591534	0.73622852	3.621526375	1.822227191	0	0	0	0	0	1.506081439	3.778722244	1.641167162	0.361714312	2.787971357	0	3.946604562	0	0	6.025721844	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.5207			3.9541	0.998452491	7.150632254	0	3.433954333	3.755591534	0.73622852	3.621526375	1.822227191	0	0	0	0	0	1.506081439	3.778722244	1.641167162	0.361714312	2.787971357	0	3.946604562	0	0	6.025721844	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.5207		$50/day - 1st 10 days	$50/day - 1st 10 days	$ 50/Day 6-14; $100/Day 15-100	Zero Cost Sharing	$150 Per Service	20% Coinsurance	20% Coinsurance/10% Diabetic Supplies	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $20 Radiation Therapy	Zero Cost Sharing	Zero Cost Sharing	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit	20% Coinsurance	Zero Cost Sharing	100% Coinsurance	$0/visit preventitive  / $15/visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.4472	0.1129	0.2499	0	5.256	0.0018	0.0685	0.4216	0.178	0	0	0	0	0	0.4329	1.0862	0.4717	0.104	0.8014	0	1.0543	0	0	0.7413	0	0	0	0	0	0	0											11.4278			4.4014	1.111384485	7.400579454	0	8.68998258	3.757409948	0.804711536	4.043123713	2.000185492	0	0	0	0	0	1.938990981	4.864881912	2.112905878	0.465685832	3.589348608	0	5.00094908	0	0	6.766983009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9485
H3920_801_0	2008	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																								0.282540961	0.602290043	0.193763167	0.949479413	4.919130574	0.395895208	0.594276221	0	0.028648014	0.690754344	0.829092337	2.34661669	0.20638375	0.056675542	0.317410204	0	0.632923099	0.01157781																				13.0575		150.1601354	13.58076079	26.10188735	16.05249647	8.310028271	17.71441303	5.698916689	27.92586509	144.680311	11.6439767	17.4787124	0	0.842588638	20.31630424	24.38506872	69.01813793	6.070110284	1.666927716	9.335594224	0	18.61538525	0.340523832																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.079939931	0.079939931	0.201011472	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2																				12.0038	1.085645085	5.24677881	0	1.662005654	3.542882605	1.139783338	5.585173019	28.9360622	2.32879534	3.495742479	0	0.168517728	4.063260848	4.877013745	13.80362759	1.214022057	0.333385543	1.867118845	0	3.723077051	0.068104766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.1448	135		12.0038	1.085645085	5.24677881	0	1.944546615	4.145172648	1.333546505	6.534652432	33.85519277	2.724690548	4.090018701	0	0.197165741	4.754015192	5.706106082	16.15024428	1.420405806	0.390061086	2.184529048	0	4.356000149	0.079682577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.2022		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.3577	0.1228	0.1834	0	2.9763	0.3856	0.124	0.7607	3.3063	0.3147	0.4724	0	0.0228	0.5491	1.6402	4.6422	0.4083	0.1121	0.6279	0	1.1637	0.0121																				19.1824	135		13.3615	1.208439175	5.430177652	0	4.920879714	4.530751201	1.457591262	7.295379205	37.16148335	3.039400246	4.562427778	0	0.219938959	5.303117799	7.34627487	20.7924865	1.828688659	0.502180631	2.812452243	0	5.519715643	0.09178886	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.3847
H3920_802_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																								0.282540961	0.602290043	0.193763167	0.949479413	4.919130574	0.395895208	0.594276221	0	0.028648014	0.690754344	0.829092337	2.34661669	0.20638375	0.056675542	0.317410204	0	0.632923099	0.01157781																				13.0575		150.1601354	13.58076079	26.10188735	16.05249647	8.310028271	17.71441303	5.698916689	27.92586509	144.680311	11.6439767	17.4787124	0	0.842588638	20.31630424	24.38506872	69.01813793	6.070110284	1.666927716	9.335594224	0	18.61538525	0.340523832																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.079939931	0.079939931	0.201011472	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2																				12.0038	1.085645085	5.24677881	0	1.662005654	3.542882605	1.139783338	5.585173019	28.9360622	2.32879534	3.495742479	0	0.168517728	4.063260848	4.877013745	13.80362759	1.214022057	0.333385543	1.867118845	0	3.723077051	0.068104766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.1448	135		12.0038	1.085645085	5.24677881	0	1.944546615	4.145172648	1.333546505	6.534652432	33.85519277	2.724690548	4.090018701	0	0.197165741	4.754015192	5.706106082	16.15024428	1.420405806	0.390061086	2.184529048	0	4.356000149	0.079682577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.2022		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.3577	0.1228	0.1834	0	2.9763	0.3856	0.124	0.7607	3.3063	0.3147	0.4724	0	0.0228	0.5491	1.6402	4.6422	0.4083	0.1121	0.6279	0	1.1637	0.0121																				19.1824	135		13.3615	1.208439175	5.430177652	0	4.920879714	4.530751201	1.457591262	7.295379205	37.16148335	3.039400246	4.562427778	0	0.219938959	5.303117799	7.34627487	20.7924865	1.828688659	0.502180631	2.812452243	0	5.519715643	0.09178886	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.3847
H3921_001_0	2008	6																					2775											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1800.010126	133.3879365	829.1501074		116.9605515	12.08662686	2.518255465	416.8572952	29.07274427	8735.218184	42.93312752		0.286396444	25.99977896	4221.580164	4216.127737	471.6718539	1.683293198			20.03848422	863.0004991			123.4605503		14.6412367															$295 (1a); $0 (1a1)	$295 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	20% (9b)	20% (8a1); $0/$5 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	$0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											164.2226	164.2226	83.503		97.4202	0.167006073	0.268729194	27.8343	0.111337382	1.1134	0.064607821		0.167006073	0.111307083	10	19.9717	37.5	0.111337382			0.167006073	20			20		20															24.6335	1.825443237	5.769712636	0	0.949526783	2.018540087	0.676728761	0.966912498	3.236883232	0.810463603	2.773815831	0	0.047829945	2.893959565	3.51798347	7.016947144	1.473974543	0.187413458	0	0	3.346548557	1.438334165	0	0	0.205767584	0	0.024402061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8147	0	39.46487995	24.6335	1.825443237	5.769712636	0	0.949526783	2.018540087	0.676728761	0.966912498	3.236883232	0.810463603	2.773815831	0	0.047829945	2.893959565	3.51798347	7.016947144	1.473974543	0.187413458	0	0	3.346548557	1.438334165	0	0	0.205767584	0	0.024402061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8147		30% (1a); $0 (1a1)	30% (1b)	"30% (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/30% (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"30%/$50 (7a); 30% (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1)"	"30% (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); 30% (17a, 17b, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	30% (17a1)	$0 n/c (17b)	30% (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											5.9401	0.2074	2.3333	0.5537	0.4264	0.9065	0.1889	0.4342	2.1805	1.4559	1.8493		0.0215	1.9487	1.5336	4.6727	0.2948	0.0891			1.0609	0.2784			0.0379		0.0031															26.4169	0	0	30.5737	2.032873866	8.102984819	0.553729457	1.37594546	2.925037101	0.865597921	1.401138847	5.417339052	2.2663333	4.623077198	0	0.069309679	4.84265521	5.051620835	11.68967113	1.768769452	0.27652898	0	0	4.407409486	1.716708808	0	0	0.243703628	0	0.027473226	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2316
H3921_003_0	2008	7																					1900											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1914.962162	145.7529954	958.54674		110.5867018	10.86176701	2.181198646	432.7346235	30.09971062	9138.562652	40.00152479		0.275996149	27.18333027	4294.275278	4623.222373	476.856646	2.090714845			19.84573084	841.7786721			133.2290886		14.66802222															$200 (1a); $0 (1a1)	$200 (1b)	"$120 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$5 (4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$15 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $15 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$15 (17a1)	$0 n/c (17b)	$15 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											99.2892	99.2892	59.5735		86.878	0.148933738	0.279894418	24.8223	0.099289159	2.9787	0.056908787		0.148933738	0.099272713	5	15	37.5	0.099289159			0.148933738	15			15		15															15.8446	1.20597436	4.758664979	0	0.800629419	1.617683566	0.610505326	0.895122017	2.98857495	2.268400498	2.276438244	0	0.041105138	2.698562951	1.789281366	5.779027966	1.490177019	0.207585318	0	0	2.955698884	1.05222334	0	0	0.166536361	0	0.018335028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4651	0	39.15318821	15.8446	1.20597436	4.758664979	0	0.800629419	1.617683566	0.610505326	0.895122017	2.98857495	2.268400498	2.276438244	0	0.041105138	2.698562951	1.789281366	5.779027966	1.490177019	0.207585318	0	0	2.955698884	1.05222334	0	0	0.166536361	0	0.018335028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4651		30% (1a); $0 (1a1)	30% (1b)	"30% (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/30% (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"30%/$50 (7a); 30% (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1)"	"30% (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); 30% (17a, 17b, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	30% (17a1)	$0 n/c (17b)	30% (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											6.3409	0.2313	2.2147	0.5305	0.4032	0.8146	0.1636	0.4508	2.2575	1.5231	1.6998		0.0207	2.0375	1.4893	4.8929	0.298	0.1107			1.0507	0.2674			0.0391		0.0031															26.8394	0	0	22.1855	1.437295584	6.97336505	0.530528521	1.203810102	2.432316092	0.774095224	1.345887249	5.246053247	3.791494273	3.976250317	0	0.061804849	4.736066293	3.278549196	10.67193077	1.788212422	0.318270222	0	0	4.006355223	1.319649527	0	0	0.205676914	0	0.021413342	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.3045
H3921_801_0	2008	2																					3200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1964.705911	149.6482077	984.4375724		113.2441416	11.29773688	2.26973325	443.1744418	31.34111271	9358.131113	41.6227375		0.286730887	28.29961084	4405.603242	4750.829952	488.859948	2.180246376			20.64677084	863.1302773			135.1308581		14.84433716															$350 (1a); $0 (1a1)	$350 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											189.4348	189.4348	81.1863		94.7174	0.162372651	0.281703859	27.0621	0.108248434	3.2475	0.061942046		0.162372651	0.10822323	25	29.9589	37.5	0.108248434			0.162372651	30			30		30															31.0153	2.362381015	6.660239085	0	0.893849029	1.834443483	0.639392615	0.999436234	3.392626363	2.53250759	2.578197507	0	0.046557254	3.062675298	9.178340088	11.86078941	1.527687337	0.236008255	0	0	3.352470909	2.157825693	0	0	0.337827145	0	0.037110843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.7057	0	50.02026019	31.0153	2.362381015	6.660239085	0	0.893849029	1.834443483	0.639392615	0.999436234	3.392626363	2.53250759	2.578197507	0	0.046557254	3.062675298	9.178340088	11.86078941	1.527687337	0.236008255	0	0	3.352470909	2.157825693	0	0	0.337827145	0	0.037110843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.7057		30% (1a); $0 (1a1)	30% (1b)	"30% (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"30%/$50 (7a); 30% (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1)"	"30% (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); 30% (17a, 17b, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	30% (17a1)	$0 n/c (17b)	30% (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											6.6027	0.241	2.3037	0.5513	0.4129	0.8473	0.1702	0.4616	2.3506	1.5597	1.7661		0.0215	2.1212	1.549	5.095	0.3055	0.1154			1.0931	0.2785			0.0394		0.0031															27.889	0	0	37.618	2.60342992	8.96398339	0.551339809	1.306718295	2.681773748	0.809622609	1.461076277	5.743209816	4.092196109	4.344267247	0	0.068062071	5.183834696	10.72732743	16.95583514	1.833224805	0.351433064	0	0	4.445535247	2.436339501	0	0	0.377201522	0	0.040226918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.5947
H3921_803_0	2008	2																					3200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1964.697743	149.6476054	984.43366		113.2436318	11.29762957	2.269712689	443.1724561	31.34084866	9358.088972	41.62235797		0.286727817	28.29936753	4405.585656	4750.811679	488.8578459	2.180231346			20.64657926	863.1265956			135.1308581		14.84433716															$350 (1a); $0 (1a1)	$350 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											189.4353	189.4353	81.1865		94.7176	0.162373074	0.281703936	27.0622	0.108248716	3.2475	0.06194223		0.162373074	0.108223513	25	29.9589	37.5	0.108248716			0.162373074	30			30		30															31.0153	2.362377667	6.660229983	0	0.893847335	1.834430843	0.639386998	0.999434362	3.392606628	2.532502789	2.57818169	0	0.046556877	3.062656958	9.178303449	11.86074372	1.527680769	0.236007244	0	0	3.352448543	2.157816489	0	0	0.337827145	0	0.037110843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.7054	0	50.01984066	31.0153	2.362377667	6.660229983	0	0.893847335	1.834430843	0.639386998	0.999434362	3.392606628	2.532502789	2.57818169	0	0.046556877	3.062656958	9.178303449	11.86074372	1.527680769	0.236007244	0	0	3.352448543	2.157816489	0	0	0.337827145	0	0.037110843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.7054		30% (1a); $0 (1a1)	30% (1b)	"30% (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"30%/$50 (7a); 30% (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1)"	"30% (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); 30% (17a, 17b, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	30% (17a1)	$0 n/c (17b)	30% (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											6.6027	0.241	2.3037	0.5513	0.4129	0.8473	0.1702	0.4616	2.3506	1.5597	1.7661		0.0215	2.1211	1.549	5.095	0.3055	0.1154			1.0931	0.2785			0.0394		0.0031															27.8888	0	0	37.6179	2.60342473	8.963952559	0.551334084	1.306714742	2.681753061	0.80961545	1.461072337	5.743170277	4.092184285	4.3442359	0	0.068061463	5.183798123	10.72727817	16.9557469	1.833216922	0.351431256	0	0	4.445502739	2.436328009	0	0	0.377201522	0	0.040226918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.5942
H3923_001_0	2008	8																					5000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	275.5826935	2.681035512	1594.590526	26.13220052	196.9196279	17.31995796	0.827898295	358.0650904	335.2368417	9.204024271	24.30030367	0	0.227002537	330.0895102	4350.094093	5172.066861	161.5650125	518.165161	25.82443478	109.3851426	6.622968285	657.7637356	81.42857143	0	0	0	144.1340254	0	0	0	11400											$250/admitUnlimited Days	$250/admitLimited Days	"$0/day for days 1-14, $75/day for days 15-50, $100/day for days 51-100"	$0/visit	$50/trip	20% Coinsurance for DME/0% for Diabetic Supplies	20% Coinsurance for DME/0% for Diabetic Supplies	"$50/visit - ER, $30/visit - UC"	$100/visit	$0/copay	0% Coinsurance - X-Ray	$0 	0%	$30/visit - PT/OT/ST	$20 PCP;	$30 Specialist	$30/visit	$30/visit	0%	$30/visit - OPSA/$30/visit - Diagnostic Hearing Exams	0%	$30/visit - Diagnostic Eye Exams	$50/trip	Not Covered	Not Covered	Not Covered	$30/visit	$400 allowance / 3 years	Not Covered	Not Covered	$0 											237.6025241	237.6031411	42.65824347	0	47.52469296	0.155976597	0.190107456	40.6894138	95.04749164	-7.54E-19	0.060594535	0	4.78E-19	28.51363411	18.18858673	28.54884037	28.52115093	28.52177202	1.07E-18	28.48531926	0	28.52156692	50	0	0	0	30	0	0	0	0											5.4566	0.053085205	5.668535907	0	0.779878738	2.701508107	0.157389639	1.214121552	2.655285076	-6.94E-18	1.472465612	0	1.08E-19	0.784337626	6.593505309	12.30470927	0.384001675	1.231582383	2.78E-17	0.259655892	0	1.563371034	0.339285714	0	0	0	0.360335064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.9796	0	4.614	5.4566	0.053085205	5.668535907	0	0.779878738	2.701508107	0.157389639	1.214121552	2.655285076	-6.94E-18	1.472465612	0	1.08E-19	0.784337626	6.593505309	12.30470927	0.384001675	1.231582383	2.78E-17	0.259655892	0	1.563371034	0.339285714	0	0	0	0.360335064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.9796	5000	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	"$50/visit - ER, $30/visit - UC"	30% Coinsurance	30% Coinsurance	30% Coinsurance	0%	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$50/trip	Not Covered	Not Covered	Not Covered	30% Coinsurance	$400 allowance / 3 years	Not Covered	Not Covered	$0 											3.721	0.0284	0.6695	0.438	0.1042	0.3298	0.0144	0.0619	0.3483	0.1393	0.3677	0	0.0033	0.3651	0.5753	1.5116	0.0167	0.0562	0.3705	0.4826	0.0992	0.0753	0.0179	0	0	0	0.0118	0	0	0	0											9.8081	500	2.3815	9.1776	0.081522254	6.338066059	0.43804129	0.884046794	3.031348068	0.171837664	1.276054952	3.00354968	0.139344007	1.840132124	0	0.003291914	1.149434471	7.168806952	13.81633682	0.400661477	1.287755395	0.370474584	0.742293162	0.099227331	1.638665541	0.357142857	0	0	0	0.37211333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.7878
H3923_002_0	2008	8																					5000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	252.2357905	2.445317315	1582.569123	23.22727649	186.5316893	16.14222213	0.775585184	426.6103849	399.212861	8.671258225	22.85958095	0	0.206958404	392.4199598	4036.417424	4728.227539	145.1986866	465.3457102	19.35018342	100.1499715	6.22348529	610.3972681	81.42857143	0	0	0	133.2548762	0	0	0	11400											$250/admitUnlimited Days	$250/admitLimited Days	"$0/day for days 1-14, $75/day for days 15-50, $100/day for days 51-100"	$0/visit	$50/trip	20% Coinsurance for DME/0% for Diabetic Supplies	20% Coinsurance for DME/0% for Diabetic Supplies	"$50/visit - ER, $30/visit - UC"	$100/visit	$0/copay	0% Coinsurance - X-Ray	$0 	0%	$30/visit - PT/OT/ST	$20 PCP;	$30 Specialist	$30/visit	$30/visit	0%	$30/visit - OPSA/$30/visit - Diagnostic Hearing Exams	0%	$30/visit - Diagnostic Eye Exams	$50/trip	Not Covered	Not Covered	Not Covered	$30/visit	$400 allowance / 3 years	Not Covered	Not Covered	$0 											238.3556452	238.3561513	42.79297468	0	47.67467801	0.156457972	0.190705625	40.81322618	95.34973533	0	0.077031522	0	0	28.60423129	18.24448779	28.62973835	28.60985676	28.61037868	-1.43E-18	28.56552115	5.57E-19	28.61019236	50	0	0	0	30	0	0	0	0											5.0102	0.048571369	5.643570034	0	0.741069852	2.525579345	0.147908457	1.450945511	3.172070053	0	1.760908303	0	0	0.935405941	6.136864033	11.28065978	0.346176135	1.109476416	-2.78E-17	0.238403011	3.47E-18	1.455298605	0.339285714	0	0	0	0.33313719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.6755	0	4.4145	5.0102	0.048571369	5.643570034	0	0.741069852	2.525579345	0.147908457	1.450945511	3.172070053	0	1.760908303	0	0	0.935405941	6.136864033	11.28065978	0.346176135	1.109476416	-2.78E-17	0.238403011	3.47E-18	1.455298605	0.339285714	0	0	0	0.33313719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.6755	5000	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	"$50/visit - ER, $30/visit - UC"	30% Coinsurance	30% Coinsurance	30% Coinsurance	0%	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$50/trip	Not Covered	Not Covered	Not Covered	30% Coinsurance	$400 allowance / 3 years	Not Covered	Not Covered	$0 											3.721	0.0284	0.6695	0.438	0.1042	0.3298	0.0144	0.0619	0.3483	0.1393	0.3677	0	0.0033	0.3651	0.5753	1.5116	0.0167	0.0562	0.3705	0.4826	0.0992	0.0753	0.0179	0	0	0	0.0118	0	0	0	0											9.8081	500	2.3815	8.7312	0.077008418	6.313100186	0.43804129	0.845237909	2.855419307	0.162356483	1.51287891	3.520334657	0.139344007	2.128574815	0	0.003291914	1.300502786	6.712165677	12.79228733	0.362835937	1.165649428	0.370474584	0.72104028	0.099227331	1.530593112	0.357142857	0	0	0	0.344915457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4836
H3923_003_0	2008	8																					5000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	269.0454348	2.615741424	1436.092182	24.52559038	206.5912015	18.15579227	0.8639283	479.26872	448.7236214	9.733938698	25.62513498	0	0.183052464	440.6453954	3789.845919	4473.788019	135.5717922	434.3354265	18.43959061	95.0471597	6.97408188	573.1165077	81.42857143	0	0	0	126.7224778	0	0	0	11400											$250/admitUnlimited Days	$250/admitLimited Days	"$0/day for days 1-14, $75/day for days 15-50, $100/day for days 51-100"	$0/visit	$50/trip	20% Coinsurance for DME/0% for Diabetic Supplies	20% Coinsurance for DME/0% for Diabetic Supplies	"$50/visit - ER, $30/visit - UC"	$100/visit	$0/copay	0% Coinsurance - X-Ray	$0 	0%	$30/visit - PT/OT/ST	$20 PCP;	$30 Specialist	$30/visit	$30/visit	0%	$30/visit - OPSA/$30/visit - Diagnostic Hearing Exams	0%	$30/visit - Diagnostic Eye Exams	$50/trip	Not Covered	Not Covered	Not Covered	$30/visit	$400 allowance / 3 years	Not Covered	Not Covered	$0 											238.5373338	238.5378504	42.82543281	-5.66E-19	47.71042136	0.156566538	0.190847953	40.83802871	95.4213096	0	0.077329332	0	-5.92E-19	28.62579101	18.25833205	28.66436761	28.63126979	28.63179058	0	28.57162498	0	28.63159822	50	0	0	0	30	0	0	0	0											5.3481	0.051996111	5.125105771	-1.39E-17	0.82137944	2.842589532	0.164878947	1.631032479	3.568149633	0	1.981574575	0	-1.08E-19	1.051151917	5.766355435	10.68652536	0.323466047	1.036316748	0	0.226304317	0	1.367436799	0.339285714	0	0	0	0.316806195	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.6485	0	4.3765	5.3481	0.051996111	5.125105771	-1.39E-17	0.82137944	2.842589532	0.164878947	1.631032479	3.568149633	0	1.981574575	0	-1.08E-19	1.051151917	5.766355435	10.68652536	0.323466047	1.036316748	0	0.226304317	0	1.367436799	0.339285714	0	0	0	0.316806195	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.6485	5000	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	"$50/visit - ER, $30/visit - UC"	30% Coinsurance	30% Coinsurance	30% Coinsurance	0%	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$50/trip	Not Covered	Not Covered	Not Covered	30% Coinsurance	$400 allowance / 3 years	Not Covered	Not Covered	$0 											3.721	0.0284	0.6695	0.438	0.1042	0.3298	0.0144	0.0619	0.3483	0.1393	0.3677	0	0.0033	0.3651	0.5753	1.5116	0.0167	0.0562	0.3705	0.4826	0.0992	0.0753	0.0179	0	0	0	0.0118	0	0	0	0											9.8081	500	2.3815	9.0691	0.08043316	5.794635923	0.43804129	0.925547496	3.172429494	0.179326973	1.692965879	3.916414237	0.139344007	2.349241087	0	0.003291914	1.416248761	6.341657079	12.19815292	0.340125848	1.09248976	0.370474584	0.708941586	0.099227331	1.442731306	0.357142857	0	0	0	0.328584461	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4566
H3923_004_0	2008	8																					5000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	239.0493432	2.313214997	1356.724402	20.74316155	187.4251982	15.97235688	0.766560295	483.429615	452.4675184	8.559116112	22.53269362	0	0.187201939	444.3009275	4087.415143	4707.447372	137.0552863	439.0821212	19.40880001	100.5679156	6.132115065	617.9401792	81.42857143	0	0	0	135.8445337	0	0	0	11400											$250/admitUnlimited Days	$250/admitLimited Days	"$0/day for days 1-14, $75/day for days 15-50, $100/day for days 51-100"	$0/visit	$50/trip	20% Coinsurance for DME/0% for Diabetic Supplies	20% Coinsurance for DME/0% for Diabetic Supplies	"$50/visit - ER, $30/visit - UC"	$100/visit	$0/copay	0% Coinsurance - X-Ray	$0 	0%	$30/visit - PT/OT/ST	$20 PCP;	$30 Specialist	$30/visit	$30/visit	0%	$30/visit - OPSA/$30/visit - Diagnostic Hearing Exams	0%	$30/visit - Diagnostic Eye Exams	$50/trip	Not Covered	Not Covered	Not Covered	$30/visit	$400 allowance / 3 years	Not Covered	Not Covered	$0 											238.6363046	238.6367164	42.84288715	0	47.72997394	0.156621606	0.190924885	40.85609834	95.46132584	0	0.088721948	0	0	28.63776929	18.2646546	28.66542678	28.64216159	28.64260173	-7.15E-19	28.57371936	5.66E-19	28.64243977	50	0	0	0	30	0	0	0	0											4.7538	0.046001503	4.843832539	0	0.745483319	2.501616182	0.146355436	1.645920658	3.5994291	0	1.999144461	0	0	1.060315621	6.221268816	11.24508233	0.327129971	1.04803786	-1.39E-17	0.239466616	3.47E-18	1.474942863	0.339285714	0	0	0	0.339611334	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.5767	0	4.3575	4.7538	0.046001503	4.843832539	0	0.745483319	2.501616182	0.146355436	1.645920658	3.5994291	0	1.999144461	0	0	1.060315621	6.221268816	11.24508233	0.327129971	1.04803786	-1.39E-17	0.239466616	3.47E-18	1.474942863	0.339285714	0	0	0	0.339611334	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.5767	5000	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	"$50/visit - ER, $30/visit - UC"	30% Coinsurance	30% Coinsurance	30% Coinsurance	0%	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$50/trip	Not Covered	Not Covered	Not Covered	30% Coinsurance	$400 allowance / 3 years	Not Covered	Not Covered	$0 											3.721	0.0284	0.6695	0.438	0.1042	0.3298	0.0144	0.0619	0.3483	0.1393	0.3677	0	0.0033	0.3651	0.5753	1.5116	0.0167	0.0562	0.3705	0.4826	0.0992	0.0753	0.0179	0	0	0	0.0118	0	0	0	0											9.8081	500	2.3815	8.4748	0.074438552	5.513362691	0.43804129	0.849651376	2.831456144	0.160803462	1.707854057	3.947693704	0.139344007	2.366810973	0	0.003291914	1.425412466	6.796570459	12.75670988	0.343789773	1.104210873	0.370474584	0.722103886	0.099227331	1.55023737	0.357142857	0	0	0	0.351389601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.3849
H3923_009_0	2008	4																					5000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	259.3717057	2.523325185	1500.789544	24.59498999	185.3359238	16.30111916	0.779197516	337.0020222	315.5167022	8.662603236	22.87085174	0	0.213649253	310.6721698	4094.200861	4867.813855	152.0609768	487.6841637	24.30532838	102.9502382	6.233376272	619.0708772	81.42857143	0	0	0	135.6555533	0	0	0	11400											$250/admitUnlimited Days	$250/admitLimited Days	"$0/day for days 1-14, $75/day for days 15-50, $100/day for days 51-100"	$0/visit	$50/trip	20% Coinsurance for DME/0% for Diabetic Supplies	20% Coinsurance for DME/0% for Diabetic Supplies	"$50/visit - ER, $30/visit - UC"	$100/visit	$0/copay	0% Coinsurance - X-Ray	$0 	0%	$30/visit - PT/OT/ST	$20 PCP;	$30 Specialist	$30/visit	$30/visit	0%	$30/visit - OPSA/$30/visit - Diagnostic Hearing Exams	0%	$30/visit - Diagnostic Eye Exams	$50/trip	Not Covered	Not Covered	Not Covered	$30/visit	$400 allowance / 3 years	Not Covered	Not Covered	$0 											238.789506	238.790064	42.87107247	0	47.76168807	0.156753693	0.191054605	40.89113779	95.52166336	4.01E-19	0.060896509	0	5.07E-19	28.65594439	18.2779639	28.68777748	28.66274101	28.66330259	-5.71E-19	28.62030256	1.11E-18	28.66311714	50	0	0	0	30	0	0	0	0											5.1613	0.050212082	5.361704776	0	0.737663048	2.555260636	0.148869273	1.148366344	2.511556684	3.47E-18	1.392755037	0	1.08E-19	0.741883702	6.236137962	11.63723006	0.363207033	1.164886563	-1.39E-17	0.245538914	6.94E-18	1.478708422	0.339285714	0	0	0	0.339138883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6137	0	4.024	5.1613	0.050212082	5.361704776	0	0.737663048	2.555260636	0.148869273	1.148366344	2.511556684	3.47E-18	1.392755037	0	1.08E-19	0.741883702	6.236137962	11.63723006	0.363207033	1.164886563	-1.39E-17	0.245538914	6.94E-18	1.478708422	0.339285714	0	0	0	0.339138883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6137	5000	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	"$50/visit - ER, $30/visit - UC"	30% Coinsurance	30% Coinsurance	30% Coinsurance	0%	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$50/trip	Not Covered	Not Covered	Not Covered	30% Coinsurance	$400 allowance / 3 years	Not Covered	Not Covered	$0 											3.5812	0.0274	0.6444	0.4216	0.1003	0.3174	0.0139	0.0596	0.3352	0.1341	0.3539	0	0.0032	0.3514	0.5534	1.4548	0.016	0.0541	0.3566	0.4645	0.0955	0.0725	0.0179	0	0	0	0.0111	0	0	0	0											9.4398	500	2.124	8.7425	0.077580726	6.006080095	0.421583696	0.83791742	2.872708221	0.162774474	1.208013753	2.846736682	0.134108731	1.746607996	0	0.003168234	1.093263539	6.789570584	13.09206444	0.379240912	1.218949106	0.356555529	0.710043079	0.095499273	1.551174049	0.357142857	0	0	0	0.350224311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.0535
H3923_010_0	2008	5																					5000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	237.3993494	2.301484448	1489.483452	21.86105201	175.5600475	15.19275144	0.729966102	401.5180396	375.7314978	8.161216281	21.51499305	0	0.194785146	369.3380801	3799.002487	4450.147271	136.6584063	437.9751199	18.2120089	94.26061135	5.857420936	574.4950415	81.42857143	0	0	0	125.4163541	0	0	0	11400											$250/admitUnlimited Days	$250/admitLimited Days	"$0/day for days 1-14, $75/day for days 15-50, $100/day for days 51-100"	$0/visit	$50/trip	20% Coinsurance for DME/0% for Diabetic Supplies	20% Coinsurance for DME/0% for Diabetic Supplies	"$50/visit - ER, $30/visit - UC"	$100/visit	$0/copay	0% Coinsurance - X-Ray	$0 	0%	$30/visit - PT/OT/ST	$20 PCP;	$30 Specialist	$30/visit	$30/visit	0%	$30/visit - OPSA/$30/visit - Diagnostic Hearing Exams	0%	$30/visit - Diagnostic Eye Exams	$50/trip	Not Covered	Not Covered	Not Covered	$30/visit	$400 allowance / 3 years	Not Covered	Not Covered	$0 											239.5357667	239.5362216	43.00460551	0	47.91034383	0.157230803	0.19164759	41.0136499	95.82102866	0	0.077411849	0	-5.57E-19	28.74568891	18.33341582	28.76861945	28.75074617	28.75121537	1.52E-18	28.70102851	5.92E-19	28.75104787	50	0	0	0	30	0	0	0	0											4.7388	0.045940741	5.337887354	0	0.70092852	2.388768511	0.139896244	1.372310025	3.000248218	0	1.665515385	0	-1.08E-19	0.884739796	5.804057691	10.66871611	0.327419263	1.04935975	2.78E-17	0.225448041	3.47E-18	1.376444537	0.339285714	0	0	0	0.313540885	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3793	0	3.8435	4.7388	0.045940741	5.337887354	0	0.70092852	2.388768511	0.139896244	1.372310025	3.000248218	0	1.665515385	0	-1.08E-19	0.884739796	5.804057691	10.66871611	0.327419263	1.04935975	2.78E-17	0.225448041	3.47E-18	1.376444537	0.339285714	0	0	0	0.313540885	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3793	5000	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	"$50/visit - ER, $30/visit - UC"	30% Coinsurance	30% Coinsurance	30% Coinsurance	0%	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$50/trip	Not Covered	Not Covered	Not Covered	30% Coinsurance	$400 allowance / 3 years	Not Covered	Not Covered	$0 											3.5812	0.0274	0.6444	0.4216	0.1003	0.3174	0.0139	0.0596	0.3352	0.1341	0.3539	0	0.0032	0.3514	0.5534	1.4548	0.016	0.0541	0.3566	0.4645	0.0955	0.0725	0.0179	0	0	0	0.0111	0	0	0	0											9.4398	500	2.124	8.32	0.073309385	5.982262673	0.421583696	0.801182892	2.706216096	0.153801445	1.431957434	3.335428216	0.134108731	2.019368345	0	0.003168234	1.236119633	6.357490313	12.12355049	0.343453141	1.103422293	0.356555529	0.689952206	0.095499273	1.448910163	0.357142857	0	0	0	0.324626313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8191
H3923_011_0	2008	5																					5000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	253.2208434	2.461890016	1351.625708	23.08305097	194.440184	17.08793127	0.813115244	451.0806516	422.3311973	9.161410579	24.11793842	0	0.172285735	414.727983	3566.946131	4210.733275	127.5982179	408.7903515	17.35501586	89.45979255	6.563882257	539.4090885	81.42857143	0	0	0	119.2682144	0	0	0	11400											$250/admitUnlimited Days	$250/admitLimited Days	"$0/day for days 1-14, $75/day for days 15-50, $100/day for days 51-100"	$0/visit	$50/trip	20% Coinsurance for DME/0% for Diabetic Supplies	20% Coinsurance for DME/0% for Diabetic Supplies	"$50/visit - ER, $30/visit - UC"	$100/visit	$0/copay	0% Coinsurance - X-Ray	$0 	0%	$30/visit - PT/OT/ST	$20 PCP;	$30 Specialist	$30/visit	$30/visit	0%	$30/visit - OPSA/$30/visit - Diagnostic Hearing Exams	0%	$30/visit - Diagnostic Eye Exams	$50/trip	Not Covered	Not Covered	Not Covered	$30/visit	$400 allowance / 3 years	Not Covered	Not Covered	$0 											239.7348383	239.7353013	43.04019438	0	47.94961538	0.15735096	0.191804078	41.04157057	95.89964916	-3.79E-19	0.077716635	0	1.26E-18	28.76935539	18.34857713	28.80392453	28.7742651	28.7747318	0	28.70743933	-1.06E-18	28.77455941	50	0	0	0	30	0	0	0	0											5.0588	0.049183495	4.847852768	0	0.776944336	2.68880239	0.155958819	1.542754866	3.375117804	-3.47E-18	1.874365021	0	2.17E-19	0.994288061	5.454032182	10.10713695	0.305962079	0.98023606	0	0.214013464	-6.94E-18	1.293438239	0.339285714	0	0	0	0.298170536	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3564	0	3.8055	5.0588	0.049183495	4.847852768	0	0.776944336	2.68880239	0.155958819	1.542754866	3.375117804	-3.47E-18	1.874365021	0	2.17E-19	0.994288061	5.454032182	10.10713695	0.305962079	0.98023606	0	0.214013464	-6.94E-18	1.293438239	0.339285714	0	0	0	0.298170536	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3564	5000	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	"$50/visit - ER, $30/visit - UC"	30% Coinsurance	30% Coinsurance	30% Coinsurance	0%	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$50/trip	Not Covered	Not Covered	Not Covered	30% Coinsurance	$400 allowance / 3 years	Not Covered	Not Covered	$0 											3.5812	0.0274	0.6444	0.4216	0.1003	0.3174	0.0139	0.0596	0.3352	0.1341	0.3539	0	0.0032	0.3514	0.5534	1.4548	0.016	0.0541	0.3566	0.4645	0.0955	0.0725	0.0179	0	0	0	0.0111	0	0	0	0											9.4398	500	2.124	8.64	0.07655214	5.492228086	0.421583696	0.877198708	3.006249975	0.16986402	1.602402275	3.710297802	0.134108731	2.22821798	0	0.003168234	1.345667898	6.007464805	11.56197134	0.321995958	1.034298604	0.356555529	0.678517629	0.095499273	1.365903865	0.357142857	0	0	0	0.309255964	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7962
H3923_012_0	2008	5																					5000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	224.988113	2.177148346	1276.920202	19.5230174	176.4006319	15.03284522	0.721470441	454.9941756	425.852892	8.055655952	21.20729219	0	0.176190437	418.1666169	3846.991019	4430.57387	128.9936426	413.2551809	18.26714502	94.65342337	5.771414778	581.5927364	81.42857143	0	0	0	127.8536787	0	0	0	11400											$250/admitUnlimited Days	$250/admitLimited Days	"$0/day for days 1-14, $75/day for days 15-50, $100/day for days 51-100"	$0/visit	$50/trip	20% Coinsurance for DME/0% for Diabetic Supplies	20% Coinsurance for DME/0% for Diabetic Supplies	"$50/visit - ER, $30/visit - UC"	$100/visit	$0/copay	0% Coinsurance - X-Ray	$0 	0%	$30/visit - PT/OT/ST	$20 PCP;	$30 Specialist	$30/visit	$30/visit	0%	$30/visit - OPSA/$30/visit - Diagnostic Hearing Exams	0%	$30/visit - Diagnostic Eye Exams	$50/trip	Not Covered	Not Covered	Not Covered	$30/visit	$400 allowance / 3 years	Not Covered	Not Covered	$0 											239.8416709	239.8420391	43.0590891	-7.11E-19	47.97076007	0.157411285	0.191887502	41.06088216	95.94275227	8.61E-19	0.089168886	0	6.15E-19	28.78226373	18.35554632	28.80699404	28.78619119	28.78658474	-1.52E-18	28.71175314	0	28.78643992	50	0	0	0	30	0	0	0	0											4.4968	0.043514308	4.581918397	-1.39E-17	0.705172699	2.366339482	0.138441161	1.556871853	3.404791544	6.94E-18	1.891030616	0	1.08E-19	1.002981821	5.884468485	10.63595959	0.309436305	0.99135044	-2.78E-17	0.226472144	0	1.395165364	0.339285714	0	0	0	0.319634197	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2896	0	3.7865	4.4968	0.043514308	4.581918397	-1.39E-17	0.705172699	2.366339482	0.138441161	1.556871853	3.404791544	6.94E-18	1.891030616	0	1.08E-19	1.002981821	5.884468485	10.63595959	0.309436305	0.99135044	-2.78E-17	0.226472144	0	1.395165364	0.339285714	0	0	0	0.319634197	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2896	5000	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	"$50/visit - ER, $30/visit - UC"	30% Coinsurance	30% Coinsurance	30% Coinsurance	0%	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$50/trip	Not Covered	Not Covered	Not Covered	30% Coinsurance	$400 allowance / 3 years	Not Covered	Not Covered	$0 											3.5812	0.0274	0.6444	0.4216	0.1003	0.3174	0.0139	0.0596	0.3352	0.1341	0.3539	0	0.0032	0.3514	0.5534	1.4548	0.016	0.0541	0.3566	0.4645	0.0955	0.0725	0.0179	0	0	0	0.0111	0	0	0	0											9.4398	500	2.124	8.078	0.070882953	5.226293716	0.421583696	0.805427071	2.683787068	0.152346361	1.616519261	3.739971542	0.134108731	2.244883575	0	0.003168234	1.354361658	6.437901108	12.09079397	0.325470183	1.045412984	0.356555529	0.690976309	0.095499273	1.46763099	0.357142857	0	0	0	0.330719624	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7295
H3923_013_0	2008	9																					3500											coin	coin	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3500	255.9489356	1.839365283	1627.919226	26.38880569	198.940445	17.48234142	0.835579831	365.7257599	338.448572	9.294403197	24.53500625	0	0.229231588	333.5328354	4134.057318	5202.809645	176.556696	524.6212748	26.07801784	112.1058697	6.688002529	665.9345136	81.42857143	855	389.921777	0	144.1340254	0	0	0	11400											$0/admitUnlimited Days	$0/admitLimited Days	"$0/day for days 1-14, $50/day for days 15-50, $75/day for days 51-100"	$0/visit	$35/trip	"10% Coinsurance for DME/0% for Diabetic Supplies"""	"10% Coinsurance for DME/0% for Diabetic Supplies"""	"$50/visit - ER, $25/visit - UC"	$50/visit	$0/copay	$0/copay - X-Ray	$0 	0%	$25/visit - PT/OT/ST	$15 PCP;	$25 Specialist	$10/visit	$25/visit	0%	$25/visit - OPSA/$25/visit - Diagnostic Hearing Exams	0%	$25/visit - Diagnostic Eye Exams	$35/trip	$5/visit	$25/visit	$20 allowance / year	$25/visit	$400 allowance / 3 years	Not Covered	Not Covered	$0 											1.93E-18	-4.72E-19	29.54739421	1.05E-18	33.39378866	0.078273385	0.095410381	39.01264499	47.7029845	0	0.030401902	0	9.46E-19	23.85198579	14.32210558	23.87417786	9.541253024	23.86055824	0	23.92239013	1.04E-18	23.86035792	35	5	25	0	25	0	0	0	0											0	-8.67E-19	4.008397593	2.78E-17	0.553614598	1.368402041	0.07972299	1.188994103	1.345417249	0	0.745910849	0	2.17E-19	0.662951704	4.934033781	10.3510669	0.140381009	1.043146373	0	0.223486696	6.94E-18	1.324119654	0.2375	0.35625	0.812337035	0	0.30027922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.676	0	3.953	0	-8.67E-19	4.008397593	2.78E-17	0.553614598	1.368402041	0.07972299	1.188994103	1.345417249	0	0.745910849	0	2.17E-19	0.662951704	4.934033781	10.3510669	0.140381009	1.043146373	0	0.223486696	6.94E-18	1.324119654	0.2375	0.35625	0.812337035	0	0.30027922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.676	3500	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	"$50/visit - ER, $25/visit - UC"	25% Coinsurance	25% Coinsurance	25% Coinsurance	0%	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	$35/trip	$5/visit	25% Coinsurance	$20 allowance / year	25% Coinsurance	$400 allowance / 3 years	Not Covered	Not Covered	$0 											2.7201	0.0208	0.4887	0.3197	0.076	0.2407	0.0105	0.0507	0.2542	0.1017	0.2684	0	0.0024	0.2665	0.4264	1.1096	0.0123	0.0415	0.2722	0.3555	0.0724	0.0556	0.0125	0.0187	0.0398	0	0.01	0	0	0	0											7.2469	250	2.623	2.7201	0.020777243	4.497075726	0.319718536	0.629645007	1.609146353	0.090268346	1.239708766	1.59960938	0.101704709	1.014264087	0	0.00240271	0.929429388	5.360415043	11.46065765	0.15266404	1.084632149	0.272176789	0.578982598	0.072424262	1.379689664	0.25	0.375	0.852130032	0	0.310312366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.9229
H3923_014_0	2008	9																					3500											coin	coin	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3500	232.9820465	1.672792522	1616.4873	23.46551345	188.5532743	16.30375347	0.783303833	436.5717197	403.235914	8.760197374	23.09059669	0	0.20908113	396.7854485	3838.125719	4775.012748	158.7627119	471.5060754	19.54865391	102.2389579	6.287318181	618.4466085	81.42857143	855	360.1181413	0	133.2548762	0	0	0	11400											$0/admitUnlimited Days	$0/admitLimited Days	"$0/day for days 1-14, $50/day for days 15-50, $75/day for days 51-100"	$0/visit	$35/trip	"10% Coinsurance for DME/0% for Diabetic Supplies"""	"10% Coinsurance for DME/0% for Diabetic Supplies"""	"$50/visit - ER, $25/visit - UC"	$50/visit	$0/copay	$0/copay - X-Ray	$0 	0%	$25/visit - PT/OT/ST	$15 PCP;	$25 Specialist	$10/visit	$25/visit	0%	$25/visit - OPSA/$25/visit - Diagnostic Hearing Exams	0%	$25/visit - Diagnostic Eye Exams	$35/trip	$5/visit	$25/visit	$20 allowance / year	$25/visit	$400 allowance / 3 years	Not Covered	Not Covered	$0 											-1.24E-18	5.19E-19	29.63081516	0	33.4880409	0.078492787	0.095679542	39.1231583	47.83860892	-7.92E-19	0.038636468	0	5.19E-19	23.91989015	14.36162782	23.93833756	9.56812906	23.92689059	0	23.97181639	0	23.92669246	35	5	25	0	25	0	0	0	0											0	8.67E-19	3.991486368	0	0.52618998	1.279727046	0.074946152	1.423338708	1.607520432	-6.94E-18	0.89213909	0	1.08E-19	0.790922028	4.593477758	9.525488919	0.12658851	0.940139523	0	0.204237794	0	1.233115151	0.2375	0.35625	0.750246128	0	0.277614325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8309	0	3.839	0	8.67E-19	3.991486368	0	0.52618998	1.279727046	0.074946152	1.423338708	1.607520432	-6.94E-18	0.89213909	0	1.08E-19	0.790922028	4.593477758	9.525488919	0.12658851	0.940139523	0	0.204237794	0	1.233115151	0.2375	0.35625	0.750246128	0	0.277614325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8309	3500	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	"$50/visit - ER, $25/visit - UC"	25% Coinsurance	25% Coinsurance	25% Coinsurance	0%	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	$35/trip	$5/visit	25% Coinsurance	$20 allowance / year	25% Coinsurance	$400 allowance / 3 years	Not Covered	Not Covered	$0 											2.7201	0.0208	0.4887	0.3197	0.076	0.2407	0.0105	0.0507	0.2542	0.1017	0.2684	0	0.0024	0.2665	0.4264	1.1096	0.0123	0.0415	0.2722	0.3555	0.0724	0.0556	0.0125	0.0187	0.0398	0	0.01	0	0	0	0											7.2469	250	2.623	2.7201	0.020777243	4.4801645	0.319718536	0.602220389	1.520471359	0.085491508	1.474053371	1.861712564	0.101704709	1.160492328	0	0.00240271	1.057399712	5.019859021	10.63507967	0.138871541	0.981625299	0.272176789	0.559733696	0.072424262	1.28868516	0.25	0.375	0.790039125	0	0.287647472	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0778
H3923_015_0	2008	10																					3500											coin	coin	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3500	219.1016503	1.571933315	1468.073168	24.7955532	209.0159311	18.35477271	0.87338758	491.048213	453.6638049	9.84108399	25.9059873	0	0.185067394	445.9293571	3607.818783	4488.749597	148.347663	440.7275499	18.64256244	95.29479134	7.050848343	581.5103938	81.42857143	855	342.2225121	0	126.7224778	0	0	0	11400											$0/admitUnlimited Days	$0/admitLimited Days	"$0/day for days 1-14, $50/day for days 15-50, $75/day for days 51-100"	$0/visit	$35/trip	"10% Coinsurance for DME/0% for Diabetic Supplies"""	"10% Coinsurance for DME/0% for Diabetic Supplies"""	"$50/visit - ER, $25/visit - UC"	$50/visit	$0/copay	$0/copay - X-Ray	$0 	0%	$25/visit - PT/OT/ST	$15 PCP;	$25 Specialist	$10/visit	$25/visit	0%	$25/visit - OPSA/$25/visit - Diagnostic Hearing Exams	0%	$25/visit - Diagnostic Eye Exams	$35/trip	$5/visit	$25/visit	$20 allowance / year	$25/visit	$400 allowance / 3 years	Not Covered	Not Covered	$0 											-2.33E-18	-5.52E-19	29.68769881	-1.12E-18	33.55202075	0.078642229	0.095862526	39.19049431	47.93018093	7.05E-19	0.038838634	0	5.86E-19	23.96564168	14.38897639	23.98601385	9.586484313	23.97292375	0	23.99770951	0	23.97270749	35	5	25	0	25	0	0	0	0											0	-8.67E-19	3.631976171	-2.78E-17	0.584408905	1.443460247	0.08372514	1.60370185	1.812015687	6.94E-18	1.006153171	0	1.08E-19	0.890581932	4.326068274	8.972267501	0.118511045	0.880460662	0	0.190571393	0	1.161698214	0.2375	0.35625	0.712963567	0	0.264005162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.2763	0	3.763	0	-8.67E-19	3.631976171	-2.78E-17	0.584408905	1.443460247	0.08372514	1.60370185	1.812015687	6.94E-18	1.006153171	0	1.08E-19	0.890581932	4.326068274	8.972267501	0.118511045	0.880460662	0	0.190571393	0	1.161698214	0.2375	0.35625	0.712963567	0	0.264005162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.2763	3500	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	"$50/visit - ER, $25/visit - UC"	25% Coinsurance	25% Coinsurance	25% Coinsurance	0%	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	$35/trip	$5/visit	25% Coinsurance	$20 allowance / year	25% Coinsurance	$400 allowance / 3 years	Not Covered	Not Covered	$0 											2.7201	0.0208	0.4887	0.3197	0.076	0.2407	0.0105	0.0507	0.2542	0.1017	0.2684	0	0.0024	0.2665	0.4264	1.1096	0.0123	0.0415	0.2722	0.3555	0.0724	0.0556	0.0125	0.0187	0.0398	0	0.01	0	0	0	0											7.2469	250	2.623	2.7201	0.020777243	4.120654304	0.319718536	0.660439314	1.68420456	0.094270496	1.654416513	2.066207819	0.101704709	1.274506409	0	0.00240271	1.157059616	4.752449536	10.08185825	0.130794076	0.921946438	0.272176789	0.546067295	0.072424262	1.217268224	0.25	0.375	0.752756564	0	0.274038309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5232
H3923_016_0	2008	10																					3500											coin	coin	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3500	210.8518131	1.505584664	1386.835945	20.97050331	189.6324771	16.148703	0.77503724	495.8606497	457.4751341	8.652922666	22.77959145	0	0.189253642	449.6911408	3891.962722	4749.757218	150.0505264	445.5713216	19.62151737	101.4260418	6.199322073	627.026501	81.42857143	855	367.212557	0	135.8445337	0	0	0	11400											$0/admitUnlimited Days	$0/admitLimited Days	"$0/day for days 1-14, $50/day for days 15-50, $75/day for days 51-100"	$0/visit	$35/trip	"10% Coinsurance for DME/0% for Diabetic Supplies"""	"10% Coinsurance for DME/0% for Diabetic Supplies"""	"$50/visit - ER, $25/visit - UC"	$50/visit	$0/copay	$0/copay - X-Ray	$0 	0%	$25/visit - PT/OT/ST	$15 PCP;	$25 Specialist	$10/visit	$25/visit	0%	$25/visit - OPSA/$25/visit - Diagnostic Hearing Exams	0%	$25/visit - Diagnostic Eye Exams	$35/trip	$5/visit	$25/visit	$20 allowance / year	$25/visit	$400 allowance / 3 years	Not Covered	Not Covered	$0 											1.85E-18	-5.76E-19	29.64242589	-1.32E-18	33.50102516	0.078520611	0.095716527	39.13919101	47.85775507	-8.02E-19	0.044478409	0	-5.73E-19	23.92951027	14.36714103	23.94797655	9.571864774	23.9360903	0	23.96481968	-5.60E-19	23.93588492	35	5	25	0	25	0	0	0	0											0	-8.67E-19	3.425765142	-2.78E-17	0.529406866	1.268006031	0.074183873	1.617298724	1.824477743	-6.94E-18	1.013199983	0	-1.08E-19	0.896740731	4.659698108	9.478922872	0.119688612	0.888769616	0	0.202554734	-3.47E-18	1.250702847	0.2375	0.35625	0.76502616	0	0.283009445	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8912	0	3.8295	0	-8.67E-19	3.425765142	-2.78E-17	0.529406866	1.268006031	0.074183873	1.617298724	1.824477743	-6.94E-18	1.013199983	0	-1.08E-19	0.896740731	4.659698108	9.478922872	0.119688612	0.888769616	0	0.202554734	-3.47E-18	1.250702847	0.2375	0.35625	0.76502616	0	0.283009445	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8912	3500	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	"$50/visit - ER, $25/visit - UC"	25% Coinsurance	25% Coinsurance	25% Coinsurance	0%	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	25% Coinsurance	$35/trip	$5/visit	25% Coinsurance	$20 allowance / year	25% Coinsurance	$400 allowance / 3 years	Not Covered	Not Covered	$0 											2.7201	0.0208	0.4887	0.3197	0.076	0.2407	0.0105	0.0507	0.2542	0.1017	0.2684	0	0.0024	0.2665	0.4264	1.1096	0.0123	0.0415	0.2722	0.3555	0.0724	0.0556	0.0125	0.0187	0.0398	0	0.01	0	0	0	0											7.2469	250	2.623	2.7201	0.020777243	3.914443275	0.319718536	0.605437275	1.508750344	0.084729229	1.668013387	2.078669875	0.101704709	1.281553221	0	0.00240271	1.163218415	5.086079371	10.58851362	0.131971643	0.930255391	0.272176789	0.558050635	0.072424262	1.306272857	0.25	0.375	0.804819158	0	0.293042592	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1381
H3923_017_0	2008	9																					2500											coin	coin	D	coin	coin	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	2500	288.2017794	2.071148865	1851.344259	29.71413316	6.285321487	19.67156024	0.940070764	421.4958218	26.44131713	10.46561703	27.60625043	0	0.258117704	375.4116491	4784.56592	6093.382276	198.9972743	620.7731617	29.78163049	125.9683873	7.530776499	787.2242438	81.42857143	855	444.9718909	0	169.4909013	0	0	0	11400											$0/admitUnlimited Days	$0/admitLimited Days	"$0/day for days 1-14, $25/day for days 15-50, $50/day for days 51-100"	$0/visit	0%/trip	5% Coinsurance for DME/0% for Diabetic Supplies	5% Coinsurance for DME/0% for Diabetic Supplies	"$50/visit - ER, $15/visit - UC"	0% Coinsurance	$0/copay	$0/copay - X-Ray	$0 	0%	$15/visit - PT/OT/ST	$10 PCP;	$15 Specialist	$10/visit	$15/visit	0%	$25/visit - OPSA/$15/visit - Diagnostic Hearing Exams	0%	$15/visit - Diagnostic Eye Exams	$0/trip	$5/visit	$20/visit	$40 allowance / 2 years	$15/visit	$400 allowance / 3 years	Not Covered	Not Covered	$0 											-3.70E-19	0	16.36776858	0	0	0.039354385	0.047977902	35.30193405	0	0	-5.03E-19	0	0	14.39332304	9.653745289	14.39915111	9.596504758	14.39633179	0	15.8820269	4.61E-19	14.39626968	0	5	20	0	15	0	0	0	0											0	0	2.525197867	0	0	0.774162151	0.045102623	1.239968142	0	0	-1.39E-17	0	0	0.450285095	3.849081726	7.31162768	0.159139857	0.744738033	0	0.166719443	3.47E-18	0.944424376	0	0.35625	0.741619818	0	0.211863627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.5202	0	3.83	0	0	2.525197867	0	0	0.774162151	0.045102623	1.239968142	0	0	-1.39E-17	0	0	0.450285095	3.849081726	7.31162768	0.159139857	0.744738033	0	0.166719443	3.47E-18	0.944424376	0	0.35625	0.741619818	0	0.211863627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.5202	2500	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"$50/visit - ER, $15/visit - UC"	20% Coinsurance	20% Coinsurance	20% Coinsurance	0%	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$0/trip	$5/visit	20% Coinsurance	$40 allowance / 2 years	20% Coinsurance	$400 allowance / 3 years	Not Covered	Not Covered	$0 											2.1627	0.0165	0.388	0.2538	0.0604	0.1911	0.0084	0.0454	0.2018	0.0807	0.213	0	0.0019	0.2116	0.3438	0.8866	0.01	0.0333	0.2183	0.2855	0.0575	0.0451	0	0.0187	0.0364	0	0.0092	0	0	0	0											5.7797	200	3.07	2.1627	0.016512048	2.913156841	0.253822847	0.060360138	0.965287782	0.053474525	1.285388488	0.201801783	0.080742828	0.21304421	0	0.001907498	0.661840313	4.192908474	8.198249138	0.169130272	0.778059278	0.218310212	0.452179091	0.057497236	0.989488988	0	0.375	0.777976016	0	0.221029666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2999
H3923_018_0	2008	8																					2500											coin	coin	D	coin	coin	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	2500	262.4826119	1.88460423	1839.431917	26.4367549	5.869954302	18.35651893	0.881805216	503.8549782	24.91468541	9.869427803	25.99033316	0	0.235555323	446.8214272	4444.821061	5601.357005	179.0480798	558.2529158	22.3348653	116.4291944	7.083428628	731.5278102	81.42857143	855	410.9049008	0	156.6409971	0	0	0	11400											$0/admitUnlimited Days	$0/admitLimited Days	"$0/day for days 1-14, $25/day for days 15-50, $50/day for days 51-100"	$0/visit	0%/trip	5% Coinsurance for DME/0% for Diabetic Supplies	5% Coinsurance for DME/0% for Diabetic Supplies	"$50/visit - ER, $15/visit - UC"	0% Coinsurance	$0/copay	$0/copay - X-Ray	$0 	0%	$15/visit - PT/OT/ST	$10 PCP;	$15 Specialist	$10/visit	$15/visit	0%	$25/visit - OPSA/$15/visit - Diagnostic Hearing Exams	0%	$15/visit - Diagnostic Eye Exams	$0/trip	$5/visit	$20/visit	$40 allowance / 2 years	$15/visit	$400 allowance / 3 years	Not Covered	Not Covered	$0 											4.46E-19	0	16.43614091	0	0	0.039518611	0.048178284	35.46034936	-5.57E-19	7.03E-19	5.34E-19	0	0	14.45365844	9.69297942	14.4584635	9.636456706	14.45606516	-6.21E-19	15.90780322	-4.90E-19	14.45600425	0	5	20	0	15	0	0	0	0											0	0	2.519430182	0	0	0.725424132	0.042483862	1.48890613	-1.39E-17	6.94E-18	1.39E-17	0	0	0.538183691	3.590296589	6.748917982	0.143782422	0.672511711	-1.39E-17	0.154344393	-3.47E-18	0.881247428	0	0.35625	0.684841501	0	0.195801246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.7424	0	3.7255	0	0	2.519430182	0	0	0.725424132	0.042483862	1.48890613	-1.39E-17	6.94E-18	1.39E-17	0	0	0.538183691	3.590296589	6.748917982	0.143782422	0.672511711	-1.39E-17	0.154344393	-3.47E-18	0.881247428	0	0.35625	0.684841501	0	0.195801246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.7424	2500	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"$50/visit - ER, $15/visit - UC"	20% Coinsurance	20% Coinsurance	20% Coinsurance	0%	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$0/trip	$5/visit	20% Coinsurance	$40 allowance / 2 years	20% Coinsurance	$400 allowance / 3 years	Not Covered	Not Covered	$0 											2.1627	0.0165	0.388	0.2538	0.0604	0.1911	0.0084	0.0454	0.2018	0.0807	0.213	0	0.0019	0.2116	0.3438	0.8866	0.01	0.0333	0.2183	0.2855	0.0575	0.0451	0	0.0187	0.0364	0	0.0092	0	0	0	0											5.7797	200	3.07	2.1627	0.016512048	2.907389156	0.253822847	0.060360138	0.916549763	0.050855764	1.534326475	0.201801783	0.080742828	0.21304421	0	0.001907498	0.749738909	3.934123337	7.635539441	0.153772837	0.705832955	0.218310212	0.439804041	0.057497236	0.92631204	0	0.375	0.721197699	0	0.204967286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.5222
H3923_019_0	2008	9																					2500											coin	coin	D	coin	coin	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	2500	246.9317041	1.771598579	1670.996628	27.94505745	6.60119998	20.67379776	0.983606346	567.0921135	27.98875411	11.0910878	29.17003668	0	0.208574454	502.3602996	4179.105269	5257.010509	167.3800867	521.8444596	21.30799607	109.5463411	7.946439446	687.8643043	81.42857143	855	390.4493354	0	148.9252565	0	0	0	11400											$0/admitUnlimited Days	$0/admitLimited Days	"$0/day for days 1-14, $25/day for days 15-50, $50/day for days 51-100"	$0/visit	0%/trip	5% Coinsurance for DME/0% for Diabetic Supplies	5% Coinsurance for DME/0% for Diabetic Supplies	"$50/visit - ER, $15/visit - UC"	0% Coinsurance	$0/copay	$0/copay - X-Ray	$0 	0%	$15/visit - PT/OT/ST	$10 PCP;	$15 Specialist	$10/visit	$15/visit	0%	$25/visit - OPSA/$15/visit - Diagnostic Hearing Exams	0%	$15/visit - Diagnostic Eye Exams	$0/trip	$5/visit	$20/visit	$40 allowance / 2 years	$15/visit	$400 allowance / 3 years	Not Covered	Not Covered	$0 											-4.53E-19	0	16.49699252	0	0	0.039664732	0.048356463	35.57896466	0	0	4.76E-19	0	0	14.50709681	9.728896156	14.5118388	9.672087841	14.50947028	0	15.95858151	-4.37E-19	14.50940796	0	5	20	0	15	0	0	0	0											0	0	2.297201573	0	0	0.820020658	0.047563724	1.681379189	0	0	1.39E-17	0	0	0.607315792	3.388173432	6.357407424	0.134909575	0.63097389	0	0.145683684	-3.47E-18	0.831708651	0	0.35625	0.650748892	0	0.186156571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1355	0	3.64	0	0	2.297201573	0	0	0.820020658	0.047563724	1.681379189	0	0	1.39E-17	0	0	0.607315792	3.388173432	6.357407424	0.134909575	0.63097389	0	0.145683684	-3.47E-18	0.831708651	0	0.35625	0.650748892	0	0.186156571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1355	2500	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"$50/visit - ER, $15/visit - UC"	20% Coinsurance	20% Coinsurance	20% Coinsurance	0%	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$0/trip	$5/visit	20% Coinsurance	$40 allowance / 2 years	20% Coinsurance	$400 allowance / 3 years	Not Covered	Not Covered	$0 											2.1627	0.0165	0.388	0.2538	0.0604	0.1911	0.0084	0.0454	0.2018	0.0807	0.213	0	0.0019	0.2116	0.3438	0.8866	0.01	0.0333	0.2183	0.2855	0.0575	0.0451	0	0.0187	0.0364	0	0.0092	0	0	0	0											5.7797	200	3.07	2.1627	0.016512048	2.685160547	0.253822847	0.060360138	1.011146289	0.055935626	1.726799534	0.201801783	0.080742828	0.21304421	0	0.001907498	0.81887101	3.73200018	7.244028882	0.14489999	0.664295134	0.218310212	0.431143333	0.057497236	0.876773263	0	0.375	0.68710509	0	0.19532261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.9152
H3923_020_0	2008	9																					2500											coin	coin	D	coin	coin	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	2500	237.7340854	1.697537184	1579.236346	23.64410982	5.818564154	18.19802178	0.87329153	573.3273891	24.61976346	9.756115566	25.65820551	0	0.213382284	506.8180375	4512.034509	5574.546044	169.3801954	528.0356857	22.43541499	117.0683165	6.989696419	742.5409288	81.42857143	855	419.0141595	0	159.6997703	0	0	0	11400											$0/admitUnlimited Days	$0/admitLimited Days	"$0/day for days 1-14, $25/day for days 15-50, $50/day for days 51-100"	$0/visit	0%/trip	5% Coinsurance for DME/0% for Diabetic Supplies	5% Coinsurance for DME/0% for Diabetic Supplies	"$50/visit - ER, $15/visit - UC"	0% Coinsurance	$0/copay	$0/copay - X-Ray	$0 	0%	$15/visit - PT/OT/ST	$10 PCP;	$15 Specialist	$10/visit	$15/visit	0%	$25/visit - OPSA/$15/visit - Diagnostic Hearing Exams	0%	$15/visit - Diagnostic Eye Exams	$0/trip	$5/visit	$20/visit	$40 allowance / 2 years	$15/visit	$400 allowance / 3 years	Not Covered	Not Covered	$0 											4.71E-19	0	16.45049873	0	0	0.03955272	0.048220251	35.50314959	5.64E-19	0	5.41E-19	0	0	14.46638825	9.701530667	14.47109081	9.644871755	14.4686972	-6.19E-19	15.83716228	-4.96E-19	14.4686329	0	5	20	0	15	0	0	0	0											0	0	2.164935458	0	0	0.719781256	0.042110337	1.696244005	1.39E-17	0	1.39E-17	0	0	0.610985542	3.64780343	6.722480168	0.136137522	0.636665704	-1.39E-17	0.154502494	-3.47E-18	0.895296009	0	0.35625	0.698356932	0	0.199624713	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.6812	0	3.7065	0	0	2.164935458	0	0	0.719781256	0.042110337	1.696244005	1.39E-17	0	1.39E-17	0	0	0.610985542	3.64780343	6.722480168	0.136137522	0.636665704	-1.39E-17	0.154502494	-3.47E-18	0.895296009	0	0.35625	0.698356932	0	0.199624713	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.6812	2500	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"$50/visit - ER, $15/visit - UC"	20% Coinsurance	20% Coinsurance	20% Coinsurance	0%	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$0/trip	$5/visit	20% Coinsurance	$40 allowance / 2 years	20% Coinsurance	$400 allowance / 3 years	Not Covered	Not Covered	$0 											2.1627	0.0165	0.388	0.2538	0.0604	0.1911	0.0084	0.0454	0.2018	0.0807	0.213	0	0.0019	0.2116	0.3438	0.8866	0.01	0.0333	0.2183	0.2855	0.0575	0.0451	0	0.0187	0.0364	0	0.0092	0	0	0	0											5.7797	200	3.07	2.1627	0.016512048	2.552894432	0.253822847	0.060360138	0.910906887	0.050482239	1.741664351	0.201801783	0.080742828	0.21304421	0	0.001907498	0.82254076	3.991630178	7.609101626	0.146127936	0.669986948	0.218310212	0.439962142	0.057497236	0.940360622	0	0.375	0.73471313	0	0.208790753	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.4609
H3923_021_0	2008	11																					5000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	270.6257881	2.632240013	854.094871	25.7928793	193.8547852	17.04959661	0.814499403	339.742473	330.1319269	9.084511919	23.96046499	0	0.224054956	325.3200494	4187.353453	4255.389175	158.1414848	506.8574375	25.48910983	101.9841551	6.536970411	643.5484092	81.42857143	0	0	0	0	0	0	0	11400											$500/admitUnlimited Days	$500/admitLimited Days	"$0/day for days 1-14, $75/day for days 15-50, $100/day for days 51-100"	$0/visit	$100/trip	20% Coinsurance for DME/0% for Diabetic Supplies	20% Coinsurance for DME/0% for Diabetic Supplies	"$50/visit - ER, $50/visit - UC"	$250/visit	$0/copay	0% Coinsurance - X-Ray	$0 	0%	$50/visit - PT/OT/ST	$30 PCP;	$50 Specialist	$50/visit	$50/visit	0%	$50/visit - OPSA/$30/visit - Diagnostic Hearing Exams	0%	$50/visit - Diagnostic Eye Exams	$50/trip	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											450.8789694	450.878332	90.1741516	-5.38E-19	90.17061935	0.147881398	0.180346098	45.09893424	225.4255368	0	0.057374227	0	-4.84E-19	45.08696367	25.35675646	42.05295687	45.07814621	45.07703039	0	29.86690729	0	45.07740931	50	0	0	0	0	0	0	0	0											10.1683	0.098901666	6.418106698	-1.39E-17	1.45666717	2.521318183	0.146891789	1.276835287	6.201680569	0	1.374713169	0	-1.08E-19	1.222307771	8.84814181	14.91264146	0.594060415	1.903969009	0	0.253829275	0	2.417457921	0.339285714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1551	0	9.2385	10.1683	0.098901666	6.418106698	-1.39E-17	1.45666717	2.521318183	0.146891789	1.276835287	6.201680569	0	1.374713169	0	-1.08E-19	1.222307771	8.84814181	14.91264146	0.594060415	1.903969009	0	0.253829275	0	2.417457921	0.339285714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1551	5000	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	"$50/visit - ER, $50/visit - UC"	30% Coinsurance	30% Coinsurance	30% Coinsurance	0%	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$50/trip	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											4.0986	0.0313	0.7375	0.4825	0.1147	0.3633	0.0159	0.0743	0.3836	0.1535	0.405	0	0.0036	0.4021	0.6319	1.6632	0.0184	0.0619	0.4081	0.5316	0.1093	0.0829	0.0179	0	0	0	0	0	0	0	0											10.7909	1000	2.3985	14.2669	0.130224112	7.155571486	0.482487646	1.571404757	2.88462573	0.1628058	1.351118884	6.585282236	0.153482704	1.77968538	0	0.003625932	1.624449581	9.48000746	16.57579542	0.612410622	1.96584168	0.408065207	0.785437883	0.109295545	2.500392271	0.357142857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.946
H3923_022_0	2008	10																					5000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	247.7718831	2.401502018	847.9413544	22.93275242	183.6365065	15.89609029	0.763323385	403.9121344	392.7703992	8.561305847	22.53958579	0	0.204334152	386.662081	3886.444126	4426.08212	142.090099	455.0362136	19.10482126	93.89646797	6.144570905	597.0388178	81.42857143	0	0	0	0	0	0	0	11400											$500/admitUnlimited Days	$500/admitLimited Days	"$0/day for days 1-14, $75/day for days 15-50, $100/day for days 51-100"	$0/visit	$100/trip	20% Coinsurance for DME/0% for Diabetic Supplies	20% Coinsurance for DME/0% for Diabetic Supplies	"$50/visit - ER, $50/visit - UC"	$250/visit	$0/copay	0% Coinsurance - X-Ray	$0 	0%	$50/visit - PT/OT/ST	$30 PCP;	$50 Specialist	$50/visit	$50/visit	0%	$50/visit - OPSA/$30/visit - Diagnostic Hearing Exams	0%	$50/visit - Diagnostic Eye Exams	$50/trip	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											453.4912001	453.4901706	90.69556585	-6.05E-19	90.68956628	0.148728312	0.181387516	45.35238984	226.7112236	-8.10E-19	0.073079823	0	-5.31E-19	45.34687273	25.50004628	43.33722802	45.33372436	45.33192109	1.45E-18	29.96610958	0	45.33258224	50	0	0	0	0	0	0	0	0											9.3635	0.090754797	6.408710079	-1.39E-17	1.387826261	2.364198681	0.138457333	1.526531715	7.420454816	-6.94E-18	1.64718895	0	-1.08E-19	1.461159681	8.258708756	15.98451084	0.536789449	1.718972144	2.78E-17	0.234475987	0	2.255442609	0.339285714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.137	0	8.697	9.3635	0.090754797	6.408710079	-1.39E-17	1.387826261	2.364198681	0.138457333	1.526531715	7.420454816	-6.94E-18	1.64718895	0	-1.08E-19	1.461159681	8.258708756	15.98451084	0.536789449	1.718972144	2.78E-17	0.234475987	0	2.255442609	0.339285714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.137	5000	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	"$50/visit - ER, $50/visit - UC"	30% Coinsurance	30% Coinsurance	30% Coinsurance	0%	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$50/trip	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											4.0986	0.0313	0.7375	0.4825	0.1147	0.3633	0.0159	0.0743	0.3836	0.1535	0.405	0	0.0036	0.4021	0.6319	1.6632	0.0184	0.0619	0.4081	0.5316	0.1093	0.0829	0.0179	0	0	0	0	0	0	0	0											10.7909	1000	2.3985	13.4621	0.122077243	7.146174867	0.482487646	1.502563848	2.727506228	0.154371343	1.600815311	7.804056483	0.153482704	2.052161161	0	0.003625932	1.863301491	8.890574406	17.6476648	0.555139656	1.780844815	0.408065207	0.766084595	0.109295545	2.338376959	0.357142857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9279
H3923_023_0	2008	10																					5000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	264.3347252	2.56931656	769.6867145	24.22104159	203.41153	17.88462423	0.850548674	453.7587578	441.4269024	9.613066614	25.27366502	0	0.180779393	434.2622932	3646.856232	4219.825928	132.4730303	423.9602607	18.21061529	87.20915246	6.887480573	559.6487291	81.42857143	0	0	0	0	0	0	0	11400											$500/admitUnlimited Days	$500/admitLimited Days	"$0/day for days 1-14, $75/day for days 15-50, $100/day for days 51-100"	$0/visit	$100/trip	20% Coinsurance for DME/0% for Diabetic Supplies	20% Coinsurance for DME/0% for Diabetic Supplies	"$50/visit - ER, $50/visit - UC"	$250/visit	$0/copay	0% Coinsurance - X-Ray	$0 	0%	$50/visit - PT/OT/ST	$30 PCP;	$50 Specialist	$50/visit	$50/visit	0%	$50/visit - OPSA/$30/visit - Diagnostic Hearing Exams	0%	$50/visit - Diagnostic Eye Exams	$50/trip	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											454.1916568	454.1900218	90.83452989	0	90.82716584	0.148949759	0.181665102	45.41833532	227.0499758	-7.22E-19	0.073422457	0	-6.00E-19	45.41625579	25.53441227	43.06210148	45.39541819	45.39231105	0	29.96145012	0	45.39349548	50	0	0	0	0	0	0	0	0											10.0049	0.097246495	5.826177572	0	1.539607731	2.663910467	0.154515011	1.717413952	8.352163959	-6.94E-18	1.855654594	0	-1.08E-19	1.643547282	7.760027541	15.14288103	0.501139051	1.603711335	0	0.217742723	0	2.117034338	0.339285714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5369	0	8.602	10.0049	0.097246495	5.826177572	0	1.539607731	2.663910467	0.154515011	1.717413952	8.352163959	-6.94E-18	1.855654594	0	-1.08E-19	1.643547282	7.760027541	15.14288103	0.501139051	1.603711335	0	0.217742723	0	2.117034338	0.339285714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5369	5000	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	"$50/visit - ER, $50/visit - UC"	30% Coinsurance	30% Coinsurance	30% Coinsurance	0%	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$50/trip	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											4.0986	0.0313	0.7375	0.4825	0.1147	0.3633	0.0159	0.0743	0.3836	0.1535	0.405	0	0.0036	0.4021	0.6319	1.6632	0.0184	0.0619	0.4081	0.5316	0.1093	0.0829	0.0179	0	0	0	0	0	0	0	0											10.7909	1000	2.3985	14.1035	0.128568942	6.56364236	0.482487646	1.654345317	3.027218014	0.170429022	1.791697548	8.735765626	0.153482704	2.260626806	0	0.003625932	2.045689092	8.391893191	16.80603499	0.519489259	1.665584006	0.408065207	0.74935133	0.109295545	2.199968687	0.357142857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3279
H3923_024_0	2008	10																					5000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	234.9526427	2.272978797	727.5184883	20.49178298	184.5431635	15.73948873	0.754971116	456.89213	444.6345254	8.455391402	22.22531322	0	0.184933309	437.8015524	3933.379944	4464.511389	133.9046934	428.5044844	19.17359206	92.8915084	6.057802268	603.3099202	81.42857143	0	0	0	0	0	0	0	11400											$500/admitUnlimited Days	$500/admitLimited Days	"$0/day for days 1-14, $75/day for days 15-50, $100/day for days 51-100"	$0/visit	$100/trip	20% Coinsurance for DME/0% for Diabetic Supplies	20% Coinsurance for DME/0% for Diabetic Supplies	"$50/visit - ER, $50/visit - UC"	$250/visit	$0/copay	0% Coinsurance - X-Ray	$0 	0%	$50/visit - PT/OT/ST	$30 PCP;	$50 Specialist	$50/visit	$50/visit	0%	$50/visit - OPSA/$30/visit - Diagnostic Hearing Exams	0%	$50/visit - Diagnostic Eye Exams	$50/trip	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											454.7794865	454.7776348	90.95121807	6.77E-19	90.94119588	0.149134222	0.181897101	45.46968315	227.3152889	0	0.084272454	0	0	45.47332462	25.56424624	43.31297751	45.44931429	45.44564964	-1.45E-18	29.84791624	-1.15E-18	45.44703996	50	0	0	0	0	0	0	0	0											8.9043	0.08614166	5.514057723	1.39E-17	1.398547998	2.347296404	0.137327058	1.731228365	8.422685466	0	1.872981697	0	0	1.659024343	8.379491121	16.11427345	0.507156375	1.622805389	-2.78E-17	0.231051497	-6.94E-18	2.284887504	0.339285714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5525	0	8.526	8.9043	0.08614166	5.514057723	1.39E-17	1.398547998	2.347296404	0.137327058	1.731228365	8.422685466	0	1.872981697	0	0	1.659024343	8.379491121	16.11427345	0.507156375	1.622805389	-2.78E-17	0.231051497	-6.94E-18	2.284887504	0.339285714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5525	5000	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	"$50/visit - ER, $50/visit - UC"	30% Coinsurance	30% Coinsurance	30% Coinsurance	0%	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$50/trip	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											4.0986	0.0313	0.7375	0.4825	0.1147	0.3633	0.0159	0.0743	0.3836	0.1535	0.405	0	0.0036	0.4021	0.6319	1.6632	0.0184	0.0619	0.4081	0.5316	0.1093	0.0829	0.0179	0	0	0	0	0	0	0	0											10.7909	1000	2.3985	13.0029	0.117464107	6.251522511	0.482487646	1.513285585	2.710603951	0.153241068	1.805511962	8.806287133	0.153482704	2.277953908	0	0.003625932	2.061166152	9.011356771	17.77742741	0.525506582	1.68467806	0.408065207	0.762660104	0.109295545	2.367821854	0.357142857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3435
H3923_801_0	2008	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	221.6710825	1.597035374	44.10901272	23.18215711	5.358248495	16.74626509	0.801059412	4.956204397	23.18151822	9.184177136	24.17559822	0	0.197459974	24.27515835	35.46787326	90.59974642	1.015242621	3.398795061	19.9958838	27.18012228	6.587701245	4.92492381	0	0	0	0	0	0	0	0	0											Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.080086594	0.080086594	0.202985124	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											17.7529	0.127901124	8.953473396	0	1.253830148	3.918626031	0.187447902	1.159751829	5.424475263	2.14909745	5.657089982	0	0.046205634	5.680387053	8.299482342	21.20034066	0.237566773	0.795318044	4.679036808	6.360148614	1.541522091	1.152432172	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.577	0	0	17.7529	0.127901124	8.953473396	0	1.253830148	3.918626031	0.187447902	1.159751829	5.424475263	2.14909745	5.657089982	0	0.046205634	5.680387053	8.299482342	21.20034066	0.237566773	0.795318044	4.679036808	6.360148614	1.541522091	1.152432172	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.577	none	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											1.1275	0.0086	0.5133	0	0.0921	0.2915	0.0128	0.0626	0.3078	0.1232	0.325	0	0.0029	0.3227	0.5064	1.3466	0.015	0.0504	0.3304	0.4318	0.0877	0.0677	0	0	0	0	0	0	0	0	0											6.0259	0	0	18.8804	0.136542308	9.466789366	0	1.345896481	4.210146835	0.200217428	1.222362384	5.732280226	2.272253167	5.982042837	0	0.04911511	6.003068772	8.805913091	22.54689435	0.252538002	0.845742133	5.009476339	6.791973535	1.629221687	1.220090207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.6029
H3923_802_0	2008	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	221.6710825	1.597035374	44.10901272	23.18215711	5.358248495	16.74626509	0.801059412	4.956204397	23.18151822	9.184177136	24.17559822	0	0.197459974	24.27515835	35.46787326	90.59974642	1.015242621	3.398795061	19.9958838	27.18012228	6.587701245	4.92492381	0	0	0	0	0	0	0	0	0											Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.080086594	0.080086594	0.202985124	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											17.7529	0.127901124	8.953473396	0	1.253830148	3.918626031	0.187447902	1.159751829	5.424475263	2.14909745	5.657089982	0	0.046205634	5.680387053	8.299482342	21.20034066	0.237566773	0.795318044	4.679036808	6.360148614	1.541522091	1.152432172	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.577	0	0	17.7529	0.127901124	8.953473396	0	1.253830148	3.918626031	0.187447902	1.159751829	5.424475263	2.14909745	5.657089982	0	0.046205634	5.680387053	8.299482342	21.20034066	0.237566773	0.795318044	4.679036808	6.360148614	1.541522091	1.152432172	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.577	none	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											1.1275	0.0086	0.5133	0	0.0921	0.2915	0.0128	0.0626	0.3078	0.1232	0.325	0	0.0029	0.3227	0.5064	1.3466	0.015	0.0504	0.3304	0.4318	0.0877	0.0677	0	0	0	0	0	0	0	0	0											6.0259	0	0	18.8804	0.136542308	9.466789366	0	1.345896481	4.210146835	0.200217428	1.222362384	5.732280226	2.272253167	5.982042837	0	0.04911511	6.003068772	8.805913091	22.54689435	0.252538002	0.845742133	5.009476339	6.791973535	1.629221687	1.220090207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.6029
H3923_803_0	2008	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	221.6710825	1.597035374	44.10901272	23.18215711	5.358248495	16.74626509	0.801059412	4.956204397	23.18151822	9.184177136	24.17559822	0	0.197459974	24.27515835	35.46787326	90.59974642	1.015242621	3.398795061	19.9958838	27.18012228	6.587701245	4.92492381	0	0	0	0	0	0	0	0	0											Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.080086594	0.080086594	0.202985124	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											17.7529	0.127901124	8.953473396	0	1.253830148	3.918626031	0.187447902	1.159751829	5.424475263	2.14909745	5.657089982	0	0.046205634	5.680387053	8.299482342	21.20034066	0.237566773	0.795318044	4.679036808	6.360148614	1.541522091	1.152432172	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.577	0	0	17.7529	0.127901124	8.953473396	0	1.253830148	3.918626031	0.187447902	1.159751829	5.424475263	2.14909745	5.657089982	0	0.046205634	5.680387053	8.299482342	21.20034066	0.237566773	0.795318044	4.679036808	6.360148614	1.541522091	1.152432172	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.577	none	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											1.1275	0.0086	0.5133	0	0.0921	0.2915	0.0128	0.0626	0.3078	0.1232	0.325	0	0.0029	0.3227	0.5064	1.3466	0.015	0.0504	0.3304	0.4318	0.0877	0.0677	0	0	0	0	0	0	0	0	0											6.0259	0	0	18.8804	0.136542308	9.466789366	0	1.345896481	4.210146835	0.200217428	1.222362384	5.732280226	2.272253167	5.982042837	0	0.04911511	6.003068772	8.805913091	22.54689435	0.252538002	0.845742133	5.009476339	6.791973535	1.629221687	1.220090207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.6029
H3924_001_0	2008	2																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1132.576976	61.72288921	909.2557572	833.555397	144.3489724	10.35714813	7.939345625	316.6133638	312.4720939	57.52910697	1736.864928	31.55767299	1.459663652	806.0107378	3236.060594	3291.308072	133.3537927	0	1435.599539	182.5508565	15.73036423	1.332178074	0	0	920.5209762	3.558579157	1.284342397	0.743953451	0	4.148382997	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											9.4381	0.257178705	1.894282828	1.041944246	1.202908103	2.019643885	1.548172397	1.319222349	1.301967058	1.060259607	2.605297392	0.065745152	3.11E-08	1.34335123	5.393434323	5.485513453	0.222256321	0	0.933139701	0.304251428	0.482747594	3.52E-10	0	0	1.534201627	0	0.002140571	0	0	5.63E-09	0	0	0	0	0	0	0	0	0	0	0	39.4558	None	0.091482469	9.4381	0.257178705	1.894282828	1.041944246	1.202908103	2.019643885	1.548172397	1.319222349	1.301967058	1.060259607	2.605297392	0.065745152	3.11E-08	1.34335123	5.393434323	5.485513453	0.222256321	0	0.933139701	0.304251428	0.482747594	3.52E-10	0	0	1.534201627	0	0.002140571	0	0	5.63E-09	0	0	0	0	0	0	0	0	0	0	0	39.4558	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											2.7395	0.0276	0.3763	0.1058	0.1475	0.1168	0.0895	0.1958	0.5523	0.6488	0.5298	0.0307	0.0165	0.2901	0.4101	1.414	0.0229	0	0.2163	0.0623	0.1774	0.015	0	0	0.1131	0.0401	0.003	0.0084	0	0.0468	0											8.3963	250	0	12.1777	0.284824455	2.270604537	1.147766124	1.350364676	2.136443682	1.637706112	1.515071494	1.85422114	1.709027772	3.135056213	0.096467943	0.016460973	1.633444402	5.803485729	6.899477351	0.245154927	0	1.149437324	0.366516602	0.66014231	0.01502326	0	0	1.647350803	0.040130866	0.005117581	0.008389724	0	0.046782217	0	0	0	0	0	0	0	0	0	0	0	47.8521
H3924_002_0	2008	2																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1132.576976	61.72288921	909.2557572	833.555397	144.3489724	10.35714813	7.939345625	316.6133638	312.4720939	57.52910697	1736.864928	31.55767299	1.459663652	806.0107378	3236.059151	3291.308072	133.3537927	0	1435.599539	182.5508565	15.73036423	1.332178074	0	0	920.5209762	3.558579157	1.284342397	0.743953451	0	4.148382997	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											9.4381	0.257178705	1.894282828	1.041944246	1.202908103	2.019643885	1.548172397	1.319222349	1.301967058	1.060259607	2.605297392	0.065745152	3.11E-08	1.34335123	5.393431919	5.485513453	0.222256321	0	0.933139701	0.304251428	0.482747594	3.52E-10	0	0	1.534201627	0	0.002140571	0	0	5.63E-09	0	0	0	0	0	0	0	0	0	0	0	39.4558	None	0.091482469	9.4381	0.257178705	1.894282828	1.041944246	1.202908103	2.019643885	1.548172397	1.319222349	1.301967058	1.060259607	2.605297392	0.065745152	3.11E-08	1.34335123	5.393431919	5.485513453	0.222256321	0	0.933139701	0.304251428	0.482747594	3.52E-10	0	0	1.534201627	0	0.002140571	0	0	5.63E-09	0	0	0	0	0	0	0	0	0	0	0	39.4558	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											2.7395	0.0276	0.3763	0.1058	0.1475	0.1168	0.0895	0.1958	0.5523	0.6488	0.5298	0.0307	0.0165	0.2901	0.4101	1.414	0.0229	0	0.2163	0.0623	0.1774	0.015	0	0	0.1131	0.0401	0.003	0.0084	0	0.0468	0											8.3963	250	0	12.1777	0.284824455	2.270604537	1.147766124	1.350364676	2.136443682	1.637706112	1.515071494	1.85422114	1.709027772	3.135056213	0.096467943	0.016460973	1.633444402	5.803483325	6.899477351	0.245154927	0	1.149437324	0.366516602	0.66014231	0.01502326	0	0	1.647350803	0.040130866	0.005117581	0.008389724	0	0.046782217	0	0	0	0	0	0	0	0	0	0	0	47.8521
H3924_003_0	2008	3																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1132.576976	61.72288921	909.2557572	833.555397	144.3489724	10.35714813	7.939345625	316.6133638	312.4720939	57.52910697	1736.864928	31.55767299	1.459663652	806.0107378	3236.059151	3291.308072	133.3537927	0	1435.599539	182.5508565	15.73036423	1.332178074	0	0	920.5209762	3.558579157	1.284342397	0.743953451	0	4.148382997	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											9.4381	0.257178705	1.894282828	1.041944246	1.202908103	2.019643885	1.548172397	1.319222349	1.301967058	1.060259607	2.605297392	0.065745152	3.11E-08	1.34335123	5.393431919	5.485513453	0.222256321	0	0.933139701	0.304251428	0.482747594	3.52E-10	0	0	1.534201627	0	0.002140571	0	0	5.63E-09	0	0	0	0	0	0	0	0	0	0	0	39.4558	None	0.091482469	9.4381	0.257178705	1.894282828	1.041944246	1.202908103	2.019643885	1.548172397	1.319222349	1.301967058	1.060259607	2.605297392	0.065745152	3.11E-08	1.34335123	5.393431919	5.485513453	0.222256321	0	0.933139701	0.304251428	0.482747594	3.52E-10	0	0	1.534201627	0	0.002140571	0	0	5.63E-09	0	0	0	0	0	0	0	0	0	0	0	39.4558	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											2.7395	0.0276	0.3763	0.1058	0.1475	0.1168	0.0895	0.1958	0.5523	0.6488	0.5298	0.0307	0.0165	0.2901	0.4101	1.414	0.0229	0	0.2163	0.0623	0.1774	0.015	0	0	0.1131	0.0401	0.003	0.0084	0	0.0468	0											8.3963	250	0	12.1777	0.284824455	2.270604537	1.147766124	1.350364676	2.136443682	1.637706112	1.515071494	1.85422114	1.709027772	3.135056213	0.096467943	0.016460973	1.633444402	5.803483325	6.899477351	0.245154927	0	1.149437324	0.366516602	0.66014231	0.01502326	0	0	1.647350803	0.040130866	0.005117581	0.008389724	0	0.046782217	0	0	0	0	0	0	0	0	0	0	0	47.8521
H3924_005_0	2008	2																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1376.955697	61.72288921	1195.817493	955.6964018	183.0615529	10.74347484	5.751450632	256.004546	385.3728518	43.26127933	1815.133988	6.075238971	0.438417718	819.1820375	3830.510253	3287.558569	133.3537927	0	1553.841157	200.2769487	10.21471883	1.242552293	0	0	746.6538889	3.471329633	1.75301074	0.946094327	0	3.985151664	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											11.4746	0.257178705	2.491286443	1.194620502	1.525512941	2.094977593	1.121532873	1.066685608	1.605720216	0.797303999	2.722700982	0.012656748	9.34E-09	1.365303396	6.384183755	5.479264282	0.222256321	0	1.009996752	0.333794914	0.313478497	3.28E-10	0	0	1.244423148	0	0.002921685	0	0	5.41E-09	0	0	0	0	0	0	0	0	0	0	0	42.7204	None	0.082474627	11.4746	0.257178705	2.491286443	1.194620502	1.525512941	2.094977593	1.121532873	1.066685608	1.605720216	0.797303999	2.722700982	0.012656748	9.34E-09	1.365303396	6.384183755	5.479264282	0.222256321	0	1.009996752	0.333794914	0.313478497	3.28E-10	0	0	1.244423148	0	0.002921685	0	0	5.41E-09	0	0	0	0	0	0	0	0	0	0	0	42.7204	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											3.3306	0.0276	0.4949	0.1213	0.187	0.1212	0.0649	0.1584	0.6811	0.4879	0.5536	0.0059	0.0049	0.2948	0.4854	1.4124	0.0229	0	0.2341	0.0683	0.1152	0.014	0	0	0.0918	0.0391	0.0041	0.0107	0	0.0449	0											9.0771	250	0	14.8053	0.284824455	2.986209989	1.315948476	1.712515514	2.216134079	1.186393224	1.225043647	2.286816975	1.28517079	3.276332543	0.018571262	0.004944141	1.660137081	6.869559746	6.891617373	0.245154927	0	1.244109498	0.402106175	0.428672088	0.014012531	0	0	1.33620082	0.039146934	0.006985033	0.01066931	0	0.044941421	0	0	0	0	0	0	0	0	0	0	0	51.7975
H3924_006_0	2008	2																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1376.955697	61.72288921	1195.817493	955.6964018	183.0615529	10.74347484	5.751450632	256.004546	385.3728518	43.26127933	1815.133988	6.075238971	0.438417718	819.1820375	3830.508546	3287.558569	133.3537927	0	1553.841157	200.2769487	10.21471883	1.242552293	0	0	746.6538889	3.471329633	1.75301074	0.946094327	0	3.985151664	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											11.4746	0.257178705	2.491286443	1.194620502	1.525512941	2.094977593	1.121532873	1.066685608	1.605720216	0.797303999	2.722700982	0.012656748	9.34E-09	1.365303396	6.384180909	5.479264282	0.222256321	0	1.009996752	0.333794914	0.313478497	3.28E-10	0	0	1.244423148	0	0.002921685	0	0	5.41E-09	0	0	0	0	0	0	0	0	0	0	0	42.7204	None	0.082474627	11.4746	0.257178705	2.491286443	1.194620502	1.525512941	2.094977593	1.121532873	1.066685608	1.605720216	0.797303999	2.722700982	0.012656748	9.34E-09	1.365303396	6.384180909	5.479264282	0.222256321	0	1.009996752	0.333794914	0.313478497	3.28E-10	0	0	1.244423148	0	0.002921685	0	0	5.41E-09	0	0	0	0	0	0	0	0	0	0	0	42.7204	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											3.3306	0.0276	0.4949	0.1213	0.187	0.1212	0.0649	0.1584	0.6811	0.4879	0.5536	0.0059	0.0049	0.2948	0.4854	1.4124	0.0229	0	0.2341	0.0683	0.1152	0.014	0	0	0.0918	0.0391	0.0041	0.0107	0	0.0449	0											9.0771	250	0	14.8053	0.284824455	2.986209989	1.315948476	1.712515514	2.216134079	1.186393224	1.225043647	2.286816975	1.28517079	3.276332543	0.018571262	0.004944141	1.660137081	6.869556899	6.891617373	0.245154927	0	1.244109498	0.402106175	0.428672088	0.014012531	0	0	1.33620082	0.039146934	0.006985033	0.01066931	0	0.044941421	0	0	0	0	0	0	0	0	0	0	0	51.7975
H3924_007_0	2008	3																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1376.955697	61.72288921	1195.817493	955.6964018	183.0615529	10.74347484	5.751450632	256.004546	385.3728518	43.26127933	1815.133988	6.075238971	0.438417718	819.1820375	3830.508546	3287.558569	133.3537927	0	1553.841157	200.2769487	10.21471883	1.242552293	0	0	746.6538889	3.471329633	1.75301074	0.946094327	0	3.985151664	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											11.4746	0.257178705	2.491286443	1.194620502	1.525512941	2.094977593	1.121532873	1.066685608	1.605720216	0.797303999	2.722700982	0.012656748	9.34E-09	1.365303396	6.384180909	5.479264282	0.222256321	0	1.009996752	0.333794914	0.313478497	3.28E-10	0	0	1.244423148	0	0.002921685	0	0	5.41E-09	0	0	0	0	0	0	0	0	0	0	0	42.7204	None	0.082474627	11.4746	0.257178705	2.491286443	1.194620502	1.525512941	2.094977593	1.121532873	1.066685608	1.605720216	0.797303999	2.722700982	0.012656748	9.34E-09	1.365303396	6.384180909	5.479264282	0.222256321	0	1.009996752	0.333794914	0.313478497	3.28E-10	0	0	1.244423148	0	0.002921685	0	0	5.41E-09	0	0	0	0	0	0	0	0	0	0	0	42.7204	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											3.3306	0.0276	0.4949	0.1213	0.187	0.1212	0.0649	0.1584	0.6811	0.4879	0.5536	0.0059	0.0049	0.2948	0.4854	1.4124	0.0229	0	0.2341	0.0683	0.1152	0.014	0	0	0.0918	0.0391	0.0041	0.0107	0	0.0449	0											9.0771	250	0	14.8053	0.284824455	2.986209989	1.315948476	1.712515514	2.216134079	1.186393224	1.225043647	2.286816975	1.28517079	3.276332543	0.018571262	0.004944141	1.660137081	6.869556899	6.891617373	0.245154927	0	1.244109498	0.402106175	0.428672088	0.014012531	0	0	1.33620082	0.039146934	0.006985033	0.01066931	0	0.044941421	0	0	0	0	0	0	0	0	0	0	0	51.7975
H3924_009_0	2008	2																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1222.43158	61.72288921	1194.666365	1260.385788	95.97694281	11.63479978	6.58556545	222.6598604	225.1735155	42.65506775	1095.178346	23.35448467	0.821406213	609.6032871	3485.552754	4032.652399	133.3537927	0	3143.102577	243.678842	9.582287485	1.738242092	0	0	674.8121745	2.90129343	1.27914739	0.934927938	0	4.704062282	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											10.1869	0.257178705	2.488888261	1.575482235	0.799807857	2.268785956	1.284185263	0.927749418	0.938222981	0.786131538	1.642767519	0.048655176	1.75E-08	1.016005478	5.809254589	6.721087331	0.222256321	0	2.043016675	0.406131403	0.294069874	4.59E-10	0	0	1.124686958	0	0.002131912	0	0	6.39E-09	0	0	0	0	0	0	0	0	0	0	0	40.8434	None	0.091101826	10.1869	0.257178705	2.488888261	1.575482235	0.799807857	2.268785956	1.284185263	0.927749418	0.938222981	0.786131538	1.642767519	0.048655176	1.75E-08	1.016005478	5.809254589	6.721087331	0.222256321	0	2.043016675	0.406131403	0.294069874	4.59E-10	0	0	1.124686958	0	0.002131912	0	0	6.39E-09	0	0	0	0	0	0	0	0	0	0	0	40.8434	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											2.9569	0.0276	0.4944	0.16	0.098	0.1312	0.0743	0.1377	0.398	0.481	0.334	0.0227	0.0093	0.2194	0.4417	1.7324	0.0229	0	0.4736	0.0831	0.1081	0.0196	0	0	0.0829	0.0327	0.003	0.0105	0	0.053	0											8.6082	250	0	13.1438	0.284824455	2.98333538	1.735491265	0.897851028	2.399994107	1.358452107	1.065481265	1.336188097	1.267161951	1.976806384	0.071391801	0.009263193	1.235409195	6.250919931	8.453536795	0.245154927	0	2.516578834	0.489246355	0.4021314	0.019602532	0	0	1.207633944	0.032718513	0.005096881	0.010543384	0	0.053048733	0	0	0	0	0	0	0	0	0	0	0	49.4517
H3924_010_0	2008	2																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1222.43158	61.72288921	1194.666365	1260.385788	95.97694281	11.63479978	6.58556545	222.6598604	225.1735155	42.65506775	1095.178346	23.35448467	0.821406213	609.6032871	3485.5512	4032.652399	133.3537927	0	3143.102577	243.678842	9.582287485	1.738242092	0	0	674.8121745	2.90129343	1.27914739	0.934927938	0	4.704062282	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											10.1869	0.257178705	2.488888261	1.575482235	0.799807857	2.268785956	1.284185263	0.927749418	0.938222981	0.786131538	1.642767519	0.048655176	1.75E-08	1.016005478	5.809252	6.721087331	0.222256321	0	2.043016675	0.406131403	0.294069874	4.59E-10	0	0	1.124686958	0	0.002131912	0	0	6.39E-09	0	0	0	0	0	0	0	0	0	0	0	40.8434	None	0.091101826	10.1869	0.257178705	2.488888261	1.575482235	0.799807857	2.268785956	1.284185263	0.927749418	0.938222981	0.786131538	1.642767519	0.048655176	1.75E-08	1.016005478	5.809252	6.721087331	0.222256321	0	2.043016675	0.406131403	0.294069874	4.59E-10	0	0	1.124686958	0	0.002131912	0	0	6.39E-09	0	0	0	0	0	0	0	0	0	0	0	40.8434	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											2.9569	0.0276	0.4944	0.16	0.098	0.1312	0.0743	0.1377	0.398	0.481	0.334	0.0227	0.0093	0.2194	0.4417	1.7324	0.0229	0	0.4736	0.0831	0.1081	0.0196	0	0	0.0829	0.0327	0.003	0.0105	0	0.053	0											8.6082	250	0	13.1438	0.284824455	2.98333538	1.735491265	0.897851028	2.399994107	1.358452107	1.065481265	1.336188097	1.267161951	1.976806384	0.071391801	0.009263193	1.235409195	6.250917341	8.453536795	0.245154927	0	2.516578834	0.489246355	0.4021314	0.019602532	0	0	1.207633944	0.032718513	0.005096881	0.010543384	0	0.053048733	0	0	0	0	0	0	0	0	0	0	0	49.4517
H3924_011_0	2008	3																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1222.43158	61.72288921	1194.666365	1260.385788	95.97694281	11.63479978	6.58556545	222.6598604	225.1735155	42.65506775	1095.178346	23.35448467	0.821406213	609.6032871	3485.5512	4032.652399	133.3537927	0	3143.102577	243.678842	9.582287485	1.738242092	0	0	674.8121745	2.90129343	1.27914739	0.934927938	0	4.704062282	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											10.1869	0.257178705	2.488888261	1.575482235	0.799807857	2.268785956	1.284185263	0.927749418	0.938222981	0.786131538	1.642767519	0.048655176	1.75E-08	1.016005478	5.809252	6.721087331	0.222256321	0	2.043016675	0.406131403	0.294069874	4.59E-10	0	0	1.124686958	0	0.002131912	0	0	6.39E-09	0	0	0	0	0	0	0	0	0	0	0	40.8434	None	0.091101826	10.1869	0.257178705	2.488888261	1.575482235	0.799807857	2.268785956	1.284185263	0.927749418	0.938222981	0.786131538	1.642767519	0.048655176	1.75E-08	1.016005478	5.809252	6.721087331	0.222256321	0	2.043016675	0.406131403	0.294069874	4.59E-10	0	0	1.124686958	0	0.002131912	0	0	6.39E-09	0	0	0	0	0	0	0	0	0	0	0	40.8434	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											2.9569	0.0276	0.4944	0.16	0.098	0.1312	0.0743	0.1377	0.398	0.481	0.334	0.0227	0.0093	0.2194	0.4417	1.7324	0.0229	0	0.4736	0.0831	0.1081	0.0196	0	0	0.0829	0.0327	0.003	0.0105	0	0.053	0											8.6082	250	0	13.1438	0.284824455	2.98333538	1.735491265	0.897851028	2.399994107	1.358452107	1.065481265	1.336188097	1.267161951	1.976806384	0.071391801	0.009263193	1.235409195	6.250917341	8.453536795	0.245154927	0	2.516578834	0.489246355	0.4021314	0.019602532	0	0	1.207633944	0.032718513	0.005096881	0.010543384	0	0.053048733	0	0	0	0	0	0	0	0	0	0	0	49.4517
H3924_013_0	2008	2																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1070.939264	61.72288921	988.5078111	1301.815833	117.6558576	12.75557244	6.136082894	249.7150704	310.8013964	70.69044207	2740.643606	14.8233669	0.814269689	986.4004317	3495.408265	3453.919892	133.3537927	0	2029.206542	149.8818267	14.04647851	1.518899074	0	0	871.6335054	3.386947203	1.213673304	0.643300994	0	3.772712074	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											8.9245	0.257178705	2.059391273	1.627269792	0.98046548	2.487336625	1.196536164	1.04047946	1.295005818	1.302822593	4.110965409	0.030882014	1.74E-08	1.64400072	5.825680441	5.756533154	0.222256321	0	1.318984252	0.249803045	0.431070992	4.01E-10	0	0	1.452722509	0	0.002022789	0	0	5.12E-09	0	0	0	0	0	0	0	0	0	0	0	42.2159	None	0.094458277	8.9245	0.257178705	2.059391273	1.627269792	0.98046548	2.487336625	1.196536164	1.04047946	1.295005818	1.302822593	4.110965409	0.030882014	1.74E-08	1.64400072	5.825680441	5.756533154	0.222256321	0	1.318984252	0.249803045	0.431070992	4.01E-10	0	0	1.452722509	0	0.002022789	0	0	5.12E-09	0	0	0	0	0	0	0	0	0	0	0	42.2159	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											2.5904	0.0276	0.4091	0.1653	0.1202	0.1438	0.0692	0.1545	0.5493	0.7972	0.8359	0.0144	0.0092	0.355	0.4429	1.4838	0.0229	0	0.3057	0.0511	0.1584	0.0171	0	0	0.1071	0.0382	0.0028	0.0073	0	0.0425	0											8.9212	250	0	11.5149	0.284824455	2.46851373	1.792538466	1.100654278	2.63118397	1.265734096	1.194946986	1.844307158	2.100013977	4.946885406	0.045313218	0.009182713	1.99901836	6.268594606	7.240355977	0.245154927	0	1.624718923	0.300925336	0.589476164	0.017128953	0	0	1.559862504	0.038195335	0.004835993	0.007254644	0	0.042545694	0	0	0	0	0	0	0	0	0	0	0	51.1371
H3924_014_0	2008	2																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1070.939264	61.72288921	988.5078111	1301.815833	117.6558576	12.75557244	6.136082894	249.7150704	310.8013964	70.69044207	2740.643606	14.8233669	0.814269689	986.4004317	3495.406707	3453.919892	133.3537927	0	2029.206542	149.8818267	14.04647851	1.518899074	0	0	871.6335054	3.386947203	1.213673304	0.643300994	0	3.772712074	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											8.9245	0.257178705	2.059391273	1.627269792	0.98046548	2.487336625	1.196536164	1.04047946	1.295005818	1.302822593	4.110965409	0.030882014	1.74E-08	1.64400072	5.825677844	5.756533154	0.222256321	0	1.318984252	0.249803045	0.431070992	4.01E-10	0	0	1.452722509	0	0.002022789	0	0	5.12E-09	0	0	0	0	0	0	0	0	0	0	0	42.2159	None	0.094458277	8.9245	0.257178705	2.059391273	1.627269792	0.98046548	2.487336625	1.196536164	1.04047946	1.295005818	1.302822593	4.110965409	0.030882014	1.74E-08	1.64400072	5.825677844	5.756533154	0.222256321	0	1.318984252	0.249803045	0.431070992	4.01E-10	0	0	1.452722509	0	0.002022789	0	0	5.12E-09	0	0	0	0	0	0	0	0	0	0	0	42.2159	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											2.5904	0.0276	0.4091	0.1653	0.1202	0.1438	0.0692	0.1545	0.5493	0.7972	0.8359	0.0144	0.0092	0.355	0.4429	1.4838	0.0229	0	0.3057	0.0511	0.1584	0.0171	0	0	0.1071	0.0382	0.0028	0.0073	0	0.0425	0											8.9212	250	0	11.5149	0.284824455	2.46851373	1.792538466	1.100654278	2.63118397	1.265734096	1.194946986	1.844307158	2.100013977	4.946885406	0.045313218	0.009182713	1.99901836	6.268592008	7.240355977	0.245154927	0	1.624718923	0.300925336	0.589476164	0.017128953	0	0	1.559862504	0.038195335	0.004835993	0.007254644	0	0.042545694	0	0	0	0	0	0	0	0	0	0	0	51.1371
H3924_015_0	2008	3																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1070.939264	61.72288921	988.5078111	1301.815833	117.6558576	12.75557244	6.136082894	249.7150704	310.8013964	70.69044207	2740.643606	14.8233669	0.814269689	986.4004317	3495.406707	3453.919892	133.3537927	0	2029.206542	149.8818267	14.04647851	1.518899074	0	0	871.6335054	3.386947203	1.213673304	0.643300994	0	3.772712074	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											8.9245	0.257178705	2.059391273	1.627269792	0.98046548	2.487336625	1.196536164	1.04047946	1.295005818	1.302822593	4.110965409	0.030882014	1.74E-08	1.64400072	5.825677844	5.756533154	0.222256321	0	1.318984252	0.249803045	0.431070992	4.01E-10	0	0	1.452722509	0	0.002022789	0	0	5.12E-09	0	0	0	0	0	0	0	0	0	0	0	42.2159	None	0.094458277	8.9245	0.257178705	2.059391273	1.627269792	0.98046548	2.487336625	1.196536164	1.04047946	1.295005818	1.302822593	4.110965409	0.030882014	1.74E-08	1.64400072	5.825677844	5.756533154	0.222256321	0	1.318984252	0.249803045	0.431070992	4.01E-10	0	0	1.452722509	0	0.002022789	0	0	5.12E-09	0	0	0	0	0	0	0	0	0	0	0	42.2159	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											2.5904	0.0276	0.4091	0.1653	0.1202	0.1438	0.0692	0.1545	0.5493	0.7972	0.8359	0.0144	0.0092	0.355	0.4429	1.4838	0.0229	0	0.3057	0.0511	0.1584	0.0171	0	0	0.1071	0.0382	0.0028	0.0073	0	0.0425	0											8.9212	250	0	11.5149	0.284824455	2.46851373	1.792538466	1.100654278	2.63118397	1.265734096	1.194946986	1.844307158	2.100013977	4.946885406	0.045313218	0.009182713	1.99901836	6.268592008	7.240355977	0.245154927	0	1.624718923	0.300925336	0.589476164	0.017128953	0	0	1.559862504	0.038195335	0.004835993	0.007254644	0	0.042545694	0	0	0	0	0	0	0	0	0	0	0	51.1371
H3924_017_0	2008	2																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1128.956336	61.72288921	1170.412714	910.01471	202.902503	13.74548678	6.142623714	340.4680341	285.4830408	46.05595296	2165.492781	50.57016332	1.203218888	845.5490953	3320.572789	3810.385374	133.3537927	0	1754.588384	170.9276914	12.16319372	1.077014077	0	0	670.0440505	3.144568931	1.094628502	0.667615986	0	4.424950903	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											9.408	0.257178705	2.43835982	1.137518388	1.690854192	2.680369921	1.197811624	1.418616809	1.18951267	0.848809744	3.248239171	0.105354507	2.56E-08	1.409248492	5.534287981	6.35064229	0.222256321	0	1.14048245	0.284879486	0.373275051	2.84E-10	0	0	1.116740084	0	0.001824381	0	0	6.01E-09	0	0	0	0	0	0	0	0	0	0	0	42.0542	None	0.099440552	9.408	0.257178705	2.43835982	1.137518388	1.690854192	2.680369921	1.197811624	1.418616809	1.18951267	0.848809744	3.248239171	0.105354507	2.56E-08	1.409248492	5.534287981	6.35064229	0.222256321	0	1.14048245	0.284879486	0.373275051	2.84E-10	0	0	1.116740084	0	0.001824381	0	0	6.01E-09	0	0	0	0	0	0	0	0	0	0	0	42.0542	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											2.7308	0.0276	0.4844	0.1155	0.2073	0.155	0.0693	0.2106	0.5046	0.5194	0.6605	0.0492	0.0136	0.3043	0.4208	1.637	0.0229	0	0.2644	0.0583	0.1372	0.0121	0	0	0.0824	0.0355	0.0025	0.0075	0	0.0499	0											8.7825	250	0	12.1387	0.284824455	2.922768865	1.25304696	1.898124858	2.835380744	1.267083319	1.629221859	1.694067085	1.368192674	3.908733194	0.154586799	0.013568985	1.713572005	5.955048193	7.987604628	0.245154927	0	1.404841198	0.343180184	0.510442014	0.012145721	0	0	1.19910098	0.035461983	0.004361648	0.00752885	0	0.049901133	0	0	0	0	0	0	0	0	0	0	0	50.8367
H3924_018_0	2008	2																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1128.956336	61.72288921	1170.412714	910.01471	202.902503	13.74548678	6.142623714	340.4680341	285.4830408	46.05595296	2165.492781	50.57016332	1.203218888	845.5490953	3320.571309	3810.385374	133.3537927	0	1754.588384	170.9276914	12.16319372	1.077014077	0	0	670.0440505	3.144568931	1.094628502	0.667615986	0	4.424950903	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											9.408	0.257178705	2.43835982	1.137518388	1.690854192	2.680369921	1.197811624	1.418616809	1.18951267	0.848809744	3.248239171	0.105354507	2.56E-08	1.409248492	5.534285514	6.35064229	0.222256321	0	1.14048245	0.284879486	0.373275051	2.84E-10	0	0	1.116740084	0	0.001824381	0	0	6.01E-09	0	0	0	0	0	0	0	0	0	0	0	42.0542	None	0.099440552	9.408	0.257178705	2.43835982	1.137518388	1.690854192	2.680369921	1.197811624	1.418616809	1.18951267	0.848809744	3.248239171	0.105354507	2.56E-08	1.409248492	5.534285514	6.35064229	0.222256321	0	1.14048245	0.284879486	0.373275051	2.84E-10	0	0	1.116740084	0	0.001824381	0	0	6.01E-09	0	0	0	0	0	0	0	0	0	0	0	42.0542	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											2.7308	0.0276	0.4844	0.1155	0.2073	0.155	0.0693	0.2106	0.5046	0.5194	0.6605	0.0492	0.0136	0.3043	0.4208	1.637	0.0229	0	0.2644	0.0583	0.1372	0.0121	0	0	0.0824	0.0355	0.0025	0.0075	0	0.0499	0											8.7825	250	0	12.1387	0.284824455	2.922768865	1.25304696	1.898124858	2.835380744	1.267083319	1.629221859	1.694067085	1.368192674	3.908733194	0.154586799	0.013568985	1.713572005	5.955045726	7.987604628	0.245154927	0	1.404841198	0.343180184	0.510442014	0.012145721	0	0	1.19910098	0.035461983	0.004361648	0.00752885	0	0.049901133	0	0	0	0	0	0	0	0	0	0	0	50.8367
H3924_019_0	2008	3																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1128.956336	61.72288921	1170.412714	910.01471	202.902503	13.74548678	6.142623714	340.4680341	285.4830408	46.05595296	2165.492781	50.57016332	1.203218888	845.5490953	3320.571309	3810.385374	133.3537927	0	1754.588384	170.9276914	12.16319372	1.077014077	0	0	670.0440505	3.144568931	1.094628502	0.667615986	0	4.424950903	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											9.408	0.257178705	2.43835982	1.137518388	1.690854192	2.680369921	1.197811624	1.418616809	1.18951267	0.848809744	3.248239171	0.105354507	2.56E-08	1.409248492	5.534285514	6.35064229	0.222256321	0	1.14048245	0.284879486	0.373275051	2.84E-10	0	0	1.116740084	0	0.001824381	0	0	6.01E-09	0	0	0	0	0	0	0	0	0	0	0	42.0542	None	0.099440552	9.408	0.257178705	2.43835982	1.137518388	1.690854192	2.680369921	1.197811624	1.418616809	1.18951267	0.848809744	3.248239171	0.105354507	2.56E-08	1.409248492	5.534285514	6.35064229	0.222256321	0	1.14048245	0.284879486	0.373275051	2.84E-10	0	0	1.116740084	0	0.001824381	0	0	6.01E-09	0	0	0	0	0	0	0	0	0	0	0	42.0542	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											2.7308	0.0276	0.4844	0.1155	0.2073	0.155	0.0693	0.2106	0.5046	0.5194	0.6605	0.0492	0.0136	0.3043	0.4208	1.637	0.0229	0	0.2644	0.0583	0.1372	0.0121	0	0	0.0824	0.0355	0.0025	0.0075	0	0.0499	0											8.7825	250	0	12.1387	0.284824455	2.922768865	1.25304696	1.898124858	2.835380744	1.267083319	1.629221859	1.694067085	1.368192674	3.908733194	0.154586799	0.013568985	1.713572005	5.955045726	7.987604628	0.245154927	0	1.404841198	0.343180184	0.510442014	0.012145721	0	0	1.19910098	0.035461983	0.004361648	0.00752885	0	0.049901133	0	0	0	0	0	0	0	0	0	0	0	50.8367
H3924_021_0	2008	2																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1419.258808	61.72288921	564.8334404	756.3791923	88.23102012	10.0029212	4.024373058	191.5294171	282.2334067	43.43412143	1194.762131	29.53368434	0.294708634	682.1107922	3397.017294	2719.927953	133.3537927	0	2147.427269	963.9514168	8.748621302	1.855300984	0	0	666.1703129	3.157218348	0.767273295	0.753356475	0	5.141820043	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											11.8272	0.257178705	1.176736334	0.94547399	0.735258501	1.950569633	0.784752746	0.798039238	1.175972528	0.800489473	1.792143197	0.061528509	6.28E-09	1.13685132	5.661695489	4.533213256	0.222256321	0	1.395827725	1.606585695	0.268485575	4.90E-10	0	0	1.110283855	0	0.001278789	0	0	6.98E-09	0	0	0	0	0	0	0	0	0	0	0	38.2418	None	0.070136471	11.8272	0.257178705	1.176736334	0.94547399	0.735258501	1.950569633	0.784752746	0.798039238	1.175972528	0.800489473	1.792143197	0.061528509	6.28E-09	1.13685132	5.661695489	4.533213256	0.222256321	0	1.395827725	1.606585695	0.268485575	4.90E-10	0	0	1.110283855	0	0.001278789	0	0	6.98E-09	0	0	0	0	0	0	0	0	0	0	0	38.2418	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											3.433	0.0276	0.2338	0.096	0.0901	0.1128	0.0454	0.1185	0.4988	0.4898	0.3644	0.0288	0.0033	0.2455	0.4304	1.1685	0.0229	0	0.3235	0.3288	0.0987	0.0209	0	0	0.0819	0.0356	0.0018	0.0085	0	0.058	0											8.3673	250	0	15.2601	0.284824455	1.410508938	1.041498162	0.825388993	2.063374736	0.830136471	0.916514568	1.674783635	1.290305442	2.156555978	0.090280858	0.003323499	1.382351379	6.092142224	5.701709139	0.245154927	0	1.71937437	1.935374088	0.367145667	0.02092263	0	0	1.192168596	0.035604633	0.003057271	0.008495764	0	0.057985422	0	0	0	0	0	0	0	0	0	0	0	46.6091
H3924_022_0	2008	2																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1419.258808	61.72288921	564.8334404	756.3791923	88.23102012	10.0029212	4.024373058	191.5294171	282.2334067	43.43412143	1194.762131	29.53368434	0.294708634	682.1107922	3397.015779	2719.927953	133.3537927	0	2147.427269	963.9514168	8.748621302	1.855300984	0	0	666.1703129	3.157218348	0.767273295	0.753356475	0	5.141820043	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											11.8272	0.257178705	1.176736334	0.94547399	0.735258501	1.950569633	0.784752746	0.798039238	1.175972528	0.800489473	1.792143197	0.061528509	6.28E-09	1.13685132	5.661692965	4.533213256	0.222256321	0	1.395827725	1.606585695	0.268485575	4.90E-10	0	0	1.110283855	0	0.001278789	0	0	6.98E-09	0	0	0	0	0	0	0	0	0	0	0	38.2418	None	0.070136471	11.8272	0.257178705	1.176736334	0.94547399	0.735258501	1.950569633	0.784752746	0.798039238	1.175972528	0.800489473	1.792143197	0.061528509	6.28E-09	1.13685132	5.661692965	4.533213256	0.222256321	0	1.395827725	1.606585695	0.268485575	4.90E-10	0	0	1.110283855	0	0.001278789	0	0	6.98E-09	0	0	0	0	0	0	0	0	0	0	0	38.2418	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											3.433	0.0276	0.2338	0.096	0.0901	0.1128	0.0454	0.1185	0.4988	0.4898	0.3644	0.0288	0.0033	0.2455	0.4304	1.1685	0.0229	0	0.3235	0.3288	0.0987	0.0209	0	0	0.0819	0.0356	0.0018	0.0085	0	0.058	0											8.3673	250	0	15.2601	0.284824455	1.410508938	1.041498162	0.825388993	2.063374736	0.830136471	0.916514568	1.674783635	1.290305442	2.156555978	0.090280858	0.003323499	1.382351379	6.0921397	5.701709139	0.245154927	0	1.71937437	1.935374088	0.367145667	0.02092263	0	0	1.192168596	0.035604633	0.003057271	0.008495764	0	0.057985422	0	0	0	0	0	0	0	0	0	0	0	46.6091
H3924_023_0	2008	3																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1419.258808	61.72288921	564.8334404	756.3791923	88.23102012	10.0029212	4.024373058	191.5294171	282.2334067	43.43412143	1194.762131	29.53368434	0.294708634	682.1107922	3397.015779	2719.927953	133.3537927	0	2147.427269	963.9514168	8.748621302	1.855300984	0	0	666.1703129	3.157218348	0.767273295	0.753356475	0	5.141820043	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											11.8272	0.257178705	1.176736334	0.94547399	0.735258501	1.950569633	0.784752746	0.798039238	1.175972528	0.800489473	1.792143197	0.061528509	6.28E-09	1.13685132	5.661692965	4.533213256	0.222256321	0	1.395827725	1.606585695	0.268485575	4.90E-10	0	0	1.110283855	0	0.001278789	0	0	6.98E-09	0	0	0	0	0	0	0	0	0	0	0	38.2418	None	0.070136471	11.8272	0.257178705	1.176736334	0.94547399	0.735258501	1.950569633	0.784752746	0.798039238	1.175972528	0.800489473	1.792143197	0.061528509	6.28E-09	1.13685132	5.661692965	4.533213256	0.222256321	0	1.395827725	1.606585695	0.268485575	4.90E-10	0	0	1.110283855	0	0.001278789	0	0	6.98E-09	0	0	0	0	0	0	0	0	0	0	0	38.2418	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											3.433	0.0276	0.2338	0.096	0.0901	0.1128	0.0454	0.1185	0.4988	0.4898	0.3644	0.0288	0.0033	0.2455	0.4304	1.1685	0.0229	0	0.3235	0.3288	0.0987	0.0209	0	0	0.0819	0.0356	0.0018	0.0085	0	0.058	0											8.3673	250	0	15.2601	0.284824455	1.410508938	1.041498162	0.825388993	2.063374736	0.830136471	0.916514568	1.674783635	1.290305442	2.156555978	0.090280858	0.003323499	1.382351379	6.0921397	5.701709139	0.245154927	0	1.71937437	1.935374088	0.367145667	0.02092263	0	0	1.192168596	0.035604633	0.003057271	0.008495764	0	0.057985422	0	0	0	0	0	0	0	0	0	0	0	46.6091
H3924_025_0	2008	2																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1108.448895	61.72288921	921.8505008	816.3929345	175.0087013	12.64414258	4.524208469	233.4112742	278.2240918	42.78953536	1714.39756	39.81339234	0.585227102	574.7084974	3074.579278	3201.57178	133.3537927	0	1337.587632	127.7495441	10.40815444	0.680858763	0	0	723.3379318	3.074334689	0.924244591	0.673198309	0	3.992447511	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											9.2371	0.257178705	1.920521877	1.020491168	1.458405844	2.465607804	0.882220651	0.972546976	1.159267049	0.788609772	2.571596341	0.082944567	1.25E-08	0.957847496	5.124298797	5.335952966	0.222256321	0	0.869431961	0.212915907	0.319414824	1.80E-10	0	0	1.20556322	0	0.001540408	0	0	5.42E-09	0	0	0	0	0	0	0	0	0	0	0	37.0657	None	0.085841755	9.2371	0.257178705	1.920521877	1.020491168	1.458405844	2.465607804	0.882220651	0.972546976	1.159267049	0.788609772	2.571596341	0.082944567	1.25E-08	0.957847496	5.124298797	5.335952966	0.222256321	0	0.869431961	0.212915907	0.319414824	1.80E-10	0	0	1.20556322	0	0.001540408	0	0	5.42E-09	0	0	0	0	0	0	0	0	0	0	0	37.0657	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											2.6812	0.0276	0.3815	0.1036	0.1788	0.1426	0.051	0.1444	0.4917	0.4825	0.5229	0.0388	0.0066	0.2068	0.3896	1.3754	0.0229	0	0.2015	0.0436	0.1174	0.0077	0	0	0.0889	0.0347	0.0021	0.0076	0	0.045	0											7.7965	250	0	11.9182	0.284824455	2.302056284	1.124134229	1.6371822	2.608198531	0.933241127	1.11692938	1.650992209	1.271156605	3.09450242	0.121704667	0.006599745	1.164692149	5.513888398	6.711365664	0.245154927	0	1.070962414	0.256489231	0.43678983	0.007678192	0	0	1.294474926	0.034669936	0.003682738	0.007591803	0	0.045023698	0	0	0	0	0	0	0	0	0	0	0	44.8622
H3924_026_0	2008	2																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1108.448895	61.72288921	921.8505008	816.3929345	175.0087013	12.64414258	4.524208469	233.4112742	278.2240918	42.78953536	1714.39756	39.81339234	0.585227102	574.7084974	3074.577907	3201.57178	133.3537927	0	1337.587632	127.7495441	10.40815444	0.680858763	0	0	723.3379318	3.074334689	0.924244591	0.673198309	0	3.992447511	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											9.2371	0.257178705	1.920521877	1.020491168	1.458405844	2.465607804	0.882220651	0.972546976	1.159267049	0.788609772	2.571596341	0.082944567	1.25E-08	0.957847496	5.124296512	5.335952966	0.222256321	0	0.869431961	0.212915907	0.319414824	1.80E-10	0	0	1.20556322	0	0.001540408	0	0	5.42E-09	0	0	0	0	0	0	0	0	0	0	0	37.0657	None	0.085841755	9.2371	0.257178705	1.920521877	1.020491168	1.458405844	2.465607804	0.882220651	0.972546976	1.159267049	0.788609772	2.571596341	0.082944567	1.25E-08	0.957847496	5.124296512	5.335952966	0.222256321	0	0.869431961	0.212915907	0.319414824	1.80E-10	0	0	1.20556322	0	0.001540408	0	0	5.42E-09	0	0	0	0	0	0	0	0	0	0	0	37.0657	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											2.6812	0.0276	0.3815	0.1036	0.1788	0.1426	0.051	0.1444	0.4917	0.4825	0.5229	0.0388	0.0066	0.2068	0.3896	1.3754	0.0229	0	0.2015	0.0436	0.1174	0.0077	0	0	0.0889	0.0347	0.0021	0.0076	0	0.045	0											7.7965	250	0	11.9182	0.284824455	2.302056284	1.124134229	1.6371822	2.608198531	0.933241127	1.11692938	1.650992209	1.271156605	3.09450242	0.121704667	0.006599745	1.164692149	5.513886113	6.711365664	0.245154927	0	1.070962414	0.256489231	0.43678983	0.007678192	0	0	1.294474926	0.034669936	0.003682738	0.007591803	0	0.045023698	0	0	0	0	0	0	0	0	0	0	0	44.8622
H3924_027_0	2008	3																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1108.448895	61.72288921	921.8505008	816.3929345	175.0087013	12.64414258	4.524208469	233.4112742	278.2240918	42.78953536	1714.39756	39.81339234	0.585227102	574.7084974	3074.577907	3201.57178	133.3537927	0	1337.587632	127.7495441	10.40815444	0.680858763	0	0	723.3379318	3.074334689	0.924244591	0.673198309	0	3.992447511	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											9.2371	0.257178705	1.920521877	1.020491168	1.458405844	2.465607804	0.882220651	0.972546976	1.159267049	0.788609772	2.571596341	0.082944567	1.25E-08	0.957847496	5.124296512	5.335952966	0.222256321	0	0.869431961	0.212915907	0.319414824	1.80E-10	0	0	1.20556322	0	0.001540408	0	0	5.42E-09	0	0	0	0	0	0	0	0	0	0	0	37.0657	None	0.085841755	9.2371	0.257178705	1.920521877	1.020491168	1.458405844	2.465607804	0.882220651	0.972546976	1.159267049	0.788609772	2.571596341	0.082944567	1.25E-08	0.957847496	5.124296512	5.335952966	0.222256321	0	0.869431961	0.212915907	0.319414824	1.80E-10	0	0	1.20556322	0	0.001540408	0	0	5.42E-09	0	0	0	0	0	0	0	0	0	0	0	37.0657	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											2.6812	0.0276	0.3815	0.1036	0.1788	0.1426	0.051	0.1444	0.4917	0.4825	0.5229	0.0388	0.0066	0.2068	0.3896	1.3754	0.0229	0	0.2015	0.0436	0.1174	0.0077	0	0	0.0889	0.0347	0.0021	0.0076	0	0.045	0											7.7965	250	0	11.9182	0.284824455	2.302056284	1.124134229	1.6371822	2.608198531	0.933241127	1.11692938	1.650992209	1.271156605	3.09450242	0.121704667	0.006599745	1.164692149	5.513886113	6.711365664	0.245154927	0	1.070962414	0.256489231	0.43678983	0.007678192	0	0	1.294474926	0.034669936	0.003682738	0.007591803	0	0.045023698	0	0	0	0	0	0	0	0	0	0	0	44.8622
H3924_029_0	2008	2																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1169.413343	61.72288921	577.8621438	853.0930687	134.9183072	10.16178345	4.343757474	268.7583539	313.9862881	67.62598746	2255.731229	8.028947817	0.319741213	576.3938993	2943.097331	3305.071612	133.3537927	75.9699437	2417.065801	470.7470523	14.25009306	2.052916585	0	0	886.4498889	3.401936112	0.975404796	0.603919783	0	4.163357891	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											9.7451	0.257178705	1.203879466	1.066366336	1.124319227	1.981547772	0.847032707	1.119826475	1.3082762	1.246344792	3.383596844	0.016726975	6.81E-09	0.960656499	4.905162219	5.508452687	0.222256321	0.09496243	1.571092771	0.78457842	0.437319698	5.42E-10	0	0	1.477416482	0	0.001625675	0	0	5.65E-09	0	0	0	0	0	0	0	0	0	0	0	39.2637	None	0.072527705	9.7451	0.257178705	1.203879466	1.066366336	1.124319227	1.981547772	0.847032707	1.119826475	1.3082762	1.246344792	3.383596844	0.016726975	6.81E-09	0.960656499	4.905162219	5.508452687	0.222256321	0.09496243	1.571092771	0.78457842	0.437319698	5.42E-10	0	0	1.477416482	0	0.001625675	0	0	5.65E-09	0	0	0	0	0	0	0	0	0	0	0	39.2637	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											2.8286	0.0276	0.2392	0.1083	0.1378	0.1146	0.049	0.1662	0.5549	0.7626	0.688	0.0078	0.0036	0.2075	0.3729	1.4199	0.0229	0.0007	0.3642	0.1606	0.1607	0.0232	0	0	0.109	0.0384	0.0023	0.0068	0	0.047	0											8.6242	250	0	12.5737	0.284824455	1.443044375	1.174668568	1.262142108	2.096144399	0.896018199	1.286073702	1.863206425	2.00897766	4.071614374	0.024543511	0.003605798	1.168107748	5.278091329	6.928329477	0.245154927	0.095676371	1.935265072	0.945142703	0.598021076	0.023151184	0	0	1.586377686	0.038364368	0.003886591	0.006810534	0	0.046951092	0	0	0	0	0	0	0	0	0	0	0	47.8879
H3924_030_0	2008	2																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1169.413343	61.72288921	577.8621438	853.0930687	134.9183072	10.16178345	4.343757474	268.7583539	313.9862881	67.62598746	2255.731229	8.028947817	0.319741213	576.3938993	2943.096019	3305.071612	133.3537927	75.9699437	2417.065801	470.7470523	14.25009306	2.052916585	0	0	886.4498889	3.401936112	0.975404796	0.603919783	0	4.163357891	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											9.7451	0.257178705	1.203879466	1.066366336	1.124319227	1.981547772	0.847032707	1.119826475	1.3082762	1.246344792	3.383596844	0.016726975	6.81E-09	0.960656499	4.905160032	5.508452687	0.222256321	0.09496243	1.571092771	0.78457842	0.437319698	5.42E-10	0	0	1.477416482	0	0.001625675	0	0	5.65E-09	0	0	0	0	0	0	0	0	0	0	0	39.2637	None	0.072527705	9.7451	0.257178705	1.203879466	1.066366336	1.124319227	1.981547772	0.847032707	1.119826475	1.3082762	1.246344792	3.383596844	0.016726975	6.81E-09	0.960656499	4.905160032	5.508452687	0.222256321	0.09496243	1.571092771	0.78457842	0.437319698	5.42E-10	0	0	1.477416482	0	0.001625675	0	0	5.65E-09	0	0	0	0	0	0	0	0	0	0	0	39.2637	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											2.8286	0.0276	0.2392	0.1083	0.1378	0.1146	0.049	0.1662	0.5549	0.7626	0.688	0.0078	0.0036	0.2075	0.3729	1.4199	0.0229	0.0007	0.3642	0.1606	0.1607	0.0232	0	0	0.109	0.0384	0.0023	0.0068	0	0.047	0											8.6242	250	0	12.5737	0.284824455	1.443044375	1.174668568	1.262142108	2.096144399	0.896018199	1.286073702	1.863206425	2.00897766	4.071614374	0.024543511	0.003605798	1.168107748	5.278089142	6.928329477	0.245154927	0.095676371	1.935265072	0.945142703	0.598021076	0.023151184	0	0	1.586377686	0.038364368	0.003886591	0.006810534	0	0.046951092	0	0	0	0	0	0	0	0	0	0	0	47.8879
H3924_031_0	2008	3																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	None	1169.413343	61.72288921	577.8621438	853.0930687	134.9183072	10.16178345	4.343757474	268.7583539	313.9862881	67.62598746	2255.731229	8.028947817	0.319741213	576.3938993	2943.096019	3305.071612	133.3537927	75.9699437	2417.065801	470.7470523	14.25009306	2.052916585	0	0	886.4498889	3.401936112	0.975404796	0.603919783	0	4.163357891	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	50	25	15	100	0.195	0.195	50	50	0.018429968	18	25	0.000255718	20	20	20	20	15	7.8	20	0.030688901	3.17E-06	0	0	20	0	20	0	0	1.63E-05	0											9.7451	0.257178705	1.203879466	1.066366336	1.124319227	1.981547772	0.847032707	1.119826475	1.3082762	1.246344792	3.383596844	0.016726975	6.81E-09	0.960656499	4.905160032	5.508452687	0.222256321	0.09496243	1.571092771	0.78457842	0.437319698	5.42E-10	0	0	1.477416482	0	0.001625675	0	0	5.65E-09	0	0	0	0	0	0	0	0	0	0	0	39.2637	None	0.072527705	9.7451	0.257178705	1.203879466	1.066366336	1.124319227	1.981547772	0.847032707	1.119826475	1.3082762	1.246344792	3.383596844	0.016726975	6.81E-09	0.960656499	4.905160032	5.508452687	0.222256321	0.09496243	1.571092771	0.78457842	0.437319698	5.42E-10	0	0	1.477416482	0	0.001625675	0	0	5.65E-09	0	0	0	0	0	0	0	0	0	0	0	39.2637	None	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	Not Covered	Not Covered	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."	N/A	"Subject to deductible, then 20% coinsurance."	"Subject to deductible, then 20% coinsurance."											2.8286	0.0276	0.2392	0.1083	0.1378	0.1146	0.049	0.1662	0.5549	0.7626	0.688	0.0078	0.0036	0.2075	0.3729	1.4199	0.0229	0.0007	0.3642	0.1606	0.1607	0.0232	0	0	0.109	0.0384	0.0023	0.0068	0	0.047	0											8.6242	250	0	12.5737	0.284824455	1.443044375	1.174668568	1.262142108	2.096144399	0.896018199	1.286073702	1.863206425	2.00897766	4.071614374	0.024543511	0.003605798	1.168107748	5.278089142	6.928329477	0.245154927	0.095676371	1.935265072	0.945142703	0.598021076	0.023151184	0	0	1.586377686	0.038364368	0.003886591	0.006810534	0	0.046951092	0	0	0	0	0	0	0	0	0	0	0	47.8879
H3931_004_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1649.246194		1092.627315	861.2289009	220.1753314	10.20356472		314.1610948	300.8550149	539.7972403	3081.589958	0	0	869.1876722	4231.008905	5451.459273	0	543.7887694	0	0	251.7925048				675.7425574		59.26569577															350/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$250 per procedure	$30 per visit	"$30 X-ray; $150 PET, MRI"	$30 per visit	$30 per visit	$30 per visit	$15 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script				$0 per visit		$0 per visit															59.18		68.64	20	100	0.2		48	250	30	51.6	30	30	30	15	30	30	30	30	30	45				0		0															8.1335	0	6.249828241	1.435381501	1.834794429	2.040712944	0	1.256644379	6.26781281	1.349493101	13.25083682	0	0	2.172969181	5.288761132	13.62864818	0	1.359471923	0	0	0.944221893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2131			8.1335	0	6.249828241	1.435381501	1.834794429	2.040712944	0	1.256644379	6.26781281	1.349493101	13.25083682	0	0	2.172969181	5.288761132	13.62864818	0	1.359471923	0	0	0.944221893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2131																																																																																				0			8.1335	0	6.249828241	1.435381501	1.834794429	2.040712944	0	1.256644379	6.26781281	1.349493101	13.25083682	0	0	2.172969181	5.288761132	13.62864818	0	1.359471923	0	0	0.944221893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2131
H3931_054_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		2188.410983		1128.428611	1026.98241	221.825794	12.52974629		346.5075893	297.9679931	558.0634507	3470.601852	0	0	741.0648797	5218.354171	5806.198032	0	387.5665486	0	0	249.3762896				645.8737064		78.05980421															$150 per day; max $1500		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$30 per visit	"$30 X-ray; $100 PET, MRI"	$30 per visit	$30 per visit	$30 per visit	$0 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script				$0 per visit		$0 per visit															122.95		68.64	20	100	0.2		48	200	30	42.6	30	30	30	0	30	30	30	30	30	45				0		0															22.4221	0	6.454611656	1.711637349	1.848548283	2.505949257	0	1.386030357	4.966133219	1.395158627	12.32063658	0	0	1.852662199	0	14.51549508	0	0.968916371	0	0	0.935161086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.283			22.4221	0	6.454611656	1.711637349	1.848548283	2.505949257	0	1.386030357	4.966133219	1.395158627	12.32063658	0	0	1.852662199	0	14.51549508	0	0.968916371	0	0	0.935161086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.283																																																																																				0			22.4221	0	6.454611656	1.711637349	1.848548283	2.505949257	0	1.386030357	4.966133219	1.395158627	12.32063658	0	0	1.852662199	0	14.51549508	0	0.968916371	0	0	0.935161086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.283
H3931_055_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1626.565218		1077.601144	849.3849975	217.1474078	10.06324194		309.840648	296.7175577	532.373771	3039.210918	0	0	857.2343172	4172.822678	5376.489011	0	536.3104072	0	0	248.3297713				666.4495233		58.45065441															850/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$35 per visit	"$35 X-ray; $150 PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$20 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															143.72		68.64	20	100	0.2		48	200	35	55.7	35	30	35	20	35	35	35	35	35	45				0		0															19.4808	0	6.163878546	1.415641663	1.809561732	2.012648388	0	1.239362592	4.945292628	1.552756832	14.10700401	0	0	2.500266759	6.954704463	15.68142628	0	1.564238688	0	0	0.931236643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.3588			19.4808	0	6.163878546	1.415641663	1.809561732	2.012648388	0	1.239362592	4.945292628	1.552756832	14.10700401	0	0	2.500266759	6.954704463	15.68142628	0	1.564238688	0	0	0.931236643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.3588																																																																																				0			19.4808	0	6.163878546	1.415641663	1.809561732	2.012648388	0	1.239362592	4.945292628	1.552756832	14.10700401	0	0	2.500266759	6.954704463	15.68142628	0	1.564238688	0	0	0.931236643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.3588
H3931_058_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		2197.878835		1133.310599	1031.425504	222.785492	12.58395447		348.0067056	299.2571097	560.4778335	3485.616922	0	0	744.2709924	5240.930645	5831.31773	0	389.2433006	0	0	250.455181				648.667988		78.39751895															350/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$20 per visit	"$20 X-ray; $125 PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$10 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit															59.18		68.64	20	100	0.2		48	200	20	38.9	20	20	20	10	20	20	20	20	20	45				0		0															10.8392	0	6.482536624	1.719042507	1.856545767	2.516790894	0	1.392026822	4.987618494	0.934129723	11.29920819	0	0	1.240451654	4.367442204	9.718862883	0	0.648738834	0	0	0.939206929	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.9418			10.8392	0	6.482536624	1.719042507	1.856545767	2.516790894	0	1.392026822	4.987618494	0.934129723	11.29920819	0	0	1.240451654	4.367442204	9.718862883	0	0.648738834	0	0	0.939206929	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.9418																																																																																				0			10.8392	0	6.482536624	1.719042507	1.856545767	2.516790894	0	1.392026822	4.987618494	0.934129723	11.29920819	0	0	1.240451654	4.367442204	9.718862883	0	0.648738834	0	0	0.939206929	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.9418
H3931_064_0	2008	5																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1626.588127		1077.616322	849.3969608	217.1504662	10.06338368		309.845012	296.7217369	532.3812693	3039.253725	0	0	857.2463911	4172.881451	5376.564737	0	536.317961	0	0	248.333269				666.45891		58.45147767															850/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$250 per procedure	$35 per visit	"$35 X-ray; $150 PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$20 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															143.72		68.64	20	100	0.2		48	250	35	55.7	35	30	35	20	35	35	35	35	35	45				0		0															19.4811	0	6.163965362	1.415661601	1.809587219	2.012676735	0	1.239380048	6.181702851	1.552778702	14.10720271	0	0	2.500301974	6.954802418	15.68164715	0	1.56426072	0	0	0.931249759	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.5963			19.4811	0	6.163965362	1.415661601	1.809587219	2.012676735	0	1.239380048	6.181702851	1.552778702	14.10720271	0	0	2.500301974	6.954802418	15.68164715	0	1.56426072	0	0	0.931249759	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.5963																																																																																				0			19.4811	0	6.163965362	1.415661601	1.809587219	2.012676735	0	1.239380048	6.181702851	1.552778702	14.10720271	0	0	2.500301974	6.954802418	15.68164715	0	1.56426072	0	0	0.931249759	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.5963
H3931_065_0	2008	6																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		2188.410983		1128.428611	1026.98241	221.825794	12.52974629		346.5075893	297.9679931	558.0634507	3470.601852	0	0	741.0648797	5218.354171	5806.198032	0	387.5665486	0	0	249.3762896				645.8737064		78.05980421															$150 per day; max $1500		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$30 per visit	"$30 X-ray; $125 PET, MRI"	$30 per visit	$30 per visit	$30 per visit	$0 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script				$0 per visit		$0 per visit															122.95		68.64	20	100	0.2		48	200	30	47.1	30	30	30	0	30	30	30	30	30	45				0		0															22.4221	0	6.454611656	1.711637349	1.848548283	2.505949257	0	1.386030357	4.966133219	1.395158627	13.62211227	0	0	1.852662199	0	14.51549508	0	0.968916371	0	0	0.935161086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5845			22.4221	0	6.454611656	1.711637349	1.848548283	2.505949257	0	1.386030357	4.966133219	1.395158627	13.62211227	0	0	1.852662199	0	14.51549508	0	0.968916371	0	0	0.935161086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5845																																																																																				0			22.4221	0	6.454611656	1.711637349	1.848548283	2.505949257	0	1.386030357	4.966133219	1.395158627	13.62211227	0	0	1.852662199	0	14.51549508	0	0.968916371	0	0	0.935161086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5845
H3931_069_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S			V	V		V																																																								0		2111.524433		1262.10163	1053.345989	251.958134	12.640363		372.2752793	342.0955705	623.7701106	3682.155783	0	0	937.3550424	5248.478439	6371.973781	0	554.0631479	0	0	286.3076775			3781.118076	758.4195371		75.63049092															$950 per admission		$0 days 1-20; $100 21+	$0 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$200 per procedure	$15 per visit	"$15 X-ray; $150 PET, MRI"	$15 per visit	$0 per visit	$15 per visit	$0 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script			$5 per visit	$0 per visit		$0 per visit															160.62		41.2	0	100	0.2		46.675	200	15	39.3	15	0	15	0	15	15	15	15	15	45			5	0		0															28.2628	0	4.333215597	0	2.099651117	2.5280726	0	1.447995722	5.701592842	0.779712638	12.05906019	0	0	1.171693803	0	7.964967226	0	0.692578935	0	0	1.073653791	0	0	1.575465865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.6904			28.2628	0	4.333215597	0	2.099651117	2.5280726	0	1.447995722	5.701592842	0.779712638	12.05906019	0	0	1.171693803	0	7.964967226	0	0.692578935	0	0	1.073653791	0	0	1.575465865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.6904																																																																																				0			28.2628	0	4.333215597	0	2.099651117	2.5280726	0	1.447995722	5.701592842	0.779712638	12.05906019	0	0	1.171693803	0	7.964967226	0	0.692578935	0	0	1.073653791	0	0	1.575465865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.6904
H3931_070_0	2008	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961																					250/admission	250/admission	$0 days 1-10;  $75 11+	$20 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $35 UC	$135 per procedure	$20 per visit	"$20 X-ray; $125 CAT, PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$0 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script																					42.27	42.27	48.27	20	100	0.2	0.2	48	135	20	38.9	20	20	20	0	20	20	20	20	20	45																					5.592	0.108939204	5.216077524	3.547740771	1.957621255	3.143561179	0.200659672	1.704269383	3.948993384	3.71953883	3.718031057	0	0	0	0	11.40257547	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.6166			5.592	0.108939204	5.216077524	3.547740771	1.957621255	3.143561179	0.200659672	1.704269383	3.948993384	3.71953883	3.718031057	0	0	0	0	11.40257547	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.6166																																																																																				0			5.592	0.108939204	5.216077524	3.547740771	1.957621255	3.143561179	0.200659672	1.704269383	3.948993384	3.71953883	3.718031057	0	0	0	0	11.40257547	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.6166
H3931_071_0	2008	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961																					$250 /admission	$250 /admission	$0 days 1-10; $75 11+	$20 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $35 UC	$135 per procedure	$20 per visit	"$20 X-ray; $125 PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$0 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script																					42.27	42.27	48.27	20	100	0.2	0.2	48	135	20	38.9	20	20	20	0	20	20	20	20	20	45																					5.592	0.108939204	5.216077524	3.547740771	1.957621255	3.143561179	0.200659672	1.704269383	3.948993384	3.71953883	3.718031057	0	0	0	0	11.40257547	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.6166			5.592	0.108939204	5.216077524	3.547740771	1.957621255	3.143561179	0.200659672	1.704269383	3.948993384	3.71953883	3.718031057	0	0	0	0	11.40257547	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.6166																																																																																				0			5.592	0.108939204	5.216077524	3.547740771	1.957621255	3.143561179	0.200659672	1.704269383	3.948993384	3.71953883	3.718031057	0	0	0	0	11.40257547	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.6166
H3931_801_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1722.846055		1177.458693	1141.972176	212.0508	11.76605524		301.2863682	286.3596065	616.5115673	3585.175033	0	41.7749863	893.0374699	4143.871755	5490.793771	0	699.3504453	0	0	7.685206534				684.6677399		56.91994361															$200 per day; $1400 max		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20%  PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	55.3	40	30	40	30	40	40	40	40	40	0.2				0		0															20.756	0	9.812155778	3.80657392	2.650635	3.529816572	0	1.255359868	4.772660109	2.055038558	16.52168161	0	0.104437466	2.976791566	10.35967939	18.3026459	0	2.331168151	0	0	1.537041307	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.7717			20.756	0	9.812155778	3.80657392	2.650635	3.529816572	0	1.255359868	4.772660109	2.055038558	16.52168161	0	0.104437466	2.976791566	10.35967939	18.3026459	0	2.331168151	0	0	1.537041307	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.7717																																																																																				0			20.756	0	9.812155778	3.80657392	2.650635	3.529816572	0	1.255359868	4.772660109	2.055038558	16.52168161	0	0.104437466	2.976791566	10.35967939	18.3026459	0	2.331168151	0	0	1.537041307	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.7717
H3931_804_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1722.846055		1177.458693	1141.972176	212.0508	11.76605524		301.2863682	286.3596065	616.5115673	3585.175033	0	41.7749863	893.0374699	4143.871755	5490.793771	0	699.3504453	0	0	7.685206534				684.6677399		56.91994361															$200 per day; $1400 max		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20%  PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	55.3	40	30	40	30	40	40	40	40	40	0.2				0		0															20.756	0	9.812155778	3.80657392	2.650635	3.529816572	0	1.255359868	4.772660109	2.055038558	16.52168161	0	0.104437466	2.976791566	10.35967939	18.3026459	0	2.331168151	0	0	1.537041307	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.7717			20.756	0	9.812155778	3.80657392	2.650635	3.529816572	0	1.255359868	4.772660109	2.055038558	16.52168161	0	0.104437466	2.976791566	10.35967939	18.3026459	0	2.331168151	0	0	1.537041307	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.7717																																																																																				0			20.756	0	9.812155778	3.80657392	2.650635	3.529816572	0	1.255359868	4.772660109	2.055038558	16.52168161	0	0.104437466	2.976791566	10.35967939	18.3026459	0	2.331168151	0	0	1.537041307	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.7717
H3949_002_0	2008	2																																D	Coin	Coin	V	T	Coin	Coin	V	COin	V	V	Coin	Coin	Coin	V	V	V	V	P	V	Coin	P	T	V	V	P	V	P	O	O	V																																																				0		2785.388017	8.447904322	47.1653324		141.8741957	10.12353228	15.94643401	486.3813457	57.85851256		1696.38397	2.345859353	1.924085105	16.88461799		8652.814539	460.0224232	1149.353723			12.32001424	808.668307																				"#1A $150/day days 1-7, $0/day days 9-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $100	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $50"	"#9A 20%, #9B 20%"	#8A $0	"#8B $20 x-ray, $150 complex radiology"	#9A 20%	#12 20%	"#3 20%, #5 20%, #9A 20%, #9C 20%, #9D $35"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $35, #7D $35, #7F $35, #7G $35"	"#7E $35, #7H $35"	"#7C $35, #7I $35"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0 n/c, #17A $35, #17B $0, #18A $35"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											106.7258	0.073	0.1705		100	0.2	0.2	50	0.2		100.2103	0.2	0.2	0.2		17.8762	34.9999	27.7171			0.2	34.9953																				24.7727	0.616697016	8.041689175	0	1.182284964	2.024706457	3.189286801	2.02658894	11.57170251	0	14.16625782	0.469171871	0.384817021	3.376923598	0	12.88995292	1.3417274	2.654729949	0	0	2.464002848	2.358295887	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5316	0	0	24.7727	0.616697016	8.041689175	0	1.182284964	2.024706457	3.189286801	2.02658894	11.57170251	0	14.16625782	0.469171871	0.384817021	3.376923598	0	12.88995292	1.3417274	2.654729949	0	0	2.464002848	2.358295887	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5316																																																																																				0		0	24.7727	0.616697016	8.041689175	0	1.182284964	2.024706457	3.189286801	2.02658894	11.57170251	0	14.16625782	0.469171871	0.384817021	3.376923598	0	12.88995292	1.3417274	2.654729949	0	0	2.464002848	2.358295887	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5316
H3949_009_0	2008	3																																Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	P	V	P	O	O	V																																																				0		471.6523976	15.11457875	65.19633482		11.75513654	16.97533423	17.87751098	742.5952755	54.21162216	11.26301789	55.16172578	2.449323262	5.2308237	9.620680957	0.844369216	169.3025156	5.368305488	6.646888389	21.23059063	3.144018234	7.152343295	3.649632018																				#1A MC cost shares w/o PB deductible and w/ $0 PCP	#1B MC cost shares w/o PB deductible and w/ $0 PCP	#2 MC cost shares w/o PB deductible and w/ $0 PCP	#6 $0	#10A MC cost shares w/o PB deductible and w/ $0 PCP	#11A MC cost shares w/o PB deductible and w/ $0 PCP	"#11B MC cost shares w/o PB deductible and w/ $0 PCP, #11C MC cost shares w/o PB deductible and w/ $0 PCP"	"#4A $50, #4B MC cost shares w/o PB deductible and w/ $0 PCP"	"#9A MC cost shares w/o PB deductible and w/ $0 PCP, #9B MC cost shares w/o PB deductible and w/ $0 PCP"	#8A MC cost shares w/o PB deductible and w/ $0 PCP	#8B MC cost shares w/o PB deductible and w/ $0 PCP	#9A MC cost shares w/o PB deductible and w/ $0 PCP	#12 MC cost shares w/o PB deductible and w/ $0 PCP	"#3 MC cost shares w/o PB deductible and w/ $0 PCP, #5 MC cost shares w/o PB deductible and w/ $0 PCP, #9A MC cost shares w/o PB deductible and w/ $0 PCP, #9C MC cost shares w/o PB deductible and w/ $0 PCP, #9D MC cost shares w/o PB deductible and w/ $0 PCP"	"#7A MC cost shares w/o PB deductible and w/ $0 PCP, #14B MC cost shares w/o PB deductible and w/ $0 PCP, #14C $0, #14D 0%-pap smears, 20%-pelvic exams, #14E MC cost shares w/o PB deductible and w/ $0 PCP, #14F MC cost shares w/o PB deductible and w/ $0 PCP, #14G MC cost shares w/o PB deductible and w/ $0 PCP, #14H MC cost shares w/o PB deductible and w/ $0 PCP"	"#7B MC cost shares w/o PB deductible and w/ $0 PCP, #7D MC cost shares w/o PB deductible and w/ $0 PCP, #7F 20%, #7G MC cost shares w/o PB deductible and w/ $0 PCP"	"#7E MC cost shares w/o PB deductible and w/ $0 PCP, #7H MC cost shares w/o PB deductible and w/ $0 PCP"	"#7C MC cost shares w/o PB deductible and w/ $0 PCP, #7I MC cost shares w/o PB deductible and w/ $0 PCP"	#8A MC cost shares w/o PB deductible and w/ $0 PCP; #8B MC cost shares w/o PB deductible and w/ $0 PCP	"#14I MC cost shares w/o PB deductible and w/ $0 PCP , #14J MC cost shares w/o PB deductible and w/ $0 PCP"	#15 MC cost shares w/o PB deductible and w/ $0 PCP	"#13A MC cost shares w/o PB deductible and w/ $0 PCP, #16B $0, #17A MC cost shares w/o PB deductible and w/ $0 PCP, #17B MC cost shares w/o PB deductible and w/ $0 PCP, #18A $0"	#10B $0	#16A $0	#17A $0	#17B $0	#18A $0	#18B $0	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											0.073326624	0.073326624	0.171498393		0.206316224	0.206316224	0.206316224	50	0.206316224	0.204606149	0.206316224	0.206316224	0.20580153	0.206316224	0.170970685	0.143245237	0.20630722	0.179319977	0.204469332	0.171339137	0.206316224	0.206288232																				34.5847	1.10830104	11.18106666	0	2.425275383	3.502286858	3.688420559	3.094146981	11.18473718	2.304482715	11.38075897	0.505335127	1.07651152	1.984902567	0.144362383	24.25177898	1.107520179	1.19191987	4.341004684	0.538693372	1.475644461	0.752876136	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.8247	0	0	34.5847	1.10830104	11.18106666	0	2.425275383	3.502286858	3.688420559	3.094146981	11.18473718	2.304482715	11.38075897	0.505335127	1.07651152	1.984902567	0.144362383	24.25177898	1.107520179	1.19191987	4.341004684	0.538693372	1.475644461	0.752876136	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.8247																																																																																				0		0	34.5847	1.10830104	11.18106666	0	2.425275383	3.502286858	3.688420559	3.094146981	11.18473718	2.304482715	11.38075897	0.505335127	1.07651152	1.984902567	0.144362383	24.25177898	1.107520179	1.19191987	4.341004684	0.538693372	1.475644461	0.752876136	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.8247
H3949_012_0	2008	3																																D	Coin	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	P	V	Coin	V	T	V	V	P	V	P	O	O	V																																																				0		1975.489859	6.479994724	36.94374216		198.3481246	7.205447923	14.7950058	644.0787984	305.5374008		1931.990373	6.942162117	1.890216814	740.6009225	1083.906024	6433.468166	361.4567868	960.2718132			13.18236319	312.7656319																				"#1A $150/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $30"	"#9A $150, #9B $100"	#8A $0	"#8B $20 x-ray, $150 complex radiology"	#9A $150	#12 20%	"#3 20%, #5 20%, #9A $150, #9C 20%, #9D $35"	"#7A $5, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $35, #7D $35, #7F $35, #7G $35"	"#7E $35, #7H $35"	"#7C $35, #7I $35"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0, #17A $35, #17B $0, #18A $35"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											88.55	0.0805	0.1937		50	0.2	0.2	49.8125	142.4636		97.0376	150	0.2	96.7605	5	26.8302	35	35			0.2	35																				14.5775	0.521639575	7.156002855	0	0.826450519	1.441089585	2.959001161	2.67359748	3.627329659	0	15.62297722	0.086777026	0.378043363	5.971741937	0.45162751	14.38427157	1.054248962	2.800792789	0	0	2.636472639	0.912233093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.0818	0	0	14.5775	0.521639575	7.156002855	0	0.826450519	1.441089585	2.959001161	2.67359748	3.627329659	0	15.62297722	0.086777026	0.378043363	5.971741937	0.45162751	14.38427157	1.054248962	2.800792789	0	0	2.636472639	0.912233093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.0818																																																																																				0	0	0	14.5775	0.521639575	7.156002855	0	0.826450519	1.441089585	2.959001161	2.67359748	3.627329659	0	15.62297722	0.086777026	0.378043363	5.971741937	0.45162751	14.38427157	1.054248962	2.800792789	0	0	2.636472639	0.912233093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.0818
H3949_013_0	2008	2																																D	Coin	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	P	V	Coin	V	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		1961.58188	7.858787829	35.30886163		176.0576766	8.544890194	27.65317366	214.4454574	278.3723829		584.1604797	24.63390257	0.504069416	305.9847001		5366.795314	429.8876261	852.1783236			29.47390812	1109.832639																				"#1A $100/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $20"	"#9A $100, #9B $50"	#8A $0	"#8B $10 x-ray, $50 complex radiology"	#9A $100	#12 20%	"#3 20%, #5 20%, #9A $100, #9C 20%, #9D $20"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $20, #7D $20, #7F $20, #7G $20"	"#7E $20, #7H $20"	"#7C $20, #7I $20"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0, #17A $20, #17B $0, #18A $20"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											61.6	0.073	0.1705		50	0.2	0.2	47.0024	85.1214		30.3392	100	0.2	99.0438		20	20	20			0.2	20																				10.0695	0.573691512	6.020160907	0	0.733573652	1.708978039	5.530634733	0.839954408	1.974620449	0	1.476915134	0.205282521	0.100813883	2.525490537	0	8.944658857	0.716479377	1.420297206	0	0	5.894781625	1.849721065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5855	0	0	10.0695	0.573691512	6.020160907	0	0.733573652	1.708978039	5.530634733	0.839954408	1.974620449	0	1.476915134	0.205282521	0.100813883	2.525490537	0	8.944658857	0.716479377	1.420297206	0	0	5.894781625	1.849721065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5855																																																																																				0	0	0	10.0695	0.573691512	6.020160907	0	0.733573652	1.708978039	5.530634733	0.839954408	1.974620449	0	1.476915134	0.205282521	0.100813883	2.525490537	0	8.944658857	0.716479377	1.420297206	0	0	5.894781625	1.849721065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5855
H3949_015_0	2008	2																																D	Coin	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	P	V	Coin	V	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		1921.528587	7.251085773	32.57928154		172.4627771	8.19949875	22.29554509	210.1318129	272.6883324		572.2325806	24.13090602	0.386912551	299.7368371		5257.211398	421.109805	834.777802			28.28254868	1087.171107																				"#1A $100/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $20"	"#9A $75, #9B $50"	#8A $0	"#8B $10 x-ray, $50 complex radiology"	#9A $75	#12 20%	"#3 20%, #5 20%, #9A $75, #9C 20%, #9D $20"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $20, #7D $20, #7F $20, #7G $20"	"#7E $20, #7H $20"	"#7C $20, #7I $20"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0, #17A $20, #17B $0, #18A $20"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											61.6	0.0805	0.1937		50	0.2	0.2	47.0033	67.5607		30.3392	75	0.2	74.3916		20	20	20			0.2	20																				9.8638	0.583712405	6.310606834	0	0.718594905	1.63989975	4.459109017	0.823074694	1.535251154	0	1.446758191	0.150818163	0.07738251	1.858158817	0	8.762018997	0.701849675	1.391296337	0	0	5.656509735	1.811951844	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.7908	0	0	9.8638	0.583712405	6.310606834	0	0.718594905	1.63989975	4.459109017	0.823074694	1.535251154	0	1.446758191	0.150818163	0.07738251	1.858158817	0	8.762018997	0.701849675	1.391296337	0	0	5.656509735	1.811951844	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.7908																																																																																				0	0	0	9.8638	0.583712405	6.310606834	0	0.718594905	1.63989975	4.459109017	0.823074694	1.535251154	0	1.446758191	0.150818163	0.07738251	1.858158817	0	8.762018997	0.701849675	1.391296337	0	0	5.656509735	1.811951844	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.7908
H3949_016_0	2008	3																																Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	Coin	Coin	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		492.0252133	39.49148977			44.81700691	8.540574381	19.40506379	296.9359355	14.32291004		7.309225098	1.482576429	3.045590512	13.84594981		319.8010918	50.11144545	97.49950012			28.00524721	9.215168584																				#1A MC cost shares	#1B MC cost shares	#2 $0	#6 $0	#10A MC Cost Shares w/o Part B Deductible and PCP $0	#11A MC Cost Shares w/o Part B Deductible and PCP $0	"#11B MC Cost Shares w/o Part B Deductible and PCP $0, #11C MC Cost Shares w/o Part B Deductible and PCP $0"	"#4A $50, #4B $$50"	"#9A MC Cost Shares w/o Part B Deductible and PCP $0, #9B MC Cost Shares w/o Part B Deductible and PCP $0"	#8A 0%	#8B MC Cost Shares w/o Part B Deductible and PCP $0	#9A MC Cost Shares w/o Part B Deductible and PCP $0	#12 MC Cost Shares w/o Part B Deductible and PCP $0	"#3 MC Cost Shares w/o Part B Deductible and PCP $0, #5 MC Cost Shares w/o Part B Deductible and PCP $0, #9C MC Cost Shares w/o Part B Deductible and PCP $0, #9D MC Cost Shares w/o Part B Deductible and PCP $0"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B MC Cost Shares w/o Part B Deductible and PCP $0, #7D MC Cost Shares w/o Part B Deductible and PCP $0, #7F MC Cost Shares w/o Part B Deductible and PCP $0, #7G MC Cost Shares w/o Part B Deductible and PCP $0"	"#7E MC Cost Shares w/o Part B Deductible and PCP $0, #7H MC Cost Shares w/o Part B Deductible and PCP $0"	"#7C MC Cost Shares w/o Part B Deductible and PCP $0, #7I MC Cost Shares w/o Part B Deductible and PCP $0"	#8B MC Cost Shares w/o Part B Deductible and PCP $0	"#14I $0 , #14J $0"	#15 MC Cost Shares w/o Part B Deductible and PCP $0	"#13A MC Cost Shares w/o Part B Deductible and PCP $0, #16B MC Cost Shares w/o Part B Deductible and PCP $0, #17A MC Cost Shares w/o Part B Deductible and PCP $0, #17B MC Cost Shares w/o Part B Deductible and PCP $0, #18A MC Cost Shares w/o Part B Deductible and PCP $0"	#10B $0	"#16A $0, #16B MC Cost Shares w/o Part B Deductible and PCP $0"	#17A $0	#17B $0	#18A $0	#18B $0	#19 $0 n/c	#14A $0 n/c	"#13B $0 n/c , #13C $0, #13D $0"											0.073	0.073			0.206	0.206	0.206	50	0.206		0.206	0.206	0.206	0.206		0.206	0.206	0.206			0.206	0.206																				35.9178	2.882878753	0	0	9.232303424	1.759358323	3.997443141	1.237233065	2.950519467	0	1.50570037	0.305410744	0.627391646	2.852265661	0	65.87902492	10.32295776	20.08489703	0	0	5.769080925	1.898324728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	167.2226	0	0	35.9178	2.882878753	0	0	9.232303424	1.759358323	3.997443141	1.237233065	2.950519467	0	1.50570037	0.305410744	0.627391646	2.852265661	0	65.87902492	10.32295776	20.08489703	0	0	5.769080925	1.898324728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	167.2226																																																																																				0	0	0	35.9178	2.882878753	0	0	9.232303424	1.759358323	3.997443141	1.237233065	2.950519467	0	1.50570037	0.305410744	0.627391646	2.852265661	0	65.87902492	10.32295776	20.08489703	0	0	5.769080925	1.898324728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	167.2226
H3949_017_0	2008	2																																D	Coin	Coin	V	T	Coin	Coin	V	COin	V	V	Coin	Coin	Coin	V	V	V	V	P	V	Coin	P	T	V	V	P	V	P	O	O	V																																																				0		2676.930906	8.118960815	45.32881423		136.3499149	9.729343371	15.32551363	467.442686	55.60562458		1630.33037	2.254516557	1.849165305	16.22716672		8315.892262	442.110124	1104.600323			11.84029897	777.1804754																				"#1A $150/day days 1-7, $0/day days 9-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $100	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $50"	"#9A 20%, #9B 20%"	#8A $0	"#8B $20 x-ray, $150 complex radiology"	#9A 20%	#12 20%	"#3 20%, #5 20%, #9A 20%, #9C 20%, #9D $35"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $35, #7D $35, #7F $35, #7G $35"	"#7E $35, #7H $35"	"#7C $35, #7I $35"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0 n/c, #17A $35, #17B $0, #18A $35"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											106.7258	0.073	0.1705		100	0.2	0.2	50	0.2		100.2103	0.2	0.2	0.220895588		17.8762	34.9999	26.8614			0.2	34.9953																				23.8081	0.592684139	7.728562826	0	1.136249291	1.945868674	3.065102726	1.947677858	11.12112492	0	13.61465373	0.450903311	0.369833061	3.584509532	0	12.38804544	1.289483376	2.472589534	0	0	2.368059794	2.266468839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.1499	0	0	23.8081	0.592684139	7.728562826	0	1.136249291	1.945868674	3.065102726	1.947677858	11.12112492	0	13.61465373	0.450903311	0.369833061	3.584509532	0	12.38804544	1.289483376	2.472589534	0	0	2.368059794	2.266468839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.1499																																																																																				0		0	23.8081	0.592684139	7.728562826	0	1.136249291	1.945868674	3.065102726	1.947677858	11.12112492	0	13.61465373	0.450903311	0.369833061	3.584509532	0	12.38804544	1.289483376	2.472589534	0	0	2.368059794	2.266468839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.1499
H3949_018_0	2008	2																																D	Coin	Coin	V	T	Coin	Coin	V	COin	V	V	Coin	Coin	Coin	V	V	V	V	P	V	Coin	P	T	V	V	P	V	P	O	O	V																																																				0		2785.388017	8.447904322	47.1653324		141.8741957	10.12353228	15.94643401	486.3813457	57.85851256		1696.38397	2.345859353	1.924085105	16.88461799		8652.814539	460.0224232	1149.353723			12.32001424	808.668307																				"#1A $150/day days 1-7, $0/day days 9-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $100	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $50"	"#9A 20%, #9B 20%"	#8A $0	"#8B $20 x-ray, $150 complex radiology"	#9A 20%	#12 20%	"#3 20%, #5 20%, #9A 20%, #9C 20%, #9D $35"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $35, #7D $35, #7F $35, #7G $35"	"#7E $35, #7H $35"	"#7C $35, #7I $35"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0 n/c, #17A $35, #17B $0, #18A $35"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	#18A $0	#18B $0	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											106.7258	0.073	0.1705		100	0.2	0.2	50	0.2		100.2103	0.2	0.2	0.2		17.8762	34.9999	27.7171			0.2	34.9953																				24.7727	0.616697016	8.041689175	0	1.182284964	2.024706457	3.189286801	2.02658894	11.57170251	0	14.16625782	0.469171871	0.384817021	3.376923598	0	12.88995292	1.3417274	2.654729949	0	0	2.464002848	2.358295887	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5316	0	0	24.7727	0.616697016	8.041689175	0	1.182284964	2.024706457	3.189286801	2.02658894	11.57170251	0	14.16625782	0.469171871	0.384817021	3.376923598	0	12.88995292	1.3417274	2.654729949	0	0	2.464002848	2.358295887	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5316																																																																																				0		0	24.7727	0.616697016	8.041689175	0	1.182284964	2.024706457	3.189286801	2.02658894	11.57170251	0	14.16625782	0.469171871	0.384817021	3.376923598	0	12.88995292	1.3417274	2.654729949	0	0	2.464002848	2.358295887	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5316
H3949_019_0	2008	2																																D	Coin	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	P	V	Coin	V	T	V	V	P	V	P	O	O	V																																																				0		1975.489859	6.479994724	36.94374216		198.3481246	7.205447923	14.7950058	644.0787984	305.5374008		1931.990373	6.942162117	1.890216814	740.6009225	1083.906024	6433.468166	361.4567868	960.2718132			13.18236319	312.7656319																				"#1A $150/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $30"	"#9A $150, #9B $100"	#8A $0	"#8B $20 x-ray, $150 complex radiology"	#9A $150	#12 20%	"#3 20%, #5 20%, #9A $150, #9C 20%, #9D $35"	"#7A $5, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $35, #7D $35, #7F $35, #7G $35"	"#7E $35, #7H $35"	"#7C $35, #7I $35"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0, #17A $35, #17B $0, #18A $35"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	#18A $0 n/c	#18B $0	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											88.55	0.0805	0.1937		50	0.2	0.2	49.8125	142.4636		97.0376	150	0.2	96.7605	5	26.8302	35	35			0.2	35																				14.5775	0.521639575	7.156002855	0	0.826450519	1.441089585	2.959001161	2.67359748	3.627329659	0	15.62297722	0.086777026	0.378043363	5.971741937	0.45162751	14.38427157	1.054248962	2.800792789	0	0	2.636472639	0.912233093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.0818	0	0	14.5775	0.521639575	7.156002855	0	0.826450519	1.441089585	2.959001161	2.67359748	3.627329659	0	15.62297722	0.086777026	0.378043363	5.971741937	0.45162751	14.38427157	1.054248962	2.800792789	0	0	2.636472639	0.912233093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.0818																																																																																				0	0	0	14.5775	0.521639575	7.156002855	0	0.826450519	1.441089585	2.959001161	2.67359748	3.627329659	0	15.62297722	0.086777026	0.378043363	5.971741937	0.45162751	14.38427157	1.054248962	2.800792789	0	0	2.636472639	0.912233093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.0818
H3949_020_0	2008	2																																D	Coin	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	P	V	Coin	V	T	V	V	P	V	P	O	O	V																																																				0		2172.024052	7.124670855	40.61881983		218.0809311	7.922298091	16.26695116	708.1302071	335.9340497		2124.189547	7.632910797	2.075998648	814.2781873	3.588176776	7069.577809	397.4171826	1035.232238			14.49391556	343.8859722																				"#1A $75/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $30"	"#9A $150, #9B $100"	#8A $0	"#8B $20 x-ray, $150 complex radiology"	#9A $150	#12 20%	"#3 20%, #5 20%, #9A $150, #9C 20%, #9D $35"	"#7A $5, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $35, #7D $35, #7F $35, #7G $35"	"#7E $35, #7H $35"	"#7C $35, #7I $35"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0, #17A $35, #17B $0, #18A $35"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											44.275	0.0805	0.1937		50	0.2	0.2	49.8125	142.4636		97.0376	150	0.2	96.7606	5	26.8257	35	35			0.2	35																				8.0139	0.573536004	7.8678654	0	0.908670546	1.584459618	3.253390231	2.939476959	3.988196697	0	17.17718662	0.095411385	0.41519973	6.565836356	0.001495074	15.80386445	1.159133449	3.019427361	0	0	2.898783111	1.003000752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.2688	0	0	8.0139	0.573536004	7.8678654	0	0.908670546	1.584459618	3.253390231	2.939476959	3.988196697	0	17.17718662	0.095411385	0.41519973	6.565836356	0.001495074	15.80386445	1.159133449	3.019427361	0	0	2.898783111	1.003000752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.2688																																																																																				0	0	0	8.0139	0.573536004	7.8678654	0	0.908670546	1.584459618	3.253390231	2.939476959	3.988196697	0	17.17718662	0.095411385	0.41519973	6.565836356	0.001495074	15.80386445	1.159133449	3.019427361	0	0	2.898783111	1.003000752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.2688
H3952_008_0	2008	8																																D	D	D		T	coin	coin	V	V		V			V	V	V	V	V	V	V	s			V	V		V																																																								0		1461.185536	40.38737585	1397.028778		291.6831546	9.614126537	11.44030679	230.9837215	323.7916331		947.4049843			287.2844545	3369.074469	5327.768481	168.5019139	1070.077117	0.094690743	153.4579306	12.28058207			690.7406018	165.26899		0.0001															$150 per day 10 day max (PBP category 1A)	$150 per day 10 day max (PBP category 1B)	$75 per day 100 day max (PBP category 2)	$0 Copay	$50 per trip (PBP category 10A)	20% coinsurance (PBP category 11A)	20% coinsurance (PBP category 11B)	$50 per visit (PBP category 4A)	$175 per visit (PBP categories 9A and 9B)	$0 Copay	$30 per visit (PBP category 8B)	$0 Copay	$0 Copay	"$30 per visit (PBP categories 3, 5, and 9D)"	$5 per visit (PBP categories 4B and 7A)	"$30 per visit (PBP categories 4B, 7B, 7D, and 7F)"	"$30 per visit (PBP categories 7E, 7H and 9C)"	$30 per visit (PBP categories 7C and 7I)	$30 per visit (per note in PBP category 8B)	$30 per visit (PBP category 7D + remainder of category 18A not shown below)	$25 per script for certain injectible drugs (PBP Category 15)	$0 Copay		$15 per visit (PBP category 16A)	$30 per visit (PBP category 17A)	$0 Copay	$30 per visit (PBP category 18A)	$0 Copay		$0 Copay												150	150	75		50	0.2	0.2	50	175		30			30	5	30	30	30	30	30	25			15	30		30															18.2648	0.504842198	8.73142986	0	1.215346477	1.922825307	2.288061357	0.962432173	4.721961317	0	2.368512461	0	0	0.718211136	1.403781029	13.3194212	0.421254785	2.675192793	0.000236727	0.383644827	0.025584546	0	0	0.863425752	0.413172475	0	0.00000025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.2042			18.2648	0.504842198	8.73142986	0	1.215346477	1.922825307	2.288061357	0.962432173	4.721961317	0	2.368512461	0	0	0.718211136	1.403781029	13.3194212	0.421254785	2.675192793	0.000236727	0.383644827	0.025584546	0	0	0.863425752	0.413172475	0	0.00000025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.2042																																																																																				0			18.2648	0.504842198	8.73142986	0	1.215346477	1.922825307	2.288061357	0.962432173	4.721961317	0	2.368512461	0	0	0.718211136	1.403781029	13.3194212	0.421254785	2.675192793	0.000236727	0.383644827	0.025584546	0	0	0.863425752	0.413172475	0	0.00000025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.2042
H3952_018_0	2008	8	a.1.	a.2.	i.2.	h.5.	a.2.						Inpatient Facility	Inpatient Facility	Professional	Professional	Inpatient Facility							IP Copays days 61-150	IPMH Copays days 61-150	podiatry visits	op mh	Inpatient non-Hospital Substance Abuse Stay						bp	bp	d		coin	coin	coin	coin	coin		v	v	coin	coin		coin	coin	v	coin	coin	coin			coin	0		0					d	d	v	coin	d																																															0		330.8827685	52.74035207	503.506223		14.36833095	13.81046307	13.17264954	19.33540458	40.01656104		216.3944688	0	2.823185974	74.96242121		21.86831826	14.86344659	485.7978345	11.59817338	152.0531079	7.067313452			38.16993163	0		0					128.8310213	5.898101207	395.4466924	0.681193819	47.10213758						PBP 1a - Medicare FFS level desired per benefit period	PBP 1b - Medicare FFS level desired per benefit period	PBP 2 - Medicare FFS level desired per benefit period		PBP 10a	PBP 11a	"PBP 11b, 11c, 14i"	PBP 4a - 20% coinsurance to maximum $50	"PBP 9a, 9b"		PBP 8b (Radiology)	20% coinsurance	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"		"PBP 4b, 7b, 7d, 7f, 7g, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15			PBP 16	0% coinsurance		0% coinsurance					PBP  1a	PBP 1b	PBP 7f	PBP 5	PBP 1b						1032	1032	129		0.2	0.199194067	0.2	0.171369808	0.2		20	0.2	0.2	0.2		0.2	0.333639889	20	0.2	0.2	0.2			0.241549598	0		0					256	256	20	0.431733685	20						28.4559	4.535670278	5.412691898	0	2.87366619	2.750962311	2.634529908	3.313504579	8.003312208	0	0.360657448	0	0.564637195	14.99248424	0	4.373663653	4.959038667	0.809663057	2.319634676	30.41062158	1.41346269	0	0	9.219931626	0	0	0	0	0	0	0	2.748395121	0.125826159	0.659077821	0.294094318	0.078503563	0	0	0	0	0	131.3099			28.4559	4.535670278	5.412691898	0	2.87366619	2.750962311	2.634529908	3.313504579	8.003312208	0	0.360657448	0	0.564637195	14.99248424	0	4.373663653	4.959038667	0.809663057	2.319634676	30.41062158	1.41346269	0	0	9.219931626	0	0	0	0	0	0	0	2.748395121	0.125826159	0.659077821	0.294094318	0.078503563	0	0	0	0	0	131.3099																																																																																				0			28.4559	4.535670278	5.412691898	0	2.87366619	2.750962311	2.634529908	3.313504579	8.003312208	0	0.360657448	0	0.564637195	14.99248424	0	4.373663653	4.959038667	0.809663057	2.319634676	30.41062158	1.41346269	0	0	9.219931626	0	0	0	0	0	0	0	2.748395121	0.125826159	0.659077821	0.294094318	0.078503563	0	0	0	0	0	131.3099
H3952_020_0	2008	8																																D	D	D		T	coin	coin	V	V		V			V	V	V	V	V	V	V	s			V	V		V																																																								0		1461.185536	40.38737585	1397.028778		291.6831546	9.614126537	11.44030679	230.9837215	323.7916331		947.4049843			287.2844545	3369.074469	5327.768481	168.5019139	1070.077117	0.094690743	153.4579306	12.28058207			690.7406018	165.26899		0.0001															$150 per day 10 day max (PBP category 1A)	$150 per day 10 day max (PBP category 1B)	$75 per day 100 day max (PBP category 2)	$0 Copay	$50 per trip (PBP category 10A)	20% coinsurance (PBP category 11A)	20% coinsurance (PBP category 11B)	$50 per visit (PBP category 4A)	$175 per visit (PBP categories 9A and 9B)	$0 Copay	$30 per visit (PBP category 8B)	$0 Copay	$0 Copay	"$30 per visit (PBP categories 3, 5, and 9D)"	$5 per visit (PBP categories 4B and 7A)	"$30 per visit (PBP categories 4B, 7B, 7D, and 7F)"	"$30 per visit (PBP categories 7E, 7H and 9C)"	$30 per visit (PBP categories 7C and 7I)	$30 per visit (per note in PBP category 8B)	$30 per visit (PBP category 7D + remainder of category 18A not shown below)	$25 per script for certain injectible drugs (PBP Category 15)	$0 Copay		$15 per visit (PBP category 16A)	$30 per visit (PBP category 17A)	$0 Copay	$30 per visit (PBP category 18A)	$0 Copay		$0 Copay												150	150	75		50	0.2	0.2	50	175		30			30	5	30	30	30	30	30	25			15	30		30															18.2648	0.504842198	8.73142986	0	1.215346477	1.922825307	2.288061357	0.962432173	4.721961317	0	2.368512461	0	0	0.718211136	1.403781029	13.3194212	0.421254785	2.675192793	0.000236727	0.383644827	0.025584546	0	0	0.863425752	0.413172475	0	0.00000025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.2042			18.2648	0.504842198	8.73142986	0	1.215346477	1.922825307	2.288061357	0.962432173	4.721961317	0	2.368512461	0	0	0.718211136	1.403781029	13.3194212	0.421254785	2.675192793	0.000236727	0.383644827	0.025584546	0	0	0.863425752	0.413172475	0	0.00000025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.2042																																																																																				0			18.2648	0.504842198	8.73142986	0	1.215346477	1.922825307	2.288061357	0.962432173	4.721961317	0	2.368512461	0	0	0.718211136	1.403781029	13.3194212	0.421254785	2.675192793	0.000236727	0.383644827	0.025584546	0	0	0.863425752	0.413172475	0	0.00000025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.2042
H3952_026_0	2008	5																																D	D	D		T	coin	coin	V	V		V			V	V	V	V	V	V	V	S			V	V		V																																																								0		1359.206629	31.44901257	1249.435303		348.9353203	10.42513056	14.6188434	381.2911442	485.3873225		298.995622			389.343499	0.0001	4303.502097	300.9776102	338.8118383	27.41101999	29.57935986	3.024225015			752.3088922	127.1848195		0.0001															$150/$300 per day 10 day max (PBP category 1A)	$150 per day 10 day max (PBP category 1A)	$75 per day 100 day max (PBP category 2)	$0 Copay	100 per trip (PBP category 10A)	20% coinsurance (PBP category 11A)	20% coinsurance (PBP category 11B)	$50 per visit (PBP category 4A)	$225/visit (PBP categories 9A and 9B)	$0 Copay	$40 per visit (PBP category 8B)	$0 Copay	$0 Copay	"$40 per visit (PBP categories 3, 5, and 9D)"	$0 per visit (PBP categories 4B and 7A)	"$40 per visit (PBP categories 4B, 7B, 7D, and 7F)"	"$40 per visit (PBP categories 7E, 7H and 9C)"	$40 per visit (PBP categories 7C and 7I)	$40 per visit (per note in PBP category 8B)	$40 per visit (PBP category 7D + remainder of category 18A not shown below)	$25 per script for certain injectible drugs (PBP Category 15)	$0 Copay		$15 per visit (PBP category 16A)	$40 per visit (PBP category 17A)	$0 Copay	$40 per visit (PBP category 18A)	$0 Copay		$0 copay												279.32	150	75		100	0.2	0.2	50	225		40			40	0	40	40	40	40	40	25			15	40		40															31.6378	0.393112657	7.808970642	0	2.907794336	2.085026113	2.92376868	1.588713101	9.101012297	0	0.996652073	0	0	1.297811663	0	14.34500699	1.003258701	1.129372794	0.091370067	0.098597866	0.006300469	0	0	0.940386115	0.423949398	0	3.33E-07	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7789			31.6378	0.393112657	7.808970642	0	2.907794336	2.085026113	2.92376868	1.588713101	9.101012297	0	0.996652073	0	0	1.297811663	0	14.34500699	1.003258701	1.129372794	0.091370067	0.098597866	0.006300469	0	0	0.940386115	0.423949398	0	3.33E-07	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7789																																																																																				0			31.6378	0.393112657	7.808970642	0	2.907794336	2.085026113	2.92376868	1.588713101	9.101012297	0	0.996652073	0	0	1.297811663	0	14.34500699	1.003258701	1.129372794	0.091370067	0.098597866	0.006300469	0	0	0.940386115	0.423949398	0	3.33E-07	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7789
H3952_040_0	2008	6																																D	D	D		T	coin	coin	V	V		V			V	V	V	V	V	V	V	S			V	V		V																																																								0		1359.206629	31.44901257	1249.435303		348.9353203	10.42513056	14.6188434	381.2911442	485.3873225		298.995622			389.343499	0.0001	4303.502097	300.9776102	338.8118383	27.41101999	29.57935986	3.024225015			752.3088922	127.1848195		0.0001															$150/$300 per day 10 day max (PBP category 1A)	$150 per day 10 day max (PBP category 1A)	$75 per day 100 day max (PBP category 2)	$0 Copay	100 per trip (PBP category 10A)	20% coinsurance (PBP category 11A)	20% coinsurance (PBP category 11B)	$50 per visit (PBP category 4A)	$225/visit (PBP categories 9A and 9B)	$0 Copay	$40 per visit (PBP category 8B)	$0 Copay	$0 Copay	"$40 per visit (PBP categories 3, 5, and 9D)"	$0 per visit (PBP categories 4B and 7A)	"$40 per visit (PBP categories 4B, 7B, 7D, and 7F)"	"$40 per visit (PBP categories 7E, 7H and 9C)"	$40 per visit (PBP categories 7C and 7I)	$40 per visit (per note in PBP category 8B)	$40 per visit (PBP category 7D + remainder of category 18A not shown below)	$25 per script for certain injectible drugs (PBP Category 15)	$0 Copay		$15 per visit (PBP category 16A)	$40 per visit (PBP category 17A)	$0 Copay	$40 per visit (PBP category 18A)	$0 Copay		$0 Copay												279.32	150	75		100	0.2	0.2	50	225		40			40	0	40	40	40	40	40	25			15	40		40															31.6378	0.393112657	7.808970642	0	2.907794336	2.085026113	2.92376868	1.588713101	9.101012297	0	0.996652073	0	0	1.297811663	0	14.34500699	1.003258701	1.129372794	0.091370067	0.098597866	0.006300469	0	0	0.940386115	0.423949398	0	3.33E-07	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7789			31.6378	0.393112657	7.808970642	0	2.907794336	2.085026113	2.92376868	1.588713101	9.101012297	0	0.996652073	0	0	1.297811663	0	14.34500699	1.003258701	1.129372794	0.091370067	0.098597866	0.006300469	0	0	0.940386115	0.423949398	0	3.33E-07	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7789																																																																																				0			31.6378	0.393112657	7.808970642	0	2.907794336	2.085026113	2.92376868	1.588713101	9.101012297	0	0.996652073	0	0	1.297811663	0	14.34500699	1.003258701	1.129372794	0.091370067	0.098597866	0.006300469	0	0	0.940386115	0.423949398	0	3.33E-07	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7789
H3952_042_0	2008	5																																D	D	D		T	coin	coin	V	V		V			V	V	V	V	V	V	V	S			V	V		V																																																								0		1415.326112	35.95520648	1321.399456		321.0201048	9.64068045	13.48632525	308.0137598	407.6323586		617.5091841			343.4063888	2922.815909	4827.523948	238.517916	692.0968759	14.28631133	90.19016946	7.537472652			722.2892053	150.0988081		0.0001															$100/$200 per day 10 day max (PBP category 1A)	$100 per day 10 day max (PBP category 1A)	$75 per day 100 day max (PBP category 2)	$0 Copay	50 per trip (PBP category 10A)	20% coinsurance (PBP category 11A)	20% coinsurance (PBP category 11B)	$50 per visit (PBP category 4A)	$200/visit (PBP categories 9A and 9B)	$0 Copay	$30 per visit (PBP category 8B)	$0 Copay	$0 Copay	"$30 per visit (PBP categories 3, 5, and 9D)"	$10 per visit (PBP categories 4B and 7A)	"$30 per visit (PBP categories 4B, 7B, 7D, and 7F)"	"$30 per visit (PBP categories 7E, 7H and 9C)"	$30 per visit (PBP categories 7C and 7I)	$30 per visit (per note in PBP category 8B)	$30 per visit (PBP category 7D + remainder of category 18A not shown below)	$25 per script for certain injectible drugs (PBP category 15)	$0 Copay		$15 per visit (PBP category 16A)	$30 per visit (PBP category 17A)	$0 Copay	$30 per visit (PBP category 18A)	$0 Copay		$0 Copay												186.2	100	75		50	0.2	0.2	50	200		30			30	10	30	30	30	30	30	25			15	30		30															21.9611	0.299626721	8.258746602	0	1.33758377	1.92813609	2.697265049	1.283390666	6.793872644	0	1.54377296	0	0	0.858515972	2.435679924	12.06880987	0.59629479	1.73024219	0.035715778	0.225475424	0.015703068	0	0	0.902861507	0.37524702	0	0.00000025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3481			21.9611	0.299626721	8.258746602	0	1.33758377	1.92813609	2.697265049	1.283390666	6.793872644	0	1.54377296	0	0	0.858515972	2.435679924	12.06880987	0.59629479	1.73024219	0.035715778	0.225475424	0.015703068	0	0	0.902861507	0.37524702	0	0.00000025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3481																																																																																				0			21.9611	0.299626721	8.258746602	0	1.33758377	1.92813609	2.697265049	1.283390666	6.793872644	0	1.54377296	0	0	0.858515972	2.435679924	12.06880987	0.59629479	1.73024219	0.035715778	0.225475424	0.015703068	0	0	0.902861507	0.37524702	0	0.00000025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3481
H3952_043_0	2008	7																																D	D	D		T	coin	coin	V	V		V			V	V	V	V	V	V	V	S			V	V		V																																																								0		1415.326112	35.95520648	1321.399456		321.0201048	9.64068045	13.48632525	308.0137598	407.6323586		617.5091841			343.4063888	2922.815909	4827.523948	238.517916	692.0968759	14.28631133	90.19016946	7.537472652			722.2892053	150.0988081		0.0001															$100/$200 per day 10 day max (PBP category 1A)	$100 per day 10 day max (PBP category 1A)	$75 per day 100 day max (PBP category 2)	$0 Copay	50 per trip (PBP category 10A)	20% coinsurance (PBP category 11A)	20% coinsurance (PBP category 11B)	$50 per visit (PBP category 4A)	$200/visit (PBP categories 9A and 9B)	$0 Copay	$30 per visit (PBP category 8B)	$0 Copay	$0 Copay	"$30 per visit (PBP categories 3, 5, and 9D)"	$10 per visit (PBP categories 4B and 7A)	"$30 per visit (PBP categories 4B, 7B, 7D, and 7F)"	"$30 per visit (PBP categories 7E, 7H and 9C)"	$30 per visit (PBP categories 7C and 7I)	$30 per visit (per note in PBP category 8B)	$30 per visit (PBP category 7D + remainder of category 18A not shown below)	$25 per script for certain injectible drugs (PBP category 15)	$0 Copay		$15 per visit (PBP category 16A)	$30 per visit (PBP category 17A)	$0 Copay	$30 per visit (PBP category 18A)	$0 Copay		$0 Copay												186.2	100	75		50	0.2	0.2	50	200		30			30	10	30	30	30	30	30	25			15	30		30															21.9611	0.299626721	8.258746602	0	1.33758377	1.92813609	2.697265049	1.283390666	6.793872644	0	1.54377296	0	0	0.858515972	2.435679924	12.06880987	0.59629479	1.73024219	0.035715778	0.225475424	0.015703068	0	0	0.902861507	0.37524702	0	0.00000025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3481			21.9611	0.299626721	8.258746602	0	1.33758377	1.92813609	2.697265049	1.283390666	6.793872644	0	1.54377296	0	0	0.858515972	2.435679924	12.06880987	0.59629479	1.73024219	0.035715778	0.225475424	0.015703068	0	0	0.902861507	0.37524702	0	0.00000025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3481																																																																																				0			21.9611	0.299626721	8.258746602	0	1.33758377	1.92813609	2.697265049	1.283390666	6.793872644	0	1.54377296	0	0	0.858515972	2.435679924	12.06880987	0.59629479	1.73024219	0.035715778	0.225475424	0.015703068	0	0	0.902861507	0.37524702	0	0.00000025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3481
H3952_802_0	2008	5																																Coin		Coin	Coin	Coin	Coin		Coin	Coin	Coin					Coin						Coin	Coin																																																													0		351.1666788		30.05911703	10.13809903	8.337672232	22.07910682		6.207023442	53.57672665	110.7699158					323.9613744						5.588316496	1.519524594																				Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS					Medicare FFS						Medicare FFS	Medicare FFS																				0.073		0.1705	0	0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				25.6352	0	5.125079454	0	1.951015302	5.166510997	0	1.452443485	12.53695404	25.92016029	0	0	0	0	75.80696162	0	0	0	0	0	1.30766606	0.355568755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.2575			25.6352	0	5.125079454	0	1.951015302	5.166510997	0	1.452443485	12.53695404	25.92016029	0	0	0	0	75.80696162	0	0	0	0	0	1.30766606	0.355568755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.2575																																																																																				0			25.6352	0	5.125079454	0	1.951015302	5.166510997	0	1.452443485	12.53695404	25.92016029	0	0	0	0	75.80696162	0	0	0	0	0	1.30766606	0.355568755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.2575
H3952_804_0	2008	5																																Coin		Coin	Coin	Coin	Coin		Coin	Coin	Coin					Coin						Coin	Coin																																																													0		351.1666788		30.05911703	10.13809903	8.337672232	22.07910682		6.207023442	53.57672665	110.7699158					323.9613744						5.588316496	1.519524594																				Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS					Medicare FFS						Medicare FFS	Medicare FFS																				0.073		0.1705	0	0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				25.6352	0	5.125079454	0	1.951015302	5.166510997	0	1.452443485	12.53695404	25.92016029	0	0	0	0	75.80696162	0	0	0	0	0	1.30766606	0.355568755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.2575			25.6352	0	5.125079454	0	1.951015302	5.166510997	0	1.452443485	12.53695404	25.92016029	0	0	0	0	75.80696162	0	0	0	0	0	1.30766606	0.355568755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.2575																																																																																				0			25.6352	0	5.125079454	0	1.951015302	5.166510997	0	1.452443485	12.53695404	25.92016029	0	0	0	0	75.80696162	0	0	0	0	0	1.30766606	0.355568755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.2575
H3954_003_0	2008	2																					None											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1089.224786	59.06496575	870.1012031	805.8713216	139.5425082	10.33067543	8.004292858	302.9792955	299.0163578	56.8397252	1662.071701	30.19873013	1.442172236	385.6510707	4325.11787	3149.577102	127.6112849	0	1373.779463	174.6898149	15.54186441	1.316214342	0	0	880.8813169	3.515936055	1.229035786	0.735038522	0	4.098672168	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.097083114	0.002645979	50	50	0.017850236	18	25	0.000247674	20	10	20	20	10	7.8	20	0.029723552	3.07E-06	0	0	20	0	20	0	0	1.58E-05	0											4.5384	0.246104024	1.81271084	0.671559435	0.581427118	1.002934137	0.021179192	1.262413731	1.245901491	1.014602495	2.493107552	0.062914021	2.98E-08	0.642751785	3.604264892	5.249295171	0.212685475	0	0.892956651	0.291149691	0.461959421	3.36E-10	0	0	1.468135528	0	0.002048393	0	0	5.39E-09	0	0	0	0	0	0	0	0	0	0	0	27.7785	None	0	4.5384	0.246104024	1.81271084	0.671559435	0.581427118	1.002934137	0.021179192	1.262413731	1.245901491	1.014602495	2.493107552	0.062914021	2.98E-08	0.642751785	3.604264892	5.249295171	0.212685475	0	0.892956651	0.291149691	0.461959421	3.36E-10	0	0	1.468135528	0	0.002048393	0	0	5.39E-09	0	0	0	0	0	0	0	0	0	0	0	27.7785	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.5384	0.246104024	1.81271084	0.671559435	0.581427118	1.002934137	0.021179192	1.262413731	1.245901491	1.014602495	2.493107552	0.062914021	2.98E-08	0.642751785	3.604264892	5.249295171	0.212685475	0	0.892956651	0.291149691	0.461959421	3.36E-10	0	0	1.468135528	0	0.002048393	0	0	5.39E-09	0	0	0	0	0	0	0	0	0	0	0	27.7785
H3954_004_0	2008	2																					None											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1324.261108	59.06496575	1144.32296	924.5884985	176.9660555	10.67723965	5.777382201	244.9804268	368.7778486	42.58720485	1736.970323	5.813625809	0.431586524	391.953128	5122.707113	3145.989061	127.6112849	0	1486.929337	191.6525825	10.05555846	1.223191497	0	0	714.5013291	3.417241203	1.677522239	0.931352783	0	3.923057129	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.097437976	0.002655651	50	50	0.017915483	18	25	0.00024858	20	10	20	20	10	7.8	20	0.029832199	3.08E-06	0	0	20	0	20	0	0	1.58E-05	0											5.5178	0.246104024	2.384006166	0.770490415	0.737358564	1.040368624	0.01534271	1.020751778	1.536574369	0.762970334	2.605455485	0.01211172	8.94E-09	0.653255213	4.268922594	5.243315102	0.212685475	0	0.966504069	0.319420971	0.299979423	3.14E-10	0	0	1.190835548	0	0.00279587	0	0	5.18E-09	0	0	0	0	0	0	0	0	0	0	0	29.807	None	0	5.5178	0.246104024	2.384006166	0.770490415	0.737358564	1.040368624	0.01534271	1.020751778	1.536574369	0.762970334	2.605455485	0.01211172	8.94E-09	0.653255213	4.268922594	5.243315102	0.212685475	0	0.966504069	0.319420971	0.299979423	3.14E-10	0	0	1.190835548	0	0.00279587	0	0	5.18E-09	0	0	0	0	0	0	0	0	0	0	0	29.807	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.5178	0.246104024	2.384006166	0.770490415	0.737358564	1.040368624	0.01534271	1.020751778	1.536574369	0.762970334	2.605455485	0.01211172	8.94E-09	0.653255213	4.268922594	5.243315102	0.212685475	0	0.966504069	0.319420971	0.299979423	3.14E-10	0	0	1.190835548	0	0.00279587	0	0	5.18E-09	0	0	0	0	0	0	0	0	0	0	0	29.807
H3954_005_0	2008	2																					None											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1175.644321	59.06496575	1143.221402	1220.736904	92.78114772	11.36587746	6.502128679	213.0716367	215.4770483	41.27235036	1048.017556	22.34878916	0.794779303	291.6762139	4542.923898	3858.997511	127.6112849	0	3007.753662	233.1854948	9.271665647	1.681894799	0	0	645.7532771	2.807244374	1.224064488	0.904621079	0	4.551574217	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.099133278	0.002701856	50	50	0.01822719	18	25	0.000252905	20	10	20	20	10	7.8	20	0.030351243	3.13E-06	0	0	20	0	20	0	0	1.61E-05	0											4.8985	0.246104024	2.381711255	1.017280753	0.386588116	1.126736693	0.017567815	0.887798486	0.897821035	0.752278984	1.572026334	0.046559977	1.68E-08	0.486127023	3.785769915	6.431662518	0.212685475	0	1.95503988	0.388642491	0.281406578	4.39E-10	0	0	1.076255462	0	0.002040107	0	0	6.11E-09	0	0	0	0	0	0	0	0	0	0	0	28.8506	None	0	4.8985	0.246104024	2.381711255	1.017280753	0.386588116	1.126736693	0.017567815	0.887798486	0.897821035	0.752278984	1.572026334	0.046559977	1.68E-08	0.486127023	3.785769915	6.431662518	0.212685475	0	1.95503988	0.388642491	0.281406578	4.39E-10	0	0	1.076255462	0	0.002040107	0	0	6.11E-09	0	0	0	0	0	0	0	0	0	0	0	28.8506	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.8985	0.246104024	2.381711255	1.017280753	0.386588116	1.126736693	0.017567815	0.887798486	0.897821035	0.752278984	1.572026334	0.046559977	1.68E-08	0.486127023	3.785769915	6.431662518	0.212685475	0	1.95503988	0.388642491	0.281406578	4.39E-10	0	0	1.076255462	0	0.002040107	0	0	6.11E-09	0	0	0	0	0	0	0	0	0	0	0	28.8506
H3954_006_0	2008	2																					None											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1029.943433	59.06496575	945.9404891	1261.005592	113.7382082	12.69231999	6.170614572	238.9617899	297.4176042	69.66649733	2622.62546	14.1850401	0.802475065	471.961929	4674.792931	3305.1865	127.6112849	0	1941.824442	143.4275854	13.84301652	1.496897957	0	0	834.0990483	3.337887575	1.16140986	0.633982837	0	3.718064676	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.097329559	0.002652696	50	50	0.017895549	18	25	0.000248303	20	10	20	20	10	7.8	20	0.029799006	3.08E-06	0	0	20	0	20	0	0	1.58E-05	0											4.2914	0.246104024	1.970709352	1.050837993	0.473909201	1.235337907	0.016368764	0.995674125	1.239240017	1.246720185	3.93393819	0.029552167	1.66E-08	0.786603215	3.895660776	5.508644167	0.212685475	0	1.262185887	0.239045976	0.412508126	3.84E-10	0	0	1.39016508	0	0.001935683	0	0	4.90E-09	0	0	0	0	0	0	0	0	0	0	0	30.4393	None	0	4.2914	0.246104024	1.970709352	1.050837993	0.473909201	1.235337907	0.016368764	0.995674125	1.239240017	1.246720185	3.93393819	0.029552167	1.66E-08	0.786603215	3.895660776	5.508644167	0.212685475	0	1.262185887	0.239045976	0.412508126	3.84E-10	0	0	1.39016508	0	0.001935683	0	0	4.90E-09	0	0	0	0	0	0	0	0	0	0	0	30.4393	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.2914	0.246104024	1.970709352	1.050837993	0.473909201	1.235337907	0.016368764	0.995674125	1.239240017	1.246720185	3.93393819	0.029552167	1.66E-08	0.786603215	3.895660776	5.508644167	0.212685475	0	1.262185887	0.239045976	0.412508126	3.84E-10	0	0	1.39016508	0	0.001935683	0	0	4.90E-09	0	0	0	0	0	0	0	0	0	0	0	30.4393
H3954_007_0	2008	2																					None											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1085.742559	59.06496575	1120.012166	880.1873452	196.1463509	13.6854683	6.180632614	325.8067312	273.1895127	45.41411608	2072.241895	48.39250078	1.1864508	404.5689451	4441.442062	3646.301794	127.6112849	0	1679.031946	163.5671688	11.99368716	1.062004783	0	0	641.1904789	3.100746142	1.04749139	0.658312073	0	4.36328468	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.097275381	0.002651219	50	50	0.017885587	18	25	0.000248165	20	10	20	20	10	7.8	20	0.029782418	3.07E-06	0	0	20	0	20	0	0	1.58E-05	0											4.5239	0.246104024	2.333358679	0.733489454	0.817276462	1.331259143	0.016386213	1.357528047	1.138289636	0.812258129	3.108362843	0.10081771	2.45E-08	0.674281575	3.701201719	6.077169656	0.212685475	0	1.091370765	0.272611948	0.357201006	2.72E-10	0	0	1.068650798	0	0.001745819	0	0	5.75E-09	0	0	0	0	0	0	0	0	0	0	0	29.976	None	0	4.5239	0.246104024	2.333358679	0.733489454	0.817276462	1.331259143	0.016386213	1.357528047	1.138289636	0.812258129	3.108362843	0.10081771	2.45E-08	0.674281575	3.701201719	6.077169656	0.212685475	0	1.091370765	0.272611948	0.357201006	2.72E-10	0	0	1.068650798	0	0.001745819	0	0	5.75E-09	0	0	0	0	0	0	0	0	0	0	0	29.976	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.5239	0.246104024	2.333358679	0.733489454	0.817276462	1.331259143	0.016386213	1.357528047	1.138289636	0.812258129	3.108362843	0.10081771	2.45E-08	0.674281575	3.701201719	6.077169656	0.212685475	0	1.091370765	0.272611948	0.357201006	2.72E-10	0	0	1.068650798	0	0.001745819	0	0	5.75E-09	0	0	0	0	0	0	0	0	0	0	0	29.976
H3954_008_0	2008	2																					None											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1364.947005	59.06496575	540.5104693	730.8585021	85.29314513	9.700991585	3.945003007	183.2817389	270.079815	41.72594898	1143.313044	28.26189889	0.283118364	326.3688001	4448.287652	2602.801869	127.6112849	0	2054.954324	922.4415471	8.404556464	1.782335907	0	0	637.4835531	3.033051604	0.734232818	0.723728553	0	4.939603098	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.099846501	0.002721295	50	50	0.018358327	18	25	0.000254724	20	10	20	20	10	7.8	20	0.030569608	3.16E-06	0	0	20	0	20	0	0	1.62E-05	0											5.6873	0.246104024	1.126063478	0.609048752	0.355388105	0.96861007	0.010735516	0.763673912	1.125332562	0.766018634	1.714969567	0.058878956	6.01E-09	0.543948	3.706906377	4.338003116	0.212685475	0	1.335720311	1.537402579	0.256923995	4.69E-10	0	0	1.062472588	0	0.001223721	0	0	6.68E-09	0	0	0	0	0	0	0	0	0	0	0	26.4274	None	0	5.6873	0.246104024	1.126063478	0.609048752	0.355388105	0.96861007	0.010735516	0.763673912	1.125332562	0.766018634	1.714969567	0.058878956	6.01E-09	0.543948	3.706906377	4.338003116	0.212685475	0	1.335720311	1.537402579	0.256923995	4.69E-10	0	0	1.062472588	0	0.001223721	0	0	6.68E-09	0	0	0	0	0	0	0	0	0	0	0	26.4274	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.6873	0.246104024	1.126063478	0.609048752	0.355388105	0.96861007	0.010735516	0.763673912	1.125332562	0.766018634	1.714969567	0.058878956	6.01E-09	0.543948	3.706906377	4.338003116	0.212685475	0	1.335720311	1.537402579	0.256923995	4.69E-10	0	0	1.062472588	0	0.001223721	0	0	6.68E-09	0	0	0	0	0	0	0	0	0	0	0	26.4274
H3954_009_0	2008	2																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	235.373971	59.06496575	32.31290352	827.9585545	122.2195548	10.28680794	7.88802567	302.4411506	48.16277748	55.21795446	45.3692489	2.652579758	1.421223814	25.05132441	5234.866954	8433.057964	127.6112849	0	18.4225777	5.375922404	15.23522142	1.297095533	0	0	1116.664597	3.517629401	19.96492293	0.735392531	0	4.100646172	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.077318576	50	0.043144809	10	50	0.110652976	0.086526004	50	0.107146718	0.085499588	0.095055645	0.076537642	0.018413772	0.113194655	10	20	20	10	0.096635523	0.089464435	0.054563296	0.119742033	0	0	20	0	20	0	0	9.62E-06	0											18.1988	0.246104024	1.394134051	0.689965462	0.509248145	1.138265908	0.682519343	1.260171461	5.160483515	4.72111233	4.312603201	0.203022199	0.026170091	2.835676021	4.362389128	14.05509661	0.212685475	0	1.780275433	0.48095386	0.831283889	0.155316856	0	0	1.861107662	0	0.033274872	0	0	3.29E-09	0	0	0	0	0	0	0	0	0	0	0	65.1506	None	31.27590541	18.1988	0.246104024	1.394134051	0.689965462	0.509248145	1.138265908	0.682519343	1.260171461	5.160483515	4.72111233	4.312603201	0.203022199	0.026170091	2.835676021	4.362389128	14.05509661	0.212685475	0	1.780275433	0.48095386	0.831283889	0.155316856	0	0	1.861107662	0	0.033274872	0	0	3.29E-09	0	0	0	0	0	0	0	0	0	0	0	65.1506	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	18.1988	0.246104024	1.394134051	0.689965462	0.509248145	1.138265908	0.682519343	1.260171461	5.160483515	4.72111233	4.312603201	0.203022199	0.026170091	2.835676021	4.362389128	14.05509661	0.212685475	0	1.780275433	0.48095386	0.831283889	0.155316856	0	0	1.861107662	0	0.033274872	0	0	3.29E-09	0	0	0	0	0	0	0	0	0	0	0	65.1506
H3954_010_0	2008	2																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	285.0949029	59.06496575	42.33985151	949.9295188	154.9973037	10.63126314	5.693187763	244.5452981	59.180129	41.37009749	47.23822382	0.50876983	0.425296965	25.36666745	6200.22399	8423.45091	127.6112849	0	19.86635591	5.876173182	9.856685794	1.205365791	0	0	905.7500978	3.418722197	27.25030679	0.931756421	0	3.924757339	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.077604936	50	0.043304602	10	50	0.111062794	0.086846465	50	0.10754355	0.085816247	0.095407696	0.076821109	0.01848197	0.113613886	10	20	20	10	0.096993426	0.089795778	0.054765378	0.120185513	0	0	20	0	20	0	0	9.66E-06	0											22.1248	0.246104024	1.833510399	0.791607932	0.645822099	1.180737783	0.494433231	1.018938742	6.364441138	3.550226485	4.506890087	0.039084262	0.007860326	2.882005671	5.166853325	14.03908485	0.212685475	0	1.926905912	0.527655544	0.539805123	0.144867506	0	0	1.509583496	0	0.045417178	0	0	3.16E-09	0	0	0	0	0	0	0	0	0	0	0	69.7993	None	34.71718672	22.1248	0.246104024	1.833510399	0.791607932	0.645822099	1.180737783	0.494433231	1.018938742	6.364441138	3.550226485	4.506890087	0.039084262	0.007860326	2.882005671	5.166853325	14.03908485	0.212685475	0	1.926905912	0.527655544	0.539805123	0.144867506	0	0	1.509583496	0	0.045417178	0	0	3.16E-09	0	0	0	0	0	0	0	0	0	0	0	69.7993	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	22.1248	0.246104024	1.833510399	0.791607932	0.645822099	1.180737783	0.494433231	1.018938742	6.364441138	3.550226485	4.506890087	0.039084262	0.007860326	2.882005671	5.166853325	14.03908485	0.212685475	0	1.926905912	0.527655544	0.539805123	0.144867506	0	0	1.509583496	0	0.045417178	0	0	3.16E-09	0	0	0	0	0	0	0	0	0	0	0	69.7993
H3954_011_0	2008	2																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	248.7119743	59.06496575	41.56468581	1254.194727	81.26319869	11.31365737	6.405670834	212.6931837	33.97860428	40.08217307	28.01164915	1.92185983	0.782988903	18.55037169	5498.405015	10332.54581	127.6112849	0	39.48785856	7.025461849	9.085882766	1.656944209	0	0	818.6004281	2.807715164	19.88416728	0.904772789	0	4.552337541	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.07897614	50	0.044069752	10	50	0.113025167	0.088380959	50	0.109443741	0.087332537	0.097093458	0.078178464	0.018808528	0.115621335	10	20	20	10	0.098707206	0.091382384	0.05573303	0.122309076	0	0	20	0	20	0	0	9.83E-06	0											19.6423	0.246104024	1.83174541	1.045162272	0.338596661	1.27872801	0.566139329	0.886221599	3.718745569	3.500477878	2.71974789	0.15024805	0.014726869	2.144818735	4.582004179	17.22090968	0.212685475	0	3.897736206	0.642003449	0.506383774	0.202659316	0	0	1.364334047	0	0.033140279	0	0	3.73E-09	0	0	0	0	0	0	0	0	0	0	0	66.7456	None	31.65199359	19.6423	0.246104024	1.83174541	1.045162272	0.338596661	1.27872801	0.566139329	0.886221599	3.718745569	3.500477878	2.71974789	0.15024805	0.014726869	2.144818735	4.582004179	17.22090968	0.212685475	0	3.897736206	0.642003449	0.506383774	0.202659316	0	0	1.364334047	0	0.033140279	0	0	3.73E-09	0	0	0	0	0	0	0	0	0	0	0	66.7456	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	19.6423	0.246104024	1.83174541	1.045162272	0.338596661	1.27872801	0.566139329	0.886221599	3.718745569	3.500477878	2.71974789	0.15024805	0.014726869	2.144818735	4.582004179	17.22090968	0.212685475	0	3.897736206	0.642003449	0.506383774	0.202659316	0	0	1.364334047	0	0.033140279	0	0	3.73E-09	0	0	0	0	0	0	0	0	0	0	0	66.7456
H3954_012_0	2008	2																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	221.9971406	59.06496575	35.03940832	1295.567095	99.61862766	12.63729297	6.080811753	238.5373514	47.78262252	67.67684646	71.3987919	1.24278806	0.790796403	30.57836322	5658.09512	8849.705351	127.6112849	0	25.97347601	4.402555386	13.56951061	1.475113148	0	0	1057.360237	3.339401307	18.86638177	0.634270348	0	3.719750819	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.077517028	50	0.043255548	10	50	0.110936986	0.086748089	50	0.107421729	0.085719037	0.095299622	0.076734089	0.018461034	0.113485189	10	20	20	10	0.096883555	0.089694061	0.054703342	0.120049372	0	0	20	0	20	0	0	9.64E-06	0											17.2086	0.246104024	1.515648802	1.079639246	0.415077615	1.401943194	0.527498797	0.993905631	5.132891908	5.80119413	6.804277865	0.09536421	0.014598919	3.47019133	4.715079267	14.74950892	0.212685475	0	2.516402699	0.394883072	0.742297579	0.177086407	0	0	1.762267061	0	0.03144397	0	0	2.99E-09	0	0	0	0	0	0	0	0	0	0	0	70.0085	None	32.90670521	17.2086	0.246104024	1.515648802	1.079639246	0.415077615	1.401943194	0.527498797	0.993905631	5.132891908	5.80119413	6.804277865	0.09536421	0.014598919	3.47019133	4.715079267	14.74950892	0.212685475	0	2.516402699	0.394883072	0.742297579	0.177086407	0	0	1.762267061	0	0.03144397	0	0	2.99E-09	0	0	0	0	0	0	0	0	0	0	0	70.0085	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	17.2086	0.246104024	1.515648802	1.079639246	0.415077615	1.401943194	0.527498797	0.993905631	5.132891908	5.80119413	6.804277865	0.09536421	0.014598919	3.47019133	4.715079267	14.74950892	0.212685475	0	2.516402699	0.394883072	0.742297579	0.177086407	0	0	1.762267061	0	0.03144397	0	0	2.99E-09	0	0	0	0	0	0	0	0	0	0	0	70.0085
H3954_013_0	2008	2																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	234.1478074	59.06496575	41.50982621	904.3114235	171.7965371	13.62566863	6.090591597	325.2280407	43.91395582	44.11643546	56.44824939	4.242089197	1.169166286	26.22688186	5375.661254	9763.048619	127.6112849	0	22.47058075	5.023466423	11.75654134	1.046533229	0	0	812.8163173	3.102105268	17.01584698	0.658600626	0	4.365197205	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.077475054	50	0.043232126	10	50	0.110876916	0.086701116	50	0.107363562	0.085672622	0.095248019	0.076692539	0.018451038	0.113423739	10	20	20	10	0.096831095	0.089645494	0.054673721	0.119984368	0	0	20	0	20	0	0	9.64E-06	0											18.1406	0.246104024	1.794558027	0.753592853	0.715818905	1.510772114	0.52806109	1.355116836	4.714758708	3.779570705	5.376583922	0.325336591	0.021572331	2.974751001	4.479717711	16.2717477	0.212685475	0	2.175850932	0.450331127	0.642773863	0.125567628	0	0	1.354693862	0	0.028359745	0	0	3.51E-09	0	0	0	0	0	0	0	0	0	0	0	67.9789	None	31.90686195	18.1406	0.246104024	1.794558027	0.753592853	0.715818905	1.510772114	0.52806109	1.355116836	4.714758708	3.779570705	5.376583922	0.325336591	0.021572331	2.974751001	4.479717711	16.2717477	0.212685475	0	2.175850932	0.450331127	0.642773863	0.125567628	0	0	1.354693862	0	0.028359745	0	0	3.51E-09	0	0	0	0	0	0	0	0	0	0	0	67.9789	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	18.1406	0.246104024	1.794558027	0.753592853	0.715818905	1.510772114	0.52806109	1.355116836	4.714758708	3.779570705	5.376583922	0.325336591	0.021572331	2.974751001	4.479717711	16.2717477	0.212685475	0	2.175850932	0.450331127	0.642773863	0.125567628	0	0	1.354693862	0	0.028359745	0	0	3.51E-09	0	0	0	0	0	0	0	0	0	0	0	67.9789
H3954_014_0	2008	2																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	286.6580254	59.06496575	19.50922524	750.8897919	74.70476459	9.655881296	3.886078214	182.956198	42.28033329	40.51850573	30.33619912	2.412741566	0.278889548	20.60582431	5383.879592	6969.055946	127.6112849	0	26.78337168	27.59014356	8.235297774	1.755713931	0	0	808.1171679	3.033246936	11.92715607	0.723775162	0	4.939921214	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.079552558	50	0.044391401	10	50	0.113850096	0.089026019	50	0.11024253	0.087969945	0.097802108	0.07874906	0.018945805	0.116465212	10	20	20	10	0.099427634	0.09204935	0.056139804	0.123201765	0	0	20	0	20	0	0	9.90E-06	0											22.8044	0.246104024	0.866041844	0.625741493	0.311269852	1.099323008	0.345962071	0.762317492	4.661090929	3.564410731	2.96694421	0.19000113	0.005283787	2.399861698	4.486566326	11.61509324	0.212685475	0	2.663007271	2.539654774	0.462328007	0.216307055	0	0	1.346861947	0	0.019878593	0	0	4.07E-09	0	0	0	0	0	0	0	0	0	0	0	64.4111	None	32.98283509	22.8044	0.246104024	0.866041844	0.625741493	0.311269852	1.099323008	0.345962071	0.762317492	4.661090929	3.564410731	2.96694421	0.19000113	0.005283787	2.399861698	4.486566326	11.61509324	0.212685475	0	2.663007271	2.539654774	0.462328007	0.216307055	0	0	1.346861947	0	0.019878593	0	0	4.07E-09	0	0	0	0	0	0	0	0	0	0	0	64.4111	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	22.8044	0.246104024	0.866041844	0.625741493	0.311269852	1.099323008	0.345962071	0.762317492	4.661090929	3.564410731	2.96694421	0.19000113	0.005283787	2.399861698	4.486566326	11.61509324	0.212685475	0	2.663007271	2.539654774	0.462328007	0.216307055	0	0	1.346861947	0	0.019878593	0	0	4.07E-09	0	0	0	0	0	0	0	0	0	0	0	64.4111
H3954_015_0	2008	2																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	229.3987498	59.06496575	32.62369572	810.819985	148.1789943	12.50657707	4.476194535	222.9633439	42.70490474	40.89902831	44.59553671	3.33254023	0.567435954	17.78912495	5004.386153	8203.133771	127.6112849	0	17.09314863	3.746374711	10.03844531	0.660160373	0	0	877.4660016	3.026267647	14.36725291	0.662672893	0	3.930025829	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.077642786	50	0.043325722	10	50	0.111116962	0.086888822	50	0.107596002	0.085858102	0.095454229	0.076858577	0.018490984	0.113669299	10	20	20	10	0.097040732	0.089839574	0.054792089	0.120244131	0	0	20	0	20	0	0	9.66E-06	0											17.8112	0.246104024	1.413445187	0.675683321	0.617412476	1.389692851	0.388931272	0.929013933	4.594877005	3.51151293	4.25683257	0.256134299	0.010492449	2.022077365	4.170321794	13.67188962	0.212685475	0	1.658731656	0.336572709	0.550027385	0.079380411	0	0	1.462443336	0	0.023945422	0	0	3.16E-09	0	0	0	0	0	0	0	0	0	0	0	60.2894	None	28.86057658	17.8112	0.246104024	1.413445187	0.675683321	0.617412476	1.389692851	0.388931272	0.929013933	4.594877005	3.51151293	4.25683257	0.256134299	0.010492449	2.022077365	4.170321794	13.67188962	0.212685475	0	1.658731656	0.336572709	0.550027385	0.079380411	0	0	1.462443336	0	0.023945422	0	0	3.16E-09	0	0	0	0	0	0	0	0	0	0	0	60.2894	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	17.8112	0.246104024	1.413445187	0.675683321	0.617412476	1.389692851	0.388931272	0.929013933	4.594877005	3.51151293	4.25683257	0.256134299	0.010492449	2.022077365	4.170321794	13.67188962	0.212685475	0	1.658731656	0.336572709	0.550027385	0.079380411	0	0	1.462443336	0	0.023945422	0	0	3.16E-09	0	0	0	0	0	0	0	0	0	0	0	60.2894
H3954_018_0	2008	2																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	240.682046	59.06496575	20.33770313	847.4690265	114.2346577	9.995289132	4.274023551	256.7282215	47.9290371	64.28268915	58.35028905	0.668359076	0.30831598	17.74316086	4707.463971	8468.323193	127.6112849	11.6851277	30.71802541	13.72917563	13.6683291	1.979560232	0	0	1075.333679	3.330330542	15.16253114	0.591208192	0	4.075725553	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.078072145	50	0.043565311	10	50	0.111731431	0.087369312	50	0.108191	0.086332891	0.095982084	0.077283599	0.018593238	0.114297883	10	20	20	10	0.097577361	0.090336381	0.055095085	0.120909073	0	0	20	0	20	0	0	9.71E-06	0											18.7906	0.246104024	0.886018356	0.706224189	0.47597774	1.116787961	0.373418495	1.069700923	5.185490465	5.549710399	5.60058236	0.051653195	0.005732592	2.028005715	3.922886643	14.11387199	0.212685475	0.009737606	2.997383844	1.240244039	0.753057755	0.239346793	0	0	1.792222799	0	0.025270885	0	0	3.30E-09	0	0	0	0	0	0	0	0	0	0	0	67.3927	None	32.11217687	18.7906	0.246104024	0.886018356	0.706224189	0.47597774	1.116787961	0.373418495	1.069700923	5.185490465	5.549710399	5.60058236	0.051653195	0.005732592	2.028005715	3.922886643	14.11387199	0.212685475	0.009737606	2.997383844	1.240244039	0.753057755	0.239346793	0	0	1.792222799	0	0.025270885	0	0	3.30E-09	0	0	0	0	0	0	0	0	0	0	0	67.3927	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	18.7906	0.246104024	0.886018356	0.706224189	0.47597774	1.116787961	0.373418495	1.069700923	5.185490465	5.549710399	5.60058236	0.051653195	0.005732592	2.028005715	3.922886643	14.11387199	0.212685475	0.009737606	2.997383844	1.240244039	0.753057755	0.239346793	0	0	1.792222799	0	0.025270885	0	0	3.30E-09	0	0	0	0	0	0	0	0	0	0	0	67.3927
H3954_019_0	2008	2																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	205.8058569	59.06496575	23.47477357	903.4628897	86.57605218	6.543532279	9.893615077	300.2924843	46.87597651	52.86409764	52.30663372	1.007626294	0.115612062	22.83466153	5638.579551	7380.882493	127.6112849	0	14.31661512	3.586368842	15.69289515	1.22788583	0	0	972.600845	4.347183216	17.08761009	0.716703677	0	4.031241797	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.076650898	50	0.042772236	10	50	0.109697441	0.085778816	50	0.106221461	0.084761263	0.094234799	0.075876707	0.018254761	0.112217172	10	20	20	10	0.095801035	0.088691872	0.054092119	0.11870801	0	0	20	0	20	0	0	9.54E-06	0											15.7752	0.246104024	1.004068544	0.752885741	0.360733551	0.717808745	0.848662588	1.251218684	4.9792347	4.480827671	4.929105132	0.076455365	0.002110471	2.562441132	4.698816292	12.30147082	0.212685475	0	1.371546544	0.318081766	0.848861947	0.145759884	0	0	1.621001408	0	0.02847935	0	0	3.20E-09	0	0	0	0	0	0	0	0	0	0	0	59.5336	None	0	15.7752	0.246104024	1.004068544	0.752885741	0.360733551	0.717808745	0.848662588	1.251218684	4.9792347	4.480827671	4.929105132	0.076455365	0.002110471	2.562441132	4.698816292	12.30147082	0.212685475	0	1.371546544	0.318081766	0.848861947	0.145759884	0	0	1.621001408	0	0.02847935	0	0	3.20E-09	0	0	0	0	0	0	0	0	0	0	0	59.5336	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	15.7752	0.246104024	1.004068544	0.752885741	0.360733551	0.717808745	0.848662588	1.251218684	4.9792347	4.480827671	4.929105132	0.076455365	0.002110471	2.562441132	4.698816292	12.30147082	0.212685475	0	1.371546544	0.318081766	0.848861947	0.145759884	0	0	1.621001408	0	0.02847935	0	0	3.20E-09	0	0	0	0	0	0	0	0	0	0	0	59.5336
H3954_020_0	2008	2																					None											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1089.224786	59.06496575	870.1012031	805.8713216	139.5425082	10.33067543	8.004292858	302.9792955	299.0163578	56.8397252	1662.071701	30.19873013	1.442172236	385.6510707	4325.115942	3149.577102	127.6112849	0	1373.779463	174.6898149	15.54186441	1.316214342	0	0	880.8813169	3.515936055	1.229035786	0.735038522	0	4.098672168	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.097083114	0.002645979	50	50	0.017850236	18	25	0.000247674	20	10	20	20	10	7.8	20	0.029723552	3.07E-06	0	0	20	0	20	0	0	1.58E-05	0											4.5384	0.246104024	1.81271084	0.671559435	0.581427118	1.002934137	0.021179192	1.262413731	1.245901491	1.014602495	2.493107552	0.062914021	2.98E-08	0.642751785	3.604263285	5.249295171	0.212685475	0	0.892956651	0.291149691	0.461959421	3.36E-10	0	0	1.468135528	0	0.002048393	0	0	5.39E-09	0	0	0	0	0	0	0	0	0	0	0	27.7785	None	0	4.5384	0.246104024	1.81271084	0.671559435	0.581427118	1.002934137	0.021179192	1.262413731	1.245901491	1.014602495	2.493107552	0.062914021	2.98E-08	0.642751785	3.604263285	5.249295171	0.212685475	0	0.892956651	0.291149691	0.461959421	3.36E-10	0	0	1.468135528	0	0.002048393	0	0	5.39E-09	0	0	0	0	0	0	0	0	0	0	0	27.7785	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.5384	0.246104024	1.81271084	0.671559435	0.581427118	1.002934137	0.021179192	1.262413731	1.245901491	1.014602495	2.493107552	0.062914021	2.98E-08	0.642751785	3.604263285	5.249295171	0.212685475	0	0.892956651	0.291149691	0.461959421	3.36E-10	0	0	1.468135528	0	0.002048393	0	0	5.39E-09	0	0	0	0	0	0	0	0	0	0	0	27.7785
H3954_021_0	2008	3																					None											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1089.224786	59.06496575	870.1012031	805.8713216	139.5425082	10.33067543	8.004292858	302.9792955	299.0163578	56.8397252	1662.071701	30.19873013	1.442172236	385.6510707	4325.115942	3149.577102	127.6112849	0	1373.779463	174.6898149	15.54186441	1.316214342	0	0	880.8813169	3.515936055	1.229035786	0.735038522	0	4.098672168	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.097083114	0.002645979	50	50	0.017850236	18	25	0.000247674	20	10	20	20	10	7.8	20	0.029723552	3.07E-06	0	0	20	0	20	0	0	1.58E-05	0											4.5384	0.246104024	1.81271084	0.671559435	0.581427118	1.002934137	0.021179192	1.262413731	1.245901491	1.014602495	2.493107552	0.062914021	2.98E-08	0.642751785	3.604263285	5.249295171	0.212685475	0	0.892956651	0.291149691	0.461959421	3.36E-10	0	0	1.468135528	0	0.002048393	0	0	5.39E-09	0	0	0	0	0	0	0	0	0	0	0	27.7785	None	0	4.5384	0.246104024	1.81271084	0.671559435	0.581427118	1.002934137	0.021179192	1.262413731	1.245901491	1.014602495	2.493107552	0.062914021	2.98E-08	0.642751785	3.604263285	5.249295171	0.212685475	0	0.892956651	0.291149691	0.461959421	3.36E-10	0	0	1.468135528	0	0.002048393	0	0	5.39E-09	0	0	0	0	0	0	0	0	0	0	0	27.7785	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.5384	0.246104024	1.81271084	0.671559435	0.581427118	1.002934137	0.021179192	1.262413731	1.245901491	1.014602495	2.493107552	0.062914021	2.98E-08	0.642751785	3.604263285	5.249295171	0.212685475	0	0.892956651	0.291149691	0.461959421	3.36E-10	0	0	1.468135528	0	0.002048393	0	0	5.39E-09	0	0	0	0	0	0	0	0	0	0	0	27.7785
H3954_023_0	2008	2																					None											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1324.261108	59.06496575	1144.32296	924.5884985	176.9660555	10.67723965	5.777382201	244.9804268	368.7778486	42.58720485	1736.970323	5.813625809	0.431586524	391.953128	5122.704829	3145.989061	127.6112849	0	1486.929337	191.6525825	10.05555846	1.223191497	0	0	714.5013291	3.417241203	1.677522239	0.931352783	0	3.923057129	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.097437976	0.002655651	50	50	0.017915483	18	25	0.00024858	20	10	20	20	10	7.8	20	0.029832199	3.08E-06	0	0	20	0	20	0	0	1.58E-05	0											5.5178	0.246104024	2.384006166	0.770490415	0.737358564	1.040368624	0.01534271	1.020751778	1.536574369	0.762970334	2.605455485	0.01211172	8.94E-09	0.653255213	4.268920691	5.243315102	0.212685475	0	0.966504069	0.319420971	0.299979423	3.14E-10	0	0	1.190835548	0	0.00279587	0	0	5.18E-09	0	0	0	0	0	0	0	0	0	0	0	29.807	None	0	5.5178	0.246104024	2.384006166	0.770490415	0.737358564	1.040368624	0.01534271	1.020751778	1.536574369	0.762970334	2.605455485	0.01211172	8.94E-09	0.653255213	4.268920691	5.243315102	0.212685475	0	0.966504069	0.319420971	0.299979423	3.14E-10	0	0	1.190835548	0	0.00279587	0	0	5.18E-09	0	0	0	0	0	0	0	0	0	0	0	29.807	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.5178	0.246104024	2.384006166	0.770490415	0.737358564	1.040368624	0.01534271	1.020751778	1.536574369	0.762970334	2.605455485	0.01211172	8.94E-09	0.653255213	4.268920691	5.243315102	0.212685475	0	0.966504069	0.319420971	0.299979423	3.14E-10	0	0	1.190835548	0	0.00279587	0	0	5.18E-09	0	0	0	0	0	0	0	0	0	0	0	29.807
H3954_024_0	2008	3																					None											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1324.261108	59.06496575	1144.32296	924.5884985	176.9660555	10.67723965	5.777382201	244.9804268	368.7778486	42.58720485	1736.970323	5.813625809	0.431586524	391.953128	5122.704829	3145.989061	127.6112849	0	1486.929337	191.6525825	10.05555846	1.223191497	0	0	714.5013291	3.417241203	1.677522239	0.931352783	0	3.923057129	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.097437976	0.002655651	50	50	0.017915483	18	25	0.00024858	20	10	20	20	10	7.8	20	0.029832199	3.08E-06	0	0	20	0	20	0	0	1.58E-05	0											5.5178	0.246104024	2.384006166	0.770490415	0.737358564	1.040368624	0.01534271	1.020751778	1.536574369	0.762970334	2.605455485	0.01211172	8.94E-09	0.653255213	4.268920691	5.243315102	0.212685475	0	0.966504069	0.319420971	0.299979423	3.14E-10	0	0	1.190835548	0	0.00279587	0	0	5.18E-09	0	0	0	0	0	0	0	0	0	0	0	29.807	None	0	5.5178	0.246104024	2.384006166	0.770490415	0.737358564	1.040368624	0.01534271	1.020751778	1.536574369	0.762970334	2.605455485	0.01211172	8.94E-09	0.653255213	4.268920691	5.243315102	0.212685475	0	0.966504069	0.319420971	0.299979423	3.14E-10	0	0	1.190835548	0	0.00279587	0	0	5.18E-09	0	0	0	0	0	0	0	0	0	0	0	29.807	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.5178	0.246104024	2.384006166	0.770490415	0.737358564	1.040368624	0.01534271	1.020751778	1.536574369	0.762970334	2.605455485	0.01211172	8.94E-09	0.653255213	4.268920691	5.243315102	0.212685475	0	0.966504069	0.319420971	0.299979423	3.14E-10	0	0	1.190835548	0	0.00279587	0	0	5.18E-09	0	0	0	0	0	0	0	0	0	0	0	29.807
H3954_026_0	2008	2																					None											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1175.644321	59.06496575	1143.221402	1220.736904	92.78114772	11.36587746	6.502128679	213.0716367	215.4770483	41.27235036	1048.017556	22.34878916	0.794779303	291.6762139	4542.921872	3858.997511	127.6112849	0	3007.753662	233.1854948	9.271665647	1.681894799	0	0	645.7532771	2.807244374	1.224064488	0.904621079	0	4.551574217	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.099133278	0.002701856	50	50	0.01822719	18	25	0.000252905	20	10	20	20	10	7.8	20	0.030351243	3.13E-06	0	0	20	0	20	0	0	1.61E-05	0											4.8985	0.246104024	2.381711255	1.017280753	0.386588116	1.126736693	0.017567815	0.887798486	0.897821035	0.752278984	1.572026334	0.046559977	1.68E-08	0.486127023	3.785768227	6.431662518	0.212685475	0	1.95503988	0.388642491	0.281406578	4.39E-10	0	0	1.076255462	0	0.002040107	0	0	6.11E-09	0	0	0	0	0	0	0	0	0	0	0	28.8506	None	0	4.8985	0.246104024	2.381711255	1.017280753	0.386588116	1.126736693	0.017567815	0.887798486	0.897821035	0.752278984	1.572026334	0.046559977	1.68E-08	0.486127023	3.785768227	6.431662518	0.212685475	0	1.95503988	0.388642491	0.281406578	4.39E-10	0	0	1.076255462	0	0.002040107	0	0	6.11E-09	0	0	0	0	0	0	0	0	0	0	0	28.8506	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.8985	0.246104024	2.381711255	1.017280753	0.386588116	1.126736693	0.017567815	0.887798486	0.897821035	0.752278984	1.572026334	0.046559977	1.68E-08	0.486127023	3.785768227	6.431662518	0.212685475	0	1.95503988	0.388642491	0.281406578	4.39E-10	0	0	1.076255462	0	0.002040107	0	0	6.11E-09	0	0	0	0	0	0	0	0	0	0	0	28.8506
H3954_027_0	2008	3																					None											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1175.644321	59.06496575	1143.221402	1220.736904	92.78114772	11.36587746	6.502128679	213.0716367	215.4770483	41.27235036	1048.017556	22.34878916	0.794779303	291.6762139	4542.921872	3858.997511	127.6112849	0	3007.753662	233.1854948	9.271665647	1.681894799	0	0	645.7532771	2.807244374	1.224064488	0.904621079	0	4.551574217	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.099133278	0.002701856	50	50	0.01822719	18	25	0.000252905	20	10	20	20	10	7.8	20	0.030351243	3.13E-06	0	0	20	0	20	0	0	1.61E-05	0											4.8985	0.246104024	2.381711255	1.017280753	0.386588116	1.126736693	0.017567815	0.887798486	0.897821035	0.752278984	1.572026334	0.046559977	1.68E-08	0.486127023	3.785768227	6.431662518	0.212685475	0	1.95503988	0.388642491	0.281406578	4.39E-10	0	0	1.076255462	0	0.002040107	0	0	6.11E-09	0	0	0	0	0	0	0	0	0	0	0	28.8506	None	0	4.8985	0.246104024	2.381711255	1.017280753	0.386588116	1.126736693	0.017567815	0.887798486	0.897821035	0.752278984	1.572026334	0.046559977	1.68E-08	0.486127023	3.785768227	6.431662518	0.212685475	0	1.95503988	0.388642491	0.281406578	4.39E-10	0	0	1.076255462	0	0.002040107	0	0	6.11E-09	0	0	0	0	0	0	0	0	0	0	0	28.8506	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.8985	0.246104024	2.381711255	1.017280753	0.386588116	1.126736693	0.017567815	0.887798486	0.897821035	0.752278984	1.572026334	0.046559977	1.68E-08	0.486127023	3.785768227	6.431662518	0.212685475	0	1.95503988	0.388642491	0.281406578	4.39E-10	0	0	1.076255462	0	0.002040107	0	0	6.11E-09	0	0	0	0	0	0	0	0	0	0	0	28.8506
H3954_029_0	2008	2																					None											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1029.943433	59.06496575	945.9404891	1261.005592	113.7382082	12.69231999	6.170614572	238.9617899	297.4176042	69.66649733	2622.62546	14.1850401	0.802475065	471.961929	4674.790847	3305.1865	127.6112849	0	1941.824442	143.4275854	13.84301652	1.496897957	0	0	834.0990483	3.337887575	1.16140986	0.633982837	0	3.718064676	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.097329559	0.002652696	50	50	0.017895549	18	25	0.000248303	20	10	20	20	10	7.8	20	0.029799006	3.08E-06	0	0	20	0	20	0	0	1.58E-05	0											4.2914	0.246104024	1.970709352	1.050837993	0.473909201	1.235337907	0.016368764	0.995674125	1.239240017	1.246720185	3.93393819	0.029552167	1.66E-08	0.786603215	3.895659039	5.508644167	0.212685475	0	1.262185887	0.239045976	0.412508126	3.84E-10	0	0	1.39016508	0	0.001935683	0	0	4.90E-09	0	0	0	0	0	0	0	0	0	0	0	30.4393	None	0	4.2914	0.246104024	1.970709352	1.050837993	0.473909201	1.235337907	0.016368764	0.995674125	1.239240017	1.246720185	3.93393819	0.029552167	1.66E-08	0.786603215	3.895659039	5.508644167	0.212685475	0	1.262185887	0.239045976	0.412508126	3.84E-10	0	0	1.39016508	0	0.001935683	0	0	4.90E-09	0	0	0	0	0	0	0	0	0	0	0	30.4393	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.2914	0.246104024	1.970709352	1.050837993	0.473909201	1.235337907	0.016368764	0.995674125	1.239240017	1.246720185	3.93393819	0.029552167	1.66E-08	0.786603215	3.895659039	5.508644167	0.212685475	0	1.262185887	0.239045976	0.412508126	3.84E-10	0	0	1.39016508	0	0.001935683	0	0	4.90E-09	0	0	0	0	0	0	0	0	0	0	0	30.4393
H3954_030_0	2008	3																					None											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1029.943433	59.06496575	945.9404891	1261.005592	113.7382082	12.69231999	6.170614572	238.9617899	297.4176042	69.66649733	2622.62546	14.1850401	0.802475065	471.961929	4674.790847	3305.1865	127.6112849	0	1941.824442	143.4275854	13.84301652	1.496897957	0	0	834.0990483	3.337887575	1.16140986	0.633982837	0	3.718064676	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.097329559	0.002652696	50	50	0.017895549	18	25	0.000248303	20	10	20	20	10	7.8	20	0.029799006	3.08E-06	0	0	20	0	20	0	0	1.58E-05	0											4.2914	0.246104024	1.970709352	1.050837993	0.473909201	1.235337907	0.016368764	0.995674125	1.239240017	1.246720185	3.93393819	0.029552167	1.66E-08	0.786603215	3.895659039	5.508644167	0.212685475	0	1.262185887	0.239045976	0.412508126	3.84E-10	0	0	1.39016508	0	0.001935683	0	0	4.90E-09	0	0	0	0	0	0	0	0	0	0	0	30.4393	None	0	4.2914	0.246104024	1.970709352	1.050837993	0.473909201	1.235337907	0.016368764	0.995674125	1.239240017	1.246720185	3.93393819	0.029552167	1.66E-08	0.786603215	3.895659039	5.508644167	0.212685475	0	1.262185887	0.239045976	0.412508126	3.84E-10	0	0	1.39016508	0	0.001935683	0	0	4.90E-09	0	0	0	0	0	0	0	0	0	0	0	30.4393	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.2914	0.246104024	1.970709352	1.050837993	0.473909201	1.235337907	0.016368764	0.995674125	1.239240017	1.246720185	3.93393819	0.029552167	1.66E-08	0.786603215	3.895659039	5.508644167	0.212685475	0	1.262185887	0.239045976	0.412508126	3.84E-10	0	0	1.39016508	0	0.001935683	0	0	4.90E-09	0	0	0	0	0	0	0	0	0	0	0	30.4393
H3954_032_0	2008	2																					None											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1085.742559	59.06496575	1120.012166	880.1873452	196.1463509	13.6854683	6.180632614	325.8067312	273.1895127	45.41411608	2072.241895	48.39250078	1.1864508	404.5689451	4441.440082	3646.301794	127.6112849	0	1679.031946	163.5671688	11.99368716	1.062004783	0	0	641.1904789	3.100746142	1.04749139	0.658312073	0	4.36328468	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.097275381	0.002651219	50	50	0.017885587	18	25	0.000248165	20	10	20	20	10	7.8	20	0.029782418	3.07E-06	0	0	20	0	20	0	0	1.58E-05	0											4.5239	0.246104024	2.333358679	0.733489454	0.817276462	1.331259143	0.016386213	1.357528047	1.138289636	0.812258129	3.108362843	0.10081771	2.45E-08	0.674281575	3.701200069	6.077169656	0.212685475	0	1.091370765	0.272611948	0.357201006	2.72E-10	0	0	1.068650798	0	0.001745819	0	0	5.75E-09	0	0	0	0	0	0	0	0	0	0	0	29.976	None	0	4.5239	0.246104024	2.333358679	0.733489454	0.817276462	1.331259143	0.016386213	1.357528047	1.138289636	0.812258129	3.108362843	0.10081771	2.45E-08	0.674281575	3.701200069	6.077169656	0.212685475	0	1.091370765	0.272611948	0.357201006	2.72E-10	0	0	1.068650798	0	0.001745819	0	0	5.75E-09	0	0	0	0	0	0	0	0	0	0	0	29.976	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.5239	0.246104024	2.333358679	0.733489454	0.817276462	1.331259143	0.016386213	1.357528047	1.138289636	0.812258129	3.108362843	0.10081771	2.45E-08	0.674281575	3.701200069	6.077169656	0.212685475	0	1.091370765	0.272611948	0.357201006	2.72E-10	0	0	1.068650798	0	0.001745819	0	0	5.75E-09	0	0	0	0	0	0	0	0	0	0	0	29.976
H3954_033_0	2008	3																					None											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1085.742559	59.06496575	1120.012166	880.1873452	196.1463509	13.6854683	6.180632614	325.8067312	273.1895127	45.41411608	2072.241895	48.39250078	1.1864508	404.5689451	4441.440082	3646.301794	127.6112849	0	1679.031946	163.5671688	11.99368716	1.062004783	0	0	641.1904789	3.100746142	1.04749139	0.658312073	0	4.36328468	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.097275381	0.002651219	50	50	0.017885587	18	25	0.000248165	20	10	20	20	10	7.8	20	0.029782418	3.07E-06	0	0	20	0	20	0	0	1.58E-05	0											4.5239	0.246104024	2.333358679	0.733489454	0.817276462	1.331259143	0.016386213	1.357528047	1.138289636	0.812258129	3.108362843	0.10081771	2.45E-08	0.674281575	3.701200069	6.077169656	0.212685475	0	1.091370765	0.272611948	0.357201006	2.72E-10	0	0	1.068650798	0	0.001745819	0	0	5.75E-09	0	0	0	0	0	0	0	0	0	0	0	29.976	None	0	4.5239	0.246104024	2.333358679	0.733489454	0.817276462	1.331259143	0.016386213	1.357528047	1.138289636	0.812258129	3.108362843	0.10081771	2.45E-08	0.674281575	3.701200069	6.077169656	0.212685475	0	1.091370765	0.272611948	0.357201006	2.72E-10	0	0	1.068650798	0	0.001745819	0	0	5.75E-09	0	0	0	0	0	0	0	0	0	0	0	29.976	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.5239	0.246104024	2.333358679	0.733489454	0.817276462	1.331259143	0.016386213	1.357528047	1.138289636	0.812258129	3.108362843	0.10081771	2.45E-08	0.674281575	3.701200069	6.077169656	0.212685475	0	1.091370765	0.272611948	0.357201006	2.72E-10	0	0	1.068650798	0	0.001745819	0	0	5.75E-09	0	0	0	0	0	0	0	0	0	0	0	29.976
H3954_035_0	2008	2																					None											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1364.947005	59.06496575	540.5104693	730.8585021	85.29314513	9.700991585	3.945003007	183.2817389	270.079815	41.72594898	1143.313044	28.26189889	0.283118364	326.3688001	4448.285669	2602.801869	127.6112849	0	2054.954324	922.4415471	8.404556464	1.782335907	0	0	637.4835531	3.033051604	0.734232818	0.723728553	0	4.939603098	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.099846501	0.002721295	50	50	0.018358327	18	25	0.000254724	20	10	20	20	10	7.8	20	0.030569608	3.16E-06	0	0	20	0	20	0	0	1.62E-05	0											5.6873	0.246104024	1.126063478	0.609048752	0.355388105	0.96861007	0.010735516	0.763673912	1.125332562	0.766018634	1.714969567	0.058878956	6.01E-09	0.543948	3.706904724	4.338003116	0.212685475	0	1.335720311	1.537402579	0.256923995	4.69E-10	0	0	1.062472588	0	0.001223721	0	0	6.68E-09	0	0	0	0	0	0	0	0	0	0	0	26.4274	None	0	5.6873	0.246104024	1.126063478	0.609048752	0.355388105	0.96861007	0.010735516	0.763673912	1.125332562	0.766018634	1.714969567	0.058878956	6.01E-09	0.543948	3.706904724	4.338003116	0.212685475	0	1.335720311	1.537402579	0.256923995	4.69E-10	0	0	1.062472588	0	0.001223721	0	0	6.68E-09	0	0	0	0	0	0	0	0	0	0	0	26.4274	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.6873	0.246104024	1.126063478	0.609048752	0.355388105	0.96861007	0.010735516	0.763673912	1.125332562	0.766018634	1.714969567	0.058878956	6.01E-09	0.543948	3.706904724	4.338003116	0.212685475	0	1.335720311	1.537402579	0.256923995	4.69E-10	0	0	1.062472588	0	0.001223721	0	0	6.68E-09	0	0	0	0	0	0	0	0	0	0	0	26.4274
H3954_036_0	2008	3																					None											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1364.947005	59.06496575	540.5104693	730.8585021	85.29314513	9.700991585	3.945003007	183.2817389	270.079815	41.72594898	1143.313044	28.26189889	0.283118364	326.3688001	4448.285669	2602.801869	127.6112849	0	2054.954324	922.4415471	8.404556464	1.782335907	0	0	637.4835531	3.033051604	0.734232818	0.723728553	0	4.939603098	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.099846501	0.002721295	50	50	0.018358327	18	25	0.000254724	20	10	20	20	10	7.8	20	0.030569608	3.16E-06	0	0	20	0	20	0	0	1.62E-05	0											5.6873	0.246104024	1.126063478	0.609048752	0.355388105	0.96861007	0.010735516	0.763673912	1.125332562	0.766018634	1.714969567	0.058878956	6.01E-09	0.543948	3.706904724	4.338003116	0.212685475	0	1.335720311	1.537402579	0.256923995	4.69E-10	0	0	1.062472588	0	0.001223721	0	0	6.68E-09	0	0	0	0	0	0	0	0	0	0	0	26.4274	None	0	5.6873	0.246104024	1.126063478	0.609048752	0.355388105	0.96861007	0.010735516	0.763673912	1.125332562	0.766018634	1.714969567	0.058878956	6.01E-09	0.543948	3.706904724	4.338003116	0.212685475	0	1.335720311	1.537402579	0.256923995	4.69E-10	0	0	1.062472588	0	0.001223721	0	0	6.68E-09	0	0	0	0	0	0	0	0	0	0	0	26.4274	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.6873	0.246104024	1.126063478	0.609048752	0.355388105	0.96861007	0.010735516	0.763673912	1.125332562	0.766018634	1.714969567	0.058878956	6.01E-09	0.543948	3.706904724	4.338003116	0.212685475	0	1.335720311	1.537402579	0.256923995	4.69E-10	0	0	1.062472588	0	0.001223721	0	0	6.68E-09	0	0	0	0	0	0	0	0	0	0	0	26.4274
H3954_038_0	2008	2																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	235.373971	59.06496575	32.31290352	827.9585545	122.2195548	10.28680794	7.88802567	302.4411506	48.16277748	55.21795446	45.3692489	2.652579758	1.421223814	25.05132441	5234.866031	8433.057964	127.6112849	0	18.4225777	5.375922404	15.23522142	1.297095533	0	0	1116.664597	3.517629401	19.96492293	0.735392531	0	4.100646172	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.077318576	50	0.043144809	10	50	0.110652976	0.086526004	50	0.107146718	0.085499588	0.095055645	0.076537642	0.018413772	0.113194655	10	20	20	10	0.096635523	0.089464435	0.054563296	0.119742033	0	0	20	0	20	0	0	9.62E-06	0											18.1988	0.246104024	1.394134051	0.689965462	0.509248145	1.138265908	0.682519343	1.260171461	5.160483515	4.72111233	4.312603201	0.203022199	0.026170091	2.835676021	4.362388359	14.05509661	0.212685475	0	1.780275433	0.48095386	0.831283889	0.155316856	0	0	1.861107662	0	0.033274872	0	0	3.29E-09	0	0	0	0	0	0	0	0	0	0	0	65.1506	None	31.27590541	18.1988	0.246104024	1.394134051	0.689965462	0.509248145	1.138265908	0.682519343	1.260171461	5.160483515	4.72111233	4.312603201	0.203022199	0.026170091	2.835676021	4.362388359	14.05509661	0.212685475	0	1.780275433	0.48095386	0.831283889	0.155316856	0	0	1.861107662	0	0.033274872	0	0	3.29E-09	0	0	0	0	0	0	0	0	0	0	0	65.1506	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	18.1988	0.246104024	1.394134051	0.689965462	0.509248145	1.138265908	0.682519343	1.260171461	5.160483515	4.72111233	4.312603201	0.203022199	0.026170091	2.835676021	4.362388359	14.05509661	0.212685475	0	1.780275433	0.48095386	0.831283889	0.155316856	0	0	1.861107662	0	0.033274872	0	0	3.29E-09	0	0	0	0	0	0	0	0	0	0	0	65.1506
H3954_039_0	2008	3																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	235.373971	59.06496575	32.31290352	827.9585545	122.2195548	10.28680794	7.88802567	302.4411506	48.16277748	55.21795446	45.3692489	2.652579758	1.421223814	25.05132441	5234.866031	8433.057964	127.6112849	0	18.4225777	5.375922404	15.23522142	1.297095533	0	0	1116.664597	3.517629401	19.96492293	0.735392531	0	4.100646172	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.077318576	50	0.043144809	10	50	0.110652976	0.086526004	50	0.107146718	0.085499588	0.095055645	0.076537642	0.018413772	0.113194655	10	20	20	10	0.096635523	0.089464435	0.054563296	0.119742033	0	0	20	0	20	0	0	9.62E-06	0											18.1988	0.246104024	1.394134051	0.689965462	0.509248145	1.138265908	0.682519343	1.260171461	5.160483515	4.72111233	4.312603201	0.203022199	0.026170091	2.835676021	4.362388359	14.05509661	0.212685475	0	1.780275433	0.48095386	0.831283889	0.155316856	0	0	1.861107662	0	0.033274872	0	0	3.29E-09	0	0	0	0	0	0	0	0	0	0	0	65.1506	None	31.27590541	18.1988	0.246104024	1.394134051	0.689965462	0.509248145	1.138265908	0.682519343	1.260171461	5.160483515	4.72111233	4.312603201	0.203022199	0.026170091	2.835676021	4.362388359	14.05509661	0.212685475	0	1.780275433	0.48095386	0.831283889	0.155316856	0	0	1.861107662	0	0.033274872	0	0	3.29E-09	0	0	0	0	0	0	0	0	0	0	0	65.1506	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	18.1988	0.246104024	1.394134051	0.689965462	0.509248145	1.138265908	0.682519343	1.260171461	5.160483515	4.72111233	4.312603201	0.203022199	0.026170091	2.835676021	4.362388359	14.05509661	0.212685475	0	1.780275433	0.48095386	0.831283889	0.155316856	0	0	1.861107662	0	0.033274872	0	0	3.29E-09	0	0	0	0	0	0	0	0	0	0	0	65.1506
H3954_041_0	2008	2																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	285.0949029	59.06496575	42.33985151	949.9295188	154.9973037	10.63126314	5.693187763	244.5452981	59.180129	41.37009749	47.23822382	0.50876983	0.425296965	25.36666745	6200.222896	8423.45091	127.6112849	0	19.86635591	5.876173182	9.856685794	1.205365791	0	0	905.7500978	3.418722197	27.25030679	0.931756421	0	3.924757339	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.077604936	50	0.043304602	10	50	0.111062794	0.086846465	50	0.10754355	0.085816247	0.095407696	0.076821109	0.01848197	0.113613886	10	20	20	10	0.096993426	0.089795778	0.054765378	0.120185513	0	0	20	0	20	0	0	9.66E-06	0											22.1248	0.246104024	1.833510399	0.791607932	0.645822099	1.180737783	0.494433231	1.018938742	6.364441138	3.550226485	4.506890087	0.039084262	0.007860326	2.882005671	5.166852414	14.03908485	0.212685475	0	1.926905912	0.527655544	0.539805123	0.144867506	0	0	1.509583496	0	0.045417178	0	0	3.16E-09	0	0	0	0	0	0	0	0	0	0	0	69.7993	None	34.71718672	22.1248	0.246104024	1.833510399	0.791607932	0.645822099	1.180737783	0.494433231	1.018938742	6.364441138	3.550226485	4.506890087	0.039084262	0.007860326	2.882005671	5.166852414	14.03908485	0.212685475	0	1.926905912	0.527655544	0.539805123	0.144867506	0	0	1.509583496	0	0.045417178	0	0	3.16E-09	0	0	0	0	0	0	0	0	0	0	0	69.7993	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	22.1248	0.246104024	1.833510399	0.791607932	0.645822099	1.180737783	0.494433231	1.018938742	6.364441138	3.550226485	4.506890087	0.039084262	0.007860326	2.882005671	5.166852414	14.03908485	0.212685475	0	1.926905912	0.527655544	0.539805123	0.144867506	0	0	1.509583496	0	0.045417178	0	0	3.16E-09	0	0	0	0	0	0	0	0	0	0	0	69.7993
H3954_042_0	2008	3																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	285.0949029	59.06496575	42.33985151	949.9295188	154.9973037	10.63126314	5.693187763	244.5452981	59.180129	41.37009749	47.23822382	0.50876983	0.425296965	25.36666745	6200.222896	8423.45091	127.6112849	0	19.86635591	5.876173182	9.856685794	1.205365791	0	0	905.7500978	3.418722197	27.25030679	0.931756421	0	3.924757339	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.077604936	50	0.043304602	10	50	0.111062794	0.086846465	50	0.10754355	0.085816247	0.095407696	0.076821109	0.01848197	0.113613886	10	20	20	10	0.096993426	0.089795778	0.054765378	0.120185513	0	0	20	0	20	0	0	9.66E-06	0											22.1248	0.246104024	1.833510399	0.791607932	0.645822099	1.180737783	0.494433231	1.018938742	6.364441138	3.550226485	4.506890087	0.039084262	0.007860326	2.882005671	5.166852414	14.03908485	0.212685475	0	1.926905912	0.527655544	0.539805123	0.144867506	0	0	1.509583496	0	0.045417178	0	0	3.16E-09	0	0	0	0	0	0	0	0	0	0	0	69.7993	None	34.71718672	22.1248	0.246104024	1.833510399	0.791607932	0.645822099	1.180737783	0.494433231	1.018938742	6.364441138	3.550226485	4.506890087	0.039084262	0.007860326	2.882005671	5.166852414	14.03908485	0.212685475	0	1.926905912	0.527655544	0.539805123	0.144867506	0	0	1.509583496	0	0.045417178	0	0	3.16E-09	0	0	0	0	0	0	0	0	0	0	0	69.7993	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	22.1248	0.246104024	1.833510399	0.791607932	0.645822099	1.180737783	0.494433231	1.018938742	6.364441138	3.550226485	4.506890087	0.039084262	0.007860326	2.882005671	5.166852414	14.03908485	0.212685475	0	1.926905912	0.527655544	0.539805123	0.144867506	0	0	1.509583496	0	0.045417178	0	0	3.16E-09	0	0	0	0	0	0	0	0	0	0	0	69.7993
H3954_044_0	2008	2																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	248.7119743	59.06496575	41.56468581	1254.194727	81.26319869	11.31365737	6.405670834	212.6931837	33.97860428	40.08217307	28.01164915	1.92185983	0.782988903	18.55037169	5498.404045	10332.54581	127.6112849	0	39.48785856	7.025461849	9.085882766	1.656944209	0	0	818.6004281	2.807715164	19.88416728	0.904772789	0	4.552337541	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.07897614	50	0.044069752	10	50	0.113025167	0.088380959	50	0.109443741	0.087332537	0.097093458	0.078178464	0.018808528	0.115621335	10	20	20	10	0.098707206	0.091382384	0.05573303	0.122309076	0	0	20	0	20	0	0	9.83E-06	0											19.6423	0.246104024	1.83174541	1.045162272	0.338596661	1.27872801	0.566139329	0.886221599	3.718745569	3.500477878	2.71974789	0.15024805	0.014726869	2.144818735	4.58200337	17.22090968	0.212685475	0	3.897736206	0.642003449	0.506383774	0.202659316	0	0	1.364334047	0	0.033140279	0	0	3.73E-09	0	0	0	0	0	0	0	0	0	0	0	66.7456	None	31.65199359	19.6423	0.246104024	1.83174541	1.045162272	0.338596661	1.27872801	0.566139329	0.886221599	3.718745569	3.500477878	2.71974789	0.15024805	0.014726869	2.144818735	4.58200337	17.22090968	0.212685475	0	3.897736206	0.642003449	0.506383774	0.202659316	0	0	1.364334047	0	0.033140279	0	0	3.73E-09	0	0	0	0	0	0	0	0	0	0	0	66.7456	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	19.6423	0.246104024	1.83174541	1.045162272	0.338596661	1.27872801	0.566139329	0.886221599	3.718745569	3.500477878	2.71974789	0.15024805	0.014726869	2.144818735	4.58200337	17.22090968	0.212685475	0	3.897736206	0.642003449	0.506383774	0.202659316	0	0	1.364334047	0	0.033140279	0	0	3.73E-09	0	0	0	0	0	0	0	0	0	0	0	66.7456
H3954_045_0	2008	3																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	248.7119743	59.06496575	41.56468581	1254.194727	81.26319869	11.31365737	6.405670834	212.6931837	33.97860428	40.08217307	28.01164915	1.92185983	0.782988903	18.55037169	5498.404045	10332.54581	127.6112849	0	39.48785856	7.025461849	9.085882766	1.656944209	0	0	818.6004281	2.807715164	19.88416728	0.904772789	0	4.552337541	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.07897614	50	0.044069752	10	50	0.113025167	0.088380959	50	0.109443741	0.087332537	0.097093458	0.078178464	0.018808528	0.115621335	10	20	20	10	0.098707206	0.091382384	0.05573303	0.122309076	0	0	20	0	20	0	0	9.83E-06	0											19.6423	0.246104024	1.83174541	1.045162272	0.338596661	1.27872801	0.566139329	0.886221599	3.718745569	3.500477878	2.71974789	0.15024805	0.014726869	2.144818735	4.58200337	17.22090968	0.212685475	0	3.897736206	0.642003449	0.506383774	0.202659316	0	0	1.364334047	0	0.033140279	0	0	3.73E-09	0	0	0	0	0	0	0	0	0	0	0	66.7456	None	31.65199359	19.6423	0.246104024	1.83174541	1.045162272	0.338596661	1.27872801	0.566139329	0.886221599	3.718745569	3.500477878	2.71974789	0.15024805	0.014726869	2.144818735	4.58200337	17.22090968	0.212685475	0	3.897736206	0.642003449	0.506383774	0.202659316	0	0	1.364334047	0	0.033140279	0	0	3.73E-09	0	0	0	0	0	0	0	0	0	0	0	66.7456	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	19.6423	0.246104024	1.83174541	1.045162272	0.338596661	1.27872801	0.566139329	0.886221599	3.718745569	3.500477878	2.71974789	0.15024805	0.014726869	2.144818735	4.58200337	17.22090968	0.212685475	0	3.897736206	0.642003449	0.506383774	0.202659316	0	0	1.364334047	0	0.033140279	0	0	3.73E-09	0	0	0	0	0	0	0	0	0	0	0	66.7456
H3954_047_0	2008	2																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	221.9971406	59.06496575	35.03940832	1295.567095	99.61862766	12.63729297	6.080811753	238.5373514	47.78262252	67.67684646	71.3987919	1.24278806	0.790796403	30.57836322	5658.094122	8849.705351	127.6112849	0	25.97347601	4.402555386	13.56951061	1.475113148	0	0	1057.360237	3.339401307	18.86638177	0.634270348	0	3.719750819	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.077517028	50	0.043255548	10	50	0.110936986	0.086748089	50	0.107421729	0.085719037	0.095299622	0.076734089	0.018461034	0.113485189	10	20	20	10	0.096883555	0.089694061	0.054703342	0.120049372	0	0	20	0	20	0	0	9.64E-06	0											17.2086	0.246104024	1.515648802	1.079639246	0.415077615	1.401943194	0.527498797	0.993905631	5.132891908	5.80119413	6.804277865	0.09536421	0.014598919	3.47019133	4.715078435	14.74950892	0.212685475	0	2.516402699	0.394883072	0.742297579	0.177086407	0	0	1.762267061	0	0.03144397	0	0	2.99E-09	0	0	0	0	0	0	0	0	0	0	0	70.0085	None	32.90670521	17.2086	0.246104024	1.515648802	1.079639246	0.415077615	1.401943194	0.527498797	0.993905631	5.132891908	5.80119413	6.804277865	0.09536421	0.014598919	3.47019133	4.715078435	14.74950892	0.212685475	0	2.516402699	0.394883072	0.742297579	0.177086407	0	0	1.762267061	0	0.03144397	0	0	2.99E-09	0	0	0	0	0	0	0	0	0	0	0	70.0085	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	17.2086	0.246104024	1.515648802	1.079639246	0.415077615	1.401943194	0.527498797	0.993905631	5.132891908	5.80119413	6.804277865	0.09536421	0.014598919	3.47019133	4.715078435	14.74950892	0.212685475	0	2.516402699	0.394883072	0.742297579	0.177086407	0	0	1.762267061	0	0.03144397	0	0	2.99E-09	0	0	0	0	0	0	0	0	0	0	0	70.0085
H3954_048_0	2008	3																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	221.9971406	59.06496575	35.03940832	1295.567095	99.61862766	12.63729297	6.080811753	238.5373514	47.78262252	67.67684646	71.3987919	1.24278806	0.790796403	30.57836322	5658.094122	8849.705351	127.6112849	0	25.97347601	4.402555386	13.56951061	1.475113148	0	0	1057.360237	3.339401307	18.86638177	0.634270348	0	3.719750819	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.077517028	50	0.043255548	10	50	0.110936986	0.086748089	50	0.107421729	0.085719037	0.095299622	0.076734089	0.018461034	0.113485189	10	20	20	10	0.096883555	0.089694061	0.054703342	0.120049372	0	0	20	0	20	0	0	9.64E-06	0											17.2086	0.246104024	1.515648802	1.079639246	0.415077615	1.401943194	0.527498797	0.993905631	5.132891908	5.80119413	6.804277865	0.09536421	0.014598919	3.47019133	4.715078435	14.74950892	0.212685475	0	2.516402699	0.394883072	0.742297579	0.177086407	0	0	1.762267061	0	0.03144397	0	0	2.99E-09	0	0	0	0	0	0	0	0	0	0	0	70.0085	None	32.90670521	17.2086	0.246104024	1.515648802	1.079639246	0.415077615	1.401943194	0.527498797	0.993905631	5.132891908	5.80119413	6.804277865	0.09536421	0.014598919	3.47019133	4.715078435	14.74950892	0.212685475	0	2.516402699	0.394883072	0.742297579	0.177086407	0	0	1.762267061	0	0.03144397	0	0	2.99E-09	0	0	0	0	0	0	0	0	0	0	0	70.0085	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	17.2086	0.246104024	1.515648802	1.079639246	0.415077615	1.401943194	0.527498797	0.993905631	5.132891908	5.80119413	6.804277865	0.09536421	0.014598919	3.47019133	4.715078435	14.74950892	0.212685475	0	2.516402699	0.394883072	0.742297579	0.177086407	0	0	1.762267061	0	0.03144397	0	0	2.99E-09	0	0	0	0	0	0	0	0	0	0	0	70.0085
H3954_050_0	2008	2																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	234.1478074	59.06496575	41.50982621	904.3114235	171.7965371	13.62566863	6.090591597	325.2280407	43.91395582	44.11643546	56.44824939	4.242089197	1.169166286	26.22688186	5375.660305	9763.048619	127.6112849	0	22.47058075	5.023466423	11.75654134	1.046533229	0	0	812.8163173	3.102105268	17.01584698	0.658600626	0	4.365197205	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.077475054	50	0.043232126	10	50	0.110876916	0.086701116	50	0.107363562	0.085672622	0.095248019	0.076692539	0.018451038	0.113423739	10	20	20	10	0.096831095	0.089645494	0.054673721	0.119984368	0	0	20	0	20	0	0	9.64E-06	0											18.1406	0.246104024	1.794558027	0.753592853	0.715818905	1.510772114	0.52806109	1.355116836	4.714758708	3.779570705	5.376583922	0.325336591	0.021572331	2.974751001	4.479716921	16.2717477	0.212685475	0	2.175850932	0.450331127	0.642773863	0.125567628	0	0	1.354693862	0	0.028359745	0	0	3.51E-09	0	0	0	0	0	0	0	0	0	0	0	67.9789	None	31.90686195	18.1406	0.246104024	1.794558027	0.753592853	0.715818905	1.510772114	0.52806109	1.355116836	4.714758708	3.779570705	5.376583922	0.325336591	0.021572331	2.974751001	4.479716921	16.2717477	0.212685475	0	2.175850932	0.450331127	0.642773863	0.125567628	0	0	1.354693862	0	0.028359745	0	0	3.51E-09	0	0	0	0	0	0	0	0	0	0	0	67.9789	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	18.1406	0.246104024	1.794558027	0.753592853	0.715818905	1.510772114	0.52806109	1.355116836	4.714758708	3.779570705	5.376583922	0.325336591	0.021572331	2.974751001	4.479716921	16.2717477	0.212685475	0	2.175850932	0.450331127	0.642773863	0.125567628	0	0	1.354693862	0	0.028359745	0	0	3.51E-09	0	0	0	0	0	0	0	0	0	0	0	67.9789
H3954_051_0	2008	3																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	234.1478074	59.06496575	41.50982621	904.3114235	171.7965371	13.62566863	6.090591597	325.2280407	43.91395582	44.11643546	56.44824939	4.242089197	1.169166286	26.22688186	5375.660305	9763.048619	127.6112849	0	22.47058075	5.023466423	11.75654134	1.046533229	0	0	812.8163173	3.102105268	17.01584698	0.658600626	0	4.365197205	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.077475054	50	0.043232126	10	50	0.110876916	0.086701116	50	0.107363562	0.085672622	0.095248019	0.076692539	0.018451038	0.113423739	10	20	20	10	0.096831095	0.089645494	0.054673721	0.119984368	0	0	20	0	20	0	0	9.64E-06	0											18.1406	0.246104024	1.794558027	0.753592853	0.715818905	1.510772114	0.52806109	1.355116836	4.714758708	3.779570705	5.376583922	0.325336591	0.021572331	2.974751001	4.479716921	16.2717477	0.212685475	0	2.175850932	0.450331127	0.642773863	0.125567628	0	0	1.354693862	0	0.028359745	0	0	3.51E-09	0	0	0	0	0	0	0	0	0	0	0	67.9789	None	31.90686195	18.1406	0.246104024	1.794558027	0.753592853	0.715818905	1.510772114	0.52806109	1.355116836	4.714758708	3.779570705	5.376583922	0.325336591	0.021572331	2.974751001	4.479716921	16.2717477	0.212685475	0	2.175850932	0.450331127	0.642773863	0.125567628	0	0	1.354693862	0	0.028359745	0	0	3.51E-09	0	0	0	0	0	0	0	0	0	0	0	67.9789	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	18.1406	0.246104024	1.794558027	0.753592853	0.715818905	1.510772114	0.52806109	1.355116836	4.714758708	3.779570705	5.376583922	0.325336591	0.021572331	2.974751001	4.479716921	16.2717477	0.212685475	0	2.175850932	0.450331127	0.642773863	0.125567628	0	0	1.354693862	0	0.028359745	0	0	3.51E-09	0	0	0	0	0	0	0	0	0	0	0	67.9789
H3954_053_0	2008	2																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	286.6580254	59.06496575	19.50922524	750.8897919	74.70476459	9.655881296	3.886078214	182.956198	42.28033329	40.51850573	30.33619912	2.412741566	0.278889548	20.60582431	5383.878642	6969.055946	127.6112849	0	26.78337168	27.59014356	8.235297774	1.755713931	0	0	808.1171679	3.033246936	11.92715607	0.723775162	0	4.939921214	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.079552558	50	0.044391401	10	50	0.113850096	0.089026019	50	0.11024253	0.087969945	0.097802108	0.07874906	0.018945805	0.116465212	10	20	20	10	0.099427634	0.09204935	0.056139804	0.123201765	0	0	20	0	20	0	0	9.90E-06	0											22.8044	0.246104024	0.866041844	0.625741493	0.311269852	1.099323008	0.345962071	0.762317492	4.661090929	3.564410731	2.96694421	0.19000113	0.005283787	2.399861698	4.486565535	11.61509324	0.212685475	0	2.663007271	2.539654774	0.462328007	0.216307055	0	0	1.346861947	0	0.019878593	0	0	4.07E-09	0	0	0	0	0	0	0	0	0	0	0	64.4111	None	32.98283509	22.8044	0.246104024	0.866041844	0.625741493	0.311269852	1.099323008	0.345962071	0.762317492	4.661090929	3.564410731	2.96694421	0.19000113	0.005283787	2.399861698	4.486565535	11.61509324	0.212685475	0	2.663007271	2.539654774	0.462328007	0.216307055	0	0	1.346861947	0	0.019878593	0	0	4.07E-09	0	0	0	0	0	0	0	0	0	0	0	64.4111	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	22.8044	0.246104024	0.866041844	0.625741493	0.311269852	1.099323008	0.345962071	0.762317492	4.661090929	3.564410731	2.96694421	0.19000113	0.005283787	2.399861698	4.486565535	11.61509324	0.212685475	0	2.663007271	2.539654774	0.462328007	0.216307055	0	0	1.346861947	0	0.019878593	0	0	4.07E-09	0	0	0	0	0	0	0	0	0	0	0	64.4111
H3954_054_0	2008	3																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	286.6580254	59.06496575	19.50922524	750.8897919	74.70476459	9.655881296	3.886078214	182.956198	42.28033329	40.51850573	30.33619912	2.412741566	0.278889548	20.60582431	5383.878642	6969.055946	127.6112849	0	26.78337168	27.59014356	8.235297774	1.755713931	0	0	808.1171679	3.033246936	11.92715607	0.723775162	0	4.939921214	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.079552558	50	0.044391401	10	50	0.113850096	0.089026019	50	0.11024253	0.087969945	0.097802108	0.07874906	0.018945805	0.116465212	10	20	20	10	0.099427634	0.09204935	0.056139804	0.123201765	0	0	20	0	20	0	0	9.90E-06	0											22.8044	0.246104024	0.866041844	0.625741493	0.311269852	1.099323008	0.345962071	0.762317492	4.661090929	3.564410731	2.96694421	0.19000113	0.005283787	2.399861698	4.486565535	11.61509324	0.212685475	0	2.663007271	2.539654774	0.462328007	0.216307055	0	0	1.346861947	0	0.019878593	0	0	4.07E-09	0	0	0	0	0	0	0	0	0	0	0	64.4111	None	32.98283509	22.8044	0.246104024	0.866041844	0.625741493	0.311269852	1.099323008	0.345962071	0.762317492	4.661090929	3.564410731	2.96694421	0.19000113	0.005283787	2.399861698	4.486565535	11.61509324	0.212685475	0	2.663007271	2.539654774	0.462328007	0.216307055	0	0	1.346861947	0	0.019878593	0	0	4.07E-09	0	0	0	0	0	0	0	0	0	0	0	64.4111	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	22.8044	0.246104024	0.866041844	0.625741493	0.311269852	1.099323008	0.345962071	0.762317492	4.661090929	3.564410731	2.96694421	0.19000113	0.005283787	2.399861698	4.486565535	11.61509324	0.212685475	0	2.663007271	2.539654774	0.462328007	0.216307055	0	0	1.346861947	0	0.019878593	0	0	4.07E-09	0	0	0	0	0	0	0	0	0	0	0	64.4111
H3954_056_0	2008	2																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	229.3987498	59.06496575	32.62369572	810.819985	148.1789943	12.50657707	4.476194535	222.9633439	42.70490474	40.89902831	44.59553671	3.33254023	0.567435954	17.78912495	5004.38527	8203.133771	127.6112849	0	17.09314863	3.746374711	10.03844531	0.660160373	0	0	877.4660016	3.026267647	14.36725291	0.662672893	0	3.930025829	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.077642786	50	0.043325722	10	50	0.111116962	0.086888822	50	0.107596002	0.085858102	0.095454229	0.076858577	0.018490984	0.113669299	10	20	20	10	0.097040732	0.089839574	0.054792089	0.120244131	0	0	20	0	20	0	0	9.66E-06	0											17.8112	0.246104024	1.413445187	0.675683321	0.617412476	1.389692851	0.388931272	0.929013933	4.594877005	3.51151293	4.25683257	0.256134299	0.010492449	2.022077365	4.170321058	13.67188962	0.212685475	0	1.658731656	0.336572709	0.550027385	0.079380411	0	0	1.462443336	0	0.023945422	0	0	3.16E-09	0	0	0	0	0	0	0	0	0	0	0	60.2894	None	28.86057658	17.8112	0.246104024	1.413445187	0.675683321	0.617412476	1.389692851	0.388931272	0.929013933	4.594877005	3.51151293	4.25683257	0.256134299	0.010492449	2.022077365	4.170321058	13.67188962	0.212685475	0	1.658731656	0.336572709	0.550027385	0.079380411	0	0	1.462443336	0	0.023945422	0	0	3.16E-09	0	0	0	0	0	0	0	0	0	0	0	60.2894	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	17.8112	0.246104024	1.413445187	0.675683321	0.617412476	1.389692851	0.388931272	0.929013933	4.594877005	3.51151293	4.25683257	0.256134299	0.010492449	2.022077365	4.170321058	13.67188962	0.212685475	0	1.658731656	0.336572709	0.550027385	0.079380411	0	0	1.462443336	0	0.023945422	0	0	3.16E-09	0	0	0	0	0	0	0	0	0	0	0	60.2894
H3954_057_0	2008	3																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	229.3987498	59.06496575	32.62369572	810.819985	148.1789943	12.50657707	4.476194535	222.9633439	42.70490474	40.89902831	44.59553671	3.33254023	0.567435954	17.78912495	5004.38527	8203.133771	127.6112849	0	17.09314863	3.746374711	10.03844531	0.660160373	0	0	877.4660016	3.026267647	14.36725291	0.662672893	0	3.930025829	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.077642786	50	0.043325722	10	50	0.111116962	0.086888822	50	0.107596002	0.085858102	0.095454229	0.076858577	0.018490984	0.113669299	10	20	20	10	0.097040732	0.089839574	0.054792089	0.120244131	0	0	20	0	20	0	0	9.66E-06	0											17.8112	0.246104024	1.413445187	0.675683321	0.617412476	1.389692851	0.388931272	0.929013933	4.594877005	3.51151293	4.25683257	0.256134299	0.010492449	2.022077365	4.170321058	13.67188962	0.212685475	0	1.658731656	0.336572709	0.550027385	0.079380411	0	0	1.462443336	0	0.023945422	0	0	3.16E-09	0	0	0	0	0	0	0	0	0	0	0	60.2894	None	28.86057658	17.8112	0.246104024	1.413445187	0.675683321	0.617412476	1.389692851	0.388931272	0.929013933	4.594877005	3.51151293	4.25683257	0.256134299	0.010492449	2.022077365	4.170321058	13.67188962	0.212685475	0	1.658731656	0.336572709	0.550027385	0.079380411	0	0	1.462443336	0	0.023945422	0	0	3.16E-09	0	0	0	0	0	0	0	0	0	0	0	60.2894	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	17.8112	0.246104024	1.413445187	0.675683321	0.617412476	1.389692851	0.388931272	0.929013933	4.594877005	3.51151293	4.25683257	0.256134299	0.010492449	2.022077365	4.170321058	13.67188962	0.212685475	0	1.658731656	0.336572709	0.550027385	0.079380411	0	0	1.462443336	0	0.023945422	0	0	3.16E-09	0	0	0	0	0	0	0	0	0	0	0	60.2894
H3954_059_0	2008	2																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	240.682046	59.06496575	20.33770313	847.4690265	114.2346577	9.995289132	4.274023551	256.7282215	47.9290371	64.28268915	58.35028905	0.668359076	0.30831598	17.74316086	4707.463141	8468.323193	127.6112849	11.6851277	30.71802541	13.72917563	13.6683291	1.979560232	0	0	1075.333679	3.330330542	15.16253114	0.591208192	0	4.075725553	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.078072145	50	0.043565311	10	50	0.111731431	0.087369312	50	0.108191	0.086332891	0.095982084	0.077283599	0.018593238	0.114297883	10	20	20	10	0.097577361	0.090336381	0.055095085	0.120909073	0	0	20	0	20	0	0	9.71E-06	0											18.7906	0.246104024	0.886018356	0.706224189	0.47597774	1.116787961	0.373418495	1.069700923	5.185490465	5.549710399	5.60058236	0.051653195	0.005732592	2.028005715	3.922885951	14.11387199	0.212685475	0.009737606	2.997383844	1.240244039	0.753057755	0.239346793	0	0	1.792222799	0	0.025270885	0	0	3.30E-09	0	0	0	0	0	0	0	0	0	0	0	67.3927	None	32.11217687	18.7906	0.246104024	0.886018356	0.706224189	0.47597774	1.116787961	0.373418495	1.069700923	5.185490465	5.549710399	5.60058236	0.051653195	0.005732592	2.028005715	3.922885951	14.11387199	0.212685475	0.009737606	2.997383844	1.240244039	0.753057755	0.239346793	0	0	1.792222799	0	0.025270885	0	0	3.30E-09	0	0	0	0	0	0	0	0	0	0	0	67.3927	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	18.7906	0.246104024	0.886018356	0.706224189	0.47597774	1.116787961	0.373418495	1.069700923	5.185490465	5.549710399	5.60058236	0.051653195	0.005732592	2.028005715	3.922885951	14.11387199	0.212685475	0.009737606	2.997383844	1.240244039	0.753057755	0.239346793	0	0	1.792222799	0	0.025270885	0	0	3.30E-09	0	0	0	0	0	0	0	0	0	0	0	67.3927
H3954_060_0	2008	3																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	240.682046	59.06496575	20.33770313	847.4690265	114.2346577	9.995289132	4.274023551	256.7282215	47.9290371	64.28268915	58.35028905	0.668359076	0.30831598	17.74316086	4707.463141	8468.323193	127.6112849	11.6851277	30.71802541	13.72917563	13.6683291	1.979560232	0	0	1075.333679	3.330330542	15.16253114	0.591208192	0	4.075725553	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.078072145	50	0.043565311	10	50	0.111731431	0.087369312	50	0.108191	0.086332891	0.095982084	0.077283599	0.018593238	0.114297883	10	20	20	10	0.097577361	0.090336381	0.055095085	0.120909073	0	0	20	0	20	0	0	9.71E-06	0											18.7906	0.246104024	0.886018356	0.706224189	0.47597774	1.116787961	0.373418495	1.069700923	5.185490465	5.549710399	5.60058236	0.051653195	0.005732592	2.028005715	3.922885951	14.11387199	0.212685475	0.009737606	2.997383844	1.240244039	0.753057755	0.239346793	0	0	1.792222799	0	0.025270885	0	0	3.30E-09	0	0	0	0	0	0	0	0	0	0	0	67.3927	None	32.11217687	18.7906	0.246104024	0.886018356	0.706224189	0.47597774	1.116787961	0.373418495	1.069700923	5.185490465	5.549710399	5.60058236	0.051653195	0.005732592	2.028005715	3.922885951	14.11387199	0.212685475	0.009737606	2.997383844	1.240244039	0.753057755	0.239346793	0	0	1.792222799	0	0.025270885	0	0	3.30E-09	0	0	0	0	0	0	0	0	0	0	0	67.3927	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	18.7906	0.246104024	0.886018356	0.706224189	0.47597774	1.116787961	0.373418495	1.069700923	5.185490465	5.549710399	5.60058236	0.051653195	0.005732592	2.028005715	3.922885951	14.11387199	0.212685475	0.009737606	2.997383844	1.240244039	0.753057755	0.239346793	0	0	1.792222799	0	0.025270885	0	0	3.30E-09	0	0	0	0	0	0	0	0	0	0	0	67.3927
H3954_062_0	2008	2																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	205.8058569	59.06496575	23.47477357	903.4628897	86.57605218	6.543532279	9.893615077	300.2924843	46.87597651	52.86409764	52.30663372	1.007626294	0.115612062	22.83466153	5638.578556	7380.882493	127.6112849	0	14.31661512	3.586368842	15.69289515	1.22788583	0	0	972.600845	4.347183216	17.08761009	0.716703677	0	4.031241797	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.076650898	50	0.042772236	10	50	0.109697441	0.085778816	50	0.106221461	0.084761263	0.094234799	0.075876707	0.018254761	0.112217172	10	20	20	10	0.095801035	0.088691872	0.054092119	0.11870801	0	0	20	0	20	0	0	9.54E-06	0											15.7752	0.246104024	1.004068544	0.752885741	0.360733551	0.717808745	0.848662588	1.251218684	4.9792347	4.480827671	4.929105132	0.076455365	0.002110471	2.562441132	4.698815463	12.30147082	0.212685475	0	1.371546544	0.318081766	0.848861947	0.145759884	0	0	1.621001408	0	0.02847935	0	0	3.20E-09	0	0	0	0	0	0	0	0	0	0	0	59.5336	None	27.66316802	15.7752	0.246104024	1.004068544	0.752885741	0.360733551	0.717808745	0.848662588	1.251218684	4.9792347	4.480827671	4.929105132	0.076455365	0.002110471	2.562441132	4.698815463	12.30147082	0.212685475	0	1.371546544	0.318081766	0.848861947	0.145759884	0	0	1.621001408	0	0.02847935	0	0	3.20E-09	0	0	0	0	0	0	0	0	0	0	0	59.5336	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	15.7752	0.246104024	1.004068544	0.752885741	0.360733551	0.717808745	0.848662588	1.251218684	4.9792347	4.480827671	4.929105132	0.076455365	0.002110471	2.562441132	4.698815463	12.30147082	0.212685475	0	1.371546544	0.318081766	0.848861947	0.145759884	0	0	1.621001408	0	0.02847935	0	0	3.20E-09	0	0	0	0	0	0	0	0	0	0	0	59.5336
H3954_063_0	2008	3																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	O	O	V	Coin	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	205.8058569	59.06496575	23.47477357	903.4628897	86.57605218	6.543532279	9.893615077	300.2924843	46.87597651	52.86409764	52.30663372	1.007626294	0.115612062	22.83466153	5638.578556	7380.882493	127.6112849	0	14.31661512	3.586368842	15.69289515	1.22788583	0	0	972.600845	4.347183216	17.08761009	0.716703677	0	4.031241797	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 5	PBP 12	"PBP 3, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.076650898	50	0.042772236	10	50	0.109697441	0.085778816	50	0.106221461	0.084761263	0.094234799	0.075876707	0.018254761	0.112217172	10	20	20	10	0.095801035	0.088691872	0.054092119	0.11870801	0	0	20	0	20	0	0	9.54E-06	0											15.7752	0.246104024	1.004068544	0.752885741	0.360733551	0.717808745	0.848662588	1.251218684	4.9792347	4.480827671	4.929105132	0.076455365	0.002110471	2.562441132	4.698815463	12.30147082	0.212685475	0	1.371546544	0.318081766	0.848861947	0.145759884	0	0	1.621001408	0	0.02847935	0	0	3.20E-09	0	0	0	0	0	0	0	0	0	0	0	59.5336	None	27.66316802	15.7752	0.246104024	1.004068544	0.752885741	0.360733551	0.717808745	0.848662588	1.251218684	4.9792347	4.480827671	4.929105132	0.076455365	0.002110471	2.562441132	4.698815463	12.30147082	0.212685475	0	1.371546544	0.318081766	0.848861947	0.145759884	0	0	1.621001408	0	0.02847935	0	0	3.20E-09	0	0	0	0	0	0	0	0	0	0	0	59.5336	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	15.7752	0.246104024	1.004068544	0.752885741	0.360733551	0.717808745	0.848662588	1.251218684	4.9792347	4.480827671	4.929105132	0.076455365	0.002110471	2.562441132	4.698815463	12.30147082	0.212685475	0	1.371546544	0.318081766	0.848861947	0.145759884	0	0	1.621001408	0	0.02847935	0	0	3.20E-09	0	0	0	0	0	0	0	0	0	0	0	59.5336
H3954_065_0	2008	4																					2000											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1773.40013	33.5741216	1325.728167	1111.39357	196.413988	48879.93281	50.47339578	360.7840506	333.5928041	2434.232583	956.2719536	0	1084.163898	859.4163396	4971.77978	8576.703571	207.5107917	649.3107627	3733.196254	17883.48723	1667.333977	6464.36178	0	0	327.9933322	0	132.7592059	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												139.3195483	50	31.46884584	10	50	0.400486254	17.73119559	50	80.69664916	3.322727046	20.37937468	0	8.951062227	13.50319356	10	15.05932371	20	10	6.17592473	5.260394728	6.517073727	3.986397893	0	0	20	0	20	0	0	0	0											20.5891	0.139892173	3.47659461	0.926161309	0.818391617	1.631311767	0.074579471	1.503266878	2.243318456	0.674024203	1.624018703	0	0.808701543	0.967072098	4.143149816	10.76327962	0.345851319	0.541092302	1.921328256	7.839516826	0.905511538	2.147459848	0	0	0.546655554	0	0.221265343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8516	None	34.19800302	20.5891	0.139892173	3.47659461	0.926161309	0.818391617	1.631311767	0.074579471	1.503266878	2.243318456	0.674024203	1.624018703	0	0.808701543	0.967072098	4.143149816	10.76327962	0.345851319	0.541092302	1.921328256	7.839516826	0.905511538	2.147459848	0	0	0.546655554	0	0.221265343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8516	2000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	20.5891	0.139892173	3.47659461	0.926161309	0.818391617	1.631311767	0.074579471	1.503266878	2.243318456	0.674024203	1.624018703	0	0.808701543	0.967072098	4.143149816	10.76327962	0.345851319	0.541092302	1.921328256	7.839516826	0.905511538	2.147459848	0	0	0.546655554	0	0.221265343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8516
H3954_066_0	2008	3																					2000											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1773.40013	33.5741216	1325.728167	1111.39357	196.413988	48879.93281	50.47339578	360.7840506	333.5928041	2434.232583	956.2719536	0	1084.163898	859.4163396	4971.77978	8576.703571	207.5107917	649.3107627	3733.196254	17883.48723	1667.333977	6464.36178	0	0	327.9933322	0	132.7592059	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												139.3195483	50	31.46884584	10	50	0.400486254	17.73119559	50	80.69664916	3.322727046	20.37937468	0	8.951062227	13.50319356	10	15.05932371	20	10	6.17592473	5.260394728	6.517073727	3.986397893	0	0	20	0	20	0	0	0	0											20.5891	0.139892173	3.47659461	0.926161309	0.818391617	1.631311767	0.074579471	1.503266878	2.243318456	0.674024203	1.624018703	0	0.808701543	0.967072098	4.143149816	10.76327962	0.345851319	0.541092302	1.921328256	7.839516826	0.905511538	2.147459848	0	0	0.546655554	0	0.221265343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8516	None	34.19800302	20.5891	0.139892173	3.47659461	0.926161309	0.818391617	1.631311767	0.074579471	1.503266878	2.243318456	0.674024203	1.624018703	0	0.808701543	0.967072098	4.143149816	10.76327962	0.345851319	0.541092302	1.921328256	7.839516826	0.905511538	2.147459848	0	0	0.546655554	0	0.221265343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8516	2000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	20.5891	0.139892173	3.47659461	0.926161309	0.818391617	1.631311767	0.074579471	1.503266878	2.243318456	0.674024203	1.624018703	0	0.808701543	0.967072098	4.143149816	10.76327962	0.345851319	0.541092302	1.921328256	7.839516826	0.905511538	2.147459848	0	0	0.546655554	0	0.221265343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8516
H3954_067_0	2008	4																					2000											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1773.40013	33.5741216	1325.728167	1111.39357	196.413988	48879.93281	50.47339578	360.7840506	333.5928041	2434.232583	956.2719536	0	1084.163898	859.4163396	4971.77978	8576.703571	207.5107917	649.3107627	3733.196254	17883.48723	1667.333977	6464.36178	0	0	327.9933322	0	132.7592059	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												139.3195483	50	31.46884584	10	50	0.400486254	17.73119559	50	80.69664916	3.322727046	20.37937468	0	8.951062227	13.50319356	10	15.05932371	20	10	6.17592473	5.260394728	6.517073727	3.986397893	0	0	20	0	20	0	0	0	0											20.5891	0.139892173	3.47659461	0.926161309	0.818391617	1.631311767	0.074579471	1.503266878	2.243318456	0.674024203	1.624018703	0	0.808701543	0.967072098	4.143149816	10.76327962	0.345851319	0.541092302	1.921328256	7.839516826	0.905511538	2.147459848	0	0	0.546655554	0	0.221265343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8516	None	34.19800302	20.5891	0.139892173	3.47659461	0.926161309	0.818391617	1.631311767	0.074579471	1.503266878	2.243318456	0.674024203	1.624018703	0	0.808701543	0.967072098	4.143149816	10.76327962	0.345851319	0.541092302	1.921328256	7.839516826	0.905511538	2.147459848	0	0	0.546655554	0	0.221265343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8516	2000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	20.5891	0.139892173	3.47659461	0.926161309	0.818391617	1.631311767	0.074579471	1.503266878	2.243318456	0.674024203	1.624018703	0	0.808701543	0.967072098	4.143149816	10.76327962	0.345851319	0.541092302	1.921328256	7.839516826	0.905511538	2.147459848	0	0	0.546655554	0	0.221265343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8516
H3954_073_0	2008	7																					2000											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1492.602249	28.25803864	1196.015487	1287.206734	220.2174842	54803.71301	56.59028846	509.2793337	484.1931728	3533.166133	1387.980633	0	1573.609355	1247.399581	5237.530933	8061.70067	168.4194406	526.9921363	3510.214096	10160.05503	1897.199593	5246.590724	0	0	345.5252041	0	139.8554398	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												153.3657455	50	32.37619788	10	50	0.385561185	17.07040056	50	64.85447373	2.670417126	18.3908781	0	7.193810847	11.77745024	10	15.88969925	20	10	6.137144799	8.011938959	5.781261652	4.580503471	0	0	20	0	20	0	0	0	0											19.0762	0.117741828	3.226869507	1.072672279	0.917572851	1.760848711	0.080501574	2.121997224	2.616841117	0.786252279	2.127181885	0	0.943354004	1.224265542	4.364609111	10.67483325	0.280699068	0.439160114	1.795224349	6.78347839	0.914017271	2.002668918	0	0	0.57587534	0	0.2330924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1359	None	31.10245794	19.0762	0.117741828	3.226869507	1.072672279	0.917572851	1.760848711	0.080501574	2.121997224	2.616841117	0.786252279	2.127181885	0	0.943354004	1.224265542	4.364609111	10.67483325	0.280699068	0.439160114	1.795224349	6.78347839	0.914017271	2.002668918	0	0	0.57587534	0	0.2330924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1359	2000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	19.0762	0.117741828	3.226869507	1.072672279	0.917572851	1.760848711	0.080501574	2.121997224	2.616841117	0.786252279	2.127181885	0	0.943354004	1.224265542	4.364609111	10.67483325	0.280699068	0.439160114	1.795224349	6.78347839	0.914017271	2.002668918	0	0	0.57587534	0	0.2330924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1359
H3954_074_0	2008	3																					2000											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1492.602249	28.25803864	1196.015487	1287.206734	220.2174842	54803.71301	56.59028846	509.2793337	484.1931728	3533.166133	1387.980633	0	1573.609355	1247.399581	5237.530933	8061.70067	168.4194406	526.9921363	3510.214096	10160.05503	1897.199593	5246.590724	0	0	345.5252041	0	139.8554398	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												153.3657455	50	32.37619788	10	50	0.385561185	17.07040056	50	64.85447373	2.670417126	18.3908781	0	7.193810847	11.77745024	10	15.88969925	20	10	6.137144799	8.011938959	5.781261652	4.580503471	0	0	20	0	20	0	0	0	0											19.0762	0.117741828	3.226869507	1.072672279	0.917572851	1.760848711	0.080501574	2.121997224	2.616841117	0.786252279	2.127181885	0	0.943354004	1.224265542	4.364609111	10.67483325	0.280699068	0.439160114	1.795224349	6.78347839	0.914017271	2.002668918	0	0	0.57587534	0	0.2330924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1359	None	31.10245794	19.0762	0.117741828	3.226869507	1.072672279	0.917572851	1.760848711	0.080501574	2.121997224	2.616841117	0.786252279	2.127181885	0	0.943354004	1.224265542	4.364609111	10.67483325	0.280699068	0.439160114	1.795224349	6.78347839	0.914017271	2.002668918	0	0	0.57587534	0	0.2330924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1359	2000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	19.0762	0.117741828	3.226869507	1.072672279	0.917572851	1.760848711	0.080501574	2.121997224	2.616841117	0.786252279	2.127181885	0	0.943354004	1.224265542	4.364609111	10.67483325	0.280699068	0.439160114	1.795224349	6.78347839	0.914017271	2.002668918	0	0	0.57587534	0	0.2330924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1359
H3954_075_0	2008	4																					2000											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1492.602249	28.25803864	1196.015487	1287.206734	220.2174842	54803.71301	56.59028846	509.2793337	484.1931728	3533.166133	1387.980633	0	1573.609355	1247.399581	5237.530933	8061.70067	168.4194406	526.9921363	3510.214096	10160.05503	1897.199593	5246.590724	0	0	345.5252041	0	139.8554398	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												153.3657455	50	32.37619788	10	50	0.385561185	17.07040056	50	64.85447373	2.670417126	18.3908781	0	7.193810847	11.77745024	10	15.88969925	20	10	6.137144799	8.011938959	5.781261652	4.580503471	0	0	20	0	20	0	0	0	0											19.0762	0.117741828	3.226869507	1.072672279	0.917572851	1.760848711	0.080501574	2.121997224	2.616841117	0.786252279	2.127181885	0	0.943354004	1.224265542	4.364609111	10.67483325	0.280699068	0.439160114	1.795224349	6.78347839	0.914017271	2.002668918	0	0	0.57587534	0	0.2330924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1359	None	31.10245794	19.0762	0.117741828	3.226869507	1.072672279	0.917572851	1.760848711	0.080501574	2.121997224	2.616841117	0.786252279	2.127181885	0	0.943354004	1.224265542	4.364609111	10.67483325	0.280699068	0.439160114	1.795224349	6.78347839	0.914017271	2.002668918	0	0	0.57587534	0	0.2330924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1359	2000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	19.0762	0.117741828	3.226869507	1.072672279	0.917572851	1.760848711	0.080501574	2.121997224	2.616841117	0.786252279	2.127181885	0	0.943354004	1.224265542	4.364609111	10.67483325	0.280699068	0.439160114	1.795224349	6.78347839	0.914017271	2.002668918	0	0	0.57587534	0	0.2330924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1359
H3954_077_0	2008	3																					2000											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1768.669786	33.48456644	1568.518977	1500.656054	210.8790265	52479.72789	54.19054251	425.0890253	397.9404652	2903.778602	1140.72996	0	1293.291343	1025.191592	5203.218413	8666.693195	201.2274835	629.6500039	3352.071157	16069.02672	1806.580963	6268.6246	0	0	343.2615725	0	138.9392079	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												145.6857587	50	33.06297605	10	50	0.386585894	17.11576872	50	76.64575352	3.155929283	19.87090965	0	8.50172735	13.06191539	10	15.29723785	20	10	5.774167309	5.399192006	6.565618045	4.11871435	0	0	20	0	20	0	0	0	0											21.4725	0.139519027	4.321658782	1.250546712	0.878662611	1.690660212	0.077292733	1.771204272	2.541703901	0.76367666	1.888945164	0	0.916267532	1.11591382	4.336015344	11.04803893	0.335379139	0.524708337	1.612951641	7.229980053	0.988443381	2.151556175	0	0	0.572102621	0	0.231565347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8593	None	38.22789516	21.4725	0.139519027	4.321658782	1.250546712	0.878662611	1.690660212	0.077292733	1.771204272	2.541703901	0.76367666	1.888945164	0	0.916267532	1.11591382	4.336015344	11.04803893	0.335379139	0.524708337	1.612951641	7.229980053	0.988443381	2.151556175	0	0	0.572102621	0	0.231565347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8593	2000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	21.4725	0.139519027	4.321658782	1.250546712	0.878662611	1.690660212	0.077292733	1.771204272	2.541703901	0.76367666	1.888945164	0	0.916267532	1.11591382	4.336015344	11.04803893	0.335379139	0.524708337	1.612951641	7.229980053	0.988443381	2.151556175	0	0	0.572102621	0	0.231565347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8593
H3954_078_0	2008	3																					2000											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1768.669786	33.48456644	1568.518977	1500.656054	210.8790265	52479.72789	54.19054251	425.0890253	397.9404652	2903.778602	1140.72996	0	1293.291343	1025.191592	5203.218413	8666.693195	201.2274835	629.6500039	3352.071157	16069.02672	1806.580963	6268.6246	0	0	343.2615725	0	138.9392079	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												145.6857587	50	33.06297605	10	50	0.386585894	17.11576872	50	76.64575352	3.155929283	19.87090965	0	8.50172735	13.06191539	10	15.29723785	20	10	5.774167309	5.399192006	6.565618045	4.11871435	0	0	20	0	20	0	0	0	0											21.4725	0.139519027	4.321658782	1.250546712	0.878662611	1.690660212	0.077292733	1.771204272	2.541703901	0.76367666	1.888945164	0	0.916267532	1.11591382	4.336015344	11.04803893	0.335379139	0.524708337	1.612951641	7.229980053	0.988443381	2.151556175	0	0	0.572102621	0	0.231565347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8593	None	38.22789516	21.4725	0.139519027	4.321658782	1.250546712	0.878662611	1.690660212	0.077292733	1.771204272	2.541703901	0.76367666	1.888945164	0	0.916267532	1.11591382	4.336015344	11.04803893	0.335379139	0.524708337	1.612951641	7.229980053	0.988443381	2.151556175	0	0	0.572102621	0	0.231565347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8593	2000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	21.4725	0.139519027	4.321658782	1.250546712	0.878662611	1.690660212	0.077292733	1.771204272	2.541703901	0.76367666	1.888945164	0	0.916267532	1.11591382	4.336015344	11.04803893	0.335379139	0.524708337	1.612951641	7.229980053	0.988443381	2.151556175	0	0	0.572102621	0	0.231565347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8593
H3954_079_0	2008	4																					2000											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1768.669786	33.48456644	1568.518977	1500.656054	210.8790265	52479.72789	54.19054251	425.0890253	397.9404652	2903.778602	1140.72996	0	1293.291343	1025.191592	5203.218413	8666.693195	201.2274835	629.6500039	3352.071157	16069.02672	1806.580963	6268.6246	0	0	343.2615725	0	138.9392079	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												145.6857587	50	33.06297605	10	50	0.386585894	17.11576872	50	76.64575352	3.155929283	19.87090965	0	8.50172735	13.06191539	10	15.29723785	20	10	5.774167309	5.399192006	6.565618045	4.11871435	0	0	20	0	20	0	0	0	0											21.4725	0.139519027	4.321658782	1.250546712	0.878662611	1.690660212	0.077292733	1.771204272	2.541703901	0.76367666	1.888945164	0	0.916267532	1.11591382	4.336015344	11.04803893	0.335379139	0.524708337	1.612951641	7.229980053	0.988443381	2.151556175	0	0	0.572102621	0	0.231565347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8593	None	38.22789516	21.4725	0.139519027	4.321658782	1.250546712	0.878662611	1.690660212	0.077292733	1.771204272	2.541703901	0.76367666	1.888945164	0	0.916267532	1.11591382	4.336015344	11.04803893	0.335379139	0.524708337	1.612951641	7.229980053	0.988443381	2.151556175	0	0	0.572102621	0	0.231565347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8593	2000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	21.4725	0.139519027	4.321658782	1.250546712	0.878662611	1.690660212	0.077292733	1.771204272	2.541703901	0.76367666	1.888945164	0	0.916267532	1.11591382	4.336015344	11.04803893	0.335379139	0.524708337	1.612951641	7.229980053	0.988443381	2.151556175	0	0	0.572102621	0	0.231565347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8593
H3954_089_0	2008	3																					2000											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1138.744414	21.55878009	968.5259576	1286.714123	225.190301	56041.25701	57.8681758	694.345405	684.4164738	4994.199096	1961.937639	0	2224.327451	1763.223587	3890.322683	6332.547229	142.8576523	447.008131	3075.955334	10085.4099	2306.808543	4450.291668	0	0	256.6485155	0	103.881542	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												161.6706625	50	31.99631585	10	50	0.429129227	18.99933934	50	79.36512137	3.267900687	20.21224242	0	8.803366031	13.3581456	10	15.44090824	20	10	5.693554486	6.434435828	5.546594218	4.154558735	0	0	20	0	20	0	0	0	0											15.3418	0.08982825	2.582438537	1.072261769	0.938292921	2.004078439	0.091621426	2.893105854	4.526566376	1.360045555	3.304596598	0	1.631797394	1.962783117	3.241935569	8.148356726	0.238096087	0.372506776	1.459426607	5.4078269	1.066244244	1.540749843	0	0	0.427747526	0	0.173135903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8752	None	26.61831155	15.3418	0.08982825	2.582438537	1.072261769	0.938292921	2.004078439	0.091621426	2.893105854	4.526566376	1.360045555	3.304596598	0	1.631797394	1.962783117	3.241935569	8.148356726	0.238096087	0.372506776	1.459426607	5.4078269	1.066244244	1.540749843	0	0	0.427747526	0	0.173135903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8752	2000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	15.3418	0.08982825	2.582438537	1.072261769	0.938292921	2.004078439	0.091621426	2.893105854	4.526566376	1.360045555	3.304596598	0	1.631797394	1.962783117	3.241935569	8.148356726	0.238096087	0.372506776	1.459426607	5.4078269	1.066244244	1.540749843	0	0	0.427747526	0	0.173135903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8752
H3954_090_0	2008	3																					2000											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1138.744414	21.55878009	968.5259576	1286.714123	225.190301	56041.25701	57.8681758	694.345405	684.4164738	4994.199096	1961.937639	0	2224.327451	1763.223587	3890.322683	6332.547229	142.8576523	447.008131	3075.955334	10085.4099	2306.808543	4450.291668	0	0	256.6485155	0	103.881542	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												161.6706625	50	31.99631585	10	50	0.429129227	18.99933934	50	79.36512137	3.267900687	20.21224242	0	8.803366031	13.3581456	10	15.44090824	20	10	5.693554486	6.434435828	5.546594218	4.154558735	0	0	20	0	20	0	0	0	0											15.3418	0.08982825	2.582438537	1.072261769	0.938292921	2.004078439	0.091621426	2.893105854	4.526566376	1.360045555	3.304596598	0	1.631797394	1.962783117	3.241935569	8.148356726	0.238096087	0.372506776	1.459426607	5.4078269	1.066244244	1.540749843	0	0	0.427747526	0	0.173135903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8752	None	26.61831155	15.3418	0.08982825	2.582438537	1.072261769	0.938292921	2.004078439	0.091621426	2.893105854	4.526566376	1.360045555	3.304596598	0	1.631797394	1.962783117	3.241935569	8.148356726	0.238096087	0.372506776	1.459426607	5.4078269	1.066244244	1.540749843	0	0	0.427747526	0	0.173135903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8752	2000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	15.3418	0.08982825	2.582438537	1.072261769	0.938292921	2.004078439	0.091621426	2.893105854	4.526566376	1.360045555	3.304596598	0	1.631797394	1.962783117	3.241935569	8.148356726	0.238096087	0.372506776	1.459426607	5.4078269	1.066244244	1.540749843	0	0	0.427747526	0	0.173135903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8752
H3954_091_0	2008	5																					2000											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1138.744414	21.55878009	968.5259576	1286.714123	225.190301	56041.25701	57.8681758	694.345405	684.4164738	4994.199096	1961.937639	0	2224.327451	1763.223587	3890.322683	6332.547229	142.8576523	447.008131	3075.955334	10085.4099	2306.808543	4450.291668	0	0	256.6485155	0	103.881542	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												161.6706625	50	31.99631585	10	50	0.429129227	18.99933934	50	79.36512137	3.267900687	20.21224242	0	8.803366031	13.3581456	10	15.44090824	20	10	5.693554486	6.434435828	5.546594218	4.154558735	0	0	20	0	20	0	0	0	0											15.3418	0.08982825	2.582438537	1.072261769	0.938292921	2.004078439	0.091621426	2.893105854	4.526566376	1.360045555	3.304596598	0	1.631797394	1.962783117	3.241935569	8.148356726	0.238096087	0.372506776	1.459426607	5.4078269	1.066244244	1.540749843	0	0	0.427747526	0	0.173135903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8752	None	26.61831155	15.3418	0.08982825	2.582438537	1.072261769	0.938292921	2.004078439	0.091621426	2.893105854	4.526566376	1.360045555	3.304596598	0	1.631797394	1.962783117	3.241935569	8.148356726	0.238096087	0.372506776	1.459426607	5.4078269	1.066244244	1.540749843	0	0	0.427747526	0	0.173135903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8752	2000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	15.3418	0.08982825	2.582438537	1.072261769	0.938292921	2.004078439	0.091621426	2.893105854	4.526566376	1.360045555	3.304596598	0	1.631797394	1.962783117	3.241935569	8.148356726	0.238096087	0.372506776	1.459426607	5.4078269	1.066244244	1.540749843	0	0	0.427747526	0	0.173135903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8752
H3954_097_0	2008	8																					N/A											Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	340.7867961	30.41155532	93.54433129	52.83807621	14.77159914	54.20964292	3.376217908	1355.787166	21.39674915	14.87662677	30.51739738	0	37.31886262	21.86854501	23.18229685	44.59117962	7.244229025	5.138832254	22.18444376	93.65156316	22.38965045	19.86458812	0	11.39	2.393412444	3.5161875	0.436079572	0.623333333	0	0	10.01											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.080003203	0.080003203	0.207984294	0	0.234	0.234	0.234	50	0.234	0.234	0.234	0	0.234	0.234	0.228759546	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											27.264	2.433021848	19.45575174	0	3.456554198	12.68505644	0.790034991	5.649113192	5.006839302	3.481130665	7.141070987	0	8.732613853	5.117239532	5.303171709	10.43433603	1.695149592	1.202486747	5.191159839	21.91446578	5.239178206	4.648313621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.8407	135	0	27.264	2.433021848	19.45575174	0	3.456554198	12.68505644	0.790034991	5.649113192	5.006839302	3.481130665	7.141070987	0	8.732613853	5.117239532	5.303171709	10.43433603	1.695149592	1.202486747	5.191159839	21.91446578	5.239178206	4.648313621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.8407	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	27.264	2.433021848	19.45575174	0	3.456554198	12.68505644	0.790034991	5.649113192	5.006839302	3.481130665	7.141070987	0	8.732613853	5.117239532	5.303171709	10.43433603	1.695149592	1.202486747	5.191159839	21.91446578	5.239178206	4.648313621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.8407
H3954_098_0	2008	4																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											31.0152	0	5.2159	3.1674	0.8434	2.8946	0.1323	0	4.027	1.21	3.4734	0	1.4517	1.543	0	0	0	0	0	0	2.9313	0	0	0	0	0	0	0	0	0	0											57.9051	N/A	1640.413101	31.086138	1272.711171	1644.352934	222.2259945	54895.00253	56.68455396	429.3361224	408.8133886	2983.118517	1658.354449	0	1328.62793	1052.277456	4735.500475	7920.65187	183.9454184	575.5736315	5061.443871	13634.38352	8012.240172	5787.906696	0	0	350.6657437	0	150.2853187	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	50	0	0	0	0	0	50	0	0	0	0	0	0	10	15.87351551	20	10	8.447527562	8.963446484	0	6.297116369	0	0	20	0	20	0	0	0	0											0	0.129525575	0	0	0	0	0	1.78890051	0	0	0	0	0	0	3.946250395	10.47738252	0.306575697	0.479644693	3.563057217	10.18425558	0	3.037260167	0	0	0.584442906	0	0.250475531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.7478	1500	0	31.0152	0.129525575	5.215914136	3.167352398	0.843352549	2.894612405	0.132334399	1.78890051	4.027044598	1.209959967	3.473351898	0	1.45172308	1.542987997	3.946250395	10.47738252	0.306575697	0.479644693	3.563057217	10.18425558	2.931326917	3.037260167	0	0	0.584442906	0	0.250475531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.6529	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	31.0152	0.129525575	5.215914136	3.167352398	0.843352549	2.894612405	0.132334399	1.78890051	4.027044598	1.209959967	3.473351898	0	1.45172308	1.542987997	3.946250395	10.47738252	0.306575697	0.479644693	3.563057217	10.18425558	2.931326917	3.037260167	0	0	0.584442906	0	0.250475531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.6529
H3954_099_0	2008	2																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											31.0152	0	5.2159	3.1674	0.8434	2.8946	0.1323	0	4.027	1.21	3.4734	0	1.4517	1.543	0	0	0	0	0	0	2.9313	0	0	0	0	0	0	0	0	0	0											57.9051	N/A	1640.413101	31.086138	1272.711171	1644.352934	222.2259945	54895.00253	56.68455396	429.3361224	408.8133886	2983.118517	1658.354449	0	1328.62793	1052.277456	4735.500475	7920.65187	183.9454184	575.5736315	5061.443871	13634.38352	8012.240172	5787.906696	0	0	350.6657437	0	150.2853187	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	50	0	0	0	0	0	50	0	0	0	0	0	0	10	15.87351551	20	10	8.447527562	8.963446484	0	6.297116369	0	0	20	0	20	0	0	0	0											0	0.129525575	0	0	0	0	0	1.78890051	0	0	0	0	0	0	3.946250395	10.47738252	0.306575697	0.479644693	3.563057217	10.18425558	0	3.037260167	0	0	0.584442906	0	0.250475531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.7478	1500	0	31.0152	0.129525575	5.215914136	3.167352398	0.843352549	2.894612405	0.132334399	1.78890051	4.027044598	1.209959967	3.473351898	0	1.45172308	1.542987997	3.946250395	10.47738252	0.306575697	0.479644693	3.563057217	10.18425558	2.931326917	3.037260167	0	0	0.584442906	0	0.250475531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.6529	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	31.0152	0.129525575	5.215914136	3.167352398	0.843352549	2.894612405	0.132334399	1.78890051	4.027044598	1.209959967	3.473351898	0	1.45172308	1.542987997	3.946250395	10.47738252	0.306575697	0.479644693	3.563057217	10.18425558	2.931326917	3.037260167	0	0	0.584442906	0	0.250475531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.6529
H3954_100_0	2008	3																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											31.0152	0	5.2159	3.1674	0.8434	2.8946	0.1323	0	4.027	1.21	3.4734	0	1.4517	1.543	0	0	0	0	0	0	2.9313	0	0	0	0	0	0	0	0	0	0											57.9051	N/A	1640.413101	31.086138	1272.711171	1644.352934	222.2259945	54895.00253	56.68455396	429.3361224	408.8133886	2983.118517	1658.354449	0	1328.62793	1052.277456	4735.500475	7920.65187	183.9454184	575.5736315	5061.443871	13634.38352	8012.240172	5787.906696	0	0	350.6657437	0	150.2853187	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	50	0	0	0	0	0	50	0	0	0	0	0	0	10	15.87351551	20	10	8.447527562	8.963446484	0	6.297116369	0	0	20	0	20	0	0	0	0											0	0.129525575	0	0	0	0	0	1.78890051	0	0	0	0	0	0	3.946250395	10.47738252	0.306575697	0.479644693	3.563057217	10.18425558	0	3.037260167	0	0	0.584442906	0	0.250475531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.7478	1500	0	31.0152	0.129525575	5.215914136	3.167352398	0.843352549	2.894612405	0.132334399	1.78890051	4.027044598	1.209959967	3.473351898	0	1.45172308	1.542987997	3.946250395	10.47738252	0.306575697	0.479644693	3.563057217	10.18425558	2.931326917	3.037260167	0	0	0.584442906	0	0.250475531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.6529	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	31.0152	0.129525575	5.215914136	3.167352398	0.843352549	2.894612405	0.132334399	1.78890051	4.027044598	1.209959967	3.473351898	0	1.45172308	1.542987997	3.946250395	10.47738252	0.306575697	0.479644693	3.563057217	10.18425558	2.931326917	3.037260167	0	0	0.584442906	0	0.250475531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.6529
H3954_106_0	2008	7																					None											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	V	P	V	P			O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	2138.522794	245.6515333	0	0	1896.940295	288662.4865	0	821.9753504	0	0	0	0	0	0	0	6203.426357	1934.848787	0	0	0	1600.678215	0	0	0	379.6944947	0	171.7665571	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	0	0	50	0.200785426	0	50	0	0	0	0	0	0	0	10	24.25	0	0	0	6.796182396	0	0	0	10	0	10	0	0	0	0											8.9105	1.023548055	0	0	7.903917896	4.829935033	0	3.424897293	0	0	0	0	0	0	0	5.169521964	3.910006924	0	0	0	0.906541759	0	0	0	0.316412079	0	0.143138798	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.5384	0	0	8.9105	1.023548055	0	0	7.903917896	4.829935033	0	3.424897293	0	0	0	0	0	0	0	5.169521964	3.910006924	0	0	0	0.906541759	0	0	0	0.316412079	0	0.143138798	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.5384	None	PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.9105	1.023548055	0	0	7.903917896	4.829935033	0	3.424897293	0	0	0	0	0	0	0	5.169521964	3.910006924	0	0	0	0.906541759	0	0	0	0.316412079	0	0.143138798	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.5384
H3954_107_0	2008	3																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1137.115202	33.5741216	897.3158982	1111.39357	196.413988	48879.93281	0	360.7840506	335.2861686	0	833.4431242	0	0	405.0108353	4971.77978	5938.75561	207.5107917	649.3107627	963.2439744	0	1682.522053	0	0	0	327.9933322	0	132.7592059	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.297497536	0	50	50	0	27.95578675	0	0	10	10	20	20	10	15	0	3.888992463	0	0	0	20	0	20	0	0	0	0											4.738	0.139892173	1.869408121	0.926161309	0.818391617	1.211804966	0	1.503266878	1.397025703	0	1.941629854	0	0	0.337509029	4.143149816	9.897926017	0.345851319	0.541092302	1.204054968	0	0.545276299	0	0	0	0.546655554	0	0.221265343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.3283	None	0	4.738	0.139892173	1.869408121	0.926161309	0.818391617	1.211804966	0	1.503266878	1.397025703	0	1.941629854	0	0	0.337509029	4.143149816	9.897926017	0.345851319	0.541092302	1.204054968	0	0.545276299	0	0	0	0.546655554	0	0.221265343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.3283	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.738	0.139892173	1.869408121	0.926161309	0.818391617	1.211804966	0	1.503266878	1.397025703	0	1.941629854	0	0	0.337509029	4.143149816	9.897926017	0.345851319	0.541092302	1.204054968	0	0.545276299	0	0	0	0.546655554	0	0.221265343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.3283
H3954_108_0	2008	3																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1137.115202	33.5741216	897.3158982	1111.39357	196.413988	48879.93281	0	360.7840506	335.2861686	0	833.4431242	0	0	405.0108353	4971.77978	5938.75561	207.5107917	649.3107627	963.2439744	0	1682.522053	0	0	0	327.9933322	0	132.7592059	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.297497536	0	50	50	0	27.95578675	0	0	10	10	20	20	10	15	0	3.888992463	0	0	0	20	0	20	0	0	0	0											4.738	0.139892173	1.869408121	0.926161309	0.818391617	1.211804966	0	1.503266878	1.397025703	0	1.941629854	0	0	0.337509029	4.143149816	9.897926017	0.345851319	0.541092302	1.204054968	0	0.545276299	0	0	0	0.546655554	0	0.221265343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.3283	None	0	4.738	0.139892173	1.869408121	0.926161309	0.818391617	1.211804966	0	1.503266878	1.397025703	0	1.941629854	0	0	0.337509029	4.143149816	9.897926017	0.345851319	0.541092302	1.204054968	0	0.545276299	0	0	0	0.546655554	0	0.221265343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.3283	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.738	0.139892173	1.869408121	0.926161309	0.818391617	1.211804966	0	1.503266878	1.397025703	0	1.941629854	0	0	0.337509029	4.143149816	9.897926017	0.345851319	0.541092302	1.204054968	0	0.545276299	0	0	0	0.546655554	0	0.221265343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.3283
H3954_109_0	2008	4																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1137.115202	33.5741216	897.3158982	1111.39357	196.413988	48879.93281	0	360.7840506	335.2861686	0	833.4431242	0	0	405.0108353	4971.77978	5938.75561	207.5107917	649.3107627	963.2439744	0	1682.522053	0	0	0	327.9933322	0	132.7592059	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.297497536	0	50	50	0	27.95578675	0	0	10	10	20	20	10	15	0	3.888992463	0	0	0	20	0	20	0	0	0	0											4.738	0.139892173	1.869408121	0.926161309	0.818391617	1.211804966	0	1.503266878	1.397025703	0	1.941629854	0	0	0.337509029	4.143149816	9.897926017	0.345851319	0.541092302	1.204054968	0	0.545276299	0	0	0	0.546655554	0	0.221265343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.3283	None	0	4.738	0.139892173	1.869408121	0.926161309	0.818391617	1.211804966	0	1.503266878	1.397025703	0	1.941629854	0	0	0.337509029	4.143149816	9.897926017	0.345851319	0.541092302	1.204054968	0	0.545276299	0	0	0	0.546655554	0	0.221265343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.3283	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.738	0.139892173	1.869408121	0.926161309	0.818391617	1.211804966	0	1.503266878	1.397025703	0	1.941629854	0	0	0.337509029	4.143149816	9.897926017	0.345851319	0.541092302	1.204054968	0	0.545276299	0	0	0	0.546655554	0	0.221265343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.3283
H3954_110_0	2008	3																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	730.1700065	21.55878009	655.544448	1286.714123	225.190301	56041.25701	0	694.345405	687.8906691	0	1709.935577	0	0	830.9414482	3890.322683	4516.492028	142.8576523	447.008131	793.6618487	0	2317.264543	0	0	0	256.6485155	0	103.881542	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.298860388	0	50	50	0	27.95578675	0	0	10	10	20	20	10	15	0	3.30959273	0	0	0	20	0	20	0	0	0	0											3.0424	0.08982825	1.3657176	1.072261769	0.938292921	1.395709319	0	2.893105854	2.866211121	0	3.983549531	0	0	0.692451207	3.241935569	7.527486714	0.238096087	0.372506776	0.992077311	0	0.639100157	0	0	0	0.427747526	0	0.173135903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9516	None	0	3.0424	0.08982825	1.3657176	1.072261769	0.938292921	1.395709319	0	2.893105854	2.866211121	0	3.983549531	0	0	0.692451207	3.241935569	7.527486714	0.238096087	0.372506776	0.992077311	0	0.639100157	0	0	0	0.427747526	0	0.173135903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9516	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	3.0424	0.08982825	1.3657176	1.072261769	0.938292921	1.395709319	0	2.893105854	2.866211121	0	3.983549531	0	0	0.692451207	3.241935569	7.527486714	0.238096087	0.372506776	0.992077311	0	0.639100157	0	0	0	0.427747526	0	0.173135903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9516
H3954_111_0	2008	3																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	730.1700065	21.55878009	655.544448	1286.714123	225.190301	56041.25701	0	694.345405	687.8906691	0	1709.935577	0	0	830.9414482	3890.322683	4516.492028	142.8576523	447.008131	793.6618487	0	2317.264543	0	0	0	256.6485155	0	103.881542	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.298860388	0	50	50	0	27.95578675	0	0	10	10	20	20	10	15	0	3.30959273	0	0	0	20	0	20	0	0	0	0											3.0424	0.08982825	1.3657176	1.072261769	0.938292921	1.395709319	0	2.893105854	2.866211121	0	3.983549531	0	0	0.692451207	3.241935569	7.527486714	0.238096087	0.372506776	0.992077311	0	0.639100157	0	0	0	0.427747526	0	0.173135903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9516	None	0	3.0424	0.08982825	1.3657176	1.072261769	0.938292921	1.395709319	0	2.893105854	2.866211121	0	3.983549531	0	0	0.692451207	3.241935569	7.527486714	0.238096087	0.372506776	0.992077311	0	0.639100157	0	0	0	0.427747526	0	0.173135903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9516	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	3.0424	0.08982825	1.3657176	1.072261769	0.938292921	1.395709319	0	2.893105854	2.866211121	0	3.983549531	0	0	0.692451207	3.241935569	7.527486714	0.238096087	0.372506776	0.992077311	0	0.639100157	0	0	0	0.427747526	0	0.173135903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9516
H3954_112_0	2008	4																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	730.1700065	21.55878009	655.544448	1286.714123	225.190301	56041.25701	0	694.345405	687.8906691	0	1709.935577	0	0	830.9414482	3890.322683	4516.492028	142.8576523	447.008131	793.6618487	0	2317.264543	0	0	0	256.6485155	0	103.881542	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.298860388	0	50	50	0	27.95578675	0	0	10	10	20	20	10	15	0	3.30959273	0	0	0	20	0	20	0	0	0	0											3.0424	0.08982825	1.3657176	1.072261769	0.938292921	1.395709319	0	2.893105854	2.866211121	0	3.983549531	0	0	0.692451207	3.241935569	7.527486714	0.238096087	0.372506776	0.992077311	0	0.639100157	0	0	0	0.427747526	0	0.173135903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9516	None	0	3.0424	0.08982825	1.3657176	1.072261769	0.938292921	1.395709319	0	2.893105854	2.866211121	0	3.983549531	0	0	0.692451207	3.241935569	7.527486714	0.238096087	0.372506776	0.992077311	0	0.639100157	0	0	0	0.427747526	0	0.173135903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9516	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	3.0424	0.08982825	1.3657176	1.072261769	0.938292921	1.395709319	0	2.893105854	2.866211121	0	3.983549531	0	0	0.692451207	3.241935569	7.527486714	0.238096087	0.372506776	0.992077311	0	0.639100157	0	0	0	0.427747526	0	0.173135903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9516
H3954_113_0	2008	3																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1070.287222	31.60097875	1136.730996	1552.188892	232.5895068	57882.63645	0	591.1946484	580.4016687	0	1442.743022	0	0	701.0994984	4018.149227	4664.892975	147.5516073	461.6957313	819.7396473	0	2063.539825	0	0	0	265.0813617	0	107.2948369	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.298860388	0	50	50	0	27.95578675	0	0	10	10	20	20	10	15	0	3.37391356	0	0	0	20	0	20	0	0	0	0											4.4595	0.131670745	2.368189576	1.293490743	0.969122945	1.441568934	0	2.463311035	2.418340286	0	3.361084688	0	0	0.584249582	3.348457689	7.774821624	0.245919346	0.384746443	1.024674559	0	0.58018375	0	0	0	0.441802269	0	0.178824728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.47	None	0	4.4595	0.131670745	2.368189576	1.293490743	0.969122945	1.441568934	0	2.463311035	2.418340286	0	3.361084688	0	0	0.584249582	3.348457689	7.774821624	0.245919346	0.384746443	1.024674559	0	0.58018375	0	0	0	0.441802269	0	0.178824728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.47	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.4595	0.131670745	2.368189576	1.293490743	0.969122945	1.441568934	0	2.463311035	2.418340286	0	3.361084688	0	0	0.584249582	3.348457689	7.774821624	0.245919346	0.384746443	1.024674559	0	0.58018375	0	0	0	0.441802269	0	0.178824728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.47
H3954_114_0	2008	3																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1070.287222	31.60097875	1136.730996	1552.188892	232.5895068	57882.63645	0	591.1946484	580.4016687	0	1442.743022	0	0	701.0994984	4018.149227	4664.892975	147.5516073	461.6957313	819.7396473	0	2063.539825	0	0	0	265.0813617	0	107.2948369	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.298860388	0	50	50	0	27.95578675	0	0	10	10	20	20	10	15	0	3.37391356	0	0	0	20	0	20	0	0	0	0											4.4595	0.131670745	2.368189576	1.293490743	0.969122945	1.441568934	0	2.463311035	2.418340286	0	3.361084688	0	0	0.584249582	3.348457689	7.774821624	0.245919346	0.384746443	1.024674559	0	0.58018375	0	0	0	0.441802269	0	0.178824728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.47	None	0	4.4595	0.131670745	2.368189576	1.293490743	0.969122945	1.441568934	0	2.463311035	2.418340286	0	3.361084688	0	0	0.584249582	3.348457689	7.774821624	0.245919346	0.384746443	1.024674559	0	0.58018375	0	0	0	0.441802269	0	0.178824728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.47	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.4595	0.131670745	2.368189576	1.293490743	0.969122945	1.441568934	0	2.463311035	2.418340286	0	3.361084688	0	0	0.584249582	3.348457689	7.774821624	0.245919346	0.384746443	1.024674559	0	0.58018375	0	0	0	0.441802269	0	0.178824728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.47
H3954_115_0	2008	4																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1070.287222	31.60097875	1136.730996	1552.188892	232.5895068	57882.63645	0	591.1946484	580.4016687	0	1442.743022	0	0	701.0994984	4018.149227	4664.892975	147.5516073	461.6957313	819.7396473	0	2063.539825	0	0	0	265.0813617	0	107.2948369	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.298860388	0	50	50	0	27.95578675	0	0	10	10	20	20	10	15	0	3.37391356	0	0	0	20	0	20	0	0	0	0											4.4595	0.131670745	2.368189576	1.293490743	0.969122945	1.441568934	0	2.463311035	2.418340286	0	3.361084688	0	0	0.584249582	3.348457689	7.774821624	0.245919346	0.384746443	1.024674559	0	0.58018375	0	0	0	0.441802269	0	0.178824728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.47	None	0	4.4595	0.131670745	2.368189576	1.293490743	0.969122945	1.441568934	0	2.463311035	2.418340286	0	3.361084688	0	0	0.584249582	3.348457689	7.774821624	0.245919346	0.384746443	1.024674559	0	0.58018375	0	0	0	0.441802269	0	0.178824728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.47	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.4595	0.131670745	2.368189576	1.293490743	0.969122945	1.441568934	0	2.463311035	2.418340286	0	3.361084688	0	0	0.584249582	3.348457689	7.774821624	0.245919346	0.384746443	1.024674559	0	0.58018375	0	0	0	0.441802269	0	0.178824728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.47
H3954_116_0	2008	3																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	957.0658529	28.25803864	809.5201851	1287.206734	220.2174842	54803.71301	0	509.2793337	486.6510062	0	1209.700766	0	0	587.8528522	5237.530933	5920.695298	168.4194406	526.9921363	905.7098387	0	1909.526505	0	0	0	345.5252041	0	139.8554398	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.280830314	0	50	50	0	27.95578675	0	0	10	10	20	20	10	15	0	3.455350693	0	0	0	20	0	20	0	0	0	0											3.9878	0.117741828	1.686500386	1.072672279	0.917572851	1.282545328	0	2.121997224	2.027712526	0	2.818178054	0	0	0.489877377	4.364609111	9.867825497	0.280699068	0.439160114	1.132137298	0	0.549840311	0	0	0	0.57587534	0	0.2330924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.9658	None	0	3.9878	0.117741828	1.686500386	1.072672279	0.917572851	1.282545328	0	2.121997224	2.027712526	0	2.818178054	0	0	0.489877377	4.364609111	9.867825497	0.280699068	0.439160114	1.132137298	0	0.549840311	0	0	0	0.57587534	0	0.2330924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.9658	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	3.9878	0.117741828	1.686500386	1.072672279	0.917572851	1.282545328	0	2.121997224	2.027712526	0	2.818178054	0	0	0.489877377	4.364609111	9.867825497	0.280699068	0.439160114	1.132137298	0	0.549840311	0	0	0	0.57587534	0	0.2330924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.9658
H3954_117_0	2008	3																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	957.0658529	28.25803864	809.5201851	1287.206734	220.2174842	54803.71301	0	509.2793337	486.6510062	0	1209.700766	0	0	587.8528522	5237.530933	5920.695298	168.4194406	526.9921363	905.7098387	0	1909.526505	0	0	0	345.5252041	0	139.8554398	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.280830314	0	50	50	0	27.95578675	0	0	10	10	20	20	10	15	0	3.455350693	0	0	0	20	0	20	0	0	0	0											3.9878	0.117741828	1.686500386	1.072672279	0.917572851	1.282545328	0	2.121997224	2.027712526	0	2.818178054	0	0	0.489877377	4.364609111	9.867825497	0.280699068	0.439160114	1.132137298	0	0.549840311	0	0	0	0.57587534	0	0.2330924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.9658	None	0	3.9878	0.117741828	1.686500386	1.072672279	0.917572851	1.282545328	0	2.121997224	2.027712526	0	2.818178054	0	0	0.489877377	4.364609111	9.867825497	0.280699068	0.439160114	1.132137298	0	0.549840311	0	0	0	0.57587534	0	0.2330924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.9658	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	3.9878	0.117741828	1.686500386	1.072672279	0.917572851	1.282545328	0	2.121997224	2.027712526	0	2.818178054	0	0	0.489877377	4.364609111	9.867825497	0.280699068	0.439160114	1.132137298	0	0.549840311	0	0	0	0.57587534	0	0.2330924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.9658
H3954_118_0	2008	4																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	957.0658529	28.25803864	809.5201851	1287.206734	220.2174842	54803.71301	0	509.2793337	486.6510062	0	1209.700766	0	0	587.8528522	5237.530933	5920.695298	168.4194406	526.9921363	905.7098387	0	1909.526505	0	0	0	345.5252041	0	139.8554398	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.280830314	0	50	50	0	27.95578675	0	0	10	10	20	20	10	15	0	3.455350693	0	0	0	20	0	20	0	0	0	0											3.9878	0.117741828	1.686500386	1.072672279	0.917572851	1.282545328	0	2.121997224	2.027712526	0	2.818178054	0	0	0.489877377	4.364609111	9.867825497	0.280699068	0.439160114	1.132137298	0	0.549840311	0	0	0	0.57587534	0	0.2330924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.9658	None	0	3.9878	0.117741828	1.686500386	1.072672279	0.917572851	1.282545328	0	2.121997224	2.027712526	0	2.818178054	0	0	0.489877377	4.364609111	9.867825497	0.280699068	0.439160114	1.132137298	0	0.549840311	0	0	0	0.57587534	0	0.2330924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.9658	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	3.9878	0.117741828	1.686500386	1.072672279	0.917572851	1.282545328	0	2.121997224	2.027712526	0	2.818178054	0	0	0.489877377	4.364609111	9.867825497	0.280699068	0.439160114	1.132137298	0	0.549840311	0	0	0	0.57587534	0	0.2330924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.9658
H3954_119_0	2008	3																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1134.082077	33.48456644	1061.64827	1500.656054	210.8790265	52479.72789	0	425.0890253	399.9604676	0	994.2083296	0	0	483.1345228	5203.218413	6108.620791	201.2274835	629.6500039	864.9055994	0	1821.309152	0	0	0	343.2615725	0	138.9392079	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.296792798	0	50	50	0	27.95578675	0	0	10	10	20	20	10	15	0	3.919507162	0	0	0	20	0	20	0	0	0	0											4.7253	0.139519027	2.211767229	1.250546712	0.878662611	1.297967107	0	1.771204272	1.666501948	0	2.316156338	0	0	0.402612102	4.336015344	10.18103465	0.335379139	0.524708337	1.081131999	0	0.594886189	0	0	0	0.572102621	0	0.231565347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5171	None	0	4.7253	0.139519027	2.211767229	1.250546712	0.878662611	1.297967107	0	1.771204272	1.666501948	0	2.316156338	0	0	0.402612102	4.336015344	10.18103465	0.335379139	0.524708337	1.081131999	0	0.594886189	0	0	0	0.572102621	0	0.231565347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5171	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.7253	0.139519027	2.211767229	1.250546712	0.878662611	1.297967107	0	1.771204272	1.666501948	0	2.316156338	0	0	0.402612102	4.336015344	10.18103465	0.335379139	0.524708337	1.081131999	0	0.594886189	0	0	0	0.572102621	0	0.231565347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5171
H3954_120_0	2008	3																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1134.082077	33.48456644	1061.64827	1500.656054	210.8790265	52479.72789	0	425.0890253	399.9604676	0	994.2083296	0	0	483.1345228	5203.218413	6108.620791	201.2274835	629.6500039	864.9055994	0	1821.309152	0	0	0	343.2615725	0	138.9392079	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.296792798	0	50	50	0	27.95578675	0	0	10	10	20	20	10	15	0	3.919507162	0	0	0	20	0	20	0	0	0	0											4.7253	0.139519027	2.211767229	1.250546712	0.878662611	1.297967107	0	1.771204272	1.666501948	0	2.316156338	0	0	0.402612102	4.336015344	10.18103465	0.335379139	0.524708337	1.081131999	0	0.594886189	0	0	0	0.572102621	0	0.231565347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5171	None	0	4.7253	0.139519027	2.211767229	1.250546712	0.878662611	1.297967107	0	1.771204272	1.666501948	0	2.316156338	0	0	0.402612102	4.336015344	10.18103465	0.335379139	0.524708337	1.081131999	0	0.594886189	0	0	0	0.572102621	0	0.231565347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5171	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.7253	0.139519027	2.211767229	1.250546712	0.878662611	1.297967107	0	1.771204272	1.666501948	0	2.316156338	0	0	0.402612102	4.336015344	10.18103465	0.335379139	0.524708337	1.081131999	0	0.594886189	0	0	0	0.572102621	0	0.231565347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5171
H3954_121_0	2008	4																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	1134.082077	33.48456644	1061.64827	1500.656054	210.8790265	52479.72789	0	425.0890253	399.9604676	0	994.2083296	0	0	483.1345228	5203.218413	6108.620791	201.2274835	629.6500039	864.9055994	0	1821.309152	0	0	0	343.2615725	0	138.9392079	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	25	10	50	0.296792798	0	50	50	0	27.95578675	0	0	10	10	20	20	10	15	0	3.919507162	0	0	0	20	0	20	0	0	0	0											4.7253	0.139519027	2.211767229	1.250546712	0.878662611	1.297967107	0	1.771204272	1.666501948	0	2.316156338	0	0	0.402612102	4.336015344	10.18103465	0.335379139	0.524708337	1.081131999	0	0.594886189	0	0	0	0.572102621	0	0.231565347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5171	None	0	4.7253	0.139519027	2.211767229	1.250546712	0.878662611	1.297967107	0	1.771204272	1.666501948	0	2.316156338	0	0	0.402612102	4.336015344	10.18103465	0.335379139	0.524708337	1.081131999	0	0.594886189	0	0	0	0.572102621	0	0.231565347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5171	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.7253	0.139519027	2.211767229	1.250546712	0.878662611	1.297967107	0	1.771204272	1.666501948	0	2.316156338	0	0	0.402612102	4.336015344	10.18103465	0.335379139	0.524708337	1.081131999	0	0.594886189	0	0	0	0.572102621	0	0.231565347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5171
H3954_801_0	2008	3																					None											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	244.1241938	2.408182118	35.11809414	10.89856054	12.52348457	11.1743568	6.805110325	15.28500851	44.93967586	52.65084043	48.0814799	2.426870462	1.006058763	24.04181045	38.17655155	129.6971805	1.989672334	0.003321836	25.01920084	6.714277075	13.03112764	1.385660484	0	0	0	0	0	0	0	0	0											Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits																				0.080459552	0.080459552	0.207867316	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											19.6421	0.193761253	7.299903961	0	2.930495389	2.614799492	1.592395816	3.576691992	10.51588415	12.32029666	11.2510663	0.567887688	0.235417751	5.625783645	8.933313063	30.34914023	0.465583326	0.00077731	5.854492996	1.571140835	3.049283869	0.324244553	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.9145	None	0	19.6421	0.193761253	7.299903961	0	2.930495389	2.614799492	1.592395816	3.576691992	10.51588415	12.32029666	11.2510663	0.567887688	0.235417751	5.625783645	8.933313063	30.34914023	0.465583326	0.00077731	5.854492996	1.571140835	3.049283869	0.324244553	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.9145	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	19.6421	0.193761253	7.299903961	0	2.930495389	2.614799492	1.592395816	3.576691992	10.51588415	12.32029666	11.2510663	0.567887688	0.235417751	5.625783645	8.933313063	30.34914023	0.465583326	0.00077731	5.854492996	1.571140835	3.049283869	0.324244553	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.9145
H3954_802_0	2008	3																					None											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	244.1241938	2.408182118	35.11809414	10.89856054	12.52348457	11.1743568	6.805110325	15.28500851	44.93967586	52.65084043	48.0814799	2.426870462	1.006058763	24.04181045	38.17655155	129.6971805	1.989672334	0.003321836	25.01920084	6.714277075	13.03112764	1.385660484	0	0	0	0	0	0	0	0	0											Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits	Medicare FFS Benefits																				0.080459552	0.080459552	0.207867316	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											19.6421	0.193761253	7.299903961	0	2.930495389	2.614799492	1.592395816	3.576691992	10.51588415	12.32029666	11.2510663	0.567887688	0.235417751	5.625783645	8.933313063	30.34914023	0.465583326	0.00077731	5.854492996	1.571140835	3.049283869	0.324244553	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.9145	None	0	19.6421	0.193761253	7.299903961	0	2.930495389	2.614799492	1.592395816	3.576691992	10.51588415	12.32029666	11.2510663	0.567887688	0.235417751	5.625783645	8.933313063	30.34914023	0.465583326	0.00077731	5.854492996	1.571140835	3.049283869	0.324244553	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.9145	None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	19.6421	0.193761253	7.299903961	0	2.930495389	2.614799492	1.592395816	3.576691992	10.51588415	12.32029666	11.2510663	0.567887688	0.235417751	5.625783645	8.933313063	30.34914023	0.465583326	0.00077731	5.854492996	1.571140835	3.049283869	0.324244553	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.9145
H3957_003_0	2008	4																																A		D		T	Coin		V	V					V	V	V					S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		426.8292683	0	1100	0	504.4594085	14.8100042	0	215.4943324	425	0	0	0	0	1037.524161	3847.324489	5444.143485	0	0	0	0	1988.217782	0	0	0	503.0601267	0	0.521127471	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												123	0	35	0	50	0.135	0	50	100	0	0	0	0	25	10	25	0	0	0	0	25	0	0	0	25	0	25	0	0	0	0											4.375	0	3.208333333	0	2.101914202	1.999350567	0	0.897893052	3.541666667	0	0	0	0	2.161508668	3.206103741	11.34196559	0	0	0	0	4.142120379	0	0	0	1.048041931	0	0.001085682	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.025	0	0	4.375	0	3.208333333	0	2.101914202	1.999350567	0	0.897893052	3.541666667	0	0	0	0	2.161508668	3.206103741	11.34196559	0	0	0	0	4.142120379	0	0	0	1.048041931	0	0.001085682	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.025																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.375	0	3.208333333	0	2.101914202	1.999350567	0	0.897893052	3.541666667	0	0	0	0	2.161508668	3.206103741	11.34196559	0	0	0	0	4.142120379	0	0	0	1.048041931	0	0.001085682	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.025
H3957_006_0	2008	5																																A		D		T	Coin		V	V					V	V	V					S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		426.8292683	0	1100	0	364.652719	12.86939305	0	239.5992967	425	0	0	0	0	1487.398456	3802.598867	5545.612977	0	0	0	0	1771.80908	0	0	0	506.8617976	0	3.88855061	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												123	0	35	0	50	0.135	0	50	100	0	0	0	0	25	10	25	0	0	0	0	25	0	0	0	25	0	25	0	0	0	0											4.375	0	3.208333333	0	1.519386329	1.737368061	0	0.998330403	3.541666667	0	0	0	0	3.098746783	3.168832389	11.55336037	0	0	0	0	3.691268917	0	0	0	1.055962078	0	0.008101147	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9564	0	0	4.375	0	3.208333333	0	1.519386329	1.737368061	0	0.998330403	3.541666667	0	0	0	0	3.098746783	3.168832389	11.55336037	0	0	0	0	3.691268917	0	0	0	1.055962078	0	0.008101147	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9564																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.375	0	3.208333333	0	1.519386329	1.737368061	0	0.998330403	3.541666667	0	0	0	0	3.098746783	3.168832389	11.55336037	0	0	0	0	3.691268917	0	0	0	1.055962078	0	0.008101147	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9564
H3957_016_0	2008	5																																A		D		T	Coin		V	V					V	V	V					S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		426.8292683	0	1100	0	319.0736089	13.27874873	0	209.5976113	425	0	0	0	0	981.3253525	3616.818691	5134.256079	0	0	0	0	2004.761656	0	0	0	502.74382	0	3.024679216	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												123	0	35	0	50	0.135	0	50	100	0	0	0	0	25	10	25	0	0	0	0	25	0	0	0	25	0	25	0	0	0	0											4.375	0	3.208333333	0	1.329473371	1.792631078	0	0.87332338	3.541666667	0	0	0	0	2.044427818	3.014015576	10.69636683	0	0	0	0	4.176586784	0	0	0	1.047382958	0	0.006301415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1055	0	0	4.375	0	3.208333333	0	1.329473371	1.792631078	0	0.87332338	3.541666667	0	0	0	0	2.044427818	3.014015576	10.69636683	0	0	0	0	4.176586784	0	0	0	1.047382958	0	0.006301415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1055																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.375	0	3.208333333	0	1.329473371	1.792631078	0	0.87332338	3.541666667	0	0	0	0	2.044427818	3.014015576	10.69636683	0	0	0	0	4.176586784	0	0	0	1.047382958	0	0.006301415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1055
H3957_020_0	2008	6																																A		D		T	Coin		V						V	V	V					S			Coin	V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		426.8292683	0	1100	0	507.2130077	14.89084483	0	216.6706114	0	0	0	0	0	1043.187502	3868.325167	5496.46166	0	0	0	0	1988.217782	0	0	8.383333333	505.8060878	0	0.523972053	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												82	0	25	0	25	0.135	0	50	0	0	0	0	0	20	10	20	0	0	0	0	25	0	0	0.4	20	0	20	0	0	0	0											2.9167	0	2.291666667	0	1.056693766	2.010264051	0	0.902794214	0	0	0	0	0	1.738645836	3.223604306	9.160769433	0	0	0	0	4.142120379	0	0	3.353333333	0.843010146	0	0.000873287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6404	0	0	2.9167	0	2.291666667	0	1.056693766	2.010264051	0	0.902794214	0	0	0	0	0	1.738645836	3.223604306	9.160769433	0	0	0	0	4.142120379	0	0	3.353333333	0.843010146	0	0.000873287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6404																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.9167	0	2.291666667	0	1.056693766	2.010264051	0	0.902794214	0	0	0	0	0	1.738645836	3.223604306	9.160769433	0	0	0	0	4.142120379	0	0	3.353333333	0.843010146	0	0.000873287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6404
H3957_021_0	2008	5																																A		D		T	Coin		V						V	V	V					S			Coin	V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		426.8292683	0	1100	0	366.9528226	12.95056874	0	241.1106064	0	0	0	0	0	1496.780452	3826.584349	5608.706514	0	0	0	0	1771.80908	0	0	8.383333333	510.058907	0	3.913078246	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												82	0	25	0	25	0.135	0	50	0	0	0	0	0	20	10	20	0	0	0	0	25	0	0	0.4	20	0	20	0	0	0	0											2.9167	0	2.291666667	0	0.764485047	1.74832678	0	1.004627527	0	0	0	0	0	2.494634087	3.188820291	9.34784419	0	0	0	0	3.691268917	0	0	3.353333333	0.850098178	0	0.006521797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6583	0	0	2.9167	0	2.291666667	0	0.764485047	1.74832678	0	1.004627527	0	0	0	0	0	2.494634087	3.188820291	9.34784419	0	0	0	0	3.691268917	0	0	3.353333333	0.850098178	0	0.006521797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6583																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.9167	0	2.291666667	0	0.764485047	1.74832678	0	1.004627527	0	0	0	0	0	2.494634087	3.188820291	9.34784419	0	0	0	0	3.691268917	0	0	3.353333333	0.850098178	0	0.006521797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6583
H3957_022_0	2008	5																																A		D		T	Coin		V						V	V	V					S			Coin	V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		426.8292683	0	1100	0	320.8715396	13.35357243	0	210.7786616	0	0	0	0	0	986.8549697	3637.198908	5187.399556	0	0	0	0	2004.761656	0	0	8.383333333	505.576704	0	3.041722818	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												82	0	25	0	25	0.135	0	50	0	0	0	0	0	20	10	20	0	0	0	0	25	0	0	0.4	20	0	20	0	0	0	0											2.9167	0	2.291666667	0	0.668482374	1.802732278	0	0.878244423	0	0	0	0	0	1.644758283	3.03099909	8.645665927	0	0	0	0	4.176586784	0	0	3.353333333	0.84262784	0	0.005069538	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2568	0	0	2.9167	0	2.291666667	0	0.668482374	1.802732278	0	0.878244423	0	0	0	0	0	1.644758283	3.03099909	8.645665927	0	0	0	0	4.176586784	0	0	3.353333333	0.84262784	0	0.005069538	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2568																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.9167	0	2.291666667	0	0.668482374	1.802732278	0	0.878244423	0	0	0	0	0	1.644758283	3.03099909	8.645665927	0	0	0	0	4.176586784	0	0	3.353333333	0.84262784	0	0.005069538	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2568
H3957_024_0	2008	5																																A		D		T	Coin		V	V					V		V					S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		426.8292683	0	1100	0	499.454814	14.66307847	0	213.3564761	425	0	0	0	0	11427.23119	0	5390.133728	0	0	0	0	1988.217782	0	0	0	498.0694141	0	0.515957517	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												164	0	45	0	50	0.135	0	50	125	0	0	0	0	18	0	30	0	0	0	0	25	0	0	0	30	0	30	0	0	0	0											5.8333	0	4.125	0	2.081061725	1.979515594	0	0.888985317	4.427083333	0	0	0	0	17.14084678	0	13.47533432	0	0	0	0	4.142120379	0	0	0	1.245173535	0	0.001289894	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3397	0	0	5.8333	0	4.125	0	2.081061725	1.979515594	0	0.888985317	4.427083333	0	0	0	0	17.14084678	0	13.47533432	0	0	0	0	4.142120379	0	0	0	1.245173535	0	0.001289894	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3397																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.8333	0	4.125	0	2.081061725	1.979515594	0	0.888985317	4.427083333	0	0	0	0	17.14084678	0	13.47533432	0	0	0	0	4.142120379	0	0	0	1.245173535	0	0.001289894	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3397
H3957_025_0	2008	5																																A		D		T	Coin		V	V					V		V					S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		426.8292683	0	1100	0	360.4779034	12.72205466	0	236.8561857	425	0	0	0	0	11870.36961	0	5482.122675	0	0	0	0	1771.80908	0	0	0	501.0588667	0	3.84403159	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												164	0	45	0	50	0.135	0	50	125	0	0	0	0	18	0	30	0	0	0	0	25	0	0	0	30	0	30	0	0	0	0											5.8333	0	4.125	0	1.501991264	1.717477379	0	0.986900774	4.427083333	0	0	0	0	17.80555442	0	13.70530669	0	0	0	0	3.691268917	0	0	0	1.252647167	0	0.009610079	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.0562	0	0	5.8333	0	4.125	0	1.501991264	1.717477379	0	0.986900774	4.427083333	0	0	0	0	17.80555442	0	13.70530669	0	0	0	0	3.691268917	0	0	0	1.252647167	0	0.009610079	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.0562																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.8333	0	4.125	0	1.501991264	1.717477379	0	0.986900774	4.427083333	0	0	0	0	17.80555442	0	13.70530669	0	0	0	0	3.691268917	0	0	0	1.252647167	0	0.009610079	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.0562
H3957_026_0	2008	5																																A		D		T	Coin		V	V					V		V					S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		426.8292683	0	1100	0	315.5912106	13.13382326	0	207.310044	425	0	0	0	0	11370.61508	0	5078.220342	0	0	0	0	2004.761656	0	0	0	497.2568284	0	2.991667593	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												164	0	45	0	50	0.135	0	50	125	0	0	0	0	18	0	30	0	0	0	0	25	0	0	0	30	0	30	0	0	0	0											5.8333	0	4.125	0	1.314963378	1.77306614	0	0.86379185	4.427083333	0	0	0	0	17.05592262	0	12.69555086	0	0	0	0	4.176586784	0	0	0	1.243142071	0	0.007479169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5159	0	0	5.8333	0	4.125	0	1.314963378	1.77306614	0	0.86379185	4.427083333	0	0	0	0	17.05592262	0	12.69555086	0	0	0	0	4.176586784	0	0	0	1.243142071	0	0.007479169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5159																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.8333	0	4.125	0	1.314963378	1.77306614	0	0.86379185	4.427083333	0	0	0	0	17.05592262	0	12.69555086	0	0	0	0	4.176586784	0	0	0	1.243142071	0	0.007479169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5159
H3957_030_0	2008	7																																Coin		Coin		Coin	Coin		Coin	Coin					Coin	Coin	Coin					Coin																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		467.8571118	0	90.96218379	0	21.27622384	43.46212461	0	6.873044439	49.87616195	0	0	0	0	109.9191881	70.37330513	280.7763869	0	0	0	0	95.97740209	0	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												0.080989894	0	0.197493634	0	0.234	0.234	0	0.234	0.234	0	0	0	0	0.234	0.234	0.234	0	0	0	0	0.234	0	0	0	0	0	0	0	0	0	0											37.8917	0	17.96445223	0	4.978636379	10.17013716	0	1.608292399	11.6710219	0	0	0	0	25.72109001	16.4673534	65.70167453	0	0	0	0	22.45871209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	214.6331	0	0	37.8917	0	17.96445223	0	4.978636379	10.17013716	0	1.608292399	11.6710219	0	0	0	0	25.72109001	16.4673534	65.70167453	0	0	0	0	22.45871209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	214.6331																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	37.8917	0	17.96445223	0	4.978636379	10.17013716	0	1.608292399	11.6710219	0	0	0	0	25.72109001	16.4673534	65.70167453	0	0	0	0	22.45871209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	214.6331
H3957_031_0	2008	8																																A		D		T	Coin		V	V					V	V	V					S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		426.8292683	0	1100	0	497.7625534	14.6133968	0	212.6335783	425	0	0	0	0	11423.75071	3796.250063	5371.870792	0	0	0	0	1988.217782	0	0	0	496.3818475	0	0.514209342	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												205	0	50	0	50	0.135	0	50	100	0	0	0	0	18	15	30	0	0	0	0	25	0	0	0	30	0	30	0	0	0	0											7.2917	0	4.583333333	0	2.074010639	1.972808568	0	0.885973243	3.541666667	0	0	0	0	17.13562606	4.745312579	13.42967698	0	0	0	0	4.142120379	0	0	0	1.240954619	0	0.001285523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0444	0	0	7.2917	0	4.583333333	0	2.074010639	1.972808568	0	0.885973243	3.541666667	0	0	0	0	17.13562606	4.745312579	13.42967698	0	0	0	0	4.142120379	0	0	0	1.240954619	0	0.001285523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0444																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.2917	0	4.583333333	0	2.074010639	1.972808568	0	0.885973243	3.541666667	0	0	0	0	17.13562606	4.745312579	13.42967698	0	0	0	0	4.142120379	0	0	0	1.240954619	0	0.001285523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0444
H3957_032_0	2008	9																																A		D		T	Coin		V	V					V	V	V					S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		426.8292683	0	1100	0	359.0642442	12.67216353	0	235.9273245	425	0	0	0	0	11864.60337	3744.322248	5460.623845	0	0	0	0	1771.80908	0	0	0	499.0939016	0	3.828956739	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												205	0	50	0	50	0.135	0	50	100	0	0	0	0	18	15	30	0	0	0	0	25	0	0	0	30	0	30	0	0	0	0											7.2917	0	4.583333333	0	1.496101018	1.710742077	0	0.983030519	3.541666667	0	0	0	0	17.79690506	4.680402809	13.65155961	0	0	0	0	3.691268917	0	0	0	1.247734754	0	0.009572392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.684	0	0	7.2917	0	4.583333333	0	1.496101018	1.710742077	0	0.983030519	3.541666667	0	0	0	0	17.79690506	4.680402809	13.65155961	0	0	0	0	3.691268917	0	0	0	1.247734754	0	0.009572392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.684																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.2917	0	4.583333333	0	1.496101018	1.710742077	0	0.983030519	3.541666667	0	0	0	0	17.79690506	4.680402809	13.65155961	0	0	0	0	3.691268917	0	0	0	1.247734754	0	0.009572392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.684
H3957_033_0	2008	8																																A		D		T	Coin		V	V					V	V	V					S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		426.8292683	0	1100	0	314.4775502	13.08747653	0	206.5784868	425	0	0	0	0	11367.18997	3564.720647	5060.300283	0	0	0	0	2004.761656	0	0	0	495.502105	0	2.981110575	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												205	0	50	0	50	0.135	0	50	100	0	0	0	0	18	15	30	0	0	0	0	25	0	0	0	30	0	30	0	0	0	0											7.2917	0	4.583333333	0	1.310323126	1.766809332	0	0.860743695	3.541666667	0	0	0	0	17.05078495	4.455900808	12.65075071	0	0	0	0	4.176586784	0	0	0	1.238755263	0	0.007452776	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.9348	0	0	7.2917	0	4.583333333	0	1.310323126	1.766809332	0	0.860743695	3.541666667	0	0	0	0	17.05078495	4.455900808	12.65075071	0	0	0	0	4.176586784	0	0	0	1.238755263	0	0.007452776	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.9348																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.2917	0	4.583333333	0	1.310323126	1.766809332	0	0.860743695	3.541666667	0	0	0	0	17.05078495	4.455900808	12.65075071	0	0	0	0	4.176586784	0	0	0	1.238755263	0	0.007452776	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.9348
H3957_805_0	2008	4																																Coin		Coin		Coin	Coin		Coin	Coin					Coin	Coin	Coin					Coin																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		286.3995859	0	42.73585871	0	10.68290058	27.18062277	0	3.908042749	33.79032685	0	0	0	0	74.31394585	46.60937551	186.437502	0	0	0	0	67.50646843	0	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												0.081016581	0	0.197695289	0	0.234	0.234	0	0.234	0.234	0	0	0	0	0.234	0.234	0.234	0	0	0	0	0.234	0	0	0	0	0	0	0	0	0	0											23.2031	0	8.44867795	0	2.499798735	6.360265729	0	0.914482003	7.906936482	0	0	0	0	17.38946333	10.90659387	43.62637548	0	0	0	0	15.79651361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.0522	0	0	23.2031	0	8.44867795	0	2.499798735	6.360265729	0	0.914482003	7.906936482	0	0	0	0	17.38946333	10.90659387	43.62637548	0	0	0	0	15.79651361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.0522																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.2031	0	8.44867795	0	2.499798735	6.360265729	0	0.914482003	7.906936482	0	0	0	0	17.38946333	10.90659387	43.62637548	0	0	0	0	15.79651361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.0522
H3957_806_0	2008	5																																Coin		Coin		Coin	Coin		Coin	Coin					Coin	Coin	Coin					Coin																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		286.3995859	0	42.73585871	0	10.68290058	27.18062277	0	3.908042749	33.79032685	0	0	0	0	74.31394585	46.60937551	186.437502	0	0	0	0	67.50646843	0	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												0.081016581	0	0.197695289	0	0.234	0.234	0	0.234	0.234	0	0	0	0	0.234	0.234	0.234	0	0	0	0	0.234	0	0	0	0	0	0	0	0	0	0											23.2031	0	8.44867795	0	2.499798735	6.360265729	0	0.914482003	7.906936482	0	0	0	0	17.38946333	10.90659387	43.62637548	0	0	0	0	15.79651361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.0522	0	0	23.2031	0	8.44867795	0	2.499798735	6.360265729	0	0.914482003	7.906936482	0	0	0	0	17.38946333	10.90659387	43.62637548	0	0	0	0	15.79651361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.0522																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.2031	0	8.44867795	0	2.499798735	6.360265729	0	0.914482003	7.906936482	0	0	0	0	17.38946333	10.90659387	43.62637548	0	0	0	0	15.79651361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.0522
H3957_808_0	2008	4																																Coin		Coin		Coin	Coin		Coin	Coin					Coin	Coin	Coin					Coin																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		286.3995859	0	42.73585871	0	10.68290058	27.18062277	0	3.908042749	33.79032685	0	0	0	0	74.31394585	46.60937551	186.437502	0	0	0	0	67.50646843	0	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	"PBP 11a, 11b, 11c"		"PBP 4a, 4b"	"PBP 9a, 9b"					"PBP 8a, 8b, 12, 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b-i, 14d-i, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 19	PBP 14a												0.081016581	0	0.197695289	0	0.234	0.234	0	0.234	0.234	0	0	0	0	0.234	0.234	0.234	0	0	0	0	0.234	0	0	0	0	0	0	0	0	0	0											23.2031	0	8.44867795	0	2.499798735	6.360265729	0	0.914482003	7.906936482	0	0	0	0	17.38946333	10.90659387	43.62637548	0	0	0	0	15.79651361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.0522	0	0	23.2031	0	8.44867795	0	2.499798735	6.360265729	0	0.914482003	7.906936482	0	0	0	0	17.38946333	10.90659387	43.62637548	0	0	0	0	15.79651361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.0522																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.2031	0	8.44867795	0	2.499798735	6.360265729	0	0.914482003	7.906936482	0	0	0	0	17.38946333	10.90659387	43.62637548	0	0	0	0	15.79651361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.0522
H3959_001_0	2008	5																					4000											D	D	D	V	T	COIN	COIN	V	V	O	O	O	O	O	P	P	P	P	P	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	1216.818744	0	297.1537448	12.01071442	7.409117255	277.115285	736.6021841	0	884.2410871	0	0	820.5025502	5732.552872	22180.74709	118.0473491	576.4657097	3606.592324	2484.199248	1392.281148	0	0	25.29965256	510.04985	0	254.9286972	0	0	0	323.0103648													2 $40 days 11-100		10a $50	11a 30% $300 OOP max	"11b 30%, $300 OOP max"	4a $50	"9a $75,9b $75"		8b $25			4b $50	7a $10	"16b $25,17a $25,18a $25,7b $25,7d $25,7f $25,7b $25"	"7e $25,7h $25,9c $25"	"7c $15,7i $15"	8b $25	7g $25	"$50/$100, 11c $20/$40, Nebulizers $10/$30"			16a $15	17a $25						"14c $10,7f $25"											0	0	21.08	0	44.36887641	0.144810943	0.26824863	50	75	0	10.12732598	0	0	0.009096924	6.771173856	4.408089909	22.35855417	13.28051726	3.799931391	0.531060342	13.31380743	0	0	15	13.81607367	0	24.82837788	0	0	0	1.707505713											0	0	2.137544928	0	1.098698148	1.739282882	1.987485555	1.154647021	4.603763651	0	0.746249811	0	0	0.000622004	3.234676011	8.147893952	0.219947337	0.637980234	1.142066949	0.109938309	1.544713591	0	0	0.031624566	0.587240525	0	0.527455502	0	0	0	0.045961837	0	0	0	0	0	0	0	0	0	0	29.6978	NA	0	0	0	2.137544928	0	1.098698148	1.739282882	1.987485555	1.154647021	4.603763651	0	0.746249811	0	0	0.000622004	3.234676011	8.147893952	0.219947337	0.637980234	1.142066949	0.109938309	1.544713591	0	0	0.031624566	0.587240525	0	0.527455502	0	0	0	0.045961837	0	0	0	0	0	0	0	0	0	0	29.6978																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	2.137544928	0	1.098698148	1.739282882	1.987485555	1.154647021	4.603763651	0	0.746249811	0	0	0.000622004	3.234676011	8.147893952	0.219947337	0.637980234	1.142066949	0.109938309	1.544713591	0	0	0.031624566	0.587240525	0	0.527455502	0	0	0	0.045961837	0	0	0	0	0	0	0	0	0	0	29.6978
H3959_002_0	2008	4																					3000											D	D	D	V	T	COIN	COIN	V	V	O	O	O	O	O	P	P	P	P	P	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	1216.818744	0	297.1537448	11.34740537	6.999938052	277.115285	736.6021841	0	884.2410871	0	0	820.5025502	5732.552872	22180.74709	118.0473491	576.4657097	3606.592324	2484.199248	1392.281148	0	0	25.29965256	510.04985	0	254.9286972	0	0	0	323.0103648													2 $40 days 21-100		10a $50	11a 20%; $200 MOOP	11b 20%; $200 MOOP	4a $50	"9a $75,9b $75"		8b $25			4b $50	7a $10	"16b $25,17a $25,18a $25,7b $25,7d $25,7f $25"	"7e $25,7h $25,9c $25"	"7c $15,7i $15"	8b $25	7g $25	"$50/$100, 11c $20/$40, Nebulizers $10/$30"			16a $15	17a $25						"14c $10,7f $25"											0	0	11.07	0	44.36887641	0.198841868	0.2	50	75	0	10.12732598	0	0	0.009096924	6.771173856	4.408089909	22.35855417	13.28051726	3.799931391	0.531060342	13.31380743	0	0	15	13.81607367	0	24.82837788	0	0	0	1.707505713											0	0	1.122515292	0	1.098698148	2.256339278	1.39998761	1.154647021	4.603763651	0	0.746249811	0	0	0.000622004	3.234676011	8.147893952	0.219947337	0.637980234	1.142066949	0.109938309	1.544713591	0	0	0.031624566	0.587240525	0	0.527455502	0	0	0	0.045961837	0	0	0	0	0	0	0	0	0	0	28.6123	NA	0	0	0	1.122515292	0	1.098698148	2.256339278	1.39998761	1.154647021	4.603763651	0	0.746249811	0	0	0.000622004	3.234676011	8.147893952	0.219947337	0.637980234	1.142066949	0.109938309	1.544713591	0	0	0.031624566	0.587240525	0	0.527455502	0	0	0	0.045961837	0	0	0	0	0	0	0	0	0	0	28.6123																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	1.122515292	0	1.098698148	2.256339278	1.39998761	1.154647021	4.603763651	0	0.746249811	0	0	0.000622004	3.234676011	8.147893952	0.219947337	0.637980234	1.142066949	0.109938309	1.544713591	0	0	0.031624566	0.587240525	0	0.527455502	0	0	0	0.045961837	0	0	0	0	0	0	0	0	0	0	28.6123
H3959_006_0	2008	5																					1500											D	D	D	V	T	COIN	COIN	V	V	O	O	O	O	O	P	P	P	P	P	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1909.224065	0	1216.818744	0	297.1537448	10.3292144	6.371840839	277.115285	736.6021841	0	0	0	0	820.5025502	5732.552872	13574.76771	118.0473491	576.4657097	0	2484.199248	1392.281148	0	0	0	510.04985	0	254.9286972	0	0	0	323.0103648													2 20% days 11-100		10a $50	11a 20%; $250 MOOP	11b 20%; $250 MOOP	4a $50	"9a $100,9b $100"					4b $50	7a $10	"16b $20,17a $20,18a $20,7b $20,7d $20,7f $20"	"7e $25,7h $25,9c $25"	"7c $15,7i $15"		7g $20	"$50/$100, Nebulizers $10/$30"				17a $20						"14c $10,7f $20"											0.522090917	0	32.55689395	0	40.69050152	0.121508174	0.18399856	45.85478021	91.70956042	0	0	0	0	0.009096924	6.209688871	5.270642503	22.35855417	12.179504	0	0.411325131	7.6921852	0	0	0	10.13652834	0	18.21599697	0	0	0	1.530417866											0.0831	0	3.301319901	0	1.007611242	1.255083977	1.172409538	1.058921707	5.629455209	0	0	0	0	0.000622004	2.966447481	5.962312305	0.219947337	0.585088868	0	0.085151132	0.892473703	0	0	0	0.430844563	0	0.386981698	0	0	0	0.041195069	0	0	0	0	0	0	0	0	0	0	25.0789	0	1.937000365	0.0831	0	3.301319901	0	1.007611242	1.255083977	1.172409538	1.058921707	5.629455209	0	0	0	0	0.000622004	2.966447481	5.962312305	0.219947337	0.585088868	0	0.085151132	0.892473703	0	0	0	0.430844563	0	0.386981698	0	0	0	0.041195069	0	0	0	0	0	0	0	0	0	0	25.0789																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.0831	0	3.301319901	0	1.007611242	1.255083977	1.172409538	1.058921707	5.629455209	0	0	0	0	0.000622004	2.966447481	5.962312305	0.219947337	0.585088868	0	0.085151132	0.892473703	0	0	0	0.430844563	0	0.386981698	0	0	0	0.041195069	0	0	0	0	0	0	0	0	0	0	25.0789
H3959_010_0	2008	4																					3000											D	D	D	V	T	COIN	COIN	V	V	O	O	O	O	O	P	P	P	P	P	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1861.493463	32.82315452	1186.398276	0	289.7249011	11.71044656	7.223889324	270.1874029	718.1871295	0	862.1350599	0	0	799.9899864	5589.23905	21626.22841	115.0961654	562.0540669	3516.427516	2422.094267	1357.474119	0	0	0	497.2986038	0	0	0	0	0	314.9351057											1a $225 per admit	1b $225 per admit	2 20% days 11-100		10a $50	11a 30%; $300 OOP max	11b 30%; $300 OOP max	4a $50	"9a $100,9b $100"		8b $25			4b $50	7a $15	"16b $30,17a $30,18a $30,7b $30,7d $30,7f $30"	"7e $25,7h $25,9c $25"	"7c $35,7i $35"	8b $25	7g $30	"$50/$100, 11c $20/$40, Nebulizers $10/$30"				17a $30						"14c $15,7f $30"											47.84218981	47.84218981	41.28	0	45.48599258	0.147322544	0.268768316	50	100	0	10.12732598	0	0	0.009096924	9.968670641	5.422841948	22.52524909	30.93386986	3.799931391	0.814972253	13.31380743	0	0	0	21.26394996	0	0	0	0	0	2.595597151											7.4215	0.130860966	4.081210068	0	1.098202059	1.72521278	1.94155257	1.125780845	5.984892746	0	0.727593566	0	0	0.000606454	4.643106935	9.772968217	0.216047483	1.448875613	1.113515275	0.164494969	1.506095751	0	0	0	0.881211052	0	0	0	0	0	0.068120389	0	0	0	0	0	0	0	0	0	0	44.0518	0	0	7.4215	0.130860966	4.081210068	0	1.098202059	1.72521278	1.94155257	1.125780845	5.984892746	0	0.727593566	0	0	0.000606454	4.643106935	9.772968217	0.216047483	1.448875613	1.113515275	0.164494969	1.506095751	0	0	0	0.881211052	0	0	0	0	0	0.068120389	0	0	0	0	0	0	0	0	0	0	44.0518																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.4215	0.130860966	4.081210068	0	1.098202059	1.72521278	1.94155257	1.125780845	5.984892746	0	0.727593566	0	0	0.000606454	4.643106935	9.772968217	0.216047483	1.448875613	1.113515275	0.164494969	1.506095751	0	0	0	0.881211052	0	0	0	0	0	0.068120389	0	0	0	0	0	0	0	0	0	0	44.0518
H3959_011_0	2008	4																					3000											D	D	D	V	T	COIN	COIN	V	V	O	O	O	O	O	P	P	P	P	P	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1861.493463	32.82315452	1186.398276	0	289.7249011	11.06372023	6.8249396	270.1874029	718.1871295	0	862.1350599	0	0	799.9899864	5589.23905	21626.22841	115.0961654	562.0540669	3516.427516	2422.094267	1357.474119	0	0	0	497.2986038	0	2.291323525	0	0	0	314.9351057											1a $110 days 1-5	1b $110 days 1-5	2 20% days 6-100		10a $50	"11a 30%, $300 OOP max"	"11b 30%, $300 OOP max"	4a $50	"9a $100,9b $100"		8b $25			4b $50	7a $15	"16b $30,17a $30,18a $30,7b $30,7d $30,7f $30"	"7e $25,7h $25,9c $25"	"7c $35,7i $35"	8b $25	7g $30	"$50/$100, 11c $20/$40, Nebulizers $10/$30"				17a $30						"14c $15,7f $30"											75.30024479	75.30024479	54.08	0	44.36887641	0.152447426	0.269828727	50	100	0	10.33069912	0	0	0.010680075	6.927652077	4.542069252	24.46288968	31.00470006	3.799931391	0.548032852	13.31380743	0	0	0	16.5792884	0	7.659574468	0	0	0	1.971200075											11.6809	0.205965964	5.346701563	0	1.071230694	1.686635676	1.841564765	1.125780845	5.984892746	0	0.742204825	0	0	0.000711996	3.226691959	8.185652258	0.234632066	1.452193147	1.113515275	0.110615602	1.506095751	0	0	0	0.687071415	0	0.001462547	0	0	0	0.051733342	0	0	0	0	0	0	0	0	0	0	46.2563	NA	0	11.6809	0.205965964	5.346701563	0	1.071230694	1.686635676	1.841564765	1.125780845	5.984892746	0	0.742204825	0	0	0.000711996	3.226691959	8.185652258	0.234632066	1.452193147	1.113515275	0.110615602	1.506095751	0	0	0	0.687071415	0	0.001462547	0	0	0	0.051733342	0	0	0	0	0	0	0	0	0	0	46.2563																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.6809	0.205965964	5.346701563	0	1.071230694	1.686635676	1.841564765	1.125780845	5.984892746	0	0.742204825	0	0	0.000711996	3.226691959	8.185652258	0.234632066	1.452193147	1.113515275	0.110615602	1.506095751	0	0	0	0.687071415	0	0.001462547	0	0	0	0.051733342	0	0	0	0	0	0	0	0	0	0	46.2563
H3959_013_0	2008	2																					NA											D	D	D	V	T	COIN	COIN	V	V	O	O	O	O	O	P	P	P	P	P	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1861.493463	32.82315452	1186.398276	0	289.7249011	11.71044656	7.223889324	270.1874029	718.1871295	0	862.1350599	0	0	799.9899864	5588.684237	20418.92061	115.0961654	562.0540669	3516.427516	2422.094267	1357.474119	0	0	0	355.2526494	0	2.291323525	0	0	0	314.9351057											1a $250	1b $250	2 $40 days 21-100		10a $50	"11a 30%, $300 OOP max"	"11b 30%, $300 OOP max"	4a $50	"9a $100,9b $100"		8b $25			4b $50	7a $15	"16b $30,17a $30,18a $30,7b $30,7d $30,7f $30"	"7e $25,7h $25,9c $25"	"7c $35,7i $35"	8b $25	7g $30	"$50/$100, 11c $20/$40, Nebulizers $10/$30"										"14c $15,7f $30"											53.15798868	53.15798868	11.07	0	44.36887641	0.147322544	0.268768316	50	100	0	10.12732598	0	0	0.009096924	6.928339815	4.559250369	24.46288968	31.00470006	3.799931391	0.548032852	13.31380743	0	0	0	23.20843205	0	7.659574468	0	0	0	1.971200075											8.2461	0.145401073	1.094452409	0	1.071230694	1.72521278	1.94155257	1.125780845	5.984892746	0	0.727593566	0	0	0.000606454	3.226691959	7.757914278	0.234632066	1.452193147	1.113515275	0.110615602	1.506095751	0	0	0	0.687071415	0	0.001462547	0	0	0	0.051733342	0	0	0	0	0	0	0	0	0	0	38.2048	NA	0	8.2461	0.145401073	1.094452409	0	1.071230694	1.72521278	1.94155257	1.125780845	5.984892746	0	0.727593566	0	0	0.000606454	3.226691959	7.757914278	0.234632066	1.452193147	1.113515275	0.110615602	1.506095751	0	0	0	0.687071415	0	0.001462547	0	0	0	0.051733342	0	0	0	0	0	0	0	0	0	0	38.2048																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.2461	0.145401073	1.094452409	0	1.071230694	1.72521278	1.94155257	1.125780845	5.984892746	0	0.727593566	0	0	0.000606454	3.226691959	7.757914278	0.234632066	1.452193147	1.113515275	0.110615602	1.506095751	0	0	0	0.687071415	0	0.001462547	0	0	0	0.051733342	0	0	0	0	0	0	0	0	0	0	38.2048
H3959_021_0	2008	5																					NA											D	D	D	V	T	COIN	COIN	V	V	O	O	O	O	O	P	P	P	P	P	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1871.039584	32.99147839	1192.482369	0	291.2106699	10.12263012	6.244404023	271.5729793	721.8701405	0	866.5562654	0	0	804.0924992	5617.897497	13293.87727	115.6864021	564.9363955	3534.460477	2434.515263	1364.435525	0	0	0	498.7434732	0	247.9137335	0	0	0	316.5501575											"1a $150, max $600/yr"	"1b $150, max $600/yr"	2 20% days 11-100		10a $50	11a 20%; $200 MOOP	11b 20%; $200 MOOP	4a $50	"9a $100,9b $100"		8b $25			4b $50	7a $15	"16b $25, 17a $25,18a $25, 7b $25, 7d $25,7f $25"	"7e $25,7h $25,9c $25"	"7c $25,7i $25"	8b $25	7g $25	"$50/$100, 11c $20/$40, Nebulizers $10/$30"				17a $25						"14c $15,7f $30"											30.68426135	30.16217043	35.5	0	44.36887641	0.10730318	0.181059345	50	100	0	10.33069912	0	0	0.504875343	6.927531619	6.170991041	24.46288968	22.14621433	3.799931391	0.480036833	13.31380743	0	0	0	13.84669464	0	24.82705123	0	0	0	1.859868946											4.7843	0.082924549	3.527760343	0	1.076724185	1.086190399	1.130607701	1.13155408	6.015584504	0	0.746011004	0	0	0.03383054	3.243180212	6.836366463	0.235835308	1.042600208	1.11922561	0.097388083	1.513819319	0	0	0	0.575495715	0	0.512913913	0	0	0	0.049061817	0	0	0	0	0	0	0	0	0	0	34.8414	0	0	4.7843	0.082924549	3.527760343	0	1.076724185	1.086190399	1.130607701	1.13155408	6.015584504	0	0.746011004	0	0	0.03383054	3.243180212	6.836366463	0.235835308	1.042600208	1.11922561	0.097388083	1.513819319	0	0	0	0.575495715	0	0.512913913	0	0	0	0.049061817	0	0	0	0	0	0	0	0	0	0	34.8414																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.7843	0.082924549	3.527760343	0	1.076724185	1.086190399	1.130607701	1.13155408	6.015584504	0	0.746011004	0	0	0.03383054	3.243180212	6.836366463	0.235835308	1.042600208	1.11922561	0.097388083	1.513819319	0	0	0	0.575495715	0	0.512913913	0	0	0	0.049061817	0	0	0	0	0	0	0	0	0	0	34.8414
H3959_022_0	2008	6																					2000											D	D	D	V	T	COIN	COIN	V	V	O	O	O	O	O	P	P	P	P	P	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1909.224065	0	1216.818744	0	297.1537448	10.92975012	6.742296702	277.115285	736.6021841	0	0	0	0	820.5025502	5732.552872	13574.76771	118.0473491	576.4657097	0	2484.199248	1392.281148	0	0	0	510.04985	0	254.9286972	0	0	0	323.0103648													2 20% days 11-100		10a $50	11a 20%; $250 MOOP	11b 20%; $250 MOOP	4a $50	"9a $100,9b $100"					4b $50	7a $10	"16b $20,17a $20,18a $20,7b $20,7d $20,7f $20"	"7e $25,7h $25,9c $25"	"7c $15,7i $15"		7g $20	"$50/$100, Nebulizers $10/$30"				17a $20						"14c $10,7f $20"											0.522090917	0	34.40259612	0	40.72028477	0.117601269	0.183190166	45.78466346	91.56932692	0	0	0	0	0.009096924	6.200193607	5.262583139	22.35855417	12.16088026	0	0.410696172	7.6921852	0	0	0	10.12102853	0	18.18814281	0	0	0	1.529671896											0.0831	0	3.488476985	0	1.008348759	1.285352488	1.235122451	1.057302505	5.620847184	0	0	0	0	0.000622004	2.961911472	5.953195307	0.219947337	0.584194206	0	0.085020927	0.892473703	0	0	0	0.430185757	0	0.386389963	0	0	0	0.04117499	0	0	0	0	0	0	0	0	0	0	25.3336	0	1.987670738	0.0831	0	3.488476985	0	1.008348759	1.285352488	1.235122451	1.057302505	5.620847184	0	0	0	0	0.000622004	2.961911472	5.953195307	0.219947337	0.584194206	0	0.085020927	0.892473703	0	0	0	0.430185757	0	0.386389963	0	0	0	0.04117499	0	0	0	0	0	0	0	0	0	0	25.3336																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.0831	0	3.488476985	0	1.008348759	1.285352488	1.235122451	1.057302505	5.620847184	0	0	0	0	0.000622004	2.961911472	5.953195307	0.219947337	0.584194206	0	0.085020927	0.892473703	0	0	0	0.430185757	0	0.386389963	0	0	0	0.04117499	0	0	0	0	0	0	0	0	0	0	25.3336
H3959_023_0	2008	7																																D	D	D	V	T	COIN	COIN	V	V	O	O	O	O	O	P	P	P	P	P	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1794.670621	31.64488743	1143.80962	0	279.3245201	11.29007156	6.96457022	260.4883679	692.4060531	0	831.1866219	0	0	771.2723972	5388.064803	19685.93372	110.9645082	541.8777671	3390.196784	2335.147293	1308.744279	0	0	0	342.4999902	0	2.209070885	0	0	0	303.6297429											1a $185 days 1-5	1b $185 days 1-5	2 $40 days 6-100		10a $50	"11a 30%, $325 OOP max"	"11b 30%, $325 OOP max"	4a $50	"9a $100,9b $100"		8b $25			4b $50	7a $20	"16b $40,17a $40,18a $40,7b $40,7d $40,7f $40"	"7e $25,7h $25,9c $25"	"7c $35,7i $35"	8b $25	7g $40	"$50/$100, 11c $20/$40, Nebulizers $10/$30"				17a $40						"14c $20,7f $40"											132.6718599	132.6718599	57.23631869	0	44.36887641	0.158085553	0.270995336	50	100	0	10.12732598	0	0	0.009096924	9.237786421	6.079000492	22.35855417	31.00470006	3.799931391	0.724839844	13.31380743	0	0	0	30.94457607	0	10.21276596	0	0	0	2.628266767											19.8419	0.349865506	5.455620993	0	1.032776259	1.784797206	1.887366044	1.085368199	5.770050442	0	0.701474822	0	0	0.000584684	4.147815989	9.97256673	0.206750497	1.400063136	1.073542932	0.14105065	1.452030775	0	0	0	0.88320975	0	0.00188006	0	0	0	0.066501664	0	0	0	0	0	0	0	0	0	0	57.2552	0	0	19.8419	0.349865506	5.455620993	0	1.032776259	1.784797206	1.887366044	1.085368199	5.770050442	0	0.701474822	0	0	0.000584684	4.147815989	9.97256673	0.206750497	1.400063136	1.073542932	0.14105065	1.452030775	0	0	0	0.88320975	0	0.00188006	0	0	0	0.066501664	0	0	0	0	0	0	0	0	0	0	57.2552																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.8419	0.349865506	5.455620993	0	1.032776259	1.784797206	1.887366044	1.085368199	5.770050442	0	0.701474822	0	0	0.000584684	4.147815989	9.97256673	0.206750497	1.400063136	1.073542932	0.14105065	1.452030775	0	0	0	0.88320975	0	0.00188006	0	0	0	0.066501664	0	0	0	0	0	0	0	0	0	0	57.2552
H3959_024_0	2008	2																					1500											D	D	D	V	T	COIN	COIN	V	V	O	O	O	O	O	P	P	P	P	P	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1909.224065	0	1216.818744	0	297.1537448	10.3292144	6.371840839	277.115285	736.6021841	0	0	0	0	820.5025502	5732.552872	13574.76771	118.0473491	576.4657097	0	2484.199248	1392.281148	0	0	0	510.04985	0	254.9286972	0	0	0	323.0103648													2 20% days 11-100		10a $50	11a 20%; $200 OOP Max	11b 20%; $200 OOP Max	4a $50	"9a $75,9b $75"					4b $50	7a $10	"16b $20,7d $20,7f $20, 17a $20, 18a $20, 7b $20"	"7e $25,7h $25,9c $25"	"7c $15,7i $15"		7g $20	"$50/$100, Nebulizers $10/$30"				17a $20						"14c $10,7f $20"											0.522090917	0	29.59794153	0	36.98771507	0.10596965	0.180783419	41.68205065	62.52307598	0	0	0	0	0.009096924	5.644614691	4.791020407	22.35855417	11.07118386	0	0.373895041	7.6921852	0	0	0	9.214116519	0	16.55836327	0	0	0	1.312583363											0.0831	0	3.001277504	0	0.915919837	1.094583237	1.15192317	0.962561112	3.837886194	0	0	0	0	0.000622004	2.696504346	5.419749094	0.219947337	0.531846488	0	0.077402482	0.892473703	0	0	0	0.391638229	0	0.351766831	0	0	0	0.035331503	0	0	0	0	0	0	0	0	0	0	21.6645	0	3.636306339	0.0831	0	3.001277504	0	0.915919837	1.094583237	1.15192317	0.962561112	3.837886194	0	0	0	0	0.000622004	2.696504346	5.419749094	0.219947337	0.531846488	0	0.077402482	0.892473703	0	0	0	0.391638229	0	0.351766831	0	0	0	0.035331503	0	0	0	0	0	0	0	0	0	0	21.6645																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.0831	0	3.001277504	0	0.915919837	1.094583237	1.15192317	0.962561112	3.837886194	0	0	0	0	0.000622004	2.696504346	5.419749094	0.219947337	0.531846488	0	0.077402482	0.892473703	0	0	0	0.391638229	0	0.351766831	0	0	0	0.035331503	0	0	0	0	0	0	0	0	0	0	21.6645
H3959_025_0	2008	2																					1500											D	D	D	V	T	COIN	COIN	V	V	O	O	O	O	O	P	P	P	P	P	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1909.224065	0	1216.818744	0	297.1537448	10.92975012	6.742296702	277.115285	736.6021841	0	0	0	0	820.5025502	5732.552872	13574.76771	118.0473491	576.4657097	0	2484.199248	1392.281148	0	0	0	510.04985	0	254.9286972	0	0	0	323.0103648													2 20% days 11-100		10a $50	11a 20%; $200 OOP Max	11b 20%; $200 OOP Max	4a $50	"9a $75,9b $75"					4b $50	7a $10	"16b $20,7d $20,7f $20, 17a $20, 18a $20, 7b $20"	"7e $25,7h $25,9c $25"	"7c $15,7i $15"		7g $20	"$50/$100, Nebulizers $10/$30"				17a $20						"14c $10,7f $20"											0.522090917	0	31.23881091	0	36.89330387	0.102379378	0.18004054	41.57565715	62.36348572	0	0	0	0	0.009096924	5.630206803	4.77879132	22.35855417	11.04292465	0	0.372940673	7.6921852	0	0	0	9.190597472	0	16.51609802	0	0	0	1.309232991											0.0831	0	3.167664223	0	0.91358195	1.118981021	1.213886741	0.960104173	3.828089983	0	0	0	0	0.000622004	2.689621515	5.405915176	0.219947337	0.530488949	0	0.077204912	0.892473703	0	0	0	0.390638572	0	0.350868946	0	0	0	0.035241319	0	0	0	0	0	0	0	0	0	0	21.8784	0	3.718084414	0.0831	0	3.167664223	0	0.91358195	1.118981021	1.213886741	0.960104173	3.828089983	0	0	0	0	0.000622004	2.689621515	5.405915176	0.219947337	0.530488949	0	0.077204912	0.892473703	0	0	0	0.390638572	0	0.350868946	0	0	0	0.035241319	0	0	0	0	0	0	0	0	0	0	21.8784																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.0831	0	3.167664223	0	0.91358195	1.118981021	1.213886741	0.960104173	3.828089983	0	0	0	0	0.000622004	2.689621515	5.405915176	0.219947337	0.530488949	0	0.077204912	0.892473703	0	0	0	0.390638572	0	0.350868946	0	0	0	0.035241319	0	0	0	0	0	0	0	0	0	0	21.8784
H3959_026_0	2008	5																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	358.3467916	56.48903194	38.82458357		14.13706283	16.98891483	16.54350175	756.1845892	30.74220291	10.80004904	20.08606339	3.399285053	1.092107466	32.6859322		100.8698839	18.80989933	11.3340263	25.19279241	8.553646112	12.87213411																					Medicare FFS	Medicare FFS	Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	4a:$50	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS		"Medicare FFS,$0 at E&M or Preventive"	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																					0.080549801	0.080549801	0.197135759		0.234	0.234	0.234	50	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234	0.234	0.234	0.234	0.234																					28.8648	4.550180279	7.653713763	0	3.308072701	3.97540607	3.87117941	3.150769122	7.19367548	2.527211475	4.700138834	0.795432702	0.255553147	7.648508135	0	23.60355284	4.401516443	2.652162154	5.895113424	2.00155319	3.012079381	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.0606	0	0	28.8648	4.550180279	7.653713763	0	3.308072701	3.97540607	3.87117941	3.150769122	7.19367548	2.527211475	4.700138834	0.795432702	0.255553147	7.648508135	0	23.60355284	4.401516443	2.652162154	5.895113424	2.00155319	3.012079381	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.0606																																																																																				0	0	0	28.8648	4.550180279	7.653713763	0	3.308072701	3.97540607	3.87117941	3.150769122	7.19367548	2.527211475	4.700138834	0.795432702	0.255553147	7.648508135	0	23.60355284	4.401516443	2.652162154	5.895113424	2.00155319	3.012079381	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.0606
H3959_027_0	2008	7																					1500											D	D	D	V	T	COIN	COIN	V	V	O	O	O	O	O	P	P	P	P	P	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	1289.575692	0	314.9213866	12.72886816	7.852128806	293.684772	780.6456599	0	937.1123	0	0	869.5626602	6075.318015	23506.99512	125.1057256	610.934184	3822.240424	2632.736371	1475.529477	0	0	26.81238855	540.547137	0	270.171587	0	0	0	342.3240452													2 $40 days 11-100		10a $50	11a 30% $300 OOP Max	11b 30% $300 OOP Max	4a $50	"9a $50,9b $50"		8b $25			4b $50	7a $10	"16b $25,17a $25,18a $25,7d $25,7f $25, 7b $25"	"7e $25,7h $25,9c $25"	"7c $25,7i $25"	8b $25	7g $25	"$50/$100, 11c $20/$40, Nebulizers $10/$30"			16a $15	17a $25						14c $10											0	0	20.46828087	0	44.36887641	0.298262802	0.3	48.5490533	48.5490533	0	9.833441774	0	0	0.009096924	6.574681608	4.280174783	22.35855417	21.49188467	3.689661432	0.515649537	13.31380743	0	0	15	13.41514594	0	24.10788482	0	0	0	1.688210006											0	0	2.199616456	0	1.16439234	3.796547879	2.355638642	1.188176471	3.158300646	0	0.767919936	0	0	0.000659195	3.328606802	8.384503977	0.233098595	1.094177252	1.17523109	0.113130774	1.637076276	0	0	0.033515486	0.604293227	0	0.542772125	0	0	0	0.048159573	0	0	0	0	0	0	0	0	0	0	31.8258	0	0.67467941	0	0	2.199616456	0	1.16439234	3.796547879	2.355638642	1.188176471	3.158300646	0	0.767919936	0	0	0.000659195	3.328606802	8.384503977	0.233098595	1.094177252	1.17523109	0.113130774	1.637076276	0	0	0.033515486	0.604293227	0	0.542772125	0	0	0	0.048159573	0	0	0	0	0	0	0	0	0	0	31.8258																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	2.199616456	0	1.16439234	3.796547879	2.355638642	1.188176471	3.158300646	0	0.767919936	0	0	0.000659195	3.328606802	8.384503977	0.233098595	1.094177252	1.17523109	0.113130774	1.637076276	0	0	0.033515486	0.604293227	0	0.542772125	0	0	0	0.048159573	0	0	0	0	0	0	0	0	0	0	31.8258
H3959_028_0	2008	7																					1500											D	D	D	V	T	COIN	COIN	V	V	O	O	O	O	O	P	P	P	P	P	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	1289.575692	0	314.9213866	12.02589803	7.41848365	293.684772	780.6456599	0	937.1123	0	0	869.5626602	6075.318015	23506.99512	125.1057256	610.934184	3822.240424	2632.736371	1475.529477	0	0	26.81238855	540.547137	0	270.171587	0	0	0	342.3240452													2 $40 days 11-100		10a $50	11a 20% $200 OOP Max	11b 20% $200 OOP Max	4a $50	"9a $50,9b $50"		8b $25			4b $50	7a $10	"16b $25,17a $25,18a $25,7d $25,7f $25, 7b $25"	"7e $25,7h $25,9c $25"	"7c $15,7i $15"	8b $25	7g $25	"$50/$100, 11c $20/$40, Nebulizers $10/$30"			16a $15	17a $25						14c $10											0	0	21.07763758	0	44.36887641	0.198841868	0.2	50	50	0	10.12732598	0	0	0.009096924	6.771173856	4.408089909	22.35855417	13.28051726	3.799931391	0.531060342	13.31380743	0	0	15	13.81607367	0	24.82837788	0	0	0	1.707505713											0	0	2.265100757	0	1.16439234	2.391252025	1.48369673	1.22368655	3.25269025	0	0.790870145	0	0	0.000659195	3.428086209	8.635078999	0.233098595	0.676126831	1.210354281	0.116511823	1.637076276	0	0	0.033515486	0.622353256	0	0.558993521	0	0	0	0.048710022	0	0	0	0	0	0	0	0	0	0	29.7723	0	0	0	0	2.265100757	0	1.16439234	2.391252025	1.48369673	1.22368655	3.25269025	0	0.790870145	0	0	0.000659195	3.428086209	8.635078999	0.233098595	0.676126831	1.210354281	0.116511823	1.637076276	0	0	0.033515486	0.622353256	0	0.558993521	0	0	0	0.048710022	0	0	0	0	0	0	0	0	0	0	29.7723																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	2.265100757	0	1.16439234	2.391252025	1.48369673	1.22368655	3.25269025	0	0.790870145	0	0	0.000659195	3.428086209	8.635078999	0.233098595	0.676126831	1.210354281	0.116511823	1.637076276	0	0	0.033515486	0.622353256	0	0.558993521	0	0	0	0.048710022	0	0	0	0	0	0	0	0	0	0	29.7723
H3959_029_0	2008	6																					1500											D	D	D	V	T	COIN	COIN	V	V	O	O	O	O	O	P	P	P	P	P	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	1823.311285	0	445.2625164	17.99715138	11.10200444	415.2363929	1103.742921	0	1324.968702	0	0	1229.461303	8589.798924	33236.17972	176.8850659	863.7904688	5404.207088	3722.385559	2086.228488	0	0	37.90962477	0	0	381.9914615	0	0	0	484.0067151													2 $40 days 11-100		10a $50	11a 30% $300 OOP Max	11b 30% $300 OOP Max	4a $50	"9a $50,9b $50"		8b $25			4b $50	7a $10	"16b $25,17a $0,18a $25,7d $25,7f $0, 7b $25"	"7e $25,7h $25,9c $25"	"7c $25,7i $25"	8b $25	7g $25	"$50/$100, 11c $10/$20, Nebulizers $10/$30"			16a $15	17a $0						14c $10											0	0	19.93724282	0	44.36887641	0.298262802	0.3	47.28947538	47.28947538	0	9.578318649	0	0	0.009096924	6.40375669	3.536631187	22.35855417	20.9342898	3.593935238	0.502271299	10.50299631	0	0	15	0	0	23.48241929	0	0	0	1.042570637											0	0	3.029316651	0	1.646316463	5.367880793	3.330601332	1.636359265	4.349618639	0	1.057581036	0	0	0.000932026	4.583915194	9.795342476	0.329574527	1.506903333	1.618530858	0.155803953	1.825970843	0	0	0.047387031	0	0	0.747506972	0	0	0	0.042050932	0	0	0	0	0	0	0	0	0	0	41.0716	0	1.632442737	0	0	3.029316651	0	1.646316463	5.367880793	3.330601332	1.636359265	4.349618639	0	1.057581036	0	0	0.000932026	4.583915194	9.795342476	0.329574527	1.506903333	1.618530858	0.155803953	1.825970843	0	0	0.047387031	0	0	0.747506972	0	0	0	0.042050932	0	0	0	0	0	0	0	0	0	0	41.0716																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	3.029316651	0	1.646316463	5.367880793	3.330601332	1.636359265	4.349618639	0	1.057581036	0	0	0.000932026	4.583915194	9.795342476	0.329574527	1.506903333	1.618530858	0.155803953	1.825970843	0	0	0.047387031	0	0	0.747506972	0	0	0	0.042050932	0	0	0	0	0	0	0	0	0	0	41.0716
H3959_030_0	2008	5																					1500											D	D	D	V	T	COIN	COIN	V	V	O	O	O	O	O	P	P	P	P	P	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	1823.311285	0	445.2625164	17.0032327	10.48888021	415.2363929	1103.742921	0	1324.968702	0	0	1229.461303	8589.798924	33236.17972	176.8850659	863.7904688	5404.207088	3722.385559	2086.228488	0	0	37.90962477	0	0	381.9914615	0	0	0	484.0067151													2 $40 days 11-100		10a $50	11a 20% $200 OOP Max	11b 20% $200 OOP Max	4a $50	"9a $50,9b $50"		8b $25			4b $50	7a $10	"16b $25,17a $0,18a $25,7d $25,7f $0, 7b$25"	"7e $25,7h $25,9c $25"	"7c $15,7i $15"	8b $25	7g $25	"$50/$100, 11c $10/$20, Nebulizers $10/$30"			16a $15	17a $0						14c $10											0	0	19.16563005	0	44.36887641	0.198841868	0.2	45.45927431	45.45927431	0	9.207617793	0	0	0.009096924	6.155917985	3.399760129	22.35855417	12.07445354	3.454842469	0.482832355	10.50299631	0	0	15	0	0	22.57360081	0	0	0	1.042570637											0	0	2.912075795	0	1.646316463	3.380954548	2.097776041	1.573028757	4.181279349	0	1.01665045	0	0	0.000932026	4.406508141	9.41625322	0.329574527	0.869149824	1.555890347	0.149774016	1.825970843	0	0	0.047387031	0	0	0.718576897	0	0	0	0.042050932	0	0	0	0	0	0	0	0	0	0	36.1701	0	2.676824081	0	0	2.912075795	0	1.646316463	3.380954548	2.097776041	1.573028757	4.181279349	0	1.01665045	0	0	0.000932026	4.406508141	9.41625322	0.329574527	0.869149824	1.555890347	0.149774016	1.825970843	0	0	0.047387031	0	0	0.718576897	0	0	0	0.042050932	0	0	0	0	0	0	0	0	0	0	36.1701																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	2.912075795	0	1.646316463	3.380954548	2.097776041	1.573028757	4.181279349	0	1.01665045	0	0	0.000932026	4.406508141	9.41625322	0.329574527	0.869149824	1.555890347	0.149774016	1.825970843	0	0	0.047387031	0	0	0.718576897	0	0	0	0.042050932	0	0	0	0	0	0	0	0	0	0	36.1701
H3959_803_0	2008	3																																COIN	COIN	COIN	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		302.8467556	1.7690878	46.02414737	0	9.091373221	10.86756512	9.422080212	10.75134465	43.33938878	4.731575522	16.95690214	2.227433935	0.04682212	13.35815737	37.82619158	130.710959	2.782025577	7.304135933	57.62933508	12.48035616	43.52508549	0	0	0	0	0	0	0	0	0	0											FFS 8.1%	FFS 8.1%	FFS 19.4%		FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%																					0.080547973	0.080547973	0.194079363	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											24.3937	0.142496437	8.932337192	0	2.127381334	2.543010238	2.20476677	2.515814647	10.14141697	1.107188672	3.9679151	0.521219541	0.010956376	3.125808825	8.851328829	30.5863644	0.650993985	1.709167808	13.48526441	2.920403341	10.18487	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.1224	0	0	24.3937	0.142496437	8.932337192	0	2.127381334	2.543010238	2.20476677	2.515814647	10.14141697	1.107188672	3.9679151	0.521219541	0.010956376	3.125808825	8.851328829	30.5863644	0.650993985	1.709167808	13.48526441	2.920403341	10.18487	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.1224																																											0.1048	0	0.0116	0	0.4762	0.0152	0.0128	0.0067	0.0111	0.0006	0.0517	0	0	0.0033	0.0313	0.1411	0	0.0013	0.0119	0.012	0.0037	0	0	0	0	0	0	0	0	0	0											0.8953	0	0	24.4985	0.142496437	8.943896426	0	2.603612919	2.558175745	2.217563412	2.52250429	10.15256544	1.10781885	4.019627564	0.521219541	0.010956376	3.129122965	8.882624562	30.72744559	0.650993985	1.710465711	13.4971911	2.932367918	10.18856385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.0177
H3959_804_0	2008	2																																COIN	COIN	COIN	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		302.8467556	1.7690878	46.02414737	0	9.091373221	10.86756512	9.422080212	10.75134465	43.33938878	4.731575522	16.95690214	2.227433935	0.04682212	13.35815737	37.82619158	130.710959	2.782025577	7.304135933	57.62933508	12.48035616	43.52508549	0	0	0	0	0	0	0	0	0	0											FFS 8.1%	FFS 8.1%	FFS 19.7%		FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%																					0.080439908	0.080439908	0.194397055	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											24.361	0.14230526	8.94695871	0	2.127381334	2.543010238	2.20476677	2.515814647	10.14141697	1.107188672	3.9679151	0.521219541	0.010956376	3.125808825	8.851328829	30.5863644	0.650993985	1.709167808	13.48526441	2.920403341	10.18487	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.1041	0	0	24.361	0.14230526	8.94695871	0	2.127381334	2.543010238	2.20476677	2.515814647	10.14141697	1.107188672	3.9679151	0.521219541	0.010956376	3.125808825	8.851328829	30.5863644	0.650993985	1.709167808	13.48526441	2.920403341	10.18487	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.1041																																											0.1047	0	0.0116	0	0.4762	0.0152	0.0128	0.0067	0.0111	0.0006	0.0517	0	0	0.0033	0.0313	0.1411	0	0.0013	0.0119	0.012	0.0037	0	0	0	0	0	0	0	0	0	0											0.8952	0	0	24.4657	0.14230526	8.958536866	0	2.603612919	2.558175745	2.217563412	2.52250429	10.15256544	1.10781885	4.019627564	0.521219541	0.010956376	3.129122965	8.882624562	30.72744559	0.650993985	1.710465711	13.4971911	2.932367918	10.18856385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9993
H3959_806_0	2008	2																																COIN	COIN	COIN	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		302.8467556	1.7690878	46.02414737	0	9.091373221	10.86756512	9.422080212	10.75134465	43.33938878	4.731575522	16.95690214	2.227433935	0.04682212	13.35815737	37.82619158	130.710959	2.782025577	7.304135933	57.62933508	12.48035616	43.52508549	0	0	0	0	0	0	0	0	0	0											FFS 8.1%	FFS 8.1%	FFS 19.4%		FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%																					0.080508454	0.080508454	0.193766979	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											24.3817	0.142426524	8.917960013	0	2.127381334	2.543010238	2.20476677	2.515814647	10.14141697	1.107188672	3.9679151	0.521219541	0.010956376	3.125808825	8.851328829	30.5863644	0.650993985	1.709167808	13.48526441	2.920403341	10.18487	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.096	0	0	24.3817	0.142426524	8.917960013	0	2.127381334	2.543010238	2.20476677	2.515814647	10.14141697	1.107188672	3.9679151	0.521219541	0.010956376	3.125808825	8.851328829	30.5863644	0.650993985	1.709167808	13.48526441	2.920403341	10.18487	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.096																																											0.1048	0	0.0115	0	0.4762	0.0152	0.0128	0.0067	0.0111	0.0006	0.0517	0	0	0.0033	0.0313	0.1411	0	0.0013	0.0119	0.012	0.0037	0	0	0	0	0	0	0	0	0	0											0.8953	0	0	24.4865	0.142426524	8.929500642	0	2.603612919	2.558175745	2.217563412	2.52250429	10.15256544	1.10781885	4.019627564	0.521219541	0.010956376	3.129122965	8.882624562	30.72744559	0.650993985	1.710465711	13.4971911	2.932367918	10.18856385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9913
H3959_807_0	2008	2																																COIN	COIN	COIN	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		302.8467556	1.7690878	46.02414737	0	9.091373221	10.86756512	9.422080212	10.75134465	43.33938878	4.731575522	16.95690214	2.227433935	0.04682212	13.35815737	37.82619158	130.710959	2.782025577	7.304135933	57.62933508	12.48035616	43.52508549	0	0	0	0	0	0	0	0	0	0											FFS 8.1%	FFS 8.1%	FFS 19.4%		FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%																					0.080439908	0.080439908	0.194397055	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											24.361	0.14230526	8.94695871	0	2.127381334	2.543010238	2.20476677	2.515814647	10.14141697	1.107188672	3.9679151	0.521219541	0.010956376	3.125808825	8.851328829	30.5863644	0.650993985	1.709167808	13.48526441	2.920403341	10.18487	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.1041	0	0	24.361	0.14230526	8.94695871	0	2.127381334	2.543010238	2.20476677	2.515814647	10.14141697	1.107188672	3.9679151	0.521219541	0.010956376	3.125808825	8.851328829	30.5863644	0.650993985	1.709167808	13.48526441	2.920403341	10.18487	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.1041																																											0.1047	0	0.0116	0	0.4762	0.0152	0.0128	0.0067	0.0111	0.0006	0.0517	0	0	0.0033	0.0313	0.1411	0	0.0013	0.0119	0.012	0.0037	0	0	0	0	0	0	0	0	0	0											0.8952	0	0	24.4657	0.14230526	8.958536866	0	2.603612919	2.558175745	2.217563412	2.52250429	10.15256544	1.10781885	4.019627564	0.521219541	0.010956376	3.129122965	8.882624562	30.72744559	0.650993985	1.710465711	13.4971911	2.932367918	10.18856385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9993
H3962_001_0	2008	9																					none											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	P	V	P	V	P	O	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	400.4099506	39.74328	1674.911227	1016.993123	688.8712017	19.41937653	0	316.2808515	470.7829474	880.2701403	1043.013207	0	0	2804.622725	4395.122354	5853.845273	238.8327552	2729.04384	0	26887.38859	7.509413168	2693.252505	36.25637904	1000	420	0	104.948125	0	0	1000	0											$0/admit	$0/admit	$0/day	$0 copay	$0/trip	0% coinsurance	0% coinsurance	$50 copay (WIA)	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	"Rehab: $10 copay, Psych: $10 copay"	$10 copay	$10 copay	"Psych: $10 copay, SA: $25 copay"	$10 copay	$0 copay	"Chiro: $10 copay, Pod: $10 copay"	0% Coins	$0 copay	$0/trip	$5 copay	$20 copay	$40 allowance every 2 years	$10 copay	$400 allowance every 3 years														0	0	0	0	0	0	0	41.57976988	0	0	0	0	0	5.851124422	9.808630159	8.437434962	11.20615215	0.471372729	0	0.732568308	0	0	0	4.904224135	19.61689654	0	10	0	0	0	0											0	0	0	0	0	0	0	1.095907085	0	0	0	0	0	1.367516377	3.592510806	4.115953231	0.223033016	0.107199737	0	1.641404063	0	0	0	0.408685345	0.686591379	0	0.087456771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.3263	0	0.26	0	0	0	0	0	0	0	1.095907085	0	0	0	0	0	1.367516377	3.592510806	4.115953231	0.223033016	0.107199737	0	1.641404063	0	0	0	0.408685345	0.686591379	0	0.087456771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.3263	2500	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	1.095907085	0	0	0	0	0	1.367516377	3.592510806	4.115953231	0.223033016	0.107199737	0	1.641404063	0	0	0	0.408685345	0.686591379	0	0.087456771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.3263
H3962_002_0	2008	9																					none											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	P	V	P	V	P	O	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	389.2081353	39.74328	2288.961797	736.0172765	646.3897472	16.42724691	0	293.5986033	517.8502973	3394.964116	1284.305013	0	0	2410.895147	4395.122354	4928.234631	238.8327552	2546.27954	0	25139.4767	7.509413168	2553.067007	34.02051301	1000	420	0	87.0258612	0	0	1000	0											$0/admit	$0/admit	$0/day	$0 copay	$0/trip	0% coinsurance	0% coinsurance	$50 copay (WIA)	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	"Rehab: $10 copay, Psych: $10 copay"	$10 copay	$10 copay	"Psych: $10 copay, SA: $25 copay"	$10 copay	$0 copay	"Chiro: $10 copay, Pod: $10 copay"	0% Coins	$0 copay	$0/trip	$5 copay	$20 copay	$40 allowance every 2 years	$10 copay	$400 allowance every 3 years														0	0	0	0	0	0	0	40.80960795	0	0	0	0	0	6.568146848	9.849079478	8.483813763	11.25237416	0.409567433	0	0.719183722	0	0	0	4.924452587	19.69781035	0	10	0	0	0	0											0	0	0	0	0	0	0	0.998470325	0	0	0	0	0	1.31959278	3.607325781	3.484185399	0.22395296	0.086906098	0	1.506658536	0	0	0	0.410371049	0.689423362	0	0.072521551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.3994	0	0.19	0	0	0	0	0	0	0	0.998470325	0	0	0	0	0	1.31959278	3.607325781	3.484185399	0.22395296	0.086906098	0	1.506658536	0	0	0	0.410371049	0.689423362	0	0.072521551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.3994	2500	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0.998470325	0	0	0	0	0	1.31959278	3.607325781	3.484185399	0.22395296	0.086906098	0	1.506658536	0	0	0	0.410371049	0.689423362	0	0.072521551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.3994
H3962_003_0	2008	8																					none											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	P	V	P	V	P	O	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	378.7688973	37.5952286	1531.1597	1214.013882	822.3253265	20.20079104	0	377.5535307	561.9871174	1050.803733	1245.074803	0	0	3347.958649	4386.945382	5412.321226	220.8188857	2523.206749	0	25251.48071	6.209774377	3215.012821	43.28028034	1000	420	0	97.03245272	0	0	1000	0											$0/admit	$0/admit	$0/day	$0 copay	$0/trip	0% coinsurance	0% coinsurance	$50 copay (WIA)	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	"Rehab: $10 copay, Psych: $10 copay"	$10 copay	$10 copay	"Psych: $10 copay, SA: $25 copay"	$10 copay	$0 copay	"Chiro: $10 copay, Pod: $10 copay"	0% Coins	$0 copay	$0/trip	$5 copay	$20 copay	$40 allowance every 2 years	$10 copay	$400 allowance every 3 years														0	0	0	0	0	0	0	41.58006207	0	0	0	0	0	5.851165538	9.808699086	8.437495513	11.2062309	0.471376041	0	0.721199269	0	0	0	4.904258598	19.61703439	0	10	0	0	0	0											0	0	0	0	0	0	0	1.308224937	0	0	0	0	0	1.632455023	3.585852263	3.805536338	0.206212285	0.099114934	0	1.517612452	0	0	0	0.408688217	0.686596204	0	0.080860377	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.3312	0	0.26	0	0	0	0	0	0	0	1.308224937	0	0	0	0	0	1.632455023	3.585852263	3.805536338	0.206212285	0.099114934	0	1.517612452	0	0	0	0.408688217	0.686596204	0	0.080860377	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.3312	2500	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	1.308224937	0	0	0	0	0	1.632455023	3.585852263	3.805536338	0.206212285	0.099114934	0	1.517612452	0	0	0	0.408688217	0.686596204	0	0.080860377	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.3312
H3962_004_0	2008	9																					none											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	P	V	P	V	P	O	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	354.2842945	35.16501	1481.968022	899.8395031	609.5159408	17.1823405	0	279.8465377	416.5505981	778.8664722	922.862176	0	0	2481.541186	3888.821494	5179.505254	211.3201584	2414.668691	0	23693.65387	6.64435822	2383.000378	32.07978636	1000	420	0	92.85851258	0	0	1000	0											$0/admit	$100/admit	$0 Days 1-14/ $25 Days 15-100	$0 copay	$35/trip	0% coinsurance	0% coinsurance	$50 copay (WIA)	$50 copay	$0 copay	$50 copay (High Tech Imaging Only)	$0 copay	$0 copay	"Rehab: $20 copay, Psych: $10 copay"	$10 copay	$20 copay	"Psych: $10 copay, SA: $25 copay"	$20 copay	$0 copay	"Chiro: $20 copay, Pod: $20 copay"	0% Coins	$0 copay	$35/trip	$5 copay	$20 copay	$40 allowance every 2 years	$10 copay	$400 allowance every 3 years														0	11.94200178	9.004492497	0	33.88159364	0	0	44.85243333	48.40227663	0	16.038638	0	0	11.54954321	9.68063484	8.32499324	11.05992021	0.465221666	0	1.277427773	0	0	0	4.840227663	19.36091065	0	10	0	0	0	0											0	0.034995051	1.112030828	0	1.720947618	0	0	1.045983181	1.68016644	0	1.233454364	0	0	2.38838893	3.137188404	3.593278852	0.194765341	0.093613016	0	2.522244291	0	0	0	0.403352305	0.677631873	0	0.077382094	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.9154	0	0.66	0	0.034995051	1.112030828	0	1.720947618	0	0	1.045983181	1.68016644	0	1.233454364	0	0	2.38838893	3.137188404	3.593278852	0.194765341	0.093613016	0	2.522244291	0	0	0	0.403352305	0.677631873	0	0.077382094	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.9154	3000	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0.034995051	1.112030828	0	1.720947618	0	0	1.045983181	1.68016644	0	1.233454364	0	0	2.38838893	3.137188404	3.593278852	0.194765341	0.093613016	0	2.522244291	0	0	0	0.403352305	0.677631873	0	0.077382094	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.9154
H3962_005_0	2008	9																					none											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	P	V	P	V	P	O	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	344.3728844	35.16501	2025.282374	651.2309726	571.9281832	14.53489249	0	259.7771956	458.1959738	3003.877564	1136.358112	0	0	2133.169481	3888.821494	4360.521328	211.3201584	2252.958123	0	22160.56962	6.64435822	2258.9637	30.10148332	1000	420	0	77.00082327	0	0	1000	0											$0/admit	$100/admit	$0 Days 1-14/ $25 Days 15-100	$0 copay	$35/trip	0% coinsurance	0% coinsurance	$50 copay (WIA)	$50 copay	$0 copay	$50 copay (High Tech Imaging Only)	$0 copay	$0 copay	"Rehab: $20 copay, Psych: $10 copay"	$10 copay	$20 copay	"Psych: $10 copay, SA: $25 copay"	$20 copay	$0 copay	"Chiro: $20 copay, Pod: $20 copay"	0% Coins	$0 copay	$35/trip	$5 copay	$20 copay	$40 allowance every 2 years	$10 copay	$400 allowance every 3 years														0	11.19117491	9.01348451	0	33.91542828	0	0	43.88460327	48.45061182	0	16.05465441	0	0	12.92451202	9.690293859	8.344191884	11.0709648	0.402964438	0	1.217963708	0	0	0	4.845061182	19.38024473	0	10	0	0	0	0											0	0.032794815	1.521237609	0	1.61643244	0	0	0.950018264	1.849989606	0	1.520319732	0	0	2.297514551	3.140318587	3.032085556	0.194959836	0.075655167	0	2.249230794	0	0	0	0.403755099	0.678308566	0	0.064167353	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.6268	0	0.63	0	0.032794815	1.521237609	0	1.61643244	0	0	0.950018264	1.849989606	0	1.520319732	0	0	2.297514551	3.140318587	3.032085556	0.194959836	0.075655167	0	2.249230794	0	0	0	0.403755099	0.678308566	0	0.064167353	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.6268	3000	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0.032794815	1.521237609	0	1.61643244	0	0	0.950018264	1.849989606	0	1.520319732	0	0	2.297514551	3.140318587	3.032085556	0.194959836	0.075655167	0	2.249230794	0	0	0	0.403755099	0.678308566	0	0.064167353	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.6268
H3962_006_0	2008	8																					none											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	P	V	P	V	P	O	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	335.7608771	33.32640832	1357.301319	1076.166413	728.952865	17.90705458	0	334.6835116	498.175243	931.4882653	1103.700465	0	0	2967.808446	3888.821494	4797.769128	195.7455939	2236.704537	0	22294.94706	5.504673975	2849.9582	38.36594026	1000	420	0	86.01472207	0	0	1000	0											$0/admit	$100/admit	$0 Days 1-14/ $25 Days 15-100	$0 copay	$35/trip	0% coinsurance	0% coinsurance	$50 copay (WIA)	$50 copay	$0 copay	$50 copay (High Tech Imaging Only)	$0 copay	$0 copay	"Rehab: $20 copay, Psych: $10 copay"	$10 copay	$20 copay	"Psych: $10 copay, SA: $25 copay"	$20 copay	$0 copay	"Chiro: $20 copay, Pod: $20 copay"	0% Coins	$0 copay	$35/trip	$5 copay	$20 copay	$40 allowance every 2 years	$10 copay	$400 allowance every 3 years														0	11.89875898	8.971886623	0	33.75890611	0	0	44.69001964	48.22700872	0	15.98056102	0	0	11.50772154	9.645580609	8.294198691	11.01987149	0.463537067	0	1.252960997	0	0	0	4.822700872	19.29080349	0	10	0	0	0	0											0	0.033045242	1.014796129	0	2.050720944	0	0	1.246417726	2.002125149	0	1.469812719	0	0	2.846059431	3.125828433	3.316137535	0.179757608	0.086399622	0	2.327891591	0	0	0	0.401891739	0.675178122	0	0.071678935	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.8477	0	0.77	0	0.033045242	1.014796129	0	2.050720944	0	0	1.246417726	2.002125149	0	1.469812719	0	0	2.846059431	3.125828433	3.316137535	0.179757608	0.086399622	0	2.327891591	0	0	0	0.401891739	0.675178122	0	0.071678935	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.8477	3000	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0.033045242	1.014796129	0	2.050720944	0	0	1.246417726	2.002125149	0	1.469812719	0	0	2.846059431	3.125828433	3.316137535	0.179757608	0.086399622	0	2.327891591	0	0	0	0.401891739	0.675178122	0	0.071678935	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.8477
H3962_007_0	2008	10																					none											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	P	V	P	V	P	O	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	296.9707133	29.476266	1242.225827	754.2698993	510.912808	14.40270426	0	234.5749648	349.1640193	652.8670207	773.5681287	0	0	2080.095188	3259.715746	4107.533845	163.7754155	1897.538295	0	19799.06442	5.569481433	1997.495608	26.89014779	0	0	0	72.97174318	0	0	1000	0											$500/admit	$500/admit	$0 Days 1-14/ $50 Days 15-100	$0 copay	$50/trip	"0% coinsurance for diabetic supplies, 20% coinsurance for all other"	"0% coinsurance for diabetic supplies, 20% coinsurance for all other"	$50 copay (WIA)	$150 copay	$0 copay	$100 copay (High Tech Imaging Only)	$0 copay	$0 copay	"Rehab: $40 copay, Psych: $40 copay"	$20 copay	$40 copay	"Psych: $40 copay, SA: $40 copay"	$40 copay	$0 copay	"Chiro: $40 copay, Pod: $40 copay"	0% Coins	$0 copay	$50/trip	0	0	0	$10 copay	$400 allowance every 3 years														81.55197922	81.56203955	17.45163438	0	46.90429999	0.185369231	0	50.85866364	140.7129	0	31.08453324	0	0	22.38420493	18.76206792	15.26299452	37.52343999	0.450823765	0	2.291699063	0	0	0	0	0	0	10	0	0	0	0											2.0182	0.200345364	1.806572579	0	1.997000635	2.669818212	0	0.99418077	4.094323478	0	2.003833684	0	0	3.880106413	5.096584017	5.22443888	0.512118081	0.071287946	0	3.781124782	0	0	0	0	0	0	0.060809786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.4108	0	2.91	2.0182	0.200345364	1.806572579	0	1.997000635	2.669818212	0	0.99418077	4.094323478	0	2.003833684	0	0	3.880106413	5.096584017	5.22443888	0.512118081	0.071287946	0	3.781124782	0	0	0	0	0	0	0.060809786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.4108	5000	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.0182	0.200345364	1.806572579	0	1.997000635	2.669818212	0	0.99418077	4.094323478	0	2.003833684	0	0	3.880106413	5.096584017	5.22443888	0.512118081	0.071287946	0	3.781124782	0	0	0	0	0	0	0.060809786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.4108
H3962_008_0	2008	11																					none											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	P	V	P	V	P	O	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	288.6627004	29.476266	1697.646666	545.87948	479.4057291	12.18354146	0	217.7522975	384.0723038	2517.93172	952.5262182	0	0	1788.080568	3259.715746	3459.901958	163.7754155	1770.459993	0	18515.55507	5.569481433	1893.524697	25.23188048	0	0	0	60.51016911	0	0	1000	0											$500/admit	$500/admit	$0 Days 1-14/ $50 Days 15-100	$0 copay	$50/trip	"0% coinsurance for diabetic supplies, 20% coinsurance for all other"	"0% coinsurance for diabetic supplies, 20% coinsurance for all other"	$50 copay (WIA)	$150 copay	$0 copay	$100 copay (High Tech Imaging Only)	$0 copay	$0 copay	"Rehab: $40 copay, Psych: $40 copay"	$20 copay	$40 copay	"Psych: $40 copay, SA: $40 copay"	$40 copay	$0 copay	"Chiro: $40 copay, Pod: $40 copay"	0% Coins	$0 copay	$50/trip	0	0	0	$10 copay	$400 allowance every 3 years														76.62319546	76.61647139	17.51076416	0	47.06322157	0.185997143	0	49.88002115	141.1896647	0	31.18985414	0	0	25.10883352	18.8256218	15.25096504	37.65057726	0.391425494	0	2.122281985	0	0	0	0	0	0	10	0	0	0	0											1.8432	0.188197291	2.477257533	0	1.880198171	2.266103908	0	0.9051241	4.518919984	0	2.475762818	0	0	3.741384775	5.113847983	4.397236985	0.513853244	0.057750265	0	3.274602413	0	0	0	0	0	0	0.050425141	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.7039	0	2.7	1.8432	0.188197291	2.477257533	0	1.880198171	2.266103908	0	0.9051241	4.518919984	0	2.475762818	0	0	3.741384775	5.113847983	4.397236985	0.513853244	0.057750265	0	3.274602413	0	0	0	0	0	0	0.050425141	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.7039	5000	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.8432	0.188197291	2.477257533	0	1.880198171	2.266103908	0	0.9051241	4.518919984	0	2.475762818	0	0	3.741384775	5.113847983	4.397236985	0.513853244	0.057750265	0	3.274602413	0	0	0	0	0	0	0.050425141	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.7039
H3962_009_0	2008	11																					none											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	P	V	P	V	P	O	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	281.443882	27.93510016	1137.726812	902.0719022	611.0280802	15.01017927	0	280.540805	417.5840126	780.7987509	925.1516917	0	0	2487.697606	3259.715746	3804.803376	151.704959	1757.687308	0	18631.17035	4.61416716	2388.91233	32.15937264	0	0	0	67.59363288	0	0	1000	0											$500/admit	$500/admit	$0 Days 1-14/ $50 Days 15-100	$0 copay	$50/trip	"0% coinsurance for diabetic supplies, 20% coinsurance for all other"	"0% coinsurance for diabetic supplies, 20% coinsurance for all other"	$50 copay (WIA)	$150 copay	$0 copay	$100 copay (High Tech Imaging Only)	$0 copay	$0 copay	"Rehab: $40 copay, Psych: $40 copay"	$20 copay	$40 copay	"Psych: $40 copay, SA: $40 copay"	$40 copay	$0 copay	"Chiro: $40 copay, Pod: $40 copay"	0% Coins	$0 copay	$50/trip	0	0	0	$10 copay	$400 allowance every 3 years														81.26213034	81.27177743	17.38952769	0	46.73737747	0.184709541	0	50.67766837	140.2121324	0	30.97390994	0	0	22.30454426	18.69529767	15.2080445	37.38990197	0.449219378	0	2.247837268	0	0	0	0	0	0	10	0	0	0	0											1.9059	0.189194604	1.648710991	0	2.379820836	2.772523322	0	1.184762823	4.879195405	0	2.387963765	0	0	4.623913447	5.078446348	4.821968255	0.472686129	0.065798933	0	3.489986589	0	0	0	0	0	0	0.056328027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.9572	0	3.15	1.9059	0.189194604	1.648710991	0	2.379820836	2.772523322	0	1.184762823	4.879195405	0	2.387963765	0	0	4.623913447	5.078446348	4.821968255	0.472686129	0.065798933	0	3.489986589	0	0	0	0	0	0	0.056328027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.9572	5000	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.9059	0.189194604	1.648710991	0	2.379820836	2.772523322	0	1.184762823	4.879195405	0	2.387963765	0	0	4.623913447	5.078446348	4.821968255	0.472686129	0.065798933	0	3.489986589	0	0	0	0	0	0	0.056328027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.9572
H3962_010_0	2008	2																					none											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	P	V	P	V	P	O	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	314.4395788	31.210164	1315.297934	798.6387169	540.9665025	15.24992215	0	248.3734922	369.7030793	691.2709631	819.0721363	0	0	2202.453728	3451.463731	4596.990259	187.5539578	2143.102074	0	21028.93823	5.897097988	2114.99535	28.47192119	1000	420	0	82.41514524	0	0	1000	0											$0/admit	$100/admit	$0 Days 1-14/ $25 Days 15-100	$0 copay	$35/trip	0% coinsurance	0% coinsurance	$50 copay (WIA)	$50 copay	$0 copay	$50 copay (High Tech Imaging Only)	$0 copay	$0 copay	"Rehab: $20 copay, Psych: $10 copay"	$10 copay	$20 copay	"Psych: $10 copay, SA: $25 copay"	$20 copay	$0 copay	"Chiro: $20 copay, Pod: $20 copay"	0% Coins	$0 copay	$35/trip	$5 copay	$20 copay	$40 allowance every 2 years	$10 copay	$400 allowance every 3 years														0	12.02869554	9.069861217	0	34.12755935	0	0	45.17804259	48.75365622	0	16.15507158	0	0	11.6333879	9.750912061	8.38673059	11.14021045	0.468598974	0	1.286701346	0	0	0	4.875365622	19.50146249	0	10	0	0	0	0											0	0.031284797	0.99413081	0	1.538488869	0	0	0.935085684	1.502031403	0	1.102680749	0	0	2.135166546	2.80457661	3.212809902	0.17411588	0.083687953	0	2.25483026	0	0	0	0.406280468	0.682551187	0	0.068679288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.9264	0	0.46	0	0.031284797	0.99413081	0	1.538488869	0	0	0.935085684	1.502031403	0	1.102680749	0	0	2.135166546	2.80457661	3.212809902	0.17411588	0.083687953	0	2.25483026	0	0	0	0.406280468	0.682551187	0	0.068679288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.9264	3000	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0.031284797	0.99413081	0	1.538488869	0	0	0.935085684	1.502031403	0	1.102680749	0	0	2.135166546	2.80457661	3.212809902	0.17411588	0.083687953	0	2.25483026	0	0	0	0.406280468	0.682551187	0	0.068679288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.9264
H3962_011_0	2008	2																					none											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	P	V	P	V	P	O	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	305.6428592	31.210164	1797.508234	577.9900377	507.6060662	12.90022037	0	230.5612561	406.6647923	2666.04535	1008.557172	0	0	1893.261778	3451.463731	3870.113666	187.5539578	1999.578345	0	19668.27287	5.897097988	2004.908503	26.71610875	1000	420	0	68.34089688	0	0	1000	0											$0/admit	$100/admit	$0 Days 1-14/ $25 Days 15-100	$0 copay	$35/trip	0% coinsurance	0% coinsurance	$50 copay (WIA)	$50 copay	$0 copay	$50 copay (High Tech Imaging Only)	$0 copay	$0 copay	"Rehab: $20 copay, Psych: $10 copay"	$10 copay	$20 copay	"Psych: $10 copay, SA: $25 copay"	$20 copay	$0 copay	"Chiro: $20 copay, Pod: $20 copay"	0% Coins	$0 copay	$35/trip	$5 copay	$20 copay	$40 allowance every 2 years	$10 copay	$400 allowance every 3 years														0	11.27568764	9.081551912	0	34.17154844	0	0	44.21600795	48.81649777	0	16.17589483	0	0	13.02211445	9.763472343	8.408538501	11.15456974	0.406007517	0	1.227161441	0	0	0	4.881649777	19.52659911	0	10	0	0	0	0											0	0.029326338	1.360347029	0	1.445473773	0	0	0.849541528	1.654329244	0	1.359526229	0	0	2.054522629	2.808189223	2.711833314	0.174340308	0.067653653	0	2.011345506	0	0	0	0.406804148	0.683430969	0	0.056950747	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.6736	0	0.43	0	0.029326338	1.360347029	0	1.445473773	0	0	0.849541528	1.654329244	0	1.359526229	0	0	2.054522629	2.808189223	2.711833314	0.174340308	0.067653653	0	2.011345506	0	0	0	0.406804148	0.683430969	0	0.056950747	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.6736	3000	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0.029326338	1.360347029	0	1.445473773	0	0	0.849541528	1.654329244	0	1.359526229	0	0	2.054522629	2.808189223	2.711833314	0.174340308	0.067653653	0	2.011345506	0	0	0	0.406804148	0.683430969	0	0.056950747	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.6736
H3962_012_0	2008	2																					none											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	P	V	P	V	P	O	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	297.9994045	29.57834134	1204.651919	955.1349552	646.9709085	15.89313099	0	297.0432053	442.147778	826.7280892	979.5723795	0	0	2634.032759	3451.463731	4258.186229	173.7309925	1985.152725	0	19787.5375	4.885588758	2529.436585	34.05110045	1000	420	0	76.34104419	0	0	1000	0											$0/admit	$100/admit	$0 Days 1-14/ $25 Days 15-100	$0 copay	$35/trip	0% coinsurance	0% coinsurance	$50 copay (WIA)	$50 copay	$0 copay	$50 copay (High Tech Imaging Only)	$0 copay	$0 copay	"Rehab: $20 copay, Psych: $10 copay"	$10 copay	$20 copay	"Psych: $10 copay, SA: $25 copay"	$20 copay	$0 copay	"Chiro: $20 copay, Pod: $20 copay"	0% Coins	$0 copay	$35/trip	$5 copay	$20 copay	$40 allowance every 2 years	$10 copay	$400 allowance every 3 years														0	11.98638042	9.037954821	0	34.00750377	0	0	45.01911309	48.58214825	0	16.09824049	0	0	11.5924634	9.716609832	8.356596661	11.10102087	0.466950513	0	1.262187694	0	0	0	4.858214825	19.4328593	0	10	0	0	0	0											0	0.029544771	0.907299135	0	1.833488801	0	0	1.114385138	1.790040742	0	1.314115978	0	0	2.544577364	2.794710535	2.965328735	0.160715948	0.07724734	0	2.08129886	0	0	0	0.404851235	0.680150075	0	0.063617537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.7614	0	0.55	0	0.029544771	0.907299135	0	1.833488801	0	0	1.114385138	1.790040742	0	1.314115978	0	0	2.544577364	2.794710535	2.965328735	0.160715948	0.07724734	0	2.08129886	0	0	0	0.404851235	0.680150075	0	0.063617537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.7614	3000	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0.029544771	0.907299135	0	1.833488801	0	0	1.114385138	1.790040742	0	1.314115978	0	0	2.544577364	2.794710535	2.965328735	0.160715948	0.07724734	0	2.08129886	0	0	0	0.404851235	0.680150075	0	0.063617537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.7614
H3962_015_0	2008	7																					none											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	P	V	P	V	P	O	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	333.1842603	33.070695	1393.706769	846.2479538	573.2151299	16.15901552	0	263.1797771	391.742183	732.4796878	867.8994703	0	0	2333.748567	3657.215782	5042.774988	183.7467071	2365.477899	0	22291.19979	6.248641595	2241.076533	30.16921736	0	420	0	90.9668312	0	0	1000	0											$150/admit	$150/admit	$0 Days 1-14/ $50 Days 15-100	$0 copay	$50/trip	"0% coinsurance for diabetic supplies, 20% coinsurance for all other"	"0% coinsurance for diabetic supplies, 20% coinsurance for all other"	$50 copay (WIA)	$50 copay	$0 copay	$100 copay (High Tech Imaging Only)	$0 copay	$0 copay	"Rehab: $30 copay, Psych: $30 copay"	$30 copay	$30 copay	"Psych: $30 copay, SA: $30 copay"	$30 copay	$0 copay	"Chiro: $30 copay, Pod: $30 copay"	0% Coins	$0 copay	$50/trip	0	$20 copay	$40 allowance every 2 years	$10 copay	$400 allowance every 3 years														24.83232123	24.83538457	17.71322597	0	47.60737286	0.188147826	0	47.86841933	47.60737286	0	31.55047543	0	0	17.03980004	4.760825569	4.479961782	28.56442372	0.457581396	0	1.798169677	0	0	0	0	19.04294914	0	10	0	0	0	0											0.6895	0.068443619	2.057253578	0	2.274105535	3.040283648	0	1.049833327	1.554151347	0	2.281886742	0	0	3.313884076	1.450947201	1.882619935	0.4373849	0.09019989	0	3.340279961	0	0	0	0	0.66650322	0	0.075805693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.2731	0	1.39	0.6895	0.068443619	2.057253578	0	2.274105535	3.040283648	0	1.049833327	1.554151347	0	2.281886742	0	0	3.313884076	1.450947201	1.882619935	0.4373849	0.09019989	0	3.340279961	0	0	0	0	0.66650322	0	0.075805693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.2731	3500	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.6895	0.068443619	2.057253578	0	2.274105535	3.040283648	0	1.049833327	1.554151347	0	2.281886742	0	0	3.313884076	1.450947201	1.882619935	0.4373849	0.09019989	0	3.340279961	0	0	0	0	0.66650322	0	0.075805693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.2731
H3962_016_0	2008	8																					none											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	P	V	P	V	P	O	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	323.863142	33.070695	1904.663064	612.4457484	537.8659783	13.669241	0	244.3057006	430.9072939	2824.976268	1068.680275	0	0	2006.124761	3657.215782	4243.860404	183.7467071	2207.061642	0	20856.11529	6.248641595	2124.427081	28.3087357	0	420	0	75.43218923	0	0	1000	0											$150/admit	$150/admit	$0 Days 1-14/ $50 Days 15-100	$0 copay	$50/trip	"0% coinsurance for diabetic supplies, 20% coinsurance for all other"	"0% coinsurance for diabetic supplies, 20% coinsurance for all other"	$50 copay (WIA)	$50 copay	$0 copay	$100 copay (High Tech Imaging Only)	$0 copay	$0 copay	"Rehab: $30 copay, Psych: $30 copay"	$30 copay	$30 copay	"Psych: $30 copay, SA: $30 copay"	$30 copay	$0 copay	"Chiro: $30 copay, Pod: $30 copay"	0% Coins	$0 copay	$50/trip	0	$20 copay	$40 allowance every 2 years	$10 copay	$400 allowance every 3 years														23.26850095	23.26645902	17.72523451	0	47.63964789	0.18827522	0	46.82050617	47.63964789	0	31.57186481	0	0	19.06227328	4.764049101	4.529000406	28.58378874	0.39621964	0	1.69555606	0	0	0	0	19.05585916	0	10	0	0	0	0											0.628	0.064119831	2.813383289	0	2.135312152	2.573579363	0	0.953209713	1.710689313	0	2.811685763	0	0	3.186774869	1.45192963	1.601703791	0.437681421	0.072873431	0	2.946892722	0	0	0	0	0.66695507	0	0.062860158	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.1176	0	1.36	0.628	0.064119831	2.813383289	0	2.135312152	2.573579363	0	0.953209713	1.710689313	0	2.811685763	0	0	3.186774869	1.45192963	1.601703791	0.437681421	0.072873431	0	2.946892722	0	0	0	0	0.66695507	0	0.062860158	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.1176	3500	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.628	0.064119831	2.813383289	0	2.135312152	2.573579363	0	0.953209713	1.710689313	0	2.811685763	0	0	3.186774869	1.45192963	1.601703791	0.437681421	0.072873431	0	2.946892722	0	0	0	0	0.66695507	0	0.062860158	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.1176
H3962_017_0	2008	7																					none											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	P	V	P	V	P	O	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	315.7640382	31.34159453	1276.464814	1012.0734	685.5387747	16.84056795	0	314.7508371	468.5055263	876.0118174	1037.967612	0	0	2791.055312	3657.215782	4671.116057	170.204341	2191.139169	0	20975.15692	5.176833281	2680.223847	36.08098814	0	420	0	84.26246002	0	0	1000	0											$150/admit	$150/admit	$0 Days 1-14/ $50 Days 15-100	$0 copay	$50/trip	"0% coinsurance for diabetic supplies, 20% coinsurance for all other"	"0% coinsurance for diabetic supplies, 20% coinsurance for all other"	$50 copay (WIA)	$50 copay	$0 copay	$100 copay (High Tech Imaging Only)	$0 copay	$0 copay	"Rehab: $30 copay, Psych: $30 copay"	$30 copay	$30 copay	"Psych: $30 copay, SA: $30 copay"	$30 copay	$0 copay	"Chiro: $30 copay, Pod: $30 copay"	0% Coins	$0 copay	$50/trip	0	$20 copay	$40 allowance every 2 years	$10 copay	$400 allowance every 3 years														24.72123229	24.72416708	17.63390284	0	47.39417816	0.187305265	0	47.65405561	47.39417816	0	31.40918651	0	0	16.96349263	4.739505704	4.459091855	28.43650689	0.455532261	0	1.762222507	0	0	0	0	18.95767126	0	10	0	0	0	0											0.6505	0.064574568	1.875754709	0	2.707545569	3.154327049	0	1.249929491	1.850369532	0	2.716809859	0	0	3.945503851	1.444449588	1.73574463	0.403334743	0.083177882	0	3.080241134	0	0	0	0	0.663518494	0	0.070218717	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.696	0	1.59	0.6505	0.064574568	1.875754709	0	2.707545569	3.154327049	0	1.249929491	1.850369532	0	2.716809859	0	0	3.945503851	1.444449588	1.73574463	0.403334743	0.083177882	0	3.080241134	0	0	0	0	0.663518494	0	0.070218717	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.696	3500	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.6505	0.064574568	1.875754709	0	2.707545569	3.154327049	0	1.249929491	1.850369532	0	2.716809859	0	0	3.945503851	1.444449588	1.73574463	0.403334743	0.083177882	0	3.080241134	0	0	0	0	0.663518494	0	0.070218717	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.696
H3962_801_0	2008	7																					none											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	227.8302414	4.196039085	25.25332651	4.444274595	7.26723259	12.62427255	0	11.58648975	47.69038362	11.43358694	35.7035196	0	0	37.63973359	28.33562197	35.2412987	2.521777524	11.77151643	0	153.1216146	7.575452833	31.84929387	0	0	0	0	0.548643582	0	0	0	0											Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing																				0.080124926	0.080124926	0.204371084	0	0.234	0.234	0	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.237642959	0.234	0.234	0	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											18.2549	0.33620732	5.161049715	0	1.700532426	2.954079776	0	2.711238602	11.15954977	2.675459345	8.354623585	0	0	8.807697659	6.630535541	8.374846494	0.590095941	2.754534845	0	35.83045781	1.772655963	7.452734765	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.5212	0	0	18.2549	0.33620732	5.161049715	0	1.700532426	2.954079776	0	2.711238602	11.15954977	2.675459345	8.354623585	0	0	8.807697659	6.630535541	8.374846494	0.590095941	2.754534845	0	35.83045781	1.772655963	7.452734765	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.5212	0	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.2549	0.33620732	5.161049715	0	1.700532426	2.954079776	0	2.711238602	11.15954977	2.675459345	8.354623585	0	0	8.807697659	6.630535541	8.374846494	0.590095941	2.754534845	0	35.83045781	1.772655963	7.452734765	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.5212
H3962_802_0	2008	4																					none											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	217.5444518	4.006601655	24.11322147	4.243630144	6.939140826	12.05432796	0	11.06339766	45.5373189	10.91739792	34.09162255	0	0	35.94042282	27.05636138	33.65026941	2.407927523	11.240071	0	146.2086748	7.233445933	30.41140249	0	0	0	0	0.52387412	0	0	0	0											Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing																				0.080465525	0.080465525	0.202862278	0	0.234	0.234	0	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.237642959	0.234	0.234	0	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											17.5048	0.322393306	4.891663031	0	1.623758953	2.820712743	0	2.588835053	10.65573262	2.554671112	7.977439676	0	0	8.410058939	6.331188564	7.996749587	0.56345504	2.630176613	0	34.21282991	1.692626348	7.116268184	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.8934	0	0	17.5048	0.322393306	4.891663031	0	1.623758953	2.820712743	0	2.588835053	10.65573262	2.554671112	7.977439676	0	0	8.410058939	6.331188564	7.996749587	0.56345504	2.630176613	0	34.21282991	1.692626348	7.116268184	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.8934	0	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.5048	0.322393306	4.891663031	0	1.623758953	2.820712743	0	2.588835053	10.65573262	2.554671112	7.977439676	0	0	8.410058939	6.331188564	7.996749587	0.56345504	2.630176613	0	34.21282991	1.692626348	7.116268184	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.8934
H3962_803_0	2008	4																					none											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	225.9344854	4.161124201	25.04319573	4.407294165	7.206762567	12.51922705	0	11.49007956	47.293556	11.33844904	35.40643365	0	0	37.32653657	28.09984367	34.94805886	2.500794028	11.67356665	0	151.8475026	7.512418135	31.5842786	0	0	0	0	0.544078365	0	0	0	0											Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing	Consistent with Medicare Cost Sharing																				0.08031553	0.08031553	0.204862493	0	0.234	0.234	0	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.237642959	0.234	0.234	0	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											18.146	0.334202896	5.130411506	0	1.686382441	2.92949913	0	2.688678616	11.0666921	2.653197075	8.285105474	0	0	8.734409557	6.575363419	8.30516011	0.585185803	2.731614595	0	35.53231562	1.757905844	7.390721193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5329	0	0	18.146	0.334202896	5.130411506	0	1.686382441	2.92949913	0	2.688678616	11.0666921	2.653197075	8.285105474	0	0	8.734409557	6.575363419	8.30516011	0.585185803	2.731614595	0	35.53231562	1.757905844	7.390721193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5329	0	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.146	0.334202896	5.130411506	0	1.686382441	2.92949913	0	2.688678616	11.0666921	2.653197075	8.285105474	0	0	8.734409557	6.575363419	8.30516011	0.585185803	2.731614595	0	35.53231562	1.757905844	7.390721193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5329
H3964_001_0	2008	5																																A	A	A	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	P	V	Coin	O	T	P	V	V	P	V	O	O	O																																																				0		387.1887811	4.78	98.189336	2046.183062	362.649784	8.457401253	2.797345072	431.773888	126.652162	639.723812	1154.723024	41.839434	60.888282	1145.652144	6360.737432	13128.75467	37.7	224.312592	2283.950368	26.06996	44.97333631	0	13.31232	177.830408	39.826024	0	0	11.759216	0	975.519112	0.221872											"$150 per day for days 1-5, $0 6+"	"$150 per day for days 1-5, $0 6+"	$0 per Admission	$0 Copay	$0 Copay	20% Coinsurance	20% Coinsurance	$50 Copay per Visit	$150 Copay per Procedure	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$40 Copay	$20 Copay	$10 Copay	$0 Copay	"$40 Copay, 7b and 7g"	20% Coinsurance	$0 Copay	$0 Copay	$0 Copay	"$0 Copay Routine Eye, $40 other"	$0 Copay	$40 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											574	666	0	0	0	0.2	0.2	50	150	0	0	0	0	0	0	40	20	10	0	40	0.2	0	0	0	9	0	40	0	0	0	0											18.5205	0.26529	0	0	0	1.691480251	0.559469014	1.799057867	1.583152025	0	0	0	0	0	0	43.76251556	0.062833333	0.18692716	0	0.086899867	8.994667263	0	0	0	0.029869518	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.5427			18.5205	0.26529	0	0	0	1.691480251	0.559469014	1.799057867	1.583152025	0	0	0	0	0	0	43.76251556	0.062833333	0.18692716	0	0.086899867	8.994667263	0	0	0	0.029869518	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.5427																																																																																				0			18.5205	0.26529	0	0	0	1.691480251	0.559469014	1.799057867	1.583152025	0	0	0	0	0	0	43.76251556	0.062833333	0.18692716	0	0.086899867	8.994667263	0	0	0	0.029869518	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.5427
H3964_002_0	2008	4																																BP	BP	A	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	P	Coin	V	P	Ded	O	O	O											13.7019	1.6671																																								15.369		399.5339898	17.22655368	45.13721699	21.23443181	14.10269127	15.14679364	5.459741561	847.2711	20.02537684	7.36	35.5302919	10.45190452	0.205218036	17.57317463	27.80152005	178.2441145	3.33	2.315369064	9.721975802	0.437944721	32.69406613	0	939.6732	1118.336307	2.057955067	1.333609355	0	0.867216021	0	0.482895803	6.440739688											$650 Ded for 1st IP Admission	$650 Ded for 1st IP Admission	$0 per Admission	$0 per Visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 per Visit	20% Coinsurance	20% Coinsurance	"20% Coins 8b, 0% Coins 14h"	20% Coinsurance	20% Coinsurance	20% Coinsurance	$0 per Visit	"20% Coinsurance, $15 7f Routine"	50% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	0% Coinsurance	$0 per Trip	$0 Copay	"0% Coins Routine Eye, 20% other"	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											0	0	0.002145863	2.11E-05	0.197125226	0.196512411	0.195714012	50	0.198416741	0.2	0.190734972	0.200428785	0.2001932	0.196470112	1.40E-07	0.199238041	0.5	0.200184052	0.198287528	0.198522636	0.2	0	0.001468904	0	0.030550369	0	0	0.00045629	0	0.001516475	0.001944569											0	0	8.07E-06	3.73E-08	2.779996198	2.976532931	1.068547924	3.53029625	3.973370008	1.472	6.776869249	2.094862526	0.041083255	3.452603592	3.24E-10	35.51300822	1.665	0.46349996	1.927746553	0.086941941	6.538813225	0	0.000115024	0	0.062871287	0	0	3.30E-08	0	6.10E-08	1.04E-06	0	0	0	0	0	0	0	0	0	0	74.4242	650		13.7019	1.66713815	8.07E-06	3.73E-08	2.779996198	2.976532931	1.068547924	3.53029625	3.973370008	1.472	6.776869249	2.094862526	0.041083255	3.452603592	3.24E-10	35.51300822	1.665	0.46349996	1.927746553	0.086941941	6.538813225	0	0.000115024	0	0.062871287	0	0	3.30E-08	0	6.10E-08	1.04E-06	0	0	0	0	0	0	0	0	0	0	89.7932																																																																																				0			13.7019	1.66713815	8.07E-06	3.73E-08	2.779996198	2.976532931	1.068547924	3.53029625	3.973370008	1.472	6.776869249	2.094862526	0.041083255	3.452603592	3.24E-10	35.51300822	1.665	0.46349996	1.927746553	0.086941941	6.538813225	0	0.000115024	0	0.062871287	0	0	3.30E-08	0	6.10E-08	1.04E-06	0	0	0	0	0	0	0	0	0	0	89.7932
H3964_003_0	2008	5																																A	A	A	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	P	V	Coin	O	T	P	V	V	P	V	O	O	O																																																				0		356.9658601	10.93	74.530324	1842.740556	297.377532	8.47	4.79	464.506575	167.222367	752.091652	1416.423697	46.509086	114.286146	1540.876402	6798.523716	14086.00072	64.74	191.849096	1782.207216	34.642596	58.8294207	0	16.120812	255.074692	40.702192	0	0	3.086964	0	2151.044512	421.427752											"$150 per day for days 1-5, $0 6+"	"$150 per day for days 1-5, $0 6+"	$0 per Admission	$0 Copay	$0 Copay	20% Coinsurance	20% Coinsurance	$50 Copay per Visit	$150 Copay per Procedure	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$40 Copay	$20 Copay	$10 Copay	$0 Copay	"$40 Copay, 7b and 7g"	20% Coinsurance	$0 Copay	$0 Copay	$0 Copay	"$0 Copay Routine Eye, $40 other"	$0 Copay	$40 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											560	666	0	0	0	0.2	0.2	50	150	0	0	0	0	0	0	40	20	10	0	40	0.2	0	0	0	9	0	40	0	0	0	0											16.6584	0.606615	0	0	0	1.694	0.958	1.935444063	2.090279588	0	0	0	0	0	0	46.95333572	0.1079	0.159874247	0	0.11547532	11.76588414	0	0	0	0.030526644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.0757			16.6584	0.606615	0	0	0	1.694	0.958	1.935444063	2.090279588	0	0	0	0	0	0	46.95333572	0.1079	0.159874247	0	0.11547532	11.76588414	0	0	0	0.030526644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.0757																																																																																				0			16.6584	0.606615	0	0	0	1.694	0.958	1.935444063	2.090279588	0	0	0	0	0	0	46.95333572	0.1079	0.159874247	0	0.11547532	11.76588414	0	0	0	0.030526644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.0757
H4003_001_0	2008	7																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	V	V	V	V	V	V	V	V	V																																																				0		1593.690148						0.006348728	417.7322481	86.11046845		100.8671299	1.813821213		167.0946204		6630.44344	0.034146565							2645.5695																		"$50 per Day, Days 4-9 (1a, 1b)"						20% Coins - (11b)	$25 per Visit (4a) $0 per Visit (4b)	"$25 per Visit - (9a, 9b)"		"$30 / $15 per Visit - (8a, 8b)"	$30 per Visit - (8a)		$30 per Visit - (8b)		"$10 per Visit - (7b, 7d, 7f, 17a, 18a)"	"$10 per Visit - (7e, 7h, 9c)"							$5 per Visit - (16a)																		18.0457						0.2	24.805	24.805		23.3928	29.766		29.3754		10	10							5																		2.3966	0	0	0	0	0	0.001269746	0.863488627	0.177997774	0	0.196630137	0.00449919	0	0.409039112	0	5.525369533	2.85E-05	0	0	0	0	0	0	1.102320625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.6773	0	0.031818747	2.3966	0	0	0	0	0	0.001269746	0.863488627	0.177997774	0	0.196630137	0.00449919	0	0.409039112	0	5.525369533	2.85E-05	0	0	0	0	0	0	1.102320625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.6773																																																																																				0	0	0	2.3966	0	0	0	0	0	0.001269746	0.863488627	0.177997774	0	0.196630137	0.00449919	0	0.409039112	0	5.525369533	2.85E-05	0	0	0	0	0	0	1.102320625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.6773
H4003_008_0	2008	4																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	V	V	V	V	V	V	V	V	V																																																				0		1590.32499						0.006313274	416.9280009	85.99644252		100.7929805	1.834263093		166.9259163		6639.392398	0.033955876							2645.5695																		"$50 per Day, Days 4-9 (1a, 1b)"						20% Coins - (11b)	$25 per Visit (4a) $0 per Visit (4b)	"$25 per Visit - (9a, 9b)"		"$30/$15 per Visit - (8a, 8b)"	$30 per Visit - (9a)		"$30 per Visit - (8b, 9a)"		"$10 per Visit - (7b, 7d, 7f, 17a, 18a)"	"$10 per Visit - (7e, 7h, 9c)"							$5 per Visit - (16a)																		18.0462						0.2	24.8056	24.8056		23.4062	29.7667		29.3742		10	10							5																		2.3916	0	0	0	0	0	0.001262655	0.861846301	0.177766223	0	0.196598301	0.004550002	0	0.408610004	0	5.532826998	2.83E-05	0	0	0	0	0	0	1.102320625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.6774	0	0.031666372	2.3916	0	0	0	0	0	0.001262655	0.861846301	0.177766223	0	0.196598301	0.004550002	0	0.408610004	0	5.532826998	2.83E-05	0	0	0	0	0	0	1.102320625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.6774																																																																																				0	0	0	2.3916	0	0	0	0	0	0.001262655	0.861846301	0.177766223	0	0.196598301	0.004550002	0	0.408610004	0	5.532826998	2.83E-05	0	0	0	0	0	0	1.102320625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.6774
H4003_009_0	2008	5																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	V	V	V	V	V	V	V	V	V																																																				0		1636.933368						0.011410949	427.6826879	108.6614898		118.5477556	2.8082329		181.2543066		8775.534458	0.031828165							2645.5695																		"$50 per Day, Days 4-9 (1a, 1b)"						20% Coins - (11b)	$25 per Visit (4a) $0 per Visit (4b)	"$25 per Visit - (9a, 9b)"		"$30/$15 per Visit - (8a, 8b)"	$30 per Visit - (9a)		"$30 per Visit - (8b, 9a)"		"$10 per Visit - (7b, 7d, 7f, 17a, 18a)"	"$10 per Visit - (7e, 7h, 9c)"							$5 per Visit - (16a)																		18.0347						0.2	24.7899	24.7899		23.323	29.7479		29.3152		10	10							5																		2.4601	0	0	0	0	0	0.00228219	0.883518568	0.224475871	0	0.230407544	0.006961589	0	0.442792742	0	7.312945382	2.65E-05	0	0	0	0	0	0	1.102320625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.6659	0	0.036000525	2.4601	0	0	0	0	0	0.00228219	0.883518568	0.224475871	0	0.230407544	0.006961589	0	0.442792742	0	7.312945382	2.65E-05	0	0	0	0	0	0	1.102320625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.6659																																																																																				0	0	0	2.4601	0	0	0	0	0	0.00228219	0.883518568	0.224475871	0	0.230407544	0.006961589	0	0.442792742	0	7.312945382	2.65E-05	0	0	0	0	0	0	1.102320625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.6659
H4003_010_0	2008	5																					3250											A	A	A	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	V	V	V	V	V	V	V	V	V																																																				0		369.8259045		0.103665285			49.39039769	0.014503878	637.8236519	135.6916571	6.290696276	171.3212859	2.328896068	5.119455252	403.9429962		9991.817279	0.356793275	1252.730922																								"$250 per Admit (1a, 1b)"		$100 per Admit (2)			20% (11a)	"20% (11b, 11c)"	$50 per Visit (4a) $15 per Visit (4b)	$15 per Visit - (9b)	$15 per Visit - (8a)	"$15 per Visit - (8b, 14h)"	$15 per Visit - (9a)	$15 per Visit (12)	"$15 per Visit (5, 9d, 13a)"		"$15 per Visit (7b, 7d, 7f, 17a, 18a)"	"$15 per Visit (7e, 7h, 9c)"	"$15 per Visit (7c, 7i)"																								239.0079		95.6032			0.2	0.2	47.796	14.3405	14.3405	14.3405	14.3405	14.3405	14.3405		15	15	15																								7.3659	0	0.000825894	0	0	9.878079537	0.002900776	2.540449872	0.162156906	0.007517631	0.204735724	0.002783123	0.006117952	0.482727884	0	12.4897716	0.000445992	1.565913653	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.7104	0	0.495466753	7.3659	0	0.000825894	0	0	9.878079537	0.002900776	2.540449872	0.162156906	0.007517631	0.204735724	0.002783123	0.006117952	0.482727884	0	12.4897716	0.000445992	1.565913653	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.7104																																																																																				0	0	0	7.3659	0	0.000825894	0	0	9.878079537	0.002900776	2.540449872	0.162156906	0.007517631	0.204735724	0.002783123	0.006117952	0.482727884	0	12.4897716	0.000445992	1.565913653	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.7104
H4003_015_0	2008	4																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	V	V	V	V	V	V	V	V	V																																																				0		1585.721697						0.006348728	415.6435868	85.6799161		100.3627943	1.804752106		166.2591473										2645.5695																		"$50 days 4-9 (1a, 1b)"						20% (11b)	$25 (4a); $0 (4b)	"$25 (9a, 9b)"		"$30 / $15 CT (8a, 8b)"	$30 (9a)		$30 (8b)										$5 Office Visit (16a)																		18.0469						0.2	24.8066	24.8066		23.3943	29.768		29.3773										5																		2.3848	0	0	0	0	0	0.001269746	0.859226355	0.177119158	0	0.195659549	0.004476982	0	0.407020051	0	0	0	0	0	0	0	0	0	1.102320625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.1319	0	0.031400998	2.3848	0	0	0	0	0	0.001269746	0.859226355	0.177119158	0	0.195659549	0.004476982	0	0.407020051	0	0	0	0	0	0	0	0	0	1.102320625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.1319																																																																																				0	0	0	2.3848	0	0	0	0	0	0.001269746	0.859226355	0.177119158	0	0.195659549	0.004476982	0	0.407020051	0	0	0	0	0	0	0	0	0	1.102320625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.1319
H4003_016_0	2008	4																					3250											A	A	A	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	V	V	V	V	V	V	V	V	V																																																				0		369.8259045		0.103665285			49.39039769	0.014503878	637.8236519	135.6916571	6.290696276	171.3212859	2.328896068	5.119455252	403.9429962		9991.817279	0.356793275	1252.730922																								"$250 per admit (1a, 1b)"		$100 per admit (2)			20% (11a)	"20% (11b, 11c)"	$50 (4a); $15 (4b)	$15 (9b)	$15 (8a)	"$15 (8b, 14b)"	$15 (9a)	$15 (12)	"$15 (5, 9d, 13a)"		"$15 (7b, 7d, 7f, 17a, 18a)"	"$15 (7e, 7h, 9c)"	"$15 (7c, 7i)"																								239.0079		95.6032			0.2	0.2	47.796	14.3405	14.3405	14.3405	14.3405	14.3405	14.3405		15	15	15																								7.3659	0	0.000825894	0	0	9.878079537	0.002900776	2.540449872	0.162156906	0.007517631	0.204735724	0.002783123	0.006117952	0.482727884	0	12.4897716	0.000445992	1.565913653	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.7104	0	0.495466753	7.3659	0	0.000825894	0	0	9.878079537	0.002900776	2.540449872	0.162156906	0.007517631	0.204735724	0.002783123	0.006117952	0.482727884	0	12.4897716	0.000445992	1.565913653	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.7104																																																																																				0	0	0	7.3659	0	0.000825894	0	0	9.878079537	0.002900776	2.540449872	0.162156906	0.007517631	0.204735724	0.002783123	0.006117952	0.482727884	0	12.4897716	0.000445992	1.565913653	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.7104
H4003_017_0	2008	3																					3250											A	A	A	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	V	V	V	V	V	V	V	V	V																																																				0		369.8259045		0.103665285			49.39039769	0.014503878	637.8236519	135.6916571	6.290696276	171.3212859	2.328896068	5.119455252	403.9429962		9991.817279	0.356793275	1252.730922																								"$500 per admit (1a, 1b)"		$200 per admit (2)			30% (11a)	"30% (11b, 11c)"	$50 (4a); $15 (4b)	$25 (9b)	$25 (8a)	"$25 (8b, 14h)"	$25 (9a)	$25 (12)	"$25 (5, 9d, 13a)"		"$25 (7b, 7d, 7f, 17a, 18a)"	"$25 (7e, 7h, 9c)"	"$25 (7c, 7i)"																								452.3633		180.9453			0.3	0.3	45.2325	22.6182	22.6182	22.6182	22.6182	22.6182	22.6182		25	25	25																								13.9413	0	0.001563146	0	0	14.81711931	0.004351163	2.404198252	0.255758021	0.011857	0.322914422	0.004389613	0.00964939	0.76137077	0	20.816286	0.000743319	2.609856088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.9614	0	1.865291133	13.9413	0	0.001563146	0	0	14.81711931	0.004351163	2.404198252	0.255758021	0.011857	0.322914422	0.004389613	0.00964939	0.76137077	0	20.816286	0.000743319	2.609856088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.9614																																																																																				0	0	0	13.9413	0	0.001563146	0	0	14.81711931	0.004351163	2.404198252	0.255758021	0.011857	0.322914422	0.004389613	0.00964939	0.76137077	0	20.816286	0.000743319	2.609856088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.9614
H4003_801_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		120.8370683				2.647904409	46.62128844	0.003478285	400.488433	15.42700748	1.746593027	4.695400954	0.048859896	0.228649461	7.959231559	48.32048738	233.4025344	8.964986933	9.572140954		19.10982941																						FFS Medicare Ded & Coins				FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins		FFS Medicare Ded & Coins																						0.159452247				0.234	0.234	0.234	45.406	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234																						19.2677	0	0	0	0.619609632	10.9093815	0.000813919	1.515381994	3.609919751	0.408702768	1.098723823	0.011433216	0.053503974	1.862460185	11.30699405	54.61619305	2.097806942	2.239880983	0	4.471700082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.0902	135	0	19.2677	0	0	0	0.619609632	10.9093815	0.000813919	1.515381994	3.609919751	0.408702768	1.098723823	0.011433216	0.053503974	1.862460185	11.30699405	54.61619305	2.097806942	2.239880983	0	4.471700082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.0902																																																																																				0	0	0	19.2677	0	0	0	0.619609632	10.9093815	0.000813919	1.515381994	3.609919751	0.408702768	1.098723823	0.011433216	0.053503974	1.862460185	11.30699405	54.61619305	2.097806942	2.239880983	0	4.471700082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.0902
H4003_803_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		120.8370683				2.647904409	46.62128844	0.003478285	400.488433	15.42700748	1.746593027	4.695400954	0.048859896	0.228649461	7.959231559	48.32048738	233.4025344	8.964986933	9.572140954		19.10982941																						FFS Medicare Ded & Coins				FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins		FFS Medicare Ded & Coins																						0.159452247				0.234	0.234	0.234	45.406	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234																						19.2677	0	0	0	0.619609632	10.9093815	0.000813919	1.515381994	3.609919751	0.408702768	1.098723823	0.011433216	0.053503974	1.862460185	11.30699405	54.61619305	2.097806942	2.239880983	0	4.471700082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.0902	135	0	19.2677	0	0	0	0.619609632	10.9093815	0.000813919	1.515381994	3.609919751	0.408702768	1.098723823	0.011433216	0.053503974	1.862460185	11.30699405	54.61619305	2.097806942	2.239880983	0	4.471700082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.0902																																																																																				0	0	0	19.2677	0	0	0	0.619609632	10.9093815	0.000813919	1.515381994	3.609919751	0.408702768	1.098723823	0.011433216	0.053503974	1.862460185	11.30699405	54.61619305	2.097806942	2.239880983	0	4.471700082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.0902
H4003_804_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		120.8370683				2.647904409	46.62128844	0.003478285	400.488433	15.42700748	1.746593027	4.695400954	0.048859896	0.228649461	7.959231559	48.32048738	233.4025344	8.964986933	9.572140954		19.10982941																						FFS Medicare Ded & Coins				FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins		FFS Medicare Ded & Coins																						0.159452247				0.234	0.234	0.234	45.406	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234																						19.2677	0	0	0	0.619609632	10.9093815	0.000813919	1.515381994	3.609919751	0.408702768	1.098723823	0.011433216	0.053503974	1.862460185	11.30699405	54.61619305	2.097806942	2.239880983	0	4.471700082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.0902	135	0	19.2677	0	0	0	0.619609632	10.9093815	0.000813919	1.515381994	3.609919751	0.408702768	1.098723823	0.011433216	0.053503974	1.862460185	11.30699405	54.61619305	2.097806942	2.239880983	0	4.471700082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.0902																																																																																				0	0	0	19.2677	0	0	0	0.619609632	10.9093815	0.000813919	1.515381994	3.609919751	0.408702768	1.098723823	0.011433216	0.053503974	1.862460185	11.30699405	54.61619305	2.097806942	2.239880983	0	4.471700082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.0902
H4004_001_0	2008	3																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	O	T	V	V	V	V	V														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		376.3831782	0	0	0	0	36.80480412	1.937094954	815.9586263	135.2933293	92.52235577	292.392186	0	0	1120.487776	0	7962.304303	2421.730516	0	2522.9074	17091.31838	0	0	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 4a	PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-g, 14i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 14h"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a	"PBP 1a, 3, 4a-b, 5, 6, 7a-d, 7f-7i, 8a-b, 9a-d, 10a-b, 11a-c, 12, 13a-b, 14a-i, 15"											500	0	0	0	0	0.2	0.2	50	25	15	20	0	0	28.58971165	0	5	5	0	10	2.256041931	0	0	0	0	0	0	0	0	0	0	0											15.6826	0	0	0	0	7.360960823	0.387418991	3.39982761	0.281861103	0.115652945	0.48732031	0	0	2.669535203	0	3.317626793	1.009054381	0	2.102422833	3.213227578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0275			15.6826	0	0	0	0	7.360960823	0.387418991	3.39982761	0.281861103	0.115652945	0.48732031	0	0	2.669535203	0	3.317626793	1.009054381	0	2.102422833	3.213227578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0275																																																																																				0			15.6826	0	0	0	0	7.360960823	0.387418991	3.39982761	0.281861103	0.115652945	0.48732031	0	0	2.669535203	0	3.317626793	1.009054381	0	2.102422833	3.213227578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0275
H4004_015_0	2008	6																																D	D	D	V	T	O	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	O	T	V	V	V	V	V														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		624.1395178	0	0	0	0	0	1.242379601	503.6863124	104.0510796	0	108.1403189	0	0	759.2531065	0	4890.514441	1848.336326	0	1967.15749	0	0	0	0	0	235.2274887	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 4a	PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-g, 14i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 14h"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a	"PBP 1a, 3, 4a-b, 5, 6, 7a-d, 7f-7i, 8a-b, 9a-d, 10a-b, 11a-c, 12, 13a-b, 14a-i, 15"											50	0	0	0	0	0	0.2	25	25	0	23.73643761	0	0	28.58971165	0	10	10	0	1.506876931	0	0	0	0	0	10	0	0	0	0	0	0											2.6006	0	0	0	0	0	0.24847592	1.049346484	0.216773083	0	0.213905494	0	0	1.808902282	0	4.075428701	1.540280272	0	0.24702202	0	0	0	0	0	0.196022907	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.1967			2.6006	0	0	0	0	0	0.24847592	1.049346484	0.216773083	0	0.213905494	0	0	1.808902282	0	4.075428701	1.540280272	0	0.24702202	0	0	0	0	0	0.196022907	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.1967																																																																																				0			2.6006	0	0	0	0	0	0.24847592	1.049346484	0.216773083	0	0.213905494	0	0	1.808902282	0	4.075428701	1.540280272	0	0.24702202	0	0	0	0	0	0.196022907	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.1967
H4004_025_0	2008	5																																D	D	D	V	T	O	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	O	T	V	V	V	V	V														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		554.1582163	0	0	0	0	0	0.960413994	447.2107606	92.38440931	0	96.01514491	0	0	674.1222679	0	4476.50198	1641.092628	0	1746.591034	0	0	0	0	0	224.587213	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 4a	PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-g, 14i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 14h"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a	"PBP 1a, 3, 4a-b, 5, 6, 7a-d, 7f-7i, 8a-b, 9a-d, 10a-b, 11a-c, 12, 13a-b, 14a-i, 15"											50	0	0	0	0	0	0.2	25	25	0	23.73643761	0	0	28.58971165	0	10	10	0	1.506876931	0	0	0	0	0	10	0	0	0	0	0	0											2.309	0	0	0	0	0	0.192082799	0.931689085	0.192467519	0	0.189921458	0	0	1.606080105	0	3.730418316	1.36757719	0	0.219324811	0	0	0	0	0	0.187156011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9257			2.309	0	0	0	0	0	0.192082799	0.931689085	0.192467519	0	0.189921458	0	0	1.606080105	0	3.730418316	1.36757719	0	0.219324811	0	0	0	0	0	0.187156011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9257																																																																																				0			2.309	0	0	0	0	0	0.192082799	0.931689085	0.192467519	0	0.189921458	0	0	1.606080105	0	3.730418316	1.36757719	0	0.219324811	0	0	0	0	0	0.187156011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9257
H4004_035_0	2008	8																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O		V	V		V				O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		998.039497	29.46781413	0	0	0	0	334.7415217	280.6032792	289.5638959	0	160.4780587	0	307.9078622	129.053391	0	14849.31349	399.375144	0	1376.439725	0	237.8288358	0	0	0	941.7276782	0	403.5975764	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												50	50	0	0	0	0	37.40975822	25.10449673	25	0	23.73643761	0	30	30	0	10	10	0	4.937962613	0	30	0	0	0	10	0	10	0	0	0	0											4.1585	0.122782559	0	0	0	0	1.04354995	0.587033676	0.603258116	0	0.317431452	0	0.769769656	0.322633478	0	12.37442791	0.33281262	0	0.566400658	0	0.59457209	0	0	0	0.784773065	0	0.336331314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.9143	0	0	4.1585	0.122782559	0	0	0	0	1.04354995	0.587033676	0.603258116	0	0.317431452	0	0.769769656	0.322633478	0	12.37442791	0.33281262	0	0.566400658	0	0.59457209	0	0	0	0.784773065	0	0.336331314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.9143		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.1585	0.122782559	0	0	0	0	1.04354995	0.587033676	0.603258116	0	0.317431452	0	0.769769656	0.322633478	0	12.37442791	0.33281262	0	0.566400658	0	0.59457209	0	0	0	0.784773065	0	0.336331314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.9143
H4004_047_0	2008	3																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	O	T	V	V	V	V	V														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		376.3831782	0	0	0	0	36.80480412	1.937094954	815.9586263	135.2933293	92.52235577	292.392186	0	0	1120.487776	0	7962.304303	2421.730516	0	2522.9074	17091.31838	0	0	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 4a	PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-g, 14i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 14h"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a	"PBP 1a, 3, 4a-b, 5, 6, 7a-d, 7f-7i, 8a-b, 9a-d, 10a-b, 11a-c, 12, 13a-b, 14a-i, 15"											500	0	0	0	0	0.2	0.2	50	25	15	20	0	0	28.58971165	0	5	5	0	10	2.256041931	0	0	0	0	0	0	0	0	0	0	0											15.6826	0	0	0	0	7.360960823	0.387418991	3.39982761	0.281861103	0.115652945	0.48732031	0	0	2.669535203	0	3.317626793	1.009054381	0	2.102422833	3.213227578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0275			15.6826	0	0	0	0	7.360960823	0.387418991	3.39982761	0.281861103	0.115652945	0.48732031	0	0	2.669535203	0	3.317626793	1.009054381	0	2.102422833	3.213227578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0275																																																																																				0			15.6826	0	0	0	0	7.360960823	0.387418991	3.39982761	0.281861103	0.115652945	0.48732031	0	0	2.669535203	0	3.317626793	1.009054381	0	2.102422833	3.213227578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0275
H4004_048_0	2008	3																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	O	T	V	V	V	V	V														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		376.3831782	0	0	0	0	36.80480412	1.937094954	815.9586263	135.2933293	92.52235577	292.392186	0	0	1120.487776	17714.03174	7962.304303	2421.730516	0	2522.9074	17091.31838	0	0	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 4a	PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-g, 14i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 14h"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a	"PBP 1a, 3, 4a-b, 5, 6, 7a-d, 7f-7i, 8a-b, 9a-d, 10a-b, 11a-c, 12, 13a-b, 14a-i, 15"											500	0	0	0	0	0.2	0.2	50	25	15	20	0	0	28.58971165	15	5	5	0	10	2.256041931	0	0	0	0	0	0	0	0	0	0	0											15.6826	0	0	0	0	7.360960823	0.387418991	3.39982761	0.281861103	0.115652945	0.48732031	0	0	2.669535203	22.14253968	3.317626793	1.009054381	0	2.102422833	3.213227578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.1701			15.6826	0	0	0	0	7.360960823	0.387418991	3.39982761	0.281861103	0.115652945	0.48732031	0	0	2.669535203	22.14253968	3.317626793	1.009054381	0	2.102422833	3.213227578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.1701																																																																																				0			15.6826	0	0	0	0	7.360960823	0.387418991	3.39982761	0.281861103	0.115652945	0.48732031	0	0	2.669535203	22.14253968	3.317626793	1.009054381	0	2.102422833	3.213227578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.1701
H4004_049_0	2008	6																																D	D	D	V	T	O	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	O	T	V	V	V	V	V														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		604.2094576	0	0	0	0	0	1.242379601	487.6025711	100.7285143	0	104.6871758	0	0	735.008591	0	0	1848.336326	0	1967.15749	0	0	0	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b	PBP 4a	PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-g, 14i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 14h"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a	"PBP 1a, 3, 4a-b, 5, 6, 7a-d, 7f-7i, 8a-b, 9a-d, 10a-b, 11a-c, 12, 13a-b, 14a-i, 15"											50	0	0	0	0	0	0.2	25	25	0	23.73643761	0	0	28.58971165	0	0	10	0	1.506876931	0	0	0	0	0	0	0	0	0	0	0	0											2.5175	0	0	0	0	0	0.24847592	1.01583869	0.209851072	0	0.207075051	0	0	1.751140307	0	0	1.540280272	0	0.24702202	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.7372			2.5175	0	0	0	0	0	0.24847592	1.01583869	0.209851072	0	0.207075051	0	0	1.751140307	0	0	1.540280272	0	0.24702202	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.7372																																																																																				0			2.5175	0	0	0	0	0	0.24847592	1.01583869	0.209851072	0	0.207075051	0	0	1.751140307	0	0	1.540280272	0	0.24702202	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.7372
H4005_001_0	2008	5																																A	A	A	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0									339.3797567																																									$25 Copay																																		0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.70704116	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.707			0	0	0	0	0	0	0	0.70704116	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.707		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.0203	0.0831	0.4347	0.1029	0	0	0	0.0002	0	0	0.0104	0	0	0.0509	0	0.1571	0.9459	0.0442	0.1672	0	0.0115	0	0	0	0	0	0	4.3168											6.3454			0	0	0	0.020305318	0.083145533	0.434728595	0.102928323	0.70704116	0	0	0.000201669	0	0	0.010431519	0	0	0.050919174	0	0.157133571	0.945887865	0.0442054	0.167234022	0	0.01146765	0	0	0	0	0	0	4.316841065	0	0	0	0	0	0	0	0	0	0	7.0525
H4005_003_0	2008	7																																A	A	A	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0									387.4233236																																									$25 Copay																																		0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.807131924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.8071			0	0	0	0	0	0	0	0.807131924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.8071		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.0232	0.0949	0.4963	0.1175	0	0	0	0.0002	0	0	0.0119	0	0	0.0581	0	0.1794	1.2119	0.0505	0.1909	0	0.0131	0	0	0	0	0	0	4.9142											7.3621			0	0	0	0.023179797	0.094915852	0.496270016	0.11749915	0.807131924	0	0	0.000230218	0	0	0.011908234	0	0	0.058127438	0	0.179377847	1.211888769	0.050463242	0.190908147	0	0.013091043	0	0	0	0	0	0	4.914212416	0	0	0	0	0	0	0	0	0	0	8.1692
H4005_004_0	2008	11																																A	A	A	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0									383.1954897																																									$25 Copay																																		0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.798323937	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7983			0	0	0	0	0	0	0	0.798323937	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7983		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.0229	0.0939	0.4909	0.1162	0	0	0	0.0002	0	0	0.0118	0	0	0.0575	0	0.1774	1.068	0.0499	0.1888	0	0.0129	0	0	0	0	0	0	0.0712											2.3617			0	0	0	0.022926842	0.093880064	0.490854371	0.116216917	0.798323937	0	0	0.000227706	0	0	0.011778283	0	0	0.057493111	0	0.177420351	1.068007024	0.049912552	0.188824824	0	0.012948184	0	0	0	0	0	0	0.071236458	0	0	0	0	0	0	0	0	0	0	3.1601
H4005_801_0	2008	5																																A	A	A	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0									390.3743291																																									$25 Copay																																		0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.813279852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.8133			0	0	0	0	0	0	0	0.813279852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.8133		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.0518	0.0298	0	0	0	0	0	0	0	0	0.096	0	0	0.067	0	0.2147	1.0578	0.0208	0.0092	0	0.0443	0	0	0	0	0	0	4.2127											5.804			0	0	0	0.051839765	0.029751515	0	0	0.813279852	0	0	0	0	0	0.095960656	0	0	0.066993214	0	0.214693103	1.057833548	0.020776617	0.009203941	0	0.044291464	0	0	0	0	0	0	4.212683215	0	0	0	0	0	0	0	0	0	0	6.6173
H4005_802_0	2008	5																																A	A	A	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0									390.3743291																																									$25 Copay																																		0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.813279852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.8133			0	0	0	0	0	0	0	0.813279852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.8133		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.0518	0.0298	0	0	0	0	0	0	0	0	0.096	0	0	0.067	0	0.2147	1.0578	0.0208	0.0092	0	0.0443	0	0	0	0	0	0	4.2127											5.804			0	0	0	0.051839765	0.029751515	0	0	0.813279852	0	0	0	0	0	0.095960656	0	0	0.066993214	0	0.214693103	1.057833548	0.020776617	0.009203941	0	0.044291464	0	0	0	0	0	0	4.212683215	0	0	0	0	0	0	0	0	0	0	6.6173
H4005_804_0	2008	5																																A	A	A	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0									390.3743291																																									$25 Copay																																		0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.813279852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.8133			0	0	0	0	0	0	0	0.813279852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.8133		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.0518	0.0298	0	0	0	0	0	0	0	0	0.096	0	0	0.067	0	0.2147	1.0578	0.0208	0.0092	0	0.0443	0	0	0	0	0	0	4.2127											5.804			0	0	0	0.051839765	0.029751515	0	0	0.813279852	0	0	0	0	0	0.095960656	0	0	0.066993214	0	0.214693103	1.057833548	0.020776617	0.009203941	0	0.044291464	0	0	0	0	0	0	4.212683215	0	0	0	0	0	0	0	0	0	0	6.6173
H4005_805_0	2008	5																																A	A	A	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0									361.1748584																																									$25 Copay																																		0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.752447622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7524			0	0	0	0	0	0	0	0.752447622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7524		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.0439	0.0254	0	0	0	0	0	0	0	0	0.0888	0	0	0.0572	0	0.1833	0.903	0.0234	0.0079	0	0.0378	0	0	0	0	0	0	4.209											5.5796			0	0	0	0.043862006	0.025396404	0	0	0.752447622	0	0	0	0	0	0.088782929	0	0	0.057186558	0	0.183265719	0.902984879	0.023427835	0.007856642	0	0.037807954	0	0	0	0	0	0	4.208996825	0	0	0	0	0	0	0	0	0	0	6.332
H4005_806_0	2008	5																																A	A	A	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0									361.1748584																																									$25 Copay																																		0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.752447622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7524			0	0	0	0	0	0	0	0.752447622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7524		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.0439	0.0254	0	0	0	0	0	0	0	0	0.0888	0	0	0.0572	0	0.1833	0.903	0.0234	0.0079	0	0.0378	0	0	0	0	0	0	4.209											5.5796			0	0	0	0.043862006	0.025396404	0	0	0.752447622	0	0	0	0	0	0.088782929	0	0	0.057186558	0	0.183265719	0.902984879	0.023427835	0.007856642	0	0.037807954	0	0	0	0	0	0	4.208996825	0	0	0	0	0	0	0	0	0	0	6.332
H4006_001_0	2008	4																					3250											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	V	V	P	P	S	P	P	P	P	P	P	P	P	P	P																																																				0							19.92430203	10.7430761	578.5632549									422.2647135																									1a (IP Acute) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $0	11a (Medical Equip) - 10%	"11b (Med Supp), 11c (Diab Supp) - 10%"	"4a (ER) $25 (WW coverage), 4b (UC) - $25 (WW coverage); $0 if an accident or hosp. in 24 hrs"	"9a (OP Surgery), 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT) - $0, 9d (Cardiac Rehab) - $0"	"14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0; 7a (PCP), 14 (Add'l Pap, Pelvis, Prostate, Colorectal) - $0"	"7b (Chiro), 7b1 (Routine Chiro), 7d (Spec), 7f (Pod) - $0; 17a (MCR Eye Exam) - $0; 18a (MCR Hearing Exam) - $0"	"7e (MH), 7h (Psychiatric) - $10"	"7c (OT), 7i (PT/ST) - $0"	8b (Professional Radiology) - 0%		15 (Part B Rx) - $0	13a1 (Add'l Blood) - $0		16a (Preventive); 16b (Comp. Dental) - $0	17a1 (Rountine Eye Exam) - $0	17b1 (Non MCR Covered) - $200 limit	18a1 (Hearing Exam Non-covered) - $0	18b (Hearing Aids) - $200 limit																			0.099627945	0.099627945	17.5734									7.9641																									0	0	0	0	0	1.98501726	1.070310592	0.847274906	0	0	0	0	0	0	0	0	0.28024547	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1828	0	0.015620626	0	0	0	0	0	1.98501726	1.070310592	0.847274906	0	0	0	0	0	0	0	0	0.28024547	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1828																																																																																				0	0	0	0	0	0	0	0	1.98501726	1.070310592	0.847274906	0	0	0	0	0	0	0	0	0.28024547	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1828
H4006_007_0	2008	6																					3250											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	V	V	P	P	S	P	P	P	P	P	P	P	P	P	P																																																				0							19.86537232	10.71084167	578.2443918									421.8104729																									1a (IP Acute) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $0	11a (Medical Equip) - 10%	"11b (Med Supp), 11c (Diab Supp) - 10%"	"4a (ER) $25 (WW coverage), 4b (UC) - $25 (WW coverage); $0 if an accident or hosp. in 24 hrs"	"9a (OP Surgery), 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT) - $0, 9d (Cardiac Rehab) - $0"	"14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0; 7a (PCP), 14 (Add'l Pap, Pelvis, Prostate, Colorectal) - $0"	"7b (Chiro), 7b1 (Routine Chiro), 7d (Spec), 7f (Pod) - $0; 17a (MCR Eye Exam) - $0; 18a (MCR Hearing Exam) - $0"	"7e (MH), 7h (Psychiatric) - $10"	"7c (OT), 7i (PT/ST) - $0"	8b (Professional Radiology) - 0%		15 (Part B Rx) - $0	13a1 (Add'l Blood)		16a (Preventive); 16b (Comp. Dental) - $0	17a1 (Rountine Eye Exam) - $0	17b1 (Non MCR Covered) - $200 limit	18a1 (Hearing Exam Non-covered) - $0	18b (Hearing Aids) - $200 limit																			0.099629057	0.099629057	17.5461									7.957																									0	0	0	0	0	1.979168305	1.067111053	0.845493243	0	0	0	0	0	0	0	0	0.279696498	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1715	0	0.015531396	0	0	0	0	0	1.979168305	1.067111053	0.845493243	0	0	0	0	0	0	0	0	0.279696498	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1715																																																																																				0	0	0	0	0	0	0	0	1.979168305	1.067111053	0.845493243	0	0	0	0	0	0	0	0	0.279696498	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1715
H4006_008_0	2008	5																					3250											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	V	V	P	P	S	V	P	P	P	P	P	P	Coin	P	P																																																				0							23.75502387	13.38494964	660.0206853									569.4395977																									1a (IP Acute) - $0; 1a1 (Add'l Days) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $0	11a (Medical Equip) - 10%	"11b (Med Supp), 11c (Diab Supp) - 10%"	"4a (ER) $25 (WW coverage), 4b (UC) - $25 (WW coverage); $0 if an accident or hosp. in 24 hrs"	"9a (OP Surgery), 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT) - $0, 9d (Cardiac Rehab) - $0"	"14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0; 7a (PCP), 14 (Add'l Pap, Pelvis, Prostate, Colorectal) - $0"	"7b (Chiro), 7b1 (Routine Chiro), 7d (Spec), 7f (Pod) - $0; 17a (MCR Eye Exam) - $0; 18a (MCR Hearing Exam) - $0"	"7e (MH), 7h (Psychiatric) - $10"	"7c (OT), 7i (PT/ST) - $0"	8b (Professional Radiology) - 0%		15 (Part B Rx) - $0	13a1 (Add'l Blood) - $0		16a (Preventive); 16b (Comp. Dental) - $0	17a1 (Rountine Eye Exam) - $0	17b1 (Non MCR Covered) - $300 limit	18a1 (Hearing Exam Non-covered) - $0	18b (Hearing Aids) - $500 limit																			0.099532298	0.099532298	18.232									9.1585																									0	0	0	0	0	2.364392125	1.332234802	1.002794105	0	0	0	0	0	0	0	0	0.434601657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.134	0	0.024124737	0	0	0	0	0	2.364392125	1.332234802	1.002794105	0	0	0	0	0	0	0	0	0.434601657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.134																																																																																				0	0	0	0	0	0	0	0	2.364392125	1.332234802	1.002794105	0	0	0	0	0	0	0	0	0.434601657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.134
H4006_013_0	2008	6																					3250											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	V	V	P	P	S	V	P	P	P	P	P	P	P	P	P																																																				0							13.6566821	7.108846005																																			1a (IP Acute) - $0; 1a1 (Add'l Days) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $0	11a (Medical Equip) - 10%	"11b (Med Supp), 11c (Diab Supp) - 10%"	"4a (ER) $0 (WW coverage), 4b (UC) - $0 (WW coverage)"	"9a (OP Surgery), 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT) - $0, 9d (Cardiac Rehab) - $0"	"14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0; 7a (PCP), 14 (Add'l Pap, Pelvis, Prostate, Colorectal) - $0"	"7b (Chiro), 7b1 (Routine Chiro), 7d (Spec), 7f (Pod) - $0; 17a (MCR Eye Exam) - $0; 18a (MCR Hearing Exam) - $0"	"7e (MH), 7h (Psychiatric) - $0"	"7c (OT), 7i (PT/ST) - $0"	8b (Professional Radiology) - 0%		15 (Part B Rx) - $0	13a1 (Add'l Blood) - $0		"16a (Preventive), 16b (Comp. Dental) -  $0"	17a1 (Rountine Eye Exam) - $0	17b1 (Non MCR Covered) - $100 limit	18a1 (Hearing Exam Non-covered) - $0	18b (Hearing Aids) - $200 limit																			0.099781471	0.099781471																																			0	0	0	0	0	1.362683831	0.709331112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.072	0	0.004537867	0	0	0	0	0	1.362683831	0.709331112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.072																																																																																				0	0	0	0	0	0	0	0	1.362683831	0.709331112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.072
H4006_015_0	2008	4																					3250											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	V	V	P	P	S	V	P	P	P	P	P	P	P	P	P																																																				0							20.62749449	10.737431																																			1a (IP Acute) - $0; 1a1 (Add'l Days) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $0	11a (Medical Equip) - 10%	"11b (Med Supp), 11c (Diab Supp) - 10%"	"4a (ER) $0 (WW coverage), 4b (UC) - $0 (WW coverage)"	"9a (OP Surgery), 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT) - $0, 9c (OP SA) - $10, 9d (Cardiac Rehab) - $0"	"14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0; 7a (PCP), 14 (Add'l Pap, Pelvis, Prostate, Colorectal) - $0"	"7b (Chiro), 7d (Spec), 7f (Pod) - $0; 17a (MCR Eye Exam) - $0; 18a (MCR Hearing Exam) - $0"	"7e (MH), 7h (Psychiatric) - $0"	"7c (OT), 7i (PT/ST) - $0"	8b (Professional Radiology) - 0%		15 (Part B Rx) - $0			16a (Preventive); 16b (Comp. Dental)																							0.1	0.1																																			0	0	0	0	0	2.062749449	1.0737431	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.1365	0	0	0	0	0	0	0	2.062749449	1.0737431	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.1365																																																																																				0	0	0	0	0	0	0	0	2.062749449	1.0737431	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.1365
H4006_018_0	2008	6																					3250											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	V	V	P	P	S	V	P	P	P	P	P	P	P	P	P																																																				0							19.59611977	10.20055945																																			1a (IP Acute) - $0; 1a1 (Add'l Days) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $0	11a (Medical Equip) - 10%	"11b (Med Supp), 11c (Diab Supp) - 10%"	"4a (ER) $0 (WW coverage), 4b (UC) - $0 (WW coverage)"	"9a (OP Surgery), 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT) - $0, 9d (Cardiac Rehab) - $0"	"14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0; 7a (PCP), 14 (Add'l Pap, Pelvis, Prostate, Colorectal) - $0"	"7b (Chiro), 7b1 (Routine Chiro) 7d (Spec), 7f (Pod) - $0; 17a (MCR Eye Exam) - $0; 18a (MCR Hearing Exam) - $0"	"7e (MH), 7h (Psychiatric) - $0"	"7c (OT), 7i (PT/ST) - $0"	8b (Professional Radiology) - 0%		15 (Part B Rx) - $0	13a1 (Add'l Blood) - $0		16a (Preventive); 16b (Comp. Dental) - $0	17a1 (Rountine Eye Exam) - $0	17b1 (Non MCR Covered) - $100 limit	18a1 (Hearing Exam Non-covered) - $0	18b (Hearing Aids) - $200 limit																			0.099736847	0.099736847																																			0	0	0	0	0	1.9544552	1.017371638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.9718	0	0.007841083	0	0	0	0	0	1.9544552	1.017371638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.9718																																																																																				0	0	0	0	0	0	0	0	1.9544552	1.017371638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.9718
H4006_020_0	2008	7																					3250											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	V	V	P	P	S	P	P	P	P	P	P	P	P	P	P																																																				0							17.57509605	9.552352012	333.8397563									316.5605143																									1a (IP Acute) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $0	11a (Medical Equip) - 10%	"11b (Med Supp), 11c (Diab Supp) - 10%"	"4a (ER) $25 (WW coverage), 4b (UC) - $25 (WW coverage); $0 if an accident or hosp. in 24 hrs"	"9a (OP Surgery), 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT) - $0, 9d (Cardiac Rehab) - $0"	"14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0; 7a (PCP), 14 (Add'l Pap, Pelvis, Prostate, Colorectal) - $0"	"7b (Chiro), 7b1 (Routine Chiro), 7d (Spec), 7f (Pod) - $0; 17a (MCR Eye Exam) - $0; 18a (MCR Hearing Exam) - $0"	"7e (MH), 7h (Psychiatric) - $10"	"7c (OT), 7i (PT/ST) - $0"	8b (Professional Radiology) - 0%		15 (Part B Rx) - $0	13a1 (Add'l Blood)		16a (Preventive); 16b (Comp. Dental) - $0	17a1 (Rountine Eye Exam) - $0	17b1 (Non MCR Covered) - $200 limit	18a1 (Hearing Exam Non-covered) - $0	18b (Hearing Aids) - $200 limit																			0.099686552	0.099686552	22.6557									7.6423																									0	0	0	0	0	1.752000727	0.952241036	0.630280138	0	0	0	0	0	0	0	0	0.201603571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.5361	0	0.011118764	0	0	0	0	0	1.752000727	0.952241036	0.630280138	0	0	0	0	0	0	0	0	0.201603571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.5361																																																																																				0	0	0	0	0	0	0	0	1.752000727	0.952241036	0.630280138	0	0	0	0	0	0	0	0	0.201603571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.5361
H4006_803_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	Coin	P	P																																																				0		117.6521006	1.414119155	1.477367829		3.022844658	23.82370233	13.4227061	7.21148856	15.04153207	1.470935773	5.467891812	0.347963993	0.304599129	6.615016954	60.36693401	105.6230868	4.040032009		24.76062299	26.48138186	12.18647264	0.103230163																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.159621234	0.159621234	0.160407733		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234	0.234	0.234																				18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504	0	0	18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504																																																																																				0	0	0	18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504
H4006_804_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	Coin	P	P																																																				0		117.6521006	1.414119155	1.477367829		3.022844658	23.82370233	13.4227061	7.21148856	15.04153207	1.470935773	5.467891812	0.347963993	0.304599129	6.615016954	60.36693401	105.6230868	4.040032009		24.76062299	26.48138186	12.18647264	0.103230163																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.159621234	0.159621234	0.160407733		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234	0.234	0.234																				18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504	0	0	18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504																																																																																				0	0	0	18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504
H4006_805_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	Coin	P	P																																																				0		117.6521006	1.414119155	1.477367829		3.022844658	23.82370233	13.4227061	7.21148856	15.04153207	1.470935773	5.467891812	0.347963993	0.304599129	6.615016954	60.36693401	105.6230868	4.040032009		24.76062299	26.48138186	12.18647264	0.103230163																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.159621234	0.159621234	0.160407733		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234	0.234	0.234																				18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504	0	0	18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504																																																																																				0	0	0	18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504
H4006_806_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	Coin	P	P																																																				0		117.6521006	1.414119155	1.477367829		3.022844658	23.82370233	13.4227061	7.21148856	15.04153207	1.470935773	5.467891812	0.347963993	0.304599129	6.615016954	60.36693401	105.6230868	4.040032009		24.76062299	26.48138186	12.18647264	0.103230163																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.159621234	0.159621234	0.160407733		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234	0.234	0.234																				18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504	0	0	18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504																																																																																				0	0	0	18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504
H4006_807_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	Coin	P	P																																																				0		117.6521006	1.414119155	1.477367829		3.022844658	23.82370233	13.4227061	7.21148856	15.04153207	1.470935773	5.467891812	0.347963993	0.304599129	6.615016954	60.36693401	105.6230868	4.040032009		24.76062299	26.48138186	12.18647264	0.103230163																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.159621234	0.159621234	0.160407733		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234	0.234	0.234																				18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504	0	0	18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504																																																																																				0	0	0	18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504
H4006_808_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	Coin	P	P																																																				0		117.6521006	1.414119155	1.477367829		3.022844658	23.82370233	13.4227061	7.21148856	15.04153207	1.470935773	5.467891812	0.347963993	0.304599129	6.615016954	60.36693401	105.6230868	4.040032009		24.76062299	26.48138186	12.18647264	0.103230163																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.159621234	0.159621234	0.160407733		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234	0.234	0.234																				18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504	0	0	18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504																																																																																				0	0	0	18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504
H4006_809_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	Coin	P	P																																																				0		117.6521006	1.414119155	1.477367829		3.022844658	23.82370233	13.4227061	7.21148856	15.04153207	1.470935773	5.467891812	0.347963993	0.304599129	6.615016954	60.36693401	105.6230868	4.040032009		24.76062299	26.48138186	12.18647264	0.103230163																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.159621234	0.159621234	0.160407733		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234	0.234	0.234																				18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504	0	0	18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504																																																																																				0	0	0	18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504
H4006_811_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	Coin	P	P																																																				0		117.6521006	1.414119155	1.477367829		3.022844658	23.82370233	13.4227061	7.21148856	15.04153207	1.470935773	5.467891812	0.347963993	0.304599129	6.615016954	60.36693401	105.6230868	4.040032009		24.76062299	26.48138186	12.18647264	0.103230163																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.159621234	0.159621234	0.160407733		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234	0.234	0.234																				18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504	0	0	18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504																																																																																				0	0	0	18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504
H4006_813_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	Coin	P	P																																																				0		117.6521006	1.414119155	1.477367829		3.022844658	23.82370233	13.4227061	7.21148856	15.04153207	1.470935773	5.467891812	0.347963993	0.304599129	6.615016954	60.36693401	105.6230868	4.040032009		24.76062299	26.48138186	12.18647264	0.103230163																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.159621234	0.159621234	0.160407733		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234	0.234	0.234																				18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504	0	0	18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504																																																																																				0	0	0	18.7798	0.225723444	0.236981224	0	0.70734565	5.574746346	3.140913228	1.687488323	3.519718504	0.344198971	1.279486684	0.081423574	0.071276196	1.547913967	14.12586256	24.7158023	0.94536749	0	5.793985779	6.196643355	2.851634598	0.024155858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8504
H4007_002_0	2008	2	s.										Health & Education (Non-Covered)										0											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0										0	0	297.74032	0	2.226273	165.215424	129.296131	17.216025	8.643682	955.998891	134.83209	13884.486	3259.154724		7.217735	2358.994385	6144.677872	4357.259829	1.361553	2586.625246			8.41596			2.15	2.72		0.08			0.08	0.02	3.4										$60/Admit	$60/Admit	$0/Day(Days 1-100) $0(Days 100-100)	$0/Visit	$0/Trip	0% Coins	0% Coins	$50/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0-$10/Visit	$0/Visit	$10/Visit	$0-$10/Visit	$0/Visit			0% Coins			Puerto Rico Dental	Puerto Rico Vision		Puerto Rico Hearing			Active Outlook Newsletter	Quit Net	Silver Sneakers										60	60	0	0	0	0	0	50.000003	0	0	0		0	0	0	10	1.709812	0			0			0	0		0			0	0	0										1.4887	0	0	0	0	0	0	3.983328951	0	0	0	0	0	0	0	3.631049858	0.000194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.1033	0	0	1.4887	0	0	0	0	0	0	3.983328951	0	0	0	0	0	0	0	3.631049858	0.000194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.1033	0																																																																																			0	0	0	1.4887	0	0	0	0	0	0	3.983328951	0	0	0	0	0	0	0	3.631049858	0.000194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.1033
H4007_005_0	2008	3	s.										Health & Education (Non-Covered)										0											A	A	A	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0										0	0	292.407054	0	0.18136	162.256006	126.980118	16.604802	8.336803	938.874588	132.416912	13635.7805	3200.775201		7.088449	2316.738959	6034.611489	4279.210524	1.337162	2540.292388			8.117167			2.15	2.72		0.08			0.08	0.02	3.4										$60/Admit	$60/Admit	$0/Admit(Days 1-100) $0(Days 100-100)	$0/Visit	$0/Trip	0% Coins	0% Coins	$25/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0-$10/Visit	$0/Visit	$10/Visit	$0-$10/Visit	$0/Visit			0% Coins			Puerto Rico Dental	Puerto Rico Vision		Puerto Rico Hearing			Active Outlook Newsletter	Quit Net	Silver Sneakers										60	60	0	0	0	0	0	25.000003	0	0	0		0	0	0	10	1.714078	0			0			0	0		0			0	0	0										1.462	0	0	0	0	0	0	1.95598896	0	0	0	0	0	0	0	3.56600877	0.000191	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.9842	0	0	1.462	0	0	0	0	0	0	1.95598896	0	0	0	0	0	0	0	3.56600877	0.000191	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.9842	0																																																																																			0	0	0	1.462	0	0	0	0	0	0	1.95598896	0	0	0	0	0	0	0	3.56600877	0.000191	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.9842
H4007_008_0	2008	3	s.	t.	u.								OP Facility - Other	Professional	Health & Education (Non-Covered)								0	Other	Mental Health (MH)									A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	V	V	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0								0	0	295	0	2.147992	159.406109	124.749814	16.026631	8.04652	922.384007	130.091117	13396.27895	3144.55615		6.963946	0	5928.618375	4204.049621	0.224832	2495.674189			7.834531			2.15	2.72		0.08			0.08	0.02	2276.047297	1.088844	3.4								$60/Admit	$60/Admit	$0/Day(Days 1-100) $0(Days 100-100)	$0/Visit	$0/Trip	0% Coins	0% Coins	$25/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$10/Visit	$0/Visit	$10/Visit	$10/Visit	$0/Visit			0% Coins			Puerto Rico Dental	Puerto Rico Vision		Puerto Hearing			Active Outlook Newsletter	Quit Net	$0/Visit	$0/Visit	Silver Sneakers								60	60	0	0	0	0	0	24.999995	0	0	0		0	0	0	9.999998	9.980785	0			0			0	0		0			0	0	0	0	0								1.475	0	0	0	0	0	0	1.921632964	0	0	0	0	0	0	0	3.503373983	0.000187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.9002	0	0	1.475	0	0	0	0	0	0	1.921632964	0	0	0	0	0	0	0	3.503373983	0.000187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.9002	0																																																																																			0	0	0	1.475	0	0	0	0	0	0	1.921632964	0	0	0	0	0	0	0	3.503373983	0.000187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.9002
H4007_010_0	2008	4	s.										Health & Education (Non-Covered)										0											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O		O										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0		0										0	0	266.334971	0	1.991448	147.788667	115.658107	13.775718	6.916399	855.16109	120.610136	12419.96437	2915.38236		6.456416	2110.17003	5496.543428	3897.660442	1.217937	2313.790616			6.734185			3	2.72		0.08			0.08		3.4										$75/Admit	$75/Admit	$0/Day(Days 1-100) $0(Days 100-100)	$0/Visit	$10/Trip	0% Coins	0% Coins	$40/Visit	$0/Visit	$0/Visit	$0-$15/Visit		$0/Proc	$0-$5/Visit	$0/Visit	$5/Visit	$0-$5/Visit	$0/Visit			0% Coins			Puerto Rico Dental	Puerto Rico Vision		Puerto Rico Hearing			Active Outlook Newsletter		Silver Sneakers										75	75	0	0	10.000025	0	0	40	0	0	1.643022		0	0	0	4.999999	0.857187	0			0			0	0		0			0		0										1.6646	0	0	0	0.096381997	0	0	2.850536967	0	0	0.39916978	0	0	0	0	1.624024859	8.70E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.6348	0	0	1.6646	0	0	0	0.096381997	0	0	2.850536967	0	0	0.39916978	0	0	0	0	1.624024859	8.70E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.6348	0																																																																																			0	0	0	1.6646	0	0	0	0.096381997	0	0	2.850536967	0	0	0.39916978	0	0	0	0	1.624024859	8.70E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.6348
H4007_801_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		283.437944	0	2.119331	157.279068	123.08521	15.601779	7.833214	910.076138	128.355239	13217.52513	3102.596631		6.871022	2245.676764	5849.509607	4147.95271	1.296147	2462.373055			7.626845																					$100/Admit	$100/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$25/Trip	20% Coins	20% Coins	$30/Visit	$75/Visit	$30-$35/Visit	$25-$30/Visit		$0-$25/Proc	$15-$25/Visit	$5/Visit	$15/Visit	$15-$25/Visit	$25/Visit			20% Coins																					100	100	28.944983	0	25.000046	0.2	0.2	29.999995	74.999977	34.830109	26.95287		16.968654	24.809135	5	14.999997	23.284395	25			0.2																					2.362	0	0.005112	0	0.256427993	3.1203558	1.5666428	2.275189966	0.802219998	38.36398676	6.968656971	0	0.009716	4.642774834	2.43729567	5.184939851	0.002515	5.129943865	0	0	1.525369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6531	0	0	2.362	0	0.005112	0	0.256427993	3.1203558	1.5666428	2.275189966	0.802219998	38.36398676	6.968656971	0	0.009716	4.642774834	2.43729567	5.184939851	0.002515	5.129943865	0	0	1.525369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6531																																																																																				0	0	0	2.362	0	0.005112	0	0.256427993	3.1203558	1.5666428	2.275189966	0.802219998	38.36398676	6.968656971	0	0.009716	4.642774834	2.43729567	5.184939851	0.002515	5.129943865	0	0	1.525369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6531
H4007_802_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		283.437944	0	2.119331	157.279068	123.08521	15.601779	7.833214	910.076138	128.355239	13217.52513	3102.596631		6.871022	2245.676764	5849.509607	4147.95271	1.296147	2462.373055			7.626845																					$100/Admit	$100/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$25/Trip	20% Coins	20% Coins	$30/Visit	$75/Visit	$30-$35/Visit	$25-$30/Visit		$0-$25/Proc	$15-$25/Visit	$5/Visit	$15/Visit	$15-$25/Visit	$25/Visit			20% Coins																					100	100	28.944983	0	25.000046	0.2	0.2	29.999995	74.999977	34.830109	26.95287		16.968654	24.809135	5	14.999997	23.284395	25			0.2																					2.362	0	0.005112	0	0.256427993	3.1203558	1.5666428	2.275189966	0.802219998	38.36398676	6.968656971	0	0.009716	4.642774834	2.43729567	5.184939851	0.002515	5.129943865	0	0	1.525369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6531	0	0	2.362	0	0.005112	0	0.256427993	3.1203558	1.5666428	2.275189966	0.802219998	38.36398676	6.968656971	0	0.009716	4.642774834	2.43729567	5.184939851	0.002515	5.129943865	0	0	1.525369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6531																																																																																				0	0	0	2.362	0	0.005112	0	0.256427993	3.1203558	1.5666428	2.275189966	0.802219998	38.36398676	6.968656971	0	0.009716	4.642774834	2.43729567	5.184939851	0.002515	5.129943865	0	0	1.525369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6531
H4007_803_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		283.437944	0	2.119331	157.279068	123.08521	15.601779	7.833214	910.076138	128.355239	13217.52513	3102.596631		6.871022	2245.676764	5849.509607	4147.95271	1.296147	2462.373055			7.626845																					$100/Admit	$100/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$25/Trip	20% Coins	20% Coins	$30/Visit	$75/Visit	$30-$35/Visit	$25-$30/Visit		$0-$25/Proc	$15-$25/Visit	$5/Visit	$15/Visit	$15-$25/Visit	$25/Visit			20% Coins																					100	100	28.944983	0	25.000046	0.2	0.2	29.999995	74.999977	34.830109	26.95287		16.968654	24.809135	5	14.999997	23.284395	25			0.2																					2.362	0	0.005112	0	0.256427993	3.1203558	1.5666428	2.275189966	0.802219998	38.36398676	6.968656971	0	0.009716	4.642774834	2.43729567	5.184939851	0.002515	5.129943865	0	0	1.525369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6531	0	0	2.362	0	0.005112	0	0.256427993	3.1203558	1.5666428	2.275189966	0.802219998	38.36398676	6.968656971	0	0.009716	4.642774834	2.43729567	5.184939851	0.002515	5.129943865	0	0	1.525369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6531																																																																																				0	0	0	2.362	0	0.005112	0	0.256427993	3.1203558	1.5666428	2.275189966	0.802219998	38.36398676	6.968656971	0	0.009716	4.642774834	2.43729567	5.184939851	0.002515	5.129943865	0	0	1.525369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6531
H4007_804_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		283.437944	0	2.119331	157.279068	123.08521	15.601779	7.833214	910.076138	128.355239	13217.52513	3102.596631		6.871022	2245.676764	5849.509607	4147.95271	1.296147	2462.373055			7.626845																					$100/Admit	$100/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$25/Trip	20% Coins	20% Coins	$30/Visit	$75/Visit	$30-$35/Visit	$25-$30/Visit		$0-$25/Proc	$15-$25/Visit	$5/Visit	$15/Visit	$15-$25/Visit	$25/Visit			20% Coins																					100	100	28.944983	0	25.000046	0.2	0.2	29.999995	74.999977	34.830109	26.95287		16.968654	24.809135	5	14.999997	23.284395	25			0.2																					2.362	0	0.005112	0	0.256427993	3.1203558	1.5666428	2.275189966	0.802219998	38.36398676	6.968656971	0	0.009716	4.642774834	2.43729567	5.184939851	0.002515	5.129943865	0	0	1.525369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6531	0	0	2.362	0	0.005112	0	0.256427993	3.1203558	1.5666428	2.275189966	0.802219998	38.36398676	6.968656971	0	0.009716	4.642774834	2.43729567	5.184939851	0.002515	5.129943865	0	0	1.525369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6531																																																																																				0	0	0	2.362	0	0.005112	0	0.256427993	3.1203558	1.5666428	2.275189966	0.802219998	38.36398676	6.968656971	0	0.009716	4.642774834	2.43729567	5.184939851	0.002515	5.129943865	0	0	1.525369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6531
H4008_001_0	2008	9	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									0											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	203.509875	4.395547	491.034101	40.595065	123.130087	8.758326	4.351621	290.661848	253.269044	4359.909918	2845.928589		8.275893	1015.968297	6817.079632	5062.553122	55.221688	1218.798885			7.63933									0.08		3.38	0.02									$175/Admit	$175/Admit	$0/Day(Days 1-100) $0(Days 100-100)	$0/Visit	$15/Trip	0% Coins	0% Coins	$35/Visit	$0-$10/Visit	$0/Visit	$0-$10/Visit		$0-$10/Proc	$10/Visit	$0/Visit	$10/Visit	$10/Visit	$10/Visit			0% Coins									Active Outlook Newsletter		Silver Sneakers	Missing Description									175	175	0	0	15.000038	0	0	35.000011	6.440044	0	9.999999		0	10.00002	0	9.999999	9.999984	10.000002			0									0		0	0									2.9679	0.064101727	0	0	0.153912999	0	0	0.84776399	0.135921982	0	2.37160692	0	0	0.846641941	0	4.218793846	0.046018	1.015665941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.6683	0	0	2.9679	0.064101727	0	0	0.153912999	0	0	0.84776399	0.135921982	0	2.37160692	0	0	0.846641941	0	4.218793846	0.046018	1.015665941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.6683	0																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	2.9679	0.064101727	0	0	0.153912999	0	0	0.84776399	0.135921982	0	2.37160692	0	0	0.846641941	0	4.218793846	0.046018	1.015665941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.6683
H4008_801_0	2008	2																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		219.755513	4.746432	530.232013	43.83566	132.959224	10.212435	5.074102	313.86459	273.486822	4707.949624	3073.1113		8.936536	1097.070272	7361.268489	5466.682917	59.629885	1316.092273			8.907656																					$100/Admit	$100/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$25/Trip	20% Coins	20% Coins	$30/Visit	$75/Visit	$30-$35/Visit	$25-$30/Visit		$0-$25/Proc	$15-$25/Visit	$5/Visit	$15/Visit	$15-$25/Visit	$25/Visit			20% Coins																					100	100	27.773129	0	23.988541	0.191908	0.191908	28.786272	71.965698	32.02205	24.040359		23.988854	23.021805	4.797714	14.393143	18.832439	23.988575			0.191908																					1.8313	0.0395536	1.227183508	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4668	0	1.768703779	1.8313	0.0395536	1.227183508	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4668																																											0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	1.8313	0.0395536	1.227183508	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4668
H4008_802_0	2008	2																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		219.755513	4.746432	530.232013	43.83566	132.959224	10.212435	5.074102	313.86459	273.486822	4707.949624	3073.1113		8.936536	1097.070272	7361.268489	5466.682917	59.629885	1316.092273			8.907656																					$100/Admit	$100/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$25/Trip	20% Coins	20% Coins	$30/Visit	$75/Visit	$30-$35/Visit	$25-$30/Visit		$0-$25/Proc	$15-$25/Visit	$5/Visit	$15/Visit	$15-$25/Visit	$25/Visit			20% Coins																					100	100	27.773129	0	23.988541	0.191908	0.191908	28.786272	71.965698	32.02205	24.040359		23.988854	23.021805	4.797714	14.393143	18.832439	23.988575			0.191908																					1.8313	0.0395536	1.227183508	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4668	0	1.768703779	1.8313	0.0395536	1.227183508	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4668																																											0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	1.8313	0.0395536	1.227183508	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4668
H4008_803_0	2008	2																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		219.755513	4.746432	530.232013	43.83566	132.959224	10.212435	5.074102	313.86459	273.486822	4707.949624	3073.1113		8.936536	1097.070272	7361.268489	5466.682917	59.629885	1316.092273			8.907656																					$100/Admit	$100/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$25/Trip	20% Coins	20% Coins	$30/Visit	$75/Visit	$30-$35/Visit	$25-$30/Visit		$0-$25/Proc	$15-$25/Visit	$5/Visit	$15/Visit	$15-$25/Visit	$25/Visit			20% Coins																					100	100	27.773129	0	23.988541	0.191908	0.191908	28.786272	71.965698	32.02205	24.040359		23.988854	23.021805	4.797714	14.393143	18.832439	23.988575			0.191908																					1.8313	0.0395536	1.227183508	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4668	0	1.768703779	1.8313	0.0395536	1.227183508	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4668																																											0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	1.8313	0.0395536	1.227183508	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4668
H4008_804_0	2008	2																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		219.755513	4.746432	530.232013	43.83566	132.959224	10.212435	5.074102	313.86459	273.486822	4707.949624	3073.1113		8.936536	1097.070272	7361.268489	5466.682917	59.629885	1316.092273			8.907656																					$100/Admit	$100/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$25/Trip	20% Coins	20% Coins	$30/Visit	$75/Visit	$30-$35/Visit	$25-$30/Visit		$0-$25/Proc	$15-$25/Visit	$5/Visit	$15/Visit	$15-$25/Visit	$25/Visit			20% Coins																					100	100	27.773129	0	23.988541	0.191908	0.191908	28.786272	71.965698	32.02205	24.040359		23.988854	23.021805	4.797714	14.393143	18.832439	23.988575			0.191908																					1.8313	0.0395536	1.227183508	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4668	0	1.768703779	1.8313	0.0395536	1.227183508	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4668																																											0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	1.8313	0.0395536	1.227183508	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4668
H4008_805_0	2008	2																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																							0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0				26.5	44	132.959224	10.212435	5.074102	313.86459	273.486822	4707.949624	3073.1113		8.936536	1097.070272	7361.268489	5466.682917	59.629885	1316.092273			8.907656																							None	None	$25/Trip	20% Coins	20% Coins	$30/Visit	$75/Visit	$30-$35/Visit	$25-$30/Visit		$0-$25/Proc	$15-$25/Visit	$5/Visit	$15/Visit	$15-$25/Visit	$25/Visit			20% Coins																							0	0	23.988541	0.191908	0.191908	28.786272	71.965698	32.02205	24.040359		23.988854	23.021805	4.797714	14.393143	18.832439	23.988575			0.191908																					0	0	0	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3687	0	1.768703779	0	0	0	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3687																																													0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	0	0	0	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3687
H4008_806_0	2008	2																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																							0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0				26.5	44	132.959224	10.212435	5.074102	313.86459	273.486822	4707.949624	3073.1113		8.936536	1097.070272	7361.268489	5466.682917	59.629885	1316.092273			8.907656																							None	None	$25/Trip	20% Coins	20% Coins	$30/Visit	$75/Visit	$30-$35/Visit	$25-$30/Visit		$0-$25/Proc	$15-$25/Visit	$5/Visit	$15/Visit	$15-$25/Visit	$25/Visit			20% Coins																							0	0	23.988541	0.191908	0.191908	28.786272	71.965698	32.02205	24.040359		23.988854	23.021805	4.797714	14.393143	18.832439	23.988575			0.191908																					0	0	0	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3687	0	1.768703779	0	0	0	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3687																																													0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	0	0	0	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3687
H4008_807_0	2008	2																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																							0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0				26.5	44	132.959224	10.212435	5.074102	313.86459	273.486822	4707.949624	3073.1113		8.936536	1097.070272	7361.268489	5466.682917	59.629885	1316.092273			8.907656																							None	None	$25/Trip	20% Coins	20% Coins	$30/Visit	$75/Visit	$30-$35/Visit	$25-$30/Visit		$0-$25/Proc	$15-$25/Visit	$5/Visit	$15/Visit	$15-$25/Visit	$25/Visit			20% Coins																							0	0	23.988541	0.191908	0.191908	28.786272	71.965698	32.02205	24.040359		23.988854	23.021805	4.797714	14.393143	18.832439	23.988575			0.191908																					0	0	0	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3687	0	1.768703779	0	0	0	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3687																																													0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	0	0	0	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3687
H4008_808_0	2008	2																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																							0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0				26.5	44	132.959224	10.212435	5.074102	313.86459	273.486822	4707.949624	3073.1113		8.936536	1097.070272	7361.268489	5466.682917	59.629885	1316.092273			8.907656																							None	None	$25/Trip	20% Coins	20% Coins	$30/Visit	$75/Visit	$30-$35/Visit	$25-$30/Visit		$0-$25/Proc	$15-$25/Visit	$5/Visit	$15/Visit	$15-$25/Visit	$25/Visit			20% Coins																							0	0	23.988541	0.191908	0.191908	28.786272	71.965698	32.02205	24.040359		23.988854	23.021805	4.797714	14.393143	18.832439	23.988575			0.191908																					0	0	0	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3687	0	1.768703779	0	0	0	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3687																																													0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	0	0	0	0	0.265791483	1.959847976	0.973760767	0.752915955	1.64013917	12.56318319	6.156558242	0	0.017864771	2.104711489	2.943105074	6.556895747	0.093581348	2.630931516	0	0	1.709450448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3687
H4009_002_0	2008	7																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1088.60683	20.82920873	687.7644398	1839.716293	188.6407184	22097.18769	22403.98554	207.1823462	212.6084456	1625.958151	659.1791126	0	45.56683395	456.1920023	8885.965927	17446.51446	1.209373841	455.2891678	3649.939569	12819.23402	307.9231475	955.0611631	9000	2643.987586	458.7533314	316.9062977	196.6085706	20.98908715	0	0	30413.6787											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	20% coinsurance	20% coinsurance	$35 copay	$0 copay	0-10% copay	10% coinsurance	$0 copay	$0 copay	$0-$10 copay	$0 copay	$0 copay	20% coinsurance	$10 copay	$0 copay	$0-10 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0.818750527	0.585044553	35	0	2.557557874	19.79485277	0	0	5.027677347	0	0	0.2	10	0	0.445568223	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	1.507673671	1.092277475	0.604281843	0	0.346540173	1.08736279	0	0	0.191132183	0	0	0.241874768	0.37940764	0	0.475986943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.9265			0	0	0	0	0	1.507673671	1.092277475	0.604281843	0	0.346540173	1.08736279	0	0	0.191132183	0	0	0.241874768	0.37940764	0	0.475986943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.9265																																																																																				0			0	0	0	0	0	1.507673671	1.092277475	0.604281843	0	0.346540173	1.08736279	0	0	0.191132183	0	0	0.241874768	0.37940764	0	0.475986943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.9265
H4009_003_0	2008	11																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	Coin	Coin	Coin	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1090.423416	20.96468063	676.3135702	1839.429679	189.0478258	22155.13174	22460.26503	206.6524475	212.5645889	1584.754303	637.1254866	0	45.53446441	455.432538	7754.226129	11520.18796	1.19660879	3.488595503	21.76878897	12895.80864	307.2629851	956.4619674	9000	1532.534463	434.4151907	316.9095075	196.9075646	20.98118684	0	0	24409.17631											"$25 copay, days 1-5"	"$25 copay, days 1-5"	"$5 copay, days 8-100"	$0 copay	20% copay	20% copay	20% copay	$35 copay	20% copay	$5 copay	20% copay	$0 copay	$0 copay	20% copay	$5 copay	$10 copay	50% coinsurance	20% coinsurance	20% coinsurance	0-20% copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											16.18714232	16.18714232	1.519246998	0	58.91927955	0.818654651	0.584788738	35	182.7924139	8.950242552	39.68295015	0	0	49.80912796	4.997951557	10.02130712	0.5	0.2	0.2	4.312356252	0	0	0	0	0	0	0	0	0	0	0											1.4709	0.028279856	0.085623947	0	0.928213475	1.511450137	1.094542504	0.602736305	3.237932859	1.181994616	2.106918244	0	0	1.890391464	3.22960388	9.620611805	0.598304395	0.697719101	4.353757795	4.63427675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.2733			1.4709	0.028279856	0.085623947	0	0.928213475	1.511450137	1.094542504	0.602736305	3.237932859	1.181994616	2.106918244	0	0	1.890391464	3.22960388	9.620611805	0.598304395	0.697719101	4.353757795	4.63427675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.2733																																																																																				0			1.4709	0.028279856	0.085623947	0	0.928213475	1.511450137	1.094542504	0.602736305	3.237932859	1.181994616	2.106918244	0	0	1.890391464	3.22960388	9.620611805	0.598304395	0.697719101	4.353757795	4.63427675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.2733
H4009_004_0	2008	7																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1091.322732	21.00603008	685.135731	1834.727739	188.9380399	22143.55852	22448.22129	210.4209873	212.2598433	1621.600476	675.2999131	0	45.46819102	454.7508558	8896.0157	17453.04563	174.1163084	466.7545473	3651.297641	12935.12443	306.7966966	956.0313852	9000	2643.987586	434.2338057	316.7426151	196.8383353	20.96873004	0	0	42413.2746											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$25 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 to $10 copay	$0 copay	$0 copay	$0 copay	$5 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	25	0	0	0	0	0	4.740688481	0	0	0	5	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.438377057	0	0	0	0	0	0.179652679	0	0	0	0.194481061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.8125			0	0	0	0	0	0	0	0.438377057	0	0	0	0	0	0.179652679	0	0	0	0.194481061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.8125																																																																																				0			0	0	0	0	0	0	0	0.438377057	0	0	0	0	0	0.179652679	0	0	0	0.194481061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.8125
H4009_006_0	2008	9																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1251.271482	24.9886317	754.0823422	2063.707328	216.0873093	25413.35969	25741.85872	247.5473893	238.3425406	1807.036864	751.4981452	0	50.85977182	504.9653855	10120.74783	19748.06539	198.689874	558.0696057	4110.24328	14937.2657	339.4156157	1087.071184	9000	2643.987586	522.4504839	356.2430813	223.9073502	23.51466049	0	0	30463.62465											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H4009_007_0	2008	9																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1110.284357	17.05781464	846.3700693	2067.723741	195.3217411	22475.33224	22884.7529	270.0873689	241.0335825	1906.150129	798.5957992	0	52.5474051	542.917869	9454.905862	19076.50193	181.2529258	483.6559347	4063.192124	12588.57417	372.1681116	1016.900438	9000	2643.987586	487.2926365	355.2443574	208.8397014	23.84720647	0	0	42469.36959											$0 copay	$0 copay	$5 copay days 8-100	$0 copay	$0 copay	$5 copay	$5 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0-$5 copay	$0 copay	$0 copay	$0 copay	$5 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	3.793411653	5	0	3.678666087	2.257164368	0	0	0	0	0	0	4.753355796	0	0	0	5	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0.267552507	0.861551559	0	6.889936874	4.304554069	0	0	0	0	0	0	0.215056817	0	0	0	0.201523306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.7402			0	0	0.267552507	0.861551559	0	6.889936874	4.304554069	0	0	0	0	0	0	0.215056817	0	0	0	0.201523306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.7402																																																																																				0			0	0	0.267552507	0.861551559	0	6.889936874	4.304554069	0	0	0	0	0	0	0.215056817	0	0	0	0.201523306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.7402
H4009_008_0	2008	6																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O	O	O	O	O	O	O	O	O	O	O	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1099.818062	21.45985107	680.3557377	1838.331334	190.2821512	22329.60539	22629.96618	214.6542086	212.4067595	1618.156899	673.5274137	0	45.43507445	453.1947398	8942.897985	17512.13221	175.130188	490.9124143	3653.839401	13066.16509	305.3313935	960.647114	0	3237.28996	461.548968	316.980116	197.8067006	20.96229464	0	0	42413.2219											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$15 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.268317761	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.2683			0	0	0	0	0	0	0	0.268317761	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.2683																																																																																				0			0	0	0	0	0	0	0	0.268317761	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.2683
H4009_009_0	2008	8																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1236.646128	24.17263581	762.9487636	2055.745771	213.9235655	25108.07399	25444.8115	194.4543627	238.5888972	1813.523901	754.3143566	0	51.02628776	508.7879466	8646.243069	12192.899	196.8782946	527.961147	4099.324029	14613.1989	342.72618	1079.726484	9000	2643.987586	518.7723264	356.086375	222.330997	23.54513551	0	0	30464.14457											$0 copay	$0 copay	$3 copay days 8-100	$3 copay	$0 copay	$3 copay	$0-$3 copay	75% copay	$0 copay	$0-$1.50 copay	$1.50 copay	$0 copay	$0 copay	$0-$3 copay	0-75% copay	0-75% copay	$0 copay	$3 copay	$0-$1.50 copay	$0-$3 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	2.276046992	3	0	3	1.815880841	127.7640844	0	1.12015671	1.5	0	0	2.843688057	1.245620086	3.673994687	0	3	0.728790285	1.131994685	0	0	0	0	0	0	0	0	0	0	0											0	0	0.144708937	0.513936443	0	6.277018498	3.850395475	2.070356967	0	0.169285914	0.094289295	0	0	0.120569517	0.897494503	3.733053846	0	0.131990287	0.248962294	1.37850529	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.6306			0	0	0.144708937	0.513936443	0	6.277018498	3.850395475	2.070356967	0	0.169285914	0.094289295	0	0	0.120569517	0.897494503	3.733053846	0	0.131990287	0.248962294	1.37850529	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.6306																																																																																				0			0	0	0.144708937	0.513936443	0	6.277018498	3.850395475	2.070356967	0	0.169285914	0.094289295	0	0	0.120569517	0.897494503	3.733053846	0	0.131990287	0.248962294	1.37850529	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.6306
H4011_001_0	2008	7																																							V																																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	277.3076344	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.577724238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5777	0	0	0	0	0	0	0	0	0	0.577724238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5777		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.7599	0	0.0106	0.4376	0.2838	0.9716	0.0444	0.102	0.1928	0.0591	0.1696	0	0	0.183	1.1187	1.5585	0.1019	0.1131	0.5404	1.719	0.48	0.6104	0	0.2952	0.09	0	0.0254	0	0	0	0											9.8671	0	0	0.7599	0	0.010638178	0.43760136	0.283822584	0.971591342	0.044418712	0.679675574	0.192775994	0.059079619	0.169595947	0	0	0.182992317	1.118656465	1.558543048	0.101856373	0.113053323	0.540434883	1.719046159	0.480003617	0.610389801	0	0.295234066	0.0900421	0	0.025421813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.4448
H4011_003_0	2008	8																																							V																																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	277.3076344	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.577724238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5777	0	0	0	0	0	0	0	0	0	0.577724238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5777		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.7599	0	0.0106	0.4376	0.2838	0.9716	0.0444	0.102	0.1928	0.0591	0.1696	0	0	0.183	1.1187	1.5585	0.1019	0.1131	0.5404	1.719	0.48	0.6104	0	0.704	0.09	0	0.0254	0	0	0	0											10.2758	0	0	0.7599	0	0.010638178	0.43760136	0.283822584	0.971591342	0.044418712	0.679675574	0.192775994	0.059079619	0.169595947	0	0	0.182992317	1.118656465	1.558543048	0.101856373	0.113053323	0.540434883	1.719046159	0.480003617	0.610389801	0	0.703979055	0.0900421	0	0.025421813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8535
H4011_004_0	2008	9																																							V																																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	277.3076344	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.577724238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5777	0	0	0	0	0	0	0	0	0	0.577724238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5777		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.7599	0	0.0106	0.4376	0.2838	0.9716	0.0444	0.102	0.1928	0.0591	0.1696	0	0	0.183	1.1187	1.5585	0.1019	0.1131	0.5404	1.719	0.48	0.6104	0	0.8526	0.09	0	0.0254	0	0	0	0											10.4244	0	0	0.7599	0	0.010638178	0.43760136	0.283822584	0.971591342	0.044418712	0.679675574	0.192775994	0.059079619	0.169595947	0	0	0.182992317	1.118656465	1.558543048	0.101856373	0.113053323	0.540434883	1.719046159	0.480003617	0.610389801	0	0.852613597	0.0900421	0	0.025421813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.0022
H4011_801_0	2008	3																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		66.13502746	0	1.09826875	0	7.639557873	26.15200028	1.195603678	3.398519803	5.461986493	1.673922534	4.805218493	0	0	5.184782325	30.53830954	38.92814967	1.096653615	3.043018622	14.5467056	50.55503068	13.0163743	16.42965881	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.158323905	0	0.154771225	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											10.4708	0	0.1699804	0	1.787656542	6.119568065	0.279771261	0.795253634	1.278104839	0.391697873	1.124421127	0	0	1.213239064	7.145964433	9.109187023	0.256616946	0.712066357	3.403929111	11.82987718	3.045831587	3.844540161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9785	0	0	10.4708	0	0.1699804	0	1.787656542	6.119568065	0.279771261	0.795253634	1.278104839	0.391697873	1.124421127	0	0	1.213239064	7.145964433	9.109187023	0.256616946	0.712066357	3.403929111	11.82987718	3.045831587	3.844540161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9785		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												1.8478	0	0.03	0	0.3321	1.1368	0.052	0.1403	0.2255	0.0691	0.1984	0	0	0.2141	1.263	1.6921	0.0477	0.1323	0.6323	2.1975	0.5616	0.7142	0	0	0	0	0	0	0	0	0											11.4868	0	0	12.3185	0	0.199976941	0	2.119728965	7.256329935	0.331741154	0.935592511	1.503652752	0.460821027	1.322848385	0	0	1.427340075	8.409001939	10.80129607	0.304285728	0.844338746	4.036237924	14.02737758	3.607435819	4.558696228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4652
H4011_802_0	2008	3																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		66.13502746	0	1.09826875	0	7.639557873	26.15200028	1.195603678	3.398519803	5.461986493	1.673922534	4.805218493	0	0	5.184782325	30.53830954	38.92814967	1.096653615	3.043018622	14.5467056	50.55503068	13.0163743	16.42965881	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.158323905	0	0.154771225	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											10.4708	0	0.1699804	0	1.787656542	6.119568065	0.279771261	0.795253634	1.278104839	0.391697873	1.124421127	0	0	1.213239064	7.145964433	9.109187023	0.256616946	0.712066357	3.403929111	11.82987718	3.045831587	3.844540161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9785	0	0	10.4708	0	0.1699804	0	1.787656542	6.119568065	0.279771261	0.795253634	1.278104839	0.391697873	1.124421127	0	0	1.213239064	7.145964433	9.109187023	0.256616946	0.712066357	3.403929111	11.82987718	3.045831587	3.844540161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9785		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												1.8478	0	0.03	0	0.3321	1.1368	0.052	0.1403	0.2255	0.0691	0.1984	0	0	0.2141	1.263	1.6921	0.0477	0.1323	0.6323	2.1975	0.5616	0.7142	0	0	0	0	0	0	0	0	0											11.4868	0	0	12.3185	0	0.199976941	0	2.119728965	7.256329935	0.331741154	0.935592511	1.503652752	0.460821027	1.322848385	0	0	1.427340075	8.409001939	10.80129607	0.304285728	0.844338746	4.036237924	14.02737758	3.607435819	4.558696228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4652
H4011_803_0	2008	3																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		66.13502746	0	1.09826875	0	7.639557873	26.15200028	1.195603678	3.398519803	5.461986493	1.673922534	4.805218493	0	0	5.184782325	30.53830954	38.92814967	1.096653615	3.043018622	14.5467056	50.55503068	13.0163743	16.42965881	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.158323905	0	0.154771225	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											10.4708	0	0.1699804	0	1.787656542	6.119568065	0.279771261	0.795253634	1.278104839	0.391697873	1.124421127	0	0	1.213239064	7.145964433	9.109187023	0.256616946	0.712066357	3.403929111	11.82987718	3.045831587	3.844540161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9785	0	0	10.4708	0	0.1699804	0	1.787656542	6.119568065	0.279771261	0.795253634	1.278104839	0.391697873	1.124421127	0	0	1.213239064	7.145964433	9.109187023	0.256616946	0.712066357	3.403929111	11.82987718	3.045831587	3.844540161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9785		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												1.8478	0	0.03	0	0.3321	1.1368	0.052	0.1403	0.2255	0.0691	0.1984	0	0	0.2141	1.263	1.6921	0.0477	0.1323	0.6323	2.1975	0.5616	0.7142	0	0	0	0	0	0	0	0	0											11.4868	0	0	12.3185	0	0.199976941	0	2.119728965	7.256329935	0.331741154	0.935592511	1.503652752	0.460821027	1.322848385	0	0	1.427340075	8.409001939	10.80129607	0.304285728	0.844338746	4.036237924	14.02737758	3.607435819	4.558696228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4652
H4011_805_0	2008	3																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		66.13502746	0	1.09826875	0	7.639557873	26.15200028	1.195603678	3.398519803	5.461986493	1.673922534	4.805218493	0	0	5.184782325	30.53830954	38.92814967	1.096653615	3.043018622	14.5467056	50.55503068	13.0163743	16.42965881	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.158323905	0	0.154771225	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											10.4708	0	0.1699804	0	1.787656542	6.119568065	0.279771261	0.795253634	1.278104839	0.391697873	1.124421127	0	0	1.213239064	7.145964433	9.109187023	0.256616946	0.712066357	3.403929111	11.82987718	3.045831587	3.844540161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9785	0	0	10.4708	0	0.1699804	0	1.787656542	6.119568065	0.279771261	0.795253634	1.278104839	0.391697873	1.124421127	0	0	1.213239064	7.145964433	9.109187023	0.256616946	0.712066357	3.403929111	11.82987718	3.045831587	3.844540161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9785		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												1.8478	0	0.03	0	0.3321	1.1368	0.052	0.1403	0.2255	0.0691	0.1984	0	0	0.2141	1.263	1.6921	0.0477	0.1323	0.6323	2.1975	0.5616	0.7142	0	0	0	0	0	0	0	0	0											11.4868	0	0	12.3185	0	0.199976941	0	2.119728965	7.256329935	0.331741154	0.935592511	1.503652752	0.460821027	1.322848385	0	0	1.427340075	8.409001939	10.80129607	0.304285728	0.844338746	4.036237924	14.02737758	3.607435819	4.558696228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4652
H4011_806_0	2008	3																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		66.13502746	0	1.09826875	0	7.639557873	26.15200028	1.195603678	3.398519803	5.461986493	1.673922534	4.805218493	0	0	5.184782325	30.53830954	38.92814967	1.096653615	3.043018622	14.5467056	50.55503068	13.0163743	16.42965881	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.158323905	0	0.154771225	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											10.4708	0	0.1699804	0	1.787656542	6.119568065	0.279771261	0.795253634	1.278104839	0.391697873	1.124421127	0	0	1.213239064	7.145964433	9.109187023	0.256616946	0.712066357	3.403929111	11.82987718	3.045831587	3.844540161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9785	0	0	10.4708	0	0.1699804	0	1.787656542	6.119568065	0.279771261	0.795253634	1.278104839	0.391697873	1.124421127	0	0	1.213239064	7.145964433	9.109187023	0.256616946	0.712066357	3.403929111	11.82987718	3.045831587	3.844540161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9785		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												1.8478	0	0.03	0	0.3321	1.1368	0.052	0.1403	0.2255	0.0691	0.1984	0	0	0.2141	1.263	1.6921	0.0477	0.1323	0.6323	2.1975	0.5616	0.7142	0	0	0	0	0	0	0	0	0											11.4868	0	0	12.3185	0	0.199976941	0	2.119728965	7.256329935	0.331741154	0.935592511	1.503652752	0.460821027	1.322848385	0	0	1.427340075	8.409001939	10.80129607	0.304285728	0.844338746	4.036237924	14.02737758	3.607435819	4.558696228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4652
H4011_807_0	2008	3																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		66.13502746	0	1.09826875	0	7.639557873	26.15200028	1.195603678	3.398519803	5.461986493	1.673922534	4.805218493	0	0	5.184782325	30.53830954	38.92814967	1.096653615	3.043018622	14.5467056	50.55503068	13.0163743	16.42965881	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.158323905	0	0.154771225	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											10.4708	0	0.1699804	0	1.787656542	6.119568065	0.279771261	0.795253634	1.278104839	0.391697873	1.124421127	0	0	1.213239064	7.145964433	9.109187023	0.256616946	0.712066357	3.403929111	11.82987718	3.045831587	3.844540161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9785	0	0	10.4708	0	0.1699804	0	1.787656542	6.119568065	0.279771261	0.795253634	1.278104839	0.391697873	1.124421127	0	0	1.213239064	7.145964433	9.109187023	0.256616946	0.712066357	3.403929111	11.82987718	3.045831587	3.844540161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9785		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												1.8478	0	0.03	0	0.3321	1.1368	0.052	0.1403	0.2255	0.0691	0.1984	0	0	0.2141	1.263	1.6921	0.0477	0.1323	0.6323	2.1975	0.5616	0.7142	0	0	0	0	0	0	0	0	0											11.4868	0	0	12.3185	0	0.199976941	0	2.119728965	7.256329935	0.331741154	0.935592511	1.503652752	0.460821027	1.322848385	0	0	1.427340075	8.409001939	10.80129607	0.304285728	0.844338746	4.036237924	14.02737758	3.607435819	4.558696228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4652
H4011_809_0	2008	3																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		66.13502746	0	1.09826875	0	7.639557873	26.15200028	1.195603678	3.398519803	5.461986493	1.673922534	4.805218493	0	0	5.184782325	30.53830954	38.92814967	1.096653615	3.043018622	14.5467056	50.55503068	13.0163743	16.42965881	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.158323905	0	0.154771225	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											10.4708	0	0.1699804	0	1.787656542	6.119568065	0.279771261	0.795253634	1.278104839	0.391697873	1.124421127	0	0	1.213239064	7.145964433	9.109187023	0.256616946	0.712066357	3.403929111	11.82987718	3.045831587	3.844540161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9785	0	0	10.4708	0	0.1699804	0	1.787656542	6.119568065	0.279771261	0.795253634	1.278104839	0.391697873	1.124421127	0	0	1.213239064	7.145964433	9.109187023	0.256616946	0.712066357	3.403929111	11.82987718	3.045831587	3.844540161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9785		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												1.8478	0	0.03	0	0.3321	1.1368	0.052	0.1403	0.2255	0.0691	0.1984	0	0	0.2141	1.263	1.6921	0.0477	0.1323	0.6323	2.1975	0.5616	0.7142	0	0	0	0	0	0	0	0	0											11.4868	0	0	12.3185	0	0.199976941	0	2.119728965	7.256329935	0.331741154	0.935592511	1.503652752	0.460821027	1.322848385	0	0	1.427340075	8.409001939	10.80129607	0.304285728	0.844338746	4.036237924	14.02737758	3.607435819	4.558696228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4652
H4011_810_0	2008	3																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		66.13502746	0	1.09826875	0	7.639557873	26.15200028	1.195603678	3.398519803	5.461986493	1.673922534	4.805218493	0	0	5.184782325	30.53830954	38.92814967	1.096653615	3.043018622	14.5467056	50.55503068	13.0163743	16.42965881	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.158323905	0	0.154771225	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											10.4708	0	0.1699804	0	1.787656542	6.119568065	0.279771261	0.795253634	1.278104839	0.391697873	1.124421127	0	0	1.213239064	7.145964433	9.109187023	0.256616946	0.712066357	3.403929111	11.82987718	3.045831587	3.844540161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9785	0	0	10.4708	0	0.1699804	0	1.787656542	6.119568065	0.279771261	0.795253634	1.278104839	0.391697873	1.124421127	0	0	1.213239064	7.145964433	9.109187023	0.256616946	0.712066357	3.403929111	11.82987718	3.045831587	3.844540161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9785		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												1.8478	0	0.03	0	0.3321	1.1368	0.052	0.1403	0.2255	0.0691	0.1984	0	0	0.2141	1.263	1.6921	0.0477	0.1323	0.6323	2.1975	0.5616	0.7142	0	0	0	0	0	0	0	0	0											11.4868	0	0	12.3185	0	0.199976941	0	2.119728965	7.256329935	0.331741154	0.935592511	1.503652752	0.460821027	1.322848385	0	0	1.427340075	8.409001939	10.80129607	0.304285728	0.844338746	4.036237924	14.02737758	3.607435819	4.558696228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4652
H4011_811_0	2008	3																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		66.13502746	0	1.09826875	0	7.639557873	26.15200028	1.195603678	3.398519803	5.461986493	1.673922534	4.805218493	0	0	5.184782325	30.53830954	38.92814967	1.096653615	3.043018622	14.5467056	50.55503068	13.0163743	16.42965881	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.158323905	0	0.154771225	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											10.4708	0	0.1699804	0	1.787656542	6.119568065	0.279771261	0.795253634	1.278104839	0.391697873	1.124421127	0	0	1.213239064	7.145964433	9.109187023	0.256616946	0.712066357	3.403929111	11.82987718	3.045831587	3.844540161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9785	0	0	10.4708	0	0.1699804	0	1.787656542	6.119568065	0.279771261	0.795253634	1.278104839	0.391697873	1.124421127	0	0	1.213239064	7.145964433	9.109187023	0.256616946	0.712066357	3.403929111	11.82987718	3.045831587	3.844540161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9785		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												1.8478	0	0.03	0	0.3321	1.1368	0.052	0.1403	0.2255	0.0691	0.1984	0	0	0.2141	1.263	1.6921	0.0477	0.1323	0.6323	2.1975	0.5616	0.7142	0	0	0	0	0	0	0	0	0											11.4868	0	0	12.3185	0	0.199976941	0	2.119728965	7.256329935	0.331741154	0.935592511	1.503652752	0.460821027	1.322848385	0	0	1.427340075	8.409001939	10.80129607	0.304285728	0.844338746	4.036237924	14.02737758	3.607435819	4.558696228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4652
H4012_001_0	2008	8																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0							6.496355172	0.970731659	599.3858121																																							10% Coins	10% Coins	$25 Copay																																		0	0	0	0	0	0.1	0.1	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0.649635517	0.097073166	1.248720442	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.9954			0	0	0	0	0	0.649635517	0.097073166	1.248720442	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.9954		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			0	0	0	0	0	0.649635517	0.097073166	1.248720442	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.9954
H4012_003_0	2008	7																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0							6.053750582	0.904594528	496.4879349																																							10% Coin	10% Coin	$5 Copay																																		0	0	0	0	0	0.1	0.1	5	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0.605375058	0.090459453	0.206869973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9027			0	0	0	0	0	0.605375058	0.090459453	0.206869973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9027		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			0	0	0	0	0	0.605375058	0.090459453	0.206869973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9027
H4012_004_0	2008	7																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0							6.496355172	0.970731659	599.3858121																																							10% Coin	10% Coin	$5 Copay																																		0	0	0	0	0	0.1	0.1	5	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0.649635517	0.097073166	0.249744088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9965			0	0	0	0	0	0.649635517	0.097073166	0.249744088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9965		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			0	0	0	0	0	0.649635517	0.097073166	0.249744088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9965
H4012_005_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0							6.459098699	0.965164531	595.948346																																							10% Coin	10% Coin	$25 Copay																																		0	0	0	0	0	0.1	0.1	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0.64590987	0.096516453	1.241559054	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.984			0	0	0	0	0	0.64590987	0.096516453	1.241559054	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.984		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			0	0	0	0	0	0.64590987	0.096516453	1.241559054	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.984
H4036_001_0	2008	4	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			D	D	D	D	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V		S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	1211.140969	83.75029749	237.1808425	0.001104849	72.31156937	10.42129639	3.903130895	290.3154311	392.6631759	691.1224061	944.2404847	45.78135683	0.880410708	0.001104849	4369.999781	1741.871066	29.75627352	553.1394133	635.4933954		338.8932405				407.8741486	392.2213394	178.9855126					855.5391058	17.60821417	194.0066495	345.9050376	122.1360044	0.054217879	634.4899288	2.425083119			$175/day (1-5) with $1750 yearly max	$175/day (1-5) with $1750 yearly max	$75/day for days 21 to 100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$175 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$175 copay	$15/$25 copay for in-home/facility	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$50/$100 copay for Lower/Higher Tier		$15/$22.50/$40/$100 copay levels				$50 max w/specialist copay	$75 yearly max	$50 max w/specialist copay					$25 copay	$50 copay	$25 copay	$25 copay	$10 copay	20% coinsurance	$25 copay	$25 copay			108.9359271	91.55391555	74.78464556	0	74.78464556	0.199425721	0.199425721	49.85643037	174.4975063	51.69826029	60.92014173	174.4975063	24.92821519	24.92821519	9.971286075	24.92821519	24.92821519	24.92821519	58.17779559		33.27209542				24.92821519	0	24.92821519					24.92821519	49.85643037	24.92821519	24.92821519	9.971286075	0.199425721	24.92821519	24.92821519			10.9947	0.638972305	1.47812377	0	0.45064959	2.078274552	0.778384695	1.206174256	5.709895418	2.977485503	4.793605346	0.665727717	0.001828922	2.30E-06	3.63120983	3.618478063	0.061814232	1.14906486	3.080967071	0	0.939640686	0	0	0	0.847297879	0	0.371815781	0	0	0	0	1.777255244	0.073156892	0.403019959	0.718566268	0.101487753	0.01081244	1.318058457	0.005037749	0	0	49.8815		0.143641927	10.9947	0.638972305	1.47812377	0	0.45064959	2.078274552	0.778384695	1.206174256	5.709895418	2.977485503	4.793605346	0.665727717	0.001828922	2.30E-06	3.63120983	3.618478063	0.061814232	1.14906486	3.080967071	0	0.939640686	0	0	0	0.847297879	0	0.371815781	0	0	0	0	1.777255244	0.073156892	0.403019959	0.718566268	0.101487753	0.01081244	1.318058457	0.005037749	0	0	49.8815	4000	$250/day (1-5) with no yearly max	$250/day (1-5) with no yearly max	20% coinsurance	$0 copay	$75 copay	30% coinsurance	30% coinsurance	$50 copay	$250 copay	20% coinsurance	20% coinsurance	$250 copay	$15/$25 copay for in-home/facility	$35 copay	$15 copay	$35 copay	$35 copay	$35 copay	20% coinsurance	0	$15/$22.50/$40/$100 copay levels	0	0	0	$50 max w/specialist copay	$75 yearly max	$50 max w/specialist copay	0	0	0	0	$35 copay	20% coinsurance	$35 copay	$35 copay	$15 copay	20% coinsurance	$35 copay	$35 copay	0	0	5.034661096	0.176268222	0.573651603	0	0.732305585	0.893515014	0.025518246	0.284397418	1.778626936	0.353897034	0.861874739	0.004572306	0.024690451	3.21E-06	0.042866668	0.171833055	0.002561537	0.007694017	0.477176041	0	0.015225215	0	0	0	0.484511181	0	3.21E-06	0	0	0	0	0.263090473	0.018024905	0.006411681	0.025005557	0.050835472	0.001699805	0	0.001923504	0	0	12.3128		0.035456819	16.0294	0.815240528	2.051775373	0	1.182955175	2.971789566	0.803902941	1.490571674	7.488522354	3.331382537	5.655480085	0.670300023	0.026519373	5.51E-06	3.674076499	3.790311119	0.064375769	1.156758878	3.558143112	0	0.954865901	0	0	0	1.33180906	0	0.371818994	0	0	0	0	2.040345717	0.091181797	0.40943164	0.743571824	0.152323225	0.012512244	1.318058457	0.006961254	0	0	62.1944
H4036_801_0	2008	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	221.0085027	1.580276849	48.91901401	17.52275552	5.000014586	15.56697461	0.764739242	5.359345535	27.42154625	10.75888196	28.92911711	0	0.177332521	28.47298783	28.02041119	80.4145147	0.927117386	3.078167717	19.09900176	26.54732157	7.885062262	4.128626046	0	0	0	0	0	0	0	0	0											Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											0.08193997	0.08193997	0.173583455	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											18.1094	0.129487838	8.491531479	0	1.170003413	3.642672059	0.178948983	1.254086855	6.416641822	2.517578378	6.769413403	0	0.04149581	6.662679152	6.556776218	18.81699644	0.216945468	0.720291246	4.469166412	6.212073246	1.845104569	0.966098495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.1874	0	0	18.1094	0.129487838	8.491531479	0	1.170003413	3.642672059	0.178948983	1.254086855	6.416641822	2.517578378	6.769413403	0	0.04149581	6.662679152	6.556776218	18.81699644	0.216945468	0.720291246	4.469166412	6.212073246	1.845104569	0.966098495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.1874	none	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											2.5714	0.0197	0.9223	0	0.1966	0.6475	0.0292	0.1383	0.7	0.276	0.742	0	0.0066	0.7262	1.1256	3.0184	0.0339	0.1142	0.7513	0.9789	0.2012	0.1508	0	0	0	0	0	0	0	0	0											13.3501	0	0	20.6808	0.149196023	9.413807772	0	1.366569728	4.290143952	0.208162615	1.392411846	7.116592911	2.79355432	7.511383246	0	0.04810318	7.388914883	7.682420375	21.83538557	0.250842019	0.834514043	5.220442873	7.190990083	2.046352611	1.116876357	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.5375
H4036_802_0	2008	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	221.0085027	1.580276849	48.91901401	17.52275552	5.000014586	15.56697461	0.764739242	5.359345535	27.42154625	10.75888196	28.92911711	0	0.177332521	28.47298783	28.02041119	80.4145147	0.927117386	3.078167717	19.09900176	26.54732157	7.885062262	4.128626046	0	0	0	0	0	0	0	0	0											Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											0.08193997	0.08193997	0.173583455	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											18.1094	0.129487838	8.491531479	0	1.170003413	3.642672059	0.178948983	1.254086855	6.416641822	2.517578378	6.769413403	0	0.04149581	6.662679152	6.556776218	18.81699644	0.216945468	0.720291246	4.469166412	6.212073246	1.845104569	0.966098495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.1874	0	0	18.1094	0.129487838	8.491531479	0	1.170003413	3.642672059	0.178948983	1.254086855	6.416641822	2.517578378	6.769413403	0	0.04149581	6.662679152	6.556776218	18.81699644	0.216945468	0.720291246	4.469166412	6.212073246	1.845104569	0.966098495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.1874	none	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											2.5714	0.0197	0.9223	0	0.1966	0.6475	0.0292	0.1383	0.7	0.276	0.742	0	0.0066	0.7262	1.1256	3.0184	0.0339	0.1142	0.7513	0.9789	0.2012	0.1508	0	0	0	0	0	0	0	0	0											13.3501	0	0	20.6808	0.149196023	9.413807772	0	1.366569728	4.290143952	0.208162615	1.392411846	7.116592911	2.79355432	7.511383246	0	0.04810318	7.388914883	7.682420375	21.83538557	0.250842019	0.834514043	5.220442873	7.190990083	2.046352611	1.116876357	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.5375
H4102_001_0	2008	6																					3950											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2348.261672	138.9525734	1562.256875		368.369019	10.67107052	1.8791172	669.518355	35.49988309	13690.98647	57.61347264		0.347695287	36.93000626	4469.727283	6395.825289	541.3324221	3.399379485			16.66876804	1520.383172			250.7194694		19.75221912															$250 (1a); $0 (1a1)	$250 (1b)	"$140 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	20% (9b)	20% (8a1); $0/$14 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											155.3015	155.3015	86.9688		108.711	0.186361746	0.271333255	31.0603	0.124241164	3.4788	0.068825798		0.186361746	0.124227041	10	25	37.5	0.124241164			0.186361746	25			25		25															30.3907	1.798294731	11.32230238	0	3.337147597	1.988679329	0.509866986	1.732952908	4.410546789	3.968962882	3.96529324	0	0.064797101	4.587705391	3.724772736	13.32463602	1.691663819	0.422342863	0	0	3.106420709	3.167464941	0	0	0.522332228	0	0.041150457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.078	0	43.4044491	30.3907	1.798294731	11.32230238	0	3.337147597	1.988679329	0.509866986	1.732952908	4.410546789	3.968962882	3.96529324	0	0.064797101	4.587705391	3.724772736	13.32463602	1.691663819	0.422342863	0	0	3.106420709	3.167464941	0	0	0.522332228	0	0.041150457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.078																																																																																				0			30.3907	1.798294731	11.32230238	0	3.337147597	1.988679329	0.509866986	1.732952908	4.410546789	3.968962882	3.96529324	0	0.064797101	4.587705391	3.724772736	13.32463602	1.691663819	0.422342863	0	0	3.106420709	3.167464941	0	0	0.522332228	0	0.041150457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.078
H4102_025_0	2008	5																					3350											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1986.098076	134.7968368	1348.495877		295.3406873	9.100534579	2.177690122	572.3535869	30.80520077	11876.63482	53.3726609		0.18070324	36.53789453	3863.983688	5668.219143	537.4002909	3.208974806			13.97284469	1346.552178			161.1790298		17.76102646															$250 (1a); $0 (1a1)	$250 (1b)	"$140 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20% (9b)	20% (8a1); $0/$13 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	$0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											154.101	154.101	86.2966		107.8707	0.184921238	0.282064521	30.8202	0.123280825	3.2053	0.07039319		0.184921238	0.123253194	10	20	37.5	0.123280825			0.184921238	20			20		20															25.505	1.731027634	9.697548273	0	2.654884436	1.682882121	0.614249121	1.470004637	3.797690576	3.172349577	3.757071838	0	0.033415867	4.503412218	3.219986406	9.447031905	1.679375909	0.395605063	0	0	2.58387574	2.244253629	0	0	0.268631716	0	0.029601711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4879	0	37.98910724	25.505	1.731027634	9.697548273	0	2.654884436	1.682882121	0.614249121	1.470004637	3.797690576	3.172349577	3.757071838	0	0.033415867	4.503412218	3.219986406	9.447031905	1.679375909	0.395605063	0	0	2.58387574	2.244253629	0	0	0.268631716	0	0.029601711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4879																																																																																				0			25.505	1.731027634	9.697548273	0	2.654884436	1.682882121	0.614249121	1.470004637	3.797690576	3.172349577	3.757071838	0	0.033415867	4.503412218	3.219986406	9.447031905	1.679375909	0.395605063	0	0	2.58387574	2.244253629	0	0	0.268631716	0	0.029601711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4879
H4102_801_0	2008	2																					5475											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1672.708492	140.9026492	1066.005354		244.1366977	8.382714146	3.789025078	595.1218656	42.72887008	14855.24944	59.704717		0.059617971	47.62547966	4469.073703	6523.104498	538.8734265	5.237230686			20.21483262	1684.54297			269.4970574		20.40154605															$380 (1a); $0 (1a1)	$380 (1b)	"$140 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											264.9555	264.9555	97.6152		122.019	0.209175369	0.265407633	34.8626	0.139450246	4.1835	0.078563953		0.209175369	0.139410618	25	34.5682	37.5	0.139450246			0.209175369	35			35		35															36.9328	3.111077274	8.671524681	0	2.482442269	1.753457325	1.005636179	1.728956053	5.958551444	5.178920471	4.690638578	0	0.012470611	6.639497549	9.310570215	18.79098311	1.683979458	0.730333107	0	0	4.228445072	4.913250328	0	0	0.786033084	0	0.059504509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.669	0	35.78663957	36.9328	3.111077274	8.671524681	0	2.482442269	1.753457325	1.005636179	1.728956053	5.958551444	5.178920471	4.690638578	0	0.012470611	6.639497549	9.310570215	18.79098311	1.683979458	0.730333107	0	0	4.228445072	4.913250328	0	0	0.786033084	0	0.059504509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.669																																																																																				0			36.9328	3.111077274	8.671524681	0	2.482442269	1.753457325	1.005636179	1.728956053	5.958551444	5.178920471	4.690638578	0	0.012470611	6.639497549	9.310570215	18.79098311	1.683979458	0.730333107	0	0	4.228445072	4.913250328	0	0	0.786033084	0	0.059504509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.669
H4102_802_0	2008	3																					5475											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1672.708492	140.9026492	1066.005354		244.1366977	8.382714146	3.789025078	595.1218656	42.72887008	14855.24944	59.704717		0.059617971	47.62547966	4469.073703	6523.104498	538.8734265	5.237230686			20.21483262	1684.54297			269.4970574		20.40154605															$380 (1a); $0 (1a1)	$380 (1b)	"$140 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											264.9555	264.9555	97.6152		122.019	0.209175369	0.265407633	34.8626	0.139450246	4.1835	0.078563953		0.209175369	0.139410618	25	34.5682	37.5	0.139450246			0.209175369	35			35		35															36.9328	3.111077274	8.671524681	0	2.482442269	1.753457325	1.005636179	1.728956053	5.958551444	5.178920471	4.690638578	0	0.012470611	6.639497549	9.310570215	18.79098311	1.683979458	0.730333107	0	0	4.228445072	4.913250328	0	0	0.786033084	0	0.059504509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.669	0	35.78663957	36.9328	3.111077274	8.671524681	0	2.482442269	1.753457325	1.005636179	1.728956053	5.958551444	5.178920471	4.690638578	0	0.012470611	6.639497549	9.310570215	18.79098311	1.683979458	0.730333107	0	0	4.228445072	4.913250328	0	0	0.786033084	0	0.059504509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.669																																																																																				0			36.9328	3.111077274	8.671524681	0	2.482442269	1.753457325	1.005636179	1.728956053	5.958551444	5.178920471	4.690638578	0	0.012470611	6.639497549	9.310570215	18.79098311	1.683979458	0.730333107	0	0	4.228445072	4.913250328	0	0	0.786033084	0	0.059504509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.669
H4106_001_0	2008	3																					1100											D	D	D	V	T	V	P	V	V	Coin	V	V	V	V	V		V	S		V	S	P	T		V	P	V																																																								0		2159.499402	305.7564871	1073.145572		434.3601737	3375.469697	1687.396275	757.9034236	402.1465723	8.950068498	198.8010223	73.96527624	42.61989876	3782.881354		3633.206716		985.2383627				705.641833					0.093111446															1(a) $110 per Day	1(b) $110 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per preocedure; other $0 per procedure	8(b) X-rays $0 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a), 9(d) $25 per visit; 9(c) $0/0 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  $0 per script	"13, 14(a)-(j) $0; 17(a), 16(b) $10 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															58.573	58.573	22.3642		39.9362	11.1454	15.9223	23.8286	13.3121	0.346371232	5.3248	13.3121	132.1179	13.3121		5.3248		5.3248				5.3248					5.3248															10.5407	1.492423638	2.000007767	0	1.445556315	3.135068762	2.238942043	1.504979771	0.446116344	3.100046249	0.088214986	0.082052468	0.469237702	4.196492805	0	1.612181236	0	0.437184814	0	0	0	0.313118028	0	0	0	0	4.13E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1024	0	29.06379324	10.5407	1.492423638	2.000007767	0	1.445556315	3.135068762	2.238942043	1.504979771	0.446116344	3.100046249	0.088214986	0.082052468	0.469237702	4.196492805	0	1.612181236	0	0.437184814	0	0	0	0.313118028	0	0	0	0	4.13E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1024																																																																																				0	0	0	10.5407	1.492423638	2.000007767	0	1.445556315	3.135068762	2.238942043	1.504979771	0.446116344	3.100046249	0.088214986	0.082052468	0.469237702	4.196492805	0	1.612181236	0	0.437184814	0	0	0	0.313118028	0	0	0	0	4.13E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1024
H4106_002_0	2008	6																					2500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2082.450776	142.8162761	935.2546875		289.0464366	11.34276251	19.69892142	449.7337238	425.085128	3563.844266	468.352532	71.37496102	16.0211799	2994.772059		4089.490854	402.8214013	588.4121074				727.8065042					0.077061507															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															129.1469	129.1469	30.9953		55.3487	0.147596511	0.147596511	30.4418	55.3487	14.7597	48.1637	55.3487	112.9405	53.5125		18.4496	14.7597	14.7597				18.4496					18.4496															22.4118	1.537023837	2.415705751	0	1.333195172	1.67415217	2.907492068	1.14089127	1.960658803	4.383424823	1.879799078	0.329209225	0.150786665	13.35481345	0	6.287443553	0.495458611	0.723729783	0	0	0	1.118976048	0	0	0	0	0.000118479	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1047	0	22.7600996	22.4118	1.537023837	2.415705751	0	1.333195172	1.67415217	2.907492068	1.14089127	1.960658803	4.383424823	1.879799078	0.329209225	0.150786665	13.35481345	0	6.287443553	0.495458611	0.723729783	0	0	0	1.118976048	0	0	0	0	0.000118479	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1047																																																																																				0	0	0	22.4118	1.537023837	2.415705751	0	1.333195172	1.67415217	2.907492068	1.14089127	1.960658803	4.383424823	1.879799078	0.329209225	0.150786665	13.35481345	0	6.287443553	0.495458611	0.723729783	0	0	0	1.118976048	0	0	0	0	0.000118479	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1047
H4125_001_0	2008	4																					5200											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1806.443966	149.6077098	1059.020219	3810.830814	160.0133835	10.45767001	5.293546477	288.2465244	282.6735656	0	15.34206389	3.122315728	0.308016271	21.2244646	3499.840777	6037.359345	408.0270716	299.5383968	0	0	22.18545384	0	0	0	144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 165 days 1-5	1b 260 days 1-5	2a 25 days 11-100	6a 10 copay	10a 125 copay	11a 20% coin; 11a 15% coin	11b 10% coin	4a 50 copay; 4b 30 copay; 4a World 50 copay	9b 450 copay; ASC:9b 225 copay		8b 15% coin; TherRad:8b 20% coin	9a 15% coin	12 20% coin	3 35 copay; 5 50 copay; 9a 15% coin; 9a 20% coin; 9c 50 copay; 9d 35 copay	7a 10 copay	7b 20 copay; ; 7d 25 copay; 16b 25 copay; 17a 25 copay	7e 50 copay; 7h 50 copay	7c 25 copay; 7i 25 copay			RX 20% coin				17a1 25 copay	17b1 70 allowance																89.44914188	140.950163	11.29740644	8.800794966	110.0099371	0.167223413	0.08800795	44.01040256	307.4308671	0	0.14272156	0.132011924	0.176015899	0.134543889	8.800794966	16.55224959	44.00397483	22.00198741	0	0	0.176015899	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.4654	1.757269256	0.997015153	2.79486172	1.466921854	1.748767266	0.465874172	1.057153798	7.241881615	0	2.189643285	0.412182908	0.054215761	2.855622007	2.566781758	8.327656562	1.496234416	0.549203336	0	0	3.90499261	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.6517		7.269577662	13.4654	1.757269256	0.997015153	2.79486172	1.466921854	1.748767266	0.465874172	1.057153798	7.241881615	0	2.189643285	0.412182908	0.054215761	2.855622007	2.566781758	8.327656562	1.496234416	0.549203336	0	0	3.90499261	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.6517																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	13.4654	1.757269256	0.997015153	2.79486172	1.466921854	1.748767266	0.465874172	1.057153798	7.241881615	0	2.189643285	0.412182908	0.054215761	2.855622007	2.566781758	8.327656562	1.496234416	0.549203336	0	0	3.90499261	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.6517
H4125_002_0	2008	6																					5100											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1902.905716	162.7967861	596.9757183	4743.187487	158.1819421	14.23899328	6.93194932	350.437028	312.7586063	0	18.6795396	4.009287588	0.85265765	26.03253047	3960.758248	6486.571324	456.2621964	317.057602	0	0	25.84158085	0	0	0	144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 160 days 1-5	1b 225 days 1-5	2a 25 days 11-100	6a 10 copay	10a 125 copay	11a 20% coin; 11a 15% coin	11b 10% coin	4a 50 copay; 4b 30 copay; 4a World 50 copay	9b 450 copay; ASC:9b 175 copay		8b 15% coin; TherRad:8b 20% coin	9a 15% coin	12 20% coin	3 20 copay; 5 50 copay; 9a 15% coin; 9a 20% coin; 9c 50 copay; 9d 20 copay	7a 10 copay	7b 12 copay; ; 7d 25 copay; 16b 25 copay; 17a 25 copay	7e 50 copay; 7h 50 copay	7c 20 copay; 7i 20 copay			RX 20% coin				17a1 25 copay	17b1 70 allowance	18a1 25 copay															85.01521798	119.5526503	11.07294669	8.625938529	107.8242316	0.16441588	0.086259385	43.13575058	284.8791736	0	0.13929708	0.129389078	0.172518771	0.129925417	8.625938529	16.1944862	43.12969265	17.25187706	0	0	0.172518771	0	0	0	10	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.4813	1.621898937	0.550856692	3.409536974	1.42132053	2.341116604	0.597945687	1.259697019	7.424867773	0	2.602005316	0.518758024	0.14709945	3.382287382	2.847104765	8.753890819	1.639870691	0.455819897	0	0	4.458157758	0	0	0	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0336		9.065792056	13.4813	1.621898937	0.550856692	3.409536974	1.42132053	2.341116604	0.597945687	1.259697019	7.424867773	0	2.602005316	0.518758024	0.14709945	3.382287382	2.847104765	8.753890819	1.639870691	0.455819897	0	0	4.458157758	0	0	0	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0336																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	13.4813	1.621898937	0.550856692	3.409536974	1.42132053	2.341116604	0.597945687	1.259697019	7.424867773	0	2.602005316	0.518758024	0.14709945	3.382287382	2.847104765	8.753890819	1.639870691	0.455819897	0	0	4.458157758	0	0	0	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0336
H4125_003_0	2008	4																					5000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1500.304306	79.52480729	550.6797921	3662.396025	117.36311	8.516131753	4.46010524	222.2262903	249.0699202	0	13.41914524	2.678459539	0.240454355	17.86854031	3119.205057	5251.952465	244.7964548	250.0945202	0	0	20.04250286	0	0	0	144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 175 days 1-5	1b 250 days 1-5	2a 25 days 11-100	6a 10 copay	10a 125 copay	11a 20% coin; 11a 15% coin	11b 10% coin	4a 50 copay; 4b 30 copay; 4a World 50 copay	9b 450 copay; ASC:9b 150 copay		8b 15% coin; TherRad:8b 20% coin	9a 15% coin	12 20% coin	3 30 copay; 5 45 copay; 9a 15% coin; 9a 20% coin; 9c 35 copay; 9d 25 copay	7a 10 copay	7b 20 copay; ; 7d 25 copay; 16b 25 copay; 17a 25 copay	7e 50 copay; 7h 50 copay	7c 20 copay; 7i 20 copay			RX 20% coin				17a1 25 copay	17b1 70 allowance																96.98956067	138.5565152	11.54977337	8.997391379	112.4673922	0.171768117	0.089973914	44.9939274	282.6394024	0	0.145524236	0.134960871	0.179947828	0.136075081	8.997391379	17.19701067	44.9869569	17.99478276	0	0	0.179947828	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.1262	0.918223348	0.5300189	2.746000868	1.099960244	1.462799913	0.401293124	0.833236131	5.866414451	0	1.952810858	0.361487232	0.043269239	2.431463073	2.338725724	7.526490216	0.91772063	0.375033047	0	0	3.60660485	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8377		5.074271453	12.1262	0.918223348	0.5300189	2.746000868	1.099960244	1.462799913	0.401293124	0.833236131	5.866414451	0	1.952810858	0.361487232	0.043269239	2.431463073	2.338725724	7.526490216	0.91772063	0.375033047	0	0	3.60660485	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8377																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	12.1262	0.918223348	0.5300189	2.746000868	1.099960244	1.462799913	0.401293124	0.833236131	5.866414451	0	1.952810858	0.361487232	0.043269239	2.431463073	2.338725724	7.526490216	0.91772063	0.375033047	0	0	3.60660485	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8377
H4125_005_0	2008	10																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	V	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		381.592743	32.8203036	36.55295815	0	16.82714459	17.02370716	7.17132744	26.40961584	35.49710485	15.00007302	17.05111088	3.594001321	2.436790689	31.81475053	45.73076987	104.4112401	11.98669482	2.556251626	0	0	14.03848019	4.259137424	0	0	144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a: MC CS; 1a1 95% coin	1b: MC CS; 1a1 95% coin	2a: MC CS; 2a2 0% coin	6a 0% coin	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS; 14c 45% coin	MC CS; 7b1 0% coin (5 visits); 7f1 0% coin (3 visits)	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS; 13a1 0% coin			17a1 25 copay	17b1 70 allowance																0.085922933	0.081602548	0.200337766	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.238918133	0.234	0.234	0.234	0	0	0.234	0.234	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7876	2.678220391	7.322937962	0	3.937551833	3.983547475	1.678090621	6.179850107	8.306322535	3.510017087	3.989959946	0.840996309	0.570209021	7.444651623	10.92591015	24.43223019	2.804886589	0.59816288	0	0	3.285004364	0.996638157	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.5728		0	32.7876	2.678220391	7.322937962	0	3.937551833	3.983547475	1.678090621	6.179850107	8.306322535	3.510017087	3.989959946	0.840996309	0.570209021	7.444651623	10.92591015	24.43223019	2.804886589	0.59816288	0	0	3.285004364	0.996638157	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.5728																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	32.7876	2.678220391	7.322937962	0	3.937551833	3.983547475	1.678090621	6.179850107	8.306322535	3.510017087	3.989959946	0.840996309	0.570209021	7.444651623	10.92591015	24.43223019	2.804886589	0.59816288	0	0	3.285004364	0.996638157	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.5728
H4152_004_0	2008	6	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									D	D	D		T	Coin		V	P		O				V	V	V	V		V		V			V		V			O		V	V									0	0	0		0	0		0	0		0				0	0	0	0		0		0			0		0			0		0	0									0		837.7298292	71.59653069	775.8211591		324.5675862	4.513518374		482.5236471	326.2062371		347.7073619				3575.604276	4666.806428	456.6837168	2142.615801		3.867502272		53.62934232			209.3188366		72.7029282			780.1836163		155.8711573	386.9974795									$250/day subject to $2500 OOP Max	$250/day subject to $2500 OOP Max	$100/day subject to $2500 OOP Max		$150 copay	20% of average PMPM cost for non-capitated services		$50 copay	$175 copay		$125 copay for MRI and CAT Scans				$10 copay	$25 copay	$25 copay	$15 copay		$10 copay		$25 copay			$25 copay		$25 copay			$15 monthly		$35 copay	$10 copay									250	250	100		150	0.2		50	175		125				10	25	25	15		10		25			25		25			15		35	10									17.4527	1.491594389	6.465176325	0	4.057094828	0.902703675	0	2.010515196	4.757174291	0	3.621951686	0	0	0	2.97967023	9.722513391	0.95142441	2.678269752	0	0.003222919	0	0.111727796	0	0	0.43608091	0	0.151464434	0	0	0.97522952	0	0.454624209	0.3224979	0	0	0	0	0	0	0	0	59.5456			17.4527	1.491594389	6.465176325	0	4.057094828	0.902703675	0	2.010515196	4.757174291	0	3.621951686	0	0	0	2.97967023	9.722513391	0.95142441	2.678269752	0	0.003222919	0	0.111727796	0	0	0.43608091	0	0.151464434	0	0	0.97522952	0	0.454624209	0.3224979	0	0	0	0	0	0	0	0	59.5456																																																																																				0			17.4527	1.491594389	6.465176325	0	4.057094828	0.902703675	0	2.010515196	4.757174291	0	3.621951686	0	0	0	2.97967023	9.722513391	0.95142441	2.678269752	0	0.003222919	0	0.111727796	0	0	0.43608091	0	0.151464434	0	0	0.97522952	0	0.454624209	0.3224979	0	0	0	0	0	0	0	0	59.5456
H4152_005_0	2008	6	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									D	D	D		T	Coin		V	P		O				V	V	V	V		V		V			V		V			O		V	V									0	0	0		0	0		0	0		0				0	0	0	0		0		0			0		0			0		0	0									0		933.6224983	48.60454602	909.8290669		396.9457353	1.970700636		527.8688605	372.2371638		374.1667027				4050.744753	5291.667708	530.1454256	2976.872724		9.350545166		64.95820806			230.1877492		85.0546112			745.1835689		161.8576819	385.8093194									$200/day subject to $2000 OOP Max	$200/day subject to $2000 OOP Max	$100/day subject to $2000 OOP Max		$150 copay	20% of average PMPM cost for non-capitated services		$50 copay	$150 copay		$125 copay for MRI and CAT Scans				$10 copay	$25 copay	$25 copay	$15 copay		$10 copay		$25 copay			$25 copay		$25 copay			$15 monthly		$35 copay	$10 copay									200	200	100		150	0.2		50	150		125				10	25	25	15		10		25			25		25			15		35	10									15.5604	0.810075767	7.581908891	0	4.961821691	0.394140127	0	2.199453585	4.652964547	0	3.89756982	0	0	0	3.375620627	11.02430773	1.104469637	3.721090905	0	0.007792121	0	0.1353296	0	0	0.479557811	0	0.177197107	0	0	0.931479461	0	0.472084905	0.321507766	0	0	0	0	0	0	0	0	61.8087			15.5604	0.810075767	7.581908891	0	4.961821691	0.394140127	0	2.199453585	4.652964547	0	3.89756982	0	0	0	3.375620627	11.02430773	1.104469637	3.721090905	0	0.007792121	0	0.1353296	0	0	0.479557811	0	0.177197107	0	0	0.931479461	0	0.472084905	0.321507766	0	0	0	0	0	0	0	0	61.8087																																																																																				0			15.5604	0.810075767	7.581908891	0	4.961821691	0.394140127	0	2.199453585	4.652964547	0	3.89756982	0	0	0	3.375620627	11.02430773	1.104469637	3.721090905	0	0.007792121	0	0.1353296	0	0	0.479557811	0	0.177197107	0	0	0.931479461	0	0.472084905	0.321507766	0	0	0	0	0	0	0	0	61.8087
H4152_007_0	2008	6	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									D	D	D		T	Coin		V	P		O				V	V	V	V		V		V			V		V			O		V	V									0	0	0		0	0		0	0		0				0	0	0	0		0		0			0		0			0		0	0									0	3000	838.2049747	43.63709352	816.8432652		453.161834	3.069076531		603.2786977	422.6273908		427.1567979				4624.417794	6041.08227	605.2254804	3398.462266		10.68633733		79.0922307			262.7873115		97.10018316			851.1961847		184.7802292	440.4482608									$95/day subject to $950 OOP Max	$95/day subject to $950 OOP Max	$75/day subject to $950 OOP Max		$150 copay	20% of average PMPM cost for non-capitated services		$50 copay	$95 copay		$125 copay for MRI and CAT Scans				$10 copay	$25 copay	$25 copay	$15 copay		$10 copay		$25 copay			$25 copay		$25 copay			$15 monthly		$35 copay	$10 copay									95	95	75		150	0.2		50	95		125				10	25	25	15		10		25			25		25			15		35	10									6.6358	0.345460324	5.105270408	0	5.664522926	0.613815306	0	2.513661241	3.345800177	0	4.449549978	0	0	0	3.853681495	12.58558806	1.260886418	4.248077833	0	0.008905281	0	0.164775481	0	0	0.547473566	0	0.202292048	0	0	1.063995231	0	0.538942335	0.367040217	0	0	0	0	0	0	0	0	53.5155			6.6358	0.345460324	5.105270408	0	5.664522926	0.613815306	0	2.513661241	3.345800177	0	4.449549978	0	0	0	3.853681495	12.58558806	1.260886418	4.248077833	0	0.008905281	0	0.164775481	0	0	0.547473566	0	0.202292048	0	0	1.063995231	0	0.538942335	0.367040217	0	0	0	0	0	0	0	0	53.5155																														20% of Out of Network Services																																									2.7801													2.7801		1.85	6.6358	0.345460324	5.105270408	0	5.664522926	0.613815306	0	2.513661241	3.345800177	0	4.449549978	0	0	0	3.853681495	12.58558806	1.260886418	4.248077833	0	0.008905281	0	0.164775481	0	0	0.547473566	0	0.202292048	0	2.78006842	1.063995231	0	0.538942335	0.367040217	0	0	0	0	0	0	0	0	56.2956
H4152_012_0	2008	6	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									D	D	D		T	Coin		V			Coin			Coin	V	V	V	Coin		Coin	Coin	V			V		V			O		V	V									0	0	0		0	0		0			0			0	0	0	0	0		0	0	0			0		0			0		0	0									0		2643.17	428.95	2693.32		1129.314253	13.46244402		1354.448939			72.83345587			36.30226358	4111.876099	5470.778922	2301.66732	23.53767714		96.15	11.94800813	62.53762055			215.1940739		87.89617104			780.1836163		265.5070546	212.7946095									$185 per day for days 1-30	$185 per day for days 1-30	$125 per day for days 21-100		$150 copay	20% of average PMPM cost for non-capitated services		$50 copay			20% coinsurance of projected average cost			20% coinsurance of projected average cost	$5 copay	$20 copay	$20 copay	20% coinsurance of projected average cost		20% coinsurance of projected average cost	20% coinsurance of projected average cost	$20 copay			$20 copay		$20 copay			$15 monthly		$35 copay	$5 copay									185	185	125		150	0.2		50			0.2			0.2	5	20	20	0.2		0.2	0.2	20			20		20			15		35	5									40.7489	6.612979167	28.05541667	0	14.11642816	2.692488805	0	5.643537247	0	0	14.56669117	0	0	7.260452717	1.713281708	9.11796487	3.836112201	4.707535427	0	19.23	2.389601625	0.104229368	0	0	0.35865679	0	0.146493618	0	0	0.97522952	0	0.774395576	0.088664421	0	0	0	0	0	0	0	0	163.139			40.7489	6.612979167	28.05541667	0	14.11642816	2.692488805	0	5.643537247	0	0	14.56669117	0	0	7.260452717	1.713281708	9.11796487	3.836112201	4.707535427	0	19.23	2.389601625	0.104229368	0	0	0.35865679	0	0.146493618	0	0	0.97522952	0	0.774395576	0.088664421	0	0	0	0	0	0	0	0	163.139																																																																																				0			40.7489	6.612979167	28.05541667	0	14.11642816	2.692488805	0	5.643537247	0	0	14.56669117	0	0	7.260452717	1.713281708	9.11796487	3.836112201	4.707535427	0	19.23	2.389601625	0.104229368	0	0	0.35865679	0	0.146493618	0	0	0.97522952	0	0.774395576	0.088664421	0	0	0	0	0	0	0	0	163.139
H4152_013_0	2008	5	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									D	D	D		T	Coin		V	P		O				V	V	V	V		V		V			V		V			O		V	V									0	0	0		0	0		0	0		0				0	0	0	0		0		0			0		0			0		0	0									0		876.5010043	74.9101069	811.7271241		332.6147165	4.762527786		494.5386781	334.3289023		356.3282056				3664.255622	4782.512372	468.0064536	2195.738507		3.963804619		54.95899543			214.5085598		74.50548014			780.1836163		159.7357315	396.5924583									$300/day subject to $3000 OOP Max	$300/day subject to $3000 OOP Max	$100/day subject to $3000 OOP Max		$150 copay	20% of average PMPM cost for non-capitated services		$50 copay	$175 copay		$125 copay for MRI and CAT Scans				$10 copay	$25 copay	$25 copay	$15 copay		$10 copay		$25 copay			$25 copay		$25 copay			$15 monthly		$35 copay	$10 copay									300	300	100		150	0.2		50	175		125				10	25	25	15		10		25			25		25			15		35	10									21.9125	1.872752672	6.764392701	0	4.157683956	0.952505557	0	2.060577826	4.875629826	0	3.711752141	0	0	0	3.053546352	9.963567442	0.975013445	2.744673134	0	0.003303171	0	0.114497907	0	0	0.446892833	0	0.15521975	0	0	0.97522952	0	0.465895884	0.330493715	0	0	0	0	0	0	0	0	65.5362			21.9125	1.872752672	6.764392701	0	4.157683956	0.952505557	0	2.060577826	4.875629826	0	3.711752141	0	0	0	3.053546352	9.963567442	0.975013445	2.744673134	0	0.003303171	0	0.114497907	0	0	0.446892833	0	0.15521975	0	0	0.97522952	0	0.465895884	0.330493715	0	0	0	0	0	0	0	0	65.5362																																																																																				0			21.9125	1.872752672	6.764392701	0	4.157683956	0.952505557	0	2.060577826	4.875629826	0	3.711752141	0	0	0	3.053546352	9.963567442	0.975013445	2.744673134	0	0.003303171	0	0.114497907	0	0	0.446892833	0	0.15521975	0	0	0.97522952	0	0.465895884	0.330493715	0	0	0	0	0	0	0	0	65.5362
H4152_815_0	2008	2	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									A	A	D		T			V							V	V	V			V		V			V		V			O		V	V									0	0	0		0			0							0	0	0			0		0			0		0			0		0	0									0	3000	377.756083	5.92837544	333.6489698		320.0617024			453.8794291							4577.360048	6753.779624	308.5968056			12.85497294		75.47723727			317.1954782		96.33698006			803.9932651		169.1072278	543.62719									$100 per admission	$100 per admission	$50/day for days 30-100		$50 copay			$50 copay							$10 copay	$20 copay	$20 copay			$10 copay		$20 copay			$20 copay		$20 copay			$15 monthly		$25 copay	$10 copay									100	100	50		50			50							10	20	20			10		20			20		20			15		25	10									3.148	0.049403129	1.390204041	0	1.333590427	0	0	1.891164288	0	0	0	0	0	0	3.814466707	11.25629937	0.514328009	0	0	0.010712477	0	0.125795395	0	0	0.52865913	0	0.160561633	0	0	1.004991581	0	0.352306725	0.453022658	0	0	0	0	0	0	0	0	26.0335			3.148	0.049403129	1.390204041	0	1.333590427	0	0	1.891164288	0	0	0	0	0	0	3.814466707	11.25629937	0.514328009	0	0	0.010712477	0	0.125795395	0	0	0.52865913	0	0.160561633	0	0	1.004991581	0	0.352306725	0.453022658	0	0	0	0	0	0	0	0	26.0335																														"20% of Out of Network Services subject to $3,000 OOP Max"																																									1.0622													1.0622		0.74	3.148	0.049403129	1.390204041	0	1.333590427	0	0	1.891164288	0	0	0	0	0	0	3.814466707	11.25629937	0.514328009	0	0	0.010712477	0	0.125795395	0	0	0.52865913	0	0.160561633	0	1.062219588	1.004991581	0	0.352306725	0.453022658	0	0	0	0	0	0	0	0	27.0957
H4152_817_0	2008	2	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									A	A	D		T			V							V	V	V			V		V			V		V			O		V	V									0	0	0		0			0							0	0	0			0		0			0		0			0		0	0									0		355.3705374	5.577064303	313.877179		300.7947356			427.1111714							4301.813666	6347.217868	290.0199988			12.09683056		66.50032866			298.1010514		90.53771891			756.3884007		158.9273677	510.9021031									$100 per admission	$100 per admission	$50/day for days 30-100		$50 copay			$50 copay							$10 copay	$20 copay	$20 copay			$10 copay		$20 copay			$20 copay		$20 copay			$15 monthly		$25 copay	$10 copay									100	100	50		50			50							10	20	20			10		20			20		20			15		25	10									2.9614	0.046475536	1.307821579	0	1.253311398	0	0	1.779629881	0	0	0	0	0	0	3.584844722	10.57869645	0.483366665	0	0	0.010080692	0	0.110833881	0	0	0.496835086	0	0.150896198	0	0	0.945485501	0	0.331098683	0.425751753	0	0	0	0	0	0	0	0	24.4665			2.9614	0.046475536	1.307821579	0	1.253311398	0	0	1.779629881	0	0	0	0	0	0	3.584844722	10.57869645	0.483366665	0	0	0.010080692	0	0.110833881	0	0	0.496835086	0	0.150896198	0	0	0.945485501	0	0.331098683	0.425751753	0	0	0	0	0	0	0	0	24.4665																																																																																				0			2.9614	0.046475536	1.307821579	0	1.253311398	0	0	1.779629881	0	0	0	0	0	0	3.584844722	10.57869645	0.483366665	0	0	0.010080692	0	0.110833881	0	0	0.496835086	0	0.150896198	0	0	0.945485501	0	0.331098683	0.425751753	0	0	0	0	0	0	0	0	24.4665
H4152_818_0	2008	2	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									D	D	D		T	Coin		V	P		O				V	V	V	V		V		V			V		V			O		V	V									0	0	0		0	0		0	0		0				0	0	0	0		0		0			0		0			0		0	0									0		837.7298292	71.59653069	775.8211591		324.5675862	4.513518374		482.5236471	326.2062371		347.7073619				3575.604276	4666.806428	456.6837168	2142.615801		3.867502272		53.62934232			209.3188366		72.7029282			780.1836163		155.8711573	386.9974795									$250/day subject to $2500 OOP Max	$250/day subject to $2500 OOP Max	$100/day subject to $2500 OOP Max		$150 copay	20% of average PMPM cost for non-capitated services		$50 copay	$175 copay		$125 copay for MRI and CAT Scans				$10 copay	$25 copay	$25 copay	$15 copay		$10 copay		$25 copay			$25 copay		$25 copay			$15 monthly		$35 copay	$10 copay									250	250	100		150	0.2		50	175		125				10	25	25	15		10		25			25		25			15		35	10									17.4527	1.491594389	6.465176325	0	4.057094828	0.902703675	0	2.010515196	4.757174291	0	3.621951686	0	0	0	2.97967023	9.722513391	0.95142441	2.678269752	0	0.003222919	0	0.111727796	0	0	0.43608091	0	0.151464434	0	0	0.97522952	0	0.454624209	0.3224979	0	0	0	0	0	0	0	0	59.5456			17.4527	1.491594389	6.465176325	0	4.057094828	0.902703675	0	2.010515196	4.757174291	0	3.621951686	0	0	0	2.97967023	9.722513391	0.95142441	2.678269752	0	0.003222919	0	0.111727796	0	0	0.43608091	0	0.151464434	0	0	0.97522952	0	0.454624209	0.3224979	0	0	0	0	0	0	0	0	59.5456																																																																																				0			17.4527	1.491594389	6.465176325	0	4.057094828	0.902703675	0	2.010515196	4.757174291	0	3.621951686	0	0	0	2.97967023	9.722513391	0.95142441	2.678269752	0	0.003222919	0	0.111727796	0	0	0.43608091	0	0.151464434	0	0	0.97522952	0	0.454624209	0.3224979	0	0	0	0	0	0	0	0	59.5456
H4152_819_0	2008	2	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									A	A	D		T			V							V	V	V			V		V			V		V			O		V	V									0	0	0		0			0							0	0	0			0		0			0		0			0		0	0									0		355.3705374	5.577064303	313.877179		300.7947356			427.1111714							4301.813666	6347.217868	290.0199988			12.09683056		66.50032866			298.1010514		90.53771891			756.3884007		158.9273677	510.9021031									$100 per admission	$100 per admission	$50/day for days 30-100		$50 copay			$50 copay							$10 copay	$20 copay	$20 copay			$10 copay		$20 copay			$20 copay		$20 copay			$15 monthly		$25 copay	$10 copay									100	100	50		50			50							10	20	20			10		20			20		20			15		25	10									2.9614	0.046475536	1.307821579	0	1.253311398	0	0	1.779629881	0	0	0	0	0	0	3.584844722	10.57869645	0.483366665	0	0	0.010080692	0	0.110833881	0	0	0.496835086	0	0.150896198	0	0	0.945485501	0	0.331098683	0.425751753	0	0	0	0	0	0	0	0	24.4665			2.9614	0.046475536	1.307821579	0	1.253311398	0	0	1.779629881	0	0	0	0	0	0	3.584844722	10.57869645	0.483366665	0	0	0.010080692	0	0.110833881	0	0	0.496835086	0	0.150896198	0	0	0.945485501	0	0.331098683	0.425751753	0	0	0	0	0	0	0	0	24.4665																																																																																				0			2.9614	0.046475536	1.307821579	0	1.253311398	0	0	1.779629881	0	0	0	0	0	0	3.584844722	10.57869645	0.483366665	0	0	0.010080692	0	0.110833881	0	0	0.496835086	0	0.150896198	0	0	0.945485501	0	0.331098683	0.425751753	0	0	0	0	0	0	0	0	24.4665
H4152_820_0	2008	2	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									A	A	D		T			V							V	V	V			V		V			V		V			O		V	V									0	0	0		0			0							0	0	0			0		0			0		0			0		0	0									0	3000	377.756083	5.92837544	333.6489698		320.0617024			453.8794291							4577.360048	6753.779624	308.5968056			12.85497294		75.47723727			317.1954782		96.33698006			803.9932651		169.1072278	543.62719									$100 per admission	$100 per admission	$50/day for days 30-100		$50 copay			$50 copay							$10 copay	$20 copay	$20 copay			$10 copay		$20 copay			$20 copay		$20 copay			$15 monthly		$25 copay	$10 copay									100	100	50		50			50							10	20	20			10		20			20		20			15		25	10									3.148	0.049403129	1.390204041	0	1.333590427	0	0	1.891164288	0	0	0	0	0	0	3.814466707	11.25629937	0.514328009	0	0	0.010712477	0	0.125795395	0	0	0.52865913	0	0.160561633	0	0	1.004991581	0	0.352306725	0.453022658	0	0	0	0	0	0	0	0	26.0335			3.148	0.049403129	1.390204041	0	1.333590427	0	0	1.891164288	0	0	0	0	0	0	3.814466707	11.25629937	0.514328009	0	0	0.010712477	0	0.125795395	0	0	0.52865913	0	0.160561633	0	0	1.004991581	0	0.352306725	0.453022658	0	0	0	0	0	0	0	0	26.0335																														"20% of Out of Network Services subject to $3,000 OOP Max"																																									1.0622													1.0622		0.74	3.148	0.049403129	1.390204041	0	1.333590427	0	0	1.891164288	0	0	0	0	0	0	3.814466707	11.25629937	0.514328009	0	0	0.010712477	0	0.125795395	0	0	0.52865913	0	0.160561633	0	1.062219588	1.004991581	0	0.352306725	0.453022658	0	0	0	0	0	0	0	0	27.0957
H4204_002_0	2008	9																					5000											D	D	D	coin	T	coin	coin	V	V	P	P	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1162.723382	15.87159506	589.2306917	17.59367008	318.1407045	30.229202	1.442672949	569.7565385	405.0121964	2140.613903	1099.395169	0	0.195043273	26.68054038	3306.626523	4049.344568	118.7145211	382.6141746	22.6016937	92.7804999	30.30802667	794.0534905	0	0	0	0	0	0	0	0	0											$150 Per Day 1-7	$150 Per Day 1-7	$75 Per Day:6-100	20%	$50 Per Trip	30% DME 20% Diab Monit	30%	"$50 copay ER, UC like physician"	$100 ASC copay/$100 OP Hosp copay	$30 copay	$30 copay	0	20%	20%	$20 copay	$30 copay	$30 copay	$30 copay	$30 copay	$30 copay Hearing/$30 copay SA	20%	$30 Blood/$30 Vision	0	0		0		0	0	0	0											134.5437052	134.542352	63.26366044	0.168872216	45.00549209	0.254931366	0.271203825	38.21996806	88.6290648	25.82864182	25.84180835	0	0.177274556	0.128041893	17.11195879	25.62406528	25.66730418	25.66678641	0	25.90355341	0.194369645	26.86613232	0	0	0	0	0	0	0	0	0											13.0364	0.177950144	3.106407533	2.97108205	1.193173247	7.706371752	0.391258422	1.814673059	2.991321016	4.607429146	2.367529939	0	0.03457621	3.416226886	4.715238066	8.646722464	0.253923477	0.818373025	0	0.20027872	5.890960395	1.777762179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1177	0	8.61	13.0364	0.177950144	3.106407533	2.97108205	1.193173247	7.706371752	0.391258422	1.814673059	2.991321016	4.607429146	2.367529939	0	0.03457621	3.416226886	4.715238066	8.646722464	0.253923477	0.818373025	0	0.20027872	5.890960395	1.777762179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1177	5000		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.0364	0.177950144	3.106407533	2.97108205	1.193173247	7.706371752	0.391258422	1.814673059	2.991321016	4.607429146	2.367529939	0	0.03457621	3.416226886	4.715238066	8.646722464	0.253923477	0.818373025	0	0.20027872	5.890960395	1.777762179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1177
H4204_003_0	2008	5																					5000											D	D	D	coin	T	coin	coin	V	V	P	P	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1239.768781	16.96194252	703.6437714	30.67338431	317.701191	29.0843558	1.386642894	448.1014536	440.3924029	2837.398018	1456.465134	0	0.225053837	29.84861782	4564.709645	5680.185949	174.7375928	563.2521387	29.01567789	116.6921675	8.400694604	792.8436823	0	0	0	0	0	0	0	0	0											$150 Per Day 1-7	$150 Per Day 1-7	$75 Per Day:6-100	20%	$50 Per Trip	30% DME 20% Diab Monit	30%	"$50 copay ER, UC like physician"	$100 ASC copay/$100 OP Hosp copay	$30 copay	$30 copay	0	20%	20%	$20 copay	$30 copay	$30 copay	$30 copay	$30 copay	$30 copay Hearing/$30 copay SA	20%	$30 Blood/$30 Vision	0	0		0		0	0	0	0											131.470823	131.4692967	65.73274139	0.175285129	43.82205635	0.247140228	0.262914595	36.49597604	87.64502454	26.28197227	26.29169477	0	0.175285129	0.12482516	17.52713041	26.24897512	26.29019804	26.28979307	0	26.1039966	0.175285129	26.29020862	0	0	0	0	0	0	0	0	0											13.5828	0.185831221	3.854369505	5.376588125	1.160193291	7.187914323	0.364568655	1.362824993	3.216516913	6.214368003	3.191078063	0	0.039448591	3.725858492	6.667188437	12.42492164	0.382823827	1.233981848	0	0.253844329	1.472516837	1.737002151	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.6346	0	10.41	13.5828	0.185831221	3.854369505	5.376588125	1.160193291	7.187914323	0.364568655	1.362824993	3.216516913	6.214368003	3.191078063	0	0.039448591	3.725858492	6.667188437	12.42492164	0.382823827	1.233981848	0	0.253844329	1.472516837	1.737002151	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.6346	5000	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.5828	0.185831221	3.854369505	5.376588125	1.160193291	7.187914323	0.364568655	1.362824993	3.216516913	6.214368003	3.191078063	0	0.039448591	3.725858492	6.667188437	12.42492164	0.382823827	1.233981848	0	0.253844329	1.472516837	1.737002151	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.6346
H4204_007_0	2008	7																					5000											D	D	D	coin	T	coin	coin	V	V	P	P	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1091.663189	15.06675319	764.7649925	31.90724512	275.3088626	27.40517549	1.303544511	349.7802347	341.8576866	2209.582338	1136.23355	0	0.227747105	27.71285071	4718.753284	5845.825511	172.0701942	553.3441002	30.3090288	120.9078269	7.767671471	809.704131	0	0	0	0	0	0	0	0	0											$150 Per Day 1-7	$150 Per Day 1-7	$75 Per Day:6-100	20%	$50 Per Trip	30% DME 20% Diab Monit	30%	"$50 copay ER, UC like physician"	$100 ASC copay/$100 OP Hosp copay	$30 copay	$30 copay	0	20%	20%	$20 copay	$30 copay	$30 copay	$30 copay	$30 copay	$30 copay Hearing/$30 copay SA	20%	$30 Blood/$30 Vision	0	0		0		0	0	0	0											133.1533045	133.1525341	66.57536341	0.177532796	44.38372392	0.250316525	0.266292354	37.23022551	88.76802839	26.62656125	26.62971025	0	0.177532796	0.116600978	17.75264243	26.6206957	26.62872521	26.62853308	0	26.49714565	0.177532796	26.62871181	0	0	0	0	0	0	0	0	0											12.1132	0.167181364	4.242875608	5.664582441	1.018269379	6.859968299	0.347123936	1.085199751	2.528836069	4.902798289	2.521464185	0	0.04043258	3.231345496	6.980861648	12.9683285	0.38183416	1.22789514	0	0.266976025	1.379016435	1.796781496	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.725	0	8.83	12.1132	0.167181364	4.242875608	5.664582441	1.018269379	6.859968299	0.347123936	1.085199751	2.528836069	4.902798289	2.521464185	0	0.04043258	3.231345496	6.980861648	12.9683285	0.38183416	1.22789514	0	0.266976025	1.379016435	1.796781496	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.725	5000	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.1132	0.167181364	4.242875608	5.664582441	1.018269379	6.859968299	0.347123936	1.085199751	2.528836069	4.902798289	2.521464185	0	0.04043258	3.231345496	6.980861648	12.9683285	0.38183416	1.22789514	0	0.266976025	1.379016435	1.796781496	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.725
H4204_008_0	2008	8																					5000											D	D	D	coin	T	coin	coin	V	V	P	P	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1209.066666	16.76903034	761.4531211	34.91942219	332.8960838	33.25880871	1.579022727	420.0588446	410.6913983	2652.488615	1364.934185	0	0.221653866	33.513914	5225.818204	6067.673524	177.8800576	571.8965928	29.34051578	130.8040013	9.392897775	899.8779736	0	0	0	0	0	0	0	0	0											$150 Per Day 1-7	$150 Per Day 1-7	$75 Per Day:6-100	20%	$50 Per Trip	30% DME 20% Diab Monit	30%	"$50 copay ER, UC like physician"	$100 ASC copay/$100 OP Hosp copay	$30 copay	$30 copay	0	20%	20%	$20 copay	$30 copay	$30 copay	$30 copay	$30 copay	$30 copay Hearing/$30 copay SA	20%	$30 Blood/$30 Vision	0	0		0		0	0	0	0											130.1504807	130.1486241	65.07204006	0.173523072	43.38195501	0.244653479	0.260269269	36.3046337	86.7652181	26.02106342	26.02801748	0	0.173523072	0.113628783	17.35060012	25.82395533	26.02529347	26.02479719	0	25.802884	0.173523072	26.02527246	0	0	0	0	0	0	0	0	0											13.1134	0.181872186	4.129109	6.059325425	1.203473578	8.136883253	0.41097109	1.270840207	2.969477396	5.751714539	2.960544235	0	0.03846206	3.808145254	7.555923494	13.05761084	0.385781725	1.24029107	0	0.281260039	1.62988448	1.951630787	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1366	0	11.74	13.1134	0.181872186	4.129109	6.059325425	1.203473578	8.136883253	0.41097109	1.270840207	2.969477396	5.751714539	2.960544235	0	0.03846206	3.808145254	7.555923494	13.05761084	0.385781725	1.24029107	0	0.281260039	1.62988448	1.951630787	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1366	5000		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.1134	0.181872186	4.129109	6.059325425	1.203473578	8.136883253	0.41097109	1.270840207	2.969477396	5.751714539	2.960544235	0	0.03846206	3.808145254	7.555923494	13.05761084	0.385781725	1.24029107	0	0.281260039	1.62988448	1.951630787	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1366
H4204_020_0	2008	7																					5000											D	D	D	coin	T	coin	coin	V	V	P	P	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1044.062451	14.15506336	654.9403503	29.24360686	291.7576938	31.23562029	1.483493733	277.2591387	270.7283417	1749.74078	899.5341949	0	0.237444852	29.54720194	5016.775133	6249.698845	190.2367855	611.8995542	32.13731179	129.5262807	8.275785378	851.4845058	0	0	0	0	0	0	0	0	0											$150 Per Day 1-7	$150 Per Day 1-7	$75 Per Day:6-100	20%	$50 Per Trip	30% DME 20% Diab Monit	30%	"$50 copay ER, UC like physician"	$100 ASC copay/$100 OP Hosp copay	$30 copay	$30 copay	0	20%	20%	$20 copay	$30 copay	$30 copay	$30 copay	$30 copay	$30 copay Hearing/$30 copay SA	20%	$30 Blood/$30 Vision	0	0		0		0	0	0	0											133.4688969	133.468636	66.73392394	0.17795663	44.48938847	0.250919261	0.266932359	37.67578825	88.97909653	26.69291777	26.69356314	0	0.17795663	0.103811703	17.79537666	26.66801805	26.69296376	26.69288163	0	26.53613241	0.17795663	26.69295102	0	0	0	0	0	0	0	0	0											11.6125	0.157438083	3.642228293	5.204093717	1.081676782	7.837618747	0.395992482	0.870496383	2.007430271	3.892140564	2.000981069	0	0.042254886	3.067345342	7.439616925	13.88892347	0.423165302	1.361113531	0	0.286427211	1.472730874	1.894052851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5782	0	8.51	11.6125	0.157438083	3.642228293	5.204093717	1.081676782	7.837618747	0.395992482	0.870496383	2.007430271	3.892140564	2.000981069	0	0.042254886	3.067345342	7.439616925	13.88892347	0.423165302	1.361113531	0	0.286427211	1.472730874	1.894052851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5782	5000	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.6125	0.157438083	3.642228293	5.204093717	1.081676782	7.837618747	0.395992482	0.870496383	2.007430271	3.892140564	2.000981069	0	0.042254886	3.067345342	7.439616925	13.88892347	0.423165302	1.361113531	0	0.286427211	1.472730874	1.894052851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5782
H4204_021_0	2008	7																					5000											D	D	D	coin	T	coin	coin	V	V	P	P	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1170.888756	16.3875947	640.0955257	37.21411556	328.7180586	33.83192849	1.605069405	431.9412256	422.4032704	2730.503876	1404.184335	0	0.217273895	35.22680063	4899.437025	5954.603558	167.1921701	537.5363285	28.26386548	123.9014038	9.873606062	847.5112756	0	0	0	0	0	0	0	0	0											$150 Per Day 1-7	$150 Per Day 1-7	$75 Per Day:6-100	20%	$50 Per Trip	30% DME 20% Diab Monit	30%	"$50 copay ER, UC like physician"	$100 ASC copay/$100 OP Hosp copay	$30 copay	$30 copay	0	20%	20%	$20 copay	$30 copay	$30 copay	$30 copay	$30 copay	$30 copay Hearing/$30 copay SA	20%	$30 Blood/$30 Vision	0	0		0		0	0	0	0											130.5120077	130.510708	65.25358172	0.174007926	43.50290492	0.245341814	0.261000716	36.27075263	87.00670684	26.09611294	26.1009246	0	0.174007926	0.112878974	17.39969358	26.08220845	26.09913527	26.09880643	0	25.94126573	0.174007926	26.09913661	0	0	0	0	0	0	0	0	0											12.7346	0.178229716	3.480710475	6.475551068	1.191682537	8.300386716	0.418924263	1.305569445	3.062659793	5.937961462	3.05420912	0	0.03780738	3.976365108	7.10405858	12.94243427	0.363630922	1.169088049	0	0.267846603	1.718085713	1.843276047	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5631	0	11.3	12.7346	0.178229716	3.480710475	6.475551068	1.191682537	8.300386716	0.418924263	1.305569445	3.062659793	5.937961462	3.05420912	0	0.03780738	3.976365108	7.10405858	12.94243427	0.363630922	1.169088049	0	0.267846603	1.718085713	1.843276047	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5631	5000	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.7346	0.178229716	3.480710475	6.475551068	1.191682537	8.300386716	0.418924263	1.305569445	3.062659793	5.937961462	3.05420912	0	0.03780738	3.976365108	7.10405858	12.94243427	0.363630922	1.169088049	0	0.267846603	1.718085713	1.843276047	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5631
H4204_022_0	2008	5																					5000											D	D	D	coin	T	coin	coin	V	V	P	P	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1214.375766	16.42822502	790.1583708	26.44782746	313.2672682	28.61207593	1.363756777	481.8602563	473.6425527	3052.590927	1566.626532	0	0.225091445	33.46941434	4905.011708	5969.50806	168.1504748	542.005105	24.99842877	123.7108546	9.419581942	851.9519748	0	0	0	0	0	0	0	0	0											$150 Per Day 1-7	$150 Per Day 1-7	$75 Per Day:6-100	20%	$50 Per Trip	30% DME 20% Diab Monit	30%	"$50 copay ER, UC like physician"	$100 ASC copay/$100 OP Hosp copay	$30 copay	$30 copay	0	20%	20%	$20 copay	$30 copay	$30 copay	$30 copay	$30 copay	$30 copay Hearing/$30 copay SA	20%	$30 Blood/$30 Vision	0	0		0		0	0	0	0											130.7952171	130.7935172	65.3946158	0.174382937	43.59661642	0.245866052	0.261559359	36.24103605	87.19449227	26.14654987	26.15642248	0	0.174382937	0.121746541	17.43687438	26.13678978	26.15478672	26.15435934	0	25.99805177	0.174382937	26.15480194	0	0	0	0	0	0	0	0	0											13.2362	0.179058778	4.30600859	4.61204984	1.138116078	7.034738156	0.356703348	1.455259577	3.441585158	6.651226741	3.414778786	0	0.039252107	4.074785425	7.127339414	13.00198144	0.366494984	1.181316357	0	0.2680201	1.642614368	1.856886264	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.3844	0	11.09	13.2362	0.179058778	4.30600859	4.61204984	1.138116078	7.034738156	0.356703348	1.455259577	3.441585158	6.651226741	3.414778786	0	0.039252107	4.074785425	7.127339414	13.00198144	0.366494984	1.181316357	0	0.2680201	1.642614368	1.856886264	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.3844	5000	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.2362	0.179058778	4.30600859	4.61204984	1.138116078	7.034738156	0.356703348	1.455259577	3.441585158	6.651226741	3.414778786	0	0.039252107	4.074785425	7.127339414	13.00198144	0.366494984	1.181316357	0	0.2680201	1.642614368	1.856886264	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.3844
H4204_023_0	2008	5																					2500											A	A	D	coin	T	coin	coin	V	V	P	P	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	325.8957944	3.239606843	756.2414762	36.24383797	294.5425845	29.6368625	1.41459566	376.861686	358.5381645	2327.796073	1192.949842	0	0.229634908	29.94479749	5220.588564	6245.934161	180.4707685	580.6518764	30.60941179	131.5848443	8.40928517	944.2509056	0	0	0	0	0	0	0	0	0											$0 Cost Share	$0 Cost Share	$75 Per Day:6-100	$0 Cost Share	$50 Per Trip	20% DME 0% Diab Monit	30%	"$50 copay ER, UC like physician"	$25 ASC copay/$50 OP Hosp copay	$10 copay	$10 copay	0	20%	20%	$10 copay	$20 copay	$20 copay	$20 copay	$10 copay	$20 copay Hearing/$20 copay SA	20%	$30 Blood/$10 Vision	0	0		0		0	0	0	0											0	0	65.38532342	0	43.58661867	0.143124193	0.261707628	32.9192113	26.20037814	8.718317035	8.715170091	0	0.174386725	0.113229709	8.718219749	17.45779916	17.44210683	17.44325066	0	17.48878771	0.174386725	9.429062904	0	0	0	0	0	0	0	0	0											0	0	4.120591126	0	1.069842942	4.241752023	0.370210475	1.033832456	0.782819624	1.691205346	0.866396732	0	0.04004528	3.390640711	3.792853193	9.086688682	0.262315869	0.844038019	0	0.191771617	1.466467701	0.741950099	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.9934	0	4.98	0	0	4.120591126	0	1.069842942	4.241752023	0.370210475	1.033832456	0.782819624	1.691205346	0.866396732	0	0.04004528	3.390640711	3.792853193	9.086688682	0.262315869	0.844038019	0	0.191771617	1.466467701	0.741950099	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.9934	2500	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	4.120591126	0	1.069842942	4.241752023	0.370210475	1.033832456	0.782819624	1.691205346	0.866396732	0	0.04004528	3.390640711	3.792853193	9.086688682	0.262315869	0.844038019	0	0.191771617	1.466467701	0.741950099	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.9934
H4204_024_0	2008	4																					2500											A	A	D	coin	T	coin	coin	V	V	P	P	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	319.023996	3.171240761	908.4217601	29.9152222	299.1405984	27.01100482	1.294857843	402.1503991	384.1705148	2491.428697	1272.102826	0	0.21896273	27.1465962	4972.963719	6022.642526	179.2966262	578.2975777	28.44460674	126.2761755	7.652713925	906.533212	0	0	0	0	0	0	0	0	0											$0 Cost Share	$0 Cost Share	$75 Per Day:6-100	$0 Cost Share	$50 Per Trip	20% DME 0% Diab Monit	30%	"$50 copay ER, UC like physician"	$25 ASC copay/$50 OP Hosp copay	$10 copay	$10 copay	0	20%	20%	$10 copay	$20 copay	$20 copay	$20 copay	$10 copay	$20 copay Hearing/$20 copay SA	20%	$30 Blood/$10 Vision	0	0		0		0	0	0	0											0	0	65.43504023	0	43.62232537	0.143225201	0.261895923	32.87572612	26.22121943	8.72592345	8.722216448	0	0.174516602	0.12202955	8.725091598	17.47354716	17.45603203	17.45722407	0	17.50851554	0.174516602	9.519174067	0	0	0	0	0	0	0	0	0											0	0	4.953551201	0	1.087434043	3.868656591	0.33911799	1.101748865	0.839451614	1.811668008	0.924629682	0	0.038212632	3.312686932	3.615796997	8.769744018	0.260817304	0.8412892	0	0.184242365	1.335525629	0.71912062	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.0037	0	4.95	0	0	4.953551201	0	1.087434043	3.868656591	0.33911799	1.101748865	0.839451614	1.811668008	0.924629682	0	0.038212632	3.312686932	3.615796997	8.769744018	0.260817304	0.8412892	0	0.184242365	1.335525629	0.71912062	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.0037	2500	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	4.953551201	0	1.087434043	3.868656591	0.33911799	1.101748865	0.839451614	1.811668008	0.924629682	0	0.038212632	3.312686932	3.615796997	8.769744018	0.260817304	0.8412892	0	0.184242365	1.335525629	0.71912062	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.0037
H4204_025_0	2008	4																					2500											A	A	D	coin	T	coin	coin	V	V	P	P	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	351.1464833	3.494166664	753.5478397	32.47710823	323.7847107	29.6374945	1.418679773	483.9099588	462.3299336	3000.45352	1531.385508	0	0.230920074	31.89947524	5117.361457	6161.99127	181.0703286	584.0005498	28.28523466	129.2505642	8.992678041	935.3239708	0	0	0	0	0	0	0	0	0											$0 Cost Share	$0 Cost Share	$75 Per Day:6-100	$0 Cost Share	$50 Per Trip	20% DME 0% Diab Monit	30%	"$50 copay ER, UC like physician"	$25 ASC copay/$50 OP Hosp copay	$10 copay	$10 copay	0	20%	20%	$10 copay	$20 copay	$20 copay	$20 copay	$10 copay	$20 copay Hearing/$20 copay SA	20%	$30 Blood/$10 Vision	0	0		0		0	0	0	0											0	0	64.67782564	0	43.11640669	0.141569525	0.258878205	32.31372294	25.9163258	8.625144319	8.62095264	0	0.172497039	0.12196184	8.623767856	17.27055996	17.25353677	17.25475232	0	17.3037539	0.172497039	9.529213529	0	0	0	0	0	0	0	0	0											0	0	4.061486315	0	1.163369439	4.195766013	0.367265274	1.303077695	0.998491099	2.156612053	1.100166828	0	0.039833029	3.890518688	3.677578103	8.868419975	0.260341964	0.83973207	0	0.186376663	1.551210338	0.74274182	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.403	0	5.63	0	0	4.061486315	0	1.163369439	4.195766013	0.367265274	1.303077695	0.998491099	2.156612053	1.100166828	0	0.039833029	3.890518688	3.677578103	8.868419975	0.260341964	0.83973207	0	0.186376663	1.551210338	0.74274182	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.403	2500	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	4.061486315	0	1.163369439	4.195766013	0.367265274	1.303077695	0.998491099	2.156612053	1.100166828	0	0.039833029	3.890518688	3.677578103	8.868419975	0.260341964	0.83973207	0	0.186376663	1.551210338	0.74274182	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.403
H4204_026_0	2008	6																					5000											A	A	D	V	coin	coin	coin	V	coin	P	coin	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											17.3208	0.1292	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											17.45	none	337.2819066	3.352768366	736.8361688	2220.599293	9.170666528	31.54986715	1.502034588	431.575967	30.87076238	2636.871709	32.82076439	0	0.251599671	31.7891946	191.0506721	8418.406065	199.4433075	641.8859104	33.45841665	6960.104347	8.922503936	940.8258086	0	0	0	0	0	0	0	0	0											$0 Cost Share	$0 Cost Share	$100 Per Day:11-100	$20 	20%	20% DME 0% Diab Monit	30%	"$50 copay ER, UC like physician"	20% 20%	$20 copay	20%	0	20%	20%	0%	$20 copay	$20 copay	$20 copay	20%	$20 copay Hearing/$20 copay SA	20%	$20 Blood/$20 Vision	0	0		0		0	0	0	0											0	0	92.72256113	18.54451223	0.185445122	0.152072418	0.278167683	32.65292695	0.185445122	18.54451223	0.185445122	0	0.185445122	0.105531455	20.2053489	22.54596205	18.54451223	18.54451223	0.041080079	3.831875209	0.185445122	18.54451223	0	0	0	0	0	0	0	0	0											0	0	5.693444725	3.431660895	1.700655376	4.797864586	0.417817482	1.174351544	5.724832304	4.074958303	6.086450665	0	0.046657932	3.354759948	0.321687124	15.81675531	0.308214905	0.991955093	1.374474415	2.222520942	1.654634833	1.453929642	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6476	1000	4.76	17.3208	0.129206519	5.693444725	3.431660895	1.700655376	4.797864586	0.417817482	1.174351544	5.724832304	4.074958303	6.086450665	0	0.046657932	3.354759948	0.321687124	15.81675531	0.308214905	0.991955093	1.374474415	2.222520942	1.654634833	1.453929642	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.0976	5000	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	1000	0	17.3208	0.129206519	5.693444725	3.431660895	1.700655376	4.797864586	0.417817482	1.174351544	5.724832304	4.074958303	6.086450665	0	0.046657932	3.354759948	0.321687124	15.81675531	0.308214905	0.991955093	1.374474415	2.222520942	1.654634833	1.453929642	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.0976
H4204_801_0	2008	1																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	311.4288969	2.336684929	50.42506189	39.62633841	7.961254495	26.41963294	1.234957156	6.123365628	31.68777471	12.41125171	33.5043828	0	0.27899083	32.73948736	47.13507038	127.1336646	1.437663904	4.83951166	31.542538	41.61398391	9.104811323	6.424134051	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	0	0				0	0	0	0											0.076443998	0.076443998	0.188203023	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											23.8069	0.178625538	9.490149102	0	1.862933552	6.182194108	0.288979974	1.432867557	7.414939282	2.9042329	7.840025574	0	0.065283854	7.661040043	11.02960647	29.74927752	0.336413353	1.132445729	7.380953893	9.737672234	2.13052585	1.503247368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.1283	0	0	23.8069	0.178625538	9.490149102	0	1.862933552	6.182194108	0.288979974	1.432867557	7.414939282	2.9042329	7.840025574	0	0.065283854	7.661040043	11.02960647	29.74927752	0.336413353	1.132445729	7.380953893	9.737672234	2.13052585	1.503247368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.1283	none	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	0	0	N/A	N/A	N/A	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.8069	0.178625538	9.490149102	0	1.862933552	6.182194108	0.288979974	1.432867557	7.414939282	2.9042329	7.840025574	0	0.065283854	7.661040043	11.02960647	29.74927752	0.336413353	1.132445729	7.380953893	9.737672234	2.13052585	1.503247368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.1283
H4204_802_0	2008	1																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	311.4288969	2.336684929	50.42506189	39.62633841	7.961254495	26.41963294	1.234957156	6.123365628	31.68777471	12.41125171	33.5043828	0	0.27899083	32.73948736	47.13507038	127.1336646	1.437663904	4.83951166	31.542538	41.61398391	9.104811323	6.424134051	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	0	0				0	0	0	0											0.076443998	0.076443998	0.188203023	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											23.8069	0.178625538	9.490149102	0	1.862933552	6.182194108	0.288979974	1.432867557	7.414939282	2.9042329	7.840025574	0	0.065283854	7.661040043	11.02960647	29.74927752	0.336413353	1.132445729	7.380953893	9.737672234	2.13052585	1.503247368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.1283	0	0	23.8069	0.178625538	9.490149102	0	1.862933552	6.182194108	0.288979974	1.432867557	7.414939282	2.9042329	7.840025574	0	0.065283854	7.661040043	11.02960647	29.74927752	0.336413353	1.132445729	7.380953893	9.737672234	2.13052585	1.503247368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.1283	none	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	0	0	N/A	N/A	N/A	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.8069	0.178625538	9.490149102	0	1.862933552	6.182194108	0.288979974	1.432867557	7.414939282	2.9042329	7.840025574	0	0.065283854	7.661040043	11.02960647	29.74927752	0.336413353	1.132445729	7.380953893	9.737672234	2.13052585	1.503247368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.1283
H4205_002_0	2008	12																					5000											D	D	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	786.5369809	9.279472004	700.2385835	19.84911595	226.1735846	27.7167618	1.329445009	473.180175	28.66689993	8.908639495	24.45336413	0	0.182102465	23.65686978	3494.387017	4993.05973	125.2001957	403.5235322	21.70829148	4066.916486	4.748406461	3381.309782	0	0	420.9371054	341.3942659	176.9750654	0	0	0	0											$150 Per Day 1-4	$150 Per Day 1-4	"$100/day, days 11-100"	15%	$100 Per Trip	30% DME $10 Diab Monit	30%	"$50 copay ER/ ER, UC like physician"	15% ASC/15% OP Hosp	15%	15%	0	20%	15%	$10 copay	$20 copay	$20 copay	$20 copay	15%	$20 copay Hearing/$20 copay SA	20%	15% Blood/$25 Vision	0	0	$25 copay	$0 frames/$25 lenses	$20 copay	0	0	0	0											135.8600491	135.8600238	57.76338614	0.133236991	89.47902412	0.250897285	0.276538376	35.06629915	0.138488248	0.135663141	0.135663141	0	0.180884061	0.135663141	9.034840969	19.29812747	17.61737028	17.61736418	0.031001334	2.755032589	0.173194571	25.20999486	0	0	22.87180817	22.87191392	18.22049475	0	0	0	0											8.9049	0.105059107	3.370679308	2.644636491	1.686482636	6.954060298	0.367642564	1.382723131	3.970028759	1.208574015	3.317420184	0	0.032939433	3.20936526	2.630935915	8.029725263	0.183808184	0.592418418	0.672986	0.933707288	0.822398222	7.103566851	0	0	0.802299394	0.650695022	0.268714437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8458	0	5.99	8.9049	0.105059107	3.370679308	2.644636491	1.686482636	6.954060298	0.367642564	1.382723131	3.970028759	1.208574015	3.317420184	0	0.032939433	3.20936526	2.630935915	8.029725263	0.183808184	0.592418418	0.672986	0.933707288	0.822398222	7.103566851	0	0	0.802299394	0.650695022	0.268714437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8458	5000		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.9049	0.105059107	3.370679308	2.644636491	1.686482636	6.954060298	0.367642564	1.382723131	3.970028759	1.208574015	3.317420184	0	0.032939433	3.20936526	2.630935915	8.029725263	0.183808184	0.592418418	0.672986	0.933707288	0.822398222	7.103566851	0	0	0.802299394	0.650695022	0.268714437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8458
H4205_003_0	2008	9																					5000											D	D	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1065.070919	12.61402426	844.6864333	29.56480998	317.628734	30.03757305	1.438329405	458.1290737	30.21130319	11.69626228	32.09219035	0	0.204632979	31.03582865	4899.376122	7117.819881	175.8259994	566.6336148	28.30047039	6311.105087	8.736249624	770.3196653	0	0	407.8129422	353.0436167	179.0066088	0	0	0	0											$150 Per Day 1-4	$150 Per Day 1-4	"$100/day, days 11-100"	15%	$100 Per Trip	30% DME $10 Diab Monit	30%	"$50 copay ER, UC like physician"	15% ASC/15% OP Hosp	15%	15%	0	20%	15%	$10 copay	$20 copay	$20 copay	$20 copay	15%	$20 copay Hearing/$20 copay SA	20%	15% Blood/$25 Vision	0	0	$25 copay	$0 frames/$25 lenses	$20 copay	0	0	0	0											133.1173154	133.1176437	58.48931108	0.133119446	88.74912283	0.240715893	0.266247072	33.23388454	0.133119446	0.133119446	0.133119446	0	0.177494185	0.133119446	9.120980299	19.67987671	17.74968043	17.74974241	0.030476279	2.802006799	0.177494185	22.87147149	0	0	22.19065024	22.18914058	17.75009598	0	0	0	0											11.8149	0.139929099	4.117093964	3.935651118	2.349105961	7.230521209	0.382950993	1.268784062	4.021711936	1.556999953	4.272094593	0	0.036321164	4.131472308	3.72392609	11.67315148	0.260071275	0.838133392	0.862493019	1.473646614	1.550633509	1.468195355	0	0	0.754136197	0.652811203	0.264782041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7796	0	8.72	11.8149	0.139929099	4.117093964	3.935651118	2.349105961	7.230521209	0.382950993	1.268784062	4.021711936	1.556999953	4.272094593	0	0.036321164	4.131472308	3.72392609	11.67315148	0.260071275	0.838133392	0.862493019	1.473646614	1.550633509	1.468195355	0	0	0.754136197	0.652811203	0.264782041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7796	5000		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.8149	0.139929099	4.117093964	3.935651118	2.349105961	7.230521209	0.382950993	1.268784062	4.021711936	1.556999953	4.272094593	0	0.036321164	4.131472308	3.72392609	11.67315148	0.260071275	0.838133392	0.862493019	1.473646614	1.550633509	1.468195355	0	0	0.754136197	0.652811203	0.264782041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7796
H4205_004_0	2008	9																					5000											D	D	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	927.4308635	11.06304326	949.1741845	29.27128317	316.2169024	28.58419739	1.367205013	471.3507408	30.02012419	11.62390379	31.88636208	0	0.219086439	30.83166971	5408.971347	7767.598115	176.7666758	569.7020796	26.29306928	5865.761269	8.677811005	844.1228167	0	0	468.460629	351.7855526	206.0605727	0	0	0	0											$150 Per Day 1-4	$150 Per Day 1-4	"$100/day, days 11-100"	15%	$100 Per Trip	30% DME $10 Diab Monit	30%	"$50 copay ER, UC like physician"	15% ASC/15% OP Hosp	15%	15%	0	20%	15%	$10 copay	$20 copay	$20 copay	$20 copay	15%	$20 copay Hearing/$20 copay SA	20%	15% Blood/$25 Vision	0	0	$25 copay	$0 frames/$25 lenses	$20 copay	0	0	0	0											133.3228572	133.3226104	58.57749622	0.133321413	88.87876544	0.242101991	0.266637171	33.24916625	0.133321413	0.133321413	0.133321413	0	0.177760784	0.133321413	9.157053149	19.79930144	17.7759426	17.77590431	0.030516103	2.996596166	0.177760784	22.79006572	0	0	22.21688844	22.21819196	17.77560997	0	0	0	0											10.304	0.122912817	4.633353933	3.902488831	2.342080658	6.920291111	0.364547676	1.306001595	4.002325374	1.549715278	4.251134847	0	0.038944977	4.110521769	4.127519843	12.81608471	0.261849524	0.843914138	0.802362001	1.464776478	1.542574492	1.603134539	0	0	0.867311461	0.651336578	0.305237698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1344	0	8.65	10.304	0.122912817	4.633353933	3.902488831	2.342080658	6.920291111	0.364547676	1.306001595	4.002325374	1.549715278	4.251134847	0	0.038944977	4.110521769	4.127519843	12.81608471	0.261849524	0.843914138	0.802362001	1.464776478	1.542574492	1.603134539	0	0	0.867311461	0.651336578	0.305237698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1344	5000		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.304	0.122912817	4.633353933	3.902488831	2.342080658	6.920291111	0.364547676	1.306001595	4.002325374	1.549715278	4.251134847	0	0.038944977	4.110521769	4.127519843	12.81608471	0.261849524	0.843914138	0.802362001	1.464776478	1.542574492	1.603134539	0	0	0.867311461	0.651336578	0.305237698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1344
H4205_801_0	2008	1																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	309.8295935	2.316087535	50.24263071	39.55353144	7.914255689	26.24594617	1.232504132	6.115494214	31.6481179	12.38930268	33.45856314	0	0.279027847	32.7650868	47.07864479	127.0008333	1.437014198	4.837402495	31.47210043	41.57183715	9.111311779	6.428422061	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	0	0				0	0	0	0											0.076443998	0.076443998	0.188203023	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											23.6846	0.177050991	9.455815002	0	1.851935831	6.141551405	0.288405967	1.431025646	7.405659589	2.899096827	7.829303774	0	0.065292516	7.667030312	11.01640288	29.71819499	0.336261322	1.131952184	7.3644715	9.727809893	2.132046956	1.504250762	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.8282	0	0	23.6846	0.177050991	9.455815002	0	1.851935831	6.141551405	0.288405967	1.431025646	7.405659589	2.899096827	7.829303774	0	0.065292516	7.667030312	11.01640288	29.71819499	0.336261322	1.131952184	7.3644715	9.727809893	2.132046956	1.504250762	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.8282	none	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	0	0	N/A	N/A	N/A	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.6846	0.177050991	9.455815002	0	1.851935831	6.141551405	0.288405967	1.431025646	7.405659589	2.899096827	7.829303774	0	0.065292516	7.667030312	11.01640288	29.71819499	0.336261322	1.131952184	7.3644715	9.727809893	2.132046956	1.504250762	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.8282
H4205_802_0	2008	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	309.8295935	2.316087535	50.24263071	39.55353144	7.914255689	26.24594617	1.232504132	6.115494214	31.6481179	12.38930268	33.45856314	0	0.279027847	32.7650868	47.07864479	127.0008333	1.437014198	4.837402495	31.47210043	41.57183715	9.111311779	6.428422061	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	0	0				0	0	0	0											0.076443998	0.076443998	0.188203023	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											23.6846	0.177050991	9.455815002	0	1.851935831	6.141551405	0.288405967	1.431025646	7.405659589	2.899096827	7.829303774	0	0.065292516	7.667030312	11.01640288	29.71819499	0.336261322	1.131952184	7.3644715	9.727809893	2.132046956	1.504250762	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.8282	0	0	23.6846	0.177050991	9.455815002	0	1.851935831	6.141551405	0.288405967	1.431025646	7.405659589	2.899096827	7.829303774	0	0.065292516	7.667030312	11.01640288	29.71819499	0.336261322	1.131952184	7.3644715	9.727809893	2.132046956	1.504250762	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.8282	none	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	0	0	N/A	N/A	N/A	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.6846	0.177050991	9.455815002	0	1.851935831	6.141551405	0.288405967	1.431025646	7.405659589	2.899096827	7.829303774	0	0.065292516	7.667030312	11.01640288	29.71819499	0.336261322	1.131952184	7.3644715	9.727809893	2.132046956	1.504250762	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.8282
H4206_001_0	2008	6																					5000											D	D	D	coin	T	coin	coin	V	V	P	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	938.909343	12.86693837	797.7353254	31.12712582	304.8274169	27.08526017	1.315370878	405.8784137	415.3388111	2681.006027	1379.061078	0	0.18764757	1719.243322	4782.117186	5582.632132	151.8708071	487.2171163	27.12108711	117.7159124	7.828967304	804.337882	0	0	0	0	0	0	0	0	0											$150 Per Day 1-7	$150 Per Day 1-7	$75 Per Day:6-100		$50 Per Trip	20% DME 0% Diab Monit	20%	$50 copay	$50 ASC copay/$100 OP Hosp copay	$20 copay	$20 copay	0	20%	20%	$15 copay	$30 copay	$30 copay	$30 copay	$20 copay	$30 copay Hearing/$30 copay SA	20%	$30 Blood/$30 Vision	0	0		0		0	0	0	0											137.8235781	137.8235781	68.91178904	0	45.94119269	0.150694463	0.183764771	46.9971584	55.25030976	18.37647708	18.37647708	0	0.183764771	19.63644742	13.78235781	27.55466605	27.56471562	27.56471562	0	27.40605802	0.183764771	27.56471562	0	0	0	0	0	0	0	0	0											10.7837	0.147780624	4.581114038	0	1.167011258	4.081598726	0.241718828	1.589594342	1.912299831	4.105620484	2.111857023	0	0.034483013	2.813319257	5.492404178	12.81896367	0.348856301	1.119166771	0	0.268844094	1.438688382	1.847612081	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9046	0	5.6446	10.7837	0.147780624	4.581114038	0	1.167011258	4.081598726	0.241718828	1.589594342	1.912299831	4.105620484	2.111857023	0	0.034483013	2.813319257	5.492404178	12.81896367	0.348856301	1.119166771	0	0.268844094	1.438688382	1.847612081	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9046	5000	20%	20%	$75 Per Day:6-100		$50 Per Trip	30% DME 0% Diab Monit	30%	$50 copay	20% ASC/30% OP Hosp	20%	20%	0	20%	20%	20%	20%	50%	20%	20%	20% Hearing/20% SA	20%	20% Blood/20% Vision	0	0		0		0	0	0	0											1.3372	0.0075	0.1986	0.0445	0.0268	0.1288	0.0069	0.0331	0.1415	0.0505	0.1382	0	0.0011	0.1334	0.1977	0.6339	0.011	0.0195	0.142	0.1814	0.0374	0.0259	0	0	0	0	0	0	0	0	0											3.4969	750	0.6172	12.1209	0.155278196	4.779697704	0.04448007	1.193765508	4.210378946	0.248660501	1.622658174	2.053836734	4.1561119	2.250020545	0	0.035554346	2.946725356	5.690124767	13.45282811	0.359881488	1.138685804	0.142017855	0.450255717	1.476101239	1.873511595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4014
H4206_002_0	2008	7																					2500											coin	coin	D	coin	T	coin	coin	V	V	P	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	2500	246.6130148	1.788749864	797.7353254	31.12712582	304.8274169	27.08526017	1.315370878	428.8960445	415.3388111	2681.006027	1379.061078	0	0.18764757	1719.243322	4927.707738	5696.347707	155.1757079	497.8538841	27.3132693	120.2791385	7.828967304	820.938653	0	0	0	0	0	0	0	0	0													$75 Per Day:6-100		$50 Per Trip	20% DME 0% Diab Monit	20%	$50 copay	$25 ASC copay/$50 OP Hosp copay	$10 copay	$10 copay	0	20%	20%	$10 copay	$20 copay	$20 copay	$20 copay	$10 copay	$20 copay Hearing/$20 copay SA	20%	$20 Blood/$20 Vision	0	0		0		0	0	0	0											-7.76E-19	2.42E-19	65.72506758	0	43.81671172	0.143725825	0.175266847	34.95192736	26.34767138	8.763342345	8.763342345	0	0.175266847	16.71402641	8.763342345	17.52668469	17.52668469	17.52668469	0	17.52668469	0.175266847	17.52668469	0	0	0	0	0	0	0	0	0											0	4.34E-19	4.369267348	0	1.113044588	3.892851367	0.230540906	1.249228616	0.911934209	1.957881137	1.007098695	0	0.032888398	2.39462319	3.598599157	8.319840845	0.226642975	0.727144004	0	0.175674545	1.372158414	1.199027743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7784	0	5.7222	0	4.34E-19	4.369267348	0	1.113044588	3.892851367	0.230540906	1.249228616	0.911934209	1.957881137	1.007098695	0	0.032888398	2.39462319	3.598599157	8.319840845	0.226642975	0.727144004	0	0.175674545	1.372158414	1.199027743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7784	2500	20%	20%	$75 Per Day:6-100		$50 Per Trip	30% DME 0% Diab Monit	30%	$50 copay	20% ASC/30% OP Hosp	20%	20%	0	20%	20%	20%	20%	50%	20%	20%	20% Hearing/20% SA	20%	20% Blood/20% Vision	0	0		0		0	0	0	0											1.0489	0.008	0.1523	0.0313	0.0208	0.1015	0.0055	0.0229	0.1114	0.0396	0.1084	0	0.0008	0.1046	0.1555	0.5023	0.0088	0.0153	0.1117	0.1428	0.0293	0.0203	0	0	0	0	0	0	0	0	0											2.7422	500	1.0966	1.0489	0.00800833	4.521551801	0.031264351	1.133834809	3.994399396	0.236043753	1.272153976	1.023349847	1.997485732	1.115471776	0	0.033728733	2.49926463	3.754062361	8.822182787	0.235457481	0.742454397	0.111730262	0.318452158	1.401504412	1.219342875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5206
H4206_005_0	2008	6																					5000											D	D	D	coin	T	coin	coin	V	V	P	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	1014.896097	13.72712849	675.1869971	27.31533233	272.0781972	23.62583187	1.15241476	375.3867715	384.0431724	2478.100462	1274.920412	0	0.195706433	1590.063436	4476.251583	5349.850128	156.1834557	501.158413	25.61607565	111.6688089	7.022733913	752.4928836	0	0	0	0	0	0	0	0	0											$150 Per Day 1-7	$150 Per Day 1-7	$75 Per Day:6-100		$50 Per Trip	20% DME 0% Diab Monit	20%	$50 copay	$50 ASC copay/$100 OP Hosp copay	$20 copay	$20 copay	0	20%	20%	$15 copay	$30 copay	$30 copay	$30 copay	$20 copay	$30 copay Hearing/$30 copay SA	20%	$30 Blood/$30 Vision	0	0		0		0	0	0	0											138.7801964	138.7801964	69.39009818	0	46.26006545	0.151740416	0.185040262	47.40972906	55.63379608	18.50402618	18.50402618	0	0.185040262	19.37099084	13.87801964	27.75603927	27.75603927	27.75603927	-2.71E-19	27.60605599	0.185040262	27.75603927	0	0	0	0	0	0	0	0	0											11.7373	0.158754466	3.904274335	0	1.048862934	3.584993563	0.213243129	1.483082094	1.780481628	3.821236319	1.965930057	0	0.03621357	2.566758688	5.176792281	12.37422085	0.361252844	1.159181049	-6.94E-18	0.256894616	1.299488522	1.740518503	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.6695	0	5.0368	11.7373	0.158754466	3.904274335	0	1.048862934	3.584993563	0.213243129	1.483082094	1.780481628	3.821236319	1.965930057	0	0.03621357	2.566758688	5.176792281	12.37422085	0.361252844	1.159181049	-6.94E-18	0.256894616	1.299488522	1.740518503	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.6695	5000	20%	20%	$75 Per Day:6-100		$50 Per Trip	30% DME 0% Diab Monit	30%	$50 copay	20% ASC/30% OP Hosp	20%	20%	0	20%	20%	20%	20%	50%	20%	20%	20% Hearing/20% SA	20%	20% Blood/20% Vision	0	0		0		0	0	0	0											1.3373	0.0073	0.1986	0.0445	0.0268	0.1288	0.0069	0.0331	0.1416	0.0505	0.1382	0	0.0011	0.1334	0.1977	0.6339	0.011	0.0195	0.142	0.1814	0.0374	0.0259	0	0	0	0	0	0	0	0	0											3.497	750	0.617	13.0746	0.166020325	4.102877589	0.04448879	1.075620055	3.713785865	0.220185419	1.516148849	1.922032026	3.871732715	2.104107207	0	0.037285009	2.700177946	5.374532295	13.00814271	0.372278929	1.178702008	0.14203147	0.438323567	1.336905069	1.766420571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1664
H4206_006_0	2008	7																					2500											coin	coin	D	coin	T	coin	coin	V	V	P	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	2500	268.5985666	1.956341089	675.1869971	27.31533233	272.0781972	23.62583187	1.15241476	396.6341716	384.0431724	2478.100462	1274.920412	0	0.195706433	1590.063436	4612.271856	5458.974055	159.589507	512.1213552	25.79783305	114.0969977	7.022733913	768.0026525	0	0	0	0	0	0	0	0	0													$75 Per Day:6-100		$50 Per Trip	20% DME 0% Diab Monit	20%	$50 copay	$25 ASC copay/$50 OP Hosp copay	$10 copay	$10 copay	0	20%	20%	$10 copay	$20 copay	$20 copay	$20 copay	$10 copay	$20 copay Hearing/$20 copay SA	20%	$20 Blood/$20 Vision	0	0		0		0	0	0	0											3.26E-19	0	66.94634113	0	44.63089409	0.146396474	0.178523576	35.68400351	26.83725192	8.926178818	8.926178818	0	0.178523576	16.63673734	8.926178818	17.85235764	17.85235764	17.85235764	0	17.85235764	0.178523576	17.85235764	0	0	0	0	0	0	0	0	0											0	0	3.76677492	0	1.011924433	3.45873847	0.205733204	1.179457931	0.858888614	1.843330654	0.948347298	0	0.034938212	2.204455645	3.430830278	8.121296429	0.237420746	0.761881132	0	0.169741701	1.253723574	1.142554835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.63	0	4.7814	0	0	3.76677492	0	1.011924433	3.45873847	0.205733204	1.179457931	0.858888614	1.843330654	0.948347298	0	0.034938212	2.204455645	3.430830278	8.121296429	0.237420746	0.761881132	0	0.169741701	1.253723574	1.142554835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.63	2500	20%	20%	$75 Per Day:6-100		$50 Per Trip	30% DME 0% Diab Monit	30%	$50 copay	20% ASC/30% OP Hosp	20%	20%	0	20%	20%	20%	20%	50%	20%	20%	20% Hearing/20% SA	20%	20% Blood/20% Vision	0	0		0		0	0	0	0											1.0489	0.008	0.1523	0.0313	0.0208	0.1015	0.0055	0.0229	0.1114	0.0396	0.1084	0	0.0008	0.1046	0.1555	0.5023	0.0088	0.0153	0.1117	0.1428	0.0293	0.0203	0	0	0	0	0	0	0	0	0											2.7422	500	1.0966	1.0489	0.00800833	3.919059373	0.031264351	1.032714655	3.560286499	0.211236051	1.20238329	0.970304252	1.882935249	1.056720379	0	0.035778548	2.309097085	3.586293482	8.623638371	0.246235251	0.777191525	0.111730262	0.312519314	1.283069573	1.162869966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.3722
H4206_007_0	2008	6																					5000											D	D	D	coin	T	coin	coin	V	V	P	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	1012.984784	13.37237169	599.7189116	29.35320049	265.2900115	27.10651785	1.322250682	254.1695525	259.6213786	1670.395606	860.6290446	0	0.207152648	1076.898577	4981.974711	5992.350794	177.544937	570.0376685	33.28000097	124.6368459	7.622055105	820.2782158	0	0	0	0	0	0	0	0	0											$150 Per Day 1-7	$150 Per Day 1-7	$75 Per Day:6-100		$50 Per Trip	20% DME 0% Diab Monit	20%	$50 copay	$50 ASC copay/$100 OP Hosp copay	$20 copay	$20 copay	0	20%	20%	$15 copay	$30 copay	$30 copay	$30 copay	$20 copay	$30 copay Hearing/$30 copay SA	20%	$30 Blood/$30 Vision	0	0		0		0	0	0	0											138.7022026	138.7022026	69.35110132	0	46.23406755	0.151655139	0.18493627	47.93106849	55.60253019	18.49362702	18.49362702	0	0.18493627	27.22180521	13.87022026	27.54701596	27.74044053	27.74044053	-1.04E-19	27.55274321	0.18493627	27.74044053	0	0	0	0	0	0	0	0	0											11.7086	0.154564784	3.465930584	0	1.022119692	4.110842732	0.244532109	1.015218186	1.202967129	2.574306109	1.326346046	0	0.038310038	2.442926942	5.758423883	13.75594858	0.41043123	1.317758004	-3.47E-18	0.286173917	1.409594442	1.896239922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1412	0	5.027	11.7086	0.154564784	3.465930584	0	1.022119692	4.110842732	0.244532109	1.015218186	1.202967129	2.574306109	1.326346046	0	0.038310038	2.442926942	5.758423883	13.75594858	0.41043123	1.317758004	-3.47E-18	0.286173917	1.409594442	1.896239922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1412	5000	20%	20%	$75 Per Day:6-100		$50 Per Trip	30% DME 0% Diab Monit	30%	$50 copay	20% ASC/30% OP Hosp	20%	20%	0	20%	20%	20%	20%	50%	20%	20%	20% Hearing/20% SA	20%	20% Blood/20% Vision	0	0		0		0	0	0	0											1.3372	0.007	0.1986	0.0445	0.0268	0.1288	0.0069	0.0331	0.1415	0.0505	0.1382	0	0.0011	0.1334	0.1977	0.6339	0.011	0.0195	0.142	0.1814	0.0374	0.0259	0	0	0	0	0	0	0	0	0											3.4965	750	0.617	13.0458	0.161599527	3.66451899	0.04448007	1.04887452	4.23962624	0.251473969	1.048282913	1.344507549	2.62479873	1.464512866	0	0.039381397	2.576336226	5.956149215	14.38982907	0.421456755	1.337277503	0.142021361	0.467590041	1.447008192	1.922140054	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6377
H4206_008_0	2008	7																					2500											coin	coin	D	coin	T	coin	coin	V	V	P	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	2500	288.1831694	2.101842084	599.7189116	29.35320049	265.2900115	27.10651785	1.322250682	268.3382878	259.6213786	1670.395606	860.6290446	0	0.207152648	1076.898577	5134.17219	6115.237227	181.4399398	582.576349	33.51737783	127.3624099	7.622055105	837.6309641	0	0	0	0	0	0	0	0	0													$75 Per Day:6-100		$50 Per Trip	20% DME 0% Diab Monit	20%	$50 copay	$25 ASC copay/$50 OP Hosp copay	$10 copay	$10 copay	0	20%	20%	$10 copay	$20 copay	$20 copay	$20 copay	$10 copay	$20 copay Hearing/$20 copay SA	20%	$20 Blood/$20 Vision	0	0		0		0	0	0	0											1.10E-19	2.06E-19	66.73274662	0	44.48849775	0.145929391	0.177953991	36.09615368	26.75162678	8.89769955	8.89769955	0	0.177953991	24.1464647	8.89769955	17.7953991	17.7953991	17.7953991	-2.07E-19	17.7953991	0.177953991	17.7953991	0	0	0	0	0	0	0	0	0											0	4.34E-19	3.335074181	0	0.983529506	3.955637635	0.235299786	0.807165006	0.578774519	1.238556519	0.638134889	0	0.03686364	2.166941124	3.806860132	9.068590587	0.269066345	0.863931553	-6.94E-18	0.188872076	1.356375125	1.242164775	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.7718	0	4.9088	0	4.34E-19	3.335074181	0	0.983529506	3.955637635	0.235299786	0.807165006	0.578774519	1.238556519	0.638134889	0	0.03686364	2.166941124	3.806860132	9.068590587	0.269066345	0.863931553	-6.94E-18	0.188872076	1.356375125	1.242164775	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.7718	2500	20%	20%	$75 Per Day:6-100		$50 Per Trip	30% DME 0% Diab Monit	30%	$50 copay	20% ASC/30% OP Hosp	20%	20%	0	20%	20%	20%	20%	50%	20%	20%	20% Hearing/20% SA	20%	20% Blood/20% Vision	0	0		0		0	0	0	0											1.0489	0.008	0.1523	0.0313	0.0208	0.1015	0.0055	0.0229	0.1114	0.0396	0.1084	0	0.0008	0.1046	0.1555	0.5023	0.0088	0.0153	0.1117	0.1428	0.0293	0.0203	0	0	0	0	0	0	0	0	0											2.7422	500	1.0966	1.0489	0.00800833	3.487358634	0.031264351	1.004319728	4.057185664	0.240802633	0.830090366	0.690190157	1.278161114	0.74650797	0	0.037703976	2.271582565	3.962323336	9.570932529	0.27788085	0.879241946	0.111730262	0.331649689	1.385721124	1.262479907	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.514
H4206_009_0	2008	6																					5000											D	D	D	coin	T	coin	coin	V	V	P	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	982.5724215	13.36411989	735.6585109	32.13551284	308.9145191	32.72719873	1.587733583	288.1274896	294.4845565	1896.237157	976.5914119	0	0.186077271	1220.88359	4997.032143	5790.3521	153.6676157	493.0266876	28.19083389	122.4639322	7.463808593	826.2977005	0	0	0	0	0	0	0	0	0											$150 Per Day 1-7	$150 Per Day 1-7	$75 Per Day:6-100		$50 Per Trip	20% DME 0% Diab Monit	20%	$50 copay	$50 ASC copay/$100 OP Hosp copay	$20 copay	$20 copay	0	20%	20%	$15 copay	$30 copay	$30 copay	$30 copay	$20 copay	$30 copay Hearing/$30 copay SA	20%	$30 Blood/$30 Vision	0	0		0		0	0	0	0											138.294641	138.294641	69.14732048	0	46.09821365	0.151209516	0.184392855	47.57588584	55.43914806	18.43928546	18.43928546	0	0.184392855	24.28753809	13.8294641	27.59129273	27.65892819	27.65892819	-1.23E-19	27.48795188	0.184392855	27.65892819	0	0	0	0	0	0	0	0	0											11.3237	0.154015513	4.239067901	0	1.186700625	4.948663896	0.292766728	1.142326713	1.360497744	2.913771521	1.500637319	0	0.034311319	2.471021391	5.758856384	13.31360832	0.354190129	1.136382479	-3.47E-18	0.280523556	1.376272973	1.904542397	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6919	0	5.3182	11.3237	0.154015513	4.239067901	0	1.186700625	4.948663896	0.292766728	1.142326713	1.360497744	2.913771521	1.500637319	0	0.034311319	2.471021391	5.758856384	13.31360832	0.354190129	1.136382479	-3.47E-18	0.280523556	1.376272973	1.904542397	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6919	5000	20%	20%	$75 Per Day:6-100		$50 Per Trip	30% DME 0% Diab Monit	30%	$50 copay	20% ASC/30% OP Hosp	20%	20%	0	20%	20%	20%	20%	50%	20%	20%	20% Hearing/20% SA	20%	20% Blood/20% Vision	0	0		0		0	0	0	0											1.3297	0.0073	0.1975	0.0444	0.0266	0.128	0.0069	0.0329	0.1407	0.0502	0.1374	0	0.0011	0.1327	0.1966	0.6301	0.011	0.0194	0.1412	0.1804	0.0372	0.0258	0	0	0	0	0	0	0	0	0											3.4769	750	0.6044	12.6534	0.16133396	4.436535954	0.044410311	1.213314195	5.076695219	0.299666591	1.175190835	1.501220259	2.963979283	1.638024658	0	0.035376634	2.603678034	5.955463014	13.94369767	0.365145601	1.155791857	0.141203805	0.460892689	1.413475649	1.930296411	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.1688
H4206_010_0	2008	7																					2500											coin	coin	D	coin	T	coin	coin	V	V	P	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	2500	242.4877324	1.763214099	735.6585109	32.13551284	308.9145191	32.72719873	1.587733583	304.2604519	294.4845565	1896.237157	976.5914119	0	0.186077271	1220.88359	5149.494407	5908.411296	157.0147363	503.7996052	28.39091524	125.1361251	7.463808593	843.6814691	0	0	0	0	0	0	0	0	0													$75 Per Day:6-100		$50 Per Trip	20% DME 0% Diab Monit	20%	$50 copay	$25 ASC copay/$50 OP Hosp copay	$10 copay	$10 copay	0	20%	20%	$10 copay	$20 copay	$20 copay	$20 copay	$10 copay	$20 copay Hearing/$20 copay SA	20%	$20 Blood/$20 Vision	0	0		0		0	0	0	0											2.38E-19	0	66.01241478	0	44.00827652	0.144354188	0.176033106	35.50380059	26.46286228	8.801655305	8.801655305	0	0.176033106	21.16151632	8.801655305	17.60331061	17.60331061	17.60331061	0	17.60331061	0.176033106	17.60331061	0	0	0	0	0	0	0	0	0											0	0	4.046882897	0	1.132899632	4.724308208	0.279493674	0.900200201	0.649408689	1.390835486	0.716301748	0	0.03275576	2.152979001	3.77700623	8.667299937	0.230331598	0.739045078	0	0.183567507	1.31387741	1.237632246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1748	0	5.4596	0	0	4.046882897	0	1.132899632	4.724308208	0.279493674	0.900200201	0.649408689	1.390835486	0.716301748	0	0.03275576	2.152979001	3.77700623	8.667299937	0.230331598	0.739045078	0	0.183567507	1.31387741	1.237632246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1748	2500	20%	20%	$75 Per Day:6-100		$50 Per Trip	30% DME 0% Diab Monit	30%	$50 copay	20% ASC/30% OP Hosp	20%	20%	0	20%	20%	20%	20%	50%	20%	20%	20% Hearing/20% SA	20%	20% Blood/20% Vision	0	0		0		0	0	0	0											1.0435	0.008	0.1515	0.0312	0.0207	0.101	0.0055	0.0228	0.1108	0.0394	0.1078	0	0.0008	0.1041	0.1547	0.4996	0.0088	0.0152	0.1111	0.142	0.0292	0.0202	0	0	0	0	0	0	0	0	0											2.728	500	1.079	1.0435	0.007967171	4.198389842	0.03123821	1.153590091	4.825316618	0.284966211	0.923003323	0.760237813	1.43023653	0.824117838	0	0.033591777	2.257082629	3.931668003	9.166893039	0.239095545	0.754276782	0.111144324	0.325594505	1.343072583	1.257842966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.9028
H4206_025_0	2008	7																					3000											A	A	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	V	V	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											46.2283	0.3365	8.9259	7.9188	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											63.4095	3000	328.1378438	3.211654479	60.73768044	53.9095972	13.98265061	47.8394328	2.328629557	5.65373083	28.24008859	10.92798611	29.86035628	0	0.183410003	28.31722644	146.2158385	2736.955387	1.012259207	3.323467523	29.15116572	33.37817198	7.934415572	5.545030898	0	0	0	0	0	0	0	0	0											"$1075 Ded, $250/day 61+"	"$1075 Ded, $250/day 61+"	20%		20% Per Trip	20% DME 0% Diab Monit	20%	20%	20% 20%	20%	20%	0	20%	20%	0%	0%	20%	20%	20%	20% Hearing/20% SA	20%	20% Blood/20% Vision	0	0		0		0	0	0	0											62.08148222	62.08099216	0.007096368	0	0.178373506	0.14627341	0.178373506	0.181963711	0.178373506	0.178373506	0.178373506	0	0.178373506	0.178373506	18.98367004	20.78068599	0.178373506	0.178373506	0.036375229	0.051982829	0.178373506	0.178373506	0	0	0	0	0	0	0	0	0											1.6976	0.016615225	0.431016915	0	2.494134413	6.99763696	0.415365818	1.028773841	5.037283612	1.949263195	5.32629644	0	0.032715485	5.05104296	0.231309436	4.739650873	0.180560224	0.592818554	1.060380335	1.735091818	1.415289524	0.989086602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.4219	1075	5.5525	47.9259	0.353129365	9.356913254	7.918780429	2.494134413	6.99763696	0.415365818	1.028773841	5.037283612	1.949263195	5.32629644	0	0.032715485	5.05104296	0.231309436	4.739650873	0.180560224	0.592818554	1.060380335	1.735091818	1.415289524	0.989086602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.8314	3000	20%	20%	$0.2 Per Day:0-0		$0.2 Per Trip	20% DME 20% Diab Monit	20%	20%	20% ASC/20% OP Hosp	20%	20%	0	20%	20%	20%	20%	20%	20%	20%	20% Hearing/20% SA	20%	20% Blood/20% Vision	0	0		0		0	0	0	0											0.939	0.0072	0.0935	0.0796	0.0227	0.0784	0.0036	0.0094	0.0455	0.0177	0.0485	0	0.0003	0.0469	0.0621	0.1652	0.0019	0.0062	0.0416	0.0527	0.0131	0.0083	0	0	0	0	0	0	0	0	0											1.7435	1075	0.5134	48.865	0.360299052	9.450431126	7.998403531	2.516880256	7.076012509	0.418999663	1.038221373	5.082796753	1.967000412	5.374832142	0	0.033053089	5.097907418	0.293428148	4.904816526	0.182427263	0.598969488	1.101955396	1.787746767	1.42843235	0.997394364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.575
H4207_004_0	2008	4																					6000											D	D	coin	coin	T	coin	coin	V	coin	coin	coin	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0.3182	1.7053	0.6511	1.7742	0	0	1.7488	0	0	0	0	0	0	0.4917	0.0531	0	0	0	0	0	0	0	0	0											6.7424	6000	860.0400811	10.37823499	31.98253035	25.49747522	266.922263	21.77366434	1.111740212	335.181656	24.01442909	9.168650635	24.98599953	0	0.197153621	24.62825456	4686.694048	6812.097251	165.7745429	543.0310976	24.02056229	5319.917431	6.913215037	774.8089039	0	0	440.146222	0	189.2266417	0	0	0	0											$150 Per Day 1-5	$150 Per Day 1-5	$10 day 1-10; $100 day 11-100	10%	$50 Per Trip	25% DME $7 Diab Monit	25%	$50 copay ER/$30 copay UC	10% ASC/10% OP Hosp	10%	10%	0	20%	10%	$20 copay	$30 copay	$30 copay	$20 copay	10%	$30 copay Hearing/$30 copay SA	20%	10% Blood/$25 Vision	0	0	$25 copay	$0 frames/$25 lenses	$30 copay	0	0	0	0											142.1174046	142.1174046	0	0.094744936	47.37246819	0.213438438	0.236862341	41.83089765	0.094676837	0.094676837	0.094676837	0	0.189489873	0.094676837	18.70624485	26.57157128	28.42348091	18.94898727	0.021710861	2.356848714	0.189336401	23.74839068	0	0	23.68623409	0	28.42348091	0	0	0	0											10.1856	0.122910652	0	2.415756668	1.053730534	4.64733691	0.263329389	1.168412462	2.27361019	0.868058842	2.365595407	0	0.037358615	2.331725245	7.305870532	15.08401064	0.392657463	0.85749078	0.521507086	1.04485338	1.308923253	1.533372046	0	0	0.868783871	0	0.448206653	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0991	100	3.8568	10.1856	0.122910652	0	2.415756668	1.053730534	4.64733691	0.263329389	1.486584701	3.978865466	1.51912116	4.139841522	0	0.037358615	4.080568029	7.305870532	15.08401064	0.392657463	0.85749078	0.521507086	1.04485338	1.800624447	1.586492119	0	0	0.868783871	0	0.448206653	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8415	6000	30%	30%	30%	30%	$50 Per Trip	30% DME 30%Diab Monit	30%	30%ER/30%UC	30% ASC/30% OP Hosp	30%	30%	0	30%	30%	30%	30%	30%	30%	30%	30% Hearing/30% SA	30%	30% Blood/$30 Vision	0	0	Up to $35	Up to $50	30%	0	0	0	0											2.2082	0.0169	0.3238	0.2224	0.0371	0.1853	0.0086	0.0403	0.2153	0.0836	0.2295	0	0.0017	0.221	0.307	0.8357	0.0089	0.0301	0.2082	0.2636	0.0622	0.0457	0	0	0.0137	0.0008	0.0054	0	0	0	0											5.5753	2000	0.6816	12.3938	0.139787726	0.323842251	2.638159785	1.090802914	4.832675337	0.271969406	1.526886381	4.194121337	1.602750462	4.369309135	0	0.039063045	4.301606355	7.612885547	15.91966384	0.401591733	0.887637663	0.72972749	1.308494102	1.862868079	1.63221711	0	0	0.882519908	0.000769655	0.453589464	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4167
H4207_005_0	2008	4																					4000											D	D	coin	coin	T	coin	coin	V	coin	coin	coin	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0.1735	0.9164	0.3499	0.9535	0	0	0.9399	0	0	0	0	0	0	0.2642	0.0285	0	0	0	0	0	0	0	0	0											3.626	4000	774.2908328	8.888744534	31.98253035	25.49747522	266.922263	21.77366434	1.111740212	342.3738742	24.03574416	9.179240885	25.01485961	0	0.197153621	24.65670143	4965.450407	6928.385007	169.2859896	543.0310976	24.18389562	5367.899605	6.922212859	774.8480003	0	0	440.146222	0	193.1863011	0	0	0	0											$150 Per Day 1-4	$150 Per Day 1-4	$10 day 1-10; $100 day 11-100	10%	$50 Per Trip	25% DME $8 Diab Monit	25%	$50 copay ER/$20 copay UC	$100 ASC copay/10% OP Hosp	10%	10%	0	20%	10%	$10 copay	$20 copay	$20 copay	$20 copay	10%	$20 copay Hearing/$20 copay SA	20%	10% Blood/$25 Vision	0	0	$25 copay	$0 frames/$25 lenses	$20 copay	0	0	0	0											136.8397949	136.8397949	2.17E-19	0.09122653	45.61326497	0.208153535	0.228066325	36.60960119	0.109138006	0.09112309	0.09112309	0	0.18245306	0.09112309	9.134719529	18.27447203	18.24530599	18.24530599	0.02076343	2.076944846	0.182219976	22.86610771	0	0	22.80663249	0	18.24530599	0	0	0	0											8.8295	0.101361165	6.94E-18	2.326046187	1.014599659	4.532265205	0.253550504	1.044514249	2.623213179	0.83644079	2.279431294	0	0.035971281	2.246794814	3.779833067	10.55104817	0.257389557	0.825647378	0.502140628	0.929069285	1.261365459	1.47647982	0	0	0.836521094	0	0.293728598	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.8369	50	5.2378	8.8295	0.101361165	6.94E-18	2.326046187	1.014599659	4.532265205	0.253550504	1.218038519	3.539642775	1.186331381	3.232937595	0	0.035971281	3.186648986	3.779833067	10.55104817	0.257389557	0.825647378	0.502140628	0.929069285	1.525613008	1.505027339	0	0	0.836521094	0	0.293728598	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4629	4000	20%	20%	20%	20%	$50 Per Trip	30% DME 20%Diab Monit	30%	20%ER/20%UC	20% ASC/20% OP Hosp	20%	20%	0	20%	20%	20%	20%	20%	20%	20%	30% Hearing/30% SA	20%	20% Blood/$30 Vision	0	0	Up to $35	Up to $50	30%	0	0	0	0											1.3923	0.0106	0.2035	0.1398	0.0283	0.1453	0.0071	0.0276	0.1353	0.0526	0.1442	0	0.0011	0.1389	0.1983	0.5317	0.0059	0.0194	0.1334	0.1695	0.0391	0.0371	0	0	0.01	0.0005	0.0044	0	0	0	0											3.5758	1000	0.72	10.2217	0.111991237	0.203540225	2.465830235	1.042871992	4.677609557	0.260621305	1.245653546	3.674934659	1.238893784	3.377161796	0	0.037042544	3.32557524	3.978139572	11.0827423	0.263257589	0.844997472	0.635573514	1.098592439	1.564734162	1.542102152	0	0	0.846521735	0.000473836	0.298133772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0387
H4207_006_0	2008	4																					6000											D	D	coin	coin	T	coin	coin	V	coin	coin	coin	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0.3178	1.6953	0.6502	1.7877	0	0	1.7471	0	0	0	0	0	0	0.4912	0.0531	0	0	0	0	0	0	0	0	0											6.7424	6000	940.1157869	11.26179681	34.30720589	32.87671448	235.046087	19.33001823	1.001743609	339.7805597	23.58132266	9.044103112	24.86577898	0	0.20073998	24.30178626	4554.036563	6851.169051	171.3283206	561.2409764	29.70381177	6011.648133	6.821448881	752.9665096	0	0	414.7142828	0	178.2930014	0	0	0	0											$150 Per Day 1-5	$150 Per Day 1-5	$10 day 1-10; $100 day 11-100	10%	$50 Per Trip	25% DME $7 Diab Monit	25%	$50 copay ER/$30 copay UC	10% ASC/10% OP Hosp	10%	10%	0	20%	10%	$20 copay	$30 copay	$30 copay	$20 copay	10%	$30 copay Hearing/$30 copay SA	20%	10% Blood/$25 Vision	0	0	$25 copay	$0 frames/$25 lenses	$30 copay	0	0	0	0											141.7648313	141.7648313	-2.02E-19	0.094509888	47.25494378	0.212709962	0.236274719	41.70711859	0.094438495	0.094438495	0.094438495	0	0.189019775	0.094438495	18.64133365	26.57019641	28.35296627	18.90197751	0.021705815	2.264706268	0.18885888	23.66135213	0	0	23.62747189	0	28.35296627	0	0	0	0											11.1063	0.133043894	-6.94E-18	3.107174589	0.925590802	4.111687451	0.23668669	1.180939008	2.226984615	0.854111484	2.348286737	0	0.037943826	2.295024114	7.07444292	15.16974228	0.404805508	0.884047026	0.644745451	1.134551434	1.288291194	1.484683811	0	0	0.816554172	0	0.421261288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8869	100	4.0528	11.1063	0.133043894	-6.94E-18	3.107174589	0.925590802	4.111687451	0.23668669	1.498719861	3.922315442	1.504318728	4.135960916	0	0.037943826	4.042151193	7.07444292	15.16974228	0.404805508	0.884047026	0.644745451	1.134551434	1.779503729	1.537751093	0	0	0.816554172	0	0.421261288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6293	6000	30%	30%	30%	30%	$50 Per Trip	30% DME 30%Diab Monit	30%	30%ER/30%UC	30% ASC/30% OP Hosp	30%	30%	0	30%	30%	30%	30%	30%	30%	30%	30% Hearing/30% SA	30%	30% Blood/$30 Vision	0	0	Up to $35	Up to $50	30%	0	0	0	0											2.2082	0.0169	0.3238	0.2224	0.0371	0.1853	0.0086	0.0403	0.2153	0.0836	0.2295	0	0.0017	0.221	0.307	0.8357	0.0089	0.0301	0.2082	0.2636	0.0622	0.0457	0	0	0.0137	0.0008	0.0054	0	0	0	0											5.5753	2000	0.6816	13.3145	0.149920968	0.323842251	3.329577706	0.962663182	4.297025878	0.245326707	1.539021541	4.137571313	1.587948029	4.36542853	0	0.039648257	4.26318952	7.381457934	16.00539548	0.413739778	0.91419391	0.852965855	1.398192157	1.841747361	1.583476084	0	0	0.830290209	0.000769655	0.426644099	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.2045
H4207_007_0	2008	4																					4000											D	D	coin	coin	T	coin	coin	V	coin	coin	coin	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0.1728	0.9086	0.3485	0.9581	0	0	0.9364	0	0	0	0	0	0	0.2633	0.0284	0	0	0	0	0	0	0	0	0											3.6162	4000	844.5528852	9.620139519	34.30720589	32.87671448	235.046087	19.33001823	1.001743609	347.0368899	23.59876859	9.053629209	24.89196995	0	0.20073998	24.32738318	4823.118725	6966.033541	174.9583746	561.2409764	29.9072537	6065.923743	6.829545154	753.0026633	0	0	414.7142828	0	182.004169	0	0	0	0											$150 Per Day 1-4	$150 Per Day 1-4	$10 day 1-10; $100 day 11-100	10%	$50 Per Trip	25% DME $8 Diab Monit	25%	$50 copay ER/$20 copay UC	$100 ASC copay/10% OP Hosp	10%	10%	0	20%	10%	$10 copay	$20 copay	$20 copay	$20 copay	10%	$20 copay Hearing/$20 copay SA	20%	10% Blood/$25 Vision	0	0	$25 copay	$0 frames/$25 lenses	$20 copay	0	0	0	0											136.3087508	136.3087508	-2.02E-19	0.090872501	45.43625026	0.207127101	0.227181251	36.44739792	0.111436937	0.090763536	0.090763536	0	0.181745001	0.090763536	9.10165955	18.44754332	18.17450011	18.17450011	0.020728457	2.011368308	0.181499465	22.7502594	0	0	22.71812513	0	18.17450011	0	0	0	0											9.5933	0.109275767	-6.94E-18	2.987589254	0.889967736	4.003770645	0.227577367	1.054049301	2.6297745	0.821739403	2.259283216	0	0.036483488	2.208039324	3.658198717	10.70885046	0.26498175	0.850022849	0.619931235	1.016733898	1.239558791	1.427583826	0	0	0.785127581	0	0.275652899	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.6675	50	5.522	9.5933	0.109275767	-6.94E-18	2.987589254	0.889967736	4.003770645	0.227577367	1.226889461	3.538409541	1.170226598	3.217410902	0	0.036483488	3.144435254	3.658198717	10.70885046	0.26498175	0.850022849	0.619931235	1.016733898	1.502830665	1.45602594	0	0	0.785127581	0	0.275652899	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2837	4000	20%	20%	20%	20%	$50 Per Trip	30% DME 20%Diab Monit	30%	20%ER/20%UC	20% ASC/20% OP Hosp	20%	20%	0	20%	20%	20%	20%	20%	20%	20%	30% Hearing/30% SA	20%	20% Blood/$30 Vision	0	0	Up to $35	Up to $50	30%	0	0	0	0											1.3923	0.0106	0.2035	0.1398	0.0283	0.1453	0.0071	0.0276	0.1353	0.0526	0.1442	0	0.0011	0.1389	0.1983	0.5317	0.0059	0.0194	0.1334	0.1695	0.0391	0.0371	0	0	0.01	0.0005	0.0044	0	0	0	0											3.5758	1000	0.72	10.9856	0.119905839	0.203540225	3.127373301	0.918240069	4.149114997	0.234648167	1.254504488	3.673701425	1.222789001	3.361635102	0	0.037554751	3.283361508	3.856505223	11.24054459	0.270849782	0.869372942	0.753364121	1.186257051	1.541951819	1.493100753	0	0	0.795128222	0.000473836	0.280058073	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.8596
H4209_001_0	2008	4																					6000											D	D	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0.3174	1.6972	0.6564	1.8021	0	0	1.7448	0	0	0	0	0	0	0.4911	0.0531	0	0	0	0	0	0	0	0	0											6.762	6000	941.1543412	11.61598043	1078.808872	24.15925221	292.5249033	22.29699128	1.072043994	342.9194261	24.30275679	9.399331779	25.80588193	0	0.191171909	24.98492059	4733.773859	6950.630366	168.8132584	555.9755211	23.00458047	5484.199955	7.020382363	781.6804785	0	0	441.5254983	0	189.8196169	0	0	0	0											$150 Per Day 1-5	$150 Per Day 1-5	$10 day 1-10; $100 day 11-100	10%	$50 Per Trip	25% DME $7 Diab Monit	25%	$50 copay ER/$30 copay UC	10% ASC/10% OP Hosp	10%	10%	0	20%	10%	$20 copay	$30 copay	$30 copay	$20 copay	10%	$30 copay Hearing/$30 copay SA	20%	10% Blood/$25 Vision	0	0	$25 copay	$0 frames/$25 lenses	$30 copay	0	0	0	0											140.2872894	140.2872894	64.82698737	0.09352486	46.76242982	0.212204761	0.233812149	41.2369451	0.093441121	0.093441121	0.093441121	0	0.187049719	0.093441121	18.45768133	25.93289171	28.05745789	18.70497193	0.021540345	2.251374972	0.186861002	23.44033756	0	0	23.38121491	0	28.05745789	0	0	0	0											11.0027	0.135797867	5.827994092	2.259490672	1.139931272	4.731527715	0.25065691	1.178412462	2.270876836	0.878284097	2.411330533	0	0.035758652	2.334618986	7.281207449	15.02082872	0.394705907	0.866625543	0.495526603	1.028915877	1.311835683	1.526904523	0	0	0.860283547	0	0.443821326	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.688	100	5.1014	11.0027	0.135797867	5.827994092	2.259490672	1.139931272	4.731527715	0.25065691	1.495770131	3.968051432	1.534683174	4.213475353	0	0.035758652	4.079432255	7.281207449	15.02082872	0.394705907	0.866625543	0.495526603	1.028915877	1.802895471	1.579955304	0	0	0.860283547	0	0.443821326	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.45	6000	30%	30%	30%	30%	$50 Per Trip	30% DME 30%Diab Monit	30%	30%ER/30%UC	30% ASC/30% OP Hosp	30%	30%	0	30%	30%	30%	30%	30%	30%	30%	30% Hearing/30% SA	30%	30% Blood/$30 Vision	0	0	Up to $35	Up to $50	30%	0	0	0	0											2.2082	0.0169	0.3238	0.2224	0.0371	0.1853	0.0086	0.0403	0.2153	0.0836	0.2295	0	0.0017	0.221	0.307	0.8357	0.0089	0.0301	0.2082	0.2636	0.0622	0.0457	0	0	0.0137	0.0008	0.0054	0	0	0	0											5.5753	2000	0.6816	13.2109	0.152674942	6.151836343	2.481893789	1.177003652	4.916866142	0.259296927	1.536071811	4.183307303	1.618312475	4.442942966	0	0.037463083	4.300470581	7.588222463	15.85648192	0.403640177	0.896772426	0.703747006	1.292556599	1.865139103	1.625680295	0	0	0.874019584	0.000769655	0.449204136	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0253
H4209_002_0	2008	5																					6000											D	D	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0.3169	1.6947	0.6555	1.7995	0	0	1.7422	0	0	0	0	0	0	0.4903	0.053	0	0	0	0	0	0	0	0	0											6.7522	6000	1000.369153	12.26285461	1091.031401	29.51898726	257.7267924	19.41887226	0.938306668	354.8177807	23.80106676	9.205632505	25.27307001	0	0.192614126	24.46804389	4548.009025	6873.747636	169.3598918	557.7407202	27.8416647	5856.350488	6.875034242	751.7438715	0	0	413.1343886	0	177.613777	0	0	0	0											$150 Per Day 1-5	$150 Per Day 1-5	$10 day 1-10; $100 day 11-100	10%	$50 Per Trip	25% DME $7 Diab Monit	25%	$50 copay ER/$30 copay UC	10% ASC/10% OP Hosp	10%	10%	0	20%	10%	$20 copay	$30 copay	$30 copay	$20 copay	10%	$30 copay Hearing/$30 copay SA	20%	10% Blood/$25 Vision	0	0	$25 copay	$0 frames/$25 lenses	$30 copay	0	0	0	0											140.1990026	140.1990026	64.78618986	0.093466002	46.73300086	0.21229391	0.233665004	41.16537667	0.09338047	0.09338047	0.09338047	0	0.186932003	0.09338047	18.42992498	26.09683483	28.03980052	18.69320034	0.021542006	2.17771136	0.186739242	23.36682963	0	0	23.36650043	0	28.03980052	0	0	0	0											11.6876	0.143269999	5.890313959	2.759021714	1.003695534	4.122508326	0.219249432	1.217183966	2.222554799	0.85962629	2.360011155	0	0.036005745	2.284837437	6.984955427	14.94858806	0.395734798	0.868829918	0.599765299	1.062786749	1.28383868	1.463822581	0	0	0.804458739	0	0.41502124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6336	100	5.1406	11.6876	0.143269999	5.890313959	2.759021714	1.003695534	4.122508326	0.219249432	1.53409065	3.917289534	1.51510553	4.15955863	0	0.036005745	4.027063711	6.984955427	14.94858806	0.395734798	0.868829918	0.599765299	1.062786749	1.774171976	1.516794876	0	0	0.804458739	0	0.41502124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.3858	6000	30%	30%	30%	30%	$50 Per Trip	30% DME 30%Diab Monit	30%	30%ER/30%UC	30% ASC/30% OP Hosp	30%	30%	0	30%	30%	30%	30%	30%	30%	30%	30% Hearing/30% SA	30%	30% Blood/$30 Vision	0	0	Up to $35	Up to $50	30%	0	0	0	0											2.2082	0.0169	0.3238	0.2224	0.0371	0.1853	0.0086	0.0403	0.2153	0.0836	0.2295	0	0.0017	0.221	0.307	0.8357	0.0089	0.0301	0.2082	0.2636	0.0622	0.0457	0	0	0.0137	0.0008	0.0054	0	0	0	0											5.5753	2000	0.6816	13.8958	0.160147073	6.21415621	2.981424832	1.040767914	4.307846753	0.227889449	1.57439233	4.132545404	1.598734832	4.389026243	0	0.037710175	4.248102038	7.291970441	15.78424126	0.404669068	0.898976802	0.807985702	1.326427471	1.836415607	1.562519867	0	0	0.818194777	0.000769655	0.42040405	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.9611
H4209_003_0	2008	5																					6000											D	D	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0.3239	1.7319	0.6701	1.8388	0	0	1.7795	0	0	0	0	0	0	0.5008	0.0541	0	0	0	0	0	0	0	0	0											6.8992	6000	1356.617548	16.30207912	537.4053205	27.71460913	326.0832747	26.37901171	1.265392371	404.2259622	28.64657626	11.08385664	30.41569209	0	0.171524191	29.43434083	4245.260637	6418.027523	165.0941084	543.6387422	23.03314481	6552.139369	8.270832305	706.2578532	0	0	381.6830731	0	164.0923005	0	0	0	0											$150 Per Day 1-5	$150 Per Day 1-5	$10 day 1-10; $100 day 11-100	10%	$50 Per Trip	25% DME $7 Diab Monit	25%	$50 copay ER/$30 copay UC	10% ASC/10% OP Hosp	10%	10%	0	20%	10%	$20 copay	$30 copay	$30 copay	$20 copay	10%	$30 copay Hearing/$30 copay SA	20%	10% Blood/$25 Vision	0	0	$25 copay	$0 frames/$25 lenses	$30 copay	0	0	0	0											139.3031971	139.3031971	64.37223668	0.092868798	46.43439904	0.209548261	0.232171995	40.74713532	0.092776257	0.092776257	0.092776257	0	0.185737596	0.092776257	18.24002387	25.33203887	27.86063942	18.57375961	0.021408653	1.954275457	0.185529041	23.29267575	0	0	23.21719952	0	27.86063942	0	0	0	0											15.7484	0.189244312	2.882831874	2.573822439	1.261790075	5.52767604	0.293788671	1.372587498	2.657722132	1.028318736	2.821854077	0	0.031858491	2.73080798	6.452804613	13.54847689	0.383302285	0.841451276	0.493108604	1.067057097	1.534479588	1.370886264	0	0	0.738467672	0	0.380976368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.9317	100	5.758	15.7484	0.189244312	2.882831874	2.573822439	1.261790075	5.52767604	0.293788671	1.696505619	4.389607121	1.698415042	4.660694435	0	0.031858491	4.510318822	6.452804613	13.54847689	0.383302285	0.841451276	0.493108604	1.067057097	2.035321407	1.424993829	0	0	0.738467672	0	0.380976368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8309	6000	30%	30%	30%	30%	$50 Per Trip	30% DME 30%Diab Monit	30%	30%ER/30%UC	30% ASC/30% OP Hosp	30%	30%	0	30%	30%	30%	30%	30%	30%	30%	30% Hearing/30% SA	30%	30% Blood/$30 Vision	0	0	Up to $35	Up to $50	30%	0	0	0	0											2.2082	0.0169	0.3238	0.2224	0.0371	0.1853	0.0086	0.0403	0.2153	0.0836	0.2295	0	0.0017	0.221	0.307	0.8357	0.0089	0.0301	0.2082	0.2636	0.0622	0.0457	0	0	0.0137	0.0008	0.0054	0	0	0	0											5.5753	2000	0.6816	17.9567	0.206121386	3.206674125	2.796225557	1.298862455	5.713014467	0.302428689	1.736807299	4.604862991	1.782044344	4.890162049	0	0.033562922	4.731357148	6.759819627	14.38413009	0.392236555	0.871598159	0.701329007	1.330697819	2.097565039	1.47071882	0	0	0.752203709	0.000769655	0.386359179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4062
H4209_004_0	2008	5																					4000											D	D	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0.1727	0.9094	0.3517	0.9657	0	0	0.9349	0	0	0	0	0	0	0.2631	0.0284	0	0	0	0	0	0	0	0	0											3.626	4000	844.6770093	9.903885789	1078.808872	24.15925221	292.5249033	22.29699128	1.072043994	350.5482796	24.32347987	9.409982135	25.8351225	0	0.191171909	25.01323094	5029.661483	7074.412078	172.5566317	555.9755211	23.16681626	5535.533222	7.029345976	781.7195189	0	0	441.5254983	0	194.0097188	0	0	0	0											$150 Per Day 1-4	$150 Per Day 1-4	$10 day 1-10; $100 day 11-100	10%	$50 Per Trip	25% DME $8 Diab Monit	25%	$50 copay ER/$20 copay UC	$100 ASC copay/10% OP Hosp	10%	10%	0	20%	10%	$10 copay	$20 copay	$20 copay	$20 copay	10%	$20 copay Hearing/$20 copay SA	20%	10% Blood/$25 Vision	0	0	$25 copay	$0 frames/$25 lenses	$20 copay	0	0	0	0											134.0092651	134.0092651	61.925902	0.08933951	44.66975505	0.205501689	0.223348775	35.77502921	0.107683333	0.089213867	0.089213867	0	0.17867902	0.089213867	8.940213544	17.73220907	17.86790202	17.86790202	0.020432294	1.977460112	0.178395905	22.39088256	0	0	22.33487752	0	17.86790202	0	0	0	0											9.4329	0.110601038	5.567184373	2.158375757	1.088917981	4.582069368	0.239439713	1.045072912	2.619233375	0.839500892	2.304851176	0	0.034158409	2.231527051	3.74718731	10.45374617	0.256935416	0.827843011	0.473351193	0.912191345	1.25400654	1.458615829	0	0	0.821784827	0	0.288878887	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7484	50	7.0312	9.4329	0.110601038	5.567184373	2.158375757	1.088917981	4.582069368	0.239439713	1.217751286	3.528653857	1.191228267	3.270519301	0	0.034158409	3.16647442	3.74718731	10.45374617	0.256935416	0.827843011	0.473351193	0.912191345	1.517137882	1.48704276	0	0	0.821784827	0	0.288878887	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3744	4000	20%	20%	20%	20%	$50 Per Trip	30% DME 20%Diab Monit	30%	20%ER/20%UC	20% ASC/20% OP Hosp	20%	20%	0	20%	20%	20%	20%	20%	20%	20%	30% Hearing/30% SA	20%	20% Blood/$30 Vision	0	0	Up to $35	Up to $50	30%	0	0	0	0											1.3923	0.0106	0.2035	0.1398	0.0283	0.1453	0.0071	0.0276	0.1353	0.0526	0.1442	0	0.0011	0.1389	0.1983	0.5317	0.0059	0.0194	0.1334	0.1695	0.0391	0.0371	0	0	0.01	0.0005	0.0044	0	0	0	0											3.5758	1000	0.72	10.8251	0.12123111	5.770724598	2.298159804	1.117190314	4.727413719	0.246510513	1.245366313	3.663945741	1.243790669	3.414743501	0	0.035229672	3.305400674	3.945493815	10.9854403	0.262803448	0.847193105	0.60678408	1.081714499	1.556259037	1.524117573	0	0	0.831785469	0.000473836	0.293284061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9502
H4209_005_0	2008	5																					4000											D	D	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0.1727	0.9094	0.3517	0.9657	0	0	0.9349	0	0	0	0	0	0	0.2631	0.0284	0	0	0	0	0	0	0	0	0											3.626	4000	896.7452567	10.4386614	1091.031401	29.51898726	257.7267924	19.41887226	0.938306668	362.705326	23.81723463	9.21522634	25.29940885	0	0.192614126	24.49354375	4831.171705	6994.325475	173.1134196	557.7407202	28.03845976	5911.104848	6.883108028	751.7810419	0	0	413.1343886	0	181.5264734	0	0	0	0											$150 Per Day 1-4	$150 Per Day 1-4	$10 day 1-10; $100 day 11-100	10%	$50 Per Trip	25% DME $8 Diab Monit	25%	$50 copay ER/$20 copay UC	$100 ASC copay/10% OP Hosp	10%	10%	0	20%	10%	$10 copay	$20 copay	$20 copay	$20 copay	10%	$20 copay Hearing/$20 copay SA	20%	10% Blood/$25 Vision	0	0	$25 copay	$0 frames/$25 lenses	$20 copay	0	0	0	0											133.7421041	133.7421041	61.80244646	0.089161403	44.58070137	0.205334788	0.222903507	35.65769865	0.112194358	0.089030954	0.089030954	0	0.178322805	0.089030954	8.931130799	17.99623469	17.83228055	17.83228055	0.020405649	1.91919149	0.178028854	22.29008427	0	0	22.29035069	0	17.83228055	0	0	0	0											9.9944	0.116340712	5.619034147	2.631954312	0.957470097	3.987370024	0.209151847	1.077769768	2.672159356	0.820440395	2.252430512	0	0.034347491	2.180683573	3.595652201	10.48929356	0.257250589	0.82881575	0.572142965	0.94537851	1.225391835	1.396438564	0	0	0.7674092	0	0.269752583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9011	50	7.1684	9.9944	0.116340712	5.619034147	2.631954312	0.957470097	3.987370024	0.209151847	1.250453604	3.581590297	1.172184588	3.218106213	0	0.034347491	3.11559949	3.595652201	10.48929356	0.257250589	0.82881575	0.572142965	0.94537851	1.488515179	1.424864632	0	0	0.7674092	0	0.269752583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.5271	4000	20%	20%	20%	20%	$50 Per Trip	30% DME 20%Diab Monit	30%	20%ER/20%UC	20% ASC/20% OP Hosp	20%	20%	0	20%	20%	20%	20%	20%	20%	20%	30% Hearing/30% SA	20%	20% Blood/$30 Vision	0	0	Up to $35	Up to $50	30%	0	0	0	0											1.3923	0.0106	0.2035	0.1398	0.0283	0.1453	0.0071	0.0276	0.1353	0.0526	0.1442	0	0.0011	0.1389	0.1983	0.5317	0.0059	0.0194	0.1334	0.1695	0.0391	0.0371	0	0	0.01	0.0005	0.0044	0	0	0	0											3.5758	1000	0.72	11.3866	0.126970784	5.822574372	2.771738359	0.98574243	4.132714376	0.216222647	1.278068631	3.716882181	1.224746991	3.362330413	0	0.035418754	3.254525744	3.793958707	11.0209877	0.263118621	0.848165843	0.705575851	1.114901664	1.527636334	1.461939445	0	0	0.777409842	0.000473836	0.274157757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1029
H4209_006_0	2008	5																					4000											D	D	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0.1746	0.9194	0.3557	0.9762	0	0	0.9447	0	0	0	0	0	0	0.2659	0.0287	0	0	0	0	0	0	0	0	0											3.6652	4000	1216.091427	13.83944286	537.4053205	27.71460913	326.0832747	26.37901171	1.265392371	413.2567665	28.67155681	11.09664307	30.45077988	0	0.171524191	29.46829652	4508.211725	6532.51233	168.7500801	543.6387422	23.19605779	6613.529889	8.281583707	706.3047129	0	0	381.6830731	0	167.6976906	0	0	0	0											$150 Per Day 1-4	$150 Per Day 1-4	$10 day 1-10; $100 day 11-100	10%	$50 Per Trip	25% DME $8 Diab Monit	25%	$50 copay ER/$20 copay UC	$100 ASC copay/10% OP Hosp	10%	10%	0	20%	10%	$10 copay	$20 copay	$20 copay	$20 copay	10%	$20 copay Hearing/$20 copay SA	20%	10% Blood/$25 Vision	0	0	$25 copay	$0 frames/$25 lenses	$20 copay	0	0	0	0											132.015074	132.015074	61.00438301	0.088010049	44.00502468	0.201178688	0.220025123	35.04971018	0.106097656	0.087868452	0.087868452	0	0.176020099	0.087868452	8.785244188	17.36694024	17.60200987	17.60200987	0.020146093	1.750959365	0.175701034	22.07329705	0	0	22.00251234	0	17.60200987	0	0	0	0											13.3785	0.152251256	2.732006667	2.439164117	1.195775213	5.306894975	0.278418112	1.207044158	3.041984969	0.975044853	2.6756629	0	0.030191705	2.589333608	3.300478404	9.454145938	0.247528381	0.797427876	0.467309941	0.965001841	1.455082824	1.299206145	0	0	0.699832211	0	0.2459847	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9343	50	8.2268	13.3785	0.152251256	2.732006667	2.439164117	1.195775213	5.306894975	0.278418112	1.381661672	3.961380901	1.330775067	3.651837621	0	0.030191705	3.534012406	3.300478404	9.454145938	0.247528381	0.797427876	0.467309941	0.965001841	1.720961871	1.32792992	0	0	0.699832211	0	0.2459847	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5995	4000	20%	20%	20%	20%	$50 Per Trip	30% DME 20%Diab Monit	30%	20%ER/20%UC	20% ASC/20% OP Hosp	20%	20%	0	20%	20%	20%	20%	20%	20%	20%	30% Hearing/30% SA	20%	20% Blood/$30 Vision	0	0	Up to $35	Up to $50	30%	0	0	0	0											1.3923	0.0106	0.2035	0.1398	0.0283	0.1453	0.0071	0.0276	0.1353	0.0526	0.1442	0	0.0011	0.1389	0.1983	0.5317	0.0059	0.0194	0.1334	0.1695	0.0391	0.0371	0	0	0.01	0.0005	0.0044	0	0	0	0											3.5758	1000	0.72	14.7708	0.162881328	2.935546892	2.578948165	1.224047546	5.452239327	0.285488913	1.409276698	4.096672785	1.383337469	3.796061821	0	0.031262968	3.67293866	3.49878491	9.985840073	0.253396413	0.816777969	0.600742827	1.134524995	1.760083026	1.365004733	0	0	0.709832852	0.000473836	0.250389874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.1753
H4209_809_0	2008	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	276.1569009	2.058531102	30.28624187	29.65909782	6.609689055	22.80385547	1.096911281	5.10357074	26.30276401	10.17672032	27.927408	0	0.221976737	27.02718097	41.48687185	110.6463868	1.17283212	3.932507268	26.37459412	34.23996707	7.606762178	5.889725256	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	0	0				0	0	0	0											0.081503646	0.081503646	0.211115925	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.5078	0.16777779	6.393907952	0	1.546667239	5.33610218	0.25667724	1.194235553	6.154846778	2.381352555	6.535013471	0	0.051942556	6.324360346	9.707928014	25.89125452	0.274442716	0.920206701	6.171655025	8.012152294	1.77998235	1.37819571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.9865	0	0	22.5078	0.16777779	6.393907952	0	1.546667239	5.33610218	0.25667724	1.194235553	6.154846778	2.381352555	6.535013471	0	0.051942556	6.324360346	9.707928014	25.89125452	0.274442716	0.920206701	6.171655025	8.012152294	1.77998235	1.37819571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.9865	none	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	0	0	Standard Medicare	Standard Medicare	Standard Medicare	0	0	0	0											0.7471	0.0057	0.3021	0	0.055	0.1907	0.0089	0.0406	0.2119	0.0823	0.2259	0	0.002	0.2176	0.3329	0.9	0.0104	0.0348	0.2281	0.2923	0.0613	0.0449	0	0	0	0	0	0	0	0	0											3.9947	0	0	23.2549	0.173503747	6.695969049	0	1.601698327	5.526826707	0.265568344	1.234867807	6.366785914	2.463693268	6.760945371	0	0.053904627	6.54199284	10.04082292	26.79129092	0.284796581	0.955043449	6.39980086	8.304431686	1.841266911	1.423102555	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9812
H4209_810_0	2008	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	276.1569009	2.058531102	30.28624187	29.65909782	6.609689055	22.80385547	1.096911281	5.10357074	26.30276401	10.17672032	27.927408	0	0.221976737	27.02718097	41.48687185	110.6463868	1.17283212	3.932507268	26.37459412	34.23996707	7.606762178	5.889725256	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	0	0				0	0	0	0											0.081503646	0.081503646	0.211115925	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.5078	0.16777779	6.393907952	0	1.546667239	5.33610218	0.25667724	1.194235553	6.154846778	2.381352555	6.535013471	0	0.051942556	6.324360346	9.707928014	25.89125452	0.274442716	0.920206701	6.171655025	8.012152294	1.77998235	1.37819571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.9865	0	0	22.5078	0.16777779	6.393907952	0	1.546667239	5.33610218	0.25667724	1.194235553	6.154846778	2.381352555	6.535013471	0	0.051942556	6.324360346	9.707928014	25.89125452	0.274442716	0.920206701	6.171655025	8.012152294	1.77998235	1.37819571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.9865	none	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	0	0	Standard Medicare	Standard Medicare	Standard Medicare	0	0	0	0											0.7471	0.0057	0.3021	0	0.055	0.1907	0.0089	0.0406	0.2119	0.0823	0.2259	0	0.002	0.2176	0.3329	0.9	0.0104	0.0348	0.2281	0.2923	0.0613	0.0449	0	0	0	0	0	0	0	0	0											3.9947	0	0	23.2549	0.173503747	6.695969049	0	1.601698327	5.526826707	0.265568344	1.234867807	6.366785914	2.463693268	6.760945371	0	0.053904627	6.54199284	10.04082292	26.79129092	0.284796581	0.955043449	6.39980086	8.304431686	1.841266911	1.423102555	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9812
H4209_811_0	2008	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	276.1569009	2.058531102	30.28624187	29.65909782	6.609689055	22.80385547	1.096911281	5.10357074	26.30276401	10.17672032	27.927408	0	0.221976737	27.02718097	41.48687185	110.6463868	1.17283212	3.932507268	26.37459412	34.23996707	7.606762178	5.889725256	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	0	0				0	0	0	0											0.081503646	0.081503646	0.211115925	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.5078	0.16777779	6.393907952	0	1.546667239	5.33610218	0.25667724	1.194235553	6.154846778	2.381352555	6.535013471	0	0.051942556	6.324360346	9.707928014	25.89125452	0.274442716	0.920206701	6.171655025	8.012152294	1.77998235	1.37819571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.9865	0	0	22.5078	0.16777779	6.393907952	0	1.546667239	5.33610218	0.25667724	1.194235553	6.154846778	2.381352555	6.535013471	0	0.051942556	6.324360346	9.707928014	25.89125452	0.274442716	0.920206701	6.171655025	8.012152294	1.77998235	1.37819571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.9865	none	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	0	0	Standard Medicare	Standard Medicare	Standard Medicare	0	0	0	0											0.7471	0.0057	0.3021	0	0.055	0.1907	0.0089	0.0406	0.2119	0.0823	0.2259	0	0.002	0.2176	0.3329	0.9	0.0104	0.0348	0.2281	0.2923	0.0613	0.0449	0	0	0	0	0	0	0	0	0											3.9947	0	0	23.2549	0.173503747	6.695969049	0	1.601698327	5.526826707	0.265568344	1.234867807	6.366785914	2.463693268	6.760945371	0	0.053904627	6.54199284	10.04082292	26.79129092	0.284796581	0.955043449	6.39980086	8.304431686	1.841266911	1.423102555	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9812
H4209_812_0	2008	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	276.1569009	2.058531102	30.28624187	29.65909782	6.609689055	22.80385547	1.096911281	5.10357074	26.30276401	10.17672032	27.927408	0	0.221976737	27.02718097	41.48687185	110.6463868	1.17283212	3.932507268	26.37459412	34.23996707	7.606762178	5.889725256	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	0	0				0	0	0	0											0.081503646	0.081503646	0.211115925	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.5078	0.16777779	6.393907952	0	1.546667239	5.33610218	0.25667724	1.194235553	6.154846778	2.381352555	6.535013471	0	0.051942556	6.324360346	9.707928014	25.89125452	0.274442716	0.920206701	6.171655025	8.012152294	1.77998235	1.37819571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.9865	0	0	22.5078	0.16777779	6.393907952	0	1.546667239	5.33610218	0.25667724	1.194235553	6.154846778	2.381352555	6.535013471	0	0.051942556	6.324360346	9.707928014	25.89125452	0.274442716	0.920206701	6.171655025	8.012152294	1.77998235	1.37819571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.9865	none	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	0	0	Standard Medicare	Standard Medicare	Standard Medicare	0	0	0	0											0.7471	0.0057	0.3021	0	0.055	0.1907	0.0089	0.0406	0.2119	0.0823	0.2259	0	0.002	0.2176	0.3329	0.9	0.0104	0.0348	0.2281	0.2923	0.0613	0.0449	0	0	0	0	0	0	0	0	0											3.9947	0	0	23.2549	0.173503747	6.695969049	0	1.601698327	5.526826707	0.265568344	1.234867807	6.366785914	2.463693268	6.760945371	0	0.053904627	6.54199284	10.04082292	26.79129092	0.284796581	0.955043449	6.39980086	8.304431686	1.841266911	1.423102555	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9812
H4270_001_0	2008	5																					3250											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	P	P	S	P	T	P	V	P	V	P	Coin	P	P	P	P	P	P	P	P	P	P	P	P																																										0	0	249.5603193	7.651358689	920.7421538		157.4770487	6.684033904	6.923863927	253.6774772	209.7563814	1393.756876	320.9717776	14.34201171		1093.777312		1896.897121	173.0341812	210.0212304				748.3442841							4.11													#1A $250	#1B $250	"#2 $0/day days 1-20, $50/day days 21-100"	#6 $0	#10A $100	#11A 20%	"#11B 20%/10%, #11C $0"	"#4A $50, #4B $25"	"#9A $100, #9B $100"	#8A $25	#8B $25	#9A $25	#12 $0	"#3 $0, #5 $0, #9A $25, #9C $25, #9D $25"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $0, #7D $25, #7F $25"	"#7E $25, #7H $25"	"#7C $0, #7I $25"	#7D $0	#7G $0	#15 $0	"#13A $0, #14J $0, #16B 0%, #17A $15, #17B $0, #18A $15"	#10B $0 n/c	"#16A $0 n/c, #16B $0 n/c"	#17A $0	#17B $0 n/c	#18A $0	#18B $0 n/c	#19 20%	#14A $0	#13B $0 n/c											249.4726	249.4726	27.0638		99.789	0.199578083	0.123160933	47.3819	99.789	24.9473	24.9473	24.9473		24.9473		24.9473	24.9473	24.9473				14.9684							0.199578083													5.1882	0.159067031	2.076561588	0	1.309540311	1.333986671	0.852749545	1.001642669	1.744282352	2.897534636	0.667280541	0.029816158	0	2.273895614	0	3.943532193	0.359727397	0.436621193	0	0	0	0.933456984	0	0	0	0	0	0	0.82026592	0	0	0	0	0	0	0	0	0	0	0	0	26.0282	0	0.055024744	5.1882	0.159067031	2.076561588	0	1.309540311	1.333986671	0.852749545	1.001642669	1.744282352	2.897534636	0.667280541	0.029816158	0	2.273895614	0	3.943532193	0.359727397	0.436621193	0	0	0	0.933456984	0	0	0	0	0	0	0.82026592	0	0	0	0	0	0	0	0	0	0	0	0	26.0282																																																																																				0	0	0	5.1882	0.159067031	2.076561588	0	1.309540311	1.333986671	0.852749545	1.001642669	1.744282352	2.897534636	0.667280541	0.029816158	0	2.273895614	0	3.943532193	0.359727397	0.436621193	0	0	0	0.933456984	0	0	0	0	0	0	0.82026592	0	0	0	0	0	0	0	0	0	0	0	0	26.0282
H4270_002_0	2008	5																					3250											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	P	P	S	P	T	P	V	P	V	P	Coin	P	P	P	P	P	P	P	P	P	P	P	P																																										0	0	298.5879724	9.154514961			188.4143794	8.49371492	8.798478163	303.397788								2269.554177	207.0278058	251.2811873				895.3611017							6.79													#1A $100	#1B $100	#2 $0	#6 $0	#10A $100	#11A 20%	"#11B 10%, #11C $0"	"#4A $50, #4B $20"	"#9A $0, #9B $0"	#8A $0	#8B $0	#9A $0	#12 $0	"#3 $0, #5 $0, #9A $0, #9C $0, #9D $0"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0, #14I"	"#7B $0, #7D $10, #7F $10"	"#7E $10, #7H $10"	"#7C $0, #7I $10"	#7D $0	#7G $0	#15 $0	"#13A $0, #14J $0, #16B 0%, #17A $10, #17B $0, #18A $10"	#10B $0 n/c	"#16A $0, #16B opt.supp"	#17A $0	#17B $0	#18A $0	#18B $0	#19 20%	#14A $0	#13B $0 n/c											100	100			100	0.2	0.1	46.983								10	10	10				10							0.2													2.4882	0.076287625	0	0	1.570119828	1.698742984	0.879847816	1.187878851	0	0	0	0	0	0	0	1.891295148	0.172523172	0.209400989	0	0	0	0.746134251	0	0	0	0	0	0	1.358	0	0	0	0	0	0	0	0	0	0	0	0	12.2785	0	0	2.4882	0.076287625	0	0	1.570119828	1.698742984	0.879847816	1.187878851	0	0	0	0	0	0	0	1.891295148	0.172523172	0.209400989	0	0	0	0.746134251	0	0	0	0	0	0	1.358	0	0	0	0	0	0	0	0	0	0	0	0	12.2785																																																																																				0	0	0	2.4882	0.076287625	0	0	1.570119828	1.698742984	0.879847816	1.187878851	0	0	0	0	0	0	0	1.891295148	0.172523172	0.209400989	0	0	0	0.746134251	0	0	0	0	0	0	1.358	0	0	0	0	0	0	0	0	0	0	0	0	12.2785
H4270_003_0	2008	5																					3250											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	P	P	S	P	T	P	V	P	V	P	Coin	P	P	P	P	P	P	P	P	P	P	P	P																																										0	0	254.7915875	7.811746003	940.0339927		160.778073	6.885682759	7.132748151	258.9813779	214.1532819	1422.972723	327.6999684	14.64264808		1116.705006		1936.659763	176.6613132	214.4236826				764.0310314							6.51													#1A $250	#1B $250	"#2 $0/day days 1-20, $50/day days 21-100"	#6 $0	#10A $100	#11A 20%	"#11B 20%/10%, #11C $0"	"#4A $50, #4B $25"	"#9A $100, #9B $100"	#8A $25	#8B $25	#9A $25	#12 $0	"#3 $0, #5 $0, #9A $25, #9C $25, #9D $25"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $0, #7D $25, #7F $25"	"#7E $25, #7H $25"	"#7C $0, #7I $25"	#7D $0	#7G $0	#15 $0	"#13A $0, #14J $0, #16B 0%, #17A $15, #17B $0, #18A $15"	#10B $0 n/c	"#16A $0 n/c, #16B $0 n/c"	#17A $0	#17B $0 n/c	#18A $0	#18B $0 n/c	#19 20%	#14A $0	#13B $0 n/c											249.4726	249.4726	27.3016		99.789	0.199578083	0.123160933	47.3824	99.789	24.9473	24.9473	24.9473		24.9473		24.9473	24.9473	24.9473				14.9684							0.199578083													5.297	0.162401384	2.138701825	0	1.336990815	1.374231363	0.878475921	1.022596409	1.780845892	2.958272581	0.681268035	0.030441163	0	2.321560875	0	4.026196275	0.367267981	0.445773619	0	0	0	0.953024052	0	0	0	0	0	0	1.299253319	0	0	0	0	0	0	0	0	0	0	0	0	27.0743	0	0.057236238	5.297	0.162401384	2.138701825	0	1.336990815	1.374231363	0.878475921	1.022596409	1.780845892	2.958272581	0.681268035	0.030441163	0	2.321560875	0	4.026196275	0.367267981	0.445773619	0	0	0	0.953024052	0	0	0	0	0	0	1.299253319	0	0	0	0	0	0	0	0	0	0	0	0	27.0743																																																																																				0	0	0	5.297	0.162401384	2.138701825	0	1.336990815	1.374231363	0.878475921	1.022596409	1.780845892	2.958272581	0.681268035	0.030441163	0	2.321560875	0	4.026196275	0.367267981	0.445773619	0	0	0	0.953024052	0	0	0	0	0	0	1.299253319	0	0	0	0	0	0	0	0	0	0	0	0	27.0743
H4270_801_0	2008	4																					3250											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	P	P	S	P	T	P	V	P	V	P	Coin	P	P	P	P	P	P	P	P	P	P	P	P																																										0	0	357.1741143	10.95072835	1317.612107		225.3832884	11.11479514	11.51360544	362.8049059	300.2061784	1994.763748	459.3791621	20.52648171		1565.428927	3928.958077	2714.864892	247.6488674	300.5852339				1071.040491							6.51													#1A $250	#1B $250	"#2 $0/day days 1-20, $50/day days 21-100"	#6 $0	#10A $100	#11A 20%	"#11B 20%/10%, #11C $0"	"#4A $50, #4B $25"	"#9A $100, #9B $100"	#8A $25	#8B $25	#9A $25	#12 $0	"#3 $0, #5 $0, #9A $25, #9C $25, #9D $25"	"#7A $25, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $0, #7D $25, #7F $25"	"#7E $25, #7H $25"	"#7C $0, #7I $25"	#7D $0	#7G $0	#15 $0	"#13A $0, #14J $0, #16B 0%, #17A $15, #17B $0, #18A $15"	#10B $0 n/c	"#16A $0 n/c, #16B $0 n/c"	#17A $0	#17B $0 n/c	#18A $0	#18B $0 n/c	#19 20%	#14A $0	#13B $0 n/c											250	250	31.7717		100	0.2	0.123421301	47.4892	100	25	25	25		25	25	25	25	25				15							0.2													7.4411	0.228140174	3.488565396	0	1.87819407	2.222959027	1.421024166	1.435777257	2.501718154	4.155757807	0.957039921	0.042763504	0	3.261310264	8.185329327	5.655968524	0.51593514	0.626219237	0	0	0	1.338800614	0	0	0	0	0	0	1.302	0	0	0	0	0	0	0	0	0	0	0	0	46.6586	0	0	7.4411	0.228140174	3.488565396	0	1.87819407	2.222959027	1.421024166	1.435777257	2.501718154	4.155757807	0.957039921	0.042763504	0	3.261310264	8.185329327	5.655968524	0.51593514	0.626219237	0	0	0	1.338800614	0	0	0	0	0	0	1.302	0	0	0	0	0	0	0	0	0	0	0	0	46.6586																																																																																				0	0	0	7.4411	0.228140174	3.488565396	0	1.87819407	2.222959027	1.421024166	1.435777257	2.501718154	4.155757807	0.957039921	0.042763504	0	3.261310264	8.185329327	5.655968524	0.51593514	0.626219237	0	0	0	1.338800614	0	0	0	0	0	0	1.302	0	0	0	0	0	0	0	0	0	0	0	0	46.6586
H4362_001_0	2008	3																					n/a											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	1397	27.2	1141.1	1873.2	206.7	13.8	0.9	374.9	308.9	1963.9	1009.3	0	0	0	4872	6020.6	177.5	513.5	842.1	1272.8	948.6	0	0	0	0	284.8	0	19.9	0	0	0											$150/day 1-5	$150/day 1-5	"$0/d 1-10, $100/d 11-100"	0	100	0.2	0.2	$50 ER; $25 UC	75	$0 	"$0 X-ray; $100 CAT, PET, MRI"	20	20	20	10	20	20	20	20	20	$45 	0	0	0	$0 	Not Covered	$0 	$300 Every 3 Yrs	0	Fitness	0											91.93	91.93	64.36	0	100	0.2	0.2	47	75	$0 	18	20	20	20	10	20	20	20	20	20	$45 	0	0	0	0	0	0	0	0	0	0											10.7022	0.208374667	6.120099667	0	1.7225	2.76	0.18	1.468358333	1.930625	0	1.51395	0	0	0	4.06	10.03433333	0.295833333	0.855833333	1.4035	2.121333333	3.55725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9342			10.7022	0.208374667	6.120099667	0	1.7225	2.76	0.18	1.468358333	1.930625	0	1.51395	0	0	0	4.06	10.03433333	0.295833333	0.855833333	1.4035	2.121333333	3.55725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9342		20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	$100 per trip	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	$50 ER; $25 UC	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	0	0	0	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	$300 Every 3 Yrs	0	0	0											3.6638	0.0284	0.5941	0.5322	0.1628	0.3032	0.0194	0.1462	0.3752	0.1302	0.3656	0	0.1199	0.4039	0.476	0.5947	0.0225	0.063	0.4423	1.6029	0.3486	0.0106	0	0	0.0619	0.0432	0.0175	0.0174	0	0	0											10.5455	500	9.202287476	14.366	0.236774667	6.714199667	0.5322	1.8853	3.0632	0.1994	1.614558333	2.305825	0.1302	1.87955	0	0.1199	0.4039	4.536	10.62903333	0.318333333	0.918833333	1.8458	3.724233333	3.90585	0.0106	0	0	0.0619	0.0432	0.0175	0.0174	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4797
H4362_002_0	2008	4																					n/a											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	1397	27.2	1141.1	1873.2	206.7	13.8	0.9	374.9	308.9	1963.9	1009.3	0	0	0	4872	6020.6	177.5	513.5	842.1	1272.8	948.6	0	0	0	0	284.8	0	19.9	0	0	0											$150/day 1-5	$150/day 1-5	"$0/d 1-10, $100/d 11-100"	0	100	0.2	0.2	$50 ER; $25 UC	75	$0 	"$0 X-ray; $100 CAT, PET, MRI"	20	20	20	10	20	20	20	20	20	$45 	0	0	0	$0 	Not Covered	$0 	$300 Every 3 Yrs	0	Fitness	0											91.93	91.93	64.36	0	100	0.2	0.2	47	75	$0 	18	20	20	20	10	20	20	20	20	20	$45 	0	0	0	0	0	0	0	0	0	0											10.7022	0.208374667	6.120099667	0	1.7225	2.76	0.18	1.468358333	1.930625	0	1.51395	0	0	0	4.06	10.03433333	0.295833333	0.855833333	1.4035	2.121333333	3.55725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9342			10.7022	0.208374667	6.120099667	0	1.7225	2.76	0.18	1.468358333	1.930625	0	1.51395	0	0	0	4.06	10.03433333	0.295833333	0.855833333	1.4035	2.121333333	3.55725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9342		20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	$100 per trip	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	$50 ER; $25 UC	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	0	0	0	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	20% coins; $500ded; $3000 maxOOP	$300 Every 3 Yrs	0	0	0											3.6638	0.0284	0.5941	0.5322	0.1628	0.3032	0.0194	0.1462	0.3752	0.1302	0.3656	0	0.1199	0.4039	0.476	0.5947	0.0225	0.063	0.4423	1.6029	0.3486	0.0106	0	0	0.0619	0.0432	0.0175	0.0174	0	0	0											10.5455	500	9.202287476	14.366	0.236774667	6.714199667	0.5322	1.8853	3.0632	0.1994	1.614558333	2.305825	0.1302	1.87955	0	0.1199	0.4039	4.536	10.62903333	0.318333333	0.918833333	1.8458	3.724233333	3.90585	0.0106	0	0	0.0619	0.0432	0.0175	0.0174	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4797
H4362_801_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1234.846677	24.05634262	1008.659047	1655.768182	182.7285135	13.83166919	0.882902555	331.4169026	273.0425222	1735.948155	892.1565356	0	0	0	4306.453503	5463.08541	156.8704877	907.7454267	1240.622878	2250.153009	15.90270259	0	0	0	0	0	0	0	0	0	0											200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance	0	N/A	Not Covered	$0 per visit	Not Covered	$0 per visit	Not Covered	N/A	Not Covered	0											144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065			14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065		"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	$100 per trip	"30% coins; $500ded; ""Unlimited OOP"	0	$50 ER/UC	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	0	0	0	"30% coins; $500ded; ""Unlimited OOP"	0	"30% coins; $500ded; ""Unlimited OOP"	0	0	0	0											7.922	0	1.2845	1.1508	0.2353	0.6555	0	0.2118	0.8113	0.2815	0.7904	0	0.2592	0.8734	1.0292	1.2859	0.0486	0.1361	0.9564	3.4659	0.7537	0	0	0	0.1338	0	0.0378	0	0	0	0											22.3232	500	0	22.7988	0.289818788	9.690032461	6.669992775	2.519435246	4.805029776	0.264870766	1.592750556	5.362014101	6.068034846	4.875000015	0	0.259194098	0.873417564	11.79529122	19.26857794	0.571469634	3.161956187	5.09182229	10.96639979	3.934222733	0	0	0	0.133775323	0	0.037769123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.0296
H4362_802_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1234.846677	24.05634262	1008.659047	1655.768182	182.7285135	13.83166919	0.882902555	331.4169026	273.0425222	1735.948155	892.1565356	0	0	0	4306.453503	5463.08541	156.8704877	907.7454267	1240.622878	2250.153009	15.90270259	0	0	0	0	0	0	0	0	0	0											200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance	0	N/A	Not Covered	$0 per visit	Not Covered	$0 per visit	Not Covered	N/A	Not Covered	0											144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065			14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065		"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	$100 per trip	"30% coins; $500ded; ""Unlimited OOP"	0	$50 ER/UC	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	0	0	0	"30% coins; $500ded; ""Unlimited OOP"	0	"30% coins; $500ded; ""Unlimited OOP"	0	0	0	0											7.922	0	1.2845	1.1508	0.2353	0.6555	0	0.2118	0.8113	0.2815	0.7904	0	0.2592	0.8734	1.0292	1.2859	0.0486	0.1361	0.9564	3.4659	0.7537	0	0	0	0.1338	0	0.0378	0	0	0	0											22.3232	500	0	22.7988	0.289818788	9.690032461	6.669992775	2.519435246	4.805029776	0.264870766	1.592750556	5.362014101	6.068034846	4.875000015	0	0.259194098	0.873417564	11.79529122	19.26857794	0.571469634	3.161956187	5.09182229	10.96639979	3.934222733	0	0	0	0.133775323	0	0.037769123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.0296
H4406_001_0	2008	7																					3850											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	5000	1891.900472	134.4602746	1311.39669		177.6626252	12.66393311	2.086864794	457.2794152	29.089956	9083.893403	39.6717585		0.149588319	19.63453447	3916.53841	3576.100704	454.6726783	1.563947651			26.99428034	714.1935438			134.7790255	1.864636735	19.73800873															$275 (1a); $0 (1a1)	$275 (1b)	"$140 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	25% (9b)	25% (8a1); $0/$18 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 (10b)	$0 n/c (16)	$25 (17a1)	$15; $0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	see OON	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											168.399	168.399	85.7304		107.163	0.183708014	0.278521815	30.618	0.153090012	4.409	0.083632639		0.183708014	0.152993748	10	24.976	37.5	0.153090012			0.183708014	25			25	0.206502156	25															26.5495	1.886914797	9.368880974	0	1.586571784	2.326466007	0.581237369	1.16674852	4.453381715	3.337568042	3.317853849	0	0.027480573	3.003961026	3.263782009	7.443053508	1.42085212	0.239424765	0	0	4.959065643	1.487903216	0	0	0.280789636	0.385051506	0.041120852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.1276	0	39.43317132	26.5495	1.886914797	9.368880974	0	1.586571784	2.326466007	0.581237369	1.16674852	4.453381715	3.337568042	3.317853849	0	0.027480573	3.003961026	3.263782009	7.443053508	1.42085212	0.239424765	0	0	4.959065643	1.487903216	0	0	0.280789636	0.385051506	0.041120852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.1276		$325 (1a); $0 (1a1)	$325 (1b)	"$0 n/c (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	30% (9b)	30% (8a1); $0/$25 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 30% (17b)"	$0 n/c n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.886	0.2051		0.7683	0.4196	0.6152	0.1463	0.3085	1.4132	1.2258	1.0625		0.0073	0.9532	1.3061	2.0861	0.2842	0.0536			0.9257	0.4288			0.0793		0.0116															15.1863	0	5.573486611	29.4355	2.092027157	9.368880974	0.768271225	2.006124415	2.941676076	0.727569133	1.475283196	5.866563045	4.563381415	4.380347514	0	0.034747529	3.957158278	4.569862957	9.529201357	1.705022544	0.293054958	0	0	5.884741432	1.916675373	0	0	0.360071416	0.385051506	0.052731445	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.314
H4406_801_0	2008	2																					4800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2159.234234	153.460096	1376.966525		233.1821956	16.62141221	2.739010042	600.1721685	38.18056725	11922.61009	52.06918303		0.196334668	25.77032649	4835.763428	4417.200628	561.654485	1.931935333			33.34587571	882.2390835			163.948728		24.08460551															$400 (1a); $0 (1a1)	$400 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$30/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $30 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											241.3404	241.3404	90.5027		105.5864	0.181005328	0.27802265	30.1676	0.181005328	3.6201	0.097523669		0.181005328	0.180870394	30	34.8909	37.5	0.181005328			0.181005328	35			35		35															43.4259	3.086343891	10.38492823	0	2.051739852	3.00856417	0.761506832	1.508810559	6.910886102	3.596759918	5.077977783	0	0.035537621	4.661089119	12.08940857	12.84335806	1.755170266	0.349690589	0	0	6.035781172	2.573197327	0	0	0.47818379	0	0.070246766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7051	0	59.31384286	43.4259	3.086343891	10.38492823	0	2.051739852	3.00856417	0.761506832	1.508810559	6.910886102	3.596759918	5.077977783	0	0.035537621	4.661089119	12.08940857	12.84335806	1.755170266	0.349690589	0	0	6.035781172	2.573197327	0	0	0.47818379	0	0.070246766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7051																																																																																				0			43.4259	3.086343891	10.38492823	0	2.051739852	3.00856417	0.761506832	1.508810559	6.910886102	3.596759918	5.077977783	0	0.035537621	4.661089119	12.08940857	12.84335806	1.755170266	0.349690589	0	0	6.035781172	2.573197327	0	0	0.47818379	0	0.070246766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7051
H4406_803_0	2008	2																					4800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2159.234234	153.460096	1376.966525		233.1821956	16.62141221	2.739010042	600.1721685	38.18056725	11922.61009	52.06918303		0.196334668	25.77032649	4835.763428	4417.200628	561.654485	1.931935333			33.34587571	882.2390835			163.948728		24.08460551															$400 (1a); $0 (1a1)	$400 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$30/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $30 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											241.3404	241.3404	90.5027		105.5864	0.181005328	0.27802265	30.1676	0.181005328	3.6201	0.097523669		0.181005328	0.180870394	30	34.8909	37.5	0.181005328			0.181005328	35			35		35															43.4259	3.086343891	10.38492823	0	2.051739852	3.00856417	0.761506832	1.508810559	6.910886102	3.596759918	5.077977783	0	0.035537621	4.661089119	12.08940857	12.84335806	1.755170266	0.349690589	0	0	6.035781172	2.573197327	0	0	0.47818379	0	0.070246766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7051	0	59.31384286	43.4259	3.086343891	10.38492823	0	2.051739852	3.00856417	0.761506832	1.508810559	6.910886102	3.596759918	5.077977783	0	0.035537621	4.661089119	12.08940857	12.84335806	1.755170266	0.349690589	0	0	6.035781172	2.573197327	0	0	0.47818379	0	0.070246766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7051																																																																																				0			43.4259	3.086343891	10.38492823	0	2.051739852	3.00856417	0.761506832	1.508810559	6.910886102	3.596759918	5.077977783	0	0.035537621	4.661089119	12.08940857	12.84335806	1.755170266	0.349690589	0	0	6.035781172	2.573197327	0	0	0.47818379	0	0.070246766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7051
H4407_001_0	2008	4	s.										Ambulance											Air										D	D	D	P	T	COIN	COIN	V	V	V	P	P	P	P	P	P	P	P	P	P	COIN																																																														0		1185.900245	45.8694972	339.0299159	1021.606934	68.6944128	7.963974526	1.712594526	394.9962588	292.7347066	728.8158611	275.1081775	33.09901041	9.73	40.2063685	3664.873608	2578.908858	951.9996114	149.4927671	138.9001059		28.80253888		405									2.61										$150/D first 10 Days; 2K OP	$150/D first 10 Days; 2K OP	$50/D (0-20 Days); $0 (21-100 Days)		$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit	$190 CP / Surg		"$75 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$190 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit		"20% Coins., 1K OP max"		$3.50 / Trip									$250 CP / Trip										150	150	50		100	0.17	0.17	50	190		75	150	30	190	15	30	30	30	30		0.074		3.5									250										14.8238	0.573368715	1.41262465	0	0.57245344	1.353875669	0.291141069	1.645817745	4.634966187	0	1.71942611	0.41373763	0.024325	0.636600835	4.58109201	6.447272146	2.379999029	0.373731918	0.347250265	0	2.131387877	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	44.5353		0	14.8238	0.573368715	1.41262465	0	0.57245344	1.353875669	0.291141069	1.645817745	4.634966187	0	1.71942611	0.41373763	0.024325	0.636600835	4.58109201	6.447272146	2.379999029	0.373731918	0.347250265	0	2.131387877	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	44.5353																																																																																				0			14.8238	0.573368715	1.41262465	0	0.57245344	1.353875669	0.291141069	1.645817745	4.634966187	0	1.71942611	0.41373763	0.024325	0.636600835	4.58109201	6.447272146	2.379999029	0.373731918	0.347250265	0	2.131387877	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	44.5353
H4407_002_0	2008	6																																D	D	D	V	T	Coin	Coin	V	P	O	V	O	V	O	V	V	V	V	V	V	Coin	Coin	T	V	V	V																																																									0		1567.585976		190.1919805		193.4686313	7.323178983		370.7355637	378.3115066		539.5690161				5407.882302	7612.613096	201.2148351	66.30033267	1633.480008		15.5239813					369																$150 per day for 1st 10 days		$95 for days 1 to 100		$150 per trip	20% coinsurance		$50 per visit	$270 per visit		$20 per visit				$5 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit		20% per Script					$100 limit on eyewear																150		95		150	0.2		50	270		20				5	20	20	20	20		0.2																					19.5948	0	1.505686512	0	2.418357892	1.464635797	0	1.544731516	8.512008899	0	0.899281693	0	0	0	2.253284293	12.68768849	0.335358059	0.110500554	2.72246668	0	3.104796261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1536			19.5948	0	1.505686512	0	2.418357892	1.464635797	0	1.544731516	8.512008899	0	0.899281693	0	0	0	2.253284293	12.68768849	0.335358059	0.110500554	2.72246668	0	3.104796261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1536																																																																																				0			19.5948	0	1.505686512	0	2.418357892	1.464635797	0	1.544731516	8.512008899	0	0.899281693	0	0	0	2.253284293	12.68768849	0.335358059	0.110500554	2.72246668	0	3.104796261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1536
H4407_003_0	2008	3																																	D																																									1.14																																								1.14			141.72																																									Medicare Cost Sharing/190 Lifetime Max																																									6.29																																								0	0.0742849	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0743	1.14		0	1.2142849	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.2143																																																																																				0			0	1.2142849	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.2143
H4407_004_0	2008	3																																D	D	D	V	T	Coin	Coin	P	P	P	P	P	P	P	V	V	V	V	V	V	Coin	Coin	T	V	V					O	V												0.4019																																								0.4019			40.06995406																																								$0 Copay	Standard Medicare Benefits	$0 Copay		$0 Per Trip	0% Coin	0% Coin	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	0% Coin	0% Coin	$0 Per Trip	$0 Copay	$0 Copay					$0 Copay	$0 Copay											0	8.085	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0					0	0											0	0.026997132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.027	0.4019		0	0.428897132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4289																																																																																				0			0	0.428897132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4289
H4407_005_0	2008	2																																D	D	D	P	T	COIN	COIN	V	V	P	P	V	P	P	V	V	P	P	P	P	COIN		V																																																												0		722.0928	48.048	267.124	800.0754	36.68928	4.47450912	1.68775344	268.2488	271.96358	833.17734	295.5886	12.16192	9.73	39.1094	2973.6165	2975.56317	0.26025	237.92055	145.22991		26.02655784		405																			$150/D first 10 Days; 2K OP	$150/D first 10 Days; 2K OP	$50/D (0-20 Days); $0 (21-100 Days)		$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit	$250 CP / Surg	$250 CP / Surg	"$75 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$250 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit		"20% Coins., 1K OP max"		$3.50 / Trip																			150	150	50		100	0.1557	0.1557	50	250		75	150	30	250	15	30	30	30	30		0.067		3.5																			9.0262	0.6006	1.113016667	0	0.305744	0.69668107	0.262783211	1.117703333	5.665907917	0	1.84742875	0.152024	0.024325	0.814779167	3.717020625	7.438907925	0.000650625	0.594801375	0.363074775	0	1.743779375	0	0.118125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.6035	0	0	9.0262	0.6006	1.113016667	0	0.305744	0.69668107	0.262783211	1.117703333	5.665907917	0	1.84742875	0.152024	0.024325	0.814779167	3.717020625	7.438907925	0.000650625	0.594801375	0.363074775	0	1.743779375	0	0.118125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.6035																																																																																				0		0	9.0262	0.6006	1.113016667	0	0.305744	0.69668107	0.262783211	1.117703333	5.665907917	0	1.84742875	0.152024	0.024325	0.814779167	3.717020625	7.438907925	0.000650625	0.594801375	0.363074775	0	1.743779375	0	0.118125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.6035
H4407_007_0	2008	4											Ambulance											Air										D	D	D	P	T	COIN	COIN	V	V	V	P	P	P	P	P	P	P	P	P	P	COIN		T									T																																																			0		1185.900245	45.8694972	339.0299159	1021.606934	68.6944128	7.963974526	1.712594526	394.9962588	292.7347066	728.8158611	275.1081775	33.09901041	9.73	40.2063685	3664.873608	2578.908858	951.9996114	149.4927671	138.9001059		28.80253888		405									2.61										$225/D first 10 Days; 2K OP	$225/D first 10 Days; 2K OP	$50/D (0-20 Days); $0 (21-100 Days)		$100 CP/Trip ($0 Admit)	20% Coins.	20% Coins.	$50 CP / Visit	$190 CP / Surg		"$75 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$190 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit		20% Coins.		$3.50 / Trip									$250 CP / Trip										225	225	50		100	0.2	0.2	50	190		75	150	30	190	15	30	30	30	30		0.2		3.5									250										22.2356	0.860053073	1.41262465	0	0.57245344	1.592794905	0.342518905	1.645817745	4.634966187	0	1.71942611	0.41373763	0.024325	0.636600835	4.58109201	6.447272146	2.379999029	0.373731918	0.347250265	0	5.760507776	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	56.1533		0	22.2356	0.860053073	1.41262465	0	0.57245344	1.592794905	0.342518905	1.645817745	4.634966187	0	1.71942611	0.41373763	0.024325	0.636600835	4.58109201	6.447272146	2.379999029	0.373731918	0.347250265	0	5.760507776	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	56.1533																																																																																				0		0	22.2356	0.860053073	1.41262465	0	0.57245344	1.592794905	0.342518905	1.645817745	4.634966187	0	1.71942611	0.41373763	0.024325	0.636600835	4.58109201	6.447272146	2.379999029	0.373731918	0.347250265	0	5.760507776	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	56.1533
H4407_009_0	2008	4											Ambulance											Air										D	D	D	P	T	COIN	COIN	V	V	V	P	P	P	P	P	P	P	P	P	P	COIN		T									T																																																			0		1185.900245	45.8694972	339.0299159	1021.606934	68.6944128	7.963974526	1.712594526	394.9962588	292.7347066	728.8158611	275.1081775	33.09901041	9.73	40.2063685	3664.873608	2578.908858	951.9996114	149.4927671	138.9001059		28.80253888		405									2.61										$200/D first 10 Days; 2K OP	$200/D first 10 Days; 2K OP	$50/D (0-20 Days); $0 (21-100 Days)		$100 CP/Trip ($0 Admit)	"20% Coins.,"	20% Coins.	$50 CP / Visit	$190 CP / Surg		"$75 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$190 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit		20% Coins.		$3.50 / Trip									$250 CP / Trip										200	200	50		100	0.2	0.2	50	190		75	150	30	190	15	30	30	30	30		0.2		3.5									250										19.765	0.76449162	1.41262465	0	0.57245344	1.592794905	0.342518905	1.645817745	4.634966187	0	1.71942611	0.41373763	0.024325	0.636600835	4.58109201	6.447272146	2.379999029	0.373731918	0.347250265	0	5.760507776	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	53.5871		0	19.765	0.76449162	1.41262465	0	0.57245344	1.592794905	0.342518905	1.645817745	4.634966187	0	1.71942611	0.41373763	0.024325	0.636600835	4.58109201	6.447272146	2.379999029	0.373731918	0.347250265	0	5.760507776	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	53.5871																																																																																				0		0	19.765	0.76449162	1.41262465	0	0.57245344	1.592794905	0.342518905	1.645817745	4.634966187	0	1.71942611	0.41373763	0.024325	0.636600835	4.58109201	6.447272146	2.379999029	0.373731918	0.347250265	0	5.760507776	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	53.5871
H4407_011_0	2008	3																																D	D	D	V	T	Coin	Coin	P	P	O	V	O	V	O	V	V	V	V	V	V	Coin	Coin	T	V	V	V				O	V																																																				0		1406.538845		210.5390175		201.1006578	7.404780687		14.45040963	311.914042		539.8836539				5379.745762	7559.859884	200.8910141	65.32898715	1633.137106		15.36825533					369.22																$150 per day for 1st 10 days		$95 for days 1 to 100		$150 per trip	20% coinsurance		$50 per visit	$200 per visit		$20 per visit				$5 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit		20% per Script					$100 limit on eyewear																150		95		150	0.2		50	200		20				5	20	20	20	20		0.2					100																17.5817	0	1.666767222	0	2.513758223	1.480956137	0	0.06021004	5.198567366	0	0.89980609	0	0	0	2.241560734	12.59976647	0.334818357	0.108881645	2.721895177	0	3.073651066	0	0	0	0	3.076833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5592			17.5817	0	1.666767222	0	2.513758223	1.480956137	0	0.06021004	5.198567366	0	0.89980609	0	0	0	2.241560734	12.59976647	0.334818357	0.108881645	2.721895177	0	3.073651066	0	0	0	0	3.076833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5592																																																																																				0			17.5817	0	1.666767222	0	2.513758223	1.480956137	0	0.06021004	5.198567366	0	0.89980609	0	0	0	2.241560734	12.59976647	0.334818357	0.108881645	2.721895177	0	3.073651066	0	0	0	0	3.076833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5592
H4407_012_0	2008	4																																D	D	D	V	T	Coin	Coin	P	P	P	P	P	P	P	V	V	V	V	V	V	Coin	Coin	T	V	V	V																																																									0		1518.990811	48.59516525	190.1919805		193.4686313	7.323178983		370.7355637	378.3115066		539.5690161				5407.882302	7612.613096	201.2148351	66.30033267	1633.480008		15.5239813					369																$290 per day for 1st 10 days	$290 per day for 1st 10 days	$150 for days 1 to 100		$150 per trip	20% coinsurance		$50 per visit	$250 per visit		$25 per visit				$5 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit		20% per Script					$100 limit on eyewear																290	290	150		150	0.2		50	250		25				5	25	25	25	25		0.2					100																36.7089	1.17438316	2.377399756	0	2.418357892	1.464635797	0	1.544731516	7.881489721	0	1.124102117	0	0	0	2.253284293	15.85961062	0.419197573	0.138125693	3.40308335	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9471			36.7089	1.17438316	2.377399756	0	2.418357892	1.464635797	0	1.544731516	7.881489721	0	1.124102117	0	0	0	2.253284293	15.85961062	0.419197573	0.138125693	3.40308335	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9471																																																																																				0			36.7089	1.17438316	2.377399756	0	2.418357892	1.464635797	0	1.544731516	7.881489721	0	1.124102117	0	0	0	2.253284293	15.85961062	0.419197573	0.138125693	3.40308335	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9471
H4407_013_0	2008	4																																D	D	D	V	T	Coin	Coin	P	P	O	V	O	V	O	V	V	V	V	V	V	Coin	Coin	T	V	V	V				O	V																																																				0		1567.585976		190.1919805		193.4686313	7.323178983		370.7355637	378.3115066		539.5690161				5407.882302	7612.613096	201.2148351	66.30033267	1633.480008		15.5239813					369																$290 per day for 1st 10 days		$150 for days 1 to 100		$150 per trip	20% coinsurance		$50 per visit	$250 per visit		$25 per visit				$5 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit		20% per Script					$100 limit on eyewear																290		150		150	0.2		50	250		25				5	25	25	25	25		0.2					100																37.8833	0	2.377399756	0	2.418357892	1.464635797	0	1.544731516	7.881489721	0	1.124102117	0	0	0	2.253284293	15.85961062	0.419197573	0.138125693	3.40308335	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9471			37.8833	0	2.377399756	0	2.418357892	1.464635797	0	1.544731516	7.881489721	0	1.124102117	0	0	0	2.253284293	15.85961062	0.419197573	0.138125693	3.40308335	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9471																																																																																				0			37.8833	0	2.377399756	0	2.418357892	1.464635797	0	1.544731516	7.881489721	0	1.124102117	0	0	0	2.253284293	15.85961062	0.419197573	0.138125693	3.40308335	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9471
H4407_014_0	2008	5																																D	D	D	V	T	Coin	Coin	V	P	O	V	O	V	O	V	V	V	V	V	V	Coin	Coin	T	V	V	V																																																									0		1567.585976		190.1919805		193.4686313	7.323178983		370.7355637	378.3115066		539.5690161				5407.882302	7612.613096	201.2148351	66.30033267	1633.480008		15.5239813					369																$150 per day for 1st 10 days		$95 for days 1 to 100		$150 per trip	20% coinsurance		$50 per visit	$270 per visit		$20 per visit				$5 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit		20% per Script					$100 limit on eyewear																150		95		150	0.2		50	270		20				5	20	20	20	20		0.2					100																19.5948	0	1.505686512	0	2.418357892	1.464635797	0	1.544731516	8.512008899	0	0.899281693	0	0	0	2.253284293	12.68768849	0.335358059	0.110500554	2.72246668	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.2286			19.5948	0	1.505686512	0	2.418357892	1.464635797	0	1.544731516	8.512008899	0	0.899281693	0	0	0	2.253284293	12.68768849	0.335358059	0.110500554	2.72246668	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.2286																																																																																				0			19.5948	0	1.505686512	0	2.418357892	1.464635797	0	1.544731516	8.512008899	0	0.899281693	0	0	0	2.253284293	12.68768849	0.335358059	0.110500554	2.72246668	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.2286
H4407_015_0	2008	2																																D	D	D	V	T	Coin	Coin	P	P	P	P	P	P	P	V	V	V	V	V	V	Coin	Coin	T	V	V					O	V												0.4019																																								0.4019			40.06995406																																								$0 Copay	Standard Medicare Benefits	$0 Copay		$0 Per Trip	0% Coin	0% Coin	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	0% Coin	0% Coin	$0 Per Trip	$0 Copay	$0 Copay					$0 Copay	$0 Copay											0	8.085	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0					0	0											0	0.026997132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.027	0.4019		0	0.428897132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4289																																																																																				0			0	0.428897132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4289
H4407_016_0	2008	2																																D	D	D	V	T	Coin	Coin	P	P	O	V	O	V	O	V	V	V	V	V	V	Coin	Coin	T	V	V	V				O	V																																																				0		1406.538845		210.5390175		201.1006578	7.404780687		14.45040963	311.914042		539.8836539				5379.745762	7559.859884	200.8910141	65.32898715	1633.137106		15.36825533					369.22																$150 per day for 1st 10 days		$95 for days 1 to 100		$150 per trip	20% coinsurance		$50 per visit	$200 per visit		$20 per visit				$5 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit		20% per Script					$100 limit on eyewear																150		95		150	0.2		50	200		20				5	20	20	20	20		0.2					100																17.5817	0	1.666767222	0	2.513758223	1.480956137	0	0.06021004	5.198567366	0	0.89980609	0	0	0	2.241560734	12.59976647	0.334818357	0.108881645	2.721895177	0	3.073651066	0	0	0	0	3.076833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5592			17.5817	0	1.666767222	0	2.513758223	1.480956137	0	0.06021004	5.198567366	0	0.89980609	0	0	0	2.241560734	12.59976647	0.334818357	0.108881645	2.721895177	0	3.073651066	0	0	0	0	3.076833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5592																																																																																				0			17.5817	0	1.666767222	0	2.513758223	1.480956137	0	0.06021004	5.198567366	0	0.89980609	0	0	0	2.241560734	12.59976647	0.334818357	0.108881645	2.721895177	0	3.073651066	0	0	0	0	3.076833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5592
H4407_017_0	2008	4																																D	D	D	V	T	Coin	Coin	P	P	P	P	P	P	P	V	V	V	V	V	V	Coin	Coin	T	V	V	V																																																									0		1518.990811	48.59516525	190.1919805		193.4686313	7.323178983		370.7355637	378.3115066		539.5690161				5407.882302	7612.613096	201.2148351	66.30033267	1633.480008		15.5239813					369.219597																$285 per day for 1st 10 days	$285 per day for 1st 10 days	$150 for days 1 to 100		$150 per trip	20% coinsurance		$50 per visit	$250 per visit		$25 per visit				$5 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit		20% per Script					$100 limit on eyewear																285	285	150		150	0.2		50	250		25				5	25	25	25	25		0.2					100																36.076	1.154135175	2.377399756	0	2.418357892	1.464635797	0	1.544731516	7.881489721	0	1.124102117	0	0	0	2.253284293	15.85961062	0.419197573	0.138125693	3.40308335	0	3.104796261	0	0	0	0	3.076829975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.2958			36.076	1.154135175	2.377399756	0	2.418357892	1.464635797	0	1.544731516	7.881489721	0	1.124102117	0	0	0	2.253284293	15.85961062	0.419197573	0.138125693	3.40308335	0	3.104796261	0	0	0	0	3.076829975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.2958																																																																																				0			36.076	1.154135175	2.377399756	0	2.418357892	1.464635797	0	1.544731516	7.881489721	0	1.124102117	0	0	0	2.253284293	15.85961062	0.419197573	0.138125693	3.40308335	0	3.104796261	0	0	0	0	3.076829975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.2958
H4407_018_0	2008	4																																D	D	D	V	T	Coin	Coin	P	P	O	V	O	V	O	V	V	V	V	V	V	Coin	Coin	T	V	V	V				O	V																																																				0		1567.585976		190.1919805		193.4686313	7.323178983		370.7355637	378.3115066		539.5690161				5407.882302	7612.613096	201.2148351	66.30033267	1633.480008		15.5239813					369																$285 per day for 1st 10 days		$150 for days 1 to 100		$150 per trip	20% coinsurance		$50 per visit	$250 per visit		$25 per visit				$5 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit		20% per Script					$100 limit on eyewear																285		150		150	0.2		50	250		25				5	25	25	25	25		0.2					100																37.2302	0	2.377399756	0	2.418357892	1.464635797	0	1.544731516	7.881489721	0	1.124102117	0	0	0	2.253284293	15.85961062	0.419197573	0.138125693	3.40308335	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.294			37.2302	0	2.377399756	0	2.418357892	1.464635797	0	1.544731516	7.881489721	0	1.124102117	0	0	0	2.253284293	15.85961062	0.419197573	0.138125693	3.40308335	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.294																																																																																				0			37.2302	0	2.377399756	0	2.418357892	1.464635797	0	1.544731516	7.881489721	0	1.124102117	0	0	0	2.253284293	15.85961062	0.419197573	0.138125693	3.40308335	0	3.104796261	0	0	0	0	3.075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.294
H4407_802_0	2008	4																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																				18.49485983	0.334768671	5.803561417	0	0.2727	0.291	0.0737	0.4198	1.1905	0.4885	0.1933	0.0058	0.0041	0.5252	2.7099	4.2421	0.0978	0.0063	0.9838	0	1.2056																					37.3432		1651.875929	29.9	434.9427285	0	8.021842345	8.614603266	2.211857595	12.34758456	35.01586931	14.36744236	5.685140783	0.170364929	0.119886432	15.44642024	79.70370122	124.7671247	2.876143953	0.184073213	28.93400816	0	36.84																					Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																			10.15088008	10.15088008	12.07417683	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0	0																	1.3973	0.02529261	0.437631285	0	1.604368469	1.722920653	0.442371519	2.469516913	7.003173861	2.873488471	1.137028157	0.034072986	0.023977286	3.089284048	15.94074024	24.95342493	0.575228791	0.036814643	5.786801633	0	7.368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9215	37.34321119		19.8922	0.36006128	6.241192701	0	1.877111109	2.01388	0.51612	2.889334788	8.193713417	3.361981511	1.330322943	0.039865393	0.028053425	3.614462336	18.65066608	29.19550717	0.673017685	0.043073132	6.77055791	0	8.573566966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2647																																																																																				0			19.8922	0.36006128	6.241192701	0	1.877111109	2.01388	0.51612	2.889334788	8.193713417	3.361981511	1.330322943	0.039865393	0.028053425	3.614462336	18.65066608	29.19550717	0.673017685	0.043073132	6.77055791	0	8.573566966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2647
H4407_807_0	2008	4																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																				18.49485983	0.334768671	5.803561417	0	0.2727	0.291	0.0737	0.4198	1.1905	0.4885	0.1933	0.0058	0.0041	0.5252	2.7099	4.2421	0.0978	0.0063	0.9838	0	1.2056																					37.3432		1651.875929	29.9	434.9427285	0	8.021842345	8.614603266	2.211857595	12.34758456	35.01586931	14.36744236	5.685140783	0.170364929	0.119886432	15.44642024	79.70370122	124.7671247	2.876143953	0.184073213	28.93400816	0	36.84																					Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																			10.15088008	10.15088008	12.07417683	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0	0																	1.3973	0.02529261	0.437631285	0	1.604368469	1.722920653	0.442371519	2.469516913	7.003173861	2.873488471	1.137028157	0.034072986	0.023977286	3.089284048	15.94074024	24.95342493	0.575228791	0.036814643	5.786801633	0	7.368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9215	37.34321119		19.8922	0.36006128	6.241192701	0	1.877111109	2.01388	0.51612	2.889334788	8.193713417	3.361981511	1.330322943	0.039865393	0.028053425	3.614462336	18.65066608	29.19550717	0.673017685	0.043073132	6.77055791	0	8.573566966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2647																																																																																				0			19.8922	0.36006128	6.241192701	0	1.877111109	2.01388	0.51612	2.889334788	8.193713417	3.361981511	1.330322943	0.039865393	0.028053425	3.614462336	18.65066608	29.19550717	0.673017685	0.043073132	6.77055791	0	8.573566966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2647
H4407_808_0	2008	4																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																				18.49485983	0.334768671	5.803561417	0	0.2727	0.291	0.0737	0.4198	1.1905	0.4885	0.1933	0.0058	0.0041	0.5252	2.7099	4.2421	0.0978	0.0063	0.9838	0	1.2056																					37.3432		1651.875929	29.9	434.9427285	0	8.021842345	8.614603266	2.211857595	12.34758456	35.01586931	14.36744236	5.685140783	0.170364929	0.119886432	15.44642024	79.70370122	124.7671247	2.876143953	0.184073213	28.93400816	0	36.84																					Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																			10.15088008	10.15088008	12.07417683	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0	0																	1.3973	0.02529261	0.437631285	0	1.604368469	1.722920653	0.442371519	2.469516913	7.003173861	2.873488471	1.137028157	0.034072986	0.023977286	3.089284048	15.94074024	24.95342493	0.575228791	0.036814643	5.786801633	0	7.368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9215	37.34321119		19.8922	0.36006128	6.241192701	0	1.877111109	2.01388	0.51612	2.889334788	8.193713417	3.361981511	1.330322943	0.039865393	0.028053425	3.614462336	18.65066608	29.19550717	0.673017685	0.043073132	6.77055791	0	8.573566966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2647																																																																																				0			19.8922	0.36006128	6.241192701	0	1.877111109	2.01388	0.51612	2.889334788	8.193713417	3.361981511	1.330322943	0.039865393	0.028053425	3.614462336	18.65066608	29.19550717	0.673017685	0.043073132	6.77055791	0	8.573566966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2647
H4407_809_0	2008	5																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																				18.49485983	0.334768671	5.803561417	0	0.2727	0.291	0.0737	0.4198	1.1905	0.4885	0.1933	0.0058	0.0041	0.5252	2.7099	4.2421	0.0978	0.0063	0.9838	0	1.2056																					37.3432		1651.875929	29.9	434.9427285	0	8.021842345	8.614603266	2.211857595	12.34758456	35.01586931	14.36744236	5.685140783	0.170364929	0.119886432	15.44642024	79.70370122	124.7671247	2.876143953	0.184073213	28.93400816	0	36.84																					Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																			10.15088008	10.15088008	12.07417683	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0	0																	1.3973	0.02529261	0.437631285	0	1.604368469	1.722920653	0.442371519	2.469516913	7.003173861	2.873488471	1.137028157	0.034072986	0.023977286	3.089284048	15.94074024	24.95342493	0.575228791	0.036814643	5.786801633	0	7.368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9215	37.34321119		19.8922	0.36006128	6.241192701	0	1.877111109	2.01388	0.51612	2.889334788	8.193713417	3.361981511	1.330322943	0.039865393	0.028053425	3.614462336	18.65066608	29.19550717	0.673017685	0.043073132	6.77055791	0	8.573566966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2647																																																																																				0			19.8922	0.36006128	6.241192701	0	1.877111109	2.01388	0.51612	2.889334788	8.193713417	3.361981511	1.330322943	0.039865393	0.028053425	3.614462336	18.65066608	29.19550717	0.673017685	0.043073132	6.77055791	0	8.573566966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2647
H4408_001_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin						O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0						0		0	0									0		1717.536768	61.380634	533.996282	223.666778	74.815011	5.403414	1.849112	353.984026	418.042876	6575.06515	1541.055314		8.779937	560.376677	5080.210573	3837.653077	50.072524	318.574432			19.396759			3.62						0.08		3.4	0.02									$150/Day(Days 1-7)	$150/Day(Days 1-7)	$0/Day(Days 1-10) $100(Days 11-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$125-$200/Visit	$0-$50/Visit	$50-$100/Visit		$0-$90/Proc	$35-$100/Visit	$15/Visit	$35/Visit	$35-$90/Visit	$50/Visit			20% Coins			0% Coins						Active Outlook Newsletter		Silver Sneakers	Quit Net									99.664799	99.664794	46.148417	0	88.653639	0.177307	0.177307	44.326836	145.497	7.540792	56.437736		26.622957	63.146653	13.298054	31.028795	51.415279	44.326834			0.177307			0						0		0	0									14.2648	0.509790687	2.053590258	0	0.552718581	0.958063126	0.327860501	1.307582656	5.068665361	4.131766557	7.247806081	0	0.01947899	2.948825964	5.629742878	9.923145884	0.214541066	1.176782997	0	0	3.439181148	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7744	0	7.650195121	14.2648	0.509790687	2.053590258	0	0.552718581	0.958063126	0.327860501	1.307582656	5.068665361	4.131766557	7.247806081	0	0.01947899	2.948825964	5.629742878	9.923145884	0.214541066	1.176782997	0	0	3.439181148	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7744	10000	30% Coins	30% Coins	"30% Coins(Days 1-10), 30%(Days 11-100)"	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$90/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			50% Coins						Active Outlook Newsletter		Silver Sneakers	Quit Net									15.5121	0.1753	0.7637	1.193	0.7885	3.0211	1.0339	0.3292	5.0637	1.2553	3.3858		0.0049	1.6927	5.2356	4.3072	0.1483	0.457			1.3757			0.91						0		0	0									46.653	1000	4.10401469	29.7769	0.685074832	2.817270056	1.193001576	1.341174118	3.979154035	1.361712324	1.636748027	10.13234146	5.387082447	10.63365591	0	0.024382035	4.641546004	10.86537203	14.23038862	0.362830014	1.633804382	0	0	4.814905534	0	0	0.91	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.4274
H4408_002_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin						O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0						0		0	0									0		1627.410496	58.159738	505.975284	211.930055	70.889158	4.851218	1.660144	335.409017	396.106435	6230.044233	1460.189756		8.319217	530.971389	4813.63087	3636.275515	47.44501	301.857512			17.414531			2.72						0.08		0.02	3.4									$150/Day(Days 1-7)	$150/Day(Days 1-7)	$0/Day(Days 1-10) $100(Days 11-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$125-$200/Visit	$0-$50/Visit	$50-$100/Visit		$0-$90/Proc	$35-$100/Visit	$15/Visit	$35/Visit	$35-$90/Visit	$50/Visit			20% Coins			0% Coins						Active Outlook Newsletter		Quit Net	Silver Sneakers									100.869493	100.869587	46.706236	0	89.725302	0.17945	0.17945	44.862663	147.25573	7.631942	57.119924		26.944713	63.909938	13.458795	31.403853	52.036918	44.862663			0.17945			0						0		0	0									13.6797	0.488879063	1.969350085	0	0.530045926	0.87055107	0.297912841	1.253945141	4.860745187	3.96227802	6.950493991	0	0.01867991	2.827862379	5.398805924	9.516088478	0.205741008	1.128510986	0	0	3.125037588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0846	0	6.536922062	13.6797	0.488879063	1.969350085	0	0.530045926	0.87055107	0.297912841	1.253945141	4.860745187	3.96227802	6.950493991	0	0.01867991	2.827862379	5.398805924	9.516088478	0.205741008	1.128510986	0	0	3.125037588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0846	10000	30% Coins	30% Coins	"30% Coins(Days 1-10), 30%(Days 11-100)"	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$90/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			50% Coins						Active Outlook Newsletter		Quit Net	Silver Sneakers									14.3951	0.1627	0.7087	1.1071	0.7722	2.8035	0.9594	0.3224	4.699	1.1649	3.142		0.0048	1.5708	4.8586	3.9971	0.1376	0.4241			1.2767			0.91						0		0	0									43.4167	1000	3.341152222	28.0747	0.651541368	2.678037433	1.107092939	1.302244499	3.674091897	1.25731705	1.576323402	9.559783758	5.127198632	10.09252781	0	0.023482434	4.398687788	10.25741405	13.51316245	0.343352803	1.552623285	0	0	4.401694664	0	0	0.91	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.5013
H4408_801_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		295.892818	6.358137	505.975284	211.930055	70.889158	4.851218	1.660144	335.409017	396.106435	6230.044233	1460.189756		8.319217	530.971389	4813.63087	3636.275515	47.44501	301.857512			17.414531																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214493	177.214174	28.944133	0	100.000002	0.2	0.199999	50.000015	200.000002	37.551768	90.505009		33.368044	87.838631	19.999999	30.000004	59.267012	99.999989			0.199999																					4.3697	0.093896	1.220417993	0	0.590742995	0.9702436	0.33202714	1.39753799	6.601773983	19.49576464	11.01287392	0	0.023133	3.886649992	8.022717716	9.09069	0.234326998	2.51547899	0	0	3.482888785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3409	0	0	4.3697	0.093896	1.220417993	0	0.590742995	0.9702436	0.33202714	1.39753799	6.601773983	19.49576464	11.01287392	0	0.023133	3.886649992	8.022717716	9.09069	0.234326998	2.51547899	0	0	3.482888785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3409		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.177	0.1037	0.4518	0.7058	0.6965	1.3405	0.4587	0.7865	2.9957	0.7427	2.0031		0.0136	1.0014	3.0974	2.5482	0.0877	0.2704			0.8139																					27.2946	0	0	13.5467	0.197595	1.672214993	0.705785	1.287234995	2.3107116	0.79075114	2.18408099	9.597467983	20.23841464	13.01595692	0	0.036773	4.888071992	11.12013872	11.638873	0.322055998	2.78585499	0	0	4.296772785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.6355
H4408_803_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		295.892818	6.358137	505.975284	211.930055	70.889158	4.851218	1.660144	335.409017	396.106435	6230.044233	1460.189756		8.319217	530.971389	4813.63087	3636.275515	47.44501	301.857512			17.414531																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214493	177.214174	28.944133	0	100.000002	0.2	0.199999	50.000015	200.000002	37.551768	90.505009		33.368044	87.838631	19.999999	30.000004	59.267012	99.999989			0.199999																					4.3697	0.093896	1.220417993	0	0.590742995	0.9702436	0.33202714	1.39753799	6.601773983	19.49576464	11.01287392	0	0.023133	3.886649992	8.022717716	9.09069	0.234326998	2.51547899	0	0	3.482888785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3409	0	0	4.3697	0.093896	1.220417993	0	0.590742995	0.9702436	0.33202714	1.39753799	6.601773983	19.49576464	11.01287392	0	0.023133	3.886649992	8.022717716	9.09069	0.234326998	2.51547899	0	0	3.482888785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3409		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.177	0.1037	0.4518	0.7058	0.6965	1.3405	0.4587	0.7865	2.9957	0.7427	2.0031		0.0136	1.0014	3.0974	2.5482	0.0877	0.2704			0.8139																					27.2946	0	0	13.5467	0.197595	1.672214993	0.705785	1.287234995	2.3107116	0.79075114	2.18408099	9.597467983	20.23841464	13.01595692	0	0.036773	4.888071992	11.12013872	11.638873	0.322055998	2.78585499	0	0	4.296772785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.6355
H4408_804_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		295.892818	6.358137	505.975284	211.930055	70.889158	4.851218	1.660144	335.409017	396.106435	6230.044233	1460.189756		8.319217	530.971389	4813.63087	3636.275515	47.44501	301.857512			17.414531																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214493	177.214174	28.944133	0	100.000002	0.2	0.199999	50.000015	200.000002	37.551768	90.505009		33.368044	87.838631	19.999999	30.000004	59.267012	99.999989			0.199999																					4.3697	0.093896	1.220417993	0	0.590742995	0.9702436	0.33202714	1.39753799	6.601773983	19.49576464	11.01287392	0	0.023133	3.886649992	8.022717716	9.09069	0.234326998	2.51547899	0	0	3.482888785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3409	0	0	4.3697	0.093896	1.220417993	0	0.590742995	0.9702436	0.33202714	1.39753799	6.601773983	19.49576464	11.01287392	0	0.023133	3.886649992	8.022717716	9.09069	0.234326998	2.51547899	0	0	3.482888785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3409		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.177	0.1037	0.4518	0.7058	0.6965	1.3405	0.4587	0.7865	2.9957	0.7427	2.0031		0.0136	1.0014	3.0974	2.5482	0.0877	0.2704			0.8139																					27.2946	0	0	13.5467	0.197595	1.672214993	0.705785	1.287234995	2.3107116	0.79075114	2.18408099	9.597467983	20.23841464	13.01595692	0	0.036773	4.888071992	11.12013872	11.638873	0.322055998	2.78585499	0	0	4.296772785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.6355
H4408_805_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		295.892818	6.358137	505.975284	211.930055	70.889158	4.851218	1.660144	335.409017	396.106435	6230.044233	1460.189756		8.319217	530.971389	4813.63087	3636.275515	47.44501	301.857512			17.414531																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214493	177.214174	28.944133	0	100.000002	0.2	0.199999	50.000015	200.000002	37.551768	90.505009		33.368044	87.838631	19.999999	30.000004	59.267012	99.999989			0.199999																					4.3697	0.093896	1.220417993	0	0.590742995	0.9702436	0.33202714	1.39753799	6.601773983	19.49576464	11.01287392	0	0.023133	3.886649992	8.022717716	9.09069	0.234326998	2.51547899	0	0	3.482888785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3409	0	0	4.3697	0.093896	1.220417993	0	0.590742995	0.9702436	0.33202714	1.39753799	6.601773983	19.49576464	11.01287392	0	0.023133	3.886649992	8.022717716	9.09069	0.234326998	2.51547899	0	0	3.482888785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3409		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.177	0.1037	0.4518	0.7058	0.6965	1.3405	0.4587	0.7865	2.9957	0.7427	2.0031		0.0136	1.0014	3.0974	2.5482	0.0877	0.2704			0.8139																					27.2946	0	0	13.5467	0.197595	1.672214993	0.705785	1.287234995	2.3107116	0.79075114	2.18408099	9.597467983	20.23841464	13.01595692	0	0.036773	4.888071992	11.12013872	11.638873	0.322055998	2.78585499	0	0	4.296772785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.6355
H4449_008_0	2008	8	h.1.	h.2.	f.	g.							OP Facility - Other	OP Facility - Other	OP Facility - Emergency	OP Facility - Surgery							3000	Complex diag	PET scans	Urgent Care	ASC							D	D	D	Coin		Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin											P	V	V	V																																																0	3000	1204.454761	16.07253263	331.981596		161.7970832	16.34643764	1.093231832	257.8666768	246.5014824	1943.505827	767.0925825	471.834901	7.357889056	1223.321034	7619.839406	5097.063554	152.4200091	1266.584946	1755.136752	1838.416609	17.59588024											45.288257	3.802524	672.675765	146.814774							"$150/day, days 1-5"	"$150/day, days 1-5"	"$125/day, days 21-100"	No cost sharing	$100/trip	20% coins	20% coins	$50/visit	$100/visit	$30/visit	$30/visit	$30/visit	20% coins	$30/visit	$10/visit	$30/visit	$30/visit	$30/visit	$30/visit	$30/visit	20% Coins											$50/procedure	$200/visit	$25/visit	$25/visit							139.5	139.5	116.25		93	0.186	0.186	46.5	93	27.9	27.9	27.9	0.186	27.9	9.3	27.9	27.9	27.9	27.9	27.9	0.186											46.5	186	23.25	23.25							14.0018	0.186843192	3.216071711	0	1.253927395	3.040437402	0.203341121	0.999233373	1.910386489	4.518651047	1.783490254	1.097016145	1.368567364	2.844221403	5.90537554	11.85067276	0.354376521	2.944809999	4.080692947	4.274318617	3.272833725	0	0	0	0	0	0	0	0	0	0	0.175491996	0.058939122	1.303309295	0.284453625	0	0	0	0	0	0	70.9292	0	5.338760575	14.0018	0.186843192	3.216071711	0	1.253927395	3.040437402	0.203341121	0.999233373	1.910386489	4.518651047	1.783490254	1.097016145	1.368567364	2.844221403	5.90537554	11.85067276	0.354376521	2.944809999	4.080692947	4.274318617	3.272833725	0	0	0	0	0	0	0	0	0	0	0.175491996	0.058939122	1.303309295	0.284453625	0	0	0	0	0	0	70.9292	3000																																																																																			0	0	0	14.0018	0.186843192	3.216071711	0	1.253927395	3.040437402	0.203341121	0.999233373	1.910386489	4.518651047	1.783490254	1.097016145	1.368567364	2.844221403	5.90537554	11.85067276	0.354376521	2.944809999	4.080692947	4.274318617	3.272833725	0	0	0	0	0	0	0	0	0	0	0.175491996	0.058939122	1.303309295	0.284453625	0	0	0	0	0	0	70.9292
H4449_011_0	2008	10	h.1.	h.2.	f.	g.							OP Facility - Other	OP Facility - Other	OP Facility - Emergency	OP Facility - Surgery							3000	Complex diag	PET scans	Urgent Care	ASC							D	D	D		T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin										P	V	V	V																																																0	N/A	345.7484237	4.245558578	171.8416882		283.7213252	32.04182329	1.686411752	397.6781084	357.0255709	17.54422031	26.25342393			25.4394607	8274.494581	5534.975543	158.9007538	1398.39674	2260.392809	1293.299976	12.672	20.8933598										45.288257	3.802524	672.675765	146.814774							$400/Stay	$400/Stay	$100 per day for days 21 -100	None	$100 per one way trip	0.25	0.25	$50 per visit	$100 per Surgery	0.2	0.2	0.2	0.2	0.2	12	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	0.2	0.2										$50/procedure	$200/visit	$25/visit	$25/visit							364.8	364.8	91.2		91.2	0.228	0.228	45.6	91.2	0.1824	0.1824	0.1824	0.1824	0.1824	10.944	36.48	36.48	36.48	36.48	36.48	0.1824	0.1824										45.6	182.4	22.8	22.8							10.5108	0.129064981	1.305996831	0	2.156282071	7.305535709	0.384501879	1.511176812	2.713394339	3.200065784	4.788624525	0	0	4.640157632	7.546339058	16.82632565	0.483058291	4.251126089	6.87159414	3.931631928	2.3113728	3.810948828	0	0	0	0	0	0	0	0	0	0.172095377	0.057798365	1.278083954	0.278948071	0	0	0	0	0	0	86.4649	0	8.343101993	10.5108	0.129064981	1.305996831	0	2.156282071	7.305535709	0.384501879	1.511176812	2.713394339	3.200065784	4.788624525	0	0	4.640157632	7.546339058	16.82632565	0.483058291	4.251126089	6.87159414	3.931631928	2.3113728	3.810948828	0	0	0	0	0	0	0	0	0	0.172095377	0.057798365	1.278083954	0.278948071	0	0	0	0	0	0	86.4649	3000																																																																																			0			10.5108	0.129064981	1.305996831	0	2.156282071	7.305535709	0.384501879	1.511176812	2.713394339	3.200065784	4.788624525	0	0	4.640157632	7.546339058	16.82632565	0.483058291	4.251126089	6.87159414	3.931631928	2.3113728	3.810948828	0	0	0	0	0	0	0	0	0	0.172095377	0.057798365	1.278083954	0.278948071	0	0	0	0	0	0	86.4649
H4449_012_0	2008	9	h.1.	h.2.	f.	g.							OP Facility - Other	OP Facility - Other	OP Facility - Emergency	OP Facility - Surgery							1000	Complex diag	PET scans	Urgent Care	ASC							D	D	D		T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin											P	V	V	V																																																0		286.774943	1.607253263	331.981596		161.7970832	16.34643764	1.093231832	257.8666768	246.5014824	1943.505827	767.0925825	471.834901	7.357889056	1223.321034	7619.839406	5097.063554	152.4200091	1266.584946	1755.136752	3362.290905	17.59588024											45.288257	3.802524	515.7333536	146.814774							$250/Admit	$250/Admit	"$125/day, days 21-100"	No Cost Sharing	$100/trip	20% coins	20% coins	$50/visit	$50/visit	$25/visit	$25/visit	$25/visit	20% coins	$25/visit	$5/visit	$25/visit	$25/visit	$25/visit	$25/visit	$25/visit	20% Coins											$50/procedure	$200/visit	$25/visit	$25/visit							196.25	196.25	98.125		78.5	0.157	0.157	39.25	39.25	21.195	19.625	19.625	0.157	19.625	3.925	19.625	19.625	19.625	19.625	19.625	0.157											39.25	157	24.1	24.1							4.69	0.026285288	2.714641176	0	1.058422586	2.56639071	0.171637398	0.843438922	0.806265265	3.432717166	1.254515994	0.771646661	1.155188582	2.000639607	2.492322472	8.335822687	0.249270223	2.07139413	2.870379896	5.498746584	2.762553198	0	0	0	0	0	0	0	0	0	0	0.148130341	0.049749689	1.035764485	0.294853005	0	0	0	0	0	0	47.3007	0	12.9549801	4.69	0.026285288	2.714641176	0	1.058422586	2.56639071	0.171637398	0.843438922	0.806265265	3.432717166	1.254515994	0.771646661	1.155188582	2.000639607	2.492322472	8.335822687	0.249270223	2.07139413	2.870379896	5.498746584	2.762553198	0	0	0	0	0	0	0	0	0	0	0.148130341	0.049749689	1.035764485	0.294853005	0	0	0	0	0	0	47.3007	1000																																																																																			0	0	0	4.69	0.026285288	2.714641176	0	1.058422586	2.56639071	0.171637398	0.843438922	0.806265265	3.432717166	1.254515994	0.771646661	1.155188582	2.000639607	2.492322472	8.335822687	0.249270223	2.07139413	2.870379896	5.498746584	2.762553198	0	0	0	0	0	0	0	0	0	0	0.148130341	0.049749689	1.035764485	0.294853005	0	0	0	0	0	0	47.3007
H4454_002_0	2008	5											Ambulance											Air										D	D	D	P	T	COIN	COIN	V	V	V	P	P	P	P	P	P	P	P	P		COIN		T									T																																																			0		971.2153369	41.7991967	499.2720174	1174.498931	82.0260324	7.416685142	1.669556828	312.150753	370.470645	1235.452138	299.8572591	14.97856057	9.73	54.84266707	3540.949559	3677.70939	903.3237086	295.2531681	188.8096977		36.65243987		405									2.61										$190/D first 10 Days; 2K OOP	$190/D first 10 Days; 2K OOP	$50/D (0-20 Days); $0 (21-100 Days)		$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit	$190 CP / Surg		"$75 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$190 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit		"20% Coins., 1K OP max"		$3.50 / Trip									$250 CP / Trip										190	190	50		100	0.17	0.17	50	190		75	150	30	190	15	30	30	30	30		0.074		3.5									250										15.3776	0.661820614	2.080300073	0	0.68355027	1.260836474	0.283824661	1.300628138	5.865785213	0	1.874107869	0.187232007	0.024325	0.868342229	4.426186949	9.194273475	2.258309272	0.73813292	0.472024244	0	2.71228055	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	50.442		0	15.3776	0.661820614	2.080300073	0	0.68355027	1.260836474	0.283824661	1.300628138	5.865785213	0	1.874107869	0.187232007	0.024325	0.868342229	4.426186949	9.194273475	2.258309272	0.73813292	0.472024244	0	2.71228055	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	50.442																																																																																				0		0	15.3776	0.661820614	2.080300073	0	0.68355027	1.260836474	0.283824661	1.300628138	5.865785213	0	1.874107869	0.187232007	0.024325	0.868342229	4.426186949	9.194273475	2.258309272	0.73813292	0.472024244	0	2.71228055	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	50.442
H4454_007_0	2008	5											Ambulance											Air										D	D	D	P	T	COIN	COIN	V	V	V	P	P	P	P	P	P	P	P	P	P	COIN		T									T																																																			0		971.2153369	41.7991967	499.2720174	1174.498931	82.0260324	7.416685142	1.669556828	312.150753	370.470645	1235.452138	299.8572591	14.97856057	9.73		3540.949559	3677.70939	903.3237086	295.2531681	188.8096977	0	36.65243987		405									2.61										$265/D first 10 Days; 2K OP	$265/D first 10 Days; 2K OP	$50/D (0-20 Days); $0 (21-100 Days)		$100 CP/Trip ($0 Admit)	20% Coins.	20% Coins.	$50 CP / Visit	$190 CP / Surg		"$75 CP / (MRI, CT, Test)"	$190 /Admit; 2K OP	$30CP/Visit		$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit	$15 CP / Visit	20% Coins.		$3.50 / Trip									$250 CP / Trip										265	265	50		100	0.2	0.2	50	190		75	190	30		15	30	30	30	30	15	0.2		3.5									250										21.4477	0.923065594	2.080300073	0	0.68355027	1.483337028	0.333911366	1.300628138	5.865785213	0	1.874107869	0.237160542	0.024325	0	4.426186949	9.194273475	2.258309272	0.73813292	0.472024244	0	7.330487973	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	60.8458		0	21.4477	0.923065594	2.080300073	0	0.68355027	1.483337028	0.333911366	1.300628138	5.865785213	0	1.874107869	0.237160542	0.024325	0	4.426186949	9.194273475	2.258309272	0.73813292	0.472024244	0	7.330487973	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	60.8458																																																																																				0		0	21.4477	0.923065594	2.080300073	0	0.68355027	1.483337028	0.333911366	1.300628138	5.865785213	0	1.874107869	0.237160542	0.024325	0	4.426186949	9.194273475	2.258309272	0.73813292	0.472024244	0	7.330487973	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	60.8458
H4454_008_0	2008	2																																	D																																									1.25																																								1.25			144.63																																									Medicare Cost Sharing/ 190 Lifetime Max																																									6.95																																								0	0.083764875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0838	1.25		0	1.333764875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.3338																																																																																				0			0	1.333764875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.3338
H4454_012_0	2008	2											Ambulance											Air										D	D	D	P	T	COIN	COIN	V	V	P	P	V	P	P	V	V	P	P	P	P	COIN		V																																																												0		722.0928	48.048	267.124	800.0754	36.68928	4.47450912	1.68775344	268.2488	271.96358	833.17734	295.5886	12.16192	9.73	39.1094	2973.6165	2975.56317	0.26025	237.92055	145.22991		26.02655784		405																			$150/D first 10 Days; 2K OP	$150/D first 10 Days; 2K OP	$50/D (0-20 Days); $0 (21-100 Days)		$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit	$250 CP / Surg	$250 CP / Surg	"$75 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$250 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit		"20% Coins., 1K OP max"		$3.50 / Trip																			150	150	50		100	0.1557	0.1557	50	250		75	150	30	250	15	30	30	30	30		0.067		3.5																			9.0262	0.6006	1.113016667	0	0.305744	0.69668107	0.262783211	1.117703333	5.665907917	0	1.84742875	0.152024	0.024325	0.814779167	3.717020625	7.438907925	0.000650625	0.594801375	0.363074775	0	1.743779375	0	0.118125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.6035		0	9.0262	0.6006	1.113016667	0	0.305744	0.69668107	0.262783211	1.117703333	5.665907917	0	1.84742875	0.152024	0.024325	0.814779167	3.717020625	7.438907925	0.000650625	0.594801375	0.363074775	0	1.743779375	0	0.118125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.6035																																																																																				0		0	9.0262	0.6006	1.113016667	0	0.305744	0.69668107	0.262783211	1.117703333	5.665907917	0	1.84742875	0.152024	0.024325	0.814779167	3.717020625	7.438907925	0.000650625	0.594801375	0.363074775	0	1.743779375	0	0.118125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.6035
H4454_013_0	2008	3																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H4454_018_0	2008	5											Ambulance											Air										D	D	D	P	T	COIN	COIN	V	V	V	P	P	P	P	P	P	P	P	P	P	COIN		T									T																																																			0		971.2153369	41.7991967	499.2720174	1174.498931	82.0260324	7.416685142	1.669556828	312.150753	370.470645	1235.452138	299.8572591	14.97856057	9.73		3540.949559	3677.70939	903.3237086	295.2531681	188.8096977		36.65243987		405									2.61										$265/D first 10 Days; 2K OP	$265/D first 10 Days; 2K OP	$50/D (0-20 Days); $0 (21-100 Days)		$100 CP/Trip ($0 Admit)	20% Coins.	20% Coins.	$50 CP / Visit	$190 CP / Surg		"$75 CP / (MRI, CT, Test)"	$190 /Admit; 2K OP	$30 CP / Visit		$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit		20% Coins.		$3.50 / Trip									$250 CP / Trip										265	265	50		100	0.2	0.2	50	190		75	190	30		15	30	30	30	30		0.2		3.5									250										21.4477	0.923065594	2.080300073	0	0.68355027	1.483337028	0.333911366	1.300628138	5.865785213	0	1.874107869	0.237160542	0.024325	0	4.426186949	9.194273475	2.258309272	0.73813292	0.472024244	0	7.330487973	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	60.8458		0	21.4477	0.923065594	2.080300073	0	0.68355027	1.483337028	0.333911366	1.300628138	5.865785213	0	1.874107869	0.237160542	0.024325	0	4.426186949	9.194273475	2.258309272	0.73813292	0.472024244	0	7.330487973	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	60.8458																																																																																				0		0	21.4477	0.923065594	2.080300073	0	0.68355027	1.483337028	0.333911366	1.300628138	5.865785213	0	1.874107869	0.237160542	0.024325	0	4.426186949	9.194273475	2.258309272	0.73813292	0.472024244	0	7.330487973	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	60.8458
H4454_019_0	2008	5											Ambulance											Air										D	D	D	P	T	COIN	COIN	V	V	V	P	P	P	P	P	P	P	P	P	P	COIN		T									T																																																			0		1185.900245	45.8694972	339.0299159	1021.606934	68.6944128	7.963974526	1.712594526	394.9962588	292.7347066	728.8158611	275.1081775	33.09901041	9.73	40.2063685	3664.873608	2578.908858	951.9996114	149.4927671	138.9001059	0	28.80253888		405									2.61										$150/D first 10 Days; 2K OP	$150/D first 10 Days; 2K OP	$50/D (0-20 Days); $0 (21-100 Days)		$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit	$190 CP / Surg		"$75 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$190 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit	$15 CP / Visit	"20% Coins., 1K OP max"		$3.50 / Trip									$250 CP / Trip										150	150	50		100	0.17	0.17	50	190		75	150	30	190	15	30	30	30	30	15	0.074		3.5									250										14.8238	0.573368715	1.41262465	0	0.57245344	1.353875669	0.291141069	1.645817745	4.634966187	0	1.71942611	0.41373763	0.024325	0.636600835	4.58109201	6.447272146	2.379999029	0.373731918	0.347250265	0	2.131387877	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	44.5353		0	14.8238	0.573368715	1.41262465	0	0.57245344	1.353875669	0.291141069	1.645817745	4.634966187	0	1.71942611	0.41373763	0.024325	0.636600835	4.58109201	6.447272146	2.379999029	0.373731918	0.347250265	0	2.131387877	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	44.5353																																																																																				0		0	14.8238	0.573368715	1.41262465	0	0.57245344	1.353875669	0.291141069	1.645817745	4.634966187	0	1.71942611	0.41373763	0.024325	0.636600835	4.58109201	6.447272146	2.379999029	0.373731918	0.347250265	0	2.131387877	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	44.5353
H4454_020_0	2008	3																																D	D	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																					27.7168	1.3221	0	0	0.6833	0.9409	0.2062	1.3944	1.7674	1.1065	1.2447	0.0285	0.0174	0	1.8203	4.2891	0.1398	0.2087	0.87	0	2.0602																					45.8162		3004.166227	143.2967729	644.38	2552.667	20.0984	27.6747	6.0641	804	51.981	32.5443	36.6086	0.8381	0.5117	0	0	135.4727	4.417	6.5931	27.4797	0	60.5955																					Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	After Pt B Ded/ $50 per visit	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	No Cost Sharing	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits																					7.44	7.44	166.29	0	0.2	0.2	0.2	50	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.2	0.2																					1.8626	0.088843999	8.92949585	0	4.019673528	5.534947026	1.212816126	3.35	10.39620873	6.508857171	7.321722652	0.167616422	0.102349851	0	0	27.0945437	0.883399654	1.318616779	5.495930257	0	12.11909681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.4067	45.82	0	29.5793	1.410915009	8.92949585	0	4.703018028	6.475888021	1.418994867	4.744356434	12.16356422	7.61536289	8.566415503	0.196111214	0.119749325	0	1.820255847	31.38360997	1.02324182	1.527353815	6.365936016	0	14.17934327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.2229																																																																																				0		0	29.5793	1.410915009	8.92949585	0	4.703018028	6.475888021	1.418994867	4.744356434	12.16356422	7.61536289	8.566415503	0.196111214	0.119749325	0	1.820255847	31.38360997	1.02324182	1.527353815	6.365936016	0	14.17934327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.2229
H4454_021_0	2008	5											Ambulance											Air										D	D	D	P	T	COIN	COIN	V	V	V	P	P	P	P	P	P	P	P	P		COIN		T									T																																																			0		1095.777837	46.13606226	508.8598752	1390.425736	79.913624	10.28368486	2.926315138	423.2267325	449.431749	792.3368459	402.1024237	23.86639276	9.730790749	72.7381909	4550.998862	4034.264455	940.503318	313.6925978	156.6565005		42.92751902		405									2.61										$225/D first 10 Days; 2K OP	$225/D first 10 Days; 2K OP	$50/D (0-20 Days); $0 (21-100 Days)		$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit	$225 CP / Surg		"$100 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$225 CP / Surg	$15 CP / Visit	$50 CP / Visit	$50 CP / Visit	$50 CP / Visit	$50 CP / Visit		"20% Coins., 1K OP max"		$3.50 / Trip									$250 CP / Trip										225	225	50		100	0.17	0.17	50	225		100	150	30	225	15	50	50	50	50		0.074		3.5									250										20.5458	0.865051167	2.12024948	0	0.665946867	1.748226426	0.497473574	1.763444719	8.426845294	0	3.350853531	0.29832991	0.024326977	1.363841079	5.688748577	16.80943523	3.918763825	1.307052491	0.652735419	0	3.176636408	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	73.3963		0	20.5458	0.865051167	2.12024948	0	0.665946867	1.748226426	0.497473574	1.763444719	8.426845294	0	3.350853531	0.29832991	0.024326977	1.363841079	5.688748577	16.80943523	3.918763825	1.307052491	0.652735419	0	3.176636408	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	73.3963																																																																																				0		0	20.5458	0.865051167	2.12024948	0	0.665946867	1.748226426	0.497473574	1.763444719	8.426845294	0	3.350853531	0.29832991	0.024326977	1.363841079	5.688748577	16.80943523	3.918763825	1.307052491	0.652735419	0	3.176636408	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	73.3963
H4454_022_0	2008	5											Ambulance											Air										D	D	D		T	COIN	COIN	V	V		P	P	P	P	P	P	P	P	P		COIN		T									T																																																			0		1095.777837	46.13606226	508.8598752		79.913624	10.28368486	2.926315138	423.2267325	449.431749		402.1024237	23.86639276	9.730790749	72.7381909	4550.998862	4034.264455	940.503318	313.6925978	156.6565005		42.92751902		405									2.61										$275/D first 10 Days; 2K OP	$275/D first 10 Days; 2K OP	$50/D (0-20 Days); $0 (21-100 Days)		$100 CP/Trip ($0 Admit)	"20% Coins.,"	"20% Coins.,"	$50 CP / Visit	$225 CP / Surg		"$100 CP / (MRI, CT, Test)"	$190 /Admit; 2K OP	$30 CP / Visit	$225 CP / Surg	$15 CP / Visit	$50 CP / Visit	$50 CP / Visit	$50 CP / Visit	$50 CP / Visit		20% Coins		$3.50 / Trip									$250 CP / Trip										275	275	50		100	0.2	0.2	50	225		100	190	30	225	15	50	50	50	50		0.2		3.5									250										25.1116	1.05728476	2.12024948	0	0.665946867	2.056736972	0.585263028	1.763444719	8.426845294	0	3.350853531	0.377884552	0.024326977	1.363841079	5.688748577	16.80943523	3.918763825	1.307052491	0.652735419	0	8.585503805	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	84.039		0	25.1116	1.05728476	2.12024948	0	0.665946867	2.056736972	0.585263028	1.763444719	8.426845294	0	3.350853531	0.377884552	0.024326977	1.363841079	5.688748577	16.80943523	3.918763825	1.307052491	0.652735419	0	8.585503805	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	84.039																																																																																				0			25.1116	1.05728476	2.12024948	0	0.665946867	2.056736972	0.585263028	1.763444719	8.426845294	0	3.350853531	0.377884552	0.024326977	1.363841079	5.688748577	16.80943523	3.918763825	1.307052491	0.652735419	0	8.585503805	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	84.039
H4454_023_0	2008	5											Ambulance											Air										D	D	D		T	COIN	COIN	V	V		P	P	P	P	P	P	P	P	P		COIN		T									T																																																			0		1095.777837	46.13606226	508.8598752		79.913624	10.28368486	2.926315138	423.2267325	449.431749		402.1024237	23.86639276	9.730790749	72.7381909	4550.998862	4034.264455	940.503318	313.6925978	156.6565005		42.92751902		405									2.61										$275/D first 10 Days; 2K OP	$275/D first 10 Days; 2K OP	$50/D (0-20 Days); $0 (21-100 Days)		$100 CP/Trip ($0 Admit)	"20% Coins.,"	"20% Coins.,"	$50 CP / Visit	$225 CP / Surg		"$100 CP / (MRI, CT, Test)"	$190 /Admit; 2K OP	$30 CP / Visit	$225 CP / Surg	$15 CP / Visit	$50 CP / Visit	$50 CP / Visit	$50 CP / Visit	$50 CP / Visit		"20% Coins., 1K OP max"		$3.50 / Trip									$250 CP / Trip										275	275	50		100	0.2	0.2	50	225		100	190	30	225	15	50	50	50	50		0.2		3.5									250										25.1116	1.05728476	2.12024948	0	0.665946867	2.056736972	0.585263028	1.763444719	8.426845294	0	3.350853531	0.377884552	0.024326977	1.363841079	5.688748577	16.80943523	3.918763825	1.307052491	0.652735419	0	8.585503805	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	84.039		0	25.1116	1.05728476	2.12024948	0	0.665946867	2.056736972	0.585263028	1.763444719	8.426845294	0	3.350853531	0.377884552	0.024326977	1.363841079	5.688748577	16.80943523	3.918763825	1.307052491	0.652735419	0	8.585503805	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	84.039																																																																																				0			25.1116	1.05728476	2.12024948	0	0.665946867	2.056736972	0.585263028	1.763444719	8.426845294	0	3.350853531	0.377884552	0.024326977	1.363841079	5.688748577	16.80943523	3.918763825	1.307052491	0.652735419	0	8.585503805	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	84.039
H4454_024_0	2008	5											Ambulance											Air										D	D	D	P	T	COIN	COIN	V	V	V	P	P	P	P	P	P	P	P	P	P	COIN		T									T																																																			0		1185.900245	45.8694972	339.0299159	1021.606934	68.6944128	7.963974526	1.712594526	394.9962588	292.7347066	728.8158611	275.1081775	33.09901041	9.73	40.2063685	3664.873608	2578.908858	951.9996114	149.4927671	138.9001059		28.80253888		405									2.61										$195/D first 10 Days; 2K OP	$195/D first 10 Days; 2K OP	$50/D (0-20 Days); $0 (21-100 Days)		$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit	$190 CP / Surg		"$75 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$190 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit		"20% Coins., 1K OP max"		$3.50 / Trip									$250 CP / Trip										195	195	50		100	0.17	0.17	50	190		75	150	30	190	15	30	30	30	30		0.074		3.5									250										19.2709	0.74537933	1.41262465	0	0.57245344	1.353875669	0.291141069	1.645817745	4.634966187	0	1.71942611	0.41373763	0.024325	0.636600835	4.58109201	6.447272146	2.379999029	0.373731918	0.347250265	0	2.131387877	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	49.1545		0	19.2709	0.74537933	1.41262465	0	0.57245344	1.353875669	0.291141069	1.645817745	4.634966187	0	1.71942611	0.41373763	0.024325	0.636600835	4.58109201	6.447272146	2.379999029	0.373731918	0.347250265	0	2.131387877	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	49.1545																																																																																				0		0	19.2709	0.74537933	1.41262465	0	0.57245344	1.353875669	0.291141069	1.645817745	4.634966187	0	1.71942611	0.41373763	0.024325	0.636600835	4.58109201	6.447272146	2.379999029	0.373731918	0.347250265	0	2.131387877	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	49.1545
H4454_025_0	2008	5											Ambulance											Air										D	D	D	P	T	COIN	COIN	V	V	V	P	P	P	P	P	P	P	P	P	P	COIN		T									T																																																			0		1185.900245	45.8694972	339.0299159	1021.606934	68.6944128	7.963974526	1.712594526	394.9962588	292.7347066	728.8158611	275.1081775	33.09901041	9.73	40.2063685	3664.873608	2578.908858	951.9996114	149.4927671	138.9001059		28.80253888		405									2.61										$195/D first 10 Days; 2K OP	$195/D first 10 Days; 2K OP	$50/D (0-20 Days); $0 (21-100 Days)		$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit	$190 CP / Surg		"$75 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$190 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit	$30 CP / Visit		"20% Coins., 1K OP max"		$3.50 / Trip									$250 CP / Trip										195	195	50		100	0.17	0.17	50	190		75	150	30	190	15	30	30	30	30		0.074		3.5									250										19.2709	0.74537933	1.41262465	0	0.57245344	1.353875669	0.291141069	1.645817745	4.634966187	0	1.71942611	0.41373763	0.024325	0.636600835	4.58109201	6.447272146	2.379999029	0.373731918	0.347250265	0	2.131387877	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	49.1545		0	19.2709	0.74537933	1.41262465	0	0.57245344	1.353875669	0.291141069	1.645817745	4.634966187	0	1.71942611	0.41373763	0.024325	0.636600835	4.58109201	6.447272146	2.379999029	0.373731918	0.347250265	0	2.131387877	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	49.1545																																																																																				0		0	19.2709	0.74537933	1.41262465	0	0.57245344	1.353875669	0.291141069	1.645817745	4.634966187	0	1.71942611	0.41373763	0.024325	0.636600835	4.58109201	6.447272146	2.379999029	0.373731918	0.347250265	0	2.131387877	0	0.118125	0	0	0	0	0	0	0	0	0.054375	0	0	0	0	0	0	0	0	0	49.1545
H4454_803_0	2008	1																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																					15.6031	0.6715	0	0	0.222	0.2458	0.0553	0.4252	1.1406	0.9071	0.2202	0.011	0	0.0403	2.3917	2.4841	0.6101	0.1994	0.1275	0	1.2146																					26.5695		946.6036422	40.7399578	486.6199	1144.7358	6.529855642	7.228737955	1.627248371	12.50686408	33.54635103	26.67934314	6.475357855	0.323459036	0	1.184316485	70.34426	73.06112139	17.94536657	5.865479098	3.750880447	0	35.7236256																					Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits																					13.2991598	13.2991598	118.1661038	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2																					1.0491	0.045150601	4.791831469	0	1.305971128	1.445747591	0.325449674	2.501372816	6.709270206	5.335868628	1.295071571	0.064691807	0	0.236863297	14.068852	14.61222428	3.589073313	1.17309582	0.750176089	0	7.14472512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4445	26.57		16.6522	0.716676202	4.791831469	0	1.52798622	1.691524681	0.380776119	2.926606195	7.849846141	6.242966294	1.515233738	0.075689414	0	0.277130057	16.46055684	17.0963024	4.199215776	1.372522109	0.877706025	0	8.35932839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0141																																																																																				0			16.6522	0.716676202	4.791831469	0	1.52798622	1.691524681	0.380776119	2.926606195	7.849846141	6.242966294	1.515233738	0.075689414	0	0.277130057	16.46055684	17.0963024	4.199215776	1.372522109	0.877706025	0	8.35932839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0141
H4454_805_0	2008	1																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin		Coin																					15.6031	0.6715	0	0	0.222	0.2458	0.0553	0.4252	1.1406	0.9071	0.2202	0.011		0.0403	2.3917	2.4841	0.6101	0.1994	0.1275		1.2146																					26.5695		946.6036422	40.7399578	486.6199	1144.7358	6.529855642	7.228737955	1.627248371	12.50686408	33.54635103	26.67934314	6.475357855	0.323459036		1.184316485	70.34426	73.06112139	17.94536657	5.865479098	3.750880447		35.7236256																					Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits		Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits		Standard Medicare Benefits																					13.2991598	13.2991598	118.1661038	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2		0.2	0.2	0.2	0.2	0.2	0.2		0.2																					1.0491	0.045150601	4.791831469	0	1.305971128	1.445747591	0.325449674	2.501372816	6.709270206	5.335868628	1.295071571	0.064691807	0	0.236863297	14.068852	14.61222428	3.589073313	1.17309582	0.750176089	0	7.14472512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4445	26.57		16.6522	0.716676202	4.791831469	0	1.52798622	1.691524681	0.380776119	2.926606195	7.849846141	6.242966294	1.515233738	0.075689414	0	0.277130057	16.46055684	17.0963024	4.199215776	1.372522109	0.877706025	0	8.35932839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0141																																																																																				0			16.6522	0.716676202	4.791831469	0	1.52798622	1.691524681	0.380776119	2.926606195	7.849846141	6.242966294	1.515233738	0.075689414	0	0.277130057	16.46055684	17.0963024	4.199215776	1.372522109	0.877706025	0	8.35932839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0141
H4454_806_0	2008	1																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																					15.6031	0.6715	0	0	0.222	0.2458	0.0553	0.4252	1.1406	0.9071	0.2202	0.011	0	0.0403	2.3917	2.4841	0.6101	0.1994	0.1275	0	1.2146																					26.5695		946.6036422	40.7399578	486.6199	1144.7358	6.529855642	7.228737955	1.627248371	12.50686408	33.54635103	26.67934314	6.475357855	0.323459036	0	1.184316485	70.34426	73.06112139	17.94536657	5.865479098	3.750880447	0	35.7236256																					Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits																					13.2991598	13.2991598	118.1661038	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2																					1.0491	0.045150601	4.791831469	0	1.305971128	1.445747591	0.325449674	2.501372816	6.709270206	5.335868628	1.295071571	0.064691807	0	0.236863297	14.068852	14.61222428	3.589073313	1.17309582	0.750176089	0	7.14472512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4445	26.57		16.6522	0.716676202	4.791831469	0	1.52798622	1.691524681	0.380776119	2.926606195	7.849846141	6.242966294	1.515233738	0.075689414	0	0.277130057	16.46055684	17.0963024	4.199215776	1.372522109	0.877706025	0	8.35932839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0141																																																																																				0			16.6522	0.716676202	4.791831469	0	1.52798622	1.691524681	0.380776119	2.926606195	7.849846141	6.242966294	1.515233738	0.075689414	0	0.277130057	16.46055684	17.0963024	4.199215776	1.372522109	0.877706025	0	8.35932839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0141
H4454_807_0	2008	1																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin		Coin																					15.6031	0.6715	0	0	0.222	0.2458	0.0553	0.4252	1.1406	0.9071	0.2202	0.011		0.0403	2.3917	2.4841	0.6101	0.1994	0.1275		1.2146																					26.5695		946.6036422	40.7399578	486.6199	1144.7358	6.529855642	7.228737955	1.627248371	12.50686408	33.54635103	26.67934314	6.475357855	0.323459036		1.184316485	70.34426	73.06112139	17.94536657	5.865479098	3.750880447		35.7236256																					Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits		Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits		Standard Medicare Benefits																					13.2991598	13.2991598	118.1661038	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2		0.2	0.2	0.2	0.2	0.2	0.2		0.2																					1.0491	0.045150601	4.791831469	0	1.305971128	1.445747591	0.325449674	2.501372816	6.709270206	5.335868628	1.295071571	0.064691807	0	0.236863297	14.068852	14.61222428	3.589073313	1.17309582	0.750176089	0	7.14472512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4445	26.57		16.6522	0.716676202	4.791831469	0	1.52798622	1.691524681	0.380776119	2.926606195	7.849846141	6.242966294	1.515233738	0.075689414	0	0.277130057	16.46055684	17.0963024	4.199215776	1.372522109	0.877706025	0	8.35932839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0141																																																																																				0			16.6522	0.716676202	4.791831469	0	1.52798622	1.691524681	0.380776119	2.926606195	7.849846141	6.242966294	1.515233738	0.075689414	0	0.277130057	16.46055684	17.0963024	4.199215776	1.372522109	0.877706025	0	8.35932839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0141
H4456_010_0	2008	6																					2650											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1621.284169	65.25343744	294.0216034		182.914524	16.7386499	1.816345563	434.2943777	43.12884317	15993.03348	61.00226762		0.287017697	42.73107752	4485.572122	4304.014456	246.2270866	1.705355514			50.83709427	954.4262897			144		16.8541424															$195 (1a); $0 (1a1)	$195 (1b)	"$95 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$5 (4b)"	15% (9b)	15% (8a1); $0/$25 (8a2)	"$25 (8b1); 15% (8b2, 8b3)"	15% (incl in h5)	30% (12)	"15% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1); $5/$20( 7g)"	"$40/$30 (7e, 7h)"	"15% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	$0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											114.9397	114.9397	55.9963		103.151	0.176830336	0.176860307	28.2041	0.088415168	5.8943	0.051743096		0.176830336	0.088412467	5	19.9553	37.5	0.088415168			0.176830336	20			20		20															15.5292	0.625017642	1.372009497	0	1.57231845	2.959901081	0.321239434	1.020740538	3.813243906	7.855704105	3.156446207	0	0.050753436	3.777959985	1.868988384	7.157334093	0.769459646	0.150779294	0	0	8.989540443	1.590710483	0	0	0.24	0	0.028090237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8494	0	35.6584812	15.5292	0.625017642	1.372009497	0	1.57231845	2.959901081	0.321239434	1.020740538	3.813243906	7.855704105	3.156446207	0	0.050753436	3.777959985	1.868988384	7.157334093	0.769459646	0.150779294	0	0	8.989540443	1.590710483	0	0	0.24	0	0.028090237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8494																																																																																				0			15.5292	0.625017642	1.372009497	0	1.57231845	2.959901081	0.321239434	1.020740538	3.813243906	7.855704105	3.156446207	0	0.050753436	3.777959985	1.868988384	7.157334093	0.769459646	0.150779294	0	0	8.989540443	1.590710483	0	0	0.24	0	0.028090237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8494
H4456_013_0	2008	6																					3200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1435.374367	64.99063284	227.9793846		230.2586787	15.33211155	1.516684601	445.0379321	38.70976965	15819.77895	55.53758486		0.284960484	39.28050761	4184.892903	3995.526094	249.0149272	1.480786865			41.67027119	814.2669738			139.9975469		12.67728374															$195 (1a); $0 (1a1)	$195 (1b)	"$95 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$5 (4b)"	15% (9b)	15% (8a1); $0/$25 (8a2)	"$25 (8b1); 15% (8b2, 8b3)"	15% (incl in h5)	30% (12)	"15% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$18 (7b, 7d, 7f, 7f1); $0 n/c (7b1); $5/$18( 7g)"	"$40/$30 (7e, 7h)"	"15% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $18 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$18 (17a1)	$0 n/c (17b)	$18 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											129.3561	129.3561	63.0196		116.0888	0.199009319	0.19903139	31.5955	0.09950466	6.6336	0.057969073		0.199009319	0.099498001	5	17.971	37.5	0.09950466			0.199009319	18			18		18															15.4729	0.700577671	1.197264474	0	2.227537226	3.051233086	0.301867845	1.171765032	3.851802457	8.745231787	3.219462336	0	0.056709792	3.908331968	1.743705376	5.983618663	0.778171648	0.147345193	0	0	8.292772311	1.221400461	0	0	0.20999632	0	0.019015926	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3007	0	26.56265026	15.4729	0.700577671	1.197264474	0	2.227537226	3.051233086	0.301867845	1.171765032	3.851802457	8.745231787	3.219462336	0	0.056709792	3.908331968	1.743705376	5.983618663	0.778171648	0.147345193	0	0	8.292772311	1.221400461	0	0	0.20999632	0	0.019015926	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3007																																																																																				0			15.4729	0.700577671	1.197264474	0	2.227537226	3.051233086	0.301867845	1.171765032	3.851802457	8.745231787	3.219462336	0	0.056709792	3.908331968	1.743705376	5.983618663	0.778171648	0.147345193	0	0	8.292772311	1.221400461	0	0	0.20999632	0	0.019015926	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3007
H4456_015_0	2008	7																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		314.3549965	10.56241444	366.7213758			14.60196252	1.659155599	411.1527506	610.1642726	15785.20621	54.18250034			3721.457089	4535.459561	4291.020102	262.0554803	384.4225603			53.79088778	965.6896785			139.169484																	$50 (1a); $0 (1a1)	$50 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$0 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $15/$15 (4b)"	$50 (9b)	$0 (8a1); $0/$5 (8a2)	$15 (8b1); 20% (8b2); $0 (8b3)	$50 (incl in h5)	$0 (12)	"$15 (3, 5, 9d); $15/$15 (9c); $50 (9a)"	"$15/$15 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$15 (7b, 7d, 7f, 7g); $0 n/c (7b1, 7f1)"	"$15/$15 (7e, 7h)"	"$15 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $15 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$15 (17a1)	$0; $0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											50	50	2.4995			0.2	0.2	40.262	50	2	0.089862988			1.6673	15	15	15	15			0.2	15			15																	1.3098	0.04401006	0.076384673	0	0	2.920392504	0.33183112	1.379485711	2.542351136	2.630867702	4.869001395	0	0	0.517074631	5.669324452	5.363775128	0.32756935	0.4805282	0	0	10.75817756	1.207112098	0	0	0.173961855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6017	0	0	1.3098	0.04401006	0.076384673	0	0	2.920392504	0.33183112	1.379485711	2.542351136	2.630867702	4.869001395	0	0	0.517074631	5.669324452	5.363775128	0.32756935	0.4805282	0	0	10.75817756	1.207112098	0	0	0.173961855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6017																																																																																				0			1.3098	0.04401006	0.076384673	0	0	2.920392504	0.33183112	1.379485711	2.542351136	2.630867702	4.869001395	0	0	0.517074631	5.669324452	5.363775128	0.32756935	0.4805282	0	0	10.75817756	1.207112098	0	0	0.173961855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6017
H4456_016_0	2008	5																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		352.9936202	8.153346856	321.1977278			18.97712755	2.058746321	474.3988035	584.5557328		34.53563692			3824.975723	4888.060892	4681.07408	268.9856114	408.3944421			57.63559355	1042.642962			144																	$50 (1a); $0 (1a1)	$50 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$0 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $15 (4b)"	$50 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b3); 20% (8b2)"	$50 (incl in h5)	$0 (12)	"$15 (3, 5, 9d); $15/$15 (9c); $50 (9a)"	"$15/$15 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$15 (7b, 7d, 7f, 7g); $0 n/c (7b1, 7f1)"	"$15/$15 (7e, 7h)"	"$15 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $15 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$15 (17a1)	$0; $0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											50	50	2.4995			0.2	0.2	39.1309	50		0.134782868			1.3489	15	15	15	15			0.2	15			15																	1.4708	0.033972279	0.066902518	0	0	3.79542551	0.411749264	1.546970249	2.435648886	0	4.654812182	0	0	0.429944206	6.110076115	5.8513426	0.336232014	0.510493053	0	0	11.52711871	1.303303703	0	0	0.18	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6648	0	0	1.4708	0.033972279	0.066902518	0	0	3.79542551	0.411749264	1.546970249	2.435648886	0	4.654812182	0	0	0.429944206	6.110076115	5.8513426	0.336232014	0.510493053	0	0	11.52711871	1.303303703	0	0	0.18	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6648																																																																																				0			1.4708	0.033972279	0.066902518	0	0	3.79542551	0.411749264	1.546970249	2.435648886	0	4.654812182	0	0	0.429944206	6.110076115	5.8513426	0.336232014	0.510493053	0	0	11.52711871	1.303303703	0	0	0.18	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6648
H4456_017_0	2008	6																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0				606.6323558			20.45759596	2.493861168	432.3470965		16997.49289	51.79285035			151.7091038				449.192261			52.0441057	961.2603339			137.2353654																	"$0 (1a, 1a1)"	$0 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$0 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $15/$0 (4b)"	$0 (9b)	$0 (8a1); $0/$5 (8a2)	$15 (8b1); 20% (8b2); $0 (8b3)	$0 (incl in h5)	$0 (12)	"$15 (3, 9d); $0 (5, 9a); $0/$0 (9c)"	"$0/$15 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1)"	"$0 (7b, 7d, 7f, 7g); $0 n/c (7b1, 7f1)"	"$0/$0 (7e, 7h)"	"$15 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 18a, 16b, 13a1); $15 (17a)"	$0 n/c (10b)	$0 n/c (16)	$15 (17a1)	$0; $0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"													1.6663			0.2	0.2	41.5343		2	0.091699118			15				15			0.2	15			15																	0	0	0.084237276	0	0	4.091519192	0.498772234	1.496435907	0	2.832915481	4.749358719	0	0	0.18963638	0	0	0	0.561490326	0	0	10.40882114	1.201575417	0	0	0.171544207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2863	0	0	0	0	0.084237276	0	0	4.091519192	0.498772234	1.496435907	0	2.832915481	4.749358719	0	0	0.18963638	0	0	0	0.561490326	0	0	10.40882114	1.201575417	0	0	0.171544207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2863																																																																																				0			0	0	0.084237276	0	0	4.091519192	0.498772234	1.496435907	0	2.832915481	4.749358719	0	0	0.18963638	0	0	0	0.561490326	0	0	10.40882114	1.201575417	0	0	0.171544207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2863
H4456_019_0	2008	6																					2400											A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		339.6301459	7.844681104	309.0379681			17.56747028	1.906282579	456.6229948	562.4258838		40.51753512		0.301229483	3680.171506	4753.445282	4503.860075	258.8024746	392.9336283			53.35431161	1003.171052			128.1234653																	$100 (1a); $0 (1a1)	$100 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $15/$15 (4b)"	$50 (9b)	20% (8a1); $0/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$50 (incl in h5)	20% (12)	"$15 (3, 5, 9d); $15/$15 (9c); $50 (9a)"	"$15/$15 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$15 (7b, 7d, 7f, 7g); $0 n/c (7b1, 7f1)"	"$15/$15 (7e, 7h)"	"$15 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $15 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$15 (17a1)	$0; $0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											83.4555	83.4555	2.0864			0.166911067	0.166919119	32.6605	41.7278		0.120444303		0.166911067	1.1259	15	15	15	12.5183			0.166911067	15			15																	2.362	0.054556837	0.053731101	0	0	2.932205214	0.318195009	1.242795976	1.955731344	0	4.880106287	0	0.050278535	0.345302339	5.941806603	5.629825094	0.323503093	0.40990607	0	0	8.905425095	1.253963815	0	0	0.160154332	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.8195	0	4.660630099	2.362	0.054556837	0.053731101	0	0	2.932205214	0.318195009	1.242795976	1.955731344	0	4.880106287	0	0.050278535	0.345302339	5.941806603	5.629825094	0.323503093	0.40990607	0	0	8.905425095	1.253963815	0	0	0.160154332	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.8195																																																																																				0			2.362	0.054556837	0.053731101	0	0	2.932205214	0.318195009	1.242795976	1.955731344	0	4.880106287	0	0.050278535	0.345302339	5.941806603	5.629825094	0.323503093	0.40990607	0	0	8.905425095	1.253963815	0	0	0.160154332	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.8195
H4456_020_0	2008	5																					2150											A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		348.1674101	7.554528531	269.0119282			16.81404672	2.080445288	461.7275953	587.1669619		39.84279671		0.28543061	3654.583616	4764.494088	4556.98648	258.7474296	537.3038133			47.10627443	1042.57873			139.9422637																	$100 (1a); $0 (1a1)	$100 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $15 (4b)"	$50 (9b)	20% (8a1); $0/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$50 (incl in h5)	20% (12)	"$15 (3, 5, 9d); $15/$15 (9c); $50 (9a)"	"$15/$15 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$15 (7b, 7d, 7f, 7g); $0 n/c (7b1, 7f1)"	"$15/$15 (7e, 7h)"	"$15 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $15 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$15 (17a1)	$0; $0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											81.8632	81.8632	2.0466			0.163726321	0.163838806	31.9473	40.9316		0.118229968		0.163726321	1.0731	15	15	15	12.2795			0.163726321	15			15																	2.3752	0.051536465	0.045879514	0	0	2.752902005	0.340857672	1.229245004	2.002805965	0	4.710612583	0	0.046732504	0.326797348	5.95561761	5.6962331	0.323434287	0.549817353	0	0	7.712536994	1.303223412	0	0	0.17492783	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5983	0	4.905832461	2.3752	0.051536465	0.045879514	0	0	2.752902005	0.340857672	1.229245004	2.002805965	0	4.710612583	0	0.046732504	0.326797348	5.95561761	5.6962331	0.323434287	0.549817353	0	0	7.712536994	1.303223412	0	0	0.17492783	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5983																																																																																				0			2.3752	0.051536465	0.045879514	0	0	2.752902005	0.340857672	1.229245004	2.002805965	0	4.710612583	0	0.046732504	0.326797348	5.95561761	5.6962331	0.323434287	0.549817353	0	0	7.712536994	1.303223412	0	0	0.17492783	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5983
H4456_021_0	2008	7																					1950											d	d	D	V	T	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2484.835673	69.0714363	317.1927661		296.8033592	48.31203154	5.605643598	759.3553212	763.6690331		55.1977812		0.098396925	6089.922645	6666.498977	6433.458347	258.6199765	1228.682854			106.5638212	1209.680549			130.5468573																	$150 (1a); $0 (1a1)	$150 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $25/$10 (4b)"	$100 (9b)	20% (8a1); $0/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	20% (12)	"$15 (3, 9d); $60 (5); $40/$30 (9c); $100 (9a)"	"$10/$25 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$15 (7b, 7d, 7f, 7g); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $15 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$15 (17a1)	$0; $0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											75.8093	75.8093	29.0097		75.8093	0.101079003	0.101132142	21.6646	50.5395		0.073090585		0.101079003	1.2369	10	15	37.5	7.5809			0.101079003	15			15																	15.6978	0.436354495	0.766804892	0	1.875036729	4.883331987	0.566910746	1.370929497	3.216287691	0	4.034438105	0	0.009945863	0.627693441	5.555415814	8.041822934	0.808187427	0.776212738	0	0	10.77136482	1.512100686	0	0	0.163183572	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1138	0	44.06998065	15.6978	0.436354495	0.766804892	0	1.875036729	4.883331987	0.566910746	1.370929497	3.216287691	0	4.034438105	0	0.009945863	0.627693441	5.555415814	8.041822934	0.808187427	0.776212738	0	0	10.77136482	1.512100686	0	0	0.163183572	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1138																																																																																				0			15.6978	0.436354495	0.766804892	0	1.875036729	4.883331987	0.566910746	1.370929497	3.216287691	0	4.034438105	0	0.009945863	0.627693441	5.555415814	8.041822934	0.808187427	0.776212738	0	0	10.77136482	1.512100686	0	0	0.163183572	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1138
H4456_024_0	2008	6	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)							Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						Coin	Coin	D	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	V		Coin	Coin	Coin	T		V	P	Coin					Coin	Coin	Coin	V	V																																															0		453.8568465	6.942329307	9195.039767	213.3580202	27.44253527	29.01467862	0.260815646	179.7782134	12.77641901	50.23078446	45.99605429	2.343520552	0.56835793	7.555178996	130.1359351	117.9935641	12.25703427	24.80808948		11.87623789	3.766485706	5.957946407	1817.255									0.954732579	0.007079672		234.745							(1a) 7.9% coins	(1b) 7.9% coins	(2a) $0/day	(6a) $0/proc	(10a) 20% coins	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) 20% coins	(8a) 10% coins	(8b) 19.2% coins	(9a) 20% coins	(12) 20% coins	(9a) 20% coins	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) 20% coins	(7e/7h) 20% coins	(7c/7i) $0/visit		(7g) 20% coins	(15) 20% coins	(Misc. PBP Cats) 20% coins	(10b) $0/trip		(17a1) $0/visit	(17b2) $0/proc	(18a) 20% coins					(4b) 20% coins	(9c) 20% coins	(9d) 20% coins	(7f1) $0/visit	(18a1) $0/visit						0.078627533	0.078627533			0.2	0.2	0.2	50	0.2	0.1	0.192	0.2	0.2	0.2		0.2	0.2			0.2	0.2	0.2										0.2	0.2									35.6856	0.545858223	0	0	5.488507055	5.802935725	0.052163129	0.749075889	2.555283801	5.023078446	8.831242424	0.46870411	0.113671586	1.511035799	0	23.59871282	2.451406854	0	0	2.375247578	0.753297141	1.191589281	0	0	0	0	0	0	0	0	0	0.190946516	0.001415934	0	0	0	0	0	0	0	0	97.3898		0	35.6856	0.545858223	0	0	5.488507055	5.802935725	0.052163129	0.749075889	2.555283801	5.023078446	8.831242424	0.46870411	0.113671586	1.511035799	0	23.59871282	2.451406854	0	0	2.375247578	0.753297141	1.191589281	0	0	0	0	0	0	0	0	0	0.190946516	0.001415934	0	0	0	0	0	0	0	0	97.3898		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					0.2	0.3	0.3	0.3	0.3						3.5075	0.0534	0.9681	0.1173	0.4333	0.4581	0.0041	0.0394	0.2017	0.7931	0.7263	0.037	0.009	0.1193	0.0086	1.8631	0.1935	0.0029		0.1875		0.1221	0.1433									0.01	0.0001		0.013							10.0118		0	39.1932	0.599260756	0.968095113	0.117299256	5.921810243	6.26106223	0.056281271	0.788500936	2.757016733	5.816196095	9.557495913	0.505707067	0.122645659	1.630328099	0.008606114	25.4617691	2.644938975	0.002908894	0	2.562767123	0.753297141	1.313692586	0.14325	0	0	0	0	0	0	0	0	0.200996332	0.001527719	0	0.01305	0	0	0	0	0	0	107.4017
H4456_801_0	2008	1																					3950											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2009.308325	65.05240617	520.1938656		323.9444786	26.16855198	3.417909573	558.5629903	53.53081683	24033.64764	86.03637392		1.963884948	58.36586212	6866.007056	6649.7074	258.583387	2.254314214			62.19076241	2125.23471			127.8496058																	$300 (1a); $0 (1a1)	$300 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$30/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $30 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1); $30/$30( 7g)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											164.873	164.873	82.4365		96.1759	0.164873027	0.16513055	27.4788	0.164873027	3.2975	0.073349653		0.164873027	0.164840225	30	30	37.5	0.164873027			0.164873027	30			30																	27.6067	0.893782257	3.573580709	0	2.596305183	4.314488366	0.564401287	1.279055149	8.825787784	6.604167043	6.310738146	0	0.323791655	9.621041818	17.16501764	16.6242685	0.808073084	0.371675607	0	0	10.25357922	5.313086776	0	0	0.319624014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.3692	0	68.13681671	27.6067	0.893782257	3.573580709	0	2.596305183	4.314488366	0.564401287	1.279055149	8.825787784	6.604167043	6.310738146	0	0.323791655	9.621041818	17.16501764	16.6242685	0.808073084	0.371675607	0	0	10.25357922	5.313086776	0	0	0.319624014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.3692																																																																																				0			27.6067	0.893782257	3.573580709	0	2.596305183	4.314488366	0.564401287	1.279055149	8.825787784	6.604167043	6.310738146	0	0.323791655	9.621041818	17.16501764	16.6242685	0.808073084	0.371675607	0	0	10.25357922	5.313086776	0	0	0.319624014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.3692
H4456_805_0	2008	1																					3950											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2009.308325	65.05240617	520.1938656		323.9444786	26.16855198	3.417909573	558.5629903	53.53081683	24033.64764	86.03637392		1.963884948	58.36586212	6866.007056	6649.7074	258.583387	2.254314214			62.19076241	2125.23471			127.8496058																	$300 (1a); $0 (1a1)	$300 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$30/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $30 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1); $30/$30( 7g)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											164.873	164.873	82.4365		96.1759	0.164873027	0.16513055	27.4788	0.164873027	3.2975	0.073349653		0.164873027	0.164840225	30	30	37.5	0.164873027			0.164873027	30			30																	27.6067	0.893782257	3.573580709	0	2.596305183	4.314488366	0.564401287	1.279055149	8.825787784	6.604167043	6.310738146	0	0.323791655	9.621041818	17.16501764	16.6242685	0.808073084	0.371675607	0	0	10.25357922	5.313086776	0	0	0.319624014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.3692	0	68.13681671	27.6067	0.893782257	3.573580709	0	2.596305183	4.314488366	0.564401287	1.279055149	8.825787784	6.604167043	6.310738146	0	0.323791655	9.621041818	17.16501764	16.6242685	0.808073084	0.371675607	0	0	10.25357922	5.313086776	0	0	0.319624014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.3692																																																																																				0			27.6067	0.893782257	3.573580709	0	2.596305183	4.314488366	0.564401287	1.279055149	8.825787784	6.604167043	6.310738146	0	0.323791655	9.621041818	17.16501764	16.6242685	0.808073084	0.371675607	0	0	10.25357922	5.313086776	0	0	0.319624014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.3692
H4461_001_0	2008	5																																	A				coin	coin	V						V			V			V		V			V		V																																																								0			60.30499675				9.358660782	1.678599532	279.086942						177.8656012			165.0227727			12156.07555		97.31404844			362.1178101		45.09480735																$100 per admission copayment				20% cost sharing	20% cost sharing	"$50 ER, $10 Urgent Care"						"$20 PT/OT/ST, $10 CORF, $10 Mental Health"			$10 MH/SA			"$10/Visit PCP, $20/Visit Specialist, $150 Drugs"		"$10 Vision, $10 Hearing"			$10 per exam		$10 per exam																9.282477978				0.2	0.2	28.29245152						16.55542474			10			15.95226778		10			10		10															0	0.046648317	0	0	0	1.871732156	0.335719906	0.658004481	0	0	0	0	0	0.245386715	0	0	0.137518977	0	0	16.15974769	0	0.08109504	0	0	0.301764842	0	0.037579006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.8752			0	0.046648317	0	0	0	1.871732156	0.335719906	0.658004481	0	0	0	0	0	0.245386715	0	0	0.137518977	0	0	16.15974769	0	0.08109504	0	0	0.301764842	0	0.037579006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.8752																																																																																				0			0	0.046648317	0	0	0	1.871732156	0.335719906	0.658004481	0	0	0	0	0	0.245386715	0	0	0.137518977	0	0	16.15974769	0	0.08109504	0	0	0.301764842	0	0.037579006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.8752
H4461_004_0	2008	2																																	A				coin	coin	V						V			V			V		V			V		V																																																								0			56.09005027				8.696131957	1.559766228	259.532424						165.4032621			153.3402952			11295.50899		90.49563802			336.7456476		41.93519258																$100 per admission copayment				20% cost sharing	20% cost sharing	"$50 ER, $10 Urgent Care"						"$20 PT/OT/ST, $10 CORF, $10 Mental Health"			$10 MH/SA			"$10/Visit PCP, $20/Visit Specialist, $150 Drug, $100 Chemo Drugs"		"$10 Vision, $10 Hearing"			$10 per exam		$10 per exam																9.282477978				0.2	0.2	28.29245152						16.55542474			10			16.06447701		10			10		10															0	0.043387888	0	0	0	1.739226391	0.311953246	0.61190071	0	0	0	0	0	0.228193438	0	0	0.127783579	0	0	15.12137038	0	0.075413032	0	0	0.280621373	0	0.034945994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.5748			0	0.043387888	0	0	0	1.739226391	0.311953246	0.61190071	0	0	0	0	0	0.228193438	0	0	0.127783579	0	0	15.12137038	0	0.075413032	0	0	0.280621373	0	0.034945994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.5748																																																																																				0			0	0.043387888	0	0	0	1.739226391	0.311953246	0.61190071	0	0	0	0	0	0.228193438	0	0	0.127783579	0	0	15.12137038	0	0.075413032	0	0	0.280621373	0	0.034945994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.5748
H4461_007_0	2008	4																																	A				coin	coin	V						V			V			V		V			V		V																																																								0			62.40135269				8.48336764	1.338772523	279.8464954						127.8884777			114.5961197			10485.18266		80.29777086			578.3692407		41.71080885																$100 per admission copayment				20% cost sharing	20% cost sharing	"$50 ER, $10 Urgent Care"						"$20 PT/OT/ST, $10 CORF, $10 Mental Health"			$10 MH/SA			"$10/Visit PCP, $20/Visit Specialist"		"$10 Vision, $10 Hearing"			$10 per exam		$10 per exam																7.311673739				0.2	0.2	28.29245152						15.73982251			10			15.14080946		10			5.165024847		10															0	0.038021528	0	0	0	1.696673528	0.267754505	0.659795284	0	0	0	0	0	0.167745162	0	0	0.095496766	0	0	13.22951273	0	0.066914809	0	0	0.248940958	0	0.034759007	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.5056			0	0.038021528	0	0	0	1.696673528	0.267754505	0.659795284	0	0	0	0	0	0.167745162	0	0	0.095496766	0	0	13.22951273	0	0.066914809	0	0	0.248940958	0	0.034759007	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.5056																																																																																				0			0	0.038021528	0	0	0	1.696673528	0.267754505	0.659795284	0	0	0	0	0	0.167745162	0	0	0.095496766	0	0	13.22951273	0	0.066914809	0	0	0.248940958	0	0.034759007	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.5056
H4461_011_0	2008	3																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H4461_012_0	2008	4																																	A				coin	coin	V						V			V			V		V			V		V																																																								0			30.49521292				11.07160614	2.032132985	326.9692405						98.40706941			163.3023053			12916.43237		93.79458694			675.716817		42.66341646																$100 per admission copayment				20% cost sharing	20% cost sharing	"$50 ER, $10 Urgent Care"						"$20 PT/OT/ST, $10 CORF, $10 Mental Health"			$10 MH/SA			"$10/Visit PCP, $20/Visit Specialist"		"$10 Vision, $10 Hearing"			$10 per exam		$10 per exam																7.311673739				0.2	0.2	28.29245152						13.74912072			10			14.49366172		10			5.165024847		10															0	0.018580921	0	0	0	2.214321229	0.406426597	0.770896782	0	0	0	0	0	0.11275089	0	0	0.136085254	0	0	15.60053345	0	0.078162156	0	0	0.290841179	0	0.035552847	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.6642			0	0.018580921	0	0	0	2.214321229	0.406426597	0.770896782	0	0	0	0	0	0.11275089	0	0	0.136085254	0	0	15.60053345	0	0.078162156	0	0	0.290841179	0	0.035552847	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.6642																																																																																				0			0	0.018580921	0	0	0	2.214321229	0.406426597	0.770896782	0	0	0	0	0	0.11275089	0	0	0.136085254	0	0	15.60053345	0	0.078162156	0	0	0.290841179	0	0.035552847	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.6642
H4461_014_0	2008	2																																A	A	D	coin	coin	coin	coin	V	coin					O			V		coin	V	coin	V			V		V																																																								0		1522.391147	54.77978669	1174.991725	7.407866349	6.475005	8.492990314	1.523330089	253.4697465	27.47369901					2541.012923			149.7582659		22.05478984	15208.5693	1.855890346	88.38165991			636.74286		40.95558648															$500 per admission copayment	$500 per admission copayment	$75 Copay days 21-100	10% cost sharing	10% cost sharing	20% cost sharing	20% cost sharing	"$50 ER, $25 Urgent Care"	10% cost sharing					"$25 PT/OT/ST, $10 CORF, $25 Mental Health, 10% coin all other"			$25 MH/SA		10% cost sharing	"10% lab, $25/Visit PCP, $25/Visit Specialist"	20% cost sharing	"$25 Vision, $25 Hearing"			$25 per exam		$25 per exam															76.28604652	54.13810861	22.30137875	0.1	0.1	0.2	0.2	31.15435077	0.1					27.73668913			25		0.1	16.58125009	0.2	25			12.91256212		25															9.6781	0.247139503	2.183661291	0.740786635	0.6475005	1.698598063	0.304666018	0.658057116	2.747369901	0	0	0	0	5.873273793	0	0	0.311996387	0	2.205478984	21.01475759	0.371178069	0.184128458	0	0	0.685165144	0	0.085324139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6372			9.6781	0.247139503	2.183661291	0.740786635	0.6475005	1.698598063	0.304666018	0.658057116	2.747369901	0	0	0	0	5.873273793	0	0	0.311996387	0	2.205478984	21.01475759	0.371178069	0.184128458	0	0	0.685165144	0	0.085324139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6372																																																																																				0			9.6781	0.247139503	2.183661291	0.740786635	0.6475005	1.698598063	0.304666018	0.658057116	2.747369901	0	0	0	0	5.873273793	0	0	0.311996387	0	2.205478984	21.01475759	0.371178069	0.184128458	0	0	0.685165144	0	0.085324139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6372
H4461_015_0	2008	3																																A	A	D	coin	coin	coin	coin	V	coin	coin	coin			O			V		coin	V	coin	V			V		V																																																								0		1638.58312	58.96069088	1264.680018	7.973381704	6.970481197	9.150039551	1.641180556	272.8655966	29.57602385	4.24921989	25.50252421			802.0294948			161.3441209		23.36144244	18443.55086	1.999468907	95.14474484			685.4672903		44.08956371															$500 per admission copayment	$500 per admission copayment	$75 Copay days 21-100	10% cost sharing	10% cost sharing	20% cost sharing	20% cost sharing	"$50 ER, $25 Urgent Care"	10% cost sharing	10% cost sharing	10% cost sharing			"$25 PT/OT/ST, $10 CORF, $25 Mental Health, 10% coin all other"			$25 MH/SA		10% cost sharing	"10% lab, $25/Visit PCP, $25/Visit Specialist"	20% cost sharing	"$25 Vision, $25 Hearing"			$25 per exam		$25 per exam															76.28604652	54.13810861	22.30137897	0.1	0.1	0.2	0.2	31.15435077	0.1	0.1	0.1			50.085893			25		0.1	18.93852226	0.2	25			12.91256212		25															10.4168	0.266001691	2.350342363	0.79733817	0.69704812	1.83000791	0.328236111	0.708412542	2.957602385	0.424921989	2.550252421	0	0	3.347530288	0	0	0.336133585	0	2.336144244	29.10779988	0.399893781	0.198218218	0	0	0.737594914	0	0.091853258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8821			10.4168	0.266001691	2.350342363	0.79733817	0.69704812	1.83000791	0.328236111	0.708412542	2.957602385	0.424921989	2.550252421	0	0	3.347530288	0	0	0.336133585	0	2.336144244	29.10779988	0.399893781	0.198218218	0	0	0.737594914	0	0.091853258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8821																																																																																				0			10.4168	0.266001691	2.350342363	0.79733817	0.69704812	1.83000791	0.328236111	0.708412542	2.957602385	0.424921989	2.550252421	0	0	3.347530288	0	0	0.336133585	0	2.336144244	29.10779988	0.399893781	0.198218218	0	0	0.737594914	0	0.091853258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8821
H4461_016_0	2008	4																																	A				coin	coin	V						V			V			V		V			V		V																																																								0			60.30499675				9.358660782	1.678599532	279.086942						177.8656012			165.0227727			12156.07555		97.31404844			701.0959692		45.09480735																$100 per admission copayment				20% cost sharing	20% cost sharing	"$50 ER, $10 Urgent Care"						"$20 PT/OT/ST, $10 CORF, $10 Mental Health"			$10 MH/SA			"$10/Visit PCP, $20/Visit Specialist, $150 Drugs, $100 Chemo Drugs"		"$10 Vision, $10 Hearing"			$10 per exam		$10 per exam																9.282477978				0.2	0.2	28.29245152						16.55542474			10			15.95226778		10			5.165024847		10															0	0.046648317	0	0	0	1.871732156	0.335719906	0.658004481	0	0	0	0	0	0.245386715	0	0	0.137518977	0	0	16.15974769	0	0.08109504	0	0	0.301764842	0	0.037579006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.8752			0	0.046648317	0	0	0	1.871732156	0.335719906	0.658004481	0	0	0	0	0	0.245386715	0	0	0.137518977	0	0	16.15974769	0	0.08109504	0	0	0.301764842	0	0.037579006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.8752																																																																																				0			0	0.046648317	0	0	0	1.871732156	0.335719906	0.658004481	0	0	0	0	0	0.245386715	0	0	0.137518977	0	0	16.15974769	0	0.08109504	0	0	0.301764842	0	0.037579006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.8752
H4461_017_0	2008	3																																A	A	D	coin	coin	coin	coin	V	coin	coin	coin			O			V		coin	V	coin	V			V		V																																																								0		1638.58312	58.96069088	29.25029496	7.973381704	6.970481197	9.150039551	1.641180556	272.8655966	29.57602385	4.24921989	25.50252421			802.0294948			161.3441209		23.36144244	18443.55086	1.999468907	95.14474484			685.4672903		44.08956371															$500 per admission copayment	$500 per admission copayment	$75 Copay days 21-100	10% cost sharing	10% cost sharing	20% cost sharing	20% cost sharing	"$50 ER, $25 Urgent Care"	10% cost sharing	10% cost sharing	10% cost sharing			"$25 PT/OT/ST, $10 CORF, $25 Mental Health, 10% coin all other"			$25 MH/SA		10% cost sharing	"10% lab, $25/Visit PCP, $25/Visit Specialist"	20% cost sharing	"$25 Vision, $25 Hearing"			$25 per exam		$25 per exam															76.28604652	54.13810861	964.2332973	0.1	0.1	0.2	0.2	31.15435077	0.1	0.1	0.1			50.085893			25		0.1	18.93852226	0.2	25			12.91256212		25															10.4168	0.266001691	2.350342363	0.79733817	0.69704812	1.83000791	0.328236111	0.708412542	2.957602385	0.424921989	2.550252421	0	0	3.347530288	0	0	0.336133585	0	2.336144244	29.10779988	0.399893781	0.198218218	0	0	0.737594914	0	0.091853258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8821			10.4168	0.266001691	2.350342363	0.79733817	0.69704812	1.83000791	0.328236111	0.708412542	2.957602385	0.424921989	2.550252421	0	0	3.347530288	0	0	0.336133585	0	2.336144244	29.10779988	0.399893781	0.198218218	0	0	0.737594914	0	0.091853258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8821																																																																																				0			10.4168	0.266001691	2.350342363	0.79733817	0.69704812	1.83000791	0.328236111	0.708412542	2.957602385	0.424921989	2.550252421	0	0	3.347530288	0	0	0.336133585	0	2.336144244	29.10779988	0.399893781	0.198218218	0	0	0.737594914	0	0.091853258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8821
H4461_802_0	2008	2																																	A				coin	coin	V						V			V			V		V			V		V																																																								0			50.80570187				9.69058621	1.44787213	12.8410797						222.8482796			188.5424626			10970.86452		105.9257117			763.2388662		55.64005052																$100 per admission copayment				20% cost sharing	20% cost sharing	"$50 ER, $10 Urgent Care"						"$20 PT/OT/ST, $10 CORF, $10 Mental Health"			$10 MH/SA			"$10/Visit PCP, $20/Visit Specialist"		"$10 Vision, $10 Hearing"			$10 per exam		$10 per exam																7.311673739				0.2	0.2	637.7390647						16.87990245			10			11.23756641		10			5.165024847		10															0	0.030956226	0	0	0	1.938117242	0.289574426	0.68243818	0	0	0	0	0	0.313471435	0	0	0.157118719	0	0	10.27381822	0	0.088271426	0	0	0.328512309	0	0.046366709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.1486			0	0.030956226	0	0	0	1.938117242	0.289574426	0.68243818	0	0	0	0	0	0.313471435	0	0	0.157118719	0	0	10.27381822	0	0.088271426	0	0	0.328512309	0	0.046366709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.1486																																																																																				0			0	0.030956226	0	0	0	1.938117242	0.289574426	0.68243818	0	0	0	0	0	0.313471435	0	0	0.157118719	0	0	10.27381822	0	0.088271426	0	0	0.328512309	0	0.046366709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.1486
H4506_003_0	2008	5																					2500											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V																																																				0		251.4944611	6.402605591	526.6725046		179.3805336	10.05135566	0.550411955	231.3013195	219.1266944		113.288488	19.82125715	4.616033048	216.9468052	4714.553946	3026.432031	0.34219666	543.820642			9.151653012	596.4499621		941.49	148.3037333																	1a: $300	1b : $300	"2a: $100 days 21 - 100 / 2a: $300/Admit, $100 days 21-100"	6a: $0	10a: $100	11a: 10%	11b: 20% 11c: 10%/20%	4a: $50 4b: $50	9b: $100	8a: $0	8b1: $0 8b2: $0/$25/$125/$300 8b3: $50/$200	9a: $150	12: $50	9a: $150 9c: $35/$20 9d: $25 3: $25 5: $25	"7a: $5, 14b, 14c, 14c, 14d, 14d, 14e, 14f, 14g, 14h: $0, 14i: $10"	7b: $25 7d: $25 7f: $25	"7e, 7h: $35/$20"	7c: $25 7i: $25	8b1: $0 8b2: $0/$25/$125/$300 8b3: $50/$200	7g: $25	15: 10%	13a: $0 14a: $0 14j: $10 16b: $0 17a: $25 17b: $0	10b: $0	16a: $20	17a1: $25	17b1: $0	18a: $25 18a1: (n/c)	18b: (n/c)	(n/c)	14a: $0	13b: (n/c)											259.2616	259.2616	55.541		86.4205	0.129630779	0.129630779	43.2103	86.4205		41.8667	129.6308	43.2103	129.6308	4.321	21.6051	27.0064	21.6051			0.086420519	21.6051		17.2841	21.6051																	5.4336	0.138329125	2.437657759	0	1.291846568	1.30296506	0.07135033	0.832882504	1.578086889	0	0.395251274	0.214120416	0.016621665	2.343581939	1.697642496	5.448871395	0.000770125	0.979109628	0	0	0.790890603	1.073864902	0	1.356067574	0.267010117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.6705	0	4.347936208	5.4336	0.138329125	2.437657759	0	1.291846568	1.30296506	0.07135033	0.832882504	1.578086889	0	0.395251274	0.214120416	0.016621665	2.343581939	1.697642496	5.448871395	0.000770125	0.979109628	0	0	0.790890603	1.073864902	0	1.356067574	0.267010117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.6705																																																																																				0	0	0	5.4336	0.138329125	2.437657759	0	1.291846568	1.30296506	0.07135033	0.832882504	1.578086889	0	0.395251274	0.214120416	0.016621665	2.343581939	1.697642496	5.448871395	0.000770125	0.979109628	0	0	0.790890603	1.073864902	0	1.356067574	0.267010117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.6705
H4506_004_0	2008	5																					2500											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V																																																				0		194.3082476	6.161189885	63.18750526		371.0719966	38.6278672	0.381863553	414.6318364	341.0681235		609.7473846	130.8602657	3.795670691	215.8109907		3420.672555	0.984818569	705.7984977			5.092718904	662.5886571		941.49	150.6630268																	1a: $300	1b : $300	"2a: $100 days 21 - 100 / 2a: $300/Admit, $100 days 21-100"	6a: $0	10a: $100	11a: 10%	11b: 20% 11c: 10%/20%	4a: $50 4b: $50	9b: $100	8a: $0	8b1: $0 8b2: $0/$25/$125/$300 8b3: $50/$200	9a: $150	12: $50	9a: $150 9c: $35/$20 9d: $25 3: $25 5: $25	"7a: $0, 14b, 14c, 14c, 14d, 14d, 14e, 14f, 14g, 14h: $0 14i: $10"	7b: $25 7d: $25 7f: $25	"7e, 7h: $35/$20"	7c: $25 7i: $25	8b1: $0 8b2: $0/$25/$125/$300 8b3: $50/$200	7g: $25	15: 10%	13a: $0 14a: $0 14j: $10 16b: $0 17a: $25 17b: $0	10b: (n/c)	16a: $20	17a1: $25	17b1: (n/c)	18a: $25 18a1: (n/c)	18b: (n/c)	(n/c)	14a: $0	13b: (n/c)											250.0776	250.0776	53.5735		83.3592	0.125038799	0.125038799	41.6796	83.3592		39.9947	125.0388	41.6796	125.0388		20.8398	26.0497	20.8398			0.083359199	20.8398		16.6718	20.8398																	4.0493	0.128397964	0.282097969	0	2.577688711	4.829982123	0.04774776	1.440140746	2.369263808	0	2.032222848	1.363550872	0.013183503	2.248728924	0	5.940510946	0.002137856	1.225724951	0	0	0.42452497	1.150684582	0	1.308030877	0.261648943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6956	0	6.327320648	4.0493	0.128397964	0.282097969	0	2.577688711	4.829982123	0.04774776	1.440140746	2.369263808	0	2.032222848	1.363550872	0.013183503	2.248728924	0	5.940510946	0.002137856	1.225724951	0	0	0.42452497	1.150684582	0	1.308030877	0.261648943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6956																																																																																				0	0	0	4.0493	0.128397964	0.282097969	0	2.577688711	4.829982123	0.04774776	1.440140746	2.369263808	0	2.032222848	1.363550872	0.013183503	2.248728924	0	5.940510946	0.002137856	1.225724951	0	0	0.42452497	1.150684582	0	1.308030877	0.261648943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6956
H4506_010_0	2008	3																					2500											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V																																																				0		251.4944611	6.402605591	526.6725046		179.3805336	10.05135566	0.550411955	231.3013195	219.1266944		113.288488	19.82125715	4.616033048	216.9468052	4714.553946	3026.432031	0.34219666	543.820642			9.151653012	596.4499621		941.49	148.3037333																	1a: $300	1b : $300	"2a: $100 days 21 - 100 / 2a: $300/Admit, $100 days 21-100"	6a: $0	10a: $100	11a: 10%	11b: 20% 11c: 10%/20%	4a: $50 4b: $50	9b: $100	8a: $0	8b1: $0 8b2: $0/$25/$125/$300 8b3: $50/$200	9a: $150	12: $50	9a: $150 9c: $35/$20 9d: $25 3: $25 5: $25	"7a: $5, 14b, 14c, 14c, 14d, 14d, 14e, 14f, 14g, 14h: $0, 14i: $10"	7b: $25 7d: $25 7f: $25	"7e, 7h: $35/$20"	7c: $25 7i: $25	8b1: $0 8b2: $0/$25/$125/$300 8b3: $50/$200	7g: $25	15: 10%	13a: $0 14a: $0 14j: $10 16b: $0 17a: $25 17b: $0	10b: $0	16a: $20	17a1: $25	17b1: $0	18a: $25 18a1: (n/c)	18b: (n/c)	(n/c)	14a: $0	13b: (n/c)											259.2616	259.2616	55.541		86.4205	0.129630779	0.129630779	43.2103	86.4205		41.8667	129.6308	43.2103	129.6308	4.321	21.6051	27.0064	21.6051			0.086420519	21.6051		17.2841	21.6051																	5.4336	0.138329125	2.437657759	0	1.291846568	1.30296506	0.07135033	0.832882504	1.578086889	0	0.395251274	0.214120416	0.016621665	2.343581939	1.697642496	5.448871395	0.000770125	0.979109628	0	0	0.790890603	1.073864902	0	1.356067574	0.267010117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.6705	0	4.347936208	5.4336	0.138329125	2.437657759	0	1.291846568	1.30296506	0.07135033	0.832882504	1.578086889	0	0.395251274	0.214120416	0.016621665	2.343581939	1.697642496	5.448871395	0.000770125	0.979109628	0	0	0.790890603	1.073864902	0	1.356067574	0.267010117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.6705																																																																																				0	0	0	5.4336	0.138329125	2.437657759	0	1.291846568	1.30296506	0.07135033	0.832882504	1.578086889	0	0.395251274	0.214120416	0.016621665	2.343581939	1.697642496	5.448871395	0.000770125	0.979109628	0	0	0.790890603	1.073864902	0	1.356067574	0.267010117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.6705
H4506_011_0	2008	3																					2500											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V																																																				0		194.3082476	6.161189885	63.18750526		371.0719966	38.6278672	0.381863553	414.6318364	341.0681235		609.7473846	130.8602657	3.795670691	215.8109907		3420.672555	0.984818569	705.7984977			5.092718904	662.5886571		941.49	150.6630268																	1a: $300	1b : $300	"2a: $100 days 21 - 100 / 2a: $300/Admit, $100 days 21-100"	6a: $0	10a: $100	11a: 10%	11b: 20% 11c: 10%/20%	4a: $50 4b: $50	9b: $100	8a: $0	8b1: $0 8b2: $0/$25/$125/$300 8b3: $50/$200	9a: $150	12: $50	9a: $150 9c: $35/$20 9d: $25 3: $25 5: $25	"7a: $0, 14b, 14c, 14c, 14d, 14d, 14e, 14f, 14g, 14h: $0, 14i: $10"	7b: $25 7d: $25 7f: $25	"7e, 7h: $35/$20"	7c: $25 7i: $25	8b1: $0 8b2: $0/$25/$125/$300 8b3: $50/$200	7g: $25	15: 10%	13a: $0 14a: $0 14j: $10 16b: $0 17a: $25 17b: $0	10b: $0	16a: $20	17a1: $25	17b1: $0	18a: $25 18a1: (n/c)	18b: (n/c)	(n/c)	14a: $0	13b: (n/c)											250.0776	250.0776	53.5735		83.3592	0.125038799	0.125038799	41.6796	83.3592		39.9947	125.0388	41.6796	125.0388		20.8398	26.0497	20.8398			0.083359199	20.8398		16.6718	20.8398																	4.0493	0.128397964	0.282097969	0	2.577688711	4.829982123	0.04774776	1.440140746	2.369263808	0	2.032222848	1.363550872	0.013183503	2.248728924	0	5.940510946	0.002137856	1.225724951	0	0	0.42452497	1.150684582	0	1.308030877	0.261648943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6956	0	6.327320648	4.0493	0.128397964	0.282097969	0	2.577688711	4.829982123	0.04774776	1.440140746	2.369263808	0	2.032222848	1.363550872	0.013183503	2.248728924	0	5.940510946	0.002137856	1.225724951	0	0	0.42452497	1.150684582	0	1.308030877	0.261648943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6956																																																																																				0	0	0	4.0493	0.128397964	0.282097969	0	2.577688711	4.829982123	0.04774776	1.440140746	2.369263808	0	2.032222848	1.363550872	0.013183503	2.248728924	0	5.940510946	0.002137856	1.225724951	0	0	0.42452497	1.150684582	0	1.308030877	0.261648943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6956
H4506_012_0	2008	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		513.6090887	29.9409999	38.09195731		22.26538107	34.94875225	24.11158158	26.12539944	37.7163455	20.88197957	53.27545305	2.430633592	8.007780894	36.50269952	61.36000761	142.1519126	26.05192261	3.629069706			33.8307818	8.157594364																				Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin											0.069895406	0.069895406	0.2005251		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				35.8989	2.092738357	7.638393558	0	5.210099169	8.178008026	5.64211009	6.113343469	8.825624847	4.88638322	12.46645601	0.568768261	1.873820729	8.541631689	14.35824178	33.26354754	6.09614989	0.849202311	0	0	7.916402941	1.908877081	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	172.3287	0	0	35.8989	2.092738357	7.638393558	0	5.210099169	8.178008026	5.64211009	6.113343469	8.825624847	4.88638322	12.46645601	0.568768261	1.873820729	8.541631689	14.35824178	33.26354754	6.09614989	0.849202311	0	0	7.916402941	1.908877081	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	172.3287																																																																																				0	0	0	35.8989	2.092738357	7.638393558	0	5.210099169	8.178008026	5.64211009	6.113343469	8.825624847	4.88638322	12.46645601	0.568768261	1.873820729	8.541631689	14.35824178	33.26354754	6.09614989	0.849202311	0	0	7.916402941	1.908877081	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	172.3287
H4506_013_0	2008	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		482.4983833	28.44083413	747.5660433		52.15353298	12.1167651	13.80183873	20.98643307	20.47579581	38.90250161	43.50085833	2.339051788	2.582372231	122.2307325	86.02062558	143.8239732	33.99496131	25.78666397			26.72369792	7.863105512					0.000767037															Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin	Medicare FFS Ded/Coin											0.069928371	0.069928371	0.200610896		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234					0.234															33.7403	1.988821193	149.9698941	0	12.20392672	2.835323033	3.229630263	4.910825338	4.791336219	9.103185378	10.17920085	0.547338118	0.604275102	28.6019914	20.12882639	33.65480973	7.954820946	6.03407937	0	0	6.253345313	1.83996669	0	0	0	0	0.000179487	0	0	0	0	0	0	0	0	0	0	0	0	0	0	338.5721	0	0	33.7403	1.988821193	149.9698941	0	12.20392672	2.835323033	3.229630263	4.910825338	4.791336219	9.103185378	10.17920085	0.547338118	0.604275102	28.6019914	20.12882639	33.65480973	7.954820946	6.03407937	0	0	6.253345313	1.83996669	0	0	0	0	0.000179487	0	0	0	0	0	0	0	0	0	0	0	0	0	0	338.5721																																																																																				0	0	0	33.7403	1.988821193	149.9698941	0	12.20392672	2.835323033	3.229630263	4.910825338	4.791336219	9.103185378	10.17920085	0.547338118	0.604275102	28.6019914	20.12882639	33.65480973	7.954820946	6.03407937	0	0	6.253345313	1.83996669	0	0	0	0	0.000179487	0	0	0	0	0	0	0	0	0	0	0	0	0	0	338.5721
H4506_015_0	2008	5																					3250											A	A	D	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	V	Coin	V	T	V	V	V	V	V	V	V	V																																																				0		194.3082476	6.161189885	63.18750526	5.394756353	17.30703303	38.6278672	0.381863553	414.6318364	56.26223709	43.7243276	83.55129522	19.01771969	1.199638324	15.10461218	4999.855424	3420.672555	2.135788459	6.03248601			5.092718904	662.5886571		941.49	150.6630268																	1a : $ Days 1-7	1b : $ Days 1-7	2a: $0 Days 1-5 / $100 Days 6-100	6a: 20%	10a: $0/$51.0605775069623	11a: 20%	11b: 20% 11c: 10%/20%	4a: $50 4b: $25	9b: 15%	8a: 10%	8b1: 20% 8b2: 20% 8b3: 20%	9a: 20%	12: 20%	9a: 20% 9c: $15 9d: $25 3: $25 5: $25	"7a: $5, 14b, 14c, 14c, 14d, 14d, 14e, 14f, 14g, 14h: $0 14i: $25"	7b: $25 7d: $25 7f: $25	"7e, 7h: $25"	7c: $25 7i: $25	8b1: 20% 8b2: 20% 8b3: 20%	7g: $25	15: 20%	13a: 20% 14a: $0 14j: $25 16b: $0 17a: $25 17b: $0	10b: $0	16a: $20	17a1: $25	17b1: $0	18a: $25 18a1: (n/c)	18b: (n/c)	(n/c)	14a: $0	13b: (n/c)											586.8771	589.3936	71.9077	0.148542404	0.067757986	0.145571556	0.145571556	35.2788	0.111406803	0.074271202	0.148542404	0.148542404	0.148542404	0.148542404	3.7136	18.5678	0.000713472	0.181035448			0.148542404	18.5678		14.8542	18.5678																	9.5029	0.302613801	0.378639177	0.801350077	1.172689697	5.623118725	0.055588471	1.218976859	6.267995959	3.247458365	12.41091024	2.824937799	0.17819716	2.243675403	1.547271966	5.292863794	0.001523826	1.092093807	0	0	0.756484708	1.025234499	0	1.165426565	0.233123419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3431	0	19.86461618	9.5029	0.302613801	0.378639177	0.801350077	1.172689697	5.623118725	0.055588471	1.218976859	6.267995959	3.247458365	12.41091024	2.824937799	0.17819716	2.243675403	1.547271966	5.292863794	0.001523826	1.092093807	0	0	0.756484708	1.025234499	0	1.165426565	0.233123419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3431																																																																																				0	0	0	9.5029	0.302613801	0.378639177	0.801350077	1.172689697	5.623118725	0.055588471	1.218976859	6.267995959	3.247458365	12.41091024	2.824937799	0.17819716	2.243675403	1.547271966	5.292863794	0.001523826	1.092093807	0	0	0.756484708	1.025234499	0	1.165426565	0.233123419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3431
H4506_018_0	2008	3																					2500											A	A	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	Coin	V	Coin	V	Coin	V	T	V	V	V	V	V	V	V	V																																																				0		251.4944611	6.402605591	526.6725046	12.8443081	179.3805336	10.05135566	0.550411955	231.3013195	219.1266944		61.53905879	19.82125715	4.616033048	216.9468052	4714.553946	3026.432031	1.300793517	543.820642			9.151653012	1171.311206			60.10373334																	1a: $195	1b : $95 Days 1-5	"2a: $100 days 21 - 100 / 2a: $195/Admit, $100 days 21-100"	6a: 15%	10a: $50	11a: 20%	11b: 20% 11c: 20%	4a: $35 4b: $35	9b: $25	8a: $0	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 50% 9d: $15 3: $15 5: $75	"7a: $10, 14b, 14c, 14c, 14d, 14d, 14e, 14f, 14g, 14h, 14i: $0"	7b: $20 7d: $25 7f: $20	7e: 50% 7h: 50%	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $0 17a: $15 17b: $15	10b: $0	16a: (n/c)	17a1: $15	17b1: (n/c)	18a: $15 18a1: $15	18b: (n/c)	(n/c)	14a: $0	13b: (n/c)											165.8373	229.0434	54.579	0.127567118	42.5224	0.17008949	0.17008949	29.7657	21.2612		0.085044745	42.5224	42.5224	42.5224	8.5045	21.0751	0.425223726	12.7567			0.17008949	12.7567			12.7567																	3.4756	0.122206237	2.395438711	1.638511362	0.63564049	1.709629961	0.093619289	0.573736385	0.388241122	0	5.233573569	0.07023724	0.016357056	0.76875774	3.341233656	5.315187543	0.553128265	0.578113599	0	0	1.556599995	1.245173287	0	0	0.063893834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7749	0	5.235959585	3.4756	0.122206237	2.395438711	1.638511362	0.63564049	1.709629961	0.093619289	0.573736385	0.388241122	0	5.233573569	0.07023724	0.016357056	0.76875774	3.341233656	5.315187543	0.553128265	0.578113599	0	0	1.556599995	1.245173287	0	0	0.063893834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7749																																																																																				0	0	0	3.4756	0.122206237	2.395438711	1.638511362	0.63564049	1.709629961	0.093619289	0.573736385	0.388241122	0	5.233573569	0.07023724	0.016357056	0.76875774	3.341233656	5.315187543	0.553128265	0.578113599	0	0	1.556599995	1.245173287	0	0	0.063893834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7749
H4506_020_0	2008	6																					2500											A	A	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	Coin	V	Coin	V	Coin	V	T	V	V	V	V	V	V	V	V																																																				0		251.4944611	6.402605591	526.6725046	12.8443081	179.3805336	10.05135566	0.550411955	231.3013195	219.1266944		61.53905879	19.82125715	4.616033048	216.9468052	4714.553946	3026.432031	1.300793517	543.820642			9.151653012	1171.311206			60.10373334																	1a: $195	1b : $95 Days 1-5	"2a: $100 days 21 - 100 / 2a: $195/Admit, $100 days 21-100"	6a: 15%	10a: $50	11a: 20%	11b: 20% 11c: 20%	4a: $35 4b: $35	9b: $25	8a: $0	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 50% 9d: $15 3: $15 5: $75	"7a: $10, 14b, 14c, 14c, 14d, 14d, 14e, 14f, 14g, 14h, 14i: $0"	7b: $20 7d: $25 7f: $20	7e: 50% 7h: 50%	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $0 17a: $15 17b: $15	10b: $0	16a: (n/c)	17a1: $15	17b1: (n/c)	18a: $15 18a1: $15	18b: (n/c)	(n/c)	14a: $0	13b: (n/c)											165.8373	229.0434	54.579	0.127567118	42.5224	0.17008949	0.17008949	29.7657	21.2612		0.085044745	42.5224	42.5224	42.5224	8.5045	21.0751	0.425223726	12.7567			0.17008949	12.7567			12.7567																	3.4756	0.122206237	2.395438711	1.638511362	0.63564049	1.709629961	0.093619289	0.573736385	0.388241122	0	5.233573569	0.07023724	0.016357056	0.76875774	3.341233656	5.315187543	0.553128265	0.578113599	0	0	1.556599995	1.245173287	0	0	0.063893834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7749	0	5.235959585	3.4756	0.122206237	2.395438711	1.638511362	0.63564049	1.709629961	0.093619289	0.573736385	0.388241122	0	5.233573569	0.07023724	0.016357056	0.76875774	3.341233656	5.315187543	0.553128265	0.578113599	0	0	1.556599995	1.245173287	0	0	0.063893834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7749																																																																																				0	0	0	3.4756	0.122206237	2.395438711	1.638511362	0.63564049	1.709629961	0.093619289	0.573736385	0.388241122	0	5.233573569	0.07023724	0.016357056	0.76875774	3.341233656	5.315187543	0.553128265	0.578113599	0	0	1.556599995	1.245173287	0	0	0.063893834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7749
H4506_022_0	2008	5																					3250											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V																																																				0		251.4944611	6.402605591	526.6725046	2409.327408	179.3805336	10.05135566	0.550411955	231.3013195	219.1266944	43.69132712	148.1611611	19.82125715	4.616033048	216.9468052	4714.553946	3026.432031	0.34219666	543.820642			9.151653012	596.4499621		941.49	148.3037333																	1a : $300 Days 1-7	1b : $300 Days 1-7	2a: $0 Days 1-5 / $100 Days 6-100	6a: 20%	10a: $0/$51.0605775069623	11a: 20%	11b: 20% 11c: 10%/20%	4a: $50 4b: $25	9b: 15%	8a: 10%	8b1: 20% 8b2: 20% 8b3: 20%	9a: 20%	12: 20%	9a: 20% 9c: $15 9d: $25 3: $25 5: $25	"7a: $5, 14b, 14c, 14c, 14d, 14d, 14e, 14f, 14g, 14h: $0 14i: $25"	7b: $25 7d: $25 7f: $25	"7e, 7h: $25"	7c: $25 7i: $25	8b1: 20% 8b2: 20% 8b3: 20%	7g: $25	15: 20%	13a: 20% 14a: $0 14j: $25 16b: $0 17a: $25 17b: $0	10b: $0	16a: $20	17a1: $25	17b1: $0	18a: $25 18a1: (n/c)	18b: (n/c)	(n/c)	14a: $0	13b: (n/c)											617.4353	620.0828	75.6519	9.9975	39.8979	0.15315135	0.15315135	37.1158	209.4937	520.3747	778.9193	275.4077	116.294	104.3133	3.9069	19.5346	19.5346	19.5346			0.156276888	19.5346		15.6277	19.5346																	12.9401	0.330845469	3.320315022	2.007268494	0.596409491	1.539378689	0.084296334	0.715410371	3.825471096	1.894655024	9.617132579	0.454910624	0.044734745	1.885868881	1.53494962	4.926681028	0.000557057	0.885277056	0	0	1.43019185	0.970951497	0	1.226109392	0.241421311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.473	0	14.12131471	12.9401	0.330845469	3.320315022	2.007268494	0.596409491	1.539378689	0.084296334	0.715410371	3.825471096	1.894655024	9.617132579	0.454910624	0.044734745	1.885868881	1.53494962	4.926681028	0.000557057	0.885277056	0	0	1.43019185	0.970951497	0	1.226109392	0.241421311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.473																																																																																				0	0	0	12.9401	0.330845469	3.320315022	2.007268494	0.596409491	1.539378689	0.084296334	0.715410371	3.825471096	1.894655024	9.617132579	0.454910624	0.044734745	1.885868881	1.53494962	4.926681028	0.000557057	0.885277056	0	0	1.43019185	0.970951497	0	1.226109392	0.241421311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.473
H4506_023_0	2008	5																					2500											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V																																																				0		251.4944611	6.402605591	526.6725046		179.3805336	10.05135566	0.550411955	231.3013195	219.1266944		113.288488	19.82125715	4.616033048	216.9468052	4714.553946	3026.432031	0.34219666	543.820642			9.151653012	596.4499621		941.49	148.3037333																	1a: $300	1b : $300	"2a: $100 days 21 - 100 / 2a: $300/Admit, $100 days 21-100"	6a: $0	10a: $100	11a: 10%	11b: 20% 11c: 10%/20%	4a: $50 4b: $50	9b: $100	8a: $0	8b1: $0 8b2: $0/$25/$125/$300 8b3: $50/$200	9a: $150	12: $50	9a: $150 9c: $35/$20 9d: $25 3: $25 5: $25	"7a: $5, 14b, 14c, 14c, 14d, 14d, 14e, 14f, 14g, 14h: $0, 14i: $10"	7b: $25 7d: $25 7f: $25	"7e, 7h: $35/$20"	7c: $25 7i: $25	8b1: $0 8b2: $0/$25/$125/$300 8b3: $50/$200	7g: $25	15: 10%	13a: $0 14a: $0 14j: $10 16b: $0 17a: $25 17b: $0	10b: $0	16a: $20	17a1: $25	17b1: $0	18a: $25 18a1: (n/c)	18b: (n/c)	(n/c)	14a: $0	13b: (n/c)											259.2616	259.2616	55.541		86.4205	0.129630779	0.129630779	43.2103	86.4205		41.8667	129.6308	43.2103	129.6308	4.321	21.6051	27.0064	21.6051			0.086420519	21.6051		17.2841	21.6051																	5.4336	0.138329125	2.437657759	0	1.291846568	1.30296506	0.07135033	0.832882504	1.578086889	0	0.395251274	0.214120416	0.016621665	2.343581939	1.697642496	5.448871395	0.000770125	0.979109628	0	0	0.790890603	1.073864902	0	1.356067574	0.267010117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.6705	0	4.347936208	5.4336	0.138329125	2.437657759	0	1.291846568	1.30296506	0.07135033	0.832882504	1.578086889	0	0.395251274	0.214120416	0.016621665	2.343581939	1.697642496	5.448871395	0.000770125	0.979109628	0	0	0.790890603	1.073864902	0	1.356067574	0.267010117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.6705																																																																																				0	0	0	5.4336	0.138329125	2.437657759	0	1.291846568	1.30296506	0.07135033	0.832882504	1.578086889	0	0.395251274	0.214120416	0.016621665	2.343581939	1.697642496	5.448871395	0.000770125	0.979109628	0	0	0.790890603	1.073864902	0	1.356067574	0.267010117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.6705
H4506_024_0	2008	5																					2500											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V																																																				0		194.3082476	6.161189885	63.18750526		371.0719966	38.6278672	0.381863553	414.6318364	341.0681235		609.7473846	130.8602657	3.795670691	215.8109907		3420.672555	0.984818569	705.7984977			5.092718904	662.5886571		941.49	150.6630268																	1a: $300	1b : $300	"2a: $100 days 21 - 100 / 2a: $300/Admit, $100 days 21-100"	6a: $0	10a: $100	11a: 10%	11b: 20% 11c: 10%/20%	4a: $50 4b: $50	9b: $100	8a: $0	8b1: $0 8b2: $0/$25/$125/$300 8b3: $50/$200	9a: $150	12: $50	9a: $150 9c: $35/$20 9d: $25 3: $25 5: $25	"7a: $0, 14b, 14c, 14c, 14d, 14d, 14e, 14f, 14g, 14h: $0 14i: $10"	7b: $25 7d: $25 7f: $25	"7e, 7h: $35/$20"	7c: $25 7i: $25	8b1: $0 8b2: $0/$25/$125/$300 8b3: $50/$200	7g: $25	15: 10%	13a: $0 14a: $0 14j: $10 16b: $0 17a: $25 17b: $0	10b: (n/c)	16a: $20	17a1: $25	17b1: (n/c)	18a: $25 18a1: (n/c)	18b: (n/c)	(n/c)	14a: $0	13b: (n/c)											250.0776	250.0776	53.5735		83.3592	0.125038799	0.125038799	41.6796	83.3592		39.9947	125.0388	41.6796	125.0388		20.8398	26.0497	20.8398			0.083359199	20.8398		16.6718	20.8398																	4.0493	0.128397964	0.282097969	0	2.577688711	4.829982123	0.04774776	1.440140746	2.369263808	0	2.032222848	1.363550872	0.013183503	2.248728924	0	5.940510946	0.002137856	1.225724951	0	0	0.42452497	1.150684582	0	1.308030877	0.261648943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6956	0	6.327320648	4.0493	0.128397964	0.282097969	0	2.577688711	4.829982123	0.04774776	1.440140746	2.369263808	0	2.032222848	1.363550872	0.013183503	2.248728924	0	5.940510946	0.002137856	1.225724951	0	0	0.42452497	1.150684582	0	1.308030877	0.261648943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6956																																																																																				0	0	0	4.0493	0.128397964	0.282097969	0	2.577688711	4.829982123	0.04774776	1.440140746	2.369263808	0	2.032222848	1.363550872	0.013183503	2.248728924	0	5.940510946	0.002137856	1.225724951	0	0	0.42452497	1.150684582	0	1.308030877	0.261648943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6956
H4506_801_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		273.06236	3.471771593	21.66803602		10.11678356	14.90161589	0.509491593	18.26955623	36.15672508	27.20188089	64.18874891	5.700340487	0.441988143	12.36084326	56.83887239	148.3835349	1.422177969	2.725989058			8.249084993	10.36222927																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS											0.071790613	0.071790613	0.213373702		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				19.6033	0.249240609	4.623389055	0	2.367327352	3.486978117	0.119221033	4.275076157	8.460673668	6.365240129	15.02016724	1.333879674	0.103425225	2.892437324	13.30029614	34.72174716	0.332789645	0.637881439	0	0	1.930285888	2.42476165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2481	0	0	19.6033	0.249240609	4.623389055	0	2.367327352	3.486978117	0.119221033	4.275076157	8.460673668	6.365240129	15.02016724	1.333879674	0.103425225	2.892437324	13.30029614	34.72174716	0.332789645	0.637881439	0	0	1.930285888	2.42476165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2481																																																																																				0	0	0	19.6033	0.249240609	4.623389055	0	2.367327352	3.486978117	0.119221033	4.275076157	8.460673668	6.365240129	15.02016724	1.333879674	0.103425225	2.892437324	13.30029614	34.72174716	0.332789645	0.637881439	0	0	1.930285888	2.42476165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2481
H4506_806_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		273.06236	3.471771593	21.66803602		10.11678356	14.90161589	0.509491593	18.26955623	36.15672508	27.20188089	64.18874891	5.700340487	0.441988143	12.36084326	56.83887239	148.3835349	1.422177969	2.725989058			8.249084993	10.36222927																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS											0.0717945	0.0717945	0.213452842		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				19.6044	0.249254107	4.625103867	0	2.367327352	3.486978117	0.119221033	4.275076157	8.460673668	6.365240129	15.02016724	1.333879674	0.103425225	2.892437324	13.30029614	34.72174716	0.332789645	0.637881439	0	0	1.930285888	2.42476165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2509	0	0	19.6044	0.249254107	4.625103867	0	2.367327352	3.486978117	0.119221033	4.275076157	8.460673668	6.365240129	15.02016724	1.333879674	0.103425225	2.892437324	13.30029614	34.72174716	0.332789645	0.637881439	0	0	1.930285888	2.42476165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2509																																																																																				0	0	0	19.6044	0.249254107	4.625103867	0	2.367327352	3.486978117	0.119221033	4.275076157	8.460673668	6.365240129	15.02016724	1.333879674	0.103425225	2.892437324	13.30029614	34.72174716	0.332789645	0.637881439	0	0	1.930285888	2.42476165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2509
H4506_808_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		273.06236	3.471771593	21.66803602		10.11678356	14.90161589	0.509491593	18.26955623	36.15672508	27.20188089	64.18874891	5.700340487	0.441988143	12.36084326	56.83887239	148.3835349	1.422177969	2.725989058			8.249084993	10.36222927																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS											0.071751056	0.071751056	0.210189988		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				19.5925	0.249103278	4.554404233	0	2.367327352	3.486978117	0.119221033	4.275076157	8.460673668	6.365240129	15.02016724	1.333879674	0.103425225	2.892437324	13.30029614	34.72174716	0.332789645	0.637881439	0	0	1.930285888	2.42476165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.1682	0	0	19.5925	0.249103278	4.554404233	0	2.367327352	3.486978117	0.119221033	4.275076157	8.460673668	6.365240129	15.02016724	1.333879674	0.103425225	2.892437324	13.30029614	34.72174716	0.332789645	0.637881439	0	0	1.930285888	2.42476165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.1682																																																																																				0	0	0	19.5925	0.249103278	4.554404233	0	2.367327352	3.486978117	0.119221033	4.275076157	8.460673668	6.365240129	15.02016724	1.333879674	0.103425225	2.892437324	13.30029614	34.72174716	0.332789645	0.637881439	0	0	1.930285888	2.42476165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.1682
H4510_012_0	2008	5	s.	t.	u.								Supplies	Health & Education (Non-Covered)	Health & Education (Non-Covered)								1500	Supplies										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		253.284357	0.86214	719.240129	1650.056396	253.868092	9.990029	0.59895	376.458585	270.587655	2075.811291	1304.947106		13.734789	187.314413	5397.19388	3517.476262	7.416884	520.133768			40.643381			3.48	1.85					0.08		8618.396527	3.4	2.3								$65 admit / LTAC =950 admit	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$30-$50/Visit	$0/Visit	$0-$100/Visit		$0-$50/Proc	$30-$100/Visit	$5/Visit	$10/Visit	$10-$50/Visit	$50/Visit			0% Coins			0% Coins	EyeMed $200 Allowance					Active Outlook Newsletter		$0 copay	Silver Sneakers	See PBP								77.769286	777.695648	23.694359	0	81.862383	0.163724	0.163724	40.931188	34.944496	0	24.530349		34.259359	40.406985	4.09312	8.186242	40.408451	40.931199			0			0	0					0		0	0	0								1.6415	0.055873544	1.420161152	0	1.731853915	1.635607508	0.09806249	1.28407476	0.787962436	0	2.667567328	0	0.039212089	0.630734223	1.840946851	2.399575992	0.024975399	1.774141564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.0322	0	3.995259114	1.6415	0.055873544	1.420161152	0	1.731853915	1.635607508	0.09806249	1.28407476	0.787962436	0	2.667567328	0	0.039212089	0.630734223	1.840946851	2.399575992	0.024975399	1.774141564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.0322																																																																																				0	0	0	1.6415	0.055873544	1.420161152	0	1.731853915	1.635607508	0.09806249	1.28407476	0.787962436	0	2.667567328	0	0.039212089	0.630734223	1.840946851	2.399575992	0.024975399	1.774141564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.0322
H4510_015_0	2008	6	s.	t.									Supplies	Health & Education (Non-Covered)									1500	Supplies										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0	0	0	0									0		285.854477	2.049724	925.849977	1177.454505	276.922166	10.158915	0.540607	333.458915	286.692177	2825.721441	1289.913047		16.945118	949.526863	6460.019367	3220.410817	11.881703	447.380187			37.597226			3.48	2.72					0.08	2.92	8618.396527	3.4									"$65 admit, ltac 950 admit"	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$50/Trip	20% Coins	20% Coins	$50/Visit	$30-$40/Visit	$0/Visit	$0-$100/Visit		$0-$40/Proc	$15-$100/Visit	$5/Visit	$15/Visit	$15-$50/Visit	$40/Visit			20% Coins			0% Coins	EyeMed $100 Allowance					Active Outlook Newsletter	See PBP	$0 copay	Silver Sneakers									71.195007	711.950755	21.691337	0	37.471038	0.149884	0.149883	37.471046	25.921932	0	23.648636		14.177557	13.747274	3.747105	11.241313	37.470977	29.976834			0.149884			0	0					0	0	0	0									1.696	0.121608546	1.673576989	0	0.864713417	1.522658816	0.081027799	1.041254529	0.61930126	0	2.54205701	0	0.020020031	1.08778383	2.017197573	3.016803832	0.037101585	1.1175868	0	0	5.635222622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.0939	0	7.721748246	1.696	0.121608546	1.673576989	0	0.864713417	1.522658816	0.081027799	1.041254529	0.61930126	0	2.54205701	0	0.020020031	1.08778383	2.017197573	3.016803832	0.037101585	1.1175868	0	0	5.635222622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.0939	1500																																																																																			0	0	0	1.696	0.121608546	1.673576989	0	0.864713417	1.522658816	0.081027799	1.041254529	0.61930126	0	2.54205701	0	0.020020031	1.08778383	2.017197573	3.016803832	0.037101585	1.1175868	0	0	5.635222622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.0939
H4510_017_0	2008	2	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	O	O	V	V	V	V		P	V	V	V	V	V			S		T	Coin	V					O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0		0	0	0					0	0	0	0	0	0							0		2273.822381	10.177035	1043.567789	1327.162742	312.131621	3528.116955	8855.966133	375.856771	323.143844	3184.999674	1453.919899		19.099616	1070.255084	7281.38283	3629.872093	13.392409	504.262639			49778.3509		5.72	3.48	2.72					0.08	0.18	0.02	3.4	0.4	1							$0/Day(Days 1-7)	$0/Day(Days 1-1)	$0/Day(Days 1-20) $0(Days 21-100)	$0/Visit	$0/Trip			$0/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			$0/Script		Transportation	Dental	EyeMed $200 Allowance					Active Outlook Newsletter	Meals on Wheels	QuitNet	Silver Sneakers	Nutritional Supplements	OTC $20 allowance							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0		0	0	0					0	0	0	0	0	0							0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H4510_018_0	2008	5	s.	t.									Supplies	Health & Education (Non-Covered)										Supplies										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin				V					O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0				0					0	0	0	0									0		314.718705	2.256695	1019.337914	1296.348271	304.884453	12.314084	0.655295	367.130014	315.640991	3111.049378	1420.16234		18.656155	1045.405575	7112.321456	3545.592612	13.08146	492.554513			45.573313				1.65					0.08	0.02	8618.396527	2.5									"150/admit(1-5), ltac 950/admit"	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$50/Trip	20% Coins	20% Coins	$50/Visit	$100/Visit	$0-$50/Visit	$0-$100/Visit		$0-$50/Proc	$15-$100/Visit	$5/Visit	$20/Visit	$20-$50/Visit	$50/Visit			20% Coins				$100 Allowance					Active Outlook Newsletter	QuitNet	$0 copay	Forever Fit									520.000017	949.999892	28.94	0	50.000004	0.2	0.2	49.999987	100.000015	6.454208	47.556478		23.647959	19.467043	4.999999	19.999999	49.999923	49.999988			0.2				0					0	0	0	0									13.6378	0.178655001	2.458303269	0	1.270351989	2.4628168	0.131059	1.529707994	2.630341986	1.673279982	5.628159923	0	0.036764999	1.69591294	2.963466681	5.909320725	0.054505999	2.052309978	0	0	9.1146626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4274	0	0	13.6378	0.178655001	2.458303269	0	1.270351989	2.4628168	0.131059	1.529707994	2.630341986	1.673279982	5.628159923	0	0.036764999	1.69591294	2.963466681	5.909320725	0.054505999	2.052309978	0	0	9.1146626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4274																																																																																				0	0	0	13.6378	0.178655001	2.458303269	0	1.270351989	2.4628168	0.131059	1.529707994	2.630341986	1.673279982	5.628159923	0	0.036764999	1.69591294	2.963466681	5.909320725	0.054505999	2.052309978	0	0	9.1146626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4274
H4510_019_0	2008	3	s.	t.	u.	v.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																		A	A	D	V	T	Coin	O	V	V	V	V		P	V	V	V	V	V			S		T	Coin	V					O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0		0	0	0					0	0	0	0	0	0							0		328.535837	2.355771	1064.090026	1353.262001	318.269831	13.419082	9030.122739	383.248167	329.498617	3247.634144	1482.511893		19.475219	1091.302141	7424.57454	3701.255181	13.655777	514.179193			50757.26483		6.3	5.44	2.72					0.08	0.02	2.5	0.18	0.4	1							$0/Admit	$0/Admit	$0/Day(Days 1-20) $0(Days 21-100)	$0/Visit	$0/Trip	0% Coins		$0/Visit	$0/Visit	$0/Visit	$0/Visit		$0/Proc	$0/Visit	$0/Visit	$0/Visit	$0/Visit	$0/Visit			$0/Script		Transportation	0% - 50%	EyeMed $200 allowance					Active Outlook Newsletter	QuitNet	See PBP	Meals on Wheels	Nutritional Supplements	OTC $20 allowance							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0		0	0.102941176	0					0	0	0	0	0	0							0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.56	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.56	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.56	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.56																																																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.56	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.56
H4510_801_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		285.854477	2.049724	925.849977	1177.454505	276.922166	10.158915	3.221119	333.458915	286.692177	2825.721441	1289.913047		16.945118	949.526863	6460.019367	3220.410817	11.881703	447.380187			37.597226																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214492	177.214103	28.944127	0	100.000012	0.2	0.199999	49.999994	200.000002	36.936265	90.379245		47.295746	99.592923	20	29.999996	99.999806	99.999993			0.199999																					4.2215	0.03027	2.233159943	0	2.307684994	2.031783	0.644220579	1.389411979	4.778202998	8.697632997	9.715113942	0	0.066786	7.880512979	10.76669895	8.051025969	0.099014	3.728167964	0	0	7.519407603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1606	0	0	4.2215	0.03027	2.233159943	0	2.307684994	2.031783	0.644220579	1.389411979	4.778202998	8.697632997	9.715113942	0	0.066786	7.880512979	10.76669895	8.051025969	0.099014	3.728167964	0	0	7.519407603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1606																																																																																				0	0	0	4.2215	0.03027	2.233159943	0	2.307684994	2.031783	0.644220579	1.389411979	4.778202998	8.697632997	9.715113942	0	0.066786	7.880512979	10.76669895	8.051025969	0.099014	3.728167964	0	0	7.519407603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1606
H4510_802_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		285.854477	2.049724	925.849977	1177.454505	276.922166	10.158915	3.221119	333.458915	286.692177	2825.721441	1289.913047		16.945118	949.526863	6460.019367	3220.410817	11.881703	447.380187			37.597226																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214492	177.214103	28.944127	0	100.000012	0.2	0.199999	49.999994	200.000002	36.936265	90.379245		47.295746	99.592923	20	29.999996	99.999806	99.999993			0.199999																					4.2215	0.03027	2.233159943	0	2.307684994	2.031783	0.644220579	1.389411979	4.778202998	8.697632997	9.715113942	0	0.066786	7.880512979	10.76669895	8.051025969	0.099014	3.728167964	0	0	7.519407603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1606	0	0	4.2215	0.03027	2.233159943	0	2.307684994	2.031783	0.644220579	1.389411979	4.778202998	8.697632997	9.715113942	0	0.066786	7.880512979	10.76669895	8.051025969	0.099014	3.728167964	0	0	7.519407603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1606																																																																																				0	0	0	4.2215	0.03027	2.233159943	0	2.307684994	2.031783	0.644220579	1.389411979	4.778202998	8.697632997	9.715113942	0	0.066786	7.880512979	10.76669895	8.051025969	0.099014	3.728167964	0	0	7.519407603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1606
H4510_803_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		285.854477	2.049724	925.849977	1177.454505	276.922166	10.158915	3.221119	333.458915	286.692177	2825.721441	1289.913047		16.945118	949.526863	6460.019367	3220.410817	11.881703	447.380187			37.597226																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214492	177.214103	28.944127	0	100.000012	0.2	0.199999	49.999994	200.000002	36.936265	90.379245		47.295746	99.592923	20	29.999996	99.999806	99.999993			0.199999																					4.2215	0.03027	2.233159943	0	2.307684994	2.031783	0.644220579	1.389411979	4.778202998	8.697632997	9.715113942	0	0.066786	7.880512979	10.76669895	8.051025969	0.099014	3.728167964	0	0	7.519407603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1606	0	0	4.2215	0.03027	2.233159943	0	2.307684994	2.031783	0.644220579	1.389411979	4.778202998	8.697632997	9.715113942	0	0.066786	7.880512979	10.76669895	8.051025969	0.099014	3.728167964	0	0	7.519407603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1606																																																																																				0	0	0	4.2215	0.03027	2.233159943	0	2.307684994	2.031783	0.644220579	1.389411979	4.778202998	8.697632997	9.715113942	0	0.066786	7.880512979	10.76669895	8.051025969	0.099014	3.728167964	0	0	7.519407603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1606
H4510_804_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		285.854477	2.049724	925.849977	1177.454505	276.922166	10.158915	3.221119	333.458915	286.692177	2825.721441	1289.913047		16.945118	949.526863	6460.019367	3220.410817	11.881703	447.380187			37.597226																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214492	177.214103	28.944127	0	100.000012	0.2	0.199999	49.999994	200.000002	36.936265	90.379245		47.295746	99.592923	20	29.999996	99.999806	99.999993			0.199999																					4.2215	0.03027	2.233159943	0	2.307684994	2.031783	0.644220579	1.389411979	4.778202998	8.697632997	9.715113942	0	0.066786	7.880512979	10.76669895	8.051025969	0.099014	3.728167964	0	0	7.519407603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1606	0	0	4.2215	0.03027	2.233159943	0	2.307684994	2.031783	0.644220579	1.389411979	4.778202998	8.697632997	9.715113942	0	0.066786	7.880512979	10.76669895	8.051025969	0.099014	3.728167964	0	0	7.519407603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1606																																																																																				0	0	0	4.2215	0.03027	2.233159943	0	2.307684994	2.031783	0.644220579	1.389411979	4.778202998	8.697632997	9.715113942	0	0.066786	7.880512979	10.76669895	8.051025969	0.099014	3.728167964	0	0	7.519407603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1606
H4513_001_0	2008	5																					3000											A	D	D	V	T	Coin	Coin	P	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	V	V	V	O	O	O																																																				0	0	238.9682097	68.81853375	684.8131623	1189.794527	249.8215282	9.059491999	0.406984452	260.7919688	259.9367912	139.2540656	0	0	36.65400721	126.2829876	4592.092529	7420.967077	51.70442373	220.6030507	1997.531671	232.5951894	2.715746815	0	841.21556	0	64.5414917	0	0	0	0	0	0											$300 per admit	"$100 per day, Days 1-10"	Days 1-10 $0 per day; Days 11-100 $25 per day	No Cost Sharing	"$50 per trip, unless being admitted for same condition w/in 3 days"	10% Coinsurance	10% Coinsurance	$50 per visit	$150 per visit	$25 copay	$25 copay	No Cost Sharing	$25 copay	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$25 copay	$25 copay	15% Coinsurance	No Cost Sharing	No Cost Sharing	0	$25 copay	1 pair of eyeglasses after cataract surgery	0	0	0	0	0											300	100	25	0	50	0.1	0.1	50	150	25	25	0	25	25	10	25	25	25	25	25	0.092	0	0	0	25	0	0	0	0	0	0											5.9742	0.573487781	1.426694088	0	1.040923034	0.9059492	0.040698445	1.086633203	3.24920989	0.290112637	0	0	0.076362515	0.263089558	3.826743774	15.46034808	0.107717549	0.459589689	4.161524314	0.484573311	0.249848707	0	0	0	0.134461441	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.8122		0.662440924	5.9742	0.573487781	1.426694088	0	1.040923034	0.9059492	0.040698445	1.086633203	3.24920989	0.290112637	0	0	0.076362515	0.263089558	3.826743774	15.46034808	0.107717549	0.459589689	4.161524314	0.484573311	0.249848707	0	0	0	0.134461441	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.8122	3000																																																																																			0		0	5.9742	0.573487781	1.426694088	0	1.040923034	0.9059492	0.040698445	1.086633203	3.24920989	0.290112637	0	0	0.076362515	0.263089558	3.826743774	15.46034808	0.107717549	0.459589689	4.161524314	0.484573311	0.249848707	0	0	0	0.134461441	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.8122
H4513_006_0	2008	6																					3000											D	D	D	V	Coin	Coin	Coin	P	Coin	Coin	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	Coin																																																													0	0	1771.066548	68.81853375	607.4186152	1290.013407	7.85	14.16371575	0.636284252	261.5401801	23.55	4.723765072	0	0	2.409279688	9.716955239	4352.69434	7034.092016	49.00893244	209.1024177	1893.394949	220.4693738	1.6	0	841.21556	0	64.5414917	0	0	0	0	0	0											"$100 per day, days 1-10"	"$150 per day, days 1-10"	$58.67 average member cost share	No Cost Sharing	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 per Visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	$100 per Visit	20% Coinsurance	20% Coinsurance	$10 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	20% Coinsurance	20% Coinsurance			$30 copay																	100	150	58.6745271	0	0.2	0.2	0.2	50	0.2	0.2	0.2	100	0.2	0.2	10	30	30	30	30	30	0.2	0.2	0	0	30	0	0	0	0	0	0											14.7589	0.860231672	2.97	0	1.57	2.83274315	0.12725685	1.08975075	4.71	0.944753014	0	0	0.481855938	1.943391048	3.627245284	17.58523004	0.122522331	0.522756044	4.733487372	0.551173435	0.32	0	0	0	0.161353729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9126		0	14.7589	0.860231672	2.97	0	1.57	2.83274315	0.12725685	1.08975075	4.71	0.944753014	0	0	0.481855938	1.943391048	3.627245284	17.58523004	0.122522331	0.522756044	4.733487372	0.551173435	0.32	0	0	0	0.161353729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9126	3000																																																																																			0			14.7589	0.860231672	2.97	0	1.57	2.83274315	0.12725685	1.08975075	4.71	0.944753014	0	0	0.481855938	1.943391048	3.627245284	17.58523004	0.122522331	0.522756044	4.733487372	0.551173435	0.32	0	0	0	0.161353729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9126
H4513_009_0	2008	3																					3000											A	D	D	V	T	Coin	Coin	P	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	V	V	V	O	O	O																																																				0	0	188.996094	54.42746585	511.3285182	986.0238116	234.214564	9.51147411	0.427289088	234.9647698	262.8525127	139.314868	0	0	33.88621916	116.7472078	4047.254511	6226.962596	43.38538485	185.1088855	1676.136664	195.1715362	2.770333326	0	0	0	0	0	0	0	0	0	0											$500 per admit	"$150 per day, Days 1-10"	Days 1-10 $0 per day; Days 11-100 $25 per day	No Cost Sharing	"$50 per trip, unless being admitted for same condition w/in 3 days"	10% Coinsurance	10% Coinsurance	$50 per visit	$150 per visit	$30 copay	$30 copay	No Cost Sharing	$30 copay	$30 copay	$10 copay	$30 copay	$30 copay	$30 copay	$30 copay	$30 copay	15% Coinsurance	No Cost Sharing	No Cost Sharing	0	0	0	0	0	0	0	0											500	150	25	0	50	0.1	0.1	50	150	30	30	0	30	30	10	30	30	30	30	30	0.15	0	0	0	0	0	0	0	0	0	0											7.8748	0.680343323	1.065267746	0	0.975894017	0.951147411	0.042728909	0.979019874	3.285656409	0.34828717	0	0	0.084715548	0.291868019	3.372712093	15.56740649	0.108463462	0.462772214	4.19034166	0.48792884	0.415549999	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1849		0.420023015	7.8748	0.680343323	1.065267746	0	0.975894017	0.951147411	0.042728909	0.979019874	3.285656409	0.34828717	0	0	0.084715548	0.291868019	3.372712093	15.56740649	0.108463462	0.462772214	4.19034166	0.48792884	0.415549999	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1849	3000																																																																																			0			7.8748	0.680343323	1.065267746	0	0.975894017	0.951147411	0.042728909	0.979019874	3.285656409	0.34828717	0	0	0.084715548	0.291868019	3.372712093	15.56740649	0.108463462	0.462772214	4.19034166	0.48792884	0.415549999	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1849
H4513_010_0	2008	5																																	D																																									0.6405																																								0.6405			68.81853375																																									Standard Medicare benefits																																									6.974865256																																								0	0.04	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.04			0	0.68046192	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.6805																																																																																				0			0	0.68046192	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.6805
H4513_014_0	2008	5																					3000											A	D	D	V	T	Coin	Coin	P	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	V	V	V	O	O	O																																																				0	0	238.9682097	68.81853375	684.8131623	1189.794527	249.8215282	9.059491999	0.406984452	260.7919688	259.9367912	139.2540656	0	0	36.65400721	126.2829876	4592.092529	7420.967077	51.70442373	220.6030507	1997.531671	232.5951894	2.715746815	0	841.21556	0	64.5414917	0	0	0	0	0	0											$500 per admit	"$100 per day, Days 1-10"	Days 1-10 $0 per day; Days 11-100 $25 per day	No Cost Sharing	"$50 per trip, unless being admitted for same condition w/in 3 days"	10% Coinsurance	10% Coinsurance	$50 per visit	$150 per visit	$25 copay	$25 copay	No Cost Sharing	$25 copay	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$25 copay	$25 copay	15% Coinsurance	No Cost Sharing	No Cost Sharing	0	$25 copay	1 pair of eyeglasses after cataract surgery	0	0	0	0	0											500	100	25	0	50	0.1	0.1	50	150	25	25	0	25	25	10	25	25	25	25	25	0.092	0	0	0	25	0	0	0	0	0	0											9.957	0.573487781	1.426694088	0	1.040923034	0.9059492	0.040698445	1.086633203	3.24920989	0.290112637	0	0	0.076362515	0.263089558	3.826743774	15.46034808	0.107717549	0.459589689	4.161524314	0.484573311	0.249848707	0	0	0	0.134461441	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.795		0.662440924	9.957	0.573487781	1.426694088	0	1.040923034	0.9059492	0.040698445	1.086633203	3.24920989	0.290112637	0	0	0.076362515	0.263089558	3.826743774	15.46034808	0.107717549	0.459589689	4.161524314	0.484573311	0.249848707	0	0	0	0.134461441	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.795	3000																																																																																			0			9.957	0.573487781	1.426694088	0	1.040923034	0.9059492	0.040698445	1.086633203	3.24920989	0.290112637	0	0	0.076362515	0.263089558	3.826743774	15.46034808	0.107717549	0.459589689	4.161524314	0.484573311	0.249848707	0	0	0	0.134461441	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.795
H4513_015_0	2008	3																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H4513_019_0	2008	6																					3000											A	D	D	V	T	Coin	Coin	P	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	V	V	V	O	O	O																																																				0	0	238.9682097	68.81853375	684.8131623	1189.794527	249.8215282	9.059491999	0.406984452	260.7919688	259.9367912	139.2540656	0	0	36.65400721	126.2829876	4592.092529	7420.967077	51.70442373	220.6030507	1997.531671	232.5951894	2.715746815	0	841.21556	0	64.5414917	0	0	0	0	0	0											$300 per admit	"$100 per day, Days 1-10"	Days 1-10 $0 per day; Days 11-100 $25 per day	No Cost Sharing	"$50 per trip, unless being admitted for same condition w/in 3 days"	10% Coinsurance	10% Coinsurance	$50 per visit	$150 per visit	$25 copay	$25 copay	No Cost Sharing	$25 copay	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$25 copay	$25 copay	15% Coinsurance	No Cost Sharing	No Cost Sharing	0	$25 copay	1 pair of eyeglasses after cataract surgery	0	0	0	0	0											300	100	25	0	50	0.1	0.1	50	150	25	25	0	25	25	10	25	25	25	25	25	0.092	0	0	0	25	0	0	0	0	0	0											5.9742	0.573487781	1.426694088	0	1.040923034	0.9059492	0.040698445	1.086633203	3.24920989	0.290112637	0	0	0.076362515	0.263089558	3.826743774	15.46034808	0.107717549	0.459589689	4.161524314	0.484573311	0.249848707	0	0	0	0.134461441	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.8122		0.662440924	5.9742	0.573487781	1.426694088	0	1.040923034	0.9059492	0.040698445	1.086633203	3.24920989	0.290112637	0	0	0.076362515	0.263089558	3.826743774	15.46034808	0.107717549	0.459589689	4.161524314	0.484573311	0.249848707	0	0	0	0.134461441	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.8122	3000																																																																																			0			5.9742	0.573487781	1.426694088	0	1.040923034	0.9059492	0.040698445	1.086633203	3.24920989	0.290112637	0	0	0.076362515	0.263089558	3.826743774	15.46034808	0.107717549	0.459589689	4.161524314	0.484573311	0.249848707	0	0	0	0.134461441	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.8122
H4513_802_0	2008	4																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				16.7536	0.6676	0	0	0.2682	0.4072	0.1315	0.9056	0.7246	0.1448	0	0	0.0738	0.2978	9.4927	0.5066	0	0.0169	0.0991	0.041	0.0693	0	0	0	0	0	0	0	0	0	0											30.6		1726.926938	68.81853375	684.8131623	1189.794527	7.886982028	11.97537208	3.866874417	26.63521268	21.31041328	4.257785655	0	0	2.171614451	8.758418761	266.5763318	14.22534235	0	0.473404873	2.781809389	1.151291857	2.037653768	0	0	0	0	0	0	0	0	0	0											Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	0	0	0	0	0	0	0	0	0											8.130048637	3.487432628	74.99855848	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0	0	0	0	0	0	0	0											1.17	0.02	4.28	0	1.577396406	2.395074417	0.773374883	5.327042536	4.262082656	0.851557131	0	0	0.43432289	1.751683752	53.31526636	2.84506847	0	0.094680975	0.556361878	0.230258371	0.407530754	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.2917			17.9236	0.687637122	4.28	0	1.845553795	2.802237068	0.904848613	6.232639767	4.986636707	0.996321843	0	0	0.508157782	2.04946999	62.80795125	3.351627666	0	0.111538748	0.655421084	0.27125545	0.476810982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.8917																																																																																				0			17.9236	0.687637122	4.28	0	1.845553795	2.802237068	0.904848613	6.232639767	4.986636707	0.996321843	0	0	0.508157782	2.04946999	62.80795125	3.351627666	0	0.111538748	0.655421084	0.27125545	0.476810982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.8917
H4513_804_0	2008	4																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				16.7536	0.6676	0	0	0.2682	0.4072	0.1315	0.9056	0.7246	0.1448	0	0	0.0738	0.2978	9.4927	0.5066	0	0.0169	0.0991	0.041	0.0693	0	0	0	0	0	0	0	0	0	0											30.6		1726.926938	68.81853375	684.8131623	1189.794527	7.886982028	11.97537208	3.866874417	26.63521268	21.31041328	4.257785655	0	0	2.171614451	8.758418761	266.5763318	14.22534235	0	0.473404873	2.781809389	1.151291857	2.037653768	0																				Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	0	0	0	0	0	0	0	0	0											8.130048637	3.487432628	74.99855848	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0	0	0	0	0	0	0	0											1.17	0.02	4.28	0	1.577396406	2.395074417	0.773374883	5.327042536	4.262082656	0.851557131	0	0	0.43432289	1.751683752	53.31526636	2.84506847	0	0.094680975	0.556361878	0.230258371	0.407530754	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.2917			17.9236	0.687637122	4.28	0	1.845553795	2.802237068	0.904848613	6.232639767	4.986636707	0.996321843	0	0	0.508157782	2.04946999	62.80795125	3.351627666	0	0.111538748	0.655421084	0.27125545	0.476810982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.8917																																																																																				0			17.9236	0.687637122	4.28	0	1.845553795	2.802237068	0.904848613	6.232639767	4.986636707	0.996321843	0	0	0.508157782	2.04946999	62.80795125	3.351627666	0	0.111538748	0.655421084	0.27125545	0.476810982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.8917
H4513_805_0	2008	2																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				16.7536	0.6676	0	0	0.2682	0.4072	0.1315	0.9056	0.7246	0.1448	0	0	0.0738	0.2978	9.4927	0.5066	0	0.0169	0.0991	0.041	0.0693	0	0	0	0	0	0	0	0	0	0											30.6		1726.926938	68.81853375	684.8131623	1189.794527	7.886982028	11.97537208	3.866874417	26.63521268	21.31041328	4.257785655	0	0	2.171614451	8.758418761	266.5763318	14.22534235	0	0.473404873	2.781809389	1.151291857	2.037653768	0	0	0	0	0	0	0	0	0	0											Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	0	0	0	0	0	0	0	0	0											8.130048637	3.487432628	74.99855848	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0	0	0	0	0	0	0	0											1.17	0.02	4.28	0	1.577396406	2.395074417	0.773374883	5.327042536	4.262082656	0.851557131	0	0	0.43432289	1.751683752	53.31526636	2.84506847	0	0.094680975	0.556361878	0.230258371	0.407530754	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.2917			17.9236	0.687637122	4.28	0	1.845553795	2.802237068	0.904848613	6.232639767	4.986636707	0.996321843	0	0	0.508157782	2.04946999	62.80795125	3.351627666	0	0.111538748	0.655421084	0.27125545	0.476810982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.8917																																																																																				0			17.9236	0.687637122	4.28	0	1.845553795	2.802237068	0.904848613	6.232639767	4.986636707	0.996321843	0	0	0.508157782	2.04946999	62.80795125	3.351627666	0	0.111538748	0.655421084	0.27125545	0.476810982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.8917
H4513_806_0	2008	2																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				16.7536	0.6676	0	0	0.2682	0.4072	0.1315	0.9056	0.7246	0.1448	0	0	0.0738	0.2978	9.4927	0.5066	0	0.0169	0.0991	0.041	0.0693	0	0	0	0	0	0	0	0	0	0											30.6		1726.926938	68.81853375	684.8131623	1189.794527	7.886982028	11.97537208	3.866874417	26.63521268	21.31041328	4.257785655	0	0	2.171614451	8.758418761	266.5763318	14.22534235	0	0.473404873	2.781809389	1.151291857	2.037653768	0	0	0	0	0	0	0	0	0	0											Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	0	0	0	0	0	0	0	0	0											8.130048637	3.487432628	74.99855848	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0	0	0	0	0	0	0	0											1.17	0.02	4.28	0	1.577396406	2.395074417	0.773374883	5.327042536	4.262082656	0.851557131	0	0	0.43432289	1.751683752	53.31526636	2.84506847	0	0.094680975	0.556361878	0.230258371	0.407530754	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.2917			17.9236	0.687637122	4.28	0	1.845553795	2.802237068	0.904848613	6.232639767	4.986636707	0.996321843	0	0	0.508157782	2.04946999	62.80795125	3.351627666	0	0.111538748	0.655421084	0.27125545	0.476810982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.8917																																																																																				0			17.9236	0.687637122	4.28	0	1.845553795	2.802237068	0.904848613	6.232639767	4.986636707	0.996321843	0	0	0.508157782	2.04946999	62.80795125	3.351627666	0	0.111538748	0.655421084	0.27125545	0.476810982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.8917
H4514_001_0	2008	5																					2500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	S	P	T	V	V	P	V	P																																																							0		2534.078227	410.7547033			1377.823132	19.68819213	5.270599303	1776.464432	185.6680847	5477.025634	457.282328	11.91114045	1.274244393	685.5229303	1091.65478	376.7136704	1006.734932	259.8582808				283.4568618																				1(a) $125 per Day	1(b) $125 per Day	2(a) $0 per day	6(a) $0 per visit	10(a) $50 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/20% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $30 per visit	9(b) $30 per Visit	8(a) Diagnostic: $30 per procedure; other $0 per procedure	8(b) X-rays $30 per visit; other: $30 per visit	9(a) $30 per Visit	12  20% Coinsurance	"3, 5, 9(a) $30 Copay Per Visit; 9c $35/$25/visit;9(d) $100 Copay per Visit"	7(a) PCP $10 per visit; Urgently Needed Servicese $30 per Visit	7(b)/7(d)/7(f) $30 per Visit	7(e)/7(h) $35/$25 per Visit	7(c)/7(i) $30 per Visit		7(g) $30 per Visit	15 $0 per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $30 per procedure"	10(b) $0 Copay	16(a)/16(b) $0 copay per visit	17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a/18a1 $10/$0 per visit	18(b) $0 copay per procedure														87.6609	87.6609			35.0644	0.140257439	0.140257439	30.1553	21.0386	21.0386	21.0386	21.0386	0.140257439	21.1168	7.0129	21.0386	22.7918	21.0386				21.0386																				18.5116	3.000593891	0	0	4.026040496	2.761415406	0.73924076	4.464158799	0.325516626	9.602419855	0.801715603	0.020882826	0.178722255	1.206337278	0.637969599	0.660461183	1.912111273	0.455588212	0	0	0	0.496961669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8018	0	21.21302894	18.5116	3.000593891	0	0	4.026040496	2.761415406	0.73924076	4.464158799	0.325516626	9.602419855	0.801715603	0.020882826	0.178722255	1.206337278	0.637969599	0.660461183	1.912111273	0.455588212	0	0	0	0.496961669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8018																																																																																				0	0	0	18.5116	3.000593891	0	0	4.026040496	2.761415406	0.73924076	4.464158799	0.325516626	9.602419855	0.801715603	0.020882826	0.178722255	1.206337278	0.637969599	0.660461183	1.912111273	0.455588212	0	0	0	0.496961669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8018
H4514_004_0	2008	6																					1500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2217.65335	152.0885857	1059.82046		328.1540779	14.56544143	25.29573248	513.9892151	485.8189629	4073.026816	535.2681767	81.57262454	18.18859169	3422.608944		4634.166648	456.8714086	666.7822134				824.7424308					0.087325263															(1a)$150/day	(1b)$150/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$10/visit"	(9b)$25/visit	"(8a)$15/procedure Diag. services, $0/procedure Other services"	(8b)$15/visit	(9a)$25/visit	(12)20%	"(3,5,9a,9d)$25/visit, (9c)$15/visit"	"(7a) $0/visit PCP, $10/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b)$15 visit, (7d,f)$10/visit"	"(7e,h)$15/visit"	"(7c,i)$15/visit"		(7g)$15/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$15/visit"	(10b)0		(17a)0	(17b)0	(18a)$15/visit															100.8466	100.8466	28.2371		50.4233	0.134462157	0.134462157	24.2032	16.8078	10.0847	10.0847	16.8078	117.2492	16.7973		7.0003	10.0847	10.0847				10.0847					10.0847															18.6369	1.278134958	2.493850545	0	1.378884538	1.958500676	3.401318759	1.03668148	0.680461102	3.422924826	0.449833211	0.11425449	0.177716514	4.790871775	0	2.703389331	0.38394947	0.560356093	0	0	0	0.69310404	0	0	0	0	7.34E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.1612	0	21.5244973	18.6369	1.278134958	2.493850545	0	1.378884538	1.958500676	3.401318759	1.03668148	0.680461102	3.422924826	0.449833211	0.11425449	0.177716514	4.790871775	0	2.703389331	0.38394947	0.560356093	0	0	0	0.69310404	0	0	0	0	7.34E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.1612																																																																																				0	0	0	18.6369	1.278134958	2.493850545	0	1.378884538	1.958500676	3.401318759	1.03668148	0.680461102	3.422924826	0.449833211	0.11425449	0.177716514	4.790871775	0	2.703389331	0.38394947	0.560356093	0	0	0	0.69310404	0	0	0	0	7.34E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.1612
H4514_005_0	2008	5	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						1000	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	P	P	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T				V					V	P	V	V																																																0		1898.172603	89.47151656	9708.818037	234.7649791	534.5305119	1945.688129	26.63115232	197.8159925	134.7956362	5047.666378	204.4576588	31.09507398	7.622821534	253.0188847	139.9069163	1506.736383	2258.039186	27.29717216		303.3335893	278.4888257	757.2512742	1657.83									113.5121147	1.43399613		247.1							(1a) $125/day	(1b) $125/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) $0/proc	(11a/11c) $0/proc	(4a) $50/visit (waived if admitted)	(9a/9b) $25/visit	(8a) $0/visit	(8b) $0/visit	(9a) $25/visit	(12) $0/proc	(9a) $25/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $10/visit	(7e/7h) $0/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $10/visit	(15) $0/proc	(Misc. PBP Cats) $10/visit	(10b) $0/trip				(18a) $10/visit					(4b) $10/visit (waived if admitted)	(9c) $0/proc 75%/25% Ind/Grp Blended Copay	(9d) $25/visit	(7f1) $0/visit							108.4606	108.4606			65.0764			43.3843	21.6921			21.6921		21.6921		8.6769				8.6769		8.6769										8.6769										17.1564	0.808678175	0	0	2.898776117	0	0	0.715174983	0.24366702	0	0	0.056209861	0	0.45737651	0	1.0894773	0	0	0	0.219331705	0	0.547546394	0	0	0	0	0	0	0	0	0	0.082077312	0	0	0	0	0	0	0	0	0	24.2747		3.701697774	17.1564	0.808678175	0	0	2.898776117	0	0	0.715174983	0.24366702	0	0	0.056209861	0	0.45737651	0	1.0894773	0	0	0	0.219331705	0	0.547546394	0	0	0	0	0	0	0	0	0	0.082077312	0	0	0	0	0	0	0	0	0	24.2747																																																																																				0		0	17.1564	0.808678175	0	0	2.898776117	0	0	0.715174983	0.24366702	0	0	0.056209861	0	0.45737651	0	1.0894773	0	0	0	0.219331705	0	0.547546394	0	0	0	0	0	0	0	0	0	0.082077312	0	0	0	0	0	0	0	0	0	24.2747
H4514_007_0	2008	5																					2500											D	D	D	V	T	Coin	Coin	V	V	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2789.295273	153.0844562	997.1856569		291.357438	20.02413646	4.991745989	2683.475305	279.8938905	12077.4103	66.59324617		1.253501306	59.2342054	7137.982074	4812.284958	550.5349571	3.202544878			22.24299823	834.6978024			93.86076196		17.633825															$185 (1a); $0 (1a1)	$185 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	$100 (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	$100 (incl in h5)	30% (12)	"30% (3, 9d); $60 (5); $40/$30 (9c); $100 (9a)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	$0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											93.6761	93.6761	50.6358		88.6126	0.151907257	0.253229387	25.3179	50.6358	3.0381	0.080388363		0.151907257	0.096037548	10	19.9773	37.5	0.151907257			0.151907257	20			20		20															21.7742	1.195030101	4.207770492	0	2.151494196	3.04181164	1.264056776	5.661657949	1.181053142	3.057743781	5.353322055	0	0.190415945	5.68870787	5.948318395	8.011353202	1.720421741	0.486489807	0	0	3.378872845	1.391163004	0	0	0.156434603	0	0.029389708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8897	0	56.15377234	21.7742	1.195030101	4.207770492	0	2.151494196	3.04181164	1.264056776	5.661657949	1.181053142	3.057743781	5.353322055	0	0.190415945	5.68870787	5.948318395	8.011353202	1.720421741	0.486489807	0	0	3.378872845	1.391163004	0	0	0.156434603	0	0.029389708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8897																																																																																				0			21.7742	1.195030101	4.207770492	0	2.151494196	3.04181164	1.264056776	5.661657949	1.181053142	3.057743781	5.353322055	0	0.190415945	5.68870787	5.948318395	8.011353202	1.720421741	0.486489807	0	0	3.378872845	1.391163004	0	0	0.156434603	0	0.029389708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8897
H4514_010_0	2008	5																					3900											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2582.830954	143.0145092	938.7629979		267.6062379	18.05967963	4.502154133	2439.217551	39.87878922	11290.69112	60.05971087		1.130598334	53.42451101	6601.64775	4503.710153	515.2138511	2.88841976			20.05967003	785.5307898			92.69605582		16.84598971															$240 (1a); $0 (1a1)	$240 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	$0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											143.4422	143.4422	89.6514		104.5933	0.179302783	0.261879652	29.8838	0.119535189	3.5861	0.065723773		0.179302783	0.119586499	10	19.9757	37.5	0.119535189			0.179302783	20			20		20															30.8739	1.709526632	7.013450747	0	2.332484737	3.238150815	1.179022556	6.07442354	4.766918588	3.374087229	3.947350823	0	0.202719427	6.388850248	5.501373125	7.49706186	1.610043285	0.345267801	0	0	3.596754659	1.309217983	0	0	0.154493426	0	0.02807665	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.1432	0	49.88808053	30.8739	1.709526632	7.013450747	0	2.332484737	3.238150815	1.179022556	6.07442354	4.766918588	3.374087229	3.947350823	0	0.202719427	6.388850248	5.501373125	7.49706186	1.610043285	0.345267801	0	0	3.596754659	1.309217983	0	0	0.154493426	0	0.02807665	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.1432																																																																																				0			30.8739	1.709526632	7.013450747	0	2.332484737	3.238150815	1.179022556	6.07442354	4.766918588	3.374087229	3.947350823	0	0.202719427	6.388850248	5.501373125	7.49706186	1.610043285	0.345267801	0	0	3.596754659	1.309217983	0	0	0.154493426	0	0.02807665	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.1432
H4514_801_0	2008	3																					4825											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2928.760995	160.7387497	1047.045503		305.9253787	21.02536086	5.241336658	2817.637953	46.42812794	12681.2865	69.92297067		1.316176875	62.19595554	7491.154641	5052.360713	578.0619719	3.36267444			23.35517769	876.4331601			94.45499978		18.03578178															$450 (1a); $0 (1a1)	$450 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$35/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $35 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											232.3671	232.3671	77.4557		90.365	0.15491143	0.254178179	25.8186	0.15491143	3.0982	0.081978152		0.15491143	0.154929159	35	39.8644	37.5	0.15491143			0.15491143	40			40		40															56.7123	3.112533698	6.758304842	0	2.303745593	3.257068719	1.33223341	6.062282287	7.192247694	3.274127046	5.732155927	0	0.203890842	9.63596711	21.84920104	16.78410144	1.806443662	0.520916706	0	0	3.617983975	2.921443867	0	0	0.314849999	0	0.060119273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	153.4519	0	101.7433999	56.7123	3.112533698	6.758304842	0	2.303745593	3.257068719	1.33223341	6.062282287	7.192247694	3.274127046	5.732155927	0	0.203890842	9.63596711	21.84920104	16.78410144	1.806443662	0.520916706	0	0	3.617983975	2.921443867	0	0	0.314849999	0	0.060119273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	153.4519																																																																																				0			56.7123	3.112533698	6.758304842	0	2.303745593	3.257068719	1.33223341	6.062282287	7.192247694	3.274127046	5.732155927	0	0.203890842	9.63596711	21.84920104	16.78410144	1.806443662	0.520916706	0	0	3.617983975	2.921443867	0	0	0.314849999	0	0.060119273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	153.4519
H4514_803_0	2008	4																					4825											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2928.761512	160.7387878	1047.045807		305.9254158	21.02537035	5.241338475	2817.638097	46.42815127	12681.28957	69.92300421		1.316177146	62.19597705	7491.155846	5052.361964	578.0621159	3.36267569			23.35519362	876.4334123			94.45499978		18.03578178															$450 (1a); $0 (1a1)	$450 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$35/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $35 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											232.3671	232.3671	77.4557		90.365	0.154911412	0.254178182	25.8186	0.154911412	3.0982	0.081978142		0.154911412	0.154929141	35	39.8644	37.5	0.154911412			0.154911412	40			40		40															56.7123	3.112534064	6.758305994	0	2.303745597	3.257069799	1.332233885	6.062281873	7.192250449	3.274127446	5.73215797	0	0.20389086	9.635969287	21.84920455	16.78410581	1.806444112	0.520916838	0	0	3.61798601	2.921444708	0	0	0.314849999	0	0.060119273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	153.452	0	101.7434391	56.7123	3.112534064	6.758305994	0	2.303745597	3.257069799	1.332233885	6.062281873	7.192250449	3.274127446	5.73215797	0	0.20389086	9.635969287	21.84920455	16.78410581	1.806444112	0.520916838	0	0	3.61798601	2.921444708	0	0	0.314849999	0	0.060119273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	153.452																																																																																				0			56.7123	3.112534064	6.758305994	0	2.303745597	3.257069799	1.332233885	6.062281873	7.192250449	3.274127446	5.73215797	0	0.20389086	9.635969287	21.84920455	16.78410581	1.806444112	0.520916838	0	0	3.61798601	2.921444708	0	0	0.314849999	0	0.060119273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	153.452
H4514_804_0	2008	5																					7635											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2711.972502	150.1652346	985.7011478		280.9865498	18.96266362	4.727261839	2561.167043	41.87272868	11855.22568	63.06269642		1.187128251	56.09573656	6928.001368	4728.354847	540.9745436	3.032840748			21.06265353	824.8073293			93.23205834		17.20855472															$450 (1a); $0 (1a1)	$450 (1b)	"$175 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											298.0996	298.0996	115.9276		115.9276	0.198733079	0.26801641	33.1222	0.165610899	3.9747	0.089118086		0.198733079	0.165625572	15	29.954	37.5	0.165610899			0.198733079	30			30		30															67.3698	3.730349935	9.522499793	0	2.714508721	3.768508531	1.266983748	7.069286292	6.934580256	3.926709173	5.620026784	0	0.235921653	9.290888438	8.66000171	11.80275182	1.690545449	0.502271484	0	0	4.185845993	2.062018323	0	0	0.233080146	0	0.043021387	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.6296	0	63.77703706	67.3698	3.730349935	9.522499793	0	2.714508721	3.768508531	1.266983748	7.069286292	6.934580256	3.926709173	5.620026784	0	0.235921653	9.290888438	8.66000171	11.80275182	1.690545449	0.502271484	0	0	4.185845993	2.062018323	0	0	0.233080146	0	0.043021387	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.6296																																																																																				0			67.3698	3.730349935	9.522499793	0	2.714508721	3.768508531	1.266983748	7.069286292	6.934580256	3.926709173	5.620026784	0	0.235921653	9.290888438	8.66000171	11.80275182	1.690545449	0.502271484	0	0	4.185845993	2.062018323	0	0	0.233080146	0	0.043021387	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.6296
H4514_805_0	2008	5																					7635											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2711.972502	150.1652346	985.7011478		280.9865498	18.96266362	4.727261839	2561.167043	41.87272868	11855.22568	63.06269642		1.187128251	56.09573656	6928.001368	4728.354847	540.9745436	3.032840748			21.06265353	824.8073293			93.23205834		17.20855472															$450 (1a); $0 (1a1)	$450 (1b)	"$175 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											298.0996	298.0996	115.9276		115.9276	0.198733079	0.26801641	33.1222	0.165610899	3.9747	0.089118086		0.198733079	0.165625572	15	29.954	37.5	0.165610899			0.198733079	30			30		30															67.3698	3.730349935	9.522499793	0	2.714508721	3.768508531	1.266983748	7.069286292	6.934580256	3.926709173	5.620026784	0	0.235921653	9.290888438	8.66000171	11.80275182	1.690545449	0.502271484	0	0	4.185845993	2.062018323	0	0	0.233080146	0	0.043021387	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.6296	0	63.77703706	67.3698	3.730349935	9.522499793	0	2.714508721	3.768508531	1.266983748	7.069286292	6.934580256	3.926709173	5.620026784	0	0.235921653	9.290888438	8.66000171	11.80275182	1.690545449	0.502271484	0	0	4.185845993	2.062018323	0	0	0.233080146	0	0.043021387	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.6296																																																																																				0			67.3698	3.730349935	9.522499793	0	2.714508721	3.768508531	1.266983748	7.069286292	6.934580256	3.926709173	5.620026784	0	0.235921653	9.290888438	8.66000171	11.80275182	1.690545449	0.502271484	0	0	4.185845993	2.062018323	0	0	0.233080146	0	0.043021387	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.6296
H4520_001_0	2008	6	s.										Health & Education (Non-Covered)										3500											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin						O	O	O										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0						0	0	0										0		309.880223	6.658698	529.89368	221.948385	74.24022	5.320708	1.820809	351.264427	414.831123	6524.55004	1529.215649		8.712484	556.071397	5041.180175	3808.169038	49.687827	316.126879			19.099868			5.74						0.08	0.02	3.4										"75/admit (1-5), ltac 950/admit"	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$50-$75/Visit	$0/Visit	$0-$100/Visit		$0-$75/Proc	$15-$100/Visit	$15/Visit	$30/Visit	$30-$75/Visit	$75/Visit			20% Coins			Coin: 25% - 75%						Active Outlook Newsletter	QuitNet	Silver Sneakers										283.178415	896.731727	27.321168	0	94.392876	0.188785	0.188785	47.196407	59.504697	0	41.845776		23.622891	45.914354	14.158919	28.317838	46.077403	70.7946			0.188785			0.355400697						0	0	0										7.3126	0.497588813	1.206442854	0	0.58397899	1.00446986	0.343741427	1.381534905	2.057033357	0	5.332601292	0	0.017151172	2.127638248	5.94813848	8.986592825	0.190790502	1.865006329	0	0	3.60576858	0	0	2.04	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5011	0	2.52	7.3126	0.497588813	1.206442854	0	0.58397899	1.00446986	0.343741427	1.381534905	2.057033357	0	5.332601292	0	0.017151172	2.127638248	5.94813848	8.986592825	0.190790502	1.865006329	0	0	3.60576858	0	0	2.04	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5011	10000	$950/Admit	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	20% Coins	$100/Trip	20% Coins	20% Coins	$50/Visit	20% Coins	20% Coins	20% Coins		$0-$75/Proc	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins			20% Coins			Coin: 50% - 89%						Active Outlook Newsletter	QuitNet	Silver Sneakers										4.0865	0.0878	0.2129	0.5845	0.584	1.1102	0.3799	0.2438	2.4811	0.6151	1.659		0.003	0.8294	2.5654	2.1105	0.0727	0.2239			0.6695			1.51						0	0	0										20.0292	0	1.1	11.3991	0.585398659	1.419344871	0.584547236	1.167957982	2.114676441	0.723666783	1.625335461	4.538136778	0.615079532	6.991601948	0	0.020177405	2.957036632	8.513495026	11.09705725	0.26344936	2.088938144	0	0	4.275287502	0	0	3.55	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5303
H4520_002_0	2008	4	s.										Health & Education (Non-Covered)																					A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin						O	O	O										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0						0	0	0										0		321.933499	6.9177	550.504724	230.581414	77.12791	5.742668	1.965208	364.927408	430.96663	6778.332639	1588.696885		9.051369	577.700667	5237.264779	3956.293739	51.620512	328.423129			20.614588			5.74						0.08	0.02	3.4										"75/day (1-5), ltac 950/admit"	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$100/Visit	$0/Visit	$0-$100/Visit		$0-$100/Proc	$15-$100/Visit	$15/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins			Coin: 25%-75%						Active Outlook Newsletter	QuitNet	Silver Sneakers										299.999982	949.999566	28.944122	0	100.000064	0.2	0.2	50.000004	100.000011	0	44.863319		33.368212	60.411943	15	29.999998	59.26737	99.999985			0.2			0.355400697						0	0	0										8.0483	0.547651	1.327822991	0	0.642732995	1.1485336	0.3930416	1.520530988	3.591388978	0	5.939517929	0	0.025169	2.90833498	6.546580974	9.890733688	0.254950999	2.736858998	0	0	4.1229176	0	0	2.04	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6851	0	0	8.0483	0.547651	1.327822991	0	0.642732995	1.1485336	0.3930416	1.520530988	3.591388978	0	5.939517929	0	0.025169	2.90833498	6.546580974	9.890733688	0.254950999	2.736858998	0	0	4.1229176	0	0	2.04	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6851		$950/Admit	$950/Admit	20% Coins(Days 1-20) $0(Days 21-100)	20% Coins	$100/Trip	20% Coins	20% Coins	$50/Visit	20% Coins	20% Coins	20% Coins		$0-$100/Proc	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins			20% Coins			Coin: 50%-80%						Active Outlook Newsletter	QuitNet	Silver Sneakers										4.4976	0.0966	0.4279	0.6684	0.6427	1.2694	0.4344	0.2683	2.8369	0.7033	1.8969		0.0044	0.9484	2.9333	2.4131	0.0831	0.256			0.7708			1.51						0	0	0										22.6617	0	0	12.5459	0.644295	1.755676991	0.668383	1.285465995	2.4179656	0.8274566	1.788859988	6.428329978	0.703294	7.836450929	0	0.029611	3.85668598	9.479857974	12.30387869	0.338030999	2.992906998	0	0	4.8936716	0	0	3.55	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3468
H4520_003_0	2008	4	s.										Health & Education (Non-Covered)										3500											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O	O	O										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0	0	0										0		307.787907	6.613738	526.315827	220.449785	73.738949	5.249099	1.796303	348.892683	412.030177	6480.496164	1518.890356		8.653656	552.316796	5007.14204	3782.456215	49.352333	313.992384			18.842812									0.08	0.02	3.4										"100(1-5), LTAC 950 admit"	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$10/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$50-$100/Visit	$0/Visit	$0-$100/Visit		$0-$50/Proc	$15-$100/Visit	$10/Visit	$25/Visit	$25-$50/Visit	$50/Visit			15% Coins									Active Outlook Newsletter	QuitNet	Silver Sneakers										350.321915	899.475902	27.404755	9.468152	94.681562	0.189363	0.189362	47.340815	72.032759	0	42.477311		15.796065	35.421793	9.468159	23.670399	33.566925	47.340814			0.142022									0	0	0										8.9854	0.495741496	1.201963024	0.173937673	0.581809906	0.993985134	0.340151529	1.37640533	2.47330587	0	5.376531502	0	0.011391143	1.630337602	3.950701414	7.461020651	0.138050505	1.238721254	0	0	2.676093846	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1056	0	2.2	8.9854	0.495741496	1.201963024	0.173937673	0.581809906	0.993985134	0.340151529	1.37640533	2.47330587	0	5.376531502	0	0.011391143	1.630337602	3.950701414	7.461020651	0.138050505	1.238721254	0	0	2.676093846	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1056	10000	$950/Admit	$950/Admit	15% Coins(Days 1-20) $0(Days 21-100)	20% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	20% Coins	20% Coins	20% Coins		$0-$50/Proc	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter	QuitNet	Silver Sneakers										4.0713	0.0875	0.2777	0.5784	0.5818	2.1972	0.7519	0.2429	2.4552	0.6087	1.6417		0.002	0.8207	2.5386	2.0884	0.0719	0.2216			0.667									0	0	0										19.9046	0	1.12	13.0567	0.583225401	1.479674572	0.752382599	1.163619817	3.191217472	1.092070189	1.61930056	4.928505801	0.608657825	7.018211031	0	0.013401233	2.451078423	6.489275122	9.549451521	0.209951712	1.460315017	0	0	3.343134239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.0102
H4520_005_0	2008	5	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)																				A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0									0		348.285654	7.483953	595.566779	249.455861	83.441284	6.721297	2.300107	394.798866	466.243789	7333.179097	1718.741085		9.792277	624.98887	5665.965757	4280.13969	55.845954	355.306497			24.127595			5.74	2.99					0.08		3.4	0.02									"150/day (1-5), ltac 950/admit"	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$10/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$100-$150/Visit	$0/Visit	$0-$100/Visit		$0-$50/Proc	$15-$100/Visit	$5/Visit	$20/Visit	$20-$50/Visit	$50/Visit			15% Coins			Coin: 25% - 75%	EyeMed $200 Allowance					Active Outlook Newsletter		Silver Sneakers	QuitNet									519.999988	950.000621	28.94	10.000005	99.999995	0.199999	0.199999	49.999991	126.078917	0	29.474394		16.683351	37.411463	4.999999	19.999999	32.543091	50.000008			0.149999			0.355400697	0					0		0	0									15.0924	0.59248	1.436308549	0.207879988	0.695343999	1.344252679	0.4600191	1.644994979	4.898625998	0	4.221570994	0	0.013614	1.948478999	2.360818593	7.133565793	0.151449997	1.480443974	0	0	3.619115122	0	0	2.04	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3413	0	0	15.0924	0.59248	1.436308549	0.207879988	0.695343999	1.344252679	0.4600191	1.644994979	4.898625998	0	4.221570994	0	0.013614	1.948478999	2.360818593	7.133565793	0.151449997	1.480443974	0	0	3.619115122	0	0	2.04	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3413		$950/Admit	$950/Admit	15% Coins(Days 1-20) $0(Days 21-100)	15% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	15% Coins	15% Coins	15% Coins		$0-$50/Proc	15% Coins	15% Coins	15% Coins	15% Coins	15% Coins			15% Coins			Coin: 50% - 80%	EyeMed $200 Allowance					Active Outlook Newsletter		Silver Sneakers	QuitNet									4.8658	0.1046	0.3756	0.5867	0.6953	2.9715	1.0169	0.2903	2.4903	0.6174	1.6651		0.0024	0.8325	2.5749	2.1183	0.0729	0.2248			0.6766			1.51	0					0		0	0									23.6917	0	0	19.9581	0.697035	1.811883549	0.794592988	1.390687999	4.315772679	1.4769081	1.935287979	7.388921998	0.617359	5.886717994	0	0.016017	2.780951999	4.935679593	9.251848793	0.224377997	1.705205974	0	0	4.295690122	0	0	3.55	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.0331
H4520_006_0	2008	4	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)																				A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0									0		336.438695	7.229385	575.30854	240.970605	80.603024	6.27182	2.146291	381.369758	450.384478	7083.740569	1660.278005		9.459192	603.729836	5473.237588	4134.550481	53.946351	343.220725			22.514097			5.74	2.99					0.08		3.4	0.02									"125/day (1-5), ltac 950 admit"	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$10/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$100-$125/Visit	$0/Visit	$0-$100/Visit		$0-$50/Proc	$15-$100/Visit	$5/Visit	$25/Visit	$25-$50/Visit	$50/Visit			15% Coins			coin: 25% - 75%	EyeMed $200 Allowance					Active Outlook Newsletter		Silver Sneakers	QuitNet									449.999997	949.999481	28.94	10.000008	100.000019	0.2	0.2	50.00001	113.039472	0	44.86332		16.683454	37.411455	5	24.999997	35.452555	49.999987			0.15			0.355400697	0					0		0	0									12.6165	0.572326	1.387452429	0.200808998	0.671691994	1.254364	0.4292582	1.589040976	4.242601966	0	6.207131952	0	0.013151	1.882200966	2.280515662	8.613645802	0.159377998	1.430085982	0	0	3.37711455	0	0	2.04	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9672	0	0	12.6165	0.572326	1.387452429	0.200808998	0.671691994	1.254364	0.4292582	1.589040976	4.242601966	0	6.207131952	0	0.013151	1.882200966	2.280515662	8.613645802	0.159377998	1.430085982	0	0	3.37711455	0	0	2.04	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9672		$700/Admit	$950/Admit	20% Coins(Days 1-20) $0(Days 21-100)	20% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	20% Coins	20% Coins	20% Coins		$0-$50/Proc	20% Coins	15% Coins	15% Coins	15%-20% Coins	20% Coins			15% Coins			coin: 50% - 80%	EyeMed $200 Allowance					Active Outlook Newsletter		Silver Sneakers	QuitNet									3.4633	0.101	0.4673	0.73	0.6717	2.7728	0.9489	0.2804	3.0983	0.7681	2.0717		0.0023	1.0357	2.4027	1.9766	0.077	0.2796			0.6313			1.51	0					0		0	0									23.2889	0	0	16.0798	0.673325	1.854730429	0.930778998	1.343383994	4.027168	1.3781442	1.869459976	7.340949966	0.768099	8.278854952	0	0.015472	2.917936966	4.683186662	10.5902718	0.236396998	1.709726982	0	0	4.00844455	0	0	3.55	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.2561
H4520_016_0	2008	4	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)																				A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		313.262878	6.731385	535.678003	224.371175	75.050627	5.437502	1.860777	355.098833	419.359423	6595.772086	1545.90858		8.807588	562.141479	5096.209743	3849.739045	50.230218	319.577723			19.519127									0.08		3.4	0.02									"75/day (1-5), ltac 950/admit"	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$50-$75/Visit	$0/Visit	$0-$100/Visit		$0-$75/Proc	$15-$100/Visit	$15/Visit	$30/Visit	$30-$75/Visit	$75/Visit			15% Coins									Active Outlook Newsletter		Silver Sneakers	QuitNet									300.000001	949.999442	28.94	0	100.000017	0.199999	0.2	49.999984	63.039461	0	44.331537		25.025693	48.641818	14.999999	30.000001	48.814679	75.000008			0.149999									0		0	0									7.8316	0.532900999	1.291876784	0	0.625421998	1.087494962	0.3721554	1.479577997	2.203015999	0	5.711041951	0	0.018367999	2.278631959	6.370261754	9.624347933	0.204330997	1.997360982	0	0	2.927849531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5562	0	0	7.8316	0.532900999	1.291876784	0	0.625421998	1.087494962	0.3721554	1.479577997	2.203015999	0	5.711041951	0	0.018367999	2.278631959	6.370261754	9.624347933	0.204330997	1.997360982	0	0	2.927849531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5562		$950/Admit	$950/Admit	20% Coins(Days 1-20) $0(Days 21-100)	20% Coins	$100/Trip	20% Coins	20% Coins	$50/Visit	20% Coins	20% Coins	20% Coins		$0-$75/Proc	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins			15% Coins									Active Outlook Newsletter		Silver Sneakers	QuitNet									4.3765	0.094	0.4051	0.6329	0.6254	1.202	0.4113	0.2611	2.6862	0.6659	1.7961		0.0032	0.898	2.7774	2.2849	0.0787	0.2424			0.5473									0		0	0									19.9885	0	0	12.208	0.626941999	1.696994784	0.632865	1.250843998	2.289468962	0.7834844	1.740679997	4.889200999	0.665921	7.507170951	0	0.021608999	3.176587959	9.147664754	11.90925793	0.282995997	2.239802982	0	0	3.475196531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5447
H4520_018_0	2008	4	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)																				A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0									0		327.362487	7.034357	559.788266	234.469868	78.428571	5.937987	2.032049	371.08143	438.234318	6892.640342	1615.488177		9.204009	587.442832	5325.584392	4023.011454	52.491023	333.961555			21.315728			5.74	2.99					0.08		3.4	0.02									"150/day (1-5), LTAC 950 admit"	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$50-$75/Visit	$0-$50/Visit	$25-$100/Visit		$0-$75/Proc	$15-$100/Visit	$5/Visit	$20/Visit	$20-$75/Visit	$75/Visit			15% Coins			Coin: 25% - 75%	EyeMed $200 Allowance					Active Outlook Newsletter		Silver Sneakers	Quit Net									520.000008	950.00069	28.94	0	99.999934	0.199999	0.199999	50.000012	63.039481	8.505898	52.032685		25.026051	48.641785	4.999998	19.999999	42.995466	75.00001			0.149999			0.355400697	0					0		0	0									14.1857	0.556887	1.350022702	0	0.653570994	1.187591462	0.406407768	1.546172996	2.302171997	4.885674642	7.004848953	0	0.019195	2.381188994	2.218992609	6.705018755	0.188073	2.087259997	0	0	3.197337884	0	0	2.04	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9161	0	0	14.1857	0.556887	1.350022702	0	0.653570994	1.187591462	0.406407768	1.546172996	2.302171997	4.885674642	7.004848953	0	0.019195	2.381188994	2.218992609	6.705018755	0.188073	2.087259997	0	0	3.197337884	0	0	2.04	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9161		$950/Admit	$950/Admit	20% Coins(Days 1-20) $0(Days 21-100)	20% Coins	$100/Trip	20% Coins	20% Coins	$50/Visit	20% Coins	20% Coins	20% Coins		$0-$75/Proc	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins			15% Coins			Coin: 50% - 80%	EyeMed $200 Allowance					Active Outlook Newsletter		Silver Sneakers	Quit Net									4.5734	0.0983	0.4424	0.6911	0.6536	1.3126	0.4492	0.2729	2.9334	0.7272	1.9615		0.0034	0.9806	3.033	2.4952	0.0859	0.2648			0.5977			1.51	0					0		0	0									23.0862	0	0	18.7592	0.655161	1.792428702	0.691116	1.307141994	2.500198462	0.855597768	1.819026996	5.235600997	5.612889642	8.966300953	0	0.022582	3.361794994	5.252035609	9.200238755	0.273979	2.352016997	0	0	3.795063884	0	0	3.55	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0023
H4520_801_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		348.285654	7.483953	595.566779	249.455861	83.441284	6.721297	2.300107	394.798866	466.243789	7333.179097	1718.741085		9.792277	624.98887	5665.965757	4280.13969	55.845954	355.306497			24.127595																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214499	177.214367	28.944119	0	99.999995	0.199999	0.199999	49.999991	200.000004	37.551767	90.50501		33.367928	87.838645	19.999999	30.000002	59.267319	99.999983			0.2																					5.1434	0.110521999	1.436512977	0	0.695343999	1.344252679	0.4600191	1.644994979	7.770729972	22.9478194	12.96288992	0	0.027228999	4.574847957	9.44327579	10.70034994	0.275819998	2.960886972	0	0	4.825519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.3245	0	0	5.1434	0.110521999	1.436512977	0	0.695343999	1.344252679	0.4600191	1.644994979	7.770729972	22.9478194	12.96288992	0	0.027228999	4.574847957	9.44327579	10.70034994	0.275819998	2.960886972	0	0	4.825519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.3245		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					12.7146	0.1437	0.626	0.9779	0.965	1.8572	0.6356	1.0897	4.1505	1.0289	2.7752		0.0189	1.3875	4.2914	3.5305	0.1215	0.3746			1.1276																					37.8163	0	0	17.8581	0.254195999	2.062470977	0.977856	1.660323999	3.201452679	1.0955751	2.734739979	11.92122297	23.9767514	15.73813592	0	0.046126999	5.962302957	13.73471079	14.23082194	0.397366998	3.335489972	0	0	5.953145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.1408
H4520_804_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		348.285654	7.483953	595.566779	249.455861	83.441284	6.721297	2.300107	394.798866	466.243789	7333.179097	1718.741085		9.792277	624.98887	5665.965757	4280.13969	55.845954	355.306497			24.127595																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214499	177.214367	28.944119	0	99.999995	0.199999	0.199999	49.999991	200.000004	37.551767	90.50501		33.367928	87.838645	19.999999	30.000002	59.267319	99.999983			0.2																					5.1434	0.110521999	1.436512977	0	0.695343999	1.344252679	0.4600191	1.644994979	7.770729972	22.9478194	12.96288992	0	0.027228999	4.574847957	9.44327579	10.70034994	0.275819998	2.960886972	0	0	4.825519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.3245	0	0	5.1434	0.110521999	1.436512977	0	0.695343999	1.344252679	0.4600191	1.644994979	7.770729972	22.9478194	12.96288992	0	0.027228999	4.574847957	9.44327579	10.70034994	0.275819998	2.960886972	0	0	4.825519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.3245		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					12.7146	0.1437	0.626	0.9779	0.965	1.8572	0.6356	1.0897	4.1505	1.0289	2.7752		0.0189	1.3875	4.2914	3.5305	0.1215	0.3746			1.1276																					37.8163	0	0	17.8581	0.254195999	2.062470977	0.977856	1.660323999	3.201452679	1.0955751	2.734739979	11.92122297	23.9767514	15.73813592	0	0.046126999	5.962302957	13.73471079	14.23082194	0.397366998	3.335489972	0	0	5.953145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.1408
H4520_805_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		348.285654	7.483953	595.566779	249.455861	83.441284	6.721297	2.300107	394.798866	466.243789	7333.179097	1718.741085		9.792277	624.98887	5665.965757	4280.13969	55.845954	355.306497			24.127595																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214499	177.214367	28.944119	0	99.999995	0.199999	0.199999	49.999991	200.000004	37.551767	90.50501		33.367928	87.838645	19.999999	30.000002	59.267319	99.999983			0.2																					5.1434	0.110521999	1.436512977	0	0.695343999	1.344252679	0.4600191	1.644994979	7.770729972	22.9478194	12.96288992	0	0.027228999	4.574847957	9.44327579	10.70034994	0.275819998	2.960886972	0	0	4.825519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.3245	0	0	5.1434	0.110521999	1.436512977	0	0.695343999	1.344252679	0.4600191	1.644994979	7.770729972	22.9478194	12.96288992	0	0.027228999	4.574847957	9.44327579	10.70034994	0.275819998	2.960886972	0	0	4.825519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.3245		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					12.7146	0.1437	0.626	0.9779	0.965	1.8572	0.6356	1.0897	4.1505	1.0289	2.7752		0.0189	1.3875	4.2914	3.5305	0.1215	0.3746			1.1276																					37.8163	0	0	17.8581	0.254195999	2.062470977	0.977856	1.660323999	3.201452679	1.0955751	2.734739979	11.92122297	23.9767514	15.73813592	0	0.046126999	5.962302957	13.73471079	14.23082194	0.397366998	3.335489972	0	0	5.953145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.1408
H4520_806_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		348.285654	7.483953	595.566779	249.455861	83.441284	6.721297	2.300107	394.798866	466.243789	7333.179097	1718.741085		9.792277	624.98887	5665.965757	4280.13969	55.845954	355.306497			24.127595																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214499	177.214367	28.944119	0	99.999995	0.199999	0.199999	49.999991	200.000004	37.551767	90.50501		33.367928	87.838645	19.999999	30.000002	59.267319	99.999983			0.2																					5.1434	0.110521999	1.436512977	0	0.695343999	1.344252679	0.4600191	1.644994979	7.770729972	22.9478194	12.96288992	0	0.027228999	4.574847957	9.44327579	10.70034994	0.275819998	2.960886972	0	0	4.825519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.3245	0	0	5.1434	0.110521999	1.436512977	0	0.695343999	1.344252679	0.4600191	1.644994979	7.770729972	22.9478194	12.96288992	0	0.027228999	4.574847957	9.44327579	10.70034994	0.275819998	2.960886972	0	0	4.825519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.3245		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					12.7146	0.1437	0.626	0.9779	0.965	1.8572	0.6356	1.0897	4.1505	1.0289	2.7752		0.0189	1.3875	4.2914	3.5305	0.1215	0.3746			1.1276																					37.8163	0	0	17.8581	0.254195999	2.062470977	0.977856	1.660323999	3.201452679	1.0955751	2.734739979	11.92122297	23.9767514	15.73813592	0	0.046126999	5.962302957	13.73471079	14.23082194	0.397366998	3.335489972	0	0	5.953145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.1408
H4521_001_0	2008	4																					3250											A	A	D	V	T	P	P	V	V	P	P	V	V	V	P	P	P	P	P	P	Coin	P	P	P	P	P	P	P	P	P	P																																																				0		275.9476282		641.9393829		264.4572355			228.7282017	113.7892836					114.8474733	5798.927763	5296.174363	109.3005733	853.7756694			33.75627122				602.7184656		249															1a (IP Acute) - $100 per visit; 1a1 (Add'l Days) - $0; 1b (IP Psych) - $100 per visit		"2 (SNF) - $0/Day for days 1 - 24, $25/Day for days 25 - 100; 2a2 (Waiver 3 Day) - $0"	6 (Home Health)- $0	10a (Ambulance) - $50	11a (Medical Equip) - $0	"11b (Med Supp), 11c (Diab Supp) - $0"	"4a (ER) - $50, 4b (UC) - $25"	"9a (OP Surgery), 9b (ASC) - $75"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	"7c (OT) - $25, 3 (CORF) - $10, 5 (Part Hospital) - $25; 7i (OP PT/ST) - $10,  9c (OP SA) - $25"	7a (PCP) - $10	"7b (Chiro), 7d (Spec), 7f (Pod); 17a (Eye Exam); 18a (Hearing Exam) - $25"	"7e (MH), 7h (Psychiatric) - $25"	7i (PT/ST) - $10	8b (Professional Radiology) - $0	8a (Professional Labs) - $0	15 (Part B Rx) - 5%	17b (MCR Eyewear); 13a (Blood); 13a1 (Add'l Blood) - $0			17a1 (Routine Eye Exam) - $25		18a1 (Hearing Exam Non-covered) - $25	18b (Hearing Aids) - $1000 Allowance														93.2962		5.7377		46.6481			41.9833	69.9722					10.5425	9.3296	23.3241	23.3241	9.3296			0.046648121				23.3241		23.3241															2.1454	0	0.306938976	0	1.028036093	0	0	0.800230562	0.663507034	0	0	0	0	0.100898175	4.508484731	10.29402427	0.212444432	0.663783845	0	0	1.574666624	0	0	0	1.171486829	0	0.483974255	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.9539	0	1.721195055	2.1454	0	0.306938976	0	1.028036093	0	0	0.800230562	0.663507034	0	0	0	0	0.100898175	4.508484731	10.29402427	0.212444432	0.663783845	0	0	1.574666624	0	0	0	1.171486829	0	0.483974255	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.9539																																																																																				0	0	0	2.1454	0	0.306938976	0	1.028036093	0	0	0.800230562	0.663507034	0	0	0	0	0.100898175	4.508484731	10.29402427	0.212444432	0.663783845	0	0	1.574666624	0	0	0	1.171486829	0	0.483974255	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.9539
H4521_002_0	2008	5																																D	D	D	V	T	P	P	V	V	P	P	V	V	V	P	P	V	V	P	P	S	V	P	P	P	P	P	P	P	P	P																																																				0																																																																	10b (Transportation) - 6 round trips/yr	16a (Preventive Dental)	17a1 (Rountine Eye Exam)	17b1 (Non MCR Covered) - $375 limit	18a1 (Hearing Exam Non-covered); 18a2 (Fit & Eval for Hearing Aids)	18b (Hearing Aids) - $1000 limit		"14a (Education/Wellness) - Nursing Hotline, Educ. Wellness Program"																																																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H4521_004_0	2008	3																					3250											A	A	D	V	T	P	P	V	V	P	P	V	V	V	P	P	P	P	P	P	Coin	P	P	P	P	P	P	P	P	P	P																																																				0		1800.501085		627.6035535		254.1548158	1374.690378	766.4153663	222.8380486	113.0821707				7.700185205	107.151116	5671.880251	5215.790208	105.7310162	834.7669272			33.45651348	3.629468331			595.2145216		131.1407306															"1a (IP Acute) - $250 for days 1 - 6, $0 for days 7 - 90; 1a1 (Add'l Days) - $0"	"1b (IP Psych) - $250 for days 1 - 6, $0 for days 7 - 90"	"2 (SNF) - $0/Day for days 1 - 24, $25/Day for days 25 - 100; 2a2 (Waiver 3 Day) - $0"	6 (Home Health)- $0	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $30"	"9a (OP Surgery), 9b (ASC) - $150"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	"9d (Cardiac Rehab) - $0, 3 (CORF),  5 (Part Hospital), 7c, 7i (OP OT/PT/ST),  9c (OP SA) - $35"	7a (PCP) - $15	"7b (Chiro), 7d (Spec), 7f (Pod), 17a (MCR Eye Exam), 18a (MCR Hearing Exam) - $35"	"7e (MH), 7h (Psychiatric) - $35"	"7c (OT), 7i (PT/ST) - $35"			15 (Part B Rx) - 15%	17b (MCR Eyewear) - $30			17a1 (Routine Eye Exam) - $35		18a1 (Hearing Exam Non-covered) - $35															131.4037		4.7889		77.8689	16.5678	17.468	35.8197	116.8033				27.2541	27.2541	11.6803	27.2541	27.2541	27.2541			0.116803311	23.3607			27.2541		27.2541															19.716	0	0.250462758	0	1.649229113	1.897963772	1.115644353	0.665165672	1.100697665	0	0	0	0.017488472	0.243358989	5.520786617	11.84597491	0.240133693	1.89590219	0	0	3.907831556	0.007065565	0	0	1.351836636	0	0.297843614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.7234	0	14.70032516	19.716	0	0.250462758	0	1.649229113	1.897963772	1.115644353	0.665165672	1.100697665	0	0	0	0.017488472	0.243358989	5.520786617	11.84597491	0.240133693	1.89590219	0	0	3.907831556	0.007065565	0	0	1.351836636	0	0.297843614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.7234																																																																																				0	0	0	19.716	0	0.250462758	0	1.649229113	1.897963772	1.115644353	0.665165672	1.100697665	0	0	0	0.017488472	0.243358989	5.520786617	11.84597491	0.240133693	1.89590219	0	0	3.907831556	0.007065565	0	0	1.351836636	0	0.297843614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.7234
H4521_801_0	2008	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		271.3409473		19.46603298		6.151056481	12.23221512	7.091172928	8.280874938	19.74546916	1.262370783	5.152775521	3.095379152	0.215195364	14.81933669	45.28822673	163.4570792	1.091212707	4.479930352	47.48509166	21.37683421	32.65860212	0.558588859																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.072380106		0.216180629		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				19.6397	0	4.208179254	0	1.439347217	2.862338339	1.659334465	1.937724736	4.620439785	0.295394763	1.205749472	0.724318722	0.050355715	3.467724786	10.59744505	38.24895652	0.255343773	1.048303702	11.11151145	5.002179204	7.642112896	0.130709793	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1472	0	0	19.6397	0	4.208179254	0	1.439347217	2.862338339	1.659334465	1.937724736	4.620439785	0.295394763	1.205749472	0.724318722	0.050355715	3.467724786	10.59744505	38.24895652	0.255343773	1.048303702	11.11151145	5.002179204	7.642112896	0.130709793	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1472																																																																																				0	0	0	19.6397	0	4.208179254	0	1.439347217	2.862338339	1.659334465	1.937724736	4.620439785	0.295394763	1.205749472	0.724318722	0.050355715	3.467724786	10.59744505	38.24895652	0.255343773	1.048303702	11.11151145	5.002179204	7.642112896	0.130709793	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1472
H4521_802_0	2008	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		271.3409473		19.46603298		6.151056481	12.23221512	7.091172928	8.280874938	19.74546916	1.262370783	5.152775521	3.095379152	0.215195364	14.81933669	45.28822673	163.4570792	1.091212707	4.479930352	47.48509166	21.37683421	32.65860212	0.558588859																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.072380106		0.216180629		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				19.6397	0	4.208179254	0	1.439347217	2.862338339	1.659334465	1.937724736	4.620439785	0.295394763	1.205749472	0.724318722	0.050355715	3.467724786	10.59744505	38.24895652	0.255343773	1.048303702	11.11151145	5.002179204	7.642112896	0.130709793	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1472	0	0	19.6397	0	4.208179254	0	1.439347217	2.862338339	1.659334465	1.937724736	4.620439785	0.295394763	1.205749472	0.724318722	0.050355715	3.467724786	10.59744505	38.24895652	0.255343773	1.048303702	11.11151145	5.002179204	7.642112896	0.130709793	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1472																																																																																				0	0	0	19.6397	0	4.208179254	0	1.439347217	2.862338339	1.659334465	1.937724736	4.620439785	0.295394763	1.205749472	0.724318722	0.050355715	3.467724786	10.59744505	38.24895652	0.255343773	1.048303702	11.11151145	5.002179204	7.642112896	0.130709793	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1472
H4521_803_0	2008	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		271.3409473		19.46603298		6.151056481	12.23221512	7.091172928	8.280874938	19.74546916	1.262370783	5.152775521	3.095379152	0.215195364	14.81933669	45.28822673	163.4570792	1.091212707	4.479930352	47.48509166	21.37683421	32.65860212	0.558588859																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.072380106		0.216180629		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				19.6397	0	4.208179254	0	1.439347217	2.862338339	1.659334465	1.937724736	4.620439785	0.295394763	1.205749472	0.724318722	0.050355715	3.467724786	10.59744505	38.24895652	0.255343773	1.048303702	11.11151145	5.002179204	7.642112896	0.130709793	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1472	0	0	19.6397	0	4.208179254	0	1.439347217	2.862338339	1.659334465	1.937724736	4.620439785	0.295394763	1.205749472	0.724318722	0.050355715	3.467724786	10.59744505	38.24895652	0.255343773	1.048303702	11.11151145	5.002179204	7.642112896	0.130709793	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1472																																																																																				0	0	0	19.6397	0	4.208179254	0	1.439347217	2.862338339	1.659334465	1.937724736	4.620439785	0.295394763	1.205749472	0.724318722	0.050355715	3.467724786	10.59744505	38.24895652	0.255343773	1.048303702	11.11151145	5.002179204	7.642112896	0.130709793	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1472
H4522_001_0	2008	7																					2000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	3000	1339.097829	132.7996707	523.675618		77.95012063	13.21273432	2.828202322	282.718882	26.36712447	7118.881862	31.6293049		0.095368967	13.48463236	3726.615474	4129.862748	425.7708655	3.643361276			12.15455801	898.6570902			128.5753511		16.0336257	53.29877151														$120 (1a); $0 (1a1)	$120 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20% (9b)	20% (8a1); $0/$5 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0; $0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											80.0156	80.0156	66.6796		116.6894	0.200038917	0.289391387	33.3398	0.133359278	1.3336	0.071021857		0.200038917	0.133274465	10	25	37.5	0.133359278			0.200038917	25			25		25	748.4601														8.9291	0.885503409	2.909875091	0	0.75799586	2.643061059	0.818457393	0.78548304	3.516300675	0.791140786	2.246371969	0	0.019077505	1.797157167	3.105512895	8.603880726	1.330533955	0.485876028	0	0	2.431384616	1.872202271	0	0	0.267865315	0	0.033403387	3.324333707	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5545	0	14.12027661	8.9291	0.885503409	2.909875091	0	0.75799586	2.643061059	0.818457393	0.78548304	3.516300675	0.791140786	2.246371969	0	0.019077505	1.797157167	3.105512895	8.603880726	1.330533955	0.485876028	0	0	2.431384616	1.872202271	0	0	0.267865315	0	0.033403387	3.324333707	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5545		$275 (1a); $0 (1a1)	$275 (1b)	"$175 (2a, 2a2)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	40% (9b)	40% (8a1); $0/$20 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	40% (incl in h5)	30% (12)	"40% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 40% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 40% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0; $0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5); 50% (14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											1.4855	0.1473	1.0992	0.64	0.1582	0.5517	0.2021	0.1639	1.4678	0.6605	0.9047		0.004	0.7499	1.2505	2.1168	0.2661	0.1432			0.3582	0.4675			0.0555		0.0083															12.9009	0	6.419002788	10.4146	1.032823604	4.009059665	0.640024072	0.916202709	3.194713629	1.02059306	0.94942694	4.984126245	1.451639864	3.151022244	0	0.02305931	2.547066701	4.355972359	10.72071821	1.596640746	0.629044122	0	0	2.789600169	2.33970898	0	0	0.323355498	0	0.041655988	3.324333707	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4554
H4522_007_0	2008	5																					1100											D	D	D	V	T	V	P	V	V	Coin	V	V	V	V	V		V	V		V	S	P	T	V	V	P	V	P																																																							0		2005.089891	197.8841093	1310.236686		348.6071788	3110.012303	732.2571551	646.7445158	302.1520968	11.75866837	188.3639548	32.73967141	19.9441366	1730.090144		1581.510002		782.9453619				671.9833811																				1(a) $110 per Day	1(b) $110 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per preocedure; other $0 per procedure	8(b) X-rays $0 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a), 9(d) $25 per visit; 9(c) $0/0 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  $0 per script	"13, 14(a)-(j) $0; 17(a), 16(b) $10 per procedure"	10(b) $0 Copay	16(a)/16(b) $0 copay per visit	17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a/18a1 $10/$0 per visit	18(b) $0 copay per procedure														64.2619	64.2619	24.5364		43.8149	12.176	16.3822	26.1429	14.605	0.270477869	5.842	14.605	136.3332	14.605		5.842		5.842				5.842																				10.7376	1.059700424	2.679035993	0	1.272849605	3.15561828	0.999665673	1.40898152	0.3677436	3.180459568	0.091701682	0.039846835	0.226587273	2.105659982	0	0.769930361	0	0.381163195	0	0	0	0.327143304	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8037	0	20.50088035	10.7376	1.059700424	2.679035993	0	1.272849605	3.15561828	0.999665673	1.40898152	0.3677436	3.180459568	0.091701682	0.039846835	0.226587273	2.105659982	0	0.769930361	0	0.381163195	0	0	0	0.327143304	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8037		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"4(a)$50 per Visit, 4(b) $35 per Visit"	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															1.9887	0.0357	0.2097	0.2242	0.0605	0.1654	0.073	0.0524	0.2137	0.0696	0.293	0.0148	0.0108	0.1666	0.0687	0.1297	0.0189	0.0468			0.1434	0.0415	0.0077		0.0015		0.006															4.0421	0	0	12.7263	1.095375472	2.888739576	0.224153646	1.333313708	3.320973875	1.072678696	1.461375656	0.581413114	3.250075437	0.384688598	0.054663717	0.237369359	2.27224759	0.068677515	0.899625652	0.018862608	0.427971393	0	0	0.143420854	0.368663626	0.00774	0	0.001459132	0	0.00598221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.8458
H4522_008_0	2008	7																					2500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2007.791315	137.7124926	901.8317643		278.7168686	10.76177808	18.68992853	433.6617212	409.8939851	3436.484205	451.6151546	68.82425491	15.48653522	2887.75942		3943.345915	388.4988483	568.6563189				701.8091767					0.074307583															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															130.0319	130.0319	31.2077		55.728	0.148607876	0.148607876	30.6504	55.728	14.8608	48.4937	55.728	111.6568	53.879		18.576	14.8608	14.8608				18.576					18.576															21.7564	1.492251325	2.345337802	0	1.294360057	1.599284982	2.777470581	1.107657844	1.903546078	4.255738488	1.825041745	0.319619573	0.144098068	12.96580625	0	6.104294381	0.481116572	0.704223397	0	0	0	1.086399699	0	0	0	0	0.000115028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.1628	0	21.49735865	21.7564	1.492251325	2.345337802	0	1.294360057	1.599284982	2.777470581	1.107657844	1.903546078	4.255738488	1.825041745	0.319619573	0.144098068	12.96580625	0	6.104294381	0.481116572	0.704223397	0	0	0	1.086399699	0	0	0	0	0.000115028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.1628		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.1814	0.0623	0.2685	0.268	0.0688	0.1318	0.1144	0.0315	0.2785	0.0437	0.1137	0.0228	0.0053	0.1988	0.0199	0.1921	0.0289	0.0312			0.1723	0.0407			0.0051																	4.2797	0	0	23.9379	1.554573784	2.6138243	0.267969135	1.363187613	1.731061856	2.891898715	1.13917579	2.182082313	4.299464595	1.938703113	0.342425797	0.149357414	13.16463417	0.019873526	6.296421264	0.509981925	0.735407938	0	0	0.172273786	1.127132916	0	0	0.005058988	0	0.000115028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4425
H4522_801_0	2008	3																					3400											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	4000	1406.052721	139.4396542	549.8593989		81.84762667	13.87337104	2.969612438	296.8548261	27.68548069	7474.825955	33.21077014		0.100137415	14.15886398	3912.946248	4336.355886	447.0594088	3.82552934			12.76228591	943.5899447			135.0041187		16.83530699															$240 (1a); $0 (1a1)	$240 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											161.6582	161.6582	91.4293		117.8758	0.202072749	0.289607232	33.6788	0.202072749	4.0415	0.103821462		0.202072749	0.201867955	25	34.8547	37.5	0.202072749			0.202072749	35			29.3472		35															18.9417	1.878463616	4.189440178	0	0.803987669	2.803430222	0.86002124	0.833142649	5.594481188	2.517431048	3.447990721	0	0.020235043	2.858220916	8.15197135	12.59518305	1.397060652	0.77303523	0	0	2.578910196	2.752137339	0	0	0.330166587	0	0.049102979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3761	0	22.92357813	18.9417	1.878463616	4.189440178	0	0.803987669	2.803430222	0.86002124	0.833142649	5.594481188	2.517431048	3.447990721	0	0.020235043	2.858220916	8.15197135	12.59518305	1.397060652	0.77303523	0	0	2.578910196	2.752137339	0	0	0.330166587	0	0.049102979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3761		$380 (1a); $0 (1a1)	$380 (1b)	"$175 (2a, 2a2)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	40% (9b)	40% (8a1); $0/$20 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	40% (incl in h5)	30% (12)	"40% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$40/$50 (7a); 40% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $40 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 40% (17b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.3184	0.2299	1.2414	0.672	0.1787	0.623	0.2132	0.1852	1.6578	0.746	1.0217		0.0045	0.8469	2.4761	2.5292	0.2794	0.1617			0.4046	0.5602			0.0583		0.0099															16.4182	0	6.571581233	21.26	2.108378874	5.430878736	0.672025275	0.982669292	3.426476422	1.073258932	1.018303798	7.252269429	3.263410424	4.469718791	0	0.024732164	3.70515325	10.62808212	15.12441125	1.676472783	0.934731815	0	0	2.983485197	3.312377593	0	0	0.388431279	0	0.0590061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.7943
H4522_803_0	2008	3																					3400											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	4000	1406.052721	139.4396542	549.8593989		81.84762667	13.87337104	2.969612438	296.8548261	27.68548069	7474.825955	33.21077014		0.100137415	14.15886398	3912.946248	4336.355886	447.0594088	3.82552934			12.76228591	943.5899447			135.0041187		16.83530699															$240 (1a); $0 (1a1)	$240 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											161.6582	161.6582	91.4293		117.8758	0.202072749	0.289607232	33.6788	0.202072749	4.0415	0.103821462		0.202072749	0.201867955	25	34.8547	37.5	0.202072749			0.202072749	35			29.3472		35															18.9417	1.878463616	4.189440178	0	0.803987669	2.803430222	0.86002124	0.833142649	5.594481188	2.517431048	3.447990721	0	0.020235043	2.858220916	8.15197135	12.59518305	1.397060652	0.77303523	0	0	2.578910196	2.752137339	0	0	0.330166587	0	0.049102979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3761	0	22.92357813	18.9417	1.878463616	4.189440178	0	0.803987669	2.803430222	0.86002124	0.833142649	5.594481188	2.517431048	3.447990721	0	0.020235043	2.858220916	8.15197135	12.59518305	1.397060652	0.77303523	0	0	2.578910196	2.752137339	0	0	0.330166587	0	0.049102979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3761		$380 (1a); $0 (1a1)	$380 (1b)	"$175 (2a, 2a2)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	40% (9b)	40% (8a1); $0/$20 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	40% (incl in h5)	30% (12)	"40% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$40/$50 (7a); 40% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $40 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 40% (17b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.3184	0.2299	1.2414	0.672	0.1787	0.623	0.2132	0.1852	1.6578	0.746	1.0217		0.0045	0.8469	2.4761	2.5292	0.2794	0.1617			0.4046	0.5602			0.0583		0.0099															16.4182	0	6.571581233	21.26	2.108378874	5.430878736	0.672025275	0.982669292	3.426476422	1.073258932	1.018303798	7.252269429	3.263410424	4.469718791	0	0.024732164	3.70515325	10.62808212	15.12441125	1.676472783	0.934731815	0	0	2.983485197	3.312377593	0	0	0.388431279	0	0.0590061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.7943
H4523_001_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0	0	0	0	0											0	0	"$0/d 1-20, $100/d 21-100"	$0 per visit	$90 per trip	20% coinsurance	20% coinsurance	"50 ER, $25 (Not Waived if Admitted) UC"	50 copay	$0 per visit	"$0 X-ray; $150 CAT, PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$5 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	45	0	0	0	$150 Every 2 Years per visit	0	$500 Every 3 Yrs per visit	Not Covered	N/A	Fitness	0											0	0	41.2	0	90	0.2	0.2	50	50	0	27	20	25	20	5	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0	0											0	0	4.452090201	0	1.76185913	3.143561179	0.200659672	1.775280607	1.462590142	0	2.580638523	0	0	0	2.30681155	11.40257547	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4427			0	0	4.452090201	0	1.76185913	3.143561179	0.200659672	1.775280607	1.462590142	0	2.580638523	0	0	0	2.30681155	11.40257547	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4427		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0	4.452090201	0	1.76185913	3.143561179	0.200659672	1.775280607	1.462590142	0	2.580638523	0	0	0	2.30681155	11.40257547	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4427
H4523_005_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0	0	0	0	0											$100/day 1-5	$100/day 1-5	"$0/d 1-20, $100/d 21-100"	$0 per visit	$90 per trip	20% coinsurance	20% coinsurance	"50 ER, $25 (Not Waived if Admitted) UC"	$$100 Copay	$0 per visit	"$0 X-ray; $150 CAT, PET, MRI"	$10 per visit	$10 per visit	$10 per visit	$5 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	45	0	0	0	$150 Every 2 Years per visit	0	$500 Every 3 Yrs per visit	Not Covered	N/A	Fitness	0											61.28	61.28	41.2	0	90	0.2	0.2	50	100	0	27	10	10	10	5	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0	0											8.1069	0.157932208	4.452090201	0	1.76185913	3.143561179	0.200659672	1.775280607	2.925180284	0	2.580638523	0	0	0	2.30681155	5.701287733	0.168059705	0.486246428	0.797468223	1.20532567	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.8117			8.1069	0.157932208	4.452090201	0	1.76185913	3.143561179	0.200659672	1.775280607	2.925180284	0	2.580638523	0	0	0	2.30681155	5.701287733	0.168059705	0.486246428	0.797468223	1.20532567	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.8117		"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	0	"50 ER, $25 (Not Waived if Admitted) UC"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	0	0	0	"100% coins; $0ded; ""Unlimited maxOOP"	0	"100% coins; $0ded; ""Unlimited maxOOP"	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			8.1069	0.157932208	4.452090201	0	1.76185913	3.143561179	0.200659672	1.775280607	2.925180284	0	2.580638523	0	0	0	2.30681155	5.701287733	0.168059705	0.486246428	0.797468223	1.20532567	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.8117
H4523_009_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0	0	0	0	0											100	100	"$0/d 1-20, $100/d 21-100"	$0 per visit	$75 per trip	20% coinsurance	20% coinsurance	"50 ER, $25 (Not Waived if Admitted) UC"	$75 Copay	$0 per visit	"$0 X-ray; $150 CAT, PET, MRI"	$15 per visit	$15 per visit	$15 per visit	$5 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	45	0	0	Not Covered	$150 Every 2 Years per visit	0	$500 Every 3 Yrs per visit	Not Covered	N/A	Fitness	0											17	17	41.2	0	75	0.2	0.2	50	75	0	27	15	25	15	5	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0	0											2.249	0.043812786	4.452090201	0	1.468215941	3.143561179	0.200659672	1.775280607	2.193885213	0	2.580638523	0	0	0	2.30681155	8.551931599	0.252089558	0.729369643	1.196202335	1.807988505	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.9939			2.249	0.043812786	4.452090201	0	1.468215941	3.143561179	0.200659672	1.775280607	2.193885213	0	2.580638523	0	0	0	2.30681155	8.551931599	0.252089558	0.729369643	1.196202335	1.807988505	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.9939		"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			2.249	0.043812786	4.452090201	0	1.468215941	3.143561179	0.200659672	1.775280607	2.193885213	0	2.580638523	0	0	0	2.30681155	8.551931599	0.252089558	0.729369643	1.196202335	1.807988505	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.9939
H4523_010_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0	0	0	0	0											$100/day 1-5	$100/day 1-5	"$0/d 1-20, $100/d 21-100"	$0 per visit	50 per trip	0.2 coinsurance	0.2 coinsurance	"50 ER, 25 UC"	$50 Copay	0 per visit	"0 X-ray; 100 CAT, PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	45	0	0	0	$150 Every 2 Years per visit	0	$500 Every 3 Yrs per visit	Not Covered	N/A	Fitness	0											61.28	61.28	41.2	0	50	0.2	0.2	50	50	0	18	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0	0											8.1069	0.157932208	4.452090201	0	0.978810628	3.143561179	0.200659672	1.775280607	1.462590142	0	1.720425682	0	0	0	4.613623101	14.25321933	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.5503			8.1069	0.157932208	4.452090201	0	0.978810628	3.143561179	0.200659672	1.775280607	1.462590142	0	1.720425682	0	0	0	4.613623101	14.25321933	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.5503		"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	0	"50 ER, 25 UC"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	0	0	0	"100% coins; $0ded; ""Unlimited maxOOP"	0	"100% coins; $0ded; ""Unlimited maxOOP"	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			8.1069	0.157932208	4.452090201	0	0.978810628	3.143561179	0.200659672	1.775280607	1.462590142	0	1.720425682	0	0	0	4.613623101	14.25321933	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.5503
H4523_011_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0	0	0	0	0											$100/day 1-5	$100/day 1-5	"$0/d 1-20, $100/d 21-100"	$0 per visit	50 per trip	0.2 coinsurance	0.2 coinsurance	"50 ER, 25 UC"	$50 Copay	0 per visit	"0 X-ray; 100 CAT, PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	45	0	0	0	$150 Every 2 Years per visit	0	$500 Every 3 Yrs per visit	Not Covered	N/A	Fitness	0											61.28	61.28	41.2	0	50	0.2	0.2	50	50	0	18	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0	0											8.1069	0.157932208	4.452090201	0	0.978810628	3.143561179	0.200659672	1.775280607	1.462590142	0	1.720425682	0	0	0	4.613623101	14.25321933	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.5503			8.1069	0.157932208	4.452090201	0	0.978810628	3.143561179	0.200659672	1.775280607	1.462590142	0	1.720425682	0	0	0	4.613623101	14.25321933	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.5503		"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	0	"50 ER, 25 UC"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	0	0	0	0	"100% coins; $0ded; ""Unlimited maxOOP"	0	"100% coins; $0ded; ""Unlimited maxOOP"	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			8.1069	0.157932208	4.452090201	0	0.978810628	3.143561179	0.200659672	1.775280607	1.462590142	0	1.720425682	0	0	0	4.613623101	14.25321933	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.5503
H4523_012_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0	0	0	0	0											$150/day 1-5	$150/day 1-5	"$0/d 1-20, $100/d 21-100"	$0 per visit	100 per trip	0.2 coinsurance	0.2 coinsurance	"50 ER, 35 UC"	$150 Copay	0 per visit	"0 X-ray; 100 CAT, PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	45	0	0	0	$150 Every 2 Years per visit	0	$500 Every 3 Yrs per visit	Not Covered	N/A	Fitness	0											91.93	91.93	41.2	0	100	0.2	0.2	50	150	0	18	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0	0											12.1617	0.236924084	4.452090201	0	1.957621255	3.143561179	0.200659672	1.775280607	4.387770426	0	1.720425682	0	0	0	4.613623101	14.25321933	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.588			12.1617	0.236924084	4.452090201	0	1.957621255	3.143561179	0.200659672	1.775280607	4.387770426	0	1.720425682	0	0	0	4.613623101	14.25321933	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.588		"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	0	"50 ER, 35 UC"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	0	0	0	"100% coins; $0ded; ""Unlimited maxOOP"	0	"100% coins; $0ded; ""Unlimited maxOOP"	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			12.1617	0.236924084	4.452090201	0	1.957621255	3.143561179	0.200659672	1.775280607	4.387770426	0	1.720425682	0	0	0	4.613623101	14.25321933	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.588
H4523_013_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0	0	0	0	0											$150/day 1-5	$150/day 1-5	"$0/d 1-20, $100/d 21-100"	$0 per visit	100 per trip	0.2 coinsurance	0.2 coinsurance	"50 ER, 35 UC"	$150 Copay	0 per visit	"0 X-ray; 100 CAT, PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	45	0	0	0	$150 Every 2 Years per visit	0	$500 Every 3 Yrs per visit	Not Covered	N/A	Fitness	0											91.93	91.93	41.2	0	100	0.2	0.2	50	150	0	18	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0	0											12.1617	0.236924084	4.452090201	0	1.957621255	3.143561179	0.200659672	1.775280607	4.387770426	0	1.720425682	0	0	0	4.613623101	14.25321933	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.588			12.1617	0.236924084	4.452090201	0	1.957621255	3.143561179	0.200659672	1.775280607	4.387770426	0	1.720425682	0	0	0	4.613623101	14.25321933	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.588		"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	0	"50 ER, 35 UC"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	"100% coins; $0ded; ""Unlimited maxOOP"	0	0	0	"100% coins; $0ded; ""Unlimited maxOOP"	0	"100% coins; $0ded; ""Unlimited maxOOP"	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			12.1617	0.236924084	4.452090201	0	1.957621255	3.143561179	0.200659672	1.775280607	4.387770426	0	1.720425682	0	0	0	4.613623101	14.25321933	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.588
H4523_014_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0	0	0	0	0											0	0	0	0	$100 per trip	20% coinsurance	20% coinsurance	"50 ER, 0 UC"	0	0 per visit	"0 X-ray; 100 CAT, PET, MRI"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	45	0	0	0	$150 Every 2 Years	0	$1000 Every 3 Yrs	Not Covered	N/A	Fitness	0											0	0	0	0	100	0.2	0.2	50	0	0	18	0	0	0	0	0	0	0	0	0	45	0	0	0	0	0	0	0	0	0	0											0	0	0	0	1.957621255	3.143561179	0.200659672	1.775280607	0	0	1.720425682	0	0	0	0	0	0	0	0	0	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.84			0	0	0	0	1.957621255	3.143561179	0.200659672	1.775280607	0	0	1.720425682	0	0	0	0	0	0	0	0	0	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.84		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0	0	0	1.957621255	3.143561179	0.200659672	1.775280607	0	0	1.720425682	0	0	0	0	0	0	0	0	0	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.84
H4523_801_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	Coin	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1403.234861	27.33675297	1146.203462	1881.554753	207.6460381	15.71780589	1.003298358	376.6101166	310.2755935	1972.668358	1013.814245	0	0	0	4893.697162	6208.051603	178.2619179	1031.528894	22.93217943	2556.992056	18.07125295	0	0	0	0	0	0	0	0	0	0											200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	20% coinsurance	$40 per visit	20% coinsurance	0	N/A	Not Covered	$0 per visit	Not Covered	$0 per visit	Not Covered	N/A	Not Covered	0											144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	0.2	40	0.2	0	0	0	0	0	0	0	0	0	0											16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.586435886	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.0536			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.586435886	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.0536																																																																																				0			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.586435886	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.0536
H4523_802_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	Coin	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1403.234861	27.33675297	1146.203462	1881.554753	207.6460381	15.71780589	1.003298358	376.6101166	310.2755935	1972.668358	1013.814245	0	0	0	4893.697162	6208.051603	178.2619179	1031.528894	22.93217943	2556.992056	18.07125295	0	0	0	0	0	0	0	0	0	0											200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	0.2	$40 per visit	20% coinsurance	0	N/A	Not Covered	$0 per visit	Not Covered	$0 per visit	Not Covered	N/A	Not Covered	0											144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	0.2	40	0.2	0	0	0	0	0	0	0	0	0	0											16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.586435886	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.0536			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.586435886	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.0536																																																																																				0			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.586435886	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.0536
H4524_001_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	1077.981961	0	0	0	0	0	0	0	0	0	0											$150/day 1-5	$150/day 1-5	"$0/d 1-20, $100/d 21-100"	0	100 per trip	0.2 coinsurance	0.2 coinsurance	"50 ER, 25 UC"	$210 Copay	0 per visit	"0 X-ray; 100 CAT, PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	45	0	0	0	$150 Every 2 Years per visit	0	$300 Every 3 Yrs per visit	Not Covered	N/A	Fitness	0											91.93	91.93	41.2	0	100	0.2	0.2	50	210	0	100	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0	0											10.7023	0.208493194	3.917839377	0	1.722706705	2.766333837	0.176580511	1.562246934	5.405733165	0	8.410970001	0	0	0	4.059988329	12.54283301	0.369731351	1.069742143	1.754430091	2.651716473	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.364			10.7023	0.208493194	3.917839377	0	1.722706705	2.766333837	0.176580511	1.562246934	5.405733165	0	8.410970001	0	0	0	4.059988329	12.54283301	0.369731351	1.069742143	1.754430091	2.651716473	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.364		"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	100	"20% coins; $150ded; ""Unlimited maxOOP"	0	"50 ER, 25 UC"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	0											2.8717	0	0.4656	0.4171	0.01	0.2376	0	0.126	0.2941	0.1021	0.2865	0	0.094	0.3166	0.3731	0.4661	0.0176	0.0493	0.3467	1.2564	0.0312	0	0	0	0.0485	0	0.0137	0	0	0	0											7.8239	150	8.702824348	13.5739	0.208493194	4.383480141	0.417147897	1.732706705	3.003960488	0.176580511	1.688247659	5.699828131	0.102057486	8.697490471	0	0.093956825	0.316610377	4.433053796	13.00897453	0.38733706	1.119091659	2.101125872	3.908087663	4.073607141	0	0	0	0.04849302	0	0.013691156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.188
H4524_002_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	1077.981961	0	0	0	0	0	0	0	0	0	0											$150/day 1-5	$150/day 1-5	"$0/d 1-20, $100/d 21-100"	0	100 per trip	0.2 coinsurance	0.2 coinsurance	"50 ER, 25 UC"	$210 Copay	0 per visit	"0 X-ray; 100 CAT, PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	45	0	0	0	$150 Every 2 Years per visit	0	$300 Every 3 Yrs per visit	Not Covered	N/A	Fitness	0											91.93	91.93	41.2	0	100	0.2	0.2	50	210	0	100	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0	0											10.7023	0.208493194	3.917839377	0	1.722706705	2.766333837	0.176580511	1.562246934	5.405733165	0	8.410970001	0	0	0	4.059988329	12.54283301	0.369731351	1.069742143	1.754430091	2.651716473	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.364			10.7023	0.208493194	3.917839377	0	1.722706705	2.766333837	0.176580511	1.562246934	5.405733165	0	8.410970001	0	0	0	4.059988329	12.54283301	0.369731351	1.069742143	1.754430091	2.651716473	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.364		"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	100	"20% coins; $150ded; ""Unlimited maxOOP"	0	"50 ER, 25 UC"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	0											2.8717	0	0.4656	0.4171	0.01	0.2376	0	0.126	0.2941	0.1021	0.2865	0	0.094	0.3166	0.3731	0.4661	0.0176	0.0493	0.3467	1.2564	0.0312	0	0	0	0.0485	0	0.0137	0	0	0	0											7.8239	150	8.702824348	13.5739	0.208493194	4.383480141	0.417147897	1.732706705	3.003960488	0.176580511	1.688247659	5.699828131	0.102057486	8.697490471	0	0.093956825	0.316610377	4.433053796	13.00897453	0.38733706	1.119091659	2.101125872	3.908087663	4.073607141	0	0	0	0.04849302	0	0.013691156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.188
H4524_003_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	1077.981961	0	0	0	0	0	0	0	0	0	0											$100/day 1-5	$100/day 1-5	"$0/d 1-20, $100/d 21-100"	0 copay	50 per trip	0.2 coinsurance	0.2 coinsurance	"50 ER, 25 UC"	$50 Copay	0 per visit	"0 X-ray; 100 CAT, PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	45	0	0	0	$150 Every 2 Years per visit	0	$300 Every 3 Yrs per visit	Not Covered	N/A	Fitness	0											61.28	61.28	41.2	0	50	0.2	0.2	50	50	0	100	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0	0											7.1341	0.138980343	3.917839377	0	0.861353352	2.766333837	0.176580511	1.562246934	1.287079325	0	8.410970001	0	0	0	4.059988329	12.54283301	0.369731351	1.069742143	1.754430091	2.651716473	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7463			7.1341	0.138980343	3.917839377	0	0.861353352	2.766333837	0.176580511	1.562246934	1.287079325	0	8.410970001	0	0	0	4.059988329	12.54283301	0.369731351	1.069742143	1.754430091	2.651716473	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7463		"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	100	"20% coins; $150ded; ""Unlimited maxOOP"	0	"50 ER, 25 UC"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	0											2.8717	0	0.4656	0.4171	0.01	0.2376	0	0.126	0.2941	0.1021	0.2865	0	0.094	0.3166	0.3731	0.4661	0.0176	0.0493	0.3467	1.2564	0.0312	0	0	0	0.0485	0	0.0137	0	0	0	0											7.8239	150	8.702824348	10.0057	0.138980343	4.383480141	0.417147897	0.871353352	3.003960488	0.176580511	1.688247659	1.58117429	0.102057486	8.697490471	0	0.093956825	0.316610377	4.433053796	13.00897453	0.38733706	1.119091659	2.101125872	3.908087663	4.073607141	0	0	0	0.04849302	0	0.013691156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5702
H4524_004_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	1077.981961	0	0	0	0	0	0	0	0	0	0											$100/day 1-5	$100/day 1-5	"$0/d 1-20, $100/d 21-100"	0 copay	50 per trip	0.2 coinsurance	0.2 coinsurance	"50 ER, 25 UC"	$50 Copay	0 per visit	"0 X-ray; 100 CAT, PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	45	0	0	0	$150 Every 2 Years per visit	0	$300 Every 3 Yrs per visit	Not Covered	N/A	Fitness	0											61.28	61.28	41.2	0	50	0.2	0.2	50	50	0	100	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0	0											7.1341	0.138980343	3.917839377	0	0.861353352	2.766333837	0.176580511	1.562246934	1.287079325	0	8.410970001	0	0	0	4.059988329	12.54283301	0.369731351	1.069742143	1.754430091	2.651716473	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7463			7.1341	0.138980343	3.917839377	0	0.861353352	2.766333837	0.176580511	1.562246934	1.287079325	0	8.410970001	0	0	0	4.059988329	12.54283301	0.369731351	1.069742143	1.754430091	2.651716473	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7463		"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	100	"20% coins; $150ded; ""Unlimited maxOOP"	0	"50 ER, 25 UC"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	0											2.8717	0	0.4656	0.4171	0.01	0.2376	0	0.126	0.2941	0.1021	0.2865	0	0.094	0.3166	0.3731	0.4661	0.0176	0.0493	0.3467	1.2564	0.0312	0	0	0	0.0485	0	0.0137	0	0	0	0											7.8239	150	8.702824348	10.0057	0.138980343	4.383480141	0.417147897	0.871353352	3.003960488	0.176580511	1.688247659	1.58117429	0.102057486	8.697490471	0	0.093956825	0.316610377	4.433053796	13.00897453	0.38733706	1.119091659	2.101125872	3.908087663	4.073607141	0	0	0	0.04849302	0	0.013691156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5702
H4524_005_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	1077.981961	0	0	0	0	0	0	0	0	0	0											$100/day 1-5	$100/day 1-5	"$0/d 1-20, $100/d 21-100"	0	50 per trip	0.2 coinsurance	0.2 coinsurance	"50 ER, 25 UC"	$100 Copay	0 per visit	"0 X-ray; 100 CAT, PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	45	0	0	Not Covered	$150 Every 2 Years per visit	0	$300 Every 3 Yrs per visit	Not Covered	N/A	Fitness	0											61.28	61.28	41.2	0	50	0.2	0.2	50	100	0	100	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0	0											7.1341	0.138980343	3.917839377	0	0.861353352	2.766333837	0.176580511	1.562246934	2.57415865	0	8.410970001	0	0	0	4.059988329	12.54283301	0.369731351	1.069742143	1.754430091	2.651716473	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0334			7.1341	0.138980343	3.917839377	0	0.861353352	2.766333837	0.176580511	1.562246934	2.57415865	0	8.410970001	0	0	0	4.059988329	12.54283301	0.369731351	1.069742143	1.754430091	2.651716473	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0334		"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	100	"20% coins; $150ded; ""Unlimited maxOOP"	0	"50 ER, 25 UC"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	0											2.8717	0	0.4656	0.4171	0.01	0.2376	0	0.126	0.2941	0.1021	0.2865	0	0.094	0.3166	0.3731	0.4661	0.0176	0.0493	0.3467	1.2564	0.0312	0	0	0	0.0485	0	0.0137	0	0	0	0											7.8239	150	8.702824348	10.0057	0.138980343	4.383480141	0.417147897	0.871353352	3.003960488	0.176580511	1.688247659	2.868253615	0.102057486	8.697490471	0	0.093956825	0.316610377	4.433053796	13.00897453	0.38733706	1.119091659	2.101125872	3.908087663	4.073607141	0	0	0	0.04849302	0	0.013691156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8573
H4524_007_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	1077.981961	0	0	0	0	0	0	0	0	0	0											$100/day 1-5	$100/day 1-5	"$0/d 1-20, $100/d 21-100"	0 copay	$75 per trip	20% coinsurance	20% coinsurance	"50 ER, $25 (Not Waived if Admitted) UC"	$$100 Copay	$0 per visit	"$0 X-ray; $100 CAT, PET, MRI"	$10 per visit	$10 per visit	$10 per visit	$5 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	45	0	0	0	$150 Every 2 Years per visit	0	$300 Every 3 Yrs per visit	Not Covered	N/A	Fitness	0											61.28	61.28	41.2	0	75	0.2	0.2	50	100	0	100	10	25	10	5	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0	0											7.1341	0.138980343	3.917839377	0	1.292030028	2.766333837	0.176580511	1.562246934	2.57415865	0	8.410970001	0	0	0	2.029994164	5.017133205	0.147892541	0.427896857	0.701772036	1.060686589	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.401			7.1341	0.138980343	3.917839377	0	1.292030028	2.766333837	0.176580511	1.562246934	2.57415865	0	8.410970001	0	0	0	2.029994164	5.017133205	0.147892541	0.427896857	0.701772036	1.060686589	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.401		"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	100	"20% coins; $150ded; ""Unlimited maxOOP"	0	"50 ER, $25 (Not Waived if Admitted) UC"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	0											2.8717	0	0.4656	0.4171	0.01	0.2376	0	0.126	0.2941	0.1021	0.2865	0	0.094	0.3166	0.3731	0.4661	0.0176	0.0493	0.3467	1.2564	0.0312	0	0	0	0.0485	0	0.0137	0	0	0	0											7.8239	150	8.702824348	10.0057	0.138980343	4.383480141	0.417147897	1.302030028	3.003960488	0.176580511	1.688247659	2.868253615	0.102057486	8.697490471	0	0.093956825	0.316610377	2.403059632	5.483274719	0.16549825	0.477246374	1.048467818	2.317057779	4.073607141	0	0	0	0.04849302	0	0.013691156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.2249
H4524_008_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	1077.981961	0	0	0	0	0	0	0	0	0	0											$100/day 1-5	$100/day 1-5	"$0/d 1-20, $100/d 21-100"	0 copay	$75 per trip	20% coinsurance	20% coinsurance	"50 ER, $25 (Not Waived if Admitted) UC"	$$100 Copay	$0 per visit	"$0 X-ray; $100 CAT, PET, MRI"	$10 per visit	$10 per visit	$10 per visit	$5 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	45	0	0	0	$150 Every 2 Years per visit	0	$300 Every 3 Yrs per visit	Not Covered	N/A	Fitness	0											61.28	61.28	41.2	0	75	0.2	0.2	50	100	0	100	10	25	10	5	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0	0											7.1341	0.138980343	3.917839377	0	1.292030028	2.766333837	0.176580511	1.562246934	2.57415865	0	8.410970001	0	0	0	2.029994164	5.017133205	0.147892541	0.427896857	0.701772036	1.060686589	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.401			7.1341	0.138980343	3.917839377	0	1.292030028	2.766333837	0.176580511	1.562246934	2.57415865	0	8.410970001	0	0	0	2.029994164	5.017133205	0.147892541	0.427896857	0.701772036	1.060686589	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.401		"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	100	"20% coins; $150ded; ""Unlimited maxOOP"	0	"50 ER, $25 (Not Waived if Admitted) UC"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	0											2.8717	0	0.4656	0.4171	0.01	0.2376	0	0.126	0.2941	0.1021	0.2865	0	0.094	0.3166	0.3731	0.4661	0.0176	0.0493	0.3467	1.2564	0.0312	0	0	0	0.0485	0	0.0137	0	0	0	0											7.8239	150	8.702824348	10.0057	0.138980343	4.383480141	0.417147897	1.302030028	3.003960488	0.176580511	1.688247659	2.868253615	0.102057486	8.697490471	0	0.093956825	0.316610377	2.403059632	5.483274719	0.16549825	0.477246374	1.048467818	2.317057779	4.073607141	0	0	0	0.04849302	0	0.013691156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.2249
H4524_009_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	1077.981961	0	0	0	0	0	0	0	0	0	0											$150/day 1-5	$150/day 1-5	"$0/d 1-20, $100/d 21-100"	0 copay	100 per trip	0.2 coinsurance	0.2 coinsurance	"50 ER, 35 UC"	$150 Copay	0 per visit	"0 X-ray; 100 CAT, PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	45	0	0	0	$150 Every 2 Years per visit	0	$300 Every 3 Yrs per visit	Not Covered	N/A	Fitness	0											91.93	91.93	41.2	0	100	0.2	0.2	50	150	0	100	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0	0											10.7023	0.208493194	3.917839377	0	1.722706705	2.766333837	0.176580511	1.562246934	3.861237975	0	8.410970001	0	0	0	4.059988329	12.54283301	0.369731351	1.069742143	1.754430091	2.651716473	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8195			10.7023	0.208493194	3.917839377	0	1.722706705	2.766333837	0.176580511	1.562246934	3.861237975	0	8.410970001	0	0	0	4.059988329	12.54283301	0.369731351	1.069742143	1.754430091	2.651716473	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8195		"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	100	"20% coins; $150ded; ""Unlimited maxOOP"	0	"50 ER, 35 UC"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	0											2.8717	0	0.4656	0.4171	0.01	0.2376	0	0.126	0.2941	0.1021	0.2865	0	0.094	0.3166	0.3731	0.4661	0.0176	0.0493	0.3467	1.2564	0.0312	0	0	0	0.0485	0	0.0137	0	0	0	0											7.8239	150	8.702824348	13.5739	0.208493194	4.383480141	0.417147897	1.732706705	3.003960488	0.176580511	1.688247659	4.15533294	0.102057486	8.697490471	0	0.093956825	0.316610377	4.433053796	13.00897453	0.38733706	1.119091659	2.101125872	3.908087663	4.073607141	0	0	0	0.04849302	0	0.013691156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.6435
H4524_010_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	1077.981961	0	0	0	0	0	0	0	0	0	0											$150/day 1-5	$150/day 1-5	"$0/d 1-20, $100/d 21-100"	0 copay	100 per trip	0.2 coinsurance	0.2 coinsurance	"50 ER, 35 UC"	$150 Copay	0 per visit	"0 X-ray; 100 CAT, PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	45	0	0	0	$150 Every 2 Years per visit	0	$300 Every 3 Yrs per visit	Not Covered	N/A	Fitness	0											91.93	91.93	41.2	0	100	0.2	0.2	50	150	0	100	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0	0											10.7023	0.208493194	3.917839377	0	1.722706705	2.766333837	0.176580511	1.562246934	3.861237975	0	8.410970001	0	0	0	4.059988329	12.54283301	0.369731351	1.069742143	1.754430091	2.651716473	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8195			10.7023	0.208493194	3.917839377	0	1.722706705	2.766333837	0.176580511	1.562246934	3.861237975	0	8.410970001	0	0	0	4.059988329	12.54283301	0.369731351	1.069742143	1.754430091	2.651716473	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8195		"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	100	"20% coins; $150ded; ""Unlimited maxOOP"	0	"50 ER, 35 UC"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	0											2.8717	0	0.4656	0.4171	0.01	0.2376	0	0.126	0.2941	0.1021	0.2865	0	0.094	0.3166	0.3731	0.4661	0.0176	0.0493	0.3467	1.2564	0.0312	0	0	0	0.0485	0	0.0137	0	0	0	0											7.8239	150	8.702824348	13.5739	0.208493194	4.383480141	0.417147897	1.732706705	3.003960488	0.176580511	1.688247659	4.15533294	0.102057486	8.697490471	0	0.093956825	0.316610377	4.433053796	13.00897453	0.38733706	1.119091659	2.101125872	3.908087663	4.073607141	0	0	0	0.04849302	0	0.013691156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.6435
H4524_011_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	1077.981961	0	0	0	0	0	0	0	0	0	0											$75/day 1-5	$75/day 1-5	"$0/d 1-20, $100/d 21-100"	0 copay	$100 per trip	20% coinsurance	20% coinsurance	"50 ER, $25 (Not Waived if Admitted) UC"	$75 Copay	$0 per visit	"$0 X-ray; $100 CAT, PET, MRI"	$15 per visit	$15 per visit	$15 per visit	$5 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	45	0	0	Not Covered	$150 Every 2 Years per visit	0	$300 Every 3 Yrs per visit	Not Covered	N/A	Fitness	0											45.96	45.96	41.2	0	100	0.2	0.2	50	75	0	100	15	25	15	5	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0	0											5.3505	0.104235257	3.917839377	0	1.722706705	2.766333837	0.176580511	1.562246934	1.930618988	0	8.410970001	0	0	0	2.029994164	7.525699807	0.221838811	0.641845286	1.052658054	1.591029884	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0476			5.3505	0.104235257	3.917839377	0	1.722706705	2.766333837	0.176580511	1.562246934	1.930618988	0	8.410970001	0	0	0	2.029994164	7.525699807	0.221838811	0.641845286	1.052658054	1.591029884	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0476		"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	100	"20% coins; $150ded; ""Unlimited maxOOP"	0	"50 ER, $25 (Not Waived if Admitted) UC"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	0											2.8717	0	0.4656	0.4171	0.01	0.2376	0	0.126	0.2941	0.1021	0.2865	0	0.094	0.3166	0.3731	0.4661	0.0176	0.0493	0.3467	1.2564	0.0312	0	0	0	0.0485	0	0.0137	0	0	0	0											7.8239	150	8.702824348	8.2222	0.104235257	4.383480141	0.417147897	1.732706705	3.003960488	0.176580511	1.688247659	2.224713953	0.102057486	8.697490471	0	0.093956825	0.316610377	2.403059632	7.991841322	0.23944452	0.691194802	1.399353836	2.847401074	4.073607141	0	0	0	0.04849302	0	0.013691156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8715
H4524_012_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	1077.981961	0	0	0	0	0	0	0	0	0	0											$75/day 1-5	$75/day 1-5	"$0/d 1-20, $100/d 21-100"	0 copay	$100 per trip	20% coinsurance	20% coinsurance	"50 ER, $25 (Not Waived if Admitted) UC"	$75 Copay	$0 per visit	"$0 X-ray; $100 CAT, PET, MRI"	$15 per visit	$15 per visit	$15 per visit	$5 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	45	0	0	Not Covered	$150 Every 2 Years per visit	0	$300 Every 3 Yrs per visit	Not Covered	Fitness	Not Covered	0											45.96	45.96	41.2	0	100	0.2	0.2	50	75	0	100	15	25	15	5	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0	0											5.3505	0.104235257	3.917839377	0	1.722706705	2.766333837	0.176580511	1.562246934	1.930618988	0	8.410970001	0	0	0	2.029994164	7.525699807	0.221838811	0.641845286	1.052658054	1.591029884	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0476			5.3505	0.104235257	3.917839377	0	1.722706705	2.766333837	0.176580511	1.562246934	1.930618988	0	8.410970001	0	0	0	2.029994164	7.525699807	0.221838811	0.641845286	1.052658054	1.591029884	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0476		"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	100	"20% coins; $150ded; ""Unlimited maxOOP"	0	"50 ER, $25 (Not Waived if Admitted) UC"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	"20% coins; $150ded; ""Unlimited maxOOP"	0	0	0	0											2.8717	0	0.4656	0.4171	0.01	0.2376	0	0.126	0.2941	0.1021	0.2865	0	0.094	0.3166	0.3731	0.4661	0.0176	0.0493	0.3467	1.2564	0.0312	0	0	0	0.0485	0	0.0137	0	0	0	0											7.8239	150	8.702824348	8.2222	0.104235257	4.383480141	0.417147897	1.732706705	3.003960488	0.176580511	1.688247659	2.224713953	0.102057486	8.697490471	0	0.093956825	0.316610377	2.403059632	7.991841322	0.23944452	0.691194802	1.399353836	2.847401074	4.073607141	0	0	0	0.04849302	0	0.013691156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8715
H4524_801_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	Coin	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1234.846677	24.05634262	1008.659047	1655.768182	182.7285135	13.83166919	0.882902555	331.4169026	273.0425222	1735.948155	892.1565356	0	0	0	4306.453503	5463.08541	156.8704877	907.7454267	20.1803179	2250.153009	15.90270259	0	0	0	0	0	0	0	0	0	0											200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	0.2	$40 per visit	20% coinsurance	0	N/A	Not Covered	$0 per visit	Not Covered	$0 per visit	Not Covered	N/A	Not Covered	0											144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	0.2	40	0.2	0	0	0	0	0	0	0	0	0	0											14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.036063579	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.6072			14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.036063579	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.6072		"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	0	$50 ER/UC	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	0	0	0	"30% coins; $500ded; ""Unlimited maxOOP"	0	"30% coins; $500ded; ""Unlimited maxOOP"	0	0	0	0											7.922	0	1.2845	1.1508	0.2353	0.6555	0	0.2118	0.8113	0.2815	0.7904	0	0.2592	0.8734	1.0292	1.2859	0.0486	0.1361	0.9564	3.4659	0.5368	0	0	0	0.1338	0	0.0378	0	0	0	0											22.1063	500	0	22.7988	0.289818788	9.690032461	6.669992775	2.519435246	4.805029776	0.264870766	1.592750556	5.362014101	6.068034846	4.875000015	0	0.259194098	0.873417564	11.79529122	19.26857794	0.571469634	3.161956187	4.992476276	10.96639979	3.717367697	0	0	0	0.133775323	0	0.037769123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7134
H4524_802_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	Coin	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1234.846677	24.05634262	1008.659047	1655.768182	182.7285135	13.83166919	0.882902555	331.4169026	273.0425222	1735.948155	892.1565356	0	0	0	4306.453503	5463.08541	156.8704877	907.7454267	20.1803179	2250.153009	15.90270259	0	0	0	0	0	0	0	0	0	0											200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	0.2	$40 per visit	20% coinsurance	0	N/A	Not Covered	$0 per visit	Not Covered	$0 per visit	Not Covered	N/A	Not Covered	0											144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	0.2	40	0.2	0	0	0	0	0	0	0	0	0	0											14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.036063579	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.6072			14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.036063579	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.6072		"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"		$50 ER/UC	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	0	0	0	"30% coins; $500ded; ""Unlimited maxOOP"	0	"30% coins; $500ded; ""Unlimited maxOOP"	0	0	0	0											7.922	0	1.2845	1.1508	0.2353	0.6555	0	0.2118	0.8113	0.2815	0.7904	0	0.2592	0.8734	1.0292	1.2859	0.0486	0.1361	0.9564	3.4659	0.5368	0	0	0	0.1338	0	0.0378	0	0	0	0											22.1063	500	0	22.7988	0.289818788	9.690032461	6.669992775	2.519435246	4.805029776	0.264870766	1.592750556	5.362014101	6.068034846	4.875000015	0	0.259194098	0.873417564	11.79529122	19.26857794	0.571469634	3.161956187	4.992476276	10.96639979	3.717367697	0	0	0	0.133775323	0	0.037769123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7134
H4525_001_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0		1815.650363	79.28046644	958.3035932	3629.9237	199.4184695	14.47626103	1.0269023	390.9620778	445.0649923	0	1295.999803	0	0	3649.756539	9316.722012	0	655.761401	574.1423983	5600.11588	27135.93744	0	170.5488782	0	0	0	25.73065399	0	0	0	0	180.2760311											$75 per day	$75 per day	$25 per day 1-20 & $150 21-100		$100 Copay	20% Coin	20% Coin	$50 for Emergency / $25 Urgent Care	$100 Copay		"$10 X-Ray / $75 MRI, CT, PET / 20% Chemo"			$20 CORF Copay	$15 PCP /  $30 Spec		$25 for Ind / $15 for Group	$20 Copay		$20 Podiatry / $25 Chiro		$30 Vision / $10 Hearing																				57.51779359	67.5	51.38726495	0	100	0.2	0.2	46.73867464	100	0	24.95401263	0	0	0.328873146	20.76	0	14.85579694	20	0	1.259770998	0	23.65163168	0	0	0	0	0	0	0	0	0											8.7027	0.445952624	4.103716721	0	1.661820579	2.895252205	0.20538046	1.522754113	3.708874936	0	2.695032955	0	0	0.100025576	16.11792908	0	0.811821518	0.956903997	0	2.848755583	0	0.336146604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1131			8.7027	0.445952624	4.103716721	0	1.661820579	2.895252205	0.20538046	1.522754113	3.708874936	0	2.695032955	0	0	0.100025576	16.11792908	0	0.811821518	0.956903997	0	2.848755583	0	0.336146604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1131		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			8.7027	0.445952624	4.103716721	0	1.661820579	2.895252205	0.20538046	1.522754113	3.708874936	0	2.695032955	0	0	0.100025576	16.11792908	0	0.811821518	0.956903997	0	2.848755583	0	0.336146604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1131
H4525_002_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0		2354.551872	65.8268986	1153.521708	4490.376512	181.5121723	19.55588315	1.357996793	370.3609514	741.7394677	0	1334.78286	0	0	3835.599029	9478.008104	0	927.3297261	518.7329065	6342.507119	32251.43312	0	399.4566868	0	0	0	8.434346276	0	0	0	0	217.0430873											$75 per day	$75 per day	$25 per day 1-20 & $120 21-100		$100 Copay	20% Coin	20% Coin	$50 for Emergency / $25 Urgent Care	$100 Copay		"$10 X-Ray / $75 MRI, CT, PET / 20% Chemo"			$20 CORF Copay	$15 PCP /  $30 Spec		$25 for Ind / $15 for Group	$20 Copay		$20 Podiatry / $25 Chiro		$30 Vision / $10 Hearing																				57.51779359	67.5	51.38726495	0	100	0.2	0.2	47.23995618	100	0	25.50953306	0	0	0.259834196	20.76	0	9.114216606	20	0	0.947912613	0	29.22862419	0	0	0	0	0	0	0	0	0											11.2857	0.370276305	4.939693803	0	1.512601436	3.911176631	0.271599359	1.45798626	6.181162231	0	2.837473958	0	0	0.083051649	16.39695402	0	0.704323666	0.864554844	0	2.547628354	0	0.972964115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.3372			11.2857	0.370276305	4.939693803	0	1.512601436	3.911176631	0.271599359	1.45798626	6.181162231	0	2.837473958	0	0	0.083051649	16.39695402	0	0.704323666	0.864554844	0	2.547628354	0	0.972964115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.3372		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			11.2857	0.370276305	4.939693803	0	1.512601436	3.911176631	0.271599359	1.45798626	6.181162231	0	2.837473958	0	0	0.083051649	16.39695402	0	0.704323666	0.864554844	0	2.547628354	0	0.972964115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.3372
H4525_003_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		375.1265818	7.310137338	52.9952977	79.0517577	4.991818377	29.04767856	2.840741256	13.95831334	37.7632159	0	41.3575348	0	0	49.44290577	57.94247161	0	3.505165734	5.920173154	39.51192579	248.8479567	0	2.34259919	0	6.35	1.393678131	1.730974837	0	0	0	0	0.229823952											Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing		Medicare Cost Sharing			Medicare Cost Sharing	Medicare Cost Sharing		Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing		Medicare Cost Sharing		Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing					Medicare Cost Sharing											0.0765	0.0765	0.2134	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234											28.6972	0.559225506	11.30919653	0	1.1680855	6.797156782	0.664733454	3.266245322	8.836592522	0	9.677663143	0	0	11.56963995	13.55853836	0	0.820208782	1.385320518	9.245790635	58.23042186	0	0.54816821	0	1.4859	0.326120683	0.405048112	0	0	0	0	0.053778805	0	0	0	0	0	0	0	0	0	0	168.605			28.6972	0.559225506	11.30919653	0	1.1680855	6.797156782	0.664733454	3.266245322	8.836592522	0	9.677663143	0	0	11.56963995	13.55853836	0	0.820208782	1.385320518	9.245790635	58.23042186	0	0.54816821	0	1.4859	0.326120683	0.405048112	0	0	0	0	0.053778805	0	0	0	0	0	0	0	0	0	0	168.605		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			28.6972	0.559225506	11.30919653	0	1.1680855	6.797156782	0.664733454	3.266245322	8.836592522	0	9.677663143	0	0	11.56963995	13.55853836	0	0.820208782	1.385320518	9.245790635	58.23042186	0	0.54816821	0	1.4859	0.326120683	0.405048112	0	0	0	0	0.053778805	0	0	0	0	0	0	0	0	0	0	168.605
H4525_004_0	2008	3																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0		1815.650363	79.28046644	958.3035932	3629.9237	199.4184695	14.47626103	1.0269023	390.9620778	445.0649923	0	1295.999803	0	0	3649.756539	9316.722012	0	655.761401	574.1423983	5600.11588	27135.93744	0	170.5488782	0	0	0	25.73065399	0	0	0	0	180.2760311											$75 per day	$75 per day	$25 per day 1-20 & $120 21-100		$100 Copay	20% Coin	20% Coin	$50 for Emergency / $25 Urgent Care	$100 Copay		"$10 X-Ray / $75 MRI, CT, PET / 20% Chemo"			$20 CORF Copay	$15 PCP /  $30 Spec		$25 for Ind / $15 for Group	$20 Copay		$20 Podiatry / $25 Chiro		$30 Vision / $10 Hearing																				57.51779359	67.5	51.38726495	0	100	0.2	0.2	46.73867464	100	0	24.95401263	0	0	0.328873146	20.76	0	14.85579694	20	0	1.259770998	0	23.65163168	0	0	0	0	0	0	0	0	0											8.7027	0.445952624	4.103716721	0	1.661820579	2.895252205	0.20538046	1.522754113	3.708874936	0	2.695032955	0	0	0.100025576	16.11792908	0	0.811821518	0.956903997	0	2.848755583	0	0.336146604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1131			8.7027	0.445952624	4.103716721	0	1.661820579	2.895252205	0.20538046	1.522754113	3.708874936	0	2.695032955	0	0	0.100025576	16.11792908	0	0.811821518	0.956903997	0	2.848755583	0	0.336146604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1131		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			8.7027	0.445952624	4.103716721	0	1.661820579	2.895252205	0.20538046	1.522754113	3.708874936	0	2.695032955	0	0	0.100025576	16.11792908	0	0.811821518	0.956903997	0	2.848755583	0	0.336146604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1131
H4525_005_0	2008	3																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0		2355.014717	65.84948028	1153.365754	4489.656627	181.602424	19.57133883	1.359078385	370.609981	741.6047841	0	1334.388236	0	0	3839.588429	9475.813615	0	927.6829709	519.2358863	6345.892188	32269.70738	0	399.4566868	0	0	0	8.434346276	0	0	0	0	217.0430873											$75 per day	$75 per day	$25 per day 1-20 & $120 21-100		$100 Copay	20% Coin	20% Coin	$50 for Emergency / $25 Urgent Care	$100 Copay		"$10 X-Ray / $75 MRI, CT, PET / 20% Chemo"			$20 CORF Copay	$15 PCP /  $30 Spec		$25 for Ind / $15 for Group	$20 Copay		$20 Podiatry / $25 Chiro		$30 Vision / $10 Hearing																				57.51779359	67.5	51.38726495	0	100	0.2	0.2	47.23901005	100	0	25.50937186	0	0	0.259653266	20.76	0	9.119945767	20	0	0.947754652	0	29.22862419	0	0	0	0	0	0	0	0	0											11.2879	0.370403327	4.939025966	0	1.513353534	3.914267765	0.271815677	1.458937385	6.180039868	0	2.836617142	0	0	0.08308014	16.39315755	0	0.705034865	0.865393144	0	2.548647106	0	0.972964115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.3407			11.2879	0.370403327	4.939025966	0	1.513353534	3.914267765	0.271815677	1.458937385	6.180039868	0	2.836617142	0	0	0.08308014	16.39315755	0	0.705034865	0.865393144	0	2.548647106	0	0.972964115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.3407		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			11.2879	0.370403327	4.939025966	0	1.513353534	3.914267765	0.271815677	1.458937385	6.180039868	0	2.836617142	0	0	0.08308014	16.39315755	0	0.705034865	0.865393144	0	2.548647106	0	0.972964115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.3407
H4525_006_0	2008	8																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0		1900.679199	92.73192375	1120.898246	4225.014719	198.9122463	15.89622548	1.112421536	317.1790619	482.0779764	0	1321.444277	0	0	3345.712983	9669.71797	0	471.637086	671.5567086	5637.430446	27517.97975	0	54.92204031	0	0	0	0	0	0	0	0	189.5035172													$0 per day 1-4 & $50 5-30		$50 Copay	10% Coin	10% Coin	$50 for Emergency / $25 Urgent Care	$50 Copay		"$0 X-Ray / $50 MRI, CT, PET / $25 Chemo"				$10 PCP /  $30 Spec		$25 Copay	$25 Copay		$25 Podiatry / $25 Chiro		$25 Vision / $10 Hearing																				0	0	26.78999188	0	50	0.1	0.1	45.29794912	50	0	11.25	0	0	0	17.68	0	25	25	0	1.409229494	0	22.72727273	0	0	0.234	0.234	0	0	0	0	0											0	0	2.502404575	0	0.828801026	1.589622548	0.111242154	1.197296751	2.008658235	0	1.23885401	0	0	0	14.24671781	0	0.982577263	1.399076476	0	3.231595723	0	0.104019016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.4409			0	0	2.502404575	0	0.828801026	1.589622548	0.111242154	1.197296751	2.008658235	0	1.23885401	0	0	0	14.24671781	0	0.982577263	1.399076476	0	3.231595723	0	0.104019016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.4409		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			0	0	2.502404575	0	0.828801026	1.589622548	0.111242154	1.197296751	2.008658235	0	1.23885401	0	0	0	14.24671781	0	0.982577263	1.399076476	0	3.231595723	0	0.104019016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.4409
H4525_007_0	2008	8																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0		1958.362622	95.54623076	1671.513175	5801.207237	129.0089854	22.13258844	1.548843659	355.9714748	635.3705101	0	1321.623768	0	0	3346.795842	10352.51613	0	504.9403255	718.9766731	6035.500704	29018.35293	0	60.13423432	0	0	0	0	0	0	0	0	188.5283967													$0 per day 1-4 & $50 5-30		$50 Copay	10% Coin	10% Coin	$50 for Emergency / $25 Urgent Care	$50 Copay		"$0 X-Ray / $50 MRI, CT, PET / $25 Chemo"				$10 PCP /  $30 Spec		$25 Copay	$25 Copay		$25 Podiatry / $25 Chiro		$25 Vision / $10 Hearing																				0	0	26.78999188	0	50	0.1	0.1	45.83191914	50	0	11.25	0	0	0	17.68	0	25	25	0	1.351688828	0	22.72727273	0	0	0.234	0.234	0	0	0	0	0											0	0	3.731652033	0	0.537537439	2.213258844	0.154884366	1.359571321	2.647377125	0	1.239022282	0	0	0	15.25270709	0	1.051959011	1.497868069	0	3.268648621	0	0.113890595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.0684			0	0	3.731652033	0	0.537537439	2.213258844	0.154884366	1.359571321	2.647377125	0	1.239022282	0	0	0	15.25270709	0	1.051959011	1.497868069	0	3.268648621	0	0.113890595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.0684		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			0	0	3.731652033	0	0.537537439	2.213258844	0.154884366	1.359571321	2.647377125	0	1.239022282	0	0	0	15.25270709	0	1.051959011	1.497868069	0	3.268648621	0	0.113890595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.0684
H4525_008_0	2008	8																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0		1900.679199	92.73192375	1120.898246	4225.014719	198.9122463	15.97146051	1.117686501	317.1790619	482.0779764	0	1321.444277	0	0	3345.712983	9669.71797	0	471.637086	671.5567086	5637.430446	27517.97975	0	54.92204031	0	0	0	0	0	0	0	0	189.5035172															$50 Copay	10% Coin	10% Coin	$50 for Emergency / $0 Urgent Care									$25 Copay	$25 Copay																								0	0	0	0	50	0.1	0.1	40.59589824	0	0	0	0	0	0	0	0	25	25	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0.828801026	1.597146051	0.11176865	1.073014077	0	0	0	0	0	0	0	0	0.982577263	1.399076476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.9924			0	0	0	0	0.828801026	1.597146051	0.11176865	1.073014077	0	0	0	0	0	0	0	0	0.982577263	1.399076476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.9924		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			0	0	0	0	0.828801026	1.597146051	0.11176865	1.073014077	0	0	0	0	0	0	0	0	0.982577263	1.399076476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.9924
H4525_009_0	2008	8																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0		1958.362622	95.54623076	1671.513175	5801.207237	129.0089854	22.09287327	1.546064382	355.9714748	635.3705101	0	1321.623768	0	0	3346.795842	10352.51613	0	504.9403255	718.9766731	6035.500704	29018.35293	0	60.13423432	0	0	0	0	0	0	0	0	188.5283967															$50 Copay	10% Coin	10% Coin	$50 for Emergency / $25 Urgent Care									$25 Copay	$25 Copay																								0	0	0	0	50	0.1	0.1	41.66383828	0	0	0	0	0	0	0	0	25	25	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0.537537439	2.209287327	0.154606438	1.235928163	0	0	0	0	0	0	0	0	1.051959011	1.497868069	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.6872			0	0	0	0	0.537537439	2.209287327	0.154606438	1.235928163	0	0	0	0	0	0	0	0	1.051959011	1.497868069	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.6872		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			0	0	0	0	0.537537439	2.209287327	0.154606438	1.235928163	0	0	0	0	0	0	0	0	1.051959011	1.497868069	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.6872
H4525_801_0	2008	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		307.5844844	8.619480092	50.10871965	68.93728103	4.052186471	24.73797723	1.731169369	10.07974714	32.68472168	0	38.40448654	0	1.644865558	46.14463732	0	0	3.501680795	0	26.51115458	273.2190988	0	0.429222217	0	0	0	0	0	0	0	0	0											Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing		Medicare Cost Sharing		Medicare Cost Sharing	Medicare Cost Sharing			Medicare Cost Sharing		Medicare Cost Sharing	Medicare Cost Sharing		Medicare Cost Sharing																				0.076390785	0.076390785	0.213310159	0	0.234	0.234	0.234	0.234	0.234		0.234		0.234	0.234			0.234		0.234	0.234		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234											23.4966	0.65844885	10.68869895	0	0.948211634	5.788686671	0.405093632	2.358660832	7.648224874	0	8.98664985	0	0.384898541	10.79784513	0	0	0.819393306	0	6.203610171	63.93326912	0	0.100437999	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.2187			23.4966	0.65844885	10.68869895	0	0.948211634	5.788686671	0.405093632	2.358660832	7.648224874	0	8.98664985	0	0.384898541	10.79784513	0	0	0.819393306	0	6.203610171	63.93326912	0	0.100437999	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.2187		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			23.4966	0.65844885	10.68869895	0	0.948211634	5.788686671	0.405093632	2.358660832	7.648224874	0	8.98664985	0	0.384898541	10.79784513	0	0	0.819393306	0	6.203610171	63.93326912	0	0.100437999	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.2187
H4525_802_0	2008	1																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		307.5844844	8.619480092	50.10871965	68.93728103	4.052186471	24.73797723	1.731169369	10.07974714	32.68472168	0	38.40448654	0	1.644865558	46.14463732	0	0	3.501680795	0	26.51115458	273.2190988	0	0.429222217	0	0	0	0	0	0	0	0	0											Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing		Medicare Cost Sharing		Medicare Cost Sharing	Medicare Cost Sharing			Medicare Cost Sharing		Medicare Cost Sharing	Medicare Cost Sharing		Medicare Cost Sharing																				0.076390785	0.076390785	0.213310159	0	0.234	0.234	0.234	0.234	0.234		0.234		0.234	0.234			0.234		0.234	0.234		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234											23.4966	0.65844885	10.68869895	0	0.948211634	5.788686671	0.405093632	2.358660832	7.648224874	0	8.98664985	0	0.384898541	10.79784513	0	0	0.819393306	0	6.203610171	63.93326912	0	0.100437999	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.2187			23.4966	0.65844885	10.68869895	0	0.948211634	5.788686671	0.405093632	2.358660832	7.648224874	0	8.98664985	0	0.384898541	10.79784513	0	0	0.819393306	0	6.203610171	63.93326912	0	0.100437999	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.2187		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			23.4966	0.65844885	10.68869895	0	0.948211634	5.788686671	0.405093632	2.358660832	7.648224874	0	8.98664985	0	0.384898541	10.79784513	0	0	0.819393306	0	6.203610171	63.93326912	0	0.100437999	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.2187
H4527_001_0	2008	7																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	V	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1495.973296	65.00727916	349.0016546		315.8157829	6.629073775	6.666365623	382.6444537			15.75670978			698.3762225		2897.627337	243.4182109	1469.846614	5037.942055		22.09563466	521.7491415			144		249.0635463															No cost sharing except for IP Rehab - $75/Day for Days 1-5	Medicare Cost Share	$100 / Days 21-100	No cost sharing	$75 / Trip	10% / Item	10% / Item	"ER: $50 / Visit, UC: $20 / Visit"	No cost sharing	No cost sharing	10%/Procedure	No cost sharing	No cost sharing	$20/Visit for Cardiac Rehab; $10/Visit for OT and MH/SA	No cost sharing	$10/Visit	$10/Visit	$10/Visit	$10/Visit	No cost sharing	10% / Script	No cost sharing	No cost sharing for 26 one-way trips per year	No cost sharing for preventive services	$10/Visit	No copay up to $300 every two years	$10/Visit	No copay up to $400 every three years	Not covered	No cost sharing	No cost sharing for Fitness Program											2.2083	149.23	30.68		75	0.1	0.1	49.981			0.046			1.2345		10	10	10	10		0.1	10			10		10															0.2753	0.808419689	0.892280897	0	1.973848643	0.662907378	0.666636562	1.59374619	0	0	0.72480865	0	0	0.071844035	0	2.414689448	0.202848509	1.224872178	4.198285046	0	2.209563466	0.434790951	0	0	0.12	0	0.207552955	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.6824	0	0	0.2753	0.808419689	0.892280897	0	1.973848643	0.662907378	0.666636562	1.59374619	0	0	0.72480865	0	0	0.071844035	0	2.414689448	0.202848509	1.224872178	4.198285046	0	2.209563466	0.434790951	0	0	0.12	0	0.207552955	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.6824																																																																																				0	0	0	0.2753	0.808419689	0.892280897	0	1.973848643	0.662907378	0.666636562	1.59374619	0	0	0.72480865	0	0	0.071844035	0	2.414689448	0.202848509	1.224872178	4.198285046	0	2.209563466	0.434790951	0	0	0.12	0	0.207552955	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.6824
H4527_002_0	2008	3																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	V	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1390.326324	26.98654589	431.1684655		399.1342566	6.908596495	5.574561387	297.238235	258.2868357		6.961925134			610.124837		3137.050271	269.0338388	1008.557449	4072.110748		20.9635272	423.4578386			312.7160299		284.5825328															"$150/Day,  days 1-5. $75/day, days 1-5 for IP Rehab"	Medicare Cost Share	"$100/Day, days 11-100"	No cost sharing	$100 / Trip	20% / Item	20% / Item	"ER: $50 / Visit,  UC: $30 / Visit"	$125 / Visist	No cost sharing	20%/Procedure	No cost sharing	No cost sharing	"$25/Visit for OT and MH/SA, $20/Visit for Cardiac Rehab and CORF"	No cost sharing	$25 / Visit	"$25 / Visit, Ind or Grp"	$25 / Visit	$25/Visit	No cost sharing	20% / Script	No cost sharing	No cost sharing for 26 one-way trips per year	No cost sharing for preventive services	$25 / Exam	No copay up to $150 every two years	$25 / Exam	Not covered	Not covered	No cost sharing	Not covered											89.6557	149.23	54.56		100	0.2	0.2	49.9858	125		0.2			2.6853		25	25	25	25		0.2	25			25		25															10.3876	0.335600187	1.96037929	0	3.326118805	1.381719299	1.114912277	1.238140172	2.690487872	0	1.392385027	0	0	0.136529269	0	6.535521399	0.560487164	2.101161352	8.483564059	0	4.19270544	0.88220383	0	0	0.651491729	0	0.592880277	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9638	0	0	10.3876	0.335600187	1.96037929	0	3.326118805	1.381719299	1.114912277	1.238140172	2.690487872	0	1.392385027	0	0	0.136529269	0	6.535521399	0.560487164	2.101161352	8.483564059	0	4.19270544	0.88220383	0	0	0.651491729	0	0.592880277	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9638																																																																																				0	0	0	10.3876	0.335600187	1.96037929	0	3.326118805	1.381719299	1.114912277	1.238140172	2.690487872	0	1.392385027	0	0	0.136529269	0	6.535521399	0.560487164	2.101161352	8.483564059	0	4.19270544	0.88220383	0	0	0.651491729	0	0.592880277	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9638
H4527_003_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	V	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		2167.078109	67.59799174	619.9927054		1750.202812	16.06859791	10.44087111	633.4803821			13.08991261			1128.555288		3957.788422	719.9205598	1163.684968	5390.425134		32.4186738																					"No cost sharing except IP Rehab $75/day, days 1-5"	Medicare Cost Share	$100 / days 11-100	No cost sharing	$100 / Trip	"10% / Item, 0% for diabetic supplies"	"10% / Item, 0% for diabetic supplies"	$50 / Visit	No cost sharing	No cost sharing	"10% for Therapeutic, CT, MRI, Diagonistic, Nuclear Medicine"	No cost sharing	No cost sharing	"$10 / Visit for OT visits, $0 for other"	$0 copay	$10 / Visit	"$10 / Visit, ind or group"	$10 / Visit	$10 on most services	No cost sharing	10% / script	No cost sharing	No cost sharing	Not covered	$0 copay for exam	No copay up to $150 every two years	Not covered	Not covered	Not covered	No cost sharing	Not covered											2.2083	149.23	54.56		100	0.1	0.1	49.9916			0.1			1.055		10	10	10	10		0.1																					0.3988	0.840637359	2.818900167	0	14.58502343	1.606859791	1.044087111	2.639059752	0	0	1.308991261	0	0	0.099221984	0	3.298157018	0.5999338	0.969737474	4.492020945	0	3.24186738	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9433	0	0	0.3988	0.840637359	2.818900167	0	14.58502343	1.606859791	1.044087111	2.639059752	0	0	1.308991261	0	0	0.099221984	0	3.298157018	0.5999338	0.969737474	4.492020945	0	3.24186738	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9433																																																																																				0	0	0	0.3988	0.840637359	2.818900167	0	14.58502343	1.606859791	1.044087111	2.639059752	0	0	1.308991261	0	0	0.099221984	0	3.298157018	0.5999338	0.969737474	4.492020945	0	3.24186738	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9433
H4527_004_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		2349.619859	45.83131286	576.3598956		1450.451534	13.01326417		697.2817284						2.217274468							32.11252418																					No cost sharing except for IP Rehab - $75/Day for Days 1-5	Medicare Cost Share	$100 / days 21-100	No cost sharing	$50 / Trip	"$0 for diabetic suppliers, 10% for other"	$0 Copay	$50 / Visit - $20 UC / Visit	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$20 / Visit for Cardiac Rehab	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	10% / Script	No cost sharing	52 round trips per year / no cost sharing	No cost sharing for preventive services	No copay for exams	No copay up to $300 every 2 years	No cost sharing	No copay up to $800 limit	Not covered	No cost sharing	No cost sharing											2.2083	149.23	30.68		50	0.05		49.9869						20							0.1																					0.4324	0.569950568	1.473560133	0	6.043548057	0.650663208	0	2.904577913	0	0	0	0	0	0.003695457	0	0	0	0	0	0	3.211252418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.2896	0	0	0.4324	0.569950568	1.473560133	0	6.043548057	0.650663208	0	2.904577913	0	0	0	0	0	0.003695457	0	0	0	0	0	0	3.211252418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.2896																																																																																				0	0	0	0.4324	0.569950568	1.473560133	0	6.043548057	0.650663208	0	2.904577913	0	0	0	0	0	0.003695457	0	0	0	0	0	0	3.211252418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.2896
H4527_005_0	2008	6																																D	D	D	V	T	Coin	Coin	V	Coin	P	Coin	V	V	V	V	V	V	V	V	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1721.438432	58.3745818	630.6789228		245.7370724	6.998024918	5.719890302	298.0170844	35.8607086		19.08671771			694.777746		3270.358933	217.6639237	805.6709287	3527.903877		20.90249287	648.7860101			144		249															"$150/Day, days 1-5. $75/day, days 1-5 for IP Rehab"	Medicare Cost Share	$75 / days 11-100	No cost sharing	$100 / Trip	20% / Item	20% / Item	$50/Visit for ER; $30/Visit for UC	20% / Procedure	No cost sharing	20%/Procedure	No cost sharing	No cost sharing	"$25/Visit for OT and MH/SA, $20/Visit for Cardiac Rehab and CORF"	No cost sharing	$25 / Visit	"$25 / Visit, Ind or Grp"	$25 / Visit	$25/Visit	No cost sharing	20% / Script	No cost sharing	Not covered	Not covered	$25 / Exam	Not covered	$25 / Exam	Not covered	Not covered	No cost sharing	Not covered											89.6557	149.23	40.92		100	0.2	0.2	49.9853	0.2		0.2			3.1629		25	25	25	25		0.2	25			25		25															12.8614	0.72593657	2.150615127	0	2.047808936	1.399604984	1.14397806	1.241372882	7.172141719	0	3.817343541	0	0	0.183126439	0	6.813247776	0.453466508	1.678481102	7.349799743	0	4.180498573	1.351637521	0	0	0.3	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3892	0	0	12.8614	0.72593657	2.150615127	0	2.047808936	1.399604984	1.14397806	1.241372882	7.172141719	0	3.817343541	0	0	0.183126439	0	6.813247776	0.453466508	1.678481102	7.349799743	0	4.180498573	1.351637521	0	0	0.3	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3892																																																																																				0	0	0	12.8614	0.72593657	2.150615127	0	2.047808936	1.399604984	1.14397806	1.241372882	7.172141719	0	3.817343541	0	0	0.183126439	0	6.813247776	0.453466508	1.678481102	7.349799743	0	4.180498573	1.351637521	0	0	0.3	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3892
H4527_006_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	V	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		2183.382214	74.03925767	799.9190496		315.8709829	9.98935646	7.220935902	377.9453546			21.60033312			733.2497932		4100.368483	294.0789996	1021.870747	4574.77255		27.27615567						249															"No Cost Sharing, except $75/day days 1-5 for IP Rehab"	Medicare Cost Share	$75 for days 11-100	No cost sharing	$100 / Trip	10% / Item	10% / Item	$50 / Visit	No Cost Sharing	No Cost Sharing	10% for Therapeutic	No cost sharing	No cost sharing	"$10 / Visit for OT visits, $0 for other"	$0 copay	$10 / Visit	$10 / Visit	$10 / Visit	"$10 - MRI, CT, PET"	No cost sharing	"20% for Diab. Items, 20% for rest"	No cost sharing	No cost sharing	Not covered	No cost sharing	No copay up to $300 every two years	$10 / Exam	No copay up to $400 every three years	Not covered	No cost sharing	Not covered											2.2083	149.23	40.92		100	0.1	0.1	49.9865			0.1			1.1765		10	10	10	10		0.2						10															0.4018	0.920739869	2.727723959	0	2.632258191	0.998935646	0.72209359	1.574345972	0	0	2.160033312	0	0	0.071890734	0	3.416973736	0.245065833	0.851558956	3.812310458	0	5.455231134	0	0	0	0	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.1985	0	0	0.4018	0.920739869	2.727723959	0	2.632258191	0.998935646	0.72209359	1.574345972	0	0	2.160033312	0	0	0.071890734	0	3.416973736	0.245065833	0.851558956	3.812310458	0	5.455231134	0	0	0	0	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.1985																																																																																				0	0	0	0.4018	0.920739869	2.727723959	0	2.632258191	0.998935646	0.72209359	1.574345972	0	0	2.160033312	0	0	0.071890734	0	3.416973736	0.245065833	0.851558956	3.812310458	0	5.455231134	0	0	0	0	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.1985
H4527_008_0	2008	3																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		3032.144041	175.8329233	2937.986409		426.084383	25.14326026	20.45488359	421.6587411	348.8606773		18.91315585			2732.187031		5052.98015	676.2252897	874.9421201	30.7288373		30.98527613						249.0661716															$75 per Admit	Medicare Cost Share	$50 for days 11-100	No cost sharing	$100 / Trip	20% / Item	20% / Item	$50 / Visit	$50/Visit	No cost sharing	20% for Therapeutic	No cost sharing	No cost sharing	"$25/Visit for OT, ST, and MH/SA, $50/Visit for Cardiac Rehab"	$0 / visit	"$25/Visit, $10/Visit for Podiatrist"	$25 / Visit	$25 / Visit	"0% for PCP, 20% - MRI, CT, PET for Spec"	No cost sharing	"0% for Diab. Items, 20% for rest"	No cost sharing	No cost sharing	No cost sharing for preventive services	No cost sharing	No copay up to $300 every two years	No cost sharing	No copay up to $400 every three years	Not covered	No cost sharing	1 pair shoes & 3 inserts per year											14.1792	149.23	27.28		100	0.2	0.2	49.9858	50		0.2			4.8575		25	25	25	0.2		0.2						20.0013															3.5828	2.186628928	6.679022436	0	3.550703192	5.028652052	4.090976718	1.756410763	1.453586156	0	3.782631171	0	0	1.105966372	0	10.52704198	1.408802687	1.822796083	6.145767459	0	6.197055225	0	0	0	0	0	0.415137857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.734	0	0	3.5828	2.186628928	6.679022436	0	3.550703192	5.028652052	4.090976718	1.756410763	1.453586156	0	3.782631171	0	0	1.105966372	0	10.52704198	1.408802687	1.822796083	6.145767459	0	6.197055225	0	0	0	0	0	0.415137857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.734																																																																																				0	0	0	3.5828	2.186628928	6.679022436	0	3.550703192	5.028652052	4.090976718	1.756410763	1.453586156	0	3.782631171	0	0	1.105966372	0	10.52704198	1.408802687	1.822796083	6.145767459	0	6.197055225	0	0	0	0	0	0.415137857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.734
H4527_011_0	2008	3																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		2917.805221	169.2024569	2827.19817		410.0172091	23.28276357	18.94130727	405.789252	335.7055245		17.51366098			2629.159261	105	4862.437821	650.725577	841.9490141	28.45503113		28.69249456						249															"$175/Day, days 1-5"	Medicare Cost Share	$100 for days 11-100	No cost sharing	$100 / Trip	20% / Item	20% / Item	$50 / Visit	$150/Visit	No cost sharing	20% for Therapeutic	No cost sharing	No cost sharing	"$40/Visit for OT, ST, and MH/SA, $50/Visit for Cardiac Rehab"	$0 / visit	"$40/Visit, $10/Visit for Podiatrist"	$40/Visit	$40/Visit	"0% for PCP, 20% - MRI, CT, PET for Spec"	No cost sharing	"0% for Diab. Items, 20% for rest"	No cost sharing	Not covered	No cost sharing for preventive services	No cost sharing	No copay up to $300 every two years	No cost sharing	No copay up to $800 every three years	Not covered	No cost sharing	Medical catalogue - $50/qtr; 1 pair shoes & 3 inserts per year											107.8	149.23	54.56		100	0.2	0.2	49.9897	150		0.2			6.3103	10	40	40	40	0.2		0.2						10															26.2116	2.104173554	12.85432768	0	3.416810076	4.656552713	3.788261455	1.690441698	4.196319057	0	3.502732195	0	0	1.382567816	0.0875	16.20812607	2.169085257	2.806496714	5.691006226	0	5.738498911	0	0	0	0	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.712	0	0	26.2116	2.104173554	12.85432768	0	3.416810076	4.656552713	3.788261455	1.690441698	4.196319057	0	3.502732195	0	0	1.382567816	0.0875	16.20812607	2.169085257	2.806496714	5.691006226	0	5.738498911	0	0	0	0	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.712																																																																																				0	0	0	26.2116	2.104173554	12.85432768	0	3.416810076	4.656552713	3.788261455	1.690441698	4.196319057	0	3.502732195	0	0	1.382567816	0.0875	16.20812607	2.169085257	2.806496714	5.691006226	0	5.738498911	0	0	0	0	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.712
H4527_012_0	2008	3																																D	D	D	V	T	Coin	Coin	V	Coin	P	Coin	V	V	V	V	V	V	V	V	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1850	67.39217362	630.7312268		250.1908672	7.490814866	6.122676013	301.002877	38.3859635		20.43077446			694.8768077	4303.245855	3332.746543	221.6090117	821.1967984	3595.628882		22.8023954				144																	"$150/Day, days 1-5."	Medicare Cost Share	$75 / days 11-100	No cost sharing	$100 / Trip	20% / Item	20% / Item	$50/Visit for ER; $30/Visit for UC	20% / Procedure	No cost sharing	20%/Procedure	No cost sharing	No cost sharing	"$30/Visit for OT and MH/SA, $20/Visit for CORF, $20/Visit for Cardiac Rehab"	$5/Visit	$25 / Visit	"$25 / Visit, Ind or Grp"	$25 / Visit	"$5/Visit for PCP, $25 / Visit for Spec"	No cost sharing	20% / Script	No cost sharing	No cost sharing for 26 one-way trips per year	No cost sharing for preventive services	$25 / Exam	No copay up to $150 every two years	Not covered	Not covered	Not covered	No cost sharing	Not covered											92.4	149.23	40.92		100	0.2	0.2	49.9864	0.2		0.2			3.1642	5	25	25	25	25		0.2				25																	14.245	0.838077839	2.150793483	0	2.084923894	1.498162973	1.224535203	1.253837666	7.6771927	0	4.086154891	0	0	0.183227963	1.793019106	6.943221965	0.461685441	1.710826663	7.490893505	0	4.56047908	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.502	0	0	14.245	0.838077839	2.150793483	0	2.084923894	1.498162973	1.224535203	1.253837666	7.6771927	0	4.086154891	0	0	0.183227963	1.793019106	6.943221965	0.461685441	1.710826663	7.490893505	0	4.56047908	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.502																																																																																				0	0	0	14.245	0.838077839	2.150793483	0	2.084923894	1.498162973	1.224535203	1.253837666	7.6771927	0	4.086154891	0	0	0.183227963	1.793019106	6.943221965	0.461685441	1.710826663	7.490893505	0	4.56047908	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.502
H4527_013_0	2008	6																																D	D	D	V	T	Coin	Coin	V	Coin	P	Coin	V	V	V	V	V	V	V	V	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1850	67.39217362	630.7312268		250.1908672	7.490814866	6.122676013	301.002877	38.3859635		20.43077446			694.8768077	4303.245855	3332.746543	221.6090117	821.1967984	3595.628882		22.8023954	661.1893618			144																	"$250/Day, days 1-5."	Medicare Cost Share	$75 / days 11-100	No cost sharing	$100 / Trip	20% / Item	20% / Item	$50/Visit for ER; $30/Visit for UC	20% / Procedure	No cost sharing	20%/Procedure	No cost sharing	No cost sharing	"$40/Visit for OT and MH/SA, $20/Visit for CORF, $40/Visit for Cardiac Rehab"	$10/Visit	$40 / Visit	"$40 / Visit, Ind or Grp"	$40 / Visit	"$0/Visit for PCP, $40 / Visit for Spec"	No cost sharing	20% / Script	No cost sharing	No cost sharing for 26 one-way trips per year	Not covered	$40 / Exam	Not covered	Not covered	Not covered	Not covered	No cost sharing	Not covered											154	149.23	40.92		100	0.2	0.2	49.9864	0.2		0.2			4.6606	10	40	40	40	40		0.2	40			40																	23.7417	0.838077839	2.150793483	0	2.084923894	1.498162973	1.224535203	1.253837666	7.6771927	0	4.086154891	0	0	0.269879622	3.586038213	11.10915514	0.738696706	2.737322661	11.98542961	0	4.56047908	2.203964539	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.2263	0	0	23.7417	0.838077839	2.150793483	0	2.084923894	1.498162973	1.224535203	1.253837666	7.6771927	0	4.086154891	0	0	0.269879622	3.586038213	11.10915514	0.738696706	2.737322661	11.98542961	0	4.56047908	2.203964539	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.2263																																																																																				0	0	0	23.7417	0.838077839	2.150793483	0	2.084923894	1.498162973	1.224535203	1.253837666	7.6771927	0	4.086154891	0	0	0.269879622	3.586038213	11.10915514	0.738696706	2.737322661	11.98542961	0	4.56047908	2.203964539	0	0	0.48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.2263
H4527_014_0	2008	3																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	V	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1850	67.39217362	630.7312268		250.1908672	7.490814866		301.002877	290.1688053		20.43077446			694.8768077	4303.245855	3332.746543	221.6090117	821.1967984	3595.628882		22.8023954				144		249															"$150/Day, days 1-5."	Medicare Cost Share	$75 / days 11-100	No cost sharing	$100 / Trip	$0 diabetic supplies 10% all other	$0 copay	$50/Visit for ER; $30/Visit for UC	$100 / Procedure	No cost sharing	20%/Procedure	No cost sharing	No cost sharing	"$25/Visit for OT and MH/SA, $20/Visit for CORF, $25/Visit for Cardiac Rehab"	$5/Visit	$25 / Visit	"$25 / Visit, Ind or Grp"	$25 / Visit	"$5/Visit for PCP, $25 / Visit for Spec"	No cost sharing	20% / Script	No cost sharing	No cost sharing for 26 one-way trips per year	No cost sharing for preventive services	$25 / Exam	No copay up to $300 every two years	$25 / Exam	No copay up to $400 every three years	Not covered	No cost sharing	Medical catalogue - $50/qtr											92.4	149.23	40.92		100	0.1		49.9864	100		0.2			3.1642	5	25	25	25	25		0.2				25		25															14.245	0.838077839	2.150793483	0	2.084923894	0.749081487	0	1.253837666	2.418073378	0	4.086154891	0	0	0.183227963	1.793019106	6.943221965	0.461685441	1.710826663	7.490893505	0	4.56047908	0	0	0	0.3	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.788	0	0	14.245	0.838077839	2.150793483	0	2.084923894	0.749081487	0	1.253837666	2.418073378	0	4.086154891	0	0	0.183227963	1.793019106	6.943221965	0.461685441	1.710826663	7.490893505	0	4.56047908	0	0	0	0.3	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.788																																																																																				0	0	0	14.245	0.838077839	2.150793483	0	2.084923894	0.749081487	0	1.253837666	2.418073378	0	4.086154891	0	0	0.183227963	1.793019106	6.943221965	0.461685441	1.710826663	7.490893505	0	4.56047908	0	0	0	0.3	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.788
H4527_015_0	2008	3																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		2350	85.4696099	799.9190496		321.4936279	10.69190458	7.728781922	381.7036447			23.11947737			733.312221		4178.243723	299.0495642	1041.476573	21.74665375		29.75291578																					"$150/day, days 1-5"	Medicare Cost Share	$75 for days 11-100	No cost sharing	$100 / Trip	20% / Item	20% / Item	$50 / Visit	No Cost Sharing	No Cost Sharing	20% for Therapeutic	No cost sharing	No cost sharing	"$10 / Visit for OT visits, $0 for other"	$0 copay	$10 / Visit	$10 / Visit	$10 / Visit	"$10 - MRI, CT, PET"	No cost sharing	"20% for Diab. Items, 20% for rest"	No cost sharing	No cost sharing	Not covered	No cost sharing	Not covered	Not covered	Not covered	Not covered	No cost sharing	Not covered											92.4	149.23	40.92		100	0.2	0.2	49.9875			0.2			1.1773		10	10	10	0.17865613		0.2																					18.095	1.062885824	2.727723959	0	2.679113566	2.138380915	1.545756384	1.590033528	0	0	4.623895474	0	0	0.071942757	0	3.481869769	0.24920797	0.867897144	3.885172995	0	5.950583155	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9695	0	0	18.095	1.062885824	2.727723959	0	2.679113566	2.138380915	1.545756384	1.590033528	0	0	4.623895474	0	0	0.071942757	0	3.481869769	0.24920797	0.867897144	3.885172995	0	5.950583155	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9695																																																																																				0	0	0	18.095	1.062885824	2.727723959	0	2.679113566	2.138380915	1.545756384	1.590033528	0	0	4.623895474	0	0	0.071942757	0	3.481869769	0.24920797	0.867897144	3.885172995	0	5.950583155	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9695
H4527_016_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1850.066652	65.92915854	630.9456937		245.4671062	7.432435488	6.074959173	320.4183508			19.73373056			676.7453777		3271.742262	217.4375705	806.0117195	21.12381412		22.20003952				144																	No cost sharing except for IP Rehab - $75/Day for Days 1-5	Medicare Cost Share	$75 / Days 11-100	No cost sharing	$100 / Trip	20% / Item	20% / Item	"ER: $50 / Visit, UC: $30 / Visit"	No cost sharing	No cost sharing	20%/Procedure	No cost sharing	No cost sharing	$20/Visit for Cardiac Rehab and CORF; $10/Visit for OT and MH/SA	No cost sharing	$10/Visit	$10/Visit	$10/Visit	"$0/Visit for PCP, $10/Visit for Spec"	No cost sharing	20% / Script	No cost sharing	Not covered	Not covered	$10/Visit	No copay up to $150 every two years	Not covered	Not covered	Not covered	No cost sharing	Not covered											2.2083	149.23	40.92		100	0.2	0.2	49.9871			0.2			1.668		10	10	10	0.139234488		0.2				10																	0.3405	0.819884027	2.151524816	0	2.045559218	1.486487098	1.214991835	1.334732678	0	0	3.946746111	0	0	0.094068305	0	2.726451885	0.181197975	0.671676433	2.941163454	0	4.440007905	0	0	0	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.515	0	0	0.3405	0.819884027	2.151524816	0	2.045559218	1.486487098	1.214991835	1.334732678	0	0	3.946746111	0	0	0.094068305	0	2.726451885	0.181197975	0.671676433	2.941163454	0	4.440007905	0	0	0	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.515																																																																																				0	0	0	0.3405	0.819884027	2.151524816	0	2.045559218	1.486487098	1.214991835	1.334732678	0	0	3.946746111	0	0	0.094068305	0	2.726451885	0.181197975	0.671676433	2.941163454	0	4.440007905	0	0	0	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.515
H4527_017_0	2008	3																																D	D	D	V	T	Coin	Coin	V	Coin	P	Coin	V	V	V	V	V	V	V	V	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1850	65.92678334	630.9229629		245.4582629	7.431899968	6.074521461	320.4068369	37.07310464		19.7323087			676.7209968	4224.340747	3271.624392	217.429737	805.9826817	3529.268993		22.19843997				144																	"$200/Day, days 1-5"	Medicare Cost Share	$75 / days 11-100	No cost sharing	$100 / Trip	20% / Item	20% / Item	$50/Visit for ER; $30/Visit for UC	20% / Procedure	No cost sharing	20%/Procedure	No cost sharing	No cost sharing	"$30/Visit for OT and MH/SA, $20/Visit for Cardiac Rehab and CORF"	$10/Visit	$30 / Visit	"$30 / Visit, Ind or Grp"	$30 / Visit	"$0/Visist for PCP, $30/Visit for Spec"	No cost sharing	20% / Script	No cost sharing	Not covered	Not covered	$30 / Exam	Not covered	Not covered	Not covered	Not covered	No cost sharing	Not covered											122.4853	149.23	40.92		100	0.2	0.2	49.9871	0.2		0.2			3.6637	10	30	30	30	30		0.2				30																	18.8832	0.81985449	2.151447304	0	2.045485524	1.486379994	1.214904292	1.334684692	7.414620928	0	3.946461741	0	0	0.206607317	3.520283956	8.179060981	0.543574343	2.014956704	8.823172483	0	4.439687994	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3843	0	0	18.8832	0.81985449	2.151447304	0	2.045485524	1.486379994	1.214904292	1.334684692	7.414620928	0	3.946461741	0	0	0.206607317	3.520283956	8.179060981	0.543574343	2.014956704	8.823172483	0	4.439687994	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3843																																																																																				0	0	0	18.8832	0.81985449	2.151447304	0	2.045485524	1.486379994	1.214904292	1.334684692	7.414620928	0	3.946461741	0	0	0.206607317	3.520283956	8.179060981	0.543574343	2.014956704	8.823172483	0	4.439687994	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3843
H4527_018_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	V	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1849.700651	65.9161157	630.820873		245.4185452	7.429495045	6.072555778	320.3551253			19.72592344			676.6114963	4328.657205	3271.095009	217.3945546	805.8522653	3528.697921		22.19125667				144		249															"$75/day, days 1-5 IP Rehab, $0 copay for all other admissions"	Medicare Cost Share	$75 / days 11-100	No cost sharing	$100 / Trip	20% / Item	20% / Item	$50/Visit for ER; $30/Visit for UC	$0  copay	No cost sharing	20%/Procedure	No cost sharing	No cost sharing	"$25/Visit for OT and MH/SA, $20/Visit for Cardiac Rehab and CORF"	$5/Visit	$25 / Visit	"$25 / Visit, Ind or Grp"	$25 / Visit	"$0/Visist for PCP, $25/Visit for Spec"	No cost sharing	20% / Script	No cost sharing	Not covered	Not covered	$25 / Exam	No copay up to $300 every two year	$25 / Exam	No copay up to $400 every three years	Not covered	No cost sharing	Medical catalogue - $100/qtr											2.21	149.23	40.92		100	0.2	0.2	49.9871			0.2			3.1648	5	25	25	25	25		0.2				25		25															0.3407	0.819721829	2.151099177	0	2.045154543	1.485899009	1.214511156	1.334469171	0	0	3.945184687	0	0	0.178442838	1.803607169	6.81478127	0.452905322	1.678858886	7.351454001	0	4.438251335	0	0	0	0.3	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.8737	0	0	0.3407	0.819721829	2.151099177	0	2.045154543	1.485899009	1.214511156	1.334469171	0	0	3.945184687	0	0	0.178442838	1.803607169	6.81478127	0.452905322	1.678858886	7.351454001	0	4.438251335	0	0	0	0.3	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.8737																																																																																				0	0	0	0.3407	0.819721829	2.151099177	0	2.045154543	1.485899009	1.214511156	1.334469171	0	0	3.945184687	0	0	0.178442838	1.803607169	6.81478127	0.452905322	1.678858886	7.351454001	0	4.438251335	0	0	0	0.3	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.8737
H4527_019_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		2350	83.58874184	799.9478671		315.2974621	10.60497161	7.665941297	406.2035164			22.32311149			701.9453784		4100.516201	293.1960338	1033.930391	21.16531687		28.95710626						249															"No Cost Sharing, except $75/day days 1-5 for IP Rehab"	Medicare Cost Share	$75 for days 11-100	No cost sharing	$100 / Trip	10% / Item	10% / Item	$50 / Visit	No Cost Sharing	No Cost Sharing	20% for Therapeutic	No cost sharing	No cost sharing	"$10 / Visit for OT visits, $0 for other"	$0 copay	$10 / Visit	$10 / Visit	$10 / Visit	"$10 - MRI, CT, PET"	No cost sharing	"20% for Diab. Items, 20% for rest"	No cost sharing	Not covered	No cost sharing for preventive services	No cost sharing	No copay up to $300 every two years	$10 / Exam	No copay up to $400 every three years	Not covered	No cost sharing	Medical catalogue - $50/qtr											2.2083	149.23	40.92		100	0.1	0.1	49.9881			0.2			1.1806		10	10	10	0.180127131		0.2						10															0.4325	1.039495662	2.727822227	0	2.62747885	1.060497161	0.76659413	1.692113047	0	0	4.464622298	0	0	0.069061999	0	3.417096834	0.244330028	0.861608659	3.812447799	0	5.791421251	0	0	0	0	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.2146	0	0	0.4325	1.039495662	2.727822227	0	2.62747885	1.060497161	0.76659413	1.692113047	0	0	4.464622298	0	0	0.069061999	0	3.417096834	0.244330028	0.861608659	3.812447799	0	5.791421251	0	0	0	0	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.2146																																																																																				0	0	0	0.4325	1.039495662	2.727822227	0	2.62747885	1.060497161	0.76659413	1.692113047	0	0	4.464622298	0	0	0.069061999	0	3.417096834	0.244330028	0.861608659	3.812447799	0	5.791421251	0	0	0	0	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.2146
H4527_020_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1495.973296	65.00727916	349.0016546		315.8157829	6.629073775		382.6444537						8.177079457		24.87164543					22.09563466																					No cost sharing except for IP Rehab - $75/Day for Days 1-5	Medicare Cost Share	$100 / Days 21-100	No cost sharing	$75 / Trip	10% / Item	No cost sharing	"ER: $50 / Visit, UC: $20 / Visit"	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$20 / Visit for Cardiac Rehab	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	10% / Script	No cost sharing	No cost sharing for 26 one-way trips per year	No cost sharing for preventive services	No cost sharing	No copay up to $300 every two years	No cost sharing	No copay up to $400 every three years	Not covered	No cost sharing	"No cost sharing for Fitness Program, 4 home attendant visit per month, and $100 per quarter for Medical catalogue"											2.2083	149.23	30.68		75	0.1		49.981						20		10					0.1																					0.2753	0.808419689	0.892280897	0	1.973848643	0.662907378	0	1.59374619	0	0	0	0	0	0.013628466	0	0.020726371	0	0	0	0	2.209563466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.4504	0	0	0.2753	0.808419689	0.892280897	0	1.973848643	0.662907378	0	1.59374619	0	0	0	0	0	0.013628466	0	0.020726371	0	0	0	0	2.209563466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.4504																																																																																				0	0	0	0.2753	0.808419689	0.892280897	0	1.973848643	0.662907378	0	1.59374619	0	0	0	0	0	0.013628466	0	0.020726371	0	0	0	0	2.209563466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.4504
H4527_022_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1390.326324	26.98654589	431.1684655		399.1342566	6.908596495	5.574561387	297.238235			6.961925134			610.1859664		3137.050271	269.08043	960.4511346	35.59451566		20.9635272				144																	No cost sharing except for IP Rehab - $75/Day for Days 1-5	Medicare Cost Share	$100 / Days 11-100	No cost sharing	$100 / Trip	10% / Item	10% / Item	"ER: $50 / Visit, UC: $30 / Visit"	No cost sharing	No cost sharing	10%/Procedure	No cost sharing	No cost sharing	$20/Visit for Cardiac Rehab; $10/Visit for OT and MH/SA	No cost sharing	$10/Visit	$10/Visit	$10/Visit	"$0/Visit for PCP, $10/Visit for Spec"	No cost sharing	20% / Script	No cost sharing	No cost sharing for 26 one-way trips per year	No cost sharing for preventive services	$10/Visit	No copay up to $300 every two years	No cost sharing	No copay up to $400 every three years	Not covered	No cost sharing	Not covered											2.2083	149.23	54.56		100	0.1	0.1	49.9858			0.1			1.1775		10	10	10	0.095335631		0.2				10																	0.2559	0.335600187	1.96037929	0	3.326118805	0.690859649	0.557456139	1.238140172	0	0	0.696192513	0	0	0.059877036	0	2.61420856	0.224233692	0.800375945	3.393425624	0	4.19270544	0	0	0	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.4654	0	0	0.2559	0.335600187	1.96037929	0	3.326118805	0.690859649	0.557456139	1.238140172	0	0	0.696192513	0	0	0.059877036	0	2.61420856	0.224233692	0.800375945	3.393425624	0	4.19270544	0	0	0	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.4654																																																																																				0	0	0	0.2559	0.335600187	1.96037929	0	3.326118805	0.690859649	0.557456139	1.238140172	0	0	0.696192513	0	0	0.059877036	0	2.61420856	0.224233692	0.800375945	3.393425624	0	4.19270544	0	0	0	0.12	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.4654
H4527_023_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1380.908692	26.80374755	428.2478663		396.430647	6.815320173		295.227702			6.867928797			5.085337264		4.94281655					20.68048843																					No cost sharing except for IP Rehab - $75/Day for Days 1-5	Medicare Cost Share	$100 / Days 11-100	No cost sharing	$75 / Trip	$0 diabetic supplies 10% all other	No cost sharing	"ER: $50 / Visit, UC: $30 / Visit"	No cost sharing	No cost sharing	10% / Radiation Therapy	No cost sharing	No cost sharing	$20/Visit for Cardiac Rehab	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	20% / Script	No cost sharing	No cost sharing for 26 one-way trips per year	No cost sharing for preventive services	No cost sharing	No copay up to $300 every two years	No cost sharing	No copay up to $400 every three years	Not covered	No cost sharing	Medical catalogue - $100/qtr											2.2083	149.23	54.56		75	0.1		49.9857			0.014			20		10					0.2																					0.2541	0.333326937	1.947100299	0	2.477691544	0.681532017	0	1.229762952	0	0	0.096151003	0	0	0.008475562	0	0.004119014	0	0	0	0	4.136097685	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.1684	0	0	0.2541	0.333326937	1.947100299	0	2.477691544	0.681532017	0	1.229762952	0	0	0.096151003	0	0	0.008475562	0	0.004119014	0	0	0	0	4.136097685	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.1684																																																																																				0	0	0	0.2541	0.333326937	1.947100299	0	2.477691544	0.681532017	0	1.229762952	0	0	0.096151003	0	0	0.008475562	0	0.004119014	0	0	0	0	4.136097685	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.1684
H4527_024_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1721.438432	58.3745818	630.6789228		245.7370724	6.998024918	5.719890302	298.0170844	290.1447428		19.08671771			694.777746		3270.358933	217.6639237	805.6709287	19.88917062		20.90249287				144		249															"$50/Day, days 1-5; $75/Day, days 1-5"	Medicare Cost Share	$75 / days 11-100	No cost sharing	$100 / Trip	20% / Item	20% / Item	"$50/Visit for ER, $30/Visit for UC"	$50/Visit	No cost sharing	20%/Procedure	No cost sharing	No cost sharing	"$10/Visit for OT and MH/SA, $20/Visit for Cardiac Rehab,  and $10/Visit for CORF"	No cost sharing	$10 / Visit	"$10 / Visit, Ind or Grp"	$10 / Visit	"$0/Visit for PCP, $10/Visit for Spec"	No cost sharing	20% / Script	No cost sharing	No cost sharing for 26 one-way trips per year	Not covered	$10 / Exam	No copay up to $300 every two year	$10 / Exam	No copay up to $400 every three years	Not covered	No cost sharing	Not covered											31.3574	149.23	40.92		100	0.2	0.2	49.9853	50		0.2			1.6339		10	10	10	0.147815108		0.2				10		10															4.4983	0.72593657	2.150615127	0	2.047808936	1.399604984	1.14397806	1.241372882	1.208936428	0	3.817343541	0	0	0.09460172	0	2.72529911	0.181386603	0.671392441	2.939919897	0	4.180498573	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.3545	0	0	4.4983	0.72593657	2.150615127	0	2.047808936	1.399604984	1.14397806	1.241372882	1.208936428	0	3.817343541	0	0	0.09460172	0	2.72529911	0.181386603	0.671392441	2.939919897	0	4.180498573	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.3545																																																																																				0	0	0	4.4983	0.72593657	2.150615127	0	2.047808936	1.399604984	1.14397806	1.241372882	1.208936428	0	3.817343541	0	0	0.09460172	0	2.72529911	0.181386603	0.671392441	2.939919897	0	4.180498573	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.3545
H4528_001_0	2008	3																																D	Coin	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	P	V	Coin	V	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		1717.132494	3.813150618	19.32911093		184.6519008	11.70077838	17.36201254	183.8051225	249.1888903		249.0893881	25.12737781	0.33899093	217.3454909		4377.705533	249.93883	477.3931613			22.64279402	819.4523981																				"#1A $125/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $35"	"#9A $150, #9B $100"	#8A $0	"#8B $15 x-ray, $100 complex radiology"	#9A $150	#12 20%	"#3 20%, #5 20%, #9A $150, #9C 20%, #9D $35"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $35, #7D $35, #7F $35, #7G $35"	"#7E $35, #7H $35"	"#7C $35, #7I $35"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0, #17A $35, #17B $0, #18A $0"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	#18A $0 n/c	#18B $0	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											77	0.070536303	0.211989085		50	0.2	0.2	48.5016	123.5073		58.3513	150	0.2	146.745		35	35	35			0.2	35																				11.0183	0.268965546	4.097560542	0	0.76938292	2.340155675	3.472402508	0.742903627	2.564721608	0	1.2112245	0.314092223	0.067798186	2.657863892	0	12.7683078	0.728988254	1.39239672	0	0	4.528558803	2.390069495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.3337	0	0	11.0183	0.268965546	4.097560542	0	0.76938292	2.340155675	3.472402508	0.742903627	2.564721608	0	1.2112245	0.314092223	0.067798186	2.657863892	0	12.7683078	0.728988254	1.39239672	0	0	4.528558803	2.390069495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.3337																																																																																				0	0	0	11.0183	0.268965546	4.097560542	0	0.76938292	2.340155675	3.472402508	0.742903627	2.564721608	0	1.2112245	0.314092223	0.067798186	2.657863892	0	12.7683078	0.728988254	1.39239672	0	0	4.528558803	2.390069495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.3337
H4528_002_0	2008	4																																A	Coin	Coin	V	Coin	Coin	Coin	V	Coin	V	Coin	Coin	Coin	Coin	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		348.1661529	19.49240107	31.00495527		13.22676773	27.21262221	30.27489065	408.0756991	28.6333067		9.116706192	1.936151138	8.002414068	18.41244914							22.22896734	0.304658327																				#1A $500	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A 20%	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $0"	"#9A 20%, #9B $0"	#8A 0%	"#8B 0%/x-ray, 20%/complex radiology"	#9A 20%	#12 20%	"#3 20%, #5 20%, #9A 20%, #9C 0%/x-ray, 20%-complex rad, #9D $0"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $0, #7D $0, #7F $0, #7G $0"	"#7E $0, #7H $0"	"#7C $0, #7I $0"		"#14I $0 , #14J $0"	#15 20%	"#13A 20%, #16B 20%, #17A $0, #17B 20%, #18A 20%"	#10B $0	#16A $0	#17A $0	#17B $0	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											500	0.070660418	0.213737585		0.206	0.206	0.206	45.0029	0.206		0.206	0.206	0.206	0.206							0.206	0.206																				14.5069	1.3773412	6.62692427	0	2.724714152	5.605800174	6.236627474	1.530381238	5.898461181	0	1.878041476	0.398847134	1.648497298	3.792964524	0	0	0	0	0	0	4.579167273	0.062759615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.8675	0	0	14.5069	1.3773412	6.62692427	0	2.724714152	5.605800174	6.236627474	1.530381238	5.898461181	0	1.878041476	0.398847134	1.648497298	3.792964524	0	0	0	0	0	0	4.579167273	0.062759615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.8675																																																																																				0	0	0	14.5069	1.3773412	6.62692427	0	2.724714152	5.605800174	6.236627474	1.530381238	5.898461181	0	1.878041476	0.398847134	1.648497298	3.792964524	0	0	0	0	0	0	4.579167273	0.062759615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.8675
H4528_005_0	2008	4																																D	Coin	Coin	V	T	Coin	Coin	V	V	V	Coins	V	Coin	V	V	V	V	V	P	V	Coin	V	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		1687.121427	3.717473036	18.8443659		181.4246597	11.29535338	16.84189667	180.5976554	244.8337083		244.7359451	24.68821577	0.329610643	213.5468498		4301.194481	245.570541	469.0495546			21.8582347	805.1304743																				"#1A $50/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $35"	"#9A $100, #9B $50"	#8A $0	"#8B $10 x-ray, $50 complex radiology"	#9A $100	#12 20%	"#3 20%, #5 20%, #9A $100, #9C 20%, #9D $20"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $20, #7D $20, #7F $20, #7G $20"	"#7E $20, #7H $20"	"#7C $20, #7I $20"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0, #17A $20, #17B $0, #18A $20"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											30.8	0.0726	0.2065		50	0.2	0.2	48.5016	73.5073		30.4006	100	0.2	99.0423		20	20	20			0.2	20																				4.3303	0.269888542	3.891361558	0	0.755936082	2.259070676	3.368379334	0.729940306	1.499756409	0	0.620010374	0.205735131	0.065922129	1.762513617	0	7.168657468	0.409284235	0.781749258	0	0	4.37164694	1.341884124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.832	0	0	4.3303	0.269888542	3.891361558	0	0.755936082	2.259070676	3.368379334	0.729940306	1.499756409	0	0.620010374	0.205735131	0.065922129	1.762513617	0	7.168657468	0.409284235	0.781749258	0	0	4.37164694	1.341884124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.832																																																																																				0	0	0	4.3303	0.269888542	3.891361558	0	0.755936082	2.259070676	3.368379334	0.729940306	1.499756409	0	0.620010374	0.205735131	0.065922129	1.762513617	0	7.168657468	0.409284235	0.781749258	0	0	4.37164694	1.341884124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.832
H4528_006_0	2008	4																																A	Coin	Coin	V	T	Coin	Coin	V	V	V	Coin	V	Coin	Coin	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		344.8487364	19.31204733	30.71817397		396.1853364	26.69651507	29.81348935	404.1896105			9.032353729		7.928371609	0.080459133							21.80737884	0.259744488																				#1A $500	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $0"	"#9A $0, #9B $0"	#8A 0%	"#8B 0%/x-ray, 20%-complex rad"	#9A $0	#12 20%	"#3 20%, #5 20%, #9A $0, #9C 20%, #9D $0"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $0, #7D $0, #7F $0, #7G $0"	"#7E $0, #7H $0"	"#7C $0, #7I $0"		"#14I $0 , #14J $0"	#15 20%	"#13A 20%, #16B $0, #17A $0, #17B $0, #18A $0"	#10B $0	#16A $0	#17A $0	#17B $0	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											500	0.0726	0.2065		50	0.2	0.2	45.0029			0.2		0.2	0.2							0.2	0.2																				14.3687	1.402054636	6.343302926	0	1.650772235	5.339303014	5.962697869	1.515808379	0	0	1.806470746	0	1.585674322	0.016091827	0	0	0	0	0	0	4.361475768	0.051948898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4043	0	0	14.3687	1.402054636	6.343302926	0	1.650772235	5.339303014	5.962697869	1.515808379	0	0	1.806470746	0	1.585674322	0.016091827	0	0	0	0	0	0	4.361475768	0.051948898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4043																																																																																				0	0	0	14.3687	1.402054636	6.343302926	0	1.650772235	5.339303014	5.962697869	1.515808379	0	0	1.806470746	0	1.585674322	0.016091827	0	0	0	0	0	0	4.361475768	0.051948898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4043
H4528_007_0	2008	2																																D	Coin	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	P	V	Coin	V	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		1717.136549	3.813168628	19.32920218		184.6523369	11.70083364	17.36209455	183.8055556	249.1894787		249.0899763	25.12743715	0.338992531	217.3460042		4377.715871	249.9394202	477.3942887			22.64290096	819.4543334																				"#1A $125/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $35"	"#9A $150, #9B $100"	#8A $0	"#8B $15 x-ray, $100 complex radiology"	#9A $150	#12 20%	"#3 20%, #5 20%, #9A $150, #9C 20%, #9D $35"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $35, #7D $35, #7F $35, #7G $35"	"#7E $35, #7H $35"	"#7C $35, #7I $35"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0, #17A $35, #17B $0, #18A $0"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	#18A $0	#18B $0	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											77	0.070536267	0.211988588		50	0.2	0.2	48.5016	123.5073		58.3513	150	0.2	146.745		35	35	35			0.2	35																				11.0183	0.268966679	4.097570283	0	0.769384737	2.340166729	3.47241891	0.742905377	2.564727665	0	1.211227361	0.314092964	0.067798506	2.657870339	0	12.76833796	0.728989976	1.392400009	0	0	4.528580193	2.390075139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.3338	0	0	11.0183	0.268966679	4.097570283	0	0.769384737	2.340166729	3.47241891	0.742905377	2.564727665	0	1.211227361	0.314092964	0.067798506	2.657870339	0	12.76833796	0.728989976	1.392400009	0	0	4.528580193	2.390075139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.3338																																																																																				0	0	0	11.0183	0.268966679	4.097570283	0	0.769384737	2.340166729	3.47241891	0.742905377	2.564727665	0	1.211227361	0.314092964	0.067798506	2.657870339	0	12.76833796	0.728989976	1.392400009	0	0	4.528580193	2.390075139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.3338
H4528_008_0	2008	3																																D	Coin	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	P	V	Coin	V	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		1687.121427	3.717473036	18.8443659		181.4246597	11.29535338	16.84189667	180.5976554	244.8337083		244.7359451	24.68821577	0.329610643	213.5468498		4301.194481	245.570541	469.0495546			21.8582347	805.1304743																				"#1A $50/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $35"	"#9A $100, #9B $50"	#8A $0	"#8B $10 x-ray, $50 complex radiology"	#9A $100	#12 20%	"#3 20%, #5 20%, #9A $100, #9C 20%, #9D $20"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $20, #7D $20, #7F $20, #7G $20"	"#7E $20, #7H $20"	"#7C $20, #7I $20"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0, #17A $20, #17B $0, #18A $0"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	#18A $0	#18B $0	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											30.8	0.0726	0.2065		50	0.2	0.2	48.5016	73.5073		30.4006	100	0.2	99.0423		20	20	20			0.2	20																				4.3303	0.269888542	3.891361558	0	0.755936082	2.259070676	3.368379334	0.729940306	1.499756409	0	0.620010374	0.205735131	0.065922129	1.762513617	0	7.168657468	0.409284235	0.781749258	0	0	4.37164694	1.341884124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.832	0	0	4.3303	0.269888542	3.891361558	0	0.755936082	2.259070676	3.368379334	0.729940306	1.499756409	0	0.620010374	0.205735131	0.065922129	1.762513617	0	7.168657468	0.409284235	0.781749258	0	0	4.37164694	1.341884124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.832																																																																																				0	0	0	4.3303	0.269888542	3.891361558	0	0.755936082	2.259070676	3.368379334	0.729940306	1.499756409	0	0.620010374	0.205735131	0.065922129	1.762513617	0	7.168657468	0.409284235	0.781749258	0	0	4.37164694	1.341884124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.832
H4528_009_0	2008	2																																D	Coin	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	P	V	Coin	V	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		1983.347978	4.416982856	22.38839265		213.2793919	13.55365751	20.11137755	212.2702711	287.8218678		287.7069393	29.02299861	0.392671907	251.0416299		5056.402723	288.6880744	551.4057678			26.22839825	946.4961282																				"#1A $125/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $35"	"#9A $150, #9B $100"	#8A $0	"#8B $15 x-ray, $100 complex radiology"	#9A $150	#12 20%	"#3 20%, #5 20%, #9A $150, #9C 20%, #9D $35"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $35, #7D $35, #7F $35, #7G $35"	"#7E $35, #7H $35"	"#7C $35, #7I $35"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0, #17A $35, #17B $0, #18A $35"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											77	0.070492479	0.211391734		50	0.2	0.2	48.5014	123.5073		58.3513	150	0.2	146.7564		35	35	35			0.2	35																				12.7265	0.31136407	4.732721141	0	0.888664133	2.710731501	4.022275511	0.857950199	2.962342996	0	1.399006584	0.362787483	0.078534381	3.070163817	0	14.74784128	0.842006884	1.608266823	0	0	5.245679649	2.760613707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3274	0	0	12.7265	0.31136407	4.732721141	0	0.888664133	2.710731501	4.022275511	0.857950199	2.962342996	0	1.399006584	0.362787483	0.078534381	3.070163817	0	14.74784128	0.842006884	1.608266823	0	0	5.245679649	2.760613707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3274																																																																																				0	0	0	12.7265	0.31136407	4.732721141	0	0.888664133	2.710731501	4.022275511	0.857950199	2.962342996	0	1.399006584	0.362787483	0.078534381	3.070163817	0	14.74784128	0.842006884	1.608266823	0	0	5.245679649	2.760613707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3274
H4528_010_0	2008	3																																D	Coin	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	P	V	Coin	V	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		1943.098471	4.281503428	21.70199383		208.9511598	13.00913114	19.39721892	207.9685988	281.9808916		281.8682954	28.43401402	0.379620534	245.9470615		4953.789506	282.8295196	540.215694			25.17465652	927.2882015																				"#1A $50/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $35"	"#9A $100, #9B $50"	#8A $0	"#8B $10 x-ray, $50 complex radiology"	#9A $100	#12 20%	"#3 20%, #5 20%, #9A $100, #9C 20%, #9D $20"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $20, #7D $20, #7F $20, #7G $20"	"#7E $20, #7H $20"	"#7C $20, #7I $20"		"#14I $0 , #14J 20%"	#15 20%	"#13A $0, #16B $0, #17A $20, #17B $0, #18A $20"	#10B $0 n/c	#16A $0	#17A $0	#17B $0	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0	"#13B $0 n/c , #13C $0"											30.8	0.0726	0.2065		50	0.2	0.2	48.5014	73.5073		30.4006	100	0.2	99.0423		20	20	20			0.2	20																				4.9873	0.310837149	4.481461725	0	0.870629833	2.601826227	3.879443785	0.840564536	1.727305657	0	0.714080913	0.236950117	0.075924107	2.029929477	0	8.256315843	0.471382533	0.90035949	0	0	5.034931303	1.545480336	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9647	0	0	4.9873	0.310837149	4.481461725	0	0.870629833	2.601826227	3.879443785	0.840564536	1.727305657	0	0.714080913	0.236950117	0.075924107	2.029929477	0	8.256315843	0.471382533	0.90035949	0	0	5.034931303	1.545480336	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9647																																																																																				0	0	0	4.9873	0.310837149	4.481461725	0	0.870629833	2.601826227	3.879443785	0.840564536	1.727305657	0	0.714080913	0.236950117	0.075924107	2.029929477	0	8.256315843	0.471382533	0.90035949	0	0	5.034931303	1.545480336	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9647
H4529_002_0	2008	8																					3500											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1587.700804	0	163.3851027	323.2093794	110.8556483	8.045194957	5.193595258	280.6842101	190.9554352	0	39.5255939	1.415039307	0.930570973	23.52549699	3502.139065	3450.422937	71.74554217	526.1339759	0	0	0	0	0	0	144	0	116.9863465	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 125 days 1-5	1b 200 days 1-5	2a 30 days 11-100;2a2 0 copay	6a 10 copay	10a 125 copay	11a 20% coin	11b 10% coin;11c 10% coin	4a 50 copay;4b 30 copay	9b 400 copay	8a 0 coin	8b 20% coin; 8b 20% coin	9a 15% coin	12 20% coin	3 10 copay;5 45 copay;9a 15% coin;9c 25 copay;9a 20% coin	7a 7 copay;14c 0 copay;	7b 10 copay;7b1  copay;7d 25 copay;;7f 25 copay	7e 45 copay	7c 15 copay;7i 10 copay			20%	14j 0% coin;16b 25 copay;17a 25 copay			17a1 25 copay	17b1 70 allowance	18a1 25 copay															66.88441289	0	13.38081824	8.686495021	108.5811878	0.1737299	0.08686495	43.36627867	347.4598009	0	0.1737299	0.130297425	0.1737299	0.143841251	6.080546515	21.65866305	39.0892276	9.107658416	0	0	0	0	0	0	25	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.8494	0	0.18218553	0.233963055	1.00306983	1.397690919	0.451141394	1.014352473	5.529111457	0	6.866777493	0.184375978	0.161668002	3.383936908	1.774576624	6.227628982	0.233706486	0.399320711	0	0	0	0	0	0	0.3	0	0.243721555	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4366		5.729690698	8.8494	0	0.18218553	0.233963055	1.00306983	1.397690919	0.451141394	1.014352473	5.529111457	0	6.866777493	0.184375978	0.161668002	3.383936908	1.774576624	6.227628982	0.233706486	0.399320711	0	0	0	0	0	0	0.3	0	0.243721555	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4366																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	8.8494	0	0.18218553	0.233963055	1.00306983	1.397690919	0.451141394	1.014352473	5.529111457	0	6.866777493	0.184375978	0.161668002	3.383936908	1.774576624	6.227628982	0.233706486	0.399320711	0	0	0	0	0	0	0.3	0	0.243721555	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4366
H4529_004_0	2008	7																					5100											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1969.462582	70.91109766	157.9631075	1286.30609	156.2854922	5.890224768	4.295216893	510.560704	175.6411488	0	28.00146829	1.700209679	0.344876252	18.37034266	2513.95163	3832.565466	186.9602454	483.6942688	0	0	6.320715706	168.5745799	0	0	144	0	0.005908219	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 160 days 1-5	1b 260 days 1-5	2a 50 days 11-100;2a2  copay	6a 15 copay	10a 140 copay	11a 20% coin	11b 10% coin;11c 10% coin	4a 50 copay;4b 30 copay	9b 500 copay	8a 0 coin	8b 15% coin; 8b 20% coin	9a 15% coin	12 20% coin	3 30 copay;5 50 copay;9a 15% coin;9c 50 copay;9a 20% coin	7a 10 copay;14c 0 copay;	7b 20 copay;7b1  copay;7d 32 copay;;7f 32 copay	7e 50 copay	7c 30 copay;7i 30 copay			RX 20% coin	14j 0% coin;16b 32 copay;17a 32 copay			17a1 25 copay	17b1 70 allowance	18a1 25 copay															88.09515524	143.1546273	22.94819636	13.40765945	125.1381549	0.178768793	0.089384396	44.26969035	410.5491731	0	0.13481548	0.134076594	0.178768793	0.157537883	8.938439633	25.24841926	44.69219817	26.8153189	0	0	0.178768793	28.60300683	0	0	25	0	28.60300683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4583	0.845937646	0.302080701	1.437196167	1.629773177	1.05298837	0.383925369	1.883530356	6.009110699	0	3.7750314	0.227958324	0.061653111	2.894024889	1.872567074	8.063851643	0.696305361	1.080868006	0	0	1.129946716	0.401811655	0	0	0.3	0	1.41E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.5069		5.725008172	14.4583	0.845937646	0.302080701	1.437196167	1.629773177	1.05298837	0.383925369	1.883530356	6.009110699	0	3.7750314	0.227958324	0.061653111	2.894024889	1.872567074	8.063851643	0.696305361	1.080868006	0	0	1.129946716	0.401811655	0	0	0.3	0	1.41E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.5069																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	14.4583	0.845937646	0.302080701	1.437196167	1.629773177	1.05298837	0.383925369	1.883530356	6.009110699	0	3.7750314	0.227958324	0.061653111	2.894024889	1.872567074	8.063851643	0.696305361	1.080868006	0	0	1.129946716	0.401811655	0	0	0.3	0	1.41E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.5069
H4529_007_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	V	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		343.198059	22.47840601	38.71762291	0	15.59453746	38.03663289	14.47984948	23.22342355	32.92447745	18.1851953	14.3199777	2.415240844	4.572482321	30.8510585	48.67807649	128.1400379	10.86737599	3.767183941	0	0	27.12980093	6.865718201	0	0	144	0	249	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a: MC CS; 1a1 0% coin	1b: MC CS; 1a1 0% coin	2a: MC CS; 2a2 0% coin	6a 0% coin	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS; 14c 0% coin	MC CS; ; 7f1 0% coin (3 visits)	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS; 13a1 0% coin			17a1 5 copay	17b1 100 allowance	18a1 5 copay															0.0715	0.0715	0.2283	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0	0	5	0	5	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.5387	1.60720603	8.839233311	0	3.649121765	8.900572096	3.388284778	5.434281111	7.704327724	4.255335701	3.350874781	0.565166358	1.069960863	7.219147689	11.3906699	29.98476888	2.542965981	0.881521042	0	0	6.348373418	1.606578059	0	0	0.06	0	0.10375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.4408		0	24.5387	1.60720603	8.839233311	0	3.649121765	8.900572096	3.388284778	5.434281111	7.704327724	4.255335701	3.350874781	0.565166358	1.069960863	7.219147689	11.3906699	29.98476888	2.542965981	0.881521042	0	0	6.348373418	1.606578059	0	0	0.06	0	0.10375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.4408																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	24.5387	1.60720603	8.839233311	0	3.649121765	8.900572096	3.388284778	5.434281111	7.704327724	4.255335701	3.350874781	0.565166358	1.069960863	7.219147689	11.3906699	29.98476888	2.542965981	0.881521042	0	0	6.348373418	1.606578059	0	0	0.06	0	0.10375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.4408
H4529_014_0	2008	4																					3800											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1761.797138	110.946427	642.3378336	4026.653373	217.7047874	12.63541874	6.000879116	281.5700505	289.4333633	0	14.67926064	2.833058645	1.00756211	24.53414622	3614.99526	4601.93683	356.548756	346.8784553	0	0	27.43736623	0	0	0	144	0	249	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 125 days 1-5	1b 200 days 1-5	2a 25 days 11-100	6a 5 copay	10a 100 copay	11a 15% coin	11b 15% coin	4a 50 copay; 4b 25 copay; 4a World 40 copay	9b 350 copay; ASC:9b 125 copay		8b 15% coin; TherRad:8b 20% coin	9a 15% coin	12 20% coin	3 30 copay; 5 50 copay; 9a 15% coin; 9a 20% coin; 9c 50 copay; 9d 20 copay	7a 5 copay	7b 12 copay; ; 7d 22 copay; 16b 22 copay; 17a 22 copay	7e 50 copay; 7h 50 copay	7c 15 copay; 7i 15 copay			RX 20% coin				17a1 10 copay	17b1 100 allowance	18a1 10 copay	18b  allowance														66.17271721	105.8763475	11.03203102	4.297032401	85.94064801	0.128910972	0.128910972	42.96706432	204.467937	0	0.135123026	0.128910972	0.171881296	0.13160599	4.297032401	18.44444153	42.97032401	12.8910972	0	0	0.171881296	0	0	0	10	0	10	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.7152	0.978883538	0.590524242	1.441888334	1.559140875	1.628844112	0.77357916	1.008186539	4.931653559	0	1.983506115	0.365212344	0.173181081	3.228840601	1.294479313	7.073346232	1.276751297	0.37263699	0	0	4.715970067	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4394		7.052662937	9.7152	0.978883538	0.590524242	1.441888334	1.559140875	1.628844112	0.77357916	1.008186539	4.931653559	0	1.983506115	0.365212344	0.173181081	3.228840601	1.294479313	7.073346232	1.276751297	0.37263699	0	0	4.715970067	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4394																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	9.7152	0.978883538	0.590524242	1.441888334	1.559140875	1.628844112	0.77357916	1.008186539	4.931653559	0	1.983506115	0.365212344	0.173181081	3.228840601	1.294479313	7.073346232	1.276751297	0.37263699	0	0	4.715970067	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4394
H4531_001_0	2008	5																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V		V	V	V	V	V	Coin	Coin	Coin	Coin			V		V				V																																																				0	5000	252.227111	102.351736	1152.796917	2782.462387	205.4034734	7.078535315	1.152903259	197.9808131	266.4027536	552.3393283	456.8128718	11.89170468		671.2807842	4276.397639	4047.311825	321.3244234	1624.344384	32.81424543	3.29120246	11.73034018	1.224349065			590.5388921		84.92072704				557.041081											$275 per admission.	$100/day-First seven days per stay	$20 per day.	$10 per visit	$100 per service	10% coinsurance.	10% coinsurance.	$50 emrg/$30 Urgent	$50 per visit.	$0 per visit.	$50 per visit.	$50 per visit.		$50 per visit.	"$10 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$30 per visit	$30 per visit	$25 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.			$30 per exam		$30 per exam				$10 PCP copay/$30 Specialist copay for routine physicals											241.6056521	49.78625878	17.57132015	8.785660076	87.85660076	0.087856601	0.087856601	39.53547034	43.92830038	0	43.92830038	43.92830038		43.92830038	8.785660076	26.35698023	26.35698023	21.96415019	0.087856601	0.087856601	0.087856601	0.083463771			26.35698023		26.35698023				7.028528061											5.0783	0.424642501	1.688013641	2.037147392	1.503837579	0.621896051	0.101290161	0.652272047	0.975218348	0	1.672251087	0.043531865	0	2.457351994	3.130914667	8.88957648	0.70576179	2.973112	2.88294806	0.289153861	1.030587814	0.10218879	0	0	1.297068492	0	0.18652116	0	0	0	0.326264906	0	0	0	0	0	0	0	0	0	0	39.0698	0	5.400171249	5.0783	0.424642501	1.688013641	2.037147392	1.503837579	0.621896051	0.101290161	0.652272047	0.975218348	0	1.672251087	0.043531865	0	2.457351994	3.130914667	8.88957648	0.70576179	2.973112	2.88294806	0.289153861	1.030587814	0.10218879	0	0	1.297068492	0	0.18652116	0	0	0	0.326264906	0	0	0	0	0	0	0	0	0	0	39.0698	7700	$550 per admission	$200/day-First seven days per stay	20% coinsurance	$20 per visit	$100 per service	20% coinsurance	20% coinsurance/10% for Diabetes' supplies	$50 emrg/$30 Urgent	$50 per visit.	$50 per visit.	$50 per visit.	$50 per visit.		$100 per visit.	$20 per visit.	$60 per visit	$60 per visit	20% coinsurance	20% coinsurance	20% coinsurance except 10% Diabetes supplies/self-monitoring training	20% coinsurance	20% coinsurance			$50 per exam		$50 per exam				$20 PCP copay/$50 Specialist copay for routine physicals											6.9421	0.2632	1.887	1.0626	0.3226	0.2897	0.0472	0.3198	0.694	0.5297	0.6433	0.0433		0.7851	2.0634	4.4972	0.2066	0.7723	1.3429	0.1347	0.4801	0.049			0.3325		0.067				0.225											24.0002	500	0.212644834	12.0204	0.687799435	3.574984731	3.099753439	1.826411065	0.91158502	0.148472713	0.972058429	1.66919798	0.529733206	2.31556934	0.086867629	0	3.242423236	5.194305887	13.38677254	0.912387489	3.745390708	4.225870642	0.42384628	1.510651838	0.15123604	0	0	1.629548855	0	0.253498975	0	0	0	0.551296577	0	0	0	0	0	0	0	0	0	0	63.0701
H4531_003_0	2008	6																					2700											D	D	D	V	T	Coin	Coin	V	V	V	V	V		V	V	V	V	V	Coin	Coin	Coin	Coin			V		V				V																																																				0	5000	1423.79138	102.3775848	635.9853148	2783.165093	205.4553477	7.080322988	1.153194423	198.0308129	266.4700332	552.4788208	456.9282392	11.89470791		671.4503152	4277.477637	4048.333968	321.4055734	1624.754609	32.82253262	3.292033648	11.73330266	1.224658272			590.6880318		55.84157054				557.1817609											$275/day-First five days per stay	$275/day-First five days per stay	$50 per day.	$40 per visit	$150 per service	20% coinsurance.	20% coinsurance.	$50 emrg/$30 Urgent	$100 per visit.	$0 per visit.	$100 per visit.	$100 per visit.		$100 per visit.	"$10 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$40 per visit	$40 per visit	$40 per visit	20% coinsurance	20% coinsurance except sustitute $0 copay for lab.	20% coinsurance.	20% coinsurance.			$40 per exam		$40 per exam				$10 PCP copay/$40 Specialist copay for routine physicals											114.8410608	83.99831299	33.77541083	27.02032866	101.3262325	0.135101643	0.135101643	30.39786975	67.55082166	0	67.55082166	67.55082166		67.55082166	6.755082166	27.02032866	27.02032866	27.02032866	0.135101643	0.135101643	0.135101643	0.128346561			27.02032866		27.02032866				5.404065733											13.6258	0.716628701	1.790055441	6.266836296	1.734834694	0.956563271	0.155798462	0.501642905	1.500022474	0	2.5721565	0.066958108	0	3.779751708	2.407892742	9.115609529	0.723707019	3.658450295	4.434378094	0.444759156	1.585188471	0.157180678	0	0	1.33004873	0	0.125738132	0	0	0	0.250920572	0	0	0	0	0	0	0	0	0	0	57.9009	0	27.81369051	13.6258	0.716628701	1.790055441	6.266836296	1.734834694	0.956563271	0.155798462	0.501642905	1.500022474	0	2.5721565	0.066958108	0	3.779751708	2.407892742	9.115609529	0.723707019	3.658450295	4.434378094	0.444759156	1.585188471	0.157180678	0	0	1.33004873	0	0.125738132	0	0	0	0.250920572	0	0	0	0	0	0	0	0	0	0	57.9009	7700	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	$150 per service	30% coinsurance	30% coinsurance/20% for Diabetes' supplies	$50 emrg/$30 Urgent	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance		30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance/20% for Diabetes' self Monitoring Training	30% coinsurance	30% coinsurance			$50 per exam		$50 per exam				30% coinsurance											12.0231	0.3633	2.2039	1.3383	0.3824	0.3383	0.0551	0.3086	1.2099	0.669	0.9685	0.079		0.6093	2.9275	5.5573	0.1368	0.902	1.5685	0.1573	0.5607	0.0585			0.3034		0.0237				0.3253											33.0697	500	1.56437157	25.6489	1.079888728	3.99393496	7.605145208	2.117191774	1.294904218	0.210905113	0.810195664	2.709927682	0.669007292	3.540670052	0.145971121	0	4.389040326	5.335353398	14.67288945	0.860555613	4.560429788	6.00283857	0.60207257	2.14587712	0.215702307	0	0	1.633433178	0	0.149480154	0	0	0	0.576240041	0	0	0	0	0	0	0	0	0	0	90.9706
H4531_004_0	2008	4											Other Non-Covered										2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V		V	V	V	V	V	Coin	Coin	Coin	Coin			V		V				V	V																																																			0	5000	247.8786617	100.5871702	1152.921214	2782.762399	205.4256205	7.079298542	1.153027568	198.0021599	266.4314778	552.3988831	456.8621266	11.89298688		671.3531636	4276.858732	4047.748218	321.3590695	1624.519525	32.81778355	3.291557327	11.73160498	1.224481078			590.6025656		84.92988343				557.1011427											$100 per admission.	$100/day-First seven days per stay	$20 per day.	$10 per visit	$100 per service	10% coinsurance.	10% coinsurance.	$50 emrg/$20 Urgent	$50 per visit.	$0 per visit.	$50 per visit.	$50 per visit.		$50 per visit.	"$0 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$20 per visit	$20 per visit	$30 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.			$20 per exam		$20 per exam				$0 PCP copay/$20 Specialist copay for routine physicals											95.65391569	54.20481282	19.13078314	9.565391569	95.65391569	0.095653916	0.095653916	40.65291417	47.82695784	0	47.82695784	47.82695784		47.82695784	9.565391569	19.13078314	19.13078314	28.69617471	0.095653916	0.095653916	0.095653916	0.09087122			19.13078314		28.69617471				3.826156627											1.9759	0.454359061	1.83802381	2.218184333	1.637480415	0.677162626	0.110291602	0.670780401	1.061883922	0	1.820860472	0.047400449	0	2.675731621	3.409152371	6.453049446	0.512320889	3.884791342	3.139149501	0.314850347	1.122173953	0.111270089	0	0	0.941557467	0	0.203096898	0	0	0	0.177629686	0	0	0	0	0	0	0	0	0	0	35.4571	0	1.611010515	1.9759	0.454359061	1.83802381	2.218184333	1.637480415	0.677162626	0.110291602	0.670780401	1.061883922	0	1.820860472	0.047400449	0	2.675731621	3.409152371	6.453049446	0.512320889	3.884791342	3.139149501	0.314850347	1.122173953	0.111270089	0	0	0.941557467	0	0.203096898	0	0	0	0.177629686	0	0	0	0	0	0	0	0	0	0	35.4571	7700	$200 per admission	$200/day-First seven days per stay	20% coinsurance	$20 per visit	$100 per service	20% coinsurance	20% coinsurance/10% diabetes supplies	$50 emrg/$20 Urgent	$50 per visit.	$50 per visit.	$50 per visit.	$50 per visit.		$100 per visit.	$20 per visit.	$40 per visit	$40 per visit	20% coinsurance	20% coinsurance	20% coinsurance except 10% Diabetes self-monitoring training	20% coinsurance	20% coinsurance			$50 per exam		$50 per exam				$20 PCP copay/$40 Specialist copay for routine physicals/$50 copay fro accidental emergency servces during foreign travel	$50 copay for emergency services due to accident during foreign travel										6.3104	0.2624	1.8922	1.0654	0.3235	0.2905	0.0473	0.3169	0.6954	0.5311	0.6448	0.0434		0.7877	2.0684	3.9231	0.1608	0.7744	1.3466	0.1351	0.4814	0.0492			0.3336		0.0672				0.2578	0.0326										22.841	500	0.118162352	8.2862	0.716710124	3.730215241	3.283596335	1.960978882	0.967653025	0.157604685	0.987670022	1.757234093	0.531129521	2.465659768	0.090817037	0	3.463397946	5.477540101	10.37614138	0.673128156	4.659206573	4.485787303	0.449915395	1.603566084	0.160451328	0	0	1.275158889	0	0.270266393	0	0	0	0.435465932	0.032580694	0	0	0	0	0	0	0	0	0	58.2981
H4531_802_0	2008	1																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V		V	V	V	V	V	Coin	Coin	Coin	Coin																																																													0	5000	252.227111	102.351736	1152.796917	2782.462387	205.4034734	7.078535315	1.152903259	197.9808131	266.4027536	552.3393283	456.8128718	11.89170468		671.2807842	4276.397639	4047.311825	321.3244234	1624.344384	32.81424543	3.29120246	11.73034018	1.224349065																				$275 per admission.	$100/day-First seven days per stay	$20 per day.	$10 per visit	$100 per service	10% coinsurance.	10% coinsurance.	$50 emrg/$30 Urgent	$50 per visit.	$0 per visit.	$50 per visit.	$50 per visit.		$50 per visit.	"$10 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$30 per visit	$30 per visit	$25 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.																				241.6056521	49.78625878	17.57132015	8.785660076	87.85660076	0.087856601	0.087856601	39.53547034	43.92830038	0	43.92830038	43.92830038		43.92830038	8.785660076	26.35698023	26.35698023	21.96415019	0.087856601	0.087856601	0.087856601	0.083463771																				5.0783	0.424642501	1.688013641	2.037147392	1.503837579	0.621896051	0.101290161	0.652272047	0.975218348	0	1.672251087	0.043531865	0	2.457351994	3.130914667	8.88957648	0.70576179	2.973112	2.88294806	0.289153861	1.030587814	0.10218879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.26	0	5.400171249	5.0783	0.424642501	1.688013641	2.037147392	1.503837579	0.621896051	0.101290161	0.652272047	0.975218348	0	1.672251087	0.043531865	0	2.457351994	3.130914667	8.88957648	0.70576179	2.973112	2.88294806	0.289153861	1.030587814	0.10218879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.26	7700	$550 per admission	$200/day-First seven days per stay	20% coinsurance	$20 per visit	$100 per service	20% coinsurance	20% coinsurance/10% for Diabetes' supplies	$50 emrg/$30 Urgent	$50 per visit.	$50 per visit.	$50 per visit.	$50 per visit.		$100 per visit.	$20 per visit.	$60 per visit	$60 per visit	20% coinsurance	20% coinsurance	20% coinsurance except 10% Diabetes supplies/self-monitoring training	20% coinsurance	20% coinsurance																				6.9421	0.2632	1.887	1.0626	0.3226	0.2897	0.0472	0.3198	0.694	0.5297	0.6433	0.0433		0.7851	2.0634	4.4972	0.2066	0.7723	1.3429	0.1347	0.4801	0.049																				23.3757	500	0.212644834	12.0204	0.687799435	3.574984731	3.099753439	1.826411065	0.91158502	0.148472713	0.972058429	1.66919798	0.529733206	2.31556934	0.086867629	0	3.242423236	5.194305887	13.38677254	0.912387489	3.745390708	4.225870642	0.42384628	1.510651838	0.15123604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6357
H4531_803_0	2008	1																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V		V	V	V	V	V	Coin	Coin	Coin	Coin																																																													0	5000	252.227111	102.351736	1152.796917	2782.462387	205.4034734	7.078535315	1.152903259	197.9808131	266.4027536	552.3393283	456.8128718	11.89170468		671.2807842	4276.397639	4047.311825	321.3244234	1624.344384	32.81424543	3.29120246	11.73034018	1.224349065																				$275 per admission.	$100/day-First seven days per stay	$20 per day.	$10 per visit	$100 per service	10% coinsurance.	10% coinsurance.	$50 emrg/$30 Urgent	$50 per visit.	$0 per visit.	$50 per visit.	$50 per visit.		$50 per visit.	"$10 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$30 per visit	$30 per visit	$25 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.																				241.6056521	49.78625878	17.57132015	8.785660076	87.85660076	0.087856601	0.087856601	39.53547034	43.92830038	0	43.92830038	43.92830038		43.92830038	8.785660076	26.35698023	26.35698023	21.96415019	0.087856601	0.087856601	0.087856601	0.083463771																				5.0783	0.424642501	1.688013641	2.037147392	1.503837579	0.621896051	0.101290161	0.652272047	0.975218348	0	1.672251087	0.043531865	0	2.457351994	3.130914667	8.88957648	0.70576179	2.973112	2.88294806	0.289153861	1.030587814	0.10218879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.26	0	5.400171249	5.0783	0.424642501	1.688013641	2.037147392	1.503837579	0.621896051	0.101290161	0.652272047	0.975218348	0	1.672251087	0.043531865	0	2.457351994	3.130914667	8.88957648	0.70576179	2.973112	2.88294806	0.289153861	1.030587814	0.10218879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.26	7700	$550 per admission	$200/day-First seven days per stay	20% coinsurance	$20 per visit	$100 per service	20% coinsurance	20% coinsurance/10% for Diabetes' supplies	$50 emrg/$30 Urgent	$50 per visit.	$50 per visit.	$50 per visit.	$50 per visit.		$100 per visit.	$20 per visit.	$60 per visit	$60 per visit	20% coinsurance	20% coinsurance	20% coinsurance except 10% Diabetes supplies/self-monitoring training	20% coinsurance	20% coinsurance																				6.9421	0.2632	1.887	1.0626	0.3226	0.2897	0.0472	0.3198	0.694	0.5297	0.6433	0.0433		0.7851	2.0634	4.4972	0.2066	0.7723	1.3429	0.1347	0.4801	0.049																				23.3757	500	0.212644834	12.0204	0.687799435	3.574984731	3.099753439	1.826411065	0.91158502	0.148472713	0.972058429	1.66919798	0.529733206	2.31556934	0.086867629	0	3.242423236	5.194305887	13.38677254	0.912387489	3.745390708	4.225870642	0.42384628	1.510651838	0.15123604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6357
H4531_804_0	2008	1																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V		V	V	V	V	V	Coin	Coin	Coin	Coin																																																													0	5000	252.227111	102.351736	1152.796917	2782.462387	205.4034734	7.078535315	1.152903259	197.9808131	266.4027536	552.3393283	456.8128718	11.89170468		671.2807842	4276.397639	4047.311825	321.3244234	1624.344384	32.81424543	3.29120246	11.73034018	1.224349065																				$275 per admission.	$100/day-First seven days per stay	$20 per day.	$10 per visit	$100 per service	10% coinsurance.	10% coinsurance.	$50 emrg/$30 Urgent	$50 per visit.	$0 per visit.	$50 per visit.	$50 per visit.		$50 per visit.	"$10 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$30 per visit	$30 per visit	$25 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.																				241.6056521	49.78625878	17.57132015	8.785660076	87.85660076	0.087856601	0.087856601	39.53547034	43.92830038	0	43.92830038	43.92830038		43.92830038	8.785660076	26.35698023	26.35698023	21.96415019	0.087856601	0.087856601	0.087856601	0.083463771																				5.0783	0.424642501	1.688013641	2.037147392	1.503837579	0.621896051	0.101290161	0.652272047	0.975218348	0	1.672251087	0.043531865	0	2.457351994	3.130914667	8.88957648	0.70576179	2.973112	2.88294806	0.289153861	1.030587814	0.10218879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.26	0	5.400171249	5.0783	0.424642501	1.688013641	2.037147392	1.503837579	0.621896051	0.101290161	0.652272047	0.975218348	0	1.672251087	0.043531865	0	2.457351994	3.130914667	8.88957648	0.70576179	2.973112	2.88294806	0.289153861	1.030587814	0.10218879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.26	7700	$550 per admission	$200/day-First seven days per stay	20% coinsurance	$20 per visit	$100 per service	20% coinsurance	20% coinsurance/10% for Diabetes' supplies	$50 emrg/$30 Urgent	$50 per visit.	$50 per visit.	$50 per visit.	$50 per visit.		$100 per visit.	$20 per visit.	$60 per visit	$60 per visit	20% coinsurance	20% coinsurance	20% coinsurance except 10% Diabetes supplies/self-monitoring training	20% coinsurance	20% coinsurance																				6.9421	0.2632	1.887	1.0626	0.3226	0.2897	0.0472	0.3198	0.694	0.5297	0.6433	0.0433		0.7851	2.0634	4.4972	0.2066	0.7723	1.3429	0.1347	0.4801	0.049																				23.3757	500	0.212644834	12.0204	0.687799435	3.574984731	3.099753439	1.826411065	0.91158502	0.148472713	0.972058429	1.66919798	0.529733206	2.31556934	0.086867629	0	3.242423236	5.194305887	13.38677254	0.912387489	3.745390708	4.225870642	0.42384628	1.510651838	0.15123604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6357
H4531_805_0	2008	1																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V		V	V	V	V	V	Coin	Coin	Coin	Coin																																																													0	5000	252.227111	102.351736	1152.796917	2782.462387	205.4034734	7.078535315	1.152903259	197.9808131	266.4027536	552.3393283	456.8128718	11.89170468		671.2807842	4276.397639	4047.311825	321.3244234	1624.344384	32.81424543	3.29120246	11.73034018	1.224349065																				$275 per admission.	$100/day-First seven days per stay	$20 per day.	$10 per visit	$100 per service	10% coinsurance.	10% coinsurance.	$50 emrg/$30 Urgent	$50 per visit.	$0 per visit.	$50 per visit.	$50 per visit.		$50 per visit.	"$10 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$30 per visit	$30 per visit	$25 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.																				241.6056521	49.78625878	17.57132015	8.785660076	87.85660076	0.087856601	0.087856601	39.53547034	43.92830038	0	43.92830038	43.92830038		43.92830038	8.785660076	26.35698023	26.35698023	21.96415019	0.087856601	0.087856601	0.087856601	0.083463771																				5.0783	0.424642501	1.688013641	2.037147392	1.503837579	0.621896051	0.101290161	0.652272047	0.975218348	0	1.672251087	0.043531865	0	2.457351994	3.130914667	8.88957648	0.70576179	2.973112	2.88294806	0.289153861	1.030587814	0.10218879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.26	0	5.400171249	5.0783	0.424642501	1.688013641	2.037147392	1.503837579	0.621896051	0.101290161	0.652272047	0.975218348	0	1.672251087	0.043531865	0	2.457351994	3.130914667	8.88957648	0.70576179	2.973112	2.88294806	0.289153861	1.030587814	0.10218879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.26	7700	$550 per admission	$200/day-First seven days per stay	20% coinsurance	$20 per visit	$100 per service	20% coinsurance	20% coinsurance/10% for Diabetes' supplies	$50 emrg/$30 Urgent	$50 per visit.	$50 per visit.	$50 per visit.	$50 per visit.		$100 per visit.	$20 per visit.	$60 per visit	$60 per visit	20% coinsurance	20% coinsurance	20% coinsurance except 10% Diabetes supplies/self-monitoring training	20% coinsurance	20% coinsurance																				6.9421	0.2632	1.887	1.0626	0.3226	0.2897	0.0472	0.3198	0.694	0.5297	0.6433	0.0433		0.7851	2.0634	4.4972	0.2066	0.7723	1.3429	0.1347	0.4801	0.049																				23.3757	500	0.212644834	12.0204	0.687799435	3.574984731	3.099753439	1.826411065	0.91158502	0.148472713	0.972058429	1.66919798	0.529733206	2.31556934	0.086867629	0	3.242423236	5.194305887	13.38677254	0.912387489	3.745390708	4.225870642	0.42384628	1.510651838	0.15123604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6357
H4577_001_0	2008	4																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.8891	1.431	0.2286	1.2666	0.689	0	2.6728	0.1371	0.0746	1.0075	0.6461	1.5513	0.6363	0.5459	0.3982	0.0058	1.0645	0.0283	0	0	0	0	0	0	0	0	0											13.2729	0	479.7124002	62.95452475	3342.498035	3075.698555	26.15103743	42.08881536	6.723018	37.25157361	20.26529702	11439.97002	22.18787084	1.137944735	0.761168357	8.363796129	43.04615473	102.0817576	16.74924913	35.9228238	26.20494743	4.945090319	31.30831177	0.8321141	0	2169	662.4	158.976	138.4	28.14915254	0	0	6											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 23%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											794.24	794.24	76.08	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.20030672	0.2	0.19754115	0.2	0.5	0.2	0.2	0.015525797	0.2	0.2	0	0	0	10	0	10	0	0	0											31.7506	4.166750145	21.19143754	0	5.230207486	8.417763073	1.3446036	7.450314721	4.053059404	0	4.437574169	0.227588947	0.152467137	1.672759226	8.503386895	20.41635151	8.374624565	7.18456476	5.240989486	0.07677647	6.261662354	0.16642282	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	146.4758	131	0	31.7506	4.166750145	21.19143754	0	6.119342758	9.848782795	1.573186212	8.716868224	4.742079503	0	7.110408747	0.36467006	0.227055132	2.680293642	9.149513313	21.96767974	9.01096703	7.730481011	5.639223955	0.082610299	7.326144954	0.194714699	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	159.7487	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	31.7506	4.166750145	21.19143754	0	6.119342758	9.848782795	1.573186212	8.716868224	4.742079503	0	7.110408747	0.36467006	0.227055132	2.680293642	9.149513313	21.96767974	9.01096703	7.730481011	5.639223955	0.082610299	7.326144954	0.194714699	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	159.7487
H4577_002_0	2008	4																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.8786	1.4184	0.2262	1.2576	0.6815	0	2.6413	0.1353	0.0736	0.9965	0.6394	1.5337	0.6295	0.5398	0.3932	0.0058	1.0538	0.028	0	0	0	0	0	0	0	0	0											13.1321	0	474.7217969	62.34182775	3306.408591	3039.68885	25.84075748	41.71724342	6.652980049	36.98855698	20.04285404	11310.31529	21.92158516	1.122856688	0.751498408	8.270388213	42.65268875	101.064805	16.59379838	35.57233325	25.91376845	4.890558108	30.99337397	0.822616798	0	2169	662.4	158.976	138.4	28.14915254	0	0	6											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 22%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											780.82	780.82	77.96	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.200261018	0.2	0.197561656	0.2	0.5	0.2	0.2	0.015550586	0.2	0.2	0	0	0	10	0	10	0	0	0											30.8894	4.056478829	21.48063448	0	5.168151496	8.343448683	1.33059601	7.397711395	4.008570808	0	4.384317033	0.224571338	0.150495836	1.654077643	8.426535818	20.212961	8.296899189	7.114466649	5.182753691	0.076051045	6.198674795	0.16452336	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	144.9172	131	0	30.8894	4.056478829	21.48063448	0	6.04673725	9.761834959	1.556797332	8.655322333	4.690027846	0	7.025584226	0.359861031	0.224105716	2.650552345	9.065908825	21.74664245	8.926435868	7.654284912	5.576001033	0.081821505	7.25244951	0.192492331	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	158.0493	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.8894	4.056478829	21.48063448	0	6.04673725	9.761834959	1.556797332	8.655322333	4.690027846	0	7.025584226	0.359861031	0.224105716	2.650552345	9.065908825	21.74664245	8.926435868	7.654284912	5.576001033	0.081821505	7.25244951	0.192492331	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	158.0493
H4577_003_0	2008	4																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.9868	1.5877	0.2537	1.405	0.7646	0	2.9664	0.1522	0.0828	1.1181	0.7176	1.7222	0.7062	0.6058	0.442	0.0065	1.1812	0.0314	0	0	0	0	0	0	0	0	0											14.73	0	533.0563838	69.89719533	3726.127319	3413.502982	29.02368977	46.69729701	7.460396565	41.32282547	22.48930893	12695.92347	24.62549956	1.263131535	0.844856168	9.281867236	47.79803941	113.3068038	18.58409017	39.86006787	29.08119131	5.487816996	34.74088187	0.92347675	0	2169	662.4	158.976	138.4	28.14915254	0	0	6											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 21%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											741.5	741.5	70.32	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.200145076	0.2	0.197540917	0.2	0.5	0.2	0.2	0.015523226	0.2	0.2	0	0	0	10	0	10	0	0	0											32.9384	4.319064195	21.83510609	0	5.804737954	9.339459402	1.492079313	8.264565093	4.497861786	0	4.925099912	0.252626307	0.169093802	1.856373447	9.442068551	22.66136076	9.292045086	7.972013573	5.816238262	0.085188624	6.948176374	0.18469535	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	158.2522	131	0	32.9384	4.319064195	21.83510609	0	6.791543406	10.9271675	1.745732796	9.669541159	5.262498289	0	7.891522956	0.404784946	0.251886106	2.974480505	10.15962431	24.3835247	9.998199723	8.57785161	6.258246839	0.091662585	8.129366357	0.216093559	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	172.9823	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	32.9384	4.319064195	21.83510609	0	6.791543406	10.9271675	1.745732796	9.669541159	5.262498289	0	7.891522956	0.404784946	0.251886106	2.974480505	10.15962431	24.3835247	9.998199723	8.57785161	6.258246839	0.091662585	8.129366357	0.216093559	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	172.9823
H4577_004_0	2008	4																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.8621	1.3885	0.2217	1.2295	0.6682	0	2.5917	0.1329	0.0723	0.9771	0.6281	1.5057	0.6172	0.5294	0.3861	0.0057	1.0326	0.0274	0	0	0	0	0	0	0	0	0											12.8762	0	467.1086785	61.17772859	3283.561522	2982.363946	25.35652782	40.83914276	6.520973418	36.16035329	19.65369794	11093.7888	21.51313684	1.103011335	0.737897564	8.111014803	41.85690098	99.11076581	16.25020382	34.84863073	25.41334237	4.795794336	30.3699735	0.806918571	0	2169	662.4	158.976	138.4	28.14915254	0	0	6											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 18% and 20%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											637.47	637.47	61	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.199825976	0.2	0.1975513	0.2	0.5	0.2	0.2	0.01553153	0.2	0.2	0	0	0	10	0	10	0	0	0											24.814	3.249913887	16.69143774	0	5.071305564	8.167828551	1.304194684	7.232070658	3.930739587	0	4.302627367	0.220602267	0.147451101	1.622202961	8.268885209	19.82215316	8.12510191	6.969726146	5.082668474	0.074486025	6.073994701	0.161383714	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	131.4887	131	0	24.814	3.249913887	16.69143774	0	5.93342751	9.556359405	1.52590778	8.46152267	4.598965317	0	6.894292831	0.353480908	0.219751708	2.59932857	8.896989861	21.32784423	8.742284781	7.499146655	5.468748053	0.080143984	7.1065738	0.188818946	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	144.3649	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.814	3.249913887	16.69143774	0	5.93342751	9.556359405	1.52590778	8.46152267	4.598965317	0	6.894292831	0.353480908	0.219751708	2.59932857	8.896989861	21.32784423	8.742284781	7.499146655	5.468748053	0.080143984	7.1065738	0.188818946	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	144.3649
H4577_012_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1617.164373	80.59314052	1231.677839	1502.897791	614.9860079	17.84057576	4.316738898	1624.791101	314.6463257	6564.982154	1299.443126	60.95587247	0.18910295	496.6666423	9268.922973	18764.07337	366.3120841	3676.471782	4542.30156	929.3424817	32.85073981	40.26877663	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $45.00 and $90.00	$20.00 copayment	"Copay between $20.00 and $90.00, 20% coinsurance"	$150.00 copayment	Coin between 25% and 27%	"Copay between $20.00 and $90.00, 20% coinsurance"	Copay between $0.00 and $15.00	"Copay between $0.00 and $30.00, 20% coinsurance"	Copay between $20.00 and $30.00	"$30.00 copayment, 20% coinsurance"	"Copay between $15.00 and $30.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											72.5978817	41.44790989	111.9155425	0	33.38245553	0.274437328	0.274437328	17.25043738	65.59975675	2.514230704	24.72753678	124.3626635	0.266260649	47.38992369	5.018195785	7.409388876	21.59633215	12.89113277	9.145390623	0	0.274437328	47.35202868	0	0	0	9.147910948	0	9.147910948	0	0	0											9.7836	0.278368102	11.48699113	0	1.710811922	4.89611995	1.184674291	2.335696429	1.720060203	1.375489975	2.677668974	0.631719555	0.050350674	1.96141619	3.876105849	11.58585971	0.659249787	3.949490489	3.461760175	0	9.015469271	0.158900689	0	0	0	0.217720281	0	0.021458828	0	0	0	0	0	0	0	0	0	0	0	0	0	73.0389	0	6.598723119	9.7836	0.278368102	11.48699113	0	1.710811922	4.89611995	1.184674291	2.335696429	1.720060203	1.375489975	2.677668974	0.631719555	0.050350674	1.96141619	3.876105849	11.58585971	0.659249787	3.949490489	3.461760175	0	9.015469271	0.158900689	0	0	0	0.217720281	0	0.021458828	0	0	0	0	0	0	0	0	0	0	0	0	0	73.0389	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.7836	0.278368102	11.48699113	0	1.710811922	4.89611995	1.184674291	2.335696429	1.720060203	1.375489975	2.677668974	0.631719555	0.050350674	1.96141619	3.876105849	11.58585971	0.659249787	3.949490489	3.461760175	0	9.015469271	0.158900689	0	0	0	0.217720281	0	0.021458828	0	0	0	0	0	0	0	0	0	0	0	0	0	73.0389
H4577_013_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1654.537916	82.47187402	1250.29271	1538.134556	629.4343903	18.26346736	4.418521033	1663.515252	322.0664795	6719.056113	1329.961341	62.37870025	0.193524408	508.3550537	9485.83981	19205.10603	375.0039539	3763.177239	4649.376244	951.2842757	33.62539793	41.21930963	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $45.00 and $90.00	$20.00 copayment	"Copay between $20.00 and $90.00, 20% coinsurance"	$150.00 copayment	Coin between 25% and 29%	"Copay between $20.00 and $90.00, 20% coinsurance"	Copay between $0.00 and $15.00	"Copay between $0.00 and $30.00, 20% coinsurance"	Copay between $20.00 and $30.00	"$30.00 copayment, 20% coinsurance"	"Copay between $15.00 and $30.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											76.27123834	43.54531525	122.4855625	0	33.11826025	0.272270812	0.272270812	17.11446639	65.08198611	2.494393612	24.53197394	123.3814514	0.264158802	47.02434687	4.980718106	7.353597693	21.42629227	12.78945294	9.072649405	0	0.272270812	46.96866255	0	0	0	9.075693722	0	9.075693722	0	0	0											10.5161	0.299271979	12.76190049	0	1.737147662	4.972609082	1.203034308	2.372514655	1.746727179	1.396664221	2.718881413	0.641364548	0.051121176	1.992088698	3.937191174	11.76888528	0.669578693	4.010748183	3.515180051	0	9.155214387	0.161334654	0	0	0	0.216001511	0	0.021289424	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8649	0	7.498964097	10.5161	0.299271979	12.76190049	0	1.737147662	4.972609082	1.203034308	2.372514655	1.746727179	1.396664221	2.718881413	0.641364548	0.051121176	1.992088698	3.937191174	11.76888528	0.669578693	4.010748183	3.515180051	0	9.155214387	0.161334654	0	0	0	0.216001511	0	0.021289424	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8649	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.5161	0.299271979	12.76190049	0	1.737147662	4.972609082	1.203034308	2.372514655	1.746727179	1.396664221	2.718881413	0.641364548	0.051121176	1.992088698	3.937191174	11.76888528	0.669578693	4.010748183	3.515180051	0	9.155214387	0.161334654	0	0	0	0.216001511	0	0.021289424	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8649
H4577_014_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1751.428794	87.25098125	1343.530255	1625.614063	665.2935751	19.31193746	4.67102131	1759.456318	340.4381443	7101.499453	1405.707243	65.91283699	0.204504497	537.3582582	10035.20371	20307.53123	396.5499379	3978.268936	4915.013195	1005.708175	35.54712634	43.57067646	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $45.00 and $90.00	$20.00 copayment	"Copay between $20.00 and $90.00, 20% coinsurance"	$150.00 copayment	Coin between 24% and 25%	"Copay between $20.00 and $90.00, 20% coinsurance"	Copay between $0.00 and $15.00	"Copay between $0.00 and $30.00, 20% coinsurance"	Copay between $20.00 and $30.00	"$30.00 copayment, 20% coinsurance"	"Copay between $15.00 and $30.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											64.49508726	36.82246048	100.0106615	0	33.10376631	0.27216254	0.27216254	17.1080841	65.0554557	2.49344274	24.52169203	123.334418	0.264055367	46.99757949	4.977661694	7.352273434	21.41855545	12.78447244	9.067902363	0	0.27216254	46.93075638	0	0	0	9.072084682	0	9.072084682	0	0	0											9.4132	0.267732984	11.19727913	0	1.835310253	5.255985961	1.271277026	2.508410554	1.845613218	1.475598521	2.872526675	0.677443449	0.05400051	2.104544788	4.162654093	12.4422102	0.707793903	4.238339132	3.714071647	0	9.674596212	0.1704004	0	0	0	0.215915615	0	0.021280958	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1262	0	7.545056124	9.4132	0.267732984	11.19727913	0	1.835310253	5.255985961	1.271277026	2.508410554	1.845613218	1.475598521	2.872526675	0.677443449	0.05400051	2.104544788	4.162654093	12.4422102	0.707793903	4.238339132	3.714071647	0	9.674596212	0.1704004	0	0	0	0.215915615	0	0.021280958	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1262	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.4132	0.267732984	11.19727913	0	1.835310253	5.255985961	1.271277026	2.508410554	1.845613218	1.475598521	2.872526675	0.677443449	0.05400051	2.104544788	4.162654093	12.4422102	0.707793903	4.238339132	3.714071647	0	9.674596212	0.1704004	0	0	0	0.215915615	0	0.021280958	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1262
H4577_015_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1756.096142	91.57479966	1300.835412	1503.110009	670.3672147	18.54717825	4.341889753	1581.745795	305.6882505	7090.076063	1328.768081	63.54071309	0.150862842	559.9199279	8485.742196	19179.27931	414.5762639	4121.031685	4676.949452	889.349779	38.01410113	44.58991634	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 29%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											121.8212658	67.62500791	122.7470901	0	31.88469839	0.261981553	0.261981553	16.36917086	105.5313605	2.397156239	34.48770621	187.426883	0.25057795	50.08828173	6.389680823	7.927434445	24.56483956	12.86259134	9.090512644	0	0.261981553	48.94452641	0	0	0	8.732718418	0	8.732718418	0	0	0											17.8275	0.516062213	13.30614679	0	1.781204704	4.859018554	1.137495018	2.157655598	2.688308079	1.416335006	3.818846934	0.992436483	0.037802902	2.337118925	4.518432015	12.67020662	0.848666618	4.417262205	3.542989011	0	9.958993232	0.181869361	0	0	0	0.207838698	0	0.020484885	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2427	0	12.57198232	17.8275	0.516062213	13.30614679	0	1.781204704	4.859018554	1.137495018	2.157655598	2.688308079	1.416335006	3.818846934	0.992436483	0.037802902	2.337118925	4.518432015	12.67020662	0.848666618	4.417262205	3.542989011	0	9.958993232	0.181869361	0	0	0	0.207838698	0	0.020484885	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2427	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.8275	0.516062213	13.30614679	0	1.781204704	4.859018554	1.137495018	2.157655598	2.688308079	1.416335006	3.818846934	0.992436483	0.037802902	2.337118925	4.518432015	12.67020662	0.848666618	4.417262205	3.542989011	0	9.958993232	0.181869361	0	0	0	0.207838698	0	0.020484885	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2427
H4577_016_0	2008	5																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1675.423548	83.82335661	1286.687829	1583.055711	647.8073767	18.79551991	4.547390882	1711.912651	329.4101991	6915.230385	1357.087035	63.78621293	0.199179501	519.9500745	9602.436976	19608.26415	378.5909172	3855.095189	4763.136205	979.0206287	34.60608038	42.10527687	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 27%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											115.8886409	66.16877634	106.0474282	0	32.17874247	0.264545389	0.264545389	16.62880207	105.3536243	2.423614512	33.4049731	167.0587549	0.256663517	52.54673439	6.375048461	8.142954938	24.3648925	12.95761029	9.421185799	0	0.264545389	45.6413673	0	0	0	8.818179631	0	8.818179631	0	0	0											16.1802	0.462207411	11.37082794	0	1.737135562	4.972268125	1.20299129	2.37225472	2.892046529	1.396654393	3.777787993	0.888003776	0.051122111	2.276806538	5.101333422	13.30576762	0.768693916	4.162735093	3.739532598	0	9.154878993	0.160145201	0	0	0	0.209872675	0	0.020685357	0	0	0	0	0	0	0	0	0	0	0	0	0	86.204	0	11.20119803	16.1802	0.462207411	11.37082794	0	1.737135562	4.972268125	1.20299129	2.37225472	2.892046529	1.396654393	3.777787993	0.888003776	0.051122111	2.276806538	5.101333422	13.30576762	0.768693916	4.162735093	3.739532598	0	9.154878993	0.160145201	0	0	0	0.209872675	0	0.020685357	0	0	0	0	0	0	0	0	0	0	0	0	0	86.204	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.1802	0.462207411	11.37082794	0	1.737135562	4.972268125	1.20299129	2.37225472	2.892046529	1.396654393	3.777787993	0.888003776	0.051122111	2.276806538	5.101333422	13.30576762	0.768693916	4.162735093	3.739532598	0	9.154878993	0.160145201	0	0	0	0.209872675	0	0.020685357	0	0	0	0	0	0	0	0	0	0	0	0	0	86.204
H4577_017_0	2008	5																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1740.662083	77.26779443	1318.866069	1443.886114	649.1586924	18.79194202	4.733644704	1541.464768	312.6945674	7169.761408	1404.5372	74.84408802	0.197502546	565.3210894	9181.133775	20211.01264	382.0115432	4059.371332	4859.023162	963.9054792	36.99524769	41.92173368	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 28%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											119.7425266	71.51736574	111.1438968	0	32.80363158	0.261925916	0.261925916	16.86964571	106.8784507	2.37696195	33.86753296	177.266319	0.250945587	51.1157635	6.560937032	8.038222106	24.55253428	12.86014495	9.259322338	0	0.261925916	47.16479074	0	0	0	8.73086385	0	8.73086385	0	0	0											17.3693	0.460499093	12.21532619	0	1.774563549	4.922096618	1.239864223	2.166997042	2.78502591	1.420187505	3.964017493	1.105611332	0.049562392	2.408068259	5.019736715	13.53838405	0.781612626	4.350341979	3.749271809	0	9.69001412	0.16476915	0	0	0	0.20779456	0	0.020480535	0	0	0	0	0	0	0	0	0	0	0	0	0	89.4035	0	12.6030611	17.3693	0.460499093	12.21532619	0	1.774563549	4.922096618	1.239864223	2.166997042	2.78502591	1.420187505	3.964017493	1.105611332	0.049562392	2.408068259	5.019736715	13.53838405	0.781612626	4.350341979	3.749271809	0	9.69001412	0.16476915	0	0	0	0.20779456	0	0.020480535	0	0	0	0	0	0	0	0	0	0	0	0	0	89.4035	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.3693	0.460499093	12.21532619	0	1.774563549	4.922096618	1.239864223	2.166997042	2.78502591	1.420187505	3.964017493	1.105611332	0.049562392	2.408068259	5.019736715	13.53838405	0.781612626	4.350341979	3.749271809	0	9.69001412	0.16476915	0	0	0	0.20779456	0	0.020480535	0	0	0	0	0	0	0	0	0	0	0	0	0	89.4035
H4577_018_0	2008	5																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1803.387674	94.02469806	1347.311178	1542.836499	681.4805091	19.0421806	4.457296964	1608.647663	310.7897174	7262.385025	1363.759248	64.58945224	0.154066702	568.5366131	8714.080994	19684.37645	425.1803646	4204.505123	4801.093515	912.9877103	38.93190445	45.34439223	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$25.00 copayment	"Copay between $25.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 28%	"Copay between $25.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											119.2011658	66.17037212	110.72283	0	31.8115021	0.26138534	0.26138534	16.3322226	105.291062	2.989626554	34.85496461	187.0050087	0.249693451	50.24242627	6.374110368	7.91391366	24.52743512	12.82053791	9.069112783	0	0.26138534	48.81288093	0	0	0	8.712844661	0	8.712844661	0	0	0											17.9138	0.518470772	12.43150887	0	1.806576554	4.977346846	1.165072082	2.18939931	2.726948283	1.80931826	3.961148361	1.006545923	0.038469446	2.380388239	4.628709501	12.98170464	0.86904865	4.492001445	3.628471548	0	10.17622907	0.184449202	0	0	0	0.207365703	0	0.020438266	0	0	0	0	0	0	0	0	0	0	0	0	0	90.1134	0	12.90615205	17.9138	0.518470772	12.43150887	0	1.806576554	4.977346846	1.165072082	2.18939931	2.726948283	1.80931826	3.961148361	1.006545923	0.038469446	2.380388239	4.628709501	12.98170464	0.86904865	4.492001445	3.628471548	0	10.17622907	0.184449202	0	0	0	0.207365703	0	0.020438266	0	0	0	0	0	0	0	0	0	0	0	0	0	90.1134	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.9138	0.518470772	12.43150887	0	1.806576554	4.977346846	1.165072082	2.18939931	2.726948283	1.80931826	3.961148361	1.006545923	0.038469446	2.380388239	4.628709501	12.98170464	0.86904865	4.492001445	3.628471548	0	10.17622907	0.184449202	0	0	0	0.207365703	0	0.020438266	0	0	0	0	0	0	0	0	0	0	0	0	0	90.1134
H4577_019_0	2008	5																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1910.572569	87.45653275	1390.910094	1563.009515	698.6088841	20.32491678	4.802967477	1459.646452	316.0844617	6023.085436	1356.723942	60.06424101	0.266084846	552.7714097	8576.368064	23118.52182	473.6521752	4575.623746	5151.167409	927.7655014	43.79042542	39.10078198	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$25.00 copayment	"Copay between $25.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 27%	"Copay between $25.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											111.8196045	64.40690326	101.6804557	0	31.80956237	0.258838665	0.258838665	16.36683416	106.0727615	2.865292156	35.02997533	188.969858	0.245561732	59.26619958	6.591069665	7.454449736	24.15461568	12.6107587	9.569852718	0	0.258838665	51.05847931	0	0	0	8.627955511	0	8.627955511	0	0	0											17.8033	0.46940037	11.78569768	0	1.851870239	5.260874334	1.243193691	1.990815951	2.793995978	1.438158288	3.960500517	0.945860925	0.065340256	2.730055057	4.710619949	14.36132157	0.953407188	4.808507246	4.107992786	0	11.33465527	0.166368872	0	0	0	0.205345341	0	0.020239136	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0075	0	14.38772119	17.8033	0.46940037	11.78569768	0	1.851870239	5.260874334	1.243193691	1.990815951	2.793995978	1.438158288	3.960500517	0.945860925	0.065340256	2.730055057	4.710619949	14.36132157	0.953407188	4.808507246	4.107992786	0	11.33465527	0.166368872	0	0	0	0.205345341	0	0.020239136	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0075	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.8033	0.46940037	11.78569768	0	1.851870239	5.260874334	1.243193691	1.990815951	2.793995978	1.438158288	3.960500517	0.945860925	0.065340256	2.730055057	4.710619949	14.36132157	0.953407188	4.808507246	4.107992786	0	11.33465527	0.166368872	0	0	0	0.205345341	0	0.020239136	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0075
H4577_020_0	2008	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1703.068825	84.77527026	1295.404509	1578.306544	645.8639545	18.73913335	4.53374871	1706.776913	331.2717485	6923.263402	1386.250038	64.27137175	0.198581963	526.9365343	10102.48498	20473.04156	402.0561791	3959.72204	4875.672255	976.0835668	34.50226214	42.46313966	0	2492.571429	662.4	158.976	138.4	28.14915254	0	0	2400											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $10.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $30.00 and $60.00	$10.00 copayment	"Copay between $10.00 and $60.00, 20% coinsurance"	$100.00 copayment	Coin between 25% and 27%	"Copay between $10.00 and $60.00, 20% coinsurance"	Copay between $0.00 and $5.00	"Copay between $0.00 and $10.00, 20% coinsurance"	Copay between $10.00 and $20.00	"$10.00 copayment, 20% coinsurance"	"Copay between $5.00 and $10.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$25.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											48.56686826	27.72771246	111.0873567	0	33.70804462	0.277117969	0.277117969	17.41908972	44.16484232	1.269398675	18.84113996	83.71854396	0.268861509	43.02826508	1.745655818	3.175226479	14.36708754	10.66285711	6.763304024	0	0.277117969	47.76477505	0	23.09316412	0	9.237265649	0	9.237265649	0	0	0											6.8927	0.19588536	11.99192189	0	1.81423425	5.192950584	1.256383237	2.477541682	1.219213712	0.732365116	2.176544249	0.448392138	0.053391046	1.889430407	1.469621807	5.41721197	0.481364694	3.518495858	2.747971148	0	9.561196826	0.169020193	0	4.796780091	0	0.122375295	0	0.021668433	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6467	0	5.193679705	6.8927	0.19588536	11.99192189	0	1.81423425	5.192950584	1.256383237	2.477541682	1.219213712	0.732365116	2.176544249	0.448392138	0.053391046	1.889430407	1.469621807	5.41721197	0.481364694	3.518495858	2.747971148	0	9.561196826	0.169020193	0	4.796780091	0	0.122375295	0	0.021668433	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6467	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.8927	0.19588536	11.99192189	0	1.81423425	5.192950584	1.256383237	2.477541682	1.219213712	0.732365116	2.176544249	0.448392138	0.053391046	1.889430407	1.469621807	5.41721197	0.481364694	3.518495858	2.747971148	0	9.561196826	0.169020193	0	4.796780091	0	0.122375295	0	0.021668433	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6467
H4577_021_0	2008	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1751.921884	77.44805782	1317.497951	1442.388307	648.4852913	18.77244831	4.728734284	1539.865738	314.3779922	7162.323896	1415.406352	75.39669294	0.197297668	568.208365	9470.49606	20487.24032	396.4964672	4091.019139	4899.29638	962.9055773	36.95687087	42.19829362	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $25.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $45.00 and $90.00	$20.00 copayment	"Copay between $20.00 and $90.00, 20% coinsurance"	$150.00 copayment	Coin between 25% and 28%	"Copay between $15.00 and $90.00, 20% coinsurance"	Copay between $0.00 and $10.00	"Copay between $0.00 and $25.00, 20% coinsurance"	Copay between $15.00 and $25.00	"$25.00 copayment, 20% coinsurance"	"Copay between $10.00 and $25.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											73.79905271	44.07301159	114.1466988	0	33.68989536	0.269002432	0.269002432	17.32541707	65.87851769	2.441180915	24.89238695	120.7493649	0.257725445	45.53409913	3.459228188	6.257011857	17.89867714	12.16881294	8.325237407	0	0.269002432	48.43293139	0	0	0	8.966747744	0	8.966747744	0	0	0											10.7742	0.284447429	12.53233681	0	1.8206168	5.049834255	1.272041024	2.223234679	1.725896343	1.457044033	2.936070216	0.758675232	0.050848629	2.156071335	2.730050577	10.6824088	0.591396854	4.148570554	3.398983791	0	9.941488156	0.170315588	0	0	0	0.213408596	0	0.021033863	0	0	0	0	0	0	0	0	0	0	0	0	0	74.939	0	8.371850899	10.7742	0.284447429	12.53233681	0	1.8206168	5.049834255	1.272041024	2.223234679	1.725896343	1.457044033	2.936070216	0.758675232	0.050848629	2.156071335	2.730050577	10.6824088	0.591396854	4.148570554	3.398983791	0	9.941488156	0.170315588	0	0	0	0.213408596	0	0.021033863	0	0	0	0	0	0	0	0	0	0	0	0	0	74.939	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.7742	0.284447429	12.53233681	0	1.8206168	5.049834255	1.272041024	2.223234679	1.725896343	1.457044033	2.936070216	0.758675232	0.050848629	2.156071335	2.730050577	10.6824088	0.591396854	4.148570554	3.398983791	0	9.941488156	0.170315588	0	0	0	0.213408596	0	0.021033863	0	0	0	0	0	0	0	0	0	0	0	0	0	74.939
H4577_022_0	2008	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1802.344374	93.63369771	1338.533907	1532.785447	677.0408967	18.9181273	4.428259199	1598.167873	310.3275143	7230.163012	1361.809078	64.61035979	0.15306301	567.1960793	8663.926873	19570.13738	422.41046	4177.11421	4769.816033	907.0399076	38.6782764	45.31304393	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $55.00 and $105.00	$20.00 copayment	"Copay between $20.00 and $105.00, 20% coinsurance"	$175.00 copayment	Coin between 25% and 28%	"Copay between $20.00 and $105.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											83.97542175	46.61558942	111.419201	0	32.01157473	0.263029275	0.263029275	16.43494114	74.33043474	2.406743411	27.23318496	138.8869595	0.251263852	45.30813715	6.409301762	7.956306669	24.68169594	12.90117035	9.126151312	0	0.263029275	49.1255583	0	0	0	8.767642507	0	8.767642507	0	0	0											12.6127	0.363732501	12.4281982	0	1.806095438	4.976021313	1.164761808	2.188816244	1.922231587	1.450095599	3.090533208	0.747794702	0.038459201	2.141549813	4.627476814	12.97550121	0.868817211	4.490805165	3.627505238	0	10.17351901	0.185502382	0	0	0	0.208669892	0	0.020566809	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1094	0	11.20366727	12.6127	0.363732501	12.4281982	0	1.806095438	4.976021313	1.164761808	2.188816244	1.922231587	1.450095599	3.090533208	0.747794702	0.038459201	2.141549813	4.627476814	12.97550121	0.868817211	4.490805165	3.627505238	0	10.17351901	0.185502382	0	0	0	0.208669892	0	0.020566809	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1094	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.6127	0.363732501	12.4281982	0	1.806095438	4.976021313	1.164761808	2.188816244	1.922231587	1.450095599	3.090533208	0.747794702	0.038459201	2.141549813	4.627476814	12.97550121	0.868817211	4.490805165	3.627505238	0	10.17351901	0.185502382	0	0	0	0.208669892	0	0.020566809	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1094
H4577_023_0	2008	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1910.566243	87.18354872	1383.383524	1554.551671	694.828533	20.21493347	4.776977393	1451.747932	316.0411355	6003.02178	1356.408717	60.23645067	0.264644993	552.0942788	8536.097996	23007.76585	471.0891223	4550.863877	5123.293127	922.7451253	43.55346425	39.11824916	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $55.00 and $105.00	$20.00 copayment	"Copay between $20.00 and $105.00, 20% coinsurance"	$175.00 copayment	Coin between 25% and 27%	"Copay between $20.00 and $105.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											78.69242765	45.3235106	102.2118759	0	31.97581106	0.260191453	0.260191453	16.45237337	74.73907891	2.304213797	27.63372036	132.9702397	0.246845129	54.77136899	6.620752235	7.487399223	24.28085675	12.67666725	9.619868354	0	0.260191453	51.33015208	0	0	0	8.673048439	0	8.673048439	0	0	0											12.5289	0.329288708	11.78318542	0	1.851475491	5.259752915	1.24292869	1.990391584	1.968385281	1.152687134	3.123551598	0.667471274	0.065326328	2.519913288	4.709615823	14.35569401	0.953203958	4.807482254	4.107117118	0	11.33223915	0.167328807	0	0	0	0.206418553	0	0.020344914	0	0	0	0	0	0	0	0	0	0	0	0	0	85.1427	0	12.68266244	12.5289	0.329288708	11.78318542	0	1.851475491	5.259752915	1.24292869	1.990391584	1.968385281	1.152687134	3.123551598	0.667471274	0.065326328	2.519913288	4.709615823	14.35569401	0.953203958	4.807482254	4.107117118	0	11.33223915	0.167328807	0	0	0	0.206418553	0	0.020344914	0	0	0	0	0	0	0	0	0	0	0	0	0	85.1427	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.5289	0.329288708	11.78318542	0	1.851475491	5.259752915	1.24292869	1.990391584	1.968385281	1.152687134	3.123551598	0.667471274	0.065326328	2.519913288	4.709615823	14.35569401	0.953203958	4.807482254	4.107117118	0	11.33223915	0.167328807	0	0	0	0.206418553	0	0.020344914	0	0	0	0	0	0	0	0	0	0	0	0	0	85.1427
H4577_024_0	2008	4																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.8743	1.4077	0.2248	1.2462	0.6776	0	2.6283	0.1348	0.0733	0.9908	0.6363	1.5265	0.626	0.537	0.3916	0.0057	1.047	0.0278	0	0	0	0	0	0	0	0	0											13.0557	0	472.435944	61.9593787	3311.598531	3024.566051	25.71527389	41.40405151	6.6122044	36.6526551	19.929813	11250.08668	21.81780678	1.118788475	0.748406624	8.225140143	42.39043163	100.4431701	16.47543857	35.33348848	25.77073086	4.863196587	30.79353393	0.818294287	0	2169	662.4	158.976	138.4	28.14915254	0	1600	6											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 21%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											740.33	740.33	67.32	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.20014031	0.2	0.197546415	0.2	0.5	0.2	0.2	0.015528841	0.2	0.2	0	0	0	10	0	10	0	0	0											29.1465	3.822532236	18.57806776	0	5.143054778	8.280810303	1.32244088	7.33053102	3.9859626	0	4.363561356	0.223757695	0.149786334	1.645028029	8.374077797	20.08863402	8.237719286	7.066697697	5.154146171	0.075519807	6.158706786	0.163658857	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	139.4672	131	0	29.1465	3.822532236	18.57806776	0	6.01737409	9.688548054	1.54725583	8.576721293	4.663576242	0	6.991813779	0.358531027	0.223118371	2.63585835	9.010392427	21.61509365	8.863672547	7.603669438	5.545790325	0.081258272	7.20568694	0.191480863	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	152.5229	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	29.1465	3.822532236	18.57806776	0	6.01737409	9.688548054	1.54725583	8.576721293	4.663576242	0	6.991813779	0.358531027	0.223118371	2.63585835	9.010392427	21.61509365	8.863672547	7.603669438	5.545790325	0.081258272	7.20568694	0.191480863	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	152.5229
H4577_026_0	2008	4																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.8745	1.3809	0.2531	1.2778	0.7408	0	2.6278	0.1155	0.0132	1.0965	0.9871	2.3395	0.7334	0.7169	0.6209	0.0084	1.0908	0.0205	0	0	0	0	0	0	0	0	0											14.8974	0	492.9449544	54.35793398	3314.998514	4345.036151	25.71945524	40.61331751	7.442712177	37.58253436	21.78853773	10140.36922	24.90191502	1.094589564	0.407466104	10.39022706	49.46401471	115.9033494	14.53394144	35.51552472	30.75962338	5.831727111	32.08337422	0.603561394	0	2169	662.4	158.976	138.4	28.14915254	0	1600	6											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 21%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											717.46	717.46	64.46	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.203365878	0.2	0.197739375	0.2	0.5	0.2	0.2	0.014196198	0.2	0.2	0	0	0	10	0	10	0	0	0											29.4724	3.249970276	17.80706702	0	5.143891048	8.122663502	1.488542435	7.516506873	4.357707547	0	4.980383005	0.218917913	0.082864702	2.078045412	9.780983354	23.18066988	7.266970718	7.103104943	6.151924675	0.08278835	6.416674843	0.120712279	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	144.7787	131	0	29.4724	3.249970276	17.80706702	0	6.018352526	9.503516298	1.741594649	8.794313041	5.09851783	0	7.608212049	0.33442687	0.096034215	3.174496846	10.76811701	25.52015034	8.000380757	7.819977032	6.77280007	0.091143662	7.507509567	0.141233366	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	159.6761	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	29.4724	3.249970276	17.80706702	0	6.018352526	9.503516298	1.741594649	8.794313041	5.09851783	0	7.608212049	0.33442687	0.096034215	3.174496846	10.76811701	25.52015034	8.000380757	7.819977032	6.77280007	0.091143662	7.507509567	0.141233366	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	159.6761
H4577_027_0	2008	4																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.8967	1.408	0.2133	1.1658	0.6408	0	2.2872	0.0664	0.0619	0.8805	0.8313	1.9991	0.7123	0.5255	0.5311	0.0057	0.9886	0.0228	0	0	0	0	0	0	0	0	0											13.237	0	518.9446605	59.94344173	3450.476841	2162.491669	26.37363872	41.41159181	6.273841141	34.28682259	18.84789679	9314.575377	21.76582472	0.631762493	0.718379416	8.379236794	47.49687802	112.9447865	16.09663253	29.69085637	30.00633792	5.803991066	29.07579841	0.670547729	0	2169	662.4	158.976	138.4	28.14915254	0	1600	6											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 20%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											679.67	679.67	61.49	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.197766952	0.2	0.5	0.2	0.2	0.011175949	0.2	0.2	0	0	0	10	0	10	0	0	0											29.3926	3.395146587	17.68081841	0	5.274727743	8.282318362	1.254768228	6.857364519	3.769579357	0	4.353164943	0.126352499	0.143675883	1.675847359	9.393312815	22.5889573	8.048316266	5.938171275	6.001267585	0.06486511	5.815159682	0.134109546	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	140.3465	131	0	29.3926	3.395146587	17.68081841	0	6.17143146	9.690312484	1.468078827	8.023116487	4.410407848	0	6.640356734	0.192739231	0.205615965	2.556352548	10.22460732	24.58804711	8.760580532	6.463690783	6.532371024	0.070605578	6.803736827	0.156908169	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	153.5835	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	29.3926	3.395146587	17.68081841	0	6.17143146	9.690312484	1.468078827	8.023116487	4.410407848	0	6.640356734	0.192739231	0.205615965	2.556352548	10.22460732	24.58804711	8.760580532	6.463690783	6.532371024	0.070605578	6.803736827	0.156908169	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	153.5835
H4577_028_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1832.88736	91.33639568	1400.330737	1702.981721	696.8715416	20.21738107	4.891644668	1841.330588	356.551587	7439.052632	1472.460446	69.06883353	0.214274399	562.805041	10504.74344	21263.98827	415.1174534	4166.113819	5147.238955	1053.123454	37.22585447	45.63217837	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $45.00 and $90.00	$20.00 copayment	"Copay between $20.00 and $90.00, 20% coinsurance"	$150.00 copayment	Coin between 25% and 27%	"Copay between $20.00 and $90.00, 20% coinsurance"	Copay between $0.00 and $15.00	"Copay between $0.00 and $30.00, 20% coinsurance"	Copay between $20.00 and $30.00	"$30.00 copayment, 20% coinsurance"	"Copay between $15.00 and $30.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											69.49366417	39.67560303	105.1819467	0	32.71339903	0.268938754	0.268938754	16.90487841	64.28544439	2.463877988	24.23216734	121.8720417	0.260927297	46.47249191	4.91738829	7.265729705	21.16365088	12.6328017	8.961927739	0	0.268938754	46.40023003	0	0	0	8.964625131	0	8.964625131	0	0	0											10.6145	0.301985548	12.27412607	0	1.899753068	5.437237272	1.315552822	2.59395581	1.910089768	1.527409836	2.973408994	0.701463313	0.05591004	2.179579393	4.304658533	12.87486594	0.732116738	4.385807478	3.844098631	0	10.01147491	0.176445298	0	0	0	0.213358078	0	0.021028883	0	0	0	0	0	0	0	0	0	0	0	0	0	80.3488	0	8.997203592	10.6145	0.301985548	12.27412607	0	1.899753068	5.437237272	1.315552822	2.59395581	1.910089768	1.527409836	2.973408994	0.701463313	0.05591004	2.179579393	4.304658533	12.87486594	0.732116738	4.385807478	3.844098631	0	10.01147491	0.176445298	0	0	0	0.213358078	0	0.021028883	0	0	0	0	0	0	0	0	0	0	0	0	0	80.3488	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.6145	0.301985548	12.27412607	0	1.899753068	5.437237272	1.315552822	2.59395581	1.910089768	1.527409836	2.973408994	0.701463313	0.05591004	2.179579393	4.304658533	12.87486594	0.732116738	4.385807478	3.844098631	0	10.01147491	0.176445298	0	0	0	0.213358078	0	0.021028883	0	0	0	0	0	0	0	0	0	0	0	0	0	80.3488
H4577_029_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1749.357343	77.65118233	1325.306736	1450.945651	658.6590078	18.88453849	4.756843096	1564.153663	317.273309	7204.74127	1411.464586	75.93811233	0.199671642	573.6023525	9226.541323	20317.04555	384.3437159	4104.116736	4882.831584	968.6347253	37.26373116	42.52975041	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 28%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											119.0379632	71.09579558	111.0290726	0	32.76449965	0.261614214	0.261614214	16.84962024	106.751082	2.374145796	33.82625288	177.0511681	0.250766572	51.05654888	6.553044977	8.026418146	24.50469049	12.85850481	9.24808412	0	0.261614214	47.11094613	0	0	0	8.720473812	0	8.720473812	0	0	0											17.3533	0.460056049	12.26229815	0	1.798386069	4.940463701	1.244457769	2.196282935	2.822439085	1.425425517	3.978713167	1.120410958	0.050070973	2.440513046	5.038495023	13.58942526	0.784851983	4.397733733	3.763069769	0	9.748721753	0.166968065	0	0	0	0.207547277	0	0.020456162	0	0	0	0	0	0	0	0	0	0	0	0	0	89.8101	0	12.77834134	17.3533	0.460056049	12.26229815	0	1.798386069	4.940463701	1.244457769	2.196282935	2.822439085	1.425425517	3.978713167	1.120410958	0.050070973	2.440513046	5.038495023	13.58942526	0.784851983	4.397733733	3.763069769	0	9.748721753	0.166968065	0	0	0	0.207547277	0	0.020456162	0	0	0	0	0	0	0	0	0	0	0	0	0	89.8101	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.3533	0.460056049	12.26229815	0	1.798386069	4.940463701	1.244457769	2.196282935	2.822439085	1.425425517	3.978713167	1.120410958	0.050070973	2.440513046	5.038495023	13.58942526	0.784851983	4.397733733	3.763069769	0	9.748721753	0.166968065	0	0	0	0.207547277	0	0.020456162	0	0	0	0	0	0	0	0	0	0	0	0	0	89.8101
H4577_030_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1764.953049	92.03571477	1318.164261	1510.180643	673.5314468	18.64194553	4.363311706	1590.320232	307.1862212	7123.513677	1335.012095	63.83308243	0.151662173	562.6026068	8530.271974	19275.41906	416.7192273	4141.408917	4699.751701	893.7361299	38.20197935	44.80547047	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 29%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											120.8344081	67.07695253	111.8932304	0	31.95123884	0.262536908	0.262536908	16.40437513	105.75485	2.402268214	34.55889826	187.8342539	0.251007839	50.18555762	6.402837771	7.945711717	24.61790772	12.89026838	9.108513462	0	0.262536908	49.02971973	0	0	0	8.751230283	0	8.751230283	0	0	0											17.7723	0.514456273	12.29113811	0	1.79334701	4.894198747	1.145530366	2.174017472	2.707202729	1.426049206	3.844712264	0.999169951	0.038068394	2.352877128	4.551495632	12.76307692	0.85489629	4.448656034	3.567312636	0	10.02942956	0.183066638	0	0	0	0.208279281	0	0.02052831	0	0	0	0	0	0	0	0	0	0	0	0	0	88.5798	0	12.26515488	17.7723	0.514456273	12.29113811	0	1.79334701	4.894198747	1.145530366	2.174017472	2.707202729	1.426049206	3.844712264	0.999169951	0.038068394	2.352877128	4.551495632	12.76307692	0.85489629	4.448656034	3.567312636	0	10.02942956	0.183066638	0	0	0	0.208279281	0	0.02052831	0	0	0	0	0	0	0	0	0	0	0	0	0	88.5798	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.7723	0.514456273	12.29113811	0	1.79334701	4.894198747	1.145530366	2.174017472	2.707202729	1.426049206	3.844712264	0.999169951	0.038068394	2.352877128	4.551495632	12.76307692	0.85489629	4.448656034	3.567312636	0	10.02942956	0.183066638	0	0	0	0.208279281	0	0.02052831	0	0	0	0	0	0	0	0	0	0	0	0	0	88.5798
H4577_031_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1874.02297	85.78173562	1364.691189	1533.042166	691.8568062	19.93692804	4.710938899	1445.789343	313.0411018	5919.744782	1330.856408	59.47821761	0.262677031	548.2090783	8412.512358	22682.57817	465.1526783	4512.979286	5052.514183	910.0149102	43.05662907	38.71651876	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 27%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											112.2222585	64.64060205	101.7952391	0	31.95639283	0.260035522	0.260035522	16.44265816	106.5629604	2.302841945	34.77163202	189.844391	0.246796644	59.20266707	6.621623912	7.485891238	24.24840866	12.68473988	9.61365135	0	0.260035522	51.30012618	0	0	0	8.66785074	0	8.66785074	0	0	0											17.5256	0.46208192	11.57658882	0	1.842437323	5.184309493	1.225011457	1.981051662	2.779882212	1.136019716	3.856337441	0.940967166	0.06482781	2.704619963	4.642041083	14.14994277	0.939934353	4.770497362	4.04775915	0	11.19625302	0.165513525	0	0	0	0.206294848	0	0.020332721	0	0	0	0	0	0	0	0	0	0	0	0	0	91.4183	0	13.67487574	17.5256	0.46208192	11.57658882	0	1.842437323	5.184309493	1.225011457	1.981051662	2.779882212	1.136019716	3.856337441	0.940967166	0.06482781	2.704619963	4.642041083	14.14994277	0.939934353	4.770497362	4.04775915	0	11.19625302	0.165513525	0	0	0	0.206294848	0	0.020332721	0	0	0	0	0	0	0	0	0	0	0	0	0	91.4183	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.5256	0.46208192	11.57658882	0	1.842437323	5.184309493	1.225011457	1.981051662	2.779882212	1.136019716	3.856337441	0.940967166	0.06482781	2.704619963	4.642041083	14.14994277	0.939934353	4.770497362	4.04775915	0	11.19625302	0.165513525	0	0	0	0.206294848	0	0.020332721	0	0	0	0	0	0	0	0	0	0	0	0	0	91.4183
H4577_032_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1862.043513	97.30934923	1324.660824	1195.492998	677.3810303	15.50986313	4.00016754	1031.301608	241.6773793	5343.490871	1179.373374	46.87518723	0.19331342	450.5312951	8427.821385	23519.24386	604.391197	5369.147781	4885.480168	837.9371396	46.6754982	27.76345846	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 31%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											120.466837	69.18593623	109.1604666	0	29.55443508	0.260029696	0.260029696	16.3101976	103.8953746	2.275711729	34.29337356	187.6077983	0.24048191	54.70711535	6.453426077	7.306958442	25.62307635	11.51450115	10.8331499	0	0.260029696	51.90650175	0	0	0	8.667656547	0	8.667656547	0	0	0											18.6929	0.561036536	12.05004946	0	1.66830114	4.033025002	1.040162351	1.401727751	2.092430154	1.013353738	3.370390972	0.732845889	0.04648838	2.053938961	4.532360192	14.32117812	1.290530149	5.151921524	4.410428249	0	12.13701563	0.120092	0	0	0	0.206290226	0	0.020332266	0	0	0	0	0	0	0	0	0	0	0	0	0	90.9468	0	13.67827276	18.6929	0.561036536	12.05004946	0	1.66830114	4.033025002	1.040162351	1.401727751	2.092430154	1.013353738	3.370390972	0.732845889	0.04648838	2.053938961	4.532360192	14.32117812	1.290530149	5.151921524	4.410428249	0	12.13701563	0.120092	0	0	0	0.206290226	0	0.020332266	0	0	0	0	0	0	0	0	0	0	0	0	0	90.9468	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.6929	0.561036536	12.05004946	0	1.66830114	4.033025002	1.040162351	1.401727751	2.092430154	1.013353738	3.370390972	0.732845889	0.04648838	2.053938961	4.532360192	14.32117812	1.290530149	5.151921524	4.410428249	0	12.13701563	0.120092	0	0	0	0.206290226	0	0.020332266	0	0	0	0	0	0	0	0	0	0	0	0	0	90.9468
H4577_801_0	2008	5																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.3569	0.7198	0.1745	0.5838	0.9225	0	0.8411	0.0358	0.007	0.3424	1.2178	4.1602	0.2972	0.881	1.1609	0.019	1.4049	0.036	0	0	0	0	0	0	0	0	0											13.1609	0	355.6710637	10.06143402	1520.822796	1656.433465	10.49565024	21.16974036	5.133599152	17.17017755	27.13355434	7765.162726	24.7396934	1.054238925	0.213608397	10.06937535	36.95214507	122.3578668	3.496875889	25.91314542	34.14287531	8.527424866	41.32186091	1.059780558	0	0	0	0	0	0	0	0	0											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 23%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											793.27	793.27	73.42	0	0.2	0.2	0.2	0.2	0.2	0	0.257003654	0.257003654	0.23523676	0.257003654	0.19771176	0.203977593	0.509943983	0.203977593	0.203977593	0.013368857	0.2	0.2	0	0	0	0	0	0	0	0	0											23.5119	0.665119481	9.304900809	0	2.099130049	4.233948072	1.02671983	3.434035509	5.426710868	0	6.358191605	0.270943256	0.050248547	2.58786626	7.305873632	24.95826318	1.783210819	5.285701035	6.964381532	0.114001921	8.264372183	0.211956112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.8575	1.31	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184
H4577_802_0	2008	5																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.3569	0.7198	0.1745	0.5838	0.9225	0	0.8411	0.0358	0.007	0.3424	1.2178	4.1602	0.2972	0.881	1.1609	0.019	1.4049	0.036	0	0	0	0	0	0	0	0	0											13.1609	0	355.6710637	10.06143402	1520.822796	1656.433465	10.49565024	21.16974036	5.133599152	17.17017755	27.13355434	7765.162726	24.7396934	1.054238925	0.213608397	10.06937535	36.95214507	122.3578668	3.496875889	25.91314542	34.14287531	8.527424866	41.32186091	1.059780558	0	0	0	0	0	0	0	0	0											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 23%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											793.27	793.27	73.42	0	0.2	0.2	0.2	0.2	0.2	0	0.257003654	0.257003654	0.23523676	0.257003654	0.19771176	0.203977593	0.509943983	0.203977593	0.203977593	0.013368857	0.2	0.2	0	0	0	0	0	0	0	0	0											23.5119	0.665119481	9.304900809	0	2.099130049	4.233948072	1.02671983	3.434035509	5.426710868	0	6.358191605	0.270943256	0.050248547	2.58786626	7.305873632	24.95826318	1.783210819	5.285701035	6.964381532	0.114001921	8.264372183	0.211956112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.8575	1.31	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184
H4577_803_0	2008	5																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.3569	0.7198	0.1745	0.5838	0.9225	0	0.8411	0.0358	0.007	0.3424	1.2178	4.1602	0.2972	0.881	1.1609	0.019	1.4049	0.036	0	0	0	0	0	0	0	0	0											13.1609	0	355.6710637	10.06143402	1520.822796	1656.433465	10.49565024	21.16974036	5.133599152	17.17017755	27.13355434	7765.162726	24.7396934	1.054238925	0.213608397	10.06937535	36.95214507	122.3578668	3.496875889	25.91314542	34.14287531	8.527424866	41.32186091	1.059780558	0	0	0	0	0	0	0	0	0											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 23%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											793.27	793.27	73.42	0	0.2	0.2	0.2	0.2	0.2	0	0.257003654	0.257003654	0.23523676	0.257003654	0.19771176	0.203977593	0.509943983	0.203977593	0.203977593	0.013368857	0.2	0.2	0	0	0	0	0	0	0	0	0											23.5119	0.665119481	9.304900809	0	2.099130049	4.233948072	1.02671983	3.434035509	5.426710868	0	6.358191605	0.270943256	0.050248547	2.58786626	7.305873632	24.95826318	1.783210819	5.285701035	6.964381532	0.114001921	8.264372183	0.211956112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.8575	1.31	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184
H4577_804_0	2008	5																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.3569	0.7198	0.1745	0.5838	0.9225	0	0.8411	0.0358	0.007	0.3424	1.2178	4.1602	0.2972	0.881	1.1609	0.019	1.4049	0.036	0	0	0	0	0	0	0	0	0											13.1609	0	355.6710637	10.06143402	1520.822796	1656.433465	10.49565024	21.16974036	5.133599152	17.17017755	27.13355434	7765.162726	24.7396934	1.054238925	0.213608397	10.06937535	36.95214507	122.3578668	3.496875889	25.91314542	34.14287531	8.527424866	41.32186091	1.059780558	0	0	0	0	0	0	0	0	0											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 23%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											793.27	793.27	73.42	0	0.2	0.2	0.2	0.2	0.2	0	0.257003654	0.257003654	0.23523676	0.257003654	0.19771176	0.203977593	0.509943983	0.203977593	0.203977593	0.013368857	0.2	0.2	0	0	0	0	0	0	0	0	0											23.5119	0.665119481	9.304900809	0	2.099130049	4.233948072	1.02671983	3.434035509	5.426710868	0	6.358191605	0.270943256	0.050248547	2.58786626	7.305873632	24.95826318	1.783210819	5.285701035	6.964381532	0.114001921	8.264372183	0.211956112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.8575	1.31	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184
H4590_010_0	2008	4																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		267.191671	2.086916086	1040.38817		528.8451401	10.98970697	12.00984288	323.8219069	263.2531941		42.57756147			1104.970322	4577.536491	3530.05406	74.62150573	215.5154721			34.17706839	1213.97863			112.0471086	0.025006815																$100 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$5 (4b)"	$100 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $100 (9a)"	"$5/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $5 (14c1, 14c)"	"$30 (7b); $0 n/c (7b1, 7f1); $20 (7d); $5/$30( 7f); $5/$20( 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $5/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c; $20 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"											100	912	46.6886		167.5713	0.2	0.2	50	100		0.146486328			3.7845	5	20.5264	30	7.9579			0.2	30			25	0.25374423																2.2266	0.158605623	4.047852988	0	7.384940479	2.197941395	2.401968576	1.349257945	2.193776618	0	6.237030638	0	0	0.348476553	1.907306871	6.038286543	0.186553764	0.142921059	0	0	6.835413679	3.034946576	0	0	0.233431476	0.006345335	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.9317	0	0	2.2266	0.158605623	4.047852988	0	7.384940479	2.197941395	2.401968576	1.349257945	2.193776618	0	6.237030638	0	0	0.348476553	1.907306871	6.038286543	0.186553764	0.142921059	0	0	6.835413679	3.034946576	0	0	0.233431476	0.006345335	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.9317																																																																																				0			2.2266	0.158605623	4.047852988	0	7.384940479	2.197941395	2.401968576	1.349257945	2.193776618	0	6.237030638	0	0	0.348476553	1.907306871	6.038286543	0.186553764	0.142921059	0	0	6.835413679	3.034946576	0	0	0.233431476	0.006345335	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.9317
H4590_012_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2095.952052	1.800604977	1033.33173		531.9475472	18.31279849	9.490430306	462.2247746	349.1737819		70.29359785			1131.47493	5085.287271	4162.983659	5.881451614	460.7748305			34.57238749	1243.846175			188.6796721	0.009588713																$100 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$180 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$5 (4b)"	$100 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $100 (9a)"	"$5/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $5 (14c1, 14c)"	"$30 (7b); $0 n/c (7b1, 7f1); $25 (7d); $5/$30( 7f); $5/$25( 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $5/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"											42.837	912	63.2242		180	0.2	0.2	50	100		0.143279686			3.6471	5	25.3732	30	7.9579			0.2	30			30	0.606188038																7.482	0.136845978	5.444300773	0	7.979213207	3.662559698	1.898086061	1.925936561	2.909781516	0	10.07164461	0	0	0.343885806	2.118869696	8.802343915	0.014703629	0.305567049	0	0	6.914477497	3.109615438	0	0	0.47169918	0.005812563	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.5974	0	0	7.482	0.136845978	5.444300773	0	7.979213207	3.662559698	1.898086061	1.925936561	2.909781516	0	10.07164461	0	0	0.343885806	2.118869696	8.802343915	0.014703629	0.305567049	0	0	6.914477497	3.109615438	0	0	0.47169918	0.005812563	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.5974																																																																																				0			7.482	0.136845978	5.444300773	0	7.979213207	3.662559698	1.898086061	1.925936561	2.909781516	0	10.07164461	0	0	0.343885806	2.118869696	8.802343915	0.014703629	0.305567049	0	0	6.914477497	3.109615438	0	0	0.47169918	0.005812563	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.5974
H4590_020_0	2008	7	F2	H5a	H5b	I2a	O1a	E2b					OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)	DME						Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests	Diabetes Monitoring Supplies					A	A	D	P	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V		V	Coin	V	T	P	V	P	V	P				V	P	V	V	V																																															0		463.412323	2.547916342	1248.585884	736.6723914	6.480397848	18.43250859	12.46763012	371.139894	353.6411072	3204.611457	64.85394281		14.88021055	25.07272472	3734.643276	5290.584885	16.8134479	453.0043192			27.72929561	1198.288551	810.3908449		182.0142179							126.1969137		41.3719894	78.6							(1a) $0/admit	(1b) $812/admit	(2a) $140/day days 21-100	(6a) $0/proc	(10a) $50/trip	(11a) 20% coins	(11b/11c) 20%/0% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $0/visit	(8a) $0/visit	(8b) 11.77% coins (0%/20%/$20)		(12) 20% coins	(9a) $0/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $0/visit	(7e/7h) $10/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit			(15) 20% coins	(16b/17a) $0/visit (13a/13a1/14a10/17b N/A $0 Copay)	(10b) $0/trip		(17a1) $0/visit							(4b) $0/visit (waived if admitted)		(9d) $0/visit	(7f1) $0/visit								812	42		50	0.2	0.2	50			0.1177		0.2				10				0.2																					0	0.172409006	4.370050592	0	0.027001658	3.686501718	2.493526023	1.546416225	0	0	7.633309068	0	2.976042111	0	0	0	0.014011207	0	0	0	5.545859123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4651		0	0	0.172409006	4.370050592	0	0.027001658	3.686501718	2.493526023	1.546416225	0	0	7.633309068	0	2.976042111	0	0	0	0.014011207	0	0	0	5.545859123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4651																																																																																				0		0	0	0.172409006	4.370050592	0	0.027001658	3.686501718	2.493526023	1.546416225	0	0	7.633309068	0	2.976042111	0	0	0	0.014011207	0	0	0	5.545859123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4651
H4590_022_0	2008	6	F2	H5a	H5b	I2a	O1a	E2b					OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)	DME						Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests	Diabetes Monitoring Supplies					A	A	D	P	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V		V	Coin	V	T	P	V	P	V	P				V	P	V	V	V																																															0		465.2260681	2.557888608	1243.732299	757.2570563	6.661478094	18.39667855	12.44339491	389.2232789	370.8718829	3360.752641	60.14621064		13.80005964	26.29436577	3670.037499	5199.062799	16.52259125	445.1677753			27.67539401	1231.772048	833.0354073		178.865545							132.3457201		43.38779428	78.6							(1a) $0/admit	(1b) $812/admit	(2a) $140/day days 21-100	(6a) $0/proc	(10a) $50/trip	(11a) 20% coins	(11b/11c) 20%/0% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $0/visit	(8a) $0/visit	(8b) 11.77% coins (0%/20%/$20)		(12) 20% coins	(9a) $0/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $0/visit	(7e/7h) $10/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit			(15) 20% coins	(16b/17a) $0/visit (13a/13a1/14a10/17b N/A $0 Copay)	(10b) $0/trip		(17a1) $0/visit							(4b) $0/visit (waived if admitted)		(9d) $0/visit	(7f1) $0/visit								812	42		50	0.2	0.2	50			0.1177		0.2				10				0.2																					0	0.173083796	4.353063045	0	0.027756159	3.679335709	2.488678981	1.621763662	0	0	7.079208992	0	2.760011927	0	0	0	0.013768826	0	0	0	5.535078801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.7317		0	0	0.173083796	4.353063045	0	0.027756159	3.679335709	2.488678981	1.621763662	0	0	7.079208992	0	2.760011927	0	0	0	0.013768826	0	0	0	5.535078801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.7317																																																																																				0		0	0	0.173083796	4.353063045	0	0.027756159	3.679335709	2.488678981	1.621763662	0	0	7.079208992	0	2.760011927	0	0	0	0.013768826	0	0	0	5.535078801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.7317
H4590_025_0	2008	5																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		299.9583967	1.833523723	846.4660549		528.2674367	16.6129669	11.29498191	441.7195637	309.0915123		55.91932605			1274.880394	5262.623867	3532.999092	33.56609814	352.6747393			26.98924667	1422.289791			139.6119946	2.41E-05																$50 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$180 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$5 (4b)"	$50 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$50 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $50 (9a)"	"$5/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $5 (14c1, 14c)"	"$30 (7b); $0 n/c (7b1, 7f1); $15 (7d); $5/$30( 7f); $5/$15( 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $5/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"											50	912	63.2242		180	0.2	0.2	50	50		0.140072007			2.1143	5	15.7798	30	7.9579			0.2	30			30	0.292479523																1.2498	0.139347803	4.459764145	0	7.92401155	3.32259338	2.258996383	1.840498182	1.287881301	0	7.832732228	0	0	0.224622331	2.192759945	4.64583339	0.083915245	0.233879483	0	0	5.397849335	3.555724476	0	0	0.349029986	7.06E-06	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.9993	0	0	1.2498	0.139347803	4.459764145	0	7.92401155	3.32259338	2.258996383	1.840498182	1.287881301	0	7.832732228	0	0	0.224622331	2.192759945	4.64583339	0.083915245	0.233879483	0	0	5.397849335	3.555724476	0	0	0.349029986	7.06E-06	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.9993																																																																																				0			1.2498	0.139347803	4.459764145	0	7.92401155	3.32259338	2.258996383	1.840498182	1.287881301	0	7.832732228	0	0	0.224622331	2.192759945	4.64583339	0.083915245	0.233879483	0	0	5.397849335	3.555724476	0	0	0.349029986	7.06E-06	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.9993
H4590_027_0	2008	3																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1960.959684	1.356112334	898.9717927		531.7163772	17.88057208	8.572455598	461.8569092	358.1322568		69.45498741			1158.132043	5022.46439	4124.657048	4.522558528	451.9949785			35.59320032	1250.32772			166.4529837	0.004868895																$100 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$5 (4b)"	$100 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $100 (9a)"	"$5/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $5 (14c1, 14c)"	"$30 (7b); $0 n/c (7b1, 7f1); $25 (7d); $5/$30( 7f); $5/$25( 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $5/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$0 n/c (13b, 13c, 13d, 13e)"											42.837	912	63.2242		100	0.2	0.2	50	100		0.142804397			3.8319	5	25.387	30	7.9579			0.2	30			30	0.618465981																7.0001	0.103064537	4.736400409	0	4.43096981	3.576114416	1.71449112	1.924403788	2.984435473	0	9.918477608	0	0	0.369820687	2.092693496	8.72604033	0.011306396	0.299744609	0	0	7.118640063	3.125819299	0	0	0.416132459	0.003011246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5517	0	0	7.0001	0.103064537	4.736400409	0	4.43096981	3.576114416	1.71449112	1.924403788	2.984435473	0	9.918477608	0	0	0.369820687	2.092693496	8.72604033	0.011306396	0.299744609	0	0	7.118640063	3.125819299	0	0	0.416132459	0.003011246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5517																																																																																				0			7.0001	0.103064537	4.736400409	0	4.43096981	3.576114416	1.71449112	1.924403788	2.984435473	0	9.918477608	0	0	0.369820687	2.092693496	8.72604033	0.011306396	0.299744609	0	0	7.118640063	3.125819299	0	0	0.416132459	0.003011246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5517
H4590_029_0	2008	3																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0			2.086919659	1040.389952		528.8460457	10.92381561	11.93484762	323.6538349			42.32216488			50.38050817		391.581434	74.62163352	215.5158411			33.98586396	1213.980709									140											"$0 (1a, 1a1)"	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$0 (4b)"	$0 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	$0 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $0 (9a)"	"$0/$50/$30 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14f1, 14h1)"	$30 (7b); $10 (7b1); $0 (7d); $0/$30( 7f); $0 n/c( 7f1); $0/$0( 7g)	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $0/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c; $20 (16)	$0 (17a1)	$0 n/c; $0 (17b)	$0 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$0 n/c (13c, 13d, 13e); $10 (13b)"												912	41.2041		100	0.2	0.2	50			0.146481651			30.6715		19.5068	30	7.9579			0.2	30									10											0	0.158605894	3.572361313	0	4.407050381	2.184763122	2.386969523	1.348557645	0	0	6.199420568	0	0	0.128770551	0	0.636541535	0.186554084	0.142921304	0	0	6.797172793	3.034951773	0	0	0	0	0	0	0	0	0.116666667	0	0	0	0	0	0	0	0	0	0	31.3013	0	0	0	0.158605894	3.572361313	0	4.407050381	2.184763122	2.386969523	1.348557645	0	0	6.199420568	0	0	0.128770551	0	0.636541535	0.186554084	0.142921304	0	0	6.797172793	3.034951773	0	0	0	0	0	0	0	0	0.116666667	0	0	0	0	0	0	0	0	0	0	31.3013																																																																																				0			0	0.158605894	3.572361313	0	4.407050381	2.184763122	2.386969523	1.348557645	0	0	6.199420568	0	0	0.128770551	0	0.636541535	0.186554084	0.142921304	0	0	6.797172793	3.034951773	0	0	0	0	0	0	0	0	0.116666667	0	0	0	0	0	0	0	0	0	0	31.3013
H4590_031_0	2008	4	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						1650	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T				V					V	P	V	V																																																0		1981.49665	93.39904601	9485.007165	231.4941012	527.0831317	33.30193283	0.299354173	188.8674812	128.6979479	4819.32741	195.2087015	29.68844039	7.277991454	241.5731855	143.1198493	1541.338268	2309.894582	27.92404598		310.2995815	274.6087626	746.7008229	1657.83									108.3772193	1.369127105		247.1							(1a) $150/day	(1b) $150/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $25/visit	(8a) $0/visit	(8b) $0/visit	(9a) $25/visit	(12) $0/proc	(9a) $25/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $10/visit	(7e/7h) $0/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $10/visit	(15) $0/proc	(Misc. PBP Cats) $10/visit	(10b) $0/trip				(18a) $10/visit					(4b) $35/visit (waived if admitted)	(9c) $0/proc 75%/25% Ind/Grp Blended Copay	(9d) $25/visit	(7f1) $0/visit							134.0391	134.0391			67.0195	0.178718763	0.178718763	44.6797	22.3398			22.3398		22.3398		8.9359				8.9359		8.9359										31.2758										22.1332	1.043260125	0	0	2.94373892	5.951680249	0.053500208	0.703211722	0.239591022	0	0	0.055269597	0	0.449725635	0	1.147775287	0	0	0	0.231068156	0	0.556039365	0	0	0	0	0	0	0	0	0	0.282465204	0	0	0	0	0	0	0	0	0	35.7905		4.261812666	22.1332	1.043260125	0	0	2.94373892	5.951680249	0.053500208	0.703211722	0.239591022	0	0	0.055269597	0	0.449725635	0	1.147775287	0	0	0	0.231068156	0	0.556039365	0	0	0	0	0	0	0	0	0	0.282465204	0	0	0	0	0	0	0	0	0	35.7905																																																																																				0		0	22.1332	1.043260125	0	0	2.94373892	5.951680249	0.053500208	0.703211722	0.239591022	0	0	0.055269597	0	0.449725635	0	1.147775287	0	0	0	0.231068156	0	0.556039365	0	0	0	0	0	0	0	0	0	0.282465204	0	0	0	0	0	0	0	0	0	35.7905
H4590_033_0	2008	5																																D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T	V	V	P	V	P																																																							0			32.60509748	1125.310887		454.6241322	32.36978691	23.11722081	788.0663749			206.712882		4.80661562	16.4091079			997.9520838				29.40300783																					1(a) $0 per Day	1(b) $812 per Stay	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $50 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $0-50 per visit	9(b) $0 per Visit	8(a) Diagnostic: 0% Coinsurance; other 0% coinsurance	8(b) X-rays 0% Coinsurance; other: 20% Coinsurance; Therapeutic Rad $20 per visit	9(a) $0 per Visit	12  20% Coinsurance	"3, 9(a), 9(d) $0 per visit; 5 $10 per Visit; 9(c) $10/10 per Visit"	7(a) PCP $0 per visit; Urgent Care $0-50 per Visit	7(b)/7(d)/7(f) $0 per Visit	7(e)/7(h) $10 per Visit	7(c)/7(i) $0 per Visit		7(g) $0 per Visit	15  20% per script	"13, 14(a)-(j), 17(a), 16(b) 0% Coinsurance"	10(b) $0 Copay	16(a)/16(b) $0 copay per visit	17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a/18a1 $0/$0 per visit	18(b) $0 copay per procedure															812	42		50	0.2	0.2	50			20		0.2	10			10				0.2																					0	2.206278263	3.938588105	0	1.894267218	6.473957383	4.623444163	3.283609895	0	0	0.34452147	0	0.961323124	0.013674257	0	0	0.831626737	0	0	0	5.880601566	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.4519	0	0	0	2.206278263	3.938588105	0	1.894267218	6.473957383	4.623444163	3.283609895	0	0	0.34452147	0	0.961323124	0.013674257	0	0	0.831626737	0	0	0	5.880601566	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.4519																																																																																				0	0	0	0	2.206278263	3.938588105	0	1.894267218	6.473957383	4.623444163	3.283609895	0	0	0.34452147	0	0.961323124	0.013674257	0	0	0.831626737	0	0	0	5.880601566	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.4519
H4590_034_0	2008	5	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						2800	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T				V					V	P	V	V																																																0		1969.271961	92.82282791	9500.314652	224.6879659	511.5864123	32.75351808	0.294424422	179.6821102	122.4388587	4584.944498	185.7149319	28.24457436	6.924034005	229.8245281	145.3072595	1564.895721	2345.19847	28.35083057		315.0421276	266.5350173	724.7471453	1657.83									103.1064074	1.302541051		247.1							(1a) $200/day	(1b) $200/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $35/visit	(8a) $0/visit	(8b) $0/visit	(9a) $35/visit	(12) $0/proc	(9a) $35/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $15/visit	(7e/7h) $32.5/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $15/visit	(15) $0/proc	(Misc. PBP Cats) $15/visit	(10b) $0/trip				(18a) $15/visit					(4b) $35/visit (waived if admitted)	(9c) $32.5/proc 75%/25% Ind/Grp Blended Copay	(9d) $35/visit	(7f1) $0/visit							184.0488	184.0488			69.0183	0.18404883	0.18404883	46.0122	32.2085			32.2085		32.2085		13.8037	29.9079			13.8037		13.8037										32.2085	29.9079									30.2035	1.423661071	0	0	2.942402515	6.028246672	0.05418847	0.688964211	0.32863146	0	0	0.075809721	0	0.616859475	0	1.800107663	5.845003584	0	0	0.362394593	0	0.8336804	0	0	0	0	0	0	0	0	0	0.276742282	0.003246359	0	0	0	0	0	0	0	0	51.4835		4.461975438	30.2035	1.423661071	0	0	2.942402515	6.028246672	0.05418847	0.688964211	0.32863146	0	0	0.075809721	0	0.616859475	0	1.800107663	5.845003584	0	0	0.362394593	0	0.8336804	0	0	0	0	0	0	0	0	0	0.276742282	0.003246359	0	0	0	0	0	0	0	0	51.4835																																																																																				0		0	30.2035	1.423661071	0	0	2.942402515	6.028246672	0.05418847	0.688964211	0.32863146	0	0	0.075809721	0	0.616859475	0	1.800107663	5.845003584	0	0	0.362394593	0	0.8336804	0	0	0	0	0	0	0	0	0	0.276742282	0.003246359	0	0	0	0	0	0	0	0	51.4835
H4590_035_0	2008	6	F2	H5a	H5b	I2a	O1a	E2b	I2b				OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)	DME	Professional				1500	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests	Diabetes Monitoring Supplies					D	D	D	P	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V		V	Coin	V	T	P	V	P	V					V	P	V				V																																													0		1971.57785	10.84005576	1130.230218	666.8419118	5.866109469	16.834234	11.38656748	335.9588867	320.1188409	2900.840666	1143.521855		13.58995415	22.69603677	3380.629831	185.1332306	15.21967143	410.0632382			1511.572625	1084.700658	607.2		164.7607681							114.2344849		37.45026532				4603.947752				(1a) $150/day	(1b) $150/day	(2a) $42/day	(6a) $0/proc	(10a) $75/trip	(11a) 15% coins	(11a/11c) 20%/0% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $25/visit	(8a) $0/visit	(8b) $15/visit		(12) 20% coins	(9a) $25/visit	"(7a, 14b-14i) $0/visit"	(7b) $15/visit	(7e/7h) $15/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $15/visit			(15) $0/proc	(16b/17a) $15/visit (13a/13a1/14a10/17b N/A $0 Copay)	(10b) $0/trip		(17a1) $0/visit							(4b) $10/visit (waived if admitted)		(9d) $25/visit				(7d/7f$10/visit				127.5791	127.5791	35.7222		63.7896	0.127579131	0.170105508	42.5264	21.2632		12.7579		0.170105508	21.2632		12.7579	12.7579	12.7579				12.7579										8.5053		21.2632				8.5053				20.961	0.115247075	3.364521751	0	0.031183048	2.14769695	1.936917849	1.190592858	0.567228939	0	1.215746041	0	2.311726058	0.040215842	0	0.196826139	0.016180937	0.435962597	0	0	0	1.153209731	0	0	0	0	0	0	0	0	0	0.080966313	0	0.066359338	0	0	0	3.263153636	0	0	0	39.0948		6.870545908	20.961	0.115247075	3.364521751	0	0.031183048	2.14769695	1.936917849	1.190592858	0.567228939	0	1.215746041	0	2.311726058	0.040215842	0	0.196826139	0.016180937	0.435962597	0	0	0	1.153209731	0	0	0	0	0	0	0	0	0	0.080966313	0	0.066359338	0	0	0	3.263153636	0	0	0	39.0948																																																																																				0		0	20.961	0.115247075	3.364521751	0	0.031183048	2.14769695	1.936917849	1.190592858	0.567228939	0	1.215746041	0	2.311726058	0.040215842	0	0.196826139	0.016180937	0.435962597	0	0	0	1.153209731	0	0	0	0	0	0	0	0	0	0.080966313	0	0.066359338	0	0	0	3.263153636	0	0	0	39.0948
H4590_036_0	2008	7																					1500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2185.131259	149.8581925	981.3697767		303.2985996	12.48890637	21.68942398	471.9089783	446.0450214	3739.568588	491.4458339	74.89428334	16.81114455	3142.436842		4291.133506	422.6835256	617.4252491				763.692838					0.080861219															(1a)$150/day	(1b)$150/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$10/visit"	(9b)$25/visit	"(8a)$15/procedure Diag. services, $0/procedure Other services"	(8b)$15/visit	(9a)$25/visit	(12)20%	"(3,5,9a,9d)$25/visit, (9c)$15/visit"	"(7a) $0/visit PCP, $10/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b)$15 visit, (7d,f)$10/visit"	"(7e,h)$15/visit"	"(7c,i)$15/visit"		(7g)$15/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$15/visit"	(10b)0		(17a)0	(17b)0	(18a)$15/visit															103.4447	103.4447	28.9645		51.7224	0.1379263	0.1379263	24.8267	17.2408	10.3445	10.3445	17.2408	110.7448	17.2299		7.1807	10.3445	10.3445				10.3445					10.3445															18.8367	1.291836623	2.368742282	0	1.307276672	1.722548642	2.99154199	0.976329887	0.640847284	3.223655359	0.423645658	0.107603035	0.155145613	4.511997176	0	2.567769198	0.364369841	0.532244874	0	0	0	0.658333295	0	0	0	0	6.97E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.6806	0	19.20841654	18.8367	1.291836623	2.368742282	0	1.307276672	1.722548642	2.99154199	0.976329887	0.640847284	3.223655359	0.423645658	0.107603035	0.155145613	4.511997176	0	2.567769198	0.364369841	0.532244874	0	0	0	0.658333295	0	0	0	0	6.97E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.6806																																																																																				0	0	0	18.8367	1.291836623	2.368742282	0	1.307276672	1.722548642	2.99154199	0.976329887	0.640847284	3.223655359	0.423645658	0.107603035	0.155145613	4.511997176	0	2.567769198	0.364369841	0.532244874	0	0	0	0.658333295	0	0	0	0	6.97E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.6806
H4590_037_0	2008	6	F2	H5a	H5b	I2a	O1a	E2b	I2b				OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)	DME	Professional				1500	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests	Diabetes Monitoring Supplies					D	D	D	P	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V		V	Coin	V	T	P	V	P	V					V	P	V				V																																													0		1979.29439	10.88248256	1125.836713	685.4753199	6.030024798	16.7533449	11.33185461	352.3281155	335.7162808	3042.180951	1199.238706		12.56733155	23.80187631	3322.148151	181.9306018	14.95638559	402.9695342			25.20321372	1115.010196	754.070507		161.9105635							119.8004351		39.27498848				4524.303834				(1a) $150/day	(1b) $150/day	(2a) $42/day	(6a) $0/proc	(10a) $75/trip	(11a) 15% coins	(11a/11c) 20%/0% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $25/visit	(8a) $0/visit	(8b) $15/visit		(12) 20% coins	(9a) $25/visit	"(7a, 14b-14i) $0/visit"	(7b) $15/visit	(7e/7h) $15/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $15/visit			(15) 20% coins	(16b/17a) $15/visit (13a/13a1/14a10/17b N/A $0 Copay)	(10b) $0/trip		(17a1) $0/visit							(4b) $10/visit (waived if admitted)		(9d) $25/visit				(7d/7f$10/visit				124.3504	124.3504	34.8181		62.1752	0.124350435	0.16580058	41.4501	20.7251		12.435		0.16580058	20.7251		12.435	12.435	12.435			0.16580058	12.435										8.29		20.7251				8.29				20.5105	0.11277012	3.266626645	0	0.031243175	2.083285723	1.878828064	1.217004288	0.579812021	0	1.242715454	0	2.083670857	0.041107968	0	0.188526245	0.015498609	0.41757864	0	0	4.178707445	1.155433355	0	0	0	0	0	0	0	0	0	0.082762423	0	0.067831415	0	0	0	3.125550827	0	0	0	42.2795		8.720917206	20.5105	0.11277012	3.266626645	0	0.031243175	2.083285723	1.878828064	1.217004288	0.579812021	0	1.242715454	0	2.083670857	0.041107968	0	0.188526245	0.015498609	0.41757864	0	0	4.178707445	1.155433355	0	0	0	0	0	0	0	0	0	0.082762423	0	0.067831415	0	0	0	3.125550827	0	0	0	42.2795																																																																																				0		0	20.5105	0.11277012	3.266626645	0	0.031243175	2.083285723	1.878828064	1.217004288	0.579812021	0	1.242715454	0	2.083670857	0.041107968	0	0.188526245	0.015498609	0.41757864	0	0	4.178707445	1.155433355	0	0	0	0	0	0	0	0	0	0.082762423	0	0.067831415	0	0	0	3.125550827	0	0	0	42.2795
H4590_801_0	2008	3																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1552.350249	10.60106235	884.5517915		7.826722556	21.89805526	8.10431481	341.5267761	410.7288427		75.27355707		2.408585547	1868.237434	5181.710202	4163.343009	0.194974184	633.020919			61.6673973	1321.904866			191.6212284	0.001826437		1.080769213														$470 (1a); $0 (1a1)	$470 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											295.7611	312.337	159.1696		0.3	0.3	0.3	48.6348	300		0.225803169		0.3	7.5	20	39.9981	0.144343134	40			0.3	40			40	0.951549532		644.8688														38.2604	0.275925372	11.73281009	0	2.348016767	6.569416577	2.431294443	1.384173692	10.26822107	0	16.99700771	0	0.722575664	1.167648396	8.636183671	13.87714327	0.028143185	2.11006973	0	0	18.50021919	4.406349552	0	0	0.638737428	0.001737945	0	0.058079527	0	0	0	0	0	0	0	0	0	0	0	0	0	140.4142	0	0	38.2604	0.275925372	11.73281009	0	2.348016767	6.569416577	2.431294443	1.384173692	10.26822107	0	16.99700771	0	0.722575664	1.167648396	8.636183671	13.87714327	0.028143185	2.11006973	0	0	18.50021919	4.406349552	0	0	0.638737428	0.001737945	0	0.058079527	0	0	0	0	0	0	0	0	0	0	0	0	0	140.4142																																																																																				0			38.2604	0.275925372	11.73281009	0	2.348016767	6.569416577	2.431294443	1.384173692	10.26822107	0	16.99700771	0	0.722575664	1.167648396	8.636183671	13.87714327	0.028143185	2.11006973	0	0	18.50021919	4.406349552	0	0	0.638737428	0.001737945	0	0.058079527	0	0	0	0	0	0	0	0	0	0	0	0	0	140.4142
H4590_802_0	2008	3																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1552.350249	10.60106235	884.5517915		7.826722556	21.89805526	8.10431481	341.5267761	410.7288427		75.27355707		2.408585547	1868.237434	5181.710202	4163.343009	0.194974184	633.020919			61.6673973	1321.904866			191.6212284	0.001826437		1.080769213														$470 (1a); $0 (1a1)	$470 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											295.7611	312.337	159.1696		0.3	0.3	0.3	48.6348	300		0.225803169		0.3	7.5	20	39.9981	0.144343134	40			0.3	40			40	0.951549532		644.8688														38.2604	0.275925372	11.73281009	0	2.348016767	6.569416577	2.431294443	1.384173692	10.26822107	0	16.99700771	0	0.722575664	1.167648396	8.636183671	13.87714327	0.028143185	2.11006973	0	0	18.50021919	4.406349552	0	0	0.638737428	0.001737945	0	0.058079527	0	0	0	0	0	0	0	0	0	0	0	0	0	140.4142	0	0	38.2604	0.275925372	11.73281009	0	2.348016767	6.569416577	2.431294443	1.384173692	10.26822107	0	16.99700771	0	0.722575664	1.167648396	8.636183671	13.87714327	0.028143185	2.11006973	0	0	18.50021919	4.406349552	0	0	0.638737428	0.001737945	0	0.058079527	0	0	0	0	0	0	0	0	0	0	0	0	0	140.4142																																																																																				0			38.2604	0.275925372	11.73281009	0	2.348016767	6.569416577	2.431294443	1.384173692	10.26822107	0	16.99700771	0	0.722575664	1.167648396	8.636183671	13.87714327	0.028143185	2.11006973	0	0	18.50021919	4.406349552	0	0	0.638737428	0.001737945	0	0.058079527	0	0	0	0	0	0	0	0	0	0	0	0	0	140.4142
H4590_803_0	2008	3																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1552.350249	10.60106235	884.5517915		7.826722556	21.89805526	8.10431481	341.5267761	410.7288427		75.27355707		2.408585547	1868.237434	5181.710202	4163.343009	0.194974184	633.020919			61.6673973	1321.904866			191.6212284	0.001826437		1.080769213														$470 (1a); $0 (1a1)	$470 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											295.7611	312.337	159.1696		0.3	0.3	0.3	48.6348	300		0.225803169		0.3	7.5	20	39.9981	0.144343134	40			0.3	40			40	0.951549532		644.8688														38.2604	0.275925372	11.73281009	0	2.348016767	6.569416577	2.431294443	1.384173692	10.26822107	0	16.99700771	0	0.722575664	1.167648396	8.636183671	13.87714327	0.028143185	2.11006973	0	0	18.50021919	4.406349552	0	0	0.638737428	0.001737945	0	0.058079527	0	0	0	0	0	0	0	0	0	0	0	0	0	140.4142	0	0	38.2604	0.275925372	11.73281009	0	2.348016767	6.569416577	2.431294443	1.384173692	10.26822107	0	16.99700771	0	0.722575664	1.167648396	8.636183671	13.87714327	0.028143185	2.11006973	0	0	18.50021919	4.406349552	0	0	0.638737428	0.001737945	0	0.058079527	0	0	0	0	0	0	0	0	0	0	0	0	0	140.4142																																																																																				0			38.2604	0.275925372	11.73281009	0	2.348016767	6.569416577	2.431294443	1.384173692	10.26822107	0	16.99700771	0	0.722575664	1.167648396	8.636183671	13.87714327	0.028143185	2.11006973	0	0	18.50021919	4.406349552	0	0	0.638737428	0.001737945	0	0.058079527	0	0	0	0	0	0	0	0	0	0	0	0	0	140.4142
H4590_804_0	2008	3																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1552.350249	10.60106235	884.5517915		7.826722556	21.89805526	8.10431481	341.5267761	410.7288427		75.27355707		2.408585547	1868.237434	5181.710202	4163.343009	0.194974184	633.020919			61.6673973	1321.904866			191.6212284	0.001826437		1.080769213														$470 (1a); $0 (1a1)	$470 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											295.7611	312.337	159.1696		0.3	0.3	0.3	48.6348	300		0.225803169		0.3	7.5	20	39.9981	0.144343134	40			0.3	40			40	0.951549532		644.8688														38.2604	0.275925372	11.73281009	0	2.348016767	6.569416577	2.431294443	1.384173692	10.26822107	0	16.99700771	0	0.722575664	1.167648396	8.636183671	13.87714327	0.028143185	2.11006973	0	0	18.50021919	4.406349552	0	0	0.638737428	0.001737945	0	0.058079527	0	0	0	0	0	0	0	0	0	0	0	0	0	140.4142	0	0	38.2604	0.275925372	11.73281009	0	2.348016767	6.569416577	2.431294443	1.384173692	10.26822107	0	16.99700771	0	0.722575664	1.167648396	8.636183671	13.87714327	0.028143185	2.11006973	0	0	18.50021919	4.406349552	0	0	0.638737428	0.001737945	0	0.058079527	0	0	0	0	0	0	0	0	0	0	0	0	0	140.4142																																																																																				0			38.2604	0.275925372	11.73281009	0	2.348016767	6.569416577	2.431294443	1.384173692	10.26822107	0	16.99700771	0	0.722575664	1.167648396	8.636183671	13.87714327	0.028143185	2.11006973	0	0	18.50021919	4.406349552	0	0	0.638737428	0.001737945	0	0.058079527	0	0	0	0	0	0	0	0	0	0	0	0	0	140.4142
H4604_003_0	2008	6																					2700											D	D	D	V	T	Coin	Coin	V	V	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	3300	867.6892651	147.215102	884.9339602		122.5654347	13.73359382	3.281426315	497.170178	182.3556578	5839.45149	15.09599637		0.099230946	17.38890035	3483.62495	4381.839172	536.4695757	3.146938376			11.87954725	732.2122322			182.0924564		16.0513131															$150 (1a); $0 (1a1)	$150 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	$100 (9b)	25% (8a1); $0/$20 (8a2)	"$0 (8b1); 25% (8b2, 8b3)"	$100 (incl in h5)	30% (12)	"25% (3, 9d); $60 (5); $40/$30 (9c); $100 (9a)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0; $0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	see OON	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											106.8174	106.8174	71.2116		124.6203	0.213634826	0.254989389	35.6058	71.2116	5.6969	0.126554877		0.213634826	0.170342411	5	25	37.5	0.178029021			0.213634826	25			25		25															7.7237	1.310428027	5.251464229	0	1.272845256	2.933973921	0.836728893	1.47517867	1.08215331	2.77224489	1.910471965	0	0.021199186	2.962067208	1.451510396	9.128831609	1.676467424	0.560246359	0	0	2.537885005	1.52544215	0	0	0.379359284	0	0.033440236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.8456	0	13.00604183	7.7237	1.310428027	5.251464229	0	1.272845256	2.933973921	0.836728893	1.47517867	1.08215331	2.77224489	1.910471965	0	0.021199186	2.962067208	1.451510396	9.128831609	1.676467424	0.560246359	0	0	2.537885005	1.52544215	0	0	0.379359284	0	0.033440236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.8456		$300 (1a); $0 (1a1)	$300 (1b)	"$175 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/30% (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.1683	0.3679	2.6101	0.7821	0.3419	0.7882	0.239	0.3963	1.1535	0.0112	0.6159		0.0057	0.9984	1.0872	2.0663	0.3093	0.0984			0.3716	0.3485			0.0865		0.0076															14.8539	0	5.706477311	9.892	1.678305337	7.861571053	0.782115626	1.61478918	3.722172291	1.075679902	1.87147852	2.23568322	2.783416149	2.526359193	0	0.026894248	3.96050243	2.538721471	11.19517649	1.985769166	0.658677393	0	0	2.909457618	1.873897984	0	0	0.465817912	0	0.041061499	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6995
H4604_005_0	2008	7																					2200											D	D	D	V	T	Coin	Coin	V	V	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	2600	946.2572083	142.6513414	811.6077477		140.1611074	13.97296805	3.381872352	514.3884189	198.7626548		14.73488891		0.088246767	17.06397174	3508.468877	4603.837839	548.4733192	3.059913003			13.33456715	738.8389857			139.21549		14.86691033															$140 (1a); $0 (1a1)	$140 (1b)	"$75 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	$75 (9b)	15% (8a1); $0/$0 (8a2)	"$0 (8b1); 15% (8b2, 8b3)"	$75 (incl in h5)	30% (12)	"15% (3, 9d); $60 (5); $40/$30 (9c); $75 (9a)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"15% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0; $0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	see OON	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											99.4225	99.4225	53.2621		124.2781	0.213048211	0.25786356	35.508	53.2621		0.075076542		0.213048211	0.130250219	5	24.9592	37.5	0.106524106			0.213048211	25			25		25															7.8399	1.181896064	3.602324557	0	1.451579946	2.976915846	0.872061643	1.522076839	0.882208917	0	1.106244499	0	0.018800816	2.222586063	1.461862032	9.57566482	1.713979123	0.325954496	0	0	2.840905677	1.539247887	0	0	0.290032271	0	0.03097273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.4553	0	10.73992571	7.8399	1.181896064	3.602324557	0	1.451579946	2.976915846	0.872061643	1.522076839	0.882208917	0	1.106244499	0	0.018800816	2.222586063	1.461862032	9.57566482	1.713979123	0.325954496	0	0	2.840905677	1.539247887	0	0	0.290032271	0	0.03097273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.4553		$265 (1a); $0 (1a1)	$265 (1b)	"$175 (2a, 2a2)"	"20% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20% (9b)	20% (8a1); $0/20% (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 20% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 20% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											1.991	0.3002	2.2818	0.4522	0.3727	0.7644	0.2458	0.3908	0.8792	0.0073	0.3788		0.0048	0.6233	1.0456	2.1713	0.3162	0.0608			0.3976	0.3512			0.0661		0.0071															13.1083	0	5.508636136	9.831	1.482048578	5.88416079	0.452201153	1.824319319	3.741333779	1.11791133	1.912918534	1.761396821	0.007312413	1.484995832	0	0.023628524	2.84584329	2.50743887	11.7469619	2.030201627	0.386775347	0	0	3.238475669	1.890457619	0	0	0.356132649	0	0.038031631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5635
H4604_006_0	2008	5																					1100											D	D	D	V	T	V	P	V	V	Coin	V	V	V	V	V		V	V		V	S	P	T		V	P	V																																																								0		2180.104833	308.6739429	1043.749226		421.6733273	3283.006494	1641.173949	730.9479344	387.8438825	8.395304676	191.7304924	71.33463737	41.32416437	3648.339915		3533.683403		958.2500316				686.3124035					0.090560873															1(a) $110 per Day	1(b) $110 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per preocedure; other $0 per procedure	8(b) X-rays $0 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a), 9(d) $25 per visit; 9(c) $0/0 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  $0 per script	"13, 14(a)-(j) $0; 17(a), 16(b) $10 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															59.0963	59.0963	22.564		40.2929	10.9369	15.6245	24.0415	13.431	0.359308123	5.3724	13.431	129.035	13.431		5.3724		5.3724				5.3724					5.3724															10.7363	1.5201245	1.962600751	0	1.41587169	2.992160446	2.136882579	1.464421131	0.434093675	3.016501166	0.085837625	0.079841184	0.444355127	4.083398898	0	1.582027909	0	0.429007956	0	0	0	0.307261645	0	0	0	0	4.05E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.6908	0	28.15878797	10.7363	1.5201245	1.962600751	0	1.41587169	2.992160446	2.136882579	1.464421131	0.434093675	3.016501166	0.085837625	0.079841184	0.444355127	4.083398898	0	1.582027909	0	0.429007956	0	0	0	0.307261645	0	0	0	0	4.05E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.6908		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3																																																								0	0	0	10.7363	1.5201245	1.962600751	0	1.41587169	2.992160446	2.136882579	1.464421131	0.434093675	3.016501166	0.085837625	0.079841184	0.444355127	4.083398898	0	1.582027909	0	0.429007956	0	0	0	0.307261645	0	0	0	0	4.05E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.6908
H4604_007_0	2008	5	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						1000	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	P	P	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T				V					V	P	V	V																																																0		2000.417976	94.29091422	8790.859138	203.9795748	464.4359943	1690.54447	23.13893301	171.8758146	117.1194982	4385.751423	177.6465402	27.01748784	6.623219105	219.8397934	124.415631	1309.153724	1961.936038	23.71761576		263.5565866	254.7050401	657.9507449	1817.255									98.62694589	1.245952109		234.745							(1a) $125/day	(1b) $125/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) $0/proc	(11a/11c) $0/proc	(4a) $50/visit (waived if admitted)	(9a/9b) $25/visit	(8a) $0/visit	(8b) $0/visit	(9a) $25/visit	(12) $0/proc	(9a) $25/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $10/visit	(7e/7h) $0/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $10/visit	(15) $0/proc	(Misc. PBP Cats) $10/visit	(10b) $0/trip				(18a) $10/visit					(4b) $10/visit (waived if admitted)	(9c) $0/proc 75%/25% Ind/Grp Blended Copay	(9d) $25/visit	(7f1) $0/visit							108.3386	108.3386			65.0032			43.3355	21.6677			21.6677		21.6677		8.6671				8.6671		8.6671										8.6671										18.0602	0.851279038	0	0	2.515817964	0	0	0.620693009	0.2114761	0	0	0.04878396	0	0.396952367	0	0.945546138	0	0	0	0.19035573	0	0.475209882	0	0	0	0	0	0	0	0	0	0.071234055	0	0	0	0	0	0	0	0	0	24.3876		3.750556624	18.0602	0.851279038	0	0	2.515817964	0	0	0.620693009	0.2114761	0	0	0.04878396	0	0.396952367	0	0.945546138	0	0	0	0.19035573	0	0.475209882	0	0	0	0	0	0	0	0	0	0.071234055	0	0	0	0	0	0	0	0	0	24.3876		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3				0.3					10	0.3	0.3	0.3							2.6048	0.0397	0.8849	0.1072	0.396	0.4187	0.0038	0.0377	0.1844	0.7249	0.6638	0.0338	0.0082	0.109	0.0079	1.7198	0.1787	0.0027		0.1731		0.1116	0.1433									0.0043	0.0001		0.013							8.5715		0	20.665	0.890937936	0.884857724	0.107213797	2.911865489	0.418736518	0.003764062	0.658385073	0.395863915	0.724924926	0.663809786	0.08260538	0.008202477	0.505987844	0.00794455	2.665386702	0.178655038	0.002685284	0	0.363460389	0	0.586814672	0.14325	0	0	0	0	0	0	0	0	0.075559798	0.000102173	0	0.01305	0	0	0	0	0	0	32.9591
H4604_008_0	2008	7																					2100											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		1981.637481	135.9186261	890.0843489		275.0862549	10.48323461	18.20618343	428.0127692	404.5546357	3391.719972	445.7323381	67.92773835	15.28480496	2850.14297		3891.979215	383.4381957	561.2489041				692.6672899					0.073339639															(1a)$150/day	(1b)$150/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															107.0463	107.0463	29.973		53.5232	0.142728422	0.142728422	29.4377	53.5232	14.2728	46.5751	53.5232	105.8423	51.7474		17.8411	14.2728	14.2728				17.8411					17.8411															17.6772	1.212465686	2.223205849	0	1.226957093	1.49625553	2.598539824	1.049977276	1.804420144	4.034123652	1.730003874	0.30297559	0.134814954	12.29062026	0	5.78641719	0.456062737	0.667551418	0	0	0	1.029826135	0	0	0	0	0.000109038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.7216	0	22.35898463	17.6772	1.212465686	2.223205849	0	1.226957093	1.49625553	2.598539824	1.049977276	1.804420144	4.034123652	1.730003874	0.30297559	0.134814954	12.29062026	0	5.78641719	0.456062737	0.667551418	0	0	0	1.029826135	0	0	0	0	0.000109038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.7216		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.125	0.0607	0.2615	0.261	0.067	0.1284	0.1115	0.0311	0.2713	0.0426	0.1107	0.0222	0.0051	0.1937	0.0194	0.1872	0.0281	0.0304			0.1678	0.0397			0.0051																	4.1695	0	0	19.8022	1.273175073	2.484744755	0.26103338	1.294003208	1.624621668	2.710006254	1.081084664	2.075747121	4.076718011	1.840723383	0.325191528	0.139938174	12.48430198	0.019359146	5.973571318	0.484180978	0.69792882	0	0	0.167814882	1.069505068	0	0	0.005058988	0	0.000109038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8911
H4604_801_0	2008	2																					4000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1053.263682	178.7002866	1222.605265		167.1345656	18.72761471	4.474669086	677.9588546	27.40790202	7962.882768	30.85137265		0.13531483	23.71212008	4253.260015	5349.916139	654.9914609	3.842189489			14.50408814	893.9794192			222.3220281		19.59751958															$265 (1a); $0 (1a1)	$265 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$35/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $35 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											186.8662	186.8662	105.7733		123.4022	0.211546615	0.253901085	35.2578	0.211546615	4.2309	0.110853924		0.211546615	0.211529483	35	34.7615	37.5	0.211546615			0.211546615	35			35		35															16.4016	2.782753278	10.77658356	0	1.718730982	3.961763501	1.136123335	1.991943068	5.7980489	2.807534827	3.419995721	0	0.028625394	5.015812493	12.40534171	15.49757565	2.046848315	0.812802181	0	0	3.068290751	2.607439973	0	0	0.648439249	0	0.057159432	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.9834	0	24.69796028	16.4016	2.782753278	10.77658356	0	1.718730982	3.961763501	1.136123335	1.991943068	5.7980489	2.807534827	3.419995721	0	0.028625394	5.015812493	12.40534171	15.49757565	2.046848315	0.812802181	0	0	3.068290751	2.607439973	0	0	0.648439249	0	0.057159432	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.9834																																																																																				0			16.4016	2.782753278	10.77658356	0	1.718730982	3.961763501	1.136123335	1.991943068	5.7980489	2.807534827	3.419995721	0	0.028625394	5.015812493	12.40534171	15.49757565	2.046848315	0.812802181	0	0	3.068290751	2.607439973	0	0	0.648439249	0	0.057159432	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.9834
H4605_001_0	2008	2																					1000											D	D			T	Coin		V							V	V	V	V		V					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0															0	2000	401.4452269	9.928989083			1.093065805	13.47540859		234.689153							6678.356615	0	303.5572175	1124.934685		560.0273463					26.24550916		85.80566568															$100/day (days 1-3)	$100/day (days 1-3)	No copay	No copay	50	0.1		"$50 ER, $5 Urgent"	No copay	No copay	No copay	No copay	No copay	No copay	5	5	5	5	No copay	$5 chiro	No copay	No copay	No copay	No copay	5	No copay	5															100	100	0	0	50	0.1	0	50	0	0	0	0	0	0	5	5	5	5	0	5	0	0	0	0	5	0	5															3.3454	0.082741576	0	0	0.004554441	1.347540859	0	0.977871471	0	0	0	0	0	0	2.78264859	0	0.126482174	0.468722785	0	0.233344728	0	0	0	0	0.010935629	0	0.035752361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.416	0	0	3.3454	0.082741576	0	0	0.004554441	1.347540859	0	0.977871471	0	0	0	0	0	0	2.78264859	0	0.126482174	0.468722785	0	0.233344728	0	0	0	0	0.010935629	0	0.035752361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.416	N/A	D	D	D	Coin	T	Coin	Coin	V	V	No cost sharing	No cost sharing	No cost sharing	No cost sharing	V	V	V	V	V	No cost sharing	V	Coin	No cost sharing	No cost sharing	No cost sharing	V	No cost sharing	V															0.2404	0.0337	0.4227	0.3885	0.2914	1.7944	0.0176	0.07	0.8489					0	0.5346	0.2858	0.111	0.1407		0.3085	0.0357				0.0194		0.003															5.5462	250	0.290962148	3.5858	0.116428635	0.422714445	0.388523408	0.295946189	3.141914973	0.0175556	1.047844582	0.848922598	0	0	0	0	0	3.317237897	0.285804437	0.237516683	0.609373766	0	0.541796757	0.035740858	0	0	0	0.030318711	0	0.038725703	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.9622
H4605_002_0	2008	3																					1000											D	D			T	Coin		V							V	V	V	V		V					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0															0	2000	401.4452269	9.928989083			1.093065805	13.47540859		234.689153							6678.356615	0	303.5572175	1124.934685		560.0273463					26.24550916		85.80566568															$100/day (days 1-3)	$100/day (days 1-3)	No copay	No copay	50	0.1		"$50 ER, $5 Urgent"	No copay	No copay	No copay	No copay	No copay	No copay	5	5	5	5	No copay	$5 chiro	No copay	No copay	No copay	No copay	5	No copay	5															100	100	0	0	50	0.1	0	50	0	0	0	0	0	0	5	5	5	5	0	5	0	0	0	0	5	0	5															3.3454	0.082741576	0	0	0.004554441	1.347540859	0	0.977871471	0	0	0	0	0	0	2.78264859	0	0.126482174	0.468722785	0	0.233344728	0	0	0	0	0.010935629	0	0.035752361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.416	0	0	3.3454	0.082741576	0	0	0.004554441	1.347540859	0	0.977871471	0	0	0	0	0	0	2.78264859	0	0.126482174	0.468722785	0	0.233344728	0	0	0	0	0.010935629	0	0.035752361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.416	N/A	D	D	D	Coin	T	Coin	Coin	V	V	No cost sharing	No cost sharing	No cost sharing	No cost sharing	V	V	V	V	V	No cost sharing	V	Coin	No cost sharing	No cost sharing	No cost sharing	V	No cost sharing	V															0.2404	0.0337	0.4227	0.3885	0.2914	1.7944	0.0176	0.07	0.8489					0	0.5346	0.2858	0.111	0.1407		0.3085	0.0357				0.0194		0.003															5.5462	250	0.290962148	3.5858	0.116428635	0.422714445	0.388523408	0.295946189	3.141914973	0.0175556	1.047844582	0.848922598	0	0	0	0	0	3.317237897	0.285804437	0.237516683	0.609373766	0	0.541796757	0.035740858	0	0	0	0.030318711	0	0.038725703	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.9622
H4605_004_0	2008	3																					1000											D	D			T	Coin		V							V	V	V	V		V					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0															0	2000	401.4452269	9.928989083			1.093065805	13.47540859		234.689153							6678.356615	0	303.5572175	1124.934685		560.0273463					26.24550916		85.80566568															$100/day (days 1-3)	$100/day (days 1-3)	No copay	No copay	50	0.1		"$50 ER, $5 Urgent"	No copay	No copay	No copay	No copay	No copay	No copay	5	5	5	5	No copay	$5 chiro	No copay	No copay	No copay	No copay	5	No copay	5															100	100	0	0	50	0.1	0	50	0	0	0	0	0	0	5	5	5	5	0	5	0	0	0	0	5	0	5															3.3454	0.082741576	0	0	0.004554441	1.347540859	0	0.977871471	0	0	0	0	0	0	2.78264859	0	0.126482174	0.468722785	0	0.233344728	0	0	0	0	0.010935629	0	0.035752361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.416	0	0	3.3454	0.082741576	0	0	0.004554441	1.347540859	0	0.977871471	0	0	0	0	0	0	2.78264859	0	0.126482174	0.468722785	0	0.233344728	0	0	0	0	0.010935629	0	0.035752361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.416	N/A	D	D	D	Coin	T	Coin	Coin	V	V	No cost sharing	No cost sharing	No cost sharing	No cost sharing	V	V	V	V	V	No cost sharing	V	Coin	No cost sharing	No cost sharing	No cost sharing	V	No cost sharing	V															0.2404	0.0337	0.4227	0.3885	0.2914	1.7944	0.0176	0.07	0.8489					0	0.5346	0.2858	0.111	0.1407		0.3085	0.0357				0.0194		0.003															5.5462	250	0.290962148	3.5858	0.116428635	0.422714445	0.388523408	0.295946189	3.141914973	0.0175556	1.047844582	0.848922598	0	0	0	0	0	3.317237897	0.285804437	0.237516683	0.609373766	0	0.541796757	0.035740858	0	0	0	0.030318711	0	0.038725703	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.9622
H4606_001_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							3000	Renal Dialysis										D	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		P	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0	0							0		1572.707834	6.144419	488.967778	204.806383	68.506338	4.530565	1.550412	324.134809	382.791982	6020.631795	1411.107938		2.682612	513.123683	4651.82878	3514.048241	45.850227	291.711079			16.263475			2.78	1.82					0.08		5.356969	0.02	0.18	3.4							$135/Day(Days 1-7)	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$10/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$125/Visit	$0-$50/Visit	$30-$125/Visit		$50/Proc	$15-$125/Visit	$5/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins			Coin:  0%	Vision					Active Outlook Newsletter		$0/Proc	QUIT NET	See PBP	Silver Sneakers							87.649759	822.975212	25.073998	8.6629	86.628977	0.173258	0.173257	43.314509	108.286236	7.368573	53.007212		43.316243	33.774309	4.33145	25.988701	33.232495	43.314506			0.173258			0	0					0		0	0	0	0							11.4873	0.421392044	1.021698091	0.147851435	0.494552832	0.784956631	0.268619732	1.169978342	3.454258575	3.696955407	6.233241469	0	0.009683389	1.444199819	1.679096981	7.61046242	0.126976453	1.05294344	0	0	2.817777152	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.9219	0	6.779256249	11.4873	0.421392044	1.021698091	0.147851435	0.494552832	0.784956631	0.268619732	1.169978342	3.454258575	3.696955407	6.233241469	0	0.009683389	1.444199819	1.679096981	7.61046242	0.126976453	1.05294344	0	0	2.817777152	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.9219	5000	$950/Admit	$950/Admit	40% Coins(Days 1-20) $0(Days 21-100)	25% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins			Coin:  50%	Vision					Active Outlook Newsletter			QUIT NET	See PBP	Silver Sneakers							3.4607	0.0744	0.5848	0.571	0.4946	1.7352	0.5938	0.2065	2.4236	0.6008	1.6206		0.0037	0.8102	2.5059	2.0616	0.071	0.2187			0.6585			0.93	0					0		0	0	0	0							19.6254	0	2.885589226	14.948	0.495755244	1.606525272	0.718853494	0.989105665	2.520123373	0.862413881	1.376444703	5.87786598	4.297782099	7.853797177	0	0.01337032	2.254379349	4.185004535	9.672019512	0.197951593	1.271685997	0	0	3.476234651	0	0	0.93	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.5473
H4606_003_0	2008	6	s.	t.	u.								OP Facility - Other	Health & Education (Non-Covered)	Health & Education (Non-Covered)									Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin						O		P	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0						0		0	0	0								0		1660.296503	59.335004	516.199814	216.212645	72.321655	5.049255	1.727915	342.186818	404.110781	6355.938269	1489.696636		2.832015	541.701029	4910.902638	3709.755795	48.403758	307.957317			18.125428			5.88						0.08		5.655314	0.02	3.4								$175/Day(Days 1-7)	$175/Day(Days 1-7)	$0/Day(Days 1-20) $125(Days 21-100)	$10/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$125/Visit	$0-$50/Visit	$50-$150/Visit		$50/Proc	$15-$150/Visit	$10/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins			Dental						Active Outlook Newsletter		$0/Proc	QUIT NET	Silver Sneakers								131.157074	131.157048	28.944117	9.999988	99.999923	0.2	0.2	49.999985	125.00002	8.505898	77.321772		49.999735	40.62093	10	30.000001	38.362062	49.999981			0.2			0.355442177						0		0	0	0								18.1466	0.648516997	1.245078984	0.180176988	0.602679994	1.009851	0.345583	1.425777981	4.209487976	4.505246884	9.59883197	0	0.0118	1.833699965	4.092418865	9.274389797	0.154738997	1.283155	0	0	3.6250856	0	0	2.09	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2832	0	0	18.1466	0.648516997	1.245078984	0.180176988	0.602679994	1.009851	0.345583	1.425777981	4.209487976	4.505246884	9.59883197	0	0.0118	1.833699965	4.092418865	9.274389797	0.154738997	1.283155	0	0	3.6250856	0	0	2.09	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2832		$950/Admit	$950/Admit	"20% Coins(Days 1-20), 20%(Days 21-100)"	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	20%-30% Coins		30% Coins	20%-30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			Dental						Active Outlook Newsletter		$0/Proc	QUIT NET	Silver Sneakers								3.1608	0.0679	0.3762	0.8815	0.6027	1.6742	0.5729	0.2516	3.7416	0.9276	2.2663		0.0057	1.2501	3.8686	3.1826	0.1096	0.3377			1.0165			1.55						0		0	0	0								25.8442	0	0	21.3074	0.716434997	1.621270984	1.061692988	1.205359994	2.684078	0.918524	1.677385981	7.951068976	5.432806884	11.86510997	0	0.017492	3.083834965	7.961055865	12.4570358	0.264310997	1.620851	0	0	4.6416166	0	0	3.64	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.1273
H4606_004_0	2008	7	s.	t.	u.	v.							OP Facility - Other	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							1500	Renal Dialysis										D	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		P	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0	0							0		1730.159033	6.759566	537.920647	225.310517	75.364831	5.483125	1.87639	356.585473	421.115095	6623.385635	1552.380607		2.951181	564.494915	5117.545297	3865.856183	50.440511	320.915653			19.682901			5.88	1.82					0.08		5.893282	0.02	0.18	3.4							$75/Day(Days 1-5)	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$10/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$50/Visit	$0-$50/Visit	$0-$50/Visit		$50/Proc	$15-$50/Visit	$5/Visit	$15/Visit	$15-$50/Visit	$25/Visit			20% Coins			Dental	$100 allowance					Active Outlook Newsletter		$0/Proc	QUIT NET	Meals on Wheels	Silver Sneakers							42.160392	821.538627	25.030238	8.64779	86.477764	0.172955	0.172955	43.238905	43.238918	7.355713	23.127269		43.24035	29.151311	4.32389	12.971669	25.626452	21.619441			0.172955			0.355442177	0					0		0	0	0	0							6.0787	0.462770381	1.122023485	0.162369836	0.543115172	0.948333884	0.324531032	1.284863783	1.517380088	4.059976985	2.991860324	0	0.010634175	1.371313902	1.843975245	4.178883901	0.107717611	0.578168086	0	0	3.404256142	0	0	2.09	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.0809	0	4.845923229	6.0787	0.462770381	1.122023485	0.162369836	0.543115172	0.948333884	0.324531032	1.284863783	1.517380088	4.059976985	2.991860324	0	0.010634175	1.371313902	1.843975245	4.178883901	0.107717611	0.578168086	0	0	3.404256142	0	0	2.09	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.0809	5000	$950/Admit	$950/Admit	20% Coins(Days 1-20) $0(Days 21-100)	20% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	25% Coins	25% Coins	20%-25% Coins	20% Coins			25% Coins			Dental	$100 allowance					Active Outlook Newsletter			QUIT NET	Meals on Wheels	Silver Sneakers							3.8005	0.0817	0.3533	0.5519	0.5431	2.0963	0.7174	0.2267	2.3424	0.5807	1.5663		0.0036	0.783	3.0275	2.4906	0.079	0.2114			0.7955			1.55	0					0		0	0	0	0							21.801	0	3.16656754	9.8792	0.544435691	1.475299999	0.714249536	1.086230348	3.0446578	1.041917135	1.51160425	3.859824147	4.64068233	4.558146238	0	0.01419706	2.154361733	4.871461843	6.669532748	0.186685679	0.789585552	0	0	4.19976456	0	0	3.64	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.8818
H4606_801_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		285.946879	6.144419	488.967778	204.806383	68.506338	4.530565	1.550412	324.134809	382.791982	6020.631795	1411.107938		8.039581	513.123683	4651.82878	3514.048241	45.850227	291.711079			16.263475																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214509	177.214477	28.944115	0	99.999973	0.2	0.199999	50.00001	199.999988	37.551769	90.505002		33.36741	87.838635	20	30.000001	59.267143	100.000014			0.2																					4.2228	0.09074	1.179394966	0	0.570885996	0.906113	0.31008085	1.350561974	6.379865984	18.84044787	10.6426939	0	0.022355	3.756006992	7.753047967	8.785120895	0.226450997	2.430925999	0	0	3.252695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7202	0	0	4.2228	0.09074	1.179394966	0	0.570885996	0.906113	0.31008085	1.350561974	6.379865984	18.84044787	10.6426939	0	0.022355	3.756006992	7.753047967	8.785120895	0.226450997	2.430925999	0	0	3.252695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7202		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.5704	0.0968	0.4219	0.6591	0.6505	1.2519	0.4284	0.7346	2.7977	0.6936	1.8707		0.0127	0.9352	2.8927	2.3798	0.0819	0.2525			0.7601																					25.4905	0	0	12.7933	0.187585	1.601328966	0.659135	1.221340996	2.15798	0.73848485	2.085116974	9.177551984	19.53401087	12.5133789	0	0.035093	4.691235992	10.64573697	11.1648749	0.308380997	2.683430999	0	0	4.012784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.2107
H4606_802_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		285.946879	6.144419	488.967778	204.806383	68.506338	4.530565	1.550412	324.134809	382.791982	6020.631795	1411.107938		8.039581	513.123683	4651.82878	3514.048241	45.850227	291.711079			16.263475																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214509	177.214477	28.944115	0	99.999973	0.2	0.199999	50.00001	199.999988	37.551769	90.505002		33.36741	87.838635	20	30.000001	59.267143	100.000014			0.2																					4.2228	0.09074	1.179394966	0	0.570885996	0.906113	0.31008085	1.350561974	6.379865984	18.84044787	10.6426939	0	0.022355	3.756006992	7.753047967	8.785120895	0.226450997	2.430925999	0	0	3.252695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7202	0	0	4.2228	0.09074	1.179394966	0	0.570885996	0.906113	0.31008085	1.350561974	6.379865984	18.84044787	10.6426939	0	0.022355	3.756006992	7.753047967	8.785120895	0.226450997	2.430925999	0	0	3.252695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7202		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.5704	0.0968	0.4219	0.6591	0.6505	1.2519	0.4284	0.7346	2.7977	0.6936	1.8707		0.0127	0.9352	2.8927	2.3798	0.0819	0.2525			0.7601																					25.4905	0	0	12.7933	0.187585	1.601328966	0.659135	1.221340996	2.15798	0.73848485	2.085116974	9.177551984	19.53401087	12.5133789	0	0.035093	4.691235992	10.64573697	11.1648749	0.308380997	2.683430999	0	0	4.012784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.2107
H4606_803_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		285.946879	6.144419	488.967778	204.806383	68.506338	4.530565	1.550412	324.134809	382.791982	6020.631795	1411.107938		8.039581	513.123683	4651.82878	3514.048241	45.850227	291.711079			16.263475																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214509	177.214477	28.944115	0	99.999973	0.2	0.199999	50.00001	199.999988	37.551769	90.505002		33.36741	87.838635	20	30.000001	59.267143	100.000014			0.2																					4.2228	0.09074	1.179394966	0	0.570885996	0.906113	0.31008085	1.350561974	6.379865984	18.84044787	10.6426939	0	0.022355	3.756006992	7.753047967	8.785120895	0.226450997	2.430925999	0	0	3.252695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7202	0	0	4.2228	0.09074	1.179394966	0	0.570885996	0.906113	0.31008085	1.350561974	6.379865984	18.84044787	10.6426939	0	0.022355	3.756006992	7.753047967	8.785120895	0.226450997	2.430925999	0	0	3.252695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7202		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.5704	0.0968	0.4219	0.6591	0.6505	1.2519	0.4284	0.7346	2.7977	0.6936	1.8707		0.0127	0.9352	2.8927	2.3798	0.0819	0.2525			0.7601																					25.4905	0	0	12.7933	0.187585	1.601328966	0.659135	1.221340996	2.15798	0.73848485	2.085116974	9.177551984	19.53401087	12.5133789	0	0.035093	4.691235992	10.64573697	11.1648749	0.308380997	2.683430999	0	0	4.012784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.2107
H4606_804_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		285.946879	6.144419	488.967778	204.806383	68.506338	4.530565	1.550412	324.134809	382.791982	6020.631795	1411.107938		8.039581	513.123683	4651.82878	3514.048241	45.850227	291.711079			16.263475																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214509	177.214477	28.944115	0	99.999973	0.2	0.199999	50.00001	199.999988	37.551769	90.505002		33.36741	87.838635	20	30.000001	59.267143	100.000014			0.2																					4.2228	0.09074	1.179394966	0	0.570885996	0.906113	0.31008085	1.350561974	6.379865984	18.84044787	10.6426939	0	0.022355	3.756006992	7.753047967	8.785120895	0.226450997	2.430925999	0	0	3.252695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7202	0	0	4.2228	0.09074	1.179394966	0	0.570885996	0.906113	0.31008085	1.350561974	6.379865984	18.84044787	10.6426939	0	0.022355	3.756006992	7.753047967	8.785120895	0.226450997	2.430925999	0	0	3.252695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7202		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.5704	0.0968	0.4219	0.6591	0.6505	1.2519	0.4284	0.7346	2.7977	0.6936	1.8707		0.0127	0.9352	2.8927	2.3798	0.0819	0.2525			0.7601																					25.4905	0	0	12.7933	0.187585	1.601328966	0.659135	1.221340996	2.15798	0.73848485	2.085116974	9.177551984	19.53401087	12.5133789	0	0.035093	4.691235992	10.64573697	11.1648749	0.308380997	2.683430999	0	0	4.012784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.2107
H4720_001_0	2008	8																					3250											D	D	D	V	T	Coin	Coin	V	V	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1590.509806	57.56935745	1747.736159		131.4143434	14.10430247	1.330392774	583.9457429	343.9934828	9745.664149	39.1226311		0.184621852	25.72960576	4142.216704	4799.710154	181.3875586	2.89366003			22.08523655	843.8634301			144		16.8541424															$240 (1a); $0 (1a1)	$240 (1b)	"$125 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$15 (4b)"	$175 (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	$175 (incl in h5)	30% (12)	"30% (3, 9d); $60 (5); $40/$30 (9c); $175 (9a)"	"$15/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											142.8619	142.8619	74.4072		104.1701	0.178577372	0.251072341	29.7629	104.1701	4.7621	0.105087871		0.178577372	0.255616754	8.9289	20.5235	22.3222	0.178577372			0.178577372	20.834			20.834		20.834															18.9353	0.685372304	10.83701842	0	1.140787477	2.51870927	0.334024827	1.448326336	2.986153925	3.867455762	4.111314009	0	0.032969285	6.576918296	3.082109057	8.208904566	0.337413683	0.516742204	0	0	3.943923505	1.465089439	0	0	0.250008321	0	0.029261638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.3078	0	48.32327334	18.9353	0.685372304	10.83701842	0	1.140787477	2.51870927	0.334024827	1.448326336	2.986153925	3.867455762	4.111314009	0	0.032969285	6.576918296	3.082109057	8.208904566	0.337413683	0.516742204	0	0	3.943923505	1.465089439	0	0	0.250008321	0	0.029261638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.3078																																																																																				0			18.9353	0.685372304	10.83701842	0	1.140787477	2.51870927	0.334024827	1.448326336	2.986153925	3.867455762	4.111314009	0	0.032969285	6.576918296	3.082109057	8.208904566	0.337413683	0.516742204	0	0	3.943923505	1.465089439	0	0	0.250008321	0	0.029261638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.3078
H4720_002_0	2008	6																					2400											D	D	D	V	T	Coin	Coin	V	V	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1590.509806	57.56935745	1747.736159		131.4143434	14.10430247	1.330392774	583.9457429	343.9934828	9745.664149	39.1226311		0.184621852	25.72960576	4142.216704	4799.710154	181.3875586	2.89366003			22.08523655	843.8634301			144		16.8541424															$225 (1a); $0 (1a1)	$225 (1b)	"$125 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	$175 (9b)	30% (8a1); $0/$13 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	$175 (incl in h5)	30% (12)	"30% (3, 9d); $60 (5); $40/$30 (9c); $175 (9a)"	"$15/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											119.2456	119.2456	66.2475		92.7466	0.158994103	0.243181196	26.499	92.7466	2.7559	0.091278384		0.158994103	0.227585141	7.9497	18.2728	19.8743	0.158994103			0.158994103	18.5493			18.5493		18.5493															15.8051	0.572074271	9.648602174	0	1.01568569	2.242500917	0.323526506	1.289499021	2.658684349	2.238171185	3.571050556	0	0.029353786	5.855675955	2.744116786	7.308694274	0.300412002	0.46007488	0	0	3.511422371	1.304423838	0	0	0.222591744	0	0.026052729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1277	0	54.00054465	15.8051	0.572074271	9.648602174	0	1.01568569	2.242500917	0.323526506	1.289499021	2.658684349	2.238171185	3.571050556	0	0.029353786	5.855675955	2.744116786	7.308694274	0.300412002	0.46007488	0	0	3.511422371	1.304423838	0	0	0.222591744	0	0.026052729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1277																																																																																				0			15.8051	0.572074271	9.648602174	0	1.01568569	2.242500917	0.323526506	1.289499021	2.658684349	2.238171185	3.571050556	0	0.029353786	5.855675955	2.744116786	7.308694274	0.300412002	0.46007488	0	0	3.511422371	1.304423838	0	0	0.222591744	0	0.026052729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1277
H4720_801_0	2008	5																					7700											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1494.853575	46.29113505	1349.283186		133.0874806	15.09417214	1.351214585	607.628003	43.39539397	11524.35095	49.77212415		0.499974016	27.63993362	4359.639901	5599.751753	155.1297728	3.779309302			34.52750489	972.796083			229.8759515		18.35281288															$450 (1a); $0 (1a1)	$450 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											334.4209	334.4209	118.9052		130.0526	0.185789389	0.218097674	37.1579	0.185789389	4.4589	0.108414334		0.222947267	0.185749076	18.5789	25.9746	27.8684	0.185789389			0.222947267	26.0105			26.0105		26.0105															41.6592	1.290060254	13.36973326	0	1.442364099	2.804337018	0.294696758	1.881513923	8.062403729	4.282204244	5.396011683	0	0.11146784	5.134092144	6.749790277	12.12092433	0.360268321	0.702155566	0	0	7.697812843	2.108577215	0	0	0.49826598	0	0.039780509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0056	0	40.03393221	41.6592	1.290060254	13.36973326	0	1.442364099	2.804337018	0.294696758	1.881513923	8.062403729	4.282204244	5.396011683	0	0.11146784	5.134092144	6.749790277	12.12092433	0.360268321	0.702155566	0	0	7.697812843	2.108577215	0	0	0.49826598	0	0.039780509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0056																																																																																				0			41.6592	1.290060254	13.36973326	0	1.442364099	2.804337018	0.294696758	1.881513923	8.062403729	4.282204244	5.396011683	0	0.11146784	5.134092144	6.749790277	12.12092433	0.360268321	0.702155566	0	0	7.697812843	2.108577215	0	0	0.49826598	0	0.039780509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0056
H4720_803_0	2008	5																					7700											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1494.853575	46.29113505	1349.283186		133.0874806	15.09417214	1.351214585	607.628003	43.39539397	11524.35095	49.77212415		0.499974016	27.63993362	4359.639901	5599.751753	155.1297728	3.779309302			34.52750489	972.796083			229.8759515		18.35281288															$450 (1a); $0 (1a1)	$450 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											334.4209	334.4209	118.9052		130.0526	0.185789389	0.218097674	37.1579	0.185789389	4.4589	0.108414334		0.222947267	0.185749076	18.5789	25.9746	27.8684	0.185789389			0.222947267	26.0105			26.0105		26.0105															41.6592	1.290060254	13.36973326	0	1.442364099	2.804337018	0.294696758	1.881513923	8.062403729	4.282204244	5.396011683	0	0.11146784	5.134092144	6.749790277	12.12092433	0.360268321	0.702155566	0	0	7.697812843	2.108577215	0	0	0.49826598	0	0.039780509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0056	0	40.03393221	41.6592	1.290060254	13.36973326	0	1.442364099	2.804337018	0.294696758	1.881513923	8.062403729	4.282204244	5.396011683	0	0.11146784	5.134092144	6.749790277	12.12092433	0.360268321	0.702155566	0	0	7.697812843	2.108577215	0	0	0.49826598	0	0.039780509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0056																																																																																				0			41.6592	1.290060254	13.36973326	0	1.442364099	2.804337018	0.294696758	1.881513923	8.062403729	4.282204244	5.396011683	0	0.11146784	5.134092144	6.749790277	12.12092433	0.360268321	0.702155566	0	0	7.697812843	2.108577215	0	0	0.49826598	0	0.039780509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0056
H4729_001_0	2008	7																					Unlimited											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	Unlimited	304.56	5.34	0	0	225.05	14.24	9.92	268.31	260.65	0	0	0	0	377.91	5602.48	5061.41	309.78	860.01	0	2560.21	0	845.73	0	0	449.02	0	0	0	0	0	0											PBP: 1A IP Acute: $500 per admit	1B IP Psych: $500 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $100	11A DME: 30%	"11B Prosthetic Medical Supplies: 30%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $35"	9B ASC Services: $125	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $20, 5 Partial Hosp: $20, 9C OP Substance Abuse: $20, 9D Cardiac Rehab: $20"	"7A PCP: $5, 14B Immunizations: $0, 14C Routine Physical Exams: $5, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $0"	7D Physician Specialist: $20	"7E Mental Health: $25, 7H Psychiatric: $25"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	Included in i.2.	"7B Chiropractic: $20, 7F Podiatry: $20, 7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $20"	15 Part B Drugs: $0	"13A Blood: $20, 16B Medicare Covered Comprehensive Dental Services: $20, 17A Medicare Covered Eye Exams: $20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $20	"17B Eye Wear: Medicare Covered: $0, Routine: $0 up to $80 benefit"	18A Routine Hearing Exams: not covered	18B Hearing Aids: $0 up to $600 max	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											500	500	0	0	100	0.299999935	0.031940537	48.91319742	125	0	0	0	0	20	5	20	25	20	0	20	0	20	0	0	20	0	0	0	0	0	0											12.69	0.2225	0	0	1.875416667	4.271999079	0.316850125	1.093658333	2.715104167	0	0	0	0	0.62985	2.334366667	8.435683333	0.645375	1.43335	0	4.267016667	0	1.40955	0	0	0.748366667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0891	0	0	12.69	0.2225	0	0	1.875416667	4.271999079	0.316850125	1.093658333	2.715104167	0	0	0	0	0.62985	2.334366667	8.435683333	0.645375	1.43335	0	4.267016667	0	1.40955	0	0	0.748366667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0891	Unlimited	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.69	0.2225	0	0	1.875416667	4.271999079	0.316850125	1.093658333	2.715104167	0	0	0	0	0.62985	2.334366667	8.435683333	0.645375	1.43335	0	4.267016667	0	1.40955	0	0	0.748366667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0891
H4729_801_0	2008	6																					Unlimited											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	Unlimited	341.28	4.33	65.4	33.58	6.83	14.42	10.04	6.48	34.33	10.32	29.63	1.16	0.2	31.24	57.61	137.59	2.49	6.42	44.79	68.81	11.22	7.69	0	0	0	0	0	0	0	0	0											"6.9%, FFS Medicare Actuarially Equivalent Cost Sharing"	"6.9%, FFS Medicare Actuarially Equivalent Cost Sharing"	"19.0%, FFS Medicare Actuarially Equivalent Cost Sharing"	"0.0%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											0.068670027	0.068594188	0.1900322	0	0.233913757	0.234000452	0.233982317	0.234138152	0.233999981	0.233979766	0.233953177	0.233999842	0.234	0.234010989	0.234011134	0.234005347	0.233990916	0.23402067	0.23400186	0.233992752	0.234004353	0.234007558	0	0	0	0	0	0	0	0	0											23.4357	0.297012835	12.42810588	0	1.59763096	3.374286523	2.349182466	1.517215222	8.033219353	2.414671189	6.932032626	0.271439817	0.0468	7.310503308	13.48138143	32.19679565	0.58263738	1.502412699	10.48094329	16.10104128	2.625528844	1.799518123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.7781	0	0	23.4357	0.297012835	12.42810588	0	1.59763096	3.374286523	2.349182466	1.517215222	8.033219353	2.414671189	6.932032626	0.271439817	0.0468	7.310503308	13.48138143	32.19679565	0.58263738	1.502412699	10.48094329	16.10104128	2.625528844	1.799518123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.7781	Unlimited	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.4357	0.297012835	12.42810588	0	1.59763096	3.374286523	2.349182466	1.517215222	8.033219353	2.414671189	6.932032626	0.271439817	0.0468	7.310503308	13.48138143	32.19679565	0.58263738	1.502412699	10.48094329	16.10104128	2.625528844	1.799518123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.7781
H4729_802_0	2008	6																					Unlimited											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	Unlimited	341.28	4.33	65.4	33.58	6.83	14.42	10.04	6.48	34.33	10.32	29.63	1.16	0.2	31.24	57.61	137.59	2.49	6.42	44.79	68.81	11.22	7.69	0	0	0	0	0	0	0	0	0											"6.9%, FFS Medicare Actuarially Equivalent Cost Sharing"	"6.9%, FFS Medicare Actuarially Equivalent Cost Sharing"	"19.0%, FFS Medicare Actuarially Equivalent Cost Sharing"	"0.0%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	"23.4%, FFS Medicare Actuarially Equivalent Cost Sharing"	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											0.068670027	0.068594188	0.1900322	0	0.233913757	0.234000452	0.233982317	0.234138152	0.233999981	0.233979766	0.233953177	0.233999842	0.234	0.234010989	0.234011134	0.234005347	0.233990916	0.23402067	0.23400186	0.233992752	0.234004353	0.234007558	0	0	0	0	0	0	0	0	0											23.4357	0.297012835	12.42810588	0	1.59763096	3.374286523	2.349182466	1.517215222	8.033219353	2.414671189	6.932032626	0.271439817	0.0468	7.310503308	13.48138143	32.19679565	0.58263738	1.502412699	10.48094329	16.10104128	2.625528844	1.799518123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.7781	0	0	23.4357	0.297012835	12.42810588	0	1.59763096	3.374286523	2.349182466	1.517215222	8.033219353	2.414671189	6.932032626	0.271439817	0.0468	7.310503308	13.48138143	32.19679565	0.58263738	1.502412699	10.48094329	16.10104128	2.625528844	1.799518123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.7781	Unlimited	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.4357	0.297012835	12.42810588	0	1.59763096	3.374286523	2.349182466	1.517215222	8.033219353	2.414671189	6.932032626	0.271439817	0.0468	7.310503308	13.48138143	32.19679565	0.58263738	1.502412699	10.48094329	16.10104128	2.625528844	1.799518123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.7781
H4779_001_0	2008	5																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							15.44319209	14.37522659	365.0684013	378.8213885		160.347696	58.93696626		1707.444499		5107.312047	228.8489422					1416.273672		821.9323512	337.0787762		315.7256545				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/PCP visit, $20/visit Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d)$20/visit, (7f)0"	"(7e,h)$20/visit"	"(7c,i)0"		(7g)$20/visit	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.176207377	0.176207377	34.801	44.0518		17.6207	44.0518		44.0381		17.6207	17.6207					17.6207		20	20		19.9999				20											0	0	0	0	0	2.721204375	2.533020975	1.058727479	1.390648403	0	0.235453725	0.216356839	0	6.266049277	0	7.499550508	0.336040599	0	0	0	0	2.079648911	0	1.369887252	0.56179796	0	0.526207091	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	27.7347	0	3.286095999	0	0	0	0	0	2.721204375	2.533020975	1.058727479	1.390648403	0	0.235453725	0.216356839	0	6.266049277	0	7.499550508	0.336040599	0	0	0	0	2.079648911	0	1.369887252	0.56179796	0	0.526207091	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	27.7347		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.4153	0.0302	0.5383	0.3878	0.0903	0.0946	0.088	0.0245	0.3049	0.0513	0.1275	0.0244	0.0017	0.2183	0.0303	0.2352	0.0141	0.0413			0.191	0.0607			0.0066		0.0078															4.9843	0	0	2.4153	0.030162952	0.538288761	0.387774747	0.090314666	2.815754531	2.621032567	1.083251631	1.695547154	0.051332183	0.36298208	0.240801182	0.001740454	6.484323256	0.030290392	7.734751812	0.350100434	0.041324229	0	0	0.191049368	2.14035269	0	1.369887252	0.568429071	0	0.534049801	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	32.7189
H4779_002_0	2008	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							15.5916795	14.51344544	366.8192823	380.6382293		161.1167293	59.21963004		1721.311056		5131.806897	229.9465098					1423.066171		821.9323512	337.0787762		315.725711				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/PCP visit, $20/visit Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d)$20/visit, (7f)0"	"(7e,h)$20/visit"	"(7c,i)0"		(7g)$20/visit	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.176014689	0.176014689	34.7629	44.0037		17.6015	44.0037		43.99		17.6015	17.6015					17.6015		20	20		19.9999				20											0	0	0	0	0	2.744364619	2.554579585	1.062641869	1.395789991	0	0.236324258	0.217156766	0	6.310036063	0	7.527278291	0.337283028	0	0	0	0	2.087337912	0	1.369887252	0.56179796	0	0.526207155	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	27.8708	0	3.334880491	0	0	0	0	0	2.744364619	2.554579585	1.062641869	1.395789991	0	0.236324258	0.217156766	0	6.310036063	0	7.527278291	0.337283028	0	0	0	0	2.087337912	0	1.369887252	0.56179796	0	0.526207155	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	27.8708		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.4385	0.0305	0.5435	0.3915	0.0912	0.0955	0.0889	0.0246	0.3078	0.0518	0.1288	0.0247	0.0018	0.2204	0.0306	0.2375	0.0142	0.0417			0.1929	0.0613			0.0066		0.0078															5.0319	0	0	2.4385	0.030452971	0.543464447	0.391503229	0.091183048	2.839823881	2.643437415	1.08728364	1.703620365	0.051825746	0.365078808	0.241836143	0.001757188	6.530408763	0.030581637	7.764741073	0.351478049	0.041721565	0	0	0.192886322	2.148625362	0	1.369887252	0.568429071	0	0.534049871	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	32.9027
H4779_003_0	2008	5																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0								27.42340929	541.9731107	548.9391405		200.3039436	90.91326467		3044.680639		6101.200167	556.2083384					0.101170918		821.9323512			240.9369924				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)0	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3,9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/PCP visit, $20/visit Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d)$20/visit, (7f)0"	"(7e,h)$20/visit"	"(7c,i)0"		(7g)$20/visit	(15) 0	"(13a,14a,17a,b)0, (16b)$20/visit"	(10b)0	(16a)$20/visit	(17a)0	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																	0.169748653	33.5254	42.4372		16.9749	42.4372		42.3841		16.9749	16.9749					16.9749		20			19.9988				20											0	0	0	0	0	0	4.655086798	1.514153594	1.941284998	0	0.283344372	0.321508422	0	10.75384999	0	8.630587603	0.786796804	0	0	0	0	0.000143114	0	1.369887252	0	0	0.401537036	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	31.5983	0	5.148008073	0	0	0	0	0	0	4.655086798	1.514153594	1.941284998	0	0.283344372	0.321508422	0	10.75384999	0	8.630587603	0.786796804	0	0	0	0	0.000143114	0	1.369887252	0	0	0.401537036	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	31.5983		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															3.238	0.0776	0.4006	0.3868	0.0989	0.1904	0.1679	0.0311	0.4242	0.0658	0.1725	0.0345	0.0061	0.2959	0.0303	0.2911	0.0366	0.047			0.2597	0.054			0.0066		0.006															6.3217	0	0	3.238	0.077647141	0.400571341	0.386840689	0.098932501	0.190401673	4.822985222	1.545271592	2.365471324	0.065774177	0.455873732	0.355968304	0.006095619	11.0497745	0.030318921	8.921709043	0.823351229	0.046995633	0	0	0.259742297	0.054158374	0	1.369887252	0.006631111	0	0.407524788	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	37.92
H4781_001_0	2008	3																					n/a											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	1397	27.2	1141.1	1873.2	206.7	13.8	0.9	374.9	308.9	1963.9	1009.3	0	0	0	4872	6020.6	177.5	513.5	842.1	1272.8	948.6	0	0	0	0	284.8	0	19.9	0	0	0											$150/day 1-8	$150/day 1-8	"$0/d 1-20, $100/d 21-100"	0	$75 	20%	20%	$50 ER; $25 UC	$100 	$0 	"$0 X-ray; $100 CAT, PET, MRI"	25	25	25	10	25	25	25	25	25	$45 	0	0	0	$0 	Not Covered	$0 	$300 Every 3 Yrs	0	Fitness	0											114.27	114.27	41.2	0	$75 	20%	20%	47	$100 	$0 	18	25	25	25	10	25	25	25	25	25	$45 	0	0	0	0	0	0	0	0	0	0											13.3029	0.259012	3.917776667	0	1.291875	2.76	0.18	1.468358333	2.574166667	0	1.51395	0	0	0	4.06	12.54291667	0.369791667	1.069791667	1.754375	2.651666667	3.55725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.2739			13.3029	0.259012	3.917776667	0	1.291875	2.76	0.18	1.468358333	2.574166667	0	1.51395	0	0	0	4.06	12.54291667	0.369791667	1.069791667	1.754375	2.651666667	3.55725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.2739		20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	$100 per trip	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	$50 ER; $25 UC	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	0	0	0	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	$300 Every 3 Yrs	0	0	0											2.8717	0.0223	0.4656	0.4171	0.1395	0.2376	0.0152	0.126	0.2941	0.1021	0.2865	0	0.094	0.3166	0.3731	0.4661	0.0176	0.0493	0.3467	1.2564	0.2732	0.0035	0	0	0.0485	0.0142	0.0137	0.0057	0	0	0											8.2563	150	8.702824348	16.1746	0.281312	4.383376667	0.4171	1.431375	2.9976	0.1952	1.594358333	2.868266667	0.1021	1.80045	0	0.094	0.3166	4.4331	13.00901667	0.387391667	1.119091667	2.101075	3.908066667	3.83045	0.0035	0	0	0.0485	0.0142	0.0137	0.0057	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5302
H4781_002_0	2008	4																					n/a											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	1397	27.2	1141.1	1873.2	206.7	13.8	0.9	374.9	308.9	1963.9	1009.3	0	0	0	4872	6020.6	177.5	513.5	842.1	1272.8	948.6	0	0	0	0	284.8	0	19.9	0	0	0											$50/day 1-5	$50/day 1-5	"$0/d 1-20, $100/d 21-100"	0	$75 	20%	20%	$50 ER; $25 UC	$50 	$0 	"$0 X-ray; $100 CAT, PET, MRI"	25	25	25	10	25	25	25	25	25	$45 	0	0	0	$0 	Not Covered	$0 	$300 Every 3 Yrs	0	Fitness	0											30.64193704	30.64193704	41.2	0	$75 	20%	20%	47	$50 	$0 	18	25	25	25	10	25	25	25	25	25	$45 	0	0	0	0	0	0	0	0	0	0											3.5672	0.069455057	3.917776667	0	1.291875	2.76	0.18	1.468358333	1.287083333	0	1.51395	0	0	0	4.06	12.54291667	0.369791667	1.069791667	1.754375	2.651666667	3.55725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.0615			3.5672	0.069455057	3.917776667	0	1.291875	2.76	0.18	1.468358333	1.287083333	0	1.51395	0	0	0	4.06	12.54291667	0.369791667	1.069791667	1.754375	2.651666667	3.55725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.0615		20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	$100 per trip	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	$50 ER; $25 UC	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	0	0	0	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	20% coins; $150ded; $3000 maxOOP	$300 Every 3 Yrs	0	0	0											2.8717	0.0223	0.4656	0.4171	0.1395	0.2376	0.0152	0.126	0.2941	0.1021	0.2865	0	0.094	0.3166	0.3731	0.4661	0.0176	0.0493	0.3467	1.2564	0.2732	0.0035	0	0	0.0485	0.0142	0.0137	0.0057	0	0	0											8.2563	150	8.702824348	6.4389	0.091755057	4.383376667	0.4171	1.431375	2.9976	0.1952	1.594358333	1.581183333	0.1021	1.80045	0	0.094	0.3166	4.4331	13.00901667	0.387391667	1.119091667	2.101075	3.908066667	3.83045	0.0035	0	0	0.0485	0.0142	0.0137	0.0057	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3178
H4781_801_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	Coin	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1234.8	24.1	1008.7	1655.8	182.7	13.8	0.9	331.4	273	1735.9	892.2	0	0	0	4306.5	5463.1	156.9	907.7	20.1803179	2250.2	15.9	0	0	0	0	0	0	0	0	0	0											200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	0.2	$40 per visit	20% coinsurance	0	N/A	Not Covered	$0 per visit	Not Covered	$0 per visit	Not Covered	N/A	Not Covered	0											144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	0.2	40	0.2	0	0	0	0	0	0	0	0	0	0											14.8763	0.29034475	8.405833333	5.519333333	2.28375	4.14	0.27	1.380833333	4.55	5.786333333	4.084789	0	0	0	10.76625	17.98270417	0.523	3.025666667	4.036063579	7.500666667	3.18	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.6018			14.8763	0.29034475	8.405833333	5.519333333	2.28375	4.14	0.27	1.380833333	4.55	5.786333333	4.084789	0	0	0	10.76625	17.98270417	0.523	3.025666667	4.036063579	7.500666667	3.18	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.6018		"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	0	$50 ER/UC	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	0	0	0	"30% coins; $500ded; ""Unlimited maxOOP"	0	"30% coins; $500ded; ""Unlimited maxOOP"	0	0	0	0											7.92	0	1.28	1.15	0.24	0.66	0	0.21	0.81	0.28	0.79	0	0.26	0.87	1.03	1.29	0.05	0.14	0.96	3.47	0.75	0	0	0	0.13	0	0.04	0	0	0	0											22.33	500	0	22.7963	0.29034475	9.685833333	6.669333333	2.52375	4.8	0.27	1.590833333	5.36	6.066333333	4.874789	0	0.26	0.87	11.79625	19.27270417	0.573	3.165666667	4.996063579	10.97066667	3.93	0	0	0	0.13	0	0.04	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.9318
H4781_802_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	Coin	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1234.8	24.1	1008.7	1655.8	182.7	13.8	0.9	331.4	273	1735.9	892.2	0	0	0	4306.5	5463.1	156.9	907.7	20.1803179	2250.2	15.9	0	0	0	0	0	0	0	0	0	0											200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	0.2	$40 per visit	20% coinsurance	0	N/A	Not Covered	$0 per visit	Not Covered	$0 per visit	Not Covered	N/A	Not Covered	0											144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	0.2	40	0.2	0	0	0	0	0	0	0	0	0	0											14.8763	0.29034475	8.405833333	5.519333333	2.28375	4.14	0.27	1.380833333	4.55	5.786333333	4.084789	0	0	0	10.76625	17.98270417	0.523	3.025666667	4.036063579	7.500666667	3.18	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.6018			14.8763	0.29034475	8.405833333	5.519333333	2.28375	4.14	0.27	1.380833333	4.55	5.786333333	4.084789	0	0	0	10.76625	17.98270417	0.523	3.025666667	4.036063579	7.500666667	3.18	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.6018		"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	0	$50 ER/UC	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	"30% coins; $500ded; ""Unlimited maxOOP"	0	0	0	"30% coins; $500ded; ""Unlimited maxOOP"	0	"30% coins; $500ded; ""Unlimited maxOOP"	0	0	0	0											7.92	0	1.28	1.15	0.24	0.66	0	0.21	0.81	0.28	0.79	0	0.26	0.87	1.03	1.29	0.05	0.14	0.96	3.47	0.75	0	0	0	0.13	0	0.04	0	0	0	0											22.33	500	0	22.7963	0.29034475	9.685833333	6.669333333	2.52375	4.8	0.27	1.590833333	5.36	6.066333333	4.874789	0	0.26	0.87	11.79625	19.27270417	0.573	3.165666667	4.996063579	10.97066667	3.93	0	0	0	0.13	0	0.04	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.9318
H4836_001_0	2008	4																					2000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1008.118443	14.50777459	1599.334142	27.99965785	227.9681457	22.09116366	1.030693176	410.8415455	392.010057	11.30685563	30.56887329	0	0.20749477	731.0549444	4024.626035	5359.6821	150.2919583	484.1857626	23.24206478	31.30019152	8.310181004	659.4502222	0	0	381.4864633	0	139.8947114	0	0	0	0											$200 days 1-8	$200 days 1-8	$100 days 1-100	$0 per visit	$100 per trip	20%	20%	"ER:  $50 per visit, UC:  $20 per visit"	$150 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $20 per visit	$15 per visit	$20 per visit	$20 per visit	$20 per visit	$0 per visit	"Medicare Hearing Exams:  $20 per visit, OPSA:  $20 per visit"	$0 per visit	Medicare Vision Exams:  $20 per visit	0	0	$20 per visit	$0 	$20 per visit	0	0	0	0											145.9403619	145.9559685	73.00113467	0	73.00888744	0.145981142	0.145981142	28.35856999	109.4789032	0	0	0	0	14.59379889	10.94973034	14.60684433	14.59925178	14.59975068	0	0.004048297	0	14.59950351	0	0	14.59803631	0	14.60239456	0	0	0	0											12.2604	0.176458024	9.729433923	0	1.386975057	3.224893296	0.150461767	0.97090656	3.576402589	0	0	0	0	0.889072403	3.672380818	6.524003505	0.182845845	0.589082618	0	0.126712484	0	0.80230382	0	0	0.464079437	0	0.170233148	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.8967	0	16.61	12.2604	0.176458024	9.729433923	0	1.386975057	3.224893296	0.150461767	0.97090656	3.576402589	0	0	0	0	0.889072403	3.672380818	6.524003505	0.182845845	0.589082618	0	0.126712484	0	0.80230382	0	0	0.464079437	0	0.170233148	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.8967	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	0	0	$0 	$0 	N/A	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.2604	0.176458024	9.729433923	0	1.386975057	3.224893296	0.150461767	0.97090656	3.576402589	0	0	0	0	0.889072403	3.672380818	6.524003505	0.182845845	0.589082618	0	0.126712484	0	0.80230382	0	0	0.464079437	0	0.170233148	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.8967
H4836_002_0	2008	7																					2000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1007.729659	14.50184348	1598.720217	27.9896521	227.8540286	22.08130666	1.030233284	410.6513322	391.8405391	11.3028151	30.55794942	0	0.207420621	730.7755867	4022.739064	5356.59595	150.2223602	483.9579567	23.23375916	31.28887566	8.307211338	659.1423755	0	0	381.3166864	0	139.8234007	0	0	0	0											$200 days 1-8	$200 days 1-8	$105 days 1-100	$0 per visit	$100 per trip	20%	20%	"ER:  $50 per visit, UC:  $20 per visit"	$150 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $20 per visit	$15 per visit	$20 per visit	$20 per visit	$20 per visit	$0 per visit	"Medicare Hearing Exams:  $20 per visit, OPSA:  $20 per visit"	$0 per visit	Medicare Vision Exams:  $20 per visit	0	0	$20 per visit	$0 	$20 per visit	0	0	0	0											145.5327187	145.5471809	76.43747498	0	72.80223066	0.14557051	0.14557051	28.27823747	109.1714383	0	0	0	0	14.55305198	10.9188491	14.56514272	14.55810525	14.55856762	0	0.004034906	0	14.55833855	0	0	14.55697879	0	14.56101807	0	0	0	0											12.2215	0.17589187	10.18351138	0	1.382356795	3.214387062	0.149971584	0.967707991	3.564816271	0	0	0	0	0.886251258	3.660306735	6.501632044	0.182246078	0.587144553	0	0.126247671	0	0.799668155	0	0	0.462568243	0	0.169664255	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2358	0	16.91	12.2215	0.17589187	10.18351138	0	1.382356795	3.214387062	0.149971584	0.967707991	3.564816271	0	0	0	0	0.886251258	3.660306735	6.501632044	0.182246078	0.587144553	0	0.126247671	0	0.799668155	0	0	0.462568243	0	0.169664255	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2358	2000	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	0	0	$0 	$0 	N/A	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.2215	0.17589187	10.18351138	0	1.382356795	3.214387062	0.149971584	0.967707991	3.564816271	0	0	0	0	0.886251258	3.660306735	6.501632044	0.182246078	0.587144553	0	0.126247671	0	0.799668155	0	0	0.462568243	0	0.169664255	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2358
H4836_801_0	2008	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	317.2547317	2.383818506	51.0285988	40.43545734	8.34741036	27.70935292	1.292321426	6.2104029	32.07902662	12.55133439	33.89803877	0	0.284347718	33.21595893	48.25237168	129.6727065	1.464449772	4.928208371	32.05726123	42.39426205	9.236498813	6.584998808	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				0.076959488	0.076959488	0.188275772	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											24.4158	0.183457451	9.607448817	0	1.953294024	6.483988583	0.302403214	1.453234279	7.50649223	2.937012248	7.932141073	0	0.066537366	7.772534389	11.29105497	30.34341332	0.342681247	1.153200759	7.501399128	9.92025732	2.161340722	1.540889721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.8685	0	0	24.4158	0.183457451	9.607448817	0	1.953294024	6.483988583	0.302403214	1.453234279	7.50649223	2.937012248	7.932141073	0	0.066537366	7.772534389	11.29105497	30.34341332	0.342681247	1.153200759	7.501399128	9.92025732	2.161340722	1.540889721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.8685	none	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.4158	0.183457451	9.607448817	0	1.953294024	6.483988583	0.302403214	1.453234279	7.50649223	2.937012248	7.932141073	0	0.066537366	7.772534389	11.29105497	30.34341332	0.342681247	1.153200759	7.501399128	9.92025732	2.161340722	1.540889721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.8685
H4836_802_0	2008	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	317.2547317	2.383818506	51.0285988	40.43545734	8.34741036	27.70935292	1.292321426	6.2104029	32.07902662	12.55133439	33.89803877	0	0.284347718	33.21595893	48.25237168	129.6727065	1.464449772	4.928208371	32.05726123	42.39426205	9.236498813	6.584998808	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				0.076959488	0.076959488	0.188275772	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											24.4158	0.183457451	9.607448817	0	1.953294024	6.483988583	0.302403214	1.453234279	7.50649223	2.937012248	7.932141073	0	0.066537366	7.772534389	11.29105497	30.34341332	0.342681247	1.153200759	7.501399128	9.92025732	2.161340722	1.540889721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.8685	0	0	24.4158	0.183457451	9.607448817	0	1.953294024	6.483988583	0.302403214	1.453234279	7.50649223	2.937012248	7.932141073	0	0.066537366	7.772534389	11.29105497	30.34341332	0.342681247	1.153200759	7.501399128	9.92025732	2.161340722	1.540889721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.8685	none	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.4158	0.183457451	9.607448817	0	1.953294024	6.483988583	0.302403214	1.453234279	7.50649223	2.937012248	7.932141073	0	0.066537366	7.772534389	11.29105497	30.34341332	0.342681247	1.153200759	7.501399128	9.92025732	2.161340722	1.540889721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.8685
H4836_803_0	2008	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	317.2547317	2.383818506	51.0285988	40.43545734	8.34741036	27.70935292	1.292321426	6.2104029	32.07902662	12.55133439	33.89803877	0	0.284347718	33.21595893	48.25237168	129.6727065	1.464449772	4.928208371	32.05726123	42.39426205	9.236498813	6.584998808	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				0.076959488	0.076959488	0.188275772	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											24.4158	0.183457451	9.607448817	0	1.953294024	6.483988583	0.302403214	1.453234279	7.50649223	2.937012248	7.932141073	0	0.066537366	7.772534389	11.29105497	30.34341332	0.342681247	1.153200759	7.501399128	9.92025732	2.161340722	1.540889721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.8685	0	0	24.4158	0.183457451	9.607448817	0	1.953294024	6.483988583	0.302403214	1.453234279	7.50649223	2.937012248	7.932141073	0	0.066537366	7.772534389	11.29105497	30.34341332	0.342681247	1.153200759	7.501399128	9.92025732	2.161340722	1.540889721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.8685	none	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.4158	0.183457451	9.607448817	0	1.953294024	6.483988583	0.302403214	1.453234279	7.50649223	2.937012248	7.932141073	0	0.066537366	7.772534389	11.29105497	30.34341332	0.342681247	1.153200759	7.501399128	9.92025732	2.161340722	1.540889721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.8685
H4836_804_0	2008	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	317.2547317	2.383818506	51.0285988	40.43545734	8.34741036	27.70935292	1.292321426	6.2104029	32.07902662	12.55133439	33.89803877	0	0.284347718	33.21595893	48.25237168	129.6727065	1.464449772	4.928208371	32.05726123	42.39426205	9.236498813	6.584998808	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				0.076959488	0.076959488	0.188275772	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											24.4158	0.183457451	9.607448817	0	1.953294024	6.483988583	0.302403214	1.453234279	7.50649223	2.937012248	7.932141073	0	0.066537366	7.772534389	11.29105497	30.34341332	0.342681247	1.153200759	7.501399128	9.92025732	2.161340722	1.540889721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.8685	0	0	24.4158	0.183457451	9.607448817	0	1.953294024	6.483988583	0.302403214	1.453234279	7.50649223	2.937012248	7.932141073	0	0.066537366	7.772534389	11.29105497	30.34341332	0.342681247	1.153200759	7.501399128	9.92025732	2.161340722	1.540889721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.8685	none	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.4158	0.183457451	9.607448817	0	1.953294024	6.483988583	0.302403214	1.453234279	7.50649223	2.937012248	7.932141073	0	0.066537366	7.772534389	11.29105497	30.34341332	0.342681247	1.153200759	7.501399128	9.92025732	2.161340722	1.540889721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.8685
H4837_001_0	2008	6																																D	D	D	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	P	V	P	V	P	O	O	O															0.0001	0.0001	0.0001		0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001																				0.0017		2791.422165	354.5412349	1677.158074		18.08744359	30.63590236	25.83520491	613.8348359	37.96658378	20.36566729	46.96550435	3.261417089	4.274604559	40.45358688	60.12394137	114.771753	11.1710957	9.12387371			25.60981409	6.611070155																				ffs medicare (1a)	ffs medicare (1b)	ffs medicare (2)	$0 (6)	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a);  20% (4b)	20% (9b)	0% or 20% (8a)	20% (8b)	20% (9a)	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"20% (7a, 14b, 14c, 14e, 14f, 14g, 14h)"	"20% (7b, 7d, 7f, 7g)"	50% (7e);  50% (7h)	"20% (7c, 7i)"	20% (incl in h2)	20% (14i)	20% (15)	"20% (13a, 14j, 16b, 17a, 18a), $0 (14a, 17b)"	$0 n/c (10b)	"$0 n/c (16a, 16b1-16b3, 16b5-16b8)"	$0 (17a)	$0 n/c (17b1-17b5)	$0 (18a)	$0 (18b)	$0 n/c	$0 n/c (14a)	$0 (13c)											125.0474	56.1293	74.4079		0.234	0.234	0.234	50.0039	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				29.0883	1.658346305	10.39949037	0	4.232461799	7.168801153	6.04543795	2.557842508	8.884180604	4.765566146	10.98992802	0.763171599	1.000257467	9.466139329	14.06900228	26.85659021	2.614036394	2.134986448	0	0	5.992696497	1.546990416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.2343	135	0	29.0883	1.658346305	10.39949037	0	4.232561799	7.168901153	6.04553795	2.557842508	8.884280604	4.765666146	10.99002802	0.763271599	1.000357467	9.466239329	14.06910228	26.85669021	2.614136394	2.135086448	0.0001	0.0001	5.992796497	1.547090416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.236																																																																																				0	0	0	29.0883	1.658346305	10.39949037	0	4.232561799	7.168901153	6.04553795	2.557842508	8.884280604	4.765666146	10.99002802	0.763271599	1.000357467	9.466239329	14.06910228	26.85669021	2.614136394	2.135086448	0.0001	0.0001	5.992796497	1.547090416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.236
H4908_001_0	2008	3	s.	t.									DME/Prosthetics/Supplies	OP Facility - Other										Diabetic Visit/Supplies	"MRI, CT & PET Scan"									A	A	A	V	T	Coin	Coin	V	V	P	P	P	P	P	V	V	V	V	V		Coin				V							V	P																																																		0		183.9015725	9.008931392	62.25700782	1050.817743	116.2351746	13.2311	1.6472	406.3838914	206.4209079	5453.310496	1039.366224	0.8154	0.06	3480.154587	2491.017763	1867.116445	371.6284807	1403.04513	4266.902408		21.0538				183.34							950.8262674	271.1004691									$0 	$0 	$0 	$0 	$50 per trip	0	0	$50 per visit	$0 	$0 	$0 	0	$10 per visit	$0 	$10 per office visit	$10 per office visit	$10 per visit	$0  per visit	$0  per visit		10%				$10 per Visit							$10 per visit or supply	$50 per service									0	0	0	0	49.65	0	0	49.65	0	0	0	0	10	0	9.93	9.93	9.93	0	0		0.1				9.93							9.93	49.65									0	0	0	0	0.480923035	0	0	1.681413351	0	0	0	0	0.00005	0	2.061317199	1.545038858	0.307522568	0	0	0	2.105378845	0	0	0	0.15171385	0	0	0	0	0	0	0.786808736	1.121678191	0	0	0	0	0	0	0	0	10.2418		0.042821955	0	0	0	0	0.480923035	0	0	1.681413351	0	0	0	0	0.00005	0	2.061317199	1.545038858	0.307522568	0	0	0	2.105378845	0	0	0	0.15171385	0	0	0	0	0	0	0.786808736	1.121678191	0	0	0	0	0	0	0	0	10.2418	3000	$500 per admit	$500 per admit	$150 per admit	$15 per visit	$50 per trip	0.2	0.2	$50 per visit	$250 per admit	$15 per visit	$15 per visit	$0 	$15 per visit	$0 	$15 per office visit	$15 per office visit	$15 per office visit	$15  per visit	$15 per visit		0.2				$10 per Visit							$15 per visit or supply	$100 per service									1.8889	0.0925	0.1918	0.3238	0.1194	0.6569	0.0818	0.4174	1.0601	1.6804	0.2562	0	0	0	0.6141	0.4603	0.0916	0.3459	1.0518		0.8363				0							0.2344	0.4455									10.8492		0.033696512	1.8889	0.092533831	0.191838938	0.323799308	0.600312178	0.656923318	0.081781981	2.098824215	1.060110051	1.6803848	0.256216507	0	6.48E-05	0	2.675383592	2.005305934	0.399133541	0.345867812	1.051843713	0	2.941635322	0	0	0	0.15171385	0	0	0	0	0	0	1.021199059	1.567208768	0	0	0	0	0	0	0	0	21.091
H4908_002_0	2008	4	s.	t.									DME/Prosthetics/Supplies	OP Facility - Other										Diabetic Visit/Supplies	"MRI, CT & PET Scan"									A	A	A	V	T	Coin	Coin	V	V	P	P	P	P	P	V	V	V	V	V		Coin				V							V	P																																																		0		191.9851581	9.404928376	64.99357959	1097.007534	121.344413	13.9193	1.7328	424.2469196	215.4943544	5693.016452	1085.052652	0.8513	0.06	4541.410519	2631.372255	1972.317694	392.5676034	1482.098636	14.86802799		22.1475				183.34							992.6208286	283.1868185									$0 	$0 	$0 	$0 	$50 per trip	0	0	$50 per visit	$0 	$0 	$0 	0	$10 per visit	$0 	$10 per office visit	$10 per office visit	$10 per visit	$0  per visit	0		10%				$10 							$10 per visit or supply	$50 per service									0	0	0	0	49.65	0	0	49.65	0	0	0	0	0	0	9.93	9.93	9.93	0	0		0.1				9.93							9.93	49.65									0	0	0	0	0.502062509	0	0	1.75532163	0	0	0	0	0	0	2.177460541	1.632092892	0.324849692	0	0	0	2.214752293	0	0	0	0.15171385	0	0	0	0	0	0	0.821393736	1.171685462	0	0	0	0	0	0	0	0	10.7513		0.044930663	0	0	0	0	0.502062509	0	0	1.75532163	0	0	0	0	0	0	2.177460541	1.632092892	0.324849692	0	0	0	2.214752293	0	0	0	0.15171385	0	0	0	0	0	0	0.821393736	1.171685462	0	0	0	0	0	0	0	0	10.7513	3000	$500 per admit	$500 per admit	$150 per admit	$15 per visit	$50 per trip	0.2	0.2	$50 per visit	$250 per admit	$15 per visit	$15 per visit	$0 	$15 per visit	$0 	$15 per office visit	$15 per office visit	$15 per office visit	$15  per visit	$15 per visit		0.2				$10 							$15 per visit or supply	$100 per service									1.9719	0.0966	0.2003	0.338	0.1246	0.6911	0.086	0.4358	1.1067	1.7542	0.2675	0	0	0	0.6487	0.4862	0.0968	0.3654	0.0037		0.8797				0							0.2447	0.4654									10.2633		0.035309702	1.9719	0.096601252	0.200271419	0.338032244	0.626699527	0.691090932	0.08603559	2.191080224	1.106708295	1.754247868	0.267478771	0	0	0	2.826126037	2.118293365	0.421622415	0.365355469	0.003665151	0	3.094451904	0	0	0	0.15171385	0	0	0	0	0	0	1.06608693	1.637078927	0	0	0	0	0	0	0	0	21.0146
H4908_005_0	2008	4	s.										DME/Prosthetics/Supplies											Diabetic Visit/Supplies										D	D	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin		Coin											Coin																																																			0		880.0664146	82.75672532	467.8644822	874.8057711	2.7169	11.0149	1.3713	357.5796922	9.5211	7.0533	20.6145	0.1983	0.016	29.4297	1658.935132	1243.437567	247.4922306	12.2208	9.4852		14.0218											1.7013										$125 for days 1-5	$125 for days 1-5	$90 for days 4-100	$0 	0.2	0.2	0.2	$50 per visit	0.2	0.2	0.2	0.2	0.2	0.2	$10 per office visit	$10 per office visit	$10 per visit	0.2	0.2		0.2											0.2										81.3	53.58	68.33	0	0.19916	0.2	0.2	49.79	0.19916	0.19916	0.19916	0.2	0.2	0.2	9.958	9.958	9.958	0.19916	0.19916		0.2											0.19916										5.9624	0.369508779	2.664098339	0	0.541090515	2.202975477	0.274253772	1.483657739	1.896230393	1.404732775	4.105574582	0.039665461	0.0032	5.885937823	1.376639671	1.031845941	0.205377303	2.433888734	1.88906762	0	2.804364621	0	0	0	0	0	0	0	0	0	0	0.33883709	0	0	0	0	0	0	0	0	0	36.9134		0.069201702	5.9624	0.369508779	2.664098339	0	0.541090515	2.202975477	0.274253772	1.483657739	1.896230393	1.404732775	4.105574582	0.039665461	0.0032	5.885937823	1.376639671	1.031845941	0.205377303	2.433888734	1.88906762	0	2.804364621	0	0	0	0	0	0	0	0	0	0	0.33883709	0	0	0	0	0	0	0	0	0	36.9134	3250	$125 for days 1-5	$125 for days 1-5	$90 for days 4-100	$15 per visit	0.2	0.2	0.2	$50 per visit	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2		0.2											0.2										1.4906	0.0924	0.666	0.2711	0.1347	0.5461	0.068	0.3694	0.4741	0.3512	1.0264	0.0098	0.0008	1.4591	0.7297	0.5469	0.3475	0.6059	0.4703		0.6952											0.0844										10.4396		0.02251652	7.4531	0.461885973	3.330122924	0.271085261	0.675794999	2.749102813	0.342242491	1.853014334	2.370287992	1.755915969	5.131968228	0.049498703	0.003993294	7.345087766	2.106307634	1.57876097	0.552923338	3.039805334	2.359351004	0	3.499578978	0	0	0	0	0	0	0	0	0	0	0.423190584	0	0	0	0	0	0	0	0	0	47.353
H4908_006_0	2008	6	s.										DME/Prosthetics/Supplies											Diabetic Visit/Supplies										D	D	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin		Coin											Coin																																																			0		893.9195539	84.05940024	475.2291444	888.5761025	2.7596	11.1883	1.3929	363.2083597	9.671	7.1643	20.9389	0.2056	0.016	29.8929	1662.033501	1245.759917	247.9544682	12.4722	9.63		14.2425											1.7281										$185 for days 1-7	$185 for days 1-7	$110 for days 4-100	$0 	0.2	0.2	0.2	$50 per visit	0.2	0.2	0.2	0.2	0.2	0.2	$10 per office visit	$10 per office visit	$10 per visit	0.2	0.2		0.2											0.2										120.33	79.3	83.52	0	0.19916	0.19916	0.19916	49.79	0.19916	0.19916	0.19916	0.19916	0.19916	0.19916	9.958	9.958	9.958	0.19916	0.19916		0.19916											0.19916										8.9638	0.555492537	3.307594845	0	0.54960783	2.228254408	0.277400807	1.507012019	1.926078986	1.426844696	4.170200496	0.040939406	0.00318656	5.953478392	1.3792108	1.033773104	0.205760883	2.483970802	1.9179108	0	2.836544434	0	0	0	0	0	0	0	0	0	0	0.34417073	0	0	0	0	0	0	0	0	0	41.1112		0.052521937	8.9638	0.555492537	3.307594845	0	0.54960783	2.228254408	0.277400807	1.507012019	1.926078986	1.426844696	4.170200496	0.040939406	0.00318656	5.953478392	1.3792108	1.033773104	0.205760883	2.483970802	1.9179108	0	2.836544434	0	0	0	0	0	0	0	0	0	0	0.34417073	0	0	0	0	0	0	0	0	0	41.1112	3250	$195 for days 1-7	$195 for days 1-7	$110 for days 4-100	$15 per visit	0.35	0.35	0.35	$50 per visit	0.35	0.35	0.35	0.35	0.35	0.35	0.35	0.35	0.35	0.35	0.35		0.35											0.35										2.362	0.2221	0.8269	0.2765	0.2405	0.979	0.1219	0.3768	0.8427	0.6242	1.8245	0.0179	0.0014	2.6046	2.2698	1.7013	0.6207	1.0822	0.853		1.2358											0.1499										19.2336		0.033298423	11.3258	0.777601989	4.134493556	0.276513776	0.790061255	3.207227398	0.399275534	1.883765024	2.768738542	2.05108925	5.994663214	0.058850396	0.00458068	8.558125188	3.648993939	2.735065438	0.826481475	3.566143732	2.770921732	0	4.072320474	0	0	0	0	0	0	0	0	0	0	0.494113011	0	0	0	0	0	0	0	0	0	60.3448
H4908_801_0	2008	1																																Coin		Coin		Coin	Coin		Coin	Coin	Coin					Coin						Coin																																																														0		221.9487		27.5832		3.4765	18.0262		10.2497	12.1832	75.228					154.0707						17.9422																					Medicare FFS Cost Sharing		Medicare FFS Cost Sharing		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing					Medicare FFS Cost Sharing						Medicare FFS Cost Sharing																					0.089370679		0.190986641		0.234	0.234		0.234	0.234	0.234					0.234						0.234																					19.8357	0	5.26802661	0	0.813496252	4.218139916	0	2.398428383	2.850865564	17.60334114	0	0	0	0	36.05253509	0	0	0	0	0	4.198481428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.239			19.8357	0	5.26802661	0	0.813496252	4.218139916	0	2.398428383	2.850865564	17.60334114	0	0	0	0	36.05253509	0	0	0	0	0	4.198481428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.239	3000	Medicare FFS Cost Sharing		Medicare FFS Cost Sharing		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing					Medicare FFS Cost Sharing						Medicare FFS Cost Sharing																					4.9589		1.317		0.2034	1.0545		0.5996	0.7127	4.4008					9.0131						1.0496																					23.3098		0.031896296	24.7946	0	6.585033262	0	1.016870315	5.272674895	0	2.998035479	3.563581956	22.00417642	0	0	0	0	45.06566886	0	0	0	0	0	5.248101785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.5488
H4908_802_0	2008	1																																Coin		Coin		Coin	Coin		Coin	Coin	Coin					Coin						Coin																																																														0		221.9487		27.5832		3.4765	18.0262		10.2497	12.1832	75.228					154.0707						17.9422																					Medicare FFS Cost Sharing		Medicare FFS Cost Sharing		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing					Medicare FFS Cost Sharing						Medicare FFS Cost Sharing																					0.089370679		0.190986641		0.234	0.234		0.234	0.234	0.234					0.234						0.234																					19.8357	0	5.26802661	0	0.813496252	4.218139916	0	2.398428383	2.850865564	17.60334114	0	0	0	0	36.05253509	0	0	0	0	0	4.198481428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.239			19.8357	0	5.26802661	0	0.813496252	4.218139916	0	2.398428383	2.850865564	17.60334114	0	0	0	0	36.05253509	0	0	0	0	0	4.198481428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.239	3000	Medicare FFS Cost Sharing		Medicare FFS Cost Sharing		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing					Medicare FFS Cost Sharing						Medicare FFS Cost Sharing																					4.9589		1.317		0.2034	1.0545		0.5996	0.7127	4.4008					9.0131						1.0496																					23.3098		0.031896296	24.7946	0	6.585033262	0	1.016870315	5.272674895	0	2.998035479	3.563581956	22.00417642	0	0	0	0	45.06566886	0	0	0	0	0	5.248101785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.5488
H4908_803_0	2008	1																																Coin		Coin		Coin	Coin		Coin	Coin	Coin					Coin						Coin																																																														0		221.9487		27.5832		3.4765	18.0262		10.2497	12.1832	75.228					154.0707						17.9422																					Medicare FFS Cost Sharing		Medicare FFS Cost Sharing		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing					Medicare FFS Cost Sharing						Medicare FFS Cost Sharing																					0.089370679		0.190986641		0.234	0.234		0.234	0.234	0.234					0.234						0.234																					19.8357	0	5.26802661	0	0.813496252	4.218139916	0	2.398428383	2.850865564	17.60334114	0	0	0	0	36.05253509	0	0	0	0	0	4.198481428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.239			19.8357	0	5.26802661	0	0.813496252	4.218139916	0	2.398428383	2.850865564	17.60334114	0	0	0	0	36.05253509	0	0	0	0	0	4.198481428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.239	3000	Medicare FFS Cost Sharing		Medicare FFS Cost Sharing		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing					Medicare FFS Cost Sharing						Medicare FFS Cost Sharing																					4.9589		1.317		0.2034	1.0545		0.5996	0.7127	4.4008					9.0131						1.0496																					23.3098		0.031896296	24.7946	0	6.585033262	0	1.016870315	5.272674895	0	2.998035479	3.563581956	22.00417642	0	0	0	0	45.06566886	0	0	0	0	0	5.248101785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.5488
H4908_804_0	2008	1																																Coin		Coin		Coin	Coin		Coin	Coin	Coin					Coin						Coin																																																														0		221.9487		27.5832		3.4765	18.0262		10.2497	12.1832	75.228					154.0707						17.9422																					Medicare FFS Cost Sharing		Medicare FFS Cost Sharing		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing					Medicare FFS Cost Sharing						Medicare FFS Cost Sharing																					0.089370679		0.190986641		0.234	0.234		0.234	0.234	0.234					0.234						0.234																					19.8357	0	5.26802661	0	0.813496252	4.218139916	0	2.398428383	2.850865564	17.60334114	0	0	0	0	36.05253509	0	0	0	0	0	4.198481428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.239			19.8357	0	5.26802661	0	0.813496252	4.218139916	0	2.398428383	2.850865564	17.60334114	0	0	0	0	36.05253509	0	0	0	0	0	4.198481428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.239	3000	Medicare FFS Cost Sharing		Medicare FFS Cost Sharing		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing					Medicare FFS Cost Sharing						Medicare FFS Cost Sharing																					4.9589		1.317		0.2034	1.0545		0.5996	0.7127	4.4008					9.0131						1.0496																					23.3098		0.031896296	24.7946	0	6.585033262	0	1.016870315	5.272674895	0	2.998035479	3.563581956	22.00417642	0	0	0	0	45.06566886	0	0	0	0	0	5.248101785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.5488
H4909_001_0	2008	5	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			D	D	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V		S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	1202.1781	83.13051589	235.425621		71.77643837	10.26762461	3.845575572	288.166995	389.7573306	686.0078576	937.2527736	45.44255872	0.87389536	0	4337.660248	1728.980608	29.53606664	549.0459874	630.3024902		336.3853115				404.8557367	389.3187637	177.660957					849.2078161	17.4779072	192.5709322	343.3452189	121.2321551	0.053418386	629.7944806	2.407136653			$175/day (1-10) with $2450 yearly max	$175/day (1-10) with $2450 yearly max	$75/day for days 21 to 100		$75 copay	20% coinsurance	20% coinsurance	$50 copay	$175 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$175 copay	$15/$25 copay for in-home/facility	$30 copay	$15 copay	$30 copay	$30 copay	$30 copay	$50/$100 copay for Lower/Higher Tier		$15/$22.50/$40/$100 copay levels				$30 copay	$75 yearly max	$50 max w/specialist copay					$30 copay	$50 copay	$30 copay	$30 copay	$15 copay	20% coinsurance	$30 copay	$30 copay			136.4729884	138.7143963	74.80717951		74.80717951	0.199485812	0.199485812	49.871453	174.5500855	51.71383789	60.93849805	174.5500855	24.9357265	0	14.9614359	29.9228718	29.9228718	29.9228718	60.93849805		33.28212089				29.9228718	0	29.9228718					29.9228718	49.871453	29.9228718	29.9228718	14.9614359	0.199485812	29.9228718	29.9228718			13.6721	0.960949944	1.467627224	0	0.447449409	2.048245433	0.767137766	1.197608896	5.669347948	2.956341595	4.759564693	0.661000209	0.001815935	0	5.40813548	4.311338758	0.073650328	1.369086058	3.200807256	0	0.93296805	0	0	0	1.009537192	0	0.443010503	0	0	0	0	2.117561384	0.072637386	0.48018961	0.856156247	0.151150593	0.01065621	1.570438292	0.00600237	0	0	56.6225		0.14594823	13.6721	0.960949944	1.467627224	0	0.447449409	2.048245433	0.767137766	1.197608896	5.669347948	2.956341595	4.759564693	0.661000209	0.001815935	0	5.40813548	4.311338758	0.073650328	1.369086058	3.200807256	0	0.93296805	0	0	0	1.009537192	0	0.443010503	0	0	0	0	2.117561384	0.072637386	0.48018961	0.856156247	0.151150593	0.01065621	1.570438292	0.00600237	0	0	56.6225	4000	$250/day days(1-10)	$250/day days(1-10)	20% coinsurance		$75 copay	30% coinsurance	30% coinsurance	$50 copay	$250 copay	20% coinsurance	20% coinsurance	$250 copay	$15/$25 copay for in-home/facility	$40 copay	$25 copay	$40 copay	$40 copay	$40 copay	20% coinsurance	0	$15/$22.50/$40/$100 copay levels	0	0	0	$50 max w/specialist copay	$75 yearly max	$50 max w/specialist copay	0	0	0	0	$40 copay	20% coinsurance	$40 copay	$40 copay	$25 copay	20% coinsurance	$40 copay	$40 copay	0	0	5.338920128	0.216504958	0.565362875		0.72710529	0.88060456	0.025149531	0.282377837	1.765996438	0.348783554	0.849421457	0.004539837	0.024515118	0	0.070937101	0.194986084	0.002906682	0.00873072	0.549476573	0	0.015117096	0	0	0	0.549794903	0	0	0	0	0	0	0.298539655	0.017764462	0.0072756	0.028374841	0.084124127	0.001675244	0	0.00218268	0	0	12.8612		0.033150516	19.011	1.177454901	2.032990099	0	1.174554699	2.928849993	0.792287297	1.479986732	7.435344386	3.305125149	5.60898615	0.665540046	0.026331052	0	5.479072582	4.506324842	0.07655701	1.377816778	3.750283829	0	0.948085147	0	0	0	1.559332095	0	0.443010503	0	0	0	0	2.416101039	0.090401848	0.48746521	0.884531088	0.23527472	0.012331454	1.570438292	0.00818505	0	0	69.4837
H4909_004_0	2008	6	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			D	D	D		T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V		S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	1236.583289	85.50963182	242.1632773	0	73.83061146	10.86373352	4.068838687	296.414059	400.911813	705.640747	964.0760525	46.74308133	0.89890541	0	4461.79994	1778.462382	30.38136065	564.759159	648.3411453		346.0123378				416.442321	400.4606948	182.7454438					873.5113324	17.9781082	198.0821283	353.171431	124.7017035	0.056519705	647.8185969	2.476026604			$125/day (1-10) with $1875 yearly max	$125/day (1-10) with $1875 yearly max	$75/day for days 21 to 100		$75 copay	20% coinsurance	20% coinsurance	$50 copay	$125 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$125 copay	$15/$25 copay for in-home/facility	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$50/$100 copay for Lower/Higher Tier		$15/$22.50/$40/$100 copay levels				$25 copay	$75 yearly max	$50 max w/specialist copay					$25 copay	$50 copay	$25 copay	$25 copay	$10 copay	20% coinsurance	$25 copay	$25 copay			97.61661108	98.93785988	73.71198169		73.71198169	0.196565285	0.196565285	49.14132113	147.4239634	50.95673299	60.04634158	147.4239634	24.57066056	0	9.828264226	24.57066056	24.57066056	24.57066056	60.04634158		32.79486143				24.57066056	0	24.57066056					24.57066056	49.14132113	24.57066056	24.57066056	9.828264226	0.196565285	24.57066056	24.57066056			10.0593	0.705011664	1.487527922	0	0.453516723	2.13543287	0.799792434	1.213848205	4.925334036	2.996428928	4.824103329	0.574254193	0.001840558	0	3.654312395	3.641499625	0.062207508	1.156375466	3.244209489	0	0.945618889	0	0	0	0.852688576	0	0.374181356	0	0	0	0	1.788562537	0.073622332	0.405584062	0.723137946	0.102133441	0.011109812	1.326444238	0.005069801	0	0	48.5431		0.848225829	10.0593	0.705011664	1.487527922	0	0.453516723	2.13543287	0.799792434	1.213848205	4.925334036	2.996428928	4.824103329	0.574254193	0.001840558	0	3.654312395	3.641499625	0.062207508	1.156375466	3.244209489	0	0.945618889	0	0	0	0.852688576	0	0.374181356	0	0	0	0	1.788562537	0.073622332	0.405584062	0.723137946	0.102133441	0.011109812	1.326444238	0.005069801	0	0	48.5431	4000	$200/day days(1-10)	$200/day days(1-10)	20% coinsurance		$75 copay	30% coinsurance	30% coinsurance	$50 copay	$250 copay	20% coinsurance	20% coinsurance	$250 copay	$15/$25 copay for in-home/facility	$35 copay	$20 copay	$35 copay	$35 copay	$35 copay	20% coinsurance	0	$15/$22.50/$40/$100 copay levels	0	0	0	$50 max w/specialist copay	$75 yearly max	$50 max w/specialist copay	0	0	0	0	$35 copay	20% coinsurance	$35 copay	$35 copay	$20 copay	20% coinsurance	$35 copay	$35 copay	0	0	4.589579245	0.190960113	0.589428614		0.736964675	0.918089157	0.026220068	0.286206817	1.789942956	0.363630185	0.885578686	0.004601396	0.024847537	3.23E-06	0.057519194	0.172926295	0.002577834	0.007742968	0.572866082	0	0.015322081	0	0	0	0.487593749	0	3.23E-06	0	0	0	0	0.264764313	0.01852064	0.006452474	0.025164647	0.068211865	0.001746554	0	0.001935742	0	0	12.1094		0.211595577	14.6488	0.895971777	2.076956536	0	1.190481399	3.053522027	0.826012503	1.500055022	6.715276993	3.360059113	5.709682016	0.578855588	0.026688095	3.23E-06	3.711831589	3.814425921	0.064785342	1.164118435	3.817075571	0	0.96094097	0	0	0	1.340282326	0	0.374184589	0	0	0	0	2.05332685	0.092142972	0.412036535	0.748302594	0.170345306	0.012856366	1.326444238	0.007005543	0	0	60.6525
H4910_002_0	2008	5																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1599.413138	0	259.2847501	268.5554307	318.1462144	12.73667873	0	568.3319631	449.5544333	804.6998377	4199.976758	0	0	541.8712824	5842.751484	4798.675375	0	1437.934068	0	0	376.2424796	0	0	0	472.5104044	0	59.89153989	0	0	0	0											$350/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$25 per visit	"$25 X-ray; $125 CAT, PET, MRI"	$25 per visit	$30 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit															59.17692516	59.17692516	68.6350679	20	100	0.2	0.2	48	200	25	43	25	30	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0	0											7.8874	0	1.483002202	0.447592385	2.651218453	2.547335745	0	2.273327852	7.492573889	1.676457995	15.04991672	0	0	1.128898505	4.86895957	9.997240365	0	2.995695976	0	0	1.410909298	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9105	0	0	7.8874	0	1.483002202	0.447592385	2.651218453	2.547335745	0	2.273327852	7.492573889	1.676457995	15.04991672	0	0	1.128898505	4.86895957	9.997240365	0	2.995695976	0	0	1.410909298	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9105																																																																																				0	0	0	7.8874	0	1.483002202	0.447592385	2.651218453	2.547335745	0	2.273327852	7.492573889	1.676457995	15.04991672	0	0	1.128898505	4.86895957	9.997240365	0	2.995695976	0	0	1.410909298	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9105
H4910_004_0	2008	3																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1599.413138	0	259.2847501	268.5554307	318.1462144	12.73667873	0	568.3319631	449.5544333	804.6998377	4199.976758	0	0	541.8712824	5842.751484	4798.675375	0	1437.934068	0	0	376.2424796	0	0	0	472.5104044	0	59.89153989	0	0	0	0											$850/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$35 per visit	"$35 X-ray; $150 CAT, PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$20 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															143.7153897	143.7153897	68.6350679	20	100	0.2	0.2	48	200	35	55.7	35	30	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0	0											19.155	0	1.483002202	0.447592385	2.651218453	2.547335745	0	2.273327852	7.492573889	2.347041193	19.49489212	0	0	1.580457907	9.737919139	13.99613651	0	4.193974366	0	0	1.410909298	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.8114	0	0	19.155	0	1.483002202	0.447592385	2.651218453	2.547335745	0	2.273327852	7.492573889	2.347041193	19.49489212	0	0	1.580457907	9.737919139	13.99613651	0	4.193974366	0	0	1.410909298	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.8114																																																																																				0	0	0	19.155	0	1.483002202	0.447592385	2.651218453	2.547335745	0	2.273327852	7.492573889	2.347041193	19.49489212	0	0	1.580457907	9.737919139	13.99613651	0	4.193974366	0	0	1.410909298	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.8114
H4910_801_0	2008	1																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1390.881312	0	1269.560306	223.4994079	223.1771952	4.044676053	0	198.9055989	315.3590801	695.4896816	5334.123813	0	0	556.420797	3549.482016	4706.566839	0	920.1285534	0	0	8.463483005	0	0	0	411.0272009	0	41.80313655	0	0	0	0											$200/day; $1400 max		$100/day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$39.5 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											16.7566	0	10.57966922	0.744998026	2.789714939	1.213402816	0	0.828773329	5.255984668	2.318298939	24.42139686	0	0	1.85473599	8.873705039	15.49244918	0	3.067095178	0	0	0.000141058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.197	0	0	16.7566	0	10.57966922	0.744998026	2.789714939	1.213402816	0	0.828773329	5.255984668	2.318298939	24.42139686	0	0	1.85473599	8.873705039	15.49244918	0	3.067095178	0	0	0.000141058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.197																																																																																				0	0	0	16.7566	0	10.57966922	0.744998026	2.789714939	1.213402816	0	0.828773329	5.255984668	2.318298939	24.42139686	0	0	1.85473599	8.873705039	15.49244918	0	3.067095178	0	0	0.000141058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.197
H4910_802_0	2008	1																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1183.728776	0	1080.476856	190.212262	189.9380384	3.442277492	0	169.2813608	268.3907065	591.906112	4539.679841	0	0	473.5496144	3020.835758	4005.588799	0	783.0881306	0	0	7.202964259	0	0	0	349.8103837	0	35.57713749	0	0	0	0											$200/day; $1400 max		$100/day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$39.5 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											14.261	0	9.003973803	0.634040873	2.37422548	1.032683247	0	0.705339003	4.473178441	1.973020373	20.78416754	0	0	1.578498715	7.552089395	13.18506313	0	2.610293769	0	0	0.000120049	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1677	0	0	14.261	0	9.003973803	0.634040873	2.37422548	1.032683247	0	0.705339003	4.473178441	1.973020373	20.78416754	0	0	1.578498715	7.552089395	13.18506313	0	2.610293769	0	0	0.000120049	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1677																																																																																				0	0	0	14.261	0	9.003973803	0.634040873	2.37422548	1.032683247	0	0.705339003	4.473178441	1.973020373	20.78416754	0	0	1.578498715	7.552089395	13.18506313	0	2.610293769	0	0	0.000120049	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1677
H4911_002_0	2008	4																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	1441.646555	0	918.2365992	4716.968832	230.6639879	9.45508123	0	471.6968832	310.0096738	1781.282594	4585.211975	0	0	441.8096445	4235.0891	4590.465049	0	744.0232171	0	0	259.45425	0	0	0	465.4075914	0	50.3143342	0	0	0	0											$350/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$25 per visit	"$25 X-ray; $150 CAT, PET, MRI"	$25 per visit	$30 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit															59.17692516	59.17692516	68.6350679	20	100	0.2	0.2	48	200	25	47.5	25	30	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0	0											7.1094	0	5.251935945	7.86161472	1.922199899	1.891016246	0	1.886787533	5.166827896	3.711005403	18.1497974	0	0	0.920436759	3.529240917	9.563468852	0	1.550048369	0	0	0.972953438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4867	0	0	7.1094	0	5.251935945	7.86161472	1.922199899	1.891016246	0	1.886787533	5.166827896	3.711005403	18.1497974	0	0	0.920436759	3.529240917	9.563468852	0	1.550048369	0	0	0.972953438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4867		$150 ded; 20 % coins; $5000 max OOP	$150 ded; 20 % coins; $5000 max OOP	$150 ded; 20 % coins; $5000 max OOP	$150 ded; 20 % coins; $5000 max OOP	$150 ded; 20 % coins; $5000 max OOP	$150 ded; 20 % coins; $5000 max OOP	0	$50 ER; $35 UC	$150 ded; 20 % coins; $5000 max OOP	$150 ded; 20 % coins; $5000 max OOP	$150 ded; 20 % coins; $5000 max OOP	$150 ded; 20 % coins; $5000 max OOP	$150 ded; 20 % coins; $5000 max OOP	$150 ded; 20 % coins; $5000 max OOP	$150 ded; 20 % coins; $5000 max OOP	$150 ded; 20 % coins; $5000 max OOP	$150 ded; 20 % coins; $5000 max OOP	$150 ded; 20 % coins; $5000 max OOP	$150 ded; 20 % coins; $5000 max OOP	$150 ded; 20 % coins; $5000 max OOP	$150 ded; 20 % coins; $5000 max OOP	0	0	0	$150 ded; 20 % coins; $5000 max OOP	0	$150 ded; 20 % coins; $5000 max OOP	0	0	0	0											8.9752	0	0.5651	0.9374	0.059	0.1895	0	0.191	0.4594	0.3957	1.3984	0	0	0.3063	0.9429	3.1523	0	0.1561	0	0	0.1025	0	0	0	0.0554	0	0.0035	0	0	0	0											17.8899	150	6.026174805	16.0846	0	5.817053622	8.799058586	1.981228497	2.080542783	0	2.077808415	5.626254846	4.106683433	19.54816314	0	0	1.226721393	4.472184849	12.71581792	0	1.706114616	0	0	1.075494452	0	0	0	0.05541249	0	0.003500675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.3766
H4911_003_0	2008	4																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	7500	1861.630366	0	918.2365992	4716.968832	230.6639879	9.45508123	0	471.6968832	310.0096738	1781.282594	4585.211975	0	0	441.8096445	4235.0891	4590.465049	0	744.0232171	0	0	259.45425	0	0	0	465.4075914	0	50.3143342	0	0	0	0											$850/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$35 per visit	"$35 X-ray; $150 CAT, PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$20 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															143.7153897	143.7153897	68.6350679	20	100	0.2	0.2	48	200	35	55.7	35	30	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0	0											22.2954	0	5.251935945	7.86161472	1.922199899	1.891016246	0	1.886787533	5.166827896	5.195407565	21.28302558	0	0	1.288611463	7.058481833	13.38885639	0	2.170067716	0	0	0.972953438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.6332	0	0	22.2954	0	5.251935945	7.86161472	1.922199899	1.891016246	0	1.886787533	5.166827896	5.195407565	21.28302558	0	0	1.288611463	7.058481833	13.38885639	0	2.170067716	0	0	0.972953438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.6332		$500 ded; 30 % coins; $7500 max OOP	$500 ded; 30 % coins; $7500 max OOP	$500 ded; 30 % coins; $7500 max OOP	$500 ded; 30 % coins; $7500 max OOP	$500 ded; 30 % coins; $7500 max OOP	$500 ded; 30 % coins; $7500 max OOP	0	$50 ER; $35 UC	$500 ded; 30 % coins; $7500 max OOP	$500 ded; 30 % coins; $7500 max OOP	$500 ded; 30 % coins; $7500 max OOP	$500 ded; 30 % coins; $7500 max OOP	$500 ded; 30 % coins; $7500 max OOP	$500 ded; 30 % coins; $7500 max OOP	$500 ded; 30 % coins; $7500 max OOP	$500 ded; 30 % coins; $7500 max OOP	$500 ded; 30 % coins; $7500 max OOP	$500 ded; 30 % coins; $7500 max OOP	$500 ded; 30 % coins; $7500 max OOP	$500 ded; 30 % coins; $7500 max OOP	$500 ded; 30 % coins; $7500 max OOP	0	0	0	$500 ded; 30 % coins; $7500 max OOP	0	$500 ded; 30 % coins; $7500 max OOP	0	0	0	0											14.2258	0	0.8957	1.4859	0.0936	0.3004	0	0.2147	0.7282	0.6272	2.2164	0	0	0.4855	1.4946	4.9965	0	0.2474	0	0	0.1217	0	0	0	0.0878	0	0.0055	0	0	0	0											28.2268	500	9.229125484	36.5212	0	6.147653737	9.347473657	2.015760882	2.191417912	0	2.101455313	5.895024714	5.822561635	23.49945081	0	0	1.774076008	8.553058437	18.38536467	0	2.417434452	0	0	1.094681955	0	0	0	0.087829412	0	0.005548608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.86
H4911_801_0	2008	2																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1356.652049	0	490.2354028	294.7366693	196.0643897	12.67081209	0	338.7321542	277.0475072	1499.911378	4492.085927	0	0	513.2970586	3873.240023	4572.993616	0	1073.258276	0	0	7.435292075	0	0	0	543.3276984	0	31.25994977	0	0	0	0											$200/day; $1400 max		$100/day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$39.5 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											16.3443	0	4.085295023	0.982455564	2.450804872	3.801243626	0	1.411383976	4.617458454	4.999704594	20.56626673	0	0	1.710990195	9.683100058	15.05277065	0	3.577527585	0	0	0.000123922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2834	0	0	16.3443	0	4.085295023	0.982455564	2.450804872	3.801243626	0	1.411383976	4.617458454	4.999704594	20.56626673	0	0	1.710990195	9.683100058	15.05277065	0	3.577527585	0	0	0.000123922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2834		$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	0	$50 per visit	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	0	0	0	$500 ded; 30% coins; No max OOP	0	$500 ded; 30% coins; No max OOP	0	0	0	0											14.2745	0	0.7884	0.1299	0.1799	0.3684	0	0.1356	1.4681	0.7988	2.6128	0	0	0.9832	1.2178	5.5438	0	0.4136	0	0	0.0367	0	0	0	0.1118	0	0.0043	0	0	0	0											29.0674	500	0	30.6187	0	4.873688496	1.11235323	2.630698712	4.169644956	0	1.546953271	6.085508979	5.798528134	23.17903329	0	0	2.694180365	10.90086542	20.59658114	0	3.991089208	0	0	0.036787607	0	0	0	0.111775588	0	0.004343967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.3508
H4911_802_0	2008	2																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1356.652049	0	490.2354028	294.7366693	196.0643897	12.67081209	0	338.7321542	277.0475072	1499.911378	4492.085927	0	0	513.2970586	3873.240023	4572.993616	0	1073.258276	0	0	7.435292075	0	0	0	543.3276984	0	31.25994977	0	0	0	0											$200/day; $1400 max	$200/day; $1400 max	$100/day	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$39.5 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											16.3443	0	4.085295023	0.982455564	2.450804872	3.801243626	0	1.411383976	4.617458454	4.999704594	20.56626673	0	0	1.710990195	9.683100058	15.05277065	0	3.577527585	0	0	0.000123922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2834	0	0	16.3443	0	4.085295023	0.982455564	2.450804872	3.801243626	0	1.411383976	4.617458454	4.999704594	20.56626673	0	0	1.710990195	9.683100058	15.05277065	0	3.577527585	0	0	0.000123922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2834		$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	0	$50 per visit	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	$500 ded; 30% coins; No max OOP	0	0	0	$500 ded; 30% coins; No max OOP	0	$500 ded; 30% coins; No max OOP	0	0	0	0											14.2745	0	0.7884	0.1299	0.1799	0.3684	0	0.1356	1.4681	0.7988	2.6128	0	0	0.9832	1.2178	5.5438	0	0.4136	0	0	0.0367	0	0	0	0.1118	0	0.0043	0	0	0	0											29.0674	500	0	30.6187	0	4.873688496	1.11235323	2.630698712	4.169644956	0	1.546953271	6.085508979	5.798528134	23.17903329	0	0	2.694180365	10.90086542	20.59658114	0	3.991089208	0	0	0.036787607	0	0	0	0.111775588	0	0.004343967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.3508
H4971_001_0	2008	6																					3875											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1894.146805	139.6775142	907.3134587		118.2451222	12.61626333	2.417444042	460.8204152	31.04448388	9772.857757	44.62200908		0.360999472	28.60676233	4189.794807	4253.923456	487.4713752	1.767174781			22.52474668	853.8222152			122.4		14.32602104															$125 (1a); $0 (1a1)	$125 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$195 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$5 (4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$20 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	$0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											89.9313	89.9313	71.9451		140.2929	0.215835227	0.287389064	35.9725	0.143890151	4.3167	0.085718694		0.215835227	0.143835155	5	19.9616	37.5	0.143890151			0.215835227	20			20		20															14.1953	1.046782223	5.439727959	0	1.38241257	2.723034062	0.694746981	1.381406653	4.466995489	3.515544958	3.824940344	0	0.077916403	4.114658085	1.745747836	7.076252593	1.523348048	0.254279047	0	0	4.861633818	1.423037025	0	0	0.204	0	0.023876702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9756	0	18.46834104	14.1953	1.046782223	5.439727959	0	1.38241257	2.723034062	0.694746981	1.381406653	4.466995489	3.515544958	3.824940344	0	0.077916403	4.114658085	1.745747836	7.076252593	1.523348048	0.254279047	0	0	4.861633818	1.423037025	0	0	0.204	0	0.023876702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9756		$225 (1a); $0 (1a1)	$225 (1b)	"$150 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$195 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	30% (9b)	30% (8a1); $0/$30 (8a2)	"$25 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $30 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											3.0883	0.2277	3.7805	0.6731	0.4804	0.9462	0.1813	0.48	2.3283	2.4432	1.9545		0.0271	2.1442	1.5018	1.872	0.3047	0.0936			1.1925	0.3843			0.054		0.0063															24.1639	0	0	17.2835	1.274517301	9.220200703	0.673120857	1.862783379	3.669253811	0.876055284	1.861427919	6.79533178	5.958759397	5.77945845	0	0.104991363	6.25882584	3.247505886	8.94820503	1.828017657	0.347835359	0	0	6.054120407	1.807342731	0	0	0.258	0	0.030197005	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.1395
H4971_801_0	2008	2																					4750											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2161.797984	159.4145543	1270.238842		155.1967229	16.55884562	3.172895305	604.806795	40.7458851	12826.87581	58.56638691		0.473811806	37.54637556	5169.07888	5253.896622	602.1705223	2.182980612			27.82468708	1054.72156			144		16.8541424															$425 (1a); $0 (1a1)	$425 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											249.6484	249.6484	88.1112		102.7964	0.176222426	0.28145363	29.3704	0.176222426	3.5244	0.09879384		0.176222426	0.176128619	25	29.9272	37.5	0.176222426			0.176222426	30			30		30															44.9741	3.316466188	9.32685709	0	1.329472229	2.918039944	0.8930229	1.480285008	7.180338715	3.767305284	5.785998265	0	0.083496266	6.612991292	10.76891433	13.10288489	1.881782882	0.384690139	0	0	4.903333855	2.6368039	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.7489	0	64.72188598	44.9741	3.316466188	9.32685709	0	1.329472229	2.918039944	0.8930229	1.480285008	7.180338715	3.767305284	5.785998265	0	0.083496266	6.612991292	10.76891433	13.10288489	1.881782882	0.384690139	0	0	4.903333855	2.6368039	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.7489																																																																																				0			44.9741	3.316466188	9.32685709	0	1.329472229	2.918039944	0.8930229	1.480285008	7.180338715	3.767305284	5.785998265	0	0.083496266	6.612991292	10.76891433	13.10288489	1.881782882	0.384690139	0	0	4.903333855	2.6368039	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.7489
H4971_802_0	2008	2																					4750											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2161.797984	159.4145543	1270.238842		155.1967229	16.55884562	3.172895305	604.806795	40.7458851	12826.87581	58.56638691		0.473811806	37.54637556	5169.07888	5253.896622	602.1705223	2.182980612			27.82468708	1054.72156			144		16.8541424															$425 (1a); $0 (1a1)	$425 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											249.6484	249.6484	88.1112		102.7964	0.176222426	0.28145363	29.3704	0.176222426	3.5244	0.09879384		0.176222426	0.176128619	25	29.9272	37.5	0.176222426			0.176222426	30			30		30															44.9741	3.316466188	9.32685709	0	1.329472229	2.918039944	0.8930229	1.480285008	7.180338715	3.767305284	5.785998265	0	0.083496266	6.612991292	10.76891433	13.10288489	1.881782882	0.384690139	0	0	4.903333855	2.6368039	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.7489	0	64.72188598	44.9741	3.316466188	9.32685709	0	1.329472229	2.918039944	0.8930229	1.480285008	7.180338715	3.767305284	5.785998265	0	0.083496266	6.612991292	10.76891433	13.10288489	1.881782882	0.384690139	0	0	4.903333855	2.6368039	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.7489																																																																																				0			44.9741	3.316466188	9.32685709	0	1.329472229	2.918039944	0.8930229	1.480285008	7.180338715	3.767305284	5.785998265	0	0.083496266	6.612991292	10.76891433	13.10288489	1.881782882	0.384690139	0	0	4.903333855	2.6368039	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.7489
H5005_001_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1403.818894	12.32961559	1268.474554		528.9545002	12.70591834	12.93631824	443.3747033	220.5670009		54.99256292			1329.147225	4737.550508	3960.522092	441.9331306	317.0857616			27.95179573	1408.07091			207.639415	0.006148626																$175 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$175 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$175 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $175 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											74.9647	912	63.2242		100	0.2	0.2	47.0639	175		0.135980075			5.4528	15	29.9994	30	7.9579			0.2	30			30	1																8.7697	0.937050785	6.683194564	0	4.407954168	2.541183669	2.587263648	1.738910235	3.216602096	0	7.477892842	0	0	0.603959851	5.921938134	9.901109501	1.104832827	0.210278327	0	0	5.590359146	3.520177274	0	0	0.519098538	0.006148626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.7377	0	0	8.7697	0.937050785	6.683194564	0	4.407954168	2.541183669	2.587263648	1.738910235	3.216602096	0	7.477892842	0	0	0.603959851	5.921938134	9.901109501	1.104832827	0.210278327	0	0	5.590359146	3.520177274	0	0	0.519098538	0.006148626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.7377																																																																																				0			8.7697	0.937050785	6.683194564	0	4.407954168	2.541183669	2.587263648	1.738910235	3.216602096	0	7.477892842	0	0	0.603959851	5.921938134	9.901109501	1.104832827	0.210278327	0	0	5.590359146	3.520177274	0	0	0.519098538	0.006148626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.7377
H5005_010_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1574.883899	10.97683727	1111.275492		529.1132079	15.4224121	14.78188352	429.2984963	169.6427433	13107.04017	61.46210679			460.5676498	4543.370678	4499.587542	403.0568321	401.624436			23.82396255	1213.116743			360.5115364	0.065448876					341.54											$200 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$200 (9b)	$0 (8a1); $0/$8 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $10 (7b1); $15/$30( 7f, 7g); $0 n/c( 7f1)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	$0 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$10 (13b); $0 n/c (13c, 13d, 13e)"											85.6739	912	63.2242		100	0.2	0.2	48.9893	200	3.2	0.14213243			6.4239	15	29.1794	30	7.9579			0.2	30			30	0.513402742					10											11.2439	0.834239633	5.854962008	0	4.409276733	3.08448242	2.956376704	1.75258557	2.827379054	3.495210713	8.735758582	0	0	0.24655411	5.679213347	10.94126064	1.00764208	0.266340923	0	0	4.764792509	3.032791858	0	0	0.901278841	0.033601632	0	0	0	0	0.284616667	0	0	0	0	0	0	0	0	0	0	72.3522	0	0	11.2439	0.834239633	5.854962008	0	4.409276733	3.08448242	2.956376704	1.75258557	2.827379054	3.495210713	8.735758582	0	0	0.24655411	5.679213347	10.94126064	1.00764208	0.266340923	0	0	4.764792509	3.032791858	0	0	0.901278841	0.033601632	0	0	0	0	0.284616667	0	0	0	0	0	0	0	0	0	0	72.3522																																																																																				0			11.2439	0.834239633	5.854962008	0	4.409276733	3.08448242	2.956376704	1.75258557	2.827379054	3.495210713	8.735758582	0	0	0.24655411	5.679213347	10.94126064	1.00764208	0.266340923	0	0	4.764792509	3.032791858	0	0	0.901278841	0.033601632	0	0	0	0	0.284616667	0	0	0	0	0	0	0	0	0	0	72.3522
H5005_011_0	2008	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1315.632093	11.38760137	1355.231677		528.9668007	17.04262402	14.64834453	439.5285023	172.8534944	15361.5064	58.59204367			1032.720323	4914.258301	4347.501135	414.6808644	375.8794211			29.21219274	1530.093634			419.3778862	0.032014664					341.54											$200 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$200 (9b)	$0 (8a1); $0/$7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $10 (7b1); $15/$30( 7f, 7g); $0 n/c( 7f1)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	$0 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7)"	"$10 (13b), $0 n/c (13c, 13d, 13e)"											85.6739	912	63.2242		100	0.2	0.2	47.4517	200	2.8	0.137819893			5.7439	15	29.1505	30	7.9579			0.2	29.9994			30	0.425775907					10											9.3929	0.865457704	7.140290631	0	4.408056673	3.408524804	2.929668906	1.738031127	2.880891574	3.584351494	8.075149161	0	0	0.494316238	6.142822877	10.56098928	1.036702161	0.24926788	0	0	5.842438548	3.825160518	0	0	1.048444716	0.013631072	0	0	0	0	0.284616667	0	0	0	0	0	0	0	0	0	0	73.9218	0	0	9.3929	0.865457704	7.140290631	0	4.408056673	3.408524804	2.929668906	1.738031127	2.880891574	3.584351494	8.075149161	0	0	0.494316238	6.142822877	10.56098928	1.036702161	0.24926788	0	0	5.842438548	3.825160518	0	0	1.048444716	0.013631072	0	0	0	0	0.284616667	0	0	0	0	0	0	0	0	0	0	73.9218																																																																																				0			9.3929	0.865457704	7.140290631	0	4.408056673	3.408524804	2.929668906	1.738031127	2.880891574	3.584351494	8.075149161	0	0	0.494316238	6.142822877	10.56098928	1.036702161	0.24926788	0	0	5.842438548	3.825160518	0	0	1.048444716	0.013631072	0	0	0	0	0.284616667	0	0	0	0	0	0	0	0	0	0	73.9218
H5005_015_0	2008	3																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1403.922522	12.33052575	1268.568191		528.9935469	12.35078119	12.54361756	443.2387651	220.5832828		53.31969108			1329.24534	4515.442313	3960.814452	441.9657535	317.1091685			27.09641576	1408.174851			144	1.802446166																$200 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$200 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											85.6739	912	63.2242		100	0.2	0.2	47.0627	200		0.136168836			6.0522	15	29.9994	30	7.9579			0.2	30			30	0.428573133																10.0233	0.937119957	6.683687908	0	4.408279557	2.470156238	2.508723512	1.738335817	3.676388047	0	7.260480248	0	0	0.670409693	5.644302892	9.901840388	1.104914384	0.210293849	0	0	5.419283152	3.520437128	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3104	0	0	10.0233	0.937119957	6.683687908	0	4.408279557	2.470156238	2.508723512	1.738335817	3.676388047	0	7.260480248	0	0	0.670409693	5.644302892	9.901840388	1.104914384	0.210293849	0	0	5.419283152	3.520437128	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3104																																																																																				0			10.0233	0.937119957	6.683687908	0	4.408279557	2.470156238	2.508723512	1.738335817	3.676388047	0	7.260480248	0	0	0.670409693	5.644302892	9.901840388	1.104914384	0.210293849	0	0	5.419283152	3.520437128	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3104
H5005_018_0	2008	3																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	O	O	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1630.063568	11.36143594	1150.211577		547.6519024	15.80671391	15.75619239	444.1514049	175.5865658		64.15168996			476.7046935	4607.041361	4466.152324	417.1788525	415.6962691			24.95690124	1255.62107			144	1.796073749																$200 (1a); $0 (1a1)	$912 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$15 (4b)"	$200 (9b)	$0 (8a1); $0/$0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	$0 (12)	"$30 (3, 9d); $150 (5); $30/$30 (9c); $200 (9a)"	"$15/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30( 7f, 7g)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	$0 (incl in h2)		20%/$0 (15); 20% (15a1)	"$0 (13a, 17b, 13a1); $15/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											85.6739	912	63.2242		100	0.2	0.2	48.9889	200		0.143072533			6.4283	15	30	30	7.9579			0.2	30			30	0.430093698																11.6378	0.863469131	6.060104028	0	4.563765854	3.161342782	3.151238478	1.813205805	2.926442763	0	9.178344802	0	0	0.255368563	5.758801701	11.16537231	1.042947131	0.275672788	0	0	4.991380249	3.139052676	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.1168	0	0	11.6378	0.863469131	6.060104028	0	4.563765854	3.161342782	3.151238478	1.813205805	2.926442763	0	9.178344802	0	0	0.255368563	5.758801701	11.16537231	1.042947131	0.275672788	0	0	4.991380249	3.139052676	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.1168																																																																																				0			11.6378	0.863469131	6.060104028	0	4.563765854	3.161342782	3.151238478	1.813205805	2.926442763	0	9.178344802	0	0	0.255368563	5.758801701	11.16537231	1.042947131	0.275672788	0	0	4.991380249	3.139052676	0	0	0.36	0.77248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.1168
H5005_019_0	2008	4																					3225											D	A	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1319.388779	11.58807346	1192.184477		497.1415012	11.30084882	11.46098434	416.5743178	44.0003076	14204.77209	48.71581352		6.508916763	13.50859658	4251.443901	3722.323749	415.3538724	2.183506318			24.75413259	1323.385065			144																	$295 (1a); $0 (1a1)	$295 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	30% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$10 (4b)"	30% (9b)	$15 (8a1); $15/$20 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $150 (5); $40/$40 (9c)"	"$10/$50/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $10 (14c1, 14c)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $10/$30( 7f, 7g)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		30%/30% (15); 30% (15a1)	"$0 (13a, 17b, 13a1); $10/$30 (17a); $30( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $30 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											173.7582	173.7582	94.2417		103.0769	0.176703223	0.176703223	27.7206	0.176703223	4.7121	0.117789912		0.176703223	0.008188446	5.8901	17.6699	22.0879	0.176703223			0.176703223	29.8045			17.6703																	19.1045	0.167793536	9.362792888	0	4.270316251	1.996896413	2.025192877	0.962306055	7.774996183	5.577842258	5.738231367	0	1.150146573	0.110614408	2.086788448	5.481077238	0.764524668	0.385832605	0	0	4.37413502	3.286902596	0	0	0.212043868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.833	0	49.94368794	19.1045	0.167793536	9.362792888	0	4.270316251	1.996896413	2.025192877	0.962306055	7.774996183	5.577842258	5.738231367	0	1.150146573	0.110614408	2.086788448	5.481077238	0.764524668	0.385832605	0	0	4.37413502	3.286902596	0	0	0.212043868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.833																																																																																				0			19.1045	0.167793536	9.362792888	0	4.270316251	1.996896413	2.025192877	0.962306055	7.774996183	5.577842258	5.738231367	0	1.150146573	0.110614408	2.086788448	5.481077238	0.764524668	0.385832605	0	0	4.37413502	3.286902596	0	0	0.212043868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.833
H5005_024_0	2008	4																					2200											D	A	D	V	T	Coin	Coin	V	V	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1416.67361	12.44251741	1280.089928		533.7981164	12.15135441	12.30290523	447.2608362	222.5867245	15252.15772	52.29207901		6.831208965	14.40572855			445.9798955	2.34917499			26.56799577				144																	$275 (1a); $0 (1a1)	$275 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $50/$30/$0 (4b)"	$200 (9b)	$15 (8a1); $15/$20 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	$200 (incl in h5)	20% (12)	"20% (3, 9d); $150 (5); $40/$40 (9c); $200 (9a)"	"$0/$50/$30 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$0 (7b, 7d); $0 n/c (7b1, 7f1); $0/$0( 7f, 7g)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		20%/20% (15); 20% (15a1)	"$0 (13a, 17b, 18a, 16b, 13a1); $0/$0 (17a)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c; $0 (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											152.7381	152.7381	88.8658		97.197	0.111082271	0.111082271	26.1392	111.0823	4.4433	0.07571499		0.111082271	0.023207644			20.8279	0.111082271			0.111082271				16.6623																	18.0317	0.158370563	9.479686416	0	4.32363072	1.349800044	1.366634652	0.974252094	2.060453237	5.647481058	3.95929424	0	0.758826205	0.334323022	0	0	0.774069681	0.260951693	0	0	2.951233306	0	0	0	0.199948088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6306	0	42.12909778	18.0317	0.158370563	9.479686416	0	4.32363072	1.349800044	1.366634652	0.974252094	2.060453237	5.647481058	3.95929424	0	0.758826205	0.334323022	0	0	0.774069681	0.260951693	0	0	2.951233306	0	0	0	0.199948088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6306																																																																																				0			18.0317	0.158370563	9.479686416	0	4.32363072	1.349800044	1.366634652	0.974252094	2.060453237	5.647481058	3.95929424	0	0.758826205	0.334323022	0	0	0.774069681	0.260951693	0	0	2.951233306	0	0	0	0.199948088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6306
H5005_801_0	2008	2																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1096.836489	111.2624599	930.7739824		8.670003879	16.50515161	11.65858788	410.3885356	224.7334185		64.66137735		6.106671928	1653.626537	4900.939347	4590.371162	3.660219357	720.3260289			47.14558998	1524.451277			220.4137475																	$300 (1a); $0 (1a1)	$300 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											188.7837	199.3641	159.1696		0.3	0.3	0.3	47.2816	300		0.221468533		0.3	7.5083	20	39.9934	0.406825347	40			0.3	40			40																	17.2554	1.848478069	12.34590724	0	2.601001164	4.951545484	3.497576365	1.616984613	5.618335463	0	14.3204604	0	1.832001578	1.03466027	8.168232245	15.29872321	1.489070009	2.401086763	0	0	14.14367699	5.081504257	0	0	0.734712492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2394	0	0	17.2554	1.848478069	12.34590724	0	2.601001164	4.951545484	3.497576365	1.616984613	5.618335463	0	14.3204604	0	1.832001578	1.03466027	8.168232245	15.29872321	1.489070009	2.401086763	0	0	14.14367699	5.081504257	0	0	0.734712492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2394																																																																																				0			17.2554	1.848478069	12.34590724	0	2.601001164	4.951545484	3.497576365	1.616984613	5.618335463	0	14.3204604	0	1.832001578	1.03466027	8.168232245	15.29872321	1.489070009	2.401086763	0	0	14.14367699	5.081504257	0	0	0.734712492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2394
H5005_802_0	2008	2																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1096.836489	111.2624599	930.7739824		8.670003879	16.5480649	11.70826976	410.3885356	224.7334185		64.83783615		6.163197902	1653.626537	4900.939347	4590.371162	3.660874347	720.3260289			47.23940348	1524.451277			220.4137475																	$315 (1a); $0 (1a1)	$315 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											198.2229	209.3323	159.1696		0.3	0.3	0.3	47.2816	300		0.221480761		0.3	7.5083	20	39.9934	0.406752559	40			0.3	40			40																	18.1182	1.940901973	12.34590724	0	2.601001164	4.964419471	3.512480928	1.616984613	5.618335463	0	14.36033329	0	1.84895937	1.03466027	8.168232245	15.29872321	1.489070009	2.401086763	0	0	14.17182104	5.081504257	0	0	0.734712492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.3073	0	0	18.1182	1.940901973	12.34590724	0	2.601001164	4.964419471	3.512480928	1.616984613	5.618335463	0	14.36033329	0	1.84895937	1.03466027	8.168232245	15.29872321	1.489070009	2.401086763	0	0	14.17182104	5.081504257	0	0	0.734712492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.3073																																																																																				0			18.1182	1.940901973	12.34590724	0	2.601001164	4.964419471	3.512480928	1.616984613	5.618335463	0	14.36033329	0	1.84895937	1.03466027	8.168232245	15.29872321	1.489070009	2.401086763	0	0	14.17182104	5.081504257	0	0	0.734712492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.3073
H5005_803_0	2008	2																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1129.87828	107.6056857	986.4203933		8.710417661	17.49736608	12.4994631	433.5914821	214.7729973		72.81912234		5.768855084	1522.992436	4699.39864	4456.420251	3.674995064	574.1085539			53.93760774	1469.011365			183.6314988																	$300 (1a); $0 (1a1)	$300 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											188.7837	199.3641	159.1696		0.3	0.3	0.3	47.0065	300		0.224681304		0.3	7.509	20	39.9941	0.40600267	40			0.3	40			40																	17.7752	1.787725621	13.08400848	0	2.613125298	5.249209823	3.749838931	1.698467859	5.369324933	0	16.36109534	0	1.730656525	0.953018115	7.832331067	14.85253077	1.492057809	1.91369518	0	0	16.18128232	4.89670455	0	0	0.612104996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.1524	0	0	17.7752	1.787725621	13.08400848	0	2.613125298	5.249209823	3.749838931	1.698467859	5.369324933	0	16.36109534	0	1.730656525	0.953018115	7.832331067	14.85253077	1.492057809	1.91369518	0	0	16.18128232	4.89670455	0	0	0.612104996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.1524																																																																																				0			17.7752	1.787725621	13.08400848	0	2.613125298	5.249209823	3.749838931	1.698467859	5.369324933	0	16.36109534	0	1.730656525	0.953018115	7.832331067	14.85253077	1.492057809	1.91369518	0	0	16.18128232	4.89670455	0	0	0.612104996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.1524
H5005_804_0	2008	2																																D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1132.818203	107.9039099	988.9152086		8.757354292	17.5993027	12.57681219	434.6899496	215.3753652		73.22091271		5.818515289	1527.424761	4711.438998	4468.724127	3.694996372	576.0392916			54.21984467	1473.097453			183.6314988																	$315 (1a); $0 (1a1)	$315 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d); $0 n/c (7b1, 7f1); $40/$40( 7f, 7g)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40/$40 (17a); $40( 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	"$0 n/c (18a1, 18a2)"	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											198.2229	209.3323	159.1696		0.3	0.3	0.3	47.0072	300		0.224667384		0.3	7.509	20	39.9941	0.405431279	40			0.3	40			40																	18.7125	1.88231423	13.11710003	0	2.627206288	5.27979081	3.773043656	1.702795619	5.384384131	0	16.45035091	0	1.745554587	0.955791384	7.85239833	14.89356851	1.498067106	1.920130972	0	0	16.2659534	4.910324844	0	0	0.612104996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.5834	0	0	18.7125	1.88231423	13.11710003	0	2.627206288	5.27979081	3.773043656	1.702795619	5.384384131	0	16.45035091	0	1.745554587	0.955791384	7.85239833	14.89356851	1.498067106	1.920130972	0	0	16.2659534	4.910324844	0	0	0.612104996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.5834																																																																																				0			18.7125	1.88231423	13.11710003	0	2.627206288	5.27979081	3.773043656	1.702795619	5.384384131	0	16.45035091	0	1.745554587	0.955791384	7.85239833	14.89356851	1.498067106	1.920130972	0	0	16.2659534	4.910324844	0	0	0.612104996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.5834
H5006_010_0	2008	3																																D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	V	Coin	Coin																																																													0		922.7087295	7.674127059	37.06722001	18.7735694	139.2501749	14.58307723	6.812902944	326.4700312	88.84104773	33.80475576	4.07028286	0.955056828	0.087197716	0.046847275	3667.953921	2575.042111	1.339017738	3.978537171	0	0	23.13148326	0.561043344																				$150 day for 1st 5 days	$150 day for 1st 5 days	$35 day for days 11+	15% Coinsurance	$150 Copay	20% Coinsurance	20% Coinsurance	$50 per visit	15% Coinsurance	15% Coinsurance	15% Coinsurance	50% Coinsurance	15% Coinsurance	50% Coinsurance	$10 Per Visit	$35 Per Visit	50% Coinsurance	15% Coinsurance	15% Coinsurance	$35 Per Visit	20% Coinsurance	15% Coinsurance																				150	150	35	0.15	150	0.2	0.2	50	0.15	0.15	0.15	0.5	0.15	0.5	10	35	0.5	0.15	0.15	35	0.2	0.15																				11.5339	0.095926588	0.108112725	2.81603541	1.740627187	2.916615445	1.362580589	1.360291797	13.32615716	5.070713364	0.610542429	0.477528414	0.013079657	0.023423637	3.056628268	7.510539489	0.669508869	0.596780576	0	0	4.626296653	0.084156502	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9994			11.5339	0.095926588	0.108112725	2.81603541	1.740627187	2.916615445	1.362580589	1.360291797	13.32615716	5.070713364	0.610542429	0.477528414	0.013079657	0.023423637	3.056628268	7.510539489	0.669508869	0.596780576	0	0	4.626296653	0.084156502	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9994																																																																																				0			11.5339	0.095926588	0.108112725	2.81603541	1.740627187	2.916615445	1.362580589	1.360291797	13.32615716	5.070713364	0.610542429	0.477528414	0.013079657	0.023423637	3.056628268	7.510539489	0.669508869	0.596780576	0	0	4.626296653	0.084156502	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9994
H5006_011_0	2008	3																																D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	V	Coin	Coin																																																													0		922.7087295	7.674127059	37.06722001	18.7735694	139.2501749	14.58307723	6.812902944	326.4700312	88.84104773	33.80475576	4.07028286	0.955056828	0.087197716	0.040092376	3667.953921	2624.935265	1.339017738	3.978537171	0	0	23.13148326	0.561043344																				$100 day for 1st 5 days	$100 day for 1st 5 days	$30 day for days 11+	10% Coinsurance	$100 Copay	20% Coinsurance	20% Coinsurance	$50 per visit	10% Coinsurance	10% Coinsurance	10% Coinsurance	50% Coinsurance	10% Coinsurance	50% Coinsurance	$10 Per Visit	$30 Per Visit	50% Coinsurance	10% Coinsurance	10% Coinsurance	$30 Per Visit	20% Coinsurance	10% Coinsurance																				100	100	30	0.1	100	0.2	0.2	50	0.1	0.1	0.1	0.5	0.1	0.5	10	30	0.5	0.1	0.1	0.3	0.2	0.1																				7.6892	0.063951059	0.09266805	1.87735694	1.160418124	2.916615445	1.362580589	1.360291797	8.884104773	3.380475576	0.407028286	0.477528414	0.008719772	0.020046188	3.056628268	6.562338164	0.669508869	0.397853717	0	0	4.626296653	0.056104334	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0698			7.6892	0.063951059	0.09266805	1.87735694	1.160418124	2.916615445	1.362580589	1.360291797	8.884104773	3.380475576	0.407028286	0.477528414	0.008719772	0.020046188	3.056628268	6.562338164	0.669508869	0.397853717	0	0	4.626296653	0.056104334	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0698																																																																																				0			7.6892	0.063951059	0.09266805	1.87735694	1.160418124	2.916615445	1.362580589	1.360291797	8.884104773	3.380475576	0.407028286	0.477528414	0.008719772	0.020046188	3.056628268	6.562338164	0.669508869	0.397853717	0	0	4.626296653	0.056104334	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0698
H5006_012_0	2008	3																					3000											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	V	Coin	Coin																																																													0		816.1644182	6.788002807	32.78710289	16.60580295	123.1710879	12.89918298	6.026223433	288.7728429	78.58265529	29.90135233	3.600291117	0.844777312	0.077129077	0.035462947	3244.418723	2321.836453	1.184402616	3.519139216	0	0	20.46051259	0.496260196																				$100 day for 1st 5 days	$100 day for 1st 5 days	$30 day for days 11+	10% Coinsurance	$100 Copay	20% Coinsurance	20% Coinsurance	$50 per visit	10% Coinsurance	10% Coinsurance	10% Coinsurance	50% Coinsurance	10% Coinsurance	50% Coinsurance	$10 Per Visit	$30 Per Visit	50% Coinsurance	10% Coinsurance	10% Coinsurance	$30 Per Visit	20% Coinsurance	10% Coinsurance																				100	100	30	0.1	100	0.2	0.2	50	0.1	0.1	0.1	0.5	0.1	0.5	10	30	0.5	0.1	0.1	0.3	0.2	0.1																				6.8014	0.05656669	0.081967757	1.660580295	1.026425732	2.579836596	1.205244687	1.203220179	7.858265529	2.990135233	0.360029112	0.422388656	0.007712908	0.017731474	2.703682269	5.804591132	0.592201308	0.351913922	0	0	4.092102518	0.04962602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.8656		5.2	6.8014	0.05656669	0.081967757	1.660580295	1.026425732	2.579836596	1.205244687	1.203220179	7.858265529	2.990135233	0.360029112	0.422388656	0.007712908	0.017731474	2.703682269	5.804591132	0.592201308	0.351913922	0	0	4.092102518	0.04962602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.8656																																																																																				0			6.8014	0.05656669	0.081967757	1.660580295	1.026425732	2.579836596	1.205244687	1.203220179	7.858265529	2.990135233	0.360029112	0.422388656	0.007712908	0.017731474	2.703682269	5.804591132	0.592201308	0.351913922	0	0	4.092102518	0.04962602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.8656
H5006_013_0	2008	3																					4000											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	V	Coin	Coin																																																													0		821.2800777	6.830549517	32.99261008	16.70988693	123.9431153	12.98003413	6.063995365	290.5828502	79.07520569	30.08877184	3.622857481	0.850072315	0.077612517	0.041697594	3264.754505	2291.9809	1.191826366	3.541196926	0	0	20.5887576	0.499370719																				$150 day for 1st 5 days	$150 day for 1st 5 days	$35 day for days 11+	15% Coinsurance	$150 Copay	20% Coinsurance	20% Coinsurance	$50 per visit	15% Coinsurance	15% Coinsurance	15% Coinsurance	50% Coinsurance	15% Coinsurance	50% Coinsurance	$10 Per Visit	$35 Per Visit	50% Coinsurance	15% Coinsurance	15% Coinsurance	$35 Per Visit	20% Coinsurance	15% Coinsurance																				150	150	35	0.15	150	0.2	0.2	50	0.15	0.15	0.15	0.5	0.15	0.5	10	35	0.5	0.15	0.15	35	0.2	0.15																				10.266	0.085381869	0.096228446	2.506483039	1.549288942	2.596006825	1.212799073	1.210761876	11.86128085	4.513315776	0.543428622	0.425036157	0.011641878	0.020848797	2.720628754	6.684944293	0.595913183	0.531179539	0	0	4.117751521	0.074905608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6238		6.35	10.266	0.085381869	0.096228446	2.506483039	1.549288942	2.596006825	1.212799073	1.210761876	11.86128085	4.513315776	0.543428622	0.425036157	0.011641878	0.020848797	2.720628754	6.684944293	0.595913183	0.531179539	0	0	4.117751521	0.074905608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6238																																																																																				0			10.266	0.085381869	0.096228446	2.506483039	1.549288942	2.596006825	1.212799073	1.210761876	11.86128085	4.513315776	0.543428622	0.425036157	0.011641878	0.020848797	2.720628754	6.684944293	0.595913183	0.531179539	0	0	4.117751521	0.074905608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6238
H5006_801_0	2008	1																																D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	V	Coin	Coin		v	v	v	v	v																																																							0		859.5540229	7.148872201	211.2153054	16.97473659	129.7192107	13.65286407	6.359650934	304.1248226	78.09482883	36.15623256	4.353413902	0.839533092	0.075540258	0.043159901	3995.034014	3049.204785	1.458421104	4.333312704	0	0	20.90391103	8.952262701	0			23.08003333																$250 day for 1st 5 days	$250 day for 1st 5 days	$75 day	20% Coinsurance	$150 Copay	20% Coinsurance	20% Coinsurance	$50 per visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	50% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Per Visit	$40 Per Visit	50% Coinsurance	20% Coinsurance	20% Coinsurance	$40 Per Visit	25% Coinsurance	20% Coinsurance				$40 Copay																250	250	75	0.2	150	0.2	0.2	50	0.2	0.2	0.2	0.5	0.2	0.2	20	40	0.5	0.2	0.2	40	0.25	0.2				40																17.9074	0.148934838	1.320095659	3.394947318	1.621490133	2.730572814	1.271930187	1.267186761	15.61896577	7.231246512	0.87068278	0.419766546	0.015108052	0.00863198	6.658390024	10.16401595	0.729210552	0.866662541	0	0	5.225977758	1.79045254	0	0	0	0.076933444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3386			17.9074	0.148934838	1.320095659	3.394947318	1.621490133	2.730572814	1.271930187	1.267186761	15.61896577	7.231246512	0.87068278	0.419766546	0.015108052	0.00863198	6.658390024	10.16401595	0.729210552	0.866662541	0	0	5.225977758	1.79045254	0	0	0	0.076933444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3386																																																																																				0			17.9074	0.148934838	1.320095659	3.394947318	1.621490133	2.730572814	1.271930187	1.267186761	15.61896577	7.231246512	0.87068278	0.419766546	0.015108052	0.00863198	6.658390024	10.16401595	0.729210552	0.866662541	0	0	5.225977758	1.79045254	0	0	0	0.076933444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3386
H5008_001_0	2008	4	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						2800	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T		V	P	V					V	P	V	V																																																0		1651.955296	54.76199074	9126.089652	160.9148215	501.522467	23.49873143	0.220075318	203.6574271	108.3103298	3685.21868	182.8654842	45.82336099	30.25381893	211.9272826	13983.47734	1254.755444	2014.09261	18.106676		345.8829392	196.0170134	575.777247	1423.134606		247.1860162	292.8						116.2403984	0.951193888		247.1							(1a) $200/day	(1b) $200/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $35/visit	(8a) $0/visit	(8b) $0/visit	(9a) $35/visit	(12) $0/proc	(9a) $35/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $15/visit	(7e/7h) $32.5/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $15/visit	(15) $0/proc	(Misc. PBP Cats) $15/visit	(10b) $0/trip		(17a1) $0/visit	(17b2) $0/proc	(18a) $15/visit					(4b) $35/visit (waived if admitted)	(9c) $32.5/proc 75%/25% Ind/Grp Blended Copay	(9d) $35/visit	(7f1) $0/visit							188.6267	188.6267			70.735	0.18862674	0.18862674	47.1567	33.0097			33.0097		33.0097		14.147	30.6518			14.147		14.147										33.0097	30.6518									25.9669	0.860797982	0	0	2.956267122	4.432489101	0.04151209	0.800317427	0.297940773	0	0	0.126051205	0	0.582970973	0	1.479252679	5.144637912	0	0	0.40776732	0	0.678793656	0	0	0	0	0	0	0	0	0	0.319754858	0.002429654	0	0	0	0	0	0	0	0	44.0979		2.658885091	25.9669	0.860797982	0	0	2.956267122	4.432489101	0.04151209	0.800317427	0.297940773	0	0	0.126051205	0	0.582970973	0	1.479252679	5.144637912	0	0	0.40776732	0	0.678793656	0	0	0	0	0	0	0	0	0	0.319754858	0.002429654	0	0	0	0	0	0	0	0	44.0979																																																																																				0		0	25.9669	0.860797982	0	0	2.956267122	4.432489101	0.04151209	0.800317427	0.297940773	0	0	0.126051205	0	0.582970973	0	1.479252679	5.144637912	0	0	0.40776732	0	0.678793656	0	0	0	0	0	0	0	0	0	0.319754858	0.002429654	0	0	0	0	0	0	0	0	44.0979
H5008_002_0	2008	5																					1650											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		3478.946816	671.7690836	1432.190574		1004.903668	39.68408045	18.00782028	1208.591061	412.3057399	9535.318961	627.6974787	70.5588114	3.480539926	3588.054459		3126.477376		992.3111183			30.18808842	601.3112084																				1(a) $150 per Day	1(b) $150 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $10 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per procedure; other $0 per procedure	8(b) X-rays $10 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a)/(d) $25 Copay Per Visit; 9(c) $0 Copay per Visit"	7(a) PCP $0 per visit; Urgent Care $10 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $10 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															75.2891	75.2891	21.0809		37.6445	0.100385416	0.100385416	18.0694	12.5482	5.0193	5.0193	12.5482	0.100385416	12.5482		5.0193		5.0193			0.100385416	5.0193																				21.8272	4.214738683	2.515993315	0	3.152427275	3.983702925	1.80772253	1.819873747	0.43114045	3.988362336	0.262548636	0.073782038	0.349395448	3.75196187	0	1.307719717	0	0.415056518	0	0	3.030443814	0.251511983	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1836	0	52.77521924	21.8272	4.214738683	2.515993315	0	3.152427275	3.983702925	1.80772253	1.819873747	0.43114045	3.988362336	0.262548636	0.073782038	0.349395448	3.75196187	0	1.307719717	0	0.415056518	0	0	3.030443814	0.251511983	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1836																																																																																				0	0	0	21.8272	4.214738683	2.515993315	0	3.152427275	3.983702925	1.80772253	1.819873747	0.43114045	3.988362336	0.262548636	0.073782038	0.349395448	3.75196187	0	1.307719717	0	0.415056518	0	0	3.030443814	0.251511983	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1836
H5008_003_0	2008	5																					1650											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2345.764641	332.1291756	1116.254257		420.4080725	27.99391299	19.99214483	714.2339905	378.9753974	6583.71564	556.0365162	69.70349092	4.075020344	3564.916532		3758.444533		1002.629016			25.42819467	733.9295021					0.090798534															1(a) $150 per Day	1(b) $150 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $10 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per procedure; other $0 per procedure	8(b) X-rays $10 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a)/(d) $25 Copay Per Visit; 9(c) $0 Copay per Visit"	7(a) PCP $0 per visit; Urgent Care $10 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $10 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															87.0676	87.0676	24.3789		43.5338	0.116090115	0.116090115	20.8962	14.5113	5.8045	5.8045	14.5113	0.116090115	14.5113		5.8045		5.8045			0.116090115	5.8045					5.8045															17.02	2.409807131	2.267756482	0	1.525163167	3.24981657	2.320890386	1.243732588	0.458284347	3.184601265	0.268959762	0.084290482	0.473069579	4.310953845	0	1.817992737	0	0.484980489	0	0	2.951962035	0.355008167	0	0	0	0	4.39E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4273	0	32.11204672	17.02	2.409807131	2.267756482	0	1.525163167	3.24981657	2.320890386	1.243732588	0.458284347	3.184601265	0.268959762	0.084290482	0.473069579	4.310953845	0	1.817992737	0	0.484980489	0	0	2.951962035	0.355008167	0	0	0	0	4.39E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4273																																																																																				0	0	0	17.02	2.409807131	2.267756482	0	1.525163167	3.24981657	2.320890386	1.243732588	0.458284347	3.184601265	0.268959762	0.084290482	0.473069579	4.310953845	0	1.817992737	0	0.484980489	0	0	2.951962035	0.355008167	0	0	0	0	4.39E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4273
H5008_004_0	2008	6																					2500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2044.201967	140.1931397	918.0766689		283.7374602	10.92991925	18.98193851	441.4733703	417.2775005	3498.386392	459.7502031	70.06400217	15.72691554	2939.766454		4014.37832	395.4226963	577.6046191				714.4387298					0.075646102															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															130.1616	130.1616	31.2388		55.7835	0.148756059	0.148756059	30.6809	55.7835	14.8756	48.5421	55.7835	111.7371	53.9329		18.5945	14.8756	14.8756				18.5945					18.5945															22.173	1.520646387	2.389965682	0	1.318989578	1.625891719	2.823678374	1.128734732	1.939767396	4.336718119	1.859769256	0.325701402	0.146439968	13.21251392	0	6.220448959	0.490179351	0.716018226	0	0	0	1.107053023	0	0	0	0	0.000117217	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3357	0	21.81806627	22.173	1.520646387	2.389965682	0	1.318989578	1.625891719	2.823678374	1.128734732	1.939767396	4.336718119	1.859769256	0.325701402	0.146439968	13.21251392	0	6.220448959	0.490179351	0.716018226	0	0	0	1.107053023	0	0	0	0	0.000117217	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3357																																																																																				0	0	0	22.173	1.520646387	2.389965682	0	1.318989578	1.625891719	2.823678374	1.128734732	1.939767396	4.336718119	1.859769256	0.325701402	0.146439968	13.21251392	0	6.220448959	0.490179351	0.716018226	0	0	0	1.107053023	0	0	0	0	0.000117217	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3357
H5008_005_0	2008	4	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						2800	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T		V	P	V					V	P	V	V																																																0		2518.929407	118.7312649	8857.66722	214.1836475	487.6693924	27.77768474	0.249696193	180.4738976	122.978398	4605.14852	186.5333035	28.36903694	6.954545462	230.8372731	127.6415833	1374.644104	2060.081835	24.90408885		276.7409978	254.0743202	690.8647132	1912.9		302.4	292.8						103.5607562	1.30828083		247.1							(1a) $200/day	(1b) $200/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $35/visit	(8a) $0/visit	(8b) $0/visit	(9a) $35/visit	(12) $0/proc	(9a) $35/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $15/visit	(7e/7h) $32.5/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $15/visit	(15) $0/proc	(Misc. PBP Cats) $15/visit	(10b) $0/trip		(17a1) $0/visit	(17b2) $0/proc	(18a) $15/visit					(4b) $35/visit (waived if admitted)	(9c) $32.5/proc 75%/25% Ind/Grp Blended Copay	(9d) $35/visit	(7f1) $0/visit							180.5711	180.5711			67.7142	0.180571108	0.180571108	45.1428	31.5999			31.5999		31.5999		13.5428	29.3428			13.5428		13.5428										31.5999	29.3428									37.9038	1.786619667	0	0	2.751843821	5.015847298	0.045087918	0.678924408	0.323842539	0	0	0.074704998	0	0.607870405	0	1.551381302	5.037381627	0	0	0.312321428	0	0.77968879	0	0	0	0	0	0	0	0	0	0.272709506	0.003199052	0	0	0	0	0	0	0	0	57.1452		6.148651611	37.9038	1.786619667	0	0	2.751843821	5.015847298	0.045087918	0.678924408	0.323842539	0	0	0.074704998	0	0.607870405	0	1.551381302	5.037381627	0	0	0.312321428	0	0.77968879	0	0	0	0	0	0	0	0	0	0.272709506	0.003199052	0	0	0	0	0	0	0	0	57.1452																																																																																				0		0	37.9038	1.786619667	0	0	2.751843821	5.015847298	0.045087918	0.678924408	0.323842539	0	0	0.074704998	0	0.607870405	0	1.551381302	5.037381627	0	0	0.312321428	0	0.77968879	0	0	0	0	0	0	0	0	0	0.272709506	0.003199052	0	0	0	0	0	0	0	0	57.1452
H5008_006_0	2008	5																					1800											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2029.659488	139.1958039	911.5454599		281.7189483	10.77496124	18.71282367	438.3327232	414.3089831	3473.498827	456.4795343	69.56556598	15.61503406	2918.852918		3985.819981	392.6096543	573.4955325				709.3562037					0.075107955															(1a)$150/day	(1b)$150/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															100.1468	100.1468	28.0411		50.0734	0.133529131	0.133529131	27.5404	50.0734	13.3529	43.5732	50.0734	99.5859	48.4122		16.6911	13.3529	13.3529				16.6911					16.6911															16.9387	1.161668423	2.130062784	0	1.175552701	1.438771214	2.498707088	1.005987602	1.728822456	3.865110674	1.657523917	0.290282175	0.129586496	11.77568548	0	5.543990412	0.436873551	0.638153002	0	0	0	0.986663725	0	0	0	0	0.00010447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4022	0	26.58364847	16.9387	1.161668423	2.130062784	0	1.175552701	1.438771214	2.498707088	1.005987602	1.728822456	3.865110674	1.657523917	0.290282175	0.129586496	11.77568548	0	5.543990412	0.436873551	0.638153002	0	0	0	0.986663725	0	0	0	0	0.00010447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4022																																																																																				0	0	0	16.9387	1.161668423	2.130062784	0	1.175552701	1.438771214	2.498707088	1.005987602	1.728822456	3.865110674	1.657523917	0.290282175	0.129586496	11.77568548	0	5.543990412	0.436873551	0.638153002	0	0	0	0.986663725	0	0	0	0	0.00010447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4022
H5009_001_0	2008	2																					1000											D	D			T	Coin		V							V	V	V	V		V					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0															0	2000	339.1122603	13.11805173			1.363619172	64.48410722		209.5749032							7192.194415	18.99357872	489.5911002	1228.830326		942.1801214					134.8403522		93.27155134															$100/day (days 1-3)	$100/day (days 1-3)	No copay	No copay	50	0.1		"$50 ER, $5 Urgent"	No copay	No copay	No copay	No copay	No copay	No copay	5	5	5	5	No copay	$5 chiro	No copay	No copay	No copay	No copay	5	No copay	5															100	100			50	0.1	0	50	0	0	0	0	0	0	5	5	5	5	0	5	0	0	0	0	5	0	5															2.8259	0.109317098	0	0	0.005681747	6.448410722	0	0.873228763	0	0	0	0	0	0	2.996747673	0.007913991	0.203996292	0.512012636	0	0.392575051	0	0	0	0	0.05618348	0	0.038863146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4709	0	0	2.8259	0.109317098	0	0	0.005681747	6.448410722	0	0.873228763	0	0	0	0	0	0	2.996747673	0.007913991	0.203996292	0.512012636	0	0.392575051	0	0	0	0	0.05618348	0	0.038863146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4709	N/A	D	D	D	Coin	T	Coin	Coin	V	V	No cost sharing	No cost sharing	No cost sharing	No cost sharing	V	V	V	V	V	No cost sharing	V	Coin	No cost sharing	No cost sharing	No cost sharing	V	No cost sharing	V															1.2429	0.1596	0.6269	0.1165	0.3914	0.4544	0.0416	0.2634	2.4245					0.1656	2.2127	0.3795	0.6464	0.2461		0.5697	0.0251				0.0412		0.0213															10.029	250	0.479975736	4.0689	0.268931307	0.626851051	0.116529913	0.39704827	6.902848955	0.041595508	1.136632466	2.424542204	0	0	0	0	0.165634289	5.209412551	0.387453465	0.850357875	0.758126435	0	0.962307946	0.025147189	0	0	0	0.097406549	0	0.060165483	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.4999
H5009_002_0	2008	3																					1000											D	D			T	Coin		V							V	V	V	V		V					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0															0	2000	339.1122603	13.11805173			1.363619172	64.48410722		209.5749032							7192.194415	18.99357872	489.5911002	1228.830326		942.1801214					134.8403522		93.27155134															$100/day (days 1-3)	$100/day (days 1-3)	No copay	No copay	50	0.1		"$50 ER, $5 Urgent"	No copay	No copay	No copay	No copay	No copay	No copay	5	5	5	5	No copay	$5 chiro	No copay	No copay	No copay	No copay	5	No copay	5															100	100			50	0.1	0	50	0	0	0	0	0	0	5	5	5	5	0	5	0	0	0	0	5	0	5															2.8259	0.109317098	0	0	0.005681747	6.448410722	0	0.873228763	0	0	0	0	0	0	2.996747673	0.007913991	0.203996292	0.512012636	0	0.392575051	0	0	0	0	0.05618348	0	0.038863146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4709	0	0	2.8259	0.109317098	0	0	0.005681747	6.448410722	0	0.873228763	0	0	0	0	0	0	2.996747673	0.007913991	0.203996292	0.512012636	0	0.392575051	0	0	0	0	0.05618348	0	0.038863146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4709	N/A	D	D	D	Coin	T	Coin	Coin	V	V	No cost sharing	No cost sharing	No cost sharing	No cost sharing	V	V	V	V	V	No cost sharing	V	Coin	No cost sharing	No cost sharing	No cost sharing	V	No cost sharing	V															1.2429	0.1596	0.6269	0.1165	0.3914	0.4544	0.0416	0.2634	2.4245					0.1656	2.2127	0.3795	0.6464	0.2461		0.5697	0.0251				0.0412		0.0213															10.029	250	0.479975736	4.0689	0.268931307	0.626851051	0.116529913	0.39704827	6.902848955	0.041595508	1.136632466	2.424542204	0	0	0	0	0.165634289	5.209412551	0.387453465	0.850357875	0.758126435	0	0.962307946	0.025147189	0	0	0	0.097406549	0	0.060165483	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.4999
H5009_004_0	2008	3																					1000											D	D			T	Coin		V							V	V	V	V		V					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0															0	2000	339.1122603	13.11805173			1.363619172	64.48410722		209.5749032							7192.194415	18.99357872	489.5911002	1228.830326		942.1801214					134.8403522		93.27155134															$100/day (days 1-3)	$100/day (days 1-3)	No copay	No copay	50	0.1		"$50 ER, $5 Urgent"	No copay	No copay	No copay	No copay	No copay	No copay	5	5	5	5	No copay	$5 chiro	No copay	No copay	No copay	No copay	5	No copay	5															100	100			50	0.1	0	50	0	0	0	0	0	0	5	5	5	5	0	5	0	0	0	0	5	0	5															2.8259	0.109317098	0	0	0.005681747	6.448410722	0	0.873228763	0	0	0	0	0	0	2.996747673	0.007913991	0.203996292	0.512012636	0	0.392575051	0	0	0	0	0.05618348	0	0.038863146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4709	0	0	2.8259	0.109317098	0	0	0.005681747	6.448410722	0	0.873228763	0	0	0	0	0	0	2.996747673	0.007913991	0.203996292	0.512012636	0	0.392575051	0	0	0	0	0.05618348	0	0.038863146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4709	N/A	D	D	D	Coin	T	Coin	Coin	V	V	No cost sharing	No cost sharing	No cost sharing	No cost sharing	V	V	V	V	V	No cost sharing	V	Coin	No cost sharing	No cost sharing	No cost sharing	V	No cost sharing	V															1.2429	0.1596	0.6269	0.1165	0.3914	0.4544	0.0416	0.2634	2.4245					0.1656	2.2127	0.3795	0.6464	0.2461		0.5697	0.0251				0.0412		0.0213															10.029	250	0.479975736	4.0689	0.268931307	0.626851051	0.116529913	0.39704827	6.902848955	0.041595508	1.136632466	2.424542204	0	0	0	0	0.165634289	5.209412551	0.387453465	0.850357875	0.758126435	0	0.962307946	0.025147189	0	0	0	0.097406549	0	0.060165483	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.4999
H5010_001_0	2008	2																					1000											D	D			T	Coin		V							V	V	V	V		V					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0															0	2000	503.8541011	12.71811027			1.299146979	13.98764945		380.8072438							8715.098457	328.8143015	440.0341784	1730.293825		477.5475218					142.8614187		107.2143698															$100/day (days 1-3)	$100/day (days 1-3)	No copay	No copay	50	0.1	No copay	"$50 ER, $5 Urgent"	No copay	No copay	No copay	No copay	No copay	No copay	5	5	5	5	No copay	$5 chiro	No copay	No copay	No copay	No copay	5	No copay	5															100	100			50	0.1	0	50	0	0	0	0	0	0	5	5	5	5	0	5	0	0	0	0	5	0	5															4.1988	0.105984252	0	0	0.005413112	1.398764945	0	1.586696849	0	0	0	0	0	0	3.631291024	0.137005959	0.183347574	0.72095576	0	0.198978134	0	0	0	0	0.059525591	0	0.044672654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.2714	0	0	4.1988	0.105984252	0	0	0.005413112	1.398764945	0	1.586696849	0	0	0	0	0	0	3.631291024	0.137005959	0.183347574	0.72095576	0	0.198978134	0	0	0	0	0.059525591	0	0.044672654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.2714	N/A	D	D	D	Coin	T	Coin	Coin	V	V	No cost sharing	No cost sharing	No cost sharing	No cost sharing	V	V	V	V	V	No cost sharing	V	Coin	No cost sharing	No cost sharing	No cost sharing	V	No cost sharing	V															0.0078	1.3827	0.2002	0.3825	1.0884	0.0749	0.075	1.0867	0.1577					1.4006	0.3136	0.6204	0.3773	0.1191		0.0732	0				0.3886		0															7.7488	250	0.369490498	4.2066	1.488672177	0.200194187	0.382543282	1.093845236	1.473693331	0.074993137	2.673433094	0.157717752	0	0	0	0	1.400576626	3.944931234	0.757367397	0.560612974	0.84010321	0	0.272221419	0	0	0	0	0.448115226	0	0.044672654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.0202
H5010_002_0	2008	3																					1000											D	D			T	Coin		V							V	V	V	V		V					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0															0	2000	503.8541011	12.71811027			1.299146979	13.98764945		380.8072438							8715.098457	328.8143015	440.0341784	1730.293825		477.5475218					142.8614187		107.2143698															$100/day (days 1-3)	$100/day (days 1-3)	No copay	No copay	50	0.1	No copay	"$50 ER, $5 Urgent"	No copay	No copay	No copay	No copay	No copay	No copay	5	5	5	5	No copay	$5 chiro	No copay	No copay	No copay	No copay	5	No copay	5															100	100			50	0.1	0	50	0	0	0	0	0	0	5	5	5	5	0	5	0	0	0	0	5	0	5															4.1988	0.105984252	0	0	0.005413112	1.398764945	0	1.586696849	0	0	0	0	0	0	3.631291024	0.137005959	0.183347574	0.72095576	0	0.198978134	0	0	0	0	0.059525591	0	0.044672654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.2714	0	0	4.1988	0.105984252	0	0	0.005413112	1.398764945	0	1.586696849	0	0	0	0	0	0	3.631291024	0.137005959	0.183347574	0.72095576	0	0.198978134	0	0	0	0	0.059525591	0	0.044672654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.2714	N/A	D	D	D	Coin	T	Coin	Coin	V	V	No cost sharing	No cost sharing	No cost sharing	No cost sharing	V	V	V	V	V	No cost sharing	V	Coin	No cost sharing	No cost sharing	No cost sharing	V	No cost sharing	V															0.0078	1.3827	0.2002	0.3825	1.0884	0.0749	0.075	1.0867	0.1577					1.4006	0.3136	0.6204	0.3773	0.1191		0.0732	0				0.3886		0															7.7488	250	0.369490498	4.2066	1.488672177	0.200194187	0.382543282	1.093845236	1.473693331	0.074993137	2.673433094	0.157717752	0	0	0	0	1.400576626	3.944931234	0.757367397	0.560612974	0.84010321	0	0.272221419	0	0	0	0	0.448115226	0	0.044672654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.0202
H5010_004_0	2008	3																					1000											D	D			T	Coin		V							V	V	V	V		V					V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0															0	2000	503.8541011	12.71811027			1.299146979	13.98764945		380.8072438							8715.098457	328.8143015	440.0341784	1730.293825		477.5475218					142.8614187		107.2143698															$100/day (days 1-3)	$100/day (days 1-3)	No copay	No copay	50	0.1	No copay	"$50 ER, $5 Urgent"	No copay	No copay	No copay	No copay	No copay	No copay	5	5	5	5	No copay	$5 chiro	No copay	No copay	No copay	No copay	5	No copay	5															100	100			50	0.1	0	50	0	0	0	0	0	0	5	5	5	5	0	5	0	0	0	0	5	0	5															4.1988	0.105984252	0	0	0.005413112	1.398764945	0	1.586696849	0	0	0	0	0	0	3.631291024	0.137005959	0.183347574	0.72095576	0	0.198978134	0	0	0	0	0.059525591	0	0.044672654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.2714	0	0	4.1988	0.105984252	0	0	0.005413112	1.398764945	0	1.586696849	0	0	0	0	0	0	3.631291024	0.137005959	0.183347574	0.72095576	0	0.198978134	0	0	0	0	0.059525591	0	0.044672654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.2714	N/A	D	D	D	Coin	T	Coin	Coin	V	V	No cost sharing	No cost sharing	No cost sharing	No cost sharing	V	V	V	V	V	No cost sharing	V	Coin	No cost sharing	No cost sharing	No cost sharing	V	No cost sharing	V															0.0078	1.3827	0.2002	0.3825	1.0884	0.0749	0.075	1.0867	0.1577					1.4006	0.3136	0.6204	0.3773	0.1191		0.0732	0				0.3886		0															7.7488	250	0.369490498	4.2066	1.488672177	0.200194187	0.382543282	1.093845236	1.473693331	0.074993137	2.673433094	0.157717752	0	0	0	0	1.400576626	3.944931234	0.757367397	0.560612974	0.84010321	0	0.272221419	0	0	0	0	0.448115226	0	0.044672654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.0202
H5042_001_0	2008	3																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	116.885	3.125799898	0	0	114.585	7.22	5.03	219.135	221.69	1619.135	900.1	0	0.97	287.845	5093.42	2928.055	178.4	249.12	984.29	3315.4	0	333.62	0	0	177.19	145.63	0	0	0	0	0											1B Inpatient Hospital-Acute:  $250 per admit (Limit 2 Copays)	1B Inpatient Psychiatric Hosp: $250 per admit (Limit 2 Copays)	2 SNF: $0	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%	"11B Pros./Med. Supp.: 20%, 11C Diabetes Mon Supplies: 20%"	"4A Emergency Care: $50, 4B Urgently Needed Services: $12/$35"	9B ASC Services: $125	8A Outpatient Diag Procs/Tests/Lab Services: $0/$20	8B Outpatient Diag/Therapeutic Rad Services: $0/$20	9A Outpatient Hospital: $0	12 Renal Dialysis: $20	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $20"	"7A PCP: $12, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $20, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $20, 7D Physician Specialist: $20, 7F Podiatry: $20"	"7E Mental Health: $10/$25, 7H Psychiatric: $10/$25, 9C OP Substance Abuse: $10/$25"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	8B Outpatient Diag/Therapeutic Rad Services: $0/$20	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $20	"17B Eye Wear: Medicare Covered: 20%, Routine: 20%"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	0	0	75	0.199999628	0.200014896	49.05659513	125	2.8667	1.4667	0	20	20	12	20	17.68	20	1.4667	20	0	20	0	0	20	20	0	0	0	0	0											2.4351	0.065120831	0	0	0.71615625	1.443997317	1.006074927	0.895834748	2.309270833	0.386797859	0.110014723	0	0.001616667	0.479741667	5.09342	4.880091667	0.262842667	0.4152	0.120304845	5.525666667	0	0.556033333	0	0	0.295316667	0.242716667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.2413	0	0	2.4351	0.065120831	0	0	0.71615625	1.443997317	1.006074927	0.895834748	2.309270833	0.386797859	0.110014723	0	0.001616667	0.479741667	5.09342	4.880091667	0.262842667	0.4152	0.120304845	5.525666667	0	0.556033333	0	0	0.295316667	0.242716667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.2413	0	1B Inpatient Hospital-Acute:  $750 per admit	1B Inpatient Psychiatric Hosp: $750 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%	"11B Pros./Med. Supp.: 20%, 11C Diabetes Mon Supplies: 20%"	"4A Emergency Care: $50, 4B Urgently Needed Services: $12/$35"	9B ASC Services: $125	8A Outpatient Diag Procs/Tests/Lab Services: $0/$20	8B Outpatient Diag/Therapeutic Rad Services: $0/$20	9A Outpatient Hospital: $0	12 Renal Dialysis: $20	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $20"	"7A PCP: $12, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $20, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $20, 7D Physician Specialist: $20, 7F Podiatry: $20"	"7E Mental Health: $10/$25, 7H Psychiatric: $10/$25, 9C OP Substance Abuse: $10/$25"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	8B Outpatient Diag/Therapeutic Rad Services: $0/$20	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $20	"17B Eye Wear: Medicare Covered: 20%, Routine: 20%"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											8.5316	0.2084	0	0	0.7448	1.502	1.0485	0.8975	2.4012	0.4023	0.1144	0	0.0017	0.4989	0	5.4128	0.3004	0.4798	0.1324	6.5824	0	0.6425	0	0	0.3412	0.2524	0	0	0	0	0											30.4953	0	0	10.9667	0.273507491	0	0	1.46096875	2.946030837	2.054548202	1.793326828	4.71046875	0.789068731	0.224430156	0	0.0033	0.978675	5.09342	10.292925	0.563255333	0.894983333	0.252703854	12.10809167	0	1.198558333	0	0	0.636566667	0.495141667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7366
H5042_002_0	2008	2																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	124.14	3.264724338	0	0	113.715	7.18	5.005	222.535	224.805	1642.22	912.93	0	0.985	291.95	5341.15	3054.09	174.2	264.415	1024.225	3435.115	0	355.065	0	0	188.58	145.63	0	0	0	0	0											1B Inpatient Hospital-Acute:  $350 per admit (Limit 2 Copays)	1B Inpatient Psychiatric Hosp: $350 per admit (Limit 2 Copays)	2 SNF: $0	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%	"11B Pros./Med. Supp.: 20%, 11C Diabetes Mon Supplies: 20%"	"4A Emergency Care: $50, 4B Urgently Needed Services: $5/$12/$35"	9B ASC Services: $100	8A Outpatient Diag Procs/Tests/Lab Services: $0/$10	8B Outpatient Diag/Therapeutic Rad Services: $0/$10	9A Outpatient Hospital: $0	12 Renal Dialysis: $10	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $10"	"7A PCP: $5, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $10, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $10, 7D Physician Specialist: $10, 7F Podiatry: $10"	"7E Mental Health: $20/$25, 7H Psychiatric: $20/$25, 9C OP Substance Abuse: $20/$25,"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	8B Outpatient Diag/Therapeutic Rad Services: $0/$20	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: 20%, Routine: 20%"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											350	350	0	0	75	0.19999999	0.199895805	48.88811536	100	1.4333	0.7333	0	10	10	5	10	22.73	10	0.7333	10	0	10	0	0	10	20	0	0	0	0	0											3.6208	0.095221127	0	0	0.71071875	1.435999929	1.000478506	0.906609729	1.873375	0.196149494	0.055787631	0	0.000820833	0.243291667	2.225479167	2.545075	0.329963833	0.220345833	0.062588683	2.862595833	0	0.2958875	0	0	0.15715	0.242716667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.081	0	0	3.6208	0.095221127	0	0	0.71071875	1.435999929	1.000478506	0.906609729	1.873375	0.196149494	0.055787631	0	0.000820833	0.243291667	2.225479167	2.545075	0.329963833	0.220345833	0.062588683	2.862595833	0	0.2958875	0	0	0.15715	0.242716667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.081	0	1B Inpatient Hospital-Acute:  $800 per admit	1B Inpatient Psychiatric Hosp: $800 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%	"11B Pros./Med. Supp.: 20%, 11C Diabetes Mon Supplies: 20%"	"4A Emergency Care: $50, 4B Urgently Needed Services: $5/$12/$35"	9B ASC Services: $100	8A Outpatient Diag Procs/Tests/Lab Services: $0/$10	8B Outpatient Diag/Therapeutic Rad Services: $0/$10	9A Outpatient Hospital: $0	12 Renal Dialysis: $10	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $10"	"7A PCP: $5, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $10, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $10, 7D Physician Specialist: $10, 7F Podiatry: $10"	"7E Mental Health: $20/$25, 7H Psychiatric: $20/$25, 9C OP Substance Abuse: $20/$25,"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	8B Outpatient Diag/Therapeutic Rad Services: $0/$20	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: 20%, Routine: 20%"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											9.0533	0.2223	0	0	0.7391	1.494	1.0407	0.9074	1.9484	0.204	0.058	0	0.0009	0.253	0	2.698	0.3857	0.2387	0.0662	3.275	0	0.3205	0	0	0.1702	0.2524	0	0	0	0	0											23.3277	0	0	12.6741	0.31750023	0	0	1.44984375	2.929965491	2.041204183	1.813965839	3.82175	0.400144514	0.113806632	0	0.001675	0.4963125	2.225479167	5.243029167	0.715616167	0.45905	0.12873937	6.1376125	0	0.616433333	0	0	0.327395833	0.495141667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.4087
H5042_003_0	2008	3																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	116.885	3.125799898	0	0	114.585	7.22	5.03	219.135	221.69	1619.135	900.1	0	0.97	287.845	5093.42	2928.055	178.4	249.12	984.29	3315.4	0	333.62	0	0	177.19	145.63	0	0	0	0	0											1B Inpatient Hospital-Acute:  $250 per admit (Limit 2 Copays)	1B Inpatient Psychiatric Hosp: $250 per admit (Limit 2 Copays)	2 SNF: $0	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%	"11B Pros./Med. Supp.: 20%, 11C Diabetes Mon Supplies: 20%"	"4A Emergency Care: $50, 4B Urgently Needed Services: $12/$35"	9B ASC Services: $125	8A Outpatient Diag Procs/Tests/Lab Services: $0/$20	8B Outpatient Diag/Therapeutic Rad Services: $0/$20	9A Outpatient Hospital: $0	12 Renal Dialysis: $20	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $20"	"7A PCP: $12, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $20, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $20, 7D Physician Specialist: $20, 7F Podiatry: $20"	"7E Mental Health: $10/$25, 7H Psychiatric: $10/$25, 9C OP Substance Abuse: $10/$25"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	8B Outpatient Diag/Therapeutic Rad Services: $0/$20	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $20	"17B Eye Wear: Medicare Covered: 20%, Routine: 20%"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	0	0	75	0.199999628	0.200014896	49.05659513	125	2.8667	1.4667	0	20	20	12	20	17.68	20	1.4667	20	0	20	0	0	20	20	0	0	0	0	0											2.4351	0.065120831	0	0	0.71615625	1.443997317	1.006074927	0.895834748	2.309270833	0.386797859	0.110014723	0	0.001616667	0.479741667	5.09342	4.880091667	0.262842667	0.4152	0.120304845	5.525666667	0	0.556033333	0	0	0.295316667	0.242716667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.2413	0	0	2.4351	0.065120831	0	0	0.71615625	1.443997317	1.006074927	0.895834748	2.309270833	0.386797859	0.110014723	0	0.001616667	0.479741667	5.09342	4.880091667	0.262842667	0.4152	0.120304845	5.525666667	0	0.556033333	0	0	0.295316667	0.242716667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.2413	0	1B Inpatient Hospital-Acute:  $800 per admit	1B Inpatient Psychiatric Hosp: $750 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%	"11B Pros./Med. Supp.: 20%, 11C Diabetes Mon Supplies: 20%"	"4A Emergency Care: $50, 4B Urgently Needed Services: $12/$35"	9B ASC Services: $125	8A Outpatient Diag Procs/Tests/Lab Services: $0/$20	8B Outpatient Diag/Therapeutic Rad Services: $0/$20	9A Outpatient Hospital: $0	12 Renal Dialysis: $20	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $20"	"7A PCP: $12, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $20, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $20, 7D Physician Specialist: $20, 7F Podiatry: $20"	"7E Mental Health: $10/$25, 7H Psychiatric: $10/$25, 9C OP Substance Abuse: $10/$25"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	8B Outpatient Diag/Therapeutic Rad Services: $0/$20	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $20	"17B Eye Wear: Medicare Covered: 20%, Routine: 20%"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											8.5316	0.2084	0	0	0.7448	1.502	1.0485	0.8975	2.4012	0.4023	0.1144	0	0.0017	0.4989	0	5.4128	0.3004	0.4798	0.1324	6.5824	0	0.6425	0	0	0.3412	0.2524	0	0	0	0	0											30.4953	0	0	10.9667	0.273507491	0	0	1.46096875	2.946030837	2.054548202	1.793326828	4.71046875	0.789068731	0.224430156	0	0.0033	0.978675	5.09342	10.292925	0.563255333	0.894983333	0.252703854	12.10809167	0	1.198558333	0	0	0.636566667	0.495141667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7366
H5042_801_0	2008	3																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	247.05	4.338	0	0	217.773	14.058	9.792	339.876	340.443	2486.817	1382.454	0	1.494	442.098	5680.12	6001.884	196.479	533.349	1795.401	7158.141	0	681.615	0	0	362.016	267.669	0	0	0	0	0											1B Inpatient Hospital-Acute:  $250 per admit (Limit 2 Copays)	1B Inpatient Psychiatric Hosp: $250 per admit (Limit 2 Copays)	2 SNF: $0	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%	"11B Pros./Med. Supp.: 20%, 11C Diabetes Mon Supplies: 20%"	"4A Emergency Care: $50, 4B Urgently Needed Services: $12/$35"	9B ASC Services: $125	8A Outpatient Diag Procs/Tests/Lab Services: $0/$20	8B Outpatient Diag/Therapeutic Rad Services: $0/$20	9A Outpatient Hospital: $0	12 Renal Dialysis: $20	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $20"	"7A PCP: $12, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $20, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $20, 7D Physician Specialist: $20, 7F Podiatry: $20"	"7E Mental Health: $10/$25, 7H Psychiatric: $10/$25, 9C OP Substance Abuse: $10/$25"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	8B Outpatient Diag/Therapeutic Rad Services: $0/$20	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $20	"17B Eye Wear: Medicare Covered: 20%, Routine: 20%"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											500	500	0	0	100	0.249999758	0.249966415	49.34501112	100	3.5833	1.8333	0	25	25	25	25	38.2804	25	1.8333	25	0	25	0	0	25	20	0	0	0	0	0											10.2937	0.18075	0	0	1.814775	3.514496604	2.447671139	1.39759875	2.837025	0.74258428	0.21120441	0	0.0031125	0.9210375	11.83358333	12.503925	0.626774559	1.11114375	0.274292388	14.91279375	0	1.42003125	0	0	0.7542	0.446115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2469	0	0	10.2937	0.18075	0	0	1.814775	3.514496604	2.447671139	1.39759875	2.837025	0.74258428	0.21120441	0	0.0031125	0.9210375	11.83358333	12.503925	0.626774559	1.11114375	0.274292388	14.91279375	0	1.42003125	0	0	0.7542	0.446115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2469	0	1B Inpatient Hospital-Acute:  $750 per admit	1B Inpatient Psychiatric Hosp: $750 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%	"11B Pros./Med. Supp.: 20%, 11C Diabetes Mon Supplies: 20%"	"4A Emergency Care: $50, 4B Urgently Needed Services: $12/$35"	9B ASC Services: $125	8A Outpatient Diag Procs/Tests/Lab Services: $0/$20	8B Outpatient Diag/Therapeutic Rad Services: $0/$20	9A Outpatient Hospital: $0	12 Renal Dialysis: $20	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $20"	"7A PCP: $12, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $20, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $20, 7D Physician Specialist: $20, 7F Podiatry: $20"	"7E Mental Health: $10/$25, 7H Psychiatric: $10/$25, 9C OP Substance Abuse: $10/$25"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	8B Outpatient Diag/Therapeutic Rad Services: $0/$20	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $20	"17B Eye Wear: Medicare Covered: 20%, Routine: 20%"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											2.3289	0.0408	1.3098	0.2614	0.4033	0.4686	0.326	0.1583	0.9457	0.2742	0.787	0.0306	0.0007	0.2193	0.0448	3.0685	0.0534	0.2806	0.536	3.8473	0.2982	0.382	0	0	0.1905	0.0496	0	0	0	0	0											16.3054	0	0	12.6227	0.221583333	1.309791795	0.261366667	2.218058333	3.983081177	2.773621627	1.55588625	3.7827	1.016755854	0.99822184	0.03059998	0.003804167	1.140368163	11.87842306	15.57242917	0.680173779	1.391735417	0.81032526	18.76009792	0.298189305	1.802022841	0	0	0.944654167	0.495683333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.5522
H5042_802_0	2008	3																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	247.05	4.338	0	0	217.773	14.058	9.792	339.876	340.443	2486.817	1382.454	0	1.494	442.098	5680.12	6001.884	196.479	533.349	1795.401	7158.141	0	681.615	0	0	362.016	267.669	0	0	0	0	0											1B Inpatient Hospital-Acute:  $250 per admit (Limit 2 Copays)	1B Inpatient Psychiatric Hosp: $250 per admit (Limit 2 Copays)	2 SNF: $0	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%	"11B Pros./Med. Supp.: 20%, 11C Diabetes Mon Supplies: 20%"	"4A Emergency Care: $50, 4B Urgently Needed Services: $12/$35"	9B ASC Services: $125	8A Outpatient Diag Procs/Tests/Lab Services: $0/$20	8B Outpatient Diag/Therapeutic Rad Services: $0/$20	9A Outpatient Hospital: $0	12 Renal Dialysis: $20	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $20"	"7A PCP: $12, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $20, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $20, 7D Physician Specialist: $20, 7F Podiatry: $20"	"7E Mental Health: $10/$25, 7H Psychiatric: $10/$25, 9C OP Substance Abuse: $10/$25"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	8B Outpatient Diag/Therapeutic Rad Services: $0/$20	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $20	"17B Eye Wear: Medicare Covered: 20%, Routine: 20%"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											500	500	0	0	100	0.249999758	0.249966415	49.34501112	100	3.5833	1.8333	0	25	25	25	25	38.2804	25	1.8333	25	0	25	0	0	25	20	0	0	0	0	0											10.2937	0.18075	0	0	1.814775	3.514496604	2.447671139	1.39759875	2.837025	0.74258428	0.21120441	0	0.0031125	0.9210375	11.83358333	12.503925	0.626774559	1.11114375	0.274292388	14.91279375	0	1.42003125	0	0	0.7542	0.446115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2469	0	0	10.2937	0.18075	0	0	1.814775	3.514496604	2.447671139	1.39759875	2.837025	0.74258428	0.21120441	0	0.0031125	0.9210375	11.83358333	12.503925	0.626774559	1.11114375	0.274292388	14.91279375	0	1.42003125	0	0	0.7542	0.446115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2469	0	1B Inpatient Hospital-Acute:  $800 per admit	1B Inpatient Psychiatric Hosp: $750 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%	"11B Pros./Med. Supp.: 20%, 11C Diabetes Mon Supplies: 20%"	"4A Emergency Care: $50, 4B Urgently Needed Services: $12/$35"	9B ASC Services: $125	8A Outpatient Diag Procs/Tests/Lab Services: $0/$20	8B Outpatient Diag/Therapeutic Rad Services: $0/$20	9A Outpatient Hospital: $0	12 Renal Dialysis: $20	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $20"	"7A PCP: $12, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $20, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $20, 7D Physician Specialist: $20, 7F Podiatry: $20"	"7E Mental Health: $10/$25, 7H Psychiatric: $10/$25, 9C OP Substance Abuse: $10/$25"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	8B Outpatient Diag/Therapeutic Rad Services: $0/$20	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $20	"17B Eye Wear: Medicare Covered: 20%, Routine: 20%"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											2.3289	0.0408	1.3098	0.2614	0.4033	0.4686	0.326	0.1583	0.9457	0.2742	0.787	0.0306	0.0007	0.2193	0.0448	3.0685	0.0534	0.2806	0.536	3.8473	0.2982	0.382	0	0	0.1905	0.0496	0	0	0	0	0											16.3054	0	0	12.6227	0.221583333	1.309791795	0.261366667	2.218058333	3.983081177	2.773621627	1.55588625	3.7827	1.016755854	0.99822184	0.03059998	0.003804167	1.140368163	11.87842306	15.57242917	0.680173779	1.391735417	0.81032526	18.76009792	0.298189305	1.802022841	0	0	0.944654167	0.495683333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.5522
H5042_803_0	2008	3																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	244.827	4.293	0	0	222.876	14.247	9.918	350.487	351.252	2565.729	1426.32	0	1.539	456.12	5787.12	6107.427	199.08	540.405	1817.226	7253.388	0	695.187	0	0	369.225	271.071	0	0	0	0	0											1B Inpatient Hospital-Acute:  $500 per admit (Limit 2 Copays)	1B Inpatient Psychiatric Hosp: $500 per admit (Limit 2 Copays)	2 SNF: $0	6 Home Health: $0	10A Ambulance: $100	11A DME: 25%	"11B Pros./Med. Supp.: 25%, 11C Diabetes Mon Supplies: 25%"	"4A Emergency Care: $50, 4B Urgently Needed Services: $35"	9B ASC Services: $100	8A Outpatient Diag Procs/Tests/Lab Services: $0/$25	8B Outpatient Diag/Therapeutic Rad Services: $0/$25	9A Outpatient Hospital: $0	12 Renal Dialysis: $25	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $25"	"7A PCP: $25, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $25, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $25, 7D Physician Specialist: $25, 7F Podiatry: $25"	"7E Mental Health: $25/$50, 7H Psychiatric: $25/$50, 9C OP Substance Abuse: $25/$50"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	8B Outpatient Diag/Therapeutic Rad Services: $0/$25	"7G Other Health Care: $25, 18A Medicare Covered Hearing Exams: $25"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $25"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $25	"17B Eye Wear: Medicare Covered: 20%, Routine: 20%"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											500	500	0	0	100	0.25000037	0.250071423	49.35213004	100	3.5833	1.8333	0	25	25	25	25	38.2804	25	1.8333	25	0	25	0	0	25	20	0	0	0	0	0											10.2011	0.178875	0	0	1.8573	3.561755274	2.48020837	1.44144	2.9271	0.76614806	0.217906038	0	0.00320625	0.95025	12.0565	12.72380625	0.635071836	1.12584375	0.277626702	15.111225	0	1.44830625	0	0	0.76921875	0.451785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1847	0	0	10.2011	0.178875	0	0	1.8573	3.561755274	2.48020837	1.44144	2.9271	0.76614806	0.217906038	0	0.00320625	0.95025	12.0565	12.72380625	0.635071836	1.12584375	0.277626702	15.111225	0	1.44830625	0	0	0.76921875	0.451785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1847	0	1B Inpatient Hospital-Acute:  $1000 per admit	1B Inpatient Psychiatric Hosp: $1000 per admit	2 SNF: 30%	6 Home Health: $20	10A Ambulance: $200	11A DME: 30%	"11B Pros./Med. Supp.: 30%, 11C Diabetes Mon Supplies: 30%"	"4A Emergency Care: $50, 4B Urgently Needed Services: $35"	9B ASC Services: $300	8A Outpatient Diag Procs/Tests/Lab Services: 30%	8B Outpatient Diag/Therapeutic Rad Services: 30%	9A Outpatient Hospital: 30%	12 Renal Dialysis: $50	"3 CORF: 30%, 5 Partial Hosp: 30%, 9D Cardiac Rehab: $50"	"7A PCP: $50, 14B Immunizations: $50, 14C Routine Physical Exams: $25, 14D Pap Smears: $50, 14D Pelvic Exams: $50, 14E Prostate Screening: $50, 14F Colorectal Screening: $50, 14G Bone Mass Measurement: $50, 14H Mammography: $50, 14I Diabetes Monitoring: 30%"	"7B Chiropractic: $50, 7D Physician Specialist: $50, 7F Podiatry: $50"	"7E Mental Health: 30%, 7H Psychiatric: 30%, 9C OP Substance Abuse: 30%"	"7C Occupational Therapy: $50, 7I Physical and Speech Therapy: $50"	8B Outpatient Diag/Therapeutic Rad Services: 30%	"7G Other Health Care: $50, 18A Medicare Covered Hearing Exams: $50"	15 Part B Drugs: 30%	"13A Blood: 30%, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $50"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $50	"17B Eye Wear: Medicare Covered: 30%, Routine: 30%"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											2.3078	0.0404	1.2957	0.2647	0.4127	0.4749	0.3303	0.1632	0.9757	0.2665	0.765	0.03	0.0007	0.2254	0.0455	3.1226	0.0537	0.2843	0.5316	3.8985	0.2898	0.3885	0	0	0.1942	0.0502	0	0	0	0	0											16.4122	0	0	12.509	0.219291667	1.295724749	0.264721667	2.270033333	4.036666194	2.810487661	1.604660833	3.9028	1.032627525	0.982937404	0.030000016	0.00391875	1.175651199	12.10200075	15.84645625	0.6887749	1.410147917	0.80925982	19.00972083	0.289798025	1.836839542	0	0	0.963464583	0.501983333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.5969
H5050_001_0	2008	5																					2500											D	D			T	Coin	Coin	V	V						V	V	V	V	V	V		V	T																																																												0		600.4403894	9.143762275	0	0	233.924639	3.59862242	1.79931121	167.4210194	147.6746482	0	0	0	0	0	3661.327087	2305.280017	149.1651776	176.286119	0	488.1769449	0	618.3999306	10.50789044	0	0	0	0	0	0	0	0											$200 per day for 1st 5 days	$200 per day for 1st 5 days	$0 Copay	$0 Copay	$150 per trip	20% coinsurance	20% coinsurance	$50 per visit	$200 per visit	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$20 Copay	$20 Copay	$20 Copay	$20 Copay	$0 Copay	$20 Copay	$0 Copay	$20 Copay	$150 per trip	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											200	200	0	0	150	0.2	0.2	50	200	0	0	0	0	0	20	20	20	20	0	20	0	20	150	0	0	0	0	0	0	0	0											10.0073	0.152396038	0	0	2.924057988	0.719724484	0.359862242	0.697587581	2.461244136	0	0	0	0	0	6.102211811	3.842133362	0.248608629	0.293810198	0	0.813628241	0	1.030666551	0.13134863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7846	0	0	10.0073	0.152396038	0	0	2.924057988	0.719724484	0.359862242	0.697587581	2.461244136	0	0	0	0	0	6.102211811	3.842133362	0.248608629	0.293810198	0	0.813628241	0	1.030666551	0.13134863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7846																																																																																				0			10.0073	0.152396038	0	0	2.924057988	0.719724484	0.359862242	0.697587581	2.461244136	0	0	0	0	0	6.102211811	3.842133362	0.248608629	0.293810198	0	0.813628241	0	1.030666551	0.13134863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7846
H5050_004_0	2008	4																					1000											D	D			T	Coin	Coin	V	V						V	V	V	V	V	V		V	T		V		V		Coin																																																						0		854.3500003	13.0104061	0	0	583.058022	9.84221713	4.921108565	317.4800211	99.86902391	0	0	0	0	0	4767.703303	3001.887265	194.2397642	229.556085	0	635.6937737	0	816.5115801	16.1483665	0	201.4626306	0	104.9343327	0	0.400117392	0	166											$100 per day for 1st 3 days	$100 per day for 1st 3 days	$0 Copay	$0 Copay	$75 per trip	20% coinsurance	20% coinsurance	$50 per visit	$100 per visit	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$15 Copay	$15 Copay	$15 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$15 Copay	$75 per trip	$0 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	20% coinsurance	$0 Copay	$15 Copay for Alternative Care											95	95	0	0	71.25	0.19	0.19	47.5	95	0	0	0	0	0	14.25	14.25	14.25	14.25	0	14.25	0	14.25	71.25	0	14.25	0	14.25	0	0.19	0	15											6.7636	0.102999048	0	0	3.461907006	1.870021255	0.935010627	1.25669175	0.790629773	0	0	0	0	0	5.661647672	3.564741127	0.23065972	0.272597851	0	0.754886356	0	0.969607501	0.095880926	0	0.239236874	0	0.12460952	0	0.076022305	0	0.2075	0	0	0	0	0	0	0	0	0	0	27.3783	0	1.440960709	6.7636	0.102999048	0	0	3.461907006	1.870021255	0.935010627	1.25669175	0.790629773	0	0	0	0	0	5.661647672	3.564741127	0.23065972	0.272597851	0	0.754886356	0	0.969607501	0.095880926	0	0.239236874	0	0.12460952	0	0.076022305	0	0.2075	0	0	0	0	0	0	0	0	0	0	27.3783																																																																																				0			6.7636	0.102999048	0	0	3.461907006	1.870021255	0.935010627	1.25669175	0.790629773	0	0	0	0	0	5.661647672	3.564741127	0.23065972	0.272597851	0	0.754886356	0	0.969607501	0.095880926	0	0.239236874	0	0.12460952	0	0.076022305	0	0.2075	0	0	0	0	0	0	0	0	0	0	27.3783
H5050_009_0	2008	4																					2500											D	D			T	Coin	Coin	V	V						V	V	V	V	V	V		V	T																																																												0		757.2565881	11.53182621	0	0	333.0113657	7.601521273	3.800760637	208.8533543	175.9706948	0	0	0	0	0	4707.481533	2963.969854	191.7862847	226.6565183	0	627.6642044	0	716.2603789	14.31625992	0	0	0	0	0	0	0	0											$200 per day for 1st 5 days	$200 per day for 1st 5 days	$0 Copay	$0 Copay	$150 per trip	20% coinsurance	20% coinsurance	$50 per visit	$200 per visit	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$15 Copay	$15 Copay	$15 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$15 Copay	$150 per trip	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay											200	200	0	0	150	0.2	0.2	50	200	0	0	0	0	0	15	15	15	15	0	15	0	15	150	0	0	0	0	0	0	0	0											12.6209	0.192197104	0	0	4.162642071	1.520304255	0.760152127	0.87022231	2.932844913	0	0	0	0	0	5.884351917	3.704962318	0.239732856	0.283320648	0	0.784580256	0	0.895325474	0.178953249	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0305	0	0	12.6209	0.192197104	0	0	4.162642071	1.520304255	0.760152127	0.87022231	2.932844913	0	0	0	0	0	5.884351917	3.704962318	0.239732856	0.283320648	0	0.784580256	0	0.895325474	0.178953249	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0305																																																																																				0			12.6209	0.192197104	0	0	4.162642071	1.520304255	0.760152127	0.87022231	2.932844913	0	0	0	0	0	5.884351917	3.704962318	0.239732856	0.283320648	0	0.784580256	0	0.895325474	0.178953249	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0305
H5050_012_0	2008	6																																D	D			T			V	V					P	V	V	V	P		P			T																			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1579.667593	46.62293286	0	0	348.0305694	0	0	674.3177787	521.6869357	0	0	0	0	271.1180924	6741.400425	9405.423432	308.0732958	2440.062832	0	3786.289045	0	0	59.48202584	0	0	0	0	0	0	0	0											$200/Day for first 5 days of IP Medical; $200/Day for first 5 days of IP Surgical	$200/Day for first 5 days of IP Psych; $200/Day for first 5 days of IP Substance Abuse			$150/Trip for Ambulance			$50/Case for ER - Facility; $50/Case for ER - Worldwide; $15/Visit for Urgent Care; $15/Visit for Urgent Care - Worldwide;	$200/Case for OP Fac - Surgery; $200/Case for OP Fac - ASC					$15/Service for Prof - CORF; $15/Service for Prof - CORF;	$15/Visit for 2nd and subsequent PCP - Office Visits; $15/Consult for PCP - Consults; $15/Procedure for PCP - Cardio;	$15/Visit for Speclst - Office Visits; $15/Consult for Speclst - Consults; $15/Procedure for Speclst - Cardio;	$15/Visit for OP Psych - Non-Physician; $15/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$15/Service for PT/ST (PCP); $15/Service for Occ Therapy (PCP); $15/Service for PT/ST (Specialist); $15/Service for Occ Therapy (Specialist);		$15/Visit for Chiropractor; $15/Exam for Vistion Exams; $15/Service for Podiatrist; $15/Exam for Hearing/Speech Exams;			$150/Trip for Non-Emergent Transport																			200	200	0	0	150	0	0	41.0832649	200	0	0	0	0	15	15	15	15	15	0	15	0	0	150	0	0	0	0	0	0	0	0											26.3278	0.777048881	0	0	4.350382117	0	0	2.308597994	8.694782262	0	0	0	0	0.338897616	8.426750532	11.75677929	0.38509162	3.050078539	0	4.732861306	0	0	0.743525323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.8926	0	0	26.3278	0.777048881	0	0	4.350382117	0	0	2.308597994	8.694782262	0	0	0	0	0.338897616	8.426750532	11.75677929	0.38509162	3.050078539	0	4.732861306	0	0	0.743525323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.8926																																																																																				0	0		26.3278	0.777048881	0	0	4.350382117	0	0	2.308597994	8.694782262	0	0	0	0	0.338897616	8.426750532	11.75677929	0.38509162	3.050078539	0	4.732861306	0	0	0.743525323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.8926
H5050_801_0	2008	3																					2500											D	D			T	Coin	Coin	V	V						V	V	V	V	V	V		V	T						Coin																																																						0		635.3762591	9.675780595	0	0	255.00277	6.073087729	3.036543865	171.3847156	173.016951	0	0	0	0	0	4556.258805	2868.755544	185.6253587	219.3754239	0	607.501174	0	731.190566	9.601384629	0	0	0	0	0	0.304156151	0	0											$200 per day for 1st 5 days	$200 per day for 1st 5 days	$0 Copay	$0 Copay	$150 per trip	20% coinsurance	20% coinsurance	$50 per visit	$200 per visit	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$20 Copay	$20 Copay	$20 Copay	$20 Copay	$0 Copay	$20 Copay	$0 Copay	$20 Copay	$150 per trip	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	20% coinsurance	$0 Copay	$0 Copay											200	200	0	0	150	0.2	0.2	50	200	0	0	0	0	0	20	20	20	20	0	20	0	20	150	0	0	0	0	0	0.2	0	0											10.5896	0.16126301	0	0	3.187534624	1.214617546	0.607308773	0.714102982	2.88361585	0	0	0	0	0	7.593764675	4.78125924	0.309375598	0.365625707	0	1.012501957	0	1.218650943	0.120017308	0	0	0	0	0	0.06083123	0	0	0	0	0	0	0	0	0	0	0	0	34.8201	0	0	10.5896	0.16126301	0	0	3.187534624	1.214617546	0.607308773	0.714102982	2.88361585	0	0	0	0	0	7.593764675	4.78125924	0.309375598	0.365625707	0	1.012501957	0	1.218650943	0.120017308	0	0	0	0	0	0.06083123	0	0	0	0	0	0	0	0	0	0	0	0	34.8201																																																																																				0			10.5896	0.16126301	0	0	3.187534624	1.214617546	0.607308773	0.714102982	2.88361585	0	0	0	0	0	7.593764675	4.78125924	0.309375598	0.365625707	0	1.012501957	0	1.218650943	0.120017308	0	0	0	0	0	0.06083123	0	0	0	0	0	0	0	0	0	0	0	0	34.8201
H5050_802_0	2008	3																					2500											D	D			T	Coin	Coin	V	V						V	V	V	V	V	V		V	T						Coin																																																						0		635.3762591	9.675780595	0	0	255.00277	6.073087729	3.036543865	171.3847156	173.016951	0	0	0	0	0	4556.258805	2868.755544	185.6253587	219.3754239	0	607.501174	0	731.190566	9.601384629	0	0	0	0	0	0.304156151	0	0											$200 per day for 1st 5 days	$200 per day for 1st 5 days	$0 Copay	$0 Copay	$150 per trip	20% coinsurance	20% coinsurance	$50 per visit	$200 per visit	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$20 Copay	$20 Copay	$20 Copay	$20 Copay	$0 Copay	$20 Copay	$0 Copay	$20 Copay	$150 per trip	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	20% coinsurance	$0 Copay	$0 Copay											200	200	0	0	150	0.2	0.2	50	200	0	0	0	0	0	20	20	20	20	0	20	0	20	150	0	0	0	0	0	0.2	0	0											10.5896	0.16126301	0	0	3.187534624	1.214617546	0.607308773	0.714102982	2.88361585	0	0	0	0	0	7.593764675	4.78125924	0.309375598	0.365625707	0	1.012501957	0	1.218650943	0.120017308	0	0	0	0	0	0.06083123	0	0	0	0	0	0	0	0	0	0	0	0	34.8201	0	0	10.5896	0.16126301	0	0	3.187534624	1.214617546	0.607308773	0.714102982	2.88361585	0	0	0	0	0	7.593764675	4.78125924	0.309375598	0.365625707	0	1.012501957	0	1.218650943	0.120017308	0	0	0	0	0	0.06083123	0	0	0	0	0	0	0	0	0	0	0	0	34.8201																																																																																				0			10.5896	0.16126301	0	0	3.187534624	1.214617546	0.607308773	0.714102982	2.88361585	0	0	0	0	0	7.593764675	4.78125924	0.309375598	0.365625707	0	1.012501957	0	1.218650943	0.120017308	0	0	0	0	0	0.06083123	0	0	0	0	0	0	0	0	0	0	0	0	34.8201
H5087_001_0	2008	10																					Unlimited											D	D	D	V	T	P	P	V	V	V	V	V	V	V	P	P	P	P	P	P	S	P	T	P	P	P	P	P	P	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											1A - no cost sharing	1B - no cost sharing	2 - no cost sharing	6 - no cost sharing	10A - no cost sharing	11A - no cost sharing	11B - no cost sharing	4A - no cost sharing	9 - no cost sharing	8A - no cost sharing	8B - no cost sharing	no cost sharing	11C - no cost sharing	9D - no cost sharing	no cost sharing	no cost sharing	7E & 7H - no cost sharing	7C & 7I - no copay	no cost sharing	7B - no cost sharing	no cost sharing	no cost sharing	10B - no cost sharing	16A - no cost sharing	17A - no cost sharing	17B - no cost sharing	18A - no cost sharing	18B - no cost sharing	no cost sharing	no cost sharing	no cost sharing											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5106_013_0	2008	8																																D		D		T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	321.8210232	0	411.2168009	0	269.5467746	11.58767769	0.52975948	271.3346747	278.8356397	306.6290317	673.6760198	0	0	540.3838078	3444.07668	4606.955546	133.8056938	392.5163801	835.0048061	1063.497566	1002.082641	0	0	0	315.8837462	0	135.3787484	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												227.5	0	35	0	50	0.135	0.135	50	75	20	27.5	0	0	30	15	30	30	30	27.5	20	25	0	0	0	30	0	30	0	0	0	0											6.1012	0	1.199382336	0	1.123111561	1.564336489	0.07151753	1.130561144	1.742722748	0.511048386	1.543840879	0	0	1.35095952	4.30509585	11.51738886	0.334514235	0.98129095	1.913552681	1.772495944	2.087672168	0	0	0	0.789709366	0	0.338446871	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3788	0	0	6.1012	0	1.199382336	0	1.123111561	1.564336489	0.07151753	1.130561144	1.742722748	0.511048386	1.543840879	0	0	1.35095952	4.30509585	11.51738886	0.334514235	0.98129095	1.913552681	1.772495944	2.087672168	0	0	0	0.789709366	0	0.338446871	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3788		"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												4.3261	0	0.5933	0.3634	0.0568	0.8795	0.0402	0.0573	0.5072	0.1378	0.3908	0	0	0.4815	0.3202	0.5671	0.018	0.05	0.3846	1.2927	0.4435	0.2964	0	0	0.0439	0	0.0124	0	0	0	0											11.2626	250	11.16122272	10.4273	0	1.792671963	0.363396293	1.179940361	2.443831253	0.111725818	1.187850377	2.249917635	0.648842375	1.934662901	0	0	1.83241349	4.625272344	12.08444542	0.352535411	1.031296508	2.298180778	3.065231145	2.531177106	0.29638177	0	0	0.833597747	0	0.350837988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6415
H5106_014_0	2008	8																																D				T	Coin	Coin	V	V					V	V	V	V	V			S			Coin	V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	322.4678996	0	0	0	270.908122	11.58767769	0.52975948	271.3346747	280.2510491	0	0	0	0	544.4984054	3444.07668	4962.527699	144.6968549	424.4653878	0	0	1012.529968	0	0	8.1	341.5952139	0	146.3979488	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												136.5	0	0	0	25	0.135	0.135	50	50	0	0	0	0	15	15	15	15	15	0	0	25	0	0	0.3	15	0	15	0	0	0	0											3.6681	0	0	0	0.564391921	1.564336489	0.07151753	1.130561144	1.167712704	0	0	0	0	0.680623007	4.30509585	6.203159623	0.180871069	0.530581735	0	0	2.109437434	0	0	2.43	0.426994017	0	0.182997436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2164	0	0	3.6681	0	0	0	0.564391921	1.564336489	0.07151753	1.130561144	1.167712704	0	0	0	0	0.680623007	4.30509585	6.203159623	0.180871069	0.530581735	0	0	2.109437434	0	0	2.43	0.426994017	0	0.182997436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2164		"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												3.5917	0	0.5057	0.3011	0.0677	1.0421	0.0476	0.0679	0.4224	0.1237	0.3551	0	0	0.402	0.2648	0.5004	0.0161	0.0448	0.3464	1.0863	0.4079	0.2495	0	0.2428	0.0375	0	0.0106	0	0	0	0											10.1341	250	6.999021544	7.2598	0	0.505746452	0.30110145	0.632066766	2.606423905	0.119159145	1.198424593	1.590095465	0.12370375	0.355108158	0	0	1.082581687	4.569921164	6.703544487	0.197018372	0.575387627	0.346384425	1.086277614	2.517314854	0.249514527	0	2.672812762	0.464483867	0	0.193582039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.3504
H5106_015_0	2008	8																																D		D		T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	348.429861	0	502.8756356	0	267.1358074	11.56493732	0.528719847	330.8226758	339.9681686	373.855044	821.3742078	0	0	658.858723	3364.713335	4492.398568	129.3804179	379.53492	848.6944429	949.5328365	1057.469936	0	0	0	304.1175067	0	130.3360743	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												227.5	0	35	0	50	0.135	0.135	50	75	20	27.5	0	0	30	15	30	30	30	27.5	20	25	0	0	0	30	0	30	0	0	0	0											6.6056	0	1.466720604	0	1.113065864	1.561266539	0.071377179	1.378427816	2.124801054	0.62309174	1.882315893	0	0	1.647146807	4.205891668	11.23099642	0.323451045	0.9488373	1.944924765	1.582554728	2.203062368	0	0	0	0.760293767	0	0.325840186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9997	0	0	6.6056	0	1.466720604	0	1.113065864	1.561266539	0.071377179	1.378427816	2.124801054	0.62309174	1.882315893	0	0	1.647146807	4.205891668	11.23099642	0.323451045	0.9488373	1.944924765	1.582554728	2.203062368	0	0	0	0.760293767	0	0.325840186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9997		"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												4.3214	0	0.6863	0.402	0.0553	0.8615	0.0394	0.0685	0.552	0.15	0.4253	0	0	0.524	0.3016	0.5338	0.0168	0.0466	0.3399	1.3074	0.4489	0.2765	0	0	0.0406	0	0.0115	0	0	0	0											11.4095	250	11.72402084	10.9271	0	2.15305495	0.402038111	1.168345239	2.422809235	0.110764745	1.446975759	2.67679855	0.773057638	2.307660831	0	0	2.171129586	4.507509149	11.76481287	0.340261757	0.995484036	2.28483011	2.889973812	2.651932863	0.27647411	0	0	0.800943074	0	0.337316807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4093
H5106_016_0	2008	8																																D				T	Coin	Coin	V	V					V	V	V	V	V			S			Coin	V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	349.1302226	0	0	0	268.4849781	11.56493732	0.528719847	330.8226758	341.6938954	0	0	0	0	663.8754137	3364.713335	4839.014978	139.9113821	410.4272972	0	0	1067.571746	0	0	8.1	328.8712572	0	140.9448245	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												136.5	0	0	0	25	0.135	0.135	50	50	0	0	0	0	15	15	15	15	15	0	0	25	0	0	0.3	15	0	15	0	0	0	0											3.9714	0	0	0	0.559343704	1.561266539	0.071377179	1.378427816	1.423724564	0	0	0	0	0.829844267	4.205891668	6.048768722	0.174889228	0.513034121	0	0	2.224107803	0	0	2.43	0.411089072	0	0.176181031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9793	0	0	3.9714	0	0	0	0.559343704	1.561266539	0.071377179	1.378427816	1.423724564	0	0	0	0	0.829844267	4.205891668	6.048768722	0.174889228	0.513034121	0	0	2.224107803	0	0	2.43	0.411089072	0	0.176181031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9793		"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												3.5946	0	0.5862	0.3337	0.066	1.0241	0.0468	0.0815	0.4606	0.1349	0.3872	0	0	0.4383	0.25	0.4719	0.0151	0.0419	0.3067	1.0995	0.4141	0.2332	0	0.2391	0.0348	0	0.0098	0	0	0	0											10.2698	250	7.352228165	7.5659	0	0.586157332	0.33374284	0.625383702	2.585344076	0.118195429	1.459889289	1.884278825	0.134883084	0.38719993	0	0	1.268128686	4.455852518	6.5206907	0.189980135	0.554908704	0.306681601	1.099499772	2.638199557	0.233190684	0	2.669085546	0.445922997	0	0.186015781	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.2491
H5106_017_0	2008	9																																D		D		T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	321.8210232	0	411.2168009	0	269.5467746	11.58767769	0.52975948	271.3346747	271.0508884	306.6290317	673.6760198	0	0	540.3838078	3444.07668	4606.955546	133.8056938	392.5163801	835.0048061	1063.497566	1002.082641	0	0	0	315.8837462	0	135.3787484	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												227.5	0	35	0	50	0.135	0.135	50	250	20	27.5	0	0	30	15	30	30	30	27.5	20	25	0	0	0	30	0	30	0	0	0	0											6.1012	0	1.199382336	0	1.123111561	1.564336489	0.07151753	1.130561144	5.646893507	0.511048386	1.543840879	0	0	1.35095952	4.30509585	11.51738886	0.334514235	0.98129095	1.913552681	1.772495944	2.087672168	0	0	0	0.789709366	0	0.338446871	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.283	0	0	6.1012	0	1.199382336	0	1.123111561	1.564336489	0.07151753	1.130561144	5.646893507	0.511048386	1.543840879	0	0	1.35095952	4.30509585	11.51738886	0.334514235	0.98129095	1.913552681	1.772495944	2.087672168	0	0	0	0.789709366	0	0.338446871	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.283		"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												4.3318	0	0.5941	0.3639	0.0569	0.8805	0.0403	0.0574	0.4937	0.138	0.3913	0	0	0.4821	0.3206	0.5678	0.018	0.0501	0.3851	1.285	0.444	0.2968	0	0	0.0439	0	0.0124	0	0	0	0											11.2536	250	11.127224	10.433	0	1.793453084	0.363874738	1.18000571	2.444842598	0.111772055	1.187916351	6.140577257	0.649023793	1.935177455	0	0	1.833047369	4.62569188	12.085192	0.352559138	1.031362345	2.298687177	3.057537965	2.531687099	0.296771984	0	0	0.833648215	0	0.350852237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.5366
H5106_018_0	2008	8																																D		D		T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	348.429861	0	502.8756356	0	267.1358074	11.56493732	0.528719847	330.8226758	330.4766715	373.855044	821.3742078	0	0	658.858723	3364.713335	4492.398568	129.3804179	379.53492	848.6944429	949.5328365	1057.469936	0	0	0	304.1175067	0	130.3360743	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												227.5	0	35	0	50	0.135	0.135	50	250	20	27.5	0	0	30	15	30	30	30	27.5	20	25	0	0	0	30	0	30	0	0	0	0											6.6056	0	1.466720604	0	1.113065864	1.561266539	0.071377179	1.378427816	6.884930657	0.62309174	1.882315893	0	0	1.647146807	4.205891668	11.23099642	0.323451045	0.9488373	1.944924765	1.582554728	2.203062368	0	0	0	0.760293767	0	0.325840186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7598	0	0	6.6056	0	1.466720604	0	1.113065864	1.561266539	0.071377179	1.378427816	6.884930657	0.62309174	1.882315893	0	0	1.647146807	4.205891668	11.23099642	0.323451045	0.9488373	1.944924765	1.582554728	2.203062368	0	0	0	0.760293767	0	0.325840186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7598		"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												4.3273	0	0.6873	0.4026	0.0553	0.8626	0.0394	0.0686	0.5373	0.1502	0.4259	0	0	0.5247	0.302	0.5345	0.0168	0.0467	0.3404	1.2996	0.4494	0.2769	0	0	0.0407	0	0.0115	0	0	0	0											11.3998	250	11.68709632	10.933	0	2.153991049	0.402586455	1.168410925	2.423832955	0.110811546	1.44705732	7.422248911	0.773262178	2.308240963	0	0	2.171844252	4.507918571	11.76554095	0.340284686	0.995547658	2.285293711	2.882109385	2.652466229	0.276851196	0	0	0.800991375	0	0.337330444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1596
H5106_806_0	2008	6																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		232.7964639	0	34.54783301	0	7.202050486	24.65430977	1.127133034	5.292738989	28.52161496	8.56956298	24.60007657	0	0	27.07409938	18.28918929	33.79391125	1.103593668	3.062276035	22.39541777	76.96979448	21.32423615	16.69415282	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.081379405	0	0.207120436	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											18.9448	0	7.15556222	0	1.685279814	5.769108486	0.26374913	1.238500923	6.6740579	2.005277737	5.756417917	0	0	6.335339255	4.279670294	7.907775232	0.258240918	0.716572592	5.240527757	18.01093191	4.989871258	3.90643176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1382	0	0	18.9448	0	7.15556222	0	1.685279814	5.769108486	0.26374913	1.238500923	6.6740579	2.005277737	5.756417917	0	0	6.335339255	4.279670294	7.907775232	0.258240918	0.716572592	5.240527757	18.01093191	4.989871258	3.90643176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1382		"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.105	0	0.7951	0	0.1873	0.641	0.0293	0.1376	0.7416	0.2228	0.6396	0	0	0.7039	0.4755	0.8786	0.0287	0.0796	0.5823	2.0012	0.5544	0.434	0	0	0	0	0	0	0	0	0											11.2376	0	0	21.0498	0	7.950624688	0	1.872533126	6.41012054	0.293054589	1.376112137	7.415619889	2.228086375	6.396019907	0	0	7.039265839	4.755189215	8.786416925	0.286934354	0.796191769	5.822808619	20.01214656	5.544301398	4.340479733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3757
H5106_807_0	2008	7																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		232.7964639	0	34.54783301	0	7.202050486	24.65430977	1.127133034	5.292738989	28.52161496	8.56956298	24.60007657	0	0	27.07409938	18.28918929	33.79391125	1.103593668	3.062276035	22.39541777	76.96979448	21.32423615	16.69415282	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.081379405	0	0.207120436	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											18.9448	0	7.15556222	0	1.685279814	5.769108486	0.26374913	1.238500923	6.6740579	2.005277737	5.756417917	0	0	6.335339255	4.279670294	7.907775232	0.258240918	0.716572592	5.240527757	18.01093191	4.989871258	3.90643176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1382	0	0	18.9448	0	7.15556222	0	1.685279814	5.769108486	0.26374913	1.238500923	6.6740579	2.005277737	5.756417917	0	0	6.335339255	4.279670294	7.907775232	0.258240918	0.716572592	5.240527757	18.01093191	4.989871258	3.90643176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1382		"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.105	0	0.7951	0	0.1873	0.641	0.0293	0.1376	0.7416	0.2228	0.6396	0	0	0.7039	0.4755	0.8786	0.0287	0.0796	0.5823	2.0012	0.5544	0.434	0	0	0	0	0	0	0	0	0											11.2376	0	0	21.0498	0	7.950624688	0	1.872533126	6.41012054	0.293054589	1.376112137	7.415619889	2.228086375	6.396019907	0	0	7.039265839	4.755189215	8.786416925	0.286934354	0.796191769	5.822808619	20.01214656	5.544301398	4.340479733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3757
H5106_808_0	2008	7																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		232.7964639	0	34.54783301	0	7.202050486	24.65430977	1.127133034	5.292738989	28.52161496	8.56956298	24.60007657	0	0	27.07409938	18.28918929	33.79391125	1.103593668	3.062276035	22.39541777	76.96979448	21.32423615	16.69415282	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.081379405	0	0.207120436	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											18.9448	0	7.15556222	0	1.685279814	5.769108486	0.26374913	1.238500923	6.6740579	2.005277737	5.756417917	0	0	6.335339255	4.279670294	7.907775232	0.258240918	0.716572592	5.240527757	18.01093191	4.989871258	3.90643176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1382	0	0	18.9448	0	7.15556222	0	1.685279814	5.769108486	0.26374913	1.238500923	6.6740579	2.005277737	5.756417917	0	0	6.335339255	4.279670294	7.907775232	0.258240918	0.716572592	5.240527757	18.01093191	4.989871258	3.90643176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1382		"PBP 1a, 1b"	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 12, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												2.105	0	0.7951	0	0.1873	0.641	0.0293	0.1376	0.7416	0.2228	0.6396	0	0	0.7039	0.4755	0.8786	0.0287	0.0796	0.5823	2.0012	0.5544	0.434	0	0	0	0	0	0	0	0	0											11.2376	0	0	21.0498	0	7.950624688	0	1.872533126	6.41012054	0.293054589	1.376112137	7.415619889	2.228086375	6.396019907	0	0	7.039265839	4.755189215	8.786416925	0.286934354	0.796191769	5.822808619	20.01214656	5.544301398	4.340479733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3757
H5151_002_0	2008	4																					3250											D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	2132.9	58.5	2857.6	2501.3	384.5	20.96010821	0	385.2	377.4	16135.7	659	53.3	7.8	6171.9	4373.4	4056.6	216	16.2	64.7	0	40.72684867	0	0	0	357.2	0	13.6	0	0	0.2	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	"$50 Scans, $25 Rad Ther"	$0.00 	$0.00 	$0.00 	"$15.00, $0.00 Prev."	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	"20%, 10% Chemo, $5 Diab Supp"	$0.00 	$0.00 	$0.00 	$15.00 	$0.00 	$25.00 	$0.00 	$0.00 	$0.00 	$0.00 											42.23097508	42.23097508	7.229307394	0	23.54778254	0.18838226	0.18838226	47.09556508	94.19113016	0	7.064334762	0	0	0	14.12866952	23.54778254	23.54778254	23.54778254	0	0	0.169544034	0	0	0	14.12866952	0	23.54778254	0	0	0	0											7.5062	0.205876004	1.721539067	0	0.754510199	3.948512562	0	1.511767639	2.962311044	0	0.387949717	0	0	0	5.149193608	7.960327888	0.423860086	0.031789506	0	0	6.904994226	0	0	0	0.420563396	0	0.026687487	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.9161		2.461668627	7.5062	0.205876004	1.721539067	0	0.754510199	3.948512562	0	1.511767639	2.962311044	0	0.387949717	0	0	0	5.149193608	7.960327888	0.423860086	0.031789506	0	0	6.904994226	0	0	0	0.420563396	0	0.026687487	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.9161	0																																																																																			0		0	7.5062	0.205876004	1.721539067	0	0.754510199	3.948512562	0	1.511767639	2.962311044	0	0.387949717	0	0	0	5.149193608	7.960327888	0.423860086	0.031789506	0	0	6.904994226	0	0	0	0.420563396	0	0.026687487	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.9161
H5151_004_0	2008	3																					3250											D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1854.3	30.6	1734	1718.2	288.7	15.23813392	0	326.2	293.2	12700.6	597.6	33.6	4.1	4958.1	3627.2	3428.5	143.7	13.2	58.7	0	23.36732916	0	0	0	345.8	0	15.4	0	0	0.1	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	"$50 Scans, $25 Rad Ther"	$0.00 	$0.00 	$0.00 	"$15.00, $0.00 Prev."	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	"20%, 10% Chemo, $5 Diab Supp"	$0.00 	$0.00 	$0.00 	$15.00 	$0.00 	$25.00 	$0.00 	$0.00 	$0.00 	$0.00 											42.23097508	42.23097508	7.229307394	0	23.54778254	0.18838226	0.18838226	47.09556508	94.19113016	0	7.064334762	0	0	0	14.12866952	23.54778254	23.54778254	23.54778254	0	0	0.169544034	0	0	0	14.12866952	0	23.54778254	0	0	0	0											6.5257	0.107688986	1.044634918	0	0.566520402	2.870594112	0	1.280214444	2.30140328	0	0.351803871	0	0	0	4.270625841	6.727797703	0.281984696	0.025902561	0	0	3.961791256	0	0	0	0.40714116	0	0.030219654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.7541		1.896636725	6.5257	0.107688986	1.044634918	0	0.566520402	2.870594112	0	1.280214444	2.30140328	0	0.351803871	0	0	0	4.270625841	6.727797703	0.281984696	0.025902561	0	0	3.961791256	0	0	0	0.40714116	0	0.030219654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.7541	0																																																																																			0		0	6.5257	0.107688986	1.044634918	0	0.566520402	2.870594112	0	1.280214444	2.30140328	0	0.351803871	0	0	0	4.270625841	6.727797703	0.281984696	0.025902561	0	0	3.961791256	0	0	0	0.40714116	0	0.030219654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.7541
H5151_802_0	2008	3																					3250											D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1384.1	58.2	1387.3	1278	200.1	13.15737634	0	301.9	299.7	11499	509.4	52.2	2.3	4212.3	3321.1	3294.9	121.2	46.6	50.6	0	25.36819262	0	0	0	335	0	9	0	0	0.1	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	"$50 Scans, $25 Rad Ther"	$0.00 	$0.00 	$0.00 	"$15.00, $0.00 Prev."	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	"20%, 10% Chemo, $5 Diab Supp"	$0.00 	$0.00 	$0.00 	$15.00 	$0.00 	$25.00 	$0.00 	$0.00 	$0.00 	$0.00 											42.23097508	42.23097508	7.229307394	0	23.54778254	0.18838226	0.18838226	47.09556508	94.19113016	0	7.064334762	0	0	0	14.12866952	23.54778254	23.54778254	23.54778254	0	0	0.169544034	0	0	0	14.12866952	0	23.54778254	0	0	0	0											4.871	0.204820229	0.835768179	0	0.392659274	2.478616296	0	1.184845925	2.352423476	0	0.299881011	0	0	0	3.91022703	6.465632391	0.237832604	0.091443889	0	0	4.301025719	0	0	0	0.394425358	0	0.017660837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.0383		1.729149693	4.871	0.204820229	0.835768179	0	0.392659274	2.478616296	0	1.184845925	2.352423476	0	0.299881011	0	0	0	3.91022703	6.465632391	0.237832604	0.091443889	0	0	4.301025719	0	0	0	0.394425358	0	0.017660837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.0383	0																																																																																			0		0	4.871	0.204820229	0.835768179	0	0.392659274	2.478616296	0	1.184845925	2.352423476	0	0.299881011	0	0	0	3.91022703	6.465632391	0.237832604	0.091443889	0	0	4.301025719	0	0	0	0.394425358	0	0.017660837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.0383
H5151_803_0	2008	3																					3250											D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1550.1	42.5	2076.8	1817.9	279.5	15.2330746	0	280	274.3	11726.8	478.9	38.7	5.7	4485.5	3178.4	2948.2	157	11.8	47	0	29.59885119	0	0	0	259.6	0	9.9	0	0	0.1	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	"$50 Scans, $25 Rad Ther"	$0.00 	$0.00 	$0.00 	"$15.00, $0.00 Prev."	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	"20%, 10% Chemo, $5 Diab Supp"	$0.00 	$0.00 	$0.00 	$15.00 	$0.00 	$25.00 	$0.00 	$0.00 	$0.00 	$0.00 											42.23097508	42.23097508	7.229307394	0	23.54778254	0.18838226	0.18838226	47.09556508	94.19113016	0	7.064334762	0	0	0	14.12866952	23.54778254	23.54778254	23.54778254	0	0	0.169544034	0	0	0	14.12866952	0	23.54778254	0	0	0	0											5.4552	0.149568037	1.251152133	0	0.548467102	2.869641025	0	1.098896519	2.15305225	0	0.281925826	0	0	0	3.742213601	5.785297707	0.308083488	0.023155319	0	0	5.018308641	0	0	0	0.305650217	0	0.019426921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.01		1.789079916	5.4552	0.149568037	1.251152133	0	0.548467102	2.869641025	0	1.098896519	2.15305225	0	0.281925826	0	0	0	3.742213601	5.785297707	0.308083488	0.023155319	0	0	5.018308641	0	0	0	0.305650217	0	0.019426921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.01	0																																																																																			0		0	5.4552	0.149568037	1.251152133	0	0.548467102	2.869641025	0	1.098896519	2.15305225	0	0.281925826	0	0	0	3.742213601	5.785297707	0.308083488	0.023155319	0	0	5.018308641	0	0	0	0.305650217	0	0.019426921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.01
H5179_001_0	2008	7																					3000											A	A	D	coin	T	coin	coin	V	V	P	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	244.4009093	2.371738304	600.8789787	20.86404117	203.0835646	20.69249491	1.060851474	220.5646588	211.5097148	1354.964033	687.9462953	0	0.301546934	196.9631163	4591.528313	5714.202555	201.3820451	651.7246018	43.88882105	114.2120391	6.025529143	694.3559519	0	0	0	0	164.8571878	0	0	0	0											$550 Per Admit	$550 Per Admit	"$150 / Day, Days 5-100"		$100 per	20% per	20% per	$50 ER / $10 UC	$100 ASC / $100 OP	$30 per	$10 - $100 per	0	15% per	$25 PT/OT/ST	$10 PCP	$25 SCP / $30 Chiro / $30 Podiatrist	$30 MH	$25 Therapy		$30 Hearing / $30 OP SA	20% per	$30 Vision/$0 Blood		0			$30 Hearing				0											466.1909309	466.1909309	127.1429812	0	84.76198744	0.169523975	0.169523975	29.3175471	84.76198744	25.42859623	40.92062195	0	0.127142981	21.19049686	8.49217046	22.51040953	25.42859623	21.19049686	0	25.35944551	0.169523975	25.42859623	0	0	0	0	30	0	0	0	0											9.4948	0.092140241	6.366462056	0	1.434480546	3.507873987	0.179839759	0.538867898	1.493998649	2.871236108	2.345932523	0	0.038339576	0.347812191	3.249336759	10.71908664	0.426738559	1.150864011	0	0.241362832	1.021471651	1.471374762	0	0	0	0	0.412142969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4042	0	8.44	9.4948	0.092140241	6.366462056	0	1.434480546	3.507873987	0.179839759	0.538867898	1.493998649	2.871236108	2.345932523	0	0.038339576	0.347812191	3.249336759	10.71908664	0.426738559	1.150864011	0	0.241362832	1.021471651	1.471374762	0	0	0	0	0.412142969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4042	3000		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.4948	0.092140241	6.366462056	0	1.434480546	3.507873987	0.179839759	0.538867898	1.493998649	2.871236108	2.345932523	0	0.038339576	0.347812191	3.249336759	10.71908664	0.426738559	1.150864011	0	0.241362832	1.021471651	1.471374762	0	0	0	0	0.412142969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4042
H5179_002_0	2008	7																					3000											A	A	D	coin	T	coin	coin	V	V	P	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	207.3120313	1.956614435	605.483476	20.00966859	209.2069836	22.03902185	1.166553207	244.8169562	235.8487549	1490.207937	761.8804518	0	0.235739287	222.5908164	3864.400255	4719.457957	164.3812098	528.9924361	25.72299301	96.11602144	6.320412326	588.3294152	0	0	0	0	141.9761363	0	0	0	0											$550 Per Admit	$550 Per Admit	"$150 / Day, Days 5-100"		$100 per	20% per	20% per	$50 ER / $10 UC	$100 ASC / $100 OP	$30 per	$10 - $100 per	0	15% per	$25 PT/OT/ST	$10 PCP	$25 SCP / $30 Chiro / $30 Podiatrist	$30 MH	$25 Therapy		$30 Hearing / $30 OP SA	20% per	$30 Vision/$0 Blood		0			$30 Hearing				0											475.5929394	475.5929394	129.7071653	0	86.47144353	0.172942887	0.172942887	29.99853185	86.47144353	25.94143306	41.74589762	0	0.129707165	21.61786088	8.66196742	22.9092163	25.94143306	21.61786088	0	25.84272031	0.172942887	25.94143306	0	0	0	0	30	0	0	0	0											8.2163	0.077546001	6.544628776	0	1.507535822	3.811492067	0.20174708	0.612012438	1.699515191	3.221510787	2.650448612	0	0.030577075	0.400994775	2.789442426	9.009923595	0.355357013	0.952973741	0	0.206991622	1.093070355	1.271842345	0	0	0	0	0.354940341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0089	0	6.98	8.2163	0.077546001	6.544628776	0	1.507535822	3.811492067	0.20174708	0.612012438	1.699515191	3.221510787	2.650448612	0	0.030577075	0.400994775	2.789442426	9.009923595	0.355357013	0.952973741	0	0.206991622	1.093070355	1.271842345	0	0	0	0	0.354940341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0089	3000		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.2163	0.077546001	6.544628776	0	1.507535822	3.811492067	0.20174708	0.612012438	1.699515191	3.221510787	2.650448612	0	0.030577075	0.400994775	2.789442426	9.009923595	0.355357013	0.952973741	0	0.206991622	1.093070355	1.271842345	0	0	0	0	0.354940341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0089
H5179_003_0	2008	7																					3000											A	A	D	coin	T	coin	coin	V	V	P	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	261.5394713	2.541096717	559.0665538	17.78570313	270.488029	32.72688281	1.649656881	296.5035889	284.4772965	1826.219779	926.2418899	0	0.243775032	264.3658329	4095.646893	4823.193929	149.0833783	482.2038966	29.80362495	98.73715052	7.053332089	619.8642754	0	0	0	0	139.1868647	0	0	0	0											$550 Per Admit	$550 Per Admit	"$150 / Day, Days 5-100"		$100 per	20% per	20% per	$50 ER / $10 UC	$100 ASC / $100 OP	$30 per	$10 - $100 per	0	15% per	$25 PT/OT/ST	$10 PCP	$25 SCP / $30 Chiro / $30 Podiatrist	$30 MH	$25 Therapy		$30 Hearing / $30 OP SA	20% per	$30 Vision/$0 Blood		0			$30 Hearing				0											460.0443549	460.0443549	125.4666422	0	83.64442816	0.167288856	0.167288856	28.89455075	83.64442816	25.09332845	40.38109684	0	0.125466642	20.91110704	8.380677941	22.05013029	25.09332845	20.91110704	0	25.0749433	0.167288856	25.09332845	0	0	0	0	30	0	0	0	0											10.0266	0.0974181	5.845350275	0	1.885401376	5.474842796	0.275969213	0.713944833	1.982911732	3.818827728	3.116888621	0	0.030585635	0.460681853	2.860358131	8.862671211	0.311749848	0.840284775	0	0.206319038	1.179943858	1.296204821	0	0	0	0	0.347967162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.635	0	9.63	10.0266	0.0974181	5.845350275	0	1.885401376	5.474842796	0.275969213	0.713944833	1.982911732	3.818827728	3.116888621	0	0.030585635	0.460681853	2.860358131	8.862671211	0.311749848	0.840284775	0	0.206319038	1.179943858	1.296204821	0	0	0	0	0.347967162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.635	3000		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.0266	0.0974181	5.845350275	0	1.885401376	5.474842796	0.275969213	0.713944833	1.982911732	3.818827728	3.116888621	0	0.030585635	0.460681853	2.860358131	8.862671211	0.311749848	0.840284775	0	0.206319038	1.179943858	1.296204821	0	0	0	0	0.347967162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.635
H5179_004_0	2008	5																					3200											A	A	D	coin	T	coin	coin	V	V	P	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	233.5980959	2.220324126	599.77742	21.25635933	203.6237492	21.07244879	1.119455397	227.8105887	221.7672752	1399.258491	715.8922012	0	0.280532487	209.5840114	4256.639544	5351.636412	185.6886552	598.069235	38.519796	108.7898186	6.235073552	666.1941577	0	0	0	0	0	0	0	0	0											$550 Per Admit	$550 Per Admit	"$150 / Day, Days 5-100"		$150 per	20% per	20% per	$50 ER / $15 UC	$125 ASC / $125 OP	$35 per	$15 - $125 per	0	17.5% per	$35 PT/OT/ST	$15 PCP	$35 SCP / $35 Chiro / $35 Podiatrist	$35 MH	$35 Therapy		$35 Hearing / $35 OP SA	20% per	$35 Vision/$0 Blood		0							0											462.037535	462.037535	126.0102368	0	126.0102368	0.168013649	0.168013649	30.96149473	105.0085307	29.40238859	49.14325075	0	0.147011943	29.40238859	12.62690139	29.33177488	29.40238859	29.40238859	0	29.2310504	0.168013649	29.40238859	0	0	0	0	0	0	0	0	0											8.9943	0.085489424	6.298174561	0	2.138223072	3.540459016	0.188083786	0.587779695	1.94062131	3.428461823	2.931772496	0	0.041241626	0.513522545	4.47901398	13.08108288	0.454974166	1.465388671	0	0.265003389	1.04757746	1.632308292	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1134	0	10.1	8.9943	0.085489424	6.298174561	0	2.138223072	3.540459016	0.188083786	0.587779695	1.94062131	3.428461823	2.931772496	0	0.041241626	0.513522545	4.47901398	13.08108288	0.454974166	1.465388671	0	0.265003389	1.04757746	1.632308292	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1134	3200		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.9943	0.085489424	6.298174561	0	2.138223072	3.540459016	0.188083786	0.587779695	1.94062131	3.428461823	2.931772496	0	0.041241626	0.513522545	4.47901398	13.08108288	0.454974166	1.465388671	0	0.265003389	1.04757746	1.632308292	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1134
H5189_001_0	2008	3																																D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	Coin	V	V	V	V	V	V	V	Coin																																																				0		1224.205253	309.121536	1085.008827	325.9338569	294.7224622	14.85051741	4.777570751	889.0563105	3060.941647	2973.978088	928.7973803	0	13.48886407	153.4980272	3818.016365	6293.355706	889.6090357	196.0704111	1889.055368	0	15.60582913	10.07757488	0	1630.659814	250.4272643	352.5690945	21.21352426	94.77302646	0	1.976018008	42.99127698											$100/day - 1st 10 days	$100/day - 1st 10 days	$50/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $30 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$30/visit	$10/visit	$30/visit	$30/visit	$30/visit	$30/visit	Zero Cost Sharing	20% Coinsurance	10% Blood	100% Coinsurance	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											70.03328531	70.03328531	40.52480559	0	126.3157895	0.2	0.121870541	44.1609844	65.85289683	0	0	0	0	0	8.552971576	9.764057143	30	30	0.344827586	0	0.2	0	0	29.38604651	0	0	0	0	0	0	0											7.1446	1.804066394	3.664147648	0	3.102341708	2.970103483	0.582245133	3.271800155	16.79765621	0	0	0	0	0	2.721282121	5.120723728	2.224022589	0.490176028	0.0542832	0	3.121165827	0	0	3.993220427	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0618			7.1446	1.804066394	3.664147648	0	3.102341708	2.970103483	0.582245133	3.271800155	16.79765621	0	0	0	0	0	2.721282121	5.120723728	2.224022589	0.490176028	0.0542832	0	3.121165827	0	0	3.993220427	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0618		$100/day - 1st 10 days	$100/day - 1st 10 days	$50/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $30 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$30/visit	$10/visit	$30/visit	$30/visit	$30/visit	$30/visit	Zero Cost Sharing	20% Coinsurance	10% Blood	100% Coinsurance	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.8081	0.2041	0.1281	0	4.7485	0.0016	0.0542	0.3809	1.6405	0	0	0	0	0	0.7822	1.4719	0.6393	0.1409	0.0156	0	0.8338	0	0	0.4912	0	0	0	0	0	0	0											12.3408			7.9527	2.008118983	3.792226315	0	7.850801958	2.971746295	0.636404815	3.652684372	18.43811156	0	0	0	0	0	3.503490151	6.592629632	2.863297847	0.631072711	0.069886417	0	3.954992482	0	0	4.484451071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4026
H5189_002_0	2008	3																																D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	Coin	V	V	V	V	V	V	V	Coin																																																				0		1666.250632	420.7415003	1201.992701	349.0813282	798.334512	19.84807257	6.385337853	1062.43391	3596.417293	3551.04152	1109.018952	0	16.10621025	183.2824089	5261.534169	8672.751219	1225.952927	270.2008238	2603.270499	0	24.18047512	12.7195666	0	2125.927667	268.0580698	377.390981	32.26161903	134.6513792	0	2.49968961	46.71294959											$95/day - 1st 10 days	$95/day - 1st 10 days	$75/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $20 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	Zero Cost Sharing	20% Coinsurance	10% Blood	100% Coinsurance	$10/visit Preventative; $10/Visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											35.01664265	35.01664265	60.78720838	0	126.3157895	0.2	0.121870541	44.1609844	65.85289683	0	0	0	0	0	4.276485788	6.509371429	20	20	0.229885057	0	0.2	0	0	9.795348837	0	0	0	0	0	0	0											4.8622	1.227746231	6.088815064	0	8.403521179	3.969614515	0.778184579	3.909843943	19.73620808	0	0	0	0	0	1.875073008	4.704513249	2.043254878	0.450334706	0.049871082	0	4.836095024	0	0	1.735350258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6706			4.8622	1.227746231	6.088815064	0	8.403521179	3.969614515	0.778184579	3.909843943	19.73620808	0	0	0	0	0	1.875073008	4.704513249	2.043254878	0.450334706	0.049871082	0	4.836095024	0	0	1.735350258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6706		$95/day - 1st 10 days	$95/day - 1st 10 days	$75/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $20 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	Zero Cost Sharing	20% Coinsurance	10% Blood	100% Coinsurance	$10/visit Preventative; $10/Visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.4941	0.1248	0.2056	0	5.0828	0.0018	0.0662	0.4077	1.7559	0	0	0	0	0	0.4186	1.0504	0.4562	0.1005	0.0111	0	1.0196	0	0	0.1901	0	0	0	0	0	0	0											11.3854			5.3563	1.352502184	6.294458729	0	13.4862868	3.971372986	0.844410084	4.317543513	21.49215625	0	0	0	0	0	2.29371188	5.754868148	2.499442938	0.550878852	0.061005568	0	5.855683545	0	0	1.925442025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.056
H5189_003_0	2008	6																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0.2708	0.5772	0.1857	0.9099	5.3455	0.3794	0.5695	0	0.0275	0.0405	0.7945	2.2487	0.1978	0.0543	0.3042	0	0.6065	0.0111	0	0	0	0	0	0	0	0	0											12.5228		281.9948506	142.6905995	1240.254288	15.38278139	7.963331338	16.97536227	5.461156134	26.76078942	157.2196339	11.15818641	16.74949514	0	0.807435582	1.190396986	23.36771617	66.13868001	5.816863418	1.59738298	8.946110365	0	17.83874566	0.326317073	0	27.08502505	1.104824369	2.013302956	0.065865782	1.214723858	0	19.46345041	0.343612817											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	100% Coinsurance	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											500.9695286	89.54195553	53.19728971	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0	0	0	0	0	0	0	0											11.7726	1.064732943	5.498180557	0	1.592666268	3.395072454	1.092231227	5.352157885	31.44392678	2.231637283	3.349899029	0	0.161487116	0.238079397	4.673543233	13.227736	1.163372684	0.319476596	1.789222073	0	3.567749132	0.065263415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.999	135		11.7726	1.064732943	5.498180557	0	1.863419533	3.972234772	1.277910535	6.262024725	36.78939433	2.611015621	3.919381864	0	0.188939926	0.278552895	5.468045583	15.47645112	1.36114604	0.373787617	2.093389825	0	4.174266485	0.076358195	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.5218		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	100% Coinsurance	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											1.3316	0.1204	0.1922	0	2.8522	0.3695	0.1189	0.729	3.5928	0.3016	0.4527	0	0.0218	0.0322	1.5717	4.4486	0.3912	0.1074	0.6017	0	1.1152	0.0137	0	0	0	0	0	0	0	0	0											18.3644	135		13.1041	1.185161722	5.690367036	0	4.7155791	4.341726869	1.396780106	6.991013743	40.38223838	2.912595534	4.37208189	0	0.210763038	0.310726566	7.039786025	19.92501757	1.752395207	0.4812295	2.695115872	0	5.289431411	0.090037755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.8862
H5189_004_0	2008	2																																D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	Coin	V	V	V	V	V	V	V	V																																																				0		1224.205253	309.121536	949.7982931	325.9338569	294.7224622	14.85051741	4.777570751	889.0563105	3060.941647	2973.978088	928.7973803	0	13.48886407	153.4980272	3818.016365	6293.355706	889.6090357	196.0704111	1889.055368	0	15.60582913	10.07757488	0	1630.659814	250.4272643	352.5690945	21.21352426	94.77302646	0	1.976018008	42.99127698											$50/day - 1st 10 days	$50/day - 1st 10 days	$50/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $20 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	Zero Cost Sharing	20% Coinsurance	10% Blood	100% Coinsurance	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											35.01664265	35.01664265	40.52480559	0	126.3157895	0.2	0.121870541	44.1609844	65.85289683	0	0	0	0	0	4.276485788	6.509371429	20	20	0.229885057	0	0.2	0	0	9.795348837	0	0	0	0	0	0	0											3.5723	0.902033197	3.207532598	0	3.102341708	2.970103483	0.582245133	3.271800155	16.79765621	0	0	0	0	0	1.36064106	3.413815819	1.482681726	0.326784018	0.0361888	0	3.121165827	0	0	1.331073476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4784			3.5723	0.902033197	3.207532598	0	3.102341708	2.970103483	0.582245133	3.271800155	16.79765621	0	0	0	0	0	1.36064106	3.413815819	1.482681726	0.326784018	0.0361888	0	3.121165827	0	0	1.331073476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4784		$50/day - 1st 10 days	$50/day - 1st 10 days	$50/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $20 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	Zero Cost Sharing	20% Coinsurance	10% Blood	100% Coinsurance	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.4041	0.102	0.1121	0	4.7485	0.0016	0.0542	0.3809	1.6405	0	0	0	0	0	0.3911	0.9813	0.4262	0.0939	0.0104	0	0.8338	0	0	0.1637	0	0	0	0	0	0	0											10.3443			3.9763	1.004059492	3.319650487	0	7.850801958	2.971746295	0.636404815	3.652684372	18.43811156	0	0	0	0	0	1.751745076	4.395086422	1.908865231	0.420715141	0.046590945	0	3.954992482	0	0	1.494817024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8226
H5204_002_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		611.7184461		257.4108295		67.10219157	92.17227542		28.83674538	26.79486115	277.6827099					371.3273522						45.12436318	5.323483																				Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co																				0.0847		0.1727		0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				51.8126	0	44.45485026	0	15.70191283	21.56831245	0	6.747798419	6.269997509	64.97775411	0	0	0	0	86.89060041	0	0	0	0	0	10.55910099	1.245695022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	310.2286	0	0	51.8126	0	44.45485026	0	15.70191283	21.56831245	0	6.747798419	6.269997509	64.97775411	0	0	0	0	86.89060041	0	0	0	0	0	10.55910099	1.245695022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	310.2286																																																																																				0	0	0	51.8126	0	44.45485026	0	15.70191283	21.56831245	0	6.747798419	6.269997509	64.97775411	0	0	0	0	86.89060041	0	0	0	0	0	10.55910099	1.245695022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	310.2286
H5206_002_0	2008	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		674.8724934		227.3470195		51.8027384	77.82989587		40.7632153	26.70457823	164.8309453					394.9449856						46.30990463	3.195149449																				Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co																				0.0847		0.1727		0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				57.1617	0	39.26283027	0	12.12184079	18.21219563	0	9.538592381	6.248871306	38.57044119	0	0	0	0	92.41712663	0	0	0	0	0	10.83651768	0.747664971	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	285.1178	0	0	57.1617	0	39.26283027	0	12.12184079	18.21219563	0	9.538592381	6.248871306	38.57044119	0	0	0	0	92.41712663	0	0	0	0	0	10.83651768	0.747664971	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	285.1178																																																																																				0	0	0	57.1617	0	39.26283027	0	12.12184079	18.21219563	0	9.538592381	6.248871306	38.57044119	0	0	0	0	92.41712663	0	0	0	0	0	10.83651768	0.747664971	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	285.1178
H5206_003_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		561.7721252		482.3263971		81.70156418	37.94658498		34.44535807	24.52462527	248.5748085					377.4457348						51.75473919	7.849303362																				Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co																				0.0788		0.1512		0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				44.2676	0	72.92775123	0	19.11816602	8.879500886	0	8.060213789	5.738762313	58.16650519	0	0	0	0	88.32230193	0	0	0	0	0	12.11060897	1.836736987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	319.4282	0	0	44.2676	0	72.92775123	0	19.11816602	8.879500886	0	8.060213789	5.738762313	58.16650519	0	0	0	0	88.32230193	0	0	0	0	0	12.11060897	1.836736987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	319.4282																																																																																				0	0	0	44.2676	0	72.92775123	0	19.11816602	8.879500886	0	8.060213789	5.738762313	58.16650519	0	0	0	0	88.32230193	0	0	0	0	0	12.11060897	1.836736987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	319.4282
H5207_001_0	2008	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		593.9424902		368.33153		48.76970709	93.07219018		47.51838433	14.51639106	239.9285404					466.0709351						69.34915466	22.48671019																				Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co																				0.079863124		0.175125362		0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				47.4341	0	64.50419268	0	11.41211146	21.7788925	0	11.11930193	3.396835509	56.14327845	0	0	0	0	109.0605988	0	0	0	0	0	16.22770219	5.261890184	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	346.3389	0	0	47.4341	0	64.50419268	0	11.41211146	21.7788925	0	11.11930193	3.396835509	56.14327845	0	0	0	0	109.0605988	0	0	0	0	0	16.22770219	5.261890184	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	346.3389																																																																																				0	0	0	47.4341	0	64.50419268	0	11.41211146	21.7788925	0	11.11930193	3.396835509	56.14327845	0	0	0	0	109.0605988	0	0	0	0	0	16.22770219	5.261890184	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	346.3389
H5209_002_0	2008	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		421.7876937		328.789249		35.38901621	19.74617961		20.77562452	18.33446678	167.8232002					440.1624168						25.33776787	24.88989731																				Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co																				0.0847		0.1727		0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				35.7254	0	56.78190331	0	8.281029792	4.620606029	0	4.861496138	4.290265226	39.27062886	0	0	0	0	102.9980055	0	0	0	0	0	5.929037681	5.82423597	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	268.5826	0	0	35.7254	0	56.78190331	0	8.281029792	4.620606029	0	4.861496138	4.290265226	39.27062886	0	0	0	0	102.9980055	0	0	0	0	0	5.929037681	5.82423597	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	268.5826																																																																																				0	0	0	35.7254	0	56.78190331	0	8.281029792	4.620606029	0	4.861496138	4.290265226	39.27062886	0	0	0	0	102.9980055	0	0	0	0	0	5.929037681	5.82423597	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	268.5826
H5211_001_0	2008	7																					$500 on all but ER; no limit on ER																		V							V	V	V								V		V																																																								0	POS available as on optional rider (see Wkst 7)								282.6517632							3222.510511	5684.329146	78.22471302								1.15889102		0.463556408															no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	$50 per visit if not admitted	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	$15 per visit	$15 per visit	$15 per visit	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	$15 per visit	no cost sharing	$15 per visit	no cost sharing	an optional benefit (see wkst 7)	no cost sharing	no cost sharing																		49.97215934							14.87766389	14.6690892	14.12184436								14.87766389		14.87766389															0	0	0	0	0	0	0	1.177059913	0	0	0	0	0	0	3.995285688	6.948660942	0.092056435	0	0	0	0	0	0	0	0.001436799	0	0.00057472	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.2151	0	0.193343677	0	0	0	0	0	0	0	1.177059913	0	0	0	0	0	0	3.995285688	6.948660942	0.092056435	0	0	0	0	0	0	0	0.001436799	0	0.00057472	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.2151	$500 on all but ER; no limit on ER																																																																																			0			0	0	0	0	0	0	0	1.177059913	0	0	0	0	0	0	3.995285688	6.948660942	0.092056435	0	0	0	0	0	0	0	0.001436799	0	0.00057472	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.2151
H5211_002_0	2008	7																					$2500 on all but ER; no limit on ER											D	D	D		T	Coin	Coin	V	V					V	V	V	V								V		V																																																								0		851.8266893	17.55692613	860.2161979		102.9761679	3.162894659	5.695996038	172.2639658	479.0299895					146.0339725	1924.172408	3399.448197	46.09812522								1.122438958		0.448975583															$150 each of days 1-5/admit	$150 each of days 1-5/admit	$50 for each of days 1-20/admit	no cost sharing	$50 per trip	20% coinsurance	20% coinsurance	$50 per visit if not admitted	$50 per visit	no cost sharing	no cost sharing	no cost sharing	no cost sharing	ASC $50/visit	$30 per visit	$30 per visit	$30 per visit	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	$30 per visit	no cost sharing	$30 per visit	no cost sharing	no cost sharing	no cost sharing	no cost sharing											89.07013238	43.95929535	88.16753833		41.13145769	0.170052238	0.170052238	49.96164522	33.1340555					40.72258376	28.73791487	27.88390396	28.2484196								28.73791487		28.73791487															6.3227	0.064315842	6.32026205	0	0.352963325	0.537857314	0.968616871	0.717215929	1.322683855	0	0	0	0	0.49557339	4.608058572	7.899157252	0.108516599	0	0	0	0	0	0	0	0.002688046	0	0.001075219	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7217	0	3.490355755	6.3227	0.064315842	6.32026205	0	0.352963325	0.537857314	0.968616871	0.717215929	1.322683855	0	0	0	0	0.49557339	4.608058572	7.899157252	0.108516599	0	0	0	0	0	0	0	0.002688046	0	0.001075219	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7217																																																																																				0			6.3227	0.064315842	6.32026205	0	0.352963325	0.537857314	0.968616871	0.717215929	1.322683855	0	0	0	0	0.49557339	4.608058572	7.899157252	0.108516599	0	0	0	0	0	0	0	0.002688046	0	0.001075219	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7217
H5211_003_0	2008	5																					$2500 on all but ER; no limit on ER											D	D	D		T	Coin	Coin	V	V					V	V	V	V								V		V																																																								0		851.8266893	17.55692613	860.2161979		102.9761679	3.162894659	5.695996038	172.2639658	479.0299895					146.0339725	1924.172408	3399.448197	46.09812522								1.122438958		0.448975583															$150 each of days 1-5/admit	$150 each of days 1-5/admit	$50 for each of days 1-20/admit	no cost sharing	$50 per trip	20% coinsurance	20% coinsurance	$50 per visit if not admitted	$50 per visit	no cost sharing	no cost sharing	no cost sharing	no cost sharing	ASC $50/visit	$30 per visit	$30 per visit	$30 per visit	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	$30 per visit	no cost sharing	$30 per visit	no cost sharing	no cost sharing	no cost sharing	no cost sharing											89.07013238	43.95929535	88.16753833		41.13145769	0.170052238	0.170052238	49.96164522	33.1340555					40.72258376	28.73791487	27.88390396	28.2484196								28.73791487		28.73791487															6.3227	0.064315842	6.32026205	0	0.352963325	0.537857314	0.968616871	0.717215929	1.322683855	0	0	0	0	0.49557339	4.608058572	7.899157252	0.108516599	0	0	0	0	0	0	0	0.002688046	0	0.001075219	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7217		3.490355755	6.3227	0.064315842	6.32026205	0	0.352963325	0.537857314	0.968616871	0.717215929	1.322683855	0	0	0	0	0.49557339	4.608058572	7.899157252	0.108516599	0	0	0	0	0	0	0	0.002688046	0	0.001075219	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7217																																																																																				0			6.3227	0.064315842	6.32026205	0	0.352963325	0.537857314	0.968616871	0.717215929	1.322683855	0	0	0	0	0.49557339	4.608058572	7.899157252	0.108516599	0	0	0	0	0	0	0	0.002688046	0	0.001075219	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7217
H5211_004_0	2008	7																					$500 on all but ER; no limit on ER																		V							V	V	V								V		V																																																								0	POS available as on optional rider (see Wkst 7)								282.6517632							3222.510511	5684.329146	78.22471302								1.15889102		0.463556408															no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	$50 per visit if not admitted	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	$15 per visit	$15 per visit	$15 per visit	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	$15 per visit	no cost sharing	$15 per visit	no cost sharing	an optional benefit (see wkst 7)	no cost sharing	no cost sharing																		49.97215934							14.87766389	14.6690892	14.12184436								14.87766389		14.87766389															0	0	0	0	0	0	0	1.177059913	0	0	0	0	0	0	3.995285688	6.948660942	0.092056435	0	0	0	0	0	0	0	0.001436799	0	0.00057472	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.2151	0	0.193343677	0	0	0	0	0	0	0	1.177059913	0	0	0	0	0	0	3.995285688	6.948660942	0.092056435	0	0	0	0	0	0	0	0.001436799	0	0.00057472	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.2151	$500 on all but ER; no limit on ER																																																																																			0			0	0	0	0	0	0	0	1.177059913	0	0	0	0	0	0	3.995285688	6.948660942	0.092056435	0	0	0	0	0	0	0	0.001436799	0	0.00057472	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.2151
H5214_003_0	2008	13	s.	t.									Other Non-Covered	Other Non-Covered									3000											D	D	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0	0	0	0									0		1582.580044	56.557605	492.037127	206.091995	68.936367	4.587624	1.569939	326.169469	385.194848	6058.424535	1419.965751		8.090048	516.344664	4681.029262	3536.106642	46.138039	293.542211			16.4683			6.06	2.99					3.4	0.02	0.08	0.18									$125/Day(Days 1-5)	$125/Day(Days 1-5)	$0/Day(Days 1-20) $50(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$100/Visit	$0-$50/Visit	$50/Visit		$0-$50/Proc	$25-$50/Visit	$0/Visit	$25/Visit	$25-$50/Visit	$50/Visit			20% Coins			Coin: 25%- 75%	EyeMed: $200 Allowance					Silver Sneakers	Quit Net	Humana Active Outlook	Meals On Wheels									71.184604	71.184697	10.142787	0	87.606741	0.175213	0.175213	43.803335	77.128469	7.451736	43.80335		14.616479	43.134255	0	21.901675	31.058977	43.803366			0.175213			0.355361596	0					0	0	0	0									9.3879	0.335502998	0.415885648	0	0.503274204	0.803811364	0.275073722	1.19060921	2.475790741	3.762148351	5.183271398	0	0.009854001	1.856011867	0	6.453888203	0.119416691	1.071511409	0	0	2.885460248	0	0	2.153491272	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8829	0	5.195941342	9.3879	0.335502998	0.415885648	0	0.503274204	0.803811364	0.275073722	1.19060921	2.475790741	3.762148351	5.183271398	0	0.009854001	1.856011867	0	6.453888203	0.119416691	1.071511409	0	0	2.885460248	0	0	2.153491272	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8829	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	25% Coins	25% Coins	25% Coins		$0-$50/Proc	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins			Coin: 50%- 80%						Silver Sneakers	Quit Net	Humana Active Outlook	Meals On Wheels									7.6028	0.0859	0.3743	0.5847	0.5033	1.7768	0.6081	0.2101	2.4818	0.6153	1.6595		0.0017	0.8296	2.5661	2.1111	0.0727	0.224			0.6743			1.95	0					0	0	0	0									24.9322	0	3.251175783	16.9908	0.421413632	0.790183522	0.584718654	1.006548414	2.580660966	0.883132553	1.400716358	4.957618467	4.377408453	6.842756933	0	0.011592994	2.685654325	2.566106247	8.564968755	0.192096961	1.2955086	0	0	3.559734851	0	0	4.103491272	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8151
H5214_004_0	2008	7	s.										Other Non-Covered										3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O	O	O										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0	0	0										0		298.016404	6.403769	509.606607	213.451051	71.397921	4.921093	1.684056	337.816207	398.94924	6274.756497	1470.669357		8.378924	534.78211	4848.177708	3662.372617	47.785519	304.023906			17.665361			6.2	2.99					3.4	0.02	0.08										$550/Admit	$550/Admit	$0/Day(Days 1-20) $100(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$100-$125/Visit	$0-$75/Visit	$50-$75/Visit		$0-$75/Proc	$30-$75/Visit	$5/Visit	$30/Visit	$30-$75/Visit	$75/Visit			20% Coins			Coin: 25%- 75%	EyeMed: $200 Allowance					Silver Sneakers	Quit Net	Humana Active Outlook										462.321743	462.321625	19.463994	0	84.058545	0.168117	0.168116	42.029264	95.019277	10.724895	63.043878		21.036184	61.888314	4.202924	25.217551	41.032838	63.043861			0.168116			0.35483871	0					0	0	0										11.4816	0.246716741	0.826581662	0	0.50013378	0.827319392	0.283116758	1.183180546	3.158989029	5.608008715	7.726391627	0	0.014688382	2.758063595	1.698043537	7.696339021	0.163397955	1.597236739	0	0	2.96982983	0	0	2.2	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.9397	0	9.243367438	11.4816	0.246716741	0.826581662	0	0.50013378	0.827319392	0.283116758	1.183180546	3.158989029	5.608008715	7.726391627	0	0.014688382	2.758063595	1.698043537	7.696339021	0.163397955	1.597236739	0	0	2.96982983	0	0	2.2	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.9397	5000	$850/Admit	$850/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$75/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			Coin: 50%- 80%						Silver Sneakers	Quit Net	Humana Active Outlook										3.1314	0.0673	0.4623	0.7222	0.5001	1.8288	0.6258	0.2088	3.0653	0.7599	2.0496		0.0026	1.0247	3.1694	2.6074	0.0898	0.2767			0.8328			2	0					0	0	0										23.4247	0	4.063152622	14.613	0.314003048	1.288873991	0.722181037	1.000267565	2.656130582	0.908956668	1.391976816	6.224274696	6.367911004	9.776007685	0	0.017280746	3.782745957	4.867420526	10.30371769	0.253164027	1.873894277	0	0	3.802620926	0	0	4.2	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3644
H5214_801_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		288.616461	6.201784	493.532749	206.718443	69.145909	4.615552	1.579496	327.160909	386.365705	6076.840022	1424.281948		8.114638	517.91417	4695.257952	3546.855167	46.278283	294.434475			16.568554																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214507	177.214169	28.944121	0	100.000015	0.199999	0.199999	49.999983	200.000018	37.551768	90.505007		33.367847	87.838639	20	30	59.267108	100.000015			0.2																					4.2623	0.091587	1.190405967	0	0.576215995	0.923105784	0.315897621	1.363169991	6.439428996	19.01634056	10.74205397	0	0.022564	3.791072984	7.82542992	8.867137918	0.228565	2.453620993	0	0	3.3137108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.4226	0	0	4.2623	0.091587	1.190405967	0	0.576215995	0.923105784	0.315897621	1.363169991	6.439428996	19.01634056	10.74205397	0	0.022564	3.791072984	7.82542992	8.867137918	0.228565	2.453620993	0	0	3.3137108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.4226		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.7312	0.0987	0.4298	0.6715	0.6627	1.2753	0.4364	0.7483	2.8502	0.7066	1.9058		0.013	0.9528	2.947	2.4244	0.0835	0.2572			0.7743																					25.9687	0	0	12.9935	0.190248	1.620254967	0.671499	1.238872995	2.198455784	0.752337621	2.111503991	9.289594996	19.72291456	12.64783097	0	0.035542	4.743845984	10.77238192	11.29153392	0.312032	2.710862993	0	0	4.0880578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.3912
H5214_803_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		288.616461	6.201784	493.532749	206.718443	69.145909	4.615552	1.579496	327.160909	386.365705	6076.840022	1424.281948		8.114638	517.91417	4695.257952	3546.855167	46.278283	294.434475			16.568554																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214507	177.214169	28.944121	0	100.000015	0.199999	0.199999	49.999983	200.000018	37.551768	90.505007		33.367847	87.838639	20	30	59.267108	100.000015			0.2																					4.2623	0.091587	1.190405967	0	0.576215995	0.923105784	0.315897621	1.363169991	6.439428996	19.01634056	10.74205397	0	0.022564	3.791072984	7.82542992	8.867137918	0.228565	2.453620993	0	0	3.3137108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.4226	0	0	4.2623	0.091587	1.190405967	0	0.576215995	0.923105784	0.315897621	1.363169991	6.439428996	19.01634056	10.74205397	0	0.022564	3.791072984	7.82542992	8.867137918	0.228565	2.453620993	0	0	3.3137108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.4226		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.7312	0.0987	0.4298	0.6715	0.6627	1.2753	0.4364	0.7483	2.8502	0.7066	1.9058		0.013	0.9528	2.947	2.4244	0.0835	0.2572			0.7743																					25.9687	0	0	12.9935	0.190248	1.620254967	0.671499	1.238872995	2.198455784	0.752337621	2.111503991	9.289594996	19.72291456	12.64783097	0	0.035542	4.743845984	10.77238192	11.29153392	0.312032	2.710862993	0	0	4.0880578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.3912
H5214_804_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		288.616461	6.201784	493.532749	206.718443	69.145909	4.615552	1.579496	327.160909	386.365705	6076.840022	1424.281948		8.114638	517.91417	4695.257952	3546.855167	46.278283	294.434475			16.568554																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214507	177.214169	28.944121	0	100.000015	0.199999	0.199999	49.999983	200.000018	37.551768	90.505007		33.367847	87.838639	20	30	59.267108	100.000015			0.2																					4.2623	0.091587	1.190405967	0	0.576215995	0.923105784	0.315897621	1.363169991	6.439428996	19.01634056	10.74205397	0	0.022564	3.791072984	7.82542992	8.867137918	0.228565	2.453620993	0	0	3.3137108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.4226	0	0	4.2623	0.091587	1.190405967	0	0.576215995	0.923105784	0.315897621	1.363169991	6.439428996	19.01634056	10.74205397	0	0.022564	3.791072984	7.82542992	8.867137918	0.228565	2.453620993	0	0	3.3137108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.4226		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.7312	0.0987	0.4298	0.6715	0.6627	1.2753	0.4364	0.7483	2.8502	0.7066	1.9058		0.013	0.9528	2.947	2.4244	0.0835	0.2572			0.7743																					25.9687	0	0	12.9935	0.190248	1.620254967	0.671499	1.238872995	2.198455784	0.752337621	2.111503991	9.289594996	19.72291456	12.64783097	0	0.035542	4.743845984	10.77238192	11.29153392	0.312032	2.710862993	0	0	4.0880578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.3912
H5214_805_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		288.616461	6.201784	493.532749	206.718443	69.145909	4.615552	1.579496	327.160909	386.365705	6076.840022	1424.281948		8.114638	517.91417	4695.257952	3546.855167	46.278283	294.434475			16.568554																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214507	177.214169	28.944121	0	100.000015	0.199999	0.199999	49.999983	200.000018	37.551768	90.505007		33.367847	87.838639	20	30	59.267108	100.000015			0.2																					4.2623	0.091587	1.190405967	0	0.576215995	0.923105784	0.315897621	1.363169991	6.439428996	19.01634056	10.74205397	0	0.022564	3.791072984	7.82542992	8.867137918	0.228565	2.453620993	0	0	3.3137108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.4226	0	0	4.2623	0.091587	1.190405967	0	0.576215995	0.923105784	0.315897621	1.363169991	6.439428996	19.01634056	10.74205397	0	0.022564	3.791072984	7.82542992	8.867137918	0.228565	2.453620993	0	0	3.3137108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.4226		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.7312	0.0987	0.4298	0.6715	0.6627	1.2753	0.4364	0.7483	2.8502	0.7066	1.9058		0.013	0.9528	2.947	2.4244	0.0835	0.2572			0.7743																					25.9687	0	0	12.9935	0.190248	1.620254967	0.671499	1.238872995	2.198455784	0.752337621	2.111503991	9.289594996	19.72291456	12.64783097	0	0.035542	4.743845984	10.77238192	11.29153392	0.312032	2.710862993	0	0	4.0880578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.3912
H5215_001_0	2008	4																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0.943099261	4.209812937	0.616544796	233.3072914	0	2885.221436	1581.658372	0	0	1151.547067	8971.746711	3602.06215	90.4145161	165.6574354	0	0	0.00021517	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $0	1B IP Psych: $0	2 SNF: $0	6 Home Health: $0	10A Ambulance: $25	11A DME: 10%	"11B Prosthetics/Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: $10"	"4A ER: $50, 4B Urgent Care: $10"	9B ASC Services: $0	8A: Lab $5	"8B: CAT, MRI = $50; 8B OP X-Ray: $5"	9A OP Hospital: $0	12 Renal Dialysis: $10 copay (not for facility)	"3 CORF: $10, 9C OP Sub Abuse:  $10, 9D Cardiac Rehab: $10"	"7A PCP: $5, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $10, 7D Physician Specialist: $10, 7F Podiatry: $10, 7G Other Health Care: $5, 18A Medicare Covered Hearing Exams: $5"	"7E Mental Health: $10, 7H Psychiatric: $10"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	Included in i.1.	Included in i.2.	"15 Part B Drugs: 10% coins, 1000 OOP max"	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10, 17A Medicare Covered Eye Exams: $10"	10B Transportation: Not Covered	16A Preventive Dental Services: Not Covered	17A: Eye Exams: $10	"17B Eye Wear: $10, $100 Annual max plan coverage"	18A Routine Hearing Exams: $10	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	25	0.1	0.1	50	0	5	9	0	10	10	5	10	10	10	10	10	0.1	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0.00196479	0.420981294	0.06165448	0.972113714	0	1.202175598	1.186243779	0	0	0.959622556	3.738227796	3.001718459	0.07534543	0.138047863	0	0	2.15E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.7581	0	0	0	0	0	0	0.00196479	0.420981294	0.06165448	0.972113714	0	1.202175598	1.186243779	0	0	0.959622556	3.738227796	3.001718459	0.07534543	0.138047863	0	0	2.15E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.7581	1000	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0.4144	0.0103	0.0203	0.0003	0.2024	0.6	0.0803	0.212	0.3142	0.1321	0.3048	0	0	0.217	1.1325	1.3808	0.0703	0.1046	0	0	0.0115	0	0	0	0	0	0	0	0	0	0											5.2077	0	0	0.4144	0.010258914	0.020318786	0.000273936	0.204346203	1.020968155	0.141994197	1.184135067	0.314165265	1.334309093	1.491000712	0	0	1.176578727	4.870730708	4.382552222	0.145650746	0.242672766	0	0	0.011474046	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.9658
H5215_002_0	2008	5																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0.943099261	4.209812937	0.616544796	233.3072914	0	2885.221436	1581.658372	0	0	1151.547067	8971.746711	3602.06215	90.4145161	165.6574354	0	0	0.00021517	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $0	1B IP Psych: $0	2 SNF: $0	6 Home Health: $0	10A Ambulance: $25	11A DME: 10%	"11B Prosthetics/Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: $10"	"4A ER: $50, 4B Urgent Care: $10"	9B ASC Services: $0	8A: Lab $5	"8B: CAT, MRI = $50; 8B OP X-Ray: $5"	9A OP Hospital: $0	12 Renal Dialysis: $10 copay (not for facility)	"3 CORF: $10, 9C OP Sub Abuse:  $10, 9D Cardiac Rehab: $10"	"7A PCP: $5, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $10, 7D Physician Specialist: $10, 7F Podiatry: $10, 7G Other Health Care: $5, 18A Medicare Covered Hearing Exams: $5"	"7E Mental Health: $10, 7H Psychiatric: $10"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	Included in i.1.	Included in i.2.	"15 Part B Drugs: 10% coins, 1000 OOP max"	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10, 17A Medicare Covered Eye Exams: $10"	10B Transportation: Not Covered	16A Preventive Dental Services: Not Covered	17A: Eye Exams: $10	"17B Eye Wear: $10, $100 Annual max plan coverage"	18A Routine Hearing Exams: $10	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	25	0.1	0.1	50	0	5	9	0	10	10	5	10	10	10	10	10	0.1	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0.00196479	0.420981294	0.06165448	0.972113714	0	1.202175598	1.186243779	0	0	0.959622556	3.738227796	3.001718459	0.07534543	0.138047863	0	0	2.15E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.7581	0	0	0	0	0	0	0.00196479	0.420981294	0.06165448	0.972113714	0	1.202175598	1.186243779	0	0	0.959622556	3.738227796	3.001718459	0.07534543	0.138047863	0	0	2.15E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.7581	1000	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0.4144	0.0103	0.0203	0.0003	0.2024	0.6	0.0803	0.212	0.3142	0.1321	0.3048	0	0	0.217	1.1325	1.3808	0.0703	0.1046	0	0	0.0115	0	0	0	0	0	0	0	0	0	0											5.2077	0	0	0.4144	0.010258914	0.020318786	0.000273936	0.204346203	1.020968155	0.141994197	1.184135067	0.314165265	1.334309093	1.491000712	0	0	1.176578727	4.870730708	4.382552222	0.145650746	0.242672766	0	0	0.011474046	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.9658
H5215_005_0	2008	5																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	1.254065511	778.1760972	22.14973976	385.3000067	0	3970.358582	2175.265933	0	0	1442.703486	12051.76999	4838.659174	125.2984018	229.571675	0	0	0	0	0	0	0	0	0	0	0	0	0											No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	Not Covered	Not Covered	Routine Exams Bi-Annually - No Cost Share	$50 Benefit Bi-Annually	No Cost Share	Not Covered	Not Covered	No Cost Share	Not Covered											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1000	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0.3807	0.0129	0.0128	0.0003	0.2691	0.379	0.0508	0	0.3936	0.0909	0.2515	0	0	0.1812	0.7606	1.2366	0.065	0.0967	0	0	0.0072	0	0	0	0	0	0	0	0	0	0											4.1889	0	0	0.3807	0.012852772	0.012781998	0.000343198	0.269112235	0.379027414	0.050752704	0	0.393598609	0.090914574	0.251480617	0	0	0.181207487	0.760647009	1.236584985	0.064953757	0.096660977	0	0	0.007232432	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1889
H5215_006_0	2008	4																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	1.254065511	778.1760972	22.14973976	385.3000067	0	3970.358582	2175.265933	0	0	1442.703486	12051.76999	4838.659174	125.2984018	229.571675	0	0	0	0	0	0	0	0	109.7	17.6	0	0	0											No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	No Cost Share	Not Covered	Not Covered	Routine Exams Annually - No Cost Share	$100 Benefit Annually	Routine Hearing Covered	$100 Benefit Annually	Not Covered	No Cost Share	Not Covered											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1000	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0.3807	0.0129	0.0128	0.0003	0.2691	0.379	0.0508	0	0.3936	0.0909	0.2515	0	0	0.1812	0.7606	1.2366	0.065	0.0967	0	0	0.0072	0	0	0	0	0	0	0	0	0	0											4.1889	0	0	0.3807	0.012852772	0.012781998	0.000343198	0.269112235	0.379027414	0.050752704	0	0.393598609	0.090914574	0.251480617	0	0	0.181207487	0.760647009	1.236584985	0.064953757	0.096660977	0	0	0.007232432	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1889
H5215_007_0	2008	6																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	286.58	23.71	126.51	21.46	13	20.85	19.18	9.87	24.28	14.79	27.04	13.51	0.23	45.82	46.35	92.56	7	3.92	18.31	32.78	10.82	3.33	0	12.25	0	0	0	0	0	0	18.79											Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing											0.084698982	0.084695081	0.172697555	0	0.23406711	0.234000431	0.233988268	0.233883232	0.23400001	0.233932522	0.234069735	0.234000089	0.234000011	0.234006101	0.234009871	0.234000131	0.233997846	0.234037302	0.233995472	0.233998762	0.233993677	0.234004755	0	0	0	0	0	0	0	0	0											24.273	2.008120373	21.84796767	0	3.042872436	4.878908993	4.487894971	2.308427504	5.681520242	3.459861997	6.329245636	3.161341198	0.053820003	10.72215953	10.8463575	21.6590521	1.637984924	0.917426224	4.284457095	7.670479428	2.531811587	0.779235835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.582	0	0	24.273	2.008120373	21.84796767	0	3.042872436	4.878908993	4.487894971	2.308427504	5.681520242	3.459861997	6.329245636	3.161341198	0.053820003	10.72215953	10.8463575	21.6590521	1.637984924	0.917426224	4.284457095	7.670479428	2.531811587	0.779235835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.273	2.008120373	21.84796767	0	3.042872436	4.878908993	4.487894971	2.308427504	5.681520242	3.459861997	6.329245636	3.161341198	0.053820003	10.72215953	10.8463575	21.6590521	1.637984924	0.917426224	4.284457095	7.670479428	2.531811587	0.779235835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.582
H5215_801_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	174.8442593	0.945887439	18.681744	7.178242147	3.859778413	9.28481292	0	15.38473199	37.49008415	13.76308523	24.28051703	0	0	18.74767934	36.27490162	101.2653975	1.101030445	1.656766406	0	28.02080487	0.058833217	0.042731762	0	0	0	0	0	0	0	0	0											Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing											0.084703498	0.084819218	0.172717832	0	0.233920867	0.234000616	0.234030086	0.234	0.234000016	0.234011927	0.234073707	0.234	0.234000005	0.234061651	0.233996071	0.233996071	0.234001788	0.234045125	0.234016565	0.233985832	0.234002827	0.233991905	0	0	0	0	0	0	0	0	0											14.8099	0.080229432	3.226670316	0	0.902882713	2.172651939	0	3.600027286	8.772680309	3.220726099	5.683430631	0	0	4.388112788	8.488184454	23.69570514	0.257643093	0.387758101	0	6.556471344	0.013767139	0.009998886	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.2669	0	0	14.8099	0.080229432	3.226670316	0	0.902882713	2.172651939	0	3.600027286	8.772680309	3.220726099	5.683430631	0	0	4.388112788	8.488184454	23.69570514	0.257643093	0.387758101	0	6.556471344	0.013767139	0.009998886	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.2669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.8099	0.080229432	3.226670316	0	0.902882713	2.172651939	0	3.600027286	8.772680309	3.220726099	5.683430631	0	0	4.388112788	8.488184454	23.69570514	0.257643093	0.387758101	0	6.556471344	0.013767139	0.009998886	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.2669
H5215_804_0	2008	3																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	174.8442593	0.945887439	18.681744	7.178242147	3.859778413	9.28481292	0	15.38473199	37.49008415	13.76308523	24.28051703	0	0	18.74767934	36.27490162	101.2653975	1.101030445	1.656766406	0	28.02080487	0.058833217	0.042731762	0	0	0	0	0	0	0	0	0											Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing											0.084703498	0.084819218	0.172717832	0	0.233920867	0.234000616	0.234030086	0.234	0.234000016	0.234011927	0.234073707	0.234	0.234000005	0.234061651	0.233996071	0.233996071	0.234001788	0.234045125	0.234016565	0.233985832	0.234002827	0.233991905	0	0	0	0	0	0	0	0	0											14.8099	0.080229432	3.226670316	0	0.902882713	2.172651939	0	3.600027286	8.772680309	3.220726099	5.683430631	0	0	4.388112788	8.488184454	23.69570514	0.257643093	0.387758101	0	6.556471344	0.013767139	0.009998886	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.2669	0	0	14.8099	0.080229432	3.226670316	0	0.902882713	2.172651939	0	3.600027286	8.772680309	3.220726099	5.683430631	0	0	4.388112788	8.488184454	23.69570514	0.257643093	0.387758101	0	6.556471344	0.013767139	0.009998886	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.2669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.8099	0.080229432	3.226670316	0	0.902882713	2.172651939	0	3.600027286	8.772680309	3.220726099	5.683430631	0	0	4.388112788	8.488184454	23.69570514	0.257643093	0.387758101	0	6.556471344	0.013767139	0.009998886	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.2669
H5215_805_0	2008	3																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	174.8442593	0.945887439	18.681744	7.178242147	3.859778413	9.28481292	0	15.38473199	37.49008415	13.76308523	24.28051703	0	0	18.74767934	36.27490162	101.2653975	1.101030445	1.656766406	0	28.02080487	0.058833217	0.042731762	0	0	0	0	0	0	0	0	0											Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing											0.084703498	0.084819218	0.172717832	0	0.233920867	0.234000616	0.234030086	0.234	0.234000016	0.234011927	0.234073707	0.234	0.234000005	0.234061651	0.233996071	0.233996071	0.234001788	0.234045125	0.234016565	0.233985832	0.234002827	0.233991905	0	0	0	0	0	0	0	0	0											14.8099	0.080229432	3.226670316	0	0.902882713	2.172651939	0	3.600027286	8.772680309	3.220726099	5.683430631	0	0	4.388112788	8.488184454	23.69570514	0.257643093	0.387758101	0	6.556471344	0.013767139	0.009998886	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.2669	0	0	14.8099	0.080229432	3.226670316	0	0.902882713	2.172651939	0	3.600027286	8.772680309	3.220726099	5.683430631	0	0	4.388112788	8.488184454	23.69570514	0.257643093	0.387758101	0	6.556471344	0.013767139	0.009998886	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.2669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.8099	0.080229432	3.226670316	0	0.902882713	2.172651939	0	3.600027286	8.772680309	3.220726099	5.683430631	0	0	4.388112788	8.488184454	23.69570514	0.257643093	0.387758101	0	6.556471344	0.013767139	0.009998886	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.2669
H5216_001_0	2008	12	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)									Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O	O	V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0	0	0	0	0								0		281.81	6.05	481.9	201.85	67.51	4.4	1.51	319.45	377.25	5933.67	2594.06		7.92	505.69	4617.74	3458.34	18.89	431.28			15.79			4.53	2.99					0.02	0.06	26.29	0.08	3.38								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$50/Visit	$50/Visit			20% Coins			DEN 749	$200 Allowance					QuitNet	Meals on Wheels	$30/Visit	Active Outlook	Silver Sneakers								549.99999	550.000223	28.71257	0	100.000059	0.2	0.2	49.999996	85.431633	0	49.999996		16.667081	49.389206	9.999999	30	49.99996	49.999988			0.2			0	0					0	0	29.999922	0	0								12.9163	0.277291779	1.153048957	0	0.562583665	0.88	0.302	1.33104156	2.685756962	0	10.80858247	0	0.011000273	2.081302299	3.848116282	8.64585	0.07870827	1.796999569	0	0	3.158	0	0	0	0	0	0	0	0	0	0	0.065724829	0	0	0	0	0	0	0	0	0	50.6023	0	0	12.9163	0.277291779	1.153048957	0	0.562583665	0.88	0.302	1.33104156	2.685756962	0	10.80858247	0	0.011000273	2.081302299	3.848116282	8.64585	0.07870827	1.796999569	0	0	3.158	0	0	0	0	0	0	0	0	0	0	0.065724829	0	0	0	0	0	0	0	0	0	50.6023		$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	30% Coins	30% Coins			30% Coins			DEN 749	$200 Allowance					QuitNet	Meals on Wheels	$35/Visit	Active Outlook	Silver Sneakers								4.1738	0.0896	0.6189	0.9667	0.7083	1.8355	0.6285	0.2957	4.1046	1.0175	2.7435		0.0024	1.3704	4.0532	4.0968	0.047	0.3703			1.115			0	0					0	0	0.0965	0	0								28.3342	500	1.714491825	17.0901	0.366876779	1.771947957	0.966711	1.270855665	2.715506	0.930452	1.62674156	6.790352962	1.017531	13.55211147	0	0.013444273	3.451684299	7.901291282	12.742697	0.12566227	2.167280569	0	0	4.273005	0	0	0	0	0	0	0	0	0	0	0.162271829	0	0	0	0	0	0	0	0	0	78.9365
H5216_003_0	2008	10	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)									Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		278.43	5.98	476.12	199.43	66.7	4.29	1.47	315.62	372.73	5862.53	2562.96		7.82	499.63	4562.38	3416.88	18.66	426.11			15.42			5.53	2.99					0.02		25.98	0.08	3.38								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$50/Visit	$50/Visit			20% Coins			DEN 749	$200 Allowance					QuitNet		$30/Visit	Active Outlook	Silver Sneakers								549.99999	549.999799	28.712566	0	99.999913	0.2	0.199999	49.999986	85.431655	0	50		16.666843	49.389176	9.999999	30.000001	50.000318	49.999991			0.2			0	0					0		29.999972	0	0								12.7614	0.274083233	1.13921891	0	0.55583285	0.858	0.29399853	1.315082965	2.653578397	0	10.679	0	0.010861226	2.0563595	3.801982953	8.542200285	0.077750494	1.775458014	0	0	3.084	0	0	0	0	0	0	0	0	0	0	0.064949939	0	0	0	0	0	0	0	0	0	49.9437	0	0	12.7614	0.274083233	1.13921891	0	0.55583285	0.858	0.29399853	1.315082965	2.653578397	0	10.679	0	0.010861226	2.0563595	3.801982953	8.542200285	0.077750494	1.775458014	0	0	3.084	0	0	0	0	0	0	0	0	0	0	0.064949939	0	0	0	0	0	0	0	0	0	49.9437		$750/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	30% Coins	30% Coins			30% Coins			DEN 749	$200 Allowance					QuitNet		$35/Visit	Active Outlook	Silver Sneakers								3.8858	0.089	0.6072	0.9485	0.7034	1.8009	0.6166	0.2936	4.0272	0.9984	2.6918		0.0024	1.3445	4.025	4.0684	0.0461	0.3633			1.094			0	0					0		0.0959	0	0								27.702	500	1.701326633	16.6471	0.363046233	1.74645091	0.948489	1.25918585	2.658906	0.91060353	1.608727965	6.680802397	0.998351	13.370816	0	0.013287226	3.4009085	7.827011953	12.61059828	0.123819494	2.138760014	0	0	4.177987	0	0	0	0	0	0	0	0	0	0	0.160826939	0	0	0	0	0	0	0	0	0	77.6457
H5216_801_0	2008	2																					100											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		280.2	6.01	479.14	200.69	67.13	4.37	1.5	317.62	375.09	5899.71	2579.22		7.87	502.8	4583.3	3433.21	44.92	428.81			15.81																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					189.5949	189.595036	6.097396	0	21.066115	0.042132	0.042132	10.533051	42.132204	7.910692	19.993761		7.02217	18.504285	4.21322	6.319829	12.484433	21.066098			0.042132																					4.427	0.094955514	0.24345886	0	0.117847358	0.18411684	0.063198	0.278792305	1.316947367	3.889232392	4.297359021	0	0.004605373	0.775329542	1.609204269	1.808108343	0.046733394	0.752779457	0	0	0.66610692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.5758	0	77.0964972	4.427	0.094955514	0.24345886	0	0.117847358	0.18411684	0.063198	0.278792305	1.316947367	3.889232392	4.297359021	0	0.004605373	0.775329542	1.609204269	1.808108343	0.046733394	0.752779457	0	0	0.66610692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.5758	500	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					1.78	0.0201	0.0858	0.134	0.1323	0.2545	0.0871	0.1504	0.5719	0.1416	0.3829		0.0025	0.1913	0.5858	0.4823	0.0164	0.0517			0.1556																					5.2261	0	19.58186824	6.207	0.115021514	0.32926886	0.134035	0.250154358	0.43860984	0.150333	0.429192305	1.888816367	4.030820392	4.680287021	0	0.007083373	0.966591542	2.194987269	2.290374343	0.063117394	0.804461457	0	0	0.82173392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.8019
H5216_802_0	2008	2																					100											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		280.2	6.01	479.14	200.69	67.13	4.37	1.5	317.62	375.09	5899.71	2579.22		7.87	502.8	4583.3	3433.21	44.92	428.81			15.81																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					189.5949	189.595036	6.097396	0	21.066115	0.042132	0.042132	10.533051	42.132204	7.910692	19.993761		7.02217	18.504285	4.21322	6.319829	12.484433	21.066098			0.042132																					4.427	0.094955514	0.24345886	0	0.117847358	0.18411684	0.063198	0.278792305	1.316947367	3.889232392	4.297359021	0	0.004605373	0.775329542	1.609204269	1.808108343	0.046733394	0.752779457	0	0	0.66610692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.5758	0	77.0964972	4.427	0.094955514	0.24345886	0	0.117847358	0.18411684	0.063198	0.278792305	1.316947367	3.889232392	4.297359021	0	0.004605373	0.775329542	1.609204269	1.808108343	0.046733394	0.752779457	0	0	0.66610692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.5758	500	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					1.78	0.0201	0.0858	0.134	0.1323	0.2545	0.0871	0.1504	0.5719	0.1416	0.3829		0.0025	0.1913	0.5858	0.4823	0.0164	0.0517			0.1556																					5.2261	0	19.58186824	6.207	0.115021514	0.32926886	0.134035	0.250154358	0.43860984	0.150333	0.429192305	1.888816367	4.030820392	4.680287021	0	0.007083373	0.966591542	2.194987269	2.290374343	0.063117394	0.804461457	0	0	0.82173392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.8019
H5216_803_0	2008	2																					100											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		280.2	6.01	479.14	200.69	67.13	4.37	1.5	317.62	375.09	5899.71	2579.22		7.87	502.8	4583.3	3433.21	44.92	428.81			15.81																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					189.5949	189.595036	6.097396	0	21.066115	0.042132	0.042132	10.533051	42.132204	7.910692	19.993761		7.02217	18.504285	4.21322	6.319829	12.484433	21.066098			0.042132																					4.427	0.094955514	0.24345886	0	0.117847358	0.18411684	0.063198	0.278792305	1.316947367	3.889232392	4.297359021	0	0.004605373	0.775329542	1.609204269	1.808108343	0.046733394	0.752779457	0	0	0.66610692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.5758	0	77.0964972	4.427	0.094955514	0.24345886	0	0.117847358	0.18411684	0.063198	0.278792305	1.316947367	3.889232392	4.297359021	0	0.004605373	0.775329542	1.609204269	1.808108343	0.046733394	0.752779457	0	0	0.66610692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.5758	500	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					1.78	0.0201	0.0858	0.134	0.1323	0.2545	0.0871	0.1504	0.5719	0.1416	0.3829		0.0025	0.1913	0.5858	0.4823	0.0164	0.0517			0.1556																					5.2261	0	19.58186824	6.207	0.115021514	0.32926886	0.134035	0.250154358	0.43860984	0.150333	0.429192305	1.888816367	4.030820392	4.680287021	0	0.007083373	0.966591542	2.194987269	2.290374343	0.063117394	0.804461457	0	0	0.82173392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.8019
H5216_804_0	2008	2																					100											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		280.2	6.01	479.14	200.69	67.13	4.37	1.5	317.62	375.09	5899.71	2579.22		7.87	502.8	4583.3	3433.21	44.92	428.81			15.81																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					189.5949	189.595036	6.097396	0	21.066115	0.042132	0.042132	10.533051	42.132204	7.910692	19.993761		7.02217	18.504285	4.21322	6.319829	12.484433	21.066098			0.042132																					4.427	0.094955514	0.24345886	0	0.117847358	0.18411684	0.063198	0.278792305	1.316947367	3.889232392	4.297359021	0	0.004605373	0.775329542	1.609204269	1.808108343	0.046733394	0.752779457	0	0	0.66610692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.5758	0	77.0964972	4.427	0.094955514	0.24345886	0	0.117847358	0.18411684	0.063198	0.278792305	1.316947367	3.889232392	4.297359021	0	0.004605373	0.775329542	1.609204269	1.808108343	0.046733394	0.752779457	0	0	0.66610692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.5758	500	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					1.78	0.0201	0.0858	0.134	0.1323	0.2545	0.0871	0.1504	0.5719	0.1416	0.3829		0.0025	0.1913	0.5858	0.4823	0.0164	0.0517			0.1556																					5.2261	0	19.58186824	6.207	0.115021514	0.32926886	0.134035	0.250154358	0.43860984	0.150333	0.429192305	1.888816367	4.030820392	4.680287021	0	0.007083373	0.966591542	2.194987269	2.290374343	0.063117394	0.804461457	0	0	0.82173392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.8019
H5227_001_0	2008	6																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	Coin	P	P																																																				0	0	1722.48629	155.6922571	872.6142904		174.9703668	13.99203995	13.33503544	348.7709656	309.3854056	1251.784109	427.7940599	43.40746692	0.700955418	605.5497888	3761.739877	4484.259776	474.1372487	605.2946394	4508.386792	7926.530599	25.74979925			1244.330761	144		249															1a:$180 1-5; 1a1:$180 1-5;	1b:$180 1-5;	2a:$92 4-38; 2a2:$92 4-38;		10a:$150;	11a:20%;	11b:20%; 11c:20%;	4a:$50; 4b:$50;	9b:$90;	8a:$5;	8b:$15-50;20%;	9a:$90;	12:20%;	3:20%; 5:$60; 9a:$90; 9c:$35; 9d:$30;	7a:$15;	7b:$35; 7d:$30; 7f:$30; 17a:$30; 18a:$30;	7e:$35; 7h:$35;	7c:$30; 7i:$30;	8b:$15-50;20%;	7g:$15-30;	15:20%;			16a:50%;	17a1:$30;		18a1:$30;															106.3877	81.8256	57.2721		76.7035	0.170452163	0.170452163	42.613	76.7035	4.2613	40.836	76.7035	0.170452163	27.8318	12.7863	25.9515	29.8294	25.5678	8.0684	1.2215	0.170452163			22.3145	25.5678		25.5678															15.2709	1.061633855	4.164706526	0	1.118402905	2.384973475	2.272985634	1.238515947	1.977577935	0.444519394	1.455781981	0.277458624	0.119479367	1.404463862	4.008227572	9.697767516	1.178604444	1.289672257	3.031301827	0.806887478	4.389108979	0	0	2.313888113	0.306813893	0	0.530532357	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7443	0	10.53	15.2709	1.061633855	4.164706526	0	1.118402905	2.384973475	2.272985634	1.238515947	1.977577935	0.444519394	1.455781981	0.277458624	0.119479367	1.404463862	4.008227572	9.697767516	1.178604444	1.289672257	3.031301827	0.806887478	4.389108979	0	0	2.313888113	0.306813893	0	0.530532357	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7443																																																																																				0	0	0	15.2709	1.061633855	4.164706526	0	1.118402905	2.384973475	2.272985634	1.238515947	1.977577935	0.444519394	1.455781981	0.277458624	0.119479367	1.404463862	4.008227572	9.697767516	1.178604444	1.289672257	3.031301827	0.806887478	4.389108979	0	0	2.313888113	0.306813893	0	0.530532357	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7443
H5227_002_0	2008	5																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	P	T	Coin	V	P	V	P	Coin	P	P																																																				0	0	1821.476092	163.2083312	913.159302		188.7501326	13.95286781	13.69959614	358.3163647	327.8735925	1261.365874	465.2888346	58.42437479	0.618701632	733.6444005	3620.899702	4522.173119	526.5367867	635.5571514	4616.688696	7982.572657	24.87288614			5.43	144		249															1a:$180 1-5; 1a1:$180 1-5;	1b:$180 1-5;	2a:$92 4-38; 2a2:$92 4-38;		10a:$150;	11a:20%;	11b:20%; 11c:20%;	4a:$50; 4b:$50;	9b:$90;	8a:$5;	8b:$15-50;20%;	9a:$90;	12:20%;	3:20%; 5:$60; 9a:$90; 9c:$35; 9d:$30;	7a:$15;	7b:$35; 7d:$30; 7f:$30; 17a:$30; 18a:$30;	7e:$35; 7h:$35;	7c:$30; 7i:$30;	8b:$15-50;20%;	7g:$15-30;	15:20%;			16a:50%;	17a1:$30;		18a1:$30;															105.8571	79.8915	56.7999		76.0711	0.169046848	0.169046848	42.2617	76.0711	4.2262	41.0445	76.0711	0.169046848	26.8493	12.6802	25.697	29.5833	25.357	7.9739	1.2264	0.169046848			0.42261712	25.357		25.357															16.068	1.086580414	4.322282917	0	1.196535561	2.358688322	2.315873545	1.261921917	2.0784749	0.44422901	1.591462992	0.370367115	0.104589561	1.641488959	3.826144801	9.683860071	1.298056119	1.342986664	3.067767235	0.815822565	4.204683	0	0	2.29481096	0.304284326	0	0.526158314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2051	0	11.39	16.068	1.086580414	4.322282917	0	1.196535561	2.358688322	2.315873545	1.261921917	2.0784749	0.44422901	1.591462992	0.370367115	0.104589561	1.641488959	3.826144801	9.683860071	1.298056119	1.342986664	3.067767235	0.815822565	4.204683	0	0	2.29481096	0.304284326	0	0.526158314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2051																																																																																				0	0	0	16.068	1.086580414	4.322282917	0	1.196535561	2.358688322	2.315873545	1.261921917	2.0784749	0.44422901	1.591462992	0.370367115	0.104589561	1.641488959	3.826144801	9.683860071	1.298056119	1.342986664	3.067767235	0.815822565	4.204683	0	0	2.29481096	0.304284326	0	0.526158314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2051
H5227_801_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	279.9502046	5.799325459	32.50836494		7.609448133	11.49613416	12.04604242	13.89108623	46.36444814	6.874349981	20.98960026	3.513845989	0.392421019	23.95679598	35.42233949	114.9119924	3.308200069	13.88213265	34.09340107	18.15915508	28.44083959																					MEDICARE FFS	MEDICARE FFS	MEDICARE FFS		MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS																					0.077354942	0.077354942	0.188446115		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					21.6555	0.448606482	6.126075093	0	1.780610863	2.690095392	2.818773926	3.250514179	10.84928086	1.608597896	4.911566462	0.822239961	0.091826518	5.605890259	8.288827441	26.88940623	0.774118816	3.248419041	7.977855851	4.249242288	6.655156463	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7426	0	0	21.6555	0.448606482	6.126075093	0	1.780610863	2.690095392	2.818773926	3.250514179	10.84928086	1.608597896	4.911566462	0.822239961	0.091826518	5.605890259	8.288827441	26.88940623	0.774118816	3.248419041	7.977855851	4.249242288	6.655156463	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7426																																																																																				0	0	0	21.6555	0.448606482	6.126075093	0	1.780610863	2.690095392	2.818773926	3.250514179	10.84928086	1.608597896	4.911566462	0.822239961	0.091826518	5.605890259	8.288827441	26.88940623	0.774118816	3.248419041	7.977855851	4.249242288	6.655156463	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7426
H5227_802_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	279.9502053	5.799325474	32.50836502		7.609448152	11.49613418	12.04604245	13.89108627	46.36444825	6.874349998	20.98960032	3.513845998	0.39242102	23.95679604	35.42233958	114.9119927	3.308200078	13.88213269	34.09340116	18.15915512	28.44083966																					MEDICARE FFS	MEDICARE FFS	MEDICARE FFS		MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS																					0.077354941	0.077354941	0.188446116		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					21.6555	0.448606482	6.126075109	0	1.780610868	2.690095399	2.818773933	3.250514187	10.84928089	1.6085979	4.911566474	0.822239963	0.091826519	5.605890273	8.288827461	26.8894063	0.774118818	3.248419049	7.977855871	4.249242299	6.65515648	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7426	0	0	21.6555	0.448606482	6.126075109	0	1.780610868	2.690095399	2.818773933	3.250514187	10.84928089	1.6085979	4.911566474	0.822239963	0.091826519	5.605890273	8.288827461	26.8894063	0.774118818	3.248419049	7.977855871	4.249242299	6.65515648	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7426																																																																																				0	0	0	21.6555	0.448606482	6.126075109	0	1.780610868	2.690095399	2.818773933	3.250514187	10.84928089	1.6085979	4.911566474	0.822239963	0.091826519	5.605890273	8.288827461	26.8894063	0.774118818	3.248419049	7.977855871	4.249242299	6.65515648	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7426
H5253_004_0	2008	8																					3600											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	3900	1614.889102	148.4469332	771.8102737		185.2812265	6.578489002	1.469495147	557.956681	32.04385458	9001.973813	41.1636471		0.585318464	27.24790193	3746.825147	4081.227815	596.9769344	2.585761853			22.17351703	733.1300946			175.640897	2.559124965	18.9795538															$210 (1a); $0 (1a1)	$210 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1); $50/$40 (4b)"	25% (9b)	25% (8a1); $0/$5 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$15; $0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	see OON	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											146.6123	146.6123	76.7969		122.1769	0.174538486	0.23655459	32.733	0.174538486	1.3963	0.112345823		0.209446183	0.174549053	15	30	37.5	0.174538486			0.209446183	30			28.0068	0.205534556	30															19.7302	1.813679203	4.939388532	0	1.88642444	1.148199508	0.347615821	1.521967571	5.592885851	1.047460584	4.624563813	0	0.122592718	4.756095471	4.683531433	10.20306954	1.86555292	0.451314958	0	0	4.644158498	1.832825237	0	0	0.409928541	0.525988614	0.047448885	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1949	0	22.62037882	19.7302	1.813679203	4.939388532	0	1.88642444	1.148199508	0.347615821	1.521967571	5.592885851	1.047460584	4.624563813	0	0.122592718	4.756095471	4.683531433	10.20306954	1.86555292	0.451314958	0	0	4.644158498	1.832825237	0	0	0.409928541	0.525988614	0.047448885	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1949		$325 (1a); $0 (1a1)	$325 (1b)	"$150 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); $0 (14b); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											0.5337	0.0491	0.5017	0.0891	0.0761	0.0556	0.0193	0.0655	0.2709	0.1691	0.2258		0.0049	0.2304	0.2909	0.496	0.0881	0.0193			0.1657	0.0904			0.0171		0.0023															3.4611	0	1.613943359	20.264	1.862743144	5.441046701	0.089104887	1.962559119	1.203808076	0.36690081	1.587473943	5.863755479	1.216559487	4.850409744	0	0.127540468	4.986464689	4.974480494	10.69905209	1.953648475	0.470642815	0	0	4.809899423	1.923199245	0	0	0.427008897	0.525988614	0.049755427	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.656
H5253_007_0	2008	7	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						2800	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T				V					V	P	V	V																																																0		1695.832652	43.97398629	8340.174358	98.08077038	659.4108538	14.87297834	0.121541653	204.2043449	113.3483398	2713.765038	183.218779	47.03337319	7.588337228	277.9975429	23672.43529	1255.368709	1351.68177	29.3858394		296.897227	225.9684711	682.1091826	1276.583032									218.0936252	0.543282097		198.7141604							(1a) $200/day	(1b) $200/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $35/visit	(8a) $0/visit	(8b) $0/visit	(9a) $35/visit	(12) $0/proc	(9a) $35/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $15/visit	(7e/7h) $32.5/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $15/visit	(15) $0/proc	(Misc. PBP Cats) $15/visit	(10b) $0/trip				(18a) $15/visit					(4b) $35/visit (waived if admitted)	(9c) $32.5/proc 75%/25% Ind/Grp Blended Copay	(9d) $35/visit	(7f1) $0/visit							189.2413	189.2413			70.9655	0.189241268	0.189241268	47.3103	33.1172			33.1172		33.1172		14.1931	30.7517			14.1931		14.1931										33.1172	30.7517									26.7435	0.693474411	0	0	3.899617068	2.814581282	0.023000697	0.805081025	0.312815177	0	0	0.129801221	0	0.76720886	0	1.48479729	3.463876708	0	0	0.351157548	0	0.806770042	0	0	0	0	0	0	0	0	0	0.601887915	0.001392238	0	0	0	0	0	0	0	0	42.8989		2.438886621	26.7435	0.693474411	0	0	3.899617068	2.814581282	0.023000697	0.805081025	0.312815177	0	0	0.129801221	0	0.76720886	0	1.48479729	3.463876708	0	0	0.351157548	0	0.806770042	0	0	0	0	0	0	0	0	0	0.601887915	0.001392238	0	0	0	0	0	0	0	0	42.8989		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3				0.3					35	0.3	0.3	0.3							2.2536	0.0235	0.7755	0.0482	0.5229	0.2348	0.0019	0.0448	0.1484	0.5231	0.4506	0.0327	0.0046	0.0774	0.0059	1.5022	0.1246	0.0033		0.1077		0.1078	0.0798									0.0335			0.0112							7.1181		0	28.997	0.717013636	0.775459765	0.048249439	4.42252075	3.049417782	0.024919775	0.849862679	0.4612359	0.523060441	0.450646856	0.162489784	0.004596975	0.844565103	0.005925703	2.987045653	3.588436087	0.003338268	0	0.458901325	0	0.914539272	0.07980155	0	0	0	0	0	0	0	0	0.6353672	0.001392238	0	0.01118632	0	0	0	0	0	0	50.017
H5253_011_0	2008	8																					2500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	3000	1197.595171	136.9555884	902.8348365		119.0264366	5.539143963	1.231943396	382.2548323	28.35532984	8372.344714	30.13027839		0.19694834	20.62010686	3323.951407	3942.375797	569.596356	1.94537819			19.96975936	721.916263			263.3089429	1.816603065	16.99914101															$150 (1a); $0 (1a1)	$150 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	20% (9b)	20% (8a1); $0/$10 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	20% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	15; $15; $0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											103.9328	103.9328	69.2886		121.255	0.138577103	0.190158872	34.6443	0.138577103	2.7715	0.088709107		0.138577103	0.138803736	10	19.9837	37.5	0.138577103			0.138577103	20			20	0.206804316	20															10.3725	1.186181792	5.213009834	0	1.2027122	0.767598523	0.234264967	1.103578484	3.929399461	1.933692125	2.672830099	0	0.02729253	2.862147865	2.769959506	6.565274733	1.779988613	0.269584874	0	0	2.767351397	1.203193772	0	0	0.438848238	0.375681355	0.028331902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.7034	0	15.2142071	10.3725	1.186181792	5.213009834	0	1.2027122	0.767598523	0.234264967	1.103578484	3.929399461	1.933692125	2.672830099	0	0.02729253	2.862147865	2.769959506	6.565274733	1.779988613	0.269584874	0	0	2.767351397	1.203193772	0	0	0.438848238	0.375681355	0.028331902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.7034		$250 (1a); $0 (1a1)	$250 (1b)	"$125 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$15 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$15/$50 (7a); $0 (14b); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $30 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											1.3315	0.1523	0.7871	0.1301	0.1522	0.1457	0.0495	0.1396	0.7458	0.4894	0.5013		0.0052	0.5429	0.3986	0.7981	0.1636	0.029			0.2981	0.1497			0.0534		0.0034															7.0665	0	3.389635365	11.7039	1.338449736	6.000061884	0.130053797	1.354896552	0.913289841	0.283794897	1.24321902	4.675205204	2.423048902	3.174129936	0	0.032472692	3.405078336	3.16860712	7.363338373	1.943555134	0.298625945	0	0	3.065464745	1.352913028	0	0	0.492221673	0.375681355	0.031777674	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7698
H5253_021_0	2008	5																					3200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	3200	1961.434162	154.0715909	1291.544243		206.6865263	6.558740294	1.800104835	544.8443183	35.88134656	9445.955614	41.02798107		4.881960058	31.70159247	4028.727554	4764.237893	638.2445171	2.354805701			20.23418858	799.7643953			162.1381047	1.506942429	17.58141742															$250 (1a); $0 (1a1)	$250 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1); $50/$40 (4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$15; $0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	see OON	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											146.0783	146.0783	87.647		102.2548	0.146078305	0.232423464	27.5268	0.146078305	3.5059	0.092913018		0.175293966	0.146083967	15	29.9556	37.5	0.146078305			0.175293966	30			30	0.207703593	30															23.8769	1.875543073	9.433329705	0	1.761224353	0.958089667	0.418386601	1.249817471	5.241486295	2.759698375	3.812033534	0	0.855778142	4.631094403	5.035909442	11.89296973	1.994514116	0.343986026	0	0	3.54693117	1.999410988	0	0	0.405345262	0.312997357	0.043953544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.4494	0	42.95969078	23.8769	1.875543073	9.433329705	0	1.761224353	0.958089667	0.418386601	1.249817471	5.241486295	2.759698375	3.812033534	0	0.855778142	4.631094403	5.035909442	11.89296973	1.994514116	0.343986026	0	0	3.54693117	1.999410988	0	0	0.405345262	0.312997357	0.043953544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.4494		$325 (1a); $0 (1a1)	$325 (1b)	"$150 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); $0 (14b); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											0.5451	0.0428	0.7059	0.0912	0.0714	0.0466	0.0233	0.0538	0.2551	0.1492	0.1872		0.0347	0.2254	0.3071	0.5762	0.0942	0.0148			0.1272	0.0988			0.0197		0.0021															3.6718	0	2.460430857	24.4221	1.918364703	10.13925063	0.091167676	1.832643178	1.004711079	0.44169344	1.303607889	5.496541225	2.908908528	3.999253011	0	0.890480518	4.856466705	5.34305152	12.46912821	2.088699505	0.35878732	0	0	3.674114561	2.09817116	0	0	0.425049545	0.312997357	0.046090174	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.1212
H5253_024_0	2008	6																					1650											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2823.89026	378.5668186	2551.706882		1152.737578	30.00614696	16.03914194	1440.070836	455.3963363	8355.30555	823.520437	65.15304063	3.280844559	3402.187322		2972.756122		800.9565709			26.0823616	624.774853																				1(a) $150 per Day	1(b) $150 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $10 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per procedure; other $0 per procedure	8(b) X-rays $10 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a)/(d) $25 Copay Per Visit; 9(c) $0 Copay per Visit"	7(a) PCP $0 per visit; Urgent Care $10 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $10 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															79.1804	79.1804	22.1705		39.5902	0.105573828	0.105573828	19.0033	13.1967	5.2787	5.2787	13.1967	0.105573828	13.1967		5.2787		5.2787			0.105573828	5.2787																				18.6331	2.497921756	4.7143856	0	3.803091201	3.16786379	1.693313608	2.280506855	0.500811816	3.675423287	0.362259186	0.071650582	0.346371318	3.741478524	0	1.307688511	0	0.352333546	0	0	2.753614751	0.274832803	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1766	0	44.87840139	18.6331	2.497921756	4.7143856	0	3.803091201	3.16786379	1.693313608	2.280506855	0.500811816	3.675423287	0.362259186	0.071650582	0.346371318	3.741478524	0	1.307688511	0	0.352333546	0	0	2.753614751	0.274832803	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1766		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"4(a)$50 per Visit, 4(b) $10 per Visit"	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3																																																								0	0	0	18.6331	2.497921756	4.7143856	0	3.803091201	3.16786379	1.693313608	2.280506855	0.500811816	3.675423287	0.362259186	0.071650582	0.346371318	3.741478524	0	1.307688511	0	0.352333546	0	0	2.753614751	0.274832803	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1766
H5253_027_0	2008	6																					2500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	S	V			V	P	V																																																								0		1994.324881	136.7888427	895.7830987		276.8474899	10.6179018	18.44005928	430.7531136	407.1447898	3413.435401	448.5861317	68.36264453	0.956689493	2868.390961		3916.897545	385.8931521	564.8422906				697.1020803					0.073809195															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															130.4041	130.4041	31.297		55.8875	0.149033206	0.149033206	30.7381	55.8875	14.9033	48.6325	55.8875	0.149033206	54.0332		18.6292	14.9033	14.9033				18.6292					18.6292															21.6723	1.486484987	2.336274978	0	1.289358408	1.582419949	2.748181159	1.103377647	1.89619042	4.239293519	1.817989443	0.318384503	0.142578503	12.91570396	0	6.080706247	0.479257448	0.701502147	0	0	0	1.082201647	0	0	0	0	0.000114584	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8924	0	21.16612185	21.6723	1.486484987	2.336274978	0	1.289358408	1.582419949	2.748181159	1.103377647	1.89619042	4.239293519	1.817989443	0.318384503	0.142578503	12.91570396	0	6.080706247	0.479257448	0.701502147	0	0	0	1.082201647	0	0	0	0	0.000114584	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8924		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.1523	0.0615	0.2649	0.2644	0.0679	0.13	0.1129	0.0313	0.2748	0.0431	0.1121	0.0225	0.0052	0.1962	0.0196	0.1896	0.0285	0.0308			0.17	0.0402			0.0051																	4.2228	0	0	23.8246	1.547974245	2.601172831	0.264386604	1.357265795	1.712435073	2.861079481	1.134684199	2.171002851	4.282435044	1.93013125	0.340885826	0.147767535	13.1118737	0.019607833	6.270264549	0.507736895	0.732269775	0	0	0.169970625	1.122390294	0	0	0.005058988	0	0.000114584	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1151
H5253_801_0	2008	1																					4800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1591.790176	151.1977601	620.2259847		183.0702103	6.282811333	1.583335122	517.1219518	38.70235194	10923.28258	46.31778783		0.232577958	28.87686407	4157.018793	5166.975378	636.7892555	2.95388696			22.54916972	991.62622			250.8107456		19.30582158															$350 (1a); $0 (1a1)	$350 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$30/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $30 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											244.8047	244.8047	111.9107		122.4024	0.174860505	0.235023553	34.7401	0.174860505	4.1967	0.109643162		0.209832606	0.17480603	30	34.6124	37.5	0.174860505			0.209832606	35			35		35															32.4731	3.084493606	5.784161529	0	1.867352045	1.09861556	0.372121045	1.497073486	6.767512791	3.820101407	5.078428734	0	0.048802439	5.047849968	10.39254698	14.90345331	1.989966423	0.516518164	0	0	4.731551034	2.892243142	0	0	0.731531341	0	0.056308646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1538	0	30.88244867	32.4731	3.084493606	5.784161529	0	1.867352045	1.09861556	0.372121045	1.497073486	6.767512791	3.820101407	5.078428734	0	0.048802439	5.047849968	10.39254698	14.90345331	1.989966423	0.516518164	0	0	4.731551034	2.892243142	0	0	0.731531341	0	0.056308646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1538																																																																																				0			32.4731	3.084493606	5.784161529	0	1.867352045	1.09861556	0.372121045	1.497073486	6.767512791	3.820101407	5.078428734	0	0.048802439	5.047849968	10.39254698	14.90345331	1.989966423	0.516518164	0	0	4.731551034	2.892243142	0	0	0.731531341	0	0.056308646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1538
H5253_802_0	2008	2																					4800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1590.12135	151.044355	619.3763792		182.8737283	6.268985838	1.5802468	516.5308411	38.63500788	10913.73641	46.23127742		0.23134784	28.81959929	4153.200759	5162.673467	636.159487	2.948480971			22.50281208	990.8528195			250.8107456		19.30582158															$350 (1a); $0 (1a1)	$350 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$30/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $30 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											244.9275	244.9275	111.9669		122.4638	0.174948224	0.235037936	34.7323	0.174948224	4.1988	0.109700575		0.209937869	0.174893754	30	34.6097	37.5	0.174948224			0.209937869	35			35		35															32.4554	3.082909857	5.779135864	0	1.866283648	1.096747938	0.371417946	1.495026542	6.759126009	3.818677602	5.071597725	0	0.048568672	5.040367921	10.3830019	14.88987232	1.987998397	0.515831509	0	0	4.724192407	2.88998739	0	0	0.731531341	0	0.056308646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.064	0	30.80440479	32.4554	3.082909857	5.779135864	0	1.866283648	1.096747938	0.371417946	1.495026542	6.759126009	3.818677602	5.071597725	0	0.048568672	5.040367921	10.3830019	14.88987232	1.987998397	0.515831509	0	0	4.724192407	2.88998739	0	0	0.731531341	0	0.056308646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.064																																																																																				0			32.4554	3.082909857	5.779135864	0	1.866283648	1.096747938	0.371417946	1.495026542	6.759126009	3.818677602	5.071597725	0	0.048568672	5.040367921	10.3830019	14.88987232	1.987998397	0.515831509	0	0	4.724192407	2.88998739	0	0	0.731531341	0	0.056308646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.064
H5262_001_0	2008	3	f.										Professional										2500											A	A	Coin	V	P	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V	V																																																			0				19.10731217			10.18380134	0.846367416	262.7692266							2349.778666	4502.493215	105.9992747	194.4389186		26.2039298	10.13558172	378.6172976			414.4090372							283.7901739												"10% for days 1 - 20 (PBP#2base2, #2base4)"			10% of the cost (PBP #11Abase1)	"10% of the cost (PBP #11Bbase1, #11Bbase2)"	$50 per visit (PBP #4Abase2)							$15 for office visits & specialty (PBP #7Abase1)	"$15 for group therapy or visits (PBP #7Bbase3, #7Dbase1, #7Fbase2, #14Ibase2)"	"$15 per visit (PBP #7Ebase4,#7Hbase4, #9Cbase4)"	"$15 rehab $10 cardiac or pulmonary rehab (PBP #7Cbase1, #7Ibase1, #9Dbase2)"		$15 per visit (PBP #7Gbase1)	10% per Diabetic supply (PBP #11Cbase1)	"$15 per visit (PBP #16Bbase7, #17Abase2)"			"$15 per visit (PBP #17A, base2)"							$15 per visit (PBP #4Bbase2)												0.1			0.1	0.1	50							15	15	15	15		15	0.1	15			15							15										0	0	1.910731217	0	0	1.018380134	0.084636742	1.094871778	0	0	0	0	0	0	2.937223333	5.628116518	0.132499093	0.243048648	0	0.032754912	1.013558172	0.473271622	0	0	0.518011297	0	0	0	0	0	0	0.354737717	0	0	0	0	0	0	0	0	0	15.4418	0	0.03088	0	0	1.910731217	0	0	1.018380134	0.084636742	1.094871778	0	0	0	0	0	0	2.937223333	5.628116518	0.132499093	0.243048648	0	0.032754912	1.013558172	0.473271622	0	0	0.518011297	0	0	0	0	0	0	0.354737717	0	0	0	0	0	0	0	0	0	15.4418	2500																																																																																			0	0	0	0	0	1.910731217	0	0	1.018380134	0.084636742	1.094871778	0	0	0	0	0	0	2.937223333	5.628116518	0.132499093	0.243048648	0	0.032754912	1.013558172	0.473271622	0	0	0.518011297	0	0	0	0	0	0	0.354737717	0	0	0	0	0	0	0	0	0	15.4418
H5262_003_0	2008	3	f.										Professional										2500											A	A	Coin	V	P	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	Coin	V	V	V	V	V	V	V	V	V	V	V										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0										0		50.6252977	0	7.96582399			1.173195465	0.435913579	85.34059066	108.9877444	6.55235697	3.652612152				998.1364755	1588.860704	18.2167363	70.86215194	8.554502968	1.432037881	31.95844055	135.9692827			236.3115514							133.8445984										$200 for each stay (PBP #1Abase6)	$200 for each stay (PBP #1Bbase6)	"10% Coins for days 1 - 20 (PBP #2base2, #2base4)"			20% coins (PBP # 11Abase1)	"20% coins (PBP # 11Bbase1, #11Bbase2)"	$50 per visit (PBP #4Abase2)	"$75 per visit (PBP #9Abase2,#9Bbase2)"	"10% coins (PBP # 8Abase2, #9Abase1, #9Bbase1)"	"10% coins (PBP # 8Abase2, #8Bbase1, #9Abase1, #9Bbase1)"				$30 per visit (PBP #7Abase1)	"$30 per visit (PBP #7Bbase3, #7Dbase1, 7Fbase2, 14Ibase2)"	"$30 per visit (PBP #7Ebase4, #7Hbase4, #9Cbase4)"	"$30 per  rehab $15 per cardiac or pulmonary visit (PBP #7Cbase1, #7Ibase1, #9Dbase2)"	10% coins (PBP # 8Abase2)	$30 per exam of existing cond (7Gbase1)	20% Coins for diabetic supplies (PBP # 11Cbase1)	"$30 per Visit (PBP #16B,base7, #17Abase2)"			$30 per Visit (PBP #17Abase2)							$30 per visit (PBP #4Bbase2)										200	200	0.1			0.2	0.2	50	75	0.1	0.1				30	30	30	30	0.1	30	0.2	30			30							30										0.8438	0	0.796582399	0	0	0.234639093	0.087182716	0.355585794	0.681173403	0.655235697	0.365261215	0	0	0	2.495341189	3.97215176	0.045541841	0.17715538	0.855450297	0.003580095	6.391688109	0.339923207	0	0	0.590778879	0	0	0	0	0	0	0.334611496	0	0	0	0	0	0	0	0	0	19.2256	0	0.9615	0.8438	0	0.796582399	0	0	0.234639093	0.087182716	0.355585794	0.681173403	0.655235697	0.365261215	0	0	0	2.495341189	3.97215176	0.045541841	0.17715538	0.855450297	0.003580095	6.391688109	0.339923207	0	0	0.590778879	0	0	0	0	0	0	0.334611496	0	0	0	0	0	0	0	0	0	19.2256	2500	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0										0	0	0	0.8438	0	0.796582399	0	0	0.234639093	0.087182716	0.355585794	0.681173403	0.655235697	0.365261215	0	0	0	2.495341189	3.97215176	0.045541841	0.17715538	0.855450297	0.003580095	6.391688109	0.339923207	0	0	0.590778879	0	0	0	0	0	0	0.334611496	0	0	0	0	0	0	0	0	0	19.2256
H5262_004_0	2008	5	i.1.										Professional										2500											A	A	Coin	V	P	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	Coin	V	V	V	V	V	V	V	V	V	V	V										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0										0		50.6252977	0	7.96582399			1.173195465	0.435913579	85.34059066	108.9877444	6.55235697	3.652612152				998.1364755	1588.860704	18.2167363	70.86215194	8.554502968	1.432037881	31.95844055	135.9692827			236.3115514							133.8445984										$200 for each stay (PBP #1Abase6)	$200 for each stay (PBP #1Bbase6)	"10% Coins for days 1 - 20 (PBP #2base2, #2base4)"			20% coins (PBP # 11Abase1)	"20% coins (PBP # 11Bbase1, #11Bbase2)"	$50 per visit (PBP #4Abase2)	"$75 per visit (PBP #9Abase2,#9Bbase2)"	"10% coins (PBP # 8Abase2, #9Abase1, #9Bbase1)"	"10% coins (PBP # 8Abase2, #8Bbase1, #9Abase1, #9Bbase1)"				$30 per visit (PBP #7Abase1)	"$30 per visit (PBP #7Bbase3, #7Dbase1, 7Fbase2, 14Ibase2)"	"$30 per visit (PBP #7Ebase4, #7Hbase4, #9Cbase4)"	"$30 per  rehab $15 per cardiac or pulmonary visit (PBP #7Cbase1, #7Ibase1, #9Dbase2)"	10% coins (PBP # 8Abase2)	$30 per exam of existing cond (7Gbase1)	20% Coins for diabetic supplies (PBP # 11Cbase1)	"$30 per Visit (PBP #16B,base7, #17Abase2)"			$30 per Visit (PBP #17Abase2)							$30 per visit (PBP #4Bbase2)										200	200	0.1			0.2	0.2	50	75	0.1	0.1				30	30	30	30	0.1	30	0.2	30			30							30										0.8438	0	0.796582399	0	0	0.234639093	0.087182716	0.355585794	0.681173403	0.655235697	0.365261215	0	0	0	2.495341189	3.97215176	0.045541841	0.17715538	0.855450297	0.003580095	6.391688109	0.339923207	0	0	0.590778879	0	0	0	0	0	0	0.334611496	0	0	0	0	0	0	0	0	0	19.2256	0	0.9615	0.8438	0	0.796582399	0	0	0.234639093	0.087182716	0.355585794	0.681173403	0.655235697	0.365261215	0	0	0	2.495341189	3.97215176	0.045541841	0.17715538	0.855450297	0.003580095	6.391688109	0.339923207	0	0	0.590778879	0	0	0	0	0	0	0.334611496	0	0	0	0	0	0	0	0	0	19.2256	2500																																																																																			0			0.8438	0	0.796582399	0	0	0.234639093	0.087182716	0.355585794	0.681173403	0.655235697	0.365261215	0	0	0	2.495341189	3.97215176	0.045541841	0.17715538	0.855450297	0.003580095	6.391688109	0.339923207	0	0	0.590778879	0	0	0	0	0	0	0.334611496	0	0	0	0	0	0	0	0	0	19.2256
H5262_005_0	2008	4	f.										Professional										2500											A	A	Coin	V	P	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V	V																																																			0				19.10731217			10.18380134	0.846367416	262.7692266							2349.778666	4502.493215	105.9992747	194.4389186		26.2039298	10.13558172	378.6172976			414.4090372							283.7901739												"10% for days 1 - 20 (PBP#2base2, #2base4)"			10% of the cost (PBP #11Abase1)	"10% of the cost (PBP #11Bbase1, #11Bbase2)"	$50 per visit (PBP #4Abase2)							$15 for office visits & specialty (PBP #7Abase1)	"$15 for group therapy or visits (PBP #7Bbase3, #7Dbase1, #7Fbase2, #14Ibase2)"	"$15 per visit (PBP #7Ebase4,#7Hbase4, #9Cbase4)"	"$15 rehab $10 cardiac or pulmonary rehab (PBP #7Cbase1, #7Ibase1, #9Dbase2)"		$15 per visit (PBP #7Gbase1)	10% per Diabetic supply (PBP #11Cbase1)	"$15 per visit (PBP #16Bbase7, #17Abase2)"			"$15 per visit (PBP #17A, base2)"							$15 per visit (PBP #4Bbase2)												0.1			0.1	0.1	50							15	15	15	15		15	0.1	15			15							15										0	0	1.910731217	0	0	1.018380134	0.084636742	1.094871778	0	0	0	0	0	0	2.937223333	5.628116518	0.132499093	0.243048648	0	0.032754912	1.013558172	0.473271622	0	0	0.518011297	0	0	0	0	0	0	0.354737717	0	0	0	0	0	0	0	0	0	15.4418	0	0.03088	0	0	1.910731217	0	0	1.018380134	0.084636742	1.094871778	0	0	0	0	0	0	2.937223333	5.628116518	0.132499093	0.243048648	0	0.032754912	1.013558172	0.473271622	0	0	0.518011297	0	0	0	0	0	0	0.354737717	0	0	0	0	0	0	0	0	0	15.4418	2500																																																																																			0	0	0	0	0	1.910731217	0	0	1.018380134	0.084636742	1.094871778	0	0	0	0	0	0	2.937223333	5.628116518	0.132499093	0.243048648	0	0.032754912	1.013558172	0.473271622	0	0	0.518011297	0	0	0	0	0	0	0.354737717	0	0	0	0	0	0	0	0	0	15.4418
H5291_001_0	2008	6	s.	t.	u.								Supplies	Health & Education (Non-Covered)	Health & Education (Non-Covered)									Supplies										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin				V					O		O	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0				0					0		0	0	0								0		290.045275	2.079774	939.423494	1194.716694	280.982013	10.458965	0.556575	338.347623	290.895256	2867.148212	1308.823944		17.193545	963.447495	6554.727125	3267.623969	12.055895	453.939048			38.707685				1.65					0.08		8618.396527	3.4	0.02								"175/day (1-5), ltac 950/admit"	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$10/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$100-$150/Visit	$0-$50/Visit	$50-$100/Visit		$0-$50/Proc	$15-$100/Visit	$10/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins				EyeMed $100 Allowance					Active Outlook Newsletter		$0 copay	Silver Sneakers	QuitNet								600.00001	950.001298	28.94	9.999997	100.000009	0.2	0.2	50.000008	122.946315	6.454209	65.777931		23.647479	19.467041	10	30	50.000103	50.000007			0.2				0					0		0	0	0								14.5023	0.164649	2.265576326	0.995596946	2.341516986	2.091793	0.111315	1.409781988	2.980374981	1.542097816	7.174310923	0	0.033882	1.562955991	5.462272604	8.169059923	0.050232999	1.891412965	0	0	7.741537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4906	0	0	14.5023	0.164649	2.265576326	0.995596946	2.341516986	2.091793	0.111315	1.409781988	2.980374981	1.542097816	7.174310923	0	0.033882	1.562955991	5.462272604	8.169059923	0.050232999	1.891412965	0	0	7.741537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4906																																																																																				0	0	0	14.5023	0.164649	2.265576326	0.995596946	2.341516986	2.091793	0.111315	1.409781988	2.980374981	1.542097816	7.174310923	0	0.033882	1.562955991	5.462272604	8.169059923	0.050232999	1.891412965	0	0	7.741537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4906
H5291_801_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		290.045275	2.079774	939.423494	1194.716694	280.982013	10.458965	3.316258	338.347623	290.895256	2867.148212	1308.823944		17.193545	963.447495	6554.727125	3267.623969	12.055895	453.939048			38.707685																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					196.904983	196.902163	28.944121	0	100.000009	0.2	0.2	50.000008	199.999989	43.390472	99.999998		47.295656	99.589858	25	35	100.000207	99.999989			0.2																					4.7593	0.034126	2.26589894	0	2.341516986	2.091793	0.6632516	1.409781988	4.848254	10.36724285	10.90686598	0	0.067764999	7.995799935	13.65568151	9.53056991	0.100466	3.782824984	0	0	7.741537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5627	0	0	4.7593	0.034126	2.26589894	0	2.341516986	2.091793	0.6632516	1.409781988	4.848254	10.36724285	10.90686598	0	0.067764999	7.995799935	13.65568151	9.53056991	0.100466	3.782824984	0	0	7.741537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5627																																																																																				0	0	0	4.7593	0.034126	2.26589894	0	2.341516986	2.091793	0.6632516	1.409781988	4.848254	10.36724285	10.90686598	0	0.067764999	7.995799935	13.65568151	9.53056991	0.100466	3.782824984	0	0	7.741537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5627
H5291_802_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		290.045275	2.079774	939.423494	1194.716694	280.982013	10.458965	3.316258	338.347623	290.895256	2867.148212	1308.823944		17.193545	963.447495	6554.727125	3267.623969	12.055895	453.939048			38.707685																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					196.904983	196.902163	28.944121	0	100.000009	0.2	0.2	50.000008	199.999989	43.390472	99.999998		47.295656	99.589858	25	35	100.000207	99.999989			0.2																					4.7593	0.034126	2.26589894	0	2.341516986	2.091793	0.6632516	1.409781988	4.848254	10.36724285	10.90686598	0	0.067764999	7.995799935	13.65568151	9.53056991	0.100466	3.782824984	0	0	7.741537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5627	0	0	4.7593	0.034126	2.26589894	0	2.341516986	2.091793	0.6632516	1.409781988	4.848254	10.36724285	10.90686598	0	0.067764999	7.995799935	13.65568151	9.53056991	0.100466	3.782824984	0	0	7.741537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5627																																																																																				0	0	0	4.7593	0.034126	2.26589894	0	2.341516986	2.091793	0.6632516	1.409781988	4.848254	10.36724285	10.90686598	0	0.067764999	7.995799935	13.65568151	9.53056991	0.100466	3.782824984	0	0	7.741537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5627
H5291_803_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		290.045275	2.079774	939.423494	1194.716694	280.982013	10.458965	3.316258	338.347623	290.895256	2867.148212	1308.823944		17.193545	963.447495	6554.727125	3267.623969	12.055895	453.939048			38.707685																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					196.904983	196.902163	28.944121	0	100.000009	0.2	0.2	50.000008	199.999989	43.390472	99.999998		47.295656	99.589858	25	35	100.000207	99.999989			0.2																					4.7593	0.034126	2.26589894	0	2.341516986	2.091793	0.6632516	1.409781988	4.848254	10.36724285	10.90686598	0	0.067764999	7.995799935	13.65568151	9.53056991	0.100466	3.782824984	0	0	7.741537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5627	0	0	4.7593	0.034126	2.26589894	0	2.341516986	2.091793	0.6632516	1.409781988	4.848254	10.36724285	10.90686598	0	0.067764999	7.995799935	13.65568151	9.53056991	0.100466	3.782824984	0	0	7.741537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5627																																																																																				0	0	0	4.7593	0.034126	2.26589894	0	2.341516986	2.091793	0.6632516	1.409781988	4.848254	10.36724285	10.90686598	0	0.067764999	7.995799935	13.65568151	9.53056991	0.100466	3.782824984	0	0	7.741537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5627
H5291_804_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		290.045275	2.079774	939.423494	1194.716694	280.982013	10.458965	3.316258	338.347623	290.895256	2867.148212	1308.823944		17.193545	963.447495	6554.727125	3267.623969	12.055895	453.939048			38.707685																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					196.904983	196.902163	28.944121	0	100.000009	0.2	0.2	50.000008	199.999989	43.390472	99.999998		47.295656	99.589858	25	35	100.000207	99.999989			0.2																					4.7593	0.034126	2.26589894	0	2.341516986	2.091793	0.6632516	1.409781988	4.848254	10.36724285	10.90686598	0	0.067764999	7.995799935	13.65568151	9.53056991	0.100466	3.782824984	0	0	7.741537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5627	0	0	4.7593	0.034126	2.26589894	0	2.341516986	2.091793	0.6632516	1.409781988	4.848254	10.36724285	10.90686598	0	0.067764999	7.995799935	13.65568151	9.53056991	0.100466	3.782824984	0	0	7.741537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5627																																																																																				0	0	0	4.7593	0.034126	2.26589894	0	2.341516986	2.091793	0.6632516	1.409781988	4.848254	10.36724285	10.90686598	0	0.067764999	7.995799935	13.65568151	9.53056991	0.100466	3.782824984	0	0	7.741537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5627
H5294_001_0	2008	8																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		390.2153224	35.30464718	80.68356317	0	18.77548626	41.76924467	29.42457946	9.655464776	21.4501373	11.18218133	23.28312428	0	4.310950746	40.47646235	69.85962217	130.9034318	11.51767448	5.403123095	34.51906307	48.98519046	9.341310369	0.690613303	0	0	0	0	0	0	0	0	0											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing																				0.0726	0.0726	0.2065	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											28.3296	2.563117385	16.66115579	0	4.393463784	9.774003253	6.885351595	2.259378758	5.019332129	2.616630431	5.448251081	0	1.008762475	9.471492191	16.34715159	30.63140303	2.695135829	1.264330804	8.077460759	11.46253457	2.185866626	0.161603513	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	167.2561			28.3296	2.563117385	16.66115579	0	4.393463784	9.774003253	6.885351595	2.259378758	5.019332129	2.616630431	5.448251081	0	1.008762475	9.471492191	16.34715159	30.63140303	2.695135829	1.264330804	8.077460759	11.46253457	2.185866626	0.161603513	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	167.2561																																																																																				0			28.3296	2.563117385	16.66115579	0	4.393463784	9.774003253	6.885351595	2.259378758	5.019332129	2.616630431	5.448251081	0	1.008762475	9.471492191	16.34715159	30.63140303	2.695135829	1.264330804	8.077460759	11.46253457	2.185866626	0.161603513	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	167.2561
H5302_003_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	P	T	P	V	P	V	P	Coin	P	P																																																				0		1532.03063	64.31027815	407.6413669		106.409985	15.65627584	12.57789436	259.45142	320.3187154	670.7094981	345.5487169	15.59693248	0.048623638	162.3975087	3817.344621	5512.955036	258.8037064	663.676852	4323.162447	10024.67158	26.71905905																					1a:$180 1-5; 1a1:$180 1-5;	1b:$180 1-5;	Medicare FFS		10a:$30;	11a:20%;	11b:20%; 11c:20%;	4a:$50; 4b:$50;	9a:$125; 9b:$75;	8a:$30;	8b:$30;	9a:$125;	12:20%;	9a:$125; 3:20%; 5:20%; 9c:$50; 9d:20%;	7a:$10; 14c:$10;	7b:$30; 7d:$30; 7f:$30; 7f1:$30; 17a:$30; 17b:$30; 18a:$30;	7e:$50; 7h:$50;	7c:$30; 7i:$30;	7g:$10-30;	7g:$10-30;	15:25%;																					112.1078	101.1011	73.5936		27.1618	0.181078461	0.181078461	45.2696	93.1015	27.1618	27.1618	113.174	0.250114515	110.6053	9.0539	27.1618	27.2576	26.6949	16.3398	5.7351	0.226348076																					14.3127	0.541819958	2.499981765	0	0.240856954	2.835014335	2.277585755	0.978772164	2.485179925	1.518138047	0.782142874	0.147097319	0.012161478	1.496835322	2.880162039	12.47846767	0.58786415	1.476397098	5.886633607	4.791029653	6.047807618	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2767	0	6.7165	14.3127	0.541819958	2.499981765	0	0.240856954	2.835014335	2.277585755	0.978772164	2.485179925	1.518138047	0.782142874	0.147097319	0.012161478	1.496835322	2.880162039	12.47846767	0.58786415	1.476397098	5.886633607	4.791029653	6.047807618	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2767	5000	0.3		0.3		0.3				0.3		0.3	0.3	0.3	0.3		0.3		0.3	0.3	0.3																						3.8612		0.2107		0.0866				0.785		0.0266	0.0229	0.0008	0.162		1.6642		0.1644	0.5024	0.2308																						7.7176	0	0.3535	18.1739	0.541819958	2.710667454	0	0.327454284	2.835014335	2.277585755	0.978772164	3.27019991	1.518138047	0.808785117	0.170004456	0.012934231	1.658863337	2.880162039	14.14271129	0.58786415	1.640767448	6.388984717	5.021861599	6.047807618	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9943
H5302_004_0	2008	5																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	P	T	P	V	P	V	Coin	Coin	P	P																																																				0		290.7421196	9.057925352	404.8448956		105.6794528	15.54879143	12.49154384	257.6728895	318.119644	666.1049026	343.1764349	15.48985547	0.048289824	161.2826075	3686.858408	5475.107164	257.0269515	659.1205374	4293.48281	9955.8496	26.53562575				144		249	0.458333333														1a:$200/admit; 1a1:$200/admit;	1b:$100/admit;	Medicare FFS		10a:$30;	11a:20%;	11b:20%; 11c:20%;	4a:$50; 4b:$20;	9a:$50; 9b:$25;	8a:$20;	8b:$20;	9a:$50;	12:20%;	9a:$50; 3:20%; 5:20%; 9c:$20; 9d:20%;	7a:$10; 14d:$30; 14d1:$30; 14d2:$30; 14e:$30; 14e1:$30; 14f:$30; 14f1:$30;	7b:$20; 7d:$20; 7f:$20; 17a:$20; 18a:$30;	7e:$20; 7h:$20;	7c:$20; 7i:$20;	7g:$10-20;	7g:$10-20;	15:20%;				17a1:$30;		18a1:$30;	18b:20%;														167.1603	87.5606	71.1725		26.2682	0.175121292	0.175121292	43.7605	34.0742	17.5121	17.5121	43.7803	0.161257452	43.5648	8.7561	17.5121	17.5121	17.2864	10.5881	3.9181	0.175121292				26.2682		26.2682	0.175121292														4.05	0.066093149	2.40115069	0	0.231334028	2.722924436	2.18753529	0.939657686	0.903307069	0.972076257	0.500812504	0.056512573	0.007787094	0.585519738	2.690197525	7.990065313	0.375090764	0.949482805	3.788333479	3.250629139	4.646953052	0	0	0	0.315218325	0	0.54506502	0.080263925	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2561	0	5.719	4.05	0.066093149	2.40115069	0	0.231334028	2.722924436	2.18753529	0.939657686	0.903307069	0.972076257	0.500812504	0.056512573	0.007787094	0.585519738	2.690197525	7.990065313	0.375090764	0.949482805	3.788333479	3.250629139	4.646953052	0	0	0	0.315218325	0	0.54506502	0.080263925	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2561	2500	0.3		0.3		0.3				0.3		0.3	0.3	0.3	0.3		0.3		0.3	0.3	0.3																						3.8597		0.2106		0.0866				0.7847		0.0266	0.0229	0.0008	0.162		1.6636		0.1643	0.5022	0.2307																						7.7147	0	0.301	7.9098	0.066093149	2.611756928	0	0.317898701	2.722924436	2.18753529	0.939657686	1.688031015	0.972076257	0.5274447	0.079411071	0.008559556	0.747486651	2.690197525	9.653681323	0.375090764	1.11379117	4.290495148	3.481374036	4.646953052	0	0	0	0.315218325	0	0.54506502	0.080263925	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9708
H5304_002_0	2008	9	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	A	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1283.037364	8.02882277	350.267334	7.126458107	218.6087903	9.35142633	3.334001068	183.854652	387.0651071	800.5149199	846.9799023	47.49783561	13.70877944	0.36216932	5253.112049	1864.499079	0.103816967	408.9825083	560.201141	0	26.61311166	0	0	0	5.0799941	329.4369565	155.8898802	0	0		0	1030.546093	16.84758021	71.86385816	391.925558	106.0516623	0.045932138	794.5523569	3.695179873	1.217580477		"$150/day, days(1-5) no yrly max"	"$500/admit, no yrly max"	$50/day for days 21 to 100	15% Coinsurance	$100 copay	30% coinsurance	30% coinsurance	$50 copay	$150 copay	$10 copay	$15/$35 copay for Lower/Higher Tier	$100 copay	$25 copay	$15 copay	$15 copay	$15 copay	50% coinsurance	$15 copay	$15/$35 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$15 copay	$0 copay	$15 copay	$15 copay	$10 copay	$0 copay	$10 copay	$10 copay	$15 copay		150	500	50	0.15	100	0.3	0.3	50	150	10	19.33492	100	25	15	15	15	0.5	15	23.33	0	0.2	0	0	0	0.5	0	10	0	0		0	15	0	15	15	10	0	10	10	15		16.038	0.334534282	1.459447225	1.068968716	1.821739919	2.805427899	1.00020032	0.76606105	4.838313839	0.667095767	1.364690721	0.395815297	0.028559957	0.000452712	6.566390061	2.330623849	0.051908484	0.511228135	1.089124385	0	5.322622333	0	0	0	2.53999705	0	0.129908234	0	0	0	0	1.288182616	0	0.089829823	0.489906948	0.088376385	0	0.662126964	0.003079317	0.001521976	0	53.7541		0	16.038	0.334534282	1.459447225	1.068968716	1.821739919	2.805427899	1.00020032	0.76606105	4.838313839	0.667095767	1.364690721	0.395815297	0.028559957	0.000452712	6.566390061	2.330623849	0.051908484	0.511228135	1.089124385	0	5.322622333	0	0	0	2.53999705	0	0.129908234	0	0	0	0	1.288182616	0	0.089829823	0.489906948	0.088376385	0	0.662126964	0.003079317	0.001521976	0	53.7541	None																																																																																			0		0	16.038	0.334534282	1.459447225	1.068968716	1.821739919	2.805427899	1.00020032	0.76606105	4.838313839	0.667095767	1.364690721	0.395815297	0.028559957	0.000452712	6.566390061	2.330623849	0.051908484	0.511228135	1.089124385	0	5.322622333	0	0	0	2.53999705	0	0.129908234	0	0	0	0	1.288182616	0	0.089829823	0.489906948	0.088376385	0	0.662126964	0.003079317	0.001521976	0	53.7541
H5304_003_0	2008	7	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	342.8215425	7.724120862	320.5883759	0	209.6910873	9.492807498	3.384406744	184.1382254	388.5217318	803.5274615	850.1673035	47.67658207	13.76036907	0.363532255	5254.769029	1865.087195	0.103882471	409.111513	560.3778443	0	27.59590836	0	0	0	4.868089279	333.5444477	157.8335489	0	0		0	1034.4243	16.91098195	71.88652606	392.0491824	106.085114	0.045961119	794.8029812	3.696345437	1.219458447		$100/admit with no yearly max	$100/admit with no yearly max	$50/day for days 21 to 100	$0 Copay	$50 copay	20% coinsurance	20% coinsurance	$25 copay	$50 copay	$0 copay	$0/$35 copay for Lower/Higher Tier	$50 copay	$10 copay	$10 copay	$10 copay	$10 copay	50% coinsurance	$10 copay	$0/$35 copay for Lower/Higher Tier	N/A	0% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay		113.1675498	113.1675498	50	0	50	0.2	0.2	25	50	0	7.586114	50	10	10	10	10	0.5	10	15.88	0	0	0	0	0	0.5	0	10	0	0		0	10	0	10	10	10	0	10	10	10		3.233	0.072843319	1.335784899	0	0.873712864	1.8985615	0.676881349	0.383621303	1.618840549	0	0.537455507	0.198652425	0.011466974	0.000302944	4.378974191	1.554239329	0.051941236	0.340926261	0.741566681	0	0	0	0	0	2.43404464	0	0.131527957	0	0	0	0	0.86202025	0	0.059905438	0.326707652	0.088404262	0	0.662335818	0.003080288	0.001016215	0	22.4778		0	3.233	0.072843319	1.335784899	0	0.873712864	1.8985615	0.676881349	0.383621303	1.618840549	0	0.537455507	0.198652425	0.011466974	0.000302944	4.378974191	1.554239329	0.051941236	0.340926261	0.741566681	0	0	0	0	0	2.43404464	0	0.131527957	0	0	0	0	0.86202025	0	0.059905438	0.326707652	0.088404262	0	0.662335818	0.003080288	0.001016215	0	22.4778	None																																																																																			0		0	3.233	0.072843319	1.335784899	0	0.873712864	1.8985615	0.676881349	0.383621303	1.618840549	0	0.537455507	0.198652425	0.011466974	0.000302944	4.378974191	1.554239329	0.051941236	0.340926261	0.741566681	0	0	0	0	0	2.43404464	0	0.131527957	0	0	0	0	0.86202025	0	0.059905438	0.326707652	0.088404262	0	0.662335818	0.003080288	0.001016215	0	22.4778
H5304_004_0	2008	6	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	335.1885131	7.552140884	313.4503749	0	205.0222493	9.074792818	3.235374784	180.03833	379.8711733	785.6366701	831.2380613	46.61504799	13.45399013	0.355438095	5137.769945	1823.560443	0.099308019	400.0025166	547.9008555	0	26.38072573	0	0	0	4.730112736	326.1179758	154.3193354	0	0		0	1011.392518	16.53445362	70.28594996	383.3200842	103.7230956	0.043937226	777.1064431	3.614045144	1.192306821		$100/admit with no yearly max	$100/admit with no yearly max	$50/day for days 21 to 100	$0 Copay	$50 copay	20% coinsurance	20% coinsurance	$25 copay	$50 copay	$0 copay	$0/$35 copay for Lower/Higher Tier	$50 copay	$10 copay	$10 copay	$10 copay	$10 copay	50% coinsurance	$10 copay	$0/$35 copay for Lower/Higher Tier	N/A	0% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay		113.1675498	113.1675498	50	0	50	0.2	0.2	25	50	0	7.586114	50	10	10	10	10	0.5	10	15.88	0	0	0	0	0	0.5	0	10	0	0		0	10	0	10	10	10	0	10	10	10		3.161	0.07122144	1.306043229	0	0.854259372	1.814958564	0.647074957	0.375079854	1.582796555	0	0.525488891	0.194229367	0.011211658	0.000296198	4.281474955	1.519633702	0.049654009	0.33333543	0.725055465	0	0	0	0	0	2.365056368	0	0.128599446	0	0	0	0	0.842827098	0	0.058571625	0.319433403	0.086435913	0	0.647588703	0.003011704	0.000993589	0	21.9054		0	3.161	0.07122144	1.306043229	0	0.854259372	1.814958564	0.647074957	0.375079854	1.582796555	0	0.525488891	0.194229367	0.011211658	0.000296198	4.281474955	1.519633702	0.049654009	0.33333543	0.725055465	0	0	0	0	0	2.365056368	0	0.128599446	0	0	0	0	0.842827098	0	0.058571625	0.319433403	0.086435913	0	0.647588703	0.003011704	0.000993589	0	21.9054	None																																																																																			0		0	3.161	0.07122144	1.306043229	0	0.854259372	1.814958564	0.647074957	0.375079854	1.582796555	0	0.525488891	0.194229367	0.011211658	0.000296198	4.281474955	1.519633702	0.049654009	0.33333543	0.725055465	0	0	0	0	0	2.365056368	0	0.128599446	0	0	0	0	0.842827098	0	0.058571625	0.319433403	0.086435913	0	0.647588703	0.003011704	0.000993589	0	21.9054
H5304_005_0	2008	8	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	D	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1225.578848	32.4542575	318.3116508	9.326380624	208.2019224	9.358455966	3.336507297	182.8305295	385.7625639	797.8210441	844.1296635	47.3379969	13.66264695	0.360950555	5217.451194	1851.84189	0.102412224	406.2061224	765.3147043	0	27.20534397	0	0	0	4.82393415	331.1757124	156.7126612	0	0		0	1027.078121	16.79088509	71.37600894	389.2649636	105.3317285	0.045310632	789.1585225	3.670095071	1.210798209		"$250/day, days(1-5) no yrly max"	"$250/day, days(1-5) no yrly max"	$100/day for days 21 to 100	15% Coinsurance	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$175 copay	$20 copay	$30/$100 copay for Lower/Higher Tier	$150 copay	$25 copay	$30 copay	$20 copay	$30 copay	50% coinsurance	$30 copay	$30/$100 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$25 copay	N/A	N/A		N/A	$30 copay	$0 copay	$30 copay	$30 copay	$10 copay	$0 copay	$25 copay	$25 copay	Min. $20 / Max. $30 copay		249.4326468	249.4326468	99.77305871	0.149659588	149.6595881	0.299319176	0.299319176	49.88652935	174.6028527	19.95461174	45.06971368	149.6595881	24.94326468	29.93191761	19.95461174	29.93191761	0.498865294	29.93191761	42.21398114	0	0.199546117	0	0	0	0.498865294	0	24.94326468	0	0		0	29.93191761	0	29.93191761	29.93191761	9.977305871	0	24.94326468	24.94326468	22.56822427		25.4749	0.674595946	2.646577252	1.395782282	2.596617828	2.80116533	0.998680615	0.760065048	5.612937011	1.326684098	3.170390187	0.590382093	0.028399252	0.000900329	8.676017738	4.619098241	0.051089904	1.013210683	2.692248374	0	5.428720762	0	0	0	2.406493326	0	0.325743782	0	0	0	0	2.561868141	0	0.178035068	0.970953902	0.087577239	0	1.640349158	0.007628679	0.00227713	0	78.7394		0.179098746	25.4749	0.674595946	2.646577252	1.395782282	2.596617828	2.80116533	0.998680615	0.760065048	5.612937011	1.326684098	3.170390187	0.590382093	0.028399252	0.000900329	8.676017738	4.619098241	0.051089904	1.013210683	2.692248374	0	5.428720762	0	0	0	2.406493326	0	0.325743782	0	0	0	0	2.561868141	0	0.178035068	0.970953902	0.087577239	0	1.640349158	0.007628679	0.00227713	0	78.7394	4000																																																																																			0		0	25.4749	0.674595946	2.646577252	1.395782282	2.596617828	2.80116533	0.998680615	0.760065048	5.612937011	1.326684098	3.170390187	0.590382093	0.028399252	0.000900329	8.676017738	4.619098241	0.051089904	1.013210683	2.692248374	0	5.428720762	0	0	0	2.406493326	0	0.325743782	0	0	0	0	2.561868141	0	0.178035068	0.970953902	0.087577239	0	1.640349158	0.007628679	0.00227713	0	78.7394
H5304_006_0	2008	7	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	D	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1213.26116	32.12807578	315.1124576	9.139853012	206.1093876	9.171286847	3.269777151	180.9929901	381.8854548	789.8025386	835.645733	46.86222607	13.52533043	0.357322819	5165.013168	1833.229942	0.10036398	402.1235452	757.622904	0	26.66123709	0	0	0	4.762120201	327.8472288	155.1376196	0	0		0	1016.755466	16.62212819	70.65864391	385.3526536	104.2730913	0.044404419	781.2270798	3.633208757	1.198629074		"$250/day, days(1-5) no yrly max"	"$250/day, days(1-5) no yrly max"	$100/day for days 21 to 100	15% Coinsurance	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$175 copay	$20 copay	$30/$100 copay for Lower/Higher Tier	$150 copay	$25 copay	$30 copay	$20 copay	$30 copay	50% coinsurance	$30 copay	$30/$100 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$25 copay	N/A	N/A		N/A	$30 copay	$0 copay	$30 copay	$30 copay	$10 copay	$0 copay	$25 copay	$25 copay	Min $20/ max $30		249.4260557	249.4260557	99.7704223	0.149655633	149.6556334	0.299311267	0.299311267	49.88521115	174.598239	19.95408446	45.06852275	149.6556334	24.94260557	29.93112669	19.95408446	29.93112669	0.498852111	29.93112669	42.21286567	0	0.199540845	0	0	0	0.498852111	0	24.94260557	0	0		0	29.93112669	0	29.93112669	29.93112669	9.97704223	0	24.94260557	24.94260557	22.75		25.2182	0.667798268	2.61990858	1.367830492	2.57045258	2.745069485	0.978681141	0.752406127	5.556377326	1.313315547	3.138443227	0.584433011	0.028113082	0.000891256	8.588592415	4.572553136	0.050066783	1.003000898	2.66511949	0	5.320005767	0	0	0	2.375593718	0	0.322461371	0	0	0	0	2.536053055	0	0.176241069	0.961169925	0.086694753	0	1.62381991	0.007551808	0.002272401	0	77.8332		0.179098746	25.2182	0.667798268	2.61990858	1.367830492	2.57045258	2.745069485	0.978681141	0.752406127	5.556377326	1.313315547	3.138443227	0.584433011	0.028113082	0.000891256	8.588592415	4.572553136	0.050066783	1.003000898	2.66511949	0	5.320005767	0	0	0	2.375593718	0	0.322461371	0	0	0	0	2.536053055	0	0.176241069	0.961169925	0.086694753	0	1.62381991	0.007551808	0.002272401	0	77.8332	4000																																																																																			0		0	25.2182	0.667798268	2.61990858	1.367830492	2.57045258	2.745069485	0.978681141	0.752406127	5.556377326	1.313315547	3.138443227	0.584433011	0.028113082	0.000891256	8.588592415	4.572553136	0.050066783	1.003000898	2.66511949	0	5.320005767	0	0	0	2.375593718	0	0.322461371	0	0	0	0	2.536053055	0	0.176241069	0.961169925	0.086694753	0	1.62381991	0.007551808	0.002272401	0	77.8332
H5304_007_0	2008	7	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	A	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1234.344804	7.724120862	320.5883759	9.460271677	209.6910873	9.492807498	3.384406744	184.1382254	380.7512971	803.5274615	850.1673035	47.67658207	13.76036907	0.363532255	5254.769029	1865.087195	0.103882471	409.111513	770.78862	0	27.59590836	0	0	0	4.868089279	333.5444477	157.8335489	0	0		0	1034.4243	16.91098195	71.88652606	392.0491824	106.085114	0.045961119	794.8029812	3.696345437	1.219458447		"$200/day, days(1-5) no yrly max"	"$900/admit, no yrly max"	$100/day for days 21 to 100	15% Coinsurance	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$20 copay	$30/$35 copay for Lower/Higher Tier	$150 copay	$25 copay	$30 copay	$15 copay	$30 copay	50% coinsurance	$30 copay	$30/$35 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$50 maximum per year	$25 copay	N/A	N/A		N/A	$30 copay	$0 copay	$30 copay	$30 copay	$25 copay	$0 copay	$25 copay	$25 copay	Min. $15 / Max. $30copay		200	900	100	0.15	150	0.3	0.3	50	200	20	31.08373	150	25	30	15	30	0.5	30	30.79	0	0.2	0	0	0	0.5	0	25	0	0		0	30	0	30	30	25	0	25	25	18.92933608		20.5724	0.579309065	2.671569799	1.419040752	2.621138591	2.847842249	1.015322023	0.767242606	6.345854952	1.339212436	2.202197576	0.595957276	0.028667436	0.000908831	6.568461287	4.662717988	0.051941236	1.022778782	1.977715134	0	5.519181672	0	0	0	2.43404464	0	0.328819894	0	0	0	0	2.586060751	0	0.179716315	0.980122956	0.221010654	0	1.655839544	0.00770072	0.001923628	0	71.2047		0	20.5724	0.579309065	2.671569799	1.419040752	2.621138591	2.847842249	1.015322023	0.767242606	6.345854952	1.339212436	2.202197576	0.595957276	0.028667436	0.000908831	6.568461287	4.662717988	0.051941236	1.022778782	1.977715134	0	5.519181672	0	0	0	2.43404464	0	0.328819894	0	0	0	0	2.586060751	0	0.179716315	0.980122956	0.221010654	0	1.655839544	0.00770072	0.001923628	0	71.2047	None																																																																																			0		0	20.5724	0.579309065	2.671569799	1.419040752	2.621138591	2.847842249	1.015322023	0.767242606	6.345854952	1.339212436	2.202197576	0.595957276	0.028667436	0.000908831	6.568461287	4.662717988	0.051941236	1.022778782	1.977715134	0	5.519181672	0	0	0	2.43404464	0	0.328819894	0	0	0	0	2.586060751	0	0.179716315	0.980122956	0.221010654	0	1.655839544	0.00770072	0.001923628	0	71.2047
H5304_801_0	2008	5																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	294.2917212	2.168919813	47.5196641	38.12543058	8.169585462	25.55783243	1.220237577	5.962756756	30.81159577	12.10537002	32.68873913	0	0.274308799	31.88388633	45.94707502	124.1420761	1.417555032	4.772028736	30.86237842	40.98906846	8.870753485	6.310207568	0	0	0	0	0	0	0	0	0											Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											0.076813085	0.076813085	0.188134857	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.6055	0.166601421	8.940105187	0	1.911682998	5.980532788	0.285535593	1.395285081	7.209913409	2.832656584	7.649164956	0	0.064188259	7.460829402	10.75161555	29.0492458	0.331707878	1.116654724	7.22179655	9.59144202	2.075756315	1.476588571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1168	0	0	22.6055	0.166601421	8.940105187	0	1.911682998	5.980532788	0.285535593	1.395285081	7.209913409	2.832656584	7.649164956	0	0.064188259	7.460829402	10.75161555	29.0492458	0.331707878	1.116654724	7.22179655	9.59144202	2.075756315	1.476588571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1168	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.6055	0.166601421	8.940105187	0	1.911682998	5.980532788	0.285535593	1.395285081	7.209913409	2.832656584	7.649164956	0	0.064188259	7.460829402	10.75161555	29.0492458	0.331707878	1.116654724	7.22179655	9.59144202	2.075756315	1.476588571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1168
H5304_802_0	2008	5																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	294.2917212	2.168919813	47.5196641	38.12543058	8.169585462	25.55783243	1.220237577	5.962756756	30.81159577	12.10537002	32.68873913	0	0.274308799	31.88388633	45.94707502	124.1420761	1.417555032	4.772028736	30.86237842	40.98906846	8.870753485	6.310207568	0	0	0	0	0	0	0	0	0											Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											0.076813085	0.076813085	0.188134857	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.6055	0.166601421	8.940105187	0	1.911682998	5.980532788	0.285535593	1.395285081	7.209913409	2.832656584	7.649164956	0	0.064188259	7.460829402	10.75161555	29.0492458	0.331707878	1.116654724	7.22179655	9.59144202	2.075756315	1.476588571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1168	0	0	22.6055	0.166601421	8.940105187	0	1.911682998	5.980532788	0.285535593	1.395285081	7.209913409	2.832656584	7.649164956	0	0.064188259	7.460829402	10.75161555	29.0492458	0.331707878	1.116654724	7.22179655	9.59144202	2.075756315	1.476588571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1168	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.6055	0.166601421	8.940105187	0	1.911682998	5.980532788	0.285535593	1.395285081	7.209913409	2.832656584	7.649164956	0	0.064188259	7.460829402	10.75161555	29.0492458	0.331707878	1.116654724	7.22179655	9.59144202	2.075756315	1.476588571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1168
H5402_007_0	2008	4																					3500											D	D	D	V	T	Coin	Coin	V	V	V	P	Coin	V	V	P	P	V	V	P	P	Coin	Coin	T	V	P	P	P	P	P	V	P																																																				0		1618.047614	56.87164386	454.1222342		0.655740532	0.808258444	0.030821045	256.802539	338.5217241	25.74154329	31.87048217	1.516519531	18.3689117	86.41803819		4626.910094	296.1131584	266.0981615	3617.645341	636.3024269	23.77586191		285.0285511			1.092900886	21.25069816															$110/Day 1-5; $0/Day 6-90	$125/Day 1-5; $0/Day 6-90	$0/Day 1-10; $100/Day 11-100	$0/Visit	$100/Trip	0%-20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $20/Visit	"$75 ASC, HOSP 20% Coinsurance"	$0-$150/Visit	"X-rays $5; Thera Rad $30; CT $100; MRI,PET,NM $150"	20% Coinsurance	$30/Visit	Chemo $30; 20% Coinsurance; OP Rehab $15/Visit	Hep B 20% Coinsurance	"$5/Visit SPC, Routine Foot Care; Chiropractic"	$25/Visit	$15/Visit	$5/Visit	"$5/Visit, $15 Medicare covered eye exam, $15 Medicare Covered Hearing Exam"	20% Coinsurance	Medicare Covered Eyewear $15	$75/Trip		Routine $0/Visit	$15 Eyewear	$15/Procedure	$500 MAB for 2 years														67.9346	51.6757	56.4545		92.4911	0.184982134	0.184982134	46.2235	198.7887	138.7366	79.0165	0.184982134	27.7473	150.4579		4.6246	23.1228	13.8737	4.6246	13.8228	0.2		69.3683			13.8737	13.8737															9.1601	0.244906746	2.136438784	0	0.005054178	0.149513372	0.005701343	0.98919181	5.607858832	0.297607851	0.20985773	0.280529019	0.042474006	1.08352322	0	1.78311605	0.570579625	0.307646286	1.394166158	0.732958069	4.755172382	0	1.647662178	0	0	0.001263545	0.024568747	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.4299	0	2.165228365	9.1601	0.244906746	2.136438784	0	0.005054178	0.149513372	0.005701343	0.98919181	5.607858832	0.297607851	0.20985773	0.280529019	0.042474006	1.08352322	0	1.78311605	0.570579625	0.307646286	1.394166158	0.732958069	4.755172382	0	1.647662178	0	0	0.001263545	0.024568747	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.4299																																																																																				0	0	0	9.1601	0.244906746	2.136438784	0	0.005054178	0.149513372	0.005701343	0.98919181	5.607858832	0.297607851	0.20985773	0.280529019	0.042474006	1.08352322	0	1.78311605	0.570579625	0.307646286	1.394166158	0.732958069	4.755172382	0	1.647662178	0	0	0.001263545	0.024568747	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.4299
H5402_010_0	2008	7																					3500											D	D	D	V	T	Coin	Coin	V	V	V	P	Coin	V	V	P	P	V	V	P	P	Coin	Coin	T	V	P	P	P	P	P	V	P																																																				0		2330.355596	131.1950364	1082.065091		104.1985964	8.939961254	4.871710289	386.0327235	374.0696756	2197.712526	525.2833547	1.84551216	20.5104691	929.6928903		7470.780182	318.4335313	414.8034686	2933.344065	859.8239418	31.68408092	0.623797143	373.5188965			1.432204358	19.33311125															$75/Day 1-3; $0/Day 4-90	$100/Day 1-5; $0/Day 6-90	$0/Day 1-14; $75/Day 15-100		$100/Trip	0%-20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $20/Visit	"$0 ASC, HOSP 20% Coinsurance"	$0-$100/Visit	"X-rays $5; Thera Rad $35; CT $100; MRI,PET,NM $100"	20% Coinsurance	$35/Visit	20% Coinsurance; OP Rehab $15/Visit	Hep B 20% Coinsurance	"$5/Visit SPC, Routine Foot Care; Chiropractic"	$25/Visit	$15/Visit	$5/Visit	"$5/Visit; $10 Medicare Covered Eye Exam, $10 Medicare covered hearing exam"	20% Coinsurance	Medicare Covered Eyewear $10	$75/Trip		Routine $0/Visit	$10 Eyewear	$10/Procedure	$500 MAB for 2 years														29.5733	37.0996	31.6569		83.0028	0.166005591	0.166005591	41.4909	139.2591	83.0028	48.4076	0.166005591	29.051	34.7525		4.1501	20.7507	12.4504	4.1501	8.2869	0.2	0.185223092	62.2521			8.3003	8.3003															5.743	0.405606856	2.85457269	0	0.720731234	1.484083555	0.808731148	1.334737907	4.341050068	15.20135698	2.118973467	0.306365338	0.0496541	2.692428391	0	2.583731839	0.550643195	0.430373095	1.014482326	0.593770394	6.336816184	0.115541636	1.937694541	0	0	0.000990641	0.013372519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6387	0	9.205342346	5.743	0.405606856	2.85457269	0	0.720731234	1.484083555	0.808731148	1.334737907	4.341050068	15.20135698	2.118973467	0.306365338	0.0496541	2.692428391	0	2.583731839	0.550643195	0.430373095	1.014482326	0.593770394	6.336816184	0.115541636	1.937694541	0	0	0.000990641	0.013372519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6387																																																																																				0	0	0	5.743	0.405606856	2.85457269	0	0.720731234	1.484083555	0.808731148	1.334737907	4.341050068	15.20135698	2.118973467	0.306365338	0.0496541	2.692428391	0	2.583731839	0.550643195	0.430373095	1.014482326	0.593770394	6.336816184	0.115541636	1.937694541	0	0	0.000990641	0.013372519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6387
H5402_011_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	V	Coin	P	V	V	Coin	P	Coin	Coin	T	V	P	P	P	P	P	V	P																																																				0		1566.606077	35.09	1609.131724	719.2356537	153.2786359		13.47690286	247.3698074	333.6202252		11.90272254	3.630899877	0.591182787	751.0989043	18.46324326	5639.765529	177.9250723	989.8033343	37.14528453	992.6682919	44.34953384	3.265762827			144	669.7	20.7															"$150/Day 1-5; $0/Day 6-90, $476/Day for Lifetime Days"	"$150/Day 1-5; $0/Day 6-90, $476/Day for Lifetime Days"	$0/Day 1-10; $50/Day 11-100	$20/Visit	$100/Trip	0%-20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $25/Visit	"$100 ASC, HOSP 20% Coinsurance"	0%-10% Coinsurance	X-rays and Diagnostic Benefits 0%-20% Coinsurance; Thera Rad 20% Coinsurance	20% Coinsurance	20% Coinsurance	Chemo 20%; OP Rehab $25/Visit	"$10/Visit, Hep B 20% Coinsurance"	"$25/Visit SPC, Routine Foot Care; Chiropractic"	$25/Visit	$25/Visit	0%10% Coinsurance	"$25/Visit, $15 Medicare covered eye exam, $20 Medicare Covered Hearing Exam"	20% Coinsurance	Medicare Covered Eyewear $15	$75/Trip		Routine $15/Visit	$15 Eyewear	$20/Procedure															68.2245	166.0459	30.5189	20	100		0.2	49.9777	230.6445		0.124521617	0.2	0.2	80.4001	0.164680405	25	25	25	0.1	15.0002	0.2	0.271575928			15	15	20															8.9067	0.485545821	4.092413408	1.198726089	1.277321965	0	2.695380572	1.030246824	6.412306908	0	1.482146259	0.726179975	0.118236557	5.03236584	3.040534371	11.74951152	0.370677234	2.06209028	3.714528453	1.240849482	8.869906768	0.886902571	0	0	0.18	0.837125	0.0345	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4442	0	0	8.9067	0.485545821	4.092413408	1.198726089	1.277321965	0	2.695380572	1.030246824	6.412306908	0	1.482146259	0.726179975	0.118236557	5.03236584	3.040534371	11.74951152	0.370677234	2.06209028	3.714528453	1.240849482	8.869906768	0.886902571	0	0	0.18	0.837125	0.0345	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4442																																																																																				0	0	0	8.9067	0.485545821	4.092413408	1.198726089	1.277321965	0	2.695380572	1.030246824	6.412306908	0	1.482146259	0.726179975	0.118236557	5.03236584	3.040534371	11.74951152	0.370677234	2.06209028	3.714528453	1.240849482	8.869906768	0.886902571	0	0	0.18	0.837125	0.0345	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4442
H5402_012_0	2008	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	P	Coin	V	V	P	P	V	V	P	P	Coin	Coin	T	V	P	P	P	P	P	V	P																																																				0		1575.287353	36.3035	1617.788603		161.0659614	2.589081362	13.38620917	248.7436091	374.1176783	3009.342659	642.5770498	3.606465502	11.03514691	1319.855338	0.852002566	5668.557869	217.3943248	995.2882844	5033.537534	998.1691181	44.05108078	3.243785665				669.7	20.7															$110/Day 1-5; $0/Day 6-90	$125/Day 1-5; $0/Day 6-90	$0/Day 1-10; $100/Day 11-100		$100/Trip	0%-20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $20/Visit	"$75 ASC, HOSP 20% Coinsurance"	$0-$150/Visit	"X-rays $5; Thera Rad $30; CT $100; MRI,PET,NM $150"	20% Coinsurance	$30/Visit	$30 Chemo; 20% Coinsurance; OP Rehab $15/Visit	Hep B 20% Coinsurance	"$5/Visit SPC, Routine Foot Care; Chiropractic"	$25/Visit	$15/Visit	$8/Visit	"$5/Visit, $20 Medicare covered eye exam, $15 Medicare Covered Hearing Exam"	20% Coinsurance	Medicare Covered Eyewear $20			Routine $0/Visit	$20 Eyewear	$15/Procedure	$400 MAB for 2 years														40.5847	48.1213	52.5715		86.1294	0.022560038	0.172258741	43.0414	185.1157	0.090644289	61.1475	0.172258741	25.8388	38.9138	6.6034	4.3065	21.5323	12.9194	6.8903	17.2257	0.2	0.315728475				17.2259	12.9194															5.3277	0.145581083	7.087465228	0	1.156042486	0.058409775	2.305891535	0.892190054	5.771254699	0.022731644	3.274332874	0.621245206	0.023761256	4.280053104	0.000468841	2.034288834	0.39008409	1.071544416	2.890236123	1.432849068	8.810216157	1.024155502	0	0	0	0.961347322	0.022285975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6042	0	6.510799373	5.3277	0.145581083	7.087465228	0	1.156042486	0.058409775	2.305891535	0.892190054	5.771254699	0.022731644	3.274332874	0.621245206	0.023761256	4.280053104	0.000468841	2.034288834	0.39008409	1.071544416	2.890236123	1.432849068	8.810216157	1.024155502	0	0	0	0.961347322	0.022285975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6042																																																																																				0	0	0	5.3277	0.145581083	7.087465228	0	1.156042486	0.058409775	2.305891535	0.892190054	5.771254699	0.022731644	3.274332874	0.621245206	0.023761256	4.280053104	0.000468841	2.034288834	0.39008409	1.071544416	2.890236123	1.432849068	8.810216157	1.024155502	0	0	0	0.961347322	0.022285975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6042
H5402_013_0	2008	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	P	Coin	V	V	P	P	V	V	P	P	Coin	Coin	T	V	P	P	P	P	P	V	P																																																				0		1493.996909	36.44586834	1534.304942		152.7543835	2.548347032	12.7928224	235.9272485	354.8118722	2985.57563	609.417783	3.446597321	10.46569398	1251.746097	0.808036196	5398.184069	154.9408959	943.9278603	4773.789051	946.6600327	42.09837497	3.099994434				669.7	20.7															$75/Day 1-3; $0/Day 4-90	$100/Day 1-5; $0/Day 6-90	$0/Day 1-14; $75/Day 15-100		$100/Trip	0%-20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $20/Visit	"$0 ASC, HOSP 20% Coinsurance"	$0-$100/Visit	"X-rays $5; Thera Rad $35; CT $100; MRI,PET,NM $100"	20% Coinsurance	$35/Visit	20% Coinsurance; OP Rehab $15/Visit	Hep B 20% Coinsurance	"$5/Visit SPC, Routine Foot Care; Chiropractic"	$25/Visit	$15/Visit	$5/Visit	"$5/Visit; $10 Medicare Covered Eye Exam, $10 Medicare covered hearing exam"	20% Coinsurance	Medicare Covered Eyewear $10			Routine $0/Visit	$10 Eyewear	$10/Procedure	$500 MAB for 2 years														32.2333	40.4366	34.5044		90.4687	0.023696657	0.180937469	45.2088	151.7852	0.094067929	51.8547	0.180937469	31.6641	41.1655	6.9893	4.5234	22.6172	13.5703	4.5234	9.0469	0.2	0.164555404				9.0469	9.0469															4.013	0.122812332	4.411692144	0	1.151624646	0.060387304	2.314700906	0.888832504	4.487931601	0.02340391	2.633432798	0.623618596	0.027615528	4.294062513	0.000470632	2.034862004	0.292027224	1.067449487	1.799494391	0.713692793	8.419674995	0.510120835	0	0	0	0.504890929	0.015605857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4114	0	3.328391984	4.013	0.122812332	4.411692144	0	1.151624646	0.060387304	2.314700906	0.888832504	4.487931601	0.02340391	2.633432798	0.623618596	0.027615528	4.294062513	0.000470632	2.034862004	0.292027224	1.067449487	1.799494391	0.713692793	8.419674995	0.510120835	0	0	0	0.504890929	0.015605857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4114																																																																																				0	0	0	4.013	0.122812332	4.411692144	0	1.151624646	0.060387304	2.314700906	0.888832504	4.487931601	0.02340391	2.633432798	0.623618596	0.027615528	4.294062513	0.000470632	2.034862004	0.292027224	1.067449487	1.799494391	0.713692793	8.419674995	0.510120835	0	0	0	0.504890929	0.015605857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4114
H5402_024_0	2008	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	P	Coin	V	V	P	P	V	V	P	P	Coin	Coin	T	V	P	P	P	P	P	V	P																																																				0		2323.209433		3232.945703		300.7754368	2.247969629	28.86360427	407.878214	290.6503763		113.9061835	3.074052504	33.34884265	1733.713717	0.905532313						101.3056219																					$20/Day 1-5; $0/Day 6-90	$0/Day 1-10; $0/Day 6-90	$0/Day 1-25; $40/Day 26-100		$100/Trip	0%-20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $0/Visit	"$0 ASC, $100 HOSP"	$0-$100/Visit	"X-rays $0; Thera Rad $15; CT $0; MRI,PET,NM $0"	$100/Visit	$15/Visit	Chemo $15; OP Rehab $0/Visit	Hep B 20% Coinsurance	"$0/Visit SPC, Routine Foot Care; Chiropractic"	$0/Visit	$0/Visit	$0/Visit	$0/Visit	20% Coinsurance	Medicare Covered Eyewear $0			Routine $0/Visit	$0 Eyewear	$0/Procedure	$500 MAB for 2 years														10.315		11.5738		91.5595	0.023982375	0.183119096	45.7798	33.9977		15	0.110728034	13.7339	90.8616	7.5549						0.2																					1.997	0	3.11811544	0	2.294905248	0.053911652	5.285477108	1.556047701	0.823454788	0	0.142382729	0.340383791	0.038167562	13.12733445	0.000570102	0	0	0	0	0	20.26112439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0389	0	2.637939584	1.997	0	3.11811544	0	2.294905248	0.053911652	5.285477108	1.556047701	0.823454788	0	0.142382729	0.340383791	0.038167562	13.12733445	0.000570102	0	0	0	0	0	20.26112439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0389																																																																																				0	0	0	1.997	0	3.11811544	0	2.294905248	0.053911652	5.285477108	1.556047701	0.823454788	0	0.142382729	0.340383791	0.038167562	13.12733445	0.000570102	0	0	0	0	0	20.26112439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0389
H5402_025_0	2008	4																					3000											D	D	D	V	T	Coin	Coin	V	V	V	P	Coin	V	V	P	P	V	V	P	P	Coin	Coin	T	V	P	P	P	P	P	V	P																																																				0		1617.147993	36.14999331	1660.778643		165.3460213	2.606138286	14.10709421	254.8939159	384.0592331	3019.239193	659.6524658	3.80068382	11.32838758	1354.928298	0.874643117	5460.711811	184.0878422	1021.736415	5167.295419	1024.693802	46.42335547	3.418472653																				$150/Day 1-5; $0/Day 6-90	$150/Day 1-5; $0/Day 6-90	$0/Day 1-10; $75/Day 11-100	$0/Visit	$100/Trip	0%-20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $20/Visit	"$75 ASC, HOSP 20% Coinsurance"	$0-$150/Visit	"X-rays $5; Thera Rad 20% Coin; CT $100; MRI,PET,NM $150"	20% Coinsurance	$30/Visit	Chemo $30; OP Rehab $15/Visit	Hep B 20% Coinsurance	"$5/Visit SPC, Routine Foot Care; Chiropractic"	$25/Visit	$15/Visit	$5/Visit	"$5/Visit, $15 Medicare covered eye exam, $15 Medicare Covered Hearing Exam"	20% Coinsurance	Medicare Covered Eyewear $15			Routine $0/Visit	$15 Eyewear	$15/Procedure	$500 MAB for 2 years														53.6972	46.6905	38.2562		83.5683	0.021889218	0.167136646	41.7842	179.6113	0.087872746	64.3174	0.167136646	25.0705	38.7503	6.5773	4.1784	20.8921	12.5352	4.1784	12.5352	0.2	0.22380792																				7.2364	0.140654971	5.294593223	0	1.151474143	0.057046329	2.357812412	0.887544046	5.748448382	0.02210907	3.535593384	0.635233546	0.023667359	4.375327156	0.000479398	1.901427203	0.320498172	1.067309984	1.79925922	1.070399283	9.284671094	0.765081253	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.675	0	7.422906761	7.2364	0.140654971	5.294593223	0	1.151474143	0.057046329	2.357812412	0.887544046	5.748448382	0.02210907	3.535593384	0.635233546	0.023667359	4.375327156	0.000479398	1.901427203	0.320498172	1.067309984	1.79925922	1.070399283	9.284671094	0.765081253	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.675																																																																																				0	0	0	7.2364	0.140654971	5.294593223	0	1.151474143	0.057046329	2.357812412	0.887544046	5.748448382	0.02210907	3.535593384	0.635233546	0.023667359	4.375327156	0.000479398	1.901427203	0.320498172	1.067309984	1.79925922	1.070399283	9.284671094	0.765081253	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.675
H5402_032_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	V	Coin	P	V	V	Coin	P	Coin	Coin	T	V	P	P	P	P	P	V	P																																																				0						168.6189676								0.981463475								101.1793314																					No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$50.00 Copay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% Coinsurance	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% Coinsurance	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing															50								0.2								0.2																					0	0	0	0	0.702579032	0	0	0	0	0	0	0	0.196292695	0	0	0	0	0	0	0	20.23586627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.1347	0	0	0	0	0	0	0.702579032	0	0	0	0	0	0	0	0.196292695	0	0	0	0	0	0	0	20.23586627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.1347																																																																																				0	0	0	0	0	0	0	0.702579032	0	0	0	0	0	0	0	0.196292695	0	0	0	0	0	0	0	20.23586627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.1347
H5402_034_0	2008	4																					4000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	V	Coin	P	V	V	Coin	P	Coin	Coin	T	V	P	P	P	P	P	V	P																																																				0		1300.174255	141.806279	1208.937746		159.5999431	30.68050691	21.57731325	171.6413288	111.9924847	3.180407852	13.43390508	2.999990195	0.928967346	680.5852483	0.002341369						95.76749138																					"$25/Day 1-7; $0/Day 8-90, $476/Day for Lifetime Days"	"$25/Day 1-7; $0/Day 8-90, $476/Day for Lifetime Days"	$0/Day 1-10; $25/Day 11-100	$0/Visit	$100/Trip	0%-20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $25/Visit	"$25 ASC, HOSP 20% Coinsurance"	0%-10% Coinsurance	"0%-20% Coinsurance, 20% Thera Rad"	20% Coinsurance	20% Coinsurance	20% Coinsurance; $0/Visit OP Rehab	Hep B 20% Coinsurance	"$0/Visit SPC, Routine Foot Care; Chiropractic"	$0/Visit	$0/Visit	0% Coinsurance	$0/Visit	20% Coinsurance	Medicare Covered Eyewear $0			Routine $0/Visit	$0 Eyewear	$0/Procedure	$500 MAB for 2 years														16.122	13.7284	14.3972		94.3492	0.18869831	0.18869831	47.1746	173.1245	0.18869831	0.126686487	0.18869831	0.18869831	116.1332	0.18869831						0.2																					1.7468	0.162231514	1.4504403	0	1.254843312	5.789359795	4.071602539	0.67475893	1.615720149	0.600137586	1.701894239	0.566093079	0.175294568	6.586542833	0.000441812	0	0	0	0	0	19.15349828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.5496	0	1.531688076	1.7468	0.162231514	1.4504403	0	1.254843312	5.789359795	4.071602539	0.67475893	1.615720149	0.600137586	1.701894239	0.566093079	0.175294568	6.586542833	0.000441812	0	0	0	0	0	19.15349828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.5496																																																																																				0	0	0	1.7468	0.162231514	1.4504403	0	1.254843312	5.789359795	4.071602539	0.67475893	1.615720149	0.600137586	1.701894239	0.566093079	0.175294568	6.586542833	0.000441812	0	0	0	0	0	19.15349828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.5496
H5402_035_0	2008	6																					3250											D	D	D	V	T	Coin	Coin	V	V	V	P	Coin	V	V	P	P	V	V	P	P	Coin	Coin	T	V	P	P	P	P	P	V	P																																																				0		3007.917271	164.8663349	3148.180832		292.9781311	36.52642456	28.93238739	338.3229878	380.2663303	1265.478214	354.8581418	5.6364941	30.40764095	1051.724992	400.8617223	7794.811627	858.5548236	1299.095087	6669.123532	1205.061243	58.27706205	4.424963013				669.7149318	20.7279201															$110/Day 1-5; $0/Day 6-90	$125/Day 1-5; $0/Day 6-90	$0/Day 1-10; $100/Day 11-100		$100/Trip	20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $20/Visit	"$75 ASC, HOSP 20% Coinsurance"	$0-$150/Visit	"X-rays $5; Thera Rad $30; CT $100; MRI,PET,NM $150"	20% Coinsurance	$30/Visit	20% Coinsurance; OP Rehab $15/Visit	"Hep B 20% Coinsurance, Radiology $9/visit"	"$5/Visit SPC, Routine Foot Care; Chiropractic"	$25/Visit	$15/Visit	$9/Visit	"$5/Visit, $15 Medicare covered eye exam, $15 Medicare Covered Hearing Exam"	20% Coinsurance	Medicare Covered Eyewear $15			Routine $0/Visit	$15 Eyewear	$15/Procedure	$500 MAB for 2 years														33.2273	39.3977	43.0411		70.5154	0.141030787	0.141030787	35.2577	93.0713	105.7731	49.7704	0.141030787	21.1546	59.1287	6.3464	3.5258	17.6288	10.5773	6.3464	10.5773	0.2	0.186425485				10.5773	10.5773															8.3288	0.541278893	11.29175641	0	1.721622348	5.151350396	4.080357359	0.994040774	2.949322909	11.15446176	1.471784494	0.794919198	0.053605169	5.182258813	0.212001915	2.290225869	1.261277732	1.145077514	3.527069022	1.062192096	11.65541241	0.824925875	0	0	0	0.590315149	0.018270468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.3023	0	27.01095117	8.3288	0.541278893	11.29175641	0	1.721622348	5.151350396	4.080357359	0.994040774	2.949322909	11.15446176	1.471784494	0.794919198	0.053605169	5.182258813	0.212001915	2.290225869	1.261277732	1.145077514	3.527069022	1.062192096	11.65541241	0.824925875	0	0	0	0.590315149	0.018270468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.3023																																																																																				0	0	0	8.3288	0.541278893	11.29175641	0	1.721622348	5.151350396	4.080357359	0.994040774	2.949322909	11.15446176	1.471784494	0.794919198	0.053605169	5.182258813	0.212001915	2.290225869	1.261277732	1.145077514	3.527069022	1.062192096	11.65541241	0.824925875	0	0	0	0.590315149	0.018270468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.3023
H5404_001_0	2008	4																					3200											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1134.107645	28.45805109	587.5807644	1874.0893	179.7772315	23218.62202	23389.04623	212.5038817	273.1379272	1447.779563	598.4276772	0	46.85984873	424.5058634	8922.836167	13897.53207	204.7788992	588.4977504	5267.570886	16005.57074	200.4970197	697.7116887	0	0	398.3918772	267.1908563	170.7393759	16.65908864	0	0	12394.60976											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$100 copay, days 11-100"	$20 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$20 copay	$0 copay	Varies	$20 copay	$20 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	$10 copay	$10 copay	$10 copay	$500 credit														81.01447376	150.3313733	58.5304677	8.982495887	125	0.691410471	0.782687667	45	245.0359087	35.5941507	24.33477776	0	0	20	0	10.80324941	20	20	0	10.29340031	0.413449727	11.86366462	0	0	10	10	10	0	0	0	0											7.6566	0.356511492	2.865948079	1.402833286	1.872679495	1.337799866	1.525526502	0.796889556	5.57738335	4.294373661	1.213550378	0	0	0.707509772	0	12.5115421	0.341298165	0.980829584	0	13.72931223	0.006907953	0.68978479	0	0	0.331993231	0.222659047	0.142282813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5642		17.20648881	7.6566	0.356511492	2.865948079	1.402833286	1.872679495	1.337799866	1.525526502	0.796889556	5.57738335	4.294373661	1.213550378	0	0	0.707509772	0	12.5115421	0.341298165	0.980829584	0	13.72931223	0.006907953	0.68978479	0	0	0.331993231	0.222659047	0.142282813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5642																																																																																				0			7.6566	0.356511492	2.865948079	1.402833286	1.872679495	1.337799866	1.525526502	0.796889556	5.57738335	4.294373661	1.213550378	0	0	0.707509772	0	12.5115421	0.341298165	0.980829584	0	13.72931223	0.006907953	0.68978479	0	0	0.331993231	0.222659047	0.142282813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5642
H5404_002_0	2008	4																					3200											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1063.871204	25.77711575	689.2352358	1540.974497	156.7680499	21354.37198	21514.54898	225.1943245	285.4866543	1165.265556	481.5408697	0	37.76635061	341.6156418	6260.108284	10195.12183	155.5713293	447.5501015	3855.162964	11540.39059	287.6294416	483.8486791	0	0	374.8251699	253.2346327	160.6393585	15.78893175	0	0	12408.22585											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$100 copay, days 11-100"	$20 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$25 copay	$0 copay	Varies	$25 copay	$25 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	$10 copay	$10 copay	$10 copay	$500 credit														75.37307358	150.3313733	58.33470796	8.505832542	125	0.620031028	0.70298477	45	215.3669848	34.50262166	21.38117115	0	0	25	0	13.45278203	25	25	0	10.35333796	0.511366797	11.7034682	0	0	10	10	10	0	0	0	0											6.6823	0.322925767	3.350528016	1.092272586	1.63300052	1.103364434	1.26036669	0.844478717	5.123699994	3.350393051	0.857992313	0	0	0.711699254	0	11.42939599	0.324106936	0.932396045	0	9.956796994	0.012257012	0.471892302	0	0	0.312354308	0.211028861	0.133866132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1171		14.76018243	6.6823	0.322925767	3.350528016	1.092272586	1.63300052	1.103364434	1.26036669	0.844478717	5.123699994	3.350393051	0.857992313	0	0	0.711699254	0	11.42939599	0.324106936	0.932396045	0	9.956796994	0.012257012	0.471892302	0	0	0.312354308	0.211028861	0.133866132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1171																																																																																				0			6.6823	0.322925767	3.350528016	1.092272586	1.63300052	1.103364434	1.26036669	0.844478717	5.123699994	3.350393051	0.857992313	0	0	0.711699254	0	11.42939599	0.324106936	0.932396045	0	9.956796994	0.012257012	0.471892302	0	0	0.312354308	0.211028861	0.133866132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1171
H5404_003_0	2008	4																					3200											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		800.0374162	19.38454297	650.7504869	1481.638428	132.0032714	20532.11015	20686.11945	273.0104674	246.7439329	1679.51793	694.0534034	0	54.43331153	492.3766886	6293.828891	10250.03873	156.4093275	449.9608683	3875.929128	11611.19566	505.9301468	346.474255	0	0	360.3923208	243.483694	154.4538518	15.18097026	0	0	12416.04183											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$100 copay, days 11-100"	$20 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$25 copay	$0 copay	Varies	$25 copay	$25 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	$10 copay	$10 copay	$10 copay	$500 credit														80.44205887	150.3313733	58.97999604	9.283114924	125	0.602194425	0.681909035	45	208.0638509	34.19684818	20.55787741	0	0	25	0	13.64803365	25	25	0	10.06998759	0.539503609	11.67533139	0	0	10	10	10	0	0	0	0											5.3631	0.24284208	3.198438428	1.146184983	1.375034077	1.030360189	1.175504313	1.023789253	4.278207738	4.786184972	1.189022065	0	0	1.025784768	0	11.65773946	0.325852766	0.937418476	0	9.743716343	0.022745928	0.337100145	0	0	0.300326934	0.202903078	0.128711543	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4909		13.23212396	5.3631	0.24284208	3.198438428	1.146184983	1.375034077	1.030360189	1.175504313	1.023789253	4.278207738	4.786184972	1.189022065	0	0	1.025784768	0	11.65773946	0.325852766	0.937418476	0	9.743716343	0.022745928	0.337100145	0	0	0.300326934	0.202903078	0.128711543	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4909																																																																																				0			5.3631	0.24284208	3.198438428	1.146184983	1.375034077	1.030360189	1.175504313	1.023789253	4.278207738	4.786184972	1.189022065	0	0	1.025784768	0	11.65773946	0.325852766	0.937418476	0	9.743716343	0.022745928	0.337100145	0	0	0.300326934	0.202903078	0.128711543	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4909
H5404_004_0	2008	4																					3250											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1256.910352	31.95259116	698.0776719	1882.31652	392.7830736	24086.55792	24248.8997	232.7983704	183.7314453	1306.994183	539.9767554	0	42.4197517	383.1017404	4513.73741	6771.86509	88.35497675	252.4980225	2752.064459	7781.111274	444.7860684	554.4109001	0	947.7448539	334.2655835	260.2362303	143.2566787	16.1819426	0	0	12399.31816											"$250 copay, days 1-7"	"$250 copay, days 1-7"	"$100 copay, days 6-100"	$20 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$25 copay	$0 copay	Varies	$25 copay	$25 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	$10 copay	$10 copay	$10 copay	$500 credit														119.8715612	187.9142166	72.69243653	9.323172838	125	0.741079906	0.834699537	45	184.0078268	34.30721703	20.83422617	0	0	25	0	11.5844483	25	25	0	9.600306205	1.126794977	10.8332409	0	0	10	10	10	0	0	0	0											12.5557	0.500362178	4.228747238	1.462430188	4.09149035	1.487505339	1.686712113	0.872993889	2.81733533	3.736611091	0.937499821	0	0	0.798128626	0	6.537360086	0.184072868	0.526037547	0	6.22508757	0.041765226	0.50050557	0	0	0.278554653	0.216863525	0.119380566	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8051		16.74764012	12.5557	0.500362178	4.228747238	1.462430188	4.09149035	1.487505339	1.686712113	0.872993889	2.81733533	3.736611091	0.937499821	0	0	0.798128626	0	6.537360086	0.184072868	0.526037547	0	6.22508757	0.041765226	0.50050557	0	0	0.278554653	0.216863525	0.119380566	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8051																																																																																				0			12.5557	0.500362178	4.228747238	1.462430188	4.09149035	1.487505339	1.686712113	0.872993889	2.81733533	3.736611091	0.937499821	0	0	0.798128626	0	6.537360086	0.184072868	0.526037547	0	6.22508757	0.041765226	0.50050557	0	0	0.278554653	0.216863525	0.119380566	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8051
H5404_013_0	2008	5																					3250											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1402.369413	34.38857626	809.8538078	1623.882302	192.1680317	22253.16317	22420.8015	285.4685413	193.8058663	1911.136474	787.8272197	0	61.33633146	566.0602675	7531.854635	11956.96851	175.9541342	504.3992859	5020.334378	15084.94302	395.8438666	504.111336	0	0	357.2506012	265.4629634	153.1074005	16.55135621	0	0	12387.71758											"$225 copay, days 1-7"	"$225 copay, days 1-7"	"$100 copay, days 6-100"	$20 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$25 copay	$5 copay	Varies	$25 copay	$25 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	$10 copay	$10 copay	$10 copay	$500 credit														88.89428852	169.1227949	72.43911282	7.056686573	125	0.624274243	0.710744634	45	296.8846659	37.6660195	29.86973576	0	0	25	1.809388852	13.32315505	25	25	0	10.08276839	0.896654214	11.61904134	0	0	10	10	10	0	0	0	0											10.3886	0.484657678	4.888757613	0.954935703	2.00175033	1.157673049	1.327955362	1.07050703	4.794832488	5.998741975	1.961015907	0	0	1.179292224	1.135671151	13.27537878	0.366571113	1.050831846	0	12.67483222	0.029577923	0.488107538	0	0	0.297708834	0.221219136	0.1275895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8762		17.515348	10.3886	0.484657678	4.888757613	0.954935703	2.00175033	1.157673049	1.327955362	1.07050703	4.794832488	5.998741975	1.961015907	0	0	1.179292224	1.135671151	13.27537878	0.366571113	1.050831846	0	12.67483222	0.029577923	0.488107538	0	0	0.297708834	0.221219136	0.1275895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8762																																																																																				0			10.3886	0.484657678	4.888757613	0.954935703	2.00175033	1.157673049	1.327955362	1.07050703	4.794832488	5.998741975	1.961015907	0	0	1.179292224	1.135671151	13.27537878	0.366571113	1.050831846	0	12.67483222	0.029577923	0.488107538	0	0	0.297708834	0.221219136	0.1275895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8762
H5404_016_0	2008	4																					3200											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1196.108878	30.0138419	693.9450234	1765.641628	263.6651382	21875.03317	22035.59547	238.3889746	210.7495558	1148.699902	474.8055796	0	37.17962668	336.8122167	5555.477348	8652.789671	127.4980863	366.4065842	3279.660209	9977.189016	199.1655837	532.0521674	0	0	375.3381885	251.7293593	160.8592236	15.69507942	0	0	12454.46962											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$100 copay, days 11-100"	$20 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$20 copay	$0 copay	Varies	$20 copay	$20 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	$10 copay	$10 copay	$10 copay	$500 credit														90.03354554	150.3313733	59.74657769	10.41602308	125	0.667462557	0.753340793	45	192.4555047	35.07231238	22.92660048	0	0	20	0	10.17494879	20	20	0	9.830392683	0.48979517	11.78731918	0	0	10	10	10	0	0	0	0											8.9742	0.376001839	3.455070021	1.53258033	2.746511857	1.216730464	1.383359413	0.893958655	3.379992677	3.357296817	0.907139819	0	0	0.561353694	0	7.336807652	0.212496811	0.61067764	0	8.173307158	0.008129195	0.522622393	0	0	0.312781824	0.209774466	0.134049353	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3048		14.10155718	8.9742	0.376001839	3.455070021	1.53258033	2.746511857	1.216730464	1.383359413	0.893958655	3.379992677	3.357296817	0.907139819	0	0	0.561353694	0	7.336807652	0.212496811	0.61067764	0	8.173307158	0.008129195	0.522622393	0	0	0.312781824	0.209774466	0.134049353	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3048																																																																																				0			8.9742	0.376001839	3.455070021	1.53258033	2.746511857	1.216730464	1.383359413	0.893958655	3.379992677	3.357296817	0.907139819	0	0	0.561353694	0	7.336807652	0.212496811	0.61067764	0	8.173307158	0.008129195	0.522622393	0	0	0.312781824	0.209774466	0.134049353	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3048
H5404_022_0	2008	4																					3200											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1258.158472	31.57084623	887.5080382	1772.282294	218.0324736	21957.30625	22118.47243	277.1923501	272.8812242	1658.787723	685.6461504	0	53.68948682	486.3759183	8059.344047	12552.62231	184.9617735	531.546893	4757.810775	14472.87179	356.2484448	627.7941526	0	0	376.749854	252.6761259	161.4642231	15.75410939	0	0	12498.18303											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$100 copay, days 11-100"	$20 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$20 copay	$0 copay	Varies	$20 copay	$20 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	$10 copay	$10 copay	$10 copay	$500 credit														89.62658399	150.3313733	59.69170397	10.35133899	125	0.669395032	0.755600471	45	193.0669011	35.10426654	23.01282855	0	0	20	0	10.90110292	20	20	0	9.860498443	0.510193306	11.76692104	0	0	10	10	10	0	0	0	0											9.397	0.395507389	4.414738924	1.528791234	2.2711716	1.224842644	1.39272735	1.039471313	4.390361026	4.852543862	1.314888109	0	0	0.81062653	0	11.40311898	0.308269623	0.885911488	0	11.89247748	0.015146298	0.615600352	0	0	0.313958212	0.210563438	0.134553519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8123		14.25012589	9.397	0.395507389	4.414738924	1.528791234	2.2711716	1.224842644	1.39272735	1.039471313	4.390361026	4.852543862	1.314888109	0	0	0.81062653	0	11.40311898	0.308269623	0.885911488	0	11.89247748	0.015146298	0.615600352	0	0	0.313958212	0.210563438	0.134553519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8123																																																																																				0			9.397	0.395507389	4.414738924	1.528791234	2.2711716	1.224842644	1.39272735	1.039471313	4.390361026	4.852543862	1.314888109	0	0	0.81062653	0	11.40311898	0.308269623	0.885911488	0	11.89247748	0.015146298	0.615600352	0	0	0.313958212	0.210563438	0.134553519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8123
H5404_025_0	2008	4																					3250											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		984.0889006	23.53993938	861.6711571	1598.453762	190.6239122	22921.97116	23097.58515	202.7893853	277.0852678	1774.990876	739.5632547	0	56.57025317	512.9861355	7358.561414	11942.63026	183.7146223	527.9186632	4810.963616	12837.84592	328.1750783	845.6593031	0	3065.068925	387.3993721	265.8526043	166.0283023	16.61741615	0	0	12374.89368											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$100 copay, days 6-100"	$20 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$20 copay	$0 copay	Varies	$20 copay	$20 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	$10 copay	$10 copay	$10 copay	$500 credit														144.8485366	225.4970599	70.27035565	7.587173538	125	0.698429055	0.79033498	45	200.2704561	34.12836705	20.21582826	0	0	20	0	8.177074655	20	20	0	11.03718442	0.888090924	11.24482411	0	0	10	10	10	0	0	0	0											11.8787	0.442348927	5.045828222	1.010645507	1.985665752	1.334114222	1.521235791	0.760460195	4.624332746	5.048128344	1.245906979	0	0	0.854976892	0	8.137981602	0.306191037	0.879864439	0	11.80780608	0.024287442	0.792440844	0	0	0.32283281	0.221543837	0.138356919	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.3836		16.53444097	11.8787	0.442348927	5.045828222	1.010645507	1.985665752	1.334114222	1.521235791	0.760460195	4.624332746	5.048128344	1.245906979	0	0	0.854976892	0	8.137981602	0.306191037	0.879864439	0	11.80780608	0.024287442	0.792440844	0	0	0.32283281	0.221543837	0.138356919	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.3836																																																																																				0			11.8787	0.442348927	5.045828222	1.010645507	1.985665752	1.334114222	1.521235791	0.760460195	4.624332746	5.048128344	1.245906979	0	0	0.854976892	0	8.137981602	0.306191037	0.879864439	0	11.80780608	0.024287442	0.792440844	0	0	0.32283281	0.221543837	0.138356919	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.3836
H5404_028_0	2008	4																					3250											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1132.376652	27.96971824	1106.832723	1695.639606	196.3103757	23628.09867	23803.88175	204.0501848	279.8267522	1789.543067	745.5140055	0	57.09599806	517.077873	7412.106927	11260.80383	167.6325966	480.7632852	4822.285314	13507.5957	330.5398933	833.8912595	0	3065.068925	380.1845236	271.1212753	162.9362244	16.92179867	0	0	12368.59319											"$275 copay, days 1-7"	"$275 copay, days 1-7"	"$100 copay, days 6-100"	$20 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$15 copay	$0 copay	Varies	$15 copay	$15 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	$10 copay	$10 copay	$10 copay	$500 credit														133.9675725	206.7056383	72.48154646	7.85607403	125	0.705006318	0.797325203	45	204.1116245	35.16428078	23.03181101	0	0	15	0	7.672578581	15	15	0	9.74424657	1.020104424	11.05139808	0	0	10	10	10	0	0	0	0											12.6418	0.481791538	6.685412287	1.110089189	2.044899747	1.388163237	1.58161957	0.765188193	4.759657748	5.243999573	1.43087814	0	0	0.646347341	0	7.199950187	0.209540746	0.600954106	0	10.96844525	0.028098767	0.767972022	0	0	0.316820436	0.225934396	0.135780187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.2334		17.1597682	12.6418	0.481791538	6.685412287	1.110089189	2.044899747	1.388163237	1.58161957	0.765188193	4.759657748	5.243999573	1.43087814	0	0	0.646347341	0	7.199950187	0.209540746	0.600954106	0	10.96844525	0.028098767	0.767972022	0	0	0.316820436	0.225934396	0.135780187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.2334																																																																																				0			12.6418	0.481791538	6.685412287	1.110089189	2.044899747	1.388163237	1.58161957	0.765188193	4.759657748	5.243999573	1.43087814	0	0	0.646347341	0	7.199950187	0.209540746	0.600954106	0	10.96844525	0.028098767	0.767972022	0	0	0.316820436	0.225934396	0.135780187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.2334
H5404_034_0	2008	4																					3250											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1349.758245	34.07396118	1166.5866	1882.764538	223.1876302	26907.5547	27097.31274	312.3841601	457.7905852	2795.642125	1151.245087	0	92.43136125	817.6434097	7877.141785	12485.96195	179.8564784	516.0936036	5237.571659	14131.61135	515.3924691	984.3132578	0	3065.068925	413.4322385	312.0516938	177.1852451	19.39852169	0	0	12394.63802											"$250 copay, days 1-7"	"$250 copay, days 1-7"	"$75 copay, days 6-100"	$20 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$20 copay	$0 copay	Varies	$20 copay	$20 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	$10 copay	$10 copay	$10 copay	$500 credit														96.23184892	187.9142166	48.07799478	3.568174726	125	0.743809612	0.846510849	45	199.970453	33.90787625	19.71101559	0	0	20	0	9.635596042	20	20	0	10.94765246	1.385389887	9.746176663	0	0	10	10	10	0	0	0	0											10.8241	0.53358181	4.673928705	0.55983607	2.324871148	1.667841485	1.911514101	1.171440601	7.628715893	7.899523936	1.891017489	0	0	1.362739016	0	10.02580713	0.299760797	0.860156006	0	12.89233081	0.059501626	0.799440909	0	0	0.344526865	0.260043078	0.147654371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.1384		25.78104827	10.8241	0.53358181	4.673928705	0.55983607	2.324871148	1.667841485	1.911514101	1.171440601	7.628715893	7.899523936	1.891017489	0	0	1.362739016	0	10.02580713	0.299760797	0.860156006	0	12.89233081	0.059501626	0.799440909	0	0	0.344526865	0.260043078	0.147654371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.1384																																																																																				0			10.8241	0.53358181	4.673928705	0.55983607	2.324871148	1.667841485	1.911514101	1.171440601	7.628715893	7.899523936	1.891017489	0	0	1.362739016	0	10.02580713	0.299760797	0.860156006	0	12.89233081	0.059501626	0.799440909	0	0	0.344526865	0.260043078	0.147654371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.1384
H5404_037_0	2008	4																					3200											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1192.274293	29.91762103	615.6997296	1774.347454	202.7030156	21982.8921	22144.24608	252.1815176	333.8526486	1525.792005	630.6734733	0	49.38485414	447.3800218	7745.723795	12064.15122	177.7641954	510.8623473	4572.665953	13909.35961	413.4852437	572.2053491	0	0	377.1888634	252.9705578	161.65237	15.77246694	0	0	12392.8546											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$100 copay, days 11-100"	$20 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$20 copay	$0 copay	Varies	$20 copay	$20 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	$10 copay	$10 copay	$10 copay	$500 credit														89.50041667	150.3313733	59.67469187	10.33128545	125	0.669997265	0.756304451	45	193.2572549	35.11420386	23.03964435	0	0	20	0	10.82938174	20	20	0	9.869864421	0.542625429	11.73448892	0	0	10	10	10	0	0	0	0											8.8924	0.374796421	3.061807637	1.527607503	2.111489746	1.227373133	1.395649323	0.945680691	5.376620534	4.464747626	1.210874377	0	0	0.74563337	0	10.88727492	0.296273659	0.851437245	0	11.44029113	0.018697301	0.559544777	0	0	0.314324053	0.210808798	0.134710308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0481		14.29638253	8.8924	0.374796421	3.061807637	1.527607503	2.111489746	1.227373133	1.395649323	0.945680691	5.376620534	4.464747626	1.210874377	0	0	0.74563337	0	10.88727492	0.296273659	0.851437245	0	11.44029113	0.018697301	0.559544777	0	0	0.314324053	0.210808798	0.134710308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0481																																																																																				0			8.8924	0.374796421	3.061807637	1.527607503	2.111489746	1.227373133	1.395649323	0.945680691	5.376620534	4.464747626	1.210874377	0	0	0.74563337	0	10.88727492	0.296273659	0.851437245	0	11.44029113	0.018697301	0.559544777	0	0	0.314324053	0.210808798	0.134710308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0481
H5404_043_0	2008	4																					3250											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1202.832486	30.43761426	970.374824	1893.153105	198.0405941	23880.95994	24048.17192	238.1987663	341.4715888	2106.959882	868.7086014	0	69.18197416	616.73478	8005.360776	12820.63706	193.9428445	558.8136542	5077.473968	13656.60155	390.575219	942.8559857	0	3065.068925	422.8342244	271.329457	181.2146676	16.87496126	0	0	12391.3403											"$250 copay, days 1-7"	"$250 copay, days 1-7"	"$75 copay, days 6-100"	$20 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$20 copay	$0 copay	Varies	$20 copay	$20 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	$10 copay	$10 copay	$10 copay	$500 credit														107.7096234	187.9142166	48.91048399	7.260315883	125	0.671365234	0.763244369	45	185.2949256	33.52430638	18.71607565	0	0	20	0	10.45509018	20	20	0	11.00655681	0.990135332	10.94938345	0	0	10	10	10	0	0	0	0											10.7964	0.47663837	3.955125191	1.145407463	2.062922855	1.336070522	1.52955265	0.893245374	5.272746053	5.886197384	1.354901325	0	0	1.0278913	0	11.17007639	0.323238074	0.93135609	0	12.5260134	0.03222686	0.860307644	0	0	0.352361854	0.226107881	0.151012223	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3098		20.09847711	10.7964	0.47663837	3.955125191	1.145407463	2.062922855	1.336070522	1.52955265	0.893245374	5.272746053	5.886197384	1.354901325	0	0	1.0278913	0	11.17007639	0.323238074	0.93135609	0	12.5260134	0.03222686	0.860307644	0	0	0.352361854	0.226107881	0.151012223	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3098																																																																																				0			10.7964	0.47663837	3.955125191	1.145407463	2.062922855	1.336070522	1.52955265	0.893245374	5.272746053	5.886197384	1.354901325	0	0	1.0278913	0	11.17007639	0.323238074	0.93135609	0	12.5260134	0.03222686	0.860307644	0	0	0.352361854	0.226107881	0.151012223	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3098
H5404_053_0	2008	4																					4000											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1559.504648	40.31665721	737.7332485	2653.935242	245.6979911	29688.7058	29882.33559	249.8512619	319.579471	2078.501706	880.8301167	0	65.03844695	585.6478023	9716.580183	14930.12755	275.440549	796.1188198	5929.435411	19436.81527	373.1146161	973.5498887	0	3065.068925	445.7699101	289.5989806	191.0442472	18.05342889	0	0	12430.40293											"$25 copay, days 1-7"	"$25 copay, days 1-7"	"$25 copay, days 11-100"	$20 copay	$50 copay	20% coinsurance	20% coinsurance	$25 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$0 copay	$0 copay	Varies	$0 copay	0% coinsurance	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	$10 copay	$10 copay	$10 copay	$500 credit														0.928520789	18.79142166	12.24916847	17.37585186	50	1.162331385	1.280831763	22.5	342.6783973	38.78887241	32.43438722	0	0	0	0	0.070796379	0	0	0	9.766608216	1.651676779	10.51683704	0	0	10	10	10	0	0	0	0											0.1207	0.063133942	0.75305157	3.842865467	1.02374163	2.875676211	3.189520382	0.468471116	9.126081743	6.718561456	2.380765424	0	0	0	0	0.088083248	0	0	0	15.81931331	0.051355396	0.853222127	0	0	0.371474925	0.241332484	0.159203539	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.1465		5.803599361	0.1207	0.063133942	0.75305157	3.842865467	1.02374163	2.875676211	3.189520382	0.468471116	9.126081743	6.718561456	2.380765424	0	0	0	0	0.088083248	0	0	0	15.81931331	0.051355396	0.853222127	0	0	0.371474925	0.241332484	0.159203539	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.1465																																																																																				0			0.1207	0.063133942	0.75305157	3.842865467	1.02374163	2.875676211	3.189520382	0.468471116	9.126081743	6.718561456	2.380765424	0	0	0	0	0.088083248	0	0	0	15.81931331	0.051355396	0.853222127	0	0	0.371474925	0.241332484	0.159203539	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.1465
H5404_056_0	2008	4																					3800											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1334.938634	33.99255144	923.4646004	2519.301268	202.6563097	24416.07435	24592.05585	226.0043198	317.3017201	2007.515714	835.5080089	0	64.49768733	579.2372299	9603.634532	14694.95197	238.4264595	688.6479486	5780.268309	18086.05231	368.4498166	1056.000442	0	3065.068925	491.5798131	274.8880601	210.6770627	17.13611216	0	0	12452.65195											"$150 copay, days 1-7"	"$150 copay, days 1-7"	"$50 copay, days 7-100"	$20 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$20 copay	$0 copay	Varies	$20 copay	$20 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	$10 copay	$10 copay	$10 copay	$500 credit														55.27739321	112.74853	28.99774767	12.3867342	125	0.77042632	0.866482026	45	259.0253675	37.47255672	29.18639011	0	0	20	0	8.789450005	20	20	0	10.56861828	1.451028259	10.97119892	0	0	10	10	10	0	0	0	0											6.1493	0.319384184	2.231532789	2.600492931	2.111003226	1.567565526	1.775714531	0.847516199	6.849099553	6.268895539	2.03212189	0	0	0.965395383	0	10.7633788	0.397377432	1.147746581	0	15.92871524	0.044552591	0.965465908	0	0	0.409649844	0.229073383	0.175564219	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7796		15.98342516	6.1493	0.319384184	2.231532789	2.600492931	2.111003226	1.567565526	1.775714531	0.847516199	6.849099553	6.268895539	2.03212189	0	0	0.965395383	0	10.7633788	0.397377432	1.147746581	0	15.92871524	0.044552591	0.965465908	0	0	0.409649844	0.229073383	0.175564219	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7796																																																																																				0			6.1493	0.319384184	2.231532789	2.600492931	2.111003226	1.567565526	1.775714531	0.847516199	6.849099553	6.268895539	2.03212189	0	0	0.965395383	0	10.7633788	0.397377432	1.147746581	0	15.92871524	0.044552591	0.965465908	0	0	0.409649844	0.229073383	0.175564219	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7796
H5404_062_0	2008	4																					3200											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1131.188608	28.43120413	932.263001	1560.741964	181.412508	23045.09294	23214.78779	203.3739345	250.3785109	1545.739074	638.4548032	0	50.23974831	453.0059268	6746.936766	10279.58146	151.5968474	435.4123649	3989.190925	11726.58709	280.3487281	688.563925	0	2371.46937	396.8719587	262.1854617	170.0879823	16.35952795	0	0	12371.93987											"$250 copay, days 1-7"	"$250 copay, days 1-7"	"$100 copay, days 6-100"	$20 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$20 copay	$0 copay	Varies	$20 copay	$20 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	$10 copay	$10 copay	$10 copay	$500 credit														113.4898067	187.9142166	71.69459595	5.727048215	125	0.668728186	0.759860394	45	200.4610087	34.15735914	20.44396748	0	0	20	0	10.16045215	20	20	0	9.598234948	0.7266984	11.40202054	0	0	10	10	10	0	0	0	0											10.6982	0.445218954	5.569851598	0.744870373	1.889713625	1.284241934	1.469999817	0.762652255	4.182594072	4.399863725	1.087712436	0	0	0.755009878	0	8.703766301	0.252661412	0.725687275	0	9.379544839	0.016977414	0.654251668	0	0	0.330726632	0.218487885	0.141739985	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.7138		18.56366233	10.6982	0.445218954	5.569851598	0.744870373	1.889713625	1.284241934	1.469999817	0.762652255	4.182594072	4.399863725	1.087712436	0	0	0.755009878	0	8.703766301	0.252661412	0.725687275	0	9.379544839	0.016977414	0.654251668	0	0	0.330726632	0.218487885	0.141739985	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.7138																																																																																				0			10.6982	0.445218954	5.569851598	0.744870373	1.889713625	1.284241934	1.469999817	0.762652255	4.182594072	4.399863725	1.087712436	0	0	0.755009878	0	8.703766301	0.252661412	0.725687275	0	9.379544839	0.016977414	0.654251668	0	0	0.330726632	0.218487885	0.141739985	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.7138
H5404_086_0	2008	4																					3250											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1496.270632	37.90496413	766.8393509	1812.86311	250.2153326	24283.60248	24443.51811	289.2086895	273.7932717	2351.837753	964.2384795	0	77.57711999	695.2421228	9446.845521	15393.68096	235.4202314	679.2123972	5968.658428	17777.34675	415.3601367	690.204781	0	0.143623133	412.2394525	0	0	0	0	0	6777.938615											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$150 copay, days 1-100"	$20 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$30 copay	$0 copay	Varies	$30 copay	$25 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	$10 copay																	106.3675172	225.4970599	131.4593259	1.505637102	125	0.551704004	0.640823847	45	187.7486842	35.08233663	22.9571267	0	0	25	0	15.30272309	30	25	0	10.57557493	1.442675829	-1.442675829	0	0	10	0	0	0	0	0	0											13.2629	0.712288164	8.40068201	0.227459497	2.606409714	1.116446727	1.305332442	1.084532586	4.283693875	6.875663644	1.844678745	0	0	1.448421089	0	19.63043643	0.588550578	1.415025828	0	15.66713855	0.049935836	-0.08297848	0	0	0.343532877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.7801		27.93979019	13.2629	0.712288164	8.40068201	0.227459497	2.606409714	1.116446727	1.305332442	1.084532586	4.283693875	6.875663644	1.844678745	0	0	1.448421089	0	19.63043643	0.588550578	1.415025828	0	15.66713855	0.049935836	-0.08297848	0	0	0.343532877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.7801																																																																																				0			13.2629	0.712288164	8.40068201	0.227459497	2.606409714	1.116446727	1.305332442	1.084532586	4.283693875	6.875663644	1.844678745	0	0	1.448421089	0	19.63043643	0.588550578	1.415025828	0	15.66713855	0.049935836	-0.08297848	0	0	0.343532877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.7801
H5404_094_0	2008	5																					3250											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1018.570807	24.74926156	828.2134818	1260.31563	186.6753202	22454.98254	22625.18524	175.8422199	234.1146458	1517.89423	633.1214053	0	48.00233464	439.3712386	7735.200054	12475.94307	183.8649251	528.8005797	5142.932124	15308.00673	282.6074275	853.7874402	0	3065.068925	403.7307783	270.5419466	173.0274764	16.86685085	0	0	12384.59174											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$100 copay, days 6-100"	$20 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$25 copay	$0 copay	Varies	$25 copay	$25 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	$10 copay	$10 copay	$10 copay	$500 credit														139.9422155	225.4970599	68.63128368	2.713920052	125	0.622201649	0.709227151	45	251.752778	36.11426319	25.75328954	0	0	25	0	8.075539966	25	25	0	11.32974857	0.948809367	11.60571012	0	0	10	10	10	0	0	0	0											11.8784	0.46507381	4.736779535	0.285032988	1.944534585	1.164293931	1.33719964	0.659408325	4.911584371	4.568135975	1.358746572	0	0	0.915356747	0	8.395831407	0.383051927	1.101667874	0	14.45298895	0.022345048	0.825734128	0	0	0.336442315	0.225451622	0.144189564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1123		18.15493062	11.8784	0.46507381	4.736779535	0.285032988	1.944534585	1.164293931	1.33719964	0.659408325	4.911584371	4.568135975	1.358746572	0	0	0.915356747	0	8.395831407	0.383051927	1.101667874	0	14.45298895	0.022345048	0.825734128	0	0	0.336442315	0.225451622	0.144189564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1123																																																																																				0			11.8784	0.46507381	4.736779535	0.285032988	1.944534585	1.164293931	1.33719964	0.659408325	4.911584371	4.568135975	1.358746572	0	0	0.915356747	0	8.395831407	0.383051927	1.101667874	0	14.45298895	0.022345048	0.825734128	0	0	0.336442315	0.225451622	0.144189564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1123
H5404_110_0	2008	10																					1750											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1622.315058	41.44694453	1006.208521	3136.361974	252.4279398	30443.92443	30656.01339	264.1833267	369.7083615	2541.249041	1017.134316	0	75.18912572	676.0293284	13504.78699	28284.26106	329.7621391	953.9527454	7006.60728	23016.8345	430.3115313	1197.200093	0	3065.068925	608.8817374	313.9606039	237.6737606	20.2967429	0	0	4379.967493											"$100 copay, days 1 - 5"	"$100 copay, days 1 - 5"	"$50 copay days 1 - 10, $25 copay days 11 - 100"		$100 copay	25% coinsurance	30% coinsurance	"$50 copay , waived if admitted"	$125 copay		$125 copay			$125 copay								30% coinsurance				$10 copay	$10 copay															54.94725635	64.74856929	30.21879769	0	100	1.500938518	1.987296472	45	86.2905313	0	10.7961583	0	0	7.59558519	0	0	0	0	0	0	0	12.34449796	0	0	0	10	10	0	0	0	0											7.4285	0.223635863	2.533867643	0	2.103566165	3.807871569	5.07688227	0.990687475	2.658527579	0	0.915095258	0	0	0.427903196	0	0	0	0	0	0	0	1.231569509	0	0	0	0.261633837	0.198061467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.8578		3.31267033	7.4285	0.223635863	2.533867643	0	2.103566165	3.807871569	5.07688227	0.990687475	2.658527579	0	0.915095258	0	0	0.427903196	0	0	0	0	0	0	0	1.231569509	0	0	0	0.261633837	0.198061467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.8578																																																																																				0			7.4285	0.223635863	2.533867643	0	2.103566165	3.807871569	5.07688227	0.990687475	2.658527579	0	0.915095258	0	0	0.427903196	0	0	0	0	0	0	0	1.231569509	0	0	0	0.261633837	0.198061467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.8578
H5404_111_0	2008	10																					1750											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1269.699504	30.47256851	1232.61662	2120.061647	214.5853638	25725.34385	25940.71005	220.7894629	290.6578596	2040.044946	821.3476141	0	59.70869587	548.7573138	10369.90106	21526.02847	228.8740017	656.8301295	5456.201928	16624.17956	353.794352	962.3794046	0	3065.068925	487.3997173	299.0917741	191.893975	19.42672013	0	0	4299.182378											"$100 copay, days 1 - 5"	"$100 copay, days 1 - 5"	"$50 copay days 1- 10, $25 copay days 11 - 100"		$100 copay	25% coinsurance	30% coinsurance	"$50 copay , waived if admitted"	$125 copay		$125 copay			$125 copay								30% coinsurance				$10 copay	$10 copay															58.32603239	64.74856929	31.36716634	0	100	1.280970829	1.697166383	45	88.15966881	0	10.99498054	0	0	7.356466356	0	0	0	0	0	0	0	12.28396744	0	0	0	10	10	0	0	0	0											6.1714	0.164421268	3.221974214	0	1.788211365	2.746117921	3.66880842	0.827960486	2.135358387	0	0.752558419	0	0	0.33640956	0	0	0	0	0	0	0	0.985153106	0	0	0	0.249243145	0.159911646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.2075		1.698894151	6.1714	0.164421268	3.221974214	0	1.788211365	2.746117921	3.66880842	0.827960486	2.135358387	0	0.752558419	0	0	0.33640956	0	0	0	0	0	0	0	0.985153106	0	0	0	0.249243145	0.159911646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.2075																																																																																				0			6.1714	0.164421268	3.221974214	0	1.788211365	2.746117921	3.66880842	0.827960486	2.135358387	0	0.752558419	0	0	0.33640956	0	0	0	0	0	0	0	0.985153106	0	0	0	0.249243145	0.159911646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.2075
H5404_112_0	2008	8																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		3343.173751	90.8452594	12576.35279	1299.652332	331.0551827	40080.77314	40300.06241	411.0116933	274.9301708	1912.242127	782.3888316	0	56.23148187	928.8080305	7815.011584	16346.56135	184.8377842	531.0602188	3978.771232	12812.68214	328.2517291	808.6306727	0	3065.068925	795.5744029	412.9299669	340.9604584	0	0	0	3051.418179																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5404_113_0	2008	8																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2552.472194	66.42481979	16346.64583	1019.857896	275.0176611	33089.23662	33311.32046	328.0050605	221.5865625	1581.762862	650.47526	0	45.89464285	743.840557	6364.486966	13207.94508	136.2151232	387.0180441	3247.686929	9714.097745	279.459779	679.0026128	0	3065.068925	619.7297375	387.2672868	265.5984589	0	0	0	3041.184522																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5407_001_0	2008	9																					2500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	P	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1560.388828	60.94161635	1502.235274	378.6197958	166.2864026	10.8375906	0.83274571	426.9464429	270.4527225	307.2587914	239.5887004	76.81469784	12.80244964	305.42987	8891.483131	3604.083865	150.4551139	931.795876	3467.306489	463.5835647	4.8039159	136.5184496	0	750	0	405	20.87272727	25	0	0	0											$150/Day days 6-10	$150/Day days 6-10	$100/Day days 15-45	$25/visits after 25 visits	$150 per trip	5% (10% electric wheelchair)	0.2	"$50/ER, $25 urgent care"	$125 hospital/$75 ASC	$10 freestanding/$50 hospital	$50 basic/$100 major freestanding/$100 basic/$250 major hospital	None	None	None	None	$10 per visit	$25 per visit	$25 per visit	None	Chiro/Pod/Rad Ther	0.1	None	None	None	None	None	None	None	None	None	None											30.64639207	12.8517128	35.58935854	6.419436965	148.2889939	0.049429665	0.197718659	44.48669817	113.9908593	13.8403061	73.6502003	0	0	0	0	9.885932926	24.71483232	24.71483232	0	22.21733815	0.098859329	0	0	0	0	0	0	0	0	0	0											3.985	0.065267013	4.455299147	0.202543826	2.054870278	0.535698469	0.164649365	1.582786462	2.569094852	0.354379644	1.470479648	0	0	0	0	2.969144279	0.309872743	1.919098236	0	0.858299402	0.474911904	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.9714	0	0.271110259	3.985	0.065267013	4.455299147	0.202543826	2.054870278	0.535698469	0.164649365	1.582786462	2.569094852	0.354379644	1.470479648	0	0	0	0	2.969144279	0.309872743	1.919098236	0	0.858299402	0.474911904	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.9714	2500																																																																																			0	0	0	3.985	0.065267013	4.455299147	0.202543826	2.054870278	0.535698469	0.164649365	1.582786462	2.569094852	0.354379644	1.470479648	0	0	0	0	2.969144279	0.309872743	1.919098236	0	0.858299402	0.474911904	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.9714
H5407_004_0	2008	3																					2500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	P	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1456.231303	56.87370213	1350.949111	324.8669006	147.7105172	8.806574255	0.676685179	408.218361	245.0814405	241.5836402	188.3777194	60.39591005	10.06598501	240.1456424	7801.218629	3162.154815	132.0064629	817.5400256	3042.148939	406.7394256	4.533754369	137.086096	0	750	0	405	20.87272727	25	0	0	0											"$50/day 1-5, $100/day 6-10"	"$50/day 1-5, $100/day 6-10"	$50/day days 15-45	$25/visit after 25 visits	$100 per trip	5% (10% electric wheelchair)	0.2	"$50/ER, $20 urgent care"	"$125 hospital, $50 ASC"	"$25 freestanding, $100 OP hospital"	"$25/$100 freestanding, $75/$250 hospital (basic/major)"	None	None	None	None	$25/visit	$25/visit	$25/visit	None	"$25 radiation therapy, chiro, and podiatry"	0.2	None	None	None	None	None	None	None	None	None	None											49.44336085	48.47388318	17.45059795	6.295309505	96.94776637	0.048473883	0.193895533	42.6570172	107.0877113	31.50802407	48.7162526	0	0	0	0	24.23694159	24.23694159	24.23694159	0	36.22787249	0.193895533	0	0	0	0	0	0	0	0	0	0											6.0001	0.229740766	1.964572482	0.170428141	1.193350393	0.426888852	0.131206233	1.451114804	2.187100879	0.634318596	0.764754714	0	0	0	0	6.386746796	0.266619411	1.651222488	0	1.227942004	0.879074719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.5652	0	0.77719899	6.0001	0.229740766	1.964572482	0.170428141	1.193350393	0.426888852	0.131206233	1.451114804	2.187100879	0.634318596	0.764754714	0	0	0	0	6.386746796	0.266619411	1.651222488	0	1.227942004	0.879074719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.5652	2500																																																																																			0	0	0	6.0001	0.229740766	1.964572482	0.170428141	1.193350393	0.426888852	0.131206233	1.451114804	2.187100879	0.634318596	0.764754714	0	0	0	0	6.386746796	0.266619411	1.651222488	0	1.227942004	0.879074719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.5652
H5407_005_0	2008	2																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	P	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1361.460695	53.1723977	1196.554927	319.7102832	145.3659059	8.666787362	0.665944144	401.7387045	217.072133	213.9740813	166.8488372	53.49352033	8.915586722	212.7004261	6525.781298	2645.167599	110.4244538	683.8787198	2544.781732	340.2407576	4.461790014	134.9101262	0	750	0	405	20.87272727	25	0	0	0											$200/day 1-15 days	$200/day 1-15 days	"$50/day 1-14, $75/day days 15-100"	$25/visit	$150 per trip	0.2	0.2	"$50/ER, $20 urgent care"	"$150 hospital, $75 ASC"	"$50 freestanding, $150 OP hospital"	"$50/$150 freestanding, $100/$250 hospital (basic/major)"	None	None	None	None	$35/visit	$35/visit	$35/visit	None	"$50 radiation therapy, $35 chiro, and podiatry"	0.2	None	None	None	None	None	None	None	None	None	None											165.0317477	171.5955104	58.13618386	23.44200962	140.6520577	0.187536077	0.187536077	41.25793693	127.0174195	56.26082309	72.20138963	0	0	0	0	32.81881347	32.81881347	32.81881347	0	39.77740227	0.187536077	0	0	0	0	0	0	0	0	0	0											18.7237	0.760345394	5.796928102	0.624554294	1.703834482	1.625335302	0.124888552	1.381242511	2.297661848	1.003196495	1.003893159	0	0	0	0	7.234271835	0.301999963	1.870340679	0	1.127824457	0.836746595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.4168	0	0.77719899	18.7237	0.760345394	5.796928102	0.624554294	1.703834482	1.625335302	0.124888552	1.381242511	2.297661848	1.003196495	1.003893159	0	0	0	0	7.234271835	0.301999963	1.870340679	0	1.127824457	0.836746595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.4168	3250																																																																																			0	0	0	18.7237	0.760345394	5.796928102	0.624554294	1.703834482	1.625335302	0.124888552	1.381242511	2.297661848	1.003196495	1.003893159	0	0	0	0	7.234271835	0.301999963	1.870340679	0	1.127824457	0.836746595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.4168
H5407_006_0	2008	6																					2500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	P	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1896.6636	74.07496347	1759.244165	434.1097722	186.0036514	13.16108305	1.011279708	543.9957638	331.7931696	480.2849459	374.5079043	120.0712365	20.01187275	477.426107	11623.05178	4711.301001	196.6767021	1218.054576	4532.503999	606.0019117	6.22124644	185.2931231	0	750	0	0	20.87272727	25	0	0	0											None	None	"$75/day days 15-30, $100/day days 31-100"	$25/visit after 25 visits	$50 per trip	5% (10% electric wheelchair)	0.2	"$25/ER, $0 urgent care"	"$50 hospital, $0 ASC"	"$25 freestanding, $50 OP hospital"	"$25/$50 freestanding, $75/$100 hospital (basic/major)"	None	None	None	None	None	None	$15/visit	None	$25 radiation therapy	0.1	None	None	None	None	None	None	None	None	None	None											0	0	28	6.493506494	50	0.05	0.2	20	40.30612245	27.5	43.25	0	0	0	0	0	0	15	0	12.36844472	0.1	0	0	0	0	0	0	0	0	0	0											0	0	4.104903053	0.234907885	0.775015214	0.658054153	0.202255942	0.906659606	1.114441343	1.100653001	1.349788905	0	0	0	0	0	0	1.52256822	0	0.624608429	0.622124644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.216	0	0	0	0	4.104903053	0.234907885	0.775015214	0.658054153	0.202255942	0.906659606	1.114441343	1.100653001	1.349788905	0	0	0	0	0	0	1.52256822	0	0.624608429	0.622124644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.216	2500																																																																																			0	0	0	0	0	4.104903053	0.234907885	0.775015214	0.658054153	0.202255942	0.906659606	1.114441343	1.100653001	1.349788905	0	0	0	0	0	0	1.52256822	0	0.624608429	0.622124644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.216
H5407_007_0	2008	6																					2500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	P	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1665.867567	65.06113115	1623.223269	404.6494193	161.9133403	11.05219938	0.849235957	472.6922546	280.5336929	302.9859875	236.2569307	75.74649687	12.62441615	301.1824995	9634.394128	3905.216252	163.0261054	1009.650312	3757.010702	502.3174096	5.299580301	107.5795175	0	750	0	0	20.87272727	25	0	0	0											None	None	$50/day from day 16 to 100	$25/visit after 25 visits	$50 per trip	5% (10% electric wheelchair)	0.2	"$50/ER, $20 urgent care"	"$50 Hospital, $0 ASC"	"$25 freestanding, $50 OP hospital"	"$25/$50 freestanding, $75/$100 hospital (basic/major)"	None	None	None	None	None	$15/visit	$25/visit	None	"$20 chiro/podiatry after 5 visits, $25 radiation therapy"	0.2	None	None	None	None	None	None	None	None	None	None											0	0	18	6.493506494	50	0.05	0.2	44	40.30612245	27.5	43.25	0	0	0	0	0	15	25	0	16.64657731	0.2	0	0	0	0	0	0	0	0	0	0											0	0	2.434834903	0.218966136	0.674638918	0.552609969	0.169847191	1.733204933	0.942268782	0.694342888	0.851509355	0	0	0	0	0	0.203782632	2.10343815	0	0.696822133	1.05991606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.3362	0	0	0	0	2.434834903	0.218966136	0.674638918	0.552609969	0.169847191	1.733204933	0.942268782	0.694342888	0.851509355	0	0	0	0	0	0.203782632	2.10343815	0	0.696822133	1.05991606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.3362	2500																																																																																			0	0	0	0	0	2.434834903	0.218966136	0.674638918	0.552609969	0.169847191	1.733204933	0.942268782	0.694342888	0.851509355	0	0	0	0	0	0.203782632	2.10343815	0	0.696822133	1.05991606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.3362
H5407_009_0	2008	3																					2000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	P	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1595.629804	62.31796692	1500.808509	461.4364091	172.3922931	10.28424089	0.790227072	431.4368834	278.4106331	275.2801663	214.6529869	68.82004159	11.47000693	273.6415939	9719.525828	3939.723632	164.4666412	1018.571812	3790.208504	506.7560006	4.751825387	115.125247	0	750	0	330	20.87272727	25	0	0	0											None	None	None	None	None	5% (10% electric wheelchair)	0.2	"$20/ER, $0 urgent care"	None	None	$25 basic/$100 major hospital	None	None	None	None	None	None	None	None	$25 radiation therapy	0.1	None	None	None	None	None	None	None	None	None	None											0	0	0	0	0	0.05	0.2	16	0	0	31	0	0	0	0	0	0	0	0	12.36844472	0.1	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0.514212045	0.158045414	0.575249178	0	0	0.554520216	0	0	0	0	0	0	0	0	0.522315299	0.475182539	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.7995	0	0	0	0	0	0	0	0.514212045	0.158045414	0.575249178	0	0	0.554520216	0	0	0	0	0	0	0	0	0.522315299	0.475182539	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.7995	2000																																																																																			0	0	0	0	0	0	0	0	0.514212045	0.158045414	0.575249178	0	0	0.554520216	0	0	0	0	0	0	0	0	0.522315299	0.475182539	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.7995
H5407_011_0	2008	5																					2800											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	P	T	V	V	P	V	P	P	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1557.485052	60.82820822	1472.601107	436.4048178	170.8147906	11.1057328	0.853349392	407.8709028	259.5513218	301.0370251	234.7372041	75.25925628	12.54320938	299.2451381	9650.263183	3911.648633	163.2946298	1011.313333	3763.19897	503.1447894	49.90636793	202.4392684	3000	750	0	405	20.87272727	25	0	0	0											None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.88026607	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.210912949	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.2109	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.210912949	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.2109	2800																																																																																			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.210912949	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.2109
H5407_014_0	2008	7																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	P	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1482.371005	57.89459873	1352.013222	378.6202091	166.2865841	10.83760243	0.832746619	426.946909	243.4077159	276.5332141	215.6300658	69.13330352	11.52221725	274.8871831	7557.768911	3063.47463	127.8869864	792.0273592	2947.213733	394.0464602	4.803921144	136.5185986	0	750	0	405	20.87272727	25	0	0	0											$200/Day days 1-10	$200/Day days 1-10	"$0/Day 1-6, $100/day 7-30"	"$5/visit for 1-25, $25/visits after 25 visits"	$150 per trip	5% (10% electric wheelchair)	0.2	"$50/ER, $25 urgent care"	$150 hospital/$100 ASC	$25 freestanding/$100 hospital	$25 basic/$100 major freestanding/$100 basic/$250 major hospital	None	None	None	None	$35 per visit	$35 per visit	$25 per visit	None	$35 Chiro/Pod/ $25 Rad Ther	0.2	None	None	None	None	None	None	None	None	None	None											155.0420945	174.0656644	65.63131609	9.697079453	142.6767741	0.047558925	0.190235699	42.80303223	133.4561663	30.91330106	54.21717416	0	0	0	0	33.29124729	33.29124729	23.77946235	0	28.58540784	0.190235699	0	0	0	0	0	0	0	0	0	0											19.1525	0.839788483	7.39453393	0.305959187	1.977102784	0.515424718	0.158418135	1.522885192	2.707021717	0.712379542	0.974237736	0	0	0	0	8.498907623	0.354793108	1.569498731	0	0.938664898	0.913877296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.536	0	2.444318324	19.1525	0.839788483	7.39453393	0.305959187	1.977102784	0.515424718	0.158418135	1.522885192	2.707021717	0.712379542	0.974237736	0	0	0	0	8.498907623	0.354793108	1.569498731	0	0.938664898	0.913877296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.536	3000																																																																																			0	0	0	19.1525	0.839788483	7.39453393	0.305959187	1.977102784	0.515424718	0.158418135	1.522885192	2.707021717	0.712379542	0.974237736	0	0	0	0	8.498907623	0.354793108	1.569498731	0	0.938664898	0.913877296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.536
H5407_015_0	2008	4																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	P	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1801.83042	70.3712153	1583.319749	434.1097722	186.0036514	13.16108305	1.011279708	543.9957638	298.6138526	432.2564513	337.0571138	108.0641128	18.01068547	429.6834963	10460.7466	4240.170901	177.0090319	1096.249118	4079.253599	545.4017206	6.22124644	185.2931231	0	750	0	0	20.87272727	25	0	0	0											None	None	"$50/day days 15-30, $100/day 31+"	$25/visit after 25 visits	$150 per trip	5% (10% electric wheelchair)	0.2	"$50/ER, $25 urgent care"	"$100 hospital, $50 ASC"	"$50 freestanding, $100 OP hospital"	"$50/$100 freestanding, $75/$150 hospital (basic/major)"	None	None	None	None	$5/visit	$25/visit	$25/visit	None	"$5 Chiro/podiatry, $25 radiation therapy"	0.2	None	None	None	None	None	None	None	None	None	None											0	0	21	6.493506494	150	0.05	0.2	45	90.30612245	55	64.75	0	0	0	0	5	25	25	0	14.89475578	0.2	0	0	0	0	0	0	0	0	0	0											0	0	2.770809561	0.234907885	2.325045643	0.658054153	0.202255942	2.039984114	2.247221595	1.981175402	1.81870401	0	0	0	0	1.766737875	0.368768816	2.283852329	0	0.676968786	1.244249288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.6187	0	0	0	0	2.770809561	0.234907885	2.325045643	0.658054153	0.202255942	2.039984114	2.247221595	1.981175402	1.81870401	0	0	0	0	1.766737875	0.368768816	2.283852329	0	0.676968786	1.244249288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.6187	3000																																																																																			0	0	0	0	0	2.770809561	0.234907885	2.325045643	0.658054153	0.202255942	2.039984114	2.247221595	1.981175402	1.81870401	0	0	0	0	1.766737875	0.368768816	2.283852329	0	0.676968786	1.244249288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.6187
H5407_016_0	2008	8																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	P	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1615.89154	63.10929722	1542.062105	404.6494193	161.9133403	11.05219938	0.849235957	472.6922546	266.5070083	272.6873887	212.6312377	68.17184719	11.36197453	271.0642495	8189.235009	3319.433815	138.5721896	858.2027652	3193.459097	426.9697982	5.299580301	107.5795175	0	750	0	0	20.87272727	25	0	0	0											"$75/day for 10 days, then $100/day for next 15"	"$75/day for 10 days, then $100/day for next 15"	$75/day for days 8-30	$25/visit after 25 visits	$100 per trip	5% (10% electric wheelchair)	0.2	"$50/ER, $25 urgent care"	"$150 Hospital, $50 ASC"	"$50 freestanding, $100 OP hospital"	"$50/$100 freestanding, $75/$100 hospital (basic/major)"	None	None	None	None	$35/visit	$35/visit	$25/visit	None	"$25 radiation therapy, $35 chiro and podiatry"	0.2	None	None	None	None	None	None	None	None	None	None											88.68286063	66.51214547	45.30537445	6.259377515	96.39441373	0.048197207	0.192788827	43.37748618	125.9029077	53.01692755	60.96946668	0	0	0	0	33.73804481	33.73804481	24.09860343	0	28.96904889	0.192788827	0	0	0	0	0	0	0	0	0	0											11.9418	0.349794563	5.821975092	0.211071123	1.300628459	0.53268514	0.163723204	1.708683478	2.796167273	1.204753961	1.08033443	0	0	0	0	9.332600564	0.389596228	1.723457342	0	1.030742413	1.021699872	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6097	0	1.480771313	11.9418	0.349794563	5.821975092	0.211071123	1.300628459	0.53268514	0.163723204	1.708683478	2.796167273	1.204753961	1.08033443	0	0	0	0	9.332600564	0.389596228	1.723457342	0	1.030742413	1.021699872	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6097	3000																																																																																			0	0	0	11.9418	0.349794563	5.821975092	0.211071123	1.300628459	0.53268514	0.163723204	1.708683478	2.796167273	1.204753961	1.08033443	0	0	0	0	9.332600564	0.389596228	1.723457342	0	1.030742413	1.021699872	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6097
H5407_021_0	2008	8																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	P	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1665.867567	65.06113115	1623.223269	404.6494193	161.9133403	11.05219938	0.849235957	472.6922546	280.5336929	302.9859875	236.2569307	75.74649687	12.62441615	301.1824995	9634.394128	3905.216252	163.0261054	1009.650312	3757.010702	502.3174096	5.299580301	107.5795175	4.382036086	750	0	0	20.87272727	25	0	0	0											None	None	$50/day days 15-30	$25/visit after 25 visits	$50 per trip	5% (10% electric wheelchair)	0.2	"$50/ER, $20 urgent care"	"$25 Hospital, $0 ASC"	"$0 freestanding, $50 OP hospital"	"$0/$50 freestanding, $50/$75 hospital (basic/major)"	None	None	None	None	None	None	$25/visit	None	$25 radiation therapy	0.1	None	None	None	None	None	None	None	None	None	None											0	0	18	6.493506494	50	0.05	0.2	44	20.15306122	5	18.25	0	0	0	0	0	0	25	0	12.36844472	0.1	0	0	0	0	0	0	0	0	0	0											0	0	2.434834903	0.218966136	0.674638918	0.552609969	0.169847191	1.733204933	0.471134391	0.126244161	0.359307415	0	0	0	0	0	0	2.10343815	0	0.517740426	0.52995803	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.8919	0	0	0	0	2.434834903	0.218966136	0.674638918	0.552609969	0.169847191	1.733204933	0.471134391	0.126244161	0.359307415	0	0	0	0	0	0	2.10343815	0	0.517740426	0.52995803	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.8919	3000																																																																																			0	0	0	0	0	2.434834903	0.218966136	0.674638918	0.552609969	0.169847191	1.733204933	0.471134391	0.126244161	0.359307415	0	0	0	0	0	0	2.10343815	0	0.517740426	0.52995803	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.8919
H5407_022_0	2008	2																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	P	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1361.460695	53.1723977	1196.554927	319.7102832	145.3659059	8.666787362	0.665944144	401.7387045	217.072133	213.9740813	166.8488372	53.49352033	8.915586722	212.7004261	6525.781298	2645.167599	110.4244538	683.8787198	2544.781732	340.2407576	4.533754369	137.086096	1200	750	0	405	20.87272727	25	0	0	0											None	None	"$50/day days 15-45, $75/day 46-100"	$25/visit after 25 visits	$100 per trip	5% (10% electric wheelchair)	0.2	"$50/ER, $20 urgent care"	"$75 hospital, $25 ASC"	"$25 freestanding, $100 OP hospital"	"$25/$100 freestanding, $75/$250 hospital (basic/major)"	None	None	None	None	$10/visit	$25/visit	$25/visit	None	"$50 radiation therapy, $10 chiro, and podiatry"	0.2	None	None	None	None	None	None	None	None	None	None											0	0	18.42007561	6.295309505	96.94776637	0.048473883	0.193895533	42.6570172	63.31282702	31.50802407	48.7162526	0	0	0	0	9.694776637	24.23694159	24.23694159	0	28.88026607	0.193895533	0	0	0	0	0	0	0	0	0	0											0	0	1.836719352	0.167722932	1.174408323	0.420112838	0.129123595	1.428081236	1.145287534	0.561825042	0.677354175	0	0	0	0	2.137025753	0.223029253	1.381260716	0	0.818853634	0.879074719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.9799	0	3.029313961	0	0	1.836719352	0.167722932	1.174408323	0.420112838	0.129123595	1.428081236	1.145287534	0.561825042	0.677354175	0	0	0	0	2.137025753	0.223029253	1.381260716	0	0.818853634	0.879074719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.9799	3250																																																																																			0	0	0	0	0	1.836719352	0.167722932	1.174408323	0.420112838	0.129123595	1.428081236	1.145287534	0.561825042	0.677354175	0	0	0	0	2.137025753	0.223029253	1.381260716	0	0.818853634	0.879074719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.9799
H5407_023_0	2008	8																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	P	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1595.690891	62.32035268	1501.309394	461.3465024	172.3947142	10.28962807	0.790641016	431.6684933	278.5795286	275.3505127	214.7078403	68.83762817	11.47293803	273.7115215	9721.711292	3940.609491	164.503622	1018.800841	3791.060744	506.8699462	4.87151973	164.956753	1200	750	0	405	20.87272727	25	0	0	0											None	None	"$50/Day 15-30, $100/day 31+"	$25/visits after 25 visits	$100 per trip	5% (10% electric wheelchair)	0.2	"$50/ER, $25 urgent care"	$100 hospital/$50 ASC	$25 freestanding/$75 hospital	$25 basic/$75 major freestanding/$25 basic/$100 major hospital	None	None	None	None	None	$25 per visit	$25 per visit	None	$5 Chiro/Pod/ $25 Rad Ther	0.1	None	None	None	None	None	None	None	None	None	None											0	0	20.88945985	6.459325866	99.47361833	0.049736809	0.198947237	44.76312825	89.83076758	29.8420855	32.08024191	0	0	0	0	0	24.86840458	24.86840458	0	14.81635252	0.099473618	0	0	0	0	0	0	0	0	0	0											0	0	2.613461858	0.248332283	1.4290605	0.511773268	0.157295845	1.610236011	2.085417741	0.684752795	0.573989955	0	0	0	0	0	0.340911886	2.111329292	0	0.625830317	0.484587694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.477	0	0.068751463	0	0	2.613461858	0.248332283	1.4290605	0.511773268	0.157295845	1.610236011	2.085417741	0.684752795	0.573989955	0	0	0	0	0	0.340911886	2.111329292	0	0.625830317	0.484587694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.477	3000																																																																																			0	0	0	0	0	2.613461858	0.248332283	1.4290605	0.511773268	0.157295845	1.610236011	2.085417741	0.684752795	0.573989955	0	0	0	0	0	0.340911886	2.111329292	0	0.625830317	0.484587694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.477
H5407_024_0	2008	7																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	P	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1580.935524	61.74407586	1560.53243	496.4984231	805.5661164	11.44013711	0.879044564	458.737425	259.8715202	283.2351918	220.8560127	70.80879796	11.80146633	281.5492681	9524.299485	3860.590365	161.1631651	998.112784	3714.078396	496.5773023	4.732701241	140.8751996	0	750	0	405	20.87272727	25	0	0	0											None	None	$75/day days 15-60	$25/visit	$100/trip	0.05	0.2	"$50 ER, $25 Urgent care"	"$150 hospital, $75 ASC"	None	"$25 freestanding, $50 hospital for major only"	None	None	None	None	None	$15/visit	$25/visit	None	$25 radiation therapy	0.15	None	None	None	None	None	None	None	None	None	None											0	0	28.15727978	24.27351705	97.0940682	0.048547034	0.194188136	43.69233069	131.5228322	0	2.670086875	0	0	0	0	0	14.56411023	24.27351705	0	12.00902616	0.709905186	0	0	0	0	0	0	0	0	0	0											0	0	3.661695685	1.004313578	6.517974287	0.555384727	0.170700026	1.670275606	2.848253195	0	0.049142062	0	0	0	0	0	0.195599842	2.01897564	0	0.496950818	3.359769156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.549	0	0.574316205	0	0	3.661695685	1.004313578	6.517974287	0.555384727	0.170700026	1.670275606	2.848253195	0	0.049142062	0	0	0	0	0	0.195599842	2.01897564	0	0.496950818	3.359769156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.549	3250																																																																																			0	0	0	0	0	3.661695685	1.004313578	6.517974287	0.555384727	0.170700026	1.670275606	2.848253195	0	0.049142062	0	0	0	0	0	0.195599842	2.01897564	0	0.496950818	3.359769156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.549
H5410_001_0	2008	6																					0											Coin	A	D	P	P	P	P	V	V	V	V	V	V	V	P	Coin	P	P	P	P	S	P	P	P	P	P	P	P	P	P	P																																																				0	0	0.03															0.01								4.058218065		2.454681675																30% Gastric Bypass Surgery															30% Gastric Bypass Surgery								Various Copays		$150 Copay for contact lenses																0.3															0.3								94.5035		150																0.009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.003	0	0	0	0	0	0	0	0.031959656	0	0.030683521	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0746	0	0	0.009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.003	0	0	0	0	0	0	0	0.031959656	0	0.030683521	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0746																																																																																				0	0	0	0.009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.003	0	0	0	0	0	0	0	0.031959656	0	0.030683521	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0746
H5414_002_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7556.080099	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0															150/d 7	150/d 7	"$0 days 1-8, $75 days 9-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $25 UC	$150 per visit	$30 per visit	"$30 X-ray; $175 PET, MRI"	$30 per visit	$30 per visit	$30 per visit	$15 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script		0	0	$0 per visit	0	$0 per visit															108.43	108.43	66.23	20	100	0.2	0.2	46.75	150	30	56.1	30	30	30	15	30	30	30	30	30	45	0	0	0	0	0	0															14.3445	0.279448259	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	4.387770426	5.579308245	5.361993375	0	0	0	6.920434651	18.89020025	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.4437			14.3445	0.279448259	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	4.387770426	5.579308245	5.361993375	0	0	0	6.920434651	18.89020025	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.4437																																																																																				0			14.3445	0.279448259	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	4.387770426	5.579308245	5.361993375	0	0	0	6.920434651	18.89020025	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.4437
H5414_004_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7704.379779	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961				0		0															100/d 7	100/d 7	"$0 days 1-8, $75 days 9-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $25 UC	$150 per visit	$20 per visit	"$20 X-ray; $175 PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$10 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit															72.29	72.29	66.23	20	100	0.2	0.2	46.75	150	20	47.9	20	20	20	10	20	20	20	20	20	45				0		0															9.5634	0.18630743	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	4.387770426	3.71953883	4.578243898	0	0	0	4.613623101	12.84063296	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9125			9.5634	0.18630743	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	4.387770426	3.71953883	4.578243898	0	0	0	4.613623101	12.84063296	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9125																																																																																				0			9.5634	0.18630743	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	4.387770426	3.71953883	4.578243898	0	0	0	4.613623101	12.84063296	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9125
H5414_009_0	2008	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7704.379779	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961				0		0															200/d 10	200/d 10	"$0 days 1-8, $75 days 9-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $25 UC	$175 per visit	$35 per visit	"$35 X-ray; $175 PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$25 per visit	"$35 Specialist, $30 Renal Dialysis"	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															163.93	163.93	66.23	20	100	0.2	0.2	46.75	175	35	60.2	35	30	35	25	34.61	35	35	35	35	45				0		0															21.6867	0.42248412	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	5.119065498	6.509192953	5.753868114	0	0	0	11.53405775	22.22071534	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.2547			21.6867	0.42248412	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	5.119065498	6.509192953	5.753868114	0	0	0	11.53405775	22.22071534	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.2547																																																																																				0			21.6867	0.42248412	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	5.119065498	6.509192953	5.753868114	0	0	0	11.53405775	22.22071534	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.2547
H5414_010_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7704.379779	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961				0		0															200/d 10	200/d 10	"$0 days 1-8, $75 days 9-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $25 UC	$175 per visit	$35 per visit	"$35 X-ray; $175 PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$20 per visit	"$35 Specialist, $30 Renal Dialysis"	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															163.93	163.93	66.23	20	100	0.2	0.2	46.75	175	35	60.2	35	30	35	20	34.61	35	35	35	35	45				0		0															21.6867	0.42248412	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	5.119065498	6.509192953	5.753868114	0	0	0	9.227246202	22.22071534	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.9479			21.6867	0.42248412	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	5.119065498	6.509192953	5.753868114	0	0	0	9.227246202	22.22071534	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.9479																																																																																				0			21.6867	0.42248412	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	5.119065498	6.509192953	5.753868114	0	0	0	9.227246202	22.22071534	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.9479
H5414_011_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7704.379779	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961				0		0															100/d 7	100/d 7	"$0 days 1-8, $75 days 9-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $25 UC	$150 per visit	$20 per visit	"$20 X-ray; $175 PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$10 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit															72.29	72.29	66.23	20	100	0.2	0.2	46.75	150	20	47.9	20	20	20	10	20	20	20	20	20	45				0		0															9.5634	0.18630743	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	4.387770426	3.71953883	4.578243898	0	0	0	4.613623101	12.84063296	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9125			9.5634	0.18630743	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	4.387770426	3.71953883	4.578243898	0	0	0	4.613623101	12.84063296	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9125																																																																																				0			9.5634	0.18630743	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	4.387770426	3.71953883	4.578243898	0	0	0	4.613623101	12.84063296	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9125
H5414_012_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7556.080099	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961				0		0															150/d 7	150/d 7	"$0 days 1-8, $75 days 9-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $25 UC	$150 per visit	$30 per visit	"$30 X-ray; $175 PET, MRI"	$30 per visit	$30 per visit	$30 per visit	$15 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script				$0 per visit		$0 per visit															108.43	108.43	66.23	20	100	0.2	0.2	46.75	150	30	56.1	30	30	30	15	30	30	30	30	30	45				0		0															14.3445	0.279448259	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	4.387770426	5.579308245	5.361993375	0	0	0	6.920434651	18.89020025	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.4437			14.3445	0.279448259	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	4.387770426	5.579308245	5.361993375	0	0	0	6.920434651	18.89020025	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.4437																																																																																				0			14.3445	0.279448259	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	4.387770426	5.579308245	5.361993375	0	0	0	6.920434651	18.89020025	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.4437
H5414_801_0	2008	2																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		888.3240027		285.263143	119.9007493	151.9147699	5.967115288		142.8773883	349.0507899	858.8236317	4517.766743	0	0	657.8845086	3944.637097	3847.661746	0	335.4791731	0	0	9.367687864				504.8281366		15.26955997															$200 per day; max $1400		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20 % per script				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2				0		0															10.7021	0	2.377192858	0.399669164	1.898934624	1.790134586	0	0.595322451	5.817513164	2.862745439	20.68384207	0	0	2.192948362	9.861592743	12.66521991	0	1.11826391	0	0	1.873537573	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.839			10.7021	0	2.377192858	0.399669164	1.898934624	1.790134586	0	0.595322451	5.817513164	2.862745439	20.68384207	0	0	2.192948362	9.861592743	12.66521991	0	1.11826391	0	0	1.873537573	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.839																																																																																				0			10.7021	0	2.377192858	0.399669164	1.898934624	1.790134586	0	0.595322451	5.817513164	2.862745439	20.68384207	0	0	2.192948362	9.861592743	12.66521991	0	1.11826391	0	0	1.873537573	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.839
H5414_803_0	2008	2																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		887.6324006		285.0410522	119.8074009	151.7964971	5.962469608		142.7661515	348.7790374	858.154997	4514.249449	0	0	657.3723145	3941.566011	3844.66616	0	335.2179868	0	0	9.360394678				504.4351041		15.25767189															$200 per day; max $1400		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20 % per script				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2				0		0															10.6938	0	2.375342102	0.399358003	1.897456213	1.788740882	0	0.594858965	5.812983956	2.860516657	20.66773873	0	0	2.191241048	9.853915028	12.65535944	0	1.117393289	0	0	1.872078936	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7807			10.6938	0	2.375342102	0.399358003	1.897456213	1.788740882	0	0.594858965	5.812983956	2.860516657	20.66773873	0	0	2.191241048	9.853915028	12.65535944	0	1.117393289	0	0	1.872078936	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7807																																																																																				0			10.6938	0	2.375342102	0.399358003	1.897456213	1.788740882	0	0.594858965	5.812983956	2.860516657	20.66773873	0	0	2.191241048	9.853915028	12.65535944	0	1.117393289	0	0	1.872078936	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7807
H5415_039_0	2008	5	s.	t.	u.	v.	w.	x.	y.	z.	aa.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered				Radiology	Renal Dialysis	Other	Mental Health (MH)						D	D	D	Coin	T	Coin	Coin	V	Coin	V	Coin		Coin	Coin	V	V	Coin	Coin			Coin			Coin	V		V			O	O	V	V	P	V	V	O	O	O	O		3.4839	0.0824	0.533	0.0449	0.1024	0.0853	0.0292	0.2422	0.8214	0	0.741		0.0016	0.3724	0.7003	1.3112	0.0129	0.1017			0.3062			0	0		0			0	0	0.0821	0.0454	0	0.0059	0.01	0	0	0	0		9.1155		2496.782936	59.019375	513.466929	2.629266	71.936509	4.992217	1.709265	340.374521	48.092478	6322.366215	43.380716		0.095573	21.800268	4920.234889	3684.890363	0.755029	5.954216			17.929548			3.38	1.14		2.99			0.02	0.06	192.307286	106.326832	5.624203	16.456113	28.01694	0.08	4.65	0.3	0.4		$125/Day(Days 1-8)	$125/Day(Days 1-8)	$0/Day(Days 1-6) $100(Days 7-100)	10% Coins	$100/Trip	10% Coins	10% Coins	$50/Visit	10% Coins	$0/Visit	10% Coins		10% Coins	10% Coins	$10/Visit	$25/Visit	10% Coins	10% Coins			10% Coins			DEN 762	VIS 827		HER 758			QuitNet	Meals on Wheels	$30/Visit	$30/Visit	$0/Proc	$25/Visit	$25/Visit	Active Outlook	Silver Sneakers	Nutritional Supplements	OTC $10 Mail Order		95.980555	95.980613	71.405402	0.097906	97.906014	0.097906	0.097905	48.952994	0.097906	0	0.097906		0.097902	0.097906	9.7906	24.4765	0.097906	0.097906			0.097906			0	0		0			0	0	29.371786	29.371791	0	24.476093	24.476657	0	0	0	0		19.9702	0.472059649	3.055359373	0.257420917	0.586918071	0.488767998	0.16734559	1.388529324	4.708542151	0	4.247232381	0	0.009356788	2.134377039	4.014337642	7.516101581	0.073921869	0.582953472	0	0	1.755410326	0	0	0	0	0	0	0	0	0	0	0.470700704	0.260250791	0	0.033565113	0.057146753	0	0	0	0	0	52.2505	200	1.117526883	23.4542	0.554413823	3.588388612	0.3023299	0.689310116	0.574037112	0.196540434	1.630768168	5.529980946	0	4.988192431	0	0.010989162	2.506734371	4.71466752	8.827339122	0.086818084	0.684653931	0	0	2.061654212	0	0	0	0	0	0	0	0	0	0	0.552817802	0.305653397	0	0.039420786	0.067116411	0	0	0	0	0	61.366		$200/Day(Days 1-8)	$200/Day(Days 1-8)	"20% Coins(Days 1-6), 20%(Days 7-100)"	20% Coins	$100/Trip	20% Coins	20% Coins	$50/Visit	20% Coins	20% Coins	20% Coins		10% Coins	20% Coins	$35/Visit	$35/Visit	20% Coins	20% Coins			20% Coins			DEN 762	VIS 827		HER 758			QuitNet	Meals on Wheels	20% Coins	20% Coins	$0/Proc	20% Coins	$35/Visit	Active Outlook	Silver Sneakers	Nutritional Supplements	OTC $10 Mail Order		6.5032	0.1537	0.4202	0.6563	0.6769	1.2461	0.4266	0.2826	2.0304	0.6908	1.8315		0.002	0.9204	3.8737	3.9154	0.0319	0.2514			0.757			0	0		0			0	0	0.7561	0.0311	0	0.01	0.0923	0	0	0	0		25.5594	200	0.473986951	29.9574	0.708137177	4.00854711	0.958612023	1.366216584	1.820128072	0.623184902	1.913371941	7.560366114	0.690782874	6.819654578	0	0.013006994	3.427105216	8.588349696	12.74276005	0.118694637	0.936031553	0	0	2.818610012	0	0	0	0	0	0	0	0	0	0	1.308967372	0.336722593	0	0.049374446	0.159387912	0	0	0	0	0	86.9254
H5415_801_0	2008	2	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered							2500											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		300.28	6.45	513.47	215.07	71.94	4.99	1.71	340.38	401.97	6322.44	2764.02		8.44	538.82	4920.29	3684.93	48.14	459.54			17.93			3.38	1.14		2.99			0.02	0.06	0.08	4.65	0.3	0.4							$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins			DEN 762	VIS 827		HER 758			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	OTC $10 Mail Order							453.446105	453.446123	14.582883	0	50.382929	0.100765	0.100765	25.191448	100.765788	18.919668	47.818232		16.793985	44.255926	10.07658	15.114871	29.858454	50.382898			0.100765			0	0		0			0	0	0	0	0	0							11.3467	0.243727291	0.623989411	0	0.302045659	0.50281735	0.17230815	0.714555423	3.375401984	9.968205479	11.01421247	0	0.011811769	1.987164837	4.131641317	4.6414368	0.119782165	1.929413079	0	0	1.80671645	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.892	0	52.08791845	11.3467	0.243727291	0.623989411	0	0.302045659	0.50281735	0.17230815	0.714555423	3.375401984	9.968205479	11.01421247	0	0.011811769	1.987164837	4.131641317	4.6414368	0.119782165	1.929413079	0	0	1.80671645	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.892	500	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins			DEN 762	VIS 827		HER 758			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	OTC $10 Mail Order							4.7616	0.0537	0.2343	0.366	0.3613	0.695	0.238	0.408	1.5542	0.3853	1.0388		0.0068	0.5189	1.6069	1.3215	0.0447	0.1402			0.4222			0	0		0			0	0	0	0	0	0							14.1575	0	13.94232174	16.1083	0.297406291	0.858333411	0.366043	0.663369659	1.19782735	0.41027015	1.122571423	4.929599984	10.35349148	12.05304447	0	0.018563769	2.506056837	5.738560317	5.9629418	0.164526165	2.069620079	0	0	2.22891145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.0495
H5415_803_0	2008	2	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered							2500											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		300.28	6.45	513.47	215.07	71.94	4.99	1.71	340.38	401.97	6322.44	2764.02		8.44	538.82	4920.29	3684.93	48.14	459.54			17.93			3.38	1.14		2.99			0.02	0.06	0.08	4.65	0.3	0.4							$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins			DEN 762	VIS 827		HER 758			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	OTC $10 Mail Order							453.446105	453.446123	14.582883	0	50.382929	0.100765	0.100765	25.191448	100.765788	18.919668	47.818232		16.793985	44.255926	10.07658	15.114871	29.858454	50.382898			0.100765			0	0		0			0	0	0	0	0	0							11.3467	0.243727291	0.623989411	0	0.302045659	0.50281735	0.17230815	0.714555423	3.375401984	9.968205479	11.01421247	0	0.011811769	1.987164837	4.131641317	4.6414368	0.119782165	1.929413079	0	0	1.80671645	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.892	0	52.08791845	11.3467	0.243727291	0.623989411	0	0.302045659	0.50281735	0.17230815	0.714555423	3.375401984	9.968205479	11.01421247	0	0.011811769	1.987164837	4.131641317	4.6414368	0.119782165	1.929413079	0	0	1.80671645	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.892	500	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins			DEN 762	VIS 827		HER 758			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	OTC $10 Mail Order							4.7616	0.0537	0.2343	0.366	0.3613	0.695	0.238	0.408	1.5542	0.3853	1.0388		0.0068	0.5189	1.6069	1.3215	0.0447	0.1402			0.4222			0	0		0			0	0	0	0	0	0							14.1575	0	13.94232174	16.1083	0.297406291	0.858333411	0.366043	0.663369659	1.19782735	0.41027015	1.122571423	4.929599984	10.35349148	12.05304447	0	0.018563769	2.506056837	5.738560317	5.9629418	0.164526165	2.069620079	0	0	2.22891145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.0495
H5415_804_0	2008	2	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered							2500											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		300.28	6.45	513.47	215.07	71.94	4.99	1.71	340.38	401.97	6322.44	2764.02		8.44	538.82	4920.29	3684.93	48.14	459.54			17.93			3.38	1.14		2.99			0.02	0.06	0.08	4.65	0.3	0.4							$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins			DEN 762	VIS 827		HER 758			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	OTC $10 Mail Order							453.446105	453.446123	14.582883	0	50.382929	0.100765	0.100765	25.191448	100.765788	18.919668	47.818232		16.793985	44.255926	10.07658	15.114871	29.858454	50.382898			0.100765			0	0		0			0	0	0	0	0	0							11.3467	0.243727291	0.623989411	0	0.302045659	0.50281735	0.17230815	0.714555423	3.375401984	9.968205479	11.01421247	0	0.011811769	1.987164837	4.131641317	4.6414368	0.119782165	1.929413079	0	0	1.80671645	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.892	0	52.08791845	11.3467	0.243727291	0.623989411	0	0.302045659	0.50281735	0.17230815	0.714555423	3.375401984	9.968205479	11.01421247	0	0.011811769	1.987164837	4.131641317	4.6414368	0.119782165	1.929413079	0	0	1.80671645	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.892	500	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins			DEN 762	VIS 827		HER 758			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	OTC $10 Mail Order							4.7616	0.0537	0.2343	0.366	0.3613	0.695	0.238	0.408	1.5542	0.3853	1.0388		0.0068	0.5189	1.6069	1.3215	0.0447	0.1402			0.4222			0	0		0			0	0	0	0	0	0							14.1575	0	13.94232174	16.1083	0.297406291	0.858333411	0.366043	0.663369659	1.19782735	0.41027015	1.122571423	4.929599984	10.35349148	12.05304447	0	0.018563769	2.506056837	5.738560317	5.9629418	0.164526165	2.069620079	0	0	2.22891145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.0495
H5415_805_0	2008	2	s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered							2500											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0	0	0							0		300.28	6.45	513.47	215.07	71.94	4.99	1.71	340.38	401.97	6322.44	2764.02		8.44	538.82	4920.29	3684.93	48.14	459.54			17.93			3.38	1.14		2.99			0.02	0.06	0.08	4.65	0.3	0.4							$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins			DEN 762	VIS 827		HER 758			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	OTC $10 Mail Order							453.446105	453.446123	14.582883	0	50.382929	0.100765	0.100765	25.191448	100.765788	18.919668	47.818232		16.793985	44.255926	10.07658	15.114871	29.858454	50.382898			0.100765			0	0		0			0	0	0	0	0	0							11.3467	0.243727291	0.623989411	0	0.302045659	0.50281735	0.17230815	0.714555423	3.375401984	9.968205479	11.01421247	0	0.011811769	1.987164837	4.131641317	4.6414368	0.119782165	1.929413079	0	0	1.80671645	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.892	0	52.08791845	11.3467	0.243727291	0.623989411	0	0.302045659	0.50281735	0.17230815	0.714555423	3.375401984	9.968205479	11.01421247	0	0.011811769	1.987164837	4.131641317	4.6414368	0.119782165	1.929413079	0	0	1.80671645	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.892	500	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins			DEN 762	VIS 827		HER 758			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers	Nutritional Supplements	OTC $10 Mail Order							4.7616	0.0537	0.2343	0.366	0.3613	0.695	0.238	0.408	1.5542	0.3853	1.0388		0.0068	0.5189	1.6069	1.3215	0.0447	0.1402			0.4222			0	0		0			0	0	0	0	0	0							14.1575	0	13.94232174	16.1083	0.297406291	0.858333411	0.366043	0.663369659	1.19782735	0.41027015	1.122571423	4.929599984	10.35349148	12.05304447	0	0.018563769	2.506056837	5.738560317	5.9629418	0.164526165	2.069620079	0	0	2.22891145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.0495
H5416_001_0	2008	6																					5000											d	d	d	v	t	coin	coin	v	v	coin	coin	coin	coin	coin	v	v	v	v	coin	coin	coin	v	v	v	v	p	v	p	v	v	v	v	v	v	v	v	v	v	v	v	v																																										0		1325.47071	55.22794624	414.5678461	953.0335306	84.46219292	5.712478198	5.273056798	276.9416839	628.2087723		28.59814669	1.301290531	0.497908085	3.76550078	3491.880063	4664.545933	201.6059852	1790.661856	13.5794711	28.64455923	21.375	650.4774318			498.5875922		53.82785545															"$100/day, days 1-5 only"	"$200/day, days 1-5 only"	"$25/day, days 11-100 only"	$10/visit	$100/trip	20% coins	15% prosth/10% supplies coins	"$50/visit, waived if admitted"	"$400(hosp), 200(ASC)"	no copay	"10% radiolog, 20% radiation therapy"	15% coins	20% coins	15% coins	$5 per office visit	$23 per office visit	$40/visit	$15 per visit	15% coins	"15% coins card testing, 20% nutrition therapy, $25/visit podiatrist, $8/visit med cov chiro"	20% coins	$20/visit vision and hearing			$25 per visit	$100 max/2 years	$25 per visit	"$400 max, no copay"														66.72	133.44	14.18	10	100	0.2	0.13	50	287.5		0.18811	0.15	0.2	0.15	5	23	40	15	0.15	0.15	0.2	20			25		25															7.3696	0.614134762	0.489881005	0.794194609	0.703851608	1.14249564	0.685497384	1.153923683	15.05083517	0	5.379597374	0.19519358	0.099581617	0.564825117	1.454950026	8.940379705	0.672019951	2.23832732	2.036920665	4.296683884	4.275	1.084129053	0	0	1.03872415	0	0.112141366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.3929		4	7.3696	0.614134762	0.489881005	0.794194609	0.703851608	1.14249564	0.685497384	1.153923683	15.05083517	0	5.379597374	0.19519358	0.099581617	0.564825117	1.454950026	8.940379705	0.672019951	2.23832732	2.036920665	4.296683884	4.275	1.084129053	0	0	1.03872415	0	0.112141366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.3929																																																																																				0		0	7.3696	0.614134762	0.489881005	0.794194609	0.703851608	1.14249564	0.685497384	1.153923683	15.05083517	0	5.379597374	0.19519358	0.099581617	0.564825117	1.454950026	8.940379705	0.672019951	2.23832732	2.036920665	4.296683884	4.275	1.084129053	0	0	1.03872415	0	0.112141366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.3929
H5416_002_0	2008	7																					5000											d	d	d	v	t	coin	coin	v	v	coin	coin	coin	coin	coin	v	v	v	v	coin	coin	coin	v	v	v	v	p	v	p	v	v	v	v	v	v	v	v	v	v	v	v	v																																										0		802.3869699	33.43279041	263.3093922	1808.791757	64.24549122	5.18650945	4.787547185	344.7581552	380.8136781		23.37562	0.686306509	0.552120603	1.990303382	3177.086317	3789.308206	206.5672768	1577.942797	11.58482624	23.14815008	21.375	560.7659565			516.9467107		33.83109705															"$160/day, days 1-5 only"	"$250/day, days 1-5 only"	"$35/day, days 11-100 only"	$15/visit	$120/trip	20% coins	20% coins	"$50/visit, waived if admitted"	"$475(hosp), 300(ASC)"	no copay	"15% radiolog, 20% radiation therapy"	15% coins	20% coins	15% coins	$8 per office visit	$28 spec /$30 pod per office visit	$55 per visit	$25 per visit	15% coins	"15% coins card testing, 20% nutrition therapy,  $8/visit med cov chiro"	20% coins	$25/visit vision and hearing			$25 per visit	$70 max/2 years	$30 per visit	"$400 max, no copay"														106.752	166.8	19.85	15	120	0.2	0.17	50	375		0.19136	0.15	0.2	0.15	8	28	55	25	0.15	0.15	0.2	25			25		30															7.138	0.464715787	0.43555762	2.260989696	0.642454912	1.03730189	0.813883021	1.436492313	11.90042744	0	4.473158643	0.102945976	0.110424121	0.298545507	2.118057545	8.841719147	0.946766685	3.287380827	1.737723936	3.472222513	4.275	1.168262409	0	0	1.076972314	0	0.084577743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1236	5000	4	7.138	0.464715787	0.43555762	2.260989696	0.642454912	1.03730189	0.813883021	1.436492313	11.90042744	0	4.473158643	0.102945976	0.110424121	0.298545507	2.118057545	8.841719147	0.946766685	3.287380827	1.737723936	3.472222513	4.275	1.168262409	0	0	1.076972314	0	0.084577743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1236																																																																																				0		0	7.138	0.464715787	0.43555762	2.260989696	0.642454912	1.03730189	0.813883021	1.436492313	11.90042744	0	4.473158643	0.102945976	0.110424121	0.298545507	2.118057545	8.841719147	0.946766685	3.287380827	1.737723936	3.472222513	4.275	1.168262409	0	0	1.076972314	0	0.084577743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1236
H5416_003_0	2008	3																					5000											d	d	d	v	t	coin	coin	v	v	coin	coin	coin	coin	coin	v	v	v	v	coin	coin	coin	v	v	v	v	p	v	p	v	v	v	v	v	v	v	v	v	v	v	v	v																																										0		802.3974611	33.43322754	263.3093922	1808.791757	64.24549122	5.18650945	4.787547185	344.7506585	381.120748		23.37562	0.686596641	0.552120603	1.990303382	3177.087715	3789.309873	206.5673677	1577.588382	11.58482624	23.14848089	21.375	560.7659565			516.9467107		33.83109705															"$150/day, days 1-5 only"	"$200/day, days 1-5 only"	"$25/day, days 11-100 only"	$5 /visit	$100/trip	20% coins	20% coins prosth/10% supplies	"$50/visit, waived if admitted"	"400(hosp), 200(ASC)"	no copay	"15% radiolog, 20% radiation therapy"	15% coins	20% coins	15% coins	$8 per office visit	spec$30 per / pod $30  office visit	$50/ visit	$20 per visit	15% coins	"15% coins card testing, 20% nutrition therapy, $30/visit podiatrist, $8/visit med cov chiro"	20% coins	$30/Dental/Vision/Hearing visit	no copay	no copay	$25 per visit	$70 max/2 years	$30 per visit	"$400 max, no copay"														100.082283	133.44	14.18	5	100	0.2	0.17	50	325		0.1914	0.15	0.2	0.15	8	30	50	20	0.15	0.15	0.2	30			25		30															6.6921	0.37177749	0.311143932	0.753663232	0.535379094	1.03730189	0.813883021	1.436461077	10.32202026	0	4.474093668	0.102989496	0.110424121	0.298545507	2.118058476	9.473274682	0.860697365	2.629313971	1.737723936	3.472272133	4.275	1.401914891	0	0	1.076972314	0	0.084577743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.3896		4	6.6921	0.37177749	0.311143932	0.753663232	0.535379094	1.03730189	0.813883021	1.436461077	10.32202026	0	4.474093668	0.102989496	0.110424121	0.298545507	2.118058476	9.473274682	0.860697365	2.629313971	1.737723936	3.472272133	4.275	1.401914891	0	0	1.076972314	0	0.084577743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.3896																																																																																				0			6.6921	0.37177749	0.311143932	0.753663232	0.535379094	1.03730189	0.813883021	1.436461077	10.32202026	0	4.474093668	0.102989496	0.110424121	0.298545507	2.118058476	9.473274682	0.860697365	2.629313971	1.737723936	3.472272133	4.275	1.401914891	0	0	1.076972314	0	0.084577743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.3896
H5416_004_0	2008	7																					5000											d	d	d	v	t	coin	coin	v	v	coin	coin	coin	coin	coin	v	v	V	v	coin	coin	coin	v	v	v	v	p	v	p	v	v	v	v	v	v	v	v	v	v	v	v	v																																										0		1147.919301	47.82997089	354.6651268	2746.817899	115.6882798	5.416050152	4.999430909	327.561558	1014.876391	18.78001677	16.86764327	3.279503362	4.388085523	0.690783447	3599.219694	3210.612214	130.7085047	467.1408297	7.657222239	25.98618229	19.2375	643.9648827			485.1723489	485.1723489	142.5															"$150/day, days 1-5 only"	"$260/day, days 1-5 only"	"$35/day, days 11-100 only"	$15/visit	$125/trip	25% coins	20% coins prosth/10% supplies	"$50/visit, waived if admitted"	"$450(hosp), $225(ASC)"	no copay	"15% radiolog, 20% radiation therapy"	15% coins	20% coins	15% coins	$10 per office visit	$30 per office visit	$55/visit	$20 per visit	15% coins	"15% coins card testing, 20% nutrition therapy, $8/visit med cov chiro"	20% coins	$30/Dental/Vision/Hearing visit	no copay	no copay	$25 per visit	$70 max/2 years	$30 per visit	"$400 max, no copay"														100.08	173.472	19.85	15	125	0.25	0.17	50	348.5		0.1969	0.15	0.2	0.15	10	30	55	20	0.15	0.15	0.2	30			25		30															9.5736	0.691430059	0.586675231	3.433522374	1.205086248	1.354012538	0.849903255	1.364839825	29.47370185	0	3.321238959	0.491925504	0.877617105	0.103617517	2.999349745	8.026530535	0.599080646	0.77856805	1.148583336	3.897927343	3.8475	1.609912207	0	0	1.010775727	0	0.35625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.6017		4	9.5736	0.691430059	0.586675231	3.433522374	1.205086248	1.354012538	0.849903255	1.364839825	29.47370185	0	3.321238959	0.491925504	0.877617105	0.103617517	2.999349745	8.026530535	0.599080646	0.77856805	1.148583336	3.897927343	3.8475	1.609912207	0	0	1.010775727	0	0.35625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.6017																																																																																				0		0	9.5736	0.691430059	0.586675231	3.433522374	1.205086248	1.354012538	0.849903255	1.364839825	29.47370185	0	3.321238959	0.491925504	0.877617105	0.103617517	2.999349745	8.026530535	0.599080646	0.77856805	1.148583336	3.897927343	3.8475	1.609912207	0	0	1.010775727	0	0.35625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.6017
H5417_001_0	2008	4	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						2400	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	P	P	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T				V					V	P	V	V																																																0		1751.631054	37.13859806	11072.57048	14.8290507	261.3620186	1300.322383	18.53631338	170.6701001	109.1716562	5318.900298	117.2761023	16.68562431	6.197517601	160.7155565	29676.98663	1704.886847	3665.123519	1.74571256		505.383786	315.5915652	1195.57966	1334.614563									7.62771397	7.150981847		54.55351749							(1a) $175/day	(1b) $175/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) $0/proc	(11a/11c) $0/proc	(4a) $50/visit (waived if admitted)	(9a/9b) $35/visit	(8a) $0/visit	(8b) $0/visit	(9a) $35/visit	(12) $0/proc	(9a) $35/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $15/visit	(7e/7h) $32.5/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $15/visit	(15) $0/proc	(Misc. PBP Cats) $15/visit	(10b) $0/trip				(18a) $15/visit					(4b) $35/visit (waived if admitted)	(9c) $32.5/proc 75%/25% Ind/Grp Blended Copay	(9d) $35/visit	(7f1) $0/visit							158.614	158.614			67.9774			45.3183	31.7228			31.7228		31.7228		13.5955	29.4569			13.5955		13.5955										31.7228	29.4569									23.1528	0.490891845	0	0	1.480559967	0	0	0.644539756	0.288602578	0	0	0.044109564	0	0.424862327	0	1.93156391	8.996927888	0	0	0.572578223	0	1.354540642	0	0	0	0	0	0	0	0	0	0.020164372	0.017553806	0	0	0	0	0	0	0	0	39.4197		4.072339008	23.1528	0.490891845	0	0	1.480559967	0	0	0.644539756	0.288602578	0	0	0.044109564	0	0.424862327	0	1.93156391	8.996927888	0	0	0.572578223	0	1.354540642	0	0	0	0	0	0	0	0	0	0.020164372	0.017553806	0	0	0	0	0	0	0	0	39.4197		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3				0.3					35	0.3	0.3	0.3							2.4789	0.006	1.0483	0.0022	0.2957	0.3984	0.0052	0.0374	0.2149	0.8866	0.7334	0.044	0.0031	0.0551	0.01	2.5461	0.3208	0.0009		0.2305		0.1521	0.1382									0.0012	0.0007		0.0025							9.6122		0	25.6316	0.496888799	1.048319283	0.002249886	1.776283356	0.398393145	0.005154889	0.68196741	0.50350212	0.886599136	0.733446746	0.08815358	0.003099162	0.479974268	0.009951412	4.477685632	9.31767791	0.000924342	0	0.80307027	0	1.506650272	0.138198706	0	0	0	0	0	0	0	0	0.021335293	0.018227612	0	0.002452214	0	0	0	0	0	0	49.0318
H5417_005_0	2008	6																					2500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2055.11357	140.958281	957.7030905		296.5352966	12.13653616	21.07746431	464.464575	439.0086242	3680.576583	483.693235	73.7128198	16.47630546	3092.840039		4187.64865	412.9277445	603.886374				745.2884718					0.078911172															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"	(10b)0	(16a)0	(17a)0	(17b)0	(18a)$25/visit															127.3174	127.3174	30.5562		54.5646	0.145505589	0.145505589	30.0105	54.5646	14.5506	47.4814	54.5646	117.0606	52.7548		18.1882	14.5506	14.5506				18.1882					18.1882															21.8043	1.495536707	2.438645165	0	1.348360719	1.765933842	3.06688886	1.161568917	1.996194014	4.46287053	1.913868778	0.335175852	0.160727246	13.59683529	0	6.347148785	0.500694122	0.732240355	0	0	0	1.12962123	0	0	0	0	0.000119604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2567	0	24.06528242	21.8043	1.495536707	2.438645165	0	1.348360719	1.765933842	3.06688886	1.161568917	1.996194014	4.46287053	1.913868778	0.335175852	0.160727246	13.59683529	0	6.347148785	0.500694122	0.732240355	0	0	0	1.12962123	0	0	0	0	0.000119604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2567		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.4597	0.0703	0.3028	0.3022	0.0776	0.1486	0.129	0.0335	0.3141	0.0493	0.1282	0.0257	0.0059	0.2242	0.0224	0.2167	0.0326	0.0352			0.1943	0.0459			0.0051																	4.8233	0	0	24.264	1.565820519	2.741421675	0.302200721	1.425980617	1.914544489	3.195934559	1.1950395	2.310311725	4.512182408	2.042049762	0.360895446	0.166658444	13.82106238	0.022412259	6.563818823	0.533246866	0.767408549	0	0	0.194280817	1.175557892	0	0	0.005058988	0	0.000119604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.08
H5417_006_0	2008	9																					3250											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	7950	1395.893975	43.94625781	464.8426384		111.8032425	11.78824212	1.286551485	190.5174092	19.16006942	11305.4858	39.34030657		0.303354129	16.48351851	1968.875321	6226.68241	179.5403374	3.925179284			16.13025041	1237.650841			122.4		14.32602104															$175/$325 (1a); $0 (1a1)	$175/$325 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$5 (4b)"	10%/20% (9b)	10%/20% (8a1); $0/$20 (8a2)	"$20 (8b1); 10%/20% (8b2, 8b3)"	10%/20% (incl in h5)	30% (12)	"10%/20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"10%/20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c; $0 (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											202.6244	202.6244	68.6862		120.2009	0.206058738	0.289302492	34.3431	0.068686246	5.4949	0.029947582		0.206058738	0.068723418	5	24.871	37.5	0.068686246			0.206058738	25			25		25															23.5702	0.74204877	2.660691314	0	1.11990448	2.42907029	0.37220255	0.545246901	1.316033239	5.176875851	1.178147062	0	0.062508769	1.132803733	0.820364717	12.90532344	0.561063554	0.269605829	0	0	3.323779038	2.578439251	0	0	0.255	0	0.029845877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0491	0	19.85725026	23.5702	0.74204877	2.660691314	0	1.11990448	2.42907029	0.37220255	0.545246901	1.316033239	5.176875851	1.178147062	0	0.062508769	1.132803733	0.820364717	12.90532344	0.561063554	0.269605829	0	0	3.323779038	2.578439251	0	0	0.255	0	0.029845877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0491		$375 (1a); $0 (1a1)	$375 (1b)	"$150 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$40 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$40/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $40 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c; $40 (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5); 50% (14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											3.049	0.096	1.5568	0.3591	0.3276	0.7107	0.0943	0.1595	1.1551	1.5146	0.8182		0.0183	0.9936	1.3597	3.5893	0.1122	0.167			0.6864	0.7367		0.2175	0.072		0.0084															17.8021	0	2.798021605	26.6192	0.83803789	4.217526527	0.359080675	1.447546157	3.139724349	0.466538084	0.704765513	2.471097833	6.691433848	1.996384995	0	0.080796469	2.126381792	2.180104635	16.49466562	0.673276265	0.436638343	0	0	4.010187498	3.315118507	0	0.2175	0.327	0	0.038272948	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.8512
H5419_001_0	2008	8	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	A	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1470.227421	9.200196131	330.0433617	9.854775937	262.9119163	11.94460118	4.258528238	196.3508227	403.4262308	834.3524406	882.7814835	49.50555459	14.28824535	0.377478106	6153.607209	2184.113887	0.142460529	479.0908109	656.2315343	0	23.92533174	0	0	0	4.674546052	329.6475	0.377516932	0	0		0	1074.106961	17.55972227	84.18285229	459.1099365	124.2311734	0.063029357	930.7555343	4.328612314	1.300336574		"$150/day, days(1-5) no yrly max"	"$500/admit, no yrly max"	$50/day for days 21 to 100	15% Coinsurance	$100 copay	30% coinsurance	30% coinsurance	$50 copay	$150 copay	$10 copay	$15/$35 copay for Lower/Higher Tier	$100 copay	$25 copay	$15 copay	$15 copay	$15 copay	50% coinsurance	$15 copay	$15/$35 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$15 copay	$0 copay	$15 copay	$15 copay	$10 copay	$0 copay	$10 copay	$10 copay	$15 copay		150	500	50	0.15	100	0.3	0.3	50	150	10	19.33492	100	25	15	15	15	0.5	15	23.33	0	0.2	0	0	0	0.5	0	10	0	0		0	15	0	15	15	10	0	10	10	15		18.3778	0.383341505	1.375180674	1.478216391	2.190932636	3.583380354	1.277558471	0.818128428	5.042827885	0.6952937	1.42237578	0.412546288	0.029767178	0.000471848	7.692009012	2.730142359	0.071230264	0.598863514	1.275823475	0	4.785066348	0	0	0	2.337273026	0	0.000314597	0	0	0	0	1.342633701	0	0.105228565	0.573887421	0.103525978	0	0.775629612	0.003607177	0.001625421	0	59.4847		0	18.3778	0.383341505	1.375180674	1.478216391	2.190932636	3.583380354	1.277558471	0.818128428	5.042827885	0.6952937	1.42237578	0.412546288	0.029767178	0.000471848	7.692009012	2.730142359	0.071230264	0.598863514	1.275823475	0	4.785066348	0	0	0	2.337273026	0	0.000314597	0	0	0	0	1.342633701	0	0.105228565	0.573887421	0.103525978	0	0.775629612	0.003607177	0.001625421	0	59.4847	None																																																																																			0		0	18.3778	0.383341505	1.375180674	1.478216391	2.190932636	3.583380354	1.277558471	0.818128428	5.042827885	0.6952937	1.42237578	0.412546288	0.029767178	0.000471848	7.692009012	2.730142359	0.071230264	0.598863514	1.275823475	0	4.785066348	0	0	0	2.337273026	0	0.000314597	0	0	0	0	1.342633701	0	0.105228565	0.573887421	0.103525978	0	0.775629612	0.003607177	0.001625421	0	59.4847
H5419_004_0	2008	7	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	A	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1282.985223	8.028496485	333.2214364	10.22054207	217.9541448	10.25569262	3.656393038	191.3943505	395.7551293	835.1911519	883.6688769	49.55531877	14.30260824	0.377857556	5461.83772	1938.582559	0.112230938	425.2329038	801.1622082	0	29.81364087	0	0	0	5.115587434	346.6880534	0.423717296	0	0		0	1075.186679	17.57737373	74.71927641	407.4982175	110.2654891	0.049654763	826.1228759	3.842003106	1.267512255		"$200/day, days(1-5) no yrly max"	"$900/admit, no yrly max"	$100/day for days 21 to 100	15% Coinsurance	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$20 copay	$30/$35 copay for Lower/Higher Tier	$150 copay	$25 copay	$30 copay	$15 copay	$30 copay	50% coinsurance	$30 copay	$30/$35 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$50 maximum per year	$25 copay	N/A	N/A		N/A	$30 copay	$0 copay	$30 copay	$30 copay	$25 copay	$0 copay	$25 copay	$25 copay	Min. $15 / Max. $30copay		200	900	100	0.15	150	0.3	0.3	50	200	20	31.08373	150	25	30	15	30	0.5	30	30.79	0	0.2	0	0	0	0.5	0	25	0	0		0	30	0	30	30	25	0	25	25	18.92933608		21.3831	0.602137236	2.776845303	1.53308131	2.72442681	3.076707785	1.096917911	0.79747646	6.595918822	1.391985253	2.288977065	0.619441485	0.029797101	0.000944644	6.82729715	4.846456398	0.056115469	1.06308226	2.055648699	0	5.962728173	0	0	0	2.557793717	0	0.000882744	0	0	0	0	2.687966698	0	0.186798191	1.018745544	0.229719769	0	1.721089325	0.008004173	0.00199943	0	74.1421		0	21.3831	0.602137236	2.776845303	1.53308131	2.72442681	3.076707785	1.096917911	0.79747646	6.595918822	1.391985253	2.288977065	0.619441485	0.029797101	0.000944644	6.82729715	4.846456398	0.056115469	1.06308226	2.055648699	0	5.962728173	0	0	0	2.557793717	0	0.000882744	0	0	0	0	2.687966698	0	0.186798191	1.018745544	0.229719769	0	1.721089325	0.008004173	0.00199943	0	74.1421	None																																																																																			0		0	21.3831	0.602137236	2.776845303	1.53308131	2.72442681	3.076707785	1.096917911	0.79747646	6.595918822	1.391985253	2.288977065	0.619441485	0.029797101	0.000944644	6.82729715	4.846456398	0.056115469	1.06308226	2.055648699	0	5.962728173	0	0	0	2.557793717	0	0.000882744	0	0	0	0	2.687966698	0	0.186798191	1.018745544	0.229719769	0	1.721089325	0.008004173	0.00199943	0	74.1421
H5419_009_0	2008	6	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	376.2390661	8.477051933	351.8386571	0	230.1313338	11.43368545	4.076374891	202.0876327	426.3940138	881.85363	933.0398257	52.32399511	15.10170093	0.398968616	5766.992872	2046.891976	0.125122046	448.9908436	615.002299	0	33.23810536	0	0	0	5.224104375	366.0576596	173.2188316	0	0		0	1135.257807	18.55942893	78.89387356	430.2653129	116.426068	0.055358225	872.2787057	4.056657423	1.338328693		$100/admit with no yearly max	$100/admit with no yearly max	$50/day for days 21 to 100	$0 Copay	$50 copay	20% coinsurance	20% coinsurance	$25 copay	$50 copay	$0 copay	$0/$35 copay for Lower/Higher Tier	$50 copay	$10 copay	$10 copay	$10 copay	$10 copay	50% coinsurance	$10 copay	$0/$35 copay for Lower/Higher Tier	N/A	0% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay		113.1675498	113.1675498	50	0	50	0.2	0.2	25	50	0	7.586114	50	10	10	10	10	0.5	10	15.88	0	0	0	0	0	0.5	0	10	0	0		0	10	0	10	10	10	0	10	10	10		3.5482	0.079943933	1.465994405	0	0.958880558	2.286737089	0.815274978	0.421015901	1.776641724	0	0.58984554	0.218016646	0.012584751	0.000332474	4.805827394	1.705743313	0.062561023	0.374159036	0.813853042	0	0	0	0	0	2.612052187	0	0.144349026	0	0	0	0	0.946048173	0	0.065744895	0.358554427	0.097021723	0	0.726898921	0.003380548	0.001115274	0	24.8907		0	3.5482	0.079943933	1.465994405	0	0.958880558	2.286737089	0.815274978	0.421015901	1.776641724	0	0.58984554	0.218016646	0.012584751	0.000332474	4.805827394	1.705743313	0.062561023	0.374159036	0.813853042	0	0	0	0	0	2.612052187	0	0.144349026	0	0	0	0	0.946048173	0	0.065744895	0.358554427	0.097021723	0	0.726898921	0.003380548	0.001115274	0	24.8907	None																																																																																			0		0	3.5482	0.079943933	1.465994405	0	0.958880558	2.286737089	0.815274978	0.421015901	1.776641724	0	0.58984554	0.218016646	0.012584751	0.000332474	4.805827394	1.705743313	0.062561023	0.374159036	0.813853042	0	0	0	0	0	2.612052187	0	0.144349026	0	0	0	0	0.946048173	0	0.065744895	0.358554427	0.097021723	0	0.726898921	0.003380548	0.001115274	0	24.8907
H5419_013_0	2008	7	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	373.3082766	8.411018241	349.0979395	0	228.3386798	11.25624928	4.013114768	200.5134307	423.0725323	874.9842548	925.7717254	51.91640688	14.98406321	0.39586077	5722.069728	2030.947301	0.123180312	445.4933396	610.2116156	0	32.72229249	0	0	0	5.432614372	363.2061802	171.8695089	0	0		0	1126.41449	18.41485655	78.27931395	426.9136752	115.5191439	0.054499137	865.4839162	4.025057278	1.327903514		$100/admit with no yearly max	$100/admit with no yearly max	$50/day for days 21 to 100	$0 Copay	$50 copay	20% coinsurance	20% coinsurance	$25 copay	$50 copay	$0 copay	$0/$35 copay for Lower/Higher Tier	$50 copay	$10 copay	$10 copay	$10 copay	$10 copay	50% coinsurance	$10 copay	$0/$35 copay for Lower/Higher Tier	N/A	0% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay		113.1675498	113.1675498	50	0	50	0.2	0.2	25	50	0	7.586114	50	10	10	10	10	0.5	10	15.88	0	0	0	0	0	0.5	0	10	0	0		0	10	0	10	10	10	0	10	10	10		3.5205	0.079321194	1.454574748	0	0.951411166	2.251249855	0.802622954	0.417736314	1.762802218	0	0.585250821	0.216318362	0.012486719	0.000329884	4.76839144	1.692456084	0.061590156	0.37124445	0.807513371	0	0	0	0	0	2.716307186	0	0.143224591	0	0	0	0	0.938678741	0	0.065232762	0.355761396	0.096265953	0	0.721236597	0.003354214	0.001106586	0	24.797		0	3.5205	0.079321194	1.454574748	0	0.951411166	2.251249855	0.802622954	0.417736314	1.762802218	0	0.585250821	0.216318362	0.012486719	0.000329884	4.76839144	1.692456084	0.061590156	0.37124445	0.807513371	0	0	0	0	0	2.716307186	0	0.143224591	0	0	0	0	0.938678741	0	0.065232762	0.355761396	0.096265953	0	0.721236597	0.003354214	0.001106586	0	24.797	None																																																																																			0		0	3.5205	0.079321194	1.454574748	0	0.951411166	2.251249855	0.802622954	0.417736314	1.762802218	0	0.585250821	0.216318362	0.012486719	0.000329884	4.76839144	1.692456084	0.061590156	0.37124445	0.807513371	0	0	0	0	0	2.716307186	0	0.143224591	0	0	0	0	0.938678741	0	0.065232762	0.355761396	0.096265953	0	0.721236597	0.003354214	0.001106586	0	24.797
H5419_017_0	2008	8	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	A	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1553.92106	9.7239232	348.8312918	11.00868951	277.8783458	13.34321618	4.757167026	207.5282193	426.3915278	881.8484887	933.034386	52.32369005	15.10161289	0.39896629	6503.905248	2308.445972	0.15914149	506.3633628	693.5879355	0	26.72679219	0	0	0	5.013240867	348.4128955	0.399007325	0	0		0	1135.251189	18.55932073	88.97501517	485.2450642	131.3031127	0.070409578	983.7393903	4.575021348	1.374359068		"$150/day, days(1-5) no yrly max"	"$500/admit, no yrly max"	$50/day for days 21 to 100	15% Coinsurance	$100 copay	30% coinsurance	30% coinsurance	$50 copay	$150 copay	$10 copay	$15/$35 copay for Lower/Higher Tier	$100 copay	$25 copay	$15 copay	$15 copay	$15 copay	50% coinsurance	$15 copay	$15/$35 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$15 copay	$0 copay	$15 copay	$15 copay	$10 copay	$0 copay	$10 copay	$10 copay	$15 copay		150	500	50	0.15	100	0.3	0.3	50	150	10	19.33492	100	25	15	15	15	0.5	15	23.33	0	0.2	0	0	0	0.5	0	10	0	0		0	15	0	15	15	10	0	10	10	15		19.424	0.405163467	1.453463716	1.651303426	2.315652882	4.002964853	1.427150108	0.864700914	5.329894098	0.734873741	1.503345434	0.43603075	0.031461694	0.000498708	8.129881561	2.885557465	0.079570745	0.632954203	1.348450545	0	5.345358438	0	0	0	2.506620434	0	0.000332506	0	0	0	0	1.419063986	0	0.111218769	0.60655633	0.109419261	0	0.819782825	0.003812518	0.001717949	0	63.5808		0	19.424	0.405163467	1.453463716	1.651303426	2.315652882	4.002964853	1.427150108	0.864700914	5.329894098	0.734873741	1.503345434	0.43603075	0.031461694	0.000498708	8.129881561	2.885557465	0.079570745	0.632954203	1.348450545	0	5.345358438	0	0	0	2.506620434	0	0.000332506	0	0	0	0	1.419063986	0	0.111218769	0.60655633	0.109419261	0	0.819782825	0.003812518	0.001717949	0	63.5808	None																																																																																			0		0	19.424	0.405163467	1.453463716	1.651303426	2.315652882	4.002964853	1.427150108	0.864700914	5.329894098	0.734873741	1.503345434	0.43603075	0.031461694	0.000498708	8.129881561	2.885557465	0.079570745	0.632954203	1.348450545	0	5.345358438	0	0	0	2.506620434	0	0.000332506	0	0	0	0	1.419063986	0	0.111218769	0.60655633	0.109419261	0	0.819782825	0.003812518	0.001717949	0	63.5808
H5419_018_0	2008	7	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	A	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1353.23223	8.468078984	351.4662363	11.37038807	229.8877401	11.40949317	4.067749783	201.8737232	417.4238227	880.920189	932.0522042	52.26861022	15.0857158	0.398546308	5760.888517	2044.725343	0.124857303	448.5155873	845.0280661	0	33.16777761	0	0	0	5.480476645	365.670188	0.446916996	0	0		0	1134.056138	18.5397838	78.81036449	429.8098776	116.3028312	0.055241094	871.3553998	4.052363456	1.336912074		"$200/day, days(1-5) no yrly max"	"$900/admit, no yrly max"	$100/day for days 21 to 100	15% Coinsurance	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$20 copay	$30/$35 copay for Lower/Higher Tier	$150 copay	$25 copay	$30 copay	$15 copay	$30 copay	50% coinsurance	$30 copay	$30/$35 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$50 maximum per year	$25 copay	N/A	N/A		N/A	$30 copay	$0 copay	$30 copay	$30 copay	$25 copay	$0 copay	$25 copay	$25 copay	Min. $15 / Max. $30copay		200	900	100	0.15	150	0.3	0.3	50	200	20	31.08373	150	25	30	15	30	0.5	30	30.79	0	0.2	0	0	0	0.5	0	25	0	0		0	30	0	30	30	25	0	25	25	18.92933608		22.5539	0.635105924	2.928885303	1.70555821	2.873596751	3.422847952	1.220324935	0.841140513	6.957063712	1.468200315	2.414304922	0.653357628	0.031428575	0.000996366	7.201110647	5.111813358	0.062428652	1.121288968	2.16820118	0	6.633555523	0	0	0	2.740238323	0	0.000931077	0	0	0	0	2.835140346	0	0.197025911	1.074524694	0.242297565	0	1.81532375	0.008442424	0.002108905	0	78.9211		0	22.5539	0.635105924	2.928885303	1.70555821	2.873596751	3.422847952	1.220324935	0.841140513	6.957063712	1.468200315	2.414304922	0.653357628	0.031428575	0.000996366	7.201110647	5.111813358	0.062428652	1.121288968	2.16820118	0	6.633555523	0	0	0	2.740238323	0	0.000931077	0	0	0	0	2.835140346	0	0.197025911	1.074524694	0.242297565	0	1.81532375	0.008442424	0.002108905	0	78.9211	None																																																																																			0		0	22.5539	0.635105924	2.928885303	1.70555821	2.873596751	3.422847952	1.220324935	0.841140513	6.957063712	1.468200315	2.414304922	0.653357628	0.031428575	0.000996366	7.201110647	5.111813358	0.062428652	1.121288968	2.16820118	0	6.633555523	0	0	0	2.740238323	0	0.000931077	0	0	0	0	2.835140346	0	0.197025911	1.074524694	0.242297565	0	1.81532375	0.008442424	0.002108905	0	78.9211
H5419_019_0	2008	7	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	389.5054966	8.775958215	364.2447135	0	238.2459121	12.25421924	4.368914281	209.2133721	441.4289399	912.948354	965.9394077	54.16897269	15.63419658	0.413036505	5970.340735	2119.066698	0.134101379	464.8225483	636.6876741	0	35.6234245	0	0	0	3.219268033	378.9650872	179.3266386	0	0		0	1175.287725	19.21384629	81.67572208	445.4367435	120.5313258	0.059330986	903.0358117	4.199697762	1.385519021		$100/admit with no yearly max	$100/admit with no yearly max	$50/day for days 21 to 100	$0 Copay	$50 copay	20% coinsurance	20% coinsurance	$25 copay	$50 copay	$0 copay	$0/$35 copay for Lower/Higher Tier	$50 copay	$10 copay	$10 copay	$10 copay	$10 copay	50% coinsurance	$10 copay	$0/$35 copay for Lower/Higher Tier	N/A	0% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay		113.1675498	113.1675498	50	0	50	0.2	0.2	25	50	0	7.586114	50	10	10	10	10	0.5	10	15.88	0	0	0	0	0	0.5	0	10	0	0		0	10	0	10	10	10	0	10	10	10		3.6733	0.082762807	1.517686306	0	0.9926913	2.450843848	0.873782856	0.435861192	1.839287249	0	0.610643872	0.225704053	0.013028497	0.000344197	4.975283946	1.765888915	0.06705069	0.387352124	0.842550022	0	0	0	0	0	1.609634016	0	0.149438866	0	0	0	0	0.979406437	0	0.068063102	0.371197286	0.100442771	0	0.752529843	0.003499748	0.001154599	0	24.7894		0	3.6733	0.082762807	1.517686306	0	0.9926913	2.450843848	0.873782856	0.435861192	1.839287249	0	0.610643872	0.225704053	0.013028497	0.000344197	4.975283946	1.765888915	0.06705069	0.387352124	0.842550022	0	0	0	0	0	1.609634016	0	0.149438866	0	0	0	0	0.979406437	0	0.068063102	0.371197286	0.100442771	0	0.752529843	0.003499748	0.001154599	0	24.7894	None																																																																																			0		0	3.6733	0.082762807	1.517686306	0	0.9926913	2.450843848	0.873782856	0.435861192	1.839287249	0	0.610643872	0.225704053	0.013028497	0.000344197	4.975283946	1.765888915	0.06705069	0.387352124	0.842550022	0	0	0	0	0	1.609634016	0	0.149438866	0	0	0	0	0.979406437	0	0.068063102	0.371197286	0.100442771	0	0.752529843	0.003499748	0.001154599	0	24.7894
H5419_020_0	2008	6	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	389.5054966	8.775958215	364.2447135	0	238.2459121	12.25421924	4.368914281	209.2133721	441.4289399	912.948354	965.9394077	54.16897269	15.63419658	0.413036505	5970.340735	2119.066698	0.134101379	464.8225483	636.6876741	0	35.6234245	0	0	0	5.741283743	378.9650872	179.3266386	0	0		0	1175.287725	19.21384629	81.67572208	445.4367435	120.5313258	0.059330986	903.0358117	4.199697762	1.385519021		$100/admit with no yearly max	$100/admit with no yearly max	$50/day for days 21 to 100	$0 Copay	$50 copay	20% coinsurance	20% coinsurance	$25 copay	$50 copay	$0 copay	$0/$35 copay for Lower/Higher Tier	$50 copay	$10 copay	$10 copay	$10 copay	$10 copay	50% coinsurance	$10 copay	$0/$35 copay for Lower/Higher Tier	N/A	0% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay		113.1675498	113.1675498	50	0	50	0.2	0.2	25	50	0	7.586114	50	10	10	10	10	0.5	10	15.88	0	0	0	0	0	0.5	0	10	0	0		0	10	0	10	10	10	0	10	10	10		3.6733	0.082762807	1.517686306	0	0.9926913	2.450843848	0.873782856	0.435861192	1.839287249	0	0.610643872	0.225704053	0.013028497	0.000344197	4.975283946	1.765888915	0.06705069	0.387352124	0.842550022	0	0	0	0	0	2.870641872	0	0.149438866	0	0	0	0	0.979406437	0	0.068063102	0.371197286	0.100442771	0	0.752529843	0.003499748	0.001154599	0	26.0504		0	3.6733	0.082762807	1.517686306	0	0.9926913	2.450843848	0.873782856	0.435861192	1.839287249	0	0.610643872	0.225704053	0.013028497	0.000344197	4.975283946	1.765888915	0.06705069	0.387352124	0.842550022	0	0	0	0	0	2.870641872	0	0.149438866	0	0	0	0	0.979406437	0	0.068063102	0.371197286	0.100442771	0	0.752529843	0.003499748	0.001154599	0	26.0504	None																																																																																			0		0	3.6733	0.082762807	1.517686306	0	0.9926913	2.450843848	0.873782856	0.435861192	1.839287249	0	0.610643872	0.225704053	0.013028497	0.000344197	4.975283946	1.765888915	0.06705069	0.387352124	0.842550022	0	0	0	0	0	2.870641872	0	0.149438866	0	0	0	0	0.979406437	0	0.068063102	0.371197286	0.100442771	0	0.752529843	0.003499748	0.001154599	0	26.0504
H5419_805_0	2008	4																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	294.2917212	2.168919813	47.5196641	38.12543058	8.169585462	25.55783243	1.220237577	5.962756756	30.81159577	12.10537002	32.68873913	0	0.274308799	31.88388633	45.94707502	124.1420761	1.417555032	4.772028736	30.86237842	40.98906846	8.870753485	6.310207568	0	0	0	0	0	0	0	0	0											Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											0.076813085	0.076813085	0.188134857	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.6055	0.166601421	8.940105187	0	1.911682998	5.980532788	0.285535593	1.395285081	7.209913409	2.832656584	7.649164956	0	0.064188259	7.460829402	10.75161555	29.0492458	0.331707878	1.116654724	7.22179655	9.59144202	2.075756315	1.476588571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1168	0	0	22.6055	0.166601421	8.940105187	0	1.911682998	5.980532788	0.285535593	1.395285081	7.209913409	2.832656584	7.649164956	0	0.064188259	7.460829402	10.75161555	29.0492458	0.331707878	1.116654724	7.22179655	9.59144202	2.075756315	1.476588571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1168	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.6055	0.166601421	8.940105187	0	1.911682998	5.980532788	0.285535593	1.395285081	7.209913409	2.832656584	7.649164956	0	0.064188259	7.460829402	10.75161555	29.0492458	0.331707878	1.116654724	7.22179655	9.59144202	2.075756315	1.476588571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1168
H5419_806_0	2008	4																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	294.2917212	2.168919813	47.5196641	38.12543058	8.169585462	25.55783243	1.220237577	5.962756756	30.81159577	12.10537002	32.68873913	0	0.274308799	31.88388633	45.94707502	124.1420761	1.417555032	4.772028736	30.86237842	40.98906846	8.870753485	6.310207568	0	0	0	0	0	0	0	0	0											Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											0.076813085	0.076813085	0.188134857	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.6055	0.166601421	8.940105187	0	1.911682998	5.980532788	0.285535593	1.395285081	7.209913409	2.832656584	7.649164956	0	0.064188259	7.460829402	10.75161555	29.0492458	0.331707878	1.116654724	7.22179655	9.59144202	2.075756315	1.476588571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1168	0	0	22.6055	0.166601421	8.940105187	0	1.911682998	5.980532788	0.285535593	1.395285081	7.209913409	2.832656584	7.649164956	0	0.064188259	7.460829402	10.75161555	29.0492458	0.331707878	1.116654724	7.22179655	9.59144202	2.075756315	1.476588571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1168	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.6055	0.166601421	8.940105187	0	1.911682998	5.980532788	0.285535593	1.395285081	7.209913409	2.832656584	7.649164956	0	0.064188259	7.460829402	10.75161555	29.0492458	0.331707878	1.116654724	7.22179655	9.59144202	2.075756315	1.476588571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1168
H5420_001_0	2008	6																																				T	P		V								V																																																																			0							164.2151045		216.6385642																																							$0 to $25 for diabetic supplies		$50 / waived if admitted																																							12.5		50																																		0	0	0	0	0	0.1710574	0	0.902660684	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.0737	0	0	0	0	0	0	0	0.1710574	0	0.902660684	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.0737																																																																																				0			0	0	0	0	0	0.1710574	0	0.902660684	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.0737
H5420_003_0	2008	6	e.3.										DME/Prosthetics/Supplies											Diabetic Supplies												D		T	Coin	Coin	V					Coin			V	V	V	V		Coin											P																																																			0				730.6921788		605.8484963	6.539732294	10.00674941	408.6204101					0.035651284			176.8479054	303.8671195	2175.763827	5317.689368		12.59378479											163.9656709												$25 / days 7-21		$40 	0% to 20% varies by type	20%	$50 / waived if admitted					20%			$25 for urgent care	$10 	$10 	$0 to $25 / varies by service		20%											$0-$25 copay for diabetic supplies												25		40	0.1	0.2	50					0.2			25	10	10	9.450317656		0.2											12.5										0	0	1.522275373	0	2.019494988	0.653973229	2.001349882	1.702585042	0	0	0	0	0.007130257	0	0	0.368433136	0.2532226	1.813136523	4.187821143	0	2.518756957	0	0	0	0	0	0	0	0	0	0	0.170797574	0	0	0	0	0	0	0	0	0	17.219	0	0	0	0	1.522275373	0	2.019494988	0.653973229	2.001349882	1.702585042	0	0	0	0	0.007130257	0	0	0.368433136	0.2532226	1.813136523	4.187821143	0	2.518756957	0	0	0	0	0	0	0	0	0	0	0.170797574	0	0	0	0	0	0	0	0	0	17.219																																																																																				0			0	0	1.522275373	0	2.019494988	0.653973229	2.001349882	1.702585042	0	0	0	0	0.007130257	0	0	0.368433136	0.2532226	1.813136523	4.187821143	0	2.518756957	0	0	0	0	0	0	0	0	0	0	0.170797574	0	0	0	0	0	0	0	0	0	17.219
H5420_004_0	2008	6																																																																																																																		0								164.2151045	216.6385642																																								$0 to $25 for diabetic supplies	$50 / waived if admitted																																								12.5	50																																		0	0	0	0	0	0	0.1710574	0.902660684	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.0737	0	0	0	0	0	0	0	0	0.1710574	0.902660684	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.0737																																																																																				0			0	0	0	0	0	0	0.1710574	0.902660684	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.0737
H5420_005_0	2008	6	e.3.										DME/Prosthetics/Supplies											Diabetic Supplies											D	D		T	Coin	Coin	V	V				Coin			V	V	V	P		Coin				V							P																																																			0			325.6321245	725.1149051		601.2241373	6.539732294	10.00674941	405.5014663	444.7168717				0.035651284			5318.122711	301.5477432	2159.156519	4221.680136		13.60128757				471.5825139							163.9656709											$175 / days 1-5	$25 / days 7-100		$60 	0% to 20% varies by type	20%	$50 / waived if admitted	$100 				20%			$25 	$25 	$25 	$0 to $50 varying by service		20%				$25 per exam							$0 - $25 for diabetic supplies											175	25		60	0.1	0.2	50	100				0.2			25	25	25	18.90063531		0.2				25							12.5										0	4.748801816	1.510656052	0	3.006120687	0.653973229	2.001349882	1.689589443	3.705973931	0	0	0	0.007130257	0	0	11.07942232	0.628224465	4.498242747	6.649369721	0	2.720257514	0	0	0	0.982463571	0	0	0	0	0	0	0.170797574	0	0	0	0	0	0	0	0	0	44.0524	0	0	0	4.748801816	1.510656052	0	3.006120687	0.653973229	2.001349882	1.689589443	3.705973931	0	0	0	0.007130257	0	0	11.07942232	0.628224465	4.498242747	6.649369721	0	2.720257514	0	0	0	0.982463571	0	0	0	0	0	0	0.170797574	0	0	0	0	0	0	0	0	0	44.0524																																																																																				0			0	4.748801816	1.510656052	0	3.006120687	0.653973229	2.001349882	1.689589443	3.705973931	0	0	0	0.007130257	0	0	11.07942232	0.628224465	4.498242747	6.649369721	0	2.720257514	0	0	0	0.982463571	0	0	0	0	0	0	0.170797574	0	0	0	0	0	0	0	0	0	44.0524
H5420_006_0	2008	8																																				T			V																																																																											0						209.6618213			257.9826217																																						$50 			$25 / Waived if admitted																																						50			25																																		0	0	0	0	0.873590922	0	0	0.537463795	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.4111	0	0	0	0	0	0	0.873590922	0	0	0.537463795	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.4111																																																																																				0			0	0	0	0	0.873590922	0	0	0.537463795	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.4111
H5420_007_0	2008	4																																																																																																																		0						176.0616107	164.2151045		216.6385642								576.2863864																														$50 / waived if admitted	$0 to $25 for diabetic supplies		$50 / waived if admitted								$25 urgent care																														50	12.5		50								25																										0	0	0	0	0.733590045	0.1710574	0	0.902660684	0	0	0	0	0	0	0	1.200596638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.0079	0	0	0	0	0	0	0.733590045	0.1710574	0	0.902660684	0	0	0	0	0	0	0	1.200596638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.0079																																																																																				0			0	0	0	0	0.733590045	0.1710574	0	0.902660684	0	0	0	0	0	0	0	1.200596638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.0079
H5420_008_0	2008	4	e.3.										DME/Prosthetics/Supplies											Diabetic Supplies											D	D		T	Coin	Coin	V	V				Coin			V	V	V	P		Coin				V							P																																																			0			325.6321245	725.1149051		601.2241373	6.539732294	10.00674941	405.5014663	444.7168717				0.035651284			5318.122711	301.5477432	2159.156519	4221.680136		13.60128757				471.5825139							163.9656709											$175 / days 1-5	$25 / days 7-100		$100 	0% to 20% varies by type	20%	$50 / waived if admitted	$100 				20%			$25 	$25 	$25 	$0 to $50 varying by service		20%				$25 per exam							$0 - $25 for diabetic supplies											175	25		100	0.1	0.2	50	100				0.2			25	25	25	18.90063531		0.2				25							12.5										0	4.748801816	1.510656052	0	5.010201144	0.653973229	2.001349882	1.689589443	3.705973931	0	0	0	0.007130257	0	0	11.07942232	0.628224465	4.498242747	6.649369721	0	2.720257514	0	0	0	0.982463571	0	0	0	0	0	0	0.170797574	0	0	0	0	0	0	0	0	0	46.0565	0	0	0	4.748801816	1.510656052	0	5.010201144	0.653973229	2.001349882	1.689589443	3.705973931	0	0	0	0.007130257	0	0	11.07942232	0.628224465	4.498242747	6.649369721	0	2.720257514	0	0	0	0.982463571	0	0	0	0	0	0	0.170797574	0	0	0	0	0	0	0	0	0	46.0565																																																																																				0			0	4.748801816	1.510656052	0	5.010201144	0.653973229	2.001349882	1.689589443	3.705973931	0	0	0	0.007130257	0	0	11.07942232	0.628224465	4.498242747	6.649369721	0	2.720257514	0	0	0	0.982463571	0	0	0	0	0	0	0.170797574	0	0	0	0	0	0	0	0	0	46.0565
H5421_046_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		279.9952077	116.0110868	799.2530242	25.77996148	172.2616175	12.67409921	11.97892678	312.5213189	319.5829506		41.43223486		8.869711213	0.543318351	4016.13908	4050.956525	3.241374252	530.761048			25.80856439	7.752116421			432		249.0226934															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															157.0691	40.7655	24.7042	0.120822417	40.2741	0.161096556	0.161096556	28.1919	32.2342		0.080548278		40.2741	0.188321069	8.0548	19.5211	0.40274139	20.1371			0.161096556	0.171629793			12.0822		12.0822															3.6649	0.394104004	1.645406009	3.114797259	0.578140694	2.041753735	1.929763851	0.734214078	0.858458188	0	3.337295175	0	0.029768332	0.102318293	2.695775728	6.589913841	1.305435573	0.890664344	0	0	4.157670842	1.330494136	0	0	0.434960702	0	0.250729364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0865	0	8.71459347	3.6649	0.394104004	1.645406009	3.114797259	0.578140694	2.041753735	1.929763851	0.734214078	0.858458188	0	3.337295175	0	0.029768332	0.102318293	2.695775728	6.589913841	1.305435573	0.890664344	0	0	4.157670842	1.330494136	0	0	0.434960702	0	0.250729364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0865																																																																																				0	0	0	3.6649	0.394104004	1.645406009	3.114797259	0.578140694	2.041753735	1.929763851	0.734214078	0.858458188	0	3.337295175	0	0.029768332	0.102318293	2.695775728	6.589913841	1.305435573	0.890664344	0	0	4.157670842	1.330494136	0	0	0.434960702	0	0.250729364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0865
H5421_047_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		269.2233148	91.16864807	824.0688031	21.25545279	166.9467316	11.94802117	12.03134133	308.4218539	317.1344857		38.84623774		9.770970773	0.529076882	3745.660367	3765.98114	2.579451518	540.4247823			22.75736583	7.436270222			432		249.0118337															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															159.7693	41.4663	25.1289	0.122899498	40.9665	0.163865998	0.163865998	28.6765	32.7414		0.081932999		40.9665	0.194573588	8.1933	19.774	0.409664994	20.4832			0.163865998	0.176479634			12.2899		12.2899															3.5845	0.315035472	1.725658497	2.612284484	0.569935266	1.95787441	1.971527752	0.737039549	0.865285028	0	3.182788752	0	0.033356872	0.102944387	2.557443221	6.205716037	1.056710992	0.922471314	0	0	3.729158457	1.312350246	0	0	0.442438194	0	0.255028579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.1395	0	7.528086365	3.5845	0.315035472	1.725658497	2.612284484	0.569935266	1.95787441	1.971527752	0.737039549	0.865285028	0	3.182788752	0	0.033356872	0.102944387	2.557443221	6.205716037	1.056710992	0.922471314	0	0	3.729158457	1.312350246	0	0	0.442438194	0	0.255028579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.1395																																																																																				0	0	0	3.5845	0.315035472	1.725658497	2.612284484	0.569935266	1.95787441	1.971527752	0.737039549	0.865285028	0	3.182788752	0	0.033356872	0.102944387	2.557443221	6.205716037	1.056710992	0.922471314	0	0	3.729158457	1.312350246	0	0	0.442438194	0	0.255028579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.1395
H5421_048_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		303.1210992	115.0161366	822.2307517	29.35490895	175.1539835	13.12658222	11.99296408	307.7827375	326.2583085		43.98222804		11.03617456	0.562496493	3874.011791	4377.561955	3.538354155	564.5040101			27.61513562	8.748290841			432		249.015758															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															155.0681	40.2461	24.3894	0.119283192	39.7611	0.159044255	0.159044255	27.8327	31.4421		0.079522128		39.7611	0.17470079	7.9522	19.2972	0.397610639	19.8805			0.159044255	0.167475467			11.9283		11.9283															3.917	0.38574638	1.671145398	3.501547229	0.58035906	2.087707495	1.907412043	0.713869863	0.854853556	0	3.497560356	0	0.036567503	0.098268582	2.567247171	7.039553196	1.406887255	0.93522	0	0	4.392028684	1.465124093	0	0	0.42941949	0	0.247528286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.7351	0	9.717222071	3.917	0.38574638	1.671145398	3.501547229	0.58035906	2.087707495	1.907412043	0.713869863	0.854853556	0	3.497560356	0	0.036567503	0.098268582	2.567247171	7.039553196	1.406887255	0.93522	0	0	4.392028684	1.465124093	0	0	0.42941949	0	0.247528286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.7351																																																																																				0	0	0	3.917	0.38574638	1.671145398	3.501547229	0.58035906	2.087707495	1.907412043	0.713869863	0.854853556	0	3.497560356	0	0.036567503	0.098268582	2.567247171	7.039553196	1.406887255	0.93522	0	0	4.392028684	1.465124093	0	0	0.42941949	0	0.247528286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.7351
H5421_049_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		312.7179719	96.89469405	850.0388968	26.49391901	172.8441251	13.20811687	12.71254159	306.647828	366.3341245		47.048214		10.63077859	0.72192436	3929.635433	4402.485289	2.848779975	520.2207405			27.12554688	8.223623496			432		249.0857348															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															155.2403	40.2908	24.4165	0.119415606	39.8052	0.159220807	0.159220807	27.8636	30.7179		0.079610404		39.8052	0.155912123	7.961	19.3106	0.398052019	19.9026			0.159220807	0.169337407			11.9416		11.9416															4.0455	0.325330599	1.729581994	3.163787383	0.573341274	2.103007033	2.024101137	0.71202709	0.937751609	0	3.745527311	0	0.035263357	0.11255676	2.606998861	7.084540164	1.13396262	0.86281215	0	0	4.318951476	1.392567078	0	0	0.42989618	0	0.247872699	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5854	0	9.62627181	4.0455	0.325330599	1.729581994	3.163787383	0.573341274	2.103007033	2.024101137	0.71202709	0.937751609	0	3.745527311	0	0.035263357	0.11255676	2.606998861	7.084540164	1.13396262	0.86281215	0	0	4.318951476	1.392567078	0	0	0.42989618	0	0.247872699	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5854																																																																																				0	0	0	4.0455	0.325330599	1.729581994	3.163787383	0.573341274	2.103007033	2.024101137	0.71202709	0.937751609	0	3.745527311	0	0.035263357	0.11255676	2.606998861	7.084540164	1.13396262	0.86281215	0	0	4.318951476	1.392567078	0	0	0.42989618	0	0.247872699	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5854
H5421_050_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		343.5106868	102.6015255	861.4884535	32.57650579	186.9441929	14.33884058	13.19804514	332.2863703	401.1383839		52.08630556		10.71138593	0.725635181	4085.917314	4803.897904	2.958855938	650.4839256			30.99569604	9.02499238			432		249.1451782															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															151.1384	39.2262	23.7714	0.116260313	38.7534	0.155013751	0.155013751	27.1274	29.7515		0.077506875		38.7534	0.15176225	7.7507	18.8309	0.387534376	19.3767			0.155013751	0.165077397			11.626		11.626															4.3265	0.335389249	1.706562583	3.787354756	0.60372751	2.222717457	2.045878476	0.751172282	0.994539541	0	4.037046787	0	0.034591919	0.110124028	2.639055696	7.538462113	1.14665839	1.050353677	0	0	4.804759093	1.48982225	0	0	0.418537126	0	0.241380803	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2846	0	11.69091965	4.3265	0.335389249	1.706562583	3.787354756	0.60372751	2.222717457	2.045878476	0.751172282	0.994539541	0	4.037046787	0	0.034591919	0.110124028	2.639055696	7.538462113	1.14665839	1.050353677	0	0	4.804759093	1.48982225	0	0	0.418537126	0	0.241380803	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2846																																																																																				0	0	0	4.3265	0.335389249	1.706562583	3.787354756	0.60372751	2.222717457	2.045878476	0.751172282	0.994539541	0	4.037046787	0	0.034591919	0.110124028	2.639055696	7.538462113	1.14665839	1.050353677	0	0	4.804759093	1.48982225	0	0	0.418537126	0	0.241380803	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2846
H5421_051_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		354.2021837	117.9222208	887.0538321	40.6340534	175.157536	13.69916289	13.32996643	284.5101743	368.2677404		55.19433448		13.9166824	1.302719613	4094.534442	5463.556811	4.45133482	920.517551			33.06195791	10.0158666			432		249.0150709															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															147.5601	38.2975	23.2085	0.113507739	37.8359	0.151343653	0.151343653	26.4851	30.1034		0.075671826		37.8359	0.092426942	7.5672	18.3723	0.378359131	18.918			0.151343653	0.154695228			11.3508		11.3508															4.3555	0.376343965	1.715602703	4.612279545	0.552270443	2.073281349	2.017405807	0.627940964	0.923842228	0	4.17665609	0	0.043879199	0.12040639	2.582007492	8.364832776	1.684203176	1.451192588	0	0	5.00371747	1.549406765	0	0	0.408627862	0	0.235542815	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.8749	0	13.78411524	4.3555	0.376343965	1.715602703	4.612279545	0.552270443	2.073281349	2.017405807	0.627940964	0.923842228	0	4.17665609	0	0.043879199	0.12040639	2.582007492	8.364832776	1.684203176	1.451192588	0	0	5.00371747	1.549406765	0	0	0.408627862	0	0.235542815	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.8749																																																																																				0	0	0	4.3555	0.376343965	1.715602703	4.612279545	0.552270443	2.073281349	2.017405807	0.627940964	0.923842228	0	4.17665609	0	0.043879199	0.12040639	2.582007492	8.364832776	1.684203176	1.451192588	0	0	5.00371747	1.549406765	0	0	0.408627862	0	0.235542815	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.8749
H5421_052_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1428.587582	140.4245623	786.9019806	25.92457608	178.9485882	13.02677198	11.97606294	328.6205391	299.494635		38.66859629		9.665362722	0.496106994	3831.112845	3790.485451	3.661359491	489.9144967			24.02622397	7.12469992			432		249.0235104															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												98.5049	98.5049	22.9605	0.112294719	74.8631	0.149726292	0.149726292	37.4316	120.0193		0.149726292		37.4316	0.312017471	14.9726	23.0268	0.37431573	22.1711			0.149726292	0.272172473			22.4589		22.4589															11.7269	1.152709277	1.505640339	2.911192985	1.116387857	1.950450264	1.793131496	1.025065308	2.995427887	0	5.789705538	0	0.030149144	0.15479405	4.78015267	7.273570978	1.37050445	0.905161412	0	0	3.597357425	1.939147199	0	0	0.808521977	0	0.466067085	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.292	0	17.89391013	11.7269	1.152709277	1.505640339	2.911192985	1.116387857	1.950450264	1.793131496	1.025065308	2.995427887	0	5.789705538	0	0.030149144	0.15479405	4.78015267	7.273570978	1.37050445	0.905161412	0	0	3.597357425	1.939147199	0	0	0.808521977	0	0.466067085	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.292																																																																																				0	0	0	11.7269	1.152709277	1.505640339	2.911192985	1.116387857	1.950450264	1.793131496	1.025065308	2.995427887	0	5.789705538	0	0.030149144	0.15479405	4.78015267	7.273570978	1.37050445	0.905161412	0	0	3.597357425	1.939147199	0	0	0.808521977	0	0.466067085	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.292
H5421_053_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1269.715449	88.61732268	767.3171517	19.96317032	157.0704379	11.29655481	11.31138896	291.0068073	292.4096743		36.12500449		9.367187338	0.490183138	3467.07017	3476.915748	2.488319817	498.6973294			21.12513348	6.899020302			432		249.011979															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												101.5956	101.5956	23.6809	0.115818098	77.2121	0.15442413	0.15442413	38.606	123.4944		0.15442413		38.606	0.333930307	15.4424	23.8306	0.386060325	22.8463			0.15442413	0.279998094			23.1636		23.1636															10.7498	0.750261098	1.514232641	2.312096407	1.010644405	1.744460648	1.746751399	0.936218188	3.009245378	0	5.578572391	0	0.030135828	0.163687006	4.461660789	6.904735356	0.960641557	0.949448021	0	0	3.262230359	1.931712535	0	0	0.833890302	0	0.480668228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3311	0	14.55930015	10.7498	0.750261098	1.514232641	2.312096407	1.010644405	1.744460648	1.746751399	0.936218188	3.009245378	0	5.578572391	0	0.030135828	0.163687006	4.461660789	6.904735356	0.960641557	0.949448021	0	0	3.262230359	1.931712535	0	0	0.833890302	0	0.480668228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3311																																																																																				0	0	0	10.7498	0.750261098	1.514232641	2.312096407	1.010644405	1.744460648	1.746751399	0.936218188	3.009245378	0	5.578572391	0	0.030135828	0.163687006	4.461660789	6.904735356	0.960641557	0.949448021	0	0	3.262230359	1.931712535	0	0	0.833890302	0	0.480668228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3311
H5421_054_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1426.794224	135.3796334	726.7745675	26.66637616	165.8904572	12.17329346	10.68177736	298.257767	269.2370933		36.60146791		11.21931772	0.476659086	3286.044014	3621.642117	4.10757731	465.411058			22.56987354	7.189553007			432		249.0168034															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												99.8316	99.8316	23.2698	0.113807167	75.8714	0.151742889	0.151742889	37.9357	120.4772		0.151742889		37.9357	0.281399376	15.1743	23.3131	0.379357224	22.4016			0.151742889	0.269765918			22.7614		22.7614															11.8699	1.126264314	1.409323212	3.034824727	1.048862388	1.847210723	1.62088376	0.94288532	2.703077537	0	5.554012497	0	0.035467744	0.134131569	4.155281779	7.035978628	1.558239124	0.868828775	0	0	3.424817825	1.939496368	0	0	0.819411603	0	0.472331616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6013	0	16.4101786	11.8699	1.126264314	1.409323212	3.034824727	1.048862388	1.847210723	1.62088376	0.94288532	2.703077537	0	5.554012497	0	0.035467744	0.134131569	4.155281779	7.035978628	1.558239124	0.868828775	0	0	3.424817825	1.939496368	0	0	0.819411603	0	0.472331616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6013																																																																																				0	0	0	11.8699	1.126264314	1.409323212	3.034824727	1.048862388	1.847210723	1.62088376	0.94288532	2.703077537	0	5.554012497	0	0.035467744	0.134131569	4.155281779	7.035978628	1.558239124	0.868828775	0	0	3.424817825	1.939496368	0	0	0.819411603	0	0.472331616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6013
H5421_055_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1524.707433	127.0561415	805.3882835	26.11899782	176.9342996	13.45660321	12.39920031	319.5491265	324.5141302		42.06482265		11.81905452	0.649003555	3566.788694	3909.716578	3.579852169	458.8662628			24.3460333	7.214517411			432		249.0801391															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												97.7286	97.7286	22.7796	0.111409684	74.2731	0.148546245	0.148546245	37.1366	115.224		0.148546245		37.1366	0.257502951	14.8546	22.8259	0.371365613	21.9284			0.148546245	0.264698331			22.2819		22.2819															12.4173	1.034751303	1.528866346	2.909909294	1.095121912	1.998927883	1.841854652	0.988912978	3.115984617	0	6.248571468	0	0.036576587	0.167120331	4.415275572	7.436898772	1.329433997	0.838516544	0	0	3.616511837	1.909670721	0	0	0.802149725	0	0.462498993	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1948	0	18.77212172	12.4173	1.034751303	1.528866346	2.909909294	1.095121912	1.998927883	1.841854652	0.988912978	3.115984617	0	6.248571468	0	0.036576587	0.167120331	4.415275572	7.436898772	1.329433997	0.838516544	0	0	3.616511837	1.909670721	0	0	0.802149725	0	0.462498993	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1948																																																																																				0	0	0	12.4173	1.034751303	1.528866346	2.909909294	1.095121912	1.998927883	1.841854652	0.988912978	3.115984617	0	6.248571468	0	0.036576587	0.167120331	4.415275572	7.436898772	1.329433997	0.838516544	0	0	3.616511837	1.909670721	0	0	0.802149725	0	0.462498993	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1948
H5421_056_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1548.442142	112.2415108	750.9636965	29.42120176	171.2221117	13.04130681	11.66821984	305.6303255	333.1097728		43.22923682		10.50336829	0.662400473	3473.011024	3992.339524	3.071125172	557.0515502			25.58248098	7.395597116			432		249.1334678															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												97.4045	97.4045	22.704	0.111040185	74.0268	0.14805358	0.14805358	37.0134	113.9923		0.14805358		37.0134	0.238244076	14.8054	22.7227	0.37013395	21.9588			0.14805358	0.264652103			22.208		22.208															12.5688	0.911068555	1.420824347	3.26693569	1.056251943	1.930812163	1.727521721	0.942701331	3.164328198	0	6.400243278	0	0.03239711	0.157812989	4.284930966	7.559713258	1.136727692	1.019349463	0	0	3.787577898	1.957260331	0	0	0.799489333	0	0.461063773	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5858	0	19.15208995	12.5688	0.911068555	1.420824347	3.26693569	1.056251943	1.930812163	1.727521721	0.942701331	3.164328198	0	6.400243278	0	0.03239711	0.157812989	4.284930966	7.559713258	1.136727692	1.019349463	0	0	3.787577898	1.957260331	0	0	0.799489333	0	0.461063773	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5858																																																																																				0	0	0	12.5688	0.911068555	1.420824347	3.26693569	1.056251943	1.930812163	1.727521721	0.942701331	3.164328198	0	6.400243278	0	0.03239711	0.157812989	4.284930966	7.559713258	1.136727692	1.019349463	0	0	3.787577898	1.957260331	0	0	0.799489333	0	0.461063773	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5858
H5421_057_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1663.578023	128.3386092	761.6563179	37.14040801	157.9827468	12.95494399	12.4345389	257.3677742	306.056424		45.87174524		14.39655621	1.343488516	3516.321036	4563.930748	4.653155819	851.0681749			29.3632119	8.264217098			432		249.014227															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												94.6552	94.6552	22.0632	0.107906102	71.9374	0.143874802	0.143874802	35.9687	114.6182		0.143874802		35.9687	0.12341999	14.3875	22.0993	0.359687005	21.3863			0.143874802	0.243596459			21.5812		21.5812															13.1222	1.012326739	1.400381364	4.007676641	0.947072352	1.863890004	1.789016824	0.771432033	2.923302653	0	6.59978827	0	0.043152118	0.165813339	4.215916612	8.404974317	1.673679682	1.516769414	0	0	4.224626303	2.013134022	0	0	0.776923932	0	0.447835908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9199	0	22.5944108	13.1222	1.012326739	1.400381364	4.007676641	0.947072352	1.863890004	1.789016824	0.771432033	2.923302653	0	6.59978827	0	0.043152118	0.165813339	4.215916612	8.404974317	1.673679682	1.516769414	0	0	4.224626303	2.013134022	0	0	0.776923932	0	0.447835908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9199																																																																																				0	0	0	13.1222	1.012326739	1.400381364	4.007676641	0.947072352	1.863890004	1.789016824	0.771432033	2.923302653	0	6.59978827	0	0.043152118	0.165813339	4.215916612	8.404974317	1.673679682	1.516769414	0	0	4.224626303	2.013134022	0	0	0.776923932	0	0.447835908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9199
H5421_058_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1432.291177	140.7886112	788.942014	25.99178521	179.4125102	13.06054372	12.00711073	329.4713358	300.271071		38.76884414		9.690420052	0.497393146	6908.611716	3800.312236	3.670851519	491.1845938			24.08851165	7.143170614			432		249.0235713															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												123.7935	123.7935	24.8781	0.137220527	120.068	0.137220527	0.137220527	37.7426	219.9896		0.137220527		34.3051	0.326719486	13.7221	25.0545	0.343051318	23.6618			0.137220527	0.283645081			24.0136		24.0136															14.7757	1.452392895	1.635613648	3.566606469	1.795141194	1.792174694	1.647622064	1.03625763	5.504708482	0	5.31988123	0	0.027702595	0.162508033	7.900027847	7.934575084	1.259290452	0.968527629	0	0	3.305438267	2.026125208	0	0	0.864489321	0	0.498329209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4731	0	29.03944661	14.7757	1.452392895	1.635613648	3.566606469	1.795141194	1.792174694	1.647622064	1.03625763	5.504708482	0	5.31988123	0	0.027702595	0.162508033	7.900027847	7.934575084	1.259290452	0.968527629	0	0	3.305438267	2.026125208	0	0	0.864489321	0	0.498329209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4731																																																																																				0	0	0	14.7757	1.452392895	1.635613648	3.566606469	1.795141194	1.792174694	1.647622064	1.03625763	5.504708482	0	5.31988123	0	0.027702595	0.162508033	7.900027847	7.934575084	1.259290452	0.968527629	0	0	3.305438267	2.026125208	0	0	0.864489321	0	0.498329209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4731
H5421_059_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1265.263309	88.30659421	764.6266248	19.89317131	156.5196849	11.25694448	11.27172661	289.9878718	291.3843668		35.9983355		9.334342159	0.488464357	6226.667626	3464.724263	2.479594753	496.9486932			21.05106015	6.874829524			432		249.011937															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												128.7817	128.7817	25.8805	0.142749728	124.906	0.142749728	0.142749728	39.2638	228.3165		0.142749728		35.6874	0.355245964	14.275	26.2142	0.356874319	24.5901			0.142749728	0.294235793			24.9812		24.9812															13.5786	0.947689199	1.649078247	2.839744786	1.629187466	1.606925759	1.609035905	0.948836077	5.543987384	0	5.138752589	0	0.027759892	0.173524991	7.407125899	7.568756311	0.884903689	1.01833336	0	0	3.005033103	2.022820913	0	0	0.899323284	0	0.518384799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.0178	0	23.6692783	13.5786	0.947689199	1.649078247	2.839744786	1.629187466	1.606925759	1.609035905	0.948836077	5.543987384	0	5.138752589	0	0.027759892	0.173524991	7.407125899	7.568756311	0.884903689	1.01833336	0	0	3.005033103	2.022820913	0	0	0.899323284	0	0.518384799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.0178																																																																																				0	0	0	13.5786	0.947689199	1.649078247	2.839744786	1.629187466	1.606925759	1.609035905	0.948836077	5.543987384	0	5.138752589	0	0.027759892	0.173524991	7.407125899	7.568756311	0.884903689	1.01833336	0	0	3.005033103	2.022820913	0	0	0.899323284	0	0.518384799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.0178
H5421_060_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1445.598736	137.1638766	736.3531322	27.01782711	168.0768195	12.33373204	10.82255842	302.1829457	272.7855181		37.08385893		11.36718333	0.48294124	6173.242304	3669.373745	4.161713347	471.5449681			22.86733441	7.28430811			432		249.0170249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												125.4902	125.4902	25.2191	0.139101287	121.7136	0.139101287	0.139101287	38.2604	220.8806		0.139101287		34.7753	0.294191506	13.9101	25.3542	0.347753218	23.9029			0.139101287	0.280935834			24.3427		24.3427															15.1174	1.434393827	1.54751136	3.758214532	1.704769934	1.715638004	1.505431808	0.963468855	5.021086649	0	5.158412516	0	0.032941455	0.142077211	7.155882929	7.752824108	1.44724921	0.939274307	0	0	3.180875654	2.046423177	0	0	0.87633811	0	0.505146086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0053	0	27.14601137	15.1174	1.434393827	1.54751136	3.758214532	1.704769934	1.715638004	1.505431808	0.963468855	5.021086649	0	5.158412516	0	0.032941455	0.142077211	7.155882929	7.752824108	1.44724921	0.939274307	0	0	3.180875654	2.046423177	0	0	0.87633811	0	0.505146086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0053																																																																																				0	0	0	15.1174	1.434393827	1.54751136	3.758214532	1.704769934	1.715638004	1.505431808	0.963468855	5.021086649	0	5.158412516	0	0.032941455	0.142077211	7.155882929	7.752824108	1.44724921	0.939274307	0	0	3.180875654	2.046423177	0	0	0.87633811	0	0.505146086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0053
H5421_061_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1529.962689	127.4940698	808.1642399	26.20902296	177.5441445	13.5029845	12.44193701	320.6490735	325.632643		42.20980876		11.85979162	0.651240496	6700.371875	3923.192317	3.592190955	460.4478512			24.42994752	7.239383908			432		249.0804153															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												122.6037	122.6037	24.639	0.135901662	118.914	0.135901662	0.135901662	37.3797	210.8318		0.135901662		33.9754	0.270806254	13.5902	24.7781	0.339754154	23.3515			0.135901662	0.274903003			23.7828		23.7828															15.6316	1.302603555	1.659361291	3.561849773	1.759373019	1.835078031	1.690879915	0.998812664	5.721141784	0	5.736383151	0	0.033578446	0.176359999	7.588263932	8.100772195	1.2204618	0.896013167	0	0	3.320070463	1.990128376	0	0	0.856180469	0	0.493652284	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5726	0	30.45579637	15.6316	1.302603555	1.659361291	3.561849773	1.759373019	1.835078031	1.690879915	0.998812664	5.721141784	0	5.736383151	0	0.033578446	0.176359999	7.588263932	8.100772195	1.2204618	0.896013167	0	0	3.320070463	1.990128376	0	0	0.856180469	0	0.493652284	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5726																																																																																				0	0	0	15.6316	1.302603555	1.659361291	3.561849773	1.759373019	1.835078031	1.690879915	0.998812664	5.721141784	0	5.736383151	0	0.033578446	0.176359999	7.588263932	8.100772195	1.2204618	0.896013167	0	0	3.320070463	1.990128376	0	0	0.856180469	0	0.493652284	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5726
H5421_062_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1524.643877	110.5164523	739.4220106	28.96902242	168.5905706	12.8408728	11.48888903	300.9394597	327.9901533		42.5648395		10.34194028	0.65221993	6481.90137	3930.980594	3.023924539	548.4901323			25.18929958	7.281932954			432		249.1314165															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												122.9304	122.9304	24.7046	0.136263823	119.2308	0.136263823	0.136263823	37.4796	209.8297		0.136263823		34.066	0.251752686	13.6264	24.7934	0.340659558	23.5403			0.136263823	0.276096625			23.8462		23.8462															15.6188	1.132152715	1.522262336	3.947429748	1.675099686	1.74974642	1.565519943	0.939925251	5.735174081	0	5.800047761	0	0.029359007	0.164198119	7.360405516	8.121880155	1.030128796	1.075970253	0	0	3.432390263	2.010517109	0	0	0.858462086	0	0.495069156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2645	0	30.05913971	15.6188	1.132152715	1.522262336	3.947429748	1.675099686	1.74974642	1.565519943	0.939925251	5.735174081	0	5.800047761	0	0.029359007	0.164198119	7.360405516	8.121880155	1.030128796	1.075970253	0	0	3.432390263	2.010517109	0	0	0.858462086	0	0.495069156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2645																																																																																				0	0	0	15.6188	1.132152715	1.522262336	3.947429748	1.675099686	1.74974642	1.565519943	0.939925251	5.735174081	0	5.800047761	0	0.029359007	0.164198119	7.360405516	8.121880155	1.030128796	1.075970253	0	0	3.432390263	2.010517109	0	0	0.858462086	0	0.495069156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2645
H5421_063_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1644.820601	126.8915467	753.0683777	36.72163698	156.2014363	12.80887249	12.29433514	254.47066	302.6055312		45.35452534		14.23423003	1.328340215	6925.655626	4512.47084	4.600689867	841.4720849			29.03213146	8.171035173			432		249.0140666															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												118.9384	118.9384	23.9024	0.131838791	115.3589	0.131838791	0.131838791	36.2639	210.0593		0.131838791		32.9597	0.128573343	13.1839	24.0213	0.329596977	22.8337			0.131838791	0.252457425			23.0718		23.0718															16.3027	1.257689425	1.50001009	4.841336213	1.501602701	1.688706259	1.620870278	0.769008916	5.297093153	0	5.979485774	0	0.039096327	0.170789142	7.608917189	9.032941338	1.516373471	1.601159019	0	0	3.827561104	2.062838496	0	0	0.830584381	0	0.478766654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.9275	0	35.1188132	16.3027	1.257689425	1.50001009	4.841336213	1.501602701	1.688706259	1.620870278	0.769008916	5.297093153	0	5.979485774	0	0.039096327	0.170789142	7.608917189	9.032941338	1.516373471	1.601159019	0	0	3.827561104	2.062838496	0	0	0.830584381	0	0.478766654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.9275																																																																																				0	0	0	16.3027	1.257689425	1.50001009	4.841336213	1.501602701	1.688706259	1.620870278	0.769008916	5.297093153	0	5.979485774	0	0.039096327	0.170789142	7.608917189	9.032941338	1.516373471	1.601159019	0	0	3.827561104	2.062838496	0	0	0.830584381	0	0.478766654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.9275
H5421_064_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		279.9952077	116.0110868	799.2530242	25.77996148	172.2616175	12.67409921	11.97892678	312.5213189	319.5829506		41.43223486		8.869711213	0.543318351	4016.13908	4050.956525	3.241374252	530.761048			25.80856439	7.752116421			432		249.0226934															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															157.0691	40.7655	24.7042	0.120822417	40.2741	0.161096556	0.161096556	28.1919	32.2342		0.080548278		40.2741	0.188321069	8.0548	19.5211	0.40274139	20.1371			0.161096556	0.171629793			12.0822		12.0822															3.6649	0.394104004	1.645406009	3.114797259	0.578140694	2.041753735	1.929763851	0.734214078	0.858458188	0	3.337295175	0	0.029768332	0.102318293	2.695775728	6.589913841	1.305435573	0.890664344	0	0	4.157670842	1.330494136	0	0	0.434960702	0	0.250729364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0865	0	8.71459347	3.6649	0.394104004	1.645406009	3.114797259	0.578140694	2.041753735	1.929763851	0.734214078	0.858458188	0	3.337295175	0	0.029768332	0.102318293	2.695775728	6.589913841	1.305435573	0.890664344	0	0	4.157670842	1.330494136	0	0	0.434960702	0	0.250729364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0865																																																																																				0	0	0	3.6649	0.394104004	1.645406009	3.114797259	0.578140694	2.041753735	1.929763851	0.734214078	0.858458188	0	3.337295175	0	0.029768332	0.102318293	2.695775728	6.589913841	1.305435573	0.890664344	0	0	4.157670842	1.330494136	0	0	0.434960702	0	0.250729364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0865
H5421_065_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		269.2233148	91.16864807	824.0688031	21.25545279	166.9467316	11.94802117	12.03134133	308.4218539	317.1344857		38.84623774		9.770970773	0.529076882	3745.660367	3765.98114	2.579451518	540.4247823			22.75736583	7.436270222			432		249.0118337															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															159.7693	41.4663	25.1289	0.122899498	40.9665	0.163865998	0.163865998	28.6765	32.7414		0.081932999		40.9665	0.194573588	8.1933	19.774	0.409664994	20.4832			0.163865998	0.176479634			12.2899		12.2899															3.5845	0.315035472	1.725658497	2.612284484	0.569935266	1.95787441	1.971527752	0.737039549	0.865285028	0	3.182788752	0	0.033356872	0.102944387	2.557443221	6.205716037	1.056710992	0.922471314	0	0	3.729158457	1.312350246	0	0	0.442438194	0	0.255028579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.1395	0	7.528086365	3.5845	0.315035472	1.725658497	2.612284484	0.569935266	1.95787441	1.971527752	0.737039549	0.865285028	0	3.182788752	0	0.033356872	0.102944387	2.557443221	6.205716037	1.056710992	0.922471314	0	0	3.729158457	1.312350246	0	0	0.442438194	0	0.255028579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.1395																																																																																				0	0	0	3.5845	0.315035472	1.725658497	2.612284484	0.569935266	1.95787441	1.971527752	0.737039549	0.865285028	0	3.182788752	0	0.033356872	0.102944387	2.557443221	6.205716037	1.056710992	0.922471314	0	0	3.729158457	1.312350246	0	0	0.442438194	0	0.255028579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.1395
H5421_066_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		303.1210992	115.0161366	822.2307517	29.35490895	175.1539835	13.12658222	11.99296408	307.7827375	326.2583085		43.98222804		11.03617456	0.562496493	3874.011791	4377.561955	3.538354155	564.5040101			27.61513562	8.748290841			432		249.015758															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															155.0681	40.2461	24.3894	0.119283192	39.7611	0.159044255	0.159044255	27.8327	31.4421		0.079522128		39.7611	0.17470079	7.9522	19.2972	0.397610639	19.8805			0.159044255	0.167475467			11.9283		11.9283															3.917	0.38574638	1.671145398	3.501547229	0.58035906	2.087707495	1.907412043	0.713869863	0.854853556	0	3.497560356	0	0.036567503	0.098268582	2.567247171	7.039553196	1.406887255	0.93522	0	0	4.392028684	1.465124093	0	0	0.42941949	0	0.247528286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.7351	0	9.717222071	3.917	0.38574638	1.671145398	3.501547229	0.58035906	2.087707495	1.907412043	0.713869863	0.854853556	0	3.497560356	0	0.036567503	0.098268582	2.567247171	7.039553196	1.406887255	0.93522	0	0	4.392028684	1.465124093	0	0	0.42941949	0	0.247528286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.7351																																																																																				0	0	0	3.917	0.38574638	1.671145398	3.501547229	0.58035906	2.087707495	1.907412043	0.713869863	0.854853556	0	3.497560356	0	0.036567503	0.098268582	2.567247171	7.039553196	1.406887255	0.93522	0	0	4.392028684	1.465124093	0	0	0.42941949	0	0.247528286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.7351
H5421_067_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		312.7179719	96.89469405	850.0388968	26.49391901	172.8441251	13.20811687	12.71254159	306.647828	366.3341245		47.048214		10.63077859	0.72192436	3929.635433	4402.485289	2.848779975	520.2207405			27.12554688	8.223623496			432		249.0857348															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															155.2403	40.2908	24.4165	0.119415606	39.8052	0.159220807	0.159220807	27.8636	30.7179		0.079610404		39.8052	0.155912123	7.961	19.3106	0.398052019	19.9026			0.159220807	0.169337407			11.9416		11.9416															4.0455	0.325330599	1.729581994	3.163787383	0.573341274	2.103007033	2.024101137	0.71202709	0.937751609	0	3.745527311	0	0.035263357	0.11255676	2.606998861	7.084540164	1.13396262	0.86281215	0	0	4.318951476	1.392567078	0	0	0.42989618	0	0.247872699	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5854	0	9.62627181	4.0455	0.325330599	1.729581994	3.163787383	0.573341274	2.103007033	2.024101137	0.71202709	0.937751609	0	3.745527311	0	0.035263357	0.11255676	2.606998861	7.084540164	1.13396262	0.86281215	0	0	4.318951476	1.392567078	0	0	0.42989618	0	0.247872699	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5854																																																																																				0	0	0	4.0455	0.325330599	1.729581994	3.163787383	0.573341274	2.103007033	2.024101137	0.71202709	0.937751609	0	3.745527311	0	0.035263357	0.11255676	2.606998861	7.084540164	1.13396262	0.86281215	0	0	4.318951476	1.392567078	0	0	0.42989618	0	0.247872699	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5854
H5421_068_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		343.5106868	102.6015255	861.4884535	32.57650579	186.9441929	14.33884058	13.19804514	332.2863703	401.1383839		52.08630556		10.71138593	0.725635181	4085.917314	4803.897904	2.958855938	650.4839256			30.99569604	9.02499238			432		249.1451782															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															151.1384	39.2262	23.7714	0.116260313	38.7534	0.155013751	0.155013751	27.1274	29.7515		0.077506875		38.7534	0.15176225	7.7507	18.8309	0.387534376	19.3767			0.155013751	0.165077397			11.626		11.626															4.3265	0.335389249	1.706562583	3.787354756	0.60372751	2.222717457	2.045878476	0.751172282	0.994539541	0	4.037046787	0	0.034591919	0.110124028	2.639055696	7.538462113	1.14665839	1.050353677	0	0	4.804759093	1.48982225	0	0	0.418537126	0	0.241380803	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2846	0	11.69091965	4.3265	0.335389249	1.706562583	3.787354756	0.60372751	2.222717457	2.045878476	0.751172282	0.994539541	0	4.037046787	0	0.034591919	0.110124028	2.639055696	7.538462113	1.14665839	1.050353677	0	0	4.804759093	1.48982225	0	0	0.418537126	0	0.241380803	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2846																																																																																				0	0	0	4.3265	0.335389249	1.706562583	3.787354756	0.60372751	2.222717457	2.045878476	0.751172282	0.994539541	0	4.037046787	0	0.034591919	0.110124028	2.639055696	7.538462113	1.14665839	1.050353677	0	0	4.804759093	1.48982225	0	0	0.418537126	0	0.241380803	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2846
H5421_069_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		354.2021837	117.9222208	887.0538321	40.6340534	175.157536	13.69916289	13.32996643	284.5101743	368.2677404		55.19433448		13.9166824	1.302719613	4094.534442	5463.556811	4.45133482	920.517551			33.06195791	10.0158666			432		249.0150709															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															147.5601	38.2975	23.2085	0.113507739	37.8359	0.151343653	0.151343653	26.4851	30.1034		0.075671826		37.8359	0.092426942	7.5672	18.3723	0.378359131	18.918			0.151343653	0.154695228			11.3508		11.3508															4.3555	0.376343965	1.715602703	4.612279545	0.552270443	2.073281349	2.017405807	0.627940964	0.923842228	0	4.17665609	0	0.043879199	0.12040639	2.582007492	8.364832776	1.684203176	1.451192588	0	0	5.00371747	1.549406765	0	0	0.408627862	0	0.235542815	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.8749	0	13.78411524	4.3555	0.376343965	1.715602703	4.612279545	0.552270443	2.073281349	2.017405807	0.627940964	0.923842228	0	4.17665609	0	0.043879199	0.12040639	2.582007492	8.364832776	1.684203176	1.451192588	0	0	5.00371747	1.549406765	0	0	0.408627862	0	0.235542815	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.8749																																																																																				0	0	0	4.3555	0.376343965	1.715602703	4.612279545	0.552270443	2.073281349	2.017405807	0.627940964	0.923842228	0	4.17665609	0	0.043879199	0.12040639	2.582007492	8.364832776	1.684203176	1.451192588	0	0	5.00371747	1.549406765	0	0	0.408627862	0	0.235542815	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.8749
H5421_070_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1428.587582	140.4245623	786.9019806	25.92457608	178.9485882	13.02677198	11.97606294	328.6205391	299.494635		38.66859629		9.665362722	0.496106994	3831.112845	3790.485451	3.661359491	489.9144967			24.02622397	7.12469992			432		249.0235104															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												98.5049	98.5049	22.9605	0.112294719	74.8631	0.149726292	0.149726292	37.4316	120.0193		0.149726292		37.4316	0.312017471	14.9726	23.0268	0.37431573	22.1711			0.149726292	0.272172473			22.4589		22.4589															11.7269	1.152709277	1.505640339	2.911192985	1.116387857	1.950450264	1.793131496	1.025065308	2.995427887	0	5.789705538	0	0.030149144	0.15479405	4.78015267	7.273570978	1.37050445	0.905161412	0	0	3.597357425	1.939147199	0	0	0.808521977	0	0.466067085	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.292	0	17.89391013	11.7269	1.152709277	1.505640339	2.911192985	1.116387857	1.950450264	1.793131496	1.025065308	2.995427887	0	5.789705538	0	0.030149144	0.15479405	4.78015267	7.273570978	1.37050445	0.905161412	0	0	3.597357425	1.939147199	0	0	0.808521977	0	0.466067085	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.292																																																																																				0	0	0	11.7269	1.152709277	1.505640339	2.911192985	1.116387857	1.950450264	1.793131496	1.025065308	2.995427887	0	5.789705538	0	0.030149144	0.15479405	4.78015267	7.273570978	1.37050445	0.905161412	0	0	3.597357425	1.939147199	0	0	0.808521977	0	0.466067085	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.292
H5421_071_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1269.715449	88.61732268	767.3171517	19.96317032	157.0704379	11.29655481	11.31138896	291.0068073	292.4096743		36.12500449		9.367187338	0.490183138	3467.07017	3476.915748	2.488319817	498.6973294			21.12513348	6.899020302			432		249.011979															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												101.5956	101.5956	23.6809	0.115818098	77.2121	0.15442413	0.15442413	38.606	123.4944		0.15442413		38.606	0.333930307	15.4424	23.8306	0.386060325	22.8463			0.15442413	0.279998094			23.1636		23.1636															10.7498	0.750261098	1.514232641	2.312096407	1.010644405	1.744460648	1.746751399	0.936218188	3.009245378	0	5.578572391	0	0.030135828	0.163687006	4.461660789	6.904735356	0.960641557	0.949448021	0	0	3.262230359	1.931712535	0	0	0.833890302	0	0.480668228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3311	0	14.55930015	10.7498	0.750261098	1.514232641	2.312096407	1.010644405	1.744460648	1.746751399	0.936218188	3.009245378	0	5.578572391	0	0.030135828	0.163687006	4.461660789	6.904735356	0.960641557	0.949448021	0	0	3.262230359	1.931712535	0	0	0.833890302	0	0.480668228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3311																																																																																				0	0	0	10.7498	0.750261098	1.514232641	2.312096407	1.010644405	1.744460648	1.746751399	0.936218188	3.009245378	0	5.578572391	0	0.030135828	0.163687006	4.461660789	6.904735356	0.960641557	0.949448021	0	0	3.262230359	1.931712535	0	0	0.833890302	0	0.480668228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3311
H5421_072_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1426.794224	135.3796334	726.7745675	26.66637616	165.8904572	12.17329346	10.68177736	298.257767	269.2370933		36.60146791		11.21931772	0.476659086	3286.044014	3621.642117	4.10757731	465.411058			22.56987354	7.189553007			432		249.0168034															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												99.8316	99.8316	23.2698	0.113807167	75.8714	0.151742889	0.151742889	37.9357	120.4772		0.151742889		37.9357	0.281399376	15.1743	23.3131	0.379357224	22.4016			0.151742889	0.269765918			22.7614		22.7614															11.8699	1.126264314	1.409323212	3.034824727	1.048862388	1.847210723	1.62088376	0.94288532	2.703077537	0	5.554012497	0	0.035467744	0.134131569	4.155281779	7.035978628	1.558239124	0.868828775	0	0	3.424817825	1.939496368	0	0	0.819411603	0	0.472331616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6013	0	16.4101786	11.8699	1.126264314	1.409323212	3.034824727	1.048862388	1.847210723	1.62088376	0.94288532	2.703077537	0	5.554012497	0	0.035467744	0.134131569	4.155281779	7.035978628	1.558239124	0.868828775	0	0	3.424817825	1.939496368	0	0	0.819411603	0	0.472331616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6013																																																																																				0	0	0	11.8699	1.126264314	1.409323212	3.034824727	1.048862388	1.847210723	1.62088376	0.94288532	2.703077537	0	5.554012497	0	0.035467744	0.134131569	4.155281779	7.035978628	1.558239124	0.868828775	0	0	3.424817825	1.939496368	0	0	0.819411603	0	0.472331616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6013
H5421_073_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1524.707433	127.0561415	805.3882835	26.11899782	176.9342996	13.45660321	12.39920031	319.5491265	324.5141302		42.06482265		11.81905452	0.649003555	3566.788694	3909.716578	3.579852169	458.8662628			24.3460333	7.214517411			432		249.0801391															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												97.7286	97.7286	22.7796	0.111409684	74.2731	0.148546245	0.148546245	37.1366	115.224		0.148546245		37.1366	0.257502951	14.8546	22.8259	0.371365613	21.9284			0.148546245	0.264698331			22.2819		22.2819															12.4173	1.034751303	1.528866346	2.909909294	1.095121912	1.998927883	1.841854652	0.988912978	3.115984617	0	6.248571468	0	0.036576587	0.167120331	4.415275572	7.436898772	1.329433997	0.838516544	0	0	3.616511837	1.909670721	0	0	0.802149725	0	0.462498993	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1948	0	18.77212172	12.4173	1.034751303	1.528866346	2.909909294	1.095121912	1.998927883	1.841854652	0.988912978	3.115984617	0	6.248571468	0	0.036576587	0.167120331	4.415275572	7.436898772	1.329433997	0.838516544	0	0	3.616511837	1.909670721	0	0	0.802149725	0	0.462498993	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1948																																																																																				0	0	0	12.4173	1.034751303	1.528866346	2.909909294	1.095121912	1.998927883	1.841854652	0.988912978	3.115984617	0	6.248571468	0	0.036576587	0.167120331	4.415275572	7.436898772	1.329433997	0.838516544	0	0	3.616511837	1.909670721	0	0	0.802149725	0	0.462498993	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1948
H5421_074_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1548.442142	112.2415108	750.9636965	29.42120176	171.2221117	13.04130681	11.66821984	305.6303255	333.1097728		43.22923682		10.50336829	0.662400473	3473.011024	3992.339524	3.071125172	557.0515502			25.58248098	7.395597116			432		249.1334678															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												97.4045	97.4045	22.704	0.111040185	74.0268	0.14805358	0.14805358	37.0134	113.9923		0.14805358		37.0134	0.238244076	14.8054	22.7227	0.37013395	21.9588			0.14805358	0.264652103			22.208		22.208															12.5688	0.911068555	1.420824347	3.26693569	1.056251943	1.930812163	1.727521721	0.942701331	3.164328198	0	6.400243278	0	0.03239711	0.157812989	4.284930966	7.559713258	1.136727692	1.019349463	0	0	3.787577898	1.957260331	0	0	0.799489333	0	0.461063773	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5858	0	19.15208995	12.5688	0.911068555	1.420824347	3.26693569	1.056251943	1.930812163	1.727521721	0.942701331	3.164328198	0	6.400243278	0	0.03239711	0.157812989	4.284930966	7.559713258	1.136727692	1.019349463	0	0	3.787577898	1.957260331	0	0	0.799489333	0	0.461063773	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5858																																																																																				0	0	0	12.5688	0.911068555	1.420824347	3.26693569	1.056251943	1.930812163	1.727521721	0.942701331	3.164328198	0	6.400243278	0	0.03239711	0.157812989	4.284930966	7.559713258	1.136727692	1.019349463	0	0	3.787577898	1.957260331	0	0	0.799489333	0	0.461063773	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5858
H5421_075_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1663.578023	128.3386092	761.6563179	37.14040801	157.9827468	12.95494399	12.4345389	257.3677742	306.056424		45.87174524		14.39655621	1.343488516	3516.321036	4563.930748	4.653155819	851.0681749			29.3632119	8.264217098			432		249.014227															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												94.6552	94.6552	22.0632	0.107906102	71.9374	0.143874802	0.143874802	35.9687	114.6182		0.143874802		35.9687	0.12341999	14.3875	22.0993	0.359687005	21.3863			0.143874802	0.243596459			21.5812		21.5812															13.1222	1.012326739	1.400381364	4.007676641	0.947072352	1.863890004	1.789016824	0.771432033	2.923302653	0	6.59978827	0	0.043152118	0.165813339	4.215916612	8.404974317	1.673679682	1.516769414	0	0	4.224626303	2.013134022	0	0	0.776923932	0	0.447835908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9199	0	22.5944108	13.1222	1.012326739	1.400381364	4.007676641	0.947072352	1.863890004	1.789016824	0.771432033	2.923302653	0	6.59978827	0	0.043152118	0.165813339	4.215916612	8.404974317	1.673679682	1.516769414	0	0	4.224626303	2.013134022	0	0	0.776923932	0	0.447835908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9199																																																																																				0	0	0	13.1222	1.012326739	1.400381364	4.007676641	0.947072352	1.863890004	1.789016824	0.771432033	2.923302653	0	6.59978827	0	0.043152118	0.165813339	4.215916612	8.404974317	1.673679682	1.516769414	0	0	4.224626303	2.013134022	0	0	0.776923932	0	0.447835908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9199
H5421_076_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1432.291177	140.7886112	788.942014	25.99178521	179.4125102	13.06054372	12.00711073	329.4713358	300.271071		38.76884414		9.690420052	0.497393146	6908.611716	3800.312236	3.670851519	491.1845938			24.08851165	7.143170614			432		249.0235713															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												123.7935	123.7935	24.8781	0.137220527	120.068	0.137220527	0.137220527	37.7426	219.9896		0.137220527		34.3051	0.326719486	13.7221	25.0545	0.343051318	23.6618			0.137220527	0.283645081			24.0136		24.0136															14.7757	1.452392895	1.635613648	3.566606469	1.795141194	1.792174694	1.647622064	1.03625763	5.504708482	0	5.31988123	0	0.027702595	0.162508033	7.900027847	7.934575084	1.259290452	0.968527629	0	0	3.305438267	2.026125208	0	0	0.864489321	0	0.498329209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4731	0	29.03944661	14.7757	1.452392895	1.635613648	3.566606469	1.795141194	1.792174694	1.647622064	1.03625763	5.504708482	0	5.31988123	0	0.027702595	0.162508033	7.900027847	7.934575084	1.259290452	0.968527629	0	0	3.305438267	2.026125208	0	0	0.864489321	0	0.498329209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4731																																																																																				0	0	0	14.7757	1.452392895	1.635613648	3.566606469	1.795141194	1.792174694	1.647622064	1.03625763	5.504708482	0	5.31988123	0	0.027702595	0.162508033	7.900027847	7.934575084	1.259290452	0.968527629	0	0	3.305438267	2.026125208	0	0	0.864489321	0	0.498329209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4731
H5421_077_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1265.263309	88.30659421	764.6266248	19.89317131	156.5196849	11.25694448	11.27172661	289.9878718	291.3843668		35.9983355		9.334342159	0.488464357	6226.667626	3464.724263	2.479594753	496.9486932			21.05106015	6.874829524			432		249.011937															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												128.7817	128.7817	25.8805	0.142749728	124.906	0.142749728	0.142749728	39.2638	228.3165		0.142749728		35.6874	0.355245964	14.275	26.2142	0.356874319	24.5901			0.142749728	0.294235793			24.9812		24.9812															13.5786	0.947689199	1.649078247	2.839744786	1.629187466	1.606925759	1.609035905	0.948836077	5.543987384	0	5.138752589	0	0.027759892	0.173524991	7.407125899	7.568756311	0.884903689	1.01833336	0	0	3.005033103	2.022820913	0	0	0.899323284	0	0.518384799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.0178	0	23.6692783	13.5786	0.947689199	1.649078247	2.839744786	1.629187466	1.606925759	1.609035905	0.948836077	5.543987384	0	5.138752589	0	0.027759892	0.173524991	7.407125899	7.568756311	0.884903689	1.01833336	0	0	3.005033103	2.022820913	0	0	0.899323284	0	0.518384799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.0178																																																																																				0	0	0	13.5786	0.947689199	1.649078247	2.839744786	1.629187466	1.606925759	1.609035905	0.948836077	5.543987384	0	5.138752589	0	0.027759892	0.173524991	7.407125899	7.568756311	0.884903689	1.01833336	0	0	3.005033103	2.022820913	0	0	0.899323284	0	0.518384799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.0178
H5421_078_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1445.598736	137.1638766	736.3531322	27.01782711	168.0768195	12.33373204	10.82255842	302.1829457	272.7855181		37.08385893		11.36718333	0.48294124	6173.242304	3669.373745	4.161713347	471.5449681			22.86733441	7.28430811			432		249.0170249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												125.4902	125.4902	25.2191	0.139101287	121.7136	0.139101287	0.139101287	38.2604	220.8806		0.139101287		34.7753	0.294191506	13.9101	25.3542	0.347753218	23.9029			0.139101287	0.280935834			24.3427		24.3427															15.1174	1.434393827	1.54751136	3.758214532	1.704769934	1.715638004	1.505431808	0.963468855	5.021086649	0	5.158412516	0	0.032941455	0.142077211	7.155882929	7.752824108	1.44724921	0.939274307	0	0	3.180875654	2.046423177	0	0	0.87633811	0	0.505146086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0053	0	27.14601137	15.1174	1.434393827	1.54751136	3.758214532	1.704769934	1.715638004	1.505431808	0.963468855	5.021086649	0	5.158412516	0	0.032941455	0.142077211	7.155882929	7.752824108	1.44724921	0.939274307	0	0	3.180875654	2.046423177	0	0	0.87633811	0	0.505146086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0053																																																																																				0	0	0	15.1174	1.434393827	1.54751136	3.758214532	1.704769934	1.715638004	1.505431808	0.963468855	5.021086649	0	5.158412516	0	0.032941455	0.142077211	7.155882929	7.752824108	1.44724921	0.939274307	0	0	3.180875654	2.046423177	0	0	0.87633811	0	0.505146086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0053
H5421_079_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1529.962689	127.4940698	808.1642399	26.20902296	177.5441445	13.5029845	12.44193701	320.6490735	325.632643		42.20980876		11.85979162	0.651240496	6700.371875	3923.192317	3.592190955	460.4478512			24.42994752	7.239383908			432		249.0804153															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												122.6037	122.6037	24.639	0.135901662	118.914	0.135901662	0.135901662	37.3797	210.8318		0.135901662		33.9754	0.270806254	13.5902	24.7781	0.339754154	23.3515			0.135901662	0.274903003			23.7828		23.7828															15.6316	1.302603555	1.659361291	3.561849773	1.759373019	1.835078031	1.690879915	0.998812664	5.721141784	0	5.736383151	0	0.033578446	0.176359999	7.588263932	8.100772195	1.2204618	0.896013167	0	0	3.320070463	1.990128376	0	0	0.856180469	0	0.493652284	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5726	0	30.45579637	15.6316	1.302603555	1.659361291	3.561849773	1.759373019	1.835078031	1.690879915	0.998812664	5.721141784	0	5.736383151	0	0.033578446	0.176359999	7.588263932	8.100772195	1.2204618	0.896013167	0	0	3.320070463	1.990128376	0	0	0.856180469	0	0.493652284	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5726																																																																																				0	0	0	15.6316	1.302603555	1.659361291	3.561849773	1.759373019	1.835078031	1.690879915	0.998812664	5.721141784	0	5.736383151	0	0.033578446	0.176359999	7.588263932	8.100772195	1.2204618	0.896013167	0	0	3.320070463	1.990128376	0	0	0.856180469	0	0.493652284	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5726
H5421_080_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1524.643877	110.5164523	739.4220106	28.96902242	168.5905706	12.8408728	11.48888903	300.9394597	327.9901533		42.5648395		10.34194028	0.65221993	6481.90137	3930.980594	3.023924539	548.4901323			25.18929958	7.281932954			432		249.1314165															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												122.9304	122.9304	24.7046	0.136263823	119.2308	0.136263823	0.136263823	37.4796	209.8297		0.136263823		34.066	0.251752686	13.6264	24.7934	0.340659558	23.5403			0.136263823	0.276096625			23.8462		23.8462															15.6188	1.132152715	1.522262336	3.947429748	1.675099686	1.74974642	1.565519943	0.939925251	5.735174081	0	5.800047761	0	0.029359007	0.164198119	7.360405516	8.121880155	1.030128796	1.075970253	0	0	3.432390263	2.010517109	0	0	0.858462086	0	0.495069156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2645	0	30.05913971	15.6188	1.132152715	1.522262336	3.947429748	1.675099686	1.74974642	1.565519943	0.939925251	5.735174081	0	5.800047761	0	0.029359007	0.164198119	7.360405516	8.121880155	1.030128796	1.075970253	0	0	3.432390263	2.010517109	0	0	0.858462086	0	0.495069156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2645																																																																																				0	0	0	15.6188	1.132152715	1.522262336	3.947429748	1.675099686	1.74974642	1.565519943	0.939925251	5.735174081	0	5.800047761	0	0.029359007	0.164198119	7.360405516	8.121880155	1.030128796	1.075970253	0	0	3.432390263	2.010517109	0	0	0.858462086	0	0.495069156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2645
H5421_081_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1644.820601	126.8915467	753.0683777	36.72163698	156.2014363	12.80887249	12.29433514	254.47066	302.6055312		45.35452534		14.23423003	1.328340215	6925.655626	4512.47084	4.600689867	841.4720849			29.03213146	8.171035173			432		249.0140666															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												118.9384	118.9384	23.9024	0.131838791	115.3589	0.131838791	0.131838791	36.2639	210.0593		0.131838791		32.9597	0.128573343	13.1839	24.0213	0.329596977	22.8337			0.131838791	0.252457425			23.0718		23.0718															16.3027	1.257689425	1.50001009	4.841336213	1.501602701	1.688706259	1.620870278	0.769008916	5.297093153	0	5.979485774	0	0.039096327	0.170789142	7.608917189	9.032941338	1.516373471	1.601159019	0	0	3.827561104	2.062838496	0	0	0.830584381	0	0.478766654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.9275	0	35.1188132	16.3027	1.257689425	1.50001009	4.841336213	1.501602701	1.688706259	1.620870278	0.769008916	5.297093153	0	5.979485774	0	0.039096327	0.170789142	7.608917189	9.032941338	1.516373471	1.601159019	0	0	3.827561104	2.062838496	0	0	0.830584381	0	0.478766654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.9275																																																																																				0	0	0	16.3027	1.257689425	1.50001009	4.841336213	1.501602701	1.688706259	1.620870278	0.769008916	5.297093153	0	5.979485774	0	0.039096327	0.170789142	7.608917189	9.032941338	1.516373471	1.601159019	0	0	3.827561104	2.062838496	0	0	0.830584381	0	0.478766654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.9275
H5421_082_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		255.6606043	146.9763551	756.8769833	19.17362164	133.1127322	11.84047632	11.02361409	307.8445657	247.1212514		34.86093694		10.85663953	0.608107136	3594.788435	3604.803819	3.729193699	357.8698316			22.02824121	6.74977437			432		249.0398106															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															161.6002	41.9415	25.4168	0.124307828	41.4359	0.165743771	0.165743771	29.0052	36.4593		0.082871885		41.4359	0.195829864	8.2872	20.0896	0.414359426	20.718			0.165743771	0.177950201			12.4308		12.4308															3.4429	0.513700257	1.603116364	2.38343126	0.459637628	1.962485191	1.827095364	0.74409007	0.75082151	0	2.888991567	0	0.037487924	0.119085538	2.482557457	6.034915444	1.545226562	0.617861409	0	0	3.651043758	1.201123703	0	0	0.447508181	0	0.257979983	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.9711	0	6.81451954	3.4429	0.513700257	1.603116364	2.38343126	0.459637628	1.962485191	1.827095364	0.74409007	0.75082151	0	2.888991567	0	0.037487924	0.119085538	2.482557457	6.034915444	1.545226562	0.617861409	0	0	3.651043758	1.201123703	0	0	0.447508181	0	0.257979983	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.9711																																																																																				0	0	0	3.4429	0.513700257	1.603116364	2.38343126	0.459637628	1.962485191	1.827095364	0.74409007	0.75082151	0	2.888991567	0	0.037487924	0.119085538	2.482557457	6.034915444	1.545226562	0.617861409	0	0	3.651043758	1.201123703	0	0	0.447508181	0	0.257979983	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.9711
H5421_083_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		271.8896734	98.00675318	781.8166672	20.16177816	154.9245539	12.53649292	12.09573363	311.7928573	276.2666389		36.4452174		9.571274081	0.620463587	3639.148945	3620.329663	2.428845754	338.7758566			20.60424888	7.101162262			432		249.0286372															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															161.485	41.9116	25.3987	0.124219212	41.4064	0.165625616	0.165625616	28.9845	35.3135		0.082812808		41.4064	0.190599516	8.2813	19.9683	0.414064041	20.7032			0.165625616	0.181327548			12.4219		12.4219															3.6588	0.342301345	1.654759819	2.504480202	0.534572391	2.076364369	2.003363338	0.753096228	0.812995511	0	3.0181308	0	0.033026004	0.118260059	2.511401198	6.024330311	1.005697688	0.584478751	0	0	3.412591423	1.287636338	0	0	0.447189165	0	0.25778451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.0413	0	6.857479979	3.6588	0.342301345	1.654759819	2.504480202	0.534572391	2.076364369	2.003363338	0.753096228	0.812995511	0	3.0181308	0	0.033026004	0.118260059	2.511401198	6.024330311	1.005697688	0.584478751	0	0	3.412591423	1.287636338	0	0	0.447189165	0	0.25778451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.0413																																																																																				0	0	0	3.6588	0.342301345	1.654759819	2.504480202	0.534572391	2.076364369	2.003363338	0.753096228	0.812995511	0	3.0181308	0	0.033026004	0.118260059	2.511401198	6.024330311	1.005697688	0.584478751	0	0	3.412591423	1.287636338	0	0	0.447189165	0	0.25778451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.0413
H5421_084_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		284.4197462	131.8706485	795.8348263	23.22762372	143.541733	13.00807588	12.07748005	309.2299581	284.7751432		40.48920684		11.19784983	0.567556071	3785.555488	3945.589552	2.965885624	421.1030033			25.53267439	8.067778349			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															158.0575	41.022	24.8596	0.121582719	40.5276	0.162110292	0.162110292	28.3693	34.2901		0.081055146		40.5276	0.183011381	8.1055	19.6643	0.40527573	20.2638			0.162110292	0.171737142			12.1583		12.1583															3.7462	0.450799916	1.648678837	2.824077651	0.484783172	2.108742981	1.95788382	0.73105315	0.813746973	0	3.281858576	0	0.037818473	0.10386922	2.556989609	6.465593093	1.202001463	0.711095114	0	0	4.139109306	1.385537195	0	0	0.437697789	0	0.252284142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.3398	0	8.25990966	3.7462	0.450799916	1.648678837	2.824077651	0.484783172	2.108742981	1.95788382	0.73105315	0.813746973	0	3.281858576	0	0.037818473	0.10386922	2.556989609	6.465593093	1.202001463	0.711095114	0	0	4.139109306	1.385537195	0	0	0.437697789	0	0.252284142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.3398																																																																																				0	0	0	3.7462	0.450799916	1.648678837	2.824077651	0.484783172	2.108742981	1.95788382	0.73105315	0.813746973	0	3.281858576	0	0.037818473	0.10386922	2.556989609	6.465593093	1.202001463	0.711095114	0	0	4.139109306	1.385537195	0	0	0.437697789	0	0.252284142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.3398
H5421_085_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		299.0612285	96.14217928	813.6914188	22.13612574	172.6929261	12.59832245	12.65668799	315.6889883	322.4137804		43.36270209		11.13771311	0.576718044	3659.618835	4068.254791	2.776854131	435.9806145			25.57110812	7.607635631			432		249.0574751															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															157.6307	40.9112	24.7925	0.121254416	40.4181	0.161672555	0.161672555	28.2927	33.458		0.080836278		40.4181	0.18860333	8.0836	19.5382	0.404181388	20.2091			0.161672555	0.171954505			12.1254		12.1254															3.9284	0.327774648	1.681119447	2.684103005	0.581660554	2.036802979	2.046239085	0.744307744	0.898944656	0	3.50527942	0	0.037513803	0.108770944	2.465249698	6.623875147	1.122352756	0.734230207	0	0	4.134146384	1.308167217	0	0	0.436515899	0	0.25166099	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.6572	0	8.453181881	3.9284	0.327774648	1.681119447	2.684103005	0.581660554	2.036802979	2.046239085	0.744307744	0.898944656	0	3.50527942	0	0.037513803	0.108770944	2.465249698	6.623875147	1.122352756	0.734230207	0	0	4.134146384	1.308167217	0	0	0.436515899	0	0.25166099	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.6572																																																																																				0	0	0	3.9284	0.327774648	1.681119447	2.684103005	0.581660554	2.036802979	2.046239085	0.744307744	0.898944656	0	3.50527942	0	0.037513803	0.108770944	2.465249698	6.623875147	1.122352756	0.734230207	0	0	4.134146384	1.308167217	0	0	0.436515899	0	0.25166099	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.6572
H5421_086_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		317.0251165	119.39592	799.222641	23.20341944	185.7229452	12.89182807	12.20644038	353.5361938	299.577101		42.44430488		5.869709598	0.578911088	3420.990858	3662.923574	3.079131894	354.0678748			22.60164275	6.96902925			432		249.231791															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															158.6668	41.1801	24.9554	0.12205138	40.6838	0.162735173	0.162735173	28.4787	35.6351		0.081367586		40.6838	0.214399268	8.1368	19.6457	0.406837932	20.3419			0.162735173	0.175576329			12.2051		12.2051															4.1918	0.409728347	1.662079307	2.832009358	0.629659492	2.097953872	1.986417186	0.839019616	0.88962144	0	3.453590648	0	0.019900171	0.124118114	2.31964808	5.996735427	1.252707654	0.600201009	0	0	3.678082244	1.223596571	0	0	0.439384967	0	0.253492366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.8997	0	7.991709592	4.1918	0.409728347	1.662079307	2.832009358	0.629659492	2.097953872	1.986417186	0.839019616	0.88962144	0	3.453590648	0	0.019900171	0.124118114	2.31964808	5.996735427	1.252707654	0.600201009	0	0	3.678082244	1.223596571	0	0	0.439384967	0	0.253492366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.8997																																																																																				0	0	0	4.1918	0.409728347	1.662079307	2.832009358	0.629659492	2.097953872	1.986417186	0.839019616	0.88962144	0	3.453590648	0	0.019900171	0.124118114	2.31964808	5.996735427	1.252707654	0.600201009	0	0	3.678082244	1.223596571	0	0	0.439384967	0	0.253492366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.8997
H5421_087_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		365.0785213	132.6099143	977.0637445	39.45773289	169.4345634	11.27065701	11.82276069	286.5349302	325.7889818		52.66373344		13.38176149	0.827541188	4181.884289	4737.043283	4.044456941	661.1684423			25.15784564	9.389066887			432		249.0333464															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															151.1992	39.242	23.7809	0.116307048	38.769	0.155076064	0.155076064	27.1383	34.5085		0.077538032		38.769	0.161471797	7.7538	18.7126	0.38769016	19.3845			0.155076064	0.151768175			11.6307		11.6307															4.6	0.433656499	1.936289107	4.589212432	0.547400941	1.747809128	1.833427194	0.648006175	0.936875025	0	4.083442248	0	0.043233144	0.133624563	2.702125648	7.38685011	1.567996158	1.068035413	0	0	3.90137968	1.42496155	0	0	0.418705373	0	0.241369445	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2444	0	11.65837703	4.6	0.433656499	1.936289107	4.589212432	0.547400941	1.747809128	1.833427194	0.648006175	0.936875025	0	4.083442248	0	0.043233144	0.133624563	2.702125648	7.38685011	1.567996158	1.068035413	0	0	3.90137968	1.42496155	0	0	0.418705373	0	0.241369445	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2444																																																																																				0	0	0	4.6	0.433656499	1.936289107	4.589212432	0.547400941	1.747809128	1.833427194	0.648006175	0.936875025	0	4.083442248	0	0.043233144	0.133624563	2.702125648	7.38685011	1.567996158	1.068035413	0	0	3.90137968	1.42496155	0	0	0.418705373	0	0.241369445	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2444
H5421_088_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1384.739173	179.9214851	776.527495	19.59998364	141.4611451	12.54337683	11.49247152	334.2279309	236.3281239		33.51413413		11.97968469	0.58236888	3480.31603	3447.251996	4.360850911	333.064778			21.58470917	6.330153832			432		249.0479116															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												100.7176	100.7176	23.4763	0.114817138	76.5448	0.153089517	0.153089517	38.2724	134.9779		0.153089517		38.2724	0.300782448	15.309	23.5386	0.382723792	22.4991			0.153089517	0.279478284			22.9634		22.9634															11.6223	1.510104911	1.519164574	2.250414019	0.902342431	1.920259498	1.759376912	1.065974843	2.658255685	0	5.130662603	0	0.038207586	0.175166337	4.439999163	6.761960071	1.669001398	0.624471552	0	0	3.304392698	1.769140531	0	0	0.826683391	0	0.476582806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4245	0	15.45132458	11.6223	1.510104911	1.519164574	2.250414019	0.902342431	1.920259498	1.759376912	1.065974843	2.658255685	0	5.130662603	0	0.038207586	0.175166337	4.439999163	6.761960071	1.669001398	0.624471552	0	0	3.304392698	1.769140531	0	0	0.826683391	0	0.476582806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4245																																																																																				0	0	0	11.6223	1.510104911	1.519164574	2.250414019	0.902342431	1.920259498	1.759376912	1.065974843	2.658255685	0	5.130662603	0	0.038207586	0.175166337	4.439999163	6.761960071	1.669001398	0.624471552	0	0	3.304392698	1.769140531	0	0	0.826683391	0	0.476582806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4245
H5421_089_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1292.750874	102.1066726	730.0078105	18.84290466	147.0911691	11.89565709	11.32937626	300.5704964	248.3493759		32.96435621		9.430019298	0.55392781	3303.885352	3268.412191	2.416618707	301.7774798			18.54546828	6.364753916			432		249.0344008															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												102.9084	102.9084	23.9869	0.117314645	78.2098	0.156419527	0.156419527	39.1049	133.6086		0.156419527		39.1049	0.318269105	15.642	24.1487	0.391048816	22.8413			0.156419527	0.290917677			23.4629		23.4629															11.0862	0.875636248	1.459220789	2.21054867	0.958663793	1.86071305	1.77213567	0.979481141	2.765134319	0	5.156268993	0	0.030729982	0.176298108	4.306601522	6.577322587	0.945015885	0.574415231	0	0	2.900873369	1.851619423	0	0	0.844665444	0	0.486923038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.8185	0	13.32284671	11.0862	0.875636248	1.459220789	2.21054867	0.958663793	1.86071305	1.77213567	0.979481141	2.765134319	0	5.156268993	0	0.030729982	0.176298108	4.306601522	6.577322587	0.945015885	0.574415231	0	0	2.900873369	1.851619423	0	0	0.844665444	0	0.486923038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.8185																																																																																				0	0	0	11.0862	0.875636248	1.459220789	2.21054867	0.958663793	1.86071305	1.77213567	0.979481141	2.765134319	0	5.156268993	0	0.030729982	0.176298108	4.306601522	6.577322587	0.945015885	0.574415231	0	0	2.900873369	1.851619423	0	0	0.844665444	0	0.486923038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.8185
H5421_090_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1378.129705	148.2570504	732.6951351	21.40178544	137.987222	12.24780622	11.04247205	301.9710135	245.3473662		35.15111431		11.31791793	0.497889781	3299.741522	3402.542345	3.014894759	354.1300633			22.20008396	6.894430384			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												101.1769	101.1769	23.5833	0.115340771	76.8938	0.153787695	0.153787695	38.4469	130.7202		0.153787695		38.4469	0.276038956	15.3788	23.6279	0.384469237	22.5647			0.153787695	0.276080425			23.0682		23.0682															11.6196	1.250016033	1.439950059	2.468498438	0.884197367	1.883561887	1.698196324	0.967488044	2.672655282	0	5.405808846	0	0.036261594	0.137436975	4.228830356	6.699575981	1.159134289	0.665902317	0	0	3.414099741	1.903417273	0	0	0.830453553	0	0.478664201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8437	0	14.97774874	11.6196	1.250016033	1.439950059	2.468498438	0.884197367	1.883561887	1.698196324	0.967488044	2.672655282	0	5.405808846	0	0.036261594	0.137436975	4.228830356	6.699575981	1.159134289	0.665902317	0	0	3.414099741	1.903417273	0	0	0.830453553	0	0.478664201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8437																																																																																				0	0	0	11.6196	1.250016033	1.439950059	2.468498438	0.884197367	1.883561887	1.698196324	0.967488044	2.672655282	0	5.405808846	0	0.036261594	0.137436975	4.228830356	6.699575981	1.159134289	0.665902317	0	0	3.414099741	1.903417273	0	0	0.830453553	0	0.478664201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8437
H5421_091_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1442.596283	119.0932878	790.7101355	21.90227051	179.4156157	12.90666967	12.44315771	332.9477503	294.4148967		39.96692859		11.53118744	0.532983897	3407.365158	3723.535553	3.19446704	391.568758			23.52632665	6.865895559			432		249.06046															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												99.287	99.287	23.1428	0.113186275	75.4575	0.150915034	0.150915034	37.7288	125.5094		0.150915034		37.7288	0.315085399	15.0915	23.2541	0.377287584	22.2082			0.150915034	0.2705795			22.6373		22.6373															11.9359	0.985367946	1.524938556	2.47903642	1.128188071	1.947810489	1.877859567	1.046808771	3.079320976	0	6.031610378	0	0.036254782	0.167935444	4.285188566	7.215620741	1.205232753	0.724668602	0	0	3.550476381	1.857770589	0	0	0.814941182	0	0.469837097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.3648	0	17.03159604	11.9359	0.985367946	1.524938556	2.47903642	1.128188071	1.947810489	1.877859567	1.046808771	3.079320976	0	6.031610378	0	0.036254782	0.167935444	4.285188566	7.215620741	1.205232753	0.724668602	0	0	3.550476381	1.857770589	0	0	0.814941182	0	0.469837097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.3648																																																																																				0	0	0	11.9359	0.985367946	1.524938556	2.47903642	1.128188071	1.947810489	1.877859567	1.046808771	3.079320976	0	6.031610378	0	0.036254782	0.167935444	4.285188566	7.215620741	1.205232753	0.724668602	0	0	3.550476381	1.857770589	0	0	0.814941182	0	0.469837097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.3648
H5421_092_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1398.915974	117.2517263	729.7373779	21.24585465	172.8788963	12.0402677	11.23425374	330.6987008	268.6475972		38.08644907		5.396304322	0.518499043	3088.617995	3286.347596	2.936588194	315.1832567			20.25377289	6.21526273			432		249.2364161															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												101.1838	101.1838	23.5849	0.115348554	76.899	0.153798072	0.153798072	38.4495	134.8027		0.153798072		38.4495	0.350840949	15.3798	23.7218	0.384495179	22.6015			0.153798072	0.280256			23.0697		23.0697															11.7956	0.988664126	1.434234008	2.450678606	1.107851703	1.851769954	1.727806561	1.059600468	3.017867644	0	5.85762242	0	0.017290442	0.181910696	3.958529096	6.496516914	1.129104003	0.593633452	0	0	3.114991213	1.741864669	0	0	0.830509587	0	0.479151002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8352	0	14.97082226	11.7956	0.988664126	1.434234008	2.450678606	1.107851703	1.851769954	1.727806561	1.059600468	3.017867644	0	5.85762242	0	0.017290442	0.181910696	3.958529096	6.496516914	1.129104003	0.593633452	0	0	3.114991213	1.741864669	0	0	0.830509587	0	0.479151002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8352																																																																																				0	0	0	11.7956	0.988664126	1.434234008	2.450678606	1.107851703	1.851769954	1.727806561	1.059600468	3.017867644	0	5.85762242	0	0.017290442	0.181910696	3.958529096	6.496516914	1.129104003	0.593633452	0	0	3.114991213	1.741864669	0	0	0.830509587	0	0.479151002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8352
H5421_093_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1733.243872	154.0453401	859.0157648	36.16338348	160.051904	10.56660189	10.65971916	275.07833	280.1724399		44.83782023		13.73559519	0.727538585	3672.784236	4081.438881	4.062333748	586.351173			21.36521054	7.892396528			432		249.0354304															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												96.0497	96.0497	22.3882	0.109495832	72.9972	0.145994443	0.145994443	36.4986	130.261		0.145994443		36.4986	0.25544684	14.5994	22.5275	0.364986108	21.5479			0.145994443	0.240211536			21.8992		21.8992															13.8731	1.233001291	1.60265482	3.959739772	0.973612024	1.542665157	1.556259762	0.836664741	3.041294166	0	6.546072591	0	0.041777512	0.185847432	4.468384074	7.662049886	1.482695382	1.052884942	0	0	3.119202012	1.895844691	0	0	0.788369992	0	0.454472362	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3166	0	20.83237433	13.8731	1.233001291	1.60265482	3.959739772	0.973612024	1.542665157	1.556259762	0.836664741	3.041294166	0	6.546072591	0	0.041777512	0.185847432	4.468384074	7.662049886	1.482695382	1.052884942	0	0	3.119202012	1.895844691	0	0	0.788369992	0	0.454472362	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3166																																																																																				0	0	0	13.8731	1.233001291	1.60265482	3.959739772	0.973612024	1.542665157	1.556259762	0.836664741	3.041294166	0	6.546072591	0	0.041777512	0.185847432	4.468384074	7.662049886	1.482695382	1.052884942	0	0	3.119202012	1.895844691	0	0	0.788369992	0	0.454472362	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3166
H5421_094_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1370.711088	178.0987925	768.6608918	19.40142622	140.0280745	12.41630629	11.37604716	330.8467623	233.9340045		33.17461957		11.85832463	0.576469199	6428.937422	3412.329648	4.31667336	329.690669			21.36604551	6.266026278			432		249.0474262															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												127.7615	127.7615	25.6755	0.141618928	123.9166	0.141618928	0.141618928	38.9527	249.7287		0.141618928		35.4047	0.313671088	14.1619	25.8475	0.35404732	24.2106			0.141618928	0.294269219			24.7833		24.7833															14.5937	1.896180975	1.644646806	2.747609181	1.44598313	1.758383985	1.611063603	1.073947614	4.868336002	0	4.698154058	0	0.034986734	0.180821721	7.587160212	7.350011287	1.528306633	0.66516741	0	0	3.025836459	1.843898662	0	0	0.892199246	0	0.51435168	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9607	0	24.71824437	14.5937	1.896180975	1.644646806	2.747609181	1.44598313	1.758383985	1.611063603	1.073947614	4.868336002	0	4.698154058	0	0.034986734	0.180821721	7.587160212	7.350011287	1.528306633	0.66516741	0	0	3.025836459	1.843898662	0	0	0.892199246	0	0.51435168	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9607																																																																																				0	0	0	14.5937	1.896180975	1.644646806	2.747609181	1.44598313	1.758383985	1.611063603	1.073947614	4.868336002	0	4.698154058	0	0.034986734	0.180821721	7.587160212	7.350011287	1.528306633	0.66516741	0	0	3.025836459	1.843898662	0	0	0.892199246	0	0.51435168	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9607
H5421_095_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1278.762529	101.0018168	722.1086854	18.63901306	145.4995539	11.7669389	11.20678557	297.3228007	245.6620857		32.60766198		9.327980797	0.547933977	6029.625464	3233.045998	2.390469433	298.5120653			18.34479512	6.295883437			432		249.0340286															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												130.8931	130.8931	26.3048	0.145090167	126.9539	0.145090167	0.145090167	39.9077	247.8628		0.145090167		36.2725	0.337620917	14.509	26.663	0.362725417	24.6219			0.145090167	0.306917364			25.3908		25.3908															13.9484	1.101703359	1.582913222	2.704337515	1.539311269	1.707267128	1.625994387	0.988788456	5.074208435	0	4.731051117	0	0.028195798	0.184993972	7.290328038	7.183548501	0.867084022	0.612495597	0	0	2.661649385	1.932315949	0	0	0.914068051	0	0.526930669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2056	0	21.64964688	13.9484	1.101703359	1.582913222	2.704337515	1.539311269	1.707267128	1.625994387	0.988788456	5.074208435	0	4.731051117	0	0.028195798	0.184993972	7.290328038	7.183548501	0.867084022	0.612495597	0	0	2.661649385	1.932315949	0	0	0.914068051	0	0.526930669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2056																																																																																				0	0	0	13.9484	1.101703359	1.582913222	2.704337515	1.539311269	1.707267128	1.625994387	0.988788456	5.074208435	0	4.731051117	0	0.028195798	0.184993972	7.290328038	7.183548501	0.867084022	0.612495597	0	0	2.661649385	1.932315949	0	0	0.914068051	0	0.526930669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2056
H5421_096_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1364.441039	146.784445	725.4174321	21.18920611	136.6166246	12.1261514	10.93278956	298.9756342	242.9103837		34.80196586		11.20549949	0.492944349	6127.174526	3368.745624	2.984948458	350.6125656			21.97957531	6.825949492			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												128.4519	128.4519	25.8143	0.142384189	124.5862	0.142384189	0.142384189	39.1629	242.0544		0.142384189		35.596	0.287291335	14.2384	25.9537	0.355960474	24.2957			0.142384189	0.290651879			24.9172		24.9172															14.6054	1.571228361	1.560509126	3.017007936	1.418378453	1.726572238	1.556656379	0.975729527	4.899793782	0	4.955249699	0	0.033239291	0.14161864	7.270106485	7.285952013	1.062523667	0.709864767	0	0	3.129544014	1.983975049	0	0	0.897020393	0	0.517032588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3174	0	24.00281509	14.6054	1.571228361	1.560509126	3.017007936	1.418378453	1.726572238	1.556656379	0.975729527	4.899793782	0	4.955249699	0	0.033239291	0.14161864	7.270106485	7.285952013	1.062523667	0.709864767	0	0	3.129544014	1.983975049	0	0	0.897020393	0	0.517032588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3174																																																																																				0	0	0	14.6054	1.571228361	1.560509126	3.017007936	1.418378453	1.726572238	1.556656379	0.975729527	4.899793782	0	4.955249699	0	0.033239291	0.14161864	7.270106485	7.285952013	1.062523667	0.709864767	0	0	3.129544014	1.983975049	0	0	0.897020393	0	0.517032588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3174
H5421_097_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1386.098195	114.4290978	759.742628	21.04448622	172.3889517	12.40119065	11.95583175	319.924197	282.8843811		38.40165693		11.07957804	0.512110024	6311.276755	3577.706367	3.069358384	376.2332919			22.60493756	6.596998447			432		249.0580921															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												126.6432	126.6432	25.4508	0.14037931	122.8319	0.14037931	0.14037931	38.6111	233.4947		0.14037931		35.0948	0.337062125	14.0379	25.7139	0.350948275	24.0342			0.14037931	0.286041547			24.5664		24.5664															14.6283	1.207638876	1.611336172	2.954210458	1.764571821	1.740870588	1.678351413	1.029384411	5.504333553	0	5.390798108	0	0.03240299	0.172612893	7.383105641	7.666408434	1.077186031	0.753538819	0	0	3.17326554	1.887015644	0	0	0.884389654	0	0.509871296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0496	0	25.92846707	14.6283	1.207638876	1.611336172	2.954210458	1.764571821	1.740870588	1.678351413	1.029384411	5.504333553	0	5.390798108	0	0.03240299	0.172612893	7.383105641	7.666408434	1.077186031	0.753538819	0	0	3.17326554	1.887015644	0	0	0.884389654	0	0.509871296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0496																																																																																				0	0	0	14.6283	1.207638876	1.611336172	2.954210458	1.764571821	1.740870588	1.678351413	1.029384411	5.504333553	0	5.390798108	0	0.03240299	0.172612893	7.383105641	7.666408434	1.077186031	0.753538819	0	0	3.17326554	1.887015644	0	0	0.884389654	0	0.509871296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0496
H5421_098_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1356.358412	113.684716	707.5374425	20.5995172	167.6196066	11.67398091	10.89248735	320.6504529	260.4748498		36.92779017		5.232138952	0.502725362	5903.805272	3186.370938	2.847251852	305.59481			19.63761637	6.026183158			432		249.2292239															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												128.9569	128.9569	25.9157	0.142943925	125.0759	0.142943925	0.142943925	39.3163	250.5782		0.142943925		35.736	0.371737025	14.2944	26.2274	0.357359813	24.4349			0.142943925	0.29584744			25.0152		25.0152															14.576	1.221702019	1.528029323	2.944575842	1.747098243	1.668724652	1.557014896	1.05056544	5.439109888	0	5.27860327	0	0.015581302	0.18688163	7.032609152	6.964183736	1.017493388	0.622265216	0	0	2.807077962	1.782830862	0	0	0.900546728	0	0.519542968	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8604	0	23.49413707	14.576	1.221702019	1.528029323	2.944575842	1.747098243	1.668724652	1.557014896	1.05056544	5.439109888	0	5.27860327	0	0.015581302	0.18688163	7.032609152	6.964183736	1.017493388	0.622265216	0	0	2.807077962	1.782830862	0	0	0.900546728	0	0.519542968	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8604																																																																																				0	0	0	14.576	1.221702019	1.528029323	2.944575842	1.747098243	1.668724652	1.557014896	1.05056544	5.439109888	0	5.27860327	0	0.015581302	0.18688163	7.032609152	6.964183736	1.017493388	0.622265216	0	0	2.807077962	1.782830862	0	0	0.900546728	0	0.519542968	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8604
H5421_099_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1691.182095	150.3070198	838.1694603	35.28578271	156.1678185	10.31017516	10.4010327	268.4126521	273.3733098		43.74971116		13.4022644	0.709882924	7014.807131	3982.391901	3.963750405	572.1218008			20.84672682	7.700866515			432		249.0345706															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												120.9913	120.9913	24.3149	0.134114419	117.3501	0.134114419	0.134114419	36.8891	239.3224		0.134114419		33.5286	0.265875146	13.4114	24.6244	0.335286048	23.0397			0.134114419	0.249907597			23.47		23.47															17.0515	1.515487101	1.69833697	4.732332249	1.527192643	1.382743152	1.394928458	0.825124093	5.452030419	0	5.867467096	0	0.037446602	0.188740226	7.839889859	8.172009027	1.328990207	1.098461642	0	0	2.795846657	1.924505045	0	0	0.84492084	0	0.487070599	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1651	0	32.50450604	17.0515	1.515487101	1.69833697	4.732332249	1.527192643	1.382743152	1.394928458	0.825124093	5.452030419	0	5.867467096	0	0.037446602	0.188740226	7.839889859	8.172009027	1.328990207	1.098461642	0	0	2.795846657	1.924505045	0	0	0.84492084	0	0.487070599	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1651																																																																																				0	0	0	17.0515	1.515487101	1.69833697	4.732332249	1.527192643	1.382743152	1.394928458	0.825124093	5.452030419	0	5.867467096	0	0.037446602	0.188740226	7.839889859	8.172009027	1.328990207	1.098461642	0	0	2.795846657	1.924505045	0	0	0.84492084	0	0.487070599	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1651
H5421_100_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		429.3049209	166.9808375	715.0196368	73.97954202	349.6858159	19.7279181	14.77924277	323.5258963	393.6326373		66.26152552		26.9614666	0.987702118	4429.547615	5835.865636	8.700224569	514.9333497			36.02030324	9.664503466			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															138.6231	35.978	21.8029	0.106633135	35.5444	0.142177513	0.142177513	24.8811	26.6499		0.071088757		35.5444	0.072508629	7.1089	17.4321	0.355443783	17.7722			0.142177513	0.136826875			10.6633		10.6633															4.9593	0.500636655	1.299126427	7.888670487	1.035780411	2.804866338	2.101275985	0.670805733	0.874189752	0	4.710449461	0	0.079860714	0.071616927	2.624091936	8.477600439	3.092440735	0.762624408	0	0	5.121277141	1.322363809	0	0	0.383879286	0	0.221263755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0021	0	19.92877946	4.9593	0.500636655	1.299126427	7.888670487	1.035780411	2.804866338	2.101275985	0.670805733	0.874189752	0	4.710449461	0	0.079860714	0.071616927	2.624091936	8.477600439	3.092440735	0.762624408	0	0	5.121277141	1.322363809	0	0	0.383879286	0	0.221263755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0021																																																																																				0	0	0	4.9593	0.500636655	1.299126427	7.888670487	1.035780411	2.804866338	2.101275985	0.670805733	0.874189752	0	4.710449461	0	0.079860714	0.071616927	2.624091936	8.477600439	3.092440735	0.762624408	0	0	5.121277141	1.322363809	0	0	0.383879286	0	0.221263755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0021
H5421_101_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2226.817515	104.9668274	566.5823426	54.94401462	263.52399	15.24547941	11.44851646	245.8914935	323.00719		54.1417736		18.76398452	0.833927234	3513.793264	4754.700592	5.978574946	412.524196			29.22133854	7.932054939			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												90.7355	90.7355	21.1495	0.103437619	68.9584	0.137916825	0.137916825	34.4792	103.1457		0.137916825		34.4792	0.118774484	13.7917	21.0209	0.344792063	20.3466			0.137916825	0.223891917			20.6875		20.6875															16.8376	0.793684615	0.998579901	5.683278038	1.514349667	2.102608116	1.578943041	0.70651196	2.776401036	0	7.467061516	0	0.053913941	0.099049277	4.038426756	8.328988719	2.061365187	0.699455567	0	0	4.030114234	1.775922987	0	0	0.744750855	0	0.429266118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7203	0	28.23349791	16.8376	0.793684615	0.998579901	5.683278038	1.514349667	2.102608116	1.578943041	0.70651196	2.776401036	0	7.467061516	0	0.053913941	0.099049277	4.038426756	8.328988719	2.061365187	0.699455567	0	0	4.030114234	1.775922987	0	0	0.744750855	0	0.429266118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7203																																																																																				0	0	0	16.8376	0.793684615	0.998579901	5.683278038	1.514349667	2.102608116	1.578943041	0.70651196	2.776401036	0	7.467061516	0	0.053913941	0.099049277	4.038426756	8.328988719	2.061365187	0.699455567	0	0	4.030114234	1.775922987	0	0	0.744750855	0	0.429266118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7203
H5421_102_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2214.597063	104.3907846	563.4730207	54.64248982	262.0778085	15.16181443	11.38568865	244.5439923	321.2345733		53.84465138		18.66101049	0.829350762	6473.554596	4728.607483	5.945765392	410.2603229			29.06097607	7.888524969			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												113.3771	113.3771	22.7848	0.125674324	109.965	0.125674324	0.125674324	34.5672	187.9795		0.125674324		31.4186	0.123304464	12.5674	22.6005	0.31418581	21.5788			0.125674324	0.231867252			21.993		21.993															20.9237	0.986293627	1.069882891	6.867157968	2.401616248	1.905450778	1.430888724	0.704432748	5.03212698	0	6.766890161	0	0.048858539	0.102262651	6.779663312	8.905736651	1.868075115	0.737743723	0	0	3.652218521	1.829090604	0	0	0.791748241	0	0.456354889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2602	0	43.32718274	20.9237	0.986293627	1.069882891	6.867157968	2.401616248	1.905450778	1.430888724	0.704432748	5.03212698	0	6.766890161	0	0.048858539	0.102262651	6.779663312	8.905736651	1.868075115	0.737743723	0	0	3.652218521	1.829090604	0	0	0.791748241	0	0.456354889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2602																																																																																				0	0	0	20.9237	0.986293627	1.069882891	6.867157968	2.401616248	1.905450778	1.430888724	0.704432748	5.03212698	0	6.766890161	0	0.048858539	0.102262651	6.779663312	8.905736651	1.868075115	0.737743723	0	0	3.652218521	1.829090604	0	0	0.791748241	0	0.456354889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2602
H5421_103_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		429.3049209	166.9808375	715.0196368	73.97954202	349.6858159	19.7279181	14.77924277	323.5258963	393.6326373		66.26152552		26.9614666	0.987702118	4429.547615	5835.865636	8.700224569	514.9333497			36.02030324	9.664503466			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															138.6231	35.978	21.8029	0.106633135	35.5444	0.142177513	0.142177513	24.8811	26.6499		0.071088757		35.5444	0.072508629	7.1089	17.4321	0.355443783	17.7722			0.142177513	0.136826875			10.6633		10.6633															4.9593	0.500636655	1.299126427	7.888670487	1.035780411	2.804866338	2.101275985	0.670805733	0.874189752	0	4.710449461	0	0.079860714	0.071616927	2.624091936	8.477600439	3.092440735	0.762624408	0	0	5.121277141	1.322363809	0	0	0.383879286	0	0.221263755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0021	0	19.92877946	4.9593	0.500636655	1.299126427	7.888670487	1.035780411	2.804866338	2.101275985	0.670805733	0.874189752	0	4.710449461	0	0.079860714	0.071616927	2.624091936	8.477600439	3.092440735	0.762624408	0	0	5.121277141	1.322363809	0	0	0.383879286	0	0.221263755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0021																																																																																				0	0	0	4.9593	0.500636655	1.299126427	7.888670487	1.035780411	2.804866338	2.101275985	0.670805733	0.874189752	0	4.710449461	0	0.079860714	0.071616927	2.624091936	8.477600439	3.092440735	0.762624408	0	0	5.121277141	1.322363809	0	0	0.383879286	0	0.221263755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0021
H5421_104_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2226.817515	104.9668274	566.5823426	54.94401462	263.52399	15.24547941	11.44851646	245.8914935	323.00719		54.1417736		18.76398452	0.833927234	3513.793264	4754.700592	5.978574946	412.524196			29.22133854	7.932054939			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												90.7355	90.7355	21.1495	0.103437619	68.9584	0.137916825	0.137916825	34.4792	103.1457		0.137916825		34.4792	0.118774484	13.7917	21.0209	0.344792063	20.3466			0.137916825	0.223891917			20.6875		20.6875															16.8376	0.793684615	0.998579901	5.683278038	1.514349667	2.102608116	1.578943041	0.70651196	2.776401036	0	7.467061516	0	0.053913941	0.099049277	4.038426756	8.328988719	2.061365187	0.699455567	0	0	4.030114234	1.775922987	0	0	0.744750855	0	0.429266118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7203	0	28.23349791	16.8376	0.793684615	0.998579901	5.683278038	1.514349667	2.102608116	1.578943041	0.70651196	2.776401036	0	7.467061516	0	0.053913941	0.099049277	4.038426756	8.328988719	2.061365187	0.699455567	0	0	4.030114234	1.775922987	0	0	0.744750855	0	0.429266118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7203																																																																																				0	0	0	16.8376	0.793684615	0.998579901	5.683278038	1.514349667	2.102608116	1.578943041	0.70651196	2.776401036	0	7.467061516	0	0.053913941	0.099049277	4.038426756	8.328988719	2.061365187	0.699455567	0	0	4.030114234	1.775922987	0	0	0.744750855	0	0.429266118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7203
H5421_105_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2214.597063	104.3907846	563.4730207	54.64248982	262.0778085	15.16181443	11.38568865	244.5439923	321.2345733		53.84465138		18.66101049	0.829350762	6473.554596	4728.607483	5.945765392	410.2603229			29.06097607	7.888524969			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												113.3771	113.3771	22.7848	0.125674324	109.965	0.125674324	0.125674324	34.5672	187.9795		0.125674324		31.4186	0.123304464	12.5674	22.6005	0.31418581	21.5788			0.125674324	0.231867252			21.993		21.993															20.9237	0.986293627	1.069882891	6.867157968	2.401616248	1.905450778	1.430888724	0.704432748	5.03212698	0	6.766890161	0	0.048858539	0.102262651	6.779663312	8.905736651	1.868075115	0.737743723	0	0	3.652218521	1.829090604	0	0	0.791748241	0	0.456354889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2602	0	43.32718274	20.9237	0.986293627	1.069882891	6.867157968	2.401616248	1.905450778	1.430888724	0.704432748	5.03212698	0	6.766890161	0	0.048858539	0.102262651	6.779663312	8.905736651	1.868075115	0.737743723	0	0	3.652218521	1.829090604	0	0	0.791748241	0	0.456354889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2602																																																																																				0	0	0	20.9237	0.986293627	1.069882891	6.867157968	2.401616248	1.905450778	1.430888724	0.704432748	5.03212698	0	6.766890161	0	0.048858539	0.102262651	6.779663312	8.905736651	1.868075115	0.737743723	0	0	3.652218521	1.829090604	0	0	0.791748241	0	0.456354889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2602
H5421_106_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		349.2372315	131.8735689	817.2065607	77.5424353	186.0201142	18.5678963	12.85881689	291.9525022	407.7995099		62.21427717		25.82455557	0.59122415	4325.559062	5369.138744	3.570410423	373.7671834			43.77795007	10.23270341			432		249.0720472															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															141.9773	36.8486	22.3305	0.109213306	36.4044	0.145617741	0.145617741	25.4831	26.4382		0.07280887		36.4044	0.194729783	7.2809	17.8214	0.364044352	18.2022			0.145617741	0.136480749			10.9213		10.9213															4.132	0.404946028	1.520717934	8.468665681	0.564329766	2.70381511	1.872471865	0.619988013	0.898457104	0	4.529751242	0	0.07834403	0.115128951	2.624492242	7.97378412	1.299787749	0.5669493	0	0	6.374846184	1.396567021	0	0	0.3931679	0	0.22668318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7649	0	17.4647639	4.132	0.404946028	1.520717934	8.468665681	0.564329766	2.70381511	1.872471865	0.619988013	0.898457104	0	4.529751242	0	0.07834403	0.115128951	2.624492242	7.97378412	1.299787749	0.5669493	0	0	6.374846184	1.396567021	0	0	0.3931679	0	0.22668318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7649																																																																																				0	0	0	4.132	0.404946028	1.520717934	8.468665681	0.564329766	2.70381511	1.872471865	0.619988013	0.898457104	0	4.529751242	0	0.07834403	0.115128951	2.624492242	7.97378412	1.299787749	0.5669493	0	0	6.374846184	1.396567021	0	0	0.3931679	0	0.22668318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7649
H5421_107_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2269.287306	171.643136	820.321439	93.52545172	198.121196	20.2095183	13.25350204	318.9304155	364.8961931		56.85073683		37.74323163	0.545639064	4106.958755	4852.014547	4.072792887	338.0732422			39.54699561	9.241746784			432		249.0589014															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												80.5336	80.5336	18.7716	0.091807574	61.205	0.122410099	0.122410099	30.6025	89.1772		0.122410099		30.6025	0.288622991	12.241	18.6875	0.306025248	17.9961			0.122410099	0.192788394			18.3615		18.3615															15.2295	1.151920032	1.283228054	8.586344858	1.010501468	2.473849137	1.622362498	0.813339661	2.711701613	0	6.959104328	0	0.096253182	0.157483978	4.189443568	7.556002948	1.246377452	0.506998619	0	0	4.840951651	1.781701517	0	0	0.661014535	0	0.38109156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2592	0	40.09695345	15.2295	1.151920032	1.283228054	8.586344858	1.010501468	2.473849137	1.622362498	0.813339661	2.711701613	0	6.959104328	0	0.096253182	0.157483978	4.189443568	7.556002948	1.246377452	0.506998619	0	0	4.840951651	1.781701517	0	0	0.661014535	0	0.38109156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2592																																																																																				0	0	0	15.2295	1.151920032	1.283228054	8.586344858	1.010501468	2.473849137	1.622362498	0.813339661	2.711701613	0	6.959104328	0	0.096253182	0.157483978	4.189443568	7.556002948	1.246377452	0.506998619	0	0	4.840951651	1.781701517	0	0	0.661014535	0	0.38109156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2592
H5421_108_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2255.234506	170.5802179	815.2415123	92.94628554	196.8943097	20.08436873	13.17142834	316.9578502	362.6365351		56.49868268		37.5095027	0.542260137	7725.307125	4821.967938	4.047571689	335.9796882			39.30209669	9.184516296			432		249.0585366															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												99.2482	99.2482	19.9454	0.110012968	96.2613	0.110012968	0.110012968	30.2587	160.2915		0.110012968		27.5032	0.301324116	11.0013	19.8382	0.275032421	18.8143			0.110012968	0.196423261			19.2523		19.2523															18.6523	1.410814956	1.355023187	10.22529676	1.579442626	2.209541021	1.449027928	0.799227842	4.843962277	0	6.215587786	0	0.085969411	0.163396056	7.082366399	7.971603536	1.11321344	0.526769526	0	0	4.323740317	1.804052639	0	0	0.6930817	0	0.399578505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.904	0	59.63312345	18.6523	1.410814956	1.355023187	10.22529676	1.579442626	2.209541021	1.449027928	0.799227842	4.843962277	0	6.215587786	0	0.085969411	0.163396056	7.082366399	7.971603536	1.11321344	0.526769526	0	0	4.323740317	1.804052639	0	0	0.6930817	0	0.399578505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.904																																																																																				0	0	0	18.6523	1.410814956	1.355023187	10.22529676	1.579442626	2.209541021	1.449027928	0.799227842	4.843962277	0	6.215587786	0	0.085969411	0.163396056	7.082366399	7.971603536	1.11321344	0.526769526	0	0	4.323740317	1.804052639	0	0	0.6930817	0	0.399578505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.904
H5421_109_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		349.2372315	131.8735689	817.2065607	77.5424353	186.0201142	18.5678963	12.85881689	291.9525022	407.7995099		62.21427717		25.82455557	0.59122415	4325.559062	5369.138744	3.570410423	373.7671834			43.77795007	10.23270341			432		249.0720472															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															141.9773	36.8486	22.3305	0.109213306	36.4044	0.145617741	0.145617741	25.4831	26.4382		0.07280887		36.4044	0.194729783	7.2809	17.8214	0.364044352	18.2022			0.145617741	0.136480749			10.9213		10.9213															4.132	0.404946028	1.520717934	8.468665681	0.564329766	2.70381511	1.872471865	0.619988013	0.898457104	0	4.529751242	0	0.07834403	0.115128951	2.624492242	7.97378412	1.299787749	0.5669493	0	0	6.374846184	1.396567021	0	0	0.3931679	0	0.22668318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7649	0	17.4647639	4.132	0.404946028	1.520717934	8.468665681	0.564329766	2.70381511	1.872471865	0.619988013	0.898457104	0	4.529751242	0	0.07834403	0.115128951	2.624492242	7.97378412	1.299787749	0.5669493	0	0	6.374846184	1.396567021	0	0	0.3931679	0	0.22668318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7649																																																																																				0	0	0	4.132	0.404946028	1.520717934	8.468665681	0.564329766	2.70381511	1.872471865	0.619988013	0.898457104	0	4.529751242	0	0.07834403	0.115128951	2.624492242	7.97378412	1.299787749	0.5669493	0	0	6.374846184	1.396567021	0	0	0.3931679	0	0.22668318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7649
H5421_110_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2269.287306	171.643136	820.321439	93.52545172	198.121196	20.2095183	13.25350204	318.9304155	364.8961931		56.85073683		37.74323163	0.545639064	4106.958755	4852.014547	4.072792887	338.0732422			39.54699561	9.241746784			432		249.0589014															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												80.5336	80.5336	18.7716	0.091807574	61.205	0.122410099	0.122410099	30.6025	89.1772		0.122410099		30.6025	0.288622991	12.241	18.6875	0.306025248	17.9961			0.122410099	0.192788394			18.3615		18.3615															15.2295	1.151920032	1.283228054	8.586344858	1.010501468	2.473849137	1.622362498	0.813339661	2.711701613	0	6.959104328	0	0.096253182	0.157483978	4.189443568	7.556002948	1.246377452	0.506998619	0	0	4.840951651	1.781701517	0	0	0.661014535	0	0.38109156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2592	0	40.09695345	15.2295	1.151920032	1.283228054	8.586344858	1.010501468	2.473849137	1.622362498	0.813339661	2.711701613	0	6.959104328	0	0.096253182	0.157483978	4.189443568	7.556002948	1.246377452	0.506998619	0	0	4.840951651	1.781701517	0	0	0.661014535	0	0.38109156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2592																																																																																				0	0	0	15.2295	1.151920032	1.283228054	8.586344858	1.010501468	2.473849137	1.622362498	0.813339661	2.711701613	0	6.959104328	0	0.096253182	0.157483978	4.189443568	7.556002948	1.246377452	0.506998619	0	0	4.840951651	1.781701517	0	0	0.661014535	0	0.38109156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2592
H5421_111_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2255.234506	170.5802179	815.2415123	92.94628554	196.8943097	20.08436873	13.17142834	316.9578502	362.6365351		56.49868268		37.5095027	0.542260137	7725.307125	4821.967938	4.047571689	335.9796882			39.30209669	9.184516296			432		249.0585366															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												99.2482	99.2482	19.9454	0.110012968	96.2613	0.110012968	0.110012968	30.2587	160.2915		0.110012968		27.5032	0.301324116	11.0013	19.8382	0.275032421	18.8143			0.110012968	0.196423261			19.2523		19.2523															18.6523	1.410814956	1.355023187	10.22529676	1.579442626	2.209541021	1.449027928	0.799227842	4.843962277	0	6.215587786	0	0.085969411	0.163396056	7.082366399	7.971603536	1.11321344	0.526769526	0	0	4.323740317	1.804052639	0	0	0.6930817	0	0.399578505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.904	0	59.63312345	18.6523	1.410814956	1.355023187	10.22529676	1.579442626	2.209541021	1.449027928	0.799227842	4.843962277	0	6.215587786	0	0.085969411	0.163396056	7.082366399	7.971603536	1.11321344	0.526769526	0	0	4.323740317	1.804052639	0	0	0.6930817	0	0.399578505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.904																																																																																				0	0	0	18.6523	1.410814956	1.355023187	10.22529676	1.579442626	2.209541021	1.449027928	0.799227842	4.843962277	0	6.215587786	0	0.085969411	0.163396056	7.082366399	7.971603536	1.11321344	0.526769526	0	0	4.323740317	1.804052639	0	0	0.6930817	0	0.399578505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.904
H5421_112_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		314.0080612	67.03255182	989.6193403	15.85189243	195.6751823	9.429024857	9.437222925	246.9945998	346.1822694		46.46335022		11.39180466	0.660190649	3520.6741	4147.551993	3.001819187	460.3070884			26.38188599	6.971329513			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															158.4845	41.1328	24.9268	0.121911129	40.637	0.162548173	0.162548173	28.4459	34.5838		0.081274086		40.637	0.175427953	8.1274	19.6617	0.406370432	20.3185			0.162548173	0.181052187			12.1911		12.1911															4.1471	0.229769797	2.05566717	1.932522111	0.662638402	1.53267076	1.534003341	0.585499262	0.997691773	0	3.776266336	0	0.038577438	0.115815894	2.384496422	6.795661652	1.219850559	0.779396626	0	0	4.288327358	1.262174456	0	0	0.438880066	0	0.252965594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.03	0	8.071067066	4.1471	0.229769797	2.05566717	1.932522111	0.662638402	1.53267076	1.534003341	0.585499262	0.997691773	0	3.776266336	0	0.038577438	0.115815894	2.384496422	6.795661652	1.219850559	0.779396626	0	0	4.288327358	1.262174456	0	0	0.438880066	0	0.252965594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.03																																																																																				0	0	0	4.1471	0.229769797	2.05566717	1.932522111	0.662638402	1.53267076	1.534003341	0.585499262	0.997691773	0	3.776266336	0	0.038577438	0.115815894	2.384496422	6.795661652	1.219850559	0.779396626	0	0	4.288327358	1.262174456	0	0	0.438880066	0	0.252965594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.03
H5421_113_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1514.43653	69.80379458	918.6884038	14.60501482	185.5972854	8.802307655	8.7676644	238.8964702	321.577733		42.25653344		10.45772925	0.600935488	3277.593131	3845.612346	2.93293468	426.6294123			24.1867475	6.311258366			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												94.3429	94.3429	21.9904	0.10755009	71.7001	0.14340012	0.14340012	35.85	122.1421		0.14340012		35.85	0.285114232	14.34	22.0874	0.3585003	20.5152			0.14340012	0.273916563			21.51		21.51															11.9064	0.548791261	1.683527765	1.570770658	1.108944707	1.262251974	1.257284127	0.713703802	3.27318237	0	6.059591964	0	0.031242492	0.17133526	3.916727067	7.078306588	1.051457962	0.729366176	0	0	3.468382493	1.728758202	0	0	0.774360648	0	0.446332873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7807	0	19.25368606	11.9064	0.548791261	1.683527765	1.570770658	1.108944707	1.262251974	1.257284127	0.713703802	3.27318237	0	6.059591964	0	0.031242492	0.17133526	3.916727067	7.078306588	1.051457962	0.729366176	0	0	3.468382493	1.728758202	0	0	0.774360648	0	0.446332873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7807																																																																																				0	0	0	11.9064	0.548791261	1.683527765	1.570770658	1.108944707	1.262251974	1.257284127	0.713703802	3.27318237	0	6.059591964	0	0.031242492	0.17133526	3.916727067	7.078306588	1.051457962	0.729366176	0	0	3.468382493	1.728758202	0	0	0.774360648	0	0.446332873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7807
H5421_114_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1498.825839	69.08426264	909.218637	14.4544675	183.6841633	8.71157417	8.677288015	236.43862	318.2629354		41.82095646		10.34993181	0.594741093	6099.220442	3805.97208	2.902702223	422.2317504			23.93743244	6.246202419			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												117.9426	117.9426	23.7023	0.130735052	114.3932	0.130735052	0.130735052	35.9615	222.7091		0.130735052		32.6838	0.298637711	13.0735	23.9315	0.32683763	21.6694			0.130735052	0.28358691			22.8786		22.8786															14.7313	0.678998286	1.795878419	1.889705561	1.751017819	1.138908103	1.134425701	0.708558161	5.906671572	0	5.467464923	0	0.02818956	0.177612119	6.644849186	7.590204918	0.948712316	0.762458278	0	0	3.129461477	1.771341241	0	0	0.823630828	0	0.474731658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5541	0	30.4928345	14.7313	0.678998286	1.795878419	1.889705561	1.751017819	1.138908103	1.134425701	0.708558161	5.906671572	0	5.467464923	0	0.02818956	0.177612119	6.644849186	7.590204918	0.948712316	0.762458278	0	0	3.129461477	1.771341241	0	0	0.823630828	0	0.474731658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5541																																																																																				0	0	0	14.7313	0.678998286	1.795878419	1.889705561	1.751017819	1.138908103	1.134425701	0.708558161	5.906671572	0	5.467464923	0	0.02818956	0.177612119	6.644849186	7.590204918	0.948712316	0.762458278	0	0	3.129461477	1.771341241	0	0	0.823630828	0	0.474731658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5541
H5421_115_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		314.0080612	67.03255182	989.6193403	15.85189243	195.6751823	9.429024857	9.437222925	246.9945998	346.1822694		46.46335022		11.39180466	0.660190649	3520.6741	4147.551993	3.001819187	460.3070884			26.38188599	6.971329513			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															158.4845	41.1328	24.9268	0.121911129	40.637	0.162548173	0.162548173	28.4459	34.5838		0.081274086		40.637	0.175427953	8.1274	19.6617	0.406370432	20.3185			0.162548173	0.181052187			12.1911		12.1911															4.1471	0.229769797	2.05566717	1.932522111	0.662638402	1.53267076	1.534003341	0.585499262	0.997691773	0	3.776266336	0	0.038577438	0.115815894	2.384496422	6.795661652	1.219850559	0.779396626	0	0	4.288327358	1.262174456	0	0	0.438880066	0	0.252965594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.03	0	8.071067066	4.1471	0.229769797	2.05566717	1.932522111	0.662638402	1.53267076	1.534003341	0.585499262	0.997691773	0	3.776266336	0	0.038577438	0.115815894	2.384496422	6.795661652	1.219850559	0.779396626	0	0	4.288327358	1.262174456	0	0	0.438880066	0	0.252965594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.03																																																																																				0	0	0	4.1471	0.229769797	2.05566717	1.932522111	0.662638402	1.53267076	1.534003341	0.585499262	0.997691773	0	3.776266336	0	0.038577438	0.115815894	2.384496422	6.795661652	1.219850559	0.779396626	0	0	4.288327358	1.262174456	0	0	0.438880066	0	0.252965594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.03
H5421_116_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1514.43653	69.80379458	918.6884038	14.60501482	185.5972854	8.802307655	8.7676644	238.8964702	321.577733		42.25653344		10.45772925	0.600935488	3277.593131	3845.612346	2.93293468	426.6294123			24.1867475	6.311258366			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												94.3429	94.3429	21.9904	0.10755009	71.7001	0.14340012	0.14340012	35.85	122.1421		0.14340012		35.85	0.285114232	14.34	22.0874	0.3585003	20.5152			0.14340012	0.273916563			21.51		21.51															11.9064	0.548791261	1.683527765	1.570770658	1.108944707	1.262251974	1.257284127	0.713703802	3.27318237	0	6.059591964	0	0.031242492	0.17133526	3.916727067	7.078306588	1.051457962	0.729366176	0	0	3.468382493	1.728758202	0	0	0.774360648	0	0.446332873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7807	0	19.25368606	11.9064	0.548791261	1.683527765	1.570770658	1.108944707	1.262251974	1.257284127	0.713703802	3.27318237	0	6.059591964	0	0.031242492	0.17133526	3.916727067	7.078306588	1.051457962	0.729366176	0	0	3.468382493	1.728758202	0	0	0.774360648	0	0.446332873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7807																																																																																				0	0	0	11.9064	0.548791261	1.683527765	1.570770658	1.108944707	1.262251974	1.257284127	0.713703802	3.27318237	0	6.059591964	0	0.031242492	0.17133526	3.916727067	7.078306588	1.051457962	0.729366176	0	0	3.468382493	1.728758202	0	0	0.774360648	0	0.446332873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7807
H5421_117_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1498.825839	69.08426264	909.218637	14.4544675	183.6841633	8.71157417	8.677288015	236.43862	318.2629354		41.82095646		10.34993181	0.594741093	6099.220442	3805.97208	2.902702223	422.2317504			23.93743244	6.246202419			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												117.9426	117.9426	23.7023	0.130735052	114.3932	0.130735052	0.130735052	35.9615	222.7091		0.130735052		32.6838	0.298637711	13.0735	23.9315	0.32683763	21.6694			0.130735052	0.28358691			22.8786		22.8786															14.7313	0.678998286	1.795878419	1.889705561	1.751017819	1.138908103	1.134425701	0.708558161	5.906671572	0	5.467464923	0	0.02818956	0.177612119	6.644849186	7.590204918	0.948712316	0.762458278	0	0	3.129461477	1.771341241	0	0	0.823630828	0	0.474731658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5541	0	30.4928345	14.7313	0.678998286	1.795878419	1.889705561	1.751017819	1.138908103	1.134425701	0.708558161	5.906671572	0	5.467464923	0	0.02818956	0.177612119	6.644849186	7.590204918	0.948712316	0.762458278	0	0	3.129461477	1.771341241	0	0	0.823630828	0	0.474731658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5541																																																																																				0	0	0	14.7313	0.678998286	1.795878419	1.889705561	1.751017819	1.138908103	1.134425701	0.708558161	5.906671572	0	5.467464923	0	0.02818956	0.177612119	6.644849186	7.590204918	0.948712316	0.762458278	0	0	3.129461477	1.771341241	0	0	0.823630828	0	0.474731658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5541
H5421_118_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		220.4698428	49.48955112	840.9451002	8.30322932	140.5308516	6.944725091	6.566286181	245.5184206	267.5797304		34.83838172		6.879527189	0.349512665	2672.369173	2993.776795	1.576334339	217.8115412			29.46283864	6.517026319			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															167.9758	43.5962	26.4196	0.129212189	43.0707	0.172282918	0.172282918	30.1495	39.4334		0.086141459		43.0707	0.247517467	8.6141	20.5542	0.430707296	21.5354			0.172282918	0.191175856			12.9212		12.9212															3.0861	0.179796333	1.851451749	1.072878434	0.504397192	1.196457505	1.131258945	0.616855021	0.879297263	0	3.001029034	0	0.024692188	0.08651049	1.918348165	5.127884894	0.6789387	0.390887583	0	0	5.07594382	1.245898085	0	0	0.465163879	0	0.268115291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8019	0	4.6336903	3.0861	0.179796333	1.851451749	1.072878434	0.504397192	1.196457505	1.131258945	0.616855021	0.879297263	0	3.001029034	0	0.024692188	0.08651049	1.918348165	5.127884894	0.6789387	0.390887583	0	0	5.07594382	1.245898085	0	0	0.465163879	0	0.268115291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8019																																																																																				0	0	0	3.0861	0.179796333	1.851451749	1.072878434	0.504397192	1.196457505	1.131258945	0.616855021	0.879297263	0	3.001029034	0	0.024692188	0.08651049	1.918348165	5.127884894	0.6789387	0.390887583	0	0	5.07594382	1.245898085	0	0	0.465163879	0	0.268115291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8019
H5421_119_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		874.4249271	39.96452251	737.8846154	7.293186331	122.1910711	6.020032848	5.704837341	211.8253995	234.8944957		30.59763058		6.079491962	0.306297555	2338.062728	2627.367105	1.289403487	191.6495177			25.9684009	5.736409759			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												104.7735	104.7735	24.4217	0.119440792	79.6272	0.15925439	0.15925439	39.8136	145.8055		0.15925439		39.8136	0.440977445	15.9254	24.7964	0.398135974	23.0925			0.15925439	0.298167424			23.8882		23.8882															7.6347	0.348935119	1.501697308	0.871103954	0.810811019	0.958716658	0.90852039	0.702794265	2.854075823	0	4.872806986	0	0.020170537	0.135070313	3.102889609	5.429096336	0.513357914	0.368805413	0	0	4.135581839	1.710410523	0	0	0.859973705	0	0.495679288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2352	0	9.782567812	7.6347	0.348935119	1.501697308	0.871103954	0.810811019	0.958716658	0.90852039	0.702794265	2.854075823	0	4.872806986	0	0.020170537	0.135070313	3.102889609	5.429096336	0.513357914	0.368805413	0	0	4.135581839	1.710410523	0	0	0.859973705	0	0.495679288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2352																																																																																				0	0	0	7.6347	0.348935119	1.501697308	0.871103954	0.810811019	0.958716658	0.90852039	0.702794265	2.854075823	0	4.872806986	0	0.020170537	0.135070313	3.102889609	5.429096336	0.513357914	0.368805413	0	0	4.135581839	1.710410523	0	0	0.859973705	0	0.495679288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2352
H5421_120_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		859.5325291	39.28388366	725.3176459	7.168975515	120.1100256	5.917505207	5.607677819	208.2239267	230.8939895		30.07651998		5.975951668	0.301080978	5231.263523	2582.620215	1.267443558	188.38552			25.52613107	5.638712524			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												133.0197	133.0197	26.7322	0.147447463	129.0165	0.147447463	0.147447463	40.5576	269.9913		0.147447463		36.8619	0.474135504	14.7447	27.4851	0.368618658	24.8211			0.147447463	0.313561475			25.8033		25.8033															9.5279	0.435460963	1.615779548	1.057047254	1.29134823	0.872521132	0.826837869	0.703755724	5.19494774	0	4.434706576	0	0.018357061	0.142753181	6.427804469	5.915288028	0.467203344	0.389660855	0	0	3.763763274	1.768083015	0	0	0.928919019	0	0.535418601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3176	0	16.50828663	9.5279	0.435460963	1.615779548	1.057047254	1.29134823	0.872521132	0.826837869	0.703755724	5.19494774	0	4.434706576	0	0.018357061	0.142753181	6.427804469	5.915288028	0.467203344	0.389660855	0	0	3.763763274	1.768083015	0	0	0.928919019	0	0.535418601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3176																																																																																				0	0	0	9.5279	0.435460963	1.615779548	1.057047254	1.29134823	0.872521132	0.826837869	0.703755724	5.19494774	0	4.434706576	0	0.018357061	0.142753181	6.427804469	5.915288028	0.467203344	0.389660855	0	0	3.763763274	1.768083015	0	0	0.928919019	0	0.535418601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3176
H5421_121_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		220.4698428	49.48955112	840.9451002	8.30322932	140.5308516	6.944725091	6.566286181	245.5184206	267.5797304		34.83838172		6.879527189	0.349512665	2672.369173	2993.776795	1.576334339	217.8115412			29.46283864	6.517026319			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															167.9758	43.5962	26.4196	0.129212189	43.0707	0.172282918	0.172282918	30.1495	39.4334		0.086141459		43.0707	0.247517467	8.6141	20.5542	0.430707296	21.5354			0.172282918	0.191175856			12.9212		12.9212															3.0861	0.179796333	1.851451749	1.072878434	0.504397192	1.196457505	1.131258945	0.616855021	0.879297263	0	3.001029034	0	0.024692188	0.08651049	1.918348165	5.127884894	0.6789387	0.390887583	0	0	5.07594382	1.245898085	0	0	0.465163879	0	0.268115291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8019	0	4.6336903	3.0861	0.179796333	1.851451749	1.072878434	0.504397192	1.196457505	1.131258945	0.616855021	0.879297263	0	3.001029034	0	0.024692188	0.08651049	1.918348165	5.127884894	0.6789387	0.390887583	0	0	5.07594382	1.245898085	0	0	0.465163879	0	0.268115291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8019																																																																																				0	0	0	3.0861	0.179796333	1.851451749	1.072878434	0.504397192	1.196457505	1.131258945	0.616855021	0.879297263	0	3.001029034	0	0.024692188	0.08651049	1.918348165	5.127884894	0.6789387	0.390887583	0	0	5.07594382	1.245898085	0	0	0.465163879	0	0.268115291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8019
H5421_122_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		874.4249271	39.96452251	737.8846154	7.293186331	122.1910711	6.020032848	5.704837341	211.8253995	234.8944957		30.59763058		6.079491962	0.306297555	2338.062728	2627.367105	1.289403487	191.6495177			25.9684009	5.736409759			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												104.7735	104.7735	24.4217	0.119440792	79.6272	0.15925439	0.15925439	39.8136	145.8055		0.15925439		39.8136	0.440977445	15.9254	24.7964	0.398135974	23.0925			0.15925439	0.298167424			23.8882		23.8882															7.6347	0.348935119	1.501697308	0.871103954	0.810811019	0.958716658	0.90852039	0.702794265	2.854075823	0	4.872806986	0	0.020170537	0.135070313	3.102889609	5.429096336	0.513357914	0.368805413	0	0	4.135581839	1.710410523	0	0	0.859973705	0	0.495679288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2352	0	9.782567812	7.6347	0.348935119	1.501697308	0.871103954	0.810811019	0.958716658	0.90852039	0.702794265	2.854075823	0	4.872806986	0	0.020170537	0.135070313	3.102889609	5.429096336	0.513357914	0.368805413	0	0	4.135581839	1.710410523	0	0	0.859973705	0	0.495679288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2352																																																																																				0	0	0	7.6347	0.348935119	1.501697308	0.871103954	0.810811019	0.958716658	0.90852039	0.702794265	2.854075823	0	4.872806986	0	0.020170537	0.135070313	3.102889609	5.429096336	0.513357914	0.368805413	0	0	4.135581839	1.710410523	0	0	0.859973705	0	0.495679288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2352
H5421_123_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		859.5325291	39.28388366	725.3176459	7.168975515	120.1100256	5.917505207	5.607677819	208.2239267	230.8939895		30.07651998		5.975951668	0.301080978	5231.263523	2582.620215	1.267443558	188.38552			25.52613107	5.638712524			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												133.0197	133.0197	26.7322	0.147447463	129.0165	0.147447463	0.147447463	40.5576	269.9913		0.147447463		36.8619	0.474135504	14.7447	27.4851	0.368618658	24.8211			0.147447463	0.313561475			25.8033		25.8033															9.5279	0.435460963	1.615779548	1.057047254	1.29134823	0.872521132	0.826837869	0.703755724	5.19494774	0	4.434706576	0	0.018357061	0.142753181	6.427804469	5.915288028	0.467203344	0.389660855	0	0	3.763763274	1.768083015	0	0	0.928919019	0	0.535418601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3176	0	16.50828663	9.5279	0.435460963	1.615779548	1.057047254	1.29134823	0.872521132	0.826837869	0.703755724	5.19494774	0	4.434706576	0	0.018357061	0.142753181	6.427804469	5.915288028	0.467203344	0.389660855	0	0	3.763763274	1.768083015	0	0	0.928919019	0	0.535418601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3176																																																																																				0	0	0	9.5279	0.435460963	1.615779548	1.057047254	1.29134823	0.872521132	0.826837869	0.703755724	5.19494774	0	4.434706576	0	0.018357061	0.142753181	6.427804469	5.915288028	0.467203344	0.389660855	0	0	3.763763274	1.768083015	0	0	0.928919019	0	0.535418601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3176
H5421_124_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		389.9169089	128.0348254	640.3600425	51.14582782	150.6494827	15.88962196	13.94141885	295.8234648	416.3980048		50.69379519		10.4235783	0.815944788	4283.106079	4417.8421	3.626510763	515.4483648			30.28575992	7.88297921			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															149.3793	38.7697	23.4947	0.11490719	38.3024	0.153209586	0.153209586	26.8117	29.0034		0.076604793		38.3024	0.071171915	7.6605	18.6612	0.383023966	19.1512			0.153209586	0.165069623			11.4907		11.4907															4.8538	0.41365583	1.253755062	5.877023347	0.48085302	2.434442409	2.135959016	0.660960281	1.00641326	0	3.883387698	0	0.033270669	0.058072353	2.734220463	6.8701947	1.389040536	0.822621154	0	0	4.640068753	1.301240404	0	0	0.413665883	0	0.238432419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5011	0	12.67448305	4.8538	0.41365583	1.253755062	5.877023347	0.48085302	2.434442409	2.135959016	0.660960281	1.00641326	0	3.883387698	0	0.033270669	0.058072353	2.734220463	6.8701947	1.389040536	0.822621154	0	0	4.640068753	1.301240404	0	0	0.413665883	0	0.238432419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5011																																																																																				0	0	0	4.8538	0.41365583	1.253755062	5.877023347	0.48085302	2.434442409	2.135959016	0.660960281	1.00641326	0	3.883387698	0	0.033270669	0.058072353	2.734220463	6.8701947	1.389040536	0.822621154	0	0	4.640068753	1.301240404	0	0	0.413665883	0	0.238432419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5011
H5421_125_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2139.114244	172.6642818	617.1998129	50.54369432	154.1527074	16.32285277	13.61875994	320.4033184	381.6064102		46.3717954		9.178423127	0.748123252	4040.345903	4056.385685	4.656600829	472.6807			27.10270693	7.046699028			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												86.0183	86.0183	20.05	0.098060111	65.3734	0.130746814	0.130746814	32.6867	99.4457		0.130746814		32.6867	0.107841116	13.0747	20.0206	0.326867035	19.4085			0.130746814	0.245541012			19.612		19.612															15.3336	1.237691084	1.031239253	4.956320256	0.839790641	2.134160997	1.780609476	0.872744023	3.162427646	0	6.062964516	0	0.025001033	0.080678446	4.402186292	6.767600337	1.522089308	0.764503431	0	0	3.543592586	1.73025361	0	0	0.706032797	0	0.406949459	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3604	0	30.3823228	15.3336	1.237691084	1.031239253	4.956320256	0.839790641	2.134160997	1.780609476	0.872744023	3.162427646	0	6.062964516	0	0.025001033	0.080678446	4.402186292	6.767600337	1.522089308	0.764503431	0	0	3.543592586	1.73025361	0	0	0.706032797	0	0.406949459	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3604																																																																																				0	0	0	15.3336	1.237691084	1.031239253	4.956320256	0.839790641	2.134160997	1.780609476	0.872744023	3.162427646	0	6.062964516	0	0.025001033	0.080678446	4.402186292	6.767600337	1.522089308	0.764503431	0	0	3.543592586	1.73025361	0	0	0.706032797	0	0.406949459	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3604
H5421_126_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2122.179911	171.2973822	612.3137405	50.14356434	152.932355	16.19363264	13.51094681	317.8706095	378.5854169		46.00469233		9.10576199	0.742200723	6974.942636	4024.273241	4.619736773	468.9387155			26.88814791	6.990913721			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												106.6662	106.6662	21.4361	0.118235578	103.4561	0.118235578	0.118235578	32.5214	179.8594		0.118235578		29.5589	0.111227013	11.8236	21.4302	0.295588944	20.4459			0.118235578	0.25306218			20.6912		20.6912															18.8637	1.522637114	1.09380207	5.928753299	1.318482473	1.91466351	1.597474602	0.8614671	5.674346805	0	5.439391376	0	0.022429688	0.08255277	6.872386435	7.186733618	1.365543116	0.798988552	0	0	3.179135702	1.769135865	0	0	0.74488414	0	0.429342942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6659	0	46.10201493	18.8637	1.522637114	1.09380207	5.928753299	1.318482473	1.91466351	1.597474602	0.8614671	5.674346805	0	5.439391376	0	0.022429688	0.08255277	6.872386435	7.186733618	1.365543116	0.798988552	0	0	3.179135702	1.769135865	0	0	0.74488414	0	0.429342942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6659																																																																																				0	0	0	18.8637	1.522637114	1.09380207	5.928753299	1.318482473	1.91466351	1.597474602	0.8614671	5.674346805	0	5.439391376	0	0.022429688	0.08255277	6.872386435	7.186733618	1.365543116	0.798988552	0	0	3.179135702	1.769135865	0	0	0.74488414	0	0.429342942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6659
H5421_127_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		389.9169089	128.0348254	640.3600425	51.14582782	150.6494827	15.88962196	13.94141885	295.8234648	416.3980048		50.69379519		10.4235783	0.815944788	4283.106079	4417.8421	3.626510763	515.4483648			30.28575992	7.88297921			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															149.3793	38.7697	23.4947	0.11490719	38.3024	0.153209586	0.153209586	26.8117	29.0034		0.076604793		38.3024	0.071171915	7.6605	18.6612	0.383023966	19.1512			0.153209586	0.165069623			11.4907		11.4907															4.8538	0.41365583	1.253755062	5.877023347	0.48085302	2.434442409	2.135959016	0.660960281	1.00641326	0	3.883387698	0	0.033270669	0.058072353	2.734220463	6.8701947	1.389040536	0.822621154	0	0	4.640068753	1.301240404	0	0	0.413665883	0	0.238432419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5011	0	12.67448305	4.8538	0.41365583	1.253755062	5.877023347	0.48085302	2.434442409	2.135959016	0.660960281	1.00641326	0	3.883387698	0	0.033270669	0.058072353	2.734220463	6.8701947	1.389040536	0.822621154	0	0	4.640068753	1.301240404	0	0	0.413665883	0	0.238432419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5011																																																																																				0	0	0	4.8538	0.41365583	1.253755062	5.877023347	0.48085302	2.434442409	2.135959016	0.660960281	1.00641326	0	3.883387698	0	0.033270669	0.058072353	2.734220463	6.8701947	1.389040536	0.822621154	0	0	4.640068753	1.301240404	0	0	0.413665883	0	0.238432419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5011
H5421_128_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2139.114244	172.6642818	617.1998129	50.54369432	154.1527074	16.32285277	13.61875994	320.4033184	381.6064102		46.3717954		9.178423127	0.748123252	4040.345903	4056.385685	4.656600829	472.6807			27.10270693	7.046699028			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												86.0183	86.0183	20.05	0.098060111	65.3734	0.130746814	0.130746814	32.6867	99.4457		0.130746814		32.6867	0.107841116	13.0747	20.0206	0.326867035	19.4085			0.130746814	0.245541012			19.612		19.612															15.3336	1.237691084	1.031239253	4.956320256	0.839790641	2.134160997	1.780609476	0.872744023	3.162427646	0	6.062964516	0	0.025001033	0.080678446	4.402186292	6.767600337	1.522089308	0.764503431	0	0	3.543592586	1.73025361	0	0	0.706032797	0	0.406949459	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3604	0	30.3823228	15.3336	1.237691084	1.031239253	4.956320256	0.839790641	2.134160997	1.780609476	0.872744023	3.162427646	0	6.062964516	0	0.025001033	0.080678446	4.402186292	6.767600337	1.522089308	0.764503431	0	0	3.543592586	1.73025361	0	0	0.706032797	0	0.406949459	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3604																																																																																				0	0	0	15.3336	1.237691084	1.031239253	4.956320256	0.839790641	2.134160997	1.780609476	0.872744023	3.162427646	0	6.062964516	0	0.025001033	0.080678446	4.402186292	6.767600337	1.522089308	0.764503431	0	0	3.543592586	1.73025361	0	0	0.706032797	0	0.406949459	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3604
H5421_129_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2122.179911	171.2973822	612.3137405	50.14356434	152.932355	16.19363264	13.51094681	317.8706095	378.5854169		46.00469233		9.10576199	0.742200723	6974.942636	4024.273241	4.619736773	468.9387155			26.88814791	6.990913721			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												106.6662	106.6662	21.4361	0.118235578	103.4561	0.118235578	0.118235578	32.5214	179.8594		0.118235578		29.5589	0.111227013	11.8236	21.4302	0.295588944	20.4459			0.118235578	0.25306218			20.6912		20.6912															18.8637	1.522637114	1.09380207	5.928753299	1.318482473	1.91466351	1.597474602	0.8614671	5.674346805	0	5.439391376	0	0.022429688	0.08255277	6.872386435	7.186733618	1.365543116	0.798988552	0	0	3.179135702	1.769135865	0	0	0.74488414	0	0.429342942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6659	0	46.10201493	18.8637	1.522637114	1.09380207	5.928753299	1.318482473	1.91466351	1.597474602	0.8614671	5.674346805	0	5.439391376	0	0.022429688	0.08255277	6.872386435	7.186733618	1.365543116	0.798988552	0	0	3.179135702	1.769135865	0	0	0.74488414	0	0.429342942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6659																																																																																				0	0	0	18.8637	1.522637114	1.09380207	5.928753299	1.318482473	1.91466351	1.597474602	0.8614671	5.674346805	0	5.439391376	0	0.022429688	0.08255277	6.872386435	7.186733618	1.365543116	0.798988552	0	0	3.179135702	1.769135865	0	0	0.74488414	0	0.429342942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6659
H5421_130_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		289.3722065	76.78577969	805.082711	8.000832541	99.96514675	10.24497331	10.42945176	213.6349888	281.9236059		39.70656143		1.179333112	1.00892657	2959.05129	3234.706098	1.301193236	209.5602255			25.60140504	5.860833706			432		249															1a (IP Acute) - $500 per admit	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															405.7614	41.0712	24.8894	0.121728423	40.5761	0.162304563	0.162304563	28.4033	35.7795		0.081152282		40.5761	0.21611253	8.1152	19.2045	0.405761409	20.2881			0.162304563	0.19105815			12.1728		12.1728															9.7847	0.262806816	1.669835791	0.973928725	0.338016656	1.66280592	1.692747616	0.505661531	0.840590764	0	3.222278059	0	0.003987732	0.218041673	2.001114699	5.176737739	0.527974	0.354297718	0	0	4.155224868	1.119760047	0	0	0.438222321	0	0.252586477	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2013	0	8.175543812	9.7847	0.262806816	1.669835791	0.973928725	0.338016656	1.66280592	1.692747616	0.505661531	0.840590764	0	3.222278059	0	0.003987732	0.218041673	2.001114699	5.176737739	0.527974	0.354297718	0	0	4.155224868	1.119760047	0	0	0.438222321	0	0.252586477	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2013																																																																																				0	0	0	9.7847	0.262806816	1.669835791	0.973928725	0.338016656	1.66280592	1.692747616	0.505661531	0.840590764	0	3.222278059	0	0.003987732	0.218041673	2.001114699	5.176737739	0.527974	0.354297718	0	0	4.155224868	1.119760047	0	0	0.438222321	0	0.252586477	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2013
H5421_131_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1298.456697	75.5273061	791.8878808	7.869703619	98.32677702	10.07706424	10.25851921	210.1392258	277.3030444		39.05579433		1.160004539	0.992390859	2910.554187	3181.691175	1.279867447	206.1256571			25.18181313	5.764778102			432		249															"1a (IP Acute) - $295/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												151.5815	100.2014	23.356	0.114228725	76.1525	0.152304966	0.152304966	38.0762	134.3005		0.152304966		38.0762	0.354775009	15.2305	23.8626	0.380762415	21.9863			0.152304966	0.314681437			22.8457		22.8457															16.4018	0.630662051	1.541275571	0.898946207	0.623985685	1.534786928	1.56242342	0.666775993	3.103495605	0	5.948391431	0	0.003680718	0.352075476	3.694098806	6.326945091	0.48732542	0.377661361	0	0	3.835315194	1.814068659	0	0	0.822446817	0	0.474049207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1002	0	16.00228824	16.4018	0.630662051	1.541275571	0.898946207	0.623985685	1.534786928	1.56242342	0.666775993	3.103495605	0	5.948391431	0	0.003680718	0.352075476	3.694098806	6.326945091	0.48732542	0.377661361	0	0	3.835315194	1.814068659	0	0	0.822446817	0	0.474049207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1002																																																																																				0	0	0	16.4018	0.630662051	1.541275571	0.898946207	0.623985685	1.534786928	1.56242342	0.666775993	3.103495605	0	5.948391431	0	0.003680718	0.352075476	3.694098806	6.326945091	0.48732542	0.377661361	0	0	3.835315194	1.814068659	0	0	0.822446817	0	0.474049207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1002
H5421_132_0	2008	6																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1217.288697	70.8060086	742.3860719	7.377759527	92.18025875	9.447135536	9.617247547	197.0244994	259.9685169		36.61437237		1.087491341	0.930355382	5997.907647	2982.800054	1.199861483	193.2405087			23.60766945	5.40441529			432		249															"1a (IP Acute) - $350/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $250/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												170.4628	130.2253	26.1706	0.144349904	126.3062	0.144349904	0.144349904	39.7056	254.5717		0.144349904		36.0875	0.384257789	14.435	27.1887	0.360874761	24.1751			0.144349904	0.341019465			25.2612		25.2612															17.2919	0.768394276	1.61905974	1.064978881	0.97024459	1.36369311	1.388248763	0.651914528	5.515052933	0	5.285281146	0	0.003270401	0.357496302	7.214978289	6.758197477	0.432999725	0.389301265	0	0	3.407764825	1.843010809	0	0	0.909404397	0	0.52417059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7593	0	22.26750606	17.2919	0.768394276	1.61905974	1.064978881	0.97024459	1.36369311	1.388248763	0.651914528	5.515052933	0	5.285281146	0	0.003270401	0.357496302	7.214978289	6.758197477	0.432999725	0.389301265	0	0	3.407764825	1.843010809	0	0	0.909404397	0	0.52417059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7593																																																																																				0	0	0	17.2919	0.768394276	1.61905974	1.064978881	0.97024459	1.36369311	1.388248763	0.651914528	5.515052933	0	5.285281146	0	0.003270401	0.357496302	7.214978289	6.758197477	0.432999725	0.389301265	0	0	3.407764825	1.843010809	0	0	0.909404397	0	0.52417059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7593
H5421_133_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		289.3722065	76.78577969	805.082711	8.000832541	99.96514675	10.24497331	10.42945176	213.6349888	281.9236059		39.70656143		1.179333112	1.00892657	2959.05129	3234.706098	1.301193236	209.5602255			25.60140504	5.860833706			432		249															1a (IP Acute) - $500 per admit	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															405.7614	41.0712	24.8894	0.121728423	40.5761	0.162304563	0.162304563	28.4033	35.7795		0.081152282		40.5761	0.21611253	8.1152	19.2045	0.405761409	20.2881			0.162304563	0.19105815			12.1728		12.1728															9.7847	0.262806816	1.669835791	0.973928725	0.338016656	1.66280592	1.692747616	0.505661531	0.840590764	0	3.222278059	0	0.003987732	0.218041673	2.001114699	5.176737739	0.527974	0.354297718	0	0	4.155224868	1.119760047	0	0	0.438222321	0	0.252586477	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2013	0	8.175543812	9.7847	0.262806816	1.669835791	0.973928725	0.338016656	1.66280592	1.692747616	0.505661531	0.840590764	0	3.222278059	0	0.003987732	0.218041673	2.001114699	5.176737739	0.527974	0.354297718	0	0	4.155224868	1.119760047	0	0	0.438222321	0	0.252586477	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2013																																																																																				0	0	0	9.7847	0.262806816	1.669835791	0.973928725	0.338016656	1.66280592	1.692747616	0.505661531	0.840590764	0	3.222278059	0	0.003987732	0.218041673	2.001114699	5.176737739	0.527974	0.354297718	0	0	4.155224868	1.119760047	0	0	0.438222321	0	0.252586477	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2013
H5421_134_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1298.456697	75.5273061	791.8878808	7.869703619	98.32677702	10.07706424	10.25851921	210.1392258	277.3030444		39.05579433		1.160004539	0.992390859	2910.554187	3181.691175	1.279867447	206.1256571			25.18181313	5.764778102			432		249															"1a (IP Acute) - $295/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												151.5815	100.2014	23.356	0.114228725	76.1525	0.152304966	0.152304966	38.0762	134.3005		0.152304966		38.0762	0.354775009	15.2305	23.8626	0.380762415	21.9863			0.152304966	0.314681437			22.8457		22.8457															16.4018	0.630662051	1.541275571	0.898946207	0.623985685	1.534786928	1.56242342	0.666775993	3.103495605	0	5.948391431	0	0.003680718	0.352075476	3.694098806	6.326945091	0.48732542	0.377661361	0	0	3.835315194	1.814068659	0	0	0.822446817	0	0.474049207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1002	0	16.00228824	16.4018	0.630662051	1.541275571	0.898946207	0.623985685	1.534786928	1.56242342	0.666775993	3.103495605	0	5.948391431	0	0.003680718	0.352075476	3.694098806	6.326945091	0.48732542	0.377661361	0	0	3.835315194	1.814068659	0	0	0.822446817	0	0.474049207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1002																																																																																				0	0	0	16.4018	0.630662051	1.541275571	0.898946207	0.623985685	1.534786928	1.56242342	0.666775993	3.103495605	0	5.948391431	0	0.003680718	0.352075476	3.694098806	6.326945091	0.48732542	0.377661361	0	0	3.835315194	1.814068659	0	0	0.822446817	0	0.474049207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1002
H5421_135_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1217.288697	70.8060086	742.3860719	7.377759527	92.18025875	9.447135536	9.617247547	197.0244994	259.9685169		36.61437237		1.087491341	0.930355382	5997.907647	2982.800054	1.199861483	193.2405087			23.60766945	5.40441529			432		249															"1a (IP Acute) - $350/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $250/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												170.4628	130.2253	26.1706	0.144349904	126.3062	0.144349904	0.144349904	39.7056	254.5717		0.144349904		36.0875	0.384257789	14.435	27.1887	0.360874761	24.1751			0.144349904	0.341019465			25.2612		25.2612															17.2919	0.768394276	1.61905974	1.064978881	0.97024459	1.36369311	1.388248763	0.651914528	5.515052933	0	5.285281146	0	0.003270401	0.357496302	7.214978289	6.758197477	0.432999725	0.389301265	0	0	3.407764825	1.843010809	0	0	0.909404397	0	0.52417059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7593	0	22.26750606	17.2919	0.768394276	1.61905974	1.064978881	0.97024459	1.36369311	1.388248763	0.651914528	5.515052933	0	5.285281146	0	0.003270401	0.357496302	7.214978289	6.758197477	0.432999725	0.389301265	0	0	3.407764825	1.843010809	0	0	0.909404397	0	0.52417059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7593																																																																																				0	0	0	17.2919	0.768394276	1.61905974	1.064978881	0.97024459	1.36369311	1.388248763	0.651914528	5.515052933	0	5.285281146	0	0.003270401	0.357496302	7.214978289	6.758197477	0.432999725	0.389301265	0	0	3.407764825	1.843010809	0	0	0.909404397	0	0.52417059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7593
H5421_801_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P																																																				0		246.1990317	6.498420079	27.4350321		7.140464037	12.40253128	11.83437711	13.75257744	41.58433865	16.98663708	43.18314009	3.321116832	0.512477563	26.92568312	36.57759599	93.60476148	3.184560605	4.961882756			25.74767853	8.278733064																				Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare														0.080910157	0.080910157	0.195734505		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				19.92	0.52578819	5.36998242	0	1.670868585	2.902192319	2.769244244	3.21810312	9.730735243	3.974873078	10.10485478	0.777141339	0.11991975	6.300609851	8.559157462	21.90351419	0.745187182	1.161080565	0	0	6.024956776	1.937223537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.7154	0	0	19.92	0.52578819	5.36998242	0	1.670868585	2.902192319	2.769244244	3.21810312	9.730735243	3.974873078	10.10485478	0.777141339	0.11991975	6.300609851	8.559157462	21.90351419	0.745187182	1.161080565	0	0	6.024956776	1.937223537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.7154																																																																																				0	0	0	19.92	0.52578819	5.36998242	0	1.670868585	2.902192319	2.769244244	3.21810312	9.730735243	3.974873078	10.10485478	0.777141339	0.11991975	6.300609851	8.559157462	21.90351419	0.745187182	1.161080565	0	0	6.024956776	1.937223537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.7154
H5421_804_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P																																																				0		246.1990317	6.498420079	27.4350321		7.140464037	12.40253128	11.83437711	13.75257744	41.58433865	16.98663708	43.18314009	3.321116832	0.512477563	26.92568312	36.57759599	93.60476148	3.184560605	4.961882756			25.74767853	8.278733064																				Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare														0.080910157	0.080910157	0.195734505		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				19.92	0.52578819	5.36998242	0	1.670868585	2.902192319	2.769244244	3.21810312	9.730735243	3.974873078	10.10485478	0.777141339	0.11991975	6.300609851	8.559157462	21.90351419	0.745187182	1.161080565	0	0	6.024956776	1.937223537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.7154	0	0	19.92	0.52578819	5.36998242	0	1.670868585	2.902192319	2.769244244	3.21810312	9.730735243	3.974873078	10.10485478	0.777141339	0.11991975	6.300609851	8.559157462	21.90351419	0.745187182	1.161080565	0	0	6.024956776	1.937223537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.7154																																																																																				0	0	0	19.92	0.52578819	5.36998242	0	1.670868585	2.902192319	2.769244244	3.21810312	9.730735243	3.974873078	10.10485478	0.777141339	0.11991975	6.300609851	8.559157462	21.90351419	0.745187182	1.161080565	0	0	6.024956776	1.937223537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.7154
H5421_805_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P																																																				0		246.1990317	6.498420079	27.4350321		7.140464037	12.40253128	11.83437711	13.75257744	41.58433865	16.98663708	43.18314009	3.321116832	0.512477563	26.92568312	36.57759599	93.60476148	3.184560605	4.961882756			25.74767853	8.278733064																				Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare														0.080910157	0.080910157	0.195734505		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				19.92	0.52578819	5.36998242	0	1.670868585	2.902192319	2.769244244	3.21810312	9.730735243	3.974873078	10.10485478	0.777141339	0.11991975	6.300609851	8.559157462	21.90351419	0.745187182	1.161080565	0	0	6.024956776	1.937223537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.7154	0	0	19.92	0.52578819	5.36998242	0	1.670868585	2.902192319	2.769244244	3.21810312	9.730735243	3.974873078	10.10485478	0.777141339	0.11991975	6.300609851	8.559157462	21.90351419	0.745187182	1.161080565	0	0	6.024956776	1.937223537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.7154																																																																																				0	0	0	19.92	0.52578819	5.36998242	0	1.670868585	2.902192319	2.769244244	3.21810312	9.730735243	3.974873078	10.10485478	0.777141339	0.11991975	6.300609851	8.559157462	21.90351419	0.745187182	1.161080565	0	0	6.024956776	1.937223537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.7154
H5422_002_0	2008	5	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			none	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			A	A	D		T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin		Coin			V	V	V	V					V	V	V	V	V	V	V	V																																												0	none	337.878979	7.612759838	344.1214362	0	220.4608546	12.41477775	4.426157125	265.3911033	340.4216606	704.0485266	6.227399559	41.77408859	0.132432135	0.318525951	5561.562485	1973.978098	3.174499025	432.9970033	3.679996301	0	12.13482441	0	0	1900.71	416.745	329.6475	178.605	0	0	0	0	906.3596944	14.81735534	76.0835356	414.9385088	112.2787676	13.07062357	841.2066104	3.91215218			$400/admit	$400/admit	$175/day for days 21 to 100	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	20% coin on Higher Tier	$200 copay	20% coin	$15 copay	$15 copay	$15 copay	$25 copay	$15 copay	20% coin on Higher Tier	N/A	20% coinsurance	N/A	N/A	$15/$40/$40/$5	$15 copay	$100 glasses / $110 contacts	$15 copay	N/A	N/A	0	N/A	$15 copay	$0 copay	$15 copay	$15 copay	$15 copay	$0 copay	$15 copay	$15 copay			400	400	175	0	100	0.2	0.2	50	200	51.0657015	0.2	200	0.2	15	15	15	25	15	0.2	0	0.2	0	0	28.5	15	0	15	0	0	0	0	15	0	15	15	15	0	15	15			11.2626	0.253758661	5.018437611	0	1.837173789	2.48295555	0.885231425	1.105796264	5.673694344	2.996060992	1.245479912	0.69623481	0.026486427	0.000398157	6.951953106	2.467472623	0.00661354	0.541246254	0.73599926	0	2.426964882	0	0	4.51418625	0.52093125	0	0.22325625	0	0	0	0	1.132949618	0	0.095104419	0.518673136	0.140348459	0	1.051508263	0.00489019	0	0	54.8164		0	11.2626	0.253758661	5.018437611	0	1.837173789	2.48295555	0.885231425	1.105796264	5.673694344	2.996060992	1.245479912	0.69623481	0.026486427	0.000398157	6.951953106	2.467472623	0.00661354	0.541246254	0.73599926	0	2.426964882	0	0	4.51418625	0.52093125	0	0.22325625	0	0	0	0	1.132949618	0	0.095104419	0.518673136	0.140348459	0	1.051508263	0.00489019	0	0	54.8164	none																																																																																			0		0	11.2626	0.253758661	5.018437611	0	1.837173789	2.48295555	0.885231425	1.105796264	5.673694344	2.996060992	1.245479912	0.69623481	0.026486427	0.000398157	6.951953106	2.467472623	0.00661354	0.541246254	0.73599926	0	2.426964882	0	0	4.51418625	0.52093125	0	0.22325625	0	0	0	0	1.132949618	0	0.095104419	0.518673136	0.140348459	0	1.051508263	0.00489019	0	0	54.8164
H5424_001_0	2008	7																					2200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	3750	1532.691547	188.632025	359.8219611		68.32590533	5.961387392	1.509183074	575.4003088	19.55139838	9289.117418	32.7976615		0.114920516	16.58313619	4503.537481	4366.857594	441.4299906	3.751837379			9.444707413	989.4090948			224.848647		15.46132082				115.6											$175 (1a); $0 (1a1)	$175 (1b)	"$110 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20% (9b)	20% (8a1); $0/$20 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	20% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $10 (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 (10b)	$0 n/c; $0 (16)	$20 (17a1)	$0; $0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											110.4268	110.4268	69.4112		110.4268	0.126202097	0.177250204	31.5505	0.126202097	5.0481	0.080003772		0.126202097	0.126143979	5	19.3673	37.5	0.126202097			0.126202097	20			20		20				10											14.1042	1.73583645	2.081304769	0	0.62875112	0.752339587	0.267503007	1.512848444	2.467427466	3.907686977	2.62393663	0	0.01450321	2.091862777	1.876473951	7.047858953	1.379468721	0.473489743	0	0	1.191941877	1.649015158	0	0	0.374747745	0	0.025768868	0	0	0	0.096333333	0	0	0	0	0	0	0	0	0	0	46.3033	0	19.67332727	14.1042	1.73583645	2.081304769	0	0.62875112	0.752339587	0.267503007	1.512848444	2.467427466	3.907686977	2.62393663	0	0.01450321	2.091862777	1.876473951	7.047858953	1.379468721	0.473489743	0	0	1.191941877	1.649015158	0	0	0.374747745	0	0.025768868	0	0	0	0.096333333	0	0	0	0	0	0	0	0	0	0	46.3033		$375 (1a); $0 (1a1)	$375 (1b)	"$125 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); 50% (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	50% (10b)	$0 n/c; 50% (16)	$35 (17a1)	$0; $0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5); 50% (14a6); $0/50% (14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.6166	0.322	0.7849	0.1901	0.1565	0.2809	0.1002	0.3765	0.9212	0.9726	0.9691		0.0054	0.7808	1.5008	2.2563	0.2759	0.1248			0.3141	0.5143		0.2963	0.1157		0.008				0.0638											13.9469	0	5.221290666	16.7207	2.057861877	2.866210925	0.190135115	0.785247668	1.03322628	0.367719812	1.889397371	3.388643833	4.880312718	3.593085274	0	0.019917997	2.872693356	3.377287248	9.304186293	1.655362465	0.598274102	0	0	1.506068433	2.163309704	0	0.29625	0.490478666	0	0.033726901	0	0	0	0.160083333	0	0	0	0	0	0	0	0	0	0	60.2502
H5424_003_0	2008	6																					2500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	3750	1573.98302	131.7010549	679.8692272		83.98874274	9.874318964	1.99002339	570.1389021	28.18687277	10673.71272	46.81046329		0.221524224	22.45616477	4388.756239	4852.100412	448.3587966	3.486063905			16.4893244	1148.331066			196.2686655		29.65131031				115.6											$250 (1a); $0 (1a1)	$250 (1b)	"$25 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	20% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$10 (7b, 7b1, 7d, 7f, 7f1, 7g)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $10 (17a, 18a, 16b)"	$0 (10b)	$0 n/c; $0 (16)	$10 (17a1)	$0; $0 n/c (17b)	$10 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											149.3526	149.3526	14.9353		104.5468	0.119482041	0.190689522	29.8705	0.119482041	3.5845	0.078635822		0.119482041	0.119447395	5	9.9997	37.5	0.119482041			0.119482041	10			10		10				10											19.5899	1.63915738	0.846168363	0	0.731729425	1.179803784	0.379476608	1.419194994	3.367825089	3.188292452	3.680979265	0	0.026468166	2.682330377	1.828648433	4.043305293	1.40112124	0.416522031	0	0	1.970178134	0.956942555	0	0	0.163557221	0	0.024709425	0	0	0	0.096333333	0	0	0	0	0	0	0	0	0	0	49.6326	0	27.47078641	19.5899	1.63915738	0.846168363	0	0.731729425	1.179803784	0.379476608	1.419194994	3.367825089	3.188292452	3.680979265	0	0.026468166	2.682330377	1.828648433	4.043305293	1.40112124	0.416522031	0	0	1.970178134	0.956942555	0	0	0.163557221	0	0.024709425	0	0	0	0.096333333	0	0	0	0	0	0	0	0	0	0	49.6326		$375 (1a); $0 (1a1)	$375 (1b)	"$125 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); 50% (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	50% (10b)	$0 n/c; 50% (16)	$35 (17a1)	$0; $0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7); $0 n/c (14a2, 14a3, 14a4, 14a5); 50% (14a6); $0/50% (14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.4945	0.2087	1.3768	0.4131	0.1786	0.4319	0.1421	0.3464	1.2329	1.0375	1.3362		0.0097	0.9818	1.4785	2.4897	0.2802	0.1076			0.5091	0.5984		0.2963	0.101		0.0153				0.0638											16.1299	0	7.467358253	22.0843	1.847878374	2.222926325	0.41305483	0.910313444	1.61171364	0.521535258	1.765560107	4.6007393	4.225794492	5.017216832	0	0.036157796	3.66412141	3.307144344	6.532990872	1.681345487	0.52415706	0	0	2.479299298	1.555333541	0	0.29625	0.264577858	0	0.039971129	0	0	0	0.160083333	0	0	0	0	0	0	0	0	0	0	65.7625
H5424_005_0	2008	4																					1100											D	D	D	V	T	V	P	V	V	Coin	V	V	V	V	V		V	V		V	S	P	T	V	V	P	V	P																																																							0		1828.635287	222.4253897	1146.509939		321.4495139	2186.796299	800.2788759	826.4916866	258.1737779	12.64478235	177.412622	37.58864287	22.1229284	1948.844164		1813.338197		732.6637639				664.7139941																				1(a) $110 per Day	1(b) $110 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per preocedure; other $0 per procedure	8(b) X-rays $0 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a), 9(d) $25 per visit; 9(c) $0/0 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  $0 per script	"13, 14(a)-(j) $0; 17(a), 16(b) $10 per procedure"	10(b) $0 Copay	16(a)/16(b) $0 copay per visit	17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a/18a1 $10/$0 per visit	18(b) $0 copay per procedure														64.6614	64.6614	24.6889		44.0873	11.4802	16.8745	26.3054	14.6958	0.334123084	5.8783	14.6958	159.218	14.6958		5.8783		5.8783				5.8783																				9.8535	1.198528302	2.358839344	0	1.180987458	2.09207027	1.125359925	1.811768806	0.316171986	4.224913677	0.086907201	0.046032854	0.293530676	2.386647997	0	0.888280357	0	0.358902069	0	0	0	0.32561625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.5481	0	20.01702584	9.8535	1.198528302	2.358839344	0	1.180987458	2.09207027	1.125359925	1.811768806	0.316171986	4.224913677	0.086907201	0.046032854	0.293530676	2.386647997	0	0.888280357	0	0.358902069	0	0	0	0.32561625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.5481		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"4(a)$50 per Visit, 4(b) $35 per Visit"	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															1.711	0.0533	0.2862	0.2154	0.0856	0.1089	0.06	0.0668	0.1594	0.0747	0.1421	0.0127	0.014	0.1454	0.0728	0.1108	0.026	0.0395			0.1279	0.0417	0.0077		0.0049		0.006															3.5729	0	0	11.5645	1.251857518	2.64505089	0.21537576	1.266616021	2.201018192	1.185321491	1.878585621	0.475588457	4.299583578	0.229021352	0.058767403	0.307523598	2.532027657	0.072806286	0.999038818	0.026048178	0.398377145	0	0	0.127875887	0.36735965	0.00774	0	0.004862961	0	0.00598221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1209
H5424_801_0	2008	1																					3500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1609.326125	198.0636262	377.8130592		71.74220059	6.259456762	1.584642228	604.1661299	20.5289683	9753.573288	34.43754457		0.120666542	17.412293	4727.254863	4299.388792	463.5014901	3.939429248			9.916942784	1038.87955			234.486752		16.04661213															$350 (1a); $0 (1a1)	$350 (1b)	"$130 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	$0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											216.2977	216.2977	80.3391		108.1488	0.185398017	0.264671466	30.8997	0.185398017	3.708	0.113750757		0.185398017	0.185252882	10	19.99	37.5	0.185398017			0.185398017	20			20		20															29.0078	3.570058685	2.529431382	0	0.646569669	1.160490874	0.419409581	1.555711148	3.806030022	3.013821917	3.917296768	0	0.022371338	3.225677469	3.939379053	7.162077615	1.448442157	0.730362372	0	0	1.838581531	1.731465916	0	0	0.390811253	0	0.026744354	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1425	0	34.06774968	29.0078	3.570058685	2.529431382	0	0.646569669	1.160490874	0.419409581	1.555711148	3.806030022	3.013821917	3.917296768	0	0.022371338	3.225677469	3.939379053	7.162077615	1.448442157	0.730362372	0	0	1.838581531	1.731465916	0	0	0.390811253	0	0.026744354	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1425		$350 (1a); $0 (1a1)	$350 (1b)	"$130 (2a, 2a2)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	40% (9b)	40% (8a1); $0/$20 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	40% (incl in h5)	30% (12)	"40% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 40% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 40% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											4.0816	0.5023	1.3643	0.2662	0.2616	0.4695	0.1188	0.6293	2.0529	1.6256	2.1129		0.009	1.7395	1.7831	2.2114	0.2897	0.2781			0.525	0.5418			0.1207		0.0083															20.9916	0	0	33.0894	4.072393969	3.893756318	0.266189161	0.908129775	1.629950131	0.538257749	2.185050867	5.858926852	4.639417465	6.030208666	0	0.031421328	4.965144738	5.722500184	9.37343436	1.738130588	1.008439731	0	0	2.363596149	2.273239142	0	0	0.511502964	0	0.035003639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.1341
H5425_001_0	2008	10																																D	D	D		T	Coin	Coin	V	V		Coin			V	V	V	V	V	Coin	V	Coin	O			V	P	V																																																								0		352.5300292	6.239210321	300.2077301	0	146.6753018	4.792453987	2.998140928	148.071214	192.6468659	0	19.44528327	0	0	163.0847331	4204.108936	3809.723796	183.030028	1570.126053	34.79819877	10831.09557	9.704579281	2599.031707	0	0	276.1685577	189.8217388	522.7602777	0	0	0	3392.811589											copay/days 1-4	copay/days 1-4	copay/days 21-100	0	$100/run	0-10% DME	"0-10% Prosthetics, 0% Diab Supplies"	"$50 ER, $25 urgent care"	$100/OP hospital and ASC visits	0	"20% rad therapy, 20% specialized"	0	0	$10/visit cardiac rehab	$10/visit	$10/visit	$10/visit	"$10 PT & OT, $20 CORF"	"20% rad therapy, 20% specialized"	"$10 hearing, podiatry, & chiro, 20% lab"	20% coinsurance	$10/visit	0	0	$10/visit	$25/service	$0-$10/visit	0	0	0	Copay for In-Home Assistance Benefit											100	100	20	0	100	0.05	0.04570521	40.42664427	100	0	0.088	0	0	10	10	10	10	11	0.088	4.071963142	0.2	10	0	0	10	25	5	0	0	0	15											2.9378	0.051993419	0.500346217	0	1.222294182	0.239622699	0.13703066	0.498835191	1.60539055	0	1.711184928	0	0	0.135903944	3.503424113	3.17476983	0.152525023	1.439282215	3.062241491	3.675318495	1.940915856	2.165859756	0	0	0.230140465	0.395461956	0.217816782	0	0	0	4.241014486	0	0	0	0	0	0	0	0	0	0	33.2391			2.9378	0.051993419	0.500346217	0	1.222294182	0.239622699	0.13703066	0.498835191	1.60539055	0	1.711184928	0	0	0.135903944	3.503424113	3.17476983	0.152525023	1.439282215	3.062241491	3.675318495	1.940915856	2.165859756	0	0	0.230140465	0.395461956	0.217816782	0	0	0	4.241014486	0	0	0	0	0	0	0	0	0	0	33.2391																																																																																				0			2.9378	0.051993419	0.500346217	0	1.222294182	0.239622699	0.13703066	0.498835191	1.60539055	0	1.711184928	0	0	0.135903944	3.503424113	3.17476983	0.152525023	1.439282215	3.062241491	3.675318495	1.940915856	2.165859756	0	0	0.230140465	0.395461956	0.217816782	0	0	0	4.241014486	0	0	0	0	0	0	0	0	0	0	33.2391
H5425_003_0	2008	9																																D	D	D		T	Coin	Coin	V	V		Coin			V	V	V	V	V	Coin	V	Coin	O			V	P	V																																																								0		537.1537172	9.562779438	433.1030939	0	193.1358838	13.75521222	8.58571065	302.4217646	190.7107011	0	20.86011811	0	0	173.1834795	3922.793103	3548.465387	179.0957259	1535.214278	37.81096532	10443.27264	5.96202221	668.1361295	0	0	294.8057885	218.5629122	174.3568044	0	0	0	1730.702601											copay/days 1-4	copay/days 1-4	copay/days 21-100	0	$100/run	0-10% DME	"0-10% Prosthetics, 0% Diab Supplies"	"$50 ER, $25 urgent care"	$100/OP hospital and ASC visits	0	"20% rad therapy, 20% specialized"	0	0	$10/visit cardiac rehab	$10/visit	$10/visit	$10/visit	"$10 PT & OT, $20 CORF"	"20% rad therapy, 20% specialized"	"$10 hearing, podiatry, & chiro, 20% lab"	20% coinsurance	$10/visit	0	0	$10/visit	$25/service	$0-$10/visit	0	0	0	Copay for In-Home Assistance Benefits											100	100	20	0	100	0.05	0.045684211	41.741239	100	0	0.088	0	0	10	10	10	10	11	0.088	4.335471306	0.2	10	0	0	10	25	5	0	0	0	15											4.4763	0.079689829	0.72183849	0	1.609465699	0.687760611	0.392231413	1.051954929	1.589255842	0	1.835690394	0	0	0.144319566	3.268994253	2.957054489	0.149246438	1.407279754	3.327364948	3.773042407	1.192404442	0.556780108	0	0	0.24567149	0.4553394	0.072648668	0	0	0	2.163378251	0	0	0	0	0	0	0	0	0	0	32.1577			4.4763	0.079689829	0.72183849	0	1.609465699	0.687760611	0.392231413	1.051954929	1.589255842	0	1.835690394	0	0	0.144319566	3.268994253	2.957054489	0.149246438	1.407279754	3.327364948	3.773042407	1.192404442	0.556780108	0	0	0.24567149	0.4553394	0.072648668	0	0	0	2.163378251	0	0	0	0	0	0	0	0	0	0	32.1577																																																																																				0			4.4763	0.079689829	0.72183849	0	1.609465699	0.687760611	0.392231413	1.051954929	1.589255842	0	1.835690394	0	0	0.144319566	3.268994253	2.957054489	0.149246438	1.407279754	3.327364948	3.773042407	1.192404442	0.556780108	0	0	0.24567149	0.4553394	0.072648668	0	0	0	2.163378251	0	0	0	0	0	0	0	0	0	0	32.1577
H5425_004_0	2008	9																																				T	Coin	Coin	V	V		Coin			V	V	V	V	V	Coin	V	Coin	O			V	P	V																																																								0		0	0	0	0	162.4918989	11.91067387	7.471319863	333.6962648	220.0050557	0	24.11458924	0	0	199.7414321	4057.342889	3671.85564	176.7029866	1513.536591	26.54384314	1346.731019	6.494695618	644.902913	0	0	301.1074036	219.2529638	176.6346029	0	0	0	1459.07042											0	0	0	0	$100/run	20% DME	"20% Prosthetics, 0% Diab. Supplies"	"$50 ER, $25 urgent care"	$200/OP hospital and ASC visits	0	"20% rad therapy, 20% specialized"	0	0	$25/visit cardiac rehab	$10/visit	$25/visit	$25/visit	"$25 PT & OT, $20 CORF"	"20% rad therapy, 20% specialized"	"$10 hearing, $25 podiatry & chiro"	20% coinsurance	$10/visit	0	0	$10/visit	$25/service	$0-$10/visit	0	0	0	Copay for In-Home Assistance Benefit											0	0	0	0	100	0.2	0.182790698	42.63909517	200	0	0.088	0	0	25	10	25	25	24.5	0.088	24.03351495	0.2	10	0	0	10	25	5	0	0	0	15											0	0	0	0	1.354099157	2.382134775	1.36568777	1.185708899	3.666750928	0	2.122083853	0	0	0.416127984	3.381119074	7.649699249	0.368131222	3.090137206	2.335858196	2.697223341	1.298939124	0.537419094	0	0	0.250922836	0.456777008	0.073597751	0	0	0	1.823838025	0	0	0	0	0	0	0	0	0	0	36.4563			0	0	0	0	1.354099157	2.382134775	1.36568777	1.185708899	3.666750928	0	2.122083853	0	0	0.416127984	3.381119074	7.649699249	0.368131222	3.090137206	2.335858196	2.697223341	1.298939124	0.537419094	0	0	0.250922836	0.456777008	0.073597751	0	0	0	1.823838025	0	0	0	0	0	0	0	0	0	0	36.4563																																																																																				0			0	0	0	0	1.354099157	2.382134775	1.36568777	1.185708899	3.666750928	0	2.122083853	0	0	0.416127984	3.381119074	7.649699249	0.368131222	3.090137206	2.335858196	2.697223341	1.298939124	0.537419094	0	0	0.250922836	0.456777008	0.073597751	0	0	0	1.823838025	0	0	0	0	0	0	0	0	0	0	36.4563
H5425_005_0	2008	9																																				T	Coin	Coin	V	V		Coin			V	V	V	V	V	Coin	V	Coin	O			V	P	V																																																								0		0	0	0	0	146.5311746	10.74075105	6.737451422	300.9190364	198.3951166	0	21.74594001	0	0	180.1218822	3281.257505	2969.505956	142.9033771	1224.028492	21.46655752	1089.12936	6.366038955	632.1277098	0	0	294.0678799	214.127097	173.13556	0	0	0	1425.128655											0	0	0	0	$100/run	20% DME	"20% Prosthetics, 0% Diab. Supplies"	"$50 ER, $25 urgent care"	$100/OP hospital and ASC visits	0	"20% rad therapy, 20% specialized"	0	0	$25/visit cardiac rehab	$10/visit	$25/visit	$25/visit	"$25 PT & OT, $20 CORF"	"20% rad therapy, 20% specialized"	"$10 hearing, $25 podiatry & chiro"	20% coinsurance	$10/visit	0	0	$10/visit	$25/service	$0-$10/visit	0	0	0	Copay for In-Home Assistance Benefit											0	0	0	0	100	0.2	0.182790698	42.63909517	100	0	0.088	0	0	25	10	25	25	24.5	0.088	24.03351495	0.2	10	0	0	10	25	5	0	0	0	15											0	0	0	0	1.221093122	2.148150209	1.231543446	1.069242953	1.653292638	0	1.913642721	0	0	0.375253921	2.734381254	6.186470741	0.297715369	2.499058171	1.889057062	2.181300563	1.273207791	0.526773091	0	0	0.245056567	0.446098119	0.072139817	0	0	0	1.781410819	0	0	0	0	0	0	0	0	0	0	29.7449			0	0	0	0	1.221093122	2.148150209	1.231543446	1.069242953	1.653292638	0	1.913642721	0	0	0.375253921	2.734381254	6.186470741	0.297715369	2.499058171	1.889057062	2.181300563	1.273207791	0.526773091	0	0	0.245056567	0.446098119	0.072139817	0	0	0	1.781410819	0	0	0	0	0	0	0	0	0	0	29.7449																																																																																				0			0	0	0	0	1.221093122	2.148150209	1.231543446	1.069242953	1.653292638	0	1.913642721	0	0	0.375253921	2.734381254	6.186470741	0.297715369	2.499058171	1.889057062	2.181300563	1.273207791	0.526773091	0	0	0.245056567	0.446098119	0.072139817	0	0	0	1.781410819	0	0	0	0	0	0	0	0	0	0	29.7449
H5425_006_0	2008	9																																D	D	D		T	Coin	Coin	V	V		Coin			V	V	V	V	V	Coin	V	Coin				V	P	V				V																																																				0		699.3939676	12.5482961	354.208241	0	247.2857329	2.485971734	1.559902835	796.9276111	164.9969226	0	0	0	0	0	5816.608889	5271.473881	263.8490148	2265.430584	41.55048398	2315.561897	0.000155569		0	0	195.1235416	133.4903312	25.86218138	0	0	0	2343.877459											copay/days 1-8	copay/days 1-8	copay/days 21-100	0	$50/run	0-10% DME	"0-10% Prosthetics, 0% Diab Supplies"	"$50 ER, $25 urgent care"	$50/OP hospital and ASC visits	0	"20% rad therapy, 0% specialized"	0	0	$10/visit cardiac rehab	$5/visit	$10/visit	$10/visit	"$10 PT & OT, $20 CORF"	"20% rad therapy, 20% specialized"	"$10 hearing, podiatry, & chiro"	20% coinsurance		0	0	$10/visit	$25/service	$0-$10/visit	0	0	0	ILP Services											50	50	20	0	50	0.05	0.045702532	42.50122452	50	0	0.045	0	0	10	5	10	10	11	0.088	10	0.2	0	0	0	10	25	5	0	0	0	15											2.9141	0.052284567	0.590347068	0	1.030357221	0.124298587	0.071291509	2.822533277	0.687487178	0	0	0	0	0	2.423587037	4.392894901	0.219874179	2.076644702	3.65644259	1.929634914	3.11E-05	0	0	0	0.162602951	0.278104857	0.010775909	0	0	0	2.929846824	0	0	0	0	0	0	0	0	0	0	26.3732			2.9141	0.052284567	0.590347068	0	1.030357221	0.124298587	0.071291509	2.822533277	0.687487178	0	0	0	0	0	2.423587037	4.392894901	0.219874179	2.076644702	3.65644259	1.929634914	3.11E-05	0	0	0	0.162602951	0.278104857	0.010775909	0	0	0	2.929846824	0	0	0	0	0	0	0	0	0	0	26.3732																																																																																				0			2.9141	0.052284567	0.590347068	0	1.030357221	0.124298587	0.071291509	2.822533277	0.687487178	0	0	0	0	0	2.423587037	4.392894901	0.219874179	2.076644702	3.65644259	1.929634914	3.11E-05	0	0	0	0.162602951	0.278104857	0.010775909	0	0	0	2.929846824	0	0	0	0	0	0	0	0	0	0	26.3732
H5425_007_0	2008	9																																D	D	D		T	Coin	Coin	V	V		Coin			V	V	V	V	V	Coin	V	Coin				V	P	V				V																																																				0		695.8885479	12.25531133	348.4665986	0	237.2978478	1.923839838	1.206342193	669.179177	186.0293883	0	0	0	0	0	4566.769149	4138.348966	216.6982766	1862.881343	35.19650504	11730.66036	0.000778737		0	0	199.4006425	137.0268638	19.00217978	0	0	0	3626.392461											copay/days 1-10	copay/days 1-10	copay/days 21-100	0	$50/run	0-10% DME	"0-10% Prosthetics, 0% Diab Supplies"	"$50 ER, $25 urgent care"	$50/OP hospital and ASC visits	0	"20% rad therapy, 10% specialized"	0	0	$10/visit cardiac rehab	$5/visit	$10/visit	$10/visit	"$10 PT & OT, $20 CORF"	"20% rad therapy, 20% specialized"	"$10 hearing, podiatry, & chiro"	20% coinsurance		0	0	$10/visit	$25/service	$0-$10/visit	0	0	0	ILP Services											50	50	20	0	50	0.05	0.045699346	42.42533366	50	0	0.075	0	0	10	5	10	10	11	0.088	2.974315465	0.2	0	0	0	10	25	5	0	0	0	15											2.8995	0.051063797	0.580777664	0	0.988741032	0.096191992	0.05512905	2.365845822	0.775122451	0	0	0	0	0	1.902820479	3.448624138	0.180581897	1.707641231	3.097292444	2.907557043	0.000155747	0	0	0	0.166167202	0.285472633	0.007917575	0	0	0	4.532990576	0	0	0	0	0	0	0	0	0	0	26.0496			2.8995	0.051063797	0.580777664	0	0.988741032	0.096191992	0.05512905	2.365845822	0.775122451	0	0	0	0	0	1.902820479	3.448624138	0.180581897	1.707641231	3.097292444	2.907557043	0.000155747	0	0	0	0.166167202	0.285472633	0.007917575	0	0	0	4.532990576	0	0	0	0	0	0	0	0	0	0	26.0496																																																																																				0			2.8995	0.051063797	0.580777664	0	0.988741032	0.096191992	0.05512905	2.365845822	0.775122451	0	0	0	0	0	1.902820479	3.448624138	0.180581897	1.707641231	3.097292444	2.907557043	0.000155747	0	0	0	0.166167202	0.285472633	0.007917575	0	0	0	4.532990576	0	0	0	0	0	0	0	0	0	0	26.0496
H5425_008_0	2008	9																																D	D	D		T	Coin	Coin	V	V		Coin			V	V	V	V	V	Coin	V	Coin				V	P	V				V																																																				0		692.4837627	12.35976211	352.6940718	0	210.2522006	3.57194443	2.234292662	954.3560597	217.7720587	0	0	0	0	0	5143.432957	4656.319475	216.5185363	1853.075063	36.07577775	10850.09088	0.018987697		0	0	204.4719861	146.6034138	14.66122999	0	0	0	3768.73705											copay/days 1-10	copay/days 1-10	copay/days 21-100	0	$75/run	0-10% DME	"0-10% Prosthetics, 0% Diab Supplies"	"$50 ER, $25 urgent care"	$50/OP hospital and ASC visits	0	"20% rad therapy, 10% specialized"	0	0	$10/visit cardiac rehab	$10/visit	$10/visit	$10/visit	"$10 PT & OT, $20 CORF"	"20% rad therapy, 20% specialized"	"$10 hearing, podiatry, & chiro, 10% lab"	20% coinsurance		0	0	$10/visit	$25/service	$0-$10/visit	0	0	0	ILP Services											50	50	20	0	75	0.05	0.045692475	43.24184699	50	0	0.075	0	0	10	10	10	10	11	0.088	3.137147174	0.2	0	0	0	10	25	5	0	0	0	15											2.8853	0.051499009	0.587823453	0	1.314076253	0.178597222	0.102090363	3.439009892	0.907383578	0	0	0	0	0	4.286194131	3.880266229	0.180432114	1.698652142	3.174668442	2.836527661	0.003797539	0	0	0	0.170393322	0.305423779	0.006108846	0	0	0	4.710921313	0	0	0	0	0	0	0	0	0	0	30.7192			2.8853	0.051499009	0.587823453	0	1.314076253	0.178597222	0.102090363	3.439009892	0.907383578	0	0	0	0	0	4.286194131	3.880266229	0.180432114	1.698652142	3.174668442	2.836527661	0.003797539	0	0	0	0.170393322	0.305423779	0.006108846	0	0	0	4.710921313	0	0	0	0	0	0	0	0	0	0	30.7192																																																																																				0			2.8853	0.051499009	0.587823453	0	1.314076253	0.178597222	0.102090363	3.439009892	0.907383578	0	0	0	0	0	4.286194131	3.880266229	0.180432114	1.698652142	3.174668442	2.836527661	0.003797539	0	0	0	0.170393322	0.305423779	0.006108846	0	0	0	4.710921313	0	0	0	0	0	0	0	0	0	0	30.7192
H5425_009_0	2008	9																																D	D	D		T	Coin	Coin	V	V		Coin			V	V	V	V	V	Coin	V	Coin				V	P	V				V																																																				0		789.2460829	14.08681959	420.7387325	0	272.1072246	5.059453473	3.164746817	1829.874033	158.2943048	0	0	0	0	0	4791.274717	4337.512701	201.6940431	1726.199559	33.60575772	10107.21177	0.006350469		0	0	198.1224227	142.05087	24.71651933	0	0	0	5946.150168											copay/days 1-10	copay/days 1-10	copay/days 21-100	0	$75/run	0-10% DME	"0-10% Prosthetics, 0% Diab Supplies"	"$50 ER, $25 urgent care"	$50/OP hospital and ASC visits	0	"20% rad therapy, 10% specialized"	0	0	$10/visit cardiac rehab	$10/visit	$10/visit	$10/visit	"$10 PT & OT, $20 CORF"	"20% rad therapy, 20% specialized"	"$10 hearing, podiatry, & chiro, 10% lab"	20% coinsurance		0	0	$10/visit	$25/service	$0-$10/visit	0	0	0	ILP Services											50	50	20	0	75	0.05	0.045692475	43.24184699	50	0	0.075	0	0	10	10	10	10	11	0.088	3.137147174	0.2	0	0	0	10	25	5	0	0	0	15											3.2885	0.058695082	0.701231221	0	1.700670154	0.252972674	0.144605116	6.593927745	0.659559603	0	0	0	0	0	3.992728931	3.614593918	0.168078369	1.582349596	2.95730668	2.642317569	0.001270094	0	0	0	0.165102019	0.295939312	0.01029855	0	0	0	7.43268771	0	0	0	0	0	0	0	0	0	0	36.2629			3.2885	0.058695082	0.701231221	0	1.700670154	0.252972674	0.144605116	6.593927745	0.659559603	0	0	0	0	0	3.992728931	3.614593918	0.168078369	1.582349596	2.95730668	2.642317569	0.001270094	0	0	0	0.165102019	0.295939312	0.01029855	0	0	0	7.43268771	0	0	0	0	0	0	0	0	0	0	36.2629																																																																																				0			3.2885	0.058695082	0.701231221	0	1.700670154	0.252972674	0.144605116	6.593927745	0.659559603	0	0	0	0	0	3.992728931	3.614593918	0.168078369	1.582349596	2.95730668	2.642317569	0.001270094	0	0	0	0.165102019	0.295939312	0.01029855	0	0	0	7.43268771	0	0	0	0	0	0	0	0	0	0	36.2629
H5425_010_0	2008	7																																D	D	D		T	Coin	Coin	V	V		Coin			V	V	V	V	V	Coin	V	Coin				V	P	V				V																																																				0		711.4126356	12.76393109	421.8686512	0	286.4124541	2.915559584	1.829461534	1108.97825	182.038018	0	0	0	0	0	7800.202221	7069.16402	353.8274122	3037.992929	55.72012552	3105.220137	0.000260862		0	0	262.5622097	179.6273072	484.3558658	0	0	0	2000.335211											copay/days 1-8	copay/days 1-8	copay/days 21-100	0	$50/run	0-10% DME	"0-10% Prosthetics, 0% Diab Supplies"	"$50 ER, $25 urgent care"	$50/OP hospital and ASC visits	0	"20% rad therapy, 0% specialized"	0	0	$10/visit cardiac rehab	$5/visit	$10/visit	$10/visit	"$10 PT & OT, $20 CORF"	"20% rad therapy, 20% specialized"	"$10 hearing, podiatry, & chiro"	20% coinsurance		0	0	$10/visit	$25/service	$0-$10/visit	0	0	0	ILP Services											50	50	20	0	50	0.05	0.045702532	42.50122452	50	0	0.045	0	0	10	5	10	10	11	0.088	10	0.2	0	0	0	10	25	5	0	0	0	15											2.9642	0.053183046	0.703114419	0	1.193385225	0.145777979	0.083611024	3.927744465	0.758491741	0	0	0	0	0	3.250084259	5.890970017	0.294856177	2.784826852	4.903371046	2.587683448	5.22E-05	0	0	0	0.218801841	0.374223557	0.201814944	0	0	0	2.500419014	0	0	0	0	0	0	0	0	0	0	32.8366			2.9642	0.053183046	0.703114419	0	1.193385225	0.145777979	0.083611024	3.927744465	0.758491741	0	0	0	0	0	3.250084259	5.890970017	0.294856177	2.784826852	4.903371046	2.587683448	5.22E-05	0	0	0	0.218801841	0.374223557	0.201814944	0	0	0	2.500419014	0	0	0	0	0	0	0	0	0	0	32.8366																																																																																				0			2.9642	0.053183046	0.703114419	0	1.193385225	0.145777979	0.083611024	3.927744465	0.758491741	0	0	0	0	0	3.250084259	5.890970017	0.294856177	2.784826852	4.903371046	2.587683448	5.22E-05	0	0	0	0.218801841	0.374223557	0.201814944	0	0	0	2.500419014	0	0	0	0	0	0	0	0	0	0	32.8366
H5425_011_0	2008	7																																D	D	D		T	Coin	Coin	V	V		Coin			V	V	V	V	V	Coin	V	Coin				V	P	V				V																																																				0		881.4217906	15.73201314	611.9778252	0	291.4699418	6.379902929	3.990703265	1716.249526	367.2539599	0	0	0	0	0	7441.591282	6736.828632	313.2620694	2681.055115	52.19494361	15698.06438	0		0	0	297.2666395	213.1358187	864.5691313	0	0	0	3840.336458											copay/days 1-10	copay/days 1-10	copay/days 21-100	0	$75/run	0-10% DME	"0-10% Prosthetics, 0% Diab Supplies"	"$50 ER, $25 urgent care"	$50/OP hospital and ASC visits	0	"20% rad therapy, 10% specialized"	0	0	$10/visit cardiac rehab	$10/visit	$10/visit	$10/visit	"$10 PT & OT, $20 CORF"	"20% rad therapy, 20% specialized"	"$10 hearing, podiatry, & chiro, 10% lab"	20% coinsurance		0	0	$10/visit	$25/service	$0-$10/visit	0	0	0	ILP Services											50	50	20	0	75	0.05	0.045692475	43.24184699	50	0	0.075	0	0	10	10	10	10	11	0.088	3.137147174	0.2	0	0	0	10	25	5	0	0	0	15											3.6726	0.065550055	1.019963042	0	1.821687136	0.318995146	0.182345111	6.184483283	1.530224833	0	0	0	0	0	6.201326068	5.61402386	0.261051724	2.457633855	4.593155038	4.103928191	0	0	0	0	0.2477222	0.444032956	0.360237138	0	0	0	4.800420572	0	0	0	0	0	0	0	0	0	0	43.8794			3.6726	0.065550055	1.019963042	0	1.821687136	0.318995146	0.182345111	6.184483283	1.530224833	0	0	0	0	0	6.201326068	5.61402386	0.261051724	2.457633855	4.593155038	4.103928191	0	0	0	0	0.2477222	0.444032956	0.360237138	0	0	0	4.800420572	0	0	0	0	0	0	0	0	0	0	43.8794																																																																																				0			3.6726	0.065550055	1.019963042	0	1.821687136	0.318995146	0.182345111	6.184483283	1.530224833	0	0	0	0	0	6.201326068	5.61402386	0.261051724	2.457633855	4.593155038	4.103928191	0	0	0	0	0.2477222	0.444032956	0.360237138	0	0	0	4.800420572	0	0	0	0	0	0	0	0	0	0	43.8794
H5425_012_0	2008	7																																D	D	D		T	Coin	Coin	V	V		Coin			V	V	V	V	V	Coin	V	Coin				V	P	V				V																																																				0		944.4454201	16.85688726	353.0645149	0	427.3207169	5.9707859	3.734795819	3519.336115	170.5775461	0	0	0	0	0	6520.635331	5903.09265	274.4934033	2349.253277	45.73540531	13755.30439	0		0	0	270.5347461	193.9694433	273.9368657	0	0	0	202.4781485											copay/days 1-10	copay/days 1-10	copay/days 21-100	0	$75/run	0-10% DME	"0-10% Prosthetics, 0% Diab Supplies"	"$50 ER, $25 urgent care"	$50/OP hospital and ASC visits	0	"20% rad therapy, 10% specialized"	0	0	$10/visit cardiac rehab	$10/visit	$10/visit	$10/visit	"$10 PT & OT, $20 CORF"	"20% rad therapy, 20% specialized"	"$10 hearing, podiatry, & chiro, 10% lab"	20% coinsurance	0	0	0	$10/visit	$25/service	$0-$10/visit	0	0	0	ILP Services											50	50	20	0	75	0.05	0.045692475	43.24184699	50	0	0.075	0	0	10	10	10	10	11	0.088	3.137147174	0.2	0	0	0	10	25	5	0	0	0	15											3.9352	0.07023703	0.588440858	0	2.67075448	0.298539295	0.170652066	12.68188281	0.710739775	0	0	0	0	0	5.433862776	4.919243875	0.228744503	2.153482171	4.024715667	3.596034524	0	0	0	0	0.225445622	0.404103007	0.114140361	0	0	0	0.253097686	0	0	0	0	0	0	0	0	0	0	42.4793			3.9352	0.07023703	0.588440858	0	2.67075448	0.298539295	0.170652066	12.68188281	0.710739775	0	0	0	0	0	5.433862776	4.919243875	0.228744503	2.153482171	4.024715667	3.596034524	0	0	0	0	0.225445622	0.404103007	0.114140361	0	0	0	0.253097686	0	0	0	0	0	0	0	0	0	0	42.4793																																																																																				0			3.9352	0.07023703	0.588440858	0	2.67075448	0.298539295	0.170652066	12.68188281	0.710739775	0	0	0	0	0	5.433862776	4.919243875	0.228744503	2.153482171	4.024715667	3.596034524	0	0	0	0	0.225445622	0.404103007	0.114140361	0	0	0	0.253097686	0	0	0	0	0	0	0	0	0	0	42.4793
H5425_801_0	2008	2																																A	A	D					V	V	V	V				V	V	V	V	V	V	Coin	O		V	V	P	V				V																																																				0		173.3403287	3.067126795	329.8222613	0	0	0	0	312.5393706	177.9105549	1068.055202	565.301725	0	0	0	4941.572803	4476.118222	216.5571569	1857.155506	4693.431126	12632.15384	5.539293162	793.7482147	0	90	280.5970436	196.4849486	197.0218105	0	0	0	1550.311646											copay/admit	copay/admit	copay/days 21-100	0	0	0	0	"$50 ER, $15 urgent care"	$15/OP hospital and ASC visits	$15 copay	$15 copay	0	0	0	$15/visit	$30/visit	$15/visit	$10/visit	$15 copay	"$15 hearing, pod, chiro, lab"	20% coinsurance	$15/visit	0	$8/visit	$15/visit	$20/service	$0-$15/visit	0	0	0	Copay for In-Home Assistance Benefits											100	100	100	0	0	0	0	36.27987312	15	15	15	0	0	0	15	30	15	10	15	14.19990089	0.2	15	0	8	15	20	7.5	0	0	0	15											1.4445	0.02555939	2.748518844	0	0	0	0	0.944907393	0.222388194	1.335069002	0.706627156	0	0	0	6.176966004	11.19029556	0.270696446	1.547629588	5.866788908	14.94794438	1.107858632	0.992185268	0	0.06	0.350746304	0.327474914	0.123138632	0	0	0	1.937889557	0	0	0	0	0	0	0	0	0	0	52.3272			1.4445	0.02555939	2.748518844	0	0	0	0	0.944907393	0.222388194	1.335069002	0.706627156	0	0	0	6.176966004	11.19029556	0.270696446	1.547629588	5.866788908	14.94794438	1.107858632	0.992185268	0	0.06	0.350746304	0.327474914	0.123138632	0	0	0	1.937889557	0	0	0	0	0	0	0	0	0	0	52.3272																																																																																				0			1.4445	0.02555939	2.748518844	0	0	0	0	0.944907393	0.222388194	1.335069002	0.706627156	0	0	0	6.176966004	11.19029556	0.270696446	1.547629588	5.866788908	14.94794438	1.107858632	0.992185268	0	0.06	0.350746304	0.327474914	0.123138632	0	0	0	1.937889557	0	0	0	0	0	0	0	0	0	0	52.3272
H5425_802_0	2008	2																																A	A	D					V	V	V	V				V	V	V	V	V	V	Coin	O		V	V	P	V				V																																																				0		173.3403287	3.067126795	329.8222613	0	0	0	0	312.5393706	177.9105549	1068.055202	565.301725	0	0	0	4941.572803	4476.118222	216.5571569	1857.155506	4693.431126	12632.15384	5.539293162	793.7482147	0	90	280.5970436	196.4849486	197.0218105	0	0	0	1550.311646											copay/admit	copay/admit	copay/days 21-100	0	0	0	0	"$50 ER, $15 urgent care"	$15/OP hospital and ASC visits	$15 copay	$15 copay	0	0	0	$15/visit	$30/visit	$15/visit	$10/visit	$15 copay	"$15 hearing, pod, chiro, lab"	20% coinsurance	$15/visit	0	$8/visit	$15/visit	$20/service	$0-$15/visit	0	0	0	Copay for In-Home Assistance Benefits											100	100	100	0	0	0	0	36.27987312	15	15	15	0	0	0	15	30	15	10	15	14.19990089	0.2	15	0	8	15	20	7.5	0	0	0	15											1.4445	0.02555939	2.748518844	0	0	0	0	0.944907393	0.222388194	1.335069002	0.706627156	0	0	0	6.176966004	11.19029556	0.270696446	1.547629588	5.866788908	14.94794438	1.107858632	0.992185268	0	0.06	0.350746304	0.327474914	0.123138632	0	0	0	1.937889557	0	0	0	0	0	0	0	0	0	0	52.3272			1.4445	0.02555939	2.748518844	0	0	0	0	0.944907393	0.222388194	1.335069002	0.706627156	0	0	0	6.176966004	11.19029556	0.270696446	1.547629588	5.866788908	14.94794438	1.107858632	0.992185268	0	0.06	0.350746304	0.327474914	0.123138632	0	0	0	1.937889557	0	0	0	0	0	0	0	0	0	0	52.3272																																																																																				0			1.4445	0.02555939	2.748518844	0	0	0	0	0.944907393	0.222388194	1.335069002	0.706627156	0	0	0	6.176966004	11.19029556	0.270696446	1.547629588	5.866788908	14.94794438	1.107858632	0.992185268	0	0.06	0.350746304	0.327474914	0.123138632	0	0	0	1.937889557	0	0	0	0	0	0	0	0	0	0	52.3272
H5425_803_0	2008	2																																A	A	D					V	V	V	V				V	V	V	V	V	V	Coin	O		V	V	P	V				V																																																				0		173.3403287	3.067126795	329.8222613	0	0	0	0	312.5393706	177.9105549	1068.055202	565.301725	0	0	0	4941.572803	4476.118222	216.5571569	1857.155506	4693.431126	12632.15384	5.539293162	793.7482147	0	90	280.5970436	196.4849486	197.0218105	0	0	0	1550.311646											copay/admit	copay/admit	copay/days 21-100	0	0	0	0	"$50 ER, $15 urgent care"	$15/OP hospital and ASC visits	$15 copay	$15 copay	0	0	0	$15/visit	$30/visit	$15/visit	$10/visit	$15 copay	"$15 hearing, pod, chiro, lab"	20% coinsurance	$15/visit	0	$8/visit	$15/visit	$20/service	$0-$15/visit	0	0	0	Copay for In-Home Assistance Benefits											100	100	100	0	0	0	0	36.27987312	15	15	15	0	0	0	15	30	15	10	15	14.19990089	0.2	15	0	8	15	20	7.5	0	0	0	15											1.4445	0.02555939	2.748518844	0	0	0	0	0.944907393	0.222388194	1.335069002	0.706627156	0	0	0	6.176966004	11.19029556	0.270696446	1.547629588	5.866788908	14.94794438	1.107858632	0.992185268	0	0.06	0.350746304	0.327474914	0.123138632	0	0	0	1.937889557	0	0	0	0	0	0	0	0	0	0	52.3272			1.4445	0.02555939	2.748518844	0	0	0	0	0.944907393	0.222388194	1.335069002	0.706627156	0	0	0	6.176966004	11.19029556	0.270696446	1.547629588	5.866788908	14.94794438	1.107858632	0.992185268	0	0.06	0.350746304	0.327474914	0.123138632	0	0	0	1.937889557	0	0	0	0	0	0	0	0	0	0	52.3272																																																																																				0			1.4445	0.02555939	2.748518844	0	0	0	0	0.944907393	0.222388194	1.335069002	0.706627156	0	0	0	6.176966004	11.19029556	0.270696446	1.547629588	5.866788908	14.94794438	1.107858632	0.992185268	0	0.06	0.350746304	0.327474914	0.123138632	0	0	0	1.937889557	0	0	0	0	0	0	0	0	0	0	52.3272
H5425_804_0	2008	2																																A	A	D					V	V	V	V				V	V	V	V	V	V	Coin	O		V	V	P	V				V																																																				0		173.3403287	3.067126795	329.8222613	0	0	0	0	312.5393706	177.9105549	1068.055202	565.301725	0	0	0	4941.572803	4476.118222	216.5571569	1857.155506	4693.431126	12632.15384	5.539293162	793.7482147	0	90	280.5970436	196.4849486	197.0218105	0	0	0	1550.311646											copay/admit	copay/admit	copay/days 21-100	0	0	0	0	"$50 ER, $15 urgent care"	$15/OP hospital and ASC visits	$15 copay	$15 copay	0	0	0	$15/visit	$30/visit	$15/visit	$10/visit	$15 copay	"$15 hearing, pod, chiro, lab"	20% coinsurance	$15/visit	0	$8/visit	$15/visit	$20/service	$0-$15/visit	0	0	0	Copay for In-Home Assistance Benefits											100	100	100	0	0	0	0	36.27987312	15	15	15	0	0	0	15	30	15	10	15	14.19990089	0.2	15	0	8	15	20	7.5	0	0	0	15											1.4445	0.02555939	2.748518844	0	0	0	0	0.944907393	0.222388194	1.335069002	0.706627156	0	0	0	6.176966004	11.19029556	0.270696446	1.547629588	5.866788908	14.94794438	1.107858632	0.992185268	0	0.06	0.350746304	0.327474914	0.123138632	0	0	0	1.937889557	0	0	0	0	0	0	0	0	0	0	52.3272			1.4445	0.02555939	2.748518844	0	0	0	0	0.944907393	0.222388194	1.335069002	0.706627156	0	0	0	6.176966004	11.19029556	0.270696446	1.547629588	5.866788908	14.94794438	1.107858632	0.992185268	0	0.06	0.350746304	0.327474914	0.123138632	0	0	0	1.937889557	0	0	0	0	0	0	0	0	0	0	52.3272																																																																																				0			1.4445	0.02555939	2.748518844	0	0	0	0	0.944907393	0.222388194	1.335069002	0.706627156	0	0	0	6.176966004	11.19029556	0.270696446	1.547629588	5.866788908	14.94794438	1.107858632	0.992185268	0	0.06	0.350746304	0.327474914	0.123138632	0	0	0	1.937889557	0	0	0	0	0	0	0	0	0	0	52.3272
H5426_001_0	2008	6																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	V	V																																																				0		1625.747719	3.684246889	875.2341919		232.6404875	3.936883521	3.291288525	269.4816029	193.9350591	205.8044756	348.4412409	21.08986458		472.5803068		5483.462972	122.866656	912.1514679	6585.612614	140.4937404	1842.800001				379.090712		1.161074156		3549.4													$100 (Days 1-7)	$400/Admit	$0(1-10)/$35(11-100)		$75/Trip	20% Coinsurance	20% Coinsurance	50	$100 OP/$50 ASC	25	$25/$100	25	$100 OP/$0 Non-Hopsital	25		15	$20 Psych/$10 Therapy	10	10	$10 Chiro & Podiatry	50				$10 Routine Eye Exam		10		20%/OOP Max $5000													45.7337	385.1503	19.2081		65.3338	0.2	0.174223536	43.383	65.3338	21.7779	32.7671	21.7779		21.6524		12.9298	15.6959	8.7112	8.7112	9.2139	43.5559				8.7112		8.7112		33.3125													6.196	0.118249062	1.400968765	0	1.266607764	0.787376704	0.573419926	0.97424287	1.05587662	0.373499829	0.951450505	0.038274487	0	0.85270806	0	5.908344575	0.160708122	0.662159394	4.780702998	0.107875138	6.688731941	0	0	0	0.275193852	0	0.00084286	0	9.8532729	0	0	0	0	0	0	0	0	0	0	0	0	43.0265	0	4.74802991	6.196	0.118249062	1.400968765	0	1.266607764	0.787376704	0.573419926	0.97424287	1.05587662	0.373499829	0.951450505	0.038274487	0	0.85270806	0	5.908344575	0.160708122	0.662159394	4.780702998	0.107875138	6.688731941	0	0	0	0.275193852	0	0.00084286	0	9.8532729	0	0	0	0	0	0	0	0	0	0	0	0	43.0265																																																																																				0	0	0	6.196	0.118249062	1.400968765	0	1.266607764	0.787376704	0.573419926	0.97424287	1.05587662	0.373499829	0.951450505	0.038274487	0	0.85270806	0	5.908344575	0.160708122	0.662159394	4.780702998	0.107875138	6.688731941	0	0	0	0.275193852	0	0.00084286	0	9.8532729	0	0	0	0	0	0	0	0	0	0	0	0	43.0265
H5426_002_0	2008	8																					3000											D	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V																																																				0		1861.34575	2.619080435	792.515924		121.343761	3.938404765	6.330286542	337.6667849	310.8425959	402.248744	260.9051516	21.97183027	9.06069452	392.4109185		4737.374548	121.5239341	883.7108263	5110.543675	220.8099295	31.28419135	175.8454886			51.27175188		88.65740429		3110													$150 (Days 1-7)	$400/Admit	$0(1-10)/$35(11-100)		$100/Trip	20% Coinsurance	20% Coinsurance	50	$100 Hosp/$50 ASC	25	$25/$100	25	$100 OP/$0 Non-Hospital	25		20	$20 Psych/$10 Therapy	10	10	$10 Chiro & Podiatry	20% Coinsurance	$20 Eye Exam			$10 Routine Eye Exam		10		20%/OOP Max $5000													67.0448	400	18.7725		85.1363	0.2	0.170272555	42.4248	76.6226	21.2841	33.416	21.2841	85.1363	21.1392		16.7781	15.6749	8.5136	8.5136	8.8817	0.170272555	17.0273			8.5136		8.5136		33.5458													10.3995	0.087302681	1.239795351	0	0.860896344	0.787680953	1.077874066	1.193788391	1.984798618	0.713457516	0.72653364	0.03897083	0.064282817	0.691272309	0	6.623666665	0.158739964	0.626965419	3.625772213	0.163429956	5.326839207	0.249513839	0	0	0.036375718	0	0.062899678	0	8.6939426	0	0	0	0	0	0	0	0	0	0	0	0	45.4343	0	6.22569369	10.3995	0.087302681	1.239795351	0	0.860896344	0.787680953	1.077874066	1.193788391	1.984798618	0.713457516	0.72653364	0.03897083	0.064282817	0.691272309	0	6.623666665	0.158739964	0.626965419	3.625772213	0.163429956	5.326839207	0.249513839	0	0	0.036375718	0	0.062899678	0	8.6939426	0	0	0	0	0	0	0	0	0	0	0	0	45.4343																																																																																				0	0	0	10.3995	0.087302681	1.239795351	0	0.860896344	0.787680953	1.077874066	1.193788391	1.984798618	0.713457516	0.72653364	0.03897083	0.064282817	0.691272309	0	6.623666665	0.158739964	0.626965419	3.625772213	0.163429956	5.326839207	0.249513839	0	0	0.036375718	0	0.062899678	0	8.6939426	0	0	0	0	0	0	0	0	0	0	0	0	45.4343
H5426_003_0	2008	5																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	V	V																																																				0		1184.902804	2.755238095	645.423969		103.0331446	4.127619048	7.608083289	199.750615	333.6133034	854.4970271	319.4125517	37.81828286	4.750856034	608.1354818		5815.830346	125.6828571	920.2061003	4954.276139	466.9056219	1401.71281	0.11998876			144		249		3028.2													$150 (Days 1-7)	$400/Admit	$0(1-10)/$35(11-100)		$100/Trip	20% Coinsurance	20% Coinsurance	50	$100 Hosp/$50 ASC	25	$25/$100	25	$100 OP/$0 Non-Hospital	25		20	$20 Psych/$10 Therapy	10	10	$10 Chiro & Podiatry	20% Coinsurance	$20 Eye Exam			$10 Routine Eye Exam		10		20%/OOP Max $5000													68.0626	400	19.0575		86.4287	0.2	0.172857323	43.2143	58.3393	21.6072	35.2197	21.6072	86.4287	21.5058		17.0736	15.6539	8.6429	8.6429	8.804	39.5367	17.2857			8.6429		8.6429		33.4209													6.7206	0.09184127	1.025015009	0	0.742084732	0.82552381	1.31511291	0.719340762	1.621898509	1.538604881	0.93746731	0.068095491	0.034217511	1.089869441	0	8.274767066	0.163952381	0.66276818	3.568262129	0.342553525	4.618252523	0.000172841	0	0	0.103714394	0	0.179339473	0	8.4337615	0	0	0	0	0	0	0	0	0	0	0	0	43.0772	0	5.262101937	6.7206	0.09184127	1.025015009	0	0.742084732	0.82552381	1.31511291	0.719340762	1.621898509	1.538604881	0.93746731	0.068095491	0.034217511	1.089869441	0	8.274767066	0.163952381	0.66276818	3.568262129	0.342553525	4.618252523	0.000172841	0	0	0.103714394	0	0.179339473	0	8.4337615	0	0	0	0	0	0	0	0	0	0	0	0	43.0772																																																																																				0	0	0	6.7206	0.09184127	1.025015009	0	0.742084732	0.82552381	1.31511291	0.719340762	1.621898509	1.538604881	0.93746731	0.068095491	0.034217511	1.089869441	0	8.274767066	0.163952381	0.66276818	3.568262129	0.342553525	4.618252523	0.000172841	0	0	0.103714394	0	0.179339473	0	8.4337615	0	0	0	0	0	0	0	0	0	0	0	0	43.0772
H5426_007_0	2008	5																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	V	V																																																				0		1625.051518	3.684246889	874.8593864		232.5408628	3.936883521	3.289879082	269.3662016	193.8520094	205.716343	348.2920263	21.08083317		472.3800888		5481.114764	122.866656	912.1514679	6582.792428	140.4595074	1842.01085				378.9283723		1.160576944		3549.4													$300 (Days 1-7)	$400/Admit	$0(1-7)/$120(8-100)		$75/Trip	20% Coinsurance	20% Coinsurance	50	20% Coinsurance	25	$25/$150	20% Coinsurance	$100 OP/$0 Non-Hopsital	20% Coinsurance		30	$20 Psych/$10 Therapy	10	10	$10 Chiro & Podiatry	50				$10 Routine Eye Exam		10		30% Coinsurance													119.9593	372.5371	65.989		57.1235	0.2	0.152329227	37.9311	363.064	19.0412	35.0548	118.8516		47.0904		22.3704	15.6441	7.6165	7.6165	8.5465	38.0823				7.6165		7.6165		70.7271													16.245	0.114376544	4.810926225	0	1.106961562	0.787376704	0.501144739	0.851447022	5.865057148	0.326423037	1.017441216	0.208790916	0	1.853715309	0	10.21789735	0.160178519	0.578947202	4.17813202	0.100036479	5.845668535	0	0	0	0.240507776	0	0.000736624	0	20.9199	0	0	0	0	0	0	0	0	0	0	0	0	75.9307	0	16.87703184	16.245	0.114376544	4.810926225	0	1.106961562	0.787376704	0.501144739	0.851447022	5.865057148	0.326423037	1.017441216	0.208790916	0	1.853715309	0	10.21789735	0.160178519	0.578947202	4.17813202	0.100036479	5.845668535	0	0	0	0.240507776	0	0.000736624	0	20.9199	0	0	0	0	0	0	0	0	0	0	0	0	75.9307																																																																																				0	0	0	16.245	0.114376544	4.810926225	0	1.106961562	0.787376704	0.501144739	0.851447022	5.865057148	0.326423037	1.017441216	0.208790916	0	1.853715309	0	10.21789735	0.160178519	0.578947202	4.17813202	0.100036479	5.845668535	0	0	0	0.240507776	0	0.000736624	0	20.9199	0	0	0	0	0	0	0	0	0	0	0	0	75.9307
H5426_008_0	2008	6																					3250											D	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V																																																				0		1853.831516	2.619101449	789.3180243		120.8541	3.938468162	6.304821084	336.3035081	309.5887939	400.6295715	259.8530847	21.88331745	9.024108598	390.8499316		4718.271814	121.5248926	880.1461046	5089.925826	220.1858369	31.15816761	175.1347237			51.27175188		88.65740429		3110													$350 (Days 1-7)	$400/Admit	$0(1-7)/$120(8-100)		$100/Trip	20% Coinsurance	20% Coinsurance	50	20% Coinsurance	25	$25/$150	20% Coinsurance	$100 OP/$0 Non-Hospital	20% Coinsurance		40	$20 Psych/$10 Therapy	10	10	$10 Chiro & Podiatry	20% Coinsurance				$10 Routine Eye Exam		10		30% Coinsurance													135.5377	400	63.9074		73.762	0.2	0.147524033	36.7569	252.0658	18.4405	35.959	158.8625	73.762	69.0489		28.8571	15.6403	7.3762	7.3762	8.0277	0.147524033	14.7524			7.3762		7.3762		67.1811													20.9387	0.087303382	4.203605955	0	0.742870177	0.787693632	0.930112634	1.030121699	6.50306164	0.615650939	0.778671056	0.289703195	0.055469704	2.248979127	0	11.34631292	0.15839041	0.541011262	3.128693273	0.147299153	4.596578547	0.21530484	0	0	0.031515898	0	0.054496241	0	17.4111	0	0	0	0	0	0	0	0	0	0	0	0	76.8426	0	20.75598487	20.9387	0.087303382	4.203605955	0	0.742870177	0.787693632	0.930112634	1.030121699	6.50306164	0.615650939	0.778671056	0.289703195	0.055469704	2.248979127	0	11.34631292	0.15839041	0.541011262	3.128693273	0.147299153	4.596578547	0.21530484	0	0	0.031515898	0	0.054496241	0	17.4111	0	0	0	0	0	0	0	0	0	0	0	0	76.8426																																																																																				0	0	0	20.9387	0.087303382	4.203605955	0	0.742870177	0.787693632	0.930112634	1.030121699	6.50306164	0.615650939	0.778671056	0.289703195	0.055469704	2.248979127	0	11.34631292	0.15839041	0.541011262	3.128693273	0.147299153	4.596578547	0.21530484	0	0	0.031515898	0	0.054496241	0	17.4111	0	0	0	0	0	0	0	0	0	0	0	0	76.8426
H5426_009_0	2008	4																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	V	V																																																				0		1189.028997	2.755238095	647.6705975		103.3919374	4.127619048	7.63457695	200.4462074	334.7750465	857.4726458	320.5248434	37.94997764	4.76739996	610.2346986		5835.10246	125.6828571	923.410538	4971.528437	468.3384704	1406.594	0.120406598			144		249		3028.2													$350 (Days 1-7)	$400/Admit	$0(1-7)/$120(8-100)		$100/Trip	20% Coinsurance	20% Coinsurance	50	20% Coinsurance	25	$25/$150	20% Coinsurance	$100 OP/$0 Non-Hospital	20% Coinsurance		40	$20 Psych/$10 Therapy	10	10	$10 Chiro & Podiatry	20% Coinsurance				$10 Routine Eye Exam		10		30% Coinsurance													139.6881	400	65.8643		76.0207	0.2	0.152041432	38.0104	207.2992	19.0052	38.9606	183.9959	76.0207	60.232		29.8485	15.6539	7.6021	7.6021	7.8859	34.7756	15.2041			7.6021		7.6021		66.0927													13.8411	0.09184127	3.554866817	0	0.654994092	0.82552381	1.160772011	0.634919341	5.783216808	1.358035092	1.040653803	0.581886594	0.030201763	3.062972921	0	14.51406451	0.163952381	0.584986085	3.149492925	0.307773644	4.076257047	0.000152557	0	0	0.091224859	0	0.157742986	0	16.6785	0	0	0	0	0	0	0	0	0	0	0	0	72.3451	0	17.20192545	13.8411	0.09184127	3.554866817	0	0.654994092	0.82552381	1.160772011	0.634919341	5.783216808	1.358035092	1.040653803	0.581886594	0.030201763	3.062972921	0	14.51406451	0.163952381	0.584986085	3.149492925	0.307773644	4.076257047	0.000152557	0	0	0.091224859	0	0.157742986	0	16.6785	0	0	0	0	0	0	0	0	0	0	0	0	72.3451																																																																																				0	0	0	13.8411	0.09184127	3.554866817	0	0.654994092	0.82552381	1.160772011	0.634919341	5.783216808	1.358035092	1.040653803	0.581886594	0.030201763	3.062972921	0	14.51406451	0.163952381	0.584986085	3.149492925	0.307773644	4.076257047	0.000152557	0	0	0.091224859	0	0.157742986	0	16.6785	0	0	0	0	0	0	0	0	0	0	0	0	72.3451
H5426_013_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	V	V																																																				0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5426_014_0	2008	6																																D	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V																																																				0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5426_015_0	2008	5																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	V	V																																																				0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5427_051_0	2008	4	g.2.	i.7.	i.8.	e.3.							OP Facility - Surgery	Professional	Professional	DME/Prosthetics/Supplies							4000	ASC	Chiropractic	Podiatry	Diabetic Supplies							D	D	D	V	T	Coin	Coin	V	Coin		Coin				V	V	V	V			Coin			V	V	P	V	P				Coin	V	V	Coin							0	0	0	0	0	0	0	0	0		0				0	0	0	0			0			0	0	0	0	0				0	0	0	0							0	4000	792.1287435	37.06170728	822.0087219	1047.036228	126.8771329	4.264106276	0.414179425	488.5804745	14.86106526		10.87842181				1246.886532	1207.609163	5.960458184	18.23715167			2.287857254			209.5526126	223.416	161.784	29.42828724	7.357071809				8.002112065	44.62035927	81.12792594	0.661206439							$175 for 1st 10 days	$250 for 1st 7 days	$0 for days 1-10 and $100 for days 11-100	$35 Copay	$100 Copay	20% Copay	20% Copay	$50 ER; $10 Urgent Care	20% Copay		Varies by service				$0 Copay	$20 Copay	$20 Copay	$37.50 Copay			20% Copay			$5 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay				20% Copay	$20 Copay	$20 Copay	20% Copay							137.8999019	122.5926029	34.56476677	32.76748741	93.6213926	0.187242785	0.187242785	39.32098489	0.187242785	0	0.143334352	0	0	0	0	18.72427852	18.72427852	35.10802223	0	0	0.187242785	0	0	4.68106963	0	0	0	0	0	0	0	0.187242785	18.72427852	18.72427852	0.187242785							9.1029	0.378624264	2.367711646	2.859062201	0.989867823	0.798423136	0.077552109	1.600955455	2.782627251	0	1.559251542	0	0	0	0	1.88430086	0.00930044	0.053355861	0	0	0.428384764	0	0	0.081744198	0	0	0	0	0	0	0	1.498337751	0.06962367	0.12658849	0.123806135	0	0	0	0	0	0	26.7924	0	1.825417633	9.1029	0.378624264	2.367711646	2.859062201	0.989867823	0.798423136	0.077552109	1.600955455	2.782627251	0	1.559251542	0	0	0	0	1.88430086	0.00930044	0.053355861	0	0	0.428384764	0	0	0.081744198	0	0	0	0	0	0	0	1.498337751	0.06962367	0.12658849	0.123806135	0	0	0	0	0	0	26.7924	4000																																																																																			0	0	0	9.1029	0.378624264	2.367711646	2.859062201	0.989867823	0.798423136	0.077552109	1.600955455	2.782627251	0	1.559251542	0	0	0	0	1.88430086	0.00930044	0.053355861	0	0	0.428384764	0	0	0.081744198	0	0	0	0	0	0	0	1.498337751	0.06962367	0.12658849	0.123806135	0	0	0	0	0	0	26.7924
H5427_052_0	2008	5	g.2.	i.7.	i.8.	e.3.							OP Facility - Surgery	Professional	Professional	DME/Prosthetics/Supplies							4000	ASC	Chiropractic	Podiatry	Diabetic Supplies							D	D	D	V	T	Coin	Coin	V	Coin		Coin				V	V	V	V			Coin			V	V	P	V	P				Coin	V	V	Coin							0	0	0	0	0	0	0	0	0		0				0	0	0	0			0			0	0	0	0	0				0	0	0	0							0	4000	859.6304496	40.21994196	892.0566675	1136.260022	137.6890407	4.323994639	0.419996477	530.2151404	15.06978541		11.03830396				1353.140684	1310.516272	6.468382053	19.79124103			2.287857254			209.5526126	223.416	161.784	29.42828724	7.357071809				8.114499834	48.42270882	88.04128877	0.670492927							$175 for 1st 10 days	$250 for 1st 7 days	$0 for days 1-10 and $100 for days 11-100	$35 Copay	$100 Copay	20% Copay	20% Copay	$50 ER; $10 Urgent Care	20% Copay		Varies by service				$0 Copay	$20 Copay	$20 Copay	$37.50 Copay			20% Copay			$5 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay				20% Copay	$20 Copay	$20 Copay	20% Copay							138.4771496	123.1057744	34.70945457	32.90465181	94.0132909	0.188026582	0.188026582	39.48558218	0.188026582	0	0.143934348	0	0	0	0	18.80265818	18.80265818	35.25498409	0	0	0.188026582	0	0	4.700664545	0	0	0	0	0	0	0	0.188026582	18.80265818	18.80265818	0.188026582							9.9199	0.412608925	2.580233364	3.115686699	1.078716653	0.813025932	0.078970502	1.744654458	2.833520238	0	1.588791087	0	0	0	0	2.053432459	0.010135231	0.058144991	0	0	0.430177979	0	0	0.082086378	0	0	0	0	0	0	0	1.525741667	0.07587297	0.137950855	0.126070493	0	0	0	0	0	0	28.6658	0	1.825417633	9.9199	0.412608925	2.580233364	3.115686699	1.078716653	0.813025932	0.078970502	1.744654458	2.833520238	0	1.588791087	0	0	0	0	2.053432459	0.010135231	0.058144991	0	0	0.430177979	0	0	0.082086378	0	0	0	0	0	0	0	1.525741667	0.07587297	0.137950855	0.126070493	0	0	0	0	0	0	28.6658	4000																																																																																			0	0	0	9.9199	0.412608925	2.580233364	3.115686699	1.078716653	0.813025932	0.078970502	1.744654458	2.833520238	0	1.588791087	0	0	0	0	2.053432459	0.010135231	0.058144991	0	0	0.430177979	0	0	0.082086378	0	0	0	0	0	0	0	1.525741667	0.07587297	0.137950855	0.126070493	0	0	0	0	0	0	28.6658
H5427_053_0	2008	6	g.2.	i.7.	i.8.	e.3.							OP Facility - Surgery	Professional	Professional	DME/Prosthetics/Supplies							4000	ASC	Chiropractic	Podiatry	Diabetic Supplies							D	D	D	V	T	Coin	Coin	V	Coin		Coin				V	V	V	V			Coin			P	V	P	V	P				Coin	V	V	Coin							0	0	0	0	0	0	0	0	0		0				0	0	0	0			0			0	0	0	0	0				0	0	0	0							0	4000	693.0014686	32.42379194	719.1422558	916.0097389	110.999683	3.730494488	0.362348864	427.4393388	13.00134623		9.453854622				1090.850704	1056.48852	5.21456431	15.95494797			2.287857254			209.5526126	223.416	161.784	29.42828724	7.357071809				7.000724893	39.03655151	70.97554821	0.578462828							$175 for 1st 10 days	$250 for 1st 7 days	$0 for days 1-10 and $100 for days 11-100	$35 Copay	$100 Copay	20% Copay	20% Copay	$50 ER; $10 Urgent Care	20% Copay		Varies by service				$0 Copay	$20 Copay	$20 Copay	$37.50 Copay			20% Copay			$5 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay				20% Copay	$20 Copay	$20 Copay	20% Copay							136.5810179	121.420119	34.23418702	32.45409696	92.72599133	0.185451983	0.185451983	38.94491636	0.185451983	0	0.141963493	0	0	0	0	18.54519827	18.54519827	34.77224675	0	0	0.185451983	0	0	4.636299566	0	0	0	0	0	0	0	0.185451983	18.54519827	18.54519827	0.185451983							7.8876	0.328075056	2.051604207	2.477355741	0.85771297	0.691827599	0.067198315	1.387215775	2.411125435	0	1.342102222	0	0	0	0	1.632732422	0.008058761	0.046232449	0	0	0.424287664	0	0	0.080962391	0	0	0	0	0	0	0	1.298298311	0.060328382	0.109687968	0.107277078	0	0	0	0	0	0	23.2697	0	1.825417633	7.8876	0.328075056	2.051604207	2.477355741	0.85771297	0.691827599	0.067198315	1.387215775	2.411125435	0	1.342102222	0	0	0	0	1.632732422	0.008058761	0.046232449	0	0	0.424287664	0	0	0.080962391	0	0	0	0	0	0	0	1.298298311	0.060328382	0.109687968	0.107277078	0	0	0	0	0	0	23.2697	4000																																																																																			0	0	0	7.8876	0.328075056	2.051604207	2.477355741	0.85771297	0.691827599	0.067198315	1.387215775	2.411125435	0	1.342102222	0	0	0	0	1.632732422	0.008058761	0.046232449	0	0	0.424287664	0	0	0.080962391	0	0	0	0	0	0	0	1.298298311	0.060328382	0.109687968	0.107277078	0	0	0	0	0	0	23.2697
H5427_054_0	2008	7	g.2.	i.7.	i.8.	e.3.							OP Facility - Surgery	Professional	Professional	DME/Prosthetics/Supplies							4000	ASC	Chiropractic	Podiatry	Diabetic Supplies							D	D	D	V	T	Coin	Coin	V	Coin		Coin				V	V	V	V			Coin			P	V	P	V	P				Coin	V	V	Coin							0	0	0	0	0	0	0	0	0		0				0	0	0	0			0			0	0	0	0	0				0	0	0	0							0	4000	859.6304496	40.21994196	892.0566675	1136.260022	137.6890407	3.846965329	0.373661862	530.2151404	13.407265		9.76479329				1353.140684	1310.516272	6.468382053	19.79124103			2.287857254			209.5526126	223.416	161.784	29.42828724	7.357071809				7.219296537	48.42270882	88.04128877	0.596523182							$175 for 1st 10 days	$250 for 1st 7 days	$0 for days 1-10 and $100 for days 11-100	$35 Copay	$100 Copay	20% Copay	20% Copay	$50 ER; $10 Urgent Care	20% Copay		Varies by service				$0 Copay	$20 Copay	$20 Copay	$37.50 Copay			20% Copay			$5 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay				20% Copay	$20 Copay	$20 Copay	20% Copay							138.2316207	122.8875	34.64791247	32.84630975	93.84659927	0.187693199	0.187693199	39.41557169	0.187693199	0	0.143679143	0	0	0	0	18.76931985	18.76931985	35.19247473	0	0	0.187693199	0	0	4.692329964	0	0	0	0	0	0	0	0.187693199	18.76931985	18.76931985	0.187693199							9.9023	0.411877343	2.575658444	3.110162385	1.076804019	0.722049227	0.07013379	1.741561073	2.516452451	0	1.402997136	0	0	0	0	2.049791591	0.010117261	0.058041896	0	0	0.429415246	0	0	0.081940834	0	0	0	0	0	0	0	1.355012858	0.075738443	0.137706259	0.111963344	0	0	0	0	0	0	27.8398	0	1.825417633	9.9023	0.411877343	2.575658444	3.110162385	1.076804019	0.722049227	0.07013379	1.741561073	2.516452451	0	1.402997136	0	0	0	0	2.049791591	0.010117261	0.058041896	0	0	0.429415246	0	0	0.081940834	0	0	0	0	0	0	0	1.355012858	0.075738443	0.137706259	0.111963344	0	0	0	0	0	0	27.8398	4000																																																																																			0	0	0	9.9023	0.411877343	2.575658444	3.110162385	1.076804019	0.722049227	0.07013379	1.741561073	2.516452451	0	1.402997136	0	0	0	0	2.049791591	0.010117261	0.058041896	0	0	0.429415246	0	0	0.081940834	0	0	0	0	0	0	0	1.355012858	0.075738443	0.137706259	0.111963344	0	0	0	0	0	0	27.8398
H5427_055_0	2008	5	g.2.	i.7.	i.8.	e.3.							OP Facility - Surgery	Professional	Professional	DME/Prosthetics/Supplies							4000	ASC	Chiropractic	Podiatry	Diabetic Supplies							D	D	D	V	T	Coin	Coin	V	Coin		Coin				V	V	V	V			Coin			V	V	P	V	P				V	V	V	Coin							0	0	0	0	0	0	0	0	0		0				0	0	0	0			0			0	0	0	0	0				0	0	0	0							0	4000	930.646861	43.54262084	965.751897	1230.129555	149.0639071	5.57587144	0.334884831	574.0176564	17.45979281		12.86907842				1464.927319	1418.781589	7.002752701	21.42624932			2.287857254			209.5526126	223.416	161.784	29.42828724	7.357071809				229.6070625	52.42304061	95.31461929	0.362443181							$150 for 1st 7 days	$150 for 1st 7 days	$0 for days 1-7 and $50 for days 8-100	$20 Copay	$125 Copay	20% Copay	20% Copay	$50 ER; $10 Urgent Care	25% Copay		Varies by service				$0 Copay	$15 Copay	$20 Copay	$20.00 Copay			33% Copay			$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay				$0 Copay	$20 Copay	$20 Copay	20% Copay							105.4821002	73.32282821	23.73275743	18.66503395	116.6564622	0.18665034	0.18665034	39.1965713	0.233312924	0	0.159306065	0	0	0	0	13.99877546	18.66503395	18.66503395	0	0	0.30797306	0	0	0	0	0	0	0	0	0	0	0	18.66503395	18.66503395	0.18665034							8.1805	0.266055676	1.909996292	1.913367492	1.449105671	1.040738297	0.062506367	1.874960333	4.073595319	0	2.050122241	0	0	0	0	1.655100407	0.010892218	0.033326806	0	0	0.7045984	0	0	0	0	0	0	0	0	0	0	0	0.081539819	0.148254217	0.067650143	0	0	0	0	0	0	25.5224	0	1.825417633	8.1805	0.266055676	1.909996292	1.913367492	1.449105671	1.040738297	0.062506367	1.874960333	4.073595319	0	2.050122241	0	0	0	0	1.655100407	0.010892218	0.033326806	0	0	0.7045984	0	0	0	0	0	0	0	0	0	0	0	0.081539819	0.148254217	0.067650143	0	0	0	0	0	0	25.5224	4000																																																																																			0	0	0	8.1805	0.266055676	1.909996292	1.913367492	1.449105671	1.040738297	0.062506367	1.874960333	4.073595319	0	2.050122241	0	0	0	0	1.655100407	0.010892218	0.033326806	0	0	0.7045984	0	0	0	0	0	0	0	0	0	0	0	0.081539819	0.148254217	0.067650143	0	0	0	0	0	0	25.5224
H5427_056_0	2008	5	g.2.	i.7.	i.8.	e.3.							OP Facility - Surgery	Professional	Professional	DME/Prosthetics/Supplies							4000	ASC	Chiropractic	Podiatry	Diabetic Supplies							D	D	D	V	T	Coin	Coin	V	Coin		Coin				V	V	V	V			Coin			V	V	P	V	P				V	V	V	Coin							0	0	0	0	0	0	0	0	0		0				0	0	0	0			0			0	0	0	0	0				0	0	0	0							0	4000	1270.646308	59.45033796	1318.576502	1679.541019	203.5224221	7.612941875	0.457230547	783.7273689	23.83849578		17.75524176				2000.119022	1937.114563	9.561115218	29.2540444			2.287857254			209.5526126	223.416	161.784	29.42828724	7.357071809				313.4909475	71.57510092	130.1365471	0.494856974							$75 for 1st 5 days	$75 for 1st 5 days	$0 for days 1-7 and $50 for days 8-100	$10 Copay	$50 Copay	0% Copay	20% Copay	$25 ER; $0 Urgent Care	25% Copay		Varies by service				$0 Copay	$0 Copay	$0 Copay	$10.00 Copay			33% Copay			$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay				$0 Copay	$0 Copay	$0 Copay	20% Copay							44.66551365	29.43662782	23.2843522	9.156188984	45.78094492	0	0.18312378	18.31237797	0.228904725	0	0.156296146	0	0	0	0	0	0	9.156188984	0	0	0.302154236	0	0	0	0	0	0	0	0	0	0	0	0	0	0.18312378							4.7295	0.145834789	2.558516639	1.281516248	0.776454066	0	0.083729786	1.19599265	5.456744311	0	2.775075858	0	0	0	0	0	0	0.022321297	0	0	0.691285762	0	0	0	0	0	0	0	0	0	0	0	0	0	0.090620079	0	0	0	0	0	0	19.8076	0	1.825417633	4.7295	0.145834789	2.558516639	1.281516248	0.776454066	0	0.083729786	1.19599265	5.456744311	0	2.775075858	0	0	0	0	0	0	0.022321297	0	0	0.691285762	0	0	0	0	0	0	0	0	0	0	0	0	0	0.090620079	0	0	0	0	0	0	19.8076	4000																																																																																			0	0	0	4.7295	0.145834789	2.558516639	1.281516248	0.776454066	0	0.083729786	1.19599265	5.456744311	0	2.775075858	0	0	0	0	0	0	0.022321297	0	0	0.691285762	0	0	0	0	0	0	0	0	0	0	0	0	0	0.090620079	0	0	0	0	0	0	19.8076
H5427_057_0	2008	3	g.2.	i.7.	i.8.	e.3.							OP Facility - Surgery	Professional	Professional	DME/Prosthetics/Supplies							2500	ASC	Chiropractic	Podiatry	Diabetic Supplies							D	D	D	V	T	Coin	Coin	V	Coin		P				V	V	V	V			Coin			P	V	P	V					Coin	V	V	Coin							0	0	0	0	0	0	0	0	0		0				0	0	0	0			0			0	0	0	0					0	0	0	0							0	2500	840.5528923	39.32735114	872.2594835	1111.043296	134.6333433	4.524778192	0.439498903	518.4482123	15.76954692		247.0472206				1323.110781	1281.432322	6.324830915	19.35201911			2.287857254			209.5526126	223.416	161.784	29.42828724					8.491294497	47.34807611	86.08741112	0.701627089							$75 for 1st 7 days	$150 for 1st 7 days	$0 for days 1-7 and $75 for days 8-100	$0 Copay	$100 Copay	20% Copay	20% Copay	$50 ER; $10 Urgent Care	20% Copay		Varies by service				$0 Copay	$10 Copay	$10 Copay	$30.00 Copay			20% Copay			$5 Copay	$0 Copay	$10 Copay	$0 Copay					20% Copay	$10 Copay	$10 Copay	0% Copay							47.520296	66.06471607	32.07523331	0	84.08705708	0.168174114	0.168174114	35.31656398	0.168174114	0	47.95644631	0	0	0	0	8.408705708	8.408705708	25.22611713	0	0	0.168174114	0	0	4.204352854	0	8.408705708	0		0	0	0	0.168174114	8.408705708	8.408705708	0							3.3286	0.216512524	2.33149387	0	0.943410135	0.760950564	0.073912339	1.525817455	2.652029585	0	0.987292231	0	0	0	0	0.897932273	0.00443197	0.040681358	0	0	0.384758367	0	0	0.073419427	0	0.11336617	0	0	0	0	0	1.42801593	0.033178003	0.060323642	0	0	0	0	0	0	0	15.8561	0	3.049453582	3.3286	0.216512524	2.33149387	0	0.943410135	0.760950564	0.073912339	1.525817455	2.652029585	0	0.987292231	0	0	0	0	0.897932273	0.00443197	0.040681358	0	0	0.384758367	0	0	0.073419427	0	0.11336617	0	0	0	0	0	1.42801593	0.033178003	0.060323642	0	0	0	0	0	0	0	15.8561	2500																																																																																			0	0	0	3.3286	0.216512524	2.33149387	0	0.943410135	0.760950564	0.073912339	1.525817455	2.652029585	0	0.987292231	0	0	0	0	0.897932273	0.00443197	0.040681358	0	0	0.384758367	0	0	0.073419427	0	0.11336617	0	0	0	0	0	1.42801593	0.033178003	0.060323642	0	0	0	0	0	0	0	15.8561
H5427_058_0	2008	4	g.2.	i.7.	i.8.	e.3.							OP Facility - Surgery	Professional	Professional	DME/Prosthetics/Supplies							2500	ASC	Chiropractic	Podiatry	Diabetic Supplies							D	D	D	V	T	Coin	Coin	V	Coin		P				V	V	V	V			Coin			P	V	P	V					Coin	V	V	Coin							0	0	0	0	0	0	0	0	0		0				0	0	0	0			0			0	0	0	0					0	0	0	0							0	2500	859.6304496	40.21994196	892.0566675	1136.260022	137.6890407	4.839819497	0.470099366	530.2151404	16.86751426		258.0169081				1353.140684	1310.516272	6.468382053	19.79124103			2.287857254			209.5526126	223.416	161.784	29.42828724					9.082507677	48.42270882	88.04128877	0.750478437							$75 for 1st 7 days	$150 for 1st 7 days	$0 for days 1-7 and $75 for days 8-100	$0 Copay	$100 Copay	20% Copay	20% Copay	$50 ER; $10 Urgent Care	20% Copay		Varies by service				$0 Copay	$10 Copay	$10 Copay	$30.00 Copay			20% Copay			$5 Copay	$0 Copay	$10 Copay	$0 Copay					20% Copay	$10 Copay	$10 Copay	0% Copay							47.8426022	66.51279972	32.29278344	0	84.65737719	0.169314754	0.169314754	35.55609842	0.169314754	0	48.2817107	0	0	0	0	8.465737719	8.465737719	25.39721316	0	0	0.169314754	0	0	4.232868859	0	8.465737719	0		0	0	0	0.169314754	8.465737719	8.465737719	0							3.4272	0.222928412	2.400582732	0	0.971366088	0.819452849	0.079594759	1.57103181	2.855919034	0	1.038124809	0	0	0	0	0.924540586	0.004563302	0.041886864	0	0	0.387367989	0	0	0.073917394	0	0.114135076	0	0	0	0	0	1.537802557	0.034161163	0.062111205	0	0	0	0	0	0	0	16.5667	0	3.049453582	3.4272	0.222928412	2.400582732	0	0.971366088	0.819452849	0.079594759	1.57103181	2.855919034	0	1.038124809	0	0	0	0	0.924540586	0.004563302	0.041886864	0	0	0.387367989	0	0	0.073917394	0	0.114135076	0	0	0	0	0	1.537802557	0.034161163	0.062111205	0	0	0	0	0	0	0	16.5667	2500																																																																																			0	0	0	3.4272	0.222928412	2.400582732	0	0.971366088	0.819452849	0.079594759	1.57103181	2.855919034	0	1.038124809	0	0	0	0	0.924540586	0.004563302	0.041886864	0	0	0.387367989	0	0	0.073917394	0	0.114135076	0	0	0	0	0	1.537802557	0.034161163	0.062111205	0	0	0	0	0	0	0	16.5667
H5427_059_0	2008	6	g.2.	i.7.	i.8.	e.3.							OP Facility - Surgery	Professional	Professional	DME/Prosthetics/Supplies							2500	ASC	Chiropractic	Podiatry	Diabetic Supplies							D	D	D	V	T	Coin	Coin	V	Coin		P				V	V	V	V			Coin			P	V	P	V					Coin	V	V	Coin							0	0	0	0	0	0	0	0	0		0				0	0	0	0			0			0	0	0	0					0	0	0	0							0	2500	716.8668002	33.54039065	743.9078142	947.554948	114.8222496	3.858963896	0.374827302	442.1593387	13.44908184		209.9230086				1128.417022	1092.871486	5.394141572	16.50439865			2.287857254			209.5526126	223.416	161.784	29.42828724					7.241813301	40.38087802	73.41977823	0.59838372							$75 for 1st 7 days	$150 for 1st 7 days	$0 for days 1-7 and $75 for days 8-100	$0 Copay	$100 Copay	20% Copay	20% Copay	$50 ER; $10 Urgent Care	20% Copay		Varies by service				$0 Copay	$10 Copay	$10 Copay	$30.00 Copay			20% Copay			$5 Copay	$0 Copay	$10 Copay	$0 Copay					20% Copay	$10 Copay	$10 Copay	0% Copay							46.05916788	64.03339424	31.08900154	0	81.50159415	0.163003188	0.163003188	34.23066954	0.163003188	0	46.48190768	0	0	0	0	8.150159415	8.150159415	24.45047825	0	0	0.163003188	0	0	4.075079708	0	8.150159415	0		0	0	0	0.163003188	8.150159415	8.150159415	0							2.7515	0.178975421	1.927279265	0	0.779849699	0.629023419	0.061098045	1.261284184	2.19224322	0	0.813135159	0	0	0	0	0.742256402	0.003663593	0.03362837	0	0	0.372928027	0	0	0.071161967	0	0.109880449	0	0	0	0	0	1.180438657	0.027425883	0.049865241	0	0	0	0	0	0	0	13.1857	0	3.049453582	2.7515	0.178975421	1.927279265	0	0.779849699	0.629023419	0.061098045	1.261284184	2.19224322	0	0.813135159	0	0	0	0	0.742256402	0.003663593	0.03362837	0	0	0.372928027	0	0	0.071161967	0	0.109880449	0	0	0	0	0	1.180438657	0.027425883	0.049865241	0	0	0	0	0	0	0	13.1857	2500																																																																																			0	0	0	2.7515	0.178975421	1.927279265	0	0.779849699	0.629023419	0.061098045	1.261284184	2.19224322	0	0.813135159	0	0	0	0	0.742256402	0.003663593	0.03362837	0	0	0.372928027	0	0	0.071161967	0	0.109880449	0	0	0	0	0	1.180438657	0.027425883	0.049865241	0	0	0	0	0	0	0	13.1857
H5427_060_0	2008	6	g.2.	i.7.	i.8.	e.3.							OP Facility - Surgery	Professional	Professional	DME/Prosthetics/Supplies							2500	ASC	Chiropractic	Podiatry	Diabetic Supplies							D	D	D	V	T	Coin	Coin	V	Coin		P				V	V	V	V			Coin			P	V	P	V					Coin	V	V	Coin							0	0	0	0	0	0	0	0	0		0				0	0	0	0			0			0	0	0	0					0	0	0	0							0	2500	859.6304496	40.21994196	892.0566675	1136.260022	137.6890407	4.046419505	0.393035163	530.2151404	14.10239343		258.0169081				1353.140684	1310.516272	6.468382053	19.79124103			2.287857254			209.5526126	223.416	161.784	29.42828724					7.593596464	48.42270882	88.04128877	0.627451207							$75 for 1st 7 days	$150 for 1st 7 days	$0 for days 1-7 and $75 for days 8-100	$0 Copay	$100 Copay	20% Copay	20% Copay	$50 ER; $10 Urgent Care	20% Copay		Varies by service				$0 Copay	$10 Copay	$10 Copay	$30.00 Copay			20% Copay			$5 Copay	$0 Copay	$10 Copay	$0 Copay					20% Copay	$10 Copay	$10 Copay	0% Copay							47.37118983	65.85742239	31.97458967	0	83.82321405	0.167646428	0.167646428	35.2057499	0.167646428	0	47.80597161	0	0	0	0	8.382321405	8.382321405	25.14696422	0	0	0.167646428	0	0	4.191160703	0	8.382321405	0		0	0	0	0.167646428	8.382321405	8.382321405	0							3.3935	0.220731809	2.376928826	0	0.961794828	0.678367777	0.065890941	1.555551802	2.364215887	0	1.027895749	0	0	0	0	0.915430717	0.004518338	0.041474136	0	0	0.383551097	0	0	0.073189056	0	0.113010457	0	0	0	0	0	1.273039324	0.033824559	0.061499198	0	0	0	0	0	0	0	15.5444	0	3.049453582	3.3935	0.220731809	2.376928826	0	0.961794828	0.678367777	0.065890941	1.555551802	2.364215887	0	1.027895749	0	0	0	0	0.915430717	0.004518338	0.041474136	0	0	0.383551097	0	0	0.073189056	0	0.113010457	0	0	0	0	0	1.273039324	0.033824559	0.061499198	0	0	0	0	0	0	0	15.5444	2500																																																																																			0	0	0	3.3935	0.220731809	2.376928826	0	0.961794828	0.678367777	0.065890941	1.555551802	2.364215887	0	1.027895749	0	0	0	0	0.915430717	0.004518338	0.041474136	0	0	0.383551097	0	0	0.073189056	0	0.113010457	0	0	0	0	0	1.273039324	0.033824559	0.061499198	0	0	0	0	0	0	0	15.5444
H5427_061_0	2008	5	g.2.	i.7.	i.8.								OP Facility - Surgery	Professional	Professional								2500	ASC	Chiropractic	Podiatry								D	D	D	V	T		Coin	V	P		P				V	V	V	V			Coin			P	V	P	V	P				V	V	V								0	0	0	0	0		0	0	0	0	0				0	0	0	0			0			0	0	0	0	0				0	0	0								0	2500	1015.603793	47.51754153	1053.913499	1342.425676	162.6716597		0.365455812	626.4186055	465.3395355	1053.041389	299.5885098				1598.657669	1548.299385	7.642020299	23.38220972			2.287857254			209.5526126	223.416	161.784	29.42828724	7.357071809				250.5674422	57.20863745	104.0157045								$0 for days 1-30 and $50 for days 31-90	$0 for days 1-30 and $50 for days 31-90	$0 for days 1-19 and $25 for days 20-100	$0 Copay	$0 Copay		20% Copay	$50 ER; $0 Urgent Care	$50 Copay	$12.50 Copay	Varies by service				$0 Copay	$0 Copay	$0 Copay	$12.50 Copay			20% Copay			$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay				$0 Copay	$0 Copay	$0 Copay								0.63028174	3.090343097	1.671648377	0	0	0	0.105459981	21.09199613	26.36499517	6.591248791	7.802667589	0	0	0	0	0	0	6.591248791	0	0	0.105459981	0	0	0	0	0	0	0	0	0	0	0	0	0								0.0533	0.012237126	0.146814399	0	0	0	0.038540963	1.1010349	1.02238955	0.578404815	0.19479913	0	0	0	0	0	0	0.012843163	0	0	0.241277382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.4017	0	3.049453582	0.0533	0.012237126	0.146814399	0	0	0	0.038540963	1.1010349	1.02238955	0.578404815	0.19479913	0	0	0	0	0	0	0.012843163	0	0	0.241277382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.4017	2500																																																																																			0	0	0	0.0533	0.012237126	0.146814399	0	0	0	0.038540963	1.1010349	1.02238955	0.578404815	0.19479913	0	0	0	0	0	0	0.012843163	0	0	0.241277382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.4017
H5427_062_0	2008	5	g.2.	i.7.	i.8.								OP Facility - Surgery	Professional	Professional								2500	ASC	Chiropractic	Podiatry								D	D	D	V	T	Coin	Coin	V	P	P	P				V	V	V	V			Coin			P	V	P	V					V	V	V								0	0	0	0	0	0	0	0	0	0	0				0	0	0	0			0			0	0	0	0					0	0	0								0	2500	1372.474543	64.21462441	1424.245811	1814.137638	219.8324911	8.223034888	0.493872514	846.5344413	628.8541564	1429.543676	406.7027792				2160.406419	2092.35285	10.32733276	31.59843221			2.287857254			209.5526126	223.416	161.784	29.42828724					338.6137765	77.31105289	140.5655507								$0 for days 1-30 and $25 for days 31-90	$0 for days 1-30 and $25 for days 31-90	$0 for days 1-30 and $25 for days 31-100	$0 Copay	$0 Copay	0% Copay	20% Copay	$25 ER; $0 Urgent Care	$50 Copay	$12.50 Copay	Varies by service				$0 Copay	$0 Copay	$0 Copay	$12.50 Copay			20% Copay			$0 Copay	$0 Copay	$0 Copay	$0 Copay					$0 Copay	$0 Copay	$0 Copay								0.311783198	1.528708498	0.175710631	0	0	0	0.104336356	10.43363559	26.08408898	6.521022246	7.719533966	0	0	0	0	0	0	6.521022246	0	0	0.104336356	0	0	0	0	0	0		0	0	0	0	0	0								0.0357	0.008180454	0.020854594	0	0	0	0.051528858	0.73603599	1.366923981	0.77684051	0.26162966	0	0	0	0	0	0	0.017171173	0	0	0.238706689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.5135	0	3.049453582	0.0357	0.008180454	0.020854594	0	0	0	0.051528858	0.73603599	1.366923981	0.77684051	0.26162966	0	0	0	0	0	0	0.017171173	0	0	0.238706689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.5135	2500																																																																																			0	0	0	0.0357	0.008180454	0.020854594	0	0	0	0.051528858	0.73603599	1.366923981	0.77684051	0.26162966	0	0	0	0	0	0	0.017171173	0	0	0.238706689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.5135
H5427_063_0	2008	5	g.2.	i.7.	i.8.	e.3.							OP Facility - Surgery	Professional	Professional	DME/Prosthetics/Supplies							2500	ASC	Chiropractic	Podiatry	Diabetic Supplies							D	D	D	V	T	Coin	Coin	V	Coin		P				V	V	V	V			Coin			P	V	P	V					Coin	V	V	Coin							0	0	0	0	0	0	0	0	0		0				0	0	0	0			0			0	0	0	0					0	0	0	0							0	2500	750.8932191	35.13240102	779.2177475	992.5310879	120.2723415	4.042131427	0.392618655	463.146639	14.08744882		220.1359919				1181.977866	1144.745143	5.650177032	17.28778767			2.287857254			209.5526126	223.416	161.784	29.42828724					7.585549366	42.29757534	76.90468243	0.626786283							$75 for 1st 7 days	$150 for 1st 7 days	$0 for days 1-7 and $75 for days 8-100	$0 Copay	$100 Copay	20% Copay	20% Copay	$50 ER; $10 Urgent Care	20% Copay		Varies by service				$0 Copay	$10 Copay	$10 Copay	$30.00 Copay			20% Copay			$5 Copay	$0 Copay	$10 Copay	$0 Copay					20% Copay	$10 Copay	$10 Copay	0% Copay							46.50644524	64.65521806	31.39090467	0	82.29305045	0.164586101	0.164586101	34.56308119	0.164586101	0	46.93329024	0	0	0	0	8.229305045	8.229305045	24.68791513	0	0	0.164586101	0	0	4.114652522	0	8.229305045	0		0	0	0	0.164586101	8.229305045	8.229305045	0							2.9101	0.189291087	2.038362502	0	0.824798155	0.665278651	0.064619574	1.333981241	2.318598273	0	0.860975533	0	0	0	0	0.785038082	0.003874753	0.03556662	0	0	0.376549505	0	0	0.071853015	0	0.110947491	0	0	0	0	0	1.248475993	0.029006638	0.052739341	0	0	0	0	0	0	0	13.9201	0	3.049453582	2.9101	0.189291087	2.038362502	0	0.824798155	0.665278651	0.064619574	1.333981241	2.318598273	0	0.860975533	0	0	0	0	0.785038082	0.003874753	0.03556662	0	0	0.376549505	0	0	0.071853015	0	0.110947491	0	0	0	0	0	1.248475993	0.029006638	0.052739341	0	0	0	0	0	0	0	13.9201	2500																																																																																			0	0	0	2.9101	0.189291087	2.038362502	0	0.824798155	0.665278651	0.064619574	1.333981241	2.318598273	0	0.860975533	0	0	0	0	0.785038082	0.003874753	0.03556662	0	0	0.376549505	0	0	0.071853015	0	0.110947491	0	0	0	0	0	1.248475993	0.029006638	0.052739341	0	0	0	0	0	0	0	13.9201
H5427_064_0	2008	5	g.2.	i.7.	i.8.	e.3.							OP Facility - Surgery	Professional	Professional	DME/Prosthetics/Supplies							2500	ASC	Chiropractic	Podiatry	Diabetic Supplies							D	D	D	V	T	Coin	Coin	V	Coin		P				V	V	V	V			Coin			P	V	P	V					Coin	V	V	Coin							0	0	0	0	0	0	0	0	0		0				0	0	0	0			0			0	0	0	0					0	0	0	0							0	2500	859.6304496	40.21994196	892.0566675	1136.260022	137.6890407	4.233316418	0.411188758	530.2151404	14.75375788		258.0169081				1353.140684	1310.516272	6.468382053	19.79124103			2.287857254			209.5526126	223.416	161.784	29.42828724					7.944331166	48.42270882	88.04128877	0.656432061							$75 for 1st 7 days	$150 for 1st 7 days	$0 for days 1-7 and $75 for days 8-100	$0 Copay	$100 Copay	20% Copay	20% Copay	$50 ER; $10 Urgent Care	20% Copay		Varies by service				$0 Copay	$10 Copay	$10 Copay	$30.00 Copay			20% Copay			$5 Copay	$0 Copay	$10 Copay	$0 Copay					20% Copay	$10 Copay	$10 Copay	0% Copay							47.48679485	66.01814135	32.05262071	0	84.02777687	0.168055554	0.168055554	35.29166628	0.168055554	0	47.92263767	0	0	0	0	8.402777687	8.402777687	25.20833306	0	0	0.168055554	0	0	4.201388843	0	8.402777687	0		0	0	0	0.168055554	8.402777687	8.402777687	0							3.4018	0.221270484	2.382729501	0	0.964141999	0.711432335	0.069102554	1.559347983	2.47945095	0	1.030404233	0	0	0	0	0.917664741	0.004529365	0.04157535	0	0	0.384487118	0	0	0.073367667	0	0.113286249	0	0	0	0	0	1.335088973	0.033907105	0.061649281	0	0	0	0	0	0	0	15.7852	0	3.049453582	3.4018	0.221270484	2.382729501	0	0.964141999	0.711432335	0.069102554	1.559347983	2.47945095	0	1.030404233	0	0	0	0	0.917664741	0.004529365	0.04157535	0	0	0.384487118	0	0	0.073367667	0	0.113286249	0	0	0	0	0	1.335088973	0.033907105	0.061649281	0	0	0	0	0	0	0	15.7852	2500																																																																																			0	0	0	3.4018	0.221270484	2.382729501	0	0.964141999	0.711432335	0.069102554	1.559347983	2.47945095	0	1.030404233	0	0	0	0	0.917664741	0.004529365	0.04157535	0	0	0.384487118	0	0	0.073367667	0	0.113286249	0	0	0	0	0	1.335088973	0.033907105	0.061649281	0	0	0	0	0	0	0	15.7852
H5427_065_0	2008	5	g.2.	i.7.	i.8.	e.3.							OP Facility - Surgery	Professional	Professional	DME/Prosthetics/Supplies							2500	ASC	Chiropractic	Podiatry	Diabetic Supplies							D	D	D	V	T	Coin	Coin	V	P	P	P				V	V	V	V			Coin			P	V	P	V					V	V	V	Coin							0	0	0	0	0	0	0	0	0	0	0				0	0	0	0			0			0	0	0	0					0	0	0	0							0	2500	997.2356232	46.65814118	1034.852461	1318.146619	159.7295865	5.974830909	0.358846193	615.0892237	456.9234233	1033.662783	294.0753288				1569.74441	1520.296904	7.503807026	22.95932001			2.287857254			209.5526126	223.416	161.784	29.42828724					246.0356895	56.17396433	102.1344806	0.388376372							$0 for days 1-30 and $50 for days 31-90	$0 for days 1-30 and $50 for days 31-90	$0 for days 1-19 and $25 for days 20-100	$0 Copay	$0 Copay	0% Copay	20% Copay	$50 ER; $0 Urgent Care	$50 Copay	$12.50 Copay	Varies by service				$0 Copay	$0 Copay	$0 Copay	$12.50 Copay			20% Copay			$0 Copay	$0 Copay	$0 Copay	$0 Copay					$0 Copay	$0 Copay	$0 Copay	0% Copay							0.647080735	3.172710483	1.716203076	0	0	0	0.108270822	21.65416432	27.0677054	6.76692635	8.010633278	0	0	0	0	0	0	6.76692635	0	0	0.108270822	0	0	0	0	0	0		0	0	0	0	0	0	0							0.0538	0.012336064	0.148001415	0	0	0	0.038852572	1.109936927	1.030655718	0.582893327	0.196310801	0	0	0	0	0	0	0.012947002	0	0	0.247708185	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.4334	0	3.049453582	0.0538	0.012336064	0.148001415	0	0	0	0.038852572	1.109936927	1.030655718	0.582893327	0.196310801	0	0	0	0	0	0	0.012947002	0	0	0.247708185	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.4334	2500																																																																																			0	0	0	0.0538	0.012336064	0.148001415	0	0	0	0.038852572	1.109936927	1.030655718	0.582893327	0.196310801	0	0	0	0	0	0	0.012947002	0	0	0.247708185	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.4334
H5427_066_0	2008	5	g.2.	i.7.	i.8.								OP Facility - Surgery	Professional	Professional								2500	ASC	Chiropractic	Podiatry								D	D	D	V	T	Coin	Coin	V	P	P	P				V	V	V	V			Coin			P	V	P	V					V	V	V								0	0	0	0	0	0	0	0	0	0	0				0	0	0	0			0			0	0	0	0					0	0	0								0	2500	1372.474543	64.21462441	1424.245811	1814.137638	219.8324911	8.223034888	0.493872514	846.5344413	628.8541564	1429.543676	406.7027792				2160.406419	2092.35285	10.32733276	31.59843221			2.287857254			209.5526126	223.416	161.784	29.42828724					338.6137765	77.31105289	140.5655507								$0 for days 1-30 and $25 for days 31-90	$0 for days 1-30 and $25 for days 31-90	$0 for days 1-30 and $25 for days 31-100	$0 Copay	$0 Copay	0% Copay	20% Copay	$25 ER; $0 Urgent Care	$50 Copay	$12.50 Copay	Varies by service				$0 Copay	$0 Copay	$0 Copay	$12.50 Copay			20% Copay			$0 Copay	$0 Copay	$0 Copay	$0 Copay					$0 Copay	$0 Copay	$0 Copay								0.338828523	1.661314804	0.190952475	0	0	0	0.11338691	11.33869099	28.34672747	7.086681868	8.389157302	0	0	0	0	0	0	7.086681868	0	0	0.11338691	0	0	0	0	0	0		0	0	0	0	0	0								0.0388	0.008890059	0.022663605	0	0	0	0.055998678	0.799882703	1.485496449	0.844226771	0.284324466	0	0	0	0	0	0	0.01866067	0	0	0.259413064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.8183	0	3.049453582	0.0388	0.008890059	0.022663605	0	0	0	0.055998678	0.799882703	1.485496449	0.844226771	0.284324466	0	0	0	0	0	0	0.01866067	0	0	0.259413064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.8183	2500																																																																																			0	0	0	0.0388	0.008890059	0.022663605	0	0	0	0.055998678	0.799882703	1.485496449	0.844226771	0.284324466	0	0	0	0	0	0	0.01866067	0	0	0.259413064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.8183
H5427_068_0	2008	7	g.2.	i.7.	i.8.	e.3.							OP Facility - Surgery	Professional	Professional	DME/Prosthetics/Supplies							4000	ASC	Chiropractic	Podiatry	Diabetic Supplies							D	D	D	V	T	Coin	Coin	V	P		Coin				V	V	V	V			Coin			V	V	P	V	P				V	V	V	Coin							0	0	0	0	0	0	0	0	0		0				0	0	0	0			0			0	0	0	0	0				0	0	0	0							0	4000	1158.516229	54.2040542	1202.216751	1531.327416	185.5622823	6.521246908	0.529412456	714.566178	530.8205894		16.14381008				1823.615535	1766.170998	8.717380342	26.67247761			2.287857254			209.5526126	223.416	161.784	29.42828724	7.357071809				285.8264712	65.25884936	118.6524534	0.758536236							$0 for days 1-15 and $25 for days 16-90	$0 for days 1-15 and $25 for days 16-90	$0 for days 1-30 and $25 for days 31-100	$0 Copay	$0 Copay	0% Copay	0% Copay	$0 ER; $0 Urgent Care	$25 Copay		$0 Copay				$0 Copay	$0 Copay	$0 Copay	$0.00 Copay			20% Copay			$0 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay				$0 Copay	$0 Copay	$0 Copay	0% Copay							2.099417634	6.627799939	0.336815732	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0.2	0	0	0	0	0	0	0	0	0	0	0	0	0	0							0.2027	0.029937802	0.033743793	0	0	0	0	0	1.105876228	0	0	0	0	0	0	0	0	0	0	0	0.457571451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.8298	0	0	0.2027	0.029937802	0.033743793	0	0	0	0	0	1.105876228	0	0	0	0	0	0	0	0	0	0	0	0.457571451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.8298	4000																																																																																			0	0	0	0.2027	0.029937802	0.033743793	0	0	0	0	0	1.105876228	0	0	0	0	0	0	0	0	0	0	0	0.457571451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.8298
H5427_070_0	2008	6	g.2.	i.7.	i.8.								OP Facility - Surgery	Professional	Professional								2500	ASC	Chiropractic	Podiatry								D	D	D	V	T	Coin	Coin	V	Coin		P				V	V	V	V			Coin			V	V	P	V	P				Coin	V	V								0	0	0	0	0	0	0	0	0		0				0	0	0	0			0			0	0	0	0	0				0	0	0								0	2500	2162.88534	101.1959533	2244.471784	2858.903084	346.4344565	12.17480514	0.988383599	1334.055296	40.57772232		643.943503				3404.588739	3297.342985	16.27486407	49.79603166			2.287857254			209.5526126	223.416	161.784	29.42828724	7.357071809				21.84954279	121.8346408	221.5175287								$75 for days 1-7 and $0 for days 8-90	$150 for days 1-7 and $0 for days 8-90	$0 for days 1-7 and $75 for days 8-100	$0 Copay	$100 Copay	20% Copay	20% Copay	$50 ER; $10 Urgent Care	20% Copay		Varies by service				$0 Copay	$10 Copay	$10 Copay	$30.00 Copay			20% Copay			$5 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay				20% Copay	$10 Copay	$10 Copay								52.88534009	73.52342622	35.69652895	0	93.58049055	0.187160981	0.187160981	39.30380603	0.187160981	0	54.55985908	0	0	0	0	9.358049055	9.358049055	28.07414716	0	0	0.187160981	0	0	4.679024527	0	0	0	0	0	0	0	0.187160981	9.358049055	9.358049055								9.5321	0.620022767	6.676654334	0	2.701625532	2.278648474	0.184986844	4.369454217	7.59456632	0	2.927788898	0	0	0	0	2.571391451	0.012691748	0.116498427	0	0	0.428197608	0	0	0.081708484	0	0	0	0	0	0	0	4.089381865	0.095011212	0.172747658	0	0	0	0	0	0	0	44.4535	0	3.049453582	9.5321	0.620022767	6.676654334	0	2.701625532	2.278648474	0.184986844	4.369454217	7.59456632	0	2.927788898	0	0	0	0	2.571391451	0.012691748	0.116498427	0	0	0.428197608	0	0	0.081708484	0	0	0	0	0	0	0	4.089381865	0.095011212	0.172747658	0	0	0	0	0	0	0	44.4535	2500																																																																																			0	0	0	9.5321	0.620022767	6.676654334	0	2.701625532	2.278648474	0.184986844	4.369454217	7.59456632	0	2.927788898	0	0	0	0	2.571391451	0.012691748	0.116498427	0	0	0.428197608	0	0	0.081708484	0	0	0	0	0	0	0	4.089381865	0.095011212	0.172747658	0	0	0	0	0	0	0	44.4535
H5427_072_0	2008	6	g.2.	i.7.	i.8.								OP Facility - Surgery	Professional	Professional								2500	ASC	Chiropractic	Podiatry								D	D	D	V	T	Coin	Coin	V	Coin		P				V	V	V	V			Coin			V	V	P	V	P				Coin	V	V								0	0	0	0	0	0	0	0	0		0				0	0	0	0			0			0	0	0	0	0				0	0	0								0	2500	1340.044575	62.69730794	1390.592548	1771.271688	214.6381065	7.543063552	0.612366294	826.5318226	25.14047122		396.9689685				2109.358543	2042.913	10.08330996	30.85179821			2.287857254			209.5526126	223.416	161.784	29.42828724	7.357071809				13.53717681	75.48428314	137.2441512								$75 for days 1-7 and $0 for days 8-90	$150 for days 1-7 and $0 for days 8-90	$0 for days 1-7 and $75 for days 8-100	$0 Copay	$100 Copay	20% Copay	20% Copay	$50 ER; $10 Urgent Care	20% Copay		Varies by service				$0 Copay	$10 Copay	$10 Copay	$30.00 Copay			20% Copay			$5 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay				20% Copay	$10 Copay	$10 Copay								50.69673499	70.48073528	34.21926502	0	89.70775875	0.179415517	0.179415517	37.67725867	0.179415517	0	52.30195575	0	0	0	0	8.970775875	8.970775875	26.91232762	0	0	0.179415517	0	0	4.485387937	0	0	0	0	0	0	0	0.179415517	8.970775875	8.970775875								5.6613	0.36824603	3.965421246	0	1.604558623	1.353342651	0.109868016	2.595121107	4.510590655	0	1.730187785	0	0	0	0	1.527209554	0.007537926	0.069191142	0	0	0.410477093	0	0	0.078327063	0	0	0	0	0	0	0	2.428779583	0.056429382	0.102598877	0	0	0	0	0	0	0	26.5792	0	3.049453582	5.6613	0.36824603	3.965421246	0	1.604558623	1.353342651	0.109868016	2.595121107	4.510590655	0	1.730187785	0	0	0	0	1.527209554	0.007537926	0.069191142	0	0	0.410477093	0	0	0.078327063	0	0	0	0	0	0	0	2.428779583	0.056429382	0.102598877	0	0	0	0	0	0	0	26.5792	2500																																																																																			0	0	0	5.6613	0.36824603	3.965421246	0	1.604558623	1.353342651	0.109868016	2.595121107	4.510590655	0	1.730187785	0	0	0	0	1.527209554	0.007537926	0.069191142	0	0	0.410477093	0	0	0.078327063	0	0	0	0	0	0	0	2.428779583	0.056429382	0.102598877	0	0	0	0	0	0	0	26.5792
H5427_073_0	2008	5	g.2.	i.7.	i.8.	e.3.							OP Facility - Surgery	Professional	Professional	DME/Prosthetics/Supplies							2000	ASC	Chiropractic	Podiatry	Diabetic Supplies							D	D	D	V	T	Coin	Coin	V	Coin		P				V	V	V	V			Coin			P	V	P	V					Coin	V	V	Coin							0	0	0	0	0	0	0	0	0		0				0	0	0	0			0			0	0	0	0					0	0	0	0							0	2000	781.289269	36.55455559	810.7603704	1032.708604	125.1409487	4.205756328	0.408511802	481.8947487	14.65770673		229.2593248				1229.82416	1191.084263	5.878895389	17.98759484			2.287857254			209.5526126	223.416	161.784	29.42828724					7.892611318	44.00977513	80.01777296	0.652158502							$100 for 1st 5 days	$100 for 1st 5 days	$0 for days 1-7 and $50 for days 8-100	$0 Copay	$100 Copay	10% Copay	20% Copay	$50 ER; $10 Urgent Care	20% Copay		Varies by service				$0 Copay	$5 Copay	$20 Copay	$30.00 Copay			20% Copay			$5 Copay	$0 Copay	$10 Copay	$0 Copay					20% Copay	$5 Copay	$5 Copay	0% Copay							49.19733809	32.42330856	19.23511094	0	75.63891381	0.075638914	0.151277828	31.7683438	0.151277828	0	43.13830969	0	0	0	0	3.781945691	15.12778276	22.69167414	0	0	0.151277828	0	0	3.781945691	0	7.563891381	0		0	0	0	0.151277828	3.781945691	3.781945691	0							3.2031	0.098768303	1.299588806	0	0.788793786	0.31811884	0.061798778	1.275749838	2.217386032	0	0.824154979	0	0	0	0	0.375384666	0.007411221	0.034014053	0	0	0.346102075	0	0	0.06604305	0	0.101976384	0	0	0	0	0	1.193977094	0.013870215	0.025218573	0	0	0	0	0	0	0	12.2515	0	4.020518269	3.2031	0.098768303	1.299588806	0	0.788793786	0.31811884	0.061798778	1.275749838	2.217386032	0	0.824154979	0	0	0	0	0.375384666	0.007411221	0.034014053	0	0	0.346102075	0	0	0.06604305	0	0.101976384	0	0	0	0	0	1.193977094	0.013870215	0.025218573	0	0	0	0	0	0	0	12.2515	2000																																																																																			0	0	0	3.2031	0.098768303	1.299588806	0	0.788793786	0.31811884	0.061798778	1.275749838	2.217386032	0	0.824154979	0	0	0	0	0.375384666	0.007411221	0.034014053	0	0	0.346102075	0	0	0.06604305	0	0.101976384	0	0	0	0	0	1.193977094	0.013870215	0.025218573	0	0	0	0	0	0	0	12.2515
H5427_074_0	2008	5	g.2.	i.7.	i.8.	e.3.							OP Facility - Surgery	Professional	Professional	DME/Prosthetics/Supplies							2000	ASC	Chiropractic	Podiatry	Diabetic Supplies							D	D	D	V	T	Coin	Coin	V	Coin		P				V	V	V	V			Coin			P	V	P	V					Coin	V	V	Coin							0	0	0	0	0	0	0	0	0		0				0	0	0	0			0			0	0	0	0					0	0	0	0							0	2000	859.6304496	40.21994196	892.0566675	1136.260022	137.6890407	3.516779117	0.34159035	530.2151404	12.25651534		258.0169081				1353.140684	1310.516272	6.468382053	19.79124103			2.287857254			209.5526126	223.416	161.784	29.42828724					6.599662104	48.42270882	88.04128877	0.545323415							$100 for 1st 5 days	$100 for 1st 5 days	$0 for days 1-7 and $50 for days 8-100	$0 Copay	$100 Copay	10% Copay	20% Copay	$50 ER; $10 Urgent Care	20% Copay		Varies by service				$0 Copay	$5 Copay	$20 Copay	$30.00 Copay			20% Copay			$5 Copay	$0 Copay	$10 Copay	$0 Copay					20% Copay	$5 Copay	$5 Copay	0% Copay							49.44279901	32.5850786	19.33108093	0	76.01630004	0.0760163	0.1520326	31.92684602	0.1520326	0	43.35354022	0	0	0	0	3.800815002	15.20326001	22.80489001	0	0	0.1520326	0	0	3.800815002	0	7.601630004	0		0	0	0	0.1520326	3.800815002	3.800815002	0							3.5419	0.109214164	1.43703497	0	0.872217619	0.267332537	0.051932869	1.410674762	1.863389894	0	0.9321622	0	0	0	0	0.415085826	0.008195041	0.037611423	0	0	0.347828887	0	0	0.066372559	0	0.102485176	0	0	0	0	0	1.003363789	0.015337147	0.027885721	0	0	0	0	0	0	0	12.51	0	4.020518269	3.5419	0.109214164	1.43703497	0	0.872217619	0.267332537	0.051932869	1.410674762	1.863389894	0	0.9321622	0	0	0	0	0.415085826	0.008195041	0.037611423	0	0	0.347828887	0	0	0.066372559	0	0.102485176	0	0	0	0	0	1.003363789	0.015337147	0.027885721	0	0	0	0	0	0	0	12.51	2000																																																																																			0	0	0	3.5419	0.109214164	1.43703497	0	0.872217619	0.267332537	0.051932869	1.410674762	1.863389894	0	0.9321622	0	0	0	0	0.415085826	0.008195041	0.037611423	0	0	0.347828887	0	0	0.066372559	0	0.102485176	0	0	0	0	0	1.003363789	0.015337147	0.027885721	0	0	0	0	0	0	0	12.51
H5428_001_0	2008	2																					0											D	D	D	V	T	P	P	V	V	P	P	V		V	V	V	V	V	V	V	S																					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5429_001_0	2008	6																					3250											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		958.4194846	24.91360214	1093.1972	1662.703293	184.351681	23362.06279	23500.22875	267.6459494	263.1749061	1770.791423	725.4252964	0	58.64528141	523.3243457	12002.09037	19429.47722	289.7189698	837.3549041	7514.722762	22984.94172	383.6919783	939.6629182	0	87.58412991	425.8776271	260.7421743	165.68529	0	0	0	6673.483445											"$300 copay, days 1-10"	"$300 copay, days 1-10"	"$150 copay, days 7-100"	$30 copay	$150 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$25 copay	$5 copay	Varies	$25 copay	$25 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	0% coinsurance	$10 copay	$10 copay															137.51474	252.4592421	103.7715038	11.09564344	150	0.522569524	0.606760317	45	195.1197928	35.47561858	23.92326672	0	0	25	1.965332736	13.21359302	25	25	0	10.10736914	1.306305096	7.00105387	0	0	0	10	10	0	0	0	0											10.9831	0.524139093	9.453559778	1.537396906	2.304396013	1.017358502	1.18825052	1.00367231	4.279219429	5.234993426	1.446211904	0	0	1.090259054	1.965675091	21.39443372	0.603581187	1.744489384	0	19.35977422	0.041768232	0.548219226	0	0	0	0.217285145	0.138071075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.0758		26.19361326	10.9831	0.524139093	9.453559778	1.537396906	2.304396013	1.017358502	1.18825052	1.00367231	4.279219429	5.234993426	1.446211904	0	0	1.090259054	1.965675091	21.39443372	0.603581187	1.744489384	0	19.35977422	0.041768232	0.548219226	0	0	0	0.217285145	0.138071075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.0758																																																																																				0			10.9831	0.524139093	9.453559778	1.537396906	2.304396013	1.017358502	1.18825052	1.00367231	4.279219429	5.234993426	1.446211904	0	0	1.090259054	1.965675091	21.39443372	0.603581187	1.744489384	0	19.35977422	0.041768232	0.548219226	0	0	0	0.217285145	0.138071075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.0758
H5429_005_0	2008	6																					3250											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1215.682252	32.46136134	831.5220661	1601.589934	296.2746618	24109.82253	24238.23935	218.4945163	331.8440112	2001.915583	816.503825	0	67.73674837	590.7038105	6052.337872	9654.70095	135.5637477	391.5801606	4067.422672	11173.39947	260.8594126	690.1576903	0	1561.023436	382.3618189	260.7951066	148.6750113	0	0	0	3490.516701											"$300 copay, days 1-10"	"$300 copay, days 1-10"	"$150 copay, days 6-100"	$30 copay	$150 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$25 copay	$5 copay	Varies	$25 copay	$25 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	0% coinsurance	$10 copay	$10 copay															145.5557103	252.4592421	107.3903897	10.03926894	150	0.543307613	0.627926517	45	142.3557688	32.72682167	16.7503892	0	0	25	0	10.84885582	25	25	0	9.414168557	0.626103148	6.865112958	0	0	0	10	10	0	0	0	0											14.7458	0.68293089	7.441456559	1.339899341	3.703433272	1.091587511	1.268319435	0.819354436	3.936659111	5.459694524	1.139729737	0	0	1.230632939	0	8.728538217	0.282424474	0.815792001	0	8.765688828	0.013610408	0.394834209	0	0	0	0.217329256	0.123895843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2016		26.64075495	14.7458	0.68293089	7.441456559	1.339899341	3.703433272	1.091587511	1.268319435	0.819354436	3.936659111	5.459694524	1.139729737	0	0	1.230632939	0	8.728538217	0.282424474	0.815792001	0	8.765688828	0.013610408	0.394834209	0	0	0	0.217329256	0.123895843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2016																																																																																				0			14.7458	0.68293089	7.441456559	1.339899341	3.703433272	1.091587511	1.268319435	0.819354436	3.936659111	5.459694524	1.139729737	0	0	1.230632939	0	8.728538217	0.282424474	0.815792001	0	8.765688828	0.013610408	0.394834209	0	0	0	0.217329256	0.123895843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2016
H5429_007_0	2008	6																					3250											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1287.545461	33.9825865	975.7754033	2667.299913	210.6451477	25539.44874	25685.8707	229.7071759	339.068653	2043.310167	835.2747713	0	68.38470312	603.4025354	9842.861625	15340.94319	251.388828	729.4527263	5986.782255	19076.62993	379.7631627	1155.025953	0	3065.068925	581.5050937	274.6245012	225.1160207	0	0	0	446.750803											"$300 copay, days 1-5"	"$300 copay, days 1-5"	"$150 copay, days 7-100"	$20 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$25 copay	$5 copay	Varies	$25 copay	$25 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	0% coinsurance	$10 copay	$10 copay															62.54776533	194.2457079	96.42574265	4.106859589	100	0.534532193	0.627489009	45	245.3700344	37.27983378	28.44298941	0	0	25	0.715250492	12.71369315	25	25	0	10.33512987	1.470962237	6.909615035	0	0	0	10	10	0	0	0	0											6.7111	0.550080964	7.840822326	0.912852185	1.75537623	1.137638128	1.343133462	0.86140191	6.933107254	6.347855282	1.97980929	0	0	1.257088615	0.586675968	16.25333703	0.523726725	1.51969318	0	16.42995398	0.046551439	0.665065391	0	0	0	0.228853751	0.187596684	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.0717		35.32647669	6.7111	0.550080964	7.840822326	0.912852185	1.75537623	1.137638128	1.343133462	0.86140191	6.933107254	6.347855282	1.97980929	0	0	1.257088615	0.586675968	16.25333703	0.523726725	1.51969318	0	16.42995398	0.046551439	0.665065391	0	0	0	0.228853751	0.187596684	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.0717																																																																																				0			6.7111	0.550080964	7.840822326	0.912852185	1.75537623	1.137638128	1.343133462	0.86140191	6.933107254	6.347855282	1.97980929	0	0	1.257088615	0.586675968	16.25333703	0.523726725	1.51969318	0	16.42995398	0.046551439	0.665065391	0	0	0	0.228853751	0.187596684	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.0717
H5429_011_0	2008	6																					3250											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1636.520841	43.83419169	714.4089337	2801.517735	260.4468943	31628.59133	31798.06518	232.0531973	337.8838939	2069.615172	852.5725685	0	68.28917588	605.4485153	9607.657293	14885.87575	251.4614336	728.7219168	5847.243868	19694.36155	382.1615201	1116.992863	0	3065.068925	506.0632403	290.8528461	216.8842458	0	0	0	409.8124062											"$250 copay, days 1-7"	"$250 copay, days 1-7"	"$150 copay, days 7-100"	$20 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance			$20 copay	$5 copay	Varies	$20 copay	$20 copay		Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	0% coinsurance	0% coinsurance	0% coinsurance															84.09961329	187.9142166	88.42138235	4.839042797	100	0.885253627	1.002761871	45	287.0861936	38.77320614	32.34088584	0	0	20	0.242196488	9.211600212	20	20	0	9.933746251	1.681089853	0	0	0	0	0	0	0	0	0	0											11.4692	0.686422316	5.264085457	1.129722018	2.170390786	2.333277098	2.657157277	0.87019949	8.083483414	6.687134642	2.297746009	0	0	1.009080859	0.193911738	11.42689469	0.419102389	1.214536528	0	16.30323252	0.053537321	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.2691		35.39474207	11.4692	0.686422316	5.264085457	1.129722018	2.170390786	2.333277098	2.657157277	0.87019949	8.083483414	6.687134642	2.297746009	0	0	1.009080859	0.193911738	11.42689469	0.419102389	1.214536528	0	16.30323252	0.053537321	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.2691																																																																																				0			11.4692	0.686422316	5.264085457	1.129722018	2.170390786	2.333277098	2.657157277	0.87019949	8.083483414	6.687134642	2.297746009	0	0	1.009080859	0.193911738	11.42689469	0.419102389	1.214536528	0	16.30323252	0.053537321	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.2691
H5429_015_0	2008	6																					3250											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1400.191759	37.66417987	821.1311669	1565.84544	187.5675716	25446.35986	25579.65604	234.528055	243.3659654	1966.172324	803.1763307	0	66.0286179	580.4780738	7610.710627	11722.03909	171.3832141	496.3083891	4563.318093	13650.54339	330.7765855	694.7010753	0	1626.607554	466.0912683	267.7926906	180.6531623	0	0	0	3328.508083											"$300 copay, days 1-9"	"$300 copay, days 1-9"	"$150 copay, days 7-100"	$30 copay	$150 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$25 copay	$5 copay	Varies	$25 copay	$25 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	0% coinsurance	$10 copay	$10 copay															131.116616	245.0962654	102.8760593	5.96084062	150	0.553386425	0.642623149	45	159.7177336	34.06558717	20.15166613	0	0	25	0	11.45239869	25	25	0	9.63934131	0.60483399	7.549980051	0	0	0	10	10	0	0	0	0											15.299	0.769279152	7.039561549	0.777812925	2.344594645	1.17347251	1.369839927	0.879480206	3.239155035	5.581567891	1.348778439	0	0	1.20932932	0	11.1871221	0.357048363	1.033975811	0	10.96518723	0.016672077	0.437081605	0	0	0	0.223160576	0.150544302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.4027		31.36800674	15.299	0.769279152	7.039561549	0.777812925	2.344594645	1.17347251	1.369839927	0.879480206	3.239155035	5.581567891	1.348778439	0	0	1.20932932	0	11.1871221	0.357048363	1.033975811	0	10.96518723	0.016672077	0.437081605	0	0	0	0.223160576	0.150544302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.4027																																																																																				0			15.299	0.769279152	7.039561549	0.777812925	2.344594645	1.17347251	1.369839927	0.879480206	3.239155035	5.581567891	1.348778439	0	0	1.20932932	0	11.1871221	0.357048363	1.033975811	0	10.96518723	0.016672077	0.437081605	0	0	0	0.223160576	0.150544302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.4027
H5429_020_0	2008	6																					3250											D	D	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	V	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1048.844562	26.7126509	904.1468042	1477.809309	200.058069	24212.99369	24361.77423	196.4826954	280.9224317	1735.532034	715.6729302	0	56.93847296	508.0637402	7675.92077	12678.17274	196.6811353	568.4864098	5121.405348	14287.25586	321.9354208	898.9406025	0	3065.068925	445.682811	269.8648562	173.569582	0	0	0	365.8589332											"$275 copay, days 1-12"	"$275 copay, days 1-12"	"$150 copay, days 11-100"	$30 copay	$150 copay	20% coinsurance	20% coinsurance	$50 copay (waived if admitted)	25% coinsurance	$0-75 copay	20% coinsurance		25% coinsurance	$20 copay	$5 copay	Varies	$20 copay	$20 copay	20% coinsurance	Varies	20% coinsurance	Varies		$0 - $75 copay X-rays	0% coinsurance	$10 copay	$10 copay															95.38753518	178.0585656	39.71025265	15.33148693	150	0.677905716	0.765933137	45	192.3097227	34.5744476	21.44335232	0	0	20	1.834926638	10.49086614	20	20	0	11.06791395	0.933878595	7.302209453	0	0	0	10	10	0	0	0	0											8.3372	0.396368025	2.991991503	1.888084509	2.500725862	1.367843903	1.554957513	0.736810108	4.502009579	5.00042178	1.278868899	0	0	0.8467729	1.173729291	11.08375109	0.327801892	0.94747735	0	13.17750987	0.02505405	0.547021047	0	0	0	0.22488738	0.144641318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.054		18.06438763	8.3372	0.396368025	2.991991503	1.888084509	2.500725862	1.367843903	1.554957513	0.736810108	4.502009579	5.00042178	1.278868899	0	0	0.8467729	1.173729291	11.08375109	0.327801892	0.94747735	0	13.17750987	0.02505405	0.547021047	0	0	0	0.22488738	0.144641318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.054																																																																																				0			8.3372	0.396368025	2.991991503	1.888084509	2.500725862	1.367843903	1.554957513	0.736810108	4.502009579	5.00042178	1.278868899	0	0	0.8467729	1.173729291	11.08375109	0.327801892	0.94747735	0	13.17750987	0.02505405	0.547021047	0	0	0	0.22488738	0.144641318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.054
H5430_001_0	2008	6																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5431_001_0	2008	6																																	D						V																																																																											0			199.0086242						414.5792112																																			$200 Copay days 1-5						$50 each visit																																			200						50																																		0	3.316810403	0	0	0	0	0	1.72741338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.0442			0	3.316810403	0	0	0	0	0	1.72741338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.0442																																																																																				0			0	3.316810403	0	0	0	0	0	1.72741338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.0442
H5431_002_0	2008	8																																	D	D		T			V	V								V								V																																																										0			290.4488068	1081.081689		343.1068866			420.2042527	683.9892852								760.6055928								1184.071141																		$75 per day days 1-5	$25 per day for days 7-25		25			$25 each visit	"$50 ASC, $0 OP Hospital"								$20 each visit								10																		52.08298151	25		25			25	17.5								20								10																	0	1.260619986	2.252253519	0	0.714806014	0	0	0.875425526	0.997484374	0	0	0	0	0	0	0	1.267675988	0	0	0	0	0	0	0	0.986725951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.355			0	1.260619986	2.252253519	0	0.714806014	0	0	0.875425526	0.997484374	0	0	0	0	0	0	0	1.267675988	0	0	0	0	0	0	0	0.986725951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.355																																																																																				0			0	1.260619986	2.252253519	0	0.714806014	0	0	0.875425526	0.997484374	0	0	0	0	0	0	0	1.267675988	0	0	0	0	0	0	0	0.986725951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.355
H5433_001_0	2008	5																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	251.6131467	0	36.25121832	3.840957262	13.6522016	6.886219833	0	20.69939405	8.169471982	0	0	0	0	19.82284552	308.7730781	0	0	0	0	0	0	0	0	0	4.29	0	0	0	0	0	0											PBP: 1A IP Acute: Cost Sharing is 45% of Standard Medicare	1B IP Psych: Cost Sharing is 45% of Standard Medicare	2 SNF: Cost Sharing is 45% of Standard Medicare	6 Home Health: Cost Sharing is 45% of Standard Medicare	10A Ambulance: Cost Sharing is 45% of Standard Medicare	11A DME: Cost Sharing is 45% of Standard Medicare	"11B Prosthetic Medical Supplies:Cost Sharing is 45% of Standard Medicare, 11C Diabetes Monitoring Supplies: Cost Sharing is 45% of Standard Medicare"	"4A ER: Cost Sharing is 45% of Standard Medicare, 4B Urgent Care: Cost Sharing is 45% of Standard Medicare"	9B ASC Services: Cost Sharing is 45% of Standard Medicare	8A OP C/D/T: Cost Sharing is 45% of Standard Medicare	8B OP X-Ray: Cost Sharing is 45% of Standard Medicare	9A OP Hospital: Cost Sharing is 45% of Standard Medicare	12 Renal Dialysis: Cost Sharing is 45% of Standard Medicare	"3 CORF: Cost Sharing is 45% of Standard Medicare, 5 Partial Hosp: Cost Sharing is 45% of Standard Medicare, 9C OP Substance Abuse: Cost Sharing is 45% of Standard Medicare, 9D Cardiac Rehab: Cost Sharing is 45% of Standard Medicare"	"7A PCP: Cost Sharing is 45% of Standard Medicare, 14B Immunizations: Cost Sharing is 45% of Standard Medicare, 14C Routine Physical Exams: Cost Sharing is 45% of Standard Medicare, 14D Pap Smears: Cost Sharing is 45% of Standard Medicare, 14D Pelvic Exams: Cost Sharing is 45% of Standard Medicare, 14E Prostate Screening: Cost Sharing is 45% of Standard Medicare, 14F Colorectal Screening: Cost Sharing is 45% of Standard Medicare, 14G Bone Mass Measurement: Cost Sharing is 45% of Standard Medicare, 14H Mammography: Cost Sharing is 45% of Standard Medicare, 14I Diabetes Monitoring: Cost Sharing is 45% of Standard Medicare"	7D Physician Specialist: Cost Sharing is 45% of Standard Medicare	"7E Mental Health: Cost Sharing is 45% of Standard Medicare, 7H Psychiatric: Cost Sharing is 45% of Standard Medicare"	"7C Occupational Therapy: Cost Sharing is 45% of Standard Medicare, 7I Physical and Speech Therapy: Cost Sharing is 45% of Standard Medicare"	Included in i.2.	"7B Chiropractic: Cost Sharing is 45% of Standard Medicare, 7F Podiatry: Cost Sharing is 45% of Standard Medicare, 7G Other Health Care: Cost Sharing is 45% of Standard Medicare, 18A Medicare Covered Hearing Exams: Cost Sharing is 45% of Standard Medicare"	15 Part B Drugs: Cost Sharing is 45% of Standard Medicare	"13A Blood: Cost Sharing is 45% of Standard Medicare, 16B Medicare Covered Comprehensive Dental Services: Cost Sharing is 45% of Standard Medicare, 17A Medicare Covered Eye Exams: Cost Sharing is 45% of Standard Medicare"	10B Transportation: 0% Cost Sharing	"16A Preventive Dental Services: 0% Cost Sharing, 16B Non Medicare Covered Comprehensive Dental: 0% Cost Sharing"	17A Routine Eye Exams: 0% Cost Sharing	17B Eye Wear: Medicare Covered: 0% Cost Sharing	18A Routine Hearing Exams: 0% Cost Sharing	18B Hearing Aids: 0% Cost Sharing	19 POS: N/A	14A Health Education/Wellness Programs: Cost Sharing is 45% of Standard Medicare	13B Acupuncture: Not Covered											0.03168	0.03168	0.07515	0	0.1053	0.1053	0.1053	0.1053	0.1053	0.1053	0.1053	0.1053	0.1053	0.1053	0.1053	0.1053	0.1053	0.1053	0.1053	0.1053	0.1053	0.1053	0	0	0	0	0	0	0	0	0											7.9711	0	2.724279057	0	1.437576828	0.725118948	0	2.179646194	0.8602454	0	0	0	0	2.087345633	32.51380512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4991	0	0	7.9711	0	2.724279057	0	1.437576828	0.725118948	0	2.179646194	0.8602454	0	0	0	0	2.087345633	32.51380512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4991	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.9711	0	2.724279057	0	1.437576828	0.725118948	0	2.179646194	0.8602454	0	0	0	0	2.087345633	32.51380512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4991
H5434_001_0	2008	6	e.3.	f.1.	f.2.	f.3.	g.2.	h.6.	i.7.				DME/Prosthetics/Supplies	OP Facility - Emergency	OP Facility - Emergency	OP Facility - Emergency	OP Facility - Surgery	OP Facility - Other	Professional				3000	Electric Wheelchairs	Urgent Care	Worldwide ER	Worldwide Urgent Care	Ambulatory Surgical Center	Cardiac Rehab	Allergy Shots				A	A	D		T	O		V	V					V	V	V	V	V														V	V	V	V	V	V	O																																													0		221.9597154	2.370482674	850.5308173		234.6279049			205.1974142	84.92740192					241.9053326	3579.950661	5602.532127	214.4057229															0.578684855	8.50837227	0	0	65.59461375	1309.305862	404.6030136				$150 for days 1-5	$150 for days 1-5	$100 for days 7-25	"$0 copay for Home Health Care, $0 copay for Respite Care"	$100 per trip	$0 copay for DME except electric wheelchairs and scooters		$50 copay	$150 copay					"$100 copay on OP Facility, $75 copay on IDTF"	$10 copay	$25 copay	$25 copay	with Cardiac Rehab														$500 copay	$25 copay	$50 copay	$25 copay	$100 copay	$25 copay for Cardiac Rehab and PT/OT/ST	$5 copay				506.3878314	506.3878314	47.26701697		100			50	148.5464304					54.54250339	9.90309536	24.7577384	24.7577384															314.1490667	24.7577384	0	0	100	24.7577384	5				9.3665	0.100031965	3.350171215	0	1.955232541	0	0	0.854989226	1.0513052	0	0	0	0	1.099510202	2.954382732	11.5588354	0.442350067	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.015149442	0.017554005	0	0	0.546621781	2.701287668	0.168584589	0	0	0	36.1825	0	0.286628035	9.3665	0.100031965	3.350171215	0	1.955232541	0	0	0.854989226	1.0513052	0	0	0	0	1.099510202	2.954382732	11.5588354	0.442350067	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.015149442	0.017554005	0	0	0.546621781	2.701287668	0.168584589	0	0	0	36.1825		CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	$100 per trip	CYD + 30% coins	CYD + 30% coins	$50 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	$0 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 50% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	$25 copay	$50 copay	$25 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins				13.1685	0.1406	1.5728	0.9362	0.1757	1.2922	0.0261	0.0867	1.2289	1.8273	2.7348	0	0	0.9822	2.8164	2.2661	0.3265	0.2061	2.8952	12.9931	1.5501	1.3649	0	0	0	0	0	0	0	0	0	0.0005	0.0006	0.0149	0	2.4024	1.6676	0.025				52.7014	500	0	22.535	0.240588846	4.922923339	0.936162517	2.130953	1.292163046	0.026060564	0.941713399	2.280188404	1.827346168	2.734788376	0	0	2.081722929	5.770818584	13.82493848	0.768819216	0.206115363	2.895243191	12.99313523	1.550146111	1.364852567	0	0	0	0	0	0	0	0	0	0.015688745	0.018105613	0.014928044	2.23E-10	2.948982445	4.368896818	0.193631739	0	0	0	88.8839
H5434_002_0	2008	5	e.3.	f.1.	f.2.	f.3.	g.2.	h.6.	i.7.				DME/Prosthetics/Supplies	OP Facility - Emergency	OP Facility - Emergency	OP Facility - Emergency	OP Facility - Surgery	OP Facility - Other	Professional				3000	Electric Wheelchairs	Urgent Care	Worldwide ER	Worldwide Urgent Care	Ambulatory Surgical Center	Cardiac Rehab	Allergy Shots				A	A	D		T	O		V	V					V		V	V	V														V	V	V	V	V	V	O																																													0		294.9087471	3.149562858	1472.289488		231.6429826			256.4487052	126.9612835					393.5061	3425.045079	5712.228455	242.64045															0.817707783	0.044544847	0	0	103.5579665	426.62295	460.72215				$150 for days 1-5	$150 for days 1-5	$100 for days 7-25	"$0 copay for Home Health Care, $0 copay for Respite Care"	$100 per trip	$0 copay for DME except electric wheelchairs and scooters		$50 copay	$150 copay					"$100 copay on OP Facility, $75 copay on IDTF"	$10 copay	$25 copay	$25 copay	with Cardiac Rehab														$500 copay	$25 copay	$50 copay	$25 copay	$100 copay	$25 copay for Cardiac Rehab and PT/OT/ST	$5 copay				506.3878314	506.3878314	47.26701697		100			50	148.5464304					54.54250339	9.90309536	24.7577384	24.7577384															314.1490667	24.7577384	0	0	100	24.7577384	5				12.4449	0.132908359	5.799227683	0	1.930358188	0	0	1.068536271	1.571637122	0	0	0	0	1.788567316	2.826545669	11.78515481	0.500602399	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.021406845	9.19E-05	0	0	0.862983054	0.880184949	0.191967563	0	0	0	41.805	0	0.312449555	12.4449	0.132908359	5.799227683	0	1.930358188	0	0	1.068536271	1.571637122	0	0	0	0	1.788567316	2.826545669	11.78515481	0.500602399	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.021406845	9.19E-05	0	0	0.862983054	0.880184949	0.191967563	0	0	0	41.805		CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	$100 per trip	CYD + 30% coins	CYD + 30% coins	$50 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	$0 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 50% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	$25 copay	$50 copay	$25 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins				10.2148	0.1092	1.7563	1.3397	0.2145	0.7045	0.0491	0.1187	0.5039	0.4744	0.71	0	0	0.255	0.8874	0.8001	0.1153	0.0728	1.1099	4.9206	1.685	1.1178	0	0	0	0	0	0	0	0	0	0.0008	0	0.0177	0	0.1644	0.433	0.0158				27.7907	500	0	22.6596	0.242086982	7.555549669	1.339679721	2.144842432	0.704534801	0.049070091	1.187262524	2.075516576	0.474442258	0.710045635	0	0	2.043583706	3.713961611	12.58525101	0.615883044	0.07277344	1.109875254	4.92064487	1.685034093	1.117800037	0	0	0	0	0	0	0	0	0	0.022168324	0.000102114	0.01772582	2.65E-10	1.027381933	1.313153953	0.207769795	0	0	0	69.5957
H5434_010_0	2008	5	e.3.	f.1.	f.2.	f.3.	g.2.	h.6.	i.7.				DME/Prosthetics/Supplies	OP Facility - Emergency	OP Facility - Emergency	OP Facility - Emergency	OP Facility - Surgery	OP Facility - Other	Professional				3000	Electric Wheelchairs	Urgent Care	Worldwide ER	Worldwide Urgent Care	Ambulatory Surgical Center	Cardiac Rehab	Allergy Shots				A	A	D		T	O		V	V					V	V	V	V	V														V	V	V	V	V	V	O																																													0		135.2062757	1.443974342	513.070579		173.2614179			269.5999208	133.4721186					413.6859	3228.526099	5462.685694	240.584175															0.61161883	0.046829199	0	0	108.8686314	448.50105	456.817725				$150 for days 1-5	$150 for days 1-5	$100 for days 7-25	"$0 copay for Home Health Care, $0 copay for Respite Care"	$100 per trip	$0 copay for DME except electric wheelchairs and scooters		$50 copay	$250 copay					"$150 copay on OP Facility, $75 copay on IDTF"	$5 copay	$20 copay	$20 copay	with Cardiac Rehab														$500 copay	$20 copay	$50 copay	$20 copay	$100 copay	$20 copay for Cardiac Rehab and PT/OT/ST	$5 copay				497.9502672	497.9502672	47.26701697		100			50	243.452186					80.45055328	4.86904372	19.47617488	19.47617488															314.1490667	19.47617488	0	0	100	19.47617488	5				5.6105	0.059918951	2.02094298	0	1.443845149	0	0	1.123333003	2.707839919	0	0	0	0	2.773438295	1.309986227	8.866018492	0.390471622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.016011624	7.60E-05	0	0	0.907238595	0.72792374	0.190340719	0	0	0	28.1479	0	0.603705271	5.6105	0.059918951	2.02094298	0	1.443845149	0	0	1.123333003	2.707839919	0	0	0	0	2.773438295	1.309986227	8.866018492	0.390471622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.016011624	7.60E-05	0	0	0.907238595	0.72792374	0.190340719	0	0	0	28.1479		$150 for days 1-5	$150 for days 1-5	$100 for days 7-25	"$0 copay for Home Health Care, $0 copay for Respite Care"	$100 per trip	$0 copay for DME except electric wheelchairs and scooters	$0 copay	$50 copay	$250 copay	$0 copay	$0 copay	$0 copay	$0 copay	"$150 copay on OP Facility, $75 copay on IDTF"	$15 copay	$50 copay	$50 copay	with Cardiac Rehab	$0 copay	$50 copay on routine physical exams	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$500 copay	$50 copay	$50 copay	$50 copay	$100 copay	$50 copay for Cardiac Rehab and PT/OT/ST	$0 copay				6.2285	0.0665	2.1848	0	0.1604	0	0	0.1248	0.3358	0.6245	0.6245	0	0	0.6245	0.4873	2.7486	0.1211	0.4538	0	0.0217	1.3005	0	0	0	0	0	0	0	0	0	0	0.0019	0	0.0185	0	0.1096	0.2257	0				16.4629	0	0	11.839	0.126438423	4.205746203	0	1.604272388	0	0	1.248147781	3.043630645	0.624453512	0.624453512	0	0	3.397891807	1.797328063	11.61463628	0.511524522	0.45382585	0	0.021677178	1.300459341	0	0	0	0	0	0	0	0	0	0	0.017945171	8.44E-05	0.018548787	2.18E-10	1.016795789	0.953592584	0.190340719	0	0	0	44.6108
H5434_013_0	2008	5	e.3.	f.1.	f.2.	f.3.	g.2.	h.6.	i.7.				DME/Prosthetics/Supplies	OP Facility - Emergency	OP Facility - Emergency	OP Facility - Emergency	OP Facility - Surgery	OP Facility - Other	Professional				3000	Electric Wheelchairs	Urgent Care	Worldwide ER	Worldwide Urgent Care	Ambulatory Surgical Center	Cardiac Rehab	Allergy Shots				A	A	D		T	O		V	V					V	V	V	V	V														V	V	V	V	V	V	O																																													0		272.0032134	2.904936616	1458.905038		229.7597063			161.1023917	79.75772938					247.20255	2947.784699	4881.601808	203.571225															0.811059753	0.027983302	0	0	65.05564562	268.006725	386.538075				$150 for days 1-5	$150 for days 1-5	$100 for days 7-25	"$0 copay for Home Health Care, $0 copay for Respite Care"	$100 per trip	$0 copay for DME except electric wheelchairs and scooters		$50 copay	$150 copay					"$75 copay on OP Facility, $75 copay on IDTF"	$0 copay	$15 copay	$15 copay	with Cardiac Rehab														$500 copay	$15 copay	$50 copay	$15 copay	$100 copay	$15 copay for Cardiac Rehab and PT/OT/ST	$5 copay				508.7290311	508.7290311	47.26701697		100			50	149.23321					41.09600367	0	14.923321	14.923321															314.1490667	14.923321	0	0	100	14.923321	5				11.5313	0.123152133	5.746507431	0	1.914664219	0	0	0.671259965	0.991875165	0	0	0	0	0.846586408	0	6.070809233	0.253163228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.021232805	3.48E-05	0	0	0.54213038	0.333295866	0.161057531	0	0	0	29.2071	0	0.10353597	11.5313	0.123152133	5.746507431	0	1.914664219	0	0	0.671259965	0.991875165	0	0	0	0	0.846586408	0	6.070809233	0.253163228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.021232805	3.48E-05	0	0	0.54213038	0.333295866	0.161057531	0	0	0	29.2071		CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	$100 per trip	CYD + 30% coins	CYD + 30% coins	$50 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	$0 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 50% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	$15 copay	$50 copay	$15 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins				9.2761	0.0992	1.7728	1.1889	0.2127	0.7464	0.052	0.0746	0.4009	0.3775	0.5649	0	0	0.2029	0.7305	0.6586	0.0949	0.0599	1.2336	4.4115	1.7243	0.9201	0	0	0	0	0	0	0	0	0	0.0008	0	0.012	0	0.1308	0.3445	0.013				25.3033	500	0	20.8074	0.22230278	7.519300904	1.188871654	2.127404688	0.746384523	0.051984879	0.745844406	1.392777892	0.377481547	0.564935185	0	0	1.049485665	0.730474407	6.729406591	0.348019656	0.059903291	1.233637541	4.411506803	1.724329591	0.920114545	0	0	0	0	0	0	0	0	0	0.021986545	3.87E-05	0.012000686	1.08E-10	0.672931424	0.677779956	0.174065103	0	0	0	54.5104
H5434_014_0	2008	6	e.3.	f.1.	f.2.	f.3.	g.2.	h.6.	i.7.				DME/Prosthetics/Supplies	OP Facility - Emergency	OP Facility - Emergency	OP Facility - Emergency	OP Facility - Surgery	OP Facility - Other	Professional				3000	Electric Wheelchairs	Urgent Care	Worldwide ER	Worldwide Urgent Care	Ambulatory Surgical Center	Cardiac Rehab	Allergy Shots				A	A	D		T	O		V	V					V	V	V	V	V														V	V	V	V	V	V	O																																													0		251.9608713	2.690888655	1284.907189		190.2109044			249.8730973	123.705866					383.4162	3396.970939	5800.493546	261.146925															0.671451107	0.043402672	0	0	100.902634	415.6839	495.861975				$150 for days 1-5	$150 for days 1-5	$100 for days 7-25	"$0 copay for Home Health Care, $0 copay for Respite Care"	$100 per trip	$0 copay for DME except electric wheelchairs and scooters		$50 copay	$250 copay					"$150 copay on OP Facility, $75 copay on IDTF"	$10 copay	$25 copay	$25 copay	with Cardiac Rehab														$500 copay	$25 copay	$50 copay	$25 copay	$100 copay	$25 copay for Cardiac Rehab and PT/OT/ST	$10 copay				500.0160306	500.0160306	47.26701697		100			50	244.4621556					80.7843051	9.778486223	24.44621556	24.44621556															314.1490667	24.44621556	0	0	100	24.44621556	10				10.4987	0.112123955	5.06114416	0	1.58509087	0	0	1.041137906	2.520116888	0	0	0	0	2.581167607	2.768102794	11.8166763	0.532004502	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.017577978	8.84E-05	0	0	0.840855284	0.846824852	0.413218313	0	0	0	40.6348	0	0.717557757	10.4987	0.112123955	5.06114416	0	1.58509087	0	0	1.041137906	2.520116888	0	0	0	0	2.581167607	2.768102794	11.8166763	0.532004502	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.017577978	8.84E-05	0	0	0.840855284	0.846824852	0.413218313	0	0	0	40.6348		$300 for days 1-10	$300 for days 1-10	$100 for days 7-25	"$0 copay for Home Health Care, $0 copay for Respite Care"	$100 per trip	$0 copay for DME except electric wheelchairs and scooters	$0 copay	$50 copay	$500 copay	$300 copay	$300 copay	$300 copay	$0 copay	"$300 copay on OP Facility, $75 copay on IDTF"	$25 copay	$60 copay	$60 copay	with Cardiac Rehab	$0 copay	$60 copay on routine physical exams	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$500 copay	$60 copay	$50 copay	$60 copay	$100 copay	$60 copay for Cardiac Rehab and PT/OT/ST	$0 copay				3.1213	0.0333	0.6079	0	0.1761	0	0	0.1157	0.6224	1.1575	1.1575	0	0	1.1575	0.8546	3.5023	0.1577	0.5911	0	0.0274	1.3289	0	0	0	0	0	0	0	0	0	0	0.0023	0	0.0177	0	0.1015	0.251	0				14.9838	0	0	13.62	0.145458735	5.669089404	0	1.761212078	0	0	1.156819895	3.142558233	1.157523583	1.157523583	0	0	3.73869119	3.622716738	15.31898427	0.689683663	0.591137261	0	0.027369793	1.328873682	0	0	0	0	0	0	0	0	0	0	0.019832753	9.82E-05	0.01766823	2.61E-10	0.942396097	1.097812639	0.413218313	0	0	0	55.6187
H5434_015_0	2008	8	e.3.	f.1.	f.2.	f.3.	g.2.	h.6.	i.7.				DME/Prosthetics/Supplies	OP Facility - Emergency	OP Facility - Emergency	OP Facility - Emergency	OP Facility - Surgery	OP Facility - Other	Professional				3000	Electric Wheelchairs	Urgent Care	Worldwide ER	Worldwide Urgent Care	Ambulatory Surgical Center	Cardiac Rehab	Allergy Shots				A	A	D		T	O		V	V					V	V	V	V	V														V	V	V	V	V	V	O																																													0		201.9969646	2.15728473	822.7279248		205.2771147			424.1267047	209.9744304					650.79855	2975.858839	4698.465016	170.670825															0.724635353	0.073670325	0	0	171.2689446	705.568725	324.067275				$150 for days 1-5	$150 for days 1-5	$100 for days 7-25	"$0 copay for Home Health Care, $0 copay for Respite Care"	$100 per trip	$0 copay for DME except electric wheelchairs and scooters		$50 copay	$250 copay					"$100 copay on OP Facility, $75 copay on IDTF"	$10 copay	$25 copay	$25 copay	with Cardiac Rehab														$500 copay	$25 copay	$50 copay	$25 copay	$100 copay	$25 copay for Cardiac Rehab and PT/OT/ST	$5 copay				560.4482486	560.4482486	47.26701697		100			50	247.5380538					54.53383876	9.901522153	24.75380538	24.75380538															314.1490667	24.75380538	0	0	100	24.75380538	5				9.4341	0.100753871	3.240657899	0	1.710642622	0	0	1.767194603	4.331388488	0	0	0	0	2.957545266	2.455461018	9.692074051	0.352062699	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.018970293	0.000151968	0	0	1.427241205	1.455459242	0.135028031	0	0	0	39.0787	0	0.306119238	9.4341	0.100753871	3.240657899	0	1.710642622	0	0	1.767194603	4.331388488	0	0	0	0	2.957545266	2.455461018	9.692074051	0.352062699	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.018970293	0.000151968	0	0	1.427241205	1.455459242	0.135028031	0	0	0	39.0787		CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	$100 per trip	CYD + 30% coins	CYD + 30% coins	$50 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	$0 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 50% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	$25 copay	$50 copay	$25 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins				39.523	0.4224	4.7359	3.6434	0.1901	0.6896	0.048	0.1964	0.5913	0.5568	0.8332	0	0	0.2993	0.744	0.6708	0.0966	0.061	0.6631	4.3022	1.596	0.9372	0	0	0	0	0	0	0	0	0	0.0007	0	0.0239	0	0.1929	0.5081	0.0132				61.5391	500	0	48.9571	0.523193243	7.9765531	3.643449932	1.900714025	0.689610524	0.048030631	1.963549559	4.922688688	0.556755762	0.83323522	0	0	3.256805803	3.199486005	10.36288865	0.448686763	0.061014521	0.663057004	4.302160852	1.596005839	0.937183045	0	0	0	0	0	0	0	0	0	0.019643688	0.000168854	0.02386878	3.57E-10	1.620162526	1.963546336	0.148276899	0	0	0	100.6178
H5434_016_0	2008	7	e.3.	f.1.	f.2.	f.3.	g.2.	h.6.	i.7.				DME/Prosthetics/Supplies	OP Facility - Emergency	OP Facility - Emergency	OP Facility - Emergency	OP Facility - Surgery	OP Facility - Other	Professional				3000	Electric Wheelchairs	Urgent Care	Worldwide ER	Worldwide Urgent Care	Ambulatory Surgical Center	Cardiac Rehab	Allergy Shots				A	A	D		T	O		V	V					V	V	V	V	V														V	V	V	V	V	V	O																																													0		202.326267	2.16080161	1225.24953		214.6934961			213.7072543	105.8010696					327.92175	2975.858839	5037.292516	222.0777															0.757875506	0.037120706	0	0	86.29830542	355.519125	421.6779				$200 for days 1-10	$200 for days 1-10	$100 for days 7-25	"$0 copay for Home Health Care, $0 copay for Respite Care"	$100 per trip	$0 copay for DME except electric wheelchairs and scooters		$50 copay	$250 copay					"$150 copay on OP Facility, $75 copay on IDTF"	$5 copay	$25 copay	$25 copay	with Cardiac Rehab														$500 copay	$25 copay	$50 copay	$25 copay	$100 copay	$25 copay for Cardiac Rehab and PT/OT/ST	$10 copay				1073.638161	1073.638161	47.26701697		100			50	245.2931727					81.05892079	4.905863455	24.52931727	24.52931727															314.1490667	24.52931727	0	0	100	24.52931727	10				18.1021	0.193326589	4.826157526	0	1.789112467	0	0	0.890446893	2.162690003	0	0	0	0	2.21508193	1.216596427	10.29677886	0.453951197	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.01984049	7.59E-05	0	0	0.719152545	0.726720118	0.35139825	0	0	0	43.9634	0	0.678648613	18.1021	0.193326589	4.826157526	0	1.789112467	0	0	0.890446893	2.162690003	0	0	0	0	2.21508193	1.216596427	10.29677886	0.453951197	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.01984049	7.59E-05	0	0	0.719152545	0.726720118	0.35139825	0	0	0	43.9634		CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	$100 per trip	CYD + 30% coins	CYD + 30% coins	$50 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	$0 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 50% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	$25 copay	$50 copay	$25 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins				25.0085	0.2673	5.5228	2.4034	0.1988	0.6789	0.0473	0.0989	0.4391	0.4134	0.6187	0	0	0.2222	0.7835	0.7064	0.1018	0.0642	1.5996	4.7262	1.5848	0.9869	0	0	0	0	0	0	0	0	0	0.0007	0	0.0167	0	0.1433	0.3773	0.014				47.0245	500	0	43.1106	0.46062007	10.34895725	2.403382248	1.987902741	0.6789383	0.047287322	0.989385437	2.601752197	0.413411656	0.618707835	0	0	2.437293899	2.000052872	11.00314495	0.555706116	0.064248138	1.599643555	4.726234822	1.584759124	0.986851397	0	0	0	0	0	0	0	0	0	0.020546112	8.43E-05	0.016696415	2.47E-10	0.862403737	1.103993496	0.365349274	0	0	0	90.9879
H5434_801_0	2008	4																																Coin		Coin		Coin	Coin		Coin	Coin					Coin						Coin	Coin	Coin																																																													0		229.07251		33.23193038		7.068275402	20.35361621		4.240317697	20.5717401					57.64070661						220.1297326	55.9081829	31.88329679																				8.2% coinsurance		18.9% coinsurance	0% coinsurance	23.4% coinsurance	23.4% coinsurance		23.4% coinsurance	23.4% coinsurance					23.4% coinsurance						23.4% coinsurance	23.4% coinsurance	23.4% coinsurance																				0.082418684		0.188750064		0.234	0.234		0.234	0.234					0.234						0.234	0.234	0.234																				18.8799	0	6.272528989	0	1.653976444	4.762746193	0	0.992234341	4.813787183	0	0	0	0	13.48792535	0	0	0	0	0	51.51035743	13.0825148	7.460691449	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.9166	0	0	18.8799	0	6.272528989	0	1.653976444	4.762746193	0	0.992234341	4.813787183	0	0	0	0	13.48792535	0	0	0	0	0	51.51035743	13.0825148	7.460691449	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.9166		8.2% coinsurance		18.9% coinsurance		23.4% coinsurance	23.4% coinsurance		23.4% coinsurance	23.4% coinsurance					23.4% coinsurance						23.4% coinsurance	23.4% coinsurance	23.4% coinsurance																				2.0978		0.6969		0.1838	0.5292		0.1102	0.5349					1.4987						5.7234	0	0.829																				12.2038	0	0	20.9776	0	6.969476654	0	1.837751604	5.291940215	0	1.102482601	5.348652426	0	0	0	0	14.98658372	0	0	0	0	0	57.23373047	13.0825148	8.289657166	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.1204
H5434_802_0	2008	5																																Coin		Coin		Coin	Coin		Coin	Coin					Coin						Coin	Coin	Coin																																																													0		229.07251		33.23193038		7.068275402	20.35361621		4.240317697	20.5717401					57.64070661						220.1297326	55.9081829	31.88329679																				8.2% coinsurance		18.9% coinsurance	0% coinsurance	23.4% coinsurance	23.4% coinsurance		23.4% coinsurance	23.4% coinsurance					23.4% coinsurance						23.4% coinsurance	23.4% coinsurance	23.4% coinsurance																				0.082418684		0.188750064		0.234	0.234		0.234	0.234					0.234						0.234	0.234	0.234																				18.8799	0	6.272528989	0	1.653976444	4.762746193	0	0.992234341	4.813787183	0	0	0	0	13.48792535	0	0	0	0	0	51.51035743	13.0825148	7.460691449	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.9166	0	0	18.8799	0	6.272528989	0	1.653976444	4.762746193	0	0.992234341	4.813787183	0	0	0	0	13.48792535	0	0	0	0	0	51.51035743	13.0825148	7.460691449	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.9166		8.2% coinsurance		18.9% coinsurance		23.4% coinsurance	23.4% coinsurance		23.4% coinsurance	23.4% coinsurance					23.4% coinsurance						23.4% coinsurance	23.4% coinsurance	23.4% coinsurance																				2.0978		0.6969		0.1838	0.5292		0.1102	0.5349					1.4987						5.7234	0	0.829																				12.2038	0	0	20.9776	0	6.969476654	0	1.837751604	5.291940215	0	1.102482601	5.348652426	0	0	0	0	14.98658372	0	0	0	0	0	57.23373047	13.0825148	8.289657166	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.1204
H5435_001_0	2008	7																					2800											D	D	D	V	T	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1515.498691	42.93343332	1582.950329		127.8671918	15.47169276	2.07791141	593.59895	351.7475935		40.85829304		0.328268982	807.1798976	4138.800045	6000.945293	197.971943	1033.052184			35.47466331	952.877555			172.7698743		19.47205734															$90 (1a); $0 (1a1)	$90 (1b)	"$50 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	30% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $30 (4b)"	$100 (9b)	20% (8a1); $0/$0 (8a2)	"$25 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	20% (12)	"$20 (3, 9d); $40 (5); $25/$25 (9c); $100 (9a)"	"$5/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$15 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$25/$25 (7e, 7h)"	"$20 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $15 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$15 (17a1)	$0 n/c (17b)	$15 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											65.4991	65.4991	36.3884		72.7768	0.218330391	0.183767975	30.5987	72.7768		0.086486925		0.145553594	70.6877	3.6388	10.9165	18.1942	14.5554			0.145553594	10.9165			10.9165		10.9165															8.272	0.234341832	4.800085617	0	0.775480388	3.377940732	0.381853573	1.513611503	2.133255268	0	3.533708123	0	0.04778073	4.754807713	1.255035878	5.459119719	0.300161748	1.253037151	0	0	5.163464742	0.866842205	0	0	0.157170476	0	0.017713925	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2974	0	16.46096648	8.272	0.234341832	4.800085617	0	0.775480388	3.377940732	0.381853573	1.513611503	2.133255268	0	3.533708123	0	0.04778073	4.754807713	1.255035878	5.459119719	0.300161748	1.253037151	0	0	5.163464742	0.866842205	0	0	0.157170476	0	0.017713925	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2974																																																																																				0			8.272	0.234341832	4.800085617	0	0.775480388	3.377940732	0.381853573	1.513611503	2.133255268	0	3.533708123	0	0.04778073	4.754807713	1.255035878	5.459119719	0.300161748	1.253037151	0	0	5.163464742	0.866842205	0	0	0.157170476	0	0.017713925	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2974
H5435_002_0	2008	7																					2900											D	D	D	V	T	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2532.494361	61.39646066	1960.183858		161.3667923	29.28411747	3.514879077	1070.055949	418.8743775		48.29731734		0.31628702	906.0984626	5347.963058	7057.131368	249.7833229	1317.572628			44.10929605	1014.619303			131.0113166		19.10961034															$100 (1a); $0 (1a1)	$100 (1b)	"$50 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	30% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $30 (4b)"	$125 (9b)	20% (8a1); $0/$0 (8a2)	"$25 (8b1); 20% (8b2, 8b3)"	$125 (incl in h5)	20% (12)	"$25 (3, 9d); $40 (5); $25/$25 (9c); $125 (9a)"	"$10/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$25/$25 (7e, 7h)"	"$25 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	$0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											62.7769	62.7769	31.3885		78.4712	0.188330769	0.182101457	25.7838	78.4712		0.075959472		0.125553846	76.6694	6.2777	12.5554	15.6942	15.6942			0.125553846	12.5554			12.5554		12.5554															13.2485	0.321190073	5.127262958	0	1.055219863	5.515100358	0.640064599	2.299176394	2.739129638	0	3.668638701	0	0.039711052	5.789165516	2.797738874	7.383749869	0.326679759	1.723190736	0	0	5.538091759	1.061577963	0	0	0.137074789	0	0.019994042	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4313	0	34.92269106	13.2485	0.321190073	5.127262958	0	1.055219863	5.515100358	0.640064599	2.299176394	2.739129638	0	3.668638701	0	0.039711052	5.789165516	2.797738874	7.383749869	0.326679759	1.723190736	0	0	5.538091759	1.061577963	0	0	0.137074789	0	0.019994042	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4313																																																																																				0			13.2485	0.321190073	5.127262958	0	1.055219863	5.515100358	0.640064599	2.299176394	2.739129638	0	3.668638701	0	0.039711052	5.789165516	2.797738874	7.383749869	0.326679759	1.723190736	0	0	5.538091759	1.061577963	0	0	0.137074789	0	0.019994042	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4313
H5435_003_0	2008	8																					3200											D	D	D	V	T	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2083.983465	57.5253576	2193.410759		129.0269859	21.59683825	3.182591125	692.3714499	345.6234211		41.27344314		0.236312239	719.4609991	4526.565119	5964.775942	204.6505686	1231.080635			40.41890061	906.5094853			126.1544601		18.57070457															$110 (1a); $0 (1a1)	$110 (1b)	"$75 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	30% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	$125 (9b)	20% (8a1); $0/$0 (8a2)	"$25 (8b1); 20% (8b2, 8b3)"	$125 (incl in h5)	20% (12)	"$25 (3, 9d); $40 (5); $25/$25 (9c); $125 (9a)"	"$10/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$25/$25 (7e, 7h)"	"$25 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	$0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											74.0274	74.0274	50.4732		84.122	0.201892811	0.18098414	31.243	84.122		0.079065396		0.134595207	82.3415	6.7298	13.4595	16.8244	16.8244			0.134595207	13.4595			13.4595		13.4595															12.856	0.354870882	9.22570549	0	0.904500724	4.360246381	0.575998518	1.802644043	2.422877916	0	3.263301112	0	0.031806495	4.936790387	2.538558209	6.690252117	0.286926934	1.726016179	0	0	5.440190303	1.016765267	0	0	0.141498214	0	0.020829399	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5958	0	28.25447024	12.856	0.354870882	9.22570549	0	0.904500724	4.360246381	0.575998518	1.802644043	2.422877916	0	3.263301112	0	0.031806495	4.936790387	2.538558209	6.690252117	0.286926934	1.726016179	0	0	5.440190303	1.016765267	0	0	0.141498214	0	0.020829399	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5958																																																																																				0			12.856	0.354870882	9.22570549	0	0.904500724	4.360246381	0.575998518	1.802644043	2.422877916	0	3.263301112	0	0.031806495	4.936790387	2.538558209	6.690252117	0.286926934	1.726016179	0	0	5.440190303	1.016765267	0	0	0.141498214	0	0.020829399	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5958
H5435_013_0	2008	6																					3450											D	D	D	V	T	Coin	Coin	V	V	O	Coin	Coin	Coin	Coin	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2071.744228	57.18751111	2180.528856		128.2692103	21.75230622	3.205501468	688.1787866	343.5935744	9792.130663	41.57055599		0.238013367	27.17599904	4545.467133	5944.916949	203.4486556	1223.850497			40.70986191	901.1855542			144		16.8541424															$110 (1a); $0 (1a1)	$110 (1b)	"$75 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $40/$10 (4b)"	$150 (9b)	20% (8a1); $0/$15 (8a2)	"$25 (8b1); 20% (8b2, 8b3)"	$150 (incl in h5)	20% (12)	$25 (3); $40 (5); $25/$25 (9c); 20%( 9d); $150 (9a)	"$10/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$25/$25 (7e, 7h)"	"$25 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	$0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											73.9067	73.9067	50.3909		100.7819	0.201563732	0.180920356	31.1916	100.7819	4.0313	0.078749669		0.134375821	0.21678375	6.7188	13.4159	16.797	16.797			0.134375821	13.4376			13.4376		13.4376															12.7596	0.352211693	9.156573603	0	1.077267528	4.384476012	0.579940465	1.788782354	2.885666792	3.289563994	3.273667514	0	0.031983242	5.891314987	2.545003659	6.646343392	0.284776876	1.713082452	0	0	5.47042112	1.00914624	0	0	0.161250985	0	0.018873244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.32	0	30.70108086	12.7596	0.352211693	9.156573603	0	1.077267528	4.384476012	0.579940465	1.788782354	2.885666792	3.289563994	3.273667514	0	0.031983242	5.891314987	2.545003659	6.646343392	0.284776876	1.713082452	0	0	5.47042112	1.00914624	0	0	0.161250985	0	0.018873244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.32																																																																																				0			12.7596	0.352211693	9.156573603	0	1.077267528	4.384476012	0.579940465	1.788782354	2.885666792	3.289563994	3.273667514	0	0.031983242	5.891314987	2.545003659	6.646343392	0.284776876	1.713082452	0	0	5.47042112	1.00914624	0	0	0.161250985	0	0.018873244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.32
H5435_014_0	2008	9																					3240											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2020.403048	55.7703119	2126.491816		125.0904913	21.72192763	3.201024765	671.1345135	35.56960376	9549.465793	41.51249986		0.237680965	27.1380459	4436.069483	5798.063122	198.4068681	4.088058667			40.6530078	878.8527155			144		16.8541424															$180 (1a); $0 (1a1)	$180 (1b)	"$100 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	$0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											110.7816	110.7816	61.5453		61.5453	0.184636	0.266458946	30.7727	0.123090667	3.6927	0.066746364		0.184636	0.123196002	6.1545	12.2887	23.0795	0.123090667			0.184636	12.3091			12.3091		12.3091															18.652	0.514860366	10.90630398	0	0.641561332	4.010649831	0.852941686	1.72104989	4.378286242	2.938625278	2.770808439	0	0.043884463	3.343298766	2.275161459	5.937533847	0.381594276	0.503201867	0	0	7.50600875	0.901488056	0	0	0.1477088	0	0.01728823	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.4442	0	42.33964628	18.652	0.514860366	10.90630398	0	0.641561332	4.010649831	0.852941686	1.72104989	4.378286242	2.938625278	2.770808439	0	0.043884463	3.343298766	2.275161459	5.937533847	0.381594276	0.503201867	0	0	7.50600875	0.901488056	0	0	0.1477088	0	0.01728823	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.4442																																																																																				0			18.652	0.514860366	10.90630398	0	0.641561332	4.010649831	0.852941686	1.72104989	4.378286242	2.938625278	2.770808439	0	0.043884463	3.343298766	2.275161459	5.937533847	0.381594276	0.503201867	0	0	7.50600875	0.901488056	0	0	0.1477088	0	0.01728823	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.4442
H5435_017_0	2008	6																					2800											A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		333.2944775	5.204052523	1582.950329		127.8671918	15.47169276	2.07791141	593.59895	351.7475935		40.85829304		0.328268982	807.1798976	4138.800045	6000.945293	197.971943	1033.052184			35.47466331	952.877555			172.7698743		19.47205734															$400 (1a); $0 (1a1)	$400 (1b)	"$50 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	30% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $30 (4b)"	$100 (9b)	20% (8a1); $0/$0 (8a2)	"$25 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	20% (12)	"$20 (3, 9d); $40 (5); $25/$25 (9c); $100 (9a)"	"$10/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$20 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$25/$25 (7e, 7h)"	"$20 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $20 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$20 (17a1)	$0 n/c (17b)	$20 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											284.4598	284.4598	35.5575		71.1149	0.213344838	0.182777085	29.9	71.1149		0.084512004		0.142229892	69.0736	7.1115	14.223	17.7787	14.223			0.142229892	14.223			14.223		14.223															7.9007	0.123361971	4.690476122	0	0.757772368	3.300805779	0.37979459	1.47904833	2.084542588	0	3.453016237	0	0.046689662	4.646232135	2.452754509	7.112614992	0.293307583	1.224424168	0	0	5.04555752	1.129397262	0	0	0.204775338	0	0.023079238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3484	0	18.7070438	7.9007	0.123361971	4.690476122	0	0.757772368	3.300805779	0.37979459	1.47904833	2.084542588	0	3.453016237	0	0.046689662	4.646232135	2.452754509	7.112614992	0.293307583	1.224424168	0	0	5.04555752	1.129397262	0	0	0.204775338	0	0.023079238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3484																																																																																				0			7.9007	0.123361971	4.690476122	0	0.757772368	3.300805779	0.37979459	1.47904833	2.084542588	0	3.453016237	0	0.046689662	4.646232135	2.452754509	7.112614992	0.293307583	1.224424168	0	0	5.04555752	1.129397262	0	0	0.204775338	0	0.023079238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3484
H5435_018_0	2008	6																					2900											A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		497.469986	7.504806018	1960.183858		161.3667923	29.28411747	3.514879077	1070.055949	418.8743775		48.29731734		0.31628702	906.0984626	5347.963058	7057.131368	249.7833229	1317.572628			44.10929605	1014.619303			131.0113166		19.10961034															$450 (1a); $0 (1a1)	$450 (1b)	"$50 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	30% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $30 (4b)"	$125 (9b)	20% (8a1); $0/$0 (8a2)	"$25 (8b1); 20% (8b2, 8b3)"	$125 (incl in h5)	20% (12)	"$25 (3, 9d); $40 (5); $25/$25 (9c); $125 (9a)"	"$15/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$25/$25 (7e, 7h)"	"$25 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											279.1559	279.1559	31.0173		77.5433	0.186103924	0.181744534	25.4789	77.5433		0.075061318		0.124069283	75.7628	9.3052	15.5087	15.5087	15.5087			0.124069283	15.5087			15.2741		15.5087															11.5726	0.174584231	5.066637609	0	1.042742822	5.449889175	0.638810059	2.271990667	2.706741853	0	3.625260294	0	0.039241504	5.720713755	4.14698713	9.120554448	0.322817059	1.70281553	0	0	5.472608723	1.311282179	0	0	0.166756172	0	0.024697038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5778	0	36.7469619	11.5726	0.174584231	5.066637609	0	1.042742822	5.449889175	0.638810059	2.271990667	2.706741853	0	3.625260294	0	0.039241504	5.720713755	4.14698713	9.120554448	0.322817059	1.70281553	0	0	5.472608723	1.311282179	0	0	0.166756172	0	0.024697038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5778																																																																																				0			11.5726	0.174584231	5.066637609	0	1.042742822	5.449889175	0.638810059	2.271990667	2.706741853	0	3.625260294	0	0.039241504	5.720713755	4.14698713	9.120554448	0.322817059	1.70281553	0	0	5.472608723	1.311282179	0	0	0.166756172	0	0.024697038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5778
H5435_019_0	2008	6																					3200											A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		409.205771	6.847707898	2193.410759		129.0269859	21.59683825	3.182591125	692.3714499	345.6234211		41.27344314		0.236312239	719.4609991	4526.565119	5964.775942	204.6505686	1231.080635			40.41890061	906.5094853			126.1544601		18.57070457															$500 (1a); $0 (1a1)	$500 (1b)	"$75 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	30% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	$125 (9b)	20% (8a1); $0/$0 (8a2)	"$25 (8b1); 20% (8b2, 8b3)"	$125 (incl in h5)	20% (12)	"$25 (3, 9d); $40 (5); $25/$25 (9c); $125 (9a)"	"$15/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$25/$25 (7e, 7h)"	"$25 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											333.0135	333.0135	49.952		83.2534	0.199808092	0.180580065	30.9203	83.2534		0.078248977		0.133205395	81.4912	9.9904	16.6507	16.6507	16.6507			0.133205395	16.6507			16.6507		16.6507															11.3559	0.190031591	9.130442071	0	0.895160969	4.315223051	0.574712511	1.784030178	2.397859598	0	3.229604695	0	0.031478065	4.885813741	3.768518088	8.27646182	0.283964165	1.708193563	0	0	5.384015615	1.257832853	0	0	0.175046403	0	0.025767896	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.6701	0	29.69462604	11.3559	0.190031591	9.130442071	0	0.895160969	4.315223051	0.574712511	1.784030178	2.397859598	0	3.229604695	0	0.031478065	4.885813741	3.768518088	8.27646182	0.283964165	1.708193563	0	0	5.384015615	1.257832853	0	0	0.175046403	0	0.025767896	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.6701																																																																																				0			11.3559	0.190031591	9.130442071	0	0.895160969	4.315223051	0.574712511	1.784030178	2.397859598	0	3.229604695	0	0.031478065	4.885813741	3.768518088	8.27646182	0.283964165	1.708193563	0	0	5.384015615	1.257832853	0	0	0.175046403	0	0.025767896	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.6701
H5435_020_0	2008	7																					2400											A	A	D	V	T	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		349.9592014	5.46425515	1662.097846		134.2605513	16.2452774	2.181806981	623.2788975	369.3349732		42.90120769		0.344682431	847.5388925	4345.740047	6300.992557	207.8705402	1084.704793			36.45196327	1000.521433			181.408368		20.44566021															$150 (1a); $0 (1a1)	$150 (1b)	"$50 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$50 (10a)	30% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $30 (4b)"	$100 (9b)	20% (8a1); $0/$0 (8a2)	"$25 (8b1); 20% (8b2, 8b3)"	$100 (incl in h5)	20% (12)	"$20 (3, 9d); $40 (5); $25/$25 (9c); $100 (9a)"	"$5/$30 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$15 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$25/$25 (7e, 7h)"	"$20 (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $15 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$15 (17a1)	$0 n/c (17b)	$15 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											107.0575	107.0575	35.6858		35.6858	0.21411504	0.182930165	30.0079	71.3717		0.084817104		0.14274336	69.3229	3.5686	10.7058	17.8429	14.2743			0.14274336	10.7058			10.7058		10.7058															3.1221	0.048749134	4.942779822	0	0.399266713	3.478358225	0.39911831	1.558607282	2.196671463	0	3.638756181	0	0.049201128	4.896155922	1.292344868	5.621405313	0.309084785	1.290286724	0	0	5.203275722	0.892611195	0	0	0.16184275	0	0.018240514	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5189	0	15.72881307	3.1221	0.048749134	4.942779822	0	0.399266713	3.478358225	0.39911831	1.558607282	2.196671463	0	3.638756181	0	0.049201128	4.896155922	1.292344868	5.621405313	0.309084785	1.290286724	0	0	5.203275722	0.892611195	0	0	0.16184275	0	0.018240514	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5189																																																																																				0			3.1221	0.048749134	4.942779822	0	0.399266713	3.478358225	0.39911831	1.558607282	2.196671463	0	3.638756181	0	0.049201128	4.896155922	1.292344868	5.621405313	0.309084785	1.290286724	0	0	5.203275722	0.892611195	0	0	0.16184275	0	0.018240514	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5189
H5435_849_0	2008	5																					7700											D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2430.682735	34.49368686	1976.936584		26.19064376	29.36492387	2.704081169	502.7290826	402.7259465		41.33525458		1.079534724	714.0593823	4868.353066	8769.365606	1.721161533	3002.912617			49.00456317	1301.762797			194.5018885		18.87187631															$450 (1a); $0 (1a1)	$450 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											285.4962	285.4962	101.5098		0.190330807	0.190330807	0.235281098	30.0284	190.3308		0.137702013		0.190330807	190.1984	12.6887	24.9819	0.263132969	25.2687			0.190330807	25.3774			21.5174		25.3774															57.8292	0.820651407	16.72319711	0	4.984886358	5.589049653	0.636219187	1.258014168	6.387596194	0	5.691947781	0	0.205468715	11.31774461	5.147764262	18.25626955	0.452894345	6.323306605	0	0	9.327078048	2.752950706	0	0	0.348764333	0	0.039909994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	154.0929	0	88.59723645	57.8292	0.820651407	16.72319711	0	4.984886358	5.589049653	0.636219187	1.258014168	6.387596194	0	5.691947781	0	0.205468715	11.31774461	5.147764262	18.25626955	0.452894345	6.323306605	0	0	9.327078048	2.752950706	0	0	0.348764333	0	0.039909994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	154.0929																																																																																				0			57.8292	0.820651407	16.72319711	0	4.984886358	5.589049653	0.636219187	1.258014168	6.387596194	0	5.691947781	0	0.205468715	11.31774461	5.147764262	18.25626955	0.452894345	6.323306605	0	0	9.327078048	2.752950706	0	0	0.348764333	0	0.039909994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	154.0929
H5435_850_0	2008	5																					7700											D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2430.682735	34.49368686	1976.936584		26.19064376	29.36492387	2.704081169	502.7290826	402.7259465		41.33525458		1.079534724	714.0593823	4868.353066	8769.365606	1.721161533	3002.912617			49.00456317	1301.762797			194.5018885		18.87187631															$450 (1a); $0 (1a1)	$450 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											285.4962	285.4962	101.5098		0.190330807	0.190330807	0.235281098	30.0284	190.3308		0.137702013		0.190330807	190.1984	12.6887	24.9819	0.263132969	25.2687			0.190330807	25.3774			21.5174		25.3774															57.8292	0.820651407	16.72319711	0	4.984886358	5.589049653	0.636219187	1.258014168	6.387596194	0	5.691947781	0	0.205468715	11.31774461	5.147764262	18.25626955	0.452894345	6.323306605	0	0	9.327078048	2.752950706	0	0	0.348764333	0	0.039909994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	154.0929	0	88.59723645	57.8292	0.820651407	16.72319711	0	4.984886358	5.589049653	0.636219187	1.258014168	6.387596194	0	5.691947781	0	0.205468715	11.31774461	5.147764262	18.25626955	0.452894345	6.323306605	0	0	9.327078048	2.752950706	0	0	0.348764333	0	0.039909994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	154.0929																																																																																				0			57.8292	0.820651407	16.72319711	0	4.984886358	5.589049653	0.636219187	1.258014168	6.387596194	0	5.691947781	0	0.205468715	11.31774461	5.147764262	18.25626955	0.452894345	6.323306605	0	0	9.327078048	2.752950706	0	0	0.348764333	0	0.039909994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	154.0929
H5435_869_0	2008	5																					7700											D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2430.682735	34.49368686	1976.936584		26.19064376	29.36492387	2.704081169	502.7290826	402.7259465		41.33525458		1.079534724	714.0593823	4868.353066	8769.365606	1.721161533	3002.912617			49.00456317	1301.762797			194.5018885		18.87187631															$450 (1a); $0 (1a1)	$450 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											285.4962	285.4962	101.5098		0.190330807	0.190330807	0.235281098	30.0284	190.3308		0.137702013		0.190330807	190.1984	12.6887	24.9819	0.263132969	25.2687			0.190330807	25.3774			21.5174		25.3774															57.8292	0.820651407	16.72319711	0	4.984886358	5.589049653	0.636219187	1.258014168	6.387596194	0	5.691947781	0	0.205468715	11.31774461	5.147764262	18.25626955	0.452894345	6.323306605	0	0	9.327078048	2.752950706	0	0	0.348764333	0	0.039909994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	154.0929	0	88.59723645	57.8292	0.820651407	16.72319711	0	4.984886358	5.589049653	0.636219187	1.258014168	6.387596194	0	5.691947781	0	0.205468715	11.31774461	5.147764262	18.25626955	0.452894345	6.323306605	0	0	9.327078048	2.752950706	0	0	0.348764333	0	0.039909994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	154.0929																																																																																				0			57.8292	0.820651407	16.72319711	0	4.984886358	5.589049653	0.636219187	1.258014168	6.387596194	0	5.691947781	0	0.205468715	11.31774461	5.147764262	18.25626955	0.452894345	6.323306605	0	0	9.327078048	2.752950706	0	0	0.348764333	0	0.039909994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	154.0929
H5435_870_0	2008	5																					7700											D	D	D	V	Coin	Coin	Coin	V	V	O	Coin	O	Coin	O	V	V	Coin	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2430.682735	34.49368686	1976.936584		26.19064376	29.36492387	2.704081169	502.7290826	402.7259465		41.33525458		1.079534724	714.0593823	4868.353066	8769.365606	1.721161533	3002.912617			49.00456317	1301.762797			194.5018885		18.87187631															$450 (1a); $0 (1a1)	$450 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40/$40/$20 (4b)"	$300 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	$300 (incl in h5)	30% (12)	"$0 (3, 5, 9d); $40/$40 (9c); $300 (9a)"	"$20/$40/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	50%/50% (7e); $40/$40 (7h)	"$40 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $40 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											285.4962	285.4962	101.5098		0.190330807	0.190330807	0.235281098	30.0284	190.3308		0.137702013		0.190330807	190.1984	12.6887	24.9819	0.263132969	25.2687			0.190330807	25.3774			21.5174		25.3774															57.8292	0.820651407	16.72319711	0	4.984886358	5.589049653	0.636219187	1.258014168	6.387596194	0	5.691947781	0	0.205468715	11.31774461	5.147764262	18.25626955	0.452894345	6.323306605	0	0	9.327078048	2.752950706	0	0	0.348764333	0	0.039909994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	154.0929	0	88.59723645	57.8292	0.820651407	16.72319711	0	4.984886358	5.589049653	0.636219187	1.258014168	6.387596194	0	5.691947781	0	0.205468715	11.31774461	5.147764262	18.25626955	0.452894345	6.323306605	0	0	9.327078048	2.752950706	0	0	0.348764333	0	0.039909994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	154.0929																																																																																				0			57.8292	0.820651407	16.72319711	0	4.984886358	5.589049653	0.636219187	1.258014168	6.387596194	0	5.691947781	0	0.205468715	11.31774461	5.147764262	18.25626955	0.452894345	6.323306605	0	0	9.327078048	2.752950706	0	0	0.348764333	0	0.039909994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	154.0929
H5436_001_0	2008	8																																D	D	D	P	T	Coin	P	V	P	P	P	V	P	P	V	V	V	V	P	P	S	V	T	V	V	P	V	P	P	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1254.372835	0.207634712	738.8343359	0	218.9135065	0.014971564	0	179.5625851	331.3785524	0	985.8074053	0	0	6.030141044	2827.111619	6079.609391	2.38609315	994.6168485	0	0	1134.98948	11.29826333	0	0	104.9756444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	"$100 per day for days 1-10, unlimited days"	$100 per day for days 1-10	$110 for Days 21-100	No Cost Sharing	$100 per Trip	10% per Device	$25 for Diabetes Supplies	$50 per ER Visit; $25 per Urgent Care Visit	$100 Copayment	No Cost Sharing	$25 Copayment	No Cost Sharing	No Cost Sharing	"$20 Copayment for Cadiac Rehab, $10 for CORF, $20/$10 for OP MH Ind/Grp"	$10 per Visit Copayment	$20 per Visit Copayment	$20 per Visit Individual Copayment; $10 per Visit Group Copays	$20 per Visit Copayment	No Cost Sharing	No Cost Sharing	$25/Script	$20 for Nutrition Therapy	Not covered	Not covered	$20 per Visit Copayment	$20 per Pair (1 pair per year)	Not covered	Not covered	Not Applicable	Not covered	Not covered											62.93	66.45	45.1	0	100	0.1	0	49.64549938	100	0	25	0	0	14.38596491	10	20	19	20	0	0	25	20	0	0	20	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5781	0.001149777	2.776785712	0	1.824279221	0.001497156	0	0.742872851	2.761487937	0	2.053765428	0	0	0.007229116	2.35592635	10.13268232	0.003777981	1.657694748	0	0	2.364561416	0.018830439	0	0	0.174959407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.4556	0	0	6.5781	0.001149777	2.776785712	0	1.824279221	0.001497156	0	0.742872851	2.761487937	0	2.053765428	0	0	0.007229116	2.35592635	10.13268232	0.003777981	1.657694748	0	0	2.364561416	0.018830439	0	0	0.174959407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.4556		20% Coinsurance	10% Coinsurance	20% Coinsurance	20% Coinsurance	$100/Trip	20% Coinsurance	20% Coinsurance	$50 per ER Visit; $25 per Urgent Care Visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	10% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50/Script	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance; $40 frame allowance	Not covered	Not covered	Not Applicable	Not covered	Not covered											43.7311	0.0041	3.0878	0.0142	1.0946	0.0022	0.0171	0.4457	8.1004	0	7.6676	0	0	0.0724	2.4121	6.1195	0.0012	1.8825	0	0	2.8375	0.0082	0	0	0.1273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.6255	0	0	50.3093	0.005214253	5.864553522	0.014178075	2.918846754	0.003742891	0.01710106	1.188596561	10.86193262	0	9.721408281	0	0	0.079622864	4.76798041	16.25216121	0.004971532	3.540187827	0	0	5.202035115	0.027058387	0	0	0.302232393	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.0811
H5436_002_0	2008	7																																D	D	D	P	T	Coin	P	V	P	P	P	V	P	P	V	V	V	V	P	P	S	V	T	V	V	P	V	P	P	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1022.363621	0.708737	556.4534214	0	251.5698268	0.002685087	0	247.9647328	348.289528	0	995.5484763	0	0	93.77673142	2347.768298	3000.536045	169.6949036	922.5494431	0	0	901.5847536	18.74363499	0	0	94.13209119	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	"$100 per day for days 1-10, unlimited days"	$100 per day for days 1-10	$110 for Days 21-100	No Cost Sharing	$100 per Trip	10% per Device	$25 for Diabetes Supplies	$50 per ER Visit; $25 per Urgent Care Visit	$150 Copayment	No Cost Sharing	$25 Copayment	No Cost Sharing	No Cost Sharing	"$20 Copayment for Cadiac Rehab, $10 for CORF, $20/$10 for OP MH Ind/Grp"	$10 per Visit Copayment	$20 per Visit Copayment	$20 per Visit Individual Copayment; $10 per Visit Group Copays	$20 per Visit Copayment	No Cost Sharing	No Cost Sharing	$25/Script	$20 for Nutrition Therapy	Not covered	Not covered	$20 per Visit Copayment	$20 per Pair (1 pair per year)	Not covered	Not covered	Not Applicable	Not covered	Not covered											62.93	66.45	45.1	0	100	0.1	0	48.75524895	150	0	25	0	0	18.76910175	10	20	19	20	0	0	25	20	0	0	20	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.3614	0.003924631	2.091337442	0	2.096415224	0.000268509	0	1.00746519	4.3536191	0	2.074059326	0	0	0.146675418	1.956473581	5.000893408	0.268683597	1.537582405	0	0	1.87830157	0.031239392	0	0	0.156886819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.9653	0	0	5.3614	0.003924631	2.091337442	0	2.096415224	0.000268509	0	1.00746519	4.3536191	0	2.074059326	0	0	0.146675418	1.956473581	5.000893408	0.268683597	1.537582405	0	0	1.87830157	0.031239392	0	0	0.156886819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.9653		20% Coinsurance	10% Coinsurance	20% Coinsurance	20% Coinsurance	$100/Trip	20% Coinsurance	20% Coinsurance	$50 per ER Visit; $25 per Urgent Care Visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	10% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50/Script	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance; $40 frame allowance	Not covered	Not covered	Not Applicable	Not covered	Not covered											36.1486	0.0226	2.0964	0.0225	1.2578	0.0004	0.0151	0.6045	9.303	0	5.449	0	0	0.1245	1.8741	3.0576	0.096	1.8476	0	0	2.254	0.0136	0	0	0.1132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3005	0	0	41.51	0.026574315	4.187751504	0.022527745	3.354264358	0.000671272	0.01512769	1.611944304	13.65662838	0	7.523036014	0	0	0.271137996	3.830585928	8.058484195	0.364668296	3.385176794	0	0	4.132263454	0.044801632	0	0	0.270103122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.2658
H5437_001_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	948.624126				0		0															200/d 7	200/d 7	"$0 days 1-8, $75 days 9-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $25 UC	$150 per visit	$30 per visit	"$30 X-ray; $175 PET, MRI"	$30 per visit	$30 per visit	$30 per visit	$20 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script				$0 per visit		$0 per visit															144.57	144.57	66.23	20	100	0.2	0.2	46.75	150	30	56.1	30	30	30	20	30	30	30	30	30	45				0		0															16.8305	0.327878398	6.298021891	3.122011879	1.722706705	2.766333837	0.176580511	1.460700884	3.861237975	4.909791256	4.71855417	0	0	0	8.119976658	15.05139961	0.443677622	1.283690571	2.105316109	3.182059768	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9377			16.8305	0.327878398	6.298021891	3.122011879	1.722706705	2.766333837	0.176580511	1.460700884	3.861237975	4.909791256	4.71855417	0	0	0	8.119976658	15.05139961	0.443677622	1.283690571	2.105316109	3.182059768	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9377		30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	$100 per trip	30% coins; $500ded; $5000 OOP max	0	$50 ER; $25 UC	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max				30% coins; $500ded; $5000 OOP max		30% coins; $500ded; $5000 OOP max															4.9627	0.0385	0.8047	0.7209	0.1626	0.4107	0.0262	0.138	0.5082	0.1764	0.4952	0	0.1624	0.5472	0.6447	0.8056	0.0304	0.0853	0.5991	2.1712	0.4721				0.0838		0.0237															14.0695	500	12.52979307	21.7932	0.366361934	7.102724968	3.842911382	1.885337704	3.17699139	0.202793587	1.59865433	4.369481972	5.086163212	5.213708207	0	0.162372695	0.547154296	8.764694544	15.85696807	0.474103154	1.368974573	2.704462883	5.3532738	4.029486303	0	0	0	0.083803836	0	0.023660548	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0073
H5437_003_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	948.624126				0		0															200/d 7	200/d 7	"$0 days 1-8, $75 days 9-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $25 UC	$150 per visit	$30 per visit	"$30 X-ray; $175 PET, MRI"	$30 per visit	$30 per visit	$30 per visit	$20 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script				$0 per visit		$0 per visit															144.57	144.57	66.23	20	100	0.2	0.2	46.75	150	30	56.1	30	30	30	20	30	30	30	30	30	45				0		0															16.8305	0.327878398	6.298021891	3.122011879	1.722706705	2.766333837	0.176580511	1.460700884	3.861237975	4.909791256	4.71855417	0	0	0	8.119976658	15.05139961	0.443677622	1.283690571	2.105316109	3.182059768	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9377			16.8305	0.327878398	6.298021891	3.122011879	1.722706705	2.766333837	0.176580511	1.460700884	3.861237975	4.909791256	4.71855417	0	0	0	8.119976658	15.05139961	0.443677622	1.283690571	2.105316109	3.182059768	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9377		30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	$100 per trip	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	$50 ER; $25 UC	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max	30% coins; $500ded; $5000 OOP max				30% coins; $500ded; $5000 OOP max		30% coins; $500ded; $5000 OOP max															4.9627	0.0385	0.8047	0.7209	0.1626	0.4107	0.0262	0.138	0.5082	0.1764	0.4952	0	0.1624	0.5472	0.6447	0.8056	0.0304	0.0853	0.5991	2.1712	0.4721				0.0838		0.0237															14.0695	500	12.52979307	21.7932	0.366361934	7.102724968	3.842911382	1.885337704	3.17699139	0.202793587	1.59865433	4.369481972	5.086163212	5.213708207	0	0.162372695	0.547154296	8.764694544	15.85696807	0.474103154	1.368974573	2.704462883	5.3532738	4.029486303	0	0	0	0.083803836	0	0.023660548	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0073
H5437_801_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1139.822122		395.1004362	1114.240079	162.0196033	9.061256591		253.9254602	246.3455957	1566.786002	4700.854728	0	0	738.2788007	3202.492744	5013.826275	0	992.5832541	0	0	6.611326244				589.8082051		25.58204263															$200 per day; max $1400		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20 % per script				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2				0		0															13.732	0	3.292503635	3.714133597	2.025245042	2.718376977	0	1.058022751	4.105759928	5.222620005	21.52207989	0	0	2.460929336	8.006231861	16.50384482	0	3.308610847	0	0	1.322265249	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.9926			13.732	0	3.292503635	3.714133597	2.025245042	2.718376977	0	1.058022751	4.105759928	5.222620005	21.52207989	0	0	2.460929336	8.006231861	16.50384482	0	3.308610847	0	0	1.322265249	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.9926		500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP		50	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP				500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP															8.5496		0.3397	0.3725	0.1642	0.4298		0.2043	1.2696	0.8517	2.1988	0	0	0.6836	1.0898	5.4599	0	0.4946	0	0	0.3355				0.1232		0.0025															22.5694	500		22.2817	0	3.632190482	4.086593982	2.189415274	3.148165941	0	1.262353586	5.375365197	6.074345161	23.72088481	0	0	3.144562942	9.096054979	21.96373584	0	3.803212902	0	0	1.657801306	0	0	0	0.123213729	0	0.002504699	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.5621
H5437_802_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1107.426479		383.8710238	1082.57152	157.4147364	8.803720587		246.7084757	239.3440436	1522.255334	4567.248607	0	0	717.2956876	3111.472567	4871.324982	0	964.3723849	0	0	6.423421341				573.0448736		24.85495837															$200 per day; max $1400		$100 per day	$20 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20 % per script				$0 per visit		$0 per visit															144.57		100	20	150	0.3		50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2				0		0															13.3417	0	3.198925198	1.804285867	1.967684205	2.641116176	0	1.027951982	3.989067393	5.074184446	20.91038654	0	0	2.390985625	7.778681417	16.03477806	0	3.214574616	0	0	1.284684268	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.659			13.3417	0	3.198925198	1.804285867	1.967684205	2.641116176	0	1.027951982	3.989067393	5.074184446	20.91038654	0	0	2.390985625	7.778681417	16.03477806	0	3.214574616	0	0	1.284684268	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.659		500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP		50	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP				500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP															8.3401		0.3314	0.3633	0.1601	0.4193		0.2002	1.2385	0.8308	2.1449	0	0	0.6669	1.0631	5.3261	0	0.4825	0	0	0.3273				0.1202		0.0024															22.0171	500		21.6818	0	3.530285185	2.167616003	2.127830076	3.060369577	0	1.228182258	5.227550393	5.905030972	23.0552914	0	0	3.057861087	8.841789329	21.3608289	0	3.697052322	0	0	1.611995216	0	0	0	0.120193349	0	0.002443301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.6761
H5439_001_0	2008	4																					1500											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	coin	coin	S	O	T	P	V	P	V	P	O	O	V											8.8497	0.0604	1.6078	1.2411	0.2751	0.8857	0.0457	0.1832	0.9399	0.3545	0.9646	0	0	0.9836	0.3872	1.9168	0	0	0.3506	0.4044	0.2741	0.0296	0	0	0	0	0	0	0	0	0											19.754	2750	168.9241961	1.590441004	33.7545812	23.62625046	152.5194413	16.83713718	0.869774582	179.3617899	179.9026127	6.74792034	18.36034884	0	13.30513184	344.3578053	4166.34462	4777.997022	138.2272472	438.9279185	23.72963417	34.72219787	354.7767897	575.0556212	0	0	337.7128277	0	145.7307195	0	0	850	0											Per Admit: $50	Per Admit: $50	Per Admit: $50 100 Days Limit	no charge	$25 per Ambulance Service	$10 DME	$10 DME	$50 ER/	$50 ASC / $50 OP	No Charge	$0 X-Ray/ $10 MRI	Included in Lab	$10 RD	$25 OP SA	$10 PCP	$10 SCP/ $15 Chiro / $25 Pod.	$25 MH	$25 per Visit	no charge	$10 per Visit	$10 Rx	$10 Mdcr Cov Vision/Hearing	not covered	optional	$10 per Visit	optional	$10 per Visit	not covered	not covered	$0 copay												45.4565311	45.45643608	45.45656514	0	22.72499139	0.049414359	0.0338288	45.42366788	45.45214364	-5.14E-19	0.006252906	0	9.112771461	22.72495271	9.112771461	12.49535776	22.78192865	22.78192865	0	0.002479095	9.090096316	9.112771461	0	0	9.112771461	0	9.112771461	0	0	0	0											0.6399	0.006024648	0.127863943	0	0.288833583	0.831996346	0.02942343	0.678939198	0.681413283	-3.47E-18	0.114805542	0	0.010103885	0.652126237	3.163912196	4.975231847	0.262423607	0.833302044	0	0.08607963	0.268746266	0.436695871	0	0	0.256458318	0	0.110667562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4549	500	1.4195	9.4896	0.066433554	1.735661727	1.24106674	0.563900455	1.717681855	0.075154495	0.862163814	1.621296623	0.354462487	1.079420864	0	0.010103885	1.63575612	3.551148302	6.892056121	0.262423607	0.833302044	0.350567006	0.490480677	0.542820306	0.466304978	0	0	0.256458318	0	0.110667562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.2089	4250	10% Coin	10% Coin + $250 Ded	10% Coin	no charge	$25 per Ambulance Service	10% Coin	10% Coin	$50 ER	10% ASC / 10% OP	10% Coin	10% Coin	included in Lab	10% Coin	$50 OP SA	10% Coin	10% SCP/ $50 Chiro /$35 Pod.	$50 MH	$35 per Visit	10% Coin	10% Coin	10% Coin	10% Coin	not covered	optional	10% Coin	optional	10% Coin	not covered														5.2754	0.0511	0.9107	0.2884	0.1186	0.463	0.021	0.1959	0.5014	0.1975	0.5307	0	0.0028	0.5443	0.5856	2.2067	0.078	0.1761	0.4034	0.5165	0.1444	0.0748	0	0	0.0384	0	0.0112	0	0	0	0											13.3361	750	2.1195	14.765	0.117581956	2.646329258	1.529460953	0.68248714	2.180729107	0.096187306	1.058048914	2.122741583	0.551992181	1.610074684	0	0.012950131	2.180018797	4.136760457	9.098776337	0.340421344	1.009417873	0.753923811	1.007001432	0.687251084	0.541107087	0	0	0.294877605	0	0.121905515	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.545
H5440_001_0	2008	5																																Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	Coin	T	V	V	P	V																																																								0		556.6391787	24.90913319	170.8929632		36.15669201	46.81383224	12.93974134	890.4522032	38.52545226	19.40198296	49.17762927	27.00591818	2.049613963	27.70338747	419.0953646	179.4542271	15.65107351	18.245289			33.47459571	5.611439875																				1(a) 20% Coinsurance	1(b) 20% Coinsurance	2(a) $140 per Day for days 21-100	6(a) $0 per Visit	10(a) 20% Coinsurance	11(a) 20% Coinsurance	11(b)/11(c) 20% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; 20% coinsurance	9(b) 20% Coinsurance	8(a) Diagnostic: 20% Coinsurance; other 0% coinsurance	8(b) X-rays 20% Coinsurance; other: 20% Coinsurance	9(a) 20% Coinsurance	12 20% Coinsurance	"3, 5, 9(a), 9(c), 9(d) 20% Coinsurance"	7(a) PCP $0 per visit; Urgent Care 20% coinsurance	7(b)/7(d)/7(f) 20% Coinsurance	7(e)/7(h) 20% Coinsurance	7(c)/7(i) 20% Coinsurance		7(g) 20% Coinsurance	15  20% per script	"13, 14(b), 14(e)-(j), 17(a), 16(b) 20% Coinsurance; 14(a) and 14(c) $0; 14(d) Pap Smear $0 copay, Pelvic Exam 20% Coinsurance"	10(b) $0 Copay	16(a) $0 copay per visit	17(a1) $0 copay per Visit	17(b) $0 copay per procedure	18a $10 per visit															0.085468907	0.085468907	0.110176745		0.2	0.2	0.2	50	0.2	0.1	0.2	189.8573	0.2	0.2	16.4761	0.2	0.2	0.2			0.2	0.2																				47.5753	2.128956381	18.82843044	0	7.231338402	9.362766449	2.587948268	3.710217513	7.705090452	1.940198296	9.835525854	0.427272526	0.409922793	5.540677494	0.575420473	35.89084541	3.130214702	3.6490578	0	0	6.694919141	1.122287975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	168.3464	0	0	47.5753	2.128956381	18.82843044	0	7.231338402	9.362766449	2.587948268	3.710217513	7.705090452	1.940198296	9.835525854	0.427272526	0.409922793	5.540677494	0.575420473	35.89084541	3.130214702	3.6490578	0	0	6.694919141	1.122287975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	168.3464																																																																																				0	0	0	47.5753	2.128956381	18.82843044	0	7.231338402	9.362766449	2.587948268	3.710217513	7.705090452	1.940198296	9.835525854	0.427272526	0.409922793	5.540677494	0.575420473	35.89084541	3.130214702	3.6490578	0	0	6.694919141	1.122287975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	168.3464
H5470_002_0	2008	10	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)									Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		293.67	6.3	502.17	210.34	70.35	4.77	1.63	332.89	393.12	6183.29	2703.19		8.25	526.97	4812	3603.83	19.68	449.42			17.15			5.13	2.99					0.02		27.4	0.08	3.38								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$50/Visit	$50/Visit			20% Coins			DEN 749	$200 Allowance					QuitNet		$30/Visit	Active Outlook	Silver Sneakers								550.000007	550.000341	28.712569	0	99.999981	0.2	0.199999	50.000005	85.431643	0	49.999999		16.666169	49.389168	9.999999	29.999997	50.000035	49.999989			0.2			0	0					0		30.000176	0	0								13.4599	0.288750179	1.201549231	0	0.586249889	0.954	0.32599837	1.387041805	2.798740625	0	11.26329144	0	0.011457991	2.168884155	4.009999599	9.009574099	0.082000057	1.872582921	0	0	3.43	0	0	0	0	0	0	0	0	0	0	0.068500402	0	0	0	0	0	0	0	0	0	52.9185	0	0	13.4599	0.288750179	1.201549231	0	0.586249889	0.954	0.32599837	1.387041805	2.798740625	0	11.26329144	0	0.011457991	2.168884155	4.009999599	9.009574099	0.082000057	1.872582921	0	0	3.43	0	0	0	0	0	0	0	0	0	0	0.068500402	0	0	0	0	0	0	0	0	0	52.9185		$750/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	30% Coins	30% Coins			30% Coins			DEN 749	$200 Allowance					QuitNet		$35/Visit	Active Outlook	Silver Sneakers								4.0521	0.0928	0.6679	1.0432	0.7335	1.9808	0.6782	0.3062	4.4294	1.0981	2.9606		0.0025	1.4788	4.1973	4.2426	0.0507	0.3996			1.2032			0	0					0		0.1	0	0								29.7174	500	1.691322225	17.512	0.381522179	1.869422231	1.043211	1.319713889	2.934755	1.00418137	1.693258805	7.228146625	1.098051	14.22392544	0	0.013987991	3.647706155	8.207338599	13.2521381	0.132670057	2.272165921	0	0	4.633238	0	0	0	0	0	0	0	0	0	0	0.168482402	0	0	0	0	0	0	0	0	0	82.6359
H5470_801_0	2008	2																					2000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		293.66	6.3	502.16	210.34	70.35	4.77	1.63	332.88	393.12	6183.17	2703.14		8.25	526.95	4811.91	3603.76	47.08	449.41			17.15																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					570.153598	570.153419	18.336218	0	63.350347	0.1267	0.1267	31.675192	126.700804	23.789192	60.125641		21.116587	55.646485	12.670079	19.005117	37.543445	63.350407			0.1267																					13.9526	0.299330545	0.767309603	0	0.371391409	0.604359	0.206521	0.878669826	4.150718339	12.25771819	13.5440021	0	0.014517654	2.443576273	5.080606653	5.707490037	0.147295449	2.372525534	0	0	2.172905	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.9715	0	37.58826296	13.9526	0.299330545	0.767309603	0	0.371391409	0.604359	0.206521	0.878669826	4.150718339	12.25771819	13.5440021	0	0.014517654	2.443576273	5.080606653	5.707490037	0.147295449	2.372525534	0	0	2.172905	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.9715	3000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					5.7263	0.0646	0.2818	0.4402	0.4345	0.8358	0.2862	0.4907	1.8691	0.4633	1.2493		0.0081	0.624	1.9325	1.5892	0.0538	0.1686			0.5077																					17.0258	0	9.849782672	19.6789	0.363884545	1.049131603	0.440202	0.805919409	1.440176	0.492693	1.369348826	6.019790339	12.72106219	14.7932981	0	0.022637654	3.067593273	7.013081653	7.296727037	0.201104449	2.541137534	0	0	2.680634	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.9973
H5470_802_0	2008	2																					2000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		293.66	6.3	502.16	210.34	70.35	4.77	1.63	332.88	393.12	6183.17	2703.14		8.25	526.95	4811.91	3603.76	47.08	449.41			17.15																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					570.153598	570.153419	18.336218	0	63.350347	0.1267	0.1267	31.675192	126.700804	23.789192	60.125641		21.116587	55.646485	12.670079	19.005117	37.543445	63.350407			0.1267																					13.9526	0.299330545	0.767309603	0	0.371391409	0.604359	0.206521	0.878669826	4.150718339	12.25771819	13.5440021	0	0.014517654	2.443576273	5.080606653	5.707490037	0.147295449	2.372525534	0	0	2.172905	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.9715	0	37.58826296	13.9526	0.299330545	0.767309603	0	0.371391409	0.604359	0.206521	0.878669826	4.150718339	12.25771819	13.5440021	0	0.014517654	2.443576273	5.080606653	5.707490037	0.147295449	2.372525534	0	0	2.172905	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.9715	3000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					5.7263	0.0646	0.2818	0.4402	0.4345	0.8358	0.2862	0.4907	1.8691	0.4633	1.2493		0.0081	0.624	1.9325	1.5892	0.0538	0.1686			0.5077																					17.0258	0	9.849782672	19.6789	0.363884545	1.049131603	0.440202	0.805919409	1.440176	0.492693	1.369348826	6.019790339	12.72106219	14.7932981	0	0.022637654	3.067593273	7.013081653	7.296727037	0.201104449	2.541137534	0	0	2.680634	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.9973
H5470_803_0	2008	2																					2000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		293.66	6.3	502.16	210.34	70.35	4.77	1.63	332.88	393.12	6183.17	2703.14		8.25	526.95	4811.91	3603.76	47.08	449.41			17.15																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					570.153598	570.153419	18.336218	0	63.350347	0.1267	0.1267	31.675192	126.700804	23.789192	60.125641		21.116587	55.646485	12.670079	19.005117	37.543445	63.350407			0.1267																					13.9526	0.299330545	0.767309603	0	0.371391409	0.604359	0.206521	0.878669826	4.150718339	12.25771819	13.5440021	0	0.014517654	2.443576273	5.080606653	5.707490037	0.147295449	2.372525534	0	0	2.172905	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.9715	0	37.58826296	13.9526	0.299330545	0.767309603	0	0.371391409	0.604359	0.206521	0.878669826	4.150718339	12.25771819	13.5440021	0	0.014517654	2.443576273	5.080606653	5.707490037	0.147295449	2.372525534	0	0	2.172905	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.9715	3000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					5.7263	0.0646	0.2818	0.4402	0.4345	0.8358	0.2862	0.4907	1.8691	0.4633	1.2493		0.0081	0.624	1.9325	1.5892	0.0538	0.1686			0.5077																					17.0258	0	9.849782672	19.6789	0.363884545	1.049131603	0.440202	0.805919409	1.440176	0.492693	1.369348826	6.019790339	12.72106219	14.7932981	0	0.022637654	3.067593273	7.013081653	7.296727037	0.201104449	2.541137534	0	0	2.680634	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.9973
H5470_804_0	2008	2																					2000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		293.66	6.3	502.16	210.34	70.35	4.77	1.63	332.88	393.12	6183.17	2703.14		8.25	526.95	4811.91	3603.76	47.08	449.41			17.15																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					570.153598	570.153419	18.336218	0	63.350347	0.1267	0.1267	31.675192	126.700804	23.789192	60.125641		21.116587	55.646485	12.670079	19.005117	37.543445	63.350407			0.1267																					13.9526	0.299330545	0.767309603	0	0.371391409	0.604359	0.206521	0.878669826	4.150718339	12.25771819	13.5440021	0	0.014517654	2.443576273	5.080606653	5.707490037	0.147295449	2.372525534	0	0	2.172905	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.9715	0	37.58826296	13.9526	0.299330545	0.767309603	0	0.371391409	0.604359	0.206521	0.878669826	4.150718339	12.25771819	13.5440021	0	0.014517654	2.443576273	5.080606653	5.707490037	0.147295449	2.372525534	0	0	2.172905	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.9715	3000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					5.7263	0.0646	0.2818	0.4402	0.4345	0.8358	0.2862	0.4907	1.8691	0.4633	1.2493		0.0081	0.624	1.9325	1.5892	0.0538	0.1686			0.5077																					17.0258	0	9.849782672	19.6789	0.363884545	1.049131603	0.440202	0.805919409	1.440176	0.492693	1.369348826	6.019790339	12.72106219	14.7932981	0	0.022637654	3.067593273	7.013081653	7.296727037	0.201104449	2.541137534	0	0	2.680634	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.9973
H5485_001_0	2008	5																																A	A	D		T	Coin	Coin	V	Coin	V	V			V	V	V	V	P	P		Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		338.9986154	5.944333154	978.8416515	0	259.3305583	16.74526256	10.19101486	476.5639758	40.24390436	2830.704799	1573.625678	0	0	518.5381988	4593.880564	8415.631713	178.448681	470.6570092	1701.987946	0	12.86114688	0	0	0	358.157354	0	144.9684528	0	0	0	0											$700/Admit for IP Medical$700/Admit for IP Surgical	$700/Admit for IP Psych$700/Admit for IP Substance Abuse	$50/Day for SNF Days 11-30; $75/Day for SNF Days 31-100		$125/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $25/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	$25/Case for OP Fac - Pathology	$25/Case for OP Fac - Radiology; 15% Coinsurance for Radiation Therapy$25/Case for OP Fac - CT/MRI/PET			$25/Case for OP Fac - Occ Therapy; $25/Case for OP Fac - Physical/Speech Therapy; $25/Case for OP Fac - CORF; $25/Service for Prof - CORF; $25/Service for Prof - CORF;	$25/Visit for PCP - Office Visits; $25/Consult for PCP - Consults; $25/Exam for PCP - Routine Physicals;	$25/Visit for Speclst - Office Visits; $25/Consult for Speclst - Consults; $25/Visit for Chiropractor; $25/Exam for Vistion Exams; $25/Service for Podiatrist; $25/Exam for Hearing/Speech Exams; $25/Procedure for Prof Path (Office); $25/Procedure for Prof Path (Labs)	$25/Visit for OP Psych - Non-Physician; $25/Visit for OP Psych - Psychiatrist; $25/Visit for OP Substance Abuse;	$25/Service for PT/ST (PCP); $25/Service for Occ Therapy (PCP); $25/Service for PT/ST (Specialist); $25/Service for Occ Therapy (Specialist);	$25/Procedure for Prof Radiology (Office);		15% Coinsurance for Part B Rx				$25/Exam for Vision (Refractions)		$25/Exam for Routine Hearing Exams															700	699.9999999	57.89473684	0	125	0.2	0.2	44.40864271	0.2	25	26.94060526	0	0	25	25	25	25	25	25	0	0.0678	0	0	0	25	0	25	0	0	0	0											19.7749	0.346752767	4.722481652	0	2.701359983	3.349052511	2.038202972	1.763629944	8.048780871	5.897301665	3.532869018	0	0	1.080287914	9.570584508	17.53256607	0.371768086	0.980535436	3.545808221	0	0.871985759	0	0	0	0.746161154	0	0.30201761	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.1771	0	0	19.7749	0.346752767	4.722481652	0	2.701359983	3.349052511	2.038202972	1.763629944	8.048780871	5.897301665	3.532869018	0	0	1.080287914	9.570584508	17.53256607	0.371768086	0.980535436	3.545808221	0	0.871985759	0	0	0	0.746161154	0	0.30201761	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.1771																																																																																				0	0		19.7749	0.346752767	4.722481652	0	2.701359983	3.349052511	2.038202972	1.763629944	8.048780871	5.897301665	3.532869018	0	0	1.080287914	9.570584508	17.53256607	0.371768086	0.980535436	3.545808221	0	0.871985759	0	0	0	0.746161154	0	0.30201761	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.1771
H5485_801_0	2008	2																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		284.3243561	4.775669111	29.19915206	6.613476572	6.407221205	9.517257	8.961011663	4.683307115	16.2789038	22.02084741	35.91463603	0	0.687969712	64.85597418	57.20218925	217.771373	1.843567121	6.032046833	39.65347627	0	57.50936202	0	0	0	0	0	0	0	0	0	0											8% Coinsurance for IP Medical; 8% Coinsurance for IP Surgical	8% Coinsurance for IP Psych; 8% Coinsurance for IP Substance Abuse	19% Coinsurance for SNF		23% Coinsurance for Ambulance	23% Coinsurance for DME	23% Coinsurance for Prosthetics/Supplies; 23% Coinsurance for Diabetes Monitoring Supplies; 23% Coinsurance for Prosthetics;	23% Coinsurance for ER - Facility; 23% Coinsurance for Urgent Care;	23% Coinsurance for OP Fac - Surgery; 23% Coinsurance for OP Fac - ASC	23% Coinsurance for OP Fac - Pathology	23% Coinsurance for OP Fac - Radiology; 23% Coinsurance for OP Fac - CT/MRI/PET		23% Coinsurance for Renal Dialysis - Fac; 23% Coinsurance for Renal Dialysis - Prof	23% Coinsurance for OP Fac - Cardiovascular; 23% Coinsurance for OP Fac - Occ Therapy; 23% Coinsurance for OP Fac - Physical/Speech Therapy; 23% Coinsurance for OP Fac - CORF; 23% Coinsurance for OP Fac - Other; 23% Coinsurance for Prof - CORF; 23% Coinsurance for Prof - CORF;	23% Coinsurance for PCP - Office Visits; 23% Coinsurance for PCP - Consults; 23% Coinsurance for PCP - Primary Surgeon (IP); 23% Coinsurance for PCP - Asst Surgeon (IP); 23% Coinsurance for PCP - Primary Surgeon (OP); 23% Coinsurance for PCP - Asst Surgeon (OP); 23% Coinsurance for PCP - IP Visits; 23% Coinsurance for PCP - Tx Injections; 23% Coinsurance for PCP - Allergy Testing; 23% Coinsurance for PCP - Allergy Tx; 23% Coinsurance for PCP - ER Visits; 23% Coinsurance for PCP - Cardio; 23% Coinsurance for PCP - Immunizations; 23% Coinsurance for Misc. Medical (PCP);	23% Coinsurance for Speclst - Primary Surgeon (IP); 23% Coinsurance for Speclst - Asst Surgeon (IP); 23% Coinsurance for Speclst - Anesthesia (IP); 23% Coinsurance for Speclst - Primary Surgeon (OP); 23% Coinsurance for Speclst - Asst Surgeon (OP); 23% Coinsurance for Speclst - Anesthesia (OP); 23% Coinsurance for Speclst - IP Visits; 23% Coinsurance for Speclst - Office Visits; 23% Coinsurance for Speclst - Tx Injections; 23% Coinsurance for Speclst - Allergy Testing; 23% Coinsurance for Speclst - Allergy Tx; 23% Coinsurance for Speclst - ER Visits; 23% Coinsurance for Speclst - Consults; 23% Coinsurance for Speclst - Cardio; 23% Coinsurance for Speclst - Immunizations; 23% Coinsurance for Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical; 23% Coinsurance for Prof Path (IP); 23% Coinsurance for Prof Path (OP); 23% Coinsurance for Prof Path (Office); 23% Coinsurance for Prof Path (Labs)	23% Coinsurance for OP Psych - Non-Physician; 23% Coinsurance for OP Psych - Psychiatrist; 23% Coinsurance for OP Substance Abuse;	23% Coinsurance for PT/ST (PCP); 23% Coinsurance for Occ Therapy (PCP); 23% Coinsurance for PT/ST (Specialist); 23% Coinsurance for Occ Therapy (Specialist);	23% Coinsurance for Prof Radiology (Office); 23% Coinsurance for Prof Radiology (OP); 23% Coinsurance for Prof Radiology (IP);		23% Coinsurance for Part B Rx	23% Coinsurance for Blood Products																				0.078588568	0.078588568	0.194456291	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.3446	0.375312997	5.677958799	0	1.499289762	2.227038138	2.096876729	1.095893865	3.809263488	5.152878293	8.404024831	0	0.160984913	15.17629796	13.38531228	50.95850127	0.431394706	1.411498959	9.278913446	0	13.45719071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.9433	0	0	22.3446	0.375312997	5.677958799	0	1.499289762	2.227038138	2.096876729	1.095893865	3.809263488	5.152878293	8.404024831	0	0.160984913	15.17629796	13.38531228	50.95850127	0.431394706	1.411498959	9.278913446	0	13.45719071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.9433																																																																																				0	0		22.3446	0.375312997	5.677958799	0	1.499289762	2.227038138	2.096876729	1.095893865	3.809263488	5.152878293	8.404024831	0	0.160984913	15.17629796	13.38531228	50.95850127	0.431394706	1.411498959	9.278913446	0	13.45719071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.9433
H5485_802_0	2008	2																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		284.3243561	4.775669111	29.19915206	6.613476572	6.407221205	9.517257	8.961011663	4.683307115	16.2789038	22.02084741	35.91463603	0	0.687969712	64.85597418	57.20218925	217.771373	1.843567121	6.032046833	39.65347627	0	57.50936202	0	0	0	0	0	0	0	0	0	0											8% Coinsurance for IP Medical; 8% Coinsurance for IP Surgical	8% Coinsurance for IP Psych; 8% Coinsurance for IP Substance Abuse	19% Coinsurance for SNF		23% Coinsurance for Ambulance	23% Coinsurance for DME	23% Coinsurance for Prosthetics/Supplies; 23% Coinsurance for Diabetes Monitoring Supplies; 23% Coinsurance for Prosthetics;	23% Coinsurance for ER - Facility; 23% Coinsurance for Urgent Care;	23% Coinsurance for OP Fac - Surgery; 23% Coinsurance for OP Fac - ASC	23% Coinsurance for OP Fac - Pathology	23% Coinsurance for OP Fac - Radiology; 23% Coinsurance for OP Fac - CT/MRI/PET		23% Coinsurance for Renal Dialysis - Fac; 23% Coinsurance for Renal Dialysis - Prof	23% Coinsurance for OP Fac - Cardiovascular; 23% Coinsurance for OP Fac - Occ Therapy; 23% Coinsurance for OP Fac - Physical/Speech Therapy; 23% Coinsurance for OP Fac - CORF; 23% Coinsurance for OP Fac - Other; 23% Coinsurance for Prof - CORF; 23% Coinsurance for Prof - CORF;	23% Coinsurance for PCP - Office Visits; 23% Coinsurance for PCP - Consults; 23% Coinsurance for PCP - Primary Surgeon (IP); 23% Coinsurance for PCP - Asst Surgeon (IP); 23% Coinsurance for PCP - Primary Surgeon (OP); 23% Coinsurance for PCP - Asst Surgeon (OP); 23% Coinsurance for PCP - IP Visits; 23% Coinsurance for PCP - Tx Injections; 23% Coinsurance for PCP - Allergy Testing; 23% Coinsurance for PCP - Allergy Tx; 23% Coinsurance for PCP - ER Visits; 23% Coinsurance for PCP - Cardio; 23% Coinsurance for PCP - Immunizations; 23% Coinsurance for Misc. Medical (PCP);	23% Coinsurance for Speclst - Primary Surgeon (IP); 23% Coinsurance for Speclst - Asst Surgeon (IP); 23% Coinsurance for Speclst - Anesthesia (IP); 23% Coinsurance for Speclst - Primary Surgeon (OP); 23% Coinsurance for Speclst - Asst Surgeon (OP); 23% Coinsurance for Speclst - Anesthesia (OP); 23% Coinsurance for Speclst - IP Visits; 23% Coinsurance for Speclst - Office Visits; 23% Coinsurance for Speclst - Tx Injections; 23% Coinsurance for Speclst - Allergy Testing; 23% Coinsurance for Speclst - Allergy Tx; 23% Coinsurance for Speclst - ER Visits; 23% Coinsurance for Speclst - Consults; 23% Coinsurance for Speclst - Cardio; 23% Coinsurance for Speclst - Immunizations; 23% Coinsurance for Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical; 23% Coinsurance for Prof Path (IP); 23% Coinsurance for Prof Path (OP); 23% Coinsurance for Prof Path (Office); 23% Coinsurance for Prof Path (Labs)	23% Coinsurance for OP Psych - Non-Physician; 23% Coinsurance for OP Psych - Psychiatrist; 23% Coinsurance for OP Substance Abuse;	23% Coinsurance for PT/ST (PCP); 23% Coinsurance for Occ Therapy (PCP); 23% Coinsurance for PT/ST (Specialist); 23% Coinsurance for Occ Therapy (Specialist);	23% Coinsurance for Prof Radiology (Office); 23% Coinsurance for Prof Radiology (OP); 23% Coinsurance for Prof Radiology (IP);		23% Coinsurance for Part B Rx	23% Coinsurance for Blood Products																				0.078588568	0.078588568	0.194456291	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.3446	0.375312997	5.677958799	0	1.499289762	2.227038138	2.096876729	1.095893865	3.809263488	5.152878293	8.404024831	0	0.160984913	15.17629796	13.38531228	50.95850127	0.431394706	1.411498959	9.278913446	0	13.45719071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.9433	0	0	22.3446	0.375312997	5.677958799	0	1.499289762	2.227038138	2.096876729	1.095893865	3.809263488	5.152878293	8.404024831	0	0.160984913	15.17629796	13.38531228	50.95850127	0.431394706	1.411498959	9.278913446	0	13.45719071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.9433																																																																																				0	0		22.3446	0.375312997	5.677958799	0	1.499289762	2.227038138	2.096876729	1.095893865	3.809263488	5.152878293	8.404024831	0	0.160984913	15.17629796	13.38531228	50.95850127	0.431394706	1.411498959	9.278913446	0	13.45719071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.9433
H5485_803_0	2008	2																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		284.3243561	4.775669111	29.19915206	6.613476572	6.407221205	9.517257	8.961011663	4.683307115	16.2789038	22.02084741	35.91463603	0	0.687969712	64.85597418	57.20218925	217.771373	1.843567121	6.032046833	39.65347627	0	57.50936202	0	0	0	0	0	0	0	0	0	0											8% Coinsurance for IP Medical; 8% Coinsurance for IP Surgical	8% Coinsurance for IP Psych; 8% Coinsurance for IP Substance Abuse	19% Coinsurance for SNF		23% Coinsurance for Ambulance	23% Coinsurance for DME	23% Coinsurance for Prosthetics/Supplies; 23% Coinsurance for Diabetes Monitoring Supplies; 23% Coinsurance for Prosthetics;	23% Coinsurance for ER - Facility; 23% Coinsurance for Urgent Care;	23% Coinsurance for OP Fac - Surgery; 23% Coinsurance for OP Fac - ASC	23% Coinsurance for OP Fac - Pathology	23% Coinsurance for OP Fac - Radiology; 23% Coinsurance for OP Fac - CT/MRI/PET		23% Coinsurance for Renal Dialysis - Fac; 23% Coinsurance for Renal Dialysis - Prof	23% Coinsurance for OP Fac - Cardiovascular; 23% Coinsurance for OP Fac - Occ Therapy; 23% Coinsurance for OP Fac - Physical/Speech Therapy; 23% Coinsurance for OP Fac - CORF; 23% Coinsurance for OP Fac - Other; 23% Coinsurance for Prof - CORF; 23% Coinsurance for Prof - CORF;	23% Coinsurance for PCP - Office Visits; 23% Coinsurance for PCP - Consults; 23% Coinsurance for PCP - Primary Surgeon (IP); 23% Coinsurance for PCP - Asst Surgeon (IP); 23% Coinsurance for PCP - Primary Surgeon (OP); 23% Coinsurance for PCP - Asst Surgeon (OP); 23% Coinsurance for PCP - IP Visits; 23% Coinsurance for PCP - Tx Injections; 23% Coinsurance for PCP - Allergy Testing; 23% Coinsurance for PCP - Allergy Tx; 23% Coinsurance for PCP - ER Visits; 23% Coinsurance for PCP - Cardio; 23% Coinsurance for PCP - Immunizations; 23% Coinsurance for Misc. Medical (PCP);	23% Coinsurance for Speclst - Primary Surgeon (IP); 23% Coinsurance for Speclst - Asst Surgeon (IP); 23% Coinsurance for Speclst - Anesthesia (IP); 23% Coinsurance for Speclst - Primary Surgeon (OP); 23% Coinsurance for Speclst - Asst Surgeon (OP); 23% Coinsurance for Speclst - Anesthesia (OP); 23% Coinsurance for Speclst - IP Visits; 23% Coinsurance for Speclst - Office Visits; 23% Coinsurance for Speclst - Tx Injections; 23% Coinsurance for Speclst - Allergy Testing; 23% Coinsurance for Speclst - Allergy Tx; 23% Coinsurance for Speclst - ER Visits; 23% Coinsurance for Speclst - Consults; 23% Coinsurance for Speclst - Cardio; 23% Coinsurance for Speclst - Immunizations; 23% Coinsurance for Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical; 23% Coinsurance for Prof Path (IP); 23% Coinsurance for Prof Path (OP); 23% Coinsurance for Prof Path (Office); 23% Coinsurance for Prof Path (Labs)	23% Coinsurance for OP Psych - Non-Physician; 23% Coinsurance for OP Psych - Psychiatrist; 23% Coinsurance for OP Substance Abuse;	23% Coinsurance for PT/ST (PCP); 23% Coinsurance for Occ Therapy (PCP); 23% Coinsurance for PT/ST (Specialist); 23% Coinsurance for Occ Therapy (Specialist);	23% Coinsurance for Prof Radiology (Office); 23% Coinsurance for Prof Radiology (OP); 23% Coinsurance for Prof Radiology (IP);		23% Coinsurance for Part B Rx	23% Coinsurance for Blood Products																				0.078588568	0.078588568	0.194456291	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.3446	0.375312997	5.677958799	0	1.499289762	2.227038138	2.096876729	1.095893865	3.809263488	5.152878293	8.404024831	0	0.160984913	15.17629796	13.38531228	50.95850127	0.431394706	1.411498959	9.278913446	0	13.45719071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.9433	0	0	22.3446	0.375312997	5.677958799	0	1.499289762	2.227038138	2.096876729	1.095893865	3.809263488	5.152878293	8.404024831	0	0.160984913	15.17629796	13.38531228	50.95850127	0.431394706	1.411498959	9.278913446	0	13.45719071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.9433																																																																																				0	0		22.3446	0.375312997	5.677958799	0	1.499289762	2.227038138	2.096876729	1.095893865	3.809263488	5.152878293	8.404024831	0	0.160984913	15.17629796	13.38531228	50.95850127	0.431394706	1.411498959	9.278913446	0	13.45719071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.9433
H5485_804_0	2008	2																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		284.3243561	4.775669111	29.19915206	6.613476572	6.407221205	9.517257	8.961011663	4.683307115	16.2789038	22.02084741	35.91463603	0	0.687969712	64.85597418	57.20218925	217.771373	1.843567121	6.032046833	39.65347627	0	57.50936202	0	0	0	0	0	0	0	0	0	0											8% Coinsurance for IP Medical; 8% Coinsurance for IP Surgical	8% Coinsurance for IP Psych; 8% Coinsurance for IP Substance Abuse	19% Coinsurance for SNF		23% Coinsurance for Ambulance	23% Coinsurance for DME	23% Coinsurance for Prosthetics/Supplies; 23% Coinsurance for Diabetes Monitoring Supplies; 23% Coinsurance for Prosthetics;	23% Coinsurance for ER - Facility; 23% Coinsurance for Urgent Care;	23% Coinsurance for OP Fac - Surgery; 23% Coinsurance for OP Fac - ASC	23% Coinsurance for OP Fac - Pathology	23% Coinsurance for OP Fac - Radiology; 23% Coinsurance for OP Fac - CT/MRI/PET		23% Coinsurance for Renal Dialysis - Fac; 23% Coinsurance for Renal Dialysis - Prof	23% Coinsurance for OP Fac - Cardiovascular; 23% Coinsurance for OP Fac - Occ Therapy; 23% Coinsurance for OP Fac - Physical/Speech Therapy; 23% Coinsurance for OP Fac - CORF; 23% Coinsurance for OP Fac - Other; 23% Coinsurance for Prof - CORF; 23% Coinsurance for Prof - CORF;	23% Coinsurance for PCP - Office Visits; 23% Coinsurance for PCP - Consults; 23% Coinsurance for PCP - Primary Surgeon (IP); 23% Coinsurance for PCP - Asst Surgeon (IP); 23% Coinsurance for PCP - Primary Surgeon (OP); 23% Coinsurance for PCP - Asst Surgeon (OP); 23% Coinsurance for PCP - IP Visits; 23% Coinsurance for PCP - Tx Injections; 23% Coinsurance for PCP - Allergy Testing; 23% Coinsurance for PCP - Allergy Tx; 23% Coinsurance for PCP - ER Visits; 23% Coinsurance for PCP - Cardio; 23% Coinsurance for PCP - Immunizations; 23% Coinsurance for Misc. Medical (PCP);	23% Coinsurance for Speclst - Primary Surgeon (IP); 23% Coinsurance for Speclst - Asst Surgeon (IP); 23% Coinsurance for Speclst - Anesthesia (IP); 23% Coinsurance for Speclst - Primary Surgeon (OP); 23% Coinsurance for Speclst - Asst Surgeon (OP); 23% Coinsurance for Speclst - Anesthesia (OP); 23% Coinsurance for Speclst - IP Visits; 23% Coinsurance for Speclst - Office Visits; 23% Coinsurance for Speclst - Tx Injections; 23% Coinsurance for Speclst - Allergy Testing; 23% Coinsurance for Speclst - Allergy Tx; 23% Coinsurance for Speclst - ER Visits; 23% Coinsurance for Speclst - Consults; 23% Coinsurance for Speclst - Cardio; 23% Coinsurance for Speclst - Immunizations; 23% Coinsurance for Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical; 23% Coinsurance for Prof Path (IP); 23% Coinsurance for Prof Path (OP); 23% Coinsurance for Prof Path (Office); 23% Coinsurance for Prof Path (Labs)	23% Coinsurance for OP Psych - Non-Physician; 23% Coinsurance for OP Psych - Psychiatrist; 23% Coinsurance for OP Substance Abuse;	23% Coinsurance for PT/ST (PCP); 23% Coinsurance for Occ Therapy (PCP); 23% Coinsurance for PT/ST (Specialist); 23% Coinsurance for Occ Therapy (Specialist);	23% Coinsurance for Prof Radiology (Office); 23% Coinsurance for Prof Radiology (OP); 23% Coinsurance for Prof Radiology (IP);		23% Coinsurance for Part B Rx	23% Coinsurance for Blood Products																				0.078588568	0.078588568	0.194456291	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.3446	0.375312997	5.677958799	0	1.499289762	2.227038138	2.096876729	1.095893865	3.809263488	5.152878293	8.404024831	0	0.160984913	15.17629796	13.38531228	50.95850127	0.431394706	1.411498959	9.278913446	0	13.45719071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.9433	0	0	22.3446	0.375312997	5.677958799	0	1.499289762	2.227038138	2.096876729	1.095893865	3.809263488	5.152878293	8.404024831	0	0.160984913	15.17629796	13.38531228	50.95850127	0.431394706	1.411498959	9.278913446	0	13.45719071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.9433																																																																																				0	0		22.3446	0.375312997	5.677958799	0	1.499289762	2.227038138	2.096876729	1.095893865	3.809263488	5.152878293	8.404024831	0	0.160984913	15.17629796	13.38531228	50.95850127	0.431394706	1.411498959	9.278913446	0	13.45719071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.9433
H5501_001_0	2008	8																																				T			V																																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	284.0600591	0	0	326.3764524	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0															"$50 Copay, per Trip"			"ER: $50 Copay, MC & WW, Choice 1: Urgent Care: $35 Copay, Worldwide: $35 Copay"																																		0	0	0	0	50	0	0	45.7418306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	1.18358358	0	0	1.244088033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.4277	0	0	0	0	0	0	1.18358358	0	0	1.244088033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.4277		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	20% of MA services	20% of MA services	20% of MA services	20% of MA services	20% of MA services	"$50 Copay, MC & WW"	20% of MA services	20% of MA services	20% of MA services		20% of MA services	20% of MA services	20% of MA services	20% of MA services	20% of MA services	20% of MA services	20% of MA services	20% of MA services	20% of MA services	20% of MA services																				7.32	0.23	1.74	3.04	0.47	1.18	0.89	0.46	2.31	0.46	3.06	0	0.02	1.82	2.74	9.8	0.14	0.37	1.58	4.23	0.71	0.31	0	0	0	0	0	0	0	0	0											42.88	0	0	7.32	0.23	1.74	3.04	1.65358358	1.18	0.89	1.704088033	2.31	0.46	3.06	0	0.02	1.82	2.74	9.8	0.14	0.37	1.58	4.23	0.71	0.31	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.3077
H5507_001_0	2008	5																					4200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2010.538421	114.6469692	644.730884		152.5448545	14.0901861	1.948567434	372.1420089	36.79234496	10138.00081	62.1387187		2.280858335	41.01637607	3866.832523	5780.007842	425.2274135	3.412749976			27.05170178	2171.957075			379.7084833		17.62808381															$265 (1a); $0 (1a1)	$265 (1b)	"$125 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											171.9706	171.9706	81.1182		113.5655	0.162236371	0.240634587	32.4473	0.162236371	3.8937	0.106997863		0.194683645	0.162187452	15	29.9994	37.5	0.162236371			0.194683645	30			30		30															28.8128	1.642991894	4.358283289	0	1.443652211	2.28594066	0.46889272	1.006249484	5.969056529	3.289504922	6.648710102	0	0.444045815	6.652341511	4.833540654	14.44972886	1.328835667	0.553672171	0	0	5.266523914	5.429892687	0	0	0.949271208	0	0.04407021	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.878	0	37.0050626	28.8128	1.642991894	4.358283289	0	1.443652211	2.28594066	0.46889272	1.006249484	5.969056529	3.289504922	6.648710102	0	0.444045815	6.652341511	4.833540654	14.44972886	1.328835667	0.553672171	0	0	5.266523914	5.429892687	0	0	0.949271208	0	0.04407021	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.878		30% (1a); $0 (1a1)	30% (1b)	"30% (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"30%/$50 (7a); 30% (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1)"	"30% (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); 30% (17a, 17b, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	30% (17a1)	$0 n/c (17b)	30% (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											1.3889	0.0322	0.5113	0.2309	0.1547	0.2939	0.0406	0.1078	0.7673	0.4699	0.8603		0.0476	0.8551	0.6275	2.6713	0.1134	0.0771			0.6108	0.3438			0.0594		0.0016															10.2654	0	0	30.2017	1.675142081	4.86963126	0.23094686	1.598304414	2.579800156	0.509531292	1.114044629	6.73638351	3.759358792	7.509044156	0	0.491614518	7.507440273	5.461007971	17.1210767	1.442191541	0.630734268	0	0	5.877368792	5.773649076	0	0	1.008701505	0	0.045671984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.1433
H5508_001_0	2008	4																					4000											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	P	P	V	V	P	P	Coin	P	T	P	V	V	P	P	P	P	P																																																				0	0	1599.920403	16.78104833			2.801455076	12.08833174	4.99181277	281.9664534	325.5757708		321.7004246	104.5876562		12.16677597	2482.630638	5498.875791	217.5741027	264.2705955			38.36585324	643.3182796			144																	$100 Days 1-5 (1a)	$100 Days 1-5 (1b)	$0 (2)	$0 (6)	$50 (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4b)"	$100 (9b)	$0 (8a)	$100/20% up to $100/$0 (8b)	$100 (9a)	$0 (12)	"$25 (9c) $0 (3, 5, 9a, 9d)"	"$10 (7a), $0 (14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i)"	"$25 (7b, 7d, 7f)"	"$25 (7e, 7h)"	"$25 (7c, 7i)"		$0 (7g)	20% (15)	"$25 (17a) $0 (13a, 14j, 16b, 17b, 18a)"	$0 n/c (10b)	$0 n/c (16a)	$20 (17a)	$0 (17b)	$0 n/c (18a)	$0 n/c (18b)		$0 (14a)	$0 n/c (13b)											65.7396	56.1785			50	0.2	0.2	49.5227	99.0453		63.1019	99.0453		24.7613	10	25	25	25			0.198090668	25			20																	8.7649	0.078561196	0	0	0.011672729	2.417666347	0.998362554	1.163644232	2.687230082	0	1.691657768	0.863243279	0	0.025105466	2.068858865	11.45599123	0.453279381	0.550563741	0	0	7.599917503	1.340246416	0	0	0.24	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.4109	0	0.210860574	8.7649	0.078561196	0	0	0.011672729	2.417666347	0.998362554	1.163644232	2.687230082	0	1.691657768	0.863243279	0	0.025105466	2.068858865	11.45599123	0.453279381	0.550563741	0	0	7.599917503	1.340246416	0	0	0.24	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.4109		FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing											1.3301	0.0468	4.1759	0.0029	1.1692	0.5262	0.3651	0.1867	0.8652	0.7722	1.6201	0.1122		1.4398	0.9305	4.7565	0.2479	0.7631		0.0039	0.2746	0.3214																				19.9104	0	0	10.095	0.125395737	4.175906593	0.002925946	1.180844319	2.943866755	1.36349272	1.350299116	3.552412117	0.77222164	3.311753336	0.975490006	0	1.464899055	2.999313916	16.21252627	0.701199924	1.313664012	0	0.003857225	7.874550399	1.661662656	0	0	0.24	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3213
H5508_002_0	2008	3																					4000											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	P	P	V	V	P	P	Coin	P	T	P	V	V	P	P	P	P	P																																																				0	0	1599.920403	16.78104833			2.801455076	12.08833174	4.99181277	281.9664534	325.5757708		321.7004246	104.5876562		12.16677597	2482.630638	5498.875791	217.5741027	264.2705955			38.36585324	643.3182796			144																	$100 Days 1-5 (1a)	$100 Days 1-5 (1b)	$0 (2)	$0 (6)	$50 (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4b)"	$100 (9b)	$0 (8a)	$100/20% up to $100/$0 (8b)	$100 (9a)	$0 (12)	"$25 (9c) $0 (3, 5, 9a, 9d)"	"$10 (7a), $0 (14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i)"	"$25 (7b, 7d, 7f)"	"$25 (7e, 7h)"	"$25 (7c, 7i)"		$0 (7g)	20% (15)	"$25 (17a) $0 (13a, 14j, 16b, 17b, 18a)"	$0 n/c (10b)	$0 n/c (16a)	$20 (17a)	$0 (17b)	$0 n/c (18a)	$0 n/c (18b)		$0 (14a)	$0 n/c (13b)											65.7396	56.1785			50	0.2	0.2	49.5227	99.0453		63.1019	99.0453		24.7613	10	25	25	25			0.198090668	25			20																	8.7649	0.078561196	0	0	0.011672729	2.417666347	0.998362554	1.163644232	2.687230082	0	1.691657768	0.863243279	0	0.025105466	2.068858865	11.45599123	0.453279381	0.550563741	0	0	7.599917503	1.340246416	0	0	0.24	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.4109	0	0.210860574	8.7649	0.078561196	0	0	0.011672729	2.417666347	0.998362554	1.163644232	2.687230082	0	1.691657768	0.863243279	0	0.025105466	2.068858865	11.45599123	0.453279381	0.550563741	0	0	7.599917503	1.340246416	0	0	0.24	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.4109		FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing											1.3301	0.0468	4.1759	0.0029	1.1692	0.5262	0.3651	0.1867	0.8652	0.7722	1.6201	0.1122		1.4398	0.9305	4.7565	0.2479	0.7631		0.0039	0.2746	0.3214																				19.9104	0	0	10.095	0.125395737	4.175906593	0.002925946	1.180844319	2.943866755	1.36349272	1.350299116	3.552412117	0.77222164	3.311753336	0.975490006	0	1.464899055	2.999313916	16.21252627	0.701199924	1.313664012	0	0.003857225	7.874550399	1.661662656	0	0	0.24	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3213
H5509_001_0	2008	16																					2000											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	O	O	P	P	P	P	P	P	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1343.773578	25.82887939	837.0497821	0	180.4358308	9.303035801	1.441829033	325.4935932	400.4663507	0	17.96270629	0	0	762.848481	4819.460053	15627.67662	174.4399237	544.1225549	3014.807821	643.2245971	19.44243859	0	0	0	434.8581508	0	0.076899466	0	0	0	501.7304502											1a $165 days 1-5	1b $100 days 1-90	2 $100 days 8-100		10a $100	11a 20%	11b 20%	"4a $50, 4b $10"	"9a $100,9b $100"		8b $100			9d $30	"17a $5,7a $5,7f $5"	"17a $30,18a $30,7b $30,7d $30,7f $30"	7e $30	"7c $30,7i $30"	8b $100	7g $30	20%				17a $5		18a $5				"14c $5,7f $30"											83.00198588	75.93190181	51.91600144	0	70.85119106	0.151863804	0.151863804	37.96595091	75.93190181	0	0.078574212	0	0	1.283430032	2.303720037	5.231532686	22.77957054	22.45537421	13.02192682	0.160860955	0.167999719	0	0	0	3.795923708	0	3.796595091	0	0	0	3.409552552											9.2947	0.163436328	3.621356474	0	1.065341127	1.412794402	0.218961641	1.029806148	2.534014302	0	1.411405497	0	0	0.081588554	0.925223891	6.813058422	0.331138879	1.018206299	3.271550568	0.008622477	3.266324213	0	0	0	0.137557364	0	2.43E-05	0	0	0	0.142556361	0	0	0	0	0	0	0	0	0	0	36.7476	0	11.64787647	9.2947	0.163436328	3.621356474	0	1.065341127	1.412794402	0.218961641	1.029806148	2.534014302	0	1.411405497	0	0	0.081588554	0.925223891	6.813058422	0.331138879	1.018206299	3.271550568	0.008622477	3.266324213	0	0	0	0.137557364	0	2.43E-05	0	0	0	0.142556361	0	0	0	0	0	0	0	0	0	0	36.7476		20%	20%	20%	20%	100	20%	20%	"4a $50, 4b $10"	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%		20%	20%	20%	20%	20%			20%											5.135	0.0702	0.6676	0.2267	0.1957	0.2537	0.0393	0.0924	1.0277	0.2647	0.4899	0.0034	0.0078	0.2634	0.6768	2.6163	0.0334	0.1124	0.7465	0.0532	0.5882	0	0	0.1284	0.0735	0.065	0	0.0456	0	0	0.0634											13.94	0	0	14.4297	0.233593669	4.28892265	0.226695842	1.261052878	1.66651356	0.258284251	1.122217111	3.561702619	0.264730153	1.901297487	0.003397817	0.007756583	0.344948753	1.601990812	9.429312232	0.364562518	1.130643802	4.018052761	0.061840492	3.854498803	0	0	0.128372124	0.211021985	0.064972696	2.62E-05	0.045551399	0	0	0.205992922	0	0	0	0	0	0	0	0	0	0	50.6876
H5509_003_0	2008	17																					2750											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	O	O	P	P	P	P	P	P	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1389.308669	26.7041164	865.4140382	0	186.5811222	9.637343302	1.479538927	336.5185293	414.0365474	0	18.1275234	0	0	788.6784517	4982.772203	16157.59039	180.3509923	562.5606835	3116.967553	665.020896	20.190004	0	0	0	449.5939051	0	0.079662873	0	0	0	518.9627956											1a $180 days 1-7	1b $180 days 1-7	2 $90 days 4-100		10a $150	11a 20%	11b 20%	"4a $50, 4b $15"	"9a $150,9b $150"		8b $100			9d $30	"17a $10,7a $10,7f $10"	"17a $30,18a $30,7b $30,7d $30,7f $30"	7e $30	"7c $30,7i $30"	8b $100	7g $30	20%				17a $10		18a $10				"14c $10,7f $30"											108.9940728	109.0376585	60.9802979	0	110.8213622	0.158378376	0.158378376	39.59459395	118.7837818	0	0.083458265	0	0	1.365900998	4.805087573	5.45635774	23.75675637	23.48627354	13.58053447	0.205736144	0.174782173	0	0	0	7.917515648	0	7.91891879	0	0	0	10.67122162											12.6189	0.242646194	4.397767155	0	1.723097844	1.526346779	0.234326972	1.110359544	4.098402243	0	1.512891647	0	0	0.08977139	1.995221399	7.346799448	0.357046215	1.101037841	3.527507107	0.01140157	3.528852772	0	0	0	0.296638898	0	5.26E-05	0	0	0	0.46149725	0	0	0	0	0	0	0	0	0	0	46.1805	0	12.13618181	12.6189	0.242646194	4.397767155	0	1.723097844	1.526346779	0.234326972	1.110359544	4.098402243	0	1.512891647	0	0	0.08977139	1.995221399	7.346799448	0.357046215	1.101037841	3.527507107	0.01140157	3.528852772	0	0	0	0.296638898	0	5.26E-05	0	0	0	0.46149725	0	0	0	0	0	0	0	0	0	0	46.1805		20%	20%	20%	20%	150	20%	20%	"4a $50, 4b $15"	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%		20%	20%	20%	20%	20%			20%											4.6313	0.0633	0.6021	0.1914	0.2455	0.2142	0.0329	0.1557	0.8451	0.2188	0.4028	0.0028	0.0064	0.2168	0.5529	2.137	0.0273	0.0923	0.6099	0.0435	0.4965	0	0	0.1091	0.06	0.0545	0	0.0378	0	0	0.0521											12.1016	0	0	17.2501	0.305921138	4.999845449	0.191352927	1.968573444	1.740509964	0.267205615	1.266058267	4.943461263	0.218822806	1.9157255	0.002793995	0.006361341	0.306560205	2.548104361	9.48382959	0.384363733	1.193318438	4.137360117	0.054877887	4.025328261	0	0	0.10905741	0.356655835	0.054493614	5.42E-05	0.037750642	0	0	0.51356144	0	0	0	0	0	0	0	0	0	0	58.2821
H5509_004_0	2008	12																					2000											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	O	O	P	P	P	P	P	P	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2298.415098	44.17819142	1431.705377	0	308.620771	15.91208392	2.466130956	556.7302417	684.9650283	0	30.72374396	0	0	1304.790104	8243.293314	26729.86617	298.365261	930.6772479	5156.58287	1100.183208	33.25470536	0	0	0	743.7893971	0	0.131530264	0	0	0	858.1690107											1a $165 days 1-5	1b $100 days 1-90	2 $100 days 8-100		10a $100	11a 20%	11b 20%	"4a $50, 4b $10"	"9a $100,9b $100"		8b $100			9d $30	"17a $5,7a $5,7f $0"	"17a $30,18a $30,7b $30,7d $30,7f $0"	7e $30	"7c $30,7i $30"	8b $100	7g $30	20%				17a $5		18a $5				"14c $5,7f $0"											67.3336234	61.59816571	42.11576931	0	57.47654548	0.123196331	0.123196331	30.79908286	61.59816571	0	0.063741685	0	0	1.041155745	1.868844652	4.243971369	18.47944971	18.21645223	10.56376552	0.130495082	0.136286255	0	0	0	3.079363641	0	3.079908286	0	0	0	2.074842715											12.8967	0.22677463	5.024781115	0	1.478204648	1.960310364	0.303818287	1.428898404	3.51604911	0	1.958383201	0	0	0.113207476	1.283786219	9.453398894	0.45946882	1.412803135	4.539411026	0.011964042	4.532159243	0	0	0	0.190866502	0	3.38E-05	0	0	0	0.148380477	0	0	0	0	0	0	0	0	0	0	50.9394	0	31.7569045	12.8967	0.22677463	5.024781115	0	1.478204648	1.960310364	0.303818287	1.428898404	3.51604911	0	1.958383201	0	0	0.113207476	1.283786219	9.453398894	0.45946882	1.412803135	4.539411026	0.011964042	4.532159243	0	0	0	0.190866502	0	3.38E-05	0	0	0	0.148380477	0	0	0	0	0	0	0	0	0	0	50.9394		20%	20%	20%	20%	100	20%	20%	"4a $50, 4b $10"	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%		20%	20%	20%	20%	20%			20%											8.783	0.12	1.1418	0.3877	0.3347	0.434	0.0673	0.1581	1.7578	0.4528	0.8379	0.0058	0.0133	0.4505	1.1576	4.4749	0.0572	0.1923	1.2768	0.091	1.006	0	0	0.2196	0.1257	0.1111	0	0.0779	0	0	0.1085											23.8432	0	0	21.6798	0.34677304	6.166598607	0.387744747	1.812953636	2.394276289	0.371076404	1.586959817	5.273826151	0.452799333	2.796303491	0.005811689	0.013267002	0.563663615	2.441340835	13.92828764	0.516637228	1.605118314	5.816242137	0.102989115	5.538183904	0	0	0.219570047	0.316521745	0.111130497	3.70E-05	0.077911952	0	0	0.256883539	0	0	0	0	0	0	0	0	0	0	74.7827
H5509_005_0	2008	11																					2750											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	O	O	P	P	P	P	P	P	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2287.932305	43.97670004	1425.175542	0	307.2643154	15.87090729	2.436524714	554.1832651	681.8409857	0	29.8526507	0	0	1298.80634	8205.696651	26608.53837	297.0044532	926.4325416	5133.06432	1095.165405	33.24917164	0	0	0	740.3973232	0	0.131189896	0	0	0	854.6349504											1a $180 days 1-7	1b $180 days 1-7	2 $90 days 4-100		10a $150	11a 20%	11b 20%	"4a $50, 4b $15"	"9a $150,9b $150"		8b $100			9d $30	"17a $10,7a $10,7f $0"	"17a $30,18a $30,7b $30,7d $30,7f $0"	7e $30	"7c $30,7i $30"	8b $100	7g $30	20%				"17a $10,7a $10,7f $0"		18a $10				"14c $10,7f $0"											91.27786734	91.3143685	51.06838748	0	92.80814397	0.132635106	0.132635106	33.15877645	99.47632935	0	0.069892722	0	0	1.14388358	4.024055023	4.569465891	19.89526587	19.66874809	11.37311591	0.172295208	0.146372583	0	0	0	6.630580219	0	6.63175529	0	0	0	4.465630359											17.4031	0.334642049	6.065118068	0	2.376385902	2.105039467	0.323168713	1.531336583	5.652253205	0	2.086483012	0	0	0.123806937	2.751681236	10.13223404	0.492415213	1.51848069	4.864911291	0.015724313	4.866767146	0	0	0	0.40910532	0	7.25E-05	0	0	0	0.318040315	0	0	0	0	0	0	0	0	0	0	63.3708	0	32.18580075	17.4031	0.334642049	6.065118068	0	2.376385902	2.105039467	0.323168713	1.531336583	5.652253205	0	2.086483012	0	0	0.123806937	2.751681236	10.13223404	0.492415213	1.51848069	4.864911291	0.015724313	4.866767146	0	0	0	0.40910532	0	7.25E-05	0	0	0	0.318040315	0	0	0	0	0	0	0	0	0	0	63.3708		20%	20%	20%	20%	150	20%	20%	"4a $50, 4b $15"	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%		20%	20%	20%	20%	20%			20%											7.6269	0.1042	0.9915	0.3151	0.4043	0.3527	0.0541	0.2564	1.3917	0.3604	0.6634	0.0046	0.0105	0.357	0.9105	3.5193	0.045	0.152	1.0043	0.0716	0.8176	0	0	0.1796	0.0988	0.0897	0	0.0622	0	0	0.0857											19.929	0	0	25.03	0.438844083	7.056628745	0.315122587	2.78063844	2.457726295	0.377313707	1.787743348	7.043907828	0.360360356	2.74987525	0.004601189	0.010475942	0.480817689	3.662176375	13.65152418	0.537402071	1.670449625	5.869225475	0.087321701	5.684369696	0	0	0.179597218	0.507942024	0.08974082	7.51E-05	0.062168268	0	0	0.403780327	0	0	0	0	0	0	0	0	0	0	83.2998
H5509_006_0	2008	12																					2000											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	O	O	P	P	P	P	P	P	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2011.242509	38.65840277	1252.822746	0	270.0605363	13.92396857	2.091643028	487.1812483	599.3829329	0	24.62316842	0	0	1141.810549	7213.345382	24037.42371	261.0863881	814.3949477	4512.300098	962.7221982	28.9875393	0	0	0	650.8575648	0	0.115096381	0	0	0	782.3931773											1a $165 days 1-5	1b $100 days 1-90	2 $100 days 8-100		10a $100	11a 20%	11b 20%	"4a $50, 4b $10"	"9a $100,9b $100"		8b $100			9d $30	"17a $5,7a $5,7f $0"	"17a $30,18a $30,7b $30,7d $30,7f $0"	7e $30	"7c $30,7i $30"	8b $100	7g $30	20%				17a $5		18a $5				"14c $5,7f $0"											71.29970446	65.22641718	44.59646984	0	60.86202552	0.130452834	0.130452834	32.61320859	65.22641718	0	0.072172677	0	0	1.10266043	1.978923228	4.372935067	19.56792516	19.28943661	11.1859918	0.138181496	0.144872358	0	0	0	3.260744134	0	3.261320859	0	0	0	2.239831406											11.9501	0.210129092	4.655955984	0	1.369702604	1.816421166	0.272860761	1.324045306	3.257966769	0	1.777119985	0	0	0.104919109	1.189554727	8.759507757	0.425743242	1.309101643	4.206212659	0.011085866	4.199493166	0	0	0	0.176856666	0	3.13E-05	0	0	0	0.146035734	0	0	0	0	0	0	0	0	0	0	47.1628	0	25.14350053	11.9501	0.210129092	4.655955984	0	1.369702604	1.816421166	0.272860761	1.324045306	3.257966769	0	1.777119985	0	0	0.104919109	1.189554727	8.759507757	0.425743242	1.309101643	4.206212659	0.011085866	4.199493166	0	0	0	0.176856666	0	3.13E-05	0	0	0	0.146035734	0	0	0	0	0	0	0	0	0	0	47.1628		20%	20%	20%	20%	100	20%	20%	"4a $50, 4b $10"	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%		20%	20%	20%	20%	20%			20%											10.2443	0.14	1.3318	0.4391	0.3791	0.4914	0.0738	0.358	1.8231	0.3117	0.8691	0.006	0.0139	0.4673	1.2316	4.573	0.0607	0.201	1.3585	0.0968	1.1392	0	0	0.2503	0.1337	0.1266	0	0	0	0	0.1165											26.2364	0	0	22.1944	0.350092431	5.987745202	0.439092133	1.748780975	2.307855351	0.346683457	1.682030933	5.081053565	0.311744299	2.646172988	0.006027621	0.013904148	0.572196769	2.421109258	13.33249933	0.486462063	1.510068479	5.564668768	0.107929972	5.338741389	0	0	0.250250946	0.310545664	0.126649122	3.49E-05	0	0	0	0.262510289	0	0	0	0	0	0	0	0	0	0	73.3993
H5509_007_0	2008	11																					2000											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	O	O	P	P	P	P	P	P	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1572.317421	30.22175588	979.4119904	0	211.1236631	10.88526036	1.687049771	380.852292	468.5761278	0	21.01773431	0	0	892.5908174	5639.135288	18285.57177	204.1079952	636.6648268	3527.554743	752.6217633	22.74913379	0	0	0	508.817153	0	0.089978232	0	0	0	587.062836											1a $165 days 1-5	1b $100 days 1-90	2 $100 days 8-100		10a $100	11a 20%	11b 20%	"4a $50, 4b $10"	"9a $100,9b $100"		8b $100			9d $30	"17a $5,7a $5,7f $5"	"17a $30,18a $30,7b $30,7d $30,7f $30"	7e $30	"7c $30,7i $30"	8b $100	7g $30	20%				17a $5		18a $5				"14c $5,7f $30"											78.52377631	71.83514478	49.11497527	0	67.02855382	0.14367029	0.14367029	35.91757239	71.83514478	0	0.074334895	0	0	1.214185078	2.179427335	4.949275587	21.55054343	21.24383848	12.31935426	0.152182017	0.158935623	0	0	0	3.59112208	0	3.591757239	0	0	0	3.225596822											10.2887	0.180915351	4.008649641	0	1.179276151	1.563888508	0.242378929	1.139940814	2.805019499	0	1.562351063	0	0	0.090314204	1.024173799	7.541694498	0.366553185	1.127100396	3.621433047	0.009544625	3.615647748	0	0	0	0.152268709	0	2.69E-05	0	0	0	0.157802335	0	0	0	0	0	0	0	0	0	0	40.6777	0	15.94874938	10.2887	0.180915351	4.008649641	0	1.179276151	1.563888508	0.242378929	1.139940814	2.805019499	0	1.562351063	0	0	0.090314204	1.024173799	7.541694498	0.366553185	1.127100396	3.621433047	0.009544625	3.615647748	0	0	0	0.152268709	0	2.69E-05	0	0	0	0.157802335	0	0	0	0	0	0	0	0	0	0	40.6777		20%	20%	20%	20%	100	20%	20%	"4a $50, 4b $10"	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%		20%	20%	20%	20%	20%			20%											6.0084	0.0821	0.7811	0.2653	0.229	0.2969	0.046	0.1081	1.2025	0.3098	0.5732	0.004	0.0091	0.3082	0.7919	3.0612	0.0391	0.1316	0.8735	0.0623	0.6882	0	0	0.1502	0.086	0.076	0	0.0533	0	0	0.0742											16.3109	0	0	16.2971	0.263004783	4.789752905	0.265251399	1.408273805	1.860759245	0.288389377	1.248068677	4.007493093	0.309754439	2.135561999	0.003975705	0.009075792	0.398465693	1.816042636	10.6029107	0.405661387	1.258660837	4.494897462	0.071813755	4.303856811	0	0	0.150205161	0.238227911	0.076023003	2.91E-05	0.053298606	0	0	0.232027941	0	0	0	0	0	0	0	0	0	0	56.9885
H5509_008_0	2008	12																					2750											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	O	O	P	P	P	P	P	P	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1568.11803	30.14103874	976.7961484	0	210.5948292	10.8777064	1.669961268	379.8297563	467.3246411	0	20.46060528	0	0	890.1843972	5624.074121	18237.13432	203.5628576	634.9644039	3518.133247	750.6116392	22.78853505	0	0	0	507.4583673	0	0.08991579	0	0	0	585.7553005											1a $180 days 1-7	1b $180 days 1-7	2 $90 days 4-100		10a $150	11a 20%	11b 20%	"4a $50, 4b $15"	"9a $150,9b $150"		8b $100			9d $30	"17a $10,7a $10,7f $10"	"17a $30,18a $30,7b $30,7d $30,7f $30"	7e $30	"7c $30,7i $30"	8b $100	7g $30	20%				"17a $10,7a $10,7f $10"		18a $10				"14c $10,7f $30"											104.8859286	104.9278715	58.6818623	0	106.6443448	0.152408866	0.152408866	38.10221645	114.3066493	0	0.080312602	0	0	1.314418215	4.623976874	5.250699727	22.86132987	22.60104193	13.06866448	0.197981652	0.16819438	0	0	0	7.619093035	0	7.62044329	0	0	0	10.26900784											13.7061	0.26355292	4.776684756	0	1.871562299	1.657858894	0.254516903	1.206029632	4.451526157	0	1.643244449	0	0	0.097506216	2.16713239	7.979809684	0.387809803	1.19590476	3.831441918	0.012383944	3.832903528	0	0	0	0.322197709	0	5.71E-05	0	0	0	0.501260481	0	0	0	0	0	0	0	0	0	0	50.1595	0	15.66278938	13.7061	0.26355292	4.776684756	0	1.871562299	1.657858894	0.254516903	1.206029632	4.451526157	0	1.643244449	0	0	0.097506216	2.16713239	7.979809684	0.387809803	1.19590476	3.831441918	0.012383944	3.832903528	0	0	0	0.322197709	0	5.71E-05	0	0	0	0.501260481	0	0	0	0	0	0	0	0	0	0	50.1595		20%	20%	20%	20%	150	20%	20%	"4a $50, 4b $15"	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%		20%	20%	20%	20%	20%			20%											5.2273	0.0714	0.6796	0.216	0.2771	0.2417	0.0371	0.1757	0.9538	0.247	0.4547	0.0032	0.0072	0.2447	0.624	2.4121	0.0308	0.1042	0.6883	0.0491	0.5604	0	0	0.1231	0.0677	0.0615	0	0.0426	0	0	0.0588											13.6591	0	0	18.9335	0.334971592	5.456252839	0.215980783	2.148631551	1.899585703	0.291627153	1.38176738	5.405347518	0.246986141	2.097924566	0.003153593	0.007180069	0.342196583	2.791173512	10.39188381	0.41864319	1.300062224	4.519785352	0.061455831	4.393277319	0	0	0.123093518	0.389939056	0.061507151	5.89E-05	0.042609295	0	0	0.560025532	0	0	0	0	0	0	0	0	0	0	63.8186
H5509_009_0	2008	12																					2000											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	O	O	P	P	P	P	P	P	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1368.003446	26.29460544	852.1428057	0	183.6893078	9.470780829	1.422690132	331.3700977	407.6872452	0	16.74814405	0	0	776.6347214	4906.360768	16349.73323	177.5852873	553.933745	3069.168465	654.8227174	19.71669428	0	0	0	442.6991711	0	0.078286057	0	0	0	532.1668363											1a $165 days 1-5	1b $100 days 1-90	2 $100 days 8-100		10a $100	11a 20%	11b 20%	"4a $50, 4b $10"	"9a $100,9b $100"		8b $100			9d $30	"17a $5,7a $5,7f $5"	"17a $30,18a $30,7b $30,7d $30,7f $30"	7e $30	"7c $30,7i $30"	8b $100	7g $30	20%				17a $5		18a $5				"14c $5,7f $30"											82.53001619	75.50013436	51.6207943	0	70.44831377	0.151000269	0.151000269	37.75006718	75.50013436	0	0.08354049	0	0	1.276338855	2.290620519	5.061709647	22.71060909	22.32768744	12.94788094	0.15994626	0.16769099	0	0	0	3.774339153	0	3.775006718	0	0	0	3.405633082											9.4084	0.165437187	3.665690707	0	1.078383499	1.43009045	0.214826592	1.042436954	2.565036815	0	1.399148153	0	0	0.082604089	0.936550888	6.896466868	0.33608917	1.030671627	3.311602324	0.008728037	3.306311985	0	0	0	0.139241401	0	2.46E-05	0	0	0	0.151030415	0	0	0	0	0	0	0	0	0	0	37.1688	0	12.06131669	9.4084	0.165437187	3.665690707	0	1.078383499	1.43009045	0.214826592	1.042436954	2.565036815	0	1.399148153	0	0	0.082604089	0.936550888	6.896466868	0.33608917	1.030671627	3.311602324	0.008728037	3.306311985	0	0	0	0.139241401	0	2.46E-05	0	0	0	0.151030415	0	0	0	0	0	0	0	0	0	0	37.1688		20%	20%	20%	20%	100	20%	20%	"4a $50, 4b $10"	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%		20%	20%	20%	20%	20%			20%											6.968	0.0952	0.9059	0.2987	0.2578	0.3343	0.0502	0.2435	1.24	0.212	0.5911	0.0041	0.0095	0.3178	0.8377	3.1104	0.0413	0.1367	0.924	0.0659	0.7749	0	0	0.1702	0.0909	0.0861	0	0	0	0	0.0792											17.8455	0	0	16.3764	0.260637208	4.57154479	0.298660927	1.336224369	1.764353303	0.265039185	1.285930998	3.805060835	0.212041697	1.990259119	0.004099857	0.009457299	0.400436199	1.774227515	10.00691635	0.377388793	1.167364901	4.235594647	0.074599293	4.081203869	0	0	0.170215255	0.230173752	0.086143981	2.71E-05	0	0	0	0.230253876	0	0	0	0	0	0	0	0	0	0	55.0143
H5509_010_0	2008	16																					2000											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	O	O	P	P	P	P	P	P	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1168.166803	22.45351447	727.6625946	0	156.8561483	8.087298168	1.21486491	282.9638688	348.1326799	0	14.30159108	0	0	663.1846595	4189.644251	13961.37974	151.6437973	473.0156301	2620.827253	559.1668373	16.83649832	0	0	0	378.030097	0	0.066850104	0	0	0	454.4284107											1a $165 days 1-5	1b $100 days 1-90	2 $100 days 8-100		10a $100	11a 20%	11b 20%	"4a $50, 4b $10"	"9a $100,9b $100"		8b $100			9d $30	"17a $5,7a $5,7f $5"	"17a $30,18a $30,7b $30,7d $30,7f $30"	7e $30	"7c $30,7i $30"	8b $100	7g $30	20%				17a $5		18a $5				"14c $5,7f $30"											86.79216269	79.3992325	54.28667755	0	74.08651776	0.158798465	0.158798465	39.69961625	79.3992325	0	0.087854821	0	0	1.342253579	2.408916391	5.323114516	23.81976975	23.48076942	13.61655603	0.16820646	0.176351155	0	0	0	3.969259585	0	3.969961625	0	0	0	3.581512208											8.449	0.148565985	3.291865387	0	0.968410485	1.284250535	0.192918683	0.93612975	2.303455633	0	1.256463718	0	0	0.074180165	0.841041892	6.193168597	0.301010028	0.925564245	2.973886761	0.007837956	2.969135928	0	0	0	0.125041632	0	2.21E-05	0	0	0	0.135628408	0	0	0	0	0	0	0	0	0	0	33.3776	0	8.660074224	8.449	0.148565985	3.291865387	0	0.968410485	1.284250535	0.192918683	0.93612975	2.303455633	0	1.256463718	0	0	0.074180165	0.841041892	6.193168597	0.301010028	0.925564245	2.973886761	0.007837956	2.969135928	0	0	0	0.125041632	0	2.21E-05	0	0	0	0.135628408	0	0	0	0	0	0	0	0	0	0	33.3776		20%	20%	20%	20%	100	20%	20%	"4a $50, 4b $10"	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%		20%	20%	20%	20%	20%			20%											5.9501	0.0813	0.7735	0.255	0.2202	0.2854	0.0429	0.2079	1.0589	0.1811	0.5048	0.0035	0.0081	0.2714	0.7153	2.6561	0.0353	0.1167	0.789	0.0562	0.6617	0	0	0.1454	0.0776	0.0736	0	0	0	0	0.0677											15.2386	0	0	14.3991	0.229859277	4.065393166	0.255032822	1.188586205	1.569684588	0.235796268	1.144054416	3.362338122	0.181066848	1.761225756	0.003500953	0.008075786	0.345583662	1.556351514	8.849246577	0.336276641	1.042289496	3.762903164	0.064086802	3.630832342	0	0	0.145350372	0.202690672	0.07356015	2.42E-05	0	0	0	0.203278982	0	0	0	0	0	0	0	0	0	0	48.6162
H5509_801_0	2008	6																																COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		172.7478149	2.360979722	22.46536388	0	6.066481945	8.632240887	1.332545441	8.313301068	34.58442448	3.55778216	16.48615854	0.11434551	0.261029481	8.632548436	22.77499323	80.92742506	1.124793665	3.783818777	25.1217692	1.790926667	18.08433845	0	0	0	0	0	0	0	0	0	0											FFS Medicare 8.6%	FFS Medicare 8.6%	FFS Medicare 19.2%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				0.08571886	0.08571886	0.192115345	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											14.8077	0.202380491	4.315941127	0	1.419556775	2.019944367	0.311815633	1.94531245	8.092755328	0.832521026	3.857761099	0.026756849	0.061080899	2.020016334	5.329348415	18.93701746	0.263201718	0.885413594	5.878493994	0.41907684	4.231735197	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8579	0	0	14.8077	0.202380491	4.315941127	0	1.419556775	2.019944367	0.311815633	1.94531245	8.092755328	0.832521026	3.857761099	0.026756849	0.061080899	2.020016334	5.329348415	18.93701746	0.263201718	0.885413594	5.878493994	0.41907684	4.231735197	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8579		FFS Medicare 8.6%	FFS Medicare 8.6%	FFS Medicare 19.2%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				1.6453	0.0225	0.4795	0	0.1577	0.2244	0.0346	0.2161	0.8992	0.0924	0.4286	0.003	0.0068	0.2244	0.5921	2.0728	0.0292	0.0984	0.6532	0.0466	0.5203	0	0	0	0	0	0	0	0	0	0											8.4474	0	0	16.4531	0.224867212	4.795490141	0	1.577285306	2.244382631	0.346461815	2.161458278	8.991950365	0.924953981	4.286401221	0.029729833	0.067867665	2.244462593	5.921498239	21.00982804	0.292446353	0.983792882	6.531659993	0.465640933	4.752030489	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.3053
H5509_802_0	2008	6																																COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		172.7478149	2.360979722	22.46536388	0	6.066481945	8.632240887	1.332545441	8.313301068	34.58442448	3.55778216	16.48615854	0.11434551	0.261029481	8.632548436	22.77499323	80.92742506	1.124793665	3.783818777	25.1217692	1.790926667	18.08433845	0	0	0	0	0	0	0	0	0	0											FFS Medicare 8.6%	FFS Medicare 8.6%	FFS Medicare 19.2%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				0.085719075	0.085719075	0.192115106	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											14.8078	0.202380999	4.315935771	0	1.419556775	2.019944367	0.311815633	1.94531245	8.092755328	0.832521026	3.857761099	0.026756849	0.061080899	2.020016334	5.329348415	18.93701746	0.263201718	0.885413594	5.878493994	0.41907684	4.231735197	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8579	0	0	14.8078	0.202380999	4.315935771	0	1.419556775	2.019944367	0.311815633	1.94531245	8.092755328	0.832521026	3.857761099	0.026756849	0.061080899	2.020016334	5.329348415	18.93701746	0.263201718	0.885413594	5.878493994	0.41907684	4.231735197	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8579		FFS Medicare 8.6%	FFS Medicare 8.6%	FFS Medicare 19.2%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				1.6453	0.0225	0.4795	0	0.1577	0.2244	0.0346	0.2161	0.8992	0.0924	0.4286	0.003	0.0068	0.2244	0.5921	2.0728	0.0292	0.0984	0.6532	0.0466	0.5203	0	0	0	0	0	0	0	0	0	0											8.4474	0	0	16.4531	0.224867777	4.79548419	0	1.577285306	2.244382631	0.346461815	2.161458278	8.991950365	0.924953981	4.286401221	0.029729833	0.067867665	2.244462593	5.921498239	21.00982804	0.292446353	0.983792882	6.531659993	0.465640933	4.752030489	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.3053
H5509_803_0	2008	6																																COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		172.7478149	2.360979722	22.46536388	0	6.066481945	8.632240887	1.332545441	8.313301068	34.58442448	3.55778216	16.48615854	0.11434551	0.261029481	8.632548436	22.77499323	80.92742506	1.124793665	3.783818777	25.1217692	1.790926667	18.08433845	0	0	0	0	0	0	0	0	0	0											FFS Medicare 8.6%	FFS Medicare 8.6%	FFS Medicare 19.2%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				0.085719075	0.085719075	0.192115106	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											14.8078	0.202380999	4.315935771	0	1.419556775	2.019944367	0.311815633	1.94531245	8.092755328	0.832521026	3.857761099	0.026756849	0.061080899	2.020016334	5.329348415	18.93701746	0.263201718	0.885413594	5.878493994	0.41907684	4.231735197	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8579	0	0	14.8078	0.202380999	4.315935771	0	1.419556775	2.019944367	0.311815633	1.94531245	8.092755328	0.832521026	3.857761099	0.026756849	0.061080899	2.020016334	5.329348415	18.93701746	0.263201718	0.885413594	5.878493994	0.41907684	4.231735197	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8579		FFS Medicare 8.6%	FFS Medicare 8.6%	FFS Medicare 19.2%		FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%	FFS Medicare 23.4%																				1.6453	0.0225	0.4795	0	0.1577	0.2244	0.0346	0.2161	0.8992	0.0924	0.4286	0.003	0.0068	0.2244	0.5921	2.0728	0.0292	0.0984	0.6532	0.0466	0.5203	0	0	0	0	0	0	0	0	0	0											8.4474	0	0	16.4531	0.224867777	4.79548419	0	1.577285306	2.244382631	0.346461815	2.161458278	8.991950365	0.924953981	4.286401221	0.029729833	0.067867665	2.244462593	5.921498239	21.00982804	0.292446353	0.983792882	6.531659993	0.465640933	4.752030489	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.3053
H5510_002_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V			O												0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0			0												0	5000	1392.08986		1047.98353	608.8627665	183.0664614	12.48861405		279.992986	253.7837679	1211.830123	3879.936111	0	0	419.6184626	3499.721902	4366.989808	0	1076.115507	0	0	7.065790036				510.3815894		40.31693562			0												$350 per Stay		"$0 for days 1-7, $75 for days 8-14, $100 for days 15-100"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$250 per procedure	$25 per visit	"$25 X-ray; $150 CAT,PET,MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit			Fitness												59.18		68.64	20	100	0.2		48	250	25	47.5	25	25	25	10	25	25	25	25	25	45				0		0			0												6.8653	0	5.994465793	1.014771278	1.525553845	2.49772281	0	1.119971944	5.287161831	2.524646089	15.35808044	0	0	0.87420513	2.916434918	9.097895433	0	2.241907306	0	0	0.026496713	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3446	0	0	6.8653	0	5.994465793	1.014771278	1.525553845	2.49772281	0	1.119971944	5.287161831	2.524646089	15.35808044	0	0	0.87420513	2.916434918	9.097895433	0	2.241907306	0	0	0.026496713	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3446		"20%, $150 ded, $5000 OOP max"		"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	$100 per trip	"20%, $150 ded, $5000 OOP max"		$50 ER; $35 UC	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"				"20%, $150 ded, $5000 OOP max"		"20%, $150 ded, $5000 OOP max"			0												9.6433		0.5677	0.1071	0.1478	0.251		0.1191	0.7	0.3801	0.9258	0	0	0.4667	0.6685	2.7775	0	0.2139	0	0	0.1577				0.0509		0.0027			0												17.1798	150	6.026174805	16.5087	0	6.56213692	1.121853475	1.673391678	2.748755776	0	1.239057265	5.98720917	2.904711406	16.28384738	0	0	1.340903357	3.584958498	11.87538006	0	2.455851505	0	0	0.18414898	0	0	0	0.050901628	0	0.002704842	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5245
H5510_003_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V			O												0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0			0												0	7500	1385.286806		1042.862102	605.8872933	182.1718274	12.42758299		278.6246783	252.5435429	1205.907987	3860.975113	0	0	417.5678141	3482.618986	4345.648609	0	1070.856599	0	0	7.031259974				507.8873874		40.11990934			0												$850 per Stay		"$0 for days 1-7, $75 for days 8-14, $100 for days 15-100"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$250 per procedure	$35 per visit	"$35 X-ray; $150 CAT,PET,MRI"	$35 per visit	$30 per visit	$35 per visit	$20 per visit	$35 per visit; $30 per dialysis visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit			Fitness												143.72		68.64	20	100	0.2		48	250	35	55.7	35	30	35	20	31.4	35	35	35	35	45				0		0			0												16.5911	0	5.965171224	1.009812156	1.518098562	2.485516599	0	1.114498713	5.261323811	3.517231628	17.92135948	0	0	1.217906125	5.804364977	11.37111386	0	3.123331748	0	0	0.026367225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9272	0	0	16.5911	0	5.965171224	1.009812156	1.518098562	2.485516599	0	1.114498713	5.261323811	3.517231628	17.92135948	0	0	1.217906125	5.804364977	11.37111386	0	3.123331748	0	0	0.026367225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9272		"30%, $500 ded, $7500 OOP max"		"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	$100 per trip	"30%, $500 ded, $7500 OOP max"		$50 ER; $35 UC	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"				"30%, $500 ded, $7500 OOP max"		"30%, $500 ded, $7500 OOP max"			0												15.2483		0.8976	0.1693	0.1548	0.3969		0.1425	1.1069	0.601	1.4638	0	0	0.738	1.0571	4.3918	0	0.3383	0	0	0.2493				0.0805		0.0043			0												27.0404	500	9.229125484	31.8394	0	6.862787216	1.179133243	1.672891773	2.882456295	0	1.256965215	6.368256429	4.118200552	19.38520566	0	0	1.955861203	6.861451425	15.76294304	0	3.461625745	0	0	0.27565099	0	0	0	0.080486945	0	0.004276964	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.9676
H5510_005_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V			O												0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0			0												0	7500	1685.76593		668.1763141	328.5711049	188.7901369	11.96942135		274.8309304	241.4629818	1287.366647	4022.514711	0	0	903.610304	3676.978136	5113.819148	0	644.9433945	0	0	6.494757051				459.7543445		20.84219695			0												$100/day 1-7		"$0 for days 1-7, $75 for days 8-14, $100 for days 15-100"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$25 per visit	"$25 X-ray; $125 CAT,PET,MRI"	$25 per visit	$25 per visit	$25 per visit	$0 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit			Fitness												71.21		68.64	20	100	0.2		48	200	25	43	25	25	25	0	25	25	25	25	25	45				0		0			0												10.0036	0	3.821968516	0.547618508	1.573251141	2.393884269	0	1.099323722	4.024383029	2.682013849	14.41401105	0	0	1.882521467	0	10.65378989	0	1.343632072	0	0	0.024355339	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4644	0	0	10.0036	0	3.821968516	0.547618508	1.573251141	2.393884269	0	1.099323722	4.024383029	2.682013849	14.41401105	0	0	1.882521467	0	10.65378989	0	1.343632072	0	0	0.024355339	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4644		"30%, $500 ded, $7500 OOP max"		"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	$100 per trip	"30%, $500 ded, $7500 OOP max"		$50 ER; $35 UC	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"	"30%, $500 ded, $7500 OOP max"				"30%, $500 ded, $7500 OOP max"		"30%, $500 ded, $7500 OOP max"			0												16.7378		0.8675	0.1023	0.1621	0.3783		0.1381	1.7067	0.6925	1.5248	0	0	1.257	1.1339	4.6414	0	0.2296	0	0	0.2278				0.0695		0.0022			0												29.8716	500	9.229125484	26.7414	0	4.689471085	0.649914123	1.735388208	2.772141303	0	1.237378883	5.731068828	3.374526258	15.93878506	0	0	3.139554188	1.133887105	15.29521917	0	1.573271977	0	0	0.252179482	0	0	0	0.069523595	0	0.002239561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.336
H5510_006_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V			O												0		0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0			0												0	5000	1673.434192		663.2884617	326.1675371	187.4090968	11.88186247		272.8204835	239.6966285	1277.949286	3993.089158	0	0	897.0002018	3650.080256	5076.410469	0	640.2254959	0	0	6.447246516				456.3911434		20.68973183			0												$50/day 1-8		"$0 for days 1-7, $75 for days 8-14, $100 for days 15-100"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$10 per visit	"$10 X-ray; $125 CAT,PET,MRI"	$10 per visit	$10 per visit	$10 per visit	$0 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script				$0 per visit		$0 per visit			Fitness												38.09		68.64	20	100	0.2		48	200	10	30.7	10	10	10	0	10	10	10	10	10	45				0		0			0												5.3118	0	3.794010001	0.543612562	1.561742473	2.376372495	0	1.091281934	3.994943808	1.064957738	10.21565309	0	0	0.747500168	0	4.230342058	0	0.533521247	0	0	0.024177174	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4899	0	0	5.3118	0	3.794010001	0.543612562	1.561742473	2.376372495	0	1.091281934	3.994943808	1.064957738	10.21565309	0	0	0.747500168	0	4.230342058	0	0.533521247	0	0	0.024177174	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4899		"20%, $150 ded, $5000 OOP max"		"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	$100 per trip	"20%, $150 ded, $5000 OOP max"		$50 ER; $35 UC	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"	"20%, $150 ded, $5000 OOP max"				"20%, $150 ded, $5000 OOP max"		"20%, $150 ded, $5000 OOP max"			0												10.5105		0.5447	0.0642	0.152	0.2375		0.1153	1.0717	0.4349	0.9575	0	0	0.7894	0.712	2.9146	0	0.1442	0	0	0.1431				0.0437		0.0014			0												18.8367	150	6.026174805	15.8223	0	4.338758233	0.607849093	1.713760666	2.613898997	0	1.206569213	5.066657145	1.499820901	11.17313493	0	0	1.536853858	0.7120244	7.144927548	0	0.677723624	0	0	0.167239344	0	0	0	0.043657341	0	0.001406332	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.3266
H5510_801_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0		1234.846677	24.05634262	1008.659047	1655.768182	182.7285135	13.83166919	0.882902555	331.4169026	273.0425222	1735.948155	892.1565356	0	0	0	4306.453503	5463.08541	156.8704877	907.7454267	1240.622878	2250.153009	15.90270259				0		0															200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2				0		0															14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065	0	0	14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065		"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	0	$50 ER/UC	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"				"30% coins; $500ded; ""Unlimited OOP"		"30% coins; $500ded; ""Unlimited OOP"															7.922	0	1.2845	1.1508	0.2023	0.6555	0	0.2118	0.8113	0.2815	0.7904	0	0.2592	0.8734	1.0292	1.2859	0.0486	0.1361	0.9564	3.4659	0.7537				0.1338		0.0378															22.2902	500	3.135526218	22.7988	0.289818788	9.690032461	6.669992775	2.486439732	4.805029776	0.264870766	1.592750556	5.362014101	6.068034846	4.875000015	0	0.259194098	0.873417564	11.79529122	19.26857794	0.571469634	3.161956187	5.09182229	10.96639979	3.934222733	0	0	0	0.133775323	0	0.037769123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.9967
H5510_802_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0				0		0															0		1234.846677	24.05634262	1008.659047	1655.768182	182.7285135	13.83166919	0.882902555	331.4169026	273.0425222	1735.948155	892.1565356	0	0	0	4306.453503	5463.08541	156.8704877	907.7454267	1240.622878	2250.153009	15.90270259				0		0															200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2				0		0															14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065	0	0	14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065		"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	0	$50 ER/UC	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"				"30% coins; $500ded; ""Unlimited OOP"		"30% coins; $500ded; ""Unlimited OOP"															7.922	0	1.2845	1.1508	0.2023	0.6555	0	0.2118	0.8113	0.2815	0.7904	0	0.2592	0.8734	1.0292	1.2859	0.0486	0.1361	0.9564	3.4659	0.7537				0.1338		0.0378															22.2902	500	3.135526218	22.7988	0.289818788	9.690032461	6.669992775	2.486439732	4.805029776	0.264870766	1.592750556	5.362014101	6.068034846	4.875000015	0	0.259194098	0.873417564	11.79529122	19.26857794	0.571469634	3.161956187	5.09182229	10.96639979	3.934222733	0	0	0	0.133775323	0	0.037769123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.9967
H5512_001_0	2008	6																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	1496.192159		919.1205927	586.8755192	193.528103	11.72141935		277.0297549	273.4636238	1111.031373	4571.722792	0	0	704.1439143	3340.064497	7074.881117	0	1300.390878	0	0	228.8680174				795.8222673		43.50504139															$150/day 1-8		"$0/day 1-5, $75 day 6-14; $100/day 15-100"	$35 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$100 per procedure	$35 per visit	"$35 X-ray; $175 CAT, PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$25 per visit	"$35 per visit Spialist, $30 Renal Dialysis"	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															114.27		73.75	35	100	0.2		48	100	35	60.2	35	30	35	25	24.63	35	35	35	35	45				0		0															14.2475	0	5.648761976	1.711720264	1.612734191	2.34428387	0	1.10811902	2.278863531	3.24050817	22.93480934	0	0	2.053753083	6.958467703	14.52119349	0	3.792806727	0	0	0.858255065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.3118			14.2475	0	5.648761976	1.711720264	1.612734191	2.34428387	0	1.10811902	2.278863531	3.24050817	22.93480934	0	0	2.053753083	6.958467703	14.52119349	0	3.792806727	0	0	0.858255065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.3118		30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	$100 per trip	30% coins; $1000ded; 5000 max OOP		$50 ER; $35 UC	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP				30% coins; $1000ded; 5000 max OOP		30% coins; $1000ded; 5000 max OOP															11.0642	0	0.9192	0.1203	0.174	0.3605		0.1323	0.7971	0.5618	2.1004	0	0	0.7971	1.046	5.9472	0	0.2587	0	0	0.2639				0.1238		0.0054															24.6718	1000	13.08602097	25.3117	0	6.567976675	1.831999921	1.786694601	2.704824782	0	1.240442053	3.075986637	3.802259714	25.03525314	0	0	2.850876189	8.004487492	20.4683659	0	4.051489432	0	0	1.122114354	0	0	0	0.123768116	0	0.005376281	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.9836
H5512_002_0	2008	5																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	3500	1470.633812		903.4199334	576.8503575	190.2222051	11.52119099		272.2974599	268.7922463	1092.052443	4493.627423	0	0	692.115543	3283.008639	6954.02614	0	1278.177259	0	0	224.9584339				782.2278223		42.76187685															$175/day 1-8		"$0/day 1-5, $75 day 6-14; $100/day 15-100"	$35 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$100 per procedure	$25 per visit	"$25 X-ray; $175 CAT, PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit															133.32		73.75	35	100	0.2		48	100	25	52	25	25	25	10	25	25	25	25	25	45				0		0															16.3387	0	5.552268341	1.682480209	1.585185043	2.304238197	0	1.08918984	2.239935386	2.275109256	19.4723855	0	0	1.441907381	2.735840532	14.48755446	0	2.66286929	0	0	0.843594127	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7113			16.3387	0	5.552268341	1.682480209	1.585185043	2.304238197	0	1.08918984	2.239935386	2.275109256	19.4723855	0	0	1.441907381	2.735840532	14.48755446	0	2.66286929	0	0	0.843594127	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7113		30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	$100 per trip	30% coins; $500ded; 3500 max OOP		$50 ER; $35 UC	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP				30% coins; $500ded; 3500 max OOP		30% coins; $500ded; 3500 max OOP															8.3974	0	0.6977	0.0913	0.1299	0.2736		0.0958	0.605	0.4264	1.5942	0	0	0.605	0.7939	4.5137	0	0.1963	0	0	0.2003				0.0939		0.0041															18.7184	500	15.27432558	24.7361	0	6.249922826	1.773768612	1.715103778	2.577877191	0	1.185028649	2.844926267	2.701460667	21.066555	0	0	2.046898262	3.529736016	19.00126765	0	2.85920117	0	0	1.043854868	0	0	0	0.093936032	0	0.004080425	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.4297
H5512_008_0	2008	5																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	7500	1207.255813		579.2974152	1379.886443	197.9231015	12.49033113		322.4755611	273.6214791	1215.275418	3399.630335	0	0	686.7416378	2861.813688	6217.149587	0	1759.743344	0	0	229.0001302				558.4427083		58.50903894															900/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$250 per procedure	$35 per visit	"$35 X-ray; $150 PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$20 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															152.17		68.64	20	100	0.2		48	250	35	55.7	35	30	35	20	35	35	35	35	35	45				0		0															15.309	0	3.313581215	2.299810738	1.649359179	2.498066227	0	1.289902245	5.700447482	3.544553303	15.77995081	0	0	2.002996444	4.76968948	18.13335296	0	5.132584754	0	0	0.858750488	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.2821			15.309	0	3.313581215	2.299810738	1.649359179	2.498066227	0	1.289902245	5.700447482	3.544553303	15.77995081	0	0	2.002996444	4.76968948	18.13335296	0	5.132584754	0	0	0.858750488	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.2821		500 ded; 30 % coins; 7500 max OOP		500 ded; 30 % coins; 7500 max OOP	500 ded; 30 % coins; 7500 max OOP	100	500 ded; 30 % coins; 7500 max OOP		48	500 ded; 30 % coins; 7500 max OOP	500 ded; 30 % coins; 7500 max OOP	500 ded; 30 % coins; 7500 max OOP	500 ded; 30 % coins; 7500 max OOP	500 ded; 30 % coins; 7500 max OOP	500 ded; 30 % coins; 7500 max OOP	500 ded; 30 % coins; 7500 max OOP	500 ded; 30 % coins; 7500 max OOP	500 ded; 30 % coins; 7500 max OOP	500 ded; 30 % coins; 7500 max OOP	500 ded; 30 % coins; 7500 max OOP	500 ded; 30 % coins; 7500 max OOP	500 ded; 30 % coins; 7500 max OOP				500 ded; 30 % coins; 7500 max OOP		500 ded; 30 % coins; 7500 max OOP															15.1501		0.6244	0.3324	0.2011	0.3975		0.1625	1.1566	0.5944	1.7851	0	0	0.771	0.9331	4.7407	0	0.4356	0	0	0.2607				0.0875		0.0083															27.6409	500	9.229125484	30.4591	0	3.937990357	2.632170958	1.850493801	2.895536624	0	1.452382325	6.857011343	4.138947599	17.56500237	0	0	2.774039018	5.702808746	22.87400711	0	5.568184786	0	0	1.119463734	0	0	0	0.087471042	0	0.008326248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9229
H5512_009_0	2008	5																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	1220.089168		585.455455	1394.554894	200.0270611	12.62310569		325.9035366	276.5301266	1228.194023	3435.769041	0	0	694.0418298	2892.235302	6283.23905	0	1778.449745	0	0	231.4344444				564.3790587		59.13100096															350/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$250 per procedure	$35 per visit	"$35 X-ray; $150 PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$10 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															59.18		68.64	20	100	0.2		48	250	35	55.7	35	30	35	10	35	35	35	35	35	45				0		0															6.0171	0	3.348805203	2.324258157	1.666892176	2.524621138	0	1.303614147	5.761044304	3.582232567	15.94769463	0	0	2.02428867	2.410196085	18.3261139	0	5.187145089	0	0	0.867879167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2919			6.0171	0	3.348805203	2.324258157	1.666892176	2.524621138	0	1.303614147	5.761044304	3.582232567	15.94769463	0	0	2.02428867	2.410196085	18.3261139	0	5.187145089	0	0	0.867879167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2919		250 ded; 20 % coins; 5000 max OOP		250 ded; 20 % coins; 5000 max OOP	250 ded; 20 % coins; 5000 max OOP	100	250 ded; 20 % coins; 5000 max OOP		48	250 ded; 20 % coins; 5000 max OOP	250 ded; 20 % coins; 5000 max OOP	250 ded; 20 % coins; 5000 max OOP	250 ded; 20 % coins; 5000 max OOP	250 ded; 20 % coins; 5000 max OOP	250 ded; 20 % coins; 5000 max OOP	250 ded; 20 % coins; 5000 max OOP	250 ded; 20 % coins; 5000 max OOP	250 ded; 20 % coins; 5000 max OOP	250 ded; 20 % coins; 5000 max OOP	250 ded; 20 % coins; 5000 max OOP	250 ded; 20 % coins; 5000 max OOP	250 ded; 20 % coins; 5000 max OOP				250 ded; 20 % coins; 5000 max OOP		250 ded; 20 % coins; 5000 max OOP															10.0789		0.4154	0.2211	0.1852	0.2644		0.1479	0.7694	0.3954	1.1875	0	0	0.513	0.6208	3.1538	0	0.2898	0	0	0.1734				0.0582		0.0055															18.4798	250	6.115522229	16.096	0	3.764205561	2.545367273	1.852054418	2.78904607	0	1.451527584	6.530470965	3.977664963	17.13523499	0	0	2.537239778	3.030971872	21.47992651	0	5.476936505	0	0	1.041323737	0	0	0	0.058191816	0	0.005539199	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.7717
H5512_801_0	2008	1																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1111.629957		817.8131689	808.3897879	176.606144	8.832988804		190.7392571	249.55216	1223.141867	3718.11471	0	126.1613408	671.3545003	3054.621739	5411.582639	0	1180.531087	0	0	6.697382756				596.8983346		53.46182464															$200 per day; max $1400		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20 % per script				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	60.52	40	30	40	30	40	40	40	40	40	0.2				0		0															13.3924	0	6.815109741	2.694632626	2.2075768	2.649896641	0	0.794746905	4.159202667	4.077139557	18.75169186	0	0.315403352	2.237848334	7.636554347	18.0386088	0	3.935103623	0	0	1.339476551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.0454			13.3924	0	6.815109741	2.694632626	2.2075768	2.649896641	0	0.794746905	4.159202667	4.077139557	18.75169186	0	0.315403352	2.237848334	7.636554347	18.0386088	0	3.935103623	0	0	1.339476551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.0454		500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP		50	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP				500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP															15.7096		1.5703	0.3236	0.2108	0.3975		0.1358	1.4431	0.7853	3.3436	0	0.3789	1.2147	1.1971	6.7548	0	0.4065	0	0	0.3324				0.1202		0.009															34.3333	500		29.102	0	8.385428489	3.018213682	2.418418554	3.047370848	0	0.930595766	5.602334475	4.862403851	22.09533915	0	0.694256341	3.452526843	8.833649337	24.79339485	0	4.341645443	0	0	1.671892539	0	0	0	0.120243268	0	0.008954486	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.3786
H5512_802_0	2008	1																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1111.629957		817.8131689	808.3897879	176.606144	8.832988804		190.7392571	249.55216	1223.141867	3718.11471	0	126.1613408	671.3545003	3054.621739	5411.582639	0	1180.531087	0	0	6.697382756				596.8983346		53.46182464															$200 per day; max $1400		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20 % per script				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	60.52	40	30	40	30	40	40	40	40	40	0.2				0		0															13.3924	0	6.815109741	2.694632626	2.2075768	2.649896641	0	0.794746905	4.159202667	4.077139557	18.75169186	0	0.315403352	2.237848334	7.636554347	18.0386088	0	3.935103623	0	0	1.339476551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.0454			13.3924	0	6.815109741	2.694632626	2.2075768	2.649896641	0	0.794746905	4.159202667	4.077139557	18.75169186	0	0.315403352	2.237848334	7.636554347	18.0386088	0	3.935103623	0	0	1.339476551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.0454		500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP		50	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP				500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP															15.7096		1.5703	0.3236	0.2108	0.3975		0.1358	1.4431	0.7853	3.3436	0	0.3789	1.2147	1.1971	6.7548	0	0.4065	0	0	0.3324				0.1202		0.009															34.3333	500		29.102	0	8.385428489	3.018213682	2.418418554	3.047370848	0	0.930595766	5.602334475	4.862403851	22.09533915	0	0.694256341	3.452526843	8.833649337	24.79339485	0	4.341645443	0	0	1.671892539	0	0	0	0.120243268	0	0.008954486	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.3786
H5516_001_0	2008	7																					3950											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	6500	1703.071551	138.0777415	795.8311869		108.3615714	11.45481421	2.973039543	417.2162962	40.79634365	11789.46503	56.33630568		0.163113638	34.60450089	4489.641163	5490.370851	519.6178596	3.525824258			29.64864882	967.1061615			252.2382274		18.68473923															$325 (1a); $0 (1a1)	$325 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$15 (4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											198.21	198.21	97.5803		106.7285	0.182963086	0.277757136	30.4938	0.182963086	3.6593	0.099605317		0.182963086	0.182863197	15	24.9922	37.5	0.182963086			0.182963086	25			25		25															28.1305	2.280699215	6.471454679	0	0.963772034	2.095808164	0.825782948	1.060210851	7.464224952	3.595061517	5.611395581	0	0.029843775	6.327889668	5.612051453	11.43468703	1.623805811	0.645095689	0	0	5.424608299	2.014804503	0	0	0.525496307	0	0.03892654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.1761	0	44.90654587	28.1305	2.280699215	6.471454679	0	0.963772034	2.095808164	0.825782948	1.060210851	7.464224952	3.595061517	5.611395581	0	0.029843775	6.327889668	5.612051453	11.43468703	1.623805811	0.645095689	0	0	5.424608299	2.014804503	0	0	0.525496307	0	0.03892654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.1761		$375 (1a); $0 (1a1)	$375 (1b)	"$185 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$25 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$25/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											0.5298	0.043	0.5119	0.1821	0.0718	0.1562	0.0579	0.079	0.5561	0.8929	0.4264		0.0022	0.4715	0.7988	1.1963	0.1385	0.052			0.4376	0.2162			0.0554		0.0041															6.8796	0	2.295802899	28.6602	2.323649843	6.983343482	0.182108952	1.035580333	2.251961708	0.88370606	1.139204571	8.020366112	4.487925676	6.037788297	0	0.032067361	6.799387659	6.410824487	12.63097357	1.762324013	0.697135751	0	0	5.86221307	2.231025137	0	0	0.580871187	0	0.043028477	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.0557
H5517_001_0	2008	5																					1000											D	D	D	V	Coin	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	P	T	P	V	P	V	P	Coin	P	P																																																				0	2000	2169.215506	88.35801716	965.1913682		9.20686146	15.53963847	15.15679122	381.0367201	365.7889829	10.83757968	24.20672227	1.759502038		26.52885984	3974.008971	4188.226994	237.2020458	643.818972	5172.459446	6604.671406	16.48383347				139.248		240.783															1a:$50 1-5; 1a1:$50 1-5;	1b:$50 1-5;	"2a:$25 1-20, 100 21+; 2a2:$25 1-20, 100 21+;"		10a:10%;	11a:10%;	11b:10%; 11c:10%;	4a:$50; 4b:$50;	9b:$50;	8a:10%;	8b:10%;	9a:10%;		3:10%; 5:10%; 9a:10%; 9c:$30;	7a:$10; 14i:$10;	7b:$30; 7d:$30; 7f:$30; 7f1:$30; 18a:$30;	7e:$30; 7h:$30;	7c:$30; 7i:$30;	7g:$10-30;	7g:$10-30;	15:10%;				17a1:$30;		18a1:$30;															24.7432	23.89	29.259		0.043006793	0.071677988	0.071677988	35.839	35.839	0.071677988	0.071677988	0.071677988		0.071677988	7.1678	23.4615	29.9338	20.737	12.9541	5.8691	0.071677988				30		30															4.4728	0.175906086	2.35337422	0	0.395957585	1.113850025	1.086408304	1.137997732	1.092459102	0.776815909	1.735089155	0.126117566	0	1.901535305	2.373741404	8.188511394	0.591696399	1.112570253	5.583692649	3.230271666	1.181528023	0	0	0	0.34812	0	0.6019575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5804	0	14.02361314	4.4728	0.175906086	2.35337422	0	0.395957585	1.113850025	1.086408304	1.137997732	1.092459102	0.776815909	1.735089155	0.126117566	0	1.901535305	2.373741404	8.188511394	0.591696399	1.112570253	5.583692649	3.230271666	1.181528023	0	0	0	0.34812	0	0.6019575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5804		0.3	0.3	0.3	0.3	0.1	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3				30	0.3	30	0.3														1.1723	0.0219	0.1246	0.0784	0.0367	0.0622	0.0607	0.0221	0.1789	0.04	0.0939	0.0065	0.0013	0.0993	0.1468	0.4113	0.0065	0.0329	0.113	0.05	0.066				0.0044	0.0089	0.0076	0.0051														2.8514	0	4.825079237	5.6451	0.197837135	2.477944376	0.078443726	0.43269662	1.176071982	1.14709731	1.160052141	1.271403318	0.816782064	1.829030722	0.132650872	0.001331944	2.000801263	2.520553238	8.599764293	0.598200803	1.145457743	5.696648015	3.280252105	1.247530612	0	0	0	0.352534018	0.008938386	0.609590072	0.005057729	0	0	0	0	0	0	0	0	0	0	0	0	0	42.4318
H5517_002_0	2008	5																					1500											D	D	D	V	Coin	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	P	T	P	V	P	V	P	Coin	P	P											0.7692	0.0263	0.4047		0.0681	0.1916	0.1868	0.1957	0.1879	0.1336	0.2984	0.0217		0.327	0.4082	1.3553	0.0884	0.1913	0.9602	0.5555	0.2032				0.054		0.0935															6.7206	2500	2087.551387	85.03161662	928.8661787		8.860744203	14.95545058	14.58699585	366.6918899	352.0181819	10.43015817	23.29670919	1.693356368		25.53154971	3824.400073	4035.322453	228.2721372	619.5812193	4977.73267	6356.026368	15.86415007				139.248		240.783															1a:$50 1-5; 1a1:$50 1-5;	1b:$50 1-5;	"2a:$25 1-20, 100 21+; 2a2:$25 1-20, 100 21+;"		10a:10%;	11a:10%;	11b:10%; 11c:10%;	4a:$50; 4b:$50;	9b:$50;	8a:10%;	8b:10%;	9a:10%;		3:10%; 5:10%; 9a:10%; 9c:$30;	7a:$10; 14i:$10;	7b:$30; 7d:$30; 7f:$30; 7f1:$30; 18a:$30;	7e:$30; 7h:$30;	7c:$30; 7i:$30;	7g:$10-30;	7g:$10-30;	15:10%;				17a1:$30;		18a1:$30;															28.478	23.89	33.6753		0.049498306	0.082497176	0.082497176	41.2486	41.2486	0.082497176	0.082497176	0.082497176		0.082497176	8.2497	25.9578	29.9338	23.867	14.9094	6.755	0.082497176				30		30															4.9541	0.169283777	2.606657605	0	0.438591826	1.233782444	1.20338597	1.26046023	1.210021085	0.860458598	1.921912727	0.139697119	0	2.10628076	2.629185062	8.729016372	0.569420897	1.232296442	6.184566387	3.577888473	1.308747587	0	0	0	0.34812	0	0.6019575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2858	100	8.349101711	5.7233	0.195566797	3.011367596	0	0.506687649	1.425339663	1.390223828	1.456159445	1.397889113	0.99405351	2.220309141	0.161386511	0	2.433302178	3.037392668	10.08428456	0.657829257	1.423622945	7.14478295	4.133391892	1.511943903	0	0	0	0.402169155	0	0.695417498	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.0064		0.3	0.3	0.3	0.3	0.1	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3				30	0.3	30	0.3														1.3977	0.0261	0.1485	0.0935	0.0438	0.0742	0.0724	0.0263	0.2134	0.0477	0.112	0.0078	0.0016	0.1184	0.1752	0.4904	0.0078	0.0392	0.1347	0.0596	0.0787				0.0055	0.0111	0.0095	0.0063														3.4011	150	3.990042529	7.121	0.221714849	3.159892385	0.093527245	0.550491034	1.499525943	1.462582394	1.482493397	1.611241542	1.041704539	2.332314223	0.169176071	0.001588056	2.551655449	3.212612531	10.57466951	0.665584358	1.462834192	7.279457891	4.192982799	1.590637772	0	0	0	0.407637494	0.011073386	0.704873167	0.006265805	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4076
H5517_003_0	2008	6																					3000											Coin	Coin	D	V	Coin	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	P	T	P	V	P	V	P	Coin	P	P											4.5708	0.1038	0.5096		0.0857	0.2412	0.2352	0.2464	0.4731	0.1682	0.3757	0.0273		0.4117	0.771	1.7102	0.1115	0.2431	1.216	0.715	0.2558				0.0724		0.1252															12.6689	4000	266.7311659	4.989347758	874.1809897		8.337886672	14.07295473	13.7262419	345.096665	331.2871213	9.814692177	21.92200978	1.593434273		24.02497614	3599.17344	3805.13444	214.8287307	583.0928318	4684.583954	5981.707157	14.9280334				139.248		240.783															1a:10%; 1a1:10%;	1b:10%;	"2a:$25 1-20, 100 21+; 2a2:$25 1-20, 100 21+;"		10a:10%;	11a:10%;	11b:10%; 11c:10%;	4a:$50; 4b:$50;	9b:$100;	8a:10%;	8b:10%;	9a:10%;		3:10%; 5:10%; 9a:10%; 9c:$30;	7a:$15; 14i:$15;	7b:$30; 7d:$30; 7f:$30; 7f1:$30; 18a:$30;	7e:$30; 7h:$30;	7c:$30; 7i:$30;	7g:$15-30;	7g:$15-30;	15:10%;				17a1:$30;		18a1:$30;															0.082396168	0.1	33.6341		0.049437701	0.082396168	0.082396168	41.1981	82.3962	0.082396168	0.082396168	0.082396168		0.082396168	12.3594	25.9321	29.9503	24.0581	14.9776	6.8963	0.082396168				30		30															21.9776	0.498934776	2.450192039	0	0.412205944	1.159557536	1.130989727	1.184776777	2.27473243	0.808693021	1.806289591	0.131292877	0	1.97956596	3.706976224	8.222931938	0.53618287	1.16900689	5.846973074	3.437633474	1.230012742	0	0	0	0.34812	0	0.6019575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.9147	200	12.13972511	26.5485	0.602701925	2.959776568	0	0.497935458	1.400719279	1.366210012	1.431183551	2.74782533	0.97688288	2.181956975	0.158598826	0	2.391270909	4.47794344	9.933115808	0.647696781	1.412133884	7.063011237	4.15258349	1.485827574	0	0	0	0.420521087	0	0.727151046	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.5835		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3				30	0.3	30	0.3														1.7935	0.0336	0.1906	0.12	0.0562	0.0952	0.0928	0.0339	0.2738	0.0611	0.1437	0.01	0.002	0.1519	0.2252	0.6294	0.01	0.0503	0.1728	0.0765	0.101				0.0075	0.0151	0.0129	0.0085														4.3674	300	2.592857074	28.342	0.636254071	3.150361373	0.120010463	0.55414223	1.49591218	1.459057663	1.465064444	3.021590732	1.038026797	2.325677467	0.168594082	0.002037731	2.543137147	4.703160442	10.5624856	0.65764782	1.462448206	7.235820796	4.229048186	1.586804436	0	0	0	0.427977854	0.015099954	0.74004504	0.008544213	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9509
H5517_004_0	2008	7																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	V	Coin	Coin	Coin	Coin																																																				0	0	330.5880564	27.65171921	42.11666177		20.67278282	30.65593833	28.83929741	43.71690466	34.71389647	9.588481624	22.89705194	1.679858696	4.180093348	34.72239108	39.16250024	85.22179952	10.74462853	9.583405485	21.08780971	10.66757369	6.67687433																					Medicare FFS	Medicare FFS	Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																					0.0837	0.0837	0.2133		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					27.6702	2.314448898	8.983483955	0	4.837431179	7.17348957	6.748395594	10.22975569	8.123051774	2.2437047	5.357910154	0.393086935	0.978141844	8.125039513	9.164025056	19.94190109	2.514243075	2.242516884	4.934547473	2.496212244	1.562388593	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.034	0	0	27.6702	2.314448898	8.983483955	0	4.837431179	7.17348957	6.748395594	10.22975569	8.123051774	2.2437047	5.357910154	0.393086935	0.978141844	8.125039513	9.164025056	19.94190109	2.514243075	2.242516884	4.934547473	2.496212244	1.562388593	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.034		Medicare FFS	Medicare FFS	Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																					0.9316	0.0779	0.3025		0.165	0.2448	0.2303	0.3439	0.2719	0.0756	0.1807	0.0134	0.0331	0.2732	0.3127	0.6805	0.0854	0.0758	0.1684	0.0852	0.0533																					4.6053	0		28.6018	2.39237074	9.285937164	0	5.002431366	7.418293247	6.978692445	10.57366759	8.394972481	2.319291194	5.538585917	0.406508751	1.011263141	8.398226098	9.476758073	20.62244166	2.599687061	2.318278223	5.102944646	2.581398391	1.615706922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.6393
H5517_802_0	2008	3																																COIN	COIN	COIN	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		292.8775646	1.746626319	52.98474778	0	6.287394656	12.39928659	12.96189142	11.50365524	35.79845921	1.404575025	55.94253202	4.328024717	0.593348245	14.53386073	47.99356265	218.1928007	1.157031379	8.844614895	25.99586084	10.79104062	59.21697088	0	0	0	0	0	0	0	0	0	0											Medicare FFS 7.9%	Medicare FFS 7.9%	Medicare FFS 19.6%		Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%																				0.080950163	0.080950163	0.200341176	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											23.7085	0.141389686	10.6150267	0	1.471250349	2.901433063	3.033082593	2.691855327	8.376839456	0.328670556	13.09055249	1.012757784	0.138843489	3.40092341	11.23049366	51.05711537	0.270745343	2.069639886	6.083031436	2.525103506	13.85677119	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	158.004	0	0	23.7085	0.141389686	10.6150267	0	1.471250349	2.901433063	3.033082593	2.691855327	8.376839456	0.328670556	13.09055249	1.012757784	0.138843489	3.40092341	11.23049366	51.05711537	0.270745343	2.069639886	6.083031436	2.525103506	13.85677119	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	158.004		Medicare FFS 7.9%		Medicare FFS 19.6%		Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%																				1.1919	0	0.4375	0	1.5365	0.0731	0.0889	0.071	0.0753	0.0551	0.1357	0.001	0.0143	0.0485	0.1698	1.793	0	0.1573	0.0851	0.102	0.2167	0	0	0	0	0	0	0	0	0	0											6.2528	0	0	24.9004	0.141389686	11.05250906	0	3.007746544	2.974537054	3.122032237	2.762819	8.45218185	0.383734657	13.2262533	1.013802762	0.153178389	3.449468075	11.40031864	52.85008101	0.270745343	2.226951129	6.168119369	2.627106846	14.07344766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.2569
H5517_804_0	2008	3																																COIN	COIN	COIN	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		292.8775646	1.746626319	52.98474778	0	6.287394656	12.39928659	12.96189142	11.50365524	35.79845921	1.404575025	55.94253202	4.328024717	0.593348245	14.53386073	47.99356265	218.1928007	1.157031379	8.844614895	25.99586084	10.79104062	59.21697088	0	0	0	0	0	0	0	0	0	0											Medicare FFS 7.7%	Medicare FFS 7.7%	Medicare FFS 18.7%		Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%																				0.080950163	0.080950163	0.200341176	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											23.7085	0.141389686	10.6150267	0	1.471250349	2.901433063	3.033082593	2.691855327	8.376839456	0.328670556	13.09055249	1.012757784	0.138843489	3.40092341	11.23049366	51.05711537	0.270745343	2.069639886	6.083031436	2.525103506	13.85677119	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	158.004	0	0	23.7085	0.141389686	10.6150267	0	1.471250349	2.901433063	3.033082593	2.691855327	8.376839456	0.328670556	13.09055249	1.012757784	0.138843489	3.40092341	11.23049366	51.05711537	0.270745343	2.069639886	6.083031436	2.525103506	13.85677119	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	158.004		Medicare FFS 7.7%		Medicare FFS 18.7%		Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%																				1.1919	0	0.4375	0	1.5365	0.0731	0.0889	0.071	0.0753	0.0551	0.1357	0.001	0.0143	0.0485	0.1698	1.793	0	0.1573	0.0851	0.102	0.2167	0	0	0	0	0	0	0	0	0	0											6.2528	0	0	24.9004	0.141389686	11.05250906	0	3.007746544	2.974537054	3.122032237	2.762819	8.45218185	0.383734657	13.2262533	1.013802762	0.153178389	3.449468075	11.40031864	52.85008101	0.270745343	2.226951129	6.168119369	2.627106846	14.07344766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.2569
H5517_805_0	2008	3																																COIN	COIN	COIN	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		292.8775646	1.746626319	52.98474778	0	6.287394656	12.39928659	12.96189142	11.50365524	35.79845921	1.404575025	55.94253202	4.328024717	0.593348245	14.53386073	47.99356265	218.1928007	1.157031379	8.844614895	25.99586084	10.79104062	59.21697088	0	0	0	0	0	0	0	0	0	0											Medicare FFS 7.9%	Medicare FFS 7.9%	Medicare FFS 19.6%		Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%																				0.080950163	0.080950163	0.200341176	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											23.7085	0.141389686	10.6150267	0	1.471250349	2.901433063	3.033082593	2.691855327	8.376839456	0.328670556	13.09055249	1.012757784	0.138843489	3.40092341	11.23049366	51.05711537	0.270745343	2.069639886	6.083031436	2.525103506	13.85677119	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	158.004	0	0	23.7085	0.141389686	10.6150267	0	1.471250349	2.901433063	3.033082593	2.691855327	8.376839456	0.328670556	13.09055249	1.012757784	0.138843489	3.40092341	11.23049366	51.05711537	0.270745343	2.069639886	6.083031436	2.525103506	13.85677119	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	158.004		Medicare FFS 7.9%		Medicare FFS 19.6%		Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%	Medicare FFS 23.4%																				1.1919	0	0.4375	0	1.5365	0.0731	0.0889	0.071	0.0753	0.0551	0.1357	0.001	0.0143	0.0485	0.1698	1.793	0	0.1573	0.0851	0.102	0.2167	0	0	0	0	0	0	0	0	0	0											6.2528	0	0	24.9004	0.141389686	11.05250906	0	3.007746544	2.974537054	3.122032237	2.762819	8.45218185	0.383734657	13.2262533	1.013802762	0.153178389	3.449468075	11.40031864	52.85008101	0.270745343	2.226951129	6.168119369	2.627106846	14.07344766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.2569
H5520_001_0	2008	4																					1500											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	655.6861244	4.343697587	318.6677231	5.772374021	143.370674	12.68819027	0.943106928	283.7133525	384.07397	8.078469639	22.66543541	0	0.11953303	98.76085464	3768.517567	3570.391039	140.316933	154.474047	21.29621234	24.03478067	15.81373612	251.9376041	0	557.6	137.5909473	0	0	0	0	850	590.75											Per Day: $100 (1-4)	Per Day: $100 (1-4)	Per Day: $100 (1-4)	$0 Per Visit	$25 per Ambulance Service	$20 - $600 Copay (estimated to equivalent coin.)	$20 - $600 Copay (estimated to equivalent coin.)	$50 ER/ $25 UC	$200 ASC / $200 OP	$0 Diagnostic Lab	$10 Simple X-Ray/$20 - $600 per Visit for Complex Rad.		$20 - $600 Copay (estimated to equivalent coin.)	$25 OP SA / $25 Cardiac Rehab	$10 PCP	$10 SCP / $15 Chiro / $25 Podiatrist	$25 MH	$25 Therapy	0% Coin	$10 Hearing / $10 Preventive	$20 - $600 Copay (estimated to equivalent coin.)	$10 Vision		"$35 Ded, 0% Coin"	$10 Routine Vision / Eyewear $100 Max in 2 yrs					$0 Per Visit	$15 Accup / $25 Message Thera											79.28921853	79.28921853	79.28921853	0	25	0.123681074	0.15	32.39340067	158.5784371	1.72E-18	0.099182703	0	0.118933828	19.82230463	7.928921853	10.43343524	8.367578514	19.82230463	0	0.00139383	0.118933828	9.223728108	0	35	7.928921853	0	0	0	0	0	17											4.3324	0.028700699	2.105576228	0	0.298688904	1.569289004	0.141466039	0.765870025	5.075487491	1.39E-17	2.248019143	0	0.014216521	0.163138979	2.490023441	3.104286975	0.097842746	0.255169301	0	0.033500391	1.880788169	0.19365033	0	1.626333333	0.090912322	0	0	0	0	0	0.836895833	0	0	0	0	0	0	0	0	0	0	27.3523	0	8.3335	4.3324	0.028700699	2.105576228	0	0.298688904	1.569289004	0.141466039	0.765870025	5.075487491	1.39E-17	2.248019143	0	0.014216521	0.163138979	2.490023441	3.104286975	0.097842746	0.255169301	0	0.033500391	1.880788169	0.19365033	0	1.626333333	0.090912322	0	0	0	0	0	0.836895833	0	0	0	0	0	0	0	0	0	0	27.3523	4500	Per Day: $200 (1-4)	Per Day: $200 (1-4)	Per Day: $200 (1-4)	$0 Per Visit	$25 per Ambulance Service	$30 - $900 Copay (estimated to equivalent coin.)	$30 - $900 Copay (estimated to equivalent coin.)	$50 ER/ $25 UC	$400 ASC / $400 OP	$20 Diagnostic Lab	$20 Simple X-Ray/$30 - $900 per Visit for Complex Rad.		$30 - $900 Copay (estimated to equivalent coin.)	$50 OP SA / $35 Cardiac Rehab	$20 PCP	$20 SCP / $50 Chiro / $35 Podiatrist	$50 MH	$35 Therapy	0% Coin	$20 Hearing / $20 Preventive	$30 - $900 Copay (estimated to equivalent coin.)	$20 Vision		"$35 Ded, 20% Coin"	$10 Routine Vision / Eyewear $100 Max in 2 yrs					$0 Per Visit	$15 Accup / $25 Message Thera											2.4504	0.0162	1.2253	0	0.058	0.4133	0.0372	0.1563	1.7691	0.3251	0.6236	0	0.0043	0.0398	0.8588	0.9886	0.0197	0.0705	0	0.0101	0.4955	0.0608	0	0.287	0.0167	0	0	0	0	0	0.1477											10.0742	0	2.358	6.7828	0.044933882	3.330918972	0	0.356731881	1.982621163	0.178629268	0.922142045	6.844609142	0.325073556	2.871630611	0	0.018507601	0.202943804	3.348842801	4.092905988	0.117531157	0.325689498	0	0.0435551	2.376336108	0.254487274	0	1.913333333	0.107585411	0	0	0	0	0	0.984583333	0	0	0	0	0	0	0	0	0	0	37.4264
H5520_002_0	2008	5																					1950											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	655.6861244	4.343697587	318.6677231	5.772374021	143.370674	12.68819027	0.943106928	283.7133525	384.07397	8.078469639	22.66543541	0	0.11953303	98.76085464	3768.517567	3570.391039	140.316933	154.474047	21.29621234	24.03478067	15.81373612	251.9376041	0	557.6	137.5909473	0	0	0	0	850	590.75											Per Day: $100 (1-4)	Per Day: $100 (1-4)	Per Day: $100 (1-4)	$0 Per Visit	$50 per Ambulance Service	$20 - $600 Copay (estimated to equivalent coin.)	$20 - $600 Copay (estimated to equivalent coin.)	$50 ER/ $25 UC	$200 ASC / $200 OP	$0 Diagnostic Lab	$10 Simple X-Ray/$20 - $600 per Visit for Complex Rad.		$20 - $600 Copay (estimated to equivalent coin.)	$25 OP SA / $25 Cardiac Rehab	$10 PCP	$10 SCP / $15 Chiro / $25 Podiatrist	$25 MH	$25 Therapy	0% Coin	$10 Hearing / $10 Preventive	$20 - $600 Copay (estimated to equivalent coin.)	$10 Vision		"$35 Ded, 0% Coin"	$10 Routine Vision / Eyewear $100 Max in 2 yrs					$0 Per Visit	$15 Accup / $25 Message Thera											85.18133275	85.18133275	85.18133275	0	50	0.123681074	0.15	34.79129277	170.3626655	1.72E-18	0.106553135	0	0.127771999	21.29533319	8.518133275	11.20876124	8.989387245	21.29533319	0	0.001497407	0.127771999	9.909158744	0	35	8.518133275	0	0	0	0	0	17											4.6544	0.030833496	2.262045113	0	0.597377808	1.569289004	0.141466039	0.822562859	5.45265544	1.39E-17	2.415073199	0	0.015272974	0.175262109	2.67506124	3.334971723	0.105113604	0.274131358	0	0.035989861	2.020552678	0.208040809	0	1.626333333	0.097668169	0	0	0	0	0	0.836895833	0	0	0	0	0	0	0	0	0	0	29.3509	0	6.6335	4.6544	0.030833496	2.262045113	0	0.597377808	1.569289004	0.141466039	0.822562859	5.45265544	1.39E-17	2.415073199	0	0.015272974	0.175262109	2.67506124	3.334971723	0.105113604	0.274131358	0	0.035989861	2.020552678	0.208040809	0	1.626333333	0.097668169	0	0	0	0	0	0.836895833	0	0	0	0	0	0	0	0	0	0	29.3509	4950	Per Day: $200 (1-4)	Per Day: $200 (1-4)	Per Day: $200 (1-4)	$0 Per Visit	$50 per Ambulance Service	$30 - $900 Copay (estimated to equivalent coin.)	$30 - $900 Copay (estimated to equivalent coin.)	$50 ER/ $25 UC	$400 ASC / $400 OP	$20 Diagnostic Lab	$20 Simple X-Ray/$30 - $900 per Visit for Complex Rad.		$30 - $900 Copay (estimated to equivalent coin.)	$50 OP SA / $35 Cardiac Rehab	$20 PCP	$20 SCP / $50 Chiro / $35 Podiatrist	$50 MH	$35 Therapy	0% Coin	$20 Hearing / $20 Preventive	$30 - $900 Copay (estimated to equivalent coin.)	$20 Vision		"$35 Ded, 20% Coin"	$10 Routine Vision / Eyewear $100 Max in 2 yrs					$0 Per Visit	$15 Accup / $25 Message Thera											2.4504	0.0162	1.2253	0	0.1161	0.4133	0.0372	0.1563	1.7691	0.3251	0.6236	0	0.0043	0.0398	0.8588	0.9886	0.0197	0.0705	0	0.0101	0.4955	0.0608	0	0.287	0.0167	0	0	0	0	0	0.1477											10.1322	0	2.358	7.1048	0.047066679	3.487387857	0	0.713463762	1.982621163	0.178629268	0.978834879	7.221777092	0.325073556	3.038684667	0	0.019564054	0.215066933	3.5338806	4.323590736	0.124802015	0.344651555	0	0.04604457	2.516100617	0.268877753	0	1.913333333	0.114341258	0	0	0	0	0	0.984583333	0	0	0	0	0	0	0	0	0	0	39.4831
H5520_003_0	2008	4																					1750											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3250	949.5054794	6.743490135	592.3063677	6.509414078	161.6768214	14.30826971	1.063526634	319.1368806	433.1140877	9.10996131	25.55944986	0	0.134795491	111.3710399	4121.439787	3937.412659	158.2331665	174.197918	23.66672434	26.87375812	17.8328979	275.6020734	0	557.6	155.1591158	0	0	0	0	850	590.75											Per Day: $100 (1-7)	Per Day: $100 (1-7)	Per Day: $100 (1-7)	$0 Per Visit	$25 per Ambulance Service	$20 - $600 Copay (estimated to equivalent coin.)	$20 - $600 Copay (estimated to equivalent coin.)	$50 ER/ $25 UC	$200 ASC / $200 OP	$0 Diagnostic Lab	$15 Simple X-Ray/$20 - $600 per Visit for Complex Rad.		$20 - $600 Copay (estimated to equivalent coin.)	$25 OP SA / $25 Cardiac Rehab	$15 PCP	$15 SCP / $15 Chiro / $25 Podiatrist	$25 MH	$25 Therapy	0% Coin	$15 Hearing / $15 Preventive	$20 - $600 Copay (estimated to equivalent coin.)	$15 Vision		"$35 Ded, 0% Coin"	$10 Routine Vision / Eyewear $100 Max in 2 yrs					$0 Per Visit	$15 Accup / $25 Message Thera											75.97323632	75.97323632	75.97323632	0	25	0.124018611	0.15	30.99626204	151.9464726	-3.05E-18	0.102812175	0	0.113959854	18.99330908	11.39598545	13.02971233	8.017635079	18.99330908	0	0.001770181	0.113959854	12.50980277	0	35	7.597323632	0	0	0	0	0	17											6.0114	0.042693731	3.749952637	0	0.336826711	1.774491742	0.159528995	0.824337531	5.484179823	-2.78E-17	2.627822644	0	0.015361275	0.176275382	3.913988986	4.275279523	0.105721316	0.275716241	0	0.047571426	2.032234449	0.287310632	0	1.626333333	0.098232835	0	0	0	0	0	0.836895833	0	0	0	0	0	0	0	0	0	0	34.7022	0	13.3475	6.0114	0.042693731	3.749952637	0	0.336826711	1.774491742	0.159528995	0.824337531	5.484179823	-2.78E-17	2.627822644	0	0.015361275	0.176275382	3.913988986	4.275279523	0.105721316	0.275716241	0	0.047571426	2.032234449	0.287310632	0	1.626333333	0.098232835	0	0	0	0	0	0.836895833	0	0	0	0	0	0	0	0	0	0	34.7022	5000	Per Day: $200 (1-7)	Per Day: $200 (1-7)	Per Day: $200 (1-7)	$0 Per Visit	$25 per Ambulance Service	$30 - $900 Copay (estimated to equivalent coin.)	$30 - $900 Copay (estimated to equivalent coin.)	$50 ER/ $25 UC	$400 ASC / $400 OP	$25 Diagnostic Lab	$25 Simple X-Ray/$30 - $900 per Visit for Complex Rad.		$30 - $900 Copay (estimated to equivalent coin.)	$50 OP SA / $35 Cardiac Rehab	$25 PCP	$25 SCP / $50 Chiro / $35 Podiatrist	$50 MH	$35 Therapy	0% Coin	$25 Hearing / $25 Preventive	$30 - $900 Copay (estimated to equivalent coin.)	$25 Vision		"$35 Ded, 20% Coin"	$10 Routine Vision / Eyewear $100 Max in 2 yrs					$0 Per Visit	$15 Accup / $25 Message Thera											3.3669	0.0239	2.161	0	0.0655	0.467	0.0419	0.1667	1.8929	0.4348	0.7016	0	0.0046	0.0426	1.1243	1.2128	0.0211	0.0755	0	0.0127	0.5302	0.0781	0	0.287	0.0178	0	0	0	0	0	0.1477											12.8766	0	3.87	9.3784	0.066606068	5.910974166	0	0.40228085	2.241538334	0.201437375	0.990987743	7.377126232	0.434782721	3.329389173	0	0.019952697	0.218866235	5.038281878	5.488103426	0.126787762	0.351172304	0	0.060229234	2.562466891	0.365442712	0	1.913333333	0.11607291	0	0	0	0	0	0.984583333	0	0	0	0	0	0	0	0	0	0	47.5788
H5520_004_0	2008	5																					2000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3500	949.5054794	6.743490135	592.3063677	6.509414078	161.6768214	14.30826971	1.063526634	319.1368806	433.1140877	9.10996131	25.55944986	0	0.134795491	111.3710399	4121.439787	3937.412659	158.2331665	174.197918	23.66672434	26.87375812	17.8328979	275.6020734	0	557.6	155.1591158	0	0	0	0	850	590.75											Per Day: $100 (1-7)	Per Day: $100 (1-7)	Per Day: $100 (1-7)	$0 Per Visit	$50 per Ambulance Service	$20 - $600 Copay (estimated to equivalent coin.)	$20 - $600 Copay (estimated to equivalent coin.)	$50 ER/ $25 UC	$200 ASC / $200 OP	$0 Diagnostic Lab	$15 Simple X-Ray/$20 - $600 per Visit for Complex Rad.		$20 - $600 Copay (estimated to equivalent coin.)	$25 OP SA / $25 Cardiac Rehab	$15 PCP	$15 SCP / $15 Chiro / $25 Podiatrist	$25 MH	$25 Therapy	0% Coin	$15 Hearing / $15 Preventive	$20 - $600 Copay (estimated to equivalent coin.)	$15 Vision		"$35 Ded, 0% Coin"	$10 Routine Vision / Eyewear $100 Max in 2 yrs					$0 Per Visit	$15 Accup / $25 Message Thera											79.33482837	79.33482837	79.33482837	0	50	0.124018611	0.15	32.36775538	158.6696567	-3.05E-18	0.107361312	0	0.119002243	19.83370709	11.90022426	13.60623875	8.372391828	19.83370709	0	0.001848507	0.119002243	13.06332472	0	35	7.933482837	0	0	0	0	0	17											6.2774	0.044582803	3.915877002	0	0.673653422	1.774491742	0.159528995	0.86081204	5.726838635	-2.78E-17	2.74409606	0	0.016040966	0.184075049	4.087171477	4.464448056	0.110399172	0.287915873	0	0.049676321	2.122154841	0.300023281	0	1.626333333	0.102579349	0	0	0	0	0	0.836895833	0	0	0	0	0	0	0	0	0	0	36.365	0	11.7365	6.2774	0.044582803	3.915877002	0	0.673653422	1.774491742	0.159528995	0.86081204	5.726838635	-2.78E-17	2.74409606	0	0.016040966	0.184075049	4.087171477	4.464448056	0.110399172	0.287915873	0	0.049676321	2.122154841	0.300023281	0	1.626333333	0.102579349	0	0	0	0	0	0.836895833	0	0	0	0	0	0	0	0	0	0	36.365	5500	Per Day: $200 (1-7)	Per Day: $200 (1-7)	Per Day: $200 (1-7)	$0 Per Visit	$50 per Ambulance Service	$30 - $900 Copay (estimated to equivalent coin.)	$30 - $900 Copay (estimated to equivalent coin.)	$50 ER/ $25 UC	$400 ASC / $400 OP	$25 Diagnostic Lab	$25 Simple X-Ray/$30 - $900 per Visit for Complex Rad.		$30 - $900 Copay (estimated to equivalent coin.)	$50 OP SA / $35 Cardiac Rehab	$25 PCP	$25 SCP / $50 Chiro / $35 Podiatrist	$50 MH	$35 Therapy	0% Coin	$25 Hearing / $25 Preventive	$30 - $900 Copay (estimated to equivalent coin.)	$25 Vision		"$35 Ded, 20% Coin"	$10 Routine Vision / Eyewear $100 Max in 2 yrs					$0 Per Visit	$15 Accup / $25 Message Thera											3.4478	0.0245	2.2129	0	0.1309	0.467	0.0419	0.1707	1.9384	0.4452	0.7184	0	0.0047	0.0436	1.1513	1.242	0.0216	0.0773	0	0.013	0.543	0.08	0	0.287	0.0183	0	0	0	0	0	0.1477											13.227	0	3.585	9.7252	0.069069398	6.128795829	0	0.8045617	2.241538334	0.201437375	1.031464385	7.665244474	0.445224102	3.462510828	0	0.020742652	0.227688728	5.238464452	5.70639813	0.131971534	0.365184026	0	0.062638109	2.665120904	0.380031717	0	1.913333333	0.120847856	0	0	0	0	0	0.984583333	0	0	0	0	0	0	0	0	0	0	49.592
H5520_005_0	2008	7																					3200											D	D	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	coin	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	6200	918.7429838	6.795512071	697.4349324	5.772374021	143.370674	12.68819027	0.943106928	270.503203	36.77424534	8.078469639	22.66543541	0	0.11953303	98.76085464	3768.517567	3570.492231	140.316933	2.695901024	21.29621234	24.03478067	15.81373612	251.9376041	0	0	137.5909473	0	0	0	0	850	590.75											Per Day: $200 (1-10)	Per Day: $200 (1-10)	Per Day: $100 (1-10)	$0 Per Visit	$150 per Ambulance Service	30% of Contract Rate	30% of Contract Rate	$50 ER/ $50 UC	30% Contracted Rate	$0 Diagnostic Lab	$10 Simple X-Ray/$20 - $600 per Visit for Complex Rad.		$20 - $600 Copay (estimated to equivalent coin.)	"$40 OP SA / $25 Cardiac Rehab/ 30% OP, PT, SLT"	$10 PCP	$10 SCP / $10 Chiro / $25 Podiatrist	$40 MH	30% of Contract Rate	0% Coin	$10 Hearing / $10 Preventive	$20 - $600 Copay (estimated to equivalent coin.)	$10 Vision			$10 Routine Vision / Eyewear Not Covered					$0 Per Visit	$15 Accup / $25 Message Thera											172.9763281	172.9763281	86.48816406	-4.81E-18	150	0.3	0.3	43.24408203	0.259464492	-5.15E-18	0.117041694	0	0.129732246	79.52674467	8.648816406	11.37692825	9.127300239	0.259464492	0	0.00152038	0.129732246	10.06118265	0	0	8.648816406	0	0	0	0	0	17											13.2434	0.097955227	5.026655571	-2.78E-17	1.792133425	3.806457081	0.282932078	0.974805225	9.541610891	-4.16E-17	2.652800962	0	0.015507288	0.654510773	2.71610138	3.385102829	0.106726231	0.69949059	0	0.036542008	2.051551506	0.211232521	0	0	0.09916657	0	0	0	0	0	0.836895833	0	0	0	0	0	0	0	0	0	0	48.2316	0	9.3145	13.2434	0.097955227	5.026655571	-2.78E-17	1.792133425	3.806457081	0.282932078	0.974805225	9.541610891	-4.16E-17	2.652800962	0	0.015507288	0.654510773	2.71610138	3.385102829	0.106726231	0.69949059	0	0.036542008	2.051551506	0.211232521	0	0	0.09916657	0	0	0	0	0	0.836895833	0	0	0	0	0	0	0	0	0	0	48.2316	9400	Per Day: $400 (1-10)	Per Day: $400 (1-10)	Per Day: $200 (1-10)	40% Coin	$150 per Ambulance Service	30% of Contract Rate	30% of Contract Rate	$50 ER/ $50 UC	40% Contracted Rate	$30 Diagnostic Lab	$30 Simple X-Ray/$30 - $900 per Visit for Complex Rad.		$30 - $900 Copay (estimated to equivalent coin.)	"$40 OP SA / $35 Cardiac Rehab/ 40% OP, PT, SLT"	$30 PCP	$30 SCP / $50 Chiro / $35 Podiatrist	$40 MH	40% Contracted Rate	0% Coin	$30 Hearing / $30 Preventive	$30 - $900 Copay (estimated to equivalent coin.)	$30 Vision			$30 Routine Vision / Eyewear Not Covered					$0 Per Visit	$15 Accup / $25 Message Thera											7.4864	0.0554	2.9244	0.3862	0.3483	0.6666	0.0496	0.1698	2.234	0.5317	0.7499	0	0.0047	0.1534	1.375	1.4082	0.0215	0.1839	0	0.015	0.5404	0.0942	0	0	0.05	0	0	0	0	0	0.1477											19.5962	0	2.829	20.7298	0.153328633	7.951016357	0.38622976	2.140391286	4.47309639	0.33248305	1.144642494	11.77559551	0.531717129	3.402747617	0	0.020186518	0.807899657	4.091054336	4.793286909	0.128195558	0.883366046	0	0.051571126	2.591924236	0.305473799	0	0	0.149165016	0	0	0	0	0	0.984583333	0	0	0	0	0	0	0	0	0	0	67.8278
H5520_006_0	2008	8																					3200											D	D	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	coin	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	6200	1036.051803	7.663190532	786.4862448	6.509414078	161.6768214	14.30826971	1.063526634	305.0421459	41.46972969	9.10996131	25.55944986	0	0.134795491	111.3710399	4121.439787	3937.412659	158.2331665	3.040124569	23.66672434	26.87375812	17.8328979	275.6020734	0	0	150.3103935	0	0	0	0	850	590.75											Per Day: $200 (1-10)	Per Day: $200 (1-10)	Per Day: $100 (1-10)	$0 Per Visit	$150 per Ambulance Service	30% of Contract Rate	30% of Contract Rate	$50 ER/ $50 UC	30% Contracted Rate	$0 Diagnostic Lab	$15 Simple X-Ray/$20 - $600 per Visit for Complex Rad.		$20 - $600 Copay (estimated to equivalent coin.)	"$40 OP SA / $25 Cardiac Rehab/ 30% OP, PT, SLT"	$15 PCP	$15 SCP / $15 Chiro / $25 Podiatrist	$40 MH	30% of Contract Rate	0% Coin	$15 Hearing / $15 Preventive	$20 - $600 Copay (estimated to equivalent coin.)	$15 Vision			$15 Routine Vision / Eyewear Not Covered					$0 Per Visit	$15 Accup / $25 Message Thera											166.1652595	166.1652595	83.08262977	-2.13E-18	150	0.3	0.3	41.54131489	0.249247889	-3.05E-18	0.112433093	0	0.124623945	76.39532133	12.46239447	14.2490016	8.767906162	0.249247889	0	0.001935831	0.124623945	13.68044015	0	0	12.46239447	0	0	0	0	0	17											14.3463	0.106113004	5.445278792	-1.39E-17	2.020960267	4.292480913	0.31905799	1.055987653	10.3362426	-2.78E-17	2.873727992	0	0.016798746	0.709018865	4.280250699	4.675349939	0.115614463	0.757744632	0	0.052023046	2.22240608	0.314196472	0	0	0.156102285	0	0	0	0	0	0.836895833	0	0	0	0	0	0	0	0	0	0	54.9326	0	13.3695	14.3463	0.106113004	5.445278792	-1.39E-17	2.020960267	4.292480913	0.31905799	1.055987653	10.3362426	-2.78E-17	2.873727992	0	0.016798746	0.709018865	4.280250699	4.675349939	0.115614463	0.757744632	0	0.052023046	2.22240608	0.314196472	0	0	0.156102285	0	0	0	0	0	0.836895833	0	0	0	0	0	0	0	0	0	0	54.9326	9400	Per Day: $400 (1-10)	Per Day: $400 (1-10)	Per Day: $200 (1-10)	40% Coin	$150 per Ambulance Service	30% of Contract Rate	30% of Contract Rate	$50 ER/ $50 UC	40% Contracted Rate	$30 Diagnostic Lab	$30 Simple X-Ray/$30 - $900 per Visit for Complex Rad.		$30 - $900 Copay (estimated to equivalent coin.)	"$40 OP SA / $35 Cardiac Rehab/ 40% OP, PT, SLT"	$30 PCP	$30 SCP / $50 Chiro / $35 Podiatrist	$40 MH	40% Contracted Rate	0% Coin	$30 Hearing / $30 Preventive	$30 - $900 Copay (estimated to equivalent coin.)	$30 Vision			$30 Routine Vision / Eyewear Not Covered					$0 Per Visit	$15 Accup / $25 Message Thera											8.2254	0.0608	3.213	0.4244	0.3927	0.7518	0.0559	0.1866	2.4545	0.4868	0.824	0	0.0051	0.1685	1.5107	1.5472	0.0236	0.202	0	0.0165	0.5937	0.1035	0	0	0.0549	0	0	0	0	0	0.1477											21.4493	0	3.705	22.5717	0.166952113	8.658292397	0.424353069	2.413685101	5.044239426	0.37493583	1.24258893	12.79073556	0.486834131	3.697699103	0	0.021939845	0.877548198	5.790920168	6.222530653	0.139202947	0.959769753	0	0.068535632	2.816117001	0.417739958	0	0	0.211035892	0	0	0	0	0	0.984583333	0	0	0	0	0	0	0	0	0	0	76.3819
H5520_007_0	2008	5																					1950											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	673.31878	4.460507934	327.2373085	6.304786634	156.5944108	13.85848043	1.030094019	304.0277845	411.5744189	8.656903895	24.288325	0	0.130558111	105.8323254	4116.10528	3899.704631	153.2590094	168.7218991	23.04782251	26.0753398	16.94603061	274.9557795	0	557.6	150.2815934	0	0	0	0	850	590.75											Per Day: $100 (1-4)	Per Day: $100 (1-4)	Per Day: $100 (1-4)	$0 Per Visit	$50 per Ambulance Service	$20 - $600 Copay (estimated to equivalent coin.)	$20 - $600 Copay (estimated to equivalent coin.)	$50 ER/ $25 UC	$200 ASC / $200 OP	$0 Diagnostic Lab	$10 Simple X-Ray/$20 - $600 per Visit for Complex Rad.		$20 - $600 Copay (estimated to equivalent coin.)	$25 OP SA / $25 Cardiac Rehab	$10 PCP	$10 SCP / $15 Chiro / $25 Podiatrist	$25 MH	$25 Therapy	0% Coin	$10 Hearing / $10 Preventive	$20 - $600 Copay (estimated to equivalent coin.)	$10 Vision		"$35 Ded, 0% Coin"	$10 Routine Vision / Eyewear $100 Max in 2 yrs					$0 Per Visit	$15 Accup / $25 Message Thera											83.83896884	83.83896884	83.83896884	0	50	0.123681074	0.15	34.24499586	167.6779377	0	0.104873975	0	0.125758453	20.95974221	8.383896884	11.03212351	8.84772441	20.95974221	0	0.001483774	0.125758453	9.728209333	0	35	8.383896884	0	0	0	0	0	17											4.7042	0.031163699	2.286269876	0	0.652476712	1.714031749	0.154514103	0.867619185	5.750995814	0	2.54721319	0	0.016418786	0.184851521	2.875750186	3.585168596	0.112999457	0.294697292	0	0.038689899	2.131106599	0.222902282	0	1.626333333	0.104995449	0	0	0	0	0	0.836895833	0	0	0	0	0	0	0	0	0	0	30.7393	0	7.6205	4.7042	0.031163699	2.286269876	0	0.652476712	1.714031749	0.154514103	0.867619185	5.750995814	0	2.54721319	0	0.016418786	0.184851521	2.875750186	3.585168596	0.112999457	0.294697292	0	0.038689899	2.131106599	0.222902282	0	1.626333333	0.104995449	0	0	0	0	0	0.836895833	0	0	0	0	0	0	0	0	0	0	30.7393	4950	Per Day: $200 (1-4)	Per Day: $200 (1-4)	Per Day: $200 (1-4)	$0 Per Visit	$50 per Ambulance Service	$30 - $900 Copay (estimated to equivalent coin.)	$30 - $900 Copay (estimated to equivalent coin.)	$50 ER/ $25 UC	$400 ASC / $400 OP	$20 Diagnostic Lab	$20 Simple X-Ray/$30 - $900 per Visit for Complex Rad.		$30 - $900 Copay (estimated to equivalent coin.)	$50 OP SA / $35 Cardiac Rehab	$20 PCP	$20 SCP / $50 Chiro / $35 Podiatrist	$50 MH	$35 Therapy	0% Coin	$20 Hearing / $20 Preventive	$30 - $900 Copay (estimated to equivalent coin.)	$20 Vision		"$35 Ded, 20% Coin"	$10 Routine Vision / Eyewear $100 Max in 2 yrs					$0 Per Visit	$15 Accup / $25 Message Thera											2.4742	0.0164	1.2373	0	0.1268	0.4515	0.0406	0.1647	1.8641	0.3425	0.6571	0	0.0046	0.0419	0.9224	1.0618	0.0211	0.0757	0	0.0108	0.5222	0.0652	0	0.287	0.0179	0	0	0	0	0	0.1477											10.5534	0	2.6565	7.1784	0.047554737	3.523528159	0	0.779269807	2.165487435	0.195105067	1.032290324	7.615095996	0.342525724	3.20430438	0	0.021027297	0.226793341	3.798100306	4.646920238	0.134144309	0.370434188	0	0.0494884	2.653258935	0.288117723	0	1.913333333	0.122901921	0	0	0	0	0	0.984583333	0	0	0	0	0	0	0	0	0	0	41.2927
H5520_008_0	2008	5																					2000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3500	975.0395002	6.9248355	608.2346203	7.109807287	176.5890185	15.62798726	1.161620589	341.9877067	464.1259051	9.762252391	27.38955655	0	0.147228299	119.3454246	4501.57914	4300.578343	172.8277394	190.2649934	25.60982733	29.15600646	19.10976833	300.7749447	0	557.6	169.470155	0	0	0	0	850	590.75											Per Day: $100 (1-7)	Per Day: $100 (1-7)	Per Day: $100 (1-7)	$0 Per Visit	$50 per Ambulance Service	$20 - $600 Copay (estimated to equivalent coin.)	$20 - $600 Copay (estimated to equivalent coin.)	$50 ER/ $25 UC	$200 ASC / $200 OP	$0 Diagnostic Lab	$15 Simple X-Ray/$20 - $600 per Visit for Complex Rad.		$20 - $600 Copay (estimated to equivalent coin.)	$25 OP SA / $25 Cardiac Rehab	$15 PCP	$15 SCP / $15 Chiro / $25 Podiatrist	$25 MH	$25 Therapy	0% Coin	$15 Hearing / $15 Preventive	$20 - $600 Copay (estimated to equivalent coin.)	$15 Vision		"$35 Ded, 0% Coin"	$10 Routine Vision / Eyewear $100 Max in 2 yrs					$0 Per Visit	$15 Accup / $25 Message Thera											77.76543021	77.76543021	77.76543021	0	50	0.124018611	0.15	31.72745784	155.5308604	2.84E-18	0.105237495	0	0.116648145	19.44135755	11.66481453	13.33708072	8.206769534	19.44135755	0	0.001824148	0.116648145	12.78428913	0	35	7.776543021	0	0	0	0	0	17											6.3187	0.044876068	3.941635576	0	0.735787577	1.93816128	0.174243088	0.904200045	6.01549178	2.78E-17	2.882408314	0	0.017173908	0.193353089	4.375840481	4.779763375	0.118196452	0.308250814	0	0.053184864	2.229119033	0.320432821	0	1.626333333	0.109824329	0	0	0	0	0	0.836895833	0	0	0	0	0	0	0	0	0	0	37.9239	0	13.322	6.3187	0.044876068	3.941635576	0	0.735787577	1.93816128	0.174243088	0.904200045	6.01549178	2.78E-17	2.882408314	0	0.017173908	0.193353089	4.375840481	4.779763375	0.118196452	0.308250814	0	0.053184864	2.229119033	0.320432821	0	1.626333333	0.109824329	0	0	0	0	0	0.836895833	0	0	0	0	0	0	0	0	0	0	37.9239	5500	Per Day: $200 (1-7)	Per Day: $200 (1-7)	Per Day: $200 (1-7)	$0 Per Visit	$50 per Ambulance Service	$30 - $900 Copay (estimated to equivalent coin.)	$30 - $900 Copay (estimated to equivalent coin.)	$50 ER/ $25 UC	$400 ASC / $400 OP	$25 Diagnostic Lab	$25 Simple X-Ray/$30 - $900 per Visit for Complex Rad.		$30 - $900 Copay (estimated to equivalent coin.)	$50 OP SA / $35 Cardiac Rehab	$25 PCP	$25 SCP / $50 Chiro / $35 Podiatrist	$50 MH	$35 Therapy	0% Coin	$25 Hearing / $25 Preventive	$30 - $900 Copay (estimated to equivalent coin.)	$25 Vision		"$35 Ded, 20% Coin"	$10 Routine Vision / Eyewear $100 Max in 2 yrs					$0 Per Visit	$15 Accup / $25 Message Thera											3.481	0.0247	2.2342	0	0.143	0.5101	0.0458	0.1798	2.0423	0.4691	0.7569	0	0.0034	0.046	1.2363	1.3337	0.0232	0.083	0	0.0139	0.5721	0.0858	0	0.287	0.0196	0	0	0	0	0	0.1477											13.7385	0	3.9975	9.7997	0.069598561	6.175873082	0	0.878770127	2.448285728	0.220016871	1.083998054	8.05778139	0.469084719	3.639324635	0	0.020539934	0.239304129	5.612188977	6.113466558	0.141362542	0.391227403	0	0.067104246	2.801183937	0.406218602	0	1.913333333	0.129442483	0	0	0	0	0	0.984583333	0	0	0	0	0	0	0	0	0	0	51.6624
H5520_801_0	2008	4																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	178.0649834	0.394689548	23.16412283	5.944941386	5.958008528	13.06750865	0.971301476	9.10949474	37.8736257	8.31997863	23.34302742	0	0.123106516	11.42624748	27.84455606	85.65877718	0.150266497	2.857025395	20.32641931	22.76693266	16.28649391	2.07280619	0	0	0	0	0	0	0	0	0											Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit																				0.076608327	0.076608327	0.145688732	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											13.6413	0.030236506	3.374751679	0	1.394173995	3.057797024	0.227284545	2.131621769	8.862428413	1.946874999	5.462268415	0	0.028806925	2.67374191	6.515626118	20.04415386	0.03516236	0.668543942	4.756382117	5.327462241	3.811039575	0.485036649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.4747	0	0	13.6413	0.030236506	3.374751679	0	1.394173995	3.057797024	0.227284545	2.131621769	8.862428413	1.946874999	5.462268415	0	0.028806925	2.67374191	6.515626118	20.04415386	0.03516236	0.668543942	4.756382117	5.327462241	3.811039575	0.485036649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.4747	none	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit																				2.838	0.0063	0.8855	0	0.2442	0.5355	0.0398	0.3731	1.5531	0.3412	0.9572	0	0.0058	0.4686	1.3439	3.6799	0.0071	0.1339	0.9559	1.0545	0.6679	0.0895	0	0	0	0	0	0	0	0	0											16.1806	0	0	16.4792	0.036524751	4.260222512	0	1.638340991	3.59332065	0.267089753	2.504754402	10.41549868	2.288049398	6.419487621	0	0.034590052	3.142293969	7.859507752	23.72403227	0.042216184	0.802487266	5.712245091	6.381950818	4.478894026	0.574575085	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.6553
H5520_803_0	2008	5																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	178.0649834	0.394689548	23.16412283	5.944941386	5.958008528	13.06750865	0.971301476	9.10949474	37.8736257	8.31997863	23.34302742	0	0.123106516	11.42624748	27.84455606	85.65877718	0.150266497	2.857025395	20.32641931	22.76693266	16.28649391	2.07280619	0	0	0	0	0	0	0	0	0											Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit																				0.076608327	0.076608327	0.145688732	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											13.6413	0.030236506	3.374751679	0	1.394173995	3.057797024	0.227284545	2.131621769	8.862428413	1.946874999	5.462268415	0	0.028806925	2.67374191	6.515626118	20.04415386	0.03516236	0.668543942	4.756382117	5.327462241	3.811039575	0.485036649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.4747	0	0	13.6413	0.030236506	3.374751679	0	1.394173995	3.057797024	0.227284545	2.131621769	8.862428413	1.946874999	5.462268415	0	0.028806925	2.67374191	6.515626118	20.04415386	0.03516236	0.668543942	4.756382117	5.327462241	3.811039575	0.485036649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.4747	none	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit																				2.838	0.0063	0.8855	0	0.2442	0.5355	0.0398	0.3731	1.5531	0.3412	0.9572	0	0.0058	0.4686	1.3439	3.6799	0.0071	0.1339	0.9559	1.0545	0.6679	0.0895	0	0	0	0	0	0	0	0	0											16.1806	0	0	16.4792	0.036524751	4.260222512	0	1.638340991	3.59332065	0.267089753	2.504754402	10.41549868	2.288049398	6.419487621	0	0.034590052	3.142293969	7.859507752	23.72403227	0.042216184	0.802487266	5.712245091	6.381950818	4.478894026	0.574575085	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.6553
H5520_804_0	2008	5																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	178.0649834	0.394689548	23.16412283	5.944941386	5.958008528	13.06750865	0.971301476	9.10949474	37.8736257	8.31997863	23.34302742	0	0.123106516	11.42624748	27.84455606	85.65877718	0.150266497	2.857025395	20.32641931	22.76693266	16.28649391	2.07280619	0	0	0	0	0	0	0	0	0											Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit																				0.076608327	0.076608327	0.145688732	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											13.6413	0.030236506	3.374751679	0	1.394173995	3.057797024	0.227284545	2.131621769	8.862428413	1.946874999	5.462268415	0	0.028806925	2.67374191	6.515626118	20.04415386	0.03516236	0.668543942	4.756382117	5.327462241	3.811039575	0.485036649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.4747	0	0	13.6413	0.030236506	3.374751679	0	1.394173995	3.057797024	0.227284545	2.131621769	8.862428413	1.946874999	5.462268415	0	0.028806925	2.67374191	6.515626118	20.04415386	0.03516236	0.668543942	4.756382117	5.327462241	3.811039575	0.485036649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.4747	none	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit																				2.838	0.0063	0.8855	0	0.2442	0.5355	0.0398	0.3731	1.5531	0.3412	0.9572	0	0.0058	0.4686	1.3439	3.6799	0.0071	0.1339	0.9559	1.0545	0.6679	0.0895	0	0	0	0	0	0	0	0	0											16.1806	0	0	16.4792	0.036524751	4.260222512	0	1.638340991	3.59332065	0.267089753	2.504754402	10.41549868	2.288049398	6.419487621	0	0.034590052	3.142293969	7.859507752	23.72403227	0.042216184	0.802487266	5.712245091	6.381950818	4.478894026	0.574575085	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.6553
H5520_806_0	2008	4																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	178.0649834	0.394689548	23.16412283	5.944941386	5.958008528	13.06750865	0.971301476	9.10949474	37.8736257	8.31997863	23.34302742	0	0.123106516	11.42624748	27.84455606	85.65877718	0.150266497	2.857025395	20.32641931	22.76693266	16.28649391	2.07280619	0	0	0	0	0	0	0	0	0											Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit																				0.076608327	0.076608327	0.145688732	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											13.6413	0.030236506	3.374751679	0	1.394173995	3.057797024	0.227284545	2.131621769	8.862428413	1.946874999	5.462268415	0	0.028806925	2.67374191	6.515626118	20.04415386	0.03516236	0.668543942	4.756382117	5.327462241	3.811039575	0.485036649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.4747	0	0	13.6413	0.030236506	3.374751679	0	1.394173995	3.057797024	0.227284545	2.131621769	8.862428413	1.946874999	5.462268415	0	0.028806925	2.67374191	6.515626118	20.04415386	0.03516236	0.668543942	4.756382117	5.327462241	3.811039575	0.485036649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.4747	none	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit	Medicare FFS Benefit																				2.838	0.0063	0.8855	0	0.2442	0.5355	0.0398	0.3731	1.5531	0.3412	0.9572	0	0.0058	0.4686	1.3439	3.6799	0.0071	0.1339	0.9559	1.0545	0.6679	0.0895	0	0	0	0	0	0	0	0	0											16.1806	0	0	16.4792	0.036524751	4.260222512	0	1.638340991	3.59332065	0.267089753	2.504754402	10.41549868	2.288049398	6.419487621	0	0.034590052	3.142293969	7.859507752	23.72403227	0.042216184	0.802487266	5.712245091	6.381950818	4.478894026	0.574575085	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.6553
H5521_005_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	7500	1423.469848		800.3421819	1084.575854	198.7744828	10.72379298		295.9808464	272.5386408	1105.490419	3367.643646	0	0	905.4801117	3699.140345	5615.040839	0	1166.969097	0	0	228.0938778				634.9227877		63.29089864															850/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$250 per procedure	$35 per visit	"$35 X-ray; $150 PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$20 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															143.72		68.64	20	100	0.2		48	250	35	55.7	35	30	35	20	35	35	35	35	35	45				0		0															17.0484	0	4.57795728	1.807626423	1.656454024	2.144758595	0	1.183923386	5.67788835	3.224347056	15.63147926	0	0	2.640983659	6.165233909	16.37720245	0	3.403659865	0	0	0.855352042	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.3953			17.0484	0	4.57795728	1.807626423	1.656454024	2.144758595	0	1.183923386	5.67788835	3.224347056	15.63147926	0	0	2.640983659	6.165233909	16.37720245	0	3.403659865	0	0	0.855352042	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.3953		30% coins; $500ded; 7500 max OOP		30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP		$50 ER; $35 UC	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	$45 per script				30% coins; $500ded; 7500 max OOP		30% coins; $500ded; 7500 max OOP															13.8612		1.1391	0.2681	0.1771	0.3432		0.1392	1.5109	0.6267	1.9174	0	0	0.8136	0.9322	4.1698	0	0.3298	0	0	0.2613				0.0909		0.0085															26.5889	500	9.229125484	30.9096	0	5.717052517	2.075699531	1.833568533	2.487980943	0	1.323137719	7.188779872	3.851091264	17.54884891	0	0	3.454540633	7.097439019	20.54700179	0	3.733448448	0	0	1.116635443	0	0	0	0.090895111	0	0.008466377	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.9842
H5521_006_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	1437.103257		808.0075304	1094.963476	200.6782631	10.82650106		298.8156294	275.1489039	1116.078352	3399.897553	0	0	914.1524281	3734.569191	5668.819392	0	1178.145847	0	0	230.2784672				641.0038173		63.89707286															350/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$250 per procedure	$30 per visit	"$30 X-ray; $150 PET, MRI"	$30 per visit	$30 per visit	$30 per visit	$15 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script				$0 per visit		$0 per visit															59.18		68.64	20	100	0.2		48	250	30	51.6	30	30	30	15	30	30	30	30	30	45				0		0															7.0873	0	4.621803074	1.824939126	1.672318859	2.165300211	0	1.195262517	5.732268831	2.79019588	14.61955948	0	0	2.28538107	4.668211489	14.17204848	0	2.945364617	0	0	0.863544252	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6435			7.0873	0	4.621803074	1.824939126	1.672318859	2.165300211	0	1.195262517	5.732268831	2.79019588	14.61955948	0	0	2.28538107	4.668211489	14.17204848	0	2.945364617	0	0	0.863544252	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6435		20% coins; $250ded; 5000 max OOP		20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP		$50 ER; $35 UC	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	$45 per script				20% coins; $250ded; 5000 max OOP		20% coins; $250ded; 5000 max OOP															9.2075		0.7567	0.1781	0.1709	0.228		0.1297	1.0036	0.4163	1.2736	0	0	0.5404	0.6192	2.7698	0	0.2191	0	0	0.1736				0.0604		0.0056															17.7525	250	6.115522229	16.2948	0	5.378462545	2.003010327	1.843195024	2.393290315	0	1.32496054	6.735899032	3.206519227	15.89319829	0	0	2.825797332	5.287441386	16.94189429	0	3.16443116	0	0	1.037105298	0	0	0	0.060378311	0	0.005623906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.396
H5521_008_0	2008	5																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	7500	1368.724505		968.8010767	793.9871728	204.8208241	10.40080907		341.2452045	278.7826015	855.2570297	3771.195024	0	0	870.7653092	3695.18777	5320.261607	0	843.4038406	0	0	233.3195926				549.8336756		44.43593648															$800/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$30 per visit	"$30 X-ray; $125 PET, MRI"	$30 per visit	$30 per visit	$30 per visit	$0 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script				$0 per visit		$0 per visit															135.26		68.64	20	100	0.2		48	200	30	47.1	30	30	30	0	30	30	30	30	30	45				0		0															15.4278	0	5.541542159	1.323311955	1.706840201	2.080161813	0	1.364980818	4.646376692	2.138142574	14.80194047	0	0	2.176913273	0	13.30065402	0	2.108509602	0	0	0.874948472	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.4921			15.4278	0	5.541542159	1.323311955	1.706840201	2.080161813	0	1.364980818	4.646376692	2.138142574	14.80194047	0	0	2.176913273	0	13.30065402	0	2.108509602	0	0	0.874948472	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.4921		30% coins; $500ded; 7500 max OOP		30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP		$50 ER; $35 UC	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	$45 per script				30% coins; $500ded; 7500 max OOP		30% coins; $500ded; 7500 max OOP															12.5202		1.0971	0.1507	0.1849	0.3367		0.1567	1.3507	0.4651	1.6208	0	0	0.7273	1.1513	3.837	0	0.259	0	0	0.2735				0.0793		0.0058															24.2162	500	9.229125484	27.948	0	6.638654483	1.474027168	1.89170987	2.416872393	0	1.521664791	5.997065936	2.603219934	16.42277691	0	0	2.904207481	1.151293894	17.13769769	0	2.367481571	0	0	1.148491636	0	0	0	0.079342303	0	0.005839294	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.7084
H5521_009_0	2008	5																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	1362.479854		964.3810311	790.3646958	203.8863521	10.35335655		339.6883118	277.5106873	851.3550159	3753.989372	0	0	866.7925406	3678.328892	5295.988513	0	839.5559057	0	0	232.2550983				547.3251215		44.23320253															$350/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$20 per visit	"$20 X-ray; $125 PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$10 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit															59.18		68.64	20	100	0.2		48	200	20	38.9	20	20	20	10	20	20	20	20	20	45				0		0															6.7193	0	5.516259498	1.317274493	1.699052935	2.070671309	0	1.358753247	4.625178122	1.418925026	12.16918221	0	0	1.444654234	3.065274077	8.826647522	0	1.399259843	0	0	0.870956619	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5014			6.7193	0	5.516259498	1.317274493	1.699052935	2.070671309	0	1.358753247	4.625178122	1.418925026	12.16918221	0	0	1.444654234	3.065274077	8.826647522	0	1.399259843	0	0	0.870956619	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5014		20% coins; $250ded; 5000 max OOP		20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP		$50 ER; $35 UC	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	20% coins; $250ded; 5000 max OOP	$45 per script				20% coins; $250ded; 5000 max OOP		20% coins; $250ded; 5000 max OOP															8.203		0.7188	0.0987	0.1752	0.2206		0.1454	0.8849	0.3047	1.0619	0	0	0.4765	0.7543	2.514	0	0.1697	0	0	0.1792				0.052		0.0038															15.9628	250	6.115522229	14.9223	0	6.235067352	1.416020334	1.874240451	2.2912779	0	1.50415231	5.510124919	1.723635175	13.2311245	0	0	1.921164048	3.819580701	11.3406081	0	1.568933523	0	0	1.050177078	0	0	0	0.05198362	0	0.003825799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.4642
H5521_801_0	2008	1																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1034.752438		604.7254509	544.6065464	190.4146816	8.04794341		190.1407704	268.6946654	1125.139158	3246.698041	0	0	831.5086936	3353.268268	5228.750757	0	1220.201576	0	0	7.21112179				590.9334669		65.06987308															$200 per day; $1400 max		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	55.3	40	30	40	30	40	40	40	40	40	0.2				0		0															12.4662	0	5.039378757	1.815355155	2.38018352	2.414383023	0	0.79225321	4.478244424	3.75046386	14.96186681	0	0	2.771695645	8.38317067	17.42916919	0	4.067338588	0	0	1.442224358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1919			12.4662	0	5.039378757	1.815355155	2.38018352	2.414383023	0	0.79225321	4.478244424	3.75046386	14.96186681	0	0	2.771695645	8.38317067	17.42916919	0	4.067338588	0	0	1.442224358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1919		30% coins; $500ded;  no max OOP		30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	$150 per trip	30% coins; $500ded;  no max OOP		$50 per visit	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP				30% coins; $500ded;  no max OOP		30% coins; $500ded;  no max OOP															14.2197		1.3081	0.2112	0.343	0.367		0.1346	1.8189	0.8144	2.6027	0	0	0.9794	1.2274	5.5225	0	0.4818	0	0	0.3617				0.1147		0.0121															30.5193	500		26.6859	0	6.347436655	2.026588698	2.723189606	2.781371015	0	0.926828923	6.297164033	4.564906655	17.56460972	0	0	3.751113896	9.61056571	22.95171136	0	4.549092742	0	0	1.803935974	0	0	0	0.114748128	0	0.012106416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.7112
H5521_802_0	2008	1																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1034.752438		604.7254509	544.6065464	190.4146816	8.04794341		190.1407704	268.6946654	1125.139158	3246.698041	0	0	831.5086936	3353.268268	5228.750757	0	1220.201576	0	0	7.21112179				590.9334669		65.06987308															$200 per day; $1400 max		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	55.3	40	30	40	30	40	40	40	40	40	0.2				0		0															12.4662	0	5.039378757	1.815355155	2.38018352	2.414383023	0	0.79225321	4.478244424	3.75046386	14.96186681	0	0	2.771695645	8.38317067	17.42916919	0	4.067338588	0	0	1.442224358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1919			12.4662	0	5.039378757	1.815355155	2.38018352	2.414383023	0	0.79225321	4.478244424	3.75046386	14.96186681	0	0	2.771695645	8.38317067	17.42916919	0	4.067338588	0	0	1.442224358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1919		30% coins; $500ded;  no max OOP		30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	$150 per trip	30% coins; $500ded;  no max OOP		$50 per visit	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP	30% coins; $500ded;  no max OOP				30% coins; $500ded;  no max OOP		30% coins; $500ded;  no max OOP															14.2197		1.3081	0.2112	0.343	0.367		0.1346	1.8189	0.8144	2.6027	0	0	0.9794	1.2274	5.5225	0	0.4818	0	0	0.3617				0.1147		0.0121															30.5193	500		26.6859	0	6.347436655	2.026588698	2.723189606	2.781371015	0	0.926828923	6.297164033	4.564906655	17.56460972	0	0	3.751113896	9.61056571	22.95171136	0	4.549092742	0	0	1.803935974	0	0	0	0.114748128	0	0.012106416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.7112
H5522_001_0	2008	3																					1000											D	D	D	V	T	O	O	V	V	O	O	O	O	O	P	P	P	P	P	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	0	0	0	0	285.820837	0	0	266.5466079	0	0	0	0	0	789.923794	5513.947253	13105.11318	117.6848752	554.4803475	0	2390.055904	1339.182057	0	0	0	496.1537525	0	254.8390696	0	0	0	310.6913323															10a $25			4a $50						4b $50	7a $10	"16b $15,17a $15,18a $15,7b $15,7d $15,7f $15"	"7e $25,7h $25,9c $25"	"7c $15,7i $15"		7g $15	"$50/$100, 11c $20/$40, Nebulizers $10/$30"				17a $15						"14c $10,7f $15"											0	0	0	0	15.93318657	0	0	35.91072811	0	0	0	0	0	0.009088705	4.862939655	3.089897689	22.42741937	9.538260889	0	0.263639135	13.31380743	0	0	0	5.887068919	0	10.70205709	0	0	0	1.035329047											0	0	0	0	0.37950306	0	0	0.797656897	0	0	0	0	0	0.000598282	2.234499396	3.37445491	0.219947337	0.440731518	0	0.052509356	1.485801001	0	0	0	0.243407611	0	0.227275189	0	0	0	0.026805647	0	0	0	0	0	0	0	0	0	0	9.4832	0	3.051179117	0	0	0	0	0.37950306	0	0	0.797656897	0	0	0	0	0	0.000598282	2.234499396	3.37445491	0.219947337	0.440731518	0	0.052509356	1.485801001	0	0	0	0.243407611	0	0.227275189	0	0	0	0.026805647	0	0	0	0	0	0	0	0	0	0	9.4832	4000	0.2	0.2	0.2	0.2	0.2	0.2	0.2	50	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2			0.2	0.2	0.2	0.2		0.5	0.2											2.5335	0.0049	0.3473	0.1479	0.0859	0.1044	0.0532	0.0439	0.383	0.0144	0.1241	0.0166	0.0012	0.0505	0.1891	0.3578	0	0.0337	0.3142	0.0125	0.0464	0	0	0	0.026	0	0	0	0	0.071	0.0186											4.9803	300	0.015388431	2.5335	0.004913783	0.347299374	0.147909528	0.465401385	0.104403243	0.053202691	0.841549235	0.382968289	0.014438446	0.124125743	0.016646194	0.001191497	0.051082403	2.423594466	3.732282925	0.219947337	0.474421536	0.31421226	0.065041653	1.532212629	0	0	0	0.26939167	1.91E-05	0.227306915	0	0	0.071000267	0.045413103	0	0	0	0	0	0	0	0	0	0	14.4635
H5522_002_0	2008	5																					1500											D	D	D	V	T	COIN	COIN	V	V	O	O	O	O	O	P	P	P	P	P	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	2500	1836.622871	0	1170.411473	0	285.820837	10.51290917	6.48515767	266.5466079	708.5095057	0	0	0	0	789.923794	5513.947253	13105.11318	117.6848752	554.4803475	0	2390.055904	1339.182057	0	0	0	496.1537525	0	254.8390696	0	0	0	310.6913323													2 $45 days 14-100		10a $50	"11a 20%, $200 OOP max"	"11b 20%, $200 OOP max"	4a $50	"9a $100, 9b $100"					4b $50	7a $10	"16b $20,17a $20,18a $20,7d $20,7f $20, 7b $20"	"7e $25,7h $25,9c $25"	"7c $20, 7i $20"		7g $20	"$50/$100, Nebulizers $10/$30"				17a $20						"14c $10,7f $20"											0.446672552	0	16.75352604	0	37.96400033	0.068282431	0.1500536	50	85.5644844	0	0	0	0	0.007776704	5.79357919	4.908199054	22.42741937	15.15120816	0	0.383867596	7.6921852	0	0	0	9.351411926	0	16.99985947	0	0	0	1.347228806											0.0684	0	1.634043258	0	0.904241863	0.717846991	0.973121257	1.110610866	5.051937546	0	0	0	0	0.000511917	2.662124171	5.360208674	0.219947337	0.700087264	0	0.076455418	0.858436367	0	0	0	0.386644843	0	0.361019031	0	0	0	0.034881026	0	0	0	0	0	0	0	0	0	0	21.1205	0	3.397628308	0.0684	0	1.634043258	0	0.904241863	0.717846991	0.973121257	1.110610866	5.051937546	0	0	0	0	0.000511917	2.662124171	5.360208674	0.219947337	0.700087264	0	0.076455418	0.858436367	0	0	0	0.386644843	0	0.361019031	0	0	0	0.034881026	0	0	0	0	0	0	0	0	0	0	21.1205	4000	0.2	0.2	0.2	0.2	0.2	0.2	0.2	50	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2			0.2	0.2		0.2		0.5	0.2											2.475	0.0048	0.3393	0.144	0.0839	0.102	0.052	0.044	0.3741	0.0141	0.1213	0.0165	0.0012	0.0493	0.1847	0.3496	0	0.0329	0.307	0.0122	0.0459	0	0	0	0.0254	0	0	0	0	0.071	0.0182											4.8684	300	0.074277879	2.5434	0.00480026	1.973318985	0.144020485	0.988155681	0.819838209	1.025094809	1.154647021	5.42605813	0.014104875	0.12125807	0.016465257	0.001160168	0.049849579	2.846850584	5.709775549	0.219947337	0.732998943	0.306953024	0.088698182	0.90434352	0	0	0	0.412028593	1.89E-05	0.361050024	0	0	0.071000267	0.053058595	0	0	0	0	0	0	0	0	0	0	25.9888
H5522_003_0	2008	3																					1000											D	D	D	V	T	O	O	V	V	O	O	O	O	O	P	P	P	P	P	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	3000	0	0	0	0	285.820837	0	0	266.5466079	0	0	0	0	0	789.923794	5513.947253	13105.11318	117.6848752	554.4803475	0	2390.055904	1339.182057	0	0	0	496.1537525	0	254.8390696	0	0	0	310.6913323															10a $25			4a $50						4b $50	7a $10	"16b $15,17a $15,18a $15,7b $15,7d $15,7f $15"	"7e $25,7h $25,9c $25"	"7c $15,7i $15"		7g $15	"$50/$100, 11c $20/$40, Nebulizers $10/$30"				17a $25						"14c $10,7f $15"											0	0	0	0	16.17576094	0	0	36.45745003	0	0	0	0	0	0.009088705	4.93697535	3.136939754	22.42741937	9.683475886	0	0.267652902	13.31380743	0	0	0	5.976696442	0	10.86499027	0	0	0	1.051091386											0	0	0	0	0.385280794	0	0	0.809800803	0	0	0	0	0	0.000598282	2.268518472	3.425829208	0.219947337	0.447441423	0	0.053308783	1.485801001	0	0	0	0.247113364	0	0.230735334	0	0	0	0.027213749	0	0	0	0	0	0	0	0	0	0	9.6016	0	2.93278077	0	0	0	0	0.385280794	0	0	0.809800803	0	0	0	0	0	0.000598282	2.268518472	3.425829208	0.219947337	0.447441423	0	0.053308783	1.485801001	0	0	0	0.247113364	0	0.230735334	0	0	0	0.027213749	0	0	0	0	0	0	0	0	0	0	9.6016	4000	0.2	0.2	0.2	0.2	0.2	0.2	0.2	50	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2			0.2	0.2	0.2	0.2		0.5	0.2											2.3761	0.0046	0.3257	0.1387	0.0806	0.0979	0.0499	0.0439	0.3592	0.0135	0.1164	0.0156	0.0011	0.0473	0.1773	0.3356	0	0.0316	0.2947	0.0118	0.0435	0	0	0	0.0244	0	0	0	0	0.071	0.0175											4.6779	300	0.014366991	2.3761	0.004608406	0.325715727	0.138715058	0.465840787	0.097914885	0.049896299	0.853693876	0.359167922	0.013541139	0.116411689	0.01561142	0.00111743	0.047944959	2.445861833	3.761419245	0.219947337	0.479037705	0.294684881	0.065062235	1.529327552	0	0	0	0.271482589	1.79E-05	0.230765089	0	0	0.071000267	0.044664805	0	0	0	0	0	0	0	0	0	0	14.2795
H5522_004_0	2008	3																																D	D	D	V	T	COIN	COIN	V	V	O	O	O	O	O	P	P	P	P	P	P	S	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1799.890414	32.78149468	1147.003243	0	280.1044203	10.30265099	6.355454516	261.2156758	694.3393156	384.858075	833.5073727	0	0	774.1253182	5403.668307	12843.01091	115.3311777	543.3907405	0	2342.254786	1312.398416	0	0	0	486.2306774	0	249.7422882	0	0	0	304.4775056											"1a $150, max $600/yr"	"1b $150, max $600/yr"	2 20% days 11-100		10a $50	"11a 20%, $200 OOP max"	"11b 20%, $200 OOP max"	4a $50	"9a $100, 9b $100"		8b $25			4b $50	7a $15	"16b $25, 17a $25,18a $25, 7b $25, 7d $25,7f $25"	"7e $25,7h $25,9c $25"	"7c $25,7i $25"		7g $25	"$50/$100, 11c $20/$40, Nebulizers $10/$30"				17a $25						14c $15											30.68420075	30.16217043	37.93385746	0	44.36887641	0.098136475	0.179162623	50	100	25	10.33069912	0	0	14.50103116	6.927497262	6.12080068	22.42741937	21.33398157	0	0.461605429	13.31380743	0	0	0	13.66135142	0	24.83486518	0	0	0	1.859868946											4.6023	0.082396752	3.625854795	0	1.035659867	1.011065851	1.138659904	1.088398649	5.786160963	0.801787656	0.71755949	0	0	0.935467947	3.11949145	6.550792493	0.215548391	0.966057337	0	0.090099794	1.456084981	0	0	0	0.553547346	0	0.516859671	0	0	0	0.047190688	0	0	0	0	0	0	0	0	0	0	34.341	0	0	4.6023	0.082396752	3.625854795	0	1.035659867	1.011065851	1.138659904	1.088398649	5.786160963	0.801787656	0.71755949	0	0	0.935467947	3.11949145	6.550792493	0.215548391	0.966057337	0	0.090099794	1.456084981	0	0	0	0.553547346	0	0.516859671	0	0	0	0.047190688	0	0	0	0	0	0	0	0	0	0	34.341		0.2	0.2	0.2	0.2	0.2	0.2	0.2	50	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2			0.2	0.2	0.2	0.2			0.2											2.5142	0.0049	0.3446	0.1463	0.0852	0.1036	0.0528	0.044	0.38	0.0143	0.1232	0.0165	0.0012	0.0501	0.1877	0.3551	0	0.0334	0.3118	0.0124	0.0459	0	0	0	0.0258	0	0	0	0	0	0.0185											4.8716	300	0	7.1165	0.08727305	3.97050476	0.146301816	1.120902907	1.114672643	1.191456733	1.132434803	6.166207739	0.816115957	0.840738327	0.016465257	0.001178546	0.985566433	3.307143989	6.905889257	0.215548391	0.999490348	0.311815259	0.102536487	1.501992135	0	0	0	0.579333183	1.89E-05	0.516891155	0	0	0	0.065656195	0	0	0	0	0	0	0	0	0	0	39.2127
H5522_802_0	2008	2																																COIN	COIN	COIN	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		292.7684532	1.748156167	44.33595542	0	10.98476466	10.524432	9.126757873	10.3752912	41.74313697	4.567900215	16.57289626	2.142483623	0.045036409	12.88032744	36.53079609	126.4575724	2.774546722	7.031674501	55.49100306	12.07255615	41.82652632	0	0	0	0	0	0	0	0	0	0											FFS 8.1%	FFS 8.1%	FFS 19.4%		FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%																					0.080508454	0.080508454	0.193766979	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											23.5703	0.14074135	8.59084416	0	2.570434931	2.462717089	2.135661342	2.427818141	9.767894051	1.06888865	3.878057725	0.501341168	0.01053852	3.013996622	8.548206284	29.59107193	0.649243933	1.645411833	12.98489472	2.824978138	9.787407159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1705	0	0	23.5703	0.14074135	8.59084416	0	2.570434931	2.462717089	2.135661342	2.427818141	9.767894051	1.06888865	3.878057725	0.501341168	0.01053852	3.013996622	8.548206284	29.59107193	0.649243933	1.645411833	12.98489472	2.824978138	9.787407159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1705		FFS 8.1%	FFS 8.1%	FFS 19.4%		FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%																					1.0742	0.0019	0.3917	0	0.1172	0.1123	0.0974	0.1107	0.4454	0.0449	0.1768	0.0229	0.0005	0.1332	0.3898	1.3302	0.0008	0.075	0.5911	0.1253	0.4619	0	0	0	0	0	0	0	0	0	0											5.7033	0	0	24.6445	0.14267803	8.982569032	0	2.687641492	2.575011936	2.233043119	2.538521669	10.21328998	1.113829306	4.054889203	0.524201297	0.011019055	3.14722597	8.937982226	30.92130542	0.650021319	1.720439238	13.57600544	2.950266565	10.24935051	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.8738
H5522_803_0	2008	2																																COIN	COIN	COIN	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		292.7684532	1.748156167	44.33595542	0	10.98476466	10.524432	9.126757873	10.3752912	41.74313697	4.567900215	16.57289626	2.142483623	0.045036409	12.88032744	36.53079609	126.4575724	2.774546722	7.031674501	55.49100306	12.07255615	41.82652632	0	0	0	0	0	0	0	0	0	0											FFS 8.1%	FFS 8.1%	FFS 19.4%		FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%																					0.080506994	0.080506994	0.193780429	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											23.5699	0.140738797	8.591440441	0	2.570434931	2.462717089	2.135661342	2.427818141	9.767894051	1.06888865	3.878057725	0.501341168	0.01053852	3.013996622	8.548206284	29.59107193	0.649243933	1.645411833	12.98489472	2.824978138	9.787407159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1706	0	0	23.5699	0.140738797	8.591440441	0	2.570434931	2.462717089	2.135661342	2.427818141	9.767894051	1.06888865	3.878057725	0.501341168	0.01053852	3.013996622	8.548206284	29.59107193	0.649243933	1.645411833	12.98489472	2.824978138	9.787407159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1706		FFS 8.1%	FFS 8.1%	FFS 19.4%		FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%																					1.0742	0.0019	0.3918	0	0.1172	0.1123	0.0974	0.1107	0.4454	0.0449	0.1768	0.0229	0.0005	0.1332	0.3898	1.3302	0.0008	0.075	0.5911	0.1253	0.4619	0	0	0	0	0	0	0	0	0	0											5.7033	0	0	24.6441	0.142675442	8.983192503	0	2.687641492	2.575011936	2.233043119	2.538521669	10.21328998	1.113829306	4.054889203	0.524201297	0.011019055	3.14722597	8.937982226	30.92130542	0.650021319	1.720439238	13.57600544	2.950266565	10.24935051	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.874
H5522_805_0	2008	2																																COIN	COIN	COIN	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		292.7684532	1.748156167	44.33595542	0	10.98476466	10.524432	9.126757873	10.3752912	41.74313697	4.567900215	16.57289626	2.142483623	0.045036409	12.88032744	36.53079609	126.4575724	2.774546722	7.031674501	55.49100306	12.07255615	41.82652632	0	0	0	0	0	0	0	0	0	0											FFS 8.1%	FFS 8.1%	FFS 19.4%		FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%																					0.080508454	0.080508454	0.193766979	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											23.5703	0.14074135	8.59084416	0	2.570434931	2.462717089	2.135661342	2.427818141	9.767894051	1.06888865	3.878057725	0.501341168	0.01053852	3.013996622	8.548206284	29.59107193	0.649243933	1.645411833	12.98489472	2.824978138	9.787407159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1705	0	0	23.5703	0.14074135	8.59084416	0	2.570434931	2.462717089	2.135661342	2.427818141	9.767894051	1.06888865	3.878057725	0.501341168	0.01053852	3.013996622	8.548206284	29.59107193	0.649243933	1.645411833	12.98489472	2.824978138	9.787407159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1705		FFS 8.1%	FFS 8.1%	FFS 19.4%		FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%																					1.0742	0.0019	0.3917	0	0.1172	0.1123	0.0974	0.1107	0.4454	0.0449	0.1768	0.0229	0.0005	0.1332	0.3898	1.3302	0.0008	0.075	0.5911	0.1253	0.4619	0	0	0	0	0	0	0	0	0	0											5.7033	0	0	24.6445	0.14267803	8.982569032	0	2.687641492	2.575011936	2.233043119	2.538521669	10.21328998	1.113829306	4.054889203	0.524201297	0.011019055	3.14722597	8.937982226	30.92130542	0.650021319	1.720439238	13.57600544	2.950266565	10.24935051	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.8738
H5522_806_0	2008	2																																COIN	COIN	COIN	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	V	V	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		292.7684532	1.748156167	44.33595542	0	10.98476466	10.524432	9.126757873	10.3752912	41.74313697	4.567900215	16.57289626	2.142483623	0.045036409	12.88032744	36.53079609	126.4575724	2.774546722	7.031674501	55.49100306	12.07255615	41.82652632	0	0	0	0	0	0	0	0	0	0											FFS 8.1%	FFS 8.1%	FFS 19.4%		FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%																					0.080509774	0.080509774	0.194493735	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0	0											23.5707	0.140743658	8.623065557	0	2.570434931	2.462717089	2.135661342	2.427818141	9.767894051	1.06888865	3.878057725	0.501341168	0.01053852	3.013996622	8.548206284	29.59107193	0.649243933	1.645411833	12.98489472	2.824978138	9.787407159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.2031	0	0	23.5707	0.140743658	8.623065557	0	2.570434931	2.462717089	2.135661342	2.427818141	9.767894051	1.06888865	3.878057725	0.501341168	0.01053852	3.013996622	8.548206284	29.59107193	0.649243933	1.645411833	12.98489472	2.824978138	9.787407159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.2031		FFS 8.1%	FFS 8.1%	FFS 19.4%		FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%	FFS 23.4%																					1.0742	0.0019	0.3932	0	0.1172	0.1123	0.0974	0.1107	0.4454	0.0449	0.1768	0.0229	0.0005	0.1332	0.3898	1.3302	0.0008	0.075	0.5911	0.1253	0.4619	0	0	0	0	0	0	0	0	0	0											5.7048	0	0	24.6449	0.14268037	9.016259659	0	2.687641492	2.575011936	2.233043119	2.538521669	10.21328998	1.113829306	4.054889203	0.524201297	0.011019055	3.14722597	8.937982226	30.92130542	0.650021319	1.720439238	13.57600544	2.950266565	10.24935051	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9079
H5523_001_0	2008	5																																A	A	A			coin	coin	V	P					V			V			V		V			V																																																										0		1833.152105	149.5706744	45.31995792			5.914587274	2.957293637	392.6534149	299.1370603					161.8964865			328.6664237			10481.52336		28.31413608			110.1510905																	$250 per admission copayment	$250 per admission copayment	$100 per admission copayment			20% cost sharing	20% cost sharing	"$40 ER, $15 Urgent Care"	$100 per case					$15 PT/OT/ST			$20 MH/SA			$15 Office Visit Copay		"$15 Vision, $10 Hearing"			$15 per exam																	38.8559322	38.8559322	276.6600126			0.2	0.2	37.14067278	100					15			20			15		14.97599253			15																	5.9357	0.484308999	1.044851677	0	0	1.182917455	0.591458727	1.215284333	2.492808836	0	0	0	0	0.202370608	0	0	0.547777373	0	0	13.1019042	0	0.035336024	0	0	0.137688863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.9724			5.9357	0.484308999	1.044851677	0	0	1.182917455	0.591458727	1.215284333	2.492808836	0	0	0	0	0.202370608	0	0	0.547777373	0	0	13.1019042	0	0.035336024	0	0	0.137688863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.9724		30% cost sharing	50% cost sharing	30% cost sharing	30% cost sharing	30% cost sharing	30% cost sharing	30% cost sharing	"$40 ER, $15 Urgent Care"	30% cost sharing				30% cost sharing	"$15 PT/OT/ST, 30% cost sharing all other"			30% cost sharing		30% cost sharing	30% cost sharing		"$15 Vision, $10 Hearing"			$15 per exam																	10.84406544	0.565870945	2.46037016	0.878958151	0.486368433	0.33799618	0.16899809	0.171858391	0.946947571				0.159956017	1.662209096			0.161759558		1.330714298	11.63725906		0.004997014			0.019471152																	31.8378			16.7798	1.050179944	3.505221837	0.878958151	0.486368433	1.520913635	0.760456818	1.387142724	3.439756407	0	0	0	0.159956017	1.864579704	0	0	0.709536931	0	1.330714298	24.73916325	0	0.040333038	0	0	0.157160015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8102
H5525_001_0	2008	3																					1000											A	A			T	Coin	Coin	V				V		V	V	V	V				Coin	V	T		V		V																																																								0	2400	307.765916	6.31017338	0	0	198.012424	14.12143225	7.07620043	499.3415019	0	0	0	117.7936401	0	23.0348378	3855.955792	3536.2147	273.3877536	0	0	0	0	934.0665904	8.165149594	0	35.53774484	0	16.73433539	0	0	0	0											1a. $150 copay / admit	1b. $150 copay /admit	2. no copay	6. no copay	10a. $50 copay	"11a. 10% coinsurance (no copay on rentals), $1000 OOP Max"	"11b. 10% coins, 11c. no coins"	"4a. $50 copay, 4b. $10 copay"	9a/9b. no copay	8a. no copay	8b. no copay	5. $20 copay	12. no copay	"3/9d. no copay, 9c. $20 copay"	7a/14b-i. $10 copay	"7b/7d/7f/7g. $15 copay, 14j. $10-$15 copay"	7e/7h. $20 copay	7c/7i. no copay			15. no copay	"13a/17b. no copay, 16b. $10-15 copay, 17a/18a. $15 copay"	10b. $25 copay		17a1. $15 copay		18a1. $10 - $15 copay			"14a. $10 nutrition, $0 other"												143.6507258	143.6507258	0	0	47.87293996	0.021959775	0.00855489	36.98239042	0	0	0	19.14917598	0	19.14917598	9.583096232	14.37464435	19.16619246	0	0	0	0	14.36188199	25	0	15	0	12.5	0	0	0	0											3.6842	0.075538415	0	0	0.789953074	0.310103477	0.060536114	1.538903531	0	0	0	0.187970929	0	0.03675818	3.079332951	4.235985721	0.436650192	0	0	0	0	1.117912845	0.017010728	0	0.044422181	0	0.017431599	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.6327	0	0.682305756	3.6842	0.075538415	0	0	0.789953074	0.310103477	0.060536114	1.538903531	0	0	0	0.187970929	0	0.03675818	3.079332951	4.235985721	0.436650192	0	0	0	0	1.117912845	0.017010728	0	0.044422181	0	0.017431599	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.6327		$800-$1000 / admit	$800-$1000 / admit	"$100-$120 / day, days 21-103"	$120 / day		20%	20%		20%-30%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%			20%		20%			0.5	0.2											0.2595	0	0.0645	0.006	0	0.3995	0.1477	0	0.1165	0.0022	0.0778	0.0002	0	0.0085	0	3.3764	0.0011	0.3358	0.082	0.0004	0.1747	0.1994	0	0	0.0006	0	0.0059	0	0	0	0.0001	0										5.2587	110	1.704796196	3.9438	0.075538415	0.064525366	0.00600397	0.789953074	0.709611209	0.208270744	1.538903531	0.116493749	0.002173683	0.077759605	0.188138997	0	0.045251232	3.079332951	7.612419441	0.437709796	0.335783514	0.081952814	0.000363293	0.17470596	1.317313279	0.017010728	0	0.045005451	0	0.023324297	0	0	0	0.000108922	0	0	0	0	0	0	0	0	0	0	20.8914
H5525_002_0	2008	2																					1000											A	A			T	Coin	Coin	V				V		V	V	V	V				Coin	V	T		V		V																																																								0	2400	327.1576709	6.707765606	0	0	210.4888166	15.01119729	7.522058587	530.8040762	0	0	0	125.2155971	0	24.48621985	4098.912356	3759.024976	290.6134047	0	0	0	0	992.9203797	8.679620402	0	37.77691169	0	17.78873458	0	0	0	0											1a. $150 copay / admit	1b. $150 copay /admit	2. no copay	6. no copay	10a. $50 copay	"11a. 10% coinsurance (no copay on rentals), $1000 OOP Max"	"11b. 10% coins, 11c. no coins"	"4a. $50 copay, 4b. $10 copay"	9a/9b. no copay	8a. no copay	8b. no copay	5. $20 copay	12. no copay	"3/9d. no copay, 9c. $20 copay"	7a/14b-i. $10 copay	"7b/7d/7f/7g. $15 copay, 14j. $10-$15 copay"	7e/7h. $20 copay	7c/7i. no copay			15. no copay	"13a/17b. no copay, 16b. $10-15 copay, 17a/18a. $15 copay"	10b. $25 copay		17a1. $15 copay		18a1. $10 - $15 copay			"14a. $10 nutrition, $0 other"												143.4008616	143.4008616	0	0	47.78923336	0.021921378	0.008539931	36.91840119	0	0	0	19.11569334	0	19.11569334	9.566689739	14.35003461	19.13337948	0	0	0	0	14.33677001	25	0	15	0	12.5	0	0	0	0											3.9096	0.080158281	0	0	0.838258265	0.329066132	0.064237864	1.633036487	0	0	0	0.199465246	0	0.039005922	3.267751898	4.495178208	0.463368046	0	0	0	0	1.186272593	0.018082543	0	0.04722114	0	0.018529932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.5892	0	0.753839299	3.9096	0.080158281	0	0	0.838258265	0.329066132	0.064237864	1.633036487	0	0	0	0.199465246	0	0.039005922	3.267751898	4.495178208	0.463368046	0	0	0	0	1.186272593	0.018082543	0	0.04722114	0	0.018529932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.5892		$800-$1000 / admit	$800-$1000 / admit	"$100-$120 / day, days 21-103"	$120 / day		20%	20%		20%-30%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%			20%		20%			0.5	0.2											0.2759	0	0.0686	0.0064	0	0.4247	0.157	0	0.1238	0.0023	0.0827	0.0002	0	0.009	0	3.5892	0.0011	0.3569	0.0871	0.0004	0.1857	0.212	0	0	0.0006	0	0.0063	0	0	0	0.0001	0										5.59	110	1.861768231	4.1855	0.080158281	0.068590989	0.006382268	0.838258265	0.753746099	0.221280977	1.633036487	0.123833802	0.002310643	0.082659093	0.199643904	0	0.048034106	3.267751898	8.084354704	0.464494414	0.356940606	0.087116507	0.000386183	0.185713856	1.398236875	0.018082543	0	0.04784116	0	0.024793918	0	0	0	0.000115785	0	0	0	0	0	0	0	0	0	0	22.1792
H5525_003_0	2008	3																					1000											A	A			T	Coin	Coin	V				V		V	V	V	V				Coin	V	T	Coin	V		V																																																								0	2400	319.6511852	6.553858938	0	0	205.6592453	14.66677211	7.349468333	518.6250152	0	0	0	122.3425815	0	23.92439454	4004.864653	3672.775837	283.9454107	0	0	0	0	970.1382677	8.480470412	54.43758698	36.91013742	0	17.38058005	0	0	0	0											1a. $150 copay / admit	1b. $150 copay /admit	2. no copay	6. no copay	10a. $50 copay	"11a. 10% coinsurance (no copay on rentals), $1000 OOP Max"	"11b. 10% coins, 11c. no coins"	"4a. $50 copay, 4b. $10 copay"	9a/9b. no copay	8a. no copay	8b. no copay	5. $20 copay	12. no copay	"3/9d. no copay, 9c. $20 copay"	7a/14b-i. $10 copay	"7b/7d/7f/7g. $15 copay, 14j. $10-$15 copay"	7e/7h. $20 copay	7c/7i. no copay			15. no copay	"13a/17b. no copay, 16b. $10-15 copay, 17a/18a. $15 copay"	10b. $25 copay	"16. 90/75/50 dental plan, $250 deductible (class II & III), $850 annual max"	17a1. $15 copay	"17b1. no copay, $150 annual max"	18a1. $10 - $15 copay			"14a. $10 nutrition, $0 other"												143.4944313	143.4944313	0	0	47.82058001	0.021935757	0.008545533	36.94236403	0	0	0	19.128232	0	19.128232	9.572833682	14.35925052	19.14566736	0	0	0	0	14.346174	25	0.588377431	15	0	12.5	0	0	0	0											3.8223	0.078370188	0	0	0.819562033	0.321726751	0.062805124	1.596602842	0	0	0	0.19501644	0	0.038135947	3.19482527	4.39485903	0.453027032	0	0	0	0	1.159814366	0.017667647	32.02984757	0.046137672	0	0.018104771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.2488	0	0.726099292	3.8223	0.078370188	0	0	0.819562033	0.321726751	0.062805124	1.596602842	0	0	0	0.19501644	0	0.038135947	3.19482527	4.39485903	0.453027032	0	0	0	0	1.159814366	0.017667647	32.02984757	0.046137672	0	0.018104771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.2488		$800-$1000 / admit	$800-$1000 / admit	"$100-$120 / day, days 21-103"	$120 / day		20%	20%		20%-30%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%			20%		20%			0.5	0.2											0.2696	0	0.067	0.0062	0	0.4149	0.1534	0	0.121	0.0023	0.0808	0.0002	0	0.0088	0	3.5068	0.0011	0.3488	0.0851	0.0004	0.1815	0.2071	0	0	0.0108	0	0.0061	0	0	0	0.0001	0										5.472	110	1.866998386	4.0919	0.078370188	0.0670172	0.00623583	0.819562033	0.736662627	0.216244953	1.596602842	0.120992491	0.002257627	0.080762517	0.195190999	0	0.046956983	3.19482527	7.901683483	0.454127556	0.348750764	0.085117658	0.000377322	0.181452735	1.366915223	0.017667647	32.02984757	0.056929856	0	0.024225032	0	0	0	0.000113129	0	0	0	0	0	0	0	0	0	0	53.7208
H5525_004_0	2008	3																					1000											A	A			T	Coin	Coin	V				V		V	V	V	V				Coin	V	T		V		V																																																								0	2400	300.2594303	6.156266713	0	0	193.1828527	13.77700707	6.903610176	487.1624409	0	0	0	114.9206245	0	22.47301248	3761.908089	3449.965561	266.7197596	0	0	0	0	911.2844785	7.965999604	0	34.67097057	0	16.32618087	0	0	0	0											1a. $150 copay / admit	1b. $150 copay /admit	2. no copay	6. no copay	10a. $50 copay	"11a. 10% coinsurance (no copay on rentals), $1000 OOP Max"	"11b. 10% coins, 11c. no coins"	"4a. $50 copay, 4b. $10 copay"	9a/9b. no copay	8a. no copay	8b. no copay	5. $20 copay	12. no copay	"3/9d. no copay, 9c. $20 copay"	7a/14b-i. $10 copay	"7b/7d/7f/7g. $15 copay, 14j. $10-$15 copay"	7e/7h. $20 copay	7c/7i. no copay			15. no copay	"13a/17b. no copay, 16b. $10-15 copay, 17a/18a. $15 copay"	10b. $25 copay		17a1. $15 copay		18a1. $10 - $15 copay			"14a. $10 nutrition, $0 other"												143.7536518	143.7536518	0	0	47.90742103	0.021975592	0.008561051	37.00874936	0	0	0	19.16296841	0	19.16296841	9.589854523	14.38478178	19.17970905	0	0	0	0	14.37222631	25	0	15	0	12.5	0	0	0	0											3.5969	0.073748818	0	0	0.771241022	0.302757885	0.059102162	1.502439389	0	0	0	0.183518358	0	0.035887469	3.006345942	4.13558348	0.426300615	0	0	0	0	1.09143223	0.016595833	0	0.043338713	0	0.017006438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.2622	0	0.675773583	3.5969	0.073748818	0	0	0.771241022	0.302757885	0.059102162	1.502439389	0	0	0	0.183518358	0	0.035887469	3.006345942	4.13558348	0.426300615	0	0	0	0	1.09143223	0.016595833	0	0.043338713	0	0.017006438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.2622		$800-$1000 / admit	$800-$1000 / admit	"$100-$120 / day, days 21-103"	$120 / day		20%	20%		20%-30%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%			20%		20%			0.5	0.2											0.2532	0	0.063	0.0059	0	0.3898	0.1441	0	0.1137	0.0021	0.0759	0.0002	0	0.0083	0	3.2941	0.001	0.3276	0.08	0.0004	0.1704	0.1945	0	0	0.0006	0	0.0057	0	0	0	0.0001	0										5.1304	110	1.644433717	3.8502	0.073748818	0.062951577	0.005857531	0.771241022	0.692521526	0.203233509	1.502439389	0.113652438	0.002120667	0.07586303	0.183682327	0	0.044173373	3.006345942	7.429665158	0.427334376	0.327593673	0.079953965	0.000354432	0.170444839	1.285969238	0.016595833	0	0.043907757	0	0.022755412	0	0	0	0.000106266	0	0	0	0	0	0	0	0	0	0	20.3927
H5525_801_0	2008	1																					1000											A	A			T	Coin	Coin	V				V		V	V	V	V				Coin	V	T		V		V																																																								0	2400	305.9043528	6.272005453	0	0	197.4087276	14.0783791	7.054626648	497.8191193	0	0	0	117.4345132	0	22.70801376	3603.937339	3335.894119	266.4974931	0	0	0	0	905.8402399	8.140255845	0	34.06531093	0	15.7863636	0	0	0	0											1a. $300 copay / admit	1b. $300 copay /admit	2. no copay	6. no copay	10a. $50 copay	"11a. 20% coinsurance (no copay on rentals), $1000 OOP Max"	"11b. 20% coins, 11c. no coins"	"4a. $50 copay, 4b. $20 copay"	9a/9b. no copay	8a. no copay	8b. no copay	5. $40 copay	12. no copay	"3/9d. no copay, 9c. $30 copay"	7a/14b-i. $20 copay	"7b/7d/7f/7g. $30 copay, 14j. $20 copay"	7e/7h. $30 copay	7c/7i. no copay			15. no copay	"13a/17b. no copay, 16b. $10-50 copay, 17a/18a. $30 copay"	10b. $25 copay		17a1. $20 - $30 copay		18a1. $20 - $30 copay			"14a. $10 nutrition, $0 other"												275.9043931	275.9043931	0	0	45.96388494	0.042168147	0.016427484	38.64356672	0	0	0	36.77110795	0	27.57833097	18.4178429	27.62676435	27.62676435	0	0	0	0	27.57833097	25	0	25	0	25	0	0	0	0											7.0334	0.144206155	0	0	0.756139337	0.593659155	0.115889763	1.603125529	0	0	0	0.359849763	0	0.052187427	5.531395978	7.679996726	0.61353862	0	0	0	0	2.081796828	0.016958866	0	0.070969398	0	0.032888258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.686	0	2.301379146	7.0334	0.144206155	0	0	0.756139337	0.593659155	0.115889763	1.603125529	0	0	0	0.359849763	0	0.052187427	5.531395978	7.679996726	0.61353862	0	0	0	0	2.081796828	0.016958866	0	0.070969398	0	0.032888258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.686		$800-$1000 / admit	$800-$1000 / admit	"$100-$120 / day, days 21-103"	$120 / day		20%	20%		20%-30%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%			20%		20%			0.5	0.2											0.258	0	0.0643	0.006	0	0.3983	0.1473	0	0.1161	0.0022	0.0775	0.0002	0	0.0085	0	3.2094	0.001	0.3192	0.0779	0.0003	0.1742	0.1934	0	0	0.0006	0	0.0056	0	0	0	0.0001	0										5.0599	110	1.600158916	7.2913	0.144206155	0.064328643	0.005985665	0.756139337	0.991948876	0.263173983	1.603125529	0.116138585	0.002167056	0.077522534	0.360017319	0	0.060654585	5.531395978	10.88937824	0.614545799	0.319170312	0.077898122	0.000345319	0.17417332	2.275171624	0.016958866	0	0.071550889	0	0.038447144	0	0	0	0.00010859	0	0	0	0	0	0	0	0	0	0	31.7459
H5525_802_0	2008	1																					1000											A	A			T	Coin	Coin	V				V		V	V	V	V				Coin	V	T		V		V																																																								0	2400	305.9043528	6.272005453	0	0	197.4087276	14.0783791	7.054626648	497.8191193	0	0	0	117.4345132	0	22.70801376	3603.937339	3335.894119	266.4974931	0	0	0	0	905.8402399	8.140255845	0	34.06531093	0	15.7863636	0	0	0	0											1a. $300 copay / admit	1b. $300 copay /admit	2. no copay	6. no copay	10a. $50 copay	"11a. 20% coinsurance (no copay on rentals), $1000 OOP Max"	"11b. 20% coins, 11c. no coins"	"4a. $50 copay, 4b. $20 copay"	9a/9b. no copay	8a. no copay	8b. no copay	5. $40 copay	12. no copay	"3/9d. no copay, 9c. $30 copay"	7a/14b-i. $20 copay	"7b/7d/7f/7g. $30 copay, 14j. $20 copay"	7e/7h. $30 copay	7c/7i. no copay			15. no copay	"13a/17b. no copay, 16b. $10-50 copay, 17a/18a. $30 copay"	10b. $25 copay		17a1. $20 - $30 copay		18a1. $20 - $30 copay			"14a. $10 nutrition, $0 other"												275.9043931	275.9043931	0	0	45.96388494	0.042168147	0.016427484	38.64356672	0	0	0	36.77110795	0	27.57833097	18.4178429	27.62676435	27.62676435	0	0	0	0	27.57833097	25	0	25	0	25	0	0	0	0											7.0334	0.144206155	0	0	0.756139337	0.593659155	0.115889763	1.603125529	0	0	0	0.359849763	0	0.052187427	5.531395978	7.679996726	0.61353862	0	0	0	0	2.081796828	0.016958866	0	0.070969398	0	0.032888258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.686	0	2.301379146	7.0334	0.144206155	0	0	0.756139337	0.593659155	0.115889763	1.603125529	0	0	0	0.359849763	0	0.052187427	5.531395978	7.679996726	0.61353862	0	0	0	0	2.081796828	0.016958866	0	0.070969398	0	0.032888258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.686		$800-$1000 / admit	$800-$1000 / admit	"$100-$120 / day, days 21-103"	$120 / day		20%	20%		20%-30%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%			20%		20%			0.5	0.2											0.258	0	0.0643	0.006	0	0.3983	0.1473	0	0.1161	0.0022	0.0775	0.0002	0	0.0085	0	3.2094	0.001	0.3192	0.0779	0.0003	0.1742	0.1934	0	0	0.0006	0	0.0056	0	0	0	0.0001	0										5.0599	110	1.600158916	7.2913	0.144206155	0.064328643	0.005985665	0.756139337	0.991948876	0.263173983	1.603125529	0.116138585	0.002167056	0.077522534	0.360017319	0	0.060654585	5.531395978	10.88937824	0.614545799	0.319170312	0.077898122	0.000345319	0.17417332	2.275171624	0.016958866	0	0.071550889	0	0.038447144	0	0	0	0.00010859	0	0	0	0	0	0	0	0	0	0	31.7459
H5525_805_0	2008	1																					1000											A	A			T	Coin	Coin	V				V		V	V	V	V				Coin	V	T		V		V																																																								0	2400	305.9043528	6.272005453	0	0	197.4087276	14.0783791	7.054626648	497.8191193	0	0	0	117.4345132	0	22.70801376	3603.937339	3335.894119	266.4974931	0	0	0	0	905.8402399	8.140255845	0	34.06531093	0	15.7863636	0	0	0	0											1a. $300 copay / admit	1b. $300 copay /admit	2. no copay	6. no copay	10a. $50 copay	"11a. 20% coinsurance (no copay on rentals), $1000 OOP Max"	"11b. 20% coins, 11c. no coins"	"4a. $50 copay, 4b. $20 copay"	9a/9b. no copay	8a. no copay	8b. no copay	5. $40 copay	12. no copay	"3/9d. no copay, 9c. $30 copay"	7a/14b-i. $20 copay	"7b/7d/7f/7g. $30 copay, 14j. $20 copay"	7e/7h. $30 copay	7c/7i. no copay			15. no copay	"13a/17b. no copay, 16b. $10-50 copay, 17a/18a. $30 copay"	10b. $25 copay		17a1. $20 - $30 copay		18a1. $20 - $30 copay			"14a. $10 nutrition, $0 other"												275.9043931	275.9043931	0	0	45.96388494	0.042168147	0.016427484	38.64356672	0	0	0	36.77110795	0	27.57833097	18.4178429	27.62676435	27.62676435	0	0	0	0	27.57833097	25	0	25	0	25	0	0	0	0											7.0334	0.144206155	0	0	0.756139337	0.593659155	0.115889763	1.603125529	0	0	0	0.359849763	0	0.052187427	5.531395978	7.679996726	0.61353862	0	0	0	0	2.081796828	0.016958866	0	0.070969398	0	0.032888258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.686	0	2.301379146	7.0334	0.144206155	0	0	0.756139337	0.593659155	0.115889763	1.603125529	0	0	0	0.359849763	0	0.052187427	5.531395978	7.679996726	0.61353862	0	0	0	0	2.081796828	0.016958866	0	0.070969398	0	0.032888258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.686		$800-$1000 / admit	$800-$1000 / admit	"$100-$120 / day, days 21-103"	$120 / day		20%	20%		20%-30%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%			20%		20%			0.5	0.2											0.258	0	0.0643	0.006	0	0.3983	0.1473	0	0.1161	0.0022	0.0775	0.0002	0	0.0085	0	3.2094	0.001	0.3192	0.0779	0.0003	0.1742	0.1934	0	0	0.0006	0	0.0056	0	0	0	0.0001	0										5.0599	110	1.600158916	7.2913	0.144206155	0.064328643	0.005985665	0.756139337	0.991948876	0.263173983	1.603125529	0.116138585	0.002167056	0.077522534	0.360017319	0	0.060654585	5.531395978	10.88937824	0.614545799	0.319170312	0.077898122	0.000345319	0.17417332	2.275171624	0.016958866	0	0.071550889	0	0.038447144	0	0	0	0.00010859	0	0	0	0	0	0	0	0	0	0	31.7459
H5526_001_0	2008	3																																A	A	A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V																																																							0		215.4964351	0.952325818	33.08743018		194.4811126	9.225113713	2.210206118	252.2076329	412.7274967		1957.644638	0.429493075		20.51725078	3609.05425	5997.87664	0.779558268	967.5213974	1848.086334	2267.901304	15.14059729	130.5579715			545.1713949	0.910364936	0	16.8385498		100												$250 Copay	$250 Copay	$250 Copay		$50 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	$100 Copay		$15 Copay	50% Coinsurance		20% Coinsurance	$15 Copay	$15 Copay	50% Coinsurance	$15 Copay	$15 Copay	$15 Copay	20% Coinsurance	$15 Copay			$15 Copay	$15 Copay	$15 Copay	$15 Copay		$10 Copay												250	250	250		50	0.25	0.25	50	100		15	0.5		0.2	15	15	0.5	15	15	15	0.2	15			15	15	15	15		10												4.4895	0.019840121	0.689321462	0	0.810337969	2.306278428	0.552551529	1.050865137	3.439395806	0	2.447055797	0.214746538	0	4.103450157	4.511317812	7.497345799	0.389779134	1.209401747	2.310107918	2.83487663	3.028119457	0.163197464	0	0	0.681464244	0.001137956	0	0.021048187	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	42.8545		0.75	4.4895	0.019840121	0.689321462	0	0.810337969	2.306278428	0.552551529	1.050865137	3.439395806	0	2.447055797	0.214746538	0	4.103450157	4.511317812	7.497345799	0.389779134	1.209401747	2.310107918	2.83487663	3.028119457	0.163197464	0	0	0.681464244	0.001137956	0	0.021048187	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	42.8545	3250	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$50 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance	$20 Copay	$20 Copay	55% Coinsurance	$20 Copay	55% Coinsurance	$20 Copay	$20 Copay	50% Coinsurance	$20 Copay	$20 Copay	$20 Copay	20% Coinsurance	$20 Copay			$20 Copay	$20 Copay	$20 Copay	$20 Copay														4.7619	0.0056	0.2894	0.0098	0.2772	0.439	0.091	0.0496	0.4162	0.51	0.1145	0.1566	0.0052	0.8397	1.1283	3.0446	0.1068	0.251	1.3132	3.0305	0.504	0.0024			0.1308	0.0002	0	0.0183														17.4958		0.31	9.2514	0.025426482	0.978733135	0.009792384	1.087570774	2.745277253	0.643540594	1.100450774	3.855603961	0.509983602	2.56150818	0.371370213	0.005239237	4.943169293	5.639589631	10.54191383	0.496619525	1.460409116	3.623271681	5.865359657	3.532155831	0.165629967	0	0	0.812223526	0.00134818	0	0.039337669	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	60.3502
H5526_002_0	2008	3																																A	A	A		T	Coin	Coin	V	V	Coin	V	Coin	V	Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		268.7312367	1.151468779	23.50078142		190.1732469	11.52740544	3.246312118	229.6365596	367.4361122	0	626.584135	0.022551387	0	12.41920701	4072.01325	5382.158554	0.753915586	1072.216543	1053.842677	1529.814408	7.704728098	16.83327214			749.5047263	0	0	30.9397943		100												$250 Copay	$250 Copay	$250 Copay		$50 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$50 Copay	0% Coinsurance	$20 Copay	50% Coinsurance	0% Coinsurance	20% Coinsurance	$10 Copay	$20 Copay	50% Coinsurance	$20 Copay	$20 Copay	$20 Copay	20% Coinsurance	$20 Copay			$20 Copay	$20 Copay	$20 Copay	$20 Copay		$10 Copay												250	250	250		50	0.3	0.3	50	50	0	20	0.5	0	0.2	10	20	0.5	20	20	20	0.2	20			20	20	20	20		10												5.5986	0.023988933	0.489599613	0	0.792388529	3.458221632	0.973893635	0.956818998	1.530983801	0	1.044306892	0.011275693	0	2.483841402	3.393344375	8.970264257	0.376957793	1.787027571	1.756404462	2.54969068	1.54094562	0.028055454	0	0	1.249174544	0	0	0.051566324	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	39.1507		0.72	5.5986	0.023988933	0.489599613	0	0.792388529	3.458221632	0.973893635	0.956818998	1.530983801	0	1.044306892	0.011275693	0	2.483841402	3.393344375	8.970264257	0.376957793	1.787027571	1.756404462	2.54969068	1.54094562	0.028055454	0	0	1.249174544	0	0	0.051566324	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	39.1507	3250	20% Coinsurance	20% Coinsurance	20% Coinsurance	$25 Copay	$50 Copay	35% Coinsurance	35% Coinsurance	$50 Copay	$75 Copay	$25 Copay	$25 Copay	55% Coinsurance	$25 Copay	55% Coinsurance	$15 Copay	$25 Copay	50% Coinsurance	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$25 Copay			$25 Copay	$25 Copay	$25 Copay	$25 Copay														4.7205	0.0115	0.612	0.007	0.2986	0.4782	0.1934	0.0634	0.1816	0.3301	0.1531	0.0443	0.0074	0.769	0.7595	2.8348	0.0858	0.2896	1.2502	4.5467	0.2349	0.0078			0.214	0	0	0.0296														18.123		0.34	10.3191	0.035462285	1.101573014	0.007027334	1.091030623	3.936378642	1.167312724	1.020181849	1.712609506	0.330117781	1.197456037	0.055584677	0.007394558	3.252813727	4.152862451	11.80504429	0.46273078	2.076618915	3.006649659	7.096369532	1.775893025	0.035833928	0	0	1.463157812	0	0	0.08116914	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	57.2737
H5526_003_0	2008	6																																A	A	A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V																																																							0		215.4964351	0.952325818	33.08743018		194.4811126	9.225113713	2.210206118	252.2076329	412.7274967		1957.644638	0.429493075		20.51725078	3609.05425	5997.87664	0.779558268	967.5213974	1848.086334	2267.901304	15.14059729	130.5579715			545.1713949	0.910364936	0	16.8385498		100												$250 Copay	$250 Copay	$250 Copay		$50 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	$100 Copay		$15 Copay	50% Coinsurance		20% Coinsurance	$15 Copay	$15 Copay	50% Coinsurance	$15 Copay	$15 Copay	$15 Copay	20% Coinsurance	$15 Copay			$15 Copay	$15 Copay	$15 Copay	$15 Copay		$10 Copay												250	250	250		50	0.25	0.25	50	100		15	0.5		0.2	15	15	0.5	15	15	15	0.2	15			15	15	15	15		10												4.4895	0.019840121	0.689321462	0	0.810337969	2.306278428	0.552551529	1.050865137	3.439395806	0	2.447055797	0.214746538	0	4.103450157	4.511317812	7.497345799	0.389779134	1.209401747	2.310107918	2.83487663	3.028119457	0.163197464	0	0	0.681464244	0.001137956	0	0.021048187	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	42.8545		0.75	4.4895	0.019840121	0.689321462	0	0.810337969	2.306278428	0.552551529	1.050865137	3.439395806	0	2.447055797	0.214746538	0	4.103450157	4.511317812	7.497345799	0.389779134	1.209401747	2.310107918	2.83487663	3.028119457	0.163197464	0	0	0.681464244	0.001137956	0	0.021048187	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	42.8545	3250	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$50 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance	$20 Copay	$20 Copay	55% Coinsurance	$20 Copay	55% Coinsurance	$20 Copay	$20 Copay	50% Coinsurance	$20 Copay	$20 Copay	$20 Copay	20% Coinsurance	$20 Copay			$20 Copay	$20 Copay	$20 Copay	$20 Copay														4.7619	0.0056	0.2894	0.0098	0.2772	0.439	0.091	0.0496	0.4162	0.51	0.1145	0.1566	0.0052	0.8397	1.1283	3.0446	0.1068	0.251	1.3132	3.0305	0.504	0.0024			0.1308	0.0002	0	0.0183														17.4958		0.31	9.2514	0.025426482	0.978733135	0.009792384	1.087570774	2.745277253	0.643540594	1.100450774	3.855603961	0.509983602	2.56150818	0.371370213	0.005239237	4.943169293	5.639589631	10.54191383	0.496619525	1.460409116	3.623271681	5.865359657	3.532155831	0.165629967	0	0	0.812223526	0.00134818	0	0.039337669	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	60.3502
H5526_004_0	2008	6																																A		A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V			V		V			V																																																					0		268.7312367	1.151468779	23.50078142		190.1732469	11.52740544	3.246312118	229.6365596	370.4274521		637.0925031	0.022551387		12.41920701	3974.689815	5464.297109	0.753915586	1105.103053	1060.862413	1533.849646	7.704728098	32.74982322			771.1781449	0	0	31.19616428		100												$250 Copay	$250 Copay	$250 Copay		$50 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$50 Copay		$15 Copay	50% Coinsurance		20% Coinsurance	$10 Copay	$15 Copay	50% Coinsurance	$15 Copay	$15 Copay	$15 Copay	20% Coinsurance	$15 Copay			$15 Copay	$15 Copay	$15 Copay	$15 Copay		$10 Copay												250	250	250		50	0.3	0.3	50	50		15	0.5		0.2	10	15	0.5	15	15	15	0.2	15			15	15	15	15		10												5.5986	0.023988933	0.489599613	0	0.792388529	3.458221632	0.973893635	0.956818998	1.543447717	0	0.796365629	0.011275693	0	2.483841402	3.312241513	6.830371386	0.376957793	1.381378816	1.326078016	1.917312057	1.54094562	0.040937279	0	0	0.963972681	0	0	0.038995205	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	34.9409		0.72	5.5986	0.023988933	0.489599613	0	0.792388529	3.458221632	0.973893635	0.956818998	1.543447717	0	0.796365629	0.011275693	0	2.483841402	3.312241513	6.830371386	0.376957793	1.381378816	1.326078016	1.917312057	1.54094562	0.040937279	0	0	0.963972681	0	0	0.038995205	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	34.9409	3250	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$50 Copay	35% Coinsurance	35% Coinsurance	$50 Copay	$75 Copay	$20 Copay	$20 Copay	55% Coinsurance	$20 Copay	55% Coinsurance	$15 Copay	$20 Copay	50% Coinsurance	$20 Copay	$20 Copay	$20 Copay	20% Coinsurance	$20 Copay			$20 Copay	$20 Copay	$20 Copay	$20 Copay														4.7205	0.0115	0.612	0.0056	0.2986	0.4782	0.1934	0.0634	0.1816	0.2641	0.1225	0.0443	0.0059	0.769	0.7595	2.2678	0.0858	0.2317	1.0002	3.6373	0.2349	0.0062			0.1712	0	0	0.0237														16.1889		0.34	10.3191	0.035462285	1.101573014	0.005621867	1.091030623	3.936378642	1.167312724	1.020181849	1.725073422	0.264094225	0.918884945	0.055584677	0.005915647	3.252813727	4.071759588	9.098195409	0.46273078	1.613051891	2.326274173	5.554655139	1.775893025	0.047160058	0	0	1.135159296	0	0	0.062677458	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	51.1299
H5526_007_0	2008	8																																A	A	A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V																																																							0		215.8443041	0.952325818	33.09168154		194.4811126	9.225113713	2.210206118	252.2076329	439.3073088		1957.644638	0.429493075		20.51725078	3703.113047	5997.87664	0.779558268	967.5213974	1848.086334	2267.901304	15.14059729	130.5579715			545.1713949	0.910364936	0	16.8385498		100												$150 Copay	$150 Copay	$150 Copay		$50 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	$75 Copay		$15 Copay	50% Coinsurance		20% Coinsurance	$10 Copay	$15 Copay	50% Coinsurance	$15 Copay	$15 Copay	$15 Copay	20% Coinsurance	$15 Copay			$15 Copay	$15 Copay	$15 Copay	$15 Copay		$10 Copay												150	150	150		50	0.25	0.25	50	75		15	0.5		0.2	10	15	0.5	15	15	15	0.2	15			15	15	15	15		10												2.6981	0.011904073	0.413646019	0	0.810337969	2.306278428	0.552551529	1.050865137	2.74567068	0	2.447055797	0.214746538	0	4.103450157	3.085927539	7.497345799	0.389779134	1.209401747	2.310107918	2.83487663	3.028119457	0.163197464	0	0	0.681464244	0.001137956	0	0.021048187	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	38.6603		0.73	2.6981	0.011904073	0.413646019	0	0.810337969	2.306278428	0.552551529	1.050865137	2.74567068	0	2.447055797	0.214746538	0	4.103450157	3.085927539	7.497345799	0.389779134	1.209401747	2.310107918	2.83487663	3.028119457	0.163197464	0	0	0.681464244	0.001137956	0	0.021048187	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	38.6603	3250	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$50 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance	$20 Copay	$20 Copay	55% Coinsurance	$20 Copay	55% Coinsurance	$20 Copay	$20 Copay	50% Coinsurance	$20 Copay	$20 Copay	$20 Copay	20% Coinsurance	$20 Copay			$20 Copay	$20 Copay	$20 Copay	$20 Copay														4.7619	0.0056	0.2894	0.0098	0.2772	0.439	0.091	0.0496	0.4162	0.51	0.1145	0.1566	0.0052	0.8397	1.1283	3.0446	0.1068	0.251	1.3132	3.0305	0.504	0.0024			0.1308	0.0002	0	0.0183														17.4958		0.33	7.4599	0.017490433	0.703057693	0.009792384	1.087570774	2.745277253	0.643540594	1.100450774	3.161878836	0.509983602	2.56150818	0.371370213	0.005239237	4.943169293	4.214199358	10.54191383	0.496619525	1.460409116	3.623271681	5.865359657	3.532155831	0.165629967	0	0	0.812223526	0.00134818	0	0.039337669	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	56.1561
H5526_008_0	2008	7																																A	A	A	Coin	T	Coin	Coin	V	V	Coin	V	Coin	V	Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		269.7455447	1.151468779	23.5034568	0	190.1732469	11.52740544	3.246312118	229.6365596	395.6498857	0	661.6120287	0.022551387	0	0.117054604	4201.777831	5655.953736	0.753915586	1181.838244	1077.241795	1543.2652	7.704728098	17.32318305			821.7494549	0	0	31.79436092		100												$100 Copay	$100 Copay	$100 Copay	0% Coinsurance	$50 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$35 Copay	0% Coinsurance	$5 Copay	50% Coinsurance	0% Coinsurance	20% Coinsurance	$5 Copay	$5 Copay	50% Coinsurance	$5 Copay	$5 Copay	$5 Copay	20% Coinsurance	$5 Copay			$5 Copay	$5 Copay	$5 Copay	$5 Copay		$10 Copay												100	100	100	0	50	0.3	0.3	50	35	0	5	0.5	0	0.2	5	5	0.5	5	5	5	0.2	5			5	5	5	5		10												2.2479	0.009595573	0.19586214	0	0.792388529	3.458221632	0.973893635	0.956818998	1.153978833	0	0.275671679	0.011275693	0	0.023410921	1.750740763	2.35664739	0.376957793	0.492432601	0.448850748	0.643027167	1.54094562	0.007217993	0	0	0.342395606	0	0	0.01324765	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	18.1548		0.63	2.2479	0.009595573	0.19586214	0	0.792388529	3.458221632	0.973893635	0.956818998	1.153978833	0	0.275671679	0.011275693	0	0.023410921	1.750740763	2.35664739	0.376957793	0.492432601	0.448850748	0.643027167	1.54094562	0.007217993	0	0	0.342395606	0	0	0.01324765	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	18.1548	3250	20% Coinsurance	20% Coinsurance	20% Coinsurance	$10 Copay	$50 Copay	35% Coinsurance	35% Coinsurance	$50 Copay	20% Coinsurance	$10 Copay	$10 Copay	55% Coinsurance	$10 Copay	55% Coinsurance	$10 Copay	$10 Copay	50% Coinsurance	$10 Copay	$10 Copay	$10 Copay	20% Coinsurance	$10 Copay			$10 Copay	$10 Copay	$10 Copay	$10 Copay														4.7205	0.0115	0.612	0.0028	0.2986	0.4782	0.1934	0.0634	0.4385	0.132	0.0613	0.0443	0.003	0.769	0.5063	1.1339	0.0858	0.1158	0.5001	1.8187	0.2349	0.0031			0.0856	0	0	0.0118														12.3245		0.43	6.9684	0.021068925	0.807835541	0.002810934	1.091030623	3.936378642	1.167312724	1.020181849	1.592497447	0.132047112	0.336931337	0.055584677	0.002957823	0.792383246	2.257086147	3.490559401	0.46273078	0.608269139	0.948948827	2.461698708	1.775893025	0.010329383	0	0	0.427988914	0	0	0.025088777	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	30.4793
H5526_801_0	2008	3																																A	A	A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		269.1021319	1.161829234	27.84687054		201.7443793	11.3206172	3.060852017	235.3108998	366.3234982		988.0044316	0.136496033		14.27219065	4174.000581	5834.469233	0.800355479	1087.632847	1358.811483	1840.982627	8.98702845	47.16714748			720.3337258	0.273966047	0	28.13336639		100												$250 Copay	$250 Copay	$250 Copay		$50 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$50 Copay		$20 Copay	50% Coinsurance		20% Coinsurance	$10 Copay	$20 Copay	50% Coinsurance	$20 Copay	$20 Copay	$20 Copay	20% Coinsurance	$20 Copay			$20 Copay	$20 Copay	$20 Copay	$20 Copay		$10 Copay												250	250	250		50	0.3	0.3	50	50		20	0.5		0.2	10	20	0.5	20	20	20	0.2	20			20	20	20	20		10												5.6063	0.024204776	0.580143136	0	0.84060158	3.396185159	0.918255605	0.980462083	1.526347909	0	1.646674053	0.068248016	0	2.85443813	3.478333817	9.724115389	0.40017774	1.812721411	2.264685805	3.068304378	1.79740569	0.078611912	0	0	1.20055621	0.00045661	0	0.046888944	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	42.3974		0.74	5.6063	0.024204776	0.580143136	0	0.84060158	3.396185159	0.918255605	0.980462083	1.526347909	0	1.646674053	0.068248016	0	2.85443813	3.478333817	9.724115389	0.40017774	1.812721411	2.264685805	3.068304378	1.79740569	0.078611912	0	0	1.20055621	0.00045661	0	0.046888944	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	42.3974	3250	20% Coinsurance	20% Coinsurance	20% Coinsurance	$25 Copay	$50 Copay	35% Coinsurance	35% Coinsurance	$50 Copay	$75 Copay	$25 Copay	$25 Copay	55% Coinsurance	$25 Copay	55% Coinsurance	$15 Copay	$25 Copay	50% Coinsurance	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$25 Copay			$25 Copay	$25 Copay	$25 Copay	$25 Copay														4.7539	0.0101	0.537	0.0085	0.2957	0.4845	0.1756	0.0586	0.1669	0.418	0.1486	0.0769	0.0071	0.7787	0.7802	3.0414	0.0899	0.2957	1.334	4.4148	0.2885	0.0063			0.2048	0.0001	0	0.0284														18.4041		0.32	10.3602	0.034311837	1.117171578	0.008502703	1.136265591	3.880706584	1.09388241	1.039090246	1.693278533	0.417962816	1.795268915	0.145169113	0.007068234	3.63312025	4.258508354	12.76548623	0.490109831	2.108411703	3.598642975	7.483106816	2.085880337	0.08490507	0	0	1.405365955	0.000509173	0	0.075272689	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	60.8016
H5526_802_0	2008	3																																A	A	A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		269.1021319	1.161829234	27.84687054		201.7443793	11.3206172	3.060852017	235.3108998	366.3234982		988.0044316	0.136496033		14.27219065	4174.000581	5834.469233	0.800355479	1087.632847	1358.811483	1840.982627	8.98702845	47.16714748			720.3337258	0.273966047	0	28.13336639		100												$250 Copay	$250 Copay	$250 Copay		$50 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$50 Copay		$20 Copay	50% Coinsurance		20% Coinsurance	$10 Copay	$20 Copay	50% Coinsurance	$20 Copay	$20 Copay	$20 Copay	20% Coinsurance	$20 Copay			$20 Copay	$20 Copay	$20 Copay	$20 Copay		$10 Copay												250	250	250		50	0.3	0.3	50	50		20	0.5		0.2	10	20	0.5	20	20	20	0.2	20			20	20	20	20		10												5.6063	0.024204776	0.580143136	0	0.84060158	3.396185159	0.918255605	0.980462083	1.526347909	0	1.646674053	0.068248016	0	2.85443813	3.478333817	9.724115389	0.40017774	1.812721411	2.264685805	3.068304378	1.79740569	0.078611912	0	0	1.20055621	0.00045661	0	0.046888944	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	42.3974		0.74	5.6063	0.024204776	0.580143136	0	0.84060158	3.396185159	0.918255605	0.980462083	1.526347909	0	1.646674053	0.068248016	0	2.85443813	3.478333817	9.724115389	0.40017774	1.812721411	2.264685805	3.068304378	1.79740569	0.078611912	0	0	1.20055621	0.00045661	0	0.046888944	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	42.3974	3250	20% Coinsurance	20% Coinsurance	20% Coinsurance	$25 Copay	$50 Copay	35% Coinsurance	35% Coinsurance	$50 Copay	$75 Copay	$25 Copay	$25 Copay	55% Coinsurance	$25 Copay	55% Coinsurance	$15 Copay	$25 Copay	50% Coinsurance	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$25 Copay			$25 Copay	$25 Copay	$25 Copay	$25 Copay														4.7539	0.0101	0.537	0.0085	0.2957	0.4845	0.1756	0.0586	0.1669	0.418	0.1486	0.0769	0.0071	0.7787	0.7802	3.0414	0.0899	0.2957	1.334	4.4148	0.2885	0.0063			0.2048	0.0001	0	0.0284														18.4041		0.32	10.3602	0.034311837	1.117171578	0.008502703	1.136265591	3.880706584	1.09388241	1.039090246	1.693278533	0.417962816	1.795268915	0.145169113	0.007068234	3.63312025	4.258508354	12.76548623	0.490109831	2.108411703	3.598642975	7.483106816	2.085880337	0.08490507	0	0	1.405365955	0.000509173	0	0.075272689	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	60.8016
H5526_803_0	2008	3																																A	A	A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		274.8035727	1.186444797	28.43685948		206.1972885	11.68015498	3.15806332	238.2301042	370.86801		1000.261352	0.143682915		15.02365974	4266.129273	5963.24785	0.825774414	1111.639118	1388.803219	1881.616862	8.98702845	47.75229055			736.2329579	0.280013035	0	28.75432708		100												$250 Copay	$250 Copay	$250 Copay		$50 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$50 Copay		$20 Copay	50% Coinsurance		20% Coinsurance	$10 Copay	$20 Copay	50% Coinsurance	$20 Copay	$20 Copay	$20 Copay	20% Coinsurance	$20 Copay			$20 Copay	$20 Copay	$20 Copay	$20 Copay		$10 Copay												250	250	250		50	0.3	0.3	50	50		20	0.5		0.2	10	20	0.5	20	20	20	0.2	20			20	20	20	20		10												5.7251	0.0247176	0.592434572	0	0.859155369	3.504046495	0.947418996	0.992625434	1.545283375	0	1.667102253	0.071841457	0	3.004731947	3.555107728	9.938746417	0.412887207	1.852731864	2.314672032	3.136028104	1.79740569	0.079587151	0	0	1.22705493	0.000466688	0	0.047923878	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	43.3804		0.87	5.7251	0.0247176	0.592434572	0	0.859155369	3.504046495	0.947418996	0.992625434	1.545283375	0	1.667102253	0.071841457	0	3.004731947	3.555107728	9.938746417	0.412887207	1.852731864	2.314672032	3.136028104	1.79740569	0.079587151	0	0	1.22705493	0.000466688	0	0.047923878	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	43.3804	3250	20% Coinsurance	20% Coinsurance	20% Coinsurance	$25 Copay	$50 Copay	35% Coinsurance	35% Coinsurance	$50 Copay	$75 Copay	$25 Copay	$25 Copay	55% Coinsurance	$25 Copay	55% Coinsurance	$15 Copay	$25 Copay	50% Coinsurance	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$25 Copay			$25 Copay	$25 Copay	$25 Copay	$25 Copay														4.7539	0.0101	0.537	0.0085	0.2957	0.4845	0.1756	0.0586	0.1669	0.418	0.1486	0.0769	0.0071	0.7787	0.7802	3.0414	0.0899	0.2957	1.334	4.4148	0.2885	0.0063			0.2048	0.0001	0	0.0284														18.4041		0.37	10.479	0.034824661	1.129463014	0.008502703	1.154819379	3.988567919	1.123045801	1.051253598	1.712213999	0.417962816	1.815697115	0.148762554	0.007068234	3.783414067	4.335282265	12.98011725	0.502819298	2.148422155	3.648629203	7.550830542	2.085880337	0.085880308	0	0	1.431864675	0.000519251	0	0.076307623	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	61.7845
H5526_804_0	2008	3																																A	A	A		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V			V	V	V	V		V																																																					0		274.8035727	1.186444797	28.43685948		206.1972885	11.68015498	3.15806332	238.2301042	370.86801		1000.261352	0.143682915		15.02365974	4266.129273	5963.24785	0.825774414	1111.639118	1388.803219	1881.616862	8.98702845	47.75229055			736.2329579	0.280013035	0	28.75432708		100												$250 Copay	$250 Copay	$250 Copay		$50 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$50 Copay		$20 Copay	50% Coinsurance		20% Coinsurance	$10 Copay	$20 Copay	50% Coinsurance	$20 Copay	$20 Copay	$20 Copay	20% Coinsurance	$20 Copay			$20 Copay	$20 Copay	$20 Copay	$20 Copay		$10 Copay												250	250	250		50	0.3	0.3	50	50		20	0.5		0.2	10	20	0.5	20	20	20	0.2	20			20	20	20	20		10												5.7251	0.0247176	0.592434572	0	0.859155369	3.504046495	0.947418996	0.992625434	1.545283375	0	1.667102253	0.071841457	0	3.004731947	3.555107728	9.938746417	0.412887207	1.852731864	2.314672032	3.136028104	1.79740569	0.079587151	0	0	1.22705493	0.000466688	0	0.047923878	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	43.3804		0.87	5.7251	0.0247176	0.592434572	0	0.859155369	3.504046495	0.947418996	0.992625434	1.545283375	0	1.667102253	0.071841457	0	3.004731947	3.555107728	9.938746417	0.412887207	1.852731864	2.314672032	3.136028104	1.79740569	0.079587151	0	0	1.22705493	0.000466688	0	0.047923878	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	43.3804	3250	20% Coinsurance	20% Coinsurance	20% Coinsurance	$25 Copay	$50 Copay	35% Coinsurance	35% Coinsurance	$50 Copay	$75 Copay	$25 Copay	$25 Copay	55% Coinsurance	$25 Copay	55% Coinsurance	$15 Copay	$25 Copay	50% Coinsurance	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$25 Copay			$25 Copay	$25 Copay	$25 Copay	$25 Copay														4.7539	0.0101	0.537	0.0085	0.2957	0.4845	0.1756	0.0586	0.1669	0.418	0.1486	0.0769	0.0071	0.7787	0.7802	3.0414	0.0899	0.2957	1.334	4.4148	0.2885	0.0063			0.2048	0.0001	0	0.0284														18.4041		0.37	10.479	0.034824661	1.129463014	0.008502703	1.154819379	3.988567919	1.123045801	1.051253598	1.712213999	0.417962816	1.815697115	0.148762554	0.007068234	3.783414067	4.335282265	12.98011725	0.502819298	2.148422155	3.648629203	7.550830542	2.085880337	0.085880308	0	0	1.431864675	0.000519251	0	0.076307623	0	0.083333333	0	0	0	0	0	0	0	0	0	0	0	61.7845
H5528_001_0	2008	7	i.6.	i.6.	i.6.	i.6.	i.6.	i.6.					Professional	Professional	Professional	Professional	Professional	Professional					Unlimited	Chiropractic	Podiatry	Hearing Exams	High Tech Radiology	Vision Exams	Hepatitis B					A	A	D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	Coin			V	V	V					Coin	V	V	V	V	V	V																																														0	Unlimited	267.6739136	13.16639755	1100.328199	1753.05675	406.6776978	4.3965		155.4013648	160.2299424	291.8825888	285.1817056			588.5937552	3752.880292	4041.401341	569.8382586	1031.147919	233.5714416	2106.539609	2.655			39.2	502.2331335	502.3441733						300.8088145	641.2421124	6.386732267	250.5252447	654.0451731	1.94					$0 per stay	$0 per stay	$0 copayment days 1-100	$0 copayment	$50 copayment	Diabetic Supplies @ 0%; all others: 20% coinsurance	20% coinsurance	"ER @ $50 copayment; Urgent Care @ $0 if admisistered by PCP, $10 for a specialist"	$0 copayment	$0 copayment	Outpatient Radiation Therapy @ $20 copayment; Others: $0			"CORF, Outpatient Rehab, Substance Abuse, Partial Hospital @ $10 copayment; Other: $0"	$0 copayment	$10 copayment	$10 copayment	$10 copayment	$10 copayment	$10 copayment	0% coinsurance			$0 copay	$0 copay	$0 copayment for eyewear every year						$10 copayment	$10 copayment	$10 copayment	$0 copayment	$10 copayment	$10 copayment					0	0	0	0	50	0.2	0.2	50	0	0	2.76			0.67	0	10	10	10	10	10	0			0	0	0						10	10	10	0	10	10					0	0	0	0	1.694490407	0.8793	0	0.647505687	0	0	0.065591792	0	0	0.032863151	0	3.367834451	0.474865215	0.859289933	0.194642868	1.755449674	0	0	0	0	0	0	0	0	0	0	0	0.250674012	0.534368427	0.005322277	0	0.545037644	0.001616667	0	0	0	0	11.3089	0	0	0	0	0	0	1.694490407	0.8793	0	0.647505687	0	0	0.065591792	0	0	0.032863151	0	3.367834451	0.474865215	0.859289933	0.194642868	1.755449674	0	0	0	0	0	0	0	0	0	0	0	0.250674012	0.534368427	0.005322277	0	0.545037644	0.001616667	0	0	0	0	11.3089	Unlimited	25%; $1500 OOP Max	25%; $7500 OOP Max	25% coinsurance after Ded	$40 copayment	"25%, no deductible"	50% coinsurance after Ded	50% coinsurance after Ded	"ER @ $50 copayment; Urgent Care @ $0 if admisistered by PCP, $10 for a specialist"	25% coinsurance after Ded	25% coinsurance after Ded	25% coinsurance after Ded			"50% outpatient rehab & substance abuse, CORF, Partial Hospital; all other 25% after ded"	25% coinsurance after Ded	25% coinsurance after Ded	50% coinsurance after Ded	50% coinsurance after Ded	25% coinsurance after Ded	25% coinsurance after Ded	50% coinsurance after Ded			50% coinsurance after Ded	50% coinsurance after Ded	50% coinsurance after Ded					Routine Physicals @25% after Ded	$40 copayment	$40 copayment	$40 copayment		50% coinsurance after Ded						1.991	0.056	1.156	0.526	0.277	0.493		0.186	1.288	0.21	0.948			0.864	1.3041	4.0149	0.312	0.566	1.423	2.382	0.17			0.001	0.0496	0.0594					0.026	0.108	0.273	0.003		0.0782						18.7652	150	6.6	1.991	0.056	1.156	0.526	1.971490407	1.3723	0	0.833505687	1.288	0.21	1.013591792	0	0	0.896863151	1.304139964	7.382694487	0.786865215	1.425289933	1.617642868	4.137449674	0.17	0	0	0.001	0.0496	0.0594	0	0	0	0	0.026	0.358674012	0.807368427	0.008322277	0	0.623237644	0.001616667	0	0	0	0	30.0741
H5528_002_0	2008	6	i.6.	i.6.	i.6.	i.6.	i.6.	i.6.					Professional	Professional	Professional	Professional	Professional	Professional					Unlimited	Chiropractic	Podiatry	Hearing Exams	High Tech Radiology	Vision Exams	Hepatitis B					A	A	D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	Coin				V	V					Coin	V	V	V	V	V	V																																														0	Unlimited	262.940976	12.93359288	1080.872494	1722.059676	399.486933	4.2885		152.6536	157.3968	286.7216	280.1392			578.1864	3686.52288	3969.942378	559.762533	1012.915441	229.4414947	2069.258044	2.61				493.3527834	493.4618598						295.4899945	629.9038433	6.273803799	246.0955252	642.4805237	1.94					$0 per stay	$0 per stay	$0 days 1-20; $50 per day for days 21-100	$0 copayment	$50 copayment	Diabetic Supplies @ 0%; All Other: 20% coinsurance	20% coinsurance	$50 copayment	$0 copayment	$0 copayment	Outpatient Radiology Therapy @$20 copayment; $75 High-tech Radiology; Others: $0			"CORF, Outpatient Rehab, Substance Abuse, Partial Hospital @ $20 copayment; Other: $0"	$0 copayment	$10 copayment	$20 copayment	$20 copayment	$10 copayment	$10 copayment	0% coinsurance				$0 copay	Eyewear every year						$10 copayment	$10 copayment	$10 copayment	$75 copayment	$10 copayment	$10 copayment					0	0	24.25	0	50	0.2	0.2	50	0	0	7.86			1.34	0	10	20	20	10	10	0				0	0						10	10	10	75	10	10					0	0	2.184263164	0	1.664528888	0.8577	0	0.636056667	0	0	0.183491176	0	0	0.064564148	0	3.308285315	0.932937555	1.688192402	0.191201246	1.724381704	0	0	0	0	0	0	0	0	0	0	0	0.246241662	0.524919869	0.00522817	1.538097033	0.535400436	0.001616667	0	0	0	0	16.2871	0	0	0	0	2.184263164	0	1.664528888	0.8577	0	0.636056667	0	0	0.183491176	0	0	0.064564148	0	3.308285315	0.932937555	1.688192402	0.191201246	1.724381704	0	0	0	0	0	0	0	0	0	0	0	0.246241662	0.524919869	0.00522817	1.538097033	0.535400436	0.001616667	0	0	0	0	16.2871	Unlimited	25%; $1500 OOP Max	25%; $1500 OOP Max	25% coinsurance after Ded	$40 copayment	"25%, no deductible"	50% coinsurance after Ded	50% coinsurance after Ded	$50 copayment	25% coinsurance after Ded	25% coinsurance after Ded	25% coinsurance after Ded			"50% outpatient rehab & substance abuse, CORF, Partial Hospital; all other 25% after ded"	25% coinsurance after Ded	25% coinsurance after Ded	50% coinsurance after Ded	50% coinsurance after Ded	25% coinsurance after Ded	25% coinsurance after Ded	50% coinsurance after Ded			50% coinsurance after Ded	50% coinsurance after Ded	50% coinsurance after Ded					Routine Physicals @25% after Ded	$40 copayment	$40 copayment	$40 copayment		50% coinsurance after Ded						1.779	0.018	1.056	0.517	0.272	0.484		0.182	1.178	0.192	0.868			0.848	1.1917	3.6713	0.306	0.556	1.301	2.179	0.167			0.001	0.0486	0.0584					0.024	0.106	0.268	0.003		0.0768						17.3518	0	6.5	1.779	0.018	3.240263164	0.517	1.936528888	1.3417	0	0.818056667	1.178	0.192	1.051491176	0	0	0.912564148	1.191693065	6.97959225	1.238937555	2.244192402	1.492201246	3.903381704	0.167	0	0	0.001	0.0486	0.0584	0	0	0	0	0.024	0.352241662	0.792919869	0.00822817	1.538097033	0.612200436	0.001616667	0	0	0	0	33.6389
H5528_003_0	2008	7	i.6.	i.6.	i.6.	i.6.	i.6.	i.6.					Professional	Professional	Professional	Professional	Professional	Professional					Unlimited	Chiropractic	Podiatry	Hearing Exams	High Tech Radiology	Vision Exams	Hepatitis B					A	A	D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	Coin				V	V					Coin	V	V	V	V	V	V																																														0	Unlimited	262.940976	12.93359288	1080.872494	1722.059676	399.486933	4.2885		152.6536	157.3968	286.7216	280.1392			578.1864	3686.52288	3969.942378	559.762533	1012.915441	229.4414947	2069.258044	2.61				493.3527834	493.4618598						295.4899945	629.9038433	6.273803799	246.0955252	642.4805237	1.94					$50 per day; days 1-5	$50 per day; days 1-5	$0 days 1-20; $50 per day for days 21-100	$10 per day	$50 copayment	Diabetic Supplies @ 0%; All Other: 20% coinsurance	20% coinsurance	$50 copayment	$50 copayment		Outpatient Radiology Therapy @$20 copayment; $75 High-tech Radiology; Others: $0			"CORF, Outpatient Rehab, Substance Abuse, Partial Hospital @ $20 copayment; Others: $0"	$5 copayment	$10 copayment	$20 copayment	$20 copayment	$10 copayment	$10 copayment	0% coinsurance				$0 copay	Eyewear every year						$10 copayment	$10 copayment	$10 copayment	$75 copayment	$10 copayment	$10 copayment					180	225	24.25	0	50	0.2	0.2	50	50	0	7.86			1.34	5	10	20	20	10	10	0				0	0						10	10	10	75	10	10					3.9441	0.242504866	2.184263164	0	1.664528888	0.8577	0	0.636056667	0.65582	0	0.183491176	0	0	0.064564148	1.5360512	3.308285315	0.932937555	1.688192402	0.191201246	1.724381704	0	0	0	0	0	0	0	0	0	0	0	0.246241662	0.524919869	0.00522817	1.538097033	0.535400436	0.001616667	0	0	0	0	22.6656	0	0	3.9441	0.242504866	2.184263164	0	1.664528888	0.8577	0	0.636056667	0.65582	0	0.183491176	0	0	0.064564148	1.5360512	3.308285315	0.932937555	1.688192402	0.191201246	1.724381704	0	0	0	0	0	0	0	0	0	0	0	0.246241662	0.524919869	0.00522817	1.538097033	0.535400436	0.001616667	0	0	0	0	22.6656	Unlimited	25%; $1500 OOP Max	25%; $1500 OOP Max	25% coinsurance after Ded	$40 copayment	"25%, no deductible"	50% coinsurance after Ded	50% coinsurance after Ded	$50 copayment	25% coinsurance after Ded	25% coinsurance after Ded	25% coinsurance after Ded			"50% outpatient rehab & substance abuse, CORF, Partial Hospital; all other 25% after ded"	25% coinsurance after Ded	25% coinsurance after Ded	50% coinsurance after Ded	50% coinsurance after Ded	25% coinsurance after Ded	25% coinsurance after Ded	50% coinsurance after Ded			50% coinsurance after Ded	50% coinsurance after Ded	50% coinsurance after Ded					Routine Physicals @25% after Ded	$40 copayment	$40 copayment	$40 copayment		50% coinsurance after Ded						1.779	0.018	1.056	0.517	0.272	0.484		0.182	1.178	0.192	0.868			0.848	1.1917	3.6713	0.306	0.556	1.301	2.179	0.167			0.001	0.0486	0.0584					0.024	0.106	0.268	0.003		0.0768						17.3518	0	6.5	5.7231	0.260504866	3.240263164	0.517	1.936528888	1.3417	0	0.818056667	1.83382	0.192	1.051491176	0	0	0.912564148	2.727744265	6.97959225	1.238937555	2.244192402	1.492201246	3.903381704	0.167	0	0	0.001	0.0486	0.0584	0	0	0	0	0.024	0.352241662	0.792919869	0.00822817	1.538097033	0.612200436	0.001616667	0	0	0	0	40.0174
H5528_004_0	2008	5	i.6.	i.6.	i.6.	i.6.	i.6.	i.6.					Professional	Professional	Professional	Professional	Professional	Professional					Unlimited	Chiropractic	Podiatry	Hearing Exams	High Tech Radiology	Vision Exams	Hepatitis B					A	A	D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	Coin			V	V	V					Coin	V	V	V	V	V	V																																														0	Unlimited	219.6722011	12.69221188	721.0285237	1505.598635	316.9617591	4.401411238		154.845457	168.1216106	221.2888576	275.4981125			456.9865804	3569.35378	3835.369599	743.9515085	814.8567598	229.8421049	2274.959752	2.438410701			39.2	441.5456643	484.316						302.9080696	577.4405352	5.33078756	246.5252138	574.973546	1.94					$0 per stay	$0 per stay	$0 copayment days 1-100	$0 copayment	$50 copayment	Diabetic Supplies @ 0%; All Other: 20% coinsurance	20% coinsurance	"ER @ $50 copayment; Urgent Care @ $0 if admisistered by PCP, $10 for a specialist"	$0 copayment	$0 copayment	Outpatient Radiation Therapy @$20 copayment; Others: $0			"CORF, Outpatient Rehab, Substance Abuse, Partial Hospital @ $10 copayment; Others: $0"	$0 copayment	$10 copayment	$10 copayment	$10 copayment	$10 copayment	$10 copayment	0% coinsurance			$0 copay	$0 copay	$0 copay for eyewear every year						$10 copayment	$10 copayment	$10 copayment	$0 copayment	$10 copayment	$10 copayment					0	0	0	0	50	0.2	0.2	50	0	0	2.76			0.67	0	10	10	10	10	10	0			0	0	0						10	10	10	0	10	10					0	0	0	0	1.320673996	0.880282248	0	0.645189404	0	0	0.063364566	0	0	0.025515084	0	3.196141333	0.61995959	0.6790473	0.191535087	1.895799793	0	0	0	0	0	0	0	0	0	0	0	0.252423391	0.481200446	0.004442323	0	0.479144622	0.001616667	0	0	0	0	10.7363	0	0	0	0	0	0	1.320673996	0.880282248	0	0.645189404	0	0	0.063364566	0	0	0.025515084	0	3.196141333	0.61995959	0.6790473	0.191535087	1.895799793	0	0	0	0	0	0	0	0	0	0	0	0.252423391	0.481200446	0.004442323	0	0.479144622	0.001616667	0	0	0	0	10.7363	Unlimited	25%; $1500 OOP Max	25%; $7500 OOP Max	25% coinsurance after Ded	$40 copayment	"25%, no deductible"	50% coinsurance after Ded	50% coinsurance after Ded	"ER @ $50 copayment; Urgent Care @ $0 if admisistered by PCP, $10 for a specialist"	25% coinsurance after Ded	25% coinsurance after Ded	25% coinsurance after Ded			"50% outpatient rehab & substance abuse, CORF, Partial Hospital; all other 25% after ded"	25% coinsurance after Ded	25% coinsurance after Ded	50% coinsurance after Ded	50% coinsurance after Ded	25% coinsurance after Ded	25% coinsurance after Ded	50% coinsurance after Ded			50% coinsurance after Ded	50% coinsurance after Ded	50% coinsurance after Ded					Routine Physicals @25% after Ded	$40 copayment	$40 copayment	$40 copayment		50% coinsurance after Ded						3.168	0.08	1.72	1.442	0.536	1.072		0.318	2.241	0.21	2.304			1.776	2.8417	10.1503	0.898	1.044	3.326	5.428	0.35			0.001	0.0476	0.0574					0.136	0.279	0.2689	0.0001		0.0588						39.7537	150	10.49	3.168	0.08	1.72	1.442	1.856673996	1.952282248	0	0.963189404	2.241	0.21	2.367364566	0	0	1.801515084	2.841749927	13.34639141	1.51795959	1.7230473	3.517535087	7.323799793	0.35	0	0	0.001	0.0476	0.0574	0	0	0	0	0.136	0.53143431	0.750064124	0.004499337	0	0.537944622	0.001616667	0	0	0	0	50.4901
H5528_005_0	2008	5	i.6.	i.6.	i.6.	i.6.	i.6.	i.6.					Professional	Professional	Professional	Professional	Professional	Professional					Unlimited	Chiropractic	Podiatry	Hearing Exams	High Tech Radiology	Vision Exams	Hepatitis B					A	A	D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	Coin				V	V					Coin	V	V	V	V	V	V																																														0	Unlimited	215.7687276	12.47336972	708.2721064	1478.979792	311.3313386	4.301642806		152.1235619	165.1237679	217.3607527	270.6617567			448.90591	3506.24894	3767.581455	730.780662	800.4529186	225.7772841	2234.671952	2.398410701				433.7404808	216.8961587						297.5539962	567.2202412	5.236681035	242.1653476	564.8073446	1.94					$50 per day; days 1-5	$50 per day; days 1-5	$0 days 1-20; $100 per day for days 21-100	$0 copayment	$50 copayment	Diabetic Supplies @ 0%; All Other: 20% coinsurance	20% coinsurance	$50 copayment	$50 copayment	$0 copayment	Outpatient Radiology Therapy @$20 copayment; $75 High-tech Radiology; Others: $0			"CORF, Outpatient Rehab, Substance Abuse, Partial Hospital @ $20 copayment; Others: $0"	$5 copayment	$15 copayment	$20 copayment	$20 copayment	$15 copayment	$15 copayment	0% coinsurance				$0 copay	Eyewear every 2 years						$15 copayment	$15 copayment	$15 copayment	$75 copayment	$20 copayment	$10 copayment					180	225	48.5	0	50	0.2	0.2	50	50	0	7.86			1.34	5	15	20	20	15	15	0				0	10						15	15	15	75	20	10					3.2365	0.233875682	2.862599763	0	1.297213911	0.860328561	0	0.633848174	0.6880157	0	0.177283451	0	0	0.050127827	1.460937058	4.709476819	1.21796777	1.334088198	0.282221605	2.79333994	0	0	0	0	0	0.180746799	0	0	0	0	0	0.371942495	0.709025301	0.006545851	1.513533423	0.941345574	0.001616667	0	0	0	0	25.5626	0	0	3.2365	0.233875682	2.862599763	0	1.297213911	0.860328561	0	0.633848174	0.6880157	0	0.177283451	0	0	0.050127827	1.460937058	4.709476819	1.21796777	1.334088198	0.282221605	2.79333994	0	0	0	0	0	0.180746799	0	0	0	0	0	0.371942495	0.709025301	0.006545851	1.513533423	0.941345574	0.001616667	0	0	0	0	25.5626	Unlimited	25%; $1500 OOP Max	25%; $1500 OOP Max	25% coinsurance after Ded	$40 copayment	"25%, no deductible"	50% coinsurance after Ded	50% coinsurance after Ded	$50 copayment	25% coinsurance after Ded	25% coinsurance after Ded	25% coinsurance after Ded			"50% outpatient rehab & substance abuse, CORF, Partial Hospital; all other 25% after ded"	25% coinsurance after Ded	25% coinsurance after Ded	50% coinsurance after Ded	50% coinsurance after Ded	25% coinsurance after Ded	25% coinsurance after Ded	50% coinsurance after Ded			50% coinsurance after Ded	50% coinsurance after Ded	50% coinsurance after Ded					Routine Physicals @25% after Ded	$40 copayment	$40 copayment	$40 copayment		50% coinsurance after Ded						2.832	0.026	1.572	1.418	0.526	1.052		0.312	2.049	0.192	2.106			1.743	2.5976	9.2744	0.882	1.026	3.04	4.96	0.342			0.001	0.0468	0.0234					0.124	0.2752	0.264	0.0001		0.0578						36.7422	0	10.34	6.0685	0.259875682	4.434599763	1.418	1.823213911	1.912328561	0	0.945848174	2.7370157	0.192	2.283283451	0	0	1.793127827	4.058563961	13.98384992	2.09996777	2.360088198	3.322221605	7.75333994	0.342	0	0	0.001	0.0468	0.204146799	0	0	0	0	0.124	0.647104987	0.973035844	0.006602866	1.513533423	0.999145574	0.001616667	0	0	0	0	62.3048
H5528_008_0	2008	7	i.6.	i.6.	i.6.	i.6.	i.6.	i.6.					Professional	Professional	Professional	Professional	Professional	Professional					Unlimited	Chiropractic	Podiatry	Hearing Exams	High Tech Radiology	Vision Exams	Hepatitis B					A	A	D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	Coin				V	V					Coin	V	V	V	V	V	V																																														0	Unlimited	215.7687276	12.47336972	708.2721064	1478.979792	311.3313386	4.301642806		152.1235619	165.1237679	217.3607527	270.6617567			448.90591	3506.24894	3767.581455	730.780662	800.4529186	225.7772841	2234.671952	2.398410701				433.7404808	216.8961587						297.5539962	567.2202412	5.236681035	242.1653476	564.8073446	1.94					$50 per day; days 1-5	$50 per day; days 1-5	$0 days 1-20; $75 per day for days 21-100	$0 copayment	$50 copayment	Diabetic Supplies @ 0%; All Other: 20% coinsurance	20% coinsurance	$50 copayment	$50 copayment	$0 copayment	Outpatient Radiology Therapy @$20 copayment; $50 High-tech Radiology; Other: $0			"CORF, Outpatient Rehab, Substance Abuse, Partial Hospital @ $20 copayment; Other: $0"	$5 copayment	$15 copayment	$20 copayment	$20 copayment	$15 copayment	$15 copayment	0% coinsurance				$0 copay	Eyewear every 2 years						$15 copayment	$15 copayment	$15 copayment	$50 copayment	$20 copayment	$10 copayment					180	225	36.375	0	50	0.2	0.2	50	50	0	6.16			1.34	5	15	20	20	15	15	0				0	10						15	15	15	50	20	10					3.2365	0.233875682	2.146949822	0	1.297213911	0.860328561	0	0.633848174	0.6880157	0	0.138939702	0	0	0.050127827	1.460937058	4.709476819	1.21796777	1.334088198	0.282221605	2.79333994	0	0	0	0	0	0.180746799	0	0	0	0	0	0.371942495	0.709025301	0.006545851	1.009022282	0.941345574	0.001616667	0	0	0	0	24.3041	0	0	3.2365	0.233875682	2.146949822	0	1.297213911	0.860328561	0	0.633848174	0.6880157	0	0.138939702	0	0	0.050127827	1.460937058	4.709476819	1.21796777	1.334088198	0.282221605	2.79333994	0	0	0	0	0	0.180746799	0	0	0	0	0	0.371942495	0.709025301	0.006545851	1.009022282	0.941345574	0.001616667	0	0	0	0	24.3041	Unlimited	25%; $1500 OOP Max	25%; $1500 OOP Max	25% coinsurance after Ded	$40 copayment	"25%, no deductible"	50% coinsurance after Ded		$50 copayment	25% coinsurance after Ded	25% coinsurance after Ded	25% coinsurance after Ded			"50% outpatient rehab & substance abuse, CORF, Partial Hospital; all other 25% after ded"	25% coinsurance after Ded	25% coinsurance after Ded	50% coinsurance after Ded	50% coinsurance after Ded	25% coinsurance after Ded	25% coinsurance after Ded	50% coinsurance after Ded			50% coinsurance after Ded	50% coinsurance after Ded	50% coinsurance after Ded					Routine Physicals @25% after Ded	$40 copayment	$40 copayment	$40 copayment		50% coinsurance after Ded						2.832	0.026	1.572	1.418	0.526	1.052		0.312	2.049	0.192	2.106			1.743	2.5976	9.2744	0.882	1.026	3.04	4.96	0.342			0.001	0.0468	0.0234					0.124	0.2752	0.264	0.0001		0.0578						36.7422	0	10.34	6.0685	0.259875682	3.718949822	1.418	1.823213911	1.912328561	0	0.945848174	2.7370157	0.192	2.244939702	0	0	1.793127827	4.058563961	13.98384992	2.09996777	2.360088198	3.322221605	7.75333994	0.342	0	0	0.001	0.0468	0.204146799	0	0	0	0	0.124	0.647104987	0.973035844	0.006602866	1.009022282	0.999145574	0.001616667	0	0	0	0	61.0463
H5528_009_0	2008	6	i.6.	i.6.	i.6.	i.6.	i.6.	i.6.					Professional	Professional	Professional	Professional	Professional	Professional					Unlimited	Chiropractic	Podiatry	Hearing Exams	High Tech Radiology	Vision Exams	Hepatitis B					A	A	D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	Coin			V	V	V					Coin	V	V	V	V	V	V																																														0	Unlimited	75.47440179	26.26362948	659.4740747	958.9622808	230.6882283	3.525684489		60.14953311	60.28272421	85.21972309	99.56736528			134.1758193	3791.186695	4039.455578	500.055108	850.326063	241.7101239	2831.885613	3.049821283			39.2	473.3093394	236.7526697						475.7160593	560.4279765	5.064821433	259.2546739	616.4181204	1.94					$50 per day; days 1-5	$50 per day; days 1-5	$0 days 1-20; $25 per day for days 21-100	$0 copayment	$50 copayment	Diabetic Supplies @ 0%; All Other: 20% coinsurance	20% coinsurance	"ER @ $50 copayment; Urgent Care @ $0 if admisistered by PCP, $10 for a specialist"	$0 copayment	$0 copayment	Outpatient Radiation Therapy @$20 copayment; Other: $0			"CORF, Outpatient Rehab, Substance Abuse, Partial Hospital @ $10 copayment; Other $0"	$0 copayment	$10 copayment	$10 copayment	$10 copayment	$10 copayment	$10 copayment	0% coinsurance			$0 copay	$0 copay	$10 copayment for eyewear every 2 years						$10 copayment	$10 copayment	$10 copayment	$0 copayment	$10 copayment	$10 copayment					180	225	12.125	0	50	0.2	0.2	50	0	0	2.76			0.67	0	10	10	10	10	10	0			0	0	10						10	10	10	0	10	10					1.1321	0.492443053	0.666343596	0	0.961200951	0.705136898	0	0.250623055	0	0	0.022900494	0	0	0.007491483	0	3.366212982	0.41671259	0.708605052	0.201425103	2.359904677	0	0	0	0	0	0.197293891	0	0	0	0	0	0.396430049	0.467023314	0.004220685	0	0.513681767	0.001616667	0	0	0	0	12.8714	0	0	1.1321	0.492443053	0.666343596	0	0.961200951	0.705136898	0	0.250623055	0	0	0.022900494	0	0	0.007491483	0	3.366212982	0.41671259	0.708605052	0.201425103	2.359904677	0	0	0	0	0	0.197293891	0	0	0	0	0	0.396430049	0.467023314	0.004220685	0	0.513681767	0.001616667	0	0	0	0	12.8714	Unlimited	$50 per day; days 1-5 $1500 OOP Max	25%; $7500 OOP Max	25% coinsurance after Ded	$40 copayment	"25%, no deductible"	50% coinsurance after Ded	50% coinsurance after Ded	"ER @ $50 copayment; Urgent Care @ $0 if admisistered by PCP, $10 for a specialist"	$0 copayment	$0 copayment	Outpatient Radiation Therapy @$20 copayment			"CORF,Outpatient Rehab, Partial Hospital @ $10 copayment; Substance Abuse @50%; Other: $0"	25% Coinsurance after Ded	25% Coinsurance after Ded	50% coinsurance after Ded	$10 copayment	25% Coinsurance after Ded	25% Coinsurance after Ded	50% coinsurance after Ded			50% coinsurance after Ded	50% coinsurance after Ded	50% coinsurance after Ded					Routine Physicals @25% after Ded	$40 copayment	$40 copayment	$40 copayment		50% coinsurance after Ded						3.038	0.041	0.156	0.288	0.166	0.422		0.672	0	0	0.063			0.056	1.469	4.235	0.276	0.642	1.62	2.411	0.196			0.001	0.0466	0.0232					0.02	0.1818	0.116	0.0001		0.0782						16.2179	150	0.54	4.1701	0.533443053	0.822343596	0.288	1.127200951	1.127136898	0	0.922623055	0	0	0.085900494	0	0	0.063491483	1.468991423	7.601221558	0.69271259	1.350605052	1.821425103	4.770904677	0.196	0	0	0.001	0.0466	0.220493891	0	0	0	0	0.02	0.5782682	0.58301324	0.004277699	0	0.591881767	0.001616667	0	0	0	0	29.0893
H5528_010_0	2008	6	i.6.	i.6.	i.6.	i.6.	i.6.	i.6.					Professional	Professional	Professional	Professional	Professional	Professional					Unlimited	Chiropractic	Podiatry	Hearing Exams	High Tech Radiology	Vision Exams	Hepatitis B					A	A	D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	Coin					V					Coin	V	V	V	V	V	V																																														0	Unlimited	75.47440179	26.26362948	659.3395892	958.7833099	230.5982283	3.521133033		60.13470463	60.25272421	85.21972309	99.55219377			134.1609908	3790.446819	4038.678882	499.9206225	850.1612646	241.6614208	2831.263854	3.049821283				473.2113394	236.6546697						475.5856798	560.3185313	5.062255792	259.2024357	616.3330448	1.94					$50 per day; days 1-5	$50 per day; days 1-5	$0 days 1-20; $50 per day for days 21-100	$0 copayment	$50 copayment	Diabetic Supplies @ 0%; All Other: 20% coinsurance	20% coinsurance	$50 copayment	$0 copayment	$0 copayment	Outpatient Radiology Therapy @$20 copayment; $50 High-tech Radiology; Others: $0			"CORF, Outpatient Rehab, Substance Abuse, Partial Hospital @ $20 copayment; Others: $0"	$0 copayment	$20 copayment	$20 copayment	$20 copayment	$20 copayment	$20 copayment	0% coinsurance				$0 copay	Eyewear every 2 years						$20 copayment	$20 copayment	$20 copayment	$50 copayment	$20 copayment	$10 copayment					180	225	24.25	0	50	0.2	0.2	50	0	0	6.16			1.34	0	20	20	20	20	20	0				0	10						20	20	20	50	20	10					1.1321	0.492443053	1.33241542	0	0.960825951	0.704226607	0	0.250561269	0	0	0.051103459	0	0	0.014981311	0	6.731131471	0.833201038	1.416935441	0.402769035	4.71877309	0	0	0	0	0	0.197212225	0	0	0	0	0	0.7926428	0.933864219	0.008437093	1.080010149	1.027221741	0.001616667	0	0	0	0	23.0825	0	0	1.1321	0.492443053	1.33241542	0	0.960825951	0.704226607	0	0.250561269	0	0	0.051103459	0	0	0.014981311	0	6.731131471	0.833201038	1.416935441	0.402769035	4.71877309	0	0	0	0	0	0.197212225	0	0	0	0	0	0.7926428	0.933864219	0.008437093	1.080010149	1.027221741	0.001616667	0	0	0	0	23.0825	Unlimited	$50 per day; days 1-5	25%; $1500 OOP Max	25% coinsurance after Ded	$40 copayment	"25%, no deductible"	50% coinsurance after Ded	50% coinsurance after Ded	$50 copayment	$50 copayment	$0 copayment	Outpatient Radiology Therapy @$20 copayment; $50 High-tech Radiology; Other: $0			"CORF,Outpatient Rehab, Partial Hospital @ $20 copayment; Substance Abuse @50%; Other $0"	25% after Ded	25% after Ded	50% coinsurance after Ded	$20 copayment	25% after Ded	25% after Ded	50% coinsurance after Ded			50% coinsurance after Ded	50% coinsurance after Ded	50% coinsurance after Ded					Routine Physicals @25% after Ded	$40 copayment	$40 copayment	$40 copayment		50% coinsurance after Ded						3.038	0.014	0.142	0.288	0.166	0.422		0.672	0	0	0.14			0.077	1.3669	3.9411	0.276	0.642	1.507	2.244	0.196			0.001	0.0466	0.0232					0.019	0.189	0.239	0.002		0.0782						15.73	0	0.52	4.1701	0.506443053	1.47441542	0.288	1.126825951	1.126226607	0	0.922561269	0	0	0.191103459	0	0	0.091981311	1.366927827	10.67220364	1.109201038	2.058935441	1.909769035	6.96277309	0.196	0	0	0.001	0.0466	0.220412225	0	0	0	0	0.019	0.9816428	1.172864219	0.010437093	1.080010149	1.105421741	0.001616667	0	0	0	0	38.8125
H5528_011_0	2008	7	i.6.	i.6.	i.6.	i.6.	i.6.	i.6.					Professional	Professional	Professional	Professional	Professional	Professional					Unlimited	Chiropractic	Podiatry	Hearing Exams	High Tech Radiology	Vision Exams	Hepatitis B					A	A	D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	Coin					V					Coin	V	V	V	V	V	V																																														0	Unlimited	75.47440179	26.26362948	659.3395892	958.7833099	230.5982283	3.521133033		60.13470463	60.25272421	85.21972309	99.55219377			134.1609908	3790.446819	4038.678882	499.9206225	850.1612646	241.6614208	2831.263854	3.049821283				473.2113394	450.016						475.5856798	560.3185313	5.062255792	259.2024357	616.3330448	1.94					$50 per day; days 1-5	$50 per day; days 1-5	$0 days 1-20; $50 per day for days 21-100	$0 copayment	$50 copayment	Diabetic Supplies @ 0%; All Other: 20% coinsurance	20% coinsurance	$50 copayment	$0 copayment	$0 copayment	Outpatient Radiology Therapy @$20 copayment; $0 High-tech Radiology; Others: $0			"CORF, Outpatient Rehab, Substance Abuse, Partial Hospital @ $20 copayment; Other: $0"	$0 copayment	$15 copayment	$20 copayment	$20 copayment	$15 copayment	$15 copayment	0% coinsurance				$0 Copay	Eyewear every year						$15 copayment	$15 copayment	$15 copayment	$0 copayment	$15 copayment	$10 copayment					180	225	24.25	0	50	0.2	0.2	50	0	0	2.76			1.34	0	15	20	20	15	15	0				0	0						15	15	15	0	15	10					1.1321	0.492443053	1.33241542	0	0.960825951	0.704226607	0	0.250561269	0	0	0.022897005	0	0	0.014981311	0	5.048348603	0.833201038	1.416935441	0.302076776	3.539079817	0	0	0	0	0	0	0	0	0	0	0	0.5944821	0.700398164	0.00632782	0	0.770416306	0.001616667	0	0	0	0	18.1233	0	0	1.1321	0.492443053	1.33241542	0	0.960825951	0.704226607	0	0.250561269	0	0	0.022897005	0	0	0.014981311	0	5.048348603	0.833201038	1.416935441	0.302076776	3.539079817	0	0	0	0	0	0	0	0	0	0	0	0.5944821	0.700398164	0.00632782	0	0.770416306	0.001616667	0	0	0	0	18.1233	Unlimited	$50 per day; days 1-5	25%; $1500 OOP Max	25% coinsurance after Ded	$40 copayment	"25%, no deductible"	50% coinsurance after Ded	50% coinsurance after Ded	$50 copayment	$50 copayment	$0 copayment	"CORF,Outpatient Rehab, Partial Hospital @ $20 copayment; $0 High-tech Radiology; Other: $0"			Outpatient Rehab $20 copayment; Substance Abuse @50%; Other $0	25% after Ded	25% after Ded	50% coinsurance after Ded	$20 copayment	25% after Ded	25% after Ded	50% coinsurance after Ded			50% coinsurance after Ded	50% coinsurance after Ded	50% coinsurance after Ded					Routine Physicals @25% after Ded	$40 copayment	$40 copayment	$40 copayment		50% coinsurance after Ded						3.038	0.014	0.142	0.288	0.166	0.422		0.672	0	0	0.063			0.077	1.3669	3.9411	0.276	0.642	1.507	2.244	0.196			0.001	0.0466	0.0532					0.019	0.189	0.239	0.002		0.0782						15.683	0	0.52	4.1701	0.506443053	1.47441542	0.288	1.126825951	1.126226607	0	0.922561269	0	0	0.085897005	0	0	0.091981311	1.366927827	8.989420776	1.109201038	2.058935441	1.809076776	5.783079817	0.196	0	0	0.001	0.0466	0.0532	0	0	0	0	0.019	0.7834821	0.939398164	0.00832782	0	0.848616306	0.001616667	0	0	0	0	33.8063
H5528_012_0	2008	6																					Unlimited											A	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	O	O	V																																																				0	Unlimited	258.1534761	76.73861348	1070.743999	2102.312967	541.3378256	15.68930065		272.0602771	113.2679037	767.9246612	0			1502.0372	4466.801669	5702.174214	1190.918541	1061.821123	233.9375069	801.7649105	4.910143937				311.3859899	89.8010841																PBP: 1A IP Acute - $0 per day (unlimited days)	1B IP Psych - $0 per day (190 day lifetime limit)	2 SNF - $0 per day for days 1-100	6 Home Health - $0 per day	10A Ambulance - $0 per trip	11A DME - 0%	11B Pros./Med Supp. - 0%; 11C Diabetes Mon Supplies - 0%	4A Emergency Care - $50; 4B Urgent Care - $15	9B ASC Services - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0	9A Outpatient Hospital - $0	12 Renal Dialysis - $0	3 CORF - $15; 5 Partial Hosp - $40; 7C Occupational Therapy - $15; 7I PT and ST Services - $15; 9D Cardiac Rehab Svcs - $15	7A Primary Care - $0; 14B Immunizations - $0; 14C Routine Physical Exams - $0; 14D Pap/Pelvic - $0; 14E Prostate Screening - $0; 14F Colorectal Screening - $0; 14G Bone Mass Meas. - $0; 14H Mammography - $0; 14I Diabetes Monitoring - $0	7D Physician Specialist - $15	7E Mental Health - $40; 7H Psychiatric Services - $40; 9C Outpatient Sub Abuse - $40	7C Occupational Therapy - $15; 7I PT and ST Services - $15	8B Outpatient X-Rays - $0	7B Chiropractic Services - $15; 7F Podiatry Services - $15; 7G Other Health Care - $0; 18A Hearing Exams (Medicare Covered) - $0	15 Medicare Part B Rx Drugs - $0	13A Blood - $0; 17A Eye Exams (Medicare Covered) - $0	10B Transportation - $0	16A Preventative Dental - $0	17A Eye Exams (Routine) - $0	17B Eye Wear - $0	18A Hearing Exams (Routine) - $0	18B Hearing Aids - $0	19 POS - not covered	14A Health Ed/Wellness - $0	13B Acupuncture - not covered; Respite Care - not covered											0	0	0	0	0	0	0	50	0	0	2.07			1.005	0	15	40	10	15	15	0				0	0																0	0	0	0	0	0	0	1.133584488	0	0	0	0	0	0.125795616	0	7.127717768	3.96972847	0.884850936	0.292421884	1.002206138	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.5363	0	0	0	0	0	0	0	0	0	1.133584488	0	0	0	0	0	0.125795616	0	7.127717768	3.96972847	0.884850936	0.292421884	1.002206138	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.5363	Unlimited	PBP: 1A IP Acute - $0 per day (unlimited days)	1B IP Psych - $0 per day (190 day lifetime limit)	2 SNF - $0 per day for days 1-100	6 Home Health - $0 per day	10A Ambulance - $0 per trip	11A DME - 0%	11B Pros./Med Supp. - 0%; 11C Diabetes Mon Supplies - 0%	4A Emergency Care - $50; 4B Urgent Care - $15	9B ASC Services - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0	9A Outpatient Hospital - $0	12 Renal Dialysis - $0	3 CORF - $15; 5 Partial Hosp - $40; 7C Occupational Therapy - $15; 7I PT and ST Services - $15; 9D Cardiac Rehab Svcs - $15	7A Primary Care - $0; 14B Immunizations - $0; 14C Routine Physical Exams - $0; 14D Pap/Pelvic - $0; 14E Prostate Screening - $0; 14F Colorectal Screening - $0; 14G Bone Mass Meas. - $0; 14H Mammography - $0; 14I Diabetes Monitoring - $0	7D Physician Specialist - $15	7E Mental Health - $40; 7H Psychiatric Services - $40; 9C Outpatient Sub Abuse - $40	7C Occupational Therapy - $15; 7I PT and ST Services - $15	8B Outpatient X-Rays - $0	7B Chiropractic Services - $15; 7F Podiatry Services - $15; 7G Other Health Care - $0;  18A Hearing Exams (Medicare Covered) - $0	15 Medicare Part B Rx Drugs - $0	13A Blood - $0; 17A Eye Exams (Medicare Covered) - $0	10B Transportation - $0	16A Preventative Dental - $0	17A Eye Exams (Routine) - $0	17B Eye Wear - $0	18A Hearing Exams (Routine) - $0	18B Hearing Aids - $0	19 POS - not covered	14A Health Ed/Wellness - $0	13B Acupuncture - not covered; Respite Care - not covered											0	0	0	0	0	0		0.828	0	0	0.052			0.092	0	1.5045	0.8715	0.226	0	0.2265	0			0	0	0					0											3.8005	0	0	0	0	0	0	0	0	0	1.961584488	0	0	0.052	0	0	0.217795616	0	8.632217768	4.84122847	1.110850936	0.292421884	1.228706138	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.3368
H5528_013_0	2008	5																					Unlimited											A	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	O	O	V																																																				0	Unlimited	387.7894822	120.9697704	1430.380844	3616.717232	652.6880952	18.20474589		409.9783476	173.4578499	1138.207956	0			2333.092412	4890.683631	6243.492375	1165.480238	1294.271124	252.3017795	582.3509413	8.381799474				604.856	195.608																PBP: 1A IP Acute - $0 per day (unlimited days)	1B IP Psych - $0 per day (190 day lifetime limit)	2 SNF - $0 per day for days 1-100	6 Home Health - $0 per day	10A Ambulance - $0 per trip	11A DME - 0%	11B Pros./Med Supp. - 0%; 11C Diabetes Mon Supplies - 0%	4A Emergency Care - $50; 4B Urgent Care - $10	9B ASC Services - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0	9A Outpatient Hospital - $0	12 Renal Dialysis - $0	3 CORF - $10; 5 Partial Hosp - $20; 7C Occupational Therapy - $10; 7I PT and ST Services - $10; 9D Cardiac Rehab Svcs - $10	7A Primary Care - $0; 14B Immunizations - $0; 14C Routine Physical Exams - $0; 14D Pap/Pelvic - $0; 14E Prostate Screening - $0; 14F Colorectal Screening - $0; 14G Bone Mass Meas. - $0; 14H Mammography - $0; 14I Diabetes Monitoring - $0	7D Physician Specialist - $10	7E Mental Health - $20; 7H Psychiatric Services - $20; 9C Outpatient Sub Abuse - $20	7C Occupational Therapy - $10; 7I PT and ST Services - $10	8B Outpatient X-Rays - $0	7B Chiropractic Services - $0; 7F Podiatry Services - $10; 7G Other Health Care - $0; 16B Comp Dental - $0; 18A Hearing Exams (Medicare Covered) - $0	15 Medicare Part B Rx Drugs - $0	13A Blood - $0; 17A Eye Exams (Medicare Covered) - $0	10B Transportation - $0	16A Preventative Dental - $0	17A Eye Exams (Routine) - $0	17B Eye Wear - $0	18A Hearing Exams (Routine) - $0	18B Hearing Aids - $0	19 POS - not covered	14A Health Ed/Wellness - $0	13B Acupuncture - not covered; Respite Care - not covered											0	0	0	0	0	0	0	50	0	0	0			0.67	0	10	20	10	0	10	0				0	0																0	0	0	0	0	0	0	1.708243115	0	0	0	0	0	0.130264326	0	5.202910313	1.942467064	1.07855927	0	0.485292451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.5477	0	0	0	0	0	0	0	0	0	1.708243115	0	0	0	0	0	0.130264326	0	5.202910313	1.942467064	1.07855927	0	0.485292451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.5477	Unlimited	PBP: 1A IP Acute - $0 per day (unlimited days)	1B IP Psych - $0 per day (190 day lifetime limit)	2 SNF - $0 per day for days 1-100	6 Home Health - $0 per day	10A Ambulance - $0 per trip	11A DME - 0%	11B Pros./Med Supp. - 0%; 11C Diabetes Mon Supplies - 0%	4A Emergency Care - $50; 4B Urgent Care - $10	9B ASC Services - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0	9A Outpatient Hospital - $0	12 Renal Dialysis - $0	3 CORF - $10; 5 Partial Hosp - $20; 7C Occupational Therapy - $10; 7I PT and ST Services - $10; 9D Cardiac Rehab Svcs - $10	7A Primary Care - $0; 14B Immunizations - $0; 14C Routine Physical Exams - $0; 14D Pap/Pelvic - $0; 14E Prostate Screening - $0; 14F Colorectal Screening - $0; 14G Bone Mass Meas. - $0; 14H Mammography - $0; 14I Diabetes Monitoring - $0	7D Physician Specialist - $10	7E Mental Health - $20; 7H Psychiatric Services - $20; 9C Outpatient Sub Abuse - $20	7C Occupational Therapy - $10; 7I PT and ST Services - $10	8B Outpatient X-Rays - $0	7B Chiropractic Services - $0; 7F Podiatry Services - $10; 7G Other Health Care - $0; 16B Comp Dental - $0; 18A Hearing Exams (Medicare Covered) - $0	15 Medicare Part B Rx Drugs - $0	13A Blood - $0; 17A Eye Exams (Medicare Covered) - $0	10B Transportation - $0	16A Preventative Dental - $0	17A Eye Exams (Routine) - $0	17B Eye Wear - $0	18A Hearing Exams (Routine) - $0	18B Hearing Aids - $0	19 POS - not covered	14A Health Ed/Wellness - $0	13B Acupuncture - not covered; Respite Care - not covered											0	0	0	0	0	0		0.482	0	0	0			0.036	0	0.722	0.299	0.102	0	0.073	0			0	0	0					0											1.714	0	0	0	0	0	0	0	0	0	2.190243115	0	0	0	0	0	0.166264326	0	5.924910313	2.241467064	1.18055927	0	0.558292451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.2617
H5528_014_0	2008	5																					Unlimited											A	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	O	O	V																																																				0	Unlimited	268.4349025	82.97801904	1003.696582	2437.402461	435.7098857	11.99425209		302.1911634	127.2630109	842.1287673	0			1714.133252	3250.642471	4180.176957	820.5659139	926.6512765	170.6217885	410.2624172	4.224843116				548.016	326.144																PBP: 1A IP Acute - $0 per day (unlimited days)	1B IP Psych - $0 per day (190 day lifetime limit)	2 SNF - $0 per day for days 1-100	6 Home Health - $0 per day	10A Ambulance - $0 per trip	11A DME - 0%	11B Pros./Med Supp. - 0%; 11C Diabetes Mon Supplies - 0%	4A Emergency Care - $50; 4B Urgent Care - $10	9B ASC Services - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0	9A Outpatient Hospital - $0	12 Renal Dialysis - $0	3 CORF - $10; 5 Partial Hosp - $20; 7C Occupational Therapy - $10; 7I PT and ST Services - $10; 9D Cardiac Rehab Svcs - $10	7A Primary Care - $0; 14B Immunizations - $0; 14C Routine Physical Exams - $0; 14D Pap/Pelvic - $0; 14E Prostate Screening - $0; 14F Colorectal Screening - $0; 14G Bone Mass Meas. - $0; 14H Mammography - $0; 14I Diabetes Monitoring - $0	7D Physician Specialist - $10	7E Mental Health - $20; 7H Psychiatric Services - $20; 9C Outpatient Sub Abuse - $20	7C Occupational Therapy - $10; 7I PT and ST Services - $10	8B Outpatient X-Rays - $0	7B Chiropractic Services - $0; 7F Podiatry Services - $10; 7G Other Health Care - $0; 16B Comp Dental - $0; 18A Hearing Exams (Medicare Covered) - $0	15 Medicare Part B Rx Drugs - $0	13A Blood - $0; 17A Eye Exams (Medicare Covered) - $0	10B Transportation - $0	16A Preventative Dental - $0	17A Eye Exams (Routine) - $0	17B Eye Wear - $0	18A Hearing Exams (Routine) - $0	18B Hearing Aids - $0	19 POS - not covered	14A Health Ed/Wellness - $0	13B Acupuncture - not covered; Respite Care - not covered											0	0	0	0	0	0	0	50	0	0	1.38			0.67	0	10	20	10	10	10	0				0	0																0	0	0	0	0	0	0	1.259129847	0	0	0	0	0	0.095705773	0	3.483480798	1.367609857	0.772209397	0.142184824	0.341885348	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.4622	0	0	0	0	0	0	0	0	0	1.259129847	0	0	0	0	0	0.095705773	0	3.483480798	1.367609857	0.772209397	0.142184824	0.341885348	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.4622	Unlimited	PBP: 1A IP Acute - $0 per day (unlimited days)	1B IP Psych - $0 per day (190 day lifetime limit)	2 SNF - $0 per day for days 1-100	6 Home Health - $0 per day	10A Ambulance - $0 per trip	11A DME - 0%	11B Pros./Med Supp. - 0%; 11C Diabetes Mon Supplies - 0%	4A Emergency Care - $50; 4B Urgent Care - $10	9B ASC Services - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0	9A Outpatient Hospital - $0	12 Renal Dialysis - $0	3 CORF - $10; 5 Partial Hosp - $20; 7C Occupational Therapy - $10; 7I PT and ST Services - $10; 9D Cardiac Rehab Svcs - $10	7A Primary Care - $0; 14B Immunizations - $0; 14C Routine Physical Exams - $0; 14D Pap/Pelvic - $0; 14E Prostate Screening - $0; 14F Colorectal Screening - $0; 14G Bone Mass Meas. - $0; 14H Mammography - $0; 14I Diabetes Monitoring - $0	7D Physician Specialist - $10	7E Mental Health - $20; 7H Psychiatric Services - $20; 9C Outpatient Sub Abuse - $20	7C Occupational Therapy - $10; 7I PT and ST Services - $10	8B Outpatient X-Rays - $0	7B Chiropractic Services - $0; 7F Podiatry Services - $10; 7G Other Health Care - $0; 16B Comp Dental - $0; 18A Hearing Exams (Medicare Covered) - $0	15 Medicare Part B Rx Drugs - $0	13A Blood - $0; 17A Eye Exams (Medicare Covered) - $0	10B Transportation - $0	16A Preventative Dental - $0	17A Eye Exams (Routine) - $0	17B Eye Wear - $0	18A Hearing Exams (Routine) - $0	18B Hearing Aids - $0	19 POS - not covered	14A Health Ed/Wellness - $0	13B Acupuncture - not covered; Respite Care - not covered											0	0	0	0	0	0		0.342	0	0	0.014			0.026	0	1.012	0.412	0.13	0	0.104	0			0	0	0					0											2.04	0	0	0	0	0	0	0	0	0	1.601129847	0	0	0.014	0	0	0.121705773	0	4.495480798	1.779609857	0.902209397	0.142184824	0.445885348	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.5022
H5528_015_0	2008	7	i.6.	i.6.	i.6.	i.6.	i.6.	i.6.					Professional	Professional	Professional	Professional	Professional	Professional					2000	Chiropractic	Podiatry	Hearing Exams	High Tech Radiology	Vision Exams	Hepatitis B					A	A	D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	Coin				V	V					Coin	V	V	V	V	V	V																																														0	2000	271.4865577	13.35393464	1116.00085	1778.026615	412.4702583	4.4775		157.614842	162.512196	296.040052	289.243724			596.977458	3806.334874	4098.965505	577.9548153	1045.835193	236.8983433	2136.571981	2.691				509.3867488	254.7496851						305.0934194	650.3757182	6.477702422	254.0936298	663.3611407	1.94					$0 per stay	$0 per stay	$0 copayment days 1-100	$0 copayment	$50 copayment	Diabetic Supplies: 0% coinsurance; All Other: 20% coinsurance	20% coinsurance	$50 copayment	$0 copayment	$0 copayment	Outpatient Radiology Therapy @ $20 copayment; Others: $0			"CORF, Outpatient Rehab, Substance Abuse, Partial Hospital @ $10 copayment; Other: $0"	$0 copayment	$10 copayment	$10 copayment	$10 copayment	$10 copayment	$10 copayment	0% coinsurance				$0 copay	Eyewear every 2 years						$10 copayment	$10 copayment	$10 copayment	$0 copayment	$20 copayment	$10 copayment					0	0	0	0	50	0.2	0.2	50	0	0	2.76			0.67	0	10	10	10	10	10	0				0	10						10	10	10	0	20	10					0	0	0	0	1.718626076	0.8955	0	0.656728508	0	0	0.066526057	0	0	0.033331241	0	3.415804588	0.481629013	0.871529327	0.197415286	1.780476651	0	0	0	0	0	0.212291404	0	0	0	0	0	0.254244516	0.541979765	0.005398085	0	1.105601901	0.001616667	0	0	0	0	12.2387	0	0	0	0	0	0	1.718626076	0.8955	0	0.656728508	0	0	0.066526057	0	0	0.033331241	0	3.415804588	0.481629013	0.871529327	0.197415286	1.780476651	0	0	0	0	0	0.212291404	0	0	0	0	0	0.254244516	0.541979765	0.005398085	0	1.105601901	0.001616667	0	0	0	0	12.2387	2000	$0 per stay	20%; $1500 OOP Max	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$50 copayment	$0 copayment	$10 copayment	Outpatient Radiology Therapy @ 20% coinsurance; Others: $10 copayment			20% coinsurance	$10 copayment	$20 copayment	20% coinsurance	20% coinsurance	$20 copayment	$20 copayment	20% coinsurance			50% coinsurance	50% coinsurance	50% coinsurance					0	20% coinsurance	20% coinsurance	$20 copayment		50% coinsurance						0	0.02	0.711	0.087	0.183	0.163		0.188	0	0.07	0.176			0.554	0.7609	1.4351	0.103	0.187	0.422	1.283	0.056			0.001	0.0502	0.0252					0	0.019	0.195	0.001		0.0258						6.7162	0	0.78	0	0.02	0.711	0.087	1.901626076	1.0585	0	0.844728508	0	0.07	0.242526057	0	0	0.587331241	0.760938294	4.850866294	0.584629013	1.058529327	0.619415286	3.063476651	0.056	0	0	0.001	0.0502	0.237491404	0	0	0	0	0	0.273244516	0.736979765	0.006398085	0	1.131401901	0.001616667	0	0	0	0	18.9549
H5528_016_0	2008	7	i.6.	i.6.	i.6.	i.6.	i.6.	i.6.					Professional	Professional	Professional	Professional	Professional	Professional					Unlimited	Chiropractic	Podiatry	Hearing Exams	High Tech Radiology	Vision Exams	Hepatitis B					A	A	D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	Coin				V	V					Coin	V	V	V	V	V	V																																														0	Unlimited	222.813359	12.85221188	731.291047	1527.076319	321.4510218	4.48517967		157.0443783	170.4935057	224.4284494	279.4429814			463.4902246	3620.203576	3890.011606	754.5597225	826.4643539	233.1160574	2307.358152	2.474179134				447.8549295	223.8914239						307.2049397	585.654441	5.406649524	250.0368063	583.1555825	1.94					$0 per stay	$0 per stay	$0 copayment days 1-100	$0 copayment	$50 copayment	Diabetic Supplies: 0% coinsurance; All Other: 20% coinsurance	20% coinsurance	$50 copayment	$0 copayment	$0 copayment	Outpatient Radiology Therapy @ $20 copayment; Others: $0			"CORF, Outpatient Rehab, Substance Abuse, Partial Hospital @ $10 copayment; Other: $0"	$0 copayment	$10 copayment	$10 copayment	$10 copayment	$10 copayment	$10 copayment	0% coinsurance				$0 copay	Eyewear every 2 years						$10 copayment	$10 copayment	$10 copayment	$0 copayment	$20 copayment	$10 copayment					0	0	0	0	50	0.2	0.2	50	0	0	2.76			0.67	0	10	10	10	10	10	0				0	10						10	10	10	0	20	10					0	0	0	0	1.339379258	0.897035934	0	0.654351576	0	0	0.064271886	0	0	0.025878204	0	3.241676338	0.628799769	0.688720295	0.194263381	1.92279846	0	0	0	0	0	0.186576187	0	0	0	0	0	0.256004116	0.488045368	0.004505541	0	0.971925971	0.001616667	0	0	0	0	11.5658	0	0	0	0	0	0	1.339379258	0.897035934	0	0.654351576	0	0	0.064271886	0	0	0.025878204	0	3.241676338	0.628799769	0.688720295	0.194263381	1.92279846	0	0	0	0	0	0.186576187	0	0	0	0	0	0.256004116	0.488045368	0.004505541	0	0.971925971	0.001616667	0	0	0	0	11.5658	Unlimited	$0 per stay	20%; $1500 OOP Max	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$50 copayment	$0 copayment	$10 copayment	Outpatient Radiology Therapy @ 20% coinsurance; Others: $10 copayment			20% coinsurance	$10 copayment	$20 copayment	20% coinsurance	20% coinsurance	$20 copayment	$20 copayment	20% coinsurance			50% coinsurance	50% coinsurance	50% coinsurance					0	20% coinsurance	20% coinsurance	$20 copayment		50% coinsurance						0	0.028	1.058	0.25	0.354	0.354		0.321	0	0.093	0.384			1.137	1.544	3.05	0.298	0.346	0.934	2.898	0.116			0.001	0.0484	0.0242					0	0.064	0.478	0.002		0.0194						13.802	0	1.8	0	0.028	1.058	0.25	1.693379258	1.251035934	0	0.975351576	0	0.093	0.448271886	0	0	1.162878204	1.544009009	6.291667329	0.926799769	1.034720295	1.128263381	4.82079846	0.116	0	0	0.001	0.0484	0.210776187	0	0	0	0	0	0.320004116	0.966045368	0.006505541	0	0.991325971	0.001616667	0	0	0	0	25.3678
H5528_017_0	2008	7	i.6.	i.6.	i.6.	i.6.	i.6.	i.6.					Professional	Professional	Professional	Professional	Professional	Professional					Unlimited	Chiropractic	Podiatry	Hearing Exams	High Tech Radiology	Vision Exams	Hepatitis B					A	A	D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	Coin					V					Coin	V	V	V	V	V	V																																														0	Unlimited	76.55371571	26.62568771	668.7371043	972.4100293	233.9066168	3.593133033		60.99090527	61.12375333	86.41766486	100.9628798			136.0558712	3844.448065	4096.199037	507.0285643	862.2665109	245.1033092	2871.658017	3.094924195				479.9767012	240.0373506						482.4161321	568.287558	5.135273892	262.8941538	625.1006991	1.94					$0 per stay	$0 per stay	$0 copayment days 1-100	$0 copayment	$50 copayment	Diabetic Supplies: 0% coinsurance; All Other: 20% coinsurance	20% coinsurance	$50 copayment	$0 copayment	$0 copayment	Outpatient Radiology Therapy @ $20 copayment; Others: $0			"CORF, Outpatient Rehab, Substance Abuse, Partial Hospital @ $10 copayment; Other: $0"	$0 copayment	$10 copayment	$10 copayment	$10 copayment	$10 copayment	$10 copayment	0% coinsurance				$0 copay	Eyewear every 2 years						$10 copayment	$10 copayment	$10 copayment	$0 copayment	$20 copayment	$10 copayment					0	0	0	0	50	0.2	0.2	50	0	0	2.76			0.67	0	10	10	10	10	10	0				0	10						10	10	10	0	20	10					0	0	0	0	0.974610903	0.718626607	0	0.254128772	0	0	0.023221462	0	0	0.007596453	0	3.413499198	0.422523804	0.718555426	0.204252758	2.393048347	0	0	0	0	0	0.200031125	0	0	0	0	0	0.402013443	0.473572965	0.004279395	0	1.041834499	0.001616667	0	0	0	0	11.2534	0	0	0	0	0	0	0.974610903	0.718626607	0	0.254128772	0	0	0.023221462	0	0	0.007596453	0	3.413499198	0.422523804	0.718555426	0.204252758	2.393048347	0	0	0	0	0	0.200031125	0	0	0	0	0	0.402013443	0.473572965	0.004279395	0	1.041834499	0.001616667	0	0	0	0	11.2534	Unlimited	$0 per stay	20%; $1500 OOP Max	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$50 copayment	$0 copayment	$0 copayment	Outpatient Radiology Therapy @ $20 coinsurance; Others: $0 copayment			"CORF, Outpatient Rehab, Substance Abuse, Partial Hospital @ $10 copayment; Other $0"	$10 copayment	$20 copayment	20% coinsurance	20% coinsurance	$20 copayment	$20 copayment	20% coinsurance			50% coinsurance	50% coinsurance	50% coinsurance					0	20% coinsurance	20% coinsurance	$20 copayment		50% coinsurance						0	0.015	0.437	0.048	0.11	0.14		0.679	0	0	0.063			0.056	0.7712	1.4448	0.091	0.156	0.437	1.26	0.065			0.001	0.0472	0.0236					0	0.032	0.228	0.001		0.0258						6.1316	0	0.63	0	0.015	0.437	0.048	1.084610903	0.858626607	0	0.933128772	0	0	0.086221462	0	0	0.063596453	0.771236589	4.858262609	0.513523804	0.874555426	0.641252758	3.653048347	0.065	0	0	0.001	0.0472	0.223631125	0	0	0	0	0	0.434013443	0.701572965	0.005279395	0	1.067634499	0.001616667	0	0	0	0	17.385
H5528_802_0	2008	5																					Unlimited											Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																														0	Unlimited	366.237	12.42	36.864	12.807	2.043	5.877		152.6536	24.6	9.016	16.192			28.408	26.47307543	111.4969246	3.402	8.01	33.597	52.893	2.61																					Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day	Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day. Lifetime max of 190 days	$130 for Days 21-100	$0 Copayment	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	ER @ $50 copayment; Urgent Care @ 20% coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded			20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	50% Coinsurance after Ded of Medicare approved amounts; 20% for certain approved charges	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded																					0.0569	0.0569	0.1798	0	0.234	0.234	0.234	50	0.234	0.234	0.234			0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					20.8389	0.706698	6.6281472	0	0.478062	1.375218	0	0.636056667	5.7564	2.109744	3.788928	0	0	6.647472	6.19469965	26.09028035	0.796068	1.87434	7.861698	12.376962	0.61074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.7704	0	0	20.8389	0.706698	6.6281472	0	0.478062	1.375218	0	0.636056667	5.7564	2.109744	3.788928	0	0	6.647472	6.19469965	26.09028035	0.796068	1.87434	7.861698	12.376962	0.61074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.7704	Unlimited	Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day	Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day. Lifetime max of 190 days	$130 for Days 21-100	$0 Copayment	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	ER @ $50 copayment; Urgent Care @ 20% coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded			20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	50% Coinsurance after Ded of Medicare approved amounts; 20% for certain approved charges	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded																					1.883	0.019	0.76	0	0.255	0.226		0.182	1.104	0.18	0.812			0.626	1.1157	3.4353	0.143	0.26	1.218	2.547	0.078																					14.844	0	0	22.7219	0.725698	7.3881472	0	0.733062	1.601218	0	0.818056667	6.8604	2.289744	4.600928	0	0	7.273472	7.310382195	29.5255978	0.939068	2.13434	9.079698	14.923962	0.68874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.6144
H5528_804_0	2008	5																					Unlimited											Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																														0	Unlimited	229.1309461	3.294679493	24.90753042	10.11690444	5.746919648	5.713642806		152.1235619	18.90947342	3.1427955	10.17173783			12.23211872	24.83889695	102.8656818	4.111916965	6.209462599	35.05266947	50.32408948	2.398410701																					Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day	Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day. Lifetime max of 190 days	$130 for Days 21-100	$0 Copayment	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	ER @ $50 copayment; Urgent Care @ 20% coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded			20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	50% Coinsurance after Ded of Medicare approved amounts; 20% for certain approved charges	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded																					0.064217529	0.064217529	0.185740788	0	0.234	0.234	0.234	50	0.234	0.234	0.234			0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					14.7142	0.211576177	4.626344327	0	1.344779198	1.336992417	0	0.633848174	4.424816781	0.735414147	2.380186652	0	0	2.862315779	5.812301887	24.07056954	0.96218857	1.453014248	8.202324656	11.77583694	0.561228104	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.108	0	0	14.7142	0.211576177	4.626344327	0	1.344779198	1.336992417	0	0.633848174	4.424816781	0.735414147	2.380186652	0	0	2.862315779	5.812301887	24.07056954	0.96218857	1.453014248	8.202324656	11.77583694	0.561228104	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.108	Unlimited	Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day	Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day. Lifetime max of 190 days	$130 for Days 21-100	$0 Copayment	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	ER @ $50 copayment; Urgent Care @ 20% coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded			20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	50% Coinsurance after Ded of Medicare approved amounts; 20% for certain approved charges	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded																					3.382	0.032	1.168	0	0.492	0.492		0.312	1.917	0.18	1.971			1.287	2.4316	8.6804	0.414	0.48	2.846	5.682	0.16																					31.927	0	0	18.0962	0.243576177	5.794344327	0	1.836779198	1.828992417	0	0.945848174	6.341816781	0.915414147	4.351186652	0	0	4.149315779	8.243866716	32.75100471	1.37618857	1.933014248	11.04832466	17.45783694	0.721228104	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.035
H5528_806_0	2008	5																					Unlimited											Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																														0	Unlimited	366.237	12.42	36.864	12.807	2.043	5.877		152.6536	24.6	9.016	16.192			28.408	26.47307543	111.4969246	3.402	8.01	33.597	52.893	2.61																					Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day	Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day. Lifetime max of 190 days	$130 for Days 21-100	$0 Copayment	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	ER @ $50 copayment; Urgent Care @ 20% coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded			20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	50% Coinsurance after Ded of Medicare approved amounts; 20% for certain approved charges	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded																					0.0569	0.0569	0.1798	0	0.234	0.234	0.234	50	0.234	0.234	0.234			0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					20.8389	0.706698	6.6281472	0	0.478062	1.375218	0	0.636056667	5.7564	2.109744	3.788928	0	0	6.647472	6.19469965	26.09028035	0.796068	1.87434	7.861698	12.376962	0.61074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.7704	0	0	20.8389	0.706698	6.6281472	0	0.478062	1.375218	0	0.636056667	5.7564	2.109744	3.788928	0	0	6.647472	6.19469965	26.09028035	0.796068	1.87434	7.861698	12.376962	0.61074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.7704	Unlimited	Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day	Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day. Lifetime max of 190 days	$130 for Days 21-100	$0 Copayment	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	ER @ $50 copayment; Urgent Care @ 20% coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded			20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	50% Coinsurance after Ded of Medicare approved amounts; 20% for certain approved charges	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded																					1.883	0.019	0.76	0	0.255	0.226		0.182	1.104	0.18	0.812			0.626	1.1157	3.4353	0.143	0.26	1.218	2.547	0.078																					14.844	0	0	22.7219	0.725698	7.3881472	0	0.733062	1.601218	0	0.818056667	6.8604	2.289744	4.600928	0	0	7.273472	7.310382195	29.5255978	0.939068	2.13434	9.079698	14.923962	0.68874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.6144
H5528_807_0	2008	5																					Unlimited											Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																														0	Unlimited	229.1309461	3.294679493	24.90753042	10.11690444	5.746919648	5.713642806		152.1235619	18.90947342	3.1427955	10.17173783			12.23211872	24.83889695	102.8656818	4.111916965	6.209462599	35.05266947	50.32408948	2.398410701																					Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day	Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day. Lifetime max of 190 days	$130 for Days 21-100	$0 Copayment	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	ER @ $50 copayment; Urgent Care @ 20% coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded			20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	50% Coinsurance after Ded of Medicare approved amounts; 20% for certain approved charges	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded																					0.064217529	0.064217529	0.185740788	0	0.234	0.234	0.234	50	0.234	0.234	0.234			0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					14.7142	0.211576177	4.626344327	0	1.344779198	1.336992417	0	0.633848174	4.424816781	0.735414147	2.380186652	0	0	2.862315779	5.812301887	24.07056954	0.96218857	1.453014248	8.202324656	11.77583694	0.561228104	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.108	0	0	14.7142	0.211576177	4.626344327	0	1.344779198	1.336992417	0	0.633848174	4.424816781	0.735414147	2.380186652	0	0	2.862315779	5.812301887	24.07056954	0.96218857	1.453014248	8.202324656	11.77583694	0.561228104	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.108	Unlimited	Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day	Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day. Lifetime max of 190 days	$130 for Days 21-100	$0 Copayment	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	ER @ $50 copayment; Urgent Care @ 20% coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded			20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	50% Coinsurance after Ded of Medicare approved amounts; 20% for certain approved charges	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded																					3.382	0.032	1.168	0	0.492	0.492		0.312	1.917	0.18	1.971			1.287	2.4316	8.6804	0.414	0.48	2.846	5.682	0.16																					31.927	0	0	18.0962	0.243576177	5.794344327	0	1.836779198	1.828992417	0	0.945848174	6.341816781	0.915414147	4.351186652	0	0	4.149315779	8.243866716	32.75100471	1.37618857	1.933014248	11.04832466	17.45783694	0.721228104	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.035
H5528_809_0	2008	5																					Unlimited											Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																														0	Unlimited	79.81966357	5.089841123	22.76877789	7.125992733	2.227322288	5.109633033		60.13470463	17.03241237	9.405456138	7.078753002			5.234292004	26.85252692	112.1145007	3.150823293	6.607796186	38.84039907	52.22239758	3.049821283																					Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day	Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day. Lifetime max of 190 days	$130 for Days 21-100	$0 Copayment	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	ER @ $50 copayment; Urgent Care @ 20% coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded			20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	50% Coinsurance after Ded of Medicare approved amounts; 20% for certain approved charges	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded																					0.065938851	0.065938851	0.176459118	0	0.234	0.234	0.234	50	0.234	0.234	0.234			0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					5.2632	0.335618277	4.017758457	0	0.521193415	1.19565413	0	0.250561269	3.985584494	2.200876736	1.656428203	0	0	1.224824329	6.2834913	26.23479315	0.737292651	1.546224308	9.088653383	12.22004103	0.71365818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.4759	0	0	5.2632	0.335618277	4.017758457	0	0.521193415	1.19565413	0	0.250561269	3.985584494	2.200876736	1.656428203	0	0	1.224824329	6.2834913	26.23479315	0.737292651	1.546224308	9.088653383	12.22004103	0.71365818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.4759	Unlimited	Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day	Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day. Lifetime max of 190 days	$130 for Days 21-100	$0 Copayment	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	ER @ $50 copayment; Urgent Care @ 20% coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded			20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	50% Coinsurance after Ded of Medicare approved amounts; 20% for certain approved charges	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded																					11.046	0.017	0.466	0	0.155	0.197		0.672	4.249	1.162	3.416			1.722	1.279	3.686	0.129	0.22	1.411	2.666	0.092																					32.585	0	0	16.3092	0.352618277	4.483758457	0	0.676193415	1.39265413	0	0.922561269	8.234584494	3.362876736	5.072428203	0	0	2.946824329	7.562452294	29.92083216	0.866292651	1.766224308	10.49965338	14.88604103	0.80565818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.0609
H5528_810_0	2008	5																					Unlimited											Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																														0	Unlimited	79.81966357	5.089841123	22.76877789	7.125992733	2.227322288	5.109633033		60.13470463	17.03241237	9.405456138	7.078753002			5.234292004	26.85252692	112.1145007	3.150823293	6.607796186	38.84039907	52.22239758	3.049821283																					Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day	Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day. Lifetime max of 190 days	$130 for Days 21-100	$0 Copayment	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	ER @ $50 copayment; Urgent Care @ 20% coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded			20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	50% Coinsurance after Ded of Medicare approved amounts; 20% for certain approved charges	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded																					0.065938851	0.065938851	0.176459118	0	0.234	0.234	0.234	50	0.234	0.234	0.234			0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					5.2632	0.335618277	4.017758457	0	0.521193415	1.19565413	0	0.250561269	3.985584494	2.200876736	1.656428203	0	0	1.224824329	6.2834913	26.23479315	0.737292651	1.546224308	9.088653383	12.22004103	0.71365818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.4759	0	0	5.2632	0.335618277	4.017758457	0	0.521193415	1.19565413	0	0.250561269	3.985584494	2.200876736	1.656428203	0	0	1.224824329	6.2834913	26.23479315	0.737292651	1.546224308	9.088653383	12.22004103	0.71365818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.4759	Unlimited	Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day	Deductible for days 1-60: $1040; Days 61-90:$260 per day; Days 91-150:$520 per day. Lifetime max of 190 days	$130 for Days 21-100	$0 Copayment	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	ER @ $50 copayment; Urgent Care @ 20% coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded			20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	50% Coinsurance after Ded of Medicare approved amounts; 20% for certain approved charges	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded	20% Coinsurance after Ded																					11.046	0.017	0.466	0	0.155	0.197		0.672	4.249	1.162	3.416			1.722	1.279	3.686	0.129	0.22	1.411	2.666	0.092																					32.585	0	0	16.3092	0.352618277	4.483758457	0	0.676193415	1.39265413	0	0.922561269	8.234584494	3.362876736	5.072428203	0	0	2.946824329	7.562452294	29.92083216	0.866292651	1.766224308	10.49965338	14.88604103	0.80565818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.0609
H5529_001_0	2008	5	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			D	D	D	D	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V		S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	1194.736236	82.61591157	233.9682616	0.001089884	71.3321194	10.14089835	3.798112265	286.3831497	387.3446088	681.7612509	931.450881	45.16125484	0.86848567	0.001089884	4310.808752	1718.277669	29.353229	545.6472182	626.8857273		334.3029795				402.349551	386.9087568	176.5611792					843.9509497	17.3697134	191.3788569	341.2198029	120.4816895	0.052759079	625.8958525	2.392235712			$175/day (1-5) with $1750 yearly max	$175/day (1-5) with $1750 yearly max	$75/day for days 21 to 100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$175 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$175 copay	$15/$25 copay for in-home/facility	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$50/$100 copay for Lower/Higher Tier		$15/$22.50/$40/$100 copay levels				$50 max w/specialist copay	$75 yearly max	$50 max w/specialist copay					$25 copay	$50 copay	$25 copay	$25 copay	$10 copay	20% coinsurance	$25 copay	$25 copay			108.9312492	91.5499841	74.78143421	0	74.78143421	0.199417158	0.199417158	49.85428947	174.4900131	51.69604029	60.91752574	174.4900131	24.92714474	24.92714474	9.970857894	24.92714474	24.92714474	24.92714474	58.17529735		33.27066667				24.92714474	0	24.92714474					24.92714474	49.85428947	24.92714474	24.92714474	9.970857894	0.199417158	24.92714474	24.92714474			10.8453	0.630290449	1.45804018	0	0.444526516	2.022269127	0.757408753	1.189785704	5.632313823	2.937029758	4.728473584	0.656682329	0.001804072	2.26E-06	3.58187179	3.569313012	0.060974349	1.133452265	3.039105299	0	0.926873583	0	0	0	0.835785458	0	0.366763839	0	0	0	0	1.753107289	0.072162893	0.397544039	0.708802951	0.100108817	0.010521066	1.300149709	0.0049693	0	0	49.1655		0.143697312	10.8453	0.630290449	1.45804018	0	0.444526516	2.022269127	0.757408753	1.189785704	5.632313823	2.937029758	4.728473584	0.656682329	0.001804072	2.26E-06	3.58187179	3.569313012	0.060974349	1.133452265	3.039105299	0	0.926873583	0	0	0	0.835785458	0	0.366763839	0	0	0	0	1.753107289	0.072162893	0.397544039	0.708802951	0.100108817	0.010521066	1.300149709	0.0049693	0	0	49.1655	4000	$250/day (1-5) with no yearly max	$250/day (1-5) with no yearly max	20% coinsurance	$0 copay	$75 copay	30% coinsurance	30% coinsurance	$50 copay	$250 copay	20% coinsurance	20% coinsurance	$250 copay	$15/$35 copay for in-home/facility	$35 copay	$15 copay	$35 copay	$35 copay	$35 copay	20% coinsurance	0	$15/$22.50/$40/$100 copay levels	0	0	0	$50 max w/specialist copay	$150 yearly max	$50 max w/specialist copay	0	0	0	0	$35 copay	20% coinsurance	$35 copay	$35 copay	$15 copay	20% coinsurance	$35 copay	$35 copay	0	0	4.966254057	0.173873227	0.558192817	0	0.722355589	0.869436536	0.024830579	0.280533248	1.754460344	0.344360203	0.838648904	0.004510181	0.034096967	3.17E-06	0.04228423	0.169498322	0.002526732	0.007589477	0.464317082	0	0.015018346	0	0	0	0.477928022	0	3.17E-06	0	0	0	0	0.259515805	0.017539169	0.006324564	0.024665801	0.050144759	0.001653998	0	0.001897369	0	0	12.1125		0.035401434	15.8116	0.804163677	2.016232997	0	1.166882105	2.891705663	0.782239332	1.470318951	7.386774167	3.28138996	5.567122488	0.66119251	0.035901039	5.43E-06	3.624156019	3.738811334	0.063501081	1.141041742	3.503422382	0	0.94189193	0	0	0	1.31371348	0	0.366767009	0	0	0	0	2.012623095	0.089702063	0.403868603	0.733468752	0.150253576	0.012175064	1.300149709	0.00686667	0	0	61.2779
H5529_002_0	2008	6	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			D	D	D	D	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V		S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	1223.169171	84.58204669	239.5363562	0.001115821	73.02971715	10.62931826	3.981042179	293.1986403	396.5628311	697.9861489	953.6180188	46.23602515	0.88915433	0.001115821	4413.399553	1759.170107	30.05179195	558.6328059	641.80467		342.2588904				578.8207187	556.6075671	180.7630711					864.03572	17.7830866	195.9333875	349.3403238	123.3489735	0.055300135	640.7912377	2.449167343			$175/day (1-5) with $1750 yearly max	$175/day (1-5) with $1750 yearly max	$75/day for days 21 to 100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$150 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$150 copay	$15/$25 copay for in-home/facility	$20 copay	$10 copay	$20 copay	$20 copay	$20 copay	$50/$100 copay for Lower/Higher Tier		$15/$22.50/$40/$100 copay levels				$50 max w/specialist copay	$150 yearly max	$50 max w/specialist copay					$20 copay	$50 copay	$20 copay	$20 copay	$10 copay	20% coinsurance	$20 copay	$20 copay			108.9836494	91.59402317	74.81740695	0	74.81740695	0.199513085	0.199513085	49.8782713	149.6348139	51.72090808	60.94682941	149.6348139	24.93913565	19.95130852	9.97565426	19.95130852	19.95130852	19.95130852	58.20328191		33.28667114				19.95130852	0	19.95130852					19.95130852	49.8782713	19.95130852	19.95130852	9.97565426	0.199513085	19.95130852	19.95130852			11.1088	0.645600829	1.49345742	0	0.455324506	2.12068808	0.794270007	1.218686777	4.94496712	3.008373121	4.843332893	0.576543252	0.001847895	1.86E-06	3.668879004	2.924812129	0.049964381	0.928787955	3.112928178	0	0.949388261	0	0	0	0.962352561	0	0.300538317	0	0	0	0	1.436553602	0.073915801	0.325760622	0.580816382	0.102540559	0.011033101	1.065385307	0.004072008	0	0	47.7096		0.116436043	11.1088	0.645600829	1.49345742	0	0.455324506	2.12068808	0.794270007	1.218686777	4.94496712	3.008373121	4.843332893	0.576543252	0.001847895	1.86E-06	3.668879004	2.924812129	0.049964381	0.928787955	3.112928178	0	0.949388261	0	0	0	0.962352561	0	0.300538317	0	0	0	0	1.436553602	0.073915801	0.325760622	0.580816382	0.102540559	0.011033101	1.065385307	0.004072008	0	0	47.7096	4000	20% coinsurance	20% coinsurance	20% coinsurance	0	$75 copay	30% coinsurance	30% coinsurance	$50 copay	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$15/$35 copay for in-home/facility	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0	$15/$22.50/$40/$100 copay levels	0	0	0	20% coinsurance	$150 yearly max	$50 max w/specialist copay	0	0	0	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0	0	13.91524163	0.252899889	0.690302101	0	0.872552362	1.07520887	0.030707312	0.338863507	1.828830056	0.425861036	1.03713463	0.005206969	0.041186626	0.000287386	3.606991308	3.907495951	0.042991352	0.439329294	0.574208496	0	0.018141057	0	0	0	0.192477321	0	2.19E-08	0	0	0	0	0.162934661	0.021690221	0.232998668	0.159035484	0.078658547	0.002045455	0.324080077	0.001857359	0	0	30.2792	150	0.062662703	25.024	0.898500718	2.183759522	0	1.327876868	3.19589695	0.824977319	1.557550284	6.773797175	3.434234157	5.880467523	0.58175022	0.043034521	0.000289241	7.275870312	6.832308081	0.092955733	1.368117249	3.687136674	0	0.967529317	0	0	0	1.154829882	0	0.300538339	0	0	0	0	1.599488263	0.095606022	0.55875929	0.739851866	0.181199106	0.013078556	1.389465383	0.005929367	0	0	77.9888
H5530_001_0	2008	8	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			D	D	D	D	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V		S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	1180.383	81.62338649	231.1574305	0.00107679	70.47515473	9.898701995	3.707401471	282.9426204	382.6911561	673.5707568	920.2606836	44.61869981	0.858051919	0.00107679	4259.019869	1697.634749	29.0005873	539.0919611	619.3544928		330.2867545				397.515833	382.2605403	174.4400212					833.8119527	17.16103839	189.0796834	337.120481	119.0342553	0.051499028	618.3765101	2.363496043			$175/day (1-5) with $1750 yearly max	$175/day (1-5) with $1750 yearly max	$75/day for days 21 to 100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$175 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$175 copay	$15/$25 copay for in-home/facility	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$50/$100 copay for Lower/Higher Tier		$15/$22.50/$40/$100 copay levels				$50 max w/specialist copay	$75 yearly max	$50 max w/specialist copay					$25 copay	$50 copay	$25 copay	$25 copay	$10 copay	20% coinsurance	$25 copay	$25 copay			108.9269527	91.54637315	74.77848464	0	74.77848464	0.199409292	0.199409292	49.85232309	174.4831308	51.69400127	60.915123	174.4831308	24.92616155	24.92616155	9.970464619	24.92616155	24.92616155	24.92616155	58.17300277		33.26935439				24.92616155	0	24.92616155					24.92616155	49.85232309	24.92616155	24.92616155	9.970464619	0.199409292	24.92616155	24.92616155			10.7146	0.62269375	1.440466864	0	0.439168773	1.97389316	0.739290304	1.175445578	5.564429254	2.90163063	4.671482728	0.648767536	0.001782328	2.24E-06	3.538700577	3.526293166	0.060239444	1.119791109	3.002475886	0	0.915702257	0	0	0	0.825711989	0	0.362343346	0	0	0	0	1.731977619	0.071293136	0.392752561	0.700259964	0.098902236	0.010269385	1.284479399	0.004909407	0	0	48.5398		0.14378878	10.7146	0.62269375	1.440466864	0	0.439168773	1.97389316	0.739290304	1.175445578	5.564429254	2.90163063	4.671482728	0.648767536	0.001782328	2.24E-06	3.538700577	3.526293166	0.060239444	1.119791109	3.002475886	0	0.915702257	0	0	0	0.825711989	0	0.362343346	0	0	0	0	1.731977619	0.071293136	0.392752561	0.700259964	0.098902236	0.010269385	1.284479399	0.004909407	0	0	48.5398	4000	$250/day (1-5) with no yearly max	$250/day (1-5) with no yearly max	20% coinsurance	$0 copay	$75 copay	30% coinsurance	30% coinsurance	$50 copay	$250 copay	20% coinsurance	20% coinsurance	$250 copay	$15/$25 copay for in-home/facility	$35 copay	$15 copay	$35 copay	$35 copay	$35 copay	20% coinsurance	0	$15/$22.50/$40/$100 copay levels	0	0	0	$50 max w/specialist copay	$75 yearly max	$50 max w/specialist copay	0	0	0	0	$35 copay	20% coinsurance	$35 copay	$35 copay	$15 copay	20% coinsurance	$35 copay	$35 copay	0	0	4.906397304	0.171777586	0.544839937	0	0.713649256	0.8486382	0.024236591	0.277152066	1.733314366	0.336122546	0.818587058	0.004455821	0.024061433	3.13E-06	0.041774591	0.16745541	0.002496278	0.007498003	0.453209863	0	0.014837335	0	0	0	0.472167701	0	3.13E-06	0	0	0	0	0.25638794	0.017119604	0.006248336	0.024368511	0.04954038	0.001614432	0	0.001874501	0	0	11.9198		0.035309965	15.621	0.794471336	1.985306801	0	1.152818029	2.82253136	0.763526895	1.452597643	7.29774362	3.237753176	5.490069786	0.653223357	0.025843762	5.37E-06	3.580475167	3.693748576	0.062735722	1.127289113	3.455685748	0	0.930539592	0	0	0	1.29787969	0	0.362346477	0	0	0	0	1.988365559	0.08841274	0.399000897	0.724628475	0.148442616	0.011883817	1.284479399	0.006783908	0	0	60.4596
H5530_002_0	2008	7	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			D	D	D	D	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V		S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	1257.782784	86.97557514	246.3148288	0.001147397	75.09633427	11.23941351	4.209543655	301.4956644	407.7848866	717.737973	980.6037911	47.54442623	0.914315889	0.001147397	4538.291274	1808.951637	30.90220669	574.4411667	659.9666534		351.9442364				595.2003632	572.3586171	185.8783594					888.4864653	18.28631778	201.47797	359.2260624	126.8395402	0.058474219	658.9245427	2.518474625			$175/day (1-5) with $1750 yearly max	$175/day (1-5) with $1750 yearly max	$75/day for days 21 to 100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$150 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$150 copay	$15/$25 copay for in-home/facility	$20 copay	$10 copay	$20 copay	$20 copay	$20 copay	$50/$100 copay for Lower/Higher Tier		$15/$22.50/$40/$100 copay levels				$50 max w/specialist copay	$150 yearly max	$50 max w/specialist copay					$20 copay	$50 copay	$20 copay	$20 copay	$10 copay	20% coinsurance	$20 copay	$20 copay			108.9940814	91.60279066	74.82456857	0	74.82456857	0.199532183	0.199532183	49.88304571	149.6491371	51.72585887	60.95266332	149.6491371	24.94152286	19.95321829	9.976609143	19.95321829	19.95321829	19.95321829	58.2088532		33.28985738				19.95321829	0	19.95321829					19.95321829	49.88304571	19.95321829	19.95321829	9.976609143	0.199532183	19.95321829	19.95321829			11.4242	0.663933784	1.535866733	0	0.468254234	2.242624712	0.839939434	1.253293501	5.085388034	3.093801091	4.980867727	0.592915197	0.001900369	1.91E-06	3.773063185	3.007867241	0.051383206	0.955162499	3.201325171	0	0.976347787	0	0	0	0.989680231	0	0.309072623	0	0	0	0	1.477347032	0.076014769	0.33501116	0.59730967	0.105452376	0.011667489	1.09563877	0.004187639	0	0	49.1496		0.115234572	11.4242	0.663933784	1.535866733	0	0.468254234	2.242624712	0.839939434	1.253293501	5.085388034	3.093801091	4.980867727	0.592915197	0.001900369	1.91E-06	3.773063185	3.007867241	0.051383206	0.955162499	3.201325171	0	0.976347787	0	0	0	0.989680231	0	0.309072623	0	0	0	0	1.477347032	0.076014769	0.33501116	0.59730967	0.105452376	0.011667489	1.09563877	0.004187639	0	0	49.1496	4000	20% coinsurance	20% coinsurance	20% coinsurance	0	$75 copay	30% coinsurance	30% coinsurance	$50 copay	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$15/$25 copay for in-home/facility	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0	$15/$22.50/$40/$100 copay levels	0	0	0	20% coinsurance	$150 yearly max	$50 max w/specialist copay	0	0	0	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0	0	14.62739988	0.265842873	0.725630581	0	0.891966947	1.13023622	0.03227886	0.346403334	1.922426448	0.447655875	1.090213406	0.005473452	0.030073601	0.000302094	3.79159095	4.107474907	0.045191575	0.461813415	0.603595504	0	0.018544701	0	0	0	0.352914462	0	2.24E-08	0	0	0	0	0.171273379	0.022800289	0.244923142	0.167174648	0.082684156	0.002150138	0.34066594	0.001952416	0	0	31.9307		0.063864174	26.0516	0.929776656	2.261497315	0	1.360221181	3.372860931	0.872218294	1.599696835	7.007814482	3.541456966	6.071081133	0.598388649	0.031973971	0.000304002	7.564654135	7.115342147	0.096574782	1.416975914	3.804920675	0	0.994892488	0	0	0	1.342594692	0	0.309072646	0	0	0	0	1.648620411	0.098815058	0.579934301	0.764484318	0.188136533	0.013817627	1.43630471	0.006140055	0	0	81.0802
H5531_001_0	2008	6																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	1211.225901		638.8385987	918.2360946	183.1161113	6.700165159		242.1444964	258.7510278	1477.311735	5334.846445	0	0	580.3438383	3791.588385	7089.19165	0	1369.500807	0	0	216.5547063				907.6642974		92.88078917															$225/d 10		"$0 days 1-8, $75 days 9-15; $100 16+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$35 per visit	"$35 X-ray; $165 PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$25 per visit	"$35 per visit Spcialist, $30 Renal Dialysis"	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															184.42		64.79	20	100	0.2		48.05	200	35	58.4	35	30	35	25	34.58	35	35	35	35	45				0		0															18.6145	0	3.449196067	1.530393491	1.525967594	1.340033032	0	0.969586921	4.312517129	4.308825892	25.96291937	0	0	1.692669528	7.89914247	20.42868727	0	3.994377353	0	0	0.812080149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.8409			18.6145	0	3.449196067	1.530393491	1.525967594	1.340033032	0	0.969586921	4.312517129	4.308825892	25.96291937	0	0	1.692669528	7.89914247	20.42868727	0	3.994377353	0	0	0.812080149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.8409		30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP		$50 ER; $35 UC	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	$45 per script				30% coins; $1000ded; 5000 max OOP		30% coins; $1000ded; 5000 max OOP															12.5193	0	1.1241	0.2235	0.1074	0.2015		0.1214	0.8839	0.5567	2.5178	0	0	0.4759	0.9753	6.9137	0	0.3077	0	0	0.1087				0.1804		0.0146															27.2319	1000	13.09	31.1338	0	4.573277993	1.753845119	1.633362867	1.541551727	0	1.090992483	5.196414395	4.865519162	28.48071558	0	0	2.16861421	8.874477703	27.3424363	0	4.302124903	0	0	0.920759965	0	0	0	0.180358985	0	0.014576931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.0728
H5531_002_0	2008	4																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	3500	1072.513112		565.6771151	813.0772718	162.1451706	5.932844549		214.4134691	229.1181767	1308.126093	4723.88574	0	0	513.8813291	3357.365669	6277.318698	0	1212.661957	0	0	191.7542894				803.7161848		82.24383588															$150/d 10		"$0 days 1-8, $75 days 9-15; $100 16+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$25 per visit	"$25 X-ray; $175 PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit															122.95		64.79	20	100	0.2		48.05	200	25	52	25	25	25	10	25	25	25	25	25	45				0		0															10.9888	0	3.054185024	1.355128786	1.351209755	1.18656891	0	0.858547266	3.818636278	2.725262693	20.47017154	0	0	1.070586102	2.797804724	13.07774729	0	2.526379078	0	0	0.719078585	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.0001			10.9888	0	3.054185024	1.355128786	1.351209755	1.18656891	0	0.858547266	3.818636278	2.725262693	20.47017154	0	0	1.070586102	2.797804724	13.07774729	0	2.526379078	0	0	0.719078585	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.0001		30% coins; $1000ded; 3500 max OOP	30% coins; $1000ded; 3500 max OOP	30% coins; $1000ded; 3500 max OOP	30% coins; $1000ded; 3500 max OOP	30% coins; $1000ded; 3500 max OOP	30% coins; $1000ded; 3500 max OOP		$50 ER; $35 UC	30% coins; $1000ded; 3500 max OOP	30% coins; $1000ded; 3500 max OOP	30% coins; $1000ded; 3500 max OOP	30% coins; $1000ded; 3500 max OOP	30% coins; $1000ded; 3500 max OOP	30% coins; $1000ded; 3500 max OOP	30% coins; $1000ded; 3500 max OOP	30% coins; $1000ded; 3500 max OOP	30% coins; $1000ded; 3500 max OOP	30% coins; $1000ded; 3500 max OOP	30% coins; $1000ded; 3500 max OOP	30% coins; $1000ded; 3500 max OOP	$45 per script				30% coins; $1000ded; 3500 max OOP		30% coins; $1000ded; 3500 max OOP															9.8349	0	0.8831	0.1755	0.0844	0.1583		0.0986	0.6944	0.4373	1.9779	0	0	0.3739	0.7662	5.4313	0	0.2418	0	0	0.089				0.1417		0.0115															21.3996	1000	16.03	20.8237	0	3.937238523	1.530667364	1.435577067	1.344877468	0	0.957124087	4.513006105	3.162588416	22.44809566	0	0	1.444477548	3.564006165	18.50903315	0	2.768138637	0	0	0.8080641	0	0	0	0.141685965	0	0.01145131	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.3997
H5531_003_0	2008	5																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V			O																																																					0	5000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	948.624126				0		0			0												250/stay	250/stay	"$0 days 1-8, $75 days 9-15; $100 16+"	$0 per visit	$150 per trip	20% coinsurance	20% coinsurance	$50 ER; $50 UC	$250 per procedure	$0 per visit	"$15 X-ray; $125 PET, MRI"	$15 per visit	$15 per visit	$15 per visit	$5 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script				$0 per visit		$0 per visit			0												42.27	42.27	65.64	0	150	0.2	0.2	50	250	0	34.8	15	15	15	5	15	15	15	15	15	45				0		0			0												4.921	0.0958665	6.24191691	0	2.584060057	2.766333837	0.176580511	1.562246934	6.435396625	0	2.92701756	0	0	0	2.029994164	7.525699807	0.221838811	0.641845286	1.052658054	1.591029884	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3308			4.921	0.0958665	6.24191691	0	2.584060057	2.766333837	0.176580511	1.562246934	6.435396625	0	2.92701756	0	0	0	2.029994164	7.525699807	0.221838811	0.641845286	1.052658054	1.591029884	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3308		30% coins; $1000ded; $5000 OOP max	30% coins; $1000ded; $5000 OOP max	30% coins; $1000ded; $5000 OOP max	30% coins; $1000ded; $5000 OOP max	30% coins; $1000ded; $5000 OOP max	30% coins; $1000ded; $5000 OOP max		$50 ER; $50 UC	30% coins; $1000ded; $5000 OOP max	30% coins; $1000ded; $5000 OOP max	30% coins; $1000ded; $5000 OOP max	30% coins; $1000ded; $5000 OOP max	30% coins; $1000ded; $5000 OOP max	30% coins; $1000ded; $5000 OOP max	30% coins; $1000ded; $5000 OOP max	30% coins; $1000ded; $5000 OOP max	30% coins; $1000ded; $5000 OOP max	30% coins; $1000ded; $5000 OOP max	30% coins; $1000ded; $5000 OOP max	30% coins; $1000ded; $5000 OOP max	$45 per script				30% coins; $1000ded; $5000 OOP max		30% coins; $1000ded; $5000 OOP max			0												5.7858	0.0449	0.9382	0.8405	0.1478	0.4788		0.1651	0.5925	0.2056	0.5773	0	0.1893	0.6379	0.7516	0.9392	0.0355	0.0994	0.6985	2.5313	0.1532				0.0977		0.0276			0												15.9376	1000	13.09	10.7068	0.140732484	7.180079031	0.840459825	2.731833883	3.245098455	0.176580511	1.72730189	7.027932282	0.205623035	3.504292303	0	0.189302013	0.637899183	2.781637743	8.464870828	0.257310382	0.741273537	1.751172606	4.122337171	3.710583066	0	0	0	0.097702603	0	0.027584622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.2684
H5531_004_0	2008	4																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	3500	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	948.624126				0		0																	"$0 days 1-8, $75 days 9-15; $100 16+"	$0 per visit	$150 per trip	20% coinsurance	20% coinsurance	$50 ER; $50 UC	$250 per procedure	$0 per visit	"$10 X-ray; $125 PET, MRI"	$10 per visit	$10 per visit	$10 per visit	$0 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script				$0 per visit		$0 per visit															0	0	65.64	0	150	0.2	0.2	50	250	0	30.7	10	10	10	0	10	10	10	10	10	45				0		0															0	0	6.24191691	0	2.584060057	2.766333837	0.176580511	1.562246934	6.435396625	0	2.58216779	0	0	0	0	5.017133205	0.147892541	0.427896857	0.701772036	1.060686589	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2614			0	0	6.24191691	0	2.584060057	2.766333837	0.176580511	1.562246934	6.435396625	0	2.58216779	0	0	0	0	5.017133205	0.147892541	0.427896857	0.701772036	1.060686589	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2614		30% coins; $500ded; $3500 OOP max	30% coins; $500ded; $3500 OOP max	30% coins; $500ded; $3500 OOP max	30% coins; $500ded; $3500 OOP max	30% coins; $500ded; $3500 OOP max	30% coins; $500ded; $3500 OOP max	30% coins; $500ded; $3500 OOP max	$50 ER; $50 UC	30% coins; $500ded; $3500 OOP max	30% coins; $500ded; $3500 OOP max	30% coins; $500ded; $3500 OOP max	30% coins; $500ded; $3500 OOP max	30% coins; $500ded; $3500 OOP max	30% coins; $500ded; $3500 OOP max	30% coins; $500ded; $3500 OOP max	30% coins; $500ded; $3500 OOP max	30% coins; $500ded; $3500 OOP max	30% coins; $500ded; $3500 OOP max	30% coins; $500ded; $3500 OOP max	30% coins; $500ded; $3500 OOP max	$45 per script				30% coins; $500ded; $3500 OOP max		30% coins; $500ded; $3500 OOP max															4.2923	0.0333	0.696	0.6235	0.1096	0.3552	0.0227	0.1259	0.4396	0.1525	0.4283	0	0.1404	0.4732	0.5576	0.6967	0.0263	0.0738	0.5182	1.8779	0.0787				0.0725		0.0205															11.8148	500	15.27	4.2923	0.033284932	6.937915517	0.62351576	2.693689698	3.121517126	0.199252556	1.688165727	6.874983753	0.152546498	3.010433234	0	0.140438347	0.473241173	0.557625246	5.713880289	0.174207996	0.501660147	1.219982209	2.938599059	3.636045663	0	0	0	0.072483075	0	0.020464329	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0763
H5531_005_0	2008	6																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	2081.813619		1301.460809	702.7741044	202.7886596	8.855509873		235.9851306	286.5491928	1297.076633	4268.867768	0	0	439.9779393	5421.155688	6966.300868	0	622.1969227	0	0	239.8196322				1003.041543		91.90243079															$150/d 10		$0 days 1-15; $100 16+	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$20 per visit	"$20 X-ray; $125 PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$10 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit															122.95		51.41	20	100	0.2		48.05	200	20	38.9	20	20	20	10	20	20	20	20	20	45				0		0															21.3299	0	5.575675014	1.171290174	1.689905497	1.771101975	0	0.944923794	4.775819881	2.161794389	13.83824635	0	0	0.733296566	4.51762974	11.61050145	0	1.036994871	0	0	0.899323621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.0564			21.3299	0	5.575675014	1.171290174	1.689905497	1.771101975	0	0.944923794	4.775819881	2.161794389	13.83824635	0	0	0.733296566	4.51762974	11.61050145	0	1.036994871	0	0	0.899323621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.0564		30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP		$50 ER; $35 UC	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	$45 per script				30% coins; $1000ded; 5000 max OOP		30% coins; $1000ded; 5000 max OOP															12.3326	0	1.1304	0.1329	0.1986	0.2684		0.1175	0.8159	0.5041	1.5712	0	0	0.4586	1.6121	6.6449	0	0.1603	0	0	0.1196				0.1858		0.012															26.2649	1000	13.09	33.6625	0	6.706032573	1.304156174	1.888502907	2.039473984	0	1.062452041	5.591716613	2.66591746	15.4094387	0	0	1.191914441	6.129762665	18.25543252	0	1.197297063	0	0	1.01892167	0	0	0	0.185815565	0	0.011983884	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.3213
H5531_006_0	2008	6																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	3500	2103.104826		1314.77116	709.9615435	204.8626279	8.946077294		238.3986071	289.4798001	1310.342147	4312.526502	0	0	444.4776991	5476.599146	7037.546896	0	628.5602797	0	0	242.272325				1013.299889		92.84233896															0		$0 days 1-15; $100 16+	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$175 per procedure	$25 per visit	"$25 X-ray; $125 PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit															0		51.41	20	100	0.2		48.05	175	25	43	25	25	25	10	25	25	25	25	25	45				0		0															0	0	5.632698778	1.183269239	1.707188565	1.789215459	0	0.954587756	4.221580418	2.729879472	15.45321996	0	0	0.925995207	4.563832622	14.66155603	0	1.309500583	0	0	0.908521219	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.041			0	0	5.632698778	1.183269239	1.707188565	1.789215459	0	0.954587756	4.221580418	2.729879472	15.45321996	0	0	0.925995207	4.563832622	14.66155603	0	1.309500583	0	0	0.908521219	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.041		30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP		$50 ER; $35 UC	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	$45 per script				30% coins; $500ded; 3500 max OOP		30% coins; $500ded; 3500 max OOP															9.6357	0	0.8832	0.1038	0.1552	0.2097		0.0859	0.6375	0.3939	1.2276	0	0	0.3583	1.2596	5.1918	0	0.1252	0	0	0.0857				0.1452		0.0094															20.5077	500	15.27	9.6357	0	6.515869813	1.28708011	1.862356706	1.998899893	0	1.040505482	4.859056901	3.12376094	16.68082407	0	0	1.284322552	5.823424414	19.85337397	0	1.434747901	0	0	0.99426874	0	0	0	0.145181428	0	0.009363249	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.5487
H5531_007_0	2008	6																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	2303.577582		1045.095869	460.564674	211.722627	9.364326247		200.3379833	299.1732776	1407.158249	3945.189438	0	0	387.1092515	6034.761853	6922.980392	0	512.78973	0	0	250.38502				984.6490454		80.89026685															0		$0 days 1-15; $100 16+	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$150 per procedure	$20 per visit	"$20 X-ray; $125 PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$10 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit															0		51.41	20	100	0.2		48.05	150	20	38.9	20	20	20	10	20	20	20	20	20	45				0		0															0	0	4.477364887	0.76760779	1.764355225	1.872865249	0	0.802186675	3.73966597	2.345263748	12.78898909	0	0	0.645182086	5.028968211	11.53830065	0	0.85464955	0	0	0.938943825	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5643			0	0	4.477364887	0.76760779	1.764355225	1.872865249	0	0.802186675	3.73966597	2.345263748	12.78898909	0	0	0.645182086	5.028968211	11.53830065	0	0.85464955	0	0	0.938943825	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5643		30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP		$50 ER; $35 UC	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	30% coins; $1000ded; 5000 max OOP	$45 per script				30% coins; $1000ded; 5000 max OOP		30% coins; $1000ded; 5000 max OOP															12.235	0	1.0364	0.0821	0.2174	0.2644		0.0879	0.8063	0.4091	1.265	0	0	0.4645	1.5342	6.2937	0	0.1489	0	0	0.1123				0.1769		0.0095															25.1435	1000	13.91	12.235	0	5.513775452	0.849743359	1.981712649	2.13730397	0	0.89008177	4.54595166	2.754363635	14.05396277	0	0	1.109668473	6.563164601	17.83199809	0	1.003542694	0	0	1.051219574	0	0	0	0.176869839	0	0.009503951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.7078
H5531_008_0	2008	6																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	3500	2338.276076		1060.838015	467.5021008	214.9117778	9.505379895		203.3556488	303.6796864	1428.354093	4004.615321	0	0	392.9402286	6125.662698	7027.260359	0	520.5138161	0	0	254.1565375				999.4806879		82.10870659															0		$0 days 1-15; $100 16+	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$100 per procedure	$20 per visit	"$20 X-ray; $125 PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$0 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit															0		51.41	20	100	0.2		48.05	100	20	38.9	20	20	20	0	20	20	20	20	20	45				0		0															0	0	4.544806861	0.779170168	1.790931482	1.901075979	0	0.81426991	2.530664053	2.380590156	12.981628	0	0	0.654900381	0	11.7121006	0	0.867523027	0	0	0.953087016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9107			0	0	4.544806861	0.779170168	1.790931482	1.901075979	0	0.81426991	2.530664053	2.380590156	12.981628	0	0	0.654900381	0	11.7121006	0	0.867523027	0	0	0.953087016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9107		30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP		$50 ER; $35 UC	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	30% coins; $500ded; 3500 max OOP	$45 per script				30% coins; $500ded; 3500 max OOP		30% coins; $500ded; 3500 max OOP															10.272	0	0.8701	0.069	0.1825	0.222		0.0711	0.6769	0.3435	1.062	0	0	0.39	1.2881	5.2839	0	0.125	0	0	0.0891				0.1485		0.008															21.1017	500	15.27	10.272	0	5.414937063	0.848128013	1.973416364	2.123088495	0	0.885399988	3.207590316	2.724054589	14.04365094	0	0	1.044865176	1.288051917	16.9960454	0	0.992527948	0	0	1.042211632	0	0	0	0.148493072	0	0.007979149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.0124
H5531_801_0	2008	2																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1530.809496		340.8945517	64.31972674	186.5272076	4.784777143		169.3752804	237.4335913	1637.174214	2865.46894	0	0	280.6537677	2647.085856	5109.236444	0	648.3428456	0	0	6.372149373				762.1887619		77.18367209															$200 per day; max $1400		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit Specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2				0		0															18.4424	0	2.840787931	0.214399089	2.331590094	1.435433143	0	0.705730335	3.957226521	5.457247381	13.11907197	0	0	0.935512559	6.617714639	16.81790329	0	2.161142819	0	0	1.274429875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.3106			18.4424	0	2.840787931	0.214399089	2.331590094	1.435433143	0	0.705730335	3.957226521	5.457247381	13.11907197	0	0	0.935512559	6.617714639	16.81790329	0	2.161142819	0	0	1.274429875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.3106		500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP		50	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP				500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP															15.3909		0.5317	0.0134	0.1116	0.2183		0.1199	0.9072	0.9432	1.668	0	0	0.4885	1.3037	7.7508	0	0.1826	0	0	0.3244				0.2303		0.0149															30.1994	500		33.8333	0	3.372492286	0.22776728	2.443175293	1.653761368	0	0.825587806	4.864440993	6.40046454	14.78709378	0	0	1.424012659	7.921444609	24.56872989	0	2.343789087	0	0	1.598783879	0	0	0	0.230261013	0	0.014855583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.51
H5531_802_0	2008	2																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1530.809496		340.8945517	64.31972674	186.5272076	4.784777143		169.3752804	237.4335913	1637.174214	2865.46894	0	0	280.6537677	2647.085856	5109.236444	0	648.3428456	0	0	6.372149373				762.1887619		77.18367209															$200 per day; max $1400		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit Specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2				0		0															18.4424	0	2.840787931	0.214399089	2.331590094	1.435433143	0	0.705730335	3.957226521	5.457247381	13.11907197	0	0	0.935512559	6.617714639	16.81790329	0	2.161142819	0	0	1.274429875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.3106			18.4424	0	2.840787931	0.214399089	2.331590094	1.435433143	0	0.705730335	3.957226521	5.457247381	13.11907197	0	0	0.935512559	6.617714639	16.81790329	0	2.161142819	0	0	1.274429875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.3106		500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP		50	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP				500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP															15.3909		0.5317	0.0134	0.1116	0.2183		0.1199	0.9072	0.9432	1.668	0	0	0.4885	1.3037	7.7508	0	0.1826	0	0	0.3244				0.2303		0.0149															30.1994	500		33.8333	0	3.372492286	0.22776728	2.443175293	1.653761368	0	0.825587806	4.864440993	6.40046454	14.78709378	0	0	1.424012659	7.921444609	24.56872989	0	2.343789087	0	0	1.598783879	0	0	0	0.230261013	0	0.014855583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.51
H5532_001_0	2008	7																					4000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1869.410149	100.6480659	935.9584355		156.8339871	10.32726504	2.891655328	353.0902436	38.86425299	12816.71465	58.12633852		0.120977375	23.52168085	5136.652539	7014.560931	388.5714939	4.836053121			42.37421519	1915.613544			194.6356117		16.8185977															$295 (1a); $0 (1a1)	$295 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1); $50/$15 (4b)"	25% (9b)	25% (8a1); $0/$20 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											182.0975	182.0975	92.592		108.0239	0.15431992	0.199734471	30.864	0.15431992	4.9382	0.084848084		0.185183904	0.154281443	15	24.9819	37.5	0.15431992			0.185183904	25			25		25															28.3679	1.527313476	7.221851532	0	1.411818817	1.593702712	0.577563246	0.908147634	5.997528402	5.27433167	4.931908454	0	0.022403062	3.628958863	6.420815673	14.60311033	1.214285919	0.746299329	0	0	7.847022584	3.99086155	0	0	0.405490858	0	0.035038745	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.7264	0	43.22242017	28.3679	1.527313476	7.221851532	0	1.411818817	1.593702712	0.577563246	0.908147634	5.997528402	5.27433167	4.931908454	0	0.022403062	3.628958863	6.420815673	14.60311033	1.214285919	0.746299329	0	0	7.847022584	3.99086155	0	0	0.405490858	0	0.035038745	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.7264		$350 (1a); $0 (1a1)	$350 (1b)	"$175 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$20 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $30 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											0.8303	0.0447	0.8712	0.2665	0.159	0.2154	0.0603	0.1023	0.8105	0.594	0.6721		0.0025	0.4904	0.7741	1.3188	0.1036	0.1092			0.9568	0.3658			0.0366		0.0032															8.7875	0	0	29.1982	1.572017566	8.093089437	0.266536651	1.570819406	1.809084176	0.637870496	1.01042422	6.808066299	5.868332706	5.604001703	0	0.02492612	4.119326439	7.194948971	15.92192299	1.317870165	0.855500529	0	0	8.803859701	4.356668842	0	0	0.442115839	0	0.038203535	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.5138
H5533_002_0	2008	3																					3100											A	A	D		T	coin	coin	V	V		P	V		V	V	V	V	V			S	P	T		V		V																																																								0	N/A	367.452978	9.712413515	2046.08178		0	3.88711202	8.434474837	376.6731894	860.0148927		3783.39885	1640.0284		4440.076888	16945.29344	8227.623636	31.66721504	1501.091285			285.9842199	194.5093143	98.33503618		0		0															"1a:  $100 per Admit, max 3"	"1b:  $100 per Admit, max 3"	"2:  $60 per day, day 16 - 100"		10a:  $100 per Trip	11a:  20% Coinsurance	11b:  20% Coinsurance	"4a,b:  $50 Copay"	"9a,b:  $60 Copay, max 3x"		8b:  $15/$50 Copay depending on type of Service	9a:  $50 Copay		"7c,i:  $25 Copay"	"7a, 14c:  $10 copay"	"7b,d,f,g, 16b,17a, 18a:  $25 Copay"	"7e,h 9c:  $25 Copay"	"7c,i:  $25 Copay"			15:  $15/$45 Copay per 30/90 day supply	11c:  $15/$45 Copay per 30/90 day supply	10a:  $100 per Trip		17a:  $25 copay		18a:  $25 copay															97.35682819	100	7.120253165		0	0.2	0.2	50	60		28.04845815	50		1.210585586	3.650044261	19.62674755	21.05263158	25			0	145.1171766	50		0		0															2.9812	0.080936779	1.214051689	0	0	0.777422404	1.686894967	1.569471623	4.300074464	0	8.843208692	6.833451667	0	0.447924423	5.154255922	13.456791	0.055556518	3.127273511	0	0	0	2.352220209	0.409729317	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.2904		0.87128137	2.9812	0.080936779	1.214051689	0	0	0.777422404	1.686894967	1.569471623	4.300074464	0	8.843208692	6.833451667	0	0.447924423	5.154255922	13.456791	0.055556518	3.127273511	0	0	0	2.352220209	0.409729317	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.2904		20% Coinsurance	0	0	0	0	50% Coinsurance	50% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	0	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	0	0	0	0	0	0	0	0	0	0	0	0	0											4.9284	0	0	0	0	0.2507	0.0435	0.1528	0.4529	0.3914	0.2635	0.1597	0	0.2067	0.1836	0.3989	0.0027	0.9263	0	0	0	0	0.0004	0	0	0	0	0	0	0	0											8.3616			7.9096	0.080936779	1.214051689	0	0	1.028082287	1.730426199	1.722252046	4.752961597	0.391373712	9.106748927	6.993176655	0	0.654672605	5.337862435	13.85572411	0.058235175	4.053572886	0	0	0	2.352220209	0.410122926	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.652
H5533_801_0	2008	3																					3250											A	A	D		T	coin	coin	V	V		P	V		V	V	V	V	V			S	P	T	V	V		V																																																								0		232.9964079	3.949091659	943.8329064		105.7184818	19.52809541	1.072362813	386.2790683	223.6352501		2858.465105	1276.753973		4989.099124	14389.91182	8508.03641	69.12362275	1473.86599			193.8031667	4930.89808	12.19828637	106.3262509	0		0															"1a:  $100 per Admit, max 3"	"1b:  $100 per Admit, max 3"	"2:  $25 per day, day 16 - 100"		10a:  $75 per Trip	11a:  15% Coinsurance	11b:  15% Coinsurance	"4a,b:  $50 Copay"	"9a,b:  $100 Copay, max 3x"		8b:  $0/$30 Copay depending on type of Service	9a:  $50 Copay for Observations		"7c,i:  $25 Copay"	"7a, 14c:  $10 copay"	"7b,d,f,g 16b,17a, 18a:  $20 Copay"	"7e,h 9c:  $20 Copay"	"7c,i:  $25 Copay"			15:  $15/$45 Copay per 30/90 day supply	11c:  $15/$45 Copay per 30/90 day supply	10a:  $75 per Trip	"16a:  $20 Copay, 16b:  20% coinsurance"	17a:  $20 copay		18a:  $20 copay															95	95	2.782426778		71.25	0.041654066	0.1425	47.5	95		10.90540541	47.5		1.052974735	3.317886409	16.10110332	19	23.75			0	20.48546924	71.25	0	0		0															1.8446	0.031263642	0.218845496	0	0.627703486	0.813424567	0.152811701	1.529021312	1.77044573	0	2.597726734	5.05381781	0	0.437782944	3.978674403	11.41573111	0.109445736	2.917026439	0	0	0	8.417646743	0.072427325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9884		0	1.8446	0.031263642	0.218845496	0	0.627703486	0.813424567	0.152811701	1.529021312	1.77044573	0	2.597726734	5.05381781	0	0.437782944	3.978674403	11.41573111	0.109445736	2.917026439	0	0	0	8.417646743	0.072427325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9884		20% Coinsurance					50% Coinsurance	50% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance		20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance																								0.5388					0.9092	0.2462	0.1127	0.1758	0.1903	0.2229	0		0.2604	0.1017	0.3069	0	0.9821																								4.047			2.3833	0.031263642	0.218845496	0	0.627703486	1.722631921	0.399006145	1.64168604	1.946291446	0.190330584	2.820672914	5.05381781	0	0.698143217	4.080395304	11.72260533	0.109445736	3.899106416	0	0	0	8.417646743	0.072427325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0353
H5533_802_0	2008	3																					3250											A	A	D		T	coin	coin	V	V		P	V		V	V	V	V	V			S	P	T	V	V		V																																																								0		232.9964079	3.949091659	943.8329064		105.7184818	19.52809541	1.072362813	386.2790683	223.6352501		2858.465105	1276.753973		4989.099124	14389.91182	8508.03641	69.12362275	1473.86599			193.8031667	4930.89808	12.19828637	106.3262509	0		0															"1a:  $100 per Admit, max 3"	"1b:  $100 per Admit, max 3"	"2:  $25 per day, day 16 - 100"		10a:  $75 per Trip	11a:  15% Coinsurance	11b:  15% Coinsurance	"4a,b:  $50 Copay"	"9a,b:  $100 Copay, max 3x"		8b:  $0/$30 Copay depending on type of Service	9a:  $50 Copay for Observations		"7c,i:  $25 Copay"	"7a, 14c:  $10 copay"	"7b,d,f,g 16b,17a, 18a:  $20 Copay"	"7e,h 9c:  $20 Copay"	"7c,i:  $25 Copay"			15:  $15/$45 Copay per 30/90 day supply	11c:  $15/$45 Copay per 30/90 day supply	10a:  $75 per Trip	"16a:  $20 Copay, 16b:  20% coinsurance"	17a:  $20 copay		18a:  $20 copay															95	95	2.782426778		71.25	0.041654066	0.1425	47.5	95		10.90540541	47.5		1.052974735	3.317886409	16.10110332	19	23.75			0	20.48546924	71.25	0	0		0															1.8446	0.031263642	0.218845496	0	0.627703486	0.813424567	0.152811701	1.529021312	1.77044573	0	2.597726734	5.05381781	0	0.437782944	3.978674403	11.41573111	0.109445736	2.917026439	0	0	0	8.417646743	0.072427325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9884		0	1.8446	0.031263642	0.218845496	0	0.627703486	0.813424567	0.152811701	1.529021312	1.77044573	0	2.597726734	5.05381781	0	0.437782944	3.978674403	11.41573111	0.109445736	2.917026439	0	0	0	8.417646743	0.072427325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9884		20% Coinsurance					50% Coinsurance	50% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance		20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance																								0.5388					0.9092	0.2462	0.1127	0.1758	0.1903	0.2229	0		0.2604	0.1017	0.3069	0	0.9821																								4.047			2.3833	0.031263642	0.218845496	0	0.627703486	1.722631921	0.399006145	1.64168604	1.946291446	0.190330584	2.820672914	5.05381781	0	0.698143217	4.080395304	11.72260533	0.109445736	3.899106416	0	0	0	8.417646743	0.072427325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0353
H5533_803_0	2008	3																					3250											A	A	D		T	coin	coin	V	V		P	V		V	V	V	V	V			S	P	T	V	V		V																																																								0		232.9964079	3.949091659	943.8329064		105.7184818	19.52809541	1.072362813	386.2790683	223.6352501		2858.465105	1276.753973		4989.099124	14389.91182	8508.03641	69.12362275	1473.86599			193.8031667	4930.89808	12.19828637	106.3262509	0		0															"1a:  $100 per Admit, max 3"	"1b:  $100 per Admit, max 3"	"2:  $25 per day, day 16 - 100"		10a:  $75 per Trip	11a:  15% Coinsurance	11b:  15% Coinsurance	"4a,b:  $50 Copay"	"9a,b:  $100 Copay, max 3x"		8b:  $0/$30 Copay depending on type of Service	9a:  $50 Copay for Observations		"7c,i:  $25 Copay"	"7a, 14c:  $10 copay"	"7b,d,f,g 16b,17a, 18a:  $20 Copay"	"7e,h 9c:  $20 Copay"	"7c,i:  $25 Copay"			15:  $15/$45 Copay per 30/90 day supply	11c:  $15/$45 Copay per 30/90 day supply	10a:  $75 per Trip	"16a:  $20 Copay, 16b:  20% coinsurance"	17a:  $20 copay		18a:  $20 copay															95	95	2.782426778		71.25	0.041654066	0.1425	47.5	95		10.90540541	47.5		1.052974735	3.317886409	16.10110332	19	23.75			0	20.48546924	71.25	0	0		0															1.8446	0.031263642	0.218845496	0	0.627703486	0.813424567	0.152811701	1.529021312	1.77044573	0	2.597726734	5.05381781	0	0.437782944	3.978674403	11.41573111	0.109445736	2.917026439	0	0	0	8.417646743	0.072427325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9884		0	1.8446	0.031263642	0.218845496	0	0.627703486	0.813424567	0.152811701	1.529021312	1.77044573	0	2.597726734	5.05381781	0	0.437782944	3.978674403	11.41573111	0.109445736	2.917026439	0	0	0	8.417646743	0.072427325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9884		20% Coinsurance					50% Coinsurance	50% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance		20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance																								0.5388					0.9092	0.2462	0.1127	0.1758	0.1903	0.2229	0		0.2604	0.1017	0.3069	0	0.9821																								4.047			2.3833	0.031263642	0.218845496	0	0.627703486	1.722631921	0.399006145	1.64168604	1.946291446	0.190330584	2.820672914	5.05381781	0	0.698143217	4.080395304	11.72260533	0.109445736	3.899106416	0	0	0	8.417646743	0.072427325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0353
H5539_001_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		335.949766	39.46710477	38.62642628		15.13653378	22.25349355	19.09961298	27.08240548	38.06642936	10.75874327	19.41457819	2.902209898	3.111149094	36.994423	45.29819497	105.8356101	17.22274783	3.93345119	27.39563392	8.139748531	18.88070969	6.496135247																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.0684	0.0684	0.1835		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				22.979	2.699549967	7.087949222	0	3.541948904	5.207317492	4.469309438	6.337282883	8.90754447	2.517545926	4.543011297	0.679117116	0.728008888	8.656694981	10.59977762	24.76553277	4.030122992	0.920427578	6.410578337	1.904701156	4.418086067	1.520095648	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.9236	0	0	22.979	2.699549967	7.087949222	0	3.541948904	5.207317492	4.469309438	6.337282883	8.90754447	2.517545926	4.543011297	0.679117116	0.728008888	8.656694981	10.59977762	24.76553277	4.030122992	0.920427578	6.410578337	1.904701156	4.418086067	1.520095648	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.9236																																																																																				0	0	0	22.979	2.699549967	7.087949222	0	3.541948904	5.207317492	4.469309438	6.337282883	8.90754447	2.517545926	4.543011297	0.679117116	0.728008888	8.656694981	10.59977762	24.76553277	4.030122992	0.920427578	6.410578337	1.904701156	4.418086067	1.520095648	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.9236
H5549_001_0	2008	7																																coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin																																																													0		640.0471993	54.06506966	62.2703676		26.15623188	25.68351758	18.07077973	15.73637727	28.04851995	25.51896813	53.06956913	2.270894298	12.85463032	49.96438136	92.99040955	150.3909297	27.01665624	30.03406291			14.2220454	15.05632973																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.0569	0.0569	0.1798		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				36.4187	3.076302463	11.19621209	0	6.120558261	6.009943114	4.228562456	3.68231228	6.563353669	5.971438543	12.41827918	0.531389266	3.007983495	11.69166524	21.75975583	35.19147756	6.32189756	7.02797072	0	0	3.327958623	3.523181157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	188.0689	0	0	36.4187	3.076302463	11.19621209	0	6.120558261	6.009943114	4.228562456	3.68231228	6.563353669	5.971438543	12.41827918	0.531389266	3.007983495	11.69166524	21.75975583	35.19147756	6.32189756	7.02797072	0	0	3.327958623	3.523181157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	188.0689																																																																																				0	0	0	36.4187	3.076302463	11.19621209	0	6.120558261	6.009943114	4.228562456	3.68231228	6.563353669	5.971438543	12.41827918	0.531389266	3.007983495	11.69166524	21.75975583	35.19147756	6.32189756	7.02797072	0	0	3.327958623	3.523181157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	188.0689
H5549_002_0	2008	6																																coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin																																																													0		640.0471993	54.06506966	62.2703676		26.15623188	25.68351758	18.07077973	15.73637727	28.04851995	25.51896813	53.06956913	2.270894298	12.85463032	49.96438136	92.99040955	150.3909297	27.01665624	30.03406291			14.2220454	15.05632973																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.0569	0.0569	0.1798		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				36.4187	3.076302463	11.19621209	0	6.120558261	6.009943114	4.228562456	3.68231228	6.563353669	5.971438543	12.41827918	0.531389266	3.007983495	11.69166524	21.75975583	35.19147756	6.32189756	7.02797072	0	0	3.327958623	3.523181157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	188.0689	0	0	36.4187	3.076302463	11.19621209	0	6.120558261	6.009943114	4.228562456	3.68231228	6.563353669	5.971438543	12.41827918	0.531389266	3.007983495	11.69166524	21.75975583	35.19147756	6.32189756	7.02797072	0	0	3.327958623	3.523181157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	188.0689																																																																																				0	0	0	36.4187	3.076302463	11.19621209	0	6.120558261	6.009943114	4.228562456	3.68231228	6.563353669	5.971438543	12.41827918	0.531389266	3.007983495	11.69166524	21.75975583	35.19147756	6.32189756	7.02797072	0	0	3.327958623	3.523181157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	188.0689
H5549_003_0	2008	7																					3250											D	Coin	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	P	P	Coin	P	Coin	P	Coin	P	P	P	P	P	P	P	P	P	P																																																				0									485.9940414						39.00084906		7880.396501	21.76684205	4875.005192																								1a (IP Acute) - $0	1b (IP Psych) - $0	2 (SNF) - $0	6 (Home Health)- $0	10a (Ambulance) - $0	11a (Medical Equip) - $0	"11b (Med Supp), 11c (Diab Supp) - $0"	"4a (ER) $50, 4b (UC) - $10"	"9a (OP Surgery), 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	"3 (CORF)-$10, 7i, 7c (OP PT/ST/OT)-$10, 9c (OP SA)-$20"	"14g (Bone Mass) 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) - $0, 14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0; 7a (PCP)- $0"	"7b (Chiro), 7d (Spec), 7f (Pod) - $10"	"7e (MH), 7h (Psychiatric) - $20"	"7c (OT), 7i (PT/ST) - $10"	8b (Professional Radiology) - $0		15 (Part B Rx) - $0	13a (Blood) - $0; 17a (MCR Eye Exam) - $0; 17b (MCR Eyewear) - $0; 18a (MCR Hearing Exam) - $0	10b (Transportation-wheelchair) - $0																										48.148						18.7176		9.6296	0.175511969	9.6296																								0	0	0	0	0	0	0	1.949970538	0	0	0	0	0	0.060833432	0	6.323756958	3.820341318	3.912030061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0669	0	0.618006458	0	0	0	0	0	0	0	1.949970538	0	0	0	0	0	0.060833432	0	6.323756958	3.820341318	3.912030061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0669																																																																																				0	0	0	0	0	0	0	0	0	0	1.949970538	0	0	0	0	0	0.060833432	0	6.323756958	3.820341318	3.912030061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0669
H5554_001_0	2008	4																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	288.61	9.79	88.71	60.02	10.56	22.01	16.8	7.87	25.95	9.71	21.32	1	1.98	34.37	63.3	116.87	4.58	6.03	24.39	44.38	8.48	4.92	0	0	0	0	0	0	0	0.5	20.99											Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing											0.056799766	0.056822224	0.131898556	0	0.233983334	0.233999933	0.233917312	0.234054195	0.234000005	0.234022738	0.233966641	0.234000028	0.234000005	0.234011606	0.230673933	0.233998067	0.233989015	0.234019689	0.233997631	0.226260067	0.234003301	0.234005422	0	0	0	0	0	0	0	0	0											16.393	0.556289571	11.70072088	0	2.470864003	5.150338531	3.929810836	1.842006516	6.072300119	2.272360787	4.98816878	0.234000028	0.463320011	8.042978885	14.60165994	27.34735406	1.07166969	1.411138722	5.707202224	10.04142177	1.98434799	1.151306677	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.4322	0	0	16.393	0.556289571	11.70072088	0	2.470864003	5.150338531	3.929810836	1.842006516	6.072300119	2.272360787	4.98816878	0.234000028	0.463320011	8.042978885	14.60165994	27.34735406	1.07166969	1.411138722	5.707202224	10.04142177	1.98434799	1.151306677	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.4322	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.393	0.556289571	11.70072088	0	2.470864003	5.150338531	3.929810836	1.842006516	6.072300119	2.272360787	4.98816878	0.234000028	0.463320011	8.042978885	14.60165994	27.34735406	1.07166969	1.411138722	5.707202224	10.04142177	1.98434799	1.151306677	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.4322
H5575_005_0	2008	8																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	397.73	20.1	347.12	4.93	51.47	8.7	41.98	9.49	11.23	21.14	14.41	0.79	1.21	120.75	60.3	99.08	6.64	0.67	19.89	37.82	3.52	5.17	13.33	0	0	0	0	0	0	0	52.5											PBP: 1A IP Acute: Medicare Cost Sharing	1B IP Psych: Medicare Cost Sharing	2 SNF: $0	6 Home Health: Medicare Cost Sharing	10A Ambulance: Medicare Cost Sharing	11A DME: Medicare Cost Sharing	11B Prosthetic Medical Supplies: Medicare Cost Sharing	"4A ER: $0, 4B Urgent Care: Medicare Cost Sharing"	9B ASC Services: Medicare Cost Sharing	8A OP C/D/T: Medicare Cost Sharing	8B OP X-Ray: Medicare Cost Sharing	9A OP Hospital: Medicare Cost Sharing	12 Renal Dialysis: Medicare Cost Sharing	"3 CORF, 5 Partial Hosp, 9C OP Substance Abuse, 9D Cardiac Rehab: Medicare Cost Sharing"	"7A PCP and 14C Routine Physical Exams:$0; 14B Immunizations, 14D Pap Smears, 14D Pelvic Exams, 14E Prostate Screening, 14F Colorectal Screening, 14G Bone Mass Measurement, 14H Mammography, 14I Diabetes Monitoring: Medicare Cost Sharing"	"7B Chiropractic, 7D Physician Specialist, 7F Podiatry: Medicare Cost Sharing"	"7E Mental Health, 7H Psychiatric:Medicare Cost Sharing"	"7C Occupational Therapy, 7I Physical and Speech Therapy: Medicare Cost Sharing"	Included in i.2.	"7G Other Health Care, 18A Medicare Covered Hearing Exams: Medicare Cost Sharing"	15 Part B Drugs: Medicare Cost Sharing	"13A Blood, 16B Medicare Covered Comprehensive Dental Services, 17A Medicare Covered Eye Exams: Medicare Cost Sharing"	10B Transportation: $0	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: $0"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.081518206	0.08153178	0	0	0.234000647	0.234000561	0.233993231	0.234101507	0.234000006	0.233955476	0.233979311	0.234000191	0.234000012	0.234004313	0	0.23400153	0.233998698	0.234037092	0.233999291	0.233162483	0.234005995	0.234003291	0	0	0	0	0	0	0	0	0											32.4222	1.638788768	0	0	12.04401333	2.03580488	9.823035855	2.221623298	2.62782007	4.945818768	3.371641872	0.184860151	0.283140014	28.2560208	0	23.18487155	1.553751355	0.156804852	4.654245907	8.818205116	0.823701101	1.209797014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2562	0	0	32.4222	1.638788768	0	0	12.04401333	2.03580488	9.823035855	2.221623298	2.62782007	4.945818768	3.371641872	0.184860151	0.283140014	28.2560208	0	23.18487155	1.553751355	0.156804852	4.654245907	8.818205116	0.823701101	1.209797014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	32.4222	1.638788768	0	0	12.04401333	2.03580488	9.823035855	2.221623298	2.62782007	4.945818768	3.371641872	0.184860151	0.283140014	28.2560208	0	23.18487155	1.553751355	0.156804852	4.654245907	8.818205116	0.823701101	1.209797014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2562
H5575_006_0	2008	8																					500											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1896.99	139.72	0	0	1802.02	0	0	399.56	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											"PBP: 1A IP Acute: $25 per day for days 1-20, $0 thereafter"	"1B IP Psych: $25 per day for days 1- 20, $0 thereafter"	2 SNF: $0	6 Home Health: $0	10A Ambulance: $50	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $0, 7D Physician Specialist: $0, 7F Podiatry: $0"	"7E Mental Health: $0, 7H Psychiatric: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: $0	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: $0"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											19.20122135	19.20122135	0	0	38.4024427	0	0	38.20868125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											3.0354	0.223566221	0	0	5.766830816	0	0	1.272221723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.298	0	0	3.0354	0.223566221	0	0	5.766830816	0	0	1.272221723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.298	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.0354	0.223566221	0	0	5.766830816	0	0	1.272221723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.298
H5575_007_0	2008	11																					500											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	2309.97	192.53	0	0	2186.13	0	0	460.51	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											"PBP: 1A IP Acute: $25 per day for days 1-20, $0 thereafter"	"1B IP Psych: $25 per day for days 1- 20, $0 thereafter"	2 SNF: $0	6 Home Health: $0	10A Ambulance: $50	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $0, 7D Physician Specialist: $0, 7F Podiatry: $0"	"7E Mental Health: $0, 7H Psychiatric: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: $0	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: $0"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											18.23848039	18.23848039	0	0	36.47696078	0	0	36.2935106	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											3.5109	0.292621219	0	0	6.645281522	0	0	1.392793714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.8416	0	0	3.5109	0.292621219	0	0	6.645281522	0	0	1.392793714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.8416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.5109	0.292621219	0	0	6.645281522	0	0	1.392793714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.8416
H5576_005_0	2008	7																					3250											D	D	D	V	Coin	Coin	Coin	V	V	P	P	V	Coin	Coin	P	P	V	Coin	Coin	P	S	V	P	P	P	P	P	P	Coin	P	P																																																				0		2382.023281	147.9540416			6.86305629	19.72504078	12.38417318	307.182379	408.8224138	1175.950824	442.1211319		0.036323818	8.847027581	3644.125589	4294.172457	228.378826	3.381593231		172.4315988	1305.405691	1452.867849			259.8270369				16.30260146													1a (IP Acute) - $250 Days 1-4	1b (IP Psych) - $250 Days 1-4	2 (SNF) - $0	6 (Home Health)- $0	10a (Ambulance) - 20%	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) $50, 4b (UC) - $50"	"9a (OP Surgery), 9b (ASC) - $250"	8a (OP Diag Proc/Test/Lab) - $250	"8b (OP Diag & Therap Rad) - $0 diagnostic, $200 High Tech, $0 Radiation Therapy"		12 (Renal Dialysis) - 20%	"3 (CORF)-$20%, 7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - 20%"	"14g (Bone Mass) 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) - $0, 14j (Nutrition Therap) - 20%; 14i (Diab Mon.) - $0; 7a (PCP)- $10"	"7b (Chiro), 7d (Spec), 7f (Pod) - $35"	"7e (MH), 7h (Psychiatric) - $35"	"7c (OT), 7i (PT/ST) - 20%"	8b (Professional Radiology) - $0	7g (Prof. Other - allergy visits)  - 20%	15 (Part B Rx) - 20%	13a (Blood) - $0; 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - 20%; 18a (MCR Hearing Exam) - 20%			17a1 (Vision) - $35				additional 20%													90.0585	90.0585			0.132927704	0.132927704	0.132927704	33.2319	166.1596	166.1596	166.1596		0.132927704	0.133025979	6.6447	23.2623	23.2623	0.132927704		5.2272	26.952	23.2126			23.2623				0.505678163													17.8768	1.110376827	0	0	0.912290314	2.622004378	1.646199705	0.850688506	5.660815076	16.2829628	6.1218903	0	0.004828442	1.176884507	2.017843554	8.324377898	0.44271898	0.449507423	0	0.075111612	2.931943234	2.810404398	0	0	0.50368225	0	0	0	8.243869562	0	0	0	0	0	0	0	0	0	0	0	0	80.0652	0	40.39907425	17.8768	1.110376827	0	0	0.912290314	2.622004378	1.646199705	0.850688506	5.660815076	16.2829628	6.1218903	0	0.004828442	1.176884507	2.017843554	8.324377898	0.44271898	0.449507423	0	0.075111612	2.931943234	2.810404398	0	0	0.50368225	0	0	0	8.243869562	0	0	0	0	0	0	0	0	0	0	0	0	80.0652																																																																																				0	0	0	17.8768	1.110376827	0	0	0.912290314	2.622004378	1.646199705	0.850688506	5.660815076	16.2829628	6.1218903	0	0.004828442	1.176884507	2.017843554	8.324377898	0.44271898	0.449507423	0	0.075111612	2.931943234	2.810404398	0	0	0.50368225	0	0	0	8.243869562	0	0	0	0	0	0	0	0	0	0	0	0	80.0652
H5576_006_0	2008	7																					3250											A	A	D	V	Coin	Coin	Coin	V	V	P	P	V	Coin	Coin	P	P	V	Coin	Coin	P	S	V	P	P	P	P	P	P	Coin	P	P																																																				0		390.4939737	16.27447931			6.876899656	19.72504078	12.38417318	318.4837222	423.8842922	1219.275328	458.4098052		0.037662064	9.172970702	3774.514426	4443.796973	236.7927828	3.506178245		178.7843419	1305.405691	1506.206292			259.8270369				16.479													1a (IP Acute) - $100	1b (IP Psych) - $100	2 (SNF) - $0	6 (Home Health)- $0	10a (Ambulance) - 20%	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) $50, 4b (UC) - $50"	"9a (OP Surgery), 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $50	"8b (OP Diag & Therap Rad) - $0 diagnostic, $50 High Tech, $0 Radiation Therapy"		12 (Renal Dialysis) - 20%	"3 (CORF)-$20%, 7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - 20%"	"14g (Bone Mass) 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) - $0, 14j (Nutrition Therap) - 20%; 14i (Diab Mon.) - $0; 7a (PCP)- $5"	"7b (Chiro), 7d (Spec), 7f (Pod) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - 20%"	8b (Professional Radiology) - $0	7g (Prof. Other - allergy visits)  - 20%	15 (Part B Rx) - 20%	13a (Blood) - $0; 17a (MCR Eye Exam) - $25; 17b (MCR Eyewear) - 20%; 18a (MCR Hearing Exam) - 20%			17a1 (Vision) - $25				additional 20%													85.373	85.373			0.170746042	0.170746042	0.170746042	42.6865	85.373	42.6865	42.6865		0.170746042	0.170811277	4.2699	21.3433	21.3433	0.170746042		6.7144	34.62	21.3106			21.3433				0.65353444													2.7781	0.115783455	0	0	1.174203398	3.367972642	2.114548555	1.13291323	3.015690216	4.337217426	1.630659581	0	0.006430648	1.566846836	1.343057327	7.903757759	0.421160734	0.598666058	0	0.100035662	3.76609005	2.674845598	0	0	0.462129564	0	0	0	10.76959403	0	0	0	0	0	0	0	0	0	0	0	0	49.2797	0	8.443109028	2.7781	0.115783455	0	0	1.174203398	3.367972642	2.114548555	1.13291323	3.015690216	4.337217426	1.630659581	0	0.006430648	1.566846836	1.343057327	7.903757759	0.421160734	0.598666058	0	0.100035662	3.76609005	2.674845598	0	0	0.462129564	0	0	0	10.76959403	0	0	0	0	0	0	0	0	0	0	0	0	49.2797																																																																																				0	0	0	2.7781	0.115783455	0	0	1.174203398	3.367972642	2.114548555	1.13291323	3.015690216	4.337217426	1.630659581	0	0.006430648	1.566846836	1.343057327	7.903757759	0.421160734	0.598666058	0	0.100035662	3.76609005	2.674845598	0	0	0.462129564	0	0	0	10.76959403	0	0	0	0	0	0	0	0	0	0	0	0	49.2797
H5576_801_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		335.6046714	10.49055253	22.29912435		6.745246186	19.34741856	12.14708678	14.45492092	47.16759956	18.50781349	19.37935249	4.350115364	0.03694105	33.36548332	38.33055044	99.17509436	4.681914999	3.439054897	30.73799448	0.574657822	21.6344158	8.597491715																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.074982085	0.074982085	0.23213878		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				25.1643	0.786603499	5.176491512	0	1.578387607	4.527295944	2.842418307	3.382451494	11.0372183	4.330828357	4.534768483	1.017926995	0.008644206	7.807523096	8.969348804	23.20697208	1.09556811	0.804738846	7.192690707	0.13446993	5.062453298	2.011813061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.673	0	0	25.1643	0.786603499	5.176491512	0	1.578387607	4.527295944	2.842418307	3.382451494	11.0372183	4.330828357	4.534768483	1.017926995	0.008644206	7.807523096	8.969348804	23.20697208	1.09556811	0.804738846	7.192690707	0.13446993	5.062453298	2.011813061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.673																																																																																				0	0	0	25.1643	0.786603499	5.176491512	0	1.578387607	4.527295944	2.842418307	3.382451494	11.0372183	4.330828357	4.534768483	1.017926995	0.008644206	7.807523096	8.969348804	23.20697208	1.09556811	0.804738846	7.192690707	0.13446993	5.062453298	2.011813061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.673
H5576_802_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		335.6046714	10.49055253	22.29912435		6.745246186	19.34741856	12.14708678	14.45492092	47.16759956	18.50781349	19.37935249	4.350115364	0.03694105	33.36548332	38.33055044	99.17509436	4.681914999	3.439054897	30.73799448	0.574657822	21.6344158	8.597491715																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.074982085	0.074982085	0.23213878		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				25.1643	0.786603499	5.176491512	0	1.578387607	4.527295944	2.842418307	3.382451494	11.0372183	4.330828357	4.534768483	1.017926995	0.008644206	7.807523096	8.969348804	23.20697208	1.09556811	0.804738846	7.192690707	0.13446993	5.062453298	2.011813061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.673	0	0	25.1643	0.786603499	5.176491512	0	1.578387607	4.527295944	2.842418307	3.382451494	11.0372183	4.330828357	4.534768483	1.017926995	0.008644206	7.807523096	8.969348804	23.20697208	1.09556811	0.804738846	7.192690707	0.13446993	5.062453298	2.011813061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.673																																																																																				0	0	0	25.1643	0.786603499	5.176491512	0	1.578387607	4.527295944	2.842418307	3.382451494	11.0372183	4.330828357	4.534768483	1.017926995	0.008644206	7.807523096	8.969348804	23.20697208	1.09556811	0.804738846	7.192690707	0.13446993	5.062453298	2.011813061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.673
H5576_803_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		335.6046714	10.49055253	22.29912435		6.745246186	19.34741856	12.14708678	14.45492092	47.16759956	18.50781349	19.37935249	4.350115364	0.03694105	33.36548332	38.33055044	99.17509436	4.681914999	3.439054897	30.73799448	0.574657822	21.6344158	8.597491715																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.074982085	0.074982085	0.23213878		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				25.1643	0.786603499	5.176491512	0	1.578387607	4.527295944	2.842418307	3.382451494	11.0372183	4.330828357	4.534768483	1.017926995	0.008644206	7.807523096	8.969348804	23.20697208	1.09556811	0.804738846	7.192690707	0.13446993	5.062453298	2.011813061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.673	0	0	25.1643	0.786603499	5.176491512	0	1.578387607	4.527295944	2.842418307	3.382451494	11.0372183	4.330828357	4.534768483	1.017926995	0.008644206	7.807523096	8.969348804	23.20697208	1.09556811	0.804738846	7.192690707	0.13446993	5.062453298	2.011813061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.673																																																																																				0	0	0	25.1643	0.786603499	5.176491512	0	1.578387607	4.527295944	2.842418307	3.382451494	11.0372183	4.330828357	4.534768483	1.017926995	0.008644206	7.807523096	8.969348804	23.20697208	1.09556811	0.804738846	7.192690707	0.13446993	5.062453298	2.011813061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.673
H5577_001_0	2008	6																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1106.28658	22.34411542	657.6934671	1813.528846	190.2884391	22400.29288	22684.79476	216.6348555	209.5958475	1584.880494	658.7949548	0	44.66600636	442.3368334	8937.34639	17439.3655	176.3866758	496.035366	3640.500112	13271.46462	296.9322371	958.6835795	0	1532.534463	460.738566	321.3865987	0	0	0	0	407.0513303											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	varies	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.228244026	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.25242771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.2524			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.25242771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.2524																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.25242771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.2524
H5577_002_0	2008	5																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1134.822881	20.27734076	766.7354915	1988.004679	197.2065894	22959.12733	23311.94769	248.2153007	230.182011	1781.616001	743.648812	0	49.63399628	502.6110215	9411.626967	18682.78303	183.234489	510.0926455	3942.113031	13272.89295	341.1870025	1010.40693	0	1532.534463	484.8775884	349.004122	0	0	0	0	447.5148529											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	varies	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.263400555	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.291340614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.2913			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.291340614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.2913																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.291340614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.2913
H5577_004_0	2008	5																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1122.643084	22.20445712	683.7911651	1863.049678	193.4592438	22728.10834	23027.66038	224.459934	215.3940754	1636.027891	680.6026074	0	46.00495097	457.5661279	9112.829588	17838.32544	179.4032013	503.5937278	3731.260816	13419.14687	307.8300162	977.6580684	0	1532.534463	469.7297609	329.575236	0	0	0	0	418.3979339											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5578_002_0	2008	9																					5000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1789.418652	183.3581042	1280.62582	2342.467449	244.1198983	13.82511803	6.275720679	437.5341016	289.4702094	0	16.91327653	2.692243974	0.52742409	24.9646511	3775.771358	7333.702795	392.3617565	340.3867676	0	0	24.74870139	0	0	0	144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 175 days 1-5	1b 250 days 1-5	2a 25 days 11-100	6a 15 copay	10a 125 copay	11a 20% coin	11b 10% coin	4a 50 copay; 4b 30 copay; 4a World 50 copay	9b 475 copay; ASC:9b 250 copay		8b 15% coin; TherRad:8b 20% coin	9a 15% coin	12 20% coin	3 35 copay; 5 50 copay; 9a 15% coin; 9a 20% coin; 9c 50 copay; 9d 35 copay	7a 15 copay	7b 20 copay; ; 7d 30 copay; 16b 30 copay; 17a 30 copay	7e 50 copay; 7h 50 copay	7c 25 copay; 7i 25 copay			RX 20% coin				17a1 25 copay	17b1 70 allowance	18a1 30 copay															90.92762773	129.7762221	10.817867	12.64084326	105.3403605	0.168544577	0.084272288	42.14169791	327.512753	0	0.133982598	0.126408433	0.168544577	0.130536657	12.64084326	19.17195711	42.13614421	21.06807211	0	0	0.168544577	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.559	1.98296017	1.154469983	2.467563656	2.142973175	2.330148668	0.528869343	1.536535828	7.9004321	0	2.26608473	0.340322341	0.08889447	3.258802101	3.977411161	11.71678629	1.37771763	0.597607747	0	0	4.171259403	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6978		11.45841338	13.559	1.98296017	1.154469983	2.467563656	2.142973175	2.330148668	0.528869343	1.536535828	7.9004321	0	2.26608473	0.340322341	0.08889447	3.258802101	3.977411161	11.71678629	1.37771763	0.597607747	0	0	4.171259403	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6978																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	13.559	1.98296017	1.154469983	2.467563656	2.142973175	2.330148668	0.528869343	1.536535828	7.9004321	0	2.26608473	0.340322341	0.08889447	3.258802101	3.977411161	11.71678629	1.37771763	0.597607747	0	0	4.171259403	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6978
H5578_006_0	2008	7																					5100											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1508.319593	120.7495425	1014.616028	1880.171051	187.5685494	10.36094887	4.928038528	325.5015917	282.7123765	0	15.23105788	2.222481178	0.363460484	20.64297017	3480.506039	6984.933219	290.9346502	343.4480118	0	0	22.30546944	0	0	0	144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 160 days 1-5	1b 250 days 1-5	2a 25 days 11-100	6a 15 copay	10a 125 copay	11a 20% coin	11b 10% coin	4a 50 copay; 4b 30 copay; 4a World 50 copay	9b 450 copay; ASC:9b 250 copay		8b 15% coin; TherRad:8b 20% coin	9a 15% coin	12 20% coin	3 35 copay; 5 50 copay; 9a 15% coin; 9a 20% coin; 9c 50 copay; 9d 35 copay	7a 15 copay	7b 20 copay; ; 7d 30 copay; 16b 30 copay; 17a 30 copay	7e 50 copay; 7h 50 copay	7c 25 copay; 7i 25 copay			RX 20% coin				17a1 25 copay	17b1 70 allowance	18a1 30 copay															85.97982889	134.3434826	11.19858402	13.08571694	109.0476412	0.174476226	0.087238113	43.62511392	321.096493	0	0.139027231	0.130857169	0.174476226	0.136036962	13.08571694	20.15789045	43.61905647	21.80952823	0	0	0.174476226	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8071	1.351826172	0.946855237	2.050282181	1.704492322	1.807739255	0.429912782	1.183337002	7.564829384	0	2.117531801	0.290827596	0.063415214	2.808206954	3.795409736	11.73345988	1.057524578	0.624203259	0	0	3.891774124	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5287		7.932820795	10.8071	1.351826172	0.946855237	2.050282181	1.704492322	1.807739255	0.429912782	1.183337002	7.564829384	0	2.117531801	0.290827596	0.063415214	2.808206954	3.795409736	11.73345988	1.057524578	0.624203259	0	0	3.891774124	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5287																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	10.8071	1.351826172	0.946855237	2.050282181	1.704492322	1.807739255	0.429912782	1.183337002	7.564829384	0	2.117531801	0.290827596	0.063415214	2.808206954	3.795409736	11.73345988	1.057524578	0.624203259	0	0	3.891774124	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5287
H5578_007_0	2008	9																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	V	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		342.808338	20.57875655	41.76884152	0	14.15427612	15.05088353	6.307800407	31.02571229	36.49910575	16.45953259	17.86064722	3.571651467	0.968788568	30.30515996	44.12450356	118.5407221	7.487511012	2.688775999	0	0	26.13138374	5.087118189	0	0	144	1.372	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a: MC CS; 1a1 0% coin	1b: MC CS; 1a1 0% coin	2a: MC CS; 2a2 0% coin	6a 0% coin	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS; 14c 0% coin	MC CS; ;	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS; 13a1 0% coin			17a1 25 copay	17b1 70 allowance																0.079646326	0.079646326	0.204124209	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.3034	1.639022352	8.526031754	0	3.312100611	3.521906746	1.476025295	7.260016676	8.540790746	3.851530626	4.179391448	0.835766443	0.226696525	7.09140743	10.32513383	27.73852898	1.752077577	0.629173584	0	0	6.114743796	1.190385656	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.8142		0	27.3034	1.639022352	8.526031754	0	3.312100611	3.521906746	1.476025295	7.260016676	8.540790746	3.851530626	4.179391448	0.835766443	0.226696525	7.09140743	10.32513383	27.73852898	1.752077577	0.629173584	0	0	6.114743796	1.190385656	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.8142																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	27.3034	1.639022352	8.526031754	0	3.312100611	3.521906746	1.476025295	7.260016676	8.540790746	3.851530626	4.179391448	0.835766443	0.226696525	7.09140743	10.32513383	27.73852898	1.752077577	0.629173584	0	0	6.114743796	1.190385656	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.8142
H5580_001_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		506.2620954				16.66456129	16.90520651	7.597622215	15.68773473	14.34865475	7.611783188	12.20266878	2.689349035	0.832911914	42.25424142	48.11680602	164.5798754	4.71619417	7.041704221	36.36499905	18.98569607	30.58258241	2.018791765																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.07498351				0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				37.9613	0	0	0	3.899507341	3.955818323	1.777843598	3.670929927	3.357585211	1.781157266	2.855424494	0.629307674	0.194901388	9.887492491	11.25933261	38.51169085	1.103589436	1.647758788	8.509409778	4.442652881	7.156324284	0.472397273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.0744	0	0	37.9613	0	0	0	3.899507341	3.955818323	1.777843598	3.670929927	3.357585211	1.781157266	2.855424494	0.629307674	0.194901388	9.887492491	11.25933261	38.51169085	1.103589436	1.647758788	8.509409778	4.442652881	7.156324284	0.472397273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.0744																																																																																				0	0	0	37.9613	0	0	0	3.899507341	3.955818323	1.777843598	3.670929927	3.357585211	1.781157266	2.855424494	0.629307674	0.194901388	9.887492491	11.25933261	38.51169085	1.103589436	1.647758788	8.509409778	4.442652881	7.156324284	0.472397273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.0744
H5586_001_0	2008	6																																																																																																																		0																																											No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5586_002_0	2008	6																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0		293.2670442	25.53853378	78.98333883	0	11.90792406	26.36642931	18.68508441	11.4416523	26.67019921	13.76108228	28.48966011	0	4.884818816	49.17565608	41.54943796	90.59569452	7.467461569	3.502540612	17.49675626	31.93750984	11.49585906	0.849901446																				Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing											0.0895	0.0895	0.1354	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				26.2474	2.285698773	10.69434408	0	2.786454231	6.169744459	4.372309751	2.677346637	6.240826614	3.220093254	6.666580465	0	1.143047603	11.50710352	9.722568484	21.19939252	1.747386007	0.819594503	4.094240965	7.473377303	2.690031019	0.198876938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9564	0	0	26.2474	2.285698773	10.69434408	0	2.786454231	6.169744459	4.372309751	2.677346637	6.240826614	3.220093254	6.666580465	0	1.143047603	11.50710352	9.722568484	21.19939252	1.747386007	0.819594503	4.094240965	7.473377303	2.690031019	0.198876938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9564																																																																																				0	0		26.2474	2.285698773	10.69434408	0	2.786454231	6.169744459	4.372309751	2.677346637	6.240826614	3.220093254	6.666580465	0	1.143047603	11.50710352	9.722568484	21.19939252	1.747386007	0.819594503	4.094240965	7.473377303	2.690031019	0.198876938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9564
H5586_004_0	2008	7																																																																																																																		0																																											No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5587_001_0	2008	4																					0											Ded	Ded	D		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin		V	P	P		P			O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0		0			0											0	0	2305.987731	445.7876044	1164.251311	0	16.55747633	12.44643913	1.429189778	13.70629113	14.39090061	16.5281512	47.34419213	1.393940462	1.717533784	19.44049109	52.1834481	113.2038838	1.903061296	1.582744048	1.130531463	23.98739224	27.57098433	5.996743573		6.241743547	3.648834437	1.608049437		4.820586301			3											Medicare FFS Cost Share	Medicare FFS Cost Share	Medicare FFS Cost Share		Medicare FFS Cost Share	Medicare FFS Cost Share	Medicare FFS Cost Share	Medicare FFS Cost Share	Medicare FFS Cost Share	Medicare FFS Cost Share	Medicare FFS Cost Share	Medicare FFS Cost Share	Medicare FFS Cost Share	Medicare FFS Cost Share	Medicare FFS Cost Share	Medicare FFS Cost Share	Medicare FFS Cost Share	Medicare FFS Cost Share	Medicare FFS Cost Share	Medicare FFS Cost Share	Medicare FFS Cost Share	Medicare FFS Cost Share		No Cost Sharing - Limited to one dental exam and one dental cleaning per year	No Cost Sharing - Limited to one vision exam per year	No Cost sharing - Limited to 50.00 per year for frames and lenses		No Cost sharing - Limited to 500/year for hearing aid			No Cost sharing - Limited to 40/year for OTC drugs											158.5271253	43.15975665	49.42076616	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0	0	0		0			0											30.4635	1.603340377	4.794849317	0	3.874449462	2.912466757	0.334430408	3.207272124	3.367470742	3.86758738	11.07854096	0.326182068	0.401902905	4.549074915	12.21092686	26.48970881	0.445316343	0.370362107	0.264544362	5.613049785	6.451610334	1.403237996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.0298			30.4635	1.603340377	4.794849317	0	3.874449462	2.912466757	0.334430408	3.207272124	3.367470742	3.86758738	11.07854096	0.326182068	0.401902905	4.549074915	12.21092686	26.48970881	0.445316343	0.370362107	0.264544362	5.613049785	6.451610334	1.403237996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.0298	0																																																																																			0			30.4635	1.603340377	4.794849317	0	3.874449462	2.912466757	0.334430408	3.207272124	3.367470742	3.86758738	11.07854096	0.326182068	0.401902905	4.549074915	12.21092686	26.48970881	0.445316343	0.370362107	0.264544362	5.613049785	6.451610334	1.403237996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.0298
H5588_001_0	2008	11																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		334.6099056	25.4657099	54.36450579		18.29215662	39.81027833	28.83155762	9.998122703	22.82002781	10.28935508	21.37062375	0	3.850388294	36.6423498	73.96391289	141.8249545	12.49077413	6.038873258	45.13050484	50.80698353	9.276453019	0.685818328	0	0	0	0	0	0	0	0	0											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0.069625993	0.069625993	0.170652425	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.23	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											23.2975	1.773075339	9.277434726	0	4.280364649	9.31560513	6.746584484	2.339560712	5.339886506	2.407709088	5.000725957	0	0.900990861	8.574309854	17.30755562	33.18703936	2.922841146	1.413096342	10.56053813	11.88883415	2.170690006	0.160481489	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	158.8649	0	0	23.2975	1.773075339	9.277434726	0	4.280364649	9.31560513	6.746584484	2.339560712	5.339886506	2.407709088	5.000725957	0	0.900990861	8.574309854	17.30755562	33.18703936	2.922841146	1.413096342	10.56053813	11.88883415	2.170690006	0.160481489	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	158.8649																																																																																				0	0		23.2975	1.773075339	9.277434726	0	4.280364649	9.31560513	6.746584484	2.339560712	5.339886506	2.407709088	5.000725957	0	0.900990861	8.574309854	17.30755562	33.18703936	2.922841146	1.413096342	10.56053813	11.88883415	2.170690006	0.160481489	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	158.8649
H5588_002_0	2008	4																					2400											D	D	D		T	Coin	Coin	V	Coin		Coin			V	V	V	V	P	Coin	P	Coin			Coin	V		V																																																								0		1219.82411	29.20589194	794.9357117	0	208.6030227	16.12477279	10.05206704	264.1932209	29.51495894	0	12.51051838	0	0	363.9295224	7489.854295	14164.61558	184.0145736	1524.793307	43.08175294	2030.229007	8.581097066	0	0	36.03	392.3692845	0	185.072855	0	0	0	0											"$400 per Day, Days 1-5$400 per Day, Days 1-5"	"$400 per Day, Days 1-5$400 per Day, Days 1-5"	"$400 per Day, Days 1-5"	No Cost Sharing	$100/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $30/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology;	No Cost Sharing	No Cost Sharing	$20/Case for OP Fac - Occ Therapy; $20/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $7/Service for Prof - CORF; $7/Service for Prof - CORF;	$10/Visit for PCP - Office Visits; $8/Consult for PCP - Consults; 20% Coinsurance for PCP - Primary Surgeon (OP); $3/Procedure for PCP - Asst Surgeon (OP); $3/Services for PCP - Tx Injections; $1/Tests for PCP - Allergy Testing; $6/Service for PCP - Allergy Tx;	20% Coinsurance for Speclst - Primary Surgeon (OP); $7/Procedure for Speclst - Asst Surgeon (OP); 20% Coinsurance for Speclst - Anesthesia (OP); $20/Visit for Speclst - Office Visits; $6/Services for Speclst - Tx Injections; $1/Tests for Speclst - Allergy Testing; $12/Service for Speclst - Allergy Tx; $16/Consult for Speclst - Consults;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$7/Service for PT/ST (PCP); $7/Service for Occ Therapy (PCP); $7/Service for PT/ST (Specialist); $7/Service for Occ Therapy (Specialist);	3% Coinsurance for Prof Radiology (Office); 4% Coinsurance for Prof Radiology (OP);	$20/Visit for Chiropractor; $20/Exam for Vistion Exams; $20/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	$5/Procedure for Dental - Preventive; 53% Coinsurance for Dental - Comprehensive;	$20/Exam for Vision (Refractions)	No Cost Sharing	$20/Exam for Routine Hearing Exams	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											226.56	166.4	108.52	0	100	0.2	0.2	42.63517525	0.2	0	0.2	0	0	13.79288321	6.93300355	13.08643604	20	6.666666667	0.031999714	20	0.2	0	0	0.427988251	20	0	20	0	0	0	0											23.0303	0.404988368	7.18886862	0	1.738358522	3.224954558	2.010413409	0.938660356	5.902991787	0	2.502103676	0	0	0.418303117	4.327265535	15.44702799	0.306690956	0.847107393	1.378603771	3.383715012	1.716219413	0	0	15.42041667	0.653948808	0	0.308454758	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.1494	0	0	23.0303	0.404988368	7.18886862	0	1.738358522	3.224954558	2.010413409	0.938660356	5.902991787	0	2.502103676	0	0	0.418303117	4.327265535	15.44702799	0.306690956	0.847107393	1.378603771	3.383715012	1.716219413	0	0	15.42041667	0.653948808	0	0.308454758	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.1494																																																																																				0	0		23.0303	0.404988368	7.18886862	0	1.738358522	3.224954558	2.010413409	0.938660356	5.902991787	0	2.502103676	0	0	0.418303117	4.327265535	15.44702799	0.306690956	0.847107393	1.378603771	3.383715012	1.716219413	0	0	15.42041667	0.653948808	0	0.308454758	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.1494
H5590_001_0	2008	7																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		292.4544201	13.49742675	151.5034497	0	24.081624	20.91931888	55.29967391	8.655398985	15.12247635	13.28311903	14.64562977	0	17.85876629	77.09843676	49.82323536	93.45910183	64.12457992	2.341776791	22.87902072	63.55376412	7.379712875	0.964245414	0	0	0	0	0	0	0	0	0											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing																				0.073360199	0.073360199	0.169538405	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.4545	0.990173918	25.68565327	0	5.635100016	4.895120617	12.94012369	2.025363363	3.538659465	3.108249853	3.427077366	0	4.178951312	18.0410342	11.65863708	21.86942983	15.0051517	0.547975769	5.353690848	14.8715808	1.726852813	0.225633427	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	177.179			21.4545	0.990173918	25.68565327	0	5.635100016	4.895120617	12.94012369	2.025363363	3.538659465	3.108249853	3.427077366	0	4.178951312	18.0410342	11.65863708	21.86942983	15.0051517	0.547975769	5.353690848	14.8715808	1.726852813	0.225633427	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	177.179																																																																																				0			21.4545	0.990173918	25.68565327	0	5.635100016	4.895120617	12.94012369	2.025363363	3.538659465	3.108249853	3.427077366	0	4.178951312	18.0410342	11.65863708	21.86942983	15.0051517	0.547975769	5.353690848	14.8715808	1.726852813	0.225633427	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	177.179
H5591_001_0	2008	2																					2500											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	P	T	P	P	P	P	P	P	P	P																																																				0		1909.385836	52.16161194	877.7165996		260.4628886	6.622295337	5.412494637	351.5767813	1844.334028		21.33817698	42.13053272	12.10733801	15.22063694	4385.090178	3273.427312	302.2070882	871.069534			24.64414511	623.727774																				$100 per day for days 1-7	$100 per day for days 1-7; $0 per day for days 8-90	$0 per day for days 1-20; $125 per day for days 21-100	$0 per Visit	$100 per Trip	20% Coinsurance	20% Coinsurance	ER - $50 per Visit; UC - $35 per Visit	$75 per Visit	0% Coinsurance	"PET, MRI, CAT, Thera Rad - 20% Coinsurance"	$50 per Visit	$75 per Visit	OP Rehab - $20 per visit; Partial Hosp - $50 per Visit; OP Chemo - 20% Coinsurance	$15 per Visit; 1 Physical per Year - $0 Copay	$20 per Visit	Individual - $20 per Visit; Group - $10 per Visit	$20 per Visit		$20 per Visit	20% Coinsurance	"$20 Eye Exam, $20 Hearing Exam"		2 Preventive Dental Visits - $200 MAB per Year	1 Routine Eye Exam - $0 Copay	Eyewear - $100 MAB every 2 years	1 Routine Hearing Exam - $0 Copay	Hearing Aid - $500 MAB every 3 years			"Travel Benefit - Same CS as In-Network, $1000 MAB"											40.2307	56.6261	39.1247		76.6677	0.153335395	0.153335395	38.3259	57.5008		0.145668625	38.3338	57.5008	56.3715	11.5002	15.3335	14.5669	15.3335			0.153335395	15.3335																				6.4013	0.246142483	2.861701678	0	1.664090827	1.01543227	0.829927002	1.122873275	8.837552698	0	3.1083029	0.134585456	0.058015108	0.071500783	4.202434585	4.182768909	0.366850758	1.113048257	0	0	3.77881972	0.796996204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7924	0	12.4143534	6.4013	0.246142483	2.861701678	0	1.664090827	1.01543227	0.829927002	1.122873275	8.837552698	0	3.1083029	0.134585456	0.058015108	0.071500783	4.202434585	4.182768909	0.366850758	1.113048257	0	0	3.77881972	0.796996204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7924																																																																																				0	0	0	6.4013	0.246142483	2.861701678	0	1.664090827	1.01543227	0.829927002	1.122873275	8.837552698	0	3.1083029	0.134585456	0.058015108	0.071500783	4.202434585	4.182768909	0.366850758	1.113048257	0	0	3.77881972	0.796996204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7924
H5591_002_0	2008	2																					3500											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	P	T	P	P	P	P	P	P	P	P																																																				0		1899.886404	52.16161194	877.7165996		260.4628886	6.619965069	5.410590077	351.5769535	1844.334028		21.33066845	42.13053272	12.10733801	15.22063694	4385.090178	3273.427312	302.2070882	871.069534			24.63547328	623.727774																				$150 per day for days 1-7	$150 per day for days 1-7; $0 per day for days 8-90	$0 per day for days 1-20; $150 per day for days 21-100	$0 per Visit	$150 per Trip	20% Coinsurance	20% Coinsurance	ER - $50 per Visit; UC - $35 per Visit	$125 per Visit	0% Coinsurance	"PET, MRI, CAT, Thera Rad - 20% Coinsurance"	$50 per Visit	$100 per Visit	OP Rehab - $25 per visit; Partial Hosp - $50 per Visit; OP Chemo - 20% Coinsurance	$20 per Visit; 1 Physical per Year - $0 Copay	$25 per Visit	Individual - $25 per Visit; Group - $15 per Visit	$25 per Visit		$25 per Visit	20% Coinsurance	"$25 Eye Exam, $25 Hearing Exam"			1 Routine Eye Exam - $0 Copay		1 Routine Hearing Exam - $0 Copay				"Travel Benefit - Same CS as In-Network, $1000 MAB"											61.1552	86.0781	47.5792		116.5436	0.155391428	0.155391428	38.8397	97.1196		0.147621856	38.8479	77.6957	59.611	15.5391	19.4239	18.647	19.4239			0.155391428	19.4239																				9.6823	0.374164412	3.480088156	0	2.529606258	1.028685823	0.840759317	1.137930054	14.92675509	0	3.148872873	0.136390076	0.078390689	0.075609834	5.678378528	5.29856816	0.469603909	1.409966026	0	0	3.828141365	1.009603638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1338	0	15.82739794	9.6823	0.374164412	3.480088156	0	2.529606258	1.028685823	0.840759317	1.137930054	14.92675509	0	3.148872873	0.136390076	0.078390689	0.075609834	5.678378528	5.29856816	0.469603909	1.409966026	0	0	3.828141365	1.009603638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1338																																																																																				0	0	0	9.6823	0.374164412	3.480088156	0	2.529606258	1.028685823	0.840759317	1.137930054	14.92675509	0	3.148872873	0.136390076	0.078390689	0.075609834	5.678378528	5.29856816	0.469603909	1.409966026	0	0	3.828141365	1.009603638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1338
H5591_003_0	2008	5																					3500											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	P	T	P	P	P	P	P	P	P	P																																																				0		1899.886404	52.16161194	877.7165996		260.4628886	6.628535398	5.417594727	351.576321	1844.334028		21.35828353	42.13053272	12.10733801	15.22063694	4385.090178	3273.427312	302.2070882	871.069534			24.66736682	623.727774																				$150 per day for days 1-7	$150 per day for days 1-7; $0 per day for days 8-90	$0 per day for days 1-20; $150 per day for days 21-100	$0 per Visit	$150 per Trip	20% Coinsurance	20% Coinsurance	ER - $50 per Visit; UC - $35 per Visit	$125 per Visit	0% Coinsurance	"PET, MRI, CAT, Thera Rad - 20% Coinsurance"	$50 per Visit	$100 per Visit	OP Rehab - $25 per visit; Partial Hosp - $50 per Visit; OP Chemo - 20% Coinsurance	$20 per Visit; 1 Physical per Year - $0 Copay	$25 per Visit	Individual - $25 per Visit; Group - $15 per Visit	$25 per Visit		$25 per Visit	20% Coinsurance	"$25 Eye Exam, $25 Hearing Exam"			1 Routine Eye Exam - $0 Copay		1 Routine Hearing Exam - $0 Copay				"Travel Benefit - Same CS as In-Network, $1000 MAB"											61.1516	86.073	47.5764		116.5367	0.155382205	0.155382205	38.8375	97.1139		0.147613095	38.8456	77.6911	59.6683	15.5382	19.4228	18.6459	19.4228			0.155382205	19.4228																				9.6818	0.374142205	3.479881609	0	2.529456123	1.029956446	0.841797815	1.137860776	14.92586917	0	3.152762331	0.136381981	0.078386037	0.075682521	5.67804151	5.298253684	0.469576037	1.409882343	0	0	3.832869849	1.009543717	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1421	0	15.83398031	9.6818	0.374142205	3.479881609	0	2.529456123	1.029956446	0.841797815	1.137860776	14.92586917	0	3.152762331	0.136381981	0.078386037	0.075682521	5.67804151	5.298253684	0.469576037	1.409882343	0	0	3.832869849	1.009543717	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1421																																																																																				0	0	0	9.6818	0.374142205	3.479881609	0	2.529456123	1.029956446	0.841797815	1.137860776	14.92586917	0	3.152762331	0.136381981	0.078386037	0.075682521	5.67804151	5.298253684	0.469576037	1.409882343	0	0	3.832869849	1.009543717	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1421
H5594_001_0	2008	3	s.										DME/Prosthetics/Supplies										3000	Diabetic Supplies										Ded	Ded	Ded	V	T	Coin	Coin	V	V		V				V	V	V	V			Coin					Ded	V					Coin																																																			0		1518.293682	199.0990565	1762.412692	723.8645329	40.0082233	10.37988299	2.626236604	391.549166	128.1027165		788.5849916				3085.248546	3188.801972	14.74833073	45.12531353			23.93745883					548.1	175					2.181759379										$100 1st 7 days	$100 1st 7 days	$50 days 8-100	$25 per visit	$100 per trip	20% coin	20% coin	$50 ER	$250 hosp; $25 ASC		$25 rad; $15 to $150 xray				$5 per visit;$20 urgent care	$20 per visit	$20 per visit	$20 per visit			20% coin					$15 per glasses/contacts	$15 per exam					20% coin										75.0129514	52.14308151	25.31610827	24.8878592	99.55143681	0.199102874	0.199102874	49.77571841	170.4818355		30.3651831				5.470351453	19.91028736	19.91028736	19.91028736			0.199102874					14.93271552	14.93271552					0.199102874										9.491	0.865136527	3.71811921	1.501286548	0.331906343	2.066664532	0.522891255	1.624136752	1.819932187	0	1.995460638	0	0	0	1.406449489	5.2908303	0.024470292	0.074871497	0	0	4.766016841	0	0	0	0	0.682051781	0.217768768	0	0	0	0	0.434394562	0	0	0	0	0	0	0	0	0	36.8334		0.180340474	9.491	0.865136527	3.71811921	1.501286548	0.331906343	2.066664532	0.522891255	1.624136752	1.819932187	0	1.995460638	0	0	0	1.406449489	5.2908303	0.024470292	0.074871497	0	0	4.766016841	0	0	0	0	0.682051781	0.217768768	0	0	0	0	0.434394562	0	0	0	0	0	0	0	0	0	36.8334																																																																																				0			9.491	0.865136527	3.71811921	1.501286548	0.331906343	2.066664532	0.522891255	1.624136752	1.819932187	0	1.995460638	0	0	0	1.406449489	5.2908303	0.024470292	0.074871497	0	0	4.766016841	0	0	0	0	0.682051781	0.217768768	0	0	0	0	0.434394562	0	0	0	0	0	0	0	0	0	36.8334
H5594_002_0	2008	3	s.										DME/Prosthetics/Supplies										1850	Diabetic Supplies												Ded			Coin	Coin	V	P		P				V						Coin					Ded	V					Coin																																																			0				1762.412692			10.92456978	2.764048983	391.549166	83.26676574		788.5849916				3085.248546						25.19358258					548.1	175					2.296247712												$100 days 21-100			20% coin	20% coin	$50 ER	$200 Hosp; $0 ASC		$10 to $50 per visit				$0 per visit;$10 urgent care						20% coin					$15 per glasses/contacts	$10 per exam					20% coin												10.97317371			0.198908755	0.198908755	49.72718867	129.2906905		34.74579294				0.328199445						0.198908755					14.9181566	9.945437733					0.198908755										0	0	1.611605052	0	0	2.17299257	0.549793541	1.622553271	0.897134803	0	2.283334236	0	0	0	0.084381405	0	0	0	0	0	5.011224136	0	0	0	0	0.681386803	0.145037634	0	0	0	0	0.456743773	0	0	0	0	0	0	0	0	0	15.5162		0.086569995	0	0	1.611605052	0	0	2.17299257	0.549793541	1.622553271	0.897134803	0	2.283334236	0	0	0	0.084381405	0	0	0	0	0	5.011224136	0	0	0	0	0.681386803	0.145037634	0	0	0	0	0.456743773	0	0	0	0	0	0	0	0	0	15.5162																																																																																				0			0	0	1.611605052	0	0	2.17299257	0.549793541	1.622553271	0.897134803	0	2.283334236	0	0	0	0.084381405	0	0	0	0	0	5.011224136	0	0	0	0	0.681386803	0.145037634	0	0	0	0	0.456743773	0	0	0	0	0	0	0	0	0	15.5162
H5594_004_0	2008	4																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5608_001_0	2008	3																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	456.9263932	23.57567478	46.52860363		21.13916364	25.82760227	19.29763247	26.20157921	24.43868353	15.48623008	23.91759811	3.505142086	3.627402165	73.47594245	19.49216216	76.02685979	9.514594127	9.393051166	15.38558113	9.007549923	8.490459153																					Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																					0.0732	0.0732	0.1644		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					33.447	1.725739394	7.649302437	0	4.946564291	6.043658931	4.515645998	6.131169534	5.718651945	3.623777838	5.596717959	0.820203248	0.848812107	17.19337053	4.561165945	17.79028519	2.226415026	2.197973973	3.600225985	2.107766682	1.986767442	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.7312	0	0	33.447	1.725739394	7.649302437	0	4.946564291	6.043658931	4.515645998	6.131169534	5.718651945	3.623777838	5.596717959	0.820203248	0.848812107	17.19337053	4.561165945	17.79028519	2.226415026	2.197973973	3.600225985	2.107766682	1.986767442	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.7312																																																																																				0	0	0	33.447	1.725739394	7.649302437	0	4.946564291	6.043658931	4.515645998	6.131169534	5.718651945	3.623777838	5.596717959	0.820203248	0.848812107	17.19337053	4.561165945	17.79028519	2.226415026	2.197973973	3.600225985	2.107766682	1.986767442	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.7312
H5608_002_0	2008	3																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	340.853061	38.9335773	53.23388632		15.58259945	16.30319588	33.85528985	33.64476782	34.23788472	10.0824785	19.36376848	4.857759523	1.081149102	36.89705796	32.96672223	84.05483401	11.04756293	14.91073274	21.18224483	11.99399399	18.37396413																					FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare deductible only	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																					0.0732	0.0732	0.1644		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.231267215	0.234	0.034	0.234	0.226478741	0.231807667	0.232572066	0.211350518	0.234																					24.9504	2.849937858	8.751650911	0	3.646328271	3.814947836	7.922137826	7.872875669	8.011665024	2.35929997	4.531121825	1.136715728	0.250034341	8.633911563	1.120868556	19.66883116	2.50203814	3.456422166	4.926398432	2.534936846	4.299507606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.2401	0	0	24.9504	2.849937858	8.751650911	0	3.646328271	3.814947836	7.922137826	7.872875669	8.011665024	2.35929997	4.531121825	1.136715728	0.250034341	8.633911563	1.120868556	19.66883116	2.50203814	3.456422166	4.926398432	2.534936846	4.299507606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.2401																																																																																				0	0	0	24.9504	2.849937858	8.751650911	0	3.646328271	3.814947836	7.922137826	7.872875669	8.011665024	2.35929997	4.531121825	1.136715728	0.250034341	8.633911563	1.120868556	19.66883116	2.50203814	3.456422166	4.926398432	2.534936846	4.299507606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.2401
H5608_801_0	2008	1																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	286.745196	7.019917756	37.36567006		7.426157007	8.866528095	22.32873484	16.42748703	44.26759078	7.316662059	22.03135843	5.932514052	0.162624825	26.11534185	31.78667783	101.1650412	3.047516264	15.95783789	28.15476431	15.24068813	28.46556036																					FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																				0.0732	0.0732	0.1644		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					20.9897	0.51385798	6.142916158	0	1.73772074	2.074767574	5.224923952	3.844031964	10.35861624	1.712098922	5.155337873	1.388208288	0.038054209	6.110989992	7.438082613	23.67261964	0.713118806	3.734134067	6.588214849	3.566321021	6.660941125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.6647	0	0	20.9897	0.51385798	6.142916158	0	1.73772074	2.074767574	5.224923952	3.844031964	10.35861624	1.712098922	5.155337873	1.388208288	0.038054209	6.110989992	7.438082613	23.67261964	0.713118806	3.734134067	6.588214849	3.566321021	6.660941125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.6647																																																																																				0	0	0	20.9897	0.51385798	6.142916158	0	1.73772074	2.074767574	5.224923952	3.844031964	10.35861624	1.712098922	5.155337873	1.388208288	0.038054209	6.110989992	7.438082613	23.67261964	0.713118806	3.734134067	6.588214849	3.566321021	6.660941125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.6647
H5609_001_0	2008	4	e3	g2	i7	i8	i9	i10	h.6.				DME/Prosthetics/Supplies	OP Facility - Surgery	Professional	Professional	Professional	Professional	OP Facility - Other				0	Diabetic Supplies	ASC	Lab	Podiatry	Chiropractor	Chemo Drugs	Radiation Therapy				A	A			T	Coin	Coin	V	P	Coin					V	V	V	V						P	V	V							P		V	V	Coin	Coin				0	0			0	0	0	0	0	0					0	0	0	0						0	0	0							0		0	0	0	0				0	0	296.1336645	18.50835403			261.7241856	11.2814061	1.363112361	449.5497777	147.4379579	2.699449723					2481.327619	2403.164918	11.86142374	2457.491616						423	363.9	268							79.38966964		161.4460965	465.1	7.8125	0.967934197				$150 per admission	$948.48 per admission			$175 per trip	20% coins	20% coins	20% $10 UR; 80% $50 ER	$100 per surgery	20% coins					$0 per visit	$10 per visit	$30 per visit	$10 per visit						Copays: $2 to $1900. Capitation: $4.25	$10 per exam	$75 per glasses/contacts							$100 per surgery		$10 per viist	$10 per viist	20% coins	20% coins				150	948.48			175	0.2	0.2	42	100	0.2					0	10	30	10						20	10	75							100		10	10	0.2	0.2				3.7017	1.462900303	0	0	3.816811041	2.25628122	0.272622472	1.573424222	1.228649649	0.539889945	0	0	0	0	0	2.002637432	0.029653559	2.04790968	0	0	0	0	0	0.705	0.30325	1.675	0	0	0	0	0	0	0.66158058	0	0.134538414	0.387583333	1.5625	0.193586839	0	0	0	24.5555	0	0	3.7017	1.462900303	0	0	3.816811041	2.25628122	0.272622472	1.573424222	1.228649649	0.539889945	0	0	0	0	0	2.002637432	0.029653559	2.04790968	0	0	0	0	0	0.705	0.30325	1.675	0	0	0	0	0	0	0.66158058	0	0.134538414	0.387583333	1.5625	0.193586839	0	0	0	24.5555	0																																																																																			0	0	0	3.7017	1.462900303	0	0	3.816811041	2.25628122	0.272622472	1.573424222	1.228649649	0.539889945	0	0	0	0	0	2.002637432	0.029653559	2.04790968	0	0	0	0	0	0.705	0.30325	1.675	0	0	0	0	0	0	0.66158058	0	0.134538414	0.387583333	1.5625	0.193586839	0	0	0	24.5555
H5609_002_0	2008	6																					0												A				Coin		V																																			0				0		0																																		0	0		24.18535236				16.5229244		587.4385026																																			$948.48 per admission				20% coins		$0 UC; $50 ER																																			948.48				0.2		40																																		0	1.911610251	0	0	0	3.30458488	0	1.958128342	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.1743	0	0	0	1.911610251	0	0	0	3.30458488	0	1.958128342	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.1743	0																																																																																			0	0	0	0	1.911610251	0	0	0	3.30458488	0	1.958128342	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.1743
H5609_801_0	2008	2																					0											Coin		Coin		Coin	Coin		Coin	Coin	Coin					Coin						Coin																																																														0	0	261.248944		23.09990663		12.44578965	12.64451846		6.812907325	27.42871127	26.01555264					255.1140644						7.749066078																					FFS Medicare Actl. Equiv. Cost		FFS Medicare Actl. Equiv. Cost		FFS Medicare Actl. Equiv. Cost	FFS Medicare Actl. Equiv. Cost		FFS Medicare Actl. Equiv. Cost	FFS Medicare Actl. Equiv. Cost	FFS Medicare Actl. Equiv. Cost					FFS Medicare Actl. Equiv. Cost						FFS Medicare Actl. Equiv. Cost																					0.0663		0.1968		0.234	0.234		0.234	0.234	0.234					0.234						0.234																					17.3208	0	4.546061625	0	2.912314779	2.95881732	0	1.594220314	6.418318437	6.087639317	0	0	0	0	59.69669106	0	0	0	0	0	1.813281462	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.3481	0	0	17.3208	0	4.546061625	0	2.912314779	2.95881732	0	1.594220314	6.418318437	6.087639317	0	0	0	0	59.69669106	0	0	0	0	0	1.813281462	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.3481	0																																																																																			0	0	0	17.3208	0	4.546061625	0	2.912314779	2.95881732	0	1.594220314	6.418318437	6.087639317	0	0	0	0	59.69669106	0	0	0	0	0	1.813281462	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.3481
H5619_001_0	2008	6																					5100											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1380.963446	159.0670578	1445.166908	2399.491947	336.7573765	6.767553111	4.524588008	431.1478242	258.9825807	0	20.23974192	7.412035367	0.664020142	44.93697413	3178.718499	5876.985971	738.1736581	455.980305	0	0	11.1113178	0	0	0	144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 150 days 1-5	1b 260 days 1-5	2a 25 days 11-100	6a 15 copay	10a 125 copay	11a 15% coin; 11a 20% coin	11b 10% coin	4a 50 copay; 4b 30 copay; 4a World 40 copay	9b 425 copay; ASC:9b 225 copay		8b 15% coin; TherRad:8b 20% coin	9a 15% coin	12 20% coin	3 30 copay; 5 50 copay; 9a 15% coin; 9a 20% coin; 9c 50 copay; 9d 25 copay	7a 7 copay	7b 15 copay; ; 7d 25 copay; 16b 25 copay; 17a 25 copay	7e 50 copay; 7h 50 copay	7c 25 copay; 7i 25 copay			RX 20% coin				17a1 25 copay	17b1 70 allowance	18a1 25 copay															80.6311344	139.760633	11.20206349	13.08978276	109.081523	0.141120405	0.087265218	43.63000572	330.5332413	0	0.142008584	0.130897828	0.174530437	0.134693891	6.108565286	18.10062072	43.63260918	21.81630459	0	0	0.174530437	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.2791	1.85260939	1.349070955	2.617402359	3.061167292	0.955039835	0.394839161	1.567581837	7.133529321	0	2.874217085	0.970219327	0.115891725	6.052735883	1.618117456	8.864757835	2.684036894	0.828983768	0	0	1.939263148	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4585		7.903306591	9.2791	1.85260939	1.349070955	2.617402359	3.061167292	0.955039835	0.394839161	1.567581837	7.133529321	0	2.874217085	0.970219327	0.115891725	6.052735883	1.618117456	8.864757835	2.684036894	0.828983768	0	0	1.939263148	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4585																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	9.2791	1.85260939	1.349070955	2.617402359	3.061167292	0.955039835	0.394839161	1.567581837	7.133529321	0	2.874217085	0.970219327	0.115891725	6.052735883	1.618117456	8.864757835	2.684036894	0.828983768	0	0	1.939263148	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4585
H5619_003_0	2008	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	V	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		276.2506149	34.07383156	54.84365011	0	20.49924227	9.106920109	5.440437085	33.30001451	38.80560442	19.63476765	22.38305862	7.289871518	0.1958167	56.69216345	36.4768098	98.58575883	21.4586723	5.517718815	0	0	8.991572286	6.798903699	0	0	144	1.372	249	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a: MC CS; 1a1 0% coin	1b: MC CS; 1a1 0% coin	2a: MC CS; 2a2 0% coin	6a 0% coin	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS; 14c 0% coin	MC CS; ;	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS; 13a1 0% coin			17a1 25 copay	17b1 70 allowance	18a1 15 copay															0.078423865	0.078423865	0.159965923	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0	0	25	0	15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.6646	2.672201562	8.773115092	0	4.79682269	2.131019305	1.273062278	7.792203394	9.080511433	4.59453563	5.237635716	1.705829935	0.045821108	13.26596625	8.535573494	23.06906757	5.021329318	1.291146203	0	0	2.104027915	1.590943466	0	0	0.3	0	0.31125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.2567		0	21.6646	2.672201562	8.773115092	0	4.79682269	2.131019305	1.273062278	7.792203394	9.080511433	4.59453563	5.237635716	1.705829935	0.045821108	13.26596625	8.535573494	23.06906757	5.021329318	1.291146203	0	0	2.104027915	1.590943466	0	0	0.3	0	0.31125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.2567																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	21.6646	2.672201562	8.773115092	0	4.79682269	2.131019305	1.273062278	7.792203394	9.080511433	4.59453563	5.237635716	1.705829935	0.045821108	13.26596625	8.535573494	23.06906757	5.021329318	1.291146203	0	0	2.104027915	1.590943466	0	0	0.3	0	0.31125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.2567
H5619_004_0	2008	5																					5000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1384.109822	159.429475	1448.459565	2404.958931	337.5246419	6.872212985	4.594560538	432.1294441	259.5726446	0	20.55274853	7.526662128	0.674104085	45.6318822	3185.960866	5890.37605	739.8555072	457.0192069	0	0	11.28315378	0	0	0	144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 175 days 1-5	1b 260 days 1-5	2a 25 days 11-100	6a 15 copay	10a 125 copay	11a 20% coin	11b 10% coin	4a 50 copay; 4b 30 copay; 4a World 40 copay	9b 450 copay; ASC:9b 200 copay		8b 15% coin; TherRad:8b 20% coin	9a 15% coin	12 20% coin	3 35 copay; 5 50 copay; 9a 15% coin; 9a 20% coin; 9c 50 copay; 9d 25 copay	7a 15 copay	7b 15 copay; ; 7d 32 copay; 16b 32 copay; 17a 32 copay	7e 50 copay; 7h 50 copay	7c 25 copay; 7i 25 copay			RX 20% coin				17a1 25 copay	17b1 70 allowance																91.95143208	136.6135562	10.94981969	12.79503201	106.6252667	0.170600427	0.085300213	42.6482117	334.5566011	0	0.138810888	0.12795032	0.170600427	0.131604163	12.79503201	21.1216419	42.6501067	21.32505335	0	0	0.170600427	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.6059	1.815018962	1.321697589	2.564293875	2.999054582	1.172402468	0.391916994	1.535795668	7.236811811	0	2.852945284	0.963038829	0.115002445	6.005345647	3.397039272	10.3678678	2.62957636	0.812163247	0	0	1.92491085	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.0108		10.11745323	10.6059	1.815018962	1.321697589	2.564293875	2.999054582	1.172402468	0.391916994	1.535795668	7.236811811	0	2.852945284	0.963038829	0.115002445	6.005345647	3.397039272	10.3678678	2.62957636	0.812163247	0	0	1.92491085	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.0108																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	10.6059	1.815018962	1.321697589	2.564293875	2.999054582	1.172402468	0.391916994	1.535795668	7.236811811	0	2.852945284	0.963038829	0.115002445	6.005345647	3.397039272	10.3678678	2.62957636	0.812163247	0	0	1.92491085	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.0108
H5628_001_0	2008	5																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		290.3422171	26.72770733	69.62159293		12.19417414	36.07616179	25.3392694	44.32032853	24.82304017	15.20766917	31.72127868	0	5.618300677	55.02491698	52.71424155	117.2020663	9.61136337	4.496258552	21.11132906	37.58767336	18.214677	0.937180177	0	0	0	0	0	0	0	0	0											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0.081868716	0.081868716	0.189480708	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.23	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											23.7699	2.188163081	13.19194869	0	2.853436748	8.44182186	5.92938904	10.37095688	5.8085914	3.558594585	7.422779212	0	1.314682359	12.87583057	12.33513252	27.4252835	2.249059029	1.052124501	4.940050999	8.795515567	4.262234419	0.219300161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	159.0048	0	0	23.7699	2.188163081	13.19194869	0	2.853436748	8.44182186	5.92938904	10.37095688	5.8085914	3.558594585	7.422779212	0	1.314682359	12.87583057	12.33513252	27.4252835	2.249059029	1.052124501	4.940050999	8.795515567	4.262234419	0.219300161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	159.0048																																																																																				0	0		23.7699	2.188163081	13.19194869	0	2.853436748	8.44182186	5.92938904	10.37095688	5.8085914	3.558594585	7.422779212	0	1.314682359	12.87583057	12.33513252	27.4252835	2.249059029	1.052124501	4.940050999	8.795515567	4.262234419	0.219300161	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	159.0048
H5628_002_0	2008	3																					2400											D	D	D		T	Coin	Coin	V	Coin		Coin			V	V	V	V	P	Coin	P	Coin			Coin	V		V																																																								0		900.1279779	20.38490291	1028.866209	0	201.2173554	14.3130135	8.908319681	362.3414716	29.10472719	0	13.05241956	0	0	463.7542301	6724.79643	12536.90864	150.070528	1206.863618	17.86485966	1732.037577	8.600105326	0	0	33.24369033	360.658883	0	164.2546913	0	0	0	0											"$400 per Day, Days 1-5$400 per Day, Days 1-5"	"$400 per Day, Days 1-5$400 per Day, Days 1-5"	"$400 per Day, Days 1-5"	No Cost Sharing	$100/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $30/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology;	No Cost Sharing	No Cost Sharing	$20/Case for OP Fac - Occ Therapy; $20/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $7/Service for Prof - CORF; $7/Service for Prof - CORF;	$5/Visit for PCP - Office Visits; $4/Consult for PCP - Consults; 20% Coinsurance for PCP - Primary Surgeon (OP); $2/Procedure for PCP - Asst Surgeon (OP); $2/Services for PCP - Tx Injections; $0/Tests for PCP - Allergy Testing; $3/Service for PCP - Allergy Tx;	20% Coinsurance for Speclst - Primary Surgeon (OP); $5/Procedure for Speclst - Asst Surgeon (OP); 20% Coinsurance for Speclst - Anesthesia (OP); $15/Visit for Speclst - Office Visits; $5/Services for Speclst - Tx Injections; $1/Tests for Speclst - Allergy Testing; $9/Service for Speclst - Allergy Tx; $12/Consult for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $15/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$7/Service for PT/ST (PCP); $7/Service for Occ Therapy (PCP); $7/Service for PT/ST (Specialist); $7/Service for Occ Therapy (Specialist);	3% Coinsurance for Prof Radiology (Office); 4% Coinsurance for Prof Radiology (OP);	$15/Visit for Chiropractor; $15/Exam for Vistion Exams; $15/Service for Podiatrist; $15/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	$5/Procedure for Dental - Preventive; 63% Coinsurance for Dental - Comprehensive;	$15/Exam for Vision (Refractions)	No Cost Sharing	$15/Exam for Routine Hearing Exams	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											226.56	166.4	108.52	0	100	0.2	0.2	45.06379147	0.2	0	0.2	0	0	16.14462578	3.595970676	10.81452578	15	6.666666665	0.031991055	15	0.2	0	0	0.507413576	15	0	15	0	0	0	0											16.9944	0.282670654	9.304380087	0	1.676811295	2.862602699	1.781663936	1.36070671	5.820945439	0	2.610483912	0	0	0.623928208	2.015180897	11.29839347	0.18758816	0.670479788	0.571515716	2.165046971	1.720021065	0	0	16.86829979	0.450823604	0	0.205318364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4713	0	0	16.9944	0.282670654	9.304380087	0	1.676811295	2.862602699	1.781663936	1.36070671	5.820945439	0	2.610483912	0	0	0.623928208	2.015180897	11.29839347	0.18758816	0.670479788	0.571515716	2.165046971	1.720021065	0	0	16.86829979	0.450823604	0	0.205318364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4713																																																																																				0	0		16.9944	0.282670654	9.304380087	0	1.676811295	2.862602699	1.781663936	1.36070671	5.820945439	0	2.610483912	0	0	0.623928208	2.015180897	11.29839347	0.18758816	0.670479788	0.571515716	2.165046971	1.720021065	0	0	16.86829979	0.450823604	0	0.205318364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4713
H5628_006_0	2008	7																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		293.1166534	26.98311049	70.30970873		12.29185475	36.37746686	25.55090084	44.72658717	25.02974823	15.33554827	31.98801834	0	5.66992243	55.49175607	53.43234024	118.1494022	9.709227	4.542039797	21.13721424	38.07803459	18.37417682	0.945124567	0	0	0	0	0	0	0	0	0											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0.081692087	0.081692087	0.191061526	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.23	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											23.9453	2.204306619	13.43348027	0	2.876294011	8.512327244	5.978910797	10.4660214	5.856961087	3.588518294	7.485196292	0	1.326761849	12.98507092	12.50316762	27.6469601	2.271959118	1.062837313	4.946108132	8.910260095	4.299557376	0.221159149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.5212	0	0	23.9453	2.204306619	13.43348027	0	2.876294011	8.512327244	5.978910797	10.4660214	5.856961087	3.588518294	7.485196292	0	1.326761849	12.98507092	12.50316762	27.6469601	2.271959118	1.062837313	4.946108132	8.910260095	4.299557376	0.221159149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.5212																																																																																				0	0		23.9453	2.204306619	13.43348027	0	2.876294011	8.512327244	5.978910797	10.4660214	5.856961087	3.588518294	7.485196292	0	1.326761849	12.98507092	12.50316762	27.6469601	2.271959118	1.062837313	4.946108132	8.910260095	4.299557376	0.221159149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.5212
H5640_001_0	2008	5																					None											coin	Coin	Coin	V	T	O	O	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	267.6311242	14.57077387	56.536916	0	0	0	0	0	0	0	0	0	0	0	0	0	7.633944543	0	0	0	0	0	0	0	0	0	0	0	0	0	0											6% Medicare Equivalent Coin	6% Medicare Equivalent Coin	15% Medicare Equivalent Coin	0	0	0	0	0	0	0	0	0	0	0	0	0	50% Medicare Equivalent Coin	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0.064699519	0.064690204	0.150613696	0	0	0	0	0	0	0	0	0	0	0	0	0	0.500022199	0	0	0	0	0	0	0	0	0	0	0	0	0	0											17.3156	0.942586327	8.515233892	0	0	0	0	0	0	0	0	0	0	0	0	0	3.817141738	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.5906	0	0	17.3156	0.942586327	8.515233892	0	0	0	0	0	0	0	0	0	0	0	0	0	3.817141738	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.5906	0																																																																																			0	0	0	17.3156	0.942586327	8.515233892	0	0	0	0	0	0	0	0	0	0	0	0	0	3.817141738	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.5906
H5649_001_0	2008	5																					Unlimited											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	P	P	P	P	P	P	Coin	P	T	P	P	P	P	P	P	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	128.2359201	7.1	0.67	182.0401687	0	0	3.08	0	0.11	0	34.75759529	0	134.6074026	0	0	0	4.21	0	0	1008.154208	0	235.1595301	0	0	0	0	399.8547162											1A - no cost sharing	1B - no cost sharing	2 - no cost sharing	6 - no cost sharing	10A - $50 copay	11A - 10% coinsurance	"11B - 10% coinsurance, prosthetics"	4A - $50 copay	9 - no cost sharing	8A - no cost sharing	8B - 20% coinsurance radiation therapy	no cost sharing	11C - 20% coinsurance	9D - no cost sharing	no cost sharing	no cost sharing	7E & 7H - $10 copay	7C & 7I - no copay	no cost sharing	7B - no cost sharing	20% coinsurance	no cost sharing	10B - no cost sharing	16A - $10 copay	17A - no cost sharing	17B - $10 copay	18A - no cost sharing	18B - no cost sharing	no cost sharing	no cost sharing	$10 copay - accupuncture											0	0	0	0	50	0.099972901	0.099770372	50	0	0	0.200163567	0	0.30703989	0	5	0	10	0	0	0	0.199925372	0	0	10	0	10	0	0	0	0	10											0	0	0	0	0.534316334	0.709807595	0.066846149	0.758500703	0	0	0.616503786	0	0.033774388	0	0.014482331	0	0.112172836	0	0	0	0.841685814	0	0	0.840128507	0	0.195966275	0	0	0	0	0.333212264	0	0	0	0	0	0	0	0	0	0	5.0574	0	0	0	0	0	0	0.534316334	0.709807595	0.066846149	0.758500703	0	0	0.616503786	0	0.033774388	0	0.014482331	0	0.112172836	0	0	0	0.841685814	0	0	0.840128507	0	0.195966275	0	0	0	0	0.333212264	0	0	0	0	0	0	0	0	0	0	5.0574	0	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.534316334	0.709807595	0.066846149	0.758500703	0	0	0.616503786	0	0.033774388	0	0.014482331	0	0.112172836	0	0	0	0.841685814	0	0	0.840128507	0	0.195966275	0	0	0	0	0.333212264	0	0	0	0	0	0	0	0	0	0	5.0574
H5649_002_0	2008	5																					Unlimited											D	D	D	V	T	P	P	V	V	V	Coin	V	V	V	P	P	P	P	P	P	Coin	P	T	P	P	P	P	P	P	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	370.7068591	0	0	3.94	0	0	0	0	0	0	0	0	0	5.04	0	0	0	0	0	0	0	0	0	0											1A - no cost sharing	1B - no cost sharing	2 - no cost sharing	6 - no cost sharing	10A - no cost sharing	11A - no cost sharing	11B - no cost sharing	4A - $50 copay	9 - no cost sharing	8A - no cost sharing	8B - 20% coinsurance radiation therapy	no cost sharing	11C - no cost sharing	9D - no cost sharing	no cost sharing	no cost sharing	7E & 7H - no cost sharing	7C & 7I - no copay	no cost sharing	7B - no cost sharing	20% coinsurance	no cost sharing	10B - no cost sharing	16A - no cost sharing	17A - no cost sharing	17B - no cost sharing	18A - no cost sharing	18B - no cost sharing	no cost sharing	no cost sharing	no cost sharing											0	0	0	0	0	0	0	50	0	0	0.200016316	0	0	0	0	0	0	0	0	0	0.200121282	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.544611913	0	0	0.788064286	0	0	0	0	0	0	0	0	0	1.008611263	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.3413	0	0	0	0	0	0	0	0	0	1.544611913	0	0	0.788064286	0	0	0	0	0	0	0	0	0	1.008611263	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.3413	0	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	1.544611913	0	0	0.788064286	0	0	0	0	0	0	0	0	0	1.008611263	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.3413
H5652_001_0	2008	5																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							17.20455268	10.09264202	349.2447107	453.4663547		157.0092093	43.6482722		1286.612575	398.1620937	1923.547269	348.1594037	127.8563384				1282.904394		821.9323512	337.0787762		315.7191776				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/visit Tier 1, $20/visit Tier 2 + Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b)$20/visit, (7d) $0/visit Tier 1, $20/visit Tier 2, (7f)0"	"(7e) $0/visit Tier 1, $20/visit Tier 2, (7h)$20/visit"	"(7c,i)$0/visit Tier 1, $20 visit Tier 2"		"(7g) $0/ visit Tier 1, $20/visit Tier 2"	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.182858242	0.182858242	36.1145	45.7146		18.2858	45.7146		45.7051	18.2858	18.2858	18.2858	18.2858				18.2858		20	20		20				20											0	0	0	0	0	3.145994262	1.845522779	1.051066592	1.727501262	0	0.239253567	0.166280132	0	4.900400056	0.606726838	2.931137273	0.530531805	0.194829878	0	0	0	1.954913689	0	1.369887252	0.56179796	0	0.526197873	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	22.6921	0	1.808701195	0	0	0	0	0	3.145994262	1.845522779	1.051066592	1.727501262	0	0.239253567	0.166280132	0	4.900400056	0.606726838	2.931137273	0.530531805	0.194829878	0	0	0	1.954913689	0	1.369887252	0.56179796	0	0.526197873	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	22.6921		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.2694	0.0185	0.7073	0.2633	0.0735	0.1053	0.0618	0.0235	0.3378	0.0795	0.2604	0.0309	0.001	0.2473	0.0421	0.2328	0.017	0.0824			0.1693	0.075			0.0066		0.0078															5.1125	0	0	2.2694	0.018509086	0.707269303	0.263333438	0.073520167	3.251328258	1.907314465	1.074527759	2.065278853	0.079453271	0.499663428	0.197175954	0.001002068	5.147701347	0.64883541	3.163964238	0.547486393	0.277207811	0	0	0.169284836	2.029927042	0	1.369887252	0.568429071	0	0.534040196	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	27.8046
H5652_002_0	2008	5																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							17.34209979	10.22061012	350.9392396	455.1205299		157.7111056	43.88547412		1299.292613	400.541099	1935.80087	349.1640133	128.2114997				1289.362251		821.9323512	337.0787762		315.7192163				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/visit Tier 1, $20/visit Tier 2 + Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b)$20/visit, (7d) $0/visit Tier 1, $20/visit Tier 2, (7f)0"	"(7e) $0/visit Tier 1, $20/visit Tier 2, (7h)$20/visit"	"(7c,i)$0/visit Tier 1, $20 visit Tier 2"		"(7g) $0/ visit Tier 1, $20/visit Tier 2"	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.182691935	0.182691935	36.0817	45.673		18.2692	45.673		45.6636	18.2692	18.2692	18.2692	18.2692				18.2692		20	20		20				20											0	0	0	0	0	3.168261761	1.867223036	1.055205775	1.732226043	0	0.240104558	0.167031712	0	4.944197069	0.609796902	2.947126717	0.531578742	0.195193391	0	0	0	1.962967367	0	1.369887252	0.56179796	0	0.526197925	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	22.8189	0	1.839920163	0	0	0	0	0	3.168261761	1.867223036	1.055205775	1.732226043	0	0.240104558	0.167031712	0	4.944197069	0.609796902	2.947126717	0.531578742	0.195193391	0	0	0	1.962967367	0	1.369887252	0.56179796	0	0.526197925	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	22.8189		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.2912	0.0188	0.7125	0.267	0.0744	0.1062	0.0626	0.0236	0.3404	0.0799	0.2615	0.0311	0.001	0.2493	0.0424	0.2349	0.0171	0.0827			0.1709	0.0756			0.0066		0.0078															5.1573	0	0	2.2912	0.018780845	0.712471631	0.267018089	0.074368057	3.274437882	1.9297982	1.078780775	2.072607477	0.079905564	0.501600618	0.198095536	0.001016781	5.193451456	0.652157715	3.182019118	0.548654616	0.277928115	0	0	0.17093509	2.03852231	0	1.369887252	0.568429071	0	0.534040252	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	27.9762
H5652_003_0	2008	4	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						500	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	P	P	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T		V	P	V	P				V	P	V	V	V																																															0		1855.398081	83.4481366	6770.848704	71.60812559	369.368467	1548.272862	32.76982018	145.2531339	155.6580862	9114.7382	152.7446995	3.329584731	8.740159918	153.5770957	110.4039684	1312.373648	2915.992841	1.179131759		29.87133791	274.9684493	377.4597806	1817.255		287.28	278.16		95.475				74.91565644			234.745	287.945						(1a) $25/day	(1b) $25/day	(2a) $0/day	(6a) $0/proc	(10a) $50/trip	(11a) $0/proc	(11a/11c) $0/proc	(4a) $50/visit (waived if admitted)	(9a/9b) $0/visit	(8a) $0/visit	(8b) $0/visit	(9a) $0/visit	(12) $0/proc	(9a) $0/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $0/visit	(7e/7h) $0/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $0/visit	(15) $0/proc	(Misc. PBP Cats) $0/visit	(10b) $0/trip		(17a1) $0/visit	(17b2) $0/proc	(18a) $0/visit	(18b) $0/proc				(4b) $20/visit (waived if admitted)	(9c) $0/proc 75%/25% Ind/Grp Blended Copay	(9d) $0/visit	(7f1) $0/visit	(18a1) $0/visit						23.7798	23.7798			47.5595			47.5595																								19.0238										3.6767	0.16536478	0	0	1.463916096	0	0	0.575680979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11876513	0	0	0	0	0	0	0	0	0	6.0005		0.307907354	3.6767	0.16536478	0	0	1.463916096	0	0	0.575680979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.11876513	0	0	0	0	0	0	0	0	0	6.0005		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					20	0.3	0.3	0.3	0.3						3.1059	0.0685	0.9639	0.1086	0.208	0.3729	0.0069	0.0319	0.3518	0.8122	0.773	0.012	0.0215	0.1193	0.0115	2.1956	0.2758	0.0003		0.3098		0.064	0.1433		0.0146							0.0066			0.013	0.0185						10.0093		0	6.7826	0.233907703	0.963920403	0.108647458	1.671930312	0.372896999	0.006923947	0.607534736	0.351805122	0.812242808	0.772956156	0.011962232	0.021468754	0.11927694	0.011483436	2.195602024	0.275778269	0.000330816	0	0.309793797	0	0.064028339	0.14325	0	0.01455	0	0	0	0	0	0	0.125336679	0	0	0.01305	0.01845	0	0	0	0	0	16.0098
H5652_004_0	2008	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0								26.48465759	532.6159876	539.4617495		196.8457118	89.34365432		2973.573117	482.6872258	3215.13893	546.6054452	91.09769471				0.09942421		821.9323512			240.9353064				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)0	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3,9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/visit Tier 1, $20/visit Tier 2 + Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b)$20/visit, (7d) $0/visit Tier 1, $20/visit Tier 2, (7f)0"	"(7e) $0/visit Tier 1, $20/visit Tier 2, (7h)$20/visit"	"(7c,i)$0/visit Tier 1, $20 visit Tier 2"		"(7g) $0/ visit Tier 1, $20/visit Tier 2"	(15) 0	"(13a,14a,17a,b)0, (16b)$20/visit"	(10b)0	(16a)$20/visit	(17a)0	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																	0.174287582	34.4218	43.5719		17.4288	43.5719		43.5171	17.4288	17.4288	17.4288	17.4288				17.4288		20			19.999				20											0	0	0	0	0	0	4.615946944	1.527799974	1.95878092	0	0.285898027	0.324406032	0	10.78344609	0.701053247	4.669656595	0.793887847	0.132309975	0	0	0	0.000144403	0	1.369887252	0	0	0.401538281	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	28.5048	0	3.805276577	0	0	0	0	0	0	4.615946944	1.527799974	1.95878092	0	0.285898027	0.324406032	0	10.78344609	0.701053247	4.669656595	0.793887847	0.132309975	0	0	0	0.000144403	0	1.369887252	0	0	0.401538281	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	28.5048		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															3.1272	0.075	0.3869	0.3736	0.0955	0.1839	0.1622	0.0306	0.4097	0.0635	0.1666	0.0333	0.0059	0.2858	0.0293	0.2812	0.0353	0.0454			0.2509	0.0522			0.0066		0.006															6.1063	0	0	3.1272	0.074989143	0.386859077	0.37359845	0.095545867	0.183883887	4.778097908	1.558380723	2.368446599	0.06352261	0.452521402	0.357686291	0.005886955	11.06924058	0.730334298	4.950812434	0.82919095	0.177696864	0	0	0.250850859	0.052310626	0	1.369887252	0.006631111	0	0.407525843	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	34.6111
H5656_001_0	2008	5																					2500											D	D	D	V	P	Coin	Coin	V	V	V	Coin	V	V	V	P	P	P	P	Coin	Coin	Coin	P	P	P	P																																																										0		1606.32272	87.62767998	594.5234698		104.6960881	7.483932159	7.029439516	212.1997008	313.7391033		8.248844766		18.96597495	97.05160368		4672.952253	319.3164561	329.9614008	39.48390866		24.82546521	921.942056																				1a (IP Acute) - $75 days 1-7	1b (IP Psych) - $75 days 1-7	2 (SNF) - $125 days 21-100		10a (Ambulance) - $100	11a (Medical Equip) - 15%	"11b (Med Supp) - 15%, 11c (Diab Supp) - 10%"	"4a (ER) $50, 4b (UC) - $20"	"9a (OP Surgery) - $150, 9b (ASC) - $75"		"8b (Therap Rad), (PET), (CT Scan), (MRI) - 20%"		12 (Renal Dialysis) - $50	"3 (CORF)-$25, 7i, 7c (OP PT/ST/OT) - $25, 9c (OP SA) - $35 ind./$20 grp, 9d (Cardiac Rehab) - $20"		"7b (Chiro), 7d (Spec), 7f (Pod) - $20"	"7e (MH), 7h (Psychiatric) - $35 ind/$20 grp"	"7c (OT), 7i (PT/ST) - $20"			15 (Part B Rx) - 20%	13a (Blood) - $0; 17a (MCR Eye Exam) - $25; 17b (MCR Eyewear) - $0; 18a (MCR Hearing Exam) - $20; 14j (Nutrition Therap) - $0																				43.7253	43.7253	55.01		80.7486	0.121122836	0.113181801	35.5162	87.8942		0.161497114		40.3743	16.2648		16.1497	25.2339	16.1497	0.161497114		0.161497114	20.1871																				5.8531	0.319295868	2.725392419	0	0.704504837	0.906475085	0.795604627	0.628043891	2.297986392	0	1.332164625	0	0.063811463	0.13154409	0	6.288902528	0.671467268	0.444065117	6.376537304	0	4.009240988	1.550947723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0991	0	8.368046949	5.8531	0.319295868	2.725392419	0	0.704504837	0.906475085	0.795604627	0.628043891	2.297986392	0	1.332164625	0	0.063811463	0.13154409	0	6.288902528	0.671467268	0.444065117	6.376537304	0	4.009240988	1.550947723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0991																																																																																				0	0	0	5.8531	0.319295868	2.725392419	0	0.704504837	0.906475085	0.795604627	0.628043891	2.297986392	0	1.332164625	0	0.063811463	0.13154409	0	6.288902528	0.671467268	0.444065117	6.376537304	0	4.009240988	1.550947723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0991
H5656_003_0	2008	3																					2500											D	D	D	V	P	Coin	Coin	V	V	V	Coin	V	V	V	P	P	P	P	Coin	Coin	Coin	P	P	P	P																																																										0		1606.32272	87.62767998	594.5234698		104.6960881	7.483932159	7.029439516	212.1997008	313.7391033		8.248844766		18.96597495	97.05160368		4672.952253	319.3164561	329.9614008	39.48390866		24.82546521	921.942056																				1a (IP Acute) - $75 days 1-7	1b (IP Psych) - $75 days 1-7	2 (SNF) - $125 days 21-100		10a (Ambulance) - $100	11a (Medical Equip) - 15%	"11b (Med Supp) - 15%, 11c (Diab Supp) - 10%"	"4a (ER) $50, 4b (UC) - $20"	"9a (OP Surgery) - $150, 9b (ASC) - $75"		"8b (Therap Rad), (PET), (CT Scan), (MRI) - 20%"		12 (Renal Dialysis) - $50	"3 (CORF)-$25, 7i, 7c (OP PT/ST/OT) - $25, 9c (OP SA) - $35 ind./$20 grp, 9d (Cardiac Rehab) - $20"		"7b (Chiro), 7d (Spec), 7f (Pod) - $20"	"7e (MH), 7h (Psychiatric) - $35 ind/$20 grp"	"7c (OT), 7i (PT/ST) - $20"			15 (Part B Rx) - 20%	13a (Blood) - $0; 17a (MCR Eye Exam) - $25; 17b (MCR Eyewear) - $0; 18a (MCR Hearing Exam) - $20; 14j (Nutrition Therap) - $0																				43.7253	43.7253	55.01		80.7486	0.121122836	0.113181801	35.5162	87.8942		0.161497114		40.3743	16.2648		16.1497	25.2339	16.1497	0.161497114		0.161497114	20.1871																				5.8531	0.319295868	2.725392419	0	0.704504837	0.906475085	0.795604627	0.628043891	2.297986392	0	1.332164625	0	0.063811463	0.13154409	0	6.288902528	0.671467268	0.444065117	6.376537304	0	4.009240988	1.550947723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0991	0	8.368046949	5.8531	0.319295868	2.725392419	0	0.704504837	0.906475085	0.795604627	0.628043891	2.297986392	0	1.332164625	0	0.063811463	0.13154409	0	6.288902528	0.671467268	0.444065117	6.376537304	0	4.009240988	1.550947723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0991																																																																																				0	0	0	5.8531	0.319295868	2.725392419	0	0.704504837	0.906475085	0.795604627	0.628043891	2.297986392	0	1.332164625	0	0.063811463	0.13154409	0	6.288902528	0.671467268	0.444065117	6.376537304	0	4.009240988	1.550947723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0991
H5656_004_0	2008	6																					3250											D	D	D	Coin	P	Coin	Coin	V	Coin	V	Coin	V	Coin	V	P	P	P	P	Coin	Coin	Coin	P	P	P	P																																																										0		1606.32272	87.62767998	594.5234698	30.15665979	104.6960881	7.483932159	7.029439516	212.1997008	40.43064721		8.248844766		0.666963472	97.05160368	3794.163637	4672.952253	319.3164561	329.9614008	39.48390866		24.82546521	950.6741143																				1a (IP Acute) - $300 days 1-7	1b (IP Psych) - $300 days 1-7	2 (SNF) - $100 days 6-100	6a: (Home Health) - 20%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%, 11c (Diab Supp) - 10%"	"4a (ER) $50, 4b (UC) - $25"	"9a (OP Surgery) - 20%, 9b (ASC) - 15%"		8b: 20%		12 (Renal Dialysis) - .2	"3 (CORF)-$25, 7i, 7c (OP PT/ST/OT) - $25, 9c (OP SA) - $15, 9d (Cardiac Rehab) - $25"	"14g (Bone Mass) 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) - $0; 14i (Diab Mon.) - $25; 7a (PCP)- $5"	"7b (Chiro), 7d (Spec), 7f (Pod) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"	8b: 20%		15 (Part B Rx) - 20%	13a (Blood) - 20%; 17a (MCR Eye Exam) - $25; 17b (MCR Eyewear) - $0; 18a (MCR Hearing Exam) - $25; 14j (Nutrition Therap) - $25																				158.0993	158.0993	53.8676	0.145982716	72.9914	0.166311187	0.100356977	32.8362	0.136380239		0.145982716		0.145982716	18.1553	3.6667	18.2478	18.2478	18.2478	0.145982716		0.145982716	19.1202																				21.1632	1.154489437	2.668797139	4.402351102	0.636825804	1.244661641	0.705453299	0.580652527	5.513941342	0	1.204188763	0	0.097365139	0.146833672	1.159335795	7.105940226	0.48556962	0.50175689	5.763968225	0	3.624088837	1.514756687	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.6742	0	22.08095117	21.1632	1.154489437	2.668797139	4.402351102	0.636825804	1.244661641	0.705453299	0.580652527	5.513941342	0	1.204188763	0	0.097365139	0.146833672	1.159335795	7.105940226	0.48556962	0.50175689	5.763968225	0	3.624088837	1.514756687	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.6742																																																																																				0	0	0	21.1632	1.154489437	2.668797139	4.402351102	0.636825804	1.244661641	0.705453299	0.580652527	5.513941342	0	1.204188763	0	0.097365139	0.146833672	1.159335795	7.105940226	0.48556962	0.50175689	5.763968225	0	3.624088837	1.514756687	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.6742
H5656_007_0	2008	3																					2500											A	D	D	Coin	P	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	P	Coin	Coin	Coin	P	P	P	P		P																																																								0		255.3622339	87.62767998	594.5234698	30.15665979	104.6960881	7.483932159	7.029439516	212.1997008	313.7391033		8.248844766		18.96597495	0.442140877	3789.712992	4672.952253	2.793794953	329.9614008	39.48390866		24.82546521	1358.589973					249															1a (IP Acute) - $195	1b (IP Psych) - $95 days 1-5	2 (SNF) - $100 days 21-100	6a: (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%, 11c (Diab Supp) - 20%"	"4a (ER) $35, 4b (UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b: 10%		12 (Renal Dialysis) - $50	"3 (CORF)-$15, 7i, 7c (OP PT/ST/OT) - $15, 9c (OP SA) - 50%, 9d (Cardiac Rehab) - $15"	"14g (Bone Mass) 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) - $0; 14i (Diab Mon.) - $0; 7a (PCP)- $10"	"7b (Chiro) - $20 7d (Spec) - $25, 7f (Pod) - $20"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"	8b: 10%		15 (Part B Rx) - 20%	13a (Blood) - $0; 17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15; 14j (Nutrition Therap) - $0					18a: $15															157.9454	47.3998	44.1437	0.121496493	40.4988	0.161995324	0.161995324	28.3492	29.3884		0.080997662		40.4988	0.227336287	8.0998	19.8997	0.40498831	12.1496	0.080997662		0.161995324	12.1496					12.1496															3.3611	0.346128108	2.187040088	3.663928409	0.353339099	1.212362016	1.138736333	0.501307323	0.768358519	0	0.668137141	0	0.064008318	0.100514665	2.557982436	7.749200124	1.131454298	0.334076276	3.198104292	0	4.021609284	1.375532644	0	0	0	0	0.252105223	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.985	0	8.207612436	3.3611	0.346128108	2.187040088	3.663928409	0.353339099	1.212362016	1.138736333	0.501307323	0.768358519	0	0.668137141	0	0.064008318	0.100514665	2.557982436	7.749200124	1.131454298	0.334076276	3.198104292	0	4.021609284	1.375532644	0	0	0	0	0.252105223	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.985																																																																																				0	0	0	3.3611	0.346128108	2.187040088	3.663928409	0.353339099	1.212362016	1.138736333	0.501307323	0.768358519	0	0.668137141	0	0.064008318	0.100514665	2.557982436	7.749200124	1.131454298	0.334076276	3.198104292	0	4.021609284	1.375532644	0	0	0	0	0.252105223	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.985
H5656_008_0	2008	5																					2500											A	D	D	V	P	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	P	P	Coin	Coin	Coin	P	P	P	P		P																																																								0		255.3622339	87.62767998	594.5234698	2533.376387	104.6960881	7.483932159	7.029439516	212.1997008	313.7391033		8.248844766		18.96597495	0.442140877	3789.712992	4672.952253	319.3164561	329.9614008	39.48390866		24.82546521	1358.589973					249.042823															1a (IP Acute) - $195	1b (IP Psych) - $95 days 1-5	2 (SNF) - $100 days 21-100	6a: (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%, 11c (Diab Supp) - 20%"	"4a (ER) $35, 4b (UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b: 10%		12 (Renal Dialysis) - $50	"3 (CORF)-$15, 7i, 7c (OP PT/ST/OT) - $15, 9c (OP SA) - 50%, 9d (Cardiac Rehab) - $15"	"14g (Bone Mass) 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) - $0; 14i (Diab Mon.) - $0; 7a (PCP)- $10"	"7b (Chiro) - $20 7d (Spec) - $25, 7f (Pod) - $20"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"	8b: 10%		15 (Part B Rx) - 20%	13a (Blood) - $0; 17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15; 14j (Nutrition Therap) - $0					18a: $15															157.9454	47.3998	44.1437	17.3552	40.4988	0.161995278	0.161995278	28.3492	29.3884		0.080997639		40.4988	0.227336222	8.0998	19.8997	42.5204	12.1496	0.080997639		0.161995278	12.1496					12.1496															3.3611	0.346128009	2.187039465	3.663927365	0.353338998	1.212361671	1.138736009	0.501307181	0.768358301	0	0.668136951	0	0.0640083	0.100514637	2.557981708	7.749197916	1.131453976	0.33407618	3.19810338	0	4.021608138	1.375532253	0	0	0	0	0.252148508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.9851	0	8.207632575	3.3611	0.346128009	2.187039465	3.663927365	0.353338998	1.212361671	1.138736009	0.501307181	0.768358301	0	0.668136951	0	0.0640083	0.100514637	2.557981708	7.749197916	1.131453976	0.33407618	3.19810338	0	4.021608138	1.375532253	0	0	0	0	0.252148508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.9851																																																																																				0	0	0	3.3611	0.346128009	2.187039465	3.663927365	0.353338998	1.212361671	1.138736009	0.501307181	0.768358301	0	0.668136951	0	0.0640083	0.100514637	2.557981708	7.749197916	1.131453976	0.33407618	3.19810338	0	4.021608138	1.375532253	0	0	0	0	0.252148508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.9851
H5656_801_0	2008	7																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P																																																										0		241.0161802	7.210939304	21.65581945		3.659302037	7.483932159	7.029439516	11.01909825	40.43064721	19.00387131	9.478354157	1.092641573	0.666963472	19.75252729	48.6219248	112.983885	2.793794953	3.326900845	39.48390866		24.82546521	9.635495097																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.0723	0.0723	0.2112		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234																				17.4255	0.521350912	4.573709067	0	0.856276677	1.751240125	1.644888847	2.578468991	9.460771448	4.446905887	2.217934873	0.255678128	0.156069452	4.622091387	11.3775304	26.4382291	0.653748019	0.778494798	9.239234627	0	5.809158858	2.254705853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.062	0	0	17.4255	0.521350912	4.573709067	0	0.856276677	1.751240125	1.644888847	2.578468991	9.460771448	4.446905887	2.217934873	0.255678128	0.156069452	4.622091387	11.3775304	26.4382291	0.653748019	0.778494798	9.239234627	0	5.809158858	2.254705853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.062																																																																																				0	0	0	17.4255	0.521350912	4.573709067	0	0.856276677	1.751240125	1.644888847	2.578468991	9.460771448	4.446905887	2.217934873	0.255678128	0.156069452	4.622091387	11.3775304	26.4382291	0.653748019	0.778494798	9.239234627	0	5.809158858	2.254705853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.062
H5656_802_0	2008	7																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P																																																										0		241.0161802	7.210939304	21.65581945		3.659302037	7.483932159	7.029439516	11.01909825	40.43064721	19.00387131	9.478354157	1.092641573	0.666963472	19.75252729	48.6219248	112.983885	2.793794953	3.326900845	39.48390866		24.82546521	9.635495097																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.0723	0.0723	0.2112		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234																				17.4255	0.521350912	4.573709067	0	0.856276677	1.751240125	1.644888847	2.578468991	9.460771448	4.446905887	2.217934873	0.255678128	0.156069452	4.622091387	11.3775304	26.4382291	0.653748019	0.778494798	9.239234627	0	5.809158858	2.254705853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.062	0	0	17.4255	0.521350912	4.573709067	0	0.856276677	1.751240125	1.644888847	2.578468991	9.460771448	4.446905887	2.217934873	0.255678128	0.156069452	4.622091387	11.3775304	26.4382291	0.653748019	0.778494798	9.239234627	0	5.809158858	2.254705853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.062																																																																																				0	0	0	17.4255	0.521350912	4.573709067	0	0.856276677	1.751240125	1.644888847	2.578468991	9.460771448	4.446905887	2.217934873	0.255678128	0.156069452	4.622091387	11.3775304	26.4382291	0.653748019	0.778494798	9.239234627	0	5.809158858	2.254705853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.062
H5656_803_0	2008	7																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P																																																										0		241.0161802	7.210939304	21.65581945		3.659302037	7.483932159	7.029439516	11.01909825	40.43064721	19.00387131	9.478354157	1.092641573	0.666963472	19.75252729	48.6219248	112.983885	2.793794953	3.326900845	39.48390866		24.82546521	9.635495097																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.0723	0.0723	0.2112		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234																				17.4255	0.521350912	4.573709067	0	0.856276677	1.751240125	1.644888847	2.578468991	9.460771448	4.446905887	2.217934873	0.255678128	0.156069452	4.622091387	11.3775304	26.4382291	0.653748019	0.778494798	9.239234627	0	5.809158858	2.254705853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.062	0	0	17.4255	0.521350912	4.573709067	0	0.856276677	1.751240125	1.644888847	2.578468991	9.460771448	4.446905887	2.217934873	0.255678128	0.156069452	4.622091387	11.3775304	26.4382291	0.653748019	0.778494798	9.239234627	0	5.809158858	2.254705853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.062																																																																																				0	0	0	17.4255	0.521350912	4.573709067	0	0.856276677	1.751240125	1.644888847	2.578468991	9.460771448	4.446905887	2.217934873	0.255678128	0.156069452	4.622091387	11.3775304	26.4382291	0.653748019	0.778494798	9.239234627	0	5.809158858	2.254705853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.062
H5657_004_0	2008	10	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		235.485665	5.086183	568.186148	46.973427	6.029331	11.726772	5.82651	336.331092	48.536721	16.322537	0.861781		0.061556	21.123887	7888.189855	5857.989394	0.841262	4.986017			10.228516									0.08		3257.529784	34.335503	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							571.424982	571.424214	26.348031	0	0.183529	0.183529	0.183529	45.882414	0.183529	0.183529	0.183529		0.183526	0.183529	13.764719	27.529439	0.183529	0.183529			0.183529									0		0	27.529517	0	0							11.2135	0.242197344	1.247548853	0	1.106557089	2.152202738	1.069333554	1.285973534	8.907895868	2.995658893	0.158161805	0	0.011297126	3.876845857	9.048226398	13.43893014	0.154395974	0.915078714	0	0	1.877229313	0	0	0	0	0	0	0	0	0	0	0	0.078769984	0	0	0	0	0	0	0	0	59.7798	0	5.244761871	11.2135	0.242197344	1.247548853	0	1.106557089	2.152202738	1.069333554	1.285973534	8.907895868	2.995658893	0.158161805	0	0.011297126	3.876845857	9.048226398	13.43893014	0.154395974	0.915078714	0	0	1.877229313	0	0	0	0	0	0	0	0	0	0	0	0.078769984	0	0	0	0	0	0	0	0	59.7798	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	11.2135	0.242197344	1.247548853	0	1.106557089	2.152202738	1.069333554	1.285973534	8.907895868	2.995658893	0.158161805	0	0.011297126	3.876845857	9.048226398	13.43893014	0.154395974	0.915078714	0	0	1.877229313	0	0	0	0	0	0	0	0	0	0	0	0.078769984	0	0	0	0	0	0	0	0	59.7798
H5657_005_0	2008	10	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		270.410052	5.840504	652.452647	53.939957	163.606866	15.463062	7.682905	386.211654	336.526647	5793.151153	3781.475947		10.996444	1349.94943	9058.0708	6726.775553	73.374815	1619.456893			13.487445									0.08		3.38	0.02									$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$0-$100/Visit		$50/Proc	$50/Visit	$15/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins									Active Outlook Newsletter		Silver Sneakers	QUITNET									502.660004	502.660138	23.256296	0	80.996926	0.161993	0.161993	40.498444	71.180138	0	0.437389		40.498877	40.498455	12.149534	24.29907	31.793695	40.498449			0.161993									0		0	0									11.327	0.244649046	1.264469324	0	1.104304435	2.504907803	1.24457683	1.303414253	1.996167765	0	0.137831332	0	0.037111969	4.55590552	9.17094493	13.62119917	0.194404707	5.465457699	0	0	2.184871678	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3572	0	12.91345418	11.327	0.244649046	1.264469324	0	1.104304435	2.504907803	1.24457683	1.303414253	1.996167765	0	0.137831332	0	0.037111969	4.55590552	9.17094493	13.62119917	0.194404707	5.465457699	0	0	2.184871678	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3572	3000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0	0	0	11.327	0.244649046	1.264469324	0	1.104304435	2.504907803	1.24457683	1.303414253	1.996167765	0	0.137831332	0	0.037111969	4.55590552	9.17094493	13.62119917	0.194404707	5.465457699	0	0	2.184871678	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3572
H5657_006_0	2008	10	s.	t.	u.	v.							OP Facility - Other	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000	Radiology	Mental Health (MH)									A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	Coin	Coin			Coin									O		V	V	O	O							0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0		266.214518	5.749886	642.329549	53.103055	7.705549	14.98694	7.446341	380.219404	62.03045	20.860377	1.101365		0.078669	26.996554	8917.530732	6622.406586	1.075142	6.372183			13.072154									0.08		3682.609382	38.81599	3.38	0.02							$625/Admit	$625/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	20% Coins	20% Coins	20% Coins	"20% Coins, up to $50 maximum"	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$15/Visit	$30/Visit	20% Coins	20% Coins			20% Coins									Active Outlook Newsletter		$0/Visit	$30/Visit	Silver Sneakers	QUITNET							554.186855	554.186451	25.569404	0	0.178106	0.178106	0.178105	44.526513	0.178106	0.178105	0.178106		0.178108	0.178106	13.357949	26.715899	0.178105	0.178106			0.178106									0		0	26.715906	0	0							12.2944	0.26554241	1.368665312	0	1.37240451	2.669263936	1.326230564	1.410820353	11.04799533	3.715337446	0.196159715	0	0.014011578	4.808248247	9.92666006	14.74362879	0.191488166	1.134924025	0	0	2.32822906	0	0	0	0	0	0	0	0	0	0	0	0.086417028	0	0	0	0	0	0	0	0	68.9004	0	8.290306287	12.2944	0.26554241	1.368665312	0	1.37240451	2.669263936	1.326230564	1.410820353	11.04799533	3.715337446	0.196159715	0	0.014011578	4.808248247	9.92666006	14.74362879	0.191488166	1.134924025	0	0	2.32822906	0	0	0	0	0	0	0	0	0	0	0	0.086417028	0	0	0	0	0	0	0	0	68.9004	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0	0	0							0	0	0	12.2944	0.26554241	1.368665312	0	1.37240451	2.669263936	1.326230564	1.410820353	11.04799533	3.715337446	0.196159715	0	0.014011578	4.808248247	9.92666006	14.74362879	0.191488166	1.134924025	0	0	2.32822906	0	0	0	0	0	0	0	0	0	0	0	0.086417028	0	0	0	0	0	0	0	0	68.9004
H5657_805_0	2008	8																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		270.266242	5.837397	652.10566	53.91127	163.519856	15.446606	7.674728	386.006259	336.347676	5790.070242	3779.464885		10.990595	1349.231502	9053.253544	6723.198123	73.335793	1618.595634			13.47309																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					138.371205	138.371289	22.599925	0	78.081173	0.156162	0.156162	39.040589	156.162411	31.141464	77.659797		78.080951	72.574306	15.61624	23.42436	48.711537	78.0812			0.156162																					3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	0	28.14902404	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751
H5657_806_0	2008	8																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		270.266242	5.837397	652.10566	53.91127	163.519856	15.446606	7.674728	386.006259	336.347676	5790.070242	3779.464885		10.990595	1349.231502	9053.253544	6723.198123	73.335793	1618.595634			13.47309																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					138.371205	138.371289	22.599925	0	78.081173	0.156162	0.156162	39.040589	156.162411	31.141464	77.659797		78.080951	72.574306	15.61624	23.42436	48.711537	78.0812			0.156162																					3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	0	28.14902404	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751
H5657_807_0	2008	8																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		270.266242	5.837397	652.10566	53.91127	163.519856	15.446606	7.674728	386.006259	336.347676	5790.070242	3779.464885		10.990595	1349.231502	9053.253544	6723.198123	73.335793	1618.595634			13.47309																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					138.371205	138.371289	22.599925	0	78.081173	0.156162	0.156162	39.040589	156.162411	31.141464	77.659797		78.080951	72.574306	15.61624	23.42436	48.711537	78.0812			0.156162																					3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	0	28.14902404	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751
H5657_808_0	2008	8																					5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		270.266242	5.837397	652.10566	53.91127	163.519856	15.446606	7.674728	386.006259	336.347676	5790.070242	3779.464885		10.990595	1349.231502	9053.253544	6723.198123	73.335793	1618.595634			13.47309																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					138.371205	138.371289	22.599925	0	78.081173	0.156162	0.156162	39.040589	156.162411	31.141464	77.659797		78.080951	72.574306	15.61624	23.42436	48.711537	78.0812			0.156162																					3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	0	28.14902404	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751	5000																																										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	3.1164	0.067310679	1.228128251	0	1.06398518	2.412172886	1.198500874	1.255825976	4.377072002	15.02593867	24.45937298	0	0.071513009	8.159961658	11.78148168	13.12388443	0.2976916	10.53182412	0	0	2.103984681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2751
H5657_809_0	2008	3																					5000														V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																								0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0					53.91127	113.395769	7.428239	3.69076	267.682943	233.246312	4015.227753	2620.937512		7.621625	935.648714	6278.140567	4662.321968	50.856016	1122.444087			6.47918																								$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																								0	87.298023	0.174596	0.174596	43.649015	174.595976	34.817442	86.826855		87.29863	81.14105	17.4596	26.1894	54.461328	87.298002			0.174596																					0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	0	10.61682495	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	5000																																													0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671
H5657_810_0	2008	3																					5000														V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																								0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0					53.91127	113.395769	7.428239	3.69076	267.682943	233.246312	4015.227753	2620.937512		7.621625	935.648714	6278.140567	4662.321968	50.856016	1122.444087			6.47918																								$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																								0	87.298023	0.174596	0.174596	43.649015	174.595976	34.817442	86.826855		87.29863	81.14105	17.4596	26.1894	54.461328	87.298002			0.174596																					0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	0	10.61682495	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	5000																																													0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671
H5657_811_0	2008	3																					5000														V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																								0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0					53.91127	113.395769	7.428239	3.69076	267.682943	233.246312	4015.227753	2620.937512		7.621625	935.648714	6278.140567	4662.321968	50.856016	1122.444087			6.47918																								$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																								0	87.298023	0.174596	0.174596	43.649015	174.595976	34.817442	86.826855		87.29863	81.14105	17.4596	26.1894	54.461328	87.298002			0.174596																					0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	0	10.61682495	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	5000																																													0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671
H5657_812_0	2008	3																					5000														V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																								0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0					53.91127	113.395769	7.428239	3.69076	267.682943	233.246312	4015.227753	2620.937512		7.621625	935.648714	6278.140567	4662.321968	50.856016	1122.444087			6.47918																								$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																								0	87.298023	0.174596	0.174596	43.649015	174.595976	34.817442	86.826855		87.29863	81.14105	17.4596	26.1894	54.461328	87.298002			0.174596																					0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	0	10.61682495	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671	5000																																													0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0	0	0	0	0	0	0	0.824935538	1.296940816	0.644391933	0.973674733	3.393655624	11.64999662	18.96398011	0	0.055446452	6.32662659	9.134485254	10.17528458	0.230807181	8.165593846	0	0	1.131238911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9671
H5665_001_0	2008	15																					0											A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	S	Coin	T	V	V	V	V	V	Coin	O	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	564.5605359	33.4869221	2170.408001	40.4966077	22.03190488	45.29963848	44.74767881	28.09117973	45.74321833	30.56575898	35.4281459	3.997993196	7.074415708	115.2025723	97.00820226	191.9950278	10.92731199	4.036251807	53.52915383	60.01122537	918.7639808	6.163377658	0	0	1072.111047	0	0	0	0	0	10											PBP: 1A IP Acute: Traditional FFS Cost Sharing	1B IP Psych: Traditional FFS Cost Sharing	2 SNF: Traditional FFS Cost Sharing	6 Home Health: Traditional FFS Cost Sharing	10A Ambulance: Traditional FFS Cost Sharing	11A DME: Traditional FFS Cost Sharing	"11B Prosthetic Medical Supplies: Traditional FFS Cost Sharing, 11C Diabetes Monitoring Supplies: Traditional FFS Cost Sharing"	"4A ER: Traditional FFS Cost Sharing, 4B Urgent Care: Traditional FFS Cost Sharing"	9B ASC Services: Traditional FFS Cost Sharing	8A OP C/D/T: Traditional FFS Cost Sharing	8B OP X-Ray: Traditional FFS Cost Sharing	9A OP Hospital: Traditional FFS Cost Sharing	12 Renal Dialysis: Traditional FFS Cost Sharing	"3 CORF: Traditional FFS Cost Sharing, 5 Partial Hosp: Traditional FFS Cost Sharing, 9C OP Substance Abuse: Traditional FFS Cost Sharing, 9D Cardiac Rehab: Traditional FFS Cost Sharing"	"7A PCP: Traditional FFS Cost Sharing, 14B Immunizations: Traditional FFS Cost Sharing, 14C Routine Physical Exams: Traditional FFS Cost Sharing, 14D Pap Smears: Traditional FFS Cost Sharing, 14D Pelvic Exams: Traditional FFS Cost Sharing, 14E Prostate Screening: Traditional FFS Cost Sharing, 14F Colorectal Screening: Traditional FFS Cost Sharing, 14G Bone Mass Measurement: Traditional FFS Cost Sharing, 14H Mammography: Traditional FFS Cost Sharing, 14I Diabetes Monitoring: Traditional FFS Cost Sharing"	7D Physician Specialist: Traditional FFS Cost Sharing	7E Mental Health: Traditional FFS Cost Sharing	"7C Occupational Therapy: Traditional FFS Cost Sharing, 7I Physical and Speech Therapy: Traditional FFS Cost Sharing"	Included in i.2.	"7G Other Health Care: Traditional FFS Cost Sharing, 18A Medicare Covered Hearing Exams: Traditional FFS Cost Sharing 7B Chiropractic: Traditional FFS Cost Sharing, 7F Podiatry: $0 copay"	15 Part B Drugs: Traditional FFS Cost Sharing	"13A Blood: Traditional FFS Cost Sharing, 16B Medicare Covered Comprehensive Dental Services: Traditional FFS Cost Sharing, 17A Medicare Covered Eye Exams: Traditional FFS Cost Sharing"	10B Transportation: $0 Copay	"16A Preventive Dental Services: Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams:  $10	"17B Eye Wear: Medicare Covered: Traditional FFS Cost Sharing, Routine: $0 Copay with a $200 benefit amount"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs:  Covered	13B Acupuncture: Not Covered   13C OTC Drug Benefit Amount: $10 Monthly											1064.832232	1126.313711	129.6365333	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.23286197	0.234	0.234	0.234	0.234	0.197960774	52.25723353	0.234	0	0	10	0	0	0	0	0	0											50.0969	3.143064959	23.44701409	0	5.155465741	10.6001154	10.47095684	6.573336056	10.70391309	7.152387601	8.290186142	0.935530408	1.655413276	26.95740191	22.58952105	44.92683652	2.556991006	0.944482923	12.525822	11.87986861	4.001005325	1.442230372	0	0	0.893425873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	266.9418	0	0	50.0969	3.143064959	23.44701409	0	5.155465741	10.6001154	10.47095684	6.573336056	10.70391309	7.152387601	8.290186142	0.935530408	1.655413276	26.95740191	22.58952105	44.92683652	2.556991006	0.944482923	12.525822	11.87986861	4.001005325	1.442230372	0	0	0.893425873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	266.9418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	50.0969	3.143064959	23.44701409	0	5.155465741	10.6001154	10.47095684	6.573336056	10.70391309	7.152387601	8.290186142	0.935530408	1.655413276	26.95740191	22.58952105	44.92683652	2.556991006	0.944482923	12.525822	11.87986861	4.001005325	1.442230372	0	0	0.893425873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	266.9418
H5665_002_0	2008	12																					0											D	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1433.197525	4.518602626	1400.626689	34.22535428	351.1688986	30.43960804	25.49247507	256.8020835	505.8269107	17.46730909	37.44570017	61.92559514	0.473274446	1422.544381	14792.08917	17658.40388	671.6602958	1000.741896	63.95147954	76.68982423	26.31931127	1114.047505	526.5	0	839.1297904	407.2	0	0	0	0	0											PBP: 1A IP Acute: $40 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%    OON DME: 50%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $100	8A OP C/D/T: 10%	"8B OP X-Ray: 10%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $25"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $25	"7E Mental Health: $25 Individual $10 Group, 7H Psychiatric: $25 Individual $10 Group"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $25, 7F Podiatry: $0"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $25"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $25	"17B Eye Wear: Medicare Covered: $25 copay, Routine: $25 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											10.94798937	661.8220194	118.4436287	0	84.79119613	0.224209296	0.046914198	93.90831251	213.1218255	0.167258867	0.199121243	43.55929339	0.081865048	41.14602797	7.204631479	12.32673483	26.44163149	27.27697038	0.123390966	0.087306904	0.179496829	28.17316417	0	0	24.89991558	9.775739135	0	0	0	0	0											1.3076	0.249209226	13.82460896	0	2.481335913	6.824843101	1.195959032	2.009654193	8.983562881	2.921562334	7.456234358	0.224786264	0.038744635	4.877670908	8.880962604	18.13920519	1.479982836	2.274767254	7.891034811	6.695551087	4.724232911	2.615520272	0	0	1.741188412	0.331723415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.1699	0	1.522315432	1.3076	0.249209226	13.82460896	0	2.481335913	6.824843101	1.195959032	2.009654193	8.983562881	2.921562334	7.456234358	0.224786264	0.038744635	4.877670908	8.880962604	18.13920519	1.479982836	2.274767254	7.891034811	6.695551087	4.724232911	2.615520272	0	0	1.741188412	0.331723415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.1699	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.3076	0.249209226	13.82460896	0	2.481335913	6.824843101	1.195959032	2.009654193	8.983562881	2.921562334	7.456234358	0.224786264	0.038744635	4.877670908	8.880962604	18.13920519	1.479982836	2.274767254	7.891034811	6.695551087	4.724232911	2.615520272	0	0	1.741188412	0.331723415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.1699
H5665_003_0	2008	17																					0											D	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1433.197525	4.518602626	1400.626689	34.22535428	351.1688986	30.43960804	25.49247507	256.8020835	505.8269107	17.46730909	37.44570017	61.92559514	0.473274446	1422.544381	14792.08917	17658.40388	671.6602958	1000.741896	63.95147954	76.68982423	26.31931127	1114.047505	526.5	0	839.1297904	407.2	0	0	0	0	0											PBP: 1A IP Acute: $0 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $0	11A DME: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item     OON DME: 50%	"11B Prosthetic Medical Supplies: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: 0%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $0	"7E Mental Health: $0, 9C OP Substance Abuse: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0, 7B Chiropractic: $0, 7F Podiatry: $0"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $0 copay, Routine: $10 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											4.670690188	677.9757702	19.61538501	0	10.22137301	0.176429579	0.040178265	91.70756984	115.0807263	0.076211857	0.134243532	43.55929339	0.081865048	35.94559147	1.822243921	4.130696526	2.291787722	2.371287519	0.027547697	0.045292242	0.089787845	3.427907886	0	0	9.942469258	9.896046672	0	0	0	0	0											0.5578	0.255291925	2.28948598	0	0.299119025	5.370447229	1.02424342	1.962557917	4.850910687	1.331216066	5.026843056	0.224786264	0.038744635	4.261183264	2.24623288	6.078458966	0.128275235	0.197753897	1.761716009	3.473454079	2.363154249	0.318237686	0	0	0.695251845	0.33580585	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.091	0	0.080431272	0.5578	0.255291925	2.28948598	0	0.299119025	5.370447229	1.02424342	1.962557917	4.850910687	1.331216066	5.026843056	0.224786264	0.038744635	4.261183264	2.24623288	6.078458966	0.128275235	0.197753897	1.761716009	3.473454079	2.363154249	0.318237686	0	0	0.695251845	0.33580585	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.091	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.5578	0.255291925	2.28948598	0	0.299119025	5.370447229	1.02424342	1.962557917	4.850910687	1.331216066	5.026843056	0.224786264	0.038744635	4.261183264	2.24623288	6.078458966	0.128275235	0.197753897	1.761716009	3.473454079	2.363154249	0.318237686	0	0	0.695251845	0.33580585	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.091
H5665_004_0	2008	12																					0											D	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1433.197525	4.518602626	1400.626689	34.22535428	351.1688986	30.43960804	25.49247507	256.8020835	505.8269107	17.46730909	37.44570017	61.92559514	0.473274446	1422.544381	14792.08917	17658.40388	671.6602958	1000.741896	63.95147954	76.68982423	26.31931127	1114.047505	526.5	0	839.1297904	407.2	0	0	0	0	0											PBP: 1A IP Acute: $40 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%    OON DME: 50%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $100	8A OP C/D/T: 10%	"8B OP X-Ray: 10%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $25"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $25	"7E Mental Health: $25 Individual $10 Group, 7H Psychiatric: $25 Individual $10 Group"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $25, 7F Podiatry: $0"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $25"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $25	"17B Eye Wear: Medicare Covered: $25 copay, Routine: $25 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											10.94798937	661.8220194	118.4436287	0	84.79119613	0.224209296	0.046914198	93.90831251	213.1218255	0.167258867	0.199121243	43.55929339	0.081865048	41.14602797	7.204631479	12.32673483	26.44163149	27.27697038	0.123390966	0.087306904	0.179496829	28.17316417	0	0	24.89991558	9.775739135	0	0	0	0	0											1.3076	0.249209226	13.82460896	0	2.481335913	6.824843101	1.195959032	2.009654193	8.983562881	2.921562334	7.456234358	0.224786264	0.038744635	4.877670908	8.880962604	18.13920519	1.479982836	2.274767254	7.891034811	6.695551087	4.724232911	2.615520272	0	0	1.741188412	0.331723415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.1699	0	1.522315432	1.3076	0.249209226	13.82460896	0	2.481335913	6.824843101	1.195959032	2.009654193	8.983562881	2.921562334	7.456234358	0.224786264	0.038744635	4.877670908	8.880962604	18.13920519	1.479982836	2.274767254	7.891034811	6.695551087	4.724232911	2.615520272	0	0	1.741188412	0.331723415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.1699	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.3076	0.249209226	13.82460896	0	2.481335913	6.824843101	1.195959032	2.009654193	8.983562881	2.921562334	7.456234358	0.224786264	0.038744635	4.877670908	8.880962604	18.13920519	1.479982836	2.274767254	7.891034811	6.695551087	4.724232911	2.615520272	0	0	1.741188412	0.331723415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.1699
H5665_005_0	2008	12																					0											D	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1433.197525	4.518602626	1400.626689	34.22535428	351.1688986	30.43960804	25.49247507	256.8020835	505.8269107	17.46730909	37.44570017	61.92559514	0.473274446	1422.544381	14792.08917	17658.40388	671.6602958	1000.741896	63.95147954	76.68982423	26.31931127	1114.047505	526.5	0	839.1297904	407.2	0	0	0	0	0											PBP: 1A IP Acute: $40 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%    OON DME: 50%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $100	8A OP C/D/T: 10%	"8B OP X-Ray: 10%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $25"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $25	"7E Mental Health: $25 Individual $10 Group, 7H Psychiatric: $25 Individual $10 Group"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $25, 7F Podiatry: $0"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $25"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $25	"17B Eye Wear: Medicare Covered: $25 copay, Routine: $25 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											10.94798937	661.8220194	118.4436287	0	84.79119613	0.224209296	0.046914198	93.90831251	213.1218255	0.167258867	0.199121243	43.55929339	0.081865048	41.14602797	7.204631479	12.32673483	26.44163149	27.27697038	0.123390966	0.087306904	0.179496829	28.17316417	0	0	24.89991558	9.775739135	0	0	0	0	0											1.3076	0.249209226	13.82460896	0	2.481335913	6.824843101	1.195959032	2.009654193	8.983562881	2.921562334	7.456234358	0.224786264	0.038744635	4.877670908	8.880962604	18.13920519	1.479982836	2.274767254	7.891034811	6.695551087	4.724232911	2.615520272	0	0	1.741188412	0.331723415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.1699	0	1.522315432	1.3076	0.249209226	13.82460896	0	2.481335913	6.824843101	1.195959032	2.009654193	8.983562881	2.921562334	7.456234358	0.224786264	0.038744635	4.877670908	8.880962604	18.13920519	1.479982836	2.274767254	7.891034811	6.695551087	4.724232911	2.615520272	0	0	1.741188412	0.331723415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.1699	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.3076	0.249209226	13.82460896	0	2.481335913	6.824843101	1.195959032	2.009654193	8.983562881	2.921562334	7.456234358	0.224786264	0.038744635	4.877670908	8.880962604	18.13920519	1.479982836	2.274767254	7.891034811	6.695551087	4.724232911	2.615520272	0	0	1.741188412	0.331723415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.1699
H5665_006_0	2008	12																					0											D	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1433.197525	4.518602626	1400.626689	34.22535428	351.1688986	30.43960804	25.49247507	256.8020835	505.8269107	17.46730909	37.44570017	61.92559514	0.473274446	1422.544381	14792.08917	17658.40388	671.6602958	1000.741896	63.95147954	76.68982423	26.31931127	1114.047505	526.5	0	839.1297904	407.2	0	0	0	0	0											PBP: 1A IP Acute: $0 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $0	11A DME: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item     OON DME: 50%	"11B Prosthetic Medical Supplies: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: 0%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $0	"7E Mental Health: $0, 9C OP Substance Abuse: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0, 7B Chiropractic: $0, 7F Podiatry: $0"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $0 copay, Routine: $10 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											4.670690188	677.9757702	19.61538501	0	10.22137301	0.176429579	0.040178265	91.70756984	115.0807263	0.076211857	0.134243532	43.55929339	0.081865048	35.94559147	1.822243921	4.130696526	2.291787722	2.371287519	0.027547697	0.045292242	0.089787845	3.427907886	0	0	9.942469258	9.896046672	0	0	0	0	0											0.5578	0.255291925	2.28948598	0	0.299119025	5.370447229	1.02424342	1.962557917	4.850910687	1.331216066	5.026843056	0.224786264	0.038744635	4.261183264	2.24623288	6.078458966	0.128275235	0.197753897	1.761716009	3.473454079	2.363154249	0.318237686	0	0	0.695251845	0.33580585	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.091	0	0.080431272	0.5578	0.255291925	2.28948598	0	0.299119025	5.370447229	1.02424342	1.962557917	4.850910687	1.331216066	5.026843056	0.224786264	0.038744635	4.261183264	2.24623288	6.078458966	0.128275235	0.197753897	1.761716009	3.473454079	2.363154249	0.318237686	0	0	0.695251845	0.33580585	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.091	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.5578	0.255291925	2.28948598	0	0.299119025	5.370447229	1.02424342	1.962557917	4.850910687	1.331216066	5.026843056	0.224786264	0.038744635	4.261183264	2.24623288	6.078458966	0.128275235	0.197753897	1.761716009	3.473454079	2.363154249	0.318237686	0	0	0.695251845	0.33580585	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.091
H5665_007_0	2008	12																					0											D	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1433.197525	4.518602626	1400.626689	34.22535428	351.1688986	30.43960804	25.49247507	256.8020835	505.8269107	17.46730909	37.44570017	61.92559514	0.473274446	1422.544381	14792.08917	17658.40388	671.6602958	1000.741896	63.95147954	76.68982423	26.31931127	1114.047505	526.5	0	839.1297904	407.2	0	0	0	0	0											PBP: 1A IP Acute: $0 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $0	11A DME: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item     OON DME: 50%	"11B Prosthetic Medical Supplies: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: 0%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $0	"7E Mental Health: $0, 9C OP Substance Abuse: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0, 7B Chiropractic: $0, 7F Podiatry: $0"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $0 copay, Routine: $10 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											4.670690188	677.9757702	19.61538501	0	10.22137301	0.176429579	0.040178265	91.70756984	115.0807263	0.076211857	0.134243532	43.55929339	0.081865048	35.94559147	1.822243921	4.130696526	2.291787722	2.371287519	0.027547697	0.045292242	0.089787845	3.427907886	0	0	9.942469258	9.896046672	0	0	0	0	0											0.5578	0.255291925	2.28948598	0	0.299119025	5.370447229	1.02424342	1.962557917	4.850910687	1.331216066	5.026843056	0.224786264	0.038744635	4.261183264	2.24623288	6.078458966	0.128275235	0.197753897	1.761716009	3.473454079	2.363154249	0.318237686	0	0	0.695251845	0.33580585	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.091	0	0.080431272	0.5578	0.255291925	2.28948598	0	0.299119025	5.370447229	1.02424342	1.962557917	4.850910687	1.331216066	5.026843056	0.224786264	0.038744635	4.261183264	2.24623288	6.078458966	0.128275235	0.197753897	1.761716009	3.473454079	2.363154249	0.318237686	0	0	0.695251845	0.33580585	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.091	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.5578	0.255291925	2.28948598	0	0.299119025	5.370447229	1.02424342	1.962557917	4.850910687	1.331216066	5.026843056	0.224786264	0.038744635	4.261183264	2.24623288	6.078458966	0.128275235	0.197753897	1.761716009	3.473454079	2.363154249	0.318237686	0	0	0.695251845	0.33580585	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.091
H5665_803_0	2008	10																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	S	Coin	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	446.5488603	7.338888785	99.34075242	34.22535428	10.35272758	30.43960804	25.49247507	13.2478232	60.61364284	17.46730909	37.44570017	61.92559514	0.473274446	52.65481048	90.71152769	196.9461375	4.985209361	7.19291003	63.95147954	76.68982423	593.3461108	10.79329191	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Traditional FFS Cost Sharing	1B IP Psych: Traditional FFS Cost Sharing	2 SNF: Traditional FFS Cost Sharing	6 Home Health: Traditional FFS Cost Sharing	10A Ambulance: Traditional FFS Cost Sharing	11A DME: Traditional FFS Cost Sharing	"11B Prosthetic Medical Supplies: Traditional FFS Cost Sharing, 11C Diabetes Monitoring Supplies: Traditional FFS Cost Sharing"	"4A ER: Traditional FFS Cost Sharing, 4B Urgent Care: Traditional FFS Cost Sharing"	9B ASC Services: Traditional FFS Cost Sharing	8A OP C/D/T: Traditional FFS Cost Sharing	8B OP X-Ray: Traditional FFS Cost Sharing	9A OP Hospital: Traditional FFS Cost Sharing	12 Renal Dialysis: Traditional FFS Cost Sharing	"3 CORF: Traditional FFS Cost Sharing, 5 Partial Hosp: Traditional FFS Cost Sharing, 9C OP Substance Abuse: Traditional FFS Cost Sharing, 9D Cardiac Rehab: Traditional FFS Cost Sharing"	"7A PCP: Traditional FFS Cost Sharing, 14B Immunizations: Traditional FFS Cost Sharing, 14C Routine Physical Exams: Traditional FFS Cost Sharing, 14D Pap Smears: Traditional FFS Cost Sharing, 14D Pelvic Exams: Traditional FFS Cost Sharing, 14E Prostate Screening: Traditional FFS Cost Sharing, 14F Colorectal Screening: Traditional FFS Cost Sharing, 14G Bone Mass Measurement: Traditional FFS Cost Sharing, 14H Mammography: Traditional FFS Cost Sharing, 14I Diabetes Monitoring: Traditional FFS Cost Sharing"	7D Physician Specialist: Traditional FFS Cost Sharing	7E Mental Health: Traditional FFS Cost Sharing	"7C Occupational Therapy: Traditional FFS Cost Sharing, 7I Physical and Speech Therapy: Traditional FFS Cost Sharing"	Included in i.2.	"7G Other Health Care: Traditional FFS Cost Sharing, 18A Medicare Covered Hearing Exams: Traditional FFS Cost Sharing, 7B Chiropractic: Traditional FFS Cost Sharing,  7F Podiatry: Traditional FFS Cost Sharing"	15 Part B Drugs: Traditional FFS Cost Sharing	"13A Blood: Traditional FFS Cost Sharing, 16B Medicare Covered Comprehensive Dental Services: Traditional FFS Cost Sharing, 17A Medicare Covered Eye Exams: Traditional FFS Cost Sharing"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	"17B Eye Wear: Medicare Covered: Traditional FFS Cost Sharing, Routine: Not Covered"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											0.064739053	0.064739053	0.167997927	0	0.234	0	0.513410621	0.234	0.234	0.234	0.234	124.5082598	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	124.5556762	0.234	0	0	0	0	0	0	0	0	0											28.9092	0.475112713	16.68904044	0	2.422538254	0	13.08810745	3.099990628	14.18359243	4.087350328	8.762293839	0.642520674	0.11074622	12.32122565	21.22649748	46.08539617	1.16653899	1.683140947	14.96464621	17.94541887	6.158718837	2.525630308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	216.5477	0	0	28.9092	0.475112713	16.68904044	0	2.422538254	0	13.08810745	3.099990628	14.18359243	4.087350328	8.762293839	0.642520674	0.11074622	12.32122565	21.22649748	46.08539617	1.16653899	1.683140947	14.96464621	17.94541887	6.158718837	2.525630308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	216.5477	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.9092	0.475112713	16.68904044	0	2.422538254	0	13.08810745	3.099990628	14.18359243	4.087350328	8.762293839	0.642520674	0.11074622	12.32122565	21.22649748	46.08539617	1.16653899	1.683140947	14.96464621	17.94541887	6.158718837	2.525630308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	216.5477
H5665_804_0	2008	9																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	S	Coin	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	446.5488603	7.338888785	99.34075242	34.22535428	10.35272758	30.43960804	25.49247507	13.2478232	60.61364284	17.46730909	37.44570017	61.92559514	0.473274446	52.65481048	90.71152769	196.9461375	4.985209361	7.19291003	63.95147954	76.68982423	593.3461108	10.79329191	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Traditional FFS Cost Sharing	1B IP Psych: Traditional FFS Cost Sharing	2 SNF: Traditional FFS Cost Sharing	6 Home Health: Traditional FFS Cost Sharing	10A Ambulance: Traditional FFS Cost Sharing	11A DME: Traditional FFS Cost Sharing	"11B Prosthetic Medical Supplies: Traditional FFS Cost Sharing, 11C Diabetes Monitoring Supplies: Traditional FFS Cost Sharing"	"4A ER: Traditional FFS Cost Sharing, 4B Urgent Care: Traditional FFS Cost Sharing"	9B ASC Services: Traditional FFS Cost Sharing	8A OP C/D/T: Traditional FFS Cost Sharing	8B OP X-Ray: Traditional FFS Cost Sharing	9A OP Hospital: Traditional FFS Cost Sharing	12 Renal Dialysis: Traditional FFS Cost Sharing	"3 CORF: Traditional FFS Cost Sharing, 5 Partial Hosp: Traditional FFS Cost Sharing, 9C OP Substance Abuse: Traditional FFS Cost Sharing, 9D Cardiac Rehab: Traditional FFS Cost Sharing"	"7A PCP: Traditional FFS Cost Sharing, 14B Immunizations: Traditional FFS Cost Sharing, 14C Routine Physical Exams: Traditional FFS Cost Sharing, 14D Pap Smears: Traditional FFS Cost Sharing, 14D Pelvic Exams: Traditional FFS Cost Sharing, 14E Prostate Screening: Traditional FFS Cost Sharing, 14F Colorectal Screening: Traditional FFS Cost Sharing, 14G Bone Mass Measurement: Traditional FFS Cost Sharing, 14H Mammography: Traditional FFS Cost Sharing, 14I Diabetes Monitoring: Traditional FFS Cost Sharing"	7D Physician Specialist: Traditional FFS Cost Sharing	7E Mental Health: Traditional FFS Cost Sharing	"7C Occupational Therapy: Traditional FFS Cost Sharing, 7I Physical and Speech Therapy: Traditional FFS Cost Sharing"	Included in i.2.	"7G Other Health Care: Traditional FFS Cost Sharing, 18A Medicare Covered Hearing Exams: Traditional FFS Cost Sharing, 7B Chiropractic: Traditional FFS Cost Sharing,  7F Podiatry: Traditional FFS Cost Sharing"	15 Part B Drugs: Traditional FFS Cost Sharing	"13A Blood: Traditional FFS Cost Sharing, 16B Medicare Covered Comprehensive Dental Services: Traditional FFS Cost Sharing, 17A Medicare Covered Eye Exams: Traditional FFS Cost Sharing"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	"17B Eye Wear: Medicare Covered: Traditional FFS Cost Sharing, Routine: Not Covered"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											0.064739053	0.064739053	0.167997927	0	0.234	0	0.513410621	0.234	0.234	0.234	0.234	124.5082598	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	124.5556762	0.234	0	0	0	0	0	0	0	0	0											28.9092	0.475112713	16.68904044	0	2.422538254	0	13.08810745	3.099990628	14.18359243	4.087350328	8.762293839	0.642520674	0.11074622	12.32122565	21.22649748	46.08539617	1.16653899	1.683140947	14.96464621	17.94541887	6.158718837	2.525630308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	216.5477	0	0	28.9092	0.475112713	16.68904044	0	2.422538254	0	13.08810745	3.099990628	14.18359243	4.087350328	8.762293839	0.642520674	0.11074622	12.32122565	21.22649748	46.08539617	1.16653899	1.683140947	14.96464621	17.94541887	6.158718837	2.525630308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	216.5477	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.9092	0.475112713	16.68904044	0	2.422538254	0	13.08810745	3.099990628	14.18359243	4.087350328	8.762293839	0.642520674	0.11074622	12.32122565	21.22649748	46.08539617	1.16653899	1.683140947	14.96464621	17.94541887	6.158718837	2.525630308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	216.5477
H5678_001_0	2008	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							12.36380784	11.51648071	324.6515359	340.8947596		144.4377222	53.00833404		1408.282718	376.9787873	2479.848065	200.3245326	71.99234913				1258.515788		821.9323512	337.0787762		315.7256659				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/visit Tier 1, $20/visit Tier 2 + Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b)$20/visit, (7d) $0/visit Tier 1, $20/visit Tier 2, (7f)0"	"(7e) $0/visit Tier 1, $20/visit Tier 2, (7h)$20/visit"	"(7c,i)$0/visit Tier 1, $20 visit Tier 2"		"(7g) $0/ visit Tier 1, $20/visit Tier 2"	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.183053692	0.183053692	36.1531	45.7634		18.3054	45.7634		45.7469	18.3054	18.3054	18.3054	18.3054				18.3054		20	20		19.9999				20											0	0	0	0	0	2.263240677	2.108134317	0.978096735	1.300042593	0	0.220332153	0.202153568	0	5.368715676	0.575061325	3.782877875	0.305584545	0.109820544	0	0	0	1.919799682	0	1.369887252	0.56179796	0	0.526207779	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	22.5318	0	1.771330433	0	0	0	0	0	2.263240677	2.108134317	0.978096735	1.300042593	0	0.220332153	0.202153568	0	5.368715676	0.575061325	3.782877875	0.305584545	0.109820544	0	0	0	1.919799682	0	1.369887252	0.56179796	0	0.526207779	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	22.5318		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															1.9389	0.0236	0.4231	0.3051	0.0718	0.0757	0.0705	0.0218	0.2471	0.0412	0.1032	0.0198	0.0014	0.1757	0.0239	0.1889	0.011	0.0329			0.1556	0.0482			0.0066		0.0078															3.9938	0	0	1.9389	0.023637616	0.423079805	0.305077603	0.071803132	2.33893746	2.178643383	0.999905809	1.547122013	0.041170571	0.323513893	0.221980814	0.001433155	5.544371897	0.598927254	3.971796601	0.316599586	0.142695527	0	0	0.155581954	1.968032269	0	1.369887252	0.568429071	0	0.534050419	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	26.5257
H5678_002_0	2008	3																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							12.36380784	11.51648071	324.6515359	340.8947596		144.4377222	53.00833404		1408.282718	376.9787873	2479.848065	200.3245326	71.99234913				1258.515788		821.9323512	337.0787762		315.7256659				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/visit Tier 1, $20/visit Tier 2 + Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b)$20/visit, (7d) $0/visit Tier 1, $20/visit Tier 2, (7f)0"	"(7e) $0/visit Tier 1, $20/visit Tier 2, (7h)$20/visit"	"(7c,i)$0/visit Tier 1, $20 visit Tier 2"		"(7g) $0/ visit Tier 1, $20/visit Tier 2"	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.183053692	0.183053692	36.1531	45.7634		18.3054	45.7634		45.7469	18.3054	18.3054	18.3054	18.3054				18.3054		20	20		19.9999				20											0	0	0	0	0	2.263240677	2.108134317	0.978096735	1.300042593	0	0.220332153	0.202153568	0	5.368715676	0.575061325	3.782877875	0.305584545	0.109820544	0	0	0	1.919799682	0	1.369887252	0.56179796	0	0.526207779	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	22.5318	0	1.771330433	0	0	0	0	0	2.263240677	2.108134317	0.978096735	1.300042593	0	0.220332153	0.202153568	0	5.368715676	0.575061325	3.782877875	0.305584545	0.109820544	0	0	0	1.919799682	0	1.369887252	0.56179796	0	0.526207779	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	22.5318		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															1.9389	0.0236	0.4231	0.3051	0.0718	0.0757	0.0705	0.0218	0.2471	0.0412	0.1032	0.0198	0.0014	0.1757	0.0239	0.1889	0.011	0.0329			0.1556	0.0482			0.0066		0.0078															3.9938	0	0	1.9389	0.023637616	0.423079805	0.305077603	0.071803132	2.33893746	2.178643383	0.999905809	1.547122013	0.041170571	0.323513893	0.221980814	0.001433155	5.544371897	0.598927254	3.971796601	0.316599586	0.142695527	0	0	0.155581954	1.968032269	0	1.369887252	0.568429071	0	0.534050419	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	26.5257
H5678_003_0	2008	4	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						500	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	P	P	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T		V	P	V	P				V	P	V	V	V																																															0		1689.479141	75.9857885	6165.365681	65.20457025	336.3376985	1409.81859	29.83937961	132.263875	141.7383646	8299.652902	139.0855075	3.031836676	7.958571276	139.8434667	100.5310956	1195.014659	2655.230234	1.073687923		27.20009406	250.3794007	343.7054466	1817.255		287.28	278.16		95.475				68.21632522			234.745	287.945						(1a) $25/day	(1b) $25/day	(2a) $0/day	(6a) $0/proc	(10a) $50/trip	(11a) $0/proc	(11a/11c) $0/proc	(4a) $50/visit (waived if admitted)	(9a/9b) $0/visit	(8a) $0/visit	(8b) $0/visit	(9a) $0/visit	(12) $0/proc	(9a) $0/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $0/visit	(7e/7h) $0/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $0/visit	(15) $0/proc	(Misc. PBP Cats) $0/visit	(10b) $0/trip		(17a1) $0/visit	(17b2) $0/proc	(18a) $0/visit	(18b) $0/proc				(4b) $20/visit (waived if admitted)	(9c) $0/proc 75%/25% Ind/Grp Blended Copay	(9d) $0/visit	(7f1) $0/visit	(18a1) $0/visit						24.0065	24.0065			48.013			48.013																								19.2052										3.3799	0.152012682	0	0	1.345714684	0	0	0.529198599	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.109175642	0	0	0	0	0	0	0	0	0	5.516		0.228278541	3.3799	0.152012682	0	0	1.345714684	0	0	0.529198599	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.109175642	0	0	0	0	0	0	0	0	0	5.516		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					20	0.3	0.3	0.3	0.3						2.5752	0.0568	0.7992	0.0901	0.1725	0.3092	0.0057	0.029	0.2917	0.6735	0.6409	0.0099	0.0178	0.0989	0.0095	1.8205	0.2287	0.0003		0.2569		0.0531	0.1433		0.0146							0.006			0.013	0.0185						8.3347		0	5.9551	0.208844832	0.799231579	0.090084699	1.518189019	0.309186377	0.005740969	0.558203834	0.291698114	0.673468577	0.640894173	0.009918447	0.01780075	0.098898101	0.00952155	1.820494805	0.228662982	0.000274298	0	0.256867133	0	0.053088897	0.14325	0	0.01455	0	0	0	0	0	0	0.11515953	0	0	0.01305	0.01845	0	0	0	0	0	13.8506
H5678_004_0	2008	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0								22.15148323	457.9575744	463.8437449		169.2532459	76.82008083		2430.523654	441.4383196	2940.383442	497.6679552	83.31277714				0.090927735		821.9323512			240.9271053				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)0	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3,9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/visit Tier 1, $20/visit Tier 2 + Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b)$20/visit, (7d) $0/visit Tier 1, $20/visit Tier 2, (7f)0"	"(7e) $0/visit Tier 1, $20/visit Tier 2, (7h)$20/visit"	"(7c,i)$0/visit Tier 1, $20 visit Tier 2"		"(7g) $0/ visit Tier 1, $20/visit Tier 2"	(15) 0	"(13a,14a,17a,b)0, (16b)$20/visit"	(10b)0	(16a)$20/visit	(17a)0	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																	0.178708991	35.295	44.6772		17.8709	44.6772		44.6149	17.8709	17.8709	17.8709	17.8709				17.8709		20			19.9992				20											0	0	0	0	0	0	3.958669222	1.346968699	1.726938494	0	0.252058974	0.286009149	0	9.036454123	0.657408306	4.378941322	0.741147819	0.124072853	0	0	0	0.000135413	0	1.369887252	0	0	0.401529604	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	25.2203	0	2.681666614	0	0	0	0	0	0	3.958669222	1.346968699	1.726938494	0	0.252058974	0.286009149	0	9.036454123	0.657408306	4.378941322	0.741147819	0.124072853	0	0	0	0.000135413	0	1.369887252	0	0	0.401529604	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	25.2203		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.6155	0.0627	0.3236	0.3125	0.0799	0.1538	0.1356	0.028	0.3426	0.0531	0.1394	0.0278	0.0049	0.239	0.0245	0.2352	0.0295	0.038			0.2098	0.0436			0.0066		0.006															5.1117	0	0	2.6155	0.062720114	0.323564778	0.312473732	0.079913537	0.153798509	4.094290548	1.374936114	2.069578469	0.053129629	0.391420975	0.313844401	0.004923786	9.275489572	0.681898663	4.614097047	0.770674955	0.16203396	0	0	0.209808965	0.043766682	0	1.369887252	0.006631111	0	0.40751629	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	30.332
H5679_001_0	2008	4	H.	H.	I.	I.	I.	I.	I.	I.	I.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Vision (Covered) Eyeware		A	A	D		T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin		S				V	V	V					V	V	V	V	V	V	V	V	Coin																																											0	None	330.4380714	7.445108561	470.7477404	0	249.3685562	9.83345846	3.505856738	300.1902373	385.0590988	796.3661615	7.91261819	47.25167275	0.168270063	0.360292337	4750.299243	1686.03458	2.711435924	369.8358766	4.757182891		254.852868				359.148774	284.0885805	162					1025.205172	16.76026574	64.98525595	354.4115686	95.90070165	0.04189102	718.5000861	3.341487862	3.62768529		$300/admit	$700/admit	$100/day for days 21 to 100	$0 copay	$125 copay	30% coinsurance	30% coinsurance	$50 copay	$175 copay	$0 copay	20% coin on Higher Tier	$150 copay	20% coin	$30 copay	$10 copay	$25 copay	$30 copay	$30 copay	20% coin on Higher Tier	N/A	$0 copay	N/A	N/A	N/A	$20 copay	$75 frames / $95 contacts	$20 copay	N/A	N/A		N/A	$30 copay	$0 copay	$30 copay	$30 copay	$10 copay	$0 copay	$20 copay	$20 copay	30% coinsurance		300	700	100	0	125	0.3	0.3	50	175	51.0657015	0.2	150	0.2	30	10	25	30	30	0.2	0	0	0	0	0	20	0	20	0	0		0	30	0	30	30	10	0	20	20	0.3		8.261	0.434297999	3.922897837	0	2.597589127	2.950037538	1.051757021	1.250792655	5.615445191	3.388916391	1.582523638	0.590645909	0.033654013	0.000900731	3.958582702	3.512572041	0.00677859	0.924589692	0.951436578	0	0	0	0	0	0.59858129	0	0.27	0	0	0	0	2.56301293	0	0.16246314	0.886028922	0.079917251	0	1.197500144	0.005569146	1.088305587	0	47.8857		0	8.261	0.434297999	3.922897837	0	2.597589127	2.950037538	1.051757021	1.250792655	5.615445191	3.388916391	1.582523638	0.590645909	0.033654013	0.000900731	3.958582702	3.512572041	0.00677859	0.924589692	0.951436578	0	0	0	0	0	0.59858129	0	0.27	0	0	0	0	2.56301293	0	0.16246314	0.886028922	0.079917251	0	1.197500144	0.005569146	1.088305587	0	47.8857	None																																																																																			0		0	8.261	0.434297999	3.922897837	0	2.597589127	2.950037538	1.051757021	1.250792655	5.615445191	3.388916391	1.582523638	0.590645909	0.033654013	0.000900731	3.958582702	3.512572041	0.00677859	0.924589692	0.951436578	0	0	0	0	0	0.59858129	0	0.27	0	0	0	0	2.56301293	0	0.16246314	0.886028922	0.079917251	0	1.197500144	0.005569146	1.088305587	0	47.8857
H5685_001_0	2008	3																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	343.72	31.17	67.9	69.22	13.32	27.54	22.81	9.44	20.77	13.53	27.58	1.13	1.79	42.31	65.78	118.89	9.92	5.17	24.7	37.89	9.66	4.02	8.33	0	0	0	0	0	0	0	0											Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing	Standard Medicare Cost Sharing								14A Health Education/Wellness Programs: $0												0.069299868	0.06931578	0.191609367	0	0.234044052	0.234000228	0.233969205	0.233887862	0.234000047	0.234021609	0.234046632	0.234000098	0.233999982	0.233985576	0.234004689	0.234009177	0.233989689	0.233996598	0.234000589	0.234025461	0.233989628	0.234000904	0	0	0	0	0	0	0	0	0											23.8198	2.16057286	13.01027603	0	3.117466769	6.444366287	5.336837573	2.207901419	4.860180968	3.166312367	6.455006097	0.264420111	0.418859968	9.899929726	15.39282845	27.82135108	2.321177715	1.209762411	5.779814556	8.867224714	2.260339802	0.940683634	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.7551	0	0	23.8198	2.16057286	13.01027603	0	3.117466769	6.444366287	5.336837573	2.207901419	4.860180968	3.166312367	6.455006097	0.264420111	0.418859968	9.899929726	15.39282845	27.82135108	2.321177715	1.209762411	5.779814556	8.867224714	2.260339802	0.940683634	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.7551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.8198	2.16057286	13.01027603	0	3.117466769	6.444366287	5.336837573	2.207901419	4.860180968	3.166312367	6.455006097	0.264420111	0.418859968	9.899929726	15.39282845	27.82135108	2.321177715	1.209762411	5.779814556	8.867224714	2.260339802	0.940683634	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.7551
H5696_001_0	2008	3	i.6.										Professional										2700	Acpuncture										A	A	A		T	Coin	Coin	V	P		V	P		V		V	V	V	V	V	Coin						V					V																																																			0		269.9963293	3.994781544	109.1661823		95.05643588	6.821313509	2.221147697	136.2439132	183.112931		2438.221349	346.1672285		0		1757.171098	585.7236994	149.9787284	63.63639274	210.6274971	4.048256524						210.6274971					20										$150 per day Days 1-5	$150 per day Days 1-5	"$75 per day, days 8-43"		$100 per trip	20% per Medicare Covered	20% per Medicare Covered	"$50 per ER, waived if admit/20 Urgent"	$200 O/P Hosp/ $50 ASC		$0-$100	$200 Per Visit		0		$20 per visit	$20 per visit	$20 per visit	$20 per visit	"$20 per visit  (Chiro, Podiatry)"	20% Coinsurance						$10 per visit					$30 Per Visit										510.1623017	580.4709141	425.5217028	0	100	0.2	0.2	40	155	0	26.43	200	0	0	0	20	20	20	20	20	0.2						10					30										11.4785	0.193237875	3.871048317	0	0.792136966	1.364262702	0.444229539	0.454146377	2.365208692	0	5.370182521	5.769453809	0	0	0	2.928618497	0.976206166	0.249964547	0.106060655	0.351045828	0.809651305	0	0	0	0	0	0.175522914	0	0	0	0	0.05	0	0	0	0	0	0	0	0	0	37.7495		0.502816372	11.4785	0.193237875	3.871048317	0	0.792136966	1.364262702	0.444229539	0.454146377	2.365208692	0	5.370182521	5.769453809	0	0	0	2.928618497	0.976206166	0.249964547	0.106060655	0.351045828	0.809651305	0	0	0	0	0	0.175522914	0	0	0	0	0.05	0	0	0	0	0	0	0	0	0	37.7495																																																																																				0			11.4785	0.193237875	3.871048317	0	0.792136966	1.364262702	0.444229539	0.454146377	2.365208692	0	5.370182521	5.769453809	0	0	0	2.928618497	0.976206166	0.249964547	0.106060655	0.351045828	0.809651305	0	0	0	0	0	0.175522914	0	0	0	0	0.05	0	0	0	0	0	0	0	0	0	37.7495
H5696_002_0	2008	4																					3250											A	A	A		T	Coin	Coin	V	P		V	P				V	V	V	V	V				0	V		V																																																								0		288.0767874	4.326305028	102.9109608		101.235367	20.46394053	2.221147697	124.3271494	86.31028058		2262.218997	321.1792403				1336.231399	445.4104662	114.0505249	48.39195577	160.1705578					372.4148546		43.07558704															$250 per day Days 1-7	$250 per day Days 1-7	"$130 per day, days 8-43"		$125 per trip	20% per Medicare Covered	20% per Medicare Covered	"$50 per ER, waived if admit/30 Urgent"	$150 O/P Hosp/ $50 ASC		Copay varies by service.  One copay per visit	$250 Per Visit				$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit  (Chiro & Podiatry)					$30 per visit		$30 per visit															985.0301242	1182.132964	734.2793545		125	0.2	0.2	42	110		28.81	250				30	30	30	30	30					30		30															23.647	0.426188982	6.297116153	0	1.054535073	4.092788106	0.444229539	0.435145023	0.791177572	0	5.431210775	6.691234173	0	0	0	3.340578496	1.113526165	0.285126312	0.120979889	0.400426395	0	0	0	0	0.931037137	0	0.107688968	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.61		0.564241995	23.647	0.426188982	6.297116153	0	1.054535073	4.092788106	0.444229539	0.435145023	0.791177572	0	5.431210775	6.691234173	0	0	0	3.340578496	1.113526165	0.285126312	0.120979889	0.400426395	0	0	0	0	0.931037137	0	0.107688968	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.61																																																																																				0			23.647	0.426188982	6.297116153	0	1.054535073	4.092788106	0.444229539	0.435145023	0.791177572	0	5.431210775	6.691234173	0	0	0	3.340578496	1.113526165	0.285126312	0.120979889	0.400426395	0	0	0	0	0.931037137	0	0.107688968	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.61
H5696_003_0	2008	2																					2500											A	A	A		T	Coin	Coin	V	P		V	P				V	V	V		V	Coin																																																														0		353.171174	5.225410623	136.2760821		181.4573936	6.2581	0.5215	339.8510531	126.9772591		1354.150358	192.255915			2763.01582	3106.610121	1035.536707	265.1565554	0	372.3812183	2.908200308																					"Day 1-6 $100, $0 to 90 per benefit period, $0 for lifetime day (maximum of 60 life time days)"	"Day 1-7 $150, $0 to 90 (maximum benefit of 190 life time days)(life threating only)"	"Day 1-6: $ 0 day 7-58: $50, day 59-100: $0"		$100 Per trip	Coinsurance	Coinsurance	"$50 for er, waived if admitted;  $20 for urgent"	$100 Per procedure including lab work; $25 ASC		One copay per visit	$100 Per observation		0		$5 Per visit	$20 Per visit	$25 Per visit	0	$20 Per visit	20% Coinsurance																					370.3020616	709.2797784	368.1552588	0	100	0.2	0.2	33.5	70	12.5	34.17	100	0	0	0	14.75	20	25	0	20	0.2																					10.8983	0.308856507	4.180896354	0	1.512144947	1.251624574	0.104302048	0.948750856	0.740700678	0	3.855943143	1.602132625	0	0	0	3.818541607	1.725894512	0.55240949	0	0.620635364	0.581640062	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7028		0.461756602	10.8983	0.308856507	4.180896354	0	1.512144947	1.251624574	0.104302048	0.948750856	0.740700678	0	3.855943143	1.602132625	0	0	0	3.818541607	1.725894512	0.55240949	0	0.620635364	0.581640062	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7028																																																																																				0			10.8983	0.308856507	4.180896354	0	1.512144947	1.251624574	0.104302048	0.948750856	0.740700678	0	3.855943143	1.602132625	0	0	0	3.818541607	1.725894512	0.55240949	0	0.620635364	0.581640062	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7028
H5696_004_0	2008	3																					3200											A	A	A		T	Coin	Coin	V	P		V	P		V	V	V	V	V	V	V	Coin						V	V																																																							0		156.1681512	52.26437615	84.75182887		128.9630099	6.239	0.5199	77.69353555	141.12		1150.223729	163.303369	0	199.3957802	1964.823563	2209.15882	736.3862732	188.5569544	80.00524162	264.8060814	2.849679311						200	0														"Day 1-7 $205, $0 to 90 per benefit period, $0 for lifetime day (maximum of 60 life time days)"	"Day 1-7 $205, $0 to 90 (maximum benefit of 190 life time days)(life threating only)"	"Day 1-7: $ 0 day 8-39: $100, day 40-100: $0"		$100 Per trip	Coinsurance	Coinsurance	"$50 for er, waived if admitted;  $20 for urgent"	$150 Per procedure including lab work; $50 ASC		"One copay per visit, max $155"	$150 Per observation		$50 Per Visit	$10 Per Visit	$20 Per visit	$25 Per visit	$30 Per visit	$30 Per visit	$25 Per visit	20% Coinsurance						$10 Per visit	0														809.6553609	971.6660111	686.9643851	0	100	0.2	0.2	35	110	0	44.08	150	0	50	10	20	25	30	30	25	0.2						10	0														10.5369	4.231959824	4.851790667	0	1.074691749	1.247799462	0.103983289	0.226606145	1.2936	0	4.225155165	2.041292112	0	0.830815751	1.637352969	3.681931366	1.534138069	0.471392386	0.200013104	0.551679336	0.569935862	0	0	0	0	0	0.166666667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4777		0.495946625	10.5369	4.231959824	4.851790667	0	1.074691749	1.247799462	0.103983289	0.226606145	1.2936	0	4.225155165	2.041292112	0	0.830815751	1.637352969	3.681931366	1.534138069	0.471392386	0.200013104	0.551679336	0.569935862	0	0	0	0	0	0.166666667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4777																																																																																				0			10.5369	4.231959824	4.851790667	0	1.074691749	1.247799462	0.103983289	0.226606145	1.2936	0	4.225155165	2.041292112	0	0.830815751	1.637352969	3.681931366	1.534138069	0.471392386	0.200013104	0.551679336	0.569935862	0	0	0	0	0	0.166666667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4777
H5696_005_0	2008	3	i.6.										Professional										2500	Acupuncture										A	A	A		T	Coin	Coin	V	P		V	P		V		V	V	V	V	V	Coin				V		V					V																																																			0		166.9704695	38.21121571	112.2982896		107.0480699	20.7376	1.7281	190.9691061	89.39280803		1212.678624	172.1704219	0	210.2225804	2516.501228	3112.38428	1037.461427	265.6493936	102.4688896	339.1575924	2.682394961				354.0719507		41.67958937					30										"Day 1-6 $50, $0 to 90 per benefit period, $0 for lifetime day (maximum of 60 life time days)"	"Day 1-6 $50, $0 to 90 (maximum benefit of 190 life time days)(life threating only)"	"Day 1-7: $ 0 day 8-55: $50, day 56-100: $0"		$100 Per trip	Coinsurance	Coinsurance	"$50 for er, waived if admitted;  $20 for urgent"	$125 Per procedure including lab work; $50 ASC		Copay varies by service.  One Copay per visit	$125 Per observation		$50 Per Visit	$0 Per visit	"$20 Per visit ( chiro, podiatry - $20 Copay)"	$20 Per visit	$20 Per visit	$20 Per visit	$20 Per visit	20% Coinsurance				$10 Copay		$10 Copay					$20 Per Visit										185.1510308	217.0360111	281.3717307	0	100	0.2	0.2	35	95	0	41.48	125	0	50	0	20	20	20	20	20	0.2				10		10					20										2.5762	0.69110082	2.63313034	0	0.892067249	4.147511423	0.345625952	0.556993226	0.707693064	0	4.191825777	1.793441895	0	0.875927418	0	5.187307134	1.729102378	0.442748989	0.170781483	0.565262654	0.536478992	0	0	0	0.295059959	0	0.034732991	0	0	0	0	0.05	0	0	0	0	0	0	0	0	0	28.423		0.34944403	2.5762	0.69110082	2.63313034	0	0.892067249	4.147511423	0.345625952	0.556993226	0.707693064	0	4.191825777	1.793441895	0	0.875927418	0	5.187307134	1.729102378	0.442748989	0.170781483	0.565262654	0.536478992	0	0	0	0.295059959	0	0.034732991	0	0	0	0	0.05	0	0	0	0	0	0	0	0	0	28.423																																																																																				0			2.5762	0.69110082	2.63313034	0	0.892067249	4.147511423	0.345625952	0.556993226	0.707693064	0	4.191825777	1.793441895	0	0.875927418	0	5.187307134	1.729102378	0.442748989	0.170781483	0.565262654	0.536478992	0	0	0	0.295059959	0	0.034732991	0	0	0	0	0.05	0	0	0	0	0	0	0	0	0	28.423
H5696_006_0	2008	3																					3200											A	A	A		T	Coin	Coin	V	P		V	P		V		V	V	V	V	V	Coin																																																														0		229.5824649	3.396830601	87.87905356		107.3429409	19.0172	1.5848	189.6764814	86.01292071		1028.460949	146.0160606		178.2877262	1991.580559	2239.243176	746.4143921	191.1247258	81.09475416	268.4122145	2.39091893																					"Day 1-7 $225, $0 to 90 per benefit period, $0 for lifetime day (maximum of 60 life time days)"	"Day 1-7 $225, $0 to 90 (maximum benefit of 190 life time days)(life threating only)"	"Day 1-7: $ 0 day 8-39: $100, day 40-100: $0"		$125 Per trip	Coinsurance	Coinsurance	"$50 for er, waived if admitted;  $25 for urgent"	$150 Per procedure including lab work; $75 ASC		Copay varies by service.  One Copay per visit	$150 Per observation		$50 Per Visit	$10 Per Visit	"$30 Per visit ( chiro, podiatry - $30 Copay)"	$30 Per visit	$30 Per visit	$30 Per visit	$30 Per visit	20% Coinsurance																					886.5271118	1063.919668	563.6755704	0	125	0.2	0.2	37	120	0	39.65	150	0	50	10	30	30	30	30	30	0.2																					16.9609	0.301162907	4.127939637	0	1.118155634	3.803437058	0.316953088	0.584835818	0.860129207	0	3.398206384	1.825200758	0	0.742865526	1.659650466	5.598107941	1.86603598	0.477811814	0.202736885	0.671030536	0.478183786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9934		0.655970576	16.9609	0.301162907	4.127939637	0	1.118155634	3.803437058	0.316953088	0.584835818	0.860129207	0	3.398206384	1.825200758	0	0.742865526	1.659650466	5.598107941	1.86603598	0.477811814	0.202736885	0.671030536	0.478183786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9934																																																																																				0			16.9609	0.301162907	4.127939637	0	1.118155634	3.803437058	0.316953088	0.584835818	0.860129207	0	3.398206384	1.825200758	0	0.742865526	1.659650466	5.598107941	1.86603598	0.477811814	0.202736885	0.671030536	0.478183786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9934
H5696_018_0	2008	2	i.6.										Professional										2500	Acupuncture										A	A	A		T	Coin	Coin	V	P		V	P		V		V	V	V	V	V	Coin																																																														0		175.028693	40.05534129	26.58455773		127.5005556	34.64147059	2.886789216	171.2428965	118.7102014		1316.172677	186.8640221		0		1981.36176	660.4539199	169.1139341	71.75551386	237.5006445	2.958231826											60										"Day 1-6 $100, $0 to 90 per benefit period, $0 for lifetime day (maximum of 60 life time days)"	"Day 1-6 $100, $0 to 90 per benefit period, $0 for lifetime day (maximum of 60 life time days)"	"Day 1-10: $ 0 day 11-60: $50, day 33-100: $0"		$100 Per trip	Coinsurance	Coinsurance	"$50 for er, waived if admitted;  $20 for urgent"	$150 Per procedure including lab work; $75 ASC		One copay per visit	$150 Per observation		0		"$15 Per visit ( chiro, podiatry - $15 Copay)"	$15 Per visit	$15 Per visit	$15 Per visit	$15 Per visit	20% Coinsurance											$20 Per Visit										370.3020616	434.0720222	287.86867		100	0.2	0.2	35	120		27.35	150		0		15	15	15	15	15	0.2											20										5.4011	1.448908583	0.63773844	0	1.06250463	6.928294118	0.577357843	0.499458448	1.187102014	0	2.999776893	2.335800276	0	0	0	2.4767022	0.8255674	0.211392418	0.089694392	0.296875806	0.591646365	0	0	0	0	0	0	0	0	0	0	0.1	0	0	0	0	0	0	0	0	0	27.6699		0.354920337	5.4011	1.448908583	0.63773844	0	1.06250463	6.928294118	0.577357843	0.499458448	1.187102014	0	2.999776893	2.335800276	0	0	0	2.4767022	0.8255674	0.211392418	0.089694392	0.296875806	0.591646365	0	0	0	0	0	0	0	0	0	0	0.1	0	0	0	0	0	0	0	0	0	27.6699																																																																																				0			5.4011	1.448908583	0.63773844	0	1.06250463	6.928294118	0.577357843	0.499458448	1.187102014	0	2.999776893	2.335800276	0	0	0	2.4767022	0.8255674	0.211392418	0.089694392	0.296875806	0.591646365	0	0	0	0	0	0	0	0	0	0	0.1	0	0	0	0	0	0	0	0	0	27.6699
H5696_019_0	2008	2																					3600											A	A	A		T	Coin	Coin	V	P		V	P			V	V	V	V	V	V	Coin																																																														0		171.8463531	39.32706236	49.4522776		106.250463	27.71317647	2.309431373	190.269885	84.79300099		1165.752943	165.5081338			1384.602288	1556.78424	518.9280799	132.8752339	0	186.6076492	2.958231826																					"Day 1-7 $175, $0 to 90 per benefit period, $0 for lifetime day (maximum of 60 life time days)"	"Day 1-7 $175, $0 to 90 per benefit period, $0 for lifetime day (maximum of 60 life time days)"	"Day 1-10: $ 0 day 11-46: $100, day 47-100: $0"		$100 Per trip	Coinsurance	Coinsurance	"$50 for er, waived if admitted;  $30 for urgent"	$200 Per procedure including lab work; $100 ASC		One copay per visit	$150 Per observation			$10 Per visit	"$25 Per visit ( chiro, podiatry - $25 Copay)"	$25 Per visit	$25 Per visit	0	$25 Per visit - chiro & podiatry	20% Coinsurance																					689.5210869	827.4930748	405.0083472		100	0.2	0.2	39	160		39.65	150			10	25	25	25	0	25	0.2																					9.8743	2.711905979	1.669048768	0	0.885420525	5.542635295	0.461886275	0.618377126	1.130573347	0	3.851842015	2.068851673	0	0	1.15383524	3.243300499	1.081100166	0.276823404	0	0.388765936	0.591646365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5503		0.259340457	9.8743	2.711905979	1.669048768	0	0.885420525	5.542635295	0.461886275	0.618377126	1.130573347	0	3.851842015	2.068851673	0	0	1.15383524	3.243300499	1.081100166	0.276823404	0	0.388765936	0.591646365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5503																																																																																				0			9.8743	2.711905979	1.669048768	0	0.885420525	5.542635295	0.461886275	0.618377126	1.130573347	0	3.851842015	2.068851673	0	0	1.15383524	3.243300499	1.081100166	0.276823404	0	0.388765936	0.591646365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5503
H5696_021_0	2008	4																																A	A				Coin	Coin	V			V										Coin				V		V																																																								0		784.1549359	115.5068994				63.543563	5.295296917	858.266181			2497.927235										4.106589117				567.1977623		38.4173262															"Day 1-5 $25, $0 to 90 per benefit period, $0 for lifetime day (maximum of 60 life time days)"	"Day 1-5 $25, $0 to 90 per benefit period, $0 for lifetime day (maximum of 60 life time days)"				Coinsurance	Coinsurance	"$50 for er, waived if admitted;  $0 for urgent"			One copay per visit										20% Coinsurance				$10 Copay		$10 Copay															85.02705029	96.74515235				0.2	0.2	27			41.48										0.2				10		10															5.5562	0.931227715	0	0	0	12.7087126	1.059059383	1.931098907	0	0	8.634501809	0	0	0	0	0	0	0	0	0	0.821317823	0	0	0	0.472664802	0	0.032014439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1468			5.5562	0.931227715	0	0	0	12.7087126	1.059059383	1.931098907	0	0	8.634501809	0	0	0	0	0	0	0	0	0	0.821317823	0	0	0	0.472664802	0	0.032014439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1468																																																																																				0			5.5562	0.931227715	0	0	0	12.7087126	1.059059383	1.931098907	0	0	8.634501809	0	0	0	0	0	0	0	0	0	0.821317823	0	0	0	0.472664802	0	0.032014439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1468
H5696_022_0	2008	3																					1000											A	A	A		T	Coin	Coin	V	P		V	P		V		V	V	V	V	V	Coin																																																														0		851.5580911	12.59938813	136.2760821		207.8653515	40.40708648	3.367257207	519.3257096	218.4490641		3120.155041	442.9849749		0		3842.118225	1088.600164	278.7438318	139.1432767	460.5446482	2.893699854																					$75 1-10	$75 1-10	$120 21-26		$100 Copay	Coinsurance	Coinsurance	"$50 for er, waived if admitted;  $10 for urgent"	$25 Copay		One copay per visit	0		0		$10 Per Visit	$10 Per Visit	$10 Per Visit	$10 Per Visit	0	20% Coinsurance																					330.0903726	422.9916898	74.09015025		100	0.2	0.2	31	25		7.5	0		0		10	10	10	10	0	0.2																					23.4243	0.444119706	0.84139295	0	1.732211263	8.081417296	0.673451441	1.341591416	0.455102217	0	1.950096901	0	0	0	0	3.201765187	0.907166803	0.232286526	0.115952731	0	0.578739971	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.9796		2.516470631	23.4243	0.444119706	0.84139295	0	1.732211263	8.081417296	0.673451441	1.341591416	0.455102217	0	1.950096901	0	0	0	0	3.201765187	0.907166803	0.232286526	0.115952731	0	0.578739971	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.9796																																																																																				0			23.4243	0.444119706	0.84139295	0	1.732211263	8.081417296	0.673451441	1.341591416	0.455102217	0	1.950096901	0	0	0	0	3.201765187	0.907166803	0.232286526	0.115952731	0	0.578739971	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.9796
H5697_001_0	2008	6																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							13.94050895	13.1450307	321.4282832	399.8051982		168.1923848	56.04528199		1693.889614		5113.474275	226.4484538					1322.988401		821.9323512	337.0787762		315.7328536				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/PCP visit, $20/visit Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d)$20/visit, (7f)0"	"(7e,h)$20/visit"	"(7c,i)0"		(7g)$20/visit	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.177081103	0.177081103	34.9735	44.2703		17.7081	44.2703		44.2505		17.7081	17.7081					17.7081		20	20		19.9999				20											0	0	0	0	0	2.468600697	2.327736532	0.936789815	1.474957196	0	0.248197442	0.206761674	0	6.246292171	0	7.54583053	0.334164516	0	0	0	0	1.952302042	0	1.369887252	0.56179796	0	0.5262178	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	27.1396	0	3.072787953	0	0	0	0	0	2.468600697	2.327736532	0.936789815	1.474957196	0	0.248197442	0.206761674	0	6.246292171	0	7.54583053	0.334164516	0	0	0	0	1.952302042	0	1.369887252	0.56179796	0	0.5262178	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	27.1396		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.1276	0.0259	0.361	0.2808	0.0689	0.0854	0.0805	0.0216	0.3131	0.048	0.1309	0.0234	0.0018	0.2081	0.031	0.2226	0.0133	0.0399			0.192	0.0546			0.0066		0.0078															4.3446	0	0	2.1276	0.025859053	0.360962236	0.280751723	0.068894232	2.553950752	2.408216312	0.958382362	1.788047321	0.047993747	0.379071938	0.230117905	0.001820266	6.454356639	0.030983153	7.768479878	0.347501619	0.039894611	0	0	0.192003081	2.006889482	0	1.369887252	0.568429071	0	0.534060889	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	31.4842
H5697_002_0	2008	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							13.7458793	12.96150708	319.1765948	397.0044592		167.0141536	55.65267026		1673.745869		5077.653062	224.8621237					1313.720525		821.9323512	337.0787762		315.7327207				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/PCP visit, $20/visit Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d)$20/visit, (7f)0"	"(7e,h)$20/visit"	"(7c,i)0"		(7g)$20/visit	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.177373451	0.177373451	35.0313	44.3434		17.7373	44.3434		44.3235		17.7373	17.7373					17.7373		20	20		19.9999				20											0	0	0	0	0	2.438154042	2.299027235	0.931763096	1.467042725	0	0.246865639	0.205652212	0	6.182187118	0	7.505340368	0.332371423	0	0	0	0	1.941826187	0	1.369887252	0.56179796	0	0.52621765	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	26.9482	0	3.004176069	0	0	0	0	0	2.438154042	2.299027235	0.931763096	1.467042725	0	0.246865639	0.205652212	0	6.182187118	0	7.505340368	0.332371423	0	0	0	0	1.941826187	0	1.369887252	0.56179796	0	0.52621765	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	26.9482		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.0978	0.0255	0.3559	0.2768	0.0679	0.0842	0.0794	0.0214	0.3087	0.0473	0.129	0.023	0.0018	0.2052	0.0306	0.2195	0.0132	0.0393			0.1893	0.0538			0.0066		0.0078															4.2843	0	0	2.0978	0.025498023	0.355922682	0.276832024	0.067932369	2.522312487	2.378383401	0.953204381	1.775761659	0.047323685	0.375912939	0.228682356	0.001794853	6.387346705	0.030550583	7.72488121	0.345522321	0.039337625	0	0	0.189322441	1.995651508	0	1.369887252	0.568429071	0	0.534060724	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	31.2325
H5697_003_0	2008	5																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0								26.39331078	531.6966857	538.5306317		196.5059536	89.18944604		2966.569315		5985.514491	545.6619973					0.099252603		821.9323512			240.9351408				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)0	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3,9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/PCP visit, $20/visit Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d)$20/visit, (7f)0"	"(7e,h)$20/visit"	"(7c,i)0"		(7g)$20/visit	(15) 0	"(13a,14a,17a,b)0, (16b)$20/visit"	(10b)0	(16a)$20/visit	(17a)0	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																	0.170561462	33.6859	42.6404		17.0561	42.6404		42.5867		17.0561	17.0561					17.0561		20			19.9988				20											0	0	0	0	0	0	4.501681671	1.492556282	1.913595246	0	0.279302856	0.316922548	0	10.52804103	0	8.507484181	0.775574233	0	0	0	0	0.000141072	0	1.369887252	0	0	0.401535066	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	31.0268	0	4.88718267	0	0	0	0	0	0	4.501681671	1.492556282	1.913595246	0	0.279302856	0.316922548	0	10.52804103	0	8.507484181	0.775574233	0	0	0	0	0.000141072	0	1.369887252	0	0	0.401535066	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	31.0268		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															3.1164	0.0747	0.3855	0.3723	0.0952	0.1832	0.1616	0.0305	0.4083	0.0633	0.166	0.0332	0.0059	0.2848	0.0292	0.2802	0.0352	0.0452			0.25	0.052			0.0066		0.006															6.0853	0	0	3.1164	0.074730502	0.385524782	0.372309892	0.095216325	0.183249663	4.663273369	1.523084248	2.32184797	0.063303518	0.445351539	0.350088022	0.005866651	10.81284981	0.029180059	8.787670301	0.810755574	0.045230348	0	0	0.249985663	0.052127371	0	1.369887252	0.006631111	0	0.407522609	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	37.1121
H5697_004_0	2008	5	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						500	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	P	P	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T		V	P	V					V	P	V	V	V																																															0		1997.44147	94.15061481	9509.260421	220.6490704	502.3903522	1828.698124	25.02987893	185.9217462	126.6906672	4744.161153	192.1640635	29.22539467	7.164477818	237.8054083	134.58305	1416.139594	2122.268191	25.65585244		285.0947989	275.5198916	711.7193985	1741.54		287.28	278.16						106.6868776	1.347773055		234.745	287.945						(1a) $25/day	(1b) $25/day	(2a) $0/day	(6a) $0/proc	(10a) $50/trip	(11a) $0/proc	(11a/11c) $0/proc	(4a) $50/visit (waived if admitted)	(9a/9b) $0/visit	(8a) $0/visit	(8b) $0/visit	(9a) $0/visit	(12) $0/proc	(9a) $0/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $0/visit	(7e/7h) $0/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $0/visit	(15) $0/proc	(Misc. PBP Cats) $0/visit	(10b) $0/trip		(17a1) $0/visit	(17b2) $0/proc	(18a) $0/visit					(4b) $20/visit (waived if admitted)	(9c) $0/proc 75%/25% Ind/Grp Blended Copay	(9d) $0/visit	(7f1) $0/visit	(18a1) $0/visit						23.3484	23.3484			46.6969			46.6969																								18.6788										3.8864	0.18318918	0	0	1.955005326	0	0	0.723497182	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.166064824	0	0	0	0	0	0	0	0	0	6.9142		0.489076694	3.8864	0.18318918	0	0	1.955005326	0	0	0.723497182	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.166064824	0	0	0	0	0	0	0	0	0	6.9142		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					20	0.3	0.3	0.3	0.3						2.8135	0.0428	1.0354	0.1255	0.4634	0.49	0.0044	0.0408	0.2158	0.8483	0.7767	0.0396	0.0096	0.1276	0.0092	1.9926	0.207	0.0031		0.2006		0.1006	0.1373		0.0146							0.0094	0.0001		0.013	0.0185						9.7391		0	6.6999	0.226025226	1.035390763	0.125453134	2.418428922	0.489972468	0.004404408	0.764269494	0.215756088	0.848250009	0.776737889	0.03957516	0.009597892	0.127584722	0.009204355	1.992563782	0.206985209	0.003111102	0	0.20055468	0	0.100612167	0.13725	0	0.01455	0	0	0	0	0	0	0.175423322	0.000119555	0	0.01305	0.01845	0	0	0	0	0	16.6532
H5698_002_0	2008	7																					2000											D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1784.151159	61.35276735	920.6108132		276.2526841	7.337089114	6.399166505	363.9128822	41.59443245		5336.661036	43.01703757		6.129322556	4535.243404	3573.558446	258.6139166	983.07147			24.74502462	724.1533011	1000		144		249															"$100/Day, days 1-5, $2K OOP"	"$100/Day, days 1-10"	"$100/Day, days 1-5, $2K OOP"	No cost sharing	$50/Trip	20%/Item	"20%/Item, 10% for Diab Supplies"	"$50/Visit for ER, $30/Visit for UC"	Min of 20% Coins/$250 Copay	No cost sharing	"$75 for CT, Nuc Med, MRI/MRA, PET, $0 for Diag Test, X-Ray, Rad Therapy"	$50/Visit	No cost sharing	"$50/Visit for Partial Hosp, $20/$15 OP MH Ind/Grp, $30/Visit for OT/PT/ST"	$20/Visit	"$20/Visit, $30/Visit for Podiatry, Chiro"	$20/$15 for Ind/Grp	$30/visit	No cost sharing	No cost sharing	20%/Script	$20/Visit for Eye exam	$3 for 40 one-way	Not covered	$30/Visit for Routine eye exam	$75 Allowance per year	$30/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"$20 per month for OTC, 1 meal per day, 100 limit"											59.7728	72.26	30.68		50	0.2	0.165400744	49.9883	0.175		34.8857	50		24.046	20	21.0115	19.5	30			0.2	20	3		30		30															8.887	0.369445914	2.353694979	0	1.15105285	1.467417823	1.0584269	1.515948441	7.27902568	0	15.51441231	0.179237657	0	0.012282134	7.558739007	6.257142075	0.420247614	2.457678675	0	0	4.949004924	1.206922168	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8702	0	0.271659903	8.887	0.369445914	2.353694979	0	1.15105285	1.467417823	1.0584269	1.515948441	7.27902568	0	15.51441231	0.179237657	0	0.012282134	7.558739007	6.257142075	0.420247614	2.457678675	0	0	4.949004924	1.206922168	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8702																																																																																				0	0	0	8.887	0.369445914	2.353694979	0	1.15105285	1.467417823	1.0584269	1.515948441	7.27902568	0	15.51441231	0.179237657	0	0.012282134	7.558739007	6.257142075	0.420247614	2.457678675	0	0	4.949004924	1.206922168	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8702
H5698_003_0	2008	9																																D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0									882.3750979				5.430000602									24.88026232				144		249															No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	"$35/Visit for ER, $25/Visit for UC"	No cost sharing	No cost sharing	No cost sharing	$35/Visit	No cost sharing	No cost sharing except for Partial Hosp $35	$0/Visit	$0/Visit	No cost sharing	No cost sharing	No cost sharing	No cost sharing	20%/Script	No cost sharing	$0 for 40 one-way	Preventive Services	$10/Visit for Routine eye exam	$150 Allowance per year	$10/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"$20 per month for OTC, 1 meal per day, 100 limit"																		35				35									0.2				10		10															0	0	0	0	0	0	0	2.573594036	0	0	0	0.015837502	0	0	0	0	0	0	0	0	4.976052465	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.893	0	0	0	0	0	0	0	0	0	2.573594036	0	0	0	0.015837502	0	0	0	0	0	0	0	0	4.976052465	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.893																																																																																				0	0	0	0	0	0	0	0	0	0	2.573594036	0	0	0	0.015837502	0	0	0	0	0	0	0	0	4.976052465	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.893
H5698_005_0	2008	6																					2000											D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1831.699889	102.8462433	472.5859751		287.7860969	7.109633259	4.126006857	291.2820437	33.16753857		4058.252716	23.89618813		134.0436487	3290.370618	2926.46623	148.9527714	687.7943404			16.23438635	612.1569351	566.7596772		80.25525904		138.7747188															"$100/Day, days 1-5, $2K OOP"	"$100/Day, days 1-10"	"$100/Day, days 1-5, $2K OOP"	No cost sharing	$50/Trip	20%/Item	"20%/Item, 10% for Diab Supplies"	"$50/Visit for ER, $30/Visit for UC"	Min of 20% Coins/$250 Copay	No cost sharing	"$75 for CT, Nuc Med, MRI/MRA, PET, $0 for Diag Test, X-Ray, Rad Therapy"	$50/Visit	No cost sharing	"$50/Visit for Partial Hosp, $20/$15 OP MH Ind/Grp, $30/Visit for OT/PT/ST"	$20/Visit	"$20/Visit, $30/Visit for Podiatry, Chiro"	$20/$15 for Ind/Grp	$30/visit	No cost sharing	No cost sharing	20%/Script	$20/Visit for Eye exam	$3 for 40 one-way	Not covered	$30/Visit for Routine eye exam	$75 Allowance per year	$30/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"$20 per month for OTC, 1 meal per day, 100 limit"											59.6575	72.26	30.68		50	0.2	0.165400744	49.9919	0.175		34.8857	50		29.8699	20	21.1083	19.5	30			0.2	20	3		30		30															9.1062	0.619305795	1.20824481	0	1.199108737	1.421926652	0.682444603	1.213477587	5.804319249	0	11.79790238	0.099567451	0	0.333655958	5.48395103	5.147722705	0.242048254	1.719485851	0	0	3.24687727	1.020261559	0.141689919	0	0.200638148	0	0.346936797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.0358	0	0.2965019	9.1062	0.619305795	1.20824481	0	1.199108737	1.421926652	0.682444603	1.213477587	5.804319249	0	11.79790238	0.099567451	0	0.333655958	5.48395103	5.147722705	0.242048254	1.719485851	0	0	3.24687727	1.020261559	0.141689919	0	0.200638148	0	0.346936797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.0358																																																																																				0	0	0	9.1062	0.619305795	1.20824481	0	1.199108737	1.421926652	0.682444603	1.213477587	5.804319249	0	11.79790238	0.099567451	0	0.333655958	5.48395103	5.147722705	0.242048254	1.719485851	0	0	3.24687727	1.020261559	0.141689919	0	0.200638148	0	0.346936797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.0358
H5698_006_0	2008	7																					2000											D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1736.025572	59.44702012	896.3987416		276.3783902	7.35167545	6.411888225	361.9034337	41.37343817		5241.802467	43.65369439		6.047383332	4383.41924	3477.619023	252.5164113	1004.457021			24.7686211	704.2067132	1000		144		249															"$100/Day, days 1-5, $2K OOP"	"$100/Day, days 1-10"	"$100/Day, days 1-5, $2K OOP"	No cost sharing	$50/Trip	20%/Item	"20%/Item, 10% for Diab Supplies"	"$50/Visit for ER, $30/Visit for UC"	Min of 20% Coins/$250 Copay	No cost sharing	"$75 for CT, Nuc Med, MRI/MRA, PET, $0 for Diag Test, X-Ray, Rad Therapy"	$50/Visit	No cost sharing	"$50/Visit for Partial Hosp, $20/$15 OP MH Ind/Grp, $30/Visit for OT/PT/ST"	$20/Visit	"$20/Visit, $30/Visit for Podiatry, Chiro"	$20/$15 for Ind/Grp	$30/visit	No cost sharing	No cost sharing	20%/Script	$20/Visit for Eye exam	$3 for 40 one-way	Not covered	$30/Visit for Routine eye exam	$75 Allowance per year	$30/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"$20 per month for OTC, 1 meal per day, 100 limit"											59.846	72.26	30.68		50	0.2	0.165400744	49.9882	0.175		34.8857	50		24.0912	20	21.0181	19.5	30			0.2	20	3		30		30															8.6579	0.357970139	2.291792783	0	1.151576626	1.47033509	1.060531082	1.507575781	7.240351681	0	15.23864532	0.181890393	0	0.012140752	7.305698733	6.0910826	0.410339168	2.511142554	0	0	4.95372422	1.173677855	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8488	0	0.253742083	8.6579	0.357970139	2.291792783	0	1.151576626	1.47033509	1.060531082	1.507575781	7.240351681	0	15.23864532	0.181890393	0	0.012140752	7.305698733	6.0910826	0.410339168	2.511142554	0	0	4.95372422	1.173677855	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8488																																																																																				0	0	0	8.6579	0.357970139	2.291792783	0	1.151576626	1.47033509	1.060531082	1.507575781	7.240351681	0	15.23864532	0.181890393	0	0.012140752	7.305698733	6.0910826	0.410339168	2.511142554	0	0	4.95372422	1.173677855	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8488
H5698_007_0	2008	5																					2000											D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1629.004128	53.38059619	891.0398892		245.3582336	6.678058758	5.824382021	296.4473216	34.38626752		4710.39757	45.16745634		5.513830509	4567.318725	3599.405628	234.0727001	853.8106174			22.3126255	698.9766199	1000		144		249															"$100/Day, days 1-5, $2K OOP"	"$100/Day, days 1-10"	"$100/Day, days 1-5, $2K OOP"	No cost sharing	$50/Trip	20%/Item	"20%/Item, 10% for Diab Supplies"	"$50/Visit for ER, $30/Visit for UC"	Min of 20% Coins/$250 Copay	No cost sharing	"$75 for CT, Nuc Med, MRI/MRA, PET, $0 for Diag Test, X-Ray, Rad Therapy"	$50/Visit	No cost sharing	"$50/Visit for Partial Hosp, $20/$15 OP MH Ind/Grp, $30/Visit for OT/PT/ST"	$20/Visit	"$20/Visit, $30/Visit for Podiatry, Chiro"	$20/$15 for Ind/Grp	$30/visit	No cost sharing	No cost sharing	20%/Script	$20/Visit for Eye exam	$3 for 40 one-way	Not covered	$30/Visit for Routine eye exam	$75 Allowance per year	$30/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"$20 per month for OTC, 1 meal per day, 100 limit"											60.0133	72.26	30.68		50	0.2	0.165400744	49.9857	0.175		34.8857	50		24.0222	20	20.958	19.5	30			0.2	20	3		30		30															8.1468	0.321440157	2.278091983	0	1.022325973	1.335611752	0.963357119	1.234842742	6.017596817	0	13.69377773	0.188197735	0	0.011037873	7.612197875	6.286369457	0.380368138	2.134526544	0	0	4.4625251	1.164961033	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4866	0	0.215397705	8.1468	0.321440157	2.278091983	0	1.022325973	1.335611752	0.963357119	1.234842742	6.017596817	0	13.69377773	0.188197735	0	0.011037873	7.612197875	6.286369457	0.380368138	2.134526544	0	0	4.4625251	1.164961033	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4866																																																																																				0	0	0	8.1468	0.321440157	2.278091983	0	1.022325973	1.335611752	0.963357119	1.234842742	6.017596817	0	13.69377773	0.188197735	0	0.011037873	7.612197875	6.286369457	0.380368138	2.134526544	0	0	4.4625251	1.164961033	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4866
H5698_009_0	2008	7																																D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0									496.9342433				9.244020914		0.015185125							21.44029				144		249															No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	"$35/Visit for ER, $25/Visit for UC"	No cost sharing	No cost sharing	No cost sharing	$35/Visit	No cost sharing	No cost sharing except for Partial Hosp $35	$0/Visit	$0/Visit	No cost sharing	No cost sharing	No cost sharing	No cost sharing	10%/Script	No cost sharing	$0 for 40 one-way	$0 per visit	$10/Visit for Routine eye exam	$150 Allowance per year	$10/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"$20 per month for OTC, 1 meal per day, 100 limit"																		34.9992				35		35							0.1				10		10															0	0	0	0	0	0	0	1.449359616	0	0	0	0.026961728	0	4.43E-05	0	0	0	0	0	0	2.144029	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.9479	0	0	0	0	0	0	0	0	0	1.449359616	0	0	0	0.026961728	0	4.43E-05	0	0	0	0	0	0	2.144029	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.9479																																																																																				0	0	0	0	0	0	0	0	0	0	1.449359616	0	0	0	0.026961728	0	4.43E-05	0	0	0	0	0	0	2.144029	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.9479
H5698_017_0	2008	8																					2000											D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1966.013782	50.57690378			397.4806567			436.377869	52.05965429			37.14010721		0.023643447		518.9033462		1021.395508			29.70539795		755.3963577		104.6517091		180.9602469				218.0243939											"$100/Day, days 1-5, $2K OOP"	"$100/Day, days 1-10"	No cost sharing	No cost sharing	$50/Trip	No cost sharing	No cost sharing	"$50/Visit for ER, $30/Visit for UC"	Min of 20% Coins/$250 Copay	No cost sharing	No cost sharing	$50/Visit	No cost sharing	No cost sharing	$0/Visit	"$0/Visit, $10/Visit for Podiatry, Chiro"	No cost sharing	$10/visit	No cost sharing	No cost sharing	10%/Script	No cost sharing	$3 for 40 one-way	$250 Allowance	$10/Visit for Routine eye exam	$150 Allowance per year	$10/Visit for Routine Hearing exam	$500 Allowance	Not covered	Not covered	"$20 copay for Medical Alert, $20 per month for OTC, 1 meal per day, 100 limit"											59.3944	72.26			50			49.9929	0.175			50		50		10		10			0.1		3		10		10				20											9.7309	0.304557256	0	0	1.656169403	0	0	1.817982962	9.110439501	0	0	0.154750447	0	9.85E-05	0	0.432419455	0	0.851162923	0	0	2.970539795	0	0.188849089	0	0.087209758	0	0.150800206	0	0	0	0.36337399	0	0	0	0	0	0	0	0	0	0	27.8192	0	0.361352185	9.7309	0.304557256	0	0	1.656169403	0	0	1.817982962	9.110439501	0	0	0.154750447	0	9.85E-05	0	0.432419455	0	0.851162923	0	0	2.970539795	0	0.188849089	0	0.087209758	0	0.150800206	0	0	0	0.36337399	0	0	0	0	0	0	0	0	0	0	27.8192																																																																																				0	0	0	9.7309	0.304557256	0	0	1.656169403	0	0	1.817982962	9.110439501	0	0	0.154750447	0	9.85E-05	0	0.432419455	0	0.851162923	0	0	2.970539795	0	0.188849089	0	0.087209758	0	0.150800206	0	0	0	0.36337399	0	0	0	0	0	0	0	0	0	0	27.8192
H5698_018_0	2008	6																					2000											D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1607.929625	52.69000891			242.1840226			292.6175377	33.95205317			44.58312283		0.024634326		340.3709842		842.7648293			22.03087168		1000		144		249				300											"$100/Day, days 1-5, $2K OOP"	"$100/Day, days 1-10"	No cost sharing	No cost sharing	$50/Trip	No cost sharing	No cost sharing	"$50/Visit for ER, $30/Visit for UC"	Min of 20% Coins/$250 Copay	No cost sharing	No cost sharing	$50/Visit	No cost sharing	No cost sharing	$0/Visit	"$0/Visit, $10/Visit for Podiatry, Chiro"	No cost sharing	$10/visit	No cost sharing	No cost sharing	10%/Script	No cost sharing	$3 for 40 one-way	$250 Allowance	$10/Visit for Routine eye exam	$150 Allowance per year	$10/Visit for Routine Hearing exam	$500 Allowance	Not covered	Not covered	"$20 copay for Medical Alert, $20 per month for OTC, 1 meal per day, 100 limit"											60.0488	72.26			50			49.9855	0.175			50		50		10		10			0.1		3		10		10				20											8.0462	0.31728167	0	0	1.009100094	0	0	1.21888542	5.941609305	0	0	0.185763012	0	0.000102643	0	0.283642487	0	0.702304024	0	0	2.203087168	0	0.25	0	0.12	0	0.2075	0	0	0	0.5	0	0	0	0	0	0	0	0	0	0	20.9855	0	0.207846987	8.0462	0.31728167	0	0	1.009100094	0	0	1.21888542	5.941609305	0	0	0.185763012	0	0.000102643	0	0.283642487	0	0.702304024	0	0	2.203087168	0	0.25	0	0.12	0	0.2075	0	0	0	0.5	0	0	0	0	0	0	0	0	0	0	20.9855																																																																																				0	0	0	8.0462	0.31728167	0	0	1.009100094	0	0	1.21888542	5.941609305	0	0	0.185763012	0	0.000102643	0	0.283642487	0	0.702304024	0	0	2.203087168	0	0.25	0	0.12	0	0.2075	0	0	0	0.5	0	0	0	0	0	0	0	0	0	0	20.9855
H5698_019_0	2008	2																					2000											D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1759.021279	60.24036853	843.5919033		249.1251549	6.851321643	5.97549618	325.8921924	38.06666435		4748.617058	40.56213971		5.523460008	3944.762319	3129.578028	227.5840276	903.7057663			22.06901535	633.6933424	1000		144		249															"$100/Day, days 1-5, $2K OOP"	"$100/Day, days 1-10"	"$100/Day, days 1-5, $2K OOP"	No cost sharing	$50/Trip	20%/Item	"20%/Item, 10% for Diab Supplies"	"$50/Visit for ER, $30/Visit for UC"	Min of 20% Coins/$250 Copay	No cost sharing	"$75 for CT, Nuc Med, MRI/MRA, PET, $0 for Diag Test, X-Ray, Rad Therapy"	$50/Visit	No cost sharing	"$50/Visit for Partial Hosp, $20/$15 OP MH Ind/Grp, $30/Visit for OT/PT/ST"	$20/Visit	"$20/Visit, $30/Visit for Podiatry, Chiro"	$20/$15 for Ind/Grp	$30/visit	No cost sharing	No cost sharing	20%/Script	$20/Visit for Eye exam	$3 for 40 one-way	Not covered	$30/Visit for Routine eye exam	$75 Allowance per year	$30/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"$20 per month for OTC, 1 meal per day, 100 limit"											59.8128	72.26	30.68		50	0.2	0.165400744	49.9868	0.175		34.8857	50		24.1705	20	21.018	19.5	30			0.2	20	3		30		30															8.7677	0.362747419	2.156783299	0	1.038021479	1.370264329	0.988351513	1.357525456	6.661666261	0	13.80488707	0.169008915	0	0.011125406	6.574603865	5.481463689	0.369824045	2.259264416	0	0	4.41380307	1.056155571	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0757	0	0.261981144	8.7677	0.362747419	2.156783299	0	1.038021479	1.370264329	0.988351513	1.357525456	6.661666261	0	13.80488707	0.169008915	0	0.011125406	6.574603865	5.481463689	0.369824045	2.259264416	0	0	4.41380307	1.056155571	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0757																																																																																				0	0	0	8.7677	0.362747419	2.156783299	0	1.038021479	1.370264329	0.988351513	1.357525456	6.661666261	0	13.80488707	0.169008915	0	0.011125406	6.574603865	5.481463689	0.369824045	2.259264416	0	0	4.41380307	1.056155571	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0757
H5698_020_0	2008	3																					2000											D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1758.543483	60.22400565	843.3627614		249.0574859	6.847600147	5.972250415	325.8039053	38.04598733		4747.327208	40.55112196		5.52195969	3943.690817	3128.727952	227.5222097	903.4602959			22.05702792	633.5212145	1000		144		249															"$100/Day, days 1-5, $2K OOP"	"$100/Day, days 1-10"	"$100/Day, days 1-5, $2K OOP"	No cost sharing	$50/Trip	20%/Item	"20%/Item, 10% for Diab Supplies"	"$50/Visit for ER, $30/Visit for UC"	Min of 20% Coins/$250 Copay	No cost sharing	"$75 for CT, Nuc Med, MRI/MRA, PET, $0 for Diag Test, X-Ray, Rad Therapy"	$50/Visit	No cost sharing	"$50/Visit for Partial Hosp, $20/$15 OP MH Ind/Grp, $30/Visit for OT/PT/ST"	$20/Visit	"$20/Visit, $30/Visit for Podiatry, Chiro"	$20/$15 for Ind/Grp	$30/visit	No cost sharing	No cost sharing	20%/Script	$20/Visit for Eye exam	$3 for 40 one-way	Not covered	$30/Visit for Routine eye exam	$75 Allowance per year	$30/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"$20 per month for OTC, 1 meal per day, 100 limit"											59.8135	72.26	30.68		50	0.2	0.165400744	49.9868	0.175		34.8857	50		24.1705	20	21.018	19.5	30			0.2	20	3		30		30															8.7654	0.362648887	2.15619746	0	1.037739525	1.369520029	0.987814661	1.357157495	6.658047782	0	13.8011373	0.168963008	0	0.011122384	6.572818028	5.479974778	0.369723591	2.25865074	0	0	4.411405584	1.055868691	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0567	0	0.261809955	8.7654	0.362648887	2.15619746	0	1.037739525	1.369520029	0.987814661	1.357157495	6.658047782	0	13.8011373	0.168963008	0	0.011122384	6.572818028	5.479974778	0.369723591	2.25865074	0	0	4.411405584	1.055868691	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0567																																																																																				0	0	0	8.7654	0.362648887	2.15619746	0	1.037739525	1.369520029	0.987814661	1.357157495	6.658047782	0	13.8011373	0.168963008	0	0.011122384	6.572818028	5.479974778	0.369723591	2.25865074	0	0	4.411405584	1.055868691	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0567
H5698_021_0	2008	3																					2000											D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1759.70186	60.26367605			249.2215436			326.0179499	38.09612668			40.57783355		0.025830583		318.7236399		904.0554178			22.08609603		1000		144		249				300											"$100/Day, days 1-5, $2K OOP"	"$100/Day, days 1-10"	No cost sharing	No cost sharing	$50/Trip	No cost sharing	No cost sharing	"$50/Visit for ER, $30/Visit for UC"	Min of 20% Coins/$250 Copay	No cost sharing	No cost sharing	$50/Visit	No cost sharing	No cost sharing	$0/Visit	"$0/Visit, $10/Visit for Podiatry, Chiro"	No cost sharing	$10/visit	No cost sharing	No cost sharing	10%/Script	No cost sharing	$3 for 40 one-way	$250 Allowance	$10/Visit for Routine eye exam	$150 Allowance per year	$10/Visit for Routine Hearing exam	$500 Allowance	Not covered	Not covered	"$20 copay for Medical Alert, $20 per month for OTC, 1 meal per day, 100 limit"											59.8118	72.26			50			49.9868	0.175			50		50		10		10			0.1		3		10		10				20											8.7709	0.362887769	0	0	1.038423098	0	0	1.358049584	6.666822169	0	0	0.169074306	0	0.000107627	0	0.265603033	0	0.753379515	0	0	2.208609603	0	0.25	0	0.12	0	0.2075	0	0	0	0.5	0	0	0	0	0	0	0	0	0	0	22.6714	0	0.262224987	8.7709	0.362887769	0	0	1.038423098	0	0	1.358049584	6.666822169	0	0	0.169074306	0	0.000107627	0	0.265603033	0	0.753379515	0	0	2.208609603	0	0.25	0	0.12	0	0.2075	0	0	0	0.5	0	0	0	0	0	0	0	0	0	0	22.6714																																																																																				0	0	0	8.7709	0.362887769	0	0	1.038423098	0	0	1.358049584	6.666822169	0	0	0.169074306	0	0.000107627	0	0.265603033	0	0.753379515	0	0	2.208609603	0	0.25	0	0.12	0	0.2075	0	0	0	0.5	0	0	0	0	0	0	0	0	0	0	22.6714
H5698_022_0	2008	3																																D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0									391.0223128				58.2042283		0.095625552							28.53393413				144		249															No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	"$50/Visit for ER, $25/Visit for UC"	No cost sharing	No cost sharing	No cost sharing	$35/Visit	No cost sharing	No cost sharing except for Partial Hosp $35	$0/Visit	$0/Visit	No cost sharing	No cost sharing	No cost sharing	No cost sharing	20%/Script	No cost sharing	$0 for 40 one-way	$0/Visit for Preventive Dental	$10/Visit for Routine eye exam	$150 Allowance per year	$10/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"$20 per month for OTC, 1 meal per day, 100 limit"																		49.9839				35		35							0.2				10		10															0	0	0	0	0	0	0	1.628736466	0	0	0	0.169762333	0	0.000278908	0	0	0	0	0	0	5.706786826	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.8331	0	0	0	0	0	0	0	0	0	1.628736466	0	0	0	0.169762333	0	0.000278908	0	0	0	0	0	0	5.706786826	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.8331																																																																																				0	0	0	0	0	0	0	0	0	0	1.628736466	0	0	0	0.169762333	0	0.000278908	0	0	0	0	0	0	5.706786826	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.8331
H5698_027_0	2008	4																					2000											D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1698.886476	55.67775786	809.1699612		225.8934642	5.96543805	5.202857805	280.0273167	30.71688287		4328.025248	41.01741049		5.04714142	4208.436861	3316.578552	215.5286639	786.7215517			20.22365608	644.0537982	1000		144		249															"$100/Day, days 1-5, $2K OOP"	"$100/Day, days 1-10"	"$100/Day, days 1-5, $2K OOP"	No cost sharing	$50/Trip	20%/Item	"20%/Item, 10% for Diab Supplies"	"$50/Visit for ER, $30/Visit for UC"	Min of 20% Coins/$250 Copay	No cost sharing	"$75 for CT, Nuc Med, MRI/MRA, PET, $0 for Diag Test, X-Ray, Rad Therapy"	$50/Visit	No cost sharing	"$50/Visit for Partial Hosp, $20/$15 OP MH Ind/Grp, $30/Visit for OT/PT/ST"	$20/Visit	"$20/Visit, $30/Visit for Podiatry, Chiro"	$20/$15 for Ind/Grp	$30/visit	No cost sharing	No cost sharing	20%/Script	$20/Visit for Eye exam	$3 for 40 one-way	Not covered	$30/Visit for Routine eye exam	$75 Allowance per year	$30/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"$20 per month for OTC, 1 meal per day, 100 limit"											59.9017	72.26	30.68		50	0.2	0.165400744	49.9846	0.175		34.8857	50		23.9864	20	20.958	19.5	30			0.2	20	3		30		30															8.4805	0.335272899	2.068777867	0	0.941222767	1.19308761	0.860556551	1.166420171	5.375454503	0	12.58216847	0.170905877	0	0.010088583	7.014061435	5.792411377	0.350234079	1.966803879	0	0	4.044731216	1.073422997	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.6586	0	0.240435633	8.4805	0.335272899	2.068777867	0	0.941222767	1.19308761	0.860556551	1.166420171	5.375454503	0	12.58216847	0.170905877	0	0.010088583	7.014061435	5.792411377	0.350234079	1.966803879	0	0	4.044731216	1.073422997	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.6586																																																																																				0	0	0	8.4805	0.335272899	2.068777867	0	0.941222767	1.19308761	0.860556551	1.166420171	5.375454503	0	12.58216847	0.170905877	0	0.010088583	7.014061435	5.792411377	0.350234079	1.966803879	0	0	4.044731216	1.073422997	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.6586
H5698_028_0	2008	4																					2000											D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1697.818013	55.64274104	808.6610586		225.7513954	5.957936852	5.196315508	279.8517462	30.67825814		4325.30327	40.99161385		5.043967176	4205.790094	3314.492691	215.3931138	786.2267674			20.19822599	643.6487403	1000		144		249															"$100/Day, days 1-5, $2K OOP"	"$100/Day, days 1-10"	"$100/Day, days 1-5, $2K OOP"	No cost sharing	$50/Trip	20%/Item	"20%/Item, 10% for Diab Supplies"	"$50/Visit for ER, $30/Visit for UC"	Min of 20% Coins/$250 Copay	No cost sharing	"$75 for CT, Nuc Med, MRI/MRA, PET, $0 for Diag Test, X-Ray, Rad Therapy"	$50/Visit	No cost sharing	"$50/Visit for Partial Hosp, $20/$15 OP MH Ind/Grp, $30/Visit for OT/PT/ST"	$20/Visit	"$20/Visit, $30/Visit for Podiatry, Chiro"	$20/$15 for Ind/Grp	$30/visit	No cost sharing	No cost sharing	20%/Script	$20/Visit for Eye exam	$3 for 40 one-way	Not covered	$30/Visit for Routine eye exam	$75 Allowance per year	$30/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"$20 per month for OTC, 1 meal per day, 100 limit"											59.9033	72.26	30.68		50	0.2	0.165400744	49.9845	0.175		34.8857	50		23.9864	20	20.958	19.5	30			0.2	20	3		30		30															8.4754	0.335062039	2.067476773	0	0.940630814	1.19158737	0.85947445	1.165688401	5.368695175	0	12.5742553	0.170798391	0	0.010082239	7.009650156	5.788768418	0.35001381	1.965566918	0	0	4.039645197	1.072747901	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.6181	0	0.240052817	8.4754	0.335062039	2.067476773	0	0.940630814	1.19158737	0.85947445	1.165688401	5.368695175	0	12.5742553	0.170798391	0	0.010082239	7.009650156	5.788768418	0.35001381	1.965566918	0	0	4.039645197	1.072747901	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.6181																																																																																				0	0	0	8.4754	0.335062039	2.067476773	0	0.940630814	1.19158737	0.85947445	1.165688401	5.368695175	0	12.5742553	0.170798391	0	0.010082239	7.009650156	5.788768418	0.35001381	1.965566918	0	0	4.039645197	1.072747901	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.6181
H5698_029_0	2008	5																					2000											D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1700.009197	55.71455291			226.0427475			280.2118035	30.75749524			41.04451714		0.022679076		317.946528		787.2414624			20.25039481		1000		144		249				300											"$100/Day, days 1-5, $2K OOP"	"$100/Day, days 1-10"	No cost sharing	No cost sharing	$50/Trip	No cost sharing	No cost sharing	"$50/Visit for ER, $30/Visit for UC"	Min of 20% Coins/$250 Copay	No cost sharing	No cost sharing	$50/Visit	No cost sharing	No cost sharing	$0/Visit	"$0/Visit, $10/Visit for Podiatry, Chiro"	No cost sharing	$10/visit	No cost sharing	No cost sharing	10%/Script	No cost sharing	$3 for 40 one-way	$250 Allowance	$10/Visit for Routine eye exam	$150 Allowance per year	$10/Visit for Routine Hearing exam	$500 Allowance	Not covered	Not covered	"$20 copay for Medical Alert, $20 per month for OTC, 1 meal per day, 100 limit"											59.9	72.26			50			49.9846	0.175			50		50		10		10			0.1		3		10		10				20											8.4859	0.335494466	0	0	0.941844781	0	0	1.167189104	5.382561667	0	0	0.171018821	0	9.45E-05	0	0.26495544	0	0.656034552	0	0	2.025039481	0	0.25	0	0.12	0	0.2075	0	0	0	0.5	0	0	0	0	0	0	0	0	0	0	20.5076	0	0.240837889	8.4859	0.335494466	0	0	0.941844781	0	0	1.167189104	5.382561667	0	0	0.171018821	0	9.45E-05	0	0.26495544	0	0.656034552	0	0	2.025039481	0	0.25	0	0.12	0	0.2075	0	0	0	0.5	0	0	0	0	0	0	0	0	0	0	20.5076																																																																																				0	0	0	8.4859	0.335494466	0	0	0.941844781	0	0	1.167189104	5.382561667	0	0	0.171018821	0	9.45E-05	0	0.26495544	0	0.656034552	0	0	2.025039481	0	0.25	0	0.12	0	0.2075	0	0	0	0.5	0	0	0	0	0	0	0	0	0	0	20.5076
H5698_030_0	2008	7																																D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0									393.3343186				57.62213604		0.094669229							28.73611514				144		249															No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	"$50/Visit for ER, $25/Visit for UC"	No cost sharing	No cost sharing	No cost sharing	$35/Visit	No cost sharing	No cost sharing except for Partial Hosp $35	$0/Visit	$0/Visit	No cost sharing	No cost sharing	No cost sharing	No cost sharing	20%/Script	No cost sharing	$0 for 40 one-way	$0/Visit for Preventive Dental	$10/Visit for Routine eye exam	$150 Allowance per year	$10/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"$20 per month for OTC, 1 meal per day, 100 limit"																		49.9841				35		35							0.2				10		10															0	0	0	0	0	0	0	1.638370276	0	0	0	0.168064563	0	0.000276119	0	0	0	0	0	0	5.747223028	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.8814	0	0	0	0	0	0	0	0	0	1.638370276	0	0	0	0.168064563	0	0.000276119	0	0	0	0	0	0	5.747223028	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.8814																																																																																				0	0	0	0	0	0	0	0	0	0	1.638370276	0	0	0	0.168064563	0	0.000276119	0	0	0	0	0	0	5.747223028	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.8814
H5698_035_0	2008	4																					2000											D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1728.407323	59.1893313	860.7593952		254.1233075	6.778715285	5.912171316	330.2541426	37.10618286		4832.188442	40.7791487		5.598520461	4027.475189	3195.198713	232.1716884	922.6577547			21.84840877	646.9810728	1000		144		249															"$100/Day, days 1-5, $2K OOP"	"$100/Day, days 1-10"	"$100/Day, days 1-5, $2K OOP"	No cost sharing	$50/Trip	20%/Item	"20%/Item, 10% for Diab Supplies"	"$50/Visit for ER, $30/Visit for UC"	Min of 20% Coins/$250 Copay	No cost sharing	"$75 for CT, Nuc Med, MRI/MRA, PET, $0 for Diag Test, X-Ray, Rad Therapy"	$50/Visit	No cost sharing	"$50/Visit for Partial Hosp, $20/$15 OP MH Ind/Grp, $30/Visit for OT/PT/ST"	$20/Visit	"$20/Visit, $30/Visit for Podiatry, Chiro"	$20/$15 for Ind/Grp	$30/visit	No cost sharing	No cost sharing	20%/Script	$20/Visit for Eye exam	$3 for 40 one-way	Not covered	$30/Visit for Routine eye exam	$75 Allowance per year	$30/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"$20 per month for OTC, 1 meal per day, 100 limit"											59.8573	72.26	30.68		50	0.2	0.165400744	49.9866	0.175		34.8857	50		24.1323	20	21.018	19.5	30			0.2	20	3		30		30															8.6215	0.356418423	2.200674854	0	1.058847115	1.355743057	0.977877534	1.375689029	6.493582001	0	14.04784066	0.16991312	0	0.01125875	6.712458648	5.596398789	0.377278994	2.306644387	0	0	4.369681754	1.078301788	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.3426	0	0.251012565	8.6215	0.356418423	2.200674854	0	1.058847115	1.355743057	0.977877534	1.375689029	6.493582001	0	14.04784066	0.16991312	0	0.01125875	6.712458648	5.596398789	0.377278994	2.306644387	0	0	4.369681754	1.078301788	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.3426																																																																																				0	0	0	8.6215	0.356418423	2.200674854	0	1.058847115	1.355743057	0.977877534	1.375689029	6.493582001	0	14.04784066	0.16991312	0	0.01125875	6.712458648	5.596398789	0.377278994	2.306644387	0	0	4.369681754	1.078301788	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.3426
H5698_036_0	2008	5																					2000											D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1730.73624	59.2690851	861.9192128		254.4657222	6.796995354	5.928114587	330.6979433	37.2062466		4838.699503	40.83409597		5.606064105	4032.901951	3199.504036	232.4845247	923.9009764			21.90732707	647.852838	1000		144		249															"$100/Day, days 1-5, $2K OOP"	"$100/Day, days 1-10"	"$100/Day, days 1-5, $2K OOP"	No cost sharing	$50/Trip	20%/Item	"20%/Item, 10% for Diab Supplies"	"$50/Visit for ER, $30/Visit for UC"	Min of 20% Coins/$250 Copay	No cost sharing	"$75 for CT, Nuc Med, MRI/MRA, PET, $0 for Diag Test, X-Ray, Rad Therapy"	$50/Visit	No cost sharing	"$50/Visit for Partial Hosp, $20/$15 OP MH Ind/Grp, $30/Visit for OT/PT/ST"	$20/Visit	"$20/Visit, $30/Visit for Podiatry, Chiro"	$20/$15 for Ind/Grp	$30/visit	No cost sharing	No cost sharing	20%/Script	$20/Visit for Eye exam	$3 for 40 one-way	Not covered	$30/Visit for Routine eye exam	$75 Allowance per year	$30/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"$20 per month for OTC, 1 meal per day, 100 limit"											59.8538	72.26	30.68		50	0.2	0.165400744	49.9866	0.175		34.8857	50		24.1323	20	21.018	19.5	30			0.2	20	3		30		30															8.6326	0.356898674	2.203640121	0	1.060273843	1.359399071	0.980514563	1.377538696	6.511093154	0	14.06676921	0.170142067	0	0.01127392	6.721503251	5.603939575	0.377787353	2.309752441	0	0	4.381465414	1.07975473	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4368	0	0.251846985	8.6326	0.356898674	2.203640121	0	1.060273843	1.359399071	0.980514563	1.377538696	6.511093154	0	14.06676921	0.170142067	0	0.01127392	6.721503251	5.603939575	0.377787353	2.309752441	0	0	4.381465414	1.07975473	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4368																																																																																				0	0	0	8.6326	0.356898674	2.203640121	0	1.060273843	1.359399071	0.980514563	1.377538696	6.511093154	0	14.06676921	0.170142067	0	0.01127392	6.721503251	5.603939575	0.377787353	2.309752441	0	0	4.381465414	1.07975473	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4368
H5698_037_0	2008	5																					2000											D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1727.00732	59.14138819			253.9174687			329.9873575	37.04609551			40.74611777		0.025936137		325.0176451		921.9104059			21.81302887		1000		144		249				300											"$100/Day, days 1-5, $2K OOP"	"$100/Day, days 1-10"	No cost sharing	No cost sharing	$50/Trip	No cost sharing	No cost sharing	"$50/Visit for ER, $30/Visit for UC"	Min of 20% Coins/$250 Copay	No cost sharing	No cost sharing	$50/Visit	No cost sharing	No cost sharing	$0/Visit	"$0/Visit, $10/Visit for Podiatry, Chiro"	No cost sharing	$10/visit	No cost sharing	No cost sharing	10%/Script	No cost sharing	$3 for 40 one-way	$250 Allowance	$10/Visit for Routine eye exam	$150 Allowance per year	$10/Visit for Routine Hearing exam	$500 Allowance	Not covered	Not covered	"$20 copay for Medical Alert, $20 per month for OTC, 1 meal per day, 100 limit"											59.8593	72.26			50			49.9865	0.175			50		50		10		10			0.1		3		10		10				20											8.6148	0.356129726	0	0	1.057989453	0	0	1.374577125	6.483066714	0	0	0.169775491	0	0.000108067	0	0.270848038	0	0.768258672	0	0	2.181302887	0	0.25	0	0.12	0	0.2075	0	0	0	0.5	0	0	0	0	0	0	0	0	0	0	22.3543	0	0.250510962	8.6148	0.356129726	0	0	1.057989453	0	0	1.374577125	6.483066714	0	0	0.169775491	0	0.000108067	0	0.270848038	0	0.768258672	0	0	2.181302887	0	0.25	0	0.12	0	0.2075	0	0	0	0.5	0	0	0	0	0	0	0	0	0	0	22.3543																																																																																				0	0	0	8.6148	0.356129726	0	0	1.057989453	0	0	1.374577125	6.483066714	0	0	0.169775491	0	0.000108067	0	0.270848038	0	0.768258672	0	0	2.181302887	0	0.25	0	0.12	0	0.2075	0	0	0	0.5	0	0	0	0	0	0	0	0	0	0	22.3543
H5698_038_0	2008	4																																D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0									412.8561279				61.02891674		0.100266321							29.51129836				144		249															No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	"$35/Visit for ER, $25/Visit for UC"	No cost sharing	No cost sharing	No cost sharing	$35/Visit	No cost sharing	No cost sharing except for Partial Hosp $35	$0/Visit	$0/Visit	No cost sharing	No cost sharing	No cost sharing	No cost sharing	20%/Script	No cost sharing	$0 for 40 one-way	No cost sharing	$10/Visit for Routine eye exam	$150 Allowance per year	$10/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"$20 per month for OTC, 1 meal per day, 100 limit"																		34.9937				35		35							0.2				10		10															0	0	0	0	0	0	0	1.203948644	0	0	0	0.178001007	0	0.000292443	0	0	0	0	0	0	5.902259671	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.612	0	0	0	0	0	0	0	0	0	1.203948644	0	0	0	0.178001007	0	0.000292443	0	0	0	0	0	0	5.902259671	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.612																																																																																				0	0	0	0	0	0	0	0	0	0	1.203948644	0	0	0	0.178001007	0	0.000292443	0	0	0	0	0	0	5.902259671	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.612
H5698_055_0	2008	3																					2000											D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1697.723269	58.14029377	825.1223185		227.0789573	6.259418586	5.459257907	300.6873128	31.91524369		4317.591323	36.4280978		5.001605122	3600.234993	2856.203529	207.4823995	824.4288032			18.80743756	578.2849015	1000		144		249															"$100/Day, days 1-5, $2K OOP"	"$100/Day, days 1-10"	"$100/Day, days 1-5, $2K OOP"	No cost sharing	$50/Trip	20%/Item	"20%/Item, 10% for Diab Supplies"	"$50/Visit for ER, $30/Visit for UC"	Min of 20% Coins/$250 Copay	No cost sharing	"$75 for CT, Nuc Med, MRI/MRA, PET, $0 for Diag Test, X-Ray, Rad Therapy"	$50/Visit	No cost sharing	"$50/Visit for Partial Hosp, $20/$15 OP MH Ind/Grp, $30/Visit for OT/PT/ST"	$20/Visit	"$20/Visit, $30/Visit for Podiatry, Chiro"	$20/$15 for Ind/Grp	$30/visit	No cost sharing	No cost sharing	20%/Script	$20/Visit for Eye exam	$3 for 40 one-way	Not covered	$30/Visit for Routine eye exam	$75 Allowance per year	$30/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"$20 per month for OTC, 1 meal per day, 100 limit"											59.9035	72.26	30.68		50	0.2	0.165400744	49.9847	0.175		34.8857	50		24.1305	20	21.0179	19.5	30			0.2	20	3		30		30															8.475	0.350101469	2.109562728	0	0.946162322	1.251883717	0.902965319	1.252479802	5.585167646	0	12.5518356	0.151783741	0	0.010057591	6.000391655	5.002614929	0.337158899	2.061072008	0	0	3.761487513	0.963808169	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.946	0	0.240018871	8.475	0.350101469	2.109562728	0	0.946162322	1.251883717	0.902965319	1.252479802	5.585167646	0	12.5518356	0.151783741	0	0.010057591	6.000391655	5.002614929	0.337158899	2.061072008	0	0	3.761487513	0.963808169	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.946																																																																																				0	0	0	8.475	0.350101469	2.109562728	0	0.946162322	1.251883717	0.902965319	1.252479802	5.585167646	0	12.5518356	0.151783741	0	0.010057591	6.000391655	5.002614929	0.337158899	2.061072008	0	0	3.761487513	0.963808169	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.946
H5698_056_0	2008	4																					2000											D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1697.723269	58.14029377	825.1223185		227.0789573	6.259418586	5.459257907	300.6873128	31.91524369		4317.591323	36.4280978		5.001605122	3600.234993	2856.203529	207.4823995	824.4288032			18.80743756	578.2849015	1000		144		249															"$100/Day, days 1-5, $2K OOP"	"$100/Day, days 1-10"	"$100/Day, days 1-5, $2K OOP"	No cost sharing	$50/Trip	20%/Item	"20%/Item, 10% for Diab Supplies"	"$50/Visit for ER, $30/Visit for UC"	Min of 20% Coins/$250 Copay	No cost sharing	"$75 for CT, Nuc Med, MRI/MRA, PET, $0 for Diag Test, X-Ray, Rad Therapy"	$50/Visit	No cost sharing	"$50/Visit for Partial Hosp, $20/$15 OP MH Ind/Grp, $30/Visit for OT/PT/ST"	$20/Visit	"$20/Visit, $30/Visit for Podiatry, Chiro"	$20/$15 for Ind/Grp	$30/visit	No cost sharing	No cost sharing	20%/Script	$20/Visit for Eye exam	$3 for 40 one-way	Not covered	$30/Visit for Routine eye exam	$75 Allowance per year	$30/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"$20 per month for OTC, 1 meal per day, 100 limit"											59.9035	72.26	30.68		50	0.2	0.165400744	49.9847	0.175		34.8857	50		24.1305	20	21.0179	19.5	30			0.2	20	3		30		30															8.475	0.350101469	2.109562728	0	0.946162322	1.251883717	0.902965319	1.252479802	5.585167646	0	12.5518356	0.151783741	0	0.010057591	6.000391655	5.002614929	0.337158899	2.061072008	0	0	3.761487513	0.963808169	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.946	0	0.240018871	8.475	0.350101469	2.109562728	0	0.946162322	1.251883717	0.902965319	1.252479802	5.585167646	0	12.5518356	0.151783741	0	0.010057591	6.000391655	5.002614929	0.337158899	2.061072008	0	0	3.761487513	0.963808169	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.946																																																																																				0	0	0	8.475	0.350101469	2.109562728	0	0.946162322	1.251883717	0.902965319	1.252479802	5.585167646	0	12.5518356	0.151783741	0	0.010057591	6.000391655	5.002614929	0.337158899	2.061072008	0	0	3.761487513	0.963808169	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.946
H5698_057_0	2008	5																					2000											D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1697.268698	58.12472652			227.0181562			300.6069521	31.90490093			36.41834406		0.023174402		290.6530134		824.2080597			18.80134264		1000		144		249				300											"$100/Day, days 1-5, $2K OOP"	"$100/Day, days 1-10"	No cost sharing	No cost sharing	$50/Trip	No cost sharing	No cost sharing	"$50/Visit for ER, $30/Visit for UC"	Min of 20% Coins/$250 Copay	No cost sharing	No cost sharing	$50/Visit	No cost sharing	No cost sharing	$0/Visit	"$0/Visit, $10/Visit for Podiatry, Chiro"	No cost sharing	$10/visit	No cost sharing	No cost sharing	10%/Script	No cost sharing	$3 for 40 one-way	$250 Allowance	$10/Visit for Routine eye exam	$150 Allowance per year	$10/Visit for Routine Hearing exam	$500 Allowance	Not covered	Not covered	"$20 copay for Medical Alert, $20 per month for OTC, 1 meal per day, 100 limit"											59.9042	72.26			50			49.9847	0.175			50		50		10		10			0.1		3		10		10				20											8.4728	0.350007728	0	0	0.945908984	0	0	1.252144944	5.583357663	0	0	0.1517431	0	9.66E-05	0	0.242210845	0	0.68684005	0	0	1.880134264	0	0.25	0	0.12	0	0.2075	0	0	0	0.5	0	0	0	0	0	0	0	0	0	0	20.6427	0	0.239856004	8.4728	0.350007728	0	0	0.945908984	0	0	1.252144944	5.583357663	0	0	0.1517431	0	9.66E-05	0	0.242210845	0	0.68684005	0	0	1.880134264	0	0.25	0	0.12	0	0.2075	0	0	0	0.5	0	0	0	0	0	0	0	0	0	0	20.6427																																																																																				0	0	0	8.4728	0.350007728	0	0	0.945908984	0	0	1.252144944	5.583357663	0	0	0.1517431	0	9.66E-05	0	0.242210845	0	0.68684005	0	0	1.880134264	0	0.25	0	0.12	0	0.2075	0	0	0	0.5	0	0	0	0	0	0	0	0	0	0	20.6427
H5698_058_0	2008	4																																D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0									337.9832022				49.14216146		0.080725677							22.80909598				144		249															No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	"$35/Visit for ER, $25/Visit for UC"	No cost sharing	No cost sharing	No cost sharing	$35/Visit	No cost sharing	No cost sharing except for Partial Hosp $35	$0/Visit	$0/Visit	No cost sharing	No cost sharing	No cost sharing	No cost sharing	20%/Script	No cost sharing	$0 for 40 one-way	No cost sharing	$10/Visit for Routine eye exam	$150 Allowance per year	$10/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"$20 per month for OTC, 1 meal per day, 100 limit"																		34.992				35		35							0.2				10		10															0	0	0	0	0	0	0	0.985560213	0	0	0	0.143331304	0	0.00023545	0	0	0	0	0	0	4.561819195	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.0184	0	0	0	0	0	0	0	0	0	0.985560213	0	0	0	0.143331304	0	0.00023545	0	0	0	0	0	0	4.561819195	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.0184																																																																																				0	0	0	0	0	0	0	0	0	0	0.985560213	0	0	0	0.143331304	0	0.00023545	0	0	0	0	0	0	4.561819195	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.0184
H5698_059_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1508.617004	49.43564829	825.1900076		227.2257001	6.182638994	5.392293286	274.5707502	247.6651132		4362.288438	41.82947822		5.106345849	4229.783446	3333.401336	216.7741933	790.712064			20.65733673	647.3206523	1000		144		249															"$150/Day, days 1-5, $2K OOP"	Medicare cost sharing	"$100/Day, days 1-5, $2K OOP"	No cost sharing	$50/Trip	20%/Item	"20%/Item, 10% for Diab Supplies"	"$50/Visit for ER, $30/Visit for UC"	$300 copay	No cost sharing	"$75 for CT, Nuc Med, MRI/MRA, PET, $0 for Diag Test, X-Ray, Rad Therapy"	$50/Visit	No cost sharing	"$50/Visit for Partial Hosp, $30/Visit OP MH, $30/Visit for OT/PT/ST"	$15/Visit	$30/Visit	$30/Visit	$30/visit	No cost sharing	No cost sharing	30%/Script	$20/Visit for Eye exam	$3 for 40 one-way	Not covered	$30/Visit for Routine eye exam	$75 Allowance per year	$30/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"1 meal per day, 100 limit"											107.7974	149.23	30.68		50	0.2	0.165400744	49.9845	300		34.8857	50		30.0905	15	30	30	30			0.2	30	3		30		30															13.5521	0.614773483	2.109735786	0	0.94677375	1.236527799	0.891889321	1.143690253	6.191627831	0	12.6817763	0.174289493	0	0.012804386	5.287229308	8.333503341	0.541935483	1.97678016	0	0	4.131467346	1.618301631	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.6777	0	0	13.5521	0.614773483	2.109735786	0	0.94677375	1.236527799	0.891889321	1.143690253	6.191627831	0	12.6817763	0.174289493	0	0.012804386	5.287229308	8.333503341	0.541935483	1.97678016	0	0	4.131467346	1.618301631	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.6777																																																																																				0	0	0	13.5521	0.614773483	2.109735786	0	0.94677375	1.236527799	0.891889321	1.143690253	6.191627831	0	12.6817763	0.174289493	0	0.012804386	5.287229308	8.333503341	0.541935483	1.97678016	0	0	4.131467346	1.618301631	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.6777
H5698_060_0	2008	8																																D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1784.151159	61.35276735	920.6108132		276.2526841	7.337089114	6.399166505	363.9128822	324.2215829		5336.661036	43.01703757		6.129322556	4535.243404	3573.558446	258.6139166	983.07147			24.74502462	724.1533011	1000		144		249															"$150/Day, days 1-5, $2K OOP"	Medicare cost sharing	"$100/Day, days 1-5, $2K OOP"	No cost sharing	$50/Trip	20%/Item	"20%/Item, 10% for Diab Supplies"	"$50/Visit for ER, $30/Visit for UC"	$300 copay	No cost sharing	"$75 for CT, Nuc Med, MRI/MRA, PET, $0 for Diag Test, X-Ray, Rad Therapy"	$50/Visit	No cost sharing	"$50/Visit for Partial Hosp, $30/Visit OP MH, $30/Visit for OT/PT/ST"	$15/Visit	$30/Visit	$30/Visit	$30/visit	No cost sharing	No cost sharing	20%/Script	$20/Visit for Eye exam	$3 for 40 one-way	Not covered	$30/Visit for Routine eye exam	$75 Allowance per year	$30/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"1 meal per day, 100 limit"											107.8	149.23	30.68		50	0.2	0.165400744	49.9883	300		34.8857	50		30.091	15	30	30	30			0.2	30	3		30		30															16.0276	0.762972789	2.353694979	0	1.15105285	1.467417823	1.0584269	1.515948441	8.105539574	0	15.51441231	0.179237657	0	0.015369788	5.669054255	8.933896115	0.646534791	2.457678675	0	0	4.949004924	1.810383253	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.8507	0	0	16.0276	0.762972789	2.353694979	0	1.15105285	1.467417823	1.0584269	1.515948441	8.105539574	0	15.51441231	0.179237657	0	0.015369788	5.669054255	8.933896115	0.646534791	2.457678675	0	0	4.949004924	1.810383253	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.8507																																																																																				0	0	0	16.0276	0.762972789	2.353694979	0	1.15105285	1.467417823	1.0584269	1.515948441	8.105539574	0	15.51441231	0.179237657	0	0.015369788	5.669054255	8.933896115	0.646534791	2.457678675	0	0	4.949004924	1.810383253	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.8507
H5698_061_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1699.988989	55.71389063	809.6950821		226.0400606	5.973183254	5.209612915	280.2084829	243.0146056		4330.833974	41.04402925		5.050416825	4211.167978	3318.730887	215.6685339	787.2321045			20.24991339	644.4717649	1000		144		249															"$150/Day, days 1-5, $2K OOP"	Medicare cost sharing	"$100/Day, days 1-5, $2K OOP"	No cost sharing	$50/Trip	20%/Item	"20%/Item, 10% for Diab Supplies"	"$50/Visit for ER, $30/Visit for UC"	$300 copay	No cost sharing	"$75 for CT, Nuc Med, MRI/MRA, PET, $0 for Diag Test, X-Ray, Rad Therapy"	$50/Visit	No cost sharing	"$50/Visit for Partial Hosp, $30/Visit OP MH, $30/Visit for OT/PT/ST"	$15/Visit	$30/Visit	$30/Visit	$30/visit	No cost sharing	No cost sharing	30%/Script	$20/Visit for Eye exam	$3 for 40 one-way	Not covered	$30/Visit for Routine eye exam	$75 Allowance per year	$30/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"1 meal per day, 100 limit"											107.8	149.23	30.68		50	0.2	0.165400744	49.9846	300		34.8857	50		30.0898	15	30	30	30			0.2	30	3		30		30															15.2716	0.692848658	2.070120427	0	0.941833586	1.194636651	0.861673851	1.167175264	6.075365139	0	12.59033382	0.171016789	0	0.01266384	5.263959973	8.296827216	0.539171335	1.968080261	0	0	4.049982677	1.611179412	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.0109	0	0	15.2716	0.692848658	2.070120427	0	0.941833586	1.194636651	0.861673851	1.167175264	6.075365139	0	12.59033382	0.171016789	0	0.01266384	5.263959973	8.296827216	0.539171335	1.968080261	0	0	4.049982677	1.611179412	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.0109																																																																																				0	0	0	15.2716	0.692848658	2.070120427	0	0.941833586	1.194636651	0.861673851	1.167175264	6.075365139	0	12.59033382	0.171016789	0	0.01266384	5.263959973	8.296827216	0.539171335	1.968080261	0	0	4.049982677	1.611179412	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.0109
H5698_062_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1730.73624	59.2690851	861.9192128		254.4657222	6.796995354	5.928114587	330.6979433	301.5817612		4838.699503	40.83409597		5.606064105	4032.901951	3199.504036	232.4845247	923.9009764			21.90732707	647.852838	1000		144		249															"$150/Day, days 1-5, $2K OOP"	Medicare cost sharing	"$100/Day, days 1-5, $2K OOP"	No cost sharing	$50/Trip	20%/Item	"20%/Item, 10% for Diab Supplies"	"$50/Visit for ER, $30/Visit for UC"	$300 copay	No cost sharing	"$75 for CT, Nuc Med, MRI/MRA, PET, $0 for Diag Test, X-Ray, Rad Therapy"	$50/Visit	No cost sharing	"$50/Visit for Partial Hosp, $30/Visit OP MH, $30/Visit for OT/PT/ST"	$15/Visit	$30/Visit	$30/Visit	$30/visit	No cost sharing	No cost sharing	30%/Script	$20/Visit for Eye exam	$3 for 40 one-way	Not covered	$30/Visit for Routine eye exam	$75 Allowance per year	$30/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"1 meal per day, 100 limit"											107.8	149.23	30.68		50	0.2	0.165400744	49.9866	300		34.8857	50		30.0927	15	30	30	30			0.2	30	3		30		30															15.5478	0.737060464	2.203640121	0	1.060273843	1.359399071	0.980514563	1.377538696	7.539544029	0	14.06676921	0.170142067	0	0.01405848	5.041127439	7.998760091	0.581211312	2.309752441	0	0	4.381465414	1.619632095	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2212	0	0	15.5478	0.737060464	2.203640121	0	1.060273843	1.359399071	0.980514563	1.377538696	7.539544029	0	14.06676921	0.170142067	0	0.01405848	5.041127439	7.998760091	0.581211312	2.309752441	0	0	4.381465414	1.619632095	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2212																																																																																				0	0	0	15.5478	0.737060464	2.203640121	0	1.060273843	1.359399071	0.980514563	1.377538696	7.539544029	0	14.06676921	0.170142067	0	0.01405848	5.041127439	7.998760091	0.581211312	2.309752441	0	0	4.381465414	1.619632095	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2212
H5698_063_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1758.543483	60.22400565	843.3627614		249.0574859	6.847600147	5.972250415	325.8039053	299.5190927		4747.327208	40.55112196		5.52195969	3943.690817	3128.727952	227.5222097	903.4602959			22.05702792	633.5212145	1000		144		249															"$150/Day, days 1-5, $2K OOP"	Medicare cost sharing	"$100/Day, days 1-5, $2K OOP"	No cost sharing	$50/Trip	20%/Item	"20%/Item, 10% for Diab Supplies"	"$50/Visit for ER, $30/Visit for UC"	$300 copay	No cost sharing	"$75 for CT, Nuc Med, MRI/MRA, PET, $0 for Diag Test, X-Ray, Rad Therapy"	$50/Visit	No cost sharing	"$50/Visit for Partial Hosp, $30/Visit OP MH, $30/Visit for OT/PT/ST"	$15/Visit	$30/Visit	$30/Visit	$30/visit	No cost sharing	No cost sharing	30%/Script	$20/Visit for Eye exam	$3 for 40 one-way	Not covered	$30/Visit for Routine eye exam	$75 Allowance per year	$30/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"1 meal per day, 100 limit"											107.8	149.23	30.68		50	0.2	0.165400744	49.9868	300		34.8857	50		30.0935	15	30	30	30			0.2	30	3		30		30															15.7976	0.748935697	2.15619746	0	1.037739525	1.369520029	0.987814661	1.357157495	7.487977318	0	13.8011373	0.168963008	0	0.013847922	4.929613521	7.82181988	0.568805524	2.25865074	0	0	4.411405584	1.583803036	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.7335	0	0	15.7976	0.748935697	2.15619746	0	1.037739525	1.369520029	0.987814661	1.357157495	7.487977318	0	13.8011373	0.168963008	0	0.013847922	4.929613521	7.82181988	0.568805524	2.25865074	0	0	4.411405584	1.583803036	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.7335																																																																																				0	0	0	15.7976	0.748935697	2.15619746	0	1.037739525	1.369520029	0.987814661	1.357157495	7.487977318	0	13.8011373	0.168963008	0	0.013847922	4.929613521	7.82181988	0.568805524	2.25865074	0	0	4.411405584	1.583803036	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.7335
H5698_064_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1697.723269	58.14029377	825.1223185		227.0789573	6.259418586	5.459257907	300.6873128	268.9193969		4317.591323	36.4280978		5.001605122	3600.234993	2856.203529	207.4823995	824.4288032			18.80743756	578.2849015	1000		144		249															"$150/Day, days 1-5, $2K OOP"	Medicare cost sharing	"$100/Day, days 1-5, $2K OOP"	No cost sharing	$50/Trip	20%/Item	"20%/Item, 10% for Diab Supplies"	"$50/Visit for ER, $30/Visit for UC"	$300 copay	No cost sharing	"$75 for CT, Nuc Med, MRI/MRA, PET, $0 for Diag Test, X-Ray, Rad Therapy"	$50/Visit	No cost sharing	"$50/Visit for Partial Hosp, $30/Visit OP MH, $30/Visit for OT/PT/ST"	$15/Visit	$30/Visit	$30/Visit	$30/visit	No cost sharing	No cost sharing	30%/Script	$20/Visit for Eye exam	$3 for 40 one-way	Not covered	$30/Visit for Routine eye exam	$75 Allowance per year	$30/Visit for Routine Hearing exam	Not covered	Not covered	Not covered	"1 meal per day, 100 limit"											107.8	149.23	30.68		50	0.2	0.165400744	49.9847	300		34.8857	50		30.0927	15	30	30	30			0.2	30	3		30		30															15.2512	0.723023003	2.109562728	0	0.946162322	1.251883717	0.902965319	1.252479802	6.722984922	0	12.5518356	0.151783741	0	0.012542647	4.500293741	7.140508822	0.518705999	2.061072008	0	0	3.761487513	1.445712254	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.5367	0	0	15.2512	0.723023003	2.109562728	0	0.946162322	1.251883717	0.902965319	1.252479802	6.722984922	0	12.5518356	0.151783741	0	0.012542647	4.500293741	7.140508822	0.518705999	2.061072008	0	0	3.761487513	1.445712254	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.5367																																																																																				0	0	0	15.2512	0.723023003	2.109562728	0	0.946162322	1.251883717	0.902965319	1.252479802	6.722984922	0	12.5518356	0.151783741	0	0.012542647	4.500293741	7.140508822	0.518705999	2.061072008	0	0	3.761487513	1.445712254	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.5367
H5698_065_0	2008	5																																D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0						242.1840226			292.6175377																																		No cost sharing	No cost sharing	No cost sharing	No cost sharing	$50/Trip	No cost sharing	No cost sharing	"$50/Visit for ER, $30/Visit for UC"	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$0/Visit	$0/Visit	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$250 Allowance	No cost sharing	$150 Allowance per year	No cost sharing	$1000 Allowance	Not covered	Not covered	"$40 per month for OTC, 1 meal per day, 100 limit"															50			49.9855																																		0	0	0	0	1.009100094	0	0	1.21888542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.228	0	0	0	0	0	0	1.009100094	0	0	1.21888542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.228																																																																																				0	0	0	0	0	0	0	1.009100094	0	0	1.21888542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.228
H5698_066_0	2008	8																																D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0						267.8402125			350.7363311																																		No cost sharing	No cost sharing	No cost sharing	No cost sharing	$50/Trip	No cost sharing	No cost sharing	"$50/Visit for ER, $30/Visit for UC"	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$0/Visit	$0/Visit	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$250 Allowance	No cost sharing	$150 Allowance per year	No cost sharing	$1000 Allowance	Not covered	Not covered	"$40 per month for OTC, 1 meal per day, 100 limit"															50			49.9878																																		0	0	0	0	1.116000886	0	0	1.461046155	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.577	0	0	0	0	0	0	1.116000886	0	0	1.461046155	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.577																																																																																				0	0	0	0	0	0	0	1.116000886	0	0	1.461046155	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.577
H5698_067_0	2008	4																																D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0						226.0427475			280.2118035																																		No cost sharing	No cost sharing	No cost sharing	No cost sharing	$50/Trip	No cost sharing	No cost sharing	"$50/Visit for ER, $30/Visit for UC"	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$0/Visit	$0/Visit	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$250 Allowance	No cost sharing	$150 Allowance per year	No cost sharing	$1000 Allowance	Not covered	Not covered	"$40 per month for OTC, 1 meal per day, 100 limit"															50			49.9846																																		0	0	0	0	0.941844781	0	0	1.167189104	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.109	0	0	0	0	0	0	0.941844781	0	0	1.167189104	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.109																																																																																				0	0	0	0	0	0	0	0.941844781	0	0	1.167189104	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.109
H5698_068_0	2008	4																																D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0						253.9174687			329.9873575																																		No cost sharing	No cost sharing	No cost sharing	No cost sharing	$50/Trip	No cost sharing	No cost sharing	"$50/Visit for ER, $30/Visit for UC"	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$0/Visit	$0/Visit	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$250 Allowance	No cost sharing	$150 Allowance per year	No cost sharing	$1000 Allowance	Not covered	Not covered	"$40 per month for OTC, 1 meal per day, 100 limit"															50			49.9865																																		0	0	0	0	1.057989453	0	0	1.374577125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.4326	0	0	0	0	0	0	1.057989453	0	0	1.374577125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.4326																																																																																				0	0	0	0	0	0	0	1.057989453	0	0	1.374577125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.4326
H5698_069_0	2008	4																																D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0						249.2215436			326.0179499																																		No cost sharing	No cost sharing	No cost sharing	No cost sharing	$50/Trip	No cost sharing	No cost sharing	"$50/Visit for ER, $30/Visit for UC"	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$0/Visit	$0/Visit	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$250 Allowance	No cost sharing	$150 Allowance per year	No cost sharing	$1000 Allowance	Not covered	Not covered	"$40 per month for OTC, 1 meal per day, 100 limit"															50			49.9868																																		0	0	0	0	1.038423098	0	0	1.358049584	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.3965	0	0	0	0	0	0	1.038423098	0	0	1.358049584	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.3965																																																																																				0	0	0	0	0	0	0	1.038423098	0	0	1.358049584	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.3965
H5698_070_0	2008	5																																D	D	D	V	T	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0						227.0181562			300.6069521																																		No cost sharing	No cost sharing	No cost sharing	No cost sharing	$50/Trip	No cost sharing	No cost sharing	"$50/Visit for ER, $30/Visit for UC"	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$0/Visit	$0/Visit	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$250 Allowance	No cost sharing	$150 Allowance per year	No cost sharing	$1000 Allowance	Not covered	Not covered	"$40 per month for OTC, 1 meal per day, 100 limit"															50			49.9847																																		0	0	0	0	0.945908984	0	0	1.252144944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.1981	0	0	0	0	0	0	0.945908984	0	0	1.252144944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.1981																																																																																				0	0	0	0	0	0	0	0.945908984	0	0	1.252144944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.1981
H5698_071_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0		1846.030279	929.3811902	2336.442535		313.9892678	10.53288127	8.89005805	389.9371329	244.0191149		4677.10548	38.3634321		29.65335117	3001.542225	3815.010442	4563.531982	705.3047841			15.89448652	563.2572344			144		249															"100/day, days 1-5 (additional days covered)"	"$100/day, days 1-10"	"$75, days 21-100"	Paid in Full	$50 copay (wia)	20% coins	20% coins - DME/10% coins - Diabetic Supplies	$50 copay (wia) - Emergency/$30 copay (wia) - UC	Min 20% coins/$250 copay	Paid in Full	Paid in Full	$50 copay	Paid in Full	Paid in Full - Cardiac Rehab/$30 Copay - CORF	"$20 Copay PCP OV, Preventive Services Paid in Full"	"$20 copay SPC, $30 copay Podiatry"	$20 copay - ind	$30 copay		$20 copay	20% coins	Paid in Full	$3 copay (40 one-way)	Not Covered	$30 copay	$75 allowance	$30 copay	Not Covered			"1 meal per day, 100 limit (Post Surgery Meal Delivery)"											61.6	72.26	30.68		50	0.2	0.165400744	49.9879	234.6097		34.8857	50		19.5	20	21.324	19.5	30			0.2	20			30		30															9.4763	5.596423734	5.973504748	0	1.308288616	2.106576255	1.470422215	1.624346024	4.770770592	0	13.59699302	0.159847634	0	0.048186696	5.002570374	6.779266077	7.41573947	1.76326196	0	0	3.178897303	0.938762057	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1926	0	0	9.4763	5.596423734	5.973504748	0	1.308288616	2.106576255	1.470422215	1.624346024	4.770770592	0	13.59699302	0.159847634	0	0.048186696	5.002570374	6.779266077	7.41573947	1.76326196	0	0	3.178897303	0.938762057	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1926																																																																																				0	0	0	9.4763	5.596423734	5.973504748	0	1.308288616	2.106576255	1.470422215	1.624346024	4.770770592	0	13.59699302	0.159847634	0	0.048186696	5.002570374	6.779266077	7.41573947	1.76326196	0	0	3.178897303	0.938762057	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1926
H5698_072_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0		1975.395066	994.509699	2500.17408		335.9927826	12.06083782	10.17969781	417.199093	261.1193116		5004.864326	41.0518372		31.73137746	3211.882149	4082.356009	4883.331905	754.7306272			18.20022643	602.7287711			144		249															"100/day, days 1-5 (additional days covered)"	"$100/day, days 1-10"	"$75, days 21-100"	Paid in Full	$50 copay (wia)	20% coins	20% coins - DME/10% coins - Diabetic Supplies	$50 copay (wia) - Emergency/$30 copay (wia) - UC	Min 20% coins/$250 copay	Paid in Full	Paid in Full	$50 copay	Paid in Full	Paid in Full - Cardiac Rehab/$30 Copay - CORF	"$20 Copay PCP OV, Preventive Services Paid in Full"	"$20 copay SPC, $30 copay Podiatry"	$20 copay - ind	$30 copay		$20 copay	20% coins	Paid in Full	$3 copay (40 one-way)	Not Covered	$30 copay	$75 allowance	$30 copay	Not Covered			"1 meal per day, 100 limit (Post Surgery Meal Delivery)"											61.6	72.26	30.68		50	0.2	0.165400744	49.9895	251.0505		34.8857	50		19.5	20	21.324	19.5	30			0.2	20			30		30															10.1404	5.988605904	6.392111732	0	1.399969928	2.412167565	1.68372959	1.737963197	5.462844298	0	14.54983335	0.171049322	0	0.051563488	5.353136915	7.254338626	7.935414345	1.886826568	0	0	3.640045287	1.004547952	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.047	0	0	10.1404	5.988605904	6.392111732	0	1.399969928	2.412167565	1.68372959	1.737963197	5.462844298	0	14.54983335	0.171049322	0	0.051563488	5.353136915	7.254338626	7.935414345	1.886826568	0	0	3.640045287	1.004547952	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.047																																																																																				0	0	0	10.1404	5.988605904	6.392111732	0	1.399969928	2.412167565	1.68372959	1.737963197	5.462844298	0	14.54983335	0.171049322	0	0.051563488	5.353136915	7.254338626	7.935414345	1.886826568	0	0	3.640045287	1.004547952	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.047
H5698_073_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0		1998.429813	1006.106508	2529.328186		339.9107374	12.34375656	10.41848945	422.053787	264.1641795		5063.225199	41.5305357		32.10139167	3249.335362	4129.95967	4940.275609	763.5314129			18.62716071	609.757089			144		249															"100/day, days 1-5 (additional days covered)"	"$100/day, days 1-10"	"$75, days 21-100"	Paid in Full	$50 copay (wia)	20% coins	20% coins - DME/10% coins - Diabetic Supplies	$50 copay (wia) - Emergency/$30 copay (wia) - UC	Min 20% coins/$250 copay	Paid in Full	Paid in Full	$50 copay	Paid in Full	Paid in Full - Cardiac Rehab/$30 Copay - CORF	"$20 Copay PCP OV, Preventive Services Paid in Full"	"$20 copay SPC, $30 copay Podiatry"	$20 copay - ind	$30 copay		$20 copay	20% coins	Paid in Full	$3 copay (40 one-way)	Not Covered	$30 copay	$75 allowance	$30 copay	Not Covered			"1 meal per day, 100 limit (Post Surgery Meal Delivery)"											61.6	72.26	30.68		50	0.2	0.165400744	49.9897	253.9779		34.8857	50		19.5	20	21.324	19.5	30			0.2	20			30		30															10.2586	6.058438021	6.466649062	0	1.416294739	2.468751312	1.723225904	1.758195312	5.590989708	0	14.71949649	0.173043899	0	0.052164761	5.415558936	7.338930237	8.027947864	1.908828532	0	0	3.725432142	1.016261815	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.1013	0	0	10.2586	6.058438021	6.466649062	0	1.416294739	2.468751312	1.723225904	1.758195312	5.590989708	0	14.71949649	0.173043899	0	0.052164761	5.415558936	7.338930237	8.027947864	1.908828532	0	0	3.725432142	1.016261815	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.1013																																																																																				0	0	0	10.2586	6.058438021	6.466649062	0	1.416294739	2.468751312	1.723225904	1.758195312	5.590989708	0	14.71949649	0.173043899	0	0.052164761	5.415558936	7.338930237	8.027947864	1.908828532	0	0	3.725432142	1.016261815	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.1013
H5698_074_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0		2003.715558	1008.767608	2536.01813		340.809784	12.40914013	10.47367508	423.167802	264.8628803		5076.617172	41.64038186		32.18629821	3257.929688	4140.883203	4953.342387	765.5509147			18.72582681	611.3698655			144		249															"100/day, days 1-5 (additional days covered)"	"$100/day, days 1-10"	"$75, days 21-100"	Paid in Full	$50 copay (wia)	20% coins	20% coins - DME/10% coins - Diabetic Supplies	$50 copay (wia) - Emergency/$30 copay (wia) - UC	Min 20% coins/$250 copay	Paid in Full	Paid in Full	$50 copay	Paid in Full	Paid in Full - Cardiac Rehab/$30 Copay - CORF	"$20 Copay PCP OV, Preventive Services Paid in Full"	"$20 copay SPC, $30 copay Podiatry"	$20 copay - ind	$30 copay		$20 copay	20% coins	Paid in Full	$3 copay (40 one-way)	Not Covered	$30 copay	$75 allowance	$30 copay	Not Covered			"1 meal per day, 100 limit (Post Surgery Meal Delivery)"											61.6	72.26	30.68		50	0.2	0.165400744	49.9898	254.6497		34.8857	50		19.5	20	21.324	19.5	30			0.2	20			30		30															10.2857	6.074462282	6.48375302	0	1.420040767	2.481828026	1.732353649	1.762837997	5.620604588	0	14.75842881	0.173501591	0	0.052302735	5.429882814	7.358341334	8.049181378	1.913877287	0	0	3.745165361	1.018949776	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3438	0	0	10.2857	6.074462282	6.48375302	0	1.420040767	2.481828026	1.732353649	1.762837997	5.620604588	0	14.75842881	0.173501591	0	0.052302735	5.429882814	7.358341334	8.049181378	1.913877287	0	0	3.745165361	1.018949776	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3438																																																																																				0	0	0	10.2857	6.074462282	6.48375302	0	1.420040767	2.481828026	1.732353649	1.762837997	5.620604588	0	14.75842881	0.173501591	0	0.052302735	5.429882814	7.358341334	8.049181378	1.913877287	0	0	3.745165361	1.018949776	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3438
H5698_075_0	2008	6																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0		2000.662013	1007.230306	2532.153388		340.29041	12.37134735	10.44177688	422.5242413	264.4592449		5068.880707	41.57692437		32.13724819	3252.964796	4134.572741	4945.793785	764.3842602			18.66879618	610.4381739			144		249															"100/day, days 1-5 (additional days covered)"	"$100/day, days 1-10"	"$75, days 21-100"	Paid in Full	$50 copay (wia)	20% coins	20% coins - DME/10% coins - Diabetic Supplies	$50 copay (wia) - Emergency/$30 copay (wia) - UC	Min 20% coins/$250 copay	Paid in Full	Paid in Full	$50 copay	Paid in Full	Paid in Full - Cardiac Rehab/$30 Copay - CORF	"$20 Copay PCP OV, Preventive Services Paid in Full"	"$20 copay SPC, $30 copay Podiatry"	$20 copay - ind	$30 copay		$20 copay	20% coins	Paid in Full	$3 copay (40 one-way)	Not Covered	$30 copay	$75 allowance	$30 copay	Not Covered			"1 meal per day, 100 limit (Post Surgery Meal Delivery)"											61.6	72.26	30.68		50	0.2	0.165400744	49.9897	254.2616		34.8857	50		19.5	20	21.324	19.5	30			0.2	20			30		30															10.2701	6.065205159	6.473872162	0	1.417876708	2.474269471	1.727077663	1.760155942	5.603486701	0	14.73593783	0.173237185	0	0.052223028	5.421607993	7.347127656	8.0369149	1.910960651	0	0	3.733759237	1.017396956	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.2037	0	0	10.2701	6.065205159	6.473872162	0	1.417876708	2.474269471	1.727077663	1.760155942	5.603486701	0	14.73593783	0.173237185	0	0.052223028	5.421607993	7.347127656	8.0369149	1.910960651	0	0	3.733759237	1.017396956	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.2037																																																																																				0	0	0	10.2701	6.065205159	6.473872162	0	1.417876708	2.474269471	1.727077663	1.760155942	5.603486701	0	14.73593783	0.173237185	0	0.052223028	5.421607993	7.347127656	8.0369149	1.910960651	0	0	3.733759237	1.017396956	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.2037
H5698_076_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0		1923.049952	968.1566295	2433.923081		327.0894595	11.43011708	9.647351163	406.1675361	254.2000272		4872.242655	39.96402285		30.89054182	3126.771915	3974.179476	4753.930668	734.7313565			17.24844676	586.7573299			144		249															"100/day, days 1-5 (additional days covered)"	"$100/day, days 1-10"	"$75, days 21-100"	Paid in Full	$50 copay (wia)	20% coins	20% coins - DME/10% coins - Diabetic Supplies	$50 copay (wia) - Emergency/$30 copay (wia) - UC	Min 20% coins/$250 copay	Paid in Full	Paid in Full	$50 copay	Paid in Full	Paid in Full - Cardiac Rehab/$30 Copay - CORF	"$20 Copay PCP OV, Preventive Services Paid in Full"	"$20 copay SPC, $30 copay Podiatry"	$20 copay - ind	$30 copay		$20 copay	20% coins	Paid in Full	$3 copay (40 one-way)	Not Covered	$30 copay	$75 allowance	$30 copay	Not Covered			"1 meal per day, 100 limit (Post Surgery Meal Delivery)"											61.6	72.26	30.68		50	0.2	0.165400744	49.9889	244.398		34.8857	50		19.5	20	21.324	19.5	30			0.2	20			30		30															9.8717	5.829916504	6.22273001	0	1.362872748	2.286023417	1.595679059	1.691988405	5.177165207	0	14.1642838	0.166516762	0	0.05019713	5.211286525	7.062109138	7.725137335	1.836828391	0	0	3.449689352	0.977928883	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.6645	0	0	9.8717	5.829916504	6.22273001	0	1.362872748	2.286023417	1.595679059	1.691988405	5.177165207	0	14.1642838	0.166516762	0	0.05019713	5.211286525	7.062109138	7.725137335	1.836828391	0	0	3.449689352	0.977928883	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.6645																																																																																				0	0	0	9.8717	5.829916504	6.22273001	0	1.362872748	2.286023417	1.595679059	1.691988405	5.177165207	0	14.1642838	0.166516762	0	0.05019713	5.211286525	7.062109138	7.725137335	1.836828391	0	0	3.449689352	0.977928883	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.6645
H5698_077_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0									779.1919537				36.91811758									19.80916736				144		249															Paid in Full (add'l days allowed)	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full	$35 copay (wia) - Emergency/$25 copay (wia) - UC	Paid in Full	Paid in Full	Paid in Full	$35 copay	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full		Paid in Full	"20% coins (014), 10% coins (003,009,038,022,030)"	Paid in Full	Paid in Full	Not Covered	$10 copay	$75 allowance	$10 copay	Not Covered			"1 meal per day, 100 limit (Post-Surgery Meal Delivery)"																		34.9963				35									0.2				10		10															0	0	0	0	0	0	0	2.272400281	0	0	0	0.107677843	0	0	0	0	0	0	0	0	3.961833472	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.6694	0	0	0	0	0	0	0	0	0	2.272400281	0	0	0	0.107677843	0	0	0	0	0	0	0	0	3.961833472	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.6694																																																																																				0	0	0	0	0	0	0	0	0	0	2.272400281	0	0	0	0.107677843	0	0	0	0	0	0	0	0	3.961833472	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.6694
H5698_078_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0									831.4574058				39.39804913									22.55986823				144		249															Paid in Full (add'l days allowed)	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full	$35 copay (wia) - Emergency/$25 copay (wia) - UC	Paid in Full	Paid in Full	Paid in Full	$35 copay	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full		Paid in Full	"20% coins (014), 10% coins (003,009,038,022,030)"	Paid in Full	Paid in Full	Not Covered	$10 copay	$75 allowance	$10 copay	Not Covered			"1 meal per day, 100 limit (Post-Surgery Meal Delivery)"																		34.9967				35									0.2				10		10															0	0	0	0	0	0	0	2.424856474	0	0	0	0.114910977	0	0	0	0	0	0	0	0	4.511973645	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.3792	0	0	0	0	0	0	0	0	0	2.424856474	0	0	0	0.114910977	0	0	0	0	0	0	0	0	4.511973645	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.3792																																																																																				0	0	0	0	0	0	0	0	0	0	2.424856474	0	0	0	0.114910977	0	0	0	0	0	0	0	0	4.511973645	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.3792
H5698_079_0	2008	5																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0									838.7675638				39.74488983									22.95882822				144		249															Paid in Full (add'l days allowed)	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full	$35 copay (wia) - Emergency/$25 copay (wia) - UC	Paid in Full	Paid in Full	Paid in Full	$35 copay	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full		Paid in Full	"20% coins (014), 10% coins (003,009,038,022,030)"	Paid in Full	Paid in Full	Not Covered	$10 copay	$75 allowance	$10 copay	Not Covered			"1 meal per day, 100 limit (Post-Surgery Meal Delivery)"																		34.9968				35									0.2				10		10															0	0	0	0	0	0	0	2.446179754	0	0	0	0.115922595	0	0	0	0	0	0	0	0	4.591765645	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.4814	0	0	0	0	0	0	0	0	0	2.446179754	0	0	0	0.115922595	0	0	0	0	0	0	0	0	4.591765645	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.4814																																																																																				0	0	0	0	0	0	0	0	0	0	2.446179754	0	0	0	0.115922595	0	0	0	0	0	0	0	0	4.591765645	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.4814
H5698_080_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0									842.9657929				39.94407892									23.18952997				144		249															Paid in Full (add'l days allowed)	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full	$35 copay (wia) - Emergency/$25 copay (wia) - UC	Paid in Full	Paid in Full	Paid in Full	$35 copay	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full		Paid in Full	"20% coins (014), 10% coins (003,009,038,022,030)"	Paid in Full	Paid in Full	Not Covered	$10 copay	$75 allowance	$10 copay	Not Covered			"1 meal per day, 100 limit (Post-Surgery Meal Delivery)"																		34.9968				35									0.1				10		10															0	0	0	0	0	0	0	2.458425714	0	0	0	0.116503564	0	0	0	0	0	0	0	0	2.318952997	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.2214	0	0	0	0	0	0	0	0	0	2.458425714	0	0	0	0.116503564	0	0	0	0	0	0	0	0	2.318952997	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.2214																																																																																				0	0	0	0	0	0	0	0	0	0	2.458425714	0	0	0	0.116503564	0	0	0	0	0	0	0	0	2.318952997	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.2214
H5698_081_0	2008	7																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0									843.4007028				39.96471358									23.21349505				144		249															Paid in Full (add'l days allowed)	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full	$35 copay (wia) - Emergency/$25 copay (wia) - UC	Paid in Full	Paid in Full	Paid in Full	$35 copay	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full		Paid in Full	"20% coins (014), 10% coins (003,009,038,022,030)"	Paid in Full	Paid in Full	Not Covered	$10 copay	$75 allowance	$10 copay	Not Covered			"1 meal per day, 100 limit (Post-Surgery Meal Delivery)"																		34.9968				35									0.2				10		10															0	0	0	0	0	0	0	2.459694318	0	0	0	0.116563748	0	0	0	0	0	0	0	0	4.642699011	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.5465	0	0	0	0	0	0	0	0	0	2.459694318	0	0	0	0.116563748	0	0	0	0	0	0	0	0	4.642699011	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.5465																																																																																				0	0	0	0	0	0	0	0	0	0	2.459694318	0	0	0	0.116563748	0	0	0	0	0	0	0	0	4.642699011	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.5465
H5698_082_0	2008	5																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0									810.6404444				38.41033681									21.44289181				144		249															Paid in Full (add'l days allowed)	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full	$35 copay (wia) - Emergency/$25 copay (wia) - UC	Paid in Full	Paid in Full	Paid in Full	$35 copay	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full	Paid in Full		Paid in Full	"20% coins (014), 10% coins (003,009,038,022,030)"	Paid in Full	Paid in Full	Not Covered	$10 copay	$75 allowance	$10 copay	Not Covered			"1 meal per day, 100 limit (Post-Surgery Meal Delivery)"																		34.9965				35									0.2				10		10															0	0	0	0	0	0	0	2.364134483	0	0	0	0.112030149	0	0	0	0	0	0	0	0	4.288578363	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.0922	0	0	0	0	0	0	0	0	0	2.364134483	0	0	0	0.112030149	0	0	0	0	0	0	0	0	4.288578363	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.0922																																																																																				0	0	0	0	0	0	0	0	0	0	2.364134483	0	0	0	0.112030149	0	0	0	0	0	0	0	0	4.288578363	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.0922
H5698_086_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0		3948.696683	277.0230483	3421.680166		536.4766638	38.82819164	45.55052802	510.2448714	359.3913489		8351.926656			12.0891262	4931.374361	5898.230437	934.9587443	776.6397985			38.63608762	893.2101104	1000		144		249															"100/day, days 1-5 (add'l days allowed)"	"$100/day, days 1-10"	"$100, days 21-100"	Paid in Full	$50 copay (wia)	20% coins	10% coins	$50 copay (wia) - ER/$30 copay (wia) - UC	"15% coins - Hospital,"	Paid in Full	Paid in Full	$50 copay	Paid in Full	$30 copay - CORF/Cardiac Rehab Paid in Full	"$20 copay - PCP OV, Preventive Services Paid in Full"	Paid in Full for Cardiologist & Pulmonologist/$30 Copay Podiatry/$20 Copay other Specialists	$20/$15 copay - ind/grp	$30 copay		$20 copay	20% coins	Paid in Full	$3 copay (40 one-way)	Not Covered	$30 copay	$75 allowance	$30 copay	Not Covered			"1 meal per day, 100 limit (Post-Surgery Meal Delivery)"											61.6	72.26	30.68		50	0.2	0.165400744	49.9918	272.3803		34.8857			19.5	20	13.8175	19.5	30			0.2	20	3		30		30															20.27	1.668140456	8.748095624	0	2.235319432	7.765638327	7.534091218	2.12567223	8.157593362	0	24.28020683	0	0	0.01964483	8.218957269	6.791546114	1.51930796	1.941599496	0	0	7.727217524	1.488683517	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.7242	0	0	20.27	1.668140456	8.748095624	0	2.235319432	7.765638327	7.534091218	2.12567223	8.157593362	0	24.28020683	0	0	0.01964483	8.218957269	6.791546114	1.51930796	1.941599496	0	0	7.727217524	1.488683517	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.7242																																																																																				0	0	0	20.27	1.668140456	8.748095624	0	2.235319432	7.765638327	7.534091218	2.12567223	8.157593362	0	24.28020683	0	0	0.01964483	8.218957269	6.791546114	1.51930796	1.941599496	0	0	7.727217524	1.488683517	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.7242
H5698_087_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0		2789.199757	179.6096471	2599.972145		381.6678979	26.37729174	21.77208872	395.3059124	332.9581071		6283.469385			4.408720446	4639.429714	5106.145933	704.0832475	791.6728071			28.66725128	1054.88209	1000				249															"100/day, days 1-5 (acute additional days covered)"	"$100/day, days 1-10"	"$100, days 21-100"	Paid in Full	$50 copay (wia)	20% coins	20% coins - DME/Diabetic Supplies Paid in Full	$50 copay (wia) - ER/$30 copay (wia) - UC	15% coins - Hospital/$250 copay - ASC	Paid in Full	Paid in Full	$50 copay	Paid in Full	$30 copay CORF/Cardiac Rehab Paid in Full	$20 copay PCP OV/Preventive Services Paid in Full	"Endocrinologist and Opthamologist Paid in Full, $20 copay other OV"	$20/$15 copay - ind/grp	$30 copay		$20 copay	20% coins	Paid in Full	$3 copay (40 one-way)	Not covered	Paid in Full	$75 allowance	$30 copay	Not covered			"1 meal per day, 100 limit (Post-Surgery Meal Delivery)"											61.6	72.26	30.68		50	0.2	0.165400744	49.9894	278.2275		34.8857			19.5	20	14.6795	19.5	30			0.2	20	3				30															14.3179	1.081549425	6.647262118	0	1.590282908	5.275458348	3.60111967	1.646757501	7.719842694	0	18.26691524	0	0	0.007164171	7.732382856	6.246292436	1.144135277	1.979182018	0	0	5.733450256	1.758136816	0.25	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.6203	0	0	14.3179	1.081549425	6.647262118	0	1.590282908	5.275458348	3.60111967	1.646757501	7.719842694	0	18.26691524	0	0	0.007164171	7.732382856	6.246292436	1.144135277	1.979182018	0	0	5.733450256	1.758136816	0.25	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.6203																																																																																				0	0	0	14.3179	1.081549425	6.647262118	0	1.590282908	5.275458348	3.60111967	1.646757501	7.719842694	0	18.26691524	0	0	0.007164171	7.732382856	6.246292436	1.144135277	1.979182018	0	0	5.733450256	1.758136816	0.25	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.6203
H5698_088_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0		4716.09435	168.0325546	4771.25476		658.1650954	31.06112368	33.80926287	504.3843006	340.9535965		8358.601195			4.757283401	4991.576983	6537.158492	705.7984907	778.0203609			36.47193968	968.5996053	1000		144		249															"100/day, days 1-5 (acute additional days covered)"	"$100/day, days 1-10"	"$100, days 21-100"	Paid in Full	$50 copay (wia)	20% coins	10% coins	$50 copay (wia) - ER/$30 copay (wia) - UC	15% coins - Hospital/$250 copay - ASC	Paid in Full	Paid in Full	$50 copay	Paid in Full	$30 copay CORF/Cardiac Rehab Paid in Full	"$20 copay PCP OV, Preventive Services Paid in Full"	Cardiologist & Pulmonologist Paid in Full/$30 Copay Podiatry/$20 copay others	$20/$15 copay - ind/grp	$30 copay		$20 copay	20% coins	Paid in Full	$3 copay (40 one-way)	Not Covered	$30 copay	$75 allowance	$30 copay	Not Covered			"1 meal per day, 100 limit (Post-Surgery Meal Delivery)"											61.6	72.26	30.68		50	0.2	0.165400744	49.9921	331.2558		34.8857			19.5	20	13.8696	19.5	30			0.2	20	3		30		30															24.2093	1.011836033	12.198508	0	2.742354564	6.212224735	5.592077228	2.101270477	9.411906085	0	24.29961064	0	0	0.007730586	8.319294972	7.555657071	1.146922547	1.945050902	0	0	7.294387937	1.614332676	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.8949	0	0	24.2093	1.011836033	12.198508	0	2.742354564	6.212224735	5.592077228	2.101270477	9.411906085	0	24.29961064	0	0	0.007730586	8.319294972	7.555657071	1.146922547	1.945050902	0	0	7.294387937	1.614332676	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.8949																																																																																				0	0	0	24.2093	1.011836033	12.198508	0	2.742354564	6.212224735	5.592077228	2.101270477	9.411906085	0	24.29961064	0	0	0.007730586	8.319294972	7.555657071	1.146922547	1.945050902	0	0	7.294387937	1.614332676	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.8949
H5698_089_0	2008	5																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0		3980.406524	279.2476701	3449.157822		540.7848167	39.45431187	46.28504863	514.3356895	362.2774258		8418.996446			12.18620741	4970.975552	5945.595925	942.4668906	782.8765712			39.2591101	900.3829961	1000		144		249															"100/day, days 1-5 (add'l days allowed)"	"$100/day, days 1-10"	"$100, days 21-100"	Paid in Full	$50 copay (wia)	20% coins	10% coins	$50 copay (wia) - ER/$30 copay (wia) - UC	"15% coins - Hospital,"	Paid in Full	Paid in Full	$50 copay	Paid in Full	$30 copay - CORF/Cardiac Rehab Paid in Full	"$20 copay - PCP OV, Preventive Services Paid in Full"	Paid in Full for Cardiologist & Pulmonologist/$30 Copay Podiatry/$20 Copay other Specialists	$20/$15 copay - ind/grp	$30 copay		$20 copay	20% coins	Paid in Full	$3 copay (40 one-way)	Not Covered	$30 copay	$75 allowance	$30 copay	Not Covered			"1 meal per day, 100 limit (Post-Surgery Meal Delivery)"											61.6	72.26	30.68		50	0.2	0.165400744	49.9919	274.5676		34.8857			19.5	20	13.8175	19.5	30			0.2	20	3		30		30															20.4328	1.681536387	8.818346832	0	2.25327007	7.890862374	7.655581474	2.142720078	8.289137841	0	24.475188	0	0	0.019802587	8.284959254	6.846085335	1.531508697	1.957191428	0	0	7.851822019	1.500638327	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8639	0	0	20.4328	1.681536387	8.818346832	0	2.25327007	7.890862374	7.655581474	2.142720078	8.289137841	0	24.475188	0	0	0.019802587	8.284959254	6.846085335	1.531508697	1.957191428	0	0	7.851822019	1.500638327	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8639																																																																																				0	0	0	20.4328	1.681536387	8.818346832	0	2.25327007	7.890862374	7.655581474	2.142720078	8.289137841	0	24.475188	0	0	0.019802587	8.284959254	6.846085335	1.531508697	1.957191428	0	0	7.851822019	1.500638327	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8639
H5698_090_0	2008	5																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0		2811.598306	181.0519947	2620.85111		384.7328657	26.80263619	22.12317242	398.473672	335.6319129		6333.928518			4.444124487	4676.686456	5147.15062	709.737358	798.0303018			29.12952226	1063.353275	1000				249															"100/day, days 1-5 (acute additional days covered)"	"$100/day, days 1-10"	"$100, days 21-100"	Paid in Full	$50 copay (wia)	20% coins	20% coins - DME/Diabetic Supplies Paid in Full	$50 copay (wia) - ER/$30 copay (wia) - UC	15% coins - Hospital/$250 copay - ASC	Paid in Full	Paid in Full	$50 copay	Paid in Full	$30 copay CORF/Cardiac Rehab Paid in Full	$20 copay PCP OV/Preventive Services Paid in Full	"Endocrinologist and Opthamologist Paid in Full, $20 copay other OV"	$20/$15 copay - ind/grp	$30 copay		$20 copay	20% coins	Paid in Full	$3 copay (40 one-way)	Not covered	Paid in Full	$75 allowance	$30 copay	Not covered			"1 meal per day, 100 limit (Post-Surgery Meal Delivery)"											61.6	72.26	30.68		50	0.2	0.165400744	49.9895	280.4618		34.8857			19.5	20	14.6795	19.5	30			0.2	20	3				30															14.4329	1.090234761	6.700642672	0	1.603053607	5.360527239	3.659189176	1.659959291	7.844328267	0	18.41360692	0	0	0.007221702	7.794477427	6.29645302	1.153323207	1.995075754	0	0	5.825904451	1.772255459	0.25	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4816	0	0	14.4329	1.090234761	6.700642672	0	1.603053607	5.360527239	3.659189176	1.659959291	7.844328267	0	18.41360692	0	0	0.007221702	7.794477427	6.29645302	1.153323207	1.995075754	0	0	5.825904451	1.772255459	0.25	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4816																																																																																				0	0	0	14.4329	1.090234761	6.700642672	0	1.603053607	5.360527239	3.659189176	1.659959291	7.844328267	0	18.41360692	0	0	0.007221702	7.794477427	6.29645302	1.153323207	1.995075754	0	0	5.825904451	1.772255459	0.25	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4816
H5698_091_0	2008	5																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0		4757.612483	169.5118291	4813.258498		663.9592514	31.61042413	34.40716279	508.8176892	343.9551813		8432.186135			4.799164143	5035.520328	6594.708363	712.0119873	784.8696627			37.11692771	977.1266713	1000		144		249															"100/day, days 1-5 (acute additional days covered)"	"$100/day, days 1-10"	"$100, days 21-100"	Paid in Full	$50 copay (wia)	20% coins	10% coins	$50 copay (wia) - ER/$30 copay (wia) - UC	15% coins - Hospital/$250 copay - ASC	Paid in Full	Paid in Full	$50 copay	Paid in Full	$30 copay CORF/Cardiac Rehab Paid in Full	"$20 copay PCP OV, Preventive Services Paid in Full"	Cardiologist & Pulmonologist Paid in Full/$30 Copay Podiatry/$20 copay others	$20/$15 copay - ind/grp	$30 copay		$20 copay	20% coins	Paid in Full	$3 copay (40 one-way)	Not Covered	$30 copay	$75 allowance	$30 copay	Not Covered			"1 meal per day, 100 limit (Post-Surgery Meal Delivery)"											61.6	72.26	30.68		50	0.2	0.165400744	49.9923	334.1721		34.8857			19.5	20	13.8696	19.5	30			0.2	20	3		30		30															24.4224	1.020743731	12.30589756	0	2.766496881	6.322084825	5.69097032	2.119745816	9.578350941	0	24.51353225	0	0	0.007798642	8.392533879	7.622173293	1.157019479	1.962174157	0	0	7.423385543	1.628544452	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.1664	0	0	24.4224	1.020743731	12.30589756	0	2.766496881	6.322084825	5.69097032	2.119745816	9.578350941	0	24.51353225	0	0	0.007798642	8.392533879	7.622173293	1.157019479	1.962174157	0	0	7.423385543	1.628544452	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.1664																																																																																				0	0	0	24.4224	1.020743731	12.30589756	0	2.766496881	6.322084825	5.69097032	2.119745816	9.578350941	0	24.51353225	0	0	0.007798642	8.392533879	7.622173293	1.157019479	1.962174157	0	0	7.423385543	1.628544452	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.1664
H5698_092_0	2008	5																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0		3999.549363	280.5906468	3465.745745		543.3855956	39.83471709	46.73131352	516.8052914	364.0197148		8459.485652			12.24481414	4994.882304	5974.189886	946.999466	786.6416341			39.63763325	904.7131788	1000		144		249															"100/day, days 1-5 (add'l days allowed)"	"$100/day, days 1-10"	"$100, days 21-100"	Paid in Full	$50 copay (wia)	20% coins	10% coins	$50 copay (wia) - ER/$30 copay (wia) - UC	"15% coins - Hospital,"	Paid in Full	Paid in Full	$50 copay	Paid in Full	$30 copay - CORF/Cardiac Rehab Paid in Full	"$20 copay - PCP OV, Preventive Services Paid in Full"	Paid in Full for Cardiologist & Pulmonologist/$30 Copay Podiatry/$20 Copay other Specialists	$20/$15 copay - ind/grp	$30 copay		$20 copay	20% coins	Paid in Full	$3 copay (40 one-way)	Not Covered	$30 copay	$75 allowance	$30 copay	Not Covered			"1 meal per day, 100 limit (Post-Surgery Meal Delivery)"											61.6	72.26	30.68		50	0.2	0.165400744	49.992	275.8881		34.8857			19.5	20	13.8175	19.5	30			0.2	20	3		30		30															20.531	1.689623345	8.860756621	0	2.264106648	7.966943418	7.729394019	2.153011739	8.369058924	0	24.59289573	0	0	0.019897823	8.324803839	6.879009991	1.538874132	1.966604085	0	0	7.927526649	1.507855298	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.5539	0	0	20.531	1.689623345	8.860756621	0	2.264106648	7.966943418	7.729394019	2.153011739	8.369058924	0	24.59289573	0	0	0.019897823	8.324803839	6.879009991	1.538874132	1.966604085	0	0	7.927526649	1.507855298	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.5539																																																																																				0	0	0	20.531	1.689623345	8.860756621	0	2.264106648	7.966943418	7.729394019	2.153011739	8.369058924	0	24.59289573	0	0	0.019897823	8.324803839	6.879009991	1.538874132	1.966604085	0	0	7.927526649	1.507855298	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.5539
H5698_093_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0		2825.388152	181.9399875	2633.705412		386.6198376	27.06619491	22.3407165	400.4239549	337.2780629		6364.994086			4.465921268	4699.623867	5172.395483	713.2183563	801.9443442			29.41596197	1068.568629	1000				249															"100/day, days 1-5 (acute additional days covered)"	"$100/day, days 1-10"	"$100, days 21-100"	Paid in Full	$50 copay (wia)	20% coins	20% coins - DME/Diabetic Supplies Paid in Full	$50 copay (wia) - ER/$30 copay (wia) - UC	15% coins - Hospital/$250 copay - ASC	Paid in Full	Paid in Full	$50 copay	Paid in Full	$30 copay CORF/Cardiac Rehab Paid in Full	$20 copay PCP OV/Preventive Services Paid in Full	"Endocrinologist and Opthamologist Paid in Full, $20 copay other OV"	$20/$15 copay - ind/grp	$30 copay		$20 copay	20% coins	Paid in Full	$3 copay (40 one-way)	Not covered	Paid in Full	$75 allowance	$30 copay	Not covered			"1 meal per day, 100 limit (Post-Surgery Meal Delivery)"											61.6	72.26	30.68		50	0.2	0.165400744	49.9896	281.8374		34.8857			19.5	20	14.6795	19.5	30			0.2	20	3				30															14.5037	1.095581958	6.733506837	0	1.61091599	5.413238981	3.695171128	1.668087167	7.921464003	0	18.50391883	0	0	0.007257122	7.832706445	6.327334785	1.158979829	2.00486086	0	0	5.883192393	1.780947714	0.25	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.0133	0	0	14.5037	1.095581958	6.733506837	0	1.61091599	5.413238981	3.695171128	1.668087167	7.921464003	0	18.50391883	0	0	0.007257122	7.832706445	6.327334785	1.158979829	2.00486086	0	0	5.883192393	1.780947714	0.25	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.0133																																																																																				0	0	0	14.5037	1.095581958	6.733506837	0	1.61091599	5.413238981	3.695171128	1.668087167	7.921464003	0	18.50391883	0	0	0.007257122	7.832706445	6.327334785	1.158979829	2.00486086	0	0	5.883192393	1.780947714	0.25	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.0133
H5698_094_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0		4781.456165	170.3613699	4837.381061		667.2868098	31.92806142	34.75290311	511.363792	345.6789782		8474.445644			4.823216069	5060.756798	6627.759001	715.5803711	788.8031867			37.4898971	982.0237279	1000		144		249															"100/day, days 1-5 (acute additional days covered)"	"$100/day, days 1-10"	"$100, days 21-100"	Paid in Full	$50 copay (wia)	20% coins	10% coins	$50 copay (wia) - ER/$30 copay (wia) - UC	15% coins - Hospital/$250 copay - ASC	Paid in Full	Paid in Full	$50 copay	Paid in Full	$30 copay CORF/Cardiac Rehab Paid in Full	"$20 copay PCP OV, Preventive Services Paid in Full"	Cardiologist & Pulmonologist Paid in Full/$30 Copay Podiatry/$20 copay others	$20/$15 copay - ind/grp	$30 copay		$20 copay	20% coins	Paid in Full	$3 copay (40 one-way)	Not Covered	$30 copay	$75 allowance	$30 copay	Not Covered			"1 meal per day, 100 limit (Post-Surgery Meal Delivery)"											61.6	72.26	30.68		50	0.2	0.165400744	49.9923	335.8468		34.8857			19.5	20	13.8696	19.5	30			0.2	20	3		30		30															24.5448	1.025859383	12.36757091	0	2.780361707	6.385612285	5.748156026	2.130356213	9.674598985	0	24.63638649	0	0	0.007837726	8.434594663	7.660373268	1.162818103	1.972007967	0	0	7.49797942	1.636706213	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.8985	0	0	24.5448	1.025859383	12.36757091	0	2.780361707	6.385612285	5.748156026	2.130356213	9.674598985	0	24.63638649	0	0	0.007837726	8.434594663	7.660373268	1.162818103	1.972007967	0	0	7.49797942	1.636706213	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.8985																																																																																				0	0	0	24.5448	1.025859383	12.36757091	0	2.780361707	6.385612285	5.748156026	2.130356213	9.674598985	0	24.63638649	0	0	0.007837726	8.434594663	7.660373268	1.162818103	1.972007967	0	0	7.49797942	1.636706213	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.8985
H5698_095_0	2008	7																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0		4009.039767	281.2564515	3473.969503		544.674978	40.02398645	46.95335115	518.0296476	364.8834857		8479.558897			12.27386947	5006.734501	5988.365852	949.246571	788.508231			39.82596619	906.859944	1000		144		249															"100/day, days 1-5 (add'l days allowed)"	"$100/day, days 1-10"	"$100, days 21-100"	Paid in Full	$50 copay (wia)	20% coins	10% coins	$50 copay (wia) - ER/$30 copay (wia) - UC	"15% coins - Hospital,"	Paid in Full	Paid in Full	$50 copay	Paid in Full	$30 copay - CORF/Cardiac Rehab Paid in Full	"$20 copay - PCP OV, Preventive Services Paid in Full"	Paid in Full for Cardiologist & Pulmonologist/$30 Copay Podiatry/$20 Copay other Specialists	$20/$15 copay - ind/grp	$30 copay		$20 copay	20% coins	Paid in Full	$3 copay (40 one-way)	Not Covered	$30 copay	$75 allowance	$30 copay	Not Covered			"1 meal per day, 100 limit (Post-Surgery Meal Delivery)"											61.6	72.26	30.68		50	0.2	0.165400744	49.9921	276.5427		34.8857			19.5	20	13.8175	19.5	30			0.2	20	3		30		30															20.5797	1.693632599	8.88178203	0	2.269479075	8.00479729	7.766119207	2.158114037	8.408823394	0	24.65125143	0	0	0.019945038	8.344557502	6.895332975	1.542525678	1.971270578	0	0	7.965193238	1.51143324	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.8965	0	0	20.5797	1.693632599	8.88178203	0	2.269479075	8.00479729	7.766119207	2.158114037	8.408823394	0	24.65125143	0	0	0.019945038	8.344557502	6.895332975	1.542525678	1.971270578	0	0	7.965193238	1.51143324	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.8965																																																																																				0	0	0	20.5797	1.693632599	8.88178203	0	2.269479075	8.00479729	7.766119207	2.158114037	8.408823394	0	24.65125143	0	0	0.019945038	8.344557502	6.895332975	1.542525678	1.971270578	0	0	7.965193238	1.51143324	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.8965
H5698_096_0	2008	7																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0		2823.529242	181.8202835	2631.972616		386.3654684	27.03059124	22.31132887	400.16105	337.0561572		6360.806359			4.462983	4696.531838	5168.992403	712.7491077	801.4167201			29.37726735	1067.865584	1000				249															"100/day, days 1-5 (acute additional days covered)"	"$100/day, days 1-10"	"$100, days 21-100"	Paid in Full	$50 copay (wia)	20% coins	20% coins - DME/Diabetic Supplies Paid in Full	$50 copay (wia) - ER/$30 copay (wia) - UC	15% coins - Hospital/$250 copay - ASC	Paid in Full	Paid in Full	$50 copay	Paid in Full	$30 copay CORF/Cardiac Rehab Paid in Full	$20 copay PCP OV/Preventive Services Paid in Full	"Endocrinologist and Opthamologist Paid in Full, $20 copay other OV"	$20/$15 copay - ind/grp	$30 copay		$20 copay	20% coins	Paid in Full	$3 copay (40 one-way)	Not covered	Paid in Full	$75 allowance	$30 copay	Not covered			"1 meal per day, 100 limit (Post-Surgery Meal Delivery)"											61.6	72.26	30.68		50	0.2	0.165400744	49.9896	281.652		34.8857			19.5	20	14.6795	19.5	30			0.2	20	3				30															14.4941	1.094861141	6.729076654	0	1.609856118	5.406118248	3.690310392	1.666991502	7.911043877	0	18.49174453	0	0	0.007252347	7.827553064	6.323171835	1.1582173	2.0035418	0	0	5.875453469	1.779775973	0.25	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.9416	0	0	14.4941	1.094861141	6.729076654	0	1.609856118	5.406118248	3.690310392	1.666991502	7.911043877	0	18.49174453	0	0	0.007252347	7.827553064	6.323171835	1.1582173	2.0035418	0	0	5.875453469	1.779775973	0.25	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.9416																																																																																				0	0	0	14.4941	1.094861141	6.729076654	0	1.609856118	5.406118248	3.690310392	1.666991502	7.911043877	0	18.49174453	0	0	0.007252347	7.827553064	6.323171835	1.1582173	2.0035418	0	0	5.875453469	1.779775973	0.25	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.9416
H5698_097_0	2008	7																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	P	V	V	V		V	Coin	P	T	V	V	P	V	P			P																																																				0		4772.805297	170.053143	4828.62901		666.0795185	31.812634	34.62726322	510.440023	345.0535572		8459.11322			4.814489646	5051.600604	6615.767703	714.2857045	787.3760414			37.35436234	980.2469977	1000		144		249															"100/day, days 1-5 (acute additional days covered)"	"$100/day, days 1-10"	"$100, days 21-100"	Paid in Full	$50 copay (wia)	20% coins	10% coins	$50 copay (wia) - ER/$30 copay (wia) - UC	15% coins - Hospital/$250 copay - ASC	Paid in Full	Paid in Full	$50 copay	Paid in Full	$30 copay CORF/Cardiac Rehab Paid in Full	"$20 copay PCP OV, Preventive Services Paid in Full"	Cardiologist & Pulmonologist Paid in Full/$30 Copay Podiatry/$20 copay others	$20/$15 copay - ind/grp	$30 copay		$20 copay	20% coins	Paid in Full	$3 copay (40 one-way)	Not Covered	$30 copay	$75 allowance	$30 copay	Not Covered			"1 meal per day, 100 limit (Post-Surgery Meal Delivery)"											61.6	72.26	30.68		50	0.2	0.165400744	49.9923	335.2392		34.8857			19.5	20	13.8696	19.5	30			0.2	20	3		30		30															24.5004	1.024003342	12.34519484	0	2.775331327	6.362526799	5.727375095	2.126506584	9.639623042	0	24.59181301	0	0	0.007823546	8.41933434	7.646513708	1.16071427	1.968440104	0	0	7.470872467	1.633744996	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6327	0	0	24.5004	1.024003342	12.34519484	0	2.775331327	6.362526799	5.727375095	2.126506584	9.639623042	0	24.59181301	0	0	0.007823546	8.41933434	7.646513708	1.16071427	1.968440104	0	0	7.470872467	1.633744996	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6327																																																																																				0	0	0	24.5004	1.024003342	12.34519484	0	2.775331327	6.362526799	5.727375095	2.126506584	9.639623042	0	24.59181301	0	0	0.007823546	8.41933434	7.646513708	1.16071427	1.968440104	0	0	7.470872467	1.633744996	0.25	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6327
H5700_002_0	2008	8																					5000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1773.915843	56.97106319	346.2695971	1176.729781	147.4910045	10.36717838	5.032458853	277.1216041	209.132888	0	22.65260571	1.397826468	0.042028401	19.83622802	3423.155388	5213.039959	227.2782593	669.3225437	0	0	12.00773185	386.2060731	0	0	144	0	116.9898977	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 175 days 1-5	1b 225 days 1-5	2a 25 days 11-100;2a2 0 copay	6a 10 copay	10a 125 copay	11a 15% coin	11b 10% coin;11c 10% coin	4a 50 copay;4b 30 copay	9b 450 copay	8a 0 coin	8b 15% coin; 8b 20% coin	9a 15% coin	12 20% coin	3 30 copay;5 45 copay;9a 15% coin;9c 35 copay;9a 20% coin	7a 10 copay;14c 0 copay;	7b 15 copay;7b1  copay;7d 25 copay;;7f 25 copay	7e 35 copay	7c 20 copay;7i 20 copay			RX 20% coin	14j 0% coin;16b 25 copay;17a 25 copay			17a1 25 copay	17b1 70 allowance	18a1 25 copay															96.4075777	123.9525999	11.4804693	8.9434028	111.792535	0.134151042	0.089434028	44.25436739	313.0936345	0	0.135570282	0.134151042	0.178868056	0.152728206	8.9434028	18.56128549	31.3019098	17.8868056	0	0	0.178868056	22.358507	0	0	25	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.2516	0.58847595	0.331278123	0.876997368	1.374032773	1.390767782	0.450073066	1.021986773	5.456514665	0	3.07102014	0.187519877	0.007517538	3.029551527	2.551221457	8.063393578	0.592853631	0.997670185	0	0	2.147799654	0.719582599	0	0	0.3	0	0.243728954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.6536		5.565613807	14.2516	0.58847595	0.331278123	0.876997368	1.374032773	1.390767782	0.450073066	1.021986773	5.456514665	0	3.07102014	0.187519877	0.007517538	3.029551527	2.551221457	8.063393578	0.592853631	0.997670185	0	0	2.147799654	0.719582599	0	0	0.3	0	0.243728954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.6536																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	14.2516	0.58847595	0.331278123	0.876997368	1.374032773	1.390767782	0.450073066	1.021986773	5.456514665	0	3.07102014	0.187519877	0.007517538	3.029551527	2.551221457	8.063393578	0.592853631	0.997670185	0	0	2.147799654	0.719582599	0	0	0.3	0	0.243728954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.6536
H5700_005_0	2008	6																					5000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		2198.292235	189.8882349	89.41892732	844.1492309	167.0733564	11.43690024	4.511634709	493.2665807	392.7148303	0	29.53911488	1.243500226	0.293425088	30.87823657	2830.37964	4539.825092	161.1640164	540.0875997	0	0	4.355663276	123.4417479	0	0	144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 160 days 1-5	1b 250 days 1-5	2a 30 days 11-100;2a2 0 copay	6a 15 copay	10a 125 copay	11a 20% coin	11b 10% coin;11c 10% coin	4a 50 copay;4b 30 copay	9b 450 copay	8a 0 coin	8b 15% coin; 8b 20% coin	9a 15% coin	12 20% coin	3 30 copay;5 50 copay;9a 15% coin;9c 50 copay;9a 20% coin	7a 12 copay;14c 0 copay;	7b 25 copay;7b1  copay;7d 30 copay;;7f 30 copay	7e 50 copay	7c 25 copay;7i 25 copay			RX 20% coin	14j 0% coin;16b 30 copay;17a 30 copay			17a1 25 copay	17b1 70 allowance	18a1 30 copay															83.99214973	131.237734	13.12763458	12.78320172	106.526681	0.17044269	0.085221345	42.51808979	372.1252598	0	0.128230065	0.127832017	0.17044269	0.153363727	10.22656138	24.01061936	42.6106724	21.3053362	0	0	0.17044269	25.56640344	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.3866	2.076708471	0.097821584	0.899244158	1.483147512	1.949336037	0.384487577	1.747729397	12.17825902	0	3.787802619	0.158959142	0.050012161	4.73560143	2.412087592	9.083667686	0.572275592	0.958895657	0	0	0.742390964	0.262996794	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.268		10.22561884	15.3866	2.076708471	0.097821584	0.899244158	1.483147512	1.949336037	0.384487577	1.747729397	12.17825902	0	3.787802619	0.158959142	0.050012161	4.73560143	2.412087592	9.083667686	0.572275592	0.958895657	0	0	0.742390964	0.262996794	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.268																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	15.3866	2.076708471	0.097821584	0.899244158	1.483147512	1.949336037	0.384487577	1.747729397	12.17825902	0	3.787802619	0.158959142	0.050012161	4.73560143	2.412087592	9.083667686	0.572275592	0.958895657	0	0	0.742390964	0.262996794	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.268
H5700_009_0	2008	6																					5100											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1838.720611	142.8372607	593.561	2220.116607	222.397888	13.14042461	6.52200797	336.5131477	341.1829094	0	16.39399271	2.606088128	0.101555871	22.89882976	3794.807426	6685.104703	344.4779871	323.5122867	0	0	26.6420431	0	0	0	144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 150 days 1-5	1b 260 days 1-5	2a 25 days 11-100	6a 10 copay	10a 125 copay	11a 20% coin; 11a 15% coin	11b 10% coin	4a 50 copay; 4b 30 copay; 4a World 50 copay	9b 450 copay; ASC:9b 225 copay		8b 15% coin; TherRad:8b 20% coin	9a 15% coin	12 20% coin	3 35 copay; 5 50 copay; 9a 15% coin; 9a 20% coin; 9c 50 copay; 9d 35 copay	7a 10 copay	7b 20 copay; ; 7d 25 copay; 16b 25 copay; 17a 25 copay	7e 50 copay; 7h 50 copay	7c 25 copay; 7i 25 copay			RX 20% coin				17a1 25 copay	17b1 70 allowance	18a1 30 copay															80.3408081	139.2574007	11.16172853	8.69510049	108.6887561	0.166638573	0.086951005	43.48149351	305.9068773	0	0.134791277	0.130426507	0.17390201	0.13691908	8.69510049	16.59931532	43.47550245	21.73775123	0	0	0.17390201	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.3104	1.657595471	0.552097229	1.608678083	2.014345818	2.18970161	0.567095147	1.219341187	8.697516534	0	2.209767205	0.339902972	0.01766077	3.135286703	2.749685992	9.247346743	1.248029464	0.586035801	0	0	4.633104841	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.2835		8.251351128	12.3104	1.657595471	0.552097229	1.608678083	2.014345818	2.18970161	0.567095147	1.219341187	8.697516534	0	2.209767205	0.339902972	0.01766077	3.135286703	2.749685992	9.247346743	1.248029464	0.586035801	0	0	4.633104841	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.2835																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	12.3104	1.657595471	0.552097229	1.608678083	2.014345818	2.18970161	0.567095147	1.219341187	8.697516534	0	2.209767205	0.339902972	0.01766077	3.135286703	2.749685992	9.247346743	1.248029464	0.586035801	0	0	4.633104841	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.2835
H5700_013_0	2008	5																					5000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1891.116447	149.9218081	1269.825838	2104.41898	265.0300702	12.19952235	6.263354921	320.8629815	328.9750346	0	16.34881086	2.509280547	0.125841616	24.80985594	3620.054269	6580.986681	338.4749163	341.9533574	0	0	28.01533396	1.6676313	0	0	144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 175 days 1-5	1b 260 days 1-5	2a 30 days 11-100	6a 15 copay	10a 150 copay	11a 20% coin; 11a 30% coin	11b 20% coin	4a 50 copay; 4b 30 copay; 4a World 50 copay	9b 500 copay; ASC:9b 250 copay		8b 15% coin; TherRad:8b 20% coin	9a 15% coin	12 20% coin	3 35 copay; 5 50 copay; 9a 15% coin; 9a 20% coin; 9c 50 copay; 9d 35 copay	7a 15 copay	7b 25 copay; ; 7d 35 copay; 16b 35 copay; 17a 35 copay	7e 50 copay; 7h 50 copay	7c 35 copay; 7i 35 copay			RX 20% coin	14j 20% coin			17a1 25 copay	17b1 70 allowance																89.99324466	133.7042492	12.85996027	12.52255044	125.2255044	0.18141109	0.166967339	41.74978764	326.162117	0	0.129414747	0.125225504	0.166967339	0.130992224	12.52255044	20.88030677	41.74183479	29.21928436	0	0	0.166967339	6.143909953	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.1823	1.6704319	1.360825819	2.196057735	2.765710351	2.213128649	1.045775705	1.116330111	8.941599477	0	2.115777227	0.314225922	0.02101144	3.249898205	3.777692681	11.45108506	1.177380337	0.832636032	0	0	4.677645767	0.000853815	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4104		12.48544232	14.1823	1.6704319	1.360825819	2.196057735	2.765710351	2.213128649	1.045775705	1.116330111	8.941599477	0	2.115777227	0.314225922	0.02101144	3.249898205	3.777692681	11.45108506	1.177380337	0.832636032	0	0	4.677645767	0.000853815	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4104																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	14.1823	1.6704319	1.360825819	2.196057735	2.765710351	2.213128649	1.045775705	1.116330111	8.941599477	0	2.115777227	0.314225922	0.02101144	3.249898205	3.777692681	11.45108506	1.177380337	0.832636032	0	0	4.677645767	0.000853815	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4104
H5700_018_0	2008	4																																D	D	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	V	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		2794.326022	449.5303688	38.45493523	0	15.68742739	15.76859888	0	664.991216	331.8938762	0	16.41532948	2.900401535	0.121964792	26.11715777	4410.165103	14519.16837	4.925544311	1.923218008	0	0	18.42712236	5.112962513	0	0	144	1.96	249	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a: MC CS; 1a1 0% coin	1b: MC CS; 1a1 0% coin	2a: MC CS; 2a2 0% coin	6a 0% coin	MC CS	MC CS	MC CS	4a 50 copay	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS; 14c 0% coin	MC CS; 7b1 0% coin (5 visits); 7f1 0% coin (3 visits)	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS; 13a1 0% coin			17a1 5 copay	17b1 100 allowance	18a1 5 copay															46.19889568	46.19889568	0.03581449	0	0.234	0.234	0	50	285.1331892	0	0.160258101	0.234	0.234	0.234	5	11.64441256	0.234	0.234	0	0	0.234	0.171267095	0	0	5	0	5	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.7579	1.730650551	1.377243883	0	3.670858009	3.689852139	0	2.770796733	7.886163283	0	2.630689528	0.678693959	0.028539761	6.111414919	1.837568793	14.08893221	1.152577369	0.450033014	0	0	4.311946633	0.875682235	0	0	0.06	0	0.10375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2133		0	10.7579	1.730650551	1.377243883	0	3.670858009	3.689852139	0	2.770796733	7.886163283	0	2.630689528	0.678693959	0.028539761	6.111414919	1.837568793	14.08893221	1.152577369	0.450033014	0	0	4.311946633	0.875682235	0	0	0.06	0	0.10375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2133																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	10.7579	1.730650551	1.377243883	0	3.670858009	3.689852139	0	2.770796733	7.886163283	0	2.630689528	0.678693959	0.028539761	6.111414919	1.837568793	14.08893221	1.152577369	0.450033014	0	0	4.311946633	0.875682235	0	0	0.06	0	0.10375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2133
H5700_020_0	2008	4																					4900											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1736.482047	152.4681047	591.1150374	3975.328772	225.9716478	13.39883262	6.035376919	314.6051804	274.8085185	0	14.02475585	2.599713266	1.17895092	23.65233856	3519.580517	6735.875236	431.6682074	328.9327176	0	0	25.22990554	0	0	0	144	0	249	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 135 days 1-5	1b 225 days 1-5	2a 25 days 11-100	6a 10 copay	10a 100 copay	11a 20% coin; 11a 15% coin	11b 10% coin	4a 50 copay; 4b 30 copay; 4a World 50 copay	9b 425 copay; ASC:9b 200 copay		8b 15% coin; TherRad:8b 20% coin	9a 15% coin	12 20% coin	3 20 copay; 5 50 copay; 9a 15% coin; 9a 20% coin; 9c 50 copay; 9d 20 copay	7a 5 copay	7b 12 copay; ; 7d 25 copay; 16b 25 copay; 17a 25 copay	7e 50 copay; 7h 50 copay	7c 18 copay; 7i 18 copay			RX 20% coin				17a1 10 copay	17b1 100 allowance	18a1 25 copay															73.08679844	121.8113307	11.2821453	8.788906382	87.88906382	0.168265451	0.087889064	43.95047949	279.7143343	0	0.137460242	0.131833596	0.175778128	0.134324125	4.394453191	17.03737298	43.94453191	15.82003149	0	0	0.175778128	0	0	0	10	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.5762	1.547695227	0.555753812	2.911566035	1.655036382	2.254560613	0.530443627	1.152254044	6.405656818	0	1.927846333	0.342729548	0.207233785	3.177079692	1.288885986	9.56346823	1.58078811	0.433643829	0	0	4.434865556	0	0	0	0.12	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1844		6.964913818	10.5762	1.547695227	0.555753812	2.911566035	1.655036382	2.254560613	0.530443627	1.152254044	6.405656818	0	1.927846333	0.342729548	0.207233785	3.177079692	1.288885986	9.56346823	1.58078811	0.433643829	0	0	4.434865556	0	0	0	0.12	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1844																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	10.5762	1.547695227	0.555753812	2.911566035	1.655036382	2.254560613	0.530443627	1.152254044	6.405656818	0	1.927846333	0.342729548	0.207233785	3.177079692	1.288885986	9.56346823	1.58078811	0.433643829	0	0	4.434865556	0	0	0	0.12	0	0.51875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1844
H5703_001_0	2008	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		272.7386593		40.33694333		20.40753076	45.88620984		28.61191625	25.81115228	77.09964588					146.2585588						24.35322859	2.503578887		0.000123576	0.003808038		0.000966185															Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co											0.0834		0.1658		0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234		0.234	0.234		0.234															22.7464	0	6.687865205	0	4.775362198	10.7373731	0	6.695188403	6.039809633	18.04131714	0	0	0	0	34.22450275	0	0	0	0	0	5.69865549	0.585837459	0	2.89E-05	0.000891081	0	0.000226087	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.2335	0	0	22.7464	0	6.687865205	0	4.775362198	10.7373731	0	6.695188403	6.039809633	18.04131714	0	0	0	0	34.22450275	0	0	0	0	0	5.69865549	0.585837459	0	2.89E-05	0.000891081	0	0.000226087	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.2335																																																																																				0	0	0	22.7464	0	6.687865205	0	4.775362198	10.7373731	0	6.695188403	6.039809633	18.04131714	0	0	0	0	34.22450275	0	0	0	0	0	5.69865549	0.585837459	0	2.89E-05	0.000891081	0	0.000226087	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.2335
H5711_001_0	2008	9																																																																																																																		0																																											No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5711_004_0	2008	9																																																																																																																		0																																											No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5721_001_0	2008	6																					2500											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	282.6868183	2.846274544	1362.476056	23.80126814	240.7930151	22.04401357	0.968560547	485.3743788	454.0351194	9.506073869	25.04986424	0	0.199884598	863.8993534	3998.1569	5014.281402	151.2325761	497.8065676	24.63338642	30.91198575	6.787274581	659.635489	0	0	0	0	0	0	0	12000	0											$200/admit	$200/admit	"$75/day, days 9 - 100"		$50 copay	20% DME / 20% Diabetes Monitoring	20% coinsurance	$50 ER / $30 UC	$75 ASC / $75 OP		"$15 X-Ray, 20% - 30% Coinsurance Other"	0	0% coinsurance	$20 Cardiac Rehab; $20 PT/OT/ST	$10 PCP	$20 SCP / $15 Chiro / $20 Podiatrist	$25 MH	$20 Therapy		$20 Hearing / $25 OPSA	20% coinsurance	$15 Vision	0	0	0	0	0	0	0	0	0											169.3651449	169.3651449	63.51192934	0	42.34128623	0.169365145	0.169365145	36.20330293	63.51192934	0	0.194767117	0	0	16.93651449	8.468257245	16.38814458	21.17064311	16.93651449	0	0.004810066	0.169365145	12.70238587	0	0	0	0	0	0	0	0	0											3.9898	0.040171642	7.211123581	0	0.849623831	3.733487553	0.164040397	1.464346306	2.403053869	0	4.878889847	0	0	1.219286993	2.821451762	6.847897383	0.266807575	0.702592345	0	0.148688705	1.149527743	0.698245376	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.589	0	6.98	3.9898	0.040171642	7.211123581	0	0.849623831	3.733487553	0.164040397	1.464346306	2.403053869	0	4.878889847	0	0	1.219286993	2.821451762	6.847897383	0.266807575	0.702592345	0	0.148688705	1.149527743	0.698245376	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.589	2500																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.9898	0.040171642	7.211123581	0	0.849623831	3.733487553	0.164040397	1.464346306	2.403053869	0	4.878889847	0	0	1.219286993	2.821451762	6.847897383	0.266807575	0.702592345	0	0.148688705	1.149527743	0.698245376	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.589
H5721_002_0	2008	6																					4000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1579.863186	19.23936892	1165.640462	20.45712271	234.7665865	21.81543418	0.958517323	524.3152091	494.8718246	9.352805191	24.64597935	0	0.175474123	941.5999578	3836.108612	4388.160173	127.4288288	410.1314996	19.75699025	25.94684543	6.677841748	653.8294714	0	0	0	0	0	0	0	12000	0											$200/day with limits	$200/day with limits	"$120/day, days 9 - 100"		$150 copay	30% DME / 30% Diabetes Monitoring	30% coinsurance	$50 ER / $35 UC	$100 ASC / $125 OP		"$15 X-Ray, 25% Coinsurance Other"	0	0% coinsurance	$35 Cardiac Rehab; $35 PT/OT/ST	$5 PCP	$35 SCP / $35 Chiro / $35 Podiatrist	$35 MH	$35 Therapy		$35 Hearing / $35 OPSA	25% coinsurance	$5 Vision	0	0	0	0	0	0	0	0	0											170.3473456	170.3473456	102.2084074	0	127.7605092	0.255521018	0.255521018	38.02989858	102.152381	0	0.20088587	0	0	29.81078548	4.25868364	29.45870645	29.81078548	29.81078548	0	0.008448634	0.212934182	4.25868364	0	0	0	0	0	0	0	0	0											22.4271	0.273114619	9.928187929	0	2.499491553	5.574301958	0.244921322	1.661637852	4.212694599	0	4.951029002	0	0	2.339152863	1.361397749	10.7724602	0.31656279	1.018861846	0	0.219215413	1.42194077	0.232037739	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4541	0	12.09	22.4271	0.273114619	9.928187929	0	2.499491553	5.574301958	0.244921322	1.661637852	4.212694599	0	4.951029002	0	0	2.339152863	1.361397749	10.7724602	0.31656279	1.018861846	0	0.219215413	1.42194077	0.232037739	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4541	4000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.4271	0.273114619	9.928187929	0	2.499491553	5.574301958	0.244921322	1.661637852	4.212694599	0	4.951029002	0	0	2.339152863	1.361397749	10.7724602	0.31656279	1.018861846	0	0.219215413	1.42194077	0.232037739	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4541
H5721_003_0	2008	6																					1000											coin	coin	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	295.046935	2.248231482	1096.335592	30.92238508	315.0207949	28.86226103	1.268137821	407.6422315	31.10802606	12.45383717	32.81764213	0	0.260028945	582.4120954	5427.177293	7177.683153	200.7520198	717.9147044	33.31884941	40.90140006	8.8919583	924.9920029	0	0	0	0	0	0	0	12000	0											$0/admit	$0/admit	"$50/day, days 21 - 100"		$100 copay	20% DME / 0% Diabetes Monitoring	20% coinsurance	$50 ER / $0 UC	$0 ASC / $0 OP		"$0 X-Ray, 0% Coinsurance Other"	0	0% coinsurance	$0 Cardiac Rehab; $5 PT/OT/ST	$5 PCP	$5 SCP / $5 Chiro / $5 Podiatrist	$20 MH	$5 Therapy		$5 Hearing / $20 OPSA	20% coinsurance	$5 Vision	0	0	0	0	0	0	0	0	0											0	0	39.03764147	0	78.07528294	0.12804971	0.156150566	39.03764147	0	0	0	0	0	3.903764147	3.903764147	3.903764147	15.61505659	3.903764147	0	0.001655891	0.156150566	3.903764147	0	0	0	0	0	0	0	0	0											0	0	3.566529647	0	2.049611474	3.695804156	0.198020438	1.32611594	0	0	0	0	0	0.189466621	1.765535011	2.334998513	0.261229512	0.233547474	0	0.067728267	1.38848432	0.300912551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.378	0	4.88	0	0	3.566529647	0	2.049611474	3.695804156	0.198020438	1.32611594	0	0	0	0	0	0.189466621	1.765535011	2.334998513	0.261229512	0.233547474	0	0.067728267	1.38848432	0.300912551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.378	1000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	3.566529647	0	2.049611474	3.695804156	0.198020438	1.32611594	0	0	0	0	0	0.189466621	1.765535011	2.334998513	0.261229512	0.233547474	0	0.067728267	1.38848432	0.300912551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.378
H5721_004_0	2008	5																					3750											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	281.5666512	2.834995974	1362.549231	23.80382481	240.8059474	22.04638148	0.968664588	485.400447	454.0595044	9.507094986	25.05255503	0	0.199906069	863.945751	4161.79785	5056.690857	151.2406984	497.8333034	24.81872736	31.00443203	6.788003652	624.2047379	0	0	0	0	0	0	0	12000	0											$400/admit	$400/admit	"$75/day, days 9 - 100"		$100 copay	30% DME / 30% Diabetes Monitoring	30% coinsurance	$50 ER / $30 UC	$125 ASC / $150 OP		"$15 X-Ray, 25% Coinsurance Other"	0	0% coinsurance	$20 Cardiac Rehab; $20 PT/OT/ST	$5 PCP	$15 SCP / $30 Chiro / $30 Podiatrist	$25 MH	$20 Therapy		$30 Hearing / $25 OPSA	25% coinsurance	$30 Vision	0	0	0	0	0	0	0	0	0											357.2589127	357.2589127	66.98604613	0	89.31472818	0.267944185	0.267944185	38.18363173	129.4476056	0	0.205305268	0	0	17.86294564	4.465736409	17.12841574	22.32868204	17.86294564	0	0.006936246	0.22328682	26.79441845	0	0	0	0	0	0	0	0	0											8.3827	0.084402298	7.605982135	0	1.792293145	5.907199708	0.259548043	1.544529326	4.898076303	0	5.143421513	0	0	1.286051332	1.548791016	7.217758607	0.281417122	0.741064103	0	0.215054375	1.515671753	1.393766912	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8177	0	5.96	8.3827	0.084402298	7.605982135	0	1.792293145	5.907199708	0.259548043	1.544529326	4.898076303	0	5.143421513	0	0	1.286051332	1.548791016	7.217758607	0.281417122	0.741064103	0	0.215054375	1.515671753	1.393766912	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8177	3750																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.3827	0.084402298	7.605982135	0	1.792293145	5.907199708	0.259548043	1.544529326	4.898076303	0	5.143421513	0	0	1.286051332	1.548791016	7.217758607	0.281417122	0.741064103	0	0.215054375	1.515671753	1.393766912	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8177
H5721_005_0	2008	7																					4000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1573.843615	19.16606337	1165.68255	20.45860006	234.7750634	21.81700962	0.958586544	524.3341409	494.8896933	9.353480621	24.64775921	0	0.175486796	941.6339569	3836.247125	4388.318619	127.4334299	410.1463085	19.75841704	25.94871923	6.678324	653.8530797	0	0	0	0	0	0	0	12000	0											$225/day with limits	$225/day with limits	"$120/day, days 9 - 100"		$150 copay	30% DME / 30% Diabetes Monitoring	30% coinsurance	$50 ER / $35 UC	$150 ASC / $175 OP		"$15 X-Ray, 25% Coinsurance Other"	0	0% coinsurance	$35 Cardiac Rehab; $35 PT/OT/ST	$5 PCP	$35 SCP / $35 Chiro / $35 Podiatrist	$35 MH	$35 Therapy		$35 Hearing / $35 OPSA	25% coinsurance	$5 Vision	0	0	0	0	0	0	0	0	0											189.7311444	189.7311444	101.1899437	0	126.4874296	0.252974859	0.252974859	37.65094667	143.2969521	0	0.198882255	0	0	29.51373357	4.216247653	29.1652744	29.51373357	29.51373357	0	0.008364402	0.210812383	4.216247653	0	0	0	0	0	0	0	0	0											24.8839	0.303033261	9.829612633	0	2.474674525	5.519154936	0.242498296	1.645139732	5.909682058	0	4.902001922	0	0	2.31592781	1.347880661	10.66554306	0.313419692	1.00874574	0	0.217045509	1.407873395	0.229733876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2159	0	13.61	24.8839	0.303033261	9.829612633	0	2.474674525	5.519154936	0.242498296	1.645139732	5.909682058	0	4.902001922	0	0	2.31592781	1.347880661	10.66554306	0.313419692	1.00874574	0	0.217045509	1.407873395	0.229733876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2159	4000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.8839	0.303033261	9.829612633	0	2.474674525	5.519154936	0.242498296	1.645139732	5.909682058	0	4.902001922	0	0	2.31592781	1.347880661	10.66554306	0.313419692	1.00874574	0	0.217045509	1.407873395	0.229733876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2159
H5721_802_0	2008	4																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	321.2093796	2.461816271	51.8336902	40.159959	8.401592338	27.99689614	1.273978742	6.169491636	32.02851409	12.5823237	33.98099769	0	0.285618966	33.13961551	48.52880453	130.8385688	1.471127486	4.960264184	32.37113303	42.60010025	9.220376608	6.537718955	0	0	0	0	0	0	0	0	0											Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits											0.076559627	0.076559627	0.188294026	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											24.5917	0.188475735	9.759974235	0	1.965972607	6.551273697	0.298111026	1.443661043	7.494672297	2.944263746	7.951553459	0	0.066834838	7.75467003	11.35574026	30.6162251	0.344243832	1.160701819	7.574845129	9.968423459	2.157568126	1.529826236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7187	0	0	24.5917	0.188475735	9.759974235	0	1.965972607	6.551273697	0.298111026	1.443661043	7.494672297	2.944263746	7.951553459	0	0.066834838	7.75467003	11.35574026	30.6162251	0.344243832	1.160701819	7.574845129	9.968423459	2.157568126	1.529826236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7187	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.5917	0.188475735	9.759974235	0	1.965972607	6.551273697	0.298111026	1.443661043	7.494672297	2.944263746	7.951553459	0	0.066834838	7.75467003	11.35574026	30.6162251	0.344243832	1.160701819	7.574845129	9.968423459	2.157568126	1.529826236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7187
H5721_804_0	2008	6																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	321.2093796	2.461816271	51.8336902	40.159959	8.401592338	27.99689614	1.273978742	6.169491636	32.02851409	12.5823237	33.98099769	0	0.285618966	33.13961551	48.52880453	130.8385688	1.471127486	4.960264184	32.37113303	42.60010025	9.220376608	6.537718955	0	0	0	0	0	0	0	0	0											Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits											0.076559627	0.076559627	0.188294026	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											24.5917	0.188475735	9.759974235	0	1.965972607	6.551273697	0.298111026	1.443661043	7.494672297	2.944263746	7.951553459	0	0.066834838	7.75467003	11.35574026	30.6162251	0.344243832	1.160701819	7.574845129	9.968423459	2.157568126	1.529826236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7187	0	0	24.5917	0.188475735	9.759974235	0	1.965972607	6.551273697	0.298111026	1.443661043	7.494672297	2.944263746	7.951553459	0	0.066834838	7.75467003	11.35574026	30.6162251	0.344243832	1.160701819	7.574845129	9.968423459	2.157568126	1.529826236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7187	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.5917	0.188475735	9.759974235	0	1.965972607	6.551273697	0.298111026	1.443661043	7.494672297	2.944263746	7.951553459	0	0.066834838	7.75467003	11.35574026	30.6162251	0.344243832	1.160701819	7.574845129	9.968423459	2.157568126	1.529826236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7187
H5729_001_0	2008	11																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2157.422964	51.33102028	12179.36756	1055.180752	229.508926	27219.21419	27480.59498	307.1814854	210.4964572	1557.418981	644.8132637	0	44.37314619	725.4120003	6018.548174	12419.23117	121.985419	341.0727764	2978.412622	8422.311736	285.615885	655.409198	1440	4067.062707	520.6032014	350.9855873	223.1156578	0	0	0	636.4108058											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5729_004_0	2008	9																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1065.690546	20.588758	712.7771841	2039.419698	177.9173293	20820.19515	21114.28643	220.27013	235.199578	1763.23559	731.790584	0	49.90658024	490.1230199	8516.363328	17701.03546	183.5161916	515.7956323	4137.275317	12730.312	327.6014885	861.3983563	2400	3877.574558	402.6241242	279.0801832	172.5531961	18.20219885	0	0	2779.471653											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$35 copay	$0 to $25 copay	$0 copay	$0 copay	$0 copay	$0 copay	$25 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	31.5	16.66666667	0	0	0	0	1.332996278	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.578209091	0.326666081	0	0	0	0	0.054444347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9593			0	0	0	0	0	0	0	0.578209091	0.326666081	0	0	0	0	0.054444347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9593																																																																																				0			0	0	0	0	0	0	0	0.578209091	0.326666081	0	0	0	0	0.054444347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9593
H5729_005_0	2008	9																					3000											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		887.7331863	15.40806841	825.213528	1665.39581	155.6884722	18088.88178	18375.73367	201.3484744	215.4908937	1633.72947	673.8285751	0	45.98271552	456.528722	6534.815709	9839.006278	156.6417953	437.1036631	3732.85615	10739.72272	306.8536872	805.6568915	1440	3678.843085	378.2503882	268.5207103	162.1073092	17.56492766	0	0	2527.96371											"$25 copay, days 1-5"	"$25 copay, days 1-5"	"$25 copay, days 8-100"	$0 copay	$75 copay	$0 copay	10% coinsurance	$50 copay	$0 to $100 copay	$0 to $20 copay	$0 to $25 copay	$0 copay	$0 copay	$0 to $100 copay	$0 copay	$0 to $5 copay	$0 copay	$0 copay	$0 copay	0% to 10% coinsurance	10% coinsurance	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											15.98516138	16.18714232	18.93989784	0	75	0	0.335054094	45	66.56265694	5.066254203	5.908922972	0	0	5.244671689	0	3.018452351	0	0	0	1.318197081	20.17748693	0	0	0	0	0	0	0	0	0	0											1.1825	0.020784383	1.302454993	0	0.973052951	0	0.513072067	0.755056779	1.195303869	0.689740733	0.331800096	0	0	0.199528605	0	2.474880969	0	0	0	1.179755928	0.515961355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.3339		0.037355247	1.1825	0.020784383	1.302454993	0	0.973052951	0	0.513072067	0.755056779	1.195303869	0.689740733	0.331800096	0	0	0.199528605	0	2.474880969	0	0	0	1.179755928	0.515961355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.3339																																																																																				0			1.1825	0.020784383	1.302454993	0	0.973052951	0	0.513072067	0.755056779	1.195303869	0.689740733	0.331800096	0	0	0.199528605	0	2.474880969	0	0	0	1.179755928	0.515961355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.3339
H5729_007_0	2008	7																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1127.551307	23.81203801	791.7135303	2115.226052	170.5143433	20049.10554	20309.35808	212.9657441	249.9145354	1828.546093	747.8977252	0	52.39232064	502.3468603	7879.195464	11838.7508	203.9320227	578.580446	4536.169976	13944.53686	331.5618302	936.7689247	1440	3678.843085	437.6598996	271.2632802	187.5685284	17.52822917	0	0	4380.9378											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$50 copay	$0 to 75 copay	$0 to 25 copay	$0 to 25 copay	$0 copay	$0 copay	$0 to 75 copay	$0 copay	$5 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	45	50	6.446800653	5.77296352	0	0	4.14578311	0	2.988829681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.798621541	1.041310564	0.982356012	0.359798857	0	0	0.173551761	0	2.948667481	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.3043			0	0	0	0	0	0	0	0.798621541	1.041310564	0.982356012	0.359798857	0	0	0.173551761	0	2.948667481	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.3043																																																																																				0			0	0	0	0	0	0	0	0.798621541	1.041310564	0.982356012	0.359798857	0	0	0.173551761	0	2.948667481	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.3043
H5729_008_0	2008	7																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1154.476078	20.97840413	943.8753729	1850.811614	175.9484987	20440.30734	20765.05807	253.9092538	244.6434689	1854.081346	771.0083709	0	52.19403745	518.0169325	8500.090029	17548.81127	170.5656087	474.9820151	4152.3558	11687.43915	348.1213867	898.8983179	1440	2439.794864	421.0328965	297.2889317	180.4426699	19.86025367	0	0	2111.22452											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5729_009_0	2008	4																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2278.677497	56.06082043	13478.8763	1025.144659	241.8829849	28832.79937	29080.12298	317.4413147	216.3472393	1579.29262	652.2304501	0	45.3035801	747.6666592	6025.84344	12426.6423	123.6011397	347.2337688	3028.293939	8610.00329	285.6861888	655.6653997	1440	4157.092864	541.1691806	358.1071733	231.9296488	0	0	0	637.240832											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5729_010_0	2008	7																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1058.290159	23.63697094	939.0021148	1898.544045	178.8041943	21258.87409	21478.45639	237.3811449	255.9075134	1826.958147	751.3238763	0	53.00597426	495.7758537	8723.679186	18148.32366	191.8146853	546.9105595	4505.948726	13826.39059	322.8181383	894.9171293	960	4494.778897	412.4199758	258.3783026	176.7514182	16.94357589	0	0	3791.431266											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5729_011_0	2008	5																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2871.816438	73.70056045	10181.60421	1320.534237	290.480023	34805.86971	35068.14558	375.8432162	254.5962281	1830.142399	753.6285368	0	52.91183235	851.5538128	7522.008938	15698.55383	169.5677916	481.862171	3725.167073	11613.69672	325.7736028	788.5502214	1440	4067.062707	705.0407871	395.2676065	302.1603373	0	0	0	647.223356											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5729_012_0	2008	5																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1071.950923	20.92298614	710.2635148	2022.209138	179.4597036	21023.05969	21314.62485	213.8638029	237.1137727	1772.904271	725.9602212	0	50.24652693	492.1936898	8579.805953	17834.87493	185.6328321	522.2691923	4178.300617	12899.64398	328.5475733	866.066343	1440	2571.592828	404.4943323	279.2113068	173.3547139	18.19081101	0	0	1529.525067											"$125 copay, days 1-5"	"$125 copay, days 1-5"	"$25 copay, days 21-100"	$10 copay	$25 copay	20% copay	20% copay	$50 copay	$0 to $75 copay	$0 to $20 copay	$0 to $50 copay	$0 copay	$25 copay	$0 to $25 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											80.93571162	80.93571162	11.86539497	10	25	1.205552499	0.861399301	45	50	5.101445689	11.55945107	0	25	4.014574234	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											7.2299	0.141118064	0.702296428	1.685174282	0.373874382	2.112033513	1.530033578	0.801989261	0.987974053	0.753697904	0.699308471	0	0.104680264	0.164662342	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.2868			7.2299	0.141118064	0.702296428	1.685174282	0.373874382	2.112033513	1.530033578	0.801989261	0.987974053	0.753697904	0.699308471	0	0.104680264	0.164662342	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.2868																																																																																				0			7.2299	0.141118064	0.702296428	1.685174282	0.373874382	2.112033513	1.530033578	0.801989261	0.987974053	0.753697904	0.699308471	0	0.104680264	0.164662342	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.2868
H5729_013_0	2008	6																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		847.554255	14.70429686	777.8901248	1573.350305	149.1190103	17326.59831	17601.11959	192.7928828	206.4100119	1518.315707	619.0162153	0	44.04176417	437.1971466	6030.888729	9172.646748	136.644817	380.3638593	3414.94591	9895.184283	293.8391151	771.6062231	960	2439.794864	362.2497799	257.1096462	155.2499057	16.81748677	0	0	426.7766917											"$125 copay, days 1-5"	"$125 copay, days 1-6"	"$75 copay, days 8-100"	$10 copay	$100 copay	$0 copay	20% coinsurance	$50 copay	$100 copay	$0 to $20 copay	$0 to $75 copay	$0 copay	$25 copay	$0 to $20 copay	$0 to $20 copay	$0 to $20 copay	$20 copay	$20 copay	$0 copay	$0 to $20 copay	10% coinsurance	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											80.93571162	80.93571162	56.90117479	10	100	0	0.647713949	45	66.66666667	5.221257684	17.68427583	0	25	24.19663229	0.613870345	12.98264624	20	20	0	2.252082526	19.46789929	0	0	0	0	0	0	0	0	0	0											5.7165	0.099175228	3.68857183	1.311125254	1.242658419	0	0.95004089	0.722973311	1.146722288	0.660626463	0.912237791	0	0.091753675	0.881558216	0.308515312	9.923768985	0.227741362	0.633939765	0	1.857064301	0.476702525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.8516			5.7165	0.099175228	3.68857183	1.311125254	1.242658419	0	0.95004089	0.722973311	1.146722288	0.660626463	0.912237791	0	0.091753675	0.881558216	0.308515312	9.923768985	0.227741362	0.633939765	0	1.857064301	0.476702525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.8516																																																																																				0			5.7165	0.099175228	3.68857183	1.311125254	1.242658419	0	0.95004089	0.722973311	1.146722288	0.660626463	0.912237791	0	0.091753675	0.881558216	0.308515312	9.923768985	0.227741362	0.633939765	0	1.857064301	0.476702525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.8516
H5729_014_0	2008	5																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1112.949807	23.30306477	784.9799491	2063.506998	169.6730702	19935.66078	20197.92507	212.659384	248.30478	1776.470353	719.4389101	0	52.10337842	500.51683	7606.966217	11540.4612	202.1124476	573.0410875	4334.105989	13463.20735	330.686687	931.7134091	1000	2439.794864	435.4795019	271.1632796	186.6340723	17.53691404	0	0	1530.851415											"$125 copay, days 1-5"	"$125 copay, days 1-5"	"$25 copay, days 21-100"	$10 copay	$25 copay	20% coinsurance	20% coinsurance	$50 copay	$0 to $100 copay	$0 to $50 copay	$0 to $50 copay	$0 copay	$25 copay	$0 to $100 copay	$0 copay	$0 to $10 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											80.93571162	80.93571162	11.86539497	10	25	0.983730664	0.701460228	45	66.66666667	13.19837409	11.50543777	0	25	5.512186273	0	5.909253196	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											7.5064	0.157170844	0.776174762	1.719589165	0.353485563	1.634276735	1.180670094	0.79747269	1.379471	1.953876691	0.689788301	0	0.108548705	0.229911833	0	5.682958934	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.1698			7.5064	0.157170844	0.776174762	1.719589165	0.353485563	1.634276735	1.180670094	0.79747269	1.379471	1.953876691	0.689788301	0	0.108548705	0.229911833	0	5.682958934	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.1698																																																																																				0			7.5064	0.157170844	0.776174762	1.719589165	0.353485563	1.634276735	1.180670094	0.79747269	1.379471	1.953876691	0.689788301	0	0.108548705	0.229911833	0	5.682958934	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.1698
H5729_015_0	2008	5																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1186.245551	21.89904011	968.5496814	1885.315191	180.0635149	20945.58574	21271.75457	258.6727102	250.7469995	1894.074684	787.1713321	0	53.40760935	528.3743321	8686.654885	17931.20912	174.841972	487.4930074	4260.286046	12008.37089	354.5051735	917.8627302	1440	4209.228237	429.4811563	301.955128	184.0633527	20.15354303	0	0	1031.743548											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5729_016_0	2008	4																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1535.022171	33.48510145	920.3647317	2521.039488	208.0865172	24518.9301	24824.71291	286.6210538	295.7667134	2160.416209	892.3349067	0	61.95366706	593.0315886	10855.9592	22653.27915	243.9455241	692.6999864	5366.502124	16694.05665	391.0653977	1099.600826	1440	2439.794864	513.0321286	312.8188383	219.8709123	20.70634739	0	0	2116.237576											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5729_017_0	2008	4																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1629.587523	37.16310251	939.4903314	2631.955364	216.0793467	25586.94882	25875.84271	292.3354023	309.0951759	2229.063801	918.4632172	0	64.33944448	607.9924705	11334.6465	23672.01635	259.4145266	739.7924937	5662.141735	17836.20811	398.1397682	1140.029404	1440	4209.228237	530.3096434	313.0246489	227.2755614	20.63251352	0	0	1036.895762											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5729_018_0	2008	5																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		912.1139239	15.83777915	803.7886415	1631.815095	160.9619038	18709.67939	19004.41062	246.8203613	274.5292021	2023.368287	837.1305935	0	57.76084548	557.8573954	7246.359216	14677.46394	135.3371487	374.0145341	3481.483707	8718.162321	369.6282508	805.7352581	960	3877.574558	362.6805175	273.5409503	155.4345075	17.90590195	0	0	8227.155136											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$35 copay	$0 to $25 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 to $25 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	31.5	16.66666667	0	0	0	0	1.366982177	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.647903449	0.381290559	0	0	0	0	0.063548426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.0927			0	0	0	0	0	0	0	0.647903449	0.381290559	0	0	0	0	0.063548426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.0927																																																																																				0			0	0	0	0	0	0	0	0.647903449	0.381290559	0	0	0	0	0.063548426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.0927
H5729_019_0	2008	4																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2855.334997	73.10108029	10097.86962	1358.023124	299.8101933	35933.73979	36202.52963	387.4994469	262.4084476	1884.762709	775.9993669	0	54.51367484	857.1063096	7745.436075	16165.72572	174.8123707	496.9050116	3838.419251	11976.57212	335.2050988	811.7174524	1440	4067.062707	727.4958764	407.0626442	311.783947	0	0	0	1206.392137											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5729_020_0	2008	4																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		906.3845126	15.71841318	795.1790843	1608.47544	160.7281886	18683.1902	18977.33988	238.1663851	274.2042524	2020.763351	824.3554091	0	57.68950632	557.1110548	7234.867263	14653.72253	135.1213819	373.4288917	3476.289948	8704.159902	369.1135944	804.4940835	480	2571.592828	362.0912712	273.0848397	155.1819734	17.87539521	0	0	1527.108768											"$125 copay, days 1-5"	"$125 copay, days 1-5"	"$25 copay, days 21-100"	$10 copay	$25 copay	20% coinsurance	20% coinsurance	$50 copay	$0 to $75 copay	$0 to $20 copay	$0 to $50 copay	$0 copay	$25 copay	$0 to $25 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											97.12285394	97.12285394	23.73078994	10	25	0.986026533	0.708331	45	50	5.138707178	11.43504064	0	25	4.101579778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											7.3359	0.127218096	1.572518985	1.3403962	0.334850393	1.535176771	1.120186511	0.893123944	1.142517718	0.865342595	0.7855448	0	0.120186472	0.19041962	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.3634			7.3359	0.127218096	1.572518985	1.3403962	0.334850393	1.535176771	1.120186511	0.893123944	1.142517718	0.865342595	0.7855448	0	0.120186472	0.19041962	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.3634																																																																																				0			7.3359	0.127218096	1.572518985	1.3403962	0.334850393	1.535176771	1.120186511	0.893123944	1.142517718	0.865342595	0.7855448	0	0.120186472	0.19041962	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.3634
H5729_030_0	2008	11																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1054.746413	20.14310893	712.3337213	2022.990295	176.4360669	20625.36849	20921.8858	238.5305531	233.3612275	1753.950002	728.2764419	0	49.58010291	488.1343939	8455.434423	17572.49897	181.4834165	509.5785674	4097.875519	12567.68928	326.6928895	856.9153244	2400	4436.61117	400.8280173	278.9542549	171.783436	18.21313549	0	0	5144.129005											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5729_031_0	2008	11																					0											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		920.4399296	17.00406936	867.2451398	1692.563929	160.6978912	18769.97949	19043.58567	226.5745834	223.6165344	1672.754156	693.9629138	0	47.39721932	464.4916165	7890.098961	16392.50782	163.8364433	459.5246436	3903.57481	11433.29522	310.1281935	826.1221232	1440	3678.843085	386.4644668	269.1730757	165.6276286	17.50827097	0	0	2528.163436											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5729_032_0	2008	11																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1105.587319	22.91898235	785.116719	2082.431378	168.3996912	19763.94699	20029.25636	241.182776	245.8682003	1807.56382	747.494903	0	51.6660258	497.746835	9080.386288	18811.28821	199.358278	564.6565292	4446.25454	13606.72447	329.3620411	924.0612115	1440	4157.092864	432.1791791	271.0119152	185.2196482	17.55005975	0	0	4595.640422											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5729_033_0	2008	9																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		972.9492808	18.75403076	850.5607166	1654.757774	170.9955063	20058.63453	20330.29441	292.8210484	311.5169256	2239.333895	922.1299476	0	64.74177208	609.8081603	7436.269746	14936.8001	138.5773911	385.8414243	3661.086974	8899.067582	398.6157233	836.7361766	1440	3877.574558	368.3884359	274.6921916	157.8807583	17.8059188	0	0	4376.975632											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5732_001_0	2008	8																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1448.400832	32.54869031	234.8941495	601.5792109	126.6229564	7829.102655	7925.022386	540.4567257	129.4517798	7506.882686	3116.027696	0	212.3869528	2087.489037	7838.816924	15338.59951	157.4307312	444.0111114	3208.730412	11677.28645	54.53444966	177.6230143	0	2643.987586	538.25581	372.1497725	45.04711395	4.651343145	0	0	77.71583445											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$25 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.125951512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.126			0	0	0	0	0	0	0	1.125951512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.126																																																																																				0			0	0	0	0	0	0	0	1.125951512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.126
H5732_002_0	2008	8																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1287.854317	31.12233177	509.74243	1833.835623	200.087804	23612.50998	23898.35539	211.7444684	223.2427416	1672.427084	694.0141409	0	47.35291708	464.7268647	9423.018011	18376.40031	188.1607386	530.6784987	3836.159438	14072.089	310.516988	1011.50967	0	2643.987586	485.0990722	335.5283081	207.8996024	21.46202655	0	0	423.7589091											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$25 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.441134309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4411			0	0	0	0	0	0	0	0.441134309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4411																																																																																				0			0	0	0	0	0	0	0	0.441134309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4411
H5732_003_0	2008	10																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1214.509249	27.1822872	671.7062602	1823.021668	206.3727179	24547.32911	24798.33908	199.9930217	220.5539393	1620.460447	670.0437422	0	46.33242935	446.0901454	9635.806234	18575.87545	195.0259983	554.1188011	3847.891999	14925.64496	295.0843005	1032.18853	0	2643.987586	495.6056754	334.105349	212.4024323	21.13821102	0	0	418.2728664											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$10 copay	$0 copay	$0 copay	$5 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.416652129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4167			0	0	0	0	0	0	0	0.416652129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4167																																																																																				0			0	0	0	0	0	0	0	0.416652129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4167
H5736_002_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V			0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0			0												0		1612.481546	39.12292551	1469.710191	2220.113124	255.8982033	13.04874451	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	4844.4453	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	16.9292035	0			0		0			0												$185/day 1-7	$185/day 1-7	"$0/day 1-10, $50/day 11-20, $100/day 21-100"	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $15 UC	$185 per procedure	$15 per visit	"$15 X-ray; $125 CAT, PET, MRI"	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	20% coinsurance	0			0		0			Not Covered												133.73	133.73	30.23	0	100	0.2	0.2	45.5	185	15	34.8	15	15	15	15	15	15	15	15	15	0.2	0			0		0			0												17.9698	0.435992402	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	5.894971161	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3403		-1.340209796	17.9698	0.435992402	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	5.894971161	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3403	2500																																																																																			0			17.9698	0.435992402	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	5.894971161	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3403
H5736_003_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V			0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0			0												0		1612.481546	39.12292551	1469.710191	2220.113124	255.8982033	13.04874451	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	4844.4453	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	16.9292035	0			0		0			0												$185/day 1-7	$185/day 1-7	"$0/day 1-10, $50/day 11-20, $100/day 21-100"	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $15 UC	$185 per procedure	$15 per visit	"$15 X-ray; $125 CAT, PET, MRI"	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	20% coinsurance	0			0		0			Not Covered												133.73	133.73	30.23	0	100	0.2	0.2	45.5	185	15	34.8	15	15	15	15	15	15	15	15	15	0.2	0			0		0			0												17.9698	0.435992402	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	5.894971161	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3403		-1.340209796	17.9698	0.435992402	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	5.894971161	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3403	2500																																																																																			0			17.9698	0.435992402	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	5.894971161	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3403
H5736_007_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V			0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0			0												0		1612.481546	39.12292551	1469.710191	2220.113124	255.8982033	13.04874451	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	4844.4453	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	16.9292035	0			0		0			0												$185/day 1-7	$185/day 1-7	"$0/day 1-10, $50/day 11-20, $100/day 21-100"	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $15 UC	$185 per procedure	$15 per visit	"$15 X-ray; $125 CAT, PET, MRI"	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	20% coinsurance	0			0		0			Not Covered												133.73	133.73	30.23	0	100	0.2	0.2	45.5	185	15	34.8	15	15	15	15	15	15	15	15	15	0.2	0			0		0			0												17.9698	0.435992402	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	5.894971161	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3403		-1.340209796	17.9698	0.435992402	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	5.894971161	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3403	2500																																																																																			0			17.9698	0.435992402	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	5.894971161	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3403
H5736_011_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0															0		1612.481546	39.12292551	1469.710191	2220.113124	255.8982033	13.04874451	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	4844.4453	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	16.9292035	0			0		0															$150/day 1-7	$150/day 1-7	"$0/day 1-10, $50/day 11-20, $100/day 21-100"	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $15 UC	$150 per procedure	$15 per visit	"$15 X-ray; $125 CAT, PET, MRI"	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	20% coinsurance	0			0		0															108.43	108.43	30.23	0	100	0.2	0.2	45.5	150	15	34.8	15	15	15	15	15	15	15	15	15	0.2	0			0		0															14.5701	0.353508234	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	4.779706347	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7429		3.257187779	14.5701	0.353508234	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	4.779706347	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7429	2500																																																																																			0			14.5701	0.353508234	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	4.779706347	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7429
H5736_012_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V			0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0			0												0		1612.481546	39.12292551	1469.710191	2220.113124	255.8982033	13.04874451	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	4844.4453	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	16.9292035	0			0		0			0												$185/day 1-7	$185/day 1-7	"$0/day 1-10, $50/day 11-20, $100/day 21-100"	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $15 UC	$185 per procedure	$15 per visit	"$15 X-ray; $125 CAT, PET, MRI"	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	20% coinsurance	0			0		0			Not Covered												133.73	133.73	30.23	0	100	0.2	0.2	45.5	185	15	34.8	15	15	15	15	15	15	15	15	15	0.2	0			0		0			0												17.9698	0.435992402	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	5.894971161	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3403		-1.340209796	17.9698	0.435992402	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	5.894971161	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3403	2500																																																																																			0			17.9698	0.435992402	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	5.894971161	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3403
H5736_013_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V			0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0			0												0		1853.427064	39.12292551	1469.710191	2220.113124	255.8982033	10.83045795	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	5568.327931	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	14.05123891	0			0		0			0												0	0	"$0/day 1-10, $0/day 11-20, $0/day 21-100"	$0 per visit	$50 per trip	20% coinsurance	20% coinsurance	$0 per visit	$0 per procedure	$0 per visit	"$0 X-ray; 20% CAT, PET, MRI"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	20% coinsurance	0			0		0			Not Covered												0	0	0	0	50	0.2	0.2	0	0	0	2.9916	0	0	0	0	0	0	0	0	0	0.2	0			0		0			0												0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537		1.019250233	0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537	1000																																																																																			0			0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537
H5736_014_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V			0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0			0												0		1853.427064	39.12292551	1469.710191	2220.113124	255.8982033	10.83045795	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	5568.327931	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	14.05123891	0			0		0			0												0	0	"$0/day 1-10, $0/day 11-20, $0/day 21-100"	$0 per visit	$50 per trip	20% coinsurance	20% coinsurance	$0 per visit	$0 per procedure	$0 per visit	"$0 X-ray; 20% CAT, PET, MRI"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	20% coinsurance	0			0		0			Not Covered												0	0	0	0	50	0.2	0.2	0	0	0	2.9916	0	0	0	0	0	0	0	0	0	0.2	0			0		0			0												0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537		1.019250233	0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537	1000																																																																																			0			0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537
H5736_015_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V			0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0			0												0		1612.481546	39.12292551	1469.710191	2220.113124	255.8982033	13.04874451	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	4844.4453	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	16.9292035	0			0		0			0												$150/day 1-7	$150/day 1-7	"$0/day 1-10, $50/day 11-20, $100/day 21-100"	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $15 UC	$150 per procedure	$15 per visit	"$15 X-ray; $125 CAT, PET, MRI"	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	20% coinsurance	0			0		0			Not Covered												108.43	108.43	30.23	0	100	0.2	0.2	45.5	150	15	34.8	15	15	15	15	15	15	15	15	15	0.2	0			0		0			0												14.5701	0.353508234	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	4.779706347	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7429		3.257187779	14.5701	0.353508234	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	4.779706347	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7429	2500																																																																																			0			14.5701	0.353508234	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	4.779706347	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7429
H5736_016_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V			0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0			0												0		1853.427064	39.12292551	1469.710191	2220.113124	255.8982033	10.83045795	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	5568.327931	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	14.05123891	0			0		0			0												0	0	"$0/day 1-10, $0/day 11-20, $0/day 21-100"	$0 per visit	$50 per trip	20% coinsurance	20% coinsurance	$0 per visit	$0 per procedure	$0 per visit	"$0 X-ray; 20% CAT, PET, MRI"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	20% coinsurance	0			0		0			Not Covered												0	0	0	0	50	0.2	0.2	0	0	0	2.9916	0	0	0	0	0	0	0	0	0	0.2	0			0		0			0												0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537		1.019250233	0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537	1000																																																																																			0			0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537
H5736_017_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V			0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0			0												0		1853.427064	39.12292551	1469.710191	2220.113124	255.8982033	10.83045795	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	5568.327931	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	14.05123891	0			0		0			0												0	0	"$0/day 1-10, $0/day 11-20, $0/day 21-100"	$0 per visit	$50 per trip	20% coinsurance	20% coinsurance	$0 per visit	$0 per procedure	$0 per visit	"$0 X-ray; 20% CAT, PET, MRI"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	20% coinsurance	0			0		0			Not Covered												0	0	0	0	50	0.2	0.2	0	0	0	2.9916	0	0	0	0	0	0	0	0	0	0.2	0			0		0			0												0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537		1.019250233	0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537	1000																																																																																			0			0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537
H5736_018_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V			0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0			0												0		1612.481546	39.12292551	1469.710191	2220.113124	255.8982033	13.04874451	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	4844.4453	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	16.9292035	0			0		0			0												$150/day 1-7	$150/day 1-7	"$0/day 1-10, $50/day 11-20, $100/day 21-100"	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $15 UC	$150 per procedure	$15 per visit	"$15 X-ray; $125 CAT, PET, MRI"	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	20% coinsurance	0			0		0			Not Covered												108.43	108.43	30.23	0	100	0.2	0.2	45.5	150	15	34.8	15	15	15	15	15	15	15	15	15	0.2	0			0		0			0												14.5701	0.353508234	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	4.779706347	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7429		3.257187779	14.5701	0.353508234	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	4.779706347	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7429	2500																																																																																			0			14.5701	0.353508234	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	4.779706347	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7429
H5736_019_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V			0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0			0												0		1853.427064	39.12292551	1469.710191	2220.113124	255.8982033	10.83045795	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	5568.327931	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	14.05123891	0			0		0			0												0	0	"$0/day 1-10, $0/day 11-20, $0/day 21-100"	$0 per visit	$50 per trip	20% coinsurance	20% coinsurance	$0 per visit	$0 per procedure	$0 per visit	"$0 X-ray; 20% CAT, PET, MRI"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	20% coinsurance	0			0		0			Not Covered												0	0	0	0	50	0.2	0.2	0	0	0	2.9916	0	0	0	0	0	0	0	0	0	0.2	0			0		0			0												0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537		1.019250233	0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537	1000																																																																																			0			0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537
H5736_020_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V			0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0			0												0		1612.481546	39.12292551	1469.710191	2220.113124	255.8982033	13.04874451	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	4844.4453	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	16.9292035	0			0		0			0												$150/day 1-7	$150/day 1-7	"$0/day 1-10, $50/day 11-20, $100/day 21-100"	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $15 UC	$150 per procedure	$15 per visit	"$15 X-ray; $125 CAT, PET, MRI"	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	20% coinsurance	0			0		0			Not Covered												108.43	108.43	30.23	0	100	0.2	0.2	45.5	150	15	34.8	15	15	15	15	15	15	15	15	15	0.2	0			0		0			0												14.5701	0.353508234	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	4.779706347	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7429		3.257187779	14.5701	0.353508234	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	4.779706347	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7429	2500																																																																																			0			14.5701	0.353508234	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	4.779706347	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7429
H5736_021_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V			0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0			0												0		1853.427064	39.12292551	1469.710191	2220.113124	255.8982033	10.83045795	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	5568.327931	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	14.05123891	0			0		0			0												0	0	"$0/day 1-10, $0/day 11-20, $0/day 21-100"	$0 per visit	$50 per trip	20% coinsurance	20% coinsurance	$0 per visit	$0 per procedure	$0 per visit	"$0 X-ray; 20% CAT, PET, MRI"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	20% coinsurance	0			0		0			Not Covered												0	0	0	0	50	0.2	0.2	0	0	0	2.9916	0	0	0	0	0	0	0	0	0	0.2	0			0		0			0												0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537		1.019250233	0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537	1000																																																																																			0			0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537
H5736_022_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V			0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0			0												0		1612.481546	39.12292551	1469.710191	2220.113124	255.8982033	13.04874451	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	4844.4453	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	16.9292035	0			0		0			0												$150/day 1-7	$150/day 1-7	"$0/day 1-10, $50/day 11-20, $100/day 21-100"	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $15 UC	$150 per procedure	$15 per visit	"$15 X-ray; $125 CAT, PET, MRI"	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	20% coinsurance	0			0		0			Not Covered												108.43	108.43	30.23	0	100	0.2	0.2	45.5	150	15	34.8	15	15	15	15	15	15	15	15	15	0.2	0			0		0			0												14.5701	0.353508234	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	4.779706347	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7429		3.257187779	14.5701	0.353508234	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	4.779706347	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7429	2500																																																																																			0			14.5701	0.353508234	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	4.779706347	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7429
H5736_023_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V			0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0			0												0		1853.427064	39.12292551	1469.710191	2220.113124	255.8982033	10.83045795	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	5568.327931	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	14.05123891	0			0		0			0												0	0	"$0/day 1-10, $0/day 11-20, $0/day 21-100"	$0 per visit	$50 per trip	20% coinsurance	20% coinsurance	$0 per visit	$0 per procedure	$0 per visit	"$0 X-ray; 20% CAT, PET, MRI"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	20% coinsurance	0			0		0			Not Covered												0	0	0	0	50	0.2	0.2	0	0	0	2.9916	0	0	0	0	0	0	0	0	0	0.2	0			0		0			0												0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537		1.019250233	0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537	1000																																																																																			0			0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537
H5736_024_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V			0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0			0												0		1853.427064	39.12292551	1469.710191	2220.113124	255.8982033	10.83045795	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	5568.327931	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	14.05123891	0			0		0			0												0	0	"$0/day 1-10, $0/day 11-20, $0/day 21-100"	$0 per visit	$50 per trip	20% coinsurance	20% coinsurance	$0 per visit	$0 per procedure	$0 per visit	"$0 X-ray; 20% CAT, PET, MRI"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	20% coinsurance	0			0		0			Not Covered												0	0	0	0	50	0.2	0.2	0	0	0	2.9916	0	0	0	0	0	0	0	0	0	0.2	0			0		0			0												0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537		1.019250233	0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537	1000																																																																																			0			0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537
H5736_025_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V			0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0			0												0		1612.481546	39.12292551	1469.710191	2220.113124	255.8982033	13.04874451	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	4844.4453	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	16.9292035	0			0		0			0												$185/day 1-7	$185/day 1-7	"$0/day 1-10, $50/day 11-20, $100/day 21-100"	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $15 UC	$185 per procedure	$15 per visit	"$15 X-ray; $125 CAT, PET, MRI"	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	20% coinsurance	0			0		0			Not Covered												133.73	133.73	30.23	0	100	0.2	0.2	45.5	185	15	34.8	15	15	15	15	15	15	15	15	15	0.2	0			0		0			0												17.9698	0.435992402	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	5.894971161	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3403		-1.340209796	17.9698	0.435992402	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	5.894971161	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3403	2500																																																																																			0			17.9698	0.435992402	3.702444922	0	2.132485027	2.609748903	0.195236437	1.771375097	5.894971161	3.125662883	3.67429585	0	0	0	6.055556625	9.039163601	0.270845617	0.794520308	1.285202616	1.997225633	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3403
H5736_026_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V			0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0			0												0		1853.427064	39.12292551	1469.710191	2220.113124	255.8982033	10.83045795	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	5568.327931	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	14.05123891	0			0		0			0												0	0	"$0/day 1-10, $0/day 11-20, $0/day 21-100"	$0 per visit	$50 per trip	20% coinsurance	20% coinsurance	$0 per visit	$0 per procedure	$0 per visit	"$0 X-ray; 20% CAT, PET, MRI"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	20% coinsurance	0			0		0			Not Covered												0	0	0	0	50	0.2	0.2	0	0	0	2.9916	0	0	0	0	0	0	0	0	0	0.2	0			0		0			0												0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537		1.019250233	0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537	1000																																																																																			0			0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537
H5736_027_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V			0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0			0												0		1853.427064	39.12292551	1469.710191	2220.113124	255.8982033	10.83045795	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	5568.327931	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	14.05123891	0			0		0			0												0	0	"$0/day 1-10, $0/day 11-20, $0/day 21-100"	$0 per visit	$50 per trip	20% coinsurance	20% coinsurance	$0 per visit	$0 per procedure	$0 per visit	"$0 X-ray; 20% CAT, PET, MRI"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	20% coinsurance	0			0		0			Not Covered												0	0	0	0	50	0.2	0.2	0	0	0	2.9916	0	0	0	0	0	0	0	0	0	0.2	0			0		0			0												0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537		1.019250233	0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537	1000																																																																																			0			0	0	0	0	1.066242514	2.166091589	0.195236437	0	0	0	0.315862743	0	0	0	0	0	0	0	0	0	2.810247782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5537
H5736_801_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0															0		1853.427064	39.12292551	1469.710191	2220.113124	255.8982033	13.04874451	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	5568.327931	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	16.9292035	0			0		0															$200/day 1-7	$200/day 1-7	$100/day 1-100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER; $40 UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance	0			0		0															144.57	144.57	100	40	150	0.3	0.3	48.7	200	40	19.1128	40	30	40	40	40	40	40	40	40	0.2	0			0		0															22.3292	0.471333445	12.24758492	7.400377079	3.198727541	3.914623354	0.292854656	1.895955323	6.372941796	8.33510102	2.017990854	0	0	0	18.5610931	24.10443627	0.722254978	2.118720821	3.427206975	5.325935022	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1221			22.3292	0.471333445	12.24758492	7.400377079	3.198727541	3.914623354	0.292854656	1.895955323	6.372941796	8.33510102	2.017990854	0	0	0	18.5610931	24.10443627	0.722254978	2.118720821	3.427206975	5.325935022	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1221																																																																																				0			22.3292	0.471333445	12.24758492	7.400377079	3.198727541	3.914623354	0.292854656	1.895955323	6.372941796	8.33510102	2.017990854	0	0	0	18.5610931	24.10443627	0.722254978	2.118720821	3.427206975	5.325935022	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1221
H5736_802_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0															0		1853.427064	39.12292551	1469.710191	2220.113124	255.8982033	13.04874451	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	5568.327931	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	16.9292035	0			0		0															$200/day 1-7	$200/day 1-7	$100/day 1-100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER; $40 UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance	0			0		0															144.57	144.57	100	40	150	0.3	0.3	48.7	200	40	19.1128	40	30	40	40	40	40	40	40	40	0.2	0			0		0															22.3292	0.471333445	12.24758492	7.400377079	3.198727541	3.914623354	0.292854656	1.895955323	6.372941796	8.33510102	2.017990854	0	0	0	18.5610931	24.10443627	0.722254978	2.118720821	3.427206975	5.325935022	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1221			22.3292	0.471333445	12.24758492	7.400377079	3.198727541	3.914623354	0.292854656	1.895955323	6.372941796	8.33510102	2.017990854	0	0	0	18.5610931	24.10443627	0.722254978	2.118720821	3.427206975	5.325935022	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1221																																																																																				0			22.3292	0.471333445	12.24758492	7.400377079	3.198727541	3.914623354	0.292854656	1.895955323	6.372941796	8.33510102	2.017990854	0	0	0	18.5610931	24.10443627	0.722254978	2.118720821	3.427206975	5.325935022	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1221
H5736_808_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0															0		1853.427064	39.12292551	1469.710191	2220.113124	255.8982033	13.04874451	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	5568.327931	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	16.9292035	0			0		0															$200/day 1-7	$200/day 1-7	$100/day 1-100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER; $40 UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance	0			0		0															144.57	144.57	100	40	150	0.3	0.3	48.7	200	40	19.1128	40	30	40	40	40	40	40	40	40	0.2	0			0		0															22.3292	0.471333445	12.24758492	7.400377079	3.198727541	3.914623354	0.292854656	1.895955323	6.372941796	8.33510102	2.017990854	0	0	0	18.5610931	24.10443627	0.722254978	2.118720821	3.427206975	5.325935022	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1221			22.3292	0.471333445	12.24758492	7.400377079	3.198727541	3.914623354	0.292854656	1.895955323	6.372941796	8.33510102	2.017990854	0	0	0	18.5610931	24.10443627	0.722254978	2.118720821	3.427206975	5.325935022	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1221																																																																																				0			22.3292	0.471333445	12.24758492	7.400377079	3.198727541	3.914623354	0.292854656	1.895955323	6.372941796	8.33510102	2.017990854	0	0	0	18.5610931	24.10443627	0.722254978	2.118720821	3.427206975	5.325935022	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1221
H5736_809_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	P	P	V	P	V	V	V	V	V	V	V	Coin	P			V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0															0		1853.427064	39.12292551	1469.710191	2220.113124	255.8982033	13.04874451	0.976182186	467.1758497	382.3765078	2500.530306	1266.998569	0	0	0	5568.327931	7231.330881	216.6764934	635.6162464	1028.162093	1597.780507	16.9292035	0			0		0															$200/day 1-7	$200/day 1-7	$100/day 1-100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER; $40 UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance	0			0		0															144.57	144.57	100	40	150	0.3	0.3	48.7	200	40	19.1128	40	30	40	40	40	40	40	40	40	0.2	0			0		0															22.3292	0.471333445	12.24758492	7.400377079	3.198727541	3.914623354	0.292854656	1.895955323	6.372941796	8.33510102	2.017990854	0	0	0	18.5610931	24.10443627	0.722254978	2.118720821	3.427206975	5.325935022	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1221			22.3292	0.471333445	12.24758492	7.400377079	3.198727541	3.914623354	0.292854656	1.895955323	6.372941796	8.33510102	2.017990854	0	0	0	18.5610931	24.10443627	0.722254978	2.118720821	3.427206975	5.325935022	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1221																																																																																				0			22.3292	0.471333445	12.24758492	7.400377079	3.198727541	3.914623354	0.292854656	1.895955323	6.372941796	8.33510102	2.017990854	0	0	0	18.5610931	24.10443627	0.722254978	2.118720821	3.427206975	5.325935022	3.385840701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1221
H5746_006_0	2008	5																					0											Coin	Coin	Coin	V	T	O	O	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	283.6546	22.23825	84.67	0	0	0	0	10.5	19.9	16.46	28.36	0.94	1.11	52.97	0	0	0	0	0	0	8.98	3.53	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Medicare FFS cost sharing	1B IP Psych: Medicare FFS cost sharing	2 SNF: Medicare FFS cost sharing	6 Home Health: $0	10A Ambulance: Medicare FFS cost sharing	11A DME: Medicare FFS cost sharing	"11B Prosthetic/Medical Supplies: Medicare FFS cost sharing, 11C Diabetes Monitoring Supplies: Medicare FFS cost sharing"	"4A ER: Medicare FFS cost sharing, 4B Urgent Care: Medicare FFS cost sharing"	9B ASC Services: Medicare FFS cost sharing	8A OP C/D/T: Medicare FFS cost sharing	8B OP X-Ray: Medicare FFS cost sharing	9A OP Hospital: Medicare FFS cost sharing	12 Renal Dialysis: Medicare FFS cost sharing	"3 CORF: Medicare FFS cost sharing, 5 Partial Hosp: Medicare FFS cost sharing, 9C OP Substance Abuse: Medicare FFS cost sharing, 9D Cardiac Rehab: Medicare FFS cost sharing"	"7A PCP: Medicare FFS cost sharing, 14B Immunizations: Medicare FFS cost sharing, 14C Routine Physical Exams: Medicare FFS cost sharing, 14D Pap Smears: Medicare FFS cost sharing, 14D Pelvic Exams: Medicare FFS cost sharing, 14E Prostate Screening: Medicare FFS cost sharing, 14F Colorectal Screening: Medicare FFS cost sharing, 14G Bone Mass Measurement: Medicare FFS cost sharing, 14H Mammography: Medicare FFS cost sharing, 14I Diabetes Monitoring: Medicare FFS cost sharing"	"7D Physician Specialist: Medicare FFS cost sharing,"	"7E Mental Health: Medicare FFS cost sharing, 7H Psychiatric: Medicare FFS cost sharing"	"7C Occupational Therapy: Medicare FFS cost sharing, 7I Physical and Speech Therapy: Medicare FFS cost sharing"	7D Physician Specialist: Medicare FFS cost sharing	"7B Chiropractic: Medicare FFS cost sharing, 7F Podiatry: Medicare FFS cost sharing, 7G Other Health Care: Medicare FFS cost sharing, 18A Medicare Covered Hearing Exams: Medicare FFS cost sharing"	15 Part B Drugs: Medicare FFS cost sharing	"13A Blood: Medicare FFS cost sharing, 16B Medicare Covered Comprehensive Dental Services: Medicare FFS cost sharing, 17A Medicare Covered Eye Exams: Medicare FFS cost sharing"	10B Transportation: $0	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental:Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.074299605	0.074313434	0.191014557	0	0	0	0	0.233957611	0.233993911	0.233876746	0.234029337	0.234006809	0.23400232	0.234009388	0	0	0	0	0	0	0.234028894	0.031154065	0	0	0	0	0	0	0	0	0											21.0754	1.652600724	16.1732025	0	0	0	0	2.456554917	4.656478833	3.849611233	6.637072	0.2199664	0.259742575	12.3954773	0	0	0	0	0	0	2.101579467	0.10997385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5877	0	0	21.0754	1.652600724	16.1732025	0	0	0	0	2.456554917	4.656478833	3.849611233	6.637072	0.2199664	0.259742575	12.3954773	0	0	0	0	0	0	2.101579467	0.10997385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.0754	1.652600724	16.1732025	0	0	0	0	2.456554917	4.656478833	3.849611233	6.637072	0.2199664	0.259742575	12.3954773	0	0	0	0	0	0	2.101579467	0.10997385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5877
H5746_007_0	2008	8																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	543.36	7.5	595.3536	0	228.28	15.6	9.5	371.96	364.24	0	1692.69	48.66	0.75	952.34	4516.99	5082.52	147.69	407.67	1853.69	1355.91	501.21	603.84	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute:   $50   for 1st 5   Days	1B IP Psych:   $50   for 1st 5   Days	2 SNF:   $50   for Days 7   - 100	6 Home Health:   $0	10A Ambulance:     $75	11A DME:     20%	"11B Prosthetic Medical Supplies:      20%,  11C Diabetes Monitoring Supplies:     20%"	"4A ER:     $50,  4B Urgent Care:     $25"	9B ASC Services:     $100	8A OP Clinical/Diagnostic/Therapy Radiological Lab Services:      $0	8B OP X-Ray:     $17.2	"5 Partial Hospitalization:     $100,  9A OP Hospital,  $100"	12 Renal Dialysis:      $20	"3 CORF ,  100,  9D Cardiac Rehab:     $20"	"7A PCP:     $5,  14B Immunizations:     $0,  14C Routine Physical Exams:     $0,  14D Pap Smears:      $,  14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement:      $16,  14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist:     $20	"7E Mental Health:     $20,  7H Psychiatric:     $20,  9C OP Substance Abuse,  20"	"7C Occupational Therapy:     $20,  7I Physical and Speech Therapy:     $20"	7D Physician Specialist Services - Radiology:   16	"7G Other Health Care:     $20,  18A Medicare Covered Hearing Exams:   $20,  7B Chiropractic:     $20,  7F Podiatry:     $20"	15 Part B Drugs:     $100	"13A Blood:     $100,  16B Medicare Covered Comprehensive Dental Services:     $20,  17A Medicare Covered Eye Exams:   $20"	10B Transportation:     Not Covered	"16A Preventive Dental Services:   $0,  16B Non Medicare Covered Comprehensive Dental:   $0"	17A Routine Eye Exams:    $0	17B Eye Wear: $0	18A Routine Hearing Exams:   $0	18B Hearing Aids:   $0	19 POS:   $0	14A Health Education/Wellness Programs:   $0	13B Acupuncture: Not Covered											50	50	50	0	75	0.20000039	0.200653611	49.10070975	100	0	17.2	100	20	88.55787316	5	20	20	20	16	20	73.8	22.81928988	0	0	0	0	0	0	0	0	0											2.264	0.03125	2.48064	0	1.42675	3.120006083	1.9062093	1.521958333	3.035333333	0	2.426189	0.4055	0.00125	7.028100411	1.882079167	8.470866667	0.24615	0.67945	2.471586667	2.25985	3.0824415	1.148266667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8879	0	0	2.264	0.03125	2.48064	0	1.42675	3.120006083	1.9062093	1.521958333	3.035333333	0	2.426189	0.4055	0.00125	7.028100411	1.882079167	8.470866667	0.24615	0.67945	2.471586667	2.25985	3.0824415	1.148266667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.264	0.03125	2.48064	0	1.42675	3.120006083	1.9062093	1.521958333	3.035333333	0	2.426189	0.4055	0.00125	7.028100411	1.882079167	8.470866667	0.24615	0.67945	2.471586667	2.25985	3.0824415	1.148266667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8879
H5749_001_0	2008	6																					3200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1983.006729	146.2301918	949.8781665		123.7923441	13.82776052	2.649583035	482.4238263	34.0255809	10231.33088	48.90691002		0.395665033	31.35377318	4381.12649	4452.729708	510.3400723	1.936870611			24.68772209	893.8774935			122.4		14.32602104															$175 (1a); $0 (1a1)	$175 (1b)	"$125 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$5 (4b)"	20% (9b)	20% (8a1); $0/$20 (8a2)	"$20 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	30% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											107.2065	107.2065	76.576		107.2065	0.183782517	0.282586406	30.6304	0.122521678	4.9009	0.072603549		0.183782517	0.122480594	5	29.927	37.5	0.122521678			0.183782517	30			30		30															17.7159	1.306401868	6.061493065	0	1.105945001	2.541300632	0.748736146	1.231403681	4.168871267	4.178532759	3.550815231	0	0.072716316	3.840228764	1.825469371	11.1047461	1.594812726	0.237308637	0	0	4.537171705	2.234693734	0	0	0.306	0	0.035815053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.3984	0	32.00971045	17.7159	1.306401868	6.061493065	0	1.105945001	2.541300632	0.748736146	1.231403681	4.168871267	4.178532759	3.550815231	0	0.072716316	3.840228764	1.825469371	11.1047461	1.594812726	0.237308637	0	0	4.537171705	2.234693734	0	0	0.306	0	0.035815053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.3984		$250 (1a); $0 (1a1)	$250 (1b)	"$175 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	30% (9b)	30% (8a1); $0/$25 (8a2)	"$25 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$10/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											3.5924	0.2649	4.6175	0.7378	0.4513	1.0371	0.1987	0.5025	2.5519	2.1315	2.1326		0.0297	2.35	0.9396	2.28	0.319	0.1025			1.307	0.4684			0.063		0.0074															26.0849	0	0	21.3083	1.571311636	10.67895637	0.737758381	1.557271255	3.578382671	0.947454874	1.7339285	6.720789835	6.310060025	5.683402849	0	0.102391193	6.190250072	2.765093997	13.38476395	1.913775271	0.339848846	0	0	5.844168756	2.703128841	0	0	0.369	0	0.04318874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.4833
H5749_801_0	2008	3																					4600											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2263.214202	166.8931537	1329.829433		162.4774517	18.14893568	3.477577734	633.161272	44.65857494	13428.62178	64.1903194		0.519310355	41.15182729	5405.429782	5499.480816	630.4200893	2.392604873			30.49659787	1104.20161			144		16.8541424															$450 (1a); $0 (1a1)	$450 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											254.5259	254.5259	84.842		98.9823	0.169683911	0.280473923	28.2807	0.141403259	3.3937	0.079999339		0.169683911	0.141340788	25	34.8237	37.5	0.141403259			0.169683911	35			35		35															48.0039	3.539885377	9.40211079	0	1.340199069	3.079582384	0.97536987	1.492184456	6.31486804	3.797701768	5.135183124	0	0.088118612	5.816431705	11.26131205	15.95934273	1.970062779	0.338322127	0	0	5.174781995	3.220588028	0	0	0.42	0	0.049157915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.3791	0	71.891133	48.0039	3.539885377	9.40211079	0	1.340199069	3.079582384	0.97536987	1.492184456	6.31486804	3.797701768	5.135183124	0	0.088118612	5.816431705	11.26131205	15.95934273	1.970062779	0.338322127	0	0	5.174781995	3.220588028	0	0	0.42	0	0.049157915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.3791																																																																																				0			48.0039	3.539885377	9.40211079	0	1.340199069	3.079582384	0.97536987	1.492184456	6.31486804	3.797701768	5.135183124	0	0.088118612	5.816431705	11.26131205	15.95934273	1.970062779	0.338322127	0	0	5.174781995	3.220588028	0	0	0.42	0	0.049157915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.3791
H5749_802_0	2008	3																					4600											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2263.214202	166.8931537	1329.829433		162.4774517	18.14893568	3.477577734	633.161272	44.65857494	13428.62178	64.1903194		0.519310355	41.15182729	5405.429782	5499.480816	630.4200893	2.392604873			30.49659787	1104.20161			144		16.8541424															$450 (1a); $0 (1a1)	$450 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											254.5259	254.5259	84.842		98.9823	0.169683911	0.280473923	28.2807	0.141403259	3.3937	0.079999339		0.169683911	0.141340788	25	34.8237	37.5	0.141403259			0.169683911	35			35		35															48.0039	3.539885377	9.40211079	0	1.340199069	3.079582384	0.97536987	1.492184456	6.31486804	3.797701768	5.135183124	0	0.088118612	5.816431705	11.26131205	15.95934273	1.970062779	0.338322127	0	0	5.174781995	3.220588028	0	0	0.42	0	0.049157915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.3791	0	71.891133	48.0039	3.539885377	9.40211079	0	1.340199069	3.079582384	0.97536987	1.492184456	6.31486804	3.797701768	5.135183124	0	0.088118612	5.816431705	11.26131205	15.95934273	1.970062779	0.338322127	0	0	5.174781995	3.220588028	0	0	0.42	0	0.049157915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.3791																																																																																				0			48.0039	3.539885377	9.40211079	0	1.340199069	3.079582384	0.97536987	1.492184456	6.31486804	3.797701768	5.135183124	0	0.088118612	5.816431705	11.26131205	15.95934273	1.970062779	0.338322127	0	0	5.174781995	3.220588028	0	0	0.42	0	0.049157915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.3791
H5750_001_0	2008	3																					1750											A	A	A	P	T	Coin	Coin	V	V	V	V	P	P	O	V	V	V	P	P	P	O	O	T	P	V	Coin	V	P	O	O	O																																																				0	1750	218.5854231	11.67132852	39.3948301	0	537.2289518	21.7	1.16	248.8196199	171.5222747	281.4102074	493.9109792	0	0	174.9343683	5483.072668	545.0796468	442.7935366	181.3619728	0	0	0	0	0	0	521.7150917	0	260.8575459	0	0	0	0											$250 per admit	$250 per admit	$250 per admit		$50 per trip	20% of cost	20% of cost	$50 per ER visit	$50 per OP surgical visit	$50 per lab visit	$50 per radiology visit			$50 per visit	$10 per office visit	$10 per office visit	$10 per specialist office visit	$10 per specialist office visit							$10 per visit		$10 per visit															250	250	250	0	50	0.19	0.19	50	50	50	50	0	0	50	10	10	10	10	0	0	0	0	0	0	10	0	10	0	0	0	0											4.5539	0.243152678	0.820725627	0	2.238453966	4.123	0.2204	1.036748416	0.714676145	1.172542531	2.057962413	0	0	0.728893201	4.569227224	0.454233039	0.368994614	0.151134977	0	0	0	0	0	0	0.434762576	0	0.217381288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.1062		0.01	4.5539	0.243152678	0.820725627	0	2.238453966	4.123	0.2204	1.036748416	0.714676145	1.172542531	2.057962413	0	0	0.728893201	4.569227224	0.454233039	0.368994614	0.151134977	0	0	0	0	0	0	0.434762576	0	0.217381288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.1062	1750																																																																																			0		0.01	4.5539	0.243152678	0.820725627	0	2.238453966	4.123	0.2204	1.036748416	0.714676145	1.172542531	2.057962413	0	0	0.728893201	4.569227224	0.454233039	0.368994614	0.151134977	0	0	0	0	0	0	0.434762576	0	0.217381288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.1062
H5750_002_0	2008	3																					2700											A	A	A	P	T	Coin	Coin	V	V	V	V	P	P	O	V	V	V	P	P	P	O	O	T	P	V	Coin	V	P	O	O	O																																																				0	2700	218.5738471	11.67071043	39.39274381	0	537.2005009	21.7	1.16	248.8064428	171.5131911	281.3953043	493.8848224	0	0	55.86332707	5482.782293	545.0507801	442.7700868	181.3523681	0	0	0	0	0	0	521.6874624	0	260.8437312	0	0	0	0											$100 per admit	$100 per admit	$100 per admit		$50 per trip	20% of cost	20% of cost	$50 per ER visit	$50 per OP surgical visit	$15 per lab visit	$15 per radiology visit			$15 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit							$10 per visit		$10 per visit															100	100	100	0	50	0.19	0.19	50	50	15	15	0	0	15	10	10	10	10	0	0	0	0	0	0	10	0	10	0	0	0	0											1.8214	0.09725592	0.328272865	0	2.238335421	4.123	0.2204	1.036693512	0.714638296	0.35174413	0.617356028	0	0	0.069829159	4.568985244	0.454208983	0.368975072	0.151126973	0	0	0	0	0	0	0.434739552	0	0.217369776	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8144		0.01	1.8214	0.09725592	0.328272865	0	2.238335421	4.123	0.2204	1.036693512	0.714638296	0.35174413	0.617356028	0	0	0.069829159	4.568985244	0.454208983	0.368975072	0.151126973	0	0	0	0	0	0	0.434739552	0	0.217369776	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8144	2700																																																																																			0			1.8214	0.09725592	0.328272865	0	2.238335421	4.123	0.2204	1.036693512	0.714638296	0.35174413	0.617356028	0	0	0.069829159	4.568985244	0.454208983	0.368975072	0.151126973	0	0	0	0	0	0	0.434739552	0	0.217369776	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8144
H5750_003_0	2008	4																					1750											A	A	A	P	T	Coin	Coin	V	V	V	P	P	P	O	V	V	V	P	P	P	O	O	T	P	V	Coin	V	P	O	O	O																																																				0	1750	213.2587798	11.38691338	38.43482918	0	498.8308388	20.15	1.08	242.7562084	167.3424993	274.5526055	481.8750091	0	0	170.6714446	5091.17338	506.1204101	411.1451375	168.399236	0	0	0	0	0	0	484.4258224	0	242.2129112	0	0	0	0											$250 per admit	$250 per admit	$250 per admit		$50 per trip	20% of cost	20% of cost	$50 per ER visit	$100 per OP surgical visit	$50 per lab visit	$50 per radiology visit			$50 per visit	$25 per office visit	$25 per office visit	$25 per office visit	$25 per office visit							$25 per visit		$25 per visit															250	250	250	0	50	0.19	0.19	50	100	50	50	0	0	50	25	25	25	25	0	0	0	0	0	0	25	0	25	0	0	0	0											4.4429	0.237227362	0.800725608	0	2.078461828	3.8285	0.2052	1.011484202	1.394520827	1.14396919	2.007812538	0	0	0.711131019	10.60661121	1.054417521	0.85655237	0.350831742	0	0	0	0	0	0	1.009220463	0	0.504610232	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.2442		0.01	4.4429	0.237227362	0.800725608	0	2.078461828	3.8285	0.2052	1.011484202	1.394520827	1.14396919	2.007812538	0	0	0.711131019	10.60661121	1.054417521	0.85655237	0.350831742	0	0	0	0	0	0	1.009220463	0	0.504610232	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.2442	1750																																																																																			0		0.01	4.4429	0.237227362	0.800725608	0	2.078461828	3.8285	0.2052	1.011484202	1.394520827	1.14396919	2.007812538	0	0	0.711131019	10.60661121	1.054417521	0.85655237	0.350831742	0	0	0	0	0	0	1.009220463	0	0.504610232	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.2442
H5750_004_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		718.4828746		133.0463071	30.70605009	29.49319242	54.66325423		15.9662021	54.5732074	213.7434761					291.6618507						18.76433188	0.910786869																				Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare	Same As Medicare											0.0788		0.1512	0	0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				56.6165	0	20.11660163	0	6.901407025	12.79120149	0	3.736091293	12.77013053	50.0159734	0	0	0	0	68.24887306	0	0	0	0	0	4.390853659	0.213124127	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	235.8007			56.6165	0	20.11660163	0	6.901407025	12.79120149	0	3.736091293	12.77013053	50.0159734	0	0	0	0	68.24887306	0	0	0	0	0	4.390853659	0.213124127	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	235.8007																																																																																				0			56.6165	0	20.11660163	0	6.901407025	12.79120149	0	3.736091293	12.77013053	50.0159734	0	0	0	0	68.24887306	0	0	0	0	0	4.390853659	0.213124127	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	235.8007
H5754_001_0	2008	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							12.77048132	9.961302581	581.8933051	406.7036127		243.7652148	51.53240584		1523.589413	356.7468192	2120.247484	210.9963918	71.51578424				1227.299134		821.9323512	337.0787762		315.7256588				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/visit Tier 1, $20/visit Tier 2 + Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b)$20/visit, (7d) $0/visit Tier 1, $20/visit Tier 2, (7f)0"	"(7e) $0/visit Tier 1, $20/visit Tier 2, (7h)$20/visit"	"(7c,i)$0/visit Tier 1, $20 visit Tier 2"		"(7g) $0/ visit Tier 1, $20/visit Tier 2"	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.182164768	0.182164768	35.9775	45.5412		18.2165	45.5412		45.4989	18.2165	18.2165	18.2165	18.2165				18.2165		20	20		19.9999				20											0	0	0	0	0	2.326331762	1.81459837	1.744590883	1.543480606	0	0.370045281	0.195570599	0	5.776805928	0.541555845	3.218619918	0.320300906	0.108563802	0	0	0	1.863088847	0	1.369887252	0.56179796	0	0.526207682	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	23.2215	0	1.940869211	0	0	0	0	0	2.326331762	1.81459837	1.744590883	1.543480606	0	0.370045281	0.195570599	0	5.776805928	0.541555845	3.218619918	0.320300906	0.108563802	0	0	0	1.863088847	0	1.369887252	0.56179796	0	0.526207682	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	23.2215		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.1365	0.0251	0.4886	0.2463	0.107	0.0782	0.061	0.0391	0.263	0.08	0.2681	0.0287	0.002	0.2364	0.0387	0.205	0.0128	0.0384			0.1372	0.0614			0.0066		0.0078															4.5681	0	0	2.1365	0.025099878	0.488562829	0.246307296	0.107047153	2.404518383	1.875585937	1.783680654	1.806523897	0.080020922	0.638188112	0.224258055	0.002036119	6.01317939	0.580294718	3.423585608	0.333143401	0.147009292	0	0	0.137211633	1.924464052	0	1.369887252	0.568429071	0	0.534050367	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	27.7896
H5754_002_0	2008	3																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							12.72948661	9.923366134	581.4072981	406.1548458		243.533499	51.46512331		1519.481737	356.1007104	2116.36055	210.6562589	71.39844434				1225.379939		821.9323512	337.0787762		315.7256357				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/visit Tier 1, $20/visit Tier 2 + Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b)$20/visit, (7d) $0/visit Tier 1, $20/visit Tier 2, (7f)0"	"(7e) $0/visit Tier 1, $20/visit Tier 2, (7h)$20/visit"	"(7c,i)$0/visit Tier 1, $20 visit Tier 2"		"(7g) $0/ visit Tier 1, $20/visit Tier 2"	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.182213643	0.182213643	35.9872	45.5534		18.2214	45.5534		45.511	18.2214	18.2214	18.2214	18.2214				18.2214		20	20		19.9999				20											0	0	0	0	0	2.319486134	1.808172698	1.743601463	1.541811546	0	0.369792718	0.195367659	0	5.762766552	0.540720065	3.213581387	0.31987037	0.108414756	0	0	0	1.860674526	0	1.369887252	0.56179796	0	0.526207651	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	23.1822	0	1.931195781	0	0	0	0	0	2.319486134	1.808172698	1.743601463	1.541811546	0	0.369792718	0.195367659	0	5.762766552	0.540720065	3.213581387	0.31987037	0.108414756	0	0	0	1.860674526	0	1.369887252	0.56179796	0	0.526207651	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	23.1822		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.1303	0.025	0.4873	0.2454	0.1068	0.0779	0.0608	0.0391	0.2622	0.0799	0.2678	0.0286	0.002	0.2358	0.0387	0.2043	0.0128	0.0383			0.1367	0.0612			0.0066		0.0078															4.5553	0	0	2.1303	0.025020443	0.487322876	0.24537981	0.106827645	2.397421766	1.868928001	1.782658586	1.80400026	0.079883224	0.637576719	0.223999777	0.002030962	5.998534017	0.579370547	3.417914144	0.332672875	0.146745624	0	0	0.136684396	1.921890838	0	1.369887252	0.568429071	0	0.534050334	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	27.7376
H5754_003_0	2008	4	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						500	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	P	P	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T		V	P	V	P				V	P	V	V	V																																															0		1772.900436	132.3202178	10962.91544	522.0671743	488.1264213	2845.366462	29.37882386	238.5970802	131.7821796	4252.69729	256.2431271	33.22713076	9.949366838	400.2752751	117.3495181	1304.065997	2260.841987	7.268448324		428.4838927	346.3251753	931.910891	1817.255		287.28	278.16		95.475				210.8139426	0.563171708		234.745	287.945						(1a) $25/day	(1b) $25/day	(2a) $0/day	(6a) $0/proc	(10a) $50/trip	(11a) $0/proc	(11a/11c) $0/proc	(4a) $50/visit (waived if admitted)	(9a/9b) $0/visit	(8a) $0/visit	(8b) $0/visit	(9a) $0/visit	(12) $0/proc	(9a) $0/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $0/visit	(7e/7h) $0/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $0/visit	(15) $0/proc	(Misc. PBP Cats) $0/visit	(10b) $0/trip		(17a1) $0/visit	(17b2) $0/proc	(18a) $0/visit	(18b) $0/proc				(4b) $20/visit (waived if admitted)	(9c) $0/proc 75%/25% Ind/Grp Blended Copay	(9d) $0/visit	(7f1) $0/visit	(18a1) $0/visit						23.3765	23.3765			46.753			46.753																								18.7012										3.4537	0.257765069	0	0	1.901779525	0	0	0.929593282	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.328539183	0	0	0	0	0	0	0	0	0	6.8714		0.477222944	3.4537	0.257765069	0	0	1.901779525	0	0	0.929593282	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.328539183	0	0	0	0	0	0	0	0	0	6.8714		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					20	0.3	0.3	0.3	0.3						2.1477	0.0501	1.2569	0.2774	0.6028	0.6724	0.004	0.0523	0.1672	1.0705	0.795	0.0524	0.0144	0.1905	0.0098	1.7542	0.2312	0.0025		0.1826		0.1325	0.1433		0.0146							0.0185			0.0131	0.0185						9.8743		0	5.6014	0.30789171	1.256896886	0.277358995	2.504569951	0.672433025	0.004022047	0.981917203	0.167246222	1.070498669	0.794981529	0.052381452	0.01438062	0.19049838	0.009786859	1.754229775	0.231205413	0.002511736	0	0.182607205	0	0.132472666	0.14325	0	0.01455	0	0	0	0	0	0	0.347031635	0	0	0.01305	0.01845	0	0	0	0	0	16.7456
H5754_004_0	2008	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0								25.8629081	526.3270561	533.0919858		194.5214308	88.28871767		2925.594847	476.9878345	3177.175765	540.1513314	90.02204701				0.098250246		821.9323512			240.9341733				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)0	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3,9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/visit Tier 1, $20/visit Tier 2 + Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b)$20/visit, (7d) $0/visit Tier 1, $20/visit Tier 2, (7f)0"	"(7e) $0/visit Tier 1, $20/visit Tier 2, (7h)$20/visit"	"(7c,i)$0/visit Tier 1, $20 visit Tier 2"		"(7g) $0/ visit Tier 1, $20/visit Tier 2"	(15) 0	"(13a,14a,17a,b)0, (16b)$20/visit"	(10b)0	(16a)$20/visit	(17a)0	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																	0.174719508	34.5071	43.6799		17.472	43.6799		43.6247	17.472	17.472	17.472	17.472				17.472		20			19.999				20											0	0	0	0	0	0	4.518754574	1.513501819	1.940449362	0	0.283222405	0.321370027	0	10.63569022	0.694492331	4.625954882	0.786458123	0.131071731	0	0	0	0.000143052	0	1.369887252	0	0	0.401536977	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	28.1626	0	3.682588451	0	0	0	0	0	0	4.518754574	1.513501819	1.940449362	0	0.283222405	0.321370027	0	10.63569022	0.694492331	4.625954882	0.786458123	0.131071731	0	0	0	0.000143052	0	1.369887252	0	0	0.401536977	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	28.1626		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															3.0537	0.0732	0.3778	0.3648	0.0933	0.1796	0.1583	0.0302	0.4	0.062	0.1627	0.0325	0.0057	0.2791	0.0286	0.2746	0.0345	0.0443			0.245	0.0509			0.0066		0.006															5.9636	0	0	3.0537	0.07322871	0.377777237	0.364827914	0.093302848	0.179567059	4.677098909	1.543721481	2.340497796	0.062031364	0.445934157	0.353869005	0.005748754	10.91477546	0.723085984	4.900510353	0.820932456	0.175393125	0	0	0.244961926	0.051084629	0	1.369887252	0.006631111	0	0.407524413	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	34.1262
H5756_001_0	2008	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		350.1046169	41.13000512	40.25390561		15.77429394	23.1911185	19.90435286	28.223491	39.67031388	11.21205035	20.23258876	3.024491121	3.242233726	38.55313978	47.20678149	110.2042785	17.94840819	4.099182559	28.54991694	8.482707325	19.67622633	6.769842315																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.0722	0.0722	0.1738		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				25.2776	2.96958637	6.996128796	0	3.691184782	5.42672173	4.657618569	6.604296893	9.282853448	2.623619782	4.73442577	0.707730922	0.758682692	9.021434709	11.04638687	25.78780116	4.199927516	0.959208719	6.680680565	1.984953514	4.604236961	1.584143102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.5992	0	0	25.2776	2.96958637	6.996128796	0	3.691184782	5.42672173	4.657618569	6.604296893	9.282853448	2.623619782	4.73442577	0.707730922	0.758682692	9.021434709	11.04638687	25.78780116	4.199927516	0.959208719	6.680680565	1.984953514	4.604236961	1.584143102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.5992																																																																																				0	0	0	25.2776	2.96958637	6.996128796	0	3.691184782	5.42672173	4.657618569	6.604296893	9.282853448	2.623619782	4.73442577	0.707730922	0.758682692	9.021434709	11.04638687	25.78780116	4.199927516	0.959208719	6.680680565	1.984953514	4.604236961	1.584143102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.5992
H5760_001_0	2008	2																																D	D	D	V	T	P	P	V	V	P	P	P	P	P	V	V	V	V	P	P	S	P	T	V	P	P	P	P	Coin	P	P																																																				0									851.9668401							17043.09851	6834.630504													13.62522701																				$25 ER/'$25 Urgent Care							$2 per visit	$5 per visit													20% Coinsurance																				25							2	5													0.824918525													0	0	0	0	0	0	0	1.774930917	0	0	0	0	0	0	2.840516418	2.84776271	0	0	0	0	0	0	0	0	0	0	0	0	11.23970217	0	0	0	0	0	0	0	0	0	0	0	0	18.7029	0	0	0	0	0	0	0	0	0	1.774930917	0	0	0	0	0	0	2.840516418	2.84776271	0	0	0	0	0	0	0	0	0	0	0	0	11.23970217	0	0	0	0	0	0	0	0	0	0	0	0	18.7029																																																																																				0	0	0	0	0	0	0	0	0	0	1.774930917	0	0	0	0	0	0	2.840516418	2.84776271	0	0	0	0	0	0	0	0	0	0	0	0	11.23970217	0	0	0	0	0	0	0	0	0	0	0	0	18.7029
H5760_002_0	2008	4																																D	D	D	V	T	P	P	V	V	P	P	P	P	P	V	V	V	V	P	P	S	P	T	V	P	P	P	P	Coin	P	P																																																				0									856.1053649							17127.61279	6871.839826													13.69841987																				$25 ER/'$25 Urgent Care							$2 per visit	$5 per visit													20% Coinsurance																				25							2	5													0.824925584													0	0	0	0	0	0	0	1.783552844	0	0	0	0	0	0	2.854602131	2.863266594	0	0	0	0	0	0	0	0	0	0	0	0	11.30017702	0	0	0	0	0	0	0	0	0	0	0	0	18.8016	0	0	0	0	0	0	0	0	0	1.783552844	0	0	0	0	0	0	2.854602131	2.863266594	0	0	0	0	0	0	0	0	0	0	0	0	11.30017702	0	0	0	0	0	0	0	0	0	0	0	0	18.8016																																																																																				0	0	0	0	0	0	0	0	0	0	1.783552844	0	0	0	0	0	0	2.854602131	2.863266594	0	0	0	0	0	0	0	0	0	0	0	0	11.30017702	0	0	0	0	0	0	0	0	0	0	0	0	18.8016
H5760_003_0	2008	3																																D	D	D	V	T	P	P	V	V	P	P	P	P	P	V	V	V	V	P	P	S	P	T	V	P	P	P	P	Coin	P	P																																																				0									822.6452079							16450.12481	6583.946563													13.10183528																				$25 ER/'$25 Urgent Care							$2 per visit	$5 per visit													20% Coinsurance																				25							2	5													0.824802314													0	0	0	0	0	0	0	1.713844183	0	0	0	0	0	0	2.741687469	2.743311068	0	0	0	0	0	0	0	0	0	0	0	0	10.80642405	0	0	0	0	0	0	0	0	0	0	0	0	18.0053	0	0	0	0	0	0	0	0	0	1.713844183	0	0	0	0	0	0	2.741687469	2.743311068	0	0	0	0	0	0	0	0	0	0	0	0	10.80642405	0	0	0	0	0	0	0	0	0	0	0	0	18.0053																																																																																				0	0	0	0	0	0	0	0	0	0	1.713844183	0	0	0	0	0	0	2.741687469	2.743311068	0	0	0	0	0	0	0	0	0	0	0	0	10.80642405	0	0	0	0	0	0	0	0	0	0	0	0	18.0053
H5760_004_0	2008	6																																D	D	D	V	T	P	P	V	V	P	P	P	P	P	V	V	V	V	P	P	S	P	T	V	P	P	P	P	Coin	P	P																																																				0		1952.574327	455.3263788			289.5157334	3146.802804	2506.313403	376.1200204	204.544146	13999.60443	5266.67137			143.5120107	3893.274314	3768.769945	1822.03004	1024.852836				576.1715523		1000	144		249.0840309															$25 Copay	$25 Copay			$25 Copay	$3 Copay	$3 Copay	(ER) - $25; (UC) - $15	$15 Copay	$3 Copay	$3 Copay			"3 (CORF) -$2, 5 (Partial Hospital) - $5, 7i, 7c (OP PT/ST/OT)-$5, 9c (OP SA) -$5, 9d (Cardiac Rehab) - $2"	$2 Copay	$5 Copay	$5 Copay	$2 Copay		$5 Copay		$3 Copay		$3 Copay	$3 Copay		$3 Copay															25	25			25	3	3	25	15	3	3			2.364	2.1736	5	5	2				3		3	3		3															4.0679	0.948596623	0	0	0.603157778	0.786700701	0.626578351	0.783583376	0.255680183	3.499901107	1.316667842	0	0	0.028271651	0.705188124	1.570320811	0.759179183	0.170808806	0	0	0	0.144042888	0	0.25	0.036	0	0.062271008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.6148	0	0	4.0679	0.948596623	0	0	0.603157778	0.786700701	0.626578351	0.783583376	0.255680183	3.499901107	1.316667842	0	0	0.028271651	0.705188124	1.570320811	0.759179183	0.170808806	0	0	0	0.144042888	0	0.25	0.036	0	0.062271008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.6148																																																																																				0	0	0	4.0679	0.948596623	0	0	0.603157778	0.786700701	0.626578351	0.783583376	0.255680183	3.499901107	1.316667842	0	0	0.028271651	0.705188124	1.570320811	0.759179183	0.170808806	0	0	0	0.144042888	0	0.25	0.036	0	0.062271008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.6148
H5760_005_0	2008	7																																D	D	D	V	T	P	P	V	V	P	P	P	P	P	V	V	V	V	P	P	S	P	T	V	P	P	P	P	Coin	P	P																																																				0		2196.644019	512.241687			289.5154569	3146.799799	2506.311009	376.1196612	204.5439507	14241.15496	5383.390143			143.9363725	3987.648355	3857.851092	1863.919096	1048.778176				590.3002179		1000	144		249.0840308		20.31766441													$25 Copay	$25 Copay			$25 Copay	$3 Copay	$3 Copay	(ER) - $25; (UC) - $15	$15 Copay	$3 Copay	$3 Copay			"3 (CORF) -$2, 5 (Partial Hospital) - $5, 7i, 7c (OP PT/ST/OT)-$5, 9c (OP SA) -$5, 9d (Cardiac Rehab) - $2"	$2 Copay	$5 Copay	$5 Copay	$2 Copay		$5 Copay		$3 Copay		$3 Copay	$3 Copay		$3 Copay		20% Coinsurance													25	25			25	3	3	25	15	3	3			2.3718	2.1736	5	5	2				3		3	3		3		0.787799011													4.5763	1.067170181	0	0	0.603157202	0.78669995	0.626577752	0.783582628	0.255679938	3.560288741	1.345847536	0	0	0.028448499	0.722297921	1.607437955	0.776632957	0.174796363	0	0	0	0.147575054	0	0.25	0.036	0	0.062271008	0	16.00623593	0	0	0	0	0	0	0	0	0	0	0	0	33.417	0	0	4.5763	1.067170181	0	0	0.603157202	0.78669995	0.626577752	0.783582628	0.255679938	3.560288741	1.345847536	0	0	0.028448499	0.722297921	1.607437955	0.776632957	0.174796363	0	0	0	0.147575054	0	0.25	0.036	0	0.062271008	0	16.00623593	0	0	0	0	0	0	0	0	0	0	0	0	33.417																																																																																				0	0	0	4.5763	1.067170181	0	0	0.603157202	0.78669995	0.626577752	0.783582628	0.255679938	3.560288741	1.345847536	0	0	0.028448499	0.722297921	1.607437955	0.776632957	0.174796363	0	0	0	0.147575054	0	0.25	0.036	0	0.062271008	0	16.00623593	0	0	0	0	0	0	0	0	0	0	0	0	33.417
H5760_006_0	2008	7																																D	D	D	V	T	P	P	V	V	P	P	P	P	P	V	V	V	V	P	P	S	P	T	V	P	P	P	P	Coin	P	P																																																				0		2135.62817	498.0132269			289.5157334	3146.802804	2506.313403	376.1200204	204.544146	14071.86694	5301.588651			143.6389972	3921.5069	3795.419155	1834.56144	1032.010262				580.3982292		1000	144		249.0840309															$25 Copay	$25 Copay			$25 Copay	$3 Copay	$3 Copay	(ER) - $25; (UC) - $15	$15 Copay	$3 Copay	$3 Copay			"3 (CORF) -$2, 5 (Partial Hospital) - $5, 7i, 7c (OP PT/ST/OT)-$5, 9c (OP SA) -$5, 9d (Cardiac Rehab) - $2"	$2 Copay	$5 Copay	$5 Copay	$2 Copay		$5 Copay		$3 Copay		$3 Copay	$3 Copay		$3 Copay															25	25			25	3	3	25	15	3	3			2.3663	2.1736	5	5	2				3		3	3		3															4.4492	1.037527556	0	0	0.603157778	0.786700701	0.626578351	0.783583376	0.255680183	3.517966734	1.325397163	0	0	0.028324562	0.710306627	1.581424648	0.7644006	0.17200171	0	0	0	0.145099557	0	0.25	0.036	0	0.062271008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.1356	0	0	4.4492	1.037527556	0	0	0.603157778	0.786700701	0.626578351	0.783583376	0.255680183	3.517966734	1.325397163	0	0	0.028324562	0.710306627	1.581424648	0.7644006	0.17200171	0	0	0	0.145099557	0	0.25	0.036	0	0.062271008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.1356																																																																																				0	0	0	4.4492	1.037527556	0	0	0.603157778	0.786700701	0.626578351	0.783583376	0.255680183	3.517966734	1.325397163	0	0	0.028324562	0.710306627	1.581424648	0.7644006	0.17200171	0	0	0	0.145099557	0	0.25	0.036	0	0.062271008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.1356
H5760_802_0	2008	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		109.4942511	2.168827684	1.382718312		3.540949578	33.52160208	18.37006926	7.373809288	15.67531116	16.24288894	24.3953525	0.570506026	0.541084589	7.319097073	63.47102744	80.61491179	4.08730531	4.689860382			15.94694645	5.661893437																				FFS Medicare Deductible/Coinsurance	FFS Medicare Deductible/Coinsurance	FFS Medicare Deductible/Coinsurance		FFS Medicare Deductible/Coinsurance	FFS Medicare Deductible/Coinsurance	FFS Medicare Deductible/Coinsurance	FFS Medicare Deductible/Coinsurance	FFS Medicare Deductible/Coinsurance	FFS Medicare Deductible/Coinsurance	FFS Medicare Deductible/Coinsurance	FFS Medicare Deductible/Coinsurance	FFS Medicare Deductible/Coinsurance	FFS Medicare Deductible/Coinsurance	FFS Medicare Deductible/Coinsurance	FFS Medicare Deductible/Coinsurance	FFS Medicare Deductible/Coinsurance	FFS Medicare Deductible/Coinsurance	FFS Medicare Deductible/Coinsurance	FFS Medicare Deductible/Coinsurance	FFS Medicare Deductible/Coinsurance	FFS Medicare Deductible/Coinsurance																				0.160117543	0.160117543	0.161975		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				17.532	0.34726736	0.223965799	0	0.828582201	7.844054887	4.298596207	1.725471373	3.668022811	3.800836011	5.708512486	0.13349841	0.126613794	1.712668715	14.85222042	18.86388936	0.956429443	1.097427329	0	0	3.731585469	1.324883064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.7765	0	0	17.532	0.34726736	0.223965799	0	0.828582201	7.844054887	4.298596207	1.725471373	3.668022811	3.800836011	5.708512486	0.13349841	0.126613794	1.712668715	14.85222042	18.86388936	0.956429443	1.097427329	0	0	3.731585469	1.324883064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.7765																																																																																				0	0	0	17.532	0.34726736	0.223965799	0	0.828582201	7.844054887	4.298596207	1.725471373	3.668022811	3.800836011	5.708512486	0.13349841	0.126613794	1.712668715	14.85222042	18.86388936	0.956429443	1.097427329	0	0	3.731585469	1.324883064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.7765
H5774_003_0	2008	2																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	606.161307	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$25 ER Copay and $5 Urgent Care Copay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.262836056	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.2628			0	0	0	0	0	0	0	1.262836056	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.2628																																																																																				0			0	0	0	0	0	0	0	1.262836056	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.2628
H5774_004_0	2008	2																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5774_005_0	2008	4																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	141584.623	159.3661338	602.4713603	311.6550542	0	0	0	0	0	0	13349.72605	172.4904036	0	0	0	0	0	0	953.4383725	704.62353	0	0	0	0	0	0											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% Coinsurance on all services	20% Coinsurance on all services	$25 Copay for Emergency Room and $5 urgent Care Co-pay	$10 Copay per visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	"$10 Copay on Chiropractors and Podiatrist, No"	$10 Copay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	"$10 Copay on Dental Visits, no ther cost sharing"	"$5 Copay on Vision Exams, no other cost sharing"	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0	0	0	0	0	0.932379759	62.79015063	25	10	0	0	0	0	0	0	5.166251185	10	0	0	0	0	0	0	10	5	0	0	0	0	0	0											0	0	0	0	0	11.00088639	0.833885295	1.255148667	0.259712545	0	0	0	0	0	0	5.747336501	0.143742003	0	0	0	0	0	0	0.794531977	0.293593137	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.3288			0	0	0	0	0	11.00088639	0.833885295	1.255148667	0.259712545	0	0	0	0	0	0	5.747336501	0.143742003	0	0	0	0	0	0	0.794531977	0.293593137	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.3288																																																																																				0			0	0	0	0	0	11.00088639	0.833885295	1.255148667	0.259712545	0	0	0	0	0	0	5.747336501	0.143742003	0	0	0	0	0	0	0.794531977	0.293593137	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.3288
H5774_006_0	2008	7																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5774_007_0	2008	5																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	625.120818	0	0	0	0	0	0	0	13391.03001	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$25 Copay for Emergency Room and $5 urgent Care Co-pay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$10 Copay SpecialistsOffice visits and Podiatrists Offce Visits.	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	10	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.302335037	0	0	0	0	0	0	0	11.15919168	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.4615			0	0	0	0	0	0	0	1.302335037	0	0	0	0	0	0	0	11.15919168	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.4615																																																																																				0			0	0	0	0	0	0	0	1.302335037	0	0	0	0	0	0	0	11.15919168	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.4615
H5774_008_0	2008	7																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	625.4463	0	0	0	0	0	0	0	13398.0016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$25 Copay for Emergency Room and $5 urgent Care Co-pay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$10 Copay SpecialistsOffice visits and Podiatrists Offce Visits.	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	10	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.303013054	0	0	0	0	0	0	0	11.16500133	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.468			0	0	0	0	0	0	0	1.303013054	0	0	0	0	0	0	0	11.16500133	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.468		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0	0	0	0	0	0	1.303013054	0	0	0	0	0	0	0	11.16500133	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.468
H5774_009_0	2008	7																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	625.4463	0	0	0	0	0	0	0	13398.0016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$25 Copay for Emergency Room and $5 urgent Care Co-pay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$10 Copay SpecialistsOffice visits and Podiatrists Offce Visits.	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	10	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.303013054	0	0	0	0	0	0	0	11.16500133	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.468			0	0	0	0	0	0	0	1.303013054	0	0	0	0	0	0	0	11.16500133	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.468																																																																																				0			0	0	0	0	0	0	0	1.303013054	0	0	0	0	0	0	0	11.16500133	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.468
H5774_010_0	2008	4																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	625.120818	0	0	0	0	0	0	0	13391.03001	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$25 Copay for Emergency Room and $5 urgent Care Co-pay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$10 Copay SpecialistsOffice visits and Podiatrists Offce Visits.	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	10	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.302335037	0	0	0	0	0	0	0	11.15919168	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.4615			0	0	0	0	0	0	0	1.302335037	0	0	0	0	0	0	0	11.15919168	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.4615																																																																																				0			0	0	0	0	0	0	0	1.302335037	0	0	0	0	0	0	0	11.15919168	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.4615
H5774_012_0	2008	7																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2239.379637	0	0	0	0	0	0	625.4413389	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											$75 per admit	$75 per admit	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$25 Copay for Emergency Room and $5 urgent Care Co-pay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											15	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											2.7992	0	0	0	0	0	0	1.303002789	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1022			2.7992	0	0	0	0	0	0	1.303002789	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1022																																																																																				0			2.7992	0	0	0	0	0	0	1.303002789	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1022
H5774_013_0	2008	7																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2239.379637	0	0	0	0	0	0	625.4413389	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											$75 per admit	$75 per admit	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$25 Copay for Emergency Room and $5 urgent Care Co-pay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											15	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											2.7992	0	0	0	0	0	0	1.303002789	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1022			2.7992	0	0	0	0	0	0	1.303002789	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1022																																																																																				0			2.7992	0	0	0	0	0	0	1.303002789	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1022
H5774_014_0	2008	7																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	625.4413389	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$25 Copay for Emergency Room and $5 urgent Care Co-pay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.303002789	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.303			0	0	0	0	0	0	0	1.303002789	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.303																																																																																				0			0	0	0	0	0	0	0	1.303002789	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.303
H5774_015_0	2008	7																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	625.4413389	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$25 Copay for Emergency Room and $5 urgent Care Co-pay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.303002789	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.303			0	0	0	0	0	0	0	1.303002789	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.303																																																																																				0			0	0	0	0	0	0	0	1.303002789	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.303
H5774_016_0	2008	3																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$25 Copay for Emergency Room and $5 urgent Care Co-pay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5774_017_0	2008	3																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2005.617879	0	0	0	0	131639.6541	148.1721834	560.1534954	289.7642601	942.4873185	611.3896721	0	0	2482.155957	9033.70938	12421.18697	160.3745985	5212.610251	2515.876514	15414.70088	677.6698387	3617.372195	0	953.4383725	704.62353	341.0437981	0	67.60780138	0	0	12697.2459											$200 er admit copay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% Coinsurance	20% Coinsurance	$25 ER Copay and $5 Urgent Care Copay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	0	0	15% coinsurance											40	0	0	0	0	0.932379759	62.79015063	25	10	10	10	0	0	10	35.65113323	8.456648656	9.112907609	3.333333333	8.467322016	1.621739561	2.984340542	4.409089894	0	3.862807546	8.776545842	26.51828194	0	4.433333333	0	0	0.728516054											6.6854	0	0	0	0	10.22817908	0.77531281	1.166986449	0.241470217	0.785406099	0.509491393	0	0	2.068463298	26.83849805	8.753467843	0.121789908	1.447947292	1.77522805	2.083219186	0.168533131	1.329109932	0	0.306912412	0.515346726	0.753657966	0	0.024977327	0	0	0.770845623	0	0	0	0	0	0	0	0	0	0	67.3502			6.6854	0	0	0	0	10.22817908	0.77531281	1.166986449	0.241470217	0.785406099	0.509491393	0	0	2.068463298	26.83849805	8.753467843	0.121789908	1.447947292	1.77522805	2.083219186	0.168533131	1.329109932	0	0.306912412	0.515346726	0.753657966	0	0.024977327	0	0	0.770845623	0	0	0	0	0	0	0	0	0	0	67.3502																																																																																				0			6.6854	0	0	0	0	10.22817908	0.77531281	1.166986449	0.241470217	0.785406099	0.509491393	0	0	2.068463298	26.83849805	8.753467843	0.121789908	1.447947292	1.77522805	2.083219186	0.168533131	1.329109932	0	0.306912412	0.515346726	0.753657966	0	0.024977327	0	0	0.770845623	0	0	0	0	0	0	0	0	0	0	67.3502
H5774_018_0	2008	6																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5774_019_0	2008	3																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5774_020_0	2008	2																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	631.1046135	0	0	0	0	0	0	0	10806.92433	0	0	2834.546759	17354.41801	0	0	0	0	0	0	0	0	0	0	0											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$25 Copay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.454807991	0	0	1.181061149	7.231007505	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.011897739	0	0	0.278981088	10.45749391	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.7484			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.011897739	0	0	0.278981088	10.45749391	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.7484																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.011897739	0	0	0.278981088	10.45749391	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.7484
H5774_802_0	2008	1																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2005.617879	0	0	0	0	131639.6541	148.1721834	560.1534954	289.7642601	942.4873185	611.3896721	0	0	2482.155957	9033.70938	12421.18697	160.3745985	5212.610251	2515.876514	15414.70088	677.6698387	3617.372195	0	953.4383725	704.62353	341.0437981	0	67.60780138	0	0	12697.2459											$200 er admit copay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% Coinsurance	20% Coinsurance	$25 ER Copay and $5 Urgent Care Copay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	0	0	15% coinsurance											40	0	0	0	0	0.932379759	62.79015063	25	10	10	10	0	0	10	35.65113323	8.456648656	9.112907609	3.333333333	8.467322016	1.621739561	10	4.409089894	0	3.862807546	8.776545842	26.51828194	0	4.433333333	0	0	0.728516054											6.6854	0	0	0	0	10.22817908	0.77531281	1.166986449	0.241470217	0.785406099	0.509491393	0	0	2.068463298	26.83849805	8.753467843	0.121789908	1.447947292	1.77522805	2.083219186	0.564724866	1.329109932	0	0.306912412	0.515346726	0.753657966	0	0.024977327	0	0	0.770845623	0	0	0	0	0	0	0	0	0	0	67.7464			6.6854	0	0	0	0	10.22817908	0.77531281	1.166986449	0.241470217	0.785406099	0.509491393	0	0	2.068463298	26.83849805	8.753467843	0.121789908	1.447947292	1.77522805	2.083219186	0.564724866	1.329109932	0	0.306912412	0.515346726	0.753657966	0	0.024977327	0	0	0.770845623	0	0	0	0	0	0	0	0	0	0	67.7464																																																																																				0			6.6854	0	0	0	0	10.22817908	0.77531281	1.166986449	0.241470217	0.785406099	0.509491393	0	0	2.068463298	26.83849805	8.753467843	0.121789908	1.447947292	1.77522805	2.083219186	0.564724866	1.329109932	0	0.306912412	0.515346726	0.753657966	0	0.024977327	0	0	0.770845623	0	0	0	0	0	0	0	0	0	0	67.7464
H5774_804_0	2008	1																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2005.617879	0	0	0	0	131639.6541	148.1721834	560.1534954	289.7642601	942.4873185	611.3896721	0	0	2482.155957	9033.70938	12421.18697	160.3745985	5212.610251	2515.876514	15414.70088	677.6698387	3617.372195	0	953.4383725	704.62353	341.0437981	0	67.60780138	0	0	12697.2459											$200 er admit copay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% Coinsurance	20% Coinsurance	$25 ER Copay and $5 Urgent Care Copay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	0	0	15% coinsurance											40	0	0	0	0	0.932379759	62.79015063	25	10	10	10	0	0	10	35.65113323	8.456648656	9.112907609	3.333333333	8.467322016	1.621739561	10	4.409089894	0	3.862807546	8.776545842	26.51828194	0	4.433333333	0	0	0.728516054											6.6854	0	0	0	0	10.22817908	0.77531281	1.166986449	0.241470217	0.785406099	0.509491393	0	0	2.068463298	26.83849805	8.753467843	0.121789908	1.447947292	1.77522805	2.083219186	0.564724866	1.329109932	0	0.306912412	0.515346726	0.753657966	0	0.024977327	0	0	0.770845623	0	0	0	0	0	0	0	0	0	0	67.7464			6.6854	0	0	0	0	10.22817908	0.77531281	1.166986449	0.241470217	0.785406099	0.509491393	0	0	2.068463298	26.83849805	8.753467843	0.121789908	1.447947292	1.77522805	2.083219186	0.564724866	1.329109932	0	0.306912412	0.515346726	0.753657966	0	0.024977327	0	0	0.770845623	0	0	0	0	0	0	0	0	0	0	67.7464																																																																																				0			6.6854	0	0	0	0	10.22817908	0.77531281	1.166986449	0.241470217	0.785406099	0.509491393	0	0	2.068463298	26.83849805	8.753467843	0.121789908	1.447947292	1.77522805	2.083219186	0.564724866	1.329109932	0	0.306912412	0.515346726	0.753657966	0	0.024977327	0	0	0.770845623	0	0	0	0	0	0	0	0	0	0	67.7464
H5774_806_0	2008	1																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2005.617879	0	0	0	0	131639.6541	148.1721834	560.1534954	289.7642601	942.4873185	611.3896721	0	0	2482.155957	9033.70938	12421.18697	160.3745985	5212.610251	2515.876514	15414.70088	677.6698387	3617.372195	0	953.4383725	704.62353	341.0437981	0	67.60780138	0	0	12697.2459											$200 er admit copay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% Coinsurance	20% Coinsurance	$25 ER Copay and $5 Urgent Care Copay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	0	0	15% coinsurance											40	0	0	0	0	0.932379759	62.79015063	25	10	10	10	0	0	10	35.65113323	8.456648656	9.112907609	3.333333333	8.467322016	1.621739561	10	4.409089894	0	3.862807546	8.776545842	26.51828194	0	4.433333333	0	0	0.728516054											6.6854	0	0	0	0	10.22817908	0.77531281	1.166986449	0.241470217	0.785406099	0.509491393	0	0	2.068463298	26.83849805	8.753467843	0.121789908	1.447947292	1.77522805	2.083219186	0.564724866	1.329109932	0	0.306912412	0.515346726	0.753657966	0	0.024977327	0	0	0.770845623	0	0	0	0	0	0	0	0	0	0	67.7464			6.6854	0	0	0	0	10.22817908	0.77531281	1.166986449	0.241470217	0.785406099	0.509491393	0	0	2.068463298	26.83849805	8.753467843	0.121789908	1.447947292	1.77522805	2.083219186	0.564724866	1.329109932	0	0.306912412	0.515346726	0.753657966	0	0.024977327	0	0	0.770845623	0	0	0	0	0	0	0	0	0	0	67.7464																																																																																				0			6.6854	0	0	0	0	10.22817908	0.77531281	1.166986449	0.241470217	0.785406099	0.509491393	0	0	2.068463298	26.83849805	8.753467843	0.121789908	1.447947292	1.77522805	2.083219186	0.564724866	1.329109932	0	0.306912412	0.515346726	0.753657966	0	0.024977327	0	0	0.770845623	0	0	0	0	0	0	0	0	0	0	67.7464
H5774_807_0	2008	1																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	P	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2005.617879	0	0	0	0	131639.6541	148.1721834	560.1534954	289.7642601	942.4873185	611.3896721	0	0	2482.155957	9033.70938	12421.18697	160.3745985	5212.610251	2515.876514	15414.70088	677.6698387	3617.372195	0	953.4383725	704.62353	341.0437981	0	67.60780138	0	0	12697.2459											$200 er admit copay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% Coinsurance	20% Coinsurance	$25 ER Copay and $5 Urgent Care Copay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	$10 per procedure Caopay	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	15% coinsurance	0	0	15% coinsurance											40	0	0	0	0	0.932379759	62.79015063	25	10	10	10	0	0	10	35.65113323	8.456648656	9.112907609	3.333333333	8.467322016	1.621739561	10	4.409089894	0	3.862807546	8.776545842	26.51828194	0	4.433333333	0	0	0.728516054											6.6854	0	0	0	0	10.22817908	0.77531281	1.166986449	0.241470217	0.785406099	0.509491393	0	0	2.068463298	26.83849805	8.753467843	0.121789908	1.447947292	1.77522805	2.083219186	0.564724866	1.329109932	0	0.306912412	0.515346726	0.753657966	0	0.024977327	0	0	0.770845623	0	0	0	0	0	0	0	0	0	0	67.7464			6.6854	0	0	0	0	10.22817908	0.77531281	1.166986449	0.241470217	0.785406099	0.509491393	0	0	2.068463298	26.83849805	8.753467843	0.121789908	1.447947292	1.77522805	2.083219186	0.564724866	1.329109932	0	0.306912412	0.515346726	0.753657966	0	0.024977327	0	0	0.770845623	0	0	0	0	0	0	0	0	0	0	67.7464																																																																																				0			6.6854	0	0	0	0	10.22817908	0.77531281	1.166986449	0.241470217	0.785406099	0.509491393	0	0	2.068463298	26.83849805	8.753467843	0.121789908	1.447947292	1.77522805	2.083219186	0.564724866	1.329109932	0	0.306912412	0.515346726	0.753657966	0	0.024977327	0	0	0.770845623	0	0	0	0	0	0	0	0	0	0	67.7464
H5782_001_0	2008	6																					0																																																																																													0	0																																										PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $0	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $0, 4B Urgent Care: $0"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $0, 7D Physician Specialist: $0, 7F Podiatry: $0"	"7E Mental Health: $0, 7H Psychiatric: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5783_002_0	2008	8																					5000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1940.30292	129.3749753	722.8337329	1865.623233	245.0526347	14.39237218	6.132402471	340.3318904	337.6728822	0	18.69407746	1.530862	0.458184126	26.74003501	3930.673738	7472.231968	337.7478847	332.485467	0	0	26.74980589	0.701337664	0	0	144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 160 days 1-5	1b 260 days 1-5	2a 25 days 11-100	6a 15 copay	10a 125 copay	11a 20% coin	11b 10% coin	4a 50 copay; 4b 30 copay; 4a World 50 copay	9b 450 copay; ASC:9b 250 copay		8b 15% coin; TherRad:8b 20% coin	9a 15% coin	12 20% coin	3 35 copay; 5 50 copay; 9a 15% coin; 9a 20% coin; 9c 50 copay; 9d 25 copay	7a 15 copay	7b 15 copay; ; 7d 30 copay; 16b 30 copay; 17a 30 copay	7e 50 copay; 7h 50 copay	7c 25 copay; 7i 25 copay			RX 20% coin	14j 15% coin			17a1 25 copay	17b1 70 allowance	18a1 30 copay															83.06675723	134.9834805	10.81916622	12.64236143	105.3530119	0.168564819	0.08428241	42.14834005	312.9508661	0	0.134069527	0.126423614	0.168564819	0.130499547	12.64236143	19.41578431	42.14120476	21.07060238	0	0	0.168564819	5.98018121	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.4312	1.455290372	0.651704859	1.965490266	2.151419428	2.426047612	0.516853656	1.195368687	8.806251746	0	2.506306128	0.193537107	0.077233724	3.489562466	4.141083171	12.08993701	1.186091897	0.583805756	0	0	4.509076189	0.000349511	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6766		11.44571613	13.4312	1.455290372	0.651704859	1.965490266	2.151419428	2.426047612	0.516853656	1.195368687	8.806251746	0	2.506306128	0.193537107	0.077233724	3.489562466	4.141083171	12.08993701	1.186091897	0.583805756	0	0	4.509076189	0.000349511	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6766																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	13.4312	1.455290372	0.651704859	1.965490266	2.151419428	2.426047612	0.516853656	1.195368687	8.806251746	0	2.506306128	0.193537107	0.077233724	3.489562466	4.141083171	12.08993701	1.186091897	0.583805756	0	0	4.509076189	0.000349511	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6766
H5783_006_0	2008	4																					3300											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1914.712228	135.2466074	1329.460626	1809.208281	279.8261521	12.89071656	5.370503995	327.1571908	310.7782206	0	16.21089554	1.330328752	0.388019547	25.69601446	3613.259998	7036.978292	345.7193807	321.333925	0	0	24.35935172	0	0	0	144	0	249	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 125 days 1-5	1b 200 days 1-5	2a 25 days 11-100	6a 5 copay	10a 100 copay	11a 20% coin; 11a 15% coin	11b 15% coin	4a 50 copay; 4b 25 copay; 4a World 50 copay	9b 350 copay; ASC:9b 150 copay		8b 15% coin; TherRad:8b 20% coin	9a 15% coin	12 20% coin	3 25 copay; 5 50 copay; 9a 15% coin; 9a 20% coin; 9c 50 copay; 9d 25 copay	7a 5 copay	7b 12 copay; 7b1 0% coin (5 visits); 7d 25 copay; 16b 25 copay; 17a 25 copay	7e 50 copay; 7h 50 copay	7c 15 copay; 7i 15 copay			RX 20% coin				17a1 10 copay	17b1 100 allowance	18a1 15 copay															62.45102023	99.92163237	10.41156569	4.055357989	81.10715978	0.154201185	0.12166074	40.56250204	220.3869716	0	0.129043485	0.12166074	0.16221432	0.125291988	4.055357989	15.74769669	40.55357989	12.16607397	0	0	0.16221432	0	0	0	10	0	15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.9646	1.126171815	1.153480554	0.611415605	1.891325369	1.987763772	0.653379488	1.105859518	5.707622572	0	2.091910454	0.16184878	0.062942327	3.219504747	1.221088567	9.234683315	1.168346544	0.325781025	0	0	3.951435664	0	0	0	0.12	0	0.31125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0705		10.63074919	9.9646	1.126171815	1.153480554	0.611415605	1.891325369	1.987763772	0.653379488	1.105859518	5.707622572	0	2.091910454	0.16184878	0.062942327	3.219504747	1.221088567	9.234683315	1.168346544	0.325781025	0	0	3.951435664	0	0	0	0.12	0	0.31125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0705																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	9.9646	1.126171815	1.153480554	0.611415605	1.891325369	1.987763772	0.653379488	1.105859518	5.707622572	0	2.091910454	0.16184878	0.062942327	3.219504747	1.221088567	9.234683315	1.168346544	0.325781025	0	0	3.951435664	0	0	0	0.12	0	0.31125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0705
H5783_008_0	2008	4																																D	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	V	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		3280.12181	466.9389737	54.81639015	0	18.4333729	18.63335822	7.274693234	28.1437647	34.02214086	15.77373777	17.11289064	1.636355956	1.072749619	33.60400688	44.79477678	114.6100612	4.660364328	2.475584708	0	0	27.8914052	5.385632324	0	0	144	1.96	249	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a: MC CS; 1a1 0% coin	1b: MC CS; 1a1 0% coin	2a: MC CS; 2a2 0% coin	6a 0% coin	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS; 14c 0% coin	MC CS; 7b1 0% coin (5 visits); 7f1 0% coin (3 visits)	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS; 13a1 0% coin			17a1 5 copay	17b1 100 allowance	18a1 5 copay															46.19889568	46.19889568	0.211167716	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.156625743	0.234	0.234	0.234	0	0	0.234	0.234	0	0	5	0	5	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.6282	1.797672078	11.57545191	0	4.313409258	4.360205824	1.702278217	6.58564094	7.961180961	3.691054639	4.00441641	0.382907294	0.251023411	7.86333761	7.016015216	26.81875431	1.090525253	0.579286822	0	0	6.526588817	1.260237964	0	0	0.06	0	0.10375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.5719		0	12.6282	1.797672078	11.57545191	0	4.313409258	4.360205824	1.702278217	6.58564094	7.961180961	3.691054639	4.00441641	0.382907294	0.251023411	7.86333761	7.016015216	26.81875431	1.090525253	0.579286822	0	0	6.526588817	1.260237964	0	0	0.06	0	0.10375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.5719																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	12.6282	1.797672078	11.57545191	0	4.313409258	4.360205824	1.702278217	6.58564094	7.961180961	3.691054639	4.00441641	0.382907294	0.251023411	7.86333761	7.016015216	26.81875431	1.090525253	0.579286822	0	0	6.526588817	1.260237964	0	0	0.06	0	0.10375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.5719
H5783_009_0	2008	3																					5000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		2059.369611	182.8668236	1415.825652	2043.692447	326.9832996	14.3800943	5.864260982	390.2364769	295.0600209	0	15.22065513	1.285992738	0.4698351	25.52264225	3512.183682	6818.661062	415.3730244	289.717258	0	0	23.15448804	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 160 days 1-5	1b 225 days 1-5	2a 25 days 11-100	6a 15 copay	10a 125 copay	11a 20% coin	11b 10% coin	4a 50 copay; 4b 30 copay; 4a World 50 copay	9b 450 copay; ASC:9b 250 copay		8b 15% coin; TherRad:8b 20% coin	9a 15% coin	12 20% coin	3 35 copay; 5 50 copay; 9a 15% coin; 9a 20% coin; 9c 50 copay; 9d 35 copay	7a 15 copay	7b 20 copay; ; 7d 30 copay; 16b 30 copay; 17a 30 copay	7e 50 copay; 7h 50 copay	7c 25 copay; 7i 25 copay			RX 20% coin				17a1 25 copay	17b1 70 allowance	18a1 30 copay															79.28485767	132.1414294	11.0150256	12.87122611	107.2602176	0.171616348	0.085808174	42.90970578	249.5202177	0	0.136337374	0.128712261	0.171616348	0.134005662	6.864653927	19.11159588	42.90408705	21.45204352	0	0	0.171616348	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.6064	2.013690289	1.299612984	2.192068966	2.922691656	2.46785927	0.503201527	1.395411034	6.135286721	0	2.075144152	0.165523033	0.080631384	3.420178564	2.009160459	10.85962456	1.485100033	0.517918936	0	0	3.973688681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1232		9.447400177	13.6064	2.013690289	1.299612984	2.192068966	2.922691656	2.46785927	0.503201527	1.395411034	6.135286721	0	2.075144152	0.165523033	0.080631384	3.420178564	2.009160459	10.85962456	1.485100033	0.517918936	0	0	3.973688681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1232																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	13.6064	2.013690289	1.299612984	2.192068966	2.922691656	2.46785927	0.503201527	1.395411034	6.135286721	0	2.075144152	0.165523033	0.080631384	3.420178564	2.009160459	10.85962456	1.485100033	0.517918936	0	0	3.973688681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1232
H5793_001_0	2008	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7219.035373	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0															$200/day 1-10	$200/day 1-10	$0/day 1-8; $75/day 9-15; $100/day 16-100	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER/UC	$100 per procedure	$35 per visit	"$35 X-ray; $175 CAT, PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$20 per visit	"$35 per visit specialist, $30 Renal Dialysis"	$35 per visit	$35 per visit	$35 per visit	$35 per visit	45$ per script		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															163.93	163.93	65.64	0	100	0.2	0.2	50	100	35	60.2	35	30	35	20	34.55	35	35	35	35	45	0	0	0	0	0	0															21.6867	0.42248412	7.093087398	0	1.957621255	3.143561179	0.200659672	1.775280607	2.925180284	6.509192953	5.753868114	0	0	0	9.227246202	20.78480601	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.822			21.6867	0.42248412	7.093087398	0	1.957621255	3.143561179	0.200659672	1.775280607	2.925180284	6.509192953	5.753868114	0	0	0	9.227246202	20.78480601	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.822																																																																																				0			21.6867	0.42248412	7.093087398	0	1.957621255	3.143561179	0.200659672	1.775280607	2.925180284	6.509192953	5.753868114	0	0	0	9.227246202	20.78480601	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.822
H5793_003_0	2008	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7380.816841	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0															$0/day	$0/day	$0/day 1-8; $75/day 9-15; $100/day 16-100	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER/UC	$100 per procedure	$15 per visit	"$15 X-ray; $175 CAT, PET, MRI"	$15 per visit	$15 per visit	$15 per visit	$10 per visit	"$15 per visit specialist, $15 Renal Dialysis"	$15 per visit	$15 per visit	$15 per visit	$15 per visit	45$ per script		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															0	0	65.64	0	100	0.2	0.2	50	100	15	43.8	15	15	15	10	15	15	15	15	15	45	0	0	0	0	0	0															0	0	7.093087398	0	1.957621255	3.143561179	0.200659672	1.775280607	2.925180284	2.789654123	4.186369159	0	0	0	4.613623101	9.226021052	0.252089558	0.729369643	1.196202335	1.807988505	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9391			0	0	7.093087398	0	1.957621255	3.143561179	0.200659672	1.775280607	2.925180284	2.789654123	4.186369159	0	0	0	4.613623101	9.226021052	0.252089558	0.729369643	1.196202335	1.807988505	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9391																																																																																				0			0	0	7.093087398	0	1.957621255	3.143561179	0.200659672	1.775280607	2.925180284	2.789654123	4.186369159	0	0	0	4.613623101	9.226021052	0.252089558	0.729369643	1.196202335	1.807988505	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9391
H5793_007_0	2008	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7219.035373	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0															$200/day 1-10	$200/day 1-10	$0/day 1-8; $75/day 9-15; $100/day 16-100	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER/UC	$100 per procedure	$35 per visit	"$35 X-ray; $100 CAT, PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$20 per visit	"$35 per visit specialist, $30 Renal Dialysis"	$35 per visit	$35 per visit	$35 per visit	$35 per visit	45$ per script		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															163.93	163.93	65.64	0	100	0.2	0.2	50	100	35	46.7	35	30	35	20	34.55	35	35	35	35	45	0	0	0	0	0	0															21.6867	0.42248412	7.093087398	0	1.957621255	3.143561179	0.200659672	1.775280607	2.925180284	6.509192953	4.463548853	0	0	0	9.227246202	20.78480601	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5317			21.6867	0.42248412	7.093087398	0	1.957621255	3.143561179	0.200659672	1.775280607	2.925180284	6.509192953	4.463548853	0	0	0	9.227246202	20.78480601	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5317																																																																																				0			21.6867	0.42248412	7.093087398	0	1.957621255	3.143561179	0.200659672	1.775280607	2.925180284	6.509192953	4.463548853	0	0	0	9.227246202	20.78480601	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5317
H5793_801_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1403.234861	27.33675297	1146.203462	1881.554753	207.6460381	15.71780589	1.003298358	376.6101166	310.2755935	1972.668358	1013.814245	0	0	0	4893.697162	6208.051603	178.2619179	1031.528894	1409.798725	2556.992056	18.07125295	0	0	0	0	0	0															$200/d 7	$200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665																																																																																				0			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665
H5793_802_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1403.234861	27.33675297	1146.203462	1881.554753	207.6460381	15.71780589	1.003298358	376.6101166	310.2755935	1972.668358	1013.814245	0	0	0	4893.697162	6208.051603	178.2619179	1031.528894	1409.798725	2556.992056	18.07125295	0	0	0	0	0	0															$200/d 7	$200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance		N/A	Not Covered	$0 per visit	Not Covered	$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665																																																																																				0			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665
H5810_001_0	2008	10																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		339.5065627	28.75402737	62.87803021		13.53267897	28.82815965	20.58076894	9.295940933	21.14834099	10.59329186	21.91068147	0	4.16574017	38.10371149	74.15966366	137.350529	13.17174151	6.283499113	28.52144999	53.52427023	9.743959229	4.216095552	0	0	0	0	0	0	0	0	0											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0.062118956	0.062118956	0.179239093	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.23	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.0898	1.786170175	11.27020111	0	3.166646879	6.745789357	4.815899931	2.175250178	4.948711792	2.478830296	5.127099464	0	0.9747832	8.916268489	17.3533613	32.14002379	3.082187513	1.470338792	6.674019298	12.52467923	2.28008646	0.986566359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.0067	0	0	21.0898	1.786170175	11.27020111	0	3.166646879	6.745789357	4.815899931	2.175250178	4.948711792	2.478830296	5.127099464	0	0.9747832	8.916268489	17.3533613	32.14002379	3.082187513	1.470338792	6.674019298	12.52467923	2.28008646	0.986566359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.0067																																																																																				0	0		21.0898	1.786170175	11.27020111	0	3.166646879	6.745789357	4.815899931	2.175250178	4.948711792	2.478830296	5.127099464	0	0.9747832	8.916268489	17.3533613	32.14002379	3.082187513	1.470338792	6.674019298	12.52467923	2.28008646	0.986566359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.0067
H5810_002_0	2008	6																																D	D	D		T	Coin	Coin	V	V					V	V	V	V	P		P	Coin						V				V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1127.133634	22.86636598	937.8882741	0	178.7362887	12.24411062	7.121493756	346.6766376	240.597022	0	0	0	0	447.4260973	8489.644222	15075.8231	197.6234233	1573.793223	0	1600.86805	9.257677583	0	0	0	0	0	187.2070474	0	0	0	95.72500211											"$75 per Day, Days 1-8$75 per Day, Days 1-8"	"$75 per Day, Days 1-8$75 per Day, Days 1-8"	"$0 per Day, Days 1-10, $50 per Day, Days 11-100"	No Cost Sharing	$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $25/Visit for Urgent Care;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$10/Case for OP Fac - Occ Therapy; $10/Case for OP Fac - Physical/Speech Therapy; $10/Case for OP Fac - CORF; $3/Service for Prof - CORF; $3/Service for Prof - CORF;	$5/Visit for PCP - Office Visits; $4/Consult for PCP - Consults; $3/Exam for PCP - Routine Physicals; $2/Procedure for PCP - Asst Surgeon (OP); $2/Services for PCP - Tx Injections; $0/Tests for PCP - Allergy Testing; $3/Service for PCP - Allergy Tx;	$2/Procedure for Speclst - Asst Surgeon (OP); $7/Visit for Speclst - Office Visits; $2/Services for Speclst - Tx Injections; $0/Tests for Speclst - Allergy Testing; $4/Service for Speclst - Allergy Tx; $6/Consult for Speclst - Consults;	$10/Visit for OP Psych - Non-Physician; $10/Visit for OP Psych - Psychiatrist; $10/Visit for OP Substance Abuse;	$3/Service for PT/ST (PCP); $3/Service for Occ Therapy (PCP); $3/Service for PT/ST (Specialist); $3/Service for Occ Therapy (Specialist);	No Cost Sharing	$10/Visit for Chiropractor; $10/Service for Podiatrist; $10/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$10/Exam for Routine Hearing Exams	No Cost Sharing	No Cost Sharing	No Cost Sharing	$10/Visit for Other Benefit;											33.51	28.70499997	26.41	0	50	0.2	0.2	41.97247224	50	0	0	0	0	7.394490924	3.45909104	3.497193209	10	3.333333334	0	10	0.2	0	0	0	0	0	10	0	0	0	10											3.1475	0.054698253	2.064135777	0	0.744734536	2.448822124	1.424298751	1.212572962	1.002487592	0	0	0	0	0.275707351	2.447204355	4.393588848	0.164686186	0.437164784	0	1.334056708	1.851535517	0	0	0	0	0	0.156005873	0	0	0	0.079770835	0	0	0	0	0	0	0	0	0	0	23.239	0	0	3.1475	0.054698253	2.064135777	0	0.744734536	2.448822124	1.424298751	1.212572962	1.002487592	0	0	0	0	0.275707351	2.447204355	4.393588848	0.164686186	0.437164784	0	1.334056708	1.851535517	0	0	0	0	0	0.156005873	0	0	0	0.079770835	0	0	0	0	0	0	0	0	0	0	23.239																																																																																				0	0		3.1475	0.054698253	2.064135777	0	0.744734536	2.448822124	1.424298751	1.212572962	1.002487592	0	0	0	0	0.275707351	2.447204355	4.393588848	0.164686186	0.437164784	0	1.334056708	1.851535517	0	0	0	0	0	0.156005873	0	0	0	0.079770835	0	0	0	0	0	0	0	0	0	0	23.239
H5810_003_0	2008	6																																D	D	D		T	Coin	Coin	V	V					V	V	V	V	P		P	Coin						V				V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1123.184181	26.81581931	932.1431225	0	185.9350841	13.38942328	7.66725202	333.5196157	238.0846949	0	0	0	0	438.6431234	7577.076787	13432.23246	182.5583362	1477.714445	0	1556.95471	7.839543044	0	0	0	0	0	189.2893874	0	0	0	109.1938611											"$100 per Day, Days 1-8$100 per Day, Days 1-8"	"$100 per Day, Days 1-8$100 per Day, Days 1-8"	"$0 per Day, Days 1-10, $50 per Day, Days 11-100"	No Cost Sharing	$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $25/Visit for Urgent Care;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$10/Case for OP Fac - Occ Therapy; $10/Case for OP Fac - Physical/Speech Therapy; $10/Case for OP Fac - CORF; $3/Service for Prof - CORF; $3/Service for Prof - CORF;	$10/Visit for PCP - Office Visits; $8/Consult for PCP - Consults; $3/Exam for PCP - Routine Physicals; $3/Procedure for PCP - Asst Surgeon (OP); $3/Services for PCP - Tx Injections; $1/Tests for PCP - Allergy Testing; $6/Service for PCP - Allergy Tx;	$5/Procedure for Speclst - Asst Surgeon (OP); $15/Visit for Speclst - Office Visits; $5/Services for Speclst - Tx Injections; $1/Tests for Speclst - Allergy Testing; $9/Service for Speclst - Allergy Tx; $12/Consult for Speclst - Consults;	$10/Visit for OP Psych - Non-Physician; $10/Visit for OP Psych - Psychiatrist; $10/Visit for OP Substance Abuse;	$3/Service for PT/ST (PCP); $3/Service for Occ Therapy (PCP); $3/Service for PT/ST (Specialist); $3/Service for Occ Therapy (Specialist);	No Cost Sharing	$10/Visit for Chiropractor; $10/Service for Podiatrist; $10/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$10/Exam for Routine Hearing Exams	No Cost Sharing	No Cost Sharing	No Cost Sharing	$10/Visit for Other Benefit;											50.265	43.05749998	26.41	0	50	0.2	0.2	42.3317857	50	0	0	0	0	7.504569812	6.969890193	7.554131677	9.999999992	3.333333333	0	10	0.2	0	0	0	0	0	9.999999998	0	0	0	10											4.7047	0.096218512	2.051491656	0	0.774729517	2.677884656	1.533450404	1.176540075	0.992019562	0	0	0	0	0.274318995	4.400949432	8.455737728	0.152131947	0.410476235	0	1.297462258	1.567908609	0	0	0	0	0	0.157741156	0	0	0	0.090994884	0	0	0	0	0	0	0	0	0	0	30.8148	0	0	4.7047	0.096218512	2.051491656	0	0.774729517	2.677884656	1.533450404	1.176540075	0.992019562	0	0	0	0	0.274318995	4.400949432	8.455737728	0.152131947	0.410476235	0	1.297462258	1.567908609	0	0	0	0	0	0.157741156	0	0	0	0.090994884	0	0	0	0	0	0	0	0	0	0	30.8148																																																																																				0	0		4.7047	0.096218512	2.051491656	0	0.774729517	2.677884656	1.533450404	1.176540075	0.992019562	0	0	0	0	0.274318995	4.400949432	8.455737728	0.152131947	0.410476235	0	1.297462258	1.567908609	0	0	0	0	0	0.157741156	0	0	0	0.090994884	0	0	0	0	0	0	0	0	0	0	30.8148
H5810_004_0	2008	4																																D	A	D		T	Coin	Coin	V	V		Coin			V	V	V	V	P	P	P	Coin						V				V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1121.95632	3.480930974	1001.243153	0	186.4513029	13.38393678	7.621519845	312.1399124	214.4923333	0	23.19060461	0	0	419.5205598	7717.584381	13960.22539	183.1770532	1542.846771	3230.474071	2295.339032	9.073011026	0	0	0	0	0	190.3277339	0	0	0	126.160514											"$200 per Day, Days 1-8$200 per Day, Days 1-8"	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse	"$0 per Day, Days 1-10, $100 per Day, Days 11-100"	No Cost Sharing	$100/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $25/Visit for Urgent Care;	$200/Case for OP Fac - Surgery; $200/Case for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; $10/Case for OP Fac - CT/MRI/PET	No Cost Sharing	No Cost Sharing	$30/Case for OP Fac - Occ Therapy; $30/Case for OP Fac - Physical/Speech Therapy; $30/Case for OP Fac - CORF; $10/Service for Prof - CORF; $10/Service for Prof - CORF;	$15/Visit for PCP - Office Visits; $12/Consult for PCP - Consults; $15/Exam for PCP - Routine Physicals; $5/Procedure for PCP - Asst Surgeon (OP); $5/Services for PCP - Tx Injections; $1/Tests for PCP - Allergy Testing; $8/Service for PCP - Allergy Tx;	$8/Procedure for Speclst - Asst Surgeon (OP); $25/Visit for Speclst - Office Visits; $8/Services for Speclst - Tx Injections; $1/Tests for Speclst - Allergy Testing; $13/Service for Speclst - Allergy Tx; $20/Consult for Speclst - Consults;	$30/Visit for OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/Visit for OP Substance Abuse;	$10/Service for PT/ST (PCP); $10/Service for Occ Therapy (PCP); $10/Service for PT/ST (Specialist); $10/Service for Occ Therapy (Specialist);	$13/Procedure for Prof Radiology (Office); $5/Procedure for Prof Radiology (OP);	$30/Visit for Chiropractor; $25/Exam for Vistion Exams; $30/Service for Podiatrist; $30/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$30/Exam for Routine Hearing Exams	No Cost Sharing	No Cost Sharing	No Cost Sharing	$30/Visit for Other Benefit;											134.04	900.0000001	52.82	0	100	0.2	0.2	41.66005353	200	0	0.123553487	0	0	21.82746042	10.42192607	12.32022522	30	9.999999999	10.08979615	28.52317331	0.2	0	0	0	0	0	30	0	0	0	30											12.5323	0.261069823	4.407138614	0	1.553760857	2.676787356	1.524303969	1.083647122	3.574872222	0	2.865280061	0	0	0.763089035	6.702674486	14.33276008	0.457942633	1.285705642	2.716235405	5.455862752	1.814602205	0	0	0	0	0	0.475819335	0	0	0	0.315401285	0	0	0	0	0	0	0	0	0	0	64.7992	0	0	12.5323	0.261069823	4.407138614	0	1.553760857	2.676787356	1.524303969	1.083647122	3.574872222	0	2.865280061	0	0	0.763089035	6.702674486	14.33276008	0.457942633	1.285705642	2.716235405	5.455862752	1.814602205	0	0	0	0	0	0.475819335	0	0	0	0.315401285	0	0	0	0	0	0	0	0	0	0	64.7992																																																																																				0	0		12.5323	0.261069823	4.407138614	0	1.553760857	2.676787356	1.524303969	1.083647122	3.574872222	0	2.865280061	0	0	0.763089035	6.702674486	14.33276008	0.457942633	1.285705642	2.716235405	5.455862752	1.814602205	0	0	0	0	0	0.475819335	0	0	0	0.315401285	0	0	0	0	0	0	0	0	0	0	64.7992
H5811_001_0	2008	5																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	596.5	19.3	1008.69	126.2	172.93	12.81	9.086710701	258.36	299.34	0	0	0	0	1139.57	0	5891.78	155.32	405.34	0	1113.84	0	612.06	0	0	339.5	0	0	0	0	0	47											PBP: 1A IP Acute: $200 per admit	1B IP Psych: $200 per admit	"2 SNF: $0/day days 1-10, $50/day days 11-20, $100/day days 21-100"	6 Home Health: $0	10A Ambulance: $100	"11A DME: 20%, 11C Diabetes Monitoring Supplies: 20%"	11B Prosthetic Medical Supplies: 20%	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $100	8A OP C/D/T: $0	8B OP X-Ray: $0	9C OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $20, 5 Partial Hosp: $20, 9C OP Substance Abuse: $20, 9D Cardiac Rehab: $20"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $20	"7E Mental Health: $20, 7H Psychiatric: $20"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	8B OP X-Ray: $0	"7B Chiropractic: $20, 7F Podiatry: $20, 7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $20"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Comprehensive Dental Services: $5, 17A Medicare Covered Eye Exams: $20"	10B Transportation: Not Covered	16A Preventive Dental Services: Not Covered	17A Routine Eye Exams: $20	17B Eye Wear: $50 Allowance Every 2 Years	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: $20											200	200	57.5	0	100	0.200000078	0.2000601	48.44990826	100	0	0	0	0	20	0	20	20	20	0	20	0	20	0	0	20	0	0	0	0	0	20											9.9417	0.321666667	4.83330625	0	1.441083333	2.562001004	1.817888248	1.043126525	2.4945	0	0	0	0	1.899283333	0	9.819633333	0.258866667	0.675566667	0	1.8564	0	1.0201	0	0	0.565833333	0	0	0	0	0	0.078333333	0	0	0	0	0	0	0	0	0	0	40.6293	0	0	9.9417	0.321666667	4.83330625	0	1.441083333	2.562001004	1.817888248	1.043126525	2.4945	0	0	0	0	1.899283333	0	9.819633333	0.258866667	0.675566667	0	1.8564	0	1.0201	0	0	0.565833333	0	0	0	0	0	0.078333333	0	0	0	0	0	0	0	0	0	0	40.6293	3000	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.9417	0.321666667	4.83330625	0	1.441083333	2.562001004	1.817888248	1.043126525	2.4945	0	0	0	0	1.899283333	0	9.819633333	0.258866667	0.675566667	0	1.8564	0	1.0201	0	0	0.565833333	0	0	0	0	0	0.078333333	0	0	0	0	0	0	0	0	0	0	40.6293
H5811_002_0	2008	4																					0											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	40.71	276.6289722	76.91056874	48.69825048	19.49994836	0	66.80122302	8.413031809	20.11860348	0	0	0	0	68.44409621	0	0	0	0	0	223.5431324	15.02214325	4.410502026	8.064314952	0	0	0	0	0	0	0	5.18543406											PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $0	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $0, 4B Urgent Care: $0"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $0	"7E Mental Health: $0, 7H Psychiatric: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	8B OP X-Ray: $0	"7B Chiropractic: $0, 7F Podiatry: $0, 7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Comprehensive Dental Services: $5, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: $0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	Unlimited	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5811_003_0	2008	4																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	596.5	19.3	1008.69	126.2	172.93	12.81	9.086710701	258.36	299.34	0	0	0	0	1139.57	0	5891.78	155.32	405.34	0	1113.84	0	612.06	0	0	339.5	0	0	0	0	0	47											PBP: 1A IP Acute: $200 per admit	1B IP Psych: $200 per admit	"2 SNF: $0/day days 1-10, $50/day days 11-20, $100/day days 21-100"	6 Home Health: $0	10A Ambulance: $100	"11A DME: 20%, 11C Diabetes Monitoring Supplies: 20%"	11B Prosthetic Medical Supplies: 20%	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $100	8A OP C/D/T: $0	8B OP X-Ray: $0	9C OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $20, 5 Partial Hosp: $20, 9C OP Substance Abuse: $20, 9D Cardiac Rehab: $20"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $20	"7E Mental Health: $20, 7H Psychiatric: $20"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	8B OP X-Ray: $0	"7B Chiropractic: $20, 7F Podiatry: $20, 7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $20"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Comprehensive Dental Services: $5, 17A Medicare Covered Eye Exams: $20"	10B Transportation: Not Covered	16A Preventive Dental Services: Not Covered	17A Routine Eye Exams: $20	17B Eye Wear: $50 Allowance Every 2 Years	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: $20											200	200	57.5	0	100	0.200000078	0.2000601	48.44990826	100	0	0	0	0	20	0	20	20	20	0	20	0	20	0	0	20	0	0	0	0	0	20											9.9417	0.321666667	4.83330625	0	1.441083333	2.562001004	1.817888248	1.043126525	2.4945	0	0	0	0	1.899283333	0	9.819633333	0.258866667	0.675566667	0	1.8564	0	1.0201	0	0	0.565833333	0	0	0	0	0	0.078333333	0	0	0	0	0	0	0	0	0	0	40.6293	0	0	9.9417	0.321666667	4.83330625	0	1.441083333	2.562001004	1.817888248	1.043126525	2.4945	0	0	0	0	1.899283333	0	9.819633333	0.258866667	0.675566667	0	1.8564	0	1.0201	0	0	0.565833333	0	0	0	0	0	0.078333333	0	0	0	0	0	0	0	0	0	0	40.6293	3000	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.9417	0.321666667	4.83330625	0	1.441083333	2.562001004	1.817888248	1.043126525	2.4945	0	0	0	0	1.899283333	0	9.819633333	0.258866667	0.675566667	0	1.8564	0	1.0201	0	0	0.565833333	0	0	0	0	0	0.078333333	0	0	0	0	0	0	0	0	0	0	40.6293
H5812_002_0	2008	3																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	181.7746675	3.187414737	1385.914319	1303.837358	180.4075566	45354.67195	46.83321306	362.2975293	342.3232855	2497.939059	976.1606836	0	1112.537629	879.8091441	4217.340716	7539.57402	164.2457603	544.1638231	2911.337762	14140.07805	7549.514175	5542.708857	0	0	323.0272866	0	138.4402657	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												329.3247848	329.3247848	20.58279905	8.23311962	82.3311962	0.753786701	33.37327879	41.1655981	74.72407878	3.076803313	15.04113349	0	8.288570665	12.02895043	16.39416885	12.51428164	38.36230604	8.23311962	3.966190245	5.249766309	2.683425934	4.074208649	0	0	16.46623924	0	16.46623924	0	0	0	0											4.9886	0.087474556	2.377166327	0.894554078	1.237764162	2.848979043	0.130248156	1.24284954	2.131649346	0.640472265	1.223546929	0	0.768445563	0.881931715	5.761649649	7.862696062	0.52507051	0.373347154	0.962243286	6.186008781	1.688213511	1.88184603	0	0	0.443253715	0	0.189965878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.328	None	9.727669694	4.9886	0.087474556	2.377166327	0.894554078	1.237764162	2.848979043	0.130248156	1.24284954	2.131649346	0.640472265	1.223546929	0	0.768445563	0.881931715	5.761649649	7.862696062	0.52507051	0.373347154	0.962243286	6.186008781	1.688213511	1.88184603	0	0	0.443253715	0	0.189965878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.328	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.9886	0.087474556	2.377166327	0.894554078	1.237764162	2.848979043	0.130248156	1.24284954	2.131649346	0.640472265	1.223546929	0	0.768445563	0.881931715	5.761649649	7.862696062	0.52507051	0.373347154	0.962243286	6.186008781	1.688213511	1.88184603	0	0	0.443253715	0	0.189965878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.328
H5812_003_0	2008	4																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	189.1152567	3.316131805	869.6467553	888.4580084	203.8654803	51252.02155	52.92281351	374.3776273	361.9098996	2640.862929	1032.013392	0	1176.193378	930.1489338	3336.759721	5828.747596	123.3908787	408.8072178	2827.040731	9387.783514	5934.548943	4164.539858	0	0	255.5791697	0	109.5339299	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												341.2176769	341.2176769	21.3261048	8.530441922	85.30441922	0.825771468	36.56034446	42.65220961	76.3609756	3.144203403	15.45035947	0	8.470139113	12.34743056	16.98621077	13.02369029	38.18890871	8.530441922	3.940335765	6.177581732	3.058217153	4.05889526	0	0	17.06088384	0	17.06088384	0	0	0	0											5.3775	0.094293566	1.545514821	0.631578287	1.449218866	3.526871423	0.161239691	1.330669419	2.302982751	0.69195085	1.328748157	0	0.830210128	0.957079114	4.723241994	6.325983621	0.39268025	0.290608852	0.928290808	4.832816662	1.512428281	1.408619258	0	0	0.363367211	0	0.155728805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1616	None	7.090996081	5.3775	0.094293566	1.545514821	0.631578287	1.449218866	3.526871423	0.161239691	1.330669419	2.302982751	0.69195085	1.328748157	0	0.830210128	0.957079114	4.723241994	6.325983621	0.39268025	0.290608852	0.928290808	4.832816662	1.512428281	1.408619258	0	0	0.363367211	0	0.155728805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1616	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.3775	0.094293566	1.545514821	0.631578287	1.449218866	3.526871423	0.161239691	1.330669419	2.302982751	0.69195085	1.328748157	0	0.830210128	0.957079114	4.723241994	6.325983621	0.39268025	0.290608852	0.928290808	4.832816662	1.512428281	1.408619258	0	0	0.363367211	0	0.155728805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1616
H5812_004_0	2008	4																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	197.4119715	3.461614514	1056.886253	1376.409561	204.1301973	51318.57171	52.99153318	381.6371986	363.1014805	2649.557915	1035.411275	0	1180.065971	933.21143	4129.481409	7888.199321	185.1172334	613.3132525	3287.430053	12700.19099	8451.826465	6245.055908	0	0	316.2977014	0	135.5561577	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												330.9711181	330.9711181	20.68569488	8.274277952	82.74277952	0.761644912	33.72119455	41.37138976	70.75603473	2.913417009	14.56850377	0	7.848425881	11.61501078	16.47612522	12.0686089	31.61235454	8.274277952	3.811090744	4.719281539	2.306864993	3.350999741	0	0	16.5485559	0	16.5485559	0	0	0	0											5.4448	0.095474535	1.821868879	0.949066274	1.407524992	3.257210751	0.148911483	1.315738441	2.140968413	0.643272258	1.257032755	0	0.771805026	0.903271735	5.669821067	7.933299377	0.487665968	0.422893694	1.044057854	4.994648073	1.62476855	1.743931727	0	0	0.436189183	0	0.186938221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7012	None	9.323083573	5.4448	0.095474535	1.821868879	0.949066274	1.407524992	3.257210751	0.148911483	1.315738441	2.140968413	0.643272258	1.257032755	0	0.771805026	0.903271735	5.669821067	7.933299377	0.487665968	0.422893694	1.044057854	4.994648073	1.62476855	1.743931727	0	0	0.436189183	0	0.186938221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7012	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.4448	0.095474535	1.821868879	0.949066274	1.407524992	3.257210751	0.148911483	1.315738441	2.140968413	0.643272258	1.257032755	0	0.771805026	0.903271735	5.669821067	7.933299377	0.487665968	0.422893694	1.044057854	4.994648073	1.62476855	1.743931727	0	0	0.436189183	0	0.186938221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7012
H5812_005_0	2008	4																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	181.5448674	3.183385198	1270.149088	1020.999155	171.0451631	43000.9552	44.40276625	315.9028607	295.0875	2153.258699	841.4642765	0	959.0231269	758.4078906	4101.999124	7596.846777	172.4108552	571.2156587	3300.480969	16022.25878	7763.52623	5817.214489	0	0	314.1926953	0	134.6540123	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												330.6472638	330.6472638	20.66545399	8.266181595	82.66181595	0.779847874	34.52711554	41.33090797	78.56837728	3.23509433	15.54874451	0	8.714989302	12.46426152	16.46000338	12.36859401	37.08032124	8.266181595	4.363714738	5.107262395	2.521875689	3.933897325	0	0	16.53236319	0	16.53236319	0	0	0	0											5.0023	0.0877148	2.187350627	0.703313702	1.178241983	2.794516956	0.127758287	1.088046005	1.932045503	0.580499584	1.090309421	0	0.696489691	0.787749524	5.626576621	7.830192792	0.532754158	0.39348103	1.200196454	6.819156644	1.631554005	1.907027043	0	0	0.432862312	0	0.18551242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.8156	None	9.400006011	5.0023	0.0877148	2.187350627	0.703313702	1.178241983	2.794516956	0.127758287	1.088046005	1.932045503	0.580499584	1.090309421	0	0.696489691	0.787749524	5.626576621	7.830192792	0.532754158	0.39348103	1.200196454	6.819156644	1.631554005	1.907027043	0	0	0.432862312	0	0.18551242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.8156	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.0023	0.0877148	2.187350627	0.703313702	1.178241983	2.794516956	0.127758287	1.088046005	1.932045503	0.580499584	1.090309421	0	0.696489691	0.787749524	5.626576621	7.830192792	0.532754158	0.39348103	1.200196454	6.819156644	1.631554005	1.907027043	0	0	0.432862312	0	0.18551242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.8156
H5812_006_0	2008	4																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	172.2812863	3.02094851	929.5812665	1088.251049	206.263478	51854.88099	53.54532589	558.2172672	552.4260238	4031.062451	1575.284498	0	1795.36352	1419.796689	3376.008849	5897.309097	124.8422821	413.6158729	2860.294214	9498.2087	6471.917276	4213.525871	0	0	258.5854573	0	110.8223389	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												331.8426475	331.8426475	20.74016547	8.296066188	82.96066188	0.803083219	35.5558411	41.48033094	74.26294131	3.057815735	15.0258575	0	8.237420212	12.00818224	16.51951097	12.66586158	37.1396602	8.296066188	3.832074189	6.00785134	3.5127789	3.947376237	0	0	16.59213238	0	16.59213238	0	0	0	0											4.7642	0.083539963	1.606639107	0.752350228	1.425979555	3.470315394	0.158654092	1.929586415	3.418731781	1.027187183	1.972500033	0	1.232430312	1.420764781	4.647501266	6.224541729	0.386383328	0.285948721	0.913404969	4.755318822	1.894534538	1.386030991	0	0	0.357540345	0	0.153231576	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2673	None	9.092087264	4.7642	0.083539963	1.606639107	0.752350228	1.425979555	3.470315394	0.158654092	1.929586415	3.418731781	1.027187183	1.972500033	0	1.232430312	1.420764781	4.647501266	6.224541729	0.386383328	0.285948721	0.913404969	4.755318822	1.894534538	1.386030991	0	0	0.357540345	0	0.153231576	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2673	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.7642	0.083539963	1.606639107	0.752350228	1.425979555	3.470315394	0.158654092	1.929586415	3.418731781	1.027187183	1.972500033	0	1.232430312	1.420764781	4.647501266	6.224541729	0.386383328	0.285948721	0.913404969	4.755318822	1.894534538	1.386030991	0	0	0.357540345	0	0.153231576	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2673
H5812_009_0	2008	4																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	187.8264245	3.293532162	1115.213305	1041.878951	186.1124835	46788.89727	48.31419347	434.5527882	414.1522237	3022.07609	1180.986322	0	1345.97894	1064.417552	4613.931671	8143.000723	174.6191171	578.5318672	3252.982673	12558.56735	8152.360566	5893.188306	0	0	353.4041778	0	151.4589333	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												327.0244119	327.0244119	20.43902574	8.175610298	81.75610298	0.753072605	33.34166282	40.87805149	64.55902213	2.65825175	13.71930475	0	7.16103866	10.89196415	16.27965362	12.36224589	34.15465689	8.175610298	4.127796134	5.50995867	2.461345004	3.628857598	0	0	16.3512206	0	16.3512206	0	0	0	0											5.1187	0.089755452	1.899489454	0.709833024	1.267985947	2.936286397	0.134239629	1.480305937	2.228105214	0.669453255	1.350192605	0	0.803217269	0.966133151	6.259434121	8.38881477	0.497004669	0.394154258	1.118970775	5.766432255	1.672147662	1.78212843	0	0	0.481549139	0	0.206378203	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.2207	None	10.31415393	5.1187	0.089755452	1.899489454	0.709833024	1.267985947	2.936286397	0.134239629	1.480305937	2.228105214	0.669453255	1.350192605	0	0.803217269	0.966133151	6.259434121	8.38881477	0.497004669	0.394154258	1.118970775	5.766432255	1.672147662	1.78212843	0	0	0.481549139	0	0.206378203	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.2207	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.1187	0.089755452	1.899489454	0.709833024	1.267985947	2.936286397	0.134239629	1.480305937	2.228105214	0.669453255	1.350192605	0	0.803217269	0.966133151	6.259434121	8.38881477	0.497004669	0.394154258	1.118970775	5.766432255	1.672147662	1.78212843	0	0	0.481549139	0	0.206378203	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.2207
H5812_010_0	2008	4																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	172.8326855	3.030617283	1456.61469	1274.61878	206.522952	51920.11305	53.61268448	540.4040802	529.6150512	3864.610382	1502.059843	0	1721.228729	1362.801831	3579.939676	6017.571438	122.6833555	393.761145	2883.562376	8757.669626	6225.76204	4058.061745	0	0	274.2055426	0	117.5166611	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												312.8737842	312.8737842	19.55461151	7.821844604	78.21844604	0.726000088	32.14304967	39.10922302	102.6417555	4.226328361	20.99964424	0	11.38526506	16.71623955	15.575219	12.60700616	34.53238218	11.73276691	5.522639712	8.940256748	4.862386306	5.513834624	0	0	15.64368921	0	15.64368921	0	0	0	0											4.5062	0.079016725	2.373627865	0.830822502	1.346158698	3.141167222	0.143606265	1.761231975	4.530051549	1.361092705	2.628560195	0	1.633053776	1.898410156	4.646528705	6.321963347	0.35304571	0.384992311	1.327073007	6.524651247	2.522671674	1.864623446	0	0	0.357465524	0	0.15319951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.6892	None	14.11547613	4.5062	0.079016725	2.373627865	0.830822502	1.346158698	3.141167222	0.143606265	1.761231975	4.530051549	1.361092705	2.628560195	0	1.633053776	1.898410156	4.646528705	6.321963347	0.35304571	0.384992311	1.327073007	6.524651247	2.522671674	1.864623446	0	0	0.357465524	0	0.15319951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.6892	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.5062	0.079016725	2.373627865	0.830822502	1.346158698	3.141167222	0.143606265	1.761231975	4.530051549	1.361092705	2.628560195	0	1.633053776	1.898410156	4.646528705	6.321963347	0.35304571	0.384992311	1.327073007	6.524651247	2.522671674	1.864623446	0	0	0.357465524	0	0.15319951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.6892
H5812_011_0	2008	2																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	181.7746675	3.187414737	1385.914319	1303.837358	180.4075566	45354.67195	46.83321306	362.2975293	342.3232855	2497.939059	976.1606836	0	1112.537629	879.8091441	4217.340716	7539.57402	164.2457603	544.1638231	2911.337762	14140.07805	7549.514175	5542.708857	0	0	323.0272866	0	138.4402657	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												329.3247848	329.3247848	20.58279905	8.23311962	82.3311962	0.753786701	33.37327879	41.1655981	74.72407878	3.076803313	15.04113349	0	8.288570665	12.02895043	16.39416885	12.51428164	38.36230604	8.23311962	3.966190245	5.249766309	2.683425934	4.074208649	0	0	16.46623924	0	16.46623924	0	0	0	0											4.9886	0.087474556	2.377166327	0.894554078	1.237764162	2.848979043	0.130248156	1.24284954	2.131649346	0.640472265	1.223546929	0	0.768445563	0.881931715	5.761649649	7.862696062	0.52507051	0.373347154	0.962243286	6.186008781	1.688213511	1.88184603	0	0	0.443253715	0	0.189965878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.328	None	9.727669694	4.9886	0.087474556	2.377166327	0.894554078	1.237764162	2.848979043	0.130248156	1.24284954	2.131649346	0.640472265	1.223546929	0	0.768445563	0.881931715	5.761649649	7.862696062	0.52507051	0.373347154	0.962243286	6.186008781	1.688213511	1.88184603	0	0	0.443253715	0	0.189965878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.328	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.9886	0.087474556	2.377166327	0.894554078	1.237764162	2.848979043	0.130248156	1.24284954	2.131649346	0.640472265	1.223546929	0	0.768445563	0.881931715	5.761649649	7.862696062	0.52507051	0.373347154	0.962243286	6.186008781	1.688213511	1.88184603	0	0	0.443253715	0	0.189965878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.328
H5812_012_0	2008	3																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	181.7746675	3.187414737	1385.914319	1303.837358	180.4075566	45354.67195	46.83321306	362.2975293	342.3232855	2497.939059	976.1606836	0	1112.537629	879.8091441	4217.340716	7539.57402	164.2457603	544.1638231	2911.337762	14140.07805	7549.514175	5542.708857	0	0	323.0272866	0	138.4402657	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												329.3247848	329.3247848	20.58279905	8.23311962	82.3311962	0.753786701	33.37327879	41.1655981	74.72407878	3.076803313	15.04113349	0	8.288570665	12.02895043	16.39416885	12.51428164	38.36230604	8.23311962	3.966190245	5.249766309	2.683425934	4.074208649	0	0	16.46623924	0	16.46623924	0	0	0	0											4.9886	0.087474556	2.377166327	0.894554078	1.237764162	2.848979043	0.130248156	1.24284954	2.131649346	0.640472265	1.223546929	0	0.768445563	0.881931715	5.761649649	7.862696062	0.52507051	0.373347154	0.962243286	6.186008781	1.688213511	1.88184603	0	0	0.443253715	0	0.189965878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.328	None	9.727669694	4.9886	0.087474556	2.377166327	0.894554078	1.237764162	2.848979043	0.130248156	1.24284954	2.131649346	0.640472265	1.223546929	0	0.768445563	0.881931715	5.761649649	7.862696062	0.52507051	0.373347154	0.962243286	6.186008781	1.688213511	1.88184603	0	0	0.443253715	0	0.189965878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.328	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.9886	0.087474556	2.377166327	0.894554078	1.237764162	2.848979043	0.130248156	1.24284954	2.131649346	0.640472265	1.223546929	0	0.768445563	0.881931715	5.761649649	7.862696062	0.52507051	0.373347154	0.962243286	6.186008781	1.688213511	1.88184603	0	0	0.443253715	0	0.189965878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.328
H5812_014_0	2008	2																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	189.1152567	3.316131805	869.6467553	888.4580084	203.8654803	51252.02155	52.92281351	374.3776273	361.9098996	2640.862929	1032.013392	0	1176.193378	930.1489338	3336.759721	5828.747596	123.3908787	408.8072178	2827.040731	9387.783514	5934.548943	4164.539858	0	0	255.5791697	0	109.5339299	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												341.2176769	341.2176769	21.3261048	8.530441922	85.30441922	0.825771468	36.56034446	42.65220961	76.3609756	3.144203403	15.45035947	0	8.470139113	12.34743056	16.98621077	13.02369029	38.18890871	8.530441922	3.940335765	6.177581732	3.058217153	4.05889526	0	0	17.06088384	0	17.06088384	0	0	0	0											5.3775	0.094293566	1.545514821	0.631578287	1.449218866	3.526871423	0.161239691	1.330669419	2.302982751	0.69195085	1.328748157	0	0.830210128	0.957079114	4.723241994	6.325983621	0.39268025	0.290608852	0.928290808	4.832816662	1.512428281	1.408619258	0	0	0.363367211	0	0.155728805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1616	None	7.090996081	5.3775	0.094293566	1.545514821	0.631578287	1.449218866	3.526871423	0.161239691	1.330669419	2.302982751	0.69195085	1.328748157	0	0.830210128	0.957079114	4.723241994	6.325983621	0.39268025	0.290608852	0.928290808	4.832816662	1.512428281	1.408619258	0	0	0.363367211	0	0.155728805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1616	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.3775	0.094293566	1.545514821	0.631578287	1.449218866	3.526871423	0.161239691	1.330669419	2.302982751	0.69195085	1.328748157	0	0.830210128	0.957079114	4.723241994	6.325983621	0.39268025	0.290608852	0.928290808	4.832816662	1.512428281	1.408619258	0	0	0.363367211	0	0.155728805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1616
H5812_015_0	2008	3																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	189.1152567	3.316131805	869.6467553	888.4580084	203.8654803	51252.02155	52.92281351	374.3776273	361.9098996	2640.862929	1032.013392	0	1176.193378	930.1489338	3336.759721	5828.747596	123.3908787	408.8072178	2827.040731	9387.783514	5934.548943	4164.539858	0	0	255.5791697	0	109.5339299	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												341.2176769	341.2176769	21.3261048	8.530441922	85.30441922	0.825771468	36.56034446	42.65220961	76.3609756	3.144203403	15.45035947	0	8.470139113	12.34743056	16.98621077	13.02369029	38.18890871	8.530441922	3.940335765	6.177581732	3.058217153	4.05889526	0	0	17.06088384	0	17.06088384	0	0	0	0											5.3775	0.094293566	1.545514821	0.631578287	1.449218866	3.526871423	0.161239691	1.330669419	2.302982751	0.69195085	1.328748157	0	0.830210128	0.957079114	4.723241994	6.325983621	0.39268025	0.290608852	0.928290808	4.832816662	1.512428281	1.408619258	0	0	0.363367211	0	0.155728805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1616	None	7.090996081	5.3775	0.094293566	1.545514821	0.631578287	1.449218866	3.526871423	0.161239691	1.330669419	2.302982751	0.69195085	1.328748157	0	0.830210128	0.957079114	4.723241994	6.325983621	0.39268025	0.290608852	0.928290808	4.832816662	1.512428281	1.408619258	0	0	0.363367211	0	0.155728805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1616	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.3775	0.094293566	1.545514821	0.631578287	1.449218866	3.526871423	0.161239691	1.330669419	2.302982751	0.69195085	1.328748157	0	0.830210128	0.957079114	4.723241994	6.325983621	0.39268025	0.290608852	0.928290808	4.832816662	1.512428281	1.408619258	0	0	0.363367211	0	0.155728805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1616
H5812_017_0	2008	2																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	197.4119715	3.461614514	1056.886253	1376.409561	204.1301973	51318.57171	52.99153318	381.6371986	363.1014805	2649.557915	1035.411275	0	1180.065971	933.21143	4129.481409	7888.199321	185.1172334	613.3132525	3287.430053	12700.19099	8451.826465	6245.055908	0	0	316.2977014	0	135.5561577	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												330.9711181	330.9711181	20.68569488	8.274277952	82.74277952	0.761644912	33.72119455	41.37138976	70.75603473	2.913417009	14.56850377	0	7.848425881	11.61501078	16.47612522	12.0686089	31.61235454	8.274277952	3.811090744	4.719281539	2.306864993	3.350999741	0	0	16.5485559	0	16.5485559	0	0	0	0											5.4448	0.095474535	1.821868879	0.949066274	1.407524992	3.257210751	0.148911483	1.315738441	2.140968413	0.643272258	1.257032755	0	0.771805026	0.903271735	5.669821067	7.933299377	0.487665968	0.422893694	1.044057854	4.994648073	1.62476855	1.743931727	0	0	0.436189183	0	0.186938221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7012	None	9.323083573	5.4448	0.095474535	1.821868879	0.949066274	1.407524992	3.257210751	0.148911483	1.315738441	2.140968413	0.643272258	1.257032755	0	0.771805026	0.903271735	5.669821067	7.933299377	0.487665968	0.422893694	1.044057854	4.994648073	1.62476855	1.743931727	0	0	0.436189183	0	0.186938221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7012	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.4448	0.095474535	1.821868879	0.949066274	1.407524992	3.257210751	0.148911483	1.315738441	2.140968413	0.643272258	1.257032755	0	0.771805026	0.903271735	5.669821067	7.933299377	0.487665968	0.422893694	1.044057854	4.994648073	1.62476855	1.743931727	0	0	0.436189183	0	0.186938221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7012
H5812_018_0	2008	3																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	197.4119715	3.461614514	1056.886253	1376.409561	204.1301973	51318.57171	52.99153318	381.6371986	363.1014805	2649.557915	1035.411275	0	1180.065971	933.21143	4129.481409	7888.199321	185.1172334	613.3132525	3287.430053	12700.19099	8451.826465	6245.055908	0	0	316.2977014	0	135.5561577	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												330.9711181	330.9711181	20.68569488	8.274277952	82.74277952	0.761644912	33.72119455	41.37138976	70.75603473	2.913417009	14.56850377	0	7.848425881	11.61501078	16.47612522	12.0686089	31.61235454	8.274277952	3.811090744	4.719281539	2.306864993	3.350999741	0	0	16.5485559	0	16.5485559	0	0	0	0											5.4448	0.095474535	1.821868879	0.949066274	1.407524992	3.257210751	0.148911483	1.315738441	2.140968413	0.643272258	1.257032755	0	0.771805026	0.903271735	5.669821067	7.933299377	0.487665968	0.422893694	1.044057854	4.994648073	1.62476855	1.743931727	0	0	0.436189183	0	0.186938221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7012	None	9.323083573	5.4448	0.095474535	1.821868879	0.949066274	1.407524992	3.257210751	0.148911483	1.315738441	2.140968413	0.643272258	1.257032755	0	0.771805026	0.903271735	5.669821067	7.933299377	0.487665968	0.422893694	1.044057854	4.994648073	1.62476855	1.743931727	0	0	0.436189183	0	0.186938221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7012	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.4448	0.095474535	1.821868879	0.949066274	1.407524992	3.257210751	0.148911483	1.315738441	2.140968413	0.643272258	1.257032755	0	0.771805026	0.903271735	5.669821067	7.933299377	0.487665968	0.422893694	1.044057854	4.994648073	1.62476855	1.743931727	0	0	0.436189183	0	0.186938221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7012
H5812_020_0	2008	2																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	181.5448674	3.183385198	1270.149088	1020.999155	171.0451631	43000.9552	44.40276625	315.9028607	295.0875	2153.258699	841.4642765	0	959.0231269	758.4078906	4101.999124	7596.846777	172.4108552	571.2156587	3300.480969	16022.25878	7763.52623	5817.214489	0	0	314.1926953	0	134.6540123	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												330.6472638	330.6472638	20.66545399	8.266181595	82.66181595	0.779847874	34.52711554	41.33090797	78.56837728	3.23509433	15.54874451	0	8.714989302	12.46426152	16.46000338	12.36859401	37.08032124	8.266181595	4.363714738	5.107262395	2.521875689	3.933897325	0	0	16.53236319	0	16.53236319	0	0	0	0											5.0023	0.0877148	2.187350627	0.703313702	1.178241983	2.794516956	0.127758287	1.088046005	1.932045503	0.580499584	1.090309421	0	0.696489691	0.787749524	5.626576621	7.830192792	0.532754158	0.39348103	1.200196454	6.819156644	1.631554005	1.907027043	0	0	0.432862312	0	0.18551242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.8156	None	9.400006011	5.0023	0.0877148	2.187350627	0.703313702	1.178241983	2.794516956	0.127758287	1.088046005	1.932045503	0.580499584	1.090309421	0	0.696489691	0.787749524	5.626576621	7.830192792	0.532754158	0.39348103	1.200196454	6.819156644	1.631554005	1.907027043	0	0	0.432862312	0	0.18551242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.8156	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.0023	0.0877148	2.187350627	0.703313702	1.178241983	2.794516956	0.127758287	1.088046005	1.932045503	0.580499584	1.090309421	0	0.696489691	0.787749524	5.626576621	7.830192792	0.532754158	0.39348103	1.200196454	6.819156644	1.631554005	1.907027043	0	0	0.432862312	0	0.18551242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.8156
H5812_021_0	2008	3																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	181.5448674	3.183385198	1270.149088	1020.999155	171.0451631	43000.9552	44.40276625	315.9028607	295.0875	2153.258699	841.4642765	0	959.0231269	758.4078906	4101.999124	7596.846777	172.4108552	571.2156587	3300.480969	16022.25878	7763.52623	5817.214489	0	0	314.1926953	0	134.6540123	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												330.6472638	330.6472638	20.66545399	8.266181595	82.66181595	0.779847874	34.52711554	41.33090797	78.56837728	3.23509433	15.54874451	0	8.714989302	12.46426152	16.46000338	12.36859401	37.08032124	8.266181595	4.363714738	5.107262395	2.521875689	3.933897325	0	0	16.53236319	0	16.53236319	0	0	0	0											5.0023	0.0877148	2.187350627	0.703313702	1.178241983	2.794516956	0.127758287	1.088046005	1.932045503	0.580499584	1.090309421	0	0.696489691	0.787749524	5.626576621	7.830192792	0.532754158	0.39348103	1.200196454	6.819156644	1.631554005	1.907027043	0	0	0.432862312	0	0.18551242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.8156	None	9.400006011	5.0023	0.0877148	2.187350627	0.703313702	1.178241983	2.794516956	0.127758287	1.088046005	1.932045503	0.580499584	1.090309421	0	0.696489691	0.787749524	5.626576621	7.830192792	0.532754158	0.39348103	1.200196454	6.819156644	1.631554005	1.907027043	0	0	0.432862312	0	0.18551242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.8156	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.0023	0.0877148	2.187350627	0.703313702	1.178241983	2.794516956	0.127758287	1.088046005	1.932045503	0.580499584	1.090309421	0	0.696489691	0.787749524	5.626576621	7.830192792	0.532754158	0.39348103	1.200196454	6.819156644	1.631554005	1.907027043	0	0	0.432862312	0	0.18551242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.8156
H5812_023_0	2008	2																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	172.2812863	3.02094851	929.5812665	1088.251049	206.263478	51854.88099	53.54532589	558.2172672	552.4260238	4031.062451	1575.284498	0	1795.36352	1419.796689	3376.008849	5897.309097	124.8422821	413.6158729	2860.294214	9498.2087	6471.917276	4213.525871	0	0	258.5854573	0	110.8223389	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												331.8426475	331.8426475	20.74016547	8.296066188	82.96066188	0.803083219	35.5558411	41.48033094	74.26294131	3.057815735	15.0258575	0	8.237420212	12.00818224	16.51951097	12.66586158	37.1396602	8.296066188	3.832074189	6.00785134	3.5127789	3.947376237	0	0	16.59213238	0	16.59213238	0	0	0	0											4.7642	0.083539963	1.606639107	0.752350228	1.425979555	3.470315394	0.158654092	1.929586415	3.418731781	1.027187183	1.972500033	0	1.232430312	1.420764781	4.647501266	6.224541729	0.386383328	0.285948721	0.913404969	4.755318822	1.894534538	1.386030991	0	0	0.357540345	0	0.153231576	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2673	None	9.092087264	4.7642	0.083539963	1.606639107	0.752350228	1.425979555	3.470315394	0.158654092	1.929586415	3.418731781	1.027187183	1.972500033	0	1.232430312	1.420764781	4.647501266	6.224541729	0.386383328	0.285948721	0.913404969	4.755318822	1.894534538	1.386030991	0	0	0.357540345	0	0.153231576	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2673	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.7642	0.083539963	1.606639107	0.752350228	1.425979555	3.470315394	0.158654092	1.929586415	3.418731781	1.027187183	1.972500033	0	1.232430312	1.420764781	4.647501266	6.224541729	0.386383328	0.285948721	0.913404969	4.755318822	1.894534538	1.386030991	0	0	0.357540345	0	0.153231576	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2673
H5812_024_0	2008	3																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	172.2812863	3.02094851	929.5812665	1088.251049	206.263478	51854.88099	53.54532589	558.2172672	552.4260238	4031.062451	1575.284498	0	1795.36352	1419.796689	3376.008849	5897.309097	124.8422821	413.6158729	2860.294214	9498.2087	6471.917276	4213.525871	0	0	258.5854573	0	110.8223389	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												331.8426475	331.8426475	20.74016547	8.296066188	82.96066188	0.803083219	35.5558411	41.48033094	74.26294131	3.057815735	15.0258575	0	8.237420212	12.00818224	16.51951097	12.66586158	37.1396602	8.296066188	3.832074189	6.00785134	3.5127789	3.947376237	0	0	16.59213238	0	16.59213238	0	0	0	0											4.7642	0.083539963	1.606639107	0.752350228	1.425979555	3.470315394	0.158654092	1.929586415	3.418731781	1.027187183	1.972500033	0	1.232430312	1.420764781	4.647501266	6.224541729	0.386383328	0.285948721	0.913404969	4.755318822	1.894534538	1.386030991	0	0	0.357540345	0	0.153231576	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2673	None	9.092087264	4.7642	0.083539963	1.606639107	0.752350228	1.425979555	3.470315394	0.158654092	1.929586415	3.418731781	1.027187183	1.972500033	0	1.232430312	1.420764781	4.647501266	6.224541729	0.386383328	0.285948721	0.913404969	4.755318822	1.894534538	1.386030991	0	0	0.357540345	0	0.153231576	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2673	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.7642	0.083539963	1.606639107	0.752350228	1.425979555	3.470315394	0.158654092	1.929586415	3.418731781	1.027187183	1.972500033	0	1.232430312	1.420764781	4.647501266	6.224541729	0.386383328	0.285948721	0.913404969	4.755318822	1.894534538	1.386030991	0	0	0.357540345	0	0.153231576	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2673
H5812_026_0	2008	2																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	187.8264245	3.293532162	1115.213305	1041.878951	186.1124835	46788.89727	48.31419347	434.5527882	414.1522237	3022.07609	1180.986322	0	1345.97894	1064.417552	4613.931671	8143.000723	174.6191171	578.5318672	3252.982673	12558.56735	8152.360566	5893.188306	0	0	353.4041778	0	151.4589333	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												327.0244119	327.0244119	20.43902574	8.175610298	81.75610298	0.753072605	33.34166282	40.87805149	64.55902213	2.65825175	13.71930475	0	7.16103866	10.89196415	16.27965362	12.36224589	34.15465689	8.175610298	4.127796134	5.50995867	2.461345004	3.628857598	0	0	16.3512206	0	16.3512206	0	0	0	0											5.1187	0.089755452	1.899489454	0.709833024	1.267985947	2.936286397	0.134239629	1.480305937	2.228105214	0.669453255	1.350192605	0	0.803217269	0.966133151	6.259434121	8.38881477	0.497004669	0.394154258	1.118970775	5.766432255	1.672147662	1.78212843	0	0	0.481549139	0	0.206378203	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.2207	None	10.31415393	5.1187	0.089755452	1.899489454	0.709833024	1.267985947	2.936286397	0.134239629	1.480305937	2.228105214	0.669453255	1.350192605	0	0.803217269	0.966133151	6.259434121	8.38881477	0.497004669	0.394154258	1.118970775	5.766432255	1.672147662	1.78212843	0	0	0.481549139	0	0.206378203	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.2207	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.1187	0.089755452	1.899489454	0.709833024	1.267985947	2.936286397	0.134239629	1.480305937	2.228105214	0.669453255	1.350192605	0	0.803217269	0.966133151	6.259434121	8.38881477	0.497004669	0.394154258	1.118970775	5.766432255	1.672147662	1.78212843	0	0	0.481549139	0	0.206378203	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.2207
H5812_027_0	2008	3																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	187.8264245	3.293532162	1115.213305	1041.878951	186.1124835	46788.89727	48.31419347	434.5527882	414.1522237	3022.07609	1180.986322	0	1345.97894	1064.417552	4613.931671	8143.000723	174.6191171	578.5318672	3252.982673	12558.56735	8152.360566	5893.188306	0	0	353.4041778	0	151.4589333	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												327.0244119	327.0244119	20.43902574	8.175610298	81.75610298	0.753072605	33.34166282	40.87805149	64.55902213	2.65825175	13.71930475	0	7.16103866	10.89196415	16.27965362	12.36224589	34.15465689	8.175610298	4.127796134	5.50995867	2.461345004	3.628857598	0	0	16.3512206	0	16.3512206	0	0	0	0											5.1187	0.089755452	1.899489454	0.709833024	1.267985947	2.936286397	0.134239629	1.480305937	2.228105214	0.669453255	1.350192605	0	0.803217269	0.966133151	6.259434121	8.38881477	0.497004669	0.394154258	1.118970775	5.766432255	1.672147662	1.78212843	0	0	0.481549139	0	0.206378203	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.2207	None	10.31415393	5.1187	0.089755452	1.899489454	0.709833024	1.267985947	2.936286397	0.134239629	1.480305937	2.228105214	0.669453255	1.350192605	0	0.803217269	0.966133151	6.259434121	8.38881477	0.497004669	0.394154258	1.118970775	5.766432255	1.672147662	1.78212843	0	0	0.481549139	0	0.206378203	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.2207	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.1187	0.089755452	1.899489454	0.709833024	1.267985947	2.936286397	0.134239629	1.480305937	2.228105214	0.669453255	1.350192605	0	0.803217269	0.966133151	6.259434121	8.38881477	0.497004669	0.394154258	1.118970775	5.766432255	1.672147662	1.78212843	0	0	0.481549139	0	0.206378203	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.2207
H5812_029_0	2008	2																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	172.8326855	3.030617283	1456.61469	1274.61878	206.522952	51920.11305	53.61268448	540.4040802	529.6150512	3864.610382	1502.059843	0	1721.228729	1362.801831	3579.939676	6017.571438	122.6833555	393.761145	2883.562376	8757.669626	6225.76204	4058.061745	0	0	274.2055426	0	117.5166611	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												312.8737842	312.8737842	19.55461151	7.821844604	78.21844604	0.726000088	32.14304967	39.10922302	102.6417555	4.226328361	20.99964424	0	11.38526506	16.71623955	15.575219	12.60700616	34.53238218	11.73276691	5.522639712	8.940256748	4.862386306	5.513834624	0	0	15.64368921	0	15.64368921	0	0	0	0											4.5062	0.079016725	2.373627865	0.830822502	1.346158698	3.141167222	0.143606265	1.761231975	4.530051549	1.361092705	2.628560195	0	1.633053776	1.898410156	4.646528705	6.321963347	0.35304571	0.384992311	1.327073007	6.524651247	2.522671674	1.864623446	0	0	0.357465524	0	0.15319951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.6892	None	14.11547613	4.5062	0.079016725	2.373627865	0.830822502	1.346158698	3.141167222	0.143606265	1.761231975	4.530051549	1.361092705	2.628560195	0	1.633053776	1.898410156	4.646528705	6.321963347	0.35304571	0.384992311	1.327073007	6.524651247	2.522671674	1.864623446	0	0	0.357465524	0	0.15319951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.6892	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.5062	0.079016725	2.373627865	0.830822502	1.346158698	3.141167222	0.143606265	1.761231975	4.530051549	1.361092705	2.628560195	0	1.633053776	1.898410156	4.646528705	6.321963347	0.35304571	0.384992311	1.327073007	6.524651247	2.522671674	1.864623446	0	0	0.357465524	0	0.15319951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.6892
H5812_030_0	2008	3																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	172.8326855	3.030617283	1456.61469	1274.61878	206.522952	51920.11305	53.61268448	540.4040802	529.6150512	3864.610382	1502.059843	0	1721.228729	1362.801831	3579.939676	6017.571438	122.6833555	393.761145	2883.562376	8757.669626	6225.76204	4058.061745	0	0	274.2055426	0	117.5166611	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												312.8737842	312.8737842	19.55461151	7.821844604	78.21844604	0.726000088	32.14304967	39.10922302	102.6417555	4.226328361	20.99964424	0	11.38526506	16.71623955	15.575219	12.60700616	34.53238218	11.73276691	5.522639712	8.940256748	4.862386306	5.513834624	0	0	15.64368921	0	15.64368921	0	0	0	0											4.5062	0.079016725	2.373627865	0.830822502	1.346158698	3.141167222	0.143606265	1.761231975	4.530051549	1.361092705	2.628560195	0	1.633053776	1.898410156	4.646528705	6.321963347	0.35304571	0.384992311	1.327073007	6.524651247	2.522671674	1.864623446	0	0	0.357465524	0	0.15319951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.6892	None	14.11547613	4.5062	0.079016725	2.373627865	0.830822502	1.346158698	3.141167222	0.143606265	1.761231975	4.530051549	1.361092705	2.628560195	0	1.633053776	1.898410156	4.646528705	6.321963347	0.35304571	0.384992311	1.327073007	6.524651247	2.522671674	1.864623446	0	0	0.357465524	0	0.15319951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.6892	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	4.5062	0.079016725	2.373627865	0.830822502	1.346158698	3.141167222	0.143606265	1.761231975	4.530051549	1.361092705	2.628560195	0	1.633053776	1.898410156	4.646528705	6.321963347	0.35304571	0.384992311	1.327073007	6.524651247	2.522671674	1.864623446	0	0	0.357465524	0	0.15319951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.6892
H5812_032_0	2008	4																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	174.6639265	3.062728053	999.9547234	1211.169158	202.6256647	50940.33044	52.60096142	318.4324623	303.9997922	2218.291853	866.8783505	0	987.987737	781.3134788	3316.467091	5793.299847	122.6404724	406.3210413	2809.847976	9330.691355	5758.612277	4139.213052	0	0	254.0248554	0	108.8677952	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												344.0126885	344.0126885	21.50079303	8.600317214	86.00317214	0.832535599	36.85982071	43.00158607	76.98647021	3.169958473	15.57691778	0	8.539520447	12.4485719	17.12534969	13.13037106	38.501725	8.600317214	3.972612184	6.228184073	2.895586105	4.092142833	0	0	17.20063443	0	17.20063443	0	0	0	0											5.0072	0.087801443	1.791651629	0.86803658	1.45220416	3.534136542	0.161571834	1.141091745	1.950322579	0.585991088	1.125274399	0	0.703078457	0.810519751	4.732971556	6.339014723	0.393489145	0.291207487	0.930203025	4.84277194	1.389546474	1.411520919	0	0	0.364115723	0	0.156049595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0698	None	6.521270225	5.0072	0.087801443	1.791651629	0.86803658	1.45220416	3.534136542	0.161571834	1.141091745	1.950322579	0.585991088	1.125274399	0	0.703078457	0.810519751	4.732971556	6.339014723	0.393489145	0.291207487	0.930203025	4.84277194	1.389546474	1.411520919	0	0	0.364115723	0	0.156049595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0698	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.0072	0.087801443	1.791651629	0.86803658	1.45220416	3.534136542	0.161571834	1.141091745	1.950322579	0.585991088	1.125274399	0	0.703078457	0.810519751	4.732971556	6.339014723	0.393489145	0.291207487	0.930203025	4.84277194	1.389546474	1.411520919	0	0	0.364115723	0	0.156049595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0698
H5812_033_0	2008	2																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	174.6639265	3.062728053	999.9547234	1211.169158	202.6256647	50940.33044	52.60096142	318.4324623	303.9997922	2218.291853	866.8783505	0	987.987737	781.3134788	3316.467091	5793.299847	122.6404724	406.3210413	2809.847976	9330.691355	5758.612277	4139.213052	0	0	254.0248554	0	108.8677952	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												344.0126885	344.0126885	21.50079303	8.600317214	86.00317214	0.832535599	36.85982071	43.00158607	76.98647021	3.169958473	15.57691778	0	8.539520447	12.4485719	17.12534969	13.13037106	38.501725	8.600317214	3.972612184	6.228184073	2.895586105	4.092142833	0	0	17.20063443	0	17.20063443	0	0	0	0											5.0072	0.087801443	1.791651629	0.86803658	1.45220416	3.534136542	0.161571834	1.141091745	1.950322579	0.585991088	1.125274399	0	0.703078457	0.810519751	4.732971556	6.339014723	0.393489145	0.291207487	0.930203025	4.84277194	1.389546474	1.411520919	0	0	0.364115723	0	0.156049595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0698	None	6.521270225	5.0072	0.087801443	1.791651629	0.86803658	1.45220416	3.534136542	0.161571834	1.141091745	1.950322579	0.585991088	1.125274399	0	0.703078457	0.810519751	4.732971556	6.339014723	0.393489145	0.291207487	0.930203025	4.84277194	1.389546474	1.411520919	0	0	0.364115723	0	0.156049595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0698	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.0072	0.087801443	1.791651629	0.86803658	1.45220416	3.534136542	0.161571834	1.141091745	1.950322579	0.585991088	1.125274399	0	0.703078457	0.810519751	4.732971556	6.339014723	0.393489145	0.291207487	0.930203025	4.84277194	1.389546474	1.411520919	0	0	0.364115723	0	0.156049595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0698
H5812_034_0	2008	3																					3000											A	A	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	174.6639265	3.062728053	999.9547234	1211.169158	202.6256647	50940.33044	52.60096142	318.4324623	303.9997922	2218.291853	866.8783505	0	987.987737	781.3134788	3316.467091	5793.299847	122.6404724	406.3210413	2809.847976	9330.691355	5758.612277	4139.213052	0	0	254.0248554	0	108.8677952	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												344.0126885	344.0126885	21.50079303	8.600317214	86.00317214	0.832535599	36.85982071	43.00158607	76.98647021	3.169958473	15.57691778	0	8.539520447	12.4485719	17.12534969	13.13037106	38.501725	8.600317214	3.972612184	6.228184073	2.895586105	4.092142833	0	0	17.20063443	0	17.20063443	0	0	0	0											5.0072	0.087801443	1.791651629	0.86803658	1.45220416	3.534136542	0.161571834	1.141091745	1.950322579	0.585991088	1.125274399	0	0.703078457	0.810519751	4.732971556	6.339014723	0.393489145	0.291207487	0.930203025	4.84277194	1.389546474	1.411520919	0	0	0.364115723	0	0.156049595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0698	None	6.521270225	5.0072	0.087801443	1.791651629	0.86803658	1.45220416	3.534136542	0.161571834	1.141091745	1.950322579	0.585991088	1.125274399	0	0.703078457	0.810519751	4.732971556	6.339014723	0.393489145	0.291207487	0.930203025	4.84277194	1.389546474	1.411520919	0	0	0.364115723	0	0.156049595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0698	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	5.0072	0.087801443	1.791651629	0.86803658	1.45220416	3.534136542	0.161571834	1.141091745	1.950322579	0.585991088	1.125274399	0	0.703078457	0.810519751	4.732971556	6.339014723	0.393489145	0.291207487	0.930203025	4.84277194	1.389546474	1.411520919	0	0	0.364115723	0	0.156049595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0698
H5812_044_0	2008	2																					3000											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	845.6087931	24.967191	1089.634817	1372.340982	186.7998678	46961.70648	48.49263618	362.1426516	331.5324585	2495.593937	957.7015466	0	1111.493153	880.0529325	3925.901399	6529.218289	148.6658707	451.5004794	2884.487565	11408.73504	6669.425435	4814.679661	0	0	278.2230337	0	119.238443	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												143.8152484	143.8152484	46.73995571	14.38152484	71.90762418	1.015419037	44.95683275	35.95381209	251.6766846	5.192430221	28.35326357	0	13.98783751	22.21381595	10.78614363	16.78552189	31.76130482	17.97690604	8.149650864	9.666753603	4.703706957	6.749982941	0	0	21.57228725	0	21.57228725	0	0	0	0											10.1343	0.299221898	4.244123592	1.644696326	1.119361224	3.973817566	0.181672945	1.08503407	6.953249166	1.079849782	2.262830364	0	1.295615469	1.629111155	3.52877803	9.133028043	0.39348517	0.676381808	1.958963881	9.190452544	2.614251901	2.708250465	0	0	0.500158934	0	0.214353829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.821	None	26.10515861	10.1343	0.299221898	4.244123592	1.644696326	1.119361224	3.973817566	0.181672945	1.08503407	6.953249166	1.079849782	2.262830364	0	1.295615469	1.629111155	3.52877803	9.133028043	0.39348517	0.676381808	1.958963881	9.190452544	2.614251901	2.708250465	0	0	0.500158934	0	0.214353829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.821	3000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	10.1343	0.299221898	4.244123592	1.644696326	1.119361224	3.973817566	0.181672945	1.08503407	6.953249166	1.079849782	2.262830364	0	1.295615469	1.629111155	3.52877803	9.133028043	0.39348517	0.676381808	1.958963881	9.190452544	2.614251901	2.708250465	0	0	0.500158934	0	0.214353829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.821
H5812_047_0	2008	3																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.71568721	0	0	0	0	0	0	0	0	0	305.3464139	0	130.8627488	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	10	0	0	0	0	0	0	0	0	0	10	0	10	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.027263073	0	0	0	0	0	0	0	0	0	0.254455345	0	0.109052291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.3908	None	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.027263073	0	0	0	0	0	0	0	0	0	0.254455345	0	0.109052291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.3908	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.027263073	0	0	0	0	0	0	0	0	0	0.254455345	0	0.109052291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.3908
H5812_048_0	2008	3																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.14752322	0	0	0	0	0	0	0	0	0	365.3768834	0	156.5900929	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	10	0	0	0	0	0	0	0	0	0	10	0	10	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.032622936	0	0	0	0	0	0	0	0	0	0.304480736	0	0.130491744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4676	None	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.032622936	0	0	0	0	0	0	0	0	0	0.304480736	0	0.130491744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4676	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.032622936	0	0	0	0	0	0	0	0	0	0.304480736	0	0.130491744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4676
H5812_049_0	2008	3																					N/A											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	O	O	V	O	V	O	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.67978361	0	0	0	0	0	0	0	0	0	314.344647	0	134.7191344	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	10	0	0	0	0	0	0	0	0	0	10	0	10	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.028066486	0	0	0	0	0	0	0	0	0	0.261953873	0	0.112265945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4023	None	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.028066486	0	0	0	0	0	0	0	0	0	0.261953873	0	0.112265945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4023	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.028066486	0	0	0	0	0	0	0	0	0	0.261953873	0	0.112265945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4023
H5812_801_0	2008	4																					N/A											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	211.2973663	2.678012374	37.0685066	22.10172954	5.687548378	19.46981347	0.890110903	5.203011721	26.95242408	8.098086169	23.24663933	0	9.716171535	15.8683758	22.87646521	45.27329025	1.360863477	3.776153971	24.52235037	74.00969652	23.39816107	20.93300086	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.079691159	0.079691159	0.205457523	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											16.8385	0.21341391	7.616003561	0	1.330886321	4.555936352	0.208285951	1.217504743	6.306867234	1.894952164	5.439713603	0	2.273584139	3.713199938	5.35309286	10.59394992	0.318442054	0.883620029	5.738229986	17.31826898	5.47516969	4.898322201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.188	135	0	16.8385	0.21341391	7.616003561	0	1.330886321	4.555936352	0.208285951	1.217504743	6.306867234	1.894952164	5.439713603	0	2.273584139	3.713199938	5.35309286	10.59394992	0.318442054	0.883620029	5.738229986	17.31826898	5.47516969	4.898322201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.188	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	16.8385	0.21341391	7.616003561	0	1.330886321	4.555936352	0.208285951	1.217504743	6.306867234	1.894952164	5.439713603	0	2.273584139	3.713199938	5.35309286	10.59394992	0.318442054	0.883620029	5.738229986	17.31826898	5.47516969	4.898322201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.188
H5812_802_0	2008	4																					N/A											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	211.2973663	2.678012374	37.0685066	22.10172954	5.687548378	19.46981347	0.890110903	5.203011721	26.95242408	8.098086169	23.24663933	0	9.716171535	15.8683758	22.87646521	45.27329025	1.360863477	3.776153971	24.52235037	74.00969652	23.39816107	20.93300086	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.079691159	0.079691159	0.205457523	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											16.8385	0.21341391	7.616003561	0	1.330886321	4.555936352	0.208285951	1.217504743	6.306867234	1.894952164	5.439713603	0	2.273584139	3.713199938	5.35309286	10.59394992	0.318442054	0.883620029	5.738229986	17.31826898	5.47516969	4.898322201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.188	135	0	16.8385	0.21341391	7.616003561	0	1.330886321	4.555936352	0.208285951	1.217504743	6.306867234	1.894952164	5.439713603	0	2.273584139	3.713199938	5.35309286	10.59394992	0.318442054	0.883620029	5.738229986	17.31826898	5.47516969	4.898322201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.188	N/A																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	N/A	0	16.8385	0.21341391	7.616003561	0	1.330886321	4.555936352	0.208285951	1.217504743	6.306867234	1.894952164	5.439713603	0	2.273584139	3.713199938	5.35309286	10.59394992	0.318442054	0.883620029	5.738229986	17.31826898	5.47516969	4.898322201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.188
H5813_003_0	2008	3																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	948.624126	0	0	0	0	0	0	0	0	0	0											$850/admission	$850/admission	"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $35 UC	$250 per procedure	$35 per visit	"$35 X-ray; $150 CAT, PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$20 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															143.7153897	143.7153897	68.6350679	20	100	0.2	0.2	48	250	35	55.7	35	30	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0	0											16.731	0.325940179	6.526727467	3.122011879	1.722706705	2.766333837	0.176580511	1.499757057	6.435396625	5.728089799	4.68491029	0	0	0	8.119976658	17.55996622	0.517623892	1.497639	2.456202127	3.712403063	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.1406	0	0	16.731	0.325940179	6.526727467	3.122011879	1.722706705	2.766333837	0.176580511	1.499757057	6.435396625	5.728089799	4.68491029	0	0	0	8.119976658	17.55996622	0.517623892	1.497639	2.456202127	3.712403063	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.1406																																																																																				0	0	0	16.731	0.325940179	6.526727467	3.122011879	1.722706705	2.766333837	0.176580511	1.499757057	6.435396625	5.728089799	4.68491029	0	0	0	8.119976658	17.55996622	0.517623892	1.497639	2.456202127	3.712403063	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.1406
H5813_004_0	2008	4																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	948.624126	0	0	0	0	0	0	0	0	0	0											$350/admission	$350/admission	"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $35 UC	$250 per procedure	$25 per visit	"$25 X-ray; $150 CAT, PET, MRI"	$25 per visit	$30 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit															59.17692516	59.17692516	68.6350679	20	100	0.2	0.2	48	250	25	47.5	25	30	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0	0											6.8892	0.134210662	6.526727467	3.122011879	1.722706705	2.766333837	0.176580511	1.499757057	6.435396625	4.091492713	3.99521075	0	0	0	4.059988329	12.54283301	0.369731351	1.069742143	1.754430091	2.651716473	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3654	0	0	6.8892	0.134210662	6.526727467	3.122011879	1.722706705	2.766333837	0.176580511	1.499757057	6.435396625	4.091492713	3.99521075	0	0	0	4.059988329	12.54283301	0.369731351	1.069742143	1.754430091	2.651716473	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3654																																																																																				0	0	0	6.8892	0.134210662	6.526727467	3.122011879	1.722706705	2.766333837	0.176580511	1.499757057	6.435396625	4.091492713	3.99521075	0	0	0	4.059988329	12.54283301	0.369731351	1.069742143	1.754430091	2.651716473	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3654
H5813_005_0	2008	4																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S			V	V		V																																																								0		1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	948.624126	0	0	0	0	0	0	0	0	0	0											$950/admission		"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	20% coinsurance		$50 ER; $25 UC	$200 per procedure	$15 per visit	"$15 X-ray; $150 CAT, PET, MRI"	$15 per visit	$0 per visit	$15 per visit	$0 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script			$5 per visit	$0 per visit		$0 per visit															160.62	0	41.19723561	0	100	0.2	0	46.675	200	15	39.3	15	0	15	0	15	15	15	15	15	45	0	0	5	0	0	0	0	0	0	0											18.699	0	3.917576502	0	1.722706705	2.766333837	0	1.458357513	5.1483173	2.454895628	3.30551121	0	0	0	0	7.525699807	0.221838811	0.641845286	1.052658054	1.591029884	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0631	0	0	18.699	0	3.917576502	0	1.722706705	2.766333837	0	1.458357513	5.1483173	2.454895628	3.30551121	0	0	0	0	7.525699807	0.221838811	0.641845286	1.052658054	1.591029884	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0631																																																																																				0	0	0	18.699	0	3.917576502	0	1.722706705	2.766333837	0	1.458357513	5.1483173	2.454895628	3.30551121	0	0	0	0	7.525699807	0.221838811	0.641845286	1.052658054	1.591029884	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0631
H5813_801_0	2008	2																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1279.906739	0	1168.265601	205.6670083	205.370504	3.721962538	0	183.0354714	290.1974514	639.9984836	4908.528828	0	0	512.0255206	3266.278663	4331.042889	0	846.7140412	0	0	242.8729439	0	0	0	378.2324774	0	38.46777991	0	0	0	0											$200/day; $1400 max		$100/day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$39.5 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											15.4197	0	9.735546675	0.685556694	2.567131301	1.116588761	0	0.762647797	4.83662419	2.133328279	22.47288115	0	0	1.706751735	8.165696659	14.25634951	0	2.822380137	0	0	0.004047882	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.6852	0	0	15.4197	0	9.735546675	0.685556694	2.567131301	1.116588761	0	0.762647797	4.83662419	2.133328279	22.47288115	0	0	1.706751735	8.165696659	14.25634951	0	2.822380137	0	0	0.004047882	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.6852																																																																																				0	0	0	15.4197	0	9.735546675	0.685556694	2.567131301	1.116588761	0	0.762647797	4.83662419	2.133328279	22.47288115	0	0	1.706751735	8.165696659	14.25634951	0	2.822380137	0	0	0.004047882	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.6852
H5813_802_0	2008	2																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1279.906739	0	1168.265601	205.6670083	205.370504	3.721962538	0	183.0354714	290.1974514	639.9984836	4908.528828	0	0	512.0255206	3266.278663	4331.042889	0	846.7140412	0	0	242.8729439	0	0	0	378.2324774	0	38.46777991	0	0	0	0											$200/day; $1400 max		$100/day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$39.5 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											15.4197	0	9.735546675	0.685556694	2.567131301	1.116588761	0	0.762647797	4.83662419	2.133328279	22.47288115	0	0	1.706751735	8.165696659	14.25634951	0	2.822380137	0	0	0.004047882	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.6852	0	0	15.4197	0	9.735546675	0.685556694	2.567131301	1.116588761	0	0.762647797	4.83662419	2.133328279	22.47288115	0	0	1.706751735	8.165696659	14.25634951	0	2.822380137	0	0	0.004047882	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.6852																																																																																				0	0	0	15.4197	0	9.735546675	0.685556694	2.567131301	1.116588761	0	0.762647797	4.83662419	2.133328279	22.47288115	0	0	1.706751735	8.165696659	14.25634951	0	2.822380137	0	0	0.004047882	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.6852
H5817_009_0	2008	7																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	431.1191127	95.64346824	11.45441831	10.88865544	19.09022509	19.63586513	0	22.06512829	25.75805504	11.69420531	3.553512814	0	0	56.42975072	8.49377899	87.31524728	13.11172849	2.675267928	0	127.6815494	0	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Medicare FFS cost sharing	1B IP Psych: Medicare FFS cost sharing	2 SNF: Medicare FFS cost sharing	6 Home Health: $0	10A Ambulance: 20%	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: 13%, 4B Urgent Care: 13%"	9B ASC Services: 13%	8A OP C/D/T: 13%	8B OP X-Ray: 13%	9A OP Hospital: 13%	12 Renal Dialysis: 13%	"3 CORF: 13%, 5 Partial Hosp: 13%, 9C OP Substance Abuse: 13%, 9D Cardiac Rehab: 13%"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $0, 7D Physician Specialist: $0, 7F Podiatry: $0"	"7E Mental Health: $0, 7H Psychiatric: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.069825391	0.069825391	0.200341909	0	0.2	0.2	0.2	0.13	0.13	0.13	0.13	0.13	0.13	0.13	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											30.1031	6.678342583	2.294800035	0	3.818045018	3.927173026	0	2.868466677	3.348547155	1.520246691	0.461956666	0	0	7.335867593	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3565	0	0	30.1031	6.678342583	2.294800035	0	3.818045018	3.927173026	0	2.868466677	3.348547155	1.520246691	0.461956666	0	0	7.335867593	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3565	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.1031	6.678342583	2.294800035	0	3.818045018	3.927173026	0	2.868466677	3.348547155	1.520246691	0.461956666	0	0	7.335867593	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3565
H5817_010_0	2008	5																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	652.32	8.45	634.3568	0	351.82	27.79	16.93	263.25	250.83	0	915.67	26.33	0.41	515.17	5300	6100.6	156.53	534.09	2567.91	1764	271.13	681.28	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute:   $100   for 1st 5   Days	1B IP Psych:   $100   for 1st 5   Days	2 SNF:   $85   for Days 7   - 100	6 Home Health:   $0	10A Ambulance:     $100	11A DME:     20%	"11B Prosthetic Medical Supplies:      20%,  11C Diabetes Monitoring Supplies:     20%"	"4A ER:     $50,  4B Urgent Care:     $25"	9B ASC Services:     $100	8A OP Clinical/Diagnostic/Therapy Radiological Lab Services:      $0	8B OP X-Ray:     $13.1	"5 Partial Hospitalization:     $100,  9A OP Hospital,  $100"	12 Renal Dialysis:      $20	"3 CORF ,  100,  9D Cardiac Rehab:     $20"	"7A PCP:     $5,  14B Immunizations:     $0,  14C Routine Physical Exams:     $0,  14D Pap Smears:      $,  14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement:      $11.75,  14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist:     $20	"7E Mental Health:     $20,  7H Psychiatric:     $20,  9C OP Substance Abuse,  20"	"7C Occupational Therapy:     $20,  7I Physical and Speech Therapy:     $20"	7D Physician Specialist Services - Radiology:   11.75	"7G Other Health Care:     $20,  18A Medicare Covered Hearing Exams:   $20,  7B Chiropractic:     $20,  7F Podiatry:     $20"	15 Part B Drugs:     $100	"13A Blood:     $100,  16B Medicare Covered Comprehensive Dental Services:     $20,  17A Medicare Covered Eye Exams:   $20"	"10B Transportation:     $0,  Number of Trips Covered - 24"	"16A Preventive Dental Services:   $0,  16B Non Medicare Covered Comprehensive Dental:   $0"	17A Routine Eye Exams:    $0	17B Eye Wear: $0	18A Routine Hearing Exams:   $0	18B Hearing Aids:   $0	19 POS:   $0	14A Health Education/Wellness Programs:   $0	13B Acupuncture: Not Covered											100	100	85	0	100	0.200034839	0.201551381	48.53846154	100	0	13.1	100	20	100	5	20	20	20	11.75	20	100	21.35157351	0	0	0	0	0	0	0	0	0											5.436	0.070416667	4.493360667	0	2.931833333	5.558968167	3.412264883	1.0648125	2.09025	0	0.999606417	0.219416667	0.000683333	4.293083333	2.208333333	10.16766667	0.260883333	0.89015	2.514411875	2.94	2.259416667	1.2122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0238	0	0	5.436	0.070416667	4.493360667	0	2.931833333	5.558968167	3.412264883	1.0648125	2.09025	0	0.999606417	0.219416667	0.000683333	4.293083333	2.208333333	10.16766667	0.260883333	0.89015	2.514411875	2.94	2.259416667	1.2122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.436	0.070416667	4.493360667	0	2.931833333	5.558968167	3.412264883	1.0648125	2.09025	0	0.999606417	0.219416667	0.000683333	4.293083333	2.208333333	10.16766667	0.260883333	0.89015	2.514411875	2.94	2.259416667	1.2122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0238
H5817_011_0	2008	6																					0											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											17.5488	0.1354	2.5917	3.0136	0	1.7652	1.075	0	2.1541	0.8743	2.377	0.057	0.0074	1.4094	0	0	0	0	0	0	0.625	0.0462	0	0	0	0	0	0	0	0	0											33.68	0	0	0	0	0	313.94	0	0	258.05	0	0	0	0	0	233.67	0	6514.4	165.25	580.51	398.21	1927.13	0	724.32	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute:   $0	1B IP Psych:   $0	2 SNF:   $0	6 Home Health:   $0	10A Ambulance:     $100	11A DME:     $0	"11B Prosthetic Medical Supplies:      $0,11C Diabetes Monitoring Supplies:     $0"	"4A ER:     $50,4B Urgent Care:     $25"	9B ASC Services:     $0	8A OP Clinical/Diagnostic/Therapy Radiological Lab Services:      $0	8B OP X-Ray:     $0	"9A OP Hospital,  $0,  5 Partial Hosp:     $0"	12 Renal Dialysis:      $0	"3 CORF:,  $0,   9D Cardiac Rehab:     $10"	"7A PCP:     $0,  14B Immunizations:     $0,  14C Routine Physical Exams:     $0,  14D Pap Smears:      $,  14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement:50,   14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist:     $10	"7E Mental Health:     $10,  7H Psychiatric:     $10,     9C OP Substance Abuse: $10"	"7C Occupational Therapy:     $10,  7I Physical and Speech Therapy:     $10"	7D Physician Specialist Services - Radiology:   $50	"7G Other Health Care:     $10,  18A Medicare Covered Hearing Exams:   $10,  7B Chiropractic:     $10,  7F Podiatry:     $10"	15 Part B Drugs:     $0	"13A Blood:     $0,  16B Medicare Covered Comprehensive Dental Services:     $10,  17A Medicare Covered Eye Exams:   $10"	"10B Transportation:     $0,  Number of Trips Covered - 24"	"16A Preventive Dental Services:   $0,  16B Non Medicare Covered Comprehensive Dental:    $0"	17A Routine Eye Exams:    $0	17B Eye Wear:    $0	18A Routine Hearing Exams:   $0	18B Hearing Aids:   $0	19 POS:   $0	14A Health Education/Wellness Programs:   $0	13B Acupuncture: Not Covered											0	0	0	0	100	0	0	48.39275334	0	0	0	0	0	10	0	10	10	10	50	10	0	10	0	0	0	0	0	0	0	0	0											0	0	0	0	2.616166667	0	0	1.040645833	0	0	0	0	0	0.194725	0	5.428666667	0.137708333	0.483758333	1.659208333	1.605941667	0	0.6036	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.7704	1200	0	17.5488	0.135403623	2.591658373	3.013556247	2.616166667	1.765200892	1.074972667	1.040645833	2.154073493	0.874344128	2.376994092	0.056968598	0.007430687	1.604078566	0	5.428666667	0.137708333	0.483758333	1.659208333	1.605941667	0.625003309	0.649835384	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4504	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.5488	0.135403623	2.591658373	3.013556247	2.616166667	1.765200892	1.074972667	1.040645833	2.154073493	0.874344128	2.376994092	0.056968598	0.007430687	1.604078566	0	5.428666667	0.137708333	0.483758333	1.659208333	1.605941667	0.625003309	0.649835384	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4504
H5817_014_0	2008	7																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	626.63	8.5	702.1184	0	273.39	17.84	10.86	246.55	233.9	0	715.88	20.58	0.32	402.76	5402.46	6236.02	162.54	542.39	2522.44	1789.91	211.97	682.37	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute:   $100   for 1st 5   Days	1B IP Psych:   $100   for 1st 5   Days	2 SNF:   $85   for Days 7   - 100	6 Home Health:   $0	10A Ambulance:     $100	11A DME:     20%	"11B Prosthetic Medical Supplies:      20%,  11C Diabetes Monitoring Supplies:     20%"	"4A ER:     $50,  4B Urgent Care:     $25"	9B ASC Services:     $100	8A OP Clinical/Diagnostic/Therapy Radiological Lab Services:      $0	8B OP X-Ray:     $13.1	"5 Partial Hospitalization:     $100,  9A OP Hospital,  $100"	12 Renal Dialysis:      $25	"3 CORF ,  100,  9D Cardiac Rehab:     $25"	"7A PCP:     $5,  14B Immunizations:     $0,  14C Routine Physical Exams:     $0,  14D Pap Smears:      $,  14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement:      $11.75,  14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist:     $25	"7E Mental Health:     $25,  7H Psychiatric:     $25,  9C OP Substance Abuse,  25"	"7C Occupational Therapy:     $25,  7I Physical and Speech Therapy:     $25"	7D Physician Specialist Services - Radiology:   11.75	"7G Other Health Care:     $25,  18A Medicare Covered Hearing Exams:   $25,  7B Chiropractic:     $25,  7F Podiatry:     $25"	15 Part B Drugs:     $100	"13A Blood:     $100,  16B Medicare Covered Comprehensive Dental Services:     $25,  17A Medicare Covered Eye Exams:   $25"	"10B Transportation:     $0,  Number of Trips Covered - 24"	"16A Preventive Dental Services:   $0,  16B Non Medicare Covered Comprehensive Dental:   $0"	17A Routine Eye Exams:    $0	17B Eye Wear: $0	18A Routine Hearing Exams:   $0	18B Hearing Aids:   $0	19 POS:   $0	14A Health Education/Wellness Programs:   $0	13B Acupuncture: Not Covered											100	100	85	0	100	0.199983885	0.19903661	48.4120868	100	0	13.1	100	25	100	5	25	25	25	11.75	25	100	25.98919941	0	0	0	0	0	0	0	0	0											5.2219	0.070833333	4.973338667	0	2.27825	3.5677125	2.161537583	0.994666667	1.949166667	0	0.781502333	0.1715	0.000666667	3.356333333	2.251025	12.99170833	0.338625	1.129979167	2.469889167	3.728979167	1.766416667	1.477854167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6819	0	0	5.2219	0.070833333	4.973338667	0	2.27825	3.5677125	2.161537583	0.994666667	1.949166667	0	0.781502333	0.1715	0.000666667	3.356333333	2.251025	12.99170833	0.338625	1.129979167	2.469889167	3.728979167	1.766416667	1.477854167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.2219	0.070833333	4.973338667	0	2.27825	3.5677125	2.161537583	0.994666667	1.949166667	0	0.781502333	0.1715	0.000666667	3.356333333	2.251025	12.99170833	0.338625	1.129979167	2.469889167	3.728979167	1.766416667	1.477854167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6819
H5817_015_0	2008	3																					0											Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	403.97	31.79025	124.47	0	23.1	39.92	30.01	9.17	17.41	14.24	24.54	0.81	0.96	45.83	73.76	130.56	10.4	4.83	34.03	44.54	7.77	4.11	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Medicare FFS cost sharing	1B IP Psych: Medicare FFS cost sharing	2 SNF: Medicare FFS cost sharing	6 Home Health: $0	10A Ambulance: Medicare FFS cost sharing	11A DME: Medicare FFS cost sharing	"11B Prosthetic/Medical Supplies: Medicare FFS cost sharing, 11C Diabetes Monitoring Supplies: Medicare FFS cost sharing"	"4A ER: Medicare FFS cost sharing, 4B Urgent Care: Medicare FFS cost sharing"	9B ASC Services: Medicare FFS cost sharing	8A OP C/D/T: Medicare FFS cost sharing	8B OP X-Ray: Medicare FFS cost sharing	9A OP Hospital: Medicare FFS cost sharing	12 Renal Dialysis: Medicare FFS cost sharing	"3 CORF: Medicare FFS cost sharing, 5 Partial Hosp: Medicare FFS cost sharing, 9C OP Substance Abuse: Medicare FFS cost sharing, 9D Cardiac Rehab: Medicare FFS cost sharing"	"7A PCP: Medicare FFS cost sharing, 14B Immunizations: Medicare FFS cost sharing, 14C Routine Physical Exams: Medicare FFS cost sharing, 14D Pap Smears: Medicare FFS cost sharing, 14D Pelvic Exams: Medicare FFS cost sharing, 14E Prostate Screening: Medicare FFS cost sharing, 14F Colorectal Screening: Medicare FFS cost sharing, 14G Bone Mass Measurement: Medicare FFS cost sharing, 14H Mammography: Medicare FFS cost sharing, 14I Diabetes Monitoring: Medicare FFS cost sharing"	"7D Physician Specialist: Medicare FFS cost sharing,"	"7E Mental Health: Medicare FFS cost sharing, 7H Psychiatric: Medicare FFS cost sharing"	"7C Occupational Therapy: Medicare FFS cost sharing, 7I Physical and Speech Therapy: Medicare FFS cost sharing"	7D Physician Specialist: Medicare FFS cost sharing	"7B Chiropractic: Medicare FFS cost sharing, 7F Podiatry: Medicare FFS cost sharing, 7G Other Health Care: Medicare FFS cost sharing, 18A Medicare Covered Hearing Exams: Medicare FFS cost sharing"	15 Part B Drugs: Medicare FFS cost sharing	"13A Blood: Medicare FFS cost sharing, 16B Medicare Covered Comprehensive Dental Services: Medicare FFS cost sharing, 17A Medicare Covered Eye Exams: Medicare FFS cost sharing"	10B Transportation: $0	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental:Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.072600271	0.072599483	0.206502248	0	0.234029766	0.233985387	0.233984304	0.234109537	0.233997511	0.234077101	0.234016182	0.233985309	0.233999219	0.234007571	0.233000913	0.234026648	0.233973065	0.234027288	0.234032353	0.227908316	0.233977937	0.234009753	0	0	0	0	0	0	0	0	0											29.3283	2.307955699	25.7033348	0	5.406087592	9.340696667	7.021868953	2.146784458	4.073896667	3.333257917	5.742757108	0.1895281	0.22463925	10.72456696	17.18614735	30.55451913	2.433319875	1.1303518	7.964120983	10.1510364	1.818008567	0.961780083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	177.743	0	0	29.3283	2.307955699	25.7033348	0	5.406087592	9.340696667	7.021868953	2.146784458	4.073896667	3.333257917	5.742757108	0.1895281	0.22463925	10.72456696	17.18614735	30.55451913	2.433319875	1.1303518	7.964120983	10.1510364	1.818008567	0.961780083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	177.743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	29.3283	2.307955699	25.7033348	0	5.406087592	9.340696667	7.021868953	2.146784458	4.073896667	3.333257917	5.742757108	0.1895281	0.22463925	10.72456696	17.18614735	30.55451913	2.433319875	1.1303518	7.964120983	10.1510364	1.818008567	0.961780083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	177.743
H5820_002_0	2008	7																					4000											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1620.806295	42.53810869	1127.304578	2720.826133	249.0465981	30139.04081	30324.93999	255.0022472	366.8070482	2316.584656	879.1596573	0	74.2753131	661.3459355	7914.535349	12073.84754	175.8249051	505.2300652	5005.530094	14112.42897	418.5249872	894.2558363	0	3065.068925	379.8888772	0	162.8095188	0	0	0	337.9199128											"$300 copay, days 1 - 7"	"$300 copay, days 1 - 7"	"$100 copay, days 6 - 30"		$100 copay	30% coinsurance	30% coinsurance	"$50 copay , waived if admitted"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance		20% coinsurance	$10 copay	$30 copay	$30 copay	$30 copay	10% coinsurance	Varies	20% coinsurance	20% coinsurance		Varies	$30 copay		$30 copay				Varies											158.6539289	225.4970599	36.35880036	0	100	1.0864338	1.040124915	45	163.3227595	9.728929919	26.2886915	0	0	43.58022703	4.973948148	19.81881467	30	30	0	1.059401037	1.205930888	21.8786262	0	0	30	0	30	0	0	0	0											21.4289	0.799351537	3.415620174	0	2.075388317	2.72867272	2.628477135	0.956258427	4.992328276	1.878157481	1.925996417	0	0	2.401800501	3.280540704	19.94077889	0.439562263	1.263075163	0	1.245893491	0.042059351	1.630424098	0	0	0.949722193	0	0.407023797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4301		22.5707849	21.4289	0.799351537	3.415620174	0	2.075388317	2.72867272	2.628477135	0.956258427	4.992328276	1.878157481	1.925996417	0	0	2.401800501	3.280540704	19.94077889	0.439562263	1.263075163	0	1.245893491	0.042059351	1.630424098	0	0	0.949722193	0	0.407023797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4301																																																																																				0			21.4289	0.799351537	3.415620174	0	2.075388317	2.72867272	2.628477135	0.956258427	4.992328276	1.878157481	1.925996417	0	0	2.401800501	3.280540704	19.94077889	0.439562263	1.263075163	0	1.245893491	0.042059351	1.630424098	0	0	0.949722193	0	0.407023797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4301
H5820_003_0	2008	6																					4000											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1400.396035	36.07313112	1028.937908	2194.145238	239.0274783	28909.16648	29091.53065	232.855128	330.1922159	2098.359267	798.2530751	0	67.0117668	599.6938053	7667.139653	12040.94829	180.049543	517.7078461	4943.268074	14511.04123	380.6606722	875.2938556	0	3065.068925	379.6069057	0	162.6886739	0	0	0	337.4039847											"$300 copay, days 1 - 7"	"$300 copay, days 1 - 7"	"$100 copay, days 6 - 30"		$100 copay	30% coinsurance	30% coinsurance	"$50 copay , waived if admitted"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance		20% coinsurance	$10 copay	$30 copay	$30 copay	$30 copay	10% coinsurance	Varies	20% coinsurance	20% coinsurance		Varies	$30 copay		$30 copay				Varies											158.2910143	225.4970599	36.93842048	0	100	1.042845971	0.999109514	45	165.8180167	9.776566307	26.50921523	0	0	43.59192291	5.630153866	20.78071552	30	30	0	1.171421241	1.104491907	22.46945185	0	0	30	0	30	0	0	0	0											18.4725	0.677865418	3.167278425	0	1.991895652	2.512317316	2.422135419	0.87320673	4.56265153	1.709562375	1.763421882	0	0	2.178483844	3.597264663	20.85162675	0.450123857	1.294269615	0	1.416545161	0.035036386	1.638947762	0	0	0.949017264	0	0.406721685	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.9709		19.6073083	18.4725	0.677865418	3.167278425	0	1.991895652	2.512317316	2.422135419	0.87320673	4.56265153	1.709562375	1.763421882	0	0	2.178483844	3.597264663	20.85162675	0.450123857	1.294269615	0	1.416545161	0.035036386	1.638947762	0	0	0.949017264	0	0.406721685	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.9709																																																																																				0			18.4725	0.677865418	3.167278425	0	1.991895652	2.512317316	2.422135419	0.87320673	4.56265153	1.709562375	1.763421882	0	0	2.178483844	3.597264663	20.85162675	0.450123857	1.294269615	0	1.416545161	0.035036386	1.638947762	0	0	0.949017264	0	0.406721685	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.9709
H5820_004_0	2008	6																					4000											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1485.65522	38.50815314	1196.408451	2382.941184	238.9316742	28889.00279	29073.23957	258.7711383	372.6719058	2352.918835	893.8992544	0	75.44885289	671.5133513	8296.053199	12989.51861	190.9362694	549.480543	5219.080383	15231.83619	424.8519666	953.9641664	0	3065.068925	410.052794	0	175.7369117	0	0	0	362.1395533											"$300 copay, days 1 - 7"	"$300 copay, days 1 - 7"	"$100 copay, days 6 - 30"		$100 copay	30% coinsurance	30% coinsurance	"$50 copay , waived if admitted"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance		20% coinsurance	$10 copay	$30 copay	$30 copay	$30 copay	10% coinsurance	Varies	20% coinsurance	20% coinsurance		Varies	$30 copay		$30 copay				Varies											151.4905261	225.4970599	36.88462537	0	100	1.003801506	0.960621268	45	155.7066468	9.282827999	25.07707778	0	0	42.88015642	5.44273996	20.6956944	30	30	0	1.207682939	1.168022251	22.25137063	0	0	30	0	30	0	0	0	0											18.7552	0.723622943	3.677423126	0	1.991097285	2.416568709	2.327364355	0.970391769	4.835624402	1.82014507	1.868031761	0	0	2.399549795	3.762771688	22.40225896	0.477340673	1.373701357	0	1.532935725	0.041353046	1.768917519	0	0	1.025131985	0	0.439342279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6088		22.9058736	18.7552	0.723622943	3.677423126	0	1.991097285	2.416568709	2.327364355	0.970391769	4.835624402	1.82014507	1.868031761	0	0	2.399549795	3.762771688	22.40225896	0.477340673	1.373701357	0	1.532935725	0.041353046	1.768917519	0	0	1.025131985	0	0.439342279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6088																																																																																				0			18.7552	0.723622943	3.677423126	0	1.991097285	2.416568709	2.327364355	0.970391769	4.835624402	1.82014507	1.868031761	0	0	2.399549795	3.762771688	22.40225896	0.477340673	1.373701357	0	1.532935725	0.041353046	1.768917519	0	0	1.025131985	0	0.439342279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6088
H5820_005_0	2008	6																					4000											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1608.635482	42.199771	1114.672965	2714.020578	248.4236622	30063.65455	30249.08875	254.3644145	365.8895602	2298.372024	873.7971817	0	74.08952956	659.6917225	7822.669144	11988.77438	175.3851173	503.9663421	4953.411678	13998.24936	417.478138	892.0190498	0	3065.068925	378.9386678	0	162.4022862	0	0	0	333.7881645											"$350 copay, days 1 - 7"	"$350 copay, days 1 - 7"	"$150 copay, days 4 - 20"		$150 copay	30% coinsurance	30% coinsurance	"$50 copay , waived if admitted"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance		20% coinsurance	$15 copay	$35 copay	$35 copay	$35 copay	10% coinsurance	Varies	20% coinsurance	20% coinsurance		Varies	$30 copay		$30 copay				Varies											174.2306338	263.0799032	45.05267202	0	150	1.012911032	0.967084827	45	201.3337983	9.759723592	26.28785413	0	0	48.2596549	7.167296782	21.63918262	35	35	0	0.838237114	1.201944608	21.88261248	0	0	30	0	30	0	0	0	0.418291703											23.3561	0.925159306	4.184916292	0	3.105295777	2.537650613	2.437786231	0.953866554	6.138827908	1.869289639	1.914187738	0	0	2.653041239	4.672282616	21.61893985	0.511539926	1.469901831	0	0.977821011	0.041815466	1.626642266	0	0	0.94734667	0	0.406005716	0	0	0	0.011635068	0	0	0	0	0	0	0	0	0	0	82.3601		29.77626821	23.3561	0.925159306	4.184916292	0	3.105295777	2.537650613	2.437786231	0.953866554	6.138827908	1.869289639	1.914187738	0	0	2.653041239	4.672282616	21.61893985	0.511539926	1.469901831	0	0.977821011	0.041815466	1.626642266	0	0	0.94734667	0	0.406005716	0	0	0	0.011635068	0	0	0	0	0	0	0	0	0	0	82.3601																																																																																				0			23.3561	0.925159306	4.184916292	0	3.105295777	2.537650613	2.437786231	0.953866554	6.138827908	1.869289639	1.914187738	0	0	2.653041239	4.672282616	21.61893985	0.511539926	1.469901831	0	0.977821011	0.041815466	1.626642266	0	0	0.94734667	0	0.406005716	0	0	0	0.011635068	0	0	0	0	0	0	0	0	0	0	82.3601
H5820_006_0	2008	6																					4000											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1387.901803	35.73316618	1016.006205	2185.2864	238.0624074	28792.44604	28974.07391	231.914978	328.8590684	2078.900039	792.2663925	0	66.74120752	597.2725481	7564.090979	11937.44255	179.3225949	515.6176063	4884.771218	14370.8541	379.1237589	871.7598661	0	3065.068925	378.074247	0	162.0318201	0	0	0	332.750524											"$350 copay, days 1 - 7"	"$350 copay, days 1 - 7"	"$150 copay, days 4 - 20"		$150 copay	30% coinsurance	30% coinsurance	"$50 copay , waived if admitted"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance		20% coinsurance	$15 copay	$35 copay	$35 copay	$35 copay	10% coinsurance	Varies	20% coinsurance	20% coinsurance		Varies	$30 copay		$30 copay				Varies											173.0516952	263.0799032	45.70774706	0	150	0.973464115	0.930211021	45	204.348177	9.80178094	26.49550263	0	0	48.26594682	7.978755523	22.6437847	35	35	0	0.971044663	1.098600279	22.47534348	0	0	30	0	30	0	0	0	0.418435432											20.0149	0.783389825	3.869946219	0	2.975780093	2.335701084	2.246000239	0.869681168	5.600145927	1.698076899	1.749291357	0	0	2.402327087	5.029336056	22.52573991	0.523024235	1.503884685	0	1.162895098	0.034708789	1.632758535	0	0	0.945185617	0	0.40507955	0	0	0	0.011602884	0	0	0	0	0	0	0	0	0	0	78.3195		26.03131506	20.0149	0.783389825	3.869946219	0	2.975780093	2.335701084	2.246000239	0.869681168	5.600145927	1.698076899	1.749291357	0	0	2.402327087	5.029336056	22.52573991	0.523024235	1.503884685	0	1.162895098	0.034708789	1.632758535	0	0	0.945185617	0	0.40507955	0	0	0	0.011602884	0	0	0	0	0	0	0	0	0	0	78.3195																																																																																				0			20.0149	0.783389825	3.869946219	0	2.975780093	2.335701084	2.246000239	0.869681168	5.600145927	1.698076899	1.749291357	0	0	2.402327087	5.029336056	22.52573991	0.523024235	1.503884685	0	1.162895098	0.034708789	1.632758535	0	0	0.945185617	0	0.40507955	0	0	0	0.011602884	0	0	0	0	0	0	0	0	0	0	78.3195
H5820_007_0	2008	6																					4000											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1476.901946	38.26259989	1184.725404	2380.668085	238.7037562	28861.44544	29045.50648	258.5242953	372.3164124	2337.932999	889.6062321	0	75.37688188	670.8727916	8208.375018	12916.39605	190.7541344	548.956391	5173.313934	15131.67976	424.4466983	953.0541756	0	3065.068925	409.6616427	0	175.5692755	0	0	0	358.1207859											"$350 copay, days 1 - 7"	"$350 copay, days 1 - 7"	"$150 copay, days 4 - 20"		$150 copay	30% coinsurance	30% coinsurance	"$50 copay , waived if admitted"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance		20% coinsurance	$15 copay	$35 copay	$35 copay	$35 copay	10% coinsurance	Varies	20% coinsurance	20% coinsurance		Varies	$30 copay		$30 copay				Varies											164.7710714	263.0799032	45.76126206	0	150	0.92687054	0.884189128	45	190.0577305	9.317178281	25.08392976	0	0	47.56731066	7.810180813	22.62928152	35	35	0	1.007820648	1.166549417	22.25284346	0	0	30	0	30	0	0	0	0.419611485											20.2792	0.838843423	4.517877475	0	2.983796952	2.229235292	2.140143421	0.969466107	5.896801029	1.81524488	1.859568354	0	0	2.659301208	5.342407756	24.35739687	0.556366225	1.601122807	0	1.270834941	0.041261504	1.767347115	0	0	1.024154107	0	0.438923189	0	0	0	0.012522633	0	0	0	0	0	0	0	0	0	0	82.6018		30.24843858	20.2792	0.838843423	4.517877475	0	2.983796952	2.229235292	2.140143421	0.969466107	5.896801029	1.81524488	1.859568354	0	0	2.659301208	5.342407756	24.35739687	0.556366225	1.601122807	0	1.270834941	0.041261504	1.767347115	0	0	1.024154107	0	0.438923189	0	0	0	0.012522633	0	0	0	0	0	0	0	0	0	0	82.6018																																																																																				0			20.2792	0.838843423	4.517877475	0	2.983796952	2.229235292	2.140143421	0.969466107	5.896801029	1.81524488	1.859568354	0	0	2.659301208	5.342407756	24.35739687	0.556366225	1.601122807	0	1.270834941	0.041261504	1.767347115	0	0	1.024154107	0	0.438923189	0	0	0	0.012522633	0	0	0	0	0	0	0	0	0	0	82.6018
H5820_008_0	2008	6																					3000											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1694.444597	44.53703861	1170.284904	2796.861728	256.0063983	30981.29967	31172.39394	262.1284826	377.0577555	2436.665124	903.7517827	0	76.3509943	679.8277603	8364.795765	12613.23773	184.0247509	519.349111	5311.861287	14795.57161	430.2209924	950.0065813	0	3065.068925	407.0484446	314.8904459	170.1992607	20.25448779	0	0	353.2486133											"$150 copay, days 1 - 5"	"$150 copay, days 1 - 5"	"$50 copay, days 11 - 100"		$100 copay	20% coinsurance	20% coinsurance	"$50 copay , waived if admitted"	$200 copay	$200 copay	$200 copay	$200 copay		$200 copay	$5 copay	$20 copay	$20 copay	$25 copay	$100 copay	Varies	20% coinsurance	20% coinsurance		Varies	$15 copay	$15 copay	$20 copay				Varies											60.32032296	97.12285394	27.27774086	0	100	0.755906264	0.841449135	45	145.993491	7.787196468	100	0	0	35.78461194	2.314427412	10.51671568	20	25	0	0.715083812	1.250467905	10.40376751	0	0	15	15	20	0	0	0	0											8.5175	0.360463691	2.660227361	0	2.133386653	1.951579874	2.185831993	0.98298181	4.587331503	1.581232504	7.531264856	0	0	2.027281049	1.613309385	11.05415291	0.306707918	1.081977315	0	0.881672812	0.044831462	0.8236373	0	0	0.508810556	0.393613057	0.283665435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.5114		12.99163537	8.5175	0.360463691	2.660227361	0	2.133386653	1.951579874	2.185831993	0.98298181	4.587331503	1.581232504	7.531264856	0	0	2.027281049	1.613309385	11.05415291	0.306707918	1.081977315	0	0.881672812	0.044831462	0.8236373	0	0	0.508810556	0.393613057	0.283665435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.5114																																																																																				0			8.5175	0.360463691	2.660227361	0	2.133386653	1.951579874	2.185831993	0.98298181	4.587331503	1.581232504	7.531264856	0	0	2.027281049	1.613309385	11.05415291	0.306707918	1.081977315	0	0.881672812	0.044831462	0.8236373	0	0	0.508810556	0.393613057	0.283665435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.5114
H5820_009_0	2008	6																					3000											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1471.219818	37.96145066	1073.643231	2267.434377	247.0115068	29874.79441	30063.24993	240.6329869	341.2213414	2217.865399	825.1452316	0	69.25010299	619.7248598	8154.634652	12650.17763	189.4731753	535.0003944	5276.620041	15283.88033	393.375552	935.5118342	0	3065.068925	408.9467852	314.0144615	170.9827594	20.19814243	0	0	354.6080695											"$150 copay, days 1 - 5"	"$150 copay, days 1 - 5"	"$50 copay, days 11 - 100"		$100 copay	20% coinsurance	20% coinsurance	"$50 copay , waived if admitted"	$200 copay	$200 copay	$200 copay	$200 copay		$200 copay	$5 copay	$20 copay	$20 copay	$25 copay	$100 copay	Varies	20% coinsurance	20% coinsurance		Varies	$15 copay	$15 copay	$20 copay				Varies											60.38273335	97.12285394	27.64534482	0	100	0.726421982	0.80804355	45	146.8654457	7.836340115	100	0	0	35.70613727	2.639360993	10.84154499	20	25	0	0.798347051	1.153233327	10.74014423	0	0	15	15	20	0	0	0	0											7.403	0.307243702	2.473436445	0	2.058429223	1.808475615	2.024367933	0.902373701	4.176135365	1.448328966	6.876210263	0	0	1.843998409	1.793585384	11.42895583	0.315788626	1.114584155	0	1.016820065	0.037804483	0.837294335	0	0	0.511183481	0.392518077	0.284971266	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0555		11.26099865	7.403	0.307243702	2.473436445	0	2.058429223	1.808475615	2.024367933	0.902373701	4.176135365	1.448328966	6.876210263	0	0	1.843998409	1.793585384	11.42895583	0.315788626	1.114584155	0	1.016820065	0.037804483	0.837294335	0	0	0.511183481	0.392518077	0.284971266	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0555																																																																																				0			7.403	0.307243702	2.473436445	0	2.058429223	1.808475615	2.024367933	0.902373701	4.176135365	1.448328966	6.876210263	0	0	1.843998409	1.793585384	11.42895583	0.315788626	1.114584155	0	1.016820065	0.037804483	0.837294335	0	0	0.511183481	0.392518077	0.284971266	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0555
H5820_010_0	2008	6																					3000											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1553.439328	40.33047275	1242.706834	2450.622485	245.7179125	29709.52045	29898.99	266.1208654	383.2566907	2475.538331	917.933571	0	77.59178307	690.5859571	8785.010452	13581.77677	199.9941504	565.0871214	5548.026484	15980.64605	436.9187916	1015.069453	0	3065.068925	439.9704743	317.3720584	183.8644133	20.41411089	0	0	378.9958551											"$150 copay, days 1 - 5"	"$150 copay, days 1 - 5"	"$50 copay, days 11 - 100"		$100 copay	20% coinsurance	20% coinsurance	"$50 copay , waived if admitted"	$200 copay	$200 copay	$200 copay	$200 copay		$200 copay	$5 copay	$20 copay	$20 copay	$25 copay	$100 copay	Varies	20% coinsurance	20% coinsurance		Varies	$15 copay	$15 copay	$20 copay				Varies											56.41500603	97.12285394	27.57766637	0	100	0.702106381	0.783538993	45	146.041726	7.432512894	100	0	0	35.79114534	2.512735453	10.66546456	20	25	0	0.767751606	1.211875742	10.60806391	0	0	15	15	20	0	0	0	0											7.3031	0.326417551	2.855912871	0	2.047649271	1.738270323	1.952252043	0.997953245	4.664289052	1.533289214	7.649446425	0	0	2.05973853	1.839533935	12.0713299	0.333323584	1.177264836	0	1.022430555	0.044124274	0.897326803	0	0	0.549963093	0.396715073	0.306440689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.7668		13.17441081	7.3031	0.326417551	2.855912871	0	2.047649271	1.738270323	1.952252043	0.997953245	4.664289052	1.533289214	7.649446425	0	0	2.05973853	1.839533935	12.0713299	0.333323584	1.177264836	0	1.022430555	0.044124274	0.897326803	0	0	0.549963093	0.396715073	0.306440689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.7668																																																																																				0			7.3031	0.326417551	2.855912871	0	2.047649271	1.738270323	1.952252043	0.997953245	4.664289052	1.533289214	7.649446425	0	0	2.05973853	1.839533935	12.0713299	0.333323584	1.177264836	0	1.022430555	0.044124274	0.897326803	0	0	0.549963093	0.396715073	0.306440689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.7668
H5820_011_0	2008	6																					4000											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1638.936314	42.90292075	1094.347611	2892.243016	256.8512459	31083.14961	31274.96335	276.0354613	400.1060374	2517.57913	953.10939	0	80.9216902	718.5914126	9261.256956	14696.23095	230.4197957	665.0448792	5827.849246	18705.9983	454.0153627	1039.782142	0	3065.068925	448.3580243	0	192.153439	0	0	0	393.4474035											"$300 copay, days 1 - 7"	"$300 copay, days 1 - 7"	"$100 copay, days 6 - 30"		$100 copay	30% coinsurance	30% coinsurance	"$50 copay , waived if admitted"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance		20% coinsurance	$10 copay	$30 copay	$30 copay	$30 copay	10% coinsurance	Varies	20% coinsurance	20% coinsurance		Varies	$30 copay		$30 copay				Varies											140.4290298	225.4970599	32.44680638	0	100	1.071138953	1.023710815	45	169.5093013	10.49175366	28.29672281	0	0	44.82305998	5.138644965	20.58608698	30	30	0	1.203784516	1.408900896	22.13918487	0	0	30	0	30	0	0	0	0											19.1795	0.806206874	2.959007087	0	2.140427049	2.774531028	2.668043185	1.03513298	5.651807903	2.201151671	2.247489351	0	0	2.684122165	3.965859286	25.21149071	0.576049489	1.662612198	0	1.87649926	0.053305221	1.918327423	0	0	1.120895061	0	0.480383597	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.2129		29.0460591	19.1795	0.806206874	2.959007087	0	2.140427049	2.774531028	2.668043185	1.03513298	5.651807903	2.201151671	2.247489351	0	0	2.684122165	3.965859286	25.21149071	0.576049489	1.662612198	0	1.87649926	0.053305221	1.918327423	0	0	1.120895061	0	0.480383597	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.2129																																																																																				0			19.1795	0.806206874	2.959007087	0	2.140427049	2.774531028	2.668043185	1.03513298	5.651807903	2.201151671	2.247489351	0	0	2.684122165	3.965859286	25.21149071	0.576049489	1.662612198	0	1.87649926	0.053305221	1.918327423	0	0	1.120895061	0	0.480383597	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.2129
H5820_012_0	2008	6																					4000											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1629.948276	42.64816676	1084.403291	2890.848116	256.7273691	31068.15852	31259.87975	275.9023322	399.9130703	2502.838772	949.2630823	0	80.88266248	718.2448431	9167.744916	14621.34494	230.3086665	664.7241347	5779.26997	18587.74595	453.7963956	1039.280666	0	3065.068925	448.1417857	0	192.0607653	0	0	0	389.1230457											"$350 copay, days 1 - 7"	"$350 copay, days 1 - 7"	"$150 copay, days 4 - 20"		$150 copay	30% coinsurance	30% coinsurance	"$50 copay , waived if admitted"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance		20% coinsurance	$15 copay	$35 copay	$35 copay	$35 copay	10% coinsurance	Varies	20% coinsurance	20% coinsurance		Varies	$30 copay		$30 copay				Varies											151.1550984	263.0799032	40.05144149	0	150	0.984269535	0.937380515	45	212.5361819	10.53184362	28.31769258	0	0	49.5111449	7.44632246	22.53273835	35	35	0	1.00549358	1.40800305	22.14008271	0	0	30	0	30	0	0	0	0.420793614											20.5312	0.934989632	3.619326247	0	3.209092114	2.54828683	2.441866848	1.034633746	7.082999755	2.196625546	2.240078345	0	0	2.963427042	5.688832073	27.45491165	0.671733611	1.938778726	0	1.557488269	0.053245559	1.917479992	0	0	1.120354464	0	0.480151913	0	0	0	0.013645041	0	0	0	0	0	0	0	0	0	0	89.6992		38.00659224	20.5312	0.934989632	3.619326247	0	3.209092114	2.54828683	2.441866848	1.034633746	7.082999755	2.196625546	2.240078345	0	0	2.963427042	5.688832073	27.45491165	0.671733611	1.938778726	0	1.557488269	0.053245559	1.917479992	0	0	1.120354464	0	0.480151913	0	0	0	0.013645041	0	0	0	0	0	0	0	0	0	0	89.6992																																																																																				0			20.5312	0.934989632	3.619326247	0	3.209092114	2.54828683	2.441866848	1.034633746	7.082999755	2.196625546	2.240078345	0	0	2.963427042	5.688832073	27.45491165	0.671733611	1.938778726	0	1.557488269	0.053245559	1.917479992	0	0	1.120354464	0	0.480151913	0	0	0	0.013645041	0	0	0	0	0	0	0	0	0	0	89.6992
H5820_013_0	2008	6																					3000											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1699.385087	44.55285812	1126.692441	2948.913086	261.8839412	31692.18704	31887.75914	281.4440486	407.9456404	2628.200712	973.1848061	0	82.50725469	732.6713585	9723.560745	15234.08833	239.4331619	678.0756444	6149.046758	19472.07928	462.9112549	1097.783581	0	3065.068925	477.338942	322.3462828	199.3846133	20.73406461	0	0	408.4855105											"$150 copay, days 1 - 5"	"$150 copay, days 1 - 5"	"$50 copay, days 11 - 100"		$100 copay	20% coinsurance	20% coinsurance	"$50 copay , waived if admitted"	$200 copay	$200 copay	$200 copay	$200 copay		$200 copay	$5 copay	$20 copay	$20 copay	$25 copay	$100 copay	Varies	20% coinsurance	20% coinsurance		Varies	$15 copay	$15 copay	$20 copay				Varies											51.85607985	97.12285394	25.40403733	0	100	0.754844297	0.842939268	45	143.0956093	8.374715287	100	0	0	35.82651348	2.406424445	10.64088739	20	25	0	0.759924523	1.445377354	10.43923993	0	0	15	15	20	0	0	0	0											7.3436	0.360591728	2.385211404	0	2.182366177	1.993555553	2.239953696	1.055415182	4.864602497	1.834202723	8.109873384	0	0	2.187421692	1.949917856	13.50868487	0.39905527	1.412657592	0	1.233109213	0.055756787	0.955002183	0	0	0.596673678	0.402932854	0.332307689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.4029		16.0261835	7.3436	0.360591728	2.385211404	0	2.182366177	1.993555553	2.239953696	1.055415182	4.864602497	1.834202723	8.109873384	0	0	2.187421692	1.949917856	13.50868487	0.39905527	1.412657592	0	1.233109213	0.055756787	0.955002183	0	0	0.596673678	0.402932854	0.332307689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.4029																																																																																				0			7.3436	0.360591728	2.385211404	0	2.182366177	1.993555553	2.239953696	1.055415182	4.864602497	1.834202723	8.109873384	0	0	2.187421692	1.949917856	13.50868487	0.39905527	1.412657592	0	1.233109213	0.055756787	0.955002183	0	0	0.596673678	0.402932854	0.332307689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.4029
H5820_801_0	2008	1																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				18.816	0.2098	0	0	0.2101	0.3531	0.3895	0.1505	1.2809	0.4912	0.6481	0	0.0284	0.6339	1.3549	3.2211	0.0407	0.123	0.9199	1.2859	0.2017	0.2541																				30.6127		1532.019482	40.37775401	1094.076965	2507.550159	6.178349329	10.3844721	11.4559033	4.426376284	37.67248917	14.44749273	19.06045089	0	0.833928569	18.64424633	39.8505703	94.73797694	1.196129235	3.619081787	27.0565631	37.8195166	5.933442256	7.474016176	0	0	0	0	0	0	0	0	0											Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	$0 per visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	0	0	0	0	0	0	0	0	0											10.58230107	4.476462477	61.74581217	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0	0	0	0	0	0	0	0											1.351	0.015062458	5.629555899	0	1.235669866	2.076894421	2.291180659	0.885275257	7.534497834	2.889498547	3.812090178	0	0.166785714	3.728849266	7.97011406	18.94759539	0.239225847	0.723816357	5.411312621	7.56390332	1.186688451	1.494803235	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1538	Medicare Allowed		20.167	0.224840373	5.629555899	0	1.445733743	2.429966472	2.680681371	1.035772051	8.815362466	3.3807133	4.460145508	0	0.195139285	4.362753642	9.32503345	22.1686866	0.279894241	0.846865138	6.331235766	8.849766884	1.388425488	1.748919785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.7665																																																																																				0			20.167	0.224840373	5.629555899	0	1.445733743	2.429966472	2.680681371	1.035772051	8.815362466	3.3807133	4.460145508	0	0.195139285	4.362753642	9.32503345	22.1686866	0.279894241	0.846865138	6.331235766	8.849766884	1.388425488	1.748919785	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.7665
H5821_001_0	2008	7																																D	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	Coin	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1503.014779	48.73728746	1.037330249	0	2.305121734	13.5839078	6.498151004	4.899331784	10.38263418	12.34845455	17.89928399	0.401919296	0.356435299	5.145104642	46.32979249	61.59307404	2.885096334	3.016860748	0	0.65408735	13.76860994	2.843664444	0	0	0	0	0	0	7.258173165	0	0	0	0	0	0	0	0	0	0	0	0	1a (IP Acute) - $2;	1b (IP Psych) - $2	2 (SNF) - $35;	6 (Home Health)- $0	10a (Ambulance) - 20%	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) -20%, 4(b) -20%"	9b (OP Surg/ASC) - 20%	8a (OP Diag Proc/Test/Lab) - 20%	8b (OP Diag & Therap Rad) - 20%	9a (OP Observation) -0%	12 (Renal Dialysis) - 20%	"3 (CORF), 5 (Partial Hospital),9a (OP Other), 9c (OP SA), 9d (Cardiac Rehab) - 20%"	"7a (PCP), 7a(UC w/o Copay), 7a(PCP w/o Copay), 14b (Immunizations), 14c(Routine Physical), 14d (Pap & Pelvic),14e (Prostrate Screen), 14f (Colorectal Screen), 14g (Bone Mass), 14h (Mamm), 14i (Diab Mon.), 14j (Nutrition Therap) - 20%"	"7b (Chiro), 7d (Spec), 7f (Pod) - 20%"	"7e (MH), 7h (Psychiatric) -50%"	"7c (OT), 7i (PT/ST) - 20%"		7g (Prof Others) - 20%	15 (Part B Rx) - 20%	"13a (Blood), 14a (Education/Wellness), 14j (Nutrient Therapy), 16b(Comp Den),  17a (Eye Exam), 17b (MCR Eyewear), 18a (MCR Hearing Exam) - 20%"	10b(Transportation)	16a(Preventative Den)	17a1(Routine Eye Exam)	17b1(Non MCR Covered)	"18a(Hearing Exam), 18a1(Routine Hearing Exam)"	18b(Hearing Aids)	19a (POS)		13c (Other)											7.683095631	7.683095631	0.194324526	0	0.2	0.234	0.232225418	0.215648692	0.2	0.234	0.234	0.2	0.2	0.2	0.2	0.2	0.5	0.2	0	0.2	0.2	0.2	0	0	0	0	0	0	0.417607444	0	0	0	0	0	0	0	0	0	0	0	0	0.9623	0.031204437	0.201578709	0	0.461024347	3.178634425	1.509035834	1.056534489	2.076526835	2.889538366	4.188432453	0.080383859	0.07128706	1.029020928	9.265958497	12.31861481	1.442548167	0.60337215	0	0.13081747	2.753721987	0.568732889	0	0	0	0	0	0	3.031067143	0	0	0	0	0	0	0	0	0	0	0	0	47.8504		0	0.9623	0.031204437	0.201578709	0	0.461024347	3.178634425	1.509035834	1.056534489	2.076526835	2.889538366	4.188432453	0.080383859	0.07128706	1.029020928	9.265958497	12.31861481	1.442548167	0.60337215	0	0.13081747	2.753721987	0.568732889	0	0	0	0	0	0	3.031067143	0	0	0	0	0	0	0	0	0	0	0	0	47.8504																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0.9623	0.031204437	0.201578709	0	0.461024347	3.178634425	1.509035834	1.056534489	2.076526835	2.889538366	4.188432453	0.080383859	0.07128706	1.029020928	9.265958497	12.31861481	1.442548167	0.60337215	0	0.13081747	2.753721987	0.568732889	0	0	0	0	0	0	3.031067143	0	0	0	0	0	0	0	0	0	0	0	0	47.8504
H5821_004_0	2008	8																																Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	Coin	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0	0	305.9132892	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.630890411	0	0	0	0	0	0	0	0	0	0	0	0	"1a (IP Acute) , 1a1 (Add'l Days) - 0%"	1b (IP Psych) - 0%	"2 (SNF), 2a2 (Waiver 3 Day) - 0%"	6 (Home Health)- $0	10a (Ambulance) - 0%	11a (Medical Equip) - 0%	"11b (Med Supp), 11c (Diab Supp) - 0%"	"4a (ER), 4(b) -$25"	9b (OP Surg/ASC) - 0%	8a (OP Diag Proc/Test/Lab) - 0%	8b (OP Diag & Therap Rad) - 0%	9a (OP Observation) -0%	12 (Renal Dialysis) - 0%	"3 (CORF), 5 (Partial Hospital),9a (OP Other), 9c (OP SA), 9d (Cardiac Rehab) - 0%"	"7a (PCP), 7a(UC w/o Copay), 7a(PCP w/o Copay), 14b (Immunizations), 14c(Routine Physical), 14d (Pap & Pelvic),14e (Prostrate Screen), 14f (Colorectal Screen), 14g (Bone Mass), 14h (Mamm), 14i (Diab Mon.), 14j (Nutrition Therap) - 0%"	"7b (Chiro), 7d (Spec), 7f (Pod) - 0%"	"7e (MH), 7h (Psychiatric) -0%"	"7c (OT), 7i (PT/ST) - 0%"		7g (Prof Others) - 0%	15 (Part B Rx) - 0%	"13a (Blood), 14a (Education/Wellness), 14j (Nutrient Therapy), 16b(Comp Den),  17a (Eye Exam), 17b (MCR Eyewear), 18a (MCR Hearing Exam) - 0%"	10b(Transportation)	16a(Preventative Den)	17a1(Routine Eye Exam)	17b1(Non MCR Covered)	"18a(Hearing Exam), 18a1(Routine Hearing Exam)"	18b(Hearing Aids)	19a (POS)		13c (Other)											0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.866666667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.637319352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.013438356	0	0	0	0	0	0	0	0	0	0	0	0	4.6508		0	0	0	0	0	0	0	0	0.637319352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.013438356	0	0	0	0	0	0	0	0	0	0	0	0	4.6508																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0	0	0	0.637319352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.013438356	0	0	0	0	0	0	0	0	0	0	0	0	4.6508
H5821_009_0	2008	8																																A	A	Coin	V	T	P	P	V	P	P	P	P	V	V	V	V	V	V	V	P	S	P	P	P	P	P	P	P	Coin	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		304.4200269	10.68694411	0	0	125.4662492	3673.678573	1521.01306	405.8879355	138.182228	13508.37367	3680.6901	0	0	5.716617171	8563.168653	5754.253045	676.8685322	1155.528686	0	0	0	1813.052852	0	1000	144	0	249	0	13.44498625	0	0	0	0	0	0	0	0	0	0	0	0	1a (IP Acute) - $25	1b (IP Psych) - $25	2 (SNF) - 0%	6 (Home Health)- $0	10a (Ambulance) - $25	11a (Medical Equip) - $3	"11b (Med Supp), 11c (Diab Supp) - %3"	4a (ER) - $25; 4b (UC) - $15	"9a (OP Surgery)-$0, 9b (ASC) - $15"	8a (OP Diag Proc/Test/Lab) - $3	8b (OP Diag & Therap Rad) - $3	9a (OP Observation) -$0	12 (Renal Dialysis) - $0	"3 (CORF) -$2, 5 (Partial Hospital) - $5, 7i, 7c (OP PT/ST/OT)-$5, 9c (OP SA) -$5, 9d (Cardiac Rehab) - $2"	"14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14j (Nutrition Therap),14i (Diab Mon.) - $5, 14f (Colorectal Screen), 14h (Mamm) - $2, 7a (PCP)- $2"	"7b (Chiro) -$5, 7d (Spec), 7f (Pod) - $5"	"7e (MH), 7h (Psychiatric) -$5"	"7c (OT)-$2, 7i (PT/ST) - $5"		7g (Prof Others) - $5	15 (Part B Rx) - $0	"13a (Blood) - $0, 18a (MCR Hearing Exam) - $3"	10b(Transportation)	16a(Preventative Den)	17a1(Routine Eye Exam)	17b1(Non MCR Covered)	"18a(Hearing Exam), 18a1(Routine Hearing Exam)"	18b(Hearing Aids)	19a (POS)		13c (Other)											25	25	0	0	25	3	3	23.99028723	15	3	3	0	0	2.673354124	2	5	5	2	0	0	0	3	0	3	3	0	3	0	0.811455177	0	0	0	0	0	0	0	0	0	0	0	0	0.6342	0.022264467	0	0	0.261388019	0.918419643	0.380253265	0.811447346	0.172727785	3.377093417	0.920172525	0	0	0.001273545	1.427194776	2.397605435	0.282028555	0.192588114	0	0	0	0.453263213	0	0.25	0.036	0	0.06225	0	10.91000369	0	0	0	0	0	0	0	0	0	0	0	0	23.5102		0	0.6342	0.022264467	0	0	0.261388019	0.918419643	0.380253265	0.811447346	0.172727785	3.377093417	0.920172525	0	0	0.001273545	1.427194776	2.397605435	0.282028555	0.192588114	0	0	0	0.453263213	0	0.25	0.036	0	0.06225	0	10.91000369	0	0	0	0	0	0	0	0	0	0	0	0	23.5102																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0.6342	0.022264467	0	0	0.261388019	0.918419643	0.380253265	0.811447346	0.172727785	3.377093417	0.920172525	0	0	0.001273545	1.427194776	2.397605435	0.282028555	0.192588114	0	0	0	0.453263213	0	0.25	0.036	0	0.06225	0	10.91000369	0	0	0	0	0	0	0	0	0	0	0	0	23.5102
H5821_013_0	2008	8																																Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	Coin	Coin	P	P	P	P	P	P	Coin	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0	0	312.0915012	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.109470804	0	0	0	0	0	0	0	0	0	0	0	0	"1a (IP Acute) , 1a1 (Add'l Days) - 0%"	1b (IP Psych) - 0%	"2 (SNF), 2a2 (Waiver 3 Day) - 0%"	6 (Home Health)- $0	10a (Ambulance) - 0%	11a (Medical Equip) - 0%	"11b (Med Supp), 11c (Diab Supp) - 0%"	"4a (ER), 4(b) -$25"	9b (OP Surg/ASC) - 0%	8a (OP Diag Proc/Test/Lab) - 0%	8b (OP Diag & Therap Rad) - 0%	9a (OP Observation) -0%	12 (Renal Dialysis) - 0%	"3 (CORF), 5 (Partial Hospital),9a (OP Other), 9c (OP SA), 9d (Cardiac Rehab) - 0%"	"7a (PCP), 7a(UC w/o Copay), 7a(PCP w/o Copay), 14b (Immunizations), 14c(Routine Physical), 14d (Pap & Pelvic),14e (Prostrate Screen), 14f (Colorectal Screen), 14g (Bone Mass), 14h (Mamm), 14i (Diab Mon.), 14j (Nutrition Therap) - 0%"	"7b (Chiro), 7d (Spec), 7f (Pod) - 0%"	"7e (MH), 7h (Psychiatric) -0%"	"7c (OT), 7i (PT/ST) - 0%"		7g (Prof Others) - 20%	15 (Part B Rx) - 0%	"13a (Blood), 14a (Education/Wellness), 14j (Nutrient Therapy), 16b(Comp Den),  17a (Eye Exam), 17b (MCR Eyewear), 18a (MCR Hearing Exam) - 0%"	10b(Transportation)	16a(Preventative Den)	17a1(Routine Eye Exam)	17b1(Non MCR Covered)	"18a(Hearing Exam), 18a1(Routine Hearing Exam)"	18b(Hearing Aids)	19a (POS)		13c (Other)											0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.866666667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.650190628	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.161541364	0	0	0	0	0	0	0	0	0	0	0	0	6.8117		0	0	0	0	0	0	0	0	0.650190628	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.161541364	0	0	0	0	0	0	0	0	0	0	0	0	6.8117																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0	0	0	0.650190628	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.161541364	0	0	0	0	0	0	0	0	0	0	0	0	6.8117
H5821_014_0	2008	8																																A	A	Coin	V	T	P	P	V	P	P	P	P	V	V	V	V	V	V	V	Coin	S	P	P	P	P	P	P	P	Coin	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		288.9171551	10.14270158	0	0	119.8687607	3510.40397	1453.41248	386.2772799	131.4896414	303.8695226	431.1208617	0	0	5.382241209	8621.796843	5219.772938	614.278111	1049.058936	0	0	0	1737.237835	0	1000	144	0	249	0	12.61469804	0	0	0	0	0	0	0	0	0	0	0	0	1a (IP Acute) - $25	1b (IP Psych) - $25	2 (SNF) - 0%	6 (Home Health)- $0	10a (Ambulance) - $25	11a (Medical Equip) - $3	"11b (Med Supp), 11c (Diab Supp) - %3"	4a (ER) - $25; 4b (UC) - $15	"9a (OP Surgery)-$0, 9b (ASC) - $15"	8a (OP Diag Proc/Test/Lab) - $3	8b (OP Diag & Therap Rad) - $3	9a (OP Observation) -$0	12 (Renal Dialysis) - $0	"3 (CORF) -$2, 5 (Partial Hospital) - $5, 7i, 7c (OP PT/ST/OT)-$5, 9c (OP SA) -$5, 9d (Cardiac Rehab) - $2"	"14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14j (Nutrition Therap),14i (Diab Mon.) - $5, 14f (Colorectal Screen), 14h (Mamm) - $2, 7a (PCP)- $2"	"7b (Chiro) -$5, 7d (Spec), 7f (Pod) - $5"	"7e (MH), 7h (Psychiatric) -$5"	"7c (OT)-$2, 7i (PT/ST) - $5"		7g (Prof Others) - 0%	15 (Part B Rx) - $0	"13a (Blood) - $0, 18a (MCR Hearing Exam) - $3"	10b(Transportation)	16a(Preventative Den)	17a1(Routine Eye Exam)	17b1(Non MCR Covered)	"18a(Hearing Exam), 18a1(Routine Hearing Exam)"	18b(Hearing Aids)	19a (POS)		13c (Other)											25	25	0	0	25	3	3	23.98979412	15	3	3	0	0	2.648496715	2.180852846	5	5	2	0	0	0	3	0	3	3	0	3	0	0.809840446	0	0	0	0	0	0	0	0	0	0	0	0	0.6019	0.021130628	0	0	0.249726585	0.877600992	0.36335312	0.772226035	0.164362052	0.075967381	0.107780215	0	0	0.001187904	1.566905849	2.174905391	0.255949213	0.174843156	0	0	0	0.434309459	0	0.25	0.036	0	0.06225	0	10.21589269	0	0	0	0	0	0	0	0	0	0	0	0	18.4063		0	0.6019	0.021130628	0	0	0.249726585	0.877600992	0.36335312	0.772226035	0.164362052	0.075967381	0.107780215	0	0	0.001187904	1.566905849	2.174905391	0.255949213	0.174843156	0	0	0	0.434309459	0	0.25	0.036	0	0.06225	0	10.21589269	0	0	0	0	0	0	0	0	0	0	0	0	18.4063																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0.6019	0.021130628	0	0	0.249726585	0.877600992	0.36335312	0.772226035	0.164362052	0.075967381	0.107780215	0	0	0.001187904	1.566905849	2.174905391	0.255949213	0.174843156	0	0	0	0.434309459	0	0.25	0.036	0	0.06225	0	10.21589269	0	0	0	0	0	0	0	0	0	0	0	0	18.4063
H5821_015_0	2008	9																																D	D	D	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		3022.996713	80.17461737	0	0	0	24.70267624	15.23770823	457.6051752	0	0	0	0	0	0	0.141503156	0	0	0	0	0	24.35171075	1.612963711	0	0	0	0	0	0	17.81253425	0	0	0	0	0	0	0	0	0	0	0	0	"1a (IP Acute) , 1a1 (Add'l Days) - 0%"	1b (IP Psych) - 0%	"2 (SNF), 2a2 (Waiver 3 Day) - 0%"	6 (Home Health)- $0	10a (Ambulance) - 0%	11a (Medical Equip) - 0%	"11b (Med Supp), 11c (Diab Supp) - 0%"	"4a (ER), 4(b) -$25"	9b (OP Surg/ASC) - 0%	8a (OP Diag Proc/Test/Lab) - 0%	8b (OP Diag & Therap Rad) - 0%	9a (OP Observation) -0%	12 (Renal Dialysis) - 0%	"3 (CORF), 5 (Partial Hospital),9a (OP Other), 9c (OP SA), 9d (Cardiac Rehab) - 0%"	"7a (PCP), 7a(UC w/o Copay), 7a(PCP w/o Copay), 14b (Immunizations), 14c(Routine Physical), 14d (Pap & Pelvic),14e (Prostrate Screen), 14f (Colorectal Screen), 14g (Bone Mass), 14h (Mamm), 14i (Diab Mon.), 14j (Nutrition Therap) - 0%"	"7b (Chiro), 7d (Spec), 7f (Pod) - 0%"	"7e (MH), 7h (Psychiatric) -0%"	"7c (OT), 7i (PT/ST) - 0%"		7g (Prof Others) - 20%	15 (Part B Rx) - 0%	"13a (Blood), 14a (Education/Wellness), 14j (Nutrient Therapy), 16b(Comp Den),  17a (Eye Exam), 17b (MCR Eyewear), 18a (MCR Hearing Exam) - 0%"	10b(Transportation)	16a(Preventative Den)	17a1(Routine Eye Exam)	17b1(Non MCR Covered)	"18a(Hearing Exam), 18a1(Routine Hearing Exam)"	18b(Hearing Aids)	19a (POS)		13c (Other)											85	85	0	0	0	0.1	0.1	25	0	0	0	0	0	0	0.1	0	0	0	0	0	0.1	0.1	0	0	0	0	0	0	0.706187238	0	0	0	0	0	0	0	0	0	0	0	0	21.4129	0.56790354	0	0	0	2.470267624	1.523770823	0.953344115	0	0	0	0	0	0	0.014150316	0	0	0	0	0	2.435171075	0.161296371	0	0	0	0	0	0	12.57898437	0	0	0	0	0	0	0	0	0	0	0	0	42.1178		0	21.4129	0.56790354	0	0	0	2.470267624	1.523770823	0.953344115	0	0	0	0	0	0	0.014150316	0	0	0	0	0	2.435171075	0.161296371	0	0	0	0	0	0	12.57898437	0	0	0	0	0	0	0	0	0	0	0	0	42.1178																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	21.4129	0.56790354	0	0	0	2.470267624	1.523770823	0.953344115	0	0	0	0	0	0	0.014150316	0	0	0	0	0	2.435171075	0.161296371	0	0	0	0	0	0	12.57898437	0	0	0	0	0	0	0	0	0	0	0	0	42.1178
H5821_016_0	2008	9																																Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	Coin	Coin	P	P	P	P	P	P	Coin	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	27.8183291	17.15958134	515.2010241	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.96115487	0	0	0	0	0	0	0	0	0	0	0	0	"1a (IP Acute) , 1a1 (Add'l Days) - 0%"	1b (IP Psych) - 0%	"2 (SNF), 2a2 (Waiver 3 Day) - 0%"	6 (Home Health)- $0	10a (Ambulance) - 0%	11a (Medical Equip) - 0%	"11b (Med Supp), 11c (Diab Supp) - 0%"	"4a (ER), 4(b) -$25"	9b (OP Surg/ASC) - 0%	8a (OP Diag Proc/Test/Lab) - 0%	8b (OP Diag & Therap Rad) - 0%	9a (OP Observation) -0%	12 (Renal Dialysis) - 0%	"3 (CORF), 5 (Partial Hospital),9a (OP Other), 9c (OP SA), 9d (Cardiac Rehab) - 0%"	"7a (PCP), 7a(UC w/o Copay), 7a(PCP w/o Copay), 14b (Immunizations), 14c(Routine Physical), 14d (Pap & Pelvic),14e (Prostrate Screen), 14f (Colorectal Screen), 14g (Bone Mass), 14h (Mamm), 14i (Diab Mon.), 14j (Nutrition Therap) - 0%"	"7b (Chiro), 7d (Spec), 7f (Pod) - 0%"	"7e (MH), 7h (Psychiatric) -0%"	"7c (OT), 7i (PT/ST) - 0%"		7g (Prof Others) - 20%	15 (Part B Rx) - 0%	"13a (Blood), 14a (Education/Wellness), 14j (Nutrient Therapy), 16b(Comp Den),  17a (Eye Exam), 17b (MCR Eyewear), 18a (MCR Hearing Exam) - 0%"	10b(Transportation)	16a(Preventative Den)	17a1(Routine Eye Exam)	17b1(Non MCR Covered)	"18a(Hearing Exam), 18a1(Routine Hearing Exam)"	18b(Hearing Aids)	19a (POS)		13c (Other)											0	0	0	0	0	0.06	0.06	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.853147035	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.669099746	1.02957488	1.073335467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.02980009	0	0	0	0	0	0	0	0	0	0	0	0	20.8018		0	0	0	0	0	0	1.669099746	1.02957488	1.073335467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.02980009	0	0	0	0	0	0	0	0	0	0	0	0	20.8018																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0	1.669099746	1.02957488	1.073335467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.02980009	0	0	0	0	0	0	0	0	0	0	0	0	20.8018
H5821_017_0	2008	8																																A	A	Coin	V	T	P	P	V	P	P	P	P	V	V	V	V	V	V	V	P	S	P	P	P	P	P	P	P	Coin	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		274.8236354	9.647935653	0	0	114.2864227	3347.129366	1385.811899	367.8201922	125.1907364	289.3128988	410.4683654	0	0	5.053389618	8039.791708	4653.659505	548.001488	936.3443213	0	0	0	1656.919665	0	1000	144	0	249	0	11.8051107	0	0	0	0	0	0	0	0	0	0	0	0	1a (IP Acute) - $25	1b (IP Psych) - $25	2 (SNF) - 0%	6 (Home Health)- $0	10a (Ambulance) - $25	11a (Medical Equip) - $3	"11b (Med Supp), 11c (Diab Supp) - %3"	4a (ER) - $25; 4b (UC) - $15	"9a (OP Surgery)-$0, 9b (ASC) - $15"	8a (OP Diag Proc/Test/Lab) - $3	8b (OP Diag & Therap Rad) - $3	9a (OP Observation) -$0	12 (Renal Dialysis) - $0	"3 (CORF) -$2, 5 (Partial Hospital) - $5, 7i, 7c (OP PT/ST/OT)-$5, 9c (OP SA) -$5, 9d (Cardiac Rehab) - $2"	"14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14j (Nutrition Therap),14i (Diab Mon.) - $5, 14f (Colorectal Screen), 14h (Mamm) - $2, 7a (PCP)- $2"	"7b (Chiro) -$5, 7d (Spec), 7f (Pod) - $5"	"7e (MH), 7h (Psychiatric) -$5"	"7c (OT)-$2, 7i (PT/ST) - $5"		7g (Prof Others) - $5	15 (Part B Rx) - $0	"13a (Blood) - $0, 18a (MCR Hearing Exam) - $3"	10b(Transportation)	16a(Preventative Den)	17a1(Routine Eye Exam)	17b1(Non MCR Covered)	"18a(Hearing Exam), 18a1(Routine Hearing Exam)"	18b(Hearing Aids)	19a (POS)		13c (Other)											25	25	0	0	25	3	3	23.989282	15	3	3	0	0	2.615448995	2.173043248	5	5	2	0	0	0	3	0	3	3	0	3	0	0.810333295	0	0	0	0	0	0	0	0	0	0	0	0	0.5725	0.020099866	0	0	0.238096714	0.836782342	0.346452975	0.73531186	0.156488421	0.072328225	0.102617091	0	0	0.001101407	1.455901257	1.939024794	0.228333953	0.156057387	0	0	0	0.414229916	0	0.25	0.036	0	0.06225	0	9.566074251	0	0	0	0	0	0	0	0	0	0	0	0	17.1897		0	0.5725	0.020099866	0	0	0.238096714	0.836782342	0.346452975	0.73531186	0.156488421	0.072328225	0.102617091	0	0	0.001101407	1.455901257	1.939024794	0.228333953	0.156057387	0	0	0	0.414229916	0	0.25	0.036	0	0.06225	0	9.566074251	0	0	0	0	0	0	0	0	0	0	0	0	17.1897																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0.5725	0.020099866	0	0	0.238096714	0.836782342	0.346452975	0.73531186	0.156488421	0.072328225	0.102617091	0	0	0.001101407	1.455901257	1.939024794	0.228333953	0.156057387	0	0	0	0.414229916	0	0.25	0.036	0	0.06225	0	9.566074251	0	0	0	0	0	0	0	0	0	0	0	0	17.1897
H5821_018_0	2008	8																																A	A	Coin	V	T	P	P	V	P	P	P	P	V	V	V	V	V	V	V	P	S	P	P	P	P	P	P	P	Coin	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1957.903845	83.88030254	0	0	119.8687607	3510.40397	1453.41248	386.2772799	131.4896414	13462.14191	3361.447223	0	0	5.382241209	8207.783423	5219.772938	614.278111	1049.058936	0	0	0	1737.237835	0	1000	455.2899539	0	249	0	13.66465368	0	0	0	0	0	0	0	0	0	0	0	0	1a (IP Acute) - $25	1b (IP Psych) - $25	2 (SNF) - 0%	6 (Home Health)- $0	10a (Ambulance) - $25	11a (Medical Equip) - $3	"11b (Med Supp), 11c (Diab Supp) - %3"	4a (ER) - $25; 4b (UC) - $15	"9a (OP Surgery)-$0, 9b (ASC) - $15"	8a (OP Diag Proc/Test/Lab) - $3	8b (OP Diag & Therap Rad) - $3	9a (OP Observation) -$0	12 (Renal Dialysis) - $0	"3 (CORF) -$2, 5 (Partial Hospital) - $5, 7i, 7c (OP PT/ST/OT)-$5, 9c (OP SA) -$5, 9d (Cardiac Rehab) - $2"	"14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14j (Nutrition Therap),14i (Diab Mon.) - $5, 14f (Colorectal Screen), 14h (Mamm) - $2, 7a (PCP)- $2"	"7b (Chiro) -$5, 7d (Spec), 7f (Pod) - $5"	"7e (MH), 7h (Psychiatric) -$5"	"7c (OT)-$2, 7i (PT/ST) - $5"		7g (Prof Others) - $5	15 (Part B Rx) - $0	"13a (Blood) - $0, 18a (MCR Hearing Exam) - $3"	10b(Transportation)	16a(Preventative Den)	17a1(Routine Eye Exam)	17b1(Non MCR Covered)	"18a(Hearing Exam), 18a1(Routine Hearing Exam)"	18b(Hearing Aids)	19a (POS)		13c (Other)											25	25	0	0	25	3	3	24.98724266	15	3	3	0	0	2.648496715	2.036669053	5	5	2	0	0	0	3	0	3	3	0	3	0	0.758905115	0	0	0	0	0	0	0	0	0	0	0	0	4.079	0.17475063	0	0	0.249726585	0.877600992	0.36335312	0.804333677	0.164362052	3.365535477	0.840361806	0	0	0.001187904	1.393044874	2.174905391	0.255949213	0.174843156	0	0	0	0.434309459	0	0.25	0.113822488	0	0.06225	0	10.37017557	0	0	0	0	0	0	0	0	0	0	0	0	26.1495		0	4.079	0.17475063	0	0	0.249726585	0.877600992	0.36335312	0.804333677	0.164362052	3.365535477	0.840361806	0	0	0.001187904	1.393044874	2.174905391	0.255949213	0.174843156	0	0	0	0.434309459	0	0.25	0.113822488	0	0.06225	0	10.37017557	0	0	0	0	0	0	0	0	0	0	0	0	26.1495																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	4.079	0.17475063	0	0	0.249726585	0.877600992	0.36335312	0.804333677	0.164362052	3.365535477	0.840361806	0	0	0.001187904	1.393044874	2.174905391	0.255949213	0.174843156	0	0	0	0.434309459	0	0.25	0.113822488	0	0.06225	0	10.37017557	0	0	0	0	0	0	0	0	0	0	0	0	26.1495
H5821_019_0	2008	8																																A	A	Coin	V	T	P	P	V	P	P	P	P	V	V	V	V	V	V	V	P	S	P	P	P	P	P	P	P	Coin	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		274.8236354	9.647935653	0	0	114.2864227	3347.129366	1385.811899	367.8201922	125.1907364	289.3128988	410.4683654	0	0	5.053389618	8039.791708	4653.659505	548.001488	936.3443213	0	0	0	1656.919665	0	1000	144	0	249	0	11.8051107	0	0	0	0	0	0	0	0	0	0	0	0	1a (IP Acute) - $25	1b (IP Psych) - $25	2 (SNF) - 0%	6 (Home Health)- $0	10a (Ambulance) - $25	11a (Medical Equip) - $3	"11b (Med Supp), 11c (Diab Supp) - %3"	4a (ER) - $25; 4b (UC) - $15	"9a (OP Surgery)-$0, 9b (ASC) - $15"	8a (OP Diag Proc/Test/Lab) - $3	8b (OP Diag & Therap Rad) - $3	9a (OP Observation) -$0	12 (Renal Dialysis) - $0	"3 (CORF) -$2, 5 (Partial Hospital) - $5, 7i, 7c (OP PT/ST/OT)-$5, 9c (OP SA) -$5, 9d (Cardiac Rehab) - $2"	"14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14j (Nutrition Therap),14i (Diab Mon.) - $5, 14f (Colorectal Screen), 14h (Mamm) - $2, 7a (PCP)- $2"	"7b (Chiro) -$5, 7d (Spec), 7f (Pod) - $5"	"7e (MH), 7h (Psychiatric) -$5"	"7c (OT)-$2, 7i (PT/ST) - $5"		7g (Prof Others) - $5	15 (Part B Rx) - $0	"13a (Blood) - $0, 18a (MCR Hearing Exam) - $3"	10b(Transportation)	16a(Preventative Den)	17a1(Routine Eye Exam)	17b1(Non MCR Covered)	"18a(Hearing Exam), 18a1(Routine Hearing Exam)"	18b(Hearing Aids)	19a (POS)		13c (Other)											25	25	0	0	25	3	3	23.989282	15	3	3	0	0	2.615448995	2.173043248	5	5	2	0	0	0	3	0	3	3	0	3	0	0.810333295	0	0	0	0	0	0	0	0	0	0	0	0	0.5725	0.020099866	0	0	0.238096714	0.836782342	0.346452975	0.73531186	0.156488421	0.072328225	0.102617091	0	0	0.001101407	1.455901257	1.939024794	0.228333953	0.156057387	0	0	0	0.414229916	0	0.25	0.036	0	0.06225	0	9.566074251	0	0	0	0	0	0	0	0	0	0	0	0	17.1897		0	0.5725	0.020099866	0	0	0.238096714	0.836782342	0.346452975	0.73531186	0.156488421	0.072328225	0.102617091	0	0	0.001101407	1.455901257	1.939024794	0.228333953	0.156057387	0	0	0	0.414229916	0	0.25	0.036	0	0.06225	0	9.566074251	0	0	0	0	0	0	0	0	0	0	0	0	17.1897																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0.5725	0.020099866	0	0	0.238096714	0.836782342	0.346452975	0.73531186	0.156488421	0.072328225	0.102617091	0	0	0.001101407	1.455901257	1.939024794	0.228333953	0.156057387	0	0	0	0.414229916	0	0.25	0.036	0	0.06225	0	9.566074251	0	0	0	0	0	0	0	0	0	0	0	0	17.1897
H5821_803_0	2008	2																																D	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	Coin	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1853.041295	79.68792206	2.540264914	0	3.70426337	26.47524581	15.33094138	7.262394228	15.30798746	16.00154432	23.81667861	0.556225093	0.526584411	7.141570788	61.52368667	79.46229162	4.654467287	4.957959165	0	0	16.88692367	5.523757768	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a (IP Acute) - $2;	1b (IP Psych) - $2	2 (SNF) - $35;	6 (Home Health)- $0	10a (Ambulance) - 20%	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) -20%, 4(b) -20%"	9b (OP Surg/ASC) - 20%	8a (OP Diag Proc/Test/Lab) - 20%	8b (OP Diag & Therap Rad) - 20%	9a (OP Observation) -0%	12 (Renal Dialysis) - 20%	"3 (CORF), 5 (Partial Hospital),9a (OP Other), 9c (OP SA), 9d (Cardiac Rehab) - 20%"	"7a (PCP), 7a(UC w/o Copay), 7a(PCP w/o Copay), 14b (Immunizations), 14c(Routine Physical), 14d (Pap & Pelvic),14e (Prostrate Screen), 14f (Colorectal Screen), 14g (Bone Mass), 14h (Mamm), 14i (Diab Mon.), 14j (Nutrition Therap) - 20%"	"7b (Chiro), 7d (Spec), 7f (Pod) - 20%"	"7e (MH), 7h (Psychiatric) -50%"	"7c (OT), 7i (PT/ST) - 20%"		7g (Prof Others) - 20%	15 (Part B Rx) - 20%	"13a (Blood), 14a (Education/Wellness), 14j (Nutrient Therapy), 16b(Comp Den),  17a (Eye Exam), 17b (MCR Eyewear), 18a (MCR Hearing Exam) - 20%"	10b(Transportation)	16a(Preventative Den)	17a1(Routine Eye Exam)	17b1(Non MCR Covered)	"18a(Hearing Exam), 18a1(Routine Hearing Exam)"	18b(Hearing Aids)	19a (POS)		13c (Other)											129.5254475	73.7565938	0.158411912	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.0013	0.489792475	0.402408222	0	0.866797629	6.195207521	3.587440282	1.699400249	3.582069065	3.74436137	5.573102795	0.130156672	0.123220752	1.671127564	14.39654268	18.59417624	1.089145345	1.160162445	0	0	3.951540139	1.292559318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.5505		0	20.0013	0.489792475	0.402408222	0	0.866797629	6.195207521	3.587440282	1.699400249	3.582069065	3.74436137	5.573102795	0.130156672	0.123220752	1.671127564	14.39654268	18.59417624	1.089145345	1.160162445	0	0	3.951540139	1.292559318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.5505																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	20.0013	0.489792475	0.402408222	0	0.866797629	6.195207521	3.587440282	1.699400249	3.582069065	3.74436137	5.573102795	0.130156672	0.123220752	1.671127564	14.39654268	18.59417624	1.089145345	1.160162445	0	0	3.951540139	1.292559318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.5505
H5823_001_0	2008	4																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		262.8848257	21.77755452	62.62569334		10.8210138	23.80116424	17.00909993	10.33742986	23.48610631	11.91133006	24.58405491	0	4.316352507	42.46477023	49.26945431	101.2534455	8.703245411	4.098325808	23.64109674	34.70907545	10.01211741	0.740206802	0	0	0	0	0	0	0	0	0											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0.070558742	0.070558742	0.16542599	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.23	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											18.5488	1.536596844	10.35991735	0	2.53211723	5.569472432	3.980129384	2.418958588	5.495748877	2.787251235	5.752668849	0	1.010026487	9.936756233	11.52905231	23.69330626	2.036559426	0.959008239	5.532016637	8.121923655	2.342835474	0.173208392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.3164	0	0	18.5488	1.536596844	10.35991735	0	2.53211723	5.569472432	3.980129384	2.418958588	5.495748877	2.787251235	5.752668849	0	1.010026487	9.936756233	11.52905231	23.69330626	2.036559426	0.959008239	5.532016637	8.121923655	2.342835474	0.173208392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.3164																																																																																				0	0		18.5488	1.536596844	10.35991735	0	2.53211723	5.569472432	3.980129384	2.418958588	5.495748877	2.787251235	5.752668849	0	1.010026487	9.936756233	11.52905231	23.69330626	2.036559426	0.959008239	5.532016637	8.121923655	2.342835474	0.173208392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.3164
H5823_002_0	2008	3																					2500											A	A	D		T	Coin	Coin	V	Coin		Coin			V	V	V	V	P	Coin	P	Coin				V	0	V				P																																																				0		204.346349	2.826926869	940.2053043	0	160.4869144	10.25381857	5.914449895	334.6708842	31.53536868	0	13.5507863	0	0	419.936365	6547.016806	12218.85464	147.6663013	1196.901343	24.54147886	1813.689633	9.104275195	0	0	0	364.812275	214.7840236	173.6821477	0	0	0	226.701266											$375/Admit for IP Medical; $375/Admit for IP Surgical	$375/Admit for IP Psych; $375/Admit for IP Substance Abuse	"$0 per Day, Days 1-14, $100 per Day, Days 15-100"	No Cost Sharing	$100/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $20/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 15% Coinsurance for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology;	No Cost Sharing	No Cost Sharing	$20/Case for OP Fac - Occ Therapy; $20/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $7/Service for Prof - CORF; $7/Service for Prof - CORF;	$15/Visit for PCP - Office Visits; $12/Consult for PCP - Consults; 20% Coinsurance for PCP - Primary Surgeon (OP); $5/Procedure for PCP - Asst Surgeon (OP); $5/Services for PCP - Tx Injections; $1/Tests for PCP - Allergy Testing; $9/Service for PCP - Allergy Tx;	20% Coinsurance for Speclst - Primary Surgeon (OP); $7/Procedure for Speclst - Asst Surgeon (OP); 20% Coinsurance for Speclst - Anesthesia (OP); $20/Visit for Speclst - Office Visits; $6/Services for Speclst - Tx Injections; $1/Tests for Speclst - Allergy Testing; $12/Service for Speclst - Allergy Tx; $16/Consult for Speclst - Consults;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$7/Service for PT/ST (PCP); $7/Service for Occ Therapy (PCP); $7/Service for PT/ST (Specialist); $7/Service for Occ Therapy (Specialist);	3% Coinsurance for Prof Radiology (Office); 4% Coinsurance for Prof Radiology (OP);	$20/Visit for Chiropractor; $20/Exam for Vistion Exams; $20/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	No Cost Sharing	$25/Exam for Vision (Refractions)	$25/Service for Vision Hardware	$25/Exam for Routine Hearing Exams	No Cost Sharing	No Cost Sharing	No Cost Sharing	$25/Service for Acupunture;											375	375.0000001	41.02	0	100	0.2	0.2	41.68267871	0.175	0	0.2	0	0	15.77748602	10.56572334	13.00710477	20.00000001	6.666666667	0.031960156	20.44870408	0.2	0	0	0	25	25	25	0	0	0	25											6.3858	0.088341465	3.213935132	0	1.337390953	2.050763714	1.182889979	1.162498245	5.518689519	0	2.71015726	0	0	0.552128344	5.764497355	13.24432687	0.246110502	0.66494519	0.784349488	3.090633549	1.820855039	0	0	0	0.760025573	0.447466716	0.361837808	0	0	0	0.472294304	0	0	0	0	0	0	0	0	0	0	51.86	0	0	6.3858	0.088341465	3.213935132	0	1.337390953	2.050763714	1.182889979	1.162498245	5.518689519	0	2.71015726	0	0	0.552128344	5.764497355	13.24432687	0.246110502	0.66494519	0.784349488	3.090633549	1.820855039	0	0	0	0.760025573	0.447466716	0.361837808	0	0	0	0.472294304	0	0	0	0	0	0	0	0	0	0	51.86																																																																																				0	0		6.3858	0.088341465	3.213935132	0	1.337390953	2.050763714	1.182889979	1.162498245	5.518689519	0	2.71015726	0	0	0.552128344	5.764497355	13.24432687	0.246110502	0.66494519	0.784349488	3.090633549	1.820855039	0	0	0	0.760025573	0.447466716	0.361837808	0	0	0	0.472294304	0	0	0	0	0	0	0	0	0	0	51.86
H5826_005_0	2008	7																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin			V	P	V	P																																																							0	0	283.7127697	32.46826346	53.05120894		18.50185817	24.9720556	13.64367071	41.95764394	34.7440252	17.07272177	38.24552195	6.455224457	1.633161579	38.70671515	41.62451398	93.12950888	11.29932988	6.869151131			18.43071186	6.837159814																				FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing																				0.071571879	0.071571879	0.165170036		0.234	0.234	0.234	0.233991897	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				20.3059	2.323814635	8.762470065	0	4.329434812	5.84346101	3.192618946	9.817748681	8.130101896	3.995016894	8.949452136	1.510522523	0.38215981	9.057371344	9.740136272	21.79230508	2.644043192	1.607381365	0	0	4.312786574	1.599895397	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.2966	138	0	20.3059	2.323814635	8.762470065	0	4.329434812	5.84346101	3.192618946	9.817748681	8.130101896	3.995016894	8.949452136	1.510522523	0.38215981	9.057371344	9.740136272	21.79230508	2.644043192	1.607381365	0	0	4.312786574	1.599895397	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.2966																																																																																				0	0	0	20.3059	2.323814635	8.762470065	0	4.329434812	5.84346101	3.192618946	9.817748681	8.130101896	3.995016894	8.949452136	1.510522523	0.38215981	9.057371344	9.740136272	21.79230508	2.644043192	1.607381365	0	0	4.312786574	1.599895397	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.2966
H5826_006_0	2008	4																					3250											D	D	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V		P	Coin	V			V	P	V	P																																																							0	0	1010.957816	77.24124756	689.4218545		130.3164231	8.819615436	7.968687127	335.095419	40.68016253	16.40209212	43.69076509	8.116751086	0.11206844	25.42930236	4263.473208	4236.671472	287.8473444	847.8275985		1623.648305	27.34305278																					$400 per admit	$400 per admit	$100 for days 11-100		$100 per trip	0.2	0.2	$50ER/$40UC/20%WW	0.2	0.2	0.2	0.2	0.2	0.2	$20 per visit	$20 per visit	$20 per visit	$20 per visit	incl in OP Rad	20% Chiro/$20	0.2																					86.2955	35.96	40		100	0.163	0.163	44.8779	0.163	0.163	0.163	0.163	0.163	0.165227471	20	20	20	20		18.1949	0.163																					7.2701	0.231465959	2.298072848	0	1.085970193	1.437597316	1.298896002	1.253199425	6.630866493	2.673541015	7.12159471	1.323030427	0.018267156	4.201619316	7.10578868	7.061119119	0.479745574	1.413045997	0	2.46184011	4.456917603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8227	0	6.711369455	7.2701	0.231465959	2.298072848	0	1.085970193	1.437597316	1.298896002	1.253199425	6.630866493	2.673541015	7.12159471	1.323030427	0.018267156	4.201619316	7.10578868	7.061119119	0.479745574	1.413045997	0	2.46184011	4.456917603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8227																																																																																				0	0	0	7.2701	0.231465959	2.298072848	0	1.085970193	1.437597316	1.298896002	1.253199425	6.630866493	2.673541015	7.12159471	1.323030427	0.018267156	4.201619316	7.10578868	7.061119119	0.479745574	1.413045997	0	2.46184011	4.456917603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8227
H5826_007_0	2008	6																					5000											D	D	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V		P	Coin	V			V	P	V	P																																																							0	0	786.8664716	32.46966188	462.8222963		129.9579375	11.18789575	9.04835779	402.7957276	34.95024637	16.54407164	42.99923456	4.670255446	0.020993576	36.91038067	3305.051397	3340.004587	139.407969	795.174144		1790.83387	17.55575581																					$600 per admit	$600 per admit	$100 for days 11-100		150 per trip	0.25	0.25	$50 ER/ $40 UC/20% WW	0.25	0.25	0.25	0.25	0.25	0.25	25 per visit	25 per visit	25 per visit	25 per visit		25% Chiro/$25	0.25																					142.1622	61.2768	40		150	0.19	0.19	47.5391	0.19	0.19	0.19	0.19	0.19	0.192318194	25	25	25	25		21.6151	0.19																					9.3219	0.165803207	1.542740988	0	1.624474218	2.125700193	1.71918798	1.595711158	6.640546809	3.143373611	8.169854567	0.887348535	0.003988779	7.098537756	6.885523744	6.958342889	0.290433269	1.6566128	0	3.225750084	3.335593604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3914	0	10.66072224	9.3219	0.165803207	1.542740988	0	1.624474218	2.125700193	1.71918798	1.595711158	6.640546809	3.143373611	8.169854567	0.887348535	0.003988779	7.098537756	6.885523744	6.958342889	0.290433269	1.6566128	0	3.225750084	3.335593604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3914																																																																																				0	0	0	9.3219	0.165803207	1.542740988	0	1.624474218	2.125700193	1.71918798	1.595711158	6.640546809	3.143373611	8.169854567	0.887348535	0.003988779	7.098537756	6.885523744	6.958342889	0.290433269	1.6566128	0	3.225750084	3.335593604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3914
H5826_008_0	2008	6																					3250											D	D	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V		P	Coin	V			V	P	V	P																																																							0	0	1004.435164	76.74289064	706.9624084		130.2815547	8.830208699	7.978258337	333.3412467	40.44196164	16.38460303	43.65795404	8.06922381	0.111727219	25.2804022	4266.032874	4239.215047	287.9485279	848.245796		1624.623096	27.37589459				96																	$425 per admit	$425 per admit	$100 for days 11-100		$100 per trip	0.2	0.2	$50ER/$40UC	0.2	0.2	0.2	0.2	0.2	0.2	$20 per visit	$20 per visit	$20 per visit	$20 per visit	incl in OP Rad	20% Chiro/$20	0.2				25																	91.6889	38.2074	40		100	0.163	0.163	44.8479	0.163	0.163	0.163	0.163	0.163	0.165224886	20	20	20	20		18.1972	0.163				25																	7.6746	0.244345836	2.356541361	0	1.085679623	1.439324018	1.300456109	1.245804382	6.592039748	2.670690293	7.116246508	1.315283481	0.018211537	4.176951568	7.11005479	7.065358411	0.479914213	1.413742993	0	2.463626623	4.462270818	0	0	0	0.2	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4312	0	6.695586055	7.6746	0.244345836	2.356541361	0	1.085679623	1.439324018	1.300456109	1.245804382	6.592039748	2.670690293	7.116246508	1.315283481	0.018211537	4.176951568	7.11005479	7.065358411	0.479914213	1.413742993	0	2.463626623	4.462270818	0	0	0	0.2	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4312																																																																																				0	0	0	7.6746	0.244345836	2.356541361	0	1.085679623	1.439324018	1.300456109	1.245804382	6.592039748	2.670690293	7.116246508	1.315283481	0.018211537	4.176951568	7.11005479	7.065358411	0.479914213	1.413742993	0	2.463626623	4.462270818	0	0	0	0.2	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4312
H5826_009_0	2008	6																					5000											D	D	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V		P	Coin	V			V	P	V	P																																																							0	0	786.285166	32.44567459	461.9497529		129.9929153	11.19706758	9.055775632	402.6138189	34.9387391	16.55184422	43.01636575	4.668717778	0.021010786	36.89822804	3306.40586	3341.373374	139.4560103	795.4922046		1791.567782	17.57014801				96																	$625 per admit	$625 per admit	$100 for days 11-100		150 per trip	0.25	0.25	$50 ER/ $40 UC/20% WW	0.25	0.25	0.25	0.25	0.25	0.25	25 per visit	25 per visit	25 per visit	25 per visit		25% Chiro/$25	0.25				30																	148.0857	63.83	40		150	0.19	0.19	47.5369	0.19	0.19	0.19	0.19	0.19	0.192316717	25	25	25	25		21.6172	0.19				30																	9.7031	0.172584082	1.53983251	0	1.624911441	2.127442841	1.72059737	1.594919131	6.638360429	3.144850402	8.173109492	0.887056378	0.003992049	7.09614608	6.888345541	6.961194528	0.290533355	1.657275426	0	3.227386881	3.338328123	0	0	0	0.24	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.03	0	10.6627683	9.7031	0.172584082	1.53983251	0	1.624911441	2.127442841	1.72059737	1.594919131	6.638360429	3.144850402	8.173109492	0.887056378	0.003992049	7.09614608	6.888345541	6.961194528	0.290533355	1.657275426	0	3.227386881	3.338328123	0	0	0	0.24	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.03																																																																																				0	0	0	9.7031	0.172584082	1.53983251	0	1.624911441	2.127442841	1.72059737	1.594919131	6.638360429	3.144850402	8.173109492	0.887056378	0.003992049	7.09614608	6.888345541	6.961194528	0.290533355	1.657275426	0	3.227386881	3.338328123	0	0	0	0.24	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.03
H5832_001_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0	0	0	0	0											$150/day 1-8	$150/day 1-8	"$0/d 1-20, $100/d 21-100"	0	$75 	20%	20%	$50 ER; $25 UC	$100 	$0 	"$0 X-ray; $100 CAT, PET, MRI"	25	25	25	10	25	25	25	25	25	$45 	0	0	0	$0 	Not Covered	$0 	$500 Every 3 Yrs	N/A	Fitness	0											114.27	114.27	41.2	0	75	0.2	0.2	47	100	0	18	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0	0											15.1171	0.29449924	4.452090201	0	1.468215941	3.143561179	0.200659672	1.668763771	2.925180284	0	1.720425682	0	0	0	4.613623101	14.25321933	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5425			15.1171	0.29449924	4.452090201	0	1.468215941	3.143561179	0.200659672	1.668763771	2.925180284	0	1.720425682	0	0	0	4.613623101	14.25321933	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5425																																																																																				0			15.1171	0.29449924	4.452090201	0	1.468215941	3.143561179	0.200659672	1.668763771	2.925180284	0	1.720425682	0	0	0	4.613623101	14.25321933	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5425
H5832_002_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0	0	0	0	0											$50/day 1-5	$50/day 1-5	"$0/d 1-20, $100/d 21-100"	0	$75 	20%	20%	$50 ER; $25 UC	$50 	$0 	"$0 X-ray; $100 CAT, PET, MRI"	25	25	25	10	25	25	25	25	25	$45 	0	0	0	$0 	Not Covered	$0 	$500 Every 3 Yrs	N/A	Fitness	0											30.64193704	30.64193704	41.2	0	75	0.2	0.2	47	50	0	18	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0	0											4.0537	0.078971096	4.452090201	0	1.468215941	3.143561179	0.200659672	1.668763771	1.462590142	0	1.720425682	0	0	0	4.613623101	14.25321933	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.801			4.0537	0.078971096	4.452090201	0	1.468215941	3.143561179	0.200659672	1.668763771	1.462590142	0	1.720425682	0	0	0	4.613623101	14.25321933	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.801																																																																																				0			4.0537	0.078971096	4.452090201	0	1.468215941	3.143561179	0.200659672	1.668763771	1.462590142	0	1.720425682	0	0	0	4.613623101	14.25321933	0.420149263	1.215616071	1.993670558	3.013314174	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.801
H5832_801_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	Coin	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1403.23	27.34	1146.2	1881.55	207.65	15.72	1	376.61	310.28	1972.67	1013.81	0	0	0	4893.7	6208.05	178.26	1031.53	22.93217943	2556.99	18.07	0	0	0	0	0	0	0	0	0	0											200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	0.2	$40 per visit	20% coinsurance	0	N/A	Not Covered	$0 per visit	Not Covered	$0 per visit	Not Covered	N/A	Not Covered	0											144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	0.2	40	0.2	0	0	0	0	0	0	0	0	0	0											16.9054	0.32937865	9.551666667	6.271833333	2.595625	4.716	0.3	1.569208333	5.171333333	6.575566667	4.641560117	0	0	0	12.23425	20.43483125	0.5942	3.438433333	4.586435886	8.5233	3.614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.053			16.9054	0.32937865	9.551666667	6.271833333	2.595625	4.716	0.3	1.569208333	5.171333333	6.575566667	4.641560117	0	0	0	12.23425	20.43483125	0.5942	3.438433333	4.586435886	8.5233	3.614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.053																																																																																				0			16.9054	0.32937865	9.551666667	6.271833333	2.595625	4.716	0.3	1.569208333	5.171333333	6.575566667	4.641560117	0	0	0	12.23425	20.43483125	0.5942	3.438433333	4.586435886	8.5233	3.614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.053
H5832_802_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	Coin	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1403.23	27.34	1146.2	1881.55	207.65	15.72	1	376.61	310.28	1972.67	1013.81	0	0	0	4893.7	6208.05	178.26	1031.53	22.93217943	2556.99	18.07	0	0	0	0	0	0	0	0	0	0											200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	0.2	$40 per visit	20% coinsurance	0	N/A	Not Covered	$0 per visit	Not Covered	$0 per visit	Not Covered	N/A	Not Covered	0											144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	0.2	40	0.2	0	0	0	0	0	0	0	0	0	0											16.9054	0.32937865	9.551666667	6.271833333	2.595625	4.716	0.3	1.569208333	5.171333333	6.575566667	4.641560117	0	0	0	12.23425	20.43483125	0.5942	3.438433333	4.586435886	8.5233	3.614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.053			16.9054	0.32937865	9.551666667	6.271833333	2.595625	4.716	0.3	1.569208333	5.171333333	6.575566667	4.641560117	0	0	0	12.23425	20.43483125	0.5942	3.438433333	4.586435886	8.5233	3.614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.053																																																																																				0			16.9054	0.32937865	9.551666667	6.271833333	2.595625	4.716	0.3	1.569208333	5.171333333	6.575566667	4.641560117	0	0	0	12.23425	20.43483125	0.5942	3.438433333	4.586435886	8.5233	3.614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.053
H5838_001_0	2008	5																																Coin		Coin	Coin	Coin	Coin		Coin	Coin	Coin					Coin						Coin	Coin																																																													0		436.8588141		43.51705861	31.1830202	31.61552289	36.33602791		26.85554029	30.81205257	168.1421142					273.8676859						12.94274485	0.699014329																				Medicare FFS cost sharing		Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing		Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing					Medicare FFS cost sharing						Medicare FFS cost sharing	Medicare FFS cost sharing																				0.073829265		0.184152232	0	0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				32.253	0	8.013763486	0	7.398032357	8.50263053	0	6.284196429	7.210020301	39.34525471	0	0	0	0	64.0850385	0	0	0	0	0	3.028602295	0.163569353	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	176.2841			32.253	0	8.013763486	0	7.398032357	8.50263053	0	6.284196429	7.210020301	39.34525471	0	0	0	0	64.0850385	0	0	0	0	0	3.028602295	0.163569353	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	176.2841																																																																																				0			32.253	0	8.013763486	0	7.398032357	8.50263053	0	6.284196429	7.210020301	39.34525471	0	0	0	0	64.0850385	0	0	0	0	0	3.028602295	0.163569353	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	176.2841
H5839_001_0	2008	4																																D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	V	Coin	Coin																																																													0		904.2545549	7.674127059	37.06722001	18.7735694	139.2501749	14.58307723	6.812902944	326.4700312	87.06422677	33.80475576	4.07028286	0.955056828	0.087197716	0.046847275	3667.953921	2575.042111	1.339017738	3.978537171	0	0	23.13148326	0.561043344																				$150 day for 1st 5 days	$150 day for 1st 5 days	$35 day for days 11+	15% Coinsurance	$150 Copay	20% Coinsurance	20% Coinsurance	$50 per visit	15% Coinsurance	15% Coinsurance	15% Coinsurance	50% Coinsurance	15% Coinsurance	50% Coinsurance	$10 Per Visit	$35 Per Visit	50% Coinsurance	15% Coinsurance	15% Coinsurance	$35 Per Visit	20% Coinsurance	15% Coinsurance																				150	150	35	0.15	150	0.2	0.2	50	0.15	0.15	0.15	0.5	0.15	0.5	10	35	0.5	0.15	0.15	35	0.2	0.15																				11.3032	0.095926588	0.108112725	2.81603541	1.740627187	2.916615445	1.362580589	1.360291797	13.05963402	5.070713364	0.610542429	0.477528414	0.013079657	0.023423637	3.056628268	7.510539489	0.669508869	0.596780576	0	0	4.626296653	0.084156502	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5022			11.3032	0.095926588	0.108112725	2.81603541	1.740627187	2.916615445	1.362580589	1.360291797	13.05963402	5.070713364	0.610542429	0.477528414	0.013079657	0.023423637	3.056628268	7.510539489	0.669508869	0.596780576	0	0	4.626296653	0.084156502	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5022		$500 per day								20% Coinsurance																																	0.7689								0.3554																																	1.1243			12.0721	0.095926588	0.108112725	2.81603541	1.740627187	2.916615445	1.362580589	1.360291797	13.41499821	5.070713364	0.610542429	0.477528414	0.013079657	0.023423637	3.056628268	7.510539489	0.669508869	0.596780576	0	0	4.626296653	0.084156502	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.6265
H5849_003_1	2008	6	i.5.	i.6.									Professional	Professional									3000	Radiology	Other									A	A	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	V	V	V	V	V	Coin	Coin	P			V		V				O	Coin	V									0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0			0		0				0	0	0									0	N.A.	256.7286988	7.580094376	613.4860982	0	7.707306195	26.38391869	1.206206404	4.79336375	24.72164016	7.427828074	21.32257383			32.18221087	4095.420384	4761.280218	157.7703121	462.8161182	880.6176895	18.16803357	12.28113341	10.7889551			287.7054693		123.302344					4.736748272	597.7806508									$500 per admit	$500 per admit	$75 for days 4-100	No cost sharing	10% coinsurance	10% coinsurance	10% coinsurance	10% coinsuracne	10% coinsurance	10% coinsurance	10%coinsuracne			10% coinsurance	$10 copay	$25 copay	$25 copay	$25 copay	$10 PCP/$25 SCP copay	10% coinsurance	10% coinsurance	$25 copay			$25 copay		$25 copay					10% coinsurance	$10 PCP/$25 SCP copay									423.4945995	423.4945995	63.52418992	0	0.08469892	0.08469892	0.08469892	0.08469892	0.08469892	0.08469892	0.08469892			0.08469892	8.46989199	21.17472997	21.17472997	21.17472997	17.36327858	0.08469892	0.08469892	21.17472997			21.17472997		21.17472997					0.08469892	16.09279478									9.0603	0.267510753	3.247600618	0	0.65280051	2.234689416	0.10216438	0.405992732	2.093896219	0.629129015	1.805998973	0	0	2.725798501	2.890647359	8.401568578	0.278395313	0.816667194	1.274200855	1.53881282	1.040198735	0.019037768	0	0	0.507673802	0	0.217574487	0	0	0	0	0.401197462	0.801663445	0	0	0	0	0	0	0	0	41.4135	0	7.481454116	9.0603	0.267510753	3.247600618	0	0.65280051	2.234689416	0.10216438	0.405992732	2.093896219	0.629129015	1.805998973	0	0	2.725798501	2.890647359	8.401568578	0.278395313	0.816667194	1.274200855	1.53881282	1.040198735	0.019037768	0	0	0.507673802	0	0.217574487	0	0	0	0	0.401197462	0.801663445	0	0	0	0	0	0	0	0	41.4135	3000																																																																																			0	N.A.	0	9.0603	0.267510753	3.247600618	0	0.65280051	2.234689416	0.10216438	0.405992732	2.093896219	0.629129015	1.805998973	0	0	2.725798501	2.890647359	8.401568578	0.278395313	0.816667194	1.274200855	1.53881282	1.040198735	0.019037768	0	0	0.507673802	0	0.217574487	0	0	0	0	0.401197462	0.801663445	0	0	0	0	0	0	0	0	41.4135
H5849_003_2	2008	5	i.5.	i.6.									Professional	Professional									5000	Radiology	Other									D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	V	V	V	V	V	Coin	Coin	P					V				O	Coin	V									0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0					0				0	0	0									0	N.A.	1120.760712	33.09124382	611.5538338	0	8.147129298	27.88953644	1.275039461	5.445467478	28.15521988	8.459476448	24.28405845			36.65198659	4196.307409	4982.565236	174.4636107	511.7855825	938.5437795	19.1151753	13.86017487	11.41133561					127.4512809					5.156179781	644.9387475									$250 for Day first 5 days per admit	$250 for Day first 5 days per admit	$90 for days 4-100	No cost sharing	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance			20% coinsurance	$15 copay	$30 copay	$30 copay	$30 copay	$15 PCP/$30 SCP copay	20% coinsurance	20% coinsurance	$30 copay					$30 copay					20% coinsurance	$15 PCP/$30 SCP copay									207.721699	207.721699	74.77981164	0	0.166177359	0.166177359	0.166177359	0.166177359	0.166177359	0.166177359	0.166177359			0.166177359	12.46330194	24.92660388	24.92660388	24.92660388	21.1876133	0.166177359	0.166177359	24.92660388					24.92660388					0.166177359	19.9412831									19.4005	0.572814116	3.810990041	0	1.353868432	4.634609514	0.21188269	0.904913405	4.678760088	1.405773456	4.035460705	0	0	6.090730341	4.358320523	10.34986916	0.362398776	1.063089707	1.657125222	3.176509353	2.303247258	0.02370382	0	0	0	0	0.264743966	0	0	0	0	0.85684034	1.071742179	0	0	0	0	0	0	0	0	72.5879	0	14.77406517	19.4005	0.572814116	3.810990041	0	1.353868432	4.634609514	0.21188269	0.904913405	4.678760088	1.405773456	4.035460705	0	0	6.090730341	4.358320523	10.34986916	0.362398776	1.063089707	1.657125222	3.176509353	2.303247258	0.02370382	0	0	0	0	0.264743966	0	0	0	0	0.85684034	1.071742179	0	0	0	0	0	0	0	0	72.5879	5000																																																																																			0	N.A.	0	19.4005	0.572814116	3.810990041	0	1.353868432	4.634609514	0.21188269	0.904913405	4.678760088	1.405773456	4.035460705	0	0	6.090730341	4.358320523	10.34986916	0.362398776	1.063089707	1.657125222	3.176509353	2.303247258	0.02370382	0	0	0	0	0.264743966	0	0	0	0	0.85684034	1.071742179	0	0	0	0	0	0	0	0	72.5879
H5849_003_3	2008	6	i.5.	i.6.									Professional	Professional									5000	Radiology	Other									D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	V	V	V	V	V	Coin	Coin	P					V				O	Coin	V									0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0					0				0	0	0									0	N.A.	1076.646628	31.78874465	704.6235275	0	8.308011461	28.44027385	1.30021779	5.83019265	30.16244021	9.06256295	26.01529891			39.26495188	4424.425597	5196.203144	175.3808648	514.4763292	921.7839921	18.56199304	13.9204863	12.03167463					134.3797426					4.868248875	644.1414518									$250 for Day first 5 days per admit	$250 for Day first 5 days per admit	$90 for days 4-100	No cost sharing	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance			20% coinsurance	$15 copay	$30 copay	$30 copay	$30 copay	$15 PCP/$30 SCP copay	20% coinsurance	20% coinsurance	$30 copay					$30 copay					20% coinsurance	$15 PCP/$30 SCP copay									206.4582803	206.4582803	74.3249809	0	0.165166624	0.165166624	0.165166624	0.165166624	0.165166624	0.165166624	0.165166624			0.165166624	12.38749682	24.77499363	24.77499363	24.77499363	21.05874459	0.165166624	0.165166624	24.77499363					24.77499363					0.165166624	19.81999491									18.5236	0.546920796	4.364260852	0	1.372206207	4.697384025	0.214752583	0.962953239	4.981828428	1.496832929	4.296859099	0	0	6.485259553	4.5672965	10.72799165	0.362088317	1.062178982	1.617634471	3.06582173	2.29919973	0.024840389	0	0	0	0	0.277438106	0	0	0	0	0.804072233	1.063906691	0	0	0	0	0	0	0	0	73.8153	0	15.56752346	18.5236	0.546920796	4.364260852	0	1.372206207	4.697384025	0.214752583	0.962953239	4.981828428	1.496832929	4.296859099	0	0	6.485259553	4.5672965	10.72799165	0.362088317	1.062178982	1.617634471	3.06582173	2.29919973	0.024840389	0	0	0	0	0.277438106	0	0	0	0	0.804072233	1.063906691	0	0	0	0	0	0	0	0	73.8153	5000																																																																																			0	N.A.	0	18.5236	0.546920796	4.364260852	0	1.372206207	4.697384025	0.214752583	0.962953239	4.981828428	1.496832929	4.296859099	0	0	6.485259553	4.5672965	10.72799165	0.362088317	1.062178982	1.617634471	3.06582173	2.29919973	0.024840389	0	0	0	0	0.277438106	0	0	0	0	0.804072233	1.063906691	0	0	0	0	0	0	0	0	73.8153
H5849_005_0	2008	5	i.5.	i.6.									Professional	Professional									5000	Radiology	Other									D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	V	V	V	V	V	Coin	Coin	P					V				O	Coin	V									0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0					0				0	0	0									0	N.A.	910.8689818	26.89404371	594.3146576	0	7.553160071	25.85624032	1.182082276	4.697037717	24.22720735	7.279271513	20.89612235			31.53856666	3967.438497	4736.73561	157.7703121	462.8161182	870.8330485	17.8046729	11.89734799	10.7889551					0					4.642013307	591.2116327									$160 for the first 5 days per admit	$160 for the first 5 days per admit	$90 for days 4-100	No cost sharing	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance			20% coinsurance	$15 copay	$25 copay	$25 copay	$25 copay	$15 PCP/$25 SCP copay	20% coinsurance	20% coinsurance	$25 copay					$25 copay					20% coinsurance	$15 PCP/$25 SCP copay									142.0722448	142.0722448	79.91563773	0	0.177590306	0.177590306	0.177590306	0.177590306	0.177590306	0.177590306	0.177590306			0.177590306	13.31927295	22.19878826	22.19878826	22.19878826	19.53493367	0.177590306	0.177590306	22.19878826					22.19878826					0.177590306	18.64698214									10.7841	0.318408097	3.957919573	0	1.341368009	4.591817632	0.209926353	0.834148366	4.302517169	1.292728056	3.710948764	0	0	5.600943705	4.403616356	8.762482571	0.291859146	0.856163084	1.41763882	3.16193731	2.112853671	0.019958477	0	0	0	0	0	0	0	0	0	0.824376564	0.918692729	0	0	0	0	0	0	0	0	59.7144	0	7.535217203	10.7841	0.318408097	3.957919573	0	1.341368009	4.591817632	0.209926353	0.834148366	4.302517169	1.292728056	3.710948764	0	0	5.600943705	4.403616356	8.762482571	0.291859146	0.856163084	1.41763882	3.16193731	2.112853671	0.019958477	0	0	0	0	0	0	0	0	0	0.824376564	0.918692729	0	0	0	0	0	0	0	0	59.7144	5000																																																																																			0	N.A.	0	10.7841	0.318408097	3.957919573	0	1.341368009	4.591817632	0.209926353	0.834148366	4.302517169	1.292728056	3.710948764	0	0	5.600943705	4.403616356	8.762482571	0.291859146	0.856163084	1.41763882	3.16193731	2.112853671	0.019958477	0	0	0	0	0	0	0	0	0	0.824376564	0.918692729	0	0	0	0	0	0	0	0	59.7144
H5849_006_0	2008	4	i.5.	i.6.									Professional	Professional									5000	Radiology	Other									D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	V	V	V	V	V	Coin	Coin	P					V				O	Coin	V									0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0					0				0	0	0									0	N.A.	1130.133189	33.36797277	611.5538338	0	8.147129298	27.88953644	1.275039461	5.445467478	28.15521988	8.459476448	24.28405845			36.65198659	4196.307409	5087.83011	178.520904	523.6875728	949.2090498	19.1151753	13.86017487	11.41133561					0					5.156179781	659.5964463									$160 for the first 5 days per admit	$160 for the first 5 days per admit	$90 for days 4-100	No cost sharing	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance			20% coinsurance	$15 copay	$25 copay	$25 copay	$25 copay	$15 PCP/$25 SCP copay	20% coinsurance	20% coinsurance	$25 copay					$25 copay					20% coinsurance	$15 PCP/$25 SCP copay									137.8540674	137.8540674	77.5429129	0	0.172317584	0.172317584	0.172317584	0.172317584	0.172317584	0.172317584	0.172317584			0.172317584	12.92381882	21.53969803	21.53969803	21.53969803	18.95493426	0.172317584	0.172317584	21.53969803					21.53969803					0.172317584	18.09334634									12.9828	0.383325897	3.951805472	0	1.403893639	4.805857544	0.21971172	0.938349801	4.851639473	1.457716545	4.184570288	0	0	6.315781786	4.519359721	9.132527016	0.32044053	0.940006015	1.499349595	3.29388083	2.388351851	0.02048306	0	0	0	0	0	0	0	0	0	0.888500444	0.994525579	0	0	0	0	0	0	0	0	65.4929	0	10.52127514	12.9828	0.383325897	3.951805472	0	1.403893639	4.805857544	0.21971172	0.938349801	4.851639473	1.457716545	4.184570288	0	0	6.315781786	4.519359721	9.132527016	0.32044053	0.940006015	1.499349595	3.29388083	2.388351851	0.02048306	0	0	0	0	0	0	0	0	0	0.888500444	0.994525579	0	0	0	0	0	0	0	0	65.4929	5000																																																																																			0	N.A.	0	12.9828	0.383325897	3.951805472	0	1.403893639	4.805857544	0.21971172	0.938349801	4.851639473	1.457716545	4.184570288	0	0	6.315781786	4.519359721	9.132527016	0.32044053	0.940006015	1.499349595	3.29388083	2.388351851	0.02048306	0	0	0	0	0	0	0	0	0	0.888500444	0.994525579	0	0	0	0	0	0	0	0	65.4929
H5849_007_0	2008	4	i.5.	i.6.									Professional	Professional									5000	Radiology	Other									D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	V	V	V	V	V	Coin	Coin	P					V				O	Coin	V									0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0					0				0	0	0									0	N.A.	1085.650197	32.05458132	704.6235275	0	8.308011461	28.44027385	1.30021779	5.83019265	30.16244021	9.06256295	26.01529891			39.26495188	4424.425597	5305.832936	179.4594895	526.440895	932.2588102	18.56199304	13.9204863	12.03167463					0					4.868248875	658.7810303									$160 for the first 5 days per admit	$160 for the first 5 days per admit	$90 for days 4-100	No cost sharing	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance			20% coinsurance	$15 copay	$25 copay	$25 copay	$25 copay	$15 PCP/$25 SCP copay	20% coinsurance	20% coinsurance	$25 copay					$25 copay					20% coinsurance	$15 PCP/$25 SCP copay									136.9186682	136.9186682	77.01675089	0	0.171148335	0.171148335	0.171148335	0.171148335	0.171148335	0.171148335	0.171148335			0.171148335	12.83612515	21.39354191	21.39354191	21.39354191	18.82631688	0.171148335	0.171148335	21.39354191					21.39354191					0.171148335	17.97057521									12.3871	0.365739215	4.522317891	0	1.421902331	4.867505526	0.22253011	0.997827766	5.16225143	1.551042563	4.452475101	0	0	6.720131151	4.732706722	9.459213276	0.319939509	0.938536279	1.462583315	3.176854209	2.382468057	0.021450011	0	0	0	0	0	0	0	0	0	0.833192691	0.986556171	0	0	0	0	0	0	0	0	66.9844	0	11.29202119	12.3871	0.365739215	4.522317891	0	1.421902331	4.867505526	0.22253011	0.997827766	5.16225143	1.551042563	4.452475101	0	0	6.720131151	4.732706722	9.459213276	0.319939509	0.938536279	1.462583315	3.176854209	2.382468057	0.021450011	0	0	0	0	0	0	0	0	0	0.833192691	0.986556171	0	0	0	0	0	0	0	0	66.9844	5000																																																																																			0	N.A.	0	12.3871	0.365739215	4.522317891	0	1.421902331	4.867505526	0.22253011	0.997827766	5.16225143	1.551042563	4.452475101	0	0	6.720131151	4.732706722	9.459213276	0.319939509	0.938536279	1.462583315	3.176854209	2.382468057	0.021450011	0	0	0	0	0	0	0	0	0	0.833192691	0.986556171	0	0	0	0	0	0	0	0	66.9844
H5850_001_0	2008	3																																		D					V	V		V		V	V							S			P																																																											0				849.775221					223.5471368	86.56938583		60.33882455		0	88.76229371							651.3082046			701.3173445																		$0 copay	$0 copay	$50 per day (days 8 through 100)  PBP L.2	$0 copay	$0 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$100 copay @ Hospital PBP L.9a	Included in OP-Facility Other	$50 copay @ Hospital PBP L.8a/8b	$0 copay	$25 copay @ Hospital PBP L.12	"$25 copay @ Hospital PBP L.9a, 8a, 7c, 7j"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $50 copay Other Part B	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay													18.17274426					50	100		50		25	25							77.27713875			85.2110681																		0	0	1.286895648	0	0	0	0	0.931446403	0.721411549	0	0.251411769	0	0	0.184921445	0	0	0	0	0	0	4.194269541	0	0	4.98	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.5504			0	0	1.286895648	0	0	0	0	0.931446403	0.721411549	0	0.251411769	0	0	0.184921445	0	0	0	0	0	0	4.194269541	0	0	4.98	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.5504																																																																																				0			0	0	1.286895648	0	0	0	0	0.931446403	0.721411549	0	0.251411769	0	0	0.184921445	0	0	0	0	0	0	4.194269541	0	0	4.98	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.5504
H5850_002_0	2008	3																																																							P																																																											0																									2100.591872																		$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay																																		23.60651183																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.132303906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1323			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.132303906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1323																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.132303906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1323
H5850_003_0	2008	3																																		D					V	V		V		V	V							S			P																																																											0				756.1039623					339.5448875	82.05696523		1551.191722		0.103497804	109.2388536							732.968189			701.3173445																		$0 copay	$0 copay	$40 per day (days 8 through 100)  PBP L.2	$0 copay	$0 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$100 copay @ Hospital PBP L.9a	Included in OP-Facility Other	$50 copay @ Hospital PBP L.8a/8b; $5 @ Freestanding	$0 copay	$25 copay @ Hospital PBP L.12	"$25 copay @ Hospital PBP L.9a, 8a, 7c, 7j"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $50 copay Other Part B	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay													24.23032568					50	100		6.241317485		25	25							96.07960263			85.29530667																		0	0	1.526720438	0	0	0	0	1.414770365	0.683808044	0	0.806790001	0	0.00021562	0.227580945	0	0	0	0	0	0	5.868607695	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.5134			0	0	1.526720438	0	0	0	0	1.414770365	0.683808044	0	0.806790001	0	0.00021562	0.227580945	0	0	0	0	0	0	5.868607695	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.5134																																																																																				0			0	0	1.526720438	0	0	0	0	1.414770365	0.683808044	0	0.806790001	0	0.00021562	0.227580945	0	0	0	0	0	0	5.868607695	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.5134
H5850_004_0	2008	3																																D		D		T			V	V		V		V	V		V					S			P																																																											0		1518.828027		1128.260649		301.2715844			316.6657518	458.7241049		2213.494137		0	388.2219402		5123.107408					721.9094677			701.3173445																		$150 copay (days 1-7)	$0 copay	$50 per day (days 8 through 100)  PBP L.2	$0 copay	$100 copay	$0 copay	$0 copay	$100 copay PBP L.4a	$300 copay @ Hospital; $100 copay @ ASC	Included in OP-Facility Other	$200 copay @ Hospital PBP L.8a/8b; $100 @ Freestanding diagnostic center	$0 copay	$50 copay @ Hospital PBP L.12	"$100 copay @ Hospital PBP L.9a, 8a, 7c, 7j"	$0 copay	$30 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $50 copay Other Part B	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											118.1390462		30.28790711		100			50	99.2128906		102.5359056		50	100		30					92.45415283			85.29530667																		14.9527	0	2.847721144	0	2.510596537	0	0	1.319440632	3.792612036	0	18.91355214	0	0	3.235182835	0	12.80776852	0	0	0	0	5.561960688	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.9265			14.9527	0	2.847721144	0	2.510596537	0	0	1.319440632	3.792612036	0	18.91355214	0	0	3.235182835	0	12.80776852	0	0	0	0	5.561960688	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.9265																																																																																				0			14.9527	0	2.847721144	0	2.510596537	0	0	1.319440632	3.792612036	0	18.91355214	0	0	3.235182835	0	12.80776852	0	0	0	0	5.561960688	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.9265
H5850_005_0	2008	3																																																																																																																		0		1832.529072		775.1534254		269.8547409			256.0454656	76.67591725		52.81302888		4.126499716	155.0171176		6007.358538					348.693424			701.3173445																		$50 copay (days 1-5; Tier 1)	$0 copay	$55 per day (days 8 through 34)  PBP L.2	$0 copay	$100 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$250 copay @ Hospital	Included in OP-Facility Other	$175 copay @ Hospital PBP L.8a/8b	$0 copay	$100 copay @ Hospital PBP L.12; $25 copay @ Dialysis Center	"$50 copay @ Hospital PBP L.9a, 8a, 7c, 7j"	$0 copay	$20 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $40 copay Other Part B	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											34.34587977		29.02334274		100			50	250		175		25	50		20					61.43161879			85.29530667																		5.245	0	1.874795295	0	2.248789507	0	0	1.066856107	1.597414943	0	0.770190005	0	0.008596874	0.645904657	0	10.01226423	0	0	0	0	1.785066792	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2398			5.245	0	1.874795295	0	2.248789507	0	0	1.066856107	1.597414943	0	0.770190005	0	0.008596874	0.645904657	0	10.01226423	0	0	0	0	1.785066792	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2398																																																																																				0			5.245	0	1.874795295	0	2.248789507	0	0	1.066856107	1.597414943	0	0.770190005	0	0.008596874	0.645904657	0	10.01226423	0	0	0	0	1.785066792	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2398
H5850_006_0	2008	3																																		D					V	V		V		V	V							S			P																																																											0				964.5069333					193.8437967	280.3484986		64.11646021		0	93.95368596							706.8733227			701.3173445																		$0 copay	$0 copay	$40 per day (days 8 through 100)  PBP L.2	$0 copay	$0 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$100 copay @ Hospital PBP L.9a	Included in OP-Facility Other	$50 copay @ Hospital PBP L.8a/8b	$0 copay	$25 copay @ Hospital PBP L.12	"$25 copay @ Hospital PBP L.9a, 8a, 7c, 7j"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $50 copay Other Part B	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay													24.23032568					50	100		50		25	25							80.72910455			85.2110681																		0	0	1.947526427	0	0	0	0	0.807682486	2.336237489	0	0.267151918	0	0	0.195736846	0	0	0	0	0	0	4.755437531	0	0	4.98	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.2898			0	0	1.947526427	0	0	0	0	0.807682486	2.336237489	0	0.267151918	0	0	0.195736846	0	0	0	0	0	0	4.755437531	0	0	4.98	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.2898																																																																																				0			0	0	1.947526427	0	0	0	0	0.807682486	2.336237489	0	0.267151918	0	0	0.195736846	0	0	0	0	0	0	4.755437531	0	0	4.98	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.2898
H5850_007_0	2008	3																																D		D		T			V	V		V		V	V		V					S			P																																																											0		2012.58793		940.3924472		296.558151			266.6261084	421.3127478		2005.306826		5.006143351	125.8918481		5822.936282					376.979607			701.3173445																		$50 copay (days 1-5)	$0 copay	$50 per day (days 8 through 100)  PBP L.2	$0 copay	$25 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$150 copay @ Hospital	Included in OP-Facility Other	$200 copay @ Hospital PBP L.8a/8b; $50 @ Freestanding diagnostic center	$0 copay	$100 copay @ Hospital PBP L.12; $25 copay @ Dialysis Center	"$50 copay @ Hospital PBP L.9a, 8a, 7c, 7j"	$0 copay	$20 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $40 copay Other Part B	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											34.34587977		18.17274426		25			50	19		27.09880684		0	50		15					64.04929433			85.29530667																		5.7603	0	1.424125954	0	0.617829481	0	0	1.110942118	0.667078517	0	4.528451862	0	0	0.524549367	0	7.278670353	0	0	0	0	2.012106484	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.909			5.7603	0	1.424125954	0	0.617829481	0	0	1.110942118	0.667078517	0	4.528451862	0	0	0.524549367	0	7.278670353	0	0	0	0	2.012106484	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.909																																																																																				0			5.7603	0	1.424125954	0	0.617829481	0	0	1.110942118	0.667078517	0	4.528451862	0	0	0.524549367	0	7.278670353	0	0	0	0	2.012106484	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.909
H5850_010_0	2008	5																																D		D					V	V		V		V	V		V					S			P																																																											0		1247.059829		689.5429044					309.6542004	74.83335751		1414.637799		0.775949243	99.62238019		4855.679253					788.4261334			701.3173445																		$200 copay (days 1-6)	$0 copay	$50 per day (days 8 through 100)  PBP L.2	$0 copay	$0 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$150 copay @ Hospital PBP L.9a	Included in OP-Facility Other	$150 copay @ Hospital PBP L.8a/8b	$0 copay	$100 copay @ Hospital PBP L.12; $25 @ Freestanding	"$50 copay @ Hospital PBP L.9a, 8a, 7c, 7j"	$0 copay	$25 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $50 copay Other Part B	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											148.8123515		30.28790711					50	150		4.137724949		34.12302495	50		25					81.45825335			85.29530667																		15.4648	0	1.740400953	0	0	0	0	1.290225835	0.935416969	0	0.487781843	0	0.002206478	0.415093251	0	10.11599844	0	0	0	0	5.351984643	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7889			15.4648	0	1.740400953	0	0	0	0	1.290225835	0.935416969	0	0.487781843	0	0.002206478	0.415093251	0	10.11599844	0	0	0	0	5.351984643	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7889																																																																																				0			15.4648	0	1.740400953	0	0	0	0	1.290225835	0.935416969	0	0.487781843	0	0.002206478	0.415093251	0	10.11599844	0	0	0	0	5.351984643	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7889
H5850_012_0	2008	3																																		D					V	V		V		V	V							S			P																																																											0				849.775221					223.5471368	86.56938583		60.33882455		0	88.76229371							651.3082046			701.3173445																		$0 copay	$0 copay	$30 per day (days 8 through 100)  PBP L.2	$0 copay	$0 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$100 copay @ Hospital PBP L.9a	Included in OP-Facility Other	$50 copay @ Hospital PBP L.8a/8b	$0 copay	$25 copay @ Hospital PBP L.12	"$25 copay @ Hospital PBP L.9a, 8a, 7c, 7j"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $50 copay Other Part B	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay													18.17274426					50	100		50		25	25							77.27713875			85.2110681																		0	0	1.286895648	0	0	0	0	0.931446403	0.721411549	0	0.251411769	0	0	0.184921445	0	0	0	0	0	0	4.194269541	0	0	4.98	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.5504			0	0	1.286895648	0	0	0	0	0.931446403	0.721411549	0	0.251411769	0	0	0.184921445	0	0	0	0	0	0	4.194269541	0	0	4.98	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.5504																																																																																				0			0	0	1.286895648	0	0	0	0	0.931446403	0.721411549	0	0.251411769	0	0	0.184921445	0	0	0	0	0	0	4.194269541	0	0	4.98	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.5504
H5850_013_0	2008	3																																		D					V	V		V		V	V							S			P																																																											0				756.1039623					339.5448875	82.05696523		1551.191722		0.103497804	109.2388536							864.532315			701.3173445																		$0 copay	$0 copay	$40 per day (days 8 through 100)  PBP L.2	$0 copay	$0 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$100 copay @ Hospital PBP L.9a	Included in OP-Facility Other	$50 copay @ Hospital PBP L.8a/8b; $5 @ Freestanding	$0 copay	$25 copay @ Hospital PBP L.12	"$25 copay @ Hospital PBP L.9a, 8a, 7c, 7j"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $40copay Other Part B	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay													24.23032568					50	100		6.241317485		25	25							79.03984153			85.29530667																		0	0	1.526720438	0	0	0	0	1.414770365	0.683808044	0	0.806790001	0	0.00021562	0.227580945	0	0	0	0	0	0	5.694374765	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.3392			0	0	1.526720438	0	0	0	0	1.414770365	0.683808044	0	0.806790001	0	0.00021562	0.227580945	0	0	0	0	0	0	5.694374765	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.3392																																																																																				0			0	0	1.526720438	0	0	0	0	1.414770365	0.683808044	0	0.806790001	0	0.00021562	0.227580945	0	0	0	0	0	0	5.694374765	0	0	4.984923164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.3392
H5852_001_0	2008	4																																																							V																																																											0																									2814																																									$5 co-pay per oral exam; $5 co-pay per cleaning; $10 co-pay per X ray																																									6.884952587																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.614521382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6145			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.614521382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6145																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.614521382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6145
H5852_002_0	2008	4																																																							V																																																											0																									2814																																									$5 co-pay per oral exam; $5 co-pay per cleaning; $10 co-pay per X ray																																									6.884952587																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.614521382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6145			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.614521382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6145																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.614521382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6145
H5854_002_0	2008	5		i.7										Professional											Diabetes Monitoring									D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V		Coin																																																		0		1905.619007	48.40739829	1008.688854	1536.410873	308.5447618	7.37271453	5.750190093	181.1023602	210.2996906	71.06985322	281.7147825	11.19559797	4.315483801	322.4282897	4302.21677	5406.388785	180.6831418	1260.836407	26.07185078	377.5925026	34.74463662	0	0	2442.844648	341.9360396	270.6509897	209.514852	18.99507665	0	0	0	0	0.036722948	0	0	0	0	0	0			"$150/day days 1-6, with $1800 yearly max"	$150/day days 1-6	$35/day days 1-100	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 emergency copay; $25 urgent care copay	$125 copay	$0 copay	$20 radiology copay; $100 chemo copay		$0 copay	$25 copay	$15 copay	$25 copay	$25 copay	$25 copay	$0 copay	$0 copay	10% coinsurance	$0 copay	n/c	$0 copay	$10 copay	$0 copay	$0 copay	$0 copay					20% coinsurance									96.33	68.3138054	35	0	100	0.2	0.2	49.92842536	125	0	26.91721419	0	0	25	15	25	25	25	0	0	0.1	0	0	0	10	0	0	0	0	0	0	0	0.2	0	0	0	0	0	0			15.2974	0.275574466	2.942009156	0	2.571206348	1.474542906	1.150038019	0.753512973	2.190621777	0	0.631914762	0	0	0.671725603	5.377770963	11.26330997	0.376423212	2.626742515	0	0	3.474463662	0	0	0	0.2849467	0	0	0	0	0	0	0	0.00734459	0	0	0	0	0	0	0	0	51.3695		0	15.2974	0.275574466	2.942009156	0	2.571206348	1.474542906	1.150038019	0.753512973	2.190621777	0	0.631914762	0	0	0.671725603	5.377770963	11.26330997	0.376423212	2.626742515	0	0	3.474463662	0	0	0	0.2849467	0	0	0	0	0	0	0	0.00734459	0	0	0	0	0	0	0	0	51.3695																																																																																				0		0	15.2974	0.275574466	2.942009156	0	2.571206348	1.474542906	1.150038019	0.753512973	2.190621777	0	0.631914762	0	0	0.671725603	5.377770963	11.26330997	0.376423212	2.626742515	0	0	3.474463662	0	0	0	0.2849467	0	0	0	0	0	0	0	0.00734459	0	0	0	0	0	0	0	0	51.3695
H5854_003_0	2008	8		i.7										Professional											Diabetes Monitoring									D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V		Coin																																																		0		2013.367146	51.14446539	1065.722472	1623.283124	325.9906016	8.230026278	6.418831948	191.3423096	222.1905251	75.08830833	297.6435928	11.82862317	4.559491311	340.6591365	4545.474132	5712.078606	190.8993876	1332.127036	27.54601397	398.9424626	38.78480189	0	0	2580.968777	361.2699001	285.9542273	221.36131	20.06910255	0	0	0	0	0.040993155									$0 copay	$150/day days 1-6	$25/day days 1-100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 emergency copay; $25 urgent care copay	$75 copay	$0 copay	$20 radiology copay; $50 chemo copay		$0 copay	$25 copay	$10 copay	$15 copay	$25 copay	$15 copay	$0 copay	$0 copay	10% coinsurance	$0 copay	n/c	$0 copay	$10 copay	$0 copay	$0 copay	$0 copay					20% coinsurance									0	68.3138054	25	0	75	0.2	0.2	49.92842536	75	0	22.59395532	0	0	25	10	15	25	15	0	0	0.1	0	0	0	10	0	0	0	0	0	0	0	0.2									0	0.291156088	2.22025515	0	2.03744126	1.646005256	1.28376639	0.796118352	1.388690782	0	0.56041217	0	0	0.709706534	3.78789511	7.140098257	0.397707058	1.665158795	0	0	3.878480189	0	0	0	0.30105825	0	0	0	0	0	0	0	0.008198631	0	0	0	0	0	0	0	0	28.1121		0	0	0.291156088	2.22025515	0	2.03744126	1.646005256	1.28376639	0.796118352	1.388690782	0	0.56041217	0	0	0.709706534	3.78789511	7.140098257	0.397707058	1.665158795	0	0	3.878480189	0	0	0	0.30105825	0	0	0	0	0	0	0	0.008198631	0	0	0	0	0	0	0	0	28.1121																																																																																				0		0	0	0.291156088	2.22025515	0	2.03744126	1.646005256	1.28376639	0.796118352	1.388690782	0	0.56041217	0	0	0.709706534	3.78789511	7.140098257	0.397707058	1.665158795	0	0	3.878480189	0	0	0	0.30105825	0	0	0	0	0	0	0	0.008198631	0	0	0	0	0	0	0	0	28.1121
H5854_004_0	2008	3		i.7										Professional											Diabetes Monitoring									D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V		Coin																																																		0		1923.191384	48.85377978	1017.990325	1550.578653	311.3899606	7.509314197	5.856728065	182.7723682	212.2389373	71.7252131	284.3125727	11.29883648	4.355278381	325.4015133	4341.889011	5456.242981	182.349284	1272.463019	26.3122684	381.0744147	35.38837588	0	0	2465.37097	345.089151	273.1467568	211.4468615	19.17023687	0	0	0	0	0.037403341	0	0	0	0	0	0	0	0	"$150/day days 1-6, with $1800 yearly max"	$150/day days 1-6	$25/day days 1-100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 emergency copay; $25 urgent care copay	$100 copay	$0 copay	$20 radiology copay; $100 chemo copay		$0 copay	$25 copay	$15 copay	$25 copay	$25 copay	$25 copay	$0 copay	$0 copay	10% coinsurance	$0 copay	n/c	$0 copay	$10 copay	$0 copay	$0 copay	$0 copay					20% coinsurance									96.33	68.3138054	25	0	75	0.2	0.2	49.92842536	100	0	26.91721419	0	0	25	15	25	25	25	0	0	0.1	0	0	0	10	0	0	0	0	0	0	0	0.2	0	0	0	0	0	0	0	0	15.4384	0.278115634	2.120813177	0	1.946187254	1.501862839	1.171345613	0.760461378	1.768657811	0	0.637741868	0	0	0.677919819	5.427361263	11.36717288	0.379894342	2.650964623	0	0	3.538837588	0	0	0	0.287574293	0	0	0	0	0	0	0	0.007480668	0	0	0	0	0	0	0	0	49.9608		0	15.4384	0.278115634	2.120813177	0	1.946187254	1.501862839	1.171345613	0.760461378	1.768657811	0	0.637741868	0	0	0.677919819	5.427361263	11.36717288	0.379894342	2.650964623	0	0	3.538837588	0	0	0	0.287574293	0	0	0	0	0	0	0	0.007480668	0	0	0	0	0	0	0	0	49.9608																																																																																				0		0	15.4384	0.278115634	2.120813177	0	1.946187254	1.501862839	1.171345613	0.760461378	1.768657811	0	0.637741868	0	0	0.677919819	5.427361263	11.36717288	0.379894342	2.650964623	0	0	3.538837588	0	0	0	0.287574293	0	0	0	0	0	0	0	0.007480668	0	0	0	0	0	0	0	0	49.9608
H5854_801_0	2008	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	289.561698	2.122405261	93.94127042	48.24757608	7.472355629	22.95575368	1.074570262	5.73899615	29.10191383	11.59834317	30.70562279	0	0.302927358	30.40250784	46.79934643	124.3342732	1.535740274	5.178767058	32.2511321	44.49889692	8.326330604	6.500846886	0	0	0	0	0	0	0	0	0											Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											0.068604533	0.068604533	0.191202301	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											19.8652	0.145606623	17.9617871	0	1.748531217	5.371646361	0.251449441	1.342925099	6.809847836	2.714012302	7.185115732	0	0.070885002	7.114186834	10.95104707	29.09421994	0.359363224	1.211831492	7.546764912	10.41274188	1.948361361	1.521198171	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.6268	0	0	19.8652	0.145606623	17.9617871	0	1.748531217	5.371646361	0.251449441	1.342925099	6.809847836	2.714012302	7.185115732	0	0.070885002	7.114186834	10.95104707	29.09421994	0.359363224	1.211831492	7.546764912	10.41274188	1.948361361	1.521198171	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.6268	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.8652	0.145606623	17.9617871	0	1.748531217	5.371646361	0.251449441	1.342925099	6.809847836	2.714012302	7.185115732	0	0.070885002	7.114186834	10.95104707	29.09421994	0.359363224	1.211831492	7.546764912	10.41274188	1.948361361	1.521198171	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.6268
H5854_803_0	2008	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	289.561698	2.122405261	93.94127042	48.24757608	7.472355629	22.95575368	1.074570262	5.73899615	29.10191383	11.59834317	30.70562279	0	0.302927358	30.40250784	46.79934643	124.3342732	1.535740274	5.178767058	32.2511321	44.49889692	8.326330604	6.500846886	0	0	0	0	0	0	0	0	0											Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											0.068604533	0.068604533	0.191202301	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											19.8652	0.145606623	17.9617871	0	1.748531217	5.371646361	0.251449441	1.342925099	6.809847836	2.714012302	7.185115732	0	0.070885002	7.114186834	10.95104707	29.09421994	0.359363224	1.211831492	7.546764912	10.41274188	1.948361361	1.521198171	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.6268	0	0	19.8652	0.145606623	17.9617871	0	1.748531217	5.371646361	0.251449441	1.342925099	6.809847836	2.714012302	7.185115732	0	0.070885002	7.114186834	10.95104707	29.09421994	0.359363224	1.211831492	7.546764912	10.41274188	1.948361361	1.521198171	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.6268	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.8652	0.145606623	17.9617871	0	1.748531217	5.371646361	0.251449441	1.342925099	6.809847836	2.714012302	7.185115732	0	0.070885002	7.114186834	10.95104707	29.09421994	0.359363224	1.211831492	7.546764912	10.41274188	1.948361361	1.521198171	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.6268
H5859_001_0	2008	5																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	304.9710597	41.27333902	45.73852264		25.22336562	44.19263279	8.749828665	63.66423353	46.07604491	18.40949347	24.63215445	1.99071219	2.006113757	10.95335794	24.39940872	98.8852699	8.115412468	5.334616731	16.25723495	16.58249624	22.16561644	0.087635013																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.076131548	0.076131548	0.149738924		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				23.2179	3.142203202	6.848837165	0	5.902267556	10.34107607	2.047459908	14.89743065	10.78179451	4.307821472	5.763924142	0.465826652	0.469430619	2.563085758	5.709461641	23.13915316	1.899006518	1.248300315	3.804192979	3.880304119	5.186754247	0.020506593	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.6368	0	0	23.2179	3.142203202	6.848837165	0	5.902267556	10.34107607	2.047459908	14.89743065	10.78179451	4.307821472	5.763924142	0.465826652	0.469430619	2.563085758	5.709461641	23.13915316	1.899006518	1.248300315	3.804192979	3.880304119	5.186754247	0.020506593	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.6368																																																																																				0	0	0	23.2179	3.142203202	6.848837165	0	5.902267556	10.34107607	2.047459908	14.89743065	10.78179451	4.307821472	5.763924142	0.465826652	0.469430619	2.563085758	5.709461641	23.13915316	1.899006518	1.248300315	3.804192979	3.880304119	5.186754247	0.020506593	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.6368
H5862_001_0	2008	5																					5000											D	D	D		Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	V	P	P	Coin	Coin	Coin					V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		450.9404455	9.694036992	593.9782691	0	3.598171165	7.740776639	4.859458272	243.3936297	21.76003284	5.744216814	16.0222286	0	0.249532316	17.50421943	5196.464782	9980.058671	98.34504244	243.5891631	2095.688495	17.38313743	6.357119346	0.688801033	0	0	0	0	148.1445002	0	0	0	0											$250/Day for Days 1-10 for IP Medical; $250/Day for Days 1-10 for IP Surgical	$250/Day for Days 1-10 for IP Psych; $250/Day for Days 1-10 for IP Substance Abuse	$125/Day for SNF for Days 4-100		20% Coinsurance for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	Lesser of $50 copay or 20% coinsuranceLesser of $50 copay or 20% coinsurance$30/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	20% Coinsurance for OP Fac - Pathology	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	20% Coins included in Line f.	20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	20% Coinsurance for OP Fac - Cardiovascular; 20% Coinsurance for OP Fac - Occ Therapy; 20% Coinsurance for OP Fac - Physical/Speech Therapy; 20% Coinsurance for OP Fac - CORF; 20% Coinsurance for OP Fac - Other; 20% Coinsurance for Prof - CORF; 20% Coinsurance for Prof - CORF;	$30/Visit for PCP - Office Visits; $30/Consult for PCP - Consults; $30/Exam for PCP - Routine Physicals; 20% Coinsurance for PCP - Primary Surgeon (IP); 20% Coinsurance for PCP - Asst Surgeon (IP); 20% Coinsurance for PCP - Primary Surgeon (OP); 20% Coinsurance for PCP - Asst Surgeon (OP); 20% Coinsurance for PCP - Tx Injections; 20% Coinsurance for PCP - Allergy Testing; 20% Coinsurance for PCP - Allergy Tx; 20% Coinsurance for PCP - ER Visits; 20% Coinsurance for PCP - Immunizations;	20% Coinsurance for Speclst - Primary Surgeon (IP); 20% Coinsurance for Speclst - Asst Surgeon (IP); 20% Coinsurance for Speclst - Anesthesia (IP); 20% Coinsurance for Speclst - Primary Surgeon (OP); 20% Coinsurance for Speclst - Asst Surgeon (OP); 20% Coinsurance for Speclst - Anesthesia (OP); $30/Visit for Speclst - Office Visits; 20% Coinsurance for Speclst - Tx Injections; 20% Coinsurance for Speclst - Allergy Testing; 20% Coinsurance for Speclst - Allergy Tx; 20% Coinsurance for Speclst - ER Visits; $30/Consult for Speclst - Consults; 20% Coinsurance for Speclst - Immunizations; $30/Visit for Chiropractor; $30/Exam for Vision Exams; $30/Service for Podiatrist; $30/Exam for Hearing/Speech Exams;	$30 Copay Freestanding Facility for OP Psych; 20% Coinsurance in non-Freestanding Facility for OP Psych$23/Visit for OP Substance Abuse;	$30/Service for PT/ST (PCP); $30/Service for Occ Therapy (PCP); $30/Service for PT/ST (Specialist); $30/Service for Occ Therapy (Specialist);	$30/Procedure for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	20% Coinsurance for Misc. Medical; 20% Coinsurance for Misc. Medical (PCP); 20% Coinsurance for Prof Path (IP); 20% Coinsurance for Prof Path (OP); $30/Procedure for Prof Path (Office); $30/Procedure for Prof Path (Labs)	20% Coinsurance for Part B Rx	20% Coinsurance for Blood Products					$30/Exam for Routine Hearing Exams															233.8287003	233.8287003	116.9143501	0	0.18706296	0.18706296	0.18706296	36.73825257	0.18706296	0.18706296	0.18706296	0	0.18706296	0.185605632	14.86710114	18.54892526	21.41870895	28.05944403	14.80685094	0.253916553	0.18706296	0.18706296	0	0	0	0	28.05944403	0	0	0	0											8.7869	0.188895339	5.78704861	0	0.673084549	1.448012592	0.909024649	0.74515472	4.070496158	1.074530201	2.997165511	0	0.046678254	3.24888171	6.438030624	15.42661353	0.17553532	0.569581374	2.58587893	4.41386634	1.189181563	0.12884916	0	0	0	0	0.346404359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.2498	0	4.235960412	8.7869	0.188895339	5.78704861	0	0.673084549	1.448012592	0.909024649	0.74515472	4.070496158	1.074530201	2.997165511	0	0.046678254	3.24888171	6.438030624	15.42661353	0.17553532	0.569581374	2.58587893	4.41386634	1.189181563	0.12884916	0	0	0	0	0.346404359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.2498																																																																																				0	0		8.7869	0.188895339	5.78704861	0	0.673084549	1.448012592	0.909024649	0.74515472	4.070496158	1.074530201	2.997165511	0	0.046678254	3.24888171	6.438030624	15.42661353	0.17553532	0.569581374	2.58587893	4.41386634	1.189181563	0.12884916	0	0	0	0	0.346404359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.2498
H5868_001_0	2008	10	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)									Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O	O	V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0	0	0	0	0								0		279.82	6.01	478.48	200.42	67.04	4.34	1.48	317.18	374.58	5891.6	2575.67		7.86	502.11	4585	3433.82	18.75	428.22			15.57			4.19	1.82					0.02	0.06	26.11	0.08	3.38								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$50/Visit	$50/Visit			20% Coins			DEN 749	$100 Allowance					QuitNet	Meals on Wheels	$30/Visit	Active Outlook	Silver Sneakers								549.999981	549.999625	28.712561	0	99.999919	0.2	0.199999	49.999983	85.431647	0	49.999996		16.667041	49.389193	9.999999	30.000002	49.999984	50.000003			0.199999			0	0					0	0	29.999967	0	0								12.8251	0.275458146	1.144865516	0	0.558666214	0.868	0.29599852	1.321582884	2.666748861	0	10.73195747	0	0.010916912	2.066567308	3.820832951	8.584550572	0.078124975	1.784250107	0	0	3.11398443	0	0	0	0	0	0	0	0	0	0	0.065274928	0	0	0	0	0	0	0	0	0	50.2129	0	0	12.8251	0.275458146	1.144865516	0	0.558666214	0.868	0.29599852	1.321582884	2.666748861	0	10.73195747	0	0.010916912	2.066567308	3.820832951	8.584550572	0.078124975	1.784250107	0	0	3.11398443	0	0	0	0	0	0	0	0	0	0	0.065274928	0	0	0	0	0	0	0	0	0	50.2129		$750/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	30% Coins	30% Coins			30% Coins			DEN 749	$100 Allowance					QuitNet	Meals on Wheels	$35/Visit	Active Outlook	Silver Sneakers								3.9008	0.0893	0.6126	0.9569	0.7061	1.8168	0.6221	0.2948	4.0629	1.0072	2.7156		0.0024	1.3564	4.0406	4.0842	0.0465	0.3665			1.1037			0	0					0	0	0.0962	0	0								27.8817	500	1.700225265	16.7259	0.364766146	1.757472516	0.956884	1.264744214	2.684847	0.91806152	1.616365884	6.729619861	1.007187	13.44759847	0	0.013352912	3.423017308	7.861453951	12.66870957	0.124601975	2.150768107	0	0	4.21765343	0	0	0	0	0	0	0	0	0	0	0.161522928	0	0	0	0	0	0	0	0	0	78.0945
H5868_801_0	2008	2																					1000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		279.82	6.01	478.48	200.42	67.04	4.34	1.48	317.18	374.58	5891.6	2575.67		7.86	502.11	4585	3433.82	44.86	428.22			15.57																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					388.769403	388.769292	12.502875	0	43.196565	0.086393	0.086393	21.598293	86.393197	16.221085	40.997739		14.39919	37.943548	8.63932	12.95898	25.59964	43.196603			0.086393																					9.0655	0.19470862	0.498531303	0	0.24132481	0.37494562	0.12786164	0.570878881	2.696763644	7.964012032	8.799720534	0	0.009431469	1.587652907	3.300940183	3.708233725	0.095699988	1.541470778	0	0	1.34513901	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1228	0	55.39078067	9.0655	0.19470862	0.498531303	0	0.24132481	0.37494562	0.12786164	0.570878881	2.696763644	7.964012032	8.799720534	0	0.009431469	1.587652907	3.300940183	3.708233725	0.095699988	1.541470778	0	0	1.34513901	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1228	1000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					3.545	0.04	0.1745	0.2725	0.269	0.5174	0.1772	0.3038	1.1571	0.2868	0.7734		0.005	0.3863	1.1963	0.9839	0.0333	0.1044			0.3143																					10.5402	0	13.86039144	12.6105	0.23467262	0.673000303	0.272519	0.51033081	0.89237962	0.30502364	0.874646881	3.853860644	8.250857032	9.573130534	0	0.014458469	1.973967907	4.497289183	4.692092725	0.129010988	1.645853778	0	0	1.65946201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.663
H5868_802_0	2008	2																					1000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		279.82	6.01	478.48	200.42	67.04	4.34	1.48	317.18	374.58	5891.6	2575.67		7.86	502.11	4585	3433.82	44.86	428.22			15.57																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					388.769403	388.769292	12.502875	0	43.196565	0.086393	0.086393	21.598293	86.393197	16.221085	40.997739		14.39919	37.943548	8.63932	12.95898	25.59964	43.196603			0.086393																					9.0655	0.19470862	0.498531303	0	0.24132481	0.37494562	0.12786164	0.570878881	2.696763644	7.964012032	8.799720534	0	0.009431469	1.587652907	3.300940183	3.708233725	0.095699988	1.541470778	0	0	1.34513901	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1228	0	55.39078067	9.0655	0.19470862	0.498531303	0	0.24132481	0.37494562	0.12786164	0.570878881	2.696763644	7.964012032	8.799720534	0	0.009431469	1.587652907	3.300940183	3.708233725	0.095699988	1.541470778	0	0	1.34513901	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1228	1000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					3.545	0.04	0.1745	0.2725	0.269	0.5174	0.1772	0.3038	1.1571	0.2868	0.7734		0.005	0.3863	1.1963	0.9839	0.0333	0.1044			0.3143																					10.5402	0	13.86039144	12.6105	0.23467262	0.673000303	0.272519	0.51033081	0.89237962	0.30502364	0.874646881	3.853860644	8.250857032	9.573130534	0	0.014458469	1.973967907	4.497289183	4.692092725	0.129010988	1.645853778	0	0	1.65946201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.663
H5868_803_0	2008	2																					1000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		279.82	6.01	478.48	200.42	67.04	4.34	1.48	317.18	374.58	5891.6	2575.67		7.86	502.11	4585	3433.82	44.86	428.22			15.57																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					388.769403	388.769292	12.502875	0	43.196565	0.086393	0.086393	21.598293	86.393197	16.221085	40.997739		14.39919	37.943548	8.63932	12.95898	25.59964	43.196603			0.086393																					9.0655	0.19470862	0.498531303	0	0.24132481	0.37494562	0.12786164	0.570878881	2.696763644	7.964012032	8.799720534	0	0.009431469	1.587652907	3.300940183	3.708233725	0.095699988	1.541470778	0	0	1.34513901	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1228	0	55.39078067	9.0655	0.19470862	0.498531303	0	0.24132481	0.37494562	0.12786164	0.570878881	2.696763644	7.964012032	8.799720534	0	0.009431469	1.587652907	3.300940183	3.708233725	0.095699988	1.541470778	0	0	1.34513901	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1228	1000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					3.545	0.04	0.1745	0.2725	0.269	0.5174	0.1772	0.3038	1.1571	0.2868	0.7734		0.005	0.3863	1.1963	0.9839	0.0333	0.1044			0.3143																					10.5402	0	13.86039144	12.6105	0.23467262	0.673000303	0.272519	0.51033081	0.89237962	0.30502364	0.874646881	3.853860644	8.250857032	9.573130534	0	0.014458469	1.973967907	4.497289183	4.692092725	0.129010988	1.645853778	0	0	1.65946201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.663
H5868_804_0	2008	2																					1000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		279.82	6.01	478.48	200.42	67.04	4.34	1.48	317.18	374.58	5891.6	2575.67		7.86	502.11	4585	3433.82	44.86	428.22			15.57																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					388.769403	388.769292	12.502875	0	43.196565	0.086393	0.086393	21.598293	86.393197	16.221085	40.997739		14.39919	37.943548	8.63932	12.95898	25.59964	43.196603			0.086393																					9.0655	0.19470862	0.498531303	0	0.24132481	0.37494562	0.12786164	0.570878881	2.696763644	7.964012032	8.799720534	0	0.009431469	1.587652907	3.300940183	3.708233725	0.095699988	1.541470778	0	0	1.34513901	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1228	0	55.39078067	9.0655	0.19470862	0.498531303	0	0.24132481	0.37494562	0.12786164	0.570878881	2.696763644	7.964012032	8.799720534	0	0.009431469	1.587652907	3.300940183	3.708233725	0.095699988	1.541470778	0	0	1.34513901	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1228	1000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					3.545	0.04	0.1745	0.2725	0.269	0.5174	0.1772	0.3038	1.1571	0.2868	0.7734		0.005	0.3863	1.1963	0.9839	0.0333	0.1044			0.3143																					10.5402	0	13.86039144	12.6105	0.23467262	0.673000303	0.272519	0.51033081	0.89237962	0.30502364	0.874646881	3.853860644	8.250857032	9.573130534	0	0.014458469	1.973967907	4.497289183	4.692092725	0.129010988	1.645853778	0	0	1.65946201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.663
H5883_001_1	2008	5																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	O	P	T	P	P	P	P	P	P	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		195.2616323	3.415348594	897.2702551	0	200.3637143	13.18334964	0.602709588	255.4840447	233.5691295	0	0	0	0	0	3539.841356	3653.002129	150.6701621	439.4182698	2281.088613	2871.087203	0	0	0	0	0	0	12	0	0	0	0											$250 copay per admit	$250 copay per admit	"$0 copay days 1-20, $100 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery						$15 copay	$30 copay	$30 copay	$30 copay	"$40 copay on MRI, CT, PET; $0 copay all other"	"$50 office surgery, $30 allergy, $30 cardiovascular"							$25 copay on exam															246.75	246.75	44.95695514	0	50	0.15	0.15	48.41271936	100	0	0	0	0	0	15	30	30	35	8	37.67648585	0	0	0	0	0	0	25	0	0	0	0											4.0151	0.070228105	3.361544884	0	0.83484881	1.977502446	0.090406438	1.030723113	1.946409413	0	0	0	0	0	4.424801695	9.132505323	0.376675405	1.28163662	1.520725742	9.014373032	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1024			4.0151	0.070228105	3.361544884	0	0.83484881	1.977502446	0.090406438	1.030723113	1.946409413	0	0	0	0	0	4.424801695	9.132505323	0.376675405	1.28163662	1.520725742	9.014373032	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1024		n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			4.0151	0.070228105	3.361544884	0	0.83484881	1.977502446	0.090406438	1.030723113	1.946409413	0	0	0	0	0	4.424801695	9.132505323	0.376675405	1.28163662	1.520725742	9.014373032	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1024
H5883_001_2	2008	5																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	O	P	T	P	P	P	P	P	P	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		216.8680834	3.793270059	925.2304501	0	195.2665224	13.16306467	0.60178221	283.6761001	260.6186326	0	0	0	0	0	3763.010139	3692.452972	131.671514	384.0101323	2422.976313	2588.946435	0	0	0	0	0	0	12	0	0	0	0											$250 copay per admit	$250 copay per admit	"$0 copay days 1-20, $100 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery						$15 copay	$30 copay	$30 copay	$30 copay	"$40 copay on MRI, CT, PET; $0 copay all other"	"$50 office surgery, $30 allergy, $30 cardiovascular"							$25 copay on exam															246.75	246.75	44.95695514	0	50	0.15	0.15	48.48044436	100	0	0	0	0	0	15	30	30	35	8	38.05675173	0	0	0	0	0	0	25	0	0	0	0											4.4593	0.077999116	3.46629532	0	0.81361051	1.974459701	0.090267332	1.146061949	2.171821938	0	0	0	0	0	4.703762674	9.231132429	0.329178785	1.120029552	1.615317542	8.210574311	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4349			4.4593	0.077999116	3.46629532	0	0.81361051	1.974459701	0.090267332	1.146061949	2.171821938	0	0	0	0	0	4.703762674	9.231132429	0.329178785	1.120029552	1.615317542	8.210574311	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4349		n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			4.4593	0.077999116	3.46629532	0	0.81361051	1.974459701	0.090267332	1.146061949	2.171821938	0	0	0	0	0	4.703762674	9.231132429	0.329178785	1.120029552	1.615317542	8.210574311	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4349
H5883_001_3	2008	5																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	O	P	T	P	P	P	P	P	P	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		208.7460697	3.651206778	1125.451699	0	169.9969544	11.49867824	0.525690649	248.8274799	228.3292683	0	0	0	0	0	3336.277452	3405.325813	136.44335	397.9268355	2111.544191	2481.983602	0	0	0	0	0	0	12	0	0	0	0											$250 copay per admit	$250 copay per admit	"$0 copay days 1-20, $100 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery						$15 copay	$30 copay	$30 copay	$30 copay	"$40 copay on MRI, CT, PET; $0 copay all other"	"$50 office surgery, $30 allergy, $30 cardiovascular"							$25 copay on exam															246.75	246.75	44.95695514	0	50	0.15	0.15	48.46408441	100	0	0	0	0	0	15	30	30	35	8	37.09056717	0	0	0	0	0	0	25	0	0	0	0											4.2923	0.075077939	4.216406796	0	0.708320643	1.724801736	0.078853597	1.004932999	1.902743903	0	0	0	0	0	4.170346815	8.513314531	0.341108375	1.160619937	1.407696127	7.67151496	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.2931			4.2923	0.075077939	4.216406796	0	0.708320643	1.724801736	0.078853597	1.004932999	1.902743903	0	0	0	0	0	4.170346815	8.513314531	0.341108375	1.160619937	1.407696127	7.67151496	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.2931		n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			4.2923	0.075077939	4.216406796	0	0.708320643	1.724801736	0.078853597	1.004932999	1.902743903	0	0	0	0	0	4.170346815	8.513314531	0.341108375	1.160619937	1.407696127	7.67151496	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.2931
H5883_001_4	2008	5																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	O	P	T	P	P	P	P	P	P	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		229.3186726	4.01104506	817.5599409	0	235.0704608	14.61044329	0.667952721	227.5773886	203.185192	0	0	0	0	0	3774.505355	3849.765371	153.9333649	448.935157	2650.951679	2820.290158	0	0	0	0	0	0	12	0	0	0	0											$250 copay per admit	$250 copay per admit	"$0 copay days 1-20, $100 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery						$15 copay	$30 copay	$30 copay	$30 copay	"$40 copay on MRI, CT, PET; $0 copay all other"	"$50 office surgery, $30 allergy, $30 cardiovascular"							$25 copay on exam															246.75	246.75	44.95695514	0	50	0.15	0.15	48.10007635	100	0	0	0	0	0	15	30	30	35	8	37.18281458	0	0	0	0	0	0	25	0	0	0	0											4.7154	0.082477114	3.062917133	0	0.979460253	2.191566494	0.100192908	0.91220748	1.693209934	0	0	0	0	0	4.718131693	9.624413427	0.384833412	1.309394208	1.76730112	8.738860501	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3053			4.7154	0.082477114	3.062917133	0	0.979460253	2.191566494	0.100192908	0.91220748	1.693209934	0	0	0	0	0	4.718131693	9.624413427	0.384833412	1.309394208	1.76730112	8.738860501	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3053		n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			4.7154	0.082477114	3.062917133	0	0.979460253	2.191566494	0.100192908	0.91220748	1.693209934	0	0	0	0	0	4.718131693	9.624413427	0.384833412	1.309394208	1.76730112	8.738860501	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3053
H5883_001_5	2008	6																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	O	P	T	P	P	P	P	P	P	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		222.7398633	3.895974185	940.6433902	0	199.6924887	12.96048743	0.592520888	211.262004	187.065129	0	0	0	0	0	3702.262723	3920.681008	172.6542571	503.5332402	2506.748959	3043.216312	0	0	0	0	0	0	12	0	0	0	0											$250 copay per admit	$250 copay per admit	"$0 copay days 1-20, $100 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery						$15 copay	$30 copay	$30 copay	$30 copay	"$40 copay on MRI, CT, PET; $0 copay all other"	"$50 office surgery, $30 allergy, $30 cardiovascular"							$25 copay on exam															246.75	246.75	44.95695514	0	50	0.15	0.15	47.99255619	100	0	0	0	0	0	15	30	30	35	8	36.67711854	0	0	0	0	0	0	25	0	0	0	0											4.5801	0.080110969	3.524038558	0	0.832052036	1.944073115	0.088878133	0.844916967	1.558876075	0	0	0	0	0	4.627828403	9.801702519	0.431635643	1.468638617	1.671165973	9.301367119	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7804			4.5801	0.080110969	3.524038558	0	0.832052036	1.944073115	0.088878133	0.844916967	1.558876075	0	0	0	0	0	4.627828403	9.801702519	0.431635643	1.468638617	1.671165973	9.301367119	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7804		n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			4.5801	0.080110969	3.524038558	0	0.832052036	1.944073115	0.088878133	0.844916967	1.558876075	0	0	0	0	0	4.627828403	9.801702519	0.431635643	1.468638617	1.671165973	9.301367119	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7804
H5883_002_1	2008	4																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	O	P	T	P	P	P	P	P	P	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		202.5952886	3.543622604	855.7023478	0	210.2284764	13.85181803	0.633270281	269.3722643	246.7120185	0	0	0	0	0	3675.154905	3796.901924	157.0675188	458.0756827	2375.715182	2991.663155	0	0	0	0	0	0	12	0	0	0	0											$250 copay per admit	$250 copay per admit	"$0 copay days 1-20, $100 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery						$15 copay	$30 copay	$30 copay	$30 copay	"$40 copay on MRI, CT, PET; $0 copay all other"	"$50 office surgery, $30 allergy, $30 cardiovascular"							$25 copay on exam															246.75	246.75	53.95	0	50	0.15	0.15	48.43700901	100	0	0	0	0	0	15	30	30	35	8	37.67101323	0	0	0	0	0	0	25	0	0	0	0											4.1659	0.07286574	3.847095138	0	0.875951985	2.077772705	0.094990542	1.087298899	2.055933488	0	0	0	0	0	4.593943632	9.49225481	0.392668797	1.336054075	1.583810121	9.391581858	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.0931			4.1659	0.07286574	3.847095138	0	0.875951985	2.077772705	0.094990542	1.087298899	2.055933488	0	0	0	0	0	4.593943632	9.49225481	0.392668797	1.336054075	1.583810121	9.391581858	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.0931		n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			4.1659	0.07286574	3.847095138	0	0.875951985	2.077772705	0.094990542	1.087298899	2.055933488	0	0	0	0	0	4.593943632	9.49225481	0.392668797	1.336054075	1.583810121	9.391581858	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.0931
H5883_002_2	2008	4																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	O	P	T	P	P	P	P	P	P	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		213.8307394	3.74014345	813.8317791	0	210.9788162	14.24658638	0.651318098	316.3382086	292.1468737	0	0	0	0	0	4001.460105	3937.191643	141.6259678	413.041553	2574.744656	2776.551318	0	0	0	0	0	0	12	0	0	0	0											$250 copay per admit	$250 copay per admit	"$0 copay days 1-20, $100 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery						$15 copay	$30 copay	$30 copay	$30 copay	"$40 copay on MRI, CT, PET; $0 copay all other"	"$50 office surgery, $30 allergy, $30 cardiovascular"							$25 copay on exam															246.75	246.75	53.95	0	50	0.15	0.15	48.55099192	100	0	0	0	0	0	15	30	30	35	8	38.02181871	0	0	0	0	0	0	25	0	0	0	0											4.3969	0.0769067	3.65885204	0	0.879078401	2.136987957	0.097697715	1.279877818	2.434557281	0	0	0	0	0	5.001825132	9.842979109	0.35406492	1.20470453	1.716496437	8.797460905	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9034			4.3969	0.0769067	3.65885204	0	0.879078401	2.136987957	0.097697715	1.279877818	2.434557281	0	0	0	0	0	5.001825132	9.842979109	0.35406492	1.20470453	1.716496437	8.797460905	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9034		n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			4.3969	0.0769067	3.65885204	0	0.879078401	2.136987957	0.097697715	1.279877818	2.434557281	0	0	0	0	0	5.001825132	9.842979109	0.35406492	1.20470453	1.716496437	8.797460905	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9034
H5883_002_3	2008	4																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	O	P	T	P	P	P	P	P	P	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		214.8798214	3.75849309	1098.938386	0	176.3691112	11.95705469	0.546646467	261.6743822	240.6696529	0	0	0	0	0	3437.849447	3495.75391	138.6142411	404.258077	2169.268271	2534.910428	0	0	0	0	0	0	12	0	0	0	0											$250 copay per admit	$250 copay per admit	"$0 copay days 1-20, $100 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery						$15 copay	$30 copay	$30 copay	$30 copay	"$40 copay on MRI, CT, PET; $0 copay all other"	"$50 office surgery, $30 allergy, $30 cardiovascular"							$25 copay on exam															246.75	246.75	53.95	0	50	0.15	0.15	48.49502538	100	0	0	0	0	0	15	30	30	35	8	37.15899753	0	0	0	0	0	0	25	0	0	0	0											4.4185	0.077284014	4.940643826	0	0.734871296	1.793558203	0.08199697	1.057492151	2.005580441	0	0	0	0	0	4.297311809	8.739384776	0.346535603	1.179086058	1.446178847	7.84956086	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.993			4.4185	0.077284014	4.940643826	0	0.734871296	1.793558203	0.08199697	1.057492151	2.005580441	0	0	0	0	0	4.297311809	8.739384776	0.346535603	1.179086058	1.446178847	7.84956086	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.993		n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			4.4185	0.077284014	4.940643826	0	0.734871296	1.793558203	0.08199697	1.057492151	2.005580441	0	0	0	0	0	4.297311809	8.739384776	0.346535603	1.179086058	1.446178847	7.84956086	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.993
H5883_002_4	2008	4																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	O	P	T	P	P	P	P	P	P	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		242.5473329	4.242429413	767.44857	0	245.3958199	15.17238437	0.693643253	229.2432019	203.3435502	0	0	0	0	0	3972.350192	4097.561466	168.8896426	492.5540233	2871.421077	3062.215234	0	0	0	0	0	0	12	0	0	0	0											$250 copay per admit	$250 copay per admit	"$0 copay days 1-20, $100 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery						$15 copay	$30 copay	$30 copay	$30 copay	"$40 copay on MRI, CT, PET; $0 copay all other"	"$50 office surgery, $30 allergy, $30 cardiovascular"							$25 copay on exam															246.75	246.75	53.95	0	50	0.15	0.15	48.01501936	100	0	0	0	0	0	15	30	30	35	8	37.04847227	0	0	0	0	0	0	25	0	0	0	0											4.9874	0.087234955	3.450320863	0	1.022482583	2.275857655	0.104046488	0.917259732	1.694529585	0	0	0	0	0	4.96543774	10.24390366	0.422224106	1.436615901	1.914280718	9.454199683	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0008			4.9874	0.087234955	3.450320863	0	1.022482583	2.275857655	0.104046488	0.917259732	1.694529585	0	0	0	0	0	4.96543774	10.24390366	0.422224106	1.436615901	1.914280718	9.454199683	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0008		n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			4.9874	0.087234955	3.450320863	0	1.022482583	2.275857655	0.104046488	0.917259732	1.694529585	0	0	0	0	0	4.96543774	10.24390366	0.422224106	1.436615901	1.914280718	9.454199683	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0008
H5883_002_7	2008	4																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	O	P	T	P	P	P	P	P	P	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		231.7776186	4.05405483	967.4637343	0	206.3596131	13.35890934	0.610735736	217.8146183	192.5665013	0	0	0	0	0	3855.616636	4083.187393	179.8216381	524.4363714	2606.995398	3172.975798	0	0	0	0	0	0	12	0	0	0	0											$250 copay per admit	$250 copay per admit	"$0 copay days 1-20, $100 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery						$15 copay	$30 copay	$30 copay	$30 copay	"$40 copay on MRI, CT, PET; $0 copay all other"	"$50 office surgery, $30 allergy, $30 cardiovascular"							$25 copay on exam															246.75	246.75	53.95	0	50	0.15	0.15	47.97229682	100	0	0	0	0	0	15	30	30	35	8	36.69150683	0	0	0	0	0	0	25	0	0	0	0											4.7659	0.083361502	4.349555706	0	0.859831721	2.003836401	0.09161036	0.870755627	1.604720844	0	0	0	0	0	4.819520795	10.20796848	0.449554095	1.529606083	1.737996932	9.701771931	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.101			4.7659	0.083361502	4.349555706	0	0.859831721	2.003836401	0.09161036	0.870755627	1.604720844	0	0	0	0	0	4.819520795	10.20796848	0.449554095	1.529606083	1.737996932	9.701771931	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.101		n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			4.7659	0.083361502	4.349555706	0	0.859831721	2.003836401	0.09161036	0.870755627	1.604720844	0	0	0	0	0	4.819520795	10.20796848	0.449554095	1.529606083	1.737996932	9.701771931	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.101
H5883_003_1	2008	5																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	O	P	T	P	P	P	P	P	P	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	989.1643077	0	231.2836522	15.2313678	0.696339827	292.9893014	270.5966021	0	0	0	0	0	4294.386428	4372.632412	181.2600159	519.9066437	2632.866765	3356.673497	0	0	0	0	0	0	12	0	0	0	0													"$0 copay days 1-20, $75 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$50 OP surgery						$7 copay	$20 copay	$20 copay	$20 copay	"$20 copay on MRI, CT, PET; $0 copay all other"	"$30 office surgery, $20 allergy, $20 cardiovascular"							$25 copay on exam															0	0	33.71771636	0	50	0.15	0.15	48.41302198	50	0	0	0	0	0	7	20	20	25	4	23.80968737	0	0	0	0	0	0	25	0	0	0	0											0	0	2.779363463	0	0.963681884	2.284705171	0.104450974	1.182041458	1.127485842	0	0	0	0	0	2.505058749	7.287720687	0.302100026	1.083138841	0.877622255	6.660112214	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.1825			0	0	2.779363463	0	0.963681884	2.284705171	0.104450974	1.182041458	1.127485842	0	0	0	0	0	2.505058749	7.287720687	0.302100026	1.083138841	0.877622255	6.660112214	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.1825		n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0	2.779363463	0	0.963681884	2.284705171	0.104450974	1.182041458	1.127485842	0	0	0	0	0	2.505058749	7.287720687	0.302100026	1.083138841	0.877622255	6.660112214	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.1825
H5883_003_2	2008	4																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	O	P	T	P	P	P	P	P	P	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	913.8632205	0	220.9555714	14.74049096	0.673898173	341.3287019	317.217018	0	0	0	0	0	4732.728847	4584.254351	164.7476958	472.544489	2922.304616	3163.462284	0	0	0	0	0	0	12	0	0	0	0													"$0 copay days 1-20, $75 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$50 OP surgery						$7 copay	$20 copay	$20 copay	$20 copay	"$20 copay on MRI, CT, PET; $0 copay all other"	"$30 office surgery, $20 allergy, $20 cardiovascular"							$25 copay on exam															0	0	33.71771636	0	50	0.15	0.15	48.4988274	50	0	0	0	0	0	7	20	20	25	4	24.02997216	0	0	0	0	0	0	25	0	0	0	0											0	0	2.567781738	0	0.920648214	2.211073644	0.101084726	1.379503483	1.321737575	0	0	0	0	0	2.760758494	7.640423919	0.274579493	0.984467685	0.974101539	6.334825885	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.496			0	0	2.567781738	0	0.920648214	2.211073644	0.101084726	1.379503483	1.321737575	0	0	0	0	0	2.760758494	7.640423919	0.274579493	0.984467685	0.974101539	6.334825885	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.496		n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0	2.567781738	0	0.920648214	2.211073644	0.101084726	1.379503483	1.321737575	0	0	0	0	0	2.760758494	7.640423919	0.274579493	0.984467685	0.974101539	6.334825885	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.496
H5883_003_3	2008	4																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	O	P	T	P	P	P	P	P	P	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	1238.540684	0	193.2109464	13.11656833	0.599656514	290.5717616	270.2516742	0	0	0	0	0	4001.96848	4012.877731	159.7220638	458.1295091	2399.183757	2837.773087	0	0	0	0	0	0	12	0	0	0	0													"$0 copay days 1-20, $75 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$50 OP surgery						$7 copay	$20 copay	$20 copay	$20 copay	"$20 copay on MRI, CT, PET; $0 copay all other"	"$30 office surgery, $20 allergy, $20 cardiovascular"							$25 copay on exam															0	0	33.71771636	0	50	0.15	0.15	48.50888329	50	0	0	0	0	0	7	20	20	25	4	23.54781345	0	0	0	0	0	0	25	0	0	0	0											0	0	3.480063624	0	0.80504561	1.967485249	0.089948477	1.174609306	1.126048643	0	0	0	0	0	2.334481613	6.688129551	0.26620344	0.954436477	0.799727919	5.568612606	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2798			0	0	3.480063624	0	0.80504561	1.967485249	0.089948477	1.174609306	1.126048643	0	0	0	0	0	2.334481613	6.688129551	0.26620344	0.954436477	0.799727919	5.568612606	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2798		n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0	3.480063624	0	0.80504561	1.967485249	0.089948477	1.174609306	1.126048643	0	0	0	0	0	2.334481613	6.688129551	0.26620344	0.954436477	0.799727919	5.568612606	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2798
H5883_003_4	2008	4																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	O	P	T	P	P	P	P	P	P	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	894.0384877	0	274.6306923	17.07836297	0.780779801	245.9328393	219.7133744	0	0	0	0	0	4597.568597	4656.619373	190.4459449	546.2545699	3149.363006	3364.587795	0	0	0	0	0	0	12	0	0	0	0													"$0 copay days 1-20, $75 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$50 OP surgery						$7 copay	$20 copay	$20 copay	$20 copay	"$20 copay on MRI, CT, PET; $0 copay all other"	"$30 office surgery, $20 allergy, $20 cardiovascular"							$25 copay on exam															0	0	33.71771636	0	50	0.15	0.15	47.9760268	50	0	0	0	0	0	7	20	20	25	4	23.51127254	0	0	0	0	0	0	25	0	0	0	0											0	0	2.512078012	0	1.144294551	2.561754446	0.11711697	0.983240041	0.915472393	0	0	0	0	0	2.681915015	7.761032288	0.317409908	1.138030354	1.049787669	6.592145053	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.7993			0	0	2.512078012	0	1.144294551	2.561754446	0.11711697	0.983240041	0.915472393	0	0	0	0	0	2.681915015	7.761032288	0.317409908	1.138030354	1.049787669	6.592145053	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.7993		n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0	2.512078012	0	1.144294551	2.561754446	0.11711697	0.983240041	0.915472393	0	0	0	0	0	2.681915015	7.761032288	0.317409908	1.138030354	1.049787669	6.592145053	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.7993
H5883_003_5	2008	4																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	O	P	T	P	P	P	P	P	P	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	1090.237215	0	227.8468816	14.76795021	0.675153541	238.8377131	213.1997469	0	0	0	0	0	4487.667557	4686.301012	207.0058347	593.7531686	2883.06558	3550.898831	0	0	0	0	0	0	12	0	0	0	0													"$0 copay days 1-20, $75 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$50 OP surgery						$7 copay	$20 copay	$20 copay	$20 copay	"$20 copay on MRI, CT, PET; $0 copay all other"	"$30 office surgery, $20 allergy, $20 cardiovascular"							$25 copay on exam															0	0	33.71771636	0	50	0.15	0.15	47.96575535	50	0	0	0	0	0	7	20	20	25	4	23.31711549	0	0	0	0	0	0	25	0	0	0	0											0	0	3.063359099	0	0.949362007	2.215192532	0.101273031	0.954669276	0.888332279	0	0	0	0	0	2.617806075	7.810501686	0.345009725	1.236985768	0.96102186	6.899726509	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.0682			0	0	3.063359099	0	0.949362007	2.215192532	0.101273031	0.954669276	0.888332279	0	0	0	0	0	2.617806075	7.810501686	0.345009725	1.236985768	0.96102186	6.899726509	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.0682		n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0	3.063359099	0	0.949362007	2.215192532	0.101273031	0.954669276	0.888332279	0	0	0	0	0	2.617806075	7.810501686	0.345009725	1.236985768	0.96102186	6.899726509	0	0	0	0	0	0	0.025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.0682
H5883_801_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	O	P	T	P	P	P	P	P	P	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		323.3816987	4.685757115	1369.829247	0	283.2167585	18.05837256	0.825583374	621.7369638	517.1703756	3382.007449	1713.635939	0	882.5543319	2763.9829	6878.544237	7812.55662	258.0588865	2271.032057	6772.216517	35652.16045	1342.601308	762.8282601	0	0	0	0	0	0	0	0	0											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing																				705.2505616	522.4449014	73.25399031	0	78.95363149	0.234	0.234	32.45591998	180.2540594	8.621111551	57.80004478	0	31.29884902	35.49187948	12.90354597	17.37192339	21.90400999	6.906441206	15.04885658	10.50798217	57.31827031	13.05161989	0	0	0	0	0	0	0	0	0											19.0054	0.20400416	8.362121531	0	1.863415965	4.225659178	0.19318651	1.681587095	7.768504968	2.429721957	8.2540195	0	2.301911232	8.174912333	7.396467646	11.30992792	0.471043702	1.307062448	8.492842926	31.21935554	6.412965391	0.829678708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9038			19.0054	0.20400416	8.362121531	0	1.863415965	4.225659178	0.19318651	1.681587095	7.768504968	2.429721957	8.2540195	0	2.301911232	8.174912333	7.396467646	11.30992792	0.471043702	1.307062448	8.492842926	31.21935554	6.412965391	0.829678708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9038		n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			19.0054	0.20400416	8.362121531	0	1.863415965	4.225659178	0.19318651	1.681587095	7.768504968	2.429721957	8.2540195	0	2.301911232	8.174912333	7.396467646	11.30992792	0.471043702	1.307062448	8.492842926	31.21935554	6.412965391	0.829678708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9038
H5883_802_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	O	P	T	P	P	P	P	P	P	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		323.3816987	4.685757115	1369.829247	0	283.2167585	18.05837256	0.825583374	621.7369638	517.1703756	3382.007449	1713.635939	0	882.5543319	2763.9829	6878.544237	7812.55662	258.0588865	2271.032057	6772.216517	35652.16045	1342.601308	762.8282601	0	0	0	0	0	0	0	0	0											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing																				705.2505616	522.4449014	73.25399031	0	78.95363149	0.234	0.234	32.45591998	180.2540594	8.621111551	57.80004478	0	31.29884902	35.49187948	12.90354597	17.37192339	21.90400999	6.906441206	15.04885658	10.50798217	57.31827031	13.05161989	0	0	0	0	0	0	0	0	0											19.0054	0.20400416	8.362121531	0	1.863415965	4.225659178	0.19318651	1.681587095	7.768504968	2.429721957	8.2540195	0	2.301911232	8.174912333	7.396467646	11.30992792	0.471043702	1.307062448	8.492842926	31.21935554	6.412965391	0.829678708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9038			19.0054	0.20400416	8.362121531	0	1.863415965	4.225659178	0.19318651	1.681587095	7.768504968	2.429721957	8.2540195	0	2.301911232	8.174912333	7.396467646	11.30992792	0.471043702	1.307062448	8.492842926	31.21935554	6.412965391	0.829678708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9038		n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			19.0054	0.20400416	8.362121531	0	1.863415965	4.225659178	0.19318651	1.681587095	7.768504968	2.429721957	8.2540195	0	2.301911232	8.174912333	7.396467646	11.30992792	0.471043702	1.307062448	8.492842926	31.21935554	6.412965391	0.829678708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9038
H5883_805_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	O	P	T	P	P	P	P	P	P	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		323.3816987	4.685757115	1369.829247	0	283.2167585	18.05837256	0.825583374	621.7369638	517.1703756	3382.007449	1713.635939	0	882.5543319	2763.9829	6878.544237	7812.55662	258.0588865	2271.032057	6772.216517	35652.16045	1342.601308	762.8282601	0	0	0	0	0	0	0	0	0											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing																				705.2505616	522.4449014	73.25399031	0	78.95363149	0.234	0.234	32.45591998	180.2540594	8.621111551	57.80004478	0	31.29884902	35.49187948	12.90354597	17.37192339	21.90400999	6.906441206	15.04885658	10.50798217	57.31827031	13.05161989	0	0	0	0	0	0	0	0	0											19.0054	0.20400416	8.362121531	0	1.863415965	4.225659178	0.19318651	1.681587095	7.768504968	2.429721957	8.2540195	0	2.301911232	8.174912333	7.396467646	11.30992792	0.471043702	1.307062448	8.492842926	31.21935554	6.412965391	0.829678708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9038			19.0054	0.20400416	8.362121531	0	1.863415965	4.225659178	0.19318651	1.681587095	7.768504968	2.429721957	8.2540195	0	2.301911232	8.174912333	7.396467646	11.30992792	0.471043702	1.307062448	8.492842926	31.21935554	6.412965391	0.829678708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9038		n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			19.0054	0.20400416	8.362121531	0	1.863415965	4.225659178	0.19318651	1.681587095	7.768504968	2.429721957	8.2540195	0	2.301911232	8.174912333	7.396467646	11.30992792	0.471043702	1.307062448	8.492842926	31.21935554	6.412965391	0.829678708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9038
H5883_807_0	2008	2																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	O	P	T	P	P	P	P	P	P	P	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		323.3816987	4.685757115	1369.829247	0	283.2167585	18.05837256	0.825583374	621.7369638	517.1703756	3382.007449	1713.635939	0	882.5543319	2763.9829	6878.544237	7812.55662	258.0588865	2271.032057	6772.216517	35652.16045	1342.601308	762.8282601	0	0	0	0	0	0	0	0	0											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing																				705.2505616	522.4449014	73.25399031	0	78.95363149	0.234	0.234	32.45591998	180.2540594	8.621111551	57.80004478	0	31.29884902	35.49187948	12.90354597	17.37192339	21.90400999	6.906441206	15.04885658	10.50798217	57.31827031	13.05161989	0	0	0	0	0	0	0	0	0											19.0054	0.20400416	8.362121531	0	1.863415965	4.225659178	0.19318651	1.681587095	7.768504968	2.429721957	8.2540195	0	2.301911232	8.174912333	7.396467646	11.30992792	0.471043702	1.307062448	8.492842926	31.21935554	6.412965391	0.829678708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9038			19.0054	0.20400416	8.362121531	0	1.863415965	4.225659178	0.19318651	1.681587095	7.768504968	2.429721957	8.2540195	0	2.301911232	8.174912333	7.396467646	11.30992792	0.471043702	1.307062448	8.492842926	31.21935554	6.412965391	0.829678708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9038		n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			19.0054	0.20400416	8.362121531	0	1.863415965	4.225659178	0.19318651	1.681587095	7.768504968	2.429721957	8.2540195	0	2.301911232	8.174912333	7.396467646	11.30992792	0.471043702	1.307062448	8.492842926	31.21935554	6.412965391	0.829678708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9038
H5884_001_1	2008	7																					4000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	V	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	301.8475267	2.99505711	165.2802525	11.50401031	161.0450837	20.27377327	0.964240982	339.8302601	563.1626269	6.960420962	18.95638902	0	33.00827714	687.7650625	3594.765848	3993.531716	121.4735303	392.6079169	0	81.87114926	5.251374453	0	0	470.2085555	118.2988979	0	49.03827051	0	0	0	0											$250 per admit	$250 per admit	$75 days 21-100	$0 per visit	$100 per trip	20%	0%	"ER:  $50 per visit, UC:  $20 per visit"	$100 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$0 per visit	"Medicare Hearing Exams:  $20 per visit, OPSA:  $20 per visit"	$0 per visit	Medicare Vision Exams:  $20 per visit	$0 per trip	$0 per visit	$20 per visit	0	$20 per visit	0	0	0	0											240.4661547	240.4661547	64.15182383	0	93.75948322	0.156448151	0.190781122	37.37142934	97.89558665	0	0	0	19.67478777	19.67478777	19.04041918	19.04041918	19.04041918	19.04041918	0	19.04041918	0	0	0	0	20	0	20	0	0	0	0											6.0487	0.060017489	0.883585803	0	1.258291985	3.171794345	0.183958976	1.058328546	4.594261311	0	0	0	0.054119237	1.12763597	5.703820718	6.336543158	0.192742245	0.622951609	0	0.129905083	0	0	0	0	0.19716483	0	0.081730451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.7055	0	1.45	6.0487	0.060017489	0.883585803	0	1.258291985	3.171794345	0.183958976	1.058328546	4.594261311	0	0	0	0.054119237	1.12763597	5.703820718	6.336543158	0.192742245	0.622951609	0	0.129905083	0	0	0	0	0.19716483	0	0.081730451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.7055	4000	Per Day: 1-7	0	0	0	$75 per	20% DME/0% Diabetic Supplies	20%	"ER:  $50 per visit, UC:  $20 per visit"	20%	20%	20%	0	20%	20% OP PT/ST/OT	$35 	$35 SCP/20% Rad Therapy/Xrays	0	20%	20% OP only	$35 Hearing/Speech	20%	$20 Vision/$0 Blood	0	0	$20 	0	$20 	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.0487	0.060017489	0.883585803	0	1.258291985	3.171794345	0.183958976	1.058328546	4.594261311	0	0	0	0.054119237	1.12763597	5.703820718	6.336543158	0.192742245	0.622951609	0	0.129905083	0	0	0	0	0.19716483	0	0.081730451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.7055
H5884_001_2	2008	6																					4000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	V	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	314.9244018	3.124074669	164.9024137	11.47771158	160.6769268	20.22919849	0.960264622	339.0533915	561.8752096	6.947058823	18.91999785	0	31.28048584	686.297608	3604.95593	4025.958902	124.1418711	401.2321146	0	82.3468552	5.239369555	0	0	469.1336357	119.0494462	0	49.03838395	0	0	0	0											$250 per admit	$250 per admit	$75 days 21-100	$0 per visit	$100 per trip	20%	0%	"ER:  $50 per visit, UC:  $20 per visit"	$100 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$0 per visit	"Medicare Hearing Exams:  $20 per visit, OPSA:  $20 per visit"	$0 per visit	Medicare Vision Exams:  $20 per visit	$0 per trip	$0 per visit	$20 per visit	0	$20 per visit	0	0	0	0											240.4409178	240.4409178	63.4966419	0	92.8852751	0.155223975	0.189288297	37.13652766	97.54807701	0	0	0	19.62114213	19.62114213	18.9634148	18.9634148	18.9634148	18.9634148	0	18.9634148	0	0	0	0	20	0	20	0	0	0	0											6.3101	0.062596282	0.872562459	0	1.243710046	3.140056604	0.181766855	1.049272138	4.567487185	0	0	0	0.051146572	1.122161909	5.69685622	6.362160719	0.196179483	0.634060918	0	0.130131464	0	0	0	0	0.198415744	0	0.08173064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9004	0	1.59	6.3101	0.062596282	0.872562459	0	1.243710046	3.140056604	0.181766855	1.049272138	4.567487185	0	0	0	0.051146572	1.122161909	5.69685622	6.362160719	0.196179483	0.634060918	0	0.130131464	0	0	0	0	0.198415744	0	0.08173064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9004	4000	Per Day: 1-7	0	0	0	$75 per	20% DME/0% Diabetic Supplies	20%	"ER:  $50 per visit, UC:  $20 per visit"	20%	20%	20%	0	20%	20% OP PT/ST/OT	$35 	$35 SCP/20% Rad Therapy/Xrays	0	20%	20% OP only	$35 Hearing/Speech	20%	$20 Vision/$0 Blood	0	0	$20 	0	$20 	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.3101	0.062596282	0.872562459	0	1.243710046	3.140056604	0.181766855	1.049272138	4.567487185	0	0	0	0.051146572	1.122161909	5.69685622	6.362160719	0.196179483	0.634060918	0	0.130131464	0	0	0	0	0.198415744	0	0.08173064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9004
H5884_002_1	2008	10																					5000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	V	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	905.6277548	12.18123904	140.704449	9.79345934	137.0990147	17.25876345	0.821334128	289.3003174	479.4250125	5.924721912	16.1357099	0	29.74973075	585.5089248	2980.873825	3278.542395	101.0138804	326.5322923	0	66.68366757	4.470538603	0	0	0	0	0	0	0	0	0	0											$175 days 1-7	$175 days 1-7	$150 days 21-100	$0 per visit	$200 per trip	20%	0%	"ER:  $50 per visit, UC:  $40 per visit"	$250 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $40 per visit	$20 per visit	$40 per visit	$40 per visit	$40 per visit	$0 per visit	"Medicare Hearing Exams:  $40 per visit, OPSA:  $40 per visit"	$0 per visit	Medicare Vision Exams:  $40 per visit	$0 per trip	$0 per visit	$40 per visit	0	$40 per visit	0	0	0	0											166.481063	166.4817361	123.5011181	0	184.9271588	0.154786975	0.188741375	44.58468091	243.7696611	0	0	0	19.61487452	39.22975138	21.44799011	36.817417	37.59149316	37.59186848	0	34.49588467	0	0	0	0	0	0	0	0	0	0	0											12.5642	0.168996152	1.448096397	0	2.112777605	2.671431786	0.155019733	1.074863528	9.739106068	0	0	0	0.048628103	1.914114129	5.327812694	10.05895521	0.316438549	1.022913249	0	0.191692675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.815	0	2.72	12.5642	0.168996152	1.448096397	0	2.112777605	2.671431786	0.155019733	1.074863528	9.739106068	0	0	0	0.048628103	1.914114129	5.327812694	10.05895521	0.316438549	1.022913249	0	0.191692675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.815	5000		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.5642	0.168996152	1.448096397	0	2.112777605	2.671431786	0.155019733	1.074863528	9.739106068	0	0	0	0.048628103	1.914114129	5.327812694	10.05895521	0.316438549	1.022913249	0	0.191692675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.815
H5884_002_2	2008	14																					5000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	V	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	870.2896776	12.01060379	130.4372116	9.078828265	127.0948668	16.00129367	0.759494854	268.1900039	444.4412544	5.495202392	14.96593308	0	24.75312117	542.8557695	2853.090895	3132.146836	96.61626531	312.2667645	0	63.95677295	4.144322329	0	0	0	0	0	0	0	0	0	0											$175 days 1-7	$175 days 1-7	$150 days 21-100	$0 per visit	$200 per trip	20%	0%	"ER:  $50 per visit, UC:  $40 per visit"	$250 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $40 per visit	$20 per visit	$40 per visit	$40 per visit	$40 per visit	$0 per visit	"Medicare Hearing Exams:  $40 per visit, OPSA:  $40 per visit"	$0 per visit	Medicare Vision Exams:  $40 per visit	$0 per trip	$0 per visit	$40 per visit	0	$40 per visit	0	0	0	0											167.8339187	167.8339048	124.8643669	0	184.4157206	0.154435589	0.188327216	44.42982297	243.2705679	0	0	0	19.58407936	39.16815882	21.53016255	36.69153335	37.73726427	37.73725447	0	32.76045357	0	0	0	0	0	0	0	0	0	0	0											12.172	0.167982211	1.357246654	0	1.953190953	2.471169209	0.143033552	0.992969533	9.009956363	0	0	0	0.040397257	1.771888416	5.118959228	9.576939175	0.303836128	0.982007529	0	0.174604408	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.2362	0	2.43	12.172	0.167982211	1.357246654	0	1.953190953	2.471169209	0.143033552	0.992969533	9.009956363	0	0	0	0.040397257	1.771888416	5.118959228	9.576939175	0.303836128	0.982007529	0	0.174604408	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.2362	5000		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.172	0.167982211	1.357246654	0	1.953190953	2.471169209	0.143033552	0.992969533	9.009956363	0	0	0	0.040397257	1.771888416	5.118959228	9.576939175	0.303836128	0.982007529	0	0.174604408	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.2362
H5884_003_1	2008	9																					4000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	V	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	280.617727	2.784551157	156.9985576	10.92757906	152.9756004	19.25749736	0.916344068	322.8023909	534.9442466	6.611608383	18.00641388	0	31.63007357	653.2857394	3380.616886	3760.370264	114.7592901	370.9071904	0	77.04863137	4.988243922	0	0	446.6478233	112.4926749	0	46.59452544	0	0	0	0											$250 per admit	$250 per admit	$75 days 21-100	$0 per visit	$100 per trip	20%	0%	"ER:  $50 per visit, UC:  $20 per visit"	$100 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$0 per visit	"Medicare Hearing Exams:  $20 per visit, OPSA:  $20 per visit"	$0 per visit	Medicare Vision Exams:  $20 per visit	$0 per trip	$0 per visit	$20 per visit	0	$20 per visit	0	0	0	0											241.839011	241.839011	65.83585805	0	94.87420094	0.157804493	0.192435117	37.60571409	98.24683512	0	0	0	19.72906182	19.72906182	19.18912102	19.18912102	19.18912102	19.18912102	0	19.18912102	0	0	0	0	20	0	20	0	0	0	0											5.6554	0.056117758	0.861344563	0	1.209453154	3.038919615	0.176336778	1.011601202	4.379714933	0	0	0	0.05200264	1.074059562	5.405922212	6.013183339	0.183510825	0.593115247	0	0.123207959	0	0	0	0	0.187487792	0	0.077657542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.099	0	1.15	5.6554	0.056117758	0.861344563	0	1.209453154	3.038919615	0.176336778	1.011601202	4.379714933	0	0	0	0.05200264	1.074059562	5.405922212	6.013183339	0.183510825	0.593115247	0	0.123207959	0	0	0	0	0.187487792	0	0.077657542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.099	4000		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.6554	0.056117758	0.861344563	0	1.209453154	3.038919615	0.176336778	1.011601202	4.379714933	0	0	0	0.05200264	1.074059562	5.405922212	6.013183339	0.183510825	0.593115247	0	0.123207959	0	0	0	0	0.187487792	0	0.077657542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.099
H5884_003_2	2008	13																					4000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	V	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	289.1328199	2.867834543	152.1684746	10.59139053	148.2692842	18.666949	0.886241314	312.8713293	518.4866104	6.410143136	17.45773246	0	29.37241717	633.2687914	3316.867944	3707.87948	114.6233411	370.4677972	0	75.8083159	4.834779885	0	0	432.9066392	109.5114344	0	45.21383292	0	0	0	0											$250 per admit	$250 per admit	$75 days 21-100	$0 per visit	$100 per trip	20%	0%	"ER:  $50 per visit, UC:  $20 per visit"	$100 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$0 per visit	"Medicare Hearing Exams:  $20 per visit, OPSA:  $20 per visit"	$0 per visit	Medicare Vision Exams:  $20 per visit	$0 per trip	$0 per visit	$20 per visit	0	$20 per visit	0	0	0	0											241.7645418	241.7645418	64.97423769	0	93.880842	0.156470959	0.190808935	37.38726827	97.92319869	0	0	0	19.67908759	19.67908759	19.10705106	19.10705106	19.10705106	19.10705106	0	19.10705106	0	0	0	0	20	0	20	0	0	0	0											5.8252	0.057778392	0.82391922	0	1.159970437	2.920835414	0.169102761	0.974783693	4.230988947	0	0	0	0.048168531	1.038512668	5.281297099	5.903886881	0.182509503	0.589878927	0	0.120706114	0	0	0	0	0.182519057	0	0.075356388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.5854	0	1.26	5.8252	0.057778392	0.82391922	0	1.159970437	2.920835414	0.169102761	0.974783693	4.230988947	0	0	0	0.048168531	1.038512668	5.281297099	5.903886881	0.182509503	0.589878927	0	0.120706114	0	0	0	0	0.182519057	0	0.075356388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.5854	4000		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.8252	0.057778392	0.82391922	0	1.159970437	2.920835414	0.169102761	0.974783693	4.230988947	0	0	0	0.048168531	1.038512668	5.281297099	5.903886881	0.182509503	0.589878927	0	0.120706114	0	0	0	0	0.182519057	0	0.075356388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.5854
H5884_004_1	2008	9																					2500											coin	coin	coin	coin	T	coin	coin	V	coin	coin	coin	O	V	P	V	V	V	V	V	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	214.5595833	1.595130803	10.9321769	11.95948456	167.4212852	21.07631321	1.002570289	353.2850404	48.66658753	7.236409418	19.708031	0	33.4205499	715.0522501	3924.277355	4335.330695	131.5401929	425.1438235	0	89.33590848	5.45929028	0	0	488.8253579	126.8812886	0	51.40124938	0	0	0	0											$0 per admit	$0 per admit	$0 days 1-100	$0 per visit	$100 per trip	20%	0%	"ER:  $50 per visit, UC:  $10 per visit"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$0 per visit	"Medicare Hearing Exams:  $10 per visit, OPSA:  $10 per visit"	$0 per visit	Medicare Vision Exams:  $10 per visit	$0 per trip	$0 per visit	$10 per visit	0	$10 per visit	0	0	0	0											0	0	0	0	96.92194113	0.160287918	0.195463536	33.81750356	0	0	0	0	9.917610622	9.917610622	9.757546449	9.757546449	9.757546449	9.757546449	0	9.757546449	0	0	0	0	10	0	10	0	0	0	0											0	0	0	0	1.352232996	3.378278367	0.195965934	0.995601509	0	0	0	0	0.027621	0.590967483	3.190943214	3.525182552	0.106959129	0.345696717	0	0.072641606	0	0	0	0	0.105734407	0	0.042834374	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.9307	0	0.33	0	0	0	0	1.352232996	3.378278367	0.195965934	0.995601509	0	0	0	0	0.027621	0.590967483	3.190943214	3.525182552	0.106959129	0.345696717	0	0.072641606	0	0	0	0	0.105734407	0	0.042834374	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.9307	2500		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.352232996	3.378278367	0.195965934	0.995601509	0	0	0	0	0.027621	0.590967483	3.190943214	3.525182552	0.106959129	0.345696717	0	0.072641606	0	0	0	0	0.105734407	0	0.042834374	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.9307
H5884_004_2	2008	13																					2500											coin	coin	coin	coin	T	coin	coin	V	coin	coin	coin	O	V	P	V	V	V	V	V	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	214.8726774	1.596188686	10.94806536	11.97686607	167.6646097	21.10894949	1.002022713	353.798493	48.73731791	7.249221947	19.74292533	0	32.8935483	716.1279925	3913.682789	4362.655154	135.4583102	437.8073549	0	89.54270882	5.467224629	0	0	489.5358002	128.0374407	0	51.57803274	0	0	0	0											$0 per admit	$0 per admit	$0 days 1-100	$0 per visit	$100 per trip	20%	0%	"ER:  $50 per visit, UC:  $10 per visit"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$0 per visit	"Medicare Hearing Exams:  $10 per visit, OPSA:  $10 per visit"	$0 per visit	Medicare Vision Exams:  $10 per visit	$0 per trip	$0 per visit	$10 per visit	0	$10 per visit	0	0	0	0											0	0	0	0	95.8191491	0.158815485	0.193667973	33.58846736	0	0	0	0	9.888806894	9.888806894	9.687258769	9.687258769	9.687258769	9.687258769	0	9.687258769	0	0	0	0	10	0	10	0	0	0	0											0	0	0	0	1.33879002	3.352428044	0.194059708	0.990295761	0	0	0	0	0.027106496	0.590137619	3.159404826	3.521847449	0.109351642	0.353429428	0	0.072285283	0	0	0	0	0.106697867	0	0.042981694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.8588	0	0.44	0	0	0	0	1.33879002	3.352428044	0.194059708	0.990295761	0	0	0	0	0.027106496	0.590137619	3.159404826	3.521847449	0.109351642	0.353429428	0	0.072285283	0	0	0	0	0.106697867	0	0.042981694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.8588	2500		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.33879002	3.352428044	0.194059708	0.990295761	0	0	0	0	0.027106496	0.590137619	3.159404826	3.521847449	0.109351642	0.353429428	0	0.072285283	0	0	0	0	0.106697867	0	0.042981694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.8588
H5884_005_1	2008	8																					5000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	V	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1030.550899	14.08374283	157.0162398	10.9288098	152.9928295	19.26008154	0.916032003	322.8387471	535.0044955	6.61238988	18.00854225	0	31.35853553	653.3830009	3423.872126	3736.986704	113.4931947	366.8178631	0	76.48318112	4.988805731	0	0	0	0	0	0	0	0	0	0											$175 days 1-7	$175 days 1-7	$175 days 21-100	$0 per visit	$200 per trip	20%	0%	"ER:  $50 per visit, UC:  $40 per visit"	$250 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $40 per visit	$20 per visit	$40 per visit	$40 per visit	$40 per visit	$0 per visit	"Medicare Hearing Exams:  $40 per visit, OPSA:  $40 per visit"	$0 per visit	Medicare Vision Exams:  $40 per visit	$0 per trip	$0 per visit	$40 per visit	0	$40 per visit	0	0	0	0											164.0931001	164.0931433	132.9661067	0	179.2739446	0.151454658	0.184691145	43.81274898	241.2635065	0	0	0	38.91992564	38.91991272	21.01347673	36.05628704	36.83150332	36.83152708	0	33.6270757	0	0	0	0	0	0	0	0	0	0	0											14.0922	0.192587136	1.739819841	0	2.285635671	2.917029062	0.169182999	1.178704416	10.75642171	0	0	0	0.101705989	2.119134114	5.995621436	11.22848877	0.348343748	1.125871838	0	0.214325477	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4651	0	4.17	14.0922	0.192587136	1.739819841	0	2.285635671	2.917029062	0.169182999	1.178704416	10.75642171	0	0	0	0.101705989	2.119134114	5.995621436	11.22848877	0.348343748	1.125871838	0	0.214325477	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4651	5000		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.0922	0.192587136	1.739819841	0	2.285635671	2.917029062	0.169182999	1.178704416	10.75642171	0	0	0	0.101705989	2.119134114	5.995621436	11.22848877	0.348343748	1.125871838	0	0.214325477	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4651
H5884_005_2	2008	8																					5000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	V	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1046.343527	14.44804936	156.657293	10.903826	152.6430804	19.21775394	0.912236018	322.1007219	533.7814491	6.59975622	17.97413505	0	29.71299683	651.951634	3433.113271	3764.272336	115.9505826	374.7407164	0	76.96308654	4.977401077	0	0	0	0	0	0	0	0	0	0											$175 days 1-7	$175 days 1-7	$175 days 21-100	$0 per visit	$200 per trip	20%	0%	"ER:  $50 per visit, UC:  $40 per visit"	$250 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $40 per visit	$20 per visit	$40 per visit	$40 per visit	$40 per visit	$0 per visit	"Medicare Hearing Exams:  $40 per visit, OPSA:  $40 per visit"	$0 per visit	Medicare Vision Exams:  $40 per visit	$0 per trip	$0 per visit	$40 per visit	0	$40 per visit	0	0	0	0											164.3231434	164.3229267	131.4841149	0	176.9306953	0.149764134	0.182633503	43.44182383	240.0621318	0	0	0	38.77142027	38.77150492	20.91387939	35.65047578	36.65735299	36.65720327	0	31.89106148	0	0	0	0	0	0	0	0	0	0	0											14.3282	0.19784548	1.716495459	0	2.250603863	2.878130276	0.166604859	1.166053568	10.67839272	0	0	0	0.096001257	2.106428832	5.98330974	11.18317498	0.354203453	1.144745551	0	0.20453621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4547	0	4.41	14.3282	0.19784548	1.716495459	0	2.250603863	2.878130276	0.166604859	1.166053568	10.67839272	0	0	0	0.096001257	2.106428832	5.98330974	11.18317498	0.354203453	1.144745551	0	0.20453621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4547	5000		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.3282	0.19784548	1.716495459	0	2.250603863	2.878130276	0.166604859	1.166053568	10.67839272	0	0	0	0.096001257	2.106428832	5.98330974	11.18317498	0.354203453	1.144745551	0	0.20453621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4547
H5884_006_1	2008	7																					2500											coin	coin	coin	coin	T	coin	coin	V	coin	coin	coin	O	V	P	V	V	V	V	V	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	206.3880605	1.534450545	10.51582743	11.50401031	161.0450837	20.27377327	0.964240982	339.8302601	46.81313163	6.960420962	18.95638902	0	33.00827714	687.7650625	3751.11446	4154.460207	126.8778813	410.0750225	0	85.5135924	5.251374453	0	0	470.2085555	121.8234923	0	49.41978461	0	0	0	0											$0 per admit	$0 per admit	$0 days 1-100	$0 per visit	$100 per trip	20%	0%	"ER:  $50 per visit, UC:  $10 per visit"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$0 per visit	"Medicare Hearing Exams:  $10 per visit, OPSA:  $10 per visit"	$0 per visit	Medicare Vision Exams:  $10 per visit	$0 per trip	$0 per visit	$10 per visit	0	$10 per visit	0	0	0	0											0	0	0	0	96.97729471	0.160346253	0.195534672	33.84719759	0	0	0	0	9.921238836	9.921238836	9.762670748	9.762670748	9.762670748	9.762670748	0	9.762670748	0	0	0	0	10	0	10	0	0	0	0											0	0	0	0	1.301476379	3.250823573	0.188542545	0.958525163	0	0	0	0	0.02729025	0.568623454	3.051741284	3.379885594	0.103222248	0.333618952	0	0.069570087	0	0	0	0	0.101519577	0	0.041183154	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.376	0	0.31	0	0	0	0	1.301476379	3.250823573	0.188542545	0.958525163	0	0	0	0	0.02729025	0.568623454	3.051741284	3.379885594	0.103222248	0.333618952	0	0.069570087	0	0	0	0	0.101519577	0	0.041183154	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.376	2500		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.301476379	3.250823573	0.188542545	0.958525163	0	0	0	0	0.02729025	0.568623454	3.051741284	3.379885594	0.103222248	0.333618952	0	0.069570087	0	0	0	0	0.101519577	0	0.041183154	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.376
H5884_006_2	2008	7																					2500											coin	coin	coin	coin	T	coin	coin	V	coin	coin	coin	O	V	P	V	V	V	V	V	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	205.917496	1.529693985	10.49178774	11.47771158	160.6769268	20.22919849	0.960264622	339.0533915	46.70611452	6.947058823	18.91999785	0	31.28048584	686.297608	3761.907744	4188.585278	129.6704711	419.1007985	0	86.01413376	5.239369555	0	0	469.1336357	122.5597539	0	49.41364211	0	0	0	0											$0 per admit	$0 per admit	$0 days 1-100	$0 per visit	$100 per trip	20%	0%	"ER:  $50 per visit, UC:  $10 per visit"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$0 per visit	"Medicare Hearing Exams:  $10 per visit, OPSA:  $10 per visit"	$0 per visit	Medicare Vision Exams:  $10 per visit	$0 per trip	$0 per visit	$10 per visit	0	$10 per visit	0	0	0	0											0	0	0	0	96.31943309	0.159463876	0.194458656	33.69187664	0	0	0	0	9.902005224	9.902005224	9.726197421	9.726197421	9.726197421	9.726197421	0	9.726197421	0	0	0	0	10	0	10	0	0	0	0											0	0	0	0	1.289692542	3.225826403	0.186731768	0.95194542	0	0	0	0	0.025811628	0.566310208	3.049088117	3.394917277	0.10510005	0.339688092	0	0.06971587	0	0	0	0	0.102133128	0	0.041178035	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.3481	0	0.37	0	0	0	0	1.289692542	3.225826403	0.186731768	0.95194542	0	0	0	0	0.025811628	0.566310208	3.049088117	3.394917277	0.10510005	0.339688092	0	0.06971587	0	0	0	0	0.102133128	0	0.041178035	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.3481	2500		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.289692542	3.225826403	0.186731768	0.95194542	0	0	0	0	0.025811628	0.566310208	3.049088117	3.394917277	0.10510005	0.339688092	0	0.06971587	0	0	0	0	0.102133128	0	0.041178035	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.3481
H5884_802_0	2008	4																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	V	V	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	301.2478873	2.251361424	49.84318585	47.42927634	8.43105763	28.3288529	1.34186791	5.546043146	28.86751186	11.29333162	30.68216651	0	0.253670465	29.79444779	51.20322466	121.830096	1.318023603	4.430888154	5589.444478	16979.83615	8.326779088	0.899568932	0	0	0	0	0	0	0	0	0											Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	0	0	0	0	0	0	0	0	0											0.080609328	0.080609328	0.214054281	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	13.54996565	6.484943325	0.234	0.234	0	0	0	0	0	0	0	0	0											24.2834	0.181480732	10.6691473	0	1.972867485	6.628951578	0.313997091	1.297774096	6.754997775	2.642639598	7.179626964	0	0.059358889	6.971900782	11.98155457	28.50824246	0.308417523	1.036827828	6.311398392	9.17610626	1.948466306	0.21049913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4376	0	0	24.2834	0.181480732	10.6691473	0	1.972867485	6.628951578	0.313997091	1.297774096	6.754997775	2.642639598	7.179626964	0	0.059358889	6.971900782	11.98155457	28.50824246	0.308417523	1.036827828	6.311398392	9.17610626	1.948466306	0.21049913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4376	none		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.2834	0.181480732	10.6691473	0	1.972867485	6.628951578	0.313997091	1.297774096	6.754997775	2.642639598	7.179626964	0	0.059358889	6.971900782	11.98155457	28.50824246	0.308417523	1.036827828	6.311398392	9.17610626	1.948466306	0.21049913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4376
H5884_803_0	2008	4																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	V	V	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	301.2478873	2.251361424	49.84318585	47.42927634	8.43105763	28.3288529	1.34186791	5.546043146	28.86751186	11.29333162	30.68216651	0	0.253670465	29.79444779	51.20322466	121.830096	1.318023603	4.430888154	5589.444478	16979.83615	8.326779088	0.899568932	0	0	0	0	0	0	0	0	0											Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	0	0	0	0	0	0	0	0	0											0.080609328	0.080609328	0.214054281	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	13.54996565	6.484943325	0.234	0.234	0	0	0	0	0	0	0	0	0											24.2834	0.181480732	10.6691473	0	1.972867485	6.628951578	0.313997091	1.297774096	6.754997775	2.642639598	7.179626964	0	0.059358889	6.971900782	11.98155457	28.50824246	0.308417523	1.036827828	6.311398392	9.17610626	1.948466306	0.21049913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4376	0	0	24.2834	0.181480732	10.6691473	0	1.972867485	6.628951578	0.313997091	1.297774096	6.754997775	2.642639598	7.179626964	0	0.059358889	6.971900782	11.98155457	28.50824246	0.308417523	1.036827828	6.311398392	9.17610626	1.948466306	0.21049913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4376	none		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.2834	0.181480732	10.6691473	0	1.972867485	6.628951578	0.313997091	1.297774096	6.754997775	2.642639598	7.179626964	0	0.059358889	6.971900782	11.98155457	28.50824246	0.308417523	1.036827828	6.311398392	9.17610626	1.948466306	0.21049913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4376
H5884_804_0	2008	4																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	V	V	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	301.2478873	2.251361424	49.84318585	47.42927634	8.43105763	28.3288529	1.34186791	5.546043146	28.86751186	11.29333162	30.68216651	0	0.253670465	29.79444779	51.20322466	121.830096	1.318023603	4.430888154	5589.444478	16979.83615	8.326779088	0.899568932	0	0	0	0	0	0	0	0	0											Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	0	0	0	0	0	0	0	0	0											0.080609328	0.080609328	0.214054281	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	13.54996565	6.484943325	0.234	0.234	0	0	0	0	0	0	0	0	0											24.2834	0.181480732	10.6691473	0	1.972867485	6.628951578	0.313997091	1.297774096	6.754997775	2.642639598	7.179626964	0	0.059358889	6.971900782	11.98155457	28.50824246	0.308417523	1.036827828	6.311398392	9.17610626	1.948466306	0.21049913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4376	0	0	24.2834	0.181480732	10.6691473	0	1.972867485	6.628951578	0.313997091	1.297774096	6.754997775	2.642639598	7.179626964	0	0.059358889	6.971900782	11.98155457	28.50824246	0.308417523	1.036827828	6.311398392	9.17610626	1.948466306	0.21049913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4376	none		0	0	0								0					0						0	0		0		0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.2834	0.181480732	10.6691473	0	1.972867485	6.628951578	0.313997091	1.297774096	6.754997775	2.642639598	7.179626964	0	0.059358889	6.971900782	11.98155457	28.50824246	0.308417523	1.036827828	6.311398392	9.17610626	1.948466306	0.21049913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4376
H5887_001_0	2008	7																																D							V									P																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		101.3640808	0	0	0	0	0	0	316.2572061	0	0	0	0	0	0	0	0	177.9656987	0	0	0	0	0	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												100	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	5	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0.8447	0	0	0	0	0	0	0.658869179	0	0	0	0	0	0	0	0	0.074152374	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.5777	0	0	0.8447	0	0	0	0	0	0	0.658869179	0	0	0	0	0	0	0	0	0.074152374	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.5777																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.8447	0	0	0	0	0	0	0.658869179	0	0	0	0	0	0	0	0	0.074152374	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.5777
H5887_006_0	2008	7																																							V																																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	413.5463965	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	40	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.378487988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.3785	0	0	0	0	0	0	0	0	0	1.378487988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.3785																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	1.378487988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.3785
H5887_007_0	2008	7																																							V																																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	483.0546512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	40	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.610182171	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6102	0	0	0	0	0	0	0	0	0	1.610182171	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6102																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	1.610182171	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6102
H5887_008_0	2008	8																																							V								P																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	418.1413565	0	0	0	0	0	0	0	1963.632003	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	40	0	0	0	0	0	0	0	15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.393804522	0	0	0	0	0	0	0	2.454540003	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.8483	0	0	0	0	0	0	0	0	0	1.393804522	0	0	0	0	0	0	0	2.454540003	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.8483																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	1.393804522	0	0	0	0	0	0	0	2.454540003	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.8483
H5887_009_0	2008	8																																							V																																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	422.7363165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	40	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.409121055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.4091	0	0	0	0	0	0	0	0	0	1.409121055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.4091																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	1.409121055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.4091
H5893_001_0	2008	4																					2000																																																																																													0	2000																																																																																																																												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5895_001_0	2008	5																																																																																																																		0																																											0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance	0% coinsurance					0% coinsurance				0% coinsurance																																																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5896_007_0	2008	5																					0											Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	420.11885	26.67595	126.88	0	20.24	35.01	26.32	14.04	29.39	25.32	43.63	1.44	1.71	81.49	83.55	153.98	9.67	6.4	43.13	57.23	13.82	5.85	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Medicare FFS cost sharing	1B IP Psych: Medicare FFS cost sharing	2 SNF: Medicare FFS cost sharing	6 Home Health: $0	10A Ambulance: Medicare FFS cost sharing	11A DME: Medicare FFS cost sharing	"11B Prosthetic/Medical Supplies: Medicare FFS cost sharing, 11C Diabetes Monitoring Supplies: Medicare FFS cost sharing"	"4A ER: Medicare FFS cost sharing, 4B Urgent Care: Medicare FFS cost sharing"	9B ASC Services: Medicare FFS cost sharing	8A OP C/D/T: Medicare FFS cost sharing	8B OP X-Ray: Medicare FFS cost sharing	9A OP Hospital: Medicare FFS cost sharing	12 Renal Dialysis: Medicare FFS cost sharing	"3 CORF: Medicare FFS cost sharing, 5 Partial Hosp: Medicare FFS cost sharing, 9C OP Substance Abuse: Medicare FFS cost sharing, 9D Cardiac Rehab: Medicare FFS cost sharing"	"7A PCP: Medicare FFS cost sharing, 14B Immunizations: Medicare FFS cost sharing, 14C Routine Physical Exams: Medicare FFS cost sharing, 14D Pap Smears: Medicare FFS cost sharing, 14D Pelvic Exams: Medicare FFS cost sharing, 14E Prostate Screening: Medicare FFS cost sharing, 14F Colorectal Screening: Medicare FFS cost sharing, 14G Bone Mass Measurement: Medicare FFS cost sharing, 14H Mammography: Medicare FFS cost sharing, 14I Diabetes Monitoring: Medicare FFS cost sharing"	"7D Physician Specialist: Medicare FFS cost sharing,"	"7E Mental Health: Medicare FFS cost sharing, 7H Psychiatric: Medicare FFS cost sharing"	"7C Occupational Therapy: Medicare FFS cost sharing, 7I Physical and Speech Therapy: Medicare FFS cost sharing"	7D Physician Specialist: Medicare FFS cost sharing	"7B Chiropractic: Medicare FFS cost sharing, 7F Podiatry: Medicare FFS cost sharing, 7G Other Health Care: Medicare FFS cost sharing, 18A Medicare Covered Hearing Exams: Medicare FFS cost sharing"	15 Part B Drugs: Medicare FFS cost sharing	"13A Blood: Medicare FFS cost sharing, 16B Medicare Covered Comprehensive Dental Services: Medicare FFS cost sharing, 17A Medicare Covered Eye Exams: Medicare FFS cost sharing"	10B Transportation: $0	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental:$0"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.064973411	0.064976	0.167389676	0	0.234005458	0.234025183	0.234019123	0.234029962	0.233998228	0.233957032	0.233985356	0.233992188	0.233999561	0.233987761	0.23267144	0.233980975	0.233955336	0.234115501	0.23399333	0.22780405	0.233980204	0.233970239	0	0	0	0	0	0	0	0	0											27.2966	1.733296526	21.2384021	0	4.736270467	8.193221667	6.159383328	3.285780667	6.877207917	5.92379205	10.20878107	0.33694875	0.40013925	19.06766268	19.43969881	36.02839048	2.2623481	1.498339208	10.09213231	13.03722579	3.233606417	1.3687259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	202.4179	0	0	27.2966	1.733296526	21.2384021	0	4.736270467	8.193221667	6.159383328	3.285780667	6.877207917	5.92379205	10.20878107	0.33694875	0.40013925	19.06766268	19.43969881	36.02839048	2.2623481	1.498339208	10.09213231	13.03722579	3.233606417	1.3687259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	202.4179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.2966	1.733296526	21.2384021	0	4.736270467	8.193221667	6.159383328	3.285780667	6.877207917	5.92379205	10.20878107	0.33694875	0.40013925	19.06766268	19.43969881	36.02839048	2.2623481	1.498339208	10.09213231	13.03722579	3.233606417	1.3687259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	202.4179
H5896_008_0	2008	9																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	660.46	9.2	774.5616	0	236.53	15.4	9.38	277.11	263.58	0	974.31	28.01	0.44	548.16	5887.66	6802.84	172.51	591.57	2545.52	1956.61	288.49	779.59	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute:   $125   for 1st 5   Days	1B IP Psych:   $125   for 1st 5   Days	2 SNF:   $80   for Days 7   - 100	6 Home Health:   $0	10A Ambulance:     $100	11A DME:     20%	"11B Prosthetic Medical Supplies:      20%,  11C Diabetes Monitoring Supplies:     20%"	"4A ER:     $50,  4B Urgent Care:     $35"	9B ASC Services:     $200	8A OP Clinical/Diagnostic/Therapy Radiological Lab Services:      $0	8B OP X-Ray:     $51.6	"5 Partial Hospitalization:     $200,  9A OP Hospital,  $200"	12 Renal Dialysis:      $10	"3 CORF ,  200,  9D Cardiac Rehab:     $35"	"7A PCP:     $10,  14B Immunizations:     $0,  14C Routine Physical Exams:     $0,  14D Pap Smears:      $,  14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement:      $48,  14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist:     $35	"7E Mental Health:     $35,  7H Psychiatric:     $35,  9C OP Substance Abuse,  35"	"7C Occupational Therapy:     $35,  7I Physical and Speech Therapy:     $35"	7D Physician Specialist Services - Radiology:   48	"7G Other Health Care:     $35,  18A Medicare Covered Hearing Exams:   $35,  7B Chiropractic:     $35,  7F Podiatry:     $35"	15 Part B Drugs:     $200	"13A Blood:     $200,  16B Medicare Covered Dental Services:     $35,  17A Medicare Covered Eye Exams:   $35"	10B Transportation:     Not Covered	"16A Preventive Dental Services:   $0,  16B Non Medicare Covered Comprehensive Dental:   $0"	17A Routine Eye Exams:    $0	17B Eye Wear: $0	18A Routine Hearing Exams:   $Not Covered	18B Hearing Aids:   $Not Covered	19 POS:   $0	14A Health Education/Wellness Programs:   $0	13B Acupuncture: Not Covered											125	125	80	0	100	0.200002078	0.199343054	49.0754574	200	0	51.6	200	10	200	10	35	35	35	48	35	184.3725	37.59270899	0	0	0	0	0	0	0	0	0											6.8798	0.095833333	5.163744	0	1.971083333	3.080032	1.86983785	1.133275	4.393	0	4.189533	0.466833333	0.000366667	9.136	4.906383333	19.84161667	0.503154167	1.7254125	10.18208	5.706779167	4.432468544	2.442241667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.1195	0	0	6.8798	0.095833333	5.163744	0	1.971083333	3.080032	1.86983785	1.133275	4.393	0	4.189533	0.466833333	0.000366667	9.136	4.906383333	19.84161667	0.503154167	1.7254125	10.18208	5.706779167	4.432468544	2.442241667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.1195	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.8798	0.095833333	5.163744	0	1.971083333	3.080032	1.86983785	1.133275	4.393	0	4.189533	0.466833333	0.000366667	9.136	4.906383333	19.84161667	0.503154167	1.7254125	10.18208	5.706779167	4.432468544	2.442241667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.1195
H5896_009_0	2008	8																					3250											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											27.903	0.2314	4.1563	3.6515	0	1.5689	0.9566	0	3.9128	1.694	4.6025	0.1107	0.0144	2.7292	0	0	0	0	0	0	1.2101	0.0886	0	0	0	0	0	0	0	0	0											52.83	0	0	0	0	0	231.57	0	0	273.68	0	0	0	0	0	271.04	0	6807.55	169.91	577.17	2520.1	1908.64	0	746.2	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute:   $0	1B IP Psych:   $0	2 SNF:   $0	6 Home Health:   $0	10A Ambulance:     $100	11A DME:     $0	"11B Prosthetic Medical Supplies:      $0,11C Diabetes Monitoring Supplies:     $0"	"4A ER:     $50,4B Urgent Care:     $35"	9B ASC Services:     $0	8A OP Clinical/Diagnostic/Therapy Radiological Lab Services:      $0	8B OP X-Ray:     $0	"9A OP Hospital,  $0,  5 Partial Hosp:     $0"	12 Renal Dialysis:      $0	"3 CORF:,  $0,   9D Cardiac Rehab:     $30"	"7A PCP:     $0,  14B Immunizations:     $0,  14C Routine Physical Exams:     $0,  14D Pap Smears:      $,  14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement:43.75,   14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist:     $30	"7E Mental Health:     $30,  7H Psychiatric:     $30,     9C OP Substance Abuse: $30"	"7C Occupational Therapy:     $30,  7I Physical and Speech Therapy:     $30"	7D Physician Specialist Services - Radiology:   $43.75	"7G Other Health Care:     $30,  18A Medicare Covered Hearing Exams:   $30,  7B Chiropractic:     $30,  7F Podiatry:     $30"	15 Part B Drugs:     $0	"13A Blood:     $0,  16B Medicare Covered Comprehensive Dental Services:     $30,  17A Medicare Covered Eye Exams:   $30"	"10B Transportation:     $0,  Number of Trips Covered - 12"	"16A Preventive Dental Services:   $0,  16B Non Medicare Covered Comprehensive Dental:   NotCovered"	17A Routine Eye Exams:    $0	17B Eye Wear:    $0	18A Routine Hearing Exams:   $Not Covered	18B Hearing Aids:   $Not Covered	19 POS:   $0	14A Health Education/Wellness Programs:   $0	13B Acupuncture: Not Covered											0	0	0	0	100	0	0	49.04907191	0	0	0	0	0	30	0	30	30	30	43.75	30	0	30	0	0	0	0	0	0	0	0	0											0	0	0	0	1.92975	0	0	1.118645833	0	0	0	0	0	0.6776	0	17.018875	0.424775	1.442925	9.187864583	4.7716	0	1.8655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4375	1900	0	27.903	0.23139974	4.156337916	3.651465756	1.92975	1.568868095	0.956599883	1.118645833	3.912759242	1.693978959	4.602529759	0.110717579	0.014393285	3.406788323	0	17.018875	0.424775	1.442925	9.187864583	4.7716	1.210143139	1.954074063	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.2675	3250	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.903	0.23139974	4.156337916	3.651465756	1.92975	1.568868095	0.956599883	1.118645833	3.912759242	1.693978959	4.602529759	0.110717579	0.014393285	3.406788323	0	17.018875	0.424775	1.442925	9.187864583	4.7716	1.210143139	1.954074063	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.2675
H5908_001_0	2008	3																					0											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	Coin	T	Coin	V	Coin	V	V	V	V	V																																																				0		1317.401154	64.49749692	512.3479126	1462.979829	197.3256572	10.67031441	12.67450418	276.3709268	422.3496277	20.68011048	57.32834556		5.984119616	1395.667761	5120.070733	5642.619239	276.5331666	1223.904377			29.28470094	11.06904872																				1a: $150 days 1-4/$900 per admit	"1b: $175/$250 days 1-8, $300/$300 days 31-90"	"2: $0/$50 days 1-20, $50/$100 days 21-100"	6: $0/$20	10a: $150/15%	11a: 0%-20%; 30%	"11b: 0%-20%; 30%; 11c: 20%, $0-$12"	"4a: $50, 4b: $25/$35"	9b: $25-$250; $35-$250	8a: $0/20%	8b: $0-$350; 20%	9a: $0	12: $20; $30	"3: $10/$20, 9d: $10/$30;  5: $20; 9c:$20/$40; 9a: $150/$250, $25/$35, 20%"	"7a: $10/$20; 14c: $20/$30; 14f: $0-$150/$0-$250; 14g: $10/$20; 14i,14h:  $0/$20"	7b: $10/$30; 7d:$20/$40; 7f: $30/$40	"7e, 7h: $20/$40"	"7c, 7i: $10/$30"		7g: $15-$75	15: 20%	14j: $10/$20; 16b: 20%; 17a: $20/$40; 17b: $20/$30	10b: $0	16a: 0%	17a: $20/$40	17b: $20/$30	18a: $0/$20	18b: $0		14a:  $0	13b: $0											105.7359	128.0613	24.2691	4	175.8453	0.089344518	0.099127772	50	150	0.04	0.064823276		22	19.5082	11.7759	25.4027	24	14			0.2	0.277529161																				11.608	0.688302893	1.036183935	0.487659943	2.891566507	0.953334098	1.25639536	1.151545528	5.279370346	0.827204419	3.716211181	0	0.010970886	2.268914381	5.024468372	11.94482937	0.553066333	1.42788844	0	0	5.856940188	3.071983806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.0549	0	0	11.608	0.688302893	1.036183935	0.487659943	2.891566507	0.953334098	1.25639536	1.151545528	5.279370346	0.827204419	3.716211181	0	0.010970886	2.268914381	5.024468372	11.94482937	0.553066333	1.42788844	0	0	5.856940188	3.071983806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.0549																																																																																				0	0	0	11.608	0.688302893	1.036183935	0.487659943	2.891566507	0.953334098	1.25639536	1.151545528	5.279370346	0.827204419	3.716211181	0	0.010970886	2.268914381	5.024468372	11.94482937	0.553066333	1.42788844	0	0	5.856940188	3.071983806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.0549
H5918_001_0	2008	5																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							14.42501295	12.34033493	388.3026855	432.7481105		175.2711911	48.47535188		1406.751401		4518.397765	240.5751381					1405.509985		821.9323512	337.0787762		315.7219071				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/PCP visit, $20/visit Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d)$20/visit, (7f)0"	"(7e,h)$20/visit"	"(7c,i)0"		(7g)$20/visit	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.178826353	0.178826353	35.3182	44.7066		17.8826	44.7066		44.6955		17.8826	17.8826					17.8826		20	20		19.9999				20											0	0	0	0	0	2.579572455	2.206777088	1.142846143	1.612224297	0	0.261192565	0.180597299	0	5.239619741	0	6.733404938	0.358509788	0	0	0	0	2.094518535	0	1.369887252	0.56179796	0	0.526201763	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	25.8072	0	2.653334216	0	0	0	0	0	2.579572455	2.206777088	1.142846143	1.612224297	0	0.261192565	0.180597299	0	5.239619741	0	6.733404938	0.358509788	0	0	0	0	2.094518535	0	1.369887252	0.56179796	0	0.526201763	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	25.8072		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.2906	0.0231	0.5813	0.3201	0.1211	0.0883	0.0756	0.0261	0.2956	0.08	0.1843	0.0207	0.0016	0.1827	0.0355	0.2466	0.0141	0.07			0.1843	0.0707			0.0066		0.0078															4.9266	0	0	2.2906	0.023136742	0.581267778	0.320083141	0.121095529	2.66788886	2.282330159	1.168931102	1.90783803	0.080027345	0.445517087	0.201345994	0.001552539	5.422319426	0.035477866	6.979971005	0.372564364	0.069955888	0	0	0.184269822	2.165226449	0	1.369887252	0.568429071	0	0.534044233	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	30.7338
H5918_002_0	2008	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							14.31331092	12.23653407	386.8980001	431.3392284		174.675073	48.25888159		1395.898832		4499.274577	239.7075935					1400.067404		821.9323512	337.0787762		315.7218685				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/PCP visit, $20/visit Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d)$20/visit, (7f)0"	"(7e,h)$20/visit"	"(7c,i)0"		(7g)$20/visit	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.178964623	0.178964623	35.3455	44.7412		17.8965	44.7412		44.73		17.8965	17.8965					17.8965		20	20		19.9999				20											0	0	0	0	0	2.561576289	2.189906703	1.139592357	1.608217964	0	0.260505488	0.179929845	0	5.203214286	0	6.710091477	0.357493159	0	0	0	0	2.088021123	0	1.369887252	0.56179796	0	0.526201715	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	25.6965	0	2.6209573	0	0	0	0	0	2.561576289	2.189906703	1.139592357	1.608217964	0	0.260505488	0.179929845	0	5.203214286	0	6.710091477	0.357493159	0	0	0	0	2.088021123	0	1.369887252	0.56179796	0	0.526201715	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	25.6965		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.2731	0.0229	0.5771	0.3171	0.1204	0.0876	0.0749	0.026	0.2935	0.0797	0.1834	0.0206	0.0015	0.1811	0.0353	0.2449	0.014	0.0697			0.1829	0.0703			0.0066		0.0078															4.8905	0	0	2.2731	0.022914663	0.57714875	0.317140275	0.120423275	2.649208805	2.264824259	1.165582954	1.901693456	0.079657281	0.44393132	0.200511505	0.001540982	5.384344046	0.035255633	6.954966502	0.37144598	0.069655936	0	0	0.182934119	2.158283468	0	1.369887252	0.568429071	0	0.53404418	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	30.587
H5918_003_0	2008	4	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						500	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	P	P	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T		V	P	V	P				V	P	V	V	V																																															0		1753.908919	82.67156035	9665.133631	224.26589	510.6253982	1858.673646	25.44016189	188.9693248	128.7673461	4821.926152	195.3139645	29.70444938	7.281915989	241.7034498	136.7890988	1439.352569	2157.055833	26.07639619		289.7679953	280.0361387	723.3857092	1817.255		287.28	278.16		95.475				108.4356599	1.369865384		234.745	287.945						(1a) $25/day	(1b) $25/day	(2a) $0/day	(6a) $0/proc	(10a) $50/trip	(11a) $0/proc	(11a/11c) $0/proc	(4a) $50/visit (waived if admitted)	(9a/9b) $0/visit	(8a) $0/visit	(8b) $0/visit	(9a) $0/visit	(12) $0/proc	(9a) $0/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $0/visit	(7e/7h) $0/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $0/visit	(15) $0/proc	(Misc. PBP Cats) $0/visit	(10b) $0/trip		(17a1) $0/visit	(17b2) $0/proc	(18a) $0/visit	(18b) $0/proc				(4b) $20/visit (waived if admitted)	(9c) $0/proc 75%/25% Ind/Grp Blended Copay	(9d) $0/visit	(7f1) $0/visit	(18a1) $0/visit						23.5751	23.5751			47.1503			47.1503																								18.8601										3.4457	0.162416135	0	0	2.006344219	0	0	0.742496385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.170425725	0	0	0	0	0	0	0	0	0	6.5274		0.39451027	3.4457	0.162416135	0	0	2.006344219	0	0	0.742496385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.170425725	0	0	0	0	0	0	0	0	0	6.5274		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					20	0.3	0.3	0.3	0.3						2.511	0.0382	1.0696	0.1296	0.4787	0.5062	0.0045	0.0414	0.2229	0.8763	0.8024	0.0409	0.0099	0.1318	0.0095	2.0584	0.2138	0.0032		0.2072		0.1039	0.1433		0.0146							0.0095	0.0001		0.013	0.0185						9.6585		0	5.9567	0.200646063	1.069612649	0.129599629	2.485084959	0.506167108	0.004549983	0.783937027	0.222887289	0.876286491	0.802410742	0.040883204	0.009915122	0.13180167	0.009508579	2.058422288	0.213826514	0.00321393	0	0.207183442	0	0.103937615	0.14325	0	0.01455	0	0	0	0	0	0	0.179937625	0.000123506	0	0.01305	0.01845	0	0	0	0	0	16.1859
H5918_004_0	2008	5																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0								25.24345312	511.0970538	517.6662308		188.8926838	85.73396135		2818.485724		5853.679391	532.9643734					0.097066495		821.9323512			240.9330307				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)0	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3,9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/PCP visit, $20/visit Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d)$20/visit, (7f)0"	"(7e,h)$20/visit"	"(7c,i)0"		(7g)$20/visit	(15) 0	"(13a,14a,17a,b)0, (16b)$20/visit"	(10b)0	(16a)$20/visit	(17a)0	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																	0.171882682	33.9468	42.9707		17.1883	42.9707		42.9151		17.1883	17.1883					17.1883		20			19.9989				20											0	0	0	0	0	0	4.338912436	1.445843724	1.853705424	0	0.27056151	0.307003818	0	10.07964386	0	8.384550965	0.763394551	0	0	0	0	0.000139034	0	1.369887252	0	0	0.401533098	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	30.1552	0	4.489390941	0	0	0	0	0	0	4.338912436	1.445843724	1.853705424	0	0.27056151	0.307003818	0	10.07964386	0	8.384550965	0.763394551	0	0	0	0	0.000139034	0	1.369887252	0	0	0.401533098	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	30.1552		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.9806	0.0715	0.3687	0.3561	0.0911	0.1753	0.1546	0.0299	0.3905	0.0605	0.1588	0.0317	0.0056	0.2724	0.0279	0.268	0.0336	0.0433			0.2391	0.0497			0.0066		0.006															5.8214	0	0	2.9806	0.071474774	0.368728912	0.356089745	0.091068106	0.175266162	4.49346419	1.47569929	2.244172106	0.060545621	0.429376074	0.338724397	0.005611063	10.35204459	0.027908793	8.652530425	0.797043173	0.043259831	0	0	0.239094725	0.049860484	0	1.369887252	0.006631111	0	0.407520409	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	35.9767
H5926_001_0	2008	7																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		315.7225435	25.84893344	63.94221749		12.61031693	27.67285891	19.83352782	10.3731247	23.41915038	11.65259748	23.83462994	0	4.263699797	41.21055551	58.81470714	109.3659216	10.08217925	4.823049094	24.3183946	38.38433492	9.786428634	0.723521383	0	0	0	0	0	0	0	0	0											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0.069169588	0.069169588	0.190928714	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.23	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.8384	1.787960089	12.20840535	0	2.950814161	6.475448984	4.64104551	2.427311179	5.48008119	2.726707811	5.577303407	0	0.997705753	9.64326999	13.76264147	25.59162566	2.359229945	1.128593488	5.690504337	8.981934372	2.2900243	0.169304004	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.7283	0	0	21.8384	1.787960089	12.20840535	0	2.950814161	6.475448984	4.64104551	2.427311179	5.48008119	2.726707811	5.577303407	0	0.997705753	9.64326999	13.76264147	25.59162566	2.359229945	1.128593488	5.690504337	8.981934372	2.2900243	0.169304004	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.7283																																																																																				0	0		21.8384	1.787960089	12.20840535	0	2.950814161	6.475448984	4.64104551	2.427311179	5.48008119	2.726707811	5.577303407	0	0.997705753	9.64326999	13.76264147	25.59162566	2.359229945	1.128593488	5.690504337	8.981934372	2.2900243	0.169304004	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.7283
H5926_002_0	2008	5																					2400											A	A			T	Coin	Coin	V	Coin		Coin			V	V	V	V	P	Coin	P	Coin				V																																																										0		279.3416445	4.140004331	0	0	235.9109288	13.28259781	8.300859	444.7491175	35.48266665	0	15.39642605	0	0	588.1617652	8573.970283	16008.39924	206.6241352	1702.127885	27.9751179	2276.99764	10.2367619	0	0	0	453.6710793	0	0	0	0	0	0											$250/Admit for IP Medical; $250/Admit for IP Surgical	$250/Admit for IP Psych; $250/Admit for IP Substance Abuse	No Cost Sharing	No Cost Sharing	$125/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $30/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology;	No Cost Sharing	No Cost Sharing	$20/Case for OP Fac - Occ Therapy; $20/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $7/Service for Prof - CORF; $7/Service for Prof - CORF;	$10/Visit for PCP - Office Visits; $8/Consult for PCP - Consults; 20% Coinsurance for PCP - Primary Surgeon (OP); $3/Procedure for PCP - Asst Surgeon (OP); $3/Services for PCP - Tx Injections; $1/Tests for PCP - Allergy Testing; $6/Service for PCP - Allergy Tx;	20% Coinsurance for Speclst - Primary Surgeon (OP); $7/Procedure for Speclst - Asst Surgeon (OP); 20% Coinsurance for Speclst - Anesthesia (OP); $20/Visit for Speclst - Office Visits; $6/Services for Speclst - Tx Injections; $1/Tests for Speclst - Allergy Testing; $12/Service for Speclst - Allergy Tx; $16/Consult for Speclst - Consults;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$7/Service for PT/ST (PCP); $7/Service for Occ Therapy (PCP); $7/Service for PT/ST (Specialist); $7/Service for Occ Therapy (Specialist);	3% Coinsurance for Prof Radiology (Office); 4% Coinsurance for Prof Radiology (OP);	$20/Visit for Chiropractor; $20/Exam for Vistion Exams; $20/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	No Cost Sharing	$20/Exam for Vision (Refractions)	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											250	249.9999999	0	0	125	0.2	0.2	44.94276606	0.2	0	0.2	0	0	15.71262348	6.938789479	11.91136822	20	6.666666667	0.031989003	20	0.2	0	0	0	20	0	0	0	0	0	0											5.8196	0.08625009	0	0	2.457405508	2.656519563	1.6601718	1.665687962	7.09653333	0	3.07928521	0	0	0.770130364	4.957747899	15.8901615	0.344373559	0.945626603	0.894896123	3.794996066	2.047352381	0	0	0	0.756118466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9229	0	0	5.8196	0.08625009	0	0	2.457405508	2.656519563	1.6601718	1.665687962	7.09653333	0	3.07928521	0	0	0.770130364	4.957747899	15.8901615	0.344373559	0.945626603	0.894896123	3.794996066	2.047352381	0	0	0	0.756118466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9229																																																																																				0	0		5.8196	0.08625009	0	0	2.457405508	2.656519563	1.6601718	1.665687962	7.09653333	0	3.07928521	0	0	0.770130364	4.957747899	15.8901615	0.344373559	0.945626603	0.894896123	3.794996066	2.047352381	0	0	0	0.756118466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9229
H5928_001_0	2008	4																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5928_002_0	2008	5																																D	D	D		T	coin	coin	V	V	V	V			V			V			V	coin	V			V		V																																																								0		1337.223151	19.90256249	881.0674016		654.0320437	24.24417531	1.691318478	259.8632678	141.4785481	2910.811685	1474.88484			3096.415452			911.8593713			10764.04772	30.99341102	95.08659953			443.8783091		195.4849286															$50/day for days 1-3	$50/day for days 1-3	$50/day after day 20		$50 copay	20% coinsurance	20% coinsurance	$50 ER; $15/$25 urgent care	$20/$50 copay	$10 copay	$10 copay			$10 copay on other OP services			$10 copay			"$3 PCP, $5 Specialist, $5 Chiropractic, $3 Physical Exam"	20% coinsurance	$10 copay			$5 copay		$10 copay															25.7	50	11.1		50	0.2	0.2	36.79741902	27.5	10	10			10			10			4.231588326	0.2	10			5		10															2.8639	0.082927344	0.814987346	0	2.725133516	4.848835062	0.338263696	0.796858129	0.324221673	2.425676404	1.2290707	0	0	2.58034621	0	0	0.759882809	0	0	3.795751556	6.198682204	0.079238833	0	0	0.184949295	0	0.162904107	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2116			2.8639	0.082927344	0.814987346	0	2.725133516	4.848835062	0.338263696	0.796858129	0.324221673	2.425676404	1.2290707	0	0	2.58034621	0	0	0.759882809	0	0	3.795751556	6.198682204	0.079238833	0	0	0.184949295	0	0.162904107	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2116																																																																																				0			2.8639	0.082927344	0.814987346	0	2.725133516	4.848835062	0.338263696	0.796858129	0.324221673	2.425676404	1.2290707	0	0	2.58034621	0	0	0.759882809	0	0	3.795751556	6.198682204	0.079238833	0	0	0.184949295	0	0.162904107	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2116
H5928_003_0	2008	6																																	D	D		T	coin	coin	V	V	V	V			V			V			V	coin	V			V		V																																																								0			20.91361266	925.8256256		687.2568715	25.47577941	1.777237457	273.0516218	148.6656583	3058.680919	1549.80899			3297.921137			958.1818274			11308.57534	32.5678763	795.0503639			443.8783091		227.415563																$50/day for days 1-3	$50/day after day 20		$50 copay	20% coinsurance	20% coinsurance	$50 ER; $15/$25 urgent care	$20/$50 copay	$10 copay	$10 copay			$10 copay on other OP services			$10 copay			"$3 PCP, $5 Specialist, $5 Chiropractic, $3 Physical Exam"	20% coinsurance	$10 copay			$5 copay		$10 copay																50	5.55		50	0.2	0.2	36.79913052	27.5	10	10			10			10			4.231837289	0.2	1.256737979			5		9.032607984															0	0.087140053	0.428194352	0	2.863570298	5.095155883	0.355447491	0.837338522	0.340692134	2.548900766	1.291507491	0	0	2.748267614	0	0	0.798484856	0	0	3.988004235	6.51357526	0.083264166	0	0	0.184949295	0	0.171179636	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.3357			0	0.087140053	0.428194352	0	2.863570298	5.095155883	0.355447491	0.837338522	0.340692134	2.548900766	1.291507491	0	0	2.748267614	0	0	0.798484856	0	0	3.988004235	6.51357526	0.083264166	0	0	0.184949295	0	0.171179636	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.3357																																																																																				0			0	0.087140053	0.428194352	0	2.863570298	5.095155883	0.355447491	0.837338522	0.340692134	2.548900766	1.291507491	0	0	2.748267614	0	0	0.798484856	0	0	3.988004235	6.51357526	0.083264166	0	0	0.184949295	0	0.171179636	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.3357
H5928_004_0	2008	5																																D	D	D		T	coin	coin	V	V	V	V			V			V			V	coin	V			V		V																																																								0		1329.071116	28.05459751	881.0674016		654.0320437	23.62310666	1.647991581	259.8632678	141.4785481	2910.811685	1474.88484			3096.415452			911.8593713			10764.04772	32.13078682	756.6143547			443.8783091		217.4849286															$50/day for days 1-3	$50/day for days 1-3	$50/day after day 20		$50 copay	20% coinsurance	20% coinsurance	$50 ER; $15/$25 urgent care	$20/$50 copay	$10 copay	$10 copay			$10 copay on other OP services			$10 copay			"$3 PCP, $5 Specialist, $5 Chiropractic, $3 Physical Exam"	20% coinsurance	$10 copay			$5 copay		$10 copay															25.7	42.93896657	11.1		50	0.2	0.2	36.79741902	27.5	10	10			10			10			4.231588326	0.2	1.256737979			5		8.988435652															2.8464	0.100386285	0.814987346	0	2.725133516	4.724621333	0.329598316	0.796858129	0.324221673	2.425676404	1.2290707	0	0	2.58034621	0	0	0.759882809	0	0	3.795751556	6.426157365	0.079238833	0	0	0.184949295	0	0.162904107	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.3062			2.8464	0.100386285	0.814987346	0	2.725133516	4.724621333	0.329598316	0.796858129	0.324221673	2.425676404	1.2290707	0	0	2.58034621	0	0	0.759882809	0	0	3.795751556	6.426157365	0.079238833	0	0	0.184949295	0	0.162904107	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.3062																																																																																				0			2.8464	0.100386285	0.814987346	0	2.725133516	4.724621333	0.329598316	0.796858129	0.324221673	2.425676404	1.2290707	0	0	2.58034621	0	0	0.759882809	0	0	3.795751556	6.426157365	0.079238833	0	0	0.184949295	0	0.162904107	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.3062
H5928_005_0	2008	6																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5928_006_0	2008	8																																D	D	D		T	coin	coin	V	V	V	V			V			V			V	coin	V			V		V																																																								0		1182.634061	24.96354195	783.9913953		581.9707931	20.15718678	1.406202605	231.2315329	125.8904416	2590.098454	1312.382028			2755.252398			811.3907058			9578.064942	25.76866266	673.2505851			394.971797		193.5224392															$50/day for days 1-3	$50/day for days 1-3	$50/day after day 20		$50 copay	20% coinsurance	20% coinsurance	$50 ER; $15/$25 urgent care	$20/$50 copay	$10 copay	$10 copay			$10 copay on other OP services			$10 copay			"$3 PCP, $5 Specialist, $5 Chiropractic, $3 Physical Exam"	20% coinsurance	$10 copay			$5 copay		$10 copay															25.7	42.93896657	11.1		50	0.2	0.2	36.79741902	27.5	10	10			10			10			4.231588326	0.2	1.256737979			5		8.988435652															2.5328	0.089325724	0.725192041	0	2.424878305	4.031437356	0.281240521	0.709060301	0.288498929	2.158415378	1.09365169	0	0	2.296043665	0	0	0.676158921	0	0	3.37753565	5.153732531	0.070508298	0	0	0.164571582	0	0.144955333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.218			2.5328	0.089325724	0.725192041	0	2.424878305	4.031437356	0.281240521	0.709060301	0.288498929	2.158415378	1.09365169	0	0	2.296043665	0	0	0.676158921	0	0	3.37753565	5.153732531	0.070508298	0	0	0.164571582	0	0.144955333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.218																																																																																				0			2.5328	0.089325724	0.725192041	0	2.424878305	4.031437356	0.281240521	0.709060301	0.288498929	2.158415378	1.09365169	0	0	2.296043665	0	0	0.676158921	0	0	3.37753565	5.153732531	0.070508298	0	0	0.164571582	0	0.144955333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.218
H5928_007_0	2008	6																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5928_008_0	2008	8																																D	D	D		T	coin	coin	V	V	V	V			V			V			V	coin	V			V		V																																																								0		1196.021743	25.24613483	792.8663532		588.5588326	20.14969758	1.405680144	233.8491256	127.3155496	2619.418947	1327.238486			2786.442471			820.57583			9686.490779	25.75908857	680.8719323			399.442966		195.7131564															$50/day for days 1-3	$50/day for days 1-3	$50/day after day 20		$50 copay	20% coinsurance	20% coinsurance	$50 ER; $15/$25 urgent care	$20/$50 copay	$10 copay	$10 copay			$10 copay on other OP services			$10 copay			"$3 PCP, $5 Specialist, $5 Chiropractic, $3 Physical Exam"	20% coinsurance	$10 copay			$5 copay		$10 copay															25.7	42.93896657	11.1		50	0.2	0.2	36.79741902	27.5	10	10			10			10			4.231588326	0.2	1.256737979			5		8.988435652															2.5615	0.090336912	0.733401377	0	2.452328469	4.029939517	0.281136029	0.717087022	0.291764801	2.182849123	1.106032072	0	0	2.322035393	0	0	0.683813192	0	0	3.415770108	5.151817714	0.071306468	0	0	0.166434569	0	0.146596259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.4041			2.5615	0.090336912	0.733401377	0	2.452328469	4.029939517	0.281136029	0.717087022	0.291764801	2.182849123	1.106032072	0	0	2.322035393	0	0	0.683813192	0	0	3.415770108	5.151817714	0.071306468	0	0	0.166434569	0	0.146596259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.4041																																																																																				0			2.5615	0.090336912	0.733401377	0	2.452328469	4.029939517	0.281136029	0.717087022	0.291764801	2.182849123	1.106032072	0	0	2.322035393	0	0	0.683813192	0	0	3.415770108	5.151817714	0.071306468	0	0	0.166434569	0	0.146596259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.4041
H5928_009_0	2008	6																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5928_010_0	2008	8																																D	D	D		T	coin	coin	V	V	V	V			V			V			V	coin	V			V		V																																																								0		1166.073835	24.61398167	773.0132955		573.8215539	18.50446332	1.290905561	227.9936366	124.1276189	2553.82974	1294.004963			2716.671061			800.028938			9443.944908	23.65584434	663.8231703			389.4410733		190.8125769															$50/day for days 1-3	$50/day for days 1-3	$50/day after day 20		$50 copay	20% coinsurance	20% coinsurance	$50 ER; $15/$25 urgent care	$20/$50 copay	$10 copay	$10 copay			$10 copay on other OP services			$10 copay			"$3 PCP, $5 Specialist, $5 Chiropractic, $3 Physical Exam"	20% coinsurance	$10 copay			$5 copay		$10 copay															25.7	42.93896657	11.1		50	0.2	0.2	36.79741902	27.5	10	10			10			10			4.231588326	0.2	1.256737979			5		8.988435652															2.4973	0.088074911	0.715037298	0	2.390923141	3.700892664	0.258181112	0.699131448	0.284459127	2.12819145	1.078337469	0	0	2.263892551	0	0	0.666690782	0	0	3.330240585	4.731168869	0.069520982	0	0	0.162267114	0	0.142925547	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2073			2.4973	0.088074911	0.715037298	0	2.390923141	3.700892664	0.258181112	0.699131448	0.284459127	2.12819145	1.078337469	0	0	2.263892551	0	0	0.666690782	0	0	3.330240585	4.731168869	0.069520982	0	0	0.162267114	0	0.142925547	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2073																																																																																				0			2.4973	0.088074911	0.715037298	0	2.390923141	3.700892664	0.258181112	0.699131448	0.284459127	2.12819145	1.078337469	0	0	2.263892551	0	0	0.666690782	0	0	3.330240585	4.731168869	0.069520982	0	0	0.162267114	0	0.142925547	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2073
H5932_001_0	2008	3																																D	D	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		3939.221817	167.3504814	57.36519531	21.52553541	19.72438863	24.54117045	10.11058722	1718.378632	24.38744955	16.10388547	23.38866008	0	0.31973914	46.92333881	33.50006636	137.9000955	10.0062946	0.24542542	1.149752778	8.547226871	30.58397115	0.164166314	0	1.886219558	5.581777039	0	0	1.628208045	0	2.35800976	0											$135/day: PBP 1a	FFS Medicare: PBP 1b	FFS Medicare: PBP 2	FFS Medicare: PBP 6	FFS Medicare: PBP 10a	FFS Medicare: PBP 11a	"FFS Medicare: PBP 11b, 11c"	"$50 copay: PBP 4a, 4b"	"FFS Medicare: PBP 9a, 9b"	FFS Medicare: PBP 8a	FFS Medicare: PBP 8b	FFS Medicare:	FFS Medicare: PBP 12	"FFS Medicare: PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"FFS Medicare: PBP 4b, 7a, 14b-i"	"FFS Medicare: PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"FFS Medicare: PBP 7e, 7h"	"FFS Medicare: PBP 7c, 7i"	FFS Medicare: PBP 7d	"FFS Medicare: PBP 7d, 7g"	FFS Medicare: PBP 15	FFS Medicare: PBP 7g																				135	211.3621422	0.16509117	0.002756605	0.204431788	0.213233987	0.211160595	30.15039629	0.179893007	7.66E-06	0.203577264	0	0.181414395	0.272590405	0.279386443	0.22741717	0.306155419	0.205168293	0.238286215	0.000177266	0.102436947	0.069040639	0	0	0	0	0	0	0	0.000734556	0											44.3162	2.947629688	9.470487186	0.0593374	4.032292039	5.233011626	2.134957616	4.317483062	4.387131626	0.000123277	4.761399426	0	0.058005282	12.79085195	9.359464391	31.36084941	3.063481317	0.050353515	0.273970237	0.00151513	3.132928643	0.011334147	0	0	0	0	0	0	0	0.00173209	0	0	0	0	0	0	0	0	0	0	0	141.7646	135	0	44.3162	2.947629688	9.470487186	0.0593374	4.032292039	5.233011626	2.134957616	4.317483062	4.387131626	0.000123277	4.761399426	0	0.058005282	12.79085195	9.359464391	31.36084941	3.063481317	0.050353515	0.273970237	0.00151513	3.132928643	0.011334147	0	0	0	0	0	0	0	0.00173209	0	0	0	0	0	0	0	0	0	0	0	141.7646																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	44.3162	2.947629688	9.470487186	0.0593374	4.032292039	5.233011626	2.134957616	4.317483062	4.387131626	0.000123277	4.761399426	0	0.058005282	12.79085195	9.359464391	31.36084941	3.063481317	0.050353515	0.273970237	0.00151513	3.132928643	0.011334147	0	0	0	0	0	0	0	0.00173209	0	0	0	0	0	0	0	0	0	0	0	141.7646
H5938_001_0	2008	4																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1133.880775	28.54285347	1617.365874	1762.20091	164.7872085	18100.96694	18228.86415	239.7771269	202.1830076	1679.153046	672.5585971	0	53.65606865	487.5456165	4382.941976	6641.62845	87.54944256	249.7228484	2650.586181	7609.179122	750.2714765	0	0	0	48.04533494	36.99586271	0	0	0	0	0.104328617											"$250 copay, days 1-5"	"$250 copay, days 1-6"	"$75 copay, days 7-100"	$0 copay	$100 copay	20% copay	20% copay	$50 copay	$100 copay	$10 copay	20% copay	$0 copay	$0 copay	$0 to $25 copay	$15 copay	$25 copay	$25 copay	$25 copay	$0 copay	$15 copay	$0 copay	$0 copay	$0 copay	$0 copay	$15 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											67.01606718	67.01606718	59.07391883	0	100	1.034469556	1.135495885	50	100	15.50700211	22.25021915	0	0	23.50402175	9.505335229	13.36735901	25	25	0	8.239970677	0	0	0	0	15	0	0	0	0	0	0.886791674											6.3324	0.159402482	7.962011697	0	1.373226738	1.560408269	1.72490002	0.999071362	1.684858397	2.169885819	1.247048015	0	0	0.954940231	3.471777731	7.398419323	0.182394672	0.520255934	0	5.22495107	0	0	0	0	0.060056669	0	0	0	0	0	7.71E-06	0	0	0	0	0	0	0	0	0	0	43.026			6.3324	0.159402482	7.962011697	0	1.373226738	1.560408269	1.72490002	0.999071362	1.684858397	2.169885819	1.247048015	0	0	0.954940231	3.471777731	7.398419323	0.182394672	0.520255934	0	5.22495107	0	0	0	0	0.060056669	0	0	0	0	0	7.71E-06	0	0	0	0	0	0	0	0	0	0	43.026																																																																																				0			6.3324	0.159402482	7.962011697	0	1.373226738	1.560408269	1.72490002	0.999071362	1.684858397	2.169885819	1.247048015	0	0	0.954940231	3.471777731	7.398419323	0.182394672	0.520255934	0	5.22495107	0	0	0	0	0.060056669	0	0	0	0	0	7.71E-06	0	0	0	0	0	0	0	0	0	0	43.026
H5938_006_0	2008	4																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	V	T	V	P	P	P	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1196.244217	30.11271041	1706.320997	1859.12196	173.850505	19096.52012	19231.45168	252.9648689	213.303073	1771.506464	709.5493199	0	56.60715242	514.3606254	4617.948782	6997.742653	92.24371298	263.1126148	2792.706656	8017.171948	791.5364077	0	0	0	50.68782837	39.03063516	0	0	0	0	0.111694043											"$250 copay, days 1-5"	"$250 copay, days 1-6"	"$75 copay, days 7-100"	$0 copay	$100 copay	20% copay	20% copay	$50 copay	$100 copay	$10 copay	20% copay	$0 copay	$0 copay	$0 to $25 copay	$15 copay	$25 copay	$25 copay	$25 copay	$0 copay	$15 copay	$0 copay	$0 copay	$0 copay	$0 copay	$15 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											67.01606718	67.01606718	59.07391883	0	100	1.050697224	1.153308348	50	100	15.63850396	22.25021915	0	0	23.50402175	9.506064923	13.36999121	25	25	0	8.239970677	0	0	0	0	15	0	0	0	0	0	0.886791674											6.6806	0.168169619	8.39992234	0	1.448754208	1.672055056	1.848316146	1.054020287	1.777525608	2.30864257	1.315635656	0	0	1.007461944	3.658210077	7.796646477	0.192174402	0.548151281	0	5.505105147	0	0	0	0	0.063359785	0	0	0	0	0	8.25E-06	0	0	0	0	0	0	0	0	0	0	45.4448			6.6806	0.168169619	8.39992234	0	1.448754208	1.672055056	1.848316146	1.054020287	1.777525608	2.30864257	1.315635656	0	0	1.007461944	3.658210077	7.796646477	0.192174402	0.548151281	0	5.505105147	0	0	0	0	0.063359785	0	0	0	0	0	8.25E-06	0	0	0	0	0	0	0	0	0	0	45.4448																																																																																				0			6.6806	0.168169619	8.39992234	0	1.448754208	1.672055056	1.848316146	1.054020287	1.777525608	2.30864257	1.315635656	0	0	1.007461944	3.658210077	7.796646477	0.192174402	0.548151281	0	5.505105147	0	0	0	0	0.063359785	0	0	0	0	0	8.25E-06	0	0	0	0	0	0	0	0	0	0	45.4448
H5938_802_0	2008	4																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				18.4252	0.2192	0	0	0.2565	0.1731	0.19	0.2433	1.1543	0.5239	0.6765	0	0.0309	0.6787	1.4513	3.698	0.0431	0.1304	1.2852	1.5298	0.2406	0																				30.9499		838.1269433	23.38665127	1502.597388	444.2241315	7.543249648	5.090857382	5.587746794	7.156159618	33.95094565	15.40908732	19.89787106	0	0.907533629	19.96195785	42.68423096	108.7640034	1.266746893	3.836351697	37.79952247	44.9948676	7.075063971	0	0	0	0	0	0	0	0	0	0											Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	$0 per visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	0	0	0	0	0	0	0	0	0											10.03199565	4.277059825	50.53462224	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0	0	0	0	0	0	0	0											0.7007	0.008335509	6.327765949	0	1.50864993	1.018171476	1.117549359	1.431231924	6.790189129	3.081817465	3.979574212	0	0.181506726	3.99239157	8.536846193	21.75280067	0.253349379	0.767270339	7.559904494	8.99897352	1.415012794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.422	Medicare Allowed		19.1259	0.227529754	6.327765949	0	1.765120418	1.191260627	1.30753275	1.674541351	7.944521281	3.605726434	4.656101829	0	0.212362869	4.671098137	9.988110045	25.45077679	0.296418773	0.897706297	8.845088258	10.52879902	1.655564969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.3719																																																																																				0			19.1259	0.227529754	6.327765949	0	1.765120418	1.191260627	1.30753275	1.674541351	7.944521281	3.605726434	4.656101829	0	0.212362869	4.671098137	9.988110045	25.45077679	0.296418773	0.897706297	8.845088258	10.52879902	1.655564969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.3719
H5938_803_0	2008	4																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				18.4252	0.2192	0	0	0.2565	0.1731	0.19	0.2433	1.1543	0.5239	0.6765	0	0.0309	0.6787	1.4513	3.698	0.0431	0.1304	1.2852	1.5298	0.2406	0																				30.9499		838.1269433	23.38665127	1502.597388	444.2241315	7.543249648	5.090857382	5.587746794	7.156159618	33.95094565	15.40908732	19.89787106	0	0.907533629	19.96195785	42.68423096	108.7640034	1.266746893	3.836351697	37.79952247	44.9948676	7.075063971	0	0	0	0	0	0	0	0	0	0											Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	$0 per visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	0	0	0	0	0	0	0	0	0											10.03199565	4.277059825	50.53462224	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0	0	0	0	0	0	0	0											0.7007	0.008335509	6.327765949	0	1.50864993	1.018171476	1.117549359	1.431231924	6.790189129	3.081817465	3.979574212	0	0.181506726	3.99239157	8.536846193	21.75280067	0.253349379	0.767270339	7.559904494	8.99897352	1.415012794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.422	Medicare Allowed		19.1259	0.227529754	6.327765949	0	1.765120418	1.191260627	1.30753275	1.674541351	7.944521281	3.605726434	4.656101829	0	0.212362869	4.671098137	9.988110045	25.45077679	0.296418773	0.897706297	8.845088258	10.52879902	1.655564969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.3719																																																																																				0			19.1259	0.227529754	6.327765949	0	1.765120418	1.191260627	1.30753275	1.674541351	7.944521281	3.605726434	4.656101829	0	0.212362869	4.671098137	9.988110045	25.45077679	0.296418773	0.897706297	8.845088258	10.52879902	1.655564969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.3719
H5938_804_0	2008	4																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				18.4252	0.2192	0	0	0.2565	0.1731	0.19	0.2433	1.1543	0.5239	0.6765	0	0.0309	0.6787	1.4513	3.698	0.0431	0.1304	1.2852	1.5298	0.2406	0																				30.9499		838.1269433	23.38665127	1502.597388	444.2241315	7.543249648	5.090857382	5.587746794	7.156159618	33.95094565	15.40908732	19.89787106	0	0.907533629	19.96195785	42.68423096	108.7640034	1.266746893	3.836351697	37.79952247	44.9948676	7.075063971	0	0	0	0	0	0	0	0	0	0											Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	$0 per visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	0	0	0	0	0	0	0	0	0											10.03199565	4.277059825	50.53462224	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0	0	0	0	0	0	0	0											0.7007	0.008335509	6.327765949	0	1.50864993	1.018171476	1.117549359	1.431231924	6.790189129	3.081817465	3.979574212	0	0.181506726	3.99239157	8.536846193	21.75280067	0.253349379	0.767270339	7.559904494	8.99897352	1.415012794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.422	Medicare Allowed		19.1259	0.227529754	6.327765949	0	1.765120418	1.191260627	1.30753275	1.674541351	7.944521281	3.605726434	4.656101829	0	0.212362869	4.671098137	9.988110045	25.45077679	0.296418773	0.897706297	8.845088258	10.52879902	1.655564969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.3719																																																																																				0			19.1259	0.227529754	6.327765949	0	1.765120418	1.191260627	1.30753275	1.674541351	7.944521281	3.605726434	4.656101829	0	0.212362869	4.671098137	9.988110045	25.45077679	0.296418773	0.897706297	8.845088258	10.52879902	1.655564969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.3719
H5948_001_0	2008	3																																A	A	D		T	Coin	Coin	V	V		V		Coin	V		V	V	P		V	Coin	Coin		P	V						V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		202.1629857	2.333620133	184.9365713	0	159.1395158	9.692072347	5.74502307	326.1004306	228.2482989	0	154.8287353	0	0.398386191	509.8904761	0	3684.804153	151.523786	349.7447469	0	1625.975375	10.13117833	1.09772457	0	711.63125	525.9007361	0	0	0	0	0	964.9945714											$200/Admit for IP Medical; $200/Admit for IP Surgical	$750/Admit for IP Psych; $750/Admit for IP Substance Abuse	$50/Day for SNF		$100/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	$100/Case for OP Fac - Surgery; $100/Case for OP Fac - ASC		$100/Case for OP Fac - CT/MRI/PET		20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	$10/Case for OP Fac - Cardiovascular; $10/Case for OP Fac - Occ Therapy; $10/Case for OP Fac - Physical/Speech Therapy; $10/Case for OP Fac - CORF; $10/Service for Prof - CORF; $10/Service for Prof - CORF;		$10/Visit for Speclst - Office Visits; $10/Consult for Speclst - Consults;	$25/Visit for OP Psych - Non-Physician; $25/Visit for OP Psych - Psychiatrist; $25/Visit for OP Substance Abuse;	$10/Service for PT/ST (PCP); $10/Service for Occ Therapy (PCP); $10/Service for PT/ST (Specialist); $10/Service for Occ Therapy (Specialist);		$15/Visit for Chiropractor; $10/Exam for Vistion Exams; $10/Service for Podiatrist; $10/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	20% Coinsurance for Blood Products		$20/Procedure for Dental - Comprehensive;	$25/Exam for Vision (Refractions)						$15/Visit for Private Duty Nursing;											200	750	50	0	100	0.2	0.2	42.41813304	100	0	100	0	0.2	10	0	10	25	10	0	10.80150983	0.2	0.2	0	20	25	0	0	0	0	0	13.00623891											3.3694	0.145851258	0.770569047	0	1.326162632	1.938414469	1.149004614	1.152714288	1.902069158	0	1.290239461	0	0.079677238	0.42490873	0	3.070670128	0.315674554	0.291453956	0	1.463582417	2.026235666	0.219544914	0	1.186052083	1.095626534	0	0	0	0	0	1.045912496	0	0	0	0	0	0	0	0	0	0	24.2637	0	0	3.3694	0.145851258	0.770569047	0	1.326162632	1.938414469	1.149004614	1.152714288	1.902069158	0	1.290239461	0	0.079677238	0.42490873	0	3.070670128	0.315674554	0.291453956	0	1.463582417	2.026235666	0.219544914	0	1.186052083	1.095626534	0	0	0	0	0	1.045912496	0	0	0	0	0	0	0	0	0	0	24.2637																																																																																				0	0		3.3694	0.145851258	0.770569047	0	1.326162632	1.938414469	1.149004614	1.152714288	1.902069158	0	1.290239461	0	0.079677238	0.42490873	0	3.070670128	0.315674554	0.291453956	0	1.463582417	2.026235666	0.219544914	0	1.186052083	1.095626534	0	0	0	0	0	1.045912496	0	0	0	0	0	0	0	0	0	0	24.2637
H5948_002_0	2008	4																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		319.486008	24.07433714	44.90843077	0	14.74465704	32.09977622	23.23820912	13.11194493	29.07220859	14.01025591	28.79568936	0	5.314414035	49.72733145	88.28147025	169.8422951	16.46854655	8.003750474	37.19453314	66.46123867	12.08122891	0.893178481	0	0	0	0	0	0	0	0	0											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing																				0.070190507	0.070190507	0.166498629	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.232948891	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.4249	1.689789938	7.477192152	0	3.450249748	7.511347636	5.437740935	3.068195114	6.802896809	3.278399883	6.73819131	0	1.243572884	11.63619556	20.56507061	39.74309706	3.853639894	1.872877611	8.703520755	15.55192985	2.827007566	0.209003764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	174.0848	0	0	22.4249	1.689789938	7.477192152	0	3.450249748	7.511347636	5.437740935	3.068195114	6.802896809	3.278399883	6.73819131	0	1.243572884	11.63619556	20.56507061	39.74309706	3.853639894	1.872877611	8.703520755	15.55192985	2.827007566	0.209003764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	174.0848																																																																																				0	0		22.4249	1.689789938	7.477192152	0	3.450249748	7.511347636	5.437740935	3.068195114	6.802896809	3.278399883	6.73819131	0	1.243572884	11.63619556	20.56507061	39.74309706	3.853639894	1.872877611	8.703520755	15.55192985	2.827007566	0.209003764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	174.0848
H5948_003_0	2008	4																																A	A	D		T	Coin	Coin	V	V		V		Coin	V	V	V	V	P		V	Coin	Coin		P	V						V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		207.0949376	2.491179004	181.1880475	0	162.0019295	11.37435805	6.704179213	326.7057837	230.9621122	0	160.7315348	0	0.333936169	523.3368914	4074.140257	3651.973819	146.9049255	340.5990741	0	1606.309777	8.010564286	0.867953652	0	701.04375	480.8600662	0	0	0	0	0	909.3988886											$250/Admit for IP Medical; $250/Admit for IP Surgical	$750/Admit for IP Psych; $750/Admit for IP Substance Abuse	$50/Day for SNF		$100/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care;	$100/Case for OP Fac - Surgery; $100/Case for OP Fac - ASC		$100/Case for OP Fac - CT/MRI/PET		20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	$10/Case for OP Fac - Cardiovascular; $10/Case for OP Fac - Occ Therapy; $10/Case for OP Fac - Physical/Speech Therapy; $10/Case for OP Fac - CORF; $10/Service for Prof - CORF; $10/Service for Prof - CORF;	$5/Visit for PCP - Office Visits; $5/Consult for PCP - Consults;	$10/Visit for Speclst - Office Visits; $10/Consult for Speclst - Consults;	$25/Visit for OP Psych - Non-Physician; $25/Visit for OP Psych - Psychiatrist; $25/Visit for OP Substance Abuse;	$10/Service for PT/ST (PCP); $10/Service for Occ Therapy (PCP); $10/Service for PT/ST (Specialist); $10/Service for Occ Therapy (Specialist);		$15/Visit for Chiropractor; $10/Exam for Vistion Exams; $10/Service for Podiatrist; $10/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	20% Coinsurance for Blood Products		$20/Procedure for Dental - Comprehensive;	$25/Exam for Vision (Refractions)						$15/Visit for Private Duty Nursing;											250	750.0000002	50	0	100	0.2	0.2	42.54900413	100	0	100	0	0.2	9.999999998	5	10	25.00000001	9.999999996	0	10.82400581	0.2	0.2	0	20	25	0	0	0	0	0	13.36689112											4.3145	0.155698688	0.754950198	0	1.350016079	2.274871611	1.340835843	1.158417145	1.924684268	0	1.339429456	0	0.066787234	0.436114076	1.697558441	3.043311516	0.306051928	0.283832562	0	1.448892197	1.602112857	0.173590731	0	1.16840625	1.001791805	0	0	0	0	0	1.012986327	0	0	0	0	0	0	0	0	0	0	26.8548	0	0	4.3145	0.155698688	0.754950198	0	1.350016079	2.274871611	1.340835843	1.158417145	1.924684268	0	1.339429456	0	0.066787234	0.436114076	1.697558441	3.043311516	0.306051928	0.283832562	0	1.448892197	1.602112857	0.173590731	0	1.16840625	1.001791805	0	0	0	0	0	1.012986327	0	0	0	0	0	0	0	0	0	0	26.8548																																																																																				0	0		4.3145	0.155698688	0.754950198	0	1.350016079	2.274871611	1.340835843	1.158417145	1.924684268	0	1.339429456	0	0.066787234	0.436114076	1.697558441	3.043311516	0.306051928	0.283832562	0	1.448892197	1.602112857	0.173590731	0	1.16840625	1.001791805	0	0	0	0	0	1.012986327	0	0	0	0	0	0	0	0	0	0	26.8548
H5949_001_0	2008	5																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	347.79	23.28	185.05	65.5	19.47	31.26	28.75	8.45	22.12	14.15	25.89	1.26	2.23	53.52	69.17	125.85	8.13	5.79	31.38	50.36	10.36	4.79	0	5.72	2.02	1.73	0	0	0	1.8	0											Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing	Standard Medicare FFS Cost Sharing											0.068192157	0.068188521	0.192009149	0	0.234037129	0.234000239	0.233984774	0.234063882	0.234000012	0.234047193	0.23402567	0.233999904	0.234000015	0.234012986	0.233987634	0.233999903	0.233990913	0.23401759	0.234006066	0.234025772	0.234006117	0.233996622	0	0	0	0	0	0	0	0	0											23.7166	1.587428765	35.53129306	0	4.556702898	7.31484747	6.727062264	1.977839802	5.176080256	3.311767777	6.058924591	0.294839879	0.521820033	12.524375	16.18492461	29.44888774	1.902346123	1.354961849	7.343110348	11.78553786	2.424303367	1.120843821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	180.8644	0	0	23.7166	1.587428765	35.53129306	0	4.556702898	7.31484747	6.727062264	1.977839802	5.176080256	3.311767777	6.058924591	0.294839879	0.521820033	12.524375	16.18492461	29.44888774	1.902346123	1.354961849	7.343110348	11.78553786	2.424303367	1.120843821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	180.8644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.7166	1.587428765	35.53129306	0	4.556702898	7.31484747	6.727062264	1.977839802	5.176080256	3.311767777	6.058924591	0.294839879	0.521820033	12.524375	16.18492461	29.44888774	1.902346123	1.354961849	7.343110348	11.78553786	2.424303367	1.120843821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	180.8644
H5950_001_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7704.379779	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961				0		0															225/d 10	225/d 10	"$0 days 1-8, $75 days 9-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $25 UC	$225 per visit	$35 per visit	"$35 X-ray; $175 PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$25 per visit	"$35 Specialist, $30 Renal Dialysis"	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															184.42	184.42	66.23	20	100	0.2	0.2	46.75	225	35	60.2	35	30	35	25	34.61	35	35	35	35	45				0		0															24.3974	0.475291414	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	6.58165564	6.509192953	5.753868114	0	0	0	11.53405775	22.22071534	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.4808			24.3974	0.475291414	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	6.58165564	6.509192953	5.753868114	0	0	0	11.53405775	22.22071534	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.4808																																																																																				0			24.3974	0.475291414	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	6.58165564	6.509192953	5.753868114	0	0	0	11.53405775	22.22071534	0.588208968	1.7018625	2.791138781	4.218639844	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.4808
H5950_002_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7704.379779	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961				0		0															200/d 10	200/d 10	"$0 days 1-8, $75 days 9-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $25 UC	$200 per visit	$30 per visit	"$30 X-ray; $175 PET, MRI"	$30 per visit	$30 per visit	$30 per visit	$20 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script				$0 per visit		$0 per visit															163.93	163.93	66.23	20	100	0.2	0.2	46.75	200	30	56.1	30	30	30	20	30	30	30	30	30	45				0		0															21.6867	0.42248412	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	5.850360569	5.579308245	5.361993375	0	0	0	9.227246202	19.26094945	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.0691			21.6867	0.42248412	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	5.850360569	5.579308245	5.361993375	0	0	0	9.227246202	19.26094945	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.0691																																																																																				0			21.6867	0.42248412	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	5.850360569	5.579308245	5.361993375	0	0	0	9.227246202	19.26094945	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.0691
H5950_003_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7448.225787	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961				0		0															100/d 10	100/d 10	"$0 days 1-8, $75 days 9-14; $100 15+"	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $25 UC	$200 per visit	$0 per visit	"$20 X-ray; $175 PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$0 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit															81.96	81.96	66.23	0	100	0.2	0.2	46.75	200	0	47.9	20	20	20	0	20	20	20	20	20	45				0		0															10.8427	0.211229174	7.156843058	0	1.957621255	3.143561179	0.200659672	1.659887368	5.850360569	0	4.578243898	0	0	0	0	12.41370964	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3714			10.8427	0.211229174	7.156843058	0	1.957621255	3.143561179	0.200659672	1.659887368	5.850360569	0	4.578243898	0	0	0	0	12.41370964	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3714																																																																																				0			10.8427	0.211229174	7.156843058	0	1.957621255	3.143561179	0.200659672	1.659887368	5.850360569	0	4.578243898	0	0	0	0	12.41370964	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3714
H5950_004_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	7704.379779	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961				0		0															225/d 10	225/d 10	"$0 days 1-8, $75 days 9-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $25 UC	$200 per visit	$30 per visit	"$30 X-ray; $150 PET, MRI"	$30 per visit	$30 per visit	$30 per visit	$20 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script				$0 per visit		$0 per visit															184.42	184.42	66.23	20	100	0.2	0.2	46.75	200	30	51.6	30	30	30	20	30	30	30	30	30	45				0		0															24.3974	0.475291414	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	5.850360569	5.579308245	4.931886955	0	0	0	9.227246202	19.26094945	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.4025			24.3974	0.475291414	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	5.850360569	5.579308245	4.931886955	0	0	0	9.227246202	19.26094945	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.4025																																																																																				0			24.3974	0.475291414	7.156843058	3.547740771	1.957621255	3.143561179	0.200659672	1.659887368	5.850360569	5.579308245	4.931886955	0	0	0	9.227246202	19.26094945	0.504179116	1.458739285	2.392404669	3.615977009	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.4025
H5950_801_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1403.234861	27.33675297	1146.203462	1881.554753	207.6460381	15.71780589	1.003298358	376.6101166	310.2755935	1972.668358	1013.814245	0	0	0	4893.697162	6208.051603	178.2619179	1031.528894	1409.798725	2556.992056	18.07125295	0	0	0	0	0	0															200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665																																																																																				0			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665
H5950_802_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1403.234861	27.33675297	1146.203462	1881.554753	207.6460381	15.71780589	1.003298358	376.6101166	310.2755935	1972.668358	1013.814245	0	0	0	4893.697162	6208.051603	178.2619179	1031.528894	1409.798725	2556.992056	18.07125295	0	0	0	0	0	0															200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$39.5 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665																																																																																				0			16.9055	0.329339531	9.551695519	6.271849176	2.595575476	4.715341768	0.300989507	1.569208819	5.171259891	6.575561195	4.641579552	0	0	0	12.23424291	20.43483653	0.594206393	3.438429647	4.699329084	8.523306854	3.61425059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1665
H5952_001_0	2008	7																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	P	T	Coin	V	P	V	P	Coin	P	P																																																				0	0	1834.268157	267.1928125	997.2445723		156.1749596	10.90290877	12.82980647	331.0111785	265.8348329	1944.780606	462.8250023	39.4634533	0.806889614	875.5868093	3680.742929	5131.370958	1005.602062	920.6223513	4285.214399	7556.95867	21.98634052			5.43	144		249															1a:$180 1-5; 1a1:$180 1-5;	1b:$180 1-5;	2a:$94 4-38; 2a2:$94 4-38;		10a:$150;	11a:20%;	11b:20%; 11c:20%;	4a:$50; 4b:$50;	9b:$90;	8a:$5;	8b:$15-50;	9a:$90;	12:20%;	3:20%; 5:$70; 9a:$90; 9c:$40; 9d:$30;	7a:$15;	7b:$40; 7d:$30; 7f:$30; 17a:$30; 18a:$30;	7e:$40; 7h:$40;	7c:$30; 7i:$30;	8b:$15-50;	7g:$15-30;	15:20%;			16a:50%;	17a1:$30;		18a1:$30;															102.193	64.1499	58.8838		76.4059	0.169790803	0.169790803	42.4477	76.4059	4.2448	37.6315	76.4059	0.169790803	26.235	12.7346	26.1097	31.4327	25.4686	8.2539	2.7446	0.169790803			0.424477008	25.4686		25.4686															15.6208	1.428366207	4.893463464	0	0.994390194	1.851213639	2.178383147	1.170888623	1.692611618	0.687928878	1.451400207	0.251269929	0.137002436	1.914250234	3.906078163	11.16487824	2.634069707	1.953915107	2.947464518	1.728384388	3.73307842	0	0	2.304910155	0.305623446	0	0.528473875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.4788	0	11.65	15.6208	1.428366207	4.893463464	0	0.994390194	1.851213639	2.178383147	1.170888623	1.692611618	0.687928878	1.451400207	0.251269929	0.137002436	1.914250234	3.906078163	11.16487824	2.634069707	1.953915107	2.947464518	1.728384388	3.73307842	0	0	2.304910155	0.305623446	0	0.528473875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.4788																																																																																				0	0	0	15.6208	1.428366207	4.893463464	0	0.994390194	1.851213639	2.178383147	1.170888623	1.692611618	0.687928878	1.451400207	0.251269929	0.137002436	1.914250234	3.906078163	11.16487824	2.634069707	1.953915107	2.947464518	1.728384388	3.73307842	0	0	2.304910155	0.305623446	0	0.528473875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.4788
H5952_801_0	2008	3																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	279.9501133	5.799323566	32.50835433		7.60944565	11.4961304	12.04603849	13.8910817	46.364433	6.874347737	20.98959341	3.513844842	0.392420891	23.95678816	35.42232793	114.9119549	3.30819899	13.88212812	34.09338994	18.15914915	28.4408303																					MEDICARE FFS	MEDICARE FFS	MEDICARE FFS		MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS																					0.077354951	0.077354951	0.188446113		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					21.6555	0.448606388	6.126073019	0	1.780610282	2.690094514	2.818773006	3.250513118	10.84927732	1.608597371	4.911564859	0.822239693	0.091826488	5.605888429	8.288824735	26.88939746	0.774118564	3.248417981	7.977853247	4.249240901	6.655154291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7426	0	0	21.6555	0.448606388	6.126073019	0	1.780610282	2.690094514	2.818773006	3.250513118	10.84927732	1.608597371	4.911564859	0.822239693	0.091826488	5.605888429	8.288824735	26.88939746	0.774118564	3.248417981	7.977853247	4.249240901	6.655154291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7426																																																																																				0	0	0	21.6555	0.448606388	6.126073019	0	1.780610282	2.690094514	2.818773006	3.250513118	10.84927732	1.608597371	4.911564859	0.822239693	0.091826488	5.605888429	8.288824735	26.88939746	0.774118564	3.248417981	7.977853247	4.249240901	6.655154291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7426
H5952_802_0	2008	3																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	279.9501133	5.799323566	32.50835433		7.60944565	11.4961304	12.04603849	13.8910817	46.364433	6.874347737	20.98959341	3.513844842	0.392420891	23.95678816	35.42232793	114.9119549	3.30819899	13.88212812	34.09338994	18.15914915	28.4408303																					MEDICARE FFS	MEDICARE FFS	MEDICARE FFS		MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS																					0.077354951	0.077354951	0.188446113		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					21.6555	0.448606388	6.126073019	0	1.780610282	2.690094514	2.818773006	3.250513118	10.84927732	1.608597371	4.911564859	0.822239693	0.091826488	5.605888429	8.288824735	26.88939746	0.774118564	3.248417981	7.977853247	4.249240901	6.655154291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7426	0	0	21.6555	0.448606388	6.126073019	0	1.780610282	2.690094514	2.818773006	3.250513118	10.84927732	1.608597371	4.911564859	0.822239693	0.091826488	5.605888429	8.288824735	26.88939746	0.774118564	3.248417981	7.977853247	4.249240901	6.655154291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7426																																																																																				0	0	0	21.6555	0.448606388	6.126073019	0	1.780610282	2.690094514	2.818773006	3.250513118	10.84927732	1.608597371	4.911564859	0.822239693	0.091826488	5.605888429	8.288824735	26.88939746	0.774118564	3.248417981	7.977853247	4.249240901	6.655154291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7426
H5952_803_0	2008	3																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	279.9501133	5.799323566	32.50835433		7.60944565	11.4961304	12.04603849	13.8910817	46.364433	6.874347737	20.98959341	3.513844842	0.392420891	23.95678816	35.42232793	114.9119549	3.30819899	13.88212812	34.09338994	18.15914915	28.4408303																					MEDICARE FFS	MEDICARE FFS	MEDICARE FFS		MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS																					0.077354951	0.077354951	0.188446113		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					21.6555	0.448606388	6.126073019	0	1.780610282	2.690094514	2.818773006	3.250513118	10.84927732	1.608597371	4.911564859	0.822239693	0.091826488	5.605888429	8.288824735	26.88939746	0.774118564	3.248417981	7.977853247	4.249240901	6.655154291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7426	0	0	21.6555	0.448606388	6.126073019	0	1.780610282	2.690094514	2.818773006	3.250513118	10.84927732	1.608597371	4.911564859	0.822239693	0.091826488	5.605888429	8.288824735	26.88939746	0.774118564	3.248417981	7.977853247	4.249240901	6.655154291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7426																																																																																				0	0	0	21.6555	0.448606388	6.126073019	0	1.780610282	2.690094514	2.818773006	3.250513118	10.84927732	1.608597371	4.911564859	0.822239693	0.091826488	5.605888429	8.288824735	26.88939746	0.774118564	3.248417981	7.977853247	4.249240901	6.655154291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7426
H5969_001_0	2008	7																					3450											D	D	D		Coin	Coin	Coin	V	Coin		Coin		Coin	Coin	V	V	V	P	Coin	Coin	Coin	Coin			V	Coin					V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		520.3442249	12.96995608	232.9395956	0	2.899216394	6.366554005	3.930550895	238.1027361	22.43086948	0	18.37071005	0	0.298629682	20.13438396	6440.210853	10748.72387	98.25508028	766.9537098	14.96403343	30.68036924	6.920333607	0.749825932	0	0	304.7289214	6.043023846	0	0	0	0	320.3810563											$290/Day for IP Medical; $290/Day for IP Surgical	$290/Day for IP Psych; $290/Day for IP Substance Abuse	$150/Day for SNF		25% Coinsurance for Ambulance	25% Coinsurance for DME	25% Coinsurance for Prosthetics/Supplies; 25% Coinsurance for Diabetes Monitoring Supplies; 25% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $30/Visit for Urgent Care;	25% Coinsurance for OP Fac - Surgery; 25% Coinsurance for OP Fac - ASC		25% Coinsurance for OP Fac - Radiology; 25% Coinsurance for OP Fac - CT/MRI/PET		25% Coinsurance for Renal Dialysis - Fac; 25% Coinsurance for Renal Dialysis - Prof	25% Coinsurance for OP Fac - Cardiovascular; $30/Case for OP Fac - Occ Therapy; $30/Case for OP Fac - Physical/Speech Therapy; $30/Case for OP Fac - CORF; 25% Coinsurance for OP Fac - Other; $30/Service for Prof - CORF; $30/Service for Prof - CORF;	$8/Visit for PCP - Office Visits; $8/Consult for PCP - Consults; 25% Coinsurance for PCP - Primary Surgeon (IP); 25% Coinsurance for PCP - Asst Surgeon (IP); 25% Coinsurance for PCP - Primary Surgeon (OP); 25% Coinsurance for PCP - Asst Surgeon (OP); 25% Coinsurance for PCP - IP Visits; 25% Coinsurance for PCP - Tx Injections; 25% Coinsurance for PCP - Allergy Testing; 25% Coinsurance for PCP - Allergy Tx; 25% Coinsurance for PCP - Cardio;	$15/Visit for Speclst - Office Visits; 25% Coinsurance for Speclst - Primary Surgeon (IP); 25% Coinsurance for Speclst - Asst Surgeon (IP); 25% Coinsurance for Speclst - Anesthesia (IP); 25% Coinsurance for Speclst - Primary Surgeon (OP); 25% Coinsurance for Speclst - Asst Surgeon (OP); 25% Coinsurance for Speclst - Anesthesia (OP); 25% Coinsurance for Speclst - IP Visits; 25% Coinsurance for Speclst - Tx Injections; 25% Coinsurance for Speclst - Allergy Testing; 25% Coinsurance for Speclst - Allergy Tx; $15/Consult for Speclst - Consults; 25% Coinsurance for Speclst - Cardio;	$30/Visit for OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/Visit for OP Substance Abuse;	$30/Service for PT/ST (PCP); $30/Service for Occ Therapy (PCP); $30/Service for PT/ST (Specialist); $30/Service for Occ Therapy (Specialist);	25% Coinsurance for Prof Radiology (Office); 25% Coinsurance for Prof Radiology (OP); 25% Coinsurance for Prof Radiology (IP);	$30/Visit for Chiropractor; 25% Coinsurance for Vision Exams; $30/Service for Podiatrist; $30/Exam for Hearing/Speech Exams; 25% Coinsurance for Misc. Medical (PCP); 25% Coinsurance for Misc. Medical; 25% Coinsurance for Prof Path (IP); 25% Coinsurance for Prof Path (OP); 25% Coinsurance for Prof Path (Office); 25% Coinsurance for Prof Path (Labs)	25% Coinsurance for Part B Rx	25% Coinsurance for Blood Products			$25/Exam for Vision (Refractions)	$100 Coverage Limit Per Year for Vision Hardware					$50/Case for ER - Worldwide; $15/Service for Acupunture;											290	290	150	0	0.25	0.25	0.25	43.25234806	0.25	0	0.25	0	0.25	0.197898333	8.238293986	16.83976449	30	30	0.25	0.290978318	0.25	0.25	0	0	25	0.703	0	0	0	0	15.17235681											12.575	0.313440605	2.911744945	0	0.724804098	1.591638501	0.982637724	0.858208535	5.607717371	0	4.592677513	0	0.07465742	3.984561013	4.421362528	15.08383155	0.245637701	1.917384275	3.741008358	8.927322251	1.730083402	0.187456483	0	0	0.63485192	4.248245763	0	0	0	0	0.405077975	0	0	0	0	0	0	0	0	0	0	75.7593	0	38.76463342	12.575	0.313440605	2.911744945	0	0.724804098	1.591638501	0.982637724	0.858208535	5.607717371	0	4.592677513	0	0.07465742	3.984561013	4.421362528	15.08383155	0.245637701	1.917384275	3.741008358	8.927322251	1.730083402	0.187456483	0	0	0.63485192	4.248245763	0	0	0	0	0.405077975	0	0	0	0	0	0	0	0	0	0	75.7593																																																																																				0	0		12.575	0.313440605	2.911744945	0	0.724804098	1.591638501	0.982637724	0.858208535	5.607717371	0	4.592677513	0	0.07465742	3.984561013	4.421362528	15.08383155	0.245637701	1.917384275	3.741008358	8.927322251	1.730083402	0.187456483	0	0	0.63485192	4.248245763	0	0	0	0	0.405077975	0	0	0	0	0	0	0	0	0	0	75.7593
H5969_002_0	2008	6																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		380.56492	35.03323733	35.39392232	22.54780442	11.03487992	21.2963018	14.95815247	12.53831438	28.21001368	12.27767658	25.60968391	0	4.517002134	44.40568485	68.97602504	115.278751	8.814286643	4.123380853	20.34211472	42.61771974	10.42987465	0.767117748	0	0	0	0	0	0	0	7.9997	2.557435712											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing																				0.07470427	0.07470427	0.160213722	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											28.4298	2.617132426	5.670592021	0	2.582161901	4.983334622	3.500207678	2.933965566	6.601143201	2.872976319	5.992666034	0	1.056978499	10.39093025	16.14038986	26.97522773	2.062543074	0.96487112	4.760054845	9.972546419	2.440590668	0.179505553	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.1276	0	0	28.4298	2.617132426	5.670592021	0	2.582161901	4.983334622	3.500207678	2.933965566	6.601143201	2.872976319	5.992666034	0	1.056978499	10.39093025	16.14038986	26.97522773	2.062543074	0.96487112	4.760054845	9.972546419	2.440590668	0.179505553	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.1276																																																																																				0	0		28.4298	2.617132426	5.670592021	0	2.582161901	4.983334622	3.500207678	2.933965566	6.601143201	2.872976319	5.992666034	0	1.056978499	10.39093025	16.14038986	26.97522773	2.062543074	0.96487112	4.760054845	9.972546419	2.440590668	0.179505553	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.1276
H5980_005_0	2008	5																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	544.67	33.79	406.54	7.01	75.05	12.96	62.64	11.32	14.39	22.41	15.59	0.95	1.5	129.77	108.5	148.71	9.54	0.96	27.82	51.38	4.24	5.66	13.33	0	0	0	0	0	0	0	52.5											PBP: 1A IP Acute: Medicare Cost Sharing	1B IP Psych: Medicare Cost Sharing	2 SNF: $0	6 Home Health: Medicare Cost Sharing	10A Ambulance: Medicare Cost Sharing	11A DME: Medicare Cost Sharing	11B Prosthetic Medical Supplies: Medicare Cost Sharing	"4A ER: $0, 4B Urgent Care: Medicare Cost Sharing"	9B ASC Services: Medicare Cost Sharing	8A OP C/D/T: Medicare Cost Sharing	8B OP X-Ray: Medicare Cost Sharing	9A OP Hospital: Medicare Cost Sharing	12 Renal Dialysis: Medicare Cost Sharing	"3 CORF, 5 Partial Hosp, 9C OP Substance Abuse, 9D Cardiac Rehab: Medicare Cost Sharing"	"7A PCP and 14C Routine Physical Exams:$0; 14B Immunizations, 14D Pap Smears, 14D Pelvic Exams, 14E Prostate Screening, 14F Colorectal Screening, 14G Bone Mass Measurement, 14H Mammography, 14I Diabetes Monitoring: Medicare Cost Sharing"	"7B Chiropractic, 7D Physician Specialist, 7F Podiatry: Medicare Cost Sharing"	"7E Mental Health, 7H Psychiatric:Medicare Cost Sharing"	"7C Occupational Therapy, 7I Physical and Speech Therapy: Medicare Cost Sharing"	Included in i.2.	"7G Other Health Care, 18A Medicare Covered Hearing Exams: Medicare Cost Sharing"	15 Part B Drugs: Medicare Cost Sharing	"13A Blood, 16B Medicare Covered Comprehensive Dental Services, 17A Medicare Covered Eye Exams: Medicare Cost Sharing"	10B Transportation: $0	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: $0"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											0.072133344	0.072133894	0	0	0.2339854	0.233999742	0.234001939	0.233989137	0.233999979	0.233993957	0.233934765	0.233999905	0.234000004	0.233986675	0	0.233995085	0.233994694	0.233965144	0.234025334	0.232815989	0.234011781	0.233995393	0	0	0	0	0	0	0	0	0											39.2889	2.437404289	0	0	17.56060427	3.032636659	14.65788148	2.648757032	3.367259699	5.243804573	3.647042981	0.22229991	0.351000005	30.36445083	0	34.79740912	2.232309377	0.224606538	6.510584805	11.96208553	0.992209953	1.324413924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	180.8656	0	0	39.2889	2.437404289	0	0	17.56060427	3.032636659	14.65788148	2.648757032	3.367259699	5.243804573	3.647042981	0.22229991	0.351000005	30.36445083	0	34.79740912	2.232309377	0.224606538	6.510584805	11.96208553	0.992209953	1.324413924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	180.8656	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	39.2889	2.437404289	0	0	17.56060427	3.032636659	14.65788148	2.648757032	3.367259699	5.243804573	3.647042981	0.22229991	0.351000005	30.36445083	0	34.79740912	2.232309377	0.224606538	6.510584805	11.96208553	0.992209953	1.324413924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	180.8656
H5980_006_0	2008	6																					500											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	2782.26	279.81	0	0	2448.34	0	0	394.69	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											"PBP: 1A IP Acute: $25 per day for days 1-20, $0 thereafter"	"1B IP Psych: $25 per day for days 1- 20, $0 thereafter"	2 SNF: $0	6 Home Health: $0	10A Ambulance: $50	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $0, 7D Physician Specialist: $0, 7F Podiatry: $0"	"7E Mental Health: $0, 7H Psychiatric: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: $0	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: $0"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											17.63000257	17.63000257	0	0	35.26000514	0	0	35.05578316	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											4.0876	0.411087585	0	0	7.194040082	0	0	1.153013921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.8457	0	0	4.0876	0.411087585	0	0	7.194040082	0	0	1.153013921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.8457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.0876	0.411087585	0	0	7.194040082	0	0	1.153013921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.8457
H5980_007_0	2008	8																					500											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	3398.13	369.8	0	0	2963.23	0	0	440.03	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											"PBP: 1A IP Acute: $25 per day for days 1-20, $0 thereafter"	"1B IP Psych: $25 per day for days 1- 20, $0 thereafter"	2 SNF: $0	6 Home Health: $0	10A Ambulance: $50	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $0, 7D Physician Specialist: $0, 7F Podiatry: $0"	"7E Mental Health: $0, 7H Psychiatric: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: $0	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: $0"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											16.62090301	16.62090301	0	0	33.24180602	0	0	33.04191551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											4.7067	0.512200828	0	0	8.20859307	0	0	1.211619507	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.6391	0	0	4.7067	0.512200828	0	0	8.20859307	0	0	1.211619507	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.6391	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.7067	0.512200828	0	0	8.20859307	0	0	1.211619507	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.6391
H5985_001_0	2008	5																																D	Coin	D	V	T	Coin	Coin	P	P	Coin	Coin	P	P	P	Coin	P	P	P	P	P	Coin	P	T	P	P	P	P	P	P	P	V	P	P	P	P	P	P	P	P	P	P																																										0		1096.771904	3.385000375	454.2313075		136.4186394	8.214271009	7.001122405	187.9319091	319.8486388	3.120782048	7.139293008		2.572049242	45.3772217	0.959068572	4406.287744	204.0908393	1168.533982			21.70610633	722.520959			144						50											1a;$100/day 1-3	1b; $239/day 61-90	2a;$75/day 21+		10a;$100	11a;20%	11c;20%	4a;$50; 4b;$35	9b;$150; 9b;$250	8a;20%	8b;$150; 8b;20%		12;$30	3;$20; 5;$35; 7f;$10; 9c;$35; 9d;$20	14f;$25; 14i;20%; 18a;$30	7b;$30; 7d;$35; 7f;$30	7e;$35; 7h;$35	7c;$30; 7i;$30			15;20%	14j;$5; 17a;$30			17a1;$10						13c;$15											44.5751	0.06723	23.0036		100	0.2	0.2	49.7	179.6641	0.2	0.242214611		30	20.1039	0.296392353	34.1075	35	30			0.2	30.3922			10						15											4.0741	0.227573575	0.870744486	0	1.136821995	1.642854202	1.400224481	0.778351323	4.788777683	0.62415641	1.729241076	0	0.006430123	0.076021512	0.284260591	12.52396994	0.595264948	2.921334954	0	0	4.341221266	1.829917645	0	0	0.12	0	0	0	0	0	0.0625	0	0	0	0	0	0	0	0	0	0	40.0337	0	0	4.0741	0.227573575	0.870744486	0	1.136821995	1.642854202	1.400224481	0.778351323	4.788777683	0.62415641	1.729241076	0	0.006430123	0.076021512	0.284260591	12.52396994	0.595264948	2.921334954	0	0	4.341221266	1.829917645	0	0	0.12	0	0	0	0	0	0.0625	0	0	0	0	0	0	0	0	0	0	40.0337																																																																																				0	0	0	4.0741	0.227573575	0.870744486	0	1.136821995	1.642854202	1.400224481	0.778351323	4.788777683	0.62415641	1.729241076	0	0.006430123	0.076021512	0.284260591	12.52396994	0.595264948	2.921334954	0	0	4.341221266	1.829917645	0	0	0.12	0	0	0	0	0	0.0625	0	0	0	0	0	0	0	0	0	0	40.0337
H5985_002_0	2008	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		344.2711787	16.64378321	27.92961999		14.16324767	7.213820008	3.49690374	31.03859548	27.31060993	0.544379203	39.32915691	1.851392542	49.29011523	3.323634513	36.94830646	108.0077462	3.521470903	3.023386179		1.614272568	23.59306197	1.37391486																				Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing																				0.0747	0.0747	0.1593		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234	0.234																				25.7171	1.243290605	4.449188465	0	3.314199956	1.688033882	0.818275475	7.263031343	6.390682725	0.127384733	9.203022716	0.433225855	11.53388696	0.777730476	8.645903711	25.27381262	0.824024191	0.707472366	0	0.377739781	5.520776502	0.321496077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.6302	0	0	25.7171	1.243290605	4.449188465	0	3.314199956	1.688033882	0.818275475	7.263031343	6.390682725	0.127384733	9.203022716	0.433225855	11.53388696	0.777730476	8.645903711	25.27381262	0.824024191	0.707472366	0	0.377739781	5.520776502	0.321496077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.6302																																																																																				0	0	0	25.7171	1.243290605	4.449188465	0	3.314199956	1.688033882	0.818275475	7.263031343	6.390682725	0.127384733	9.203022716	0.433225855	11.53388696	0.777730476	8.645903711	25.27381262	0.824024191	0.707472366	0	0.377739781	5.520776502	0.321496077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.6302
H5985_003_0	2008	5																																D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	Coin	P	V	P	P	V	Coin	P	T	P	P	P	P	P	P	P	P																																																				0		1151.758627	52.17215444	480.7980568		141.3620198	8.538059455	7.198204541	196.7412929	333.5660105	3.298094989	7.183342701	73.82406866	2.495017475	47.60504407	0.8633094	4642.215995	218.0311902	1224.007249			21.92255609	750.6536993			144		249				50											1a;$100/day 1-3	1b;$100/day 1-5	2a;$75 days 31+		10a;$50	11a;20%	11b;20%; 11c;10%	4a;$50; 4b;$35	9a;$250; 9b;$50	8a;20%	8b;20%;  8b;$150	9a;$250	12;$30	3;$20; 5;$35; 9c;$35; 9d;$20	14f;20%; 14i;20%; 18a;$25	7b;$20; 7d;$25; 7f;$10	7e;$35; 7h;$35	7c;$30; 7i;$30			15;20%	14j;$5; 17a;$25			17a1;$10		18a1;$25				13c;$15											44.5751	61.5985	13.435		50	0.2	0.194525275	49.7	108.7187	0.2	0.2432354	250	30	20.1113	0.262318328	23.6257	35	30			0.2	24.9057			10		25				15											4.2783	0.267810658	0.538291504	0	0.589008416	1.707611891	1.400232715	0.814836855	3.022072792	0.659618998	1.747243238	1.53800143	0.006237544	0.079783399	0.226461879	9.139638571	0.635924305	3.060018123	0	0	4.384511219	1.557963763	0	0	0.12	0	0.51875	0	0	0	0.0625	0	0	0	0	0	0	0	0	0	0	36.3548	0	0	4.2783	0.267810658	0.538291504	0	0.589008416	1.707611891	1.400232715	0.814836855	3.022072792	0.659618998	1.747243238	1.53800143	0.006237544	0.079783399	0.226461879	9.139638571	0.635924305	3.060018123	0	0	4.384511219	1.557963763	0	0	0.12	0	0.51875	0	0	0	0.0625	0	0	0	0	0	0	0	0	0	0	36.3548																																																																																				0	0	0	4.2783	0.267810658	0.538291504	0	0.589008416	1.707611891	1.400232715	0.814836855	3.022072792	0.659618998	1.747243238	1.53800143	0.006237544	0.079783399	0.226461879	9.139638571	0.635924305	3.060018123	0	0	4.384511219	1.557963763	0	0	0.12	0	0.51875	0	0	0	0.0625	0	0	0	0	0	0	0	0	0	0	36.3548
H5989_002_0	2008	6																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	635.15	23.86	225.86	83.07	18.85	28.54	25.77	6.93	21.07	12.5	23.29	1.09	2.38	50.47	99.45	166.96	7.47	9.68	42.68	77.87	8.75	6.36	0	0	0	0	0	0	0	0	51.72											PBP: 1A IP Acute: Traditional FFS Cost Sharing	1B IP Psych: Traditional FFS Cost Sharing	2 SNF: Traditional FFS Cost Sharing	6 Home Health:Traditional FFS Cost Sharing	10A Ambulance: Traditional FFS Cost Sharing	11A DME: Traditional FFS Cost Sharing	"11B Prosthetic Medical Supplies: Traditional FFS Cost Sharing, 11C Diabetes Monitoring Supplies:Traditional FFS Cost Sharing"	"4A ER: Traditional FFS Cost Sharing, 4B Urgent Care: Traditional FFS Cost Sharing"	9B ASC Services: Traditional FFS Cost Sharing	8A OP C/D/T: Traditional FFS Cost Sharing	8B OP X-Ray: Traditional FFS Cost Sharing	9A OP Hospital: Traditional FFS Cost Sharing	12 Renal Dialysis: Traditional FFS Cost Sharing	"3 CORF: Traditional FFS Cost Sharing, 5 Partial Hosp: Traditional FFS Cost Sharing, 9C OP Substance Abuse: Traditional FFS Cost Sharing, 9D Cardiac Rehab: Traditional FFS Cost Sharing"	"7A PCP: Traditional FFS Cost Sharing, 14B Immunizations: Traditional FFS Cost Sharing, 14C Routine Physical Exams: Traditional FFS Cost Sharing, 14D Pap Smears: Traditional FFS Cost Sharing, 14D Pelvic Exams: Traditional FFS Cost Sharing, 14E Prostate Screening: Traditional FFS Cost Sharing, 14F Colorectal Screening: Traditional FFS Cost Sharing, 14G Bone Mass Measurement:Traditional FFS Cost Sharing, 14H Mammography: Traditional FFS Cost Sharing, 14I Diabetes Monitoring: Traditional FFS Cost Sharing"	7D Physician Specialist: Traditional FFS Cost Sharing	"7E Mental Health:Traditional FFS Cost Sharing, 7H Psychiatric: Traditional FFS Cost Sharing"	"7C Occupational Therapy: Traditional FFS Cost Sharing, 7I Physical and Speech Therapy: Traditional FFS Cost Sharing"	Included in i.2.	"7G Other Health Care: Traditional FFS Cost Sharing, 18A Medicare Covered Hearing Exams: Traditional FFS Cost Sharing,7B Chiropractic: Traditional FFS Cost Sharing, 7F Podiatry: Traditional FFS Cost Sharing"	15 Part B Drugs: Traditional FFS Cost Sharing	"13A Blood:Traditional FFS Cost Sharing, 16B Medicare Covered Comprehensive Dental Services:Traditional FFS Cost Sharing, 17A Medicare Covered Eye Exams: Traditional FFS Cost Sharing"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: Traditional FFS Cost Sharing, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	"13B Acupuncture: 0,13C OTHER: OTC Drug card - $75 benefit amount per year"											0.056899302	0.056883144	0.179797146	0	0.234001066	0.234000261	0.233973948	0.233981385	0.233999992	0.234054399	0.233978795	0.233999816	0.233999984	0.234018317	0.233989198	0.234000675	0.234002255	0.234037769	0.234002849	0.234016191	0.233999686	0.233992002	0	0	0	0	0	0	0	0	0											36.1396	1.357231824	40.60898329	0	4.410920089	6.678367445	6.029508637	1.621490999	4.930379835	2.925679983	5.449366125	0.255059799	0.556919963	11.81090445	23.27022578	39.06875264	1.747996848	2.265485606	9.987241582	18.2228408	2.047497256	1.488189131	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	220.8726	0	0	36.1396	1.357231824	40.60898329	0	4.410920089	6.678367445	6.029508637	1.621490999	4.930379835	2.925679983	5.449366125	0.255059799	0.556919963	11.81090445	23.27022578	39.06875264	1.747996848	2.265485606	9.987241582	18.2228408	2.047497256	1.488189131	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	220.8726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	36.1396	1.357231824	40.60898329	0	4.410920089	6.678367445	6.029508637	1.621490999	4.930379835	2.925679983	5.449366125	0.255059799	0.556919963	11.81090445	23.27022578	39.06875264	1.747996848	2.265485606	9.987241582	18.2228408	2.047497256	1.488189131	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	220.8726
H5989_003_0	2008	5																					0											A	A	D	V	T	O	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	446.33	20.91	2453.47	0	554.24	0	20.8	250.82	122.75	0	18.07	0	0	179.95	6409.5	5494.14	887.14	1035.15	0	2487.84	466.75	580.49	0	0	308.25	0	159.76	0	0	60	148.61											PBP: 1A IP Acute: $300 per admit	1B IP Psych: $300 per admit	2 SNF: $50	6 Home Health: $0	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $50"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: General Radiology: $100    Radiology - CT/MRI/PET: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $0, 9C OP Substance Abuse: $25, 9D Cardiac Rehab: $25"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $10, 14D Pap Smears: $10, 14D Pelvic Exams: $10, 14E Prostate Screening: $10, 14F Colorectal Screening: $10, 14G Bone Mass Measurement: $10, 14H Mammography: $10, 14I Diabetes Monitoring: $10"	7D Physician Specialist: $25	"7E Mental Health: $25, 7H Psychiatric: $25"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	Included in i.2.	"7G Other Health Care: $25, 18A Medicare Covered Hearing Exams: $25,7B Chiropractic: $25, 7F Podiatry: $25"	15 Part B Drugs: $40	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $25, 17A Medicare Covered Eye Exams: $25"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $25	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $25	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $5	"13B Acupuncture: 25 , 13C OTHER: OTC Drug card - $50 allowance per year"											300	300	50	0	50	0	0.200038144	50	100	0	100	0	0	25	10.51284812	25	25	25	0	25	40	25	0	0	25	0	25	0	0	5	25											11.1583	0.52275	10.22279167	0	2.309333333	0	4.160793394	1.045083333	1.022916667	0	0.150583333	0	0	0.374895833	5.615175	11.446125	1.848208333	2.1565625	0	5.183	1.555833333	1.209354167	0	0	0.6421875	0	0.332833333	0	0	0.025	0.309604167	0	0	0	0	0	0	0	0	0	0	61.2913	0	0	11.1583	0.52275	10.22279167	0	2.309333333	0	4.160793394	1.045083333	1.022916667	0	0.150583333	0	0	0.374895833	5.615175	11.446125	1.848208333	2.1565625	0	5.183	1.555833333	1.209354167	0	0	0.6421875	0	0.332833333	0	0	0.025	0.309604167	0	0	0	0	0	0	0	0	0	0	61.2913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.1583	0.52275	10.22279167	0	2.309333333	0	4.160793394	1.045083333	1.022916667	0	0.150583333	0	0	0.374895833	5.615175	11.446125	1.848208333	2.1565625	0	5.183	1.555833333	1.209354167	0	0	0.6421875	0	0.332833333	0	0	0.025	0.309604167	0	0	0	0	0	0	0	0	0	0	61.2913
H5991_001_0	2008	6																																A	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0	0	478.9721552	0	0	0	0	0	113.33967	0	5553.815116	2675.334615	3879.506047	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0								4a 50 copay;4b 10 copay						5 20 copay;9c 20 copay;3 10 copay		7d 10 copay;7f 10 copay	7h 20 copay	7c 10 copay;7i 10 copay																								0	0	0	0	0	0	0	47.56156115	0	0	0	0	0	19.72457412	0	10	20	10	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.898388621	0	0	0	0	0	0.18629806	0	4.628179263	4.458891025	3.232921706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4047		0	0	0	0	0	0	0	0	1.898388621	0	0	0	0	0	0.18629806	0	4.628179263	4.458891025	3.232921706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4047																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0	0	0	1.898388621	0	0	0	0	0	0.18629806	0	4.628179263	4.458891025	3.232921706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4047
H5991_002_0	2008	6																																A	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		2822.796199	569.1800935	0	0	0	0	0	423.1910033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	"1a $100 per Admit, $300 max"	"1b $100 per Admit, $300 max"						4a 25 copay																																		87.76402529	87.76402529	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.645	4.162794676	0	0	0	0	0	0.881647923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.6894		0	20.645	4.162794676	0	0	0	0	0	0.881647923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.6894																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	20.645	4.162794676	0	0	0	0	0	0.881647923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.6894
H5992_001_0	2008	9																					0											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	317.88	0	0	0	0	0	461.2	0	4982.07	496.76	638.37	0	1502.83	0	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $0	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $10"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $10, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $10	"7E Mental Health: $20, 7H Psychiatric: $20"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7B Chiropractic: $10, 7F Podiatry: $10, 7G Other Health Care: $10, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	0	0	0	47.52988549	0	0	0	0	0	10	0	10	20	10	0	10	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.259066667	0	0	0	0	0	0.384333333	0	4.151725	0.827933333	0.531975	0	1.252358333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.4074	0	0	0	0	0	0	0	0	0	1.259066667	0	0	0	0	0	0.384333333	0	4.151725	0.827933333	0.531975	0	1.252358333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.4074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	1.259066667	0	0	0	0	0	0.384333333	0	4.151725	0.827933333	0.531975	0	1.252358333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.4074
H5992_002_0	2008	9																					0											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	581.71	0	0	0	0	0	856.84	0	9256.03	1378.48	1186	0	2792.07	0	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $0	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $10"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $10, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $10	"7E Mental Health: $20, 7H Psychiatric: $20"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7B Chiropractic: $10, 7F Podiatry: $10, 7G Other Health Care: $10, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: Not Covered"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	0	0	0	47.49290884	0	0	0	0	0	10	0	10	20	10	0	10	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	2.302258333	0	0	0	0	0	0.714033333	0	7.713358333	2.297466667	0.988333333	0	2.326725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.3422	0	0	0	0	0	0	0	0	0	2.302258333	0	0	0	0	0	0.714033333	0	7.713358333	2.297466667	0.988333333	0	2.326725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.3422	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	2.302258333	0	0	0	0	0	0.714033333	0	7.713358333	2.297466667	0.988333333	0	2.326725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.3422
H5995_001_0	2008	5																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0		179.9637071	16.56671682	26.06291974	23.82857377	19.1202587	32.85017122	23.07338966	19.76863187	44.24589972	33.4374031	69.74620309	0	12.42533573	121.0281442	60.05120529	125.3097333	10.73473409	5.02177871	22.74380636	43.59459612	14.11821536	16.92831527																				Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing																				0.077	0.077	0.1421	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				13.8572	1.275637195	3.703540895	0	4.474140535	7.686940065	5.39917318	4.625859857	10.35354053	7.824352326	16.32061152	0	2.907528561	28.32058575	14.05198204	29.32247759	2.511927777	1.175096218	5.322050688	10.20113549	3.303662394	3.961225774	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	176.5987	0	0	13.8572	1.275637195	3.703540895	0	4.474140535	7.686940065	5.39917318	4.625859857	10.35354053	7.824352326	16.32061152	0	2.907528561	28.32058575	14.05198204	29.32247759	2.511927777	1.175096218	5.322050688	10.20113549	3.303662394	3.961225774	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	176.5987																																																																																				0	0		13.8572	1.275637195	3.703540895	0	4.474140535	7.686940065	5.39917318	4.625859857	10.35354053	7.824352326	16.32061152	0	2.907528561	28.32058575	14.05198204	29.32247759	2.511927777	1.175096218	5.322050688	10.20113549	3.303662394	3.961225774	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	176.5987
H5995_002_0	2008	4																					2250											D	D			T			V	V		V			V	V	V	V	P		P	Coin			P	V																	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		643.6095563	15.25579988	0	0	162.958131	0	0	330.1402226	240.5753062	0	188.5149734	0	0	265.4626863	4068.162377	3735.969413	155.2050174	391.3974581	0	1770.2618	8.317504099	0	0	1507	396.0312956	0	0	0	0	0	0											$100/Day for IP Medical; $100/Day for IP Surgical	$100/Day for IP Psych; $100/Day for IP Substance Abuse	No Cost-Sharing	No Cost-Sharing	$50/Trip for Ambulance	No Cost-Sharing	No Cost-Sharing	$50/Case for ER - Facility; $20/Visit for Urgent Care;	$100/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No Cost-Sharing	$50/Case for OP Fac - CT/MRI/PET	No Cost-Sharing	No Cost-Sharing	$15/Case for OP Fac - Occ Therapy; $15/Case for OP Fac - Physical/Speech Therapy; $15/Case for OP Fac - CORF; $15/Service for Prof - CORF; $15/Service for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults; $15/Exam for PCP - Routine Physicals;	$10/Visit for Speclst - Office Visits; $10/Consult for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $15/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$15/Service for PT/ST (PCP); $15/Service for Occ Therapy (PCP); $15/Service for PT/ST (Specialist); $15/Service for Occ Therapy (Specialist);	No Cost-Sharing	$15/Visit for Chiropractor; $15/Exam for Vistion Exams; $15/Service for Podiatrist; $15/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost-Sharing	No Cost-Sharing	$15/Procedure for Dental Office Visit;	$20/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing											92.20466031	92.20466031	0	0	46.10233016	0	0	38.0124731	69.15349523	0	46.10233016	0	0	13.83069905	9.277064157	9.220466031	13.83069905	13.83069905	0	13.83069905	0.184409321	0	0	20.74604857	18.44093206	0	0	0	0	0	0											4.9453	0.117221321	0	0	0.626062463	0	0	1.045787194	1.386385274	0	0.724248295	0	0	0.30596121	3.145050281	2.870614922	0.178882824	0.451108371	0	2.040329849	1.53382528	0	0	2.605357933	0.608598851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.5848	0	1.909402448	4.9453	0.117221321	0	0	0.626062463	0	0	1.045787194	1.386385274	0	0.724248295	0	0	0.30596121	3.145050281	2.870614922	0.178882824	0.451108371	0	2.040329849	1.53382528	0	0	2.605357933	0.608598851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.5848																																																																																				0	0		4.9453	0.117221321	0	0	0.626062463	0	0	1.045787194	1.386385274	0	0.724248295	0	0	0.30596121	3.145050281	2.870614922	0.178882824	0.451108371	0	2.040329849	1.53382528	0	0	2.605357933	0.608598851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.5848
H5995_003_0	2008	3																					2250											D	D			T			V	V		V			V	V	V	V	P		V	Coin			P	V																	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		581.4476649	13.63350475	0	0	146.7715439	0	0	297.914016	216.8632167	0	168.8252943	0	0	238.78652	3674.685647	3365.467726	139.5452206	351.3431544	0	1585.063067	7.48766178	0	0	1507	395.9060786	0	0	0	0	0	0											$100/Day for IP Medical; $100/Day for IP Surgical	$100/Day for IP Psych; $100/Day for IP Substance Abuse	No Cost-Sharing	No Cost-Sharing	$50/Trip for Ambulance	No Cost-Sharing	No Cost-Sharing	$50/Case for ER - Facility; $20/Visit for Urgent Care;	$100/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No Cost-Sharing	$50/Case for OP Fac - CT/MRI/PET	No Cost-Sharing	No Cost-Sharing	$15/Case for OP Fac - Occ Therapy; $15/Case for OP Fac - Physical/Speech Therapy; $15/Case for OP Fac - CORF; $15/Service for Prof - CORF; $15/Service for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults; $15/Exam for PCP - Routine Physicals;	$10/Visit for Speclst - Office Visits; $10/Consult for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $15/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$15/Service for PT/ST (PCP); $15/Service for Occ Therapy (PCP); $15/Service for PT/ST (Specialist); $15/Service for Occ Therapy (Specialist);	No Cost-Sharing	$15/Visit for Chiropractor; $15/Exam for Vistion Exams; $15/Service for Podiatrist; $15/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost-Sharing	No Cost-Sharing	$15/Procedure for Dental Office Visit;	$20/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing											93.29508102	93.29508105	0	0	46.64754051	0	0	38.455613	69.97131077	0	46.64754051	0	0	13.99426215	9.393247053	9.329508102	13.99426215	13.99426215	0	13.99426215	0.186590162	0	0	20.99139323	18.6590162	0	0	0	0	0	0											4.5205	0.105994911	0	0	0.570544295	0	0	0.954705509	1.264516961	0	0.656273729	0	0	0.278470097	2.876435844	2.616513202	0.162736033	0.409732351	0	1.848482341	1.397124025	0	0	2.636169133	0.615601495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.9138	0	1.503031543	4.5205	0.105994911	0	0	0.570544295	0	0	0.954705509	1.264516961	0	0.656273729	0	0	0.278470097	2.876435844	2.616513202	0.162736033	0.409732351	0	1.848482341	1.397124025	0	0	2.636169133	0.615601495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.9138																																																																																				0	0		4.5205	0.105994911	0	0	0.570544295	0	0	0.954705509	1.264516961	0	0.656273729	0	0	0.278470097	2.876435844	2.616513202	0.162736033	0.409732351	0	1.848482341	1.397124025	0	0	2.636169133	0.615601495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.9138
H5996_001_0	2008	6																					3250											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	215.7787217	2.172600359	719.034135	27.12748016	203.3607642	19.7994044	0.907106061	292.5666461	285.7718007	9.467648771	25.63975257	0	0.213286525	531.002736	4203.262595	5049.992639	142.8134556	488.0692348	24.12980794	35.34867556	6.976530005	658.3965637	0	0	0	0	0	0	0	12000	0											$300/admit	$300/admit	"$75/day, days 9 - 100"		$100 copay	30% DME / 20% Diabetes Monitoring	30% coinsurance	$50 ER / $30 UC	$75 ASC / $75 OP		"$15 X-Ray, 30% Coinsurance Other"	0	0% coinsurance	$15 Cardiac Rehab; $15 PT/OT/ST	$5 PCP	$15 SCP / $15 Chiro / $15 Podiatrist	$25 MH	$15 Therapy		$15 Hearing / $25 OPSA	30% coinsurance	$15 Vision	0	0	0	0	0	0	0	0	0											275.3116664	275.3116664	68.82791659	0	91.77055546	0.258796637	0.275311666	39.23354148	68.82791659	0	0.223179975	0	0	13.76558332	4.588527773	13.76558332	22.94263886	13.76558332	0	0.0036675	0.275311666	13.76558332	0	0	0	0	0	0	0	0	0											4.9505	0.049845185	4.124135123	0	1.555210857	5.124019277	0.249736881	0.95653547	1.639089805	0	5.722279326	0	0	0.6091302	1.607232263	5.793007869	0.273043128	0.55987981	0	0.129641258	1.920720101	0.75526773	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0193	0	3.23	4.9505	0.049845185	4.124135123	0	1.555210857	5.124019277	0.249736881	0.95653547	1.639089805	0	5.722279326	0	0	0.6091302	1.607232263	5.793007869	0.273043128	0.55987981	0	0.129641258	1.920720101	0.75526773	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0193	3250																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.9505	0.049845185	4.124135123	0	1.555210857	5.124019277	0.249736881	0.95653547	1.639089805	0	5.722279326	0	0	0.6091302	1.607232263	5.793007869	0.273043128	0.55987981	0	0.129641258	1.920720101	0.75526773	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0193
H5996_002_0	2008	6																					3250											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1468.317135	21.74482135	755.2252386	34.96235255	248.6937795	27.26268548	1.252899921	311.8901577	304.8250044	9.981007196	27.06740771	0	0.268754214	566.4973857	4342.895558	5309.763561	171.1483515	565.210811	30.38485875	42.46749337	7.357065903	669.4745227	0	0	0	0	0	0	0	12000	0											$175/day with limits	$175/day with limits	"$100/day, days 9 - 100"		$150 copay	30% DME / 30% Diabetes Monitoring	30% coinsurance	$50 ER / $30 UC	$100 ASC / $100 OP		"$15 X-Ray, 30% Coinsurance Other"	0	0% coinsurance	$20 Cardiac Rehab; $20 PT/OT/ST	$10 PCP	$30 SCP / $30 Chiro / $30 Podiatrist	$30 MH	$20 Therapy		$30 Hearing / $30 OPSA	30% coinsurance	$30 Vision	0	0	0	0	0	0	0	0	0											141.8809525	141.8809525	81.07483001	0	121.612245	0.24322449	0.24322449	34.66092899	81.07483001	0	0.197491909	0	0	16.214966	8.107483001	24.322449	24.322449	16.214966	0	0.005127149	0.24322449	24.322449	0	0	0	0	0	0	0	0	0											17.3605	0.257097997	5.10247982	0	2.520350738	6.630952773	0.304735944	0.900866884	2.059469618	0	5.345594022	0	0	0.765477987	2.934162659	10.76220445	0.346895588	0.763739507	0	0.217737186	1.789418602	1.356938328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4186	0	13.87	17.3605	0.257097997	5.10247982	0	2.520350738	6.630952773	0.304735944	0.900866884	2.059469618	0	5.345594022	0	0	0.765477987	2.934162659	10.76220445	0.346895588	0.763739507	0	0.217737186	1.789418602	1.356938328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4186	3250																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.3605	0.257097997	5.10247982	0	2.520350738	6.630952773	0.304735944	0.900866884	2.059469618	0	5.345594022	0	0	0.765477987	2.934162659	10.76220445	0.346895588	0.763739507	0	0.217737186	1.789418602	1.356938328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4186
H5996_003_0	2008	6																					3250											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1360.018801	20.1410082	842.1786382	34.79770085	242.6648613	25.13646046	1.150077524	331.6423371	322.1111408	11.2856238	30.47903706	0	0.267501814	600.2613207	4296.54266	5300.082277	173.3313517	572.4133803	30.81839614	42.67151984	8.292565031	662.6657762	0	0	0	0	0	0	0	12000	0											$175/day with limits	$175/day with limits	"$100/day, days 9 - 100"		$150 copay	30% DME / 30% Diabetes Monitoring	30% coinsurance	$50 ER / $30 UC	$100 ASC / $100 OP		"$15 X-Ray, 30% Coinsurance Other"	0	0% coinsurance	$20 Cardiac Rehab; $20 PT/OT/ST	$10 PCP	$30 SCP / $30 Chiro / $30 Podiatrist	$30 MH	$20 Therapy		$30 Hearing / $30 OPSA	30% coinsurance	$30 Vision	0	0	0	0	0	0	0	0	0											141.8808186	141.8808186	81.0747535	0	121.6121303	0.243224261	0.243224261	34.66089629	81.0747535	0	0.195727651	0	0	16.2149507	8.10747535	24.32242605	24.32242605	16.2149507	0	0.005071274	0.243224261	24.32242605	0	0	0	0	0	0	0	0	0											16.08	0.238135228	5.689952125	0	2.459249226	6.113797008	0.279726755	0.957918388	2.176256779	0	5.965590331	0	0	0.811100644	2.902842809	10.7425716	0.351319915	0.773471229	0	0.216398955	2.016952997	1.343136612	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.1185	0	13.8	16.08	0.238135228	5.689952125	0	2.459249226	6.113797008	0.279726755	0.957918388	2.176256779	0	5.965590331	0	0	0.811100644	2.902842809	10.7425716	0.351319915	0.773471229	0	0.216398955	2.016952997	1.343136612	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.1185	3250																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.08	0.238135228	5.689952125	0	2.459249226	6.113797008	0.279726755	0.957918388	2.176256779	0	5.965590331	0	0	0.811100644	2.902842809	10.7425716	0.351319915	0.773471229	0	0.216398955	2.016952997	1.343136612	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.1185
H5996_005_0	2008	7																					3250											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1104.627904	16.35881967	542.0826311	23.11455346	228.9111259	24.78185563	1.163898829	291.4485061	455.532725	9.954581769	27.35396817	0	0.182200838	836.6613287	3592.933427	4605.88543	124.5663045	448.6044433	22.93485971	31.79911372	7.463490865	600.1283358	0	0	0	0	0	0	0	12000	0											$100/day with limits	$100/day with limits	"$120/day, days 9 - 100"		$150 copay	30% DME / 30% Diabetes Monitoring	30% coinsurance	$50 ER / $0 UC	$50 ASC / $50 OP		"$15 X-Ray, 30% Coinsurance Other"	0	0% coinsurance	$5 Cardiac Rehab; $5 PT/OT/ST	$5 PCP	$5 SCP / $5 Chiro / $5 Podiatrist	$20 MH	$5 Therapy		$5 Hearing / $20 OPSA	30% coinsurance	$5 Vision	0	0	0	0	0	0	0	0	0											90.95075414	90.95075414	109.140905	0	136.4261312	0.272852262	0.272852262	45.47537707	45.47537707	0	0.236083624	0	0	4.547537707	4.547537707	4.547537707	18.19015083	4.547537707	0	0.00158121	0.272852262	4.547537707	0	0	0	0	0	0	0	0	0											8.3722	0.123987249	4.93028241	0	2.602454942	6.761785375	0.317572429	1.104477559	1.726293536	0	6.457823935	0	0	0.317062412	1.361583353	1.745453139	0.188823322	0.170003802	0	0.050281092	2.036430368	0.22742552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.494	0	3.83	8.3722	0.123987249	4.93028241	0	2.602454942	6.761785375	0.317572429	1.104477559	1.726293536	0	6.457823935	0	0	0.317062412	1.361583353	1.745453139	0.188823322	0.170003802	0	0.050281092	2.036430368	0.22742552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.494	3250																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.3722	0.123987249	4.93028241	0	2.602454942	6.761785375	0.317572429	1.104477559	1.726293536	0	6.457823935	0	0	0.317062412	1.361583353	1.745453139	0.188823322	0.170003802	0	0.050281092	2.036430368	0.22742552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.494
H5996_006_0	2008	7																					1500											coin	coin	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	311.4138668	2.37294605	905.7110988	37.16326062	264.3961445	28.16610079	1.289948601	236.2002623	29.49095502	11.56089559	31.27551394	0	0.296806243	671.6160933	5094.599206	5817.209177	206.8848974	696.1023015	35.48493336	48.16494595	8.506016027	8.021802289	0	0	0	0	0	0	0	12000	0											$0/admit	$0/admit	"$75/day, days 9 - 100"		$100 copay	30% DME / 30% Diabetes Monitoring	30% coinsurance	$50 ER / $0 UC	$0 ASC / $0 OP		"$15 X-Ray, 30% Coinsurance Other"	0	0% coinsurance	$5 Cardiac Rehab; $5 PT/OT/ST	$5 PCP	$5 SCP / $0 Chiro / $5 Podiatrist	$10 MH	$5 Therapy		$5 Hearing / $10 OPSA	30% coinsurance	$0 Vision	0	0	0	0	0	0	0	0	0											0	0	59.0907968	0	78.78772906	0.236363187	0.236363187	39.39386453	0	0	0.192560931	0	0	3.939386453	3.939386453	3.939386453	7.878772906	3.939386453	0	0.001078637	0.236363187	0	0	0	0	0	0	0	0	0	0											0	0	4.459932541	0	1.735930983	6.657429353	0.304896363	0.775403428	0	0	6.022442093	0	0	0.220479612	1.672466258	1.909686252	0.13583326	0.228517998	0	0.051952494	2.010509058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.1855	0	7.05	0	0	4.459932541	0	1.735930983	6.657429353	0.304896363	0.775403428	0	0	6.022442093	0	0	0.220479612	1.672466258	1.909686252	0.13583326	0.228517998	0	0.051952494	2.010509058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.1855	1500																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	4.459932541	0	1.735930983	6.657429353	0.304896363	0.775403428	0	0	6.022442093	0	0	0.220479612	1.672466258	1.909686252	0.13583326	0.228517998	0	0.051952494	2.010509058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.1855
H5996_007_0	2008	7																					1500											coin	coin	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	323.8170813	2.467457445	861.7846404	44.49871496	311.0774669	32.76642554	1.518416496	242.1891608	32.06500534	12.49882245	34.10403038	0	0.274453477	693.1467995	5082.6183	5735.868027	198.4003489	667.7839443	36.99766875	47.22558756	9.264966938	7.921039967	0	0	0	0	0	0	0	12000	0											$0/admit	$0/admit	"$75/day, days 9 - 100"		$100 copay	30% DME / 30% Diabetes Monitoring	30% coinsurance	$50 ER / $0 UC	$0 ASC / $0 OP		"$15 X-Ray, 30% Coinsurance Other"	0	0% coinsurance	$5 Cardiac Rehab; $5 PT/OT/ST	$5 PCP	$5 SCP / $0 Chiro / $5 Podiatrist	$10 MH	$5 Therapy		$5 Hearing / $10 OPSA	30% coinsurance	$0 Vision	0	0	0	0	0	0	0	0	0											0	0	57.74243248	0	76.98990998	0.23096973	0.23096973	38.49495499	0	0	0.186898273	0	0	3.849495499	3.849495499	3.849495499	7.698990998	3.849495499	0	0.001058567	0.23096973	0	0	0	0	0	0	0	0	0	0											0	0	4.146795118	0	1.995818848	7.568052459	0.350708248	0.776921737	0	0	6.373984365	0	0	0.222355457	1.630459689	1.840016513	0.127290208	0.214219274	0	0.049991458	2.139926911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.4365	0	8.2	0	0	4.146795118	0	1.995818848	7.568052459	0.350708248	0.776921737	0	0	6.373984365	0	0	0.222355457	1.630459689	1.840016513	0.127290208	0.214219274	0	0.049991458	2.139926911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.4365	1500																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	4.146795118	0	1.995818848	7.568052459	0.350708248	0.776921737	0	0	6.373984365	0	0	0.222355457	1.630459689	1.840016513	0.127290208	0.214219274	0	0.049991458	2.139926911	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.4365
H5996_008_0	2008	7																					1000											coin	coin	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	338.0009035	2.575536912	1586.123339	58.60503164	263.3101656	27.44852307	1.206691768	299.9413095	32.91927888	13.11972455	34.73335003	0	0.311475008	431.033231	5447.027633	7248.624493	207.5438336	744.0427684	38.94299636	50.03214243	9.418514562	928.7612261	0	0	0	0	0	0	0	12000	0											$0/admit	$0/admit	"$50/day, days 21 - 100"		$100 copay	20% DME / 0% Diabetes Monitoring	20% coinsurance	$50 ER / $0 UC	$0 ASC / $0 OP		"$0 X-Ray, 0% Coinsurance Other"	0	0% coinsurance	$0 Cardiac Rehab; $5 PT/OT/ST	$5 PCP	$5 SCP / $5 Chiro / $5 Podiatrist	$20 MH	$5 Therapy		$5 Hearing / $20 OPSA	20% coinsurance	$5 Vision	0	0	0	0	0	0	0	0	0											0	0	38.31613691	0	76.63227383	0.12568306	0.153264548	38.31613691	0	0	0	0	0	3.831613691	3.831613691	3.831613691	15.32645477	3.831613691	0	0.00134692	0.153264548	3.831613691	0	0	0	0	0	0	0	0	0											0	0	5.064509919	0	1.681504726	3.449814362	0.184943068	0.957716023	0	0	0	0	0	0.137629402	1.739242138	2.314494071	0.265075931	0.237573705	0	0.067389289	1.443524374	0.296554519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.84	0	5.44	0	0	5.064509919	0	1.681504726	3.449814362	0.184943068	0.957716023	0	0	0	0	0	0.137629402	1.739242138	2.314494071	0.265075931	0.237573705	0	0.067389289	1.443524374	0.296554519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.84	1000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	5.064509919	0	1.681504726	3.449814362	0.184943068	0.957716023	0	0	0	0	0	0.137629402	1.739242138	2.314494071	0.265075931	0.237573705	0	0.067389289	1.443524374	0.296554519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.84
H5996_009_0	2008	6																					1000											coin	coin	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	338.693356	2.580813339	1583.953683	58.79293163	264.7283929	27.56609312	1.211860381	304.9012771	33.3034956	13.27285116	35.13873964	0	0.31241873	438.160995	5459.966589	7156.57832	203.0941348	744.6381527	38.66398481	50.04631377	9.52844257	893.7291199	0	0	0	0	0	0	0	12000	0											$0/admit	$0/admit	"$50/day, days 21 - 100"		$100 copay	20% DME / 0% Diabetes Monitoring	20% coinsurance	$50 ER / $0 UC	$0 ASC / $0 OP		"$0 X-Ray, 0% Coinsurance Other"	0	0% coinsurance	$0 Cardiac Rehab; $5 PT/OT/ST	$5 PCP	$5 SCP / $10 Chiro / $10 Podiatrist	$25 MH	$5 Therapy		$10 Hearing / $25 OPSA	20% coinsurance	$10 Vision	0	0	0	0	0	0	0	0	0											0	0	37.59382662	0	75.18765325	0.123313766	0.150375306	37.59382662	0	0	0	0	0	3.759382662	3.759382662	4.841506237	18.79691331	3.759382662	0	0.002160039	0.150375306	7.518765325	0	0	0	0	0	0	0	0	0											0	0	4.96224001	0	1.658692217	3.399278766	0.182233876	0.955200479	0	0	0	0	0	0.137267904	1.710508644	2.887384881	0.31812857	0.233281647	0	0.108101983	1.432842472	0.559978293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.5451	0	6.12	0	0	4.96224001	0	1.658692217	3.399278766	0.182233876	0.955200479	0	0	0	0	0	0.137267904	1.710508644	2.887384881	0.31812857	0.233281647	0	0.108101983	1.432842472	0.559978293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.5451	1000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	4.96224001	0	1.658692217	3.399278766	0.182233876	0.955200479	0	0	0	0	0	0.137267904	1.710508644	2.887384881	0.31812857	0.233281647	0	0.108101983	1.432842472	0.559978293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.5451
H5996_011_0	2008	6																					3750											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	215.3271883	2.168054026	718.9761332	27.12310379	203.3443598	19.79621024	0.906959721	292.5430458	285.7487485	9.466121392	25.63561621	0	0.213252116	530.959902	4202.923534	4968.015778	142.8019353	472.2869652	24.12591517	35.32828967	6.975404509	622.948644	0	0	0	0	0	0	0	12000	0											$400/admit	$400/admit	"$75/day, days 9 - 100"		$100 copay	30% DME / 30% Diabetes Monitoring	30% coinsurance	$50 ER / $30 UC	$125 ASC / $150 OP		"$15 X-Ray, 25% Coinsurance Other"	0	0% coinsurance	$20 Cardiac Rehab; $20 PT/OT/ST	$5 PCP	$15 SCP / $30 Chiro / $30 Podiatrist	$25 MH	$20 Therapy		$30 Hearing / $25 OPSA	25% coinsurance	$30 Vision	0	0	0	0	0	0	0	0	0											368.9481979	368.9481979	69.1777871	0	92.23704947	0.276711148	0.276711148	39.43297595	133.6830492	0	0.192152189	0	0	18.44740989	4.611852473	17.43792609	23.05926237	18.44740989	0	0.006235352	0.230592624	27.67111484	0	0	0	0	0	0	0	0	0											6.6204	0.066658302	4.144764823	0	1.562990315	5.477832069	0.250965866	0.961320241	3.183313667	0	4.925939768	0	0	0.816236246	1.615271941	7.219324328	0.274408941	0.72603927	0	0.220284339	1.608476827	1.436473622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1107	0	3.46	6.6204	0.066658302	4.144764823	0	1.562990315	5.477832069	0.250965866	0.961320241	3.183313667	0	4.925939768	0	0	0.816236246	1.615271941	7.219324328	0.274408941	0.72603927	0	0.220284339	1.608476827	1.436473622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1107	3750																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.6204	0.066658302	4.144764823	0	1.562990315	5.477832069	0.250965866	0.961320241	3.183313667	0	4.925939768	0	0	0.816236246	1.615271941	7.219324328	0.274408941	0.72603927	0	0.220284339	1.608476827	1.436473622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1107
H5996_012_0	2008	7																					3750											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1371.088322	16.89170162	707.9282111	32.77199984	233.1189869	25.5547084	1.174407127	292.3576043	285.7349159	9.355708137	25.37166456	0	0.25191706	531.0197016	4070.915703	4977.232257	160.4299487	529.8137004	28.48128096	39.80695189	6.896153863	627.5477527	0	0	0	0	0	0	0	12000	0											$200/day with limits	$200/day with limits	"$100/day, days 9 - 100"		$150 copay	30% DME / 30% Diabetes Monitoring	30% coinsurance	$50 ER / $30 UC	$150 ASC / $175 OP		"$15 X-Ray, 25% Coinsurance Other"	0	0% coinsurance	$20 Cardiac Rehab; $20 PT/OT/ST	$10 PCP	$30 SCP / $30 Chiro / $30 Podiatrist	$30 MH	$20 Therapy		$30 Hearing / $30 OPSA	25% coinsurance	$35 Vision	0	0	0	0	0	0	0	0	0											169.5119452	169.5119452	84.75597261	0	127.1339589	0.254267918	0.254267918	36.2346828	144.0294018	0	0.176903579	0	0	16.95119452	8.475597261	25.42679178	25.42679178	16.95119452	0	0.00536007	0.211889932	29.66459041	0	0	0	0	0	0	0	0	0											19.368	0.2386121	5.000095339	0	2.469778308	6.497742494	0.298614055	0.882790421	3.429519086	0	4.488338262	0	0	0.750118188	2.875286832	10.54625402	0.339934908	0.748414591	0	0.21336803	1.46122557	1.551328921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1594	0	11	19.368	0.2386121	5.000095339	0	2.469778308	6.497742494	0.298614055	0.882790421	3.429519086	0	4.488338262	0	0	0.750118188	2.875286832	10.54625402	0.339934908	0.748414591	0	0.21336803	1.46122557	1.551328921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1594	3750																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.368	0.2386121	5.000095339	0	2.469778308	6.497742494	0.298614055	0.882790421	3.429519086	0	4.488338262	0	0	0.750118188	2.875286832	10.54625402	0.339934908	0.748414591	0	0.21336803	1.46122557	1.551328921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1594
H5996_013_0	2008	7																					3750											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1100.457146	15.11853502	542.0892507	23.11511798	228.9139212	24.78246087	1.163927255	291.4520651	455.5382876	9.954824889	27.35463623	0	0.182205287	836.6715455	3592.977302	4605.941674	124.5678256	448.6099213	22.93541985	31.79989035	7.463673145	600.1356642	0	0	0	0	0	0	0	12000	0											$125/day with limits	$125/day with limits	"$120/day, days 9 - 100"		$150 copay	30% DME / 30% Diabetes Monitoring	30% coinsurance	$50 ER / $0 UC	$100 ASC / $125 OP		"$15 X-Ray, 25% Coinsurance Other"	0	0% coinsurance	$5 Cardiac Rehab; $5 PT/OT/ST	$5 PCP	$5 SCP / $5 Chiro / $5 Podiatrist	$20 MH	$5 Therapy		$5 Hearing / $20 OPSA	25% coinsurance	$5 Vision	0	0	0	0	0	0	0	0	0											115.0666879	115.0666879	110.4640204	0	138.0800255	0.276160051	0.276160051	46.02667515	110.4034686	0	0.206844364	0	0	4.602667515	4.602667515	4.602667515	18.41067006	4.602667515	0	0.00160036	0.230133376	4.602667515	0	0	0	0	0	0	0	0	0											10.5522	0.144969979	4.990113169	0	2.634036673	6.843925656	0.32143021	1.117880794	4.191083921	0	5.658152334	0	0	0.320910079	1.378106659	1.766634844	0.191114761	0.172066859	0	0.050891271	1.717640296	0.230185411	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.2813	0	3.65	10.5522	0.144969979	4.990113169	0	2.634036673	6.843925656	0.32143021	1.117880794	4.191083921	0	5.658152334	0	0	0.320910079	1.378106659	1.766634844	0.191114761	0.172066859	0	0.050891271	1.717640296	0.230185411	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.2813	3750																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.5522	0.144969979	4.990113169	0	2.634036673	6.843925656	0.32143021	1.117880794	4.191083921	0	5.658152334	0	0	0.320910079	1.378106659	1.766634844	0.191114761	0.172066859	0	0.050891271	1.717640296	0.230185411	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.2813
H5996_014_0	2008	7																					4000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1427.000566	17.43126033	863.5938756	37.31994677	234.498984	23.95244657	1.097144296	331.0350218	326.4438434	10.07653004	27.32381721	0	0.214407906	607.1939037	4078.415686	4679.762995	142.5275777	459.9944361	27.00725291	35.10075934	7.41178459	687.8444281	0	0	0	0	0	0	0	12000	0											$200/day with limits	$200/day with limits	"$120/day, days 9 - 100"		$150 copay	30% DME / 30% Diabetes Monitoring	30% coinsurance	$50 ER / $35 UC	$100 ASC / $125 OP		"$15 X-Ray, 25% Coinsurance Other"	0	0% coinsurance	$35 Cardiac Rehab; $35 PT/OT/ST	$5 PCP	$35 SCP / $35 Chiro / $35 Podiatrist	$35 MH	$35 Therapy		$35 Hearing / $35 OPSA	25% coinsurance	$5 Vision	0	0	0	0	0	0	0	0	0											171.1679951	171.1679951	102.700797	0	128.3759963	0.256751993	0.256751993	38.21310787	102.6445008	0	0.180533063	0	0	29.95439914	4.279199876	29.95439914	29.95439914	29.95439914	0	0.006779922	0.213959994	4.279199876	0	0	0	0	0	0	0	0	0											20.3547	0.24863949	7.390981611	0	2.508670059	6.149838383	0.281693984	1.054156416	2.792305445	0	4.932852427	0	0	1.515677379	1.454362992	11.68162405	0.355777329	1.148238078	0	0.237980417	1.585825385	0.245285316	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.9386	0	10.77	20.3547	0.24863949	7.390981611	0	2.508670059	6.149838383	0.281693984	1.054156416	2.792305445	0	4.932852427	0	0	1.515677379	1.454362992	11.68162405	0.355777329	1.148238078	0	0.237980417	1.585825385	0.245285316	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.9386	4000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.3547	0.24863949	7.390981611	0	2.508670059	6.149838383	0.281693984	1.054156416	2.792305445	0	4.932852427	0	0	1.515677379	1.454362992	11.68162405	0.355777329	1.148238078	0	0.237980417	1.585825385	0.245285316	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.9386
H5996_015_0	2008	6																					4000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1402.485599	17.15553834	852.2586087	36.66835008	230.5526294	23.44233515	1.073710587	328.0087405	323.4625632	10.20927285	27.68340145	0	0.211191553	601.6510067	4062.390982	4659.251611	141.7350014	457.4463608	26.53729313	34.81602041	7.50900619	685.1753516	0	0	0	0	0	0	0	12000	0											$225/day with limits	$225/day with limits	"$120/day, days 9 - 100"		$150 copay	30% DME / 30% Diabetes Monitoring	30% coinsurance	$50 ER / $35 UC	$150 ASC / $175 OP		"$15 X-Ray, 25% Coinsurance Other"	0	0% coinsurance	$35 Cardiac Rehab; $35 PT/OT/ST	$5 PCP	$35 SCP / $35 Chiro / $35 Podiatrist	$35 MH	$35 Therapy		$35 Hearing / $35 OPSA	25% coinsurance	$5 Vision	0	0	0	0	0	0	0	0	0											191.0573587	191.0573587	101.897258	0	127.3715725	0.254743145	0.254743145	37.91412553	144.298593	0	0.178438511	0	0	29.72003358	4.245719082	29.72003358	29.72003358	29.72003358	0	0.006752314	0.212285954	4.245719082	0	0	0	0	0	0	0	0	0											22.3296	0.273140987	7.236901276	0	2.447154245	5.97177418	0.273520412	1.036347047	3.889599397	0	4.939784942	0	0	1.490090677	1.437314243	11.53942619	0.35103075	1.132943433	0	0.235088696	1.594056544	0.242421839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4202	0	11.8	22.3296	0.273140987	7.236901276	0	2.447154245	5.97177418	0.273520412	1.036347047	3.889599397	0	4.939784942	0	0	1.490090677	1.437314243	11.53942619	0.35103075	1.132943433	0	0.235088696	1.594056544	0.242421839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4202	4000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.3296	0.273140987	7.236901276	0	2.447154245	5.97177418	0.273520412	1.036347047	3.889599397	0	4.939784942	0	0	1.490090677	1.437314243	11.53942619	0.35103075	1.132943433	0	0.235088696	1.594056544	0.242421839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4202
H5996_016_0	2008	7																					4000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1447.983342	17.73236235	661.2150156	38.71770716	255.715316	27.80443142	1.294853202	273.8857427	273.1882323	9.435600166	25.77713467	0	0.202828551	504.0787559	3740.291559	4329.569224	135.113341	437.5587123	25.9979552	33.72420469	7.022840658	626.9005724	0	0	0	0	0	0	0	12000	0											$200/day with limits	$200/day with limits	"$120/day, days 9 - 100"		$150 copay	30% DME / 30% Diabetes Monitoring	30% coinsurance	$50 ER / $35 UC	$100 ASC / $125 OP		"$15 X-Ray, 25% Coinsurance Other"	0	0% coinsurance	$35 Cardiac Rehab; $35 PT/OT/ST	$5 PCP	$35 SCP / $35 Chiro / $35 Podiatrist	$35 MH	$35 Therapy		$35 Hearing / $35 OPSA	25% coinsurance	$5 Vision	0	0	0	0	0	0	0	0	0											172.688079	172.688079	103.6128474	0	129.5160592	0.259032118	0.259032118	38.55246529	103.5560512	0	0.178289615	0	0	30.22041382	4.317201974	30.16986642	30.22041382	30.22041382	0	0.006536501	0.215860099	4.317201974	0	0	0	0	0	0	0	0	0											20.8375	0.255180632	5.709197541	0	2.759936667	7.202240772	0.335408568	0.879914216	2.357524547	0	4.59579541	0	0	1.269455717	1.345632842	10.88521043	0.34026509	1.10193378	0	0.220438301	1.515951078	0.225538032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8371	0	9.78	20.8375	0.255180632	5.709197541	0	2.759936667	7.202240772	0.335408568	0.879914216	2.357524547	0	4.59579541	0	0	1.269455717	1.345632842	10.88521043	0.34026509	1.10193378	0	0.220438301	1.515951078	0.225538032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8371	4000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.8375	0.255180632	5.709197541	0	2.759936667	7.202240772	0.335408568	0.879914216	2.357524547	0	4.59579541	0	0	1.269455717	1.345632842	10.88521043	0.34026509	1.10193378	0	0.220438301	1.515951078	0.225538032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8371
H5996_017_0	2008	7																					1500											coin	coin	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	331.037932	2.522479687	936.9092195	38.47867973	214.7256472	23.28488933	1.057660269	250.4244624	33.05336508	13.02041422	34.97870327	0	0.338729848	708.1928001	5145.552779	5847.248867	199.8683544	671.5697901	35.09583658	51.58336526	9.520333504	9.440683367	0	0	0	0	0	0	0	12000	0											$0/admit	$0/admit	"$75/day, days 9 - 100"		$100 copay	30% DME / 30% Diabetes Monitoring	30% coinsurance	$50 ER / $0 UC	$0 ASC / $0 OP		"$15 X-Ray, 30% Coinsurance Other"	0	0% coinsurance	$5 Cardiac Rehab; $5 PT/OT/ST	$5 PCP	$5 SCP / $0 Chiro / $5 Podiatrist	$10 MH	$5 Therapy		$5 Hearing / $10 OPSA	30% coinsurance	$0 Vision	0	0	0	0	0	0	0	0	0											0	0	59.22363913	0	78.96485217	0.236894557	0.236894557	39.48242608	0	0	0.191257982	0	0	3.948242608	3.948242608	3.948242608	7.896485217	3.948242608	0	0.001009408	0.236894557	0	0	0	0	0	0	0	0	0	0											0	0	4.623931126	0	1.412981582	5.516063531	0.25055396	0.82394711	0	0	6.689956191	0	0	0.233009749	1.692990894	1.923863093	0.131521459	0.220960038	0	0.052068659	2.255315183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.8272	0	6.88	0	0	4.623931126	0	1.412981582	5.516063531	0.25055396	0.82394711	0	0	6.689956191	0	0	0.233009749	1.692990894	1.923863093	0.131521459	0.220960038	0	0.052068659	2.255315183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.8272	1500																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	4.623931126	0	1.412981582	5.516063531	0.25055396	0.82394711	0	0	6.689956191	0	0	0.233009749	1.692990894	1.923863093	0.131521459	0.220960038	0	0.052068659	2.255315183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.8272
H5996_018_0	2008	6																					3750											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1269.956606	15.84460452	789.4331332	32.61742372	227.4668022	23.56151589	1.078018518	310.8716339	301.9373748	10.57851423	28.56934918	0	0.250741279	562.6670562	4027.450923	4968.139025	162.4756386	536.5632276	28.88744545	39.99790242	7.77298789	621.1631313	0	0	0	0	0	0	0	12000	0											$200/day with limits	$200/day with limits	"$100/day, days 9 - 100"		$150 copay	30% DME / 30% Diabetes Monitoring	30% coinsurance	$50 ER / $30 UC	$150 ASC / $175 OP		"$15 X-Ray, 25% Coinsurance Other"	0	0% coinsurance	$20 Cardiac Rehab; $20 PT/OT/ST	$10 PCP	$30 SCP / $30 Chiro / $30 Podiatrist	$30 MH	$20 Therapy		$30 Hearing / $30 OPSA	25% coinsurance	$35 Vision	0	0	0	0	0	0	0	0	0											169.6427453	169.6427453	84.82137263	0	127.2320589	0.254464118	0.254464118	36.26264247	144.1405389	0	0.175194546	0	0	16.96427453	8.482137263	25.44641179	25.44641179	16.96427453	0	0.00530577	0.212053432	29.68748042	0	0	0	0	0	0	0	0	0											17.9532	0.223993517	5.580066829	0	2.411755799	5.995560358	0.274317031	0.93941891	3.626784659	0	5.005194152	0	0	0.795436534	2.846782629	10.53510929	0.344535167	0.758533824	0	0.212219688	1.648288756	1.536730691	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.688	0	10.86	17.9532	0.223993517	5.580066829	0	2.411755799	5.995560358	0.274317031	0.93941891	3.626784659	0	5.005194152	0	0	0.795436534	2.846782629	10.53510929	0.344535167	0.758533824	0	0.212219688	1.648288756	1.536730691	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.688	3750																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.9532	0.223993517	5.580066829	0	2.411755799	5.995560358	0.274317031	0.93941891	3.626784659	0	5.005194152	0	0	0.795436534	2.846782629	10.53510929	0.344535167	0.758533824	0	0.212219688	1.648288756	1.536730691	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.688
H5996_019_0	2008	7																					4000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1762.057334	20.75867612	811.6750655	45.96322197	275.3904261	31.12437794	1.451204334	247.6804917	247.7085955	9.33754233	25.55562527	0	0.227834076	456.6317912	3860.372989	4504.614675	143.8932075	465.9698648	30.94751161	37.9200752	6.956652094	647.0680791	0	0	0	0	0	0	0	12000	0											$225/day with limits	$225/day with limits	"$120/day, days 9 - 100"		$150 copay	30% DME / 30% Diabetes Monitoring	30% coinsurance	$50 ER / $35 UC	$150 ASC / $175 OP		"$15 X-Ray, 25% Coinsurance Other"	0	0% coinsurance	$35 Cardiac Rehab; $35 PT/OT/ST	$5 PCP	$35 SCP / $35 Chiro / $35 Podiatrist	$35 MH	$35 Therapy		$35 Hearing / $35 OPSA	25% coinsurance	$5 Vision	0	0	0	0	0	0	0	0	0											187.2818607	187.2818607	99.88365904	0	124.8545738	0.249709148	0.249709148	37.16490181	141.4470983	0	0.169624493	0	0	29.13273389	4.161819127	29.13273389	29.13273389	29.13273389	0	0.005817834	0.208090956	4.161819127	0	0	0	0	0	0	0	0	0											27.5001	0.323976957	6.756089625	0	2.865312857	7.772041885	0.362378997	0.767085096	2.919805171	0	4.334859985	0	0	1.108577705	1.338847845	10.93597838	0.349333543	1.131248006	0	0.220612718	1.447616387	0.224415026	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.3583	0	14.17	27.5001	0.323976957	6.756089625	0	2.865312857	7.772041885	0.362378997	0.767085096	2.919805171	0	4.334859985	0	0	1.108577705	1.338847845	10.93597838	0.349333543	1.131248006	0	0.220612718	1.447616387	0.224415026	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.3583	4000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.5001	0.323976957	6.756089625	0	2.865312857	7.772041885	0.362378997	0.767085096	2.919805171	0	4.334859985	0	0	1.108577705	1.338847845	10.93597838	0.349333543	1.131248006	0	0.220612718	1.447616387	0.224415026	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.3583
H5996_020_0	2008	5																					4000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	1609.556655	19.17795456	901.2199879	36.89686258	249.4371743	26.03453244	1.21584123	220.6557773	220.8528454	8.442051361	23.12503914	0	0.242356265	407.0659717	4037.737298	4797.294643	160.2176138	518.596677	32.76261776	40.25844956	6.290504192	676.6754857	0	0	0	0	0	0	0	12000	24000											$225/day with limits	$225/day with limits	"$120/day, days 9 - 100"		$150 copay	30% DME / 30% Diabetes Monitoring	30% coinsurance	$50 ER / $35 UC	$150 ASC / $175 OP		"$15 X-Ray, 25% Coinsurance Other"	0	0% coinsurance	$35 Cardiac Rehab; $35 PT/OT/ST	$5 PCP	$35 SCP / $35 Chiro / $35 Podiatrist	$35 MH	$35 Therapy		$35 Hearing / $35 OPSA	25% coinsurance	$5 Vision	0	0	0	0	0	0	0	0	0											189.8541537	189.8541537	101.2555486	0	126.5694358	0.253138872	0.253138872	37.67535709	143.3898565	0	0.171605644	0	0	29.53286835	4.218981192	29.53286835	29.53286835	29.53286835	0	0.005867901	0.21094906	4.218981192	0	0	0	0	0	0	0	0	0											25.4651	0.303417861	7.604460359	0	2.630926868	6.590352163	0.307776677	0.692773767	2.639004818	0	3.968387237	0	0	1.001818813	1.41959481	11.80648926	0.394307141	1.276303949	0	0.236232591	1.326975944	0.237906762	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.9018	0	12.57	25.4651	0.303417861	7.604460359	0	2.630926868	6.590352163	0.307776677	0.692773767	2.639004818	0	3.968387237	0	0	1.001818813	1.41959481	11.80648926	0.394307141	1.276303949	0	0.236232591	1.326975944	0.237906762	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.9018	4000																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.4651	0.303417861	7.604460359	0	2.630926868	6.590352163	0.307776677	0.692773767	2.639004818	0	3.968387237	0	0	1.001818813	1.41959481	11.80648926	0.394307141	1.276303949	0	0.236232591	1.326975944	0.237906762	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.9018
H5996_801_0	2008	5																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	321.2091264	2.461814427	51.82786415	40.15578082	8.40137275	27.99660109	1.27398215	6.169134706	32.02789189	12.58200324	33.98037197	0	0.285651514	33.13882816	48.53090627	130.8493172	1.471283425	4.960796541	32.37763756	42.60530192	9.220229358	6.537964439	0	0	0	0	0	0	0	0	0											Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits											0.076559082	0.076559082	0.18828883	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											24.5915	0.188474254	9.758607881	0	1.965921223	6.551204654	0.298111823	1.443577521	7.494526702	2.944188758	7.951407041	0	0.066842454	7.754485789	11.35623207	30.61874022	0.344280321	1.160826391	7.576367189	9.96964065	2.15753367	1.529883679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7223	0	0	24.5915	0.188474254	9.758607881	0	1.965921223	6.551204654	0.298111823	1.443577521	7.494526702	2.944188758	7.951407041	0	0.066842454	7.754485789	11.35623207	30.61874022	0.344280321	1.160826391	7.576367189	9.96964065	2.15753367	1.529883679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7223	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.5915	0.188474254	9.758607881	0	1.965921223	6.551204654	0.298111823	1.443577521	7.494526702	2.944188758	7.951407041	0	0.066842454	7.754485789	11.35623207	30.61874022	0.344280321	1.160826391	7.576367189	9.96964065	2.15753367	1.529883679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7223
H5996_802_0	2008	7																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	321.2091264	2.461814427	51.82786415	40.15578082	8.40137275	27.99660109	1.27398215	6.169134706	32.02789189	12.58200324	33.98037197	0	0.285651514	33.13882816	48.53090627	130.8493172	1.471283425	4.960796541	32.37763756	42.60530192	9.220229358	6.537964439	0	0	0	0	0	0	0	0	0											Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits											0.076559082	0.076559082	0.18828883	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											24.5915	0.188474254	9.758607881	0	1.965921223	6.551204654	0.298111823	1.443577521	7.494526702	2.944188758	7.951407041	0	0.066842454	7.754485789	11.35623207	30.61874022	0.344280321	1.160826391	7.576367189	9.96964065	2.15753367	1.529883679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7223	0	0	24.5915	0.188474254	9.758607881	0	1.965921223	6.551204654	0.298111823	1.443577521	7.494526702	2.944188758	7.951407041	0	0.066842454	7.754485789	11.35623207	30.61874022	0.344280321	1.160826391	7.576367189	9.96964065	2.15753367	1.529883679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7223	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.5915	0.188474254	9.758607881	0	1.965921223	6.551204654	0.298111823	1.443577521	7.494526702	2.944188758	7.951407041	0	0.066842454	7.754485789	11.35623207	30.61874022	0.344280321	1.160826391	7.576367189	9.96964065	2.15753367	1.529883679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7223
H5996_803_0	2008	7																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	321.2091264	2.461814427	51.82786415	40.15578082	8.40137275	27.99660109	1.27398215	6.169134706	32.02789189	12.58200324	33.98037197	0	0.285651514	33.13882816	48.53090627	130.8493172	1.471283425	4.960796541	32.37763756	42.60530192	9.220229358	6.537964439	0	0	0	0	0	0	0	0	0											Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits											0.076559082	0.076559082	0.18828883	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											24.5915	0.188474254	9.758607881	0	1.965921223	6.551204654	0.298111823	1.443577521	7.494526702	2.944188758	7.951407041	0	0.066842454	7.754485789	11.35623207	30.61874022	0.344280321	1.160826391	7.576367189	9.96964065	2.15753367	1.529883679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7223	0	0	24.5915	0.188474254	9.758607881	0	1.965921223	6.551204654	0.298111823	1.443577521	7.494526702	2.944188758	7.951407041	0	0.066842454	7.754485789	11.35623207	30.61874022	0.344280321	1.160826391	7.576367189	9.96964065	2.15753367	1.529883679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7223	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.5915	0.188474254	9.758607881	0	1.965921223	6.551204654	0.298111823	1.443577521	7.494526702	2.944188758	7.951407041	0	0.066842454	7.754485789	11.35623207	30.61874022	0.344280321	1.160826391	7.576367189	9.96964065	2.15753367	1.529883679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7223
H5996_804_0	2008	7																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	321.2091264	2.461814427	51.82786415	40.15578082	8.40137275	27.99660109	1.27398215	6.169134706	32.02789189	12.58200324	33.98037197	0	0.285651514	33.13882816	48.53090627	130.8493172	1.471283425	4.960796541	32.37763756	42.60530192	9.220229358	6.537964439	0	0	0	0	0	0	0	0	0											Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits											0.076559082	0.076559082	0.18828883	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											24.5915	0.188474254	9.758607881	0	1.965921223	6.551204654	0.298111823	1.443577521	7.494526702	2.944188758	7.951407041	0	0.066842454	7.754485789	11.35623207	30.61874022	0.344280321	1.160826391	7.576367189	9.96964065	2.15753367	1.529883679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7223	0	0	24.5915	0.188474254	9.758607881	0	1.965921223	6.551204654	0.298111823	1.443577521	7.494526702	2.944188758	7.951407041	0	0.066842454	7.754485789	11.35623207	30.61874022	0.344280321	1.160826391	7.576367189	9.96964065	2.15753367	1.529883679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7223	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.5915	0.188474254	9.758607881	0	1.965921223	6.551204654	0.298111823	1.443577521	7.494526702	2.944188758	7.951407041	0	0.066842454	7.754485789	11.35623207	30.61874022	0.344280321	1.160826391	7.576367189	9.96964065	2.15753367	1.529883679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7223
H5998_001_0	2008	5																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	Coin	V	V	V	V	V	V	V	Coin																																																				0		1254.816232	316.851051	1112.13923	334.0837602	302.0919316	16.24242495	5.225362335	911.286965	3137.479809	3048.341746	952.0217514	0	13.8261501	157.3362111	3913.485012	6450.71966	911.853511	200.9731079	1936.290776	0	17.06853044	10.32956239	0	1630.659814	256.6891421	361.385006	21.7439637	94.77302646	0	2.025427897	44.06626426											$100/day - 1st 10 days	$100/day - 1st 10 days	$50/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $30 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$30/visit	$10/visit	$30/visit	$30/visit	$30/visit	$30/visit	Zero Cost Sharing	20% Coinsurance	10% Blood	100% Coinsurance	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											70.03328531	70.03328531	40.52480559	0	126.3157895	0.2	0.121870541	44.1609844	65.85289683	0	0	0	0	0	8.552971576	9.764057143	30	30	0.344827586	0	0.2	0	0	29.38604651	0	0	0	0	0	0	0											7.3232	1.849176671	3.755768842	0	3.179915069	3.24848499	0.636817735	3.353610788	17.21767785	0	0	0	0	0	2.789327173	5.248766281	2.279633778	0.50243277	0.05564054	0	3.413706087	0	0	3.993220427	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8474			7.3232	1.849176671	3.755768842	0	3.179915069	3.24848499	0.636817735	3.353610788	17.21767785	0	0	0	0	0	2.789327173	5.248766281	2.279633778	0.50243277	0.05564054	0	3.413706087	0	0	3.993220427	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8474		$100/day - 1st 10 days	$100/day - 1st 10 days	$50/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $30 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$30/visit	$10/visit	$30/visit	$30/visit	$30/visit	$30/visit	Zero Cost Sharing	20% Coinsurance	10% Blood	100% Coinsurance	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.8283	0.2092	0.1313	0	4.8672	0.0017	0.0592	0.3904	1.6815	0	0	0	0	0	0.8018	1.5087	0.6553	0.1444	0.016	0	0.912	0	0	0.4912	0	0	0	0	0	0	0											12.6981			8.1516	2.05833155	3.887050087	0	8.047109508	3.25016888	0.69605369	3.744018929	18.89915243	0	0	0	0	0	3.59109414	6.757476864	2.93489397	0.646852543	0.071633911	0	4.325685547	0	0	4.484451071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5455
H5998_002_0	2008	5																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	Coin	V	V	V	V	V	V	V	Coin																																																				0		1534.367148	387.4398746	1359.904228	408.5117273	369.3926838	19.86095064	6.389480866	1114.305622	3836.454953	3727.458501	1164.1154	0	16.90637239	192.3879429	4785.340422	7887.826183	1114.998384	245.7463703	2367.662197	0	20.87109786	12.63080663	0	1893.051714	313.8749539	441.895209	26.58813515	94.77302646	0	2.476657496	53.88345042											$95/day - 1st 10 days	$95/day - 1st 10 days	$75/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $20 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	Zero Cost Sharing	20% Coinsurance	10% Blood	100% Coinsurance	$10/visit Preventative; $10/Visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											35.01664265	35.01664265	40.52480559	0	126.3157895	0.2	0.121870541	44.1609844	65.85289683	0	0	0	0	0	4.276485788	6.509371429	20	20	0.229885057	0	0.2	0	0	19.59069767	0	0	0	0	0	0	0											4.4774	1.130570303	4.592487872	0	3.88834404	3.972190128	0.778689491	4.100736099	21.05347268	0	0	0	0	0	1.705370026	4.278732532	1.858330641	0.409577284	0.045357513	0	4.174219571	0	0	3.090516984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.556			4.4774	1.130570303	4.592487872	0	3.88834404	3.972190128	0.778689491	4.100736099	21.05347268	0	0	0	0	0	1.705370026	4.278732532	1.858330641	0.409577284	0.045357513	0	4.174219571	0	0	3.090516984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.556		$95/day - 1st 10 days	$95/day - 1st 10 days	$75/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $20 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	Zero Cost Sharing	20% Coinsurance	10% Blood	100% Coinsurance	$10/visit Preventative; $10/Visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.5064	0.1279	0.1605	0	5.9515	0.0021	0.0724	0.4774	2.0561	0	0	0	0	0	0.4902	1.2299	0.5342	0.1177	0.013	0	1.1152	0	0	0.3802	0	0	0	0	0	0	0											13.2346			4.9838	1.258445751	4.753016263	0	9.839863521	3.97424916	0.851122171	4.578120286	23.10955013	0	0	0	0	0	2.195563276	5.508615653	2.392491042	0.527306584	0.058395122	0	5.289371964	0	0	3.470700517	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.7906
H5998_003_0	2008	4																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0.2962	0.6313	0.2031	0.9953	5.8472	0.415	0.6229	0	0.03	0.0443	0.8691	2.4598	0.2163	0.0594	0.3327	0	0.6635	0.0121	0	0	0	0	0	0	0	0	0											13.6983		321.7806433	162.8223806	1315.872564	16.82674351	8.71083912	18.56881793	5.973787913	29.27279068	171.9776409	12.20559118	18.32174895	0	0.883228532	1.302138037	25.56121395	72.34703376	6.362884987	1.747327288	9.785870364	0	19.51324602	0.356948042	0	27.64191819	1.208532827	2.202289144	0.07204852	4.983187186	0	23.35607002	0.398795222											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	100% Coinsurance	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											465.4692347	83.19672782	57.15246541	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0	0	0	0	0	0	0	0											12.4816	1.12885744	6.267113436	0	1.742167824	3.713763586	1.194757583	5.854558136	34.39552818	2.441118236	3.664349789	0	0.176645706	0.260427607	5.112242791	14.46940675	1.272576997	0.349465458	1.957174073	0	3.902649205	0.071389608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.4558	135		12.4816	1.12885744	6.267113436	0	2.038336354	4.345103396	1.397866372	6.84983302	40.24276797	2.856108336	4.287289253	0	0.206675477	0.304700301	5.981324065	16.9292059	1.488915087	0.408874585	2.289893665	0	4.566099569	0.083525842	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.1541		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	100% Coinsurance	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											1.4118	0.1277	0.2191	0	3.1199	0.4042	0.13	0.7974	3.9301	0.3299	0.4952	0	0.0239	0.0352	1.7193	4.8661	0.428	0.1175	0.6582	0	1.2198	0.015	0	0	0	0	0	0	0	0	0											20.0482	135		13.8933	1.256539151	6.486177625	0	5.158224511	4.749279246	1.527894078	7.647251309	44.17286772	3.185997171	4.782483655	0	0.230547096	0.339894073	7.700601784	21.79535363	1.916890315	0.526401901	2.94810297	0	5.785943608	0.098489484	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.2023
H5998_004_0	2008	2																																D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	Coin	V	V	V	V	V	V	V	V																																																				0		1254.816232	316.851051	1112.13923	334.0837602	302.0919316	16.24242495	5.225362335	911.286965	3137.479809	3048.341746	952.0217514	0	13.8261501	157.3362111	3913.485012	6450.71966	911.853511	200.9731079	1936.290776	0	17.06853044	10.32956239	0	1630.659814	256.6891421	361.385006	21.7439637	94.77302646	0	2.025427897	44.06626426											$50/day - 1st 10 days	$50/day - 1st 10 days	$50/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $20 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	Zero Cost Sharing	20% Coinsurance	10% Blood	100% Coinsurance	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											35.01664265	35.01664265	40.52480559	0	126.3157895	0.2	0.121870541	44.1609844	65.85289683	0	0	0	0	0	4.276485788	6.509371429	20	20	0.229885057	0	0.2	0	0	9.795348837	0	0	0	0	0	0	0											3.6616	0.924588336	3.755768842	0	3.179915069	3.24848499	0.636817735	3.353610788	17.21767785	0	0	0	0	0	1.394663586	3.499177521	1.519755852	0.33495518	0.037093693	0	3.413706087	0	0	1.331073476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5089			3.6616	0.924588336	3.755768842	0	3.179915069	3.24848499	0.636817735	3.353610788	17.21767785	0	0	0	0	0	1.394663586	3.499177521	1.519755852	0.33495518	0.037093693	0	3.413706087	0	0	1.331073476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5089		$50/day - 1st 10 days	$50/day - 1st 10 days	$50/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$250/visit	Zero Cost Sharing	$0 X-Ray / $20 Radiation Therapy	Zero Cost Sharing	20% Coinsurance	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	Zero Cost Sharing	20% Coinsurance	10% Blood	100% Coinsurance	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.4142	0.1046	0.1313	0	4.8672	0.0017	0.0592	0.3904	1.6815	0	0	0	0	0	0.4009	1.0058	0.4368	0.0963	0.0107	0	0.912	0	0	0.1637	0	0	0	0	0	0	0											10.6762			4.0758	1.029165775	3.887050087	0	8.047109508	3.25016888	0.69605369	3.744018929	18.89915243	0	0	0	0	0	1.79554707	4.504984576	1.95659598	0.431235029	0.047755941	0	4.325685547	0	0	1.494817024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1851
H6013_801_0	2008	2																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		1794.238345	129.0145388	1715	2303	8.992252244	8.61719961	1.403510341	13.17000599	30.8150544	17.03893492	24.66705459	2.012381051	0.745892319	15.51796108	74.55944385	141.5382644	3.485394431	22.97249981	39.9470922	4.006612568	14.28016932	1.490486353																				Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing																				163.5574331	68.72451685	92.87707157	0	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752																				24.4551	0.738871821	13.27368148	0	2.10419379	2.016431192	0.328422476	3.081791311	7.210745914	3.98712359	5.772109332	0.47089868	0.174539364	3.631214569	17.44696596	33.12006036	0.815584919	5.375582238	9.34764963	0.937550355	3.341570364	0.348774928	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9788			24.4551	0.738871821	13.27368148	0	2.10419379	2.016431192	0.328422476	3.081791311	7.210745914	3.98712359	5.772109332	0.47089868	0.174539364	3.631214569	17.44696596	33.12006036	0.815584919	5.375582238	9.34764963	0.937550355	3.341570364	0.348774928	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9788																																																																																				0			24.4551	0.738871821	13.27368148	0	2.10419379	2.016431192	0.328422476	3.081791311	7.210745914	3.98712359	5.772109332	0.47089868	0.174539364	3.631214569	17.44696596	33.12006036	0.815584919	5.375582238	9.34764963	0.937550355	3.341570364	0.348774928	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9788
H6013_802_0	2008	2																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		1794.238345	129.0145388	1715	2303	8.992252244	8.61719961	1.403510341	13.17000599	30.8150544	17.03893492	24.66705459	2.012381051	0.745892319	15.51796108	74.55944385	141.5382644	3.485394431	22.97249981	39.9470922	4.006612568	14.28016932	1.490486353																				Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing																				163.5574331	68.72451685	92.87707157	0	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752																				24.4551	0.738871821	13.27368148	0	2.10419379	2.016431192	0.328422476	3.081791311	7.210745914	3.98712359	5.772109332	0.47089868	0.174539364	3.631214569	17.44696596	33.12006036	0.815584919	5.375582238	9.34764963	0.937550355	3.341570364	0.348774928	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9788			24.4551	0.738871821	13.27368148	0	2.10419379	2.016431192	0.328422476	3.081791311	7.210745914	3.98712359	5.772109332	0.47089868	0.174539364	3.631214569	17.44696596	33.12006036	0.815584919	5.375582238	9.34764963	0.937550355	3.341570364	0.348774928	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9788																																																																																				0			24.4551	0.738871821	13.27368148	0	2.10419379	2.016431192	0.328422476	3.081791311	7.210745914	3.98712359	5.772109332	0.47089868	0.174539364	3.631214569	17.44696596	33.12006036	0.815584919	5.375582238	9.34764963	0.937550355	3.341570364	0.348774928	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9788
H6013_803_0	2008	2																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		1794.238345	129.0145388	1715	2303	8.992252244	8.61719961	1.403510341	13.17000599	30.8150544	17.03893492	24.66705459	2.012381051	0.745892319	15.51796108	74.55944385	141.5382644	3.485394431	22.97249981	39.9470922	4.006612568	14.28016932	1.490486353																				Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing																				163.5574331	68.72451685	92.87707157	0	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752																				24.4551	0.738871821	13.27368148	0	2.10419379	2.016431192	0.328422476	3.081791311	7.210745914	3.98712359	5.772109332	0.47089868	0.174539364	3.631214569	17.44696596	33.12006036	0.815584919	5.375582238	9.34764963	0.937550355	3.341570364	0.348774928	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9788			24.4551	0.738871821	13.27368148	0	2.10419379	2.016431192	0.328422476	3.081791311	7.210745914	3.98712359	5.772109332	0.47089868	0.174539364	3.631214569	17.44696596	33.12006036	0.815584919	5.375582238	9.34764963	0.937550355	3.341570364	0.348774928	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9788																																																																																				0			24.4551	0.738871821	13.27368148	0	2.10419379	2.016431192	0.328422476	3.081791311	7.210745914	3.98712359	5.772109332	0.47089868	0.174539364	3.631214569	17.44696596	33.12006036	0.815584919	5.375582238	9.34764963	0.937550355	3.341570364	0.348774928	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9788
H6013_804_0	2008	2																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		1794.238345	129.0145388	1715	2303	8.992252244	8.61719961	1.403510341	13.17000599	30.8150544	17.03893492	24.66705459	2.012381051	0.745892319	15.51796108	74.55944385	141.5382644	3.485394431	22.97249981	39.9470922	4.006612568	14.28016932	1.490486353																				Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing	Standard Medicare cost sharing																				163.5574331	68.72451685	92.87707157	0	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752	0.234000752																				24.4551	0.738871821	13.27368148	0	2.10419379	2.016431192	0.328422476	3.081791311	7.210745914	3.98712359	5.772109332	0.47089868	0.174539364	3.631214569	17.44696596	33.12006036	0.815584919	5.375582238	9.34764963	0.937550355	3.341570364	0.348774928	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9788			24.4551	0.738871821	13.27368148	0	2.10419379	2.016431192	0.328422476	3.081791311	7.210745914	3.98712359	5.772109332	0.47089868	0.174539364	3.631214569	17.44696596	33.12006036	0.815584919	5.375582238	9.34764963	0.937550355	3.341570364	0.348774928	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9788																																																																																				0			24.4551	0.738871821	13.27368148	0	2.10419379	2.016431192	0.328422476	3.081791311	7.210745914	3.98712359	5.772109332	0.47089868	0.174539364	3.631214569	17.44696596	33.12006036	0.815584919	5.375582238	9.34764963	0.937550355	3.341570364	0.348774928	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9788
H6110_001_0	2008	3																					2500											D	D	D	Coin	T	Coin	Coin	Coin	V	V	Coin	V	V	V	V	V	Coin	V	Coin	V	S	Coin	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	593.57	13.41	690.11	12.93	222.23	10.26	7.15	5.79	361.26	0	29.7	81.6	1.58	523.76	3811.99	3471.32	1.2	523.94	21.36	7055.23	881.53	4.53	0	0	0	0	0	0	0	0	0											"PBP: 1A IP Acute: $150 per admit for 1 to 4 days, $0 for 5 to 90 days, $1700 Max"	"1B IP Psych: $175 per admit 1 to 5 days $0 per admit 6 to 60 days, $2000 Max"	2 SNF: $0 per admit 1 to 20 days and $100 per admit 21 to 100 days	6 Home Health: 15% Coinsurance	10A Ambulance: $150	"11A DME: 20%, $750 Max"	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: 0% Coinsurance, unless admitted within 1 day then waved and 25% Worldwide, 4B Urgent Care: $50"	9B ASC Services: $150	8A OP C/D/T: $0	"8B OP X-Ray: 15% Coinsurance for X-Rays and Diagnotics, 20% Coinsurance for Therapeutic"	9A OP Hospital: $200	12 Renal Dialysis: $20	"3 CORF: $30, 5 Partial Hosp: $150, 9C OP Substance Abuse: 40% Coinsurance, 9D Cardiac Rehab: $15"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: 1 per year $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $15, 14I Diabetes Monitoring: $0"	"7B Chiropractic: $15, 7D Physician Specialist: $30, 7F Podiatry: $30"	"7E Mental Health: 40% Coinsurance, 7H Psychiatric: 40% Coinsurance"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	Included in i.2.	"7G Other Health Care: $35, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: 20% Coinsurance	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: 20% Coinsurance, 17A Medicare Covered Eye Exams: $30"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	"17B Eye Wear: Medicare Covered: 20% Coinsurance, Routine: Not Covered"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											100.6242291	117.3949339	67.0828194	0.100619685	100.6242291	0.134165446	0.134158031	0.176212791	83.85352425	0	0.083866441	83.85352425	13.41656388	19.46241963	10.06242291	20.12484582	0.268318085	20.12484582	0.061383841	19.03135069	20.54612593	0.221976753	0	0	0	0	0	0	0	0	0											4.9773	0.131188839	3.857877041	1.301012523	1.863476869	1.376537472	0.959229924	1.020272059	2.524410348	0	2.490833287	0.570203965	0.001766514	0.849469742	3.196487959	5.821648316	0.321981702	0.87868431	1.311158847	11.18921303	1.509335532	1.005554692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1576	0	0	4.9773	0.131188839	3.857877041	1.301012523	1.863476869	1.376537472	0.959229924	1.020272059	2.524410348	0	2.490833287	0.570203965	0.001766514	0.849469742	3.196487959	5.821648316	0.321981702	0.87868431	1.311158847	11.18921303	1.509335532	1.005554692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1576	2500	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.9773	0.131188839	3.857877041	1.301012523	1.863476869	1.376537472	0.959229924	1.020272059	2.524410348	0	2.490833287	0.570203965	0.001766514	0.849469742	3.196487959	5.821648316	0.321981702	0.87868431	1.311158847	11.18921303	1.509335532	1.005554692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1576
H6178_001_0	2008	5																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		356.4008109	38.37652991	86.76093479	0	15.80743023	35.15818938	25.49970764	13.10528456	27.68163919	14.69939996	29.67498236	0	4.852435698	51.96718243	68.49546121	128.3632042	11.98657262	4.430897989	23.18113394	38.98607811	12.21017434	0.855021171	0	0	0	0	0	0	0	0	0											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing																				0.077743118	0.077743118	0.193442757	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											27.7077	2.983511107	16.78327443	0	3.698938673	8.227016314	5.966931588	3.066636588	6.477503571	3.439659592	6.943945872	0	1.135469953	12.16032069	16.02793792	30.03698978	2.804857994	1.036830129	5.424385343	9.122742277	2.857180797	0.200074954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	166.1019	0	0	27.7077	2.983511107	16.78327443	0	3.698938673	8.227016314	5.966931588	3.066636588	6.477503571	3.439659592	6.943945872	0	1.135469953	12.16032069	16.02793792	30.03698978	2.804857994	1.036830129	5.424385343	9.122742277	2.857180797	0.200074954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	166.1019																																																																																				0	0		27.7077	2.983511107	16.78327443	0	3.698938673	8.227016314	5.966931588	3.066636588	6.477503571	3.439659592	6.943945872	0	1.135469953	12.16032069	16.02793792	30.03698978	2.804857994	1.036830129	5.424385343	9.122742277	2.857180797	0.200074954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	166.1019
H6181_007_0	2008	2																					0											Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	533.121	38.7453	186.38	0	19.12	33.03	24.83	10.2	20.41	16.68	28.75	0.95	1.13	53.7	91.9	161.31	14.26	8.23	40.29	71.93	9.1	5.25	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Medicare FFS cost sharing	1B IP Psych: Medicare FFS cost sharing	2 SNF: Medicare FFS cost sharing	6 Home Health: $0	10A Ambulance: Medicare FFS cost sharing	11A DME: Medicare FFS cost sharing	"11B Prosthetic/Medical Supplies: Medicare FFS cost sharing, 11C Diabetes Monitoring Supplies: Medicare FFS cost sharing"	"4A ER: Medicare FFS cost sharing, 4B Urgent Care: Medicare FFS cost sharing"	9B ASC Services: Medicare FFS cost sharing	8A OP C/D/T: Medicare FFS cost sharing	8B OP X-Ray: Medicare FFS cost sharing	9A OP Hospital: Medicare FFS cost sharing	12 Renal Dialysis: Medicare FFS cost sharing	"3 CORF: Medicare FFS cost sharing, 5 Partial Hosp: Medicare FFS cost sharing, 9C OP Substance Abuse: Medicare FFS cost sharing, 9D Cardiac Rehab: Medicare FFS cost sharing"	"7A PCP: Medicare FFS cost sharing, 14B Immunizations: Medicare FFS cost sharing, 14C Routine Physical Exams: Medicare FFS cost sharing, 14D Pap Smears: Medicare FFS cost sharing, 14D Pelvic Exams: Medicare FFS cost sharing, 14E Prostate Screening: Medicare FFS cost sharing, 14F Colorectal Screening: Medicare FFS cost sharing, 14G Bone Mass Measurement: Medicare FFS cost sharing, 14H Mammography: Medicare FFS cost sharing, 14I Diabetes Monitoring: Medicare FFS cost sharing"	"7D Physician Specialist: Medicare FFS cost sharing,"	"7E Mental Health: Medicare FFS cost sharing, 7H Psychiatric: Medicare FFS cost sharing"	"7C Occupational Therapy: Medicare FFS cost sharing, 7I Physical and Speech Therapy: Medicare FFS cost sharing"	7D Physician Specialist: Medicare FFS cost sharing	"7B Chiropractic: Medicare FFS cost sharing, 7F Podiatry: Medicare FFS cost sharing, 7G Other Health Care: Medicare FFS cost sharing, 18A Medicare Covered Hearing Exams: Medicare FFS cost sharing"	15 Part B Drugs: Medicare FFS cost sharing	"13A Blood: Medicare FFS cost sharing, 16B Medicare Covered Comprehensive Dental Services: Medicare FFS cost sharing, 17A Medicare Covered Eye Exams: Medicare FFS cost sharing"	10B Transportation: $0	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental:$0"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.056900453	0.056894328	0.179806415	0	0.233951386	0.233976228	0.234021209	0.234012111	0.233999498	0.234035795	0.233983368	0.233982632	0.234000265	0.233958315	0.232881614	0.234004748	0.233944787	0.233832065	0.233989656	0.227646022	0.233971346	0.233999016	0	0	0	0	0	0	0	0	0											30.3348	2.204387816	33.51231957	0	4.4731505	7.7282348	5.810746614	2.386923533	4.77592975	3.903717067	6.727021817	0.2222835	0.2644203	12.56356151	21.40182029	37.74730584	3.336052658	1.924437892	9.427443225	16.37457839	2.12913925	1.228494833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	208.4768	0	0	30.3348	2.204387816	33.51231957	0	4.4731505	7.7282348	5.810746614	2.386923533	4.77592975	3.903717067	6.727021817	0.2222835	0.2644203	12.56356151	21.40182029	37.74730584	3.336052658	1.924437892	9.427443225	16.37457839	2.12913925	1.228494833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	208.4768	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.3348	2.204387816	33.51231957	0	4.4731505	7.7282348	5.810746614	2.386923533	4.77592975	3.903717067	6.727021817	0.2222835	0.2644203	12.56356151	21.40182029	37.74730584	3.336052658	1.924437892	9.427443225	16.37457839	2.12913925	1.228494833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	208.4768
H6181_008_0	2008	7																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	814.02	11.77	924.0536	0	234.95	15.89	9.69	280.46	263.24	0	935.49	26.9	0.41	526.33	7551.55	9247.13	222.24	968.09	2663.85	3155.84	277	920.93	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute:   $125   for 1st 5   Days	1B IP Psych:   $125   for 1st 5   Days	2 SNF:   $50   for Days 7   - 100	6 Home Health:   $0	10A Ambulance:     $50	11A DME:     25%	"11B Prosthetic Medical Supplies:      25%,  11C Diabetes Monitoring Supplies:     25%"	"4A ER:     $50,  4B Urgent Care:     $25"	9B ASC Services:     $50	8A OP Clinical/Diagnostic/Therapy Radiological Lab Services:      $0	8B OP X-Ray:     $17.2	"5 Partial Hospitalization:     $50,  9A OP Hospital,  $50"	12 Renal Dialysis:      $25	"3 CORF ,  50,  9D Cardiac Rehab:     $25"	"7A PCP:     $10,  14B Immunizations:     $0,  14C Routine Physical Exams:     $0,  14D Pap Smears:      $,  14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement:      $16,  14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist:     $25	"7E Mental Health:     $25,  7H Psychiatric:     $25,  9C OP Substance Abuse,  25"	"7C Occupational Therapy:     $25,  7I Physical and Speech Therapy:     $25"	7D Physician Specialist Services - Radiology:   16	"7G Other Health Care:     $25,  18A Medicare Covered Hearing Exams:   $25,  7B Chiropractic:     $25,  7F Podiatry:     $25"	15 Part B Drugs:     $50	"13A Blood:     $50,  16B Medicare Covered Dental Services:     $25,  17A Medicare Covered Eye Exams:   $25"	10B Transportation:     Not Covered	"16A Preventive Dental Services:   $0,  16B Non Medicare Covered Comprehensive Dental:   $0"	17A Routine Eye Exams:    $0	17B Eye Wear: $0	18A Routine Hearing Exams:   $0	18B Hearing Aids:   $0	19 POS:   $0	14A Health Education/Wellness Programs:   $0	13B Acupuncture: Not Covered											125	125	50	0	50	0.249979572	0.251608277	48.15570848	50	0	17.2	50	25	50	10	25	25	25	16	25	50	25.3192425	0	0	0	0	0	0	0	0	0											8.4794	0.122604167	3.850223333	0	0.978958333	3.9721754	2.438084208	1.125479167	1.096833333	0	1.340869	0.112083333	0.000854167	2.193041667	6.292958333	19.26485417	0.463	2.016854167	3.5518	6.574666667	1.154166667	1.943104167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.972	0	0	8.4794	0.122604167	3.850223333	0	0.978958333	3.9721754	2.438084208	1.125479167	1.096833333	0	1.340869	0.112083333	0.000854167	2.193041667	6.292958333	19.26485417	0.463	2.016854167	3.5518	6.574666667	1.154166667	1.943104167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.972	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.4794	0.122604167	3.850223333	0	0.978958333	3.9721754	2.438084208	1.125479167	1.096833333	0	1.340869	0.112083333	0.000854167	2.193041667	6.292958333	19.26485417	0.463	2.016854167	3.5518	6.574666667	1.154166667	1.943104167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.972
H6181_009_0	2008	5																					0											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											20.8431	0.1772	3.8133	2.7518	0	1.0759	0.6554	0	1.9797	0.8512	2.3146	0.0555	0.0072	1.3719	0	0	0	0	0	0	0.6085	0.0447	0	0	0	0	0	0	0	0	0											36.55	0	0	0	0	0	234.96	0	0	281.65	0	0	0	0	0	266.85	0	9551.66	226.04	990.12	410.14	3228.68	0	929.84	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute:   $0	1B IP Psych:   $0	2 SNF:   $0	6 Home Health:   $0	10A Ambulance:     $50	11A DME:     $0	"11B Prosthetic Medical Supplies:      $0,11C Diabetes Monitoring Supplies:     $0"	"4A ER:     $50,4B Urgent Care:     $25"	9B ASC Services:     $0	8A OP Clinical/Diagnostic/Therapy Radiological Lab Services:      $0	8B OP X-Ray:     $0	"9A OP Hospital,  $0,  5 Partial Hosp:     $0"	12 Renal Dialysis:      $0	"3 CORF:,  $0,   9D Cardiac Rehab:     $20"	"7A PCP:     $0,  14B Immunizations:     $0,  14C Routine Physical Exams:     $0,  14D Pap Smears:      $,  14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement:50,   14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist:     $20	"7E Mental Health:     $20,  7H Psychiatric:     $20,     9C OP Substance Abuse: $20"	"7C Occupational Therapy:     $20,  7I Physical and Speech Therapy:     $20"	7D Physician Specialist Services - Radiology:   $50	"7G Other Health Care:     $20,  18A Medicare Covered Hearing Exams:   $20,  7B Chiropractic:     $20,  7F Podiatry:     $20"	15 Part B Drugs:     $0	"13A Blood:     $0,  16B Medicare Covered Comprehensive Dental Services:     $20,  17A Medicare Covered Eye Exams:   $20"	"10B Transportation:     $0,  Number of Trips Covered - 12"	"16A Preventive Dental Services:   $0,  16B Non Medicare Covered Comprehensive Dental:   NotCovered"	17A Routine Eye Exams:    $0	17B Eye Wear:    $0	18A Routine Hearing Exams:   $0	18B Hearing Aids:   $0	19 POS:   $0	14A Health Education/Wellness Programs:   $0	13B Acupuncture: Not Covered											0	0	0	0	50	0	0	48.06319901	0	0	0	0	0	20	0	20	20	20	50	20	0	20	0	0	0	0	0	0	0	0	0											0	0	0	0	0.979	0	0	1.128083333	0	0	0	0	0	0.44475	0	15.91943333	0.376733333	1.6502	1.708916667	5.381133333	0	1.549733333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.138	1300	0	20.8431	0.177161491	3.813293072	2.751764462	0.979	1.075931983	0.655353484	1.128083333	1.979743655	0.85123936	2.314622084	0.055452987	0.007201687	1.816671304	0	15.91943333	0.376733333	1.6502	1.708916667	5.381133333	0.60854252	1.59438379	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.8431	0.177161491	3.813293072	2.751764462	0.979	1.075931983	0.655353484	1.128083333	1.979743655	0.85123936	2.314622084	0.055452987	0.007201687	1.816671304	0	15.91943333	0.376733333	1.6502	1.708916667	5.381133333	0.60854252	1.59438379	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.688
H6184_001_0	2008	5	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			D	D	D	D	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V		S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	2128.595911	70.83636757	546.4317709	0.001102885	289.460554	12.74486821	4.543842054	348.4530436	446.9666175	924.4011909	978.0570117	54.84851651	15.83032586	0.418218002	5514.024189	1957.105222	3.147364514	429.2958959	588.0252721		295.826601				571.0378273	551.4425719	156.0440025					1190.031581	19.45488188	75.43320007	411.3917592	111.3190478	0.050608174	834.0162697	3.878712468			$150/day with $1500 yearly max	$150/day with $1500 yearly max	$75/day for days 21 to 100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$150 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$150 copay	$15/$25 copay for in-home/facility	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$50/$100 copay for Lower/Higher Tier		$15/$22.50/$40/$100 copay levels				$50 max w/specialist copay	Up to $50	$50 max w/specialist copay					$25 copay	$50 copay	$25 copay	$25 copay	$10 copay	20% coinsurance	$25 copay	$25 copay			92.21189634	94.36296599	71.14317292	0	71.14317292	0.189715128	0.189715128	47.42878194	142.2863458	48.43968043	57.70878622	142.2863458	23.71439097	23.71439097	9.485756389	23.71439097	23.71439097	23.71439097	49.56307713		30.45121892				23.71439097	0	23.71439097					23.71439097	47.42878194	23.71439097	23.71439097	9.485756389	0.189715128	23.71439097	23.71439097			16.3568	0.557027479	3.239574164	0	1.716095187	2.417894301	0.862035576	1.377225285	5.299770559	3.731474856	4.703540249	0.650349582	0.031283878	0.000826482	4.358724181	3.867629868	0.006219819	0.848374227	2.42869516	0	0.750690049	0	0	0	1.128484525	0	0.30837404	0	0	0	0	2.351739514	0.076893446	0.149071033	0.812992085	0.087995447	0.009601136	1.648182325	0.007665109	0	0	59.7853		3.241089319	16.3568	0.557027479	3.239574164	0	1.716095187	2.417894301	0.862035576	1.377225285	5.299770559	3.731474856	4.703540249	0.650349582	0.031283878	0.000826482	4.358724181	3.867629868	0.006219819	0.848374227	2.42869516	0	0.750690049	0	0	0	1.128484525	0	0.30837404	0	0	0	0	2.351739514	0.076893446	0.149071033	0.812992085	0.087995447	0.009601136	1.648182325	0.007665109	0	0	59.7853	2750																																																																																			0		0	16.3568	0.557027479	3.239574164	0	1.716095187	2.417894301	0.862035576	1.377225285	5.299770559	3.731474856	4.703540249	0.650349582	0.031283878	0.000826482	4.358724181	3.867629868	0.006219819	0.848374227	2.42869516	0	0.750690049	0	0	0	1.128484525	0	0.30837404	0	0	0	0	2.351739514	0.076893446	0.149071033	0.812992085	0.087995447	0.009601136	1.648182325	0.007665109	0	0	59.7853
H6206_025_0	2008	3																																D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	Coin	Coin	V	O	V	T	V	V	V	V	V	V	V	Coin																																																				0		2072.39964	101.109964	30.30597801	4349.279858	233.5101848	18.74946748	1.312092071	372.3478203	489.3444888	0	1322.945066	0	0	4300.890284	9815.472661	0	2.993769204	5.427716733	22.41652737	31985.95292	0	57.66814233	0	0	0	0	0	0	0	0	0.333907659											$500 per admit	$500 per admit	20% Coin		$50 Copay	20% Coin	20% Coin	$50 for Emergency / $25 Urgent Care	$50 Copay					$50 CORF Copay	$20 PCP /  $40 Spec		20% Coin	20% Coin	20% Coin	$20 Podiatry / $20 Chiro / 20% coin For Select Services		$20 Copay Vision & Hearing									20% Coin											101.09847	50	0.2	0	50	0.2	0.2	45.29794912	50	0	0	0	0	0.263650097	28.28	0	0.2	0.2	0.2	11.64161095	0	20	0	0	0.234	0.234	0	0	0	0	0.2											17.4597	0.421291517	6.061195602	0	0.972959103	3.749893496	0.262418414	1.405549385	2.03893537	0	0	0	0	0.094494178	23.13179724	0	0.598753841	1.085543347	4.483305474	31.03066831	0	0.096113571	0	0	0	0	0	0	0	0	0.066781532	0	0	0	0	0	0	0	0	0	0	92.9594			17.4597	0.421291517	6.061195602	0	0.972959103	3.749893496	0.262418414	1.405549385	2.03893537	0	0	0	0	0.094494178	23.13179724	0	0.598753841	1.085543347	4.483305474	31.03066831	0	0.096113571	0	0	0	0	0	0	0	0	0.066781532	0	0	0	0	0	0	0	0	0	0	92.9594		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			17.4597	0.421291517	6.061195602	0	0.972959103	3.749893496	0.262418414	1.405549385	2.03893537	0	0	0	0	0.094494178	23.13179724	0	0.598753841	1.085543347	4.483305474	31.03066831	0	0.096113571	0	0	0	0	0	0	0	0	0.066781532	0	0	0	0	0	0	0	0	0	0	92.9594
H6206_026_0	2008	4																																D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	Coin	Coin	V	O	V	T	V	V	V	V	V	V	V	Coin																																																				0		2134.117455	104.1211043	48.3221715	5973.560679	151.2013402	25.89332857	1.812021123	417.2063202	645.2668048	0	1324.047203	0	0	4288.692927	10513.76307	0	3.547708559	6.432011218	26.5728667	33676.15902	0	63.14094604	0	0	0	0	0	0	0	0	0.343714351											$500 per admit	$500 per admit	20% Coin		$50 Copay	20% Coin	20% Coin	$50 for Emergency / $25 Urgent Care	$50 Copay					$50 CORF Copay	$20 PCP /  $40 Spec		20% Coin	20% Coin	20% Coin	$20 Podiatry / $20 Chiro / 20% coin For Select Services		$20 Copay Vision & Hearing									20% Coin											101.09847	50	0.2	0	50	0.2	0.2	45.83191914	50	0	0	0	0	0.272273991	28.19	0	0.2	0.2	0.2	13.0069905	0	20	0	0	0.234	0.234	0	0	0	0	0.2											17.9797	0.433837934	9.6644343	0	0.630005584	5.178665715	0.362404225	1.593447194	2.688611687	0	0	0	0	0.097308295	24.69858174	0	0.709541712	1.286402244	5.314573339	36.50212337	0	0.10523491	0	0	0	0	0	0	0	0	0.06874287	0	0	0	0	0	0	0	0	0	0	107.3136			17.9797	0.433837934	9.6644343	0	0.630005584	5.178665715	0.362404225	1.593447194	2.688611687	0	0	0	0	0.097308295	24.69858174	0	0.709541712	1.286402244	5.314573339	36.50212337	0	0.10523491	0	0	0	0	0	0	0	0	0.06874287	0	0	0	0	0	0	0	0	0	0	107.3136		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			17.9797	0.433837934	9.6644343	0	0.630005584	5.178665715	0.362404225	1.593447194	2.688611687	0	0	0	0	0.097308295	24.69858174	0	0.709541712	1.286402244	5.314573339	36.50212337	0	0.10523491	0	0	0	0	0	0	0	0	0.06874287	0	0	0	0	0	0	0	0	0	0	107.3136
H6206_031_0	2008	8																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0		2078.180168	101.3919892	1216.189035	4342.922095	235.4427446	18.90464044	1.322951111	375.4294179	488.1231188	0	1318.295968	0	0	4369.895625	9790.973918	0	558.2538633	794.8889901	6516.15443	32230.02266	0	57.66814233	0	0	0	0	0	0	0	0	198.978693													$0 per day 1-4 & $50 5-30		$50 Copay	10% Coin	10% Coin	$50 for Emergency / $25 Urgent Care	$50 Copay		"$0 X-Ray / $50 MRI, CT, PET / $25 Chemo"				$10 PCP /  $30 Spec		$25 Copay	$25 Copay		$25 Podiatry / $25 Chiro		$25 Vision / $10 Hearing																				0	0	26.78999188	0	50	0.1	0.1	45.29794912	50	0	11.25	0	0	0	17.68	0	25	25	0	1.326053107	0	22.72727273	0	0	0	0	0	0	0	0	0											0	0	2.715141199	0	0.981011436	1.890464044	0.132295111	1.417181889	2.033846328	0	1.23590247	0	0	0	14.42536824	0	1.163028882	1.656018729	0	3.56156014	0	0.109219967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.321			0	0	2.715141199	0	0.981011436	1.890464044	0.132295111	1.417181889	2.033846328	0	1.23590247	0	0	0	14.42536824	0	1.163028882	1.656018729	0	3.56156014	0	0.109219967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.321		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			0	0	2.715141199	0	0.981011436	1.890464044	0.132295111	1.417181889	2.033846328	0	1.23590247	0	0	0	14.42536824	0	1.163028882	1.656018729	0	3.56156014	0	0.109219967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.321
H6206_032_0	2008	9																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0		2154.05619	105.0938919	1809.348326	5944.457054	155.4197629	26.61573623	1.862575378	428.8461153	639.9054659	0	1308.576353	0	0	4524.643419	10426.40719	0	608.3119362	866.1659011	7075.664089	34542.54898	0	63.14094604	0	0	0	0	0	0	0	0	197.9548165													$0 per day 1-4 & $50 5-30		$50 Copay	10% Coin	10% Coin	$50 for Emergency / $25 Urgent Care	$50 Copay		"$0 X-Ray / $50 MRI, CT, PET / $25 Chemo"				$10 PCP /  $30 Spec		$25 Copay	$25 Copay		$25 Podiatry / $25 Chiro		$25 Vision / $10 Hearing																				0	0	26.78999188	0	50	0.1	0.1	45.83191914	50	0	11.25	0	0	0	17.68	0	25	25	0	1.253624489	0	22.72727273	0	0	0	0	0	0	0	0	0											0	0	4.039368913	0	0.647582345	2.661573623	0.186257538	1.637903373	2.666272775	0	1.226790331	0	0	0	15.36157326	0	1.267316534	1.804512294	0	3.608615444	0	0.119585125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2274			0	0	4.039368913	0	0.647582345	2.661573623	0.186257538	1.637903373	2.666272775	0	1.226790331	0	0	0	15.36157326	0	1.267316534	1.804512294	0	3.608615444	0	0.119585125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2274		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			0	0	4.039368913	0	0.647582345	2.661573623	0.186257538	1.637903373	2.666272775	0	1.226790331	0	0	0	15.36157326	0	1.267316534	1.804512294	0	3.608615444	0	0.119585125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2274
H6206_033_0	2008	5																																D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	Coin	Coin	V	O	V	T	V	V	V	V	V	V	V	Coin																																																				0		2072.39964	101.109964	30.30597801	4349.279858	233.5101848	18.74946748	1.312092071	372.3478203	489.3444888	0	1322.945066	0	0	4300.890284	9815.472661	0	2.993769204	5.427716733	22.41652737	31985.95292	0	57.66814233	0	0	0	0	0	0	0	0	0.333907659											$500 per admit	$500 per admit	20% Coin		$50 Copay	20% Coin	20% Coin	$50 for Emergency / $25 Urgent Care	$50 Copay					$50 CORF Copay	$20 PCP /  $40 Spec		20% Coin	20% Coin	20% Coin	$20 Podiatry / $20 Chiro / 20% coin For Select Services		$20 Copay Vision & Hearing									20% Coin											101.09847	50	0.2	0	50	0.2	0.2	45.29794912	50	0	0	0	0	0.263650097	28.28	0	0.2	0.2	0.2	11.64161095	0	20	0	0	0.234	0.234	0	0	0	0	0.2											17.4597	0.421291517	6.061195602	0	0.972959103	3.749893496	0.262418414	1.405549385	2.03893537	0	0	0	0	0.094494178	23.13179724	0	0.598753841	1.085543347	4.483305474	31.03066831	0	0.096113571	0	0	0	0	0	0	0	0	0.066781532	0	0	0	0	0	0	0	0	0	0	92.9594			17.4597	0.421291517	6.061195602	0	0.972959103	3.749893496	0.262418414	1.405549385	2.03893537	0	0	0	0	0.094494178	23.13179724	0	0.598753841	1.085543347	4.483305474	31.03066831	0	0.096113571	0	0	0	0	0	0	0	0	0.066781532	0	0	0	0	0	0	0	0	0	0	92.9594		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			17.4597	0.421291517	6.061195602	0	0.972959103	3.749893496	0.262418414	1.405549385	2.03893537	0	0	0	0	0.094494178	23.13179724	0	0.598753841	1.085543347	4.483305474	31.03066831	0	0.096113571	0	0	0	0	0	0	0	0	0.066781532	0	0	0	0	0	0	0	0	0	0	92.9594
H6206_034_0	2008	5																																D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	Coin	Coin	V	O	V	T	V	V	V	V	V	V	V	Coin																																																				0		2135.29458	104.1785349	48.31165113	5971.830979	151.448252	25.93561239	1.814980154	417.8876183	644.947649	0	1323.124761	0	0	4302.159659	10508.56285	0	3.553501968	6.442514694	26.60765366	33726.7852	0	63.14094604	0	0	0	0	0	0	0	0	0.343714351											$500 per admit	$500 per admit	20% Coin		$50 Copay	20% Coin	20% Coin	$50 for Emergency / $25 Urgent Care	$50 Copay					$50 CORF Copay	$20 PCP /  $40 Spec		20% Coin	20% Coin	20% Coin	$20 Podiatry / $20 Chiro / 20% coin For Select Services		$20 Copay Vision & Hearing									20% Coin											101.09847	50	0.2	0	50	0.2	0.2	45.83191914	50	0	0	0	0	0.271571421	28.19	0	0.2	0.2	0.2	12.99816279	0	20	0	0	0.234	0.234	0	0	0	0	0.2											17.9896	0.434077229	9.662330226	0	0.631034383	5.187122477	0.362996031	1.596049294	2.687281871	0	0	0	0	0.097361968	24.68636556	0	0.710700394	1.288502939	5.321530732	36.53218703	0	0.10523491	0	0	0	0	0	0	0	0	0.06874287	0	0	0	0	0	0	0	0	0	0	107.3611			17.9896	0.434077229	9.662330226	0	0.631034383	5.187122477	0.362996031	1.596049294	2.687281871	0	0	0	0	0.097361968	24.68636556	0	0.710700394	1.288502939	5.321530732	36.53218703	0	0.10523491	0	0	0	0	0	0	0	0	0.06874287	0	0	0	0	0	0	0	0	0	0	107.3611		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			17.9896	0.434077229	9.662330226	0	0.631034383	5.187122477	0.362996031	1.596049294	2.687281871	0	0	0	0	0.097361968	24.68636556	0	0.710700394	1.288502939	5.321530732	36.53218703	0	0.10523491	0	0	0	0	0	0	0	0	0.06874287	0	0	0	0	0	0	0	0	0	0	107.3611
H6206_035_0	2008	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0		2077.782089	101.3725674	1216.281036	4343.359061	235.3093196	18.89392722	1.322201397	375.2166627	488.2070224	0	1318.615192	0	0	4365.096166	9792.656891	0	557.9375019	794.4385279	6513.193489	32213.16379	0	57.66814233	0	0	0	0	0	0	0	0	198.978693													$0 per day 1-4 & $50 5-30		$50 Copay	10% Coin	10% Coin	$50 for Emergency / $25 Urgent Care	$50 Copay		"$0 X-Ray / $50 MRI, CT, PET / $25 Chemo"				$10 PCP /  $30 Spec		$25 Copay	$25 Copay		$25 Podiatry / $25 Chiro		$25 Vision / $10 Hearing																				0	0	26.78999188	0	50	0.1	0.1	45.29794912	50	0	11.25	0	0	0	17.68	0	25	25	0	1.326434847	0	22.72727273	0	0	0	0	0	0	0	0	0											0	0	2.715346591	0	0.980455498	1.889392722	0.13222014	1.416378775	2.034195927	0	1.236201743	0	0	0	14.42784782	0	1.162369796	1.655080267	0	3.560721915	0	0.109219967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.3194			0	0	2.715346591	0	0.980455498	1.889392722	0.13222014	1.416378775	2.034195927	0	1.236201743	0	0	0	14.42784782	0	1.162369796	1.655080267	0	3.560721915	0	0.109219967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.3194		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			0	0	2.715346591	0	0.980455498	1.889392722	0.13222014	1.416378775	2.034195927	0	1.236201743	0	0	0	14.42784782	0	1.162369796	1.655080267	0	3.560721915	0	0.109219967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.3194
H6206_036_0	2008	4																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	V	V	V	P																																																				0		2154.74269	105.1273855	1809.120682	5943.462323	155.5663758	26.64084379	1.86433241	429.2506609	639.7225489	0	1308.049453	0	0	4533.070623	10423.4268	0	608.8857781	866.9829858	7081.015332	34572.71684	0	63.14094604	0	0	0	0	0	0	0	0	197.9548165													$0 per day 1-4 & $50 5-30		$50 Copay	10% Coin	10% Coin	$50 for Emergency / $25 Urgent Care	$50 Copay		"$0 X-Ray / $50 MRI, CT, PET / $25 Chemo"				$10 PCP /  $30 Spec		$25 Copay	$25 Copay		$25 Podiatry / $25 Chiro		$25 Vision / $10 Hearing																				0	0	26.78999188	0	50	0.1	0.1	45.83191914	50	0	11.25	0	0	0	17.68	0	25	25	0	1.252982158	0	22.72727273	0	0	0	0	0	0	0	0	0											0	0	4.038860698	0	0.648193232	2.664084379	0.186433241	1.639448465	2.665510621	0	1.226296362	0	0	0	15.35718216	0	1.268512038	1.806214554	0	3.609916445	0	0.119585125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2302			0	0	4.038860698	0	0.648193232	2.664084379	0.186433241	1.639448465	2.665510621	0	1.226296362	0	0	0	15.35718216	0	1.268512038	1.806214554	0	3.609916445	0	0.119585125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2302		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			0	0	4.038860698	0	0.648193232	2.664084379	0.186433241	1.639448465	2.665510621	0	1.226296362	0	0	0	15.35718216	0	1.268512038	1.806214554	0	3.609916445	0	0.119585125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2302
H6206_803_0	2008	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		309.7561943	8.680338201	53.18758982	73.53350795	3.790228373	23.1387632	1.619256001	9.428130688	35.35636777	0	42.12202759	0	1.538531396	42.95259486	0	0	3.275310748	0	25.35179627	272.1751047	0	0.448862326	0	0	0	0	0	0	0	0	0											Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing		Medicare Cost Sharing		Medicare Cost Sharing	Medicare Cost Sharing			Medicare Cost Sharing		Medicare Cost Sharing	Medicare Cost Sharing		Medicare Cost Sharing																				0.0765	0.0765	0.2134	0	0.234	0.234	0.234	0.234	0.234		0.234		0.234	0.234			0.234		0.234	0.234		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234											23.6963	0.664045872	11.35023167	0	0.886913439	5.414470588	0.378905904	2.206182581	8.273390058	0	9.856554456	0	0.360016347	10.0509072	0	0	0.766422715	0	5.932320326	63.68897451	0	0.105033784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.6307			23.6963	0.664045872	11.35023167	0	0.886913439	5.414470588	0.378905904	2.206182581	8.273390058	0	9.856554456	0	0.360016347	10.0509072	0	0	0.766422715	0	5.932320326	63.68897451	0	0.105033784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.6307		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			23.6963	0.664045872	11.35023167	0	0.886913439	5.414470588	0.378905904	2.206182581	8.273390058	0	9.856554456	0	0.360016347	10.0509072	0	0	0.766422715	0	5.932320326	63.68897451	0	0.105033784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.6307
H6206_804_0	2008	1																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		309.7561943	8.680338201	53.18758982	73.53350795	3.790228373	23.1387632	1.619256001	9.428130688	35.35636777	0	42.12202759	0	1.538531396	42.95259486	0	0	3.275310748	0	25.35179627	272.1751047	0	0.448862326	0	0	0	0	0	0	0	0	0											Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing		Medicare Cost Sharing		Medicare Cost Sharing	Medicare Cost Sharing			Medicare Cost Sharing		Medicare Cost Sharing	Medicare Cost Sharing		Medicare Cost Sharing																				0.0765	0.0765	0.2134	0	0.234	0.234	0.234	0.234	0.234		0.234		0.234	0.234			0.234		0.234	0.234		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234											23.6963	0.664045872	11.35023167	0	0.886913439	5.414470588	0.378905904	2.206182581	8.273390058	0	9.856554456	0	0.360016347	10.0509072	0	0	0.766422715	0	5.932320326	63.68897451	0	0.105033784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.6307			23.6963	0.664045872	11.35023167	0	0.886913439	5.414470588	0.378905904	2.206182581	8.273390058	0	9.856554456	0	0.360016347	10.0509072	0	0	0.766422715	0	5.932320326	63.68897451	0	0.105033784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.6307		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																				0			23.6963	0.664045872	11.35023167	0	0.886913439	5.414470588	0.378905904	2.206182581	8.273390058	0	9.856554456	0	0.360016347	10.0509072	0	0	0.766422715	0	5.932320326	63.68897451	0	0.105033784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.6307
H6228_001_0	2008	5																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							12.47691076	11.61407683	328.1400514	340.5018606		144.1277882	52.97522072		1407.940135		4590.683914	205.6998178					1273.011068		821.9323512	337.0787762		315.724464				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/PCP visit, $20/visit Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d)$20/visit, (7f)0"	"(7e,h)$20/visit"	"(7c,i)0"		(7g)$20/visit	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.180138081	0.180138081	35.5773	45.0345		18.0138	45.0345		45.0192		18.0138	18.0138					18.0138		20	20		19.9999				20											0	0	0	0	0	2.247566764	2.092137514	0.972860629	1.277861496	0	0.216357527	0.198809471	0	5.282027134	0	6.891308264	0.308786421	0	0	0	0	1.910981426	0	1.369887252	0.56179796	0	0.526205689	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	24.7967	0	2.359409448	0	0	0	0	0	2.247566764	2.092137514	0.972860629	1.277861496	0	0.216357527	0.198809471	0	5.282027134	0	6.891308264	0.308786421	0	0	0	0	1.910981426	0	1.369887252	0.56179796	0	0.526205689	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	24.7967		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															1.9514	0.0244	0.4349	0.3133	0.073	0.0764	0.0711	0.022	0.2463	0.0415	0.103	0.0197	0.0014	0.1763	0.0245	0.19	0.0114	0.0334			0.1544	0.049			0.0066		0.0078															4.0319	0	0	1.9514	0.024369344	0.434895894	0.313292154	0.0729673	2.323956013	2.163244107	0.994904051	1.524196223	0.041472454	0.319390624	0.218558619	0.001406153	5.458375712	0.024472306	7.081332818	0.320145685	0.033386797	0	0	0.154353187	1.960025408	0	1.369887252	0.568429071	0	0.534048266	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	28.8286
H6228_002_0	2008	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							12.47691076	11.61407683	328.1400514	340.5018606		144.1277882	52.97522072		1407.940135		4590.683914	205.6998178					1273.011068		821.9323512	337.0787762		315.724464				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/PCP visit, $20/visit Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d)$20/visit, (7f)0"	"(7e,h)$20/visit"	"(7c,i)0"		(7g)$20/visit	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.180138081	0.180138081	35.5773	45.0345		18.0138	45.0345		45.0192		18.0138	18.0138					18.0138		20	20		19.9999				20											0	0	0	0	0	2.247566764	2.092137514	0.972860629	1.277861496	0	0.216357527	0.198809471	0	5.282027134	0	6.891308264	0.308786421	0	0	0	0	1.910981426	0	1.369887252	0.56179796	0	0.526205689	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	24.7967	0	2.359409448	0	0	0	0	0	2.247566764	2.092137514	0.972860629	1.277861496	0	0.216357527	0.198809471	0	5.282027134	0	6.891308264	0.308786421	0	0	0	0	1.910981426	0	1.369887252	0.56179796	0	0.526205689	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	24.7967		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															1.9514	0.0244	0.4349	0.3133	0.073	0.0764	0.0711	0.022	0.2463	0.0415	0.103	0.0197	0.0014	0.1763	0.0245	0.19	0.0114	0.0334			0.1544	0.049			0.0066		0.0078															4.0319	0	0	1.9514	0.024369344	0.434895894	0.313292154	0.0729673	2.323956013	2.163244107	0.994904051	1.524196223	0.041472454	0.319390624	0.218558619	0.001406153	5.458375712	0.024472306	7.081332818	0.320145685	0.033386797	0	0	0.154353187	1.960025408	0	1.369887252	0.568429071	0	0.534048266	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	28.8286
H6228_003_0	2008	5																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0								22.50394882	461.5866148	467.5194297		170.5944768	77.42883411		2459.133719		5526.929394	501.6116767					0.091648283		821.9323512			240.9278008				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)0	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3,9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/PCP visit, $20/visit Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d)$20/visit, (7f)0"	"(7e,h)$20/visit"	"(7c,i)0"		(7g)$20/visit	(15) 0	"(13a,14a,17a,b)0, (16b)$20/visit"	(10b)0	(16a)$20/visit	(17a)0	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																	0.174969672	34.5565	43.7424		17.497	43.7424		43.6816		17.497	17.497					17.497		20			19.9991				20											0	0	0	0	0	0	3.937508542	1.329235214	1.704202525	0	0.248740497	0.282243702	0	8.951566131	0	8.058708522	0.731390254	0	0	0	0	0.000133631	0	1.369887252	0	0	0.401527883	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	27.9552	0	3.61126612	0	0	0	0	0	0	3.937508542	1.329235214	1.704202525	0	0.248740497	0.282243702	0	8.951566131	0	8.058708522	0.731390254	0	0	0	0	0.000133631	0	1.369887252	0	0	0.401527883	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	27.9552		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.6571	0.0637	0.3287	0.3174	0.0812	0.1562	0.1378	0.0282	0.3481	0.054	0.1416	0.0283	0.005	0.2428	0.0249	0.2389	0.03	0.0386			0.2131	0.0443			0.0066		0.006															5.1926	0	0	2.6571	0.063718091	0.328713212	0.31744569	0.08118509	0.15624569	4.075287821	1.357424254	2.052294452	0.053975007	0.390319971	0.310521857	0.005002132	9.194405016	0.024880037	8.297605951	0.761387214	0.038565129	0	0	0.213147362	0.044459142	0	1.369887252	0.006631111	0	0.40751464	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	33.1478
H6359_001_0	2008	5																					3200											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0		1835.755528	143.7052707	934.7879424		198.9869173	16.16007877	13.7974358	349.0271822	370.6249115		5951.585175		8.021971306	146.6008746	3670.391855	4230.554608	412.5824287	383.3858325			25.21968234	926.4511071			144		249															$180 days 1-5; $0 days 6-90	$180 days 1-5; $0 days 6-90	$0 days 1-3; $90 days 4-100	$0/Visit	$100/Trip	20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $30/Visit	ASC $75/Visit; OP Hosp $95/Visit	$0/Visit	$15/Visit; Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance	OP Rehab $30/Visit	$15/Visit	$30/Visit	MH/SA: $30	$30/Visit		$30/Visit	20% Coinsurance	Comp Dental/ Eye Exam/ Hearing Exam: $30/Visit	Not Covered	Not Covered	$30/Visit	Not Covered	$30/Visit															65.6249	68.4741	64.9409		85.1094	0.170218864	0.170218864	49.9873	78.7778		14.1729		69.7037	25.5328	15	29.1217	25.5328	25.5328			0.170218864	30			30		30															10.0393	0.820007938	5.058829255	0	1.411305292	2.750750249	2.348583847	1.453910118	2.433083852	0	7.029287224	0	0.046596787	0.311927929	4.587989818	10.26674305	0.877866404	0.815743761	0	0	4.292865677	2.316127768	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8434	0	6.69261115	10.0393	0.820007938	5.058829255	0	1.411305292	2.750750249	2.348583847	1.453910118	2.433083852	0	7.029287224	0	0.046596787	0.311927929	4.587989818	10.26674305	0.877866404	0.815743761	0	0	4.292865677	2.316127768	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8434																																																																																				0	0	0	10.0393	0.820007938	5.058829255	0	1.411305292	2.750750249	2.348583847	1.453910118	2.433083852	0	7.029287224	0	0.046596787	0.311927929	4.587989818	10.26674305	0.877866404	0.815743761	0	0	4.292865677	2.316127768	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8434
H6359_002_0	2008	4																					3200											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0		1835.699461	143.7008817	934.7593924		198.9808399	16.15909167	13.79659302	349.0165495	370.613592		5951.403404		8.021726302	146.5963971	3670.279755	4230.429401	412.5698278	383.3741233			25.21814187	926.4228118			144		249															$180 days 1-5; $0 days 6-90	$180 days 1-5; $0 days 6-90	$0 days 1-3; $90 days 4-100	$0/Visit	$100/Trip	20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $30/Visit	ASC $75/Visit; OP Hosp $95/Visit	$0/Visit	$15/Visit; Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance	OP Rehab $30/Visit	$15/Visit	$30/Visit	MH/SA: $30	$30/Visit		$30/Visit	20% Coinsurance	Comp Dental/ Eye Exam/ Hearing Exam: $30/Visit	Not Covered	Not Covered	$30/Visit	Not Covered	$30/Visit															65.6254	68.4746	64.9413		85.11	0.170219992	0.170219992	49.9873	78.7781		14.173		69.7021	25.533	15	29.1217	25.533	25.533			0.170219992	30			30		30															10.039	0.819988326	5.058708263	0	1.411271537	2.750600449	2.348455948	1.453865803	2.433020217	0	7.029084477	0	0.046594249	0.311920469	4.587849694	10.26644973	0.877845408	0.81572425	0	0	4.292631897	2.31605703	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8416	0	6.692104397	10.039	0.819988326	5.058708263	0	1.411271537	2.750600449	2.348455948	1.453865803	2.433020217	0	7.029084477	0	0.046594249	0.311920469	4.587849694	10.26644973	0.877845408	0.81572425	0	0	4.292631897	2.31605703	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8416																																																																																				0	0	0	10.039	0.819988326	5.058708263	0	1.411271537	2.750600449	2.348455948	1.453865803	2.433020217	0	7.029084477	0	0.046594249	0.311920469	4.587849694	10.26644973	0.877845408	0.81572425	0	0	4.292631897	2.31605703	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8416
H6359_003_0	2008	5																					3200											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0		1874.24682	118.5952038	611.1500367		221.6398562	17.74160302	13.25047735	340.9500174	399.7433688		5882.484595		0.168670213	85.65034232	3961.224444	4102.742289	301.316618	441.6997156			33.935982	991.4420049			144		249															$180 days 1-5; $0 days 6-90	$180 days 1-5; $0 days 6-90	$0 days 1-3; $90 days 4-100	$0/Visit	$100/Trip	20% Coinsurance	20% Coinsurance	ER $40/Visit; UC $30/Visit	ASC $75/Visit; OP Hosp $95/Visit	$0/Visit	$15/Visit; Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance	OP Rehab $30/Visit	$15/Visit	$30/Visit	MH/SA: $30	$30/Visit		$30/Visit	20% Coinsurance	Comp Dental/ Eye Exam/ Hearing Exam: $30/Visit	Not Covered	Not Covered	$30/Visit	Not Covered	$30/Visit															65.7432	68.5976	65.0579		85.2628	0.170525697	0.170525697	40	78.2595		13.2808		0.170525697	25.5789	15	29.1947	25.5789	25.5789			0.170525697	30			30		30															10.2683	0.677945263	3.313346893	0	1.574803789	3.025399219	2.259546884	1.136500058	2.606977776	0	6.510351098	0	0.028762606	0.182569804	4.951530555	9.981528858	0.642277828	0.941514398	0	0	5.786956978	2.478605012	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3494	0	6.556130246	10.2683	0.677945263	3.313346893	0	1.574803789	3.025399219	2.259546884	1.136500058	2.606977776	0	6.510351098	0	0.028762606	0.182569804	4.951530555	9.981528858	0.642277828	0.941514398	0	0	5.786956978	2.478605012	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3494																																																																																				0	0	0	10.2683	0.677945263	3.313346893	0	1.574803789	3.025399219	2.259546884	1.136500058	2.606977776	0	6.510351098	0	0.028762606	0.182569804	4.951530555	9.981528858	0.642277828	0.941514398	0	0	5.786956978	2.478605012	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3494
H6359_004_0	2008	4																					3200											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0		1874.234899	118.5944494	611.1461492		221.6384464	17.74137732	13.25030878	340.9478543	399.7408261		5882.447178		0.168668067	85.64979751	3961.199248	4102.717025	301.3147014	441.696906			33.93555028	991.4356986			144		249															$180 days 1-5; $0 days 6-90	$180 days 1-5; $0 days 6-90	$0 days 1-3; $90 days 4-100	$0/Visit	$100/Trip	20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $30/Visit	ASC $75/Visit; OP Hosp $95/Visit	$0/Visit	$15/Visit; Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance	OP Rehab $30/Visit	$15/Visit	$30/Visit	MH/SA: $30	$30/Visit		$30/Visit	20% Coinsurance	Comp Dental/ Eye Exam/ Hearing Exam: $30/Visit	Not Covered	Not Covered	$30/Visit	Not Covered	$30/Visit															65.7433	68.5977	65.058		85.263	0.170525943	0.170525943	49.9871	78.2596		13.2808		0.170525943	25.5789	15	29.1947	25.5789	25.5789			0.170525943	30			30		30															10.2682	0.677941929	3.313330599	0	1.574796044	3.025365097	2.2595214	1.420249146	2.606963309	0	6.510316431	0	0.028762281	0.182568906	4.95149906	9.981469442	0.64227467	0.941509767	0	0	5.78689171	2.478589246	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6328	0	6.556021911	10.2682	0.677941929	3.313330599	0	1.574796044	3.025365097	2.2595214	1.420249146	2.606963309	0	6.510316431	0	0.028762281	0.182568906	4.95149906	9.981469442	0.64227467	0.941509767	0	0	5.78689171	2.478589246	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6328																																																																																				0	0	0	10.2682	0.677941929	3.313330599	0	1.574796044	3.025365097	2.2595214	1.420249146	2.606963309	0	6.510316431	0	0.028762281	0.182568906	4.95149906	9.981469442	0.64227467	0.941509767	0	0	5.78689171	2.478589246	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6328
H6359_801_0	2008	2																					3200											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0		1847.605066	144.6328676	940.8218642		200.2713493	16.36937405	13.9761316	351.2743919	373.0172421		5990.001802		0.277291707	147.5471621	3694.083707	4257.016644	415.245589	385.860533			25.54631198	932.4312159			144		249															$180 days 1-5; $0 days 6-90	$180 days 1-5; $0 days 6-90	$0 days 1-3; $90 days 4-100	$0/Visit	$100/Trip	20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $30/Visit	ASC $75/Visit; OP Hosp $95/Visit	$0/Visit	$15/Visit; Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance	OP Rehab $30/Visit	$15/Visit	$30/Visit	MH/SA: $30	$30/Visit		$30/Visit	20% Coinsurance	Comp Dental/ Eye Exam/ Hearing Exam: $30/Visit	Not Covered	Not Covered	$30/Visit	Not Covered	$30/Visit															65.5337	68.3789	64.8506		84.9911	0.16998215	0.16998215	49.9874	78.7052		14.168		0.16998215	25.4973	15	29.1154	25.4973	25.4973			0.16998215	30			30		30															10.09	0.824153272	5.084402831	0	1.418439773	2.782501398	2.3756929	1.463275863	2.446533515	0	7.072178817	0	0.047134641	0.313504798	4.617604634	10.32873965	0.882304226	0.819867538	0	0	4.342417037	2.33107804	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2224	0	6.799846532	10.09	0.824153272	5.084402831	0	1.418439773	2.782501398	2.3756929	1.463275863	2.446533515	0	7.072178817	0	0.047134641	0.313504798	4.617604634	10.32873965	0.882304226	0.819867538	0	0	4.342417037	2.33107804	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2224																																																																																				0	0	0	10.09	0.824153272	5.084402831	0	1.418439773	2.782501398	2.3756929	1.463275863	2.446533515	0	7.072178817	0	0.047134641	0.313504798	4.617604634	10.32873965	0.882304226	0.819867538	0	0	4.342417037	2.33107804	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2224
H6359_802_0	2008	2																					3200											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0		1847.503991	144.6249552	940.7703954		200.2603932	16.36758309	13.97460248	351.2552233	372.9968357		5989.674112		0.277261368	147.5390904	3693.881617	4256.790925	415.2228725	385.839424			25.54351697	932.3802061			144		249															$180 days 1-5; $0 days 6-90	$180 days 1-5; $0 days 6-90	$0 days 1-3; $90 days 4-100	$0/Visit	$100/Trip	20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $30/Visit	ASC $75/Visit; OP Hosp $95/Visit	$0/Visit	$15/Visit; Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance	OP Rehab $30/Visit	$15/Visit	$30/Visit	MH/SA: $30	$30/Visit		$30/Visit	20% Coinsurance	Comp Dental/ Eye Exam/ Hearing Exam: $30/Visit	Not Covered	Not Covered	$30/Visit	Not Covered	$30/Visit															65.5345	68.3797	64.8513		84.9921	0.169984156	0.169984156	49.9874	78.7058		14.168		0.169984156	25.4976	15	29.1155	25.4976	25.4976			0.169984156	30			30		30															10.0896	0.82411791	5.084184672	0	1.418378911	2.782229794	2.375461005	1.463195974	2.446418784	0	7.071812605	0	0.04713004	0.313491347	4.617352022	10.3282108	0.882266368	0.819832359	0	0	4.341993168	2.330950515	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2191	0	6.798930686	10.0896	0.82411791	5.084184672	0	1.418378911	2.782229794	2.375461005	1.463195974	2.446418784	0	7.071812605	0	0.04713004	0.313491347	4.617352022	10.3282108	0.882266368	0.819832359	0	0	4.341993168	2.330950515	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2191																																																																																				0	0	0	10.0896	0.82411791	5.084184672	0	1.418378911	2.782229794	2.375461005	1.463195974	2.446418784	0	7.071812605	0	0.04713004	0.313491347	4.617352022	10.3282108	0.882266368	0.819832359	0	0	4.341993168	2.330950515	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2191
H6359_803_0	2008	2																					3200											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0		1863.533146	117.9172832	607.6565465		220.372906	17.53935165	13.09942407	339.0061079	397.4583333		5848.858807		0.1667474	85.16074302	3938.581071	4080.038793	299.594215	439.1748469			33.54911734	985.7746685			144		249															$180 days 1-5; $0 days 6-90	$180 days 1-5; $0 days 6-90	$0 days 1-3; $90 days 4-100	$0/Visit	$100/Trip	20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $30/Visit	ASC $75/Visit; OP Hosp $95/Visit	$0/Visit	$15/Visit; Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance	OP Rehab $30/Visit	$15/Visit	$30/Visit	MH/SA: $30	$30/Visit		$30/Visit	20% Coinsurance	Comp Dental/ Eye Exam/ Hearing Exam: $30/Visit	Not Covered	Not Covered	$30/Visit	Not Covered	$30/Visit															65.829	68.6871	65.1428		85.3741	0.170748193	0.170748193	49.9869	78.317		13.2933		0.170748193	25.6122	15	29.2001	25.6122	25.6122			0.170748193	30			30		30															10.2229	0.674949459	3.298705388	0	1.567844814	2.994812604	2.236702993	1.412156429	2.593977374	0	6.479211425	0	0.028471817	0.181763038	4.923226339	9.928136662	0.639439636	0.937353895	0	0	5.728451171	2.464436671	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.295	0	6.458896696	10.2229	0.674949459	3.298705388	0	1.567844814	2.994812604	2.236702993	1.412156429	2.593977374	0	6.479211425	0	0.028471817	0.181763038	4.923226339	9.928136662	0.639439636	0.937353895	0	0	5.728451171	2.464436671	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.295																																																																																				0	0	0	10.2229	0.674949459	3.298705388	0	1.567844814	2.994812604	2.236702993	1.412156429	2.593977374	0	6.479211425	0	0.028471817	0.181763038	4.923226339	9.928136662	0.639439636	0.937353895	0	0	5.728451171	2.464436671	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.295
H6359_804_0	2008	3																					3200											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0		1863.609529	117.9221165	607.6814534		220.3819388	17.5407895	13.10049795	339.0199669	397.4746245		5849.098543		0.16676107	85.16423363	3938.742507	4080.200658	299.6064949	439.192848			33.55186765	985.8150739			144		249															$180 days 1-5; $0 days 6-90	$180 days 1-5; $0 days 6-90	$0 days 1-3; $90 days 4-100	$0/Visit	$100/Trip	20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $30/Visit	ASC $75/Visit; OP Hosp $95/Visit	$0/Visit	$15/Visit; Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance	OP Rehab $30/Visit	$15/Visit	$30/Visit	MH/SA: $30	$30/Visit		$30/Visit	20% Coinsurance	Comp Dental/ Eye Exam/ Hearing Exam: $30/Visit	Not Covered	Not Covered	$30/Visit	Not Covered	$30/Visit															65.8284	68.6864	65.1422		85.3733	0.170746597	0.170746597	49.9869	78.3165		13.2932		0.170746597	25.612	15	29.2001	25.612	25.612			0.170746597	30			30		30															10.2232	0.674970815	3.298809764	0	1.567894423	2.99503012	2.236865447	1.41221419	2.594070055	0	6.479433335	0	0.028473885	0.181768789	4.923428134	9.928517302	0.639459869	0.937383554	0	0	5.728867234	2.464537685	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2974	0	6.459589047	10.2232	0.674970815	3.298809764	0	1.567894423	2.99503012	2.236865447	1.41221419	2.594070055	0	6.479433335	0	0.028473885	0.181768789	4.923428134	9.928517302	0.639459869	0.937383554	0	0	5.728867234	2.464537685	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2974																																																																																				0	0	0	10.2232	0.674970815	3.298809764	0	1.567894423	2.99503012	2.236865447	1.41221419	2.594070055	0	6.479433335	0	0.028473885	0.181768789	4.923428134	9.928517302	0.639459869	0.937383554	0	0	5.728867234	2.464537685	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2974
H6359_805_0	2008	2																					3200											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0		1847.605066	144.6328676	940.8218642		200.2713493	16.36937405	13.9761316	351.2743919	373.0172421		5990.001802		0.277291707	147.5471621	3694.083707	4257.016644	415.245589	385.860533			25.54631198	932.4312159			144		249															$180 days 1-5; $0 days 6-90	$180 days 1-5; $0 days 6-90	$0 days 1-3; $90 days 4-100	$0/Visit	$100/Trip	20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $30/Visit	ASC $75/Visit; OP Hosp $95/Visit	$0/Visit	$15/Visit; Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance	OP Rehab $30/Visit	$15/Visit	$30/Visit	MH/SA: $30	$30/Visit		$30/Visit	20% Coinsurance	Comp Dental/ Eye Exam/ Hearing Exam: $30/Visit	Not Covered	Not Covered	$30/Visit	Not Covered	$30/Visit															65.5337	68.3789	64.8506		84.9911	0.16998215	0.16998215	49.9874	78.7052		14.168		0.16998215	25.4973	15	29.1154	25.4973	25.4973			0.16998215	30			30		30															10.09	0.824153272	5.084402831	0	1.418439773	2.782501398	2.3756929	1.463275863	2.446533515	0	7.072178817	0	0.047134641	0.313504798	4.617604634	10.32873965	0.882304226	0.819867538	0	0	4.342417037	2.33107804	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2224	0	6.799846532	10.09	0.824153272	5.084402831	0	1.418439773	2.782501398	2.3756929	1.463275863	2.446533515	0	7.072178817	0	0.047134641	0.313504798	4.617604634	10.32873965	0.882304226	0.819867538	0	0	4.342417037	2.33107804	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2224																																																																																				0	0	0	10.09	0.824153272	5.084402831	0	1.418439773	2.782501398	2.3756929	1.463275863	2.446533515	0	7.072178817	0	0.047134641	0.313504798	4.617604634	10.32873965	0.882304226	0.819867538	0	0	4.342417037	2.33107804	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2224
H6359_806_0	2008	2																					3200											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0		1847.503991	144.6249552	940.7703954		200.2603932	16.36758309	13.97460248	351.2552233	372.9968357		5989.674112		0.277261368	147.5390904	3693.881617	4256.790925	415.2228725	385.839424			25.54351697	932.3802061			144		249															$180 days 1-5; $0 days 6-90	$180 days 1-5; $0 days 6-90	$0 days 1-3; $90 days 4-100	$0/Visit	$100/Trip	20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $30/Visit	ASC $75/Visit; OP Hosp $95/Visit	$0/Visit	$15/Visit; Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance	OP Rehab $30/Visit	$15/Visit	$30/Visit	MH/SA: $30	$30/Visit		$30/Visit	20% Coinsurance	Comp Dental/ Eye Exam/ Hearing Exam: $30/Visit	Not Covered	Not Covered	$30/Visit	Not Covered	$30/Visit															65.5345	68.3797	64.8513		84.9921	0.169984156	0.169984156	49.9874	78.7058		14.168		0.169984156	25.4976	15	29.1155	25.4976	25.4976			0.169984156	30			30		30															10.0896	0.82411791	5.084184672	0	1.418378911	2.782229794	2.375461005	1.463195974	2.446418784	0	7.071812605	0	0.04713004	0.313491347	4.617352022	10.3282108	0.882266368	0.819832359	0	0	4.341993168	2.330950515	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2191	0	6.798930686	10.0896	0.82411791	5.084184672	0	1.418378911	2.782229794	2.375461005	1.463195974	2.446418784	0	7.071812605	0	0.04713004	0.313491347	4.617352022	10.3282108	0.882266368	0.819832359	0	0	4.341993168	2.330950515	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2191																																																																																				0	0	0	10.0896	0.82411791	5.084184672	0	1.418378911	2.782229794	2.375461005	1.463195974	2.446418784	0	7.071812605	0	0.04713004	0.313491347	4.617352022	10.3282108	0.882266368	0.819832359	0	0	4.341993168	2.330950515	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2191
H6359_807_0	2008	2																					3200											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0		1863.533146	117.9172832	607.6565465		220.372906	17.53935165	13.09942407	339.0061079	397.4583333		5848.858807		0.1667474	85.16074302	3938.581071	4080.038793	299.594215	439.1748469			33.54911734	985.7746685			144		249															$180 days 1-5; $0 days 6-90	$180 days 1-5; $0 days 6-90	$0 days 1-3; $90 days 4-100	$0/Visit	$100/Trip	20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $30/Visit	ASC $75/Visit; OP Hosp $95/Visit	$0/Visit	$15/Visit; Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance	OP Rehab $30/Visit	$15/Visit	$30/Visit	MH/SA: $30	$30/Visit		$30/Visit	20% Coinsurance	Comp Dental/ Eye Exam/ Hearing Exam: $30/Visit	Not Covered	Not Covered	$30/Visit	Not Covered	$30/Visit															65.829	68.6871	65.1428		85.3741	0.170748193	0.170748193	49.9869	78.317		13.2933		0.170748193	25.6122	15	29.2001	25.6122	25.6122			0.170748193	30			30		30															10.2229	0.674949459	3.298705388	0	1.567844814	2.994812604	2.236702993	1.412156429	2.593977374	0	6.479211425	0	0.028471817	0.181763038	4.923226339	9.928136662	0.639439636	0.937353895	0	0	5.728451171	2.464436671	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.295	0	6.458896696	10.2229	0.674949459	3.298705388	0	1.567844814	2.994812604	2.236702993	1.412156429	2.593977374	0	6.479211425	0	0.028471817	0.181763038	4.923226339	9.928136662	0.639439636	0.937353895	0	0	5.728451171	2.464436671	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.295																																																																																				0	0	0	10.2229	0.674949459	3.298705388	0	1.567844814	2.994812604	2.236702993	1.412156429	2.593977374	0	6.479211425	0	0.028471817	0.181763038	4.923226339	9.928136662	0.639439636	0.937353895	0	0	5.728451171	2.464436671	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.295
H6359_808_0	2008	2																					3200											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	P	P	P	Coin	V	T	Coin	V	V	V	V	Coin	V	V																																																				0		1863.609529	117.9221165	607.6814534		220.3819388	17.5407895	13.10049795	339.0199669	397.4746245		5849.098543		0.16676107	85.16423363	3938.742507	4080.200658	299.6064949	439.192848			33.55186765	985.8150739			144		249															$180 days 1-5; $0 days 6-90	$180 days 1-5; $0 days 6-90	$0 days 1-3; $90 days 4-100	$0/Visit	$100/Trip	20% Coinsurance	20% Coinsurance	ER $50/Visit; UC $30/Visit	ASC $75/Visit; OP Hosp $95/Visit	$0/Visit	$15/Visit; Thera Rad 20% Coinsurance	$0/Visit	20% Coinsurance	OP Rehab $30/Visit	$15/Visit	$30/Visit	MH/SA: $30	$30/Visit		$30/Visit	20% Coinsurance	Comp Dental/ Eye Exam/ Hearing Exam: $30/Visit	Not Covered	Not Covered	$30/Visit	Not Covered	$30/Visit															65.8284	68.6864	65.1422		85.3733	0.170746597	0.170746597	49.9869	78.3165		13.2932		0.170746597	25.612	15	29.2001	25.612	25.612			0.170746597	30			30		30															10.2232	0.674970815	3.298809764	0	1.567894423	2.99503012	2.236865447	1.41221419	2.594070055	0	6.479433335	0	0.028473885	0.181768789	4.923428134	9.928517302	0.639459869	0.937383554	0	0	5.728867234	2.464537685	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2974	0	6.459589047	10.2232	0.674970815	3.298809764	0	1.567894423	2.99503012	2.236865447	1.41221419	2.594070055	0	6.479433335	0	0.028473885	0.181768789	4.923428134	9.928517302	0.639459869	0.937383554	0	0	5.728867234	2.464537685	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2974																																																																																				0	0	0	10.2232	0.674970815	3.298809764	0	1.567894423	2.99503012	2.236865447	1.41221419	2.594070055	0	6.479433335	0	0.028473885	0.181768789	4.923428134	9.928517302	0.639459869	0.937383554	0	0	5.728867234	2.464537685	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2974
H6411_001_0	2008	5	s.										Health & Education (Non-Covered)																					A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O	O	O										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0	0	0										0		291.380158	6.26117	498.258658	208.697911	69.808027	4.704366	1.60989	330.293696	390.065417	6135.029867	1437.92041		8.192341	522.873549	4740.218216	3580.818698	46.721428	297.253885			16.887372			5.74	2.99					0.08	0.02	3.4										"$75/day (1-5), LTAC 950/admit"	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$50-$75/Visit	$0/Visit	$0-$100/Visit		$0-$50/Proc	$15-$100/Visit	$5/Visit	$30/Visit	$30-$75/Visit	$75/Visit			15% Coins			Coin: 25%- 75%	EyeMed $200 Allowance					Active Outlook Newsletter	QuitNet	Silver Sneakers										300.000002	950.000081	28.94	0	100.000075	0.199999	0.2	50.000009	63.039487	0	44.331538		16.683875	37.12968	5	29.999997	48.814775	75.000008			0.15			0.355400697	0					0	0	0										7.2845	0.495676001	1.201633797	0	0.581733995	0.940868496	0.321978	1.376223981	2.049126982	0	5.312101941	0	0.011389999	1.617843963	1.975090923	8.95204585	0.190058	1.857836979	0	0	2.5331058	0	0	2.04	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.7412	0	0	7.2845	0.495676001	1.201633797	0	0.581733995	0.940868496	0.321978	1.376223981	2.049126982	0	5.312101941	0	0.011389999	1.617843963	1.975090923	8.95204585	0.190058	1.857836979	0	0	2.5331058	0	0	2.04	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.7412		$950/Admit	$950/Admit	20% Coins(Days 1-20) $0(Days 21-100)	20% Coins	$100/Trip	20% Coins	20% Coins	$50/Visit	20% Coins	20% Coins	20% Coins		$0-$50/Proc	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins			15% Coins			Coin: 50% - 80%	EyeMed $200 Allowance					Active Outlook Newsletter	QuitNet	Silver Sneakers										4.0708	0.0875	0.3505	0.5475	0.5817	1.0399	0.3559	0.2429	2.324	0.5761	1.554		0.002	0.7769	2.4029	1.9768	0.0681	0.2098			0.4735			1.51	0					0	0	0										19.1508	0	0	11.3553	0.583148001	1.552129797	0.547536	1.163467995	1.980780496	0.677848	1.619086981	4.373134982	0.576136	6.866059941	0	0.013399999	2.394728963	4.378017923	10.92888185	0.258116	2.067589979	0	0	3.0066538	0	0	3.55	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.892
H6411_002_0	2008	6	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)																				A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O		O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0		0	0									0		291.380158	6.26117	498.258658	208.697911	69.808027	4.704366	1.60989	330.293696	390.065417	6135.029867	1437.92041		8.192341	522.873549	4740.218216	3580.818698	46.721428	297.253885			16.887372									0.08		3.4	0.02									"150/day (1-7), ltac 950/admit"	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$50-$75/Visit	$0/Visit	$0-$100/Visit		$0-$75/Proc	$15-$100/Visit	$10/Visit	$30/Visit	$30-$75/Visit	$75/Visit			15% Coins									Active Outlook Newsletter		Silver Sneakers	QuitNet									617.999994	950.000081	28.94	0	100.000075	0.199999	0.2	50.000009	63.039487	0	40.743832		25.025813	37.12968	10	29.999997	48.814775	75.000008			0.15									0		0	0									15.0061	0.495676001	1.201633797	0	0.581733995	0.940868496	0.321978	1.376223981	2.049126982	0	4.882198968	0	0.017084999	1.617843963	3.950181847	8.95204585	0.190058	1.857836979	0	0	2.5331058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9737	0	0	15.0061	0.495676001	1.201633797	0	0.581733995	0.940868496	0.321978	1.376223981	2.049126982	0	4.882198968	0	0.017084999	1.617843963	3.950181847	8.95204585	0.190058	1.857836979	0	0	2.5331058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9737		$950/Admit	$950/Admit	20% Coins(Days 1-20) $0(Days 21-100)	20% Coins	$100/Trip	20% Coins	20% Coins	$50/Visit	20% Coins	20% Coins	20% Coins		$0-$50/Proc	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins			15% Coins									Active Outlook Newsletter		Silver Sneakers	QuitNet									4.0708	0.0875	0.3505	0.5475	0.5817	1.0399	0.3559	0.2429	2.324	0.5761	1.554		0.002	0.7769	2.4029	1.9768	0.0681	0.2098			0.4735									0		0	0									17.6408	0	0	19.0768	0.583148001	1.552129797	0.547536	1.163467995	1.980780496	0.677848	1.619086981	4.373134982	0.576136	6.436156968	0	0.019094999	2.394728963	6.353108847	10.92888185	0.258116	2.067589979	0	0	3.0066538	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6144
H6411_005_0	2008	6	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)																				A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0	0	0	0									0		298.863754	6.421976	511.055571	214.057957	71.600927	4.94912	1.693647	338.77672	400.083573	6292.597508	1474.85091		8.402748	536.302652	4861.96253	3672.78584	47.921387	304.888338			17.76597			5.74	2.99					0.08	0.02	3.4	1.53									"75/day(1-5), ltac 950/admit"	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$50-$75/Visit	$0/Visit	$0-$100/Visit		$0-$50/Proc	$15-$100/Visit	$5/Visit	$30/Visit	$30-$75/Visit	$75/Visit			15% Coins			coin: 25%-75%	EyeMed $200 Allowance					Active Outlook Newsletter	QuitNet	Silver Sneakers	Routine Chiropractic									300.000006	949.999191	28.94	0	99.999934	0.2	0.2	50.000011	63.039449	0	44.331537		16.683113	37.129691	5	29.999998	48.814446	74.999995			0.15			0.355400697	0					0	0	0	0									7.4716	0.508406	1.232495685	0	0.596673998	0.989824	0.3387294	1.411569977	2.101754	0	5.448533974	0	0.011682	1.659395979	2.025817721	9.181963988	0.194937996	1.905551985	0	0	2.6648955	0	0	2.04	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7838	0	0	7.4716	0.508406	1.232495685	0	0.596673998	0.989824	0.3387294	1.411569977	2.101754	0	5.448533974	0	0.011682	1.659395979	2.025817721	9.181963988	0.194937996	1.905551985	0	0	2.6648955	0	0	2.04	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7838		$950/Admit	$950/Admit	20% Coins(Days 1-20) $0(Days 21-100)	20% Coins	$100/Trip	20% Coins	20% Coins	$50/Visit	20% Coins	20% Coins	20% Coins		$0-$50/Proc	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins			15% Coins			coin: 50%-80%	EyeMed $200 Allowance					Active Outlook Newsletter	QuitNet	Silver Sneakers	Routine Chiropractic									4.1753	0.0897	0.3687	0.576	0.5967	1.094	0.3744	0.2491	2.4449	0.6061	1.6348		0.0021	0.8173	2.5279	2.0797	0.0716	0.2207			0.4982			1.51	0					0	0	0	0									19.9372	0	0	11.6469	0.598125	1.601226685	0.576023	1.193347998	2.08384	0.7131144	1.660670977	4.546673	0.60611	7.083339974	0	0.013744	2.476699979	4.553761721	11.26164999	0.266536996	2.126217985	0	0	3.1630805	0	0	3.55	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7211
H6411_006_0	2008	6	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)																				A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0	0	0	0									0		298.863754	6.421976	511.055571	214.057957	71.600927	4.94912	1.693647	338.77672	400.083573	6292.597508	1474.85091		8.402748	536.302652	4861.96253	3672.78584	47.921387	304.888338			17.76597									0.08	1.53	3.4	0.02									"150/day (1-7), ltac 950/admit"	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$50-$75/Visit	$0/Visit	$0-$100/Visit		$0-$75/Proc	$15-$100/Visit	$10/Visit	$30/Visit	$30-$75/Visit	$75/Visit			15% Coins									Active Outlook Newsletter	routine chiro	Silver Sneakers	QuitNet									617.999986	949.999191	28.94	0	99.999934	0.2	0.2	50.000011	63.039449	0	40.743833		25.026098	37.129691	9.999998	29.999998	48.814446	74.999995			0.15									0	0	0	0									15.3915	0.508406	1.232495685	0	0.596673998	0.989824	0.3387294	1.411569977	2.101754	0	5.007589931	0	0.017524	1.659395979	4.051634631	9.181963988	0.194937996	1.905551985	0	0	2.6648955	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2544	0	0	15.3915	0.508406	1.232495685	0	0.596673998	0.989824	0.3387294	1.411569977	2.101754	0	5.007589931	0	0.017524	1.659395979	4.051634631	9.181963988	0.194937996	1.905551985	0	0	2.6648955	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2544		$950/Admit	$950/Admit	20% Coins(Days 1-20) $0(Days 21-100)	20% Coins	$100/Trip	20% Coins	20% Coins	$50/Visit	20% Coins	20% Coins	20% Coins		$0-$50/Proc	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins			15% Coins									Active Outlook Newsletter	routine chiro	Silver Sneakers	QuitNet									4.1753	0.0897	0.3687	0.576	0.5967	1.094	0.3744	0.2491	2.4449	0.6061	1.6348		0.0021	0.8173	2.5279	2.0797	0.0716	0.2207			0.4982									0	0	0	0									18.4272	0	0	19.5668	0.598125	1.601226685	0.576023	1.193347998	2.08384	0.7131144	1.660670977	4.546673	0.60611	6.642395931	0	0.019586	2.476699979	6.579578631	11.26164999	0.266536996	2.126217985	0	0	3.1630805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6817
H6411_801_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		300.654103	6.460448	514.117058	215.340275	72.029852	5.008595	1.714	340.806167	402.480281	6330.293427	1483.686031		8.453086	539.515385	4891.088202	3694.78773	48.208461	306.714776			17.979469																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214491	177.214335	28.944132	0	100.000038	0.2	0.2	50.00001	199.999979	37.551768	90.505002		33.367695	87.838651	20	29.999998	59.267106	99.999981			0.2																					4.44	0.095407	1.240055999	0	0.600248995	1.001719	0.3428	1.42002598	6.708003979	19.80947585	11.19008393	0	0.023505	3.949191968	8.15181367	9.236968709	0.238097997	2.555955981	0	0	3.5958938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5993	0	0	4.44	0.095407	1.240055999	0	0.600248995	1.001719	0.3428	1.42002598	6.708003979	19.80947585	11.19008393	0	0.023505	3.949191968	8.15181367	9.236968709	0.238097997	2.555955981	0	0	3.5958938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5993		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.4747	0.1071	0.4665	0.7287	0.7191	1.384	0.4736	0.8121	3.0929	0.7667	2.0681		0.0141	1.0339	3.1979	2.6308	0.0906	0.2791			0.8403																					28.1801	0	0	13.9148	0.20247	1.706508999	0.728681	1.319334995	2.385673	0.816406	2.23208498	9.800878979	20.57621885	13.25814793	0	0.037587	4.983098968	11.34971667	11.86781571	0.328672997	2.835102981	0	0	4.4361808	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.7793
H6411_802_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		300.654103	6.460448	514.117058	215.340275	72.029852	5.008595	1.714	340.806167	402.480281	6330.293427	1483.686031		8.453086	539.515385	4891.088202	3694.78773	48.208461	306.714776			17.979469																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214491	177.214335	28.944132	0	100.000038	0.2	0.2	50.00001	199.999979	37.551768	90.505002		33.367695	87.838651	20	29.999998	59.267106	99.999981			0.2																					4.44	0.095407	1.240055999	0	0.600248995	1.001719	0.3428	1.42002598	6.708003979	19.80947585	11.19008393	0	0.023505	3.949191968	8.15181367	9.236968709	0.238097997	2.555955981	0	0	3.5958938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5993	0	0	4.44	0.095407	1.240055999	0	0.600248995	1.001719	0.3428	1.42002598	6.708003979	19.80947585	11.19008393	0	0.023505	3.949191968	8.15181367	9.236968709	0.238097997	2.555955981	0	0	3.5958938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5993		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.4747	0.1071	0.4665	0.7287	0.7191	1.384	0.4736	0.8121	3.0929	0.7667	2.0681		0.0141	1.0339	3.1979	2.6308	0.0906	0.2791			0.8403																					28.1801	0	0	13.9148	0.20247	1.706508999	0.728681	1.319334995	2.385673	0.816406	2.23208498	9.800878979	20.57621885	13.25814793	0	0.037587	4.983098968	11.34971667	11.86781571	0.328672997	2.835102981	0	0	4.4361808	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.7793
H6411_803_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		300.654103	6.460448	514.117058	215.340275	72.029852	5.008595	1.714	340.806167	402.480281	6330.293427	1483.686031		8.453086	539.515385	4891.088202	3694.78773	48.208461	306.714776			17.979469																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214491	177.214335	28.944132	0	100.000038	0.2	0.2	50.00001	199.999979	37.551768	90.505002		33.367695	87.838651	20	29.999998	59.267106	99.999981			0.2																					4.44	0.095407	1.240055999	0	0.600248995	1.001719	0.3428	1.42002598	6.708003979	19.80947585	11.19008393	0	0.023505	3.949191968	8.15181367	9.236968709	0.238097997	2.555955981	0	0	3.5958938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5993	0	0	4.44	0.095407	1.240055999	0	0.600248995	1.001719	0.3428	1.42002598	6.708003979	19.80947585	11.19008393	0	0.023505	3.949191968	8.15181367	9.236968709	0.238097997	2.555955981	0	0	3.5958938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5993		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.4747	0.1071	0.4665	0.7287	0.7191	1.384	0.4736	0.8121	3.0929	0.7667	2.0681		0.0141	1.0339	3.1979	2.6308	0.0906	0.2791			0.8403																					28.1801	0	0	13.9148	0.20247	1.706508999	0.728681	1.319334995	2.385673	0.816406	2.23208498	9.800878979	20.57621885	13.25814793	0	0.037587	4.983098968	11.34971667	11.86781571	0.328672997	2.835102981	0	0	4.4361808	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.7793
H6411_804_0	2008	1																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		300.654103	6.460448	514.117058	215.340275	72.029852	5.008595	1.714	340.806167	402.480281	6330.293427	1483.686031		8.453086	539.515385	4891.088202	3694.78773	48.208461	306.714776			17.979469																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214491	177.214335	28.944132	0	100.000038	0.2	0.2	50.00001	199.999979	37.551768	90.505002		33.367695	87.838651	20	29.999998	59.267106	99.999981			0.2																					4.44	0.095407	1.240055999	0	0.600248995	1.001719	0.3428	1.42002598	6.708003979	19.80947585	11.19008393	0	0.023505	3.949191968	8.15181367	9.236968709	0.238097997	2.555955981	0	0	3.5958938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5993	0	0	4.44	0.095407	1.240055999	0	0.600248995	1.001719	0.3428	1.42002598	6.708003979	19.80947585	11.19008393	0	0.023505	3.949191968	8.15181367	9.236968709	0.238097997	2.555955981	0	0	3.5958938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5993		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.4747	0.1071	0.4665	0.7287	0.7191	1.384	0.4736	0.8121	3.0929	0.7667	2.0681		0.0141	1.0339	3.1979	2.6308	0.0906	0.2791			0.8403																					28.1801	0	0	13.9148	0.20247	1.706508999	0.728681	1.319334995	2.385673	0.816406	2.23208498	9.800878979	20.57621885	13.25814793	0	0.037587	4.983098968	11.34971667	11.86781571	0.328672997	2.835102981	0	0	4.4361808	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.7793
H6421_001_0	2008	4																																D	Coin	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		1649.621257	5.261826428	900.4307397		80.95476829	8.522652571	31.23326469	240.8470699	370.1482984		18.14620334	5.785489515	0.491077254	245.59042	3490.54047	4743.109367	378.4896801	1118.081419			26.89111458	8.40722779																				"#1A $250/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $150	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $40"	"#9A $150, #9B $100"	#8A $0	#8B 20%	#9A $150	#12 20%	"#3 20%, #5 20%, #9A $150, #9C 20%, #9D $15"	"#7A $15, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $15, #7D $15, #7F $15, #7G $15"	"#7E $15, #7H $15"	"#7C $15, #7I $15"		"#14I $0 , #14J $0"	#15 20%	"#13A 20%, #16B $0, #17A $15, #17B $0, #18A $15"	#10B $0 n/c	#16A $0 n/c	#17A $0 n/c	#17B $0 n/c	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0 n/c	"#13B $0 n/c , #13C $0 n/c"											154	0.0688587	69.97		150	0.2	0.2	49.0007	124.7944		0.2	150	0.2	143.0349	15	15	15	15			0.2	0.187872657																				21.1701	0.362322529	5.250260544	0	1.011934604	1.704530514	6.246652938	0.983473876	3.849370203	0	3.629240667	0.072318619	0.098215451	2.927334434	4.363175588	5.928886709	0.4731121	1.397601774	0	0	5.378222916	1.579488221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4263	0	0	21.1701	0.362322529	5.250260544	0	1.011934604	1.704530514	6.246652938	0.983473876	3.849370203	0	3.629240667	0.072318619	0.098215451	2.927334434	4.363175588	5.928886709	0.4731121	1.397601774	0	0	5.378222916	1.579488221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4263																																																																																				0	0	0	21.1701	0.362322529	5.250260544	0	1.011934604	1.704530514	6.246652938	0.983473876	3.849370203	0	3.629240667	0.072318619	0.098215451	2.927334434	4.363175588	5.928886709	0.4731121	1.397601774	0	0	5.378222916	1.579488221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4263
H6421_002_0	2008	4																					5000											D	Coin	D	V	T	Coin	Coin	V	V	V	P	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		1649.621257	5.261826428	900.4307397		80.95476829	8.522652571	31.23326469	240.8470699	370.1482984		285.8315448	5.785489515	0.491077254	245.59042	3793.484856	5134.677163	378.4896801	1118.081419			26.89111458	8.523272517																				"#1A $50/day days 1-5, $0/day days 6-90"	#1B MC cost shares	"#2 $0/day days 1-10, $50/day days 11-100"	#6 $0	#10A $50	#11A 30%	"#11B 30%, #11C 30%"	"#4A $50, #4B $25"	"#9A $50, #9B $50"	#8A $0	#8B $15/x-ray; $100/complex rad; 20%/ther rad	#9A $50	#12 20%	"#3 20%, #5 20%, #9A $50, #9C 20%, #9D $5"	"#7A $5, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $5, #7D $5, #7F $5, #7G $5"	"#7E $5, #7H $5"	"#7C $5, #7I $5"		"#14I $0 , #14J $0"	#15 30%	"#13A 20%, #16B $0, #17A $5, #17B $0, #18A $10"	#10B $0 n/c	#16A $0 n/c	#17A $0 n/c	#17B $0 n/c	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0 n/c	"#13B $0 n/c , #13C $0 n/c"											26.716	0.059728186	36.9427		43.3701	0.260220651	0.260220651	41.2032	43.3701		96.0113	43.3701	0.173480434	43.4725	4.337	4.337	4.337	4.337			0.260220651	0.071408935																				3.6726	0.314279347	2.772025433	0	0.292584757	2.217770197	8.127540457	0.826972989	1.337780986	0	2.286922133	0.020909776	0.085192295	0.889703262	1.371032079	1.855762544	0.136792821	0.40409427	0	0	6.99762333	0.608637816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.2182	0	5.230864286	3.6726	0.314279347	2.772025433	0	0.292584757	2.217770197	8.127540457	0.826972989	1.337780986	0	2.286922133	0.020909776	0.085192295	0.889703262	1.371032079	1.855762544	0.136792821	0.40409427	0	0	6.99762333	0.608637816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.2182																																																																																				0	0	0	3.6726	0.314279347	2.772025433	0	0.292584757	2.217770197	8.127540457	0.826972989	1.337780986	0	2.286922133	0.020909776	0.085192295	0.889703262	1.371032079	1.855762544	0.136792821	0.40409427	0	0	6.99762333	0.608637816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.2182
H6421_003_0	2008	3																																D	Coin	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	P	V	Coin	P	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		1649.621257	5.261826428	900.4307397		80.95476829	8.522652571	31.23326469	240.8470699	370.1482984		18.14620334	5.785489515	0.491077254	245.59042	3490.54047	4743.109367	378.4896801	1118.081419			26.89111458	1069.35871																				"#1A $250/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $150	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $40"	"#9A $150, #9B $100"	#8A $0	#8B 20%	#9A $150	#12 20%	"#3 20%, #5 20%, #9A $150, #9C 20%, #9D $15"	"#7A $15, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $15, #7D $15, #7F $15, #7G $15"	"#7E $15, #7H $15"	"#7C $15, #7I $15"		"#14I $0 , #14J $0"	#15 20%	"#13A 20%, #16B $0, #17A $15, #17B $0, #18A $15"	#10B $0 n/c	#16A $0 n/c	#17A $0 n/c	#17B $0 n/c	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0 n/c	"#13B $0 n/c , #13C $0 n/c"											154	0.0688587	69.97		150	0.2	0.2	49.0007	124.7944		0.2	150	0.2	143.0349	15	15	15	15			0.2	17.7245																				21.1701	0.362322529	5.250260544	0	1.011934604	1.704530514	6.246652938	0.983473876	3.849370203	0	3.629240667	0.072318619	0.098215451	2.927334434	4.363175588	5.928886709	0.4731121	1.397601774	0	0	5.378222916	1.579488221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4263	0	0	21.1701	0.362322529	5.250260544	0	1.011934604	1.704530514	6.246652938	0.983473876	3.849370203	0	3.629240667	0.072318619	0.098215451	2.927334434	4.363175588	5.928886709	0.4731121	1.397601774	0	0	5.378222916	1.579488221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4263																																																																																				0	0	0	21.1701	0.362322529	5.250260544	0	1.011934604	1.704530514	6.246652938	0.983473876	3.849370203	0	3.629240667	0.072318619	0.098215451	2.927334434	4.363175588	5.928886709	0.4731121	1.397601774	0	0	5.378222916	1.579488221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4263
H6421_004_0	2008	3																																D	Coin	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		1707.259909	5.635952358	931.8723836		83.78337133	9.128629482	33.45400959	249.2500237	383.0814785		19.43643313	5.987637622	0.525993787	254.1714811	3612.501827	4908.836153	391.7143126	1157.147783			28.8031243	9.004997778																				"#1A $250/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $150	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $40"	"#9A $150, #9B $100"	#8A $0	#8B 20%	#9A $150	#12 20%	"#3 20%, #5 20%, #9A $150, #9C 20%, #9D $15"	"#7A $15, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $15, #7D $15, #7F $15, #7G $15"	"#7E $15, #7H $15"	"#7C $15, #7I $15"		"#14I $0 , #14J $0"	#15 20%	"#13A 20%, #16B $0, #17A $15, #17B $0, #18A $15"	#10B $0 n/c	#16A $0 n/c	#17A $0 n/c	#17B $0 n/c	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0 n/c	"#13B $0 n/c , #13C $0 n/c"											154	0.067042503	72.5471		150	0.2	0.2	49.0007	124.7944		0.2	150	0.2	143.1628	15	15	15	15			0.2	0.182528022																				21.9098	0.377848352	5.63372158	0	1.047292142	1.825725896	6.690801919	1.017785431	3.983869263	0	3.887286625	0.07484547	0.105198757	3.032325488	4.515627284	6.136045192	0.489642891	1.446434729	0	0	5.760624859	1.64366443	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5786	0	0	21.9098	0.377848352	5.63372158	0	1.047292142	1.825725896	6.690801919	1.017785431	3.983869263	0	3.887286625	0.07484547	0.105198757	3.032325488	4.515627284	6.136045192	0.489642891	1.446434729	0	0	5.760624859	1.64366443	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5786																																																																																				0	0	0	21.9098	0.377848352	5.63372158	0	1.047292142	1.825725896	6.690801919	1.017785431	3.983869263	0	3.887286625	0.07484547	0.105198757	3.032325488	4.515627284	6.136045192	0.489642891	1.446434729	0	0	5.760624859	1.64366443	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5786
H6421_005_0	2008	3																					5000											D	Coin	D	V	T	Coin	Coin	V	V	V	P	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		1707.259909	5.635952358	931.8723836		83.78337133	9.128629482	33.45400959	249.2500237	383.0814785		295.8186523	5.987637622	0.525993787	254.1714811	3926.031252	5314.085538	391.7143126	1157.147783			28.8031243	9.129293507																				"#1A $50/day days 1-5, $0/day days 6-90"	#1B MC cost shares	"#2 $0/day days 1-10, $50/day days 11-100"	#6 $0	#10A $50	#11A 30%	"#11B 30%, #11C 30%"	"#4A $50, #4B $25"	"#9A $50, #9B $50"	#8A $0	#8B $15/x-ray; $100/complex rad; 20%/ther rad	#9A $50	#12 20%	"#3 20%, #5 20%, #9A $50, #9C 20%, #9D $5"	"#7A $5, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $5, #7D $5, #7F $5, #7G $5"	"#7E $5, #7H $5"	"#7C $5, #7I $5"		"#14I $0 , #14J $0"	#15 30%	"#13A 20%, #16B $0, #17A $5, #17B $0, #18A $10"	#10B $0 n/c	#16A $0 n/c	#17A $0 n/c	#17B $0 n/c	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0 n/c	"#13B $0 n/c , #13C $0 n/c"											26.4502	0.057574356	36.5752		42.9387	0.257632189	0.257632189	40.7933	42.9387		96.6465	42.9387	0.171754792	43.1499	4.2939	4.2939	4.2939	4.2939			0.257632189	0.069157255																				3.7631	0.324486326	2.840283583	0	0.299795741	2.351828792	8.618829706	0.847310126	1.370751662	0	2.382486126	0.021425114	0.090341954	0.913956625	1.404822255	1.901499288	0.140164188	0.414053494	0	0	7.420611948	0.631356877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.7371	0	5.876997364	3.7631	0.324486326	2.840283583	0	0.299795741	2.351828792	8.618829706	0.847310126	1.370751662	0	2.382486126	0.021425114	0.090341954	0.913956625	1.404822255	1.901499288	0.140164188	0.414053494	0	0	7.420611948	0.631356877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.7371																																																																																				0	0	0	3.7631	0.324486326	2.840283583	0	0.299795741	2.351828792	8.618829706	0.847310126	1.370751662	0	2.382486126	0.021425114	0.090341954	0.913956625	1.404822255	1.901499288	0.140164188	0.414053494	0	0	7.420611948	0.631356877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.7371
H6421_006_0	2008	3																																D	Coin	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		1707.259909	5.635952358	931.8723836		83.78337133	9.128629482	33.45400959	249.2500237	383.0814785		19.43643313	5.987637622	0.525993787	254.1714811	3612.501827	4908.836153	391.7143126	1157.147783			28.8031243	9.004997778																				"#1A $250/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $150	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $40"	"#9A $150, #9B $100"	#8A $0	#8B 20%	#9A $150	#12 20%	"#3 20%, #5 20%, #9A $150, #9C 20%, #9D $15"	"#7A $15, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $15, #7D $15, #7F $15, #7G $15"	"#7E $15, #7H $15"	"#7C $15, #7I $15"		"#14I $0 , #14J $0"	#15 20%	"#13A 20%, #16B $0, #17A $15, #17B $0, #18A $15"	#10B $0 n/c	#16A $0 n/c	#17A $0 n/c	#17B $0 n/c	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0 n/c	"#13B $0 n/c , #13C $0 n/c"											154	0.067042503	72.5471		150	0.2	0.2	49.0007	124.7944		0.2	150	0.2	143.1628	15	15	15	15			0.2	0.182528022																				21.9098	0.377848352	5.63372158	0	1.047292142	1.825725896	6.690801919	1.017785431	3.983869263	0	3.887286625	0.07484547	0.105198757	3.032325488	4.515627284	6.136045192	0.489642891	1.446434729	0	0	5.760624859	1.64366443	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5786	0	0	21.9098	0.377848352	5.63372158	0	1.047292142	1.825725896	6.690801919	1.017785431	3.983869263	0	3.887286625	0.07484547	0.105198757	3.032325488	4.515627284	6.136045192	0.489642891	1.446434729	0	0	5.760624859	1.64366443	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5786																																																																																				0	0	0	21.9098	0.377848352	5.63372158	0	1.047292142	1.825725896	6.690801919	1.017785431	3.983869263	0	3.887286625	0.07484547	0.105198757	3.032325488	4.515627284	6.136045192	0.489642891	1.446434729	0	0	5.760624859	1.64366443	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5786
H6421_007_0	2008	3																																D	Coin	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		1698.690636	5.579517123	927.1978391		83.36283632	9.037220556	33.11902009	248.0007109	381.1586724		19.24180769	5.957583792	0.520726783	252.8957147	3594.369547	4884.197165	389.7481756	1151.339696			28.51470612	8.91482683																				"#1A $250/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $150	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $40"	"#9A $150, #9B $100"	#8A $0	#8B 20%	#9A $150	#12 20%	"#3 20%, #5 20%, #9A $150, #9C 20%, #9D $15"	"#7A $15, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $15, #7D $15, #7F $15, #7G $15"	"#7E $15, #7H $15"	"#7C $15, #7I $15"		"#14I $0 , #14J $0"	#15 20%	"#13A 20%, #16B $0, #17A $15, #17B $0, #18A $15"	#10B $0 n/c	#16A $0 n/c	#17A $0 n/c	#17B $0 n/c	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0 n/c	"#13B $0 n/c , #13C $0 n/c"											154	0.069614787	71.8562		150	0.2	0.2	49.0007	124.7944		0.2	150	0.2	143.1438	15	15	15	15			0.2	0.183299668																				21.7999	0.388416895	5.552076685	0	1.042035454	1.807444111	6.623804018	1.012684143	3.963872974	0	3.848361539	0.074469797	0.104145357	3.01670465	4.492961934	6.105246457	0.487185219	1.43917462	0	0	5.702941224	1.634084797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.0955	0	0	21.7999	0.388416895	5.552076685	0	1.042035454	1.807444111	6.623804018	1.012684143	3.963872974	0	3.848361539	0.074469797	0.104145357	3.01670465	4.492961934	6.105246457	0.487185219	1.43917462	0	0	5.702941224	1.634084797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.0955																																																																																				0	0	0	21.7999	0.388416895	5.552076685	0	1.042035454	1.807444111	6.623804018	1.012684143	3.963872974	0	3.848361539	0.074469797	0.104145357	3.01670465	4.492961934	6.105246457	0.487185219	1.43917462	0	0	5.702941224	1.634084797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.0955
H6421_008_0	2008	3																					5000											D	Coin	D	V	T	Coin	Coin	V	V	V	P	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		1698.690636	5.579517123	927.1978391		83.36283632	9.037220556	33.11902009	248.0007109	381.1586724		294.3338457	5.957583792	0.520726783	252.8957147	3906.32527	5287.412476	389.7481756	1151.339696			28.51470612	9.037877932																				"#1A $50/day days 1-5, $0/day days 6-90"	#1B MC cost shares	"#2 $0/day days 1-10, $50/day days 11-100"	#6 $0	#10A $50	#11A 30%	"#11B 30%, #11C 30%"	"#4A $50, #4B $25"	"#9A $50, #9B $50"	#8A $0	#8B $15/x-ray; $100/complex rad; 20%/ther rad	#9A $50	#12 20%	"#3 20%, #5 20%, #9A $50, #9C 20%, #9D $5"	"#7A $5, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $5, #7D $5, #7F $5, #7G $5"	"#7E $5, #7H $5"	"#7C $5, #7I $5"		"#14I $0 , #14J $0"	#15 30%	"#13A 20%, #16B $0, #17A $5, #17B $0, #18A $5"	#10B $0 n/c	#16A $0 n/c	#17A $0 n/c	#17B $0 n/c	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0 n/c	"#13B $0 n/c , #13C $0 n/c"											26.4869	0.059866134	36.6258		42.9981	0.257988872	0.257988872	40.8498	42.9981		96.5435	42.9981	0.171992581	43.1933	4.2998	4.2998	4.2998	4.2998			0.257988872	0.069475847																				3.7494	0.334024121	2.829948441	0	0.298703945	2.331502334	8.544338621	0.84423067	1.365759664	0	2.368002721	0.021347088	0.089561143	0.910283641	1.399706178	1.894574414	0.139653739	0.412545596	0	0	7.356476856	0.627914226	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.518	0	5.783779551	3.7494	0.334024121	2.829948441	0	0.298703945	2.331502334	8.544338621	0.84423067	1.365759664	0	2.368002721	0.021347088	0.089561143	0.910283641	1.399706178	1.894574414	0.139653739	0.412545596	0	0	7.356476856	0.627914226	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.518																																																																																				0	0	0	3.7494	0.334024121	2.829948441	0	0.298703945	2.331502334	8.544338621	0.84423067	1.365759664	0	2.368002721	0.021347088	0.089561143	0.910283641	1.399706178	1.894574414	0.139653739	0.412545596	0	0	7.356476856	0.627914226	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.518
H6421_009_0	2008	3																																D	Coin	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		1698.690636	5.579517123	927.1978391		83.36283632	9.037220556	9.099172677	248.0007109	381.1586724		19.24180769	5.957583792	0.520726783	626.151856	3587.603641	4884.197165	405.7868611	969.2891095			28.51470612	8.91482683																				"#1A $150/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $150	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $40"	"#9A $100, #9B $50"	#8A $0	#8B 20%	#9A $100	#12 20%	"#3 20%, #5 20%, #9A $100, #9C 20%, #9D $10"	"#7A $10, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $10, #7D $10, #7F $10, #7G $10"	"#7E $10, #7H $10"	"#7C $10, #7I $10"		"#14I $0 , #14J $0"	#15 20%	"#13A 20%, #16B $0, #17A $10, #17B $0, #18A $10"	#10B $0 n/c	#16A $0 n/c	#17A $0 n/c	#17B $0 n/c	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0 n/c	"#13B $0 n/c , #13C $0 n/c"											92.4	0.069614787	71.8562		150	0.2	0.2	49.0007	74.7944		0.2	100	0.2	72.1093	10	10	10	10			0.2	0.132054541																				13.0799	0.388416895	5.552076685	0	1.042035454	1.807444111	1.819834535	1.012684143	2.375711839	0	3.848361539	0.049646532	0.104145357	3.762613286	2.989669701	4.070164304	0.338155718	0.807740925	0	0	5.702941224	1.177243361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.9288	0	0	13.0799	0.388416895	5.552076685	0	1.042035454	1.807444111	1.819834535	1.012684143	2.375711839	0	3.848361539	0.049646532	0.104145357	3.762613286	2.989669701	4.070164304	0.338155718	0.807740925	0	0	5.702941224	1.177243361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.9288																																																																																				0	0	0	13.0799	0.388416895	5.552076685	0	1.042035454	1.807444111	1.819834535	1.012684143	2.375711839	0	3.848361539	0.049646532	0.104145357	3.762613286	2.989669701	4.070164304	0.338155718	0.807740925	0	0	5.702941224	1.177243361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.9288
H6497_001_0	2008	7																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H6497_003_0	2008	5																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H6497_005_0	2008	6																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H6497_006_0	2008	6																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H6497_007_0	2008	8																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H6497_008_0	2008	5																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H6497_801_0	2008	2																																coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin																																																														0		107.6542148	2.62738253	2.883287639	18.20622985	4.685617155	41.06464498	10.26616125	3.515844456	7.560123912	10.78002717	3.593342389	0.179667119	0.08983356	3.323841709	58.68270478	59.93219929	1.362095438	6.810477192	24.69317745	21.3815425	12.88474773																					Original Medicare Cost Sharing	Original Medicare Cost Sharing	Original Medicare Cost Sharing	Original Medicare Cost Sharing	Original Medicare Cost Sharing	Original Medicare Cost Sharing	Original Medicare Cost Sharing	Original Medicare Cost Sharing	Original Medicare Cost Sharing	Original Medicare Cost Sharing	Original Medicare Cost Sharing	Original Medicare Cost Sharing	Original Medicare Cost Sharing	Original Medicare Cost Sharing	Original Medicare Cost Sharing	Original Medicare Cost Sharing	Original Medicare Cost Sharing	Original Medicare Cost Sharing	Original Medicare Cost Sharing	Original Medicare Cost Sharing	Original Medicare Cost Sharing																					0.157476235	0.157476235	0.14907547	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					16.953	0.413750308	0.42982746	0	1.096434414	9.609126926	2.402281731	0.822707603	1.769068995	2.522526357	0.840842119	0.042042106	0.021021053	0.77777896	13.73175292	14.02413463	0.318730333	1.593651663	5.778203524	5.003280945	3.015030968	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.1652			16.953	0.413750308	0.42982746	0	1.096434414	9.609126926	2.402281731	0.822707603	1.769068995	2.522526357	0.840842119	0.042042106	0.021021053	0.77777896	13.73175292	14.02413463	0.318730333	1.593651663	5.778203524	5.003280945	3.015030968	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.1652																																																																																				0			16.953	0.413750308	0.42982746	0	1.096434414	9.609126926	2.402281731	0.822707603	1.769068995	2.522526357	0.840842119	0.042042106	0.021021053	0.77777896	13.73175292	14.02413463	0.318730333	1.593651663	5.778203524	5.003280945	3.015030968	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.1652
H6499_005_0	2008	4																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.8262	1.3285	0.2123	1.1752	0.6401	0	2.4835	0.1274	0.0693	0.9359	0.6	1.441	0.5911	0.5072	0.3701	0.0054	0.9886	0.0263	0	0	0	0	0	0	0	0	0											12.3281	0	445.1501348	58.43683663	3104.726769	2857.7917	24.2994369	39.07315949	6.244291838	34.56445429	18.82541653	10628.2778	20.61765298	1.057815925	0.707452643	7.769983609	39.9576929	94.78494707	15.55130978	33.35828105	24.34396862	4.593802449	29.07579558	0.773092362	0	2169	662.4	158.976	138.4	28.14915254	0	0	6											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 24%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											832.95	832.95	75.58	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.200426912	0.2	0.197534559	0.2	0.5	0.2	0.2	0.015518466	0.2	0.2	0	0	0	10	0	10	0	0	0											30.899	4.056246922	19.5546041	0	4.85988738	7.814631898	1.248858368	6.912890859	3.765083306	0	4.123530596	0.211563185	0.141792549	1.553996722	7.893025253	18.95698941	7.775654888	6.67165621	4.868793724	0.071288766	5.815159117	0.154618472	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	137.5052	131	0	30.899	4.056246922	19.5546041	0	5.686068235	9.14311932	1.46116429	8.088082305	4.405147468	0	6.607073532	0.338984636	0.211125498	2.489946508	8.493021351	20.39802366	8.366728962	7.178808736	5.23889988	0.076707852	6.803736167	0.180903613	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	149.8333	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.899	4.056246922	19.5546041	0	5.686068235	9.14311932	1.46116429	8.088082305	4.405147468	0	6.607073532	0.338984636	0.211125498	2.489946508	8.493021351	20.39802366	8.366728962	7.178808736	5.23889988	0.076707852	6.803736167	0.180903613	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	149.8333
H6499_013_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1776.85533	88.6011876	1330.817512	1653.39564	676.5653445	19.62626504	4.748912701	1787.383598	346.1472082	7222.371708	1429.559969	67.06114044	0.208041931	546.3949205	10190.84603	20638.22435	402.9758369	4044.541634	4997.063051	1022.379169	36.13960659	44.30013165	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $45.00 and $90.00	$20.00 copayment	"Copay between $20.00 and $90.00, 20% coinsurance"	$150.00 copayment	Coin between 25% and 31%	"Copay between $20.00 and $90.00, 20% coinsurance"	Copay between $0.00 and $15.00	"Copay between $0.00 and $30.00, 20% coinsurance"	Copay between $20.00 and $30.00	"$30.00 copayment, 20% coinsurance"	"Copay between $15.00 and $30.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											81.31209933	46.42353211	133.1732334	0	32.52197863	0.267362444	0.267362444	16.80569316	63.90860479	2.449412982	24.09012938	121.1565518	0.259396536	46.21166023	4.891515778	7.22424601	21.03951289	12.55879001	8.909716202	0	0.267362444	46.13289382	0	0	0	8.912081468	0	8.912081468	0	0	0											12.04	0.342765006	14.76910593	0	1.83360364	5.247326189	1.269680906	2.503185026	1.843482094	1.474214252	2.86985705	0.677074711	0.053965356	2.104151368	4.154057012	12.42463416	0.706534609	4.232879089	3.710201136	0	9.662373544	0.170307772	0	0	0	0.212107539	0	0.020905628	0	0	0	0	0	0	0	0	0	0	0	0	0	82.3224	0	9.760516183	12.04	0.342765006	14.76910593	0	1.83360364	5.247326189	1.269680906	2.503185026	1.843482094	1.474214252	2.86985705	0.677074711	0.053965356	2.104151368	4.154057012	12.42463416	0.706534609	4.232879089	3.710201136	0	9.662373544	0.170307772	0	0	0	0.212107539	0	0.020905628	0	0	0	0	0	0	0	0	0	0	0	0	0	82.3224	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.04	0.342765006	14.76910593	0	1.83360364	5.247326189	1.269680906	2.503185026	1.843482094	1.474214252	2.86985705	0.677074711	0.053965356	2.104151368	4.154057012	12.42463416	0.706534609	4.232879089	3.710201136	0	9.662373544	0.170307772	0	0	0	0.212107539	0	0.020905628	0	0	0	0	0	0	0	0	0	0	0	0	0	82.3224
H6499_014_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1760.187859	87.76769812	1329.119997	1637.341553	670.0618062	19.44623662	4.704100286	1771.464431	342.8769267	7152.573948	1415.79375	66.39532896	0.205993399	541.1879671	10098.63528	20445.42267	399.2984883	4006.42054	4949.848725	1012.798482	35.79877222	43.88330324	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $45.00 and $90.00	$20.00 copayment	"Copay between $20.00 and $90.00, 20% coinsurance"	$150.00 copayment	Coin between 25% and 31%	"Copay between $20.00 and $90.00, 20% coinsurance"	Copay between $0.00 and $15.00	"Copay between $0.00 and $30.00, 20% coinsurance"	Copay between $20.00 and $30.00	"$30.00 copayment, 20% coinsurance"	"Copay between $15.00 and $30.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											81.47685633	46.51753263	122.8544562	0	32.66074641	0.268514767	0.268514767	16.87857213	64.18410289	2.459993681	24.193207	121.6799103	0.260514779	46.39409612	4.913391777	7.25650533	21.13114709	12.61310457	8.946964535	0	0.268514767	46.31146767	0	0	0	8.950492222	0	8.950492222	0	0	0											11.9512	0.340228063	13.60735955	0	1.823726561	5.221601688	1.263120391	2.491649182	1.833937328	1.466273893	2.854382605	0.673248139	0.053664325	2.092327214	4.134879297	12.36352655	0.703136257	4.211116767	3.690510083	0	9.612498969	0.169358348	0	0	0	0.213021715	0	0.020995731	0	0	0	0	0	0	0	0	0	0	0	0	0	80.7918	0	9.19775863	11.9512	0.340228063	13.60735955	0	1.823726561	5.221601688	1.263120391	2.491649182	1.833937328	1.466273893	2.854382605	0.673248139	0.053664325	2.092327214	4.134879297	12.36352655	0.703136257	4.211116767	3.690510083	0	9.612498969	0.169358348	0	0	0	0.213021715	0	0.020995731	0	0	0	0	0	0	0	0	0	0	0	0	0	80.7918	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.9512	0.340228063	13.60735955	0	1.823726561	5.221601688	1.263120391	2.491649182	1.833937328	1.466273893	2.854382605	0.673248139	0.053664325	2.092327214	4.134879297	12.36352655	0.703136257	4.211116767	3.690510083	0	9.612498969	0.169358348	0	0	0	0.213021715	0	0.020995731	0	0	0	0	0	0	0	0	0	0	0	0	0	80.7918
H6499_015_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	2524.414126	131.2165675	1874.920126	2150.009448	958.8614785	26.51943299	6.209204075	2260.987348	437.1689826	10141.34646	1900.643938	90.89563531	0.21567141	800.8302148	12145.84526	27441.78182	592.7437166	6529.988463	6688.724428	1271.834046	54.36237048	63.77256714	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 22% and 25%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	Copay between $0.00 and $35.00	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											86.67345477	48.11427289	105.8679479	0	29.98637903	0.246376421	0.246376421	15.39368892	99.24549599	2.254324313	32.43485075	176.2525477	0.233400883	47.22756377	6.002437941	7.466489721	23.10088506	2.763200672	8.550190144	0	0.246376421	46.04532591	0	0	0	8.212547354	0	8.212547354	0	0	0											18.2333	0.526115811	16.54116219	0	2.396065311	6.533762976	1.529801475	2.900411323	3.615587709	1.905156992	5.137258537	1.335048942	0.050337898	3.15177167	6.075390202	17.07448183	1.141075372	1.503639043	4.76582214	0	13.39360625	0.244702387	0	0	0	0.195458627	0	0.019264687	0	0	0	0	0	0	0	0	0	0	0	0	0	108.2692	0	22.80525016	18.2333	0.526115811	16.54116219	0	2.396065311	6.533762976	1.529801475	2.900411323	3.615587709	1.905156992	5.137258537	1.335048942	0.050337898	3.15177167	6.075390202	17.07448183	1.141075372	1.503639043	4.76582214	0	13.39360625	0.244702387	0	0	0	0.195458627	0	0.019264687	0	0	0	0	0	0	0	0	0	0	0	0	0	108.2692	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.2333	0.526115811	16.54116219	0	2.396065311	6.533762976	1.529801475	2.900411323	3.615587709	1.905156992	5.137258537	1.335048942	0.050337898	3.15177167	6.075390202	17.07448183	1.141075372	1.503639043	4.76582214	0	13.39360625	0.244702387	0	0	0	0.195458627	0	0.019264687	0	0	0	0	0	0	0	0	0	0	0	0	0	108.2692
H6499_017_0	2008	5																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1739.865985	87.20483565	1322.247206	1649.13708	674.8242111	19.57594847	4.736709985	1782.811754	343.1233053	7203.776762	1413.693754	66.45467548	0.207505457	541.6169718	9994.735103	20417.67433	394.304379	4015.57402	4961.462087	1019.753564	36.04674724	43.85729092	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 31%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											131.0629787	74.83409652	121.6400882	0	31.55981088	0.25945273	0.25945273	16.30851903	103.3253702	2.376949473	32.76245616	163.8446642	0.251722493	51.57074312	6.255650715	7.991207711	23.89545104	12.70814374	9.240270119	0	0.25945273	44.77038411	0	0	0	8.64842433	0	8.64842433	0	0	0											19.0027	0.543824591	13.4031889	0	1.77477704	5.079033271	1.228952336	2.422918285	2.954445212	1.426917782	3.859673303	0.907353666	0.052233791	2.327632477	5.21029765	13.59682305	0.785173415	4.252540987	3.820437489	0	9.352426976	0.163625647	0	0	0	0.205832499	0	0.020287151	0	0	0	0	0	0	0	0	0	0	0	0	0	92.3911	0	14.01819233	19.0027	0.543824591	13.4031889	0	1.77477704	5.079033271	1.228952336	2.422918285	2.954445212	1.426917782	3.859673303	0.907353666	0.052233791	2.327632477	5.21029765	13.59682305	0.785173415	4.252540987	3.820437489	0	9.352426976	0.163625647	0	0	0	0.205832499	0	0.020287151	0	0	0	0	0	0	0	0	0	0	0	0	0	92.3911	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.0027	0.543824591	13.4031889	0	1.77477704	5.079033271	1.228952336	2.422918285	2.954445212	1.426917782	3.859673303	0.907353666	0.052233791	2.327632477	5.21029765	13.59682305	0.785173415	4.252540987	3.820437489	0	9.352426976	0.163625647	0	0	0	0.205832499	0	0.020287151	0	0	0	0	0	0	0	0	0	0	0	0	0	92.3911
H6499_018_0	2008	5																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	2287.429031	101.3565001	1721.230908	1891.21624	850.2693816	24.61746877	6.200563962	2019.539501	409.5781662	9390.970953	1839.691614	98.02565693	0.25872225	740.4906829	12030.21252	26481.15473	500.4308169	5317.394777	6364.778166	1262.63424	48.46050892	54.91036997	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 24% and 25%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											95.20913613	56.86308869	109.3270179	0	30.92141923	0.246899318	0.246899318	15.90198813	100.7463401	2.240602553	31.92376847	167.0818789	0.236547889	48.27864157	6.183226953	7.589687167	23.14417807	12.12243386	8.727587477	0	0.246899318	44.45493292	0	0	0	8.229977261	0	8.229977261	0	0	0											18.1487	0.480286971	15.6814202	0	2.190961334	6.078036245	1.530915012	2.676224432	3.438625102	1.753452791	4.894157429	1.364859245	0.061200202	2.979157022	6.198794526	16.74864002	0.965171662	5.371647208	4.629096518	0	11.96486659	0.203419734	0	0	0	0.195873459	0	0.019305574	0	0	0	0	0	0	0	0	0	0	0	0	0	107.5748	0	22.41058799	18.1487	0.480286971	15.6814202	0	2.190961334	6.078036245	1.530915012	2.676224432	3.438625102	1.753452791	4.894157429	1.364859245	0.061200202	2.979157022	6.198794526	16.74864002	0.965171662	5.371647208	4.629096518	0	11.96486659	0.203419734	0	0	0	0.195873459	0	0.019305574	0	0	0	0	0	0	0	0	0	0	0	0	0	107.5748	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.1487	0.480286971	15.6814202	0	2.190961334	6.078036245	1.530915012	2.676224432	3.438625102	1.753452791	4.894157429	1.364859245	0.061200202	2.979157022	6.198794526	16.74864002	0.965171662	5.371647208	4.629096518	0	11.96486659	0.203419734	0	0	0	0.195873459	0	0.019305574	0	0	0	0	0	0	0	0	0	0	0	0	0	107.5748
H6499_019_0	2008	5																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	2581.389146	134.169687	1917.528912	2198.164011	970.9217976	27.1157303	6.348604831	2289.734017	442.6829472	10368.59182	1943.121382	92.03679046	0.219332731	810.9139467	12418.64745	28048.77242	605.4006979	5988.465843	6838.813848	1300.387123	55.45065303	64.59337745	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 22% and 25%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											84.46202729	46.88664117	103.71177	0	29.47607824	0.242185187	0.242185187	15.13190888	97.5571416	2.215980294	31.88365102	173.2560221	0.229244511	46.45732708	5.900557864	7.346764704	22.72454208	11.87829103	8.404511864	0	0.242185187	45.25032819	0	0	0	8.072839573	0	8.072839573	0	0	0											18.1691	0.524230498	16.57252646	0	2.384913906	6.567028219	1.537538049	2.88733721	3.598906913	1.914716261	5.162817004	1.32882735	0.050280825	3.139407871	6.106412323	17.17231093	1.14645447	5.927728345	4.78974101	0	13.42932678	0.243572627	0	0	0	0.192133582	0	0.018936966	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8643	0	26.08940297	18.1691	0.524230498	16.57252646	0	2.384913906	6.567028219	1.537538049	2.88733721	3.598906913	1.914716261	5.162817004	1.32882735	0.050280825	3.139407871	6.106412323	17.17231093	1.14645447	5.927728345	4.78974101	0	13.42932678	0.243572627	0	0	0	0.192133582	0	0.018936966	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8643	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.1691	0.524230498	16.57252646	0	2.384913906	6.567028219	1.537538049	2.88733721	3.598906913	1.914716261	5.162817004	1.32882735	0.050280825	3.139407871	6.106412323	17.17231093	1.14645447	5.927728345	4.78974101	0	13.42932678	0.243572627	0	0	0	0.192133582	0	0.018936966	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8643
H6499_021_0	2008	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1761.261909	87.70315563	1322.757675	1633.756527	668.5305138	19.39337486	4.692533415	1766.184494	342.872775	7166.380579	1434.91044	66.53526131	0.205570173	545.4114634	10451.19153	21186.52318	416.0863411	4098.394383	5046.455382	1010.242909	35.71055996	43.94938912	0	2492.571429	662.4	158.976	138.4	28.14915254	0	0	2400											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $10.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $30.00 and $60.00	$10.00 copayment	"Copay between $10.00 and $60.00, 20% coinsurance"	$100.00 copayment	Coin between 25% and 31%	"Copay between $10.00 and $60.00, 20% coinsurance"	Copay between $0.00 and $5.00	"Copay between $0.00 and $10.00, 20% coinsurance"	Copay between $10.00 and $20.00	"$10.00 copayment, 20% coinsurance"	"Copay between $5.00 and $10.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$25.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											55.3005353	31.5722302	128.2836331	0	33.28349445	0.273623107	0.273623107	17.19923179	43.60780299	1.25338496	18.60367764	82.66241802	0.265470671	42.51010094	1.724111094	3.137815608	14.18560597	10.52811239	6.678419898	0	0.273623107	47.1704284	0	22.80192555	0	9.12077022	0	9.12077022	0	0	0											8.1166	0.230748685	14.14068002	0	1.854252637	5.306475476	1.283985571	2.531418042	1.245994035	0.74851947	2.224550939	0.458330465	0.054572852	1.932124697	1.501584606	5.53995026	0.49186974	3.59569639	2.808529003	0	9.771234355	0.172759293	0	4.736285679	0	0.120831964	0	0.021395163	0	0	0	0	0	0	0	0	0	0	0	0	0	68.8883	0	6.468013237	8.1166	0.230748685	14.14068002	0	1.854252637	5.306475476	1.283985571	2.531418042	1.245994035	0.74851947	2.224550939	0.458330465	0.054572852	1.932124697	1.501584606	5.53995026	0.49186974	3.59569639	2.808529003	0	9.771234355	0.172759293	0	4.736285679	0	0.120831964	0	0.021395163	0	0	0	0	0	0	0	0	0	0	0	0	0	68.8883	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.1166	0.230748685	14.14068002	0	1.854252637	5.306475476	1.283985571	2.531418042	1.245994035	0.74851947	2.224550939	0.458330465	0.054572852	1.932124697	1.501584606	5.53995026	0.49186974	3.59569639	2.808529003	0	9.771234355	0.172759293	0	4.736285679	0	0.120831964	0	0.021395163	0	0	0	0	0	0	0	0	0	0	0	0	0	68.8883
H6499_022_0	2008	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	2282.298762	100.84867	1707.853466	1876.517669	843.6610703	24.42614129	6.15237305	2003.843598	409.0070399	9317.984132	1841.429343	98.08346184	0.256711456	739.2549342	12322.84938	26657.7364	515.9043106	5322.719825	6374.267633	1252.821021	48.08387284	54.89998787	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $25.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $45.00 and $90.00	$20.00 copayment	"Copay between $20.00 and $90.00, 20% coinsurance"	$150.00 copayment	Coin between 24% and 25%	"Copay between $15.00 and $90.00, 20% coinsurance"	Copay between $0.00 and $10.00	"Copay between $0.00 and $25.00, 20% coinsurance"	Copay between $15.00 and $25.00	"$25.00 copayment, 20% coinsurance"	"Copay between $10.00 and $25.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											59.13113181	35.31222994	113.1505735	0	32.00285149	0.255534267	0.255534267	16.45813735	62.57984409	2.318964412	23.64558728	114.7041083	0.244820812	43.33680815	3.286100486	5.955676328	17.0027185	11.55969432	7.907890196	0	0.255534267	46.00386682	0	0	0	8.517808905	0	8.517808905	0	0	0											11.2462	0.296765952	16.10371659	0	2.249963329	6.241716114	1.572142139	2.74829443	2.132966399	1.800672799	3.628473188	0.937548002	0.062848307	2.669745771	3.374510112	13.23040413	0.730981314	5.127417844	4.200584044	0	12.28707721	0.210467644	0	0	0	0.202723852	0	0.019980759	0	0	0	0	0	0	0	0	0	0	0	0	0	91.0752	0	15.35076915	11.2462	0.296765952	16.10371659	0	2.249963329	6.241716114	1.572142139	2.74829443	2.132966399	1.800672799	3.628473188	0.937548002	0.062848307	2.669745771	3.374510112	13.23040413	0.730981314	5.127417844	4.200584044	0	12.28707721	0.210467644	0	0	0	0.202723852	0	0.019980759	0	0	0	0	0	0	0	0	0	0	0	0	0	91.0752	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.2462	0.296765952	16.10371659	0	2.249963329	6.241716114	1.572142139	2.74829443	2.132966399	1.800672799	3.628473188	0.937548002	0.062848307	2.669745771	3.374510112	13.23040413	0.730981314	5.127417844	4.200584044	0	12.28707721	0.210467644	0	0	0	0.202723852	0	0.019980759	0	0	0	0	0	0	0	0	0	0	0	0	0	91.0752
H6499_023_0	2008	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	2577.428297	133.7288935	1907.885012	2187.108702	966.0387039	26.97935614	6.316675553	2278.218171	442.6854866	10316.44466	1943.158272	92.20409462	0.218229633	809.2291787	12361.47461	27921.26589	602.3559333	5958.347826	6804.419143	1293.847037	55.17177297	64.64524396	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $55.00 and $105.00	$20.00 copayment	"Copay between $20.00 and $105.00, 20% coinsurance"	$175.00 copayment	Coin between 22% and 25%	"Copay between $20.00 and $105.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											59.34484078	32.94278099	104.0918129	0	29.58409081	0.243072654	0.243072654	15.18735847	68.69096879	2.224100565	25.16879356	128.3471115	0.230084558	42.02781145	5.919648124	7.36912436	22.80781423	11.92181802	8.43530948	0	0.243072654	45.42138857	0	0	0	8.102421804	0	8.102421804	0	0	0											12.7464	0.367116804	16.54960081	0	2.381614729	6.557943703	1.535411092	2.883343004	2.534041245	1.912067534	4.075579116	0.986177435	0.050211269	2.834177612	6.097965001	17.14627339	1.144868519	5.919528206	4.783115109	0	13.41074929	0.244689729	0	0	0	0.192837639	0	0.019006359	0	0	0	0	0	0	0	0	0	0	0	0	0	104.3727	0	23.68915733	12.7464	0.367116804	16.54960081	0	2.381614729	6.557943703	1.535411092	2.883343004	2.534041245	1.912067534	4.075579116	0.986177435	0.050211269	2.834177612	6.097965001	17.14627339	1.144868519	5.919528206	4.783115109	0	13.41074929	0.244689729	0	0	0	0.192837639	0	0.019006359	0	0	0	0	0	0	0	0	0	0	0	0	0	104.3727	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.7464	0.367116804	16.54960081	0	2.381614729	6.557943703	1.535411092	2.883343004	2.534041245	1.912067534	4.075579116	0.986177435	0.050211269	2.834177612	6.097965001	17.14627339	1.144868519	5.919528206	4.783115109	0	13.41074929	0.244689729	0	0	0	0.192837639	0	0.019006359	0	0	0	0	0	0	0	0	0	0	0	0	0	104.3727
H6499_025_0	2008	4																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	1.0266	1.652	0.2639	1.462	0.7955	0	3.086	0.1583	0.0861	1.1632	0.747	1.7924	0.7347	0.6303	0.4598	0.0067	1.2289	0.0327	0	0	0	0	0	0	0	0	0											15.3262	0	556.3500426	72.82525592	3877.69699	3551.133569	30.19360989	48.588922	7.761826331	43.00146491	23.39714342	13208.12806	25.6179302	1.313931773	0.878865082	9.656434924	49.76172919	117.9381707	19.33634027	41.4722945	30.25488208	5.709328002	36.14537276	0.96072864	0	2169	662.4	158.976	138.4	28.14915254	0	0	6											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 18% and 20%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											615.28	615.28	70.07	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.199757021	0.2	0.197543603	0.2	0.5	0.2	0.2	0.015524767	0.2	0.2	0	0	0	10	0	10	0	0	0											28.5259	3.733993622	22.64251901	0	6.038721977	9.7177844	1.552365266	8.600292983	4.679428684	0	5.12358604	0.262786355	0.175559471	1.931286985	9.830111286	23.58763413	9.668170137	8.2944589	6.050976417	0.088635987	7.229074552	0.192145728	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	158.0814	131	0	28.5259	3.733993622	22.64251901	0	7.065304714	11.36980775	1.816267361	10.06234279	5.47493156	0	8.209594543	0.421066301	0.261682248	3.094528514	10.57709173	25.38003514	10.40284483	8.924746636	6.510784135	0.095371348	8.458017226	0.224810502	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	173.4076	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.5259	3.733993622	22.64251901	0	7.065304714	11.36980775	1.816267361	10.06234279	5.47493156	0	8.209594543	0.421066301	0.261682248	3.094528514	10.57709173	25.38003514	10.40284483	8.924746636	6.510784135	0.095371348	8.458017226	0.224810502	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	173.4076
H6499_028_0	2008	4																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	1.0368	1.6276	0.2466	1.347	0.7411	0	2.6451	0.0768	0.0716	1.0179	0.9608	2.3118	0.8236	0.6078	0.6144	0.0066	1.1427	0.0263	0	0	0	0	0	0	0	0	0											15.3046	0	600.2399389	69.33644275	3969.792042	2499.531952	30.49536895	47.87021826	7.252507607	39.61809293	21.79653948	10772.12483	25.17135657	0.73079885	0.829973481	9.686821759	54.87851885	130.5593685	18.60498935	34.32801027	34.69940113	6.711850575	33.61004623	0.774797513	0	2169	662.4	158.976	138.4	28.14915254	0	0	6											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 19% and 20%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											664.36	664.36	67.27	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.197762095	0.2	0.5	0.2	0.2	0.01117295	0.2	0.2	0	0	0	10	0	10	0	0	0											33.2313	3.838696592	22.25399255	0	6.099073789	9.574043651	1.450501521	7.923618586	4.359307895	0	5.034271315	0.14615977	0.165994696	1.937364352	10.85289086	26.11187371	9.302494673	6.865602054	6.939880226	0.074991171	6.722009247	0.154959503	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	163.1949	131	0	33.2313	3.838696592	22.25399255	0	7.135916334	11.20163107	1.69708678	9.270633745	5.100390237	0	7.679369539	0.222954786	0.237566215	2.955291016	11.81372805	28.4236319	10.12607089	7.473433263	7.554287492	0.081630352	7.864750819	0.181302618	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	178.4996	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	33.2313	3.838696592	22.25399255	0	7.135916334	11.20163107	1.69708678	9.270633745	5.100390237	0	7.679369539	0.222954786	0.237566215	2.955291016	11.81372805	28.4236319	10.12607089	7.473433263	7.554287492	0.081630352	7.864750819	0.181302618	0	0	0	0.13248	0	0.023457627	0	0	0	0	0	0	0	0	0	0	0	0	0	178.4996
H6499_029_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1853.530415	92.42075444	1401.544705	1724.535138	705.6841159	20.47209955	4.953411976	1864.477225	361.0534895	7533.167123	1491.083736	69.94460027	0.216989449	569.9172428	10632.55046	21528.55303	420.3454203	4218.71489	5212.240309	1066.41401	37.695888	46.20811607	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$150 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $45.00 and $90.00	$20.00 copayment	"Copay between $20.00 and $90.00, 20% coinsurance"	$150.00 copayment	Coin between 25% and 31%	"Copay between $20.00 and $90.00, 20% coinsurance"	Copay between $0.00 and $15.00	"Copay between $0.00 and $30.00, 20% coinsurance"	Copay between $20.00 and $30.00	"$30.00 copayment, 20% coinsurance"	"Copay between $15.00 and $30.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											80.25963377	45.82280822	119.7609967	0	32.36777	0.266096126	0.266096126	16.72615114	63.60593857	2.437814702	23.97593749	120.5828602	0.258167979	45.99943725	4.86737402	7.191574164	20.93998104	12.4993305	8.867373856	0	0.266096126	45.91188271	0	0	0	8.869870883	0	8.869870883	0	0	0											12.397	0.352914876	13.98753256	0	1.903451763	5.447546391	1.31808374	2.598793989	1.913762173	1.53037213	2.979177537	0.70284333	0.056019728	2.184656038	4.312716655	12.90201548	0.733502094	4.394259308	3.851573621	0	10.03072978	0.1767918	0	0	0	0.211102927	0	0.020806612	0	0	0	0	0	0	0	0	0	0	0	0	0	84.0056	0	10.39015634	12.397	0.352914876	13.98753256	0	1.903451763	5.447546391	1.31808374	2.598793989	1.913762173	1.53037213	2.979177537	0.70284333	0.056019728	2.184656038	4.312716655	12.90201548	0.733502094	4.394259308	3.851573621	0	10.03072978	0.1767918	0	0	0	0.211102927	0	0.020806612	0	0	0	0	0	0	0	0	0	0	0	0	0	84.0056	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.397	0.352914876	13.98753256	0	1.903451763	5.447546391	1.31808374	2.598793989	1.913762173	1.53037213	2.979177537	0.70284333	0.056019728	2.184656038	4.312716655	12.90201548	0.733502094	4.394259308	3.851573621	0	10.03072978	0.1767918	0	0	0	0.211102927	0	0.020806612	0	0	0	0	0	0	0	0	0	0	0	0	0	84.0056
H6499_030_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	2228.017623	98.73640581	1676.12181	1842.585295	836.4424137	23.98327477	6.04096483	1986.554674	402.9148851	9149.426084	1792.453384	96.43301643	0.253579501	728.4402089	11720.23295	25807.43094	488.1127745	5212.056105	6200.957121	1230.128776	47.32344398	54.00973798	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 24% and 25%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											97.09729666	57.99091094	110.5656361	0	31.10091127	0.248331892	0.248331892	15.99421434	101.3310447	2.25360142	32.10840718	168.0554374	0.238033866	48.54945191	6.219082156	7.629708343	23.26076004	12.20575156	8.778375126	0	0.248331892	44.71745455	0	0	0	8.277729734	0	8.277729734	0	0	0											18.0279	0.477151176	15.44345617	0	2.167843441	5.955812	1.500164226	2.64778177	3.40231552	1.718263302	4.796068592	1.35050773	0.060360509	2.947114408	6.074090964	16.40859759	0.946156177	5.301421828	4.536193979	0	11.75192038	0.201264834	0	0	0	0.197009968	0	0.01941759	0	0	0	0	0	0	0	0	0	0	0	0	0	105.9308	0	21.35098502	18.0279	0.477151176	15.44345617	0	2.167843441	5.955812	1.500164226	2.64778177	3.40231552	1.718263302	4.796068592	1.35050773	0.060360509	2.947114408	6.074090964	16.40859759	0.946156177	5.301421828	4.536193979	0	11.75192038	0.201264834	0	0	0	0.197009968	0	0.01941759	0	0	0	0	0	0	0	0	0	0	0	0	0	105.9308	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.0279	0.477151176	15.44345617	0	2.167843441	5.955812	1.500164226	2.64778177	3.40231552	1.718263302	4.796068592	1.35050773	0.060360509	2.947114408	6.074090964	16.40859759	0.946156177	5.301421828	4.536193979	0	11.75192038	0.201264834	0	0	0	0.197009968	0	0.01941759	0	0	0	0	0	0	0	0	0	0	0	0	0	105.9308
H6499_031_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	2271.134368	118.0823171	1686.653671	1933.993223	862.5478725	23.87257465	5.587687028	2036.473489	393.3861389	9122.623946	1709.666755	81.74786736	0.194212382	720.4832897	10930.47562	24694.67725	533.6406635	5303.510846	6018.570325	1144.524841	48.92167539	57.37877926	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 22% and 25%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											88.57885223	49.17164574	107.8968823	0	30.50716153	0.250670369	0.250670369	15.6628558	100.9748039	2.293666653	32.99679329	179.3419029	0.23750015	48.00763342	6.109647606	7.5952495	23.50523428	12.3076684	8.696990165	0	0.250670369	46.81542303	0	0	0	8.355678951	0	8.355678951	0	0	0											16.7645	0.483858489	15.16538938	0	2.19282394	5.984147086	1.400667567	2.65808255	3.31017402	1.743688195	4.70112671	1.221734841	0.04612547	2.882391471	5.565112848	15.63018625	1.045279068	5.439487739	4.36195391	0	12.2632144	0.223850985	0	0	0	0.198865159	0	0.01960044	0	0	0	0	0	0	0	0	0	0	0	0	0	103.3023	0	19.69082606	16.7645	0.483858489	15.16538938	0	2.19282394	5.984147086	1.400667567	2.65808255	3.31017402	1.743688195	4.70112671	1.221734841	0.04612547	2.882391471	5.565112848	15.63018625	1.045279068	5.439487739	4.36195391	0	12.2632144	0.223850985	0	0	0	0.198865159	0	0.01960044	0	0	0	0	0	0	0	0	0	0	0	0	0	103.3023	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.7645	0.483858489	15.16538938	0	2.19282394	5.984147086	1.400667567	2.65808255	3.31017402	1.743688195	4.70112671	1.221734841	0.04612547	2.882391471	5.565112848	15.63018625	1.045279068	5.439487739	4.36195391	0	12.2632144	0.223850985	0	0	0	0.198865159	0	0.01960044	0	0	0	0	0	0	0	0	0	0	0	0	0	103.3023
H6499_032_0	2008	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	2267.70971	117.2486036	1598.263599	1463.75954	822.9998014	19.28578399	4.869123924	1297.96226	294.0348273	6464.292368	1432.423559	56.10269443	0.24776294	553.690694	10318.9302	28646.68763	750.0304712	6536.193133	5945.516119	1024.052939	57.1866114	34.4494442	0	1025.142857	428.4	285.6	138.4	28.14915254	0	0	2400											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	30% coinsurance	30% coinsurance	Copay between $25.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	"Copay between $20.00 and $150.00, 20% coinsurance"	$250.00 copayment	Coin between 25% and 34%	"Copay between $20.00 and $150.00, 20% coinsurance"	Copay between $0.00 and $20.00	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	"$35.00 copayment, 20% coinsurance"	"Copay between $20.00 and $35.00, 20% coinsurance"	$0.00 copayment	30% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$10.00 copayment	$0.00 copayment	$10.00 copayment	N/A	$0.00 copayment	$0.00 copayment											124.2737857	71.92747115	126.525615	0	27.71096872	0.243943988	0.243943988	15.30017966	97.5718291	2.134859017	32.16308547	175.9960169	0.226650791	51.52578746	6.145126243	6.957382062	24.03831412	10.82097521	10.0897136	0	0.243943988	48.08140095	0	0	0	8.13146626	0	8.13146626	0	0	0											23.4847	0.702782963	16.85177374	0	1.900510146	4.704651055	1.187793507	1.654921314	2.390792993	1.150029404	3.839263446	0.822820896	0.056155666	2.377445752	5.28426073	16.60882922	1.502455672	5.893998655	4.999046235	0	13.95033003	0.138031462	0	0	0	0.193528897	0	0.01907449	0	0	0	0	0	0	0	0	0	0	0	0	0	109.7132	0	24.68427568	23.4847	0.702782963	16.85177374	0	1.900510146	4.704651055	1.187793507	1.654921314	2.390792993	1.150029404	3.839263446	0.822820896	0.056155666	2.377445752	5.28426073	16.60882922	1.502455672	5.893998655	4.999046235	0	13.95033003	0.138031462	0	0	0	0.193528897	0	0.01907449	0	0	0	0	0	0	0	0	0	0	0	0	0	109.7132	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.4847	0.702782963	16.85177374	0	1.900510146	4.704651055	1.187793507	1.654921314	2.390792993	1.150029404	3.839263446	0.822820896	0.056155666	2.377445752	5.28426073	16.60882922	1.502455672	5.893998655	4.999046235	0	13.95033003	0.138031462	0	0	0	0.193528897	0	0.01907449	0	0	0	0	0	0	0	0	0	0	0	0	0	109.7132
H6499_801_0	2008	2																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.3569	0.7198	0.1745	0.5838	0.9225	0	0.8411	0.0358	0.007	0.3424	1.2178	4.1602	0.2972	0.881	1.1609	0.019	1.4049	0.036	0	0	0	0	0	0	0	0	0											13.1609	0	355.6710637	10.06143402	1520.822796	1656.433465	10.49565024	21.16974036	5.133599152	17.17017755	27.13355434	7765.162726	24.7396934	1.054238925	0.213608397	10.06937535	36.95214507	122.3578668	3.496875889	25.91314542	34.14287531	8.527424866	41.32186091	1.059780558	0	0	0	0	0	0	0	0	0											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 23%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											793.27	793.27	73.42	0	0.2	0.2	0.2	0.2	0.2	0	0.257003654	0.257003654	0.23523676	0.257003654	0.19771176	0.203977593	0.509943983	0.203977593	0.203977593	0.013368857	0.2	0.2	0	0	0	0	0	0	0	0	0											23.5119	0.665119481	9.304900809	0	2.099130049	4.233948072	1.02671983	3.434035509	5.426710868	0	6.358191605	0.270943256	0.050248547	2.58786626	7.305873632	24.95826318	1.783210819	5.285701035	6.964381532	0.114001921	8.264372183	0.211956112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.8575	1.31	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184
H6499_802_0	2008	2																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.3569	0.7198	0.1745	0.5838	0.9225	0	0.8411	0.0358	0.007	0.3424	1.2178	4.1602	0.2972	0.881	1.1609	0.019	1.4049	0.036	0	0	0	0	0	0	0	0	0											13.1609	0	355.6710637	10.06143402	1520.822796	1656.433465	10.49565024	21.16974036	5.133599152	17.17017755	27.13355434	7765.162726	24.7396934	1.054238925	0.213608397	10.06937535	36.95214507	122.3578668	3.496875889	25.91314542	34.14287531	8.527424866	41.32186091	1.059780558	0	0	0	0	0	0	0	0	0											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 23%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											793.27	793.27	73.42	0	0.2	0.2	0.2	0.2	0.2	0	0.257003654	0.257003654	0.23523676	0.257003654	0.19771176	0.203977593	0.509943983	0.203977593	0.203977593	0.013368857	0.2	0.2	0	0	0	0	0	0	0	0	0											23.5119	0.665119481	9.304900809	0	2.099130049	4.233948072	1.02671983	3.434035509	5.426710868	0	6.358191605	0.270943256	0.050248547	2.58786626	7.305873632	24.95826318	1.783210819	5.285701035	6.964381532	0.114001921	8.264372183	0.211956112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.8575	1.31	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184
H6499_803_0	2008	2																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.3569	0.7198	0.1745	0.5838	0.9225	0	0.8411	0.0358	0.007	0.3424	1.2178	4.1602	0.2972	0.881	1.1609	0.019	1.4049	0.036	0	0	0	0	0	0	0	0	0											13.1609	0	355.6710637	10.06143402	1520.822796	1656.433465	10.49565024	21.16974036	5.133599152	17.17017755	27.13355434	7765.162726	24.7396934	1.054238925	0.213608397	10.06937535	36.95214507	122.3578668	3.496875889	25.91314542	34.14287531	8.527424866	41.32186091	1.059780558	0	0	0	0	0	0	0	0	0											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 23%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											793.27	793.27	73.42	0	0.2	0.2	0.2	0.2	0.2	0	0.257003654	0.257003654	0.23523676	0.257003654	0.19771176	0.203977593	0.509943983	0.203977593	0.203977593	0.013368857	0.2	0.2	0	0	0	0	0	0	0	0	0											23.5119	0.665119481	9.304900809	0	2.099130049	4.233948072	1.02671983	3.434035509	5.426710868	0	6.358191605	0.270943256	0.050248547	2.58786626	7.305873632	24.95826318	1.783210819	5.285701035	6.964381532	0.114001921	8.264372183	0.211956112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.8575	1.31	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184
H6499_804_0	2008	2																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin											0	0	0	0	0.3569	0.7198	0.1745	0.5838	0.9225	0	0.8411	0.0358	0.007	0.3424	1.2178	4.1602	0.2972	0.881	1.1609	0.019	1.4049	0.036	0	0	0	0	0	0	0	0	0											13.1609	0	355.6710637	10.06143402	1520.822796	1656.433465	10.49565024	21.16974036	5.133599152	17.17017755	27.13355434	7765.162726	24.7396934	1.054238925	0.213608397	10.06937535	36.95214507	122.3578668	3.496875889	25.91314542	34.14287531	8.527424866	41.32186091	1.059780558	0	0	0	0	0	0	0	0	0											Standard Medicare Benefit	Standard Medicare Benefit	Standard Medicare	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	Coin between 20% and 23%	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance		$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	N/A	$0.00 copayment	$0.00 copayment											793.27	793.27	73.42	0	0.2	0.2	0.2	0.2	0.2	0	0.257003654	0.257003654	0.23523676	0.257003654	0.19771176	0.203977593	0.509943983	0.203977593	0.203977593	0.013368857	0.2	0.2	0	0	0	0	0	0	0	0	0											23.5119	0.665119481	9.304900809	0	2.099130049	4.233948072	1.02671983	3.434035509	5.426710868	0	6.358191605	0.270943256	0.050248547	2.58786626	7.305873632	24.95826318	1.783210819	5.285701035	6.964381532	0.114001921	8.264372183	0.211956112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.8575	1.31	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184	0	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	$0.00 copayment	N/A	N/A											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5119	0.665119481	9.304900809	0	2.455982157	4.953719244	1.201262201	4.017821546	6.349251715	0	7.19934118	0.306787379	0.057275384	2.930225022	8.523652994	29.11843065	2.08044527	6.166747979	8.125239292	0.133004329	9.669315454	0.24798865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0184
H6504_001_0	2008	13	s.										Professional										none	Podiatry										D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	O	O	V																																																			0	n/a	2126.250011	81.84180179	1875.305439	204.7277599	414.0181412	15.47883099	15.47883099	292.5966255	38.68256722	0	0	0	0	3254.988392	9854.13249	11385.21511	147.8119874	246.3533123	344.8946372	0	16.11671188	0	0	344.485824	1414.183912	344.485824	67.80903454	0	0	0	0	2656.923691										0	$50 days 1-7 copay max $2400	$50 days 21-100 copay	0	$125 copay	20% coinsurance	20% coinsurance	$50 copay	0	0	0	0	0	0	$5 copay	$5 copay	$25 copay	$5 copay	0	0	0% coinsurance	0	0	$150 max benefit	$10 copay	0	$10 copay	0	0	0	0	$10 copay										0	46.25	21	0	125	0.2	0.2	50	0	0	0	0	0	0	5	5	25	5	0	0	0	0	0	11.875	10	0	10	0	0	0	0	10										0	0.315431944	3.281784518	0	4.312688971	3.095766199	3.095766199	1.219152606	0	0	0	0	0	0	4.105888538	4.743839628	0.30794164	0.102647213	0	0	0	0	0	0.34089743	1.178486593	0	0.056507529	0	0	0	0	2.214103076	0	0	0	0	0	0	0	0	0	28.3709	0	0	0	0.315431944	3.281784518	0	4.312688971	3.095766199	3.095766199	1.219152606	0	0	0	0	0	0	4.105888538	4.743839628	0.30794164	0.102647213	0	0	0	0	0	0.34089743	1.178486593	0	0.056507529	0	0	0	0	2.214103076	0	0	0	0	0	0	0	0	0	28.3709	none	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0										0	0	0	0	0.315431944	3.281784518	0	4.312688971	3.095766199	3.095766199	1.219152606	0	0	0	0	0	0	4.105888538	4.743839628	0.30794164	0.102647213	0	0	0	0	0	0.34089743	1.178486593	0	0.056507529	0	0	0	0	2.214103076	0	0	0	0	0	0	0	0	0	28.3709
H6504_002_0	2008	11																					none											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	O	O																																																				0	n/a	2201.099962	84.72286227	1941.321439	211.93475	428.5927385	16.02372917	16.02372917	302.8968457	40.04430186	0	0	0	0	3369.573094	10201.02553	14536.46139	153.015383	255.0256383	357.0358937	0	16.68406525	0	0	344.485824	1414.183912	344.485824	67.80903454	0	0	0	0											0	0	$50 days 21-100 copay	0	$100 copay	20% coinsurance	20% coinsurance	$50 copay	0	0	0	0	0	0	$5 copay	$5 copay	$20 copay	$5 copay	0	0	0% coinsurance	0	0	$150 max benefit	$5 copay	0	$5 copay	0	0	0	0											0	0	21	0	100	0.2	0.2	50	0	0	0	0	0	0	5	5	20	5	0	0	0	0	0	11.875	5	0	5	0	0	0	0											0	0	3.397312518	0	3.571606154	3.204745833	3.204745833	1.26207019	0	0	0	0	0	0	4.250427306	6.056858911	0.255025638	0.106260683	0	0	0	0	0	0.34089743	0.589243297	0	0.028253764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2674	0	0	0	0	3.397312518	0	3.571606154	3.204745833	3.204745833	1.26207019	0	0	0	0	0	0	4.250427306	6.056858911	0.255025638	0.106260683	0	0	0	0	0	0.34089743	0.589243297	0	0.028253764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2674	none	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	3.397312518	0	3.571606154	3.204745833	3.204745833	1.26207019	0	0	0	0	0	0	4.250427306	6.056858911	0.255025638	0.106260683	0	0	0	0	0	0.34089743	0.589243297	0	0.028253764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2674
H6504_801_0	2008	12	s.										Professional										none	Podiatry										D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	O	O	V																																																			0	n/a	2126.250011	81.84180179	1875.305439	204.7277599	414.0181412	15.47883099	15.47883099	292.5966255	38.68256722	0	0	0	0	3254.988392	9854.13249	11385.21511	147.8119874	246.3533123	344.8946372	0	16.11671188	0	0	344.485824	1414.183912	344.485824	67.80903454	0	0	0	0	2656.923691										0	0	$50 days 21-100 copay	0	$100 copay	20% coinsurance	20% coinsurance	$50 copay	0	0	0	0	0	0	$5 copay	$5 copay	$25 copay	$5 copay	0	0	0% coinsurance	0	0	$150 max benefit	$10 copay	0	$10 copay	0	0	0	0	$10 copay										0	0	21	0	100	0.2	0.2	50	0	0	0	0	0	0	5	5	25	5	0	0	0	0	0	11.875	10	0	10	0	0	0	0	10										0	0	3.281784518	0	3.450151177	3.095766199	3.095766199	1.219152606	0	0	0	0	0	0	4.105888538	4.743839628	0.30794164	0.102647213	0	0	0	0	0	0.34089743	1.178486593	0	0.056507529	0	0	0	0	2.214103076	0	0	0	0	0	0	0	0	0	27.1929	0	0	0	0	3.281784518	0	3.450151177	3.095766199	3.095766199	1.219152606	0	0	0	0	0	0	4.105888538	4.743839628	0.30794164	0.102647213	0	0	0	0	0	0.34089743	1.178486593	0	0.056507529	0	0	0	0	2.214103076	0	0	0	0	0	0	0	0	0	27.1929	none	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0										0	0	0	0	0	3.281784518	0	3.450151177	3.095766199	3.095766199	1.219152606	0	0	0	0	0	0	4.105888538	4.743839628	0.30794164	0.102647213	0	0	0	0	0	0.34089743	1.178486593	0	0.056507529	0	0	0	0	2.214103076	0	0	0	0	0	0	0	0	0	27.1929
H6621_001_0	2008	4																					4250											D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	2238.7	64.9	2553.5	1499.8	375.6	19.53497551	0	411.5	450.6	13109.9	726.2	181.1	281.5	6198.5	4832.6	4145.7	193.5	151.7	92.5	0	36.54502221	0	0	0	259.5	0	7.3	0	0	0.1	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	"$50 Scans, $25 Rad Ther"	$0.00 	$0.00 	$0.00 	"$15.00, $0.00 Prev."	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	"20%, 10% Chemo, $5 Diab Supp"	$0.00 	$0.00 	$0.00 	$15.00 	$0.00 	$25.00 	$0.00 	$0.00 	$0.00 	$0.00 											42.07479771	42.07479771	6.84996318	0	23.98529671	0.191882374	0.191882374	47.97059341	95.94118682	0	7.195589012	0	0	0	14.39117802	23.98529671	23.98529671	23.98529671	0	0	0.172694136	0	0	0	14.39117802	0	23.98529671	0	0	0	0											7.8494	0.227554531	1.457615082	0	0.750739787	3.74841747	0	1.644991599	3.602591565	0	0.435453062	0	0	0	5.795567243	8.286320379	0.386762909	0.303214126	0	0	6.311111046	0	0	0	0.311209225	0	0.014591055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1255		1.739825223	7.8494	0.227554531	1.457615082	0	0.750739787	3.74841747	0	1.644991599	3.602591565	0	0.435453062	0	0	0	5.795567243	8.286320379	0.386762909	0.303214126	0	0	6.311111046	0	0	0	0.311209225	0	0.014591055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1255	0																																																																																			0		0	7.8494	0.227554531	1.457615082	0	0.750739787	3.74841747	0	1.644991599	3.602591565	0	0.435453062	0	0	0	5.795567243	8.286320379	0.386762909	0.303214126	0	0	6.311111046	0	0	0	0.311209225	0	0.014591055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1255
H6621_002_0	2008	4																					4250											D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1957.3	56.8	2232.6	1311.3	328.4	17.07971953	0	359.8	393.9	11462.1	635	158.3	246.1	5419.4	4225.2	3624.6	169.2	132.7	80.9	0	31.95185626	0	0	0	226.9	0	6.4	0	0	0.1	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	"$50 Scans, $25 Rad Ther"	$0.00 	$0.00 	$0.00 	"$15.00, $0.00 Prev."	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	"20%, 10% Chemo, $5 Diab Supp"	$0.00 	$0.00 	$0.00 	$15.00 	$0.00 	$25.00 	$0.00 	$0.00 	$0.00 	$0.00 											42.07479771	42.07479771	6.84996318	0	23.98529671	0.191882374	0.191882374	47.97059341	95.94118682	0	7.195589012	0	0	0	14.39117802	23.98529671	23.98529671	23.98529671	0	0	0.172694136	0	0	0	14.39117802	0	23.98529671	0	0	0	0											6.8628	0.199154042	1.27443565	0	0.65639762	3.277297124	0	1.438318292	3.149269457	0	0.380766585	0	0	0	5.067133782	7.24475887	0.338192684	0.265237406	0	0	5.517898219	0	0	0	0.272113191	0	0.012792158	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.9565		1.521148347	6.8628	0.199154042	1.27443565	0	0.65639762	3.277297124	0	1.438318292	3.149269457	0	0.380766585	0	0	0	5.067133782	7.24475887	0.338192684	0.265237406	0	0	5.517898219	0	0	0	0.272113191	0	0.012792158	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.9565	0																																																																																			0		0	6.8628	0.199154042	1.27443565	0	0.65639762	3.277297124	0	1.438318292	3.149269457	0	0.380766585	0	0	0	5.067133782	7.24475887	0.338192684	0.265237406	0	0	5.517898219	0	0	0	0.272113191	0	0.012792158	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.9565
H6621_801_0	2008	4																					4250											D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1724.8	50	1967.3	1155.5	289.4	15.05067189	0	317	347.1	10100.5	559.5	139.5	216.9	4775.6	3723.2	3194	149.1	116.9	71.3	0	28.15601883	0	0	0	200	0	5.7	0	0	0.1	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	"$50 Scans, $25 Rad Ther"	$0.00 	$0.00 	$0.00 	"$15.00, $0.00 Prev."	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	"20%, 10% Chemo, $5 Diab Supp"	$0.00 	$0.00 	$0.00 	$15.00 	$0.00 	$25.00 	$0.00 	$0.00 	$0.00 	$0.00 											42.07479771	42.07479771	6.84996318	0	23.98529671	0.191882374	0.191882374	47.97059341	95.94118682	0	7.195589012	0	0	0	14.39117802	23.98529671	23.98529671	23.98529671	0	0	0.172694136	0	0	0	14.39117802	0	23.98529671	0	0	0	0											6.0476	0.175311657	1.12299438	0	0.578445406	2.887958647	0	1.267223176	2.775098829	0	0.335494338	0	0	0	4.465102835	6.384086473	0.298017312	0.233656765	0	0	4.862379354	0	0	0	0.239852967	0	0.011393016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6846		1.340422592	6.0476	0.175311657	1.12299438	0	0.578445406	2.887958647	0	1.267223176	2.775098829	0	0.335494338	0	0	0	4.465102835	6.384086473	0.298017312	0.233656765	0	0	4.862379354	0	0	0	0.239852967	0	0.011393016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6846	0																																																																																			0		0	6.0476	0.175311657	1.12299438	0	0.578445406	2.887958647	0	1.267223176	2.775098829	0	0.335494338	0	0	0	4.465102835	6.384086473	0.298017312	0.233656765	0	0	4.862379354	0	0	0	0.239852967	0	0.011393016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6846
H6621_802_0	2008	4																					4250											D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1811.1	52.5	2065.8	1213.4	303.9	15.80379611	0	332.9	364.5	10605.9	587.5	146.5	227.7	5014.6	3909.5	3353.9	156.5	122.7	74.8	0	29.5649247	0	0	0	210	0	5.9	0	0	0.1	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	"$50 Scans, $25 Rad Ther"	$0.00 	$0.00 	$0.00 	"$15.00, $0.00 Prev."	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	"20%, 10% Chemo, $5 Diab Supp"	$0.00 	$0.00 	$0.00 	$15.00 	$0.00 	$25.00 	$0.00 	$0.00 	$0.00 	$0.00 											42.07479771	42.07479771	6.84996318	0	23.98529671	0.191882374	0.191882374	47.97059341	95.94118682	0	7.195589012	0	0	0	14.39117802	23.98529671	23.98529671	23.98529671	0	0	0.172694136	0	0	0	14.39117802	0	23.98529671	0	0	0	0											6.3501	0.18407724	1.179221161	0	0.607427639	3.03246991	0	1.330784212	2.91421355	0	0.352284045	0	0	0	4.688525874	6.703690552	0.312808245	0.245249659	0	0	5.105689135	0	0	0	0.251845615	0	0.011792771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2702		1.407503967	6.3501	0.18407724	1.179221161	0	0.607427639	3.03246991	0	1.330784212	2.91421355	0	0.352284045	0	0	0	4.688525874	6.703690552	0.312808245	0.245249659	0	0	5.105689135	0	0	0	0.251845615	0	0.011792771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2702	0																																																																																			0		0	6.3501	0.18407724	1.179221161	0	0.607427639	3.03246991	0	1.330784212	2.91421355	0	0.352284045	0	0	0	4.688525874	6.703690552	0.312808245	0.245249659	0	0	5.105689135	0	0	0	0.251845615	0	0.011792771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2702
H6793_001_0	2008	5																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							12.85902318	11.96976447	333.1268951	345.6765704		146.3181418	53.78030118		1449.250096		4660.449927	208.8259002					1292.357402		821.9323512	337.0787762		315.7246248				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/PCP visit, $20/visit Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d)$20/visit, (7f)0"	"(7e,h)$20/visit"	"(7c,i)0"		(7g)$20/visit	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.179596104	0.179596104	35.4702	44.899		17.9596	44.899		44.884		17.9596	17.9596					17.9596		20	20		19.9999				20											0	0	0	0	0	2.309430471	2.14972307	0.984673983	1.293378447	0	0.218984736	0.201223596	0	5.420672738	0	6.974988766	0.312535985	0	0	0	0	1.934186292	0	1.369887252	0.56179796	0	0.526205882	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	25.1978	0	2.476674715	0	0	0	0	0	2.309430471	2.14972307	0.984673983	1.293378447	0	0.218984736	0.201223596	0	5.420672738	0	6.974988766	0.312535985	0	0	0	0	1.934186292	0	1.369887252	0.56179796	0	0.526205882	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	25.1978		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.0111	0.0251	0.4482	0.3229	0.0752	0.0787	0.0733	0.0224	0.2539	0.0427	0.1062	0.0204	0.0014	0.1817	0.0252	0.1958	0.0117	0.0344			0.1591	0.0505			0.0066		0.0078															4.1546	0	0	2.0111	0.025115669	0.448214826	0.322886903	0.075201965	2.388159184	2.223007342	1.007052405	1.547257314	0.042742571	0.325173279	0.221577573	0.001449217	5.60242209	0.025221784	7.170832929	0.324243133	0.034409287	0	0	0.159080341	1.984732273	0	1.369887252	0.568429071	0	0.534048476	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	29.3524
H6793_002_0	2008	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0							12.85902318	11.96976447	333.1268951	345.6765704		146.3181418	53.78030118		1449.250096		4660.449927	208.8259002					1292.357402		821.9323512	337.0787762		315.7246248				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)20%	"(11b,c)20%"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3, 9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/PCP visit, $20/visit Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d)$20/visit, (7f)0"	"(7e,h)$20/visit"	"(7c,i)0"		(7g)$20/visit	(15) 0	"(13a,14a,17b)0, (16b,17a)$20/visit"	(10b)0	(16a)$20/visit	(17a)$20/visit	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																0.179596104	0.179596104	35.4702	44.899		17.9596	44.899		44.884		17.9596	17.9596					17.9596		20	20		19.9999				20											0	0	0	0	0	2.309430471	2.14972307	0.984673983	1.293378447	0	0.218984736	0.201223596	0	5.420672738	0	6.974988766	0.312535985	0	0	0	0	1.934186292	0	1.369887252	0.56179796	0	0.526205882	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	25.1978	0	2.476674715	0	0	0	0	0	2.309430471	2.14972307	0.984673983	1.293378447	0	0.218984736	0.201223596	0	5.420672738	0	6.974988766	0.312535985	0	0	0	0	1.934186292	0	1.369887252	0.56179796	0	0.526205882	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	25.1978		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.0111	0.0251	0.4482	0.3229	0.0752	0.0787	0.0733	0.0224	0.2539	0.0427	0.1062	0.0204	0.0014	0.1817	0.0252	0.1958	0.0117	0.0344			0.1591	0.0505			0.0066		0.0078															4.1546	0	0	2.0111	0.025115669	0.448214826	0.322886903	0.075201965	2.388159184	2.223007342	1.007052405	1.547257314	0.042742571	0.325173279	0.221577573	0.001449217	5.60242209	0.025221784	7.170832929	0.324243133	0.034409287	0	0	0.159080341	1.984732273	0	1.369887252	0.568429071	0	0.534048476	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	29.3524
H6793_003_0	2008	5																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V		V	S	V	T	P	V	P	V	P			V																																																				0								23.19314493	489.9015538	496.1983032		181.0591915	82.17852278		2654.590405		5610.923812	510.8620226					0.09304109		821.9323512			240.9291452				564.0437788											(1a)0	(1b)0	(2a)0	(6a)0	(10a)0	(11a)0	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$20/visit"	(9b)$50/visit	(8a)0	"(8b) $0/ visit standard services, $20/visit high tech services"	(9a)$50/visit	(12)0	"(3,9d)0, (5)$30/visit, (9a)$50/visit, (9c)$20/visit"	"(7a)$0/PCP visit, $20/visit Urgent Care Center, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d)$20/visit, (7f)0"	"(7e,h)$20/visit"	"(7c,i)0"		(7g)$20/visit	(15) 0	"(13a,14a,17a,b)0, (16b)$20/visit"	(10b)0	(16a)$20/visit	(17a)0	(17b)0	(18a)$20/visit	(18b)0			(13b)$20/visit																	0.173723219	34.3103	43.4308		17.3723	43.4308		43.3737		17.3723	17.3723					17.3723		20			19.999				20											0	0	0	0	0	0	4.029187788	1.400723897	1.795857631	0	0.262118213	0.297423281	0	9.594948807	0	8.122897868	0.739571624	0	0	0	0	0.000134695	0	1.369887252	0	0	0.40152891	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	28.9544	0	3.969425713	0	0	0	0	0	0	4.029187788	1.400723897	1.795857631	0	0.262118213	0.297423281	0	9.594948807	0	8.122897868	0.739571624	0	0	0	0	0.000134695	0	1.369887252	0	0	0.40152891	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	28.9544		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"(4a)$50/visit, (4b)$20/visit"	0.3	0.3	0.3	0.3	0.3	0.3	"(7a)$20/UCvisit, (14b,c,d,e,f,g,h,i,j)30%"	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (16b,17a)30%"			0.3		0.3															2.7385	0.0657	0.3388	0.3272	0.0837	0.161	0.142	0.0286	0.3588	0.0556	0.1459	0.0291	0.0052	0.2503	0.0256	0.2462	0.0309	0.0397			0.2197	0.0457			0.0066		0.006															5.3508	0	0	2.7385	0.065669494	0.33878024	0.327167643	0.083671429	0.161030802	4.171186634	1.429341334	2.154610069	0.055628022	0.408033638	0.32656747	0.005155325	9.845224769	0.025642002	8.369111666	0.770487258	0.039746208	0	0	0.21967512	0.0458177	0	1.369887252	0.006631111	0	0.407515807	0	0	0	0.940072965	0	0	0	0	0	0	0	0	0	0	34.3052
H6806_801_0	2008	7																					2500											A	A	D	V	Coin	Coin	Coin	V	V	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				9.9873	0.2132	2.0351	1.0941	0.3182	0.4444	0.3836	0.5109	1.6058	0.671	1.6996	0.1236	0.0129	1.1259	1.3885	3.6005	0.1203	0.2305	0	0	0.9483	0.3304	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.844		331.2145515	9.637447391	1492.861767	0	9.216915758	12.8712756	11.10935045	293.5167693	365.4417387	0	49.2244779	3.579405767	0	32.60957795	20.79332346	28.74677059	3.483039845	6.674684515	0	0.000411138	27.46545494	6.191239812	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	$250 per Admit	$250 per Admit	$0 Days 1-15; $65 Days 16-100	$0 per Visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, 20% Coin for UC"	$100 per Visit	$0 per Visit	20% Coinsurance	20% Coinsurance	$0 per Visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	0% Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											187.1495325	187.1495325	24.96368569	0	0.149719626	0.149719626	0.149719626	37.43522302	74.85981301	0	0.149719626	0.149719626	0	0.149719626	0.149719626	0.149719626	0.149719626	0.149719626	0	0.149719626	0.149719626	0.149719626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.1656	0.150303648	3.105610994	0	1.37995318	1.92708257	1.663287795	0.915655477	2.279741685	0	7.369870422	0.535907293	0	4.882293816	3.113168612	4.303955742	0.521479423	0.999331269	0	6.16E-05	4.112117642	0.926950109	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.3523	250	14.55902066	15.1529	0.363521387	5.140744779	1.094140967	1.698183028	2.371485468	2.046857202	1.426511839	3.885529442	0.670950434	9.069430073	0.659492425	0.012920583	6.008195507	4.50167261	7.904459724	0.641737356	1.229786217	0	7.58E-05	5.06040965	1.257350015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1963																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1529	0.363521387	5.140744779	1.094140967	1.698183028	2.371485468	2.046857202	1.426511839	3.885529442	0.670950434	9.069430073	0.659492425	0.012920583	6.008195507	4.50167261	7.904459724	0.641737356	1.229786217	0	7.58E-05	5.06040965	1.257350015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1963
H6806_802_0	2008	7																					2500											A	A	D	V	Coin	Coin	Coin	V	V	V	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				9.9873	0.2132	2.0351	1.0941	0.3182	0.4444	0.3836	0.5109	1.6058	0.671	1.6996	0.1236	0.0129	1.1259	1.3885	3.6005	0.1203	0.2305	0	0	0.9483	0.3304	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.844		331.2145515	9.637447391	1492.861767	0	9.216915758	12.8712756	11.10935045	293.5167693	365.4417387	0	49.2244779	3.579405767	0	32.60957795	20.79332346	28.74677059	3.483039845	6.674684515	0	0.000411138	27.46545494	6.191239812	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	$250 per Admit	$250 per Admit	$0 Days 1-15; $65 Days 16-100	$0 per Visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, 20% Coin for UC"	$100 per Visit	$0 per Visit	20% Coinsurance	20% Coinsurance	$0 per Visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	0% Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											187.1495325	187.1495325	24.96368569	0	0.149719626	0.149719626	0.149719626	37.43522302	74.85981301	0	0.149719626	0.149719626	0	0.149719626	0.149719626	0.149719626	0.149719626	0.149719626	0	0.149719626	0.149719626	0.149719626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.1656	0.150303648	3.105610994	0	1.37995318	1.92708257	1.663287795	0.915655477	2.279741685	0	7.369870422	0.535907293	0	4.882293816	3.113168612	4.303955742	0.521479423	0.999331269	0	6.16E-05	4.112117642	0.926950109	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.3523	250	14.55902066	15.1529	0.363521387	5.140744779	1.094140967	1.698183028	2.371485468	2.046857202	1.426511839	3.885529442	0.670950434	9.069430073	0.659492425	0.012920583	6.008195507	4.50167261	7.904459724	0.641737356	1.229786217	0	7.58E-05	5.06040965	1.257350015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1963																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1529	0.363521387	5.140744779	1.094140967	1.698183028	2.371485468	2.046857202	1.426511839	3.885529442	0.670950434	9.069430073	0.659492425	0.012920583	6.008195507	4.50167261	7.904459724	0.641737356	1.229786217	0	7.58E-05	5.06040965	1.257350015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1963
H6864_001_0	2008	5																					0											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	469.66	0	0	0	0	0	375.91	0	14281.39	1372.65	1153.34	0	1458.59	0	0	0	0	0	0	0	0	182.787	0	0											PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $0	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $10"	9B ASC Services: $0	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $10, 5 Partial Hosp: $20, 9C OP Substance Abuse: $20, 9D Cardiac Rehab: $10"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $10	"7E Mental Health: $20, 7H Psychiatric: $20"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	Included in i.2.	"7B Chiropractic: $0, 7F Podiatry: $10, 7G Other Health Care: $10, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10, 17A Medicare Covered Eye Exams: $0"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	"19 POS: Group #1: $0, Group #2: $10, Group #3: $20"	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	0	0	0	47.35468211	0	0	0	0	0	10	0	10	20	10	0	10	0	0	0	0	0	0	0	0	0.016476705	0	0											0	0	0	0	0	0	0	1.853383333	0	0	0	0	0	0.313258333	0	11.90115833	2.28775	0.961116667	0	1.215491667	0	0	0	0	0	0	0	0	3.0117275	0	0	0	0	0	0	0	0	0	0	0	0	21.5439	0	0	0	0	0	0	0	0	0	1.853383333	0	0	0	0	0	0.313258333	0	11.90115833	2.28775	0.961116667	0	1.215491667	0	0	0	0	0	0	0	0	3.0117275	0	0	0	0	0	0	0	0	0	0	0	0	21.5439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	1.853383333	0	0	0	0	0	0.313258333	0	11.90115833	2.28775	0.961116667	0	1.215491667	0	0	0	0	0	0	0	0	3.0117275	0	0	0	0	0	0	0	0	0	0	0	0	21.5439
H6934_001_0	2008	4																																D	D	D	V	T	P	P	V	V	P	P	P	P	P	V	V	V	V	V	V	S	P	T	V	V	P	V	P	P	P	V																																																				0				958.0659611					370.621871																																				"$0 Copay Days 1-20, $75 Copay Days 21-100"					$25 ER Copay																																				29.3163					25																																		0	0	2.340581866	0	0	0	0	0.772128898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.1127	0	0	0	0	2.340581866	0	0	0	0	0.772128898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.1127																																																																																				0	0	0	0	0	2.340581866	0	0	0	0	0.772128898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.1127
H6934_002_0	2008	5																					2250											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	P	Coin	V	T	V	V	P	V	P	V	V	V																																																				0		1585.878848	41.19290218	857.6471127		312.4172687	5.889765219	4.981384781	331.8603375	269.5102417	594.6664466	466.8841977			8.036390955	7117.930839	10805.1543	257.3564205	433.8142595	4008.026895		14.87972743	767.1083932		1021.647506																		$150 for Days 1-10; $0 for Days 11-90	$100 for Days 1-10; $0 for Days 11-90	$75 for Days 11-100; 100 days benefit period	No Cost Sharing	"$100/Trip, $0 if admitted"	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	"$50/$30, ER/UC"	$150/Visit	$20/Service	$20-$100/Service	No Cost Sharing	No Cost Sharing	$30/Visit for OP Rehab	$15/Visit	$30/Visit	$30/Visit	$30/Visit	$20/Visit		20%/Script	$20 Eye Exam	Not covered	"$30/Visit for Preventive Dental,$250 max for fillings"	$0 for 1 Routine exam per year	$100 MAB per year	Not covered	Not covered	N/A	Not covered	Not covered											90.3956	63.638	29.3163		100	0.2	0.2	50	150	20	51.0601			30	12.664	13.555	30	30	4.7619		0.2	20.0006		30																		11.9464	0.218452745	2.095255818	0	2.603477239	1.177953044	0.996276956	1.382751406	3.368878022	0.991110744	1.986594457	0	0	0.020090977	7.511773892	12.20528754	0.643391051	1.084535649	1.590486863	0	2.975945486	1.278554144	0	2.554118765	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.6313	0	0.537537191	11.9464	0.218452745	2.095255818	0	2.603477239	1.177953044	0.996276956	1.382751406	3.368878022	0.991110744	1.986594457	0	0	0.020090977	7.511773892	12.20528754	0.643391051	1.084535649	1.590486863	0	2.975945486	1.278554144	0	2.554118765	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.6313																																																																																				0	0	0	11.9464	0.218452745	2.095255818	0	2.603477239	1.177953044	0.996276956	1.382751406	3.368878022	0.991110744	1.986594457	0	0	0.020090977	7.511773892	12.20528754	0.643391051	1.084535649	1.590486863	0	2.975945486	1.278554144	0	2.554118765	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.6313
H6952_001_0	2008	7																																D	D	D	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	P	V	P	V	P	O	O	O															0.0001	0.0001	0.0001		0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001																				0.0017		2916.941386	325.8128041	1738.903897		18.10233225	33.38880679	28.22147584	685.6199035	47.27694928	22.45890951	52.56811963	3.848797995	4.550471474	53.45389462	75.36133605	125.7371315	6.790309893	11.93882922			19.40756169	8.846358936																				ffs medicare (1a)	ffs medicare (1b)	ffs medicare (2)	$0 (6)	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a);  20% (4b)	20% (9b)	0% or 20% (8a)	20% (8b)	20% (9a)	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"20% (7a, 14b, 14c, 14e, 14f, 14g, 14h)"	"20% (7b, 7d, 7f, 7g)"	50% (7e);  50% (7h)	"20% (7c, 7i)"	20% (incl in h2)	20% (14i)	20% (15)	"20% (13a, 14j, 16b, 17a, 18a), $0 (14a, 17b)"	$0 n/c (10b)	"$0 n/c (16a, 16b1-16b3, 16b5-16b8)"	$0 n/c (17a)	$0 n/c (17b1-17b5)	$0 n/c (18a)	$0 n/c (18b)	$0 n/c	$0 n/c (14a)	$0 (13c)											121.1546	50.9844	82.2998		0.234	0.234	0.234	50.0058	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				29.4501	1.384281135	11.92595231	0	4.235945747	7.81298079	6.603825347	2.857078399	11.06280613	5.255384826	12.30093999	0.900618731	1.064810325	12.50821134	17.63455264	29.42248878	1.588932515	2.793686038	0	0	4.541369435	2.070047991	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.414	135	0	29.4501	1.384281135	11.92595231	0	4.236045747	7.81308079	6.603925347	2.857078399	11.06290613	5.255484826	12.30103999	0.900718731	1.064910325	12.50831134	17.63465264	29.42258878	1.589032515	2.793786038	0.0001	0.0001	4.541469435	2.070147991	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.4157																																																																																				0	0	0	29.4501	1.384281135	11.92595231	0	4.236045747	7.81308079	6.603925347	2.857078399	11.06290613	5.255484826	12.30103999	0.900718731	1.064910325	12.50831134	17.63465264	29.42258878	1.589032515	2.793786038	0.0001	0.0001	4.541469435	2.070147991	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.4157
H7015_001_0	2008	5																																D	D	D	V	P	Coin	O	V	Coin	Coin	Coin	V	Coin	V	P	P	Coin	P	P	P	S	O		P	V	P	V	P			O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1415.585462	41.79615076	1000.090632	0	0	15.37043956	0	203.2043702	24.07419213	7.380915081	21.18790381	0	8.855701893	303.6864107	4633.102786	5635.563439	1.856315362	673.0789007	0	0	1318.373552	0	0	4502.612937	0	0	156.7369662	0	0	0	30											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 8b"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a	PBP 13											150	150	50	0	0	0.1	0	46.5763921	0.2	0	0	0	0	60.23815296	10	30	0.5	30	0	0	44.37544929	0	0	10.82237446	0	0	30	0	0	0	30.82402424											17.6948	0.522451884	4.167044302	0	0	1.537043956	0	0.788710535	4.814838425	0	0	0	0	1.524459038	3.860918988	14.0889086	0.928157681	1.682697252	0	0	4.875284891	0	0	4.060746937	0	0	0.391842416	0	0	0	0.077060061	0	0	0	0	0	0	0	0	0	0	61.015	0	0	17.6948	0.522451884	4.167044302	0	0	1.537043956	0	0.788710535	4.814838425	0	0	0	0	1.524459038	3.860918988	14.0889086	0.928157681	1.682697252	0	0	4.875284891	0	0	4.060746937	0	0	0.391842416	0	0	0	0.077060061	0	0	0	0	0	0	0	0	0	0	61.015																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.6948	0.522451884	4.167044302	0	0	1.537043956	0	0.788710535	4.814838425	0	0	0	0	1.524459038	3.860918988	14.0889086	0.928157681	1.682697252	0	0	4.875284891	0	0	4.060746937	0	0	0.391842416	0	0	0	0.077060061	0	0	0	0	0	0	0	0	0	0	61.015
H7015_002_0	2008	5																																D	D	D	V	P	Coin	O	V	Coin	Coin	Coin	V	Coin	V	P	P	Coin	P	P	P	S	O	T	P	V	P	V	P			O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1307.719694	38.61133853	914.8020019	0	0	14.72178152	0	195.7239135	23.20700881	7.115045043	20.42468831	0	8.53670814	292.7434053	4436.259743	5396.588624	1.777759954	644.6838995	0	0	1265.413463	0	0	4502.612937	0	0	159.0386207	0	0	0	30											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 8b"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a	PBP 13											150	150	50	0	0	0.1	0	46.59540711	0.2	0	0	0	0	60.23885168	10	30	0.5	30	0	0	44.37753505	0	0	10.82237446	0	0	30	0	0	0	29.85706654											16.3465	0.482641732	3.811675008	0	0	1.472178152	0	0.759986286	4.641401763	0	0	0	0	1.469543881	3.696883119	13.49147156	0.888879977	1.611709749	0	0	4.679660859	0	0	4.060746937	0	0	0.397596552	0	0	0	0.074642666	0	0	0	0	0	0	0	0	0	0	57.8855	0	0	16.3465	0.482641732	3.811675008	0	0	1.472178152	0	0.759986286	4.641401763	0	0	0	0	1.469543881	3.696883119	13.49147156	0.888879977	1.611709749	0	0	4.679660859	0	0	4.060746937	0	0	0.397596552	0	0	0	0.074642666	0	0	0	0	0	0	0	0	0	0	57.8855																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.3465	0.482641732	3.811675008	0	0	1.472178152	0	0.759986286	4.641401763	0	0	0	0	1.469543881	3.696883119	13.49147156	0.888879977	1.611709749	0	0	4.679660859	0	0	4.060746937	0	0	0.397596552	0	0	0	0.074642666	0	0	0	0	0	0	0	0	0	0	57.8855
H7015_003_0	2008	5																																D	D	D	V	P	Coin	O	V	Coin	Coin	Coin	V	Coin	V	P	P	Coin	P	P	P	S	O	T	P	V	P	V	P			O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1276.593957	37.69232938	902.1953434	0	0	14.36869053	0	189.9922904	22.50021537	6.89834899	19.80263331	0	8.276713867	283.8313746	4331.166296	5268.290184	1.735335645	629.2116775	0	0	1232.360891	0	0	4502.612937	0	0	155.5181329	0	0	0	30											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	"PBP 7d, 8b"	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a	PBP 13											150	150	50	0	0	0.1	0	46.57575253	0.2	0	0	0	0	60.23814202	10	30	0.5	30	0	0	44.37530743	0	0	10.82237446	0	0	30	0	0	0	29.46538499											15.9574	0.471154117	3.759147264	0	0	1.436869053	0	0.737419491	4.500043073	0	0	0	0	1.424789554	3.609305246	13.17072546	0.867667822	1.573029194	0	0	4.557199452	0	0	4.060746937	0	0	0.388795332	0	0	0	0.073663462	0	0	0	0	0	0	0	0	0	0	56.588	0	0	15.9574	0.471154117	3.759147264	0	0	1.436869053	0	0.737419491	4.500043073	0	0	0	0	1.424789554	3.609305246	13.17072546	0.867667822	1.573029194	0	0	4.557199452	0	0	4.060746937	0	0	0.388795332	0	0	0	0.073663462	0	0	0	0	0	0	0	0	0	0	56.588																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.9574	0.471154117	3.759147264	0	0	1.436869053	0	0.737419491	4.500043073	0	0	0	0	1.424789554	3.609305246	13.17072546	0.867667822	1.573029194	0	0	4.557199452	0	0	4.060746937	0	0	0.388795332	0	0	0	0.073663462	0	0	0	0	0	0	0	0	0	0	56.588
H7015_004_0	2008	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	P	V	P	V	P			O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		400.8896167	30.84808632	89.78854771	25.99201411	9.219173107	33.65309979	2.011386194	12.32947221	15.94257745	11.10459711	23.0944682	0	27.34147676	16.85616602	24.91721126	53.87071312	8.962568269	7.552393698	28.67591961	99.16857838	24.88167927	28.61968556	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a	PBP 13											0.066329738	0.066329738	0.156273645	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0	0.230636058	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											26.5909	2.046145491	14.03158365	0	2.157286507	7.87482535	0.470664369	2.885096498	3.730563124	2.598475723	5.40410556	0	6.397905562	3.944342849	0	12.4245289	2.097240975	1.767260125	6.710165188	23.20544734	5.822312949	6.697006422	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.8559	0	0	26.5909	2.046145491	14.03158365	0	2.157286507	7.87482535	0.470664369	2.885096498	3.730563124	2.598475723	5.40410556	0	6.397905562	3.944342849	0	12.4245289	2.097240975	1.767260125	6.710165188	23.20544734	5.822312949	6.697006422	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.8559		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.5909	2.046145491	14.03158365	0	2.157286507	7.87482535	0.470664369	2.885096498	3.730563124	2.598475723	5.40410556	0	6.397905562	3.944342849	0	12.4245289	2.097240975	1.767260125	6.710165188	23.20544734	5.822312949	6.697006422	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.8559
H7015_005_0	2008	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	P	V	P	V	P			O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		400.8878109	30.84794737	89.78814327	25.99189703	9.219131581	33.6529482	2.011377134	12.329417	15.94250564	11.10454709	23.09436418	0	27.3413536	16.85609009	24.91710185	53.87047396	8.962527898	7.55235968	28.67579044	99.16813186	24.88156719	28.61955665	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a	PBP 13											0.066329738	0.066329738	0.156273645	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0	0.230636043	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											26.5908	2.046136274	14.03152045	0	2.15727679	7.874789879	0.470662249	2.885083579	3.73054632	2.598464019	5.404081218	0	6.397876743	3.944325082	0	12.42447294	2.097231528	1.767252165	6.710134963	23.20534286	5.822286723	6.696976256	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.8552	0	0	26.5908	2.046136274	14.03152045	0	2.15727679	7.874789879	0.470662249	2.885083579	3.73054632	2.598464019	5.404081218	0	6.397876743	3.944325082	0	12.42447294	2.097231528	1.767252165	6.710134963	23.20534286	5.822286723	6.696976256	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.8552		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.5908	2.046136274	14.03152045	0	2.15727679	7.874789879	0.470662249	2.885083579	3.73054632	2.598464019	5.404081218	0	6.397876743	3.944325082	0	12.42447294	2.097231528	1.767252165	6.710134963	23.20534286	5.822286723	6.696976256	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.8552
H7065_001_0	2008	7																																Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	P	P															0.0001	0.0001	0.0001		0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001																				0.0017		284.7209884	16.00794254	100.6477693		14.2029272	16.3562106	15.06685702	625.0602168	32.36740596	16.49644882	36.61804104	1.994423378	0.234776195	42.07478151	37.90656493	71.31904957	6.455466177	4.06619937			24.36420548	5.794326676																				"Medicare FFS cost sharing: #1A $992 ded, $0/day days 1-60, $248/day days 61-90, $496/day lifetime reserve days"	"Medicare FFS cost sharing: #1B $992 ded, $0/day days 1-60, $248/day days 61-90, $496/day lifetime reserve days"	"Medicare FFS cost sharing: #2 $0/day days 1-20, $124/day days 21-100"	Medicare FFS cost sharing: #6 $0	Medicare FFS cost sharing: #10A 20%	Medicare FFS cost sharing: #11A 20%	"Medicare FFS cost sharing: #11B 20%, #11C 20%, #11D 20%"	"Medicare FFS cost sharing: #4A $50, #4B $50"	"Medicare FFS cost sharing: #9A 20%, #9B 20%"	Medicare FFS cost sharing: #8A 20%	"Medicare FFS cost sharing: #8A 20%, #8B 20%"	Medicare FFS cost sharing: #9A 20%	Medicare FFS cost sharing: #12 20%	"Medicare FFS cost sharing: #3 20%, #5 20%, #9C 20%, #9D 20%"	"Medicare FFS cost sharing: #7A 20%, #14B 20%, #14C 20%, #14D 20%, #14E 20%, #14F 20%, #14G 20%, #14H 20%, #14J 20%"	"Medicare FFS cost sharing: #7B 20%, #7D 20%, #7F 20%, #7G 20%, #16B 20%, #17A 20%, #18A 20%"	"Medicare FFS cost sharing: #7E 50%, #7H 50%"	"Medicare FFS cost sharing: #7C 20%, #7I 20%"	Medicare FFS cost sharing: #7D 20%	Medicare FFS cost sharing: #14I 20%	Medicare FFS cost sharing: #15 20%	Medicare FFS cost sharing: #13A 20%	#10B not covered	"#16A not covered, #16B1-16B5 not covered"	#17A1 not covered	#17B1-17B5 not covered	#18A1-18A5 not covered	#18B not covered	Not covered	#14A $0	#13B not covered											0.0847	0.0847	0.1727		0.234	0.234	0.234	115.7492	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				24.1159	1.355872733	17.38186977	0	3.323484965	3.82735328	3.525644543	6.029186639	7.573972995	3.860169023	8.568621604	0.46669507	0.05493763	9.845498873	8.870136194	16.6886576	1.510579085	0.951490653	0	0	5.701224081	1.355872442	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0071	0	0	24.1159	1.355872733	17.38186977	0	3.323584965	3.82745328	3.525744543	6.029186639	7.574072995	3.860269023	8.568721604	0.46679507	0.05503763	9.845598873	8.870236194	16.6887576	1.510679085	0.951590653	0.0001	0.0001	5.701324081	1.355972442	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0088																																																																																				0	0	0	24.1159	1.355872733	17.38186977	0	3.323584965	3.82745328	3.525744543	6.029186639	7.574072995	3.860269023	8.568721604	0.46679507	0.05503763	9.845598873	8.870236194	16.6887576	1.510679085	0.951590653	0.0001	0.0001	5.701324081	1.355972442	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0088
H7086_001_0	2008	5																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	312.15	39.3	36.3	42.58	13.19	22.65	18.04	8.53	19.73	12.37	21.56	68.7	1.14	74.7	56.95	123.04	11.05	7.51	29.28	40.21	18.39	5.34	7.72	0	0	0	0	0	0	0	9.6											Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	Standard Medicare Fee-for-Service Cost Sharing	0	0	0	0	0	0	0	0											0.070000119	0.070006954	0.158396368	0	0.234043385	0.234000095	0.233947869	0.234037479	0.233999999	0.234008177	0.233947477	0.233999988	0.234	0.233985478	0.234016973	0.23401689	0.233999405	0.233988478	0.234005964	0.233995727	0.23400021	0.233995504	0	0	0	0	0	0	0	0	0											21.8505	2.751273279	5.749788169	0	3.087032247	5.300102145	4.220419565	1.996339694	4.616819987	2.894681147	5.043907596	16.07579918	0.26676	17.47871524	13.3272666	28.79343816	2.585693429	1.757253469	6.851694628	9.408968197	4.303263867	1.249535991	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	159.6093	0	0	21.8505	2.751273279	5.749788169	0	3.087032247	5.300102145	4.220419565	1.996339694	4.616819987	2.894681147	5.043907596	16.07579918	0.26676	17.47871524	13.3272666	28.79343816	2.585693429	1.757253469	6.851694628	9.408968197	4.303263867	1.249535991	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	159.6093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.8505	2.751273279	5.749788169	0	3.087032247	5.300102145	4.220419565	1.996339694	4.616819987	2.894681147	5.043907596	16.07579918	0.26676	17.47871524	13.3272666	28.79343816	2.585693429	1.757253469	6.851694628	9.408968197	4.303263867	1.249535991	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	159.6093
H7146_001_0	2008	9																					Unlimited											D	D	D	V	T	P	P	V	V	V	V	V	V	V	P	P	P	P	P	P	S	P	T	P	P	P	P	P	P	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	234.5155898	0	0	0	0	0	0	0	0	142.4113599	0	0	0	0	0	0	0	0	0	0	0	0	0	0											1A - no cost sharing	1B - no cost sharing	2 - no cost sharing	6 - no cost sharing	10A - no cost sharing	11A - no cost sharing	11B - no cost sharing	4A - $50 copay	9 - no cost sharing	8A - no cost sharing	8B - no cost sharing	no cost sharing	11C - no cost sharing	9D - no cost sharing	no cost sharing	no cost sharing	7E & 7H - $15 copay	7C & 7I - no copay	no cost sharing	7B - no cost sharing	no cost sharing	no cost sharing	10B - no cost sharing	16A - no cost sharing	17A - no cost sharing	17B - no cost sharing	18A - no cost sharing	18B - no cost sharing	no cost sharing	no cost sharing	no cost sharing											0	0	0	0	0	0	0	50.14591999	0	0	0	0	0	0	0	0	15.16732936	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0.98	0	0	0	0	0	0	0	0	0.18	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.16	0	0	0	0	0	0	0	0	0	0.98	0	0	0	0	0	0	0	0	0.18	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.16	0	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0.98	0	0	0	0	0	0	0	0	0.18	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.16
H7146_002_0	2008	10																					Unlimited											D	D	D	V	T	P	P	V	V	V	V	V	V	V	P	P	P	P	P	P	S	P	T	P	P	P	P	P	P	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	459.9166304	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											1A - no cost sharing	1B - no cost sharing	2 - no cost sharing	6 - no cost sharing	10A - no cost sharing	11A - no cost sharing	11B - no cost sharing	4A - $50 copay	9 - no cost sharing	8A - no cost sharing	8B - no cost sharing	no cost sharing	11C - no cost sharing	9D - no cost sharing	no cost sharing	no cost sharing	7E & 7H - no cost sharing	7C & 7I - no copay	no cost sharing	7B - no cost sharing	no cost sharing	no cost sharing	10B - no cost sharing	16A - no cost sharing	17A - no cost sharing	17B - no cost sharing	18A - no cost sharing	18B - no cost sharing	no cost sharing	no cost sharing	no cost sharing											0	0	0	0	0	0	0	50.09603584	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.92	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.92	0	0	0	0	0	0	0	0	0	1.92	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.92	0	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	1.92	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.92
H7149_001_0	2008	7																					3750											D	D	D	Coin	T	Coin	Coin	V	V	P	P	V	Coin	V	V	V	V	V	P	V	Coin	P	T	P	V	P	V	P	Coin	P	P																																																				0	0	1330.701917	81.22085654	872.8005787	17.41309848	61.09401409	9.160295088	8.915641136	202.8829484	247.1555778		214.8307907	57.60349165	0.579331793	253.7432087	3326.4092	3983.654702	296.042833	452.2416689	356.9421048		38.76656983				144		249															1a:$200 1-10; 1a1:$200 1-10;	1b:$200 1-10;	2a:$100 4+; 2a2:$100 4+;	6a:20%;	10a:$150;	11a:20%;	11b:20%; 11c:20%;	4a:$50; 4b:$50;	9b:$250;		8b:$0-150;	9a:$250;	12:20%;	3:$30; 5:$100; 9c:$30; 9d:$35;	7a:$10; 14c:$17.5;	7b:$25; 7d:$25; 7f:$25; 7f1:$25;	7e:$30; 7h:$30;	7c:$30; 7i:$30;	7g:$10-25;		15:20%;				17a1:$30;		18a1:$30;															141.5193	121.9073	60.5413	0.167102785	125.3271	0.167102785	0.167102785	41.7757	208.8785		118.8875	208.8785	0.190997225	188.4783	10.2367	26.1905	21.0584	21.8916	20.6688		0.167102785				30		30															15.6933	0.825118084	4.403376312	2.909777253	0.638061244	1.530710821	1.489828465	0.706298036	4.302123479	0	2.128391611	1.002677488	0.110650765	3.985424368	2.837632666	8.69447831	0.519516873	0.825024387	0.614798103	0	6.478001786	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6777	0	9.46	15.6933	0.825118084	4.403376312	2.909777253	0.638061244	1.530710821	1.489828465	0.706298036	4.302123479	0	2.128391611	1.002677488	0.110650765	3.985424368	2.837632666	8.69447831	0.519516873	0.825024387	0.614798103	0	6.478001786	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6777																																																																																				0	0	0	15.6933	0.825118084	4.403376312	2.909777253	0.638061244	1.530710821	1.489828465	0.706298036	4.302123479	0	2.128391611	1.002677488	0.110650765	3.985424368	2.837632666	8.69447831	0.519516873	0.825024387	0.614798103	0	6.478001786	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6777
H7149_002_0	2008	7																					3000											D	D	D	Coin	T	Coin	Coin	V	V	P	P	V	Coin	V	V	V	V	V	P	V	Coin	P	T	P	V	P	V	P	Coin	P	P																																																				0	0	1375.820641	83.97472753	902.3836398	18.00350628	63.16546519	9.470883673	9.217934494	209.7482959	255.5356246		222.1148345	59.55659325	0.568273835	262.3466154		4223.724333	305.7853801	444.914444	362.5953768		40.08098754				144		249															1a:$200 1-10; 1a1:$200 1-10;	1b:$200 1-10;	2a:$100 4+; 2a2:$100 4+;	6a:20%;	10a:$150;	11a:20%;	11b:20%; 11c:20%;	4a:$50; 4b:$50;	9b:$200;		8b:$0-100;	9a:$200;	12:20%;	3:$30; 5:$100; 9a:$200; 9c:$30; 9d:$35;		7b:$20; 7d:$20; 7f:$20; 7f1:$20;	7e:$30; 7h:$30;	7c:$30; 7i:$30;	8b:$0-100;		15:20%;				17a1:$20;		18a1:$20;															131.8622	113.5885	56.4101	0.155699858	116.7749	0.155699858	0.155699858	38.925	155.6999		74.3498	155.6999	0.191385151	141.0912		19.4198	15.9107	18.7253	15.57		0.155699858				20		20															15.1182	0.794880188	4.241959502	2.803143375	0.614678373	1.474615245	1.435231094	0.680370415	3.315571709	0	1.376183654	0.772746094	0.108759174	3.084565733	0	6.835306753	0.405439432	0.694263396	0.470467073	0	6.240604077	0	0	0	0.24	0	0.415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.122	0	12.5	15.1182	0.794880188	4.241959502	2.803143375	0.614678373	1.474615245	1.435231094	0.680370415	3.315571709	0	1.376183654	0.772746094	0.108759174	3.084565733	0	6.835306753	0.405439432	0.694263396	0.470467073	0	6.240604077	0	0	0	0.24	0	0.415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.122																																																																																				0	0	0	15.1182	0.794880188	4.241959502	2.803143375	0.614678373	1.474615245	1.435231094	0.680370415	3.315571709	0	1.376183654	0.772746094	0.108759174	3.084565733	0	6.835306753	0.405439432	0.694263396	0.470467073	0	6.240604077	0	0	0	0.24	0	0.415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.122
H7149_801_0	2008	3																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	257.7184932	3.408038254	38.94245319		4.827222321	9.097343734	11.24923049	13.7794136	45.91766253	8.50871992	29.46394777	12.0748071	0.268976598	27.33353074	31.16980508	86.53406268	1.77475276	12.69802731	19.89133116	12.72465812	32.8563768	0.163725551																				Medicare FFS	Medicare FFS	Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.081719253	0.081719253	0.18417947		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				21.0606	0.27850234	7.172400373	0	1.129570023	2.128778434	2.632319934	3.224382782	10.74473303	1.991040461	6.894563777	2.825504861	0.062940524	6.396046193	7.293734388	20.24897067	0.415292146	2.971338391	4.654571492	2.977570001	7.68839217	0.038311779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8295	0	0	21.0606	0.27850234	7.172400373	0	1.129570023	2.128778434	2.632319934	3.224382782	10.74473303	1.991040461	6.894563777	2.825504861	0.062940524	6.396046193	7.293734388	20.24897067	0.415292146	2.971338391	4.654571492	2.977570001	7.68839217	0.038311779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8295																																																																																				0	0	0	21.0606	0.27850234	7.172400373	0	1.129570023	2.128778434	2.632319934	3.224382782	10.74473303	1.991040461	6.894563777	2.825504861	0.062940524	6.396046193	7.293734388	20.24897067	0.415292146	2.971338391	4.654571492	2.977570001	7.68839217	0.038311779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8295
H7149_802_0	2008	3																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	257.7184932	3.408038254	38.94245319		4.827222321	9.097343734	11.24923049	13.7794136	45.91766253	8.50871992	29.46394777	12.0748071	0.268976598	27.33353074	31.16980508	86.53406268	1.77475276	12.69802731	19.89133116	12.72465812	32.8563768	0.163725551																				Medicare FFS	Medicare FFS	Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.081719253	0.081719253	0.18417947		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				21.0606	0.27850234	7.172400373	0	1.129570023	2.128778434	2.632319934	3.224382782	10.74473303	1.991040461	6.894563777	2.825504861	0.062940524	6.396046193	7.293734388	20.24897067	0.415292146	2.971338391	4.654571492	2.977570001	7.68839217	0.038311779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8295	0	0	21.0606	0.27850234	7.172400373	0	1.129570023	2.128778434	2.632319934	3.224382782	10.74473303	1.991040461	6.894563777	2.825504861	0.062940524	6.396046193	7.293734388	20.24897067	0.415292146	2.971338391	4.654571492	2.977570001	7.68839217	0.038311779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8295																																																																																				0	0	0	21.0606	0.27850234	7.172400373	0	1.129570023	2.128778434	2.632319934	3.224382782	10.74473303	1.991040461	6.894563777	2.825504861	0.062940524	6.396046193	7.293734388	20.24897067	0.415292146	2.971338391	4.654571492	2.977570001	7.68839217	0.038311779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8295
H7149_803_0	2008	3																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	257.7184932	3.408038254	38.94245319		4.827222321	9.097343734	11.24923049	13.7794136	45.91766253	8.50871992	29.46394777	12.0748071	0.268976598	27.33353074	31.16980508	86.53406268	1.77475276	12.69802731	19.89133116	12.72465812	32.8563768	0.163725551																				Medicare FFS	Medicare FFS	Medicare FFS		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.081719253	0.081719253	0.18417947		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				21.0606	0.27850234	7.172400373	0	1.129570023	2.128778434	2.632319934	3.224382782	10.74473303	1.991040461	6.894563777	2.825504861	0.062940524	6.396046193	7.293734388	20.24897067	0.415292146	2.971338391	4.654571492	2.977570001	7.68839217	0.038311779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8295	0	0	21.0606	0.27850234	7.172400373	0	1.129570023	2.128778434	2.632319934	3.224382782	10.74473303	1.991040461	6.894563777	2.825504861	0.062940524	6.396046193	7.293734388	20.24897067	0.415292146	2.971338391	4.654571492	2.977570001	7.68839217	0.038311779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8295																																																																																				0	0	0	21.0606	0.27850234	7.172400373	0	1.129570023	2.128778434	2.632319934	3.224382782	10.74473303	1.991040461	6.894563777	2.825504861	0.062940524	6.396046193	7.293734388	20.24897067	0.415292146	2.971338391	4.654571492	2.977570001	7.68839217	0.038311779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8295
H7179_001_0	2008	4																					4800											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		2384.878561	278.5588908	1333.336107	5863.138944	267.2330818	13.80894361	4.370649079	355.4143388	315.5107606	0	14.37513241	3.62553636	0.242266344	27.02262033	3110.065806	4600.691995	353.2528409	508.7401209	0	0	21.31555283	0	0	0	144	0	249	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 150 days 1-5	1b 200 days 1-5	2a 25 days 11-100	6a 10 copay	10a 110 copay	11a 20% coin; 11a 15% coin	11b 10% coin	4a 50 copay; 4b 30 copay; 4a World 40 copay	9b 400 copay; ASC:9b 150 copay		8b 15% coin; TherRad:8b 20% coin	9a 15% coin	12 20% coin	3 35 copay; 5 50 copay; 9a 15% coin; 9a 20% coin; 9c 50 copay; 9d 35 copay	7a 8 copay	7b 15 copay; ; 7d 25 copay; 16b 25 copay; 17a 25 copay	7e 50 copay; 7h 50 copay	7c 20 copay; 7i 20 copay			RX 20% coin				17a1 25 copay	17b1 70 allowance	18a1 15 copay															78.594975	104.7933	10.91918037	8.506152998	93.56768298	0.162277164	0.08506153	42.52856472	239.3101789	0	0.135742271	0.127592295	0.17012306	0.132552977	6.804922399	20.98342277	42.53076499	17.012306	0	0	0.17012306	0	0	0	25	0	15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.62	2.432592118	1.213244787	4.156063076	2.083698357	2.240876208	0.371774098	1.259605143	6.292078047	0	1.951313124	0.462590505	0.041215092	3.581928763	1.763646372	8.044855429	1.252009463	0.721236884	0	0	3.626267072	0	0	0	0.3	0	0.31125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7262		10.03032262	15.62	2.432592118	1.213244787	4.156063076	2.083698357	2.240876208	0.371774098	1.259605143	6.292078047	0	1.951313124	0.462590505	0.041215092	3.581928763	1.763646372	8.044855429	1.252009463	0.721236884	0	0	3.626267072	0	0	0	0.3	0	0.31125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7262																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	15.62	2.432592118	1.213244787	4.156063076	2.083698357	2.240876208	0.371774098	1.259605143	6.292078047	0	1.951313124	0.462590505	0.041215092	3.581928763	1.763646372	8.044855429	1.252009463	0.721236884	0	0	3.626267072	0	0	0	0.3	0	0.31125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7262
H7179_002_0	2008	7																					5200											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V	V	V	V	P	V	P	V	V	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		2528.639296	295.3504505	1413.70975	6216.569586	283.3419205	15.52393024	4.913457055	376.8201266	334.5297829	0	16.16043625	4.075805879	0.272354348	30.37866508	3297.540905	4878.0222	374.5469599	539.4070298	0	0	23.96281458	0	0	0	144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a 170 days 1-5	1b 260 days 1-5	2a 25 days 11-100	6a 10 copay	10a 125 copay	11a 20% coin	11b 10% coin	4a 50 copay; 4b 30 copay; 4a World 40 copay	9b 450 copay; ASC:9b 225 copay		8b 15% coin; TherRad:8b 20% coin	9a 15% coin	12 20% coin	3 35 copay; 5 50 copay; 9a 15% coin; 9a 20% coin; 9c 50 copay; 9d 25 copay	7a 10 copay	7b 15 copay; ; 7d 30 copay; 16b 30 copay; 17a 30 copay	7e 50 copay; 7h 50 copay	7c 25 copay; 7i 25 copay			RX 20% coin				17a1 25 copay	17b1 70 allowance																86.90621758	132.9153916	10.65340521	8.299111435	103.7388929	0.165982229	0.082991114	41.49433079	284.8287896	0	0.132438276	0.124486672	0.165982229	0.127356718	8.299111435	24.48468915	41.49555717	20.74777859	0	0	0.165982229	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.3129	3.271385065	1.255068568	4.299333645	2.449464763	2.57669654	0.407773276	1.302991582	7.94030943	0	2.140260311	0.507383508	0.045205982	3.868927083	2.280554953	9.953071436	1.295169566	0.932624802	0	0	3.977401369	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.1165		13.69371423	18.3129	3.271385065	1.255068568	4.299333645	2.449464763	2.57669654	0.407773276	1.302991582	7.94030943	0	2.140260311	0.507383508	0.045205982	3.868927083	2.280554953	9.953071436	1.295169566	0.932624802	0	0	3.977401369	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.1165																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	18.3129	3.271385065	1.255068568	4.299333645	2.449464763	2.57669654	0.407773276	1.302991582	7.94030943	0	2.140260311	0.507383508	0.045205982	3.868927083	2.280554953	9.953071436	1.295169566	0.932624802	0	0	3.977401369	0	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.1165
H7179_003_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	V	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		488.7676279	61.79349426	42.32922544	0	20.31160004	21.65705848	5.696581061	844.2632694	39.01969393	20.0067224	16.64875803	2.665202496	0.777543181	40.67861564	52.27249564	136.4214339	43.39467483	6.956657746	0	0	21.84976988	6.809189175	0	0	144	1.372	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1a: MC CS; 1a1 45% coin	1b: MC CS; 1a1 45% coin	2a: MC CS; 2a2 0% coin	6a 0% coin	MC CS	MC CS	MC CS	4a 23.4% coin	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS; 14c 0% coin	MC CS; ;	MC CS	MC CS	MC CS	MC CS	MC CS	MC CS; 13a1 0% coin			17a1 25 copay	17b1 70 allowance																0.077098733	0.075234226	0.232348433	0	0.234	0.234	0.234	94.44172996	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.6834	4.648985742	9.835129213	0	4.75291441	5.067751685	1.332999968	6.644473642	9.13060838	4.681573042	3.895809379	0.623657384	0.181945104	9.518796059	12.23176398	31.92261554	10.15435391	1.627857912	0	0	5.112846152	1.593350267	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.9408		0	37.6834	4.648985742	9.835129213	0	4.75291441	5.067751685	1.332999968	6.644473642	9.13060838	4.681573042	3.895809379	0.623657384	0.181945104	9.518796059	12.23176398	31.92261554	10.15435391	1.627857912	0	0	5.112846152	1.593350267	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.9408																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	37.6834	4.648985742	9.835129213	0	4.75291441	5.067751685	1.332999968	6.644473642	9.13060838	4.681573042	3.895809379	0.623657384	0.181945104	9.518796059	12.23176398	31.92261554	10.15435391	1.627857912	0	0	5.112846152	1.593350267	0	0	0.3	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.9408
H7187_001_0	2008	6	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						700	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	P	P	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T		V	P	V	P				V	P	V	V	V																																															0		2250.028295	101.1969725	6316.123797	66.79897984	344.5619695	1444.292067	30.56902467	135.4980469	145.2042108	8502.599507	142.4864849	3.105972423	8.153177609	143.262978	102.9893242	1224.23566	2720.157041	1.099942192		27.8652022	256.5017832	352.1098768	1817.255		287.28	278.16		95.475				69.88437951			234.745	287.945						(1a) $75/day	(1b) $75/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) $0/proc	(11a/11c) $0/proc	(4a) $50/visit (waived if admitted)	(9a/9b) $25/visit	(8a) $0/visit	(8b) $0/visit	(9a) $25/visit	(12) $0/proc	(9a) $25/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $0/visit	(7e/7h) $0/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $0/visit	(15) $0/proc	(Misc. PBP Cats) $0/visit	(10b) $0/trip		(17a1) $0/visit	(17b2) $0/proc	(18a) $0/visit	(18b) $0/proc				(4b) $10/visit (waived if admitted)	(9c) $0/proc 75%/25% Ind/Grp Blended Copay	(9d) $0/visit	(7f1) $0/visit	(18a1) $0/visit						63.1448	63.1448			63.1448			42.0965	21.0483			21.0483		21.0483																		8.4193										11.8398	0.532504801	0	0	1.813106641	0	0	0.4753328	0.254691214	0	0	0.00544794	0	0.251286251	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.049031464	0	0	0	0	0	0	0	0	0	15.2212		2.857735718	11.8398	0.532504801	0	0	1.813106641	0	0	0.4753328	0.254691214	0	0	0.00544794	0	0.251286251	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.049031464	0	0	0	0	0	0	0	0	0	15.2212		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					10	0.3	0.3	0.3	0.3						3.5135	0.0775	0.8388	0.0945	0.181	0.3245	0.006	0.0297	0.3061	0.7068	0.6726	0.0104	0.0187	0.1038	0.01	1.9106	0.24	0.0003		0.2696		0.0938	0.1433		0.0146							0.0031			0.013	0.0185						9.6007		0	15.3533	0.610043949	0.83879575	0.094544141	1.994118933	0.324491957	0.006025163	0.505047284	0.56082919	0.706807132	0.672620204	0.015857378	0.018681937	0.355080082	0.009992893	1.910614327	0.239982431	0.000287876	0	0.269582766	0	0.093813703	0.14325	0	0.01455	0	0	0	0	0	0	0.052096568	0	0	0.01305	0.01845	0	0	0	0	0	24.8219
H7187_002_0	2008	5																					1650											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2231.297699	315.9221741	1055.387792		425.5779481	28.47206273	20.33362045	732.834991	388.8451622	6755.177233	570.5175345	71.51879891	4.195047697	3657.758675		3573.086554		968.9352195			25.86252068	693.9652882					0.091570693															1(a) $150 per Day	1(b) $150 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $10 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per procedure; other $0 per procedure	8(b) X-rays $10 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a)/(d) $25 Copay Per Visit; 9(c) $0 Copay per Visit"	7(a) PCP $0 per visit; Urgent Care $10 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $10 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															87.7716	87.7716	24.576		43.8858	0.117028806	0.117028806	21.0652	14.6286	5.8514	5.8514	14.6286	0.117028806	14.6286		5.8514		5.8514			0.117028806	5.8514					5.8514															16.3204	2.310749668	2.161438522	0	1.556402467	3.332051493	2.379619314	1.286442055	0.474021718	3.293959679	0.278195773	0.087184996	0.490941421	4.458990925	0	1.742308548	0	0.472472214	0	0	3.026659904	0.33839137	0	0	0	0	4.47E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.0103	0	31.20243355	16.3204	2.310749668	2.161438522	0	1.556402467	3.332051493	2.379619314	1.286442055	0.474021718	3.293959679	0.278195773	0.087184996	0.490941421	4.458990925	0	1.742308548	0	0.472472214	0	0	3.026659904	0.33839137	0	0	0	0	4.47E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.0103		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3																																																								0	0	0	16.3204	2.310749668	2.161438522	0	1.556402467	3.332051493	2.379619314	1.286442055	0.474021718	3.293959679	0.278195773	0.087184996	0.490941421	4.458990925	0	1.742308548	0	0.472472214	0	0	3.026659904	0.33839137	0	0	0	0	4.47E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.0103
H7187_003_0	2008	6																					3200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1979.73225	145.9887264	948.3096615		123.5879296	13.7821315	2.640839908	481.6277429	33.91330287	10214.43619	48.74552638		0.394359412	31.2503116	4374.075938	4445.403719	509.4973632	1.930479302			24.60625723	892.4014607			122.4		14.32602104															$195 (1a); $0 (1a1)	$195 (1b)	"$125 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$5 (4b)"	25% (9b)	25% (8a1); $0/$5 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$24 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $24 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$24 (17a1)	$0 n/c (17b)	$24 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see OON	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											117.9183	117.9183	75.5887		105.8241	0.181412791	0.282231335	30.2355	0.151177326	1.2094	0.085539109		0.181412791	0.151106328	5	23.9487	37.5	0.151177326			0.181412791	24			24		24															19.4539	1.43456204	5.973454941	0	1.089882073	2.500254939	0.745327772	1.213519903	5.126922433	1.029460765	4.169648892	0	0.071541842	4.722119821	1.822531641	8.871804272	1.59217926	0.291844698	0	0	4.463889797	1.784802921	0	0	0.2448	0	0.028652042	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6311	0	33.73732061	19.4539	1.43456204	5.973454941	0	1.089882073	2.500254939	0.745327772	1.213519903	5.126922433	1.029460765	4.169648892	0	0.071541842	4.722119821	1.822531641	8.871804272	1.59217926	0.291844698	0	0	4.463889797	1.784802921	0	0	0.2448	0	0.028652042	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6311		$250 (1a); $0 (1a1)	$250 (1b)	"$150 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$10/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $30 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	see specific bid cats	"$0 n/c (14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8)"	"$0 n/c (13b, 13c, 13d, 13e)"											3.5865	0.2645	3.9513	0.7353	0.4506	1.0337	0.1981	0.5017	2.5435	1.7024	2.085		0.0296	2.3423	0.9376	1.9564	0.3184	0.1022			1.3027	0.402			0.054		0.0063															24.504	0	0	23.0404	1.699034371	9.924745197	0.735323916	1.540463067	3.533914802	0.943390765	1.715215468	7.670420148	2.731866797	6.254608742	0	0.101118797	7.064388033	2.76014485	10.82823329	1.910615112	0.394046544	0	0	5.766574004	2.186832994	0	0	0.2988	0	0.034972345	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.1351
H7187_005_0	2008	4																					3900											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	Coin	P	T		V	P	V																																																								0		2334.120399	330.4805054	1104.022191		445.1894388	31.15662486	22.25082848	766.6055062	406.763932	7066.469431	596.8081338	74.81452948	4.590101072	3842.069718		3737.741593	977.9620648	1013.58571			28.30103538	725.9446091					0.095790455															1(a) $250 per Day	1(b) $250 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $150 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $75 per Visit	8(a) Diagnostic: 20% Coinsurance; other 0% coinsurance	8(b) X-rays 20% Coinsurance; other: 20% Coinsurance	9(a) $75 per Visit	12  20% Coinsurance	"3,5,9(a), 9(d) $75 per visit; 9(c) $25/$35 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $35 per Visit	7(e)/7(h) $25/35 per Visit	7(c)/7(i) $35 per Visit		7(g) $35 per Visit	15  20% per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $35 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $35 per visit															162.1932	162.1932	27.2485		97.3159	0.129754553	0.129754553	29.0326	48.658	2.0521	61.1729	48.658	0.129754553	48.5449		22.707	21.0851	22.707			0.129754553	22.707					22.707															31.5482	4.466807321	2.506908355	0	3.610334792	4.042713934	2.887146306	1.854711387	1.649358506	1.208443071	3.042376054	0.303360182	0.595586513	15.54273985	0	7.072756103	1.718370207	1.917961511	0	0	3.672188198	1.373671517	0	0	0	0	0.00018126	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.0138	0	48.18956473	31.5482	4.466807321	2.506908355	0	3.610334792	4.042713934	2.887146306	1.854711387	1.649358506	1.208443071	3.042376054	0.303360182	0.595586513	15.54273985	0	7.072756103	1.718370207	1.917961511	0	0	3.672188198	1.373671517	0	0	0	0	0.00018126	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.0138		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3																																																								0	0	0	31.5482	4.466807321	2.506908355	0	3.610334792	4.042713934	2.887146306	1.854711387	1.649358506	1.208443071	3.042376054	0.303360182	0.595586513	15.54273985	0	7.072756103	1.718370207	1.917961511	0	0	3.672188198	1.373671517	0	0	0	0	0.00018126	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.0138
H7187_006_0	2008	6																					3500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2098.170854	143.911539	942.4271877		291.2631436	11.75245479	20.41043203	453.1827471	428.3451204	3591.175509	471.9443436	71.92233804	16.18365245	3017.750202		4120.853299	405.9868942	594.2540468				733.4007016					0.077652495															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															143.1733	143.1733	34.3616		61.36	0.16362661	0.16362661	33.748	61.36	16.3627	53.3946	61.36	128.4753	59.3242		20.4533	16.3627	16.3627				20.4533					20.4533															25.0335	1.717023965	2.698607899	0	1.489325023	1.923014333	3.339689798	1.274500502	2.190270621	4.896765614	2.099941452	0.367762761	0.173266587	14.91880068	0	7.02376307	0.553585493	0.810298125	0	0	0	1.250040317	0	0	0	0	0.000132354	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7603	0	15.95195925	25.0335	1.717023965	2.698607899	0	1.489325023	1.923014333	3.339689798	1.274500502	2.190270621	4.896765614	2.099941452	0.367762761	0.173266587	14.91880068	0	7.02376307	0.553585493	0.810298125	0	0	0	1.250040317	0	0	0	0	0.000132354	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7603		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.3823	0.0681	0.2932	0.2926	0.0752	0.1439	0.125	0.0329	0.3042	0.0478	0.1241	0.0249	0.0057	0.2171	0.0217	0.2098	0.0315	0.0341			0.1881	0.0445			0.0051																	4.6717	0	0	27.4158	1.785083526	2.99180443	0.292637064	1.564488507	2.066921943	3.464651627	1.30743721	2.494447541	4.944516933	2.224065931	0.392668414	0.179010082	15.13593171	0.021702985	7.233576215	0.585108049	0.844353362	0	0	0.188132469	1.294523235	0	0	0.005058988	0	0.000132354	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.432
H7187_007_0	2008	5	F2	H5a	H5b	I2a	O1a						OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Hearing (Non-Covered)						2400	Urgent Care	Outpatient Substance Abuse Svcs	Cardiac Rehabilitation Services	Routine Podiatry	Routine Hearing Tests						D	D	D	P	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V		V	Coin	V	T		V	P	V					V	P	V	V																																																0		2641.376114	118.7981798	6024.434264	63.71408729	328.6495011	18.69681174	0.347162195	129.2405125	138.4984289	8109.934739	135.9062123	2.962533238	7.77664975	136.6468456	98.23309888	1167.698337	2594.535479	1.049144957		26.57833891	244.6560867	335.848833	1817.255		287.28	278.16						66.65699786			234.745							(1a) $175/day	(1b) $175/day	(2a) $0/day	(6a) $0/proc	(10a) $75/trip	(11a) 20% coins	(11a/11c) 20% coins	(4a) $50/visit (waived if admitted)	(9a/9b) $35/visit	(8a) $0/visit	(8b) $0/visit	(9a) $35/visit	(12) $0/proc	(9a) $35/visit	"(7a, 14b-14i) $0/visit"	(7b/7d/7f) $15/visit	(7e/7h) $32.5/visit 75%/25% Ind/Grp Blended Copay	(7c/7i) $0/visit		(7g) $15/visit	(15) $0/proc	(Misc. PBP Cats) $15/visit	(10b) $0/trip		(17a1) $0/visit	(17b2) $0/proc	(18a) $15/visit					(4b) $35/visit (waived if admitted)	(9c) $32.5/proc 75%/25% Ind/Grp Blended Copay	(9d) $35/visit	(7f1) $0/visit							157.039	157.039			67.3024	0.179473162	0.179473162	44.8683	31.4078			31.4078		31.4078		13.4605	29.1644			13.4605		13.4605										31.4078										34.5666	1.554662442	0	0	1.843242657	3.355575914	0.062306297	0.483233404	0.362494284	0	0	0.007753888	0	0.357648104	0	1.309815702	6.305670113	0	0	0.029813116	0	0.376724074	0	0	0	0	0	0	0	0	0	0.17446249	0	0	0	0	0	0	0	0	0	50.79		5.808991187	34.5666	1.554662442	0	0	1.843242657	3.355575914	0.062306297	0.483233404	0.362494284	0	0	0.007753888	0	0.357648104	0	1.309815702	6.305670113	0	0	0.029813116	0	0.376724074	0	0	0	0	0	0	0	0	0	0.17446249	0	0	0	0	0	0	0	0	0	50.79		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3					35	0.3	0.3	0.3							3.9342	0.0868	0.7631	0.086	0.1647	0.2952	0.0055	0.0283	0.2785	0.643	0.6119	0.0095	0.017	0.0944	0.0091	1.7382	0.2183	0.0003		0.2453		0.0853	0.1433		0.0146							0.0102			0.013							9.4958		0	38.5007	1.64148427	0.763110613	0.086013356	2.00792208	3.650788731	0.067787805	0.511575622	0.641009213	0.643031422	0.611929205	0.017224075	0.016996252	0.452076543	0.009091228	3.04803394	6.523998759	0.000261901	0	0.275071237	0	0.4620729	0.14325	0	0.01455	0	0	0	0	0	0	0.184694924	0	0	0.01305	0	0	0	0	0	0	60.2858
H7187_008_0	2008	6																					3500											D	D	D	V	T	Coin	Coin	V	V	P	V	V	V	V	V	V	V	V		V	S	V			V	P	V																																																								0		2011.253052	137.9499299	903.3866592		279.1974188	10.79891995	18.75443264	434.4094199	410.6007046	3442.409226	452.3938077	68.94291838	15.51323636	2892.738355		3950.144842	389.1686793	569.6367688				703.0192023					0.0744357															(1a)$175/day	(1b)$175/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															145.4529	145.4529	34.9087		62.337	0.166231919	0.166231919	34.2853	62.337	16.6232	54.2448	62.337	125.114	60.2688		20.779	16.6232	16.6232				20.779					20.779															24.3786	1.67210178	2.628004712	0	1.450360083	1.795125185	3.117585325	1.241155978	2.132966969	4.768652426	2.045001066	0.35814105	0.161743576	14.52848281	0	6.840001634	0.539102136	0.789098443	0	0	0	1.217335739	0	0	0	0	0.000128892	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.6635	0	14.15133837	24.3786	1.67210178	2.628004712	0	1.450360083	1.795125185	3.117585325	1.241155978	2.132966969	4.768652426	2.045001066	0.35814105	0.161743576	14.52848281	0	6.840001634	0.539102136	0.789098443	0	0	0	1.217335739	0	0	0	0	0.000128892	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.6635		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															2.189	0.0625	0.2694	0.2689	0.0691	0.1322	0.1148	0.0316	0.2795	0.0439	0.1141	0.0229	0.0053	0.1995	0.0199	0.1928	0.029	0.0313			0.1729	0.0409			0.0051																	4.2944	0	0	26.5675	1.734639331	2.897417624	0.268893971	1.519425182	1.927356858	3.232408382	1.272728265	2.41246451	4.812529444	2.159054711	0.381025985	0.167021073	14.72799693	0.019942115	7.0327916	0.568067112	0.82039061	0	0	0.172868351	1.258209538	0	0	0.005058988	0	0.000128892	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9579
H7187_801_0	2008	2																					4300											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2259.440537	166.6148775	1327.612087		162.2065381	18.08846337	3.465990434	632.1062111	44.50977243	13406.23101	63.97643706		0.517580011	41.01470928	5396.635242	5490.342708	629.3689321	2.384632706			30.39498312	1102.360473			144		16.8541424															$425 (1a); $0 (1a1)	$425 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											232.5285	232.5285	82.0689		95.747	0.16413778	0.279642912	27.3563	0.16413778	3.2828	0.091769949		0.16413778	0.164051141	25	29.9304	37.5	0.16413778			0.16413778	30			30		30															43.782	3.228559272	9.079637552	0	1.294232972	2.96900023	0.969239656	1.441007091	7.305735256	3.667448337	5.871114386	0	0.084954434	6.728509854	11.24299009	13.6940001	1.966777913	0.39140832	0	0	4.988965067	2.755901183	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.8636	0	75.25353926	43.782	3.228559272	9.079637552	0	1.294232972	2.96900023	0.969239656	1.441007091	7.305735256	3.667448337	5.871114386	0	0.084954434	6.728509854	11.24299009	13.6940001	1.966777913	0.39140832	0	0	4.988965067	2.755901183	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.8636																																																																																				0			43.782	3.228559272	9.079637552	0	1.294232972	2.96900023	0.969239656	1.441007091	7.305735256	3.667448337	5.871114386	0	0.084954434	6.728509854	11.24299009	13.6940001	1.966777913	0.39140832	0	0	4.988965067	2.755901183	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.8636
H7187_803_0	2008	2																					4300											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		2259.431553	166.6142149	1327.606807		162.2058931	18.08831951	3.465962869	632.1036991	44.50941844	13406.1777	63.97592826		0.517575895	41.01438309	5396.614304	5490.320952	629.3664294	2.384613741			30.39474139	1102.35609			144		16.8541424															$425 (1a); $0 (1a1)	$425 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$25/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $30 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											232.5291	232.5291	82.0691		95.7473	0.164138203	0.279642975	27.3564	0.164138203	3.2828	0.091770207		0.164138203	0.164051563	25	29.9304	37.5	0.164138203			0.164138203	30			30		30															43.782	3.228554741	9.079624809	0	1.294231156	2.968984257	0.969232167	1.441005072	7.305695952	3.66744319	5.871084202	0	0.084953977	6.728473662	11.24294647	13.69394571	1.966770092	0.391406214	0	0	4.988938226	2.755890224	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.8633	0	75.25291371	43.782	3.228554741	9.079624809	0	1.294231156	2.968984257	0.969232167	1.441005072	7.305695952	3.66744319	5.871084202	0	0.084953977	6.728473662	11.24294647	13.69394571	1.966770092	0.391406214	0	0	4.988938226	2.755890224	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.8633																																																																																				0			43.782	3.228554741	9.079624809	0	1.294231156	2.968984257	0.969232167	1.441005072	7.305695952	3.66744319	5.871084202	0	0.084953977	6.728473662	11.24294647	13.69394571	1.966770092	0.391406214	0	0	4.988938226	2.755890224	0	0	0.36	0	0.042135356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.8633
H7188_001_0	2008	12	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)																				A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin									O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0									0	0	0	0									0		293.98	6.31	502.71	210.57	70.43	4.79	1.46	333.24	393.55	6189.93	2706.1		8.26	527.53	4817.17	3607.7	47.13	449.9			17.19									0.02	0.06	0.08	3.38									$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$5/Visit	$100/Trip	20% Coins	0% Coins	$50/Visit	$100/Visit	$0/Visit	$0-$75/Visit		$0-$50/Proc	$0-$75/Visit	$10/Visit	$35/Visit	$35-$50/Visit	$50/Visit			20% Coins									QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers									549.999992	549.999699	28.712574	5.000019	100.000012	0.2	0	50.000004	99.999995	0	14.492628		16.667171	28.993697	10	35.000002	41.270559	49.999998			0.2									0	0	0	0									13.4741	0.289208175	1.202841506	0.087737833	0.586916737	0.958	0	1.388500111	3.279583169	0	3.268208386	0	0.011472569	1.274587082	4.014308333	10.52245893	0.16209012	1.874583258	0	0	3.438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8326	0	0	13.4741	0.289208175	1.202841506	0.087737833	0.586916737	0.958	0	1.388500111	3.279583169	0	3.268208386	0	0.011472569	1.274587082	4.014308333	10.52245893	0.16209012	1.874583258	0	0	3.438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8326		30% Coins	30% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	$100/Trip	25% Coins	25% Coins	$50/Visit	25% Coins	25% Coins	25% Coins		$0-$50/Proc	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins									QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers									10.8706	0.1225	0.4458	0.6964	0.5869	1.3222	0.4027	0.245	2.9568	0.733	1.9764		0.002	0.9872	3.0571	2.5141	0.0851	0.2667			0.8032									0	0	0	0									28.074	0	0	24.3447	0.411756175	1.648676506	0.784126833	1.173830737	2.280242	0.4027	1.633533111	6.236408169	0.732998	5.244563386	0	0.013496569	2.261767082	7.071435333	13.03659193	0.24721412	2.141322258	0	0	4.241215	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9066
H7188_003_0	2008	13	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0									0		279.96	6.01	478.72	200.52	67.07	4.34	1.32	317.34	374.77	5894.55	2576.96		7.87	502.36	4587.3	3435.55	44.89	428.44			15.59			5.3	2.99		0.77			0.02	0.06	0.08	3.38									$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$5/Visit	$100/Trip	20% Coins	0% Coins	$50/Visit	$100/Visit	$0/Visit	$0-$75/Visit		$0-$50/Proc	$0-$75/Visit	$10/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins			Plan 750	Plan ($200 Allowance)		Plan 828			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers									482.713559	482.713053	25.199907	4.388307	87.766136	0.175532	0	43.883063	87.766116	0	12.719613		14.627369	25.312642	8.776608	26.329829	33.667845	43.883045			0.175532			0	0		0			0	0	0	0									11.2617	0.241758787	1.00530829	0.07332861	0.490539562	0.76180888	0	1.160487601	2.741008941	0	2.731494493	0	0.009593116	1.05967157	3.355077823	7.538120335	0.125945797	1.566770983	0	0	2.73654388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.8592	0	5.137704235	11.2617	0.241758787	1.00530829	0.07332861	0.490539562	0.76180888	0	1.160487601	2.741008941	0	2.731494493	0	0.009593116	1.05967157	3.355077823	7.538120335	0.125945797	1.566770983	0	0	2.73654388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.8592	5000	30% Coins	30% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	$100/Trip	25% Coins	25% Coins	$50/Visit	25% Coins	25% Coins	25% Coins		$0-$50/Proc	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins			Plan 750	Plan ($200 Allowance)		Plan 828			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers									8.6519	0.0975	0.3548	0.5543	0.4905	1.0524	0.3205	0.2048	2.3533	0.5834	1.573		0.0017	0.7857	2.4332	2.001	0.0677	0.2123			0.6393			0	0		0			0	0	0	0									22.3773	0	3.119215946	19.9136	0.339293787	1.36014729	0.62758261	0.981070562	1.81417788	0.320509	1.365280601	5.094338941	0.583391	4.304471493	0	0.011285116	1.84536657	5.788238823	9.539112335	0.193694797	1.779067983	0	0	3.37582088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.2364
H7188_801_0	2008	3																					1400											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		289.01	6.2	494.2	207	69.24	4.65	1.59	327.6	386.88	6085.15	2660.29		8.12	518.6	4727.37	3541.13	46.34	442.29			16.82																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					416.627996	416.628089	13.398813	0	46.292002	0.092583	0.092584	23.146007	92.584006	17.383462	43.935574		15.430714	40.662529	9.258399	13.887601	27.43412	46.292			0.092584																					10.0341	0.215257846	0.551807782	0	0.267104852	0.43051095	0.14720856	0.631885991	2.984908353	8.815081149	9.740114013	0	0.01044145	1.757298962	3.64732314	4.098150044	0.105941427	1.70620739	0	0	1.55726288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7006	0	54.18218901	10.0341	0.215257846	0.551807782	0	0.267104852	0.43051095	0.14720856	0.631885991	2.984908353	8.815081149	9.740114013	0	0.01044145	1.757298962	3.64732314	4.098150044	0.105941427	1.70620739	0	0	1.55726288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7006	1000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					4.1611	0.0469	0.2006	0.3133	0.3093	0.5949	0.2037	0.3516	1.3369	0.331	0.8952		0.0058	0.4471	1.3694	1.1274	0.0383	0.1208			0.3638																					12.2174	0	14.17464007	14.1953	0.262167846	0.752413782	0.313345	0.576409852	1.02546095	0.35091056	0.983488991	4.321814353	9.146083149	10.63531601	0	0.01623445	2.204426962	5.01675714	5.225584044	0.144243427	1.82702839	0	0	1.92108388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.918
H7188_802_0	2008	3																					1400											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		289.01	6.2	494.2	207	69.24	4.65	1.59	327.6	386.88	6085.15	2660.29		8.12	518.6	4727.37	3541.13	46.34	442.29			16.82																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					416.627996	416.628089	13.398813	0	46.292002	0.092583	0.092584	23.146007	92.584006	17.383462	43.935574		15.430714	40.662529	9.258399	13.887601	27.43412	46.292			0.092584																					10.0341	0.215257846	0.551807782	0	0.267104852	0.43051095	0.14720856	0.631885991	2.984908353	8.815081149	9.740114013	0	0.01044145	1.757298962	3.64732314	4.098150044	0.105941427	1.70620739	0	0	1.55726288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7006	0	54.18218901	10.0341	0.215257846	0.551807782	0	0.267104852	0.43051095	0.14720856	0.631885991	2.984908353	8.815081149	9.740114013	0	0.01044145	1.757298962	3.64732314	4.098150044	0.105941427	1.70620739	0	0	1.55726288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7006	1000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					4.1611	0.0469	0.2006	0.3133	0.3093	0.5949	0.2037	0.3516	1.3369	0.331	0.8952		0.0058	0.4471	1.3694	1.1274	0.0383	0.1208			0.3638																					12.2174	0	14.17464007	14.1953	0.262167846	0.752413782	0.313345	0.576409852	1.02546095	0.35091056	0.983488991	4.321814353	9.146083149	10.63531601	0	0.01623445	2.204426962	5.01675714	5.225584044	0.144243427	1.82702839	0	0	1.92108388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.918
H7188_803_0	2008	3																					1400											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		289.01	6.2	494.2	207	69.24	4.65	1.59	327.6	386.88	6085.15	2660.29		8.12	518.6	4727.37	3541.13	46.34	442.29			16.82																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					416.627996	416.628089	13.398813	0	46.292002	0.092583	0.092584	23.146007	92.584006	17.383462	43.935574		15.430714	40.662529	9.258399	13.887601	27.43412	46.292			0.092584																					10.0341	0.215257846	0.551807782	0	0.267104852	0.43051095	0.14720856	0.631885991	2.984908353	8.815081149	9.740114013	0	0.01044145	1.757298962	3.64732314	4.098150044	0.105941427	1.70620739	0	0	1.55726288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7006	0	54.18218901	10.0341	0.215257846	0.551807782	0	0.267104852	0.43051095	0.14720856	0.631885991	2.984908353	8.815081149	9.740114013	0	0.01044145	1.757298962	3.64732314	4.098150044	0.105941427	1.70620739	0	0	1.55726288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7006	1000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					4.1611	0.0469	0.2006	0.3133	0.3093	0.5949	0.2037	0.3516	1.3369	0.331	0.8952		0.0058	0.4471	1.3694	1.1274	0.0383	0.1208			0.3638																					12.2174	0	14.17464007	14.1953	0.262167846	0.752413782	0.313345	0.576409852	1.02546095	0.35091056	0.983488991	4.321814353	9.146083149	10.63531601	0	0.01623445	2.204426962	5.01675714	5.225584044	0.144243427	1.82702839	0	0	1.92108388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.918
H7188_804_0	2008	3																					1400											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		289.01	6.2	494.2	207	69.24	4.65	1.59	327.6	386.88	6085.15	2660.29		8.12	518.6	4727.37	3541.13	46.34	442.29			16.82																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					416.627996	416.628089	13.398813	0	46.292002	0.092583	0.092584	23.146007	92.584006	17.383462	43.935574		15.430714	40.662529	9.258399	13.887601	27.43412	46.292			0.092584																					10.0341	0.215257846	0.551807782	0	0.267104852	0.43051095	0.14720856	0.631885991	2.984908353	8.815081149	9.740114013	0	0.01044145	1.757298962	3.64732314	4.098150044	0.105941427	1.70620739	0	0	1.55726288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7006	0	54.18218901	10.0341	0.215257846	0.551807782	0	0.267104852	0.43051095	0.14720856	0.631885991	2.984908353	8.815081149	9.740114013	0	0.01044145	1.757298962	3.64732314	4.098150044	0.105941427	1.70620739	0	0	1.55726288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7006	1000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					4.1611	0.0469	0.2006	0.3133	0.3093	0.5949	0.2037	0.3516	1.3369	0.331	0.8952		0.0058	0.4471	1.3694	1.1274	0.0383	0.1208			0.3638																					12.2174	0	14.17464007	14.1953	0.262167846	0.752413782	0.313345	0.576409852	1.02546095	0.35091056	0.983488991	4.321814353	9.146083149	10.63531601	0	0.01623445	2.204426962	5.01675714	5.225584044	0.144243427	1.82702839	0	0	1.92108388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.918
H7200_006_0	2008	3																					0											Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	353.01605	24.14865	131.54	0	22.02	38.03	28.6	9.73	19.38	17.04	29.36	0.97	1.15	54.83	64.87	116.49	7.33	4.01	21.64	36.87	9.29	4.24	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Medicare FFS cost sharing	1B IP Psych: Medicare FFS cost sharing	2 SNF: Medicare FFS cost sharing	6 Home Health: $0	10A Ambulance: Medicare FFS cost sharing	11A DME: Medicare FFS cost sharing	"11B Prosthetic/Medical Supplies: Medicare FFS cost sharing, 11C Diabetes Monitoring Supplies: Medicare FFS cost sharing"	"4A ER: Medicare FFS cost sharing, 4B Urgent Care: Medicare FFS cost sharing"	9B ASC Services: Medicare FFS cost sharing	8A OP C/D/T: Medicare FFS cost sharing	8B OP X-Ray: Medicare FFS cost sharing	9A OP Hospital: Medicare FFS cost sharing	12 Renal Dialysis: Medicare FFS cost sharing	"3 CORF: Medicare FFS cost sharing, 5 Partial Hosp: Medicare FFS cost sharing, 9C OP Substance Abuse: Medicare FFS cost sharing, 9D Cardiac Rehab: Medicare FFS cost sharing"	"7A PCP: Medicare FFS cost sharing, 14B Immunizations: Medicare FFS cost sharing, 14C Routine Physical Exams: Medicare FFS cost sharing, 14D Pap Smears: Medicare FFS cost sharing, 14D Pelvic Exams: Medicare FFS cost sharing, 14E Prostate Screening: Medicare FFS cost sharing, 14F Colorectal Screening: Medicare FFS cost sharing, 14G Bone Mass Measurement: Medicare FFS cost sharing, 14H Mammography: Medicare FFS cost sharing, 14I Diabetes Monitoring: Medicare FFS cost sharing"	"7D Physician Specialist: Medicare FFS cost sharing,"	"7E Mental Health: Medicare FFS cost sharing, 7H Psychiatric: Medicare FFS cost sharing"	"7C Occupational Therapy: Medicare FFS cost sharing, 7I Physical and Speech Therapy: Medicare FFS cost sharing"	7D Physician Specialist: Medicare FFS cost sharing	"7B Chiropractic: Medicare FFS cost sharing, 7F Podiatry: Medicare FFS cost sharing, 7G Other Health Care: Medicare FFS cost sharing, 18A Medicare Covered Hearing Exams: Medicare FFS cost sharing"	15 Part B Drugs: Medicare FFS cost sharing	"13A Blood: Medicare FFS cost sharing, 16B Medicare Covered Comprehensive Dental Services: Medicare FFS cost sharing, 17A Medicare Covered Eye Exams: Medicare FFS cost sharing"	10B Transportation: $0	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental:Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.07710121	0.077118743	0.203108001	0	0.234004961	0.23396012	0.234015936	0.233991821	0.233996244	0.233984534	0.233985379	0.234022405	0.233997478	0.234020115	0.232787565	0.234007361	0.233993192	0.233857596	0.234000396	0.227877052	0.233983193	0.234003386	0	0	0	0	0	0	0	0	0											27.218	1.862313524	26.7168265	0	5.15278925	8.89750335	6.692855762	2.276740417	4.5348472	3.987096467	6.869810733	0.227001733	0.2690971	12.83132292	15.10092934	27.25951744	1.7151701	0.937768958	5.063768567	8.401826925	2.173703867	0.992174358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	169.181	0	0	27.218	1.862313524	26.7168265	0	5.15278925	8.89750335	6.692855762	2.276740417	4.5348472	3.987096467	6.869810733	0.227001733	0.2690971	12.83132292	15.10092934	27.25951744	1.7151701	0.937768958	5.063768567	8.401826925	2.173703867	0.992174358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	169.181	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.218	1.862313524	26.7168265	0	5.15278925	8.89750335	6.692855762	2.276740417	4.5348472	3.987096467	6.869810733	0.227001733	0.2690971	12.83132292	15.10092934	27.25951744	1.7151701	0.937768958	5.063768567	8.401826925	2.173703867	0.992174358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	169.181
H7200_007_0	2008	5																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	799.11	12.28	780.0032	0	293.74	17.64	10.74	297.54	285.8	0	1276.27	36.69	0.57	718.05	5236.77	5910.5	154.28	466.22	2373.56	1555.38	377.91	721.32	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute:   $150   for 1st 10   Days	1B IP Psych:   $150   for 1st 10   Days	2 SNF:   $75   for Days 7   - 100	6 Home Health:   $0	10A Ambulance:     $100	11A DME:     20%	"11B Prosthetic Medical Supplies:      20%,  11C Diabetes Monitoring Supplies:     20%"	"4A ER:     $50,  4B Urgent Care:     $25"	9B ASC Services:     $200	8A OP Clinical/Diagnostic/Therapy Radiological Lab Services:      $0	8B OP X-Ray:     $17.6	"5 Partial Hospitalization:     $149.02,  9A OP Hospital,  $200"	12 Renal Dialysis:      $15	"3 CORF ,  200,  9D Cardiac Rehab:     $35"	"7A PCP:     $15,  14B Immunizations:     $0,  14C Routine Physical Exams:     $0,  14D Pap Smears:      $,  14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement:      $15.5,  14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist:     $35	"7E Mental Health:     $35,  7H Psychiatric:     $35,  9C OP Substance Abuse,  35"	"7C Occupational Therapy:     $35,  7I Physical and Speech Therapy:     $35"	7D Physician Specialist Services - Radiology:   15.5	"7G Other Health Care:     $35,  18A Medicare Covered Hearing Exams:   $35,  7B Chiropractic:     $35,  7F Podiatry:     $35"	15 Part B Drugs:     $200	"13A Blood:     $200,  16B Medicare Covered Comprehensive Dental Services:     $35,  17A Medicare Covered Eye Exams:   $35"	"10B Transportation:     $0,  Number of Trips Covered - 12"	"16A Preventive Dental Services:   $0,  16B Non Medicare Covered Comprehensive Dental:   $0"	17A Routine Eye Exams:    $0	17B Eye Wear: $0	18A Routine Hearing Exams:   $0	18B Hearing Aids:   $0	19 POS:   $0	14A Health Education/Wellness Programs:   $0	13B Acupuncture: Not Covered											150	150	75	0	100	0.200020446	0.197867969	48.69513343	200	0	17.6	149.0188062	15	147.1437694	15	35	35	35	15.5	35	105.1425	38.66910664	0	0	0	0	0	0	0	0	0											9.9889	0.1535	4.87502	0	2.447833333	3.528360667	2.125101983	1.207395833	4.763333333	0	1.871862667	0.455625	0.0007125	8.804715299	6.5459625	17.23895833	0.449983333	1.359808333	3.065848333	4.536525	3.311200181	2.3244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.055	0	0	9.9889	0.1535	4.87502	0	2.447833333	3.528360667	2.125101983	1.207395833	4.763333333	0	1.871862667	0.455625	0.0007125	8.804715299	6.5459625	17.23895833	0.449983333	1.359808333	3.065848333	4.536525	3.311200181	2.3244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.9889	0.1535	4.87502	0	2.447833333	3.528360667	2.125101983	1.207395833	4.763333333	0	1.871862667	0.455625	0.0007125	8.804715299	6.5459625	17.23895833	0.449983333	1.359808333	3.065848333	4.536525	3.311200181	2.3244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.055
H7200_008_0	2008	5																					3250											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											20.6813	0.1615	3.8731	4.1547	0	1.7165	1.0457	0	2.4092	1.202	3.2674	0.0787	0.0104	1.9371	0	0	0	0	0	0	0.8593	0.0632	0	0	0	0	0	0	0	0	0											41.46	0	0	0	0	0	293.74	0	0	298.01	0	0	0	0	0	364.05	5285.89	5948.45	154.34	466.22	356.03	1555.38	0	705.28	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute:   $0	1B IP Psych:   $0	2 SNF:   $0	6 Home Health:   $0	10A Ambulance:     $100	11A DME:     $0	"11B Prosthetic Medical Supplies:      $0,11C Diabetes Monitoring Supplies:     $0"	"4A ER:     $50,4B Urgent Care:     $25"	9B ASC Services:     $0	8A OP Clinical/Diagnostic/Therapy Radiological Lab Services:      $0	8B OP X-Ray:     $0	"9A OP Hospital,  $0,  5 Partial Hosp:     $0"	12 Renal Dialysis:      $0	"3 CORF:,  $0,   9D Cardiac Rehab:     $35"	"7A PCP:     $10,  14B Immunizations:     $0,  14C Routine Physical Exams:     $0,  14D Pap Smears:      $,  14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement:75,   14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist:     $35	"7E Mental Health:     $35,  7H Psychiatric:     $35,     9C OP Substance Abuse: $35"	"7C Occupational Therapy:     $35,  7I Physical and Speech Therapy:     $35"	7D Physician Specialist Services - Radiology:   $75	"7G Other Health Care:     $35,  18A Medicare Covered Hearing Exams:   $35,  7B Chiropractic:     $35,  7F Podiatry:     $35"	15 Part B Drugs:     $0	"13A Blood:     $0,  16B Medicare Covered Comprehensive Dental Services:     $35,  17A Medicare Covered Eye Exams:   $35"	"10B Transportation:     $0,  Number of Trips Covered - 12"	"16A Preventive Dental Services:   $0,  16B Non Medicare Covered Comprehensive Dental:    $0"	17A Routine Eye Exams:    $0	17B Eye Wear:    $0	18A Routine Hearing Exams:   $0	18B Hearing Aids:   $0	19 POS:   $0	14A Health Education/Wellness Programs:   $0	13B Acupuncture: Not Covered											0	0	0	0	100	0	0	48.6829301	0	0	0	0	0	35	10	35	35	35	75	35	0	35	0	0	0	0	0	0	0	0	0											0	0	0	0	2.447833333	0	0	1.209	0	0	0	0	0	1.0618125	4.404908333	17.34964583	0.450158333	1.359808333	2.2251875	4.536525	0	2.057066667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.1019	1500	0	20.6813	0.161508265	3.873092444	4.154696599	2.447833333	1.716542976	1.045662488	1.209	2.40916496	1.201994207	3.267436448	0.078683514	0.010353094	2.998876377	4.404908333	17.34964583	0.450158333	1.359808333	2.2251875	4.536525	0.859306797	2.12022054	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.5619	3250	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.6813	0.161508265	3.873092444	4.154696599	2.447833333	1.716542976	1.045662488	1.209	2.40916496	1.201994207	3.267436448	0.078683514	0.010353094	2.998876377	4.404908333	17.34964583	0.450158333	1.359808333	2.2251875	4.536525	0.859306797	2.12022054	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.5619
H7226_001_0	2008	10																																A	A	D	V	T	P	P	V	V	P	P	V	V	V	P	P	V	V	P	P	S	V	P	P	P	P	P	P	P	P	P																																																				0									354.4201463						289.9754986	3239.635858	5246.889927	676.1264686	484.030531		76.5841378							279															1a (IP Acute) - $0; 1a1 (Add'l Days) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $0	11a (Medical Equip) - $0	"11b (Med Supp), 11c (Diab Supp) - $0"	"4a (ER) $50 (WW Coverage), 4b (UC) - $15"	"9a (OP Surgery), 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $15"	"14j (Nutrition Therap) - $15; 14i (Diab Mon.) - $15; 7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro), 7d (Spec), 7f (Pod) - $15; 17a (MCR Eye Exam) - $15; 18a (MCR Hearing Exam) - $15"	"7e (MH), 7h (Psychiatric) - $15"	"7c (OT), 7i (PT/ST) - $15"	8b (Professional Radiology) - 0%	7g (Prof. Other - allergy visits)  - $5	15 (Part B Rx) - $0				17a1 (Rountine Eye Exam) - $100 limit	17b1 (Non MCR Covered) - $200 limit	18a1 (Hearing Exam Non-covered) - $15; 18a2 (Fit & Eval for Hearing Aids) - $15	18b (Hearing Aids) - $500 limit																					43.0038						15	15	15	15	15		5							15															0	0	0	0	0	0	0	1.270118238	0	0	0	0	0	0.362469373	4.049544822	6.558612409	0.845158086	0.605038164	0	0.031910057	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.0716	0	0	0	0	0	0	0	0	0	1.270118238	0	0	0	0	0	0.362469373	4.049544822	6.558612409	0.845158086	0.605038164	0	0.031910057	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.0716																																																																																				0	0	0	0	0	0	0	0	0	0	1.270118238	0	0	0	0	0	0.362469373	4.049544822	6.558612409	0.845158086	0.605038164	0	0.031910057	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.0716
H7226_002_0	2008	6																					3250											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	P	P	V	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P	P																																																				0		1610.556627	122.4508757	1176.330442		291.6652018	7.544250431	7.181715139	354.4201463	281.0071808		17.00528593			289.9754986	3239.635858	5246.889927	676.1264686	484.030531		76.5841378																						"1a (IP Acute), 1a1 (Add'l Days) - $150 days 1-5"	1b (IP Psych) - $150 days 1-5	2 (SNF) - $115 days 11-100	6a (Home Health) - $0	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%,11b1 (Prosthetics) - 30%"	"4a (ER) $50 (WW Coverage), 4b (UC) - $15"	"9a (OP Surgery) - $100, 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	"8b1 (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%"		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $25"	"14j (Nutrition Therap) - $25; 14i (Diab Mon.) - $25; 7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro) - $25, 7d (Spec) - $15, 7f (Pod) - $25; 18a (MCR Hearing Exam) - $25, 17a (Eye Exam) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"	8b (Professional Radiology) - 0%	7g (Prof. Other) - $5 [allergy tests]	15 (Part B Rx) - 0%																					77.4285	77.4285	52.5198		125.6957	0.167594229	0.19576605	36.036	83.7971		0.167594229			20.9493	12.5929	15.6447	20.9493	20.9493		4.1899																						10.3919	0.790099314	5.1483907	0	3.055087788	1.264372834	1.405936006	1.064322434	1.962299242	0	2.849987784	0	0	0.50623146	3.399692263	6.840497464	1.180363481	0.845007538	0	0.026739707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7309	0	7.875675537	10.3919	0.790099314	5.1483907	0	3.055087788	1.264372834	1.405936006	1.064322434	1.962299242	0	2.849987784	0	0	0.50623146	3.399692263	6.840497464	1.180363481	0.845007538	0	0.026739707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7309																																																																																				0	0	0	10.3919	0.790099314	5.1483907	0	3.055087788	1.264372834	1.405936006	1.064322434	1.962299242	0	2.849987784	0	0	0.50623146	3.399692263	6.840497464	1.180363481	0.845007538	0	0.026739707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7309
H7226_006_0	2008	3																					3250											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	P	P	V	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P	P																																																				0		1610.556627	122.4508757	1176.330442		291.6652018	7.544250431	7.181715139	354.4201463	281.0071808		17.00528593			289.9754986	3239.635858	5246.889927	676.1264686	484.030531		76.5841378																						"1a (IP Acute), 1a1 (Add'l Days) - $150 days 1-5"	1b (IP Psych) - $150 days 1-5	2 (SNF) - $115 days 11-100	6a (Home Health) - $0	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%,11b1 (Prosthetics) - 30%"	"4a (ER) $50 (WW Coverage), 4b (UC) - $15"	"9a (OP Surgery) - $100, 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	"8b1 (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%"		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $25"	"14j (Nutrition Therap) - $25; 14i (Diab Mon.) - $25; 7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro) - $25, 7d (Spec) - $15, 7f (Pod) - $25; 18a (MCR Hearing Exam) - $25, 17a (Eye Exam) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"	8b (Professional Radiology) - 0%	7g (Prof. Other) - $5 [allergy tests]	15 (Part B Rx) - 0%																					77.4285	77.4285	52.5198		125.6957	0.167594229	0.19576605	36.036	83.7971		0.167594229			20.9493	12.5929	15.6447	20.9493	20.9493		4.1899																						10.3919	0.790099314	5.1483907	0	3.055087788	1.264372834	1.405936006	1.064322434	1.962299242	0	2.849987784	0	0	0.50623146	3.399692263	6.840497464	1.180363481	0.845007538	0	0.026739707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7309	0	7.875675537	10.3919	0.790099314	5.1483907	0	3.055087788	1.264372834	1.405936006	1.064322434	1.962299242	0	2.849987784	0	0	0.50623146	3.399692263	6.840497464	1.180363481	0.845007538	0	0.026739707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7309																																																																																				0	0	0	10.3919	0.790099314	5.1483907	0	3.055087788	1.264372834	1.405936006	1.064322434	1.962299242	0	2.849987784	0	0	0.50623146	3.399692263	6.840497464	1.180363481	0.845007538	0	0.026739707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7309
H7226_007_0	2008	10																																A	A	D	V	T	P	P	V	V	P	P	V	V	V	P	P	V	V	P	P	S	V	P	P	P	P	P	P	P	P	P																																																				0									318.0307445						298.715909	3434.268421	5941.641054	1254.443964	784.3263738		67.53289639							279															1a (IP Acute) - $0; 1a1 (Add'l Days) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $0	11a (Medical Equip) - $0	"11b (Med Supp), 11c (Diab Supp) - $0"	"4a (ER) $50 (WW Coverage), 4b (UC) - $15"	"9a (OP Surgery), 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $15"	"14j (Nutrition Therap) - $15; 14i (Diab Mon.) - $15; 7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro), 7d (Spec), 7f (Pod) - $15; 17a (MCR Eye Exam) - $15; 18a (MCR Hearing Exam) - $15"	"7e (MH), 7h (Psychiatric) - $15"	"7c (OT), 7i (PT/ST) - $15"	8b (Professional Radiology) - 0%	7g (Prof. Other - allergy visits)  - $5	15 (Part B Rx) - $0				17a1 (Rountine Eye Exam) - $100 limit	17b1 (Non MCR Covered) - $200 limit	18a1 (Hearing Exam Non-covered) - $15; 18a2 (Fit & Eval for Hearing Aids) - $15	18b (Hearing Aids) - $500 limit																					43.0047						15	15	15	15	15		5							15															0	0	0	0	0	0	0	1.139735403	0	0	0	0	0	0.373394886	4.292835526	7.427051317	1.568054955	0.980407967	0	0.028138707	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.1584	0	0	0	0	0	0	0	0	0	1.139735403	0	0	0	0	0	0.373394886	4.292835526	7.427051317	1.568054955	0.980407967	0	0.028138707	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.1584																																																																																				0	0	0	0	0	0	0	0	0	0	1.139735403	0	0	0	0	0	0.373394886	4.292835526	7.427051317	1.568054955	0.980407967	0	0.028138707	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.1584
H7226_008_0	2008	6																					3250											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	P	P	V	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P	P																																																				0		1965.06185	195.7844574	1302.505386		345.5804809	6.959089222	6.637604857	318.0307445	330.5809316		18.01836891			298.715909	3434.268421	5941.641054	1254.443964	784.3263738		67.53289639																						"1a (IP Acute), 1a1 (Add'l Days) - $150 days 1-5"	1b (IP Psych) - $150 days 1-5	2 (SNF) - $115 days 11-100	6a (Home Health) - $0	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%,11b1 (Prosthetics) - 30%"	"4a (ER) $50 (WW Coverage), 4b (UC) - $15"	"9a (OP Surgery) - $100, 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	"8b1 (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%"		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $25"	"14j (Nutrition Therap) - $25; 14i (Diab Mon.) - $25; 7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro) - $25, 7d (Spec) - $15, 7f (Pod) - $25; 18a (MCR Hearing Exam) - $25, 17a (Eye Exam) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"	8b (Professional Radiology) - 0%	7g (Prof. Other) - $5 [allergy tests]	15 (Part B Rx) - 0%																					74.6564	74.6564	50.6395		121.1955	0.161593996	0.192935125	34.7465	80.797		0.161593996			20.1992	12.1559	14.8882	20.1992	20.1992		4.0398																						12.2254	1.218047326	5.496520474	0	3.490233183	1.124547038	1.280627121	0.920871992	2.225828909	0	2.911660238	0	0	0.502819765	3.478881497	7.371677486	2.111568887	1.320233678	0	0.02273523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7016	0	10.8618941	12.2254	1.218047326	5.496520474	0	3.490233183	1.124547038	1.280627121	0.920871992	2.225828909	0	2.911660238	0	0	0.502819765	3.478881497	7.371677486	2.111568887	1.320233678	0	0.02273523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7016																																																																																				0	0	0	12.2254	1.218047326	5.496520474	0	3.490233183	1.124547038	1.280627121	0.920871992	2.225828909	0	2.911660238	0	0	0.502819765	3.478881497	7.371677486	2.111568887	1.320233678	0	0.02273523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7016
H7226_009_0	2008	4																					3250											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	P	P	V	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P	P																																																				0		1965.06185	195.7844574	1302.505386		345.5804809	6.959089222	6.637604857	318.0307445	330.5809316		18.01836891			298.715909	3434.268421	5941.641054	1254.443964	784.3263738		67.53289639																						"1a (IP Acute), 1a1 (Add'l Days) - $150 days 1-5"	1b (IP Psych) - $150 days 1-5	2 (SNF) - $115 days 11-100	6a (Home Health) - $0	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%,11b1 (Prosthetics) - 30%"	"4a (ER) $50 (WW Coverage), 4b (UC) - $15"	"9a (OP Surgery) - $100, 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	"8b1 (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%"		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $25"	"14j (Nutrition Therap) - $25; 14i (Diab Mon.) - $25; 7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro) - $25, 7d (Spec) - $15, 7f (Pod) - $25; 18a (MCR Hearing Exam) - $25, 17a (Eye Exam) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"	8b (Professional Radiology) - 0%	7g (Prof. Other) - $5 [allergy tests]	15 (Part B Rx) - 0%																					74.6564	74.6564	50.6395		121.1955	0.161593996	0.192935125	34.7465	80.797		0.161593996			20.1992	12.1559	14.8882	20.1992	20.1992		4.0398																						12.2254	1.218047326	5.496520474	0	3.490233183	1.124547038	1.280627121	0.920871992	2.225828909	0	2.911660238	0	0	0.502819765	3.478881497	7.371677486	2.111568887	1.320233678	0	0.02273523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7016	0	10.8618941	12.2254	1.218047326	5.496520474	0	3.490233183	1.124547038	1.280627121	0.920871992	2.225828909	0	2.911660238	0	0	0.502819765	3.478881497	7.371677486	2.111568887	1.320233678	0	0.02273523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7016																																																																																				0	0	0	12.2254	1.218047326	5.496520474	0	3.490233183	1.124547038	1.280627121	0.920871992	2.225828909	0	2.911660238	0	0	0.502819765	3.478881497	7.371677486	2.111568887	1.320233678	0	0.02273523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7016
H7226_010_0	2008	10																																A	A	D	V	T	P	P	V	V	P	P	V	V	V	P	P	V	V	P	P	S	V	P	P	P	P	P	P	P	P	P																																																				0									387.431756						292.131994	3210.710546	4902.654954	811.7507179	467.647904		68.34225092							279															1a (IP Acute) - $0; 1a1 (Add'l Days) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $0	11a (Medical Equip) - $0	"11b (Med Supp), 11c (Diab Supp) - $0"	"4a (ER) $50 (WW Coverage), 4b (UC) - $15"	"9a (OP Surgery), 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $15"	"14j (Nutrition Therap) - $15; 14i (Diab Mon.) - $15; 7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro), 7d (Spec), 7f (Pod) - $15; 17a (MCR Eye Exam) - $15; 18a (MCR Hearing Exam) - $15"	"7e (MH), 7h (Psychiatric) - $15"	"7c (OT), 7i (PT/ST) - $15"	8b (Professional Radiology) - 0%	7g (Prof. Other - allergy visits)  - $5	15 (Part B Rx) - $0				17a1 (Rountine Eye Exam) - $100 limit	17b1 (Non MCR Covered) - $200 limit	18a1 (Hearing Exam Non-covered) - $15; 18a2 (Fit & Eval for Hearing Aids) - $15	18b (Hearing Aids) - $500 limit																					43.0038						15	15	15	15	15		5							15															0	0	0	0	0	0	0	1.388418367	0	0	0	0	0	0.365164993	4.013388183	6.128318692	1.014688397	0.58455988	0	0.028475938	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.8718	0	0	0	0	0	0	0	0	0	1.388418367	0	0	0	0	0	0.365164993	4.013388183	6.128318692	1.014688397	0.58455988	0	0.028475938	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.8718																																																																																				0	0	0	0	0	0	0	0	0	0	1.388418367	0	0	0	0	0	0.365164993	4.013388183	6.128318692	1.014688397	0.58455988	0	0.028475938	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.8718
H7226_011_0	2008	9																																A	A	D	V	T	P	P	V	V	P	P	V	V	V	P	P	V	V	P	P	S	V	P	P	P	P	P	P	P	P	P																																																				0									348.4930719						303.711062	3591.48837	5106.536269	771.7709727	469.0496856		97.46133438							279															1a (IP Acute) - $0; 1a1 (Add'l Days) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $0	11a (Medical Equip) - $0	"11b (Med Supp), 11c (Diab Supp) - $0"	"4a (ER) $50 (WW Coverage), 4b (UC) - $15"	"9a (OP Surgery), 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $15"	"14j (Nutrition Therap) - $15; 14i (Diab Mon.) - $15; 7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro), 7d (Spec), 7f (Pod) - $15; 17a (MCR Eye Exam) - $15; 18a (MCR Hearing Exam) - $15"	"7e (MH), 7h (Psychiatric) - $15"	"7c (OT), 7i (PT/ST) - $15"	8b (Professional Radiology) - 0%	7g (Prof. Other - allergy visits)  - $5	15 (Part B Rx) - $0				17a1 (Rountine Eye Exam) - $100 limit	17b1 (Non MCR Covered) - $200 limit	18a1 (Hearing Exam Non-covered) - $15; 18a2 (Fit & Eval for Hearing Aids) - $15	18b (Hearing Aids) - $500 limit																					43.0045						15	15	15	15	15		5							15															0	0	0	0	0	0	0	1.248897038	0	0	0	0	0	0.379638828	4.489360463	6.383170336	0.964713716	0.586312107	0	0.040608889	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4415	0	0	0	0	0	0	0	0	0	1.248897038	0	0	0	0	0	0.379638828	4.489360463	6.383170336	0.964713716	0.586312107	0	0.040608889	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4415																																																																																				0	0	0	0	0	0	0	0	0	0	1.248897038	0	0	0	0	0	0.379638828	4.489360463	6.383170336	0.964713716	0.586312107	0	0.040608889	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4415
H7226_012_0	2008	6																					3250											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	P	P	V	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P	P																																																				0		1477.298165	166.781336	1186.319181		293.578424	8.025267754	7.264432147	387.431756	304.5486326		17.11511998			292.131994	3210.710546	4902.654954	811.7507179	467.647904		68.34225092																						"1a (IP Acute), 1a1 (Add'l Days) - $150 days 1-5"	1b (IP Psych) - $150 days 1-5	2 (SNF) - $115 days 11-100	6a (Home Health) - $0	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%,11b1 (Prosthetics) - 30%"	"4a (ER) $50 (WW Coverage), 4b (UC) - $15"	"9a (OP Surgery) - $100, 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	"8b1 (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%"		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $25"	"14j (Nutrition Therap) - $25; 14i (Diab Mon.) - $25; 7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro) - $25, 7d (Spec) - $15, 7f (Pod) - $25; 18a (MCR Hearing Exam) - $25, 17a (Eye Exam) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"	8b (Professional Radiology) - 0%	7g (Prof. Other) - $5 [allergy tests]	15 (Part B Rx) - 0%																					77.5758	77.5758	52.6197		125.9347	0.167912887	0.190287323	36.1044	83.9564		0.167912887			20.9891	12.6057	16.0205	20.9891	20.9891		4.1978																						9.5502	1.078182322	5.20198005	0	3.080975048	1.347545879	1.382329348	1.165666683	2.130735007	0	2.87384921	0	0	0.510965901	3.372777371	6.545259202	1.419827153	0.817959476	0	0.023907385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5022	0	7.739713851	9.5502	1.078182322	5.20198005	0	3.080975048	1.347545879	1.382329348	1.165666683	2.130735007	0	2.87384921	0	0	0.510965901	3.372777371	6.545259202	1.419827153	0.817959476	0	0.023907385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5022																																																																																				0	0	0	9.5502	1.078182322	5.20198005	0	3.080975048	1.347545879	1.382329348	1.165666683	2.130735007	0	2.87384921	0	0	0.510965901	3.372777371	6.545259202	1.419827153	0.817959476	0	0.023907385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5022
H7226_013_0	2008	6																					3250											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	P	P	V	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P	P																																																				0		1368.298837	119.7564969	1011.901463		266.0271013	7.356996668	7.375433546	348.4930719	275.5103974		16.88503364			303.711062	3591.48837	5106.536269	771.7709727	469.0496856		97.46133438																						"1a (IP Acute), 1a1 (Add'l Days) - $150 days 1-5"	1b (IP Psych) - $150 days 1-5	2 (SNF) - $115 days 11-100	6a (Home Health) - $0	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%,11b1 (Prosthetics) - 30%"	"4a (ER) $50 (WW Coverage), 4b (UC) - $15"	"9a (OP Surgery) - $100, 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	"8b1 (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%"		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $25"	"14j (Nutrition Therap) - $25; 14i (Diab Mon.) - $25; 7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro) - $25, 7d (Spec) - $15, 7f (Pod) - $25; 18a (MCR Hearing Exam) - $25, 17a (Eye Exam) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"	8b (Professional Radiology) - 0%	7g (Prof. Other) - $5 [allergy tests]	15 (Part B Rx) - 0%																					78.4827	78.4827	53.2349		127.407	0.169876009	0.199870442	36.5271	84.938		0.169876009			21.2345	12.7711	16.1185	21.2345	21.2345		4.2469																						8.949	0.783234597	4.489038958	0	2.824476394	1.249777233	1.474131164	1.060788224	1.950108617	0	2.86836213	0	0	0.537429408	3.822259148	6.859148218	1.365680967	0.830003007	0	0.03449238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0979	0	6.933205136	8.949	0.783234597	4.489038958	0	2.824476394	1.249777233	1.474131164	1.060788224	1.950108617	0	2.86836213	0	0	0.537429408	3.822259148	6.859148218	1.365680967	0.830003007	0	0.03449238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0979																																																																																				0	0	0	8.949	0.783234597	4.489038958	0	2.824476394	1.249777233	1.474131164	1.060788224	1.950108617	0	2.86836213	0	0	0.537429408	3.822259148	6.859148218	1.365680967	0.830003007	0	0.03449238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0979
H7226_014_0	2008	4																					3250											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	P	P	V	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P	P																																																				0		1477.298165	166.781336	1186.319181		293.578424	8.025267754	7.264432147	387.431756	304.5486326		17.11511998			292.131994	3210.710546	4902.654954	811.7507179	467.647904		68.34225092																						"1a (IP Acute), 1a1 (Add'l Days) - $150 days 1-5"	1b (IP Psych) - $150 days 1-5	2 (SNF) - $115 days 11-100	6a (Home Health) - $0	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%,11b1 (Prosthetics) - 30%"	"4a (ER) $50 (WW Coverage), 4b (UC) - $15"	"9a (OP Surgery) - $100, 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	"8b1 (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%"		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $25"	"14j (Nutrition Therap) - $25; 14i (Diab Mon.) - $25; 7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro) - $25, 7d (Spec) - $15, 7f (Pod) - $25; 18a (MCR Hearing Exam) - $25, 17a (Eye Exam) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"	8b (Professional Radiology) - 0%	7g (Prof. Other) - $5 [allergy tests]	15 (Part B Rx) - 0%																					77.5758	77.5758	52.6197		125.9347	0.167912887	0.190287323	36.1044	83.9564		0.167912887			20.9891	12.6057	16.0205	20.9891	20.9891		4.1978																						9.5502	1.078182322	5.20198005	0	3.080975048	1.347545879	1.382329348	1.165666683	2.130735007	0	2.87384921	0	0	0.510965901	3.372777371	6.545259202	1.419827153	0.817959476	0	0.023907385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5022	0	7.739713851	9.5502	1.078182322	5.20198005	0	3.080975048	1.347545879	1.382329348	1.165666683	2.130735007	0	2.87384921	0	0	0.510965901	3.372777371	6.545259202	1.419827153	0.817959476	0	0.023907385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5022																																																																																				0	0	0	9.5502	1.078182322	5.20198005	0	3.080975048	1.347545879	1.382329348	1.165666683	2.130735007	0	2.87384921	0	0	0.510965901	3.372777371	6.545259202	1.419827153	0.817959476	0	0.023907385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5022
H7226_015_0	2008	4																					3250											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	P	P	V	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P	P																																																				0		1368.298837	119.7564969	1011.901463		266.0271013	7.356996668	7.375433546	348.4930719	275.5103974		16.88503364			303.711062	3591.48837	5106.536269	771.7709727	469.0496856		97.46133438																						"1a (IP Acute), 1a1 (Add'l Days) - $150 days 1-5"	1b (IP Psych) - $150 days 1-5	2 (SNF) - $115 days 11-100	6a (Home Health) - $0	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%,11b1 (Prosthetics) - 30%"	"4a (ER) $50 (WW Coverage), 4b (UC) - $15"	"9a (OP Surgery) - $100, 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	"8b1 (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%"		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $25"	"14j (Nutrition Therap) - $25; 14i (Diab Mon.) - $25; 7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro) - $25, 7d (Spec) - $15, 7f (Pod) - $25; 18a (MCR Hearing Exam) - $25, 17a (Eye Exam) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"	8b (Professional Radiology) - 0%	7g (Prof. Other) - $5 [allergy tests]	15 (Part B Rx) - 0%																					78.4827	78.4827	53.2349		127.407	0.169876009	0.199870442	36.5271	84.938		0.169876009			21.2345	12.7711	16.1185	21.2345	21.2345		4.2469																						8.949	0.783234597	4.489038958	0	2.824476394	1.249777233	1.474131164	1.060788224	1.950108617	0	2.86836213	0	0	0.537429408	3.822259148	6.859148218	1.365680967	0.830003007	0	0.03449238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0979	0	6.933205136	8.949	0.783234597	4.489038958	0	2.824476394	1.249777233	1.474131164	1.060788224	1.950108617	0	2.86836213	0	0	0.537429408	3.822259148	6.859148218	1.365680967	0.830003007	0	0.03449238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0979																																																																																				0	0	0	8.949	0.783234597	4.489038958	0	2.824476394	1.249777233	1.474131164	1.060788224	1.950108617	0	2.86836213	0	0	0.537429408	3.822259148	6.859148218	1.365680967	0.830003007	0	0.03449238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0979
H7226_016_0	2008	7																																A	A	D	V	T	P	P	V	V	P	P	V	V	V	P	P	V	V	P	P	S	V	P	P	P	P	P	P	P	P	P																																																				0									354.4201463						289.9754986	3239.635858	5246.889927	676.1264686	484.030531		76.5841378							279															1a (IP Acute) - $0; 1a1 (Add'l Days) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $0	11a (Medical Equip) - $0	"11b (Med Supp), 11c (Diab Supp) - $0"	"4a (ER) $50 (WW Coverage), 4b (UC) - $15"	"9a (OP Surgery), 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $15"	"14j (Nutrition Therap) - $15; 14i (Diab Mon.) - $15; 7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro), 7d (Spec), 7f (Pod) - $15; 17a (MCR Eye Exam) - $15; 18a (MCR Hearing Exam) - $15"	"7e (MH), 7h (Psychiatric) - $15"	"7c (OT), 7i (PT/ST) - $15"	8b (Professional Radiology) - 0%	7g (Prof. Other - allergy visits)  - $5	15 (Part B Rx) - $0				17a1 (Rountine Eye Exam) - $100 limit	17b1 (Non MCR Covered) - $200 limit	18a1 (Hearing Exam Non-covered) - $15; 18a2 (Fit & Eval for Hearing Aids) - $15	18b (Hearing Aids) - $500 limit																					43.0038						15	15	15	15	15		5							15															0	0	0	0	0	0	0	1.270118238	0	0	0	0	0	0.362469373	4.049544822	6.558612409	0.845158086	0.605038164	0	0.031910057	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.0716	0	0	0	0	0	0	0	0	0	1.270118238	0	0	0	0	0	0.362469373	4.049544822	6.558612409	0.845158086	0.605038164	0	0.031910057	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.0716																																																																																				0	0	0	0	0	0	0	0	0	0	1.270118238	0	0	0	0	0	0.362469373	4.049544822	6.558612409	0.845158086	0.605038164	0	0.031910057	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.0716
H7226_017_0	2008	7																																A	A	D	V	T	P	P	V	V	P	P	V	V	V	P	P	V	V	P	P	S	V	P	P	P	P	P	P	P	P	P																																																				0									318.0307445						298.715909	3434.268421	5941.641054	1254.443964	784.3263738		67.53289639							279															1a (IP Acute) - $0; 1a1 (Add'l Days) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $0	11a (Medical Equip) - $0	"11b (Med Supp), 11c (Diab Supp) - $0"	"4a (ER) $50 (WW Coverage), 4b (UC) - $15"	"9a (OP Surgery), 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $15"	"14j (Nutrition Therap) - $15; 14i (Diab Mon.) - $15; 7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro), 7d (Spec), 7f (Pod) - $15; 17a (MCR Eye Exam) - $15; 18a (MCR Hearing Exam) - $15"	"7e (MH), 7h (Psychiatric) - $15"	"7c (OT), 7i (PT/ST) - $15"	8b (Professional Radiology) - 0%	7g (Prof. Other - allergy visits)  - $5	15 (Part B Rx) - $0				17a1 (Rountine Eye Exam) - $100 limit	17b1 (Non MCR Covered) - $200 limit	18a1 (Hearing Exam Non-covered) - $15; 18a2 (Fit & Eval for Hearing Aids) - $15	18b (Hearing Aids) - $500 limit																					43.0047						15	15	15	15	15		5							15															0	0	0	0	0	0	0	1.139735403	0	0	0	0	0	0.373394886	4.292835526	7.427051317	1.568054955	0.980407967	0	0.028138707	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.1584	0	0	0	0	0	0	0	0	0	1.139735403	0	0	0	0	0	0.373394886	4.292835526	7.427051317	1.568054955	0.980407967	0	0.028138707	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.1584																																																																																				0	0	0	0	0	0	0	0	0	0	1.139735403	0	0	0	0	0	0.373394886	4.292835526	7.427051317	1.568054955	0.980407967	0	0.028138707	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.1584
H7226_018_0	2008	7																																A	A	D	V	T	P	P	V	V	P	P	V	V	V	P	P	V	V	P	P	S	V	P	P	P	P	P	P	P	P	P																																																				0									387.431756						292.131994	3210.710546	4902.654954	811.7507179	467.647904		68.34225092							279															1a (IP Acute) - $0; 1a1 (Add'l Days) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $0	11a (Medical Equip) - $0	"11b (Med Supp), 11c (Diab Supp) - $0"	"4a (ER) $50 (WW Coverage), 4b (UC) - $15"	"9a (OP Surgery), 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $15"	"14j (Nutrition Therap) - $15; 14i (Diab Mon.) - $15; 7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro), 7d (Spec), 7f (Pod) - $15; 17a (MCR Eye Exam) - $15; 18a (MCR Hearing Exam) - $15"	"7e (MH), 7h (Psychiatric) - $15"	"7c (OT), 7i (PT/ST) - $15"	8b (Professional Radiology) - 0%	7g (Prof. Other - allergy visits)  - $5	15 (Part B Rx) - $0				17a1 (Rountine Eye Exam) - $100 limit	17b1 (Non MCR Covered) - $200 limit	18a1 (Hearing Exam Non-covered) - $15; 18a2 (Fit & Eval for Hearing Aids) - $15	18b (Hearing Aids) - $500 limit																					43.0038						15	15	15	15	15		5							15															0	0	0	0	0	0	0	1.388418367	0	0	0	0	0	0.365164993	4.013388183	6.128318692	1.014688397	0.58455988	0	0.028475938	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.8718	0	0	0	0	0	0	0	0	0	1.388418367	0	0	0	0	0	0.365164993	4.013388183	6.128318692	1.014688397	0.58455988	0	0.028475938	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.8718																																																																																				0	0	0	0	0	0	0	0	0	0	1.388418367	0	0	0	0	0	0.365164993	4.013388183	6.128318692	1.014688397	0.58455988	0	0.028475938	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.8718
H7226_019_0	2008	5																																A	A	D	V	T	P	P	V	V	P	P	V	V	V	P	P	V	V	P	P	S	V	P	P	P	P	P	P	P	P	P																																																				0									348.4930719						303.711062	3591.48837	5106.536269	771.7709727	469.0496856		97.46133438							279															1a (IP Acute) - $0; 1a1 (Add'l Days) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $0	11a (Medical Equip) - $0	"11b (Med Supp), 11c (Diab Supp) - $0"	"4a (ER) $50 (WW Coverage), 4b (UC) - $15"	"9a (OP Surgery), 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $15"	"14j (Nutrition Therap) - $15; 14i (Diab Mon.) - $15; 7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro), 7d (Spec), 7f (Pod) - $15; 17a (MCR Eye Exam) - $15; 18a (MCR Hearing Exam) - $15"	"7e (MH), 7h (Psychiatric) - $15"	"7c (OT), 7i (PT/ST) - $15"	8b (Professional Radiology) - 0%	7g (Prof. Other - allergy visits)  - $5	15 (Part B Rx) - $0				17a1 (Rountine Eye Exam) - $100 limit	17b1 (Non MCR Covered) - $200 limit	18a1 (Hearing Exam Non-covered) - $15; 18a2 (Fit & Eval for Hearing Aids) - $15	18b (Hearing Aids) - $500 limit																					43.0045						15	15	15	15	15		5							15															0	0	0	0	0	0	0	1.248897038	0	0	0	0	0	0.379638828	4.489360463	6.383170336	0.964713716	0.586312107	0	0.040608889	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4415	0	0	0	0	0	0	0	0	0	1.248897038	0	0	0	0	0	0.379638828	4.489360463	6.383170336	0.964713716	0.586312107	0	0.040608889	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4415																																																																																				0	0	0	0	0	0	0	0	0	0	1.248897038	0	0	0	0	0	0.379638828	4.489360463	6.383170336	0.964713716	0.586312107	0	0.040608889	0	0	0	0	0	0	0.34875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4415
H7226_807_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		255.1800851	7.427865743	46.28108714		11.88558842	6.952402106	8.381697811	15.47817495	40.95386752	19.68283622	23.60799717	4.007006747	0.602772658	49.47015599	36.72597649	99.19077589	6.152152185	4.101780226	21.9648437	0.310666209	13.33960166	0.83991502																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.073048745	0.073048745	0.179737372		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				18.6406	0.542596267	8.318440961	0	2.78122769	1.626862093	1.961317288	3.621892938	9.583204999	4.605783675	5.524271338	0.937639579	0.141048802	11.5760165	8.5938785	23.21064156	1.439603611	0.959816573	5.139773426	0.072695893	3.121466788	0.196540115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.5953	0	0	18.6406	0.542596267	8.318440961	0	2.78122769	1.626862093	1.961317288	3.621892938	9.583204999	4.605783675	5.524271338	0.937639579	0.141048802	11.5760165	8.5938785	23.21064156	1.439603611	0.959816573	5.139773426	0.072695893	3.121466788	0.196540115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.5953																																																																																				0	0	0	18.6406	0.542596267	8.318440961	0	2.78122769	1.626862093	1.961317288	3.621892938	9.583204999	4.605783675	5.524271338	0.937639579	0.141048802	11.5760165	8.5938785	23.21064156	1.439603611	0.959816573	5.139773426	0.072695893	3.121466788	0.196540115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.5953
H7226_810_0	2008	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		255.1800851	7.427865743	46.28108714		11.88558842	6.952402106	8.381697811	15.47817495	40.95386752	19.68283622	23.60799717	4.007006747	0.602772658	49.47015599	36.72597649	99.19077589	6.152152185	4.101780226	21.9648437	0.310666209	13.33960166	0.83991502																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.073048745	0.073048745	0.179737372		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				18.6406	0.542596267	8.318440961	0	2.78122769	1.626862093	1.961317288	3.621892938	9.583204999	4.605783675	5.524271338	0.937639579	0.141048802	11.5760165	8.5938785	23.21064156	1.439603611	0.959816573	5.139773426	0.072695893	3.121466788	0.196540115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.5953	0	0	18.6406	0.542596267	8.318440961	0	2.78122769	1.626862093	1.961317288	3.621892938	9.583204999	4.605783675	5.524271338	0.937639579	0.141048802	11.5760165	8.5938785	23.21064156	1.439603611	0.959816573	5.139773426	0.072695893	3.121466788	0.196540115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.5953																																																																																				0	0	0	18.6406	0.542596267	8.318440961	0	2.78122769	1.626862093	1.961317288	3.621892938	9.583204999	4.605783675	5.524271338	0.937639579	0.141048802	11.5760165	8.5938785	23.21064156	1.439603611	0.959816573	5.139773426	0.072695893	3.121466788	0.196540115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.5953
H7292_001_0	2008	5																																																																																																																		0																																																																																																																													0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																				0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H7301_001_0	2008	5																					1500											D	D	D	V	T	Coin	Coin	V	V	P	P	V	Coin	V	V	V	V	V	P	V	Coin	P	T	P	V	P	V	P	Coin	P	P																																																				0	0	1418.428123	37.9940658	918.7405526		146.9247787	7.504964699	7.964161356	255.4645841	307.3370922		231.2384307	23.71447783		403.891251	3671.191163	4782.236712	180.817341	730.1882961	239.3719757		22.62000334				136.8		236.55															1a:$400 admit; 1a1:$400 admit;	1b:$400 admit;	2a:$100 21+; 2a2:$100 21+;		10a:$25;	11a:10%;	11b:10%; 11c:10%;	4a:$50; 4b:$30;	9b:$75;		8b:$0-50;	9a:$75;		3:$20; 5:$75; 9c:$20; 9d:$20;	7a:$10; 14c:$10; 14d:$20; 14d1:$20; 14d2:$20; 14e:$20; 14e1:$20; 14f:$20; 14f1:$20;	7b:$20; 7d:$20; 7f:$20; 7f1:$20;	7e:$20; 7h:$20;	7c:$20; 7i:$20;	7g:$10-20;		15:20%;				17a1:$20;		18a:$20; 18a1:$20;															74.0394	47.9029	15.4215		21.0791	0.08431637	0.08431637	42.1582	63.2373		62.0866	63.2373		59.2396	8.4316	16.8633	16.8505	14.4159	16.8241		0.168632739				16.8633		16.8633															8.7516	0.151668972	1.180693696	0	0.258086749	0.632791377	0.671509172	0.897493595	1.619596741	0	1.196399979	0.124969917	0	1.993862827	2.57951259	6.7203473	0.253904833	0.877191068	0.335601552	0	3.814473122	0	0	0	0.192241323	0	0.332417287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.5844	0	6.061	8.7516	0.151668972	1.180693696	0	0.258086749	0.632791377	0.671509172	0.897493595	1.619596741	0	1.196399979	0.124969917	0	1.993862827	2.57951259	6.7203473	0.253904833	0.877191068	0.335601552	0	3.814473122	0	0	0	0.192241323	0	0.332417287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.5844		0.2	0.2	0.2	0.2	25	0.2	0.2	50	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2				0.2	0.2	0.2	0.2														2.7378	0.033	0.339	0.1819	0.017	0.1039	0.1103	0.0603	0.5118	0.0987	0.2389	0.0196	0.0037	0.2349	0.3314	1.0239	0.0171	0.1105	0.2472	0.1393	0.2506				0.0102	0.0243	0.0136	0.0138														6.8726	0	0.0017	11.4895	0.184642296	1.51966844	0.181920957	0.275044826	0.736738257	0.781816116	0.95777328	2.131383836	0.098692034	1.435328125	0.144599649	0.003680629	2.228793393	2.91088157	7.744220236	0.271033604	0.987650007	0.582760818	0.139313969	4.065110278	0	0	0	0.202467723	0.0243	0.345989862	0.01375	0	0	0	0	0	0	0	0	0	0	0	0	0	39.457
H7301_002_0	2008	3																					3000											D	D	D	V	T	Coin	Coin	V	V	P	P	V	Coin	V	V	V	V	V	P	V	Coin	P	T	P	V	P	V	P	Coin	P	P																																																				0	0	1285.362012	34.42975224	832.5845874		133.1414163	6.800906134	7.217024462	231.4988447	278.5050696	1782.820032	380.7208566	21.48976634		366.0012534	3336.145784	4345.278678	163.8544368	661.6875977	3902.410988	4850.638551	20.4979671				136.8		236.55															1a:$125 1-5; 1a1:$125 1-5;	1b:$125 1-5;	2a:$75 7+; 2a2:$75 7+;		10a:$100;	11a:20%;	11b:20%; 11c:20%;	4a:$50; 4b:$30;	9b:$100;	8a:$30;	8b:$25-100;	9a:$100;		3:$30; 5:$75; 9a:$100; 9c:$30; 9d:$30;	7a:$15; 14c:$15;	7b:$30; 7d:$30; 7f:$30; 7f1:$30;	7e:$30; 7h:$30;	7c:$30; 7i:$30;	7g:$15-30;	7g:$15-30;	15:20%;				17a1:$30;		18a:$30; 18a1:$30;															117.3757	98.1232	16.5164		90.3029	0.180605853	0.180605853	45.1515	90.3029	27.0909	83.3465	90.3029		84.8537	13.5455	27.675	27.0703	23.1591	16.261	6.8686	0.180605853				30		30															12.5725	0.281529674	1.145942037	0	1.001921626	1.228283452	1.303436858	0.871042631	2.095818568	4.024846654	2.644313524	0.161715732	0	2.588047194	3.76580677	10.02129922	0.369632611	1.27700769	5.288107871	2.776437217	3.702052829	0	0	0	0.342	0	0.591375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0531	0	5.8995	12.5725	0.281529674	1.145942037	0	1.001921626	1.228283452	1.303436858	0.871042631	2.095818568	4.024846654	2.644313524	0.161715732	0	2.588047194	3.76580677	10.02129922	0.369632611	1.27700769	5.288107871	2.776437217	3.702052829	0	0	0	0.342	0	0.591375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0531		0.2	0.2	0.2	0.2	100	0.2	0.2	50	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2				0.2		0.2															2.481	0.0299	0.3072	0.1649	0.0615	0.0942	0.1	0.0547	0.4638	0.0894	0.2165	0.0178	0.0033	0.2129	0.3013	0.9281	0.0155	0.1001	0.224	0.1262	0.2271				0.0102		0.0136															6.2432	0	0.0017	15.0535	0.311409691	1.453126137	0.16485452	1.063390424	1.322478828	1.403395646	0.925790058	2.5595937	4.114280154	2.860827254	0.179503952	0.003335341	2.800938366	4.067066061	10.9494301	0.385154491	1.377104214	5.512080539	2.902681812	3.929177118	0	0	0	0.3522264	0	0.604947575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2963
H7301_801_0	2008	1																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	237.0469227	4.486108269	24.06097364		4.878970935	5.920926512	6.449200993	10.14399356	32.55920733	5.044406152	18.73544182	1.728490654	0.580867327	21.49890649	27.09294474	82.74503321	1.97773427	10.13760462	22.0111551	11.07230351	21.75272021																					Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																					0.085718412	0.085718412	0.202121052		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					20.3193	0.384542078	4.863229308	0	1.141679199	1.385496804	1.509113032	2.373694493	7.618854516	1.18039104	4.384093387	0.404466813	0.135922955	5.030744119	6.339749068	19.36233777	0.462789819	2.372199481	5.150610293	2.590919022	5.09013653	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.1003	0	0	20.3193	0.384542078	4.863229308	0	1.141679199	1.385496804	1.509113032	2.373694493	7.618854516	1.18039104	4.384093387	0.404466813	0.135922955	5.030744119	6.339749068	19.36233777	0.462789819	2.372199481	5.150610293	2.590919022	5.09013653	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.1003		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																					1.1201	0.0212	0.3349		0.0634	0.0959	0.1045	0.1342	0.4302	0.0833	0.2476	0.0228	0.0076	0.284	0.3512	1.0913	0.0257	0.133	0.2854	0.1435	0.282																					5.2617	0	0	21.4393	0.405741242	5.198100176	0	1.205078962	1.481445336	1.613622245	2.507848058	8.049020763	1.263658817	4.631647544	0.427299511	0.14357194	5.31477182	6.690981704	20.45359682	0.488521034	2.505179089	5.435962664	2.734460242	5.372138554	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.362
H7301_802_0	2008	1																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	237.0469227	4.486108269	24.06097364		4.878970935	5.920926512	6.449200993	10.14399356	32.55920733	5.044406152	18.73544182	1.728490654	0.580867327	21.49890649	27.09294474	82.74503321	1.97773427	10.13760462	22.0111551	11.07230351	21.75272021																					Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																					0.085718412	0.085718412	0.202121052		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					20.3193	0.384542078	4.863229308	0	1.141679199	1.385496804	1.509113032	2.373694493	7.618854516	1.18039104	4.384093387	0.404466813	0.135922955	5.030744119	6.339749068	19.36233777	0.462789819	2.372199481	5.150610293	2.590919022	5.09013653	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.1003	0	0	20.3193	0.384542078	4.863229308	0	1.141679199	1.385496804	1.509113032	2.373694493	7.618854516	1.18039104	4.384093387	0.404466813	0.135922955	5.030744119	6.339749068	19.36233777	0.462789819	2.372199481	5.150610293	2.590919022	5.09013653	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.1003		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																					1.1201	0.0212	0.3349		0.0634	0.0959	0.1045	0.1342	0.4302	0.0833	0.2476	0.0228	0.0076	0.284	0.3512	1.0913	0.0257	0.133	0.2854	0.1435	0.282																					5.2617	0	0	21.4393	0.405741242	5.198100176	0	1.205078962	1.481445336	1.613622245	2.507848058	8.049020763	1.263658817	4.631647544	0.427299511	0.14357194	5.31477182	6.690981704	20.45359682	0.488521034	2.505179089	5.435962664	2.734460242	5.372138554	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.362
H7301_803_0	2008	1																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	237.0469227	4.486108269	24.06097364		4.878970935	5.920926512	6.449200993	10.14399356	32.55920733	5.044406152	18.73544182	1.728490654	0.580867327	21.49890649	27.09294474	82.74503321	1.97773427	10.13760462	22.0111551	11.07230351	21.75272021																					Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																					0.085718412	0.085718412	0.202121052		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					20.3193	0.384542078	4.863229308	0	1.141679199	1.385496804	1.509113032	2.373694493	7.618854516	1.18039104	4.384093387	0.404466813	0.135922955	5.030744119	6.339749068	19.36233777	0.462789819	2.372199481	5.150610293	2.590919022	5.09013653	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.1003	0	0	20.3193	0.384542078	4.863229308	0	1.141679199	1.385496804	1.509113032	2.373694493	7.618854516	1.18039104	4.384093387	0.404466813	0.135922955	5.030744119	6.339749068	19.36233777	0.462789819	2.372199481	5.150610293	2.590919022	5.09013653	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.1003		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																					1.1201	0.0212	0.3349		0.0634	0.0959	0.1045	0.1342	0.4302	0.0833	0.2476	0.0228	0.0076	0.284	0.3512	1.0913	0.0257	0.133	0.2854	0.1435	0.282																					5.2617	0	0	21.4393	0.405741242	5.198100176	0	1.205078962	1.481445336	1.613622245	2.507848058	8.049020763	1.263658817	4.631647544	0.427299511	0.14357194	5.31477182	6.690981704	20.45359682	0.488521034	2.505179089	5.435962664	2.734460242	5.372138554	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.362
H7352_002_0	2008	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		317.4522542	29.47848527	33.64796409		25.66024242	20.42941025	18.70228222	29.48460392	27.1706176	3.667745229	9.710682124	3.31120958	0.731174967	41.60949372	44.88536135	95.83219063	10.65674545	3.250298087	26.48896412	10.4580019	22.30610546	1.438111413																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing		16a (Preventive Dental)	17a1 (Routine Eye Exam) - $0	17b1 (Non MCR Covered) - $150 allowance	18a1 (Routine Hearing Exam) - $0	18b (Hearing Aids) - $800 allowance for aids and exam														0.0764	0.0764	0.1719		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				24.2534	2.252156275	5.784085027	0	6.004496727	4.780481998	4.376334039	6.899397318	6.357924519	0.858252384	2.272299617	0.774823042	0.171094942	9.73662153	10.50317456	22.42473261	2.493678435	0.760569752	6.198417605	2.447172444	5.219628679	0.336518071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.9052	0	0	24.2534	2.252156275	5.784085027	0	6.004496727	4.780481998	4.376334039	6.899397318	6.357924519	0.858252384	2.272299617	0.774823042	0.171094942	9.73662153	10.50317456	22.42473261	2.493678435	0.760569752	6.198417605	2.447172444	5.219628679	0.336518071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.9052																																																																																				0	0	0	24.2534	2.252156275	5.784085027	0	6.004496727	4.780481998	4.376334039	6.899397318	6.357924519	0.858252384	2.272299617	0.774823042	0.171094942	9.73662153	10.50317456	22.42473261	2.493678435	0.760569752	6.198417605	2.447172444	5.219628679	0.336518071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.9052
H7352_003_0	2008	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		338.0490374	31.39109406	35.83109498		27.32511783	21.75490134	19.91571462	31.39760969	28.93348844	3.905714097	10.34072589	3.526045874	0.778614707	44.30918071	47.7975916	102.0499283	11.34817124	3.461182352	28.20760825	11.1365329	23.75335938	1.53141826																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing		16a (Preventive Dental)	17a1 (Routine Eye Exam) - $0	17b1 (Non MCR Covered) - $150 allowance	18a1 (Routine Hearing Exam) - $0	18b (Hearing Aids) - $800 allowance for aids and exam														0.0747	0.0747	0.1593		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				25.2523	2.344914726	5.70789343	0	6.394077571	5.090646912	4.660277222	7.347040668	6.770436294	0.913937099	2.419729859	0.825094735	0.182195841	10.36834829	11.18463643	23.87968323	2.65547207	0.80991667	6.60058033	2.6059487	5.558286095	0.358351873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9297	0	0	25.2523	2.344914726	5.70789343	0	6.394077571	5.090646912	4.660277222	7.347040668	6.770436294	0.913937099	2.419729859	0.825094735	0.182195841	10.36834829	11.18463643	23.87968323	2.65547207	0.80991667	6.60058033	2.6059487	5.558286095	0.358351873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9297																																																																																				0	0	0	25.2523	2.344914726	5.70789343	0	6.394077571	5.090646912	4.660277222	7.347040668	6.770436294	0.913937099	2.419729859	0.825094735	0.182195841	10.36834829	11.18463643	23.87968323	2.65547207	0.80991667	6.60058033	2.6059487	5.558286095	0.358351873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9297
H7357_001_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		272.5713589	106.69547	774.498533	25.82249336	185.8827643	12.28102111	11.58778938	303.4109918	328.6055696		40.7658757		7.432958374	0.457179377	3875.500152	3882.601069	2.877932958	542.9975368			25.17423875	7.428138032			432		249.0142383															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															158.114	41.0367	24.8685	0.121626171	40.5421	0.162168227	0.162168227	28.3794	31.367		0.081084114		40.5421	0.19463983	8.1084	19.5923	0.405420568	20.271			0.162168227	0.173268803			12.1626		12.1626															3.5914	0.364868899	1.605051247	3.140690981	0.6280058	1.991591424	1.879171262	0.717552831	0.858947729	0	3.3054649	0	0.025112285	0.088985316	2.618679124	6.339092651	1.166773215	0.917259875	0	0	4.082461672	1.287064589	0	0	0.437854214	0	0.252388735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2985	0	8.234679783	3.5914	0.364868899	1.605051247	3.140690981	0.6280058	1.991591424	1.879171262	0.717552831	0.858947729	0	3.3054649	0	0.025112285	0.088985316	2.618679124	6.339092651	1.166773215	0.917259875	0	0	4.082461672	1.287064589	0	0	0.437854214	0	0.252388735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2985																																																																																				0	0	0	3.5914	0.364868899	1.605051247	3.140690981	0.6280058	1.991591424	1.879171262	0.717552831	0.858947729	0	3.3054649	0	0.025112285	0.088985316	2.618679124	6.339092651	1.166773215	0.917259875	0	0	4.082461672	1.287064589	0	0	0.437854214	0	0.252388735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2985
H7357_002_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		268.2877096	91.41762981	788.1301271	18.32219286	176.8599837	10.84805862	10.55368785	285.1978154	320.017478		38.75539751		8.471459893	0.467414941	3655.126038	3695.583846	2.551716954	578.7684258			22.61950136	7.292724042			432		249.0080407															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															161.0495	41.7986	25.3302	0.123884268	41.2948	0.165179024	0.165179024	28.9063	32.4318		0.082589512		41.2948	0.205312927	8.259	19.9134	0.412947559	20.6474			0.165179024	0.178208716			12.3884		12.3884															3.6006	0.318427045	1.663624693	2.269831444	0.608615821	1.79187173	1.743247853	0.687001826	0.864894996	0	3.200789358	0	0.029152239	0.095966329	2.515625624	6.132630171	1.053725287	0.995837536	0	0	3.736267147	1.299626985	0	0	0.445983364	0	0.257068156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.3108	0	7.022171031	3.6006	0.318427045	1.663624693	2.269831444	0.608615821	1.79187173	1.743247853	0.687001826	0.864894996	0	3.200789358	0	0.029152239	0.095966329	2.515625624	6.132630171	1.053725287	0.995837536	0	0	3.736267147	1.299626985	0	0	0.445983364	0	0.257068156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.3108																																																																																				0	0	0	3.6006	0.318427045	1.663624693	2.269831444	0.608615821	1.79187173	1.743247853	0.687001826	0.864894996	0	3.200789358	0	0.029152239	0.095966329	2.515625624	6.132630171	1.053725287	0.995837536	0	0	3.736267147	1.299626985	0	0	0.445983364	0	0.257068156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.3108
H7357_003_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		307.4048169	114.2772337	825.7878273	29.51079748	187.9150386	12.15882055	11.01630823	287.8744424	326.0681663		43.76091119		9.785105122	0.653468876	3758.953932	4266.016876	3.626747855	589.5445464			25.79166492	8.483437308			432		249.0632681															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															155.7916	40.4339	24.5032	0.119839729	39.9466	0.159786306	0.159786306	27.9626	31.1791		0.079893153		39.9466	0.146832474	7.9893	19.3914	0.399465765	19.9733			0.159786306	0.167235334			11.984		11.984															3.9909	0.385056422	1.686205755	3.536565983	0.625546871	1.942813018	1.760255196	0.670809908	0.84720943	0	3.496197169	0	0.032573454	0.095950452	2.502622344	6.89368376	1.448761605	0.981261929	0	0	4.121154858	1.418730475	0	0	0.431423026	0	0.248730622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.1165	0	9.341167688	3.9909	0.385056422	1.686205755	3.536565983	0.625546871	1.942813018	1.760255196	0.670809908	0.84720943	0	3.496197169	0	0.032573454	0.095950452	2.502622344	6.89368376	1.448761605	0.981261929	0	0	4.121154858	1.418730475	0	0	0.431423026	0	0.248730622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.1165																																																																																				0	0	0	3.9909	0.385056422	1.686205755	3.536565983	0.625546871	1.942813018	1.760255196	0.670809908	0.84720943	0	3.496197169	0	0.032573454	0.095950452	2.502622344	6.89368376	1.448761605	0.981261929	0	0	4.121154858	1.418730475	0	0	0.431423026	0	0.248730622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.1165
H7357_004_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		318.8206591	101.9376861	866.9244335	27.32968307	175.3053786	13.31948203	12.62664489	307.1604871	376.1123523		47.90020561		10.60571139	0.775527339	3980.201071	4476.422536	2.976156196	541.6682636			27.62156826	8.3528246			432		249.0914938															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															154.646	40.1366	24.323	0.118958439	39.6528	0.158611252	0.158611252	27.757	30.096		0.079305626		39.6528	0.14709505	7.9306	19.2508	0.39652813	19.8264			0.158611252	0.168988454			11.8958		11.8958															4.1087	0.340952485	1.757186148	3.251096438	0.579279283	2.112619722	2.002727955	0.710487013	0.943290822	0	3.798755793	0	0.035045524	0.114076233	2.630436148	7.181234479	1.180129651	0.894944599	0	0	4.381091525	1.411530913	0	0	0.428250381	0	0.246929461	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1088	0	9.94427438	4.1087	0.340952485	1.757186148	3.251096438	0.579279283	2.112619722	2.002727955	0.710487013	0.943290822	0	3.798755793	0	0.035045524	0.114076233	2.630436148	7.181234479	1.180129651	0.894944599	0	0	4.381091525	1.411530913	0	0	0.428250381	0	0.246929461	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1088																																																																																				0	0	0	4.1087	0.340952485	1.757186148	3.251096438	0.579279283	2.112619722	2.002727955	0.710487013	0.943290822	0	3.798755793	0	0.035045524	0.114076233	2.630436148	7.181234479	1.180129651	0.894944599	0	0	4.381091525	1.411530913	0	0	0.428250381	0	0.246929461	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1088
H7357_005_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		344.2589641	111.9767662	872.6560888	33.38948937	187.0147126	14.08044769	12.71911735	318.0452457	398.2298215		52.07832797		12.21316992	0.779035565	4073.117515	4899.007873	3.165489926	732.1079283			31.22709573	9.19837804			432		249.1326811															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															150.7259	39.1192	23.7065	0.115943	38.6477	0.154590667	0.154590667	27.0534	29.0401		0.077295333		38.6477	0.128767274	7.7295	18.8138	0.386476667	19.3238			0.154590667	0.16232222			11.5943		11.5943															4.3241	0.365036496	1.72396692	3.871277571	0.602306857	2.176705798	1.966256832	0.717016222	0.963718752	0	4.025411724	0	0.03933421	0.100314286	2.623608137	7.680754256	1.223387996	1.178927634	0	0	4.827417553	1.493101144	0	0	0.4173948	0	0.240709921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5607	0	11.91426872	4.3241	0.365036496	1.72396692	3.871277571	0.602306857	2.176705798	1.966256832	0.717016222	0.963718752	0	4.025411724	0	0.03933421	0.100314286	2.623608137	7.680754256	1.223387996	1.178927634	0	0	4.827417553	1.493101144	0	0	0.4173948	0	0.240709921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5607																																																																																				0	0	0	4.3241	0.365036496	1.72396692	3.871277571	0.602306857	2.176705798	1.966256832	0.717016222	0.963718752	0	4.025411724	0	0.03933421	0.100314286	2.623608137	7.680754256	1.223387996	1.178927634	0	0	4.827417553	1.493101144	0	0	0.4173948	0	0.240709921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5607
H7357_006_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		350.0163672	113.2845194	834.867558	37.70261256	169.1483791	14.40916709	13.69887346	288.4180947	396.813166		56.57926057		14.11816395	1.492668053	3956.518462	5629.24655	4.509250418	1000.039713			35.43025129	10.03539118			432		249.0058766															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															147.1072	38.18	23.1373	0.113159371	37.7198	0.150879162	0.150879162	26.4039	28.1497		0.075439581		37.7198	0.07505711	7.544	18.3884	0.377197905	18.8599			0.150879162	0.15676468			11.3159		11.3159															4.2908	0.360433314	1.609716452	4.26640394	0.531686785	2.174043055	2.066874547	0.634612423	0.93084749	0	4.268315709	0	0.044377849	0.11203535	2.487317458	8.626067843	1.70087981	1.571720352	0	0	5.345686622	1.573194888	0	0	0.407373737	0	0.234811237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2372	0	14.07648831	4.2908	0.360433314	1.609716452	4.26640394	0.531686785	2.174043055	2.066874547	0.634612423	0.93084749	0	4.268315709	0	0.044377849	0.11203535	2.487317458	8.626067843	1.70087981	1.571720352	0	0	5.345686622	1.573194888	0	0	0.407373737	0	0.234811237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2372																																																																																				0	0	0	4.2908	0.360433314	1.609716452	4.26640394	0.531686785	2.174043055	2.066874547	0.634612423	0.93084749	0	4.268315709	0	0.044377849	0.11203535	2.487317458	8.626067843	1.70087981	1.571720352	0	0	5.345686622	1.573194888	0	0	0.407373737	0	0.234811237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2372
H7357_007_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1432.514236	144.7570467	794.7019514	27.61488204	205.4965764	13.45782384	12.23147116	342.1024615	318.9124524		39.2224862		9.116097291	0.424391181	3866.241741	3762.64782	3.64108785	517.9873444			23.92609588	7.016875842			432		249.0125575															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												98.0578	98.0578	22.8563	0.111785016	74.5233	0.149046688	0.149046688	37.2617	115.6531		0.149046688		37.2617	0.328330816	14.9047	22.9727	0.37261672	22.0647			0.149046688	0.272654413			22.357		22.357															11.7058	1.182879988	1.513662821	3.086930031	1.276191005	2.005844072	1.823060266	1.062275809	3.073600799	0	5.845981664	0	0.028306752	0.139340703	4.802087722	7.203183573	1.356730212	0.952438153	0	0	3.566105348	1.913182166	0	0	0.804852115	0	0.463931212	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8064	0	18.39431592	11.7058	1.182879988	1.513662821	3.086930031	1.276191005	2.005844072	1.823060266	1.062275809	3.073600799	0	5.845981664	0	0.028306752	0.139340703	4.802087722	7.203183573	1.356730212	0.952438153	0	0	3.566105348	1.913182166	0	0	0.804852115	0	0.463931212	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8064																																																																																				0	0	0	11.7058	1.182879988	1.513662821	3.086930031	1.276191005	2.005844072	1.823060266	1.062275809	3.073600799	0	5.845981664	0	0.028306752	0.139340703	4.802087722	7.203183573	1.356730212	0.952438153	0	0	3.566105348	1.913182166	0	0	0.804852115	0	0.463931212	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8064
H7357_008_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1340.697864	97.51083773	756.594039	17.90525849	174.7417394	10.7803659	10.35627642	284.5386006	301.4056382		36.92709208		8.858016537	0.440338687	3471.967474	3489.135845	2.676253253	547.1191573			21.38846563	6.906368229			432		249.0089152															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												101.1949	101.1949	23.5875	0.115361272	76.9075	0.153815029	0.153815029	38.4538	121.0203		0.153815029		38.4538	0.350206451	15.3815	23.7535	0.384537574	22.817			0.153815029	0.279409319			23.0723		23.0723															11.306	0.82230002	1.48718235	2.065573396	1.119912741	1.658182299	1.592950962	0.911798192	3.039683853	0	5.679941755	0	0.028385335	0.154209449	4.450339828	6.906599507	1.029119932	1.040302603	0	0	3.28986747	1.929703644	0	0	0.830601159	0	0.47876642	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8214	0	14.95952693	11.306	0.82230002	1.48718235	2.065573396	1.119912741	1.658182299	1.592950962	0.911798192	3.039683853	0	5.679941755	0	0.028385335	0.154209449	4.450339828	6.906599507	1.029119932	1.040302603	0	0	3.28986747	1.929703644	0	0	0.830601159	0	0.47876642	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8214																																																																																				0	0	0	11.306	0.82230002	1.48718235	2.065573396	1.119912741	1.658182299	1.592950962	0.911798192	3.039683853	0	5.679941755	0	0.028385335	0.154209449	4.450339828	6.906599507	1.029119932	1.040302603	0	0	3.28986747	1.929703644	0	0	0.830601159	0	0.47876642	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8214
H7357_009_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1573.876873	131.5094424	777.8156594	28.49546623	186.1863413	11.97084222	10.56949545	291.908826	295.3195692		39.91532377		10.48728915	0.595356813	3474.997964	3870.672069	4.268381929	537.318915			23.04629825	7.654486662			432		249.1053709															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												97.9313	97.9313	22.8268	0.111640746	74.4272	0.148854329	0.148854329	37.2136	116.4549		0.148854329		37.2136	0.24633069	14.8854	22.8689	0.372135821	22.0387			0.148854329	0.263144209			22.3281		22.3281															12.8443	1.07324048	1.479587606	3.181255119	1.154776784	1.781911681	1.573315149	0.905247756	2.86594999	0	5.941568718	0	0.032522466	0.146654655	4.310570738	7.376493346	1.588417815	0.986816264	0	0	3.430541252	2.014233835	0	0	0.803813374	0	0.463505159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.9547	0	18.53860186	12.8443	1.07324048	1.479587606	3.181255119	1.154776784	1.781911681	1.573315149	0.905247756	2.86594999	0	5.941568718	0	0.032522466	0.146654655	4.310570738	7.376493346	1.588417815	0.986816264	0	0	3.430541252	2.014233835	0	0	0.803813374	0	0.463505159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.9547																																																																																				0	0	0	12.8443	1.07324048	1.479587606	3.181255119	1.154776784	1.781911681	1.573315149	0.905247756	2.86594999	0	5.941568718	0	0.032522466	0.146654655	4.310570738	7.376493346	1.588417815	0.986816264	0	0	3.430541252	2.014233835	0	0	0.803813374	0	0.463505159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.9547
H7357_010_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1566.855317	131.1221138	816.6682161	26.88482736	177.4428906	13.4819058	12.32750566	316.4237349	333.4037805		42.84321834		11.9260358	0.696458906	3613.653348	3981.0566	3.740677851	480.2829271			24.77842257	7.342956581			432		249.0843972															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												97.1622	97.1622	22.6476	0.110764059	73.8427	0.147685412	0.147685412	36.9214	112.6149		0.147685412		36.9214	0.242746984	14.7685	22.6819	0.369213531	21.8138			0.147685412	0.263375469			22.1528		22.1528															12.6866	1.061676446	1.541295065	2.977872612	1.091905269	1.991080818	1.820592758	0.973566037	3.128852013	0	6.327318368	0	0.036693782	0.169063299	4.447365708	7.524830447	1.381108878	0.873064847	0	0	3.659411556	1.933954635	0	0	0.797501227	0	0.459826649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.8836	0	19.44140359	12.6866	1.061676446	1.541295065	2.977872612	1.091905269	1.991080818	1.820592758	0.973566037	3.128852013	0	6.327318368	0	0.036693782	0.169063299	4.447365708	7.524830447	1.381108878	0.873064847	0	0	3.659411556	1.933954635	0	0	0.797501227	0	0.459826649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.8836																																																																																				0	0	0	12.6866	1.061676446	1.541295065	2.977872612	1.091905269	1.991080818	1.820592758	0.973566037	3.128852013	0	6.327318368	0	0.036693782	0.169063299	4.447365708	7.524830447	1.381108878	0.873064847	0	0	3.659411556	1.933954635	0	0	0.797501227	0	0.459826649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.8836
H7357_011_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1612.052457	121.5461081	768.948232	30.62249072	173.3369021	12.93061228	11.39908294	295.6323372	336.6666384		44.03541625		12.26598007	0.717707027	3520.48089	4143.38595	3.294806801	639.3225994			26.23034823	7.679414658			432		249.1190319															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												96.5965	96.5965	22.5157	0.11011908	73.4127	0.14682544	0.14682544	36.7064	110.6978		0.14682544		36.7064	0.202595183	14.6825	22.5041	0.3670636	21.8131			0.14682544	0.258747319			22.0238		22.0238															12.9765	0.978410282	1.442782771	3.372120501	1.060427787	1.898542835	1.673675367	0.904298916	3.105688388	0	6.46551936	0	0.037519957	0.145403986	4.30746796	7.770279771	1.209403644	1.162135416	0	0	3.851282416	1.987027954	0	0	0.792857375	0	0.457212643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.5986	0	20.13568832	12.9765	0.978410282	1.442782771	3.372120501	1.060427787	1.898542835	1.673675367	0.904298916	3.105688388	0	6.46551936	0	0.037519957	0.145403986	4.30746796	7.770279771	1.209403644	1.162135416	0	0	3.851282416	1.987027954	0	0	0.792857375	0	0.457212643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.5986																																																																																				0	0	0	12.9765	0.978410282	1.442782771	3.372120501	1.060427787	1.898542835	1.673675367	0.904298916	3.105688388	0	6.46551936	0	0.037519957	0.145403986	4.30746796	7.770279771	1.209403644	1.162135416	0	0	3.851282416	1.987027954	0	0	0.792857375	0	0.457212643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.5986
H7357_012_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1657.180468	132.5484806	723.7400951	35.51154905	154.5374431	14.07154168	13.27471222	264.1028983	324.9092983		46.58597018		15.5344573	1.617380447	3404.666226	4646.875412	5.153806879	941.7820214			31.98088762	8.186837308			432		249.0105911															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												94.1952	94.1952	21.956	0.107381623	71.5877	0.143175498	0.143175498	35.7939	107.2518		0.143175498		35.7939	0.094299511	14.3175	21.9262	0.357938745	21.326			0.143175498	0.246529621			21.4763		21.4763															13.0082	1.040452113	1.324200872	3.813287789	0.92191564	2.014699986	1.900613532	0.787772166	2.903925129	0	6.669969477	0	0.046336535	0.152518186	4.062206519	8.490677724	1.844747166	1.673703243	0	0	4.578879509	2.018297897	0	0	0.773147689	0	0.445652692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4712	0	23.20646337	13.0082	1.040452113	1.324200872	3.813287789	0.92191564	2.014699986	1.900613532	0.787772166	2.903925129	0	6.669969477	0	0.046336535	0.152518186	4.062206519	8.490677724	1.844747166	1.673703243	0	0	4.578879509	2.018297897	0	0	0.773147689	0	0.445652692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4712																																																																																				0	0	0	13.0082	1.040452113	1.324200872	3.813287789	0.92191564	2.014699986	1.900613532	0.787772166	2.903925129	0	6.669969477	0	0.046336535	0.152518186	4.062206519	8.490677724	1.844747166	1.673703243	0	0	4.578879509	2.018297897	0	0	0.773147689	0	0.445652692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4712
H7357_013_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1420.471417	143.5401073	788.0210737	27.38273004	203.7690136	13.344687	12.12864398	339.2301777	316.2314283		38.89275172		9.039460345	0.420823421	6809.310992	3731.016099	3.610478056	513.6327432			23.72495466	6.957886571			432		249.0124519															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												123.6279	123.6279	24.8448	0.137036982	119.9074	0.137036982	0.137036982	37.6918	212.6683		0.137036982		34.2592	0.346135585	13.7037	25.1137	0.342592455	23.6232			0.137036982	0.284999146			23.9815		23.9815															14.6342	1.478796997	1.63151915	3.752446687	2.036117029	1.828715634	1.662072768	1.065517054	5.604365674	0	5.329745323	0	0.025807091	0.145661961	7.776061907	7.808287623	1.236922542	1.011137045	0	0	3.251196188	1.982991733	0	0	0.863332987	0	0.497640426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6225	0	29.23199463	14.6342	1.478796997	1.63151915	3.752446687	2.036117029	1.828715634	1.662072768	1.065517054	5.604365674	0	5.329745323	0	0.025807091	0.145661961	7.776061907	7.808287623	1.236922542	1.011137045	0	0	3.251196188	1.982991733	0	0	0.863332987	0	0.497640426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6225																																																																																				0	0	0	14.6342	1.478796997	1.63151915	3.752446687	2.036117029	1.828715634	1.662072768	1.065517054	5.604365674	0	5.329745323	0	0.025807091	0.145661961	7.776061907	7.808287623	1.236922542	1.011137045	0	0	3.251196188	1.982991733	0	0	0.863332987	0	0.497640426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6225
H7357_014_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1327.323856	96.53812737	749.0467051	17.72664623	172.9986193	10.67282736	10.25296834	281.7043117	298.3989941		36.55872928		8.769654211	0.435946129	6122.02046	3454.330293	2.649556536	541.6614206			21.17510696	6.83747439			432		249.0088262															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												128.4421	128.4421	25.8123	0.142373303	124.5766	0.142373303	0.142373303	39.1604	224.0361		0.142373303		35.5933	0.373220829	14.2373	26.1765	0.355933258	24.6003			0.142373303	0.29411535			24.9153		24.9153															14.207	1.033296453	1.611216932	2.523801178	1.795965563	1.519525685	1.459748969	0.919305574	5.571013141	0	5.204987047	0	0.026011763	0.162704175	7.263435624	7.535181581	0.94306529	1.110421064	0	0	3.014769923	2.011006176	0	0	0.89695181	0	0.517011383	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3264	0	24.01283537	14.207	1.033296453	1.611216932	2.523801178	1.795965563	1.519525685	1.459748969	0.919305574	5.571013141	0	5.204987047	0	0.026011763	0.162704175	7.263435624	7.535181581	0.94306529	1.110421064	0	0	3.014769923	2.011006176	0	0	0.89695181	0	0.517011383	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3264																																																																																				0	0	0	14.207	1.033296453	1.611216932	2.523801178	1.795965563	1.519525685	1.459748969	0.919305574	5.571013141	0	5.204987047	0	0.026011763	0.162704175	7.263435624	7.535181581	0.94306529	1.110421064	0	0	3.014769923	2.011006176	0	0	0.89695181	0	0.517011383	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3264
H7357_015_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1560.468691	130.3890863	771.1892873	28.25270747	184.6001814	11.86886015	10.47945174	289.4258385	292.8036809		39.57527689		10.39794577	0.590284845	6358.145236	3837.697015	4.232018702	532.7413843			22.84996208	7.589276511			432		249.1044732															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												123.4528	123.4528	24.8096	0.136842918	119.7376	0.136842918	0.136842918	37.6398	214.1157		0.136842918		34.2107	0.260773362	13.6843	24.9417	0.342107296	23.5927			0.136842918	0.274860359			23.9475		23.9475															16.0537	1.341408572	1.594409502	3.866182943	1.84196451	1.624169461	1.43403876	0.907827623	5.224488395	0	5.415596386	0	0.029643443	0.153930564	7.25055958	7.976557103	1.447804475	1.047399993	0	0	3.126855496	2.085991269	0	0	0.862110386	0	0.497119337	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7817	0	29.43717621	16.0537	1.341408572	1.594409502	3.866182943	1.84196451	1.624169461	1.43403876	0.907827623	5.224488395	0	5.415596386	0	0.029643443	0.153930564	7.25055958	7.976557103	1.447804475	1.047399993	0	0	3.126855496	2.085991269	0	0	0.862110386	0	0.497119337	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7817																																																																																				0	0	0	16.0537	1.341408572	1.594409502	3.866182943	1.84196451	1.624169461	1.43403876	0.907827623	5.224488395	0	5.415596386	0	0.029643443	0.153930564	7.25055958	7.976557103	1.447804475	1.047399993	0	0	3.126855496	2.085991269	0	0	0.862110386	0	0.497119337	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7817
H7357_016_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1508.42519	126.2323951	786.2135675	25.88225624	170.8258082	12.97914753	11.86779651	304.6397759	320.9707082		41.2455375		11.48129799	0.670487023	6469.730351	3832.597682	3.601182978	462.3725352			23.8544021	7.069127922			432		249.0812499															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												123.6254	123.6254	24.8443	0.137034173	119.9049	0.137034173	0.137034173	37.6916	208.9859		0.137034173		34.2585	0.258928516	13.7034	24.9629	0.342585432	23.5615			0.137034173	0.277336227			23.981		23.981															15.54	1.30046064	1.627743518	3.546753573	1.706904304	1.778586744	1.626293678	0.956863174	5.589863218	0	5.652048111	0	0.032777712	0.17360821	7.388117889	7.972715719	1.233712826	0.907849944	0	0	3.268868258	1.960525267	0	0	0.863315288	0	0.497767711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6247	0	29.23493205	15.54	1.30046064	1.627743518	3.546753573	1.706904304	1.778586744	1.626293678	0.956863174	5.589863218	0	5.652048111	0	0.032777712	0.17360821	7.388117889	7.972715719	1.233712826	0.907849944	0	0	3.268868258	1.960525267	0	0	0.863315288	0	0.497767711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6247																																																																																				0	0	0	15.54	1.30046064	1.627743518	3.546753573	1.706904304	1.778586744	1.626293678	0.956863174	5.589863218	0	5.652048111	0	0.032777712	0.17360821	7.388117889	7.972715719	1.233712826	0.907849944	0	0	3.268868258	1.960525267	0	0	0.863315288	0	0.497767711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6247
H7357_017_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1568.428662	118.2569456	748.1397034	29.79381468	168.6462276	12.58069663	11.09061206	287.6437169	327.5560935		42.84377268		11.93405006	0.698285138	6403.118442	4031.261672	3.205645946	622.0218735			25.52052808	7.471601813			432		249.1158107															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												122.3847	122.3847	24.595	0.135658945	118.7016	0.135658945	0.135658945	37.3137	204.5579		0.135658945		33.9147	0.214872243	13.5659	24.6279	0.339147363	23.4808			0.135658945	0.271025072			23.7403		23.7403															15.996	1.206070238	1.533372594	4.041797469	1.66821443	1.706684034	1.504540732	0.894421474	5.583681007	0	5.812141005	0	0.033728347	0.150042094	7.238669108	8.273463215	1.087186368	1.217128927	0	0	3.462087917	2.024991416	0	0	0.854651354	0	0.49284066	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7817	0	30.72500746	15.996	1.206070238	1.533372594	4.041797469	1.66821443	1.706684034	1.504540732	0.894421474	5.583681007	0	5.812141005	0	0.033728347	0.150042094	7.238669108	8.273463215	1.087186368	1.217128927	0	0	3.462087917	2.024991416	0	0	0.854651354	0	0.49284066	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7817																																																																																				0	0	0	15.996	1.206070238	1.533372594	4.041797469	1.66821443	1.706684034	1.504540732	0.894421474	5.583681007	0	5.812141005	0	0.033728347	0.150042094	7.238669108	8.273463215	1.087186368	1.217128927	0	0	3.462087917	2.024991416	0	0	0.854651354	0	0.49284066	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7817
H7357_018_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1614.387944	129.125749	705.0513247	34.59455248	150.5469018	13.70817945	12.93192611	257.294219	316.5193316		45.3830045		15.13331895	1.575615659	6566.721451	4526.881525	5.02072276	917.4628659			31.15506151	7.975432795			432		249.0103176															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												119.2572	119.2572	23.9664	0.132192158	115.6681	0.132192158	0.132192158	36.3611	198.0485		0.132192158		33.048	0.098789457	13.2192	23.9643	0.330480394	22.9486			0.132192158	0.257548757			23.1336		23.1336															16.0439	1.283264123	1.40813075	4.57312854	1.451123318	1.812113821	1.709499217	0.77962585	5.223847617	0	5.999277291	0	0.04167721	0.155654216	7.233908984	9.04028874	1.659250438	1.754537983	0	0	4.118454807	2.054062803	0	0	0.832810594	0	0.480042663	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.6546	0	34.70338446	16.0439	1.283264123	1.40813075	4.57312854	1.451123318	1.812113821	1.709499217	0.77962585	5.223847617	0	5.999277291	0	0.04167721	0.155654216	7.233908984	9.04028874	1.659250438	1.754537983	0	0	4.118454807	2.054062803	0	0	0.832810594	0	0.480042663	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.6546																																																																																				0	0	0	16.0439	1.283264123	1.40813075	4.57312854	1.451123318	1.812113821	1.709499217	0.77962585	5.223847617	0	5.999277291	0	0.04167721	0.155654216	7.233908984	9.04028874	1.659250438	1.754537983	0	0	4.118454807	2.054062803	0	0	0.832810594	0	0.480042663	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.6546
H7357_019_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		272.5713589	106.69547	774.498533	25.82249336	185.8827643	12.28102111	11.58778938	303.4109918	328.6055696		40.7658757		7.432958374	0.457179377	3875.500152	3882.601069	2.877932958	542.9975368			25.17423875	7.428138032			432		249.0142383															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															158.114	41.0367	24.8685	0.121626171	40.5421	0.162168227	0.162168227	28.3794	31.367		0.081084114		40.5421	0.19463983	8.1084	19.5923	0.405420568	20.271			0.162168227	0.173268803			12.1626		12.1626															3.5914	0.364868899	1.605051247	3.140690981	0.6280058	1.991591424	1.879171262	0.717552831	0.858947729	0	3.3054649	0	0.025112285	0.088985316	2.618679124	6.339092651	1.166773215	0.917259875	0	0	4.082461672	1.287064589	0	0	0.437854214	0	0.252388735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2985	0	8.234679783	3.5914	0.364868899	1.605051247	3.140690981	0.6280058	1.991591424	1.879171262	0.717552831	0.858947729	0	3.3054649	0	0.025112285	0.088985316	2.618679124	6.339092651	1.166773215	0.917259875	0	0	4.082461672	1.287064589	0	0	0.437854214	0	0.252388735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2985																																																																																				0	0	0	3.5914	0.364868899	1.605051247	3.140690981	0.6280058	1.991591424	1.879171262	0.717552831	0.858947729	0	3.3054649	0	0.025112285	0.088985316	2.618679124	6.339092651	1.166773215	0.917259875	0	0	4.082461672	1.287064589	0	0	0.437854214	0	0.252388735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2985
H7357_020_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		268.2877096	91.41762981	788.1301271	18.32219286	176.8599837	10.84805862	10.55368785	285.1978154	320.017478		38.75539751		8.471459893	0.467414941	3655.126038	3695.583846	2.551716954	578.7684258			22.61950136	7.292724042			432		249.0080407															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															161.0495	41.7986	25.3302	0.123884268	41.2948	0.165179024	0.165179024	28.9063	32.4318		0.082589512		41.2948	0.205312927	8.259	19.9134	0.412947559	20.6474			0.165179024	0.178208716			12.3884		12.3884															3.6006	0.318427045	1.663624693	2.269831444	0.608615821	1.79187173	1.743247853	0.687001826	0.864894996	0	3.200789358	0	0.029152239	0.095966329	2.515625624	6.132630171	1.053725287	0.995837536	0	0	3.736267147	1.299626985	0	0	0.445983364	0	0.257068156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.3108	0	7.022171031	3.6006	0.318427045	1.663624693	2.269831444	0.608615821	1.79187173	1.743247853	0.687001826	0.864894996	0	3.200789358	0	0.029152239	0.095966329	2.515625624	6.132630171	1.053725287	0.995837536	0	0	3.736267147	1.299626985	0	0	0.445983364	0	0.257068156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.3108																																																																																				0	0	0	3.6006	0.318427045	1.663624693	2.269831444	0.608615821	1.79187173	1.743247853	0.687001826	0.864894996	0	3.200789358	0	0.029152239	0.095966329	2.515625624	6.132630171	1.053725287	0.995837536	0	0	3.736267147	1.299626985	0	0	0.445983364	0	0.257068156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.3108
H7357_021_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		307.4048169	114.2772337	825.7878273	29.51079748	187.9150386	12.15882055	11.01630823	287.8744424	326.0681663		43.76091119		9.785105122	0.653468876	3758.953932	4266.016876	3.626747855	589.5445464			25.79166492	8.483437308			432		249.0632681															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															155.7916	40.4339	24.5032	0.119839729	39.9466	0.159786306	0.159786306	27.9626	31.1791		0.079893153		39.9466	0.146832474	7.9893	19.3914	0.399465765	19.9733			0.159786306	0.167235334			11.984		11.984															3.9909	0.385056422	1.686205755	3.536565983	0.625546871	1.942813018	1.760255196	0.670809908	0.84720943	0	3.496197169	0	0.032573454	0.095950452	2.502622344	6.89368376	1.448761605	0.981261929	0	0	4.121154858	1.418730475	0	0	0.431423026	0	0.248730622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.1165	0	9.341167688	3.9909	0.385056422	1.686205755	3.536565983	0.625546871	1.942813018	1.760255196	0.670809908	0.84720943	0	3.496197169	0	0.032573454	0.095950452	2.502622344	6.89368376	1.448761605	0.981261929	0	0	4.121154858	1.418730475	0	0	0.431423026	0	0.248730622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.1165																																																																																				0	0	0	3.9909	0.385056422	1.686205755	3.536565983	0.625546871	1.942813018	1.760255196	0.670809908	0.84720943	0	3.496197169	0	0.032573454	0.095950452	2.502622344	6.89368376	1.448761605	0.981261929	0	0	4.121154858	1.418730475	0	0	0.431423026	0	0.248730622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.1165
H7357_022_0	2008	6																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		318.8206591	101.9376861	866.9244335	27.32968307	175.3053786	13.31948203	12.62664489	307.1604871	376.1123523		47.90020561		10.60571139	0.775527339	3980.201071	4476.422536	2.976156196	541.6682636			27.62156826	8.3528246			432		249.0914938															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															154.646	40.1366	24.323	0.118958439	39.6528	0.158611252	0.158611252	27.757	30.096		0.079305626		39.6528	0.14709505	7.9306	19.2508	0.39652813	19.8264			0.158611252	0.168988454			11.8958		11.8958															4.1087	0.340952485	1.757186148	3.251096438	0.579279283	2.112619722	2.002727955	0.710487013	0.943290822	0	3.798755793	0	0.035045524	0.114076233	2.630436148	7.181234479	1.180129651	0.894944599	0	0	4.381091525	1.411530913	0	0	0.428250381	0	0.246929461	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1088	0	9.94427438	4.1087	0.340952485	1.757186148	3.251096438	0.579279283	2.112619722	2.002727955	0.710487013	0.943290822	0	3.798755793	0	0.035045524	0.114076233	2.630436148	7.181234479	1.180129651	0.894944599	0	0	4.381091525	1.411530913	0	0	0.428250381	0	0.246929461	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1088																																																																																				0	0	0	4.1087	0.340952485	1.757186148	3.251096438	0.579279283	2.112619722	2.002727955	0.710487013	0.943290822	0	3.798755793	0	0.035045524	0.114076233	2.630436148	7.181234479	1.180129651	0.894944599	0	0	4.381091525	1.411530913	0	0	0.428250381	0	0.246929461	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1088
H7357_023_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		344.2589641	111.9767662	872.6560888	33.38948937	187.0147126	14.08044769	12.71911735	318.0452457	398.2298215		52.07832797		12.21316992	0.779035565	4073.117515	4899.007873	3.165489926	732.1079283			31.22709573	9.19837804			432		249.1326811															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															150.7259	39.1192	23.7065	0.115943	38.6477	0.154590667	0.154590667	27.0534	29.0401		0.077295333		38.6477	0.128767274	7.7295	18.8138	0.386476667	19.3238			0.154590667	0.16232222			11.5943		11.5943															4.3241	0.365036496	1.72396692	3.871277571	0.602306857	2.176705798	1.966256832	0.717016222	0.963718752	0	4.025411724	0	0.03933421	0.100314286	2.623608137	7.680754256	1.223387996	1.178927634	0	0	4.827417553	1.493101144	0	0	0.4173948	0	0.240709921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5607	0	11.91426872	4.3241	0.365036496	1.72396692	3.871277571	0.602306857	2.176705798	1.966256832	0.717016222	0.963718752	0	4.025411724	0	0.03933421	0.100314286	2.623608137	7.680754256	1.223387996	1.178927634	0	0	4.827417553	1.493101144	0	0	0.4173948	0	0.240709921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5607																																																																																				0	0	0	4.3241	0.365036496	1.72396692	3.871277571	0.602306857	2.176705798	1.966256832	0.717016222	0.963718752	0	4.025411724	0	0.03933421	0.100314286	2.623608137	7.680754256	1.223387996	1.178927634	0	0	4.827417553	1.493101144	0	0	0.4173948	0	0.240709921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5607
H7357_024_0	2008	6																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		350.0163672	113.2845194	834.867558	37.70261256	169.1483791	14.40916709	13.69887346	288.4180947	396.813166		56.57926057		14.11816395	1.492668053	3956.518462	5629.24655	4.509250418	1000.039713			35.43025129	10.03539118			432		249.0058766															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															147.1072	38.18	23.1373	0.113159371	37.7198	0.150879162	0.150879162	26.4039	28.1497		0.075439581		37.7198	0.07505711	7.544	18.3884	0.377197905	18.8599			0.150879162	0.15676468			11.3159		11.3159															4.2908	0.360433314	1.609716452	4.26640394	0.531686785	2.174043055	2.066874547	0.634612423	0.93084749	0	4.268315709	0	0.044377849	0.11203535	2.487317458	8.626067843	1.70087981	1.571720352	0	0	5.345686622	1.573194888	0	0	0.407373737	0	0.234811237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2372	0	14.07648831	4.2908	0.360433314	1.609716452	4.26640394	0.531686785	2.174043055	2.066874547	0.634612423	0.93084749	0	4.268315709	0	0.044377849	0.11203535	2.487317458	8.626067843	1.70087981	1.571720352	0	0	5.345686622	1.573194888	0	0	0.407373737	0	0.234811237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2372																																																																																				0	0	0	4.2908	0.360433314	1.609716452	4.26640394	0.531686785	2.174043055	2.066874547	0.634612423	0.93084749	0	4.268315709	0	0.044377849	0.11203535	2.487317458	8.626067843	1.70087981	1.571720352	0	0	5.345686622	1.573194888	0	0	0.407373737	0	0.234811237	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2372
H7357_025_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1432.514236	144.7570467	794.7019514	27.61488204	205.4965764	13.45782384	12.23147116	342.1024615	318.9124524		39.2224862		9.116097291	0.424391181	3866.241741	3762.64782	3.64108785	517.9873444			23.92609588	7.016875842			432		249.0125575															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												98.0578	98.0578	22.8563	0.111785016	74.5233	0.149046688	0.149046688	37.2617	115.6531		0.149046688		37.2617	0.328330816	14.9047	22.9727	0.37261672	22.0647			0.149046688	0.272654413			22.357		22.357															11.7058	1.182879988	1.513662821	3.086930031	1.276191005	2.005844072	1.823060266	1.062275809	3.073600799	0	5.845981664	0	0.028306752	0.139340703	4.802087722	7.203183573	1.356730212	0.952438153	0	0	3.566105348	1.913182166	0	0	0.804852115	0	0.463931212	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8064	0	18.39431592	11.7058	1.182879988	1.513662821	3.086930031	1.276191005	2.005844072	1.823060266	1.062275809	3.073600799	0	5.845981664	0	0.028306752	0.139340703	4.802087722	7.203183573	1.356730212	0.952438153	0	0	3.566105348	1.913182166	0	0	0.804852115	0	0.463931212	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8064																																																																																				0	0	0	11.7058	1.182879988	1.513662821	3.086930031	1.276191005	2.005844072	1.823060266	1.062275809	3.073600799	0	5.845981664	0	0.028306752	0.139340703	4.802087722	7.203183573	1.356730212	0.952438153	0	0	3.566105348	1.913182166	0	0	0.804852115	0	0.463931212	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8064
H7357_026_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1340.697864	97.51083773	756.594039	17.90525849	174.7417394	10.7803659	10.35627642	284.5386006	301.4056382		36.92709208		8.858016537	0.440338687	3471.967474	3489.135845	2.676253253	547.1191573			21.38846563	6.906368229			432		249.0089152															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												101.1949	101.1949	23.5875	0.115361272	76.9075	0.153815029	0.153815029	38.4538	121.0203		0.153815029		38.4538	0.350206451	15.3815	23.7535	0.384537574	22.817			0.153815029	0.279409319			23.0723		23.0723															11.306	0.82230002	1.48718235	2.065573396	1.119912741	1.658182299	1.592950962	0.911798192	3.039683853	0	5.679941755	0	0.028385335	0.154209449	4.450339828	6.906599507	1.029119932	1.040302603	0	0	3.28986747	1.929703644	0	0	0.830601159	0	0.47876642	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8214	0	14.95952693	11.306	0.82230002	1.48718235	2.065573396	1.119912741	1.658182299	1.592950962	0.911798192	3.039683853	0	5.679941755	0	0.028385335	0.154209449	4.450339828	6.906599507	1.029119932	1.040302603	0	0	3.28986747	1.929703644	0	0	0.830601159	0	0.47876642	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8214																																																																																				0	0	0	11.306	0.82230002	1.48718235	2.065573396	1.119912741	1.658182299	1.592950962	0.911798192	3.039683853	0	5.679941755	0	0.028385335	0.154209449	4.450339828	6.906599507	1.029119932	1.040302603	0	0	3.28986747	1.929703644	0	0	0.830601159	0	0.47876642	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8214
H7357_027_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1573.876873	131.5094424	777.8156594	28.49546623	186.1863413	11.97084222	10.56949545	291.908826	295.3195692		39.91532377		10.48728915	0.595356813	3474.997964	3870.672069	4.268381929	537.318915			23.04629825	7.654486662			432		249.1053709															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												97.9313	97.9313	22.8268	0.111640746	74.4272	0.148854329	0.148854329	37.2136	116.4549		0.148854329		37.2136	0.24633069	14.8854	22.8689	0.372135821	22.0387			0.148854329	0.263144209			22.3281		22.3281															12.8443	1.07324048	1.479587606	3.181255119	1.154776784	1.781911681	1.573315149	0.905247756	2.86594999	0	5.941568718	0	0.032522466	0.146654655	4.310570738	7.376493346	1.588417815	0.986816264	0	0	3.430541252	2.014233835	0	0	0.803813374	0	0.463505159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.9547	0	18.53860186	12.8443	1.07324048	1.479587606	3.181255119	1.154776784	1.781911681	1.573315149	0.905247756	2.86594999	0	5.941568718	0	0.032522466	0.146654655	4.310570738	7.376493346	1.588417815	0.986816264	0	0	3.430541252	2.014233835	0	0	0.803813374	0	0.463505159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.9547																																																																																				0	0	0	12.8443	1.07324048	1.479587606	3.181255119	1.154776784	1.781911681	1.573315149	0.905247756	2.86594999	0	5.941568718	0	0.032522466	0.146654655	4.310570738	7.376493346	1.588417815	0.986816264	0	0	3.430541252	2.014233835	0	0	0.803813374	0	0.463505159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.9547
H7357_028_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1566.855317	131.1221138	816.6682161	26.88482736	177.4428906	13.4819058	12.32750566	316.4237349	333.4037805		42.84321834		11.9260358	0.696458906	3613.653348	3981.0566	3.740677851	480.2829271			24.77842257	7.342956581			432		249.0843972															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												97.1622	97.1622	22.6476	0.110764059	73.8427	0.147685412	0.147685412	36.9214	112.6149		0.147685412		36.9214	0.242746984	14.7685	22.6819	0.369213531	21.8138			0.147685412	0.263375469			22.1528		22.1528															12.6866	1.061676446	1.541295065	2.977872612	1.091905269	1.991080818	1.820592758	0.973566037	3.128852013	0	6.327318368	0	0.036693782	0.169063299	4.447365708	7.524830447	1.381108878	0.873064847	0	0	3.659411556	1.933954635	0	0	0.797501227	0	0.459826649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.8836	0	19.44140359	12.6866	1.061676446	1.541295065	2.977872612	1.091905269	1.991080818	1.820592758	0.973566037	3.128852013	0	6.327318368	0	0.036693782	0.169063299	4.447365708	7.524830447	1.381108878	0.873064847	0	0	3.659411556	1.933954635	0	0	0.797501227	0	0.459826649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.8836																																																																																				0	0	0	12.6866	1.061676446	1.541295065	2.977872612	1.091905269	1.991080818	1.820592758	0.973566037	3.128852013	0	6.327318368	0	0.036693782	0.169063299	4.447365708	7.524830447	1.381108878	0.873064847	0	0	3.659411556	1.933954635	0	0	0.797501227	0	0.459826649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.8836
H7357_029_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1612.052457	121.5461081	768.948232	30.62249072	173.3369021	12.93061228	11.39908294	295.6323372	336.6666384		44.03541625		12.26598007	0.717707027	3520.48089	4143.38595	3.294806801	639.3225994			26.23034823	7.679414658			432		249.1190319															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												96.5965	96.5965	22.5157	0.11011908	73.4127	0.14682544	0.14682544	36.7064	110.6978		0.14682544		36.7064	0.202595183	14.6825	22.5041	0.3670636	21.8131			0.14682544	0.258747319			22.0238		22.0238															12.9765	0.978410282	1.442782771	3.372120501	1.060427787	1.898542835	1.673675367	0.904298916	3.105688388	0	6.46551936	0	0.037519957	0.145403986	4.30746796	7.770279771	1.209403644	1.162135416	0	0	3.851282416	1.987027954	0	0	0.792857375	0	0.457212643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.5986	0	20.13568832	12.9765	0.978410282	1.442782771	3.372120501	1.060427787	1.898542835	1.673675367	0.904298916	3.105688388	0	6.46551936	0	0.037519957	0.145403986	4.30746796	7.770279771	1.209403644	1.162135416	0	0	3.851282416	1.987027954	0	0	0.792857375	0	0.457212643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.5986																																																																																				0	0	0	12.9765	0.978410282	1.442782771	3.372120501	1.060427787	1.898542835	1.673675367	0.904298916	3.105688388	0	6.46551936	0	0.037519957	0.145403986	4.30746796	7.770279771	1.209403644	1.162135416	0	0	3.851282416	1.987027954	0	0	0.792857375	0	0.457212643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.5986
H7357_030_0	2008	6																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1657.180468	132.5484806	723.7400951	35.51154905	154.5374431	14.07154168	13.27471222	264.1028983	324.9092983		46.58597018		15.5344573	1.617380447	3404.666226	4646.875412	5.153806879	941.7820214			31.98088762	8.186837308			432		249.0105911															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												94.1952	94.1952	21.956	0.107381623	71.5877	0.143175498	0.143175498	35.7939	107.2518		0.143175498		35.7939	0.094299511	14.3175	21.9262	0.357938745	21.326			0.143175498	0.246529621			21.4763		21.4763															13.0082	1.040452113	1.324200872	3.813287789	0.92191564	2.014699986	1.900613532	0.787772166	2.903925129	0	6.669969477	0	0.046336535	0.152518186	4.062206519	8.490677724	1.844747166	1.673703243	0	0	4.578879509	2.018297897	0	0	0.773147689	0	0.445652692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4712	0	23.20646337	13.0082	1.040452113	1.324200872	3.813287789	0.92191564	2.014699986	1.900613532	0.787772166	2.903925129	0	6.669969477	0	0.046336535	0.152518186	4.062206519	8.490677724	1.844747166	1.673703243	0	0	4.578879509	2.018297897	0	0	0.773147689	0	0.445652692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4712																																																																																				0	0	0	13.0082	1.040452113	1.324200872	3.813287789	0.92191564	2.014699986	1.900613532	0.787772166	2.903925129	0	6.669969477	0	0.046336535	0.152518186	4.062206519	8.490677724	1.844747166	1.673703243	0	0	4.578879509	2.018297897	0	0	0.773147689	0	0.445652692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4712
H7357_031_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1420.471417	143.5401073	788.0210737	27.38273004	203.7690136	13.344687	12.12864398	339.2301777	316.2314283		38.89275172		9.039460345	0.420823421	6809.310992	3731.016099	3.610478056	513.6327432			23.72495466	6.957886571			432		249.0124519															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												123.6279	123.6279	24.8448	0.137036982	119.9074	0.137036982	0.137036982	37.6918	212.6683		0.137036982		34.2592	0.346135585	13.7037	25.1137	0.342592455	23.6232			0.137036982	0.284999146			23.9815		23.9815															14.6342	1.478796997	1.63151915	3.752446687	2.036117029	1.828715634	1.662072768	1.065517054	5.604365674	0	5.329745323	0	0.025807091	0.145661961	7.776061907	7.808287623	1.236922542	1.011137045	0	0	3.251196188	1.982991733	0	0	0.863332987	0	0.497640426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6225	0	29.23199463	14.6342	1.478796997	1.63151915	3.752446687	2.036117029	1.828715634	1.662072768	1.065517054	5.604365674	0	5.329745323	0	0.025807091	0.145661961	7.776061907	7.808287623	1.236922542	1.011137045	0	0	3.251196188	1.982991733	0	0	0.863332987	0	0.497640426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6225																																																																																				0	0	0	14.6342	1.478796997	1.63151915	3.752446687	2.036117029	1.828715634	1.662072768	1.065517054	5.604365674	0	5.329745323	0	0.025807091	0.145661961	7.776061907	7.808287623	1.236922542	1.011137045	0	0	3.251196188	1.982991733	0	0	0.863332987	0	0.497640426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6225
H7357_032_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1327.323856	96.53812737	749.0467051	17.72664623	172.9986193	10.67282736	10.25296834	281.7043117	298.3989941		36.55872928		8.769654211	0.435946129	6122.02046	3454.330293	2.649556536	541.6614206			21.17510696	6.83747439			432		249.0088262															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												128.4421	128.4421	25.8123	0.142373303	124.5766	0.142373303	0.142373303	39.1604	224.0361		0.142373303		35.5933	0.373220829	14.2373	26.1765	0.355933258	24.6003			0.142373303	0.29411535			24.9153		24.9153															14.207	1.033296453	1.611216932	2.523801178	1.795965563	1.519525685	1.459748969	0.919305574	5.571013141	0	5.204987047	0	0.026011763	0.162704175	7.263435624	7.535181581	0.94306529	1.110421064	0	0	3.014769923	2.011006176	0	0	0.89695181	0	0.517011383	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3264	0	24.01283537	14.207	1.033296453	1.611216932	2.523801178	1.795965563	1.519525685	1.459748969	0.919305574	5.571013141	0	5.204987047	0	0.026011763	0.162704175	7.263435624	7.535181581	0.94306529	1.110421064	0	0	3.014769923	2.011006176	0	0	0.89695181	0	0.517011383	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3264																																																																																				0	0	0	14.207	1.033296453	1.611216932	2.523801178	1.795965563	1.519525685	1.459748969	0.919305574	5.571013141	0	5.204987047	0	0.026011763	0.162704175	7.263435624	7.535181581	0.94306529	1.110421064	0	0	3.014769923	2.011006176	0	0	0.89695181	0	0.517011383	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3264
H7357_033_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1560.468691	130.3890863	771.1892873	28.25270747	184.6001814	11.86886015	10.47945174	289.4258385	292.8036809		39.57527689		10.39794577	0.590284845	6358.145236	3837.697015	4.232018702	532.7413843			22.84996208	7.589276511			432		249.1044732															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												123.4528	123.4528	24.8096	0.136842918	119.7376	0.136842918	0.136842918	37.6398	214.1157		0.136842918		34.2107	0.260773362	13.6843	24.9417	0.342107296	23.5927			0.136842918	0.274860359			23.9475		23.9475															16.0537	1.341408572	1.594409502	3.866182943	1.84196451	1.624169461	1.43403876	0.907827623	5.224488395	0	5.415596386	0	0.029643443	0.153930564	7.25055958	7.976557103	1.447804475	1.047399993	0	0	3.126855496	2.085991269	0	0	0.862110386	0	0.497119337	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7817	0	29.43717621	16.0537	1.341408572	1.594409502	3.866182943	1.84196451	1.624169461	1.43403876	0.907827623	5.224488395	0	5.415596386	0	0.029643443	0.153930564	7.25055958	7.976557103	1.447804475	1.047399993	0	0	3.126855496	2.085991269	0	0	0.862110386	0	0.497119337	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7817																																																																																				0	0	0	16.0537	1.341408572	1.594409502	3.866182943	1.84196451	1.624169461	1.43403876	0.907827623	5.224488395	0	5.415596386	0	0.029643443	0.153930564	7.25055958	7.976557103	1.447804475	1.047399993	0	0	3.126855496	2.085991269	0	0	0.862110386	0	0.497119337	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7817
H7357_034_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1508.42519	126.2323951	786.2135675	25.88225624	170.8258082	12.97914753	11.86779651	304.6397759	320.9707082		41.2455375		11.48129799	0.670487023	6469.730351	3832.597682	3.601182978	462.3725352			23.8544021	7.069127922			432		249.0812499															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												123.6254	123.6254	24.8443	0.137034173	119.9049	0.137034173	0.137034173	37.6916	208.9859		0.137034173		34.2585	0.258928516	13.7034	24.9629	0.342585432	23.5615			0.137034173	0.277336227			23.981		23.981															15.54	1.30046064	1.627743518	3.546753573	1.706904304	1.778586744	1.626293678	0.956863174	5.589863218	0	5.652048111	0	0.032777712	0.17360821	7.388117889	7.972715719	1.233712826	0.907849944	0	0	3.268868258	1.960525267	0	0	0.863315288	0	0.497767711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6247	0	29.23493205	15.54	1.30046064	1.627743518	3.546753573	1.706904304	1.778586744	1.626293678	0.956863174	5.589863218	0	5.652048111	0	0.032777712	0.17360821	7.388117889	7.972715719	1.233712826	0.907849944	0	0	3.268868258	1.960525267	0	0	0.863315288	0	0.497767711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6247																																																																																				0	0	0	15.54	1.30046064	1.627743518	3.546753573	1.706904304	1.778586744	1.626293678	0.956863174	5.589863218	0	5.652048111	0	0.032777712	0.17360821	7.388117889	7.972715719	1.233712826	0.907849944	0	0	3.268868258	1.960525267	0	0	0.863315288	0	0.497767711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6247
H7357_035_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1568.428662	118.2569456	748.1397034	29.79381468	168.6462276	12.58069663	11.09061206	287.6437169	327.5560935		42.84377268		11.93405006	0.698285138	6403.118442	4031.261672	3.205645946	622.0218735			25.52052808	7.471601813			432		249.1158107															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												122.3847	122.3847	24.595	0.135658945	118.7016	0.135658945	0.135658945	37.3137	204.5579		0.135658945		33.9147	0.214872243	13.5659	24.6279	0.339147363	23.4808			0.135658945	0.271025072			23.7403		23.7403															15.996	1.206070238	1.533372594	4.041797469	1.66821443	1.706684034	1.504540732	0.894421474	5.583681007	0	5.812141005	0	0.033728347	0.150042094	7.238669108	8.273463215	1.087186368	1.217128927	0	0	3.462087917	2.024991416	0	0	0.854651354	0	0.49284066	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7817	0	30.72500746	15.996	1.206070238	1.533372594	4.041797469	1.66821443	1.706684034	1.504540732	0.894421474	5.583681007	0	5.812141005	0	0.033728347	0.150042094	7.238669108	8.273463215	1.087186368	1.217128927	0	0	3.462087917	2.024991416	0	0	0.854651354	0	0.49284066	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7817																																																																																				0	0	0	15.996	1.206070238	1.533372594	4.041797469	1.66821443	1.706684034	1.504540732	0.894421474	5.583681007	0	5.812141005	0	0.033728347	0.150042094	7.238669108	8.273463215	1.087186368	1.217128927	0	0	3.462087917	2.024991416	0	0	0.854651354	0	0.49284066	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7817
H7357_036_0	2008	6																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1614.387944	129.125749	705.0513247	34.59455248	150.5469018	13.70817945	12.93192611	257.294219	316.5193316		45.3830045		15.13331895	1.575615659	6566.721451	4526.881525	5.02072276	917.4628659			31.15506151	7.975432795			432		249.0103176															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												119.2572	119.2572	23.9664	0.132192158	115.6681	0.132192158	0.132192158	36.3611	198.0485		0.132192158		33.048	0.098789457	13.2192	23.9643	0.330480394	22.9486			0.132192158	0.257548757			23.1336		23.1336															16.0439	1.283264123	1.40813075	4.57312854	1.451123318	1.812113821	1.709499217	0.77962585	5.223847617	0	5.999277291	0	0.04167721	0.155654216	7.233908984	9.04028874	1.659250438	1.754537983	0	0	4.118454807	2.054062803	0	0	0.832810594	0	0.480042663	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.6546	0	34.70338446	16.0439	1.283264123	1.40813075	4.57312854	1.451123318	1.812113821	1.709499217	0.77962585	5.223847617	0	5.999277291	0	0.04167721	0.155654216	7.233908984	9.04028874	1.659250438	1.754537983	0	0	4.118454807	2.054062803	0	0	0.832810594	0	0.480042663	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.6546																																																																																				0	0	0	16.0439	1.283264123	1.40813075	4.57312854	1.451123318	1.812113821	1.709499217	0.77962585	5.223847617	0	5.999277291	0	0.04167721	0.155654216	7.233908984	9.04028874	1.659250438	1.754537983	0	0	4.118454807	2.054062803	0	0	0.832810594	0	0.480042663	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.6546
H7357_037_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		429.3049209	166.9808375	715.0196368	73.97954202	349.6858159	19.7279181	14.77924277	323.5258963	393.6326373		66.26152552		26.9614666	0.987702118	4429.547615	5835.865636	8.700224569	514.9333497			36.02030324	9.664503466			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															138.6231	35.978	21.8029	0.106633135	35.5444	0.142177513	0.142177513	24.8811	26.6499		0.071088757		35.5444	0.072508629	7.1089	17.4321	0.355443783	17.7722			0.142177513	0.136826875			10.6633		10.6633															4.9593	0.500636655	1.299126427	7.888670487	1.035780411	2.804866338	2.101275985	0.670805733	0.874189752	0	4.710449461	0	0.079860714	0.071616927	2.624091936	8.477600439	3.092440735	0.762624408	0	0	5.121277141	1.322363809	0	0	0.383879286	0	0.221263755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0021	0	19.92877946	4.9593	0.500636655	1.299126427	7.888670487	1.035780411	2.804866338	2.101275985	0.670805733	0.874189752	0	4.710449461	0	0.079860714	0.071616927	2.624091936	8.477600439	3.092440735	0.762624408	0	0	5.121277141	1.322363809	0	0	0.383879286	0	0.221263755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0021																																																																																				0	0	0	4.9593	0.500636655	1.299126427	7.888670487	1.035780411	2.804866338	2.101275985	0.670805733	0.874189752	0	4.710449461	0	0.079860714	0.071616927	2.624091936	8.477600439	3.092440735	0.762624408	0	0	5.121277141	1.322363809	0	0	0.383879286	0	0.221263755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0021
H7357_038_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2226.817515	104.9668274	566.5823426	54.94401462	263.52399	15.24547941	11.44851646	245.8914935	323.00719		54.1417736		18.76398452	0.833927234	3513.793264	4754.700592	5.978574946	412.524196			29.22133854	7.932054939			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												90.7355	90.7355	21.1495	0.103437619	68.9584	0.137916825	0.137916825	34.4792	103.1457		0.137916825		34.4792	0.118774484	13.7917	21.0209	0.344792063	20.3466			0.137916825	0.223891917			20.6875		20.6875															16.8376	0.793684615	0.998579901	5.683278038	1.514349667	2.102608116	1.578943041	0.70651196	2.776401036	0	7.467061516	0	0.053913941	0.099049277	4.038426756	8.328988719	2.061365187	0.699455567	0	0	4.030114234	1.775922987	0	0	0.744750855	0	0.429266118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7203	0	28.23349791	16.8376	0.793684615	0.998579901	5.683278038	1.514349667	2.102608116	1.578943041	0.70651196	2.776401036	0	7.467061516	0	0.053913941	0.099049277	4.038426756	8.328988719	2.061365187	0.699455567	0	0	4.030114234	1.775922987	0	0	0.744750855	0	0.429266118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7203																																																																																				0	0	0	16.8376	0.793684615	0.998579901	5.683278038	1.514349667	2.102608116	1.578943041	0.70651196	2.776401036	0	7.467061516	0	0.053913941	0.099049277	4.038426756	8.328988719	2.061365187	0.699455567	0	0	4.030114234	1.775922987	0	0	0.744750855	0	0.429266118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7203
H7357_039_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2214.597063	104.3907846	563.4730207	54.64248982	262.0778085	15.16181443	11.38568865	244.5439923	321.2345733		53.84465138		18.66101049	0.829350762	6473.554596	4728.607483	5.945765392	410.2603229			29.06097607	7.888524969			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												113.3771	113.3771	22.7848	0.125674324	109.965	0.125674324	0.125674324	34.5672	187.9795		0.125674324		31.4186	0.123304464	12.5674	22.6005	0.31418581	21.5788			0.125674324	0.231867252			21.993		21.993															20.9237	0.986293627	1.069882891	6.867157968	2.401616248	1.905450778	1.430888724	0.704432748	5.03212698	0	6.766890161	0	0.048858539	0.102262651	6.779663312	8.905736651	1.868075115	0.737743723	0	0	3.652218521	1.829090604	0	0	0.791748241	0	0.456354889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2602	0	43.32718274	20.9237	0.986293627	1.069882891	6.867157968	2.401616248	1.905450778	1.430888724	0.704432748	5.03212698	0	6.766890161	0	0.048858539	0.102262651	6.779663312	8.905736651	1.868075115	0.737743723	0	0	3.652218521	1.829090604	0	0	0.791748241	0	0.456354889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2602																																																																																				0	0	0	20.9237	0.986293627	1.069882891	6.867157968	2.401616248	1.905450778	1.430888724	0.704432748	5.03212698	0	6.766890161	0	0.048858539	0.102262651	6.779663312	8.905736651	1.868075115	0.737743723	0	0	3.652218521	1.829090604	0	0	0.791748241	0	0.456354889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2602
H7357_040_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		429.3049209	166.9808375	715.0196368	73.97954202	349.6858159	19.7279181	14.77924277	323.5258963	393.6326373		66.26152552		26.9614666	0.987702118	4429.547615	5835.865636	8.700224569	514.9333497			36.02030324	9.664503466			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															138.6231	35.978	21.8029	0.106633135	35.5444	0.142177513	0.142177513	24.8811	26.6499		0.071088757		35.5444	0.072508629	7.1089	17.4321	0.355443783	17.7722			0.142177513	0.136826875			10.6633		10.6633															4.9593	0.500636655	1.299126427	7.888670487	1.035780411	2.804866338	2.101275985	0.670805733	0.874189752	0	4.710449461	0	0.079860714	0.071616927	2.624091936	8.477600439	3.092440735	0.762624408	0	0	5.121277141	1.322363809	0	0	0.383879286	0	0.221263755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0021	0	19.92877946	4.9593	0.500636655	1.299126427	7.888670487	1.035780411	2.804866338	2.101275985	0.670805733	0.874189752	0	4.710449461	0	0.079860714	0.071616927	2.624091936	8.477600439	3.092440735	0.762624408	0	0	5.121277141	1.322363809	0	0	0.383879286	0	0.221263755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0021																																																																																				0	0	0	4.9593	0.500636655	1.299126427	7.888670487	1.035780411	2.804866338	2.101275985	0.670805733	0.874189752	0	4.710449461	0	0.079860714	0.071616927	2.624091936	8.477600439	3.092440735	0.762624408	0	0	5.121277141	1.322363809	0	0	0.383879286	0	0.221263755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0021
H7357_041_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2226.817515	104.9668274	566.5823426	54.94401462	263.52399	15.24547941	11.44851646	245.8914935	323.00719		54.1417736		18.76398452	0.833927234	3513.793264	4754.700592	5.978574946	412.524196			29.22133854	7.932054939			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												90.7355	90.7355	21.1495	0.103437619	68.9584	0.137916825	0.137916825	34.4792	103.1457		0.137916825		34.4792	0.118774484	13.7917	21.0209	0.344792063	20.3466			0.137916825	0.223891917			20.6875		20.6875															16.8376	0.793684615	0.998579901	5.683278038	1.514349667	2.102608116	1.578943041	0.70651196	2.776401036	0	7.467061516	0	0.053913941	0.099049277	4.038426756	8.328988719	2.061365187	0.699455567	0	0	4.030114234	1.775922987	0	0	0.744750855	0	0.429266118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7203	0	28.23349791	16.8376	0.793684615	0.998579901	5.683278038	1.514349667	2.102608116	1.578943041	0.70651196	2.776401036	0	7.467061516	0	0.053913941	0.099049277	4.038426756	8.328988719	2.061365187	0.699455567	0	0	4.030114234	1.775922987	0	0	0.744750855	0	0.429266118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7203																																																																																				0	0	0	16.8376	0.793684615	0.998579901	5.683278038	1.514349667	2.102608116	1.578943041	0.70651196	2.776401036	0	7.467061516	0	0.053913941	0.099049277	4.038426756	8.328988719	2.061365187	0.699455567	0	0	4.030114234	1.775922987	0	0	0.744750855	0	0.429266118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7203
H7357_042_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2214.597063	104.3907846	563.4730207	54.64248982	262.0778085	15.16181443	11.38568865	244.5439923	321.2345733		53.84465138		18.66101049	0.829350762	6473.554596	4728.607483	5.945765392	410.2603229			29.06097607	7.888524969			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												113.3771	113.3771	22.7848	0.125674324	109.965	0.125674324	0.125674324	34.5672	187.9795		0.125674324		31.4186	0.123304464	12.5674	22.6005	0.31418581	21.5788			0.125674324	0.231867252			21.993		21.993															20.9237	0.986293627	1.069882891	6.867157968	2.401616248	1.905450778	1.430888724	0.704432748	5.03212698	0	6.766890161	0	0.048858539	0.102262651	6.779663312	8.905736651	1.868075115	0.737743723	0	0	3.652218521	1.829090604	0	0	0.791748241	0	0.456354889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2602	0	43.32718274	20.9237	0.986293627	1.069882891	6.867157968	2.401616248	1.905450778	1.430888724	0.704432748	5.03212698	0	6.766890161	0	0.048858539	0.102262651	6.779663312	8.905736651	1.868075115	0.737743723	0	0	3.652218521	1.829090604	0	0	0.791748241	0	0.456354889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2602																																																																																				0	0	0	20.9237	0.986293627	1.069882891	6.867157968	2.401616248	1.905450778	1.430888724	0.704432748	5.03212698	0	6.766890161	0	0.048858539	0.102262651	6.779663312	8.905736651	1.868075115	0.737743723	0	0	3.652218521	1.829090604	0	0	0.791748241	0	0.456354889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2602
H7357_043_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		349.2372315	131.8735689	817.2065607	77.5424353	186.0201142	18.5678963	12.85881689	291.9525022	407.7995099		62.21427717		25.82455557	0.59122415	4325.559062	5369.138744	3.570410423	373.7671834			43.77795007	10.23270341			432		249.0720472															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															141.9773	36.8486	22.3305	0.109213306	36.4044	0.145617741	0.145617741	25.4831	26.4382		0.07280887		36.4044	0.194729783	7.2809	17.8214	0.364044352	18.2022			0.145617741	0.136480749			10.9213		10.9213															4.132	0.404946028	1.520717934	8.468665681	0.564329766	2.70381511	1.872471865	0.619988013	0.898457104	0	4.529751242	0	0.07834403	0.115128951	2.624492242	7.97378412	1.299787749	0.5669493	0	0	6.374846184	1.396567021	0	0	0.3931679	0	0.22668318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7649	0	17.4647639	4.132	0.404946028	1.520717934	8.468665681	0.564329766	2.70381511	1.872471865	0.619988013	0.898457104	0	4.529751242	0	0.07834403	0.115128951	2.624492242	7.97378412	1.299787749	0.5669493	0	0	6.374846184	1.396567021	0	0	0.3931679	0	0.22668318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7649																																																																																				0	0	0	4.132	0.404946028	1.520717934	8.468665681	0.564329766	2.70381511	1.872471865	0.619988013	0.898457104	0	4.529751242	0	0.07834403	0.115128951	2.624492242	7.97378412	1.299787749	0.5669493	0	0	6.374846184	1.396567021	0	0	0.3931679	0	0.22668318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7649
H7357_044_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2269.287306	171.643136	820.321439	93.52545172	198.121196	20.2095183	13.25350204	318.9304155	364.8961931		56.85073683		37.74323163	0.545639064	4106.958755	4852.014547	4.072792887	338.0732422			39.54699561	9.241746784			432		249.0589014															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												80.5336	80.5336	18.7716	0.091807574	61.205	0.122410099	0.122410099	30.6025	89.1772		0.122410099		30.6025	0.288622991	12.241	18.6875	0.306025248	17.9961			0.122410099	0.192788394			18.3615		18.3615															15.2295	1.151920032	1.283228054	8.586344858	1.010501468	2.473849137	1.622362498	0.813339661	2.711701613	0	6.959104328	0	0.096253182	0.157483978	4.189443568	7.556002948	1.246377452	0.506998619	0	0	4.840951651	1.781701517	0	0	0.661014535	0	0.38109156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2592	0	40.09695345	15.2295	1.151920032	1.283228054	8.586344858	1.010501468	2.473849137	1.622362498	0.813339661	2.711701613	0	6.959104328	0	0.096253182	0.157483978	4.189443568	7.556002948	1.246377452	0.506998619	0	0	4.840951651	1.781701517	0	0	0.661014535	0	0.38109156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2592																																																																																				0	0	0	15.2295	1.151920032	1.283228054	8.586344858	1.010501468	2.473849137	1.622362498	0.813339661	2.711701613	0	6.959104328	0	0.096253182	0.157483978	4.189443568	7.556002948	1.246377452	0.506998619	0	0	4.840951651	1.781701517	0	0	0.661014535	0	0.38109156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2592
H7357_045_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2255.234506	170.5802179	815.2415123	92.94628554	196.8943097	20.08436873	13.17142834	316.9578502	362.6365351		56.49868268		37.5095027	0.542260137	7725.307125	4821.967938	4.047571689	335.9796882			39.30209669	9.184516296			432		249.0585366															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												99.2482	99.2482	19.9454	0.110012968	96.2613	0.110012968	0.110012968	30.2587	160.2915		0.110012968		27.5032	0.301324116	11.0013	19.8382	0.275032421	18.8143			0.110012968	0.196423261			19.2523		19.2523															18.6523	1.410814956	1.355023187	10.22529676	1.579442626	2.209541021	1.449027928	0.799227842	4.843962277	0	6.215587786	0	0.085969411	0.163396056	7.082366399	7.971603536	1.11321344	0.526769526	0	0	4.323740317	1.804052639	0	0	0.6930817	0	0.399578505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.904	0	59.63312345	18.6523	1.410814956	1.355023187	10.22529676	1.579442626	2.209541021	1.449027928	0.799227842	4.843962277	0	6.215587786	0	0.085969411	0.163396056	7.082366399	7.971603536	1.11321344	0.526769526	0	0	4.323740317	1.804052639	0	0	0.6930817	0	0.399578505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.904																																																																																				0	0	0	18.6523	1.410814956	1.355023187	10.22529676	1.579442626	2.209541021	1.449027928	0.799227842	4.843962277	0	6.215587786	0	0.085969411	0.163396056	7.082366399	7.971603536	1.11321344	0.526769526	0	0	4.323740317	1.804052639	0	0	0.6930817	0	0.399578505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.904
H7357_046_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		349.2372315	131.8735689	817.2065607	77.5424353	186.0201142	18.5678963	12.85881689	291.9525022	407.7995099		62.21427717		25.82455557	0.59122415	4325.559062	5369.138744	3.570410423	373.7671834			43.77795007	10.23270341			432		249.0720472															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															141.9773	36.8486	22.3305	0.109213306	36.4044	0.145617741	0.145617741	25.4831	26.4382		0.07280887		36.4044	0.194729783	7.2809	17.8214	0.364044352	18.2022			0.145617741	0.136480749			10.9213		10.9213															4.132	0.404946028	1.520717934	8.468665681	0.564329766	2.70381511	1.872471865	0.619988013	0.898457104	0	4.529751242	0	0.07834403	0.115128951	2.624492242	7.97378412	1.299787749	0.5669493	0	0	6.374846184	1.396567021	0	0	0.3931679	0	0.22668318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7649	0	17.4647639	4.132	0.404946028	1.520717934	8.468665681	0.564329766	2.70381511	1.872471865	0.619988013	0.898457104	0	4.529751242	0	0.07834403	0.115128951	2.624492242	7.97378412	1.299787749	0.5669493	0	0	6.374846184	1.396567021	0	0	0.3931679	0	0.22668318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7649																																																																																				0	0	0	4.132	0.404946028	1.520717934	8.468665681	0.564329766	2.70381511	1.872471865	0.619988013	0.898457104	0	4.529751242	0	0.07834403	0.115128951	2.624492242	7.97378412	1.299787749	0.5669493	0	0	6.374846184	1.396567021	0	0	0.3931679	0	0.22668318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7649
H7357_047_0	2008	5																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2269.287306	171.643136	820.321439	93.52545172	198.121196	20.2095183	13.25350204	318.9304155	364.8961931		56.85073683		37.74323163	0.545639064	4106.958755	4852.014547	4.072792887	338.0732422			39.54699561	9.241746784			432		249.0589014															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												80.5336	80.5336	18.7716	0.091807574	61.205	0.122410099	0.122410099	30.6025	89.1772		0.122410099		30.6025	0.288622991	12.241	18.6875	0.306025248	17.9961			0.122410099	0.192788394			18.3615		18.3615															15.2295	1.151920032	1.283228054	8.586344858	1.010501468	2.473849137	1.622362498	0.813339661	2.711701613	0	6.959104328	0	0.096253182	0.157483978	4.189443568	7.556002948	1.246377452	0.506998619	0	0	4.840951651	1.781701517	0	0	0.661014535	0	0.38109156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2592	0	40.09695345	15.2295	1.151920032	1.283228054	8.586344858	1.010501468	2.473849137	1.622362498	0.813339661	2.711701613	0	6.959104328	0	0.096253182	0.157483978	4.189443568	7.556002948	1.246377452	0.506998619	0	0	4.840951651	1.781701517	0	0	0.661014535	0	0.38109156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2592																																																																																				0	0	0	15.2295	1.151920032	1.283228054	8.586344858	1.010501468	2.473849137	1.622362498	0.813339661	2.711701613	0	6.959104328	0	0.096253182	0.157483978	4.189443568	7.556002948	1.246377452	0.506998619	0	0	4.840951651	1.781701517	0	0	0.661014535	0	0.38109156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2592
H7357_048_0	2008	5																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2255.234506	170.5802179	815.2415123	92.94628554	196.8943097	20.08436873	13.17142834	316.9578502	362.6365351		56.49868268		37.5095027	0.542260137	7725.307125	4821.967938	4.047571689	335.9796882			39.30209669	9.184516296			432		249.0585366															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												99.2482	99.2482	19.9454	0.110012968	96.2613	0.110012968	0.110012968	30.2587	160.2915		0.110012968		27.5032	0.301324116	11.0013	19.8382	0.275032421	18.8143			0.110012968	0.196423261			19.2523		19.2523															18.6523	1.410814956	1.355023187	10.22529676	1.579442626	2.209541021	1.449027928	0.799227842	4.843962277	0	6.215587786	0	0.085969411	0.163396056	7.082366399	7.971603536	1.11321344	0.526769526	0	0	4.323740317	1.804052639	0	0	0.6930817	0	0.399578505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.904	0	59.63312345	18.6523	1.410814956	1.355023187	10.22529676	1.579442626	2.209541021	1.449027928	0.799227842	4.843962277	0	6.215587786	0	0.085969411	0.163396056	7.082366399	7.971603536	1.11321344	0.526769526	0	0	4.323740317	1.804052639	0	0	0.6930817	0	0.399578505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.904																																																																																				0	0	0	18.6523	1.410814956	1.355023187	10.22529676	1.579442626	2.209541021	1.449027928	0.799227842	4.843962277	0	6.215587786	0	0.085969411	0.163396056	7.082366399	7.971603536	1.11321344	0.526769526	0	0	4.323740317	1.804052639	0	0	0.6930817	0	0.399578505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.904
H7357_049_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		314.0080612	67.03255182	989.6193403	15.85189243	195.6751823	9.429024857	9.437222925	246.9945998	346.1822694		46.46335022		11.39180466	0.660190649	3520.6741	4147.551993	3.001819187	460.3070884			26.38188599	6.971329513			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															158.4845	41.1328	24.9268	0.121911129	40.637	0.162548173	0.162548173	28.4459	34.5838		0.081274086		40.637	0.175427953	8.1274	19.6617	0.406370432	20.3185			0.162548173	0.181052187			12.1911		12.1911															4.1471	0.229769797	2.05566717	1.932522111	0.662638402	1.53267076	1.534003341	0.585499262	0.997691773	0	3.776266336	0	0.038577438	0.115815894	2.384496422	6.795661652	1.219850559	0.779396626	0	0	4.288327358	1.262174456	0	0	0.438880066	0	0.252965594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.03	0	8.071067066	4.1471	0.229769797	2.05566717	1.932522111	0.662638402	1.53267076	1.534003341	0.585499262	0.997691773	0	3.776266336	0	0.038577438	0.115815894	2.384496422	6.795661652	1.219850559	0.779396626	0	0	4.288327358	1.262174456	0	0	0.438880066	0	0.252965594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.03																																																																																				0	0	0	4.1471	0.229769797	2.05566717	1.932522111	0.662638402	1.53267076	1.534003341	0.585499262	0.997691773	0	3.776266336	0	0.038577438	0.115815894	2.384496422	6.795661652	1.219850559	0.779396626	0	0	4.288327358	1.262174456	0	0	0.438880066	0	0.252965594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.03
H7357_050_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1514.43653	69.80379458	918.6884038	14.60501482	185.5972854	8.802307655	8.7676644	238.8964702	321.577733		42.25653344		10.45772925	0.600935488	3277.593131	3845.612346	2.93293468	426.6294123			24.1867475	6.311258366			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												94.3429	94.3429	21.9904	0.10755009	71.7001	0.14340012	0.14340012	35.85	122.1421		0.14340012		35.85	0.285114232	14.34	22.0874	0.3585003	20.5152			0.14340012	0.273916563			21.51		21.51															11.9064	0.548791261	1.683527765	1.570770658	1.108944707	1.262251974	1.257284127	0.713703802	3.27318237	0	6.059591964	0	0.031242492	0.17133526	3.916727067	7.078306588	1.051457962	0.729366176	0	0	3.468382493	1.728758202	0	0	0.774360648	0	0.446332873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7807	0	19.25368606	11.9064	0.548791261	1.683527765	1.570770658	1.108944707	1.262251974	1.257284127	0.713703802	3.27318237	0	6.059591964	0	0.031242492	0.17133526	3.916727067	7.078306588	1.051457962	0.729366176	0	0	3.468382493	1.728758202	0	0	0.774360648	0	0.446332873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7807																																																																																				0	0	0	11.9064	0.548791261	1.683527765	1.570770658	1.108944707	1.262251974	1.257284127	0.713703802	3.27318237	0	6.059591964	0	0.031242492	0.17133526	3.916727067	7.078306588	1.051457962	0.729366176	0	0	3.468382493	1.728758202	0	0	0.774360648	0	0.446332873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7807
H7357_051_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1498.825839	69.08426264	909.218637	14.4544675	183.6841633	8.71157417	8.677288015	236.43862	318.2629354		41.82095646		10.34993181	0.594741093	6099.220442	3805.97208	2.902702223	422.2317504			23.93743244	6.246202419			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												117.9426	117.9426	23.7023	0.130735052	114.3932	0.130735052	0.130735052	35.9615	222.7091		0.130735052		32.6838	0.298637711	13.0735	23.9315	0.32683763	21.6694			0.130735052	0.28358691			22.8786		22.8786															14.7313	0.678998286	1.795878419	1.889705561	1.751017819	1.138908103	1.134425701	0.708558161	5.906671572	0	5.467464923	0	0.02818956	0.177612119	6.644849186	7.590204918	0.948712316	0.762458278	0	0	3.129461477	1.771341241	0	0	0.823630828	0	0.474731658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5541	0	30.4928345	14.7313	0.678998286	1.795878419	1.889705561	1.751017819	1.138908103	1.134425701	0.708558161	5.906671572	0	5.467464923	0	0.02818956	0.177612119	6.644849186	7.590204918	0.948712316	0.762458278	0	0	3.129461477	1.771341241	0	0	0.823630828	0	0.474731658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5541																																																																																				0	0	0	14.7313	0.678998286	1.795878419	1.889705561	1.751017819	1.138908103	1.134425701	0.708558161	5.906671572	0	5.467464923	0	0.02818956	0.177612119	6.644849186	7.590204918	0.948712316	0.762458278	0	0	3.129461477	1.771341241	0	0	0.823630828	0	0.474731658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5541
H7357_052_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		314.0080612	67.03255182	989.6193403	15.85189243	195.6751823	9.429024857	9.437222925	246.9945998	346.1822694		46.46335022		11.39180466	0.660190649	3520.6741	4147.551993	3.001819187	460.3070884			26.38188599	6.971329513			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															158.4845	41.1328	24.9268	0.121911129	40.637	0.162548173	0.162548173	28.4459	34.5838		0.081274086		40.637	0.175427953	8.1274	19.6617	0.406370432	20.3185			0.162548173	0.181052187			12.1911		12.1911															4.1471	0.229769797	2.05566717	1.932522111	0.662638402	1.53267076	1.534003341	0.585499262	0.997691773	0	3.776266336	0	0.038577438	0.115815894	2.384496422	6.795661652	1.219850559	0.779396626	0	0	4.288327358	1.262174456	0	0	0.438880066	0	0.252965594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.03	0	8.071067066	4.1471	0.229769797	2.05566717	1.932522111	0.662638402	1.53267076	1.534003341	0.585499262	0.997691773	0	3.776266336	0	0.038577438	0.115815894	2.384496422	6.795661652	1.219850559	0.779396626	0	0	4.288327358	1.262174456	0	0	0.438880066	0	0.252965594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.03																																																																																				0	0	0	4.1471	0.229769797	2.05566717	1.932522111	0.662638402	1.53267076	1.534003341	0.585499262	0.997691773	0	3.776266336	0	0.038577438	0.115815894	2.384496422	6.795661652	1.219850559	0.779396626	0	0	4.288327358	1.262174456	0	0	0.438880066	0	0.252965594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.03
H7357_053_0	2008	5																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1514.43653	69.80379458	918.6884038	14.60501482	185.5972854	8.802307655	8.7676644	238.8964702	321.577733		42.25653344		10.45772925	0.600935488	3277.593131	3845.612346	2.93293468	426.6294123			24.1867475	6.311258366			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												94.3429	94.3429	21.9904	0.10755009	71.7001	0.14340012	0.14340012	35.85	122.1421		0.14340012		35.85	0.285114232	14.34	22.0874	0.3585003	20.5152			0.14340012	0.273916563			21.51		21.51															11.9064	0.548791261	1.683527765	1.570770658	1.108944707	1.262251974	1.257284127	0.713703802	3.27318237	0	6.059591964	0	0.031242492	0.17133526	3.916727067	7.078306588	1.051457962	0.729366176	0	0	3.468382493	1.728758202	0	0	0.774360648	0	0.446332873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7807	0	19.25368606	11.9064	0.548791261	1.683527765	1.570770658	1.108944707	1.262251974	1.257284127	0.713703802	3.27318237	0	6.059591964	0	0.031242492	0.17133526	3.916727067	7.078306588	1.051457962	0.729366176	0	0	3.468382493	1.728758202	0	0	0.774360648	0	0.446332873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7807																																																																																				0	0	0	11.9064	0.548791261	1.683527765	1.570770658	1.108944707	1.262251974	1.257284127	0.713703802	3.27318237	0	6.059591964	0	0.031242492	0.17133526	3.916727067	7.078306588	1.051457962	0.729366176	0	0	3.468382493	1.728758202	0	0	0.774360648	0	0.446332873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7807
H7357_054_0	2008	5																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1498.825839	69.08426264	909.218637	14.4544675	183.6841633	8.71157417	8.677288015	236.43862	318.2629354		41.82095646		10.34993181	0.594741093	6099.220442	3805.97208	2.902702223	422.2317504			23.93743244	6.246202419			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												117.9426	117.9426	23.7023	0.130735052	114.3932	0.130735052	0.130735052	35.9615	222.7091		0.130735052		32.6838	0.298637711	13.0735	23.9315	0.32683763	21.6694			0.130735052	0.28358691			22.8786		22.8786															14.7313	0.678998286	1.795878419	1.889705561	1.751017819	1.138908103	1.134425701	0.708558161	5.906671572	0	5.467464923	0	0.02818956	0.177612119	6.644849186	7.590204918	0.948712316	0.762458278	0	0	3.129461477	1.771341241	0	0	0.823630828	0	0.474731658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5541	0	30.4928345	14.7313	0.678998286	1.795878419	1.889705561	1.751017819	1.138908103	1.134425701	0.708558161	5.906671572	0	5.467464923	0	0.02818956	0.177612119	6.644849186	7.590204918	0.948712316	0.762458278	0	0	3.129461477	1.771341241	0	0	0.823630828	0	0.474731658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5541																																																																																				0	0	0	14.7313	0.678998286	1.795878419	1.889705561	1.751017819	1.138908103	1.134425701	0.708558161	5.906671572	0	5.467464923	0	0.02818956	0.177612119	6.644849186	7.590204918	0.948712316	0.762458278	0	0	3.129461477	1.771341241	0	0	0.823630828	0	0.474731658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5541
H7357_055_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		220.4698428	49.48955112	840.9451002	8.30322932	140.5308516	6.944725091	6.566286181	245.5184206	267.5797304		34.83838172		6.879527189	0.349512665	2672.369173	2993.776795	1.576334339	217.8115412			29.46283864	6.517026319			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															167.9758	43.5962	26.4196	0.129212189	43.0707	0.172282918	0.172282918	30.1495	39.4334		0.086141459		43.0707	0.247517467	8.6141	20.5542	0.430707296	21.5354			0.172282918	0.191175856			12.9212		12.9212															3.0861	0.179796333	1.851451749	1.072878434	0.504397192	1.196457505	1.131258945	0.616855021	0.879297263	0	3.001029034	0	0.024692188	0.08651049	1.918348165	5.127884894	0.6789387	0.390887583	0	0	5.07594382	1.245898085	0	0	0.465163879	0	0.268115291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8019	0	4.6336903	3.0861	0.179796333	1.851451749	1.072878434	0.504397192	1.196457505	1.131258945	0.616855021	0.879297263	0	3.001029034	0	0.024692188	0.08651049	1.918348165	5.127884894	0.6789387	0.390887583	0	0	5.07594382	1.245898085	0	0	0.465163879	0	0.268115291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8019																																																																																				0	0	0	3.0861	0.179796333	1.851451749	1.072878434	0.504397192	1.196457505	1.131258945	0.616855021	0.879297263	0	3.001029034	0	0.024692188	0.08651049	1.918348165	5.127884894	0.6789387	0.390887583	0	0	5.07594382	1.245898085	0	0	0.465163879	0	0.268115291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8019
H7357_056_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		874.4249271	39.96452251	737.8846154	7.293186331	122.1910711	6.020032848	5.704837341	211.8253995	234.8944957		30.59763058		6.079491962	0.306297555	2338.062728	2627.367105	1.289403487	191.6495177			25.9684009	5.736409759			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												104.7735	104.7735	24.4217	0.119440792	79.6272	0.15925439	0.15925439	39.8136	145.8055		0.15925439		39.8136	0.440977445	15.9254	24.7964	0.398135974	23.0925			0.15925439	0.298167424			23.8882		23.8882															7.6347	0.348935119	1.501697308	0.871103954	0.810811019	0.958716658	0.90852039	0.702794265	2.854075823	0	4.872806986	0	0.020170537	0.135070313	3.102889609	5.429096336	0.513357914	0.368805413	0	0	4.135581839	1.710410523	0	0	0.859973705	0	0.495679288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2352	0	9.782567812	7.6347	0.348935119	1.501697308	0.871103954	0.810811019	0.958716658	0.90852039	0.702794265	2.854075823	0	4.872806986	0	0.020170537	0.135070313	3.102889609	5.429096336	0.513357914	0.368805413	0	0	4.135581839	1.710410523	0	0	0.859973705	0	0.495679288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2352																																																																																				0	0	0	7.6347	0.348935119	1.501697308	0.871103954	0.810811019	0.958716658	0.90852039	0.702794265	2.854075823	0	4.872806986	0	0.020170537	0.135070313	3.102889609	5.429096336	0.513357914	0.368805413	0	0	4.135581839	1.710410523	0	0	0.859973705	0	0.495679288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2352
H7357_057_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		859.5325291	39.28388366	725.3176459	7.168975515	120.1100256	5.917505207	5.607677819	208.2239267	230.8939895		30.07651998		5.975951668	0.301080978	5231.263523	2582.620215	1.267443558	188.38552			25.52613107	5.638712524			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												133.0197	133.0197	26.7322	0.147447463	129.0165	0.147447463	0.147447463	40.5576	269.9913		0.147447463		36.8619	0.474135504	14.7447	27.4851	0.368618658	24.8211			0.147447463	0.313561475			25.8033		25.8033															9.5279	0.435460963	1.615779548	1.057047254	1.29134823	0.872521132	0.826837869	0.703755724	5.19494774	0	4.434706576	0	0.018357061	0.142753181	6.427804469	5.915288028	0.467203344	0.389660855	0	0	3.763763274	1.768083015	0	0	0.928919019	0	0.535418601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3176	0	16.50828663	9.5279	0.435460963	1.615779548	1.057047254	1.29134823	0.872521132	0.826837869	0.703755724	5.19494774	0	4.434706576	0	0.018357061	0.142753181	6.427804469	5.915288028	0.467203344	0.389660855	0	0	3.763763274	1.768083015	0	0	0.928919019	0	0.535418601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3176																																																																																				0	0	0	9.5279	0.435460963	1.615779548	1.057047254	1.29134823	0.872521132	0.826837869	0.703755724	5.19494774	0	4.434706576	0	0.018357061	0.142753181	6.427804469	5.915288028	0.467203344	0.389660855	0	0	3.763763274	1.768083015	0	0	0.928919019	0	0.535418601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3176
H7357_058_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		220.4698428	49.48955112	840.9451002	8.30322932	140.5308516	6.944725091	6.566286181	245.5184206	267.5797304		34.83838172		6.879527189	0.349512665	2672.369173	2993.776795	1.576334339	217.8115412			29.46283864	6.517026319			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															167.9758	43.5962	26.4196	0.129212189	43.0707	0.172282918	0.172282918	30.1495	39.4334		0.086141459		43.0707	0.247517467	8.6141	20.5542	0.430707296	21.5354			0.172282918	0.191175856			12.9212		12.9212															3.0861	0.179796333	1.851451749	1.072878434	0.504397192	1.196457505	1.131258945	0.616855021	0.879297263	0	3.001029034	0	0.024692188	0.08651049	1.918348165	5.127884894	0.6789387	0.390887583	0	0	5.07594382	1.245898085	0	0	0.465163879	0	0.268115291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8019	0	4.6336903	3.0861	0.179796333	1.851451749	1.072878434	0.504397192	1.196457505	1.131258945	0.616855021	0.879297263	0	3.001029034	0	0.024692188	0.08651049	1.918348165	5.127884894	0.6789387	0.390887583	0	0	5.07594382	1.245898085	0	0	0.465163879	0	0.268115291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8019																																																																																				0	0	0	3.0861	0.179796333	1.851451749	1.072878434	0.504397192	1.196457505	1.131258945	0.616855021	0.879297263	0	3.001029034	0	0.024692188	0.08651049	1.918348165	5.127884894	0.6789387	0.390887583	0	0	5.07594382	1.245898085	0	0	0.465163879	0	0.268115291	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8019
H7357_059_0	2008	5																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		874.4249271	39.96452251	737.8846154	7.293186331	122.1910711	6.020032848	5.704837341	211.8253995	234.8944957		30.59763058		6.079491962	0.306297555	2338.062728	2627.367105	1.289403487	191.6495177			25.9684009	5.736409759			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												104.7735	104.7735	24.4217	0.119440792	79.6272	0.15925439	0.15925439	39.8136	145.8055		0.15925439		39.8136	0.440977445	15.9254	24.7964	0.398135974	23.0925			0.15925439	0.298167424			23.8882		23.8882															7.6347	0.348935119	1.501697308	0.871103954	0.810811019	0.958716658	0.90852039	0.702794265	2.854075823	0	4.872806986	0	0.020170537	0.135070313	3.102889609	5.429096336	0.513357914	0.368805413	0	0	4.135581839	1.710410523	0	0	0.859973705	0	0.495679288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2352	0	9.782567812	7.6347	0.348935119	1.501697308	0.871103954	0.810811019	0.958716658	0.90852039	0.702794265	2.854075823	0	4.872806986	0	0.020170537	0.135070313	3.102889609	5.429096336	0.513357914	0.368805413	0	0	4.135581839	1.710410523	0	0	0.859973705	0	0.495679288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2352																																																																																				0	0	0	7.6347	0.348935119	1.501697308	0.871103954	0.810811019	0.958716658	0.90852039	0.702794265	2.854075823	0	4.872806986	0	0.020170537	0.135070313	3.102889609	5.429096336	0.513357914	0.368805413	0	0	4.135581839	1.710410523	0	0	0.859973705	0	0.495679288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2352
H7357_060_0	2008	5																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		859.5325291	39.28388366	725.3176459	7.168975515	120.1100256	5.917505207	5.607677819	208.2239267	230.8939895		30.07651998		5.975951668	0.301080978	5231.263523	2582.620215	1.267443558	188.38552			25.52613107	5.638712524			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												133.0197	133.0197	26.7322	0.147447463	129.0165	0.147447463	0.147447463	40.5576	269.9913		0.147447463		36.8619	0.474135504	14.7447	27.4851	0.368618658	24.8211			0.147447463	0.313561475			25.8033		25.8033															9.5279	0.435460963	1.615779548	1.057047254	1.29134823	0.872521132	0.826837869	0.703755724	5.19494774	0	4.434706576	0	0.018357061	0.142753181	6.427804469	5.915288028	0.467203344	0.389660855	0	0	3.763763274	1.768083015	0	0	0.928919019	0	0.535418601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3176	0	16.50828663	9.5279	0.435460963	1.615779548	1.057047254	1.29134823	0.872521132	0.826837869	0.703755724	5.19494774	0	4.434706576	0	0.018357061	0.142753181	6.427804469	5.915288028	0.467203344	0.389660855	0	0	3.763763274	1.768083015	0	0	0.928919019	0	0.535418601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3176																																																																																				0	0	0	9.5279	0.435460963	1.615779548	1.057047254	1.29134823	0.872521132	0.826837869	0.703755724	5.19494774	0	4.434706576	0	0.018357061	0.142753181	6.427804469	5.915288028	0.467203344	0.389660855	0	0	3.763763274	1.768083015	0	0	0.928919019	0	0.535418601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3176
H7357_061_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		389.9169089	128.0348254	640.3600425	51.14582782	150.6494827	15.88962196	13.94141885	295.8234648	416.3980048		50.69379519		10.4235783	0.815944788	4283.106079	4417.8421	3.626510763	515.4483648			30.28575992	7.88297921			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															149.3793	38.7697	23.4947	0.11490719	38.3024	0.153209586	0.153209586	26.8117	29.0034		0.076604793		38.3024	0.071171915	7.6605	18.6612	0.383023966	19.1512			0.153209586	0.165069623			11.4907		11.4907															4.8538	0.41365583	1.253755062	5.877023347	0.48085302	2.434442409	2.135959016	0.660960281	1.00641326	0	3.883387698	0	0.033270669	0.058072353	2.734220463	6.8701947	1.389040536	0.822621154	0	0	4.640068753	1.301240404	0	0	0.413665883	0	0.238432419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5011	0	12.67448305	4.8538	0.41365583	1.253755062	5.877023347	0.48085302	2.434442409	2.135959016	0.660960281	1.00641326	0	3.883387698	0	0.033270669	0.058072353	2.734220463	6.8701947	1.389040536	0.822621154	0	0	4.640068753	1.301240404	0	0	0.413665883	0	0.238432419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5011																																																																																				0	0	0	4.8538	0.41365583	1.253755062	5.877023347	0.48085302	2.434442409	2.135959016	0.660960281	1.00641326	0	3.883387698	0	0.033270669	0.058072353	2.734220463	6.8701947	1.389040536	0.822621154	0	0	4.640068753	1.301240404	0	0	0.413665883	0	0.238432419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5011
H7357_062_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2139.114244	172.6642818	617.1998129	50.54369432	154.1527074	16.32285277	13.61875994	320.4033184	381.6064102		46.3717954		9.178423127	0.748123252	4040.345903	4056.385685	4.656600829	472.6807			27.10270693	7.046699028			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												86.0183	86.0183	20.05	0.098060111	65.3734	0.130746814	0.130746814	32.6867	99.4457		0.130746814		32.6867	0.107841116	13.0747	20.0206	0.326867035	19.4085			0.130746814	0.245541012			19.612		19.612															15.3336	1.237691084	1.031239253	4.956320256	0.839790641	2.134160997	1.780609476	0.872744023	3.162427646	0	6.062964516	0	0.025001033	0.080678446	4.402186292	6.767600337	1.522089308	0.764503431	0	0	3.543592586	1.73025361	0	0	0.706032797	0	0.406949459	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3604	0	30.3823228	15.3336	1.237691084	1.031239253	4.956320256	0.839790641	2.134160997	1.780609476	0.872744023	3.162427646	0	6.062964516	0	0.025001033	0.080678446	4.402186292	6.767600337	1.522089308	0.764503431	0	0	3.543592586	1.73025361	0	0	0.706032797	0	0.406949459	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3604																																																																																				0	0	0	15.3336	1.237691084	1.031239253	4.956320256	0.839790641	2.134160997	1.780609476	0.872744023	3.162427646	0	6.062964516	0	0.025001033	0.080678446	4.402186292	6.767600337	1.522089308	0.764503431	0	0	3.543592586	1.73025361	0	0	0.706032797	0	0.406949459	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3604
H7357_063_0	2008	4																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2122.179911	171.2973822	612.3137405	50.14356434	152.932355	16.19363264	13.51094681	317.8706095	378.5854169		46.00469233		9.10576199	0.742200723	6974.942636	4024.273241	4.619736773	468.9387155			26.88814791	6.990913721			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												106.6662	106.6662	21.4361	0.118235578	103.4561	0.118235578	0.118235578	32.5214	179.8594		0.118235578		29.5589	0.111227013	11.8236	21.4302	0.295588944	20.4459			0.118235578	0.25306218			20.6912		20.6912															18.8637	1.522637114	1.09380207	5.928753299	1.318482473	1.91466351	1.597474602	0.8614671	5.674346805	0	5.439391376	0	0.022429688	0.08255277	6.872386435	7.186733618	1.365543116	0.798988552	0	0	3.179135702	1.769135865	0	0	0.74488414	0	0.429342942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6659	0	46.10201493	18.8637	1.522637114	1.09380207	5.928753299	1.318482473	1.91466351	1.597474602	0.8614671	5.674346805	0	5.439391376	0	0.022429688	0.08255277	6.872386435	7.186733618	1.365543116	0.798988552	0	0	3.179135702	1.769135865	0	0	0.74488414	0	0.429342942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6659																																																																																				0	0	0	18.8637	1.522637114	1.09380207	5.928753299	1.318482473	1.91466351	1.597474602	0.8614671	5.674346805	0	5.439391376	0	0.022429688	0.08255277	6.872386435	7.186733618	1.365543116	0.798988552	0	0	3.179135702	1.769135865	0	0	0.74488414	0	0.429342942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6659
H7357_064_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		389.9169089	128.0348254	640.3600425	51.14582782	150.6494827	15.88962196	13.94141885	295.8234648	416.3980048		50.69379519		10.4235783	0.815944788	4283.106079	4417.8421	3.626510763	515.4483648			30.28575992	7.88297921			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															149.3793	38.7697	23.4947	0.11490719	38.3024	0.153209586	0.153209586	26.8117	29.0034		0.076604793		38.3024	0.071171915	7.6605	18.6612	0.383023966	19.1512			0.153209586	0.165069623			11.4907		11.4907															4.8538	0.41365583	1.253755062	5.877023347	0.48085302	2.434442409	2.135959016	0.660960281	1.00641326	0	3.883387698	0	0.033270669	0.058072353	2.734220463	6.8701947	1.389040536	0.822621154	0	0	4.640068753	1.301240404	0	0	0.413665883	0	0.238432419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5011	0	12.67448305	4.8538	0.41365583	1.253755062	5.877023347	0.48085302	2.434442409	2.135959016	0.660960281	1.00641326	0	3.883387698	0	0.033270669	0.058072353	2.734220463	6.8701947	1.389040536	0.822621154	0	0	4.640068753	1.301240404	0	0	0.413665883	0	0.238432419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5011																																																																																				0	0	0	4.8538	0.41365583	1.253755062	5.877023347	0.48085302	2.434442409	2.135959016	0.660960281	1.00641326	0	3.883387698	0	0.033270669	0.058072353	2.734220463	6.8701947	1.389040536	0.822621154	0	0	4.640068753	1.301240404	0	0	0.413665883	0	0.238432419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5011
H7357_065_0	2008	5																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2139.114244	172.6642818	617.1998129	50.54369432	154.1527074	16.32285277	13.61875994	320.4033184	381.6064102		46.3717954		9.178423127	0.748123252	4040.345903	4056.385685	4.656600829	472.6807			27.10270693	7.046699028			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												86.0183	86.0183	20.05	0.098060111	65.3734	0.130746814	0.130746814	32.6867	99.4457		0.130746814		32.6867	0.107841116	13.0747	20.0206	0.326867035	19.4085			0.130746814	0.245541012			19.612		19.612															15.3336	1.237691084	1.031239253	4.956320256	0.839790641	2.134160997	1.780609476	0.872744023	3.162427646	0	6.062964516	0	0.025001033	0.080678446	4.402186292	6.767600337	1.522089308	0.764503431	0	0	3.543592586	1.73025361	0	0	0.706032797	0	0.406949459	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3604	0	30.3823228	15.3336	1.237691084	1.031239253	4.956320256	0.839790641	2.134160997	1.780609476	0.872744023	3.162427646	0	6.062964516	0	0.025001033	0.080678446	4.402186292	6.767600337	1.522089308	0.764503431	0	0	3.543592586	1.73025361	0	0	0.706032797	0	0.406949459	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3604																																																																																				0	0	0	15.3336	1.237691084	1.031239253	4.956320256	0.839790641	2.134160997	1.780609476	0.872744023	3.162427646	0	6.062964516	0	0.025001033	0.080678446	4.402186292	6.767600337	1.522089308	0.764503431	0	0	3.543592586	1.73025361	0	0	0.706032797	0	0.406949459	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3604
H7357_066_0	2008	5																					2500											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		2122.179911	171.2973822	612.3137405	50.14356434	152.932355	16.19363264	13.51094681	317.8706095	378.5854169		46.00469233		9.10576199	0.742200723	6974.942636	4024.273241	4.619736773	468.9387155			26.88814791	6.990913721			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												106.6662	106.6662	21.4361	0.118235578	103.4561	0.118235578	0.118235578	32.5214	179.8594		0.118235578		29.5589	0.111227013	11.8236	21.4302	0.295588944	20.4459			0.118235578	0.25306218			20.6912		20.6912															18.8637	1.522637114	1.09380207	5.928753299	1.318482473	1.91466351	1.597474602	0.8614671	5.674346805	0	5.439391376	0	0.022429688	0.08255277	6.872386435	7.186733618	1.365543116	0.798988552	0	0	3.179135702	1.769135865	0	0	0.74488414	0	0.429342942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6659	0	46.10201493	18.8637	1.522637114	1.09380207	5.928753299	1.318482473	1.91466351	1.597474602	0.8614671	5.674346805	0	5.439391376	0	0.022429688	0.08255277	6.872386435	7.186733618	1.365543116	0.798988552	0	0	3.179135702	1.769135865	0	0	0.74488414	0	0.429342942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6659																																																																																				0	0	0	18.8637	1.522637114	1.09380207	5.928753299	1.318482473	1.91466351	1.597474602	0.8614671	5.674346805	0	5.439391376	0	0.022429688	0.08255277	6.872386435	7.186733618	1.365543116	0.798988552	0	0	3.179135702	1.769135865	0	0	0.74488414	0	0.429342942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6659
H7357_067_0	2008	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		265.6234031	80.56494353	732.6822733	13.26005709	158.338537	10.26680658	9.446915482	218.8250681	271.0858106		45.19193087		3.027797249	0.251966632	4311.770286	3439.646782	2.38364182	312.3644973			30.75254545	7.432506669			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															161.2942	41.862	25.3687	0.124072443	41.3575	0.165429924	0.165429924	28.9502	29.5861		0.082714962		41.3575	0.269931345	8.2715	19.9153	0.413574811	20.6787			0.165429924	0.17455471			12.4072		12.4072															3.5703	0.28105109	1.548931777	1.645207681	0.545706921	1.698437035	1.562802514	0.527919794	0.668364535	0	3.738048853	0	0.010435172	0.068013692	2.972065968	5.708452398	0.985814215	0.538275366	0	0	5.087391267	1.297379045	0	0	0.446660796	0	0.25745032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1587	0	6.929210652	3.5703	0.28105109	1.548931777	1.645207681	0.545706921	1.698437035	1.562802514	0.527919794	0.668364535	0	3.738048853	0	0.010435172	0.068013692	2.972065968	5.708452398	0.985814215	0.538275366	0	0	5.087391267	1.297379045	0	0	0.446660796	0	0.25745032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1587																																																																																				0	0	0	3.5703	0.28105109	1.548931777	1.645207681	0.545706921	1.698437035	1.562802514	0.527919794	0.668364535	0	3.738048853	0	0.010435172	0.068013692	2.972065968	5.708452398	0.985814215	0.538275366	0	0	5.087391267	1.297379045	0	0	0.446660796	0	0.25745032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1587
H7357_068_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1315.662516	89.25335453	708.4037297	12.64027592	154.1870296	10.15851599	9.114140795	219.243801	255.9433905		43.04654559		2.786522852	0.241477426	4074.484835	3244.22635	2.642987303	291.5988437			28.76135558	6.944917496			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												101.4641	101.4641	23.6503	0.115668098	77.1121	0.15422413	0.15422413	38.556	110.6175		0.15422413		38.556	0.460760244	15.4224	23.8412	0.385560326	22.6201			0.15422413	0.283396948			23.1336		23.1336															11.1244	0.754667276	1.396161647	1.462076671	0.99080669	1.566688294	1.405620439	0.704430928	2.359318103	0	6.638816061	0	0.008953105	0.111263198	5.236532338	6.445514672	1.019031046	0.5496666	0	0	4.435695054	1.968168422	0	0	0.832810304	0	0.480022606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4906	0	14.68950362	11.1244	0.754667276	1.396161647	1.462076671	0.99080669	1.566688294	1.405620439	0.704430928	2.359318103	0	6.638816061	0	0.008953105	0.111263198	5.236532338	6.445514672	1.019031046	0.5496666	0	0	4.435695054	1.968168422	0	0	0.832810304	0	0.480022606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4906																																																																																				0	0	0	11.1244	0.754667276	1.396161647	1.462076671	0.99080669	1.566688294	1.405620439	0.704430928	2.359318103	0	6.638816061	0	0.008953105	0.111263198	5.236532338	6.445514672	1.019031046	0.5496666	0	0	4.435695054	1.968168422	0	0	0.832810304	0	0.480022606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4906
H7357_069_0	2008	4																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1298.286871	88.07460648	699.0480083	12.47333877	152.1507178	10.02435485	8.993772481	216.3540873	252.5632063		42.47803999		2.749721901	0.23828829	6130.657866	3201.380616	2.608081991	287.7477664			28.38151112	6.853197604			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												130.3069	130.3069	26.187	0.144440428	126.3854	0.144440428	0.144440428	39.7321	207.2002		0.144440428		36.1101	0.496550801	14.444	26.6024	0.361101071	24.6358			0.144440428	0.303194909			25.2771		25.2771															14.098	0.956394317	1.525500409	1.801654395	1.602468792	1.447922109	1.29906435	0.71634999	4.360929812	0	6.135546293	0	0.008274396	0.118322241	7.379290403	7.097038862	0.9417812	0.590742229	0	0	4.099437625	2.077854621	0	0	0.909974699	0	0.524499306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.691	0	22.1910778	14.098	0.956394317	1.525500409	1.801654395	1.602468792	1.447922109	1.29906435	0.71634999	4.360929812	0	6.135546293	0	0.008274396	0.118322241	7.379290403	7.097038862	0.9417812	0.590742229	0	0	4.099437625	2.077854621	0	0	0.909974699	0	0.524499306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.691																																																																																				0	0	0	14.098	0.956394317	1.525500409	1.801654395	1.602468792	1.447922109	1.29906435	0.71634999	4.360929812	0	6.135546293	0	0.008274396	0.118322241	7.379290403	7.097038862	0.9417812	0.590742229	0	0	4.099437625	2.077854621	0	0	0.909974699	0	0.524499306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.691
H7357_070_0	2008	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		265.6234031	80.56494353	732.6822733	13.26005709	158.338537	10.26680658	9.446915482	218.8250681	271.0858106		45.19193087		3.027797249	0.251966632	4311.770286	3439.646782	2.38364182	312.3644973			30.75254545	7.432506669			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 for days 1 - 5 and $0 for days 6 - 90	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $35, 4b (UC) - $35; 4a (WW ER) - $35, 4b (WW UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		8b (OP Diag & Therap Rad) - 10%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $25; 3 (CORF) - $15; 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $15 per visit"	"7a (PCP) - $10, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $20; 7d (Spec) - $25,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $25"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $15			17a1 (Eye Exam Non-Covered) - $15		18a1 (Hearing Exam Non-covered) - $15															161.2942	41.862	25.3687	0.124072443	41.3575	0.165429924	0.165429924	28.9502	29.5861		0.082714962		41.3575	0.269931345	8.2715	19.9153	0.413574811	20.6787			0.165429924	0.17455471			12.4072		12.4072															3.5703	0.28105109	1.548931777	1.645207681	0.545706921	1.698437035	1.562802514	0.527919794	0.668364535	0	3.738048853	0	0.010435172	0.068013692	2.972065968	5.708452398	0.985814215	0.538275366	0	0	5.087391267	1.297379045	0	0	0.446660796	0	0.25745032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1587	0	6.929210652	3.5703	0.28105109	1.548931777	1.645207681	0.545706921	1.698437035	1.562802514	0.527919794	0.668364535	0	3.738048853	0	0.010435172	0.068013692	2.972065968	5.708452398	0.985814215	0.538275366	0	0	5.087391267	1.297379045	0	0	0.446660796	0	0.25745032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1587																																																																																				0	0	0	3.5703	0.28105109	1.548931777	1.645207681	0.545706921	1.698437035	1.562802514	0.527919794	0.668364535	0	3.738048853	0	0.010435172	0.068013692	2.972065968	5.708452398	0.985814215	0.538275366	0	0	5.087391267	1.297379045	0	0	0.446660796	0	0.25745032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1587
H7357_071_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1315.662516	89.25335453	708.4037297	12.64027592	154.1870296	10.15851599	9.114140795	219.243801	255.9433905		43.04654559		2.786522852	0.241477426	4074.484835	3244.22635	2.642987303	291.5988437			28.76135558	6.944917496			432		249															"1a (IP Acute) - $195/day for days 1 - 5, $0/day for days 6 - 90"	"1b (IP Psych) - $195/day for days 1 - 5, $0/day for days 6 - 90"	2 (SNF) - $0 for days 1 - 20 and $100 for days 21 - 100	6 (Home Health) - 15%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $50; 4a (WW ER) - $50, 4b (WW UC) - $50"	"9a (OP Surgery) - $200, 9b (ASC) - $100"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $30; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30 per visit"	"7a (PCP) - $20, 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $35; 7d (Spec) - $30,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $30; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $30"			17a1 (Eye Exam Non-Covered) - $30		18a1 (Hearing Exam Non-covered) - $30			14a (Education/Wellness) - $0												101.4641	101.4641	23.6503	0.115668098	77.1121	0.15422413	0.15422413	38.556	110.6175		0.15422413		38.556	0.460760244	15.4224	23.8412	0.385560326	22.6201			0.15422413	0.283396948			23.1336		23.1336															11.1244	0.754667276	1.396161647	1.462076671	0.99080669	1.566688294	1.405620439	0.704430928	2.359318103	0	6.638816061	0	0.008953105	0.111263198	5.236532338	6.445514672	1.019031046	0.5496666	0	0	4.435695054	1.968168422	0	0	0.832810304	0	0.480022606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4906	0	14.68950362	11.1244	0.754667276	1.396161647	1.462076671	0.99080669	1.566688294	1.405620439	0.704430928	2.359318103	0	6.638816061	0	0.008953105	0.111263198	5.236532338	6.445514672	1.019031046	0.5496666	0	0	4.435695054	1.968168422	0	0	0.832810304	0	0.480022606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4906																																																																																				0	0	0	11.1244	0.754667276	1.396161647	1.462076671	0.99080669	1.566688294	1.405620439	0.704430928	2.359318103	0	6.638816061	0	0.008953105	0.111263198	5.236532338	6.445514672	1.019031046	0.5496666	0	0	4.435695054	1.968168422	0	0	0.832810304	0	0.480022606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4906
H7357_072_0	2008	5																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1298.286871	88.07460648	699.0480083	12.47333877	152.1507178	10.02435485	8.993772481	216.3540873	252.5632063		42.47803999		2.749721901	0.23828829	6130.657866	3201.380616	2.608081991	287.7477664			28.38151112	6.853197604			432		249															"1a (IP Acute) - $250/day for days 1 - 6, $0/day for days 7 - 90"	"1b (IP Psych) - $250/day for days 1 - 6, $0/day for days 7 - 90"	2 (SNF) - $0 for days 1 - 20 and $125 for days 21 - 100	6 (Home Health) - 20%	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) - $50, 4b (UC) - $75; 4a (WW ER) - $50, 4b (WW UC) - $75"	"9a (OP Surgery) - $400, 9b (ASC) - $200"		8b (OP Diag & Therap Rad) - 20%		12 (Renal Dialysis) - $50	"7i, 7c (OP PT/ST/OT) - $35; 3 (CORF) - $15, 5 (Part Hospital) - $150 per day; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $35 per visit"	"7a (PCP) - $20 14g (Bone Mass), 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) , 14j (Nutrition Therap), 14i (Diab Mon.) - $0"	"7b (Chiro), 7f (Pod) - $45; 7d (Spec) - $35,"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $35"		7g (Other Health Care) - $15	15 (Part B Rx) - 20%	"13a (Blood), 13a1 (Add'l Blood), 16b (MCR Comp Dental) - 0%, 17a (MCR Eye Exam) - $35; 17b (MCR Eyewear) - $15; 18a (MCR Hearing Exam) - $35"			17a1 (Eye Exam Non-Covered) - $35		18a1 (Hearing Exam Non-covered) - $35	18b (Hearing Aids) - 0%		14a (Education/Wellness) - $0												130.3069	130.3069	26.187	0.144440428	126.3854	0.144440428	0.144440428	39.7321	207.2002		0.144440428		36.1101	0.496550801	14.444	26.6024	0.361101071	24.6358			0.144440428	0.303194909			25.2771		25.2771															14.098	0.956394317	1.525500409	1.801654395	1.602468792	1.447922109	1.29906435	0.71634999	4.360929812	0	6.135546293	0	0.008274396	0.118322241	7.379290403	7.097038862	0.9417812	0.590742229	0	0	4.099437625	2.077854621	0	0	0.909974699	0	0.524499306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.691	0	22.1910778	14.098	0.956394317	1.525500409	1.801654395	1.602468792	1.447922109	1.29906435	0.71634999	4.360929812	0	6.135546293	0	0.008274396	0.118322241	7.379290403	7.097038862	0.9417812	0.590742229	0	0	4.099437625	2.077854621	0	0	0.909974699	0	0.524499306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.691																																																																																				0	0	0	14.098	0.956394317	1.525500409	1.801654395	1.602468792	1.447922109	1.29906435	0.71634999	4.360929812	0	6.135546293	0	0.008274396	0.118322241	7.379290403	7.097038862	0.9417812	0.590742229	0	0	4.099437625	2.077854621	0	0	0.909974699	0	0.524499306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.691
H7406_001_0	2008	5																																D	Coin	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		2000.915631	4.033413405	740.9508775		193.7741193	15.63264208	22.6744907	264.0615506	315.6239383		14.98080523	37.61731641	0.216010367	580.0805127	3481.255649	4416.126077	206.0077228	520.9794494			32.0076933	6.884478504																				"#1A $150/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $150	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $40"	"#9A $100, #9B $50"	#8A $0	#8B 20%	#9A $100	#12 20%	"#3 20%, #5 20%, #9A $100, #9C 20%, #9D $10"	"#7A $10, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $10, #7D $10, #7F $10, #7G $10"	"#7E $10, #7H $10"	"#7C $10, #7I $10"		"#14I $0 , #14J $0"	#15 20%	"#13A 20%, #16B $0, #17A $10, #17B $0, #18A $10"	#10B $0 n/c	#16A $0 n/c	#17A $0 n/c	#17B $0 n/c	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0 n/c	"#13B $0 n/c , #13C $0 n/c"											92.4	0.071623023	84.8686		150	0.2	0.2	49.0007	76.443		0.2	100	0.2	98.3775	10	10	10	10			0.2	0.136866565																				15.4071	0.288885262	5.240290934	0	2.422176491	3.126528415	4.534898139	1.078267711	2.010604036	0	2.996161046	0.313477637	0.043202073	4.755572599	2.901046374	3.680105065	0.171673102	0.434149541	0	0	6.401538661	0.942254927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.7479	0	0	15.4071	0.288885262	5.240290934	0	2.422176491	3.126528415	4.534898139	1.078267711	2.010604036	0	2.996161046	0.313477637	0.043202073	4.755572599	2.901046374	3.680105065	0.171673102	0.434149541	0	0	6.401538661	0.942254927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.7479																																																																																				0	0	0	15.4071	0.288885262	5.240290934	0	2.422176491	3.126528415	4.534898139	1.078267711	2.010604036	0	2.996161046	0.313477637	0.043202073	4.755572599	2.901046374	3.680105065	0.171673102	0.434149541	0	0	6.401538661	0.942254927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.7479
H7406_002_0	2008	4																					5000											D	Coin	D	V	T	Coin	Coin	V	V	V	P	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		2000.915631	4.033413405	740.9508775		193.7741193	15.63264208	22.6744907	264.0615506	315.6239383		364.5261102	37.61731641	0.216010367	580.0805127	3783.319742	4772.325052	206.0077228	520.9794494			32.0076933	6.957528811																				"#1A $50/day days 1-5, $0/day days 6-90"	#1B MC cost shares	"#2 $0/day days 1-10, $50/day days 11-100"	#6 $0	#10A $50	#11A 30%	"#11B 30%, #11C 30%"	"#4A $50, #4B $25"	"#9A $50, #9B $50"	#8A $0	#8B $15/x-ray; $100/complex rad; 20%/ther rad	#9A $50	#12 20%	"#3 20%, #5 20%, #9A $50, #9C 20%, #9D $5"	"#7A $5, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $5, #7D $5, #7F $5, #7G $5"	"#7E $5, #7H $5"	"#7C $5, #7I $5"		"#14I $0 , #14J $0"	#15 30%	"#13A 20%, #16B $0, #17A $5, #17B $0, #18A $5"	#10B $0 n/c	#16A $0 n/c	#17A $0 n/c	#17B $0 n/c	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0 n/c	"#13B $0 n/c , #13C $0 n/c"											26.4529	0.061514126	36.5788		42.943	0.257657903	0.257657903	40.7974	42.943		63.9721	42.943	0.171771935	42.5977	4.2943	4.2943	4.2943	4.2943			0.257657903	0.068004515																				4.4108	0.248111902	2.258593238	0	0.693436572	4.027873772	5.842261719	0.897752781	1.129486139	0	1.943290873	0.134616651	0.037104519	2.059175295	1.353891986	1.707815645	0.073721553	0.186436767	0	0	8.247035129	0.473143374	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.7246	0	5.870782908	4.4108	0.248111902	2.258593238	0	0.693436572	4.027873772	5.842261719	0.897752781	1.129486139	0	1.943290873	0.134616651	0.037104519	2.059175295	1.353891986	1.707815645	0.073721553	0.186436767	0	0	8.247035129	0.473143374	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.7246																																																																																				0	0	0	4.4108	0.248111902	2.258593238	0	0.693436572	4.027873772	5.842261719	0.897752781	1.129486139	0	1.943290873	0.134616651	0.037104519	2.059175295	1.353891986	1.707815645	0.073721553	0.186436767	0	0	8.247035129	0.473143374	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.7246
H7406_003_0	2008	4																																D	Coin	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		2000.915631	4.033413405	740.9508775		193.7741193	15.63264208	22.6744907	264.0615506	315.6239383		14.98080523	37.61731641	0.216010367	580.0805127	3481.255649	4416.126077	206.0077228	520.9794494			32.0076933	6.884478504																				"#1A $150/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $150	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $40"	"#9A $100, #9B $50"	#8A $0	#8B 20%	#9A $100	#12 20%	"#3 20%, #5 20%, #9A $100, #9C 20%, #9D $10"	"#7A $10, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $10, #7D $10, #7F $10, #7G $10"	"#7E $10, #7H $10"	"#7C $10, #7I $10"		"#14I $0 , #14J $0"	#15 20%	"#13A 20%, #16B $0, #17A $10, #17B $10, #18A $10"	#10B $0 n/c	#16A $0 n/c	#17A $0 n/c	#17B $0 n/c	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0 n/c	"#13B $0 n/c , #13C $0 n/c"											92.4	0.071623023	84.8686		150	0.2	0.2	49.0007	76.443		0.2	100	0.2	98.3775	10	10	10	10			0.2	0.136866565																				15.4071	0.288885262	5.240290934	0	2.422176491	3.126528415	4.534898139	1.078267711	2.010604036	0	2.996161046	0.313477637	0.043202073	4.755572599	2.901046374	3.680105065	0.171673102	0.434149541	0	0	6.401538661	0.942254927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.7479	0	0	15.4071	0.288885262	5.240290934	0	2.422176491	3.126528415	4.534898139	1.078267711	2.010604036	0	2.996161046	0.313477637	0.043202073	4.755572599	2.901046374	3.680105065	0.171673102	0.434149541	0	0	6.401538661	0.942254927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.7479																																																																																				0	0	0	15.4071	0.288885262	5.240290934	0	2.422176491	3.126528415	4.534898139	1.078267711	2.010604036	0	2.996161046	0.313477637	0.043202073	4.755572599	2.901046374	3.680105065	0.171673102	0.434149541	0	0	6.401538661	0.942254927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.7479
H7406_004_0	2008	4																																D	Coin	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		2101.665888	4.449820926	778.2299402		203.5310485	17.24654799	25.01539343	277.338279	331.516259		16.52741584	39.5114264	0.238311166	609.2887711	3656.5441	4638.487195	216.3806394	547.2118465			35.31215106	7.595228516																				"#1A $150/day days 1-5, $0/day days 6-90"	#1B MC cost shares	#2 MC cost shares	#6 $0	#10A $150	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $40"	"#9A $100, #9B $50"	#8A $0	#8B 20%	#9A $100	#12 20%	"#3 20%, #5 20%, #9A $100, #9C 20%, #9D $10"	"#7A $10, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $10, #7D $10, #7F $10, #7G $10"	"#7E $10, #7H $10"	"#7C $10, #7I $10"		"#14I $0 , #14J $0"	#15 20%	"#13A 20%, #16B $0, #17A $10, #17B $0, #18A $10"	#10B $0 n/c	#16A $0 n/c	#17A $0 n/c	#17B $0 n/c	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0 n/c	"#13B $0 n/c , #13C $0 n/c"											92.4	0.07107595	86.4666		150	0.2	0.2	49.0007	76.443		0.2	100	0.2	98.4187	10	10	10	10			0.2	0.131332316																				16.1828	0.316275248	5.607577124	0	2.544138107	3.449309597	5.003078686	1.132480233	2.111842124	0	3.305483168	0.329261887	0.047662233	4.99711806	3.047120083	3.865405996	0.1803172	0.456009872	0	0	7.062430212	0.997498949	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6358	0	0	16.1828	0.316275248	5.607577124	0	2.544138107	3.449309597	5.003078686	1.132480233	2.111842124	0	3.305483168	0.329261887	0.047662233	4.99711806	3.047120083	3.865405996	0.1803172	0.456009872	0	0	7.062430212	0.997498949	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6358																																																																																				0	0	0	16.1828	0.316275248	5.607577124	0	2.544138107	3.449309597	5.003078686	1.132480233	2.111842124	0	3.305483168	0.329261887	0.047662233	4.99711806	3.047120083	3.865405996	0.1803172	0.456009872	0	0	7.062430212	0.997498949	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6358
H7406_005_0	2008	4																					5000											D	Coin	D	V	T	Coin	Coin	V	V	V	P	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		2101.665888	4.449820926	778.2299402		203.5310485	17.24654799	25.01539343	277.338279	331.516259		382.8807568	39.5114264	0.238311166	609.2887711	3973.817747	5012.621528	216.3806394	547.2118465			35.31215106	7.675820499																				"#1A $50/day days 1-5, $0/day days 6-90"	#1B MC cost shares	"#2 $0/day days 1-10, $50/day days 11-100"	#6 $0	#10A $50	#11A 30%	"#11B 30%, #11C 30%"	"#4A $50, #4B $25"	"#9A $50, #9B $50"	#8A $0	#8B $15/x-ray; $100/complex rad; 20%/ther rad	#9A $50	#12 20%	"#3 20%, #5 20%, #9A $50, #9C 20%, #9D $5"	"#7A $5, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $5, #7D $5, #7F $5, #7G $5"	"#7E $5, #7H $5"	"#7C $5, #7I $5"		"#14I $0 , #14J $0"	#15 30%	"#13A 20%, #16B $0, #17A $5, #17B $0, #18A $5"	#10B $0 n/c	#16A $0 n/c	#17A $0 n/c	#17B $0 n/c	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0 n/c	"#13B $0 n/c , #13C $0 n/c"											26.1005	0.060231111	36.0916		42.371	0.254225702	0.254225702	40.2538	42.371		63.8549	42.371	0.169483801	42.0652	4.2371	4.2371	4.2371	4.2371			0.254225702	0.064743126																				4.5712	0.268017657	2.340628718	0	0.718650329	4.384515766	6.359555951	0.930327379	1.170554911	0	2.037399823	0.13951139	0.040389882	2.135821335	1.403120286	1.769912814	0.076402111	0.193215716	0	0	8.977256387	0.496956612	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0134	0	6.844465099	4.5712	0.268017657	2.340628718	0	0.718650329	4.384515766	6.359555951	0.930327379	1.170554911	0	2.037399823	0.13951139	0.040389882	2.135821335	1.403120286	1.769912814	0.076402111	0.193215716	0	0	8.977256387	0.496956612	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0134																																																																																				0	0	0	4.5712	0.268017657	2.340628718	0	0.718650329	4.384515766	6.359555951	0.930327379	1.170554911	0	2.037399823	0.13951139	0.040389882	2.135821335	1.403120286	1.769912814	0.076402111	0.193215716	0	0	8.977256387	0.496956612	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0134
H7406_006_0	2008	5																																D	Coin	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	O	V	V	V	V	V	V	V	V	V	V	V																																										0		2101.665888	4.449820926	778.2299402		203.5310485	17.24654799	25.01539343	277.338279	331.516259		382.8807568	39.5114264	0.238311166	609.2887711	3973.817747	5012.621528	216.3806394	547.2118465			35.31215106	7.675820499																				"#1A $50/day days 1-5, $0/day days 6-90"	#1B MC cost shares	"#2 $0/day days 1-10, $50/day days 11-100"	#6 $0	#10A $50	#11A 20%	"#11B 20%, #11C 20%"	"#4A $50, #4B $25"	"#9A $50, #9B $50"	#8A $0	"#8B $15-xrays, $100-complex rad; 20%-ther rad"	#9A $50	#12 20%	"#3 20%, #5 20%, #9A $50, #9C 20%, #9D $5"	"#7A $5, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $5, #7D $5, #7F $5, #7G $5"	"#7E $5, #7H $5"	"#7C $5, #7I $5"		"#14I $0 , #14J $0"	#15 20%	"#13A 20%, #16B $0, #17A $5, #17B $5, #18A $5"	#10B $0 n/c	#16A $0 n/c	#17A $0 n/c	#17B $0 n/c	#18A $0 n/c	#18B $0 n/c	#19 $0 n/c	#14A $0 n/c	"#13B $0 n/c , #13C $0 n/c"											30.8	0.07107595	42.59		50	0.2	0.2	47.5017	50		75.3522	50	0.2	49.6392	5	5	5	5			0.2	0.07640037																				5.3943	0.316275248	2.762067763	0	0.848046036	3.449309597	5.003078686	1.097836339	1.381317746	0	2.404241359	0.164630943	0.047662233	2.520384037	1.655757394	2.088592304	0.0901586	0.228004936	0	0	7.062430212	0.586435527	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.1005	0	0	5.3943	0.316275248	2.762067763	0	0.848046036	3.449309597	5.003078686	1.097836339	1.381317746	0	2.404241359	0.164630943	0.047662233	2.520384037	1.655757394	2.088592304	0.0901586	0.228004936	0	0	7.062430212	0.586435527	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.1005																																																																																				0	0	0	5.3943	0.316275248	2.762067763	0	0.848046036	3.449309597	5.003078686	1.097836339	1.381317746	0	2.404241359	0.164630943	0.047662233	2.520384037	1.655757394	2.088592304	0.0901586	0.228004936	0	0	7.062430212	0.586435527	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.1005
H7475_001_0	2008	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		259.945865		275.0630911		58.26244985	25.38160691		22.76243614	15.50863656	174.3887724					242.8291442						34.77315871	5.531563124																				Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co	Med FFS Ded/Co																				0.0847		0.1727		0.234	0.234		0.234	0.234	0.234					0.234						0.234	0.234																				22.0174	0	47.50339582	0	13.63341327	5.939296017	0	5.326410056	3.629020956	40.80697275	0	0	0	0	56.82201975	0	0	0	0	0	8.136919137	1.294385771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	205.1092	0	0	22.0174	0	47.50339582	0	13.63341327	5.939296017	0	5.326410056	3.629020956	40.80697275	0	0	0	0	56.82201975	0	0	0	0	0	8.136919137	1.294385771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	205.1092																																																																																				0	0	0	22.0174	0	47.50339582	0	13.63341327	5.939296017	0	5.326410056	3.629020956	40.80697275	0	0	0	0	56.82201975	0	0	0	0	0	8.136919137	1.294385771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	205.1092
H7485_801_0	2008	4																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	276.0035999	2.115201189	52.35387949	28.27967708	6.677661011	21.41010151	0.946911849	5.76395489	27.53511912	10.96605111	29.10599132	0	0.232955476	28.77011675	41.98000195	108.1251707	1.208234717	4.056268828	24.50015746	32.80227953	7.866088247	5.674011573	0	0	0	0	0	0	0	0	0											Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.07913894	0.07913894	0.199177018	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.8426	0.167394779	10.42768961	0	1.562572677	5.009963753	0.221577373	1.348765444	6.443217874	2.56605596	6.810801969	0	0.054511581	6.732207319	9.823320457	25.30128994	0.282726924	0.949166906	5.733036846	7.675733409	1.84066465	1.327718708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.121	0	0	21.8426	0.167394779	10.42768961	0	1.562572677	5.009963753	0.221577373	1.348765444	6.443217874	2.56605596	6.810801969	0	0.054511581	6.732207319	9.823320457	25.30128994	0.282726924	0.949166906	5.733036846	7.675733409	1.84066465	1.327718708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.121	none	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.8426	0.167394779	10.42768961	0	1.562572677	5.009963753	0.221577373	1.348765444	6.443217874	2.56605596	6.810801969	0	0.054511581	6.732207319	9.823320457	25.30128994	0.282726924	0.949166906	5.733036846	7.675733409	1.84066465	1.327718708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.121
H7485_802_0	2008	4																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	276.0035999	2.115201189	52.35387949	28.27967708	6.677661011	21.41010151	0.946911849	5.76395489	27.53511912	10.96605111	29.10599132	0	0.232955476	28.77011675	41.98000195	108.1251707	1.208234717	4.056268828	24.50015746	32.80227953	7.866088247	5.674011573	0	0	0	0	0	0	0	0	0											Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.07913894	0.07913894	0.199177018	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.8426	0.167394779	10.42768961	0	1.562572677	5.009963753	0.221577373	1.348765444	6.443217874	2.56605596	6.810801969	0	0.054511581	6.732207319	9.823320457	25.30128994	0.282726924	0.949166906	5.733036846	7.675733409	1.84066465	1.327718708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.121	0	0	21.8426	0.167394779	10.42768961	0	1.562572677	5.009963753	0.221577373	1.348765444	6.443217874	2.56605596	6.810801969	0	0.054511581	6.732207319	9.823320457	25.30128994	0.282726924	0.949166906	5.733036846	7.675733409	1.84066465	1.327718708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.121	none	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.8426	0.167394779	10.42768961	0	1.562572677	5.009963753	0.221577373	1.348765444	6.443217874	2.56605596	6.810801969	0	0.054511581	6.732207319	9.823320457	25.30128994	0.282726924	0.949166906	5.733036846	7.675733409	1.84066465	1.327718708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.121
H7485_803_0	2008	4																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	276.0035999	2.115201189	52.35387949	28.27967708	6.677661011	21.41010151	0.946911849	5.76395489	27.53511912	10.96605111	29.10599132	0	0.232955476	28.77011675	41.98000195	108.1251707	1.208234717	4.056268828	24.50015746	32.80227953	7.866088247	5.674011573	0	0	0	0	0	0	0	0	0											Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.07913894	0.07913894	0.199177018	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											21.8426	0.167394779	10.42768961	0	1.562572677	5.009963753	0.221577373	1.348765444	6.443217874	2.56605596	6.810801969	0	0.054511581	6.732207319	9.823320457	25.30128994	0.282726924	0.949166906	5.733036846	7.675733409	1.84066465	1.327718708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.121	0	0	21.8426	0.167394779	10.42768961	0	1.562572677	5.009963753	0.221577373	1.348765444	6.443217874	2.56605596	6.810801969	0	0.054511581	6.732207319	9.823320457	25.30128994	0.282726924	0.949166906	5.733036846	7.675733409	1.84066465	1.327718708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.121	none	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.8426	0.167394779	10.42768961	0	1.562572677	5.009963753	0.221577373	1.348765444	6.443217874	2.56605596	6.810801969	0	0.054511581	6.732207319	9.823320457	25.30128994	0.282726924	0.949166906	5.733036846	7.675733409	1.84066465	1.327718708	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.121
H7526_001_0	2008	5																					3000											A	A	A	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	P	P	Coin	Coin			V	P	V	P		V	Coin																																																				0	0	618.4659443	19.02737156			678.4261136	51.11559473	43.60161168	583.659723	396.26582	2024.771259	519.5318219	91.82144907		1632.549274		7172.062364	705.8184215	1386.227978			46.61918231										5.208333333											$100 (1a); $0 (1a1)	$100 (1b)	"$0 (2a, 2a2)"	$0 (6a)	$50 (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	$25 (9b)	$25 (8a1); $0 (8a2)	"$25 (8b1, 8b2); $10 (8b3)"	$25 (9a)	$0 (12)	"$25 (5, 9a); $10 (3, 9c, 9d)"	"$0 (7a, 14b, 14c, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$10 (7b, 7d, 7f, 7g, 16b); $0 (17a, 18a)"	"$10 (7e, 7h)"	"$10 (7c, 7i)"			"20% (15, 15a1)"	20% (17b); 0% (13a)			$0 (17a1)	$0 (17b)	$0 (18a1)	$0 (18b)		$0 (14a)	20% (C )											85.1852	85.1852			42.5926	0.17037037	0.17037037	42.5952	21.2963	10.6481	20.3419	21.2963		20.9621		8.5185	8.5185	8.5185			0.17037037										0.2											4.3903	0.135070848	0	0	2.407993922	8.708582807	7.42842273	2.071756193	0.703249526	1.796672028	0.880688717	0.162954732	0	2.851801177	0	5.091278839	0.501043941	0.984050725	0	0	7.942527356	0	0	0	0	0	0	0	0	0	1.041666667	0	0	0	0	0	0	0	0	0	0	47.0981	0	8.009669235	4.3903	0.135070848	0	0	2.407993922	8.708582807	7.42842273	2.071756193	0.703249526	1.796672028	0.880688717	0.162954732	0	2.851801177	0	5.091278839	0.501043941	0.984050725	0	0	7.942527356	0	0	0	0	0	0	0	0	0	1.041666667	0	0	0	0	0	0	0	0	0	0	47.0981																																																																																				0	0	0	4.3903	0.135070848	0	0	2.407993922	8.708582807	7.42842273	2.071756193	0.703249526	1.796672028	0.880688717	0.162954732	0	2.851801177	0	5.091278839	0.501043941	0.984050725	0	0	7.942527356	0	0	0	0	0	0	0	0	0	1.041666667	0	0	0	0	0	0	0	0	0	0	47.0981
H7526_002_0	2008	5																					0											Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin								V																																																					0	0	243.0749056	59.09283312	29.0420328		16.19155273	26.91391508	19.9933431	33.73407139	33.49718688	8.136092848	15.04731783	2.978349697	1.846775679	38.6695809	52.41300741	106.9770778	32.58061898	6.261356583	22.80386818		33.56315482	3.282199637																				FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins		FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins	FFS Mcare eff coins								$0 (14a)												0.078895258	0.078895258	0.151551772		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234																				19.1775	4.662144298	4.401371539	0	3.788823339	6.297856129	4.678442285	7.893772704	7.83834173	1.903845726	3.521072373	0.696933829	0.432145509	9.048681931	12.26464373	25.0326362	7.623864841	1.46515744	5.336105153	0	7.853778227	0.768034715	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.6851	0	0	19.1775	4.662144298	4.401371539	0	3.788823339	6.297856129	4.678442285	7.893772704	7.83834173	1.903845726	3.521072373	0.696933829	0.432145509	9.048681931	12.26464373	25.0326362	7.623864841	1.46515744	5.336105153	0	7.853778227	0.768034715	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.6851																																																																																				0	0	0	19.1775	4.662144298	4.401371539	0	3.788823339	6.297856129	4.678442285	7.893772704	7.83834173	1.903845726	3.521072373	0.696933829	0.432145509	9.048681931	12.26464373	25.0326362	7.623864841	1.46515744	5.336105153	0	7.853778227	0.768034715	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.6851
H7678_001_0	2008	7																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		467.8582442	41.72948716	75.59694697		24.51092478	54.43408243	38.43065406	11.91899192	26.62540831	13.8150343	28.70152456	0	5.189147741	49.76763971	83.20055593	148.1808398	12.34938555	5.809750693	33.1968711	51.62078316	11.60244551	0.8577815	0	0	0	0	0	0	0	0	0											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0.070699804	0.070699804	0.202634745	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.23	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											33.0775	2.950266582	15.3185681	0	5.7355564	12.73757529	8.992773049	2.789044109	6.230345545	3.232718026	6.716156748	0	1.214260571	11.64562769	19.46893009	34.67431652	2.889756218	1.359481662	7.768067837	12.07926326	2.71497225	0.200720871	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	191.7959	0	0	33.0775	2.950266582	15.3185681	0	5.7355564	12.73757529	8.992773049	2.789044109	6.230345545	3.232718026	6.716156748	0	1.214260571	11.64562769	19.46893009	34.67431652	2.889756218	1.359481662	7.768067837	12.07926326	2.71497225	0.200720871	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	191.7959																																																																																				0	0		33.0775	2.950266582	15.3185681	0	5.7355564	12.73757529	8.992773049	2.789044109	6.230345545	3.232718026	6.716156748	0	1.214260571	11.64562769	19.46893009	34.67431652	2.889756218	1.359481662	7.768067837	12.07926326	2.71497225	0.200720871	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	191.7959
H7678_002_0	2008	6																					2400											D	D	D		T	Coin	Coin	V	Coin		Coin			V	V	V	V	P	Coin	P	Coin			Coin	V		V																																																								0		1500.209559	37.84263213	1041.413546	0	238.79584	17.64836088	10.95142645	303.6885239	32.50085167	0	14.85001402	0	0	400.1732705	7332.237658	13328.25787	168.0961785	1391.626046	26.6113377	1920.075286	9.918806412	0	0	35.3	385.8674702	0	176.3862526	0	0	0	0											"$200 per Day, Days 1-5$200 per Day, Days 1-5"	"$200 per Day, Days 1-5$200 per Day, Days 1-5"	"$200 per Day, Days 1-5"	No Cost Sharing	$100/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $25/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology;	No Cost Sharing	No Cost Sharing	$20/Case for OP Fac - Occ Therapy; $20/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $7/Service for Prof - CORF; $7/Service for Prof - CORF;	$5/Visit for PCP - Office Visits; $4/Consult for PCP - Consults; 20% Coinsurance for PCP - Primary Surgeon (OP); $2/Procedure for PCP - Asst Surgeon (OP); $2/Services for PCP - Tx Injections; $0/Tests for PCP - Allergy Testing; $3/Service for PCP - Allergy Tx;	20% Coinsurance for Speclst - Primary Surgeon (OP); $7/Procedure for Speclst - Asst Surgeon (OP); 20% Coinsurance for Speclst - Anesthesia (OP); $20/Visit for Speclst - Office Visits; $6/Services for Speclst - Tx Injections; $1/Tests for Speclst - Allergy Testing; $12/Service for Speclst - Allergy Tx; $16/Consult for Speclst - Consults;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$7/Service for PT/ST (PCP); $7/Service for Occ Therapy (PCP); $7/Service for PT/ST (Specialist); $7/Service for Occ Therapy (Specialist);	3% Coinsurance for Prof Radiology (Office); 4% Coinsurance for Prof Radiology (OP);	$20/Visit for Chiropractor; $15/Exam for Vistion Exams; $20/Service for Podiatrist; $15/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	$5/Procedure for Dental - Preventive; 54% Coinsurance for Dental - Comprehensive;	$15/Exam for Vision (Refractions)	No Cost Sharing	$15/Exam for Routine Hearing Exams	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											113.28	83.19999998	54.26	0	100	0.2	0.2	42.00066019	0.2	0	0.2	0	0	14.84806116	3.550834526	12.55348022	20	6.666666667	0.032004882	18.06236606	0.2	0	0	0.442044381	15	0	15	0	0	0	0											14.162	0.262375583	4.708924916	0	1.989965333	3.529672175	2.19028529	1.062926542	6.500170334	0	2.970002805	0	0	0.495149766	2.169630219	13.9430018	0.280160298	0.773125581	0.851692727	2.890091891	1.983761282	0	0	15.60416667	0.482334338	0	0.220482816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.0699	0	0	14.162	0.262375583	4.708924916	0	1.989965333	3.529672175	2.19028529	1.062926542	6.500170334	0	2.970002805	0	0	0.495149766	2.169630219	13.9430018	0.280160298	0.773125581	0.851692727	2.890091891	1.983761282	0	0	15.60416667	0.482334338	0	0.220482816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.0699																																																																																				0	0		14.162	0.262375583	4.708924916	0	1.989965333	3.529672175	2.19028529	1.062926542	6.500170334	0	2.970002805	0	0	0.495149766	2.169630219	13.9430018	0.280160298	0.773125581	0.851692727	2.890091891	1.983761282	0	0	15.60416667	0.482334338	0	0.220482816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.0699
H7731_001_0	2008	4																					Unlimited											D	D	D	V	T	Coin	P	V	V	V	V	V	Coin	V	P	P	P	P	P	P	Coin	P	T	P	P	P	P	P	P	P	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.355255455	0	0	179.9345724	12.74	0	265.8906412	0	0	32.66592303	0	0.27	1.195353344	50.6829818	0	161.4640964	0	0	0	9.28	0	0	1553.959348	0	0	0	0	0	0	3.17											1A - no cost sharing	1B - $150 per admit	2 - no cost sharing	6 - no cost sharing	10A - $50 copay	11A - 10% coinsurance	11B - no cost sharing	4A - $50 copay	9 - no cost sharing	8A - no cost sharing	8B - $20 copay radiation therapy	no cost sharing	11C - 20% coinsurance	9D - $30 copay	4B - $25 copay urgent visits	No Cost Sharing	7E & 7H - $30 copay	7C & 7I - no cost sharing	no cost sharing	7B - no cost sharing	15 - 20% coinsurance	no cost sharing	10B - no cost sharing	16A - $15 copay	17A - no cost sharing	17B - no cost sharing	18A - no cost sharing	18B - no cost sharing	no cost sharing	no cost sharing	40% coinsurance worldwide coverage											0	150	0	0	50	0.100030551	0	50	0	0	20	0	0.201032852	30	25	0	30	0	0	0	0.199941787	0	0	15	0	0	0	0	0	0	0.399629928											0	0.016940693	0	0	0.749727385	1.274389216	0	1.107877672	0	0	0.054443205	0	0.05427887	0.002988383	0.105589545	0	0.403660241	0	0	0	1.855459786	0	0	1.942449185	0	0	0	0	0	0	1.266826873	0	0	0	0	0	0	0	0	0	0	8.8346	0	0	0	0.016940693	0	0	0.749727385	1.274389216	0	1.107877672	0	0	0.054443205	0	0.05427887	0.002988383	0.105589545	0	0.403660241	0	0	0	1.855459786	0	0	1.942449185	0	0	0	0	0	0	1.266826873	0	0	0	0	0	0	0	0	0	0	8.8346	0	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0.016940693	0	0	0.749727385	1.274389216	0	1.107877672	0	0	0.054443205	0	0.05427887	0.002988383	0.105589545	0	0.403660241	0	0	0	1.855459786	0	0	1.942449185	0	0	0	0	0	0	1.266826873	0	0	0	0	0	0	0	0	0	0	8.8346
H7731_002_0	2008	4																					Unlimited											D	D	D	V	T	Coin	P	V	V	V	V	V	Coin	V	P	P	P	P	P	P	Coin	P	T	P	P	P	P	P	P	P	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.505226184	34.26423165	0	179.9345724	12.74	0	265.8906412	0	0	32.66592303	0	0.27	1.195353344	50.6829818	0	156.3855546	0	0	0	9.28	0	0	1553.959348	0	0	0	0	0	0	3.17											1A - no cost sharing	1B - $50 per day 1-8	2 - $20 per day 20+	6 - no cost sharing	10A - $50 copay	11A - 15% coinsurance	11B - no cost sharing	4A - $50 copay	9 - no cost sharing	8A - no cost sharing	8B - $20 copay radiation therapy	no cost sharing	11C - 20% coinsurance	9D - $30 copay	4B - $25 copay urgent visits	No Cost Sharing	7E & 7H - $30 copay	7C & 7I - no cost sharing	no cost sharing	7B - no cost sharing	15 - 20% coinsurance	no cost sharing	10B - no cost sharing	16A - $15 copay	17A - no cost sharing	17B - no cost sharing	18A - no cost sharing	18B - no cost sharing	no cost sharing	no cost sharing	40% coinsurance worldwide coverage											0	50	20	0	50	0.150045826	0	50	0	0	20	0	0.201032852	30	25	0	30	0	0	0	0.199941787	0	0	15	0	0	0	0	0	0	0.399629928											0	0.027105109	0.057107053	0	0.749727385	1.911583824	0	1.107877672	0	0	0.054443205	0	0.05427887	0.002988383	0.105589545	0	0.390963886	0	0	0	1.855459786	0	0	1.942449185	0	0	0	0	0	0	1.266826873	0	0	0	0	0	0	0	0	0	0	9.5264	0	0	0	0.027105109	0.057107053	0	0.749727385	1.911583824	0	1.107877672	0	0	0.054443205	0	0.05427887	0.002988383	0.105589545	0	0.390963886	0	0	0	1.855459786	0	0	1.942449185	0	0	0	0	0	0	1.266826873	0	0	0	0	0	0	0	0	0	0	9.5264	0	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0.027105109	0.057107053	0	0.749727385	1.911583824	0	1.107877672	0	0	0.054443205	0	0.05427887	0.002988383	0.105589545	0	0.390963886	0	0	0	1.855459786	0	0	1.942449185	0	0	0	0	0	0	1.266826873	0	0	0	0	0	0	0	0	0	0	9.5264
H7731_003_0	2008	4																					Unlimited											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	P	P	P	P	P	P	Coin	P	T	P	P	P	P	P	P	P	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	859.9371868	9.336281667	34.26423165	0	179.9345724	12.74	7.75	265.8906412	268.867669	0	0	0	0.27	296.4768726	50.6829818	0	156.3855546	1340.798834	0	0	9.28	0	0	1553.959348	0	0	0	0	0	0	3.17											1A - $50 per day 1-8	1B - $50 per day 1-8	2 - $20 per day 20+	6 - no cost sharing	10A - $50 copay	11A - 10% coinsurance	11B - 10% coinsurance	4A - $50 copay	9 - $25 copay	8A - no cost sharing	8B - no cost sharing	no cost sharing	11C - 20% coinsurance	9D - $30 copay	4B - $30 copay urgent visits	No Cost Sharing	7E & 7H - $10 copay	7C & 7I - $30 copay	no cost sharing	7B - no cost sharing	15 - 20% coinsurance	no cost sharing	10B - no cost sharing	16A - $15 copay	17A - no cost sharing	17B - no cost sharing	18A - no cost sharing	18B - no cost sharing	no cost sharing	no cost sharing	40% coinsurance worldwide coverage											50	50	20	0	50	0.100030551	0.100085037	50	25	0	0	0	0.201032852	30	30	0	10	30	0	0	0.199941787	0	0	15	0	0	0	0	0	0	0.399629928											3.5831	0.038901174	0.057107053	0	0.749727385	1.274389216	0.775659035	1.107877672	0.560140977	0	0	0	0.05427887	0.741192182	0.126707455	0	0.130321295	3.351997085	0	0	1.855459786	0	0	1.942449185	0	0	0	0	0	0	1.266826873	0	0	0	0	0	0	0	0	0	0	17.6161	0	0	3.5831	0.038901174	0.057107053	0	0.749727385	1.274389216	0.775659035	1.107877672	0.560140977	0	0	0	0.05427887	0.741192182	0.126707455	0	0.130321295	3.351997085	0	0	1.855459786	0	0	1.942449185	0	0	0	0	0	0	1.266826873	0	0	0	0	0	0	0	0	0	0	17.6161	0	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.5831	0.038901174	0.057107053	0	0.749727385	1.274389216	0.775659035	1.107877672	0.560140977	0	0	0	0.05427887	0.741192182	0.126707455	0	0.130321295	3.351997085	0	0	1.855459786	0	0	1.942449185	0	0	0	0	0	0	1.266826873	0	0	0	0	0	0	0	0	0	0	17.6161
H7731_004_0	2008	3																					Unlimited											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	P	P	P	P	P	P	Coin	P	T	P	P	P	P	P	P	P	P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	607.0144848	8.50361829	34.26423165	0	179.9345724	12.74	7.75	265.8906412	0	0	32.66592303	0	0.27	297.672226	4829.114853	5264.049813	156.3855546	1340.798834	0	817.7315868	9.28	0	0	1553.959348	0	0	0	0	0	0	0											1A - $50 per day 3-10	1B - $50 per day 1-8	2 - $20 per day 20+	6 - no cost sharing	10A - $50 copay	11A - 20% coinsurance	11B - 20% coinsurance	4A - $50 copay	9 - no cost sharing	8A - no cost sharing	8B - $20 copay radiation therapy	no cost sharing	11C - 20% coinsurance	9D - $10 copay	7A - $5 copay	7D - $10 copay	7E & 7H - $30 copay	7C & 7I - $10 copay	no cost sharing	7B - $10 copay	15 - 20% coinsurance	no cost sharing	10B - no cost sharing	16A - $15 copay	17A - no cost sharing	17B - no cost sharing	18A - no cost sharing	18B - no cost sharing	no cost sharing	no cost sharing	no cost sharing											50	50	20	0	50	0.200061101	0.200170074	50	0	0	20	0	0.201032852	10.08031339	5.209905887	10	30	10	0	10	0.199941787	0	0	15	0	0	0	0	0	0	0											2.5292	0.035431743	0.057107053	0	0.749727385	2.548778432	1.55131807	1.107877672	0	0	0.054443205	0	0.05427887	0.250052444	2.096602825	4.386708178	0.390963886	1.117332362	0	0.681442989	1.855459786	0	0	1.942449185	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.4092	0	0	2.5292	0.035431743	0.057107053	0	0.749727385	2.548778432	1.55131807	1.107877672	0	0	0.054443205	0	0.05427887	0.250052444	2.096602825	4.386708178	0.390963886	1.117332362	0	0.681442989	1.855459786	0	0	1.942449185	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.4092	0	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits	HMO - no OON benefits											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.5292	0.035431743	0.057107053	0	0.749727385	2.548778432	1.55131807	1.107877672	0	0	0.054443205	0	0.05427887	0.250052444	2.096602825	4.386708178	0.390963886	1.117332362	0	0.681442989	1.855459786	0	0	1.942449185	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.4092
H7845_001_0	2008	4																					1500											A	Coin	D	V	T	Coin	Coin	V	V	P	P	V	V	V	Coin	P	Coin	P	Coin	P	Coin	P	P	P	P	P	P	P	P	P	P																																																				0		286.5946629	4.715683686	796.8850251		163.1727735	11.42275508	11.088787	271.166002	338.9572319	1252.820931	523.0949098		9.233500455	7.760061137	0.018533395	5190.83254	2.470867405	528.1594581			26.13140206																					1a (IP Acute) - $250	1b (IP Psych) - 50%	2 (SNF) - $75/days 21-100	6 (Home Health)- $0	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) $50, 4b (UC) - $35"	"9a (OP Surgery) - $100, 9b (ASC) - $50"	8a (OP Diag Proc/Test/Lab) - $25	"8b (OP Diag & Therap Rad) - $25 Raditaion Therapy, $75 High Cost Radiology"		12 (Renal Dialysis) - $25	"3 (CORF) - $15, 7i, 7c (OP PT/ST/OT) - $15, 9c (OP SA) - 50%, 9d (Cardiac Rehab) - $15"	"14g (Bone Mass) 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) - $0, 14j (Nutrition Therap) - $15; 14i (Diab Mon.) - 20%; 7a (PCP) - $0"	"7b (Chiro), 7d (Spec), 7f (Pod) - $15"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $15"	8b (Professional Radiology) - $0	7g (Prof. Other - allergy visits)  - $0	15 (Part B Rx) - 20%	13a (Blood) - $0; 17b (MCR Eyewear) - $0;			17a1 (Rountine Eye Exam) -$50 per yr	17b1 (Non MCR Covered) [including contacts] - $75 per year	18a1 (Hearing Exam Non-covered) - $50 per yr;	18b (Hearing Aids) - $500 per yr.														183.5473	0.367094648	16.8496		36.7095	0.146837859	0.146837859	34.5019	57.3082	18.3547	41.158		18.3547	19.7921	0.146837859	11.0128	0.367094648	11.0128			0.146837859																					4.3836	1.731102243	1.118935771	0	0.499165432	1.677292902	1.628253745	0.779645308	1.618753093	1.916266078	1.7941278	0	0.014123202	0.012798998	0.002721404	4.76381711	0.9070422	0.484711276	0	0	3.837079136	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.1695	0	9.836615136	4.3836	1.731102243	1.118935771	0	0.499165432	1.677292902	1.628253745	0.779645308	1.618753093	1.916266078	1.7941278	0	0.014123202	0.012798998	0.002721404	4.76381711	0.9070422	0.484711276	0	0	3.837079136	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.1695																																																																																				0	0	0	4.3836	1.731102243	1.118935771	0	0.499165432	1.677292902	1.628253745	0.779645308	1.618753093	1.916266078	1.7941278	0	0.014123202	0.012798998	0.002721404	4.76381711	0.9070422	0.484711276	0	0	3.837079136	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.1695
H7845_002_0	2008	4																					1500											A	Coin	D	V	T	Coin	Coin	V	V	P	P	V	V	V	Coin	P	Coin	P	Coin	P	Coin	P	P	P	P	P	P	P	P	P	P																																																				0		286.5946629	4.715683686	796.8850251		163.1727735	11.42275508	11.088787	271.166002	338.9572319	1252.820931	523.0949098		9.233500455	7.760061137	0.018533395	5190.83254	2.470867405	528.1594581			26.13140206																					1a (IP Acute) - $250	1b (IP Psych) - 50%	2 (SNF) - $75/days 21-100	6 (Home Health)- $0	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) $50, 4b (UC) - $35"	"9a (OP Surgery) - $100, 9b (ASC) - $50"	8a (OP Diag Proc/Test/Lab) - $25	"8b (OP Diag & Therap Rad) - $25 Raditaion Therapy, $75 High Cost Radiology"		12 (Renal Dialysis) - $25	"3 (CORF) - $15, 7i, 7c (OP PT/ST/OT) - $15, 9c (OP SA) - 50%, 9d (Cardiac Rehab) - $15"	"14g (Bone Mass) 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) - $0, 14j (Nutrition Therap) - $15; 14i (Diab Mon.) - 20%; 7a (PCP) - $0"	"7b (Chiro), 7d (Spec), 7f (Pod) - $15"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $15"	8b (Professional Radiology) - $0	7g (Prof. Other - allergy visits)  - $0	15 (Part B Rx) - 20%	13a (Blood) - $0; 17b (MCR Eyewear) - $0;			17a1 (Rountine Eye Exam) -$50 per yr	17b1 (Non MCR Covered) [including contacts] - $75 per year	18a1 (Hearing Exam Non-covered) - $50 per yr;	18b (Hearing Aids) - $500 per yr.														183.5473	0.367094648	16.8496		36.7095	0.146837859	0.146837859	34.5019	57.3082	18.3547	41.158		18.3547	19.7921	0.146837859	11.0128	0.367094648	11.0128			0.146837859																					4.3836	1.731102243	1.118935771	0	0.499165432	1.677292902	1.628253745	0.779645308	1.618753093	1.916266078	1.7941278	0	0.014123202	0.012798998	0.002721404	4.76381711	0.9070422	0.484711276	0	0	3.837079136	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.1695	0	9.836615136	4.3836	1.731102243	1.118935771	0	0.499165432	1.677292902	1.628253745	0.779645308	1.618753093	1.916266078	1.7941278	0	0.014123202	0.012798998	0.002721404	4.76381711	0.9070422	0.484711276	0	0	3.837079136	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.1695																																																																																				0	0	0	4.3836	1.731102243	1.118935771	0	0.499165432	1.677292902	1.628253745	0.779645308	1.618753093	1.916266078	1.7941278	0	0.014123202	0.012798998	0.002721404	4.76381711	0.9070422	0.484711276	0	0	3.837079136	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.1695
H7845_003_0	2008	5																					3500											D	Coin	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	P	P	Coin	P	Coin	P	Coin	P	P	P	P	P	P	P	P	P	P																																																				0		1480.978903	4.619445243	780.6220654		159.8427169	11.18963763	10.86248523	265.6403632	332.0397374	16.692561	42.84323048	2.992523325	0.350566938	26.06648149	3829.328787	5084.897182	2.42044154	517.3806936			25.59810814																					1a (IP Acute) - $190/days 1-10	1b (IP Psych) - 50%	2 (SNF) - $125/days 8-100	6 (Home Health)- $0	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) $50, 4b (UC) - $35"	"9a (OP Surgery) - $240, 9b (ASC) - $200"	8a (OP Diag Proc/Test/Lab) - 10%	8b (OP Diag & Therap Rad) - 10%	0.1	12 (Renal Dialysis) - 10%	"3 (CORF)-10%, 7i, 7c (OP PT/ST/OT) - $30, 9c (OP SA) - 50%, 9d (Cardiac Rehab) - $30"	"14g (Bone Mass) 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) - $0, 14j (Nutrition Therap) - $0; 14i (Diab Mon.) - 20%; 7a (PCP)- $15"	"7b (Chiro), 7d (Spec), 7f (Pod) - $30"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"	8b (Professional Radiology) - 10%	7g (Prof. Other)  - $0	15 (Part B Rx) - 20%	13a (Blood) - $0;																				119.2659	0.385101342	62.7715		38.5101	0.154040537	0.154040537	36.1942	171.3279	0.077020268	0.077020268	0.077020268	0.077020268	0.082716802	11.5514	23.1061	0.385101342	23.1061			0.154040537																					14.7192	1.778954561	4.083402714	0	0.512963706	1.723657786	1.673263054	0.801219608	4.740638446	1.285665528	3.299797108	0.230484949	0.02700076	2.156136001	3.686167945	9.791003635	0.932115284	0.996219996	0	0	3.943146316	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.381	0	16.82181679	14.7192	1.778954561	4.083402714	0	0.512963706	1.723657786	1.673263054	0.801219608	4.740638446	1.285665528	3.299797108	0.230484949	0.02700076	2.156136001	3.686167945	9.791003635	0.932115284	0.996219996	0	0	3.943146316	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.381																																																																																				0	0	0	14.7192	1.778954561	4.083402714	0	0.512963706	1.723657786	1.673263054	0.801219608	4.740638446	1.285665528	3.299797108	0.230484949	0.02700076	2.156136001	3.686167945	9.791003635	0.932115284	0.996219996	0	0	3.943146316	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.381
H7845_004_0	2008	7																					3500											D	Coin	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	P	P	Coin	P	Coin	P	Coin	P	P	P	P	P	P	P	P	P	P																																																				0		1480.978903	4.619445243	780.6220654		159.8427169	11.18963763	10.86248523	265.6403632	332.0397374	16.692561	42.84323048	2.992523325	0.350566938	26.06648149	3829.328787	5084.897182	2.42044154	517.3806936			25.59810814																					1a (IP Acute) - $190/days 1-10	1b (IP Psych) - 50%	2 (SNF) - $125/days 8-100	6 (Home Health)- $0	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	"4a (ER) $50, 4b (UC) - $35"	"9a (OP Surgery) - $240, 9b (ASC) - $200"	8a (OP Diag Proc/Test/Lab) - 10%	8b (OP Diag & Therap Rad) - 10%	0.1	12 (Renal Dialysis) - 10%	"3 (CORF)-10%, 7i, 7c (OP PT/ST/OT) - $30, 9c (OP SA) - 50%, 9d (Cardiac Rehab) - $30"	"14g (Bone Mass) 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) - $0, 14j (Nutrition Therap) - $0; 14i (Diab Mon.) - 20%; 7a (PCP)- $15"	"7b (Chiro), 7d (Spec), 7f (Pod) - $30"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $30"	8b (Professional Radiology) - 10%	7g (Prof. Other)  - $0	15 (Part B Rx) - 20%	13a (Blood) - $0;																				119.2659	0.385101342	62.7715		38.5101	0.154040537	0.154040537	36.1942	171.3279	0.077020268	0.077020268	0.077020268	0.077020268	0.082716802	11.5514	23.1061	0.385101342	23.1061			0.154040537																					14.7192	1.778954561	4.083402714	0	0.512963706	1.723657786	1.673263054	0.801219608	4.740638446	1.285665528	3.299797108	0.230484949	0.02700076	2.156136001	3.686167945	9.791003635	0.932115284	0.996219996	0	0	3.943146316	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.381	0	16.82181679	14.7192	1.778954561	4.083402714	0	0.512963706	1.723657786	1.673263054	0.801219608	4.740638446	1.285665528	3.299797108	0.230484949	0.02700076	2.156136001	3.686167945	9.791003635	0.932115284	0.996219996	0	0	3.943146316	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.381																																																																																				0	0	0	14.7192	1.778954561	4.083402714	0	0.512963706	1.723657786	1.673263054	0.801219608	4.740638446	1.285665528	3.299797108	0.230484949	0.02700076	2.156136001	3.686167945	9.791003635	0.932115284	0.996219996	0	0	3.943146316	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.381
H7845_801_0	2008	7																					1500											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		244.1905255	4.715683686	27.85482727		6.659414651	11.42275508	11.088787	13.217406	43.78700937	6.13215252	54.64396796	3.054867561	0.357870416	26.60953319	37.06701371	99.74379979	2.470867405	4.977124161			26.13140206	2.99375128																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.080296835	0.080296835	0.193643098		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				19.6077	0.378654477	5.393895053	0	1.558303028	2.672924689	2.594776159	3.092873005	10.24616019	1.43492369	12.7866885	0.714839009	0.083741677	6.226630767	8.673681209	23.34004915	0.578182973	1.164647054	0	0	6.114748083	0.700537799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.364	0	0	19.6077	0.378654477	5.393895053	0	1.558303028	2.672924689	2.594776159	3.092873005	10.24616019	1.43492369	12.7866885	0.714839009	0.083741677	6.226630767	8.673681209	23.34004915	0.578182973	1.164647054	0	0	6.114748083	0.700537799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.364																																																																																				0	0	0	19.6077	0.378654477	5.393895053	0	1.558303028	2.672924689	2.594776159	3.092873005	10.24616019	1.43492369	12.7866885	0.714839009	0.083741677	6.226630767	8.673681209	23.34004915	0.578182973	1.164647054	0	0	6.114748083	0.700537799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.364
H7845_802_0	2008	5																					1500											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		244.1905255	4.715683686	27.85482727		6.659414651	11.42275508	11.088787	13.217406	43.78700937	6.13215252	54.64396796	3.054867561	0.357870416	26.60953319	37.06701371	99.74379979	2.470867405	4.977124161			26.13140206	2.99375128																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.080296835	0.080296835	0.193643098		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				19.6077	0.378654477	5.393895053	0	1.558303028	2.672924689	2.594776159	3.092873005	10.24616019	1.43492369	12.7866885	0.714839009	0.083741677	6.226630767	8.673681209	23.34004915	0.578182973	1.164647054	0	0	6.114748083	0.700537799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.364	0	0	19.6077	0.378654477	5.393895053	0	1.558303028	2.672924689	2.594776159	3.092873005	10.24616019	1.43492369	12.7866885	0.714839009	0.083741677	6.226630767	8.673681209	23.34004915	0.578182973	1.164647054	0	0	6.114748083	0.700537799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.364																																																																																				0	0	0	19.6077	0.378654477	5.393895053	0	1.558303028	2.672924689	2.594776159	3.092873005	10.24616019	1.43492369	12.7866885	0.714839009	0.083741677	6.226630767	8.673681209	23.34004915	0.578182973	1.164647054	0	0	6.114748083	0.700537799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.364
H7845_803_0	2008	5																					1500											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		244.1905255	4.715683686	27.85482727		6.659414651	11.42275508	11.088787	13.217406	43.78700937	6.13215252	54.64396796	3.054867561	0.357870416	26.60953319	37.06701371	99.74379979	2.470867405	4.977124161			26.13140206	2.99375128																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.080296835	0.080296835	0.193643098		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				19.6077	0.378654477	5.393895053	0	1.558303028	2.672924689	2.594776159	3.092873005	10.24616019	1.43492369	12.7866885	0.714839009	0.083741677	6.226630767	8.673681209	23.34004915	0.578182973	1.164647054	0	0	6.114748083	0.700537799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.364	0	0	19.6077	0.378654477	5.393895053	0	1.558303028	2.672924689	2.594776159	3.092873005	10.24616019	1.43492369	12.7866885	0.714839009	0.083741677	6.226630767	8.673681209	23.34004915	0.578182973	1.164647054	0	0	6.114748083	0.700537799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.364																																																																																				0	0	0	19.6077	0.378654477	5.393895053	0	1.558303028	2.672924689	2.594776159	3.092873005	10.24616019	1.43492369	12.7866885	0.714839009	0.083741677	6.226630767	8.673681209	23.34004915	0.578182973	1.164647054	0	0	6.114748083	0.700537799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.364
H7908_001_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0	0	0	0	0											$150/day 1-5	$150/day 1-5	"$0/d 1-10, $100/d 11-100"	0	100	0.2	0.2	$50 ER; $25 UC	100	$0 	"$0 X-ray; $150CAT, PET, MRI"	20	20	20	10	20	20	20	20	20	$45 	0	0	0	$0 	Not Covered	$0 	$500 Every 3 Yrs	N/A	Fitness	0											91.93	91.93	64.36149503	0	100	0.2	0.2	47	100	0	27	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0	0											12.1617	0.236924084	6.954931585	0	1.957621255	3.143561179	0.200659672	1.668763771	2.925180284	0	2.580638523	0	0	0	4.613623101	11.40257547	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2028			12.1617	0.236924084	6.954931585	0	1.957621255	3.143561179	0.200659672	1.668763771	2.925180284	0	2.580638523	0	0	0	4.613623101	11.40257547	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2028																																																																																				0			12.1617	0.236924084	6.954931585	0	1.957621255	3.143561179	0.200659672	1.668763771	2.925180284	0	2.580638523	0	0	0	4.613623101	11.40257547	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2028
H7908_002_0	2008	2																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1587.510601	30.92667262	1296.725301	2128.644463	234.9145506	15.71780589	1.003298358	426.0673458	351.0216341	2231.723298	1146.950455	0	0	0	5536.347721	6841.545279	201.6716462	583.4957142	956.9618676	1446.390804	1077.981961	0	0	0	0	0	0	0	0	0	0											$150/day 1-5	$150/day 1-5	"$0/d 1-10, $100/d 11-100"	0	100	0.2	0.2	$50 ER; $25 UC	100	$0 	"$0 X-ray; $150CAT, PET, MRI"	20	20	20	10	20	20	20	20	20	$45 	0	0	0	$0 	Not Covered	$0 	$500 Every 3 Yrs	N/A	Fitness	0											91.93	91.93	64.36149503	0	100	0.2	0.2	47	100	0	27	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0	0											12.1617	0.236924084	6.954931585	0	1.957621255	3.143561179	0.200659672	1.668763771	2.925180284	0	2.580638523	0	0	0	4.613623101	11.40257547	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2028			12.1617	0.236924084	6.954931585	0	1.957621255	3.143561179	0.200659672	1.668763771	2.925180284	0	2.580638523	0	0	0	4.613623101	11.40257547	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2028																																																																																				0			12.1617	0.236924084	6.954931585	0	1.957621255	3.143561179	0.200659672	1.668763771	2.925180284	0	2.580638523	0	0	0	4.613623101	11.40257547	0.33611941	0.972492857	1.594936446	2.410651339	4.042432355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2028
H7908_801_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1403.2	27.3	1146.2	1881.6	207.6	15.7	1	376.6	310.3	1972.7	1013.8	0	0	0	4893.7	6208.1	178.3	1031.5	1409.8	2557	18.1	0	0	0	0	0	0	0	0	0	0											200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance	0	N/A	Not Covered	$0 per visit	Not Covered	$0 per visit	Not Covered	N/A	Not Covered	0											144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											16.9051	0.32889675	9.551666667	6.272	2.595	4.71	0.3	1.569166667	5.171666667	6.575666667	4.641514333	0	0	0	12.23425	20.43499583	0.594333333	3.438333333	4.699333333	8.523333333	3.62	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1652			16.9051	0.32889675	9.551666667	6.272	2.595	4.71	0.3	1.569166667	5.171666667	6.575666667	4.641514333	0	0	0	12.23425	20.43499583	0.594333333	3.438333333	4.699333333	8.523333333	3.62	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1652																																																																																				0			16.9051	0.32889675	9.551666667	6.272	2.595	4.71	0.3	1.569166667	5.171666667	6.575666667	4.641514333	0	0	0	12.23425	20.43499583	0.594333333	3.438333333	4.699333333	8.523333333	3.62	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1652
H7908_802_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V	0	V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1403.2	27.3	1146.2	1881.6	207.6	15.7	1	376.6	310.3	1972.7	1013.8	0	0	0	4893.7	6208.1	178.3	1031.5	1409.8	2557	18.1	0	0	0	0	0	0	0	0	0	0											200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance	0	N/A	Not Covered	$0 per visit	Not Covered	$0 per visit	Not Covered	N/A	Not Covered	0											144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											16.9051	0.32889675	9.551666667	6.272	2.595	4.71	0.3	1.569166667	5.171666667	6.575666667	4.641514333	0	0	0	12.23425	20.43499583	0.594333333	3.438333333	4.699333333	8.523333333	3.62	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1652			16.9051	0.32889675	9.551666667	6.272	2.595	4.71	0.3	1.569166667	5.171666667	6.575666667	4.641514333	0	0	0	12.23425	20.43499583	0.594333333	3.438333333	4.699333333	8.523333333	3.62	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1652																																																																																				0			16.9051	0.32889675	9.551666667	6.272	2.595	4.71	0.3	1.569166667	5.171666667	6.575666667	4.641514333	0	0	0	12.23425	20.43499583	0.594333333	3.438333333	4.699333333	8.523333333	3.62	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1652
H7917_001_0	2008	4																					5000											D	D	D	V	T	coin	coin	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	896.6660751	12.11304604	616.6843681	0	263.4206302	23.04256317	1.063651542	297.9041246	297.1125946	0	0	0	15.2123625	280.3874341	3753.981246	4919.291377	161.4834051	521.9178698	0	99.40698299	0	616.4059026	228	0	0	0	0	0	0	0	0											$175 days 1-7	$175 days 1-7	$150 days 21-100	$0 per visit	$200 per trip	20% DME & 0% Diabetic Supplies	20%	"ER:  $50 per visit, UC:  $40 per visit"	$250 per visit	$0 per visit	$0 per visit	$0 per visit	$20 per visit	OP PT/ST/OT:  $40 per visit	$20 per visit	$40 per visit	$40 per visit	$40 per visit	$0 per visit	"Medicare Hearing Exams:  $40 per visit, OPSA:  $40 per visit"	$0 per visit	Medicare Vision Exams:  $40 per visit	$0 per trip	$0 per visit	$0 	$0 	$0 	$0 	0	0	0											159.3065572	159.3063467	136.5480519	0	182.0575813	0.149298197	0.182063923	42.33270061	227.5791811	0	0	0	18.20644105	36.41287858	18.20629541	35.46427186	36.41220131	36.41217544	0	32.51911884	0	36.41222097	0	0	0	0	0	0	0	0	0											11.9037	0.160807093	7.017254089	0	3.9964769	3.440213125	0.193652572	1.050923843	5.634720083	0	0	0	0.023080248	0.850809466	5.695507628	14.53825723	0.489997188	1.58368042	0	0.269385624	0	1.870392328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.7189	0	6.901	11.9037	0.160807093	7.017254089	0	3.9964769	3.440213125	0.193652572	1.050923843	5.634720083	0	0	0	0.023080248	0.850809466	5.695507628	14.53825723	0.489997188	1.58368042	0	0.269385624	0	1.870392328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.7189	10000	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	0%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	0%	0%	20%	0%	20%	0%	0	0	0											4.2465	0.0324	0.6821	0.4606	0.0638	0.2165	0.01	0.082	0.4055	0.1584	0.4313	0	0.0038	0.4181	0.6605	1.7403	0.02	0.0667	0.439	0.5681	0.1171	0.0877	0	0	0.0489	0	0.0138	0	0	0	0											10.9732	2000	1.1155	16.1503	0.1932302	7.699344717	0.46057833	4.060296678	3.656726213	0.203646981	1.132924917	6.040259025	0.158381645	0.431345185	0	0.026876509	1.268934969	6.355980099	16.27855693	0.509992277	1.650384489	0.43903928	0.83751642	0.117065084	1.95804603	0	0	0.048917508	0	0.01377107	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.6921
H7917_002_0	2008	4																					2500											coin	coin	coin	V	T	coin	coin	V	coin	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	V	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	2500	234.9907317	1.678945919	48.93683103	0	277.4604744	24.26186806	1.119946288	333.5376693	23.82669559	0	0	0	0	295.2194602	4211.699878	5623.382328	185.5175004	599.6009105	0	114.1601683	0	708.1436982	228	420.375	415.9206721	0	170.0922738	0	0	0	0											$0 per admit	$0 per admit	$0 days 1-100	$0 per visit	$100 per trip	20% DME & 0% Diabetic Supplies	20%	"ER:  $50 per visit, UC:  $10 per visit"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$0 per visit	"Medicare Hearing Exams:  $10 per visit, OPSA:  $10 per visit"	$0 per visit	Medicare Vision Exams:  $10 per visit	$0 per trip	$0 per visit	$10 per visit	0	$10 per visit	0	0	0	0											-9.52E-19	0	0	0	96.51975513	0.15830012	0.19303951	33.26467706	5.82E-19	0	0	0	0	9.651975513	9.651975513	9.651975513	9.651975513	9.651975513	0	9.651975513	0	9.651975513	0	0	9.651975513	0	9.651975513	0	0	0	0											0	0	0	0	2.231701421	3.840656624	0.216193883	0.924585238	1.39E-17	0	0	0	0	0.23745425	3.387602008	4.523062377	0.149217531	0.482277775	0	0.091822596	0	0.569582136	0	0	0.334538012	0	0.136810538	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.1255	0	2.8415	0	0	0	0	2.231701421	3.840656624	0.216193883	0.924585238	1.39E-17	0	0	0	0	0.23745425	3.387602008	4.523062377	0.149217531	0.482277775	0	0.091822596	0	0.569582136	0	0	0.334538012	0	0.136810538	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.1255	5000	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	0	0	0											3.9906	0.0305	0.641	0.4328	0.057	0.1933	0.0089	0.077	0.3811	0.1488	0.4053	0	0.0036	0.3929	0.6207	1.6354	0.0188	0.0627	0.4126	0.5339	0.11	0.0824	0	0	0.046	0	0.0129	0	0	0	0											10.298	2000	2.224	3.9906	0.030468602	0.640973372	0.432814106	2.288669576	4.033925103	0.225115303	1.001595503	0.381092559	0.148834206	0.405343171	0	0.003567417	0.630374637	4.008260392	6.158454682	0.168007292	0.544960841	0.412573457	0.625705773	0.110008258	0.651951966	0	0	0.380506713	0	0.149751472	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.4235
H7917_801_0	2008	3																					none											coin	coin	coin	V	coin	coin	coin	coin	coin	V	V	V	V	V	coin	coin	coin	coin	coin	V	O	V	T	V	V	V	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	220.4625179	1.583921246	43.60202943	0	6.756898923	22.92325532	1.058154906	4.333148781	22.51497363	1931.789369	975.6074205	0	15.13781376	1488.799715	38.0745583	106.1959051	1.126829124	3.881009664	21.17509612	15309.64672	567.274225	660.4826664	0	0	0	0	0	0	0	0	0											Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	0	0	0	0	0	0	0	0	0											0.0886	0.0886	0.2087	0	0.234	0.234	0.234	0.234	0.234	12.78147748	68.92643913	0	41.12918383	43.7830854	0.234	0.234	0.234	0.234	0.234	6.336237382	32.1714262	21.31196048	0	0	0	0	0	0	0	0	0											19.533	0.140335422	9.099743542	0	1.581114348	5.364041745	0.247608248	1.013956815	5.26850383	2.057593527	5.603762124	0	0.051883827	5.432020421	8.909446643	24.8498418	0.263678015	0.908156261	4.954972491	8.083796322	1.520835072	1.17301504	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.0573	0	0	19.533	0.140335422	9.099743542	0	1.581114348	5.364041745	0.247608248	1.013956815	5.26850383	2.057593527	5.603762124	0	0.051883827	5.432020421	8.909446643	24.8498418	0.263678015	0.908156261	4.954972491	8.083796322	1.520835072	1.17301504	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.0573	none	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	0	0	0	0	0	0	0	0	0											1.2825	0.0098	0.486	0	0.0869	0.2947	0.0136	0.0628	0.324	0.1265	0.3446	0	0.003	0.334	0.5131	1.3835	0.0157	0.0529	0.348	0.4501	0.0935	0.0689	0	0	0	0	0	0	0	0	0											6.294	0	0	20.8155	0.150165674	9.585716326	0	1.667966713	5.658694511	0.261209644	1.076766734	5.592467148	2.184116131	5.948340666	0	0.054916456	5.766038468	9.422542824	26.23330932	0.279370911	0.961024257	5.302981555	8.53392005	1.614352092	1.241947904	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3513
H7917_802_0	2008	3																					none											coin	coin	coin	V	coin	coin	coin	coin	coin	V	V	V	V	V	coin	coin	coin	coin	coin	V	O	V	T	V	V	V	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	220.4625179	1.583921246	43.60202943	0	6.756898923	22.92325532	1.058154906	4.333148781	22.51497363	1931.789369	975.6074205	0	15.13781376	1488.799715	38.0745583	106.1959051	1.126829124	3.881009664	21.17509612	15309.64672	567.274225	660.4826664	0	0	0	0	0	0	0	0	0											Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	0	0	0	0	0	0	0	0	0											0.0886	0.0886	0.2087	0	0.234	0.234	0.234	0.234	0.234	12.78147748	68.92643913	0	41.12918383	43.7830854	0.234	0.234	0.234	0.234	0.234	6.336237382	32.1714262	21.31196048	0	0	0	0	0	0	0	0	0											19.533	0.140335422	9.099743542	0	1.581114348	5.364041745	0.247608248	1.013956815	5.26850383	2.057593527	5.603762124	0	0.051883827	5.432020421	8.909446643	24.8498418	0.263678015	0.908156261	4.954972491	8.083796322	1.520835072	1.17301504	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.0573	0	0	19.533	0.140335422	9.099743542	0	1.581114348	5.364041745	0.247608248	1.013956815	5.26850383	2.057593527	5.603762124	0	0.051883827	5.432020421	8.909446643	24.8498418	0.263678015	0.908156261	4.954972491	8.083796322	1.520835072	1.17301504	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.0573	none	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	0	0	0	0	0	0	0	0	0											1.2825	0.0098	0.486	0	0.0869	0.2947	0.0136	0.0628	0.324	0.1265	0.3446	0	0.003	0.334	0.5131	1.3835	0.0157	0.0529	0.348	0.4501	0.0935	0.0689	0	0	0	0	0	0	0	0	0											6.294	0	0	20.8155	0.150165674	9.585716326	0	1.667966713	5.658694511	0.261209644	1.076766734	5.592467148	2.184116131	5.948340666	0	0.054916456	5.766038468	9.422542824	26.23330932	0.279370911	0.961024257	5.302981555	8.53392005	1.614352092	1.241947904	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3513
H7917_803_0	2008	3																					none											coin	coin	coin	V	coin	coin	coin	coin	coin	V	V	V	V	V	coin	coin	coin	coin	coin	V	O	V	T	V	V	V	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	220.4625179	1.583921246	43.60202943	0	6.756898923	22.92325532	1.058154906	4.333148781	22.51497363	1931.789369	975.6074205	0	15.13781376	1488.799715	38.0745583	106.1959051	1.126829124	3.881009664	21.17509612	15309.64672	567.274225	660.4826664	0	0	0	0	0	0	0	0	0											Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	0	0	0	0	0	0	0	0	0											0.0886	0.0886	0.2087	0	0.234	0.234	0.234	0.234	0.234	12.78147748	68.92643913	0	41.12918383	43.7830854	0.234	0.234	0.234	0.234	0.234	6.336237382	32.1714262	21.31196048	0	0	0	0	0	0	0	0	0											19.533	0.140335422	9.099743542	0	1.581114348	5.364041745	0.247608248	1.013956815	5.26850383	2.057593527	5.603762124	0	0.051883827	5.432020421	8.909446643	24.8498418	0.263678015	0.908156261	4.954972491	8.083796322	1.520835072	1.17301504	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.0573	0	0	19.533	0.140335422	9.099743542	0	1.581114348	5.364041745	0.247608248	1.013956815	5.26850383	2.057593527	5.603762124	0	0.051883827	5.432020421	8.909446643	24.8498418	0.263678015	0.908156261	4.954972491	8.083796322	1.520835072	1.17301504	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.0573	none	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	0	0	0	0	0	0	0	0	0											1.2825	0.0098	0.486	0	0.0869	0.2947	0.0136	0.0628	0.324	0.1265	0.3446	0	0.003	0.334	0.5131	1.3835	0.0157	0.0529	0.348	0.4501	0.0935	0.0689	0	0	0	0	0	0	0	0	0											6.294	0	0	20.8155	0.150165674	9.585716326	0	1.667966713	5.658694511	0.261209644	1.076766734	5.592467148	2.184116131	5.948340666	0	0.054916456	5.766038468	9.422542824	26.23330932	0.279370911	0.961024257	5.302981555	8.53392005	1.614352092	1.241947904	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3513
H7981_001_0	2008	5																					3250											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	V	V	P	P	S	V	P	P	P	P	P	P	Coin	P	P																																																				0							39.03553593	21.51917827	412.2862558						1.141747323			608.7015532																									1a (IP Acute) - $0; 1a1 (Add'l Days) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $0	11a (Medical Equip) - 10%	"11b (Med Supp), 11c (Diab Supp) - 10%"	"4a (ER) $25 (WW coverage), 4b (UC) - $25 (WW coverage); $0 if an accident or hosp. in 24 hrs"	"9a (OP Surgery), 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT) - $0, 9c (OP SA) - $10, 9d (Cardiac Rehab) - $0"	"14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0; 7a (PCP), 14 (Add'l Pap, Pelvis, Prostate, Colorectal) - $0"	"7b (Chiro), 7b1 (Routine Chiro), 7d (Spec), 7f (Pod) - $0; 17a (MCR Eye Exam) - $0; 18a (MCR Hearing Exam) - $0"	"7e (MH), 7h (Psychiatric) - $10"	"7c (OT), 7i (PT/ST) - $0"	8b (Professional Radiology) - 0%		15 (Part B Rx) - $0	13a1 (Add'l Blood) - $0		16a (Preventive); 16b (Comp. Dental) - $0	17a1 (Rountine Eye Exam) - $0	17b1 (Non MCR Covered) - $300 limit	18a1 (Hearing Exam Non-covered) - $0	18b (Hearing Aids) - $500 limit																			0.099169612	0.099169612	24.7924						9.917			9.917																									0	0	0	0	0	3.871138968	2.134048569	0.851797254	0	0	0	0	0	0.000943555	0	0	0.503039143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.361	0	0.061636381	0	0	0	0	0	3.871138968	2.134048569	0.851797254	0	0	0	0	0	0.000943555	0	0	0.503039143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.361																																																																																				0	0	0	0	0	0	0	0	3.871138968	2.134048569	0.851797254	0	0	0	0	0	0.000943555	0	0	0.503039143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.361
H7981_005_0	2008	5																					3250											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	V	V	P	P	S	V	P	P	P	P	P	P	Coin	P	P																																																				0							39.03553593	21.51917827	412.2862558						1.141747323			608.7015532																									1a (IP Acute) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $0	11a (Medical Equip) - 10%	"11b (Med Supp), 11c (Diab Supp) - 10%"	"4a (ER) $25 (WW coverage), 4b (UC) - $25 (WW coverage); $0 if an accident or hosp. in 24 hrs"	"9a (OP Surgery), 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0		12 (Renal Dialysis) - $0	9c (OP SA) - $10	"14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0; 7a (PCP), 14 (Add'l Pap, Pelvis, Prostate, Colorectal) - $0"	"7b (Chiro), 7b1 (Routine Chiro), 7d (Spec), 7f (Pod) - $0; 17a (MCR Eye Exam) - $0; 18a (MCR Hearing Exam) - $0"	"7e (MH), 7h (Psychiatric) - $10"	"7c (OT), 7i (PT/ST) - $0"	8b (Professional Radiology) - 0%		15 (Part B Rx) - $0	13a1 (Add'l Blood)		16a (Preventive); 16b (Comp. Dental) - $0	17a1 (Rountine Eye Exam) - $0	17b1 (Non MCR Covered) - $100 limit	18a1 (Routine Hearing Exam) - $0	18b (Hearing Aids) - $200 limit																			0.099169612	0.099169612	24.7924						9.917			9.917																									0	0	0	0	0	3.871138968	2.134048569	0.851797254	0	0	0	0	0	0.000943555	0	0	0.503039143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.361	0	0.061636381	0	0	0	0	0	3.871138968	2.134048569	0.851797254	0	0	0	0	0	0.000943555	0	0	0.503039143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.361																																																																																				0	0	0	0	0	0	0	0	3.871138968	2.134048569	0.851797254	0	0	0	0	0	0.000943555	0	0	0.503039143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.361
H7981_801_0	2008	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	Coin	P	P																																																				0		156.8673246	3.478762794	2.571911117		5.1344869	48.84467945	27.19362667	11.15245334	23.79650702	2.473025322	6.697466262	1.048844227	0.800135325	11.26989349	78.19656389	116.7875488	5.158501113		25.91325346	18.72171754	23.64087711	0.285484804																				Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing																				0.0843	0.0843	0.1298		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234	0.234	0.234																				13.2239	0.293259704	0.333834063	0	1.201469935	11.42965499	6.363308641	2.609674082	5.568382642	0.578687925	1.567207105	0.245429549	0.187231666	2.637155076	18.29799595	27.32828641	1.20708926	0	6.06370131	4.380881904	5.531965244	0.066803444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.1159	0	0	13.2239	0.293259704	0.333834063	0	1.201469935	11.42965499	6.363308641	2.609674082	5.568382642	0.578687925	1.567207105	0.245429549	0.187231666	2.637155076	18.29799595	27.32828641	1.20708926	0	6.06370131	4.380881904	5.531965244	0.066803444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.1159																																																																																				0	0	0	13.2239	0.293259704	0.333834063	0	1.201469935	11.42965499	6.363308641	2.609674082	5.568382642	0.578687925	1.567207105	0.245429549	0.187231666	2.637155076	18.29799595	27.32828641	1.20708926	0	6.06370131	4.380881904	5.531965244	0.066803444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.1159
H7981_802_0	2008	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	Coin	P	P																																																				0		120.2097163	2.752627259	1.866709457		3.958300076	39.03553593	21.51917827	8.432755839	17.95226271	1.913959399	4.937630241	0.712269329	0.639690727	8.080111593	61.90671358	91.27050874	4.12254418		20.10960232	14.79399748	18.21232901	0.227650122																				Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing																				0.159084958	0.159084958	0.158398235		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234	0.234	0.234																				19.1236	0.437901591	0.295683483	0	0.926242218	9.134315407	5.035487716	1.973264866	4.200829475	0.447866499	1.155405476	0.166671023	0.14968763	1.890746113	14.48617098	21.35729904	0.964675338	0	4.705646943	3.461795411	4.261684988	0.053270129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.2282	0	0	19.1236	0.437901591	0.295683483	0	0.926242218	9.134315407	5.035487716	1.973264866	4.200829475	0.447866499	1.155405476	0.166671023	0.14968763	1.890746113	14.48617098	21.35729904	0.964675338	0	4.705646943	3.461795411	4.261684988	0.053270129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.2282																																																																																				0	0	0	19.1236	0.437901591	0.295683483	0	0.926242218	9.134315407	5.035487716	1.973264866	4.200829475	0.447866499	1.155405476	0.166671023	0.14968763	1.890746113	14.48617098	21.35729904	0.964675338	0	4.705646943	3.461795411	4.261684988	0.053270129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.2282
H7981_803_0	2008	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	Coin	P	P																																																				0		120.2097163	2.752627259	1.866709457		3.958300076	39.03553593	21.51917827	8.432755839	17.95226271	1.913959399	4.937630241	0.712269329	0.639690727	8.080111593	61.90671358	91.27050874	4.12254418		20.10960232	14.79399748	18.21232901	0.227650122																				Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing																				0.159084958	0.159084958	0.158398235		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234	0.234	0.234																				19.1236	0.437901591	0.295683483	0	0.926242218	9.134315407	5.035487716	1.973264866	4.200829475	0.447866499	1.155405476	0.166671023	0.14968763	1.890746113	14.48617098	21.35729904	0.964675338	0	4.705646943	3.461795411	4.261684988	0.053270129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.2282	0	0	19.1236	0.437901591	0.295683483	0	0.926242218	9.134315407	5.035487716	1.973264866	4.200829475	0.447866499	1.155405476	0.166671023	0.14968763	1.890746113	14.48617098	21.35729904	0.964675338	0	4.705646943	3.461795411	4.261684988	0.053270129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.2282																																																																																				0	0	0	19.1236	0.437901591	0.295683483	0	0.926242218	9.134315407	5.035487716	1.973264866	4.200829475	0.447866499	1.155405476	0.166671023	0.14968763	1.890746113	14.48617098	21.35729904	0.964675338	0	4.705646943	3.461795411	4.261684988	0.053270129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.2282
H7981_804_0	2008	8																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	Coin	P	P																																																				0		120.2097163	2.752627259	1.866709457		3.958300076	39.03553593	21.51917827	8.432755839	17.95226271	1.913959399	4.937630241	0.712269329	0.639690727	8.080111593	61.90671358	91.27050874	4.12254418		20.10960232	14.79399748	18.21232901	0.227650122																				Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing	Medicare cost sharing																				0.159084958	0.159084958	0.158398235		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234	0.234	0.234																				19.1236	0.437901591	0.295683483	0	0.926242218	9.134315407	5.035487716	1.973264866	4.200829475	0.447866499	1.155405476	0.166671023	0.14968763	1.890746113	14.48617098	21.35729904	0.964675338	0	4.705646943	3.461795411	4.261684988	0.053270129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.2282	0	0	19.1236	0.437901591	0.295683483	0	0.926242218	9.134315407	5.035487716	1.973264866	4.200829475	0.447866499	1.155405476	0.166671023	0.14968763	1.890746113	14.48617098	21.35729904	0.964675338	0	4.705646943	3.461795411	4.261684988	0.053270129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.2282																																																																																				0	0	0	19.1236	0.437901591	0.295683483	0	0.926242218	9.134315407	5.035487716	1.973264866	4.200829475	0.447866499	1.155405476	0.166671023	0.14968763	1.890746113	14.48617098	21.35729904	0.964675338	0	4.705646943	3.461795411	4.261684988	0.053270129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.2282
H8031_001_0	2008	2																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0		2615.418907	630.1116647	3897.347744	0	488.7475539	129709.3726	105.9758943	904.7027945	219.4352547	2301.596665	1217.299371	0	2743.520281	611.3393982	5082.38878	7380.309146	1312.857684	2057.226365	5235.869128	15356.40364	1821.780357	11314.84102																				$135 per day	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	$50 copay	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				135.625	52.26996346	69.79107192	0	78.1814412	0.960223741	76.82675247	48.60309484	238.3110611	15.76334246	60.1400411	0	33.8991255	83.87298118	13.85054349	15.54786329	16.96181998	6.357629852	10.73259266	15.21162171	32.49586643	4.521650802																				29.5597	2.744659474	22.66667306	0	3.184249012	10.37916825	0.678481983	3.664279643	4.3578207	3.023404703	6.100702853	0	7.750244859	4.27290482	5.866153902	9.562336467	1.855704641	1.089923646	4.682870882	19.46631692	4.933360929	4.263479999	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.1024	135	0	29.5597	2.744659474	22.66667306	0	3.184249012	10.37916825	0.678481983	3.664279643	4.3578207	3.023404703	6.100702853	0	7.750244859	4.27290482	5.866153902	9.562336467	1.855704641	1.089923646	4.682870882	19.46631692	4.933360929	4.263479999	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.1024																																																																																				0	0	0	29.5597	2.744659474	22.66667306	0	3.184249012	10.37916825	0.678481983	3.664279643	4.3578207	3.023404703	6.100702853	0	7.750244859	4.27290482	5.866153902	9.562336467	1.855704641	1.089923646	4.682870882	19.46631692	4.933360929	4.263479999	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.1024
H8189_001_0	2008	7																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		331.0571922	27.78195701	85.00895481	0	11.74793481	25.84691606	18.46479333	11.48325547	26.61468593	13.43382526	27.71482355	0	4.796540868	47.78525076	49.06126703	98.92067117	8.836846443	4.175048471	20.25881071	36.1522483	11.32027293	0.836920171	0	0	0	0	0	0	0	0	0											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing																				0.079109656	0.079109656	0.175550343	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											26.1898	2.197821051	14.92335116	0	2.749016745	6.048178358	4.32076164	2.68708178	6.227836507	3.143515111	6.485268712	0	1.122390563	11.18174868	11.48033649	23.14743705	2.067822068	0.976961342	4.740561705	8.459626102	2.648943865	0.19583932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.9943			26.1898	2.197821051	14.92335116	0	2.749016745	6.048178358	4.32076164	2.68708178	6.227836507	3.143515111	6.485268712	0	1.122390563	11.18174868	11.48033649	23.14743705	2.067822068	0.976961342	4.740561705	8.459626102	2.648943865	0.19583932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.9943																																																																																				0			26.1898	2.197821051	14.92335116	0	2.749016745	6.048178358	4.32076164	2.68708178	6.227836507	3.143515111	6.485268712	0	1.122390563	11.18174868	11.48033649	23.14743705	2.067822068	0.976961342	4.740561705	8.459626102	2.648943865	0.19583932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.9943
H8201_001_0	2008	4																					2700											A	A	A	P	T	Coin	Coin	V	V	V	V	P	P	O	V	V	V	P	P	P	O	O	T	P	V	Coin	V	P	O	O	O																																																				0	2700	210.7064641	11.25063295	37.9748349	0	517.8644177	20.11	1.07	239.8508627	165.3397171	271.2667154	476.1078508	0	0	168.628821	0	5810.866257	426.8329474	174.8247411	0	0	0	0	0	0	502.909758	0	251.454879	0	0	0	0											$100 per admit	$100 per admit	$100 per admit		$50 per trip	20% coinsurance	20% coinsurance	$50 per ER visit	$50 per OP surgical visit	$15 per lab visit	$15 per radiology visit			$15 per visit		$12 per visit	$12 per visit	$12 per visit							$12 per vist		$12 per visit															100	100	100	0	50	0.19	0.19	50	50	15	15	0	0	15	0	12	12	12	0	0	0	0	0	0	12	0	12	0	0	0	0											1.7559	0.093755275	0.316456958	0	2.157768407	3.8209	0.2033	0.999378595	0.688915488	0.339083394	0.595134813	0	0	0.210786026	0	5.810866257	0.426832947	0.174824741	0	0	0	0	0	0	0.502909758	0	0.251454879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.3483		0.01	1.7559	0.093755275	0.316456958	0	2.157768407	3.8209	0.2033	0.999378595	0.688915488	0.339083394	0.595134813	0	0	0.210786026	0	5.810866257	0.426832947	0.174824741	0	0	0	0	0	0	0.502909758	0	0.251454879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.3483	2700																																																																																			0		0.01	1.7559	0.093755275	0.316456958	0	2.157768407	3.8209	0.2033	0.999378595	0.688915488	0.339083394	0.595134813	0	0	0.210786026	0	5.810866257	0.426832947	0.174824741	0	0	0	0	0	0	0.502909758	0	0.251454879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.3483
H8393_001_0	2008	7																																D	D	D	Coin	T	Coin	Coin	V	V	P	P	V	Coin	V	V	V	V	V	P	V	Coin	P	T	P	V	P	V	P	Coin	P	P																																																				0		1400.504585	85.48045567	918.5464512	18.34978413	64.29806807	9.653045818	9.395231437	213.1011361	260.1175648		226.0975156	60.62448643	0.610495217	267.0506816	3491.154867	4192.576066	311.5686948	475.9593234	375.6618074		40.85190173				138.24		239.04															1a:$180 1-10; 1a1:$180 1-10;	1b:$180 1-10;	2a:$100 7+; 2a2:$100 7+;	6a:20%;	10a:$150;	11a:20%;	11b:20%; 11c:20%;	4a:$50; 4b:$50;	9b:$100;		8b:$0-100; 20%;	9a:$100;	12:20%;	3:$30; 5:$100; 9c:$30; 9d:$35;	7a:$10; 14c:$10;	7b:$10; 7d:$10; 7f:$10; 18a:$10;	7e:$30; 7h:$30;	7c:$30; 7i:$30;	8b:$0-100; 20%;		15:20%;				17a1:$10;		18a1:$10;															115.6747	99.6456	43.0859	0.151764262	150	0.151764262	0.151764262	37.9411	75.8821		132.0556	75.8821	0.180343835	70.2191	10	10	8.2519	13.4412	7.5882		0.151764262				10		10															13.5002	0.709812602	3.298031392	2.784841451	0.803725851	1.464987377	1.425860367	0.673773681	1.644856263	0	2.488119601	0.383359602	0.110099049	1.562670599	2.909295723	3.493813388	0.214251882	0.533123416	0.237550154	0	6.199858727	0	0	0	0.1152	0	0.1992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7527	0	11.7984	13.5002	0.709812602	3.298031392	2.784841451	0.803725851	1.464987377	1.425860367	0.673773681	1.644856263	0	2.488119601	0.383359602	0.110099049	1.562670599	2.909295723	3.493813388	0.214251882	0.533123416	0.237550154	0	6.199858727	0	0	0	0.1152	0	0.1992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7527	2000	0.2	0.2	0.2	0.2	150	0.2	0.2	50	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2			0.2		0.2															1.7672	0.0507	0.2399	0.1438	0.0353	0.0757	0.0736	0.0366	0.326	0.059	0.218	0.0388	0.0053	0.1843	0.2469	0.7152	0.0214	0.0856	0.1712	0.0887	0.3202	0.0011			0.0082		0.0109															4.9234	0	0.492899435	15.2675	0.760531824	3.537886952	2.928653973	0.838976985	1.540641066	1.499493491	0.710421574	1.970811482	0.058992601	2.706119452	0.422131829	0.115379144	1.746957382	3.156158859	4.209006872	0.235699272	0.618708127	0.408701018	0.088720604	6.5200268	0.001123629	0	0	0.12338112	0	0.21005806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.676
H8393_801_0	2008	5																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	P	V	P	V	P	Coin	P	P																																																				0	0	233.6381089	6.739773915	31.86826227		2.933170259	9.945951157	9.680313835	10.96743806	43.08627744	7.798191762	28.81831345	5.125083651	0.629019661	24.36081646	29.58420206	91.80654828	2.824610683	11.29913943	22.50066254	11.66381714	42.09148356	0.133300305																				MEDICARE FFS	MEDICARE FFS	MEDICARE FFS		MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS																				0.081594743	0.081594743	0.185401543		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				19.0636	0.54993012	5.908424993	0	0.686361841	2.327352571	2.265193437	2.566380507	10.08218892	1.824776872	6.743485347	1.199269574	0.147190601	5.700431051	6.922703283	21.4827323	0.6609589	2.643998626	5.265155034	2.729333211	9.849407152	0.031192271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.6501	0	0	19.0636	0.54993012	5.908424993	0	0.686361841	2.327352571	2.265193437	2.566380507	10.08218892	1.824776872	6.743485347	1.199269574	0.147190601	5.700431051	6.922703283	21.4827323	0.6609589	2.643998626	5.265155034	2.729333211	9.849407152	0.031192271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.6501		MEDICARE FFS	MEDICARE FFS	MEDICARE FFS		MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS																				0.8192	0.0236	0.2538		0.0298	0.1011	0.0984	0.1108	0.4354	0.0788	0.2912	0.0518	0.0064	0.2462	0.3006	0.9329	0.0287	0.1143	0.2286	0.1185	0.4277	0.0014																				4.6993	0	0	19.8829	0.573556368	6.162225446	0	0.716165907	2.428418776	2.363560358	2.677214895	10.5176344	1.903585433	7.034712619	1.251065618	0.153555764	5.946620839	7.223324409	22.41562844	0.689610593	2.758331741	5.493796472	2.847855585	10.27712155	0.032546808	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.3494
H8393_802_0	2008	3																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	P	V	P	V	P	Coin	P	P																																																				0	0	233.6381089	6.739773915	31.86826227		2.933170259	9.945951157	9.680313835	10.96743806	43.08627744	7.798191762	28.81831345	5.125083651	0.629019661	24.36081646	29.58420206	91.80654828	2.824610683	11.29913943	22.50066254	11.66381714	42.09148356	0.133300305																				MEDICARE FFS	MEDICARE FFS	MEDICARE FFS		MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS																				0.081594743	0.081594743	0.185401543		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				19.0636	0.54993012	5.908424993	0	0.686361841	2.327352571	2.265193437	2.566380507	10.08218892	1.824776872	6.743485347	1.199269574	0.147190601	5.700431051	6.922703283	21.4827323	0.6609589	2.643998626	5.265155034	2.729333211	9.849407152	0.031192271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.6501	0	0	19.0636	0.54993012	5.908424993	0	0.686361841	2.327352571	2.265193437	2.566380507	10.08218892	1.824776872	6.743485347	1.199269574	0.147190601	5.700431051	6.922703283	21.4827323	0.6609589	2.643998626	5.265155034	2.729333211	9.849407152	0.031192271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.6501		MEDICARE FFS	MEDICARE FFS	MEDICARE FFS		MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS																				0.8192	0.0236	0.2538		0.0298	0.1011	0.0984	0.1108	0.4354	0.0788	0.2912	0.0518	0.0064	0.2462	0.3006	0.9329	0.0287	0.1143	0.2286	0.1185	0.4277	0.0014																				4.6993	0	0	19.8829	0.573556368	6.162225446	0	0.716165907	2.428418776	2.363560358	2.677214895	10.5176344	1.903585433	7.034712619	1.251065618	0.153555764	5.946620839	7.223324409	22.41562844	0.689610593	2.758331741	5.493796472	2.847855585	10.27712155	0.032546808	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.3494
H8393_803_0	2008	3																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	P	V	P	V	P	Coin	P	P																																																				0	0	233.6381089	6.739773915	31.86826227		2.933170259	9.945951157	9.680313835	10.96743806	43.08627744	7.798191762	28.81831345	5.125083651	0.629019661	24.36081646	29.58420206	91.80654828	2.824610683	11.29913943	22.50066254	11.66381714	42.09148356	0.133300305																				MEDICARE FFS	MEDICARE FFS	MEDICARE FFS		MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS																				0.081594743	0.081594743	0.185401543		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				19.0636	0.54993012	5.908424993	0	0.686361841	2.327352571	2.265193437	2.566380507	10.08218892	1.824776872	6.743485347	1.199269574	0.147190601	5.700431051	6.922703283	21.4827323	0.6609589	2.643998626	5.265155034	2.729333211	9.849407152	0.031192271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.6501	0	0	19.0636	0.54993012	5.908424993	0	0.686361841	2.327352571	2.265193437	2.566380507	10.08218892	1.824776872	6.743485347	1.199269574	0.147190601	5.700431051	6.922703283	21.4827323	0.6609589	2.643998626	5.265155034	2.729333211	9.849407152	0.031192271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.6501		MEDICARE FFS	MEDICARE FFS	MEDICARE FFS		MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS	MEDICARE FFS																				0.8192	0.0236	0.2538		0.0298	0.1011	0.0984	0.1108	0.4354	0.0788	0.2912	0.0518	0.0064	0.2462	0.3006	0.9329	0.0287	0.1143	0.2286	0.1185	0.4277	0.0014																				4.6993	0	0	19.8829	0.573556368	6.162225446	0	0.716165907	2.428418776	2.363560358	2.677214895	10.5176344	1.903585433	7.034712619	1.251065618	0.153555764	5.946620839	7.223324409	22.41562844	0.689610593	2.758331741	5.493796472	2.847855585	10.27712155	0.032546808	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.3494
H8604_001_0	2008	3																					0											D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1817.445	55.575	1706.96	361.95	292.505	14.86034998	0	367.3	419.235	7877.59	633.365	250.99	477	4946.65	4242.32	3385.04	135.755	234.27	97.09	0	26.58920859	0	0	0	132.4	0	0.665	0	0	0	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	"$50 Scans, $25 Rad Ther"	$0.00 	$0.00 	$0.00 	"$15.00, $0.00 Prev."	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	"20%, 10% Chemo, $5 Diab Supp"	$0.00 	$0.00 	$0.00 	$15.00 	$0.00 	$25.00 	$0.00 	$0.00 	$0.00 	$0.00 											41.73646411	41.73646411	6.794880973	0	23.79242515	0.190339401	0.190339401	47.5848503	95.16970059	0	7.137727545	0	0	0	14.27545509	23.79242515	23.79242515	23.79242515	0	0	0.171305461	0	0	0	14.27545509	0	23.79242515	0	0	0	0											6.3211	0.193291999	0.966549169	0	0.579950277	2.828510118	0	1.45649296	3.324872452	0	0.376732234	0	0	0	5.046754053	6.711525902	0.269161723	0.46448762	0	0	4.554876638	0	0	0	0.157505854	0	0.001318497	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2532		1.687751282	6.3211	0.193291999	0.966549169	0	0.579950277	2.828510118	0	1.45649296	3.324872452	0	0.376732234	0	0	0	5.046754053	6.711525902	0.269161723	0.46448762	0	0	4.554876638	0	0	0	0.157505854	0	0.001318497	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2532	3750	20%	20%	20%	20%	20%	30%	30%	0	20%	20%	20%	20%	0	20%	$25 	$35 	$35 	$35 	$35 	$35 	20%	20%	0	0	0	0	$35 	0	0	0	0											2.2594	0.0691	0.3947	0.0253	0.1034	0.2233	0	0	0.3764	0.5392	0.0434	0.0172	0	0.3386	0.4427	0.4945	0.0198	0.0342	0.0142	0	0.2664	0	0	0	0	0	0	0	0	0	0											5.6616		0.287354642	8.5805	0.262380453	1.361288234	0.025324833	0.683302975	3.051813548	0	1.45649296	3.701222722	0.53917727	0.420082549	0.017178871	0	0.33857071	5.489451777	7.20605939	0.288994692	0.498713024	0.014184251	0	4.821243692	0	0	0	0.157505854	0	0.00132016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9148
H8604_002_0	2008	3																					0											D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1710	52.25	1605.975	340.575	275.215	13.98161902	0	345.6	394.44	7411.71	595.935	236.17	448.8	4654.145	3991.425	3184.875	127.68	220.4	91.295	0	25.01691985	0	0	0	124.6	0	0.665	0	0	0	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	"$50 Scans, $25 Rad Ther"	$0.00 	$0.00 	$0.00 	"$15.00, $0.00 Prev."	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	"20%, 10% Chemo, $5 Diab Supp"	$0.00 	$0.00 	$0.00 	$15.00 	$0.00 	$25.00 	$0.00 	$0.00 	$0.00 	$0.00 											41.73646411	41.73646411	6.794880973	0	23.79242515	0.190339401	0.190339401	47.5848503	95.16970059	0	7.137727545	0	0	0	14.27545509	23.79242515	23.79242515	23.79242515	0	0	0.171305461	0	0	0	14.27545509	0	23.79242515	0	0	0	0											5.9474	0.181727521	0.909367414	0	0.545669357	2.661252992	0	1.370443689	3.128228059	0	0.354468472	0	0	0	4.748284027	6.314658337	0.253151404	0.436987542	0	0	4.28553499	0	0	0	0.148226809	0	0.001318497	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.2868		1.587947032	5.9474	0.181727521	0.909367414	0	0.545669357	2.661252992	0	1.370443689	3.128228059	0	0.354468472	0	0	0	4.748284027	6.314658337	0.253151404	0.436987542	0	0	4.28553499	0	0	0	0.148226809	0	0.001318497	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.2868	3750	20%	20%	20%	20%	20%	30%	30%	0	20%	20%	20%	20%	0	20%	$25 	$35 	$35 	$35 	$35 	$35 	20%	20%	0	0	0	0	$35 	0	0	0	0											2.1258	0.065	0.3714	0.0238	0.0972	0.2101	0	0	0.3541	0.5073	0.0408	0.0162	0	0.3186	0.4165	0.4653	0.0187	0.0322	0.0133	0	0.2506	0	0	0	0	0	0	0	0	0	0											5.3268		0.270361561	8.0733	0.246682974	1.280764536	0.023827311	0.642910543	2.871351912	0	1.370443689	3.482323762	0.507290777	0.395256944	0.016164537	0	0.318550622	5.16480017	6.779948951	0.271804665	0.469186624	0.013337637	0	4.536151071	0	0	0	0.148226809	0	0.001320062	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.6136
H8604_003_0	2008	3																					0											D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	2124.105	58.235	2845.725	2411.575	370.69	19.67511759	0	392.9	365.655	15633.77	638.495	51.68	7.9	5979.87	4216.48	3911.055	208.24	15.58	62.32	0	38.2300286	0	0	0	362.5	0	13.11	0	0	0.19	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	"$50 Scans, $25 Rad Ther"	$0.00 	$0.00 	$0.00 	"$15.00, $0.00 Prev."	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	"20%, 10% Chemo, $5 Diab Supp"	$0.00 	$0.00 	$0.00 	$15.00 	$0.00 	$25.00 	$0.00 	$0.00 	$0.00 	$0.00 											41.73646411	41.73646411	6.794880973	0	23.79242515	0.190339401	0.190339401	47.5848503	95.16970059	0	7.137727545	0	0	0	14.27545509	23.79242515	23.79242515	23.79242515	0	0	0.171305461	0	0	0	14.27545509	0	23.79242515	0	0	0	0											7.3877	0.202543582	1.611363555	0	0.73496784	3.7449501	0	1.558007307	2.899939739	0	0.379783612	0	0	0	5.01601424	7.754456945	0.412877884	0.030890499	0	0	6.549012677	0	0	0	0.431237706	0	0.025993224	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.7398		1.966220657	7.3877	0.202543582	1.611363555	0	0.73496784	3.7449501	0	1.558007307	2.899939739	0	0.379783612	0	0	0	5.01601424	7.754456945	0.412877884	0.030890499	0	0	6.549012677	0	0	0	0.431237706	0	0.025993224	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.7398	3750	20%	20%	20%	20%	20%	30%	30%	0	20%	20%	20%	20%	0	20%	$25 	$35 	$35 	$35 	$35 	$35 	20%	20%	0	0	0	0	$35 	0	0	0	0											2.4196	0.0663	0.8012	0.1797	0.0917	0.2957	0	0	0.5023	0.7664	0.0313	0.0025	0	0.2932	0.44	0.5714	0.0304	0.0023	0.0091	0	0.383	0	0	0	0	0	0	0	0	0	0											6.8861		0.349498762	9.8073	0.268880408	2.412542923	0.179672604	0.82665459	4.040604055	0	1.558007307	3.402238297	0.766436322	0.411085452	0.002533581	0	0.293159588	5.456015489	8.325837983	0.443300465	0.033166641	0.009104568	0	6.931995874	0	0	0	0.431237706	0	0.026000189	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.6258
H8604_004_0	2008	3																					0											D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1845.945	50.635	2473.135	2095.89	322.145	17.09915786	0	341.4	317.775	13586.9	554.895	44.935	6.9	5196.975	3664.435	3399.005	180.975	13.585	54.245	0	33.22477191	0	0	0	315	0	11.4	0	0	0.19	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	"$50 Scans, $25 Rad Ther"	$0.00 	$0.00 	$0.00 	"$15.00, $0.00 Prev."	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	"20%, 10% Chemo, $5 Diab Supp"	$0.00 	$0.00 	$0.00 	$15.00 	$0.00 	$25.00 	$0.00 	$0.00 	$0.00 	$0.00 											41.73646411	41.73646411	6.794880973	0	23.79242515	0.190339401	0.190339401	47.5848503	95.16970059	0	7.137727545	0	0	0	14.27545509	23.79242515	23.79242515	23.79242515	0	0	0.171305461	0	0	0	14.27545509	0	23.79242515	0	0	0	0											6.4203	0.176110488	1.400388163	0	0.638717567	3.254643468	0	1.353788991	2.520212634	0	0.330057444	0	0	0	4.359289772	6.739214337	0.358819512	0.026935008	0	0	5.691584871	0	0	0	0.374730696	0	0.022602804	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.6674		1.708773345	6.4203	0.176110488	1.400388163	0	0.638717567	3.254643468	0	1.353788991	2.520212634	0	0.330057444	0	0	0	4.359289772	6.739214337	0.358819512	0.026935008	0	0	5.691584871	0	0	0	0.374730696	0	0.022602804	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.6674	3750	20%	20%	20%	20%	20%	30%	30%	0	20%	20%	20%	20%	0	20%	$25 	$35 	$35 	$35 	$35 	$35 	20%	20%	0	0	0	0	$35 	0	0	0	0											2.1028	0.0577	0.6963	0.1561	0.0797	0.2569	0	0	0.4365	0.6661	0.0272	0.0022	0	0.2548	0.3824	0.4966	0.0264	0.002	0.0079	0	0.3328	0	0	0	0	0	0	0	0	0	0											5.9845		0.303741684	8.5231	0.233791126	2.096673328	0.156149014	0.718400253	3.511589005	0	1.353788991	2.956747882	0.666089344	0.357260827	0.002202911	0	0.254778476	4.741683612	7.235788025	0.385258844	0.028919693	0.00792486	0	6.024426092	0	0	0	0.374730696	0	0.022608856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.6519
H8604_801_0	2008	3																					0											D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1556.1	45.125	1774.98	1042.53	261.06	13.578761	0	301.1	313.215	9112.685	504.83	125.875	206	4308.535	3359.105	2881.635	134.52	105.45	64.315	0	25.40244405	0	0	0	189.9	0	5.13	0	0	0.095	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	"$50 Scans, $25 Rad Ther"	$0.00 	$0.00 	$0.00 	"$15.00, $0.00 Prev."	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	"20%, 10% Chemo, $5 Diab Supp"	$0.00 	$0.00 	$0.00 	$15.00 	$0.00 	$25.00 	$0.00 	$0.00 	$0.00 	$0.00 											41.73646411	41.73646411	6.794880973	0	23.79242515	0.190339401	0.190339401	47.5848503	95.16970059	0	7.137727545	0	0	0	14.27545509	23.79242515	23.79242515	23.79242515	0	0	0.171305461	0	0	0	14.27545509	0	23.79242515	0	0	0	0											5.4122	0.156946495	1.005064819	0	0.517604209	2.584573238	0	1.193983202	2.484048148	0	0.30027825	0	0	0	3.996062714	5.713423754	0.266713086	0.209075936	0	0	4.35157739	0	0	0	0.225909077	0	0.010171262	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4276		1.442831648	5.4122	0.156946495	1.005064819	0	0.517604209	2.584573238	0	1.193983202	2.484048148	0	0.30027825	0	0	0	3.996062714	5.713423754	0.266713086	0.209075936	0	0	4.35157739	0	0	0	0.225909077	0	0.010171262	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4276	3750	20%	20%	20%	20%	20%	30%	30%	0	20%	20%	20%	20%	0	20%	$25 	$35 	$35 	$35 	$35 	$35 	20%	20%	0	0	0	0	$35 	0	0	0	0											1.8533	0.0537	0.4632	0.0769	0.0778	0.204	0	0	0.3453	0.5202	0.0288	0.0072	0	0.246	0.3505	0.421	0.0197	0.0154	0.0094	0	0.2545	0	0	0	0	0	0	0	0	0	0											4.9469		0.25107859	7.2654	0.210688505	1.468278974	0.076898688	0.595428273	2.788618493	0	1.193983202	2.829302999	0.520245448	0.32909912	0.007186235	0	0.245975332	4.346594531	6.134412872	0.286365629	0.224481531	0.009396025	0	4.6060556	0	0	0	0.225909077	0	0.010173961	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.3745
H8604_802_0	2008	3																					0											D	D	D	V	T	Coin	Coin	V	P	P	P	P	P	P	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1599.99	46.36	1825.045	1071.98	268.47	13.96182985	0	309.6	322.05	9369.755	519.08	129.39	211.8	4430.135	3453.915	2962.955	138.32	108.395	66.12	0	26.11906944	0	0	0	195.3	0	5.225	0	0	0.095	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	"$50 Scans, $25 Rad Ther"	$0.00 	$0.00 	$0.00 	"$15.00, $0.00 Prev."	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	"20%, 10% Chemo, $5 Diab Supp"	$0.00 	$0.00 	$0.00 	$15.00 	$0.00 	$25.00 	$0.00 	$0.00 	$0.00 	$0.00 											41.73646411	41.73646411	6.794880973	0	23.79242515	0.190339401	0.190339401	47.5848503	95.16970059	0	7.137727545	0	0	0	14.27545509	23.79242515	23.79242515	23.79242515	0	0	0.171305461	0	0	0	14.27545509	0	23.79242515	0	0	0	0											5.5648	0.161241873	1.033413629	0	0.532296032	2.657486333	0	1.227689138	2.55411684	0	0.308754301	0	0	0	4.108850705	5.874657088	0.274247354	0.214914994	0	0	4.474339234	0	0	0	0.232333032	0	0.010359618	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.2295		1.483532756	5.5648	0.161241873	1.033413629	0	0.532296032	2.657486333	0	1.227689138	2.55411684	0	0.308754301	0	0	0	4.108850705	5.874657088	0.274247354	0.214914994	0	0	4.474339234	0	0	0	0.232333032	0	0.010359618	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.2295	3750	20%	20%	20%	20%	20%	30%	30%	0	20%	20%	20%	20%	0	20%	$25 	$35 	$35 	$35 	$35 	$35 	20%	20%	0	0	0	0	$35 	0	0	0	0											1.9056	0.0552	0.4763	0.0791	0.08	0.2098	0	0	0.355	0.5349	0.0296	0.0074	0	0.2529	0.3604	0.4329	0.0202	0.0158	0.0097	0	0.2617	0	0	0	0	0	0	0	0	0	0											5.0865		0.25816193	7.4704	0.216456292	1.509695465	0.079068068	0.612315581	2.867287885	0	1.227689138	2.909111636	0.53492098	0.338388671	0.007386898	0	0.252917195	4.469276206	6.307526558	0.294455054	0.230750835	0.009659725	0	4.735996499	0	0	0	0.232333032	0	0.010362394	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.316
H8606_001_0	2008	7																					none											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	212.2654709	2.135164184	100.0211021	17.98892086	555.1608111	43.8326079	1.971237879	89.44941825	132.2914831	2.554492208	6.838660195	0	0.19547972	127.5790648	0	4589.737633	150.9304651	546.9148488	17.05726011	15.80126577	1.869236354	6.163018582	0	0	0	0	0	0	0	0	0											"$0/day days 1-7, $50/day days 8-15, $0/day days 16-90, $200/day days 91+"	"$0/day days 1-7, $50/day days 8-15, $0/day days 16-90"	"$0/day days 1-7, $50/day days 8-20, $0/day days 21-100"	$0/visit	$50/trip	20% Coinsurance	20% Coinsurance	"$50/visit - ER, 0% Coinsurance - UC"	$50 copay	20% Coinsurance	20% Coinsurance		20% Coinsurance	$5/visit - PT/OT/ST	0% PCP;	$10 Specialist	"$0 days 1-5, $25 days 6+"	$5/visit	0% coinsurance	$25/visit - OPSA	20% coinsurance for chemotherapy	0% coinsurance		Not Covered	$0/visit	$125 allowance / 2 years	$0/visit	$250 allowance / 2 years														73.975	122.155	15.63731721	0	50	0.164008	0.2	50	50	0.2	0.2	0	0.2	5	0	10	24.41156515	5	0	25	0.1	0	0	0	0	0	0	0	0	0	0											1.3085	0.021735082	0.130338475	0	2.313170046	7.188898357	0.394247576	0.372705909	0.551214513	0.510898442	1.367732039	0	0.039095944	0.053157944	0	3.824781361	0.307037407	0.227881187	0	0.032919304	0.186923635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.8313	0	0	1.3085	0.021735082	0.130338475	0	2.313170046	7.188898357	0.394247576	0.372705909	0.551214513	0.510898442	1.367732039	0	0.039095944	0.053157944	0	3.824781361	0.307037407	0.227881187	0	0.032919304	0.186923635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.8313	none	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.3085	0.021735082	0.130338475	0	2.313170046	7.188898357	0.394247576	0.372705909	0.551214513	0.510898442	1.367732039	0	0.039095944	0.053157944	0	3.824781361	0.307037407	0.227881187	0	0.032919304	0.186923635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.8313
H8606_002_0	2008	7																					none											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	224.7516751	2.260762077	105.9046963	19.04709268	587.8173294	46.4109966	2.087193048	94.71114874	140.073335	2.704756456	7.240934324	0	0.206978527	135.0837157	0	4859.7222	159.8087277	579.0863105	18.06062835	16.730752	1.979191434	6.525549087	0	0	0	0	0	0	0	0	0											"$0/day days 1-7, $50/day days 8-15, $0/day days 16-90, $200/day days 91+"	"$0/day days 1-7, $50/day days 8-15, $0/day days 16-90"	"$0/day days 1-7, $50/day days 8-20, $0/day days 21-100"	$0/visit	$50/trip	20% Coinsurance	20% Coinsurance	"$50/visit - ER, 0% Coinsurance - UC"	$50 copay	20% Coinsurance	20% Coinsurance		20% Coinsurance	$5/visit - PT/OT/ST	0% PCP;	$10 Specialist	"$0 days 1-5, $25 days 6+"	$5/visit	0% coinsurance	$25/visit - OPSA	20% coinsurance for chemotherapy	0% coinsurance		Not Covered	$0/visit	$125 allowance / 2 years	$0/visit	$250 allowance / 2 years														73.975	122.155	15.63731721	0	50	0.164008	0.2	50	50	0.2	0.2	0	0.2	5	0	10	24.41156515	5	0	25	0.1	0	0	0	0	0	0	0	0	0	0											1.3855	0.023013616	0.138005444	0	2.449238872	7.611774731	0.41743861	0.394629786	0.583638896	0.540951291	1.448186865	0	0.041395705	0.056284882	0	4.0497685	0.325098431	0.241285963	0	0.034855733	0.197919143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.939	0	0	1.3855	0.023013616	0.138005444	0	2.449238872	7.611774731	0.41743861	0.394629786	0.583638896	0.540951291	1.448186865	0	0.041395705	0.056284882	0	4.0497685	0.325098431	0.241285963	0	0.034855733	0.197919143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.939	none	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20% coinsurance for specialty services	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.3855	0.023013616	0.138005444	0	2.449238872	7.611774731	0.41743861	0.394629786	0.583638896	0.540951291	1.448186865	0	0.041395705	0.056284882	0	4.0497685	0.325098431	0.241285963	0	0.034855733	0.197919143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.939
H8644_001_0	2008	11	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)																				A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin				V		V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0				0		0			0	0	0	0									0		306.05	6.57	523.34	219.21	73.32	5.19	1.58	346.92	409.69	6443.92	2817.13		8.6	549.18	5014.83	3755.74	49.07	468.37			18.63				2.99		0.77			0.02	0.06	0.08	3.38									$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$5/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$100/Visit	$0/Visit	$0-$75/Visit		$0-$50/Proc	$0-$75/Visit	$10/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins				VIS (200 Allowance)		Plan 828			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers									550.000005	549.999825	28.712561	5.000019	99.999937	0.2	0.2	49.999995	100.000013	0	14.492623		16.666164	28.840972	9.999998	30	38.360932	49.999988			0.2				0		0			0	0	0	0									14.0273	0.301124904	1.252202639	0.091337847	0.610999615	1.038	0.316	1.445499855	3.414083777	0	3.402300253	0	0.011944084	1.319907084	4.179024164	9.38935	0.156864244	1.951541198	0	0	3.726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6335	0	0	14.0273	0.301124904	1.252202639	0.091337847	0.610999615	1.038	0.316	1.445499855	3.414083777	0	3.402300253	0	0.011944084	1.319907084	4.179024164	9.38935	0.156864244	1.951541198	0	0	3.726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6335		30% Coins	30% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	$100/Trip	25% Coins	25% Coins	$50/Visit	25% Coins	25% Coins	25% Coins		$0-$50/Proc	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins				VIS (200 Allowance)		Plan 828			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers									11.781	0.1328	0.4832	0.7547	0.611	1.433	0.4364	0.2551	3.2045	0.7944	2.1419		0.0021	1.0699	3.3132	2.7247	0.0923	0.2891			0.8705				0		0			0	0	0	0									30.3896	0	0	25.8083	0.433935904	1.735376639	0.846050847	1.221995615	2.470981	0.752427	1.700586855	6.618545777	0.794388	5.544177253	0	0.014051084	2.389764084	7.492189164	12.114044	0.249117244	2.240620198	0	0	4.596485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.0231
H8644_003_0	2008	7	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V		V			O	O	O	O									0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0		0			0	0	0	0									0		288.07	6.18	492.6	206.33	69.01	4.59	1.4	326.54	385.63	6065.44	2651.67		8.09	516.92	4720.28	3535.14	46.19	440.86			16.5			4.93	2.99		0.77			0.02	0.06	0.08	3.38									$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$5/Visit	$100/Trip	20% Coins	0% Coins	$50/Visit	$100/Visit	$0/Visit	$0-$75/Visit		$0-$25/Proc	$0-$75/Visit	$10/Visit	$30/Visit	$30-$50/Visit	$50/Visit			20% Coins			DEN 750	VIS 200 Allowance		Plan 828			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers									478.75464	478.754122	24.993225	4.352312	87.046234	0.174092	0	43.523155	87.046292	0	13.452435		7.25326	25.105009	8.70463	26.113887	33.391802	43.523161			0.174092			0	0		0			0	0	0	0									11.4929	0.246558373	1.025971886	0.074834378	0.500588384	0.79908228	0	1.184337586	2.797305132	0	2.972618193	0	0.004889906	1.081440104	3.424024241	7.693020541	0.128530611	1.598968397	0	0	2.872518	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.8976	0	5.639891494	11.4929	0.246558373	1.025971886	0.074834378	0.500588384	0.79908228	0	1.184337586	2.797305132	0	2.972618193	0	0.004889906	1.081440104	3.424024241	7.693020541	0.128530611	1.598968397	0	0	2.872518	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.8976	5000	30% Coins	30% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	$100/Trip	25% Coins	25% Coins	$50/Visit	25% Coins	25% Coins	25% Coins		$0-$50/Proc	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins			DEN 750	VIS 200 Allowance		Plan 828			QuitNet	Meals on Wheels	Active Outlook	Silver Sneakers									9.0857	0.1024	0.3726	0.582	0.5006	1.1051	0.3366	0.209	2.4713	0.6126	1.6518		0.0017	0.8251	2.5551	2.1013	0.0711	0.2229			0.6713			0	0		0			0	0	0	0									23.4786	0	3.493937121	20.5786	0.348984373	1.398601886	0.656877378	1.001199384	1.90421228	0.336578	1.393340586	5.268622132	0.612641	4.624456193	0	0.006616906	1.906526104	5.979173241	9.794334541	0.199676611	1.821909397	0	0	3.543846	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.3762
H8644_801_0	2008	2																					4000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		305.48	6.56	522.37	218.8	73.18	5.2	1.78	346.28	408.93	6431.99	2811.92		8.58	548.16	4996.81	3742.96	48.98	467.5			18.79																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					558.425689	558.425472	17.959052	0	62.047305	0.124094	0.124094	31.023644	124.094597	23.299856	58.888874		20.682006	54.501838	12.40946	18.614188	36.771214	62.0473			0.124094																					14.2157	0.305272591	0.781772499	0	0.378385148	0.6452888	0.22088732	0.895238954	4.228833629	12.4887034	13.79923355	0	0.014787634	2.48964396	5.167309485	5.806013426	0.150087838	2.417259396	0	0	2.33172626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3361	0	40.57552115	14.2157	0.305272591	0.781772499	0	0.378385148	0.6452888	0.22088732	0.895238954	4.228833629	12.4887034	13.79923355	0	0.014787634	2.48964396	5.167309485	5.806013426	0.150087838	2.417259396	0	0	2.33172626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3361	1000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					6.2313	0.0702	0.3004	0.4692	0.4632	0.8909	0.305	0.5265	2.002	0.4957	1.3406		0.0087	0.6696	2.0507	1.6883	0.0574	0.1809			0.5448																					18.2954	0	11.19083977	20.4469	0.375519591	1.082178499	0.46923	0.841566148	1.5362208	0.52593032	1.421761954	6.230835629	12.9843744	15.13978955	0	0.023461634	3.15921396	7.218023485	7.494334426	0.207444838	2.598188396	0	0	2.87654526	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.6315
H8644_802_0	2008	2																					4000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		305.48	6.56	522.37	218.8	73.18	5.2	1.78	346.28	408.93	6431.99	2811.92		8.58	548.16	4996.81	3742.96	48.98	467.5			18.79																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					558.425689	558.425472	17.959052	0	62.047305	0.124094	0.124094	31.023644	124.094597	23.299856	58.888874		20.682006	54.501838	12.40946	18.614188	36.771214	62.0473			0.124094																					14.2157	0.305272591	0.781772499	0	0.378385148	0.6452888	0.22088732	0.895238954	4.228833629	12.4887034	13.79923355	0	0.014787634	2.48964396	5.167309485	5.806013426	0.150087838	2.417259396	0	0	2.33172626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3361	0	40.57552115	14.2157	0.305272591	0.781772499	0	0.378385148	0.6452888	0.22088732	0.895238954	4.228833629	12.4887034	13.79923355	0	0.014787634	2.48964396	5.167309485	5.806013426	0.150087838	2.417259396	0	0	2.33172626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3361	1000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					6.2313	0.0702	0.3004	0.4692	0.4632	0.8909	0.305	0.5265	2.002	0.4957	1.3406		0.0087	0.6696	2.0507	1.6883	0.0574	0.1809			0.5448																					18.2954	0	11.19083977	20.4469	0.375519591	1.082178499	0.46923	0.841566148	1.5362208	0.52593032	1.421761954	6.230835629	12.9843744	15.13978955	0	0.023461634	3.15921396	7.218023485	7.494334426	0.207444838	2.598188396	0	0	2.87654526	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.6315
H8644_803_0	2008	2																					4000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		305.48	6.56	522.37	218.8	73.18	5.2	1.78	346.28	408.93	6431.99	2811.92		8.58	548.16	4996.81	3742.96	48.98	467.5			18.79																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					558.425689	558.425472	17.959052	0	62.047305	0.124094	0.124094	31.023644	124.094597	23.299856	58.888874		20.682006	54.501838	12.40946	18.614188	36.771214	62.0473			0.124094																					14.2157	0.305272591	0.781772499	0	0.378385148	0.6452888	0.22088732	0.895238954	4.228833629	12.4887034	13.79923355	0	0.014787634	2.48964396	5.167309485	5.806013426	0.150087838	2.417259396	0	0	2.33172626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3361	0	40.57552115	14.2157	0.305272591	0.781772499	0	0.378385148	0.6452888	0.22088732	0.895238954	4.228833629	12.4887034	13.79923355	0	0.014787634	2.48964396	5.167309485	5.806013426	0.150087838	2.417259396	0	0	2.33172626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3361	1000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					6.2313	0.0702	0.3004	0.4692	0.4632	0.8909	0.305	0.5265	2.002	0.4957	1.3406		0.0087	0.6696	2.0507	1.6883	0.0574	0.1809			0.5448																					18.2954	0	11.19083977	20.4469	0.375519591	1.082178499	0.46923	0.841566148	1.5362208	0.52593032	1.421761954	6.230835629	12.9843744	15.13978955	0	0.023461634	3.15921396	7.218023485	7.494334426	0.207444838	2.598188396	0	0	2.87654526	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.6315
H8644_804_0	2008	2																					4000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		305.48	6.56	522.37	218.8	73.18	5.2	1.78	346.28	408.93	6431.99	2811.92		8.58	548.16	4996.81	3742.96	48.98	467.5			18.79																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					558.425689	558.425472	17.959052	0	62.047305	0.124094	0.124094	31.023644	124.094597	23.299856	58.888874		20.682006	54.501838	12.40946	18.614188	36.771214	62.0473			0.124094																					14.2157	0.305272591	0.781772499	0	0.378385148	0.6452888	0.22088732	0.895238954	4.228833629	12.4887034	13.79923355	0	0.014787634	2.48964396	5.167309485	5.806013426	0.150087838	2.417259396	0	0	2.33172626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3361	0	40.57552115	14.2157	0.305272591	0.781772499	0	0.378385148	0.6452888	0.22088732	0.895238954	4.228833629	12.4887034	13.79923355	0	0.014787634	2.48964396	5.167309485	5.806013426	0.150087838	2.417259396	0	0	2.33172626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3361	1000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					6.2313	0.0702	0.3004	0.4692	0.4632	0.8909	0.305	0.5265	2.002	0.4957	1.3406		0.0087	0.6696	2.0507	1.6883	0.0574	0.1809			0.5448																					18.2954	0	11.19083977	20.4469	0.375519591	1.082178499	0.46923	0.841566148	1.5362208	0.52593032	1.421761954	6.230835629	12.9843744	15.13978955	0	0.023461634	3.15921396	7.218023485	7.494334426	0.207444838	2.598188396	0	0	2.87654526	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.6315
H8649_001_0	2008	3																					1000											D	D	D	V	T	Coin	Coin	V	V	P	P	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	Coin	V	P	V	P	Coin	P	P																																																				0	3000	941.7515945	46.27529753			63.74537786	8.713754341	16.66683464	241.7932505						8.303906246	3045.433759	3586.20926	288.7192143	974.5889573		1.893631541	16.93936936			6.255	755.0254919		224.1															1a:$100 1-3; 1a1:$100 1-3;	1b:$100 1-3;			10a:$50;	11a:10%;	11b:10%; 11c:$5;	4a:$50; 4b:$15;						5:$5; 9c:$5; 9d:$5;	7a:$5; 14c:$5; 14i:$5;	7b:$5; 7b1:$5; 7d:$5; 7f:$5; 7f1:$5; 14j:$5; 16b:10%; 17a:$5; 18a:$5;	7e:$5; 7h:$5;	7c:$5; 7i:$5;		7g:$5-5;	15:10%;			16a:10%;	17a1:$5;		18a1:$5;															51.92	37.6811			41.1294	0.082258866	0.082258866	41.1294						4.1129	5	4.9993	4.1129	4.1129		4.1129	0.082258866			0.1	4.3342		5															4.0746	0.145308646	0	0	0.21848427	0.716783548	1.370994911	0.828734938	0	0	0	0	0	0.002846125	1.268930733	1.494036181	0.098957146	0.334035759	0	0.000649033	1.393413309	0	0	0.6255	0.2727	0	0.093375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.9394	0	1.981156349	4.0746	0.145308646	0	0	0.21848427	0.716783548	1.370994911	0.828734938	0	0	0	0	0	0.002846125	1.268930733	1.494036181	0.098957146	0.334035759	0	0.000649033	1.393413309	0	0	0.6255	0.2727	0	0.093375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.9394	3000	0.2		0.2	0.2	50	0.2	0.2	50	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2		0.2	0.2	0.2	0.2			0.2	0.2		0.2				0.2											3.1345		0.4153	0.6191	0.0226	0.1485	0.284	0.0871	0.7713	0.1018	0.2759	0.0104	0.0045	0.4055	0.4093	1.3931		0.1957	0.3096	0.1833	0.2887			0.1558	0.0694		0.0198				0.0004											9.3056	250	4.895657468	7.2092	0.145308646	0.415256913	0.619086671	0.241117369	0.865288819	1.65504157	0.91586576	0.771343374	0.101830257	0.27588653	0.010406778	0.004453707	0.408375485	1.678205674	2.887179879	0.098957146	0.529690214	0.309624361	0.183906354	1.682104675	0	0	0.7812684	0.342064252	0	0.113152205	0	0	0	0.000434289	0	0	0	0	0	0	0	0	0	0	22.245
H8649_002_0	2008	3																					2000											D	D	D	V	T	Coin	Coin	V	V	P	P	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	Coin	V	P	V	P	Coin	P	P																																																				0	3000	946.7344072	46.52014038	665.5103662		64.08265499	8.759858861	16.75501895	243.0725799	292.5510871	1111.925918	345.2730309	5.020387089	0.277180173	504.2692234	3061.047165	3604.560103	290.2468292	979.7455126	3189.499452	5106.492376	17.02899566			6.465809693	129.6	625.4254919	224.1															1a:$125 1-5; 1a1:$125 1-5;	1b:$125 1-5;	2a:$75 7+; 2a2:$75 7+;		10a:$100;	11a:20%;	11b:20%; 11c:20%;	4a:$50; 4b:$20;	9b:$75;	8a:$15;	8b:$15-50;	9a:$75;	12:10%;	3:$15; 5:$40; 9a:$75; 9c:$15; 9d:$15;	7a:$5; 14c:$5; 14i:$5;	7b:$15; 7b1:$15; 7d:$15; 7f:$15; 7f1:$15; 14j:$5; 16b:20%; 17a:$15; 18a:$15;	7e:$15; 7h:$15;	7c:$15; 7i:$15;	7g:$5-15;	7g:$5-15;	15:20%;			16a:25%;	17a1:$5;	17b1:20%;	18a1:$15;															81.5311	64.9035	36.0278		86.3768	0.17275365	0.17275365	43.1884	64.7826	12.9565	28.6906	64.7826	0.093858411	63.6644	5	14.9983	12.9053	12.7598	7.7779	3.3489	0.17275365			0.25	15	8.3924	15															6.4324	0.251610173	1.998071402	0	0.461271355	1.513297588	2.894490673	0.874826569	1.579352125	1.200557878	0.825507605	0.027102819	0.026015691	2.675332655	1.275436319	4.505196021	0.312142848	1.041777098	2.067310333	1.425097785	2.941821149	0	0	1.616452423	0.162	0.4374	0.280125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.8246	0	4.503026923	6.4324	0.251610173	1.998071402	0	0.461271355	1.513297588	2.894490673	0.874826569	1.579352125	1.200557878	0.825507605	0.027102819	0.026015691	2.675332655	1.275436319	4.505196021	0.312142848	1.041777098	2.067310333	1.425097785	2.941821149	0	0	1.616452423	0.162	0.4374	0.280125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.8246	3000	0.3		0.3	0.3	100	0.3	0.3	50	0.3	0.3	0.3	0.3		0.3	0.3	0.3		0.3	0.3	0.3	0.3			0.3	0.3	0.3	0.3															3.3635		0.4456	0.6643	0.0324	0.1594	0.3048	0.0626	0.8277	0.1093	0.296	0.0112	0.0048	0.4352	0.4391	1.4949		0.2099	0.3322	0.1966	0.3098			0.1922	0.0159	0.078	0.0211				0.0004											10.0069	250	10.36597272	9.7959	0.251610173	2.443664136	0.664314121	0.493653439	1.67265193	3.199288394	0.937411757	2.40704608	1.309827356	1.121549058	0.038269865	0.030794763	3.11048801	1.7145252	6.000088813	0.312142848	1.251725113	2.399554339	1.621742991	3.251602898	0	0	1.808681485	0.177905806	0.515423631	0.301235337	0	0	0	0.000379528	0	0	0	0	0	0	0	0	0	0	46.8315
H8649_003_0	2008	13																					3000											D	D	D	V	T	Coin	Coin	V	Coin	P	P	Coin	Coin	V	V	V	V	V	P	V	Coin	P	T	Coin	V	P	V	P	Coin	P	P																																																				0	3000	910.858156	44.7572719	640.3002701		61.65425965	8.427906315	16.12009192	233.8614085	46.84030258	1069.789778	332.1890003	0.632232816	0.266676503	749.4031583	2948.630641	3472.434036	279.248002	942.6183142	3068.634209	4912.983191	16.38368635			6.462	755.0254919		224.1															1a:$200 1-7; 1a1:$200 1-7;	1b:$200 1-7;	2a:$120 7+; 2a2:$120 7+;		10a:$150;	11a:20%;	11b:20%; 11c:20%;	4a:$50; 4b:$35;	9b:20%;	8a:$25;	8b:$25 or 20%;	9a:20%;	12:20%;	3:$25; 5:$60; 9c:$30; 9d:25%;	7a:$10; 14c:$10; 14i:$10;	7b:$30; 7b1:$30; 7d:$25; 7f:$25; 7f1:$25; 14j:$10; 16b:20%; 17a:$25; 18a:$25;	7e:$30; 7h:$30;	7c:$30; 7i:$30;	7g:$10-25;	7g:$10-25;	15:20%;			16a:25%;	17a1:$25;		18a1:$25;															148.5904	125.9158	60.0092		134.8776	0.179836773	0.179836773	44.9592	0.179836773	22.4796	80.2147	0.179836773	0.186837434	69.6624	10	25.4241	22.5181	23.1203	13.5222	5.8791	0.179836773			0.25	11.2431		25															11.2787	0.469637467	3.201994404	0	0.692981442	1.515647472	2.898985306	0.87618502	8.423608849	2.004036887	2.220537835	0.113698709	0.049825153	4.350435739	2.457192201	7.356967301	0.524010988	1.816134471	3.457892676	2.406993922	2.946389278	0	0	1.6155	0.7074	0	0.466875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8517	0	5.522233962	11.2787	0.469637467	3.201994404	0	0.692981442	1.515647472	2.898985306	0.87618502	8.423608849	2.004036887	2.220537835	0.113698709	0.049825153	4.350435739	2.457192201	7.356967301	0.524010988	1.816134471	3.457892676	2.406993922	2.946389278	0	0	1.6155	0.7074	0	0.466875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8517	3000	0.3		0.3	0.3	150	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3			0.3	0.3	0.3	0.3				0.3											3.0822		0.4083	0.6088	0.0445	0.146	0.2793	0.0574	0.7585	0.1001	0.2713	0.0102	0.0044	0.3988	0.4029	1.37		0.1924	0.3045	0.1802	0.2839			0.231	0.088		0.0201				0.0004											9.2433	250	10.48002329	14.361	0.469637467	3.61032461	0.608752728	0.737492046	1.661673858	3.17829059	0.933578013	9.182076775	2.104167369	2.491819201	0.123931775	0.054204518	4.749195906	2.860141441	8.727016846	0.524010988	2.008523015	3.762348714	2.587192269	3.230261739	0	0	1.846531707	0.795449578	0	0.486981663	0	0	0	0.000391881	0	0	0	0	0	0	0	0	0	0	71.095
H8649_801_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	195.8826565	3.432009707	25.76303032		5.365741188	9.625389109	18.5068884	13.84296084	51.58767067	7.330248492	19.12109524	0.610111713	0.236523076	26.13952113	24.15607912	87.64036605	1.996990724	12.6300468	18.79270712	10.85875914	17.02665133																					Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.081769295	0.081769295	0.190376647		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					16.0172	0.280633013	4.904679333	0	1.255583438	2.252341052	4.330611887	3.239252837	12.07151494	1.715278147	4.474336287	0.142766141	0.0553464	6.116647944	5.652522514	20.50784566	0.467295829	2.95543095	4.397493465	2.54094964	3.984236412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.362	0	0	16.0172	0.280633013	4.904679333	0	1.255583438	2.252341052	4.330611887	3.239252837	12.07151494	1.715278147	4.474336287	0.142766141	0.0553464	6.116647944	5.652522514	20.50784566	0.467295829	2.95543095	4.397493465	2.54094964	3.984236412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.362		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.8719		0.5724		0.1443	0.2634	0.5065	0.3541	1.3194	0.1875	0.4891	0.0156	0.0061	0.6686	0.6611	2.3436		0.3325	0.5143	0.2972	0.466																					11.0135	0	0	17.889	0.280633013	5.477116508	0	1.399880439	2.515772754	4.837116201	3.593350211	13.39092554	1.902747977	4.963401241	0.158365588	0.061482252	6.785200774	6.313636259	22.8514081	0.467295829	3.287925833	4.911820186	2.838136732	4.450228975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.3755
H8649_802_0	2008	2																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	195.8826565	3.432009707	25.76303032		5.365741188	9.625389109	18.5068884	13.84296084	51.58767067	7.330248492	19.12109524	0.610111713	0.236523076	26.13952113	24.15607912	87.64036605	1.996990724	12.6300468	18.79270712	10.85875914	17.02665133																					Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.081769295	0.081769295	0.190376647		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					16.0172	0.280633013	4.904679333	0	1.255583438	2.252341052	4.330611887	3.239252837	12.07151494	1.715278147	4.474336287	0.142766141	0.0553464	6.116647944	5.652522514	20.50784566	0.467295829	2.95543095	4.397493465	2.54094964	3.984236412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.362	0	0	16.0172	0.280633013	4.904679333	0	1.255583438	2.252341052	4.330611887	3.239252837	12.07151494	1.715278147	4.474336287	0.142766141	0.0553464	6.116647944	5.652522514	20.50784566	0.467295829	2.95543095	4.397493465	2.54094964	3.984236412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.362		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.8719		0.5724		0.1443	0.2634	0.5065	0.3541	1.3194	0.1875	0.4891	0.0156	0.0061	0.6686	0.6611	2.3436		0.3325	0.5143	0.2972	0.466																					11.0135	0	0	17.889	0.280633013	5.477116508	0	1.399880439	2.515772754	4.837116201	3.593350211	13.39092554	1.902747977	4.963401241	0.158365588	0.061482252	6.785200774	6.313636259	22.8514081	0.467295829	3.287925833	4.911820186	2.838136732	4.450228975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.3755
H8649_803_0	2008	3																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0	0	195.8826565	3.432009707	25.76303032		5.365741188	9.625389109	18.5068884	13.84296084	51.58767067	7.330248492	19.12109524	0.610111713	0.236523076	26.13952113	24.15607912	87.64036605	1.996990724	12.6300468	18.79270712	10.85875914	17.02665133																					Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.081769295	0.081769295	0.190376647		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																					16.0172	0.280633013	4.904679333	0	1.255583438	2.252341052	4.330611887	3.239252837	12.07151494	1.715278147	4.474336287	0.142766141	0.0553464	6.116647944	5.652522514	20.50784566	0.467295829	2.95543095	4.397493465	2.54094964	3.984236412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.362	0	0	16.0172	0.280633013	4.904679333	0	1.255583438	2.252341052	4.330611887	3.239252837	12.07151494	1.715278147	4.474336287	0.142766141	0.0553464	6.116647944	5.652522514	20.50784566	0.467295829	2.95543095	4.397493465	2.54094964	3.984236412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.362		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.8719		0.5724		0.1443	0.2634	0.5065	0.3541	1.3194	0.1875	0.4891	0.0156	0.0061	0.6686	0.6611	2.3436		0.3325	0.5143	0.2972	0.466																					11.0135	0	0	17.889	0.280633013	5.477116508	0	1.399880439	2.515772754	4.837116201	3.593350211	13.39092554	1.902747977	4.963401241	0.158365588	0.061482252	6.785200774	6.313636259	22.8514081	0.467295829	3.287925833	4.911820186	2.838136732	4.450228975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.3755
H8707_001_0	2008	14	s.										Other Non-Covered										5000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O	O	O										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0	0	0										0		311.618454	6.696049	532.866048	223.193374	74.656662	5.380568	1.841293	353.234798	417.158063	6561.148644	1537.79358		8.761355	559.190608	5069.458013	3829.53046	49.966544	317.900152			19.31475			4.44	1.82					3.4	0.02	0.08										$550/Admit	$550/Admit	$0/Day(Days 1-20) $100(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$100-$125/Visit	$0-$75/Visit	$50-$75/Visit		$0-$75/Proc	$30-$75/Visit	$10/Visit	$30/Visit	$30-$75/Visit	$75/Visit			20% Coins			Coin: 0%	EyeMed: $200 Allowance					Silver Sneakers	Quit Net	Humana Active Outlook										521.536932	521.536532	21.956995	0	94.824922	0.189649	0.18965	47.412461	107.189549	12.098564	71.118675		23.731131	69.815109	9.482489	28.447469	46.288607	71.118676			0.189649			0.355855856	0					0	0	0										13.5434	0.291019514	0.975011429	0	0.589942679	1.020419341	0.349201217	1.395644257	3.72624872	6.615039732	9.113820153	0	0.017326405	3.253329437	4.00592332	9.078370754	0.192740143	1.884053159	0	0	3.663023023	0	0	1.58	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.2945	0	3.258939063	13.5434	0.291019514	0.975011429	0	0.589942679	1.020419341	0.349201217	1.395644257	3.72624872	6.615039732	9.113820153	0	0.017326405	3.253329437	4.00592332	9.078370754	0.192740143	1.884053159	0	0	3.663023023	0	0	1.58	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.2945		$850/Admit	$850/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$75/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			Coin: 50%						Silver Sneakers	Quit Net	Humana Active Outlook										3.6936	0.0794	0.5702	0.8907	0.5899	2.2557	0.7719	0.2463	3.7808	0.9373	2.528		0.0031	1.2639	3.9091	3.216	0.1107	0.3412			1.0272			1.43	0					0	0	0										27.645	0	1.43069024	17.237	0.370388904	1.545206828	0.890745284	1.179885364	3.276092252	1.121118575	1.641933918	7.507000928	7.552310853	11.64183681	0	0.02038356	4.5171851	7.915062754	12.29433732	0.303458645	2.225285303	0	0	4.690195735	0	0	3.01	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.9395
H8707_003_0	2008	9	s.										Other Non-Covered										3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O	O	O										0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0	0	0										0		294.688318	6.332255	503.915595	211.067345	70.600588	4.811803	1.646655	334.043658	394.493992	6204.683402	1454.245716		8.285353	528.80995	4794.035875	3621.473216	47.251876	300.628732			17.273039			6.2	2.99					3.4	0.02	0.08										$550/Admit	$550/Admit	$0/Day(Days 1-20) $100(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$100-$125/Visit	$0-$75/Visit	$50-$75/Visit		$0-$75/Proc	$30-$75/Visit	$5/Visit	$30/Visit	$30-$75/Visit	$75/Visit			20% Coins			Coin: 25%- 75%	EyeMed: $200 Allowance					Silver Sneakers	Quit Net	Humana Active Outlook										463.817203	463.816634	19.526962	0	84.330366	0.16866	0.16866	42.165212	95.326637	10.759587	63.247801		21.104399	62.088498	4.21652	25.299122	41.165521	63.247814			0.16866			0.35483871	0					0	0	0										11.3901	0.244750433	0.819995056	0	0.496147785	0.811558694	0.277724832	1.173751805	3.133815465	5.563319239	7.664820304	0	0.01457145	2.736084627	1.684512346	7.635007726	0.162095674	1.584509177	0	0	2.913270758	0	0	2.2	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5061	0	8.97584946	11.3901	0.244750433	0.819995056	0	0.496147785	0.811558694	0.277724832	1.173751805	3.133815465	5.563319239	7.664820304	0	0.01457145	2.736084627	1.684512346	7.635007726	0.162095674	1.584509177	0	0	2.913270758	0	0	2.2	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5061	5000	$850/Admit	$850/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$75/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			Coin: 50%- 80%						Silver Sneakers	Quit Net	Humana Active Outlook										3.1064	0.0668	0.4535	0.7084	0.4961	1.794	0.6139	0.2071	3.0069	0.7454	2.0106		0.0026	1.0052	3.109	2.5577	0.0881	0.2714			0.8169			2	0					0	0	0										23.06	0	3.913201644	14.4965	0.311500475	1.273482626	0.708426802	0.992295574	2.605538689	0.891645084	1.380884133	6.140720446	6.308748534	9.675400402	0	0.017142684	3.741252397	4.793526262	10.19272768	0.250152635	1.855897054	0	0	3.730201268	0	0	4.2	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.5661
H8707_801_0	2008	8																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		311.165043	6.686306	532.090716	222.868622	74.548034	5.364925	1.83594	352.720834	416.551091	6551.602025	1535.556054		8.748608	558.376973	5062.081837	3823.958408	49.893841	317.437599			19.258595																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214482	177.215341	28.944117	0	100.000061	0.2	0.2	49.999995	199.999994	37.551768	90.505002		33.368051	87.838636	19.999999	29.999999	59.267355	99.999987			0.2																					4.5952	0.098743	1.283407995	0	0.621233996	1.072985	0.367188	1.469669995	6.942517975	20.50201994	11.58129198	0	0.024327	4.087255974	8.43680264	9.559895701	0.246422999	2.645312981	0	0	3.851719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.386	0	0	4.5952	0.098743	1.283407995	0	0.621233996	1.072985	0.367188	1.469669995	6.942517975	20.50201994	11.58129198	0	0.024327	4.087255974	8.43680264	9.559895701	0.246422999	2.645312981	0	0	3.851719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.386		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					10.1488	0.1147	0.4996	0.7805	0.7702	1.4824	0.5073	0.8698	3.3129	0.8213	2.2152		0.0151	1.1075	3.4254	2.818	0.097	0.299			0.9001																					30.1849	0	0	14.744	0.213423	1.783045995	0.780522	1.391478996	2.555398	0.874487	2.339501995	10.25543198	21.32331094	13.79648598	0	0.039411	5.194719974	11.86221664	12.3779117	0.343441999	2.944319981	0	0	4.751787	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.5709
H8707_802_0	2008	8																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		311.165043	6.686306	532.090716	222.868622	74.548034	5.364925	1.83594	352.720834	416.551091	6551.602025	1535.556054		8.748608	558.376973	5062.081837	3823.958408	49.893841	317.437599			19.258595																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214482	177.215341	28.944117	0	100.000061	0.2	0.2	49.999995	199.999994	37.551768	90.505002		33.368051	87.838636	19.999999	29.999999	59.267355	99.999987			0.2																					4.5952	0.098743	1.283407995	0	0.621233996	1.072985	0.367188	1.469669995	6.942517975	20.50201994	11.58129198	0	0.024327	4.087255974	8.43680264	9.559895701	0.246422999	2.645312981	0	0	3.851719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.386	0	0	4.5952	0.098743	1.283407995	0	0.621233996	1.072985	0.367188	1.469669995	6.942517975	20.50201994	11.58129198	0	0.024327	4.087255974	8.43680264	9.559895701	0.246422999	2.645312981	0	0	3.851719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.386		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					10.1488	0.1147	0.4996	0.7805	0.7702	1.4824	0.5073	0.8698	3.3129	0.8213	2.2152		0.0151	1.1075	3.4254	2.818	0.097	0.299			0.9001																					30.1849	0	0	14.744	0.213423	1.783045995	0.780522	1.391478996	2.555398	0.874487	2.339501995	10.25543198	21.32331094	13.79648598	0	0.039411	5.194719974	11.86221664	12.3779117	0.343441999	2.944319981	0	0	4.751787	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.5709
H8707_803_0	2008	8																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		311.165043	6.686306	532.090716	222.868622	74.548034	5.364925	1.83594	352.720834	416.551091	6551.602025	1535.556054		8.748608	558.376973	5062.081837	3823.958408	49.893841	317.437599			19.258595																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214482	177.215341	28.944117	0	100.000061	0.2	0.2	49.999995	199.999994	37.551768	90.505002		33.368051	87.838636	19.999999	29.999999	59.267355	99.999987			0.2																					4.5952	0.098743	1.283407995	0	0.621233996	1.072985	0.367188	1.469669995	6.942517975	20.50201994	11.58129198	0	0.024327	4.087255974	8.43680264	9.559895701	0.246422999	2.645312981	0	0	3.851719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.386	0	0	4.5952	0.098743	1.283407995	0	0.621233996	1.072985	0.367188	1.469669995	6.942517975	20.50201994	11.58129198	0	0.024327	4.087255974	8.43680264	9.559895701	0.246422999	2.645312981	0	0	3.851719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.386		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					10.1488	0.1147	0.4996	0.7805	0.7702	1.4824	0.5073	0.8698	3.3129	0.8213	2.2152		0.0151	1.1075	3.4254	2.818	0.097	0.299			0.9001																					30.1849	0	0	14.744	0.213423	1.783045995	0.780522	1.391478996	2.555398	0.874487	2.339501995	10.25543198	21.32331094	13.79648598	0	0.039411	5.194719974	11.86221664	12.3779117	0.343441999	2.944319981	0	0	4.751787	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.5709
H8707_804_0	2008	8																																A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		311.165043	6.686306	532.090716	222.868622	74.548034	5.364925	1.83594	352.720834	416.551091	6551.602025	1535.556054		8.748608	558.376973	5062.081837	3823.958408	49.893841	317.437599			19.258595																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					177.214482	177.215341	28.944117	0	100.000061	0.2	0.2	49.999995	199.999994	37.551768	90.505002		33.368051	87.838636	19.999999	29.999999	59.267355	99.999987			0.2																					4.5952	0.098743	1.283407995	0	0.621233996	1.072985	0.367188	1.469669995	6.942517975	20.50201994	11.58129198	0	0.024327	4.087255974	8.43680264	9.559895701	0.246422999	2.645312981	0	0	3.851719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.386	0	0	4.5952	0.098743	1.283407995	0	0.621233996	1.072985	0.367188	1.469669995	6.942517975	20.50201994	11.58129198	0	0.024327	4.087255974	8.43680264	9.559895701	0.246422999	2.645312981	0	0	3.851719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.386		25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					10.1488	0.1147	0.4996	0.7805	0.7702	1.4824	0.5073	0.8698	3.3129	0.8213	2.2152		0.0151	1.1075	3.4254	2.818	0.097	0.299			0.9001																					30.1849	0	0	14.744	0.213423	1.783045995	0.780522	1.391478996	2.555398	0.874487	2.339501995	10.25543198	21.32331094	13.79648598	0	0.039411	5.194719974	11.86221664	12.3779117	0.343441999	2.944319981	0	0	4.751787	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.5709
H8742_001_0	2008	5																					3250											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	Coin	Coin	Coin	P	P	P	P																																																										0		1278.222616	49.28203812	781.963367		100.3566213	3.549468034	4.750204244	198.5356924	284.8335325	833.8225426	819.8911289		10.27976575	85.86424273	3171.723894	3550.567788	343.0681872	411.4194549			13.38221127	777.8949504																				1a (IP Acute) - $250 days 1-7	1b (IP Psych) - $250 days 1-7	2 (SNF) - $125 days 21-100		10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%, 11c (Diab Supp) - 10%"	"4a (ER) $50, 4b (UC) - $25"	"9a (OP Surgery) - $150, 9b (ASC) - $75"	8a (OP Diag Proc/Test/Lab) - $25	"8b (Therap Rad) - $50; (PET) - $300; (CT Scan), (MRI) - $125"		12 (Renal Dialysis) - $50	"3 (CORF)-$25, 7i, 7c (OP PT/ST/OT) - $25, 9c (OP SA) - $30, 9d (Cardiac Rehab) - $25"	"14g (Bone Mass) 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) - $0; 14i (Diab Mon.) - $10; 7a (PCP)- $5"	"7b (Chiro), 7d (Spec), 7f (Pod) - $25"	"7e (MH), 7h (Psychiatric) - $30"	"7c (OT), 7i (PT/ST) - $25"			15 (Part B Rx) - 20%	13a (Blood) - $0; 17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $0; 18a (MCR Hearing Exam) - $25; 14j (Nutrition Therap) - $10																				149.9524	149.9524	56.5956		83.0761	0.166152221	0.150992051	37.3703	106.0008	20.769	42.3026		41.5381	20.9919	4.165	20.769	24.9228	20.769			0.166152221	12.4166																				15.9727	0.615829905	3.687973838	0	0.694769812	0.589751996	0.717243079	0.618278554	2.516048065	1.443140282	2.890296182	0	0.035583456	0.150204595	1.100857302	6.145153361	0.712519264	0.712065167	0	0	2.223484119	0.804900902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6308	0	8.480840445	15.9727	0.615829905	3.687973838	0	0.694769812	0.589751996	0.717243079	0.618278554	2.516048065	1.443140282	2.890296182	0	0.035583456	0.150204595	1.100857302	6.145153361	0.712519264	0.712065167	0	0	2.223484119	0.804900902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6308																																																																																				0	0	0	15.9727	0.615829905	3.687973838	0	0.694769812	0.589751996	0.717243079	0.618278554	2.516048065	1.443140282	2.890296182	0	0.035583456	0.150204595	1.100857302	6.145153361	0.712519264	0.712065167	0	0	2.223484119	0.804900902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6308
H8742_003_0	2008	3																					3250											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	Coin	Coin	Coin	P	P	P	P																																																										0		1278.222616	49.28203812	781.963367		100.3566213	3.549468034	4.750204244	198.5356924	284.8335325	833.8225426	819.8911289		10.27976575	85.86424273	3171.723894	3550.567788	343.0681872	411.4194549			13.38221127	777.8949504																				1a (IP Acute) - $250 days 1-7	1b (IP Psych) - $250 days 1-7	2 (SNF) - $125 days 21-100		10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%, 11c (Diab Supp) - 10%"	"4a (ER) $50, 4b (UC) - $25"	"9a (OP Surgery) - $150, 9b (ASC) - $75"	8a (OP Diag Proc/Test/Lab) - $25	"8b (Therap Rad) - $50; (PET) - $300; (CT Scan), (MRI) - $125"		12 (Renal Dialysis) - $50	"3 (CORF)-$25, 7i, 7c (OP PT/ST/OT) - $25, 9c (OP SA) - $30, 9d (Cardiac Rehab) - $25"	"14g (Bone Mass) 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) - $0; 14i (Diab Mon.) - $10; 7a (PCP)- $5"	"7b (Chiro), 7d (Spec), 7f (Pod) - $25"	"7e (MH), 7h (Psychiatric) - $30"	"7c (OT), 7i (PT/ST) - $25"			15 (Part B Rx) - 20%	13a (Blood) - $0; 17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $0; 18a (MCR Hearing Exam) - $25; 14j (Nutrition Therap) - $10																				149.9524	149.9524	56.5956		83.0761	0.166152221	0.150992051	37.3703	106.0008	20.769	42.3026		41.5381	20.9919	4.165	20.769	24.9228	20.769			0.166152221	12.4166																				15.9727	0.615829905	3.687973838	0	0.694769812	0.589751996	0.717243079	0.618278554	2.516048065	1.443140282	2.890296182	0	0.035583456	0.150204595	1.100857302	6.145153361	0.712519264	0.712065167	0	0	2.223484119	0.804900902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6308	0	8.480840445	15.9727	0.615829905	3.687973838	0	0.694769812	0.589751996	0.717243079	0.618278554	2.516048065	1.443140282	2.890296182	0	0.035583456	0.150204595	1.100857302	6.145153361	0.712519264	0.712065167	0	0	2.223484119	0.804900902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6308																																																																																				0	0	0	15.9727	0.615829905	3.687973838	0	0.694769812	0.589751996	0.717243079	0.618278554	2.516048065	1.443140282	2.890296182	0	0.035583456	0.150204595	1.100857302	6.145153361	0.712519264	0.712065167	0	0	2.223484119	0.804900902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6308
H8742_004_0	2008	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		308.1390081	57.18677431	49.94169182		15.45227807	17.44935438	19.45890113	37.15735707	44.37075647	19.40820906	23.7907118	3.816765149	0.455706872	47.00024375	53.50757645	89.97042316	17.5984059	4.732001124	19.39448677		37.9753392	6.144253346																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.077439635	0.077439635	0.176545243		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234																				23.8622	4.428522937	8.816968114	0	3.615833068	4.083148925	4.553382866	8.694821555	10.38275701	4.54152092	5.567026561	0.893123045	0.106635408	10.99805704	12.52077289	21.05307902	4.11802698	1.107288263	4.538309903	0	8.886229374	1.437755283	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.2054	0	0	23.8622	4.428522937	8.816968114	0	3.615833068	4.083148925	4.553382866	8.694821555	10.38275701	4.54152092	5.567026561	0.893123045	0.106635408	10.99805704	12.52077289	21.05307902	4.11802698	1.107288263	4.538309903	0	8.886229374	1.437755283	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.2054																																																																																				0	0	0	23.8622	4.428522937	8.816968114	0	3.615833068	4.083148925	4.553382866	8.694821555	10.38275701	4.54152092	5.567026561	0.893123045	0.106635408	10.99805704	12.52077289	21.05307902	4.11802698	1.107288263	4.538309903	0	8.886229374	1.437755283	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.2054
H8742_007_0	2008	3																					2500											A	D	D	Coin	A	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	V	P	P	P	P	P	P	P	P	P																																																				0		247.5710597	49.28200884	781.9629024	6.815222862	100.3565617	3.549463816	4.750198599	198.535575	284.8333633		19.56106839		10.27975964	0.5392248	3163.160366	3550.565679	2.526449636	411.4192104	19.98808834		13.38219536	1120.906266			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 days 1-5	2 (SNF) - $100 days 21-100	6 (Home Health)- 10%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%, 11c (Diab Supp) - 20%"	"4a (ER) $35, 4b (UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		"8b (Therap Rad), (PET), (CT Scan), (MRI) - 10%"		12 (Renal Dialysis) - $50	"3 (CORF)-$15, 7i, 7c (OP PT/ST/OT) - $15, 9c (OP SA) - 50%, 9d (Cardiac Rehab) - $15"	"14g (Bone Mass) 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) - $0; 14i (Diab Mon.) - $0; 7a (PCP)- $10"	"7b (Chiro) - $20, 7d (Spec) - $25, 7f (Pod) - $20"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $15"	8b: 10%		15 (Part B Rx) - 20%	13a (Blood) - $0; 17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $0; 18a (MCR Hearing Exam) - $15; 14j (Nutrition Therap) - $0			17a1: $15 exam		18a1: $15 exam															169.7845	50.9528	26.7041	0.130603481	43.5345	0.174137974	0.174137974	30.4741	37.0318		0.087068987		43.5345	0.190960413	8.7069	21.2517	0.435344935	13.0603	0.087068987		0.174137974	13.0603			13.0603		13.0603															3.5028	0.209254577	1.740131913	0.890091827	0.364081007	0.618096438	0.827189961	0.504183499	0.878991667	0	1.703162411	0	0.037293677	0.102970591	2.295109742	6.287966724	1.099877053	0.447773174	1.740342605	0	2.33034839	1.219952165	0	0	0.47017253	0	0.271002222	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.5408	0	4.090210498	3.5028	0.209254577	1.740131913	0.890091827	0.364081007	0.618096438	0.827189961	0.504183499	0.878991667	0	1.703162411	0	0.037293677	0.102970591	2.295109742	6.287966724	1.099877053	0.447773174	1.740342605	0	2.33034839	1.219952165	0	0	0.47017253	0	0.271002222	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.5408																																																																																				0	0	0	3.5028	0.209254577	1.740131913	0.890091827	0.364081007	0.618096438	0.827189961	0.504183499	0.878991667	0	1.703162411	0	0.037293677	0.102970591	2.295109742	6.287966724	1.099877053	0.447773174	1.740342605	0	2.33034839	1.219952165	0	0	0.47017253	0	0.271002222	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.5408
H8742_008_0	2008	5																					2500											A	D	D	Coin	A	Coin	Coin	V	V	Coin	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	V	P	P	P	P	P	P	P	P	P																																																				0		247.5710597	49.28200884	781.9629024	6.815222862	100.3565617	3.549463816	4.750198599	198.535575	284.8333633		19.56106839		10.27975964	0.5392248	3163.160366	3550.565679	2.526449636	411.4192104	19.98808834		13.38219536	1120.906266			432		249															1a (IP Acute) - $195	1b (IP Psych) - $95 days 1-5	2 (SNF) - $100 days 21-100	6 (Home Health)- 10%	10a (Ambulance) - $50	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%, 11c (Diab Supp) - 20%"	"4a (ER) $35, 4b (UC) - $35"	"9a (OP Surgery) - $50, 9b (ASC) - $25"		"8b (Therap Rad), (PET), (CT Scan), (MRI) - 10%"		12 (Renal Dialysis) - $50	"3 (CORF)-$15, 7i, 7c (OP PT/ST/OT) - $15, 9c (OP SA) - 50%, 9d (Cardiac Rehab) - $15"	"14g (Bone Mass) 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) - $0; 14i (Diab Mon.) - $0; 7a (PCP)- $10"	"7b (Chiro) - $20, 7d (Spec) - $25, 7f (Pod) - $20"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - $15"	8b: 10%		15 (Part B Rx) - 20%	13a (Blood) - $0; 17a (MCR Eye Exam) - $15; 17b (MCR Eyewear) - $0; 18a (MCR Hearing Exam) - $15; 14j (Nutrition Therap) - $0			17a1: $15 exam		18a1: $15 exam															169.7845	50.9528	26.7041	0.130603481	43.5345	0.174137974	0.174137974	30.4741	37.0318		0.087068987		43.5345	0.190960413	8.7069	21.2517	0.435344935	13.0603	0.087068987		0.174137974	13.0603			13.0603		13.0603															3.5028	0.209254577	1.740131913	0.890091827	0.364081007	0.618096438	0.827189961	0.504183499	0.878991667	0	1.703162411	0	0.037293677	0.102970591	2.295109742	6.287966724	1.099877053	0.447773174	1.740342605	0	2.33034839	1.219952165	0	0	0.47017253	0	0.271002222	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.5408	0	4.090210498	3.5028	0.209254577	1.740131913	0.890091827	0.364081007	0.618096438	0.827189961	0.504183499	0.878991667	0	1.703162411	0	0.037293677	0.102970591	2.295109742	6.287966724	1.099877053	0.447773174	1.740342605	0	2.33034839	1.219952165	0	0	0.47017253	0	0.271002222	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.5408																																																																																				0	0	0	3.5028	0.209254577	1.740131913	0.890091827	0.364081007	0.618096438	0.827189961	0.504183499	0.878991667	0	1.703162411	0	0.037293677	0.102970591	2.295109742	6.287966724	1.099877053	0.447773174	1.740342605	0	2.33034839	1.219952165	0	0	0.47017253	0	0.271002222	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.5408
H8742_009_0	2008	5																					3250											D	D	D	Coin	P	Coin	Coin	V	Coin	Coin	Coin	V	Coin	V	P	P	P	P	Coin	Coin	Coin	P	P	P	P																																																										0		1278.222616	49.28203812	781.963367	6.81523096	100.3566213	3.549468034	4.750204244	198.5356924	51.9607456	14.09885773	15.83078197		0.091702456	85.86424273	3171.723894	3550.567788	343.0681872	411.4194549	19.98811209		13.38221127	808.7430665																				1a (IP Acute) - $300 days 1-7	1b (IP Psych) - $300 days 1-7	2 (SNF) - $100 days 6-100	6a: (Home Health) - 20%	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%, 11c (Diab Supp) - 10%"	"4a (ER) $50, 4b (UC) - $25"	"9a (OP Surgery) - 20%, 9b (ASC) - 15%"	8a (OP Diag Proc/Test/Lab) - 10%	"8b (Therap Rad) - 20%; (PET) - 20%; (CT Scan), (MRI) - 20%"		12 (Renal Dialysis) - 20%	"3 (CORF)-$25, 7i, 7c (OP PT/ST/OT) - $25, 9c (OP SA) - $15, 9d (Cardiac Rehab) - $25"	"14g (Bone Mass) 14b (Immunizations), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) - $0; 14i (Diab Mon.) - $25; 7a (PCP)- $5"	"7b (Chiro), 7d (Spec), 7f (Pod) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"	8b: 20%		15 (Part B Rx) - 20%	13a (Blood) - 20%; 17a (MCR Eye Exam) - $25; 17b (MCR Eyewear) - $0; 18a (MCR Hearing Exam) - $25; 14j (Nutrition Therap) - $25																				167.2631	167.2631	61.1599	0.154444255	77.2221	0.154444255	0.140352351	34.737	0.15053131	0.077222127	0.154444255		0.154444255	18.8912	3.9028	19.3055	19.3055	19.3055	0.154444255		0.154444255	20.877																				17.8166	0.686922321	3.985401736	1.052573268	0.64581265	0.548194946	0.666702332	0.574711371	7.821719129	1.088743788	2.444973326	0	0.014162917	0.135172952	1.031549423	5.712133297	0.551926152	0.661889283	3.087049078	0	2.066805648	1.407011378	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.0001	0	15.33823606	17.8166	0.686922321	3.985401736	1.052573268	0.64581265	0.548194946	0.666702332	0.574711371	7.821719129	1.088743788	2.444973326	0	0.014162917	0.135172952	1.031549423	5.712133297	0.551926152	0.661889283	3.087049078	0	2.066805648	1.407011378	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.0001																																																																																				0	0	0	17.8166	0.686922321	3.985401736	1.052573268	0.64581265	0.548194946	0.666702332	0.574711371	7.821719129	1.088743788	2.444973326	0	0.014162917	0.135172952	1.031549423	5.712133297	0.551926152	0.661889283	3.087049078	0	2.066805648	1.407011378	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.0001
H8742_801_0	2008	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P																																																										0		217.2599623	4.499620284	27.84827806		3.024550796	3.549468034	4.750204244	8.92690977	51.9607456	14.09885773	19.56109164	6.967424369	0.091702456	29.37411358	36.50720447	79.04938426	2.526452638	4.19536217	19.98811209		13.38221127	7.230739645																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.077439635	0.077439635	0.176545243		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234																				16.8245	0.348448953	4.916481015	0	0.707744886	0.83057552	1.111547793	2.088896886	12.15881447	3.299132709	4.577295443	1.630377302	0.021458375	6.873542578	8.542685846	18.49755592	0.591189917	0.981714748	4.677218228	0	3.131437436	1.691993077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5026	0	0	16.8245	0.348448953	4.916481015	0	0.707744886	0.83057552	1.111547793	2.088896886	12.15881447	3.299132709	4.577295443	1.630377302	0.021458375	6.873542578	8.542685846	18.49755592	0.591189917	0.981714748	4.677218228	0	3.131437436	1.691993077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5026																																																																																				0	0	0	16.8245	0.348448953	4.916481015	0	0.707744886	0.83057552	1.111547793	2.088896886	12.15881447	3.299132709	4.577295443	1.630377302	0.021458375	6.873542578	8.542685846	18.49755592	0.591189917	0.981714748	4.677218228	0	3.131437436	1.691993077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5026
H8742_802_0	2008	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P																																																										0		217.2599623	4.499620284	27.84827806		3.024550796	3.549468034	4.750204244	8.92690977	51.9607456	14.09885773	19.56109164	6.967424369	0.091702456	29.37411358	36.50720447	79.04938426	2.526452638	4.19536217	19.98811209		13.38221127	7.230739645																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.077439635	0.077439635	0.176545243		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234																				16.8245	0.348448953	4.916481015	0	0.707744886	0.83057552	1.111547793	2.088896886	12.15881447	3.299132709	4.577295443	1.630377302	0.021458375	6.873542578	8.542685846	18.49755592	0.591189917	0.981714748	4.677218228	0	3.131437436	1.691993077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5026	0	0	16.8245	0.348448953	4.916481015	0	0.707744886	0.83057552	1.111547793	2.088896886	12.15881447	3.299132709	4.577295443	1.630377302	0.021458375	6.873542578	8.542685846	18.49755592	0.591189917	0.981714748	4.677218228	0	3.131437436	1.691993077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5026																																																																																				0	0	0	16.8245	0.348448953	4.916481015	0	0.707744886	0.83057552	1.111547793	2.088896886	12.15881447	3.299132709	4.577295443	1.630377302	0.021458375	6.873542578	8.542685846	18.49755592	0.591189917	0.981714748	4.677218228	0	3.131437436	1.691993077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5026
H8742_803_0	2008	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P																																																										0		217.2599623	4.499620284	27.84827806		3.024550796	3.549468034	4.750204244	8.92690977	51.9607456	14.09885773	19.56109164	6.967424369	0.091702456	29.37411358	36.50720447	79.04938426	2.526452638	4.19536217	19.98811209		13.38221127	7.230739645																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.077439635	0.077439635	0.176545243		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234		0.234	0.234																				16.8245	0.348448953	4.916481015	0	0.707744886	0.83057552	1.111547793	2.088896886	12.15881447	3.299132709	4.577295443	1.630377302	0.021458375	6.873542578	8.542685846	18.49755592	0.591189917	0.981714748	4.677218228	0	3.131437436	1.691993077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5026	0	0	16.8245	0.348448953	4.916481015	0	0.707744886	0.83057552	1.111547793	2.088896886	12.15881447	3.299132709	4.577295443	1.630377302	0.021458375	6.873542578	8.542685846	18.49755592	0.591189917	0.981714748	4.677218228	0	3.131437436	1.691993077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5026																																																																																				0	0	0	16.8245	0.348448953	4.916481015	0	0.707744886	0.83057552	1.111547793	2.088896886	12.15881447	3.299132709	4.577295443	1.630377302	0.021458375	6.873542578	8.542685846	18.49755592	0.591189917	0.981714748	4.677218228	0	3.131437436	1.691993077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5026
H8778_001_0	2008	4																					2050											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	V	T	V	V	P	V	V	V	V	V																																																				0		1724.772575	55.63049311	1231.092954		175.7973336	14.19192797	13.71396565	313.4635283	367.6548666	3.184420035	39.71068336	2.038416429	0.628119678	23.17208432	4790.37057	3644.036526	162.2860842	382.0914711			21.60543757	807.4916755		600	144		249.0365925															1a: $135 Days 1-10	1b: $150	2: $75 days 21-100	6: $0	10a: $75	11a: 20%	"11b, 11c: 20%"	"4a, 4b: $50"	9b: $125	8a: 0%-20%	8b: 20% / $15	9a:  20%	12:  20%	9a: 20%; 9c: $25/$35; 9d: $25	"7a, 14c: $5"	"7b, 7f: $20; 7d: $25"	"7e, 7h: $25/$35"	"7c, 7i: $25"	$0 (incl in i.2.)	7g: $0	15: 20%	17a: $20	10b: $0	16a: $20	17a1: $20	17b1: $0	18a: $20	18b: $0		14a:  $0												69.003	93.6512	13.6005		47.0243	0.125398018	0.125398018	31.3495	78.3738	0.125398018	0.125929373	0.125398018	0.125398018	0.128284372	5	24.3572	18.8097	15.6748			0.125398018	20		20	20		12.5398															9.9179	0.434155274	1.395288914	0	0.688894911	1.779639634	1.719704107	0.818910522	2.401207888	0.39931996	5.000741437	0.255613379	0.078764962	2.972616278	1.995987738	7.396531239	0.254379416	0.499099094	0	0	2.709279041	1.345819459	0	1	0.24	0	0.260239125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5641	0	18.79103352	9.9179	0.434155274	1.395288914	0	0.688894911	1.779639634	1.719704107	0.818910522	2.401207888	0.39931996	5.000741437	0.255613379	0.078764962	2.972616278	1.995987738	7.396531239	0.254379416	0.499099094	0	0	2.709279041	1.345819459	0	1	0.24	0	0.260239125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5641																																																																																				0	0	0	9.9179	0.434155274	1.395288914	0	0.688894911	1.779639634	1.719704107	0.818910522	2.401207888	0.39931996	5.000741437	0.255613379	0.078764962	2.972616278	1.995987738	7.396531239	0.254379416	0.499099094	0	0	2.709279041	1.345819459	0	1	0.24	0	0.260239125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5641
H8778_801_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																				0		263.2763521	2.289445561	41.9106374		9.437954074	14.90152437	14.39966394	16.29142548	50.71399019	18.37259927	45.03985856	2.14033725	0.659525662	24.80104865	54.2407319	96.71348168	0.952742874	3.390347159			22.68570945	8.228860637																				Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing											0.080194376	0.080194376	0.212437373		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234			0.234	0.234																				21.1133	0.183600659	8.903385711	0	2.208481253	3.486956702	3.369521361	3.812193561	11.8670737	4.299188229	10.5393269	0.500838917	0.154329005	5.803445385	12.69233126	22.63095471	0.222941833	0.793341235	0	0	5.308456011	1.925553389	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.8152	0	0	21.1133	0.183600659	8.903385711	0	2.208481253	3.486956702	3.369521361	3.812193561	11.8670737	4.299188229	10.5393269	0.500838917	0.154329005	5.803445385	12.69233126	22.63095471	0.222941833	0.793341235	0	0	5.308456011	1.925553389	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.8152																																																																																				0	0	0	21.1133	0.183600659	8.903385711	0	2.208481253	3.486956702	3.369521361	3.812193561	11.8670737	4.299188229	10.5393269	0.500838917	0.154329005	5.803445385	12.69233126	22.63095471	0.222941833	0.793341235	0	0	5.308456011	1.925553389	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.8152
H8836_001_0	2008	13																					5000											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	V	Coin	Coin		V	V	V	V	V			V																																																				0		892.5940993	12.98389613	157.5543222	23.46850899	164.2962251	0.781573917	16.49133844	280.6916915	52.66531665	18.7404745	2.261781405	0.329928056	0.103478272	0	7848.471185	8877.55787	1.232712843	14.04133283	0	0	4.280932767	0.52602956		0																		$175 day for 1st 5 days	$175 day for 1st 5 days	$50 day for days 11+	15% Coinsurance	$150 Copay	20% Coinsurance	20% Coinsurance	$50 per visit	15% Coinsurance	15% Coinsurance	15% Coinsurance	50% Coinsurance	15% Coinsurance	50% Coinsurance	$15 Per Visit	$35 Per Visit	50% Coinsurance	15% Coinsurance	15% Coinsurance	$35 Per Visit	20% Coinsurance	15% Coinsurance		$0 per visit																		175	175	50	0.15	150	0.2	0.2	50	0.15	0.15	0.15	0.5	0.15	0.5	15	35	0.5	0.15	0.15	0.35	0.2	0.15		0																		13.017	0.189348485	0.656476343	3.520276348	2.053702814	0.156314783	3.298267688	1.169548715	7.899797498	2.811071175	0.339267211	0.164964028	0.015521741	0	9.810588981	25.89287712	0.616356421	2.106199924	0	0	0.856186553	0.078904434	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6527		20.38497158	13.017	0.189348485	0.656476343	3.520276348	2.053702814	0.156314783	3.298267688	1.169548715	7.899797498	2.811071175	0.339267211	0.164964028	0.015521741	0	9.810588981	25.89287712	0.616356421	2.106199924	0	0	0.856186553	0.078904434	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6527																																																																																				0			13.017	0.189348485	0.656476343	3.520276348	2.053702814	0.156314783	3.298267688	1.169548715	7.899797498	2.811071175	0.339267211	0.164964028	0.015521741	0	9.810588981	25.89287712	0.616356421	2.106199924	0	0	0.856186553	0.078904434	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6527
H8836_002_0	2008	5																					5000											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	V	Coin	Coin																																																													0		938.3920642	13.65008473	165.546929	24.66309144	172.7260733	0.821233447	17.32816106	292.9839494	55.3377212	19.69142538	2.376551339	0.346669648	0.108729086	0	8246.587854	9327.87535	1.295242668	14.75358474	0	0	4.500582448	0.552721962																				$125 day for 1st 5 days	$125 day for 1st 5 days	$40 day for days 11+	10% Coinsurance	$100 Copay	20% Coinsurance	20% Coinsurance	$50 per visit	15% Coinsurance	10% Coinsurance	10% Coinsurance	50% Coinsurance	10% Coinsurance	50% Coinsurance	$15 Per Visit	$30 Per Visit	50% Coinsurance	10% Coinsurance	10% Coinsurance	$30 Per Visit	20% Coinsurance	10% Coinsurance																				125	125	40	0.1	100	0.2	0.2	50	0.1	0.1	0.1	0.5	0.1	0.5	15	30	0.5	0.1	0.1	0.3	0.2	0.1																				9.7749	0.142188383	0.551823097	2.466309144	1.439383944	0.164246689	3.465632211	1.220766456	5.53377212	1.969142538	0.237655134	0.173334824	0.010872909	0	10.30823482	23.31968838	0.647621334	1.475358474	0	0	0.90011649	0.055272196	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8563		14.24425223	9.7749	0.142188383	0.551823097	2.466309144	1.439383944	0.164246689	3.465632211	1.220766456	5.53377212	1.969142538	0.237655134	0.173334824	0.010872909	0	10.30823482	23.31968838	0.647621334	1.475358474	0	0	0.90011649	0.055272196	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8563																																																																																				0			9.7749	0.142188383	0.551823097	2.466309144	1.439383944	0.164246689	3.465632211	1.220766456	5.53377212	1.969142538	0.237655134	0.173334824	0.010872909	0	10.30823482	23.31968838	0.647621334	1.475358474	0	0	0.90011649	0.055272196	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8563
H8991_011_0	2008	5																					0											Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	479.34125	31.55145	100.87	0	45.77	79.06	59.45	15.54	31.68	29.98	51.66	1.71	2.02	96.48	111.08	199.36	13.16	9.86	54.9	95.4	16.36	7.53	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Medicare FFS cost sharing	1B IP Psych: Medicare FFS cost sharing	2 SNF: Medicare FFS cost sharing	6 Home Health: $0	10A Ambulance: Medicare FFS cost sharing	11A DME: Medicare FFS cost sharing	"11B Prosthetic/Medical Supplies: Medicare FFS cost sharing, 11C Diabetes Monitoring Supplies: Medicare FFS cost sharing"	"4A ER: Medicare FFS cost sharing, 4B Urgent Care: Medicare FFS cost sharing"	9B ASC Services: Medicare FFS cost sharing	8A OP C/D/T: Medicare FFS cost sharing	8B OP X-Ray: Medicare FFS cost sharing	9A OP Hospital: Medicare FFS cost sharing	12 Renal Dialysis: Medicare FFS cost sharing	"3 CORF: Medicare FFS cost sharing, 5 Partial Hosp: Medicare FFS cost sharing, 9C OP Substance Abuse: Medicare FFS cost sharing, 9D Cardiac Rehab: Medicare FFS cost sharing"	"7A PCP: Medicare FFS cost sharing, 14B Immunizations: Medicare FFS cost sharing, 14C Routine Physical Exams: Medicare FFS cost sharing, 14D Pap Smears: Medicare FFS cost sharing, 14D Pelvic Exams: Medicare FFS cost sharing, 14E Prostate Screening: Medicare FFS cost sharing, 14F Colorectal Screening: Medicare FFS cost sharing, 14G Bone Mass Measurement: Medicare FFS cost sharing, 14H Mammography: Medicare FFS cost sharing, 14I Diabetes Monitoring: Medicare FFS cost sharing"	"7D Physician Specialist: Medicare FFS cost sharing,"	"7E Mental Health: Medicare FFS cost sharing, 7H Psychiatric: Medicare FFS cost sharing"	"7C Occupational Therapy: Medicare FFS cost sharing, 7I Physical and Speech Therapy: Medicare FFS cost sharing"	7D Physician Specialist: Medicare FFS cost sharing	"7B Chiropractic: Medicare FFS cost sharing, 7F Podiatry: Medicare FFS cost sharing, 7G Other Health Care: Medicare FFS cost sharing, 18A Medicare Covered Hearing Exams: Medicare FFS cost sharing"	15 Part B Drugs: Medicare FFS cost sharing	"13A Blood: Medicare FFS cost sharing, 16B Medicare Covered Comprehensive Dental Services: Medicare FFS cost sharing, 17A Medicare Covered Eye Exams: Medicare FFS cost sharing"	10B Transportation: $0	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental:$0"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.072789091	0.072782905	0.186719102	0	0.234009577	0.234016357	0.234006803	0.233933451	0.23399707	0.234032827	0.234001169	0.234005663	0.233999538	0.234007619	0.23249352	0.234028524	0.233978036	0.234044322	0.234002208	0.228259387	0.233999924	0.234034488	0	0	0	0	0	0	0	0	0											34.8908	2.296406179	18.83435578	0	10.71061835	18.50133315	13.91170442	3.635325825	7.413027183	7.016304167	12.08850038	0.400149683	0.472679067	22.57705508	25.82538017	46.6559266	3.079150958	2.307677017	12.84672123	21.77594548	3.82823875	1.762279692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	270.8296	0	0	34.8908	2.296406179	18.83435578	0	10.71061835	18.50133315	13.91170442	3.635325825	7.413027183	7.016304167	12.08850038	0.400149683	0.472679067	22.57705508	25.82538017	46.6559266	3.079150958	2.307677017	12.84672123	21.77594548	3.82823875	1.762279692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	270.8296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	34.8908	2.296406179	18.83435578	0	10.71061835	18.50133315	13.91170442	3.635325825	7.413027183	7.016304167	12.08850038	0.400149683	0.472679067	22.57705508	25.82538017	46.6559266	3.079150958	2.307677017	12.84672123	21.77594548	3.82823875	1.762279692	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	270.8296
H8991_012_0	2008	6																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	986.531	15.672	647.4592	0	495.74	39.59	24.26	324.68	301.59	0	1255.81	37.67	0.59	729.73	0	11142.87	231.93	1036.97	3773.42	3303.01	382.6	1202.78	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute:   $50   for 1st 10   Days	1B IP Psych:   $50   for 1st 10   Days	2 SNF:   $60   for Days 7   - 100	6 Home Health:   $0	10A Ambulance:     $100	11A DME:     20%	"11B Prosthetic Medical Supplies:      20%,  11C Diabetes Monitoring Supplies:     20%"	"4A ER:     $50,  4B Urgent Care:     $25"	9B ASC Services:     $75	8A OP Clinical/Diagnostic/Therapy Radiological Lab Services:      $0	8B OP X-Ray:     $22.1	"5 Partial Hospitalization:     $75,  9A OP Hospital,  $75"	12 Renal Dialysis:      $10	"3 CORF ,  75,  9D Cardiac Rehab:     $10"	"7A PCP:     $0,  14B Immunizations:     $0,  14C Routine Physical Exams:     $0,  14D Pap Smears:      $,  14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement:      $19.25,  14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist:     $10	"7E Mental Health:     $10,  7H Psychiatric:     $10,  9C OP Substance Abuse,  10"	"7C Occupational Therapy:     $10,  7I Physical and Speech Therapy:     $10"	7D Physician Specialist Services - Radiology:   19.25	"7G Other Health Care:     $10,  18A Medicare Covered Hearing Exams:   $10,  7B Chiropractic:     $10,  7F Podiatry:     $10"	15 Part B Drugs:     $75	"13A Blood:     $75,  16B Medicare Covered Comprehensive Dental Services:     $10,  17A Medicare Covered Eye Exams:   $10"	"10B Transportation:     $0,  Number of Trips Covered - 12"	"16A Preventive Dental Services:   $0,  16B Non Medicare Covered Comprehensive Dental:   $0"	17A Routine Eye Exams:    $0	17B Eye Wear: $0	18A Routine Hearing Exams:   $0	18B Hearing Aids:   $0	19 POS:   $0	14A Health Education/Wellness Programs:   $0	13B Acupuncture: Not Covered											50	50	60	0	100	0.200016519	0.198317461	47.91948996	75	0	22.1	75	10	75	0	10	10	10	19.25	10	75	10.8781739	0	0	0	0	0	0	0	0	0											4.1105	0.0653	3.237296	0	4.131166667	7.918654	4.8111816	1.296541667	1.8849375	0	2.312783417	0.2354375	0.000491667	4.5608125	0	9.285725	0.193275	0.864141667	6.053194583	2.752508333	2.39125	1.0903375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1956	0	0	4.1105	0.0653	3.237296	0	4.131166667	7.918654	4.8111816	1.296541667	1.8849375	0	2.312783417	0.2354375	0.000491667	4.5608125	0	9.285725	0.193275	0.864141667	6.053194583	2.752508333	2.39125	1.0903375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1956	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.1105	0.0653	3.237296	0	4.131166667	7.918654	4.8111816	1.296541667	1.8849375	0	2.312783417	0.2354375	0.000491667	4.5608125	0	9.285725	0.193275	0.864141667	6.053194583	2.752508333	2.39125	1.0903375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1956
H8991_013_0	2008	5																					3250											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											16.5315	0.1275	2.1125	3.3029	0	1.9536	1.1995	0	2.3866	1.14	3.1171	0.0791	0.0105	1.898	0	0	0	0	0	0	0.8489	0.0621	0	0	0	0	0	0	0	0	0											34.77	0	0	0	0	0	424.09	0	0	317.57	0	0	0	0	0	362.84	0	11492.96	230.28	1067.51	562.9	3436.9	0	1249.06	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute:   $0	1B IP Psych:   $0	2 SNF:   $0	6 Home Health:   $0	10A Ambulance:     $100	11A DME:     $0	"11B Prosthetic Medical Supplies:      $0,11C Diabetes Monitoring Supplies:     $0"	"4A ER:     $50,4B Urgent Care:     $25"	9B ASC Services:     $0	8A OP Clinical/Diagnostic/Therapy Radiological Lab Services:      $0	8B OP X-Ray:     $0	"9A OP Hospital,  $0,  5 Partial Hosp:     $0"	12 Renal Dialysis:      $0	"3 CORF:,  $0,   9D Cardiac Rehab:     $5"	"7A PCP:     $0,  14B Immunizations:     $0,  14C Routine Physical Exams:     $0,  14D Pap Smears:      $,  14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement:75,   14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist:     $5	"7E Mental Health:     $5,  7H Psychiatric:     $5,     9C OP Substance Abuse: $5"	"7C Occupational Therapy:     $5,  7I Physical and Speech Therapy:     $5"	7D Physician Specialist Services - Radiology:   $75	"7G Other Health Care:     $5,  18A Medicare Covered Hearing Exams:   $5,  7B Chiropractic:     $5,  7F Podiatry:     $5"	15 Part B Drugs:     $0	"13A Blood:     $0,  16B Medicare Covered Comprehensive Dental Services:     $5,  17A Medicare Covered Eye Exams:   $5"	"10B Transportation:     $0,  Number of Trips Covered - 12"	"16A Preventive Dental Services:   $0,  16B Non Medicare Covered Comprehensive Dental:    $0"	17A Routine Eye Exams:    $0	17B Eye Wear:    $0	18A Routine Hearing Exams:   $0	18B Hearing Aids:   $0	19 POS:   $0	14A Health Education/Wellness Programs:   $0	13B Acupuncture: Not Covered											0	0	0	0	100	0	0	47.78316592	0	0	0	0	0	5	0	5	5	5	75	5	0	5	0	0	0	0	0	0	0	0	0											0	0	0	0	3.534083333	0	0	1.264541667	0	0	0	0	0	0.151183333	0	4.788733333	0.09595	0.444795833	3.518125	1.432041667	0	0.520441667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.7499	1100	0	16.5315	0.127537527	2.112544675	3.302894925	3.534083333	1.953613295	1.199506791	1.264541667	2.386586848	1.139989278	3.117147963	0.07913867	0.010464618	2.049203348	0	4.788733333	0.09595	0.444795833	3.518125	1.432041667	0.848942102	0.582575334	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5199	3250	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.5315	0.127537527	2.112544675	3.302894925	3.534083333	1.953613295	1.199506791	1.264541667	2.386586848	1.139989278	3.117147963	0.07913867	0.010464618	2.049203348	0	4.788733333	0.09595	0.444795833	3.518125	1.432041667	0.848942102	0.582575334	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5199
H8991_017_0	2008	4																					0											Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	354.22995	24.96455	132.54	0	25.48	44.03	33.11	10.15	20.34	16.81	28.97	0.96	1.13	54.1	74.76	138.57	9.28	5.22	36.87	51.7	9.17	4.87	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Medicare FFS cost sharing	1B IP Psych: Medicare FFS cost sharing	2 SNF: Medicare FFS cost sharing	6 Home Health: $0	10A Ambulance: Medicare FFS cost sharing	11A DME: Medicare FFS cost sharing	"11B Prosthetic/Medical Supplies: Medicare FFS cost sharing, 11C Diabetes Monitoring Supplies: Medicare FFS cost sharing"	"4A ER: Medicare FFS cost sharing, 4B Urgent Care: Medicare FFS cost sharing"	9B ASC Services: Medicare FFS cost sharing	8A OP C/D/T: Medicare FFS cost sharing	8B OP X-Ray: Medicare FFS cost sharing	9A OP Hospital: Medicare FFS cost sharing	12 Renal Dialysis: Medicare FFS cost sharing	"3 CORF: Medicare FFS cost sharing, 5 Partial Hosp: Medicare FFS cost sharing, 9C OP Substance Abuse: Medicare FFS cost sharing, 9D Cardiac Rehab: Medicare FFS cost sharing"	"7A PCP: Medicare FFS cost sharing, 14B Immunizations: Medicare FFS cost sharing, 14C Routine Physical Exams: Medicare FFS cost sharing, 14D Pap Smears: Medicare FFS cost sharing, 14D Pelvic Exams: Medicare FFS cost sharing, 14E Prostate Screening: Medicare FFS cost sharing, 14F Colorectal Screening: Medicare FFS cost sharing, 14G Bone Mass Measurement: Medicare FFS cost sharing, 14H Mammography: Medicare FFS cost sharing, 14I Diabetes Monitoring: Medicare FFS cost sharing"	"7D Physician Specialist: Medicare FFS cost sharing,"	"7E Mental Health: Medicare FFS cost sharing, 7H Psychiatric: Medicare FFS cost sharing"	"7C Occupational Therapy: Medicare FFS cost sharing, 7I Physical and Speech Therapy: Medicare FFS cost sharing"	7D Physician Specialist: Medicare FFS cost sharing	"7B Chiropractic: Medicare FFS cost sharing, 7F Podiatry: Medicare FFS cost sharing, 7G Other Health Care: Medicare FFS cost sharing, 18A Medicare Covered Hearing Exams: Medicare FFS cost sharing"	15 Part B Drugs: Medicare FFS cost sharing	"13A Blood: Medicare FFS cost sharing, 16B Medicare Covered Comprehensive Dental Services: Medicare FFS cost sharing, 17A Medicare Covered Eye Exams: Medicare FFS cost sharing"	10B Transportation: $0	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental:$0"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.087175814	0.087160892	0.188092677	0	0.23397139	0.233977954	0.23397724	0.233899122	0.234002557	0.233986224	0.233959343	0.233983681	0.234	0.233996025	0.232495957	0.233968215	0.233923348	0.233878102	0.23402019	0.228356528	0.23396916	0.233938872	0	0	0	0	0	0	0	0	0											30.8803	2.175932441	24.92980335	0	5.961591008	10.30204933	7.746986411	2.374076083	4.759612	3.933308433	6.777802167	0.224624333	0.26442	12.65918493	17.38139771	32.42097558	2.170808667	1.220843692	8.6283244	11.80603248	2.1454972	1.139282308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	189.9028	0	0	30.8803	2.175932441	24.92980335	0	5.961591008	10.30204933	7.746986411	2.374076083	4.759612	3.933308433	6.777802167	0.224624333	0.26442	12.65918493	17.38139771	32.42097558	2.170808667	1.220843692	8.6283244	11.80603248	2.1454972	1.139282308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	189.9028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.8803	2.175932441	24.92980335	0	5.961591008	10.30204933	7.746986411	2.374076083	4.759612	3.933308433	6.777802167	0.224624333	0.26442	12.65918493	17.38139771	32.42097558	2.170808667	1.220843692	8.6283244	11.80603248	2.1454972	1.139282308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	189.9028
H8991_018_0	2008	5																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	631.92	8.65	784.5024	0	304.01	19.75	12.04	275	258.28	0	928.4	26.69	0.41	522.32	6856.42	7809.31	179.21	649.74	2806.26	2154.53	274.9	895.92	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute:   $150   for 1st 5   Days	1B IP Psych:   $150   for 1st 5   Days	2 SNF:   $85   for Days 7   - 100	6 Home Health:   $0	10A Ambulance:     $100	11A DME:     20%	"11B Prosthetic Medical Supplies:      20%,  11C Diabetes Monitoring Supplies:     20%"	"4A ER:     $50,  4B Urgent Care:     $35"	9B ASC Services:     $100	8A OP Clinical/Diagnostic/Therapy Radiological Lab Services:      $0	8B OP X-Ray:     $22.1	"5 Partial Hospitalization:     $100,  9A OP Hospital,  $100"	12 Renal Dialysis:      $30	"3 CORF ,  100,  9D Cardiac Rehab:     $30"	"7A PCP:     $5,  14B Immunizations:     $0,  14C Routine Physical Exams:     $0,  14D Pap Smears:      $,  14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement:      $19.25,  14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist:     $30	"7E Mental Health:     $30,  7H Psychiatric:     $30,  9C OP Substance Abuse,  30"	"7C Occupational Therapy:     $30,  7I Physical and Speech Therapy:     $30"	7D Physician Specialist Services - Radiology:   19.25	"7G Other Health Care:     $30,  18A Medicare Covered Hearing Exams:   $30,  7B Chiropractic:     $30,  7F Podiatry:     $30"	15 Part B Drugs:     $100	"13A Blood:     $100,  16B Medicare Covered Dental Services:     $30,  17A Medicare Covered Eye Exams:   $30"	10B Transportation:     Not Covered	"16A Preventive Dental Services:   $0,  16B Non Medicare Covered Comprehensive Dental:   $0"	17A Routine Eye Exams:    $0	17B Eye Wear: $0	18A Routine Hearing Exams:   $0	18B Hearing Aids:   $0	19 POS:   $0	14A Health Education/Wellness Programs:   $0	13B Acupuncture: Not Covered											150	150	85	0	100	0.20001307	0.199573831	48.902	100	0	22.1	100	30	100	5	30	30	30	19.25	30	100	30.91180016	0	0	0	0	0	0	0	0	0											7.899	0.108125	5.556892	0	2.533416667	3.950258125	2.402868925	1.120670833	2.152333333	0	1.709803333	0.222416667	0.001025	4.352666667	2.856841667	19.523275	0.448025	1.62435	4.50170875	5.386325	2.290833333	2.307875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.9487	0	0	7.899	0.108125	5.556892	0	2.533416667	3.950258125	2.402868925	1.120670833	2.152333333	0	1.709803333	0.222416667	0.001025	4.352666667	2.856841667	19.523275	0.448025	1.62435	4.50170875	5.386325	2.290833333	2.307875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.9487	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.899	0.108125	5.556892	0	2.533416667	3.950258125	2.402868925	1.120670833	2.152333333	0	1.709803333	0.222416667	0.001025	4.352666667	2.856841667	19.523275	0.448025	1.62435	4.50170875	5.386325	2.290833333	2.307875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.9487
H8991_019_0	2008	6																					3250											D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											22.5618	0.185	4.3018	4.3932	0	2.1086	1.285	0	2.9333	1.2613	3.4275	0.0824	0.0113	2.0308	0	0	0	0	0	0	0.9014	0.0666	0	0	0	0	0	0	0	0	0											45.55	0	0	0	0	0	306.02	0	0	276.61	0	0	0	0	0	266.58	0	8041.42	179.71	654.05	430.16	2168.81	0	890.11	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute:   $0	1B IP Psych:   $0	2 SNF:   $0	6 Home Health:   $0	10A Ambulance:     $100	11A DME:     $0	"11B Prosthetic Medical Supplies:      $0,11C Diabetes Monitoring Supplies:     $0"	"4A ER:     $50,4B Urgent Care:     $35"	9B ASC Services:     $0	8A OP Clinical/Diagnostic/Therapy Radiological Lab Services:      $0	8B OP X-Ray:     $0	"9A OP Hospital,  $0,  5 Partial Hosp:     $0"	12 Renal Dialysis:      $0	"3 CORF:,  $0,   9D Cardiac Rehab:     $25"	"7A PCP:     $0,  14B Immunizations:     $0,  14C Routine Physical Exams:     $0,  14D Pap Smears:      $,  14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement:75,   14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist:     $25	"7E Mental Health:     $25,  7H Psychiatric:     $25,     9C OP Substance Abuse: $25"	"7C Occupational Therapy:     $25,  7I Physical and Speech Therapy:     $25"	7D Physician Specialist Services - Radiology:   $75	"7G Other Health Care:     $25,  18A Medicare Covered Hearing Exams:   $25,  7B Chiropractic:     $25,  7F Podiatry:     $25"	15 Part B Drugs:     $0	"13A Blood:     $0,  16B Medicare Covered Comprehensive Dental Services:     $25,  17A Medicare Covered Eye Exams:   $25"	"10B Transportation:     $0,  Number of Trips Covered - 12"	"16A Preventive Dental Services:   $0,  16B Non Medicare Covered Comprehensive Dental:   NotCovered"	17A Routine Eye Exams:    $0	17B Eye Wear:    $0	18A Routine Hearing Exams:   $0	18B Hearing Aids:   $0	19 POS:   $0	14A Health Education/Wellness Programs:   $0	13B Acupuncture: Not Covered											0	0	0	0	100	0	0	48.86555078	0	0	0	0	0	25	0	25	25	25	75	25	0	25	0	0	0	0	0	0	0	0	0											0	0	0	0	2.550166667	0	0	1.126391667	0	0	0	0	0	0.555375	0	16.75295833	0.374395833	1.362604167	2.6885	4.518354167	0	1.854395833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.7831	1700	0	22.5618	0.185025016	4.301831624	4.393215931	2.550166667	2.108608263	1.285021301	1.126391667	2.933323426	1.261329073	3.427475603	0.082358696	0.011282013	2.586137372	0	16.75295833	0.374395833	1.362604167	2.6885	4.518354167	0.901432853	1.920959711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.3331	3250	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.5618	0.185025016	4.301831624	4.393215931	2.550166667	2.108608263	1.285021301	1.126391667	2.933323426	1.261329073	3.427475603	0.082358696	0.011282013	2.586137372	0	16.75295833	0.374395833	1.362604167	2.6885	4.518354167	0.901432853	1.920959711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.3331
H8991_022_0	2008	6																					0											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	655.53	8.39	660.1816	0	327.7	21.97	13.5	304.09	280.35	0	1158.5	34.82	0.54	674.17	0	11004.18	208.69	976.6	3595.66	3116.57	353.41	1197.34	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute:   $125   for 1st 5   Days	1B IP Psych:   $125   for 1st 5   Days	2 SNF:   $65   for Days 7   - 100	6 Home Health:   $0	10A Ambulance:     $100	11A DME:     20%	"11B Prosthetic Medical Supplies:      20%,  11C Diabetes Monitoring Supplies:     20%"	"4A ER:     $50,  4B Urgent Care:     $25"	9B ASC Services:     $75	8A OP Clinical/Diagnostic/Therapy Radiological Lab Services:      $0	8B OP X-Ray:     $8.6	"5 Partial Hospitalization:     $75,  9A OP Hospital,  $75"	12 Renal Dialysis:      $15	"3 CORF ,  75,  9D Cardiac Rehab:     $15"	"7A PCP:     $0,  14B Immunizations:     $0,  14C Routine Physical Exams:     $0,  14D Pap Smears:      $,  14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement:      $8,  14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist:     $15	"7E Mental Health:     $15,  7H Psychiatric:     $15,  9C OP Substance Abuse,  15"	"7C Occupational Therapy:     $15,  7I Physical and Speech Therapy:     $15"	7D Physician Specialist Services - Radiology:   8	"7G Other Health Care:     $15,  18A Medicare Covered Hearing Exams:   $15,  7B Chiropractic:     $15,  7F Podiatry:     $15"	15 Part B Drugs:     $75	"13A Blood:     $75,  16B Medicare Covered Comprehensive Dental Services:     $15,  17A Medicare Covered Eye Exams:   $15"	"10B Transportation:     $0,  Number of Trips Covered - 12"	"16A Preventive Dental Services:   $0,  16B Non Medicare Covered Comprehensive Dental:   $0"	17A Routine Eye Exams:    $0	17B Eye Wear: $0	18A Routine Hearing Exams:   $0	18B Hearing Aids:   $0	19 POS:   $0	14A Health Education/Wellness Programs:   $0	13B Acupuncture: Not Covered											125	125	65	0	100	0.200001462	0.202059795	47.76217567	75	0	8.6	75	15	75	0	15	15	15	8	15	75	15.75166619	0	0	0	0	0	0	0	0	0											6.8284	0.087395833	3.575983667	0	2.730833333	4.394032125	2.727807233	1.210333333	1.7521875	0	0.830258333	0.217625	0.000675	4.2135625	0	13.755225	0.2608625	1.22075	2.397106667	3.8957125	2.2088125	1.571675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8793	0	0	6.8284	0.087395833	3.575983667	0	2.730833333	4.394032125	2.727807233	1.210333333	1.7521875	0	0.830258333	0.217625	0.000675	4.2135625	0	13.755225	0.2608625	1.22075	2.397106667	3.8957125	2.2088125	1.571675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8793	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.8284	0.087395833	3.575983667	0	2.730833333	4.394032125	2.727807233	1.210333333	1.7521875	0	0.830258333	0.217625	0.000675	4.2135625	0	13.755225	0.2608625	1.22075	2.397106667	3.8957125	2.2088125	1.571675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8793
H9001_001_0	2008	5																					3250											A	A	A	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	O	V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	241.1662749	3.295183944	81.60048946	0	348.5814284	0	0	1060.960484	545.5749766	0	1446.118342	82.0551333	0	0	5249.772601	2393.666575	242.7062617	491.9002893	0	1135.039976	375.7710215	0	0	669.835248	4.786056869	0	0	0	0	79.76761448	0											"PBP: 1A IP Acute: $250 per admit, $750 annual OOP Max"	"1B IP Psych: $250 per admit, $750 annual OOP Max"	"2 SNF: $250 per admit, $750 annual OOP Max"	6 Home Health: $0	"10A Ambulance: $50, $200 annual OOP Max"	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $15"	9A OP Hospital and 9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: $50, $150 annual OOP Max"	Included in g.	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $15, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $15"	"7B Chiropractic: $15, 7D Physician Specialist: $15, 7F Podiatry: $15"	"7E Mental Health: $15, 7H Psychiatric: $15, 9C OP Substance Abuse: $15"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7G Other Health Care: $15, 18A Medicare Covered Hearing Exams: $15, 17A Medicare Covered Eye Exams: $15"	15 Part B Drugs: $5-$40	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10-$15"	10B Transportation: Not Covered	"16A Preventive Dental Services: $10, 16B Non-Medicare Covered Comprehensive Dental Services: $10-$49"	17A Routine Eye Exams: $15	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $15	13B Acupuncture: Not Covered											313.425	313.425	251.337	0	49.75	0	0	47.4801863	74.625	0	49.75	74.625	0	0	14.67645158	14.925	14.925	14.925	0	14.925	11.00575804	0	0	15.00590911	14.925	0	0	0	0	14.925	0											6.299	0.086066086	1.709101852	0	1.445160505	0	0	4.197883452	3.392794386	0	5.995365627	0.51028036	0	0	6.420669449	2.977122803	0.301865913	0.611800985	0	1.41170597	0.344637078	0	0	0.837623904	0.005952658	0	0	0	0	0.099210971	0	0	0	0	0	0	0	0	0	0	0	36.6462	0	0.183656553	6.299	0.086066086	1.709101852	0	1.445160505	0	0	4.197883452	3.392794386	0	5.995365627	0.51028036	0	0	6.420669449	2.977122803	0.301865913	0.611800985	0	1.41170597	0.344637078	0	0	0.837623904	0.005952658	0	0	0	0	0.099210971	0	0	0	0	0	0	0	0	0	0	0	36.6462	0																																																																																			0	0	0	6.299	0.086066086	1.709101852	0	1.445160505	0	0	4.197883452	3.392794386	0	5.995365627	0.51028036	0	0	6.420669449	2.977122803	0.301865913	0.611800985	0	1.41170597	0.344637078	0	0	0.837623904	0.005952658	0	0	0	0	0.099210971	0	0	0	0	0	0	0	0	0	0	0	36.6462
H9001_006_0	2008	5																					3250											A	A	A	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	O	V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	293.0983912	6.207320568	102.4207152	0	460.8796057	0	0	1343.946914	547.7842796	0	1744.069253	89.74910251	0	0	5767.756928	2790.271356	329.0169196	671.2737077	0	1294.784899	536.1734676	0	0	883.6065523	3.712112669	0	0	0	0	222.7267601	0											"PBP: 1A IP Acute: $100 per admit, $300 annual OOP Max"	"1B IP Psych: $100 per admit, $300 annual OOP Max"	"2 SNF: $100 per admit, $300 annual OOP Max"	6 Home Health: $0	"10A Ambulance: $50, $200 annual OOP Max"	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $10"	9A OP Hospital and 9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: $50, $150 annual OOP Max"	Included in g.	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $10, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $10"	"7B Chiropractic: $10, 7D Physician Specialist: $10, 7F Podiatry: $10"	"7E Mental Health: $10, 7H Psychiatric: $10, 9C OP Substance Abuse: $10"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	Included in i.2.	"7G Other Health Care: $10, 18A Medicare Covered Hearing Exams: $10, 17A Medicare Covered Eye Exams: $10"	15 Part B Drugs: $5-$40	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10"	10B Transportation: Not Covered	"16A Preventive Dental Services: $10, 16B Non-Medicare Covered Comprehensive Dental Services: $10-$49"	17A Routine Eye Exams: $10	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $10	13B Acupuncture: Not Covered											99.5	99.5	254.123	0	49.75	0	0	47.37534517	49.75	0	49.75	49.75	0	0	9.769839959	9.95	9.95	9.95	0	9.95	10.69875079	0	0	15.00423625	9.95	0	0	0	0	9.95	0											2.4303	0.051469033	2.16895495	0	1.910730032	0	0	5.305829078	2.271022326	0	7.230620446	0.372084821	0	0	4.695838509	2.3136	0.272809862	0.556597783	0	1.073592479	0.478032193	0	0	1.104820122	0.00307796	0	0	0	0	0.184677605	0	0	0	0	0	0	0	0	0	0	0	32.424	0	0.16201299	2.4303	0.051469033	2.16895495	0	1.910730032	0	0	5.305829078	2.271022326	0	7.230620446	0.372084821	0	0	4.695838509	2.3136	0.272809862	0.556597783	0	1.073592479	0.478032193	0	0	1.104820122	0.00307796	0	0	0	0	0.184677605	0	0	0	0	0	0	0	0	0	0	0	32.424	0																																																																																			0	0	0	2.4303	0.051469033	2.16895495	0	1.910730032	0	0	5.305829078	2.271022326	0	7.230620446	0.372084821	0	0	4.695838509	2.3136	0.272809862	0.556597783	0	1.073592479	0.478032193	0	0	1.104820122	0.00307796	0	0	0	0	0.184677605	0	0	0	0	0	0	0	0	0	0	0	32.424
H9001_010_0	2008	5																					3250											A	A	A	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	O	V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	145.7644602	2.147542691	34.61078673	0	185.1644758	0	0	754.634064	471.0152009	0	1136.52318	60.05929795	0	0	4604.7368	1810.78613	220.6990904	448.3296848	0	1053.865883	305.6281494	0	0	466.0743353	3.049861802	0	0	0	0	166.3560983	0											"PBP: 1A IP Acute: $450 per admit, $1,350 annual OOP Max"	"1B IP Psych: $450 per admit, $1,350 annual OOP Max"	"2 SNF: $450 per admit, $1,350 annual OOP Max"	6 Home Health: $0	"10A Ambulance: $50, $200 annual OOP Max"	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $15"	9A OP Hospital and 9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: $50, $150 annual OOP Max"	Included in g.	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $15, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $15"	"7B Chiropractic: $15, 7D Physician Specialist: $20, 7F Podiatry: $15"	"7E Mental Health: $15, 7H Psychiatric: $20, 9C OP Substance Abuse: $15"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7G Other Health Care: $15, 18A Medicare Covered Hearing Exams: $15, 17A Medicare Covered Eye Exams: $15-$20"	15 Part B Drugs: $5-$40	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10-$20"	10B Transportation: Not Covered	"16A Preventive Dental Services: $10, 16B Non-Medicare Covered Comprehensive Dental Services: $10-$49"	17A Routine Eye Exams: $15	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $15	13B Acupuncture: Not Covered											419.64125	419.64125	254.123	0	49.75	0	0	46.69373278	99.5	0	49.75	99.5	0	0	14.60867052	18.62330424	19.525	14.925	0	14.925	10.6454248	0	0	15.00673468	17.4125	0	0	0	0	14.925	0											5.0974	0.075099792	0.732949746	0	0.767661056	0	0	2.936390111	3.905501041	0	4.711835685	0.497991679	0	0	5.605756895	2.810235084	0.359095812	0.557610045	0	1.310745691	0.271128457	0	0	0.582854491	0.004425477	0	0	0	0	0.206905397	0	0	0	0	0	0	0	0	0	0	0	30.4336	0	0.151899793	5.0974	0.075099792	0.732949746	0	0.767661056	0	0	2.936390111	3.905501041	0	4.711835685	0.497991679	0	0	5.605756895	2.810235084	0.359095812	0.557610045	0	1.310745691	0.271128457	0	0	0.582854491	0.004425477	0	0	0	0	0.206905397	0	0	0	0	0	0	0	0	0	0	0	30.4336	0																																																																																			0	0	0	5.0974	0.075099792	0.732949746	0	0.767661056	0	0	2.936390111	3.905501041	0	4.711835685	0.497991679	0	0	5.605756895	2.810235084	0.359095812	0.557610045	0	1.310745691	0.271128457	0	0	0.582854491	0.004425477	0	0	0	0	0.206905397	0	0	0	0	0	0	0	0	0	0	0	30.4336
H9001_011_0	2008	4																					3250											A	A	A	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	O	V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	161.820107	2.384089974	38.42309165	0	205.5599509	0	0	837.7554091	522.8965285	0	1261.708803	66.67470251	0	0	5111.938814	2010.24039	245.0086281	497.7122508	0	1169.946979	339.2924433	0	0	517.411437	3.385797625	0	0	0	0	184.6798704	0											"PBP: 1A IP Acute: $450 per admit, $1,350 annual OOP Max"	"1B IP Psych: $450 per admit, $1,350 annual OOP Max"	"2 SNF: $450 per admit, $1,350 annual OOP Max"	6 Home Health: $0	"10A Ambulance: $50, $200 annual OOP Max"	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $15"	9A OP Hospital and 9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: $50, $150 annual OOP Max"	Included in g.	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $15, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $15"	"7B Chiropractic: $15, 7D Physician Specialist: $20, 7F Podiatry: $15"	"7E Mental Health: $15, 7H Psychiatric: $20, 9C OP Substance Abuse: $15"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7G Other Health Care: $15, 18A Medicare Covered Hearing Exams: $15, 17A Medicare Covered Eye Exams: $15-$20"	15 Part B Drugs: $5-$40	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10-$20"	10B Transportation: Not Covered	"16A Preventive Dental Services: $10, 16B Non-Medicare Covered Comprehensive Dental Services: $10-$49"	17A Routine Eye Exams: $15	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $15	13B Acupuncture: Not Covered											419.64125	419.64125	254.123	0	49.75	0	0	46.69373278	99.5	0	49.75	99.5	0	0	14.60867052	18.62330424	19.525	14.925	0	14.925	10.6454248	0	0	15.00673468	17.4125	0	0	0	0	14.925	0											5.6589	0.083371875	0.81368261	0	0.852217297	0	0	3.259827267	4.335683715	0	5.230834414	0.552844408	0	0	6.223219154	3.119776531	0.398649455	0.619029612	0	1.455121555	0.300992683	0	0	0.64705468	0.004912933	0	0	0	0	0.229695589	0	0	0	0	0	0	0	0	0	0	0	33.7858	0	0.168631234	5.6589	0.083371875	0.81368261	0	0.852217297	0	0	3.259827267	4.335683715	0	5.230834414	0.552844408	0	0	6.223219154	3.119776531	0.398649455	0.619029612	0	1.455121555	0.300992683	0	0	0.64705468	0.004912933	0	0	0	0	0.229695589	0	0	0	0	0	0	0	0	0	0	0	33.7858	0																																																																																			0	0	0	5.6589	0.083371875	0.81368261	0	0.852217297	0	0	3.259827267	4.335683715	0	5.230834414	0.552844408	0	0	6.223219154	3.119776531	0.398649455	0.619029612	0	1.455121555	0.300992683	0	0	0.64705468	0.004912933	0	0	0	0	0.229695589	0	0	0	0	0	0	0	0	0	0	0	33.7858
H9001_012_0	2008	5																					3250											A	A	A	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	O	V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	358.4656293	5.195154047	0	0	691.9986024	0	0	1721.054452	0	0	1224.423795	0	0	0	5406.932884	2476.016349	535.3871132	363.6816693	0	1131.586571	666.651426	0	0	899.664982	0	0	0	0	0	447.1495934	0											"PBP: 1A IP Acute: $100 per admit, $300 annual OOP Max"	"1B IP Psych: $100 per admit, $300 annual OOP Max"	"2 SNF: $100 per admit, $300 annual OOP Max"	6 Home Health: $0	"10A Ambulance: $50, $200 annual OOP Max"	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $5"	9A OP Hospital and 9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: $50, $150 annual OOP Max"	Included in g.	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $5, 14B Immunizations: $0, 14C Routine Physical Exams: $5, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $5"	"7B Chiropractic: $5, 7D Physician Specialist: $10, 7F Podiatry: $5"	"7E Mental Health: $5, 7H Psychiatric: $5, 9C OP Substance Abuse: $5"	"7C Occupational Therapy: $5, 7I Physical and Speech Therapy: $5"	Included in i.2.	"7G Other Health Care: $5, 18A Medicare Covered Hearing Exams: $5, 17A Medicare Covered Eye Exams: $5-$10"	15 Part B Drugs: $5-$40	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $5-$10"	10B Transportation: Not Covered	"16A Preventive Dental Services: $10, 16B Non-Medicare Covered Comprehensive Dental Services: $5-$49"	17A Routine Eye Exams: $5	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $5	13B Acupuncture: Not Covered											126.8625	126.8625	0	0	49.75	0	0	47.83937848	0	0	49.75	0	0	0	4.906977065	8.487328437	9.52341314	4.975	0	7.355031612	12.00608183	0	0	15.00390386	0	0	0	0	0	4.975	0											3.7897	0.054922519	0	0	2.868910872	0	0	6.861181276	0	0	5.076256982	0	0	0	2.210974638	1.751230331	0.424892722	0.150776359	0	0.69357125	0.666989298	0	0	1.124873908	0	0	0	0	0	0.185380769	0	0	0	0	0	0	0	0	0	0	0	25.8596	0	0.129022462	3.7897	0.054922519	0	0	2.868910872	0	0	6.861181276	0	0	5.076256982	0	0	0	2.210974638	1.751230331	0.424892722	0.150776359	0	0.69357125	0.666989298	0	0	1.124873908	0	0	0	0	0	0.185380769	0	0	0	0	0	0	0	0	0	0	0	25.8596	0																																																																																			0	0	0	3.7897	0.054922519	0	0	2.868910872	0	0	6.861181276	0	0	5.076256982	0	0	0	2.210974638	1.751230331	0.424892722	0.150776359	0	0.69357125	0.666989298	0	0	1.124873908	0	0	0	0	0	0.185380769	0	0	0	0	0	0	0	0	0	0	0	25.8596
H9001_013_0	2008	4																					3250											A	A	A	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	O	V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	147.7899989	2.177384883	35.09173724	0	187.737516	0	0	765.1204374	477.5604147	0	1152.316274	60.89388023	0	0	4668.724091	1835.948762	223.7659186	454.5596613	0	1068.510373	309.8751494	0	0	472.550891	3.092242594	0	0	0	0	168.6677779	0											"PBP: 1A IP Acute: $450 per admit, $1,350 annual OOP Max"	"1B IP Psych: $450 per admit, $1,350 annual OOP Max"	"2 SNF: $450 per admit, $1,350 annual OOP Max"	6 Home Health: $0	"10A Ambulance: $50, $200 annual OOP Max"	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $15"	9A OP Hospital and 9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: $50, $150 annual OOP Max"	Included in g.	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $15, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $15"	"7B Chiropractic: $15, 7D Physician Specialist: $20, 7F Podiatry: $15"	"7E Mental Health: $15, 7H Psychiatric: $20, 9C OP Substance Abuse: $15"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7G Other Health Care: $15, 18A Medicare Covered Hearing Exams: $15, 17A Medicare Covered Eye Exams: $15-$20"	15 Part B Drugs: $5-$40	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10-$20"	10B Transportation: Not Covered	"16A Preventive Dental Services: $10, 16B Non-Medicare Covered Comprehensive Dental Services: $10-$49"	17A Routine Eye Exams: $15	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $15	13B Acupuncture: Not Covered											419.64125	419.64125	254.123	0	49.75	0	0	46.69373278	99.5	0	49.75	99.5	0	0	14.60867052	18.62330424	19.525	14.925	0	14.925	10.6454248	0	0	15.00673468	17.4125	0	0	0	0	14.925	0											5.1682	0.076143376	0.743134795	0	0.778328452	0	0	2.977194104	3.959771772	0	4.777311219	0.504911757	0	0	5.683654333	2.84928603	0.364085797	0.565358579	0	1.328959776	0.27489605	0	0	0.59095382	0.004486973	0	0	0	0	0.209780549	0	0	0	0	0	0	0	0	0	0	0	30.8565	0	0.154010588	5.1682	0.076143376	0.743134795	0	0.778328452	0	0	2.977194104	3.959771772	0	4.777311219	0.504911757	0	0	5.683654333	2.84928603	0.364085797	0.565358579	0	1.328959776	0.27489605	0	0	0.59095382	0.004486973	0	0	0	0	0.209780549	0	0	0	0	0	0	0	0	0	0	0	30.8565	0																																																																																			0	0	0	5.1682	0.076143376	0.743134795	0	0.778328452	0	0	2.977194104	3.959771772	0	4.777311219	0.504911757	0	0	5.683654333	2.84928603	0.364085797	0.565358579	0	1.328959776	0.27489605	0	0	0.59095382	0.004486973	0	0	0	0	0.209780549	0	0	0	0	0	0	0	0	0	0	0	30.8565
H9001_014_0	2008	5																					3250											A	A	A	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	O	V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	266.2967713	3.638555373	90.10358888	0	384.9050161	0	0	1171.516836	602.4260849	0	1596.809694	90.60560844	0	0	5796.820035	2643.096266	267.997231	543.1582792	0	1253.315709	414.9278743	0	0	739.6347767	5.284783257	0	0	0	0	88.07972095	0											"PBP: 1A IP Acute: $250 per admit, $750 annual OOP Max"	"1B IP Psych: $250 per admit, $750 annual OOP Max"	"2 SNF: $250 per admit, $750 annual OOP Max"	6 Home Health: $0	"10A Ambulance: $50, $200 annual OOP Max"	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $15"	9A OP Hospital and 9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: $50, $150 annual OOP Max"	Included in g.	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $15, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $15"	"7B Chiropractic: $15, 7D Physician Specialist: $15, 7F Podiatry: $15"	"7E Mental Health: $15, 7H Psychiatric: $15, 9C OP Substance Abuse: $15"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7G Other Health Care: $15, 18A Medicare Covered Hearing Exams: $15, 17A Medicare Covered Eye Exams: $15"	15 Part B Drugs: $5-$40	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10-$15"	10B Transportation: Not Covered	"16A Preventive Dental Services: $10, 16B Non-Medicare Covered Comprehensive Dental Services: $10-$49"	17A Routine Eye Exams: $15	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $15	13B Acupuncture: Not Covered											313.425	313.425	251.337	0	49.75	0	0	47.4801863	74.625	0	49.75	74.625	0	0	14.67645158	14.925	14.925	14.925	0	14.925	11.00575804	0	0	15.00590911	14.925	0	0	0	0	14.925	0											6.9553	0.095034518	1.887197143	0	1.595752046	0	0	4.635319803	3.746337216	0	6.620106855	0.563453627	0	0	7.089729047	3.287350981	0.333321556	0.67555311	0	1.558811413	0.380549649	0	0	0.924907686	0.006572949	0	0	0	0	0.109549153	0	0	0	0	0	0	0	0	0	0	0	40.4649	0	0.202794305	6.9553	0.095034518	1.887197143	0	1.595752046	0	0	4.635319803	3.746337216	0	6.620106855	0.563453627	0	0	7.089729047	3.287350981	0.333321556	0.67555311	0	1.558811413	0.380549649	0	0	0.924907686	0.006572949	0	0	0	0	0.109549153	0	0	0	0	0	0	0	0	0	0	0	40.4649	0																																																																																			0	0	0	6.9553	0.095034518	1.887197143	0	1.595752046	0	0	4.635319803	3.746337216	0	6.620106855	0.563453627	0	0	7.089729047	3.287350981	0.333321556	0.67555311	0	1.558811413	0.380549649	0	0	0.924907686	0.006572949	0	0	0	0	0.109549153	0	0	0	0	0	0	0	0	0	0	0	40.4649
H9001_015_0	2008	5																					3250											A	A	A	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	O	V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	227.6640387	3.110695662	77.03190258	0	329.0653133	0	0	1001.560226	515.0297348	0	1365.154155	77.46109217	0	0	4955.852278	2259.65177	229.1178059	464.3601456	0	1071.492211	354.732636	0	0	632.3330156	4.518098714	0	0	0	0	75.30164523	0											"PBP: 1A IP Acute: $250 per admit, $750 annual OOP Max"	"1B IP Psych: $250 per admit, $750 annual OOP Max"	"2 SNF: $250 per admit, $750 annual OOP Max"	6 Home Health: $0	"10A Ambulance: $50, $200 annual OOP Max"	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $15"	9A OP Hospital and 9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: $50, $150 annual OOP Max"	Included in g.	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $15, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $15"	"7B Chiropractic: $15, 7D Physician Specialist: $15, 7F Podiatry: $15"	"7E Mental Health: $15, 7H Psychiatric: $15, 9C OP Substance Abuse: $15"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	Included in i.2.	"7G Other Health Care: $15, 18A Medicare Covered Hearing Exams: $15, 17A Medicare Covered Eye Exams: $15"	15 Part B Drugs: $5-$40	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10-$15"	10B Transportation: Not Covered	"16A Preventive Dental Services: $10, 16B Non-Medicare Covered Comprehensive Dental Services: $10-$49"	17A Routine Eye Exams: $15	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $15	13B Acupuncture: Not Covered											313.425	313.425	251.337	0	49.75	0	0	47.4801863	74.625	0	49.75	74.625	0	0	14.67645158	14.925	14.925	14.925	0	14.925	11.00575804	0	0	15.00590911	14.925	0	0	0	0	14.925	0											5.9463	0.081247482	1.613413942	0	1.364249945	0	0	3.962855508	3.202841163	0	5.659701602	0.481711167	0	0	6.061193833	2.810441889	0.284965271	0.577547931	0	1.332668437	0.325341797	0	0	0.790727647	0.005619385	0	0	0	0	0.093656421	0	0	0	0	0	0	0	0	0	0	0	34.5945	0	0.173374128	5.9463	0.081247482	1.613413942	0	1.364249945	0	0	3.962855508	3.202841163	0	5.659701602	0.481711167	0	0	6.061193833	2.810441889	0.284965271	0.577547931	0	1.332668437	0.325341797	0	0	0.790727647	0.005619385	0	0	0	0	0.093656421	0	0	0	0	0	0	0	0	0	0	0	34.5945	0																																																																																			0	0	0	5.9463	0.081247482	1.613413942	0	1.364249945	0	0	3.962855508	3.202841163	0	5.659701602	0.481711167	0	0	6.061193833	2.810441889	0.284965271	0.577547931	0	1.332668437	0.325341797	0	0	0.790727647	0.005619385	0	0	0	0	0.093656421	0	0	0	0	0	0	0	0	0	0	0	34.5945
H9001_016_0	2008	5																					3250											A	A	A	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	O	V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	334.5358237	7.084894226	116.90067	0	526.0374781	0	0	1533.950378	625.2284922	0	1990.640897	102.4375801	0	0	6583.186305	3184.752133	375.5324134	766.1765109	0	1477.837974	611.976176	0	0	1008.528381	4.236920798	0	0	0	0	254.2152479	0											"PBP: 1A IP Acute: $100 per admit, $300 annual OOP Max"	"1B IP Psych: $100 per admit, $300 annual OOP Max"	"2 SNF: $100 per admit, $300 annual OOP Max"	6 Home Health: $0	"10A Ambulance: $50, $200 annual OOP Max"	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $10"	9A OP Hospital and 9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: $50, $150 annual OOP Max"	Included in g.	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $10, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $10"	"7B Chiropractic: $10, 7D Physician Specialist: $10, 7F Podiatry: $10"	"7E Mental Health: $10, 7H Psychiatric: $10, 9C OP Substance Abuse: $10"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	Included in i.2.	"7G Other Health Care: $10, 18A Medicare Covered Hearing Exams: $10, 17A Medicare Covered Eye Exams: $10"	15 Part B Drugs: $5-$40	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10"	10B Transportation: Not Covered	"16A Preventive Dental Services: $10, 16B Non-Medicare Covered Comprehensive Dental Services: $10-$49"	17A Routine Eye Exams: $10	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $10	13B Acupuncture: Not Covered											99.5	99.5	254.123	0	49.75	0	0	47.37534517	49.75	0	49.75	49.75	0	0	9.769839959	9.95	9.95	9.95	0	9.95	10.69875079	0	0	15.00423625	9.95	0	0	0	0	9.95	0											2.7739	0.058745581	2.475595747	0	2.180863711	0	0	6.055952384	2.592093124	0	8.252865384	0.424689134	0	0	5.359723051	2.64069031	0.311378959	0.635288024	0	1.225373987	0.54561505	0	0	1.261016507	0.003513113	0	0	0	0	0.21078681	0	0	0	0	0	0	0	0	0	0	0	37.0081	0	0.184917934	2.7739	0.058745581	2.475595747	0	2.180863711	0	0	6.055952384	2.592093124	0	8.252865384	0.424689134	0	0	5.359723051	2.64069031	0.311378959	0.635288024	0	1.225373987	0.54561505	0	0	1.261016507	0.003513113	0	0	0	0	0.21078681	0	0	0	0	0	0	0	0	0	0	0	37.0081	0																																																																																			0	0	0	2.7739	0.058745581	2.475595747	0	2.180863711	0	0	6.055952384	2.592093124	0	8.252865384	0.424689134	0	0	5.359723051	2.64069031	0.311378959	0.635288024	0	1.225373987	0.54561505	0	0	1.261016507	0.003513113	0	0	0	0	0.21078681	0	0	0	0	0	0	0	0	0	0	0	37.0081
H9001_017_0	2008	5																					3250											A	A	A	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	O	V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	283.8872378	6.012244158	99.20195672	0	446.3956205	0	0	1301.710922	530.569156	0	1689.258685	86.92857269	0	0	5586.49461	2702.581972	318.6769607	650.1777027	0	1254.093914	519.323235	0	0	855.8375991	3.595452734	0	0	0	0	215.727164	0											"PBP: 1A IP Acute: $100 per admit, $300 annual OOP Max"	"1B IP Psych: $100 per admit, $300 annual OOP Max"	"2 SNF: $100 per admit, $300 annual OOP Max"	6 Home Health: $0	"10A Ambulance: $50, $200 annual OOP Max"	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $10"	9A OP Hospital and 9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: $50, $150 annual OOP Max"	Included in g.	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $10, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $10"	"7B Chiropractic: $10, 7D Physician Specialist: $10, 7F Podiatry: $10"	"7E Mental Health: $10, 7H Psychiatric: $10, 9C OP Substance Abuse: $10"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	Included in i.2.	"7G Other Health Care: $10, 18A Medicare Covered Hearing Exams: $10, 17A Medicare Covered Eye Exams: $10"	15 Part B Drugs: $5-$40	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10"	10B Transportation: Not Covered	"16A Preventive Dental Services: $10, 16B Non-Medicare Covered Comprehensive Dental Services: $10-$49"	17A Routine Eye Exams: $10	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $10	13B Acupuncture: Not Covered											99.5	99.5	254.123	0	49.75	0	0	47.37534517	49.75	0	49.75	49.75	0	0	9.769839959	9.95	9.95	9.95	0	9.95	10.69875079	0	0	15.00423625	9.95	0	0	0	0	9.95	0											2.3539	0.049851524	2.100791571	0	1.850681843	0	0	5.139083688	2.199651293	0	7.003384964	0.360391374	0	0	4.548263189	2.240890885	0.264236313	0.539105679	0	1.03985287	0.463009156	0	0	1.070099128	0.00298123	0	0	0	0	0.178873774	0	0	0	0	0	0	0	0	0	0	0	31.405	0	0.156921435	2.3539	0.049851524	2.100791571	0	1.850681843	0	0	5.139083688	2.199651293	0	7.003384964	0.360391374	0	0	4.548263189	2.240890885	0.264236313	0.539105679	0	1.03985287	0.463009156	0	0	1.070099128	0.00298123	0	0	0	0	0.178873774	0	0	0	0	0	0	0	0	0	0	0	31.405	0																																																																																			0	0	0	2.3539	0.049851524	2.100791571	0	1.850681843	0	0	5.139083688	2.199651293	0	7.003384964	0.360391374	0	0	4.548263189	2.240890885	0.264236313	0.539105679	0	1.03985287	0.463009156	0	0	1.070099128	0.00298123	0	0	0	0	0.178873774	0	0	0	0	0	0	0	0	0	0	0	31.405
H9001_018_0	2008	3																					3250											A	A	A	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	O	V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H9001_801_0	2008	4																					3250											A	A	A	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	O	V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	241.2560441	3.156621138	69.17313299	0	377.4253279	0	0	1076.104597	524.9980239	0	2920.332762	70.55923339	0	0	5485.228854	2693.942744	244.2123061	678.1432633	0	1272.450134	414.1424426	0	0	0	3.105051572	0	0	0	0	256.1667547	0											"PBP: 1A IP Acute: $450 per admit, $1,350 annual OOP Max"	1B IP Psych: $450 per admit	2 SNF: $450 per admit	6 Home Health: $0	10A Ambulance: $50	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $20"	9A OP Hospital and 9B ASC Services: $225	8A OP C/D/T: $0	8B OP X-Ray: $50	Included in g.	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $20, 14B Immunizations: $0, 14C Routine Physical Exams: $20, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $20"	"7B Chiropractic: $20, 7D Physician Specialist: $25, 7F Podiatry: $20"	"7E Mental Health: $20, 7H Psychiatric: $25, 9C OP Substance Abuse: $20"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	Included in i.2.	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $20, 17A Medicare Covered Eye Exams: $20-$25"	15 Part B Drugs: $0-$40	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10-$20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non-Medicare Covered Comprehensive Dental Services: Not Covered"	17A Routine Eye Exams: $20	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $20	13B Acupuncture: Not Covered											447.75	447.75	447.75	0	49.75	0	0	47.24520167	223.875	0	49.75	223.875	0	0	19.50741841	23.63583737	24.52077241	19.9	0	19.9	10.64708529	0	0	0	19.9	0	0	0	0	19.9	0											9.0019	0.117781426	2.581022525	0	1.564742505	0	0	4.236731559	9.794494384	0	12.10721291	1.316370698	0	0	8.916887863	5.306132714	0.499022865	1.124587578	0	2.110146472	0.367450826	0	0	0	0.005149211	0	0	0	0	0.424809868	0	0	0	0	0	0	0	0	0	0	0	59.4744	0	0.296745888	9.0019	0.117781426	2.581022525	0	1.564742505	0	0	4.236731559	9.794494384	0	12.10721291	1.316370698	0	0	8.916887863	5.306132714	0.499022865	1.124587578	0	2.110146472	0.367450826	0	0	0	0.005149211	0	0	0	0	0.424809868	0	0	0	0	0	0	0	0	0	0	0	59.4744	0																																																																																			0	0	0	9.0019	0.117781426	2.581022525	0	1.564742505	0	0	4.236731559	9.794494384	0	12.10721291	1.316370698	0	0	8.916887863	5.306132714	0.499022865	1.124587578	0	2.110146472	0.367450826	0	0	0	0.005149211	0	0	0	0	0.424809868	0	0	0	0	0	0	0	0	0	0	0	59.4744
H9001_803_0	2008	5																					3250											A	A	A	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	V	V	V	O	V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	241.2560441	3.156621138	69.17313299	0	377.4253279	0	0	1076.104597	524.9980239	0	2920.332762	70.55923339	0	0	5485.228854	2693.942744	244.2123061	678.1432633	0	1272.450134	414.1424426	0	0	0	3.105051572	0	0	0	0	256.1667547	0											"PBP: 1A IP Acute: $450 per admit, $1,350 annual OOP Max"	1B IP Psych: $450 per admit	2 SNF: $450 per admit	6 Home Health: $0	10A Ambulance: $50	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $20"	9A OP Hospital and 9B ASC Services: $225	8A OP C/D/T: $0	8B OP X-Ray: $50	Included in g.	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0"	"7A PCP: $20, 14B Immunizations: $0, 14C Routine Physical Exams: $20, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $20"	"7B Chiropractic: $20, 7D Physician Specialist: $25, 7F Podiatry: $20"	"7E Mental Health: $20, 7H Psychiatric: $25, 9C OP Substance Abuse: $20"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	Included in i.2.	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $20, 17A Medicare Covered Eye Exams: $20-$25"	15 Part B Drugs: $0-$40	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10-$20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non-Medicare Covered Comprehensive Dental Services: Not Covered"	17A Routine Eye Exams: $20	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $20	13B Acupuncture: Not Covered											447.75	447.75	447.75	0	49.75	0	0	47.24520167	223.875	0	49.75	223.875	0	0	19.50741841	23.63583737	24.52077241	19.9	0	19.9	10.64708529	0	0	0	19.9	0	0	0	0	19.9	0											9.0019	0.117781426	2.581022525	0	1.564742505	0	0	4.236731559	9.794494384	0	12.10721291	1.316370698	0	0	8.916887863	5.306132714	0.499022865	1.124587578	0	2.110146472	0.367450826	0	0	0	0.005149211	0	0	0	0	0.424809868	0	0	0	0	0	0	0	0	0	0	0	59.4744	0	0.296745888	9.0019	0.117781426	2.581022525	0	1.564742505	0	0	4.236731559	9.794494384	0	12.10721291	1.316370698	0	0	8.916887863	5.306132714	0.499022865	1.124587578	0	2.110146472	0.367450826	0	0	0	0.005149211	0	0	0	0	0.424809868	0	0	0	0	0	0	0	0	0	0	0	59.4744	0																																																																																			0	0	0	9.0019	0.117781426	2.581022525	0	1.564742505	0	0	4.236731559	9.794494384	0	12.10721291	1.316370698	0	0	8.916887863	5.306132714	0.499022865	1.124587578	0	2.110146472	0.367450826	0	0	0	0.005149211	0	0	0	0	0.424809868	0	0	0	0	0	0	0	0	0	0	0	59.4744
H9003_001_0	2008	9																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	Coin	V	V	V	V	V	V	V		S	O			V	V	V			V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0			0	0	0			0	0											0	3250	1023.480653	47.85184251	634.3194773	463.5235989	292.9713912	9.295435472	0.591744872	474.6834072	623.4967634	20295.24883	3854.443355	2.302438385	2.339092943	259.1775967	4238.086241	3055.918896	324.3885791	466.3113054	2864.536125		740.1219187	97.23033576			738.6324458	41.65264835	54.98146077			24.36074514	0											$200/day $1400max/admit	$200/day $1400max/admit	$0 per day	$0 copay	$150 copay	20% Coinsurance	20% Coinsurance	$0-50/copay waived if admitted	$25-$150 per visit	$0 copay	$0-50 per visit	20% Coinsurance	$0 copay	$12-25 per visit	$0-25 per visit	$0-150 per visit	$12 - $25 per visit	$25 per visit	$0 copay		$12 generic/$45 brand and a $5 administration fee in a nurse treatment room	$0 copay			$25 per visit	$0 copay	$25 per visit			$0-$165 per class	$0 copay											113	113	0	0	140.55	0.2	0.2	35.86	84.76	0	10.07	0.19	0	23.41	23.39	22.01	21.34	23.43	0	0	18.48	0	0	0	23.43	0	23.43	0	0	74	0											9.6378	0.45060485	0	0	3.431427419	1.859087094	0.118348974	1.418512249	4.403965472	0	3.234520382	0.437463293	0	0.505612295	8.260736431	5.605064574	0.576871023	0.910472824	0	0	1.139787755	0	0	0	1.44217985	0	0.107351302	0	0	0.150224595	0	0	0	0	0	0	0	0	0	0	0	43.69	0	2.03	9.6378	0.45060485	0	0	3.431427419	1.859087094	0.118348974	1.418512249	4.403965472	0	3.234520382	0.437463293	0	0.505612295	8.260736431	5.605064574	0.576871023	0.910472824	0	0	1.139787755	0	0	0	1.44217985	0	0.107351302	0	0	0.150224595	0	0	0	0	0	0	0	0	0	0	0	43.69	3250																																																																																			0	0	0	9.6378	0.45060485	0	0	3.431427419	1.859087094	0.118348974	1.418512249	4.403965472	0	3.234520382	0.437463293	0	0.505612295	8.260736431	5.605064574	0.576871023	0.910472824	0	0	1.139787755	0	0	0	1.44217985	0	0.107351302	0	0	0.150224595	0	0	0	0	0	0	0	0	0	0	0	43.69
H9003_006_0	2008	8																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	Coin	V	V	V	V	V	V	V		S	O			V		V			V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0			0		0			0	0											0	3250	691.0545703	28.33223186	430.0694457	310.9692467	195.5642518	5.879206801	0.259929527	312.7563307	428.2730543	13911.58913	2655.921971	1.518429055	1.420111135	177.4542736	2856.202613	2067.185909	213.9394769	313.5870286	1931.918911		500.6148175	48.50021898			503.3869064		37.33569493			16.4707289	0											$250/day $2500max/admit	$250/day $2500max/admit	$0 per day	$0 copay	$300 copay	20% Coinsurance	20% Coinsurance	$0-50/copay waived if admitted	$40-$200 per visit	$0 copay	$0-100 per visit	20% Coinsurance	$0 copay	$20-40 per visit	$0-40 per visit	$0-150 per visit	$20 - $40 per visit	$40 per visit	$0 copay		$12 generic/$45 brand and a $5 administration fee in a nurse treatment room	$0 copay			$40 per visit		$40 per visit			$0-$165 per class	$0 copay											192.25	192.25	0	0	268.8	0.2	0.2	37.67	110.76	0	19.16	0.18	0	35.81	35.78	32.94	32.7	35.84	0		18.37	0			35.84		35.84			74	0											11.0713	0.453905965	0	0	4.380639239	1.17584136	0.051985905	0.981794248	3.952960291	0	4.240622081	0.27331723	0	0.529553128	8.516244126	5.674425321	0.582985075	0.936579925	0	0	0.76635785	0	0	0	1.503448894	0	0.111509276	0	0	0.101569495	0	0	0	0	0	0	0	0	0	0	0	45.305	0	3.674292493	11.0713	0.453905965	0	0	4.380639239	1.17584136	0.051985905	0.981794248	3.952960291	0	4.240622081	0.27331723	0	0.529553128	8.516244126	5.674425321	0.582985075	0.936579925	0	0	0.76635785	0	0	0	1.503448894	0	0.111509276	0	0	0.101569495	0	0	0	0	0	0	0	0	0	0	0	45.305	3250																																																																																			0	0	0	11.0713	0.453905965	0	0	4.380639239	1.17584136	0.051985905	0.981794248	3.952960291	0	4.240622081	0.27331723	0	0.529553128	8.516244126	5.674425321	0.582985075	0.936579925	0	0	0.76635785	0	0	0	1.503448894	0	0.111509276	0	0	0.101569495	0	0	0	0	0	0	0	0	0	0	0	45.305
H9003_801_0	2008	4																					10000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	V	V	V	V	V	V	Coin		Coin	O			V	V	V			V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0			0	0	0			0	0											0	10000	993.2913107	33.59695964	481.9163659	522.6236568	265.9312049	10.16349074	0.884019503	466.7129039	669.7367178	26.13376794	33.42795718	3.248481694	3.399688699	275.3524494	4579.915714	3284.428464	231.7804105	620.1495078	12.65979575		9.932469536	68.76150186			868.6961349	40.87307801	70.73331959			21.07057803	0											$670/day $3350max/admit	$670/day $3350max/admit	$0 per day	$0 copay	$300 copay	20% Coinsurance	20% Coinsurance	$0-50/copay waived if admitted	$50-$350 per visit	$0 copay	20% Coinsurance	20% Coinsurance	$0 copay	$25-50 per visit	$0-50 per visit	$0-150 per visit	$25 - $50 per visit	$50 per visit	$0 copay		40% Coin $150 max per Script	$0 copay			$100 per visit	$0 copay	$100 per visit			$0-$165 per class	$0 copay											312.33	312.33	0	0	292.74	0.2	0.2	42.13	193.4	0.2	0.2	0.2	0	48.77	48.73	47.45	44.9	48.79	0.2		0.34	0			97.58	0	97.58			74	0											25.8529	0.874444867	0	0	6.487391743	2.032698148	0.176803901	1.63855122	10.79392344	5.226753588	6.685591436	0.649696339	0	1.119078246	18.5982744	12.98717755	0.867245036	2.52142454	2.531959149	0	3.377039642	0	0	0	7.063947404	0	0.575179777	0	0	0.129935231	0	0	0	0	0	0	0	0	0	0	0	110.19	0	1.555196227	25.8529	0.874444867	0	0	6.487391743	2.032698148	0.176803901	1.63855122	10.79392344	5.226753588	6.685591436	0.649696339	0	1.119078246	18.5982744	12.98717755	0.867245036	2.52142454	2.531959149	0	3.377039642	0	0	0	7.063947404	0	0.575179777	0	0	0.129935231	0	0	0	0	0	0	0	0	0	0	0	110.19	10000																															50% Coinsurance																																									0.25											0.25	0	0	25.8529	0.874444867	0	0	6.487391743	2.032698148	0.176803901	1.63855122	10.79392344	5.226753588	6.685591436	0.649696339	0	1.119078246	18.5982744	12.98717755	0.867245036	2.52142454	2.531959149	0	3.377039642	0	0	0	7.063947404	0	0.575179777	0	0	0.129935231	0.25	0	0	0	0	0	0	0	0	0	0	110.44
H9003_802_0	2008	4																					10000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	V	V	V	V	V	V	Coin		Coin	O			V	V	V			V	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0			0	0	0			0	0											0	10000	993.2913107	33.59695964	481.9163659	522.6236568	265.9312049	10.16349074	0.884019503	466.7129039	669.7367178	26.13376794	33.42795718	3.248481694	3.399688699	275.3524494	4579.915714	3284.428464	231.7804105	620.1495078	12.65979575		9.932469536	68.76150186			868.6961349	40.87307801	70.73331959			21.07057803	0											$670/day $3350max/admit	$670/day $3350max/admit	$0 per day	$0 copay	$300 copay	20% Coinsurance	20% Coinsurance	$0-50/copay waived if admitted	$50-$350 per visit	$0 copay	20% Coinsurance	20% Coinsurance	$0 copay	$25-50 per visit	$0-50 per visit	$0-150 per visit	$25 - $50 per visit	$50 per visit	$0 copay		40% Coin $150 max per Script	$0 copay			$100 per visit	$0 copay	$100 per visit			$0-$165 per class	$0 copay											312.33	312.33	0	0	292.74	0.2	0.2	42.13	193.4	0.2	0.2	0.2	0	48.77	48.73	47.45	44.9	48.79	0.2		0.34	0			97.58	0	97.58			74	0											25.8529	0.874444867	0	0	6.487391743	2.032698148	0.176803901	1.63855122	10.79392344	5.226753588	6.685591436	0.649696339	0	1.119078246	18.5982744	12.98717755	0.867245036	2.52142454	2.531959149	0	3.377039642	0	0	0	7.063947404	0	0.575179777	0	0	0.129935231	0	0	0	0	0	0	0	0	0	0	0	110.19	0	1.555196227	25.8529	0.874444867	0	0	6.487391743	2.032698148	0.176803901	1.63855122	10.79392344	5.226753588	6.685591436	0.649696339	0	1.119078246	18.5982744	12.98717755	0.867245036	2.52142454	2.531959149	0	3.377039642	0	0	0	7.063947404	0	0.575179777	0	0	0.129935231	0	0	0	0	0	0	0	0	0	0	0	110.19	10000																															50% Coinsurance																																									0.25											0.25	0	0	25.8529	0.874444867	0	0	6.487391743	2.032698148	0.176803901	1.63855122	10.79392344	5.226753588	6.685591436	0.649696339	0	1.119078246	18.5982744	12.98717755	0.867245036	2.52142454	2.531959149	0	3.377039642	0	0	0	7.063947404	0	0.575179777	0	0	0.129935231	0.25	0	0	0	0	0	0	0	0	0	0	110.44
H9005_007_0	2008	3																					3000																Coin		V									V				Coin							Coin																																																							0							24.314		361.961									347.434				6.062							0.436														1a: 0% coins	1b: 0% coins	2: 0% coins	6: 0% coins	10a: 0% coins	11a: 10% coinsurance	"11b, 11c: 10% coinsurance"	4a: $30 copay; 4b: $0 copay	"9a, 9b: 0% coins"	8a: 0% coins	8b: 0% coins	5: 0% coins	12: 0% coins	"3, 9c, 9d: 0% coins"	"7a, 14b, 14c: 0% coins"	"7b, 7d, 7f: 0% coins"	"7e, 7h: $5/$10 Copay"	"7c, 7i: 0% coins"	7d: 0% coins	"7g, 14d, 14e, 14f, 14g, 14h, 14i: 0% coins"	15: 20% coinsurance	13a: 0% coinsurance	10b: 0% coinsurance	"16a, 16b: 0% coinsurance"	17a: 0% coinsurance	17b: 0% coinsurance	18a: 0% coinsurance	"18b: 50% up to $1,000 max"		14a: 0% coinsurance	13b: 0% coinsurance																0.097		29.1									8.633				0.194							0.485														0	0	0	0	0	2.358458	0	0.877755425	0	0	0	0	0	0	0	0	0.24994981	0	0	0	1.176028	0	0	0	0	0	0	0.21146	0	0	0	0	0	0	0	0	0	0	0	0	0	4.8737		0.151	0	0	0	0	0	2.358458	0	0.877755425	0	0	0	0	0	0	0	0	0.24994981	0	0	0	1.176028	0	0	0	0	0	0	0.21146	0	0	0	0	0	0	0	0	0	0	0	0	0	4.8737		"1a: 20% coins up to $100,000 of Medicare Allowable chg"	"1b: 20% coins up to $100,000 of Medicare Allowable chgs"	"2: 20% coins up to $100,000 of Medicare Allowable chgs"	"6: 20% coins up to $100,000 of Medicare Allowable chgs"	10a: 20% coinsuance	"11a: 20% coins up to $100,000 of Medicare Allowable chgs"	"11b, 11c: 20% coins up to $100,000 of Medicare Allowable chgs"	4a and 4b: $30 copay	"9a, 9b: 20% coins up to $100,000 of Medicare Allowable chgs"	"8a: 20% coins up to $100,000 of Medicare Allowable chgs"	"8b: 20% coins up to $100,000 of Medicare Allowable chgs"	"5: 20% coins up to $100,000 of Medicare Allowable chgs"	"12: 20% coins up to $100,000 of Medicare Allowable chgs"	"3, 9c, 9d: 20% coins up to $100,000 of Medicare Allowable chgs"	"7a: 20% coins up to $100,000 of Medicare Allowable chgs"	"7b, 7d, 7f: 20% coins up to $100,000 of Medicare Allowable chgs"	"7e, 7h: 20% coins up to $100,000 of Medicare Allowable chgs"	"7c, 7i: 20% coins up to $100,000 of Medicare Allowable chgs"	"7d: 20% coins up to $100,000 of Medicare Allowable chgs"	"7g: 20% coins up to $100,000 of Medicare Allowable chgs"										"14a: 20% coins up to $100,000 of Medicare Allowable chgs"												0.103		0.123	0	0.006	0.003		0.024	0	0.127					0.099																											0.485		0.05	0.103	0	0.123	0	0.006	2.361458	0	0.901755425	0	0.127	0	0	0	0	0.099	0	0.24994981	0	0	0	1.176028	0	0	0	0	0	0	0.21146	0	0	0	0	0	0	0	0	0	0	0	0	0	5.3587
H9005_804_0	2008	8																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	V	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0		0	0	0	0	0	19.10218958	0	441.2956171	0	0	0	0	0	0	6388.646362	0	263.0007905	0	0	0	4.76600118	0																				1a (IP Acute) - 0%	1b (IP Psych) - 0%	2 (SNF) - 0%	6 (Home Health)- 0%	10a (Ambulance) - 0%	11a (Medical Equip) - 10%	"11b (Med Supp), 11c (Diab Supp) - 10%"	"4a (ER) - $30, 4b (UC) - $10"	"9a (OP Surgery), 9b (ASC) - 0%"	8a (OP Diag Proc/Test/Lab) - 0%	8b (OP Diag & Therap Rad) - 0%	5 (Partial Hosp) - 0%	12 (Renal Dialysis) - 0%	"3 (CORF), 9c (SA), 9d (Cardiac) - 0%"	"7a (PCP), 14j (Nutrition Therap), 14i (Diab Mon.) - $10"	"7d (Spec), 7f (Pod) - $10; 7b (Chiro) - $0"	7e (MH) - $10 Grp/$5 Ind; 7h (SA) - $0	7c (OT) - $0; 7i (PT/ST) - $10	7d (Radiology) - 0%	"7g (Other), 14g (Bone Mass),  14b (Immunizations), 14c (MCR Phys Exam), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) - $0"	15 (Part B Rx) - 20%	13a (Blood) - 0%																				0	0	0	0	0	0.0806	0	18.10276	0	0	0	0	0	0	8.06	0	7.1734	0	0	0	0.1612	0																				0	0	0	0	0	1.53963648	0	0.665722387	0	0	0	0	0	0	4.291040807	0	0.157217489	0	0	0	0.76827939	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.4219		1.786411825	0	0	0	0	0	1.53963648	0	0.665722387	0	0	0	0	0	0	4.291040807	0	0.157217489	0	0	0	0.76827939	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.4219	3000	"1a (IP Acute) -20% coins up to $100,000 of Medicare Allowed"	"1b (IP Psych) -20% coins up to $100,000 of Medicare Allowed"	"2 (SNF) -20% coins up to $100,000 of Medicare Allowed"	"6 (Home Health)-20% coins up to $100,000 of Medicare Allowed"	"10a (Ambulance) -20% coins up to $100,000 of Medicare Allowed"	"11a (Medical Equip) -20% coins up to $100,000 of Medicare Allowed"	"11b (Med Supp), 11c (Diab Supp) -20% coins up to $100,000 of Medicare Allowed"	"4a (ER) - $30, 4b (UC) - $30"	"9a (OP Surgery), 9b (ASC) -20% coins up to $100,000 of Medicare Allowed"	"8a (OP Diag Proc/Test/Lab) -20% coins up to $100,000 of Medicare Allowed"	"8b (OP Diag & Therap Rad) -20% coins up to $100,000 of Medicare Allowed"	"5 (Partial Hosp) -20% coins up to $100,000 of Medicare Allowed"	"12 (Renal Dialysis) -20% coins up to $100,000 of Medicare Allowed"	"3 (CORF), 9c (SA), 9d (Cardiac) -20% coins up to $100,000 of Medicare Allowed"	"7a (PCP) - 20% coins up to $100,000 of Medicare Allowed"	"7d (Spec), 7f (Pod), 7b (Chiro) -20% coins up to $100,000 of Medicare Allowed"	"7e (MH), 7h (SA) -20% coins up to $100,000 of Medicare Allowed"	"7c (OT), 7i (PT/ST) -20% coins up to $100,000 of Medicare Allowed"	"7d (Radiology) -20% coins up to $100,000 of Medicare Allowed"	"7g (Other), 14g (Bone Mass),  14b (Immunizations), 14c (MCR Phys Exam), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) -20% coins up to $100,000 of Medicare Allowed"	"15 (Part B Rx) -20% coins up to $100,000 of Medicare Allowed"	"13a (Blood) - 20% coins up to $100,000 of Medicare Allowed"																				0.0813	0	0.0964	0	0.0045	0.0024	0	0.033	0	0.0995	0	0	0	0	0.0775	0	0	0	0	0	0	0																				0.3947		0.040950705	0.0813	0	0.096427617	0	0.004492685	1.541994858	0	0.698764852	0	0.099509898	0	0	0	0	4.368563136	0	0.157217489	0	0	0	0.76827939	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.8166
H9011_003_0	2008	4																					1950											D	D	D	V	T	Coin	Coin	V	V	O	O	O	Coin	O	V	V	V	V	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0			49.82037436			145.7596533	15.8301843	1.727683137	248.5249414		14739.14043			0.407367928	0.270678951							20.38680151																					"$0 (1a, 1a1)"	$175 (1b)	"$0 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	15% (11a)	"15% (11b, 11c)"	"$50 (4a, 4a1); $50/$40/$0 (4b)"	$0 (9b)	$0 (8a1); $0/$2 (8a2)	"$0 (8b1, 8b2, 8b3)"	$0 (incl in h5)	30% (12)	"$0 (3, 9d, 9a); $60 (5); $0/$0 (9c)"	"$0/$50/$40 (7a); $0 (14b, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j, 14c); $0 n/c (14b1, 14e1, 14h1)"	"$0 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$0/$0 (7e, 7h)"	"$0 (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17a, 17b, 18a, 16b, 13a1)"	$0 (10b)	$0 n/c; $0 (16)	$0 (17a1)	$0; $0 n/c (17b)	$0 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"												160.3105			160.3105	0.137409032	0.148566211	45.073		0.732848172			0.274818064	54.9636							0.274818064																					0	0.665560916	0	0	1.947234032	2.175210303	0.256675337	0.933480151	0	0.900129343	0	0	0.111952065	0.001239791	0	0	0	0	0	0	5.60266133	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.5941	0	1.13297532	0	0.665560916	0	0	1.947234032	2.175210303	0.256675337	0.933480151	0	0.900129343	0	0	0.111952065	0.001239791	0	0	0	0	0	0	5.60266133	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.5941																																																																																				0			0	0.665560916	0	0	1.947234032	2.175210303	0.256675337	0.933480151	0	0.900129343	0	0	0.111952065	0.001239791	0	0	0	0	0	0	5.60266133	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.5941
H9011_011_0	2008	5																																Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	Coin	T	V	V	P	V																																																								0		480.9984597	23.51980616	63.71564358		28.41691262	47.68201696	34.05260955	972.678743	80.25211093	14.6185126	36.80356466	94.92561938	7.191665538	81.81557082	762.3410593	175.1764436	16.74787328	10.01826933			43.31183031	8.933526734					0.118501635															1(a) 20% Coinsurance	1(b) 20% Coinsurance	2(a) $140 per Day for days 21-100	6(a) $0 per Visit	10(a) 20% Coinsurance	11(a) 20% Coinsurance	11(b)/11(c) 20% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; 20% coinsurance	9(b) 20% Coinsurance	8(a) Diagnostic: 20% Coinsurance; other 0% coinsurance	8(b) X-rays 20% Coinsurance; other: 20% Coinsurance	9(a) 20% Coinsurance	12 20% Coinsurance	"3, 5, 9(a), 9(c), 9(d) 20% Coinsurance"	7(a) PCP $0 per visit; Urgent Care 20% coinsurance	7(b)/7(d)/7(f) 20% Coinsurance	7(e)/7(h) 20% Coinsurance	7(c)/7(i) 20% Coinsurance		7(g) 20% Coinsurance	15  20% per script	"13, 14(b), 14(e)-(j), 17(a), 16(b) 20% Coinsurance; 14(a) and 14(c) $0; 14(d) Pap Smear $0 copay, Pelvic Exam 20% Coinsurance"	10(b) $0 Copay	16(a) $0 copay per visit	17(a1) $0 copay per Visit	17(b) $0 copay per procedure	18a $10 per visit															0.0692	0.0692	0.075024287		0.2	0.2	0.2	50	0.2	0.1	0.2	182.4681	0.2	0.2	14.5741	0.2	0.2	0.2			0.2	0.2					24.7059															33.2851	1.627570586	4.780220759	0	5.683382524	9.536403392	6.810521909	4.052828096	16.05042219	1.46185126	7.360712931	1.443407754	1.438333108	16.36311416	0.925866406	35.03528871	3.349574656	2.003653866	0	0	8.662366062	1.786705347	0	0	0	0	0.000243974	0	0	0	0	0	0	0	0	0	0	0	0	0	0	161.6576	0	0	33.2851	1.627570586	4.780220759	0	5.683382524	9.536403392	6.810521909	4.052828096	16.05042219	1.46185126	7.360712931	1.443407754	1.438333108	16.36311416	0.925866406	35.03528871	3.349574656	2.003653866	0	0	8.662366062	1.786705347	0	0	0	0	0.000243974	0	0	0	0	0	0	0	0	0	0	0	0	0	0	161.6576																																																																																				0	0	0	33.2851	1.627570586	4.780220759	0	5.683382524	9.536403392	6.810521909	4.052828096	16.05042219	1.46185126	7.360712931	1.443407754	1.438333108	16.36311416	0.925866406	35.03528871	3.349574656	2.003653866	0	0	8.662366062	1.786705347	0	0	0	0	0.000243974	0	0	0	0	0	0	0	0	0	0	0	0	0	0	161.6576
H9011_801_0	2008	2																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1623.177016	51.10170031	663.0495323		149.5084334	16.23731945	1.772117271	254.9167331	26.39139617	15118.21512	54.18798824		0.417844989	22.69629866	2445.622695	7816.995011		5.088571102			20.91112792	1557.688072			128.2370679		18.90695368															$300 (1a); $0 (1a1)	$300 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$40 (4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $0/$0 (9c)"	"$35/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $35 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$0/$0 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											300	300	150		175	0.3	0.3	49.2031	0.3	6	0.164411323		0.3	0.300009922	35	34.5152		0.3			0.3	35			35		35															40.5794	1.277542508	8.288119153	0	2.180331321	4.871195836	0.531635181	1.045224137	7.917418851	7.55910756	8.909118848	0	0.125353497	6.809114795	7.133066195	22.48377473	0	1.526571331	0	0	6.273338375	4.543256876	0	0	0.374024781	0	0.055145282	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.4828	0	0	40.5794	1.277542508	8.288119153	0	2.180331321	4.871195836	0.531635181	1.045224137	7.917418851	7.55910756	8.909118848	0	0.125353497	6.809114795	7.133066195	22.48377473	0	1.526571331	0	0	6.273338375	4.543256876	0	0	0.374024781	0	0.055145282	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.4828																																																																																				0			40.5794	1.277542508	8.288119153	0	2.180331321	4.871195836	0.531635181	1.045224137	7.917418851	7.55910756	8.909118848	0	0.125353497	6.809114795	7.133066195	22.48377473	0	1.526571331	0	0	6.273338375	4.543256876	0	0	0.374024781	0	0.055145282	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.4828
H9011_802_0	2008	2																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0		1623.177016	51.10170031	663.0495323		149.5084334	16.23731945	1.772117271	254.9167331	26.39139617	15118.21512	54.18798824		0.417844989	22.69629866	2445.622695	7816.995011		5.088571102			20.91112792	1557.688072			128.2370679		18.90695368															$300 (1a); $0 (1a1)	$300 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$40 (4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $0/$0 (9c)"	"$35/$50/$40 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $35 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$0/$0 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											300	300	150		175	0.3	0.3	49.2031	0.3	6	0.164411323		0.3	0.300009922	35	34.5152		0.3			0.3	35			35		35															40.5794	1.277542508	8.288119153	0	2.180331321	4.871195836	0.531635181	1.045224137	7.917418851	7.55910756	8.909118848	0	0.125353497	6.809114795	7.133066195	22.48377473	0	1.526571331	0	0	6.273338375	4.543256876	0	0	0.374024781	0	0.055145282	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.4828	0	0	40.5794	1.277542508	8.288119153	0	2.180331321	4.871195836	0.531635181	1.045224137	7.917418851	7.55910756	8.909118848	0	0.125353497	6.809114795	7.133066195	22.48377473	0	1.526571331	0	0	6.273338375	4.543256876	0	0	0.374024781	0	0.055145282	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.4828																																																																																				0			40.5794	1.277542508	8.288119153	0	2.180331321	4.871195836	0.531635181	1.045224137	7.917418851	7.55910756	8.909118848	0	0.125353497	6.809114795	7.133066195	22.48377473	0	1.526571331	0	0	6.273338375	4.543256876	0	0	0.374024781	0	0.055145282	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.4828
H9047_001_0	2008	10																					2500											A				T	Coin		V	V		Coin			V	V				Coin		Coin				V					O												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		224.9099878	0	0	0	295.7133076	20.48774293	0	491.517391	402.1534748	0	27.5866901	0	0	148.7945517	19108.17444	0	0	0	28.47549109	0	36.82646975	0	0	0	167.8520203	0	0	0	0	1.057199139	0	0	0	0	0	0	0	0	0	0	0	$250/acute and MH admit	covered under a.1.	no cost sharing	no cost sharing	$50/trip	10% coins. for non-diabetic DME/Pros./Supplies	covered under e.1.	$50/ER visit; $25/urgent care visit	$50/visit	no cost sharing	10% coins. for fac. radiology	no cost sharing	no cost sharing	"$15/visit; diab. training, cardiac rehab, clinic"	$15/visit for all prof. visits	covered under i.1.	covered under i.1.	covered under i.1.	10% coins. for prof. radiology	no cost sharing	10% coins.	no cost sharing	no covered services	no covered services	$15/routine vision exam	no covered services	no covered services	no covered services	no covered services	plan pays up to $350 for classes; see PBP notes	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	220	0	0	0	44	0.088	0	39.99922803	44	0	0.088	0	0	13.2	13.2	0	0	0	0.088	0	0.088	0	0	0	15	0	0	0	0	450.0685722	0	0	0	0	0	0	0	0	0	0	0	4.1233	0	0	0	1.084282128	1.802921378	0	1.638359684	1.474562741	0	2.427628729	0	0	0.163674007	21.01899188	0	0	0	2.505843216	0	3.240729338	0	0	0	0.209815025	0	0	0	0	0.039651009	0	0	0	0	0	0	0	0	0	0	0	39.7298	0	5.38368312	4.1233	0	0	0	1.084282128	1.802921378	0	1.638359684	1.474562741	0	2.427628729	0	0	0.163674007	21.01899188	0	0	0	2.505843216	0	3.240729338	0	0	0	0.209815025	0	0	0	0	0.039651009	0	0	0	0	0	0	0	0	0	0	0	39.7298	2500	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			4.1233	0	0	0	1.084282128	1.802921378	0	1.638359684	1.474562741	0	2.427628729	0	0	0.163674007	21.01899188	0	0	0	2.505843216	0	3.240729338	0	0	0	0.209815025	0	0	0	0	0.039651009	0	0	0	0	0	0	0	0	0	0	0	39.7298
H9047_013_0	2008	10																					2500											A				T	Coin		V	V		Coin			V	V				Coin		Coin				V					O												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		241.3802879	0	0	0	317.3685794	21.98807325	0	527.5115193	431.6034272	0	29.6068808	0	0	159.6908705	20507.4781	0	0	0	30.56076924	0	39.52329533	0	0	0	167.8520203	0	0	0	0	1.057199139	0	0	0	0	0	0	0	0	0	0	0	$250/acute and MH admit	covered under a.1.	no cost sharing	no cost sharing	$50/trip	10% coins. for non-diabetic DME/Pros./Supplies	covered under e.1.	$50/ER visit; $25/urgent care visit	$50/visit	no cost sharing	10% coins. for fac. radiology	no cost sharing	no cost sharing	"$15/visit; diab. training, cardiac rehab, clinic"	$15/visit for all prof. visits	covered under i.1.	covered under i.1.	covered under i.1.	10% coins. for prof. radiology	no cost sharing	10% coins.	no cost sharing	no covered services	no covered services	$15/routine vision exam	no covered services	no covered services	no covered services	no covered services	plan pays up to $350 for classes; see PBP notes	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	220	0	0	0	44	0.088	0	39.99922803	44	0	0.088	0	0	13.2	13.2	0	0	0	0.088	0	0.088	0	0	0	15	0	0	0	0	450.0685722	0	0	0	0	0	0	0	0	0	0	0	4.4253	0	0	0	1.163684791	1.934950446	0	1.758337796	1.5825459	0	2.60540551	0	0	0.175659958	22.5582259	0	0	0	2.689347693	0	3.478049989	0	0	0	0.209815025	0	0	0	0	0.039651009	0	0	0	0	0	0	0	0	0	0	0	42.621	0	5.777933627	4.4253	0	0	0	1.163684791	1.934950446	0	1.758337796	1.5825459	0	2.60540551	0	0	0.175659958	22.5582259	0	0	0	2.689347693	0	3.478049989	0	0	0	0.209815025	0	0	0	0	0.039651009	0	0	0	0	0	0	0	0	0	0	0	42.621	2500	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.4253	0	0	0	1.163684791	1.934950446	0	1.758337796	1.5825459	0	2.60540551	0	0	0.175659958	22.5582259	0	0	0	2.689347693	0	3.478049989	0	0	0	0.209815025	0	0	0	0	0.039651009	0	0	0	0	0	0	0	0	0	0	0	42.621
H9047_024_0	2008	10																																A			Coin	T	Coin		V	V		Coin		Coin	V	V				Coin		Coin	Coin			V					O												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		170.8471151	0	162.603241	15.12280912	173.5471041	13.57155123	0	364.2985531	350.0639937	0	33.23199982	0	29.87422215	64.50382671	17562.00424	0	0	0	32.15843024	0	28.71421024	0	0	0	185.6411974	0	0	0	0	1.041818918	0	0	0	0	0	0	0	0	0	0	0	$350/acute and MH admit	covered under a.1.	"Days 1-21 $0, Days 22-100 $50"	10% coins.	$50/trip	10% coins. for non-diabetic DME/Pros./Supplies	covered under e.1.	$50/ER visit; $25/urgent care visit	$100/visit	no cost sharing	10% coins. for fac. radiology	covered under h.4.	10% coins.; all other OP Facility	"$20/visit; diab. training, cardiac rehab, clinic"	$20/visit for all prof. visits	covered under i.1.	covered under i.1.	covered under i.1.	10% coins. for prof. radiology	covered under i.1.	10% coins.	10% coins.; includes some prof. and some OP fac.	no covered services	no covered services	$20/routine vision exam	no covered services	no covered services	no covered services	no covered services	plan pays up to $350 for classes; see PBP notes	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	308	0	44	0.088	44	0.088	0	40.12683342	88	0	0.088	0	0.088	17.6	17.6	0	0	0	0.088	0	0.088	0.088	0	0	20	0	0	0	0	450.0685722	0	0	0	0	0	0	0	0	0	0	0	4.3851	0	0.596211883	1.330807202	0.636339382	1.194296509	0	1.218178946	2.567135953	0	2.924415984	0	2.628931549	0.094605613	25.75760622	0	0	0	2.829941861	0	2.526850501	0	0	0	0.309401996	0	0	0	0	0.039074163	0	0	0	0	0	0	0	0	0	0	0	49.0389		6.639599667	4.3851	0	0.596211883	1.330807202	0.636339382	1.194296509	0	1.218178946	2.567135953	0	2.924415984	0	2.628931549	0.094605613	25.75760622	0	0	0	2.829941861	0	2.526850501	0	0	0	0.309401996	0	0	0	0	0.039074163	0	0	0	0	0	0	0	0	0	0	0	49.0389	3500	20% coins.	covered under a.1.	20% coins.	20% coins.	20% coins.	20% coins.	covered under e.1.	20% coins.	20% coins.	covered under h.5.	covered under h.5.	covered under h.5.	covered under h.5.	20% coins.	20% coins.	covered under i.1.	covered under i.1.	covered under i.1.	covered under i.1.	covered under i.1.	20% coins.	20% coins.	no covered services	no covered services	20% coins.	no covered services	no covered services	no covered services	no covered services	20% coins.	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	1.0421	0	0.1331	0.0989	0.0555	0.1345	0	0.1547	0.438	0	0	0	0	0.5144	2.8215	0	0	0	0	0	0.2131	0	0	0	0.0167	0	0	0	0	0.0014	0	0	0	0	0	0	0	0	0	0	0	5.6239		2.650459513	5.4272	0	0.729337776	1.429677397	0.691873734	1.328772553	0	1.372921646	3.005094659	0	2.924415984	0	2.628931549	0.609011987	28.57910093	0	0	0	2.829941861	0	2.739953928	3.36E-05	0	0	0.326067165	0	0	0	0	0.040499244	0	0	0	0	0	0	0	0	0	0	0	54.6628
H9047_033_0	2008	4																					2500											A				T	Coin		V	V		Coin			V	V				Coin		Coin				V					O												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		159.4085651	0	0	0	151.159091	11.7087015	0	312.7525688	417.9305327	0	24.82870659	0	0	85.17702281	15682.50437	0	0	0	25.74421347	0	28.72235098	0	0	0	184.1686124	0	0	0	0	1.060393591	0	0	0	0	0	0	0	0	0	0	0	$250/acute and MH admit	covered under a.1.	no cost sharing	no cost sharing	$50/trip	10% coins. for non-diabetic DME/Pros./Supplies	covered under e.1.	$50/ER visit; $25/urgent care visit	$50/visit	no cost sharing	10% coins. for fac. radiology	no cost sharing	no cost sharing	"$15/visit; diab. training, cardiac rehab, clinic"	$15/visit for all prof. visits	covered under i.1.	covered under i.1.	covered under i.1.	10% coins. for prof. radiology	no cost sharing	10% coins.	no cost sharing	no covered services	no covered services	$15/routine vision exam	no covered services	no covered services	no covered services	no covered services	plan pays up to $350 for classes; see PBP notes	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	220	0	0	0	44	0.088	0	40.12683342	44	0	0.088	0	0	13.2	13.2	0	0	0	0.088	0	0.088	0	0	0	15	0	0	0	0	450.0685722	0	0	0	0	0	0	0	0	0	0	0	2.9225	0	0	0	0.55425	1.030365732	0	1.045814186	1.532411953	0	2.18492618	0	0	0.093694725	17.2507548	0	0	0	2.265490786	0	2.527566886	0	0	0	0.230210765	0	0	0	0	0.039770819	0	0	0	0	0	0	0	0	0	0	0	31.6777	0	4.282877129	2.9225	0	0	0	0.55425	1.030365732	0	1.045814186	1.532411953	0	2.18492618	0	0	0.093694725	17.2507548	0	0	0	2.265490786	0	2.527566886	0	0	0	0.230210765	0	0	0	0	0.039770819	0	0	0	0	0	0	0	0	0	0	0	31.6777	2500	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			2.9225	0	0	0	0.55425	1.030365732	0	1.045814186	1.532411953	0	2.18492618	0	0	0.093694725	17.2507548	0	0	0	2.265490786	0	2.527566886	0	0	0	0.230210765	0	0	0	0	0.039770819	0	0	0	0	0	0	0	0	0	0	0	31.6777
H9047_035_0	2008	4																																A			Coin	T	Coin		V	V		Coin		Coin	V	V				Coin		Coin	Coin			V					O												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		46.98092365	0	29.98277353	2.641184039	38.39741933	2.50287898	0	95.2745659	146.4783257	0	7.122312071	0	13.59083583	88.33328237	6047.364904	0	0	0	8.916223877	0	10.31861845	0	0	0	83.08982986	0	0	0	0	1.057931195	0	0	0	0	0	0	0	0	0	0	0	$350/acute and MH admit	covered under a.1.	"Days 1-21 $0, Days 22-100 $50"	10% coins.	$50/trip	10% coins. for non-diabetic DME/Pros./Supplies	covered under e.1.	$50/ER visit; $25/urgent care visit	$100/visit	no cost sharing	10% coins. for fac. radiology	covered under h.4.	10% coins.; all other OP Facility	"$20/visit; diab. training, cardiac rehab, clinic"	$20/visit for all prof. visits	covered under i.1.	covered under i.1.	covered under i.1.	10% coins. for prof. radiology	covered under i.1.	10% coins.	10% coins.; includes some prof. and some OP fac.	no covered services	no covered services	$20/routine vision exam	no covered services	no covered services	no covered services	no covered services	plan pays up to $350 for classes; see PBP notes	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	308	0	44	0.088	44	0.088	0	40.12683342	88	0	0.088	0	0.088	17.6	17.6	0	0	0	0.088	0	0.088	0.088	0	0	20	0	0	0	0	450.0685722	0	0	0	0	0	0	0	0	0	0	0	1.2058	0	0.109936836	0.232424195	0.140790538	0.22025335	0	0.318588886	1.074174389	0	0.626763462	0	1.195993553	0.129555481	8.869468525	0	0	0	0.784627701	0	0.908038424	0	0	0	0.13848305	0	0	0	0	0.039678465	0	0	0	0	0	0	0	0	0	0	0	15.9946		2.15678987	1.2058	0	0.109936836	0.232424195	0.140790538	0.22025335	0	0.318588886	1.074174389	0	0.626763462	0	1.195993553	0.129555481	8.869468525	0	0	0	0.784627701	0	0.908038424	0	0	0	0.13848305	0	0	0	0	0.039678465	0	0	0	0	0	0	0	0	0	0	0	15.9946	3500	20% coins.	covered under a.1.	20% coins.	20% coins.	20% coins.	20% coins.	covered under e.1.	20% coins.	20% coins.	covered under h.5.	covered under h.5.	covered under h.5.	covered under h.5.	20% coins.	20% coins.	covered under i.1.	covered under i.1.	covered under i.1.	covered under i.1.	covered under i.1.	20% coins.	20% coins.	no covered services	no covered services	20% coins.	no covered services	no covered services	no covered services	no covered services	20% coins.	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	0.774	0	0.1077	0.0806	0.0451	0.0935	0	0.1101	0.3494	0	0	0	0	0.3797	2.0957	0	0	0	0	0	0.1692	0	0	0	0.0137	0	0	0	0	0.0011	0	0	0	0	0	0	0	0	0	0	0	4.2199		1.989150027	1.9798	0	0.217610441	0.313028815	0.185881706	0.313792297	0	0.428718798	1.42360119	0	0.626763462	0	1.195993553	0.509256019	10.96518369	0	0	0	0.784627701	0	1.077235332	4.32E-05	0	0	0.152152756	0	0	0	0	0.040802632	0	0	0	0	0	0	0	0	0	0	0	20.2145
H9047_801_0	2008	3																					none											Coin		Coin		Coin	Coin		Coin	Coin					Coin	Coin						Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	none	237.6507815	0	24.49427035	13.01933107	7.910497991	19.34765777	0	16.08199557	64.1690277	0	0	0	0	67.53145809	236.5488637	0	0	0	0	0	38.95715452	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	0.076023334	0	0.150613478	0	0.234	0.234	0	0.234	0.234	0	0	0	0	0.234	0.234	0	0	0	0	0	0.234	0.234	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.067	0	3.689167244	0	1.85105653	4.527351918	0	3.763186963	15.01555248	0	0	0	0	15.80236119	55.3524341	0	0	0	0	0	9.115974157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.1841	0	0	18.067	0	3.689167244	0	1.85105653	4.527351918	0	3.763186963	15.01555248	0	0	0	0	15.80236119	55.3524341	0	0	0	0	0	9.115974157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.1841	none	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.067	0	3.689167244	0	1.85105653	4.527351918	0	3.763186963	15.01555248	0	0	0	0	15.80236119	55.3524341	0	0	0	0	0	9.115974157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.1841
H9047_804_0	2008	2																					none											Coin		Coin		Coin	Coin		Coin	Coin					Coin	Coin						Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	none	216.6710607	0	27.56098317	15.39825347	7.273292613	18.85363213	0	16.18535536	63.51205692	0	0	0	0	65.23720751	238.2271054	0	0	0	0	0	39.3184114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	0.076558839	0	0.146124755	0	0.234	0.234	0	0.234	0.234	0	0	0	0	0.234	0.234	0	0	0	0	0	0.234	0.234	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.5881	0	4.027341919	0	1.701950472	4.411749917	0	3.787373154	14.86182132	0	0	0	0	15.26550656	55.74514267	0	0	0	0	0	9.200508268	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.5895	0	0	16.5881	0	4.027341919	0	1.701950472	4.411749917	0	3.787373154	14.86182132	0	0	0	0	15.26550656	55.74514267	0	0	0	0	0	9.200508268	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.5895	none	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.5881	0	4.027341919	0	1.701950472	4.411749917	0	3.787373154	14.86182132	0	0	0	0	15.26550656	55.74514267	0	0	0	0	0	9.200508268	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.5895
H9047_805_0	2008	3																					none											Coin		Coin		Coin	Coin		Coin	Coin					Coin	Coin						Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	none	216.6710607	0	27.56098317	15.39825347	7.273292613	18.85363213	0	16.18535536	63.51205692	0	0	0	0	65.23720751	238.2271054	0	0	0	0	0	39.3184114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	0.076558839	0	0.146124755	0	0.234	0.234	0	0.234	0.234	0	0	0	0	0.234	0.234	0	0	0	0	0	0.234	0.234	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.5881	0	4.027341919	0	1.701950472	4.411749917	0	3.787373154	14.86182132	0	0	0	0	15.26550656	55.74514267	0	0	0	0	0	9.200508268	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.5895	0	0	16.5881	0	4.027341919	0	1.701950472	4.411749917	0	3.787373154	14.86182132	0	0	0	0	15.26550656	55.74514267	0	0	0	0	0	9.200508268	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.5895	none	20% coins.	covered under a.1.	20% coins.	20% coins.	20% coins.	20% coins.	covered under e.1.	20% coins.	20% coins.	covered under h.5.	covered under h.5.	covered under h.5.	covered under h.5.	20% coins.	20% coins.	covered under i.1.	covered under i.1.	covered under i.1.	covered under i.1.	covered under i.1.	20% coins.	20% coins.	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	1.0807	0	0.1396	0.1002	0.0537	0.1452	0	0.129	0.506	0	0	0	0	0.5198	2.9926	0	0	0	0	0	0.2905	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.9575	0	2.792478622	17.6688	0	4.166970278	0.100238968	1.755695976	4.556968718	0	3.916332643	15.36786411	0	0	0	0	15.78529477	58.73775995	0	0	0	0	0	9.491049013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.547
H9047_806_0	2008	4																					none											Coin		Coin		Coin	Coin		Coin	Coin					Coin	Coin						Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	none	237.6507815	0	24.49427035	13.01933107	7.910497991	19.34765777	0	16.08199557	64.1690277	0	0	0	0	67.53145809	236.5488637	0	0	0	0	0	38.95715452	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	0.076023334	0	0.150613478	0	0.234	0.234	0	0.234	0.234	0	0	0	0	0.234	0.234	0	0	0	0	0	0.234	0.234	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.067	0	3.689167244	0	1.85105653	4.527351918	0	3.763186963	15.01555248	0	0	0	0	15.80236119	55.3524341	0	0	0	0	0	9.115974157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.1841	0	0	18.067	0	3.689167244	0	1.85105653	4.527351918	0	3.763186963	15.01555248	0	0	0	0	15.80236119	55.3524341	0	0	0	0	0	9.115974157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.1841	none	20% coins.	covered under a.1.	20% coins.	20% coins.	20% coins.	20% coins.	covered under e.1.	20% coins.	20% coins.	covered under h.5.	covered under h.5.	covered under h.5.	covered under h.5.	20% coins.	20% coins.	covered under i.1.	covered under i.1.	covered under i.1.	covered under i.1.	covered under i.1.	20% coins.	20% coins.	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	no covered services	1.1853	0	0.1241	0	0.0585	0.149	0	0.1281	0.5113	0	0	0	0	0.5381	2.9715	0	0	0	0	0	0.2879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.9538	0	2.874395488	19.2524	0	3.813259144	0	1.90951062	4.676375917	0	3.891322915	15.52682979	0	0	0	0	16.34042923	58.32396924	0	0	0	0	0	9.403845419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.1379
H9082_001_0	2008	6																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																													0		265.7782495	23.38868391	43.95006543		15.87747145	35.2215355	24.9015836	10.27792385	23.26636465	12.06400638	25.00191501	0	4.378161524	43.25850569	52.18195625	101.8085393	7.955532011	3.722570168	21.07186707	34.02819464	10.06036208	0.743773583	0	0	0	0	0	0	0	0	0											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0.077562338	0.077562338	0.194168693	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.23	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											20.6144	1.814081013	8.53372678	0	3.71532832	8.241839307	5.826970562	2.405034181	5.444329328	2.822977493	5.850448113	0	1.024489797	10.12249033	12.21057776	23.8231982	1.861594491	0.871081419	4.930816895	7.962597545	2.354124727	0.174043018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.6041	0	0	20.6144	1.814081013	8.53372678	0	3.71532832	8.241839307	5.826970562	2.405034181	5.444329328	2.822977493	5.850448113	0	1.024489797	10.12249033	12.21057776	23.8231982	1.861594491	0.871081419	4.930816895	7.962597545	2.354124727	0.174043018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.6041																																																																																				0	0		20.6144	1.814081013	8.53372678	0	3.71532832	8.241839307	5.826970562	2.405034181	5.444329328	2.822977493	5.850448113	0	1.024489797	10.12249033	12.21057776	23.8231982	1.861594491	0.871081419	4.930816895	7.962597545	2.354124727	0.174043018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.6041
H9082_002_0	2008	3																					2400											A	A			T	Coin	Coin	V	Coin		Coin			V	V	V	V	P	Coin	V	Coin			Coin	V		V																																																								0		203.0192146	2.794406714	0	0	183.2124546	11.76356393	7.387237422	353.1737327	25.18871926	0	10.80831641	0	0	433.1223113	6354.436591	11552.01975	134.3827921	1058.170267	18.83885958	1664.177375	7.236026476	0	0	34.83	348.2745398	0	163.6783197	0	0	0	0											$200/Admit for IP Medical; $200/Admit for IP Surgical	$200/Admit for IP Psych; $200/Admit for IP Substance Abuse	No Cost Sharing	No Cost Sharing	$75/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $20/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; $100/Case for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology;	No Cost Sharing	No Cost Sharing	$20/Case for OP Fac - Occ Therapy; $20/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $7/Service for Prof - CORF; $7/Service for Prof - CORF;	$5/Visit for PCP - Office Visits; $4/Consult for PCP - Consults; 20% Coinsurance for PCP - Primary Surgeon (OP); $2/Procedure for PCP - Asst Surgeon (OP); $2/Services for PCP - Tx Injections; $0/Tests for PCP - Allergy Testing; $3/Service for PCP - Allergy Tx;	20% Coinsurance for Speclst - Primary Surgeon (OP); $5/Procedure for Speclst - Asst Surgeon (OP); 20% Coinsurance for Speclst - Anesthesia (OP); $15/Visit for Speclst - Office Visits; $5/Services for Speclst - Tx Injections; $1/Tests for Speclst - Allergy Testing; $9/Service for Speclst - Allergy Tx; $12/Consult for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $15/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$7/Service for PT/ST (PCP); $7/Service for Occ Therapy (PCP); $7/Service for PT/ST (Specialist); $7/Service for Occ Therapy (Specialist);	3% Coinsurance for Prof Radiology (Office); 4% Coinsurance for Prof Radiology (OP);	$15/Visit for Chiropractor; $15/Exam for Vistion Exams; $15/Service for Podiatrist; $15/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	$5/Procedure for Dental - Preventive; 53% Coinsurance for Dental - Comprehensive;	$15/Exam for Vision (Refractions)	No Cost Sharing	$15/Exam for Routine Hearing Exams	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											200	199.9999999	0	0	75	0.2	0.2	42.48575463	0.145145293	0	0.2	0	0	16.3805613	3.59120003	10.2167358	15	6.666666666	0.031957558	15	0.2	0	0	0.435316777	15	0	15	0	0	0	0											3.3837	0.046573445	0	0	1.145077841	2.352712786	1.477447484	1.250404379	3.656024035	0	2.161663282	0	0	0.591232214	1.901671073	9.835327808	0.16797849	0.58787237	0.602043941	2.080221719	1.447205295	0	0	15.16208333	0.435343175	0	0.2045979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.4891	0	0	3.3837	0.046573445	0	0	1.145077841	2.352712786	1.477447484	1.250404379	3.656024035	0	2.161663282	0	0	0.591232214	1.901671073	9.835327808	0.16797849	0.58787237	0.602043941	2.080221719	1.447205295	0	0	15.16208333	0.435343175	0	0.2045979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.4891																																																																																				0	0		3.3837	0.046573445	0	0	1.145077841	2.352712786	1.477447484	1.250404379	3.656024035	0	2.161663282	0	0	0.591232214	1.901671073	9.835327808	0.16797849	0.58787237	0.602043941	2.080221719	1.447205295	0	0	15.16208333	0.435343175	0	0.2045979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.4891
H9101_007_0	2008	7																																D	D	D	P	T	Coin	P	V	V	V	P	V	V	V	P	P	P	P	P	V	Coin	P	T	P	V	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P																																										0		3113.40052		1830.207483		730.3590645	8.304867959		210.4034679	176.0463603		314.0158475				17819.25704		267.8907542	3257.229642	4593.842865	81.97010707	5.58321035		806.2657602																			"#1A $200/day day 1, $100/day days 2-7, $0/day days 8-90, #1B $200/day day 1, $100/day days 2-7, $0/day days 8-90"		"#2 $0/day days 1-7, $100/day days 8-39 and $0/day days 40-100"	#6 $0	#10A $50	"#11A 20% $1000/year OOP, #11B 20% $1000/year OOP, #11C $0"		"#4A $50, #4B $50"	"#9A $200, #9B $200"	#8A $0	#8B 0% X-Ray; 20% Therapeutic Radiological;$175 for Diagnostic Radiological			"#3 $25, #5 $20, #9C $20, #9D $0, #12 20%"	"#7A $0, #14B $0, #14C $0, #14D $0, #14E $0, #14F $0, #14G $0, #14H $0"	"#7B $20, #7D $20, #7F $20, #7G $20"	"#7E $20, #7H $20"	"#7C $25, #7I $25"	#8B 0% X-Ray; 20% Therapeutic Radiological;$175 for Diagnostic Radiological	"#14I $0 , #14J $25"	"#15 Coins: 20%; Copay: $0 for Chemotherapy Drugs, $75 for other Drugs"	#13A $0	#10B $5/$50	"#16A $0 , #16B $0"	#17A $20	#17B $10	#18A $0	#18B $0	#19 $0 n/c	#14A $0	#13B $20											72.6019		60.19		50	0.176		46.7095	173.757		108.9655				9.514		8.5913	9.9783	12.362	17.8379	0.2		5.45																			18.8366	0	9.180015698	0	3.043162769	1.461656761	0	0.818985861	2.5491079	0	2.851407523	0	0	0	14.12763908	0	0.191793368	2.708478333	4.732439135	0.121847967	1.11664207	0	0.366179033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.1059	0	0	18.8366	0	9.180015698	0	3.043162769	1.461656761	0	0.818985861	2.5491079	0	2.851407523	0	0	0	14.12763908	0	0.191793368	2.708478333	4.732439135	0.121847967	1.11664207	0	0.366179033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.1059																																																																																				0	0	0	18.8366	0	9.180015698	0	3.043162769	1.461656761	0	0.818985861	2.5491079	0	2.851407523	0	0	0	14.12763908	0	0.191793368	2.708478333	4.732439135	0.121847967	1.11664207	0	0.366179033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.1059
H9103_001_0	2008	6	r.										Other Non-Covered										2500	Expanded Care										D	D	D	V	T	Coin	Coin	V	V	V	V	Coin	V	V	V	V	V	V	V		S	O			V	V	V	V		V	O	Coin										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0			0	0	0	0		0	0	0										0	2500	1821.486277	90.8632236	899.1729971	1609.809451	1017.222792	17.1196415	0.663034139	811.4030687	772.9665018	31086.8716	3996.659647	6.286363811	5.79812353	599.2493959	6027.929873	4393.168588	396.0918518	585.2723265	4039.384461		1209.483108	180.5038943			988.2883714	92.83721418	96.13698999	17.82439061		29.11254803	0	60.60844718										$150/day $1500max/admit	$150/day $1500max/admit	$0 per day	$0 copay	$150 copay	20% Coinsurance	20% Coinsurance	$0-50/copay waived if admitted	$20-$100 per visit	$0 copay	$0-25 per visit	20% Coinsurance	$0 copay	$10-$20 per visit	$0-20 per visit	$0-150 per visit	$10 - $20 per visit	$20 per visit	$0 copay		$5-40 per script	$0 copay			$20 per visit	$0 copay	$20 per visit	$0 Copay		$0-$165 per class	$0 copay	20% Coinsurance										100.35	100.35	0	0	136.35	0.2	0.2	30.76	53.39	0	6.41	0.18	0	18.18	18.16	15.06	17.29	18.18	0		20.43	0			18.18	0	18.18	0		74	0	0.2										15.2322	0.759843707	0	0	11.55819398	3.423928301	0.132606828	2.079896533	3.439056794	0	2.134882362	1.131545486	0	0.907862835	9.122267208	5.513426578	0.570702343	0.886687575	0	0	2.059144992	0	0	0	1.497256883	0	0.14564754	0	0	0.17952738	0	12.12168944	0	0	0	0	0	0	0	0	0	72.8963	0	3.916473559	15.2322	0.759843707	0	0	11.55819398	3.423928301	0.132606828	2.079896533	3.439056794	0	2.134882362	1.131545486	0	0.907862835	9.122267208	5.513426578	0.570702343	0.886687575	0	0	2.059144992	0	0	0	1.497256883	0	0.14564754	0	0	0.17952738	0	12.12168944	0	0	0	0	0	0	0	0	0	72.8963	2500																															20% Coinsurance																																									0.1											0.1	0	0	15.2322	0.759843707	0	0	11.55819398	3.423928301	0.132606828	2.079896533	3.439056794	0	2.134882362	1.131545486	0	0.907862835	9.122267208	5.513426578	0.570702343	0.886687575	0	0	2.059144992	0	0	0	1.497256883	0	0.14564754	0	0	0.17952738	0.1	12.12168944	0	0	0	0	0	0	0	0	0	72.9963
H9104_006_0	2008	9																																D	D	D		T	Coin	Coin	V	V		Coin			V	V	V	V	V	Coin	V	Coin				V	P	V				V																																																				0		809.051762	14.51574012	438.3021597	0	318.2434031	3.055059536	1.916995261	901.1825515	200.7280523	0	14.7405215	0	0	136.5376933	7654.782964	6937.373516	347.2310038	2981.355593	54.6813346	3047.329484	0.000845384		0	0	257.0334527	175.8449056	94.98480436	0	0	0	3532.247217											copay/days 1-8	copay/days 1-8	copay/days 21-100	0	$50/run	0-10% DME	"0-10% Prosthetics, 0% Diab Supplies"	"$50 ER, $25 urgent care"	$50/OP hospital and ASC visits	0	"20% rad therapy, 0% specialized"	0	0	$10/visit cardiac rehab	$5/visit	$10/visit	$10/visit	"$10 PT & OT, $20 CORF"	"20% rad therapy, 20% specialized"	"$10 hearing, podiatry, & chiro"	20% coinsurance		0	0	$10/visit	$25/service	$0-$10/visit	0	0	0	ILP Services											50	50	20	0	50	0.05	0.045702532	42.50122452	50	0	0.045	0	0	10	5	10	10	11	0.088	10	0.2	0	0	0	10	25	5	0	0	0	15											3.371	0.06048225	0.7305036	0	1.32601418	0.152752977	0.087611537	3.191780163	0.836366885	0	0.663323467	0	0	0.113781411	3.189492902	5.781144597	0.28935917	2.732909293	4.811957445	2.539441236	0.000169077	0	0	0	0.214194544	0.366343553	0.039577002	0	0	0	4.415309022	0	0	0	0	0	0	0	0	0	0	34.9136			3.371	0.06048225	0.7305036	0	1.32601418	0.152752977	0.087611537	3.191780163	0.836366885	0	0.663323467	0	0	0.113781411	3.189492902	5.781144597	0.28935917	2.732909293	4.811957445	2.539441236	0.000169077	0	0	0	0.214194544	0.366343553	0.039577002	0	0	0	4.415309022	0	0	0	0	0	0	0	0	0	0	34.9136																																																																																				0			3.371	0.06048225	0.7305036	0	1.32601418	0.152752977	0.087611537	3.191780163	0.836366885	0	0.663323467	0	0	0.113781411	3.189492902	5.781144597	0.28935917	2.732909293	4.811957445	2.539441236	0.000169077	0	0	0	0.214194544	0.366343553	0.039577002	0	0	0	4.415309022	0	0	0	0	0	0	0	0	0	0	34.9136
H9104_007_0	2008	9																																D	D	D		T	Coin	Coin	V	V		Coin			V	V	V	V	V	Coin	V	Coin				V	P	V				V																																																				0		855.4710418	15.06572279	498.1676156	0	286.532272	2.05220334	1.286832422	806.866796	239.9137583		24.315485	0	0	198.95268	6328.927203	5735.194509	300.3146366	2581.702736	48.77761738	16257.11592	0.006624042		0	0	276.4954673	190.0059412	31.98418483	0	0	0	5146.277064											copay/days 1-10	copay/days 1-10	copay/days 21-100	0	$50/run	0-10% DME	"0-10% Prosthetics, 0% Diab Supplies"	"$50 ER, $25 urgent care"	$50/OP hospital and ASC visits	0	"20% rad therapy, 10% specialized"	0	0	$10/visit cardiac rehab	$5/visit	$10/visit	$10/visit	"$10 PT & OT, $20 CORF"	"20% rad therapy, 20% specialized"	"$10 hearing, podiatry, & chiro"	20% coinsurance		0	0	$10/visit	$25/service	$0-$10/visit	0	0	0	ILP Services											50	50	20	0	50	0.05	0.045699346	42.42533366	50	0	0.075	0	0	10	5	10	10	11	0.088	2.974315465	0.2	0	0	0	10	25	5	0	0	0	15											3.5645	0.062773845	0.830279359	0	1.193884467	0.102610167	0.058807401	2.852632753	0.999640659	0	1.823661375	0	0	0.1657939	2.637053001	4.779328757	0.250262197	2.366560841	4.29243033	4.029482608	0.001324808	0	0	0	0.230412889	0.395845711	0.013326744	0	0	0	6.43284633	0	0	0	0	0	0	0	0	0	0	37.0834			3.5645	0.062773845	0.830279359	0	1.193884467	0.102610167	0.058807401	2.852632753	0.999640659	0	1.823661375	0	0	0.1657939	2.637053001	4.779328757	0.250262197	2.366560841	4.29243033	4.029482608	0.001324808	0	0	0	0.230412889	0.395845711	0.013326744	0	0	0	6.43284633	0	0	0	0	0	0	0	0	0	0	37.0834																																																																																				0			3.5645	0.062773845	0.830279359	0	1.193884467	0.102610167	0.058807401	2.852632753	0.999640659	0	1.823661375	0	0	0.1657939	2.637053001	4.779328757	0.250262197	2.366560841	4.29243033	4.029482608	0.001324808	0	0	0	0.230412889	0.395845711	0.013326744	0	0	0	6.43284633	0	0	0	0	0	0	0	0	0	0	37.0834
H9104_008_0	2008	9																																D	D	D		T	Coin	Coin	V	V		Coin			V	V	V	V	V	Coin	V	Coin				V	P	V				V																																																				0		843.9820398	15.0637716	460.0847305	0	250.3743847	4.463663398	2.792073217	1082.947292	289.9806453	0	12.44183635	0	0	130.9826441	6646.723361	6017.239398	279.8012193	2394.680249	46.61978035	14021.28755	0.007304115		0	0	264.3271427	189.5186828	58.71582194	0	0	0	3310.441274											copay/days 1-10	copay/days 1-10	copay/days 21-100	0	$75/run	0-10% DME	"0-10% Prosthetics, 0% Diab Supplies"	"$50 ER, $25 urgent care"	$50/OP hospital and ASC visits	0	"20% rad therapy, 10% specialized"	0	0	$10/visit cardiac rehab	$10/visit	$10/visit	$10/visit	"$10 PT & OT, $20 CORF"	"20% rad therapy, 20% specialized"	"$10 hearing, podiatry, & chiro, 10% lab"	20% coinsurance		0	0	$10/visit	$25/service	$0-$10/visit	0	0	0	ILP Services											50	50	20	0	75	0.05	0.045692475	43.24184699	50	0	0.075	0	0	10	10	10	10	11	0.088	3.137147174	0.2	0	0	0	10	25	5	0	0	0	15											3.5166	0.062765715	0.766807884	0	1.564839904	0.22318317	0.127576737	3.902386757	1.208252689	0	0.933137727	0	0	0.109152203	5.538936134	5.014366165	0.233167683	2.195123561	4.102540671	3.665570219	0.001460823	0	0	0	0.220272619	0.394830589	0.024464926	0	0	0	4.138051593	0	0	0	0	0	0	0	0	0	0	37.9435			3.5166	0.062765715	0.766807884	0	1.564839904	0.22318317	0.127576737	3.902386757	1.208252689	0	0.933137727	0	0	0.109152203	5.538936134	5.014366165	0.233167683	2.195123561	4.102540671	3.665570219	0.001460823	0	0	0	0.220272619	0.394830589	0.024464926	0	0	0	4.138051593	0	0	0	0	0	0	0	0	0	0	37.9435																																																																																				0			3.5166	0.062765715	0.766807884	0	1.564839904	0.22318317	0.127576737	3.902386757	1.208252689	0	0.933137727	0	0	0.109152203	5.538936134	5.014366165	0.233167683	2.195123561	4.102540671	3.665570219	0.001460823	0	0	0	0.220272619	0.394830589	0.024464926	0	0	0	4.138051593	0	0	0	0	0	0	0	0	0	0	37.9435
H9104_009_0	2008	9																																D	D	D		T	Coin	Coin	V	V		Coin			V	V	V	V	V	Coin	V	Coin				V	P	V				V																																																				0		877.937952	15.66983202	600.5512764	0	358.1447403	6.827762811	4.270844814	2135.495798	192.1518631	0	12.2815036	0	0	129.2947253	6398.696045	5792.701734	269.3602333	2305.321014	44.88012934	13498.07301	0.003408199		0	0	264.0908266	189.3492476	60.91285004	0	0	0	4064.477913											copay/days 1-10	copay/days 1-10	copay/days 21-100	0	$75/run	0-10% DME	"0-10% Prosthetics, 0% Diab Supplies"	"$50 ER, $25 urgent care"	$50/OP hospital and ASC visits	0	"20% rad therapy, 10% specialized"	0	0	$10/visit cardiac rehab	$10/visit	$10/visit	$10/visit	"$10 PT & OT, $20 CORF"	"20% rad therapy, 20% specialized"	"$10 hearing, podiatry, & chiro, 10% lab"	20% coinsurance	0	0	0	$10/visit	$25/service	$0-$10/visit	0	0	0	ILP Services											50	50	20	0	75	0.05	0.045692475	43.24184699	50	0	0.075	0	0	10	10	10	10	11	0.088	3.137147174	0.2	0	0	0	10	25	5	0	0	0	15											3.6581	0.065290967	1.000918794	0	2.238404627	0.341388141	0.195145472	7.695231878	0.800632763	0	0.92111277	0	0	0.107745604	5.332246704	4.827251445	0.224466861	2.113210929	3.949451382	3.5287868	0.00068164	0	0	0	0.220075689	0.394477599	0.025380354	0	0	0	5.080597391	0	0	0	0	0	0	0	0	0	0	42.7206			3.6581	0.065290967	1.000918794	0	2.238404627	0.341388141	0.195145472	7.695231878	0.800632763	0	0.92111277	0	0	0.107745604	5.332246704	4.827251445	0.224466861	2.113210929	3.949451382	3.5287868	0.00068164	0	0	0	0.220075689	0.394477599	0.025380354	0	0	0	5.080597391	0	0	0	0	0	0	0	0	0	0	42.7206																																																																																				0			3.6581	0.065290967	1.000918794	0	2.238404627	0.341388141	0.195145472	7.695231878	0.800632763	0	0.92111277	0	0	0.107745604	5.332246704	4.827251445	0.224466861	2.113210929	3.949451382	3.5287868	0.00068164	0	0	0	0.220075689	0.394477599	0.025380354	0	0	0	5.080597391	0	0	0	0	0	0	0	0	0	0	42.7206
H9104_013_0	2008	9																																D	D	D		T	Coin	Coin	V	V		Coin			V	V	V	V	V	Coin	V	Coin				V	P	V				V																																																				0		972.4780028	17.44787988	576.6807656	0	391.5165368	3.985475404	2.500814591	1515.937305	248.8400673	0	0	0	0	0	10662.62349	9663.317973	483.6705984	4152.837816	76.16760467	4244.73523	0.00035659		0	0	358.9140261	245.5447039	662.0987616	0	0	0	2734.393365											copay/days 1-8	copay/days 1-8	copay/days 21-100	0	$50/run	0-10% DME	"0-10% Prosthetics, 0% Diab Supplies"	"$50 ER, $25 urgent care"	$50/OP hospital and ASC visits	0	"20% rad therapy, 0% specialized"	0	0	$10/visit cardiac rehab	$5/visit	$10/visit	$10/visit	"$10 PT & OT, $20 CORF"	"20% rad therapy, 20% specialized"	"$10 hearing, podiatry, & chiro"	20% coinsurance		0	0	$10/visit	$25/service	$0-$10/visit	0	0	0	ILP Services											50	50	20	0	50	0.05	0.045702532	42.50122452	50	0	0.045	0	0	10	5	10	10	11	0.088	10	0.2	0	0	0	10	25	5	0	0	0	15											4.052	0.072699499	0.961134609	0	1.631318903	0.19927377	0.114293558	5.369099312	1.036833614	0	0	0	0	0	4.442759786	8.052764977	0.403058832	3.806767998	6.702749211	3.537279358	7.13E-05	0	0	0	0.299095022	0.511551466	0.275874484	0	0	0	3.417991706	0	0	0	0	0	0	0	0	0	0	44.8866			4.052	0.072699499	0.961134609	0	1.631318903	0.19927377	0.114293558	5.369099312	1.036833614	0	0	0	0	0	4.442759786	8.052764977	0.403058832	3.806767998	6.702749211	3.537279358	7.13E-05	0	0	0	0.299095022	0.511551466	0.275874484	0	0	0	3.417991706	0	0	0	0	0	0	0	0	0	0	44.8866																																																																																				0			4.052	0.072699499	0.961134609	0	1.631318903	0.19927377	0.114293558	5.369099312	1.036833614	0	0	0	0	0	4.442759786	8.052764977	0.403058832	3.806767998	6.702749211	3.537279358	7.13E-05	0	0	0	0.299095022	0.511551466	0.275874484	0	0	0	3.417991706	0	0	0	0	0	0	0	0	0	0	44.8866
H9104_014_0	2008	9																																D	D	D		T	Coin	Coin	V	V		Coin			V	V	V	V	V	Coin	V	Coin				V	P	V				V																																																				0		1088.375973	19.42582461	755.6676817	0	359.9058759	7.877877691	4.927703849	2119.217801	453.4836673	0	0	0	0	0	9188.846068	8318.608069	386.8147047	3310.555742	64.45010001	19383.90482	0		0	0	367.0636142	263.1792254	1067.56638	0	0	0	4742.031539											copay/days 1-10	copay/days 1-10	copay/days 21-100	0	$75/run	0-10% DME	"0-10% Prosthetics, 0% Diab Supplies"	"$50 ER, $25 urgent care"	$50/OP hospital and ASC visits	0	"20% rad therapy, 10% specialized"	0	0	$10/visit cardiac rehab	$10/visit	$10/visit	$10/visit	"$10 PT & OT, $20 CORF"	"20% rad therapy, 20% specialized"	"$10 hearing, podiatry, & chiro, 10% lab"	20% coinsurance		0	0	$10/visit	$25/service	$0-$10/visit	0	0	0	ILP Services											50	50	20	0	75	0.05	0.045692475	43.24184699	50	0	0.075	0	0	10	10	10	10	11	0.088	3.137147174	0.2	0	0	0	10	25	5	0	0	0	15											4.5349	0.080940936	1.259446136	0	2.249411724	0.393893885	0.225158987	7.636574322	1.88951528	0	0	0	0	0	7.657371723	6.932173391	0.322345587	3.034676097	5.671608801	5.067513519	0	0	0	0	0.305886345	0.548290053	0.444819325	0	0	0	5.927539424	0	0	0	0	0	0	0	0	0	0	54.1821			4.5349	0.080940936	1.259446136	0	2.249411724	0.393893885	0.225158987	7.636574322	1.88951528	0	0	0	0	0	7.657371723	6.932173391	0.322345587	3.034676097	5.671608801	5.067513519	0	0	0	0	0.305886345	0.548290053	0.444819325	0	0	0	5.927539424	0	0	0	0	0	0	0	0	0	0	54.1821																																																																																				0			4.5349	0.080940936	1.259446136	0	2.249411724	0.393893885	0.225158987	7.636574322	1.88951528	0	0	0	0	0	7.657371723	6.932173391	0.322345587	3.034676097	5.671608801	5.067513519	0	0	0	0	0.305886345	0.548290053	0.444819325	0	0	0	5.927539424	0	0	0	0	0	0	0	0	0	0	54.1821
H9104_015_0	2008	9																																D	D	D		T	Coin	Coin	V	V		Coin			V	V	V	V	V	Coin	V	Coin				V	P	V				V																																																				0		1247.21251	22.26081066	466.2487323	0	564.3097341	7.884880068	4.932083917	4647.552877	225.2607137	0	0	0	0	0	8610.998354	7795.485947	362.4895619	3102.368876	60.39710547	18164.93293	0		0	0	357.2618518	256.1515055	361.7546112	0	0	0	267.3879023											copay/days 1-10	copay/days 1-10	copay/days 21-100	0	$75/run	0-10% DME	"0-10% Prosthetics, 0% Diab Supplies"	"$50 ER, $25 urgent care"	$50/OP hospital and ASC visits	0	"20% rad therapy, 10% specialized"	0	0	$10/visit cardiac rehab	$10/visit	$10/visit	$10/visit	"$10 PT & OT, $20 CORF"	"20% rad therapy, 20% specialized"	"$10 hearing, podiatry, & chiro, 10% lab"	20% coinsurance	0	0	0	$10/visit	$25/service	$0-$10/visit	0	0	0	ILP Services											50	50	20	0	75	0.05	0.045692475	43.24184699	50	0	0.075	0	0	10	10	10	10	11	0.088	3.137147174	0.2	0	0	0	10	25	5	0	0	0	15											5.1967	0.092753378	0.77708122	0	3.526935838	0.394244003	0.225359123	16.74739753	0.938586307	0	0	0	0	0	7.175831961	6.496238289	0.302074635	2.843838136	5.314945281	4.748839	0	0	0	0	0.29771821	0.53364897	0.150731088	0	0	0	0.334234878	0	0	0	0	0	0	0	0	0	0	56.0972			5.1967	0.092753378	0.77708122	0	3.526935838	0.394244003	0.225359123	16.74739753	0.938586307	0	0	0	0	0	7.175831961	6.496238289	0.302074635	2.843838136	5.314945281	4.748839	0	0	0	0	0.29771821	0.53364897	0.150731088	0	0	0	0.334234878	0	0	0	0	0	0	0	0	0	0	56.0972																																																																																				0			5.1967	0.092753378	0.77708122	0	3.526935838	0.394244003	0.225359123	16.74739753	0.938586307	0	0	0	0	0	7.175831961	6.496238289	0.302074635	2.843838136	5.314945281	4.748839	0	0	0	0	0.29771821	0.53364897	0.150731088	0	0	0	0.334234878	0	0	0	0	0	0	0	0	0	0	56.0972
H9104_801_0	2008	3																																A	A	D					V	V	V	V				V	V	V	V	V	V	Coin	O		V	V	P	V				V																																																				0		251.6797233	3.265448277	447.4920287	0	0	0	0	1148.153817	205.560824	1068.484077	563.3009043	0	0	0	12132.2841	10992.77853	553.1346954	4749.153016	11263.64357	30763.73359	5.066732429	800.6220047	0	90	177.5802267	122.6904854	564.9743662	0	0	0	1556.765009											copay/admit	copay/admit	copay/days 21-100	0	0	0	0	"$50 ER, $15 urgent care"	$15/OP hospital and ASC visits	$15 copay	$15 copay	0	0	0	$15/visit	$30/visit	$15/visit	$10/visit	$15 copay	"$15 hearing, pod, chiro, lab"	20% coinsurance	$15/visit	0	$8/visit	$15/visit	$20/service	$0-$15/visit	0	0	0	$15/visit											100	100	100	0	0	0	0	39.27857074	15	15	15	0	0	0	15	30	15	10	15	14.3838103	0.2	15	0	8	15	20	7.5	0	0	0	15											2.0973	0.027212069	3.729100239	0	0	0	0	3.758153411	0.25695103	1.335605097	0.70412613	0	0	0	15.16535512	27.48194634	0.691418369	3.957627513	14.07955446	36.87497567	1.013346486	1.000777506	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0	1.945956261	0	0	0	0	0	0	0	0	0	0	114.959			2.0973	0.027212069	3.729100239	0	0	0	0	3.758153411	0.25695103	1.335605097	0.70412613	0	0	0	15.16535512	27.48194634	0.691418369	3.957627513	14.07955446	36.87497567	1.013346486	1.000777506	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0	1.945956261	0	0	0	0	0	0	0	0	0	0	114.959																																																																																				0			2.0973	0.027212069	3.729100239	0	0	0	0	3.758153411	0.25695103	1.335605097	0.70412613	0	0	0	15.16535512	27.48194634	0.691418369	3.957627513	14.07955446	36.87497567	1.013346486	1.000777506	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0	1.945956261	0	0	0	0	0	0	0	0	0	0	114.959
H9104_802_0	2008	3																																A	A	D					V	V	V	V				V	V	V	V	V	V	Coin	O		V	V	P	V				V																																																				0		251.6797233	3.265448277	447.4920287	0	0	0	0	1148.153817	205.560824	1068.484077	563.3009043	0	0	0	12132.2841	10992.77853	553.1346954	4749.153016	11263.64357	30763.73359	5.066732429	800.6220047	0	90	177.5802267	122.6904854	564.9743662	0	0	0	1556.765009											copay/admit	copay/admit	copay/days 21-100	0	0	0	0	"$50 ER, $15 urgent care"	$15/OP hospital and ASC visits	$15 copay	$15 copay	0	0	0	$15/visit	$30/visit	$15/visit	$10/visit	$15 copay	"$15 hearing, pod, chiro, lab"	20% coinsurance	$15/visit	0	$8/visit	$15/visit	$20/service	$0-$15/visit	0	0	0	$15/visit											100	100	100	0	0	0	0	39.27857074	15	15	15	0	0	0	15	30	15	10	15	14.3838103	0.2	15	0	8	15	20	7.5	0	0	0	15											2.0973	0.027212069	3.729100239	0	0	0	0	3.758153411	0.25695103	1.335605097	0.70412613	0	0	0	15.16535512	27.48194634	0.691418369	3.957627513	14.07955446	36.87497567	1.013346486	1.000777506	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0	1.945956261	0	0	0	0	0	0	0	0	0	0	114.959			2.0973	0.027212069	3.729100239	0	0	0	0	3.758153411	0.25695103	1.335605097	0.70412613	0	0	0	15.16535512	27.48194634	0.691418369	3.957627513	14.07955446	36.87497567	1.013346486	1.000777506	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0	1.945956261	0	0	0	0	0	0	0	0	0	0	114.959																																																																																				0			2.0973	0.027212069	3.729100239	0	0	0	0	3.758153411	0.25695103	1.335605097	0.70412613	0	0	0	15.16535512	27.48194634	0.691418369	3.957627513	14.07955446	36.87497567	1.013346486	1.000777506	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0	1.945956261	0	0	0	0	0	0	0	0	0	0	114.959
H9104_803_0	2008	3																																A	A	D					V	V	V	V				V	V	V	V	V	V	Coin	O		V	V	P	V				V																																																				0		251.6797233	3.265448277	447.4920287	0	0	0	0	1148.153817	205.560824	1068.484077	563.3009043	0	0	0	12132.2841	10992.77853	553.1346954	4749.153016	11263.64357	30763.73359	5.066732429	800.6220047	0	90	177.5802267	122.6904854	564.9743662	0	0	0	1556.765009											copay/admit	copay/admit	copay/days 21-100	0	0	0	0	"$50 ER, $15 urgent care"	$15/OP hospital and ASC visits	$15 copay	$15 copay	0	0	0	$15/visit	$30/visit	$15/visit	$10/visit	$15 copay	"$15 hearing, pod, chiro, lab"	20% coinsurance	$15/visit	0	$8/visit	$15/visit	$20/service	$0-$15/visit	0	0	0	$15/visit											100	100	100	0	0	0	0	39.27857074	15	15	15	0	0	0	15	30	15	10	15	14.3838103	0.2	15	0	8	15	20	7.5	0	0	0	15											2.0973	0.027212069	3.729100239	0	0	0	0	3.758153411	0.25695103	1.335605097	0.70412613	0	0	0	15.16535512	27.48194634	0.691418369	3.957627513	14.07955446	36.87497567	1.013346486	1.000777506	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0	1.945956261	0	0	0	0	0	0	0	0	0	0	114.959			2.0973	0.027212069	3.729100239	0	0	0	0	3.758153411	0.25695103	1.335605097	0.70412613	0	0	0	15.16535512	27.48194634	0.691418369	3.957627513	14.07955446	36.87497567	1.013346486	1.000777506	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0	1.945956261	0	0	0	0	0	0	0	0	0	0	114.959																																																																																				0			2.0973	0.027212069	3.729100239	0	0	0	0	3.758153411	0.25695103	1.335605097	0.70412613	0	0	0	15.16535512	27.48194634	0.691418369	3.957627513	14.07955446	36.87497567	1.013346486	1.000777506	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0	1.945956261	0	0	0	0	0	0	0	0	0	0	114.959
H9104_804_0	2008	3																																A	A	D					V	V	V	V				V	V	V	V	V	V	Coin	O		V	V	P	V				V																																																				0		251.6797233	3.265448277	447.4920287	0	0	0	0	1148.153817	205.560824	1068.484077	563.3009043	0	0	0	12132.2841	10992.77853	553.1346954	4749.153016	11263.64357	30763.73359	5.066732429	800.6220047	0	90	177.5802267	122.6904854	564.9743662	0	0	0	1556.765009											copay/admit	copay/admit	copay/days 21-100	0	0	0	0	"$50 ER, $15 urgent care"	$15/OP hospital and ASC visits	$15 copay	$15 copay	0	0	0	$15/visit	$30/visit	$15/visit	$10/visit	$15 copay	"$15 hearing, pod, chiro, lab"	20% coinsurance	$15/visit	0	$8/visit	$15/visit	$20/service	$0-$15/visit	0	0	0	$15/visit											100	100	100	0	0	0	0	39.27857074	15	15	15	0	0	0	15	30	15	10	15	14.3838103	0.2	15	0	8	15	20	7.5	0	0	0	15											2.0973	0.027212069	3.729100239	0	0	0	0	3.758153411	0.25695103	1.335605097	0.70412613	0	0	0	15.16535512	27.48194634	0.691418369	3.957627513	14.07955446	36.87497567	1.013346486	1.000777506	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0	1.945956261	0	0	0	0	0	0	0	0	0	0	114.959			2.0973	0.027212069	3.729100239	0	0	0	0	3.758153411	0.25695103	1.335605097	0.70412613	0	0	0	15.16535512	27.48194634	0.691418369	3.957627513	14.07955446	36.87497567	1.013346486	1.000777506	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0	1.945956261	0	0	0	0	0	0	0	0	0	0	114.959																																																																																				0			2.0973	0.027212069	3.729100239	0	0	0	0	3.758153411	0.25695103	1.335605097	0.70412613	0	0	0	15.16535512	27.48194634	0.691418369	3.957627513	14.07955446	36.87497567	1.013346486	1.000777506	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0	1.945956261	0	0	0	0	0	0	0	0	0	0	114.959
H9302_001_0	2008	6																					1500											D	D	D		T	Coin	Coin	V	V		V		P	V	V	V	V	P		P	Coin				V		V				P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		771.8317063	17.33271531	691.8879948	0	211.6869025	13.98281441	7.80423838	427.3077274	322.6361168	0	286.2296322	0	36.49058948	730.8554802	5563.756383	6474.085496	207.7154563	515.1795566	0	3149.813357	11.49823195	0	0	0	419.8307802	0	35.98549544	0	0	0	398.7739531											$100/Day for IP Medical; $100/Day for IP Surgical	$100/Day for IP Psych; $100/Day for IP Substance Abuse	$100/Day for SNF		$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $15/Visit for Urgent Care; $15/Visit for Urgent Care - Worldwide;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC		$50/Case for OP Fac - CT/MRI/PET		$15/Case for Renal Dialysis - Fac; $15/Procedure for Renal Dialysis - Prof	$15/Case for OP Fac - Cardiovascular; $15/Case for OP Fac - Occ Therapy; $15/Case for OP Fac - Physical/Speech Therapy; $15/Case for OP Fac - CORF; $15/Case for OP Fac - Other; $15/Service for Prof - CORF; $15/Service for Prof - CORF;	$5/Visit for PCP - Office Visits; $5/Consult for PCP - Consults; $5/Exam for PCP - Routine Physicals; $15/Procedure for PCP - Cardio;	$15/Visit for Speclst - Office Visits; $50/Visit for Speclst - ER Visits; $5/Consult for Speclst - Consults; $15/Procedure for Speclst - Cardio;	$15/Visit for OP Psych - Non-Physician; $15/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$15/Service for PT/ST (PCP); $15/Service for Occ Therapy (PCP); $15/Service for PT/ST (Specialist); $15/Service for Occ Therapy (Specialist);		$15/Visit for Chiropractor; $15/Exam for Vistion Exams; $15/Service for Podiatrist; $15/Exam for Hearing/Speech Exams; $15/Procedure for Misc. Medical (PCP);	10% Coinsurance for Part B Rx				$15/Exam for Vision (Refractions)		$15/Exam for Routine Hearing Exams				$15/Service for Acupunture;											94.32624334	94.32624336	94.32624334	0	47.16312167	0.188652487	0.188652487	38.23223609	47.16312166	0	47.16312167	0	14.14893649	14.1489365	5.787132344	14.89075997	14.1489365	14.1489365	0	14.1489365	0.094326243	0	0	0	14.1489365	0	14.1489365	0	0	0	14.1489365											6.067	0.13624416	5.438599613	0	0.831984595	2.637892708	1.472288977	1.361410827	1.268043869	0	1.124956914	0	0.043025253	0.861735648	2.683182877	8.033671096	0.244912733	0.607436903	0	3.713875764	1.084585025	0	0	0	0.495013254	0	0.042429707	0	0	0	0.470185612	0	0	0	0	0	0	0	0	0	0	38.6185	0	2.322914793	6.067	0.13624416	5.438599613	0	0.831984595	2.637892708	1.472288977	1.361410827	1.268043869	0	1.124956914	0	0.043025253	0.861735648	2.683182877	8.033671096	0.244912733	0.607436903	0	3.713875764	1.084585025	0	0	0	0.495013254	0	0.042429707	0	0	0	0.470185612	0	0	0	0	0	0	0	0	0	0	38.6185																																																																																				0	0		6.067	0.13624416	5.438599613	0	0.831984595	2.637892708	1.472288977	1.361410827	1.268043869	0	1.124956914	0	0.043025253	0.861735648	2.683182877	8.033671096	0.244912733	0.607436903	0	3.713875764	1.084585025	0	0	0	0.495013254	0	0.042429707	0	0	0	0.470185612	0	0	0	0	0	0	0	0	0	0	38.6185
H9302_002_0	2008	2																					1500											D	D	D		T	Coin	Coin	V	V		V		P	V	V	V	V	P		P	Coin				V		V				P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		771.8317063	17.33271531	691.8879948	0	211.6869025	13.98281441	7.80423838	427.3077274	322.6361168	0	286.2296322	0	36.49058948	730.8554802	5563.756383	6474.085496	207.7154563	515.1795566	0	3149.813357	11.49823195	0	0	0	419.8307802	0	35.98549544	0	0	0	398.7739531											$100/Day for IP Medical; $100/Day for IP Surgical	$100/Day for IP Psych; $100/Day for IP Substance Abuse	$100/Day for SNF		$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $15/Visit for Urgent Care; $15/Visit for Urgent Care - Worldwide;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC		$50/Case for OP Fac - CT/MRI/PET		$15/Case for Renal Dialysis - Fac; $15/Procedure for Renal Dialysis - Prof	$15/Case for OP Fac - Cardiovascular; $15/Case for OP Fac - Occ Therapy; $15/Case for OP Fac - Physical/Speech Therapy; $15/Case for OP Fac - CORF; $15/Case for OP Fac - Other; $15/Service for Prof - CORF; $15/Service for Prof - CORF;	$5/Visit for PCP - Office Visits; $5/Consult for PCP - Consults; $5/Exam for PCP - Routine Physicals; $15/Procedure for PCP - Cardio;	$15/Visit for Speclst - Office Visits; $50/Visit for Speclst - ER Visits; $5/Consult for Speclst - Consults; $15/Procedure for Speclst - Cardio;	$15/Visit for OP Psych - Non-Physician; $15/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$15/Service for PT/ST (PCP); $15/Service for Occ Therapy (PCP); $15/Service for PT/ST (Specialist); $15/Service for Occ Therapy (Specialist);		$15/Visit for Chiropractor; $15/Exam for Vistion Exams; $15/Service for Podiatrist; $15/Exam for Hearing/Speech Exams; $15/Procedure for Misc. Medical (PCP);	10% Coinsurance for Part B Rx				$15/Exam for Vision (Refractions)		$15/Exam for Routine Hearing Exams				$15/Service for Acupunture;											94.32624334	94.32624336	94.32624334	0	47.16312167	0.188652487	0.188652487	38.23223609	47.16312166	0	47.16312167	0	14.14893649	14.1489365	5.787132344	14.89075997	14.1489365	14.1489365	0	14.1489365	0.094326243	0	0	0	14.1489365	0	14.1489365	0	0	0	14.1489365											6.067	0.13624416	5.438599613	0	0.831984595	2.637892708	1.472288977	1.361410827	1.268043869	0	1.124956914	0	0.043025253	0.861735648	2.683182877	8.033671096	0.244912733	0.607436903	0	3.713875764	1.084585025	0	0	0	0.495013254	0	0.042429707	0	0	0	0.470185612	0	0	0	0	0	0	0	0	0	0	38.6185	0	2.322914793	6.067	0.13624416	5.438599613	0	0.831984595	2.637892708	1.472288977	1.361410827	1.268043869	0	1.124956914	0	0.043025253	0.861735648	2.683182877	8.033671096	0.244912733	0.607436903	0	3.713875764	1.084585025	0	0	0	0.495013254	0	0.042429707	0	0	0	0.470185612	0	0	0	0	0	0	0	0	0	0	38.6185																																																																																				0	0		6.067	0.13624416	5.438599613	0	0.831984595	2.637892708	1.472288977	1.361410827	1.268043869	0	1.124956914	0	0.043025253	0.861735648	2.683182877	8.033671096	0.244912733	0.607436903	0	3.713875764	1.084585025	0	0	0	0.495013254	0	0.042429707	0	0	0	0.470185612	0	0	0	0	0	0	0	0	0	0	38.6185
H9302_003_0	2008	4																					3250											D	D	D		T	Coin	Coin	V	V		V		P	V	V	V	V	P		P	Coin				V		V				P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		801.4738237	21.08036751	1193.779955	0	193.9519557	12.77962212	7.147856872	385.1570079	295.5952044	0	260.1235139	0	32.77591316	662.4957956	4379.433112	5657.429887	176.6824966	457.9661	0	2699.994696	10.53779001	0	0	0	418.7228478	0	35.89052982	0	0	0	385.843957											$250/Day for IP Medical; $250/Day for IP Surgical	$250/Day for IP Psych; $250/Day for IP Substance Abuse	$150/Day for SNF		$150/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $30/Visit for Urgent Care; $30/Visit for Urgent Care - Worldwide;	$200/Case for OP Fac - Surgery; $200/Case for OP Fac - ASC		$100/Case for OP Fac - CT/MRI/PET		$30/Case for Renal Dialysis - Fac; $30/Procedure for Renal Dialysis - Prof	$30/Case for OP Fac - Cardiovascular; $30/Case for OP Fac - Occ Therapy; $30/Case for OP Fac - Physical/Speech Therapy; $30/Case for OP Fac - CORF; $30/Case for OP Fac - Other; $30/Service for Prof - CORF; $30/Service for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults; $10/Exam for PCP - Routine Physicals;	$30/Visit for Speclst - Office Visits; $50/Visit for Speclst - ER Visits; $10/Consult for Speclst - Consults; $30/Procedure for Speclst - Cardio;	$30/Visit for OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/Visit for OP Substance Abuse;	$30/Service for PT/ST (PCP); $30/Service for Occ Therapy (PCP); $30/Service for PT/ST (Specialist); $30/Service for Occ Therapy (Specialist);		$25/Visit for Chiropractor; $30/Exam for Vistion Exams; $30/Service for Podiatrist; $30/Exam for Hearing/Speech Exams; $30/Procedure for Misc. Medical (PCP);	10% Coinsurance for Part B Rx				$30/Exam for Vision (Refractions)		$30/Exam for Routine Hearing Exams				$25/Service for Acupunture;											237.7078726	237.7078726	142.6247236	0	142.6247236	0.190166298	0.190166298	42.64015063	190.1662981	0	95.08314904	0	28.52494471	28.52494471	9.508314904	27.44921509	28.52494471	28.52494472	0	27.43172722	0.095083149	0	0	0	28.52494471	0	28.5249447	0	0	0	23.77078726											15.8764	0.417580776	14.18854468	0	2.305195338	2.430253429	1.359281481	1.36859607	4.684353813	0	2.06111357	0	0.077910926	1.574804662	3.470085761	12.94100082	0.419988204	1.088621474	0	6.1721265	1.001966258	0	0	0	0.995337174	0	0.085314615	0	0	0	0.764317885	0	0	0	0	0	0	0	0	0	0	73.2828	0	3.789530638	15.8764	0.417580776	14.18854468	0	2.305195338	2.430253429	1.359281481	1.36859607	4.684353813	0	2.06111357	0	0.077910926	1.574804662	3.470085761	12.94100082	0.419988204	1.088621474	0	6.1721265	1.001966258	0	0	0	0.995337174	0	0.085314615	0	0	0	0.764317885	0	0	0	0	0	0	0	0	0	0	73.2828																																																																																				0	0		15.8764	0.417580776	14.18854468	0	2.305195338	2.430253429	1.359281481	1.36859607	4.684353813	0	2.06111357	0	0.077910926	1.574804662	3.470085761	12.94100082	0.419988204	1.088621474	0	6.1721265	1.001966258	0	0	0	0.995337174	0	0.085314615	0	0	0	0.764317885	0	0	0	0	0	0	0	0	0	0	73.2828
H9302_004_0	2008	2																					3250											D	D	D		T	Coin	Coin	V	V		V		P	V	V	V	V	P		P	Coin				V		V				P											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		801.4738237	21.08036751	1193.779955	0	193.9519557	12.77962212	7.147856872	385.1570079	295.5952044	0	260.1235139	0	32.77591316	662.4957956	4379.433112	5657.429887	176.6824966	457.9661	0	2699.994696	10.53779001	0	0	0	418.7228478	0	35.89052982	0	0	0	385.843957											$250/Day for IP Medical; $250/Day for IP Surgical	$250/Day for IP Psych; $250/Day for IP Substance Abuse	$150/Day for SNF		$150/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $30/Visit for Urgent Care; $30/Visit for Urgent Care - Worldwide;	$200/Case for OP Fac - Surgery; $200/Case for OP Fac - ASC		$100/Case for OP Fac - CT/MRI/PET		$30/Case for Renal Dialysis - Fac; $30/Procedure for Renal Dialysis - Prof	$30/Case for OP Fac - Cardiovascular; $30/Case for OP Fac - Occ Therapy; $30/Case for OP Fac - Physical/Speech Therapy; $30/Case for OP Fac - CORF; $30/Case for OP Fac - Other; $30/Service for Prof - CORF; $30/Service for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults; $10/Exam for PCP - Routine Physicals;	$30/Visit for Speclst - Office Visits; $50/Visit for Speclst - ER Visits; $10/Consult for Speclst - Consults; $30/Procedure for Speclst - Cardio;	$30/Visit for OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/Visit for OP Substance Abuse;	$30/Service for PT/ST (PCP); $30/Service for Occ Therapy (PCP); $30/Service for PT/ST (Specialist); $30/Service for Occ Therapy (Specialist);		$25/Visit for Chiropractor; $30/Exam for Vistion Exams; $30/Service for Podiatrist; $30/Exam for Hearing/Speech Exams; $30/Procedure for Misc. Medical (PCP);	10% Coinsurance for Part B Rx				$30/Exam for Vision (Refractions)		$30/Exam for Routine Hearing Exams				$25/Service for Acupunture;											237.7078726	237.7078726	142.6247236	0	142.6247236	0.190166298	0.190166298	42.64015063	190.1662981	0	95.08314904	0	28.52494471	28.52494471	9.508314904	27.44921509	28.52494471	28.52494472	0	27.43172722	0.095083149	0	0	0	28.52494471	0	28.5249447	0	0	0	23.77078726											15.8764	0.417580776	14.18854468	0	2.305195338	2.430253429	1.359281481	1.36859607	4.684353813	0	2.06111357	0	0.077910926	1.574804662	3.470085761	12.94100082	0.419988204	1.088621474	0	6.1721265	1.001966258	0	0	0	0.995337174	0	0.085314615	0	0	0	0.764317885	0	0	0	0	0	0	0	0	0	0	73.2828	0	3.789530638	15.8764	0.417580776	14.18854468	0	2.305195338	2.430253429	1.359281481	1.36859607	4.684353813	0	2.06111357	0	0.077910926	1.574804662	3.470085761	12.94100082	0.419988204	1.088621474	0	6.1721265	1.001966258	0	0	0	0.995337174	0	0.085314615	0	0	0	0.764317885	0	0	0	0	0	0	0	0	0	0	73.2828																																																																																				0	0		15.8764	0.417580776	14.18854468	0	2.305195338	2.430253429	1.359281481	1.36859607	4.684353813	0	2.06111357	0	0.077910926	1.574804662	3.470085761	12.94100082	0.419988204	1.088621474	0	6.1721265	1.001966258	0	0	0	0.995337174	0	0.085314615	0	0	0	0.764317885	0	0	0	0	0	0	0	0	0	0	73.2828
H9313_001_0	2008	5																					4000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	962.2746822	13.39782004	1496.954301	20.29254844	216.7737387	13.67148571	0.675894366	384.8862967	375.2179415	11.09982554	29.99442965	0	0.212582625	703.6497072	3950.005851	5263.477252	147.2124513	471.1864342	22.01936963	28.03694442	8.238928102	655.0957404	0	0	379.5773921	0	162.8826139	0	0	0	0											$200 days 1-8	$200 days 1-8	$75 days 1-100	$0 per visit	$75 per trip	20%	20%	"ER:  $50 per visit, UC:  $30 per visit"	$150 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $30 per visit	$20 per visit	$30 per visit	$30 per visit	$30 per visit	$0 per visit	"Medicare Hearing Exams:  $30 per visit, OPSA:  $30 per visit"	$0 per visit	Medicare Vision Exams:  $30 per visit	0	0	$30 per visit	$0 	$30 per visit	0	0	0	0											176.9714655	176.9729284	66.36638146	0	66.36623799	0.176975269	0.176975269	37.87197435	150.6618561	0	0	0	0	26.54580837	17.69809192	26.55461881	26.54732718	26.54745722	0	0.008112679	0	26.54740726	0	0	26.54698672	0	26.54849772	0	0	0	0											14.1913	0.197587621	8.278953346	0	1.198871461	2.419514861	0.119616587	1.214700329	4.710919292	0	0	0	0	1.556579191	5.825630552	11.64746934	0.325674759	1.042400142	0	0.227454725	0	1.449257785	0	0	0.839719666	0	0.360357392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.606	0	7.23	14.1913	0.197587621	8.278953346	0	1.198871461	2.419514861	0.119616587	1.214700329	4.710919292	0	0	0	0	1.556579191	5.825630552	11.64746934	0.325674759	1.042400142	0	0.227454725	0	1.449257785	0	0	0.839719666	0	0.360357392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.606	4000	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	0	0	$0 	$0 	N/A	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.1913	0.197587621	8.278953346	0	1.198871461	2.419514861	0.119616587	1.214700329	4.710919292	0	0	0	0	1.556579191	5.825630552	11.64746934	0.325674759	1.042400142	0	0.227454725	0	1.449257785	0	0	0.839719666	0	0.360357392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.606
H9313_002_0	2008	6																					3000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	277.927299	2.695817784	1544.863777	20.52236494	219.4245778	13.84489806	0.684467569	389.9280614	379.712826	11.22553291	30.33412156	0	0.214990159	711.9339332	4119.737834	5387.313614	149.2034182	477.6229384	22.26874266	28.35722576	8.332235336	664.0104889	0	0	384.5722426	0	142.9824781	0	0	0	0											$750 per admit	$750 per admit	$50 days 1-100	$0 per visit	$50 per trip	20%	20%	"ER:  $50 per visit, UC:  $30 per visit"	$100 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $25 per visit	$15 per visit	$25 per visit	$25 per visit	$25 per visit	$0 per visit	"Medicare Hearing Exams:  $25 per visit, OPSA:  $25 per visit"	$0 per visit	Medicare Vision Exams:  $25 per visit	0	0	$25 per visit	$0 	$25 per visit	0	0	0	0											622.0742307	622.0860939	41.47753687	0	41.47702904	0.165921434	0.165921434	35.5107705	91.35248442	0	0	0	0	20.73574863	12.44550157	20.76347428	20.74498838	20.7457185	0	0.006430188	0	20.74543914	0	0	20.74303377	0	20.75125634	0	0	0	0											14.4076	0.139752563	5.339762023	0	0.758423299	2.297165336	0.11356784	1.153887158	2.890642502	0	0	0	0	1.230206923	4.27268364	9.321612307	0.257935265	0.825719252	0	0.182342288	0	1.147932432	0	0	0.664766251	0	0.247255505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2513	0	9.284364823	14.4076	0.139752563	5.339762023	0	0.758423299	2.297165336	0.11356784	1.153887158	2.890642502	0	0	0	0	1.230206923	4.27268364	9.321612307	0.257935265	0.825719252	0	0.182342288	0	1.147932432	0	0	0.664766251	0	0.247255505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2513	none	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	0	0	$0 	$0 	N/A	0	0	0	0											5.9594	0.0455	0.9782	0.659	0.1579	0.5301	0.0241	0.1191	0.5787	0.2272	0.6144	0	0.0054	0.5979	0.6236	1.1831	0.0288	0.096	0	0.0096	0.1664	0.1265	0	0	0.0844	0	0.0175	0	0	0	0											12.8327	0	0	20.367	0.185252664	6.318004783	0.658954173	0.916344699	2.827299079	0.137665649	1.273009084	3.469332226	0.227171477	0.614389332	0	0.005391656	1.828080731	4.896262918	10.50466243	0.286724644	0.921729924	0	0.191955521	0.166390537	1.274402712	0	0	0.749211947	0	0.264794132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.084
H9313_003_0	2008	6																					2000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	298.8201701	2.899504879	1677.904357	21.86332988	234.2832418	14.79319079	0.731349505	417.010602	404.8837394	11.95902762	32.31620275	0	0.229037968	758.9711785	4521.908465	5880.53964	162.7421977	521.1150452	23.89057563	30.28945688	8.876677241	724.1477884	0	0	419.1269733	0	156.0577119	0	0	0	0											$250 per admit	$250 per admit	$25 days 1-100	$0 per visit	$50 per trip	20%	20%	"ER:  $50 per visit, UC:  $30 per visit"	$75 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $20 per visit	$10 per visit	$20 per visit	$20 per visit	$20 per visit	$0 per visit	"Medicare Hearing Exams:  $20 per visit, OPSA:  $20 per visit"	$0 per visit	Medicare Vision Exams:  $20 per visit	0	0	$20 per visit	$0 	$20 per visit	0	0	0	0											203.9184065	203.922159	20.3970641	0	40.81053785	0.163283248	0.163283248	34.9559059	65.3251889	0	0	0	0	16.31614751	8.162545523	16.35590401	16.33269634	16.3339122	0	0.005208977	0	16.33344853	0	0	16.32937853	0	16.34274354	0	0	0	0											5.0779	0.049272775	2.852026894	0	0.796768759	2.415480239	0.119417122	1.214748614	2.20409223	0	0	0	0	1.031957142	3.075856975	8.01512849	0.221501575	0.709320616	0	0.157777089	0	0.985652552	0	0	0.57034025	0	0.212534264	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7098	0	6.673492944	5.0779	0.049272775	2.852026894	0	0.796768759	2.415480239	0.119417122	1.214748614	2.20409223	0	0	0	0	1.031957142	3.075856975	8.01512849	0.221501575	0.709320616	0	0.157777089	0	0.985652552	0	0	0.57034025	0	0.212534264	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7098	none	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	0	0	$0 	$0 	N/A	0	0	0	0											6.2732	0.0479	1.0298	0.6937	0.1662	0.5581	0.0254	0.1254	0.6092	0.2391	0.6467	0	0.0057	0.6294	0.6564	1.2454	0.0303	0.1011	0	0.0101	0.1752	0.1331	0	0	0.0735	0	0.0185	0	0	0	0											13.4932	0	0	11.3512	0.097169363	3.881793626	0.693661239	0.963007867	2.973536085	0.144784161	1.340144682	2.813261497	0.239136581	0.64674917	0	0.005675634	1.661320917	3.732280125	9.260489776	0.251807288	0.810388162	0	0.16789665	0.175154313	1.118784012	0	0	0.643829989	0	0.230996649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.203
H9313_004_0	2008	6																					4000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	954.6137028	13.82776603	1452.15055	17.58272591	225.732947	13.96532068	0.648774983	418.3274557	407.4777697	11.35923524	30.70690594	0	0.189882642	760.2426955	3665.981065	4935.652474	138.7164941	446.8362849	18.83770897	24.62047309	8.345274817	606.4360031	0	0	349.6597008	0	149.9810454	0	0	0	0											$200 days 1-8	$200 days 1-8	$75 days 1-100	$0 per visit	$75 per trip	20%	20%	"ER:  $50 per visit, UC:  $30 per visit"	$150 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $30 per visit	$20 per visit	$30 per visit	$30 per visit	$30 per visit	$0 per visit	"Medicare Hearing Exams:  $30 per visit, OPSA:  $30 per visit"	$0 per visit	Medicare Vision Exams:  $30 per visit	0	0	$30 per visit	$0 	$30 per visit	0	0	0	0											177.8695582	177.8696047	66.70115427	0	66.70115018	0.177869681	0.177869681	38.04242276	151.4232476	0	0	0	0	26.68043743	17.78698894	26.68152171	26.68049084	26.68049669	0	0.008568503	0	26.68049374	0	0	26.68047514	0	26.68052472	0	0	0	0											14.1497	0.204961606	8.071676487	0	1.2547206	2.48400714	0.1153974	1.326182494	5.141800603	0	0	0	0	1.690300639	5.433897056	10.97422655	0.308418679	0.993484502	0	0.210960589	0	1.348334332	0	0	0.777423913	0	0.333464416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.819	0	6.82	14.1497	0.204961606	8.071676487	0	1.2547206	2.48400714	0.1153974	1.326182494	5.141800603	0	0	0	0	1.690300639	5.433897056	10.97422655	0.308418679	0.993484502	0	0.210960589	0	1.348334332	0	0	0.777423913	0	0.333464416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.819	4000	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	0	0	$0 	$0 	N/A	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.1497	0.204961606	8.071676487	0	1.2547206	2.48400714	0.1153974	1.326182494	5.141800603	0	0	0	0	1.690300639	5.433897056	10.97422655	0.308418679	0.993484502	0	0.210960589	0	1.348334332	0	0	0.777423913	0	0.333464416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.819
H9313_005_0	2008	5																					3000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	288.0958053	2.873791533	1500.153574	17.77588497	228.435799	14.13655675	0.656729951	423.6947514	412.2600672	11.48402472	31.04424368	0	0.191968641	768.9513587	3831.13527	5058.676064	140.5658609	452.8776839	19.04465493	24.89453119	8.436953741	614.5778936	0	0	354.1389584	0	129.9770701	0	0	0	0											$750 per admit	$750 per admit	$50 days 1-100	$0 per visit	$50 per trip	20%	20%	"ER:  $50 per visit, UC:  $30 per visit"	$100 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $25 per visit	$15 per visit	$25 per visit	$25 per visit	$25 per visit	$0 per visit	"Medicare Hearing Exams:  $25 per visit, OPSA:  $25 per visit"	$0 per visit	Medicare Vision Exams:  $25 per visit	0	0	$25 per visit	$0 	$25 per visit	0	0	0	0											623.9327549	623.9410647	41.60021476	0	41.59986494	0.166408935	0.166408935	35.59641703	91.62482842	0	0	0	0	20.79775048	12.48202965	20.82442539	20.80560132	20.80638838	0	0.006808385	0	20.80599326	0	0	20.80342111	0	20.80998512	0	0	0	0											14.9794	0.149423046	5.200559239	0	0.791908199	2.352449352	0.109285732	1.256834589	3.147771494	0	0	0	0	1.332704874	3.985028668	8.778668521	0.243713105	0.785229082	0	0.169491562	0	1.065575293	0	0	0.613941824	0	0.225401741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.1874	0	9.111608312	14.9794	0.149423046	5.200559239	0	0.791908199	2.352449352	0.109285732	1.256834589	3.147771494	0	0	0	0	1.332704874	3.985028668	8.778668521	0.243713105	0.785229082	0	0.169491562	0	1.065575293	0	0	0.613941824	0	0.225401741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.1874	none	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	0	0	$0 	$0 	N/A	0	0	0	0											5.9594	0.0455	0.9782	0.659	0.1579	0.5301	0.0241	0.1191	0.5787	0.2272	0.6144	0	0.0054	0.5979	0.6236	1.1831	0.0288	0.096	0	0.0096	0.1664	0.1265	0	0	0.0844	0	0.0175	0	0	0	0											12.8327	0	0	20.9387	0.194923147	6.178801999	0.658954173	0.949829599	2.882583095	0.133383541	1.375956514	3.726461218	0.227171477	0.614389332	0	0.005391656	1.930578682	4.608607946	9.961718649	0.272502484	0.881239753	0	0.179104795	0.166390537	1.192045573	0	0	0.69838752	0	0.242940368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0201
H9313_006_0	2008	5																					2000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	310.1505496	3.094129628	1632.597204	18.94814543	244.0881522	15.11557457	0.702211346	453.6611828	439.9187543	12.24135793	33.09150825	0	0.204628334	820.3155084	4217.805001	5538.391089	153.703609	495.3447256	20.45068726	26.60807342	8.993342766	672.0438163	0	0	386.9209468	0	142.2778352	0	0	0	0											$250 per admit	$250 per admit	$25 days 1-100	$0 per visit	$50 per trip	20%	20%	"ER:  $50 per visit, UC:  $30 per visit"	$75 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $20 per visit	$10 per visit	$20 per visit	$20 per visit	$20 per visit	$0 per visit	"Medicare Hearing Exams:  $20 per visit, OPSA:  $20 per visit"	$0 per visit	Medicare Vision Exams:  $20 per visit	0	0	$20 per visit	$0 	$20 per visit	0	0	0	0											204.7367408	204.7398989	20.47866924	0	40.97349967	0.16392898	0.16392898	35.07972634	65.58785484	0	0	0	0	16.38169279	8.195259807	16.42382815	16.39839025	16.39993593	0	0.005553004	0	16.39916275	0	0	16.3939928	0	16.40673393	0	0	0	0											5.2916	0.052790982	2.786118177	0	0.833428819	2.477880723	0.11511279	1.326192512	2.40444395	0	0	0	0	1.119846387	2.88050065	7.580131957	0.21004098	0.67696848	0	0.14775473	0	0.918412993	0	0	0.528598268	0	0.194526215	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.5443	0	6.491837935	5.2916	0.052790982	2.786118177	0	0.833428819	2.477880723	0.11511279	1.326192512	2.40444395	0	0	0	0	1.119846387	2.88050065	7.580131957	0.21004098	0.67696848	0	0.14775473	0	0.918412993	0	0	0.528598268	0	0.194526215	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.5443	none	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	0	0	$0 	$0 	N/A	0	0	0	0											6.2732	0.0479	1.0298	0.6937	0.1662	0.5581	0.0254	0.1254	0.6092	0.2391	0.6467	0	0.0057	0.6294	0.6564	1.2454	0.0303	0.1011	0	0.0101	0.1752	0.1331	0	0	0.0735	0	0.0185	0	0	0	0											13.4932	0	0	11.5648	0.10068757	3.815884909	0.693661239	0.999667927	3.035936569	0.140479828	1.45158858	3.013613217	0.239136581	0.64674917	0	0.005675634	1.749210162	3.5369238	8.825493243	0.240346694	0.778036027	0	0.157874291	0.175154313	1.051544453	0	0	0.602088007	0	0.212988601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0376
H9313_007_0	2008	5																					1000											A	A	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											12.8401	0.092	1.9011	1.0122	0.2882	0.6919	0.034	0.2856	1.4501	0.5618	1.5181	0	0.0106	1.4993	1.9314	4.9953	0.0521	0.1599	1.1038	1.4025	0.4165	0.2705	0	0	0	0	0	0	0	0	0											32.517	1000	270.3623307	2.630912424	1428.890939	19.4235603	209.4025881	13.15277445	0.646148523	374.675002	364.6806836	10.78070131	1203.898493	0	0.203845975	685.1091185	3864.602785	4691.659361	143.0828692	457.9612618	21.18100628	26.90013602	7.992868953	635.2408742	0	0	0	0	0	0	0	0	0											$100 per admit	$100 per admit	$80 days 1-100	$0 per visit	$50 per trip	20%	20%	"ER:  $50 per visit, UC:  $25 per visit"	$100 per visit	$0 per visit	$20 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $20 per visit	$15 per visit	$20 per visit	$20 per visit	$20 per visit	$0 per visit	"Medicare Hearing Exams:  $20 per visit, OPSA:  $20 per visit"	$0 per visit	Medicare Vision Exams:  $20 per visit	0	0	$0 per visit	$0 	$0 per visit	0	0	0	0											63.8576139	63.85528025	50.7035847	0	31.80769344	0.127062873	0.127062873	25.90504994	63.69965769	0	12.72355881	0	0	12.7560591	9.511472022	12.59705433	12.68756175	12.68231456	0	0.003693795	0	12.68439738	0	0	0	0	0	0	0	0	0											1.4387	0.013999804	6.037491062	0	0.555051111	1.671229303	0.082101487	0.80883122	1.935836226	0	1.27648944	0	0	0.728274367	3.063171773	4.925090656	0.151281062	0.484000732	0	0.099363595	0	0.67147064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.9424	500	19.202	14.2789	0.106010418	7.938542271	1.012175077	0.84330019	2.363095723	0.116090397	1.094438515	3.385936902	0.561789755	2.794543131	0	0.010622554	2.227582438	4.994599043	9.920384725	0.203424014	0.643885315	1.103756795	1.501894456	0.416513895	0.941961578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.4594	2000	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	0	0	$0 	$0 	N/A	0	0	0	0											4.1474	0.0317	0.2258	0.1644	0.1099	0.3689	0.0168	0.0829	0.4027	0.1581	0.4276	0	0.0038	0.4161	0.4977	1.1216	0.02	0.0668	0.1489	0.1989	0.1158	0.088	0	0	0	0	0	0	0	0	0											8.8139	500	5.378	18.4263	0.13767616	8.164378738	1.176557455	0.953205405	2.732041686	0.132861239	1.177341281	3.788675343	0.71988948	3.222126672	0	0.01437487	2.643672019	5.49228413	11.04198673	0.223459949	0.710703831	1.252654584	1.700828334	0.532313195	1.029978423	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2733
H9313_008_0	2008	3																					1500											A	A	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											6.7307	0.0482	1.0161	0.5306	0.1511	0.3627	0.0178	0.1451	0.7601	0.2945	0.7958	0	0.0056	0.7859	1.0112	2.6146	0.0273	0.0838	0.5786	0.7352	0.2183	0.1418	0	0	0	0	0	0	0	0	0											17.055	1500	262.9587174	2.558985143	1432.886977	18.88620288	204.3677421	12.87486651	0.632495905	351.5181809	356.1750096	10.48245065	1176.467387	0	0.198206528	667.3638493	3791.959942	4641.665424	140.3165315	449.3375251	20.5950287	26.16585889	7.771744334	623.1519775	0	0	0	0	0	0	0	0	0											$100 per admit	$100 per admit	$50 days 1-100	$0 per visit	$75 per trip	20%	20%	"ER:  $50 per visit, UC:  $50 per visit"	$25 per visit	$0 per visit	$20 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $20 per visit	$15 per visit	$20 per visit	$20 per visit	$20 per visit	$0 per visit	"Medicare Hearing Exams:  $20 per visit, OPSA:  $20 per visit"	$0 per visit	Medicare Vision Exams:  $20 per visit	0	0	$0 per visit	$0 	$0 per visit	0	0	0	0											77.76080306	77.76039036	38.85796103	0	58.26628401	0.155406972	0.155406972	38.82872715	19.43911754	0	15.54371793	0	0	15.54942997	11.65234515	15.52182694	15.53743369	15.53652135	0	0.004773107	0	15.53688338	0	0	0	0	0	0	0	0	0											1.704	0.016582307	4.639922194	0	0.992312409	2.000844017	0.098294273	1.137416961	0.576977323	0	1.523889767	0	0	0.86476062	3.682102171	6.003927287	0.1816799	0.581761838	0	0.124892449	0	0.806819967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.9362	250	12.347	8.4347	0.064813642	5.655994296	0.530575261	1.143410607	2.363515669	0.116111028	1.282478393	1.337110191	0.294486352	2.319643142	0	0.00556827	1.650687668	4.693305647	8.618572468	0.20901288	0.665572244	0.578581772	0.860089546	0.218333738	0.948609469	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9912	3000	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	0	0	$0 	$0 	$0 	0	0	0	0											3.7982	0.029	0.6235	0.42	0.1007	0.3379	0.0154	0.0759	0.3688	0.1448	0.3916	0	0.0034	0.3811	0.437	0.9096	0.0183	0.0612	0.0777	0.1064	0.106	0.0806	0	0	0.0445	0	0.0112	0	0	0	0											8.5428	250	5.183	12.2329	0.093813384	6.279482756	0.950563365	1.244062689	2.701399356	0.1314699	1.358401414	1.705941303	0.439275355	2.711227597	0	0.009004672	2.031745862	5.130261842	9.528185203	0.227361951	0.726765179	0.656255311	0.966501747	0.324383672	1.029216005	0	0	0.044495518	1.35E-05	0.011178341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5339
H9313_009_0	2008	3																					2000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	285.1154406	2.77459519	1592.91427	20.5217573	223.5781702	14.09110721	0.692245438	399.4903029	387.8223683	11.390236	30.77840001	0	0.21537131	726.5814556	4270.606866	5558.716901	153.8723171	493.0165138	22.37856827	28.4435229	8.444781198	683.5789419	0	0	395.4506811	0	147.0710213	0	0	0	0											$250 per admit	$250 per admit	$25 days 1-100	$0 per visit	$50 per trip	20%	20%	"ER:  $50 per visit, UC:  $30 per visit"	$75 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	OP PT/ST/OT:  $20 per visit	$10 per visit	$20 per visit	$20 per visit	$20 per visit	$0 per visit	"Medicare Hearing Exams:  $20 per visit, OPSA:  $20 per visit"	$0 per visit	Medicare Vision Exams:  $20 per visit	0	0	$20 per visit	$0 	$20 per visit	0	0	0	0											207.119109	207.1225468	20.71676523	0	41.44880502	0.165832964	0.165832964	35.49916105	66.34906809	0	0	0	0	16.57203221	8.290179292	16.60929155	16.58747568	16.58864112	0	0.00531871	0	16.58817881	0	0	16.58428313	0	16.59668722	0	0	0	0											4.9211	0.047890102	2.75000258	0	0.772253998	2.336770075	0.114797113	1.18179755	2.144304393	0	0	0	0	1.00341094	2.950341384	7.693862472	0.21269611	0.681539501	0	0.151282842	0	0.944944143	0	0	0.546522172	0	0.203407645	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.6569	0	5.897809866	4.9211	0.047890102	2.75000258	0	0.772253998	2.336770075	0.114797113	1.18179755	2.144304393	0	0	0	0	1.00341094	2.950341384	7.693862472	0.21269611	0.681539501	0	0.151282842	0	0.944944143	0	0	0.546522172	0	0.203407645	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.6569	none	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	0	0	$0 	$0 	N/A	0	0	0	0											5.9596	0.0455	0.9783	0.659	0.1579	0.5302	0.0241	0.1191	0.5787	0.2272	0.6144	0	0.0054	0.5979	0.6236	1.1831	0.0288	0.096	0	0.0096	0.1664	0.1265	0	0	0.0698	0	0.0175	0	0	0	0											12.8185	0	0	10.8806	0.093391682	3.728277146	0.658975597	0.930180533	2.866921055	0.138895705	1.300923349	2.723012932	0.227178863	0.614409307	0	0.005391831	1.601304186	3.573940935	8.876951064	0.241486425	0.777553294	0	0.160896387	0.166395946	1.071418535	0	0	0.616337151	0	0.220946842	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.4754
H9313_801_0	2008	1																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	280.7066826	2.032550655	41.69688108	21.78888267	6.358654	15.2843387	0.745825389	6.200282777	31.74605041	12.31267312	33.27393822	0	0.231564739	32.821965	41.51797303	108.4981647	1.139964432	3.804800752	23.30017385	28.79700175	9.119480086	5.915913961	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				0.078469149	0.078469149	0.192979	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.0268	0.15949252	8.046622409	0	1.487925036	3.576535256	0.174523141	1.45086617	7.428575795	2.881165511	7.786101544	0	0.054186149	7.680339809	9.715205689	25.38857054	0.266751677	0.890323376	5.45224068	6.738498408	2.13395834	1.384323867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.723	0	0	22.0268	0.15949252	8.046622409	0	1.487925036	3.576535256	0.174523141	1.45086617	7.428575795	2.881165511	7.786101544	0	0.054186149	7.680339809	9.715205689	25.38857054	0.266751677	0.890323376	5.45224068	6.738498408	2.13395834	1.384323867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.723	none	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				1.2449	0.0095	0.5032	0	0.0985	0.3307	0.015	0.0706	0.3609	0.1417	0.3832	0	0.0034	0.3729	0.5768	1.5498	0.0176	0.0594	0.3884	0.5004	0.1038	0.0777	0	0	0	0	0	0	0	0	0											6.8085	0	0	23.2717	0.169033849	8.549822067	0	1.586426001	3.907197759	0.189553767	1.521507031	7.78952432	3.022860111	8.169317133	0	0.057549109	8.053254101	10.29197943	26.93835289	0.284393591	0.949738224	5.840593851	7.238919446	2.237741795	1.461977417	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.5315
H9313_802_0	2008	1																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	280.7066826	2.032550655	41.69688108	21.78888267	6.358654	15.2843387	0.745825389	6.200282777	31.74605041	12.31267312	33.27393822	0	0.231564739	32.821965	41.51797303	108.4981647	1.139964432	3.804800752	23.30017385	28.79700175	9.119480086	5.915913961	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				0.078469149	0.078469149	0.192979	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.0268	0.15949252	8.046622409	0	1.487925036	3.576535256	0.174523141	1.45086617	7.428575795	2.881165511	7.786101544	0	0.054186149	7.680339809	9.715205689	25.38857054	0.266751677	0.890323376	5.45224068	6.738498408	2.13395834	1.384323867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.723	0	0	22.0268	0.15949252	8.046622409	0	1.487925036	3.576535256	0.174523141	1.45086617	7.428575795	2.881165511	7.786101544	0	0.054186149	7.680339809	9.715205689	25.38857054	0.266751677	0.890323376	5.45224068	6.738498408	2.13395834	1.384323867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.723	none	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				1.2449	0.0095	0.5032	0	0.0985	0.3307	0.015	0.0706	0.3609	0.1417	0.3832	0	0.0034	0.3729	0.5768	1.5498	0.0176	0.0594	0.3884	0.5004	0.1038	0.0777	0	0	0	0	0	0	0	0	0											6.8085	0	0	23.2717	0.169033849	8.549822067	0	1.586426001	3.907197759	0.189553767	1.521507031	7.78952432	3.022860111	8.169317133	0	0.057549109	8.053254101	10.29197943	26.93835289	0.284393591	0.949738224	5.840593851	7.238919446	2.237741795	1.461977417	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.5315
H9313_803_0	2008	1																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	280.7066826	2.032550655	41.69688108	21.78888267	6.358654	15.2843387	0.745825389	6.200282777	31.74605041	12.31267312	33.27393822	0	0.231564739	32.821965	41.51797303	108.4981647	1.139964432	3.804800752	23.30017385	28.79700175	9.119480086	5.915913961	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				0.078469149	0.078469149	0.192979	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.0268	0.15949252	8.046622409	0	1.487925036	3.576535256	0.174523141	1.45086617	7.428575795	2.881165511	7.786101544	0	0.054186149	7.680339809	9.715205689	25.38857054	0.266751677	0.890323376	5.45224068	6.738498408	2.13395834	1.384323867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.723	0	0	22.0268	0.15949252	8.046622409	0	1.487925036	3.576535256	0.174523141	1.45086617	7.428575795	2.881165511	7.786101544	0	0.054186149	7.680339809	9.715205689	25.38857054	0.266751677	0.890323376	5.45224068	6.738498408	2.13395834	1.384323867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.723	none	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				1.2449	0.0095	0.5032	0	0.0985	0.3307	0.015	0.0706	0.3609	0.1417	0.3832	0	0.0034	0.3729	0.5768	1.5498	0.0176	0.0594	0.3884	0.5004	0.1038	0.0777	0	0	0	0	0	0	0	0	0											6.8085	0	0	23.2717	0.169033849	8.549822067	0	1.586426001	3.907197759	0.189553767	1.521507031	7.78952432	3.022860111	8.169317133	0	0.057549109	8.053254101	10.29197943	26.93835289	0.284393591	0.949738224	5.840593851	7.238919446	2.237741795	1.461977417	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.5315
H9313_804_0	2008	1																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	280.7066826	2.032550655	41.69688108	21.78888267	6.358654	15.2843387	0.745825389	6.200282777	31.74605041	12.31267312	33.27393822	0	0.231564739	32.821965	41.51797303	108.4981647	1.139964432	3.804800752	23.30017385	28.79700175	9.119480086	5.915913961	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				0.078469149	0.078469149	0.192979	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.0268	0.15949252	8.046622409	0	1.487925036	3.576535256	0.174523141	1.45086617	7.428575795	2.881165511	7.786101544	0	0.054186149	7.680339809	9.715205689	25.38857054	0.266751677	0.890323376	5.45224068	6.738498408	2.13395834	1.384323867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.723	0	0	22.0268	0.15949252	8.046622409	0	1.487925036	3.576535256	0.174523141	1.45086617	7.428575795	2.881165511	7.786101544	0	0.054186149	7.680339809	9.715205689	25.38857054	0.266751677	0.890323376	5.45224068	6.738498408	2.13395834	1.384323867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.723	none	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				1.2449	0.0095	0.5032	0	0.0985	0.3307	0.015	0.0706	0.3609	0.1417	0.3832	0	0.0034	0.3729	0.5768	1.5498	0.0176	0.0594	0.3884	0.5004	0.1038	0.0777	0	0	0	0	0	0	0	0	0											6.8085	0	0	23.2717	0.169033849	8.549822067	0	1.586426001	3.907197759	0.189553767	1.521507031	7.78952432	3.022860111	8.169317133	0	0.057549109	8.053254101	10.29197943	26.93835289	0.284393591	0.949738224	5.840593851	7.238919446	2.237741795	1.461977417	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.5315
H9313_805_0	2008	1																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	295.4807185	2.139527005	43.89145377	22.93566597	6.69332	16.08877758	0.785079357	6.526613449	33.41689516	12.96070855	35.02519813	0	0.243752357	34.54943684	43.70312951	114.2085944	1.19996256	4.005053423	24.52649879	30.31263342	9.599452722	6.227277854	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				0.078469149	0.078469149	0.192979	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											23.1861	0.167886863	8.470128851	0	1.56623688	3.764773953	0.183708569	1.527227547	7.819553468	3.032805801	8.195896362	0	0.057038051	8.08456822	10.2265323	26.7248111	0.280791239	0.937182501	5.739200716	7.093156219	2.246271937	1.457183018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7611	0	0	23.1861	0.167886863	8.470128851	0	1.56623688	3.764773953	0.183708569	1.527227547	7.819553468	3.032805801	8.195896362	0	0.057038051	8.08456822	10.2265323	26.7248111	0.280791239	0.937182501	5.739200716	7.093156219	2.246271937	1.457183018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7611	none	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.1861	0.167886863	8.470128851	0	1.56623688	3.764773953	0.183708569	1.527227547	7.819553468	3.032805801	8.195896362	0	0.057038051	8.08456822	10.2265323	26.7248111	0.280791239	0.937182501	5.739200716	7.093156219	2.246271937	1.457183018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7611
H9313_806_0	2008	1																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	295.4807185	2.139527005	43.89145377	22.93566597	6.69332	16.08877758	0.785079357	6.526613449	33.41689516	12.96070855	35.02519813	0	0.243752357	34.54943684	43.70312951	114.2085944	1.19996256	4.005053423	24.52649879	30.31263342	9.599452722	6.227277854	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				0.078469149	0.078469149	0.192979	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											23.1861	0.167886863	8.470128851	0	1.56623688	3.764773953	0.183708569	1.527227547	7.819553468	3.032805801	8.195896362	0	0.057038051	8.08456822	10.2265323	26.7248111	0.280791239	0.937182501	5.739200716	7.093156219	2.246271937	1.457183018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7611	0	0	23.1861	0.167886863	8.470128851	0	1.56623688	3.764773953	0.183708569	1.527227547	7.819553468	3.032805801	8.195896362	0	0.057038051	8.08456822	10.2265323	26.7248111	0.280791239	0.937182501	5.739200716	7.093156219	2.246271937	1.457183018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7611	none	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.1861	0.167886863	8.470128851	0	1.56623688	3.764773953	0.183708569	1.527227547	7.819553468	3.032805801	8.195896362	0	0.057038051	8.08456822	10.2265323	26.7248111	0.280791239	0.937182501	5.739200716	7.093156219	2.246271937	1.457183018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7611
H9313_807_0	2008	1																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	295.4807185	2.139527005	43.89145377	22.93566597	6.69332	16.08877758	0.785079357	6.526613449	33.41689516	12.96070855	35.02519813	0	0.243752357	34.54943684	43.70312951	114.2085944	1.19996256	4.005053423	24.52649879	30.31263342	9.599452722	6.227277854	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				0.078469149	0.078469149	0.192979	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											23.1861	0.167886863	8.470128851	0	1.56623688	3.764773953	0.183708569	1.527227547	7.819553468	3.032805801	8.195896362	0	0.057038051	8.08456822	10.2265323	26.7248111	0.280791239	0.937182501	5.739200716	7.093156219	2.246271937	1.457183018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7611	0	0	23.1861	0.167886863	8.470128851	0	1.56623688	3.764773953	0.183708569	1.527227547	7.819553468	3.032805801	8.195896362	0	0.057038051	8.08456822	10.2265323	26.7248111	0.280791239	0.937182501	5.739200716	7.093156219	2.246271937	1.457183018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7611	none	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.1861	0.167886863	8.470128851	0	1.56623688	3.764773953	0.183708569	1.527227547	7.819553468	3.032805801	8.195896362	0	0.057038051	8.08456822	10.2265323	26.7248111	0.280791239	0.937182501	5.739200716	7.093156219	2.246271937	1.457183018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7611
H9313_808_0	2008	1																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	295.4807185	2.139527005	43.89145377	22.93566597	6.69332	16.08877758	0.785079357	6.526613449	33.41689516	12.96070855	35.02519813	0	0.243752357	34.54943684	43.70312951	114.2085944	1.19996256	4.005053423	24.52649879	30.31263342	9.599452722	6.227277854	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				0.078469149	0.078469149	0.192979	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											23.1861	0.167886863	8.470128851	0	1.56623688	3.764773953	0.183708569	1.527227547	7.819553468	3.032805801	8.195896362	0	0.057038051	8.08456822	10.2265323	26.7248111	0.280791239	0.937182501	5.739200716	7.093156219	2.246271937	1.457183018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7611	0	0	23.1861	0.167886863	8.470128851	0	1.56623688	3.764773953	0.183708569	1.527227547	7.819553468	3.032805801	8.195896362	0	0.057038051	8.08456822	10.2265323	26.7248111	0.280791239	0.937182501	5.739200716	7.093156219	2.246271937	1.457183018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7611	none	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.1861	0.167886863	8.470128851	0	1.56623688	3.764773953	0.183708569	1.527227547	7.819553468	3.032805801	8.195896362	0	0.057038051	8.08456822	10.2265323	26.7248111	0.280791239	0.937182501	5.739200716	7.093156219	2.246271937	1.457183018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7611
H9385_001_0	2008	4																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin			V	P																0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		450.2054017	18.1607713	132.7044082	0	24.55024099	28.45186579	31.99824794	12.19094649	28.76189583	15.82193564	26.49350458	0	5.209550202	69.17569743	79.15413553	159.0861173	6.763986744	6.283488913	48.97141314	62.67200363	9.253427675	1.277740665	0	0	354.0403427	262.8035019	0	0	0	0	0											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing			Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing																0.0747	0.0747	0.1593	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	25	100	0	0	0	0	0											33.6303	1.356609616	21.13981222	0	5.744756392	6.657736595	7.487590019	2.852681479	6.730283624	3.702332941	6.199480072	0	1.219034747	16.1871132	18.52206771	37.22615144	1.582772898	1.470336406	11.45931068	14.66524885	2.165302076	0.298991316	0	0	0.737584047	2.190029183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	203.2256	0	0	33.6303	1.356609616	21.13981222	0	5.744756392	6.657736595	7.487590019	2.852681479	6.730283624	3.702332941	6.199480072	0	1.219034747	16.1871132	18.52206771	37.22615144	1.582772898	1.470336406	11.45931068	14.66524885	2.165302076	0.298991316	0	0	0.737584047	2.190029183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	203.2256																																																																																				0	0		33.6303	1.356609616	21.13981222	0	5.744756392	6.657736595	7.487590019	2.852681479	6.730283624	3.702332941	6.199480072	0	1.219034747	16.1871132	18.52206771	37.22615144	1.582772898	1.470336406	11.45931068	14.66524885	2.165302076	0.298991316	0	0	0.737584047	2.190029183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	203.2256
H9452_001_0	2008	9	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	A	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1355.496875	8.482250384	370.048675	7.954120573	230.9547176	10.43749524	3.721209904	194.23784	408.9246017	845.7239849	894.8130762	50.18027498	14.4829825	0.382622825	5549.781453	1969.79663	0.115874206	432.0797877	591.8384898	0	29.7039421	0	0	0	5.463197493	348.0419024	164.6937582	0	0		0	1088.746164	17.79904698	75.92236819	414.0595465	112.040928	0.051266668	839.4246863	3.903865086	1.286343312		"$150/day, days(1-5) no yrly max"	"$500/admit, no yrly max"	$50/day for days 21 to 100	15% Coinsurance	$100 copay	30% coinsurance	30% coinsurance	$50 copay	$150 copay	$10 copay	$15/$35 copay for Lower/Higher Tier	$100 copay	$25 copay	$15 copay	$15 copay	$15 copay	50% coinsurance	$15 copay	$15/$35 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$15 copay	$0 copay	$15 copay	$15 copay	$10 copay	$0 copay	$10 copay	$10 copay	$15 copay		150	500	50	0.15	100	0.3	0.3	50	150	10	19.33492	100	25	15	15	15	0.5	15	23.33	0	0.2	0	0	0	0.5	0	10	0	0		0	15	0	15	15	10	0	10	10	15		16.9437	0.353427099	1.541869479	1.193118086	1.924622647	3.131248572	1.116362971	0.809324334	5.111557522	0.704769987	1.441761604	0.418168958	0.03017288	0.000478279	6.937226816	2.462245787	0.057937103	0.540099735	1.150632664	0	5.940788421	0	0	0	2.731598747	0	0.137244799	0	0	0	0	1.360932705	0	0.09490296	0.517574433	0.09336744	0	0.699520572	0.003253221	0.001607929	0	57.4495		0	16.9437	0.353427099	1.541869479	1.193118086	1.924622647	3.131248572	1.116362971	0.809324334	5.111557522	0.704769987	1.441761604	0.418168958	0.03017288	0.000478279	6.937226816	2.462245787	0.057937103	0.540099735	1.150632664	0	5.940788421	0	0	0	2.731598747	0	0.137244799	0	0	0	0	1.360932705	0	0.09490296	0.517574433	0.09336744	0	0.699520572	0.003253221	0.001607929	0	57.4495	None																																																																																			0		0	16.9437	0.353427099	1.541869479	1.193118086	1.924622647	3.131248572	1.116362971	0.809324334	5.111557522	0.704769987	1.441761604	0.418168958	0.03017288	0.000478279	6.937226816	2.462245787	0.057937103	0.540099735	1.150632664	0	5.940788421	0	0	0	2.731598747	0	0.137244799	0	0	0	0	1.360932705	0	0.09490296	0.517574433	0.09336744	0	0.699520572	0.003253221	0.001607929	0	57.4495
H9452_002_0	2008	7	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		D	A	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	1304.054404	8.160340442	338.6935983	10.55898182	221.5333874	10.59529633	3.777469664	194.5374282	402.2542194	848.9066597	898.1804858	50.36911614	14.53748565	0.384062732	5551.532011	1970.417959	0.115947318	432.2160779	814.3188927	0	30.8008802	0	0	0	5.224104375	352.3813641	166.7471956	0	0		0	1092.843393	17.86602933	75.94631626	414.1901526	112.0762688	0.051299015	839.6894645	3.905096475	1.288327339		"$200/day, days(1-5) no yrly max"	"$900/admit, no yrly max"	$100/day for days 21 to 100	15% Coinsurance	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$20copay	$30/$35 copay for Lower/Higher Tier	$150 copay	$25 copay	$30 copay	$15 copay	$30 copay	50% coinsurance	$30 copay	$30/$35 copay for Lower/Higher Tier	N/A	20% coinsurance	N/A	N/A	N/A	50% coinsurance	$50 maximum per year	$25 copay	N/A	N/A		N/A	$30 copay	$0 copay	$30 copay	$30 copay	$25 copay	$0 copay	$25 copay	$25 copay	Min. $15 / Max. $30copay		200	900	100	0.15	150	0.3	0.3	50	200	20	31.08373	150	25	30	15	30	0.5	30	30.79	0	0.2	0	0	0	0.5	0	25	0	0		0	30	0	30	30	25	0	25	25	18.92933608		21.7342	0.612025533	2.822446653	1.583847273	2.769167343	3.178588899	1.133240899	0.810572618	6.70423699	1.414844433	2.326566643	0.629613952	0.030286428	0.000960157	6.939415013	4.926044898	0.057973659	1.080540195	2.089406559	0	6.16017604	0	0	0	2.612052187	0	0.347389991	0	0	0	0	2.732108483	0	0.189865791	1.035475381	0.233492227	0	1.749353051	0.008135618	0.002032265	0	75.9141		0	21.7342	0.612025533	2.822446653	1.583847273	2.769167343	3.178588899	1.133240899	0.810572618	6.70423699	1.414844433	2.326566643	0.629613952	0.030286428	0.000960157	6.939415013	4.926044898	0.057973659	1.080540195	2.089406559	0	6.16017604	0	0	0	2.612052187	0	0.347389991	0	0	0	0	2.732108483	0	0.189865791	1.035475381	0.233492227	0	1.749353051	0.008135618	0.002032265	0	75.9141	None																																																																																			0		0	21.7342	0.612025533	2.822446653	1.583847273	2.769167343	3.178588899	1.133240899	0.810572618	6.70423699	1.414844433	2.326566643	0.629613952	0.030286428	0.000960157	6.939415013	4.926044898	0.057973659	1.080540195	2.089406559	0	6.16017604	0	0	0	2.612052187	0	0.347389991	0	0	0	0	2.732108483	0	0.189865791	1.035475381	0.233492227	0	1.749353051	0.008135618	0.002032265	0	75.9141
H9452_003_0	2008	7	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	362.1823826	8.160340442	338.6935983	0	221.5333874	10.59529633	3.777469664	194.5374282	410.4634892	848.9066597	898.1804858	50.36911614	14.53748565	0.384062732	5551.532011	1970.417959	0.115947318	432.2160779	592.0251724	0	30.8008802	0	0	0	5.224104375	352.3813641	166.7471956	0	0		0	1092.843393	17.86602933	75.94631626	414.1901526	112.0762688	0.051299015	839.6894645	3.905096475	1.288327339		$100/admit with no yearly max	$100/admit with no yearly max	$50/day for days 21 to 100	$0 Copay	$50 copay	20% coinsurance	20% coinsurance	$25 copay	$50 copay	$0 copay	$0/$35 copay for Lower/Higher Tier	$50 copay	$10 copay	$10 copay	$10 copay	$10 copay	50% coinsurance	$10 copay	$0/$35 copay for Lower/Higher Tier	N/A	0% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay		113.1675498	113.1675498	50	0	50	0.2	0.2	25	50	0	7.586114	50	10	10	10	10	0.5	10	15.88	0	0	0	0	0	0.5	0	10	0	0		0	10	0	10	10	10	0	10	10	10		3.4156	0.076957144	1.411223326	0	0.923055781	2.119059266	0.755493933	0.405286309	1.710264538	0	0.567808297	0.209871317	0.012114571	0.000320052	4.626276676	1.642014966	0.057973659	0.360180065	0.783446645	0	0	0	0	0	2.612052187	0	0.138955996	0	0	0	0	0.910702828	0	0.063288597	0.34515846	0.093396891	0	0.69974122	0.003254247	0.001073606	0	23.9446		0	3.4156	0.076957144	1.411223326	0	0.923055781	2.119059266	0.755493933	0.405286309	1.710264538	0	0.567808297	0.209871317	0.012114571	0.000320052	4.626276676	1.642014966	0.057973659	0.360180065	0.783446645	0	0	0	0	0	2.612052187	0	0.138955996	0	0	0	0	0.910702828	0	0.063288597	0.34515846	0.093396891	0	0.69974122	0.003254247	0.001073606	0	23.9446	None																																																																																			0		0	3.4156	0.076957144	1.411223326	0	0.923055781	2.119059266	0.755493933	0.405286309	1.710264538	0	0.567808297	0.209871317	0.012114571	0.000320052	4.626276676	1.642014966	0.057973659	0.360180065	0.783446645	0	0	0	0	0	2.612052187	0	0.138955996	0	0	0	0	0.910702828	0	0.063288597	0.34515846	0.093396891	0	0.69974122	0.003254247	0.001073606	0	23.9446
H9452_004_0	2008	6	H.	H.	I.	I.	I.	I.	I.	I.	F.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency		None	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care		A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V		Coin				Coin	V	V					V	V	V	V	V	Coin	V	V	V																																											0	None	362.1823826	8.160340442	338.6935983	0	221.5333874	10.59529633	3.777469664	194.5374282	410.4634892	848.9066597	898.1804858	50.36911614	14.53748565	0.384062732	5551.532011	1970.417959	0.115947318	432.2160779	592.0251724	0	30.8008802	0	0	0	5.224104375	352.3813641	166.7471956	0	0		0	1092.843393	17.86602933	75.94631626	414.1901526	112.0762688	0.051299015	839.6894645	3.905096475	1.288327339		$100/admit with no yearly max	$100/admit with no yearly max	$50/day for days 21 to 100	$0 Copay	$50 copay	20% coinsurance	20% coinsurance	$25 copay	$50 copay	$0 copay	$0/$35 copay for Lower/Higher Tier	$50 copay	$10 copay	$10 copay	$10 copay	$10 copay	50% coinsurance	$10 copay	$0/$35 copay for Lower/Higher Tier	N/A	0% coinsurance	N/A	N/A	N/A	50% coinsurance	$75 maximum per year	$10 copay	N/A	N/A		N/A	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay	$0 copay	$10 copay	$10 copay	$10 copay		113.1675498	113.1675498	50	0	50	0.2	0.2	25	50	0	7.586114	50	10	10	10	10	0.5	10	15.88	0	0	0	0	0	0.5	0	10	0	0		0	10	0	10	10	10	0	10	10	10		3.4156	0.076957144	1.411223326	0	0.923055781	2.119059266	0.755493933	0.405286309	1.710264538	0	0.567808297	0.209871317	0.012114571	0.000320052	4.626276676	1.642014966	0.057973659	0.360180065	0.783446645	0	0	0	0	0	2.612052187	0	0.138955996	0	0	0	0	0.910702828	0	0.063288597	0.34515846	0.093396891	0	0.69974122	0.003254247	0.001073606	0	23.9446		0	3.4156	0.076957144	1.411223326	0	0.923055781	2.119059266	0.755493933	0.405286309	1.710264538	0	0.567808297	0.209871317	0.012114571	0.000320052	4.626276676	1.642014966	0.057973659	0.360180065	0.783446645	0	0	0	0	0	2.612052187	0	0.138955996	0	0	0	0	0.910702828	0	0.063288597	0.34515846	0.093396891	0	0.69974122	0.003254247	0.001073606	0	23.9446	None																																																																																			0		0	3.4156	0.076957144	1.411223326	0	0.923055781	2.119059266	0.755493933	0.405286309	1.710264538	0	0.567808297	0.209871317	0.012114571	0.000320052	4.626276676	1.642014966	0.057973659	0.360180065	0.783446645	0	0	0	0	0	2.612052187	0	0.138955996	0	0	0	0	0.910702828	0	0.063288597	0.34515846	0.093396891	0	0.69974122	0.003254247	0.001073606	0	23.9446
H9452_801_0	2008	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	280.6323013	2.066470508	27.25476671	31.4550965	10.0313854	33.38043323	1.695916905	3.886139364	22.93038981	8.76975387	24.48994383	0	0.343349085	23.30670141	51.9976295	148.108389	1.717754296	5.838573716	53.20855189	51.39438527	6.684348625	6.321670704	0	0	0	0	0	0	0	0	0											Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											0.070206874	0.070206874	0.171478757	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											19.7023	0.145080434	4.673613515	0	2.347344183	7.811021376	0.396844556	0.909356611	5.365711217	2.052122406	5.730646856	0	0.080343686	5.453768131	12.1674453	34.65736303	0.401954505	1.366226249	12.45080114	12.02628615	1.564137578	1.479270945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.7817	0	0	19.7023	0.145080434	4.673613515	0	2.347344183	7.811021376	0.396844556	0.909356611	5.365711217	2.052122406	5.730646856	0	0.080343686	5.453768131	12.1674453	34.65736303	0.401954505	1.366226249	12.45080114	12.02628615	1.564137578	1.479270945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.7817	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.7023	0.145080434	4.673613515	0	2.347344183	7.811021376	0.396844556	0.909356611	5.365711217	2.052122406	5.730646856	0	0.080343686	5.453768131	12.1674453	34.65736303	0.401954505	1.366226249	12.45080114	12.02628615	1.564137578	1.479270945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.7817
H9452_802_0	2008	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	280.6323013	2.066470508	27.25476671	31.4550965	10.0313854	33.38043323	1.695916905	3.886139364	22.93038981	8.76975387	24.48994383	0	0.343349085	23.30670141	51.9976295	148.108389	1.717754296	5.838573716	53.20855189	51.39438527	6.684348625	6.321670704	0	0	0	0	0	0	0	0	0											Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	0	0	0	0	0	0	0	0	0											0.070206874	0.070206874	0.171478757	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											19.7023	0.145080434	4.673613515	0	2.347344183	7.811021376	0.396844556	0.909356611	5.365711217	2.052122406	5.730646856	0	0.080343686	5.453768131	12.1674453	34.65736303	0.401954505	1.366226249	12.45080114	12.02628615	1.564137578	1.479270945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.7817	0	0	19.7023	0.145080434	4.673613515	0	2.347344183	7.811021376	0.396844556	0.909356611	5.365711217	2.052122406	5.730646856	0	0.080343686	5.453768131	12.1674453	34.65736303	0.401954505	1.366226249	12.45080114	12.02628615	1.564137578	1.479270945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.7817	none																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.7023	0.145080434	4.673613515	0	2.347344183	7.811021376	0.396844556	0.909356611	5.365711217	2.052122406	5.730646856	0	0.080343686	5.453768131	12.1674453	34.65736303	0.401954505	1.366226249	12.45080114	12.02628615	1.564137578	1.479270945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.7817
H9466_001_0	2008	5	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			D	D	D	D	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V		S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	2135.769602	71.07509687	548.2733288	0.001106602	290.43608	12.83091724	4.574520536	349.6273833	448.4729628	927.5165632	981.3532122	55.03336434	15.88367646	0.41962746	5532.607287	1963.700964	3.15797161	430.7426882	590.0070065		296.8235816				572.9623114	553.301017	156.5698944					1194.042168	19.52044778	75.6874214	412.7782118	111.6942099	0.050949863	836.827031	3.891784317			$150/day with $1500 yearly max	$150/day with $1500 yearly max	$75/day for days 21 to 100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$150 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$150 copay	$15/$25 copay for in-home/facility	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$50/$100 copay for Lower/Higher Tier		$15/$22.50/$40/$100 copay levels				$50 max w/specialist copay	Up to $50	$50 max w/specialist copay					$25 copay	$50 copay	$25 copay	$25 copay	$10 copay	20% coinsurance	$25 copay	$25 copay			92.22961087	94.38109375	71.15684	0	71.15684	0.189751573	0.189751573	47.43789334	142.31368	48.44898602	57.71987247	142.31368	23.71894667	23.71894667	9.487578667	23.71894667	23.71894667	23.71894667	49.57259854		30.45706881				23.71894667	0	23.71894667					23.71894667	47.43789334	23.71894667	23.71894667	9.487578667	0.189751573	23.71894667	23.71894667			16.4151	0.559012115	3.251116462	0	1.722209473	2.434686734	0.868022469	1.382132209	5.318653143	3.74476975	4.720298521	0.652666717	0.03139534	0.000829427	4.374253905	3.881409869	0.00624198	0.851396904	2.437348372	0	0.753364687	0	0	0	1.132505209	0	0.309472748	0	0	0	0	2.360118541	0.07716741	0.149602159	0.815888699	0.088308967	0.009667817	1.654054643	0.007692419	0	0	60.0094		3.241089319	16.4151	0.559012115	3.251116462	0	1.722209473	2.434686734	0.868022469	1.382132209	5.318653143	3.74476975	4.720298521	0.652666717	0.03139534	0.000829427	4.374253905	3.881409869	0.00624198	0.851396904	2.437348372	0	0.753364687	0	0	0	1.132505209	0	0.309472748	0	0	0	0	2.360118541	0.07716741	0.149602159	0.815888699	0.088308967	0.009667817	1.654054643	0.007692419	0	0	60.0094	2750																																																																																			0		0	16.4151	0.559012115	3.251116462	0	1.722209473	2.434686734	0.868022469	1.382132209	5.318653143	3.74476975	4.720298521	0.652666717	0.03139534	0.000829427	4.374253905	3.881409869	0.00624198	0.851396904	2.437348372	0	0.753364687	0	0	0	1.132505209	0	0.309472748	0	0	0	0	2.360118541	0.07716741	0.149602159	0.815888699	0.088308967	0.009667817	1.654054643	0.007692419	0	0	60.0094
H9519_001_0	2008	12																					0											A	A	A	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V	V	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	188.66	3.58	140.23	1428.79	250.68	7.51	6.2	282.12	527.31	0	612.71	19.33	0	872.66	7452.87	3117.44	1.72	866.66	1147.57	1333.69	7.31	717.55	0	0	457	457	24.86	0	0	0	0											PBP: 1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: $250	6 Home Health: $5	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic & Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $5"	9B ASC Services: $20	8A OP C/D/T: $0	8B OP X-Ray: $5	9A OP Hospital: $5	12 Renal Dialysis: $0	"3 CORF: $5, 5 Partial Hosp: $5, 9C OP Substance Abuse: $5, 9D Cardiac Rehab: $5"	"7A PCP: $5, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $5, 14J Nutrition Therapy: $5"	7D Physician Specialist: $5	"7E Mental Health: 50%, 7H Psychiatric: 50%"	"7C Occupational Therapy: $5, 7I Physical and Speech Therapy: $5"	Included in i.2.	"7B Chiropractic: $5, 7F Podiatry: $5, 7G Other Health Care: $5, 18A Medicare Covered Hearing Exams: $5"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $5, 17A Medicare Covered Eye Exams: $5"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $5	17B Eye Wear: Medicare Covered: $60	18A Routine Hearing Exams: $5	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											250	250	250	5	50	0.125481785	0.143721685	47.51488728	20	0	5	5	0	5	5	5	0.499985981	5	5	5	0.199988948	5	0	0	5	34.62	5	0	0	0	0											3.9304	0.074583333	2.921458333	0.595329167	1.0445	0.942368209	0.891074445	1.117075	0.87885	0	0.255295833	0.008054167	0	0.363608333	3.1053625	1.298933333	0.859975888	0.361108333	0.478154167	0.555704167	1.461919207	0.298979167	0	0	0.190416667	1.318445	0.010358333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.962	0	0	3.9304	0.074583333	2.921458333	0.595329167	1.0445	0.942368209	0.891074445	1.117075	0.87885	0	0.255295833	0.008054167	0	0.363608333	3.1053625	1.298933333	0.859975888	0.361108333	0.478154167	0.555704167	1.461919207	0.298979167	0	0	0.190416667	1.318445	0.010358333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.962	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.9304	0.074583333	2.921458333	0.595329167	1.0445	0.942368209	0.891074445	1.117075	0.87885	0	0.255295833	0.008054167	0	0.363608333	3.1053625	1.298933333	0.859975888	0.361108333	0.478154167	0.555704167	1.461919207	0.298979167	0	0	0.190416667	1.318445	0.010358333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.962
H9519_002_0	2008	8																					0											A	A	A	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V	V	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	188.66	3.58	140.23	1428.79	250.68	7.51	6.2	282.12	527.31	0	612.71	19.33	0	872.66	7452.87	3117.44	1.72	866.66	1147.57	1333.69	7.31	717.55	0	0	457	457	24.86	0	0	0	0											PBP: 1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: $250	6 Home Health: $5	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic & Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $5"	9B ASC Services: $20	8A OP C/D/T: $0	8B OP X-Ray: $5	9A OP Hospital: $5	12 Renal Dialysis: $0	"3 CORF: $5, 5 Partial Hosp: $5, 9C OP Substance Abuse: $5, 9D Cardiac Rehab: $5"	"7A PCP: $5, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $5,  14J Nutrition Therapy: $5"	7D Physician Specialist: $5	"7E Mental Health: 50%, 7H Psychiatric: 50%"	"7C Occupational Therapy: $5, 7I Physical and Speech Therapy: $5"	Included in i.2.	"7B Chiropractic: $5, 7F Podiatry: $5, 7G Other Health Care: $5, 18A Medicare Covered Hearing Exams: $5"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $5, 17A Medicare Covered Eye Exams: $5"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $5	17B Eye Wear: Medicare Covered: $60	18A Routine Hearing Exams: $5	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											250	250	250	5	50	0.125481785	0.143721685	47.51488728	20	0	5	5	0	5	5	5	0.499985981	5	5	5	0.199988948	5	0	0	5	34.62	5	0	0	0	0											3.9304	0.074583333	2.921458333	0.595329167	1.0445	0.942368209	0.891074445	1.117075	0.87885	0	0.255295833	0.008054167	0	0.363608333	3.1053625	1.298933333	0.859975888	0.361108333	0.478154167	0.555704167	1.461919207	0.298979167	0	0	0.190416667	1.318445	0.010358333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.962	0	0	3.9304	0.074583333	2.921458333	0.595329167	1.0445	0.942368209	0.891074445	1.117075	0.87885	0	0.255295833	0.008054167	0	0.363608333	3.1053625	1.298933333	0.859975888	0.361108333	0.478154167	0.555704167	1.461919207	0.298979167	0	0	0.190416667	1.318445	0.010358333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.962	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.9304	0.074583333	2.921458333	0.595329167	1.0445	0.942368209	0.891074445	1.117075	0.87885	0	0.255295833	0.008054167	0	0.363608333	3.1053625	1.298933333	0.859975888	0.361108333	0.478154167	0.555704167	1.461919207	0.298979167	0	0	0.190416667	1.318445	0.010358333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.962
H9519_003_0	2008	9																					0											A	A	A	V	T	Coin	Coin	V	Coin	V	V	V	V	V	V	V	Coin	V	V	V	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	188.29	3.58	140.23	1428.79	250.68	7.51	6.2	280.71	68.87	0	612.71	19.33	0.77	872.66	6925.51	2884.74	1.72	766.98	1028.49	1199.18	7.31	631.5	0	0	457	457	21.87	0	0	0	0											PBP: 1A IP Acute: $500 per admit	1B IP Psych: $500 per admit	2 SNF: $500	6 Home Health: $5	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic & Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: 20%	8A OP C/D/T: $0	8B OP X-Ray: $30	9A OP Hospital: $30	12 Renal Dialysis: $20	"3 CORF: $30, 5 Partial Hosp: $30, 9C OP Substance Abuse: $30, 9D Cardiac Rehab: $30"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $30, 14J Nutrition Therapy: $30"	7D Physician Specialist: $30	"7E Mental Health: 50%, 7H Psychiatric: 50%"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	Included in i.2.	"7B Chiropractic: $30, 7F Podiatry: $30, 7G Other Health Care: $30, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $30, 17A Medicare Covered Eye Exams: $30"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $5	17B Eye Wear: Medicare Covered: $60	18A Routine Hearing Exams: $30	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											500	500	500	5	50	0.125481785	0.143721685	48.99041716	0.200000011	0	30	30	20	30	10	30	0.499985981	30	30	29.77614412	0.199988948	30	0	0	5	34.62	30	0	0	0	0											7.8454	0.149166667	5.842916667	0.595329167	1.0445	0.942368209	0.891074445	1.146008333	13.77400073	0	1.531775	0.048325	0.001283333	2.18165	5.771258333	7.21185	0.859975888	1.91745	2.571225	2.975579708	1.461919207	1.57875	0	0	0.190416667	1.318445	0.054675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9054	0	0	7.8454	0.149166667	5.842916667	0.595329167	1.0445	0.942368209	0.891074445	1.146008333	13.77400073	0	1.531775	0.048325	0.001283333	2.18165	5.771258333	7.21185	0.859975888	1.91745	2.571225	2.975579708	1.461919207	1.57875	0	0	0.190416667	1.318445	0.054675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9054	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.8454	0.149166667	5.842916667	0.595329167	1.0445	0.942368209	0.891074445	1.146008333	13.77400073	0	1.531775	0.048325	0.001283333	2.18165	5.771258333	7.21185	0.859975888	1.91745	2.571225	2.975579708	1.461919207	1.57875	0	0	0.190416667	1.318445	0.054675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9054
H9519_801_0	2008	4																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	252.25	3.07	48.19	14.4	13.37	7.51	6.2	11.36	68.87	9.53	16.89	1.98	0.34	20.94	65.74	106.19	1.95	5.26	44.92	47.72	7.31	21.61	0	0	0	0	0	0	0	0	0											Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing																				0.089352375	0.08924959	0.191368834	0	0.234021323	0.23400002	0.233834949	0.234015861	0.23399997	0.233911613	0.233986791	0.234000175	0.234000021	0.234008935	0.234003364	0.234000538	0.234010334	0.234005171	0.234008909	0.233988972	0.233987647	0.050894387	0	0	0	0	0	0	0	0	0											22.5391	0.273996242	9.22206411	0	3.128865093	1.757340147	1.449776681	2.658420179	16.11557791	2.229177676	3.952036893	0.463320347	0.079560007	4.900147089	15.38338115	24.84851717	0.456320151	1.230867199	10.51168018	11.16595373	1.710449701	1.099827709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.1764	0	0	22.5391	0.273996242	9.22206411	0	3.128865093	1.757340147	1.449776681	2.658420179	16.11557791	2.229177676	3.952036893	0.463320347	0.079560007	4.900147089	15.38338115	24.84851717	0.456320151	1.230867199	10.51168018	11.16595373	1.710449701	1.099827709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.1764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.5391	0.273996242	9.22206411	0	3.128865093	1.757340147	1.449776681	2.658420179	16.11557791	2.229177676	3.952036893	0.463320347	0.079560007	4.900147089	15.38338115	24.84851717	0.456320151	1.230867199	10.51168018	11.16595373	1.710449701	1.099827709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.1764
H9519_803_0	2008	4																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	252.25	3.07	48.19	14.4	13.37	7.51	6.2	11.36	68.87	9.53	16.89	1.98	0.34	20.94	65.74	106.19	1.95	5.26	44.92	47.72	7.31	21.61	0	0	0	0	0	0	0	0	0											Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing																				0.089352375	0.08924959	0.191368834	0	0.234021323	0.23400002	0.233834949	0.234015861	0.23399997	0.233911613	0.233986791	0.234000175	0.234000021	0.234008935	0.234003364	0.234000538	0.234010334	0.234005171	0.234008909	0.233988972	0.233987647	0.050894387	0	0	0	0	0	0	0	0	0											22.5391	0.273996242	9.22206411	0	3.128865093	1.757340147	1.449776681	2.658420179	16.11557791	2.229177676	3.952036893	0.463320347	0.079560007	4.900147089	15.38338115	24.84851717	0.456320151	1.230867199	10.51168018	11.16595373	1.710449701	1.099827709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.1764	0	0	22.5391	0.273996242	9.22206411	0	3.128865093	1.757340147	1.449776681	2.658420179	16.11557791	2.229177676	3.952036893	0.463320347	0.079560007	4.900147089	15.38338115	24.84851717	0.456320151	1.230867199	10.51168018	11.16595373	1.710449701	1.099827709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.1764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.5391	0.273996242	9.22206411	0	3.128865093	1.757340147	1.449776681	2.658420179	16.11557791	2.229177676	3.952036893	0.463320347	0.079560007	4.900147089	15.38338115	24.84851717	0.456320151	1.230867199	10.51168018	11.16595373	1.710449701	1.099827709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.1764
H9519_804_0	2008	4																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	252.25	3.07	48.19	14.4	13.37	7.51	6.2	11.36	68.87	9.53	16.89	1.98	0.34	20.94	65.74	106.19	1.95	5.26	44.92	47.72	7.31	21.61	0	0	0	0	0	0	0	0	0											Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing	Standard Medicar Fee-for-Service Cost Sharing																				0.089352375	0.08924959	0.191368834	0	0.234021323	0.23400002	0.233834949	0.234015861	0.23399997	0.233911613	0.233986791	0.234000175	0.234000021	0.234008935	0.234003364	0.234000538	0.234010334	0.234005171	0.234008909	0.233988972	0.233987647	0.050894387	0	0	0	0	0	0	0	0	0											22.5391	0.273996242	9.22206411	0	3.128865093	1.757340147	1.449776681	2.658420179	16.11557791	2.229177676	3.952036893	0.463320347	0.079560007	4.900147089	15.38338115	24.84851717	0.456320151	1.230867199	10.51168018	11.16595373	1.710449701	1.099827709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.1764	0	0	22.5391	0.273996242	9.22206411	0	3.128865093	1.757340147	1.449776681	2.658420179	16.11557791	2.229177676	3.952036893	0.463320347	0.079560007	4.900147089	15.38338115	24.84851717	0.456320151	1.230867199	10.51168018	11.16595373	1.710449701	1.099827709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.1764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.5391	0.273996242	9.22206411	0	3.128865093	1.757340147	1.449776681	2.658420179	16.11557791	2.229177676	3.952036893	0.463320347	0.079560007	4.900147089	15.38338115	24.84851717	0.456320151	1.230867199	10.51168018	11.16595373	1.710449701	1.099827709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.1764
H9663_001_0	2008	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	948.624126				0		0															175/d 10	175/d 10	"$0 days 1-8, $75 days 9-14; $100 15+"	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $25 UC	$200 per visit	$0 per visit	"$30 X-ray; $175 PET, MRI"	$30 per visit	$30 per visit	$30 per visit	$20 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script				$0 per visit		$0 per visit															143.44	143.44	66.23	0	100	0.2	0.2	46.75	200	0	56.1	30	30	30	20	30	30	30	30	30	45				0		0															16.6989	0.325315608	6.298021891	0	1.722706705	2.766333837	0.176580511	1.460700884	5.1483173	0	4.71855417	0	0	0	8.119976658	15.05139961	0.443677622	1.283690571	2.105316109	3.182059768	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.0589			16.6989	0.325315608	6.298021891	0	1.722706705	2.766333837	0.176580511	1.460700884	5.1483173	0	4.71855417	0	0	0	8.119976658	15.05139961	0.443677622	1.283690571	2.105316109	3.182059768	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.0589		35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	$100 per trip	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	$50 ER; $25 UC	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max				35% coins; $0ded; $5000 OOP max		35% coins; $0ded; $5000 OOP max															4.22	0.0327	0.6843	0.613	0.1243	0.3492	0.0223	0.1054	0.4322	0.15	0.421	0	0.1381	0.4653	0.5482	0.685	0.0259	0.0725	0.5095	1.8463	0.4015	0	0	0	0.0713	0	0.0201															11.9379	0	15.29351151	20.9189	0.358039619	6.982291469	0.613008218	1.846969206	3.115531546	0.198870485	1.566064348	5.580496467	0.149975771	5.139602447	0	0.138071668	0.465266072	8.668204754	15.73640506	0.469549607	1.356210796	2.614793359	5.028325494	3.958823998	0	0	0	0.071261584	0	0.020119462	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.9968
H9663_002_0	2008	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	5000	1397.009329	27.21547191	1141.118265	1873.207127	206.7248045	13.83166919	0.882902555	374.9392643	308.899038	1963.916502	1009.3164	0	0	0	4871.985995	6020.559846	177.4710487	513.4762285	842.1264435	1272.823907	948.624126				0		0															100/d 10	100/d 10	"$0 days 1-8, $75 days 9-14; $100 15+"	$0 per visit	$100 per trip	20% coinsurance	20% coinsurance	$50 ER; $25 UC	$200 per visit	$0 per visit	"$20 X-ray; $175 PET, MRI"	$20 per visit	$20 per visit	$20 per visit	$10 per visit	$20 per visit specialist $20 Renal Dialysis	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script				$0 per visit		$0 per visit															81.96	81.96	66.23	0	100	0.2	0.2	46.75	200	0	47.9	20	20	20	10	20	20	20	20	20	45				0		0															9.5416	0.185881673	6.298021891	0	1.722706705	2.766333837	0.176580511	1.460700884	5.1483173	0	4.02885463	0	0	0	4.059988329	10.03426641	0.295785081	0.855793714	1.403544073	2.121373179	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.6571			9.5416	0.185881673	6.298021891	0	1.722706705	2.766333837	0.176580511	1.460700884	5.1483173	0	4.02885463	0	0	0	4.059988329	10.03426641	0.295785081	0.855793714	1.403544073	2.121373179	3.557340473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.6571		35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	$100 per trip	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	$50 ER; $25 UC	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max	35% coins; $0ded; $5000 OOP max				35% coins; $0ded; $5000 OOP max		35% coins; $0ded; $5000 OOP max															4.22	0.0327	0.6843	0.613	0.1243	0.3492	0.0223	0.1054	0.4322	0.15	0.421	0	0.1381	0.4653	0.5482	0.685	0.0259	0.0725	0.5095	1.8463	0.4015				0.0713		0.0201															11.9379	0	15.29351151	13.7616	0.218605685	6.982291469	0.613008218	1.846969206	3.115531546	0.198870485	1.566064348	5.580496467	0.149975771	4.449902907	0	0.138071668	0.465266072	4.608216426	10.71927185	0.321657067	0.928313939	1.913021322	3.967638904	3.958823998	0	0	0	0.071261584	0	0.020119462	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5949
H9663_801_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1234.846677	24.05634262	1008.659047	1655.768182	182.7285135	13.83166919	0.882902555	331.4169026	273.0425222	1735.948155	892.1565356	0	0	0	4306.453503	5463.08541	156.8704877	907.7454267	1240.622878	2250.153009	15.90270259	0	0	0	0	0	0															200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	"$40 per visit specialist, $30 Renal Dialysis"	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065			14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065		"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	$50 ER/UC	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"				"30% coins; $500ded; ""Unlimited OOP"		"30% coins; $500ded; ""Unlimited OOP"															7.921957272	0.061430928	1.284540404	1.150765501	0.202333313	0.65552902	0.041843702	0.211846795	0.811305397	0.281540994	0.79041001	0	0.259194098	0.873417564	1.02915746	1.285921799	0.048568008	0.136138098	0.956412696	3.465889756	0.753682214	0	0	0	0.133775323	0	0.037769123															22.3934	500		22.7988	0.351249716	9.690032461	6.669992775	2.486439732	4.805029776	0.306714469	1.592750556	5.362014101	6.068034846	4.875000015	0	0.259194098	0.873417564	11.79529122	19.26857794	0.571469634	3.161956187	5.09182229	10.96639979	3.934222733	0	0	0	0.133775323	0	0.037769123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.0999
H9663_802_0	2008	1																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1234.846677	24.05634262	1008.659047	1655.768182	182.7285135	13.83166919	0.882902555	331.4169026	273.0425222	1735.948155	892.1565356	0	0	0	4306.453503	5463.08541	156.8704877	907.7454267	1240.622878	2250.153009	15.90270259	0	0	0	0	0	0															200/d 7	200/d 7	$100/Day 1 - 100	$40 per visit	$150 per trip	30% coinsurance	30% coinsurance	$50 ER/UC	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$39.5 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0															14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065			14.8768	0.289818788	8.405492057	5.519227274	2.284106419	4.149500756	0.264870766	1.380903761	4.550708704	5.786493852	4.084590005	0	0	0	10.76613376	17.98265614	0.522901626	3.025818089	4.135409594	7.500510031	3.180540519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7065		"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	$50 ER/UC	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"	"30% coins; $500ded; ""Unlimited OOP"				"30% coins; $500ded; ""Unlimited OOP"		"30% coins; $500ded; ""Unlimited OOP"															7.921957272	0.061430928	1.284540404	1.150765501	0.202333313	0.65552902	0.041843702	0.211846795	0.811305397	0.281540994	0.79041001	0	0.259194098	0.873417564	1.02915746	1.285921799	0.048568008	0.136138098	0.956412696	3.465889756	0.753682214	0	0	0	0.133775323	0	0.037769123															22.3934	500		22.7988	0.351249716	9.690032461	6.669992775	2.486439732	4.805029776	0.306714469	1.592750556	5.362014101	6.068034846	4.875000015	0	0.259194098	0.873417564	11.79529122	19.26857794	0.571469634	3.161956187	5.09182229	10.96639979	3.934222733	0	0	0	0.133775323	0	0.037769123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.0999
H9720_008_0	2008	6	s.										Professional (Non-Covered)											Physical Exams										D	D	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	0	0	P	V	V	V	V				V																																																			0		1685.063462	116.2133261	1056.102141	138.1646537	8.68330143	21.058	14.0387	192.7009696	25.9606	9.0152	20.9015	0.5685	0.02	35.4728	3544.518679	2656.757094	275.3061368	1492.865143	3272.8787	1652.418097	28.4141	0	0	425	508.95	274.05	80	20	0	0	0	37.66838862										$200 for 1st 7 days	$200 for 1st 7 days	$90 for days 6-100	$0 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 per visit	20% Coinsurance	10% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$10 per Visit / $25 Urg Care	$25 per Visit	$25 per Visit	$25 per Visit	$25 per Visit	$25 per Visit	20% Coinsurance	0	0	$0 per procedure	$0 - 1 / Year ($3.85 Cap)	$0 - up to $100 ($3.85 Cap)	$0 (1 / 3 Years)	$500 allowable/hearing aid				$0 / 1 per year										150.0671	73.2112	55.9142	0	0.19916	0.2	0.2	49.79	0.2	0.1	0.2	0.2	0.2	0.2	10.7049	24.895	24.895	24.895	25	24.895	0.2	0	0	0	0	72.4	0	0	0	0	0	0										21.0727	0.70900991	4.920922888	0	1.729366313	4.211601076	2.80773405	0.79954844	5.19211227	0.901522115	4.180293176	0.113704	0.004	7.094552914	3.161961731	5.511663988	0.571145523	3.097073145	6.818497239	3.428079043	5.682827075	0	0	0	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.6618		0.185493986	21.0727	0.70900991	4.920922888	0	1.729366313	4.211601076	2.80773405	0.79954844	5.19211227	0.901522115	4.180293176	0.113704	0.004	7.094552914	3.161961731	5.511663988	0.571145523	3.097073145	6.818497239	3.428079043	5.682827075	0	0	0	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.6618	3250																																																																																			0			21.0727	0.70900991	4.920922888	0	1.729366313	4.211601076	2.80773405	0.79954844	5.19211227	0.901522115	4.180293176	0.113704	0.004	7.094552914	3.161961731	5.511663988	0.571145523	3.097073145	6.818497239	3.428079043	5.682827075	0	0	0	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.6618
H9720_009_0	2008	8	s.										Professional (Non-Covered)											Physical Exams										D	D	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	0	0	P	V	V	V	V				V																																																			0		1685.063462	116.2133261	1056.102141	138.1646537	8.68330143	21.058	14.0387	192.7009696	25.9606	9.0152	20.9015	0.5685	0.02	35.4728	3544.518679	2656.757094	275.3061368	1492.865143	3272.8787	1652.418097	28.4141	0	0	425	508.95	274.05	80	20	0	0	0	37.66838862										$200 for 1st 7 days	$200 for 1st 7 days	$90 for days 6-100	$0 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 per visit	20% Coinsurance	10% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$10 per Visit / $25 Urg Care	$25 per Visit	$25 per Visit	$25 per Visit	$25 per Visit	$25 per Visit	20% Coinsurance	0	0	$0-$75 ($25 Average)	$0 - 1 / Year ($3.85 Cap)	$0 - up to $100 ($3.85 Cap)	$0 (1 / 3 Years)	$500 allowable/hearing aid				$0 / 1 per year										150.0671	73.2112	55.9142	0	0.19916	0.2	0.2	49.79	0.2	0.1	0.2	0.2	0.2	0.2	10.7049	24.895	24.895	24.895	25	24.895	0.2	0	0	24.895	0	72.4	0	0	0	0	0	0										21.0727	0.70900991	4.920922888	0	1.729366313	4.211601076	2.80773405	0.79954844	5.19211227	0.901522115	4.180293176	0.113704	0.004	7.094552914	3.161961731	5.511663988	0.571145523	3.097073145	6.818497239	3.428079043	5.682827075	0	0	0.881697917	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.5435		0.185493986	21.0727	0.70900991	4.920922888	0	1.729366313	4.211601076	2.80773405	0.79954844	5.19211227	0.901522115	4.180293176	0.113704	0.004	7.094552914	3.161961731	5.511663988	0.571145523	3.097073145	6.818497239	3.428079043	5.682827075	0	0	0.881697917	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.5435	3250																																																																																			0			21.0727	0.70900991	4.920922888	0	1.729366313	4.211601076	2.80773405	0.79954844	5.19211227	0.901522115	4.180293176	0.113704	0.004	7.094552914	3.161961731	5.511663988	0.571145523	3.097073145	6.818497239	3.428079043	5.682827075	0	0	0.881697917	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.5435
H9720_010_0	2008	4	s.										Professional (Non-Covered)											Physical Exams										D	D	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	0	0	P	V	V	V	V				V																																																			0		1685.063462	116.2133261	1056.102141	138.1646537	8.68330143	21.058	14.0387	192.7009696	25.9606	9.0152	20.9015	0.5685	0.02	35.4728	3544.518679	2656.757094	275.3061368	1492.865143	3272.8787	1652.418097	28.4141	0	0	425	508.95	274.05	80	20	0	0	0	37.66838862										$100 for 1st 7 days	$100 for 1st 7 days	$90 for days 6-100	$0 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	$25 per visit	20% Coinsurance	10% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$5 per Visit / $15 Urg Care	$25 per Visit	$25 per Visit	$25 per Visit	$25 per Visit	$15 per Visit	20% Coinsurance	0	0	$0 per procedure	$0 - 1 / Year ($3.85 Cap)	$0 - up to $100 ($3.85 Cap)	$0 (1 / 3 Years)	$500 allowable/hearing aid				$0 / 1 per year										75.0345	36.6054	55.9142	0	0.19916	0.2	0.2	24.895	0.2	0.1	0.2	0.2	0.2	0.2	5.4769	24.895	24.895	24.895	25	14.937	0.2	0	0	0	0	72.4	0	0	0	0	0	0										10.5365	0.354502469	4.920922888	0	1.729366313	4.211601076	2.80773405	0.39977422	5.19211227	0.901522115	4.180293176	0.113704	0.004	7.094552914	1.617747863	5.511663988	0.571145523	3.097073145	6.818497239	2.056847426	5.682827075	0	0	0	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4558		0.131904028	10.5365	0.354502469	4.920922888	0	1.729366313	4.211601076	2.80773405	0.39977422	5.19211227	0.901522115	4.180293176	0.113704	0.004	7.094552914	1.617747863	5.511663988	0.571145523	3.097073145	6.818497239	2.056847426	5.682827075	0	0	0	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4558	3250																																																																																			0			10.5365	0.354502469	4.920922888	0	1.729366313	4.211601076	2.80773405	0.39977422	5.19211227	0.901522115	4.180293176	0.113704	0.004	7.094552914	1.617747863	5.511663988	0.571145523	3.097073145	6.818497239	2.056847426	5.682827075	0	0	0	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4558
H9720_011_0	2008	5	s.										Professional (Non-Covered)											Physical Exams										D	D	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	0	0	P	V	V	V	V				V																																																			0		1685.063462	116.2133261	1056.102141	138.1646537	8.68330143	21.058	14.0387	192.7009696	25.9606	9.0152	20.9015	0.5685	0.02	35.4728	3544.518679	2656.757094	275.3061368	1492.865143	3272.8787	1652.418097	28.4141	0	0	425	508.95	274.05	80	20	0	0	0	37.66838862										$100 for 1st 7 days	$100 for 1st 7 days	$90 for days 6-100	$0 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	$25 per visit	20% Coinsurance	10% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$5 per Visit / $15 Urg Care	$25 per Visit	$25 per Visit	$25 per Visit	$25 per Visit	$15 per Visit	20% Coinsurance	0	0	$0-$75 ($25 Average)	$0 - 1 / Year ($3.85 Cap)	$0 - up to $100 ($3.85 Cap)	$0 (1 / 3 Years)	$500 allowable/hearing aid				$0 / 1 per year										75.0345	36.6054	55.9142	0	0.19916	0.2	0.2	24.895	0.2	0.1	0.2	0.2	0.2	0.2	5.4769	24.895	24.895	24.895	25	14.937	0.2	0	0	24.895	0	72.4	0	0	0	0	0	0										10.5365	0.354502469	4.920922888	0	1.729366313	4.211601076	2.80773405	0.39977422	5.19211227	0.901522115	4.180293176	0.113704	0.004	7.094552914	1.617747863	5.511663988	0.571145523	3.097073145	6.818497239	2.056847426	5.682827075	0	0	0.881697917	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.3375		0.131904028	10.5365	0.354502469	4.920922888	0	1.729366313	4.211601076	2.80773405	0.39977422	5.19211227	0.901522115	4.180293176	0.113704	0.004	7.094552914	1.617747863	5.511663988	0.571145523	3.097073145	6.818497239	2.056847426	5.682827075	0	0	0.881697917	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.3375	3250																																																																																			0			10.5365	0.354502469	4.920922888	0	1.729366313	4.211601076	2.80773405	0.39977422	5.19211227	0.901522115	4.180293176	0.113704	0.004	7.094552914	1.617747863	5.511663988	0.571145523	3.097073145	6.818497239	2.056847426	5.682827075	0	0	0.881697917	0	1.653435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.3375
H9793_001_0	2008	5																					5000											D		D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		845.4420617	0	805.0017172	1404.65243	213.1119086	18.67367566	0.853713485	318.6349399	325.7813567	351.5312069	772.7043189	0	0	636.1965367	3644.299273	5380.482069	170.53539	500.2622239	792.0390023	927.7247277	1218.805709	0	0	0	364.0983975	0	156.0421704	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												143.3162474	0	47.77208247	23.88604123	47.77208247	0.19108833	0.19108833	47.77208247	95.54416494	28.66324948	39.41196804	0	0	23.88604123	23.88604123	23.88604123	23.88604123	23.88604123	39.41196804	28.66324948	23.88604123	0	0	0	23.88604123	0	23.88604123	0	0	0	0											10.0971	0	3.204717369	2.795965488	0.848399973	3.568321495	0.163134684	1.268487886	2.59387564	0.83966889	2.537816493	0	0	1.266351392	7.253990225	10.70986805	0.33945128	0.995773676	2.601317987	2.21596711	2.426036952	0	0	0	0.724739111	0	0.310602476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.7616	0	2.647157035	10.0971	0	3.204717369	2.795965488	0.848399973	3.568321495	0.163134684	1.268487886	2.59387564	0.83966889	2.537816493	0	0	1.266351392	7.253990225	10.70986805	0.33945128	0.995773676	2.601317987	2.21596711	2.426036952	0	0	0	0.724739111	0	0.310602476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.7616																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.0971	0	3.204717369	2.795965488	0.848399973	3.568321495	0.163134684	1.268487886	2.59387564	0.83966889	2.537816493	0	0	1.266351392	7.253990225	10.70986805	0.33945128	0.995773676	2.601317987	2.21596711	2.426036952	0	0	0	0.724739111	0	0.310602476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.7616
H9793_002_0	2008	7																					4000											D		D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		847.1500254	0	815.0642387	1450.208725	213.1119086	18.67367566	0.853713485	318.6349399	327.4435065	358.1514754	783.5934927	0	0	637.8071609	3727.124256	5495.776375	174.4111943	511.6318199	803.2006462	945.1962544	1227.480712	0	0	0	372.3733611	0	159.5885833	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												118.9314014	0	33.3007924	14.27176817	47.57256057	0.190290242	0.190290242	47.57256057	71.35884086	23.78628029	35.67942043	0	0	19.02902423	19.02902423	19.02902423	19.02902423	19.02902423	35.67942043	23.78628029	23.78628029	0	0	0	19.02902423	0	19.02902423	0	0	0	0											8.3961	0	2.261857084	1.72475356	0.844856598	3.553418266	0.162453346	1.263189998	1.947165756	0.709924282	2.329846806	0	0	1.011403993	5.910294815	8.714938484	0.276572903	0.811321191	2.388144462	1.873558586	2.433100023	0	0	0	0.590491809	0	0.253067918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4564	0	2.421513311	8.3961	0	2.261857084	1.72475356	0.844856598	3.553418266	0.162453346	1.263189998	1.947165756	0.709924282	2.329846806	0	0	1.011403993	5.910294815	8.714938484	0.276572903	0.811321191	2.388144462	1.873558586	2.433100023	0	0	0	0.590491809	0	0.253067918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4564																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.3961	0	2.261857084	1.72475356	0.844856598	3.553418266	0.162453346	1.263189998	1.947165756	0.709924282	2.329846806	0	0	1.011403993	5.910294815	8.714938484	0.276572903	0.811321191	2.388144462	1.873558586	2.433100023	0	0	0	0.590491809	0	0.253067918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4564
H9793_003_0	2008	6																					3000											D		D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		848.8579892	0	821.7725864	1472.986872	214.1882314	18.67367566	0.853713485	318.6349399	329.1056563	366.7325564	799.2192887	0	0	639.417785	3851.361731	5672.990077	180.2249008	528.6862139	819.2174323	967.8425538	1236.155716	0	0	0	384.7858064	0	164.9082028	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												94.49359343	0	23.62339836	9.449359343	23.62339836	0.188987187	0.188987187	47.24679672	47.24679672	18.89871869	31.89158778	0	0	14.17403901	14.17403901	14.17403901	14.17403901	14.17403901	31.89158778	18.89871869	23.62339836	0	0	0	14.17403901	0	14.17403901	0	0	0	0											6.6843	0	1.617755097	1.159898522	0.421654493	3.529085432	0.16134091	1.254540019	1.29576567	0.577564618	2.124031009	0	0	0.755261053	4.54911262	6.700765224	0.212876231	0.624468252	2.177178721	1.52424868	2.433516576	0	0	0	0.454497419	0	0.194784608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4526	0	2.240743624	6.6843	0	1.617755097	1.159898522	0.421654493	3.529085432	0.16134091	1.254540019	1.29576567	0.577564618	2.124031009	0	0	0.755261053	4.54911262	6.700765224	0.212876231	0.624468252	2.177178721	1.52424868	2.433516576	0	0	0	0.454497419	0	0.194784608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4526																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.6843	0	1.617755097	1.159898522	0.421654493	3.529085432	0.16134091	1.254540019	1.29576567	0.577564618	2.124031009	0	0	0.755261053	4.54911262	6.700765224	0.212876231	0.624468252	2.177178721	1.52424868	2.433516576	0	0	0	0.454497419	0	0.194784608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4526
H9793_004_0	2008	5																					5000											D		D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		884.1266149	0	1072.941301	1834.163148	219.7522733	19.94940051	0.912036416	402.1923089	411.2127693	443.7151424	975.3347644	0	0	803.029806	3126.103576	4563.900116	139.2061371	408.3584747	724.1963692	652.7691608	1178.641055	0	0	0	345.6375964	0	148.1303984	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												143.0866674	0	47.6955558	23.8477779	47.6955558	0.190782223	0.190782223	47.6955558	95.3911116	28.61733348	39.34883353	0	0	23.8477779	23.8477779	23.8477779	23.8477779	23.8477779	39.34883353	28.61733348	23.8477779	0	0	0	23.8477779	0	23.8477779	0	0	0	0											10.5422	0	4.264544308	3.645059616	0.873433901	3.80599098	0.174000335	1.598565476	3.268836931	1.058162017	3.19819044	0	0	1.595873038	6.212551981	9.069906359	0.27664642	0.811536851	2.374690198	1.556709397	2.342330842	0	0	0	0.686890719	0	0.294381737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6505	0	2.785425715	10.5422	0	4.264544308	3.645059616	0.873433901	3.80599098	0.174000335	1.598565476	3.268836931	1.058162017	3.19819044	0	0	1.595873038	6.212551981	9.069906359	0.27664642	0.811536851	2.374690198	1.556709397	2.342330842	0	0	0	0.686890719	0	0.294381737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6505																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.5422	0	4.264544308	3.645059616	0.873433901	3.80599098	0.174000335	1.598565476	3.268836931	1.058162017	3.19819044	0	0	1.595873038	6.212551981	9.069906359	0.27664642	0.811536851	2.374690198	1.556709397	2.342330842	0	0	0	0.686890719	0	0.294381737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6505
H9793_005_0	2008	5																					4000											D		D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		885.9127293	0	1086.353067	1893.649521	219.7522733	19.94940051	0.912036416	402.1923089	413.3107936	452.0714799	989.0794655	0	0	805.0627929	3197.151385	4661.615935	142.369913	417.6393491	734.4019549	665.0625421	1185.722364	0	0	0	353.4929963	0	151.4969984	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												118.7953272	0	33.2626916	14.25543926	47.51813086	0.190072523	0.190072523	47.51813086	71.2771963	23.75906543	35.63859815	0	0	19.00725235	19.00725235	19.00725235	19.00725235	19.00725235	35.63859815	23.75906543	23.75906543	0	0	0	19.00725235	0	19.00725235	0	0	0	0											8.7702	0	3.011252255	2.249567143	0.870184773	3.791832896	0.173353063	1.592618897	2.454969547	0.895066323	2.937450467	0	0	1.275169305	5.064088596	7.383709201	0.225505072	0.661514708	2.181088013	1.316772038	2.347637935	0	0	0	0.559910882	0	0.239961807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.0018	0	2.507133442	8.7702	0	3.011252255	2.249567143	0.870184773	3.791832896	0.173353063	1.592618897	2.454969547	0.895066323	2.937450467	0	0	1.275169305	5.064088596	7.383709201	0.225505072	0.661514708	2.181088013	1.316772038	2.347637935	0	0	0	0.559910882	0	0.239961807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.0018																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.7702	0	3.011252255	2.249567143	0.870184773	3.791832896	0.173353063	1.592618897	2.454969547	0.895066323	2.937450467	0	0	1.275169305	5.064088596	7.383709201	0.225505072	0.661514708	2.181088013	1.316772038	2.347637935	0	0	0	0.559910882	0	0.239961807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.0018
H9793_006_0	2008	6																					3000											D		D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	S				V		V															0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		887.6988436	0	1095.294245	1923.392707	220.8621333	19.94940051	0.912036416	402.1923089	415.408818	462.9028242	1008.802899	0	0	807.0957797	3303.723097	4811.548503	147.1155767	431.5606608	749.0468125	680.9970164	1192.803672	0	0	0	365.2760962	0	156.5468984	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												94.37235308	0	23.59308827	9.437235308	23.59308827	0.188744706	0.188744706	47.18617654	47.18617654	18.87447062	31.85066916	0	0	14.15585296	14.15585296	14.15585296	14.15585296	14.15585296	31.85066916	18.87447062	23.59308827	0	0	0	14.15585296	0	14.15585296	0	0	0	0											6.9812	0	2.153447817	1.512625797	0.434234984	3.765343737	0.172142045	1.581493107	1.633462818	0.728087146	2.677587281	0	0	0.952094099	3.897251533	5.675964427	0.173545539	0.509092438	1.988136851	1.071121515	2.345160194	0	0	0	0.430899559	0	0.18467124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8675	0	2.317763931	6.9812	0	2.153447817	1.512625797	0.434234984	3.765343737	0.172142045	1.581493107	1.633462818	0.728087146	2.677587281	0	0	0.952094099	3.897251533	5.675964427	0.173545539	0.509092438	1.988136851	1.071121515	2.345160194	0	0	0	0.430899559	0	0.18467124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8675																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.9812	0	2.153447817	1.512625797	0.434234984	3.765343737	0.172142045	1.581493107	1.633462818	0.728087146	2.677587281	0	0	0.952094099	3.897251533	5.675964427	0.173545539	0.509092438	1.988136851	1.071121515	2.345160194	0	0	0	0.430899559	0	0.18467124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8675
H9793_801_0	2008	3																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		244.7542223	0	43.14343479	0	6.809561244	23.31072694	1.065707807	5.333041966	28.73880043	8.634818211	24.78740043	0	0	27.28026236	21.59066043	40.84315601	1.53274967	4.253107567	26.09958613	92.41886395	25.78314177	23.1860312	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.078813853	0	0.195428796	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											19.29	0	8.431469527	0	1.593437331	5.454710104	0.249375627	1.24793182	6.7248793	2.020547461	5.800251701	0	0	6.383581391	5.052214542	9.557298505	0.358663423	0.995227171	6.107303155	21.62601417	6.033255175	5.425531302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3517	0	0	19.29	0	8.431469527	0	1.593437331	5.454710104	0.249375627	1.24793182	6.7248793	2.020547461	5.800251701	0	0	6.383581391	5.052214542	9.557298505	0.358663423	0.995227171	6.107303155	21.62601417	6.033255175	5.425531302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3517																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.29	0	8.431469527	0	1.593437331	5.454710104	0.249375627	1.24793182	6.7248793	2.020547461	5.800251701	0	0	6.383581391	5.052214542	9.557298505	0.358663423	0.995227171	6.107303155	21.62601417	6.033255175	5.425531302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3517
H9793_802_0	2008	3																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		244.7542223	0	43.14343479	0	6.809561244	23.31072694	1.065707807	5.333041966	28.73880043	8.634818211	24.78740043	0	0	27.28026236	21.59066043	40.84315601	1.53274967	4.253107567	26.09958613	92.41886395	25.78314177	23.1860312	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.078813853	0	0.195428796	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											19.29	0	8.431469527	0	1.593437331	5.454710104	0.249375627	1.24793182	6.7248793	2.020547461	5.800251701	0	0	6.383581391	5.052214542	9.557298505	0.358663423	0.995227171	6.107303155	21.62601417	6.033255175	5.425531302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3517	0	0	19.29	0	8.431469527	0	1.593437331	5.454710104	0.249375627	1.24793182	6.7248793	2.020547461	5.800251701	0	0	6.383581391	5.052214542	9.557298505	0.358663423	0.995227171	6.107303155	21.62601417	6.033255175	5.425531302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3517																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.29	0	8.431469527	0	1.593437331	5.454710104	0.249375627	1.24793182	6.7248793	2.020547461	5.800251701	0	0	6.383581391	5.052214542	9.557298505	0.358663423	0.995227171	6.107303155	21.62601417	6.033255175	5.425531302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3517
H9793_804_0	2008	3																																Coin		Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		244.7542223	0	43.14343479	0	6.809561244	23.31072694	1.065707807	5.333041966	28.73880043	8.634818211	24.78740043	0	0	27.28026236	21.59066043	40.84315601	1.53274967	4.253107567	26.09958613	92.41886395	25.78314177	23.1860312	0	0	0	0	0	0	0	0	0											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	PBP 8b		PBP 12	"PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"PBP 4b, 7a, 14b-i"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 19	PBP 14a												0.078813853	0	0.195428796	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											19.29	0	8.431469527	0	1.593437331	5.454710104	0.249375627	1.24793182	6.7248793	2.020547461	5.800251701	0	0	6.383581391	5.052214542	9.557298505	0.358663423	0.995227171	6.107303155	21.62601417	6.033255175	5.425531302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3517	0	0	19.29	0	8.431469527	0	1.593437331	5.454710104	0.249375627	1.24793182	6.7248793	2.020547461	5.800251701	0	0	6.383581391	5.052214542	9.557298505	0.358663423	0.995227171	6.107303155	21.62601417	6.033255175	5.425531302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3517																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.29	0	8.431469527	0	1.593437331	5.454710104	0.249375627	1.24793182	6.7248793	2.020547461	5.800251701	0	0	6.383581391	5.052214542	9.557298505	0.358663423	0.995227171	6.107303155	21.62601417	6.033255175	5.425531302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3517
H9859_001_0	2008	4	h.6.										OP Facility - Other											Substance Abuse										A	A	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	P	Coin	P	P	P	P	P	P	P		P	Coin	Coin																																																			0		278.748931	6.647581685	1174.966071	2021.259902	143.2918616	6.192962963	7.35242795	243.2747037	255.3872526		869.1886686			44.85208494	3180.650634	5645.229579	485.6391901	1230.252406			20.21511404				144		249				0.757142857	0.078762334										"$100 per Admit, max $300 per year"	"$100 per Admit, max $300 per year"	"$0 days 1-15, $65 days 16-100"	"$0 visits 1-20, $20 visits 21+"	$50 per Trip	20% Coinsurance	20% Coinsurance	ER $50 per Visit; UC $20 per Visit	$50 per Visit	$0 per Procedure	$15 per Visit	$0 per Visit	$0 per Visit	$15 OP Rehab; including Cardiac Rehab	$10 per Visit	$15 per Visit	MH $15 per Visit	$15 per Visit			20% Coinsurance	No Cost Sharing			$10 Routine Eye Exam	"$100 MAB, No cost sharing prior to MAB"	$15 per Procedure	$600 MAB every 3 years		No Cost Sharing	"30% Coin Travel, Max $3000"	50% Coinsurance										93.8	93.8	33.124	5.95	50	0.2	0.2	49.964	50		15			15	10	15	15	15			0.2				10		15				0.3	0.5										2.1789	0.05196193	3.243298011	1.002208035	0.597049423	1.238592593	1.47048559	1.012914151	1.064113553	0	1.086485836	0	0	0.056065106	2.650542195	7.056536973	0.607048988	1.537815507	0	0	4.043022809	0	0	0	0.12	0	0.31125	0	0	0	0.227142857	0.039381167	0	0	0	0	0	0	0	0	0	29.5948	0	0	2.1789	0.05196193	3.243298011	1.002208035	0.597049423	1.238592593	1.47048559	1.012914151	1.064113553	0	1.086485836	0	0	0.056065106	2.650542195	7.056536973	0.607048988	1.537815507	0	0	4.043022809	0	0	0	0.12	0	0.31125	0	0	0	0.227142857	0.039381167	0	0	0	0	0	0	0	0	0	29.5948																																																																																				0	0	0	2.1789	0.05196193	3.243298011	1.002208035	0.597049423	1.238592593	1.47048559	1.012914151	1.064113553	0	1.086485836	0	0	0.056065106	2.650542195	7.056536973	0.607048988	1.537815507	0	0	4.043022809	0	0	0	0.12	0	0.31125	0	0	0	0.227142857	0.039381167	0	0	0	0	0	0	0	0	0	29.5948
H9859_002_0	2008	6	h.6.										OP Facility - Other											Substance Abuse										A	A	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	P	Coin	P	P	P	P	P	P	P		P	Coin	Coin																																																			0		278.748931	6.647581685	1174.966071	2021.259902	143.2918616	6.192962963	7.35242795	243.2747037	255.3872526		869.1886686			44.85208494	3180.650634	5645.229579	485.6391901	1230.252406			20.21511404				144		249				0.757142857	0.078762334										"$100 per Admit, max $300 per year"	"$100 per Admit, max $300 per year"	"$0 days 1-15, $65 days 16-100"	"$0 visits 1-20, $20 visits 21+"	$50 per Trip	20% Coinsurance	20% Coinsurance	ER $50 per Visit; UC $20 per Visit	$50 per Visit	$0 per Procedure	$15 per Visit	$0 per Visit	$0 per Visit	$15 OP Rehab; including Cardiac Rehab	$10 per Visit	$15 per Visit	MH $15 per Visit	$15 per Visit			20% Coinsurance	No Cost Sharing			$10 Routine Eye Exam	"$100 MAB, No cost sharing prior to MAB"	$15 per Procedure	$600 MAB every 3 years		No Cost Sharing	"30% Coin Travel, Max $3000"	50% Coinsurance										93.8	93.8	33.124	5.95	50	0.2	0.2	49.964	50		15			15	10	15	15	15			0.2				10		15				0.3	0.5										2.1789	0.05196193	3.243298011	1.002208035	0.597049423	1.238592593	1.47048559	1.012914151	1.064113553	0	1.086485836	0	0	0.056065106	2.650542195	7.056536973	0.607048988	1.537815507	0	0	4.043022809	0	0	0	0.12	0	0.31125	0	0	0	0.227142857	0.039381167	0	0	0	0	0	0	0	0	0	29.5948	0	0	2.1789	0.05196193	3.243298011	1.002208035	0.597049423	1.238592593	1.47048559	1.012914151	1.064113553	0	1.086485836	0	0	0.056065106	2.650542195	7.056536973	0.607048988	1.537815507	0	0	4.043022809	0	0	0	0.12	0	0.31125	0	0	0	0.227142857	0.039381167	0	0	0	0	0	0	0	0	0	29.5948																																																																																				0	0	0	2.1789	0.05196193	3.243298011	1.002208035	0.597049423	1.238592593	1.47048559	1.012914151	1.064113553	0	1.086485836	0	0	0.056065106	2.650542195	7.056536973	0.607048988	1.537815507	0	0	4.043022809	0	0	0	0.12	0	0.31125	0	0	0	0.227142857	0.039381167	0	0	0	0	0	0	0	0	0	29.5948
H9859_003_0	2008	4	h.6.										OP Facility - Other											Substance Abuse										A	A	D	V	P	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	P	Coin	P	P	P	P	P	P	P		P	Coin	Coin																																																			0		287.7490281	6.862215264	1212.870383	2086.521265	147.9183929	6.978600983	8.285155462	251.0502704	263.6330603		897.2525697			46.30024519	3279.955604	5816.651157	501.3192498	1269.974141			22.77959929				144		249				0.757142857	0.088754107										$500 per Admit	$500 per Admit	"$0 days 1-15, $65 days 16-100"	"$0 visits 1-20, $20 visits 21+"	$100 per Trip	25% Coinsurance	25% Coinsurance	ER $50 per Visit; UC $30 per Visit	$100 per Visit	$0 per Procedure	$30 per Visit	$0 per Visit	$0 per Visit	$30 OP Rehab; including Cardiac Rehab	$15 per Visit	$30 per Visit	MH $30 per Visit	$30 per Visit			20% Coinsurance	No Cost Sharing			$15 Routine Eye Exam	"$100 MAB, no cost sharing prior to MAB"	$20 per Procedure	"$600 MAB, every 3 years"		No Cost Sharing	"30% Coin Travel, Max $3000"	50% Coinsurance										500	500	33.124	5.95	100	0.25	0.25	49.9787	100		30			30	15	30	30	30			0.2				15		30				0.3	0.5										11.9895	0.285925636	3.347926547	1.034566794	1.232653274	1.744650246	2.071288865	1.045596697	2.196942169	0	2.243131424	0	0	0.115750613	4.099944506	14.54162789	1.253298124	3.174935352	0	0	4.555919859	0	0	0	0.18	0	0.6225	0	0	0	0.227142857	0.044377054	0	0	0	0	0	0	0	0	0	56.0077	0	0	11.9895	0.285925636	3.347926547	1.034566794	1.232653274	1.744650246	2.071288865	1.045596697	2.196942169	0	2.243131424	0	0	0.115750613	4.099944506	14.54162789	1.253298124	3.174935352	0	0	4.555919859	0	0	0	0.18	0	0.6225	0	0	0	0.227142857	0.044377054	0	0	0	0	0	0	0	0	0	56.0077																																																																																				0	0	0	11.9895	0.285925636	3.347926547	1.034566794	1.232653274	1.744650246	2.071288865	1.045596697	2.196942169	0	2.243131424	0	0	0.115750613	4.099944506	14.54162789	1.253298124	3.174935352	0	0	4.555919859	0	0	0	0.18	0	0.6225	0	0	0	0.227142857	0.044377054	0	0	0	0	0	0	0	0	0	56.0077
H9859_004_0	2008	6	h.6.										OP Facility - Other											Substance Abuse										A	A	D	V	P	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	P	Coin	P	P	P	P	P	P	P		P	Coin	Coin																																																			0		287.7490281	6.862215264	1212.870383	2086.521265	147.9183929	6.978600983	8.285155462	251.0502704	263.6330603		897.2525697			46.30024519	3279.955604	5816.651157	501.3192498	1269.974141			22.77959929				144		249				0.757142857	0.088754107										$500 per Admit	$500 per Admit	"$0 days 1-15, $65 days 16-100"	"$0 visits 1-20, $20 visits 21+"	$100 per Trip	25% Coinsurance	25% Coinsurance	ER $50 per Visit; UC $30 per Visit	$100 per Visit	$0 per Procedure	$30 per Visit	$0 per Visit	$0 per Visit	$30 OP Rehab; including Cardiac Rehab	$15 per Visit	$30 per Visit	MH $30 per Visit	$30 per Visit			20% Coinsurance	No Cost Sharing			$15 Routine Eye Exam	"$100 MAB, no cost sharing prior to MAB"	$20 per Procedure	"$600 MAB, every 3 years"		No Cost Sharing	"30% Coin Travel, Max $3000"	50% Coinsurance										500	500	33.124	5.95	100	0.25	0.25	49.9787	100		30			30	15	30	30	30			0.2				15		30				0.3	0.5										11.9895	0.285925636	3.347926547	1.034566794	1.232653274	1.744650246	2.071288865	1.045596697	2.196942169	0	2.243131424	0	0	0.115750613	4.099944506	14.54162789	1.253298124	3.174935352	0	0	4.555919859	0	0	0	0.18	0	0.6225	0	0	0	0.227142857	0.044377054	0	0	0	0	0	0	0	0	0	56.0077	0	0	11.9895	0.285925636	3.347926547	1.034566794	1.232653274	1.744650246	2.071288865	1.045596697	2.196942169	0	2.243131424	0	0	0.115750613	4.099944506	14.54162789	1.253298124	3.174935352	0	0	4.555919859	0	0	0	0.18	0	0.6225	0	0	0	0.227142857	0.044377054	0	0	0	0	0	0	0	0	0	56.0077																																																																																				0	0	0	11.9895	0.285925636	3.347926547	1.034566794	1.232653274	1.744650246	2.071288865	1.045596697	2.196942169	0	2.243131424	0	0	0.115750613	4.099944506	14.54162789	1.253298124	3.174935352	0	0	4.555919859	0	0	0	0.18	0	0.6225	0	0	0	0.227142857	0.044377054	0	0	0	0	0	0	0	0	0	56.0077
H9859_005_0	2008	4	h.6.										OP Facility - Other											Substance Abuse										A	A	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	P	Coin	P	P	P	P	P	P	P		P	Coin	Coin																																																			0		281.9593317	6.724143059	1188.491984	2044.539109	144.9421793	6.336435329	7.52276164	246.0537256	258.3285927		879.1992681			45.36865433	3216.073446	5706.376914	491.2323825	1244.42144			20.68343757				144		249				0.757142857	0.080587021										"$100 per Admit, max $300 per year"	"$100 per Admit, max $300 per year"	"$0 days 1-15, $65 days 16-100"	"$0 visits 1-20, $20 visits 21+"	$50 per Trip	20% Coinsurance	20% Coinsurance	ER $50 per Visit; UC $20 per Visit	$50 per Visit	$0 per Procedure	$15 per Visit	$0 per Visit	$0 per Visit	$15 OP Rehab; including Cardiac Rehab	$10 per Visit	$15 per Visit	MH $15 per Visit	$15 per Visit			20% coinsurance	No Cost Sharing			$10 Routine Eye Exam	"$100 MAB, no cost sharing prior to MAB"	$15 per Procedure	"$600 MAB, every 3 years"		No Cost Sharing	"30% Coin Travel, Max $3000"	50% Coinsurance										93.8	93.8	33.124	5.95	50	0.2	0.2	49.9648	50		15			15	10	15	15	15			0.2				10		15				0.3	0.5										2.204	0.052560385	3.280634039	1.013750642	0.603925747	1.267287066	1.504552328	1.024501725	1.076369136	0	1.098999085	0	0	0.056710818	2.680061205	7.132971143	0.614040478	1.5555268	0	0	4.136687514	0	0	0	0.12	0	0.31125	0	0	0	0.227142857	0.04029351	0	0	0	0	0	0	0	0	0	30.0012	0	0	2.204	0.052560385	3.280634039	1.013750642	0.603925747	1.267287066	1.504552328	1.024501725	1.076369136	0	1.098999085	0	0	0.056710818	2.680061205	7.132971143	0.614040478	1.5555268	0	0	4.136687514	0	0	0	0.12	0	0.31125	0	0	0	0.227142857	0.04029351	0	0	0	0	0	0	0	0	0	30.0012																																																																																				0	0	0	2.204	0.052560385	3.280634039	1.013750642	0.603925747	1.267287066	1.504552328	1.024501725	1.076369136	0	1.098999085	0	0	0.056710818	2.680061205	7.132971143	0.614040478	1.5555268	0	0	4.136687514	0	0	0	0.12	0	0.31125	0	0	0	0.227142857	0.04029351	0	0	0	0	0	0	0	0	0	30.0012
H9859_006_0	2008	6	h.6.										OP Facility - Other											Substance Abuse										A	A	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	P	Coin	P	P	P	P	P	P	P		P	Coin	Coin																																																			0		281.9593317	6.724143059	1188.491984	2044.539109	144.9421793	6.336435329	7.52276164	246.0537256	258.3285927		879.1992681			45.36865433	3216.073446	5706.376914	491.2323825	1244.42144			20.68343757				144		249				0.757142857	0.080587021										"$100 per Admit, max $300 per year"	"$100 per Admit, max $300 per year"	"$0 days 1-15, $65 days 16-100"	"$0 visits 1-20, $20 visits 21+"	$50 per Trip	20% Coinsurance	20% Coinsurance	ER $50 per Visit; UC $20 per Visit	$50 per Visit	$0 per Procedure	$15 per Visit	$0 per Visit	$0 per Visit	$15 OP Rehab; including Cardiac Rehab	$10 per Visit	$15 per Visit	MH $15 per Visit	$15 per Visit			20% coinsurance	No Cost Sharing			$10 Routine Eye Exam	"$100 MAB, no cost sharing prior to MAB"	$15 per Procedure	"$600 MAB, every 3 years"		No Cost Sharing	"30% Coin Travel, Max $3000"	50% Coinsurance										93.8	93.8	33.124	5.95	50	0.2	0.2	49.9648	50		15			15	10	15	15	15			0.2				10		15				0.3	0.5										2.204	0.052560385	3.280634039	1.013750642	0.603925747	1.267287066	1.504552328	1.024501725	1.076369136	0	1.098999085	0	0	0.056710818	2.680061205	7.132971143	0.614040478	1.5555268	0	0	4.136687514	0	0	0	0.12	0	0.31125	0	0	0	0.227142857	0.04029351	0	0	0	0	0	0	0	0	0	30.0012	0	0	2.204	0.052560385	3.280634039	1.013750642	0.603925747	1.267287066	1.504552328	1.024501725	1.076369136	0	1.098999085	0	0	0.056710818	2.680061205	7.132971143	0.614040478	1.5555268	0	0	4.136687514	0	0	0	0.12	0	0.31125	0	0	0	0.227142857	0.04029351	0	0	0	0	0	0	0	0	0	30.0012																																																																																				0	0	0	2.204	0.052560385	3.280634039	1.013750642	0.603925747	1.267287066	1.504552328	1.024501725	1.076369136	0	1.098999085	0	0	0.056710818	2.680061205	7.132971143	0.614040478	1.5555268	0	0	4.136687514	0	0	0	0.12	0	0.31125	0	0	0	0.227142857	0.04029351	0	0	0	0	0	0	0	0	0	30.0012
H9859_007_0	2008	4	h.6.										OP Facility - Other											Substance Abuse										A	A	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	P	Coin	P	P	P	P	P	P	P		P	Coin	Coin																																																			0		280.0848746	6.679441159	1180.597611	2030.947075	143.9786081	6.185235688	7.343253952	244.4342892	256.6112321		873.354378			45.06704489	3195.391124	5670.674811	487.9666845	1236.148564			20.18989062				144		249				0.757142857	0.078664058										"$100 per Admit, max $300 per year"	"$100 per Admit, max $300 per year"	"$0 days 1-15, $65 days 16-100"	"$0 visits 1-20, $20 visits 21+"	$50 per Trip	20% Coinsurance	20% Coinsurance	ER $50 per Visit; UC $20 per Visit	$50 per Visit	$0 per Procedure	$15 per Visit	$0 per Visit	$0 per Visit	$15 OP Rehab; including Cardiac Rehab	$10 per Visit	$15 per Visit	MH $15 per Visit	$15 per Visit			20% Coinsurance	No Cost Sharing			$10 Routine Eye Exam	"$100 MAB, no cost sharing prior to MAB"	$15 per Procedure	$600 MAB every 3 years		No Cost Sharing	"30% Coin Travel, Max $3000"	50% Coinsurance										93.8	93.8	33.124	5.95	50	0.2	0.2	49.9639	50		15			15	10	15	15	15			0.2				10		15				0.3	0.5										2.1893	0.052210965	3.25884294	1.007011258	0.599910867	1.237047138	1.46865079	1.017741339	1.069213467	0	1.091692973	0	0	0.056333806	2.662825937	7.088343514	0.609958356	1.545185705	0	0	4.037978124	0	0	0	0.12	0	0.31125	0	0	0	0.227142857	0.039332029	0	0	0	0	0	0	0	0	0	29.69	0	0	2.1893	0.052210965	3.25884294	1.007011258	0.599910867	1.237047138	1.46865079	1.017741339	1.069213467	0	1.091692973	0	0	0.056333806	2.662825937	7.088343514	0.609958356	1.545185705	0	0	4.037978124	0	0	0	0.12	0	0.31125	0	0	0	0.227142857	0.039332029	0	0	0	0	0	0	0	0	0	29.69																																																																																				0	0	0	2.1893	0.052210965	3.25884294	1.007011258	0.599910867	1.237047138	1.46865079	1.017741339	1.069213467	0	1.091692973	0	0	0.056333806	2.662825937	7.088343514	0.609958356	1.545185705	0	0	4.037978124	0	0	0	0.12	0	0.31125	0	0	0	0.227142857	0.039332029	0	0	0	0	0	0	0	0	0	29.69
H9859_008_0	2008	6	h.6.										OP Facility - Other											Substance Abuse										A	A	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	P	Coin	P	P	P	P	P	P	P		P	Coin	Coin																																																			0		280.0848746	6.679441159	1180.597611	2030.947075	143.9786081	6.185235688	7.343253952	244.4342892	256.6112321		873.354378			45.06704489	3195.391124	5670.674811	487.9666845	1236.148564			20.18989062				144		249				0.757142857	0.078664058										"$100 per Admit, max $300 per year"	"$100 per Admit, max $300 per year"	"$0 days 1-15, $65 days 16-100"	"$0 visits 1-20, $20 visits 21+"	$50 per Trip	20% Coinsurance	20% Coinsurance	ER $50 per Visit; UC $20 per Visit	$50 per Visit	$0 per Procedure	$15 per Visit	$0 per Visit	$0 per Visit	$15 OP Rehab; including Cardiac Rehab	$10 per Visit	$15 per Visit	MH $15 per Visit	$15 per Visit			20% Coinsurance	No Cost Sharing			$10 Routine Eye Exam	"$100 MAB, no cost sharing prior to MAB"	$15 per Procedure	$600 MAB every 3 years		No Cost Sharing	"30% Coin Travel, Max $3000"	50% Coinsurance										93.8	93.8	33.124	5.95	50	0.2	0.2	49.9639	50		15			15	10	15	15	15			0.2				10		15				0.3	0.5										2.1893	0.052210965	3.25884294	1.007011258	0.599910867	1.237047138	1.46865079	1.017741339	1.069213467	0	1.091692973	0	0	0.056333806	2.662825937	7.088343514	0.609958356	1.545185705	0	0	4.037978124	0	0	0	0.12	0	0.31125	0	0	0	0.227142857	0.039332029	0	0	0	0	0	0	0	0	0	29.69	0	0	2.1893	0.052210965	3.25884294	1.007011258	0.599910867	1.237047138	1.46865079	1.017741339	1.069213467	0	1.091692973	0	0	0.056333806	2.662825937	7.088343514	0.609958356	1.545185705	0	0	4.037978124	0	0	0	0.12	0	0.31125	0	0	0	0.227142857	0.039332029	0	0	0	0	0	0	0	0	0	29.69																																																																																				0	0	0	2.1893	0.052210965	3.25884294	1.007011258	0.599910867	1.237047138	1.46865079	1.017741339	1.069213467	0	1.091692973	0	0	0.056333806	2.662825937	7.088343514	0.609958356	1.545185705	0	0	4.037978124	0	0	0	0.12	0	0.31125	0	0	0	0.227142857	0.039332029	0	0	0	0	0	0	0	0	0	29.69
H9859_801_0	2008	3	h.6.										OP Facility - Other											Substance Abuse										A	A	D	V	P	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	P	Coin	P	P	P	P	P	V	P		P	Coin	Coin																																																			0				1002.930903	1890.408769	126.7364378	5.836237607	7.010803847	224.7708547			888.6204879			53.30462538	3207.50023	5865.650797	379.8916802	1284.295442			21.37414391				144		249				0.757142857	0.053822018										No Cost Sharing	No Cost Sharing	"$0 days 1-15, $65 days 16-100"	"$0 visits 1-20, $20 visits 21+"	$50 per Trip	20% Coinsurance	20% Coinsurance	ER $50 per Visit; UC $20 per Visit	$0 per Visit	$0 per Procedure	$10 per Visit	$0 per Visit	$0 per Visit	"$10 OP Rehab, including Cardiac Rehab"	$5 per Visit	$10 per Visit	MH $10 per Visit	$10 per Visit			20% Coinsurance	No Cost Sharing			$10 per Procedure	$100 MAB	$10 per Procedure			No Cost Sharing	"30% Coin Travel, Max $3000"	50% Coinsurance												33.124	5.95	50	0.2	0.2	49.9617			10			10	5	10	10	10			0.2				10		10				0.3	0.5										0	0	2.768423603	0.937327681	0.528068491	1.167247521	1.402160769	0.935827179	0	0	0.740517073	0	0	0.044420521	1.336458429	4.888042331	0.3165764	1.070246202	0	0	4.274828783	0	0	0	0.12	0	0.2075	0	0	0	0.227142857	0.026911009	0	0	0	0	0	0	0	0	0	20.9917	0	0	0	0	2.768423603	0.937327681	0.528068491	1.167247521	1.402160769	0.935827179	0	0	0.740517073	0	0	0.044420521	1.336458429	4.888042331	0.3165764	1.070246202	0	0	4.274828783	0	0	0	0.12	0	0.2075	0	0	0	0.227142857	0.026911009	0	0	0	0	0	0	0	0	0	20.9917																																																																																				0	0	0	0	0	2.768423603	0.937327681	0.528068491	1.167247521	1.402160769	0.935827179	0	0	0.740517073	0	0	0.044420521	1.336458429	4.888042331	0.3165764	1.070246202	0	0	4.274828783	0	0	0	0.12	0	0.2075	0	0	0	0.227142857	0.026911009	0	0	0	0	0	0	0	0	0	20.9917
H9859_802_0	2008	3	h.6.										OP Facility - Other											Substance Abuse										A	A	D	V	P	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	P	Coin	P	P	P	P	P	V	P		P	Coin	Coin																																																			0				1002.930903	1890.408769	126.7364378	5.836237607	7.010803847	224.7708547			888.6204879			53.30462538	3207.50023	5865.650797	379.8916802	1284.295442			21.37414391				144		249				0.757142857	0.053822018										No Cost Sharing	No Cost Sharing	"$0 days 1-15, $65 days 16-100"	"$0 visits 1-20, $20 visits 21+"	$50 per Trip	20% Coinsurance	20% Coinsurance	ER $50 per Visit; UC $20 per Visit	$0 per Visit	$0 per Procedure	$10 per Visit	$0 per Visit	$0 per Visit	"$10 OP Rehab, including Cardiac Rehab"	$5 per Visit	$10 per Visit	MH $10 per Visit	$10 per Visit			20% Coinsurance	No Cost Sharing			$10 per Procedure	$100 MAB	$10 per Procedure			No Cost Sharing	"30% Coin Travel, Max $3000"	50% Coinsurance												33.124	5.95	50	0.2	0.2	49.9617			10			10	5	10	10	10			0.2				10		10				0.3	0.5										0	0	2.768423603	0.937327681	0.528068491	1.167247521	1.402160769	0.935827179	0	0	0.740517073	0	0	0.044420521	1.336458429	4.888042331	0.3165764	1.070246202	0	0	4.274828783	0	0	0	0.12	0	0.2075	0	0	0	0.227142857	0.026911009	0	0	0	0	0	0	0	0	0	20.9917	0	0	0	0	2.768423603	0.937327681	0.528068491	1.167247521	1.402160769	0.935827179	0	0	0.740517073	0	0	0.044420521	1.336458429	4.888042331	0.3165764	1.070246202	0	0	4.274828783	0	0	0	0.12	0	0.2075	0	0	0	0.227142857	0.026911009	0	0	0	0	0	0	0	0	0	20.9917																																																																																				0	0	0	0	0	2.768423603	0.937327681	0.528068491	1.167247521	1.402160769	0.935827179	0	0	0.740517073	0	0	0.044420521	1.336458429	4.888042331	0.3165764	1.070246202	0	0	4.274828783	0	0	0	0.12	0	0.2075	0	0	0	0.227142857	0.026911009	0	0	0	0	0	0	0	0	0	20.9917
H9859_803_0	2008	3	h.6.										OP Facility - Other											Substance Abuse										A	A	D	V	P	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	P	Coin	P	P	P	P	P	P	P		P	Coin	Coin																																																			0		281.2053718	5.32932675	1035.851674	1952.522127	130.9006302	6.583881746	7.908914369	232.0764869			917.8179842			55.05606104	3309.439405	6047.339112	392.3738209	1326.493672			24.11225269				144		249				0.757142857	0.060716823										"$100 per Admit, max $300 per year"	"$100 per Admit, max $300 per year"	"$0 days 1-15, $65 days 16-100"	"$0 visits 1-20, $20 visits 21+"	$50 per Trip	20% Coinsurance	20% Coinsurance	ER $50 per Visit; UC $20 per Visit	$0 per Visit	$0 per Procedure	$20 per Visit	$0 per Visit	$0 per Visit	"$20 OP Rehab, including Cardiac Rehab"	$15 per Visit	$20 per Visit	MH $20 per Visit	$20 per Visit			20% Coinsurance	No Cost Sharing			$20 per Procedure		$20 per Procedure			No Cost Sharing	"30% Coin Travel, Max $3000"	50% Coinsurance										93.8	93.8	33.124	5.95	50	0.2	0.2	49.966			20			20	15	20	20	20			0.2				20		20				0.3	0.5										2.1981	0.041657571	2.859295904	0.968125555	0.545419292	1.316776349	1.581782874	0.966327938	0	0	1.52969664	0	0	0.091760102	4.136799256	10.07889852	0.653956368	2.210822786	0	0	4.822450538	0	0	0	0.24	0	0.415	0	0	0	0.227142857	0.030358411	0	0	0	0	0	0	0	0	0	34.9144	0	0	2.1981	0.041657571	2.859295904	0.968125555	0.545419292	1.316776349	1.581782874	0.966327938	0	0	1.52969664	0	0	0.091760102	4.136799256	10.07889852	0.653956368	2.210822786	0	0	4.822450538	0	0	0	0.24	0	0.415	0	0	0	0.227142857	0.030358411	0	0	0	0	0	0	0	0	0	34.9144																																																																																				0	0	0	2.1981	0.041657571	2.859295904	0.968125555	0.545419292	1.316776349	1.581782874	0.966327938	0	0	1.52969664	0	0	0.091760102	4.136799256	10.07889852	0.653956368	2.210822786	0	0	4.822450538	0	0	0	0.24	0	0.415	0	0	0	0.227142857	0.030358411	0	0	0	0	0	0	0	0	0	34.9144
H9859_804_0	2008	3	h.6.										OP Facility - Other											Substance Abuse										A	A	D	V	P	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	P	Coin	P	P	P	P	P	P	P		P	Coin	Coin																																																			0		281.2053718	5.32932675	1035.851674	1952.522127	130.9006302	6.583881746	7.908914369	232.0764869			917.8179842			55.05606104	3309.439405	6047.339112	392.3738209	1326.493672			24.11225269				144		249				0.757142857	0.060716823										"$100 per Admit, max $300 per year"	"$100 per Admit, max $300 per year"	"$0 days 1-15, $65 days 16-100"	"$0 visits 1-20, $20 visits 21+"	$50 per Trip	20% Coinsurance	20% Coinsurance	ER $50 per Visit; UC $20 per Visit	$0 per Visit	$0 per Procedure	$20 per Visit	$0 per Visit	$0 per Visit	"$20 OP Rehab, including Cardiac Rehab"	$15 per Visit	$20 per Visit	MH $20 per Visit	$20 per Visit			20% Coinsurance	No Cost Sharing			$20 per Procedure		$20 per Procedure			No Cost Sharing	"30% Coin Travel, Max $3000"	50% Coinsurance										93.8	93.8	33.124	5.95	50	0.2	0.2	49.966			20			20	15	20	20	20			0.2				20		20				0.3	0.5										2.1981	0.041657571	2.859295904	0.968125555	0.545419292	1.316776349	1.581782874	0.966327938	0	0	1.52969664	0	0	0.091760102	4.136799256	10.07889852	0.653956368	2.210822786	0	0	4.822450538	0	0	0	0.24	0	0.415	0	0	0	0.227142857	0.030358411	0	0	0	0	0	0	0	0	0	34.9144	0	0	2.1981	0.041657571	2.859295904	0.968125555	0.545419292	1.316776349	1.581782874	0.966327938	0	0	1.52969664	0	0	0.091760102	4.136799256	10.07889852	0.653956368	2.210822786	0	0	4.822450538	0	0	0	0.24	0	0.415	0	0	0	0.227142857	0.030358411	0	0	0	0	0	0	0	0	0	34.9144																																																																																				0	0	0	2.1981	0.041657571	2.859295904	0.968125555	0.545419292	1.316776349	1.581782874	0.966327938	0	0	1.52969664	0	0	0.091760102	4.136799256	10.07889852	0.653956368	2.210822786	0	0	4.822450538	0	0	0	0.24	0	0.415	0	0	0	0.227142857	0.030358411	0	0	0	0	0	0	0	0	0	34.9144
H9859_805_0	2008	3	h.6.										OP Facility - Other											Substance Abuse										A	A	D	V	P	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	P	Coin	P	P	P	P	P	P	P		P	Coin	Coin																																																			0				1015.401901	1913.928128	128.3132184	5.982363096	7.186337677	227.5428013			899.6761839			53.96781034	3246.099722	5934.447476	384.6180702	1300.273894			21.90930157				144		249				0.757142857	0.055169594										No Cost Sharing	No Cost Sharing	"$0 days 1-15, $65 days 16-100"	"$0 visits 1-20, $20 visits 21+"	$50 per Trip	20% Coinsurance	20% Coinsurance	ER $50 per Visit; UC $20 per Visit	$0 per Visit	$0 per Visit	$20 per Visit	$0 per Visit	$0 per Visit	"$20 OP Rehab, including Cardiac Rehab"	$5 per Visit	$20 per Visit	MH $20 per Visit	$20 per Visit			20% Coinsurance	No Cost Sharing			$20 per Procedure	$100 MAB	$20 per Procedure			No Cost Sharing	"30% Coin Travel, Max $3000"	50% Coinsurance												33.124	5.95	50	0.2	0.2	49.9626			20			20	5	20	20	20			0.2				20		20				0.3	0.5										0	0	2.802847715	0.948989364	0.53463841	1.196472619	1.437267535	0.947385779	0	0	1.499460306	0	0	0.089946351	1.352541551	9.890745794	0.641030117	2.167123157	0	0	4.381860314	0	0	0	0.24	0	0.415	0	0	0	0.227142857	0.027584797	0	0	0	0	0	0	0	0	0	28.8	0	0	0	0	2.802847715	0.948989364	0.53463841	1.196472619	1.437267535	0.947385779	0	0	1.499460306	0	0	0.089946351	1.352541551	9.890745794	0.641030117	2.167123157	0	0	4.381860314	0	0	0	0.24	0	0.415	0	0	0	0.227142857	0.027584797	0	0	0	0	0	0	0	0	0	28.8																																																																																				0	0	0	0	0	2.802847715	0.948989364	0.53463841	1.196472619	1.437267535	0.947385779	0	0	1.499460306	0	0	0.089946351	1.352541551	9.890745794	0.641030117	2.167123157	0	0	4.381860314	0	0	0	0.24	0	0.415	0	0	0	0.227142857	0.027584797	0	0	0	0	0	0	0	0	0	28.8
H9859_806_0	2008	3	h.6.										OP Facility - Other											Substance Abuse										A	A	D	V	P	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	P	Coin	P	P	P	P	P	P	P		P	Coin	Coin																																																			0				1015.401901	1913.928128	128.3132184	5.982363096	7.186337677	227.5428013			899.6761839			53.96781034	3246.099722	5934.447476	384.6180702	1300.273894			21.90930157				144		249				0.757142857	0.055169594										No Cost Sharing	No Cost Sharing	"$0 days 1-15, $65 days 16-100"	"$0 visits 1-20, $20 visits 21+"	$50 per Trip	20% Coinsurance	20% Coinsurance	ER $50 per Visit; UC $20 per Visit	$0 per Visit	$0 per Visit	$20 per Visit	$0 per Visit	$0 per Visit	"$20 OP Rehab, including Cardiac Rehab"	$5 per Visit	$20 per Visit	MH $20 per Visit	$20 per Visit			20% Coinsurance	No Cost Sharing			$20 per Procedure	$100 MAB	$20 per Procedure			No Cost Sharing	"30% Coin Travel, Max $3000"	50% Coinsurance												33.124	5.95	50	0.2	0.2	49.9626			20			20	5	20	20	20			0.2				20		20				0.3	0.5										0	0	2.802847715	0.948989364	0.53463841	1.196472619	1.437267535	0.947385779	0	0	1.499460306	0	0	0.089946351	1.352541551	9.890745794	0.641030117	2.167123157	0	0	4.381860314	0	0	0	0.24	0	0.415	0	0	0	0.227142857	0.027584797	0	0	0	0	0	0	0	0	0	28.8	0	0	0	0	2.802847715	0.948989364	0.53463841	1.196472619	1.437267535	0.947385779	0	0	1.499460306	0	0	0.089946351	1.352541551	9.890745794	0.641030117	2.167123157	0	0	4.381860314	0	0	0	0.24	0	0.415	0	0	0	0.227142857	0.027584797	0	0	0	0	0	0	0	0	0	28.8																																																																																				0	0	0	0	0	2.802847715	0.948989364	0.53463841	1.196472619	1.437267535	0.947385779	0	0	1.499460306	0	0	0.089946351	1.352541551	9.890745794	0.641030117	2.167123157	0	0	4.381860314	0	0	0	0.24	0	0.415	0	0	0	0.227142857	0.027584797	0	0	0	0	0	0	0	0	0	28.8
H9859_807_0	2008	3	h.6.										OP Facility - Other											Substance Abuse										A	A	D	V	P	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	P	Coin	P	P	P	P	P	V	P		P	Coin	Coin																																																			0					1895.189367	127.0569378	5.802720063	6.970540763	225.3373939			890.8676939			53.43942587	3215.346051	5879.634567	380.8523771	1287.543259			21.25139209				144		249				0.757142857	0.053512918										$0 per Admit	$0 per Admit	$0 days 1-100	"$0 visits 1-20, $20 visits 21+"	$50 per Trip	20% Coinsurance	20% Coinsurance	ER $50 per Visit; UC $20 per Visit	$0 per Visit	$0 per Visit	$10 per Visit	$0 per Visit	$0 per Visit	"$10 OP Rehab, including Cardiac Rehab"	$5 per Visit	$10 per Visit	MH $10 per visit	$10 per Visit			20% Coinsurance	No Cost Sharing			$10 per Procedure	$100 MAB	$10 per Procedure	$600 MAB every 3 years		No Cost Sharing	"30% Coin Travel, Max $3000"	50% Coinsurance													5.95	50	0.2	0.2	49.9614			10			10	5	10	10	10			0.2				10		10				0.3	0.5										0	0	0	0.939698061	0.529403908	1.160544013	1.394108153	0.938181784	0	0	0.742389745	0	0	0.044532855	1.339727521	4.899695473	0.317376981	1.072952716	0	0	4.250278418	0	0	0	0.12	0	0.2075	0	0	0	0.227142857	0.026756459	0	0	0	0	0	0	0	0	0	18.2103	0	0	0	0	0	0.939698061	0.529403908	1.160544013	1.394108153	0.938181784	0	0	0.742389745	0	0	0.044532855	1.339727521	4.899695473	0.317376981	1.072952716	0	0	4.250278418	0	0	0	0.12	0	0.2075	0	0	0	0.227142857	0.026756459	0	0	0	0	0	0	0	0	0	18.2103																																																																																				0	0	0	0	0	0	0.939698061	0.529403908	1.160544013	1.394108153	0.938181784	0	0	0.742389745	0	0	0.044532855	1.339727521	4.899695473	0.317376981	1.072952716	0	0	4.250278418	0	0	0	0.12	0	0.2075	0	0	0	0.227142857	0.026756459	0	0	0	0	0	0	0	0	0	18.2103
H9859_808_0	2008	3	h.6.										OP Facility - Other											Substance Abuse										A	A	D	V	P	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	P	Coin	P	P	P	P	P	V	P		P	Coin	Coin																																																			0					1895.189367	127.0569378	5.802720063	6.970540763	225.3373939			890.8676939			53.43942587	3215.346051	5879.634567	380.8523771	1287.543259			21.25139209				144		249				0.757142857	0.053512918										$0 per Admit	$0 per Admit	$0 days 1-100	"$0 visits 1-20, $20 visits 21+"	$50 per Trip	20% Coinsurance	20% Coinsurance	ER $50 per Visit; UC $20 per Visit	$0 per Visit	$0 per Visit	$10 per Visit	$0 per Visit	$0 per Visit	"$10 OP Rehab, including Cardiac Rehab"	$5 per Visit	$10 per Visit	MH $10 per visit	$10 per Visit			20% Coinsurance	No Cost Sharing			$10 per Procedure	$100 MAB	$10 per Procedure	$600 MAB every 3 years		No Cost Sharing	"30% Coin Travel, Max $3000"	50% Coinsurance													5.95	50	0.2	0.2	49.9614			10			10	5	10	10	10			0.2				10		10				0.3	0.5										0	0	0	0.939698061	0.529403908	1.160544013	1.394108153	0.938181784	0	0	0.742389745	0	0	0.044532855	1.339727521	4.899695473	0.317376981	1.072952716	0	0	4.250278418	0	0	0	0.12	0	0.2075	0	0	0	0.227142857	0.026756459	0	0	0	0	0	0	0	0	0	18.2103	0	0	0	0	0	0.939698061	0.529403908	1.160544013	1.394108153	0.938181784	0	0	0.742389745	0	0	0.044532855	1.339727521	4.899695473	0.317376981	1.072952716	0	0	4.250278418	0	0	0	0.12	0	0.2075	0	0	0	0.227142857	0.026756459	0	0	0	0	0	0	0	0	0	18.2103																																																																																				0	0	0	0	0	0	0.939698061	0.529403908	1.160544013	1.394108153	0.938181784	0	0	0.742389745	0	0	0.044532855	1.339727521	4.899695473	0.317376981	1.072952716	0	0	4.250278418	0	0	0	0.12	0	0.2075	0	0	0	0.227142857	0.026756459	0	0	0	0	0	0	0	0	0	18.2103
H9882_001_0	2008	6																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0		2801.913769	611.0511298	3452.490963	0	528.4313458	140053.9113	111.330082	790.5745251	195.8034712	2056.017468	1084.902244	0	2431.46937	550.4080092	5364.596768	8198.373748	1218.62414	2140.433916	4832.978478	16523.40697	1696.085261	11230.66424																				$120 per day	$120 per day	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	$50 copay	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				120	120	69.50587862	0	75.83284135	0.877260707	70.05703361	48.30378661	237.0955052	15.68583152	60.58764116	0	33.55909063	84.82459331	12.65865105	15.64976965	16.70387019	6.252938427	9.811985809	12.87935905	32.78089858	4.652136863																				28.0191	6.110511298	19.99736815	0	3.339370867	10.23864944	0.649954608	3.18231193	3.868676911	2.687528634	5.477638986	0	6.799825081	3.890677961	5.659046544	10.69188839	1.696311621	1.115333457	3.951759687	17.73424093	4.633266578	4.353882259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.0974	135	0	28.0191	6.110511298	19.99736815	0	3.339370867	10.23864944	0.649954608	3.18231193	3.868676911	2.687528634	5.477638986	0	6.799825081	3.890677961	5.659046544	10.69188839	1.696311621	1.115333457	3.951759687	17.73424093	4.633266578	4.353882259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.0974																																																																																				0	0	0	28.0191	6.110511298	19.99736815	0	3.339370867	10.23864944	0.649954608	3.18231193	3.868676911	2.687528634	5.477638986	0	6.799825081	3.890677961	5.659046544	10.69188839	1.696311621	1.115333457	3.951759687	17.73424093	4.633266578	4.353882259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.0974
H9882_002_0	2008	6																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																				0		2958.82094	645.269993	3645.830457	0	558.0235012	147896.9304	117.5645666	834.8466985	206.7684656	2171.154447	1145.656769	0	2567.631655	581.2308577	5665.014187	8657.482678	1286.867092	2260.298216	5103.625273	17448.71777	1791.066036	11859.58144																				$120 per day	$120 per day	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	$50 copay	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				120	120	69.50587862	0	75.83284135	0.877260707	70.05703361	48.30378661	237.0955052	15.68583152	60.58764116	0	33.55909063	84.82459331	12.65865105	15.64976965	16.70387019	6.252938427	9.811985809	12.87935905	32.78089858	4.652136863																				29.5882	6.45269993	21.11722077	0	3.526375636	10.81201381	0.686352066	3.360521398	4.085322818	2.838030238	5.784386769	0	7.180615285	4.108555927	5.97595315	11.29063414	1.791305071	1.177792131	4.173058229	18.72735842	4.892729506	4.597699665	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.1668	135	0	29.5882	6.45269993	21.11722077	0	3.526375636	10.81201381	0.686352066	3.360521398	4.085322818	2.838030238	5.784386769	0	7.180615285	4.108555927	5.97595315	11.29063414	1.791305071	1.177792131	4.173058229	18.72735842	4.892729506	4.597699665	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.1668																																																																																				0	0	0	29.5882	6.45269993	21.11722077	0	3.526375636	10.81201381	0.686352066	3.360521398	4.085322818	2.838030238	5.784386769	0	7.180615285	4.108555927	5.97595315	11.29063414	1.791305071	1.177792131	4.173058229	18.72735842	4.892729506	4.597699665	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.1668
H9931_001_0	2008	10																					4000											D	D	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	Coin	Coin	P	P	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		1250.481322	59.50273882	1044.105649		7.452828304	8.906741989	8.585170251	286.8857855	41.74890708	8.849874567	18.77256762	2.464809876	0.242015249	40.54425585	3493.507265	4203.718223	1.432897338	1.799059421		7841.767269	18.72755199																					1a (IP Acute) - $150 days 1-10	1b (IP Psych) - $150 days 1-10	"2 (SNF) - $0 days 1-7, $100 days 8-100"	6 (Home Health)- $0	10a (Ambulance) - 20%	11a (Medical Equip) - 30%	"11b (Med Supp), 11c (Diab Supp) - 30%"	"4a (ER), 4b (UC) - $50 World-Wide Coverage - 20%"	"9a (OP Surgery), 9b (ASC) - 20%"	8a (OP Diag Proc/Test/Lab) - 20%	8b (OP Diag & Therap Rad) - 20%	9a (OP Observation) - 20%	12 (Renal Dialysis) - 20%	"7i, 7c (OP PT/ST/OT), 3 (CORF), 5 (Part Hospital) - 20%; 9c (OP SA) - 50%; 9d (Cardiac Rehab) - $30. 9a (OP Other) - 20%"	"7a (PCP), 14c (Routine Physical) - $15"	"7b (Chiro), 7d (Spec), 7f (Pod), 7g (Prof. Other) - $30; 16b (MCR Comp Dental), 17a (MCR Eye Exam) - 20%, 18a (MCR Hearing Exam) - 20%;  14j (Nutrition Therap), 14i (Diab Mon.) - $30; 14g (Bone Mass) - 20%"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - 20%"		8a (Professional Labs) - 20%	15 (Part B Rx) - 20%	13a (Blood); 13a1 (Add'l Blood) - 0%; 17b (MCR Eyewear) - $0																				98.8185	98.8185	52.7032		0.161666312	0.242499468	0.242499468	40.4642	0.161666312	0.161666312	0.161666312	0.161666312	0.161666312	0.165475228	12.125	20.112	0.40416578	0.161666312		2.2082	0.161666312																					10.2976	0.489997781	4.585643947	0	1.204871266	2.159880194	2.081899219	0.967384593	6.749391839	1.430726583	3.034891773	0.398476722	0.039125713	6.709069973	3.529890222	7.045441466	0.57912807	0.290847302	0	1.442996907	3.027614262	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0648	0	13.29387679	10.2976	0.489997781	4.585643947	0	1.204871266	2.159880194	2.081899219	0.967384593	6.749391839	1.430726583	3.034891773	0.398476722	0.039125713	6.709069973	3.529890222	7.045441466	0.57912807	0.290847302	0	1.442996907	3.027614262	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0648																																																																																				0	0	0	10.2976	0.489997781	4.585643947	0	1.204871266	2.159880194	2.081899219	0.967384593	6.749391839	1.430726583	3.034891773	0.398476722	0.039125713	6.709069973	3.529890222	7.045441466	0.57912807	0.290847302	0	1.442996907	3.027614262	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0648
H9931_801_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		233.0112734	4.007456477	41.25199174		7.527623661	8.996128585	8.671329606	15.16312009	42.16789224	8.938690452	18.96096601	2.489546302	0.244444074	40.95115133	33.47915642	75.42011496	1.44727766	1.817114485	18.31168195	9.015351241	18.91549861	1.432507943																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.083296443	0.083296443	0.166678758		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				19.409	0.333806871	6.875830739	0	1.761463937	2.105094089	2.029091128	3.548170101	9.867286784	2.091653566	4.436866047	0.582553835	0.057199913	9.582569411	7.834122602	17.6483069	0.338662972	0.425204789	4.284933576	2.10959219	4.426226676	0.335206859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.0829	0	0	19.409	0.333806871	6.875830739	0	1.761463937	2.105094089	2.029091128	3.548170101	9.867286784	2.091653566	4.436866047	0.582553835	0.057199913	9.582569411	7.834122602	17.6483069	0.338662972	0.425204789	4.284933576	2.10959219	4.426226676	0.335206859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.0829																																																																																				0	0	0	19.409	0.333806871	6.875830739	0	1.761463937	2.105094089	2.029091128	3.548170101	9.867286784	2.091653566	4.436866047	0.582553835	0.057199913	9.582569411	7.834122602	17.6483069	0.338662972	0.425204789	4.284933576	2.10959219	4.426226676	0.335206859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.0829
H9931_802_0	2008	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	P	P																																																				0		233.0112734	4.007456477	41.25199174		7.527623661	8.996128585	8.671329606	15.16312009	42.16789224	8.938690452	18.96096601	2.489546302	0.244444074	40.95115133	33.47915642	75.42011496	1.44727766	1.817114485	18.31168195	9.015351241	18.91549861	1.432507943																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																				0.083296443	0.083296443	0.166678758		0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				19.409	0.333806871	6.875830739	0	1.761463937	2.105094089	2.029091128	3.548170101	9.867286784	2.091653566	4.436866047	0.582553835	0.057199913	9.582569411	7.834122602	17.6483069	0.338662972	0.425204789	4.284933576	2.10959219	4.426226676	0.335206859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.0829	0	0	19.409	0.333806871	6.875830739	0	1.761463937	2.105094089	2.029091128	3.548170101	9.867286784	2.091653566	4.436866047	0.582553835	0.057199913	9.582569411	7.834122602	17.6483069	0.338662972	0.425204789	4.284933576	2.10959219	4.426226676	0.335206859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.0829																																																																																				0	0	0	19.409	0.333806871	6.875830739	0	1.761463937	2.105094089	2.029091128	3.548170101	9.867286784	2.091653566	4.436866047	0.582553835	0.057199913	9.582569411	7.834122602	17.6483069	0.338662972	0.425204789	4.284933576	2.10959219	4.426226676	0.335206859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.0829
H9951_001_0	2008	3																																Coin		Coin	Coin	Coin	Coin		V	Coin					Coin						Coin	Coin	Coin																																																													0		231.8643351		23.95211561	7.391312875	6.195077625	32.46339475		729.1708695	33.9763362					86.72509965						161.4478486	27.1067102	3.415904148																				traditional Medicare		traditional Medicare	traditional Medicare	traditional Medicare	traditional Medicare		$50 Copay (max for MA)	traditional Medicare					traditional Medicare						traditional Medicare	traditional Medicare	traditional Medicare																				0.0834		0.1658	0	0.234	0.234		50	0.234					0.234						0.234	0.234	0.234																				19.3375	0	3.971260768	0	1.449648164	7.596434371	0	3.038211956	7.950462671	0	0	0	0	20.29367332	0	0	0	0	0	37.77879658	6.342970187	0.799321571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.5583			19.3375	0	3.971260768	0	1.449648164	7.596434371	0	3.038211956	7.950462671	0	0	0	0	20.29367332	0	0	0	0	0	37.77879658	6.342970187	0.799321571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.5583																																																																																				0			19.3375	0	3.971260768	0	1.449648164	7.596434371	0	3.038211956	7.950462671	0	0	0	0	20.29367332	0	0	0	0	0	37.77879658	6.342970187	0.799321571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.5583
R3175_001_0	2008	6																					3050											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	4050	1492.989847	125.5122407	688.3847671		92.99689492	8.576614747	1.70998381	418.6674193	22.94604604	9837.98061	32.28677005		0.200412145	19.90699385	4225.421206	4087.333863	446.4770859	2.026752569			14.38512867	973.5522734			163.0388737		16.60138613															$275 (1a); $0 (1a1)	$275 (1b)	"$125 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $50/$5 (4b)"	20% (9b)	20% (8a1); $0/$20 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	20% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											177.0322	177.0322	80.4692		112.6569	0.128750724	0.190807213	32.1877	0.128750724	5.15	0.071703378		0.128750724	0.128699828	5	24.9625	37.5	0.128750724			0.128750724	25			25		25															22.0256	1.851642819	4.616147772	0	0.873061697	1.104245359	0.326277245	1.122994446	2.954320043	4.222157091	2.315070463	0	0.025803209	2.562026686	1.760592169	8.502502662	1.395240893	0.260945861	0	0	1.852095732	2.028233903	0	0	0.33966432	0	0.034586221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1732	0	25.3523782	22.0256	1.851642819	4.616147772	0	0.873061697	1.104245359	0.326277245	1.122994446	2.954320043	4.222157091	2.315070463	0	0.025803209	2.562026686	1.760592169	8.502502662	1.395240893	0.260945861	0	0	1.852095732	2.028233903	0	0	0.33966432	0	0.034586221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1732		$375 (1a); $0 (1a1)	$375 (1b)	"$150 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$25 (4b)"	30% (9b)	30% (8a1); $0/$25 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$25/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5); 50% (14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											4.0817	0.3431	0.48	0.245	0.1416	0.2687	0.0796	0.1822	0.7189	0.8562	0.5562		0.0063	0.6233	1.0893	1.3194	0.1757	0.0433			0.3076	0.3196			0.0528		0.0054															11.8962	0	4.876017051	26.1073	2.194779734	5.096186403	0.244953812	1.014702245	1.372965059	0.405925888	1.305182657	3.673258084	5.078380436	2.871257056	0	0.032082457	3.185374456	2.84991199	9.821917273	1.570937895	0.30428819	0	0	2.159723306	2.347832941	0	0	0.392500992	0	0.0399663	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.0694
R3175_002_0	2008	5																					2750											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	3750	1480.29707	125.4392707	731.1809021		94.88392154	10.17781306	2.373736167	399.2719285	27.08973429	10948.35168	40.25264726		0.345302678	22.91614549	4317.837146	4239.78268	455.9926581	3.032093664			21.05549363	1098.485317			177.4886643		15.65297577															$275 (1a); $0 (1a1)	$275 (1b)	"$25 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20% (9b)	20% (8a1); $0/$15 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	20% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$5/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $5 (14c1, 14c)"	"$15 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $15 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$15 (17a1)	$0 n/c (17b)	$15 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											172.0749	172.0749	15.6432		109.5022	0.125145355	0.177871757	31.2863	0.125145355	3.7544	0.071924454		0.125145355	0.125105294	5	14.9855	37.5	0.125145355			0.125145355	15			15		15															21.2268	1.79874544	0.953165555	0	0.865833063	1.273706025	0.422220623	1.040979731	3.390154405	3.425338383	2.895149683	0	0.043213026	2.866931126	1.799098811	5.294600999	1.424977057	0.379452437	0	0	2.634997218	1.373106646	0	0	0.22186083	0	0.01956622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.3499	0	25.64868225	21.2268	1.79874544	0.953165555	0	0.865833063	1.273706025	0.422220623	1.040979731	3.390154405	3.425338383	2.895149683	0	0.043213026	2.866931126	1.799098811	5.294600999	1.424977057	0.379452437	0	0	2.634997218	1.373106646	0	0	0.22186083	0	0.01956622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.3499		$375 (1a); $0 (1a1)	$375 (1b)	"$150 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$20/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5); 50% (14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											3.8349	0.325	0.4832	0.3052	0.1369	0.3022	0.1025	0.1646	0.8043	0.7223	0.6796		0.0103	0.68	0.9231	1.365	0.1794	0.0614			0.4267	0.3596			0.0575		0.0051															11.9289	0	5.659449256	25.0617	2.123711334	1.436327455	0.305219904	1.002774437	1.575882727	0.524711217	1.205622548	4.194441782	4.147680159	3.574711004	0	0.053464976	3.546970237	2.722244495	6.659614302	1.604418612	0.44089609	0	0	3.061674815	1.732750777	0	0	0.279380305	0	0.024638943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2789
R3175_003_0	2008	4																					950											D	D	D	V	T	V	V	V	V	P	V	V	V	V	V	V	V	V		V	S	P	T	V	V	P	V	P																																																							0	4500	1965.894826	278.3778519			380.2864406			659.206002	349.7773277			64.33320198		3290.258383		3186.855313						618.9514114					0.081672398															1(a) $75 per Day	1(b) $75 per Day	2(a) $0 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) $0	11(b)/11(c) $0	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $10 per visit	9(b) $25 per Visit	8(a) Diagnostic: $0 per procedure; other $0 per procedure	8(b) X-rays $0 per visit; other: $0 per visit	9(a) $25 per Visit	12 $0	"3, 5, 9(a) $25 Copay Per Visit; 9(c) $0 Copay per Visit;9(d) $25 copay per visit"	7(a) PCP $0 per visit; Urgently Needed Services $10 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $0 per Visit		7(g) $10 per Visit	15 $0 per script	"13, 14(a)-(j) $0 , 16(b), 17(a) $10 per procedure"	10(b) $0 Copay	16(a)/16(b) $0 copay per visit	17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a/18a1 $10/$0 per visit	18(b) $0 copay per procedure														50.7651	50.7651			50.7651			24.3672	16.9217			16.9217		16.9217		6.7687						6.7687					6.7687															8.3166	1.177656674	0	0	1.608773334	0	0	1.338586401	0.493235605	0	0	0.090718933	0	4.639730637	0	1.797567061	0	0	0	0	0	0.349123685	0	0	0	0	4.61E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.812	0	9.458112026	8.3166	1.177656674	0	0	1.608773334	0	0	1.338586401	0.493235605	0	0	0.090718933	0	4.639730637	0	1.797567061	0	0	0	0	0	0.349123685	0	0	0	0	4.61E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.812		0.3	0.3	0.3	0.3	0.3	0.3	0.3	50	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															1.1082	0.0684	0.1509	0.1987	0.0492	0.0847	0.0605	0.0284	0.1188	0.0216	0.0545	0.0107	0.0111	0.1212	0.0447	0.0814	0.0332	0.0232			0.0769	0.0173	0.0077		0.0066		0.006															2.3839	0	1.578346028	9.4247	1.246054254	0.150922059	0.198672924	1.657981477	0.084687474	0.060480443	1.367017612	0.612014637	0.021636475	0.054471985	0.101400681	0.011084566	4.76093258	0.044677285	1.878956591	0.03321592	0.023244586	0	0	0.076925637	0.366418381	0.00774	0	0.006631111	0	0.006030444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.1959
R3175_004_0	2008	6																					1900											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	S	V			V	P	V																																																								0	4500	1984.185408	136.093386	896.6301782		258.8226465	9.349798104	16.23774966	397.3032962	375.5282595	3148.367577	413.7515044	63.05399347	0.835287301	2645.924824		3896.789029	382.933384	561.4239675				697.7187904					0.069261554															(1a)$150/day	(1b)$150/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$25/visit"	(9b)$75/visit	"(8a)$20/procedure Diag. services, $0/procedure Other services"	"(8b) $15/vist X-rays, $75/visit Other Rad. Services"	(9a)$75/visit	(12)20%	"(3,5,9a)$75/visit, (9c)$15/visit, (9d)$25/visit"	"(7a) $0/visit PCP, $25/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b,d,f)$25/visit"	"(7e,h)$20/visit"	"(7c,i)$20/visit"		(7g)$25/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$25/visit"			(17a)0	(17b)0	(18a)$25/visit															104.3049	104.3049	29.2054		52.1524	0.139073141	0.139073141	28.6838	52.1524	13.9073	45.3823	52.1524	0.139073141	50.4179		17.3841	13.9073	13.9073				17.3841					17.3841															17.2467	1.182933416	2.182200565	0	1.12485245	1.30030579	2.258234847	0.94968186	1.632059205	3.648778065	1.564751289	0.274034904	0.116166029	11.11684212	0	5.645194686	0.443797904	0.650658288	0	0	0	1.010770247	0	0	0	0	0.000100338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.348	0	22.93326964	17.2467	1.182933416	2.182200565	0	1.12485245	1.30030579	2.258234847	0.94968186	1.632059205	3.648778065	1.564751289	0.274034904	0.116166029	11.11684212	0	5.645194686	0.443797904	0.650658288	0	0	0	1.010770247	0	0	0	0	0.000100338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.348		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$35/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															1.1542	0.033	0.142	0.1417	0.0364	0.0697	0.0605	0.0179	0.1473	0.0231	0.0601	0.0121	0.0028	0.1052	0.0105	0.1016	0.0153	0.0165			0.0911	0.0215			0.0051																	2.2678	0	1.453673998	18.4009	1.215899347	2.324246771	0.14174428	1.1612593	1.370010154	2.318762465	0.967568121	1.779393032	3.671907316	1.624873321	0.286098427	0.118947999	11.22201363	0.01051225	5.746821639	0.459066449	0.667153584	0	0	0.091125509	1.032316387	0	0	0.005058988	0	0.000100338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.6158
R3175_801_0	2008	5																					3175											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	3800	1566.90078	129.1544737	722.3503132		97.59492304	8.995130206	1.793506456	439.3887935	24.06796583	10325.59704	33.86462481		0.210137592	20.87809977	4431.436349	4289.364458	460.5863728	2.126667067			15.0862456	1021.861361			167.3483455		16.98172233															$440 (1a); $0 (1a1)	$440 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											244.6255	244.6255	88.9547		97.2942	0.16679013	0.282815934	27.7984	0.138991775	3.3358	0.075630068		0.16679013	0.13892686	15	24.9643	37.5	0.138991775			0.16679013	25			25		25															31.942	2.632873395	5.354706774	0	0.791285341	1.500298933	0.507232203	1.017857137	3.345249284	2.870346116	2.561183871	0	0.035048876	2.900528844	5.539295436	8.923399734	1.439332415	0.29558923	0	0	2.51623686	2.128877835	0	0	0.348642386	0	0.035378588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.6854	0	46.16308093	31.942	2.632873395	5.354706774	0	0.791285341	1.500298933	0.507232203	1.017857137	3.345249284	2.870346116	2.561183871	0	0.035048876	2.900528844	5.539295436	8.923399734	1.439332415	0.29558923	0	0	2.51623686	2.128877835	0	0	0.348642386	0	0.035378588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.6854		40% (1a); $0 (1a1)	40% (1b)	"40% (2a, 2a2)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	40% (9b)	40% (8a1); $0/$20 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	40% (incl in h5)	30% (12)	"40% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$25/$50 (7a); 40% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 40% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											6.1794	0.2071	0.3993	0.3425	0.1217	0.2307	0.0822	0.1565	0.8229	0.5884	0.6201		0.0054	0.7134	1.1531	1.3847	0.1812	0.0496			0.264	0.3369			0.0542		0.0055															13.8989	0	9.489737501	38.1214	2.839991859	5.753964682	0.342457509	0.912939542	1.73095867	0.589455727	1.174345056	4.168140563	3.458738436	3.181324494	0	0.040437379	3.613885343	6.692423142	10.30812327	1.620581682	0.345217654	0	0	2.780279105	2.465765839	0	0	0.402875647	0	0.040881924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.5842
R3175_802_0	2008	5																					3175											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	3800	1567.356807	129.1881019	722.6304478		97.62691747	9.001498572	1.794726719	439.5133945	24.08363628	10328.24135	33.88714886		0.210319816	20.89253973	4432.523277	4290.493848	460.7162866	2.127545668			15.09744442	1022.088909			167.3483455		16.98172233															$440 (1a); $0 (1a1)	$440 (1b)	"$160 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$15/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											244.5782	244.5782	88.9375		97.2754	0.16675785	0.282809882	27.793	0.138964875	3.3352	0.075614643		0.16675785	0.138899966	15	24.9643	37.5	0.138964875			0.16675785	25			25		25															31.9451	2.633049239	5.355746661	0	0.791391556	1.501070549	0.507566452	1.017948733	3.346779507	2.870525539	2.56236465	0	0.03507248	2.901973059	5.540654096	8.925752631	1.439738396	0.295654118	0	0	2.517617374	2.129351894	0	0	0.348642386	0	0.035378588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.7014	0	46.19209349	31.9451	2.633049239	5.355746661	0	0.791391556	1.501070549	0.507566452	1.017948733	3.346779507	2.870525539	2.56236465	0	0.03507248	2.901973059	5.540654096	8.925752631	1.439738396	0.295654118	0	0	2.517617374	2.129351894	0	0	0.348642386	0	0.035378588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.7014		40% (1a); $0 (1a1)	40% (1b)	"40% (2a, 2a2)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	40% (9b)	40% (8a1); $0/$20 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	40% (incl in h5)	30% (12)	"40% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$25/$50 (7a); 40% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $25 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $35 (17a, 18a, 16b); 40% (17b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											6.1807	0.2083	0.3994	0.3428	0.1217	0.2308	0.0823	0.1565	0.8232	0.5884	0.6204		0.0054	0.7136	1.1534	1.3851	0.1813	0.0496			0.2642	0.337			0.0542		0.0055															13.9035	0	9.499173923	38.1258	2.841338231	5.755149332	0.342752507	0.913047876	1.731821961	0.589843487	1.174432455	4.169951048	3.458885912	3.182722196	0	0.040463982	3.615601461	6.69405293	10.31085616	1.621038786	0.345287639	0	0	2.781773627	2.466316821	0	0	0.402875647	0	0.040881924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.6049
R3444_001_0	2008	17																					0											A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	S	Coin	T	V	V	V	V	V	Coin	O	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	509.0744677	34.21874617	2627.093311	52.96894714	31.23445853	63.96045046	58.01931711	15.6458815	33.99304217	23.58554598	34.48596454	2.676877152	4.736711856	83.48750979	69.4361959	149.2175392	7.112016882	2.302223904	32.58168277	46.69418816	1249.829118	4.908366497	0	0	0	0	0	0	0	0	0.019855185											PBP: 1A IP Acute: Traditional FFS Cost Sharing	1B IP Psych: Traditional FFS Cost Sharing	2 SNF: Traditional FFS Cost Sharing	6 Home Health: Traditional FFS Cost Sharing	10A Ambulance: Traditional FFS Cost Sharing	11A DME: Traditional FFS Cost Sharing	"11B Prosthetic Medical Supplies: Traditional FFS Cost Sharing, 11C Diabetes Monitoring Supplies: Traditional FFS Cost Sharing"	"4A ER: Traditional FFS Cost Sharing, 4B Urgent Care: Traditional FFS Cost Sharing"	9B ASC Services: Traditional FFS Cost Sharing	8A OP C/D/T: Traditional FFS Cost Sharing	8B OP X-Ray: Traditional FFS Cost Sharing	9A OP Hospital: Traditional FFS Cost Sharing	12 Renal Dialysis: Traditional FFS Cost Sharing	"3 CORF: Traditional FFS Cost Sharing, 5 Partial Hosp: Traditional FFS Cost Sharing, 9C OP Substance Abuse: Traditional FFS Cost Sharing, 9D Cardiac Rehab: Traditional FFS Cost Sharing"	"7A PCP: Traditional FFS Cost Sharing, 14B Immunizations: Traditional FFS Cost Sharing, 14C Routine Physical Exams: Not Covered, 14D Pap Smears: Traditional FFS Cost Sharing, 14D Pelvic Exams: Traditional FFS Cost Sharing, 14E Prostate Screening: Traditional FFS Cost Sharing, 14F Colorectal Screening: Traditional FFS Cost Sharing, 14G Bone Mass Measurement: Traditional FFS Cost Sharing, 14H Mammography: Traditional FFS Cost Sharing, 14I Diabetes Monitoring: Traditional FFS Cost Sharing"	7D Physician Specialist: Traditional FFS Cost Sharing	7E Mental Health: Traditional FFS Cost Sharing	"7C Occupational Therapy: Traditional FFS Cost Sharing, 7I Physical and Speech Therapy: Traditional FFS Cost Sharing"	Included in i.2.	"7G Other Health Care: Traditional FFS Cost Sharing, 18A Medicare Covered Hearing Exams: Traditional FFS Cost Sharing 7B Chiropractic: Traditional FFS Cost Sharing, 7F Podiatry: $0 copay"	15 Part B Drugs: Traditional FFS Cost Sharing	"13A Blood: Traditional FFS Cost Sharing, 16B Medicare Covered Comprehensive Dental Services: Traditional FFS Cost Sharing, 17A Medicare Covered Eye Exams: Traditional FFS Cost Sharing"	10B Transportation: $0 Copay	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams:  Not Covered	"17B Eye Wear: Medicare Covered: Traditional FFS Cost Sharing, Routine: Not Covered"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs:  Covered	13B Acupuncture: Not Covered											1114.666595	1070.873689	135.0343953	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.212395617	42.9798047	0.234	0	0	0	0	0	0	0	0	0											47.2874	3.053662912	29.56232971	0	7.308863296	14.96674541	13.5765202	3.661136272	7.954371868	5.51901776	8.069715702	0.626389253	1.108390574	19.53607729	16.24806984	34.91690417	1.66421195	0.538720394	7.624113767	9.917640891	4.476450948	1.14855776	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	238.7652	0	0	47.2874	3.053662912	29.56232971	0	7.308863296	14.96674541	13.5765202	3.661136272	7.954371868	5.51901776	8.069715702	0.626389253	1.108390574	19.53607729	16.24806984	34.91690417	1.66421195	0.538720394	7.624113767	9.917640891	4.476450948	1.14855776	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	238.7652	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	47.2874	3.053662912	29.56232971	0	7.308863296	14.96674541	13.5765202	3.661136272	7.954371868	5.51901776	8.069715702	0.626389253	1.108390574	19.53607729	16.24806984	34.91690417	1.66421195	0.538720394	7.624113767	9.917640891	4.476450948	1.14855776	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	238.7652
R3444_002_0	2008	13																					0											A	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1645.675897	5.761447657	1546.291602	34.89357183	461.9873607	42.13155524	33.03265089	251.7267741	432.2280957	17.85688332	36.71550179	180.5418064	0.553169796	3209.564259	14573.20915	17434.48312	334.311155	477.3739968	37.90623485	63.96957242	15.88026832	762.8590357	351	0	818.6332344	407.2	0	0	0	0	0											PBP: 1A IP Acute: $165 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%    OON DME: 50%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $100	8A OP C/D/T: 20%	"8B OP X-Ray: 20%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $30	"3 CORF: $30, 5 Partial Hosp: $50, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $30"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $30	"7E Mental Health: $30 Individual $15 Group, 7H Psychiatric: $30 Individual $15 Group"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	Included in i.2.	"7G Other Health Care: $30, 18A Medicare Covered Hearing Exams: $30, 7B Chiropractic: $30, 7F Podiatry: $0"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $30"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $30	"17B Eye Wear: Medicare Covered: $30 copay, Routine: $30 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											106.598905	685.4807379	109.5426005	0	76.14365116	0.202740437	0.019122416	69.07062329	171.2549286	0.239037282	0.242626327	11.26473866	0.052808156	14.92592403	7.267470824	9.579658627	28.95876844	30.17383187	0.200498848	0.12349081	0.157673175	29.8381358	0	0	29.72097881	9.320407672	0	0	0	0	0											14.6189	0.329113449	14.11540027	0	2.931450369	8.541769931	0.63166408	1.448910432	6.168432638	4.26846086	8.908147332	0.169479689	0.029211877	3.992142691	8.82586436	13.91803305	0.806769944	1.200350226	7.60015643	7.899654317	2.503892325	1.896857625	0	0	2.027548417	0.3162725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.1485	0	3.699986393	14.6189	0.329113449	14.11540027	0	2.931450369	8.541769931	0.63166408	1.448910432	6.168432638	4.26846086	8.908147332	0.169479689	0.029211877	3.992142691	8.82586436	13.91803305	0.806769944	1.200350226	7.60015643	7.899654317	2.503892325	1.896857625	0	0	2.027548417	0.3162725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.1485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.6189	0.329113449	14.11540027	0	2.931450369	8.541769931	0.63166408	1.448910432	6.168432638	4.26846086	8.908147332	0.169479689	0.029211877	3.992142691	8.82586436	13.91803305	0.806769944	1.200350226	7.60015643	7.899654317	2.503892325	1.896857625	0	0	2.027548417	0.3162725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.1485
R3444_003_0	2008	11																					0											D	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1645.675897	5.761447657	1546.291602	34.89357183	461.9873607	42.13155524	33.03265089	251.7267741	432.2280957	17.85688332	36.71550179	180.5418064	0.553169796	3209.564259	14573.20915	17434.48312	334.311155	477.3739968	37.90623485	63.96957242	15.88026832	762.8590357	526.5	0	818.6332344	407.2	0	0	0	0	0											PBP: 1A IP Acute: $0 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $0	11A DME: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item     OON DME: 50%	"11B Prosthetic Medical Supplies: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: 0%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $0	"7E Mental Health: $0, 9C OP Substance Abuse: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0, 7B Chiropractic: $0, 7F Podiatry: $0"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $0 copay, Routine: $10 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											12.21802887	757.4019815	12.52079154	0	2.89039658	0.156383556	0.014846459	66.76730878	76.52699342	0.053391658	0.096972293	11.26473866	0.052808156	12.43004979	0.485591751	1.369461655	0	0.415667338	0.005451329	0.030404814	0.068602524	1.524021912	0	0	9.942992048	9.89699131	0	0	0	0	0											1.6756	0.363644323	1.613399568	0	0.111277224	6.58868243	0.49041791	1.400593271	2.756426386	0.953408616	3.560386382	0.169479689	0.029211877	3.324586962	0.58971918	1.989654675	0	0.016535732	0.206639367	1.944982948	1.089426488	0.096884491	0	0	0.678305312	0.335837905	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9851	0	0.080752297	1.6756	0.363644323	1.613399568	0	0.111277224	6.58868243	0.49041791	1.400593271	2.756426386	0.953408616	3.560386382	0.169479689	0.029211877	3.324586962	0.58971918	1.989654675	0	0.016535732	0.206639367	1.944982948	1.089426488	0.096884491	0	0	0.678305312	0.335837905	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.6756	0.363644323	1.613399568	0	0.111277224	6.58868243	0.49041791	1.400593271	2.756426386	0.953408616	3.560386382	0.169479689	0.029211877	3.324586962	0.58971918	1.989654675	0	0.016535732	0.206639367	1.944982948	1.089426488	0.096884491	0	0	0.678305312	0.335837905	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9851
R3444_004_0	2008	13																					0											A	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1645.675897	5.761447657	1546.291602	34.89357183	461.9873607	42.13155524	33.03265089	251.7267741	432.2280957	17.85688332	36.71550179	180.5418064	0.553169796	3209.564259	14573.20915	17434.48312	334.311155	477.3739968	37.90623485	63.96957242	15.88026832	762.8590357	351	0	818.6332344	407.2	0	0	0	0	0											PBP: 1A IP Acute: $165 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%    OON DME: 50%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $100	8A OP C/D/T: 20%	"8B OP X-Ray: 20%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $30	"3 CORF: $30, 5 Partial Hosp: $50, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $30"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $30	"7E Mental Health: $30 Individual $15 Group, 7H Psychiatric: $30 Individual $15 Group"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	Included in i.2.	"7G Other Health Care: $30, 18A Medicare Covered Hearing Exams: $30, 7B Chiropractic: $30, 7F Podiatry: $0"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $30"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $30	"17B Eye Wear: Medicare Covered: $30 copay, Routine: $30 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											106.598905	685.4807379	109.5426005	0	76.14365116	0.202740437	0.019122416	69.07062329	171.2549286	0.239037282	0.242626327	11.26473866	0.052808156	14.92592403	7.267470824	9.579658627	28.95876844	30.17383187	0.200498848	0.12349081	0.157673175	29.8381358	0	0	29.72097881	9.320407672	0	0	0	0	0											14.6189	0.329113449	14.11540027	0	2.931450369	8.541769931	0.63166408	1.448910432	6.168432638	4.26846086	8.908147332	0.169479689	0.029211877	3.992142691	8.82586436	13.91803305	0.806769944	1.200350226	7.60015643	7.899654317	2.503892325	1.896857625	0	0	2.027548417	0.3162725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.1485	0	3.699986393	14.6189	0.329113449	14.11540027	0	2.931450369	8.541769931	0.63166408	1.448910432	6.168432638	4.26846086	8.908147332	0.169479689	0.029211877	3.992142691	8.82586436	13.91803305	0.806769944	1.200350226	7.60015643	7.899654317	2.503892325	1.896857625	0	0	2.027548417	0.3162725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.1485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.6189	0.329113449	14.11540027	0	2.931450369	8.541769931	0.63166408	1.448910432	6.168432638	4.26846086	8.908147332	0.169479689	0.029211877	3.992142691	8.82586436	13.91803305	0.806769944	1.200350226	7.60015643	7.899654317	2.503892325	1.896857625	0	0	2.027548417	0.3162725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.1485
R3444_005_0	2008	13																					0											A	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1645.675897	5.761447657	1546.291602	34.89357183	461.9873607	42.13155524	33.03265089	251.7267741	432.2280957	17.85688332	36.71550179	180.5418064	0.553169796	3209.564259	14573.20915	17434.48312	334.311155	477.3739968	37.90623485	63.96957242	15.88026832	762.8590357	351	0	818.6332344	407.2	0	0	0	0	0											PBP: 1A IP Acute: $165 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%    OON DME: 50%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $100	8A OP C/D/T: 20%	"8B OP X-Ray: 20%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $30	"3 CORF: $30, 5 Partial Hosp: $50, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $30"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $30	"7E Mental Health: $30 Individual $15 Group, 7H Psychiatric: $30 Individual $15 Group"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	Included in i.2.	"7G Other Health Care: $30, 18A Medicare Covered Hearing Exams: $30, 7B Chiropractic: $30, 7F Podiatry: $0"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $30"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $30	"17B Eye Wear: Medicare Covered: $30 copay, Routine: $30 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											106.598905	685.4807379	109.5426005	0	76.14365116	0.202740437	0.019122416	69.07062329	171.2549286	0.239037282	0.242626327	11.26473866	0.052808156	14.92592403	7.267470824	9.579658627	28.95876844	30.17383187	0.200498848	0.12349081	0.157673175	29.8381358	0	0	29.72097881	9.320407672	0	0	0	0	0											14.6189	0.329113449	14.11540027	0	2.931450369	8.541769931	0.63166408	1.448910432	6.168432638	4.26846086	8.908147332	0.169479689	0.029211877	3.992142691	8.82586436	13.91803305	0.806769944	1.200350226	7.60015643	7.899654317	2.503892325	1.896857625	0	0	2.027548417	0.3162725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.1485	0	3.699986393	14.6189	0.329113449	14.11540027	0	2.931450369	8.541769931	0.63166408	1.448910432	6.168432638	4.26846086	8.908147332	0.169479689	0.029211877	3.992142691	8.82586436	13.91803305	0.806769944	1.200350226	7.60015643	7.899654317	2.503892325	1.896857625	0	0	2.027548417	0.3162725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.1485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.6189	0.329113449	14.11540027	0	2.931450369	8.541769931	0.63166408	1.448910432	6.168432638	4.26846086	8.908147332	0.169479689	0.029211877	3.992142691	8.82586436	13.91803305	0.806769944	1.200350226	7.60015643	7.899654317	2.503892325	1.896857625	0	0	2.027548417	0.3162725	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.1485
R3444_006_0	2008	11																					0											D	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1645.675897	5.761447657	1546.291602	34.89357183	461.9873607	42.13155524	33.03265089	251.7267741	432.2280957	17.85688332	36.71550179	180.5418064	0.553169796	3209.564259	14573.20915	17434.48312	334.311155	477.3739968	37.90623485	63.96957242	15.88026832	762.8590357	526.5	0	818.6332344	407.2	0	0	0	0	0											PBP: 1A IP Acute: $0 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $0	11A DME: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item     OON DME: 50%	"11B Prosthetic Medical Supplies: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: 0%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $0	"7E Mental Health: $0, 9C OP Substance Abuse: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0, 7B Chiropractic: $0, 7F Podiatry: $0"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $0 copay, Routine: $10 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											12.21802887	757.4019815	12.52079154	0	2.89039658	0.156383556	0.014846459	66.76730878	76.52699342	0.053391658	0.096972293	11.26473866	0.052808156	12.43004979	0.485591751	1.369461655	0	0.415667338	0.005451329	0.030404814	0.068602524	1.524021912	0	0	9.942992048	9.89699131	0	0	0	0	0											1.6756	0.363644323	1.613399568	0	0.111277224	6.58868243	0.49041791	1.400593271	2.756426386	0.953408616	3.560386382	0.169479689	0.029211877	3.324586962	0.58971918	1.989654675	0	0.016535732	0.206639367	1.944982948	1.089426488	0.096884491	0	0	0.678305312	0.335837905	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9851	0	0.080752297	1.6756	0.363644323	1.613399568	0	0.111277224	6.58868243	0.49041791	1.400593271	2.756426386	0.953408616	3.560386382	0.169479689	0.029211877	3.324586962	0.58971918	1.989654675	0	0.016535732	0.206639367	1.944982948	1.089426488	0.096884491	0	0	0.678305312	0.335837905	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.6756	0.363644323	1.613399568	0	0.111277224	6.58868243	0.49041791	1.400593271	2.756426386	0.953408616	3.560386382	0.169479689	0.029211877	3.324586962	0.58971918	1.989654675	0	0.016535732	0.206639367	1.944982948	1.089426488	0.096884491	0	0	0.678305312	0.335837905	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9851
R3444_007_0	2008	11																					0											D	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1645.675897	5.761447657	1546.291602	34.89357183	461.9873607	42.13155524	33.03265089	251.7267741	432.2280957	17.85688332	36.71550179	180.5418064	0.553169796	3209.564259	14573.20915	17434.48312	334.311155	477.3739968	37.90623485	63.96957242	15.88026832	762.8590357	526.5	0	818.6332344	407.2	0	0	0	0	0											PBP: 1A IP Acute: $0 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $0	11A DME: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item     OON DME: 50%	"11B Prosthetic Medical Supplies: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: 0%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $0	"7E Mental Health: $0, 9C OP Substance Abuse: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0, 7B Chiropractic: $0, 7F Podiatry: $0"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $0 copay, Routine: $10 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											12.21802887	757.4019815	12.52079154	0	2.89039658	0.156383556	0.014846459	66.76730878	76.52699342	0.053391658	0.096972293	11.26473866	0.052808156	12.43004979	0.485591751	1.369461655	0	0.415667338	0.005451329	0.030404814	0.068602524	1.524021912	0	0	9.942992048	9.89699131	0	0	0	0	0											1.6756	0.363644323	1.613399568	0	0.111277224	6.58868243	0.49041791	1.400593271	2.756426386	0.953408616	3.560386382	0.169479689	0.029211877	3.324586962	0.58971918	1.989654675	0	0.016535732	0.206639367	1.944982948	1.089426488	0.096884491	0	0	0.678305312	0.335837905	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9851	0	0.080752297	1.6756	0.363644323	1.613399568	0	0.111277224	6.58868243	0.49041791	1.400593271	2.756426386	0.953408616	3.560386382	0.169479689	0.029211877	3.324586962	0.58971918	1.989654675	0	0.016535732	0.206639367	1.944982948	1.089426488	0.096884491	0	0	0.678305312	0.335837905	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.6756	0.363644323	1.613399568	0	0.111277224	6.58868243	0.49041791	1.400593271	2.756426386	0.953408616	3.560386382	0.169479689	0.029211877	3.324586962	0.58971918	1.989654675	0	0.016535732	0.206639367	1.944982948	1.089426488	0.096884491	0	0	0.678305312	0.335837905	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9851
R3444_801_0	2008	8																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	S	Coin	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	369.9140649	8.754238376	93.55651663	34.89357183	16.85215103	42.13155524	33.03265089	8.30434485	45.47771581	17.85688332	36.71550179	180.5418064	0.553169796	60.27481245	71.57679139	163.9187908	2.039492081	3.191849451	37.90623485	63.96957242	944.7587105	6.225507792	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Traditional FFS Cost Sharing	1B IP Psych: Traditional FFS Cost Sharing	2 SNF: Traditional FFS Cost Sharing	6 Home Health: Traditional FFS Cost Sharing	10A Ambulance: Traditional FFS Cost Sharing	11A DME: Traditional FFS Cost Sharing	"11B Prosthetic Medical Supplies: Traditional FFS Cost Sharing, 11C Diabetes Monitoring Supplies: Traditional FFS Cost Sharing"	"4A ER: Traditional FFS Cost Sharing, 4B Urgent Care: Traditional FFS Cost Sharing"	9B ASC Services: Traditional FFS Cost Sharing	8A OP C/D/T: Traditional FFS Cost Sharing	8B OP X-Ray: Traditional FFS Cost Sharing	9A OP Hospital: Traditional FFS Cost Sharing	12 Renal Dialysis: Traditional FFS Cost Sharing	"3 CORF: Traditional FFS Cost Sharing, 5 Partial Hosp: Traditional FFS Cost Sharing, 9C OP Substance Abuse: Traditional FFS Cost Sharing, 9D Cardiac Rehab: Traditional FFS Cost Sharing"	"7A PCP: Traditional FFS Cost Sharing, 14B Immunizations: Traditional FFS Cost Sharing, 14C Routine Physical Exams: Traditional FFS Cost Sharing, 14D Pap Smears: Traditional FFS Cost Sharing, 14D Pelvic Exams: Traditional FFS Cost Sharing, 14E Prostate Screening: Traditional FFS Cost Sharing, 14F Colorectal Screening: Traditional FFS Cost Sharing, 14G Bone Mass Measurement: Traditional FFS Cost Sharing, 14H Mammography: Traditional FFS Cost Sharing, 14I Diabetes Monitoring: Traditional FFS Cost Sharing"	7D Physician Specialist: Traditional FFS Cost Sharing	7E Mental Health: Traditional FFS Cost Sharing	"7C Occupational Therapy: Traditional FFS Cost Sharing, 7I Physical and Speech Therapy: Traditional FFS Cost Sharing"	Included in i.2.	"7G Other Health Care: Traditional FFS Cost Sharing, 18A Medicare Covered Hearing Exams: Traditional FFS Cost Sharing, 7B Chiropractic: Traditional FFS Cost Sharing,  7F Podiatry: Traditional FFS Cost Sharing"	15 Part B Drugs: Traditional FFS Cost Sharing	"13A Blood: Traditional FFS Cost Sharing, 16B Medicare Covered Comprehensive Dental Services: Traditional FFS Cost Sharing, 17A Medicare Covered Eye Exams: Traditional FFS Cost Sharing"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	"17B Eye Wear: Medicare Covered: Traditional FFS Cost Sharing, Routine: Not Covered"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											0.082654024	0.082654024	0.210416205	0	0.234	0	0.53245573	0.234	0.234	0.234	0.234	49.91556276	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	47.19913449	0.234	0	0	0	0	0	0	0	0	0											30.5749	0.723573027	19.68580719	0	3.94340334	0	17.58842423	1.943216695	10.6417855	4.178510696	8.591427418	0.750987156	0.129441732	14.10430611	16.74896919	38.35699704	0.477241147	0.746892772	8.870058955	14.96887995	3.715982786	1.456768823	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	198.1976	0	0	30.5749	0.723573027	19.68580719	0	3.94340334	0	17.58842423	1.943216695	10.6417855	4.178510696	8.591427418	0.750987156	0.129441732	14.10430611	16.74896919	38.35699704	0.477241147	0.746892772	8.870058955	14.96887995	3.715982786	1.456768823	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	198.1976	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.5749	0.723573027	19.68580719	0	3.94340334	0	17.58842423	1.943216695	10.6417855	4.178510696	8.591427418	0.750987156	0.129441732	14.10430611	16.74896919	38.35699704	0.477241147	0.746892772	8.870058955	14.96887995	3.715982786	1.456768823	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	198.1976
R3444_802_0	2008	8																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	S	Coin	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	369.9140649	8.754238376	93.55651663	34.89357183	16.85215103	42.13155524	33.03265089	8.30434485	45.47771581	17.85688332	36.71550179	180.5418064	0.553169796	60.27481245	71.57679139	163.9187908	2.039492081	3.191849451	37.90623485	63.96957242	944.7587105	6.225507792	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Traditional FFS Cost Sharing	1B IP Psych: Traditional FFS Cost Sharing	2 SNF: Traditional FFS Cost Sharing	6 Home Health: Traditional FFS Cost Sharing	10A Ambulance: Traditional FFS Cost Sharing	11A DME: Traditional FFS Cost Sharing	"11B Prosthetic Medical Supplies: Traditional FFS Cost Sharing, 11C Diabetes Monitoring Supplies: Traditional FFS Cost Sharing"	"4A ER: Traditional FFS Cost Sharing, 4B Urgent Care: Traditional FFS Cost Sharing"	9B ASC Services: Traditional FFS Cost Sharing	8A OP C/D/T: Traditional FFS Cost Sharing	8B OP X-Ray: Traditional FFS Cost Sharing	9A OP Hospital: Traditional FFS Cost Sharing	12 Renal Dialysis: Traditional FFS Cost Sharing	"3 CORF: Traditional FFS Cost Sharing, 5 Partial Hosp: Traditional FFS Cost Sharing, 9C OP Substance Abuse: Traditional FFS Cost Sharing, 9D Cardiac Rehab: Traditional FFS Cost Sharing"	"7A PCP: Traditional FFS Cost Sharing, 14B Immunizations: Traditional FFS Cost Sharing, 14C Routine Physical Exams: Traditional FFS Cost Sharing, 14D Pap Smears: Traditional FFS Cost Sharing, 14D Pelvic Exams: Traditional FFS Cost Sharing, 14E Prostate Screening: Traditional FFS Cost Sharing, 14F Colorectal Screening: Traditional FFS Cost Sharing, 14G Bone Mass Measurement: Traditional FFS Cost Sharing, 14H Mammography: Traditional FFS Cost Sharing, 14I Diabetes Monitoring: Traditional FFS Cost Sharing"	7D Physician Specialist: Traditional FFS Cost Sharing	7E Mental Health: Traditional FFS Cost Sharing	"7C Occupational Therapy: Traditional FFS Cost Sharing, 7I Physical and Speech Therapy: Traditional FFS Cost Sharing"	Included in i.2.	"7G Other Health Care: Traditional FFS Cost Sharing, 18A Medicare Covered Hearing Exams: Traditional FFS Cost Sharing, 7B Chiropractic: Traditional FFS Cost Sharing,  7F Podiatry: Traditional FFS Cost Sharing"	15 Part B Drugs: Traditional FFS Cost Sharing	"13A Blood: Traditional FFS Cost Sharing, 16B Medicare Covered Comprehensive Dental Services: Traditional FFS Cost Sharing, 17A Medicare Covered Eye Exams: Traditional FFS Cost Sharing"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	"17B Eye Wear: Medicare Covered: Traditional FFS Cost Sharing, Routine: Not Covered"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											0.082654024	0.082654024	0.210416205	0	0.234	0	0.53245573	0.234	0.234	0.234	0.234	49.91556276	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	47.19913449	0.234	0	0	0	0	0	0	0	0	0											30.5749	0.723573027	19.68580719	0	3.94340334	0	17.58842423	1.943216695	10.6417855	4.178510696	8.591427418	0.750987156	0.129441732	14.10430611	16.74896919	38.35699704	0.477241147	0.746892772	8.870058955	14.96887995	3.715982786	1.456768823	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	198.1976	0	0	30.5749	0.723573027	19.68580719	0	3.94340334	0	17.58842423	1.943216695	10.6417855	4.178510696	8.591427418	0.750987156	0.129441732	14.10430611	16.74896919	38.35699704	0.477241147	0.746892772	8.870058955	14.96887995	3.715982786	1.456768823	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	198.1976	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.5749	0.723573027	19.68580719	0	3.94340334	0	17.58842423	1.943216695	10.6417855	4.178510696	8.591427418	0.750987156	0.129441732	14.10430611	16.74896919	38.35699704	0.477241147	0.746892772	8.870058955	14.96887995	3.715982786	1.456768823	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	198.1976
R5287_001_0	2008	11																					3250											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	7500	1477.990206	88.66392908	622.0139736		113.8295495	9.157088307	2.109661272	321.0334675	31.99577579	10971.85078	48.00174749		0.220134522	19.79774211	4257.797641	6436.079018	357.9025544	4.220870845			29.17877877	1464.985797			169.0023061		17.19065344															$250/$325 (1a); $0 (1a1)	$250/$325 (1b)	"$125 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	20%/30% (9b)	20%/30% (8a1); $0/$15 (8a2)	"$15 (8b1); 20%/30% (8b2, 8b3)"	20%/30% (incl in h5)	30% (12)	"20%/30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20%/30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c; $0 (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											166.0593	166.0593	77.889		109.0446	0.186933541	0.256057247	31.1556	0.165747739	3.7387	0.065510032		0.186933541	0.186870069	10	24.9955	37.5	0.12462236			0.186933541	25			25		25															20.4528	1.226955798	4.037335918	0	1.03437448	1.711766939	0.540194057	0.833498927	5.303227507	3.418344856	3.144596001	0	0.041150526	3.699605438	3.548164701	13.40610411	1.118445483	0.526014888	0	0	5.454492428	3.052053745	0	0	0.352088138	0	0.035813861	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9371	0	30.86915766	20.4528	1.226955798	4.037335918	0	1.03437448	1.711766939	0.540194057	0.833498927	5.303227507	3.418344856	3.144596001	0	0.041150526	3.699605438	3.548164701	13.40610411	1.118445483	0.526014888	0	0	5.454492428	3.052053745	0	0	0.352088138	0	0.035813861	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9371		$375 (1a); $0 (1a1)	$375 (1b)	"$150 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$40 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$40/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $40 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c; $40 (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5); 50% (14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											4.8849	0.293	0.5244	0.4097	0.2096	0.3469	0.094	0.1689	1.2119	0.9235	0.945		0.0083	0.7497	1.7266	2.3472	0.1408	0.1091			0.7544	0.5486		0.3169	0.0514		0.0064															16.7714	0	3.272254919	25.3378	1.52000134	4.561722855	0.409712719	1.243969497	2.058621806	0.6342387	1.002390587	6.515172852	4.341889233	4.089632185	0	0.049488845	4.449269466	5.274752222	15.75327974	1.259286766	0.635138909	0	0	6.208864163	3.600682034	0	0.316918151	0.403468109	0	0.04218077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.7085
R5287_002_0	2008	6																					2500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	7500	1391.029547	87.2730486	602.8556571		109.2626462	8.499781502	1.877795558	306.2970154	31.79962821	10528.83496	47.07683588		0.151342596	17.97312533	4016.851114	6228.07993	369.3329188	3.659616207			32.00912778	1473.48967			142.9338599		15.6759146															$250/$325 (1a); $0 (1a1)	$250/$325 (1b)	"$125 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	20%/30% (9b)	20%/30% (8a1); $0/$15 (8a2)	"$15 (8b1); 20%/30% (8b2, 8b3)"	20%/30% (incl in h5)	30% (12)	"20%/30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20%/30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c; $0 (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											150.4976	150.4976	70.5899		98.8258	0.169415711	0.252002944	28.236	0.150215264	3.3883	0.057592965		0.169415711	0.169431917	10	24.9698	37.5	0.112943807			0.169415711	25			25		25															17.4456	1.0945322	3.546292356	0	0.899830988	1.439996528	0.473210009	0.720715648	4.776789542	2.97291677	2.711294574	0	0.025639814	3.045221088	3.347375928	12.95948397	1.154165371	0.413330988	0	0	5.422849145	3.069770145	0	0	0.297778875	0	0.032658155	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8494	0	34.39895101	17.4456	1.0945322	3.546292356	0	0.899830988	1.439996528	0.473210009	0.720715648	4.776789542	2.97291677	2.711294574	0	0.025639814	3.045221088	3.347375928	12.95948397	1.154165371	0.413330988	0	0	5.422849145	3.069770145	0	0	0.297778875	0	0.032658155	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8494		$375 (1a); $0 (1a1)	$375 (1b)	"$150 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$40/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $40 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c; $40 (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0; $0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5); 50% (14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											4.644	0.2914	0.5134	0.3436	0.2032	0.3252	0.0844	0.1628	1.2167	0.8952	0.9079		0.0058	0.6876	1.6281	2.2733	0.1453	0.0956			0.8359	0.5513		0.3157	0.0529		0.0058															16.1852	0	3.026982422	22.0895	1.385895762	4.059664156	0.343602735	1.103050123	1.76520743	0.557616716	0.883483115	5.993477969	3.868127212	3.61916856	0	0.031430346	3.732837079	4.975490876	15.23281787	1.299504714	0.508900811	0	0	6.2587583	3.621058434	0	0.315745935	0.350717341	0	0.03846405	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.0346
R5287_003_0	2008	4																					3900											Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	Coin	T	V	V	P	V																																																								0	7500	414.2926885	28.46447252	38.79698074		11.82321313	25.92747488	5.873122785	788.1391228	52.3813772	24.58858749	76.30456629	10.46613878	0.715013802	41.28582916	610.8882953	167.9720009	14.22059546	4.34386752			71.77335926	8.198492817																				1(a) $250 per Day	1(b) $250 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per Visit	10(a) 20% Coinsurance	11(a) 20% Coinsurance	11(b)/11(c) 20% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; 20% coinsurance	9(b) 20% Coinsurance	8(a) Diagnostic: 20% Coinsurance; other 0% coinsurance	8(b) X-rays 20% Coinsurance; other: 20% Coinsurance	9(a) 20% Coinsurance	12 20% Coinsurance	"3, 5, 9(a), 9(c), 9(d) 20% Coinsurance"	7(a) PCP $0 per visit; Urgent Care 20% coinsurance	7(b)/7(d)/7(f) 20% Coinsurance	7(e)/7(h) 20% Coinsurance	7(c)/7(i) 20% Coinsurance		7(g) 20% Coinsurance	15  20% per script	"13, 14(b), 14(e)-(j), 17(a), 16(b) 20% Coinsurance; 14(a) and 14(c) $0; 14(d) Pap Smear $0 copay, Pelvic Exam 20% Coinsurance"	10(b) $0 Copay	16(a) $0 copay per visit	17(a1) $0 copay per Visit	17(b) $0 copay per procedure	18a $10 per visit															0.091085049	0.185892756	0.073169918		0.114140301	0.114140301	0.114140301	28.5351	0.114140301	0.057070151	0.114140301	441.802	0.114140301	0.114140301	9.9218	0.114140301	0.114140301	0.114140301			0.114140301	0.114140301																				37.7359	5.291339256	2.838771918	0	1.349505108	2.959369793	0.670360004	1.874134102	5.978826172	1.403274391	8.709426182	0.385330097	0.081611891	4.712376977	0.505092614	19.17237478	1.623143049	0.495810347	0	0	8.192232846	0.93577844	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.9146	0	78.91987524	37.7359	5.291339256	2.838771918	0	1.349505108	2.959369793	0.670360004	1.874134102	5.978826172	1.403274391	8.709426182	0.385330097	0.081611891	4.712376977	0.505092614	19.17237478	1.623143049	0.495810347	0	0	8.192232846	0.93577844	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.9146		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"4(a)$50 per Visit, 4(b) $10 per Visit"	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															1.5244	0.0016	0.1442	0.0535	0.0431	0.0944	0.0214	0.0407	0.1947	0.0914	0.2836	0.0125	0.0026	0.1472	0.0515	0.6182	0.0006	0.016			0.2615	0.0299	0.0077		0.0034																	3.6441	0	2.473009648	39.2603	5.292914497	2.983011839	0.053525334	1.392573746	3.053816287	0.691754137	1.914822438	6.173530882	1.494671641	8.993054815	0.397878645	0.084216485	4.859551403	0.556548149	19.79053978	1.623787859	0.511793667	0	0	8.453682994	0.965643242	0.00774	0	0.003361166	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.5587
R5287_801_0	2008	4																					4450											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	7500	1550.399798	93.00774601	652.4876382		119.4062787	9.596489598	2.210893002	336.5925405	33.53108753	11509.38292	50.305103		0.230697639	20.74773332	4437.678629	6761.549632	375.4368911	4.423408599			30.5789174	1536.758278			129.6		15.16872816															$400/$450 (1a); $0 (1a1)	$400 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$30/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $30 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											261.4313	254.4343	95.4129		111.315	0.19082574	0.257569932	31.8043	0.15902145	3.8165	0.081907212		0.19082574	0.158983519	30	34.6272	37.5	0.15902145			0.19082574	35			35		35															33.7769	1.972030218	5.187976519	0	1.107642643	1.83125723	0.56945956	0.892090564	5.332162161	3.660477521	4.120350748	0	0.044023048	3.298547647	11.09419657	19.51112024	1.173240285	0.70341685	0	0	5.835244544	4.482211644	0	0	0.378	0	0.044242124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.0146	0	38.86077086	33.7769	1.972030218	5.187976519	0	1.107642643	1.83125723	0.56945956	0.892090564	5.332162161	3.660477521	4.120350748	0	0.044023048	3.298547647	11.09419657	19.51112024	1.173240285	0.70341685	0	0	5.835244544	4.482211644	0	0	0.378	0	0.044242124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.0146		$425 (1a); $0 (1a1)	$425 (1b)	"$175 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$40/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $40 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											5.6029	0.3361	0.6192	0.4294	0.2121	0.3507	0.0974	0.1708	1.2254	0.9347	0.9556		0.0084	0.758	1.7949	2.4623	0.1477	0.1103			0.7627	0.5755			0.048		0.0056															17.6077	0	4.113882288	39.3798	2.308147459	5.807127638	0.429372713	1.319761346	2.181951482	0.666870436	1.062930045	6.5575227	4.595142083	5.075931206	0	0.052453666	4.056518948	12.88906291	21.97342274	1.320981654	0.81374878	0	0	6.597966525	5.057712208	0	0	0.426	0	0.049860171	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.6223
R5287_802_0	2008	4																					4450											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	7500	1550.399798	93.00774601	652.4876382		119.4062787	9.596489598	2.210893002	336.5925405	33.53108753	11509.38292	50.305103		0.230697639	20.74773332	4437.678629	6761.549632	375.4368911	4.423408599			30.5789174	1536.758278			129.6		15.16872816															$400/$450 (1a); $0 (1a1)	$400 (1b)	"$150 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	25% (9b)	25% (8a1); $0/$15 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	25% (incl in h5)	30% (12)	"25% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$30/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $30 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											261.4313	254.4343	95.4129		111.315	0.19082574	0.257569932	31.8043	0.15902145	3.8165	0.081907212		0.19082574	0.158983519	30	34.6272	37.5	0.15902145			0.19082574	35			35		35															33.7769	1.972030218	5.187976519	0	1.107642643	1.83125723	0.56945956	0.892090564	5.332162161	3.660477521	4.120350748	0	0.044023048	3.298547647	11.09419657	19.51112024	1.173240285	0.70341685	0	0	5.835244544	4.482211644	0	0	0.378	0	0.044242124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.0146	0	38.86077086	33.7769	1.972030218	5.187976519	0	1.107642643	1.83125723	0.56945956	0.892090564	5.332162161	3.660477521	4.120350748	0	0.044023048	3.298547647	11.09419657	19.51112024	1.173240285	0.70341685	0	0	5.835244544	4.482211644	0	0	0.378	0	0.044242124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.0146		$425 (1a); $0 (1a1)	$425 (1b)	"$175 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$40/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $40 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											5.6029	0.3361	0.6192	0.4294	0.2121	0.3507	0.0974	0.1708	1.2254	0.9347	0.9556		0.0084	0.758	1.7949	2.4623	0.1477	0.1103			0.7627	0.5755			0.048		0.0056															17.6077	0	4.113882288	39.3798	2.308147459	5.807127638	0.429372713	1.319761346	2.181951482	0.666870436	1.062930045	6.5575227	4.595142083	5.075931206	0	0.052453666	4.056518948	12.88906291	21.97342274	1.320981654	0.81374878	0	0	6.597966525	5.057712208	0	0	0.426	0	0.049860171	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.6223
R5342_001_0	2008	7																					2800											D	D	D	V	T	Coin	Coin	V	V	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	2800	1549.880942	112.2042108	692.9176004		134.3457592	12.2996094	1.814680328	477.2886215	224.9271339	9752.493457	27.51491773		0.622039218	18.41432433	4129.82406	5134.948832	431.8778954	5.099232279			20.90606023	888.0706293			120.3725687		17.57647726															$150 (1a); $0 (1a1)	$150 (1b)	"$95 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	$125 (9b)	20% (8a1); $0/$1 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	20% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											107.9875	107.9875	68.3921		125.9854	0.143983334	0.190875438	35.9958	89.9896	0.287966667	0.100860593		0.143983334	0.143906663	33.1476	24.9924	37.5	0.143983334			0.143983334	25			25		25															13.9473	1.009721021	3.949173199	0	1.410467208	1.770938765	0.346377902	1.431700143	1.68675826	0.234032753	2.775170912	0	0.08956328	2.649943972	11.40782977	10.69455987	1.349618423	0.734204463	0	0	3.010124246	1.850147144	0	0	0.250776185	0	0.036617661	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.635	0	13.51566306	13.9473	1.009721021	3.949173199	0	1.410467208	1.770938765	0.346377902	1.431700143	1.68675826	0.234032753	2.775170912	0	0.08956328	2.649943972	11.40782977	10.69455987	1.349618423	0.734204463	0	0	3.010124246	1.850147144	0	0	0.250776185	0	0.036617661	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.635		$200 (1a); $0 (1a1)	$200 (1b)	"$150 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$15 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$15/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $30 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5); 50% (14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.1075	0.1526	0.4506	0.2067	0.1908	0.3594	0.0828	0.1642	0.7968	0.6332	0.6212		0.0182	0.5377	1.4627	1.4256	0.17	0.1017			0.4169	0.2502			0.0334		0.0049															10.1872	0	4.480994693	16.0548	1.16229175	4.399791171	0.206700586	1.601287736	2.130321245	0.429202814	1.595943223	2.483605548	0.867273331	3.396379725	0	0.107738654	3.187649582	12.87056869	12.12017057	1.519570373	0.835899155	0	0	3.427056685	2.100319263	0	0	0.284213009	0	0.041500016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8223
R5342_002_0	2008	7																					1700											D	D	D	V	T	Coin	Coin	V	V	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	2400	1759.634249	126.1272849	1183.115698		135.378883	14.23564391	2.684133518	531.2530321	240.7826924		33.12078452		0.311781999	27.69566961	4423.919988	5056.885332	493.5501256	2.427920137			22.28289594	1041.546845			146.1850141		16.84531399															$150 (1a); $0 (1a1)	$150 (1b)	"$95 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a, 4a1); $50/$10 (4b)"	$125 (9b)	20% (8a1); $0/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	20% (incl in h5)	20% (12)	"20% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$10/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $10 (14c1, 14c)"	"$25 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	$0 (incl in h2)		"20% (15, 15a1)"	"$0 (13a, 17b, 13a1); $25 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$25 (17a1)	$0 n/c (17b)	$25 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a6, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5)"	"$0 n/c (13b, 13c, 13d, 13e)"											81.8677	81.8677	51.8496		95.5124	0.109156994	0.18791892	27.2892	68.2231		0.077126974		0.109156994	0.109127311	33.3839	24.9655	37.5	0.109156994			0.109156994	25			25		25															12.0048	0.860479705	5.112003564	0	1.077529828	1.553920097	0.504399473	1.208124668	1.368912235	0	2.55450588	0	0.034033186	3.022353957	12.3073193	10.52064955	1.542344142	0.265024464	0	0	2.432333939	2.169889261	0	0	0.304552113	0	0.035094404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8782	0	26.24091061	12.0048	0.860479705	5.112003564	0	1.077529828	1.553920097	0.504399473	1.208124668	1.368912235	0	2.55450588	0	0.034033186	3.022353957	12.3073193	10.52064955	1.542344142	0.265024464	0	0	2.432333939	2.169889261	0	0	0.304552113	0	0.035094404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8782		$200 (1a); $0 (1a1)	$200 (1b)	"$150 (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $50/$15 (4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$15/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $15 (14c1, 14c)"	"$30 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $30 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$30 (17a1)	$0 n/c (17b)	$30 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5); 50% (14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											2.0421	0.1464	0.6567	0.4079	0.1641	0.355	0.1226	0.184	0.8241	0.6023	0.6405		0.0078	0.6904	1.5505	1.4022	0.1942	0.0413			0.3793	0.2946			0.0406		0.0047															10.7514	0	6.555401032	14.0469	1.00685697	5.768687885	0.407897527	1.241647206	1.908933879	0.626954157	1.392132802	2.193043716	0.602343464	3.194969896	0	0.041808521	3.712743278	13.85779967	11.92289219	1.736565257	0.306351133	0	0	2.811620657	2.464497247	0	0	0.345159061	0	0.039773658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.6296
R5342_003_0	2008	5																					1300											D	D	D	V	T	V	P	V	V	Coin	V	V	V	V	V		V	V		V	S	P	T		V	P	V																																																								0	4500	3774.502952	364.1905148	1515.902105		1597.954022	2920.839459	635.0184805	1521.860028	379.1691748	19.51470435	254.8498238	38.42111328	40.36294653	1956.112016		2001.612518		553.2105929				703.3028742																				1(a) $140 per Day	1(b) $140 per Day	2(a) $140 per Day for days 21-100	6(a) $0 per visit	10(a) $75 per Trip	11(a) 20% Coinsurance	11(b)/11(c) 20%/0% Coinsurance	4(a) $50 per Visit (waived if admitted w/in 24 hours) 4(b) Urgently needed svcs; $35 per visit	9(b) $25 per Visit	8(a) Diagnostic: $10 per preocedure; other $0 per procedure	8(b) X-rays $0 per visit; other: $10 per visit	9(a) $25 per Visit	12  20% Coinsurance	"3, 5, 9(a), 9(d) $25 per visit; 9(c) $0/0 per Visit"	7(a) PCP $0 per visit; Urgent Care $35 per Visit	7(b)/7(d)/7(f) $10 per Visit	7(e)/7(h) $0 per Visit	7(c)/7(i) $10 per Visit		7(g) $10 per Visit	15  $0 per script	"13, 14(a)-(j) $0; 17(a), 16(b) $10 per procedure"	10(b) $0 Copay		17(a1) $0 copay per procedure	17(b) $0 copay per procedure	18a $10 per visit															66.8371	66.8371	20.0511		35.8056	9.9797	13.1514	21.364	11.9352	0.165882383	4.7741	11.9352	57.7894	11.9352		4.7741		4.7741				4.7741																				21.0231	2.028454149	2.532963756	0	4.767976122	2.429081396	0.695950986	2.709419669	0.377121733	3.23714567	0.101389473	0.038213647	0.194379355	1.945549383	0	0.796321676	0	0.220089344	0	0	0	0.279802069	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.3769	0	47.4823055	21.0231	2.028454149	2.532963756	0	4.767976122	2.429081396	0.695950986	2.709419669	0.377121733	3.23714567	0.101389473	0.038213647	0.194379355	1.945549383	0	0.796321676	0	0.220089344	0	0	0	0.279802069	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.3769		0.3	0.3	0.3	0.3	0.3	0.3	0.3	"4(a)$50 per Visit, 4(b) $35 per Visit"	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	0.3	0.3		0.3		0.3															1.3404	0.0389	0.1633	0.0911	0.0876	0.0826	0.0276	0.0671	0.1139	0.0621	0.1157	0.0089	0.0062	0.0994	0.0442	0.0859	0.0145	0.0153			0.1019	0.0225	0.0077		0.0021																	2.5989	0	2.286481757	22.3635	2.067347472	2.696299223	0.091126436	4.855616716	2.511725826	0.723541299	2.77650589	0.49105954	3.299209149	0.217083343	0.047125749	0.200572823	2.044913855	0.044151212	0.882196533	0.014479563	0.235386152	0	0	0.101858388	0.302294293	0.00774	0	0.002093054	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9758
R5342_004_0	2008	6																					1600											D	D	D	V	T	Coin	Coin	V	V	P	V	V	Coin	V	V	V	V	V		V	S	V			V	P	V																																																								0	4500	1969.11327	135.0596024	884.458898		273.3476733	10.35114249	17.97677968	425.3076718	401.9977968	3370.283853	442.9152507	67.49842605	0.932654064	2832.129689		3867.38139	381.0148155	557.7017367				688.2895409					0.072876123															(1a)$150/day	(1b)$150/day	(2a) $140/day beginning day 21	(6a)0	(10a)$75/trip	"(11a) $0 Oxygen, PFT; 20% all other"	"(11b)20%, (11c)0"	"(4a)$50/visit, (4b)$10/visit"	(9b)$25/visit	"(8a)$15/procedure Diag. services, $0/procedure Other services"	(8b)$15/visit	(9a)$25/visit	(12)20%	"(3,5,9a,9d)$25/visit, (9c)$15/visit"	"(7a) $0/visit PCP, $10/visit Urgent Care, (14b,c,d,e,f,g,h,i,j) 0"	"(7b)$15 visit, (7d,f)$10/visit"	"(7e,h)$15/visit"	"(7c,i)$15/visit"		(7g)$15/visit	(15)0	"(13a,14a,17b)0, (16b,17a)$15/visit"			(17a)0	(17b)0	(18a)$15/visit															110.1076	110.1076	30.8301		55.0538	0.146810067	0.146810067	26.4258	18.3513	11.0108	11.0108	18.3513	0.146810067	18.3397		7.6432	11.0108	11.0108				11.0108					11.0108															18.0679	1.239256833	2.272330732	0	1.254068448	1.519651927	2.639172236	0.936591719	0.614763788	3.092447497	0.406402611	0.103223422	0.136923006	4.328361356	0	2.463256938	0.349605067	0.511726435	0	0	0	0.631548962	0	0	0	0	6.69E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5673	0	14.69769335	18.0679	1.239256833	2.272330732	0	1.254068448	1.519651927	2.639172236	0.936591719	0.614763788	3.092447497	0.406402611	0.103223422	0.136923006	4.328361356	0	2.463256938	0.349605067	0.511726435	0	0	0	0.631548962	0	0	0	0	6.69E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5673		0.3	0.3	0.3	0.3	0.3	0.3	0.3	(4a)$50 (4b)$10/visit	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3	0.3		0.3	0.3	"(13a,17b)0, (13a,16b,17a)30%"			0.3		0.3															1.2266	0.035	0.151	0.1507	0.0387	0.0741	0.0643	0.0181	0.1566	0.0246	0.0639	0.0128	0.003	0.1118	0.0112	0.108	0.0162	0.0175			0.0969	0.0229			0.0051																	2.409	0	1.708200918	19.2944	1.274299743	2.423322608	0.150674707	1.292769069	1.593747931	2.703513323	0.954661853	0.771380205	3.11703398	0.470312559	0.116046992	0.139880251	4.440159072	0.011174562	2.571286775	0.365835588	0.529260997	0	0	0.096866761	0.65445259	0	0	0.005058988	0	6.69E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.9763
R5342_801_0	2008	4																					3600											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	4200	1937.643818	142.8850558	1190.280678		135.9430988	14.77341315	2.83078267	529.7684046	36.35252169	11235.58031	36.8454059		0.422723765	33.49799443	4736.215939	4815.83521	551.9988448	2.038190265			25.97916171	966.8442095			129.6		15.16872816															$335 (1a); $0 (1a1)	$335 (1b)	"$180 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$20/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											179.1835	179.1835	96.2777		93.6033	0.160462817	0.279092269	26.7438	0.160462817	3.2093	0.112718624		0.160462817	0.160381708	20	34.772	37.5	0.160462817			0.160462817	35			35		35															28.9328	2.133553449	9.549789524	0	1.060393667	2.370583489	0.790049558	1.18066848	5.833228034	3.004821445	4.153163454	0	0.067831446	5.372465567	7.893693232	13.95467134	1.72499639	0.327053751	0	0	4.168689469	2.819962278	0	0	0.378	0	0.044242124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.7607	0	59.32439165	28.9328	2.133553449	9.549789524	0	1.060393667	2.370583489	0.790049558	1.18066848	5.833228034	3.004821445	4.153163454	0	0.067831446	5.372465567	7.893693232	13.95467134	1.72499639	0.327053751	0	0	4.168689469	2.819962278	0	0	0.378	0	0.044242124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.7607		30% (1a); $0 (1a1)	30% (1b)	"30% (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$30/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $30 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											5.7812	0.1926	0.4847	0.5133	0.1757	0.3927	0.1288	0.1956	0.9663	0.6637	0.7532		0.0112	0.8901	1.4221	1.7605	0.2172	0.037			0.4714	0.3636			0.048		0.0056															15.4745	0	9.320161839	34.714	2.326120482	10.03449765	0.513254447	1.236060974	2.763299922	0.918857724	1.376260795	6.7995743	3.668535823	4.906321057	0	0.079068563	6.262550543	9.315821342	15.71519648	1.942218158	0.364034088	0	0	4.64004789	3.183585884	0	0	0.426	0	0.049860171	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.2352
R5342_802_0	2008	4																					3600											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	Coin	Coin	Coin	V	V	V	Coin	P	P	Coin	O	T	V	P	Coin	P	P	O	O	O																																																				0	4200	1937.643818	142.8850558	1190.280678		135.9430988	14.77341315	2.83078267	529.7684046	36.35252169	11235.58031	36.8454059		0.422723765	33.49799443	4736.215939	4815.83521	551.9988448	2.038190265			25.97916171	966.8442095			129.6		15.16872816															$335 (1a); $0 (1a1)	$335 (1b)	"$180 (2a, 2a2)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$15 (8a2)	"$0 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $60 (5); $40/$30 (9c)"	"$20/$50 (7a); $0 (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $20 (14c1, 14c)"	"$35 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 17b, 13a1); $35 (17a, 18a, 16b)"	$0 n/c (10b)	$0 n/c (16)	$35 (17a1)	$0 n/c (17b)	$35 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											179.1835	179.1835	96.2777		93.6033	0.160462817	0.279092269	26.7438	0.160462817	3.2093	0.112718624		0.160462817	0.160381708	20	34.772	37.5	0.160462817			0.160462817	35			35		35															28.9328	2.133553449	9.549789524	0	1.060393667	2.370583489	0.790049558	1.18066848	5.833228034	3.004821445	4.153163454	0	0.067831446	5.372465567	7.893693232	13.95467134	1.72499639	0.327053751	0	0	4.168689469	2.819962278	0	0	0.378	0	0.044242124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.7607	0	59.32439165	28.9328	2.133553449	9.549789524	0	1.060393667	2.370583489	0.790049558	1.18066848	5.833228034	3.004821445	4.153163454	0	0.067831446	5.372465567	7.893693232	13.95467134	1.72499639	0.327053751	0	0	4.168689469	2.819962278	0	0	0.378	0	0.044242124	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.7607		30% (1a); $0 (1a1)	30% (1b)	"30% (2a, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$175 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1, 4b)"	30% (9b)	30% (8a1); $0/$20 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	30% (incl in h5)	30% (12)	"30% (3, 9d, 9a); $75 (5); $45/$35 (9c)"	"$30/$50 (7a); 30% (14b, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1); $30 (14c1, 14c)"	"$40 (7b, 7d, 7f, 7f1, 7g); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	$0 (incl in h2)		"30% (15, 15a1)"	"$0 (13a, 13a1); $40 (17a, 18a, 16b); 30% (17b)"	$0 n/c (10b)	$0 n/c (16)	$40 (17a1)	$0 n/c (17b)	$40 (18a1); $0 n/c (18a2)	$0 n/c (18b)	$0 n/c	"$0 (14a1, 14a7, 14a8); $0 n/c (14a2, 14a3, 14a4, 14a5, 14a6)"	"$0 n/c (13b, 13c, 13d, 13e)"											5.7812	0.1926	0.4847	0.5133	0.1757	0.3927	0.1288	0.1956	0.9663	0.6637	0.7532		0.0112	0.8901	1.4221	1.7605	0.2172	0.037			0.4714	0.3636			0.048		0.0056															15.4745	0	9.320161839	34.714	2.326120482	10.03449765	0.513254447	1.236060974	2.763299922	0.918857724	1.376260795	6.7995743	3.668535823	4.906321057	0	0.079068563	6.262550543	9.315821342	15.71519648	1.942218158	0.364034088	0	0	4.64004789	3.183585884	0	0	0.426	0	0.049860171	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.2352
R5553_001_0	2008	9																					5000											D	D	D	coin	T	coin	coin	V	V	P	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	5000	868.6069986	11.78979292	429.1383964	19.19834812	239.4357428	24.24429344	1.183178618	404.3933043	389.6641519	1880.799487	965.6348965	0	0.192929947	1205.501379	3121.682854	3734.118514	109.0294046	350.4747103	21.4740282	77.80766484	28.43986596	738.1041533	0	0	0	0	0	0	0	0	0											$150 Per Day 1-7	$150 Per Day 1-7	$75 Per Day:6-100	$0 Cost Share	$50 Per Trip	20% DME 0% Diab Monit	20%	$50 copay	$50 ASC copay/$100 OP Hosp copay	$20 copay	$20 copay	0	20%	20%	$15 copay	$30 copay	$30 copay	$30 copay	$20 copay	$30 copay Hearing/$30 copay SA	20%	$30 Blood/$30 Vision	0	FALSE		0		0	0	0	0											138.6278713	138.6697786	67.23197039	-0.000252127	46.41071168	0.153496225	0.187175697	48.28326474	56.56681927	18.35982674	18.34116333	0	0.187191089	20.45954414	13.61191767	27.20763474	27.22330282	27.24573154	-2.80E-05	26.36635667	0.197209961	28.06616566	0	0	0	0	0	0	0	0	0											10.0344	0.136240664	2.40431833	-0.004840413	0.926031936	3.721407529	0.221462283	1.627119081	1.836838471	2.87759606	1.475905613	0	0.036114767	2.055334056	3.5410075	8.466377716	0.247345042	0.795744989	-0.000600467	0.17095872	5.608624861	1.726312787	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9037	0	3.807270837	10.0344	0.136240664	2.40431833	-0.004840413	0.926031936	3.721407529	0.221462283	1.627119081	1.836838471	2.87759606	1.475905613	0	0.036114767	2.055334056	3.5410075	8.466377716	0.247345042	0.795744989	-0.000600467	0.17095872	5.608624861	1.726312787	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9037	5000	20%	20%	$75 Per Day:6-100	20%	$50 Per Trip	30% DME 0% Diab Monit	30%	$50 copay	20% ASC/30% OP Hosp	20%	20%	0	20%	20%	20%	20%	50%	20%	20%	20% Hearing/20% SA	20%	20% Blood/20% Vision	0	FALSE		0		0	0	0	0											1.1501	0.0064	0.1326	0.0914	0.0239	0.1246	0.0067	0.0356	0.1475	0.049	0.1343	0	0.001	0.1295	0.168	0.5326	0.009	0.0166	0.1203	0.154	0.1221	0.0251	0	0	0	0	0	0	0	0	0											3.1804	750	0.477300457	11.1845	0.142641892	2.536901705	0.086576055	0.949950814	3.845989862	0.228193961	1.662745305	1.984359511	2.926592959	1.610209454	0	0.037160583	2.184819609	3.708963306	8.998981953	0.256389899	0.812319973	0.119743259	0.324993368	5.730757123	1.751370335	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.0842
R5553_002_0	2008	10																					2500											coin	coin	D	coin	T	coin	coin	V	V	P	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	2500	211.8132711	1.546052014	249.912894	10.61548724	170.494939	29.08556609	1.419209077	429.6239866	496.6682159	1664.355237	854.4185995	0	0.205640355	1066.808419	2501.180288	2959.638287	86.22573525	277.2400853	20.56284089	61.76772057	60.61550221	802.3288979	0	735	0	0	0	0	0	0	0											$0 cost share	$0 Cost Share	$75 Per Day:6-100	$0 Cost Share	$50 Per Trip	20% DME 0% Diab Monit	20%	$50 copay	$25 ASC copay/$50 OP Hosp copay	$10 copay	$10 copay	0	20%	20%	$10 copay	$20 copay	$20 copay	$20 copay	$10 copay	$20 copay Hearing/$20 copay SA	20%	$20 Blood/$20 Vision	0	$0 Cost Share	0%	0		0	0	0	0											-0.000310364	-0.00032465	50.10846777	-0.002255435	40.85730851	0.148769328	0.181400112	35.98317141	27.91824351	8.353349173	8.229557026	0	0.178153563	16.72578995	7.754709243	15.40537063	15.50349582	15.64396001	-0.000364178	11.11011932	0.198489788	17.81004979	0	0	0	0	0	0	0	0	0											-0.0657	-0.000501925	1.043562683	-0.023942538	0.580497027	4.327040121	0.257444685	1.288269463	1.155508683	1.15857837	0.585957216	0	0.036635562	1.486934462	1.616327158	3.799527062	0.111400027	0.361427734	-0.007488527	0.057187229	12.03155821	1.190793135	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.991	0	4.122582796	-0.0657	-0.000501925	1.043562683	-0.023942538	0.580497027	4.327040121	0.257444685	1.288269463	1.155508683	1.15857837	0.585957216	0	0.036635562	1.486934462	1.616327158	3.799527062	0.111400027	0.361427734	-0.007488527	0.057187229	12.03155821	1.190793135	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.991	2500	20%	20%	$75 Per Day:6-100	20%	$50 Per Trip	30% DME 0% Diab Monit	30%	$50 copay	20% ASC/30% OP Hosp	20%	20%	0	20%	20%	20%	20%	50%	20%	20%	20% Hearing/20% SA	20%	20% Blood/20% Vision	0	$0 Cost Share	0%	0		0	0	0	0											0.795	0.0061	0.0455	0.0301	0.0127	0.1202	0.0066	0.0254	0.1502	0.0397	0.1088	0	0.0008	0.1049	0.1166	0.3696	0.0062	0.0115	0.0833	0.1066	0.2507	0.0203	0	0	0.0035	0	0	0	0	0	0											2.414	500	1.019011765	0.7292	0.005567726	1.089013244	0.006112243	0.593173827	4.447242012	0.264027298	1.313718486	1.305681875	1.198264791	0.694752917	0	0.037482987	1.591816475	1.732880516	4.16909387	0.117575602	0.372909194	0.075780567	0.163765605	12.28229076	1.211101805	0	0	0.00348051	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.405
R5553_801_0	2008	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	275.8982781	2.070085048	28.78329278	32.96955464	7.848432887	26.99669832	1.285161338	5.109793267	26.83577742	10.41120814	28.3027838	0	0.225578948	26.43664515	43.17180644	115.0032145	1.201189044	4.026539778	28.78593847	36.0525914	7.422801473	6.089373132	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	0	0				0	0	0	0											0.080255026	0.080255026	0.205717362	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.1422	0.166134729	5.92122305	0	1.836533296	6.317227407	0.300727753	1.195691624	6.279571916	2.436222705	6.62285141	0	0.052785474	6.186174965	10.10220271	26.9107522	0.281078236	0.942210308	6.735909601	8.436306387	1.736935545	1.424913313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0277	0	0	22.1422	0.166134729	5.92122305	0	1.836533296	6.317227407	0.300727753	1.195691624	6.279571916	2.436222705	6.62285141	0	0.052785474	6.186174965	10.10220271	26.9107522	0.281078236	0.942210308	6.735909601	8.436306387	1.736935545	1.424913313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0277	none	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	0	0	Standard Medicare	Standard Medicare	Standard Medicare	0	0	0	0											0.7346	0.0056	0.2967	0	0.0552	0.1906	0.0089	0.0406	0.2112	0.0822	0.2252	0	0.0019	0.2173	0.3327	0.8983	0.0104	0.0348	0.2276	0.2908	0.061	0.0449	0	0	0	0	0	0	0	0	0											3.9706	0	0	22.8768	0.17176483	6.217963203	0	1.891737175	6.507781576	0.30958151	1.236341287	6.490820359	2.518450136	6.848096955	0	0.05473359	6.403461985	10.4348584	27.80902728	0.291450121	0.977058495	6.96350991	8.727076599	1.797970055	1.469800522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.9983
R5553_802_0	2008	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	275.8982781	2.070085048	28.78329278	32.96955464	7.848432887	26.99669832	1.285161338	5.109793267	26.83577742	10.41120814	28.3027838	0	0.225578948	26.43664515	43.17180644	115.0032145	1.201189044	4.026539778	28.78593847	36.0525914	7.422801473	6.089373132	0	0	0	0	0	0	0	0	0											Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	0	0				0	0	0	0											0.080255026	0.080255026	0.205717362	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											22.1422	0.166134729	5.92122305	0	1.836533296	6.317227407	0.300727753	1.195691624	6.279571916	2.436222705	6.62285141	0	0.052785474	6.186174965	10.10220271	26.9107522	0.281078236	0.942210308	6.735909601	8.436306387	1.736935545	1.424913313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0277	0	0	22.1422	0.166134729	5.92122305	0	1.836533296	6.317227407	0.300727753	1.195691624	6.279571916	2.436222705	6.62285141	0	0.052785474	6.186174965	10.10220271	26.9107522	0.281078236	0.942210308	6.735909601	8.436306387	1.736935545	1.424913313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0277	none	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	Standard Medicare	0	0	Standard Medicare	Standard Medicare	Standard Medicare	0	0	0	0											0.7346	0.0056	0.2967	0	0.0552	0.1906	0.0089	0.0406	0.2112	0.0822	0.2252	0	0.0019	0.2173	0.3327	0.8983	0.0104	0.0348	0.2276	0.2908	0.061	0.0449	0	0	0	0	0	0	0	0	0											3.9706	0	0	22.8768	0.17176483	6.217963203	0	1.891737175	6.507781576	0.30958151	1.236341287	6.490820359	2.518450136	6.848096955	0	0.05473359	6.403461985	10.4348584	27.80902728	0.291450121	0.977058495	6.96350991	8.727076599	1.797970055	1.469800522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.9983
R5566_003_0	2008	3																					3000											A	A	D	V	Coin	Coin	Coin	V	V	P	Coin	V	V	V	P	P	P	P	P	P	Coin	P	T	P	P	P	P	V	V	V	V																																																				0		222.6673002	5.597230974	815.2397782		5.075343386	6.280776973	6.471838151	186.6738936	254.2733502		29.4776981			277.8390121	3095.381745	2595.652575	206.580566	284.6040785		282.7776137	15.30020052	1090.604783			135.0723422		233.5916326															$750 (1a)	$750 (1b)	$0 Days 1-20; $100 Days 21+ (2)	$0 (6)	20% (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a), $25 (4b)"	$150 (9b)	$0 (8a)	20% (8b)	$0 (9a)	$0 (12)	"$100 (5) $25 (3, 9a, 9c, 9d)"	"$25 (7a, 14c, 14i) $0 (14b, 14d, 14e, 14f, 14g, 14h)"	"20% (7b) $25 (7d, 7f)"	"$25 (7e, 7h)"	"$25 (7c, 7i)"		$25 (7g)	20% (15)	"$25 (14j, 16b, 17a) 20% (17b) $0 (13a, 14a)"	$0 n/c (10b)	$0 n/c (16a)	$25 (17a)	$0 n/c (17b)	$25 (18a)	$0 n/c (18b)			$0 n/c (13b)											707.2939	707.2939	43.7432		0.188611715	0.188611715	0.188611715	45.1485	141.4588		0.188611715			23.5777	23.5765	20.9252	23.5765	23.5765		23.5765	0.188611715	20.3417			23.5765		23.5765															13.1243	0.329907292	2.971763493	0	0.95726922	1.184628116	1.220664493	0.702336678	2.997433291	0	5.559839192	0	0	0.545899619	6.081513119	4.526202603	0.405869946	0.55916316	0	0.555574694	2.885797058	1.848732531	0	0	0.265377355	0	0.458938733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1812	0	2.848777047	13.1243	0.329907292	2.971763493	0	0.95726922	1.184628116	1.220664493	0.702336678	2.997433291	0	5.559839192	0	0	0.545899619	6.081513119	4.526202603	0.405869946	0.55916316	0	0.555574694	2.885797058	1.848732531	0	0	0.265377355	0	0.458938733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1812	8000	40% (1a)	40% (1b)	40% (2a)	40% (6)	40% (10a)	40% (11a)	"40% (11b, 11c)"	"$50 (4a), $25 (4b)"	40% (9b)	40% (8a)	40% (8b)	40% (9a)	40% (12)	"40% (5, 3, 9a, 9c, 9d)"	"40% (7a, 14c, 14i, 14b, 14d, 14e, 14f, 14g, 14h)"	"40% (7b, 7d, 7f)"	"40% (7e, 7h)"	"40% (7c, 7i)"		40% (7g)	40% (15)	"40% (14j, 16b, 17a, 17b, 13a, 14a)"	$0 n/c (10b)	$0 n/c (16a)	40% (17a)	$0 n/c (17b)	40% (18a)	$0 n/c (18b)			$0 n/c (13b)											3.3816	0.0535	0.5413	0.1787	0.0953	0.135	0.1545	0.0431	0.6145	0.2496	0.5905	0.0992	0.0031	0.5507	0.4969	1.0846	0.0231	0.0502		0.0182	0.3332	0.1391			0.0192		0.0255															8.8808	0	2.852694311	16.5059	0.383406293	3.513030063	0.178740643	1.052615238	1.319623185	1.37516855	0.745460925	3.611945631	0.249638776	6.150347776	0.099184143	0.003100027	1.096565577	6.578442249	5.610756171	0.429018343	0.609386213	0	0.573790859	3.219024886	1.987859218	0	0	0.284572114	0	0.484415909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.062
R5566_005_0	2008	3																					1500											A	A	D	V	Coin	Coin	Coin	V	V	P	V	V	V	V	P	P	P	P	P	P	Coin	P	T	P	P	P	P	V	V	V	V																																																				0		230.6705099	5.557638896	793.718276		5.464830817	6.688787469	6.763800263	191.9048283	263.7769898		291.144431			283.7275485	3224.391673	2668.971074	202.745387	288.6166072		291.6398165	16.37263853	1131.010498			133.555805		230.9625683															$100 (1a)	$100 (1b)	$0 Days 1-20; $50 Days 21+ (2)	$0 (6)	10% (10a)	10% (11a)	"10% (11b, 11c)"	"$50 (4a), $10 (4b)"	$50 (9b)	$0 (8a)	$50/$0 (8b)	$0 (9a)	$0 (12)	"$50 (5) $10 (3, 9a, 9c, 9d)"	"$10 (7a, 14c, 14i) $0 (14b, 14d, 14e, 14f, 14g, 14h)"	"10% (7b) $10 (7d, 7f)"	"$10 (7e, 7h)"	"$10 (7c, 7i)"		$10 (7g)	10% (15)	"$10 (14j, 16b, 17a) 10% (17b) $0 (13a, 14a)"	$0 n/c (10b)	$0 n/c (16a)	$10 (17a)	$0 n/c (17b)	$10 (18a)	$0 n/c (18b)			$0 n/c (13b)											98.5478	98.5478	24.0974		0.098547767	0.098547767	0.098547767	45.8936	49.2739		34.9243			9.8555	9.8548	9.0696	9.8548	9.8548		9.8548	0.098547767	8.8691			9.8548		9.8548															1.8943	0.045641075	1.5938822	0	0.538546877	0.659165072	0.666557415	0.733933351	1.083109727	0	0.847333489	0	0	0.233023179	2.647971674	2.017202879	0.166500877	0.237021019	0	0.239503773	1.613486974	0.835919045	0	0	0.10968022	0	0.189673712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.3525	0	0.240975726	1.8943	0.045641075	1.5938822	0	0.538546877	0.659165072	0.666557415	0.733933351	1.083109727	0	0.847333489	0	0	0.233023179	2.647971674	2.017202879	0.166500877	0.237021019	0	0.239503773	1.613486974	0.835919045	0	0	0.10968022	0	0.189673712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.3525	6500	OON: 20%; OOA: $100 (1a)	OON: 20%; OOA: $100 (1b)	OON: 20%; OOA: $0 Days 1-20; $50 Days 21+ (2)	OON: 20%; OOA: $0 (6)	OON: 20%; OOA: 10% (10a)	OON: 20%; OOA: 10% (11a)	"OON: 20%; OOA: 10% (11b, 11c)"	"OON: 20%; OOA: $50 (4a), $10 (4b)"	OON: 20%; OOA: $50 (9b)	OON: 20%; OOA: $0 (8a)	OON: 20%; OOA: $50/$0 (8b)	OON: 20%; OOA: $0 (9a)	OON: 20%; OOA: $0 (12)	"OON: 20%; OOA: $50 (5) $10 (3, 9a, 9c, 9d)"	"OON: 20% (except 14b: $0); OOA: $10 (7a, 14c, 14i) $0 (14b, 14d, 14e, 14f, 14g, 14h)"	"OON: 20%; OOA: 10% (7b) $10 (7d, 7f)"	"OON: 20%; OOA: $10 (7e, 7h)"	"OON: 20%; OOA: $10 (7c, 7i)"		OON: 20%; OOA: $10 (7g)	OON: 20%; OOA: 10% (15)	"OON: 20%; OOA: $10 (14j, 16b, 17a) 10% (17b) $0 (13a, 14a)"	$0 n/c (10b)	$0 n/c (16a)	OON: 20%; OOA: $10 (17a)	$0 n/c (17b)	OON: 20%; OOA: $10 (18a)	$0 n/c (18b)			$0 n/c (13b)											1.07	0.0166	0.2174	0.0517	0.0502	0.0693	0.075	0.0553	0.2298	0.0747	0.2092	0.0298	0.0008	0.1729	0.2484	0.4094	0.0126	0.0238		0.0145	0.1659	0.0738			0.0094		0.0142															3.2947	0	0.520968662	2.9643	0.062209732	1.811248331	0.051741734	0.58875907	0.728492063	0.741523149	0.789200379	1.312900455	0.074656283	1.056552639	0.029794034	0.000844677	0.405893709	2.896352016	2.426622767	0.179113512	0.260811648	0	0.254016115	1.779378455	0.90976055	0	0	0.119105371	0	0.203868925	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.6472
R5566_006_0	2008	3																					1500											A	A	D	V	Coin	Coin	Coin	V	V	P	V	V	V	V	P	P	P	P	P	P	Coin	P	T	P	P	P	P	V	V	V	V																																																				0		239.2725096	5.424822339	786.2950501		5.817729762	7.767006931	8.182329563	201.5712845	276.262383		310.3176742			307.6077297	3296.78113	2922.960729	198.469414	318.2815274		300.8656113	18.96808587	1197.061592			128.6089691		222.4013847															$100 (1a)	$100 (1b)	$0 Days 1-20; $50 Days 21+ (2)	$0 (6)	10% (10a)	10% (11a)	"10% (11b, 11c)"	"$50 (4a), $10 (4b)"	$50 (9b)	$0 (8a)	$50/$0 (8b)	$0 (9a)	$0 (12)	"$50 (5) $10 (3, 9a, 9c, 9d)"	"$10 (7a, 14c, 14i) $0 (14b, 14d, 14e, 14f, 14g, 14h)"	"10% (7b) $10 (7d, 7f)"	"$10 (7e, 7h)"	"$10 (7c, 7i)"		$10 (7g)	10% (15)	"$10 (14j, 16b, 17a) 10% (17b) $0 (13a, 14a)"	$0 n/c (10b)	$0 n/c (16a)	$10 (17a)	$0 n/c (17b)	$10 (18a)	$0 n/c (18b)			$0 n/c (13b)											98.5478	98.5478	25.437		0.098547767	0.098547767	0.098547767	46.4329	49.2739		34.9112			9.8553	9.8548	9.1639	9.8548	9.8548		9.8548	0.098547767	8.8998			9.8548		9.8548															1.965	0.044550344	1.666747419	0	0.57332428	0.765421193	0.806350311	0.779961776	1.134376712	0	0.90279595	0	0	0.25262944	2.707420168	2.232137414	0.162989314	0.261382783	0	0.247080286	1.869262516	0.887805188	0	0	0.105617723	0	0.182643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.5475	0	0.258585429	1.965	0.044550344	1.666747419	0	0.57332428	0.765421193	0.806350311	0.779961776	1.134376712	0	0.90279595	0	0	0.25262944	2.707420168	2.232137414	0.162989314	0.261382783	0	0.247080286	1.869262516	0.887805188	0	0	0.105617723	0	0.182643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.5475	6500	OON: 20%; OOA: $100 (1a)	OON: 20%; OOA: $100 (1b)	OON: 20%; OOA: $0 Days 1-20; $50 Days 21+ (2)	OON: 20%; OOA: $0 (6)	OON: 20%; OOA: 10% (10a)	OON: 20%; OOA: 10% (11a)	"OON: 20%; OOA: 10% (11b, 11c)"	"OON: 20%; OOA: $50 (4a), $10 (4b)"	OON: 20%; OOA: $50 (9b)	OON: 20%; OOA: $0 (8a)	OON: 20%; OOA: $50/$0 (8b)	OON: 20%; OOA: $0 (9a)	OON: 20%; OOA: $0 (12)	"OON: 20%; OOA: $50 (5) $10 (3, 9a, 9c, 9d)"	"OON: 20% (except 14b: $0); OOA: $10 (7a, 14c, 14i) $0 (14b, 14d, 14e, 14f, 14g, 14h)"	"OON: 20%; OOA: 10% (7b) $10 (7d, 7f)"	"OON: 20%; OOA: $10 (7e, 7h)"	"OON: 20%; OOA: $10 (7c, 7i)"		OON: 20%; OOA: $10 (7g)	OON: 20%; OOA: 10% (15)	"OON: 20%; OOA: $10 (14j, 16b, 17a) 10% (17b) $0 (13a, 14a)"	$0 n/c (10b)	$0 n/c (16a)	OON: 20%; OOA: $10 (17a)	$0 n/c (17b)	OON: 20%; OOA: $10 (18a)	$0 n/c (18b)			$0 n/c (13b)											2.3805	0.0323	0.4091	0.1233	0.0874	0.1324	0.1529	0.0861	0.4817	0.1747	0.4503	0.0855	0.0017	0.3901	0.4386	0.866	0.0205	0.047		0.0219	0.3275	0.1295			0.0146		0.0211															6.8748	0	1.475515265	4.3455	0.076846652	2.075879269	0.123268501	0.660733447	0.89783088	0.959225214	0.866037508	1.616039368	0.174734125	1.353100524	0.085538448	0.001691401	0.642702939	3.1460556	3.098162849	0.183467757	0.308368078	0	0.268948067	2.196767235	1.017354279	0	0	0.120264184	0	0.203775088	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.4223
R5566_008_0	2008	3																					1500											A	A	D	V	Coin	Coin	Coin	V	V	P	V	V	V	V	P	P	P	P	P	P	Coin	P	T	P	P	P	P	V	V	V	V																																																				0		316.4269668	7.539888691	1368.657714		9.313565009	11.59793475	12.02641775	260.883831	341.603712		386.4626494			385.9056454	4065.295769	3520.300282	269.1891577	390.5999651		367.5961794	29.07210641	1465.206258			130.4536469		225.6032697															$100 (1a)	$100 (1b)	$0 Days 1-20; $50 Days 21+ (2)	$0 (6)	10% (10a)	10% (11a)	"10% (11b, 11c)"	"$50 (4a), $10 (4b)"	$50 (9b)	$0 (8a)	$50/$0 (8b)	$0 (9a)	$0 (12)	"$50 (5) $10 (3, 9a, 9c, 9d)"	"$10 (7a, 14c, 14i) $0 (14b, 14d, 14e, 14f, 14g, 14h)"	"10% (7b) $10 (7d, 7f)"	"$10 (7e, 7h)"	"$10 (7c, 7i)"		$10 (7g)	10% (15)	"$10 (14j, 16b, 17a) 10% (17b) $0 (13a, 14a)"	$0 n/c (10b)	$0 n/c (16a)	$10 (17a)	$0 n/c (17b)	$10 (18a)	$0 n/c (18b)			$0 n/c (13b)											98.5478	98.5478	31.4477		0.098547767	0.098547767	0.098547767	45.981	49.2739		34.8116			9.8553	9.8548	9.5147	9.8548	9.8548		9.8548	0.098547767	9.2995			9.8548		9.8548															2.5986	0.061919933	3.586760264	0	0.917831039	1.142950577	1.18517662	0.99964166	1.402678466	0	1.121116793	0	0	0.316935597	3.338548518	2.791223276	0.221066588	0.320772954	0	0.301881523	2.864991182	1.135471766	0	0	0.10713263	0	0.185272488	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.6	0	0.362513297	2.5986	0.061919933	3.586760264	0	0.917831039	1.142950577	1.18517662	0.99964166	1.402678466	0	1.121116793	0	0	0.316935597	3.338548518	2.791223276	0.221066588	0.320772954	0	0.301881523	2.864991182	1.135471766	0	0	0.10713263	0	0.185272488	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.6	6500	OON: 20%; OOA: $100 (1a)	OON: 20%; OOA: $100 (1b)	OON: 20%; OOA: $0 Days 1-20; $50 Days 21+ (2)	OON: 20%; OOA: $0 (6)	OON: 20%; OOA: 10% (10a)	OON: 20%; OOA: 10% (11a)	"OON: 20%; OOA: 10% (11b, 11c)"	"OON: 20%; OOA: $50 (4a), $10 (4b)"	OON: 20%; OOA: $50 (9b)	OON: 20%; OOA: $0 (8a)	OON: 20%; OOA: $50/$0 (8b)	OON: 20%; OOA: $0 (9a)	OON: 20%; OOA: $0 (12)	"OON: 20%; OOA: $50 (5) $10 (3, 9a, 9c, 9d)"	"OON: 20% (except 14b: $0); OOA: $10 (7a, 14c, 14i) $0 (14b, 14d, 14e, 14f, 14g, 14h)"	"OON: 20%; OOA: 10% (7b) $10 (7d, 7f)"	"OON: 20%; OOA: $10 (7e, 7h)"	"OON: 20%; OOA: $10 (7c, 7i)"		OON: 20%; OOA: $10 (7g)	OON: 20%; OOA: 10% (15)	"OON: 20%; OOA: $10 (14j, 16b, 17a) 10% (17b) $0 (13a, 14a)"	$0 n/c (10b)	$0 n/c (16a)	OON: 20%; OOA: $10 (17a)	$0 n/c (17b)	OON: 20%; OOA: $10 (18a)	$0 n/c (18b)			$0 n/c (13b)											2.6517	0.0379	0.6126	0.1385	0.1007	0.1469	0.166	0.0801	0.5156	0.1885	0.4919	0.0955	0.0019	0.4202	0.4713	0.9278	0.0241	0.0518		0.0221	0.3775	0.136			0.0111		0.0161															7.6859	0	2.814442981	5.2503	0.099829844	4.199389395	0.138459662	1.018574743	1.289834539	1.35121075	1.079773442	1.91825363	0.188477537	1.613020406	0.095520602	0.001907834	0.737096191	3.809864301	3.719040479	0.245126342	0.372560589	0	0.324015139	3.242492264	1.271459185	0	0	0.118212045	0	0.201421015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.2859
R5566_803_0	2008	3																					3250											Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001											0.0031		280.0401763	5.125916469	46.1023672		8.732683902	10.2390614	10.18495935	264.8068455	51.63887485		50.68977286	3.933343955	0.252134618	46.60380333	45.51610084	88.80163407	2.077828787	3.734706959		1.680567527	25.51467241	11.03795974					0.000239482															FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	"$50 (4a, 4b)"	FFS Cost Sharing	$0 (8a)	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing				FFS Cost Sharing															0.051846654	0.051846654	0.100245638		0.148826249	0.148826249	0.148826249	31.8005	0.148826249		0.148826249	0.148826249	0.148826249	0.148826249	0.148826249	0.148826249	0.148826249	0.148826249		0.148826249	0.148826249	0.148826249					0.148826249															14.5191	0.265761619	4.621561229	0	1.29965259	1.523841103	1.515789297	0.701748746	7.685220055	0	7.543968765	0.585384828	0.03752425	6.935869246	6.773990564	13.21601412	0.309235465	0.555822428	0	0.250112561	3.797252993	1.642738146	0	0	0	0	3.56E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7807	135	42.2249195	14.5192	0.265861619	4.621661229	0.0001	1.29975259	1.523941103	1.515889297	0.701848746	7.685320055	0.0001	7.544068765	0.585484828	0.03762425	6.935969246	6.774090564	13.21611412	0.309335465	0.555922428	0.0001	0.250212561	3.797352993	1.642838146	0.0001	0.0001	0.0001	0.0001	0.000135641	0.0001	0.0001	0.0001	0.0001	0	0	0	0	0	0	0	0	0	0	73.7838	8000	0.5	0.5	0.5	0.5	0.5	0.5	0.5	"$50 (4a, 4b)"	0.5	0.5	0.5	0.5	0.5	0.5	50% (except 14b: $0)	0.5	0.5	0.5	0.5	0.5	0.5	0.5					0.5															3.069	0.0548	0.4895		0.0899	0.1116	0.112	0.026	0.5531	0.2213	0.5296	0.0478	0.0027	0.4944	0.4564	0.9538	0.0212	0.039		0.0174	0.2694	0.1161																				7.6751	0	5.537893002	17.5882	0.320654827	5.111204062	0.0001	1.389666566	1.63549905	1.627896199	0.727870657	8.238379139	0.22142938	8.073711614	0.633334644	0.040335898	7.4303358	7.230538962	14.16988567	0.330556315	0.594902008	0.0001	0.267624916	4.066749309	1.758906148	0.0001	0.0001	0.0001	0.0001	0.000135641	0.0001	0.0001	0.0001	0.0001	0	0	0	0	0	0	0	0	0	0	81.4588
R5566_804_0	2008	3																					3250											Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001											0.0031		280.0401763	5.125916469	46.1023672		8.732683902	10.2390614	10.18495935	264.8068455	51.63887485		50.68977286	3.933343955	0.252134618	46.60380333	45.51610084	88.80163407	2.077828787	3.734706959		1.680567527	25.51467241	11.03795974					0.000239482															FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	"$50 (4a, 4b)"	FFS Cost Sharing	$0 (8a)	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing				FFS Cost Sharing															0.051846654	0.051846654	0.100245638		0.148826249	0.148826249	0.148826249	31.8005	0.148826249		0.148826249	0.148826249	0.148826249	0.148826249	0.148826249	0.148826249	0.148826249	0.148826249		0.148826249	0.148826249	0.148826249					0.148826249															14.5191	0.265761619	4.621561229	0	1.29965259	1.523841103	1.515789297	0.701748746	7.685220055	0	7.543968765	0.585384828	0.03752425	6.935869246	6.773990564	13.21601412	0.309235465	0.555822428	0	0.250112561	3.797252993	1.642738146	0	0	0	0	3.56E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7807	135	42.2249195	14.5192	0.265861619	4.621661229	0.0001	1.29975259	1.523941103	1.515889297	0.701848746	7.685320055	0.0001	7.544068765	0.585484828	0.03762425	6.935969246	6.774090564	13.21611412	0.309335465	0.555922428	0.0001	0.250212561	3.797352993	1.642838146	0.0001	0.0001	0.0001	0.0001	0.000135641	0.0001	0.0001	0.0001	0.0001	0	0	0	0	0	0	0	0	0	0	73.7838	8000	0.5	0.5	0.5	0.5	0.5	0.5	0.5	"$50 (4a, 4b)"	0.5	0.5	0.5	0.5	0.5	0.5	50% (except 14b: $0)	0.5	0.5	0.5	0.5	0.5	0.5	0.5					0.5															3.069	0.0548	0.4895		0.0899	0.1116	0.112	0.026	0.5531	0.2213	0.5296	0.0478	0.0027	0.4944	0.4564	0.9538	0.0212	0.039		0.0174	0.2694	0.1161																				7.6751	0	5.537893002	17.5882	0.320654827	5.111204062	0.0001	1.389666566	1.63549905	1.627896199	0.727870657	8.238379139	0.22142938	8.073711614	0.633334644	0.040335898	7.4303358	7.230538962	14.16988567	0.330556315	0.594902008	0.0001	0.267624916	4.066749309	1.758906148	0.0001	0.0001	0.0001	0.0001	0.000135641	0.0001	0.0001	0.0001	0.0001	0	0	0	0	0	0	0	0	0	0	81.4588
R5566_805_0	2008	3																					3250											Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001	0.0001											0.0031		280.0401763	5.125916469	46.1023672		8.732683902	10.2390614	10.18495935	264.8068455	51.63887485		50.68977286	3.933343955	0.252134618	46.60380333	45.51610084	88.80163407	2.077828787	3.734706959		1.680567527	25.51467241	11.03795974					0.000239482															FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	"$50 (4a, 4b)"	FFS Cost Sharing	$0 (8a)	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing	FFS Cost Sharing				FFS Cost Sharing															0.051846654	0.051846654	0.100245638		0.148826249	0.148826249	0.148826249	31.8005	0.148826249		0.148826249	0.148826249	0.148826249	0.148826249	0.148826249	0.148826249	0.148826249	0.148826249		0.148826249	0.148826249	0.148826249					0.148826249															14.5191	0.265761619	4.621561229	0	1.29965259	1.523841103	1.515789297	0.701748746	7.685220055	0	7.543968765	0.585384828	0.03752425	6.935869246	6.773990564	13.21601412	0.309235465	0.555822428	0	0.250112561	3.797252993	1.642738146	0	0	0	0	3.56E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7807	135	42.2249195	14.5192	0.265861619	4.621661229	0.0001	1.29975259	1.523941103	1.515889297	0.701848746	7.685320055	0.0001	7.544068765	0.585484828	0.03762425	6.935969246	6.774090564	13.21611412	0.309335465	0.555922428	0.0001	0.250212561	3.797352993	1.642838146	0.0001	0.0001	0.0001	0.0001	0.000135641	0.0001	0.0001	0.0001	0.0001	0	0	0	0	0	0	0	0	0	0	73.7838	8000	0.5	0.5	0.5	0.5	0.5	0.5	0.5	"$50 (4a, 4b)"	0.5	0.5	0.5	0.5	0.5	0.5	50% (except 14b: $0)	0.5	0.5	0.5	0.5	0.5	0.5	0.5					0.5															3.069	0.0548	0.4895		0.0899	0.1116	0.112	0.026	0.5531	0.2213	0.5296	0.0478	0.0027	0.4944	0.4564	0.9538	0.0212	0.039		0.0174	0.2694	0.1161																				7.6751	0	5.537893002	17.5882	0.320654827	5.111204062	0.0001	1.389666566	1.63549905	1.627896199	0.727870657	8.238379139	0.22142938	8.073711614	0.633334644	0.040335898	7.4303358	7.230538962	14.16988567	0.330556315	0.594902008	0.0001	0.267624916	4.066749309	1.758906148	0.0001	0.0001	0.0001	0.0001	0.000135641	0.0001	0.0001	0.0001	0.0001	0	0	0	0	0	0	0	0	0	0	81.4588
R5595_001_0	2008	4																					7500											A		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	7500	1502.317115		897.7020928	680.345574	197.2652812	12.05587436		287.0015798	278.7444191	1145.322764	4536.459421	0	0	687.0964784	3377.110579	6815.501017	0	1327.086945	0	0	233.2876369				781.954829		46.77836843															$900/ addmission		"$0/day 1-7, $75 day 8-14; $100/day 15-100"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$200 per procedure	$35 per visit	"$35 X-ray; $165 CAT, PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$20 per visit	"$35 per visit Spialist, $30 Renal Dialysis"	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															152.17		68.64	20	100	0.2		48.05	200	35	58.4	35	30	35	20	34.58	35	35	35	35	45				0		0															19.0506	0	5.134855971	1.13390929	1.643877344	2.411174872	0	1.149202159	4.645740319	3.340524728	22.07743585	0	0	2.004031395	5.628517631	19.6400021	0	3.870670256	0	0	0.874828639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.6054		2.84	19.0506	0	5.134855971	1.13390929	1.643877344	2.411174872	0	1.149202159	4.645740319	3.340524728	22.07743585	0	0	2.004031395	5.628517631	19.6400021	0	3.870670256	0	0	0.874828639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.6054	7500	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	$100 per trip	30% coins; $500ded; 7500 max OOP		$50 ER; $35 UC	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP	30% coins; $500ded; 7500 max OOP				30% coins; $500ded; 7500 max OOP		30% coins; $500ded; 7500 max OOP															12.1888	0	0.9382	0.1499	0.1829	0.386		0.1352	0.8826	0.5981	2.1829	0	0	0.8389	1.0938	6.1542	0	0.2933	0	0	0.2789				0.1265		0.0061															26.4363	500	9.229125484	31.2394	0	6.073095037	1.283832726	1.826802689	2.797187316	0	1.284367901	5.52829102	3.93857881	24.26031566	0	0	2.842979262	6.722314456	25.79416066	0	4.163994929	0	0	1.153707356	0	0	0	0.126498974	0	0.006126407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.0417
R5595_003_0	2008	4																					10000											D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	10000	1532.309646	0	989.8059476	625.7275237	193.1286663	14.61417095	0	311.2805129	272.8992023	1304.192552	4308.399473	0	32.62869596	559.4753739	3711.668196	4806.961007	0	1086.421994	0	0	8.038494327	0	0	0	529.8032878	0	40.57935921	0	0	0	0											$850/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$250 per procedure	$35 per visit	"$35 X-ray; $150 CAT, PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$20 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															143.7153897	143.7153897	68.6350679	20	100	0.2	0.2	48	250	35	55.7	35	30	35	20	35	35	35	35	35	0.2	0	0	0	0	0	0	0	0	0	0											18.3514	0	5.661283202	1.042879206	1.609405552	2.922834191	0	1.245122052	5.685400048	3.803894943	19.99815422	0	0.08157174	1.631803174	6.186113661	14.02030294	0	3.168730817	0	0	0.000133975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.409	0	0	18.3514	0	5.661283202	1.042879206	1.609405552	2.922834191	0	1.245122052	5.685400048	3.803894943	19.99815422	0	0.08157174	1.631803174	6.186113661	14.02030294	0	3.168730817	0	0	0.000133975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.409	10000	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	0	$50 ER; $35 UC	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	0	0	0	500 ded; 30 % coins; 10000 max OOP	0	500 ded; 30 % coins; 10000 max OOP	0	0	0	0											19.2769	0	1.0815	0.2066	0.1381	0.506	0	0.1685	1.5224	0.7633	1.8692	0	0.0548	1.0149	1.3141	5.5585	0	0.4076	0	0	0.1165	0	0	0	0.0962	0	0.0051	0	0	0	0											34.1001	500	6.930608885	37.6283	0	6.742774429	1.249528067	1.747486309	3.428852563	0	1.413621697	7.207769409	4.567224925	21.86735124	0	0.136397961	2.646716081	7.500221834	19.57876034	0	3.576339088	0	0	0.116589075	0	0	0	0.096175577	0	0.005057811	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.5091
R5595_004_0	2008	3																					7500											D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	7500	1345.970145	0	869.4386662	549.6347087	169.6428784	12.83698621	0	273.4266395	239.7127629	1145.593675	3784.468158	0	28.66081979	491.4392807	3260.303551	4222.401145	0	954.3055304	0	0	7.060957558	0	0	0	465.3755264	0	35.64462715	0	0	0	0											$350/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$250 per procedure	$25 per visit	"$25 X-ray; $125 CAT, PET, MRI"	$25 per visit	$25 per visit	$25 per visit	$10 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script				$0 per visit		$0 per visit															59.17692516	59.17692516	68.6350679	20	100	0.2	0.2	48	250	25	43	25	25	25	10	25	25	25	25	25	0.2	0	0	0	0	0	0	0	0	0	0											6.6375	0	4.972831824	0.916057848	1.413690653	2.567397242	0	1.093706558	4.994015895	2.386653489	13.5610109	0	0.059710041	1.023831835	2.716919626	8.796669053	0	1.988136522	0	0	0.000117683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1283	0	0	6.6375	0	4.972831824	0.916057848	1.413690653	2.567397242	0	1.093706558	4.994015895	2.386653489	13.5610109	0	0.059710041	1.023831835	2.716919626	8.796669053	0	1.988136522	0	0	0.000117683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1283	7500	150 ded; 20 % coins; 7500 max OOP	150 ded; 20 % coins; 7500 max OOP	150 ded; 20 % coins; 7500 max OOP	150 ded; 20 % coins; 7500 max OOP	150 ded; 20 % coins; 7500 max OOP	150 ded; 20 % coins; 7500 max OOP	0	$50 ER; $35 UC	150 ded; 20 % coins; 7500 max OOP	150 ded; 20 % coins; 7500 max OOP	150 ded; 20 % coins; 7500 max OOP	150 ded; 20 % coins; 7500 max OOP	150 ded; 20 % coins; 7500 max OOP	150 ded; 20 % coins; 7500 max OOP	150 ded; 20 % coins; 7500 max OOP	150 ded; 20 % coins; 7500 max OOP	150 ded; 20 % coins; 7500 max OOP	150 ded; 20 % coins; 7500 max OOP	150 ded; 20 % coins; 7500 max OOP	150 ded; 20 % coins; 7500 max OOP	150 ded; 20 % coins; 7500 max OOP	0	0	0	150 ded; 20 % coins; 7500 max OOP	0	150 ded; 20 % coins; 7500 max OOP	0	0	0	0											11.2597	0	0.6317	0.1207	0.0807	0.2956	0	0.1329	0.8892	0.4459	1.0918	0	0.032	0.5928	0.7676	3.2467	0	0.2381	0	0	0.0916	0	0	0	0.0562	0	0.003	0	0	0	0											19.9761	150	3.945831771	17.8972	0	5.604534457	1.036762136	1.494344084	2.862964261	0	1.226624638	5.883236915	2.832517077	14.65281511	0	0.09173422	1.616645848	3.484494592	12.04338256	0	2.226221872	0	0	0.091752512	0	0	0	0.056176475	0	0.002954284	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.1044
R5595_005_0	2008	3																					10000											D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0	10000	1580.558266	0	1020.972476	645.4301276	199.2098078	15.07433486	0	321.0819623	281.4921197	1345.258333	4444.06026	0	33.65609246	577.0918623	3828.539399	4958.320257	0	1120.630722	0	0	8.291606526	0	0	0	546.485476	0	41.85710234	0	0	0	0											$850/admission		"$0 days 1-7, $75 days 8-14; $100 15+"	$20 per visit	$100 per trip	20% coinsurance		$50 ER; $35 UC	$250 per procedure	$35 per visit	"$35 X-ray; $150 CAT, PET, MRI"	$35 per visit	$30 per visit	$35 per visit	$20 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script				$0 per visit		$0 per visit															143.7153897	143.7153897	68.6350679	20	100	0.2	0.2	48	250	35	55.7	35	30	35	20	35	35	35	35	35	0.2	0	0	0	0	0	0	0	0	0	0											18.9292	0	5.839542933	1.075716879	1.660081731	3.014866972	0	1.284327849	5.864419159	3.923670137	20.62784637	0	0.084140231	1.683184598	6.380898998	14.46176742	0	3.268506272	0	0	0.000138193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.0983	0	0	18.9292	0	5.839542933	1.075716879	1.660081731	3.014866972	0	1.284327849	5.864419159	3.923670137	20.62784637	0	0.084140231	1.683184598	6.380898998	14.46176742	0	3.268506272	0	0	0.000138193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.0983	10000	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	0	$50 ER; $35 UC	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	500 ded; 30 % coins; 10000 max OOP	0	0	0	500 ded; 30 % coins; 10000 max OOP	0	500 ded; 30 % coins; 10000 max OOP	0	0	0	0											19.8335	0	1.1127	0.2126	0.1421	0.5206	0	0.1726	1.5663	0.7854	1.9232	0	0.0564	1.0442	1.3521	5.719	0	0.4194	0	0	0.1193	0	0	0	0.099	0	0.0052	0	0	0	0											35.0836	500	6.930608885	38.7627	0	6.952262772	1.288332831	1.80214964	3.535496883	0	1.456977154	7.430747712	4.70904166	22.55101741	0	0.140549588	2.727403633	7.732952715	20.18072811	0	3.687884439	0	0	0.119447725	0	0	0	0.098952696	0	0.005203857	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.1819
R5595_006_0	2008	5																					1000											D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	S			V	V		V																																																								0	1000	2366.93246		1414.348676	1071.898874	310.7956321	18.99428561		452.1770727	439.1677411	1804.480293	7147.28798	0	0	1082.535066	5320.709304	10737.96633	0	2090.853613	0	0	367.5496171			0	1231.986409		73.70031106															$0/day		$0/day 1-100	$0 per visit	$50 per trip	15% coinsurance		$50 ER; $0 UC	$0 per procedure	$0 per visit	"$0 X-ray; $50 CAT, PET, MRI"	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$45 per script			0	$0 per visit		$0 per visit															0		0	0	50	0.15		43.5	0	0	9	0	0	0	0	0	0	0	0	0	45			0	0		0															0	0	0	0	1.294981801	2.849142841	0	1.639141889	0	0	5.360465985	0	0	0	0	0	0	0	0	0	1.378311064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.522		0.29	0	0	0	0	1.294981801	2.849142841	0	1.639141889	0	0	5.360465985	0	0	0	0	0	0	0	0	0	1.378311064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.522	1000	20% coins; $0ded; 1000 max OOP	20% coins; $0ded; 1000 max OOP	20% coins; $0ded; 1000 max OOP	20% coins; $0ded; 1000 max OOP	$50 per trip	20% coins; $0ded; 1000 max OOP		$50 ER; $0 UC	20% coins; $0ded; 1000 max OOP	20% coins; $0ded; 1000 max OOP	20% coins; $0ded; 1000 max OOP	20% coins; $0ded; 1000 max OOP	20% coins; $0ded; 1000 max OOP	20% coins; $0ded; 1000 max OOP	20% coins; $0ded; 1000 max OOP	20% coins; $0ded; 1000 max OOP	20% coins; $0ded; 1000 max OOP	20% coins; $0ded; 1000 max OOP	20% coins; $0ded; 1000 max OOP	20% coins; $0ded; 1000 max OOP	20% coins; $0ded; 1000 max OOP				20% coins; $0ded; 1000 max OOP		20% coins; $0ded; 1000 max OOP															4.777	0	0.3677	0.0588	0.0516	0.1513		0.0653	0.3459	0.2344	0.8555	0	0	0.3288	0.4287	2.4119	0	0.115	0	0	0.1093				0.0496		0.0024															10.3529		13.13496824	4.777	0	0.367709137	0.058757111	1.346552488	3.000426568	0	1.70441823	0.34588408	0.234385838	6.215967402	0	0	0.328795514	0.428674419	2.41190163	0	0.11495808	0	0	1.487607571	0	0	0	0.049576734	0	0.002401025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.875
R5595_801_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1120.904581		824.6364015	815.1343988	178.079616	8.906684778		192.3306454	251.63424	1233.346865	3749.13593	0	127.2139384	676.9557893	3080.10726	5456.732911	0	1190.380571	0	0	6.7532608				601.8784161		53.90787085															$200 per day; max $1400		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20 % per script				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	60.52	40	30	40	30	40	40	40	40	40	0.2				0		0															13.5041	0	6.871970013	2.717114663	2.2259952	2.672005433	0	0.801377689	4.193904	4.111156216	18.90814221	0	0.318034846	2.256519298	7.70026815	18.1891097	0	3.967935238	0	0	1.35065216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.7883			13.5041	0	6.871970013	2.717114663	2.2259952	2.672005433	0	0.801377689	4.193904	4.111156216	18.90814221	0	0.318034846	2.256519298	7.70026815	18.1891097	0	3.967935238	0	0	1.35065216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.7883		500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP		50	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP				500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP															15.8288		1.5822	0.326	0.2124	0.4005		0.1368	1.4541	0.7912	3.369	0	0.3817	1.2239	1.2062	6.806	0	0.4096	0	0	0.3349				0.1212		0.009															34.5936	500		29.3329	0	8.454199603	3.043150075	2.438436185	3.072494476	0	0.938130748	5.647981939	4.902376727	22.27715101	0	0.699761429	3.480411123	8.906443085	24.9951307	0	4.377560672	0	0	1.685589518	0	0	0	0.121155311	0	0.009022405	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.3818
R5595_802_0	2008	3																																D		D	V	T	Coin		V	P	V	V	V	V	V	V	V	V	V	V	V	Coin				V		V																																																								0		1120.904581		824.6364015	815.1343988	178.079616	8.906684778		192.3306454	251.63424	1233.346865	3749.13593	0	127.2139384	676.9557893	3080.10726	5456.732911	0	1190.380571	0	0	6.7532608				601.8784161		53.90787085															$200 per day; max $1400		$100 per day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20 % per script				$0 per visit		$0 per visit															144.57		100	40	150	0.3		50	200	40	60.52	40	30	40	30	40	40	40	40	40	0.2				0		0															13.5041	0	6.871970013	2.717114663	2.2259952	2.672005433	0	0.801377689	4.193904	4.111156216	18.90814221	0	0.318034846	2.256519298	7.70026815	18.1891097	0	3.967935238	0	0	1.35065216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.7883			13.5041	0	6.871970013	2.717114663	2.2259952	2.672005433	0	0.801377689	4.193904	4.111156216	18.90814221	0	0.318034846	2.256519298	7.70026815	18.1891097	0	3.967935238	0	0	1.35065216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.7883		500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP		50	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP	500 ded; 30 % coins;  No max OOP				500 ded; 30 % coins;  No max OOP		500 ded; 30 % coins;  No max OOP															15.8288		1.5822	0.326	0.2124	0.4005		0.1368	1.4541	0.7912	3.369	0	0.3817	1.2239	1.2062	6.806	0	0.4096	0	0	0.3349				0.1212		0.009															34.5936	500		29.3329	0	8.454199603	3.043150075	2.438436185	3.072494476	0	0.938130748	5.647981939	4.902376727	22.27715101	0	0.699761429	3.480411123	8.906443085	24.9951307	0	4.377560672	0	0	1.685589518	0	0	0	0.121155311	0	0.009022405	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.3818
R5595_803_0	2008	4																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1220.763619	0	458.7764465	275.8230862	183.4827177	11.85771185	0	316.9953314	259.2690576	1403.660381	4203.823728	0	0	480.3582099	3624.689861	4279.53948	0	1004.386087	0	0	6.958161032	0	0	0	508.4617499	0	29.25396369	0	0	0	0											$200/day; $1400 max		$100/day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$39.5 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											14.7071	0	3.823137054	0.919410287	2.293533971	3.557313554	0	1.320813881	4.32115096	4.678867935	19.2465063	0	0	1.601194033	9.061724653	14.08681745	0	3.347953622	0	0	0.000115969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9657	0	0	14.7071	0	3.823137054	0.919410287	2.293533971	3.557313554	0	1.320813881	4.32115096	4.678867935	19.2465063	0	0	1.601194033	9.061724653	14.08681745	0	3.347953622	0	0	0.000115969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9657		500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	0	$50 per visit	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	0	0	0	500 ded; 30% coins; No max OOP	0	500 ded; 30% coins; No max OOP	0	0	0	0											14.0745	0	0.7384	0.1299	0.1799	0.3684	0	0.1356	1.3681	0.7988	2.5128	0	0	0.9832	1.2178	5.3938	0	0.4136	0	0	0.0367	0	0	0	0.1118	0	0.0043	0	0	0	0											28.4674	0	0	28.7816	0	4.561530526	1.049307953	2.473427812	3.925714883	0	1.456383176	5.689201484	5.477691475	21.75927286	0	0	2.584384203	10.27949001	19.48062794	0	3.761515246	0	0	0.036779654	0	0	0	0.111775588	0	0.004343967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.433
R5595_804_0	2008	4																																D		D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S				V		V																																																								0		1220.763619	0	458.7764465	275.8230862	183.4827177	11.85771185	0	316.9953314	259.2690576	1403.660381	4203.823728	0	0	480.3582099	3624.689861	4279.53948	0	1004.386087	0	0	6.958161032	0	0	0	508.4617499	0	29.25396369	0	0	0	0											$200/day; $1400 max		$100/day	$40 per visit	$150 per trip	30% coinsurance		$50 per visit	$200 per procedure	$40 per visit	"$40 X-ray; 20% CAT, PET, MRI"	$40 per visit	$30 per visit	$40 per visit	$30 per visit	$39.5 per visit	$40 per visit	$40 per visit	$40 per visit	$40 per visit	20% coinsurance				$0 per visit		$0 per visit															144.57	144.57	100	40	150	0.3	0.3	50	200	40	54.94	40	30	40	30	39.5	40	40	40	40	0.2	0	0	0	0	0	0	0	0	0	0											14.7071	0	3.823137054	0.919410287	2.293533971	3.557313554	0	1.320813881	4.32115096	4.678867935	19.2465063	0	0	1.601194033	9.061724653	14.08681745	0	3.347953622	0	0	0.000115969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9657	0	0	14.7071	0	3.823137054	0.919410287	2.293533971	3.557313554	0	1.320813881	4.32115096	4.678867935	19.2465063	0	0	1.601194033	9.061724653	14.08681745	0	3.347953622	0	0	0.000115969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9657		500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	0	$50 per visit	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	500 ded; 30% coins; No max OOP	0	0	0	500 ded; 30% coins; No max OOP	0	500 ded; 30% coins; No max OOP	0	0	0	0											14.0745	0	0.7384	0.1299	0.1799	0.3684	0	0.1356	1.3681	0.7988	2.5128	0	0	0.9832	1.2178	5.3938	0	0.4136	0	0	0.0367	0	0	0	0.1118	0	0.0043	0	0	0	0											28.4674	0	0	28.7816	0	4.561530526	1.049307953	2.473427812	3.925714883	0	1.456383176	5.689201484	5.477691475	21.75927286	0	0	2.584384203	10.27949001	19.48062794	0	3.761515246	0	0	0.036779654	0	0	0	0.111775588	0	0.004343967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.433
R5674_001_0	2008	8							h.1.	h.2.									OP Facility - Other	OP Facility - Other										Complex diag	PET scans			A	A	D		Coin	Coin	Coin	V	V		Coin					V	V	V	V	V	Coin																	P	V			4.5826		0.3622	0.2756	0.1634	0.4443		0.2205	0.5444	1.1279					3.6229						0.2568																					11.6006		362.3568393	28.46636614	1500.132659		7.933604319	8.62639964	12.93959946	294.4052524	368.91352		27.37561079				22193.50197	7979.770963	128.7988668	728.2596335	2715.871657		12.46804587																	45.288257	3.802524			$300/Stay	$300/Stay	$50/Day > 20	No cost sharing	40% coinsurance	20% coinsurance	20% coinsurance	$50/visit	$50/visit	No cost sharing	20% coinsurance	No cost sharing	No cost sharing	No cost sharing	$10/visit	$25/visit	$25/visit	$25/visit	$25/visit	No cost sharing	20% coinsurance																	50	200			250.3116	250.3116	44.0363	0	0.3522904	0.1761452	0.1761452	44.0363	44.0363	0	0.1761452	0	0	0	8.80726	22.01815	22.01815	22.01815	22.01815	0	0.1761452																	42.75	171			7.5585	0.593788471	5.505024317	0	2.794932639	1.51949889	2.279248335	1.080376501	1.35379887	0	4.822082437	0	0	0	16.28866184	14.6416495	0.236326064	1.336244154	4.983205794	0	2.196186433	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.161339416	0.054185967	0	0	67.4051	200	7.046956474	12.1411	0.593788471	5.867266003	0.275585632	2.958364888	1.963758471	2.279248335	1.30086215	1.898248844	1.127875164	4.822082437	0	0	0	19.91153131	14.6416495	0.236326064	1.336244154	4.983205794	0	2.453028178	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.161339416	0.054185967	0	0	79.0057	3500	"$200/Day, days 1-4"	"$200/Day, days 1-4"	0.4	30% coins	40% - not l.t. $100	25% coins	25% coins	50	50	None	0.4	None	None	None	$20/visit	$40/visit	$40/visit	$40/visit	$40/visit	None	25 % Coins	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	40% coins	40% coins	None	None	0.8153	0.064	0.3165	0.1806	0.1428	0.097	0.1456	0.0552	0.0692	0	0.2264	0	0	0	1.6645	1.197	0.0193	0.1092	0.4074	0	0.1403																	0.8152	0.0684			6.534	200	0.491804421	12.9564	0.657837795	6.183787865	0.456187867	3.101169766	2.060805467	2.424818829	1.356063135	1.967420129	1.127875164	5.048467121	0	0	0	21.57604396	15.83861515	0.255645894	1.445483099	5.390586543	0	2.593293694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.976528042	0.122631399	0	0	85.5396
R5674_801_0	2008	6							h.1.	h.2.									OP Facility - Other	OP Facility - Other										Complex diag	PET scans			A	A	D		Coin	Coin	Coin	V	V		Coin					V	V	V	V	V	Coin																	P	V			2.2635	0.1284	0.8593	0.0276	0.4717	0.216	0.324	0.1692	0.2148	0	0.6961	0	0	0	2.3511	2.2119	0.0408	0.2496	0.7729	0	0.2856																					11.2826		362.3568393	28.46636614	1500.132659		7.933604332	8.626399659	12.93959949	294.4052524	368.91352		27.37561083				22193.50197	7979.770963	128.7988668	728.2596335	2715.871657		12.46804589																	45.288257	3.802524			$100/Stay	$100/Stay	$50/Day > 20	No cost sharing	40% coinsurance	20% coinsurance	20% coinsurance	$50/visit	$50/visit	No cost sharing	20% coinsurance	No cost sharing	No cost sharing	No cost sharing	$10/visit	$25/visit	$25/visit	$25/visit	$25/visit	No cost sharing	20% coinsurance																	50	200			89.87	89.87	44.935	0	0.35948	0.17974	0.17974	44.935	44.935	0	0.17974	0	0	0	8.987	22.4675	22.4675	22.4675	22.4675	0	0.17974																	44.935	179.74			2.7138	0.21318936	5.617371752	0	2.851972085	1.550509075	2.325763612	1.102425001	1.381427418	0	4.92049229	0	0	0	16.62108352	14.94045868	0.241149045	1.363514443	5.084903872	0	2.241006568	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	63.3956	200	6.627777565	4.9772	0.341605202	6.476677757	0.027603405	3.32363027	1.766535724	2.649803586	1.271645877	1.59625392	0	5.616578161	0	0	0	18.97217355	17.15233154	0.281954079	1.613145238	5.857799217	0	2.526641804	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	74.6782	3500	"$200/Day, days 1-4"	"$200/Day, days 1-4"	0.4	30% coins	40% - not l.t. $100	25% coins	25% coins	50	50	None	0.4	None	None	None	$20/visit	$40/visit	$40/visit	$40/visit	$40/visit	None	25 % Coins	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	40% coins	40% coins	None	None	0.857	0.0673	0.3327	0.1898	0.1501	0.102	0.153	0.058	0.0727	0	0.238	0	0	0	1.7496	1.2581	0.0203	0.1148	0.4282	0	0.1474																	0.8569	0.0719			6.8679	200	0.516941091	5.8342	0.408928158	6.809377403	0.217436421	3.473734064	1.8685429	2.80281435	1.329668245	1.668960626	0	5.854533618	0	0	0	20.72176129	18.41047543	0.302261367	1.727967507	6.286001649	0	2.674076447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.026439475	0.128899226	0	0	81.5461
R5674_802_0	2008	6							h.1.	h.2.									OP Facility - Other	OP Facility - Other										Complex diag	PET scans			A	A	D		Coin	Coin	Coin	V	V		Coin					V	V	V	V	V	Coin																	P	V			2.2635	0.1284	0.8593	0.0276	0.4717	0.216	0.324	0.1692	0.2148	0	0.6961	0	0	0	2.3511	2.2119	0.0408	0.2496	0.7729	0	0.2856																					11.2826		362.3568393	28.46636614	1500.132659		7.933604318	8.626399639	12.93959946	294.4052524	368.91352		27.37561078				22193.50197	7979.770963	128.7988668	728.2596335	2715.871657		12.46804587																	45.288257	3.802524			$100/Stay	$100/Stay	$50/Day > 20	No cost sharing	40% coinsurance	20% coinsurance	20% coinsurance	$50/visit	$50/visit	No cost sharing	20% coinsurance	No cost sharing	No cost sharing	No cost sharing	$10/visit	$25/visit	$25/visit	$25/visit	$25/visit	No cost sharing	20% coinsurance																	50	200			89.87	89.87	44.935	0	0.35948	0.17974	0.17974	44.935	44.935	0	0.17974	0	0	0	8.987	22.4675	22.4675	22.4675	22.4675	0	0.17974																	44.935	179.74			2.7138	0.21318936	5.617371752	0	2.85197208	1.550509071	2.325763607	1.102425001	1.381427418	0	4.920492282	0	0	0	16.62108352	14.94045868	0.241149045	1.363514443	5.084903872	0	2.241006564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	63.3956	200	6.627777562	4.9772	0.341605202	6.476677757	0.027603405	3.323630265	1.76653572	2.649803581	1.271645877	1.59625392	0	5.616578152	0	0	0	18.97217355	17.15233154	0.281954079	1.613145238	5.857799217	0	2.5266418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	74.6782	3500	"$200/Day, days 1-4"	"$200/Day, days 1-4"	0.4	30% coins	40% - not l.t. $100	25% coins	25% coins	50	50	None	0.4	None	None	None	$20/visit	$40/visit	$40/visit	$40/visit	$40/visit	None	25 % Coins	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	40% coins	40% coins	None	None	0.857	0.0673	0.3327	0.1898	0.1501	0.102	0.153	0.058	0.0727	0	0.238	0	0	0	1.7496	1.2581	0.0203	0.1148	0.4282	0	0.1474																	0.8569	0.0719			6.8679	200	0.516941091	5.8342	0.408928158	6.809377403	0.217436421	3.473734058	1.868542896	2.802814344	1.329668245	1.668960626	0	5.854533609	0	0	0	20.72176129	18.41047543	0.302261367	1.727967507	6.286001649	0	2.674076443	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.026439475	0.128899226	0	0	81.5461
R5674_803_0	2008	6							h.1.	h.2.									OP Facility - Other	OP Facility - Other										Complex diag	PET scans			A	A	D		Coin	Coin	Coin	V	V		Coin					V	V	V	V	V	Coin																	P	V			2.2635	0.1284	0.8593	0.0276	0.4717	0.216	0.324	0.1692	0.2148	0	0.6961	0	0	0	2.3511	2.2119	0.0408	0.2496	0.7729	0	0.2856																					11.2826		362.3568393	28.46636614	1500.132659		7.933604318	8.626399639	12.93959946	294.4052524	368.91352		27.37561078				22193.50197	7979.770963	128.7988668	728.2596335	2715.871657		12.46804587																	45.288257	3.802524			$100/Stay	$100/Stay	$50/Day > 20	No cost sharing	40% coinsurance	20% coinsurance	20% coinsurance	$50/visit	$50/visit	No cost sharing	20% coinsurance	No cost sharing	No cost sharing	No cost sharing	$10/visit	$25/visit	$25/visit	$25/visit	$25/visit	No cost sharing	20% coinsurance																	50	200			89.87	89.87	44.935	0	0.35948	0.17974	0.17974	44.935	44.935	0	0.17974	0	0	0	8.987	22.4675	22.4675	22.4675	22.4675	0	0.17974																	44.935	179.74			2.7138	0.21318936	5.617371752	0	2.85197208	1.550509071	2.325763607	1.102425001	1.381427418	0	4.920492282	0	0	0	16.62108352	14.94045868	0.241149045	1.363514443	5.084903872	0	2.241006564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	63.3956	200	6.627777562	4.9772	0.341605202	6.476677757	0.027603405	3.323630265	1.76653572	2.649803581	1.271645877	1.59625392	0	5.616578152	0	0	0	18.97217355	17.15233154	0.281954079	1.613145238	5.857799217	0	2.5266418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	74.6782	3500	"$200/Day, days 1-4"	"$200/Day, days 1-4"	0.4	30% coins	40% - not l.t. $100	25% coins	25% coins	50	50	None	0.4	None	None	None	$20/visit	$40/visit	$40/visit	$40/visit	$40/visit	None	25 % Coins	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	None	40% coins	40% coins	None	None	0.857	0.0673	0.3327	0.1898	0.1501	0.102	0.153	0.058	0.0727	0	0.238	0	0	0	1.7496	1.2581	0.0203	0.1148	0.4282	0	0.1474																	0.8569	0.0719			6.8679	200	0.392038381	5.8342	0.408928158	6.809377403	0.217436421	3.473734058	1.868542896	2.802814344	1.329668245	1.668960626	0	5.854533609	0	0	0	20.72176129	18.41047543	0.302261367	1.727967507	6.286001649	0	2.674076443	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.026439475	0.128899226	0	0	81.5461
R5826_001_0	2008	10	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		238.516864	5.151652	575.499907	27.987128	84.888579	7.891309	3.920839	340.660204	296.835259	5109.882203	3335.472551		9.699476	1190.730639	7519.81437	5370.215253	20.457357	1428.451241			12.208397			2.53	1.82					0.08		29.943222	3.4	0.02								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	Silver Sneakers	QUIT NET								445.270102	445.269377	23.245183	0	80.95822	0.161916	0.161916	40.479113	71.146146	0	40.479099		40.478615	40.479094	8.09582	24.287459	24.287273	40.479098			0.161916			0	0					0		40.478962	0	0								8.8504	0.191156073	1.114800055	0	0.572702355	1.277729188	0.634846568	1.149135241	1.75989039	0	11.2514103	0	0.032718446	4.016641455	5.073255298	10.86907356	0.041404451	4.818534814	0	0	1.976734809	0	0	0	0	0	0	0	0	0	0	0.101005879	0	0	0	0	0	0	0	0	0	53.7314	0	12.63791584	8.8504	0.191156073	1.114800055	0	0.572702355	1.277729188	0.634846568	1.149135241	1.75989039	0	11.2514103	0	0.032718446	4.016641455	5.073255298	10.86907356	0.041404451	4.818534814	0	0	1.976734809	0	0	0	0	0	0	0	0	0	0	0.101005879	0	0	0	0	0	0	0	0	0	53.7314	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	Silver Sneakers	QUIT NET								3.0354	0.0656	0.9957	1.8202	0.7652	2.8304	1.4063	0.271	3.5145	1.1819	2.8006		0.0077	1.5296	5.9311	5.0804	0.0645	0.361			0.7406			0.84	0					0		0.0609	0	0								33.3029	500	5.714468554	11.8858	0.256717625	2.110498825	1.820210364	1.337924273	4.108177869	2.041170425	1.420092631	5.274425755	1.18191119	14.05204431	0	0.040433352	5.546218825	11.00434851	15.94950542	0.105948095	5.179571189	0	0	2.717379798	0	0	0.84	0	0	0	0	0	0	0	0.161921397	0	0	0	0	0	0	0	0	0	87.0343
R5826_002_0	2008	14	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		243.310394	5.255187	587.065863	28.549592	86.594605	8.211676	4.080015	347.506532	302.800828	5212.576707	3402.506326		9.894409	1214.661033	7670.941848	5478.141732	20.868493	1457.15916			12.704027			2.99	1.82					0.08		30.544998	3.4	0.02								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	Silver Sneakers	QUIT NET								442.504684	442.505182	23.100816	0	80.455432	0.16091	0.16091	40.227703	70.704256	0	40.227698		40.227988	40.227702	8.04554	24.136619	24.136512	40.227703			0.16091			0	0					0		40.227755	0	0								8.9722	0.19378729	1.130141707	0	0.580583863	1.321340785	0.656515214	1.16494913	1.784108938	0	11.40624974	0	0.033169347	4.071918506	5.143072456	11.01865165	0.041974386	4.884847159	0	0	2.044204985	0	0	0	0	0	0	0	0	0	0	0.102396391	0	0	0	0	0	0	0	0	0	54.5501	0	13.25156344	8.9722	0.19378729	1.130141707	0	0.580583863	1.321340785	0.656515214	1.16494913	1.784108938	0	11.40624974	0	0.033169347	4.071918506	5.143072456	11.01865165	0.041974386	4.884847159	0	0	2.044204985	0	0	0	0	0	0	0	0	0	0	0.102396391	0	0	0	0	0	0	0	0	0	54.5501	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	Silver Sneakers	QUIT NET								3.0634	0.0662	1.0251	1.8739	0.7723	2.914	1.4478	0.2735	3.6182	1.2168	2.8833		0.0078	1.5747	5.9858	5.1273	0.0651	0.3717			0.7625			1	0					0		0.0627	0	0								34.1119	500	6.047100217	12.0356	0.259953352	2.155216948	1.873911347	1.352862284	4.235296233	2.104329367	1.438406123	5.402332795	1.21678195	14.28951084	0	0.040955038	5.646621755	11.12885896	16.14593281	0.107113057	5.256535486	0	0	2.806700726	0	0	1	0	0	0	0	0	0	0	0.165108924	0	0	0	0	0	0	0	0	0	88.662
R5826_003_0	2008	14	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		229.309655	4.952789	553.284505	26.906772	81.611717	7.293828	3.623977	327.510066	285.376848	4912.630937	3206.716903		9.325058	1144.76615	7229.535094	5162.914631	19.667662	1373.31028			11.284054			2.75	1.82					0.08		28.787356	3.4	0.02								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	Silver Sneakers	QUIT NET								450.652406	450.652739	23.526166	0	81.936843	0.163873	0.163873	40.968391	72.006136	0	40.968401		40.967969	40.9684	8.19368	24.581038	24.580962	40.968398			0.163873			0	0					0		40.968291	0	0								8.6116	0.185998994	1.084721926	0	0.557250537	1.195261476	0.593871983	1.118130037	1.712407011	0	10.94783866	0	0.031835724	3.908269795	4.936374759	10.57581673	0.040287504	4.688526844	0	0	1.849151781	0	0	0	0	0	0	0	0	0	0	0.098280731	0	0	0	0	0	0	0	0	0	52.1356	0	11.49344509	8.6116	0.185998994	1.084721926	0	0.557250537	1.195261476	0.593871983	1.118130037	1.712407011	0	10.94783866	0	0.031835724	3.908269795	4.936374759	10.57581673	0.040287504	4.688526844	0	0	1.849151781	0	0	0	0	0	0	0	0	0	0	0.098280731	0	0	0	0	0	0	0	0	0	52.1356	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	Silver Sneakers	QUIT NET								2.9809	0.0644	0.9401	1.7185	0.7515	2.6723	1.3277	0.2661	3.3182	1.1159	2.6442		0.0076	1.4441	5.8245	4.9892	0.0634	0.3409			0.6993			0.92	0					0		0.0575	0	0								32.1461	500	5.10468615	11.5925	0.250382337	2.024788569	1.718509747	1.308726182	3.867565789	1.921619874	1.384220158	5.030575657	1.115874451	13.59199322	0	0.03941238	5.352385706	10.7609215	15.56498329	0.103671971	5.029391277	0	0	2.54841513	0	0	0.92	0	0	0	0	0	0	0	0.155792378	0	0	0	0	0	0	0	0	0	84.2817
R5826_004_0	2008	13	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		239.758872	5.178478	578.496657	28.132863	85.330613	7.973704	3.961777	342.434095	298.380944	5136.490445	3352.841063		9.749983	1196.931025	7558.971641	5398.179105	20.563882	1435.889489			12.335869			5.61	1.82					0.08		30.099142	3.4	0.02								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  25-75%	$200 allowance					Active Outlook Newsletter		$50/Visit	Silver Sneakers	QUIT NET								444.551787	444.551972	23.207678	0	80.827549	0.161655	0.161655	40.413807	71.031356	0	40.413802		40.41387	40.413795	8.082759	24.24828	24.248419	40.4138			0.161655			0.352941176	0					0		40.41377	0	0								8.8821	0.191841884	1.118797012	0	0.574755359	1.28898912	0.640441061	1.153255452	1.766200255	0	11.29175457	0	0.032836212	4.031043756	5.091445505	10.90804654	0.041553469	4.835812553	0	0	1.994154903	0	0	1.98	0	0	0	0	0	0	0	0.101368317	0	0	0	0	0	0	0	0	0	55.9244	0	12.7956751	8.8821	0.191841884	1.118797012	0	0.574755359	1.28898912	0.640441061	1.153255452	1.766200255	0	11.29175457	0	0.032836212	4.031043756	5.091445505	10.90804654	0.041553469	4.835812553	0	0	1.994154903	0	0	1.98	0	0	0	0	0	0	0	0.101368317	0	0	0	0	0	0	0	0	0	55.9244	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50-80%	$200 allowance					Active Outlook Newsletter		30% Coins	Silver Sneakers	QUIT NET								3.0427	0.0657	1.0033	1.8341	0.7671	2.852	1.417	0.2716	3.5413	1.1909	2.822		0.0077	1.5412	5.9453	5.0926	0.0647	0.3638			0.7463			1.48	0					0		0.0614	0	0								34.1108	500	5.799616873	11.9248	0.257560072	2.1220816	1.834077135	1.341812384	4.141001868	2.057478509	1.424863591	5.307510211	1.19091631	14.1137242	0	0.040569477	5.572272971	11.03676742	16.00066624	0.106252277	5.199599612	0	0	2.740442466	0	0	3.46	0	0	0	0	0	0	0	0.162747938	0	0	0	0	0	0	0	0	0	90.0352
R5826_005_0	2008	15	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		238.03391	5.141221	574.33462	27.930459	84.716695	7.859382	3.904976	339.970426	296.23422	5099.535581	3328.718799		9.679836	1188.319617	7504.588054	5359.341502	20.415934	1425.558876			12.159004			1.19	1.82					0.08		29.882592	0.02	3.4								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	QUIT NET	Silver Sneakers								445.550068	445.54949	23.259801	0	81.009047	0.162018	0.162018	40.504537	71.190864	0	40.504548		40.504901	40.504552	8.100909	24.30273	24.302808	40.504552			0.162018			0	0					0		40.504615	0	0								8.838	0.190889033	1.113242414	0	0.571901561	1.273361353	0.632676402	1.147528725	1.757430839	0	11.23568753	0	0.0326734	4.011029477	5.066165409	10.85388579	0.041347044	4.811801969	0	0	1.96997751	0	0	0	0	0	0	0	0	0	0	0.10086524	0	0	0	0	0	0	0	0	0	53.6485	0	12.5767691	8.838	0.190889033	1.113242414	0	0.571901561	1.273361353	0.632676402	1.147528725	1.757430839	0	11.23568753	0	0.0326734	4.011029477	5.066165409	10.85388579	0.041347044	4.811801969	0	0	1.96997751	0	0	0	0	0	0	0	0	0	0	0.10086524	0	0	0	0	0	0	0	0	0	53.6485	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	QUIT NET	Silver Sneakers								3.0326	0.0655	0.9928	1.8148	0.7645	2.8221	1.4022	0.2707	3.5041	1.1784	2.7923		0.0077	1.5251	5.9256	5.0757	0.0645	0.36			0.7385			0.4	0					0		0.0607	0	0								32.7977	500	5.68153547	11.8706	0.256389026	2.105996409	1.814826824	1.336407817	4.095439128	2.034840817	1.418233151	5.261570538	1.17841618	14.02803718	0	0.040381575	5.536081777	10.99171699	15.92957158	0.105830181	5.171770913	0	0	2.708432128	0	0	0.4	0	0	0	0	0	0	0	0.161600416	0	0	0	0	0	0	0	0	0	86.4461
R5826_006_0	2008	13	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		237.415926	5.127874	572.84353	27.857946	84.496753	7.818619	3.884723	339.087795	295.465136	5086.296156	3320.076772		9.654705	1185.234498	7485.104627	5345.427567	20.36293	1421.857837			12.095942			3.5	1.82					0.08		29.80501	3.4	0.02								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	Silver Sneakers	QUIT NET								445.907538	445.908388	23.27846	0	81.074145	0.162148	0.162148	40.537055	71.247962	0	40.537049		40.537112	40.537049	8.107409	24.322228	24.322074	40.537052			0.162148			0	0					0		40.537199	0	0								8.8221	0.190546836	1.111242933	0	0.570875167	1.267773434	0.629900065	1.145468383	1.754274065	0	11.21550957	0	0.032614488	4.003825743	5.057067052	10.83439234	0.041272391	4.803160423	0	0	1.961332803	0	0	0	0	0	0	0	0	0	0	0.100684302	0	0	0	0	0	0	0	0	0	53.5421	0	12.49883696	8.8221	0.190546836	1.111242933	0	0.570875167	1.267773434	0.629900065	1.145468383	1.754274065	0	11.21550957	0	0.032614488	4.003825743	5.057067052	10.83439234	0.041272391	4.803160423	0	0	1.961332803	0	0	0	0	0	0	0	0	0	0	0.100684302	0	0	0	0	0	0	0	0	0	53.5421	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	Silver Sneakers	QUIT NET								3.029	0.0654	0.989	1.8079	0.7636	2.8114	1.3968	0.2704	3.4908	1.1739	2.7818		0.0077	1.5193	5.9184	5.0696	0.0644	0.3586			0.7357			1.17	0					0		0.0605	0	0								33.4842	500	5.639607626	11.8511	0.255968329	2.100232249	1.807943261	1.334465707	4.079147364	2.026745673	1.41584823	5.245123639	1.173947528	13.9972688	0	0.040312857	5.523093738	10.97551403	15.90399306	0.105678857	5.161764073	0	0	2.696986258	0	0	1.17	0	0	0	0	0	0	0	0.161188989	0	0	0	0	0	0	0	0	0	87.0263
R5826_007_0	2008	12	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		232.757641	5.027261	561.603896	27.311351	82.838862	7.514813	3.733775	332.434629	289.66788	4986.499075	3254.934287		9.465273	1161.979278	7338.241062	5240.546129	19.963394	1393.959881			11.625932			2.69	1.82					0.08		29.220212	3.4	0.02								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	Silver Sneakers	QUIT NET								448.620719	448.620449	23.420103	0	81.567417	0.163134	0.163134	40.783691	71.681517	0	40.783696		40.784074	40.783705	8.15674	24.470219	24.469982	40.783698			0.163134			0	0					0		40.783739	0	0								8.7017	0.187944341	1.096068424	0	0.563079333	1.225921504	0.609105651	1.129825932	1.730319422	0	11.06235421	0	0.032169366	3.949151674	4.988010367	10.68644262	0.040708658	4.737569901	0	0	1.896584791	0	0	0	0	0	0	0	0	0	0	0.099309125	0	0	0	0	0	0	0	0	0	52.7362	0	11.91733542	8.7017	0.187944341	1.096068424	0	0.563079333	1.225921504	0.609105651	1.129825932	1.730319422	0	11.06235421	0	0.032169366	3.949151674	4.988010367	10.68644262	0.040708658	4.737569901	0	0	1.896584791	0	0	0	0	0	0	0	0	0	0	0.099309125	0	0	0	0	0	0	0	0	0	52.7362	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	Silver Sneakers	QUIT NET								3.0014	0.0648	0.9608	1.7564	0.7566	2.7311	1.357	0.2679	3.3912	1.1404	2.7024		0.0076	1.4759	5.8646	5.0235	0.0638	0.3484			0.7147			0.9	0					0		0.0588	0	0								32.5874	500	5.328848439	11.7031	0.2527706	2.056836254	1.756351676	1.319726212	3.957070769	1.966092536	1.397747217	5.121554647	1.140447404	13.76473479	0	0.039798048	5.425068177	10.85264076	15.70994397	0.104529817	5.085939802	0	0	2.611246516	0	0	0.9	0	0	0	0	0	0	0	0.158088339	0	0	0	0	0	0	0	0	0	85.3237
R5826_008_0	2008	10	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		236.000494	5.097301	569.428338	27.691862	83.992998	7.725672	3.838541	337.066213	293.703624	5055.972556	3300.28306		9.597146	1178.16834	7440.479756	5313.559073	20.241531	1413.380971			11.952145			6.06	1.82					0.08		29.627319	3.4	0.02								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  25-75%	$200 allowance					Active Outlook Newsletter		$50/Visit	Silver Sneakers	QUIT NET								446.729787	446.729234	23.321378	0	81.22364	0.162447	0.162447	40.611812	71.379348	0	40.611798		40.61169	40.611802	8.12236	24.36708	24.367163	40.611797			0.162447			0.353135314	0					0		40.611746	0	0								8.7857	0.189759448	1.10665446	0	0.568518086	1.255012239	0.62355947	1.140739139	1.747031099	0	11.16920241	0	0.032479693	3.987294946	5.036187929	10.78965992	0.04110239	4.783328423	0	0	1.941590099	0	0	2.14	0	0	0	0	0	0	0	0.100268096	0	0	0	0	0	0	0	0	0	55.4381	0	12.32088197	8.7857	0.189759448	1.10665446	0	0.568518086	1.255012239	0.62355947	1.140739139	1.747031099	0	11.16920241	0	0.032479693	3.987294946	5.036187929	10.78965992	0.04110239	4.783328423	0	0	1.941590099	0	0	2.14	0	0	0	0	0	0	0	0.100268096	0	0	0	0	0	0	0	0	0	55.4381	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50-80%	$200 allowance					Active Outlook Newsletter		30% Coins	Silver Sneakers	QUIT NET								3.0206	0.0652	0.9804	1.7922	0.7615	2.7869	1.3847	0.2696	3.4605	1.1637	2.7576		0.0077	1.5061	5.9022	5.0556	0.0642	0.3555			0.7293			1.6	0					0		0.06	0	0								33.7234	500	5.544129409	11.8063	0.255000434	2.087040403	1.792215629	1.330005986	4.041929882	2.008255015	1.410374974	5.207514491	1.163734787	13.92676335	0	0.040157215	5.493345819	10.93833873	15.8453	0.105331602	5.138812814	0	0	2.670843721	0	0	3.74	0	0	0	0	0	0	0	0.160246765	0	0	0	0	0	0	0	0	0	89.1615
R5826_009_0	2008	12	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		223.158071	4.819922	538.441796	26.184955	79.422357	6.907742	3.432148	318.724104	277.721175	4780.842044	3120.691783		9.074899	1114.056034	7035.59168	5024.411492	19.140048	1336.469116			10.686752			7.16	1.82					0.08		28.015091	3.4	0.02								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  25-75%	$200 allowance					Active Outlook Newsletter		$50/Visit	Silver Sneakers	Quit Net								454.266438	454.266262	23.714825	0	82.593903	0.165187	0.165187	41.296946	72.5836	0	41.296951		41.296863	41.296957	8.259389	24.778168	24.778107	41.296947			0.165187			0.353351955	0					0		41.29711	0	0								8.4478	0.182460663	1.064087747	0	0.546650204	1.141069178	0.566946232	1.096861009	1.679833556	0	10.73958797	0	0.031230405	3.833927011	4.842474044	10.37464267	0.03952118	4.599341188	0	0	1.765312503	0	0	2.53	0	0	0	0	0	0	0	0.096411858	0	0	0	0	0	0	0	0	0	53.5781	0	10.75804724	8.4478	0.182460663	1.064087747	0	0.546650204	1.141069178	0.566946232	1.096861009	1.679833556	0	10.73958797	0	0.031230405	3.833927011	4.842474044	10.37464267	0.03952118	4.599341188	0	0	1.765312503	0	0	2.53	0	0	0	0	0	0	0	0.096411858	0	0	0	0	0	0	0	0	0	53.5781	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50-80%	$200 allowance					Active Outlook Newsletter		30% Coins	Silver Sneakers	Quit Net								2.9437	0.0636	0.9034	1.6516	0.7421	2.5682	1.276	0.2628	3.1889	1.0724	2.5411		0.0075	1.3879	5.7519	4.927	0.0626	0.3276			0.672			1.89	0					0		0.0553	0	0								32.2956	500	4.720083328	11.3915	0.246041484	1.967530799	1.65155851	1.288756852	3.709263438	1.842966955	1.35963408	4.868730471	1.072401755	13.28072969	0	0.038712546	5.221780686	10.59440632	15.30161084	0.102115296	4.926926219	0	0	2.437332801	0	0	4.42	0	0	0	0	0	0	0	0.151683051	0	0	0	0	0	0	0	0	0	85.8737
R5826_010_0	2008	12	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		242.895601	5.246227	586.065039	28.50092	86.446979	8.183705	4.066118	346.914106	302.284615	5203.690349	3396.705761		9.877541	1212.590287	7657.864489	5468.802642	20.832916	1454.675008			12.660754			5.53	1.82					0.08		30.492925	0.02	3.4								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  25-75%	$200 allowance					Active Outlook Newsletter		$50/Visit	QUIT NET	Silver Sneakers								442.743398	442.743269	23.113272	0	80.498745	0.160997	0.160997	40.249387	70.742409	0	40.2494		40.248988	40.249403	8.04988	24.149638	24.149505	40.2494			0.160997			0.352622061	0					0		40.249446	0	0								8.9617	0.193560974	1.128823388	0	0.57990611	1.317551954	0.6546328	1.163590009	1.782028489	0	11.3929474	0	0.033130086	4.067169595	5.137074183	11.00580034	0.041925384	4.879149689	0	0	2.038343412	0	0	1.95	0	0	0	0	0	0	0	0.102276945	0	0	0	0	0	0	0	0	0	56.4296	0	13.1979377	8.9617	0.193560974	1.128823388	0	0.57990611	1.317551954	0.6546328	1.163590009	1.782028489	0	11.3929474	0	0.033130086	4.067169595	5.137074183	11.00580034	0.041925384	4.879149689	0	0	2.038343412	0	0	1.95	0	0	0	0	0	0	0	0.102276945	0	0	0	0	0	0	0	0	0	56.4296	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50-80%	$200 allowance					Active Outlook Newsletter		30% Coins	QUIT NET	Silver Sneakers								3.061	0.0661	1.0225	1.8692	0.7717	2.9067	1.4442	0.2732	3.6092	1.2138	2.8761		0.0078	1.5708	5.9811	5.1232	0.0651	0.3708			0.7606			1.46	0					0		0.0626	0	0								34.5156	500	6.017882718	12.0227	0.259674327	2.151345874	1.869245797	1.351575982	4.224251443	2.098842148	1.436831398	5.391243411	1.213752039	14.26902823	0	0.040910081	5.637953022	11.11815064	16.12904747	0.107013616	5.249912559	0	0	2.798940476	0	0	3.41	0	0	0	0	0	0	0	0.164833974	0	0	0	0	0	0	0	0	0	90.9453
R5826_011_0	2008	13	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		256.739739	5.545243	619.468551	30.125367	91.374134	9.143173	4.542834	366.686911	319.513706	5500.281208	3590.305265		10.440524	1281.703393	8094.334081	5780.503906	22.020315	1537.586035			14.145117			2.48	1.82					0.08		32.230907	3.4	0.02								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	Silver Sneakers	QUIT NET								434.796998	434.79705	22.698432	0	79.053987	0.158108	0.158108	39.526996	69.472733	0	39.527001		39.526833	39.527008	7.905399	23.7162	23.716291	39.526997			0.158107			0	0					0		39.526868	0	0								9.3025	0.200921275	1.171747065	0	0.601957467	1.445608797	0.718258398	1.207836005	1.849790866	0	11.82616665	0	0.034390071	4.221825022	5.332411712	11.42429889	0.043520017	5.064679883	0	0	2.236442014	0	0	0	0	0	0	0	0	0	0	0.106165567	0	0	0	0	0	0	0	0	0	56.7885	0	15.04657669	9.3025	0.200921275	1.171747065	0	0.601957467	1.445608797	0.718258398	1.207836005	1.849790866	0	11.82616665	0	0.034390071	4.221825022	5.332411712	11.42429889	0.043520017	5.064679883	0	0	2.236442014	0	0	0	0	0	0	0	0	0	0	0.106165567	0	0	0	0	0	0	0	0	0	56.7885	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	Silver Sneakers	QUIT NET								3.1349	0.0677	1.1069	2.0235	0.7903	3.1466	1.5634	0.2798	3.9071	1.3139	3.1134		0.008	1.7004	6.1256	5.247	0.0667	0.4014			0.8234			0.83	0					0		0.0677	0	0								35.7177	500	7.040731467	12.4374	0.26863186	2.278658103	2.023513586	1.392268221	4.592196652	2.281658015	1.487677987	5.756871617	1.313922468	14.93960914	0	0.042358037	5.922244178	11.45796641	16.67130257	0.110180246	5.466041389	0	0	3.059810953	0	0	0.83	0	0	0	0	0	0	0	0.173884456	0	0	0	0	0	0	0	0	0	92.5062
R5826_012_0	2008	9	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		245.877239	5.310627	593.259217	28.85078	87.50815	8.385851	4.166555	351.172613	305.995276	5267.567689	3438.401656		9.998792	1227.475309	7751.86778	5535.934337	21.088649	1472.531715			12.973488			2.5	1.82					0.08		30.867237	0.02	3.4								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	QUIT NET	Silver Sneakers								441.030132	441.030625	23.023838	0	80.187345	0.160374	0.160374	40.093643	70.46868	0	40.093651		40.094002	40.093646	8.01873	24.05619	24.056362	40.093651			0.160374			0	0					0		40.093498	0	0								9.0366	0.195179095	1.138258675	0	0.584753851	1.344872468	0.668207092	1.173315781	1.796923599	0	11.488173	0	0.033407632	4.101163376	5.180011227	11.09779069	0.042276348	4.919931056	0	0	2.080610165	0	0	0	0	0	0	0	0	0	0	0.103131292	0	0	0	0	0	0	0	0	0	54.9846	0	13.58561673	9.0366	0.195179095	1.138258675	0	0.584753851	1.344872468	0.668207092	1.173315781	1.796923599	0	11.488173	0	0.033407632	4.101163376	5.180011227	11.09779069	0.042276348	4.919931056	0	0	2.080610165	0	0	0	0	0	0	0	0	0	0	0.103131292	0	0	0	0	0	0	0	0	0	54.9846	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	QUIT Net	Silver Sneakers								3.0777	0.0665	1.0407	1.9025	0.7759	2.9584	1.4699	0.2747	3.6734	1.2353	2.9272		0.0078	1.5987	6.0136	5.1511	0.0654	0.3774			0.7741			0.83	0					0		0.0637	0	0								34.2842	500	6.229754613	12.1143	0.261652876	2.17896945	1.902495174	1.360627076	4.303275951	2.13810561	1.448044922	5.470337824	1.235341127	14.41541324	0	0.041229829	5.699887694	11.19365938	16.24893733	0.107719156	5.297288231	0	0	2.854737439	0	0	0.83	0	0	0	0	0	0	0	0.166800487	0	0	0	0	0	0	0	0	0	89.2688
R5826_013_0	2008	12	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		239.462715	5.172081	577.782079	28.098113	85.225209	7.954007	3.951991	342.011108	298.012374	5130.145688	3348.699525		9.73794	1195.452536	7549.634557	5391.511102	20.538481	1434.115833			12.305396			2.52	1.82					0.08		30.061963	0.02	3.4								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	QUIT NET	Silver Sneakers								444.723382	444.723939	23.216633	0	80.858791	0.161717	0.161717	40.429391	71.05878	0	40.4294		40.429649	40.429406	8.085879	24.257638	24.257544	40.429402			0.161717			0	0					0		40.429342	0	0								8.8746	0.19167902	1.117846207	0	0.57426728	1.28629815	0.639104129	1.152275068	1.764699643	0	11.28215938	0	0.032808458	4.027619661	5.087119294	10.89877705	0.041517759	4.831703794	0	0	1.989991725	0	0	0	0	0	0	0	0	0	0	0.101282115	0	0	0	0	0	0	0	0	0	53.8937	0	12.75792448	8.8746	0.19167902	1.117846207	0	0.57426728	1.28629815	0.639104129	1.152275068	1.764699643	0	11.28215938	0	0.032808458	4.027619661	5.087119294	10.89877705	0.041517759	4.831703794	0	0	1.989991725	0	0	0	0	0	0	0	0	0	0	0.101282115	0	0	0	0	0	0	0	0	0	53.8937	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	QUIT NET	Silver Sneakers								3.041	0.0657	1.0015	1.8308	0.7666	2.8469	1.4145	0.2715	3.5349	1.1888	2.8169		0.0077	1.5384	5.9419	5.0897	0.0647	0.3631			0.7449			0.84	0					0		0.0613	0	0								33.4307	500	5.779220209	11.9155	0.257360055	2.119320076	1.830766018	1.34088784	4.133161048	2.053584421	1.423728542	5.299616934	1.1887665	14.09903469	0	0.040537162	5.566066862	11.02905524	15.98849811	0.106179814	5.194834167	0	0	2.734931973	0	0	0.84	0	0	0	0	0	0	0	0.162551528	0	0	0	0	0	0	0	0	0	87.3244
R5826_014_0	2008	12	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		217.580467	4.699454	524.984003	25.53049	77.437278	6.566749	3.262724	310.757926	270.779824	4661.349875	3042.693342		8.848081	1086.211364	6859.744389	4898.831558	18.661663	1303.065462			10.159212			6.18	1.82					0.08		27.314882	3.4	0.02								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  25-75%	$200 allowance					Active Outlook Newsletter		$50/Visit	Silver Sneakers	QUIT NET								457.559846	457.560611	23.886768	0	83.192745	0.166385	0.166385	41.596359	73.109821	0	41.59635		41.596345	41.596352	8.31927	24.957808	24.957725	41.596346			0.166385			0.352750809	0					0		41.596346	0	0								8.2963	0.17919042	1.045014257	0	0.536851644	1.092608532	0.542868333	1.077199854	1.649722039	0	10.5470781	0	0.030670652	3.76520252	4.755672142	10.18867479	0.038812721	4.516896818	0	0	1.690340489	0	0	2.18	0	0	0	0	0	0	0	0.094683274	0	0	0	0	0	0	0	0	0	52.2278	0	10.11109134	8.2963	0.17919042	1.045014257	0	0.536851644	1.092608532	0.542868333	1.077199854	1.649722039	0	10.5470781	0	0.030670652	3.76520252	4.755672142	10.18867479	0.038812721	4.516896818	0	0	1.690340489	0	0	2.18	0	0	0	0	0	0	0	0.094683274	0	0	0	0	0	0	0	0	0	52.2278	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50-80%	$200 allowance					Active Outlook Newsletter		30% Coins	Silver Sneakers	QUIT NET								2.9096	0.0628	0.8706	1.5916	0.7335	2.4749	1.2297	0.2597	3.0731	1.0335	2.4489		0.0074	1.3375	5.6852	4.8698	0.0619	0.3157			0.6476			1.63	0					0		0.0533	0	0								31.2961	500	4.386641096	11.2059	0.242033415	1.915649116	1.591583405	1.270343101	3.567541341	1.772552108	1.336921649	4.722816994	1.033459685	12.99593961	0	0.038065684	5.102659849	10.44082739	15.05844309	0.100680472	4.832586024	0	0	2.337957053	0	0	3.81	0	0	0	0	0	0	0	0.147947735	0	0	0	0	0	0	0	0	0	83.5239
R5826_018_0	2008	8	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		222.070289	4.796428	535.817167	26.057317	79.035213	6.840558	3.398768	317.170487	276.367426	4757.537882	3105.480005		9.030663	1108.62558	7001.296766	4999.920056	19.04675	1329.954512			10.582813			1.19	1.82					0.08		27.878531	3.4	0.02								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	Silver Sneakers	Quit Net								454.907218	454.906614	23.748275	0	82.710428	0.16542	0.16542	41.355209	72.685943	0	41.355199		41.355461	41.355197	8.27104	24.813119	24.813185	41.355199			0.16542			0	0					0		41.355361	0	0								8.4184	0.181827235	1.060394453	0	0.544753025	1.131565104	0.562224203	1.093054315	1.674002248	0	10.70231197	0	0.031122269	3.820619105	4.825667134	10.33863428	0.039384211	4.583377792	0	0	1.750608926	0	0	0	0	0	0	0	0	0	0	0.096077226	0	0	0	0	0	0	0	0	0	50.8541	0	10.63042688	8.4184	0.181827235	1.060394453	0	0.544753025	1.131565104	0.562224203	1.093054315	1.674002248	0	10.70231197	0	0.031122269	3.820619105	4.825667134	10.33863428	0.039384211	4.583377792	0	0	1.750608926	0	0	0	0	0	0	0	0	0	0	0.096077226	0	0	0	0	0	0	0	0	0	50.8541	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	Silver Sneakers	Quit Net								2.9371	0.0634	0.897	1.6398	0.7404	2.5499	1.2669	0.2622	3.1662	1.0648	2.5231		0.0075	1.378	5.739	4.9159	0.0625	0.3253			0.6672			0.4	0					0		0.0549	0	0								30.661	500	4.653934823	11.3556	0.245265281	1.957407233	1.639805308	1.285188084	3.681481363	1.829163904	1.355235826	4.840203683	1.064769645	13.2253686	0	0.038587024	5.198597028	10.56464227	15.2545022	0.101837449	4.908630857	0	0	2.417846673	0	0	0.4	0	0	0	0	0	0	0	0.150955537	0	0	0	0	0	0	0	0	0	81.515
R5826_021_0	2008	8	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin				V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0				0					0		0	0	0								0		222.756866	4.811256	537.473759	26.137879	79.279569	6.882921	3.419816	318.151086	277.221875	4772.246815	3115.081253		9.058583	1112.053129	7022.942751	5015.378364	19.105637	1334.066348			10.648352				1.82					0.08		27.964723	3.4	0.02								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins				$200 allowance					Active Outlook Newsletter		$50/Visit	Silver Sneakers	Quit Net								454.502413	454.502606	23.727147	0	82.63679	0.165273	0.165273	41.318414	72.621284	0	41.318402		41.318295	41.318402	8.263679	24.79104	24.790992	41.318401			0.165273				0					0		41.318513	0	0								8.437	0.182227366	1.062726574	0	0.545950758	1.137561002	0.56520325	1.09545819	1.677684043	0	10.72584829	0	0.031190434	3.829021519	4.836278711	10.36137047	0.039470641	4.593457361	0	0	1.75988508	0	0	0	0	0	0	0	0	0	0	0.096288398	0	0	0	0	0	0	0	0	0	50.9766	0	10.71092817	8.437	0.182227366	1.062726574	0	0.545950758	1.137561002	0.56520325	1.09545819	1.677684043	0	10.72584829	0	0.031190434	3.829021519	4.836278711	10.36137047	0.039470641	4.593457361	0	0	1.75988508	0	0	0	0	0	0	0	0	0	0	0.096288398	0	0	0	0	0	0	0	0	0	50.9766	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins				$200 allowance					Active Outlook Newsletter		30% Coins	Silver Sneakers	Quit Net								2.9413	0.0635	0.9011	1.6472	0.7415	2.5614	1.2727	0.2626	3.1805	1.0696	2.5345		0.0075	1.3842	5.7472	4.9229	0.0625	0.3267			0.6703				0					0		0.0551	0	0								30.3522	500	4.695635918	11.3782	0.24575529	1.963795482	1.647218704	1.287440591	3.69900583	1.837869493	1.358013266	4.858199249	1.06958407	13.26031089	0	0.038666354	5.213229477	10.58343182	15.28424419	0.102013149	4.920181218	0	0	2.430139866	0	0	0	0	0	0	0	0	0	0	0.15141447	0	0	0	0	0	0	0	0	0	81.3288
R5826_023_0	2008	8	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		208.000958	4.492549	501.870306	24.406448	74.027914	6.001247	2.981751	297.076053	258.858083	4456.122607	2908.731364		8.458522	1038.388263	6557.727453	4683.148581	17.840037	1245.694834			9.284341			6.69	1.82					0.08		26.112278	3.4	0.02								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  10%	$200 allowance					Active Outlook Newsletter		$50/Visit	Silver Sneakers	Quit Net								463.219338	463.218234	24.18221	0	84.221661	0.168443	0.168443	42.110853	74.014106	0	42.110849		42.111039	42.110852	8.42217	25.266511	25.266457	42.110848			0.168443			0.1	0					0		42.110788	0	0								8.0292	0.173419218	1.011361094	0	0.519562823	1.010868048	0.502255084	1.0425105	1.5965958	0	10.20742894	0	0.029683096	3.643951205	4.602524619	9.860568761	0.037562877	4.371438817	0	0	1.563882251	0	0	0.669	0	0	0	0	0	0	0	0.09163405	0	0	0	0	0	0	0	0	0	48.9634	0	9.047596415	8.0292	0.173419218	1.011361094	0	0.519562823	1.010868048	0.502255084	1.0425105	1.5965958	0	10.20742894	0	0.029683096	3.643951205	4.602524619	9.860568761	0.037562877	4.371438817	0	0	1.563882251	0	0	0.669	0	0	0	0	0	0	0	0.09163405	0	0	0	0	0	0	0	0	0	48.9634	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	Silver Sneakers	Quit Net								2.8466	0.0615	0.8143	1.4886	0.7176	2.3148	1.1501	0.2541	2.8742	0.9666	2.2904		0.0072	1.2509	5.5621	4.7644	0.0605	0.2953			0.6057			2.01	0					0		0.0498	0	0								30.3846	500	3.848684117	10.8758	0.234902268	1.825650311	1.488579851	1.237177988	3.32562798	1.652357101	1.296611125	4.470805651	0.966575335	12.49780573	0	0.036918585	4.894848711	10.16463046	14.62493628	0.098090889	4.666696815	0	0	2.169586958	0	0	2.679	0	0	0	0	0	0	0	0.141451909	0	0	0	0	0	0	0	0	0	79.348
R5826_026_0	2008	9	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		227.573476	4.915289	549.095404	26.703051	80.993809	7.183791	3.569305	325.030379	283.216164	4875.435776	3182.437785		9.254454	1136.098744	7174.797883	5123.82449	19.518753	1362.912491			11.113818			2.82	1.82					0.08		28.569397	3.4	0.02								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	Silver Sneakers	Quit Net								451.6721	451.671942	23.579387	0	82.12215	0.164244	0.164244	41.061092	72.16908	0	41.061098		41.06086	41.061093	8.212219	24.636659	24.636719	41.061099			0.164244			0	0					0		41.061046	0	0								8.5657	0.185008177	1.078944419	0	0.554282144	1.179894569	0.58623693	1.112175191	1.7032875	0	10.88953248	0	0.03166632	3.887454682	4.910084291	10.51949306	0.040073169	4.66355706	0	0	1.825377924	0	0	0	0	0	0	0	0	0	0	0.097757444	0	0	0	0	0	0	0	0	0	51.8305	0	11.28338289	8.5657	0.185008177	1.078944419	0	0.554282144	1.179894569	0.58623693	1.112175191	1.7032875	0	10.88953248	0	0.03166632	3.887454682	4.910084291	10.51949306	0.040073169	4.66355706	0	0	1.825377924	0	0	0	0	0	0	0	0	0	0	0.097757444	0	0	0	0	0	0	0	0	0	51.8305	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	Silver Sneakers	Quit Net								2.9705	0.0642	0.9297	1.6995	0.7488	2.6428	1.3131	0.2652	3.2815	1.1036	2.615		0.0076	1.4282	5.8042	4.9717	0.0632	0.3371			0.6915			0.94	0					0		0.0569	0	0								31.9341	500	4.994246562	11.5362	0.24916654	2.008629903	1.69953258	1.303128851	3.822688328	1.899322635	1.377335057	4.9848135	1.103552239	13.50448808	0	0.039216386	5.315623139	10.71426203	15.49121197	0.103236321	5.000657237	0	0	2.516918466	0	0	0.94	0	0	0	0	0	0	0	0.154634237	0	0	0	0	0	0	0	0	0	83.7646
R5826_047_0	2008	9	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		250.679554	5.41435	604.846374	29.414276	89.217302	8.293711	4.120774	358.03149	311.97178	5370.450426	3505.558303		10.194081	1251.449567	7903.272264	5644.058639	21.500539	1501.292255			12.83094			2.53	1.82					0.08		31.470117	0.02	4.92								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	QUIT NET	Silver Sneakers/ Chiro								439.555066	439.555566	22.946835	0	79.919151	0.159838	0.159838	39.959553	70.232956	0	39.95955		39.959232	39.959548	7.991909	23.97573	23.975575	39.959547			0.159838			0	0					0		39.959401	0	0								9.1823	0.19832564	1.156609162	0	0.594180919	1.325650179	0.658656275	1.192231525	1.825891691	0	11.67337769	0	0.033945637	4.16727992	5.263519395	11.27670217	0.042957315	4.999246535	0	0	2.050871788	0	0	0	0	0	0	0	0	0	0	0.104793919	0	0	0	0	0	0	0	0	0	55.7465	0	14.00717215	9.1823	0.19832564	1.156609162	0	0.594180919	1.325650179	0.658656275	1.192231525	1.825891691	0	11.67337769	0	0.033945637	4.16727992	5.263519395	11.27670217	0.042957315	4.999246535	0	0	2.050871788	0	0	0	0	0	0	0	0	0	0	0.104793919	0	0	0	0	0	0	0	0	0	55.7465	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	QUIT NET	Silver Sneakers/ Chiro								3.1266	0.0675	1.0256	1.8749	0.7882	2.9155	1.4486	0.2791	3.6202	1.2174	2.8848		0.0079	1.5755	6.1093	5.2331	0.0665	0.3719			0.7629			0.84	0					0		0.0627	0	0								34.2785	500	6.33360281	12.3089	0.265856922	2.182232688	1.874912779	1.382400682	4.241163632	2.107244573	1.471332128	5.446050997	1.217432171	14.55817882	0	0.041892739	5.742825714	11.37286237	16.50981887	0.109441141	5.371132944	0	0	2.813775536	0	0	0.84	0	0	0	0	0	0	0	0.167540613	0	0	0	0	0	0	0	0	0	90.025
R5826_048_0	2008	12	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		255.708518	5.52297	616.980391	30.004365	91.00712	8.63011	4.287916	365.214075	318.230347	5478.188766	3575.884439		10.398589	1276.5553	8061.822361	5757.285923	21.931868	1531.410162			13.351373			2.99	1.82					0.08		32.101449	0.02	4.92								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	QUIT NET	Silver Sneakers/Chiro								436.715959	436.715734	22.798617	0	79.402934	0.158805	0.158805	39.701441	69.779331	0	39.701451		39.701033	39.701446	7.940289	23.82087	23.821013	39.701452			0.158805			0	0					0		39.701438	0	0								9.306	0.200997325	1.172191636	0	0.602186029	1.370504619	0.6809425	1.208293754	1.850491726	0	11.83065007	0	0.034402894	4.223424276	5.334433284	11.42862996	0.043536609	5.066600587	0	0	2.120264789	0	0	0	0	0	0	0	0	0	0	0.106206141	0	0	0	0	0	0	0	0	0	56.5798	0	14.67678554	9.306	0.200997325	1.172191636	0	0.602186029	1.370504619	0.6809425	1.208293754	1.850491726	0	11.83065007	0	0.034402894	4.223424276	5.334433284	11.42862996	0.043536609	5.066600587	0	0	2.120264789	0	0	0	0	0	0	0	0	0	0	0.106206141	0	0	0	0	0	0	0	0	0	56.5798	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	QUIT NET	Silver Sneakers/ Chiro								3.1533	0.0681	1.0552	1.9289	0.7949	2.9995	1.4903	0.2815	3.7244	1.2525	2.9679		0.008	1.6209	6.1615	5.2778	0.0671	0.3826			0.7849			1	0					0		0.0646	0	0								35.0837	500	6.697472705	12.4593	0.269104778	2.227349837	1.928906514	1.397129021	4.369977786	2.171245862	1.489775771	5.574902153	1.252491203	14.79852648	0	0.042417385	5.844340995	11.49588847	16.70638423	0.110587483	5.449196638	0	0	2.90513883	0	0	1	0	0	0	0	0	0	0	0.170759168	0	0	0	0	0	0	0	0	0	91.6634
R5826_049_0	2008	11	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		241.022334	5.205768	581.545171	28.281116	85.78028	7.666382	3.809082	344.238625	299.953327	5163.5583	3370.509589		9.801363	1203.238516	7598.805288	5426.625984	20.672247	1443.456222			11.860421			2.75	1.82					0.08		30.257757	0.02	4.92								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	QUIT NET	Silver Sneakers/Chiro								445.030851	445.031409	23.232683	0	80.914737	0.161829	0.161829	40.457361	71.107929	0	40.45735		40.457337	40.457351	8.09147	24.27441	24.274589	40.45735			0.161829			0	0					0		40.457354	0	0								8.9385	0.193060856	1.125904551	0	0.5784074	1.240642933	0.616419931	1.160582193	1.777421657	0	11.36349051	0	0.033044754	4.056653582	5.123792085	10.97734534	0.041817525	4.866534465	0	0	1.91936007	0	0	0	0	0	0	0	0	0	0	0.102012399	0	0	0	0	0	0	0	0	0	54.115	0	12.76407878	8.9385	0.193060856	1.125904551	0	0.5784074	1.240642933	0.616419931	1.160582193	1.777421657	0	11.36349051	0	0.033044754	4.056653582	5.123792085	10.97734534	0.041817525	4.866534465	0	0	1.91936007	0	0	0	0	0	0	0	0	0	0	0.102012399	0	0	0	0	0	0	0	0	0	54.115	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	QUIT NET	Silver Sneakers/Chiro								3.0706	0.0663	0.9683	1.7702	0.7741	2.7527	1.3677	0.2741	3.418	1.1494	2.7237		0.0078	1.4876	5.9998	5.1393	0.0653	0.3511			0.7203			0.92	0					0		0.0592	0	0								33.0855	500	5.669024988	12.0091	0.259380758	2.094250499	1.770206676	1.352489007	3.993335804	1.984110366	1.43467753	5.195407845	1.149443551	14.0871871	0	0.04084907	5.544212335	11.12355478	16.11659852	0.107108692	5.217652891	0	0	2.639658277	0	0	0.92	0	0	0	0	0	0	0	0.161254598	0	0	0	0	0	0	0	0	0	87.2005
R5826_050_0	2008	11	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		251.982978	5.442503	607.991309	29.567217	89.681194	8.380243	4.163768	359.893097	313.593896	5398.37441	3523.785664		10.247086	1257.956553	7944.36581	5673.405267	21.612332	1509.098315			12.964813			2.55	1.82					0.08		31.633747	0.02	4.92								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	QUIT NET	Silver Sneakers								438.821906	438.821805	22.908562	0	79.785769	0.159571	0.159571	39.892911	70.115802	0	39.892899		39.89272	39.892895	7.97858	23.935739	23.935815	39.892902			0.159571			0	0					0		39.892815	0	0								9.2146	0.199024083	1.160683883	0	0.596273586	1.337243756	0.664416624	1.196431941	1.83232396	0	11.71450213	0	0.034065344	4.181960724	5.28206318	11.31642898	0.043109065	5.016859266	0	0	2.068808175	0	0	0	0	0	0	0	0	0	0	0.105163268	0	0	0	0	0	0	0	0	0	55.964	0	14.17881053	9.2146	0.199024083	1.160683883	0	0.596273586	1.337243756	0.664416624	1.196431941	1.83232396	0	11.71450213	0	0.034065344	4.181960724	5.28206318	11.31642898	0.043109065	5.016859266	0	0	2.068808175	0	0	0	0	0	0	0	0	0	0	0.105163268	0	0	0	0	0	0	0	0	0	55.964	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	QUIT NET	Silver Sneakers								3.1336	0.0677	1.0333	1.8889	0.79	2.9372	1.4594	0.2797	3.6471	1.2265	2.9063		0.008	1.5873	6.123	5.2448	0.0666	0.3747			0.7686			0.85	0					0		0.0632	0	0								34.4557	500	6.426520902	12.3483	0.266705681	2.193945291	1.888876722	1.386249514	4.274471218	2.123793358	1.476154853	5.479444489	1.22649893	14.6207888	0	0.042030186	5.769241081	11.40502433	16.56121111	0.109741017	5.391515479	0	0	2.837393721	0	0	0.85	0	0	0	0	0	0	0	0.168376733	0	0	0	0	0	0	0	0	0	90.4197
R5826_051_0	2008	11	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		250.172449	5.403398	603.622814	29.354773	89.036823	8.260171	4.10411	357.307218	311.340684	5359.586398	3498.466815		10.173459	1248.917976	7887.284522	5632.641123	21.457045	1498.255251			12.779052			1.19	1.82					0.08		31.406455	0.02	4.92								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	QUIT NET	Silver Sneakers/Chiro								439.84159	439.842059	22.961789	0	79.971251	0.159942	0.159942	39.985597	70.278764	0	39.985599		39.98521	39.9856	7.997119	23.99136	23.991533	39.985598			0.159942			0	0					0		39.985529	0	0								9.1697	0.198053475	1.155021641	0	0.59336551	1.32114827	0.656419562	1.190595202	1.823386538	0	11.6573576	0	0.033898991	4.161561218	5.256296076	11.26122674	0.04289895	4.992386014	0	0	2.043907135	0	0	0	0	0	0	0	0	0	0	0.10465031	0	0	0	0	0	0	0	0	0	55.6619	0	13.94052469	9.1697	0.198053475	1.155021641	0	0.59336551	1.32114827	0.656419562	1.190595202	1.823386538	0	11.6573576	0	0.033898991	4.161561218	5.256296076	11.26122674	0.04289895	4.992386014	0	0	2.043907135	0	0	0	0	0	0	0	0	0	0	0.10465031	0	0	0	0	0	0	0	0	0	55.6619	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	QUIT NET	Silver Sneakers/Chiro								3.1238	0.0675	1.0226	1.8694	0.7875	2.9069	1.4443	0.2788	3.6095	1.2139	2.8763		0.0079	1.5709	6.1038	5.2283	0.0664	0.3708			0.7607			0.4	0					0		0.0626	0	0								33.772	500	6.297610319	12.2935	0.265522878	2.177632742	1.869406293	1.380864809	4.228097896	2.100753437	1.469441281	5.432912044	1.213855958	14.53368601	0	0.041837942	5.732477837	11.36005511	16.48956048	0.109321855	5.363180634	0	0	2.804570022	0	0	0.4	0	0	0	0	0	0	0	0.167213059	0	0	0	0	0	0	0	0	0	89.4339
R5826_052_0	2008	11	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		249.524138	5.389396	602.05855	29.278701	88.806087	8.217369	4.082843	356.381273	310.533858	5345.69726	3489.400687		10.147095	1245.681457	7866.844963	5618.044372	21.401439	1494.372587			12.712835			3.5	1.82					0.08		31.325066	0.02	4.92								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	QUIT NET	Silver Sneakers/Chiro								440.2068	440.20683	22.980851	0	80.037629	0.160075	0.160075	40.0188	70.337106	0	40.018798		40.019214	40.018796	8.003759	24.01128	24.01146	40.018797			0.160075			0	0					0		40.018766	0	0								9.1535	0.197704077	1.152984819	0	0.592319054	1.315395343	0.653561093	1.188495907	1.820171074	0	11.63680177	0	0.033839897	4.154222676	5.247027598	11.24136971	0.042823316	4.983582767	0	0	2.035007063	0	0	0	0	0	0	0	0	0	0	0.104465874	0	0	0	0	0	0	0	0	0	55.5533	0	13.85570182	9.1535	0.197704077	1.152984819	0	0.592319054	1.315395343	0.653561093	1.188495907	1.820171074	0	11.63680177	0	0.033839897	4.154222676	5.247027598	11.24136971	0.042823316	4.983582767	0	0	2.035007063	0	0	0	0	0	0	0	0	0	0	0.104465874	0	0	0	0	0	0	0	0	0	55.5533	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	QUIT NET	Silver Sneakers/Chiro								3.1201	0.0674	1.0187	1.8623	0.7866	2.8959	1.4389	0.2785	3.5958	1.2093	2.8654		0.0079	1.565	6.0965	5.2221	0.0663	0.3694			0.7578			1.17	0					0		0.0623	0	0								34.4562	500	6.251840202	12.2736	0.265093574	2.171719939	1.862321318	1.378876339	4.21132838	2.09242065	1.467008339	5.416017453	1.209256988	14.50222912	0	0.041769761	5.719187373	11.34348718	16.4634515	0.109166977	5.352972441	0	0	2.7927879	0	0	1.17	0	0	0	0	0	0	0	0.166790929	0	0	0	0	0	0	0	0	0	90.0095
R5826_053_0	2008	8	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		234.684283	5.068873	566.252553	27.53742	83.524558	7.639733	3.795842	335.186346	292.065597	5027.774659	3281.876899		9.543621	1171.597524	7398.983113	5283.924578	20.12864	1405.498339			11.819192			7.66	1.82					0.08		29.462082	0.02	3.4								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  10%	$200 allowance					Active Outlook Newsletter		$50/Visit	QUIT NET	Silver Sneakers								447.495401	447.494734	23.361359	0	81.362801	0.162725	0.162725	40.681406	71.501704	0	40.681399		40.68131	40.681405	8.136279	24.408841	24.409034	40.681399			0.162725			0.1	0					0		40.681507	0	0								8.7517	0.189024498	1.102369098	0	0.566315999	1.243175552	0.617678389	1.136320986	1.740265655	0	11.1259453	0	0.032353917	3.971852781	5.016682577	10.74787291	0.040943388	4.764803227	0	0	1.923278018	0	0	0.766	0	0	0	0	0	0	0	0.099880158	0	0	0	0	0	0	0	0	0	53.8364	0	12.15647321	8.7517	0.189024498	1.102369098	0	0.566315999	1.243175552	0.617678389	1.136320986	1.740265655	0	11.1259453	0	0.032353917	3.971852781	5.016682577	10.74787291	0.040943388	4.764803227	0	0	1.923278018	0	0	0.766	0	0	0	0	0	0	0	0.099880158	0	0	0	0	0	0	0	0	0	53.8364	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	QUIT NET	Silver Sneakers								3.0128	0.0651	0.9724	1.7776	0.7595	2.7642	1.3734	0.2689	3.4323	1.1543	2.7351		0.0077	1.4938	5.8869	5.0426	0.0641	0.3526			0.7233			2.3	0					0		0.0595	0	0								34.2462	500	5.456205798	11.7645	0.254097894	2.074775191	1.777627443	1.325841713	4.007409044	1.991101987	1.405262433	5.172581211	1.154262196	13.86106086	0	0.040010959	5.465645902	10.90362722	15.7904893	0.105007412	5.117393789	0	0	2.646596194	0	0	3.066	0	0	0	0	0	0	0	0.159370908	0	0	0	0	0	0	0	0	0	88.0827
R5826_054_0	2008	11	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		239.714859	5.177527	578.390459	28.127699	85.314947	7.583364	3.767835	342.371232	298.326167	5135.547508	3352.225559		9.748193	1196.711297	7557.583994	5397.188127	20.560107	1435.625895			11.731985			2.69	1.82					0.08		30.093617	0.02	4.92								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	QUIT NET	Silver Sneakers/Chiro								445.777198	445.776597	23.271652	0	81.050412	0.1621	0.1621	40.525205	71.227157	0	40.525201		40.52473	40.525199	8.10504	24.315119	24.314993	40.525202			0.1621			0	0					0		40.525177	0	0								8.905	0.192335031	1.121675123	0	0.5762343	1.229263304	0.610766054	1.15622203	1.770743728	0	11.32080121	0	0.032920241	4.041413621	5.104543381	10.93610596	0.041659905	4.848252449	0	0	1.901754769	0	0	0	0	0	0	0	0	0	0	0.101629096	0	0	0	0	0	0	0	0	0	53.8913	0	12.59979483	8.905	0.192335031	1.121675123	0	0.5762343	1.229263304	0.610766054	1.15622203	1.770743728	0	11.32080121	0	0.032920241	4.041413621	5.104543381	10.93610596	0.041659905	4.848252449	0	0	1.901754769	0	0	0	0	0	0	0	0	0	0	0.101629096	0	0	0	0	0	0	0	0	0	53.8913	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	QUIT NET	Silver Sneakers/Chiro								3.0629	0.0662	0.9607	1.7562	0.7721	2.7309	1.3568	0.2734	3.3909	1.1403	2.7021		0.0078	1.4758	5.9847	5.1264	0.0651	0.3483			0.7146			0.9	0					0		0.0588	0	0								32.8939	500	5.582325333	11.9678	0.258488935	2.082345757	1.756174804	1.348375213	3.960136254	1.967615076	1.429630364	5.161636324	1.140332699	14.02290777	0	0.040705097	5.517178283	11.08926591	16.06247529	0.106787485	5.196587855	0	0	2.616343349	0	0	0.9	0	0	0	0	0	0	0	0.160402157	0	0	0	0	0	0	0	0	0	86.7852
R5826_055_0	2008	9	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		248.040295	5.357345	598.478294	29.10459	88.277985	8.119805	4.034368	354.261983	308.687208	5313.908052	3468.6503		10.086754	1238.273777	7820.063271	5584.635602	21.274173	1485.486015			12.561896			2.79	1.82					0.08		31.138786	0.02	4.92								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	QUIT NET	Silver Sneakers/Chiro								441.045568	441.045588	23.024646	0	80.190113	0.16038	0.16038	40.09506	70.471112	0	40.095048		40.094914	40.095049	8.019009	24.057029	24.056834	40.095049			0.16038			0	0					0		40.095068	0	0								9.1164	0.196902781	1.148312572	0	0.589918466	1.302254326	0.64703194	1.183679622	1.812794234	0	11.58964169	0	0.033702295	4.137387314	5.225763146	11.19581172	0.042649104	4.963386213	0	0	2.01467688	0	0	0	0	0	0	0	0	0	0	0.104042645	0	0	0	0	0	0	0	0	0	55.3044	0	13.6622139	9.1164	0.196902781	1.148312572	0	0.589918466	1.302254326	0.64703194	1.183679622	1.812794234	0	11.58964169	0	0.033702295	4.137387314	5.225763146	11.19581172	0.042649104	4.963386213	0	0	2.01467688	0	0	0	0	0	0	0	0	0	0	0.104042645	0	0	0	0	0	0	0	0	0	55.3044	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	QUIT NET	Silver Sneakers/Chiro								3.1115	0.0672	1.0099	1.8461	0.7844	2.8708	1.4264	0.2777	3.5646	1.1987	2.8405		0.0079	1.5514	6.0797	5.2077	0.0662	0.3662			0.7512			0.93	0					0		0.0618	0	0								34.0199	500	6.147700562	12.2279	0.264107395	2.158195492	1.846138284	1.374317049	4.173021989	2.073388763	1.461428054	5.377393978	1.198748484	14.43017005	0	0.041610789	5.688753163	11.30549246	16.40356149	0.108810909	5.329565416	0	0	2.76587194	0	0	0.93	0	0	0	0	0	0	0	0.165826362	0	0	0	0	0	0	0	0	0	89.3243
R5826_056_0	2008	11	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		234.569259	5.066389	565.975017	27.523923	83.483619	7.260969	3.607651	335.022061	291.922447	5025.310402	3280.268357		9.538944	1171.023289	7395.356661	5281.334773	20.118774	1404.809464			11.233219			3.01	1.82					0.08		29.447643	0.02	4.92								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	QUIT NET	Silver Sneakers/Chiro								448.732898	448.731942	23.425963	0	81.58782	0.163175	0.163175	40.793892	71.699412	0	40.7939		40.79431	40.793902	8.158779	24.47634	24.476371	40.793901			0.163175			0	0					0		40.794062	0	0								8.7716	0.189454215	1.104875817	0	0.567603873	1.184808617	0.588678452	1.138904481	1.744222317	0	11.15124494	0	0.032427887	3.980884108	5.028090052	10.77231213	0.041036215	4.775638183	0	0	1.83298051	0	0	0	0	0	0	0	0	0	0	0.100107415	0	0	0	0	0	0	0	0	0	53.0048	0	11.9617899	8.7716	0.189454215	1.104875817	0	0.567603873	1.184808617	0.588678452	1.138904481	1.744222317	0	11.15124494	0	0.032427887	3.980884108	5.028090052	10.77231213	0.041036215	4.775638183	0	0	1.83298051	0	0	0	0	0	0	0	0	0	0	0.100107415	0	0	0	0	0	0	0	0	0	53.0048	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	QUIT NET	Silver Sneakers/Chiro								3.0324	0.0655	0.9306	1.7013	0.7645	2.6455	1.3144	0.2707	3.2849	1.1047	2.6177		0.0077	1.4296	5.9251	5.0753	0.0645	0.3374			0.6923			1	0					0		0.0569	0	0								32.3212	500	5.248224904	11.804	0.254950096	2.035524987	1.701293016	1.332057999	3.830340057	1.903124366	1.409590756	5.029147616	1.104696466	13.76890891	0	0.040135094	5.410531568	10.95323284	15.84764792	0.105515676	5.113087293	0	0	2.525238077	0	0	1	0	0	0	0	0	0	0	0.157043395	0	0	0	0	0	0	0	0	0	85.326
R5826_057_0	2008	11	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		255.273318	5.513569	615.930327	29.953298	90.852231	8.600738	4.273324	364.592502	317.688737	5468.865205	3569.79849		10.380891	1274.382675	8048.101605	5747.487356	21.894541	1528.803792			13.305933			2.52	1.82					0.08		32.046814	0.02	4.92								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	QUIT NET	Silver Sneakers/Chiro								436.963447	436.963025	22.81153	0	79.447907	0.158895	0.158895	39.723938	69.818859	0	39.723951		39.724214	39.723951	7.944789	23.834371	23.834216	39.723951			0.158895			0	0					0		39.723833	0	0								9.2954	0.200768816	1.170859428	0	0.601501633	1.366614265	0.679009817	1.206920829	1.848388761	0	11.81720836	0	0.034364395	4.218626245	5.328372425	11.4156455	0.043486602	5.06084391	0	0	2.114246224	0	0	0	0	0	0	0	0	0	0	0.106085191	0	0	0	0	0	0	0	0	0	56.5084	0	14.61795837	9.2954	0.200768816	1.170859428	0	0.601501633	1.366614265	0.679009817	1.206920829	1.848388761	0	11.81720836	0	0.034364395	4.218626245	5.328372425	11.4156455	0.043486602	5.06084391	0	0	2.114246224	0	0	0	0	0	0	0	0	0	0	0.106085191	0	0	0	0	0	0	0	0	0	56.5084	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	QUIT NET	Silver Sneakers/Chiro								3.151	0.0681	1.0526	1.9242	0.7944	2.9922	1.4867	0.2813	3.7154	1.2495	2.9607		0.008	1.617	6.157	5.2739	0.067	0.3817			0.783			0.84	0					0		0.0644	0	0								34.8679	500	6.665372192	12.4465	0.26882765	2.223458873	1.924226982	1.395869708	4.358810745	2.165698635	1.48819941	5.563763604	1.249452379	14.77788621	0	0.042373106	5.835612696	11.48537395	16.68958506	0.110488869	5.442512053	0	0	2.897215551	0	0	0.84	0	0	0	0	0	0	0	0.17048224	0	0	0	0	0	0	0	0	0	91.3763
R5826_058_0	2008	11	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		269.795725	5.827235	650.970385	31.657332	96.020783	9.608131	4.773851	385.33404	335.761937	5779.987008	3772.883059		10.971456	1346.881856	8505.955252	6074.459871	23.140114	1615.776898			14.864439			2.48	1.82					0.08		33.869945	0.02	4.92								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	QUIT NET	Silver Sneakers/Chiro								428.746436	428.747086	22.382567	0	77.953881	0.155907	0.155907	38.976962	68.505954	0	38.976949		38.976608	38.976944	7.795389	23.38617	23.386054	38.976951			0.155907			0	0					0		38.977013	0	0								9.6395	0.208200835	1.214199021	0	0.623766058	1.49797488	0.744276788	1.251595853	1.916807651	0	12.25462255	0	0.035635845	4.374778223	5.5256025	11.83819593	0.04509633	5.248171415	0	0	2.317470091	0	0	0	0	0	0	0	0	0	0	0.110012441	0	0	0	0	0	0	0	0	0	58.8459	0	16.64218466	9.6395	0.208200835	1.214199021	0	0.623766058	1.49797488	0.744276788	1.251595853	1.916807651	0	12.25462255	0	0.035635845	4.374778223	5.5256025	11.83819593	0.04509633	5.248171415	0	0	2.317470091	0	0	0	0	0	0	0	0	0	0	0.110012441	0	0	0	0	0	0	0	0	0	58.8459	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	QUIT NET	Silver Sneakers/Chiro								3.2255	0.0697	1.1389	2.082	0.8131	3.2375	1.6086	0.2879	4.02	1.3519	3.2034		0.0082	1.7496	6.3026	5.3986	0.0686	0.413			0.8472			0.83	0					0		0.0697	0	0								36.7259	500	7.787362422	12.865	0.277868608	2.353097803	2.081989822	1.436915463	4.735493874	2.352855823	1.53952468	5.93679646	1.351892783	15.45803832	0	0.043833668	6.12433501	11.82817627	17.23682944	0.113682847	5.661131517	0	0	3.164633296	0	0	0.83	0	0	0	0	0	0	0	0.179688343	0	0	0	0	0	0	0	0	0	95.5718
R5826_059_0	2008	9	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		258.399767	5.581097	623.473909	30.32015	91.96494	8.812942	4.378757	369.057834	321.579615	5535.844911	3613.519453		10.50803	1289.990626	8146.670406	5817.879473	22.162694	1547.527755			13.634228			2.5	1.82					0.08		32.439305	0.02	4.92								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	QUIT NET	Silver Sneakers/Chiro								435.186412	435.185925	22.718765	0	79.124851	0.158249	0.158249	39.5624	69.534912	0	39.562399		39.561985	39.562407	7.912479	23.73744	23.737553	39.562398			0.158249			0	0					0		39.562467	0	0								9.371	0.202401238	1.180379769	0	0.606392681	1.394639259	0.692933916	1.216734471	1.863417519	0	11.91329153	0	0.03464321	4.252927848	5.371696542	11.50846374	0.043840677	5.101992413	0	0	2.157602947	0	0	0	0	0	0	0	0	0	0	0.106948244	0	0	0	0	0	0	0	0	0	57.0193	0	15.04319643	9.371	0.202401238	1.180379769	0	0.606392681	1.394639259	0.692933916	1.216734471	1.863417519	0	11.91329153	0	0.03464321	4.252927848	5.371696542	11.50846374	0.043840677	5.101992413	0	0	2.157602947	0	0	0	0	0	0	0	0	0	0	0.106948244	0	0	0	0	0	0	0	0	0	57.0193	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	QUIT NET	Silver Sneakers/Chiro								3.1673	0.0684	1.071	1.9579	0.7985	3.0446	1.5127	0.2827	3.7804	1.2713	3.0125		0.008	1.6453	6.1889	5.3012	0.0673	0.3884			0.7967			0.83	0					0		0.0655	0	0								35.259	500	6.898135524	12.5384	0.270811867	2.25141453	1.957928656	1.404872663	4.439241474	2.205661079	1.499468535	5.643865337	1.271336414	14.92582327	0	0.042692868	5.898232641	11.56056524	16.80969984	0.111189618	5.490345154	0	0	2.954285665	0	0	0.83	0	0	0	0	0	0	0	0.172472832	0	0	0	0	0	0	0	0	0	92.2783
R5826_060_0	2008	9	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		251.671243	5.435769	607.239143	29.530639	89.570246	8.359526	4.153475	359.44786	313.205939	5391.695905	3519.426273		10.234409	1256.400293	7934.537576	5666.386512	21.585594	1507.231361			12.932762			2.52	1.82					0.08		31.594612	0.02	4.92								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	QUIT NET	Silver Sneakers/Chiro								438.996801	438.996073	22.917689	0	79.81763	0.159635	0.159635	39.908788	70.143752	0	39.908799		39.908452	39.908805	7.98176	23.945279	23.945286	39.908802			0.159635			0	0					0		39.908734	0	0								9.2069	0.19885677	1.159709819	0	0.59577373	1.334472933	0.663039982	1.19542737	1.830786643	0	11.70467298	0	0.034036618	4.178452858	5.27763122	11.30693383	0.043072768	5.01264983	0	0	2.064521462	0	0	0	0	0	0	0	0	0	0	0.105075081	0	0	0	0	0	0	0	0	0	55.912	0	14.13771973	9.2069	0.19885677	1.159709819	0	0.59577373	1.334472933	0.663039982	1.19542737	1.830786643	0	11.70467298	0	0.034036618	4.178452858	5.27763122	11.30693383	0.043072768	5.01264983	0	0	2.064521462	0	0	0	0	0	0	0	0	0	0	0.105075081	0	0	0	0	0	0	0	0	0	55.912	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	QUIT NET	Silver Sneakers/Chiro								3.132	0.0676	1.0314	1.8855	0.7896	2.932	1.4568	0.2796	3.6407	1.2243	2.9012		0.008	1.5845	6.1197	5.242	0.0666	0.374			0.7672			0.84	0					0		0.0631	0	0								34.4058	500	6.40425394	12.3389	0.266502633	2.191145791	1.885539294	1.385330523	4.266509056	2.11983779	1.47500206	5.471461567	1.22433193	14.60582366	0	0.041996511	5.762927339	11.39733924	16.54892859	0.1096693	5.38664418	0	0	2.831749303	0	0	0.84	0	0	0	0	0	0	0	0.168176664	0	0	0	0	0	0	0	0	0	90.3178
R5826_061_0	2008	8	s.	t.	u.								Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)								3000	Mental Health (MH)										A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin			Coin	V					O		V	O	O								0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0			0	0					0		0	0	0								0		228.718593	4.940023	551.85837	26.837417	81.401357	6.902872	3.429729	326.665884	284.641267	4899.968253	3198.451342		9.301022	1141.815426	7210.900409	5149.606823	19.616969	1369.770466			10.679218			2.8	1.82					0.08		28.713155	0.02	4.92								$550/Admit	$550/Admit	$0/Day(Days 1-20) $124(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$75-$95/Visit	$0/Visit	$50/Visit		$0-$50/Proc	$30-$50/Visit	$10/Visit	$30/Visit	$30/Visit	$50/Visit			20% Coins			Coin:  0%	$200 allowance					Active Outlook Newsletter		$50/Visit	QUIT NET	Silver Sneakers/Chiro								452.129171	452.129707	23.603248	0	82.205343	0.16441	0.16441	41.102654	72.242091	0	41.102651		41.102376	41.102647	8.22053	24.661587	24.661377	41.10265			0.16441			0	0					0		41.102599	0	0								8.6175	0.186127596	1.085470831	0	0.557635539	1.134901186	0.563881745	1.1189029	1.713590026	0	10.95540244	0	0.031857842	3.9109697	4.939785262	10.58312306	0.040315122	4.691766337	0	0	1.755770231	0	0	0	0	0	0	0	0	0	0	0.098348775	0	0	0	0	0	0	0	0	0	51.9854	0	11.25309976	8.6175	0.186127596	1.085470831	0	0.557635539	1.134901186	0.563881745	1.1189029	1.713590026	0	10.95540244	0	0.031857842	3.9109697	4.939785262	10.58312306	0.040315122	4.691766337	0	0	1.755770231	0	0	0	0	0	0	0	0	0	0	0.098348775	0	0	0	0	0	0	0	0	0	51.9854	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) $0(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%	$200 allowance					Active Outlook Newsletter		30% Coins	QUIT NET	Silver Sneakers/Chiro								2.9973	0.0647	0.8969	1.6396	0.7556	2.5496	1.2668	0.2676	3.1658	1.0646	2.5227		0.0076	1.3778	5.8567	5.0167	0.0637	0.3252			0.6672			0.93	0					0		0.0549	0	0								31.491	500	4.882083959	11.6149	0.250866166	1.982367032	1.639590783	1.313254888	3.68448448	1.830655982	1.386461068	4.879377171	1.064630787	13.47812922	0	0.039475913	5.28876683	10.79644926	15.59980082	0.10404894	5.016977455	0	0	2.422921258	0	0	0.93	0	0	0	0	0	0	0	0.153219163	0	0	0	0	0	0	0	0	0	83.4763
R5826_801_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		238.513413	5.151578	575.491579	27.986724	84.887351	7.89107	3.92072	340.655275	296.830963	5109.808265	3335.424288		9.699335	1190.71341	7519.705562	5370.137548	50.399849	1428.430571			12.208028																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.662303	127.662548	20.85086	0	72.038341	0.144076	0.144076	36.01915	144.076608	28.731348	71.649512		72.038485	66.957591	14.40766	21.61149	51.570315	72.038299			0.144076																					2.5374	0.054805298	0.999957862	0	0.509595328	1.136913801	0.564881655	1.022509454	3.563866525	12.23430662	19.91512688	0	0.058227117	6.643941792	9.028446753	9.671389493	0.216594674	8.575142381	0	0	1.758883842	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.492	0	30.46672076	2.5374	0.054805298	0.999957862	0	0.509595328	1.136913801	0.564881655	1.022509454	3.563866525	12.23430662	19.91512688	0	0.058227117	6.643941792	9.028446753	9.671389493	0.216594674	8.575142381	0	0	1.758883842	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.492	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.7422	0.0892	0.5526	1.0101	0.8076	1.5707	0.7804	0.6345	1.9504	0.6559	1.5542		0.0025	0.8488	2.943	1.9767	0.056	0.2004			0.411																					24.7863	0	9.620794981	11.2797	0.1439635	1.552516116	1.010116	1.317194378	2.707656345	1.345314341	1.656968051	5.514239383	12.8902031	21.46932367	0	0.060700912	7.492772683	11.97148577	11.64812909	0.272626784	8.775498183	0	0	2.169901244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.2783
R5826_802_0	2008	2	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		243.310394	5.255187	587.065863	28.549592	86.594605	8.211676	4.080015	347.506532	302.800828	5212.576707	3402.506326		9.894409	1214.661033	7670.941848	5478.141732	51.413491	1457.15916			12.704027																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					126.596882	126.596989	20.676843	0	71.437128	0.142874	0.142874	35.718552	142.874215	28.49157	71.051557		71.436746	66.398787	14.287419	21.431129	51.139932	71.4371			0.142874																					2.5669	0.055440904	1.011555723	0	0.515505823	1.173234997	0.582928063	1.034369178	3.60520255	12.37620784	20.14611435	0	0.058902032	6.721001601	9.133163359	9.783563512	0.219106869	8.674602052	0	0	1.815075154	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4728	0	31.7758535	2.5669	0.055440904	1.011555723	0	0.515505823	1.173234997	0.582928063	1.034369178	3.60520255	12.37620784	20.14611435	0	0.058902032	6.721001601	9.133163359	9.783563512	0.219106869	8.674602052	0	0	1.815075154	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4728	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.0215	0.092	0.5702	1.0424	0.8334	1.6209	0.8054	0.6547	2.0127	0.6768	1.6038		0.0026	0.8759	3.0371	2.0399	0.0578	0.2068			0.4241																					25.578	0	10.22693692	11.5884	0.147446888	1.581765227	1.042383731	1.348903176	2.794154226	1.38829064	1.6890952	5.617878549	13.05305579	21.74995939	0	0.061454479	7.596948319	12.17021523	11.82344847	0.276929487	8.88135745	0	0	2.239222219	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.0509
R5826_803_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		229.309655	4.952789	553.284505	26.906772	81.611717	7.293828	3.623977	327.510066	285.376848	4912.630937	3206.716903		9.325058	1144.76615	7229.535094	5162.914631	48.455018	1373.31028			11.284054																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					129.742444	129.742157	21.190601	0	73.212138	0.146424	0.146424	36.606042	146.424206	29.199499	72.81698		73.212272	68.048607	14.642419	21.963629	52.410627	73.212097			0.146424																					2.4793	0.053548794	0.977035932	0	0.497914024	1.067991471	0.530637208	0.999070603	3.482173198	11.95386351	19.45862005	0	0.05689239	6.491645154	8.821490168	9.449695126	0.211629823	8.378577119	0	0	1.652256323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.5623	0	28.01372448	2.4793	0.053548794	0.977035932	0	0.497914024	1.067991471	0.530637208	0.999070603	3.482173198	11.95386351	19.45862005	0	0.05689239	6.491645154	8.821490168	9.449695126	0.211629823	8.378577119	0	0	1.652256323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.5623	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.2122	0.0838	0.5191	0.9489	0.7586	1.4755	0.7331	0.596	1.8321	0.6161	1.46		0.0023	0.7974	2.7646	1.8569	0.0526	0.1882			0.3861																					23.2836	0	8.519334407	10.6915	0.13730124	1.496095079	0.948877868	1.256552447	2.543508134	1.263756089	1.595065417	5.314304537	12.56999605	20.91859452	0	0.059216142	7.289014974	11.58610719	11.30659485	0.264265662	8.566786393	0	0	2.038355707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.8459
R5826_804_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		239.758872	5.178478	578.496657	28.132863	85.330613	7.973704	3.961777	342.434095	298.380944	5136.490445	3352.841063		9.749983	1196.931025	7558.971641	5398.179105	50.663024	1435.889489			12.335869																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.384438	127.384248	20.805471	0	71.881455	0.143763	0.143762	35.940756	143.762978	28.668812	71.493557		71.881625	66.811849	14.376299	21.56445	51.458066	71.881501			0.143763																					2.5451	0.054971377	1.002991285	0	0.511140718	1.146323608	0.569552985	1.025611688	3.574677757	12.27142324	19.97554447	0	0.058403718	6.664097909	9.05583637	9.700730283	0.217251769	8.601157645	0	0	1.773441535	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7483	0	30.80464118	2.5451	0.054971377	1.002991285	0	0.511140718	1.146323608	0.569552985	1.025611688	3.574677757	12.27142324	19.97554447	0	0.058403718	6.664097909	9.05583637	9.700730283	0.217251769	8.601157645	0	0	1.773441535	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7483	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.8146	0.0899	0.5571	1.0185	0.8143	1.5837	0.7869	0.6397	1.9665	0.6613	1.5671		0.0025	0.8559	2.9674	1.9931	0.0565	0.202			0.4144																					24.9913	0	9.776057872	11.3597	0.1448671	1.560120352	1.018472441	1.32542082	2.730060664	1.356441203	1.665318941	5.541185238	12.93274526	21.54259855	0	0.060898007	7.519950676	12.02322114	11.69382242	0.273747753	8.803170537	0	0	2.187858509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.7396
R5826_805_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		238.03391	5.141221	574.33462	27.930459	84.716695	7.859382	3.904976	339.970426	296.23422	5099.535581	3328.718799		9.679836	1188.319617	7504.588054	5359.341502	50.298526	1425.558876			12.159004																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.769704	127.769858	20.868394	0	72.098853	0.144197	0.144197	36.049438	144.1978	28.755517	71.709786		72.098631	67.013912	14.41978	21.62967	51.613775	72.098898			0.144197																					2.5345	0.05474109	0.998786762	0	0.508998045	1.133299306	0.563085824	1.021311899	3.559693567	12.21998184	19.89180939	0	0.058158577	6.636162187	9.017875727	9.660065675	0.2163414	8.565101999	0	0	1.7532919	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3932	0	30.33688584	2.5345	0.05474109	0.998786762	0	0.508998045	1.133299306	0.563085824	1.021311899	3.559693567	12.21998184	19.89180939	0	0.058158577	6.636162187	9.017875727	9.660065675	0.2163414	8.565101999	0	0	1.7532919	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3932	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.7144	0.0889	0.5508	1.0069	0.805	1.5658	0.778	0.6324	1.9442	0.6538	1.5493		0.0025	0.8461	2.9337	1.9705	0.0559	0.1997			0.4097																					24.7075	0	9.561393083	11.2489	0.143615962	1.549589192	1.00690584	1.31403057	2.699050209	1.341038002	1.653754077	5.503868524	12.87379341	21.44106767	0	0.060624359	7.48229541	11.95156194	11.63052357	0.272195697	8.764820999	0	0	2.163002551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1006
R5826_806_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		237.415926	5.127874	572.84353	27.857946	84.496753	7.818619	3.884723	339.087795	295.465136	5086.296156	3320.076772		9.654705	1185.234498	7485.104627	5345.427567	50.16794	1421.857837			12.095942																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.908119	127.908443	20.891007	0	72.17704	0.144354	0.144354	36.088504	144.354001	28.786667	71.787465		72.177112	67.086505	14.435399	21.653098	51.669517	72.176998			0.144353																					2.5306	0.054658198	0.997273183	0	0.508227127	1.128648927	0.560775304	1.019764271	3.554297878	12.20145948	19.86165792	0	0.058070727	6.62610334	9.004205987	9.645422247	0.216012769	8.552119188	0	0	1.746085516	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2654	0	30.16997967	2.5306	0.054658198	0.997273183	0	0.508227127	1.128648927	0.560775304	1.019764271	3.554297878	12.20145948	19.86165792	0	0.058070727	6.62610334	9.004205987	9.645422247	0.216012769	8.552119188	0	0	1.746085516	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2654	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.6786	0.0885	0.5485	1.0028	0.8017	1.5593	0.7748	0.6298	1.9362	0.6511	1.5429		0.0025	0.8427	2.9216	1.9624	0.0556	0.1989			0.408																					24.606	0	9.485177604	11.2093	0.14316741	1.545811887	1.002768775	1.30995192	2.687966609	1.335531161	1.6496082	5.490484157	12.85258479	21.40455028	0	0.060526189	7.46875971	11.92583784	11.60778351	0.271637418	8.751017347	0	0	2.154112923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.8714
R5826_807_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		228.063765	4.925879	550.278387	26.760581	81.168302	7.214782	3.584703	325.730631	283.826332	4885.939516	3189.294093		9.274392	1138.546378	7190.255416	5134.863362	48.191752	1365.848778			11.161764																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					130.027056	130.027483	21.237082	0	73.372752	0.146745	0.146745	36.686351	146.745404	29.263552	72.976709		73.373079	68.197879	14.674539	22.011811	52.525513	73.372699			0.146745																					2.4712	0.053374971	0.973858936	0	0.496295141	1.058733185	0.526037242	0.995822355	3.470850813	11.91499542	19.39534891	0	0.056707558	6.470537344	8.79280696	9.418970153	0.210941375	8.351334272	0	0	1.637933058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2958	0	27.68809329	2.4712	0.053374971	0.973858936	0	0.496295141	1.058733185	0.526037242	0.995822355	3.470850813	11.91499542	19.39534891	0	0.056707558	6.470537344	8.79280696	9.418970153	0.210941375	8.351334272	0	0	1.637933058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2958	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.1411	0.083	0.5146	0.9407	0.7521	1.4627	0.7268	0.5908	1.8163	0.6108	1.4473		0.0023	0.7905	2.7407	1.8408	0.0522	0.1866			0.3828																					23.0818	0	8.376485265	10.6123	0.136402051	1.48841948	0.940653422	1.248357979	2.521460515	1.252801173	1.586650886	5.287102487	12.52578793	20.84266871	0	0.059010727	7.260996849	11.53346147	11.25977527	0.263121104	8.537912244	0	0	2.02068615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.3775
R5826_808_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		236.000494	5.097301	569.428338	27.691862	83.992998	7.725672	3.838541	337.066213	293.703624	5055.972556	3300.28306		9.597146	1178.16834	7440.479756	5313.559073	49.86885	1413.380971			11.952145																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					128.225685	128.22516	20.942867	0	72.356236	0.144712	0.144712	36.178111	144.712417	28.858139	71.965697		72.356004	67.253064	14.47124	21.70686	51.797845	72.356201			0.144712																					2.5218	0.054466853	0.993788496	0	0.506451432	1.117997446	0.555482945	1.016201572	3.541880109	12.1588299	19.79226423	0	0.057867595	6.602952564	8.972747355	9.611723575	0.215258247	8.522239802	0	0	1.729618807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9715	0	29.78915626	2.5218	0.054466853	0.993788496	0	0.506451432	1.117997446	0.555482945	1.016201572	3.541880109	12.1588299	19.79226423	0	0.057867595	6.602952564	8.972747355	9.611723575	0.215258247	8.522239802	0	0	1.729618807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9715	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.5968	0.0877	0.5434	0.9933	0.7942	1.5446	0.7674	0.6239	1.9179	0.645	1.5283		0.0024	0.8347	2.8941	1.9438	0.0551	0.197			0.4042																					24.3738	0	9.312053425	11.1185	0.142140861	1.537152445	0.993308084	1.3006121	2.662603337	1.32292898	1.640103037	5.459799131	12.80381162	21.32059938	0	0.06030021	7.437658753	11.86681446	11.55557144	0.27035894	8.719261393	0	0	2.133796923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.3454
R5826_809_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		223.158071	4.819922	538.441796	26.184955	79.422357	6.907742	3.432148	318.724104	277.721175	4780.842044	3120.691783		9.074899	1114.056034	7035.59168	5024.411492	47.155139	1336.469116			10.686752																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					131.158026	131.158036	21.421803	0	74.010902	0.148021	0.148021	37.005447	148.021792	29.518088	73.611466		74.010745	68.791063	14.802179	22.203268	52.982388	74.010902			0.148021																					2.4391	0.052680959	0.961199507	0	0.489843357	1.022490879	0.508029979	0.982877328	3.425732167	11.76010968	19.14322476	0	0.055970003	6.386424902	8.678507285	9.296529575	0.208199323	8.242773731	0	0	1.581863718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.2355	0	26.4191406	2.4391	0.052680959	0.961199507	0	0.489843357	1.022490879	0.508029979	0.982877328	3.425732167	11.76010968	19.14322476	0	0.055970003	6.386424902	8.678507285	9.296529575	0.208199323	8.242773731	0	0	1.581863718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.2355	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					7.8624	0.0802	0.4969	0.9085	0.7263	1.4127	0.7019	0.5706	1.7541	0.5899	1.3978		0.0022	0.7634	2.6468	1.7778	0.0504	0.1802			0.3697																					22.2917	0	7.827784116	10.3015	0.132865848	1.458147175	0.908455673	1.216163386	2.435150249	1.20991753	1.553482864	5.17981492	12.34999506	20.54100424	0	0.058194771	7.149827352	11.3253517	11.07432616	0.258592604	8.422965109	0	0	1.951514858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.5272
R5826_810_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		242.895601	5.246227	586.065039	28.50092	86.446979	8.183705	4.066118	346.914106	302.284615	5203.690349	3396.705761		9.877541	1212.590287	7657.864489	5468.802642	51.325841	1454.675008			12.660754																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					126.688346	126.688956	20.691778	0	71.488651	0.142977	0.142977	35.744339	142.977402	28.512148	71.102881		71.488837	66.446756	14.297739	21.446609	51.176852	71.488701			0.142977																					2.5643	0.055386585	1.01056064	0	0.514998159	1.17008159	0.581361353	1.033351284	3.601655743	12.36403245	20.12629713	0	0.058844493	6.714390911	9.12417898	9.77393933	0.218891247	8.666068892	0	0	1.810196625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3886	0	31.66195119	2.5643	0.055386585	1.01056064	0	0.514998159	1.17008159	0.581361353	1.033351284	3.601655743	12.36403245	20.12629713	0	0.058844493	6.714390911	9.12417898	9.77393933	0.218891247	8.666068892	0	0	1.810196625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3886	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.9973	0.0918	0.5687	1.0396	0.8312	1.6166	0.8032	0.653	2.0073	0.675	1.5995		0.0025	0.8736	3.0289	2.0344	0.0577	0.2062			0.423																					25.5093	0	10.17368889	11.5616	0.147145191	1.579238236	1.039582956	1.346156526	2.786646269	1.384559774	1.686318347	5.60892547	13.03906235	21.72583391	0	0.061390206	7.587984969	12.15307227	11.80834402	0.276558322	8.872269468	0	0	2.233203841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.8979
R5826_811_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		256.739739	5.545243	619.468551	30.125367	91.374134	9.143173	4.542834	366.686911	319.513706	5500.281208	3590.305265		10.440524	1281.703393	8094.334081	5780.503906	54.251222	1537.586035			14.145117																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					123.669835	123.669159	20.198778	0	69.785389	0.13957	0.13957	34.892697	139.570814	27.832815	69.408773		69.785105	64.863576	13.95708	20.93562	49.957554	69.7854			0.13957																					2.6459	0.057147962	1.042708978	0	0.531381624	1.276112656	0.634043341	1.066224607	3.716232336	12.75735911	20.76655693	0	0.060716089	6.927988787	9.414439026	10.08486943	0.225854863	8.941754707	0	0	1.97423398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1235	0	35.5565857	2.6459	0.057147962	1.042708978	0	0.531381624	1.276112656	0.634043341	1.066224607	3.716232336	12.75735911	20.76655693	0	0.060716089	6.927988787	9.414439026	10.08486943	0.225854863	8.941754707	0	0	1.97423398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1235	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.8126	0.1001	0.6202	1.1338	0.9065	1.7631	0.876	0.7121	2.1892	0.7362	1.7445		0.0028	0.9528	3.3034	2.2188	0.0629	0.2249			0.4613																					27.821	0	12.04551197	12.4585	0.157222319	1.662921138	1.133792228	1.437861171	3.039173095	1.51002946	1.778365074	5.905404521	13.49356158	22.51104538	0	0.06349285	7.880748615	12.71781607	12.30363621	0.288747559	9.16664095	0	0	2.435574791	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9446
R5826_812_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		245.877239	5.310627	593.259217	28.85078	87.50815	8.385851	4.166555	351.172613	305.995276	5267.567689	3438.401656		9.998792	1227.475309	7751.86778	5535.934337	51.955886	1472.531715			12.973488																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					126.029978	126.030511	20.584245	0	71.11724	0.142234	0.142234	35.558594	142.234392	28.363982	70.733385		71.116972	66.101447	14.22344	21.33516	50.91097	71.117202			0.142234																					2.5823	0.055775086	1.017649423	0	0.518611509	1.192753131	0.592625784	1.040600364	3.626921003	12.45076626	20.26748234	0	0.059256984	6.761491173	9.188185521	9.842503736	0.220427046	8.726861286	0	0	1.845271092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9895	0	32.48611097	2.5823	0.055775086	1.017649423	0	0.518611509	1.192753131	0.592625784	1.040600364	3.626921003	12.45076626	20.26748234	0	0.059256984	6.761491173	9.188185521	9.842503736	0.220427046	8.726861286	0	0	1.845271092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9895	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.1716	0.0935	0.5797	1.0597	0.8473	1.6479	0.8188	0.6656	2.0462	0.6881	1.6305		0.0026	0.8905	3.0876	2.0738	0.0588	0.2102			0.4312																					26.0036	0	10.56082686	11.7539	0.149311984	1.597345633	1.059726642	1.365874094	2.840640353	1.41138744	1.706219664	5.673083035	13.13887566	21.89801128	0	0.061852051	7.652011507	12.27576721	11.91632823	0.279211812	8.937056704	0	0	2.276474589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.9931
R5826_813_0	2008	3																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		239.462715	5.172081	577.782079	28.098113	85.225209	7.954007	3.951991	342.011108	298.012374	5130.145688	3348.699525		9.73794	1195.452536	7549.634557	5391.511102	50.600444	1434.115833			12.305396																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.450348	127.450955	20.816232	0	71.918692	0.143837	0.143837	35.959342	143.837402	28.683648	71.530555		71.919143	66.846423	14.383739	21.575608	51.484582	71.918698			0.143837																					2.5433	0.054932222	1.002270483	0	0.510773796	1.144080505	0.568442529	1.024874533	3.57211047	12.26260776	19.96119463	0	0.058362025	6.659310491	9.049331084	9.693760839	0.217095226	8.594978624	0	0	1.769971244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.6874	0	30.72420244	2.5433	0.054932222	1.002270483	0	0.510773796	1.144080505	0.568442529	1.024874533	3.57211047	12.26260776	19.96119463	0	0.058362025	6.659310491	9.049331084	9.693760839	0.217095226	8.594978624	0	0	1.769971244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.6874	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.7973	0.0897	0.556	1.0165	0.8127	1.5806	0.7854	0.6385	1.9627	0.66	1.564		0.0025	0.8542	2.9616	1.9892	0.0564	0.2016			0.4136																					24.9425	0	9.739006793	11.3406	0.144652239	1.558310632	1.016482364	1.323462298	2.724722639	1.353793295	1.663332073	5.534775389	12.92263731	21.52518687	0	0.060851131	7.513491049	12.01091798	11.682958	0.273480925	8.796596946	0	0	2.183578565	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.6299
R5826_814_0	2008	3																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		217.579605	4.699435	524.981921	25.530389	77.436971	6.56669	3.262695	310.756695	270.778749	4661.331392	3042.681274		8.848046	1086.207056	6859.717188	4898.812135	45.976364	1303.060294			10.159122																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					132.462682	132.463332	21.634896	0	74.747089	0.149494	0.149494	37.373562	149.494195	29.811712	74.34369		74.747387	69.475349	14.94942	22.424129	53.509434	74.747101			0.149494																					2.4018	0.051875235	0.946494105	0	0.482349014	0.981680755	0.487753326	0.967840384	3.373320925	11.58018908	18.85034612	0	0.055114027	6.288717858	8.545732777	9.154299605	0.205014101	8.11666495	0	0	1.518727784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.0079	0	25.0031617	2.4018	0.051875235	0.946494105	0	0.482349014	0.981680755	0.487753326	0.967840384	3.373320925	11.58018908	18.85034612	0	0.055114027	6.288717858	8.545732777	9.154299605	0.205014101	8.11666495	0	0	1.518727784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.0079	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					7.5486	0.077	0.4771	0.8722	0.6973	1.3563	0.6739	0.5478	1.6841	0.5663	1.342		0.0021	0.7329	2.5412	1.7068	0.0484	0.173			0.3549																					21.4019	0	7.230515128	9.9503	0.128859516	1.423604845	0.872193264	1.179677417	2.337951935	1.161623847	1.515669355	5.05738729	12.14652768	20.19233088	0	0.057249551	7.021648305	11.08692489	10.86113244	0.253396404	8.289663376	0	0	1.873624025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.4098
R5826_815_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		238.513413	5.151578	575.491579	27.986724	84.887351	7.89107	3.92072	340.655275	296.830963	5109.808265	3335.424288		9.699335	1190.71341	7519.705562	5370.137548	50.399849	1428.430571			12.208028																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.662303	127.662548	20.85086	0	72.038341	0.144076	0.144076	36.01915	144.076608	28.731348	71.649512		72.038485	66.957591	14.40766	21.61149	51.570315	72.038299			0.144076																					2.5374	0.054805298	0.999957862	0	0.509595328	1.136913801	0.564881655	1.022509454	3.563866525	12.23430662	19.91512688	0	0.058227117	6.643941792	9.028446753	9.671389493	0.216594674	8.575142381	0	0	1.758883842	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.492	0	30.46672076	2.5374	0.054805298	0.999957862	0	0.509595328	1.136913801	0.564881655	1.022509454	3.563866525	12.23430662	19.91512688	0	0.058227117	6.643941792	9.028446753	9.671389493	0.216594674	8.575142381	0	0	1.758883842	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.492	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.7422	0.0892	0.5526	1.0101	0.8076	1.5707	0.7804	0.6345	1.9504	0.6559	1.5542		0.0025	0.8488	2.943	1.9767	0.056	0.2004			0.411																					24.7863	0	9.620794981	11.2797	0.1439635	1.552516116	1.010116	1.317194378	2.707656345	1.345314341	1.656968051	5.514239383	12.8902031	21.46932367	0	0.060700912	7.492772683	11.97148577	11.64812909	0.272626784	8.775498183	0	0	2.169901244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.2783
R5826_816_0	2008	2	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		243.310394	5.255187	587.065863	28.549592	86.594605	8.211676	4.080015	347.506532	302.800828	5212.576707	3402.506326		9.894409	1214.661033	7670.941848	5478.141732	51.413491	1457.15916			12.704027																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					126.596882	126.596989	20.676843	0	71.437128	0.142874	0.142874	35.718552	142.874215	28.49157	71.051557		71.436746	66.398787	14.287419	21.431129	51.139932	71.4371			0.142874																					2.5669	0.055440904	1.011555723	0	0.515505823	1.173234997	0.582928063	1.034369178	3.60520255	12.37620784	20.14611435	0	0.058902032	6.721001601	9.133163359	9.783563512	0.219106869	8.674602052	0	0	1.815075154	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4728	0	31.7758535	2.5669	0.055440904	1.011555723	0	0.515505823	1.173234997	0.582928063	1.034369178	3.60520255	12.37620784	20.14611435	0	0.058902032	6.721001601	9.133163359	9.783563512	0.219106869	8.674602052	0	0	1.815075154	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4728	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.0215	0.092	0.5702	1.0424	0.8334	1.6209	0.8054	0.6547	2.0127	0.6768	1.6038		0.0026	0.8759	3.0371	2.0399	0.0578	0.2068			0.4241																					25.578	0	10.22693692	11.5884	0.147446888	1.581765227	1.042383731	1.348903176	2.794154226	1.38829064	1.6890952	5.617878549	13.05305579	21.74995939	0	0.061454479	7.596948319	12.17021523	11.82344847	0.276929487	8.88135745	0	0	2.239222219	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.0509
R5826_817_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		229.309655	4.952789	553.284505	26.906772	81.611717	7.293828	3.623977	327.510066	285.376848	4912.630937	3206.716903		9.325058	1144.76615	7229.535094	5162.914631	48.455018	1373.31028			11.284054																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					129.742444	129.742157	21.190601	0	73.212138	0.146424	0.146424	36.606042	146.424206	29.199499	72.81698		73.212272	68.048607	14.642419	21.963629	52.410627	73.212097			0.146424																					2.4793	0.053548794	0.977035932	0	0.497914024	1.067991471	0.530637208	0.999070603	3.482173198	11.95386351	19.45862005	0	0.05689239	6.491645154	8.821490168	9.449695126	0.211629823	8.378577119	0	0	1.652256323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.5623	0	28.01372448	2.4793	0.053548794	0.977035932	0	0.497914024	1.067991471	0.530637208	0.999070603	3.482173198	11.95386351	19.45862005	0	0.05689239	6.491645154	8.821490168	9.449695126	0.211629823	8.378577119	0	0	1.652256323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.5623	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.2122	0.0838	0.5191	0.9489	0.7586	1.4755	0.7331	0.596	1.8321	0.6161	1.46		0.0023	0.7974	2.7646	1.8569	0.0526	0.1882			0.3861																					23.2836	0	8.519334407	10.6915	0.13730124	1.496095079	0.948877868	1.256552447	2.543508134	1.263756089	1.595065417	5.314304537	12.56999605	20.91859452	0	0.059216142	7.289014974	11.58610719	11.30659485	0.264265662	8.566786393	0	0	2.038355707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.8459
R5826_818_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		239.758872	5.178478	578.496657	28.132863	85.330613	7.973704	3.961777	342.434095	298.380944	5136.490445	3352.841063		9.749983	1196.931025	7558.971641	5398.179105	50.663024	1435.889489			12.335869																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.384438	127.384248	20.805471	0	71.881455	0.143763	0.143762	35.940756	143.762978	28.668812	71.493557		71.881625	66.811849	14.376299	21.56445	51.458066	71.881501			0.143763																					2.5451	0.054971377	1.002991285	0	0.511140718	1.146323608	0.569552985	1.025611688	3.574677757	12.27142324	19.97554447	0	0.058403718	6.664097909	9.05583637	9.700730283	0.217251769	8.601157645	0	0	1.773441535	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7483	0	30.80464118	2.5451	0.054971377	1.002991285	0	0.511140718	1.146323608	0.569552985	1.025611688	3.574677757	12.27142324	19.97554447	0	0.058403718	6.664097909	9.05583637	9.700730283	0.217251769	8.601157645	0	0	1.773441535	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7483	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.8146	0.0899	0.5571	1.0185	0.8143	1.5837	0.7869	0.6397	1.9665	0.6613	1.5671		0.0025	0.8559	2.9674	1.9931	0.0565	0.202			0.4144																					24.9913	0	9.776057872	11.3597	0.1448671	1.560120352	1.018472441	1.32542082	2.730060664	1.356441203	1.665318941	5.541185238	12.93274526	21.54259855	0	0.060898007	7.519950676	12.02322114	11.69382242	0.273747753	8.803170537	0	0	2.187858509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.7396
R5826_819_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		238.03391	5.141221	574.33462	27.930459	84.716695	7.859382	3.904976	339.970426	296.23422	5099.535581	3328.718799		9.679836	1188.319617	7504.588054	5359.341502	50.298526	1425.558876			12.159004																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.769704	127.769858	20.868394	0	72.098853	0.144197	0.144197	36.049438	144.1978	28.755517	71.709786		72.098631	67.013912	14.41978	21.62967	51.613775	72.098898			0.144197																					2.5345	0.05474109	0.998786762	0	0.508998045	1.133299306	0.563085824	1.021311899	3.559693567	12.21998184	19.89180939	0	0.058158577	6.636162187	9.017875727	9.660065675	0.2163414	8.565101999	0	0	1.7532919	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3932	0	30.33688584	2.5345	0.05474109	0.998786762	0	0.508998045	1.133299306	0.563085824	1.021311899	3.559693567	12.21998184	19.89180939	0	0.058158577	6.636162187	9.017875727	9.660065675	0.2163414	8.565101999	0	0	1.7532919	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3932	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.7144	0.0889	0.5508	1.0069	0.805	1.5658	0.778	0.6324	1.9442	0.6538	1.5493		0.0025	0.8461	2.9337	1.9705	0.0559	0.1997			0.4097																					24.7075	0	9.561393083	11.2489	0.143615962	1.549589192	1.00690584	1.31403057	2.699050209	1.341038002	1.653754077	5.503868524	12.87379341	21.44106767	0	0.060624359	7.48229541	11.95156194	11.63052357	0.272195697	8.764820999	0	0	2.163002551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1006
R5826_820_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		237.415926	5.127874	572.84353	27.857946	84.496753	7.818619	3.884723	339.087795	295.465136	5086.296156	3320.076772		9.654705	1185.234498	7485.104627	5345.427567	50.16794	1421.857837			12.095942																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.908119	127.908443	20.891007	0	72.17704	0.144354	0.144354	36.088504	144.354001	28.786667	71.787465		72.177112	67.086505	14.435399	21.653098	51.669517	72.176998			0.144353																					2.5306	0.054658198	0.997273183	0	0.508227127	1.128648927	0.560775304	1.019764271	3.554297878	12.20145948	19.86165792	0	0.058070727	6.62610334	9.004205987	9.645422247	0.216012769	8.552119188	0	0	1.746085516	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2654	0	30.16997967	2.5306	0.054658198	0.997273183	0	0.508227127	1.128648927	0.560775304	1.019764271	3.554297878	12.20145948	19.86165792	0	0.058070727	6.62610334	9.004205987	9.645422247	0.216012769	8.552119188	0	0	1.746085516	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2654	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.6786	0.0885	0.5485	1.0028	0.8017	1.5593	0.7748	0.6298	1.9362	0.6511	1.5429		0.0025	0.8427	2.9216	1.9624	0.0556	0.1989			0.408																					24.606	0	9.485177604	11.2093	0.14316741	1.545811887	1.002768775	1.30995192	2.687966609	1.335531161	1.6496082	5.490484157	12.85258479	21.40455028	0	0.060526189	7.46875971	11.92583784	11.60778351	0.271637418	8.751017347	0	0	2.154112923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.8714
R5826_821_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		228.063765	4.925879	550.278387	26.760581	81.168302	7.214782	3.584703	325.730631	283.826332	4885.939516	3189.294093		9.274392	1138.546378	7190.255416	5134.863362	48.191752	1365.848778			11.161764																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					130.027056	130.027483	21.237082	0	73.372752	0.146745	0.146745	36.686351	146.745404	29.263552	72.976709		73.373079	68.197879	14.674539	22.011811	52.525513	73.372699			0.146745																					2.4712	0.053374971	0.973858936	0	0.496295141	1.058733185	0.526037242	0.995822355	3.470850813	11.91499542	19.39534891	0	0.056707558	6.470537344	8.79280696	9.418970153	0.210941375	8.351334272	0	0	1.637933058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2958	0	27.68809329	2.4712	0.053374971	0.973858936	0	0.496295141	1.058733185	0.526037242	0.995822355	3.470850813	11.91499542	19.39534891	0	0.056707558	6.470537344	8.79280696	9.418970153	0.210941375	8.351334272	0	0	1.637933058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2958	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.1411	0.083	0.5146	0.9407	0.7521	1.4627	0.7268	0.5908	1.8163	0.6108	1.4473		0.0023	0.7905	2.7407	1.8408	0.0522	0.1866			0.3828																					23.0818	0	8.376485265	10.6123	0.136402051	1.48841948	0.940653422	1.248357979	2.521460515	1.252801173	1.586650886	5.287102487	12.52578793	20.84266871	0	0.059010727	7.260996849	11.53346147	11.25977527	0.263121104	8.537912244	0	0	2.02068615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.3775
R5826_822_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		236.000494	5.097301	569.428338	27.691862	83.992998	7.725672	3.838541	337.066213	293.703624	5055.972556	3300.28306		9.597146	1178.16834	7440.479756	5313.559073	49.86885	1413.380971			11.952145																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					128.225685	128.22516	20.942867	0	72.356236	0.144712	0.144712	36.178111	144.712417	28.858139	71.965697		72.356004	67.253064	14.47124	21.70686	51.797845	72.356201			0.144712																					2.5218	0.054466853	0.993788496	0	0.506451432	1.117997446	0.555482945	1.016201572	3.541880109	12.1588299	19.79226423	0	0.057867595	6.602952564	8.972747355	9.611723575	0.215258247	8.522239802	0	0	1.729618807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9715	0	29.78915626	2.5218	0.054466853	0.993788496	0	0.506451432	1.117997446	0.555482945	1.016201572	3.541880109	12.1588299	19.79226423	0	0.057867595	6.602952564	8.972747355	9.611723575	0.215258247	8.522239802	0	0	1.729618807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9715	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.5968	0.0877	0.5434	0.9933	0.7942	1.5446	0.7674	0.6239	1.9179	0.645	1.5283		0.0024	0.8347	2.8941	1.9438	0.0551	0.197			0.4042																					24.3738	0	9.312053425	11.1185	0.142140861	1.537152445	0.993308084	1.3006121	2.662603337	1.32292898	1.640103037	5.459799131	12.80381162	21.32059938	0	0.06030021	7.437658753	11.86681446	11.55557144	0.27035894	8.719261393	0	0	2.133796923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.3454
R5826_823_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		223.158071	4.819922	538.441796	26.184955	79.422357	6.907742	3.432148	318.724104	277.721175	4780.842044	3120.691783		9.074899	1114.056034	7035.59168	5024.411492	47.155139	1336.469116			10.686752																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					131.158026	131.158036	21.421803	0	74.010902	0.148021	0.148021	37.005447	148.021792	29.518088	73.611466		74.010745	68.791063	14.802179	22.203268	52.982388	74.010902			0.148021																					2.4391	0.052680959	0.961199507	0	0.489843357	1.022490879	0.508029979	0.982877328	3.425732167	11.76010968	19.14322476	0	0.055970003	6.386424902	8.678507285	9.296529575	0.208199323	8.242773731	0	0	1.581863718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.2355	0	26.4191406	2.4391	0.052680959	0.961199507	0	0.489843357	1.022490879	0.508029979	0.982877328	3.425732167	11.76010968	19.14322476	0	0.055970003	6.386424902	8.678507285	9.296529575	0.208199323	8.242773731	0	0	1.581863718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.2355	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					7.8624	0.0802	0.4969	0.9085	0.7263	1.4127	0.7019	0.5706	1.7541	0.5899	1.3978		0.0022	0.7634	2.6468	1.7778	0.0504	0.1802			0.3697																					22.2917	0	7.827784116	10.3015	0.132865848	1.458147175	0.908455673	1.216163386	2.435150249	1.20991753	1.553482864	5.17981492	12.34999506	20.54100424	0	0.058194771	7.149827352	11.3253517	11.07432616	0.258592604	8.422965109	0	0	1.951514858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.5272
R5826_824_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		242.895601	5.246227	586.065039	28.50092	86.446979	8.183705	4.066118	346.914106	302.284615	5203.690349	3396.705761		9.877541	1212.590287	7657.864489	5468.802642	51.325841	1454.675008			12.660754																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					126.688346	126.688956	20.691778	0	71.488651	0.142977	0.142977	35.744339	142.977402	28.512148	71.102881		71.488837	66.446756	14.297739	21.446609	51.176852	71.488701			0.142977																					2.5643	0.055386585	1.01056064	0	0.514998159	1.17008159	0.581361353	1.033351284	3.601655743	12.36403245	20.12629713	0	0.058844493	6.714390911	9.12417898	9.77393933	0.218891247	8.666068892	0	0	1.810196625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3886	0	31.66195119	2.5643	0.055386585	1.01056064	0	0.514998159	1.17008159	0.581361353	1.033351284	3.601655743	12.36403245	20.12629713	0	0.058844493	6.714390911	9.12417898	9.77393933	0.218891247	8.666068892	0	0	1.810196625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3886	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.9973	0.0918	0.5687	1.0396	0.8312	1.6166	0.8032	0.653	2.0073	0.675	1.5995		0.0025	0.8736	3.0289	2.0344	0.0577	0.2062			0.423																					25.5093	0	10.17368889	11.5616	0.147145191	1.579238236	1.039582956	1.346156526	2.786646269	1.384559774	1.686318347	5.60892547	13.03906235	21.72583391	0	0.061390206	7.587984969	12.15307227	11.80834402	0.276558322	8.872269468	0	0	2.233203841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.8979
R5826_825_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		256.739739	5.545243	619.468551	30.125367	91.374134	9.143173	4.542834	366.686911	319.513706	5500.281208	3590.305265		10.440524	1281.703393	8094.334081	5780.503906	54.251222	1537.586035			14.145117																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					123.669835	123.669159	20.198778	0	69.785389	0.13957	0.13957	34.892697	139.570814	27.832815	69.408773		69.785105	64.863576	13.95708	20.93562	49.957554	69.7854			0.13957																					2.6459	0.057147962	1.042708978	0	0.531381624	1.276112656	0.634043341	1.066224607	3.716232336	12.75735911	20.76655693	0	0.060716089	6.927988787	9.414439026	10.08486943	0.225854863	8.941754707	0	0	1.97423398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1235	0	35.5565857	2.6459	0.057147962	1.042708978	0	0.531381624	1.276112656	0.634043341	1.066224607	3.716232336	12.75735911	20.76655693	0	0.060716089	6.927988787	9.414439026	10.08486943	0.225854863	8.941754707	0	0	1.97423398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1235	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.8126	0.1001	0.6202	1.1338	0.9065	1.7631	0.876	0.7121	2.1892	0.7362	1.7445		0.0028	0.9528	3.3034	2.2188	0.0629	0.2249			0.4613																					27.821	0	12.04551197	12.4585	0.157222319	1.662921138	1.133792228	1.437861171	3.039173095	1.51002946	1.778365074	5.905404521	13.49356158	22.51104538	0	0.06349285	7.880748615	12.71781607	12.30363621	0.288747559	9.16664095	0	0	2.435574791	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9446
R5826_826_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		245.877239	5.310627	593.259217	28.85078	87.50815	8.385851	4.166555	351.172613	305.995276	5267.567689	3438.401656		9.998792	1227.475309	7751.86778	5535.934337	51.955886	1472.531715			12.973488																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					126.029978	126.030511	20.584245	0	71.11724	0.142234	0.142234	35.558594	142.234392	28.363982	70.733385		71.116972	66.101447	14.22344	21.33516	50.91097	71.117202			0.142234																					2.5823	0.055775086	1.017649423	0	0.518611509	1.192753131	0.592625784	1.040600364	3.626921003	12.45076626	20.26748234	0	0.059256984	6.761491173	9.188185521	9.842503736	0.220427046	8.726861286	0	0	1.845271092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9895	0	32.48611097	2.5823	0.055775086	1.017649423	0	0.518611509	1.192753131	0.592625784	1.040600364	3.626921003	12.45076626	20.26748234	0	0.059256984	6.761491173	9.188185521	9.842503736	0.220427046	8.726861286	0	0	1.845271092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9895	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.1716	0.0935	0.5797	1.0597	0.8473	1.6479	0.8188	0.6656	2.0462	0.6881	1.6305		0.0026	0.8905	3.0876	2.0738	0.0588	0.2102			0.4312																					26.0036	0	10.56082686	11.7539	0.149311984	1.597345633	1.059726642	1.365874094	2.840640353	1.41138744	1.706219664	5.673083035	13.13887566	21.89801128	0	0.061852051	7.652011507	12.27576721	11.91632823	0.279211812	8.937056704	0	0	2.276474589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.9931
R5826_827_0	2008	3																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		239.462715	5.172081	577.782079	28.098113	85.225209	7.954007	3.951991	342.011108	298.012374	5130.145688	3348.699525		9.73794	1195.452536	7549.634557	5391.511102	50.600444	1434.115833			12.305396																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.450348	127.450955	20.816232	0	71.918692	0.143837	0.143837	35.959342	143.837402	28.683648	71.530555		71.919143	66.846423	14.383739	21.575608	51.484582	71.918698			0.143837																					2.5433	0.054932222	1.002270483	0	0.510773796	1.144080505	0.568442529	1.024874533	3.57211047	12.26260776	19.96119463	0	0.058362025	6.659310491	9.049331084	9.693760839	0.217095226	8.594978624	0	0	1.769971244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.6874	0	30.72420244	2.5433	0.054932222	1.002270483	0	0.510773796	1.144080505	0.568442529	1.024874533	3.57211047	12.26260776	19.96119463	0	0.058362025	6.659310491	9.049331084	9.693760839	0.217095226	8.594978624	0	0	1.769971244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.6874	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.7973	0.0897	0.556	1.0165	0.8127	1.5806	0.7854	0.6385	1.9627	0.66	1.564		0.0025	0.8542	2.9616	1.9892	0.0564	0.2016			0.4136																					24.9425	0	9.739006793	11.3406	0.144652239	1.558310632	1.016482364	1.323462298	2.724722639	1.353793295	1.663332073	5.534775389	12.92263731	21.52518687	0	0.060851131	7.513491049	12.01091798	11.682958	0.273480925	8.796596946	0	0	2.183578565	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.6299
R5826_828_0	2008	3																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		217.579605	4.699435	524.981921	25.530389	77.436971	6.56669	3.262695	310.756695	270.778749	4661.331392	3042.681274		8.848046	1086.207056	6859.717188	4898.812135	45.976364	1303.060294			10.159122																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					132.462682	132.463332	21.634896	0	74.747089	0.149494	0.149494	37.373562	149.494195	29.811712	74.34369		74.747387	69.475349	14.94942	22.424129	53.509434	74.747101			0.149494																					2.4018	0.051875235	0.946494105	0	0.482349014	0.981680755	0.487753326	0.967840384	3.373320925	11.58018908	18.85034612	0	0.055114027	6.288717858	8.545732777	9.154299605	0.205014101	8.11666495	0	0	1.518727784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.0079	0	25.0031617	2.4018	0.051875235	0.946494105	0	0.482349014	0.981680755	0.487753326	0.967840384	3.373320925	11.58018908	18.85034612	0	0.055114027	6.288717858	8.545732777	9.154299605	0.205014101	8.11666495	0	0	1.518727784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.0079	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					7.5486	0.077	0.4771	0.8722	0.6973	1.3563	0.6739	0.5478	1.6841	0.5663	1.342		0.0021	0.7329	2.5412	1.7068	0.0484	0.173			0.3549																					21.4019	0	7.230515128	9.9503	0.128859516	1.423604845	0.872193264	1.179677417	2.337951935	1.161623847	1.515669355	5.05738729	12.14652768	20.19233088	0	0.057249551	7.021648305	11.08692489	10.86113244	0.253396404	8.289663376	0	0	1.873624025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.4098
R5826_831_0	2008	2	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		243.310394	5.255187	587.065863	28.549592	86.594605	8.211676	4.080015	347.506532	302.800828	5212.576707	3402.506326		9.894409	1214.661033	7670.941848	5478.141732	51.413491	1457.15916			12.704027																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					126.596882	126.596989	20.676843	0	71.437128	0.142874	0.142874	35.718552	142.874215	28.49157	71.051557		71.436746	66.398787	14.287419	21.431129	51.139932	71.4371			0.142874																					2.5669	0.055440904	1.011555723	0	0.515505823	1.173234997	0.582928063	1.034369178	3.60520255	12.37620784	20.14611435	0	0.058902032	6.721001601	9.133163359	9.783563512	0.219106869	8.674602052	0	0	1.815075154	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4728	0	31.7758535	2.5669	0.055440904	1.011555723	0	0.515505823	1.173234997	0.582928063	1.034369178	3.60520255	12.37620784	20.14611435	0	0.058902032	6.721001601	9.133163359	9.783563512	0.219106869	8.674602052	0	0	1.815075154	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4728	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.0215	0.092	0.5702	1.0424	0.8334	1.6209	0.8054	0.6547	2.0127	0.6768	1.6038		0.0026	0.8759	3.0371	2.0399	0.0578	0.2068			0.4241																					25.578	0	10.22693692	11.5884	0.147446888	1.581765227	1.042383731	1.348903176	2.794154226	1.38829064	1.6890952	5.617878549	13.05305579	21.74995939	0	0.061454479	7.596948319	12.17021523	11.82344847	0.276929487	8.88135745	0	0	2.239222219	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.0509
R5826_832_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		229.309655	4.952789	553.284505	26.906772	81.611717	7.293828	3.623977	327.510066	285.376848	4912.630937	3206.716903		9.325058	1144.76615	7229.535094	5162.914631	48.455018	1373.31028			11.284054																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					129.742444	129.742157	21.190601	0	73.212138	0.146424	0.146424	36.606042	146.424206	29.199499	72.81698		73.212272	68.048607	14.642419	21.963629	52.410627	73.212097			0.146424																					2.4793	0.053548794	0.977035932	0	0.497914024	1.067991471	0.530637208	0.999070603	3.482173198	11.95386351	19.45862005	0	0.05689239	6.491645154	8.821490168	9.449695126	0.211629823	8.378577119	0	0	1.652256323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.5623	0	28.01372448	2.4793	0.053548794	0.977035932	0	0.497914024	1.067991471	0.530637208	0.999070603	3.482173198	11.95386351	19.45862005	0	0.05689239	6.491645154	8.821490168	9.449695126	0.211629823	8.378577119	0	0	1.652256323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.5623	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.2122	0.0838	0.5191	0.9489	0.7586	1.4755	0.7331	0.596	1.8321	0.6161	1.46		0.0023	0.7974	2.7646	1.8569	0.0526	0.1882			0.3861																					23.2836	0	8.519334407	10.6915	0.13730124	1.496095079	0.948877868	1.256552447	2.543508134	1.263756089	1.595065417	5.314304537	12.56999605	20.91859452	0	0.059216142	7.289014974	11.58610719	11.30659485	0.264265662	8.566786393	0	0	2.038355707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.8459
R5826_833_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		239.758872	5.178478	578.496657	28.132863	85.330613	7.973704	3.961777	342.434095	298.380944	5136.490445	3352.841063		9.749983	1196.931025	7558.971641	5398.179105	50.663024	1435.889489			12.335869																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.384438	127.384248	20.805471	0	71.881455	0.143763	0.143762	35.940756	143.762978	28.668812	71.493557		71.881625	66.811849	14.376299	21.56445	51.458066	71.881501			0.143763																					2.5451	0.054971377	1.002991285	0	0.511140718	1.146323608	0.569552985	1.025611688	3.574677757	12.27142324	19.97554447	0	0.058403718	6.664097909	9.05583637	9.700730283	0.217251769	8.601157645	0	0	1.773441535	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7483	0	30.80464118	2.5451	0.054971377	1.002991285	0	0.511140718	1.146323608	0.569552985	1.025611688	3.574677757	12.27142324	19.97554447	0	0.058403718	6.664097909	9.05583637	9.700730283	0.217251769	8.601157645	0	0	1.773441535	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7483	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.8146	0.0899	0.5571	1.0185	0.8143	1.5837	0.7869	0.6397	1.9665	0.6613	1.5671		0.0025	0.8559	2.9674	1.9931	0.0565	0.202			0.4144																					24.9913	0	9.776057872	11.3597	0.1448671	1.560120352	1.018472441	1.32542082	2.730060664	1.356441203	1.665318941	5.541185238	12.93274526	21.54259855	0	0.060898007	7.519950676	12.02322114	11.69382242	0.273747753	8.803170537	0	0	2.187858509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.7396
R5826_834_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		238.03391	5.141221	574.33462	27.930459	84.716695	7.859382	3.904976	339.970426	296.23422	5099.535581	3328.718799		9.679836	1188.319617	7504.588054	5359.341502	50.298526	1425.558876			12.159004																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.769704	127.769858	20.868394	0	72.098853	0.144197	0.144197	36.049438	144.1978	28.755517	71.709786		72.098631	67.013912	14.41978	21.62967	51.613775	72.098898			0.144197																					2.5345	0.05474109	0.998786762	0	0.508998045	1.133299306	0.563085824	1.021311899	3.559693567	12.21998184	19.89180939	0	0.058158577	6.636162187	9.017875727	9.660065675	0.2163414	8.565101999	0	0	1.7532919	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3932	0	30.33688584	2.5345	0.05474109	0.998786762	0	0.508998045	1.133299306	0.563085824	1.021311899	3.559693567	12.21998184	19.89180939	0	0.058158577	6.636162187	9.017875727	9.660065675	0.2163414	8.565101999	0	0	1.7532919	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3932	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.7144	0.0889	0.5508	1.0069	0.805	1.5658	0.778	0.6324	1.9442	0.6538	1.5493		0.0025	0.8461	2.9337	1.9705	0.0559	0.1997			0.4097																					24.7075	0	9.561393083	11.2489	0.143615962	1.549589192	1.00690584	1.31403057	2.699050209	1.341038002	1.653754077	5.503868524	12.87379341	21.44106767	0	0.060624359	7.48229541	11.95156194	11.63052357	0.272195697	8.764820999	0	0	2.163002551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1006
R5826_835_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		238.513413	5.151578	575.491579	27.986724	84.887351	7.89107	3.92072	340.655275	296.830963	5109.808265	3335.424288		9.699335	1190.71341	7519.705562	5370.137548	50.399849	1428.430571			12.208028																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.662303	127.662548	20.85086	0	72.038341	0.144076	0.144076	36.01915	144.076608	28.731348	71.649512		72.038485	66.957591	14.40766	21.61149	51.570315	72.038299			0.144076																					2.5374	0.054805298	0.999957862	0	0.509595328	1.136913801	0.564881655	1.022509454	3.563866525	12.23430662	19.91512688	0	0.058227117	6.643941792	9.028446753	9.671389493	0.216594674	8.575142381	0	0	1.758883842	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.492	0	30.46672076	2.5374	0.054805298	0.999957862	0	0.509595328	1.136913801	0.564881655	1.022509454	3.563866525	12.23430662	19.91512688	0	0.058227117	6.643941792	9.028446753	9.671389493	0.216594674	8.575142381	0	0	1.758883842	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.492	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.7422	0.0892	0.5526	1.0101	0.8076	1.5707	0.7804	0.6345	1.9504	0.6559	1.5542		0.0025	0.8488	2.943	1.9767	0.056	0.2004			0.411																					24.7863	0	9.620794981	11.2797	0.1439635	1.552516116	1.010116	1.317194378	2.707656345	1.345314341	1.656968051	5.514239383	12.8902031	21.46932367	0	0.060700912	7.492772683	11.97148577	11.64812909	0.272626784	8.775498183	0	0	2.169901244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.2783
R5826_836_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		237.415926	5.127874	572.84353	27.857946	84.496753	7.818619	3.884723	339.087795	295.465136	5086.296156	3320.076772		9.654705	1185.234498	7485.104627	5345.427567	50.16794	1421.857837			12.095942																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.908119	127.908443	20.891007	0	72.17704	0.144354	0.144354	36.088504	144.354001	28.786667	71.787465		72.177112	67.086505	14.435399	21.653098	51.669517	72.176998			0.144353																					2.5306	0.054658198	0.997273183	0	0.508227127	1.128648927	0.560775304	1.019764271	3.554297878	12.20145948	19.86165792	0	0.058070727	6.62610334	9.004205987	9.645422247	0.216012769	8.552119188	0	0	1.746085516	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2654	0	30.16997967	2.5306	0.054658198	0.997273183	0	0.508227127	1.128648927	0.560775304	1.019764271	3.554297878	12.20145948	19.86165792	0	0.058070727	6.62610334	9.004205987	9.645422247	0.216012769	8.552119188	0	0	1.746085516	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2654	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.6786	0.0885	0.5485	1.0028	0.8017	1.5593	0.7748	0.6298	1.9362	0.6511	1.5429		0.0025	0.8427	2.9216	1.9624	0.0556	0.1989			0.408																					24.606	0	9.485177604	11.2093	0.14316741	1.545811887	1.002768775	1.30995192	2.687966609	1.335531161	1.6496082	5.490484157	12.85258479	21.40455028	0	0.060526189	7.46875971	11.92583784	11.60778351	0.271637418	8.751017347	0	0	2.154112923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.8714
R5826_837_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		228.063765	4.925879	550.278387	26.760581	81.168302	7.214782	3.584703	325.730631	283.826332	4885.939516	3189.294093		9.274392	1138.546378	7190.255416	5134.863362	48.191752	1365.848778			11.161764																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					130.027056	130.027483	21.237082	0	73.372752	0.146745	0.146745	36.686351	146.745404	29.263552	72.976709		73.373079	68.197879	14.674539	22.011811	52.525513	73.372699			0.146745																					2.4712	0.053374971	0.973858936	0	0.496295141	1.058733185	0.526037242	0.995822355	3.470850813	11.91499542	19.39534891	0	0.056707558	6.470537344	8.79280696	9.418970153	0.210941375	8.351334272	0	0	1.637933058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2958	0	27.68809329	2.4712	0.053374971	0.973858936	0	0.496295141	1.058733185	0.526037242	0.995822355	3.470850813	11.91499542	19.39534891	0	0.056707558	6.470537344	8.79280696	9.418970153	0.210941375	8.351334272	0	0	1.637933058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2958	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.1411	0.083	0.5146	0.9407	0.7521	1.4627	0.7268	0.5908	1.8163	0.6108	1.4473		0.0023	0.7905	2.7407	1.8408	0.0522	0.1866			0.3828																					23.0818	0	8.376485265	10.6123	0.136402051	1.48841948	0.940653422	1.248357979	2.521460515	1.252801173	1.586650886	5.287102487	12.52578793	20.84266871	0	0.059010727	7.260996849	11.53346147	11.25977527	0.263121104	8.537912244	0	0	2.02068615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.3775
R5826_838_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		236.000494	5.097301	569.428338	27.691862	83.992998	7.725672	3.838541	337.066213	293.703624	5055.972556	3300.28306		9.597146	1178.16834	7440.479756	5313.559073	49.86885	1413.380971			11.952145																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					128.225685	128.22516	20.942867	0	72.356236	0.144712	0.144712	36.178111	144.712417	28.858139	71.965697		72.356004	67.253064	14.47124	21.70686	51.797845	72.356201			0.144712																					2.5218	0.054466853	0.993788496	0	0.506451432	1.117997446	0.555482945	1.016201572	3.541880109	12.1588299	19.79226423	0	0.057867595	6.602952564	8.972747355	9.611723575	0.215258247	8.522239802	0	0	1.729618807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9715	0	29.78915626	2.5218	0.054466853	0.993788496	0	0.506451432	1.117997446	0.555482945	1.016201572	3.541880109	12.1588299	19.79226423	0	0.057867595	6.602952564	8.972747355	9.611723575	0.215258247	8.522239802	0	0	1.729618807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9715	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.5968	0.0877	0.5434	0.9933	0.7942	1.5446	0.7674	0.6239	1.9179	0.645	1.5283		0.0024	0.8347	2.8941	1.9438	0.0551	0.197			0.4042																					24.3738	0	9.312053425	11.1185	0.142140861	1.537152445	0.993308084	1.3006121	2.662603337	1.32292898	1.640103037	5.459799131	12.80381162	21.32059938	0	0.06030021	7.437658753	11.86681446	11.55557144	0.27035894	8.719261393	0	0	2.133796923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.3454
R5826_839_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		223.158071	4.819922	538.441796	26.184955	79.422357	6.907742	3.432148	318.724104	277.721175	4780.842044	3120.691783		9.074899	1114.056034	7035.59168	5024.411492	47.155139	1336.469116			10.686752																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					131.158026	131.158036	21.421803	0	74.010902	0.148021	0.148021	37.005447	148.021792	29.518088	73.611466		74.010745	68.791063	14.802179	22.203268	52.982388	74.010902			0.148021																					2.4391	0.052680959	0.961199507	0	0.489843357	1.022490879	0.508029979	0.982877328	3.425732167	11.76010968	19.14322476	0	0.055970003	6.386424902	8.678507285	9.296529575	0.208199323	8.242773731	0	0	1.581863718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.2355	0	26.4191406	2.4391	0.052680959	0.961199507	0	0.489843357	1.022490879	0.508029979	0.982877328	3.425732167	11.76010968	19.14322476	0	0.055970003	6.386424902	8.678507285	9.296529575	0.208199323	8.242773731	0	0	1.581863718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.2355	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					7.8624	0.0802	0.4969	0.9085	0.7263	1.4127	0.7019	0.5706	1.7541	0.5899	1.3978		0.0022	0.7634	2.6468	1.7778	0.0504	0.1802			0.3697																					22.2917	0	7.827784116	10.3015	0.132865848	1.458147175	0.908455673	1.216163386	2.435150249	1.20991753	1.553482864	5.17981492	12.34999506	20.54100424	0	0.058194771	7.149827352	11.3253517	11.07432616	0.258592604	8.422965109	0	0	1.951514858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.5272
R5826_840_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		242.895601	5.246227	586.065039	28.50092	86.446979	8.183705	4.066118	346.914106	302.284615	5203.690349	3396.705761		9.877541	1212.590287	7657.864489	5468.802642	51.325841	1454.675008			12.660754																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					126.688346	126.688956	20.691778	0	71.488651	0.142977	0.142977	35.744339	142.977402	28.512148	71.102881		71.488837	66.446756	14.297739	21.446609	51.176852	71.488701			0.142977																					2.5643	0.055386585	1.01056064	0	0.514998159	1.17008159	0.581361353	1.033351284	3.601655743	12.36403245	20.12629713	0	0.058844493	6.714390911	9.12417898	9.77393933	0.218891247	8.666068892	0	0	1.810196625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3886	0	31.66195119	2.5643	0.055386585	1.01056064	0	0.514998159	1.17008159	0.581361353	1.033351284	3.601655743	12.36403245	20.12629713	0	0.058844493	6.714390911	9.12417898	9.77393933	0.218891247	8.666068892	0	0	1.810196625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3886	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.9973	0.0918	0.5687	1.0396	0.8312	1.6166	0.8032	0.653	2.0073	0.675	1.5995		0.0025	0.8736	3.0289	2.0344	0.0577	0.2062			0.423																					25.5093	0	10.17368889	11.5616	0.147145191	1.579238236	1.039582956	1.346156526	2.786646269	1.384559774	1.686318347	5.60892547	13.03906235	21.72583391	0	0.061390206	7.587984969	12.15307227	11.80834402	0.276558322	8.872269468	0	0	2.233203841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.8979
R5826_841_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		256.739739	5.545243	619.468551	30.125367	91.374134	9.143173	4.542834	366.686911	319.513706	5500.281208	3590.305265		10.440524	1281.703393	8094.334081	5780.503906	54.251222	1537.586035			14.145117																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					123.669835	123.669159	20.198778	0	69.785389	0.13957	0.13957	34.892697	139.570814	27.832815	69.408773		69.785105	64.863576	13.95708	20.93562	49.957554	69.7854			0.13957																					2.6459	0.057147962	1.042708978	0	0.531381624	1.276112656	0.634043341	1.066224607	3.716232336	12.75735911	20.76655693	0	0.060716089	6.927988787	9.414439026	10.08486943	0.225854863	8.941754707	0	0	1.97423398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1235	0	35.5565857	2.6459	0.057147962	1.042708978	0	0.531381624	1.276112656	0.634043341	1.066224607	3.716232336	12.75735911	20.76655693	0	0.060716089	6.927988787	9.414439026	10.08486943	0.225854863	8.941754707	0	0	1.97423398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1235	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.8126	0.1001	0.6202	1.1338	0.9065	1.7631	0.876	0.7121	2.1892	0.7362	1.7445		0.0028	0.9528	3.3034	2.2188	0.0629	0.2249			0.4613																					27.821	0	12.04551197	12.4585	0.157222319	1.662921138	1.133792228	1.437861171	3.039173095	1.51002946	1.778365074	5.905404521	13.49356158	22.51104538	0	0.06349285	7.880748615	12.71781607	12.30363621	0.288747559	9.16664095	0	0	2.435574791	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9446
R5826_842_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		245.877239	5.310627	593.259217	28.85078	87.50815	8.385851	4.166555	351.172613	305.995276	5267.567689	3438.401656		9.998792	1227.475309	7751.86778	5535.934337	51.955886	1472.531715			12.973488																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					126.029978	126.030511	20.584245	0	71.11724	0.142234	0.142234	35.558594	142.234392	28.363982	70.733385		71.116972	66.101447	14.22344	21.33516	50.91097	71.117202			0.142234																					2.5823	0.055775086	1.017649423	0	0.518611509	1.192753131	0.592625784	1.040600364	3.626921003	12.45076626	20.26748234	0	0.059256984	6.761491173	9.188185521	9.842503736	0.220427046	8.726861286	0	0	1.845271092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9895	0	32.48611097	2.5823	0.055775086	1.017649423	0	0.518611509	1.192753131	0.592625784	1.040600364	3.626921003	12.45076626	20.26748234	0	0.059256984	6.761491173	9.188185521	9.842503736	0.220427046	8.726861286	0	0	1.845271092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9895	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.1716	0.0935	0.5797	1.0597	0.8473	1.6479	0.8188	0.6656	2.0462	0.6881	1.6305		0.0026	0.8905	3.0876	2.0738	0.0588	0.2102			0.4312																					26.0036	0	10.56082686	11.7539	0.149311984	1.597345633	1.059726642	1.365874094	2.840640353	1.41138744	1.706219664	5.673083035	13.13887566	21.89801128	0	0.061852051	7.652011507	12.27576721	11.91632823	0.279211812	8.937056704	0	0	2.276474589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.9931
R5826_843_0	2008	3																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		239.462715	5.172081	577.782079	28.098113	85.225209	7.954007	3.951991	342.011108	298.012374	5130.145688	3348.699525		9.73794	1195.452536	7549.634557	5391.511102	50.600444	1434.115833			12.305396																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.450348	127.450955	20.816232	0	71.918692	0.143837	0.143837	35.959342	143.837402	28.683648	71.530555		71.919143	66.846423	14.383739	21.575608	51.484582	71.918698			0.143837																					2.5433	0.054932222	1.002270483	0	0.510773796	1.144080505	0.568442529	1.024874533	3.57211047	12.26260776	19.96119463	0	0.058362025	6.659310491	9.049331084	9.693760839	0.217095226	8.594978624	0	0	1.769971244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.6874	0	30.72420244	2.5433	0.054932222	1.002270483	0	0.510773796	1.144080505	0.568442529	1.024874533	3.57211047	12.26260776	19.96119463	0	0.058362025	6.659310491	9.049331084	9.693760839	0.217095226	8.594978624	0	0	1.769971244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.6874	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.7973	0.0897	0.556	1.0165	0.8127	1.5806	0.7854	0.6385	1.9627	0.66	1.564		0.0025	0.8542	2.9616	1.9892	0.0564	0.2016			0.4136																					24.9425	0	9.739006793	11.3406	0.144652239	1.558310632	1.016482364	1.323462298	2.724722639	1.353793295	1.663332073	5.534775389	12.92263731	21.52518687	0	0.060851131	7.513491049	12.01091798	11.682958	0.273480925	8.796596946	0	0	2.183578565	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.6299
R5826_844_0	2008	3																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		217.579605	4.699435	524.981921	25.530389	77.436971	6.56669	3.262695	310.756695	270.778749	4661.331392	3042.681274		8.848046	1086.207056	6859.717188	4898.812135	45.976364	1303.060294			10.159122																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					132.462682	132.463332	21.634896	0	74.747089	0.149494	0.149494	37.373562	149.494195	29.811712	74.34369		74.747387	69.475349	14.94942	22.424129	53.509434	74.747101			0.149494																					2.4018	0.051875235	0.946494105	0	0.482349014	0.981680755	0.487753326	0.967840384	3.373320925	11.58018908	18.85034612	0	0.055114027	6.288717858	8.545732777	9.154299605	0.205014101	8.11666495	0	0	1.518727784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.0079	0	25.0031617	2.4018	0.051875235	0.946494105	0	0.482349014	0.981680755	0.487753326	0.967840384	3.373320925	11.58018908	18.85034612	0	0.055114027	6.288717858	8.545732777	9.154299605	0.205014101	8.11666495	0	0	1.518727784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.0079	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					7.5486	0.077	0.4771	0.8722	0.6973	1.3563	0.6739	0.5478	1.6841	0.5663	1.342		0.0021	0.7329	2.5412	1.7068	0.0484	0.173			0.3549																					21.4019	0	7.230515128	9.9503	0.128859516	1.423604845	0.872193264	1.179677417	2.337951935	1.161623847	1.515669355	5.05738729	12.14652768	20.19233088	0	0.057249551	7.021648305	11.08692489	10.86113244	0.253396404	8.289663376	0	0	1.873624025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.4098
R5826_845_0	2008	2	s.	t.									Health & Education (Non-Covered)	Health & Education (Non-Covered)									3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		243.310394	5.255187	587.065863	28.549592	86.594605	8.211676	4.080015	347.506532	302.800828	5212.576707	3402.506326		9.894409	1214.661033	7670.941848	5478.141732	51.413491	1457.15916			12.704027																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					126.596882	126.596989	20.676843	0	71.437128	0.142874	0.142874	35.718552	142.874215	28.49157	71.051557		71.436746	66.398787	14.287419	21.431129	51.139932	71.4371			0.142874																					2.5669	0.055440904	1.011555723	0	0.515505823	1.173234997	0.582928063	1.034369178	3.60520255	12.37620784	20.14611435	0	0.058902032	6.721001601	9.133163359	9.783563512	0.219106869	8.674602052	0	0	1.815075154	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4728	0	31.7758535	2.5669	0.055440904	1.011555723	0	0.515505823	1.173234997	0.582928063	1.034369178	3.60520255	12.37620784	20.14611435	0	0.058902032	6.721001601	9.133163359	9.783563512	0.219106869	8.674602052	0	0	1.815075154	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4728	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.0215	0.092	0.5702	1.0424	0.8334	1.6209	0.8054	0.6547	2.0127	0.6768	1.6038		0.0026	0.8759	3.0371	2.0399	0.0578	0.2068			0.4241																					25.578	0	10.22693692	11.5884	0.147446888	1.581765227	1.042383731	1.348903176	2.794154226	1.38829064	1.6890952	5.617878549	13.05305579	21.74995939	0	0.061454479	7.596948319	12.17021523	11.82344847	0.276929487	8.88135745	0	0	2.239222219	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.0509
R5826_846_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		229.309655	4.952789	553.284505	26.906772	81.611717	7.293828	3.623977	327.510066	285.376848	4912.630937	3206.716903		9.325058	1144.76615	7229.535094	5162.914631	48.455018	1373.31028			11.284054																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					129.742444	129.742157	21.190601	0	73.212138	0.146424	0.146424	36.606042	146.424206	29.199499	72.81698		73.212272	68.048607	14.642419	21.963629	52.410627	73.212097			0.146424																					2.4793	0.053548794	0.977035932	0	0.497914024	1.067991471	0.530637208	0.999070603	3.482173198	11.95386351	19.45862005	0	0.05689239	6.491645154	8.821490168	9.449695126	0.211629823	8.378577119	0	0	1.652256323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.5623	0	28.01372448	2.4793	0.053548794	0.977035932	0	0.497914024	1.067991471	0.530637208	0.999070603	3.482173198	11.95386351	19.45862005	0	0.05689239	6.491645154	8.821490168	9.449695126	0.211629823	8.378577119	0	0	1.652256323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.5623	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.2122	0.0838	0.5191	0.9489	0.7586	1.4755	0.7331	0.596	1.8321	0.6161	1.46		0.0023	0.7974	2.7646	1.8569	0.0526	0.1882			0.3861																					23.2836	0	8.519334407	10.6915	0.13730124	1.496095079	0.948877868	1.256552447	2.543508134	1.263756089	1.595065417	5.314304537	12.56999605	20.91859452	0	0.059216142	7.289014974	11.58610719	11.30659485	0.264265662	8.566786393	0	0	2.038355707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.8459
R5826_847_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		239.758872	5.178478	578.496657	28.132863	85.330613	7.973704	3.961777	342.434095	298.380944	5136.490445	3352.841063		9.749983	1196.931025	7558.971641	5398.179105	50.663024	1435.889489			12.335869																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.384438	127.384248	20.805471	0	71.881455	0.143763	0.143762	35.940756	143.762978	28.668812	71.493557		71.881625	66.811849	14.376299	21.56445	51.458066	71.881501			0.143763																					2.5451	0.054971377	1.002991285	0	0.511140718	1.146323608	0.569552985	1.025611688	3.574677757	12.27142324	19.97554447	0	0.058403718	6.664097909	9.05583637	9.700730283	0.217251769	8.601157645	0	0	1.773441535	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7483	0	30.80464118	2.5451	0.054971377	1.002991285	0	0.511140718	1.146323608	0.569552985	1.025611688	3.574677757	12.27142324	19.97554447	0	0.058403718	6.664097909	9.05583637	9.700730283	0.217251769	8.601157645	0	0	1.773441535	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7483	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.8146	0.0899	0.5571	1.0185	0.8143	1.5837	0.7869	0.6397	1.9665	0.6613	1.5671		0.0025	0.8559	2.9674	1.9931	0.0565	0.202			0.4144																					24.9913	0	9.776057872	11.3597	0.1448671	1.560120352	1.018472441	1.32542082	2.730060664	1.356441203	1.665318941	5.541185238	12.93274526	21.54259855	0	0.060898007	7.519950676	12.02322114	11.69382242	0.273747753	8.803170537	0	0	2.187858509	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.7396
R5826_848_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		238.03391	5.141221	574.33462	27.930459	84.716695	7.859382	3.904976	339.970426	296.23422	5099.535581	3328.718799		9.679836	1188.319617	7504.588054	5359.341502	50.298526	1425.558876			12.159004																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.769704	127.769858	20.868394	0	72.098853	0.144197	0.144197	36.049438	144.1978	28.755517	71.709786		72.098631	67.013912	14.41978	21.62967	51.613775	72.098898			0.144197																					2.5345	0.05474109	0.998786762	0	0.508998045	1.133299306	0.563085824	1.021311899	3.559693567	12.21998184	19.89180939	0	0.058158577	6.636162187	9.017875727	9.660065675	0.2163414	8.565101999	0	0	1.7532919	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3932	0	30.33688584	2.5345	0.05474109	0.998786762	0	0.508998045	1.133299306	0.563085824	1.021311899	3.559693567	12.21998184	19.89180939	0	0.058158577	6.636162187	9.017875727	9.660065675	0.2163414	8.565101999	0	0	1.7532919	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3932	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.7144	0.0889	0.5508	1.0069	0.805	1.5658	0.778	0.6324	1.9442	0.6538	1.5493		0.0025	0.8461	2.9337	1.9705	0.0559	0.1997			0.4097																					24.7075	0	9.561393083	11.2489	0.143615962	1.549589192	1.00690584	1.31403057	2.699050209	1.341038002	1.653754077	5.503868524	12.87379341	21.44106767	0	0.060624359	7.48229541	11.95156194	11.63052357	0.272195697	8.764820999	0	0	2.163002551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1006
R5826_849_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		238.513413	5.151578	575.491579	27.986724	84.887351	7.89107	3.92072	340.655275	296.830963	5109.808265	3335.424288		9.699335	1190.71341	7519.705562	5370.137548	50.399849	1428.430571			12.208028																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.662303	127.662548	20.85086	0	72.038341	0.144076	0.144076	36.01915	144.076608	28.731348	71.649512		72.038485	66.957591	14.40766	21.61149	51.570315	72.038299			0.144076																					2.5374	0.054805298	0.999957862	0	0.509595328	1.136913801	0.564881655	1.022509454	3.563866525	12.23430662	19.91512688	0	0.058227117	6.643941792	9.028446753	9.671389493	0.216594674	8.575142381	0	0	1.758883842	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.492	0	30.46672076	2.5374	0.054805298	0.999957862	0	0.509595328	1.136913801	0.564881655	1.022509454	3.563866525	12.23430662	19.91512688	0	0.058227117	6.643941792	9.028446753	9.671389493	0.216594674	8.575142381	0	0	1.758883842	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.492	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.7422	0.0892	0.5526	1.0101	0.8076	1.5707	0.7804	0.6345	1.9504	0.6559	1.5542		0.0025	0.8488	2.943	1.9767	0.056	0.2004			0.411																					24.7863	0	9.620794981	11.2797	0.1439635	1.552516116	1.010116	1.317194378	2.707656345	1.345314341	1.656968051	5.514239383	12.8902031	21.46932367	0	0.060700912	7.492772683	11.97148577	11.64812909	0.272626784	8.775498183	0	0	2.169901244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.2783
R5826_850_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		237.415926	5.127874	572.84353	27.857946	84.496753	7.818619	3.884723	339.087795	295.465136	5086.296156	3320.076772		9.654705	1185.234498	7485.104627	5345.427567	50.16794	1421.857837			12.095942																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.908119	127.908443	20.891007	0	72.17704	0.144354	0.144354	36.088504	144.354001	28.786667	71.787465		72.177112	67.086505	14.435399	21.653098	51.669517	72.176998			0.144353																					2.5306	0.054658198	0.997273183	0	0.508227127	1.128648927	0.560775304	1.019764271	3.554297878	12.20145948	19.86165792	0	0.058070727	6.62610334	9.004205987	9.645422247	0.216012769	8.552119188	0	0	1.746085516	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2654	0	30.16997967	2.5306	0.054658198	0.997273183	0	0.508227127	1.128648927	0.560775304	1.019764271	3.554297878	12.20145948	19.86165792	0	0.058070727	6.62610334	9.004205987	9.645422247	0.216012769	8.552119188	0	0	1.746085516	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2654	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.6786	0.0885	0.5485	1.0028	0.8017	1.5593	0.7748	0.6298	1.9362	0.6511	1.5429		0.0025	0.8427	2.9216	1.9624	0.0556	0.1989			0.408																					24.606	0	9.485177604	11.2093	0.14316741	1.545811887	1.002768775	1.30995192	2.687966609	1.335531161	1.6496082	5.490484157	12.85258479	21.40455028	0	0.060526189	7.46875971	11.92583784	11.60778351	0.271637418	8.751017347	0	0	2.154112923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.8714
R5826_851_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		228.063765	4.925879	550.278387	26.760581	81.168302	7.214782	3.584703	325.730631	283.826332	4885.939516	3189.294093		9.274392	1138.546378	7190.255416	5134.863362	48.191752	1365.848778			11.161764																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					130.027056	130.027483	21.237082	0	73.372752	0.146745	0.146745	36.686351	146.745404	29.263552	72.976709		73.373079	68.197879	14.674539	22.011811	52.525513	73.372699			0.146745																					2.4712	0.053374971	0.973858936	0	0.496295141	1.058733185	0.526037242	0.995822355	3.470850813	11.91499542	19.39534891	0	0.056707558	6.470537344	8.79280696	9.418970153	0.210941375	8.351334272	0	0	1.637933058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2958	0	27.68809329	2.4712	0.053374971	0.973858936	0	0.496295141	1.058733185	0.526037242	0.995822355	3.470850813	11.91499542	19.39534891	0	0.056707558	6.470537344	8.79280696	9.418970153	0.210941375	8.351334272	0	0	1.637933058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2958	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.1411	0.083	0.5146	0.9407	0.7521	1.4627	0.7268	0.5908	1.8163	0.6108	1.4473		0.0023	0.7905	2.7407	1.8408	0.0522	0.1866			0.3828																					23.0818	0	8.376485265	10.6123	0.136402051	1.48841948	0.940653422	1.248357979	2.521460515	1.252801173	1.586650886	5.287102487	12.52578793	20.84266871	0	0.059010727	7.260996849	11.53346147	11.25977527	0.263121104	8.537912244	0	0	2.02068615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.3775
R5826_852_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		236.000494	5.097301	569.428338	27.691862	83.992998	7.725672	3.838541	337.066213	293.703624	5055.972556	3300.28306		9.597146	1178.16834	7440.479756	5313.559073	49.86885	1413.380971			11.952145																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					128.225685	128.22516	20.942867	0	72.356236	0.144712	0.144712	36.178111	144.712417	28.858139	71.965697		72.356004	67.253064	14.47124	21.70686	51.797845	72.356201			0.144712																					2.5218	0.054466853	0.993788496	0	0.506451432	1.117997446	0.555482945	1.016201572	3.541880109	12.1588299	19.79226423	0	0.057867595	6.602952564	8.972747355	9.611723575	0.215258247	8.522239802	0	0	1.729618807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9715	0	29.78915626	2.5218	0.054466853	0.993788496	0	0.506451432	1.117997446	0.555482945	1.016201572	3.541880109	12.1588299	19.79226423	0	0.057867595	6.602952564	8.972747355	9.611723575	0.215258247	8.522239802	0	0	1.729618807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9715	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.5968	0.0877	0.5434	0.9933	0.7942	1.5446	0.7674	0.6239	1.9179	0.645	1.5283		0.0024	0.8347	2.8941	1.9438	0.0551	0.197			0.4042																					24.3738	0	9.312053425	11.1185	0.142140861	1.537152445	0.993308084	1.3006121	2.662603337	1.32292898	1.640103037	5.459799131	12.80381162	21.32059938	0	0.06030021	7.437658753	11.86681446	11.55557144	0.27035894	8.719261393	0	0	2.133796923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.3454
R5826_853_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		223.158071	4.819922	538.441796	26.184955	79.422357	6.907742	3.432148	318.724104	277.721175	4780.842044	3120.691783		9.074899	1114.056034	7035.59168	5024.411492	47.155139	1336.469116			10.686752																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					131.158026	131.158036	21.421803	0	74.010902	0.148021	0.148021	37.005447	148.021792	29.518088	73.611466		74.010745	68.791063	14.802179	22.203268	52.982388	74.010902			0.148021																					2.4391	0.052680959	0.961199507	0	0.489843357	1.022490879	0.508029979	0.982877328	3.425732167	11.76010968	19.14322476	0	0.055970003	6.386424902	8.678507285	9.296529575	0.208199323	8.242773731	0	0	1.581863718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.2355	0	26.4191406	2.4391	0.052680959	0.961199507	0	0.489843357	1.022490879	0.508029979	0.982877328	3.425732167	11.76010968	19.14322476	0	0.055970003	6.386424902	8.678507285	9.296529575	0.208199323	8.242773731	0	0	1.581863718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.2355	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					7.8624	0.0802	0.4969	0.9085	0.7263	1.4127	0.7019	0.5706	1.7541	0.5899	1.3978		0.0022	0.7634	2.6468	1.7778	0.0504	0.1802			0.3697																					22.2917	0	7.827784116	10.3015	0.132865848	1.458147175	0.908455673	1.216163386	2.435150249	1.20991753	1.553482864	5.17981492	12.34999506	20.54100424	0	0.058194771	7.149827352	11.3253517	11.07432616	0.258592604	8.422965109	0	0	1.951514858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.5272
R5826_854_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		242.895601	5.246227	586.065039	28.50092	86.446979	8.183705	4.066118	346.914106	302.284615	5203.690349	3396.705761		9.877541	1212.590287	7657.864489	5468.802642	51.325841	1454.675008			12.660754																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					126.688346	126.688956	20.691778	0	71.488651	0.142977	0.142977	35.744339	142.977402	28.512148	71.102881		71.488837	66.446756	14.297739	21.446609	51.176852	71.488701			0.142977																					2.5643	0.055386585	1.01056064	0	0.514998159	1.17008159	0.581361353	1.033351284	3.601655743	12.36403245	20.12629713	0	0.058844493	6.714390911	9.12417898	9.77393933	0.218891247	8.666068892	0	0	1.810196625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3886	0	31.66195119	2.5643	0.055386585	1.01056064	0	0.514998159	1.17008159	0.581361353	1.033351284	3.601655743	12.36403245	20.12629713	0	0.058844493	6.714390911	9.12417898	9.77393933	0.218891247	8.666068892	0	0	1.810196625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3886	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.9973	0.0918	0.5687	1.0396	0.8312	1.6166	0.8032	0.653	2.0073	0.675	1.5995		0.0025	0.8736	3.0289	2.0344	0.0577	0.2062			0.423																					25.5093	0	10.17368889	11.5616	0.147145191	1.579238236	1.039582956	1.346156526	2.786646269	1.384559774	1.686318347	5.60892547	13.03906235	21.72583391	0	0.061390206	7.587984969	12.15307227	11.80834402	0.276558322	8.872269468	0	0	2.233203841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.8979
R5826_855_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		256.739739	5.545243	619.468551	30.125367	91.374134	9.143173	4.542834	366.686911	319.513706	5500.281208	3590.305265		10.440524	1281.703393	8094.334081	5780.503906	54.251222	1537.586035			14.145117																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					123.669835	123.669159	20.198778	0	69.785389	0.13957	0.13957	34.892697	139.570814	27.832815	69.408773		69.785105	64.863576	13.95708	20.93562	49.957554	69.7854			0.13957																					2.6459	0.057147962	1.042708978	0	0.531381624	1.276112656	0.634043341	1.066224607	3.716232336	12.75735911	20.76655693	0	0.060716089	6.927988787	9.414439026	10.08486943	0.225854863	8.941754707	0	0	1.97423398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1235	0	35.5565857	2.6459	0.057147962	1.042708978	0	0.531381624	1.276112656	0.634043341	1.066224607	3.716232336	12.75735911	20.76655693	0	0.060716089	6.927988787	9.414439026	10.08486943	0.225854863	8.941754707	0	0	1.97423398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1235	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.8126	0.1001	0.6202	1.1338	0.9065	1.7631	0.876	0.7121	2.1892	0.7362	1.7445		0.0028	0.9528	3.3034	2.2188	0.0629	0.2249			0.4613																					27.821	0	12.04551197	12.4585	0.157222319	1.662921138	1.133792228	1.437861171	3.039173095	1.51002946	1.778365074	5.905404521	13.49356158	22.51104538	0	0.06349285	7.880748615	12.71781607	12.30363621	0.288747559	9.16664095	0	0	2.435574791	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9446
R5826_856_0	2008	2																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		245.877239	5.310627	593.259217	28.85078	87.50815	8.385851	4.166555	351.172613	305.995276	5267.567689	3438.401656		9.998792	1227.475309	7751.86778	5535.934337	51.955886	1472.531715			12.973488																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					126.029978	126.030511	20.584245	0	71.11724	0.142234	0.142234	35.558594	142.234392	28.363982	70.733385		71.116972	66.101447	14.22344	21.33516	50.91097	71.117202			0.142234																					2.5823	0.055775086	1.017649423	0	0.518611509	1.192753131	0.592625784	1.040600364	3.626921003	12.45076626	20.26748234	0	0.059256984	6.761491173	9.188185521	9.842503736	0.220427046	8.726861286	0	0	1.845271092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9895	0	32.48611097	2.5823	0.055775086	1.017649423	0	0.518611509	1.192753131	0.592625784	1.040600364	3.626921003	12.45076626	20.26748234	0	0.059256984	6.761491173	9.188185521	9.842503736	0.220427046	8.726861286	0	0	1.845271092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9895	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					9.1716	0.0935	0.5797	1.0597	0.8473	1.6479	0.8188	0.6656	2.0462	0.6881	1.6305		0.0026	0.8905	3.0876	2.0738	0.0588	0.2102			0.4312																					26.0036	0	10.56082686	11.7539	0.149311984	1.597345633	1.059726642	1.365874094	2.840640353	1.41138744	1.706219664	5.673083035	13.13887566	21.89801128	0	0.061852051	7.652011507	12.27576721	11.91632823	0.279211812	8.937056704	0	0	2.276474589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.9931
R5826_857_0	2008	3																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		239.462715	5.172081	577.782079	28.098113	85.225209	7.954007	3.951991	342.011108	298.012374	5130.145688	3348.699525		9.73794	1195.452536	7549.634557	5391.511102	50.600444	1434.115833			12.305396																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					127.450348	127.450955	20.816232	0	71.918692	0.143837	0.143837	35.959342	143.837402	28.683648	71.530555		71.919143	66.846423	14.383739	21.575608	51.484582	71.918698			0.143837																					2.5433	0.054932222	1.002270483	0	0.510773796	1.144080505	0.568442529	1.024874533	3.57211047	12.26260776	19.96119463	0	0.058362025	6.659310491	9.049331084	9.693760839	0.217095226	8.594978624	0	0	1.769971244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.6874	0	30.72420244	2.5433	0.054932222	1.002270483	0	0.510773796	1.144080505	0.568442529	1.024874533	3.57211047	12.26260776	19.96119463	0	0.058362025	6.659310491	9.049331084	9.693760839	0.217095226	8.594978624	0	0	1.769971244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.6874	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					8.7973	0.0897	0.556	1.0165	0.8127	1.5806	0.7854	0.6385	1.9627	0.66	1.564		0.0025	0.8542	2.9616	1.9892	0.0564	0.2016			0.4136																					24.9425	0	9.739006793	11.3406	0.144652239	1.558310632	1.016482364	1.323462298	2.724722639	1.353793295	1.663332073	5.534775389	12.92263731	21.52518687	0	0.060851131	7.513491049	12.01091798	11.682958	0.273480925	8.796596946	0	0	2.183578565	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.6299
R5826_858_0	2008	3																					3000											A	A	D	V	T	Coin	Coin	V	V	V	V		P	V	V	V	V	V			Coin																					0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0			0																					0		217.579605	4.699435	524.981921	25.530389	77.436971	6.56669	3.262695	310.756695	270.778749	4661.331392	3042.681274		8.848046	1086.207056	6859.717188	4898.812135	45.976364	1303.060294			10.159122																					$900/Admit	$900/Admit	$0/Day(Days 1-20) $125(Days 21-100)	$0/Visit	$100/Trip	20% Coins	20% Coins	$50/Visit	$200/Visit	$35-$50/Visit	$50-$100/Visit		$0-$100/Proc	$30-$100/Visit	$20/Visit	$30/Visit	$30-$100/Visit	$100/Visit			20% Coins																					132.462682	132.463332	21.634896	0	74.747089	0.149494	0.149494	37.373562	149.494195	29.811712	74.34369		74.747387	69.475349	14.94942	22.424129	53.509434	74.747101			0.149494																					2.4018	0.051875235	0.946494105	0	0.482349014	0.981680755	0.487753326	0.967840384	3.373320925	11.58018908	18.85034612	0	0.055114027	6.288717858	8.545732777	9.154299605	0.205014101	8.11666495	0	0	1.518727784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.0079	0	25.0031617	2.4018	0.051875235	0.946494105	0	0.482349014	0.981680755	0.487753326	0.967840384	3.373320925	11.58018908	18.85034612	0	0.055114027	6.288717858	8.545732777	9.154299605	0.205014101	8.11666495	0	0	1.518727784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.0079	5000	25% Coins	25% Coins	25% Coins(Days 1-20) $0(Days 21-100)	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins		25% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins																					7.5486	0.077	0.4771	0.8722	0.6973	1.3563	0.6739	0.5478	1.6841	0.5663	1.342		0.0021	0.7329	2.5412	1.7068	0.0484	0.173			0.3549																					21.4019	0	7.230515128	9.9503	0.128859516	1.423604845	0.872193264	1.179677417	2.337951935	1.161623847	1.515669355	5.05738729	12.14652768	20.19233088	0	0.057249551	7.021648305	11.08692489	10.86113244	0.253396404	8.289663376	0	0	1.873624025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.4098
R5863_001_0	2008	2																					3100											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	coin	P	V	V	V	V	coin	coin	coin	O	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	10000	186.0615663	1.166123751	394.8093814	5.727370573	154.3737528	11.3572092	0.479708589	282.883346	347.1777367	3.800692364	9.361389973	0	0.03544024	314.2488612	2106.743937	4096.24824	117.6563757	438.7221096	18.02199988	14.42912095	21.94782775	576.8098989	0	0	0	0	0	0	0	425	0											$300/Admit	$956 ded $239 days 60-90; $478 days 91-190	$50/Day		$100/Trip	"30% Coinsurance DME, $0 Diabetic Supplies"	30% Coinsurance	$50 ER; $35 Urgent Care	$150/Visit		"$15 X-Ray, 20% Rad Ther, 30% Other"		20% Coinsurance	$35 PT/OT; $35 Cardiovascular	$10/Visit	$35/Visit	$35/Visit	$35/Visit		$35/Visit SA & Hearing Exams	30% Coinsurance	$35/Visit Vision																				262.0915858	885.5192308	43.68193096	0	87.36386193	0.246369585	0.262091586	39.02846073	131.0457929	0	0.191010548	0	0.174727724	30.57735167	8.736386193	30.57735167	30.57735167	30.57735167	0	0.008140492	0.262091586	30.57735167	0	0	0	0	0	0	0	0	0											4.0638	0.086052084	1.437169678	0	1.123890602	2.798070919	0.125727585	0.920041797	3.791348482	0	1.788124225	0	0.006192392	0.800741495	1.533777387	10.43770191	0.299801698	1.117913353	0	0.117460144	5.752340978	1.469776594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.6699	0	5.828	4.0638	0.086052084	1.437169678	0	1.123890602	2.798070919	0.125727585	0.920041797	3.791348482	0	1.788124225	0	0.006192392	0.800741495	1.533777387	10.43770191	0.299801698	1.117913353	0	0.117460144	5.752340978	1.469776594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.6699	10000	$600/admit	$1500 ded $239 days 60-90; $478 days 91-190	$100/Day		$100/Trip	"30% Coinsurance DME, $0 Diabetic Supplies"	30% Coinsurance	$50 ER; $40 Urgent Care	$300/Visit	30% Coinsurance	"$20 X-Ray, 20% Rad Ther, 30% Other"		20% Coinsurance	$40/Visit	$20/Visit	$40/Visit	$40/Visit	$40/Visit		$40/Visit SA & 30% Coinsurance Hearing	30% Coinsurance	30% Coinsurance																				1.7548	0.0287	0.9351	0	0.2291	0.1893	0.0239	0.3088	2.4714	0.4424	0.6834	0	0.0071	0.2983	0.5581	2.2287	0.0612	0.2282	0	0.0122	1.1323	0.2149	0	0	0	0	0	0	0	0	0											11.808	0	0.3795	5.8186	0.114777034	2.372236537	0	1.353016341	2.98740121	0.149595451	1.228833335	6.262778679	0.442435253	2.471482383	0	0.013297109	1.099011053	2.091829823	12.66640428	0.361006489	1.346136386	0	0.129659008	6.884642815	1.684719077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4779
R5863_801_0	2008	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	191.1570174	0.416448996	12.72132472	5.555549456	13.88829345	11.01649292	0.465317332	13.02717499	27.87137975	3.686671593	9.080548274	0	0.034377033	9.964139407	28.20562106	85.10095175	0.966570141	1.642543973	16.8349873	13.67728024	21.28939291	3.964424816	0	0	0	0	0	0	0	0	0											Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits											0.073568541	0.073568541	0.167623257	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											14.0631	0.030637545	2.132389882	0	3.249860667	2.577859344	0.108884256	3.048358947	6.521902861	0.862681153	2.124848296	0	0.008044226	2.331608621	6.600115329	19.91362271	0.226177413	0.38435529	3.939387029	3.200483576	4.981717942	0.927675407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.2338	0	0	14.0631	0.030637545	2.132389882	0	3.249860667	2.577859344	0.108884256	3.048358947	6.521902861	0.862681153	2.124848296	0	0.008044226	2.331608621	6.600115329	19.91362271	0.226177413	0.38435529	3.939387029	3.200483576	4.981717942	0.927675407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.2338	none	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits											3.3392	0.012	0.631	0	0.1775	0.1573	0.0186	0.2609	2.2098	0.3455	0.7066	0	0.0083	0.8396	1.1125	3.8125	0.033	0.1281	0.7118	0.9566	0.8842	0.1969	0	0	0	0	0	0	0	0	0											16.5419	0	0	17.4024	0.042617293	2.763362345	0	3.427363255	2.735145589	0.127523068	3.30927649	8.731707744	1.208186186	2.831488379	0	0.016366513	3.171182606	7.71261478	23.72608447	0.259183418	0.512501696	4.651143671	4.157087939	5.865951242	1.124539093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7757
R5863_803_0	2008	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	191.1570174	0.416448996	12.72132472	5.555549456	13.88829345	11.01649292	0.465317332	13.02717499	27.87137975	3.686671593	9.080548274	0	0.034377033	9.964139407	28.20562106	85.10095175	0.966570141	1.642543973	16.8349873	13.67728024	21.28939291	3.964424816	0	0	0	0	0	0	0	0	0											Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits											0.073568541	0.073568541	0.167623257	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											14.0631	0.030637545	2.132389882	0	3.249860667	2.577859344	0.108884256	3.048358947	6.521902861	0.862681153	2.124848296	0	0.008044226	2.331608621	6.600115329	19.91362271	0.226177413	0.38435529	3.939387029	3.200483576	4.981717942	0.927675407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.2338	0	0	14.0631	0.030637545	2.132389882	0	3.249860667	2.577859344	0.108884256	3.048358947	6.521902861	0.862681153	2.124848296	0	0.008044226	2.331608621	6.600115329	19.91362271	0.226177413	0.38435529	3.939387029	3.200483576	4.981717942	0.927675407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.2338	none	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits											3.3392	0.012	0.631	0	0.1775	0.1573	0.0186	0.2609	2.2098	0.3455	0.7066	0	0.0083	0.8396	1.1125	3.8125	0.033	0.1281	0.7118	0.9566	0.8842	0.1969	0	0	0	0	0	0	0	0	0											16.5419	0	0	17.4024	0.042617293	2.763362345	0	3.427363255	2.735145589	0.127523068	3.30927649	8.731707744	1.208186186	2.831488379	0	0.016366513	3.171182606	7.71261478	23.72608447	0.259183418	0.512501696	4.651143671	4.157087939	5.865951242	1.124539093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7757
R5863_804_0	2008	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	191.1570174	0.416448996	12.72132472	5.555549456	13.88829345	11.01649292	0.465317332	13.02717499	27.87137975	3.686671593	9.080548274	0	0.034377033	9.964139407	28.20562106	85.10095175	0.966570141	1.642543973	16.8349873	13.67728024	21.28939291	3.964424816	0	0	0	0	0	0	0	0	0											Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits											0.073568541	0.073568541	0.167623257	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											14.0631	0.030637545	2.132389882	0	3.249860667	2.577859344	0.108884256	3.048358947	6.521902861	0.862681153	2.124848296	0	0.008044226	2.331608621	6.600115329	19.91362271	0.226177413	0.38435529	3.939387029	3.200483576	4.981717942	0.927675407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.2338	0	0	14.0631	0.030637545	2.132389882	0	3.249860667	2.577859344	0.108884256	3.048358947	6.521902861	0.862681153	2.124848296	0	0.008044226	2.331608621	6.600115329	19.91362271	0.226177413	0.38435529	3.939387029	3.200483576	4.981717942	0.927675407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.2338	none	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits											3.3392	0.012	0.631	0	0.1775	0.1573	0.0186	0.2609	2.2098	0.3455	0.7066	0	0.0083	0.8396	1.1125	3.8125	0.033	0.1281	0.7118	0.9566	0.8842	0.1969	0	0	0	0	0	0	0	0	0											16.5419	0	0	17.4024	0.042617293	2.763362345	0	3.427363255	2.735145589	0.127523068	3.30927649	8.731707744	1.208186186	2.831488379	0	0.016366513	3.171182606	7.71261478	23.72608447	0.259183418	0.512501696	4.651143671	4.157087939	5.865951242	1.124539093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7757
R5863_806_0	2008	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	none	191.1570174	0.416448996	12.72132472	5.555549456	13.88829345	11.01649292	0.465317332	13.02717499	27.87137975	3.686671593	9.080548274	0	0.034377033	9.964139407	28.20562106	85.10095175	0.966570141	1.642543973	16.8349873	13.67728024	21.28939291	3.964424816	0	0	0	0	0	0	0	0	0											Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits											0.073568541	0.073568541	0.167623257	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0	0	0	0	0	0	0	0	0											14.0631	0.030637545	2.132389882	0	3.249860667	2.577859344	0.108884256	3.048358947	6.521902861	0.862681153	2.124848296	0	0.008044226	2.331608621	6.600115329	19.91362271	0.226177413	0.38435529	3.939387029	3.200483576	4.981717942	0.927675407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.2338	0	0	14.0631	0.030637545	2.132389882	0	3.249860667	2.577859344	0.108884256	3.048358947	6.521902861	0.862681153	2.124848296	0	0.008044226	2.331608621	6.600115329	19.91362271	0.226177413	0.38435529	3.939387029	3.200483576	4.981717942	0.927675407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.2338	none	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits	Medicare Benefits											3.3392	0.012	0.631	0	0.1775	0.1573	0.0186	0.2609	2.2098	0.3455	0.7066	0	0.0083	0.8396	1.1125	3.8125	0.033	0.1281	0.7118	0.9566	0.8842	0.1969	0	0	0	0	0	0	0	0	0											16.5419	0	0	17.4024	0.042617293	2.763362345	0	3.427363255	2.735145589	0.127523068	3.30927649	8.731707744	1.208186186	2.831488379	0	0.016366513	3.171182606	7.71261478	23.72608447	0.259183418	0.512501696	4.651143671	4.157087939	5.865951242	1.124539093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7757
R5941_001_0	2008	5	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V		S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	786.4476651	88.92694446	186.19079	0	22.86025121	9.743407037	1.788754931	202.6680766	201.7551573	357.8643514	446.41752	33.77801276	0	0	2481.708871	990.3060824	9.129192638	358.448739	395.3118376		293.9603361				380.4790576	381.8538474	169.4803378					419.9428613	4.564596319	163.6793987	156.3641183	42.97727228	0.018198152	306.3273662	0			$175/day (1-5) with $1750 yearly max	$175/day (1-5) with $1750 yearly max	$75/day for days 21 to 100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$175 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$175 copay	$15/$25 copay for in-home/facility	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$50/$100 copay for Lower/Higher Tier		$15/$22.50/$40/$100 copay levels				$25 copay	Up to $150	$50 max w/specialist copay					$25 copay	$50 copay	$25 copay	$25 copay	$10 copay	20% coinsurance	$25 copay	$25 copay			107.0964998	85.84727324	74.76627632	0	74.76627632	0.199376737	0.199376737	49.84418421	174.4546447	53.15017602	61.66816248	174.4546447	0	0	9.968836843	24.92209211	24.92209211	24.92209211	52.48971857		29.40831893				24.92209211	0	24.92209211					24.92209211	49.84418421	24.92209211	24.92209211	9.968836843	0.199376737	24.92209211	0			7.0188	0.636177975	1.160066004	0	0.142431322	1.942608701	0.356636121	0.841818745	2.933093691	1.585046106	2.29414568	0.491060935	0	0	2.061645903	2.056708283	0.018959882	0.744441041	1.729150592	0	0.72040661	0	0	0	0.79019451	0	0.351983716	0	0	0	0	0.872154556	0.018959882	0.339936087	0.324743413	0.035702785	0.003628288	0.636193236	0	0	0	30.1067		0.094115308	7.0188	0.636177975	1.160066004	0	0.142431322	1.942608701	0.356636121	0.841818745	2.933093691	1.585046106	2.29414568	0.491060935	0	0	2.061645903	2.056708283	0.018959882	0.744441041	1.729150592	0	0.72040661	0	0	0	0.79019451	0	0.351983716	0	0	0	0	0.872154556	0.018959882	0.339936087	0.324743413	0.035702785	0.003628288	0.636193236	0	0	0	30.1067	4000	$250/day (1-5) with no yearly max	$250/day (1-5) with no yearly max	20% coinsurance	0	$75 copay	30% coinsurance	30% coinsurance	$50 copay	$250 copay	20% coinsurance	20% coinsurance	$250 copay	$15/$25 copay for in-home/facility	$35 copay	$15 copay	$35 copay	$35 copay	$35 copay	20% coinsurance	0	$15/$22.50/$40/$100 copay levels	0	0	0	$35 copay	Up to $150	$50 max w/specialist copay	0	0	0	0	$35 copay	20% coinsurance	$35 copay	$35 copay	$15 copay	20% coinsurance	$35 copay	$35 copay	0	0	11.14875828	0.135578913	1.364159615	0	0.831383589	1.627405791	0.178448165	0.951310818	4.22594248	1.173702883	2.023082993	0.246355391	0	0	0.072888424	0.164758209	0.007959174	0.007972171	1.721196213	0	0.095512687	0	0	0	0.414644976	0	0	0	0	0	0	0.665917573	0.030528593	0	0.029231295	0.061499608	0.002001496	0.002603711	0.00265739	0	0	27.1855		0.084983438	18.1676	0.771756888	2.524225619	0	0.97381491	3.570014492	0.535084286	1.793129563	7.159036171	2.758748988	4.317228673	0.737416326	0	0	2.134534327	2.221466492	0.026919056	0.752413212	3.450346805	0	0.815919297	0	0	0	1.204839486	0	0.351983716	0	0	0	0	1.538072129	0.049488474	0.339936087	0.353974708	0.097202393	0.005629784	0.638796947	0.00265739	0	0	57.2922
R5941_002_0	2008	5	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			D	D	D	D	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	793.1347527	89.68308158	187.7739521	0	23.05462969	9.909805954	1.819303473	204.3913434	203.4706617	360.907237	450.2133645	34.0652239	0	0	2502.810599	998.7265583	9.20681727	361.4965936	398.6731355	0	296.4598521				383.7142338	385.1007134	170.9214125					423.5135944	4.603408635	165.0711486	157.6936671	43.34270382	0.018508942	308.9320379	0			$175/day (1-5) with $1750 yearly max	$175/day (1-5) with $1750 yearly max	$75/day for days 21 to 100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$150 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$150 copay	$15/$25 copay for in-home/facility	$20 copay	$10 copay	$20 copay	$20 copay	$20 copay	$50/$100 copay for Lower/Higher Tier	$0 copay	$15/$22.50/$40/$100 copay levels				$20 copay	Up to $75	$50 max w/specialist copay					$20 copay	$50 copay	$20 copay	$20 copay	$10 copay	20% coinsurance	$20 copay	$20 copay			105.3075718	84.41328995	73.51738877	0	73.51738877	0.19604637	0.19604637	49.01159251	147.0347775	52.2623614	60.63806436	147.0347775	0	0	9.802318502	19.604637	19.604637	19.604637	51.61293616	0	28.91708565				19.604637	0	19.604637					19.604637	49.01159251	19.604637	19.604637	9.802318502	0.19604637	19.604637	0			6.9603	0.630870331	1.150387553	0	0.141243015	1.942781485	0.356667842	0.834795436	2.49310529	1.571822038	2.275005581	0.417397718	0	0	2.044445554	1.631639304	0.015041359	0.590584125	1.714724258	0	0.714396245	0	0	0	0.626881522	0	0.279237687	0	0	0	0	0.691902524	0.018801699	0.269679996	0.257627258	0.035404916	0.003628611	0.504708372	0	0	0	28.173		0.568160305	6.9603	0.630870331	1.150387553	0	0.141243015	1.942781485	0.356667842	0.834795436	2.49310529	1.571822038	2.275005581	0.417397718	0	0	2.044445554	1.631639304	0.015041359	0.590584125	1.714724258	0	0.714396245	0	0	0	0.626881522	0	0.279237687	0	0	0	0	0.691902524	0.018801699	0.269679996	0.257627258	0.035404916	0.003628611	0.504708372	0	0	0	28.173	3250	$200/day (1-5) with no yearly max	$200/day (1-5) with no yearly max	20% coinsurance	0	$75 copay	30% coinsurance	30% coinsurance	$50 copay	$250 copay	20% coinsurance	20% coinsurance	$250 copay	$15/$25 copay for in-home/facility	$35 copay	$15 copay	$35 copay	$35 copay	$35 copay	20% coinsurance	0	$15/$22.50/$40/$100 copay levels	0	0	0	$35 copay	Up to $75	$50 max w/specialist copay	0	0	0	0	$35 copay	20% coinsurance	$35 copay	$35 copay	$15 copay	20% coinsurance	$35 copay	$35 copay	0	0	8.844595194	0.10755822	1.36428095	0	0.824447341	1.62755054	0.178464037	0.943374015	4.190685366	1.173807277	2.023262935	0.244300044	0	0	0.072280315	0.163383628	0.007892771	0.007905659	1.721349304	0	0.094715823	0	0	0	0.001776322	0	0	0	0	0	0	0.660361811	0.030531308	0	0.028987418	0.060986516	0.002001674	0.002581988	0.00263522	0	0	24.3797		0.491661101	15.8049	0.738428551	2.514668503	0	0.965690355	3.570332025	0.535131879	1.778169451	6.683790656	2.745629315	4.298268517	0.661697762	0	0	2.116725869	1.795022932	0.02293413	0.598489784	3.436073562	0	0.809112068	0	0	0	0.628657844	0	0.279237687	0	0	0	0	1.352264334	0.049333007	0.269679996	0.286614676	0.096391431	0.005630285	0.50729036	0.00263522	0	0	52.5528
R5941_003_0	2008	4	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	790.7694005	89.41562126	187.213957	0	22.98587426	9.850786403	1.808468299	203.7817906	202.8638546	359.8309095	448.8707009	33.96363177	0	0	2495.34651	995.7480731	9.179359937	360.4185085	397.4841795	0	295.5757249				382.5698894	383.9522341	170.4116765					422.2505571	4.589679968	164.5788597	157.22338	43.21344362	0.018398708	308.0107151	0			$175/day (1-5) with $1750 yearly max	$175/day (1-5) with $1750 yearly max	$75/day for days 21 to 100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$175 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$175 copay	$15/$25 copay for in-home/facility	$25 copay	$10 copay	$25 copay	$25 copay	$25 copay	$50/$100 copay for Lower/Higher Tier	0	$15/$22.50/$40/$100 copay levels				$25 copay	Up to $75	$50 max w/specialist copay					$25 copay	$50 copay	$25 copay	$25 copay	$10 copay	20% coinsurance	$25 copay	$25 copay			107.0986621	85.84900647	74.76778583	0	74.76778583	0.199380762	0.199380762	49.84519056	174.4581669	53.15124911	61.66940754	174.4581669	0	0	9.969038111	24.92259528	24.92259528	24.92259528	52.49077833	0	29.40891268				24.92259528	0	24.92259528					24.92259528	49.84519056	24.92259528	24.92259528	9.969038111	0.199380762	24.92259528	0			7.0575	0.639686854	1.16646442	0	0.14321691	1.964057301	0.360573788	0.846461849	2.949271351	1.593788526	2.306799182	0.493769412	0	0	2.073017038	2.068052186	0.019064456	0.748547051	1.738687829	0	0.724380057	0	0	0	0.794552877	0	0.353925104	0	0	0	0	0.876964978	0.019064456	0.341811026	0.326534556	0.035899706	0.003668349	0.6397022	0	0	0	30.2855		0.094060828	7.0575	0.639686854	1.16646442	0	0.14321691	1.964057301	0.360573788	0.846461849	2.949271351	1.593788526	2.306799182	0.493769412	0	0	2.073017038	2.068052186	0.019064456	0.748547051	1.738687829	0	0.724380057	0	0	0	0.794552877	0	0.353925104	0	0	0	0	0.876964978	0.019064456	0.341811026	0.326534556	0.035899706	0.003668349	0.6397022	0	0	0	30.2855	4000	$250/day (1-5) with no yearly max	$250/day (1-5) with no yearly max	20% coinsurance	0	$75 copay	30% coinsurance	30% coinsurance	$50 copay	$250 copay	20% coinsurance	20% coinsurance	$250 copay	$15/$25 copay for in-home/facility	$35 copay	$15 copay	$35 copay	$35 copay	$35 copay	20% coinsurance	0	$15/$22.50/$40/$100 copay levels	0	0	0	$35 copay	Up to $75	$50 max w/specialist copay	0	0	0	0	$35 copay	20% coinsurance	$35 copay	$35 copay	$15 copay	20% coinsurance	$35 copay	$35 copay	0	0	11.21024995	0.136326707	1.379221483	0	0.835969137	1.645374194	0.180418435	0.956557832	4.249250928	1.186661892	2.045420121	0.24771418	0	0	0.073290445	0.165666943	0.008003073	0.008016142	1.740200169	0	0.096039494	0	0	0	0.416931976	0	0	0	0	0	0	0.669590483	0.030865663	0	0.029392522	0.061838813	0.002023595	0.002618072	0.002672047	0	0	27.3803		0.085037918	18.2678	0.776013561	2.545685903	0	0.979186047	3.609431496	0.540992223	1.803019681	7.198522279	2.780450418	4.352219304	0.741483591	0	0	2.146307483	2.233719129	0.02706753	0.756563194	3.478887998	0	0.820419551	0	0	0	1.211484853	0	0.353925104	0	0	0	0	1.546555461	0.049930119	0.341811026	0.355927078	0.097738518	0.005691944	0.642320272	0.002672047	0	0	57.6658
R5941_004_0	2008	4	H.	H.	I.	I.	I.	I.	I.	I.			OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional			0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic			D	D	D	D	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S				V	V	V					V	V	V	V	V	Coin	V	V																																												0	0	829.9074083	93.84112037	196.4798458	0	24.12352745	10.85001838	1.991913486	213.8676807	212.9043128	377.640229	471.0869184	35.64461346	0	0	2618.85014	1045.031209	9.633679312	378.2569104	417.1570941	0	310.2048254				401.5046425	402.9554043	178.8459603					443.1492484	4.816839656	172.7244565	165.0049277	45.3522316	0.020265014	323.2552678	0			$175/day (1-5) with $1750 yearly max	$175/day (1-5) with $1750 yearly max	$75/day for days 21 to 100	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$150 copay	$50/$100 copay for Lower/Higher Tier	$50/$100 copay for Lower/Higher Tier	$150 copay	$15/$25 copay for in-home/facility	$20 copay	$10 copay	$20 copay	$20 copay	$20 copay	$50/$100 copay for Lower/Higher Tier	$0 copay	$15/$22.50/$40/$100 copay levels				$20 copay	Up to $75	$50 max w/specialist copay					$20 copay	$50 copay	$20 copay	$20 copay	$10 copay	20% coinsurance	$20 copay	$20 copay			107.1051953	85.85424341	74.7723468	0	74.7723468	0.199392925	0.199392925	49.8482312	149.5446936	53.15449143	61.67316949	149.5446936	0	0	9.96964624	19.93929248	19.93929248	19.93929248	52.49398036	0	29.41070668				19.93929248	0	19.93929248					19.93929248	49.8482312	19.93929248	19.93929248	9.96964624	0.199392925	19.93929248	0			7.4073	0.671388199	1.224271597	0	0.150314397	2.163416899	0.397173456	0.888410466	2.653225852	1.67277286	2.421118613	0.444205233	0	0	2.175750787	1.736431911	0.016007396	0.628514597	1.824853025	0	0.760278594	0	0	0	0.667143208	0	0.297171826	0	0	0	0	0.736340206	0.020009245	0.287000288	0.27417346	0.037678809	0.0040407	0.537123444	0	0	0	30.0961		0.091631108	7.4073	0.671388199	1.224271597	0	0.150314397	2.163416899	0.397173456	0.888410466	2.653225852	1.67277286	2.421118613	0.444205233	0	0	2.175750787	1.736431911	0.016007396	0.628514597	1.824853025	0	0.760278594	0	0	0	0.667143208	0	0.297171826	0	0	0	0	0.736340206	0.020009245	0.287000288	0.27417346	0.037678809	0.0040407	0.537123444	0	0	0	30.0961	3250	$250/day (1-5) with no yearly max	$250/day (1-5) with no yearly max	20% coinsurance	0	$75 copay	30% coinsurance	30% coinsurance	$50 copay	$250 copay	20% coinsurance	20% coinsurance	$250 copay	$15/$25 copay for in-home/facility	$35 copay	$15 copay	$35 copay	$35 copay	$35 copay	20% coinsurance	0	$15/$22.50/$40/$100 copay levels	0	0	0	$35 copay	Up to $75	$50 max w/specialist copay	0	0	0	0	$35 copay	20% coinsurance	$35 copay	$35 copay	$15 copay	20% coinsurance	$35 copay	$35 copay	0	0	11.76580303	0.143082731	1.519217927	0	0.877397761	1.812386194	0.198731621	1.003962542	4.459833605	1.307112775	2.253038367	0.2599903	0	0	0.076922543	0.173876999	0.008399687	0.008413403	1.916837381	0	0.10079898	0	0	0	0.002500538	0	0	0	0	0	0	0.70277378	0.03399865	0	0.030849145	0.064903396	0.002228998	0.002747817	0.002804468	0	0	28.7286		0.087467638	19.1731	0.81447093	2.743489525	0	1.027712157	3.975803093	0.595905077	1.892373009	7.113059457	2.979885635	4.674156981	0.704195533	0	0	2.252673331	1.91030891	0.024407082	0.636928001	3.741690406	0	0.861077575	0	0	0	0.669643746	0	0.297171826	0	0	0	0	1.439113986	0.054007895	0.287000288	0.305022605	0.102582205	0.006269698	0.539871262	0.002804468	0	0	58.8247
R5941_801_0	2008	5																																coin	coin	coin	V	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V																																																				0		137.8945985	1.747695428	11.42162929	7.519673276	1.761486603	11.91482161	1.36638837	11.46120506	25.15946574	6.984661431	19.10264104	0	0.153229169	18.49729983	21.3040952	61.44039935	0.625337709	2.133493927	13.81660074	11.35337956	10.74695389	0																				Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare																				0.079272664	0.079272664	0.190703166	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				10.9313	0.138544472	2.178140862	0	0.412187865	2.788068256	0.319734879	2.681921983	5.887314983	1.634410775	4.470018004	0	0.035855626	4.328368161	4.985158277	14.37705345	0.146329024	0.499237579	3.233084573	2.656690816	2.51478721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2182			10.9313	0.138544472	2.178140862	0	0.412187865	2.788068256	0.319734879	2.681921983	5.887314983	1.634410775	4.470018004	0	0.035855626	4.328368161	4.985158277	14.37705345	0.146329024	0.499237579	3.233084573	2.656690816	2.51478721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2182		Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare																				10.59267143	0.134252999	0.7221	0	2.3251	1.126918809	0.12923473	1.5978	3.657	0.827948472	2.26439071	0	0.018163494	2.192634715	4.21076595	12.14372819	0.123598337	0.42168623	2.730858616	2.244001616	1.4615	0																				48.9243			21.5239	0.272797471	2.90025324	0	2.737266502	3.914987066	0.448969609	4.279713892	9.544300518	2.462359247	6.734408715	0	0.05401912	6.521002877	9.195924227	26.52078164	0.269927361	0.920923809	5.963943188	4.900692433	3.976290654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.1425
R5941_802_0	2008	5																																coin	coin	coin	V	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V																																																				0		129.8381643	1.645587054	10.75432538	7.080339513	1.658572485	11.21870314	1.286557702	10.79158895	23.68953448	6.576585511	17.98657724	0	0.144276819	17.41660283	20.05941236	57.85076973	0.588802615	2.008845437	13.00937162	10.69006311	10.11906761	0																				Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare																				0.078024419	0.078024419	0.202101542	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				10.1305	0.128395975	2.173465746	0	0.388105962	2.625176536	0.301054502	2.525231814	5.543351069	1.53892101	4.208859074	0	0.033760776	4.075485063	4.693902491	13.53708012	0.137779812	0.470069832	3.04419296	2.501474768	2.36786182	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4247			10.1305	0.128395975	2.173465746	0	0.388105962	2.625176536	0.301054502	2.525231814	5.543351069	1.53892101	4.208859074	0	0.033760776	4.075485063	4.693902491	13.53708012	0.137779812	0.470069832	3.04419296	2.501474768	2.36786182	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4247		Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare																				9.816749485	0.124418856	0.7206	0	2.1892	1.06107905	0.121684245	1.5044	3.4433	0.779575929	2.132094631	0	0.0171023	2.06453095	3.964753712	11.43423596	0.116377156	0.397049388	2.571309344	2.112896761	1.3761	0																				45.9475			19.9473	0.252814831	2.894028196	0	2.577342852	3.686255585	0.422738747	4.029673399	8.986678755	2.318496938	6.340953705	0	0.050863075	6.140016013	8.658656204	24.97131608	0.254156967	0.867119221	5.615502304	4.614371529	3.743977537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.3723
R5941_805_0	2008	5																																coin	coin	coin	V	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V																																																				0		137.8945985	1.747695428	11.42162929	7.519673276	1.761486603	11.91482161	1.36638837	11.46120506	25.15946574	6.984661431	19.10264104	0	0.153229169	18.49729983	21.3040952	61.44039935	0.625337709	2.133493927	13.81660074	11.35337956	10.74695389	0																				Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare																				0.079272664	0.079272664	0.190703166	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				10.9313	0.138544472	2.178140862	0	0.412187865	2.788068256	0.319734879	2.681921983	5.887314983	1.634410775	4.470018004	0	0.035855626	4.328368161	4.985158277	14.37705345	0.146329024	0.499237579	3.233084573	2.656690816	2.51478721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2182			10.9313	0.138544472	2.178140862	0	0.412187865	2.788068256	0.319734879	2.681921983	5.887314983	1.634410775	4.470018004	0	0.035855626	4.328368161	4.985158277	14.37705345	0.146329024	0.499237579	3.233084573	2.656690816	2.51478721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2182		Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare																				10.59267143	0.134252999	0.7221	0	2.3251	1.126918809	0.12923473	1.5978	3.657	0.827948472	2.26439071	0	0.018163494	2.192634715	4.21076595	12.14372819	0.123598337	0.42168623	2.730858616	2.244001616	1.4615	0																				48.9243			21.5239	0.272797471	2.90025324	0	2.737266502	3.914987066	0.448969609	4.279713892	9.544300518	2.462359247	6.734408715	0	0.05401912	6.521002877	9.195924227	26.52078164	0.269927361	0.920923809	5.963943188	4.900692433	3.976290654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.1425
R5941_806_0	2008	5																																coin	coin	coin	V	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	O	V																																																				0		129.8381643	1.645587054	10.75432538	7.080339513	1.658572485	11.21870314	1.286557702	10.79158895	23.68953448	6.576585511	17.98657724	0	0.144276819	17.41660283	20.05941236	57.85076973	0.588802615	2.008845437	13.00937162	10.69006311	10.11906761	0																				Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare																				0.078024419	0.078024419	0.202101542	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234																				10.1305	0.128395975	2.173465746	0	0.388105962	2.625176536	0.301054502	2.525231814	5.543351069	1.53892101	4.208859074	0	0.033760776	4.075485063	4.693902491	13.53708012	0.137779812	0.470069832	3.04419296	2.501474768	2.36786182	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4247			10.1305	0.128395975	2.173465746	0	0.388105962	2.625176536	0.301054502	2.525231814	5.543351069	1.53892101	4.208859074	0	0.033760776	4.075485063	4.693902491	13.53708012	0.137779812	0.470069832	3.04419296	2.501474768	2.36786182	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4247		Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare	Similar to 2008 FFS Medicare																				9.816749485	0.124418856	0.7206	0	2.1892	1.06107905	0.121684245	1.5044	3.4433	0.779575929	2.132094631	0	0.0171023	2.06453095	3.964753712	11.43423596	0.116377156	0.397049388	2.571309344	2.112896761	1.3761	0																				45.9475			19.9473	0.252814831	2.894028196	0	2.577342852	3.686255585	0.422738747	4.029673399	8.986678755	2.318496938	6.340953705	0	0.050863075	6.140016013	8.658656204	24.97131608	0.254156967	0.867119221	5.615502304	4.614371529	3.743977537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.3723
R6801_001_0	2008	15																					0											A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	S	Coin	T	V	V	V	V	V	Coin	O	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	490.5864001	20.80176869	2954.992418	161.7453882	36.75065829	65.16873258	59.725016	15.24089104	31.58023942	22.1328904	29.63245741	2.662684263	4.711597658	84.70233763	98.80620914	195.3104785	5.862882329	3.750162034	49.28241206	67.36164649	1028.110444	7.034728167	0	0	1005.877332	0	0	0	0	0	7											PBP: 1A IP Acute: Traditional FFS Cost Sharing	1B IP Psych: Traditional FFS Cost Sharing	2 SNF: Traditional FFS Cost Sharing	6 Home Health: Traditional FFS Cost Sharing	10A Ambulance: Traditional FFS Cost Sharing	11A DME: Traditional FFS Cost Sharing	"11B Prosthetic Medical Supplies: Traditional FFS Cost Sharing, 11C Diabetes Monitoring Supplies: Traditional FFS Cost Sharing"	"4A ER: Traditional FFS Cost Sharing, 4B Urgent Care: Traditional FFS Cost Sharing"	9B ASC Services: Traditional FFS Cost Sharing	8A OP C/D/T: Traditional FFS Cost Sharing	8B OP X-Ray: Traditional FFS Cost Sharing	9A OP Hospital: Traditional FFS Cost Sharing	12 Renal Dialysis: Traditional FFS Cost Sharing	"3 CORF: Traditional FFS Cost Sharing, 5 Partial Hosp: Traditional FFS Cost Sharing, 9C OP Substance Abuse: Traditional FFS Cost Sharing, 9D Cardiac Rehab: Traditional FFS Cost Sharing"	"7A PCP: Traditional FFS Cost Sharing, 14B Immunizations: Traditional FFS Cost Sharing, 14C Routine Physical Exams: Traditional FFS Cost Sharing, 14D Pap Smears: Traditional FFS Cost Sharing, 14D Pelvic Exams: Traditional FFS Cost Sharing, 14E Prostate Screening: Traditional FFS Cost Sharing, 14F Colorectal Screening: Traditional FFS Cost Sharing, 14G Bone Mass Measurement: Traditional FFS Cost Sharing, 14H Mammography: Traditional FFS Cost Sharing, 14I Diabetes Monitoring: Traditional FFS Cost Sharing"	7D Physician Specialist: Traditional FFS Cost Sharing	7E Mental Health: Traditional FFS Cost Sharing	"7C Occupational Therapy: Traditional FFS Cost Sharing, 7I Physical and Speech Therapy: Traditional FFS Cost Sharing"	Included in i.2.	"7G Other Health Care: Traditional FFS Cost Sharing, 18A Medicare Covered Hearing Exams: Traditional FFS Cost Sharing 7B Chiropractic: Traditional FFS Cost Sharing, 7F Podiatry: $0 copay"	15 Part B Drugs: Traditional FFS Cost Sharing	"13A Blood: Traditional FFS Cost Sharing, 16B Medicare Covered Comprehensive Dental Services: Traditional FFS Cost Sharing, 17A Medicare Covered Eye Exams: Traditional FFS Cost Sharing"	10B Transportation: $0 Copay	"16A Preventive Dental Services: Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams:  $10	"17B Eye Wear: Medicare Covered: Traditional FFS Cost Sharing, Routine: $0 Copay with a $200 benefit amount"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs:  Covered	13B Acupuncture: Not Covered   13C OTC Drug Benefit Amount: $7 Monthly											1071.967483	1108.804243	127.9390029	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.232882679	0.234	0.234	0.234	0.234	0.209134129	36.62328442	0.234	0	0	10	0	0	0	0	0	0											43.8244	1.922090781	31.50489863	0	8.59965404	15.24948342	13.97565374	3.566368504	7.389776025	5.179096353	6.933995034	0.623068118	1.102513852	19.82034701	23.01025466	45.70265196	1.371914465	0.877537916	11.53208442	14.08761923	3.137731767	1.646126391	0	0	0.83823111	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	261.8955	0	0	43.8244	1.922090781	31.50489863	0	8.59965404	15.24948342	13.97565374	3.566368504	7.389776025	5.179096353	6.933995034	0.623068118	1.102513852	19.82034701	23.01025466	45.70265196	1.371914465	0.877537916	11.53208442	14.08761923	3.137731767	1.646126391	0	0	0.83823111	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	261.8955	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	43.8244	1.922090781	31.50489863	0	8.59965404	15.24948342	13.97565374	3.566368504	7.389776025	5.179096353	6.933995034	0.623068118	1.102513852	19.82034701	23.01025466	45.70265196	1.371914465	0.877537916	11.53208442	14.08761923	3.137731767	1.646126391	0	0	0.83823111	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	261.8955
R6801_002_0	2008	16																					0											D	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1771.640865	3.608075894	1455.683707	71.04043317	597.7394953	44.30933869	35.28478778	250.5621723	375.3995738	16.76330681	33.40507273	132.1430654	0.516399002	2458.250308	16355.25106	19817.18206	415.5001895	423.2843674	56.48235117	71.29599095	13.36891002	984.8521692	526.5	0	813.2756875	407.2	0	0	0	0	0											PBP: 1A IP Acute: $90 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%    OON DME: 50%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $100	8A OP C/D/T: $0	"8B OP X-Ray: 0%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $25"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $25	"7E Mental Health: $25 Individual $10 Group, 7H Psychiatric: $25 Individual $10 Group"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $25, 7F Podiatry: $0"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $10 copay, Routine: $10 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											44.89770844	535.3052067	106.6720315	0	80.3831297	0.212145244	0.029270486	73.98459345	191.2452344	0.060646714	0.10190189	17.34140387	0.063738787	22.4651779	5.604702316	9.360431034	25.00984818	25.83457554	0.014266167	0.055821554	0.166516789	10.65410729	0	0	9.927342197	9.868713313	0	0	0	0	0											6.6286	0.160951818	12.94006152	0	4.004014281	9.400015488	1.032802894	1.544811705	5.982781624	1.016639481	3.40404005	0.190962189	0.032914646	4.602085874	7.638859456	15.45811383	0.865966388	0.911280997	0.805786627	3.979852985	2.226147967	0.87439339	0	0	0.672805504	0.334878338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.7087	0	0.726696468	6.6286	0.160951818	12.94006152	0	4.004014281	9.400015488	1.032802894	1.544811705	5.982781624	1.016639481	3.40404005	0.190962189	0.032914646	4.602085874	7.638859456	15.45811383	0.865966388	0.911280997	0.805786627	3.979852985	2.226147967	0.87439339	0	0	0.672805504	0.334878338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.7087	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.6286	0.160951818	12.94006152	0	4.004014281	9.400015488	1.032802894	1.544811705	5.982781624	1.016639481	3.40404005	0.190962189	0.032914646	4.602085874	7.638859456	15.45811383	0.865966388	0.911280997	0.805786627	3.979852985	2.226147967	0.87439339	0	0	0.672805504	0.334878338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.7087
R6801_003_0	2008	15																					0											D	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1771.640865	3.608075894	1455.683707	71.04043317	597.7394953	44.30933869	35.28478778	250.5621723	375.3995738	16.76330681	33.40507273	132.1430654	0.516399002	2458.250308	16355.25106	19817.18206	415.5001895	423.2843674	56.48235117	71.29599095	13.36891002	984.8521692	526.5	0	813.2756875	407.2	0	0	0	0	0											PBP: 1A IP Acute: $0 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $0	11A DME: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item     OON DME: 50%	"11B Prosthetic Medical Supplies: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: 0%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $0	"7E Mental Health: $0, 9C OP Substance Abuse: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0, 7B Chiropractic: $0, 7F Podiatry: $0"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $0 copay, Routine: $10 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											6.408243109	537.8062907	7.299900799	0	5.663278839	0.163055016	0.024008906	71.76753684	92.36574615	0.060646714	0.10198056	17.34140387	0.063738787	19.85540495	0.849854916	2.193843872	0.810650838	0.886045981	0.014266167	0.033092854	0.074775184	1.085423868	0	0	9.941303233	9.893939761	0	0	0	0	0											0.9461	0.161703826	0.885528888	0	0.28209712	7.224859941	0.847149146	1.498519161	2.889505145	1.016639481	3.406668009	0.190962189	0.032914646	4.067462944	1.158299209	3.622983618	0.028068798	0.031254118	0.805786627	2.359387818	0.999662705	0.089081838	0	0	0.673751685	0.335734356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.5541	0	0.08066235	0.9461	0.161703826	0.885528888	0	0.28209712	7.224859941	0.847149146	1.498519161	2.889505145	1.016639481	3.406668009	0.190962189	0.032914646	4.067462944	1.158299209	3.622983618	0.028068798	0.031254118	0.805786627	2.359387818	0.999662705	0.089081838	0	0	0.673751685	0.335734356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.5541	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.9461	0.161703826	0.885528888	0	0.28209712	7.224859941	0.847149146	1.498519161	2.889505145	1.016639481	3.406668009	0.190962189	0.032914646	4.067462944	1.158299209	3.622983618	0.028068798	0.031254118	0.805786627	2.359387818	0.999662705	0.089081838	0	0	0.673751685	0.335734356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.5541
R6801_004_0	2008	16																					0											D	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1771.640865	3.608075894	1455.683707	71.04043317	597.7394953	44.30933869	35.28478778	250.5621723	375.3995738	16.76330681	33.40507273	132.1430654	0.516399002	2458.250308	16355.25106	19817.18206	415.5001895	423.2843674	56.48235117	71.29599095	13.36891002	984.8521692	526.5	0	813.2756875	407.2	0	0	0	0	0											PBP: 1A IP Acute: $90 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%    OON DME: 50%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $100	8A OP C/D/T: $0	"8B OP X-Ray: 0%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $25"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $25	"7E Mental Health: $25 Individual $10 Group, 7H Psychiatric: $25 Individual $10 Group"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $25, 7F Podiatry: $0"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $10 copay, Routine: $10 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											44.89770844	535.3052067	106.6720315	0	80.3831297	0.212145244	0.029270486	73.98459345	191.2452344	0.060646714	0.10190189	17.34140387	0.063738787	22.4651779	5.604702316	9.360431034	25.00984818	25.83457554	0.014266167	0.055821554	0.166516789	10.65410729	0	0	9.927342197	9.868713313	0	0	0	0	0											6.6286	0.160951818	12.94006152	0	4.004014281	9.400015488	1.032802894	1.544811705	5.982781624	1.016639481	3.40404005	0.190962189	0.032914646	4.602085874	7.638859456	15.45811383	0.865966388	0.911280997	0.805786627	3.979852985	2.226147967	0.87439339	0	0	0.672805504	0.334878338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.7087	0	0.726696468	6.6286	0.160951818	12.94006152	0	4.004014281	9.400015488	1.032802894	1.544811705	5.982781624	1.016639481	3.40404005	0.190962189	0.032914646	4.602085874	7.638859456	15.45811383	0.865966388	0.911280997	0.805786627	3.979852985	2.226147967	0.87439339	0	0	0.672805504	0.334878338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.7087	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.6286	0.160951818	12.94006152	0	4.004014281	9.400015488	1.032802894	1.544811705	5.982781624	1.016639481	3.40404005	0.190962189	0.032914646	4.602085874	7.638859456	15.45811383	0.865966388	0.911280997	0.805786627	3.979852985	2.226147967	0.87439339	0	0	0.672805504	0.334878338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.7087
R6801_005_0	2008	16																					0											D	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1771.640865	3.608075894	1455.683707	71.04043317	597.7394953	44.30933869	35.28478778	250.5621723	375.3995738	16.76330681	33.40507273	132.1430654	0.516399002	2458.250308	16355.25106	19817.18206	415.5001895	423.2843674	56.48235117	71.29599095	13.36891002	984.8521692	526.5	0	813.2756875	407.2	0	0	0	0	0											PBP: 1A IP Acute: $90 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%    OON DME: 50%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $100	8A OP C/D/T: $0	"8B OP X-Ray: 0%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $25"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $25	"7E Mental Health: $25 Individual $10 Group, 7H Psychiatric: $25 Individual $10 Group"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $25, 7F Podiatry: $0"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $10 copay, Routine: $10 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											44.89770844	535.3052067	106.6720315	0	80.3831297	0.212145244	0.029270486	73.98459345	191.2452344	0.060646714	0.10190189	17.34140387	0.063738787	22.4651779	5.604702316	9.360431034	25.00984818	25.83457554	0.014266167	0.055821554	0.166516789	10.65410729	0	0	9.927342197	9.868713313	0	0	0	0	0											6.6286	0.160951818	12.94006152	0	4.004014281	9.400015488	1.032802894	1.544811705	5.982781624	1.016639481	3.40404005	0.190962189	0.032914646	4.602085874	7.638859456	15.45811383	0.865966388	0.911280997	0.805786627	3.979852985	2.226147967	0.87439339	0	0	0.672805504	0.334878338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.7087	0	0.726696468	6.6286	0.160951818	12.94006152	0	4.004014281	9.400015488	1.032802894	1.544811705	5.982781624	1.016639481	3.40404005	0.190962189	0.032914646	4.602085874	7.638859456	15.45811383	0.865966388	0.911280997	0.805786627	3.979852985	2.226147967	0.87439339	0	0	0.672805504	0.334878338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.7087	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.6286	0.160951818	12.94006152	0	4.004014281	9.400015488	1.032802894	1.544811705	5.982781624	1.016639481	3.40404005	0.190962189	0.032914646	4.602085874	7.638859456	15.45811383	0.865966388	0.911280997	0.805786627	3.979852985	2.226147967	0.87439339	0	0	0.672805504	0.334878338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.7087
R6801_006_0	2008	15																					0											D	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1771.640865	3.608075894	1455.683707	71.04043317	597.7394953	44.30933869	35.28478778	250.5621723	375.3995738	16.76330681	33.40507273	132.1430654	0.516399002	2458.250308	16355.25106	19817.18206	415.5001895	423.2843674	56.48235117	71.29599095	13.36891002	984.8521692	526.5	0	813.2756875	407.2	0	0	0	0	0											PBP: 1A IP Acute: $0 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $0	11A DME: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item     OON DME: 50%	"11B Prosthetic Medical Supplies: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: 0%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $0	"7E Mental Health: $0, 9C OP Substance Abuse: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0, 7B Chiropractic: $0, 7F Podiatry: $0"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $0 copay, Routine: $10 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											6.408243109	537.8062907	7.299900799	0	5.663278839	0.163055016	0.024008906	71.76753684	92.36574615	0.060646714	0.10198056	17.34140387	0.063738787	19.85540495	0.849854916	2.193843872	0.810650838	0.886045981	0.014266167	0.033092854	0.074775184	1.085423868	0	0	9.941303233	9.893939761	0	0	0	0	0											0.9461	0.161703826	0.885528888	0	0.28209712	7.224859941	0.847149146	1.498519161	2.889505145	1.016639481	3.406668009	0.190962189	0.032914646	4.067462944	1.158299209	3.622983618	0.028068798	0.031254118	0.805786627	2.359387818	0.999662705	0.089081838	0	0	0.673751685	0.335734356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.5541	0	0.08066235	0.9461	0.161703826	0.885528888	0	0.28209712	7.224859941	0.847149146	1.498519161	2.889505145	1.016639481	3.406668009	0.190962189	0.032914646	4.067462944	1.158299209	3.622983618	0.028068798	0.031254118	0.805786627	2.359387818	0.999662705	0.089081838	0	0	0.673751685	0.335734356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.5541	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.9461	0.161703826	0.885528888	0	0.28209712	7.224859941	0.847149146	1.498519161	2.889505145	1.016639481	3.406668009	0.190962189	0.032914646	4.067462944	1.158299209	3.622983618	0.028068798	0.031254118	0.805786627	2.359387818	0.999662705	0.089081838	0	0	0.673751685	0.335734356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.5541
R6801_007_0	2008	15																					0											D	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1771.640865	3.608075894	1455.683707	71.04043317	597.7394953	44.30933869	35.28478778	250.5621723	375.3995738	16.76330681	33.40507273	132.1430654	0.516399002	2458.250308	16355.25106	19817.18206	415.5001895	423.2843674	56.48235117	71.29599095	13.36891002	984.8521692	526.5	0	813.2756875	407.2	0	0	0	0	0											PBP: 1A IP Acute: $0 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $0	11A DME: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item     OON DME: 50%	"11B Prosthetic Medical Supplies: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: 0%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $0	"7E Mental Health: $0, 9C OP Substance Abuse: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0, 7B Chiropractic: $0, 7F Podiatry: $0"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $0 copay, Routine: $10 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											6.408243109	537.8062907	7.299900799	0	5.663278839	0.163055016	0.024008906	71.76753684	92.36574615	0.060646714	0.10198056	17.34140387	0.063738787	19.85540495	0.849854916	2.193843872	0.810650838	0.886045981	0.014266167	0.033092854	0.074775184	1.085423868	0	0	9.941303233	9.893939761	0	0	0	0	0											0.9461	0.161703826	0.885528888	0	0.28209712	7.224859941	0.847149146	1.498519161	2.889505145	1.016639481	3.406668009	0.190962189	0.032914646	4.067462944	1.158299209	3.622983618	0.028068798	0.031254118	0.805786627	2.359387818	0.999662705	0.089081838	0	0	0.673751685	0.335734356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.5541	0	0.08066235	0.9461	0.161703826	0.885528888	0	0.28209712	7.224859941	0.847149146	1.498519161	2.889505145	1.016639481	3.406668009	0.190962189	0.032914646	4.067462944	1.158299209	3.622983618	0.028068798	0.031254118	0.805786627	2.359387818	0.999662705	0.089081838	0	0	0.673751685	0.335734356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.5541	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.9461	0.161703826	0.885528888	0	0.28209712	7.224859941	0.847149146	1.498519161	2.889505145	1.016639481	3.406668009	0.190962189	0.032914646	4.067462944	1.158299209	3.622983618	0.028068798	0.031254118	0.805786627	2.359387818	0.999662705	0.089081838	0	0	0.673751685	0.335734356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.5541
R6801_801_0	2008	8																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	S	Coin	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	413.2854728	4.338310016	94.23611535	71.04043317	18.89880555	44.30933869	35.28478778	9.060321244	43.3975767	16.76330681	33.40507273	132.1430654	0.516399002	62.53576381	89.06602942	194.2378037	2.743513535	2.849144989	56.48235117	71.29599095	814.025321	7.991708895	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Traditional FFS Cost Sharing	1B IP Psych: Traditional FFS Cost Sharing	2 SNF: Traditional FFS Cost Sharing	6 Home Health: Traditional FFS Cost Sharing	10A Ambulance: Traditional FFS Cost Sharing	11A DME: Traditional FFS Cost Sharing	"11B Prosthetic Medical Supplies: Traditional FFS Cost Sharing, 11C Diabetes Monitoring Supplies: Traditional FFS Cost Sharing"	"4A ER: Traditional FFS Cost Sharing, 4B Urgent Care: Traditional FFS Cost Sharing"	9B ASC Services: Traditional FFS Cost Sharing	8A OP C/D/T: Traditional FFS Cost Sharing	8B OP X-Ray: Traditional FFS Cost Sharing	9A OP Hospital: Traditional FFS Cost Sharing	12 Renal Dialysis: Traditional FFS Cost Sharing	"3 CORF: Traditional FFS Cost Sharing, 5 Partial Hosp: Traditional FFS Cost Sharing, 9C OP Substance Abuse: Traditional FFS Cost Sharing, 9D Cardiac Rehab: Traditional FFS Cost Sharing"	"7A PCP: Traditional FFS Cost Sharing, 14B Immunizations: Traditional FFS Cost Sharing, 14C Routine Physical Exams: Traditional FFS Cost Sharing, 14D Pap Smears: Traditional FFS Cost Sharing, 14D Pelvic Exams: Traditional FFS Cost Sharing, 14E Prostate Screening: Traditional FFS Cost Sharing, 14F Colorectal Screening: Traditional FFS Cost Sharing, 14G Bone Mass Measurement: Traditional FFS Cost Sharing, 14H Mammography: Traditional FFS Cost Sharing, 14I Diabetes Monitoring: Traditional FFS Cost Sharing"	7D Physician Specialist: Traditional FFS Cost Sharing	7E Mental Health: Traditional FFS Cost Sharing	"7C Occupational Therapy: Traditional FFS Cost Sharing, 7I Physical and Speech Therapy: Traditional FFS Cost Sharing"	Included in i.2.	"7G Other Health Care: Traditional FFS Cost Sharing, 18A Medicare Covered Hearing Exams: Traditional FFS Cost Sharing, 7B Chiropractic: Traditional FFS Cost Sharing,  7F Podiatry: Traditional FFS Cost Sharing"	15 Part B Drugs: Traditional FFS Cost Sharing	"13A Blood: Traditional FFS Cost Sharing, 16B Medicare Covered Comprehensive Dental Services: Traditional FFS Cost Sharing, 17A Medicare Covered Eye Exams: Traditional FFS Cost Sharing"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	"17B Eye Wear: Medicare Covered: Traditional FFS Cost Sharing, Routine: Not Covered"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											0.073944052	0.073944052	0.211056096	0	0.234	0	0.527848593	0.234	0.234	0.234	0.234	63.66435057	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	46.1163779	0.234	0	0	0	0	0	0	0	0	0											30.56	0.32079222	19.8891066	0	4.422320498	0	18.62502559	2.120115171	10.15503295	3.922613792	7.81678702	0.70106687	0.120837366	14.63336873	20.84145088	45.45164605	0.641982167	0.666699927	13.21687017	16.68326188	3.128324944	1.870059882	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	215.7874	0	0	30.56	0.32079222	19.8891066	0	4.422320498	0	18.62502559	2.120115171	10.15503295	3.922613792	7.81678702	0.70106687	0.120837366	14.63336873	20.84145088	45.45164605	0.641982167	0.666699927	13.21687017	16.68326188	3.128324944	1.870059882	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	215.7874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.56	0.32079222	19.8891066	0	4.422320498	0	18.62502559	2.120115171	10.15503295	3.922613792	7.81678702	0.70106687	0.120837366	14.63336873	20.84145088	45.45164605	0.641982167	0.666699927	13.21687017	16.68326188	3.128324944	1.870059882	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	215.7874
R6801_802_0	2008	8																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	S	Coin	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	413.2854728	4.338310016	94.23611535	71.04043317	18.89880555	44.30933869	35.28478778	9.060321244	43.3975767	16.76330681	33.40507273	132.1430654	0.516399002	62.53576381	89.06602942	194.2378037	2.743513535	2.849144989	56.48235117	71.29599095	814.025321	7.991708895	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Traditional FFS Cost Sharing	1B IP Psych: Traditional FFS Cost Sharing	2 SNF: Traditional FFS Cost Sharing	6 Home Health: Traditional FFS Cost Sharing	10A Ambulance: Traditional FFS Cost Sharing	11A DME: Traditional FFS Cost Sharing	"11B Prosthetic Medical Supplies: Traditional FFS Cost Sharing, 11C Diabetes Monitoring Supplies: Traditional FFS Cost Sharing"	"4A ER: Traditional FFS Cost Sharing, 4B Urgent Care: Traditional FFS Cost Sharing"	9B ASC Services: Traditional FFS Cost Sharing	8A OP C/D/T: Traditional FFS Cost Sharing	8B OP X-Ray: Traditional FFS Cost Sharing	9A OP Hospital: Traditional FFS Cost Sharing	12 Renal Dialysis: Traditional FFS Cost Sharing	"3 CORF: Traditional FFS Cost Sharing, 5 Partial Hosp: Traditional FFS Cost Sharing, 9C OP Substance Abuse: Traditional FFS Cost Sharing, 9D Cardiac Rehab: Traditional FFS Cost Sharing"	"7A PCP: Traditional FFS Cost Sharing, 14B Immunizations: Traditional FFS Cost Sharing, 14C Routine Physical Exams: Traditional FFS Cost Sharing, 14D Pap Smears: Traditional FFS Cost Sharing, 14D Pelvic Exams: Traditional FFS Cost Sharing, 14E Prostate Screening: Traditional FFS Cost Sharing, 14F Colorectal Screening: Traditional FFS Cost Sharing, 14G Bone Mass Measurement: Traditional FFS Cost Sharing, 14H Mammography: Traditional FFS Cost Sharing, 14I Diabetes Monitoring: Traditional FFS Cost Sharing"	7D Physician Specialist: Traditional FFS Cost Sharing	7E Mental Health: Traditional FFS Cost Sharing	"7C Occupational Therapy: Traditional FFS Cost Sharing, 7I Physical and Speech Therapy: Traditional FFS Cost Sharing"	Included in i.2.	"7G Other Health Care: Traditional FFS Cost Sharing, 18A Medicare Covered Hearing Exams: Traditional FFS Cost Sharing, 7B Chiropractic: Traditional FFS Cost Sharing,  7F Podiatry: Traditional FFS Cost Sharing"	15 Part B Drugs: Traditional FFS Cost Sharing	"13A Blood: Traditional FFS Cost Sharing, 16B Medicare Covered Comprehensive Dental Services: Traditional FFS Cost Sharing, 17A Medicare Covered Eye Exams: Traditional FFS Cost Sharing"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	"17B Eye Wear: Medicare Covered: Traditional FFS Cost Sharing, Routine: Not Covered"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											0.073944052	0.073944052	0.211056096	0	0.234	0	0.527848593	0.234	0.234	0.234	0.234	63.66435057	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	46.1163779	0.234	0	0	0	0	0	0	0	0	0											30.56	0.32079222	19.8891066	0	4.422320498	0	18.62502559	2.120115171	10.15503295	3.922613792	7.81678702	0.70106687	0.120837366	14.63336873	20.84145088	45.45164605	0.641982167	0.666699927	13.21687017	16.68326188	3.128324944	1.870059882	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	215.7874	0	0	30.56	0.32079222	19.8891066	0	4.422320498	0	18.62502559	2.120115171	10.15503295	3.922613792	7.81678702	0.70106687	0.120837366	14.63336873	20.84145088	45.45164605	0.641982167	0.666699927	13.21687017	16.68326188	3.128324944	1.870059882	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	215.7874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.56	0.32079222	19.8891066	0	4.422320498	0	18.62502559	2.120115171	10.15503295	3.922613792	7.81678702	0.70106687	0.120837366	14.63336873	20.84145088	45.45164605	0.641982167	0.666699927	13.21687017	16.68326188	3.128324944	1.870059882	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	215.7874
R9896_001_0	2008	14																					0											A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	S	Coin	T	V	V	V	V	V	Coin	O	Coin											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	478.4606453	23.43568147	2548.77298	57.2083238	29.17456333	64.89330687	61.67324257	18.72982123	33.63157938	22.66155328	32.8617346	1.999201131	3.537569774	68.44337418	76.67326446	163.7705357	3.431234014	2.101757494	33.73514467	50.65657202	1198.148325	5.110732494	0	0	994.2967024	0	0	0	0	0	6											PBP: 1A IP Acute: Traditional FFS Cost Sharing	1B IP Psych: Traditional FFS Cost Sharing	2 SNF: Traditional FFS Cost Sharing	6 Home Health: Traditional FFS Cost Sharing	10A Ambulance: Traditional FFS Cost Sharing	11A DME: Traditional FFS Cost Sharing	"11B Prosthetic Medical Supplies: Traditional FFS Cost Sharing, 11C Diabetes Monitoring Supplies: Traditional FFS Cost Sharing"	"4A ER: Traditional FFS Cost Sharing, 4B Urgent Care: Traditional FFS Cost Sharing"	9B ASC Services: Traditional FFS Cost Sharing	8A OP C/D/T: Traditional FFS Cost Sharing	8B OP X-Ray: Traditional FFS Cost Sharing	9A OP Hospital: Traditional FFS Cost Sharing	12 Renal Dialysis: Traditional FFS Cost Sharing	"3 CORF: Traditional FFS Cost Sharing, 5 Partial Hosp: Traditional FFS Cost Sharing, 9C OP Substance Abuse: Traditional FFS Cost Sharing, 9D Cardiac Rehab: Traditional FFS Cost Sharing"	"7A PCP: Traditional FFS Cost Sharing, 14B Immunizations: Traditional FFS Cost Sharing, 14C Routine Physical Exams: Traditional FFS Cost Sharing, 14D Pap Smears: Traditional FFS Cost Sharing, 14D Pelvic Exams: Traditional FFS Cost Sharing, 14E Prostate Screening: Traditional FFS Cost Sharing, 14F Colorectal Screening: Traditional FFS Cost Sharing, 14G Bone Mass Measurement: Traditional FFS Cost Sharing, 14H Mammography: Traditional FFS Cost Sharing, 14I Diabetes Monitoring: Traditional FFS Cost Sharing"	7D Physician Specialist: Traditional FFS Cost Sharing	7E Mental Health: Traditional FFS Cost Sharing	"7C Occupational Therapy: Traditional FFS Cost Sharing, 7I Physical and Speech Therapy: Traditional FFS Cost Sharing"	Included in i.2.	"7G Other Health Care: Traditional FFS Cost Sharing, 18A Medicare Covered Hearing Exams: Traditional FFS Cost Sharing 7B Chiropractic: Traditional FFS Cost Sharing, 7F Podiatry: $0 copay"	15 Part B Drugs: Traditional FFS Cost Sharing	"13A Blood: Traditional FFS Cost Sharing, 16B Medicare Covered Comprehensive Dental Services: Traditional FFS Cost Sharing, 17A Medicare Covered Eye Exams: Traditional FFS Cost Sharing"	10B Transportation: $0 Copay	"16A Preventive Dental Services: Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams:  $10	"17B Eye Wear: Medicare Covered: Traditional FFS Cost Sharing, Routine: $0 Copay with a $200 benefit amount"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs:  Covered	13B Acupuncture: Not Covered   13C OTC Drug Benefit Amount: $6 Monthly											1080.413187	866.4952298	128.8539974	0	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.232560146	0.234	0.234	0.234	0.234	0.208730578	35.73538391	0.234	0	0	10	0	0	0	0	0	0											43.0779	1.692242183	27.36829892	0	6.826847819	15.18503381	14.43153876	4.382778168	7.869789576	5.302803467	7.689645897	0.467813065	0.827791327	16.01574956	17.83114561	38.32230536	0.802908759	0.491811254	7.894023853	10.57357555	3.568024199	1.195911404	0	0	0.828580585	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	232.6466	0	0	43.0779	1.692242183	27.36829892	0	6.826847819	15.18503381	14.43153876	4.382778168	7.869789576	5.302803467	7.689645897	0.467813065	0.827791327	16.01574956	17.83114561	38.32230536	0.802908759	0.491811254	7.894023853	10.57357555	3.568024199	1.195911404	0	0	0.828580585	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	232.6466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	43.0779	1.692242183	27.36829892	0	6.826847819	15.18503381	14.43153876	4.382778168	7.869789576	5.302803467	7.689645897	0.467813065	0.827791327	16.01574956	17.83114561	38.32230536	0.802908759	0.491811254	7.894023853	10.57357555	3.568024199	1.195911404	0	0	0.828580585	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	232.6466
R9896_002_0	2008	11																					0											A	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1447.761642	4.911319043	968.3160978	33.85167727	478.7107825	41.70916569	33.92467536	259.4675184	434.269995	14.88756586	35.00079107	108.4644068	0.357493157	2093.302062	14697.00603	17330.11136	281.5672917	606.40681	43.36125195	62.12071577	13.97127241	856.5079362	526.5	0	779.6177907	407.2	0	0	0	0	0											PBP: 1A IP Acute: $145 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%    OON DME: 50%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $100	8A OP C/D/T: 20%	"8B OP X-Ray: 20%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $25"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $25	"7E Mental Health: $25 Individual $10 Group, 7H Psychiatric: $25 Individual $10 Group"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $25, 7F Podiatry: $0"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $25"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $25	"17B Eye Wear: Medicare Covered: $25 copay, Routine: $25 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											90.08095123	482.9089407	108.7425083	0	77.93315872	0.208221963	0.030751315	70.55031026	176.7952468	0.242930713	0.247920241	13.36008117	0.058222275	17.99560295	6.114948377	10.0755663	24.38530889	25.7936886	0.206248576	0.121740315	0.160928335	25.19688792	0	0	24.71089161	9.352189917	0	0	0	0	0											10.868	0.197643323	8.774760111	0	3.108953616	8.684764374	1.043228371	1.525459494	6.39807258	3.616646984	8.677404572	0.120757773	0.020814065	3.139186065	7.489286097	14.55089049	0.572175448	1.303455702	8.943196448	7.562595492	2.248373604	1.798444539	0	0	1.605420894	0.317350978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.5669	0	3.39140333	10.868	0.197643323	8.774760111	0	3.108953616	8.684764374	1.043228371	1.525459494	6.39807258	3.616646984	8.677404572	0.120757773	0.020814065	3.139186065	7.489286097	14.55089049	0.572175448	1.303455702	8.943196448	7.562595492	2.248373604	1.798444539	0	0	1.605420894	0.317350978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.5669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.868	0.197643323	8.774760111	0	3.108953616	8.684764374	1.043228371	1.525459494	6.39807258	3.616646984	8.677404572	0.120757773	0.020814065	3.139186065	7.489286097	14.55089049	0.572175448	1.303455702	8.943196448	7.562595492	2.248373604	1.798444539	0	0	1.605420894	0.317350978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.5669
R9896_003_0	2008	10																					0											D	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1447.761642	4.911319043	968.3160978	33.85167727	478.7107825	41.70916569	33.92467536	259.4675184	434.269995	14.88756586	35.00079107	108.4644068	0.357493157	2093.302062	14697.00603	17330.11136	281.5672917	606.40681	43.36125195	62.12071577	13.97127241	856.5079362	526.5	0	779.6177907	407.2	0	0	0	0	0											PBP: 1A IP Acute: $0 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $0	11A DME: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item     OON DME: 50%	"11B Prosthetic Medical Supplies: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: 0%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $0	"7E Mental Health: $0, 9C OP Substance Abuse: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0, 7B Chiropractic: $0, 7F Podiatry: $0"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $0 copay, Routine: $10 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											15.33514516	531.5912372	11.8490207	0	4.108364705	0.16195506	0.024996587	68.2818972	81.76506488	0.058022125	0.105172742	13.36008117	0.058222275	15.4666279	0.656266687	2.020471392	0.380414152	1.051255131	0.012380646	0.032074988	0.071992241	1.256123894	0	0	9.939344218	9.890399981	0	0	0	0	0											1.8501	0.217567847	0.956133124	0	0.163893207	6.755010449	0.848001107	1.476411201	2.959009527	0.863808205	3.681129181	0.120757773	0.020814065	2.698027006	0.803762954	2.917916184	0.008926015	0.053124023	0.536840326	1.992521238	1.005823212	0.089656674	0	0	0.645740798	0.335614239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.0006	0	0.080798826	1.8501	0.217567847	0.956133124	0	0.163893207	6.755010449	0.848001107	1.476411201	2.959009527	0.863808205	3.681129181	0.120757773	0.020814065	2.698027006	0.803762954	2.917916184	0.008926015	0.053124023	0.536840326	1.992521238	1.005823212	0.089656674	0	0	0.645740798	0.335614239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.0006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.8501	0.217567847	0.956133124	0	0.163893207	6.755010449	0.848001107	1.476411201	2.959009527	0.863808205	3.681129181	0.120757773	0.020814065	2.698027006	0.803762954	2.917916184	0.008926015	0.053124023	0.536840326	1.992521238	1.005823212	0.089656674	0	0	0.645740798	0.335614239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.0006
R9896_004_0	2008	11																					0											A	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1447.761642	4.911319043	968.3160978	33.85167727	478.7107825	41.70916569	33.92467536	259.4675184	434.269995	14.88756586	35.00079107	108.4644068	0.357493157	2093.302062	14697.00603	17330.11136	281.5672917	606.40681	43.36125195	62.12071577	13.97127241	856.5079362	526.5	0	779.6177907	407.2	0	0	0	0	0											PBP: 1A IP Acute: $145 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%    OON DME: 50%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $100	8A OP C/D/T: 20%	"8B OP X-Ray: 20%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $25"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $25	"7E Mental Health: $25 Individual $10 Group, 7H Psychiatric: $25 Individual $10 Group"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $25, 7F Podiatry: $0"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $25"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $25	"17B Eye Wear: Medicare Covered: $25 copay, Routine: $25 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											90.08095123	482.9089407	108.7425083	0	77.93315872	0.208221963	0.030751315	70.55031026	176.7952468	0.242930713	0.247920241	13.36008117	0.058222275	17.99560295	6.114948377	10.0755663	24.38530889	25.7936886	0.206248576	0.121740315	0.160928335	25.19688792	0	0	24.71089161	9.352189917	0	0	0	0	0											10.868	0.197643323	8.774760111	0	3.108953616	8.684764374	1.043228371	1.525459494	6.39807258	3.616646984	8.677404572	0.120757773	0.020814065	3.139186065	7.489286097	14.55089049	0.572175448	1.303455702	8.943196448	7.562595492	2.248373604	1.798444539	0	0	1.605420894	0.317350978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.5669	0	3.39140333	10.868	0.197643323	8.774760111	0	3.108953616	8.684764374	1.043228371	1.525459494	6.39807258	3.616646984	8.677404572	0.120757773	0.020814065	3.139186065	7.489286097	14.55089049	0.572175448	1.303455702	8.943196448	7.562595492	2.248373604	1.798444539	0	0	1.605420894	0.317350978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.5669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.868	0.197643323	8.774760111	0	3.108953616	8.684764374	1.043228371	1.525459494	6.39807258	3.616646984	8.677404572	0.120757773	0.020814065	3.139186065	7.489286097	14.55089049	0.572175448	1.303455702	8.943196448	7.562595492	2.248373604	1.798444539	0	0	1.605420894	0.317350978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.5669
R9896_005_0	2008	11																					0											A	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1447.761642	4.911319043	968.3160978	33.85167727	478.7107825	41.70916569	33.92467536	259.4675184	434.269995	14.88756586	35.00079107	108.4644068	0.357493157	2093.302062	14697.00603	17330.11136	281.5672917	606.40681	43.36125195	62.12071577	13.97127241	856.5079362	526.5	0	779.6177907	407.2	0	0	0	0	0											PBP: 1A IP Acute: $145 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%    OON DME: 50%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $100	8A OP C/D/T: 20%	"8B OP X-Ray: 20%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $25"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $25	"7E Mental Health: $25 Individual $10 Group, 7H Psychiatric: $25 Individual $10 Group"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $25, 7F Podiatry: $0"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $25"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $25	"17B Eye Wear: Medicare Covered: $25 copay, Routine: $25 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											90.08095123	482.9089407	108.7425083	0	77.93315872	0.208221963	0.030751315	70.55031026	176.7952468	0.242930713	0.247920241	13.36008117	0.058222275	17.99560295	6.114948377	10.0755663	24.38530889	25.7936886	0.206248576	0.121740315	0.160928335	25.19688792	0	0	24.71089161	9.352189917	0	0	0	0	0											10.868	0.197643323	8.774760111	0	3.108953616	8.684764374	1.043228371	1.525459494	6.39807258	3.616646984	8.677404572	0.120757773	0.020814065	3.139186065	7.489286097	14.55089049	0.572175448	1.303455702	8.943196448	7.562595492	2.248373604	1.798444539	0	0	1.605420894	0.317350978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.5669	0	3.39140333	10.868	0.197643323	8.774760111	0	3.108953616	8.684764374	1.043228371	1.525459494	6.39807258	3.616646984	8.677404572	0.120757773	0.020814065	3.139186065	7.489286097	14.55089049	0.572175448	1.303455702	8.943196448	7.562595492	2.248373604	1.798444539	0	0	1.605420894	0.317350978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.5669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.868	0.197643323	8.774760111	0	3.108953616	8.684764374	1.043228371	1.525459494	6.39807258	3.616646984	8.677404572	0.120757773	0.020814065	3.139186065	7.489286097	14.55089049	0.572175448	1.303455702	8.943196448	7.562595492	2.248373604	1.798444539	0	0	1.605420894	0.317350978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.5669
R9896_006_0	2008	10																					0											D	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1447.761642	4.911319043	968.3160978	33.85167727	478.7107825	41.70916569	33.92467536	259.4675184	434.269995	14.88756586	35.00079107	108.4644068	0.357493157	2093.302062	14697.00603	17330.11136	281.5672917	606.40681	43.36125195	62.12071577	13.97127241	856.5079362	526.5	0	779.6177907	407.2	0	0	0	0	0											PBP: 1A IP Acute: $0 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $0	11A DME: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item     OON DME: 50%	"11B Prosthetic Medical Supplies: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: 0%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $0	"7E Mental Health: $0, 9C OP Substance Abuse: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0, 7B Chiropractic: $0, 7F Podiatry: $0"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $0 copay, Routine: $10 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											15.33514516	531.5912372	11.8490207	0	4.108364705	0.16195506	0.024996587	68.2818972	81.76506488	0.058022125	0.105172742	13.36008117	0.058222275	15.4666279	0.656266687	2.020471392	0.380414152	1.051255131	0.012380646	0.032074988	0.071992241	1.256123894	0	0	9.939344218	9.890399981	0	0	0	0	0											1.8501	0.217567847	0.956133124	0	0.163893207	6.755010449	0.848001107	1.476411201	2.959009527	0.863808205	3.681129181	0.120757773	0.020814065	2.698027006	0.803762954	2.917916184	0.008926015	0.053124023	0.536840326	1.992521238	1.005823212	0.089656674	0	0	0.645740798	0.335614239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.0006	0	0.080798826	1.8501	0.217567847	0.956133124	0	0.163893207	6.755010449	0.848001107	1.476411201	2.959009527	0.863808205	3.681129181	0.120757773	0.020814065	2.698027006	0.803762954	2.917916184	0.008926015	0.053124023	0.536840326	1.992521238	1.005823212	0.089656674	0	0	0.645740798	0.335614239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.0006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.8501	0.217567847	0.956133124	0	0.163893207	6.755010449	0.848001107	1.476411201	2.959009527	0.863808205	3.681129181	0.120757773	0.020814065	2.698027006	0.803762954	2.917916184	0.008926015	0.053124023	0.536840326	1.992521238	1.005823212	0.089656674	0	0	0.645740798	0.335614239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.0006
R9896_007_0	2008	10																					0											D	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	Coin	Coin	V	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1447.761642	4.911319043	968.3160978	33.85167727	478.7107825	41.70916569	33.92467536	259.4675184	434.269995	14.88756586	35.00079107	108.4644068	0.357493157	2093.302062	14697.00603	17330.11136	281.5672917	606.40681	43.36125195	62.12071577	13.97127241	856.5079362	526.5	0	779.6177907	407.2	0	0	0	0	0											PBP: 1A IP Acute: $0 per day. Days 1 - 6	1B IP Psych: $1000 per admit	2 SNF: $100 per day. Days 21 - 100	6 Home Health: $0	10A Ambulance: $0	11A DME: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item     OON DME: 50%	"11B Prosthetic Medical Supplies: 10% on DME less than $1000 per item and 20% on DME greater than $1000 per item, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $0	8A OP C/D/T: $0	"8B OP X-Ray: 0%, Radiation Therapy and Chemotherapy: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $50, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $0	"7E Mental Health: $0, 9C OP Substance Abuse: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0, 7B Chiropractic: $0, 7F Podiatry: $0"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0"	10B Transportation: $0	"16A Preventive Dental Services: $10 Copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $0 copay, Routine: $10 copay with a $150 allowance"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											15.33514516	531.5912372	11.8490207	0	4.108364705	0.16195506	0.024996587	68.2818972	81.76506488	0.058022125	0.105172742	13.36008117	0.058222275	15.4666279	0.656266687	2.020471392	0.380414152	1.051255131	0.012380646	0.032074988	0.071992241	1.256123894	0	0	9.939344218	9.890399981	0	0	0	0	0											1.8501	0.217567847	0.956133124	0	0.163893207	6.755010449	0.848001107	1.476411201	2.959009527	0.863808205	3.681129181	0.120757773	0.020814065	2.698027006	0.803762954	2.917916184	0.008926015	0.053124023	0.536840326	1.992521238	1.005823212	0.089656674	0	0	0.645740798	0.335614239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.0006	0	0.080798826	1.8501	0.217567847	0.956133124	0	0.163893207	6.755010449	0.848001107	1.476411201	2.959009527	0.863808205	3.681129181	0.120757773	0.020814065	2.698027006	0.803762954	2.917916184	0.008926015	0.053124023	0.536840326	1.992521238	1.005823212	0.089656674	0	0	0.645740798	0.335614239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.0006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.8501	0.217567847	0.956133124	0	0.163893207	6.755010449	0.848001107	1.476411201	2.959009527	0.863808205	3.681129181	0.120757773	0.020814065	2.698027006	0.803762954	2.917916184	0.008926015	0.053124023	0.536840326	1.992521238	1.005823212	0.089656674	0	0	0.645740798	0.335614239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.0006
R9896_801_0	2008	8																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	S	Coin	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	354.6835848	5.40442201	63.19923722	33.85167727	13.2876282	41.70916569	33.92467536	8.471692373	45.44657094	14.88756586	35.00079107	108.4644068	0.357493157	43.94571666	76.29827768	168.960914	1.820820128	4.12936043	43.36125195	62.12071577	821.7144983	7.075174472	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Traditional FFS Cost Sharing	1B IP Psych: Traditional FFS Cost Sharing	2 SNF: Traditional FFS Cost Sharing	6 Home Health: Traditional FFS Cost Sharing	10A Ambulance: Traditional FFS Cost Sharing	11A DME: Traditional FFS Cost Sharing	"11B Prosthetic Medical Supplies: Traditional FFS Cost Sharing, 11C Diabetes Monitoring Supplies: Traditional FFS Cost Sharing"	"4A ER: Traditional FFS Cost Sharing, 4B Urgent Care: Traditional FFS Cost Sharing"	9B ASC Services: Traditional FFS Cost Sharing	8A OP C/D/T: Traditional FFS Cost Sharing	8B OP X-Ray: Traditional FFS Cost Sharing	9A OP Hospital: Traditional FFS Cost Sharing	12 Renal Dialysis: Traditional FFS Cost Sharing	"3 CORF: Traditional FFS Cost Sharing, 5 Partial Hosp: Traditional FFS Cost Sharing, 9C OP Substance Abuse: Traditional FFS Cost Sharing, 9D Cardiac Rehab: Traditional FFS Cost Sharing"	"7A PCP: Traditional FFS Cost Sharing, 14B Immunizations: Traditional FFS Cost Sharing, 14C Routine Physical Exams: Traditional FFS Cost Sharing, 14D Pap Smears: Traditional FFS Cost Sharing, 14D Pelvic Exams: Traditional FFS Cost Sharing, 14E Prostate Screening: Traditional FFS Cost Sharing, 14F Colorectal Screening: Traditional FFS Cost Sharing, 14G Bone Mass Measurement: Traditional FFS Cost Sharing, 14H Mammography: Traditional FFS Cost Sharing, 14I Diabetes Monitoring: Traditional FFS Cost Sharing"	7D Physician Specialist: Traditional FFS Cost Sharing	7E Mental Health: Traditional FFS Cost Sharing	"7C Occupational Therapy: Traditional FFS Cost Sharing, 7I Physical and Speech Therapy: Traditional FFS Cost Sharing"	Included in i.2.	"7G Other Health Care: Traditional FFS Cost Sharing, 18A Medicare Covered Hearing Exams: Traditional FFS Cost Sharing, 7B Chiropractic: Traditional FFS Cost Sharing,  7F Podiatry: Traditional FFS Cost Sharing"	15 Part B Drugs: Traditional FFS Cost Sharing	"13A Blood: Traditional FFS Cost Sharing, 16B Medicare Covered Comprehensive Dental Services: Traditional FFS Cost Sharing, 17A Medicare Covered Eye Exams: Traditional FFS Cost Sharing"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	"17B Eye Wear: Medicare Covered: Traditional FFS Cost Sharing, Routine: Not Covered"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											0.080318345	0.080318345	0.206074076	0	0.234	0	0.521694567	0.234	0.234	0.234	0.234	53.69523955	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	47.74326484	0.234	0	0	0	0	0	0	0	0	0											28.4876	0.434074231	13.02372444	0	3.109304998	0	17.69831881	1.982376015	10.6344976	3.483690411	8.190185109	0.485335192	0.083653399	10.2832977	17.85379698	39.53685387	0.42607191	0.966270341	10.14653296	14.53624749	3.269277743	1.655590826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	186.2867	0	0	28.4876	0.434074231	13.02372444	0	3.109304998	0	17.69831881	1.982376015	10.6344976	3.483690411	8.190185109	0.485335192	0.083653399	10.2832977	17.85379698	39.53685387	0.42607191	0.966270341	10.14653296	14.53624749	3.269277743	1.655590826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	186.2867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.4876	0.434074231	13.02372444	0	3.109304998	0	17.69831881	1.982376015	10.6344976	3.483690411	8.190185109	0.485335192	0.083653399	10.2832977	17.85379698	39.53685387	0.42607191	0.966270341	10.14653296	14.53624749	3.269277743	1.655590826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	186.2867
R9896_802_0	2008	4																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	S	Coin	T	V	V	V	V	V	Coin	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	354.6835848	5.40442201	63.19923722	33.85167727	13.2876282	41.70916569	33.92467536	8.471692373	45.44657094	14.88756586	35.00079107	108.4644068	0.357493157	43.94571666	76.29827768	168.960914	1.820820128	4.12936043	43.36125195	62.12071577	821.7144983	7.075174472	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Traditional FFS Cost Sharing	1B IP Psych: Traditional FFS Cost Sharing	2 SNF: Traditional FFS Cost Sharing	6 Home Health: Traditional FFS Cost Sharing	10A Ambulance: Traditional FFS Cost Sharing	11A DME: Traditional FFS Cost Sharing	"11B Prosthetic Medical Supplies: Traditional FFS Cost Sharing, 11C Diabetes Monitoring Supplies: Traditional FFS Cost Sharing"	"4A ER: Traditional FFS Cost Sharing, 4B Urgent Care: Traditional FFS Cost Sharing"	9B ASC Services: Traditional FFS Cost Sharing	8A OP C/D/T: Traditional FFS Cost Sharing	8B OP X-Ray: Traditional FFS Cost Sharing	9A OP Hospital: Traditional FFS Cost Sharing	12 Renal Dialysis: Traditional FFS Cost Sharing	"3 CORF: Traditional FFS Cost Sharing, 5 Partial Hosp: Traditional FFS Cost Sharing, 9C OP Substance Abuse: Traditional FFS Cost Sharing, 9D Cardiac Rehab: Traditional FFS Cost Sharing"	"7A PCP: Traditional FFS Cost Sharing, 14B Immunizations: Traditional FFS Cost Sharing, 14C Routine Physical Exams: Traditional FFS Cost Sharing, 14D Pap Smears: Traditional FFS Cost Sharing, 14D Pelvic Exams: Traditional FFS Cost Sharing, 14E Prostate Screening: Traditional FFS Cost Sharing, 14F Colorectal Screening: Traditional FFS Cost Sharing, 14G Bone Mass Measurement: Traditional FFS Cost Sharing, 14H Mammography: Traditional FFS Cost Sharing, 14I Diabetes Monitoring: Traditional FFS Cost Sharing"	7D Physician Specialist: Traditional FFS Cost Sharing	7E Mental Health: Traditional FFS Cost Sharing	"7C Occupational Therapy: Traditional FFS Cost Sharing, 7I Physical and Speech Therapy: Traditional FFS Cost Sharing"	Included in i.2.	"7G Other Health Care: Traditional FFS Cost Sharing, 18A Medicare Covered Hearing Exams: Traditional FFS Cost Sharing, 7B Chiropractic: Traditional FFS Cost Sharing,  7F Podiatry: Traditional FFS Cost Sharing"	15 Part B Drugs: Traditional FFS Cost Sharing	"13A Blood: Traditional FFS Cost Sharing, 16B Medicare Covered Comprehensive Dental Services: Traditional FFS Cost Sharing, 17A Medicare Covered Eye Exams: Traditional FFS Cost Sharing"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	"17B Eye Wear: Medicare Covered: Traditional FFS Cost Sharing, Routine: Not Covered"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	19 POS: N/A	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											0.080318345	0.080318345	0.206074076	0	0.234	0	0.521694567	0.234	0.234	0.234	0.234	53.69523955	0.234	0.234	0.234	0.234	0.234	0.234	0.234	0.234	47.74326484	0.234	0	0	0	0	0	0	0	0	0											28.4876	0.434074231	13.02372444	0	3.109304998	0	17.69831881	1.982376015	10.6344976	3.483690411	8.190185109	0.485335192	0.083653399	10.2832977	17.85379698	39.53685387	0.42607191	0.966270341	10.14653296	14.53624749	3.269277743	1.655590826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	186.2867	0	0	28.4876	0.434074231	13.02372444	0	3.109304998	0	17.69831881	1.982376015	10.6344976	3.483690411	8.190185109	0.485335192	0.083653399	10.2832977	17.85379698	39.53685387	0.42607191	0.966270341	10.14653296	14.53624749	3.269277743	1.655590826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	186.2867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.4876	0.434074231	13.02372444	0	3.109304998	0	17.69831881	1.982376015	10.6344976	3.483690411	8.190185109	0.485335192	0.083653399	10.2832977	17.85379698	39.53685387	0.42607191	0.966270341	10.14653296	14.53624749	3.269277743	1.655590826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	186.2867
R9943_001_0	2008	7	H.	H.	I.	I.	I.	I.	I.	I.	F.	I.	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency	Professional	0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care	Vision (Covered) Eyeware	Coin	Coin	Coin	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin		Coin				V	V	V	V				Coin	V	Coin	Coin	V	V	V	V	V	Coin																																										0	0	219.5802536	2.667976858	8.790879854	6.344520077	193.8744273	11.55717782	4.120402796	231.8508864	21.12216804	5.584022378	13.00851929	0.783360168	0.256112036	0.014193088	4508.674065	1600.274002	0.10566121	4.885335621	7.685070552		13.74371944				301.1659413	238.223853	129.0711177	11.15429412				5.534186072	13.0304597	0.267285947	2.676598057	91.02268808	10.59288426	681.9533966	3.171522233	1.535436334	3.837121047	10% Coinsurance	10% Coinsurance	10% Coinsurance Days 11-100	10% Coinsurance	$125 copay	10% Coinsurance	10% Coinsurance	$50 copay	10% Coinsurance	10% Coinsurance	10% Coinsurance	10% Coinsurance	10% Coinsurance	10% Coinsurance	$10 copay	$10 copay	10% Coinsurance	10% Coinsurance	10% Coinsurance	N/A	10% Coinsurance	N/A	N/A	N/A	$20 copay	$175 Yearly Max	$10 copay	$100 Max Every 2 Years	N/A		N/A	10% Coinsurance	$0 copay	10% Coinsurance	10% Coinsurance	$10 copay	$0 copay	$20 copay	$10 copay	$50 copay	10% Coinsurance	0.158489512	0.158489512	0.158489512	0.158489512	198.1118896	0.158489512	0.158489512	79.24475586	0.158489512	0.158489512	0.158489512	0.158489512	0.158489512	0.158489512	15.84895117	15.84895117	0.158489512	0.158489512	0.158489512	0	0.158489512	0	0	0	31.69790234	0	15.84895117	0	0		0	0.158489512	0	0.158489512	0.158489512	15.84895117	0	31.69790234	15.84895117	79.24475586	0.158489512	34.8012	0.422846349	1.393262256	1.005539889	3.200735763	1.83169147	0.653040627	1.531080574	3.347642099	0.88500898	2.061713871	0.124154371	0.040591071	0.002249456	5.954812925	2.113555377	0.016746194	0.774274457	1.218003079	0	2.178235383	0	0	0	0.795527383	0	0.170470154	0	0	0	0	0.877110448	0	0.042362019	0.424212719	0.120217845	0	1.801374347	0.004188775	0.010139606	0.608143441	68.4101		1.500889351	34.8012	0.422846349	1.393262256	1.005539889	3.200735763	1.83169147	0.653040627	1.531080574	3.347642099	0.88500898	2.061713871	0.124154371	0.040591071	0.002249456	5.954812925	2.113555377	0.016746194	0.774274457	1.218003079	0	2.178235383	0	0	0	0.795527383	0	0.170470154	0	0	0	0	0.877110448	0	0.042362019	0.424212719	0.120217845	0	1.801374347	0.004188775	0.010139606	0.608143441	68.4101	3000	10% Coinsurance	10% Coinsurance	15% Coinsurance Days 11-100	15% Coinsurance	$100 copay	15% Coinsurance	15% Coinsurance	$50 copay	10% Coinsurance	15% Coinsurance	15% Coinsurance	10% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	N/A	15% Coinsurance	N/A	N/A	N/A	$20 copay	$175 Yearly Max	15% Coinsurance	$100 Max Every 2 Years	N/A		N/A	15% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	$50 copay	15% Coinsurance	10.57193214	0.128452672	0.634869828	0.458195817	0.777858079	0.802856271	0.286236941	0.465113134	1.016949947	0.403273323	0.939464143	0.037715734	0.018496192	0.001025013	5.619375317	3.677514263	0.007340093	0.339375443	0.162178928	0	1.011739123	0	0	0	0.241666076	0	0.050594281	0	0		0	0.384449912	0.019707559	0.018567872	0.185938433	0.060202557	0.003247506	0.985873364	0.001674387	0.003080219	0.235502273	29.5505		0.648325061	45.3731	0.551299022	2.028132084	1.463735706	3.978593841	2.634547741	0.939277568	1.996193708	4.364592045	1.288282303	3.001178014	0.161870105	0.059087264	0.003274468	11.57418824	5.79106964	0.024086287	1.1136499	1.380182007	0	3.189974506	0	0	0	1.037193459	0	0.221064435	0	0	0	0	1.26156036	0.019707559	0.060929891	0.610151152	0.180420402	0.003247506	2.787247712	0.005863162	0.013219826	0.843645714	97.9606
R9943_002_0	2008	7	H.	H.	I.	I.	I.	I.	I.	I.	F.	I.	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	OP Facility - Emergency	Professional	0	Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Urgent Care	Vision (Covered) Eyeware	Coin	Coin	Coin	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin		Coin				V	V	V	V				Coin	V	Coin	Coin	V	V	V	V	V	Coin																																										0	0	239.7778525	2.913384746	9.599489289	6.928106577	202.5948587	12.62023899	4.499408839	242.279491	23.06504346	6.097656197	14.20507887	0.855415802	0.279669929	0.015498607	4711.473285	1672.253993	0.115380221	5.3347023	8.391964591		15.00790475				314.7123226	248.9391123	134.8767097	11.65601195				6.043235809	13.61656706	0.291871648	2.922798947	95.11686963	11.06934998	712.6275183	3.314176642	1.60449994	4.19007005	10% Coinsurance	10% Coinsurance	10% Coinsurance Days 11-100	10% Coinsurance	$125 copay	10% Coinsurance	10% Coinsurance	$50 copay	10% Coinsurance	10% Coinsurance	10% Coinsurance	10% Coinsurance	10% Coinsurance	10% Coinsurance	$10 copay	$10 copay	10% Coinsurance	10% Coinsurance	10% Coinsurance	N/A	10% Coinsurance	N/A	N/A	N/A	$20 copay	$175 Yearly Max	$10 copay	$100 Max Every 2 Years	N/A		N/A	10% Coinsurance	$0 copay	10% Coinsurance	10% Coinsurance	$10 copay	$0 copay	$20 copay	$10 copay	$50 copay	10% Coinsurance	0.160672	0.160672	0.160672	0.160672	200.8399999	0.160672	0.160672	80.33599994	0.160672	0.160672	0.160672	0.160672	0.160672	0.160672	16.06719999	16.06719999	0.160672	0.160672	0.160672	0	0.160672	0	0	0	32.13439998	0	16.06719999	0	0		0	0.160672	0	0.160672	0.160672	16.06719999	0	32.13439998	16.06719999	80.33599994	0.160672	38.5256	0.468099354	1.542369142	1.113152739	3.390762616	2.027719038	0.722929016	1.621980431	3.70590666	0.979722616	2.28235843	0.137441368	0.044935127	0.002490192	6.308348625	2.239036612	0.018538371	0.857137287	1.348353734	0	2.411350071	0	0	0	0.842757638	0	0.180590922	0	0	0	0	0.970978783	0	0.046895601	0.469611952	0.127355147	0	1.908321476	0.004437462	0.010741592	0.673226935	74.9831		1.497370804	38.5256	0.468099354	1.542369142	1.113152739	3.390762616	2.027719038	0.722929016	1.621980431	3.70590666	0.979722616	2.28235843	0.137441368	0.044935127	0.002490192	6.308348625	2.239036612	0.018538371	0.857137287	1.348353734	0	2.411350071	0	0	0	0.842757638	0	0.180590922	0	0	0	0	0.970978783	0	0.046895601	0.469611952	0.127355147	0	1.908321476	0.004437462	0.010741592	0.673226935	74.9831	3000	10% Coinsurance	10% Coinsurance	15% Coinsurance Days 11-100	15% Coinsurance	$100 copay	15% Coinsurance	15% Coinsurance	$50 copay	10% Coinsurance	15% Coinsurance	15% Coinsurance	10% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	N/A	15% Coinsurance	N/A	N/A	N/A	$20 copay	$175 Yearly Max	15% Coinsurance	$100 Max Every 2 Years	N/A		N/A	15% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	15% Coinsurance	$50 copay	15% Coinsurance	11.70116518	0.142173248	0.702682975	0.507137661	0.82388618	0.888612764	0.316811126	0.492635217	1.125574696	0.446348662	1.039812304	0.041744312	0.020471849	0.001134499	6.219604697	4.070325204	0.00812412	0.375625577	0.179501949	0	1.119807282	0	0	0	0.255966153	0	0.055998471	0	0		0	0.425514642	0.021812607	0.020551185	0.205799308	0.066633048	0.003594386	1.091178692	0.001853236	0.003262485	0.260657273	32.636		0.651843608	50.2268	0.610272602	2.245052117	1.6202904	4.214648796	2.916331802	1.039740142	2.114615648	4.831481356	1.426071277	3.322170734	0.17918568	0.065406976	0.003624691	12.52795332	6.309361816	0.026662491	1.232762865	1.527855682	0	3.531157353	0	0	0	1.098723791	0	0.236589394	0	0	0	0	1.396493425	0.021812607	0.067446787	0.67541126	0.193988195	0.003594386	2.999500167	0.006290697	0.014004077	0.933884208	107.6191
